Small bowel diverticulosis: imaging appearances, complications, and pitfalls.

Diverticula of the small bowel can be categorised as true, with Meckel's being the only example, or false. False small bowel diverticula (SBD) are acquired through herniation of the internal layers of the bowel wall through the muscularis propria. Peri-ampullary duodenal diverticula are a well-recognised example; however, the importance of more distal SBD in the jejunum and ileum is underappreciated, and they are under-reported on cross-sectional imaging. SBD are a known cause of anaemia, malabsorption, and diarrhoea, and there are myriad complications of SBD and Meckel's diverticula, which range in severity from inflammation and perforation to haemorrhage, tumour formation, and obstruction. Before the advent of computed tomography (CT), SBD were readily diagnosed on fluoroscopic oral contrast studies; however, radiologists are less comfortable with their cross-sectional imaging appearances. This imaging review combines our experience of multiple proven cases, with illustrative diagrams and radiological images of SBD to provide distinct imaging characteristics, allowing for confident diagnosis of SBD and their numerous complications. We discuss the importance of SBD as a cause of benign, non-surgical pneumoperitoneum. We additionally provide important pitfalls to be aware of such as SBD masquerading as other abnormalities.

Numerical analysis of an enhanced cooling rate cryopreservation process in a biological tissue.

Cryopreservation is the method of preservation of biological tissues for future references without causing significant damages to their physical and functional properties. This can be done by exposing them to very low cryogenic temperature that involves a greater heat removal rate. A two dimensional numerical model is developed to study the temperature distribution, cooling rate attained and movement of the freezing front during the cryopreservation process. The Pennes Bio-heat model is used for current study. The Finite Volume Method is employed for discretization of the governing differential equations while the Tri-Diagonal Matrix Algorithm is used to solve the discretized algebraic equations to find temperature distribution inside the domain. The Enthalpy-Porosity method is used to track the solid-liquid interfaces during the freezing process. The current model is first validated with the result of the existing literature. In the present work, freezing of tissue is done from one and two sides in two separate cases and the resulting temperature distribution inside the tissue and cooling rate in the two cases are compared. It is found that the freezing rate of tissue is enhanced about two times when it is freezed from two sides as compared to freezing from single side. Further, it is observed that a lower value of blood perfusion rate causes a lower value of the final temperature of the tissue after freezing. Thus, it can be concluded that the tissue with high blood perfusion rate is to be freezed in a lower cooling medium temperature. In the present condition, metabolic heat generation plays no significant role in the temperature distribution inside the healthy tissue.

Mitigation of environmental impacts due to ghat road formation in Palamalai Hills, South India, by optimizing cut and fill volumes using GPS and GIS techniques.

Formation of new roads generally brings about adverse impact on the environment, and in the case of hill roads, the impact is diverse and effective measures are required to mitigate it. The common problems in hill road formation are tree cutting, destruction of canopies, change in land use pattern, soil erosion, slope instability, induced landslides, invasion of foreign species, and so on. Removal of trees and vegetations causes rapid soil erosion, landslides, and invasion of foreign species posing danger to the survival of weak native species. Dumping of surplus earth materials on the valley side poses a significant threat to the environment as it would cause induced landslides. Using the cut earth for filling in road formation and dumping, the surplus cut earth in safe locations will reduce environmental degradation considerably. Conventionally, hill road alignments are finalized using traditional survey methods using ghat tracer, compass, and leveling surveys which require enormous complicated field and office works. Any revision to reduce the quantum of earthwork is difficult in this method due to its complex nature. In the present study at Palamalai Hills, South India, an alignment for a length of 7.95 km was prepared by traditional methods using ghat tracer and total station instruments for survey works. The earthwork quantities were ascertained from the longitudinal profile of the alignment. A GPS survey was also conducted along the alignment to examine its utility in alignment modification. To modify the stretches, where the earthwork cutting and filling are above normal and unbalanced and result in surplus earth, repeated GPS surveys were conducted along different paths to optimize the earthwork. The earthwork quantities of the original alignment were analyzed, and its correlation with environmental effect and the usefulness of the GPS survey in this task are presented in this paper.

Effect of patient characteristics on aortic attenuation in iodinated contrast-enhanced Abdominopelvic CT: A retrospective study.

INTRODUCTION: Contrast Enhanced Computed Tomography (CECT) abdomen and pelvis is a common imaging procedure. Hospitals typically follow fixed protocols of contrast volume administration for triple-phase CECT abdomen and pelvis scans and have found that patients are either underdosed or overdosed with respect to their body habitus. The aim of the study was to correlate different patient characteristics such as Total body weight (TBW), Lean Body Mass (LBM), Body Mass Index (BMI), Body Surface Area (BSA) and Blood Volume (BV) with aortic enhancement in the arterial and portal venous phases for CECT Abdomen and pelvis. METHODS: A total of 106 patients who underwent triple-phase CECT abdomen & pelvis were retrospectively studied. A circular region-of-interest (ROI) of 100 mm2 was positioned on descending aorta for unenhanced, arterial, and portal venous phases to measure the aortic enhancement in Hounsfield's units. Measure of contrast attenuation (ΔH) was calculated from the difference of CT values on unenhanced images and contrast images. Correlation analysis was performed to evaluate the relation of patient body characteristics with aortic enhancement. RESULTS: Correlation analysis revealed that BMI exhibited the least correlation when compared to the other characteristics in both arterial (r = -0.3; p = 0.002) and portovenous phases (r = -0.35; p < 0.001) whereas TBW, LBW, BSA and BV reported moderate inverse correlations. BV was found to be the strongest of all characteristics under linear regression. CONCLUSION: The study supports the use of protocols that adjust contrast volume to either TBW, LBW, BSA, or BV for CT abdomen and pelvis scan. IMPLICATION OF PRACTICE: The right body parameter ensures optimal contrast enhancement, improving the visualization of anatomical structures and helps in adapting tailored contrast injection protocols.

Flexible sigmoidoscopy does not significantly increase polyp and cancer detection yield when used to supplement CT colonography.

BACKGROUND AND AIMS: Flexible sigmoidoscopy (FS) increases polyp and carcinoma detection in addition to double contrast barium enema (DCBE). However, CT colonography (CTC) is now the preferred technique. Our aim was to explore whether FS increases polyp and carcinoma detection rates when used in addition to CTC. METHODS: Patients who underwent FS and CTC between 2007 and 2009 were included and data were collected from patient records. Yields of polyp, adenoma and carcinoma detection were calculated for FS and CTC. RESULTS: In a cohort of 294 patients, CTC detected 36 patients with carcinomas while FS detected 28. One rectal cancer not seen on CTC was diagnosed by FS. Polyps were seen by CTC in 66 and FS in 45 patients. In 5 patients FS found polyps that were not detected by CTC; 3 of which were small adenomas. FS detected extra adenomas or carcinomas in 1.36% (4/294). Adding FS to CTC neither increased the cancer nor the polyp detection yield significantly. CONCLUSIONS: This first study investigating the use of FS in addition to CTC detected little additional pathology. The routine use of FS as a supplement to CTC for adenoma and carcinoma detection is of questionable utility.

Removal of chromium using Rhizobium leguminosarum.

The chromium (Cr(III) and Cr(VI)) removal capability of Rhizobium leguminosarum was checked by estimating the amount of chromium in the medium before and after inoculation. To determine the efficiency of R. leguminosarum in removal of chromium, the influence of physical and chemical parameters such as temperature, pH and different concentrations (0.1-1.0 mM) of trivalent (Cr(III)) and hexavalent (Cr(VI)) chromium were studied. The chromium removal in aqueous solution by different size of active and inactivated biomass and immobilized cells of R. leguminosarum in a packed-bed column was also carried out. Results showed that in a medium containing up to 0.5 mM concentration of both Cr(III) and Cr(VI), R. leguminosarum showed optimal growth. The maximum chromium removal was at pH 7.0 and 35°C. Active biomass removed 84.4 ± 3.6% of Cr(III) and 77.3 ± 4.3% of Cr(VI) in 24 h of incubation time. However, inactivated biomass removed maximum chromium after 36 h of incubation. Immobilized bacterial cells in a packed-bed column removed 86.4 ± 1.7% of Cr(III) and 83.8 ± 2.2% of Cr(VI) in 16 and 20 h of incubation time, respectively.

Malignant tumours of the jaws.

Almost all variants of malignant primary and secondary tumours of bone have been described as occurring within the jaws. Odontogenic carcinomas and sarcomas are peculiar to the jawbones and are distinctly uncommon. Non-odontogenic tumours in comparison arise with more frequency, yet the maxilla and mandible remain unusual sites for most primary and secondary non-odontogenic tumours of bone. The most commonly occurring primary bone tumours affecting the jaws include osteosarcoma, Burkitt's lymphoma and multiple myeloma, while secondary or metastatic tumours to the jaws are rare in contrast to the remainder of the skeleton.

The adult cystic fibrosis patient with abdominal pain: what the radiologist needs to know.

As the life expectancy of cystic fibrosis (CF) patients continues to increase, abdominal manifestations of CF are increasingly being encountered by clinicians and radiologists. Imaging plays an important role in the evaluation of adult CF patients with abdominal pain as a cause is often not discernable clinically. Accurate diagnosis is crucial in these patients as some causes may be managed conservatively, whilst others may require surgical intervention. In this review, we describe clinical presentation, imaging findings, and management of adult CF patients presenting with abdominal pain.

Biomarkers in Bladder Cancer Surveillance.

Aim: This is a narrative review with an aim to summarise and describe urinary biomarkers in the surveillance of non-muscle-invasive bladder cancer (NMIBC). It provides a summary of FDA-approved protein biomarkers along with emerging ones which utilise genetic, epigenetic and exosomal markers. We discuss the current limitations of the available assays. Background: Current guidelines advice a combination of cystoscopy, imaging,and urine cytology in diagnosis and surveillance. Although cytology has a high specificity, it is limited by low sensitivity particularly in low grade tumours. There are six FDA-approved urinary assays for diagnosis and surveillance of bladder cancer. They have shown to improve sensitivity and specificity to be used alongside cytology and cystoscopy but have a lower specificity in comparison to cytology and false positives often occur in benign conditions. Recent developments in laboratory techniques has allowed for use of markers which are RNA-, DNA-based as well as extracellular vesicles in the past decade. Methods: Using the PubMed/Medline search engines as well as Google Scholar, we performed an online search using the terms "bladder cancer," "non-muscle invasive bladder cancer," and "urine biomarkers" with filter for articles in English published up to May 2021. Systematic reviews and original data of clinical trials or observational studies which contributed to the development of the biomarkers were collated. Results: Biomarkers identified were divided into FDA-approved molecular biomarkers, protein biomarkers and gene-related biomarker with a table summarising the findings of each marker with the most relevant studies. The studies conducted were mainly retrospective. Due to the early stages of development, only a few prospective studies have been done for more recently developed biomarkers and limited meta-analyses are available.Therefore a detailed evaluation of these markers are still required to decide on their clinical use. Conclusion: Advancements of analytical methods in BC has driven the research towards non-invasive liquid-based biomarkers in adjunct to urine cytology. Further large prospective studies are required to determine its feasibility in a clinical setting as they are not effective when used in isolation as they have their limitation. With the ongoing pandemic, other than reduction in costs and increased accuracy, the need for biomarkers to cope with delay in cystoscopies in diagnosis and surveillance is crucial. Thus clinical trials with direct comparison is required to improve patient care.

Treatment by limited surgery and specific immunization of guinea pigs with stage II experimental cancer.

The malignant disease produced in guinea pigs by intradermal inoculation of line-10 was allowed to progress to stage II, at which time the dermal tumor and the first draining lymph node were grossly evident. At that stage, the external appearance of the next draining lymph node was normal, but it contained tumor cells. Limited surgery consisting of excision of the dermal tumor and first draining lymph node was not curative; palpable metastases developed in the second and other draining lymph nodes, and at autopsy, some animals were found to have gross, visible lung metastases. Immunization of guinea pigs with a mixture of irradiated syngeneic tumor cells plus mycobacterial cell walls in an oil-in-water emulsion eradicated tumor cells remaining in lymph nodes after limited surgery for stage II experimental cancer and prevented progression of the disease to stage III. Tumor intravenously implanted in the lungs of animals after limited surgery for stage II disease was also eliminated by immunization.

Think before you prescribe: how dentistry contributes to antibiotic resistance.

Antibiotic resistance presents a daunting challenge to health professionals worldwide and has the potential to create major problems for modern health care, resulting in more medical expenditure, extended hospital stays and increased morbidity and mortality. Advanced genome sequencing technologies present a complex picture of resistance, extending our understanding beyond the pharmacotherapeutic interface between pathogens and antibiotics. This review discusses the global scope and scale of antibiotic resistance and contextualizes it for the dental practitioner, emphasizing the role we must play in limiting the progression of resistance through antibiotic stewardship and disease prevention.

Independent molecular pathways in initiation and loss of hormone responsiveness of breast carcinomas.

These studies were set up to determine whether those oncogenes participating in the initiation of mammary carcinogenesis (for example, ras oncogenes) play a direct role in the outcome of events associated with the late stages of tumor development such as loss of hormone dependency. Mammary carcinomas induced by a single carcinogenic insult in pubescent rats was selected as an in vivo model system with direct relevance to human breast cancer. Acquisition of hormone-independent growth in these carcinogen-induced tumors was found to be independent of the activation of ras oncogenes during the early stages of carcinogenesis. In agreement with these observations, introduction of a human ras oncogene into human MCF-7 breast carcinoma cells did not abrogate their hormonal dependency for growth in vivo. These findings suggest that those events responsible for the critical stages of breast cancer development occur independently and in an uncoordinated manner.

Activation of ras oncogenes preceding the onset of neoplasia.

The identification of ras oncogenes in human and animal cancers including precancerous lesions indicates that these genes participate in the early stages of neoplastic development. Yet, these observations do not define the timing of ras oncogene activation in the multistep process of carcinogenesis. To ascertain the timing of ras oncogene activation, an animal model system was devised that involves the induction of mammary carcinomas in rats exposed at birth to the carcinogen nitrosomethylurea. High-resolution restriction fragment length polymorphism analysis of polymerase chain reaction-amplified ras sequences revealed the presence of both H-ras and K-ras oncogenes in normal mammary glands 2 weeks after carcinogen treatment and at least 2 months before the onset of neoplasia. These ras oncogenes can remain latent within the mammary gland until exposure to estrogens, demonstrating that activation of ras oncogenes can precede the onset of neoplasia and suggesting that normal physiological proliferative processes such as estrogen-induced mammary gland development may lead to neoplasia if the targeted cells harbor latent ras oncogenes.

A transforming ras gene in tumorigenic guinea pig cell lines initiated by diverse chemical carcinogens.

Fetal guinea pig cells were transformed by treatment with four different chemical carcinogens including nitroso compounds and polycyclic hydrocarbons. As a consequence of this treatment, oncogenes capable of transforming NIH/3T3 cells became activated in each of five independently established clonal guinea pig cell lines. Molecular characterization of representative NIH/3T3 transformants revealed that the same oncogene was present in each of the cell lines tested. Moreover, detection of this transforming gene paralleled the acquisition of tumorigenic properties by these neoplastic cells.

Outburst of Jupiter's synchrotron radiation after the impact of comet Shoemaker-Levy 9.

Jupiter's nonthermal microwave emission, as measured by a global network of 11 radio telescopes, increased dramatically during the Shoemaker-Levy 9 impacts. The increase was wavelength-dependent, varying from approximately 10 percent at 70 to 90 centimeters to approximately 45 percent at 6 and 36 centimeters. The radio spectrum hardened (flattened toward shorter wavelengths) considerably during the week of impacts and continued to harden afterward. After the week of cometary impacts, the flux density began to subside at all wavelengths and was still declining 3 months later. Very Large Array and Australia Telescope images of the brightness distribution showed the enhancement to be localized in longitude and concentrated near the magnetic equator. The evidence therefore suggests that the increase in flux density was caused by a change in the resident particle population, for example, through an energization or spatial redistribution of the emitting particles.

HOXA1-stimulated oncogenicity is mediated by selective upregulation of components of the p44/42 MAP kinase pathway in human mammary carcinoma cells.

Expression of homeobox A1 (HOXA1) results in oncogenic transformation of immortalized human mammary epithelial cells with aggressive tumor formation in vivo. However, the mechanisms by which HOXA1 mediates oncogenic transformation is not well defined. To identify molecules that could potentially be involved in HOXA1-mediated oncogenic transformation, microarray analysis was utilized to characterize and compare the gene expression pattern in response to forced expression or depletion of HOXA1 in human mammary carcinoma cells. Gene expression profiling identified that genes involved in the p44/42 mitogen-activated protein (MAP) kinase activation pathway (GRB2, MAP kinase kinase (MEK1) and SDFR1) or p44/42 MAP kinase-regulated genes (IER3, EPAS1, PCNA and catalase) are downstream expression targets of HOXA1. Forced expression of HOXA1 increased GRB2 and MEK1 mRNA and protein expression and increased p44/42 MAP kinase phosphorylation, activity and Elk-1-mediated transcription. Use of a MEK1 inhibitor demonstrated that increased p44/42 MAP kinase activity is required for the HOXA1-mediated increase in cell proliferation, survival, oncogenicity and oncogenic transformation. Thus, modulation of the p44/42 MAP kinase pathway is one mechanism by which HOXA1 mediates oncogenic transformation of the human mammary epithelial cell.

Methylation is less abundant in BRCA1-associated compared with sporadic breast cancer.

BACKGROUND: Promoter methylation is a common epigenetic mechanism to silence tumor suppressor genes during breast cancer development. We investigated whether BRCA1-associated breast tumors show cancer-predictive methylation patterns similar to those found in sporadic tumors. PATIENTS AND METHODS: Quantitative multiplex methylation-specific PCR of 11 genes involved in breast carcinogenesis (RARB, RASSF1, TWIST1, CCND2, ESR1, SCGB3A1, BRCA1, BRCA2, CDKN2A, APC, CDH1) was carried out on 32 BRCA1-associated and 46 sporadic breast carcinomas and on normal breast tissue from seven BRCA1 mutation carriers and 13 non-carriers. RESULTS: The extent of cumulative methylation increased with age (P < 0.001). The median cumulative methylation index (CMI) of all studied genes was significantly higher in tumors (89) than in normal tissue (13, P < 0.001). The median CMI was significantly lower in BRCA1-associated (59) than in sporadic breast tumors (122, P = 0.001), in estrogen receptor (ER)-negative tumors (73) than in ER-positive tumors (122, P = 0.005) and in lymph node-negative (77) compared with lymph node-positive tumors (137, P = 0.007). In subgroup analysis, the effect of a BRCA1 germline mutation on methylation proved to be independent of ER status, lymph node status and age. CONCLUSIONS: These data indicate that BRCA1-associated breast cancers show less promoter methylation compared with sporadic breast carcinomas indicating a difference in disease etiology.

Interspecific rice hybrid of Oryza sativa x Oryza nivara reveals a significant increase in seed protein content.

Wild species offer a potential reservoir of genetic variation for crop improvement. Besides the valuable genes for disease resistance that the wild species have provided for rice improvement, recent studies have shown that these wild species could also provide favorable alleles for the improvement of yield and yield-related traits. The present study reports yet another potential of wild relatives of rice, which involves the improvement of seed protein content. A significant increase in seed protein content was observed in an interspecific hybrid between Oryza sativa ssp. indica and the wild species Oryza nivara. The hybrid showed a protein content of 12.4%, which was 28 and 18.2% higher than those of the parents O. nivara and IR 64, respectively. The increase in protein content was dependent on the genetic background of the rice variety used in the hybridization. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of seed storage proteins demonstrated that a significant increase in prolamins and glutelins was mainly responsible for the elevated protein content of the hybrid. Amino acid analysis of seed proteins revealed that the hybrid had net gains of 19.5% in lysine and 19.4% in threonine over the O. nivara parent on a seed dry weight basis. Molecular analysis indicated that the increase in protein content of the hybrid was not a result of chromosomal rearrangements or transposable element activation, at least in the chromosomal regions containing seed storage protein genes. A preliminary genetic analysis of the F 2 segregating population showed that the inheritance of the increased protein content was polygenic in nature. The development of this interspecific hybrid offers a great potential for selecting new rice cultivars that combine the high yield and superior cooking quality of IR 64 with improved seed protein content.