Magnetic resonance fingerprinting in multiple sclerosis.

BACKGROUND: In this cross sectional study, we used MRF to investigate tissue properties of normal-appearing white matter, gray matter, and lesions in relapsing remitting MS (n = 21), secondary progressive MS (n = 16) and healthy controls (n = 9). A FISP-based MRF sequence was used for acquisition, imaging time 5 min 15 s. MRF T1 and T2 relaxation times were measured from lesional tissue, normal-appearing frontal white matter, corpus callous, thalamus, and caudate. Differences between healthy controls and MS were examined using ANCOVA adjusted for age and sex. Spearman rank correlations were assessed between T1 and T2 relaxation times and clinical measures. OBJECTIVES: To examine brain T1 and T2 values using magnetic resonance fingerprinting (MRF) in healthy controls and MS. METHODS: The subjects included 21 relapsing-remitting (RR) MS, 16 secondary progressive (SP) MS, and 9 age- and sex-matched HC without manifest neurological disease participating in a longitudinal MRI study. A 3T/ FISP-based MRF sequence was acquired. Regions of interest were drawn for lesions and normal appearing white matter. ANCOVA adjusted for age and sex were used to compare the groups with significance set at 0.05. RESULTS: A step-wise increase in T1 and T2 relaxation times was found between healthy controls, relapsing remitting MS, and secondary progressive MS. Significant differences were found in T1 and T2 between MS and healthy controls in the frontal normal-appearing white matter, corpus callosum, and thalamus (p < 0.04 for all). Significant differences in T1 and T2 between RR and SPMS were found in the frontal normal-appearing white matter and T2 lesions (p < 0.02 for all). T1 relaxation from the frontal normal-appearing white matter correlated with the Expanded Disability Status Scale [ρ = 0.62, p < 0.001], timed 25 foot walk (ρ = 0.45, p = 0.01), 9 hole peg test (ρ = 0.62, p < 0.001), and paced auditory serial addition test (ρ = -0.4, p = 0.01). CONCLUSION: These results suggest that MRF may be a clinically feasible quantitative approach for characterizing tissue damage in MS.

A case report of angiosarcoma of the tongue: A diagnostic dilemma at presentation.

Rationale: Angiosarcoma is a malignant mesenchymal tumor arising from vascular endothelial cells. This is an aggressive malignancy associated with poor prognosis. Angiosarcoma in the head and neck is exceedingly rare, accounting for less than 4 % of tumors.[1]. Patient Concern: We report a unique case of angiosarcoma involving the tongue underlying the diagnostic conundrum and pointers towards an accurate diagnosis. Take-away lesson: Due to rarity of the disease, consensus on optimal treatment approach is lacking and multicenter prospective studies would be helpful to set clinical guidelines.

Residential Water Softeners Release Carbon, Consume Chlorine, and Require Remediation after Hydrocarbon Contamination.

Water quality impacts of new ion exchange point-of-entry residential softeners and their ability to be decontaminated following hydrocarbon exposure were investigated. During startup, significant amounts of total sulfur (445 ± 815 mg/L) and total organic carbon (937 ± 119 mg/L) were released into the drinking water that flowed through the softeners. Particulate organic carbon was released until the third regeneration cycle, and resin may also have been released. After one week of device use, softeners continued to cause organic carbon levels to be four to five times greater than background levels. Leached materials from the ion-exchange resin contributed to chlorine decay. When resins were exposed to hydrocarbon-contaminated water, they sorbed benzene, toluene, ethylbenzene, and xylenes (BTEX) and then desorbed the contaminants into drinking water during a 15 day flushing decontamination period. On day 15, benzene exceeded the federal drinking water limit for two of the four resins. The aged resin contributed to the greatest chlorine decay rates and sorbed and then retained the least amount of BTEX. Scale and biofilm on the aged resin likely prompted disinfectant reactivity and inhibited BTEX diffusion into the resin. Study results show that softeners exposed to hydrocarbon-contaminated water may need to be repeatedly flushed to remove BTEX contamination or be replaced. Additional work is recommended to better understand softener impacts on drinking water quality.

Evaluation of Workplace Exposures to Volatile Chemicals During COVID-19 Building Disinfection Activities with Proton Transfer Reaction Mass Spectrometry.

We conducted an experimental case study to demonstrate the application of proton transfer reaction time-of-flight mass spectrometry (PTR-TOF-MS) for mobile breathing zone (BZ) monitoring of volatile chemical exposures in workplace environments during COVID-19 disinfection activities. The experiments were conducted in an architectural engineering laboratory-the Purdue zero Energy Design Guidance for Engineers (zEDGE) Tiny House, which served as a simulated workplace environment. Controlled disinfection activities were carried out on impermeable high-touch indoor surfaces, including the entry door, kitchen countertop, toilet bowl, bathroom sink, and shower. Worker inhalation exposure to volatile organic compounds (VOCs) was evaluated by attaching the PTR-TOF-MS sampling line to the researcher's BZ while the disinfection activity was carried out throughout the entire building. The results demonstrate that significant spatiotemporal variations in VOC concentrations can occur in the worker's BZ during multi-surface disinfection events. Application of high-resolution monitoring techniques, such as PTR-TOF-MS, are needed to advance characterization of worker exposures towards the development of appropriate mitigation strategies for volatile disinfectant chemicals.

A systematic approach to CT evaluation of non-arthritic hip pain.

Bone morphology has been increasingly recognized as a significant variable in the evaluation of non-arthritic hip pain in young adults. Increased availability and use of multidetector CT in this patient population has contributed to better characterization of the osseous structures compared to traditional radiographs. Femoral and acetabular version, sites of impingement, acetabular coverage, femoral head-neck morphology, and other structural abnormalities are increasingly identified with the use of CT scan. In this review, a standard CT imaging technique and protocol is discussed, along with a systematic approach for evaluating pelvic CT imaging in patients with non-arthritic hip pain.

Review of spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO): What radiologists need to know about CRMO and its imitators.

We appreciate the comments written regarding our paper, "Review of spinal involvement in Chronic recurrent multifocal osteomyelitis (CRMO): What radiologists need to know about CRMO and its imitators". In this paper, we review multiple categories of mimics of CRMO. Although we do mention infectious etiology as a group, we did not specifically mention tuberculosis affecting the spine which is an important mimic of CRMO, and we acknowledge this omission.

Review of spinal involvement in Chronic recurrent multifocal osteomyelitis (CRMO): What radiologists need to know about CRMO and its imitators.

Chronic recurrent multifocal osteomyelitis (CRMO) is a distinct disease entity of unknown etiology primarily affecting children and adolescents. It is an autoinflammatory process that typically affects multiple bones with a waxing and waning course. About one third of the patients diagnosed with CRMO have spinal involvement which can lead to long term morbidity. The clinical presentation and imaging features of CRMO involving the spine are nonspecific and can mimic other disease processes like infection or malignancy. Since imaging plays a very important role in the diagnosis and management of CRMO, we intend to highlight various imaging patterns of spinal CRMO alongside its clinical features and briefly discuss its imitators, management and outcomes.

Influence of dissolved organic matter on carbonyl sulfide and carbon disulfide formation from dimethyl sulfide during sunlight photolysis.

Carbonyl sulfide (COS) and carbon disulfide (CS2 ) are important atmospheric gases photochemically generated from organic sulfur precursors in sunlit natural waters. This study examined these processes by evaluating COS and CS2 photoproduction from dimethyl sulfide (DMS) in the presence of dissolved organic matter (DOM). DOM was added because it photochemically produces various reactive intermediates (3 CDOM*, • OH, 1 O2 , and H2 O2 ) potentially involved in these reaction pathways. DMS-amended synthetic waters at pH 8 were varied in terms of their DOM type and concentration, spiked with the 3 CDOM* quenching agent, phenol, in certain cases, and subsequently irradiated over varying exposure times. Results indicated that various DOM types ranging from freshwater to open-ocean DOM increased COS but did not alter CS2 , which remained at nondetect levels. DOM type influenced COS only at higher concentrations (20 mg/L), whereas increasing DOM concentrations proportionally increased COS concentrations for all DOM types. Phenol addition lowered COS formation for reasons that remained unclear because phenol likely quenched 3 CDOM* and DMS-derived sulfur-based radicals. Further comparisons with DMS-spiked natural waters and cysteine (CYS)-spiked synthetic and natural waters assessed previously indicated that COS formation from both precursors in natural waters was always greater than in waters containing DOM alone. PRACTITIONER POINTS: DMS- and DOM-spiked synthetic waters formed COS but did not form CS2 during sunlight photolysis. In DMS-spiked synthetic solutions, DOM type has a limited influence on COS formation whereas DOM concentration has a stronger influence on COS formation. COS formation in the DMS-spiked synthetic waters was fairly proportional to the DOC concentration but was generally lower than COS formation in DMS-spiked natural waters.

Reactivity of the Polyamide Membrane Monomer with Free Chlorine: Role of Bromide.

Aromatic polyamide-based membranes are widely used for reverse osmosis (RO) and nanofiltration (NF) treatment but degrade when exposed to free chlorine (HOCl/OCl-). The reaction mechanisms with free chlorine were previously explored, but less is known about the role of bromide (Br-) in these processes. Br- may impact these reactions by reacting with HOCl to form HOBr, which then triggers other brominating agents (Br2O, Br2, BrOCl, and BrCl) to form. This study examined the reactivities of these brominating agents with a polyamide monomer model compound, benzanilide (BA), and a modified version of it, N-CH3-BA. The results indicated that all these brominating agents only attacked the aromatic ring adjacent to the amide N, rather than the amide N, different from the previously examined chlorinating agents (HOCl, OCl-, and Cl2) that attacked both sites. Orton rearrangement was not observed. Species-specific rate constants (ki, M-1 s-1) between BA and HOBr, Br2O, Br2, BrOCl, and BrCl were determined to be (5.3 ± 1.2) × 10-2, (1.2 ± 0.4) × 101, (3.7 ± 0.2) × 102, (2.2 ± 0.6) × 104, and (6.6 ± 0.9) × 104 M-1 s-1, respectively, such that kBrCl > kBrOCl > kBr2 > kBr2O > kHOBr. N-CH3-BA exhibited lower reactivity than BA. Model predictions of BA loss during chlorination with varied Br- and/or Cl- concentrations were established. These findings will ultimately enable membrane degradation and performance loss following chlorination in mixed halide solutions to be better predicted during pilot- and full-scale NF and RO treatment.

Ethanol-based disinfectant sprays drive rapid changes in the chemical composition of indoor air in residential buildings.

The COVID-19 pandemic has resulted in increased usage of ethanol-based disinfectants for surface inactivation of SARS-CoV-2 in buildings. Emissions of volatile organic compounds (VOCs) and particles from ethanol-based disinfectant sprays were characterized in real-time (1 Hz) via a proton transfer reaction time-of-flight mass spectrometer (PTR-TOF-MS) and a high-resolution electrical low-pressure impactor (HR-ELPI+), respectively. Ethanol-based disinfectants drove sudden changes in the chemical composition of indoor air. VOC and particle concentrations increased immediately after application of the disinfectants, remained elevated during surface contact time, and gradually decreased after wiping. The disinfectants produced a broad spectrum of VOCs with mixing ratios spanning the sub-ppb to ppm range. Ethanol was the dominant VOC emitted by mass, with concentrations exceeding 103 µg m-3 and emission factors ranging from 101 to 102 mg g-1. Listed and unlisted diols, monoterpenes, and monoterpenoids were also abundant. The pressurized sprays released significant quantities (104-105 cm-3) of nano-sized particles smaller than 100 nm, resulting in large deposited doses in the tracheobronchial and pulmonary regions of the respiratory system. Inhalation exposure to VOCs varied with time during the building disinfection events. Much of the VOC inhalation intake (>60 %) occurred after the disinfectant was sprayed and wiped off the surface. Routine building disinfection with ethanol-based sprays during the COVID-19 pandemic may present a human health risk given the elevated production of volatile chemicals and nano-sized particles.

Influence of dissolved organic matter on carbonyl sulfide and carbon disulfide formation from cysteine during sunlight photolysis.

Carbonyl sulfide (COS) and carbon disulfide (CS2) are important atmospheric gases that are formed from organic sulfur precursors present in natural waters when exposed to sunlight. However, it remains unclear how specific water constituents, such as dissolved organic matter (DOM), affect COS and CS2 formation. To better understand the role of DOM, irradiation experiments were conducted in O2-free synthetic waters containing four different DOM isolates, acquired from freshwater to open ocean sources, and the sulfur-based amino acid, cysteine (CYS). CYS is a known natural precursor of COS and CS2. Results indicated that COS formation did not vary strongly with DOM type, although small impacts were observed on the kinetic patterns. COS formation also increased with increasing CYS concentration but decreased with increasing DOM concentration. Quenching experiments indicated that ˙OH was not involved in the rate-limiting step of COS formation, whereas excited triplet states of DOM (3CDOM*) were plausibly involved, although the quenching agents used to remove 3CDOM* may have reacted with the CYS-derived intermediates as well. CS2 was not formed under any of the experimental conditions. Overall, DOM-containing synthetic waters had a limited to no effect towards forming COS and CS2, especially when compared to the higher concentrations formed in sunlit natural waters, as examined previously. The reasons behind this limited effect need to be explored further but may be due to the additional water quality constituents present in these natural waters. The findings of this study imply that multiple variables beyond DOM govern COS and CS2 photoproduction when moving from freshwaters to open ocean waters.

Reminder of an important clinical lesson: breast cancer metastasis to the parotid gland.

A 59-year-old woman presented to an otolaryngology clinic with an 8-week history of a painless lump over her left parotid gland. Her medical history included an invasive ductal carcinoma (33 mm) and a ductal carcinoma in situ (70 mm) of the right breast, for which she had a mastectomy and various adjuvant therapies. The primary tumour presented 8 years prior to the metachronous metastasis. This patient was a non-smoker and had no significant family history. Post-superficial parotidectomy pathology revealed the parotid gland tumour to be oestrogen receptor-positive and HER2 receptor-positive, thus ruling out the initial differential diagnosis of a pleomorphic adenoma. A consequential total parotidectomy with a posterolateral neck dissection was performed with sparing of the facial nerve. The patient recovered well having only encountered a self-resolving salivary fistula. She portrayed no signs of facial nerve palsy and subsequent imaging scans showed no abnormalities.

Reactivity of the Polyamide Membrane Monomer with Free Chlorine: Reaction Kinetics, Mechanisms, and the Role of Chloride.

Aromatic polyamide thin-film composite membranes are widely used in reverse osmosis (RO) and nanofiltration (NF) due to their high water permeability and selectivity. However, these membranes undergo biofouling and can degrade and eventually fail during free chlorine exposure. To better understand this effect, the reactivity of the polyamide monomer (benzanilide (BA)) with free chlorine was tested under varying pH and chloride (Cl-) conditions. The kinetic results indicated that the current existing mechanisms, especially the Orton rearrangement, were invalid. Revised reaction pathways were proposed where BA chlorination was driven by two independent pathways involving the anilide ring and amide nitrogen moieties. The ability for one moiety to be chosen over the other was highly dependent on the pH, Cl- concentration, and the resulting chlorinating agents (e.g., Cl2, HOCl, OCl-, and Cl2O) generated. Species-specific rate constants for BA with Cl2, OCl-, and HOCl equaled (7.6 ± 0.19) × 101, (1.7 ± 1.5) × 101, (2.1 ± 0.71) × 10-2 M-1 s-1, respectively. A similar value for Cl2O could not be accurately estimated under the tested conditions. The behavior of these chlorinating agents differed for each reactive site such that OCl- > HOCl for N-chlorination and Cl2 > HOCl > OCl- for anilide ring chlorination. Experiments with modified monomers indicated that substituent placement largely affected which reactive site was kinetically favorable. Overall, such findings provide a predictive model of how the polyamide monomer degrades during chlorine exposure and guidance on how chlorine-resistant polyamide membranes should be designed.

Dentinogenic ghost cell tumor - A case report and review of literature.

Dentinogenic ghost cell tumor (DGCT) was first described by Praetorius et al. in 1981 and now believed to be the tumor counterpart of the calcifying odontogenic cyst (COC). DGCT is an extremely rare odontogenic tumor and accounts for only 2% to 14% of all COCs. A case of DGCT in a 40-year-old female patient is being reported.

Formation of brominated trihalomethanes during chlorination or ozonation of natural organic matter extracts and model compounds in saline water.

Oxidation experiments (chlorine, ozone and bromine) were carried out with synthetic saline waters containing natural organic matter (NOM) extracts and model compounds to evaluate the potential of these surrogates to mimic the formation of brominated trihalomethanes (Br-THMs) in natural saline waters. Synthetic saline water with Pony Lake fulvic acid (PLFA) showed comparable results to natural brackish and sea water for Br-THMs formation during chlorination and ozonation for typical ballast water treatment conditions ([Cl2]0 ≥ 5 mg/L or [O3]0 ≥ 3 mg/L). The molar CHBr3 yield in synthetic saline waters is higher for chlorination than for ozonation, since ozone reacts slower with bromide and faster with THM precursors. For bromination, the molar yields of CHBr3 for the NOM model compounds phenol, resorcinol, 3-oxopentanedioic acid and hydroquinone are 28, 62, 91 and 11%, respectively. CHBr3 formation is low during chlorination or ozonation of resorcinol-containing synthetic saline waters due to the faster reaction of resorcinol with these oxidants compared to the bromine formation from bromide. Oxidation experiments with mixtures of hydroquinone and phenol (or resorcinol) were conducted to mimic various functional groups of NOM reacting with Cl2 (or O3) in saline water. With increasing hydroquinone concentrations, the CHBr3 formation increases during both chlorination and ozonation of the mixtures, except for chlorination of the mixture of hydroquinone and resorcinol. The formation of THMs during chlorination of the mixture of hydroquinone and resorcinol is similar to that of resorcinol alone due to the much faster reaction of HOX with resorcinol compared to hydroquinone. In general, PLFA seems to be a reasonable DOM surrogate to simulate CHBr3 formation for realistic ballast water treatment. During chlorination, CHBr3 formations from phenol- and PLFA-containing synthetic brackish waters are comparable, for similar phenol contents.

Indirect Photochemical Formation of Carbonyl Sulfide and Carbon Disulfide in Natural Waters: Role of Organic Sulfur Precursors, Water Quality Constituents, and Temperature.

Carbonyl sulfide (COS) and carbon disulfide (CS2) are volatile sulfur compounds that are critical precursors to sulfate aerosols, which enable climate cooling. COS and CS2 stem from the indirect photolysis of organic sulfur precursors in natural waters, but currently the chemistry behind how this occurs remains unclear. This study evaluated how different organic sulfur precursors, water quality constituents, which can form important reactive intermediates (RIs), and temperature affected COS and CS2 formation. Nine natural waters ranging in salinity were spiked with cysteine, cystine, dimethylsulfide (DMS), or methionine and exposed to simulated sunlight over varying times and water quality conditions. Results indicated that COS and CS2 formation increased up to 11× and 4×, respectively, after 12 h of sunlight, while diurnal cycling exhibited varied effects. COS and CS2 formation was also strongly affected by the DOC concentration, organic sulfur precursor type, O2 concentration, and temperature, while salinity differences and CO addition did not play a significant role. Overall, important factors in forming COS and CS2 were identified, which may ultimately impact their atmospheric concentrations.

Bilateral absence of the cruciate ligaments with meniscal dysplasia: Unexpected diagnosis in a child with juvenile idiopathic arthritis.

Bilateral agenesis of the cruciate ligaments is a rare congenital anomaly. We report a unique case of a young girl who had congenital short femur and diagnosed with polyarticular juvenile idiopathic arthritis (JIA) and later discovered to have congenital absence of both anterior and posterior cruciate ligaments and meniscal dysplasia in both the knees when MRI was performed at 11 years of age. The MRI was performed to evaluate knee laxity and persistent symptoms despite medical management and multiple steroid injections for arthritis treatment. This patient is one of the youngest with congenital absence of both the cruciate ligaments to be treated with ACL reconstruction. We highlight the unique radiographic imaging manifestations of congenital cruciate ligament agenesis and emphasize the role of MRI to confirm and depict additional intraarticular abnormalities.

Quantitative diffusion-weighted magnetic resonance imaging assessment of chemotherapy treatment response of pediatric osteosarcoma and Ewing sarcoma malignant bone tumors.

OBJECTIVE: Assessment of tumor response to chemotherapy is essential in managing malignant pediatric bone tumors prior to resection. SUBJECTS AND METHODS: Pre-chemotherapy and post-chemotherapy osteosarcoma and Ewing sarcoma cases (n=18) were analyzed with apparent diffusion coefficient (ADC) values measured by two readers. RESULTS: Treated tumors demonstrated significantly greater ADC values compared to untreated tumors (p<0.001). Intraclass correlation coefficients ranged between 0.858 and 0.935. No significant tumor volume differences were observed. Regression analysis demonstrated average ADC as the best predictor of treatment. CONCLUSIONS: Our study suggests that ADC values may be useful for evaluating chemotherapeutic response of malignant pediatric bone tumors.

Adaptive statistical iterative reconstruction use for radiation dose reduction in pediatric lower-extremity CT: impact on diagnostic image quality.

BACKGROUND: For the past several years, increased levels of imaging radiation and cumulative radiation to children has been a significant concern. Although several measures have been taken to reduce radiation dose during computed tomography (CT) scan, the newer dose reduction software adaptive statistical iterative reconstruction (ASIR) has been an effective technique in reducing radiation dose. To our knowledge, no studies are published that assess the effect of ASIR on extremity CT scans in children. OBJECTIVE: To compare radiation dose, image noise, and subjective image quality in pediatric lower extremity CT scans acquired with and without ASIR. MATERIALS AND METHODS: The study group consisted of 53 patients imaged on a CT scanner equipped with ASIR software. The control group consisted of 37 patients whose CT images were acquired without ASIR. Image noise, Computed Tomography Dose Index (CTDI) and dose length product (DLP) were measured. Two pediatric radiologists rated the studies in subjective categories: image sharpness, noise, diagnostic acceptability, and artifacts. RESULTS: The CTDI (p value = 0.0184) and DLP (p value <0.0002) were significantly decreased with the use of ASIR compared with non-ASIR studies. However, the subjective ratings for sharpness (p < 0.0001) and diagnostic acceptability of the ASIR images (p < 0.0128) were decreased compared with standard, non-ASIR CT studies. CONCLUSION: Adaptive statistical iterative reconstruction reduces radiation dose for lower extremity CTs in children, but at the expense of diagnostic imaging quality. Further studies are warranted to determine the specific utility of ASIR for pediatric musculoskeletal CT imaging.