Unilateral chronic angle-closure glaucoma in a pediatric patient with neurofibromatosis: a case report

Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disease that causes multi-system damage. It is rarely associated with angle-closure glaucoma, especially in pediatric patients. We herein report a case of unilateral chronic angle-closure glaucoma in a patient with NF1. A 5-year-old girl with a large subcutaneous soft mass and multiple scattered coffee-milk spots presented with low vision, increased intraocular pressure, and angle closure in her right eye. Lisch nodules were seen in both eyes. In her right eye, ectropion uveae was observed at the top and bottom margins of the pupil. Magnetic resonance imaging of the skull and orbit revealed no abnormalities. Finally, trabeculectomy was performed on the right eye, after which the right eye showed a stable intraocular pressure. NF1 combined with angle-closure glaucoma is rare and easily missed in the clinical setting. Early diagnosis and treatment may achieve good results

Whole-organ CT perfusion of the pancreas: impact of iterative reconstruction on image quality, perfusion parameters and radiation dose in 256-slice CT-preliminary findings.

BACKGROUND: This study was performed to assess whether iterative reconstruction can reduce radiation dose while maintaining acceptable image quality, and to investigate whether perfusion parameters vary from conventional filtered back projection (FBP) at the low-tube-voltage (80-kVp) during whole-pancreas perfusion examination using a 256-slice CT. METHODS: 76 patients with known or suspected pancreatic mass underwent whole-pancreas perfusion by a 256-slice CT. High- and low-tube-voltage CT images were acquired. 120-kVp image data (protocol A) and 80-kVp image data (protocol B) were reconstructed with conventional FBP, and 80-kVp image data were reconstructed with iDose(4) (protocol C) iterative reconstruction. The image noise; contrast-to-noise ratio (CNR) relative to muscle for the pancreas, liver, and aorta; and radiation dose of each protocol were assessed quantitatively. Overall image quality was assessed qualitatively. Among 76 patients, 23 were eventually proven to have a normal pancreas. Perfusion parameters of normal pancreas in each protocol including blood volume, blood flow, and permeability-surface area product were measured. RESULTS: In the quantitative study, protocol C reduced image noise by 36.8% compared to protocol B (P<0.001). Protocol C yielded significantly higher CNR relative to muscle for the aorta, pancreas and liver compared to protocol B (P<0.001), and offered no significant difference compared to protocol A. In the qualitative study, protocols C and A gained similar scores and protocol B gained the lowest score for overall image quality (P<0.001). Mean effective doses were 23.37 mSv for protocol A and 10.81 mSv for protocols B and C. There were no significant differences in the normal pancreas perfusion values among three different protocols. CONCLUSION: Low-tube-voltage and iDose(4) iterative reconstruction can dramatically decrease the radiation dose with acceptable image quality during whole-pancreas CT perfusion and have no significant impact on the perfusion parameters of normal pancreas compared to the conventional FBP reconstruction using a 256-slice CT scanner

Natural Deep Eutectic Solvent-Assisted Extraction, Structural Characterization, and Immunomodulatory Activity of Polysaccharides from <i>Paecilomyces hepiali</i>

Polysaccharides, which can be affected by different preparations, play a crucial role in the biological function of Paecilomyces hepiali (PHPS) as a health food. To explore high-valued polysaccharides and reduce the negative influence of human involvement, a green tailorable deep eutectic solvent (DES) was applied to optimize the extraction of polysaccharides (PHPS-D), followed by the evaluation of the structural properties and immunomodulation by comparison with the hot-water method (PHPS-W). The results indicated that the best system for PHPS-D was a type of carboxylic acid-based DES consisting of choline chloride and succinic acid in the molar ratio of 1:3, with a 30% water content. The optimal condition was as follows: liquid–solid ratio of 50 mL/g, extraction temperature of 85 °C, and extraction time of 1.7 h. The actual PHPS-D yield was 12.78 ± 0.17%, which was obviously higher than that of PHPS-W. The structural characteristics suggested that PHPS-D contained more uronic acid (22.34 ± 1.38%) and glucose (40.3 ± 0.5%), with a higher molecular weight (3.26 × 105 g/mol) and longer radius of gyration (78.2 ± 3.6 nm), as well as extended chain conformation, compared with PHPS-W, and these results were confirmed by AFM and SEM. Immunomodulatory assays suggested that PHPS-D showed better performance than PHPS-W regarding pinocytic activity and the secretion of NO and pro-inflammatory cytokines (IL-6, TNF-α and IL-1β) by activating the corresponding mRNA expression in RAW264.7 cells. This study showed that carboxylic acid-based DES could be a promising tailorable green system for acidic polysaccharide preparation and the valorization of P. hepiali in functional foods

Conventional transverse pancreas CT perfusion images.

<p>(A) Protocol A (120-kVp, filtered back projection) in a 48-year-old female patient. Images from a 66-year-old female patient showing a cystic lesion in the head of the pancreas (arrow), with (B) protocol B (80-kVp, filtered back projection), and (C) protocol C (80-kVp, iDose⁴), which show region of interests (ROIs) manually drawn on aorta (ROI 1), subcutaneous fat of anterior abdominal wall (ROI 2), pancreas (ROI 3-5), liver (ROI 6-9), paraspinal muscle (10,11). For all measurements of the same patients, size, shape, and position of ROIs were kept constant by applying copy-and-paste function at workstations.</p

Characteristics of patients with normal pancreas in 120-kVp (protocol A) and 80-kVp (protocol B and protocol C).

<p>Unless otherwise specified, data are expressed as mean±standard deviation.</p

Contrast-to-noise ratio (CNR), image noise and radiation dose for protocols A, B, and C.

<p>Data are expressed as mean±standard deviation.</p

CT scanning parameters and postprocessing algorithms of protocol A, B, and C.

<p>CT scanning parameters and postprocessing algorithms of protocol A, B, and C.</p

Measurements of blood flow (BF), blood volume (BV), and permeability-surface area product (PS) in three protocols with normal pancreas.

<p>Data are expressed as mean±standard deviation.</p

Functional perfusion CT color maps of normal pancreatic tissue in a 48-year-old female.

<p>(A) Transverse CT image. (B-D) CT perfusion parametric maps for blood flow, blood volume, and permeability-surface area product. Regions of interest (ROIs) drawn on pancreatic head (ROI 1), body (ROI 2), and tail (ROI 3). For all measurements of the same patient, size, shape, and position of ROIs were kept constant by applying copy-and-paste function at workstations.</p

Subjective image quality scores for protocols A, B, and C from the two radiologists (reader 1 and reader 2).

<p>Data are expressed as mean scores. *Value shows statistical difference. **Value was reported as follows: poor, less than 0.20; fair, 0.21–0.40; moderate, 0.41–0.60; substantial, 0.61–0.80; and almost perfect, 0.81–1.00.</p