Search Results (185)

The objective of this study was to evaluate the feasibility and efficacy of the ultrasound-guided thoracolumbar erector spinae plane (TL-ESP) block in standing horses. A total of 24 injections (n = 12) were performed at the L1 level using either 0.1 mL/kg of saline solution (SS group) or 2% lidocaine (LID group). The block feasibility was assessed based on needle visualization and injection time, while efficacy was evaluated through craniocaudal and dorsoventral (DV) spread using the pinprick technique over 270 min. Desensitization was observed at least once in 100% of horses in the LID group and in 75% in the SS group (p = 0.001). However, in the SS group, desensitization was primarily limited to the Th18 metamer at the 2 cm DV position, with a shorter duration compared to the LID group. The block onset occurred at 22.5 (11.25–60) min in the LID group and at 5 (5–30) min in the SS group (p = 0.069). The number of affected metamers was significantly higher in the LID group (2 [1–3]) compared to the SS group (1 [1–2.25], p = 0.014). At the 2 cm DV point, the end of the block effect occurred at 135 (120–210) min in the LID group and at 60 (3.75–60) min in the SS group (p = 0.001). Needle visualization was excellent in 95.8% of cases, and the mean injection time was 2.5 (2–3) min. These findings confirm that the TL-ESP block is a feasible technique in standing horses. However, its effect is predominantly localized to dorsal dermatomes with a limited ventral spread. Future studies evaluating larger volumes and multiple injection sites are warranted to enhance its clinical applicability. Full article

Introduction: Computed tomography-guided biopsies (CTGB) are essential in diagnosing various conditions, particularly in respiratory medicine, with lung cancer being a primary focus. A significant complication associated with CTGB is pneumothorax, which can occur in up to 26% of cases. At Northumbria Healthcare NHS Foundation Trust, a large interventional service collaborates closely with radiologists and respiratory physicians. This study aims to evaluate the incidence of pneumothorax following CTGB. Methods: A retrospective service review was conducted on all lung parenchymal CTGBs performed between April 2011 and July 2023, with approval from the local information governance. Demographic data and clinical outcomes were analyzed using descriptive statistics. Continuous variables are presented as medians with interquartile ranges (IQR), while categorical variables are reported as frequencies and percentages. Results: A total of 1492 CT-guided lung biopsies were analyzed. The median age of patients was 72 years (IQR 10.5), and 50.9% were male. Pneumothorax occurred in 23.8% (n = 355) of cases. Of these, 159 (44.8%) were detected on post-biopsy CT scans. The average number of pleural passes was 1.8 (range 1–4). Among those with pneumothorax, 53.6% had radiologically evident emphysema. The median forced expiratory volume in 1 s (FEV1) was 1.97 L (IQR 1.04). Sixty-seven percent (n = 234) of patients had no pleural contact, and the median lesion size was 26 mm (IQR 24). Seventy-two percent (n = 255) of lesions with pneumothoraces were less than 3 cm deep. Forty-four percent of biopsies were performed using 18 French gauge tru-cut needles. Of the 355 pneumothoraces, 89% (n = 315) were managed conservatively, with 42 requiring pleural intervention (41 small-bore 12 Fr intercostal chest drains and one pleural vent). Symptoms were initially present in 40 cases, and two cases developed symptoms up to 7 days post-procedure. Conclusions: The incidence of pneumothorax is consistent with expected rates, with more occurrences observed in biopsies of smaller lesions lacking pleural contact, lesions with surrounding emphysema, and cases requiring multiple pleural passes. FEV1 does not appear to influence the risk of pneumothorax. Conservative management is generally effective, without significant complications. Full article

Objectives: Low tidal volume ventilation (LTVV) is a ventilatory strategy with the advantages of minimizing diaphragm movements and reducing hypercapnia and barotrauma risks. This preliminary study aims to report on the safety and effectiveness of LTVV applied during percutaneous US-guided liver ablations of focal malignancies. Methods: Patients affected by focal liver malignancies treated with percutaneous microwaves ablation were retrospectively included in this single-center analysis. Arterial gas analysis was performed immediately before and after ablation to evaluate the arterial pH, partial pressure of carbon dioxide (pCO₂), partial pressure of oxygen (pO₂), and plasma lactate levels. The primary endpoint of this study was to evaluate the safety and efficacy of LTVV during percutaneous liver cancer ablation. The secondary endpoint was to assess the procedural technical success in terms of correct needle probe targeting without the need for repositioning. Results: Ten patients affected by a single liver lesion had been analyzed. The ASA score was three in all patients, with three patients also suffering from COPD. The procedural technical success was 100%: ablations were performed with a single liver puncture without the need for changing access or repositioning the needle. No variations in post-ablation arterial gas analysis requiring anesthesiological management remodulation occurred. Lactate levels remained stable and hemodynamic balance was preserved during all procedures. No switch to standard volume ventilation was required. Conclusions: In this preliminary study, LTVV was a safe and effective anesthesiological protocol in patients treated with percutaneous ablations of liver malignancies, offering an ideal balance between patient safety and percutaneous needle probe positioning precision. Larger prospective studies are needed to confirm these findings. Full article

Conventional laboratory methods for handling valuable biological samples typically use pipettes or needles, which are prone to issues such as dead volume and sample waste. Furthermore, the sampling and processing of pathogenic bacteria, such as Escherichia coli (E. coli) in environmental wastewater, require labor-intensive procedures with multiple complex steps. To overcome these limitations, we developed a pipette integrated with a microfluidic chip for bacteria sampling and delivery. This pipette can provide the negative pressure to microfluidic chips for sampling, the constant temperature unit for biological reaction, and programs for automatic control (suction, heating, liquid discharge, and cleaning) and display. The droplet chip employs a cross-channel structure to generate droplets and incorporates a designated droplet storage and detection area. Utilizing this innovative device, we have demonstrated the generation, transportation, and storage of pL droplets, as well as quantitatively detected E. coli samples across various concentrations. The test results have demonstrated the overall reliability and data consistency of the system. Overall, our device achieves the precise sampling of pL volumes, offering a simple yet promising solution for the sampling and delivery of bio-samples in remote settings. Full article

Aflatoxin B₁ (AFB₁) is widely present in raw materials for food and feedstock, posing a significant threat to the health of humans and animals. This study explored the toxicokinetics of a single oral administration of AFB₁ at a dose of 100 µg·kg⁻¹ BW (body weight). Donkey blood samples were gathered at 0, 5, 10, 15, 20, 30, 45, and 60 min and at 1.5 h, 2 h, 2.5 h, 3 h, 3.5 h, 4 h, 4.5 h, 6 h, 9 h, 12 h, 24 h, 48 h, 72 h, 96 h, and 120 h through jugular vein sampling needles at intervals. Fecal and urinary samples were collected at 0 h and every 6 h thereafter until 120 h. The concentrations of AFB₁ and AFM₁ in plasma, urine, and feces were quantitatively analyzed using LC-MS/MS. The maximum concentrations of AFB₁ and AFM₁ in plasma were 13.10 ± 6.35 µg·L⁻¹ and 0.72 ± 0.33 µg·L⁻¹, occurring at 1.38 ± 0.89 h and 2.25 ± 1.57 h after oral administration, respectively. The AFB₁ and AFM₁ elimination half-lives (T_1/2Elim) were 6.65 ± 2.84 h and 5.85 ± 3.00 h, respectively. The total clearances (CL) of AFB₁ and AFM₁ were 163 ± 52.2 L·kg⁻¹ BW⁻¹·h⁻¹ and 3210 ± 2450 L·kg⁻¹ BW⁻¹·h⁻¹, and the volumes of distribution (Vd) for AFB₁ were 1440 ± 417 L·kg⁻¹·BW and 22,400 ± 14,800 L·kg⁻¹·BW, respectively. In addition, the total amounts of AFB₁ and AFM₁ excreted over 120 h through urine and feces accounted for 3.38 ± 0.92% and 3.44 ± 1.45% of the total intake, respectively (calculated by material mass). Furthermore, the research showed that the absorption and metabolism of AFB₁ were rapid in male donkeys, with the tissue exhibiting a wide distribution and long duration. Full article

Background/Objectives: Patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) have a poor prognosis. Local therapy may enhance tumor control and increase resectability. Intratumoral injection of radioactive holmium-166 microspheres presents a promising and minimally invasive treatment with multimodality imaging capabilities (SPECT, CT, MRI). However, holmium-166 microspheres are not commonly used for intratumoral injections, and PDAC is notorious for its high intratumoral pressure. This study developed an intratumoral injection method with nonradioactive holmium-165 microspheres in ex vivo human PDAC specimens using a novel injection system for suspension homogenization. Methods: An injection system was developed and validated in a laboratory setting. Thereafter, intratumoral injections in surgically removed ex vivo PDACs were performed, and parameters were established to optimize feasibility, defined by the ability to inject and control the microsphere distribution. Also, injection limitations and cutoff values were determined. The distribution was assessed by visual confirmation, CT, MRI, ultrasound, and histopathology. Results: With a validated injection system, intratumoral injections were performed in ten ex vivo PDAC samples. Feasible injection guidelines include but are not limited to ultrasound or CT needle guidance, a maximum injection volume of <20.0% from the tumor volume, ≤3 needle positions, and an injection volume of 0.3–1.0 mL per needle position. Conclusions: Intratumoral injection of holmium-165 microspheres in ex vivo pancreatic ductal adenocarcinoma was feasible with adherence to injection parameters necessary for effective intratumoral deposition and minimal leakage. The injection system and parameters developed here provide a foundation for future studies on holmium-166 microsphere injections in pancreatic cancer patients, with the aim to improve local tumor control as a part of a multimodal therapy. Full article

Mammography is an essential tool in breast screening, often revealing lesions that appear as microcalcifications with or without an associated mass. Decisions about biopsy requirements are guided by the BI-RADS system, aiming to confirm the histopathology of suspicious lesions while avoiding unnecessary procedures. A vacuum-assisted breast biopsy (VABB) is a minimally invasive procedure for diagnosing breast abnormalities. Precise lesion targeting is ensured under stereotactic guidance, reducing the need for repeated procedures. Compared to traditional core needle biopsy (CNB) and fine-needle aspiration cytology (FNAC), it differs in using vacuum assistance to gather more tissue volume, increasing diagnostic accuracy and reducing the likelihood of histological underestimation. This is particularly crucial in cases where microcalcifications are the primary finding, as they are often the earliest signs of ductal carcinoma in situ (DCIS). Managing such findings requires precise diagnostic tools to differentiate benign from malignant lesions without subjecting patients to unnecessary surgical interventions. Building on several years of experience in our department, we have assembled a selection of ten interesting cases encountered in our clinical practice. Each case is documented with paired mammographic images and their corresponding image of histopathological findings, offering a comprehensive view of the diagnostic journey. These cases were selected for their educational value, highlighting the integration of imaging modalities, histopathological evaluation, and clinical decision-making. All cases underwent an extensive diagnostic workup at our facility. This compilation aims to provide valuable insights for both clinicians and researchers, offering a deeper understanding of advanced diagnostic techniques and their role in improving patient outcomes. Full article

Background: Both early researchers, such as new graduate students, and experienced researchers face the challenge of sifting through vast amounts of literature to find their needle in a haystack. This process can be time-consuming, tedious, or frustratingly unproductive. Methods: Using only abstracts and titles of research articles, we compare three retrieval methods—Bibliographic Indexing/Databasing (BI/D), Retrieval-Augmented Generation (RAG), and Graph Retrieval-Augmented Generation (GraphRAG)—which reportedly offer promising solutions to these common challenges. We assess their performance using two sets of Large Language Model (LLM)-generated queries: one set of queries with context and the other set without context. Our study evaluates six sub-models—four from Light Retrieval-Augmented Generation (LightRAG) and two from Microsoft’s Graph Retrieval-Augmented Generation (MGRAG). We examine these sub-models across four key criteria—comprehensiveness, diversity, empowerment, and directness—as well as the overall combination of these factors. Results: After three separate experiments, we observe that MGRAG has a slight advantage over LightRAG, naïve RAG, and BI/D for answering queries that require a semantic understanding of our data pool. The results (displayed in grouped bar charts) provide clear and accessible comparisons to help researchers quickly make informed decisions on which method best suits their needs. Conclusions: Supplementing BI/D with RAG or GraphRAG pipelines would positively impact the way both beginners and experienced researchers find and parse through volumes of potentially relevant information. Full article

TiNbZr-(Ti,Nb)B composites were produced by vacuum arc melting; the weights of TiB₂ in the charge mixture were 0.7 wt. % (Alloy A) and 4.0 wt. % (Alloy B). In addition, unreinforced TiNbZr alloy specimens were fabricated without the addition of TiB₂. The microstructure of the TiNbZr-(Ti,Nb)B composites consisted of the TiNbZr β matrix and (Ti,Nb)B fibers. The (Ti,Nb)B fibers had a needle-like shape with an average diameter of ~0.4 and ~2.0 µm for Alloys A and B, respectively. The volume fraction of borides was found to be ~2.5 and ~12.4% for Alloys A and B, respectively. The presence of 12.4 vol.% of (Ti,Nb)B reduced the corrosion resistance of Alloy B in comparison with that of the TiNbZr alloy and Alloy A, which showed rather similar values of corrosion resistance. It was found that the addition of the TiB₂ to the TiNbZr alloy led to a decrease in the friction coefficient; when adding 0.7% TiB₂ to the alloy (Alloy A), the friction coefficient decreased from 1.15 to 1.13, and when the percentage of TiB₂ in the alloy increased to 4% (Alloy B), the friction coefficient decreased by ~2 times from 1.15 to 0.58. The full biocompatibility of TiNbZr-(Ti,Nb)B composites was demonstrated; no significant differences from the unreinforced state and alloy were found. Full article

Lip augmentation has become increasingly popular in aesthetic medicine, driven by advancements in dermal filler technologies and injection techniques. This review provides a comprehensive overview of lip anatomy, age-related changes, and current best practices in lip augmentation using dermal fillers. The complex structure of the lips, including multiple layers of skin, muscle, and mucosa, contributes to their unique appearance and function. Age-related changes, such as volume loss, thinning of the vermilion border, and flattening of the philtrum, significantly impact lip aesthetics. Understanding these changes is crucial for developing effective treatment strategies. The review discusses the importance of tailoring treatments to individual patient needs, considering factors such as ethnic variations in lip structure and cultural preferences. It emphasizes the significance of proper filler selection, with hyaluronic acid-based products being the gold standard due to their biocompatibility and reversibility. Injection techniques, including needle and cannula approaches, are described in detail, with a focus on safety and optimal aesthetic outcomes. Anatomical considerations, particularly the vascular supply to the lips, are highlighted as critical for avoiding complications during filler injections. The review also addresses the evolving approach to lip augmentation, which now focuses on restoring natural contours and addressing age-related changes in the perioral region rather than simply increasing volume. Finally, the importance of managing patient expectations and the potential for future advancements in the field are discussed, including the development of more targeted filler products and refined injection techniques. Full article

Introduction: Comparative studies on Hounsfield units (HU) and bone volume fraction (BVF%) for the demonstration of cancellous bone density in the entire spine and in the various intravertebral regions are rare. The aim of the present study was to determine HU in various segments and sectional planes (sagittal, axial, coronary) of the spine and their description in the context of bone density measurement on micro-CT, as well as the significance of the values for bone loss and fracture risk. Materials/Methods: The spines of 11 body donors were analyzed by means of high-resolution spiral CT and micro-CT. Vertebral deformities were identified on sagittal reformations and classified. Cancellous bone density in the individual vertebrae from C3 to L5, expressed in HU, was measured on CT images (in all 242 vertebral bodies). For this purpose, a manually positioned ROI was established in mid-vertebral cancellous bone in the axial, sagittal, and coronary planes. Using a Jamshidi^® needle, we obtained 726 specimens from prepared vertebrae extracted from three quadrants (QI: right-sided edge, QII: central, QIII: left-sided edge) and analyzed these on a micro-CT device (SKYSCAN 1172, RJL Micro & Analytic GmbH, Germany). The study design with multiple measurements was reflected by a General Linear Model Repeated Measures. The model was adjusted to the bone density values of both procedures (HU, BVF%) in the viewed sectional planes and quadrants for 22 vertebrae, with the predictors gender and fracture status, controlled for age and body mass index (BMI). Analysis of variance provided estimations of density values and comparisons of several subgroups. Results: All spines were osteoporotic. Both procedures revealed a significant reduction in cancellous bone density from C3 to L5 (p ≤ 0.018). Gender (p = 0.002) and fracture status (p = 0.001) have an impact on bone density: men have higher bone density values than women; cases with fewer fractures also have higher bone density values. CT revealed both effects (p = 0.002 for each) with greater clarity. HU on CT measurements in the axial plane showed higher density values than in the sagittal or coronary planes. CT measurement profiles along the spine as well as along the individual profiles of the 11 body donors were independent of the measured quadrants, but the micro-CT measurements were not. Discussion: The craniocaudal reduction in bone density was demonstrated in different degrees of clarity by the two procedures. Likewise, the procedure-related visualization of differences in cancellous bone density between genders, fracture groups, sectional planes, and quadrants indicates the need for a better understanding of the advantages of each procedure for patient-oriented approaches to the diagnosis of osteoporosis. Future research should be focused on the determination of standard values and their clinical application for the prevention and treatment of osteoporosis. Full article

Background/Objectives: Structural incomplete response (SIR) (persistence/recurrence) may occur in 2–6% of low-risk differentiated thyroid cancer (DTC)-cases and in 67–75% of high risk. Regarding locoregional disease, surgery is the optimal therapeutic modality if the smallest dimension of the targeted node is ≥8 mm or ≥10 mm (central or lateral compartment). In the presence of smaller nodes, contraindications or the patient’s unwillingness for reoperation, active surveillance (AS) or minimally invasive treatments (MITs) may be considered. Methods: We retrospectively studied eight DTC patients with SIR confirmed by ultrasound (U/S)-guided fine-needle aspiration cytology (FNAC) and the measurement of Thyroglobulin (Tg) in the washout fluid. Fourteen malignant lesions were ablated by radiofrequency (RF). We assessed prior to RF ablation (RFA) and consecutively at one month, three months and, then, every three months the volume of each lesion, serum Tg and Anti-Tg antibodies and calculated the volume reduction ratio (VRR). Results: Patients were followed for a mean period of 13.25 months (range: 4–24) after RFA was performed. The targeted lesions reduced significantly from a median volume of 0.24 mL (range: 0.09–0.9) to 0.02 mL (range: 0–0.03) (p < 0.05), with a median VRR of 94.5% (range: 78–100%) and concomitant significant biochemical remission (decrease in serum Tg from a median of 1.05 ng/mL to 0.2 ng/mL, p < 0.05). In one patient with an aggressive radioiodine (RAI)-refractory histological variant, re-recurrence was documented, which was successfully re-ablated by RF. In two patients, Horner syndrome was diagnosed as an RFA complication, which was totally resolved within six months. Conclusions: RFA may be considered as an effective and safe MIT in selective DTC patients with SIR, especially in cases of smaller lesions. Additional prospective studies are needed, including aggressive DTC histological variants towards a tailored therapeutic approach. Full article

The Pelton turbine has been widely applied for the advantages of its simple structure, flexible mass flow rate, wide range of applicable heads and high efficiency. The nozzle and needle are a core part of the Pelton turbine injector. In this paper, the VOF (Volume of Fluid) model was used to simulate the jet flow behaviors and hydraulic performance for a Pelton injector with a needle tip with different breakage losses. Three types of needle tip breakage loss combined with normal needle tip were selected for numerical calculation and analysis, focusing on the influence of needle tip on the high-speed jet flow characteristics. An injector with normal needle tip hydraulic performance is compared with the model test. Finally, the injector hydraulic performance and the jet flow behavior changes with the needle tip shape were comprehensively analyzed. Results show that the needle tip shape almost does not affect the flow rate; when the tip breakage loss is larger than 0.1 of nozzle diameter, the jet efficiency will decrease rapidly and the jet will diffuse rapidly after outflow from the injector. The investigation provides a basis for the operation, maintenance and stability of the Pelton turbine. Full article

Background/Objectives: A modern classification distinguishes between two nosological entities posing an intermediate risk between differentiated and anaplastic carcinoma: poorly differentiated thyroid carcinoma and differentiated high-grade thyroid carcinoma. There are currently few studies searching for the preoperative molecular genetic markers of high-grade papillary thyroid carcinoma (PTC HG), primarily because of a recent WHO reclassification and singling out of a separate entity: high-grade follicular cell-derived nonanaplastic thyroid carcinoma. Therefore, this work was aimed at identifying PTC HG-specific microRNAs and mRNAs that reliably distinguish them from differentiated papillary thyroid carcinoma in preoperative cytology specimens (fine-needle aspiration biopsies). Methods: A molecular genetic profile (expression levels of 14 genes and eight microRNAs) was studied in 110 cytology specimens from patients with PTC: 13 PTCs HG and 97 PTCs without features of HG. Results: Of the examined eight microRNAs and 14 genes, significant differences in the expression levels between the PTC and PTC HG groups were revealed for genes SLC26A7, TFF3, and TPO. Only one gene (SLC26A7) proved to be crucial for detecting PTC HG. It showed the largest area under the ROC curve (0.816) in differentiation between the PTC and PTC HG groups and was the key element of the decision tree by ensuring 54% sensitivity and 87.6% specificity. Conclusions: Early preoperative diagnosis of PTC HG in patients with early stages of this cancer type will allow clinicians to modify a treatment strategy toward a larger surgery volume and lymph node dissection and may provide indications for subsequent radioactive iodine therapy. Full article

Botulinum toxin type A is a first-line treatment for post-stroke spasticity, with selective action at nerve endings and minimal effects beyond the injection site. However, concerns about potential adverse reactions due to toxin diffusion and spread can significantly influence physicians’ therapeutic decisions in managing post-stroke spasticity. Current evidence shows that while the main formulations of botulinum toxin type A have different molecular weights and sizes, they do not exhibit differing diffusion profiles. Instead, the key factors determining botulinum toxin type A diffusion and spread in post-stroke spasticity management are the dose (i.e., the actual amount of 150 kDa neurotoxin protein injected), dilution, and injection volume. Other injection-related factors, such as the needle gauge and injection speed, have also been suggested to have a secondary influence on botulinum toxin type A diffusion and spread. The needs of patients with post-stroke spasticity may vary, and depending on treatment goals, botulinum toxin type A diffusion and spread can be something to avoid or may offer therapeutic benefits by reaching a greater number of nerve terminals in the target muscle, enhancing the toxin’s effect. These factors should be carefully evaluated in spasticity clinics. Full article