Segmentation of Pectoral Muscle in Mammograms Using Granular Computing

In this paper, pectoral muscle segmentation was performed to study the presence of malignancy in the pectoral muscle region in mammograms. A combined approach involving granular computing and layering was employed to locate the pectoral muscle in mammograms. In most cases, the pectoral muscle is found to be triangular in shape and hence, the ant colony optimization algorithm is employed to accurately estimate the pectoral muscle boundary. The proposed method works with the left mediolateral oblique (MLO) view of mammograms to avoid artifacts. For the right MLO view, the method automatically mirrors the image to the left MLO view. The performance of this method was evaluated using the standard mini MIAS dataset (mammographic image analysis society). The algorithm was tested on 322 images and the overall accuracy of the system was about 97.47 %. The method is robust with respect to the view, shape, size and reduces the processing time. The approach correctly identifies images when the pectoral muscle is completely absent.

Smiling By Way of Zygomatic Electrical Stimulation: Investigating the Facial Feedback Hypothesis

While it is widely accepted that affective states precede facial expressions, the facial feedback hypothesis (FFH) proposes the inverse. The FFH postulates that facial muscle region activity (e.g., smiling or frowning) directly influences the experience of emotion. The purpose of the present study was to evaluate the validity of the FFH - specifically whether smiling independently enhances positive mood.

Is Infrared Thermography Reliable to Assess Pain in the Trapezius Muscle Region?

Objective: The aim of this study was to evaluate the inter- and intra-examiner reliability of infrared thermography (IT) in skin temperature analysis of people with pain complaints in the upper trapezius muscle. Methods: A total of 82 subjects (24.8 ± 6.9 years; 63.8 ± 13.1 kg) of both genders who had moderate (VAS-3) or severe pain in the upper trapezius muscle were evaluated. Skin temperatures of four areas (ROIs) were analyzed by IT using a FLIR camera (model T640SC - Sweden). Each evaluator performed two area analyses at different times. Results: The evaluation of the four areas indicated a very strong overall intraclass correlation coefficient (ICC) for both intra-examiner (Examiner 1: ICC = 0.936; 95% CI = 0.905–0.959; P < 0.001; Examiner 2: ICC = 0.979; 95% CI = 0.968–0.987; P < 0.001) and inter-examiner (Measurement 1: ICC = 0.933; 95% CI = 0.902–0.958; P < 0.001; Measurement 2: ICC = 0.979; 95% CI = 0.968–0.987; P < 0.001). The ICC was regular on ROI 3 in the measurement 1 inter-exam test, and the ROI 1, ROI 2, and ROI 4 values were strong; all points were very strong in measurement 2. The ICC was rated from strong to very strong for both examiners in the intra-examiner test at all points. Conclusion: IT was reproducible in measuring the upper trapezius muscle skin temperature, and the intra and inter-examiner agreement levels can be used as a reliable tool in clinical practice.

GdDO3NI allows imaging of hypoxia after brain injury

Purpose: In this study, we use the hypoxia targeting agent (GdDO3NI, a nitroimidazole-based T1 MRI contrast agent) for imaging hypoxia in the injured brain after experimental traumatic brain injury (TBI) using magnetic resonance imaging (MRI), and validate the results with immunohistochemistry (IHC) using pimonidazole. Methods: TBI induced mice (controlled cortical impact model) were imaged at 7T using a T2 weighted fast spin-echo sequence to estimate the extent of the injury. The mice were then were intravenously injected with either conventional T1 agent (gadoteridol) or GdDO3NI at 0.3 mmol/kg dose (n=5 for each cohort) along with pimonidazole (60 mg/kg). Mice were imaged pre- and post-contrast using a T1-weighted spin-echo sequence for three hours. Regions of interests were drawn on the brain injury region, the contralateral brain as well as on the cheek muscle region for comparison of contrast kinetics. Brains were harvested immediately post imaging for immunohistochemical analysis. Results: GdDO3NI is retained in the injury region for up to 3 hours post-injection (p< 0.05 compared to gadoteridol) while it rapidly clears out of the muscle region. On the other hand, conventional MRI contrast agent gadoteridol clears out of both the injury region and muscle rapidly, although with a relatively more delayed wash out in the injury region. Minimal contrast enhancement was seen for both agents in the contralateral hemisphere. Pimonidazole staining confirms the presence of hypoxia in both gadoteridol and GdDO3NI cohorts, and the later cohort shows good agreement with MRI contrast enhancement. Conclusion: GdDO3NI was successfully shown to visualize hypoxia in the brain post-TBI using T1-wt MRI.

EXAMINATION OF THE CONFOUNDING EFFECT OF SUBCUTANEOUS FAT ON MUSCLE ECHO INTENSITY UTILIZING EXOGENOUS FAT

We aimed to provide an unbiased estimate of the confounding effect of subcutaneous fat thickness on ultrasound echo intensity (EI) measures of muscle quality. The effect of fat thickness on EI was verified for an approximate range of 0 to 3 cm of fat using exogeneous layers of pork fat over the human tibialis anterior muscle. Sonograms were obtained i) with focus constant across fat thickness conditions and ii) with focus position adjusted to the muscle region of interest (ROI) position for each fat thickness level. In agreement with our hypothesis, increasing fat between the probe and the ROI resulted in a decrease in EI. This overestimating effect of fat on muscle quality differs between sonograms with constant focus and sonograms with focus position adjusted to the vertical displacement in ROI position that occurs for different levels of fat thickness. Correcting equations to account for the overestimating effect of fat on muscle quality are provided for both focus conditions. This is the first study to systematically analyze the confounding effect of fat thickness as an independent factor and the provided equations can be used for improved accuracy in estimates of muscle quality in obese/overweight subjects/patients. NOVELTY • The independent confounding effect of subcutaneous fat thickness on US estimates of muscle quality was quantified • US estimates of muscle quality depend on whether focus is adjusted to the muscle region of interest or not • Equations for correcting muscle quality estimates are provided

Periodicity, time constants of drainage, and the mechanical determinants of peak cardiac output during exercise

To analyze mechanical adaptations that must occur in the cardiovascular system to reach the high cardiac outputs known to occur at peak aerobic performance, we adapted a computational model of the circulation by adding a second parallel venous compartment as proposed by August Krogh in 1912. One venous compartment has a large compliance and slow time constant of emptying; it is representative of the splanchnic circulation. The other has a low compliance and fast time constant of emptying and is representative of muscle beds. Fractional distribution between the two compartments is an important determinant of cardiac output. Parameters in the model were based on values from animal and human studies normalized to a 70 kg male. The baseline cardiac output was set at 5 L/min, and we aimed for 25 L/min at peak exercise with a fractional flow to the peripheral-muscle region of 90%. Finally, we added the equivalent of a muscle pump. Adjustments in circuit and cardiac parameters alone increased cardiac output to only 15.6 L/min because volume accumulated in the muscle compartment and limited a higher cardiac output. Addition of muscle contractions decompressed the muscle region and allowed cardiac output to increase to 23.4 L/min. The pulsatility of blood flow imposes important constraints on the adaptations of cardiac and circulatory functions because it fixes the times for filling and emptying. Flow is further limited by the limits of cardiac filling on each beat. Muscle contractions play a key role by decompressing volume that would otherwise accumulate in the muscle vasculature and by decreasing the time for stroke return to the right ventricle. NEW & NOTEWORTHY We used a computational model of the circulation and previous human and animal data to model mechanical changes in the heart and circulation that are needed to reach the known high cardiac output at peak aerobic exercise. Key points are that time constants of drainage of circulatory compartments put limits on peak flow in a pulsatile system. Muscle contractions increase the rate of return to the heart and by doing so prevent accumulation of volume in the muscle compartment and greatly increase circulatory capacity.

Clear cell/endometrioid type ovarian carcinoma associated with endometriosis of the ipsilateral ovary

Introduction. Ovarian endometriosis has been identified as a risk factor for occurrence of endometriosis-associated ovarian carcinoma. We presented a rare case of simultaneous clear cell/ endometrioid ovarian carcinoma and endometriosis of the ipsilateral ovary. Case report. A 47-yearold patient underwent surgery for right ovarian endometriotic cyst. A total hysterectomy with bilateral salpingooophorectomy, lymphadenectomy in the right psoas muscle region and omentectomy were performed as well as multiple peritoneal biopsies. Six cycles of chemotherapy were instituted postoperatively using the Taxol-CBDCA protocol. Abdominal and pelvic CT did not demonstrate recurrence of the disease postoperatively and after completed chemotherapy treatment. Six months after the completion of treatment, the patient felt well without the disease recurrence. Conclusion. Clear cell and endometrioid subtypes of ovarian carcinoma have good prognosis if they are diagnosed and treated at an early stage of the disease. In our patient, the carcinoma was detected in the first stage and successfully treated with combination therapy, i.e., surgical and chemotherapy.

Anterior Segment Optical Coherence Tomography Analysis of Iris Morphometric Changes Induced by Prostaglandin Analogues Treatment in Patients with Primary Open Angle Glaucoma or Ocular Hypertension

Background: The study aimed to evaluate iris thickness changes in patients with Primary Open Angle Glaucoma (POAG) or Ocular Hypertension (OHT) under treatment with Prostaglandin Analogues (PG). Objectives: Primary outcome measures were iris thickness at the region of Dilator Muscle Region (DMR) and Sphincter Muscle Region (SMR). DMR/SMR ratio was also evaluated. The secondary outcome was the correlation between PG treatment length and iris parameters. Methods: The charts of patients with POAG or OHT who underwent Visante OCT were retrospectively selected. The patients were divided in a group using PG for at least 6 months and a group using hypotensive drops not including PG or alpha-adrenergic agonists. A third group included healthy subjects. Result: 98 subjects were selected. Patients with POAG or OHT using PG eyedrops showed a significant iris thickness reduction at DMR compared to healthy subjects and to patients using hypotensive eyedrops not containing PG. Significantly higher SMR thickness values were found in PG group compared to both control groups. DMR/SMR ratio significantly reduced in PG group. No correlation was found between PG treatment length and iris parameters. Conclusion: The present data indicate that PG treatment induced DMR thickness reduction and an increase in SMR thickness. These changes were not related to the duration of PG exposure.

Paramedian Submandibular Approach for Removal of Foreign Bodies in the Pterygoid Muscle in Two Dogs

ABSTRACT The purpose of this report is to document a unique location of an oropharyngeal foreign body, diagnosed via contrast computed tomography (CT), as well as a novel surgical approach to the pterygoid muscle region. Oropharyngeal foreign objects are an uncommon but potentially serious disease that can lead to chronic abscessation and pain. Two dogs were presented with chronic complaints, including pain and inability to fully open the mouth for a 1 yr and 5 mo duration, respectively. There was no history or evidence of skin sinus or submandibular/cervical swelling on physical examination of either dog. Both dogs had normal oropharyngeal anatomy with the exception of an asymmetric contrast-enhancing lesion within the pterygoid muscle on CT imaging. As there were no gross abnormalities visible during surgery, the use of contrast CT was vital in order to isolate the focus of infection. A paramedian submandibular approach was used to explore this region, and in both cases, foreign material was successfully removed with subsequent resolution of clinical signs. The dogs were immediately free of clinical signs and showed no recurrence for at least 8 and 17 mo after the exploration, respectively. A novel surgical approach is described to remove oropharyngeal foreign objects and necrotic debris within the pterygoid muscle.