Search Results (33)

Background/Objectives: Hydrocephalus is a complex neurological disorder marked by abnormal cerebrospinal fluid dynamics and ventricular enlargement. Despite breakthroughs in neuroimaging, diagnosis and longitudinal the application of imaging markers for the diagnosis and longitudinal monitoring of hydrocephalus remains challenging in routine clinical practice. The present study examines the behavior and cross-modality agreement of commonly used linear ventricular measurements under routine imaging conditions, at a single Romanian tertiary-care center characterized by heterogeneous acquisition protocols and limited availability of advanced volumetric techniques. Methods: We conducted a single-center retrospective observational study of 68 adults with hydrocephalus. Linear ventricular metrics, including Evans index and third-ventricle width, were measured on all available CT and MRI scans. CT–MRI agreement was assessed using paired examinations within a 90-day window. Longitudinal changes were analyzed using first–last and pre–post VP shunt comparisons. Associations between baseline imaging features and VP shunt placement were evaluated using rule-based and odds ratio analyses. Results: CT and MRI measurements demonstrated strong agreement for both Evans index (r = 0.93) and third-ventricle width (r = 0.90), with minimal systematic bias. Longitudinal analyses demonstrated small-magnitude changes in ventricular size following intervention, with substantial inter-individual variability. VP utilization increased across Evans index strata, reaching 100% in patients with values ≥0.50. Transependymal cerebrospinal fluid exudation showed the strongest association with subsequent VP shunting. Imaging-based rules exhibited expected trade-offs between sensitivity and specificity. Conclusions: Standard linear ventricular parameters exhibited adequate cross-modality agreement and clinically important longitudinal behavior in this cohort. While insufficient as standalone predictors, these readily available imaging markers remain important tools when combined with a comprehensive clinical assessment. Full article

The benefit of neoadjuvant chemotherapy (NAC) over upfront surgery (UFS) for resectable pancreatic ductal adenocarcinoma (PDAC) is increasingly recognized, yet prognostic biomarkers remain undefined. We evaluated tumor–stroma ratio (TSR), β-catenin (β-CTN) expression, and tumor budding (TB) in 84 resected PDACs (35 NAC, 49 UFS) using digital image analysis of multi-cytokeratin (m-CK) and β-CTN immunohistochemistry. TSR was defined as the proportion of malignant epithelial area within the tumor, and the β-CTN/m-CK index as the ratio of β-CTN to m-CK immunoreactivity in tumor tissue relative to intralobular ducts. TB was significantly less frequent in NAC than UFS (p = 0.003), suggesting that NAC may indirectly modulate epithelial–mesenchymal transition, with TB regarded as its morphological correlate. In the NAC cohort, low TSR was associated with more favorable histological response (Evans IIa/IIb, median 7%; Evans I, 16%; p = 0.009), likely reflecting NAC-induced tumor shrinkage with relative stromal predominance. In multivariable analysis, low β-CTN/m-CK index (<0.5) predicted shorter relapse-free survival in both NAC (HR = 2.516, p = 0.043) and UFS (HR = 2.230, p = 0.025) subgroups. High TSR (≥13%) was associated with shorter cancer-specific survival (HR = 2.414, p = 0.034) in the overall cohort, indicating prognostic value complementing its association with NAC response. These results identify the β-CTN/m-CK index and TSR as prognostic biomarkers in PDAC. Full article

Idiopathic normal-pressure hydrocephalus (iNPH) is clinically characterized by the Hakim–Adams triad: gait disturbance, cognitive decline, and urinary incontinence. Cognitive impairment in iNPH predominates as a subcortical syndrome, with deficits in executive functions, psychomotor slowing, and memory inefficiency. However, the cognitive profile is heterogeneous and often overlaps with other neurodegenerative conditions, complicating differential diagnosis. This study investigated the cognitive features of iNPH using the Rey Auditory Verbal Learning Test (RAVLT), comparing 29 iNPH patients to 28 healthy controls. Demographic and neuroimaging parameters—such as Evans Index and Callosal Angle—were assessed. Results indicated significantly lower Montreal Cognitive Assessment (MoCA) and RAVLT scores in iNPH patients compared to controls. Analysis of serial position effects revealed that, whereas healthy individuals exhibited typical primacy and recency effects in verbal memory, iNPH patients demonstrated a selective impairment of the primacy effect, likely reflecting hippocampal dysfunction. These findings underline the importance of detailed neuropsychological evaluation in differentiating iNPH from other dementias and suggest that damage to medial temporal lobe structures plays a prominent role in the verbal memory deficit observed in iNPH. Full article

Sequential drought and heat stress pose a growing threat to forest ecosystems in the context of climate change, yet systematic evaluation methods for woody plants remain limited. This study aimed to develop a comprehensive screening platform for identifying woody plant species tolerant to sequential drought and heat stress among 27 native species growing in Korea. A sequential stress protocol was applied: drought stress for 2 weeks, followed by high-temperature exposure at 45 °C. Physiological indicators, including relative water content (RWC) and electrolyte leakage index (ELI), were used for preliminary screening, supported by phenotypic observations, Evans blue staining for cell death, and DAB staining to assess oxidative stress and recovery ability. The results revealed clear differences among species. Chamaecyparis obtusa, Quercus glauca, and Q. myrsinaefolia exhibited strong tolerance, maintaining high RWC and low ELI values, while Albizia julibrissin was highly susceptible, showing severe membrane damage and low survival. DAB staining successfully distinguished tolerance levels based on oxidative recovery. Additional species such as Camellia sinensis, Q. acuta, Q. phillyraeoides, Q. salicina, and Ternstroemia japonica showed varied responses: Q. phillyraeoides demonstrated high tolerance, T. japonica showed moderate tolerance, and Q. salicina was relatively sensitive. The integrated screening system effectively differentiated tolerant species through multiscale analysis—physiological, cellular, and morphological—demonstrating its robustness and applicability. This study provides a practical and reproducible framework for evaluating sequential drought and heat stress in trees and offers valuable resources for urban forestry, reforestation, and climate-resilient species selection. Full article

Background/Objectives: Allergens can trigger severe immune responses in hypersensitive individuals, with mast cells releasing inflammatory mediators via IgE-FcɛRI signaling. Spleen tyrosine kinase (Syk) is a key regulator in this pathway, making it a promising therapeutic target. Natural modulators of Syk-mediated mast cell activation remain underexplored. This study investigated the anti-allergic effects of a 70% ethanol extract of Salvia miltiorrhiza (SME) using in vitro and in vivo models. Methods: SME was evaluated using IgE-sensitized RBL-2H3 cells, a passive cutaneous anaphylaxis model, and a DNCB-induced atopic dermatitis-like mouse model. Allergic responses were assessed via degranulation assays, histopathology, serum IgE levels, and the spleen index. Results: SME significantly inhibited mast cell degranulation by 44.4 ± 1.6% in RBL-2H3 cells at 100 µg/mL following 30 min of treatment compared to the untreated control. Western blot analysis demonstrated dose-dependent suppression of protein kinase B (PKB, also known as AKT), c-Jun N-terminal kinase (JNK), extracellular signal-regulated kinase (ERK), and spleen tyrosine kinase (Syk) phosphorylation, indicating inhibition of key allergic signaling pathways. In an IgE/Ag-induced passive cutaneous anaphylaxis model in ICR mice, SME (100 mg/kg, orally) significantly attenuated vascular permeability, as evidenced by a 20.6 ± 9.7% reduction in Evans blue extravasation relative to the Ag-treated group. In a 1-chloro-2,4-dinitrobenzene (DNCB)-induced atopic dermatitis (AD)-like model, six treatments of SME significantly improved the skin condition, reduced spleen enlargement associated with allergic inflammation, and decreased serum IgE levels by 43.3 ± 11.2% compared to the DNCB group. Conclusions: These findings suggest that SME may help to alleviate allergic responses and AD by modulating key immune signaling pathways. Full article

Hydrocephalus is a complex neurological condition marked by abnormal cerebrospinal fluid (CSF) accumulation, often leading to elevated intracranial pressure and structural brain damage. Despite advances in surgical treatment, diagnostic precision and prognosis remain challenging, especially in idiopathic normal pressure hydrocephalus (iNPH). This narrative review aims to synthesize the current knowledge regarding molecular and neuroimaging biomarkers that hold diagnostic, prognostic, and therapeutic significance in hydrocephalus. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar. The inclusion criteria encompassed peer-reviewed studies involving congenital or acquired hydrocephalus and reporting on mechanistic, diagnostic, or monitoring biomarkers. Both established and emerging biomarkers were included, and preclinical findings were considered when translational relevance was apparent. The review highlights a broad spectrum of molecular markers including aquaporins, vascular endothelial growth factor, neurofilaments, glial fibrillary acidic protein, matrix metalloproteinases, and neuroinflammatory markers. The genetic markers associated with ciliogenesis also show promise in subtyping disease. Parallel to molecular advances, neuroimaging techniques, ranging from classic markers like Evans’ index to advanced modalities such as diffusion tensor imaging (DTI), arterial spin labeling (ASL), and glymphatic MRI, provide functional perspectives on hydrocephalus diagnosis and management, while artificial intelligence may further enhance diagnostic algorithms. Molecular and imaging markers could not only increase diagnostic confidence, but also provide information on disease causes and progression. As research progresses, merging various methodologies may result in more accurate diagnoses. Full article

Intraventricular hemorrhage (IVH) is a common complication encountered in extremely-low-birth-weight (ELBW) and very-low-birth-weight (VLBW) premature babies. The neurologic outcome of these patients is influenced by the magnitude of the hemorrhagic process that damages the involved anatomic structures but also by the impaired circulation of cerebrospinal fluid (CSF) through the ventricular system, leading to posthemorrhagic ventriculomegaly (PHVM). Cranial ultrasound (CUS) performed by neonatologists (point-of-care ultrasound—POCUS) facilitates the early diagnosis of IVH and PHVM and can objectively quantify structural alterations. Our aim was to identify the best sonographic criteria to follow-up with ventricular dilatation and predict the need for neurosurgery and neurologic deterioration. We performed a literature review in search of the most relevant ventricular measurements considered by neurosurgeons, neonatologists, and pediatric neurologists to reflect the risk of white matter injury and high intracranial pressure (HIP), thus anticipating neurologic developmental impairment (NDI). The tridimensional picture of ventricular dilatation is best captured if more than one index (ventricular index and anterior horn width) or ratio (Evans ratio, fronto-occipital horn ratio, and fronto-temporal horn ratio) is used. Conclusions: If performed using the correct protocol, serially and comprehensively, CUS is an indispensable tool for the diagnosis and follow-up of neurologic complications of preterm babies, and it can make a difference in guiding adequate intervention and improving long-term developmental outcomes. Full article

The microstructure of cement paste is governed by the hydration of its major component, tricalcium silicate (C₃S). Quantitative analysis of C₃S microstructural images is critical for elucidating the microstructure-property correlation in cementitious systems. Existing image segmentation methods rely on image contrast, leading to a struggle with multi-phase segmentation in regions with close grayscale intensities. Therefore, this study proposes a weighted K-means clustering method that integrates intensity gradients, texture variations, and spatial coordinates for the quantitative analysis of hydrated C₃S microstructure. The results indicate the following: (1) The deep convolutional neural network with guided filtering demonstrates superior performance (mean squared error: 53.52; peak signal-to-noise ratio: 26.35 dB; structural similarity index: 0.8187), enabling high-fidelity preservation of cementitious phases. In contrast, wavelet denoising is effective for pore network analysis but results in partial loss of solid phase information. (2) Unhydrated C₃S reflects optimal boundary clarity at intermediate image relative resolutions (0.25–0.56), while calcium hydroxide peaks at 0.19. (3) Silhouette coefficients (0.70–0.84) validate the robustness of weighted K-means clustering, and the Clark–Evans index (0.426) indicates CH aggregation around hydration centers, contrasting with the random CH distribution observed in Portland cement systems. Full article

Background and Objectives: Intertrochanteric fractures of the femur are common in the elderly due to the increase in longer life expectancy. However, unstable intertrochanteric fractures in the elderly population were still a significant concern for the postsurgical period after total hip arthroplasty (THA). This study aimed to compare the demographics, operative time, dislocation rate, and length of stay of the novel interfragmentary technique (IFT) and the conventional posterolateral approach (CPA) for unstable intertrochanteric femoral fractures treated with THA in the elderly. Materials and Methods: This retrospective study investigated community-dwelling elderly patients with type III, IV, and V unstable femoral intertrochanteric fractures according to the Evans–Jensen classification, treated with THA by a well-experienced single surgeon. The patients were separated into IFT (n = 74) and CPA (n = 67) groups. Patient demographics (age, gender, and body mass index), total surgical duration, dislocation rates, length of stay and follow-up, and complication rates were recorded. Results: The mean age was 80.37 years in the IFT and 80.14 in the CPA groups (p = 0.838). Body mass index, gender, complication, and revision rates did not differ between groups (p > 0.05). The mean follow-up of the IFT group was 4.15 years, and 10.25 years in the CPA group (p = 0.001). Total surgical duration was comparable, with 69.98 min in the IFT group and 69.55 min in the CPA group (p = 0.697). The dislocation rate was 2.7% (n = 2) in the IFT group and 9% (n = 6) in the CPA group (p = 0.109). The mean length of stay was 66.97 h in the IFT group and 67.83 h in the CPA group (p = 0.729). Conclusions: The interfragmentary surgical technique, a novel technique for unstable intertrochanteric fracture surgery, shows promising clinical outcomes. Preserving the short rotator muscles and posterior capsule utilizing the novel IFT can be advantageous for the risk of dislocation without increasing surgical duration. It can be concluded that performing THA using IFT emerges as a practical and viable procedure for treating unstable intertrochanteric fractures in elderly patients. Full article

Due to climate change, heat-tolerant species have become increasingly important; however, the selection system for herbaceous plants has yet to be well established. This study aimed to establish a selection system for heat-tolerant plant species and to identify such species. Heat stress at 50 °C for 120 min was applied to 27 plant species using a heat treatment and recovery model. Among them, four herbaceous species—Hemerocallis fulva, Heliopsis longipes, Hosta plantagines, and Scilla scilloides—were selected by measuring their electrolyte leakage index (ELI). Additionally, species with high ELI values (Centaurea cyanus) and low ELI values (S. scilloide) were selected to determine the optimal temperature and time for the heat treatment using linear regression analysis. The selected heat-tolerant herbaceous plants survived under optimal heat stress conditions (120 min at 50 °C). The degree of cell death in the selected plant species was measured using Evans blue staining. The results showed that the cell death indexes of heat-tolerant species were less than 22% after heat treatment, compared to over 57% in heat-sensitive species. Furthermore, the recovery ability at room temperature after heat treatment was assessed using the DAB staining method. The selected heat-tolerant plant species recovered quickly (within 90 min), whereas the heat-sensitive species required over 480 min for recovery. The analytical method developed in this study can more accurately determine the response of various plants to heat stress and has high reproducibility. Therefore, it is considered an excellent method for establishing a heat-tolerant plant selection system. Full article

Heat-tolerant species have become increasingly important because of climate change; however, a selection system for woody plants is not well established. This study was conducted to establish a selection system for heat-tolerant woody plant species and to select heat-tolerant species. After selecting heat-tolerant woody plants and applying heat stress to 27 species, the electrolyte leakage index (ELI) was measured. The ELI of the heat-tolerant species was lower than that of the non heat-tolerant species, and they survived well after heat stress treatment. For the preselected species, the degree of cell death was measured by Evans blue staining method, and the heat stress recovery ability was measured by a 3,3′-diaminobenzidine (DAB) staining method. The species showed less cell death even after heat treatment, and oxidative stress was low after recovery from heat stress. Traditional screening methods are mainly performed through field screening; however, this is difficult because it requires many samples and considerable time. The results of this study are relatively rapid, reproducible, and highly sensitive, so it is judged to be a method that can complement the existing traditional method as a heat-tolerant plant selection system. The results of this study can be widely used for the selection and breeding of heat-tolerant plants in preparation for climate change. Full article

The aim of this study was to employ artificial intelligence (AI)-based magnetic resonance imaging (MRI) brain volumetry to potentially distinguish between idiopathic normal pressure hydrocephalus (iNPH), Alzheimer’s disease (AD), and age- and sex-matched healthy controls (CG) by evaluating cortical, subcortical, and ventricular volumes. Additionally, correlations between the measured brain and ventricle volumes and two established semi-quantitative radiologic markers for iNPH were examined. An IRB-approved retrospective analysis was conducted on 123 age- and sex-matched subjects (41 iNPH, 41 AD, and 41 controls), with all of the iNPH patients undergoing routine clinical brain MRI prior to ventriculoperitoneal shunt implantation. Automated AI-based determination of different cortical and subcortical brain and ventricular volumes in mL, as well as calculation of population-based normalized percentiles according to an embedded database, was performed; the CE-certified software mdbrain v4.4.1 or above was used with a standardized T1-weighted 3D magnetization-prepared rapid gradient echo (MPRAGE) sequence. Measured brain volumes and percentiles were analyzed for between-group differences and correlated with semi-quantitative measurements of the Evans’ index and corpus callosal angle: iNPH patients exhibited ventricular enlargement and changes in gray and white matter compared to AD patients and controls, with the most significant differences observed in total ventricular volume (+67%) and the lateral (+68%), third (+38%), and fourth (+31%) ventricles compared to controls. Global ventriculomegaly and marked white matter reduction with concomitant preservation of gray matter compared to AD and CG were characteristic of iNPH, whereas global and frontoparietally accentuated gray matter reductions were characteristic of AD. Evans’ index and corpus callosal angle differed significantly between the three groups and moderately correlated with the lateral ventricular volumes in iNPH patients [Evans’ index (r > 0.83, p ≤ 0.001), corpus callosal angle (r < −0.74, p ≤ 0.001)]. AI-based MRI volumetry in iNPH patients revealed global ventricular enlargement and focal brain atrophy, which, in contrast to healthy controls and AD patients, primarily involved the supratentorial white matter and was marked temporomesially and in the midbrain, while largely preserving gray matter. Integrating AI volumetry in conjunction with traditional radiologic measures could enhance iNPH identification and differentiation, potentially improving patient management and therapy response assessment. Full article

The effects of different concentrations of cadmium and 2,2′,4,4′,5,5′-hexabrominated diphenyl ether (BDE-153) on the growth and related physiological and biochemical indexes of Amaranthus mangostanus L. (amaranth) were studied. The results showed that the presence of BDE-153 promoted the absorption of Cd by the amaranth and inhibited the migration of Cd from the roots to the shoots. At the same time, 0.1 mg/L of Cd had a synergistic effect on the migration of BDE-153, but 5 mg/L Cd inhibited the accumulation of BDE-153 in the aboveground part of the amaranth. In addition, the kinetics of the uptake of pollutants by the amaranth showed that both Cd and BDE-153 could be transported by amaranth, but Cd and BDE-153 were mainly enriched in the roots, and the presence of Cd may cause a lag in the uptake of BDE-153 in the shoots. Compared with the control group, the biomass of the amaranth affected by BDE-153 and a high concentration of Cd (5 mg/L) decreased by 30.2–49.5%, the chlorophyll content decreased by 43.0–60.3%, the Evans blue increased, and the MDA content was higher. The activities of superoxide dismutase (SOD) and catalase (CAT) also decreased with an increase in the BDE-153 concentration. This indicates that the interaction between BDE-153 and a high concentration of Cd (5 mg/L) is more toxic to amaranth than single Cd pollution. This paper provides the necessary data support for phytoremediation of heavy metal and organic compound pollution. Full article

Gintonin, newly extracted from ginseng, is a glycoprotein that acts as an exogenous lysophosphatidic acid (LPA) receptor ligand. This study aimed to demonstrate the in vivo preventive effects of gintonin on gastric damage. ICR mice were randomly assigned to five groups: a normal group (received saline, 0.1 mL/10 g, p.o.); a control group (administered 0.3 M HCl/ethanol, 0.1 mL/10 g, p.o.) or indomethacin (30 mg/kg, p.o.); gintonin at two different doses (50 mg/kg or 100 mg/kg, p.o.) with either 0.3 M HCl/ethanol or indomethacin; and a positive control (Ranitidine, 40 mg/kg, p.o.). After gastric ulcer induction, the gastric tissue was examined to calculate the ulcer index. The expression of gastric damage markers, such as tumor necrosis factor (TNF)-α, cyclooxygenase 2 (COX-2), and LPA2 and LPA5 receptors, were measured by Western blotting. Interleukin-6 (IL-6) and prostaglandin E2 (PGE2) levels were measured by enzyme-linked immunosorbent assay. The platelet endothelial cell adhesion molecule (PECAM-1), Evans blue, and occludin levels in gastric tissues were measured using immunofluorescence analysis. Both HCl/ethanol- and indomethacin-induced gastric ulcers showed increased TNF-α, IL-6, Evans blue permeation, and PECAM-1, and decreased COX-2, PGE2, occludin, and LPA5 receptor expression levels. However, oral administration of gintonin alleviated the gastric ulcer index induced by HCl/ethanol and indomethacin in a dose-dependent manner. Gintonin suppressed TNF-α and IL-6 expression, but increased COX-2 expression and PGE2 levels in mouse gastric tissues. Gintonin intake also increased LPA5 receptor expression in mouse gastric tissues. These results indicate that gintonin can play a role in gastric protection against gastric damage induced by HCl/ethanol or indomethacin. Full article

The municipality of Salvador, situated in Brazil, distinguished itself as the epicenter of the emergence of microcephaly related to congenital manifestations of Zika syndrome. Despite the anticipated significant developmental setbacks in these children, research has indicated a varied range of outcomes, with certain instances even reflecting minimal developmental delay. Our objective was to pinpoint determinants that could forecast developmental anomalies in children diagnosed with microcephaly associated with congenital Zika syndrome (CZS). Methodology: A forward-looking clinical and neurodevelopmental examination was conducted focusing on neonates diagnosed with microcephaly with CZS, birthed between September 2015 and April 2016 at the Hospital Geral Roberto Santos, in Salvador city. That infants were monitored up to their third year by a multiprofessional team. Child development was assessed using the composite Bayley III score. Undertaken by two blinded experts, cranial CT scan analysis was performed during the neonate period for the detection of brain abnormalities and to quantify ventricle enlargement, measured by Evans’ index (EI). Results: Fifty newborns were evaluated with a median head circumference of 28 cm (interquartile range 27–31 cm). EI was associated with neurodevelopmental delay at three years and remained significant after adjustment for head circumference. A 0.1-point increase in EI was associated with a delay of 3.2 months in the receptive language (p = 0.016), 3.4 months in the expressive language (p = 0.016), 3.4 months in the cognitive (p = 0.016), 2.37 months in the gross motor (p = 0.026), and 3.1 months in the fine motor (p = 0.021) domains. Conclusions: EI predicted neurodevelopmental delay in all Bayley domains in children with microcephaly associated with CZS. Full article