Neuroimaging Assessment of Aggressive Pituitary Adenomas

Aggressive pituitary adenomas (APA) are adenomas that show rapid growth, invasiveness, frequent or multiple relapses, or are resistant to conventional therapies. Clinical-imaging assessment of aggressive pituitary adenomas with the aid of magnetic resonance imaging (MRI) plays an important role in early prediction, further disease outcomes and aggressive behavior of adenomas. Purpose of the Study: was to assess the correlation of neuroimaging data with the hormonal activity of APA. Materials and Methods: The study included 74 patients with aggressive pituitary adenomas. The average age of the patients was from 12 to 69. The patients underwent a basal assessment of the level of pituitary hormones: prolactin (PRL), GH (growth hormone), insulin-like growth factor-1 (IGF-1) and blood cortisol by the RIA method, as well as an MRI study. Knop's classification was used to assess the invasion. Results: The hormonal workup showed prevalence of inactive pituitary adenomas among aggressive adenomas. No correlation was found between the hormonal activity of aggressive adenomas and the volume of pituitary adenomas. Moreover, MRI data indicated that invasion into the cavernous sinus of the III degree and heterogeneity of the adenoma may be considered equivalents of aggressiveness. Conclusion: The established patterns support the need for visualization assessment of aggressive pituitary adenomas and strongly suggest the evaluation of the degree of aggression based on tumor heterogenecity, chiasm compression, hypo- and iso-intensity in T1 mode and hyperintensity in T2 modes.

Multimodal Imaging of Torpedo Maculopathy With Fluorescence Adaptive Optics Imaging of Individual Retinal Pigmented Epithelial Cells

Torpedo maculopathy (TM) is a rare congenital defect of the retinal pigment epithelium (RPE). The RPE is often evaluated clinically using fundus autofluorescence (AF), a technique that visualizes RPE structure at the tissue level from the intrinsic AF of RPE fluorophores. TM lesions typically emit little or no AF, but this macroscopic assessment is unable to resolve the RPE cells, leaving the organization of the RPE cell mosaic in TM unknown. We used fluorescence adaptive optics scanning laser ophthalmoscopy (AOSLO) to show here for the first time the microscopic cellular-level structural alterations to the RPE cell mosaic in TM that underlie the tissue-level changes seen in conventional clinical imaging. We evaluated two patients with TM using conventional clinical imaging techniques and adaptive optics (AO) infrared autofluorescence (IRAF) in AOSLO. Confocal AOSLO revealed relatively normal cones outside the TM lesion but altered cone appearance within it and along its margins in both patients. We quantified cone topography and RPE cell morphometry from the fovea to the margin of the lesion in case 1 and found cone density to be within the normal range across the locations imaged. However, RPE morphometric analysis revealed disrupted RPE cells outside the margin of the lesion; the mean RPE cell area was greater than two standard deviations above the normative range up to approximately 1.5 mm from the lesion margin. Similar morphometric changes were seen to individual RPE cells in case 2. Multi-modal imaging with AOSLO reveals that RPE cells are abnormal in TM well beyond the margins of the characteristic TM lesion boundary defined with conventional clinical imaging. Since the TM fovea appears to be fully formed, with normal cone packing, it is possible that the congenital RPE defect in TM occurs relatively late in retinal development. This work demonstrates how cellular level imaging of the RPE can provide new insight into RPE pathologies, particularly for rare conditions such as TM.

Eosinophilic fasciitis (Shulman disease) with clinical, imaging and pathological correlation

Eosinophilic fasciitis (EF) is a rare subacute fibrosing disorder of unknown aetiology, characterised by thickening of the muscular fascia and subcutaneous tissue, leading to swelling of limbs and trunk and sparing fingers and toes. Eosinophilic infiltration and degranulation may prompt tissue damage and consequent fibrosis due to the accumulation of collagen and extracellular matrix proteins. MRI is the best imaging modality for diagnosis, depicting fascial thickening and enhancement. MRI may also have a significant role in excluding alternative diagnosis and guiding the skin–muscle biopsy.We report a case of EF with clinical and pathological correlation, highlighting the diagnostic value of MRI for early diagnosis and further treatment.

Metal–Organic Frameworks (MOFs) for Cancer Therapy

MOFs exhibit inherent extraordinary features for diverse applications ranging from catalysis, storage, and optics to chemosensory and biomedical science and technology. Several procedures including solvothermal, hydrothermal, mechanochemical, electrochemical, and ultrasound techniques have been used to synthesize MOFs with tailored features. A continued attempt has also been directed towards functionalizing MOFs via “post-synthetic modification” mainly by changing linkers (by altering the type, length, functionality, and charge of the linkers) or node components within the MOF framework. Additionally, efforts are aimed towards manipulating the size and morphology of crystallite domains in the MOFs, which are aimed at enlarging their applications window. Today’s knowledge of artificial intelligence and machine learning has opened new pathways to elaborate multiple nanoporous complex MOFs and nano-MOFs (NMOFs) for advanced theranostic, clinical, imaging, and diagnostic purposes. Successful accumulation of a photosensitizer in cancerous cells was a significant step in cancer therapy. The application of MOFs as advanced materials and systems for cancer therapy is the main scope beyond this perspective. Some challenging aspects and promising features in MOF-based cancer diagnosis and cancer therapy have also been discussed.

Clinical and Microbiological Factors Associated With Abscess Formation in Adult Acute Epiglottitis

Objectives: To evaluate clinical and microbiological findings that are correlated with abscess formation in adult acute epiglottitis (AE). Methods: We reviewed 140 cases of adult AE. Demographic, clinical, imaging, and microbiological findings are analyzed for all patients with AE in comparison to those with epiglottic abscess (EA). Results: A total of 113 patients presented with AE and 27 presented or progressed to EA (19.3%). Age, sex, seasonality, smoking, body mass index (BMI), and comorbidities were statistically insignificant between the 2 groups. Muffled voice ( P < .013), respiratory distress ( P < .001), and pre-existence of epiglottic cyst ( P < .001) are symptoms and signs connected with abscess formation. A total of 120 patients were treated conservatively. Surgical treatment was performed on 20 patients with EA. About 72 out of 80 cultures revealed monomicrobial infection. Mixed flora was isolated in 8 patients with EA. Streptococcus was isolated in 51 out of 80 positive cultures (64%). Haemophilus Influenza ( Hib) was not isolated in any sample. EA and mixed flora relates to a higher rate of airway intervention ( P < .001). Conclusion: A high level of suspicion for abscess formation is required if clinical examination reveals dyspnea, muffled voice, or an epiglottic cyst in adult with AE. The existence of EA doubles the duration of hospitalization. EA is typically found on the lingual surface of the epiglottis. Supraglottic or deep neck space expansion should be treated surgically. EA is associated with a mixed flora and a higher rate of airway obstruction. Streptococcus is discovered to be the most common pathogen.

Advanced Ultrasound and Photoacoustic Imaging in Cardiology

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide. An effective management and treatment of CVDs highly relies on accurate diagnosis of the disease. As the most common imaging technique for clinical diagnosis of the CVDs, US imaging has been intensively explored. Especially with the introduction of deep learning (DL) techniques, US imaging has advanced tremendously in recent years. Photoacoustic imaging (PAI) is one of the most promising new imaging methods in addition to the existing clinical imaging methods. It can characterize different tissue compositions based on optical absorption contrast and thus can assess the functionality of the tissue. This paper reviews some major technological developments in both US (combined with deep learning techniques) and PA imaging in the application of diagnosis of CVDs.

Demographic, clinical, and paraclinical characteristics of COVID-19 pediatric cases in southeast Iran

Background Even though children seem to be less vulnerable to the Coronavirus disease 2019 (COVID-19) infection, still a diverse range of clinical presentations and symptoms have been reported in children. Few studies assessed the clinical presentations of COVID-19 among Iranian children. We aimed to evaluate the clinical and paraclinical characteristics of COVID-19 infected children. Methods All COVID-19 suspected and confirmed children were referred to the Ali-ibn-Abitaleb Hospital, Zahedan, Iran. Patients were included in this longitudinal study. Patients were evaluated at admission and during hospitalization. Patients with some of the main COVID symptoms with positive PCR test were defined as confirmed cases. Clinical, imaging and laboratory results were collected for all patients. Results A total of 62 patients participated in this study. The male:female ratio was 1:1.03. There was a significant difference in fatigue prevalence between age groups (P = 0.002). There was no significant difference between groups in terms of fever duration (P = 0.624) and maximum temperature (P = 0.629). There was a significant difference between PCR positive and negative patients in terms of neurologic signs (P = 0.003), Intensive care unit admission (P = 0.001), white blood cell (P = 0.047). Conclusions Even though our population was small, most of the findings matched other studies conducted on pediatric cases in Iran or other countries. It was also found that some clinical features such as pneumonia, cough, diarrhea, and tachycardia at admission time were statistically different among age groups.