Anatomic assessment of the left main bifurcation and dynamic bifurcation angles using computed tomography angiography

Background: An understanding of the left main coronary artery (LMCA) anatomy is important for accurate diagnosis and therapy. We aimed to investigate LMCA anatomy via 128-multisliced coronary computed-tomography-angiography (CCTA) in patients with normal LMCA. Materials and methods: A total of 201 CCTA studies were included in this study. Anatomical features of LMCA including cross-sectional areas of the LMCA ostial, LMCA distal, left anterior descending artery (LAD) ostial and left circumflex artery (LCX) ostial, and degree of tapering and LMCA bifurcation angles (BA) in the form of LMCA-LCX BA, LMCA-LAD BA, LAD-LCX BA at end-diastole and end-systole. Results: The mean age was 55 ± 11; 55.7% of patients were males. Right coronary artery was dominant in 173 (86.1%) patients. Mean LMCA length was 10.0 ± 4.5 mm. The mean values of LMCA ostial, LMCA distal, LAD ostial and LCX ostial areas were 18.2 ± 5.1 mm2, 13.2 ± 4.0 mm2, 9.0 ± 3.2 mm2 and 7.6 ± ± 2.8 mm2, respectively. LMCA ostial-distal area, LMCA distal-LAD ostial area and LMCA distal-LCX ostial area ratios were ≥ 1.44 – < 1.69 in 47 (23.4%), 53 (26.4%), 47 (23.4%) patients, respectively, and were ≥ 1.69 – < 1.96 in 19 (9.5%), 24 (11.9%), 40 (19.9%) patients respectively. Systolic motion modifies LMCA BAs; systolic motion begets an increment of LMCA-LAD angle in 72.6% of patients and decrement of LAD-LCX angle in 75.6% of patients. Patients with T-shaped LAD-LCX BA was shown to have significantly longer LMCA, larger LAD ostial area, larger LCX ostial area and higher diastolic-to-systolic range (DSR) of LAD-LCX BA compared to patients with Y-shaped LAD-LCX BA. Conclusions: LMCA with T-shaped distal BA was found to have significantly longer LMCA, larger LAD ostial area, larger LCX ostial area and higher DSR of distal BA compared to patients with Y-shaped distal BA. These findings may provide useful information for LMCA bifurcation stenting or designing dedicated stents for LMCA

Evaluation of vertebral artery dominance, hypoplasia and variations in the origin: angiographic study in 254 patients

Background: The aim of this study was to determine the dimensional characteristics and variations in the origin of vertebral arteries (VA). Materials and methods: We retrospectively reviewed angiographic studies in 254 patients (133 males, 121 females) for the evaluation of diameter differences in VA. We examined different criteria from the literature (difference of ≥ 0.3 mm, ≥ 0.8 mm, ≥ 1 mm between the widths of two VA and diameter ratio more than 1.4) to find out the dominant VA, rate of co-dominance and hypoplasia. The differences among groups were analysed using the c2 and Kruskal-Wallis test. Also concordance analysis test was used to determine correspondence between the tests. We also noticed the variations in the origin of VA. Results: The average diameter of VA in 254 patients was 3.21 ± 0.7 mm on the right, and 3.16 ± 0.7 mm on the left. The average diameter difference was found 0.88 ± 0.7 mm. The rate of hypoplasia was found 7.1% on the right and 9.4% on the left. Among 254 patients according to the criterion of any diameter difference; right side was found wider in 126 (49.6%) patients and left side was found wider in 120 (47.2%) patients. The criterion of 0.3 mm or greater difference showed right VA dominance in 107 (42.1%) patients, left VA dominance in 99 (39%) patients. Co-dominance was mainly observed when we used the criteria of 0.8 mm and 1 mm or greater difference and diameter ratio more than 1.4. We found out harmony of two criterion of difference of ≥ 0.8 mm and ≥ 1 mm (concordance analysis test, 76.1%). There was no statistically significant relation between age, gender and any dominance criteria (p > 0.05). The majority of VA showed classical origin arising from both subclavian arteries with a rate of 94.9%. Conclusions: The most striking result we have found is the dominance of the right VA in diameter by using all different criteria unlike with previous reports in the literature.

Prediction of nasal morphology in facial reconstruction: Validation and recalibration of the Rynn method

Background Prediction of the nose from the skull remains an important issue in forensic facial approximation. In 2010, Rynn et al. published a method of predicting nose projection from the skull. With this method, three craniometric measurements (x, y, z) are taken, and these are then used in regression formulae to estimate the nasal dimensions. Aim The purpose of this study was to examine and test the accuracy of the Rynn et al. method and if necessary to adapt the formulae for this population. Subjects and methods A sample of 90 CT scans of Turkish adults was used in the study. The actual and predicted dimensions were compared using t-test. The age of the individuals ranged from 20 to 40 years by sex. Results The descriptive statistics and correlations were calculated, and the actual and predicted measurements were compared. The differences between the actual and predicted values were statistically significant (p < 0.01), with −1 mm for males and −1.5 mm for females. Validation accuracies ranged from 76 to 92% in females and 72 to 82% in males. Recalibration equation accuracies ranged from 88 to 100% in females and 90 to 100% in males. Conclusion The results showed that the recalibration of the Rynn et al. method and its formulae gave satisfactory results with less error and can be employed in facial approximation cases

Molecular marks for epigenetic identification of developmental and cancer stem cells

Epigenetic regulations of genes by reversible methylation of DNA (at the carbon-5 of cytosine) and numerous reversible modifications of histones play important roles in normal physiology and development, and epigenetic deregulations are associated with developmental disorders and various disease states, including cancer. Stem cells have the capacity to self-renew indefinitely. Similar to stem cells, some malignant cells have the capacity to divide indefinitely and are referred to as cancer stem cells. In recent times, direct correlation between epigenetic modifications and reprogramming of stem cell and cancer stem cell is emerging. Major discoveries were made with investigations on reprogramming gene products, also known as master regulators of totipotency and inducer of pluoripotency, namely, OCT4, NANOG, cMYC, SOX2, Klf4, and LIN28. The challenge to induce pluripotency is the insertion of four reprogramming genes (Oct4, Sox2, Klf4, and c-Myc) into the genome. There are always risks of silencing of these genes by epigenetic modifications in the host cells, particularly, when introduced through retroviral techniques. In this contribution, we will discuss some of the major discoveries on epigenetic modifications within the chromatin of various genes associated with cancer progression and cancer stem cells in comparison to normal development of stem cell. These modifications may be considered as molecular signatures for predicting disorders of development and for identifying disease states

Anatomic assessment of the left main bifurcation and dynamic bifurcation angles using computed tomography angiography

Background: An understanding of the left main coronary artery (LMCA) anatomy is important for accurate diagnosis and therapy. We aimed to investigate LMCA anatomy via 128-multisliced coronary computed-tomography-angiography (CCTA) in patients with normal LMCA

CYSTS OF THE PROSTATE, SEMINAL-VESICLES AND DIVERTICULUM OF THE EJACULATORY DUCTS

The close proximity of the prostate, vas deferens, seminal vesicles and ejaculatory ducts are a diagnostic challenge to the cysts located in that region. Three patients with diverticulum of the ejaculatory ducts, 2 with prostate cysts and 1 patient with seminal vesicle cyst are presented. Transrectal ultrasound, computed tomography and magnetic resonance imaging together with aspiration of the cyst establish diagnosis and probably prevent unnecessary exploration

Anatomic assessment of the left main bifurcation and dynamic bifurcation angles using computed tomography angiography

Background: An understanding of the left main coronary artery (LMCA) anatomy is important for accurate diagnosis and therapy. We aimed to investigate LMCA anatomy via 128-multisliced coronary computed-tomography-angiography (CCTA) in patients with normal LMCA

The Effect of Solid Boriding Time on the Structure, Hardness and Corrosion Properties of AISI 5140 Steel

WOS: 000556021800018In this study, AISI 5140 steel samples were borided in an electrical furnace at a temperature of 950 degrees C for 4, 6 and 8 h. Structural examinations, hardness measurement and corrosion tests were performed to determine the effect of the boriding time on the microstructure, hardness and corrosion resistance of the steel surface. It was observed that 4 h of boriding treatment resulted in the forming of Fe2B layer on the surface of the AISI 5140 steel. However, when the boriding time exceeded 4 h, FeB phase formed on the surface layer of the steel in addition to the Fe2B phase. It was also observed that both the thickness and hardness of the boride layer increased with the increasing boriding time. the hardness values of the borided sample surface were approximately seven times greater than unborided AISI 5140 steel. the samples subjected to boriding for 4 h showed higher corrosion resistance than the unboriding steel samples. But boriding time of more than 4 h caused a decrease in the corrosion resistance of the AISI 5140 steel.Scientific Research Project Unit of Krkkale University [2017/079]This study was supported by project code number 2017/079 by the Scientific Research Project Unit of Krkkale University. We would like to thank the Scientific Research Project unit for supporting this project

Small colorectal liver metastases: Detection with SPIO-enhanced MRI in comparison with gadobenate dimeglumine-enhanced MRI and CT imaging

The aim of this prospective study was to compare the diagnostic role of superparamagnetic iron oxide (SPIO)-enhanced liver magnetic resonance imaging (MRI) versus gadobenate dimeglumine (GbD)-enhanced MRI and computed tomography (CT) investigations for detection of small (less than 1 cm) colorectal liver metastases (LMs) of colorectal cancer. Seventy-eight LMs in 16 patients were evaluated with dynamic CT imaging, GbD-enhanced dynamic MR imaging and SPIO-enhanced MR imaging. Two radiologists were reviewed the LMs seperately. Agreement between the readers and three algorithms was analyzed. Differences between the lesion detection ratios of the methods were analyzed by two proportion z test. Sensitivity values of each modality were also calculated. Interobserver agreement values with kappa analysis were found to be the best for three modalities and kappa values were 0.866, 0.843, and 1.0 respectively. For all 78 LMs, SPIO-enhanced MRI detected all lesions (100% sensitivity). This sensitivity value was higher than GbD-enhanced MRI, and there was a significant difference (p < 0.05). GbD-enhanced MRI depicted 71 lesions and this modality could not detected 7 lesions (91% sensitivity). This modality had moderate sensitivity, and this value is greater than CT imaging, so there was a significant difference also (p < 0.05). Dynamic triphasic CT imaging detected 64 (R1) and 65 (R2) LMs. This modality had the lowest sensitivity (R1: 0.82, R2: 0.83 respectively). Only SPIO-enhanced MRI was able to detect all LMs less than 1 cm. LMs were the best detected with SPIO-enhanced MRI. We recommend SPIO-enhanced MRI to be the primary alternative modality especially for diagnosis of small colorectal LMs. © 2009 Elsevier Ireland Ltd. All rights reserved