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BACKGROUND: Lip filler injection is one of the most common minimally invasive cosmetic procedures involving the face; however, vascular complications are not uncommon. The aim of this study was to investigate the anatomy of the superior labial artery (SLA) and provide precise topographic information for dermal filler injection into the lips. METHODS: Computed tomography (CT) scans of 52 cadaveric heads injected with lead oxide were obtained. We then used Mimics software to construct 3D images of the SLA described by a coordinate system based on the bilateral external auditory canal and the left orbit. This study aimed to classify the SLA in the Han Chinese population, measure its diameter at specific points, and determine the thickness of the lip at those points. Ultimately, we utilized a thermal imaging technique to illustrate the course and depth of the SLA within the lip. The objective of this study was to provide safe guidance for clinical injections. RESULTS: In this study, the SLA was successfully identified in all cadavers. The mean overall diameter of the superior labial arteries was 1.36 ± 0.28 mm. The superior labial artery showed a general course from deep to shallow with an average depth of 5.68 ± 1.68 mm from the oral commissure to the midline. CONCLUSIONS: There are anatomical differences in the superior labial arteries among Chinese people. Furthermore, 3D CT images can digitally elucidate the exact positions of the superior labial artery via a coordinate system, improving the safety of upper lip filler injections in clinical settings. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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BACKGROUND: Glabellar filler injection is linked to an increased risk of blindness. A thorough understanding of vascular changes in the glabellar area is critical for safety. The study's goal was to precisely determine the three-dimensional placements of the arteries in the glabellar area. METHODS: In 117 cadavers, the vascular structures in the glabellar area were examined. There were four segments (S1/S1'-S4/S4') and five points (P1-P5) specified. The number of identified arteries found in each section and at each position was tallied. Additionally, the depth of the underlying identified artery under each site was measured. RESULTS: One to three named arteries per glabellar segment were found. Each segment had at least one named artery, and the number of named arteries detected between S1/S1' and S4/S4' decreased. The chance of encountering identified arteries at the 5 designated locations, P1-P5, was 7/117 (6.0%), 6/117 (5.1%), 7/117 (6.0%), 6/117 (5.1%), and 16/117 (13.7%), respectively. At P1-P5, the major artery trunk was 1.8 ± 0.3 mm, 1.6 ± 0.3 mm, 1.4 ± 0.2 mm, 1.3 ± 0.3 mm, and 1.1 ± 0.2 mm below the skin. CONCLUSIONS: The site of the glabellar arteries was clearly shown in this investigation; these arteries were met at a rate of 14% from P1 to P5. We demonstrated that a single entry site through the glabella via cannula could readily keep the needle deep enough for safe glabellar filler injection. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Artérias , Preenchedores Dérmicos , Humanos , Injeções , Testa , Preenchedores Dérmicos/efeitos adversosRESUMO
BACKGROUND: A filler injection in the nose can be essential but is also dangerous, especially in the nasal cartilage region. To safely and accurately perform a filler injection, surgeons must have detailed knowledge of nasal anatomy. OBJECTIVES: Associated the vessel branches and the characteristics of different nasal regions to provide suggestions for more suitable injection sites. METHODS: Fifty specimens underwent computed tomography (CT) after contrast infusion. Qualified specimens were selected for 3D CT reconstruction. Dissection was performed to confirm the accuracy of the CT data. RESULTS: The branches of arteries with large diameters, the dorsal nasal artery (DNA) and the lateral nasal artery (LNA) were distributed within the superficial musculoaponeurotic system layer. The DNA was seen in only 58% of specimens. The artery crossed the midline over the upper lateral cartilage in 16% of specimens. The LNA was a constant branch that traversed the nasal tip. The LNA crossed the midline to the contralateral side in 18% of patients. We divided the nasal cartilage dorsum into two regions for easy handling: the supratip region (STR) and the nasal tip region (NTR). The branches distributed in the STR mostly originated from the DNA (81.6%, 40/49), while those in the NTR mostly originated from the LNA. CONCLUSIONS: The vasculature of the nasal cartilage region observed in this study is similar to that observed in previous studies. However, we found that the STR was an advantageous area for filler injection. At the same time, we provided suggestions for more suitable injection methods. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Cartilagens Nasais , Rinoplastia , Humanos , Nariz/diagnóstico por imagem , Nariz/anatomia & histologia , Rinoplastia/métodos , Artéria Oftálmica , DNA , Resultado do TratamentoRESUMO
BACKGROUND: Vascular complications from periorbital intravascular filler injection are major safety concerns. OBJECTIVE: To thoroughly describe the superior orbital vessels near the orbital rim and propose considerations for upper eyelid and forehead injections. METHODS: Fifty-one cadaver heads were infused with lead oxide contrast media through the external carotid artery, internal carotid artery, and facial and superficial temporal arteries. Computed tomography (CT) images were obtained after contrast agent injection, and 3-dimensional CT scans were reconstructed by using a validated algorithm. RESULTS: Eighty-six qualified hemifaces clearly showed the origin, depth, and anastomoses of the superior orbital vessels, which consistently deployed 2 distinctive layers: deep and superficial. Of all hemifaces, 59.3% had deep superior orbital vessels near the orbital rim, including 44.2% with deep superior orbital arcades and 15.1% with deep superior orbital arteries, which originated from the ophthalmic artery. Additionally, 97.7% of the hemifaces had superficial superior orbital arcades, for which 4 origins were identified: ophthalmic artery, superior medial palpebral artery, angular artery, and anastomosis between the angular and ophthalmic arteries. LIMITATIONS: The arterial depth estimated from 3-dimensional CT needs to be confirmed by standard cadaver dissection. CONCLUSION: This study elucidated novel arterial systems and proposed considerations for upper eyelid and forehead injections.
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Pálpebras/irrigação sanguínea , Artéria Oftálmica/anatomia & histologia , Órbita/irrigação sanguínea , Adulto , Cadáver , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Preenchedores Dérmicos/efeitos adversos , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Artéria Oftálmica/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Nasal filler placement is associated with a high risk of blindness. The arterial supply to the upper nose overlaying the nasal bones is poorly understood. OBJECTIVES: The aim of this study was to visualize and analyze the deployment of the ophthalmic and facial angiosomes in the upper nose to help prevent blindness following nasal filler injections. METHODS: The arterial systems of 62 cadaveric heads were filled with lead oxide contrast agent, and computed tomography (CT) images were acquired and reconstructed in 3 dimensions. RESULTS: Twenty-six of the cadaveric noses examined demonstrated clear CT images of the facial and ophthalmic angiosomes in the upper nose. The Type 1 upper nose (15.4%) is supplied by 2 independent ophthalmic angiosomes that communicate indirectly through a choke anastomosis. The Type 2 upper nose (38.5%) is supplied by 2 ophthalmic angiosomes with a true anastomosis between them. The Type 3 upper nose (46.1%) is supplied by both ophthalmic and facial angiosomes with true anastomoses across the dorsal midline. These true anastomoses are mediated by the radix arcade in 46% of the noses and involve the dorsal nasal artery in 65% of the cases. The anastomoses all cross the upper dorsal midline and are directly linked to the ophthalmic angiosome. CONCLUSIONS: The deployment and anastomosis of the facial and ophthalmic angiosomes in the upper nose fall into 3 major patterns. About 85% of the noses have true anastomotic arteries that cross the upper dorsal midline and are directly linked to the ophthalmic circulation. Dorsum filler injection poses a significant risk of blindness.
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Preenchedores Dérmicos , Osso Nasal , Face/diagnóstico por imagem , Humanos , Osso Nasal/diagnóstico por imagem , Osso Nasal/cirurgia , Nariz/diagnóstico por imagem , Nariz/cirurgia , Artéria Oftálmica/diagnóstico por imagemRESUMO
BACKGROUND: Facial bony changes vary among races, yet few studies have been conducted in Asians. OBJECTIVE: To analyze the aging of orbital and midfacial bones in Asians. METHODS: Based on the two-dimensional data obtained from the computed tomography scanner of imaging department, 3D reconstructions were conducted to take measurements (orbital diagonal diameter, orbital width, orbital area, maxillary angle, midfacial height, pyriform angle, pyriform width, and pyriform area). RESULTS: In this retrospective study of 261 subjects, a significant decrease in the orbital diagonal diameter, orbital width, and midfacial height was found in men, whereas women displayed a significant increase in the pyriform width and a significant decrease in maxillary angle and midfacial height by three-dimensional analysis. CONCLUSION: This study verifies the minor female changes in the orbital region and less dramatic male changes in the midfacial region compared with that in Caucasians. Individualized treatment should be performed according to different genders and races. Further exploration of facial bone metabolism may have valuable implications for Asians.
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Envelhecimento/fisiologia , Povo Asiático , Remodelação Óssea , Ossos Faciais/fisiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Ossos Faciais/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
OBJECTIVES: The study aimed to explore the effects of codeine-containing cough syrup (CCS) exposure on cortical morphology and the relationship between cortical characteristics and CCS dependence. METHODS: Cortical morphometry based on Computational Anatomy Toolbox (CAT12) was used to compare changes in sulcal depth, gyrification, and cortical thickness of the cerebral cortex from 40 CCS users and 40 healthy controls (HCs) with two-sample t tests (p < 0.05, multiple comparison corrected). Relationships between abnormal cortical morphological changes and the duration of CCS use, impulsivity traits, and age of first use were investigated with correlation analysis (p < 0.05, uncorrected). RESULTS: CCS users exhibited significantly increased sulcal depth in the bilateral insula, bilateral lingual, bilateral superior frontal, right precuneus, and right middle frontal regions; increased gyrification in the right precentral cortex; and increased cortical thickness in the bilateral precentral, bilateral precuneus, and right superior temporal cortices compared to HCs. In addition, we found significant correlations between the bilateral insula, right superior frontal cortex, and right precentral gyrus and Barratt Impulsiveness Scale (BIS) total scores. CONCLUSIONS: Chronic CCS abuse may be associated with aberrant sulcal depth, gyrification, and cortical thickness. These morphological changes might serve as an underlying neurobiological mechanism of impulsive behavior in the CCS users. KEY POINTS: ⢠Cortical morphological changes were detected in CCS users. ⢠Increased sulcal depth, gyrification, and cortical thickness of some regions were found in the CCS users. ⢠Positive correlations between cortical morphological changes and BIS total scores were identified.
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Córtex Cerebral/patologia , Codeína/farmacologia , Tosse/diagnóstico , Lobo Frontal/patologia , Imageamento por Ressonância Magnética/métodos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Adulto , Córtex Cerebral/efeitos dos fármacos , Tosse/tratamento farmacológico , Feminino , Lobo Frontal/efeitos dos fármacos , Humanos , Masculino , Adulto JovemRESUMO
BACKGROUND: Filler injection is a popular cosmetic procedure, but it can entail vascular complications. Periorbital injections have the highest risk within the entire injection area. OBJECTIVES: The authors sought to systematically screen for periorbital arterial variations prior to treatment. METHODS: The external carotid arteries of 10 cadaveric heads were infused with adequate lead oxide contrast. The facial and superficial temporal arteries of another 11 cadaveric heads were injected with the contrast in sequential order. Computed tomography (CT) scanning was performed after injection of contrast, and 3-dimensional (3D) CT scans were reconstructed using validated algorithms. RESULTS: Three types of periorbital blood vessels were found to derive from the ophthalmic artery, including 30% directly originating from the ophthalmic artery, 65% originating from its trochlear branch, and 5% originating from its supraorbital branch. In the forehead, the ophthalmic artery, originating from the internal carotid arteries, formed anastomoses between the frontal branch of the superficial temporal artery, originating from the external carotid artery, with the deep and superficial branches of the supratrochlear and supraorbital arteries, respectively. The lateral orbit and malar plexus can be classified into 4 types based on the trunk artery: the zygomatic orbital artery (27%), the transverse facial artery (23%), the premasseteric branch of the facial artery (19%), and all 3 contributing equally (31%). CONCLUSIONS: Postmortem 3D CT can map periorbital arterial variations. The branching pattern of the ophthalmic artery, the ophthalmic angiosome in the forehead, and the distribution of the lateral orbit and malar plexus were identified at high resolution to guide clinical practice.
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Variação Anatômica , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Embolia/prevenção & controle , Artéria Oftálmica/anatomia & histologia , Adulto , Cadáver , Embolia/etiologia , Feminino , Testa/irrigação sanguínea , Testa/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Artéria Oftálmica/diagnóstico por imagem , Órbita/irrigação sanguínea , Órbita/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
OBJECTIVE: To explore the abnormal connectivity patterns between the insular and the voxels of the brain in primary insomnia (PI) with insular-based functional connectivity (FC). METHODS: With the resting-state fMRI data acquired from 57 PI patients and 46 healthy controls, a two-sample t test was performed on individual FC correlation maps from two groups. The person correlation analysis was used to evaluate the relationship between the abnormal FC and clinical features. RESULTS: PI patients show enhanced connectivity between the left insula with the right anterior cingulate cortex (p < 0.05 and p < 0.001, AlphaSim-corrected), right frontal sup orb, bilateral thalamus and left precuneus,as well as decreased connectivity with the left middle temporal gyrus and right fusiform (p < 0.05, AlphaSim-corrected). Correlation analysis indicated the enhanced connectivities in the PI patients have significant negative correlations with Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS)scores. In addition, the decreased functional connectivities showed positive correlations with SDS and SAS scores. CONCLUSION: Our study showed the increased connectivity regions with insula were mainly in the emotional circle and decreased connectivity was in cognitive-related regions. These provide additional evidence from functional integration view to understand the possible underlying neural- mechanisms of PI. KEY POINTS: ⢠The aberrant insular-based connectivity pattern of PI patients was detected. ⢠Regions showing increased connectivity with left insular were mainly in emotional circle. ⢠Significant correlations between changed FC and SDS and SAS score were found.
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Mapeamento Encefálico/métodos , Encéfalo/diagnóstico por imagem , Conectoma , Imageamento por Ressonância Magnética/métodos , Distúrbios do Início e da Manutenção do Sono/diagnóstico por imagem , Adulto , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vias Neurais/fisiopatologiaRESUMO
PURPOSE: The study aimed to explore the regional spontaneous activity changes in primary insomnia (PI) patients. MATERIALS AND METHODS: Based on the resting-state fMRI datasets acquired from 59 PI patients and 47 healthy controls, a two-sample t-test was performed on individual normalized regional homogeneity (ReHo) maps. Relationships between abnormal ReHo values and the Pittsburgh Sleep Quality Index (PSQI), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were investigated with Pearson correlation analysis. RESULTS: In PI patients, we found increased ReHo in the left insula, right anterior cingulate gyrus, bilateral precentral gyrus and left cuneus, as well as decreased ReHo in the right middle cingulate cortex and left fusiform (p < 0.05, AlphaSim-corrected). We also found a significant positive correlation between increased ReHo in the left insula and SAS scores, decreased ReHo in the right middle cingulated cortex and SDS, SAS scores as well as a negative correlation between increased ReHo in the right precentral gyrus and SDS scores (p < 0.05). CONCLUSIONS: Our study found abnormal spontaneous activities in multiple brain regions, especially in emotion-related areas in PI patients. Alterative activities in these regions might contribute to an understanding the intrinsic functional architecture of insomnia and its clinical features. KEY POINTS: ⢠Regional spontaneous activity changes were detected in PI patients. ⢠Decreased or increased ReHo of some regions was identified in PI patients. ⢠Significant correlations between mean ReHo and SDS scores were found.
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Córtex Cerebral/patologia , Lobo Frontal/patologia , Imageamento por Ressonância Magnética/métodos , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Adulto , Feminino , Humanos , MasculinoRESUMO
The subsurface urban heat island (SubUHI) is one part of the overall UHI specifying the relative warmth of urban ground temperatures against the rural background. To combat the challenge on measuring extensive underground temperatures with in situ instruments, we utilized satellite-based moderate-resolution imaging spectroradiometer data to reconstruct the subsurface thermal field over the Beijing metropolis through a three-time-scale model. The results show the SubUHI's high spatial heterogeneity. Within the depths shallower than 0.5 m, the SubUHI dominates along the depth profiles and analyses imply the moments for the SubUHI intensity reaching first and second extremes during a diurnal temperature cycle are delayed about 3.25 and 1.97 h per 0.1 m, respectively. At depths shallower than 0.05 m in particular, there is a subsurface urban cool island (UCI) in spring daytime, mainly owing to the surface UCI that occurs in this period. At depths between 0.5 and 10 m, the time for the SubUHI intensity getting to its extremes during an annual temperature cycle is lagged 26.2 days per meter. Within these depths, the SubUHI prevails without exception, with an average intensity of 4.3 K, varying from 3.2 to 5.3 K.
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Cidades/estatística & dados numéricos , Temperatura Alta , Modelos Teóricos , Tecnologia de Sensoriamento Remoto , Monitoramento Ambiental , Estações do Ano , TemperaturaRESUMO
Background: Ischemic stroke (IS) is a neurological disease with significant disability and mortality. MicroRNAs were proven to be associated with cerebral ischemia. Previous studies have demonstrated miR-122 downregulation in both animal models of IS and the blood of IS patients. Nonetheless, the role and mechanism of miR-122-5p in IS remain unclear. Methods: We established primary human and mouse astrocytes, along with HT22 mouse hippocampal neuronal cells, through oxygen-glucose deprivation/reoxygenation (OGD/R) treatment. To assess the impact of miR-122, we employed CCK8 assays, flow cytometry, RT-qPCR, western blotting, and ELISA to evaluate cell viability, apoptosis, reactive oxygen species (ROS) generation, and cytokine expression. A dual-luciferase reporter gene assay was employed to investigate the interaction between miR-122 and sPLA2-IIA. Results: Overexpression of miR-122 resulted in decreased apoptosis, reduced cleaved caspase-3 expression, and increased cell viability in astrocytes and HT22 cells subjected to OGD/R. RT-qPCR and ELISA analyses demonstrated a decrease in mRNA and cytokine levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α in both astrocytes and HT22 cells following miR-122 overexpression. Moreover, miR-122 overexpression reversed OGD/R-induced ROS levels and 8-OHdG formation in astrocytes. Additionally, miR-122 overexpression decreased the mRNA and protein expression of inducible nitric oxide synthase (iNOS). Furthermore, we found that miR-122 attaches to the 3'-UTR of sPLA2-IIA, thereby downregulate its expression. Conclusion: Our study demonstrates that miR-122-mediated inhibition of sPLA2-IIA attenuates OGD/R-induced neuronal injury by suppressing apoptosis, alleviating post-ischemic inflammation, and reducing ROS production. Thus, the miR-122/sPLA2-IIA axis may represent a promising target for IS treatment.
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Near-surface atmospheric moisture is a key environmental and hydro-climatic variable that has significant implications for the natural and human systems. However, high-resolution moisture data are severely lacking for fine-scale studies. Here, we develop the first 1 km high spatial resolution dataset of monthly moisture index collection in China (HiMIC-Monthly) over a long period of 2003~2020. HiMIC-Monthly is generated by the light gradient boosting machine algorithm (LightGBM) based on observations at 2,419 weather stations and multiple covariates, including land surface temperature, vapor pressure, land cover, impervious surface proportion, population density, and topography. This collection includes six commonly used moisture indices, enabling fine-scale assessment of moisture conditions from different perspectives. Results show that the HiMIC-Monthly dataset has a good performance, with R2 values for all six moisture indices exceeding 0.96 and root mean square error and mean absolute error values within a reasonable range. The dataset exhibits high consistency with in situ observations over various spatial and temporal regimes, demonstrating broad applicability and strong reliability.
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BACKGROUND: Motor control exercise (MCE) is effective in alleviating non-specific chronic low back pain (NCLBP). Neuro-imaging research is warranted to explore the underlying neural mechanisms of MCE. AIM: We used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the central mechanism underpinning the effects of MCE in patients with NCLBP. DESIGN: A randomized, single-blinded, controlled trial. SETTING: The setting was out-patient and community. POPULATION: Fifty-eight patients with NCLBP. METHODS: Patients were randomized into the MCE or manual therapy (MT) group. All the participants completed pain-related clinical assessments and rs-fMRI scans before and after intervention. We performed exploratory whole-brain analyses in regional homogeneity (ReHo) and resting-state functional connectivity (rsFC) with significant post-pre differences in ReHo before and after intervention, and investigated associations between imaging and pain-related clinical assessments. RESULTS: Compared with the MT group, a greater alleviation in pain intensity and disability was observed in the MCE group after intervention, and was sustained at the 6-month follow-up (P<0.001). Only the MCE group showed increased ReHo values in the right pre-central gyrus and decreased ReHo values in the bilateral posterior cerebellum (voxel level P<0.001, cluster-level FWE corrected P<0.05). Decreased rsFC of the right posterior cerebellum-left superior parietal gyrus and left insula were significantly positively associated with pain-related disability (voxel level P<0.001, cluster-level FWE corrected P<0.05). CONCLUSIONS: These findings demonstrated that MCE had superior effects in relieving pain and pain-related disability, which might be associated with its modulation of rsFC between the cerebellum and areas involved in sensory-discriminative processing of noxious and somato-sensory stimuli, affection, and cognition. CLINICAL REHABILITATION IMPACT: This study provided preliminary evidence that MCE might alleviate NCLBP through its modulation of the function of brain areas related to chronic pain and postural control. Those results support MCE's clinical application and help physiotherapists to provide better multidisciplinary interventions with the combination of MCE and other first-line treatments.
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Dor Crônica , Dor Lombar , Humanos , Dor Lombar/diagnóstico por imagem , Dor Lombar/terapia , Imageamento por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Dor Crônica/diagnóstico por imagem , Dor Crônica/terapia , Exercício FísicoRESUMO
Active pre-chamber turbulent jet ignition with a high compression ratio has been demonstrated to be an effective method for significantly enhancing engine thermal efficiency. A dual modification of the combustion chamber and the pre-chamber was performed on an AVL 5400 single-cylinder Miller engine to achieve stable ultra-lean burn at a high compression ratio, and a breakthrough of 51.10% gross indicated thermal efficiency was achieved at the compression ratio of 16.4 and λ = 2.236. Spark ignition and pre-chamber turbulent jet ignition exhibit significant performance diversities under lean burn conditions. Pre-chamber turbulent jet ignition is able to significantly expand the lean burn limit of spark ignition to λ = 2.7 (CoVIMEP < 5%) at only the expense of an increased HC emission, while apparently reducing fuel consumption and nitrogen oxide emissions. With an increase in the compression ratio from 13.6 to16.4, spark ignition and pre-chamber turbulent jet ignition exhibit contradictory performance laws. The engine performance of a spark ignition engine decreases significantly as the compression ratio increases, whereas a pre-chamber jet ignition engine can still operate reliably at a high compression ratio with ultra-lean combustion. Within the scope of the test, the performance of the pre-chamber jet ignition engine is enhanced by a greater compression ratio. This improvement is primarily attributable to the reduction of heat transfer loss and exhaust energy loss under ultra-lean combustion, as determined by an analysis of the structure of power losses.
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BACKGROUND: Vascular complications from glabellar intravascular filler injections are major safety concerns. Filler injection into the glabella without precise knowledge of its vascular topography poses a risk of severe complications. METHODS: Computed tomography was used to study 90 cadaveric heads after contrast agent and filler injection, and 15 cadaveric heads were dissected. RESULTS: Central (CAs), paracentral (PCAs), and reverse dorsal nasal arteries (rDNAs) were found in 70 (38.9%), 58 (32.2%), and 16 (8.9%) of the 180 hemifaces, respectively. Based on the presence of CAs, PCAs, and rDNAs between the bilateral supratrochlear arteries (STAs), glabellar arteries were categorized into two main patterns: in type 1 [without named arteries between bilateral STAs; 22 of 90 (24.4%)], the glabella was supplied by bilateral STAs and their branches; in type 2 [with named arteries between bilateral STAs; 68 of 90 (75.6%)], the glabella was supplied by bilateral STAs and CAs, PCAs, and rDNAs. Type 2 could be further divided into three subtypes: in type 2a [45 of 90 (50.0%)], the glabella was supplied by bilateral STAs and one of the named arteries; in type 2b [21 of 90 (23.3%)], the glabella was supplied by bilateral STAs and two of the named arteries; and in type 2c [two of 90 (2.3%)], the glabella was supplied by bilateral STAs and unilateral CA, PCA, and rDNA. CONCLUSION: This study elucidated novel arterial systems and proposed considerations for glabellar filler injection.
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Preenchedores Dérmicos , Humanos , Preenchedores Dérmicos/efeitos adversos , Artéria Oftálmica , Testa/irrigação sanguínea , Tomografia Computadorizada por Raios X , CadáverRESUMO
BACKGROUND: Internal hernia is a rare cause of acute abdomen and intestinal obstruction in adults. Internal abdominal hernias include paraduodenal, perigastric, foramen of Winslow, intersigmoid, and post-anastomotic hernias and can be congenital or acquired. Internal hernias occur in 1%-2% of patients, and transmesocolic hernias are extremely rare. This report presents a patient with a transverse mesocolic hernia with a preoperative diagnosis of small intestinal obstruction. CASE SUMMARY: A 45-year-old Chinese woman was admitted to the hospital with middle and upper abdominal pain for 2 d, abdominal distension, and vomiting. After abdominal computed tomography, she was diagnosed with an internal abdominal hernia complicated by small intestinal obstruction and underwent emergency laparoscopic surgery. The patient recovered well and was discharged 6 d postoperatively. CONCLUSION: Transmesocolic hernias must be considered in adult patients with signs and symptoms of intestinal obstruction, even without a history of abdominal trauma or surgery.
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Purpose: Deficits in voluntary activation of the core stabilizing muscles are consistently observed in patients with chronic low back pain (CLBP); however, the underlying neural mechanism remains unclear. This cross-sectional study aimed at testing the hypothesis that the impaired voluntary activation of core stabilizing muscles is associated with structural and functional alterations in the basal ganglia, thalamus, and cortex in patients with CLBP. Methods: We obtained structural and resting-state functional magnetic resonance imaging (rs-fMRI) data from 53 patients with CLBP and 67 healthy controls and estimated the alterations in grey matter volume (GMV) and functional and effective connectivity (EC) of regions with altered GMV via whole brain analysis. The voluntary activation of the multifidus (MF) and transversus abdominis (TrA) was evaluated by ultrasound imaging in these patients. Results: Compared with the HCs, they displayed a significant decrease in GMV in the bilateral thalamus and caudate nucleus, a significant increase in GMV in the left middle frontal gyrus, and increased resting-state functional connectivity between the right caudate nucleus and the bilateral precuneus (voxel-level p < 0.005, Gaussian random field-corrected p < 0.05). The patients also showed increased EC from the right caudate nucleus to the bilateral precuneus, which was significantly correlated with voluntary activation of the bilateral MF and TrA (all p < 0.050). Conclusions: Grey matter alterations may be confined to regions responsible for perception, motor control, and emotion regulation in patients with CLBP. The interrupted EC from the basal ganglia to the default mode network might be involved in the impairment of voluntary activation of the core stabilizing muscles.
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Dor Lombar , Humanos , Dor Lombar/diagnóstico por imagem , Estudos Transversais , Gânglios da Base/diagnóstico por imagem , Músculos Abdominais/diagnóstico por imagem , EncéfaloRESUMO
Objective: This study aimed to analyze the effect of urate deposition (UD) on bone erosion and examine the association between the volume of monosodium urate (MSU) crystals and an improved bone erosion score method, as measured in the metatarsophalangeal (MTP) joints of patients with gout. Materials and methods: Fifty-six patients diagnosed with gout using the 2015 European League Against Rheumatism and American College of Rheumatology criteria were enrolled. MSU crystals volume at each MTP joint was measured using dual-energy computed tomography (DECT) images. The degree of bone erosion was evaluated with the modified Sharp/van der Heijde (SvdH) erosion scoring system based on CT images. Differences in clinical features between patients with (UD group) and without (non-UD group) UD were assessed, and the correlation between erosion scores and urate crystal volume was analyzed. Results: The UD and non-UD groups comprised 30 and 26 patients, respectively. Among the 560 MTP joints assessed, 80 showed MSU crystal deposition, and 108 showed bone erosion. Bone erosion occurred in both groups but was significantly less severe in the non-UD group (p <0.001). Both groups had equivalent levels of serum uric acid (p=0.200). Symptom duration was significantly longer in the UD group (p=0.009). The UD group also had a higher rate of kidney stones (p=0.023). The volume of MSU crystals was strongly and positively associated with the degree of bone erosion (r=0.714, p <0.001). Conclusion: This study found that patients with UD show significant increased bone erosion than those without UD. The volume of MSU crystals is associated with the improved SvdH erosion score based on CT images, regardless of serum uric acid level, demonstrating the potential of combining DECT and serum uric acid measurements in helping optimize the management of patients with gout.
Assuntos
Gota , Ácido Úrico , Humanos , Tomografia Computadorizada por Raios X/métodos , Gota/complicações , Gota/diagnóstico por imagemRESUMO
Urban thermal anisotropy (UTA) drastically impacts satellite-derived urban surface temperatures and fluxes, and consequently makes it difficult to gain a more comprehensive understanding of global urban climates. However, UTA patterns and associated biases in observed urban climate variables have not been investigated across an adequate number of global cities with diverse contexts; nor is it known whether there are globally measurable factors that are closely related to the UTA intensity (UTAI, quantified as the maximum difference between the nadir and off-nadir urban thermal radiation). Here we investigate the UTAI over more than 5500 cities worldwide using multi-angle land surface temperature (LST) observations from 2003 to 2021 provided by Moderate Resolution Imaging Spectroradiometer (MODIS). The results show that the global mean UTAI can reach 5.1, 2.7, 2.4, and 1.7 K during summer daytime, winter daytime, summer nighttime, and winter nighttime, respectively. Using nadir LST observations as a reference, our analysis reveals that UTA can lead to an underestimation of satellite-based urban surface sensible heat fluxes (H) by 45.4% and surface urban heat island intensity (Is) by 43.0% when using LST observations obtained from sensor viewing zenith angles (VZAs) of ±60°. Practitioners can limit the biases of H and Is within ±10% by using LSTs from sensor VZAs within ±30°. We also find that UTAI is closely related to urban impervious surface percentage and surface air temperature across global cities. These findings have implications for angular normalization of satellite-retrieved instantaneous LST observations across cities worldwide.