Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesia

Objectives

We aimed to probe the safety and effectiveness of flexible ureteroscopic lithotripsy (FURL) with a suctioning ureteral access sheath (S-UAS) for removing upper urinary calculi under local anesthesia (LA).

Materials and methods

The clinical data of 56 patients with upper urinary calculi treated by FURL with an S-UAS under LA during the period between September 2019 and November 2022 were analyzed retrospectively. For LA, intramuscular pethidine (1.0-2.0 mg/kg) and phenergan (25 mg) were administered 30 min prior to surgery, and oxybuprocaine hydrochloride gel was administered through the urethra at the start of the surgery. The S-UAS and flexible ureteroscope were used for FURL. Demographic characteristics, stone-related parameters, and clinical outcomes were analyzed.

Result

A total of 66 procedures were performed successfully on 46 patients (Group A), who underwent unilateral surgeries, and on 10 patients (Group B) who underwent same-session bilateral surgeries. All 56 patients were operated upon without altering the anesthesia strategy, and none required additional analgesia. The mean stone sizes of the Group A and Group B patients were 20.24 ± 5.45 mm and 29.40 ± 3.89 mm, respectively. The mean operative times of the two groups were 53.04 ± 13.35 min and 90.00 ± 15.81 min, respectively. In Group A, the stone-free rates (SFRs) were 76.1% (35/46) and 85.1% (40/46) at postoperative day 1 and day 30, respectively. In Group B, the SFRs were 80.0% (16/20) and 85.0% (17/20), respectively. Four (8.7%) patients in Group A suffered complications such as fever, stent pain, urosepsis, and steinstrasse. In Group B, one (10%) patient suffered from fever.

Conclusion

FURL, combined with an S-UAS under LA, is a feasible option and provides satisfactory clinical outcomes for appropriately selected patients.

Context-aware deep network for coronary artery stenosis classification in coronary CT angiography

Automatic coronary artery stenosis grading plays an important role in the diagnosis of coronary artery disease. Due to the difficulty of learning the informative features from varying grades of stenosis, it is still a challenging task to identify coronary artery stenosis from coronary CT angiography (CCTA). In this paper, we propose a context-aware deep network (CADN) for coronary artery stenosis classification. The proposed method integrates 3D CNN with Transformer to improve the feature representation of coronary artery stenosis in CCTA. We evaluate the proposed method on a multicenter dataset (APOLLO study with NCT05509010). Experimental results show that our proposed method can achieve the accuracy of 0.84, 0.83, and 0.86 for stenosis diagnosis on the lesion, artery, and patient levels, respectively.

Medical Imaging Compatibility of Magnesium- and Iron-Based Bioresorbable Flow Diverters

BACKGROUND AND PURPOSE

Bioresorbable flow diverters are under development to mitigate complications associated with conventional flow-diverter technology. One proposed advantage is the ability to reduce metal-induced artifacts in follow-up medical imaging. In the current work, the medical imaging compatibility of magnesium- and iron-based bioresorbable flow diverters is assessed relative to an FDA-approved control in phantom models.

MATERIALS AND METHODS

Bioresorbable flow diverters, primarily composed of braided magnesium or antiferromagnetic iron alloy wires, were compared with an FDA-approved control flow diverter. The devices were assessed for MR imaging safety in terms of magnetically induced force and radiofrequency heating using 1.5T, 3T, and 7T field strength clinical scanners. The devices were deployed in phantom models, and metal-induced image artifacts were assessed in the 3 MR imaging scanners and a clinical CT scanner following clinical scan protocols; device visibility was assessed under fluoroscopy.

RESULTS

The magnesium-based bioresorbable flow diverter, iron-based bioresorbable flow diverter, and the control device all demonstrated MR imaging safety in terms of magnetically induced force and radiofrequency heating at all 3 field strengths. The bioresorbable flow diverters did not elicit excessive MR imaging artifacts at any field strength relative to the control. Furthermore, the bioresorbable flow diverters appeared to reduce blooming artifacts in CT relative to the control. The iron-based bioresorbable flow diverter and control device were visible under standard fluoroscopy.

CONCLUSIONS

We have demonstrated the baseline medical imaging compatibility of magnesium and antiferromagnetic iron alloy bioresorbable flow diverters. Future work will evaluate the medical imaging characteristics of the bioresorbable flow diverters in large-animal models.

NLRP3 Disturbs Treg/Th17 Cell Balance to Aggravate Apical Periodontitis

Apical periodontitis is an inflammatory condition that is considered an immunological reaction of the periapical tissue to invading bacteria and their pathogenic components. Recent research has revealed that NLR family pyrin domain containing 3 (NLRP3) is crucial to the pathogenesis of apical periodontitis and serves as a link between innate and adaptive immunity. The balance between regulatory T-cell (Treg) and T helper cell 17 (Th17 cell) determines the direction of the inflammatory response. Therefore, this study aimed to investigate whether NLRP3 exacerbated periapical inflammation by disturbing Treg/Th17 balance and the underlying regulatory mechanisms. In the present study, NLRP3 was raised in apical periodontitis tissues as opposed to healthy pulp tissues. Low NLRP3 expression in dendritic cells (DCs) increased transforming growth factor β secretion while decreasing interleukin (IL)-1β and IL-6 production. The Treg ratio and IL-10 secretion rose when CD4⁺ T cells were cocultured with DCs primed with IL-1β neutralizing antibody (anti-IL-1β) and specific small interfering RNA (siRNA) targeting NLRP3 (siRNA NLRP3), but the proportion of Th17 cells and IL-17 release dropped. Furthermore, siRNA NLRP3-mediated suppression of NLRP3 expression aided Treg differentiation and elevated Foxp3 expression as well as IL-10 production in CD4⁺ T cells. Inhibition of NLRP3 activity by MCC950 boosted the percentage of Tregs while decreasing the ratio of Th17 cells, leading to reduced periapical inflammation and bone resorption. Nigericin administration, however, exacerbated periapical inflammation and bone destruction with an unbalanced Treg/Th17 response. These findings demonstrate that NLRP3 is a pivotal regulator by regulating the release of inflammatory cytokines from DCs or directly suppressing Foxp3 expression to disturb Treg/Th17 balance, thus exacerbating apical periodontitis.

Machine learning accurately quantifies epicardial adipose tissue from non-contrast CT images in coronary artery disease

Funding Acknowledgements

Type of funding sources: Other. Main funding source(s): Industry Alignment Fund – Pre-positioning Programme

Background

Epicardial adipose tissue (EAT) is the visceral fat deposit within the pericardium that surrounds the heart and the coronary arteries. EAT volume measured from non-contrast CT (NCCT) has been demonstrated to be significantly associated with adverse cardiovascular risk,1 particularly in patients with coronary artery disease.2 However, routine measurement of EAT volume is still challenging in clinical practice, as it is a tedious manual process and prone to human error.

Purpose

We aimed to develop a fully automated AI toolkit (i.e., AI EAT) for the quantification of EAT from routine NCCT scans and assess its performance in reference to clinical ground truth.

Methods

This is a multicenter study which performs CT scans in 5000 Asian Admixture patients (APOLLO study NCT05509010). In the current stage of this study, NCCT data analysis were conducted in 551 patients with 26,037 images. AI EAT was developed via a novel deep learning framework using an ensemble region-based UNet. The region-based UNet uses 2 component UNet models to perform segmentation of pericardium at the apex region and non-apex region (middle and basal). EAT volume was obtained by automated thresholding of the voxels (-190 to -30 Hounsfield Unit) within the pericardium (Figure 1). The network was trained in 501 patients with 23,712 NCCT images and tested in 50 patients with 2,325 NCCT images. The performance of AI EAT was evaluated with respect to clinical ground truth using Dice similarity coefficient (DSC), Pearson correlation, and Bland-Altman analysis.

Results

The AI EAT quantification process took less than 10 seconds per subject, compared with 20-30 minutes for expert readers. Compared to clinical ground truth, our AI EAT achieved a DSC of 0.96±0.01 and 0.91±0.02 for pericardium and EAT segmentations, respectively. There was strong agreement between the AI EAT and clinical ground truth in deriving the EAT volume (r=0.99, P<0.001) with minimal error of 7±5%.

Conclusion

End-to-end deep learning system accurately quantifies epicardial adipose tissue in standard NCCT images without manual segmentation.

Impaired sensitivity to thyroid hormones is associated with hyperuricemia in a Chinese euthyroid population

Objective

Impaired sensitivity to thyroid hormones has been reported as a common metabolic disorder, and it remains poorly understood whether it interplays with uric acid (UA) metabolism as an established risk factor for cardiovascular diseases (CVDs). We aimed to investigate the relationship between thyroid hormone sensitivity and elevated UA in a Chinese euthyroid population.

Methods

A total of 15,955 euthyroid subjects were included in this study. Thyroid hormone sensitivity indices were calculated, including the thyroid feedback quantile-based index (TFQI), the Chinese-referenced parametric TFQI (PTFQI), the TSH index (TSHI), and the thyrotropin thyroxine resistance index (TT4RI), and the FT3/FT4 ratio. Linear and logistic regression analyses were performed to detect the association between thyroid hormone sensitivity and elevated UA.

Results

Subjects with reduced sensitivity to thyroid hormones had increased UA levels in both genders (p for trend < 0.001). Logistic and linear regression analyses showed that higher TFQI, PTFQI, TSHI, and TT4RI were positively associated with elevated UA levels, but negatively associated with the FT3/FT4 ratio. The odds ratio (OR) of the highest versus the first quartile of TFQI was 1.20 (1.05, 1.38) in men and 1.80 (1.46, 2.23) in women (p < 0.001). PTHQI, TSHI, and TT4RI obtained similar results in both genders. Conversely, the highest quartile of the FT3/FT4 ratio was negatively correlated with elevated UA levels [men: OR 0.78 (0.68,0.89), women: OR 0.66 (0.53,0.81)].

Conclusion

Impaired sensitivity to thyroid hormones was associated with elevated UA levels in euthyroid subjects. Our findings shed light on the role of thyroid hormone sensitivity in UA metabolism.

Response of dryland vegetation under extreme wet events with satellite measures of greenness and fluorescence

Extreme wet events in central Australia triggered large vegetation responses that contributed greatly to large global land carbon sink anomalies. There remain significant uncertainties on the extent to which these events over dryland vegetation can be monitored and assessed with satellite data. In this study, we investigated the vegetation responses of the major Australian semiarid biomes to two extreme wet events utilizing multi-satellite observations of (1) solar-induced chlorophyll fluorescence (SIF), as a proxy for photosynthetic activity and (2) the enhanced vegetation index (EVI), as a measure of canopy chlorophyll or greenness. We related these satellite observations with gross primary productivity (GPP) estimated from eddy covariance tower sites, as a performance benchmark. The C₃-dominated Mulga woodland was the most responsive biome to both wet pulses and exhibited the highest sensitivity to soil moisture. The C₄-dominated Hummock grassland was more responsive to the 2011 "big wet" event, relative to the later 2016-2017 wet pulse. EVI swiftly responded to the extreme wet events and showed markedly amplified seasonal amplitude, however, there was a time lag as compared with SIF during the post-wet period, presumably due to the relatively slower chlorophyll degradation in contrast with declines in photosynthetic activity. Despite a robust linear SIF-GPP relationship (r² ranging from 0.59 to 0.85), the spatially coarse SIF derived from the Global Ozone Monitoring Experiment-2 (GOME-2) yielded high retrieval noise over the xeric biomes, hindering its capacity to capture thoroughly the dryland vegetation dynamics in central Australia. Our study highlights that synchronous satellite observations of greenness and fluorescence can potentially offer an improved understanding of dryland vegetation dynamics and can advance our ability to detect ecosystem alterations under future changing climates.

Utility of Dual-Energy CT to Improve Diagnosis of CSF Leaks on CT Myelography following Lateral Decubitus Digital Subtraction Myelography with Negative Findings

CSF leaks, including CSF-venous fistulas, which cause spontaneous intracranial hypotension, remain difficult to diagnose, even on digital subtraction myelography and CT myelography. Dual-energy CT technology has been used to improve diagnostic utility within multiple organ systems. The capability of dual-energy CT to create virtual monoenergetic images can be leveraged to increase conspicuity of contrast in CSF-venous fistulas and direct epidural CSF leakage to improve the diagnostic utility of CT myelography. Six cases (in 5 patients) are shown in which virtual monoenergetic images demonstrate a leak location that was either occult or poorly visible on high- or low-kilovolt series. This clinical report describes the novel application of dual-energy CT for the detection of subtle CSF leaks including CSF-venous fistulas.

A New Frontier in Temporal Bone Imaging: Photon-Counting Detector CT Demonstrates Superior Visualization of Critical Anatomic Structures at Reduced Radiation Dose

BACKGROUND AND PURPOSE

Photon-counting detector CT is a new technology with a limiting spatial resolution of ≤150 μm. In vivo comparisons between photon-counting detector CT and conventional energy-integrating detector CT are needed to determine the clinical impact of photon counting-detector CT in temporal bone imaging.

MATERIALS AND METHODS

Prospectively recruited patients underwent temporal bone CT examinations on an investigational photon-counting detector CT system after clinically indicated temporal bone energy-integrating detector CT. Photon-counting detector CT images were obtained at an average 31% lower dose compared with those obtained on the energy-integrating detector CT scanner. Reconstructed images were evaluated in axial, coronal, and Pöschl planes using the smallest available section thickness on each system (0.4 mm on energy-integrating detector CT; 0.2 mm on photon-counting detector CT). Two blinded neuroradiologists compared images side-by-side and scored them using a 5-point Likert scale. A post hoc reassignment of readers' scores was performed so that the scores reflected photon-counting detector CT performance relative to energy-integrating detector CT.

RESULTS

Thirteen patients were enrolled, resulting in 26 image sets (left and right sides). The average patient age was 63.6 [SD, 13.4] years; 7 were women. Images from the photon-counting detector CT scanner were significantly preferred by the readers in all reconstructed planes (P < .001). Photon-counting detector CT was rated superior for the evaluation of all individual anatomic structures, with the oval window (4.79) and incudostapedial joint (4.75) receiving the highest scores on a Likert scale of 1-5.

CONCLUSIONS

Temporal bone CT images obtained on a photon-counting detector CT scanner were rated as having superior spatial resolution and better critical structure visualization than those obtained on a conventional energy-integrating detector scanner, even with a substantial dose reduction.

Adipose Tissue Insulin Resistance Is Positively Associated With Serum Uric Acid Levels and Hyperuricemia in Northern Chinese Adults

OBJECTIVE

Adipose tissue plays a crucial role in serum uric acid (UA) metabolism, but the relative contribution of adipose tissue insulin resistance (IR) to serum UA levels and hyperuricemia have not explicitly been illustrated. Herein, we aimed to investigate the association between the adipose tissue insulin resistance index (Adipo-IR) and hyperuricemia in this cross-sectional study. The homeostasis model assessment of insulin resistance (HOMA-IR) index, another widely applied marker to determine systemic IR, was also explored.

METHODS

A total of 5821 adults were included in this study. The relationship between Adipo-IR or HOMA-IR and serum UA levels was assessed by multivariate linear regression. Binary logistic regression analyses were applied to determine the sex-specific association of the Adipo-IR tertiles and HOMA-IR tertiles with hyperuricemia. Participants were then divided into normal BMI (18.5 ≤ BMI < 24) and elevated BMI (BMI ≥ 24) groups for further analysis.

RESULTS

Both Adipo-IR and HOMA-IR were positively correlated with serum UA (P < 0.001). Compared with the lowest tertile, the risks of hyperuricemia increased across Adipo-IR tertiles (middle tertile: OR 1.52, 95%CI 1.24-1.88; highest tertile: OR 2.10, 95%CI 1.67-2.63) in men after full adjustment (P for trend < 0.001). In women, only the highest tertile (OR 2.09, 95%CI 1.52-2.87) was significantly associated with hyperuricemia. Those associations remained significant in participants with normal BMI status. As for HOMA-IR, only the highest tertile showed positive relationships with hyperuricemia in both genders after full adjustment (P for trend < 0.001). The association between HOMA-IR and hyperuricemia disappeared in men with normal BMI status.

CONCLUSIONS

Adipo-IR was strongly associated with serum UA and hyperuricemia regardless of BMI classification. In men with normal BMI, Adipo-IR, rather than HOMA-IR, was closely associated with hyperuricemia. Altogether, our finding highlights a critical role of adipose tissue IR on serum UA metabolism and hyperuricemia.

The association of remnant cholesterol (RC) and interaction between RC and diabetes on the subsequent risk of hypertension

PURPOSE

Whether elevated remnant cholesterol (RC) is associated with hypertension (HTN) and whether elevated RC interacts with diabetes on the subsequent risk of HTN have not been illustrated. Thus, this study is aimed to investigate the associations and interactions of RC, diabetes, and the management of cardiovascular risk factors with the risk of incident HTN in a Chinese population.

PATIENTS AND METHODS

This cohort study included 42,994 individuals who participated in the routine health check-up from April 2016 to August 2020 and follow-ups from April 2017 to August 2021 at the Medical Examination Center of Beijing Chao-Yang Hospital. RC was divided into quintiles as follows: the < 20% group, the 20-39% group, the 40-59% group, the 60-79% group, and the ≥ 80% group. This study finally included 17,006 participants who were free from HTN at baseline.

RESULTS

This study had 1,861 (10.90%) HTN occurred, 205 (5.30%) in the first quintile of RC, 335 (8.98%) in the second quintile of RC, 388 (11.17%) in the third quintile of RC, 420 (13.42%) in the fourth quintile of RC, and 513 (17.91%) in the fifth quintile of RC. Compared with participants in the first quintile of RC, participants in the fifth quintile of RC showed a greater risk of HTN events among participants with diabetes [hazard ratio (HR), 4.95; 95% confidence interval (CI), 1.05-23.39; P = 0.0432) than among participants without diabetes (HR, 1.67; 95% CI, 1.26-2.22, P = 0.0004; P for interaction = 0.0420). Compared with participants without diabetes, participants with diabetes who have the ideal management of RC and other risk factors showed no excess risk of HTN.

CONCLUSIONS

Elevated RC is significantly predictive of HTN among the diabetic population. RC and diabetes interacted with each other on the subsequent risk of HTN, and the desired management of RC, glucose, and cardiovascular risk factors on HTN risk was quite favorable.

[CRL4B complex promotes the development of pancreatic cancer by inhibiting secreted frizzled related protein 1]

Objective: To investigate the role of CUL4B-RING E3 ubiquitin ligase (CRL4B) complex in pancreatic tumorigenesis and the molecular mechanism. Methods: Pancreatic cells were divided into control group (transfected with negative control lentivirus), shCUL4B group (transfected with CUL4B lentivirus), shDDB1 group [transfected with DNA damage binding protein 1 (DDB1) lentivirus], and shCUL4B+ siSFRP1 group (transfected with CUL4B lentivirus and SFRP1-siRNA). RNA-seq was performed in pancreatic cancer cell lines with CUL4B and DDB1 knocked down respectively, to identify the target genes regulated by CRL4B complex. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression levels of target genes. Chromatin immunoprecipitation (ChIP) assay was used to identify the target genes directly regulated by CUL4B and DDB1. Western blot was used to detect the protein expression levels of the epithelial-mesenchymal transition (EMT) markers. The EdU cell proliferation test was used to detect cell proliferation ability. The scratch repair test and Transwell cell invasion test were used to detect cell migration and invasion ability. Finally, the sequencing data of pancreatic cancer-related tumor samples and normal samples in GEO, TCGA and GTEx databases were used to analyze the expression correlations of CUL4B, DDB1 and their downstream target genes. Results: RNA-seq results showed that target genes regulated by CRL4B complex involved in a number of malignant tumor-related signaling pathways. qRT-PCR results verified that the mRNA expression levels of the target genes of CUL4B or DDB1 knockdown groups were higher than those of the control group, and the difference was statistically significant (P<0.05). ChIP-PCR results showed that CRL4B complex directly bound to the promoter regions of the target genes, NME1 and SFRP1, and the enrichment of monoubiquitination of lysine at 119 of histone H2A (H2AK119ub1) in the promoter region of target gene was reduced after CUL4B knockdown. The proliferation rate in PANC-1 cell line of the control group was (32.10±3.58)%, higher than (13.95±1.66)% in the shCUL4B group and (22.38±0.77)% in the shCUL4B+ siSFRP1 group (P<0.05). The proliferation rate in AsPC-1 cell line of the control group was (35.47±7.80)%, higher than (19.60±3.58)% in the shCUL4B group and (30.09±0.81)% in the shCUL4B+ siSFRP1 group (P<0.05). The scratch repair experiment showed that the migration rate of PANC-1 cell line control group was (53.18±3.70)%, higher than that (17.46±2.62)% in the shCUL4B group and (44.99±9.18)% in the shCUL4B + siSFRP1 group (P<0.05). Western blot showed the expression levels of epithelial markers including α-catenin and γ-catenin in the control group were 1.00±0.03 and 1.01±0.11, respectively, lower than 1.44±0.01 and 1.21±0.06 in the shCUL4B group (P<0.05). The expression levels of mesenchymal markers including fibronectin and vimentin in the control group were 1.01±0.14 and 1.02±0.18, respectively, higher than 1.53±0.13 and 1.22±0.07 in the shCUL4B+ siSFRP1 group (P<0.05). The cell metastasis rate of the control group was (100.00±3.96)%, higher than the (35.49±0.34)% in the shCUL4B group and (107.06±2.77)% in the shCUL4B+ siSFRP1 group, the difference was statistically significant (P<0.05). The expressions of CUL4B and DDB1 were significantly upregulated in the pancreatic cancer tissues, and were negatively correlated with the expression of SFRP1 (r=-0.342 and r=-0.264, respectively). Conclusions: CRL4B complex inhibits the transcription of target gene SFRP1 and promotes the development of pancreatic cancer. Moreover, CRL4B complex is upregulated in pancreatic cancer, which provide a potential of therapeutic target for pancreatic cancer.

Methylenetetrahydrofolate Reductase Gene C677T Polymorphism-Dietary Pattern Interaction on Hyperhomocysteinemia in a Chinese Population: A Cross-Sectional Study

Background and aim: Hyperhomocysteinemia (Hhcy) has been recognized as a risk factor of several chronic diseases. There is accumulating evidence that both genetic and dietary factors had a notable impact on the risk of Hhcy. The present study aims to investigate the interaction effect on Hhcy between methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and dietary intake.

Methods: Data were collected in a cross-sectional survey conducted in China; 3,966 participants with complete information on sociodemographic characteristics, anthropometric measurements, and dietary intake were included in the analyses. Dietary patterns were identified by factor analysis combined with cluster analysis. Blood samples were collected and MTHFR C677T genotypes were tested. Both the multiplicative statistical model and the additive model were conducted to investigate the interactive effects.

Results: Proportions of MTHFR C677T genotypes among participants were 29.2% for TT, 47.4% for CT, and 23.4% for CC. Three dietary patterns were identified, namely, the balanced pattern, the snack pattern, and the high-meat pattern. Compared with the balanced pattern, the other two patterns were associated with an elevated risk of Hhcy [the snack pattern: odds ratio (OR) 1.2, 95% confidence interval (CI) 1.0–1.5; the high-meat pattern: OR 1.3, 95% CI 1.1–1.6] after adjustment for age group, gender, residential region, and MTHFR C677T genotypes. A multiplicative interaction between the high-meat pattern and MTHFR 677TT genotype was observed, and synergistic effects between both the snack pattern and the high-meat pattern with MTHFR 677TT were identified.

Conclusion: Our results indicated that MTHFR C677T polymorphism and dietary patterns had interactive effects on Hhcy among the Chinese population. Subsequent targeted and appropriate dietary guidelines should be recommended for high-risk populations or patients of Hhcy carrying specific genotypes.

Mechanical stimuli for left ventricular growth during pressure overload

BACKGROUND

The mechanical stimulus (i.e. stress or stretch) for growth occurring in the pressure-overloaded left ventricle (LV) is not exactly known.

OBJECTIVE

To address this issue, we investigate the correlation between local ventricular growth (indexed by local wall thickness) and the local acute changes in mechanical stimuli after aortic banding.

METHODS

LV geometric data were extracted from 3D echo measurements at baseline and 2 weeks in the aortic banding swine model (n = 4). We developed and calibrated animal-specific finite element (FE) model of LV mechanics against pressure and volume waveforms measured at baseline. After the simulation of the acute effects of pressure-overload, the local changes of maximum, mean and minimum myocardial stretches and stresses in three orthogonal material directions (i.e., fiber, sheet and sheet-normal) over a cardiac cycle were quantified. Correlation between mechanical quantities and the corresponding measured local changes in wall thickness was quantified using the Pearson correlation number (PCN) and Spearman rank correlation number (SCN).

RESULTS

At 2 weeks after banding, the average septum thickness decreased from 10.6 ± 2.92mm to 9.49 ± 2.02mm, whereas the LV free-wall thickness increased from 8.69 ± 1.64mm to 9.4 ± 1.22mm. The FE results show strong correlation of growth with the changes in maximum fiber stress (PCN = 0.5471, SCN = 0.5111) and changes in the mean sheet-normal stress (PCN= 0.5266, SCN = 0.5256). Myocardial stretches, however, do not have good correlation with growth.

CONCLUSION

These results suggest that fiber stress is the mechanical stimuli for LV growth in pressure-overload.

Use of artificial intelligence in computed tomography dose optimisation

The field of artificial intelligence (AI) is transforming almost every aspect of modern society, including medical imaging. In computed tomography (CT), AI holds the promise of enabling further reductions in patient radiation dose through automation and optimisation of data acquisition processes, including patient positioning and acquisition parameter settings. Subsequent to data collection, optimisation of image reconstruction parameters, advanced reconstruction algorithms, and image denoising methods improve several aspects of image quality, especially in reducing image noise and enabling the use of lower radiation doses for data acquisition. Finally, AI-based methods to automatically segment organs or detect and characterise pathology have been translated out of the research environment and into clinical practice to bring automation, increased sensitivity, and new clinical applications to patient care, ultimately increasing the benefit to the patient from medically justified CT examinations. In summary, since the introduction of CT, a large number of technical advances have enabled increased clinical benefit and decreased patient risk, not only by reducing radiation dose, but also by reducing the likelihood of errors in the performance and interpretation of medically justified CT examinations.

Self-adapting extraction of cropland phenological transitions of rotation agroecosystems using dynamically fused NDVI images

Remote sensing can be used to monitor cropland phenological characteristics; however, tradeoffs between the spatial and temporal resolutions of cloudless satellite images limit the accuracy of their retrieval. In this study, an improved enhanced spatial and temporal adaptive reflectance fusion model (ESTARFM) was applied to human-dominated Xiong'an New Area to develop a self-adapting algorithm automating the extraction of main phenological transition points (greenup, maturity, senescence, and dormancy). The analyses of cropland phenological characteristics were performed utilizing the Softmax classification method. By examining three different phases of fusion images, it was found that the improved ESTARFM was more accurate than the original ESTARFM (correlation coefficient > 0.76; relative root mean square error < 0.25; structural similarity index > 0.79). The reconstructed normalized difference vegetation indexes were consistent with that acquired by the Moderate Resolution Imaging Spectroradiometer (average discrepancy: 0.1136, median absolute deviation: 0.0110). The greenup, maturity, senescence, and dormancy points were monitored in 5-day resolution and 50-day length on a 30-m grid scale, and their average day of year (DOY) were 67, 119, 127, and 166 for wheat; 173, 224, 232, and 283 for single-season corn; and 189, 227, 232, and 285 for rotation corn, respectively. The corresponding median absolute deviations were 2, 3, 2, and 2 days for wheat; 2, 5, 3, and 4 days for single-season corn; and 2, 5, 2, and 2 days for rotation corn, respectively, while all coefficients of variation did not exceed 6%. The proposed self-adapting approach can be used for identifying the planting modes at grid level in rotation agroecosystems and cropland phenological dynamics on a global or regional scale.

Evaluation of Lower-Dose Spiral Head CT for Detection of Intracranial Findings Causing Neurologic Deficits

BACKGROUND AND PURPOSE

Despite the frequent use of unenhanced head CT for the detection of acute neurologic deficit, the radiation dose for this exam varies widely. Our aim was to evaluate the performance of lower-dose head CT for detection of intracranial findings resulting in acute neurologic deficit.

MATERIALS AND METHODS

Projection data from 83 patients undergoing unenhanced spiral head CT for suspected neurologic deficits were collected. Cases positive for infarction, intra-axial hemorrhage, mass, or extra-axial hemorrhage required confirmation by histopathology, surgery, progression of findings, or corresponding neurologic deficit; cases negative for these target diagnoses required negative assessments by two neuroradiologists and a clinical neurologist. A routine dose head CT was obtained using 250 effective mAs and iterative reconstruction. Lower-dose configurations were reconstructed (25-effective mAs iterative reconstruction, 50-effective mAs filtered back-projection and iterative reconstruction, 100-effective mAs filtered back-projection and iterative reconstruction, 200-effective mAs filtered back-projection). Three neuroradiologists circled findings, indicating diagnosis, confidence (0-100), and image quality. The difference between the jackknife alternative free-response receiver operating characteristic figure of merit at routine and lower-dose configurations was estimated. A lower 95% CI estimate of the difference greater than -0.10 indicated noninferiority.

RESULTS

Forty-two of 83 patients had 70 intracranial findings (29 infarcts, 25 masses, 10 extra- and 6 intra-axial hemorrhages) at routine head CT (CT dose index = 38.3 mGy). The routine-dose jackknife alternative free-response receiver operating characteristic figure of merit was 0.87 (95% CI, 0.81-0.93). Noninferiority was shown for 100-effective mAs iterative reconstruction (figure of merit difference, -0.04; 95% CI, -0.08 to 0.004) and 200-effective mAs filtered back-projection (-0.02; 95% CI, -0.06 to 0.02) but not for 100-effective mAs filtered back-projection (-0.06; 95% CI, -0.10 to -0.02) or lower-dose levels. Image quality was better at higher-dose levels and with iterative reconstruction (P < .05).

CONCLUSIONS

Observer performance for dose levels using 100-200 eff mAs was noninferior to that observed at 250 effective mAs with iterative reconstruction, with iterative reconstruction preserving noninferiority at a mean CT dose index of 15.2 mGy.

Comparison of a Photon-Counting-Detector CT with an Energy-Integrating-Detector CT for Temporal Bone Imaging: A Cadaveric Study

BACKGROUND AND PURPOSE

Evaluating abnormalities of the temporal bone requires high-spatial-resolution CT imaging. Our aim was to assess the performance of photon-counting-detector ultra-high-resolution acquisitions for temporal bone imaging and compare the results with those of energy-integrating-detector ultra-high-resolution acquisitions.

MATERIALS AND METHODS

Phantom studies were conducted to quantify spatial resolution of the ultra-high-resolution mode on a prototype photon-counting-detector CT scanner and an energy-integrating-detector CT scanner that uses a comb filter. Ten cadaveric temporal bones were scanned on both systems with the radiation dose matched to that of the clinical examinations. Images were reconstructed using a sharp kernel, 0.6-mm (minimum) thickness for energy-integrating-detector CT, and 0.6- and 0.25-mm (minimum) thicknesses for photon-counting-detector CT. Image noise was measured and compared using adjusted 1-way ANOVA. Images were reviewed blindly by 3 neuroradiologists to assess the incudomallear joint, stapes footplate, modiolus, and overall image quality. The ranking results for each specimen and protocol were compared using the Friedman test. The Krippendorff α was used for interreader agreement.

RESULTS

Photon-counting-detector CT showed an increase of in-plane resolution compared with energy-integrating-detector CT. At the same thickness (0.6 mm), images from photon-counting-detector CT had significantly lower (P < .001) image noise compared with energy-integrating-detector CT. Readers preferred the photon-counting-detector CT images to the energy-integrating-detector images for all 3 temporal bone structures. A moderate interreader agreement was observed with the Krippendorff α = 0.50. For overall image quality, photon-counting-detector CT image sets were ranked significantly higher than images from energy-integrating-detector CT (P < .001).

CONCLUSIONS

This study demonstrated substantially better delineation of fine anatomy for the temporal bones scanned with the ultra-high-resolution mode of photon-counting-detector CT compared with the ultra-high-resolution mode of a commercial energy-integrating-detector CT scanner.

Silencing NUDT21 Attenuates the Mesenchymal Identity of Glioblastoma Cells via the NF-κB Pathway

The proneural (PN) and mesenchymal (MES) subtypes of glioblastoma multiforme (GBM) are robust and generally consistent with classification schemes. GBMs in the MES subclass are predominantly primary tumors that, compared to PN tumors, exhibit a worse prognosis; thus, understanding the mechanism of MES differentiation may be of great benefit for the treatment of GBM. Nuclear factor kappa B (NF-κB) signaling is critically important in GBM, and activation of NF-κB could induce MES transdifferentiation in GBM, which warrants additional research. NUDT21 is a newly discovered tumor-associated gene according to our current research. The exact roles of NUDT21 in cancer incidence have not been elucidated. Here, we report that NUDT21 expression was upregulated in human glioma tissues and that NUDT21 promoted glioma cell proliferation, likely through the NF-κB signaling pathway. Gene set enrichment analysis, western blotting, and quantitative real-time reverse transcription polymerase chain reaction confirmed that NF-κB inhibitor zeta (NFKBIZ) was a downstream target affected by NUDT21 and that the MES identity genes in glioblastoma cells, CHI3L1 and FN1, were also differentially regulated. Our results suggest that NUDT21 is an upstream regulator of the NF-κB pathway and a potential molecular target for the MES subtype of GBM.

Ultra-High Spatial Resolution, Multi-Energy CT using Photon Counting Detector Technology

Two ultra-high-resolution (UHR) imaging modes, each with two energy thresholds, were implemented on a research, whole-body photon-counting-detector (PCD) CT scanner, referred to as sharp and UHR, respectively. The UHR mode has a pixel size of 0.25 mm at iso-center for both energy thresholds, with a collimation of 32 × 0.25 mm. The sharp mode has a 0.25 mm pixel for the low-energy threshold and 0.5 mm for the high-energy threshold, with a collimation of 48 × 0.25 mm. Kidney stones with mixed mineral composition and lung nodules with different shapes were scanned using both modes, and with the standard imaging mode, referred to as macro mode (0.5 mm pixel and 32 × 0.5 mm collimation). Evaluation and comparison of the three modes focused on the ability to accurately delineate anatomic structures using the high-spatial resolution capability and the ability to quantify stone composition using the multi-energy capability. The low-energy threshold images of the sharp and UHR modes showed better shape and texture information due to the achieved higher spatial resolution, although noise was also higher. No noticeable benefit was shown in multi-energy analysis using UHR compared to standard resolution (macro mode) when standard doses were used. This was due to excessive noise in the higher resolution images. However, UHR scans at higher dose showed improvement in multi-energy analysis over macro mode with regular dose. To fully take advantage of the higher spatial resolution in multi-energy analysis, either increased radiation dose, or application of noise reduction techniques, is needed.

Dual Energy CT Kidney Stone Differentiation in Photon Counting Computed Tomography

This study evaluates the capabilities of a whole-body photon counting CT system to differentiate between four common kidney stone materials, namely uric acid (UA), calcium oxalate monohydrate (COM), cystine (CYS),and apatite (APA) ex vivo. Two different x-ray spectra (120 kV and 140 kV) were applied and two acquisition modes were investigated; The macro-mode generates two energy threshold based image-volumes and two energy bin based image-volumes. In the chesspattern-mode, however, four energy thresholds are applied. A virtual low energy image, as well as a virtual high energy image are derived from initial threshold-based images, while considering their statistically correlated nature. The energy bin based images of the macro-mode, as well as the virtual low and high energy image of the chesspattern-mode serve as input for our dual energy evaluation. The dual energy ratio of the individually segmented kidney stones were utilized to quantify the discriminability of the different materials. The dual energy ratios of the two acquisition modes showed high correlation for both applied spectra. Wilcoxon-rank sum tests and the evaluation of the area under the receiver operating characteristics curves suggest that the UA kidney stones are best differentiable from all other materials (AUC = 1.0), followed by CYS (AUC ≈ 0.9 compared against COM and APA). COM and APA, however, are hardly distinguishable (AUC between 0.63 and 0.76). The results hold true for the measurements of both spectra and both acquisition modes.

Renal Stone Characterization using High Resolution Imaging Mode on a Photon Counting Detector CT System

In addition to the standard-resolution (SR) acquisition mode, a high-resolution (HR) mode is available on a research photon-counting-detector (PCD) whole-body CT system. In the HR mode each detector consists of a 2x2 array of 0.225 mm × 0.225 mm subpixel elements. This is in contrast to the SR mode that consists of a 4x4 array of the same sub-elements, and results in 0.25 mm isotropic resolution at iso-center for the HR mode. In this study, we quantified ex vivo the capabilities of the HR mode to characterize renal stones in terms of morphology and mineral composition. Forty pure stones - 10 uric acid (UA), 10 cystine (CYS), 10 calcium oxalate monohydrate (COM) and 10 apatite (APA) - and 14 mixed stones were placed in a 20 cm water phantom and scanned in HR mode, at radiation dose matched to that of routine dual-energy stone exams. Data from micro CT provided a reference for the quantification of morphology and mineral composition of the mixed stones. The area under the ROC curve was 1.0 for discriminating UA from CYS, 0.89 for CYS vs COM and 0.84 for COM vs APA. The root mean square error (RMSE) of the percent UA in mixed stones was 11.0% with a medium-sharp kernel and 15.6% with the sharpest kernel. The HR showed qualitatively accurate characterization of stone morphology relative to micro CT.

Lung Nodule Volume Quantification and Shape Differentiation with an Ultra-High Resolution Technique on a Photon Counting Detector CT System

A new ultra high-resolution (UHR) mode has been implemented on a whole body photon counting-detector (PCD) CT system. The UHR mode has a pixel size of 0.25 mm by 0.25 mm at the iso-center, while the conventional (macro) mode is limited to 0.5 mm by 0.5 mm. A set of synthetic lung nodules (two shapes, five sizes, and two radio-densities) was scanned using both the UHR and macro modes and reconstructed with 2 reconstruction kernels (4 sets of images in total). Linear regression analysis was performed to compare measured nodule volumes from CT images to reference volumes. Surface curvature was calculated for each nodule and the full width half maximum (FWHM) of the curvature histogram was used as a shape index to differentiate sphere and star shape nodules. Receiver operating characteristic (ROC) analysis was performed and area under the ROC curve (AUC) was used as a figure of merit for the differentiation task. Results showed strong linear relationship between measured nodule volume and reference standard for both UHR and macro mode. For all nodules, volume estimation was more accurate using UHR mode with sharp kernel (S80f), with lower mean absolute percent error (MAPE) (6.5%) compared with macro mode (11.1% to 12.9%). The improvement of volume measurement from UHR mode was more evident particularly for small nodule size (3mm, 5mm), or star-shape nodules. Images from UHR mode with sharp kernel (S80f) consistently demonstrated the best performance (AUC = 0.85) when separating star from sphere shape nodules among all acquisition and reconstruction modes. Our results showed the advantages of UHR mode on a PCD CT scanner in lung nodule characterization. Various clinical applications, including quantitative imaging, can benefit substantially from this high resolution mode.

Clinical Study of Serum Homocysteine and Non-Alcoholic Fatty Liver Disease in Euglycemic Patients

BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease. NAFLD includes a spectrum of hepatic pathologies: simple fatty liver, steatohepatitis and cirrhosis. Insulin resistance may contribute to NAFLD. The liver plays an important role in the production and metabolism of homocysteine (HCY), which is known to be an independent risk factor for cardiovascular disease. High HCY level can aggravate NAFLD by increasing the reactive oxygen species and activating oxidative stress. In this study, we investigated the relationship between HCY and NAFLD in euglycemic patients. MATERIAL AND METHODS A total of 1143 euglycemic patients were recruited: 519 patients with non-alcoholic fatty liver disease (NAFLD) and 624 sex and age-matched controls without NAFLD. RESULTS The NAFLD group had significantly higher HCY level (13.78±5.84 vs. 11.96±3.58 mmol/L, p<0.001), as well as higher body mass index (BMI), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), glutamic-pyruvic transaminase (ALT), glutamic-oxalacetic transaminase (AST), fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model assessment for insulin resistance (HOMA-IR), homeostasis model assessment for beta cell function (HOMA-B), and lower high density lipoprotein cholesterol (HDL-C). HCY level was positively correlated with HOMA-IR (r=0.239, p<0.001), TG (r=0.356, p<0.001) and negatively correlated with HDL-C (r=-0.161, p<0.001). In the logistic regression analysis, BMI (beta=0.345, p<0.001), HOMA-IR (beta=0.654, p<0.01), TG (beta=0.881, p<0.001), and HCY (beta=0.04, p=0.044) were the predictors of NAFLD. CONCLUSIONS Higher HCY level existed in NAFLD patients and was correlated with the severity of insulin resistance. HCY is an independent risk factor for NAFLD.

Genetic polymorphism of nonsyndromic cleft lip with or without cleft palate is associated with developmental dyslexia in Chinese school-aged populations

Developmental dyslexia (DD) is a neurodevelopment disorder characterized by reading disabilities without apparent etiologies. Nonsyndromic cleft lip with or without cleft palate (NSCL/P) is a structural craniofacial malformation featured by isolated orofacial abnormalities. Despite substantial phenotypic differences, potential linkage between these two disorders has been suggested as prevalence of DD among NSCL/P patients was much higher than that in general populations. Previous neuroimaging studies observed impaired short-term memory in patients with DD and NSCL/P, respectively. Genetic factors have a fundamental role during neurodevelopment and craniofacial morphogenesis but there lacks of evidence to support the linkage between DD and NSCL/P at genetic level. A recent genome-wide association study in Chinese populations identified a number of genetic polymorphisms associated with NSCL/P. Herein, we selected three risk variants of NSCL/P namely rs8049367, rs4791774 and rs2235371, and performed association analysis with DD in a Chinese population consisting 631 elementary school-aged children with 288 dyslexic cases without NSCL/P and 343 healthy controls. After Bonferroni correction for multiple comparisons, the T allele of rs8049367 showed significant association with DD (OR=1.41, P=0.0085). It is an intergenic variant between CREBBP and ADCY9 located at 16p13.3. The CREBBP gene was reported to have an essential role during memory formation, although ADCY9 was involved in dental development. In future studies, understanding functional effects of rs8049367 on CERBBP and ADCY9 might contribute to explain underlying etiologies shared by DD and NSCL/P.

Association study of C-reactive protein associated gene HNF1A with ischemic stroke in Chinese population

Background

Ischemic stroke is a life-threatening condition due to obstructed blood supply of the brain. Elevation of plasma C-reactive protein, an important inflammatory marker, was known to associate with increased risk of ischemic stroke. Previous studies reported association between genetic variants of HNF1A and plasma level of C-reactive protein. The HNF1A gene encodes a hepatocyte transcription factor which might have regulatory effects on C-reactive protein synthesis in liver. Therefore, the C-reactive protein associated gene HNF1A seems to be a promising candidate gene for ischemic stroke.

Results

We used HNF1A as a candidate gene of ischemic stroke and evaluated seven common variants of HNF1A for their contribution to ischemic stroke. The association analysis of HNF1A variants with ischemic stroke was performed in a Chinese population with 918 cases and 979 controls. For total ischemic stroke and large vessel disease subtype, none of variants exceeded significant threshold. For small vessel disease subtype of ischemic stroke, the G allele of rs7953249 showed nominal association (OR = 0.82, p = 0.04) after data adjustment for conventional risk factors. However, our preliminary results did not survived bonferroni correction for multiple comparisons.

Conclusions

Common genetic variants of HNF1A showed nominal association with small vessel disease subtype of ischemic stroke though not survived bonferroni correction for multiple comparisons. The association between HNF1A and ischemic stroke is limited by small effects of individual SNPs. Our study provided additional genetic evidences to understand the role of HNF1A gene and C-reactive protein underlying ischemic stroke.

Electronic supplementary material

The online version of this article (doi:10.1186/s12881-016-0313-3) contains supplementary material, which is available to authorized users.

Comparison of β-cell dysfunction and insulin resistance correlating obesity with type 2 diabetes: A cross-sectional study

AIM

To assess the contribution of β-cell dysfunction and insulin resistance to type 2 diabetes (T2D) in obese and non-obese Chinese people.

METHODS

In this cross-sectional study, we recruited 1384 newly diagnosed T2D patients and 1712 healthy controls. Insulin resistance was estimated by homeostasis model assessment of insulin resistance (HOMA-IR). β-cell function was estimated by homeostasis model assessment of β-cell function (HOMA-β) and 60min insulinogenic index (IGI60). We compared the insulin resistance and β-cell function of obese and non-obese Chinese patients with and without T2D.

RESULTS

50.18% of control participants and 62.28% of T2D patients were obese (BMI≥25kg/m(2)). HOMA-IR, HOMA-β and IGI60 were significantly higher in obese than non-obese, irrespective of T2D. Non-obese T2D patients had significantly greater HOMA-IR, and lower HOMA-β and IGI60 than non-obese control participants. The obese T2D group had lower HOMA-β and IGI60 than the obese control group. There was no significant difference in HOMA-IR between the obese T2D and obese control groups. Multivariate logistic regression analysis revealed that HOMA-IR was associated with T2D only in non-obese group, and HOMA-β and IGI60 were associated with T2D in both non-obese and obese groups.

CONCLUSIONS

HOMA-β and IGI60 were associated with T2D in obese and non-obese patients, but HOMA-IR was associated with T2D in non-obese Chinese.

Developmental perfluorooctane sulfonate exposure results in tau hyperphosphorylation and β-amyloid aggregation in adults rats: Incidence for link to Alzheimer's disease

With regard to the defects of the cognitive function observed after developmental exposure to perfluorooctane sulfonate (PFOS), and earlier studies on the developmental neurotoxicology, the aim of this study was to investigate the role of developmental PFOS exposure in neurodegenerative disorders in later life. Two pathological hallmarks of Alzheimer's disease (AD), Tau hyperphosphorylation and β-amyloid (Aβ) aggregation, were examined. SD rats were exposed to PFOS during only prenatal and/or postnatal period. Tau mRNA and protein levels were elevated by PFOS exposure. The phosphorylation of Tau at S199, T231 and S396 sites were also increased. Besides, PFOS exposure increased the Aβ1-42 levels, as well as the amyloid precursor protein (APP) regulation. The prenatal PFOS exposure caused alterations in the involved proteins at comparable levels with the postnatal and both prenatal and postnatal exposure. Thus, it has raised some evidence that early PFOS exposure can affect processes linked to neurodegeneration, enhancing the AD pathological risk. And PFOS exposures in early life may be of particular etiologic importance of neurodegenerative diseases.

A High-Resolution Imaging Technique using a Whole-body, Research Photon Counting Detector CT System

A high-resolution (HR) data collection mode has been introduced to the whole-body, research photon-counting-detector CT system installed in our laboratory. In this mode, 64 rows of 0.45 mm × 0.45 mm detectors pixels were used, which corresponded to a pixel size of 0.225 mm × 0.225 mm at the iso-center. Spatial resolution of this HR mode was quantified by measuring the MTF from a scan of a 50 micron wire phantom. An anthropomorphic lung phantom, cadaveric swine lung, temporal bone and heart specimens were scanned using the HR mode, and image quality was subjectively assessed by two experienced radiologists. Comparison of the HR mode images against their energy integrating system (EID) equivalents using comb filters was also performed. High spatial resolution of the HR mode was evidenced by the MTF measurement, with 15 lp/cm and 20 lp/cm at 10% and 2% MTF. Images from anthropomorphic phantom and cadaveric specimens showed clear delineation of small structures, such as lung vessels, lung nodules, temporal bone structures, and coronary arteries. Temporal bone images showed critical anatomy (i.e. stapes superstructure) that was clearly visible in the PCD system but hardly visible with the EID system. These results demonstrated the potential application of this imaging mode in lung, temporal bone, and vascular imaging. Other clinical applications that require high spatial resolution, such as musculoskeletal imaging, may also benefit from this high resolution mode.

Hyperhomocysteinemia is associated with decreased apolipoprotein AI levels in normal healthy people

Background

Hyperhomocysteinemia (HHcy) is an independent risk factor for various cardiovascular diseases. Animal studies have shown that homocysteine (Hcy) inhibits hepatic expression of apolipoprotein AI (apoAI). Our recent clinical study showed that increased plasma Hcy levels were associated with decreased apoAI levels in patients with impaired glucose tolerance. In this study, we assessed a potential association between Hcy and apoAI levels in normal healthy people.

Methods

A total of 1768 normal healthy individuals were divided into two groups: the control group (subjects without HHcy) and the HHcy group (subjects with HHcy).

Results

HHcy subjects exhibited significantly lower high-density lipoprotein cholesterol (HDL-C) and apoAI levels than the control group (HDL-C: 1.18 ± 0.25 vs. 1.29 ± 0.32 mmol/L; apoAI: 1.38 ± 0.19 vs. 1.47 ± 0.25 g/L; all P < 0.01). Plasma Hcy levels were negatively associated with HDL-C and apoAI levels after adjustments for age, BMI and TG (HDL-C: r = –0.10; apoAI: r = –0.11; all P < 0.05). Multivariate regression analysis showed that the plasma Hcy levels were an independent influencing factor for apoAI (β = –0.065, P < 0.05).

Conclusions

Increased plasma Hcy levels were associated with decreased apoAI levels in normal healthy people, and the inhibition of apoAI synthesis might be a mechanism through which Hcy is linked with the development of atherosclerosis in HHcy subjects.

A high-throughput, in-vitro assay for Bacillus thuringiensis insecticidal proteins

A high-throughput, in-vitro assay for Bacillus thuringiensis (Bt) insecticidal proteins designated as Cry was developed and evaluated for screening a large number of Cry protein variants produced by DNA shuffling. This automation-amenable assay exploits an insect cell line expressing a single receptor of Bt Cry proteins. The Cry toxin used to develop this assay is a variant of the Cry1Ab protein called IP1-88, which was produced previously by DNA shuffling. Cell mortality caused by the activated Bt Cry toxin was determined by chemical cell viability assay in 96/384-well microtiter plates utilizing CellTiter 96(®) obtained from Promega. A widely-accepted mode-of-action theory of certain Bt Cry proteins suggests that the activated toxin binds to one or more receptors and forms a pore through the insect gut epithelial cell apical membrane. A number of insect proteins such as cadherin-like protein (Cad), aminopeptidase-N (APN), alkaline phosphatase (ALP) and ABC transporter (ABCC) have been identified as the receptors of Bt Cry toxins. In this study, Bt Cry toxin receptors Ostrinia nubilalis (European corn borer) cadherin-like protein (On-Cad) and aminopeptidase-N 1 and 3 (On-APN1, On-APN3) and Spodoptera frugiperda (fall armyworm) cadherin-like protein (Sf-Cad) were cloned in an insect cell line, Sf21, and a mammalian cell line, Expi293F. It was observed by ligand blotting and immunofluorescence microscopy that trypsin-activated IP1-88 bound to On-Cad and On-APN1, but not Sf-Cad or On-APN3. In contrast, IP1-88 bound only to APN1 in BBMV (Brush Border Membrane Vesicles) prepared from the third and fourth-instar O. nubilalis larval midgut. The sensitivity of the recombinant cells to the toxin was then tested. IP1-88 showed no toxicity to non-recombinant Sf21 and Expi293F. Toxicity was observed only when the On-Cad gene was cloned and expressed. Sf-Cad and On-APN1 were not able to make those cells sensitive to the toxin. Since the expression of On-Cad alone was sufficient to make both insect and mammalian cells sensitive to the IP1-88 toxin, it is not likely that a secondary receptor, which may exist specifically in the Sf21 insect cell but not in the Expi293F cell, is involved in the cytotoxicity of IP1-88.

Temporal Bone CT: Improved Image Quality and Potential for Decreased Radiation Dose Using an Ultra-High-Resolution Scan Mode with an Iterative Reconstruction Algorithm

BACKGROUND AND PURPOSE

Radiation dose in temporal bone CT imaging can be high due to the requirement of high spatial resolution. In this study, we assessed whether CT imaging of the temporal bone by using an ultra-high-resolution scan mode combined with iterative reconstruction provides higher spatial resolution and lower image noise than a z-axis ultra-high-resolution mode.

MATERIALS AND METHODS

Patients with baseline temporal bone CT scans acquired by using a z-axis ultra-high-resolution protocol and a follow-up scan by using the ultra-high-resolution-iterative reconstruction technique were identified. Images of left and right temporal bones were reconstructed in the axial, coronal, and Poschl planes. Three neuroradiologists assessed the spatial resolution of the following structures: round and oval windows, incudomallear and incudostapedial joints, basal turn spiral lamina, and scutum. The paired z-axis ultra-high-resolution and ultra-high-resolution-iterative reconstruction images were displayed side by side in random order, with readers blinded to the imaging protocol. Image noise was compared in ROIs over the posterior fossa.

RESULTS

We identified 8 patients, yielding 16 sets of temporal bone images (left and right). Three sets were excluded because the patient underwent surgery between the 2 examinations. Spatial resolution was comparable (Poschl) or slightly better (axial and coronal planes) with ultra-high-resolution-iterative reconstruction than with z-axis ultra-high-resolution. A paired t test indicated that noise was significantly lower with ultra-high-resolution-iterative reconstruction than with z-axis ultra-high-resolution (P < .001), with a mean noise reduction of 37% (range, 18%-49%).

CONCLUSIONS

The ultra-high-resolution-iterative reconstruction scan mode has similar or slightly better resolution relative to the z-axis ultra-high-resolution mode for CT of the temporal bone but significantly (P < .01) lower image noise, which may enable the dose to be reduced by approximately 50%.