Evaluating acute nipple inversion, imaging findings and outcomes.

PURPOSE: Acute nipple inversion can be unsettling for patients and is sometimes associated with an underlying breast malignancy. It also poses a diagnostic challenge with lack of consensus management guidelines. This study reviewed institutional experience with new nipple inversion, including malignant association, imaging utilization, and outcomes, in an effort to improve management. METHODS: A multisite institutional retrospective review was conducted of all breast imaging reports from 1/2010 to 6/2022 mentioning nipple inversion as an indication or finding. Patients with new nipple inversion, defined as arising since the time of last breast imaging exam or if reported as new by the patient/provider, were included for analysis. Retroareolar imaging findings, BI-RADS assessments/recommendations, pathology obtained from percutaneous or excisional biopsies, and follow-up imaging and clinical exams were collated. Cases of chronic or stable nipple inversion were excluded. Descriptive statistics were performed. RESULTS: A total of 414 patients had new nipple inversion, 387/414 (93.5 %) with benign or negative results at initial imaging and 27/414 (6.5 %) with malignant lesions. Diagnostic mammography/ultrasound detected 25/27 (92.6 %) cancers (sensitivity 92.6 %, specificity 75.5 %, PPV 20.8 %, NPV 99.3 %). Of 62 breast MRI exams performed in patients with negative mammogram/ultrasound, no cancers were detected in the retroareolar space with 2 incidental malignant lesions discovered distant from the nipple. CONCLUSION: Diagnostic mammography/ultrasound is reliable in workups of acute nipple inversion, with a high sensitivity and NPV for excluding malignancy. Breast MRI and surgical referral should be reserved for patients with suspicious associated symptoms or clinical findings.

Phase inversion regulable bigels co-stabilized by Chlorella pyrenoidosa protein and beeswax: In-vitro digestion and food 3D printing.

Algal proteins are an emerging source of functional foods. Herein, Chlorella pyrenoidosa protein (CPP)/xanthan gum-based hydrogels (HG) and beeswax-gelled oleogels (OG) are adopted to fabricate bigels. The phase inversion of bigels can be regulated by the ratio of OG and HG: As the OG increased, bigels turn from OG-in-HG (OG/HG) to a semicontinuous state and then HG-in-OG (HG/OG). In OG/HG bigels (OG ≤ 50 %), hydrophilic CPP acts as the emulsifier at the interface of OG and HG, while beeswax emulsifies the system in HG/OG bigels (OG = 80 %). A semicontinuous bigel appears during the transition between HG/OG and OG/HG. The increase of OG can enhance the viscoelasticity, hardness, adhesiveness, chewiness, and thermal stability. OG/HG bigels exhibit stronger thixotropic recovery and oil-holding capacity than HG/OG bigels. In the in-vitro digestion and food 3D printing, the high specific surface area and the highest thixotropic recovery caused by the emulsion structure of the OG/HG bigel (OG = 50 %) are conducive to the release of free fatty acids and molding of 3D-printed objects, respectively. This study provides a new approach to structure the gelled water-oil system with CPP and helps to develop edible algal proteins-based multiphase systems in food engineering or pharmacy.

Chronic uterine inversion: Mimicking uterine cervical polyp or leiomyoma.

Key Clinical Message: The diagnosis of chronic uterine inversion occurs after birth or secondary to pathologies of the pelvic region organs. Especially, the diagnosis and treatment of isolated chronic inversion rapidly under appropriate conditions seem to reduce maternal morbidity and mortality. Abstract: Chronic uterine inversion is a rare clinical diagnosis and difficult to diagnose and treat. This is a 22-year-old patient with no particular history known for a month for uterine fibroid with a polyp, who gave birth through the cervix in the context of subfertility for a year. Non puerperal uterine inversion is a rare clinical condition, and it should be kept in mind that this may be uterine inversion when mass lesions causing clinical complaints are detected, especially in the vulva, vagina, and cervix uteri region. The quality of life of the patients is increased by reducing the morbidity and mortality rates by making a diagnosis with a good clinical and ultrasonographic evaluation.

Remote sensing estimates of global sea surface nitrate: Methodology and validation.

Information about sea surface nitrate (SSN) concentrations is crucial for estimating oceanic new productivity and for carbon cycle studies. Due to the absence of optical properties in SSN and the intricate relationships with environmental factors affecting spatiotemporal dynamics, developing a more representative and widely applicable remote sensing inversion algorithm for SSN is challenging. Most methods for the remote estimation of SSN are based on data-driven neural networks or deep learning and lack mechanistic descriptions. Since fitting functions between the SSN and sea surface temperature (SST), mixed layer depth (MLD), and chlorophyll (Chl) content have been established for the open ocean, it is important to include the remote sensing indicator photosynthetically active radiation (PAR), which is critical in nitrate biogeochemical processes. In this study, we employed an algorithm for estimating the monthly average SSN on a global 1° by 1° resolution grid; this algorithm relies on the empirical relationship between the World Ocean Atlas 2018 (WOA18) monthly interpolated climatology of nitrate in each 1°â€¯× 1° grid and the estimated monthly SST and PAR datasets from Moderate Resolution Imaging Spectroradiometer (MODIS) and MLD from the Hybrid Coordinate Ocean Model (HYCOM). These results indicated that PAR potentially affects SSN. Furthermore, validation of the SSN model with measured nitrate data from different months and locations for the years 2018-2023 yielded a high prediction accuracy (N = 12,846, R2 = 0.93, root mean square difference (RMSE) = 3.12 µmol/L, and mean absolute error (MAE) = 2.22 µmol/L). Further independent validation and sensitivity tests demonstrated the validity of the algorithm for retrieving SSN.

High-Viscosity Phase Inversion Separators for Freestanding and Direct-on-Electrode Manufacturing in Lithium-Ion Batteries.

Separators play a critical role in lithium-ion batteries (LIBs) by facilitating lithium-ion (Li-ion) transport while enabling safe battery operation. However, commercial separators made from polypropylene (PP) or polyethylene (PE) impose a discrete processing step in current LIB manufacturing as they cannot be manufactured with the same slot-die coating process used to fabricate the electrodes. Moreover, commercial separators cannot accommodate newer manufacturing processes used to produce leading-edge microbatteries and flexible batteries with customized form factors. As a path toward rethinking LIB fabrication, we have developed a high-viscosity polymer composite separator slurry that enables the fabrication of both freestanding and direct-on-electrode films. A streamlined phase inversion process is used to impart porosity in cast separator films upon drying. To understand the impacts of material composition and rheology on phase inversion processing and separator performance, we investigated four different separator formulations. We used either diethylene glycol (DEG) or triethyl phosphate (TEP) as a nonsolvent, and either silica (SiO2) or alumina (Al2O3) as an inorganic additive in a polyvinylidene fluoride-co-hexafluoropropylene (PVDF-HFP) matrix. Through a down-selection process, we developed a TEP-SiO2 separator formulation that matched or outperformed a commercial Celgard 2325 (PP/PE/PP) separator and a Beyond Battery ceramic-coated PE (CC/PE/CC) separator under rate and cycle life tests in LiFePO4|Li4Ti5O12 (LFP|LTO) and LiNi0.5Mn0.3Co0.2O2|graphite (NMC-532|graphite) coin cells at C/10-1C rates. Our TEP-SiO2 slurry had a viscosity of 298 Pa s at a 1 s-1 shear rate and shear-thinning behavior. When deposited directly onto an LTO anode and cycled against an LFP cathode, the direct-on-electrode TEP-SiO2 separator increased the specific capacity by 58% and 304% at 2C rates relative to the PP/PE/PP and CC/PE/CC separators, respectively. Additionally, the freestanding TEP-SiO2 separator maintained dimensional stability when heated to 200 °C for 1 h and demonstrated a higher elastic modulus and hardness than the PP/PE/PP and CC/PE/CC separators when measured with nanoindentation.

Surface Charge-Modulated Toxicity of Cysteine-Stabilized Silver Nanoparticles.

The toxicity of silver nanoparticles (AgNPs) depends on their physicochemical properties. The ongoing research aims to develop effective methods for modifying AgNPs using molecules that enable control over the processes induced by nanoparticles in both normal and cancerous cells. Application of amino acid-stabilized nanoparticles appears promising, exhibiting tunable electrokinetic properties. Therefore, this study focused on determining the influence of the surface charge of cysteine (CYS)-stabilized AgNPs on their toxicity towards human normal B (COLO-720L) and T (HUT-78) lymphocyte cell lines. CYS-AgNPs were synthesized via the chemical reduction. Transmission electron microcopy (TEM) imaging revealed that they exhibited a quasi-spherical shape with an average size of 18 ± 3 nm. CYS-AgNPs remained stable under mild acidic (pH 4.0) and alkaline (7.4 and 9.0) conditions, with an isoelectric point observed at pH 5.1. Following a 24 h treatment of lymphocytes with CYS-AgNPs, concentration-dependent alterations in cell morphology were observed. Positively charged CYS-AgNPs notably decreased lymphocyte viability. Furthermore, they exhibited grater genotoxicity and more pronounced disruption of biological membranes compared to negatively charged CYZ-AgNPs. Despite both types of AgNPs interacting similarly with fetal bovine serum (FBS) and showing comparable profiles of silver ion release, the biological assays consistently revealed that the positively charged CYS-AgNPs exerted stronger effects at all investigated cellular levels. Although both types of CYS-AgNPs have the same chemical structure in their stabilizing layers, the pH-induced alterations in their surface charge significantly affect their biological activity.

[Therapeutic idea for post-stroke foot inversion with Cixi Tongshu method combined with rehabilitation training].

Based on the function of xi-cleft points and shu-streams points and in association with the anatomic structure where the acupoints are located, Cixi (stimulating meridian qi at xi-cleft points) is used for regulating the physical appearance, while Tongshu (promoting the qi circulation of shu-stream points) is for regulating the spirit. The depth and direction of needle insertion are controlled and deqi is determined by muscle twitching so as to relax the muscles. Rehabilitation training is combined to restore the foot proprioceptive sensibility. The above comprehensive method co-works on correcting post-stroke foot inversion and recovering walking ability in the patients.

New non-contrast MRI of endolymphatic hydrops in Ménière's disease considering inversion time.

Objectives: Three-tesla MRI with gadolinium-based contrast agents is important in diagnosing Ménière's disease. However, contrast agents cannot be used in some patients. By using the compositional difference between the inner ear endolymph and perilymph, we performed basic and clinical research focused on potassium ions and protein to find the optimal parameters for visualizing endolymphatic hydrops on MRI without contrast. We then examined the relationship between severity stage and visualization rate of endolymphatic hydrops. Methods: In phantom experiments simulating the endolymph and perilymph, we explored MRI parameters that could be used to separate endolymph from perilymph by gradually changing the inversion time. We then used these parameters to perform both new non-contrast MRI and contrast MRI on the same day in Ménière's disease patients, and we compared the visualization rates of endolymphatic hydrops under the two modalities. Fifty patients were selected from 478 patients with Ménière's disease of different severity stages; 12 patients had asthma and allergy to contrast agents. Results: The higher the disease stage, the higher the endolymphatic hydrops visualization rate. The new non-contrast MRI gave significantly higher (p < .01) visualization rates of endolymphatic hydrops on the affected side in patients at Stage 3 or above than in Stages 1 and 2 combined. Conclusion: New non-contrast MRI with parameters focusing on the endolymph-perilymph difference in the density of protons surrounding the potassium ions and protein can produce images consistent with endolymphatic hydrops. We believe that this groundbreaking method will be useful for diagnosing Ménière's disease in patients. Evidence Level: Clinical studies are at evidence level 3 in non-randomized controlled trials.

Comparing the Saccule-to-Utricle Ratio in Early- Versus Late-Stage Meniere's Disease Patients.

OBJECTIVE: To compare the saccule-to-utricle ratio in early- versus late-stage Meniere's disease (MD) patients based on magnetic resonance imaging (MRI) images. METHODS: In this retrospective study, we performed 3-dimensional real inversion recovery (3D-real IR) MRI 24 h after intratympanic gadolinium administration in unilateral MD patients at early-stage (n = 56) and late-stage (n = 70). Two radiologists independently graded endolymphatic hydrops (EH) and the saccule-to-utricle ratio inversion (SURI) was compared between the two groups. Furthermore, early-stage MD patients were further divided into two subgroups based on disease duration: ≤6 months (n = 20) and >6 months (n = 36) and the SURI was compared. RESULTS: Among the 56 patients in the early-stage group, 26 cases (46.43%) exhibited an enlarged saccule that is larger than the utricle, showing SURI. In contrast, among the late-stage MD, only four cases (5.71%) showed SURI (p < 0.001). In the early-stage MD subgroup with a disease duration of ≤6 months, the proportion of SURI was 70% (14/20), which was higher than that in the subgroup with a disease duration of >6 months (33.33%, 12/36, p = 0.02). CONCLUSION: SURI may serve as an effective imaging marker for diagnosis of early-stage MD. Our finding suggests that endolymphatic hydrops in MD may primarily originate from the saccule. LEVEL OF EVIDENCE: Level 3 Laryngoscope, 2024.

Stacking Transformation-Triggered Circularly Polarized Luminescence Reversion in γ-Cyclodextrins-Pyrene Co-assembly.

​Considerable attention has been directed towards cyclodextrins (CDs) in the creation of co-assembled CPL-active materials, owing to their intrinsic chiral host cavities and synergistic host-guest interactions. However, achieving reversed CPL emission regulation with single-handedness CDs moiety poses a significant challenge. In this study, we have devised a series of γ-CD-based host-guest complexes comprising dual pyrene imidazolium derivatives with multiple linkers, which exhibit reversed circularly polarized emission. We have uncovered that the transformation of excimer stacking within γ-CD/pyrene complexes contributes to the inverted CPL emissions originating from a single-handed chiral host. This research elucidates the phenomenom of (+)- and (-)-circularly polarized excimer emission (CPEE) within γ-CD, arising from right- and left-handed stacking conformations, respectively.

3D Gravity and magnetic inversion modelling for geothermal assessment and temperature modelling in the central eastern desert and Red Sea, Egypt.

The Central Eastern Desert and Red Sea region have emerged as a significant area of interest for geothermal energy exploration, owing to their unique geological characteristics and active tectonic activity. This research aims to enhance our understanding of the region's geothermal potential through a comprehensive analysis of gravity and magnetic data. By utilizing a 3D gravity inversion model, a detailed examination of subsurface structures and density variations was conducted. Similarly, a 3D magnetic inversion model was employed to investigate subsurface magnetic properties. Integration result from the Pygimli library ensured robustness and accuracy in the inversion results. Furthermore, a temperature model was developed using the WINTERC-G model and inversion techniques, shedding light on the thermal structure and potential anomalies in the study area. The analysis of the Bouguer gravity map, 3D gravity inversion model, and magnetic data inversion yielded significant findings. The Red Sea exhibited higher gravity values compared to the onshore Eastern Desert, attributed to the presence of a thinner and denser oceanic crust as opposed to the less dense continental crust in the Eastern Desert. The 3D gravity inversion model revealed distinct variations in density, particularly high-density zones near the surface of the Red Sea, indicating underlying geological structures and processes. Conversely, density gradually decreased with depth along the onshore line, potentially influenced by a higher concentration of crustal fractures. The magnetic data inversion technique provided additional insights, highlighting areas with demagnetized materials, indicative of elevated temperatures. These findings were consistent with the correlation between high-density areas and low magnetic susceptibility values, reinforcing the proposition of increased heat transfer from the Red Sea. Comparative analysis of temperature profiles further confirmed the presence of elevated temperatures in promising zones, emphasizing the geothermal potential associated with heat transfer from the Red Sea.This research contributes to the understanding of the geothermal resources in the Central Eastern Desert and Red Sea region. The results from gravity and magnetic data inversions, combined with temperature profiles, provide valuable information for future geothermal exploration and utilization efforts. The findings underscore the importance of geothermal energy in achieving sustainability and contribute to the global discourse on renewable energy sources.

Mechanisms of lateral ankle ligament sprains in professional netball: A systematic video analysis.

OBJECTIVES: To undertake a systematic analysis of 17 medical attention and time-loss lateral ankle ligament sprain (LALS) events from televised Australian professional netball games during the 2020-2023 seasons. DESIGN: Case series. METHODS: Three analysts independently assessed the video footage and then convened to review and discuss each case until a consensus was reached. RESULTS: When in possession (7 cases) a player was commonly performing an agility-based manoeuvre to break free from an opponent and reposition themselves to be a passing option (5/7 cases). When out of possession (10 cases) a player was either attempting to intercept a pass (6 cases) or marking an opponent (4 cases). Players tended to land on the anterior one-third of the plantar surface of the foot - forefoot or shoe tip (7 cases). Players often landed on either the ground (7 cases) or the opponent's shoe then the ground (8 cases). In 9 cases the ankle-foot was considered to be in a neutral alignment in the frontal plane at landing. At the estimated index frame the players' weight tended to be all on the foot on the injured side (11 cases) or favouring the foot on the injured side (5 cases). Inversion and adduction was a common injury mechanism. Plantar-flexion was rarely involved. CONCLUSION: Landing on the anterior one-third of the plantar surface of the foot and subsequent weight transference onto the injured limb side was more important than ankle-foot inversion at initial ground contact. Exercises involving external perturbations that challenge the control of frontal and transverse plane ankle-foot motion and improve proprioception, neuromuscular control, and dynamic balance are warranted.

Enhancing fluid signal in driven-equilibrium short-TI inversion-recovery imaging with short TR times: A feasibility study.

PURPOSE: Fluid-sensitive turbo spin echo (TSE) MRI with short-TI inversion-recovery preparation for fat suppression (STIR) plays a critical role in the diagnostics of the musculoskeletal system (e.g., close to metal implants). Potential advantages of 3D acquisitions, however, are difficult to exploit due to long acquisition times. Shortening the TR incurs a signal loss, and a driven-equilibrium (DE) extension reduces fluid signal even further. METHODS: The phase of the flip-back pulse was changed by 180° relative to the conventional implementation (i.e., 90° along the positive x-axis (90°x) instead of -90°x). After signal modeling and numerical simulations, the modification was implemented in STIR-TSE sequences and tested on a clinical 3T system. Imaging was performed in the lumbar spine, and long-TR images without DE were acquired as reference. CSF SNR and fluid-muscle contrast were measured and compared between the sequences. Imaging was repeated in a metal implant phantom. RESULTS: A shortening of TR by 43%-57% reduced the CSF SNR by 39%-59%. A conventional DE module further reduced SNR to 26%-40%, whereas the modified DE recovered SNR to 59%-108% compared with the long-TR acquisitions. Fluid-tissue contrast was increased by about 340% with the modified DE module compared with the conventional extension. Similar results were obtained in implant measurements. CONCLUSIONS: The proposed DE element for TSE-STIR sequences has the potential to accelerate the acquisition of fluid-sensitive images. DE-STIR may work most efficiently for 3D acquisitions, in which no temporo-spatial interleaving of inversion and imaging pulses is possible.

Tunning Energetics of 2e⁻/2H+ PCET Properties with Model Ru-bisamido Complexes.

Most redox processes that break/form bonds involve net 2e- changes, and many are coupled to protons. Yet most proton-coupled electron transfer (PCET) studies focus on 1e-/1H+ reactions. Reported here is a family of molecular models that undergo tunable 2e-/2H+ redox changes. Complexes [(X2bpy)RuII(en*)2](PF6)2 and [(X2bpy)RuIV(en*-H)2](PF6)2 have been synthesized with bpy = 2,2'-bipyridine with 4,4'-subtitutions X = -NMe2, -OMe, -Me, -H, -CF3; and en* = 2,3-dimethyl-2,3-butanediamine. They have been characterized by IR, UV-vis, and NMR spectroscopies, XRD, electrochemistry, mass spectrometry, DFT and (TD)DFT computations. The introduction of electron-withdrawing and donating groups at the 4,4'-position of the bpy ligand affects the complexes' redox potentials, pKa's, and Bond Dissociation Free Energies (BDFEs) of the N-H bonds in the en* ligands. The average BDFEs for the overall 2e-/2H+ PCET span over 5 kcal/mol. Notably, these complexes all show marked potential inversion over an extended range, ΔpKa > 25 units and ΔE0 > 1.4 V. Potential inversion remains despite the electronic influence of bpy's substitutions which regulate N-H properties several bonds apart by trans-effect over dπ-molecular orbitals at Ru-center. The experimental and computational results presented in this work support the presence of strong coupling between electrons and protons, for modelling insights of 2e-/2H+ transfer reactivity.

[Bipolar affective disorder occurring with psychopharmacotherapy-induced manic phases]. / Bipolyarnoe affektivnoe rasstroistvo s indutsirovannymi psikhofarmakoterapiei maniakal'nymi fazami.

To analyze the stages of development of the problem, identify the evolution of views and the main directions of current research in the field of bipolar affective disorder, which occurs with psychopharmacotherapy-induced manic phases, the search for publications by keywords «pharmaco-induced mania¼", «bipolar affective disorder¼ was carried out in the PubMed/MEDLINE, Russian Citation index and other sources from the mid-19th century to the present. The issue of adequate treatment of bipolar depression became relevant back in the 20th century; numerous observations indicated the presence of associated risks when using antidepressants in patients with bipolar affective disorder, namely, the likelihood of affect inversion and aggravation of the course of the disease (accelerated cyclicity, continuum). In recent years, due to the expansion of research capabilities and the introduction of biological psychiatry, works have appeared that consider this problem from both clinical and pharmacodynamic, genetic and neurophysiological aspects, which opens up the prospect of developing advanced methods of personalized medicine for the diagnosis and treatment of bipolar disorder, taking into account the need to minimize iatrogenic effects.

Successful Retrograde Percutaneous Coronary Intervention for Chronic Total Occlusion in a Patient with Dextrocardia.

Dextrocardia is a very rare congenital malposition, and most cardiologists are not familiar with the radiographic angiograms of this condition. Here, we first report a case of dextrocardia with a chronic total occlusion (CTO) lesion undergoing retrograde percutaneous coronary intervention (PCI). Significant difficulties in lesion interpretation and device manipulation were encountered with the original angiograms. These challenges were not significantly improved until we adopted the double-inversion technique. The procedure was finally accomplished by using the kissing wire technique with a poor angle of attack. Retrograde CTO PCI for patients with dextrocardia is feasible with adequate techniques.

Cross-correlation adjustment full-waveform inversion with source encoding in ultrasound computed tomography.

Full-waveform inversion (FWI) is one of the leading-edge techniques in ultrasound computed tomography (USCT). FWI reconstructs the images of sound speed by iteratively minimizing the difference between the predicted and measured signals. The challenges of FWI are to improve its stability and reduce its computational cost. In this paper, a new USCT algorithm based on cross-correlation adjustment FWI with source encoding (CCAFWI-SE) is proposed. In this algorithm, the gradient is adjusted using the intermediate signals as the inversion target rather than the measured signals during iteration. The intermediate signals are generated using the travel time difference calculated by cross-correlation. In the case of conventional FWI failure, using the proposed algorithm, the estimated sound speed can converge toward the ground truth. To reduce the computational cost, an intermittent update strategy is implemented. This strategy only requires one time for the calculation of the travel time difference per stage, so that the source encoding can be used. Simulation and laboratory experiments are implemented to validate this approach. The experiment results show it has successfully recovered the sound speed model, while conventional FWI failed when the initial model greatly differed from the ground truth. This verifies that our approach improves the stability of the reconstruction in USCT. In practice, additional computational costs can be reduced by combining our approach with existing methods. The proposed approach increases the robustness of the FWI and expands its application.

Spatial and temporal distribution characteristics of dust concentration based on satellite in mining area.

The spatial and temporal distribution patterns of dust concentration in the Pingshuo mining area and urban area were analyzed utilizing satellite data. The results indicate that the correlation coefficients of the average PM2.5 and PM10 concentration retrieved by satellite in Shuozhou City are 0.88 and 0.63, respectively, and the satellite inversion data demonstrate high reliability. The spatial distribution of dust concentration in the Pingshuo Mine area is elevated during winter and spring, with significant dust accumulation in winter. The pollution phenomenon in the Pingshuo mining area was pronounced from January to March, and the air quality deteriorated significantly. The correlation analysis of dust concentration between the city and the mining area reveals a marked spatial discontinuity at the boundary between the city and the mining area, indicating that the mining area is not the primary cause of the increase of dust concentration in the urban area, and changes in dust concentration within the mining area exert no significant impact on the urban area. The research results possess significant implications for dust control in both the mining and urban areas.

Visualization of Cerebrospinal Fluid Outflow and Egress along the Nerve Roots of the Lumbar Spine.

Intrinsic cerebrospinal fluid (CSF) dynamics in the brain have been extensively studied, particularly the egress sites of tagged intrinsic CSF in the meninges. Although spinal CSF recirculates within the central nervous system (CNS), we hypothesized that CSF outflows from the lumbar spinal canal. We aimed to visualize and semi-quantify the outflow using non-contrast MRI techniques. We utilized a 3 Tesla clinical MRI with a 16-channel spine coil, employing time-spatial labeling inversion (Time-SLIP) with tag-on and tag-off acquisitions, T2-weighted coronal 2D fluid-attenuated inversion recovery (FLAIR) and T2-weighted coronal 3D centric ky-kz single-shot FSE (cSSFSE). Images were acquired using time-spatial labeling inversion pulse (Time-SLIP) with tag-on and tag-off acquisitions with varying TI periods. Ten healthy volunteers with no known spinal diseases participated. Variations in tagged CSF outflow were observed across different thoracolumbar nerve root segments in all participants. We quantified CSF outflow at all lumbar levels and the psoas region. There was no significant difference among the ROIs for signal intensity. The tagged CSF outflow from the spinal canal is small but demonstrates egress to surrounding tissues. This finding may pave the way for exploring intrathecal drug delivery, understanding of CSF-related pathologies and its potential as a biomarker for peripheral neuropathy and radiculopathy.

invdup(8)(8q24.13q24.3)-A Complex Alteration and Its Clinical Consequences.

Structural variation is a source of genetic variation that, in some cases, may trigger pathogenicity. Here, we describe two cases, a mother and son, with the same partial inverted duplication of the long arm of chromosome 8 [invdup(8)(q24.21q24.21)] of 17.18 Mb, showing different clinical manifestations: microcephaly, dorsal hypertrichosis, seizures and neuropsychomotor development delay in the child, and a cleft lip/palate, down-slanted palpebral fissures and learning disabilities in the mother. The deleterious outcome, in general, is reflected by the gain or loss of genetic material. However, discrepancies among the clinical manifestations raise some concerns about the genomic configuration within the chromosome and other genetic modifiers. With that in mind, we also performed a literature review of research published in the last 20 years about the duplication of the same, or close, chromosome region, seeking the elucidation of at least some relevant clinical features.