STIC-HD live flow technology in the antenatal diagnosis of scimitar syndrome: A case report.

Scimitar syndrome (SS) is a rare entity with an incidence of approximately 1-3 in 200 000 people. It is typically characterized by complete or partial anomalous pulmonary venous drainage from the right lung into the systemic venous circulation, most commonly the inferior vena cava (IVC). For the first time, we report the diagnosis of SS in a fetus in utero using four-dimensional (4D) spatiotemporal image correlation combined with high-definition live flow rendering mode (STIC-HD live flow).

Ultrasound visualization of the central nervous system during embryonic and fetal periods: Neurosonoembryology utilizing multiple three-dimensional transvaginal ultrasound technology.

OBJECTIVE: To study the ultrasonographic features of the central nervous system (CNS) in normally developing embryos and fetuses with a crown-rump length (CRL) of 10-84 mm, utilizing a high-frequency transvaginal probe in conjunction with various three-dimensional (3D) imaging modes. METHODS: From January 2020 to February 2021, 210 normally developing embryos and fetuses in early pregnancy were enrolled and classified based on their gestational age. A high-frequency transvaginal transducer was used to perform 2D and 3D ultrasounds, and the 3D images were saved. These images were then processed using multiple 3D technologies, such as HD live silhouette, OmniView, and TUI. Additionally, the circumference of the vermis was measured through the posterior fontanelle. RESULTS: Beginning at the 10 mm CRL stage of embryonic development, high-frequency transvaginal 3D ultrasound imaging was able to clearly visualize the prosencephalon, mesencephalon, and rhombencephalon. Notable changes were observed in the rhombencephalon during the 16-22 mm CRL stage, including the visualization of the pontine flexure and cerebellar primordium. At 23-40 mm CRL, there was a distinct pontine flexure, and the developing cerebellum, the fourth ventricle, and choroid plexus of the fourth ventricle (4th VCP) could be observed. The roof of the rhombencephalon was partitioned by the 4th VCP into the anterior membranous area (AMA) located rostrally and the posterior membranous area situated caudally. Additionally, the original Blake's pouch was identifiable. Among fetuses measuring 41-84 mm CRL, the AMA progressively decreased in size as the vermis developed. From the mid-sagittal view, the orientation of the 4th VCP seemed to shift from being perpendicular to the neural tube's long axis to being parallel to it. Furthermore, there was a significant correlation between CRL and vermis circumference. CONCLUSION: Using three-dimensional transvaginal ultrasound scanning, detailed visualization of the morphological changes in the CNS during normal embryonic development from 7 to 13+6  weeks is possible. This technology can aid in accurately characterizing the embryonic origin of the CNS.

Ultrasound evaluation of endothelial dysfunction in immunoglobulin-resistant children with acute Kawasaki disease.

INTRODUCTION: Given the evidence that brachial artery flow-mediated dilation (FMD) is declined in children later after the onset of Kawasaki disease (KD), we hypothesized that indicators that detect the situation of the endothelium are useful parameters that can accurately reflect subclinical dysfunction in resistant patients and assist in differentiating patients with KD at a higher risk of IVIG resistance, which may be valuable in better understanding how to protect patients from endothelial and thrombotic complications. METHODS: Fifty IVIG-resistant KD children, 120 IVIG-responsive KD children, 35 febrile children with acute upper respiratory infection, and 50 healthy controls were recruited, and indicators reflecting endothelial inflammation, including flow-mediated dilation (FMD), were measured. Receiver operating characteristic (ROC) curve analysis was utilized to determine the threshold values of these indicators of IVIG resistance. Multiple logistic regression analysis was performed to determine whether FMD was an independent predictor of IVIG-resistant patients. RESULTS: In comparison with the lab data, PCT, Na + , and FMD exhibited AUCs of 0.727, 0.653, and 0.698 (P < 0.05), respectively, in predicting IVIG resistance in KD through ROC analysis. PCT > 1.69 ng/ml, Na + < 133.2 mmol/l, and FMD < 5.79% were independent predictors of IVIG resistance in KD (OR 4.257, 3.516, 3.563, 95% CI 1.549 ~ 11.700, 1.277 ~ 9.680, 1.299 ~ 9.772, P < 0.05). CONCLUSION: More severe endothelial dysfunction, especially lower FMD, was present in IVIG-resistant patients than in IVIG-responsive patients. It is a helpful diagnostic tool that provides supportive criteria to detect KD patients at a higher risk of IVIG resistance when FMD < 5.79% in children. Key Points • IVIG-resistant KD patients have more severe endothelial dysfunction than IVIG-sensitive patients. • FMD < 5.79% may indicate an increased risk of IVIG resistance in children with Kawasaki disease.

Predictive value of brachial artery flow-mediated dilation on coronary artery abnormality in acute stage of Kawasaki disease.

Coronary artery abnormalities (CAAs) are a severe complication of Kawasaki disease (KD) that may lead to cardiovascular events. Given the evidence that brachial artery flow-mediated dilation (FMD) decreases in children after the onset of KD, we hypothesized that it could be an early marker of CAA development in the acute stage and investigated its relationship with variation in the coronary artery diameter. A total of 326 sex- and age-matched children were enrolled, including 120 with KD, 109 febrile children and 97 healthy controls. In this study, FMD was significantly decreased in the KD group compared with the febrile and healthy groups. FMD was lower in the CAA group than in the no coronary artery abnormality group. The comparison of FMD showed an obvious difference among the CAA subgroups. The FMD in the coronary aneurysm (CA) group showed a strong negative correlation with the pretreatment maximum coronary artery Z-score (preZmax). While preZmax was 2.5, the receiver operating characteristic curve indicated an optimal cutoff point of 3.44% for FMD. FMD ≤ 3.44% could be considered as a signal of coronary lesions in acute stage of KD.

Construction of human single-chain variable fragment antibodies of medullary thyroid carcinoma and single photon emission computed tomography/computed tomography imaging in tumor-bearing nude mice.

Medullary thyroid carcinoma (MTC) is a rare tumor of the endocrine system with poor prognosis as it exhibits high resistance against conventional therapy. Recent studies have shown that monoclonal antibodies labeled with radionuclide have become important agents for diagnosing tumors. To elucidate whether single-chain fragment of variable (scFv) antibody labeled with 131I isotope is a potential imaging agent for diagnosing MTC. A human scFv antibody library of MTC using phage display technique was constructed with a capacity of 3x10(5). The library was panned with thyroid epithelial cell lines and MTC cell lines (TT). Western blotting and enzyme-linked immunosorbent assay (ELISA) were used to identify the biological characteristics of the panned scFv. Methyl thiazolyl tetrazolium (MTT) assay was also used to explore the optimal concentration of the TT cell proliferation inhibition rate. They were categorized into TT, SW480 and control groups using phosphate-buffered saline. Western blotting showed that molecular weight of scFv was 28 kDa, cell ELISA showed that the absorbance of TT cell group was significantly increased (P=0.000??) vs. the other three groups, and MTT assay showed that the inhibition rate between the two cell lines was statistically significantly different (P<0.05) when the concentration of scFv was 0.1, 1 and 10 µmol/l. The tumor uptake of 131I-scFv was visible at 12 h and clear image was obtained at 48 h using the single photon emission computed tomography. scFv rapidly and specifically target MTC cells, suggesting the potential of this antibody as an imaging agent for diagnosing MTC.