Interleukin 26 suppresses receptor activator of nuclear factor κB ligand induced osteoclastogenesis via down-regulation of nuclear factor of activated T-cells, cytoplasmic 1 and nuclear factor κB activity.

OBJECTIVE: IL-26 has been shown to have high expression in RA. However, the effects of IL-26 on bone destruction in RA have not been evaluated. The aim of this study was to investigate the effects and mechanisms of IL-26 on RANK ligand (RANKL)-induced osteoclastogenesis. METHODS: We treated cells with IL-26 in RANKL-induced oseteoclastogenesis to monitor osteoclast formation by tartrate-resistant acid phosphatase (TRAP) staining. Osteoclast activity was assessed by pit formation assay and F-actin ring formation. The mechanism of the inhibition was studied by biochemical analyses such as RT-PCR, immunofluorescence staining and immunoblotting. In addition, cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. RESULTS: IL-26 inhibited RANKL-induced TRAP-positive multinucleated cells and inhibited RANKL-induced nuclear factor κB (NF-κB) activation and nuclear factor of activated T cells, cytoplasmic 1 (NFATc1) nuclear translocation in RAW264.7 cells. Also, IL-26 significantly inhibited the bone-resorbing activity and F-actin ring formation ability of mature osteoclasts. Moreover, IL-26 suppressed RANKL-induced mitogen-activated protein kinase activation and NFATc1 downstream gene expression. CONCLUSION: We suggest that the inhibitory activity of IL-26 on osteoclastogenesis is via down-regulation of RANKL-induced NF-κB and NFATc1 expression. Our results suggest IL-26 as a possible new remedy against osteolytic bone destruction.

Association of pulse pressure with hematoma expansion in patients with spontaneous supratentorial intracerebral hemorrhage.

Objective: Recent reports have demonstrated that a wider pulse pressure upon admission is correlated with heightened in-hospital mortality following spontaneous supratentorial intracerebral hemorrhage (ssICH). However, the underlying mechanism remains ambiguous. We investigated whether a wider pulse pressure was associated with hematoma expansion (HE). Methods: Demographic information, clinical features, and functional outcomes of patients diagnosed with ssICH were retrospectively collected and analyzed. Multivariate logistic regression was conducted to identify independent predictors of HE. Weighted logistic regression, restricted cubic spline models, and propensity score matching (PSM) were employed to estimate the association between pulse pressure and HE. Results: We included 234 eligible adult ssICH patients aged 60 (51-71) years, and 55.56% were male. The mean pulse pressure was 80.94 ± 23.32 mmHg. Twenty-seven patients (11.54%) developed early HE events, and 116 (49.57%) experienced a poor outcome (modified Rankin scale 3-6). A wider mean pulse pressure as a continuous variable was a predictor of HE [odds ratios (OR) 1.026, 95% confidence interval (CI) 1.007-1.046, p = 0.008] in multivariate analysis. We transformed pulse pressure into a dichotomous variable based on its cutoff value. After adjusting for confounding of HE variables, the occurrence of HE in patients with ssICH with wider pulse pressure levels (≥98 mmHg) had 3.78 times (OR 95% CI 1.47-9.68, p = 0.006) compared to those with narrower pulse pressure levels (<98 mmHg). A linear association was observed between pulse pressure and increased HE risk (P for overall = 0.036, P for nonlinear = 0.759). After 1:1 PSM (pulse pressure ≥98 mmHg vs. pulse pressure <98 mmHg), the rates of HE events and poor outcome still had statistically significant in wider-pulse pressure group [HE, 12/51 (23.53%) vs. 4/51 [7.84%], p = 0.029; poor outcome, 34/51 (66.67%) vs. 19/51 (37.25%), p = 0.003]. Conclusion: Widened acute pulse pressure (≥98 mmHg) levels at admission are associated with increased risks of early HE and unfavorable outcomes in patients with ssICH.

Effects of microvascular permeability changes on contrast-enhanced T1 and pharmacokinetic MR imagings after ischemia.

BACKGROUND AND PURPOSE: Brain enhancement on contrast-enhanced T1-weighted imaging (CET1-WI) after ischemic stroke is generally accepted as an indicator of the blood-brain barrier disruption. However, this phenomenon usually starts to become visible at the subacute phase. The purpose of this study was to evaluate the time-course profiles of K(trans), cerebral blood volume (vp), and CET1-WI with early detection of blood-brain barrier changes on K(trans) maps and their role for prediction of subsequent hemorrhagic transformation in acute middle cerebral arterial infarct. METHODS: Twenty-six patients with acute middle cerebral arterial stroke and early spontaneous reperfusion, whose MR images were obtained at predetermined stroke stages, were included. T2*-based MR perfusion-weighted images were acquired using the first-pass pharmacokinetic model to derive K(trans) and vp. Parenchymal enhancement observed on maps of K(trans), vp, and CET1-WI at each stage was compared. Association among these measurements and hemorrhagic transformation was analyzed. RESULTS: K(trans) map showed significantly higher parenchymal enhancement in ischemic parenchyma as compared with that of vp map and CET1-WI at early stroke stages (P<0.05). The increased K(trans) at acute stage was not associated with parenchymal enhancement in CET1-WI at the same stage. Parenchymal enhancement in CET1-WI started to occur at the late subacute stage and tended to be luxury reperfusion-dependent. Patients with hemorrhagic transformation showed higher mean K(trans) values as compared with patients without hemorrhagic transformation (P=0.02). CONCLUSIONS: Postischemic brain enhancement on routine CET1-WI seems to be closely related to the luxury reperfusion at the late subacute stage and is not dependent on microvascular permeability changes at the acute stage.

Altered TGF-ß2 and bFGF expression in scleral desmocytes from an experimentally-induced myopia guinea pig model.

PURPOSE: To determine changes in expression of transforming growth factor ß-2 (TGF-ß2) and basic fibroblast growth factor (bFGF) in scleral desmocytes from anterior and posterior portions of experimentally-induced myopic eyes of guinea pigs. METHODS: Three groups (n = 10) of 2-week-old guinea pigs were used to develop concave lens-induced myopia (LIM) in one eye via the out-of-focus method for 6, 15, or 30 days respectively, while the other eye in each guinea pig served as the self-control (SC). After myopia induction, lenses were removed, and scleral fibroblasts were cultured and passaged twice. TGF-ß2 and bFGF expression levels of scleral desmocytes in LIM and SC groups were compared by immunocytochemistry, quantitative real-time PCR (qRT-PCR) and Western blot analyses. RESULTS: The TGF-ß2 expression of the anterior portion of the sclera in the LIM group was significantly higher at 15 days, and at its highest at 30 days after myopia induction compared with the SC group (P < 0.05). The TGF-ß2 staining of the posterior sclera in the LIM group began to rise significantly at 6 days, peaked at 15 days and remained significantly higher than that of the anterior part, as well as the SC group, even at 30 days after myopia induction (P < 0.05). BFGF levels in scleral desmocytes from the anterior and posterior regions in the LIM group were both significantly lower than those of the SC group at all time points after myopia induction (P < 0.05). Furthermore, as the myopia progressed, bFGF expression in the anterior and posterior sclera in the LIM group gradually and statistically significantly decreased compared with the SC group (P < 0.05); however, no significant differences were observed between the anterior and posterior parts in the LIM group at any time after myopia induction (P > 0.05). All these results were consistent at the mRNA and protein levels. CONCLUSIONS: During myopia development in lens-induced guinea pigs, the increase in TGF-ß2 activity of scleral desmocytes initiated at the posterior pole. Along with the induction time, the TGF-ß2 activity in all scleral desmocytes became elevated. By contrast, the bFGF activity showed a general decline in all scleral desmocytes, rather than mainly in the posterior pole. These results imply that expression of TGF-ß2 in scleral desmocytes plays a direct role, while that of bFGF exerts an indirect role in myopia development.

Enhancing anatomy education through cooperative learning: harnessing virtual reality for effective gross anatomy learning.

The advent of virtual reality (VR) in education offers unique possibilities for facilitating cooperative learning strategies, particularly in fields demanding intricate spatial understanding, such as gross anatomy. This study investigates the impact of integrating cooperative learning strategies within a VR-based gross anatomy curriculum, focusing on enhancing students' anatomy knowledge and skills. We analyzed the performance of two cohorts of first-year nursing students across five semesters (2016-2020), where traditional learning methods were used in the first three semesters (2016-2018), and a VR-based cooperative learning approach was adopted in the last two semesters (2019-2020). Our findings suggest that the VR-based cooperative learning group achieved significantly higher scores in their gross anatomy laboratory courses compared to their counterparts learning through traditional methods. This research provides valuable insights into how the integration of VR technology and cooperative learning strategies can not only enhance learning outcomes but also improve the VR learning experience by reducing motion sickness. It accentuates the potential of VR-based cooperative learning as an impactful educational tool in anatomy education. Future research should further explore the optimal integration of VR and cooperative learning strategies in diverse course types and their potential to enhance educational outcomes and the learning experience.

Mechanical behavior of scleral fibroblasts in experimental myopia.

BACKGROUND: The study aims to determine the changes in the biomechanical properties of the anterior and extreme posterior portions of experimental near-sighted eyes by examining the mechanical behavior of guinea pig scleral desmocytes, thus finding a new approach to the pathogenesis of myopia and their corresponding therapies. METHODS: Guinea pigs (2 weeks old) were numbered and assigned into three groups (A, B, and C) with ten guinea pigs each. Concave lens-induced myopic (LIM) animal models were prepared via the out-of-focus method. The other eye in the same guinea pig served as the self-control (SC) group. After modeling groups A, B, and C for 6, 15, and 30 days respectively, the lenses from the guinea pigs in the experimental group were removed. The scleral fibroblasts in each group were cultured, and passaged twice in vitro. The micropipette aspiration technique coupled with a viscoelastic solid model was utilized to investigate the viscoelastic properties of the scleral fibroblasts in normal and myopic guinea pigs. The mechanical behavior of the scleral desmocytes of the LIM and SC groups were compared. RESULTS: The mechanical behavior of the scleral desmocytes was compared between the LIM and SC groups. The Young's modulus at equilibrium and the apparent cellular viscosity of the anterior portion of the sclera in the LIM group at 6 days and 15 days after myopic induction were not significantly different from that of the SC group (P < 0.05). However, the results for the anterior portions of the sclera in the LIM group at 30 days were significantly higher than those of the LIM group at 6 and 15 days, as well as those in the SC group (P < 0.05). The Young's modulus at equilibrium and the apparent cellular viscosity of the extreme posterior portions of the sclera in the LIM group at 6 days after myopic induction not significantly from those of the SC group (P < 0.05). However, the results for the extreme posterior portions of the sclera in the LIM group after 15 days and 30 days were significantly higher than those in the LIM group at 6 days and the SC group (P < 0.05). CONCLUSIONS: The Young's modulus at equilibrium or apparent cellular viscosity of all the anterior portions of the sclera in the LIM group were longer than those in the SC group at 30 days after the induction, and the results for all the extreme posterior portions of the LIM group were larger than those of the SC group on the 15th and 30th day. Therefore, the Young's modulus and apparent viscosity of the anterior and extreme posterior portions of the sclera changed on the 15th and 30th day after induction respectively.

Salvia miltiorrhiza-Containing Chinese Herbal Medicine Combined With GnRH Agonist for Postoperative Treatment of Endometriosis: A Systematic Review and meta-Analysis.

Background: Endometriosis is an estrogen-dependent gynecological inflammatory condition that may lead to infertility and recurrent pelvic pain. The purpose of this research was to determine the efficacy and safety of Salvia miltiorrhiza-containing Chinese herbal medicine (CHM) combined with gonadotropin-releasing hormone agonist (GnRH-a) for postoperative endometriosis management. Methods:Eight databases were systematically searched before October 2021, including PubMed, Embase, Cochrane Library, Scopus, Web of Sceince, CNKI, VIP, and Wanfang. Finally, all randomized controlled studies comparing Salvia miltiorrhiza-containing CHM paired with GnRH-a to GnRH-a alone for postoperative endometriosis management were included. Results: A total of 10 trials involving 836 patients were reported and analyzed. Compared with the control group, the Salvia miltiorrhiza-containing CHM combined with GnRH-a group showed significant superiority in decreasing endometriosis recurrence (risk ratio [RR] = 0.26; 95% confidence intervals [CI]: 0.16-0.41) and increasing the pregnancy rate ([RR] = 1.96; 95% CI: 1.58-2.44). Similarly, the effect of the Salvia miltiorrhiza-containing CHM combined with GnRH-a on CA-125 serum levels was positive (standardized mean difference [SMD] = -0.79; 95% CI: -1.11 to -0.47). Furthermore, this group showed a significant reduction in adverse effects. Conclusion: The results indicate that Salvia miltiorrhiza-containing CHM may be a viable choice for postoperative endometriosis therapy, with the potential to enhance pregnancy while decreasing recurrence and adverse effects.

Association Between Serum Lactate Dehydrogenase Level and Hematoma Expansion in Patients with Primary Intracerebral Hemorrhage: A Propensity-Matched Analysis.

OBJECTIVE: The present study aimed to explore whether a higher serum lactate dehydrogenase (sLDH) level on admission is associated with hematoma expansion (HE) in patients with primary intracerebral hemorrhage (ICH). METHODS: This single-center prospective observational study of patients with primary ICH aged 19 years or older was conducted at the Dehua County Hospital from January 2018 to May 2021. Clinical data and demographic information and outcomes were collected and analyzed. The association between increased sLDH levels and HE was assessed in univariate and multivariate analyses. Propensity-score matching (PSM) analysis was implemented to reduce baseline differences between the groups. RESULTS: Of 609 patients with ICH screened, 360 who met all eligibility criteria were enrolled in the study (mean age, 59.83 ± 12.64 years; 60.28% female patients), of whom 69 (19.17%) developed early HE. sLDH levels were statistically higher in the HE group compared with the non-HE group (236.0 [222.30-275.50] U/L vs. 209.6 [179.30-253.8] U/L; P < 0.001). Multivariable analysis showed that higher sLDH levels were still statistically associated with HE (odds ratio [OR], 0.08; 95% confidence interval, 0.03-0.210; P < 0.001). After PSM, the matched HE group had a significantly higher sLDH level than did the matched non-HE group (236.0 [222.0-279.10] vs. 216.30 [173.0-278.7] U/L; P = 0.003). The area under the curve of 0.704 (95% confidence interval, 0.654-0.751; P < 0.0001) (sensitivity, 92.75%; specificity, 52.58%), and the optimal cutoff value for sLDH level as a predictor for HE in patients with primary ICH was determined as 211.0U/L. The area under the curve of the logistic regression model based on these predictors (the TsL (time from onset to initial computed tomography,sLDH) modelbased on these predictors: sLDH, time from onset to initial computed tomography) was 0.817, with a sensitivity of 84.06% and specificity of 72.51% for HE. The TsL model produced the best ability to predict HE compared with single sLDH. sLDH levels were statistically correlated with poor outcome. CONCLUSIONS: The current PSM analysis study shows that increased serum LDH level is statistically associated with HE. Our findings indicate that the TsL model constructed by sLDH and time from onset to initial computed tomography markedly enhances the prediction of HE after ICH.

Utility of magnetic resonance spectroscopy and diffusion-weighted imaging for detecting changes in the femoral head in divers with hip pain at risk for dysbaric osteonecrosis.

BACKGROUND: Ischemia before the development of dysbaric osteonecrosis (DON) in femoral heads has never been investigated. We assessed whether quantitative magnetic resonance spectroscopy (MRS) and diffusion weighted imaging (DWI) could detect dysbaric changes in divers with hip pain. METHODS: This IRB-approved exploratory study recruited 17 divers [9 with hip pain (Group 1); 8 asymptomatic (Group 2)] with normal findings on radiographs and conventional magnetic resonance imaging scans were age-, gender- and body-mass-index matched to 17 non-divers as controls (Group 1C, 2C). Apparent diffusion coefficients (ADCs) and MRS spectra were obtained from regions/voxels of interest on the femoral heads of all subjects. LCModel was used to determine water content, lipid composition, and the unsaturation index in bone marrow. Mann-Whitney non-parametric test was used to compare results of quantitative MRS and ADCs of ipsilateral femoral heads between divers and controls. RESULTS: MRS of the ipsilateral femoral heads revealed higher water (peak: 4.7 ppm) content, lower total lipid fraction (TLF), and higher unsaturation index (UI) of lipids in Group 1 than in Group 2 (water: P=0.040; UI: P=0.022) and Group 1C (water: P=0.027; TLF: P=0.039; UI: P=0.009). In contrast, femoral head ADCs were comparable between divers and controls. Five out of nine symptomatic divers were contacted for follow-up MRS and DWI studies, and the mean difference in water content in the femoral heads of patients with osteonecrosis was also higher than that in patients with symptom relief (osteonecrosis: 0.077±0.130 vs. symptom relief: 0.003±0.010). CONCLUSIONS: Dysbaric change in the femoral heads of divers with hip pain can be detected using quantitative MRS, which reveals increases in water content and UI of lipids, and a decrease in TLF.

Idiopathic growth hormone deficiency in the morphologically normal pituitary gland is associated with perfusion delay.

PURPOSE: To investigate quantitatively the topographic perfusion characteristics of the adenohypophysis by using dynamic contrast material-enhanced magnetic resonance (MR) imaging in a subgroup of patients with idiopathic growth hormone deficiency (IGHD) and with normal-appearing pituitary morphology on MR images. MATERIALS AND METHODS: This HIPAA-compliant, prospective study was approved by an institutional review board, and informed consent was obtained for all patients. Twenty-five patients (mean age, 10.6 years ± 3.3 [standard deviation]) with clinical growth retardation, proved IGHD, and normal pituitary morphology on MR images were included for analysis. Sixteen children (mean age, 10.8 years ± 5.5) were included as control subjects. Time to peak (TTP) perfusion properties of the adenohypophysis in 10 regions of interest from multisection coronal dynamic contrast-enhanced T1-weighted MR images were quantitatively derived by using the Brix pharmacokinetic model. Significant difference was determined with a two-tailed Student t test. The Pearson correlation coefficient was used to correlate the perfusion parameters, including maximal enhancement peak and slope, with serum growth hormone levels in the IGHD group. RESULTS: TTP for the IGHD group was significantly prolonged compared with that for the control group (P < .005). The prolonged TTP in the IGHD group was found to be diffuse. The levels of growth hormone deficiency were negatively correlated with the peak enhancement and the slope of the wash-in phase, which suggests increased blood volume in IGHD within the pituitary gland. CONCLUSION: IGHD and the degree of growth hormone deficiency are associated with nonregional perfusion delay in morphologically normal adenohypophyses. The lack of lateralization of perfusion delay may suggest that microvascular structural abnormalities play a role in IGHD.

Potential long-term effects of MDMA on the basal ganglia-thalamocortical circuit: a proton MR spectroscopy and diffusion-tensor imaging study.

PURPOSE: To investigate the effects of 3,4-methylenedioxymethamphetamine (MDMA, commonly known as "ecstasy") on the alterations of brain metabolites and anatomic tissue integrity related to the function of the basal ganglia-thalamocortical circuit by using proton magnetic resonance (MR) spectroscopy and diffusion-tensor MR imaging. MATERIALS AND METHODS: This study was approved by a local institutional review board, and written informed consent was obtained from all subjects. Thirty-one long-term (>1 year) MDMA users and 33 healthy subjects were enrolled. Proton MR spectroscopy from the middle frontal cortex and bilateral basal ganglia and whole-brain diffusion-tensor MR imaging were performed with a 3.0-T system. Absolute concentrations of metabolites were computed, and diffusion-tensor data were registered to the International Consortium for Brain Mapping template to facilitate voxel-based group comparison. RESULTS: The mean myo-inositol level in the basal ganglia of MDMA users (left: 4.55 mmol/L ± 2.01 [standard deviation], right: 4.48 mmol/L ± 1.33) was significantly higher than that in control subjects (left: 3.25 mmol/L ± 1.30, right: 3.31 mmol/L ± 1.19) (P < .001). Cumulative lifetime MDMA dose showed a positive correlation with the levels of choline-containing compounds (Cho) in the right basal ganglia (r = 0.47, P = .02). MDMA users also showed a significant increase in fractional anisotropy (FA) in the bilateral thalami and significant changes in water diffusion in several regions related to the basal ganglia-thalamocortical circuit as compared with control subjects (P < .05; cluster size, >50 voxels). CONCLUSION: Increased myo-inositol and Cho concentrations in the basal ganglia of MDMA users are suggestive of glial response to degenerating serotonergic functions. The abnormal metabolic changes in the basal ganglia may consequently affect the inhibitory effect of the basal ganglia to the thalamus, as suggested by the increased FA in the thalamus and abnormal changes in water diffusion in the corresponding basal ganglia-thalamocortical circuit.

[Occupational health status of migrant female workers of artificial gem manufacturing cottages in Guangxi].

OBJECTIVE: To investigate occupational health status in migrant female workers in artificial gem cottages in Guangxi and to provide reference evidence for drawing up countermeasures to protect migrant female workers from occupational hazards. METHODS: Two thousands and ninety five migrant female workers in artificial gem manufacturing cottages in Wuzhou City, Guangxi Province, were randomly recruited to participate in the investigation. The standardized occupational health questionnaires were used to collect the information of demographic characteristics, occupational exposure and medical symptoms by interviewing with persons. RESULTS: Artificial gem manufacturing cottages in Wuzhou were mainly composed of family-workshops. There were only simple and crude hygienic facilities. Major occupational hazards included dusts, noise, vibration, hydrofluoric acid, and light stimulation. The mean age of workers was 30. Mean exposure duration was 5 years. There was no occupational health monitoring records for these workers in the past years. Major symptoms included back pain, eye discomfort, and headache. The incidence of discomfort symptoms increased with age. CONCLUSION: Occupational health protection and monitoring in artificial gem manufacturing cottage, in Guangxi have not been performed. More effective occupational health education and administration need to implement in family-type handicraft manufacturing.

The complete chloroplast genome of Callicarpa bodinieri (Lamiales, Lamiaceae), an ornamental and medicinal plant from Chongqing, China.

Plants classified to the genus Callicarpa L. have important medicinal and ornamental value. Here, we report and characterize the complete chloroplast (cp) genome of C. bodinieri to provide molecular basis for the further studies on the phylogeny analysis of this genus. The cp genome is 154,183 bp in length and is organized with a typical quadripartite structure, containing two inverted repeats of 25,701 bp separated by a large single-copy region of 84,956 bp and a small single-copy region of 17,825 bp. The cp genome of C. bodinieri contains 112 distinct genes, including 78 protein-coding, 30 tRNAs and 4 rRNAs genes. The phylogenetic analysis showed that C. bodinieri is fully resolved in a clade with C. nudiflora, sister to the clade of C. formosana and C. longifolia var. floccosa.

The complete chloroplast genome of Callicarpa longifolia Lamk. var. floccosa Schauer (Lamiaceae).

Callicarpa longifolia Lamk. var. floccosa Schauer is a species with medicinal and ornamental values. In this study, the complete chloroplast genome of C. longifolia var. floccose is reported. The chloroplast genome of this species is 154,285 bp in length and contains a typical circular quadripartite structure. There are two inverted repeats of 25,700 bp, which is separated by a large single-copy region of 85,008 bp and a small single-copy region of 17,877 bp. The complete chloroplast contains 112 distinct genes, including 78 protein-coding, 30 tRNAs and 4 rRNAs genes. Phylogenetic analysis suggests that C. longifolia var. floccose is closely associated with C. formosana.

The complete chloroplast genome of Rhododendron platypodum (Ericaceae): an endemic and endangered species from China.

Rhododendron platypodum Diels (Ericaceae) is a Chinese endemic and endangered species with high ornamental value. Here the complete chloroplast (cp) genome of R. platypodum was assembled and characterized. The cp genome is in a total length of 201,047 bp with the typical quadripartite structure of angiosperms, containing two inverted repeats (IRs) of 44,650 bp separated by a large single-copy (LSC) region of 109,134 bp and a small single-copy (SSC) region of 2613 bp. The whole cp genome of R. platypodum contains 143 genes, including 93 protein-coding genes, 42 transfer RNA genes and 8 ribosomal RNA genes. Phylogenetic analysis based on the coding sequences of cp genome within the Ericaceae family suggests that R. platypodum is closely related to R. delavayi.

Hypoperfusion of the infrapatellar fat pad and its relationship to MRI T2* relaxation time changes in a 5/6 nephrectomy model.

The purpose of present study was to longitudinally investigate the alterations in infrapatellar fat pad (IPFP) vascularity in 5/6 nephrectomized rats by using dynamic contrast enhanced (DCE) MRI and IPFP degeneration by using MRI T2* relaxation time. Twelve male Sprague-Dawley rats were assigned to a control group and a 5/6 nephrectomy CKD group. The right knees of all rats were longitudinally scanned by 4.7 T MRI, and serial changes in the IPFP were assessed at 0, 8, 16, 30, and 44 weeks by DCE-MRI (parameters A, kel and kep) and MRI T2* mapping. After MRI measurements, knee specimens were obtained and evaluated histologically. The CKD group had IPFPs with lower blood volume A and lower permeability kep values from 16 weeks (p < 0.05), lower venous washout kel value from 30 weeks (p < 0.001), and significantly higher T2* values reflecting adipocyte degeneration beginning at 16 weeks (p < 0.05). The histopathological results confirmed the MRI findings. Hypoperfusion and adipocytes degeneration related to CKD were demonstrated in a rodent 5/6 nephrectomy model. DCE parameters and MRI T2* can serve as imaging biomarkers of fat pad degeneration during CKD progression.

Admission Neutrophil-Lymphocyte Ratio Predicts Rebleeding Following Aneurismal Subarachnoid Hemorrhage.

OBJECTIVE: The relationship between neutrophil-lymphocyte ratio (NLR) and the occurrence of rebleeding in aneurysmal subarachnoid hemorrhage (aSAH) is poorly understood. Our study aimed to investigate the association between NLR on admission and rebleeding following aSAH. METHODS: Clinical and laboratorial data from patients with aSAH were retrospectively collected, including leukocyte, neutrophil, lymphocyte, and NLR. Univariate and multivariate analyses were performed to assess for the association of NLR with rebleeding. We performed propensity-score matching analyses to correct imbalances in patient characteristics between the rebleeding group and nonrebleeding group. RESULTS: Rebleeding occurred in 30 of 716 (4.19%) patients with aSAH in this cohort. Patients with rebleeding had significantly higher NLR comparing with patients without rebleeding (11.27 vs. 5.5; P < 0.05) in the univariate analysis. In the multivariate analysis, NLR was considered as a risk factor of rebleeding (odds ratio, 0.283; 95% confidence interval, 0.130-0.620; P = 0.002), as well as Fisher grade (odds ratio, 0.353, 95% confidence interval, 0.151-0.824; P = 0.016). The area under the curve of the NLR and combined NLR-Fisher grade model was 0.702 and 0.744 (sensitivity was 39.94%, and specificity was 100%) for predicting rebleeding, respectively. After propensity-score matching, the optimal cutoff value for NLR as a predictor for rebleeding following aSAH was determined as 5.4 (sensitivity was 83.33%, and the specificity was 63.33%). CONCLUSIONS: Higher NLR predicts the occurrence of rebleeding and poor outcome, and NLR combined with Fisher grade significantly improves the prediction of rebleeding following aSAH.

Perfusion characteristics of late radiation injury of parotid glands: quantitative evaluation with dynamic contrast-enhanced MRI.

We aimed to quantitatively investigate the alteration of parotid perfusion after irradiation using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on a two-compartment tracer kinetic model. This study enrolled 19 patients (53.2 +/- 14.9 years) treated by head and neck radiotherapy and 19 age-relevant and sex-matched subjects as a control group. Perfusion parameters (K ( el ), k (21) and A) of parotid glands were analyzed based on the Brix model from T1-weighted DCE-MRI. Suitability of the Brix model was evaluated via Monte Carlo simulation for the goodness-of-fit. Analysis of nonlinear goodness-of-fit showed that the Brix model is appropriate in evaluating the parotid perfusion (R(2) = 0.938 +/- 0.050). The irradiated parotid glands showed significantly lower K ( el ) (P < 0.0005) and k (21) (P < 0.05) and consequently significantly higher value of peak enhancement (P < 0.0005) and time-to-peak (P < 0.0005) compared with non-irradiated ones, suggestive of gradual and prolonged accumulation and delayed wash-out of contrast agent due to increased extracellular extravascular space and decreased vascular permeability in the irradiated glands. Linear regression analysis showed dose-dependent perfusion changes of the irradiated parotid glands. We conclude that quantitative DCE-MRI is a potential tool in investigating parotid gland perfusion changes after radiotherapy.

Histogram analysis of T2*-based pharmacokinetic imaging in cerebral glioma grading.

BACKGROUND AND OBJECTIVE: To investigate the feasibility of histogram analysis of the T2*-based permeability parameter volume transfer constant (Ktrans) for glioma grading and to explore the diagnostic performance of the histogram analysis of Ktrans and blood plasma volume (vp). METHODS: We recruited 31 and 11 patients with high- and low-grade gliomas, respectively. The histogram parameters of Ktrans and vp, derived from the first-pass pharmacokinetic modeling based on the T2* dynamic susceptibility-weighted contrast-enhanced perfusion-weighted magnetic resonance imaging (T2* DSC-PW-MRI) from the entire tumor volume, were evaluated for differentiating glioma grades. RESULTS: Histogram parameters of Ktrans and vp showed significant differences between high- and low-grade gliomas and exhibited significant correlations with tumor grades. The mean Ktrans derived from the T2* DSC-PW-MRI had the highest sensitivity and specificity for differentiating high-grade gliomas from low-grade gliomas compared with other histogram parameters of Ktrans and vp. CONCLUSIONS: Histogram analysis of T2*-based pharmacokinetic imaging is useful for cerebral glioma grading. The histogram parameters of the entire tumor Ktrans measurement can provide increased accuracy with additional information regarding microvascular permeability changes for identifying high-grade brain tumors.

Knee subchondral bone perfusion and its relationship to marrow fat and trabeculation on multi-parametric MRI and micro-CT in experimental CKD.

The pathogenesis of chronic kidney disease (CKD) is multifactorial. In the progression of CKD arthropathy, arteriosclerosis may alter the knee subchondral bone marrow by altering blood flow through the bone vasculature. Herein, multi-parametric MRI assessment, including dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), magnetic resonance spectroscopy (MRS), MRI T2*, contrast enhanced MR angiography (CE-MRA), and micro-CT were applied in a rodent nephrectomy model to: 1) investigate the blood perfusion of subchondral bone marrow and its relationship to fat water content and trabeculation pattern in CKD and 2) demonstrate the feasibility of using multi-parametric MRI parameters as imaging biomarkers to evaluate the disease's progression. Two groups of rats in our study underwent either 1) no intervention or 2) 5/6 nephrectomy. We found that in the CKD group, perfusion amplitude A and elimination constant k el values were significantly decreased, and vascular permeability k ep was significantly increased. MRS showed that fat fraction (FF) was significantly lower, water fraction (WF) was significantly higher in the CKD group. Micro-CT showed a significant loss of trabecular bone. Knee subchondral bone marrow perfusion deficiency in experimental CKD may be associated with decreased fat content, increased water content, and sparse trabeculation.