Correlation study of age,gender and lumbar vertebral marrow fat in adults based on MRI iterative decomposition of water and fat with echo asymmetry and least-squares estimation image quantitation imaging technique / 中国脊柱脊髓杂志

Objectives:To investigate the relationships between vertebral marrow fat in lumbar spine and age and gender in adults using iterative decomposition of water and fat with echo asymmetry and least-squares estimation image quantitation(IDE AL-IQ)magnetic resonance imaging technology.Methods:The IDEAL-IQ fat fraction images from 298 subjects(Male:138,Female:160,age range:20-69 years old)were collected.All the patients were divided into 5 groups based on age,with each group spanning a range of 10 years:age range 20-29 years(Twenties):24 males,20 females;30-39 years(Thirties):47 males,39 females;40-49 years(Forties):36 males,47 females;50-59 years(Fifties):20 males,37 females;60～69 years(Sixties):11 males,17 females.The bone marrow proton density fat fration(PDFF)were measured using GE ADW4.6 processing work station.Results:In the same age group,there were differences in vertebral bone marrow PDFF between gen-ders.PDFF of L1-L5 vertebrae was significantly higher in males than females in twenties,thirties and forties(P＜0.05).In the fifties,there was no statistically significant difference in the L1-L5 vertebrae PDFF between males and females(P＞0.05);while in the sixties,the PDFF of the L1-L5 vertebrae was lower in males than that in females(P＜0.05).The PDFF of lumbar vertebral bone marrow was positively correlated with age,with a higher correlation observed in females(r=0.72,P＜0.05)than that in males(r=0.32,P＜0.05).From the age of 20 to 69,the L4 vertebra PDFF in males had the highest growth rate(21.08％),while the L1 vertebra PDFF in female had the highest growth rate(65.68％).For males,the growth of PDFF was primarily concentrated in the thirties and fifties;The PDFF of L1,L4,and L5 vertebrae showed the largest increase in the fifties,while that of L2 and L3 vertebrae had the highest increase rate in the thirties.For females,vertebral PDFF showed a slight decrease trend in the group of thirties,which gradually increased subsequently in all vertebare in the group of forties,fifties,and sixties,with the largest increase rate observed in the fifties.Conclusions:There are differences in vertebral fat distribution between males and females across different age groups,and the growth rates of vertebral PDFF also vary;the PDFF of vertebral bodies in different segments of the lumbar spine is positively correlated with age.

Quantitative evaluation of gender differences in supraclavicular fat related to fat metabolism with IDEAL-IQ in healthy young adults / 实用放射学杂志

Objective To evaluate the gender differences in fat water fraction(FWF)related to fat metabolism in supraclavicular region of neck with iterative decomposition of water and fat with echo asymmetry and least square estimation iron quantification(IDEAL-IQ)sequence quantitatively.Methods Twenty healthy female and twenty healthy male volunteers were selected for a MRI examination with IDEAL-IQ,then the FWF of R2*,brown adipose tissue(BAT)and white adipose tissue(WAT)were obtained by post-processing.The differences of FWF between the two groups were compared by Mann-Whitney U test.Results There was sig-nificant difference in the FWF of BAT and WAT between the two groups(P＜0.05).The FWF of BAT in the female was higher than that the male,and the FWF of WAT in the male was higher than that the female,there was no significant difference in the R2*between the two groups(P＞0.05).Conclusion IDEAL-IQ sequence can be used to evaluate the FWF in supraclavicular region of neck quantitatively,and classify BAT and WAT,then provide clinical according to the quantitative study of fat content.

Application value of multiplexed sensitivity encoding diffusion weighted imaging in neck MRI scanning / 实用放射学杂志

Objective To explore the feasibility of the multiplexed sensitivity encoding diffusion weighted imaging(MUSE-DWI)sequence in neck MRI,and to compare with traditional single-shot echo-planar imaging diffusion weighted imaging(SS-EPI-DWI)sequence.Methods Thirty healthy volunteers underwent MUSE-DWI and SS-EPI-DWI sequences scanning in neck.Two groups of images were independently scored by two radiologists for magnetic sensitivity artifact,chemical shift artifact,geometric distortion and overall image quality.The noise,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the regions of interest(ROI)of the two groups of images were measured and compared on the nasopharyngeal fossa layer,parotid gland layer,glottic layer and thyroid layer.Results Qualitative analysis showed that the image quality scores of MUSE-DWI sequence were significantly better than those of SS-EPI-DWI sequence in terms of magnetic sensitivity artifact,chemical shift artifact,geometric distortion and overall image quality(P<0.001).Quantitative analysis showed that the noise values of ROIs of MUSE-DWI sequence were significantly lower than those of SS-EPI-DWI sequence(P<0.001).The SNR and CNR of ROIs of MUSE-DWI sequence were higher than those of SS-EPI-DWI sequence(P<0.001).Conclusion MUSE-DWI sequence can significantly reduce geometric distortion,magnetic sensitivity artifact and chemical shift artifact,and SNR and CNR of images are significantly increased compared with SS-EPI-DWI sequence,which is more suitable for neck MRI scanning.

Three-dimensional magnetization prepared rapid acquisition gradient echo for evaluation on the corpus callosum morphological alterations in children with spastic cerebral palsy / 实用放射学杂志

Objective To analyze the morphological alterations of corpus callosum in children with spastic cerebral palsy(SCP)using three-dimensional magnetization prepared rapid acquisition gradient echo(3D-MPRAGE)technology and to investigate the correlation between morphological indexes and gross motor function.Methods Sagittal T1WI 3D-MPRAGE data was collected from 136 children with SCP(SCP group)and 132 age-and gender-matched healthy controls(HC)(HC group),and the gross motor function measure-88(GMFM-88)was applied to assess the gross motor function.Independent sample t-test was used to compare the corpus callosum surface area,volume,maximum anterior-posterior diameter,median sagittal area(total area and area of Ⅰ-Ⅴ zone)between the two groups.Partial correlation analysis was performed to calculate the correlation between morphological indexes of the corpus callosum and GMFM-88 with age as a covariate.Results Children under 3 years old,the corpus callosum surface area of the SCP group(3 914.51 mm2±1 207.97 mm2)was lower than that of the HC group(5 725.51 mm2±1 412.66 mm2).The volume of the corpus callosum(6 108.46 mm3±2 803.97 mm3)in the SCP group was lower than that of the HC group(11 297.96 mm3±4 109.02 mm3).Also,the maximum anterior-posterior diameter of the corpus callosum in the SCP group(53.40 mm±6.31 mm)was lower than that of the HC group(57.74 mm±6.04 mm)(all P<0.05).Children over 3 years old,the corpus callosum surface area of the SCP group(4 970.06 mm2±1 191.31 mm2)was lower than that of the HC group(6 372.55 mm2±1 445.59 mm2).The volume of the corpus callosum(8 330.20 mm3±2 888.20 mm3)in the SCP group was lower than that of the HC group(13 599.82 mm3±3 429.81 mm3)(all P<0.05).Partial correlation analysis showed significant correlation between corpus callosum volume,median sagittal area and gross motor score(P<0.01)with age as a covari-ate.Conclusion The 3D-MPRAGE technology can be useful for the comprehensive assessment of morphological alterations of the corpus callosum in SCP.The corpus callosum volume,and median sagittal area may become neuroimaging references for the assess-ment of motor development in cerebral palsy(CP).

Narcisismo: considerações atuais / Narcissism: considerations today / Narcisismo: consideraciones actuales

A autora revê o conceito de narcisismo desenvolvido por Freud e o contrapõe ao conceito de individuação de Jung. A partir do mito de Eco e Narciso e seguindo a descrição de C. Byington das funções estruturantes criativas e defensivas, a autora descreve as polaridades narcisismo ­ ecoísmo como funções estruturantes criativas e defensivas. Faz uma releitura do mito desde a normalidade até a desestruturação psicótica das personalidades de Eco e Narciso, dentro da inter-relação criativa-defensiva da polaridade narcisismo-ecoísmo. Conclui citando Jung para ressaltar a importância da relação Eu-Tu no processo de individuação.

The author reviews the concept of narcissism in psychoanalysis contrasting it with Jung's concept of individuation. Starting with the myth of Echo and Narcissus following C. Byington's description of creative and defensive structuring functions, the author describes the narcissismechoism polarity in a similar way. She interprets the myth of Echo and Narcissus from normality to the psychotic reaction of their personalities, within the creative-defensive inter-relationship of the narcissism-echoism polarity. She concludes by quoting Jung to emphasize the importance of the ego-other relationship in the individuation process.

La autora revisa el concepto de narcisismo desarrollado por Freud y lo contrapone al concepto de individuación de Jung. A partir del mito de Eco y Narciso, y siguiendo la descripción de C. Byington sobre las funciones estructurantes creativas y defensivas, la autora describe las polaridades narcisismo-ecoísmo como funciones estructurantes creativas y defensivas. Hace una relectura del mito desde la normalidad hasta la desestructuración psicótica de las personalidades de Eco y Narciso, dentro de la interrelación creativa-defensiva de la polaridad narcisismo-ecoísmo. Concluye citando a Jung para resaltar la importancia de la relación Yo-Tu en el proceso de individuación.

The echocardiographic characteristics and risk stratification of patients with above grade 3+ mitral regurgitation: Based on the preliminary findings of echo core-lab / 中国胸心血管外科临床杂志

@#Objective     To analyze the echocardiographic characteristics of above grade 3+ mitral regurgitation (MR) patients by 3D transesophageal echocardiography (3D-TEE) in transcatheter edge-to-edge repair (TEER) and compare the intervention rate of TEER treatment in patients with different risk stratification. Methods     We retrospectively analyzed the clinical data of 91 patients with above grade 3+ MR in Anzhen Hospital between June 2021 and April 2022. There were 45 males and 46 females aged 66.5±15.9 years. According to pathogenesis, the patients were divided into different anatomical groups and risk stratification groups. There were 34 patients in a simple degenerative group (simple DMR group), 28 patietns in a complex disease group (Complex group), 14 patients in a simple ventricular  functional reflux group (simple VFMR group), 9 patients in a simple atrial functional reflux group (simple AFMR group), and 6 patients in a mixed functional reflux group (mixed FMR group). All patients were examined with a unified standard of transthoracic echocardiography (TTE) and 3D-TEE to compare the characteristic three-dimensional structural changes of the mitral valve in each group. According to the three partition strategy of preoperative anatomical evaluation of TEER, the risk stratification was conducted for the enrolled patients, which was divided into three regions from light to heavy: green area, yellow area, and red area. TEER treatment intervention rate of patients with different risk stratification was calculated. Results     Ant leaf angle and post leaf angle were negative in the simple DMR and Complex groups, and non-planar angle, prolapse height and prolapse volume were higher than those of the other groups (P=0.000). Ant leaf angle and post leaf angle were positive in the VFMR group and the mixed FMR group. Anterior and posterior (AP) diameter of valve ring (P=0.036), tenting height and tenting volume were higher than those of other groups (P=0.000).  AP diameter, tenting height and tenting volume were changed mildly in patients with simple AFMR. MR patients in red and yellow zone achieved a 28.1% TEER intervention rate. Conclusion     Standardized TTE and TEE examinations are crucial for the qualitative and quantitative diagnosis of MR in the echo core-lab. 3D-TEE mitral valve parameter can help determine the exact pathogenesis of MR and to improve the interventional rate of challenging MR patients.

Zero echo time 3.0T MRI for detecting lung cancer nodules / 中国介入影像与治疗学

Objective To observe the value of zero echo time(ZTE)3.0T MRI for detecting lung cancer nodules.Methods Totally 126 lung cancer patients(176 lung nodules)were prospectively enrolled and underwent 3.0T MR axial lung scanning,including T1-volumetric interpolated breath-hold examination(VIBE),T2-BLADE,T2-half-Fourier acquisition single-shot turbo spin-echo(HASTE)and ZTE sequences.The consistency between ZTE MRI and previous CT for displaying characteristics of pulmonary nodules was analyzed,and the sensitivity of different MR sequences for detecting pulmonary nodules were observed.Results Among 176 pulmonary nodules showed on CT,ZTE MRI detected 140 and missed 36 ones.The consistency between ZTE MRI and CT for displaying the maximum diameter and actual maximum diameter of pulmonary nodules were both good(ICC=0.954,0.943,both P＜0.001),and the difference between ZTE MRI and CT was small.The consistency between ZTE MRI and CT for displaying tracheal vascular bundles,pleural indentation and internal bronchial inflation signs were all good(Kappa=0.894,0.912,0.917),while for displaying the type and shape of nodules were both moderate(Kappa=0.661,0.501).The sensitivity of ZTE MRI for detecting pulmonary nodules was higher than that of other individual MR sequences(all P＜0.05),of combination of ZTE and T2 BLADE was higher than that of other sequence combinations(all P＜0.05).Conclusion ZTE 3.0T MRI could be used to detect lung cancer nodules,which was superior to conventional MRI.Combination of ZTE 3.0T MRI with T2-BLADE could improve the sensitivity for detecting pulmonary nodules.

Monitoring changes of anterior patellar tendon in amateur marathon athletes using ultra-short echo time magnetization transfer technology / 中华放射学杂志

Objective:To explore the value of ultra-short echo time magnetization transfer (UTE-MT) techniques for quantitatively dynamic monitoring of anterior patellar tendon (patellar tendon, quadriceps tendon) changes in amateur marathon runners before and after competition.Methods:Between October 2020 and January 2021, 23 amateur marathoners in Zhuhai, aged 28-50 (40±6) years, were prospectively recruited. Three-dimensional UTE-MT and dual-echo UTE-T 2* sequence scans of bilateral knee joints were performed before, 48 hours and 4 weeks after the marathon running, respectively. Another 5 non-running volunteers were recruited for verification of sequence stability. UTE-magnetization transfer ratio (MTR) and UTE-T 2* value of the patellar tendon, quadriceps tendon, and 3 tendon-bone insertion points (patellar tendon-tibial insertion point, patellar tendon-patellar insertion point, and quadriceps tendon-patellar insertion point) were measured independently on sagittal images of the knee joint by 2 radiologists. The stability of the 2 serial measurements and consistency tests between the 2 radiologists were assessed with a two-way mixed intraclass correlation coefficient (ICC). Repeated-measures analysis of variance was used to compare the differences in UTE-MTR and UTE-T 2* values of the prepatellar tendon before and after the marathon running. Results:Both UTE-MT and dual-echo UTE-T 2* sequence measurements had good stability, with ICC values of 0.98 and 0.92, respectively. Measurements of UTE-MTR and UTE-T 2* value of the patellar tendon, quadriceps tendon, and the 3 tendon-bone insertion points by the 2 radiologists were in good agreement (ICC>0.80). Forty-eight hours after the marathon running, the UTE-MTR of the patellar tendon, quadriceps tendon, and the 3 tendon-bone insertion points decreased, and UTE-MTR of the patellar tendon continued to decrease 4 weeks after the race, while UTE-MTR of other regions increased. Only the difference in UTE-MTR for the patellar tendon was statistically significant ( F=7.46, P=0.001) among pre-marathon (0.34±0.04), 48 h after the race (0.32±0.04), and 4 weeks after the race (0.31±0.04). UTE-T 2* value was mildly elevated in all regions at 48 h after the marathon running, but the differences among the three points were not statistically significant ( P>0.05). Conclusion:The UTE-MT has better reproducibility and inter-rater reliability. The UTE-MT can be used to monitor the dynamic changes of the prepatellar tendon before and after marathon exercise, where the UTE-MTR of the patellar tendon consistently decreases after marathon exercise.

The application of contrast-enhanced ultrasound guided radioactive 125I seed implantation for the treatment of metastatic liver cancer with Iso-echo imaging / 中华内分泌外科杂志

Radioactive 125I seed implantation has definite curative effect in the treatment of local liver cancer. Currently, percutaneous implantation guided by CT, nuclear magnetism or ultrasound can be adopted, which is safe and minimally invasive. However, the images of some patients with metastatic liver cancer show isodensity or iso-echo imaging under CT or ultrasound, which is easy to miss diagnosis and treatment, seriously affecting the quality of life of patients. A case of terminal cholangiocarcinoma of the biliary tract with metastasis to the liver was admitted to China-Japan Union Hospital of Jilin University. Ultrasound image showed iso-echo, and radio 125I seed implantation was performed under the guidance of contrast-enhanced ultrasound. The operation was completed according to the preoperative treatment plan.

Consistency study of FRACTURE sequence and CT in evaluating bone changes of knee and ankle / 中华放射学杂志

Objective:To explore the consistency of MRI fast field echo resembling a CT using restricted echo-spacing (FRACTURE) and CT in the evaluation of knee and ankle bone changes.Methods:From November 2020 to November 2021, seventeen patients who underwent CT and MRI FRACTURE examinations of knee joint or ankle joint in the First Affiliated Hospital of Dalian Medical University were retrospectively collected, including 14 patients with knee joint examinations and 3 patients with ankle joint examinations. According to the number of joint components, 80 components were included, including 14 for femur and patella, 17 for tibia and fibula, and 3 for talus, scaphoid, medial cuneiform, medial cuneiform, lateral cuneiform and calcaneus, respectively. The fracture, hyperosteogeny, and bone destruction of the joint bones were evaluated by two observers using CT and FRACTURE images, respectively. Kappa test was used to analyze the consistency of CT and FRACTURE images between observers in the evaluation of joint bone lesions.Results:The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by CT and FRACTURE images were 0.925 (0.823-1.027), 0.905 (0.799-1.011) and 0.895(0.752-1.038) respectively for observer 1, and were 0.963 (0.892-1.034), 0.933 (0.843-1.023) and 0.886 (0.731-1.041) respectively for observer 2. The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by observers 1 and 2 via CT images were 1.000 (1.000-1.000), 0.937(0.851-1.023) and 0.945 (0.839-1.051) respectively, and that by FRACTURE images were 0.962 (0.888-1.036), 0.966 (0.899-1.033) and 0.836 (0.656-1.016) respectively.Conclusion:For the evaluation of fracture, hyperosteogeny, and bone destruction of knee joint and ankle joint, MRI FRACTURE sequence is highly consistent with CT.

Application of echo-planar imaging correction in diffusion weighted imaging and diffusion tensor imaging of cervical spinal cord / 中华放射学杂志

Objective:To explore the value of echo-planar imaging correction (EPIC) for improving image quality of diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) of cervical cord.Methods:A total of 33 subjects (20 males, 13 females) were scanned on a 3.0 T MR scanner from January to March 2022, and the sequences included T 1WI, DWI and DTI (with and without corrections). Two observers delineated the regions of interest (ROIs) on the fused images of DWI and DTI with T 1WI before and after correction, and measured the average diffusion coefficient (ADC), fractional anisotropy (FA), and offset distance of ROIs between images with and without corrections. The subjective scores of image quality were also evaluated. The ICC or Kappa was used to test the consistency of the quantitative measurement and subjective scores by the two observers. The average values by the two observers would be used for subsequent analysis. The independent pair t-test and Wilcoxon test were used for comparison of objective measurements and Mann-Whitney U test was used for subjective image assessments between images with and without corrections. Results:The measurement data and the subjective scores of the two observers were in good agreement (ICC 0.912-0.999, Kappa 0.778-0.816). The independent sample t-test showed the subjective scores were significantly different for the DWI and DTI images between before and after geometry and/or ADC corrections. The ADC values of C6, the offset distances measured by DWI before and after correction of C4, C5, and C6 and subjective scores were significantly different ( P<0.05); The FA values of C1 and C3, ADC values of C1 and C3, offset distance of C4, C5 and C6 measured by DTI before and after correction and subjective scores were statistically significant ( P<0.001). Conclusion:EPI geometry correction and ADC value correction can significantly reduce geometric distortion, increase image quality, and thus improve the diagnosis accuracy of essential diseases.

Diagnostic value of transcranial substantia nigra ultrasound in Parkinson's disease and analysis of clinical characteristics of patients with different substantia nigra echoes / 中国现代医生

Objective To explore the diagnostic value of transcranial substantia nigra ultrasound in Parkinson's disease(PD)and the clinical characteristics of patients with different substantia nigra(SN)echoes.Methods Sixty patients with PD admitted to Yichun Hospital of Traditional Chinese Medicine from October 2020 to January 2023 were included in study group,and another 60 normal persons who received health examination in our hospital during the same period were included in control group.Both groups were examined by transcranial substantia nigra ultrasound.The SN high-echo area and ratio of total area of hyperechoic substantia nigra to total area of mesencephalon(S/M)of two groups were compared,and the positive rate of PD diagnosed by transcranial substantia nigra ultrasound was calculated.According to the intensity of SN echo,PD patients were divided into PD-SN-group and PD-SN+ group,and the clinical characteristics of patients with different SN echo were compared.Results The SN high-echo area and S/M of study group were significantly higher than those of control group(P<0.05).Transcranial substantia nigra ultrasound showed PD-SN-in 10 cases and PD-SN+ in 50 cases.The positive rate of PD diagnosed by transcranial substantia nigra ultrasound was 83.33%(50/60).There were statistically significant differences between PD-SN+ group and PD-SN-group in gender,age,H-Y stage,age of onset,score of mini mental status examination and score of Montreal cognitive assessment(P<0.05).Conclusion Transcranial substantia nigra ultrasound can better help clinical screening and detection of PD,and improve the positive detection rate of PD.

Tissue tracking of segmental strain as a predictor of provoked dynamic left ventricular outflow tract obstruction

Background: Left ventricular outflow tract obstruction (LVOTO) is commonly observed in patients with hypertrophic cardiomyopathy (HCM) or left ventricular hypertrophy (LVH). Some patients develop LVOTO provoked by physical exertion, and hence termed dynamic LVOTO (DLVOTO). However, its precise prevalence and mechanism are still unclear. Aim: Two-dimensional speckle tracking echocardiography (2D STE) seems to be helpful for the detection of early LV structural abnormalities. This study aimed to examine the possible role of segmental as well as global longitudinal strain in identifying DLVOTO non-HCM patients as detected by dobutamine stress echocardiography (DSE). Methods and results: Two hundred and fifty patients without structural heart disease had undergone conventional transthoracic echocardiography, 2D STE, and DSE. All patients with non-ischemic evidence were divided into two groups according to the DSE results; DLVOTO (þ) and DLVOTO (). Among 250 patients, 50 patients (36%) had shown DLVOTO after DSE (15 males, 35 females; mean age 55±7years). They were compared with 90 non -LVOTO obstruction patients (43 males, 47 females; mean age 57±6years). Based on multivariate logistic regression analysis, the independent predictors of provoked DLVOTO during DSE were resting basal septal longitudinal strain BS-LS average (p < 0.001), resting LA reservoir strain (p < 0.001), and systolic LVOT diameter (p ¼ 0.03). Resting BS-LS average with cut-off - 17.5% was recognized as a critical indicator of DLVOTO, with sensitivity 78%, and specificity 95% (better than systolic LVOT diameter of sensitivity 76%, and specificity 15% and resting LA reservoir strain which showed poor AUC at ROC curve 0.007). Conclusion: We demonstrate that provoked LVOTO during DSE in non HCM symptomatic patients is directly correlated to resting regional LS, where the increased BS-LS of 17.5% was a key determinant of LVOT gradient provocation. Assessment of baseline BS-LS average might be a bedside simple tool for detection of patients with DLVOTO not able to do DSE.

Transthoracic echocardiographic analysis of moderate to severe COVID-19 patients admitted to ICU at tertiary hospital in India

Background:To describe the transthoracic echocardiographic findings of moderate to severe COVID-19 patients admitted to ICU.Methods: We studied thetransthoracic echocardiographic findings performed within 48 hours on admission toICU of 426 moderate to severe COVID-19 patients from July 2020 to September 2020 during their course of treatment. Echocardiographic study included left ventricular (LV) systolic and diastolic function, left ventricle wall motion abnormalities and right ventricular (RV) assessment.Results: The median age of patients was 58.2 (range 19 to 92 years) and majority of patients were male (71%). Pre-existing comorbidities were reported in 95.5% of patient’s, majority being hypertension (42.7%) and diabetes mellitus (39.2%).Abnormal echo findings were noted in 40.8% (n=174) with majority of abnormal findingsnoted in age group of 60-69 (n=54), men (n=114) and in patients with pre-existing coronary artery disease (CAD)(n=28). The common pattern of cardiac abnormalities was LV systolic dysfunction (n=73, 17.1%), RV dysfunction (n=30, 7%) and abnormal PA pressures (n=144, 85.2%). Abnormal echo findings were noted in 46% of patients who died and 33.9% of patients who required hospital stay of more than 10 days.Conclusions:Forty percent of admitted patients to ICU had abnormal echocardiography findings with around eighty five percent of them having raised pulmonary artery pressure

Cardiac Tamponade in a Patient Supported by Veno?arterial Extracorporeal Membrane Oxygenation

Cardiac tamponade occurring in a patient supported on central veno?arterial extracorporeal membrane oxygenation is depicted in a transesophageal echocardiography image and associated rendering. Prompt recognition of tamponade, which can be assisted with echocardiography, and emergent evacuation is critical to restoring cardiovascular stability

Study of cardiac function in adults with dengue

Background: Medical literature has reports of isolated cases of atrioventricular conduction disorders, supraventricular arrhythmias, and myocarditis in dengue fever (DF).There is a paucity of data available in the published literature on the cardiac manifestations of DF from India. The aim of the present study was to assess the cardiac manifestations of DF. Methods: The140 patients aged ?18 years with DF confirmed with a serology-dengue non-structural protein 1 antigen-positivewere included for this prospective observational study. Three serial ECGs were taken on day one, day three and day seven or day of discharge. All the patients were evaluated using 2D echo on day one, day seven or day of discharge. The primary outcome measures were to find the incidence and type of echocardiographic abnormalities and electrocardiographic changes in dengue.Results: The incidence of cardiac abnormalities on ECG and 2D echo was 30 (21.4%), and 5 (7.0%) respectively. On ECG, 14 (10%) 9 (6.4%) 3 (2.1%) 3 (2.1%) and 1 (0.7%) patients had sinus bradycardia, sinus tachycardia, non-specific ST-T changes, right bundle branch block and atrio-ventricular block respectively. On 2D echo, 7 (5.0%), 5 (3.6%) and 1 (0.7%) patient had systolic dysfunction, ejection fraction (<45.0%) and diastolic dysfunctionrespectively. Conclusions: The incidence of cardiac abnormalities on ECG and 2D ECHO in dengue patients was considerable. ECG and 2 D echo should be undertaken in patients with DF.

Clinical features of LA/LAA spontaneous echo contrast and its relationship with LAD / 西安交通大学学报(医学版)

【Objective】 To analyze the clinical features of nonvalvular atrial fibrillation （NVAF） patients with left atrial/left atrial appendage spontaneous echo contrast （LA/LAASEC）， and investigate the correlation between LA/LAASEC and left atrial diameter. 【Methods】 Clinical data （including gender， age， and history of hypertension， diabetes， stroke or transient ischemic attack， vascular disease）， laboratory indexes （including coagulation indicators， blood routine， thyroid function）， and transthoracic echocardiogram parameters of 262 NVAF patients hospitalized in the Department of Cardiovascular Medicine of our hospital from November 2019 to January 2021 were collected and analyzed retrospectively. According to the results of transesophageal echocardiography， they were divided into control group and LA/LAASEC group. Logistic regression analysis was performed to investigate the influencing factors of LA/LAASEC. ROC curve analysis was used to evaluate the predictive value of left atrial diameter for LA/LAASEC. 【Results】 The proportion of non-paroxysmal atrial fibrillation was significantly higher in LA/LAASEC patients than the controls （65.9% vs. 32.2%， P<0.01）， and so was the CHA2DS2-VASC score （P=0.003）. Compared with the control group， left atrial diameter and left ventricular end-systolic/end-diastolic diameters were significantly increased， left ventricular ejection fraction was significantly decreased， and the level of NT-proBNP was significantly increased in LA/LAASEC group （P<0.05）. Logistic regression analysis showed that non-paroxysmal AF （OR=2.451， 95% CI： 1.260-4.766， P<0.05）， CHA2DS2-VASc score （OR=1.236， 95% CI： 1.023-1.494， P<0.05）， and left atrial diameter （OR=1.086， 95% CI： 1.019-1.157， P<0.05） were independent risk factors for LA/LAASEC. ROC curve analysis displayed that the AUC for left atrial diameter in predicting LA/LAASEC was 0.731 （95% CI： 0.668-0.794， P<0.001）. 【Conclusion】 Left atrial diameter is closely related to LA/LAASEC in NVAF patients. Combined with atrial fibrillation type and CHA2DS2-VASC score， it has a potential value in predicting the risk of thromboembolism in NVAF patients.

Exosomal miR-152-5p and miR-3681-5p function as potential biomarkers for ST-segment elevation myocardial infarction

Abstract Background: The strain parameters of Real-Time Three-Dimensional Spot Tracking Echocardiography (RT3D-STE) are GLS, GAS, GRS, and GCS, while each index can significantly diagnose Acute Myocardial Infarction (AMI) patients, but none of them can distinguish between NSTEMI and STEMI. MicroRNAs (miRNAs) play essential roles in Acute Myocardial Infarction (AMI), but little is known about the value of exosome miRNA combined with RealTime Three-Dimensional Spot Tracking Echocardiography (RT3D-STE) between ST-segment Elevation Myocardial Infarction (STEMI) and Non-ST-segment Elevation Myocardial Infarction (NSTEMI). Aim: To estimate the exosomal miRNAs related to strain parameters of RT3D-STE as biomarkers for early detection of STEMI and NSTEMI. Methods: The present study collected plasma samples from thirty-four (34) patients with AMI (including STEMI and NSTEMI) and employed high-throughput sequence technology and real-time quantitative polymerase chain reaction (RT-qPCR) to identify the differentially expressed miRNAs. The Pearson correlation coefficient is used to measure the strength of a linear association between differentially expressed miRNAs and strain parameters of RT3D-STE. Results: Twenty-eight (28) differentially expressed exosomal miRNAs were universally identified between STEMI, NSTEM, and normal groups. Among them, there are 10 miRNAs (miR-152-5p, miR-3681-5p, miR-193a-5p, miR-193b-5p miR-345-5p, miR-125a-5p, miR-365a-3p, miR-4520-2-3p, hsa-miR-193b-3p and hsa-miR-5579-5p) with a Pearson correlation greater than 0.6 with RT3D-STE strain parameters. Especially, miR-152-5p and miR-3681-5p showed the most significant correlation with RT3D-STE strain parameters. Target genes of these 10 miRNAs are analyzed for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways enrichment, and they were found to be mainly involved in the cellular metabolism processes and HIF-1 signaling pathway. RT-qPCR verified the significant differential expression of miR-152-5p and miR-3681-5p between STEMI and NSTEM groups. Conclusion: RT3D-STE and exosome miRNAs can be used as a hierarchical diagnostic system in AMI. If the RT3D-STE is abnormal, the exosome miRNAs can be detected again to obtain more detailed and accurate diagnostic results between STEMI and NSTEM groups. Exosomal miR-152-5p and miR-3681-5p may serve as potential biomarkers for ST-segment elevation myocardial infarction. HIGHLIGHTS RT3D-STE and exosome miRNAs can be used as a hierarchical diagnostic system in AMI. Exosomal miR-152-5p and miR-3681-5p function as potential biomarkers for ST-segment elevation myocardial infarction.

Chamado de Eco: a escuta de vozes silenciadas / Echo's Calling: listening to silenced voices / Llamada del Eco: la escuta de voces silenciadas

O presente trabalho tem por objetivo dar atenção a vozes silenciadas. Pelo levantamento de estudos em Psicologia Analítica sobre a figura mitológica de Eco e de Estudos Literários que correlacionam silenciamento e psicologia, buscou-se compreender o que leva ao silenciamento imposto. Foi possível compreender que o olhar hegemônico para Eco e para o Outro os coloca numa posição de pouco valor, algo também encontrado em discursos de resistência e narrativas testemunhais na área da Literatura, especialmente quando o encontro com o Outro parece ser ameaçador.

The present study aims to pay attention to silenced voices. By surveying studies in Analytical Psychology about the mythological figure of Echo and Literary Studies that correlate silencing and psychology, we sought to understand what leads to imposed silencing.It was possible to understand that looking at Echo e the Other through hegemonic lenses places them in a position of little worth and value, something that also appeared in resistance speech and testimonial narratives in the field of Literature, especially when the encounter with the Other seems to be threatening.

Este artículo tiene com objetivo prestar atención a las voces silenciadas. Al relevar estudios en Psicología Analítica sobre la figura mitológica de Eco y Estudios Literarios que correlacionan el silenciamiento y la psicología, buscamos comprender qué lleva al silenciamiento impuesto. Se pudo entender que la mirada hegemónica a Eco y al Otro los coloca en una posición de poco valor, algo que también se encuentra en los discursos de resistencia y las narrativas testimoniales en el campo de la literatura, especialmente cuando el encuentro con el Otro parece amenazador.

The application of magnetic resonance imaging-guided microwave ablation for lung cancer

Context: It is necessary to explore a minimally invasive, effective, and efficient treatment for those lung cancer patients who are poor candidates for surgery. Aim: This study aimed to investigate the application of microwave ablation (MWA) in the treatment of lung cancer. Settings and Design: A total of 43 patients with 44 pulmonary lesions were examined following identical procedures before being randomly divided into two groups. The experimental group consists of 17 patients with a total of 18 pulmonary lesions, while the control group consists of 26 patients with a total of 26 pulmonary lesions. Materials and Methods: The experimental group was treated using magnetic resonance imaging (MRI)-guided MWA while the control group was treated using computer tomography (CT)-guided MWA. A transverse relaxation time-turbo spin echo (T2-TSE) sequence was used for signal collection in the experimental group to determine puncture location and microwave needle position while T2-TSE, T1-turbo field echo, and diffusion-weighted MRI (DWI) sequences were used for timely efficacy evaluation. Whereas in the control group, CT axial scanning was performed to serve similar purposes. Statistical Analysis Used: A nonparametric Wilcoxon test, median (M [25%, 75%]). Results: All of the 44 lesions were successfully located on the first attempt. The mean time for scanning and locating lung lesions under MRI and CT guidance were 64.53 and 42.96 min, the mean times of positioning were 12 and 18 min, and the mean durations of MWA were 12.48 and 15.06 min, respectively. Conclusions: As a minimally invasive method for treating lung tumors, MRI-guided MWA requires fewer localization scans, a shorter MWA duration, no radiation, real-time observation of the curative effect, and it prevents overtreatment