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1.
Phys Rev Lett ; 129(22): 227202, 2022 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-36493455

RESUMEN

The two-dimensional Wigner crystal (WC) occurs in the strongly interacting regime (r_{s}≫1) of the two-dimensional electron gas (2DEG). The magnetism of a pure WC is determined by tunneling processes that induce multispin ring-exchange interactions, resulting in fully polarized ferromagnetism for large enough r_{s}. Recently, Hossain et al. [Proc. Natl. Acad. Sci. U.S.A. 117, 32244 (2020)PNASA60027-842410.1073/pnas.2018248117] reported the occurrence of a fully polarized ferromagnetic insulator at r_{s}≳35 in an AlAs quantum well, but at temperatures orders of magnitude larger than the predicted exchange energies for the pure WC. Here, we analyze the large r_{s} dynamics of an interstitial defect in the WC, and show that it produces local ferromagnetism with much higher energy scales. Three hopping processes are dominant, which favor a large, fully polarized ferromagnetic polaron. Based on the above results, we speculate concerning the phenomenology of the magnetism near the metal-insulator transition of the 2DEG.


Asunto(s)
Electrones , Temperatura
2.
Support Care Cancer ; 30(12): 9781-9791, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36396793

RESUMEN

PURPOSE: Cancer is a major reason for concurrent prescription of opioids with other sedating medications-particularly benzodiazepines and gabapentinoids-yet population-based assessments of the extent and predictors of concurrent prescribing among clinically and demographically diverse patients with cancer are lacking. METHODS: We conducted a retrospective cohort study of patients with non-metastatic cancer using North Carolina cancer registry data linked with Medicare and private insurance claims (2013-2016). We used modified Poisson regression to assess associations of patient characteristic with adjusted relative risk (aRR) of new concurrent prescribing of opioids with benzodiazepines or gabapentinoids after diagnosis. RESULTS: Overall, 15% of patients were concurrently prescribed opioids with benzodiazepines or gabapentinoids. Characteristics independently associated with an increased risk of concurrent prescribing included cancer type (e.g., aRR cervical vs. colorectal cancer: 1.55, 95% CI: 1.12-2.14); prior use of opioids (aRR: 2.43, 95% CI:2.21-2.67), benzodiazepines (aRR: 4.08, 95% CI: 3.72-4.48), or gabapentinoids (3.82, 95% CI: 3.31-4.39), and premorbid mental health conditions, including substance use disorder (aRR: 1.27, 95% CI: 1.05-1.54). Black and Hispanic patients were less likely to experience concurrent prescribing (aRR, Black vs. White: 0.35, 95% CI: 0.15-0.83; aRR, Hispanic vs. White: 0.75, 95% CI: 0.66-0.85). CONCLUSION: Approximately 1 in 7 patients with cancer was concurrently prescribed opioids with other sedating medications. Associations between patient characteristics and risk of concurrent prescribing highlight predictors of concurrent prescribing and suggest a rationale for systematic assessment of substance use history at diagnosis. Future research could explore inequitable pain and symptom management and investigate risk of adverse medication-related events.


Asunto(s)
Analgésicos Opioides , Neoplasias , Estados Unidos , Humanos , Anciano , Analgésicos Opioides/uso terapéutico , Estudios Retrospectivos , Medicare , Neoplasias/epidemiología , Benzodiazepinas/uso terapéutico
3.
Small ; 17(9): e1902138, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31441230

RESUMEN

An all-solid-state lithium battery based on a sulfide electrolyte is one of the most promising next-generation energy storage systems. However, the high interfacial impedance, particularly due to the internal pores in the electrode or electrolyte layers, is the major limiting factor to the development of sheet-type all-solid-state batteries. In this study, a low-resistance integrated all-solid composite electrode is developed using a hybrid of a pyrrolidinium-based ionic liquid and a polyethylene oxide polymer with lithium salt as a multifunctional interphase material, which is engineered to be compatible with the sulfide electrolyte as well as the fabrication process of sheet-type composite electrode. The interphase material fills the pore in the composite sheet while binding the components together, which effectively increases the interfacial contact area and strengthens the physical network between the components, thereby enabling enhanced ion transport throughout the electrode. The interphase-engineered sheet-type LiNi0.8 Co0.1 Mn0.1 O2 /Li10 GeP2 S12 electrode shows a high reversible capacity of 166 mAh g-1 at 25 °C, corresponding to 92% of the observed capacity in a current liquid-based cathode system, as well as enhanced cycle and rate performances. This study proposes a novel and practical method for the development of high-performance sheet-type all-solid-state lithium batteries.

4.
Nicotine Tob Res ; 22(10): 1842-1850, 2020 10 08.
Artículo en Inglés | MEDLINE | ID: mdl-32147712

RESUMEN

INTRODUCTION: Minimum floor price laws (MFPLs) are an emerging tobacco control policy that sets a minimum price below which a specific tobacco product cannot be sold. MFPLs target cheaper products and may disproportionately impact consumers choosing low price brands or using discounts to reduce prices. We developed a static microsimulation model for California, United States to project short-term effects of different MFPL options for a 20-stick pack of cigarettes on adult smoking behaviors. AIMS AND METHODS: We simulated 300 000 individuals defined by race and ethnicity, sex, age, and poverty status. Smoking behaviors and cigarette prices were assigned based on demographic distributions in the 2014-2016 California Behavioral Risk Factor Surveillance System. We drew 100 random samples (n = 30 000), weighted to state-level California demographic characteristics. We simulated six MFPL options and modeled impacts on smoking prevalence and cigarette consumption, in general, and separately for those in households below or above 250% of the federal poverty level, assuming a price elasticity of -0.4. RESULTS: Predicted changes in prices, prevalence, and consumption increased exponentially as the floor price increased from $7.00 to $9.50. Assuming 15% policy avoidance, projected increases in average cigarette prices ranged from $0.19 to $1.61. Decreases in smoking prevalence ranged from 0.05 to 0.43 percentage points, and decreases in average monthly cigarette consumption ranged from 1.4 to 12.3 cigarettes. Projected prices increased, and prevalence and consumption decreased, more among individuals in households below 250% federal poverty level. CONCLUSIONS: MFPLs are a promising tobacco control strategy with the potential to reduce socioeconomic disparities in cigarette smoking prevalence and consumption. IMPLICATIONS: Despite reductions in adult smoking prevalence, significant socioeconomic disparities remain, with lower-income groups smoking at substantially higher levels than higher-income groups. Policies that set a floor price below which a tobacco product cannot be sold could reduce socioeconomic disparities in smoking, depending on variation in prices paid by smokers prepolicy. By using a microsimulation model to predict changes in smoking for different population groups in California under several floor price scenarios, this study demonstrates that MFPLs have the potential to reduce adult smoking prevalence overall, and especially for lower-income tobacco users.


Asunto(s)
Fumar/economía , Fumar/epidemiología , Productos de Tabaco/economía , Adulto , California , Humanos , Modelos Estadísticos
5.
Eur Arch Otorhinolaryngol ; 277(12): 3367-3373, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32743711

RESUMEN

PURPOSE: The proportion of elderly people aged ≥ 65 years is increasing worldwide. Although the reported prevalence of sinonasal disease can vary according to the diagnostic methods used, differences in allergic rhinitis prevalence in the elderly according to diagnostic method have not been reported. We thus aimed to evaluate allergic rhinitis prevalence in the elderly according to diagnostic criteria obtained from questionnaires, physician diagnoses, and allergy tests. METHODS: We compared the allergic rhinitis prevalence in the elderly aged ≥ 65 years with adults aged 19-64 years, using data from the Korean National Health and Nutrition Examination Survey 2008-2012. Total serum IgE and IgE levels specific to allergens of Dermatophagoides farina, cockroach, and dog dander were examined, and factors affecting specific IgE levels were investigated. RESULTS: Allergic rhinitis prevalence according to the questionnaire responses, physician diagnoses, and allergy test results was 35.02%, 14.89%, and 17.56%, respectively. The prevalence based on all diagnostic methods assessed was significantly lower in the elderly than in the general adult group (p < 0.001). Rhinorrhea incidence was significantly increased in the elderly (p = 0.018). Sensitization to Dermatophagoides farina was significantly decreased in the elderly (p = 0.006) and did not correlate with socioeconomic status and/or general health factors. CONCLUSIONS: The elderly population has a distinct clinical presentation, including a low prevalence of allergic rhinitis, and an increased incidence of rhinorrhea symptoms, compared with the general adult population. The management of allergic rhinitis in elderly patients may therefore require a different therapeutic approach to improve rhinorrhea rather than nasal obstruction.


Asunto(s)
Encuestas Nutricionales , Rinitis Alérgica , Adulto , Anciano , Alérgenos , Animales , Perros , Humanos , Prevalencia , República de Corea/epidemiología , Rinitis Alérgica/diagnóstico , Rinitis Alérgica/epidemiología , Pruebas Cutáneas
7.
Eur Arch Otorhinolaryngol ; 276(7): 1975-1980, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30929057

RESUMEN

OBJECTIVE: Fungal rhinosinusitis occurs in different forms depending on race and region. While allergic fungal rhinosinusitis is common in Caucasians, fungal ball (FB) is more common in Asians. However, most cases are reported as unilateral, and clinical data on bilateral FB (BFB) are rare. Therefore, the purpose of this study was to analyze and to compare the clinical characteristics of BFB and unilateral FB (UFB) in Koreans. METHODS: We retrospectively analyzed medical records and computed tomography (CT) images of 434 patients diagnosed with FB. The patients were divided into two groups: BFB and UFB. Demographic data, multiple allergen simultaneous test including total or specific immunoglobulin E (IgE) levels, symptoms, CT findings, treatment, and outcomes were analyzed. RESULTS: Among the patients, 26 had BFB and 408 had UFB. Hypertension was noted in 61.5% of the BFB and 39% of the UBF individuals (p = 0.023). While total IgE levels were similar between the two groups, Dermatophagoides pteronyssinus (p = 0.004), Cladosporium (p = 0.017), and Aspergillus-specific IgE positivity (p = 0.025) were significantly higher in the BFB than in the UFB group. Not only symptoms such as postnasal drip (p = 0.013), mucopurulent rhinorrhea (p = 0.009), and foul odor (p = 0.037), but also sphenoid sinus involvement on CT images were more common in the BFB than in the UFB group (p = 0.011). CONCLUSION: Patients with BFB in Korea showed more common hypertension and symptoms of foul odor, mucopurulent rhinorrhea, and postnasal drip with allergy positivity compared to those with UFB. Therefore, understanding clinical characteristics of BFB will allow clinicians to approach BFB more appropriately.


Asunto(s)
Hongos , Hipertensión/epidemiología , Micosis , Rinitis , Sinusitis , Adulto , Comorbilidad , Manejo de la Enfermedad , Femenino , Hongos/clasificación , Hongos/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Micosis/epidemiología , Micosis/microbiología , Micosis/terapia , República de Corea/epidemiología , Estudios Retrospectivos , Rinitis/epidemiología , Rinitis/microbiología , Rinitis/terapia , Factores de Riesgo , Sinusitis/epidemiología , Sinusitis/microbiología , Sinusitis/cirugía , Sinusitis/terapia , Tomografía Computarizada por Rayos X/métodos
8.
Rhinology ; 57(2): 139-146, 2019 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-30471225

RESUMEN

BACKGROUND: Several previous studies have shown that serum 25(OH)D deficiency is associated with increased risk of chronic rhinosinusitis (CRS) in adults and also correlated with disease severity. We aimed to investigate the correlation between serum 25(OH)D level and endoscopy-based CRS in adults using the Korean National Health and Nutrition Examination Survey. METHODS: The data were based on the Korean National Health and Nutrition Examination Survey from 2008 to 2011. Diagnosis of endoscopy-based CRS was based on endoscopic findings of mucopurulent rhinorrhea in the middle meatus or nasal polyps, with nasal symptoms satisfying symptom-based CRS based on European Position Paper on Rhinosinusitis and Nasal Polyps 2012 criteria. Nasal symptoms included nasal obstruction, anterior/posterior nasal drip, facial pain, and the loss of smell. Serum 25(OH) D level was defined as deficient (less than 20 ng/mL), insufficient (20â€"29.9 ng/mL), or sufficient (less than or equal to 30 ng/mL). RESULTS: The serum 25(OH)D level in the CRS group was 19.293 'plus or minus' 7.035 ng/mL, which was higher than that of the control group (18.057 'plus or minus' 6.56 ng/mL, p = 0.0072). Among symptom combinations of endoscopy-based CRS, some combinations with mucopurulent rhinorrhea at the middle meatus were significantly related to normal serum 25(OH)D level. CONCLUSION: Low serum 25(OH)D level might not be associated with increased prevalence of CRS in Korean adults; rather, patients with CRS showed higher serum 25(OH)D levels than the control group. Thus, these results, contradicting those of previous studies, should be further verified in other countries to investigate the role of the serum 25(OH)D in CRS.


Asunto(s)
Pólipos Nasales , Rinitis , Sinusitis , Vitamina D/análogos & derivados , Adulto , Enfermedad Crónica , Endoscopía , Humanos , Encuestas Nutricionales , Rinitis/sangre , Sinusitis/sangre , Vitamina D/sangre
9.
J Org Chem ; 83(5): 2694-2705, 2018 03 02.
Artículo en Inglés | MEDLINE | ID: mdl-29424545

RESUMEN

We present a new and straightforward one-pot process for the synthesis of 3-carbonyl-4-quinolone derivatives through highly efficient Cu-catalyzed aza-Michael addition of 2-aminobenzoates to ß-substituted α,ß-unsaturated ketones/cyclization/mild oxidation reactions. A broad range of new versatile 3-carbonyl-quinolin-4(1H)-ones is prepared from readily available chemicals under mild reaction conditions with short reaction times, producing good to excellent yields (up to 99%).

10.
Am J Ind Med ; 2018 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-30003556

RESUMEN

BACKGROUND: Understanding of the specific risk of agricultural injury sustained by different populations of children and adolescents is needed for effective safety intervention. OBJECTIVE: To compare the rates and patterns of agricultural injury incidence (fatal and non-fatal injury) between farm and non-farm children less than 18 years of age in Alberta, Canada. METHODS: A total of 115 378 children (five subgroups: two groups of farm children and three groups of non-farm children) in Alberta were followed from 1999 to 2010 to examine injury incidence using the linkage of three administrative health databases. A recurrent event survival analysis using Cox proportional hazards regression was carried out. RESULTS: A total of 1 849 agricultural injury episodes (1 616 emergency department visits, 225 hospitalizations, and 8 deaths) were identified from 1999 to 2010. The age- and gender-adjusted rate (per 100 000 person years) of agricultural injury was 672.3 for rural-living farm children, 369.4 for urban-living farm children, 180.2 for rural non-First Nations (FN) children, 64.4 for rural FN children, and 23.7 for urban children in descending order. CONCLUSION: Specific strategies for different children's populations to prevent agricultural injuries and to extend agricultural injury controls to non-farming populations are needed.

11.
Eur Arch Otorhinolaryngol ; 274(1): 181-188, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27376646

RESUMEN

The purpose of the study was to evaluate the effect of a solid mixture of sodium hyaluronate and carboxymethylcellulose (S-HA/CMC) for the prevention of adhesions after iatrogenic mucosal injury in murine nasal cavities. We introduced iatrogenic adhesions into the bilateral nasal cavities of 20 male Sprague-Dawley rats. S-HA/CMC was applied to the left nasal cavity, while no packing was placed in the right nasal cavity as a control. At 1, 2, and 4 weeks post-procedure, we examined the number of adhesions, the ratio of the longest cross-sectional length of adhesion to septal cartilage length (RAC), and the degree of fibrosis. S-HA/CMC significantly reduced the number of adhesions when compared to the control group in total (p = 0.031), but not at each individual time point. The S-HA/CMC group showed significantly shorter RAC than the control group in total (p = 0.044), but not at each individual time point. The total fibrosis score was less severe in the S-HA/CMC group than in the control group (p < 0.001), with a significant difference between the two groups at the second week (p = 0.001). Therefore, in an animal model, S-HA/CMC can prevent post-injury mucosal adhesions suggesting a potential for clinical applications in endoscopic sinus surgery. Further clinical trials are needed to determine the safety and efficacy of S-HA/CMC as nasal packing after endoscopic sinus surgery.


Asunto(s)
Carboximetilcelulosa de Sodio/farmacología , Ácido Hialurónico/farmacología , Cavidad Nasal/cirugía , Adherencias Tisulares/prevención & control , Viscosuplementos/farmacología , Animales , Endoscopía , Fibrosis/prevención & control , Modelos Animales , Mucosa Nasal/lesiones , Mucosa Nasal/patología , Mucosa Nasal/cirugía , Ratas Sprague-Dawley
12.
Eur Arch Otorhinolaryngol ; 274(10): 3643-3649, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28707086

RESUMEN

Adhesion is a major complication of endoscopic sinus surgery that may lead to recurrence of chronic rhinosinusitis, necessitating revision surgery. The purpose of this study was to evaluate the effect of hyaluronic acid and hydroxyethyl starch (HA-HES) relative to hyaluronic acid and carboxymethylcellulose (HA-CMC) with regard to anti-adhesion effect. In this multi-center, prospective, single-blind, randomized controlled study, 77 consecutive patients who underwent bilateral endoscopic sinus surgery were enrolled between March 2014 and March 2015. HA-HES and HA-CMC were applied to randomly assigned ethmoidectomized cavities after the removal of middle meatal packing. At the 1st, 2nd and 4th weeks after surgery, the presence and grades of adhesion, edema, and infection were, respectively, examined via endoscopy by a blinded assessor. The incidence and grades of adhesion at the 2-week follow-up were significantly less in the HA-CMC group than in the HA-HES group (p < 0.05). However, with the exception of week 2, there were no significant differences in the incidence or grades of adhesion, edema, and infection between the two groups. When the primary endpoint-the presence of adhesion at the 4-week follow-up-was compared between two groups, the incidence of adhesion in HA-HES group at the 4-week follow-up was 32% and in HA-CMC was 41.3%, indicating that HA-HES was not inferior to HA-CMC in terms of anti-adhesive effect. No severe adverse reactions were noted during the study period. In conclusion, HA-HES is a safe substitutional anti-adhesion agent that has equivalent effect as HA-CMC after endoscopic sinus surgery.


Asunto(s)
Endoscopía/efectos adversos , Ácido Hialurónico/administración & dosificación , Sinusitis/cirugía , Almidón/administración & dosificación , Adherencias Tisulares/prevención & control , Adyuvantes Inmunológicos/administración & dosificación , Adulto , Carboximetilcelulosa de Sodio , Endoscopía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Senos Paranasales/patología , Senos Paranasales/cirugía , Estudios Prospectivos , Recurrencia , Método Simple Ciego , Sinusitis/diagnóstico , Resultado del Tratamiento
13.
J Craniofac Surg ; 27(4): 1013-4, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27213747

RESUMEN

Pseudoaneurysm is defined as blood leaking out of a vessel that does not have true 3 arterial walls like a true aneurysm, and is susceptible to rupture. Only 4 patients of pseudoaneurysm after endoscopic sinus surgery have been reported so far in English literature. Recently, the authors encountered a pseudoaneurysm in the internal maxillary artery after endoscopic sinus surgery, which was immediately and successfully managed with endovascular embolization. There was no bleeding or complications 6 months after the embolization.


Asunto(s)
Aneurisma Falso/etiología , Embolización Terapéutica/métodos , Endoscopía/efectos adversos , Arteria Maxilar , Procedimientos Quirúrgicos Otorrinolaringológicos/efectos adversos , Enfermedades de los Senos Paranasales/cirugía , Senos Paranasales/cirugía , Aneurisma Falso/diagnóstico , Aneurisma Falso/terapia , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos
14.
J Craniofac Surg ; 27(7): e626-e627, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27483105

RESUMEN

Although a schwannoma can originate from any central or peripheral nerves, schwannomas originating from the nasal tip are extremely rare and only 4 cases have been reported so far in English literature. These 4 cases appeared solely without any other accompanying schwannomas. However, the authors recently treated a patient with a nasal tip schwannoma coexisting with vestibular schwannoma. The nasal tip schwannoma was successfully removed without cosmetic deformity by using an open rhinoplasty approach.


Asunto(s)
Neoplasias Primarias Múltiples/diagnóstico , Neuroma Acústico/diagnóstico , Neoplasias Nasales/diagnóstico , Femenino , Humanos , Masculino , Neoplasias Primarias Múltiples/cirugía , Neurilemoma/diagnóstico , Neoplasias Nasales/cirugía , Rinoplastia
15.
Nat Commun ; 15(1): 4763, 2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38834619

RESUMEN

The state-of-the-art all-solid-state batteries have emerged as an alternative to the traditional flammable lithium-ion batteries, offering higher energy density and safety. Nevertheless, insufficient intimate contact at electrode-electrolyte surface limits their stability and electrochemical performance, hindering the commercialization of all-solid-state batteries. Herein, we conduct a systematic investigation into the effects of shear force in the dry electrode process by comparing binder-free hand-mixed pellets, wet-processed electrodes, and dry-processed electrodes. Through digitally processed images, we quantify a critical factor, 'coverage', the percentage of electrolyte-covered surface area of the active materials. The coverage of dry electrodes was significantly higher (67.2%) than those of pellets (30.6%) and wet electrodes (33.3%), enabling superior rate capability and cyclability. A physics-based electrochemical model highlights the effects of solid diffusion by elucidating the impact of coverage on active material utilization under various current densities. These results underscore the pivotal role of the electrode fabrication process, with the focus on the critical factor of coverage.

16.
Radiol Artif Intell ; 6(3): e230094, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38446041

RESUMEN

Purpose To develop an artificial intelligence (AI) system for humeral tumor detection on chest radiographs (CRs) and evaluate the impact on reader performance. Materials and Methods In this retrospective study, 14 709 CRs (January 2000 to December 2021) were collected from 13 468 patients, including CT-proven normal (n = 13 116) and humeral tumor (n = 1593) cases. The data were divided into training and test groups. A novel training method called false-positive activation area reduction (FPAR) was introduced to enhance the diagnostic performance by focusing on the humeral region. The AI program and 10 radiologists were assessed using holdout test set 1, wherein the radiologists were tested twice (with and without AI test results). The performance of the AI system was evaluated using holdout test set 2, comprising 10 497 normal images. Receiver operating characteristic analyses were conducted for evaluating model performance. Results FPAR application in the AI program improved its performance compared with a conventional model based on the area under the receiver operating characteristic curve (0.87 vs 0.82, P = .04). The proposed AI system also demonstrated improved tumor localization accuracy (80% vs 57%, P < .001). In holdout test set 2, the proposed AI system exhibited a false-positive rate of 2%. AI assistance improved the radiologists' sensitivity, specificity, and accuracy by 8.9%, 1.2%, and 3.5%, respectively (P < .05 for all). Conclusion The proposed AI tool incorporating FPAR improved humeral tumor detection on CRs and reduced false-positive results in tumor visualization. It may serve as a supportive diagnostic tool to alert radiologists about humeral abnormalities. Keywords: Artificial Intelligence, Conventional Radiography, Humerus, Machine Learning, Shoulder, Tumor Supplemental material is available for this article. © RSNA, 2024.


Asunto(s)
Inteligencia Artificial , Neoplasias , Humanos , Estudios Retrospectivos , Húmero/diagnóstico por imagen , Radiografía , Radiofármacos
17.
Invest Ophthalmol Vis Sci ; 65(5): 6, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38696188

RESUMEN

Purpose: Thyroid eye disease (TED) is characterized by proliferation of orbital tissues and complicated by compressive optic neuropathy (CON). This study aims to utilize a deep-learning (DL)-based automated segmentation model to segment orbital muscle and fat volumes on computed tomography (CT) images and provide quantitative volumetric data and a machine learning (ML)-based classifier to distinguish between TED and TED with CON. Methods: Subjects with TED who underwent clinical evaluation and orbital CT imaging were included. Patients with clinical features of CON were classified as having severe TED, and those without were classified as having mild TED. Normal subjects were used for controls. A U-Net DL-model was used for automatic segmentation of orbital muscle and fat volumes from orbital CTs, and ensemble of Random Forest Classifiers were used for volumetric analysis of muscle and fat. Results: Two hundred eighty-one subjects were included in this study. Automatic segmentation of orbital tissues was performed. Dice coefficient was recorded to be 0.902 and 0.921 for muscle and fat volumes, respectively. Muscle volumes among normal, mild, and severe TED were found to be statistically different. A classification model utilizing volume data and limited patient data had an accuracy of 0.838 and an area under the curve (AUC) of 0.929 in predicting normal, mild TED, and severe TED. Conclusions: DL-based automated segmentation of orbital images for patients with TED was found to be accurate and efficient. An ML-based classification model using volumetrics and metadata led to high diagnostic accuracy in distinguishing TED and TED with CON. By enabling rapid and precise volumetric assessment, this may be a useful tool in future clinical studies.


Asunto(s)
Tejido Adiposo , Aprendizaje Profundo , Oftalmopatía de Graves , Músculos Oculomotores , Tomografía Computarizada por Rayos X , Humanos , Oftalmopatía de Graves/diagnóstico por imagen , Oftalmopatía de Graves/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Tejido Adiposo/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Músculos Oculomotores/diagnóstico por imagen , Adulto , Órbita/diagnóstico por imagen , Anciano , Estudios Retrospectivos , Curva ROC , Tamaño de los Órganos
18.
Int J Surg ; 2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38752517

RESUMEN

BACKGROUND: Segmentectomy, recommended for early-stage lung cancer or compromised lung function, demands precise tumor detection and intersegmental plane identification. While Indocyanine green (ICG) commonly aids in these aspects using near-infrared (NIR) imaging, its separate administrations through different routes and times can lead to complications and patient anxiety. This study aims to develop a lung-specific delivery method by nebulizing low-dose ICG to targeted lung segments, allowing simultaneous detection of lung tumors and intersegmental planes across diverse animal models. METHODS: To optimizing the dose of ICG for lung tumor and interlobar fissure detection, different doses of ICG (0.25, 0.1 and 0.05 mg/kg) were nebulized to rabbit lung tumor models. The distribution of locally nebulized ICG in targeted segments was studied to evaluate the feasibility of detecting lung tumor and intersegmental planes in canine lung pseudotumor models. RESULTS: NIR fluorescence imaging demonstrated clear visualization of lung tumor margin and interlobar fissure using local nebulization of 0.1 mg/kg ICG for only 4 min during surgery in the rabbit models. In the canine model, the local nebulization of 0.05 mg/kg of ICG into the target segment enabled clear visualization of pseudotumor and intersegmental planes for 30 min. CONCLUSIONS: This innovative approach achieves a reduction in ICG dose and prolonged the visualization time of the intersegmental plane and effectively eliminates the need for the hurried marking of tumors and intersegmental planes. We anticipate that lung specific delivery of ICG will prove valuable for image-guided limited resection of lung tumors in clinical practice.

19.
Int J Surg ; 110(5): 2692-2700, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38377062

RESUMEN

BACKGROUND: This study aimed to evaluate the effectiveness of neo-mannosyl human serum albumin-indocyanine green (MSA-ICG) for detecting metastatic lymph node (LN) and mapping sentinel lymph node (SLN) using mouse footpad uterine tumor models. Additionally, the authors assessed the feasibility of MSA-ICG in SLN mapping in rabbit uterine cancer models. MATERIALS AND METHODS: The authors compared the LN targeting ability of MSA-ICG with ICG. Six mouse footpad tumor models and two normal mice were each assigned to MSA-ICG and ICG, respectively. After the assigned tracers were injected, fluorescence images were taken, and the authors compared the signal-to-background ratio (SBR) of the tracers. A SLN biopsy was performed to confirm LN metastasis status and CD206 expression level. Finally, an intraoperative SLN biopsy was performed in rabbit uterine cancer models using MSA-ICG. RESULTS: The authors detected 14 groin LNs out of 16 in the MSA-ICG and ICG groups. The SBR of the MSA-ICG group was significantly higher than that of the ICG group. The metastatic LN subgroup of MSA-ICG showed a significantly higher SBR than that of ICG. CD206 was expressed at a high level in metastatic LN, and the signal intensity difference increased as the CD206 expression level increased. SLN mapping was successfully performed in two of the three rabbit uterine cancer models. CONCLUSIONS: MSA-ICG was able to distinguish metastatic LN for an extended period due to its specific tumor-associated macrophage-targeting property. Therefore, it may be a more distinguishable tracer for identifying metastatic LNs and SLNs during uterine cancer surgery. Further research is needed to confirm these results.


Asunto(s)
Modelos Animales de Enfermedad , Verde de Indocianina , Lectinas Tipo C , Metástasis Linfática , Receptor de Manosa , Lectinas de Unión a Manosa , Receptores de Superficie Celular , Ganglio Linfático Centinela , Neoplasias Uterinas , Animales , Femenino , Conejos , Verde de Indocianina/administración & dosificación , Lectinas de Unión a Manosa/metabolismo , Lectinas de Unión a Manosa/análisis , Ratones , Neoplasias Uterinas/patología , Neoplasias Uterinas/cirugía , Ganglio Linfático Centinela/patología , Ganglio Linfático Centinela/metabolismo , Receptores de Superficie Celular/metabolismo , Lectinas Tipo C/metabolismo , Lectinas Tipo C/análisis , Biopsia del Ganglio Linfático Centinela/métodos
20.
Biomater Sci ; 12(11): 2943-2950, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38651530

RESUMEN

The widespread use of video-assisted thoracoscopic surgery (VATS) has triggered the rapid expansion in the field of computed tomography (CT)-guided preoperative localization and near-infrared (NIR) fluorescence image-guided surgery. However, its broader application has been hindered by the absence of ideal imaging contrasts that are biocompatible, minimally invasive, highly resolvable, and perfectly localized within the diseased tissue. To achieve this goal, we synthesize a dextran-based fluorescent and iodinated hydrogel, which can be injected into the tissue and imaged with both CT and NIR fluorescence modalities. By finely tuning the physical parameters such as gelation time and composition of iodinated oil (X-ray contrast agent) and indocyanine green (ICG, NIR fluorescence dye), we optimize the hydrogel for prolonged localization at the injected site without losing the dual-imaging capability. We validate the effectiveness of the developed injectable dual-imaging platform by performing image-guided resection of pulmonary nodules on tumor-bearing rabbits, which are preoperatively localized with the hydrogel. The injectable dual-imaging marker, therefore, can emerge as a powerful tool for surgical guidance.


Asunto(s)
Colorantes Fluorescentes , Hidrogeles , Verde de Indocianina , Hidrogeles/química , Hidrogeles/administración & dosificación , Animales , Verde de Indocianina/administración & dosificación , Verde de Indocianina/química , Conejos , Colorantes Fluorescentes/química , Colorantes Fluorescentes/administración & dosificación , Cirugía Asistida por Computador , Imagen Óptica , Tomografía Computarizada por Rayos X , Neoplasias Pulmonares/cirugía , Neoplasias Pulmonares/diagnóstico por imagen , Dextranos/química , Dextranos/administración & dosificación , Nódulos Pulmonares Múltiples/diagnóstico por imagen , Nódulos Pulmonares Múltiples/cirugía , Inyecciones , Humanos
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