Abstract Purpose Positron emission tomography/magnetic resonance imaging (PET/MRI) requires efficient scan protocols for whole-body cancer staging. The aim of this study was to evaluate if the ...application of diffusion-weighted MR imaging (DWI) results in a diagnostic benefit for lesion detection in oncologic patients if added to a whole-body 18F-fluorodesoxyglucose (18F-FDG) PET/MRI protocol. Methods 25 consecutive oncologic patients (16 men, 9 women; age 57 ± 12 years) prospectively underwent whole-body 18F-FDG-PET/MRI including DWI on a hybrid PET/MRI scanner. A team of two readers assessed 18F-FDG PET/MRI without DWI for primary tumors and metastases. In a second session, now considering DWI, readers reassessed 18F-FDG PET/MRI accordingly. Additionally, the lesion-to-background contrast on 18F-FDG PET and DWI was rated qualitatively (0, invisible; 1, low; 2, intermediate; 3, high). Wilcoxon's signed-rank test was performed to test for differences in the lesion-to-background contrast. Results 49 lesions were detected in 16 patients (5 primaries, 44 metastases). All 49 lesions were concordantly detected by 18F-FDG PET/MRI alone and 18F-FDG PET/MRI with DWI. The lesion-to-background contrast on DWI compared to 18F-FDG PET was rated lower in 22 (44.9%) of 49 detected lesions resulting in a significantly higher lesion-to-background contrast on 18F-FDG PET compared to DWI ( P = 0.001). Conclusions DWI as part of whole-body 18F-FDG PET/MRI does not benefit lesion detection. Given the necessity to optimize imaging protocols with regard to patient comfort and efficacy, DWI has to be questioned as a standard tool for whole-body staging in oncologic PET/MRI.
The current case reports of an iatrogenic cervicofacial and mediastinal subcutaneous emphysema (SCE) after endodontic retreatment of a maxillary canine with the usage of a rubber dam. A 79-year-old ...woman was brought to the hospital with a swelling of the right side of her face and neck. A computed tomography (CT) was performed, and she was directly treated with intravenous antibiotic chemotherapy. Clinical examination and CT revealed a pronounced cervicofacial and mediastinal SCE. After treatment with intravenous antibiotic chemotherapy, the patient showed a decrease of the SCE and was discharged from the hospital. SCEs should be diagnosed at the earliest possible stage to manage an appropriate treatment. In case of misinterpretation of the signs and symptoms or a misdiagnosed SCE, it can become life threatening for patients. Therefore, every clinician should consider preventive measures to avoid such complications.
Süßwassertang, a popular aquatic plant that is sold worldwide in aquarium markets, has been long considered a liverwort because of its ribbon-like thallus. However, its antheridia are remarkably ...fern-like in morphology. To corroborate the hypothesis that Süßwassertang is a fern gametophyte and to determine its closest relative, we have sequenced five chloroplast regions (rbcL, accD, rps4—trnS, trnL intron, and trnL-F intergenic spacer), applying a DNA-based identification approach. The BLAST results on all regions revealed that Süßwassertang is a polypod fern (order: Polypodiales) with strong affinities to the Lomariopsidaceae. Our phylogenetic analyses further showed that Süßwassertang is nested within the hemi-epiphytic fern genus Lomariopsis (Lomariopsidaceae) and aligned very close to L. lineata. Our study brings new insights on the unexpected biology of Lomariopsis gametophytes—the capacity of retaining a prolonged gametophytic stage under water. It is of great interest to discover that a fern usually known to grow on trees also has gametophytes that thrive in water.
The CII fine-structure transition at 158 micron is frequently the brightest far-infrared line in galaxies. Due to its low ionization potential, C+ can trace the ionized, atomic, and molecular phases ...of the ISM. We present velocity resolved CII and NII pointed observations from SOFIA/GREAT on ~500 pc scales in the nearby galaxies M101 and NGC 6946 and investigate the multi-phase origin of CII emission over a range of environments. We show that ionized gas makes a negligible contribution to the CII emission in these positions using NII observations. We spectrally decompose the CII emission into components associated with the molecular and atomic phases using existing CO(2-1) and HI data and show that a peak signal-to-noise ratio of 10-15 is necessary for a reliable decomposition. In general, we find that in our pointings greater than or equal to 50% of the CII emission arises from the atomic phase, with no strong dependence on star formation rate, metallicity, or galactocentric radius. We do find a difference between pointings in these two galaxies, where locations in NGC 6946 tend to have larger fractions of CII emission associated with the molecular phase than in M101. We also find a weak but consistent trend for fainter CII emission to exhibit a larger contribution from the atomic medium. We compute the thermal pressure of the cold neutral medium through the CII cooling function and find log(P_th/k)=3.8-4.6 K cm^-3, a value slightly higher than similar determinations, likely because our observations are biased towards star-forming regions.
We present the first complete, velocity-resolved CII 158um image of the M51 grand-design spiral galaxy, observed with the upGREAT instrument on SOFIA. CII is an important tracer of various phases of ...the interstellar medium (ISM), including ionized gas, neutral atomic, and diffuse molecular regions. We combine the CII data with HI, CO, 24um dust continuum, FUV, and near-infrared K-band observations to study the evolution of the ISM across M51's spiral arms in both position-position, and position-velocity space. Our data show strong velocity gradients in HI, 12CO, and CII at the locations of stellar arms (traced by K--band data) with a clear offset in position-velocity space between upstream molecular gas (traced by 12CO) and downstream star formation (traced by CII). We compare the observed position--velocity maps across spiral arms with synthetic observations from numerical simulations of galaxies with both dynamical and quasi-stationary steady spiral arms that predict both tangential and radial velocities at the location of spiral arms. We find that our observations, based on the observed velocity gradients and associated offset between CO and CII, are consistent with the presence of shocks in spiral arms in the inner parts of M51 and in the arm connecting the companion galaxy, M51b, in the outer parts of M51.
We present a CII 158um map of the entire M51 (including M51b) grand--design spiral galaxy observed with the FIFI-LS instrument on SOFIA. We compare the CII emission with the total far--infrared (TIR) ...intensity and star formation rate(SFR) surface density maps (derived using H_alpha and 24um emission) to study the relationship between CII and the star formation activity in a variety of environments within M51 on scales of 16" corresponding to ~660 pc. We find that CII and the SFR surface density are well correlated in the central, spiral arm, and inter-arm regions. The correlation is in good agreement with that found for a larger sample of nearby galaxies at kpc scales. We find that the SFR, and CII and TIR luminosities in M51 are dominated by the extended emission in M51's disk. The companion galaxy M51b, however, shows a deficit of CII emission compared with the TIR emission and SFR surface density, with CII emission detected only in the S-W part of this galaxy. The CII deficit is associated with an enhanced dust temperature in this galaxy. We interpret the faint CII emission in M51b to be a result of suppressed star formation in this galaxy, while the bright mid- and far-infrared emission, which drive the TIR and SFR values, are powered by other mechanisms. A similar but less pronounced effect is seen at the location of the black hole in M51's center. The observed CII deficit in M51b suggests that this galaxy is a valuable laboratory to study the origin of the apparent CII deficit observed in ultra-luminous galaxies.
Extrafine aerosols may improve asthma symptom control through increased lung deposition of medication to inflamed peripheral airways.
The effect of switching patients with asthma maintained on up to ...2000 microg/day chlorofluorocarbon-beclomethasone dipropionate (CFC-BDP), 1600 microg/day budesonide, 1000 microg/day fluticasone, or 2000 microg/day flunisolide, to a reduced dose of hydrofluoroalkane-134a BDP (HFA-BDP) extrafine aerosol (maximum 800 microg/day) was investigated during an open-label multicentre study. Following a 7-14-day run-in on previous medication, 716 patients were randomised to 24 weeks' treatment with an appropriate reduced dose of HFA-BDP.
Morning peak expiratory flow (AM PEF) measurements showed that, after 24 weeks, the reduced dose of HFA-BDP maintained equivalent lung function compared with all previous medications. Furthermore, asthma symptom scores revealed improvements across all groups and the proportion of symptom free days and nights and beta-agonist free days increased significantly (p < 0.05) in all but one group. Quality of life improved with 80% of patients reporting goo/very good overall asthma control compared with 70% previously. Treatment-associated adverse events were generally infrequent, mild and transient.
Patients on conventional inhaled corticosteroids may reduce their daily steroid dose to 800 microg or less whilst maintaining lung function and improving asthma symptom control by using the extrafine aerosol of HFA-BDP.
