Monodisperse magnetic nanoparticles conjugated with virus-surface-specific antibodies self-assemble in the presence of specific viral particles to create supramolecular structures with enhanced ...magnetic properties, as detected by magnetic resonance methods (NMR/MRI). The observed magnetic relaxation changes that occur upon viral-induced assembly allowed for highly sensitive and selective detection of a virus in complex biological media. The developed method was shown to specifically detect adenovirus-5 and herpes simplex virus-1 at concentrations of 5 viral particles/10 μL without the need of extensive sample preparation. The applications of this new method span from high-throughput NMR detection of viruses in biological samples to potential MR imaging of viral distribution in vivo.
A 52-year-old man with back pain was admitted to the hospital with a vertebral mass, multiple lytic bone lesions, and severe hypercalcemia. MRI showed an enhancing, marrow-replacing mass involving ...the T1 vertebral body. On the fifth hospital day, the oxygen saturation decreased acutely. A diagnosis was made.
A 39-year-old man presented with epistaxis, pain and erythema of the arm, and pancytopenia, with neutropenia and monocytopenia. Imaging studies were notable for splenomegaly and lymphadenopathy. A ...diagnostic procedure was performed.
Objectives
To evaluate posterior glenohumeral capsule edema compared to other MRI findings in adhesive capsulitis (AC).
Methods
This study was approved by the local Institutional Review Board and it ...is HIPAA compliant. A retrospective search identified subjects who received fluoroscopically guided intra-articular corticosteroid injections for AC and had an MRI within 6 months prior to injection. The study group was compared with an age-, sex-, and side-matched control group who underwent the same procedures but did not have AC. MRIs were evaluated for edema of posterior capsule, anterior capsule, axillary pouch, coracohumeral ligament (CHL) and rotator interval (RI), thickness of axillary pouch and CHL, thickness of anterior capsule, RI and subcoracoid fat replacement, and teres minor atrophy and edema. Multivariable analysis was performed.
Results
A total of 57 subjects with AC and 57 matched controls were studied: mean age 52 ± 7 (range 31–71) years, 37 female and 20 male, 22 right and 35 left. Posterior capsule edema was more common in the AC group vs. control group (66.7 vs 17.5%,
p
< 0.001). Multivariable analysis showed posterior capsule edema, CHL edema, and axillary pouch (glenoid) thickness (optimum cutoff = 4 mm) were significant independent predictors of AC. Simplified analysis using these three variables had an area under the curve of 0.860 (95%CI: 0.792–0.928). With all three variables present, the sensitivity and specificity for AC were 32% and 98%, respectively.
Conclusions
Posterior joint capsule edema may be helpful to confirm AC. Posterior capsule edema, CHL edema, and axillary pouch (glenoid) thickness produce a strong model for distinguishing AC from controls.
Clinical relevance statement
Edema involving the posterior shoulder joint capsule is an imaging marker of capsulitis and is useful in differentiating patients with adhesive capsulitis from those without in conjunction with other proven MRI findings.
Key Points
•
Posterior capsule edema has a sensitivity of 66.7% and a specificity of 82.5% for the detection of adhesive capsulitis.
•
Posterior capsule edema, coracohumeral ligament (CHL) edema, and axillary pouch (glenoid) thickness were significant independent predictors of adhesive capsulitis, and combining these variables together produces a very strong model for distinguishing cases from controls (AUC
=
0.860).
•
Optimal cutoff values for CHL, axillary pouch (humeral), axillary pouch (glenoid), and axillary pouch (total) thickness were 2.5, 2.6, 4, and 6.3 mm
,
respectively.
A Man with Sickle Cell Disease and Right Hip PainA 29-year-old man with sickle cell disease, which had been complicated by vaso-occlusive events and osteonecrosis leading to hip arthroplasty, was ...admitted because of hip pain. A diagnosis was made.
Background:
Medial patellofemoral complex (MPFC) reconstruction plays an important role in the surgical treatment of patellar instability. Anatomic reconstruction is critical in re-creating the ...native function of the ligament, which includes minimizing length changes that occur in early flexion. Anatomic risk factors for patellar instability such as trochlear dysplasia, patella alta, and increased tibial tuberosity to trochlear groove (TT-TG) distance have been shown to influence the function of the MPFC graft in cadaveric studies, but the native length change patterns of the MPFC fibers in knees with anatomic risk factors have not been described.
Purpose:
To describe the in vivo length changes of the MPFC fibers in knees with anatomic risk factors for patellar instability and identify the optimal attachment sites for MPFC reconstruction.
Study Design:
Controlled laboratory study.
Methods:
Dynamic computed tomography imaging was performed on the asymptomatic knee in patients with contralateral patellar instability. Three-dimensional digital knee models were created to assess knees between 0° and 50° of flexion in 10° increments. MPFC fiber lengths were calculated at each flexion angle between known anatomic attachment points on the extensor mechanism (quadriceps tendon, MPFC midpoint M, and patella) and femur (1, 2, and 3, representing the proximal to distal femoral footprint). Changes in MPFC fiber length were compared for each condition and assessed for their relationships to morphologic risk factors (trochlear depth, Caton Deschamps Index CDI, and TT-TG distance).
Results:
In 22 knees, native MPFC fibers were found to be longer at 0° than at 20° to 50° of flexion. Length changes observed between 0° and 50° increased with the number of risk factors present. In the central fibers of the MPFC (M-2), 1.7% ± 3.1% length change was noted in knees with no anatomic risk factors, which increased to 5.6% ± 4.6%, 17.0% ± 6.4%, and 26.7% ± 6.8% in the setting of 1, 2, and 3 risk factors, respectively. Nonanatomic patella-based attachments were more likely to demonstrate unfavorable length change patterns, in which length was greater at 50° than 0°. In patellar attachments, an independent relationship was found between increasing length changes and TT-TG distance, while in quadriceps tendon attachments, a trend toward a negative relationship between length changes and CDI was noted. All configurations demonstrated a strong relationship between percentage change in length and number of morphologic risk factors present, with the greatest influence found in patella-based attachments.
Conclusion:
The MPFC fibers demonstrated increased length changes in knees when a greater number of morphological risk factors for patellar instability were present, which worsened in the setting of nonanatomic configurations. This suggests that the function of the intact MPFC in patients with anatomic risk factors may not reflect previously described findings in anatomically normal knees. Further studies are needed to understand the pathoanatomy related to these changes, as well as the implications for graft placement and assessment of length changes during MPFC reconstruction techniques.
Clinical Relevance:
MPFC length change patterns vary based on the number of morphologic risk factors for patellar instability present and should be considered during reconstructive procedures.
Letter of intent for KM3NeT 2.0 Adrián-Martínez, S; Aharonian, F; Aiello, S ...
Journal of physics. G, Nuclear and particle physics,
08/2016, Letnik:
43, Številka:
8
Journal Article, Publication
Recenzirano
Odprti dostop
The main objectives of the KM3NeT Collaboration are (i) the discovery and subsequent observation of high-energy neutrino sources in the Universe and (ii) the determination of the mass hierarchy of ...neutrinos. These objectives are strongly motivated by two recent important discoveries, namely: (1) the high-energy astrophysical neutrino signal reported by IceCube and (2) the sizable contribution of electron neutrinos to the third neutrino mass eigenstate as reported by Daya Bay, Reno and others. To meet these objectives, the KM3NeT Collaboration plans to build a new Research Infrastructure consisting of a network of deep-sea neutrino telescopes in the Mediterranean Sea. A phased and distributed implementation is pursued which maximises the access to regional funds, the availability of human resources and the synergistic opportunities for the Earth and sea sciences community. Three suitable deep-sea sites are selected, namely off-shore Toulon (France), Capo Passero (Sicily, Italy) and Pylos (Peloponnese, Greece). The infrastructure will consist of three so-called building blocks. A building block comprises 115 strings, each string comprises 18 optical modules and each optical module comprises 31 photo-multiplier tubes. Each building block thus constitutes a three-dimensional array of photo sensors that can be used to detect the Cherenkov light produced by relativistic particles emerging from neutrino interactions. Two building blocks will be sparsely configured to fully explore the IceCube signal with similar instrumented volume, different methodology, improved resolution and complementary field of view, including the galactic plane. One building block will be densely configured to precisely measure atmospheric neutrino oscillations.
Objective
To evaluate organ dose and total effective dose of whole-body low-dose CT (WBLDCT) performed on different CT-scanner models in patients with multiple myeloma (MM) and to compare it to the ...effective dose of radiographic skeletal survey and representative diagnostic CTs.
Material and methods
We retrospectively analyzed data from 228 patients (47.4% females, mean age 67.9 ± 10.4 years, mean weight 81.8 ± 22.4 kg) who underwent WBLDCT for the work-up or surveillance of MM. Patients were scanned using one of six multi-detector CT-scanners. Organ doses and total effective doses per scan were calculated using a commercially available dose-management platform (Radimetrics, Bayer Healthcare, Leverkusen, Germany). The median effective dose was compared to radiographic skeletal survey and representative diagnostic CTs.
Results
The mean effective dose of our WBLDCT-protocol was 4.82 mSv. A significantly higher effective dose was observed in females compared to males (4.95 vs. 4.70 mSv,
P
= 0.002). Mean organ dose ranged from 3.72 mSv (esophagus) to 13.09 mSv (skeleton). Mean effective dose varied amongst different CT-scanners (range 4.34–8.37 mSv). The median effective dose of WBLDCT was more than twice the dose of a skeletal survey (4.82 vs. 2.04 mSv), 23% higher than a diagnostic contrast-enhanced chest CT (3.9 mSv), 46% lower than a diagnostic contrast-enhanced abdomen/pelvis CT (9.0 mSv), and 45% lower than a lumbar spine CT (8.7 mSv).
Conclusions
WBLDCT in MM has a higher effective dose than a radiographic skeletal survey, but a lower effective dose than diagnostic CTs of lumbar spine, abdomen and pelvis. This underlines the broad applicability of WBLDCT in the management of MM patients.
Purpose
To compare the microbiology results and needle gauge for CT-guided biopsies of suspected discitis-osteomyelitis.
Methods
All CT-guided biopsies performed for suspected discitis-osteomyelitis ...at our institution between 2002 and 2019 were reviewed. Biopsy location, needle type and gauge, microbiology, pathology, and clinical and imaging follow-up were obtained through chart review. Yield, sensitivity, specificity, and accuracy were calculated. A pairwise analysis of different needle gauges was also performed with calculations of odds ratios. Naïve Bayes predictive modeling was performed.
Results
241 (age: 59 ± 18 years; 88 35% F, 162 65% M) biopsies were performed. There were 3 (1%) 11 gauge (G), and 13 (5%) 12-G biopsies; 23 (10%) 13-G biopsies; 75 (31%) 14-G biopsies; and 90 (37%) 16-G, 33 (14%) 18-G, and 4 (2%) 20 G biopsies. True disease status (presence of infection) was determined via either pathology findings (205, 86%) or clinical and imaging follow-up (36, 14%). The most common true positive pathogen was
Staphylococcus aureus
(31, 33%). Overall biopsy yield, sensitivity, specificity, and accuracy were 39%, 56%, 89%, and 66%, respectively. Pooled biopsy yield, sensitivity, specificity, and accuracy was 56%, 69%, 71%, and 69% for 11–13-G needles and 36%, 53%, 91%, and 65% for 14–20-G needles, respectively, with an odds ratio between the two groups of 2.29 (
P
= 0.021). Pooled biopsy yield, sensitivity, specificity, and accuracy was 48%, 63%, 85%, and 68% for 11–14-G needles and 32%, 49%, 91%, and 64% for 16–20-G needles, respectively, with an odds ratio between the two groups of 2.02 (
P
= 0.0086).
Conclusion
The use of a larger inner bore diameter/lower gauge biopsy needle may increase the likelihood of culturing the causative microorganism for CT-guided biopsies of discitis-osteomyelitis.
Background
Musculoskeletal pain is a debilitating problem treated with image-guided corticosteroid injections. During the COVID-19 pandemic, multiple societies issued caution statements because of ...the unknown effect of corticosteroids on the patient’s immune system. The purpose is to determine if image-guided corticosteroid injections administered during the COVID-19 lockdown phase were associated with a higher infection rate compared to the general population.
Materials and methods
In a prospective study, patients undergoing image-guided corticosteroid injections for pain management during the lockdown phase between April 15 and May 22, 2020, were enrolled. One month after the injection, patients were surveyed by telephone for any COVID-19-related symptoms, and the electronic medical record (EMR) was reviewed for symptoms and test results.
Results
Seventy-one subjects were recruited, 31 (44%) females, 40 (56%) males, ages 58 ± 17 (20–92) years. Follow-up was available in 66 (93%) of subjects, 60 (91%) by phone survey and EMR, 6 (9%) by EMR only, 45 ± 22 (19–83) days after injection. One (1/66, 1.52%; 95% CI 0.04–8.2%) 25-year-old male subject developed symptomatic infection 19 days after a tibiotalar injection. The prevalence of COVID-19 cases in the state of Massachusetts was 0.91% (62,726/6,892,503) during the study period. There was no significant difference in the rate of occurrence of new cases of COVID-19 infection between the corticosteroid injection group and the general population (
p
= 0.44).
Conclusion
Image-guided corticosteroid injections for pain management performed during the lockdown phase of the COVID-19 pandemic were not associated with a higher infection rate compared to the general population.
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