Altered Brain Glymphatic Function at Diffusion-Tensor MRI in Pre-cirrhotic Metabolic Dysfunction-Associated Fatty Liver Disease.

RATIONALE AND OBJECTIVES: To evaluate glymphatic function changes and their relationships with clinical features in patients with metabolic dysfunction-associated fatty liver disease (MAFLD), thereby facilitating early intervention before this disease progresses to cirrhosis. MATERIALS AND METHODS: A cross-sectional cohort of 46 pre-cirrhotic MAFLD patients and 30 age-, sex-, and education-matched controls was enrolled, with diffusion-tensor imaging (DTI) data, laboratory and neurocognitive scores collected. The DTI analysis along the perivascular space (DTI-ALPS) index was computed for qualifying glymphatic function. Generalized linear model and partial correlation analyses were applied to evaluate relationships between the ALPS index and clinical variables. RESULTS: MAFLD group exhibited a decreased ALPS index and increased diffusivity along the y-axis in the projection fiber compared to the controls. The altered ALPS index was associated with clock drawing test (CDT) score (3.931 [0.914, 6.947], P = 0.011) and was correlated with diastolic pressure level (r = -0.315, P = 0.033) in MAFLD group. The relationships of ALPS index with CDT score (6.263 [2.069, 10.458], P = 0.003) and diastolic pressure level (r = -0.518, P = 0.014) remained in the MAFLD with metabolic syndrome (MetS) group. Furthermore, the ALPS index was even associated with Auditory Verbal Learning Test-Immediate recall score (-23.853 [-45.417, -2.289], P = 0.030) in MAFLD with MetS group. CONCLUSION: MAFLD patients may have a glymphatic dysfunction prior to cirrhosis, and this alteration may be related to cognition and diastolic pressure. Glymphatic dysfunction has a more severe impact on cognition when MAFLD patient is accompanied by MetS.

[Modified palatoplasty for children of Pierre Robin sequence with cleft palate：clinical analysis of 12 consecutive cases].

PURPOSE: To explore a safe, effective and functional surgical treatment for children of Pierre Robin sequence (PRS) with cleft palate. METHODS: Twelve children of PRS with cleft palate underwent mandibular distraction osteogenesis before cleft palate surgery in order to correct severe hypoxia. A modified palatoplasty was then performed, the palatal flaps on both sides were not elevated in the anterior portions to prevent soft palate backward moving, and the levator veli palatini was repositioned simultaneously. RESULTS: All children achieved velopharyngeal closure without dyspnea after follow-up of 10-12 months. CONCLUSIONS: Measures should be taken to avoid backward movement of the soft palate, which may result in dyspnea of children with PRS in palatoplasty.

What is the optimal cutoff value of the axis-line-angle technique for evaluating trunk imbalance in coronal plane?

BACKGROUND CONTEXT: Accurately evaluating the extent of trunk imbalance in the coronal plane is significant for patients before and after treatment. We preliminarily practiced a new method, axis-line-angle technique (ALAT), for evaluating coronal trunk imbalance with excellent intra-observer and interobserver reliability. Radiologists and surgeons were encouraged to use this method in clinical practice. However, the optimal cutoff value of the ALAT for determination of the extent of coronal trunk imbalance has not been calculated up to now. PURPOSE: The purpose of this study was to identify the cutoff value of the ALAT that best predicts a positive measurement point to assess coronal balance or imbalance. STUDY DESIGN/SETTING: A retrospective study at a university affiliated hospital was carried out. PATIENT SAMPLE: A total of 130 patients with C7-central sacral vertical line (CSVL) >0 mm and aged 10-18 years were recruited in this study from September 2013 to December 2014. OUTCOME MEASURES: Data were analyzed to determine the optimal cutoff value of the ALAT measurement. METHODS: The C7-CSVL and ALAT measurements were conducted respectively twice on plain film within a 2-week interval by two radiologists. The optimal cutoff value of the ALAT was analyzed via receiver operating characteristic (ROC) curve. Comparison variables were performed with chi-square test between the C7-CSVL and ALAT measurements for evaluating trunk imbalance. Kappa agreement coefficient method was used to test the intra-observer and interobserver agreement of C7-CSVL and ALAT. RESULTS: The ROC curve area for the ALAT was 0.82 (95% confidence interval: 0.753-0.894, p<.001). The maximum Youden index was 0.51, and the corresponding cutoff point was 2.59°. No statistical difference was found between the C7-CSVL and ALAT measurements for evaluating trunk imbalance (p>.05). Intra-observer agreement values for the C7-CSVL measurements by observers 1 and 2 were 0.79 and 0.91 (p<.001), respectively, whereas intra-observer agreement values for the ALAT measurements were both 0.89 by observers 1 and 2 (p<.001). The interobserver agreement values for the first and second measurements with the C7-CSVL were 0.78 and 0.85 (p<.001), respectively, whereas the interobserver agreement values for the first and second measurements with the ALAT were 0.91 and 0.88 (p<.001), respectively. CONCLUSIONS: The newly developed ALAT provided an acceptable optimal cutoff value for evaluating trunk imbalance in the coronal plane with a high level of intra-observer and interobserver agreement, which suggests that the ALAT is suitable for clinical use.

[Relationship between gestational age and apparent diffusion coefficient values in different regions of fetal brain from middle to late trimester].

OBJECTIVE: To analyze the relationship between gestational age and apparent diffusion coefficient (ADC) values in different regions of fetal brain from middle to late trimester. METHODS: DW images performed in 70 singleton non-sedated fetuses with questionably abnormal results on sonography and normal fetal MR imaging results were retrospectively reviewed. The median gestational age was 32.4 weeks (range, 24-38).With the formula of ADC = ln (S600/S0)/(B0-B600), the mean ADC values were obtained for fetal parietal white matter (WM), frontal WM, temporal WM, occipital WM, pons, cerebellum, basal ganglia and thalamus. The relationship of mean ADC values in different regions with gestational age was analyzed with linear regression. RESULTS: The mean ADC values were 1.77 ± 0.32 mm(2)/s (SD) in fetal parietal white matter (WM), 1.71 ± 0.32 mm(2)/s in occipital WM, 1.31 ± 0.18 mm(2)/s in thalamus, 1.34 ± 0.15 mm(2)/s in basal ganglia. And the mean ADC values in cerebellum, pons, frontal WM and temporal WM were 1.17 ± 0.16, 1.41 ± 0.18, 1.87 ± 0.18 and 1.74 ± 0.19 mm(2)/s respectively. A significant negative correlation between ADC values and gestational age was found for parietal WM, occipital WM, pons, cerebellum, basal ganglia and thalamus (P < 0.05). Frontal WM ADC (P > 0.05) and temporal WM ADC (P = 0.05) did not significantly change with gestational age whereas only a downward trend was present. The correlation coefficient (r) and coefficient of regression (b) were 0.420 and -0.045 in parietal WM; 0.470 and -0.052 in occipital WM; 0.370 and -0.027 in cerebellum; 0.027 and -0.020 in pons; 0.320 and -0.027 in thalamus; 0.300 and -0.021 in basal ganglia. The mean ADC values peaked in frontal WM and lowest in pons. The mean ADC values in white matter were higher than those in deep gray nuclei, cerebellum and pons.With the development of fetal brain,ADC values declined the fastest in cerebellum and occipital WM, followed by basal ganglia and thalamus. CONCLUSION: Regional differences in non-sedated fetal brain ADC values and their evolutions with gestational age are likely to reflect variations in brain maturation.

Pulsed laser deposition of ITO/AZO transparent contact layers for GaN LED applications.

In this study, indium-tin oxide (ITO)/Al-doped zinc oxide (AZO) composite films were fabricated by pulsed laser deposition and used as transparent contact layers (TCLs) in GaN-based blue light emitting diodes (LEDs). The ITO/AZO TCLs were composed of the thin ITO (50 nm) films and AZO films with various thicknesses from 200 to 1000 nm. Conventional LED with ITO (200 nm) TCL prepared by E-beam evaporation was fabricated and characterized for comparison. From the transmittance spectra, the ITO/AZO films exhibited high transparency above 90% at wavelength of 465 nm. The sheet resistance of ITO/AZO TCL decreased as the AZO thickness increased, which could be attributed to the increase in a carrier concentration, leading to a decrease in the forward bias of LED. The LEDs with ITO/AZO composite TCLs showed better light extraction as compared to LED with ITO TCL in compliance with simulation. When an injection current of 20 mA was applied, the output power for LEDs fabricated with ITO/AZO TCLs had 45%, 63%, and 71% enhancement as compared with those fabricated using ITO (200 nm) TCL for the AZO thicknesses of 200, 460, and 1000 nm, respectively.

Ionothermal synthesis of layered zirconium phosphates and their tribological properties in mineral oil.

In an attempt to synthesize novel zirconium phosphate materials, a series of syntheses have been performed in a deep eutectic solvent (DES), composed of tetrapropylammonium bromide (TPABr) and oxalic acid. As a result, this DES does not act as a template provider in reaction probably owing to the steric effects of the longer chains of the TPA cation, and only the α-Zr(HPO(4))(2)·H(2)O (α-ZrP) phase has been achieved. However, after organic amine was added to the initial reaction mixture in a normal way, the additives did act as a template to induce the zirconium phosphate framework. For example, with 1,4-dimethylpiperazine as an additive, a novel layered compound, [C(6)H(16)N(2)](0.5)Zr(H(0.5)PO(4))(2)·H(2)O (denoted as ZrPO(4)-DES8) was obtained. Its structure was determined from single-crystal X-ray diffraction (XRD) data and consists of zirconium phosphate layers with the protonated 1,4-dimethylpiperazine and water molecules in between. Interestingly, the two layered materials as additives in a liquid lubricant exhibit excellent friction behavior with higher load-carrying and antiwear capacities in comparison to typical lubricant additives such as MoS(2) and graphite, increase the P(B) value of the base oil by 27.2% and 8.5%, and decrease the wear scar diameter of the base oil by 43% and 36%, respectively. Scanning electron microscopy, XRD, and energy-dispersive X-ray spectrometry are used to investigate the lubricant behavior of those materials.

Arterial chemotherapy and conformal radiation abolish malignant biliary obstruction.

Malignant biliary obstruction has been a challenge to clinical practitioners, especially when it is serious and complete. Chemotherapy or radiation alone is often unsuccessful. In this study, the authors report a 59-year-old patient with complete common bile duct obstruction caused by cholangiocarcinoma who was treated with arterial chemotherapy followed by 3-dimensional conformal radiation, which resulted in a good clinical outcome.

[Impact of skin build-up region on evaluation of irradiation plan of radiotherapy for early stage breast cancer].

BACKGROUND & OBJECTIVE: Intensity-modulated radiation therapy (IMRT) can improve the dose distribution in the breast irradiation for early stage breast cancer, but the definition and delineation for clinical target volume (CTV) are uncertain. This study was to investigate the impact of skin build-up region on evaluation of IMRT plan for early stage breast cancer by analyzing dose-volume histograms (DVHs). METHODS: CTVs for 22 patients with early stage breast cancer were delineated on transversal CT images, which included the skin build-up region. The CTVs were contracted and modified to exclude 0.5 cm outer skin surface to form new target volumes (CTV1s). All plans were tailored by using step-and-shoot IMRT techniques. DVHs and dose distributions of these plans were evaluated. RESULTS: The percentage volume receiving more than 95% of the prescription dose (V95) for CTV was significantly lower than that for CTV1 [(89.6+/-3.2)% vs. (96.5+/-2.0)%, P<0.001]. The homogeneity index of the dose distribution within targets (D99-01) for CTV was significantly higher than that for CTV1 [(14.0+/-2.4) Gy vs. (7.3+/-1.6) Gy, P<0.001]. CONCLUSIONS: The surface effect of skin build-up region is important and must be considered in IMRT for breast cancer. It is better to use the CTV excluding surface and build-up region to evaluate such plans.