As the incidence of peripheral neurological diseases increases, the precise display of nerves becomes important in imaging examinations. Among them, the pain caused by brachial plexus neuropathy is ...very prominent, and the magnetic resonance imaging of nerve is quite complex and messy. This paper will systematically elaborate from the aspects of brachial plexus neuropathy, morphological and functional imaging, and post-processing.
To explore the usefulness of magnetic resonance neurography (MRN) in the diagnosis and management of trigeminal neuralgia (TN).
In total, 55 patients clinically diagnosed with TN were imaged with ...3.0-T magnetic resonance imaging. Images were reconstructed to show the full course of the trigeminal nerve. Clinical findings included mean duration of symptoms (41.99 months) and mean visual analog scale pain intensity (5.98). Final diagnoses were microvascular compression (19), inflammation (21), microvascular compression with inflammation (5), normal (5), tumor (1), peripheral nerve injury (2), and multiple sclerosis (2).
MRN had substantial impact on diagnosis and treatment in 56.4% of cases. A total of 33 patients underwent intervention for pain. MRN had substantial impact on 54.5% of the treated patients. The correlation between MRN results and intervention response was excellent in 19 patients (57.6%) and moderate in 14 (42.4%). Pain was reduced after surgery or interventional procedure in most cases (75.8%).
MRN is suitable for the diagnosis of clinical TN with beneficial impact on diagnosis and clinical management and moderate-to-excellent correlation with intervention response. Diagnosis of TN should focus not only on microvascular compression but also on the conditions of the peripheral branches of the trigeminal nerve.
The information of when and where region-specific patterns in both mean and extreme temperatures leading to heat stress will emerge from the present-day climate variability is important to plan ...adaptation options, but to date studies on this issue still remain limited and fragmented. Here, we estimate the time of emergence (TOE) of temperature and wet-bulb temperature (Tw), a better indication of heat stress, using fine-scale, long-term regional climate model projections under the RCP2.6 and RCP8.5 scenarios across six different domains. Differently from previous studies, the TOE is determined using three methods applied on impact-relevant variables: two different signal-to-noise frameworks based on summer mean temperature and Tw and a statistical test to identify significant differences in daily extreme distributions. The TOE response to RCP2.6 and RCP8.5 with respect to the end of 20th century variability differs significantly regardless of which TOE metric is applied. For summer mean temperature, the land fraction reaching TOE is expected to exceed 90% by the 2050s under the RCP8.5, whereas the increase rate of land exposure to TOE tends to stagnate over time under the RCP2.6 so that more than 40% of land will not experience TOE by the end of the 21st century. Compared to temperature, the TOE of Tw is reached earlier in most of the wet tropics but is delayed in hot and dry regions because of the nonlinear response of Tw to humidity. For both temperature and Tw, the TOE appears earlier in regions with low baseline variability, such as in the tropics. Despite the uncertainties arising from the choice of TOE metrics, the vast majority of regions in Africa and southeast Asia experience TOE in the early 21st century under both the RCP2.6 and RCP8.5 scenarios, which stresses the urgent need for developing adequate adaptation strategies in these regions.
The potential changes in the strength and location of five low-level jets (LLJs) located within four Coordinated Regional Climate Downscaling Experiment (CORDEX) domains are examined for present and ...future climate conditions using an ensemble of simulations conducted with the RegCM4 regional model at a 25 km horizontal grid spacing. Lateral and lower boundary forcing fields are from three General Circulation Models (GCMs), and we analyse a historical period (1995–2014) along with two future periods (2041–2060 and 2080–2099) under the Representative Concentration Pathways 2.6 and 8.5. The RegCM4, as driven by the GCMs, is capable of capturing most of the observed climatological features of the LLJs, both in terms of spatial location and seasonal evolution. Analysis of the influence of global warming on the LLJs shows a consistent strengthening of the jets and a shift in their location under both warming scenarios. The Monsoon and West African westerly LLJs exhibit a northward shift, while the Caribbean and South American LLJs present a westward expansion. The use of an ensemble of high-resolution simulations is found to provide a key element for a robust assessment of changes in LLJs associated with future global warming scenarios.
The characteristics of tropical cyclone (TC) activity over five TC basins lying within four Coordinated Regional Downscaling Experiment (CORDEX) domains are examined for present and future climate ...conditions using a new ensemble of simulations completed as part of the CORDEX-CORE initiative with the regional climate model RegCM4. The simulations are conducted at a 25 km horizontal grid spacing and are driven by three CMIP5 general circulation models (GCMs) under two Representative Concentration Pathways (RCP2.6 and RCP8.5). The RegCM4 captures most features of the observed TC climatology, except for the TC intensity, which is thus statistically adjusted using a bias correction procedure to account for the effect of the coarse model resolution. The RegCM4 exhibits an improved simulation of several TC statistics compared to the driving GCMs, over most basins analyzed. In future climate conditions we find significant increases in TC frequency over the North Indian Ocean, the Northwest Pacific and Eastern Pacific regions, which are consistent with an increase in mid-tropospheric relative humidity. The North Atlantic and Australasia regions show a decrease in TC frequency, mostly associated with an increase in wind shear. We also find a consistent increase in future storm rainfall rates associated with TCs and in the frequency of the most intense TCs over most domains. Our study shows robust responses often, but not always, in line with previous studies, still implying the presence of significant uncertainties in the projection of TC characteristics, which need to be addressed using large ensembles of simulations with high-resolution models.
Background. This study is designed to investigate whether vitamin D promotes diabetic wound healing and explore the potential mechanism which may be involved in the healing process. Material and ...Methods. Human umbilical vein endothelial cells (HUVECs) were treated with 200 μg/ml of advanced glycation end product-modified human serum albumin (AGE-HSA) and 250 mg/dl of glucose with vitamin D. Cell viability was analyzed using the CCK-8 assay, and the apoptosis rate was measured using flow cytometry. Endogenous markers of ER stress were quantified using Western blot and a real-time polymerase chain reaction. Diabetic mice were treated with vitamin D (100 ng/kg per day) for 14 days. The ulcer area and ulcerative histology were detected dynamically. Results. Vitamin D administration not only decreased the apoptosis rate but also increased cell viability. Furthermore, the expression of endogenous markers of ER stress was downregulated as a result of vitamin D treatment. Vitamin D supplementation significantly accelerated wound healing of diabetic mice and improved the healing quality. Further studies showed that reduced ER stress was associated with the positive outcome. Conclusion. These results suggest that vitamin D may ameliorate impaired wound healing in diabetic mice by suppressing ER stress.
To explore whether or not inhibition of protein kinase C βII (PKC βII) stimulates angiogenesis as well as prevents excessive NETosis in diabetics thus accelerating wound healing. Streptozotocin (STZ, ...60 mg/kg/day for 5 days, i.p.) was injected to induce type I diabetes in male ICR mice. Mice were treated with ruboxistaurin (30 mg/kg/day, orally) for 14 consecutive days. Wound closure was evaluated by wound area and number of CD31-stained capillaries. Peripheral blood flow cytometry was done to evaluate number of circulating endothelial progenitor cells (EPCs). NETosis assay and wound tissue immunofluorescence imaging were done to evaluate the percentage of neutrophils undergoing NETosis. Furthermore, the expression of PKC βII, protein kinase B (Akt), endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor (VEGF), and histone citrullation (H3Cit) were determined in the wound by Western blot analysis. Ruboxistaurin accelerated wound closure and stimulated angiogenesis in diabetic mice. The number of circulating EPCs was increased significantly in ruboxistaurin-treated diabetic mice. Moreover, ruboxistaurin treatment significantly decreases the percentages of H3Cit
cells in both peripheral blood and wound areas. This prevented excess activated neutrophils forming an extracellular trap (NETs) formation. The expressions of phospho-Akt (p-Akt), phospho-eNOS (p-eNOS), and VEGF increased significantly in diabetic mice on ruboxistaurin treatment. The expressions of PKC βII and H3Cit
, on the other hand, decreased with ruboxistaurin treatment. The results of the present study suggest that ruboxistaurin by inhibiting PKC βII activation, reverses EPCs dysfunction as well as prevents exaggerated NETs formation in a diabetic mouse model; thereby accelerating the wound healing process.
To compare the efficacy and safety of 1.5 T MRI and CT-guided VX2 hepatic para-vascular tumor model in rabbits.
Sixty New Zealand white rabbits were randomly and equally divided into MRI-guided group ...(n=30) and CT-guided group (n=30). Rabbit VX2 tumor fragments were implanted beside the rabbit hepatic great vessels under MRI and CT guidance in the MRI and CT group to evaluate the success rate of tumor model establishment, puncture needle display and tip peripheral vascular situation, operation time and safety.
In the MRI-guided group, 29 rabbits (29/30, 96.7%) had a successful establishment of liver tumor model, and 1 rabbit had needle metastasis. In the CT-guided group, 24 rabbits (24/30, 80%) had a successful establishment of liver tumor model, while 2 rabbits had needle metastasis, 3 rabbits had metastases in other parts of the liver, and 1 had an unknown cause of death. The differences in tumor model establishment success rate between the two groups were statistically significant (χ
= 4.043, P < 0.05). The fold number of artifacts at T1WI was 7.26±0.38 for the 20 G coaxial puncture needle in the MRI-guided group and 2.51±0.57 for the 20 G coaxial puncture needle in the CT-guided group, and the difference was statistically significant (t=36.76, P < 0.001), but star-shaped hypodense artifacts would appear around the needle tip. The operation time was longer in the MRI-guided group than in the CT-guided group (13.32±2.45 minutes in the MRI-guided group vs. 8.42±1.46 minutes in the CTguided group; t=9.252, P < 0.001). A small number of ascites occurred in 2 patients (2/30, 6.67%) in the CT-guided group; no serious complications such as liver abscess, jaundice or diaphragmatic perforation were observed in both groups.
Compared with CT, MRI-guided hepatic para-vascular tumor implantation in rabbits might be a more effective modeling method. Although the needle tip pseudopacity of the puncture needle is large and the operation time is long, the incidence of complications is low.
The role of aerosol on the snow darkening effect is considered one of the main factors contributing to snow melting and glacier retreat over the Himalayas and Tibetan Plateau (HTP). Using the ...International Centre for Theoretical Physics (ICTP)’s regional climate model, RegCM4, we examine the changes induced by aerosol deposition over the HTP snow and its dynamical impacts over northern India during the pre-monsoon season (March to June), which is critical for the inception and development of the monsoon. Sensitivity experiments with and without aerosol-induced snow darkening effects for the period 2006–2010 reveal that this effect causes a significant reduction of snow cover fraction by 10 to 15% and an increase in surface temperatures (> 4 °C), which improves the model performance when comparing against observations over the HTP. This response is dominated by dust deposition, which covers a larger area of the HTP compared to the black carbon. While incorporating aerosol-induced snow darkening effect, the precipitation decreases (~ 0.4–2 mm/day) over northern India due to intrusion of dry winds, which also enhance dust emissions over the Thar Desert. As a result of the decrease in precipitation, surface temperature increases and generates a low-pressure system over northern India, which further strengthens the dust transport and its burden. We also find decreases in precipitation extremes and increases in the number of consecutive dry days and extreme temperature conditions over northern India, implying strong links with changes in pre-monsoon dynamics. The aerosol-induced snow darkening effect thus facilitates an earlier monsoon onset over southern India, but the northward propagation of the precipitation band is limited by the enhanced northwesterly winds over the Indo-Gangetic Plain.
Background: The posterior condylar canal (PCC) and its associated emissary vein are important anatomical landmarks for juxta-condylar approach and extreme lateral approach for exposing lesions in the ...region lateral to the foramen magnum. The study aimed to provide a complete gender-based assessment of the morphological characteristics of PCC in an adult central Indian population. Methodology: The study was conducted on 130 dry adult central Indian human skulls of known sex (81 males, 49 females). The presence of PCC on both sides, their patency, variations, and site of internal opening in relation to important anatomical landmarks, i.e., sigmoid sulcus, jugular foramen, and foramen magnum were assessed. Results: The PCC and probe patency were statistically more common bilaterally than unilateral. Females showed statistically significant higher incidence of bilateral PCC and bilateral probe patency than males. Three morphological variations in PCC were found, i.e., double condylar canal, septation, and spur. They showed no significant gender differences. In both sexes, bilateral intrasinus was the most common type of internal opening of PCC. Internal opening into jugular foramen, foramen magnum, and retro sinus was significantly more unilaterally than bilateral. Significant gender differences in unilateral intrasinus and unilateral retro sinus type of internal opening were noted. Conclusion: This study gives knowledge about the comparison of various morphological variations of PCC in both sexes of an adult central Indian population, and its clinical impact on the surgeries of this region.
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