Morphometry of Cerebral Arterial Bifurcations Harbouring Aneurysms: A Case-Control Study On 253 Patients

Abstract Objectives This study aimed to evaluate serum otolin-1 levels in patients with benign paroxysmal positional vertigo and to compare these levels with healthy individuals. Method This was a case-control study. After obtaining institutional ethical committee clearance, the serum level of otolin-1 was calculated in adult individuals (18–75 years old) who were divided into group 1 (patients presenting with benign paroxysmal positional vertigo) and group 2 (healthy patients without benign paroxysmal positional vertigo as the control group). Data analysis was carried out to compare the serum levels in the cases and controls. A p-value less than 0.05 was considered significant. Results A total of 70 age-matched individuals (cases, n = 40; controls, n = 30) were included in the study. The mean serum level of otolin-1 was 636.8 pg/ml (range, 259–981 pg/ml) in the group of patients with benign paroxysmal positional vertigo and 236.2 pg/ml (range, 189–370 pg/ml) in the control group. The difference was statistically significant (p = 0.0000). Conclusion The serum levels of otolin-1 in patients with benign paroxysmal positional vertigo are significantly higher compared with individuals without benign paroxysmal positional vertigo.

Abstract Objectives To observe and compare the difference in retinal thickness using optical coherence tomography (OCT) between patients with high myopia (HM) during the third trimester of pregnancy and age-matched HM non-pregnant women. Methods A case-control study. A total of 39 eyes from 39 HM women in the third trimester (study group) and 50 eyes of 50 age-matched non-pregnant women with HM (control group) were included. All subjects underwent SD-OCT examination. The built-in software was used to measure the retinal thickness in macular region. The data from two groups were compared using independent-samples t test. Results Among the 89 subjects in this study, the mean gestational age of the study group was 35.09 ± 2.44 weeks, and the average age was 32.24 ± 3.75 years. The average age of the control group was 34.04 ± 7.19 years old. Compared with the control group, the average thickness of parafoveal area, and the average thickness of parafoveal superior, inferior, temporal quadrants of the superficial retina and the average thickness of the foveal and parafoveal of the superficial retina were significantly decreased in the study group (P < 0.05). Compared with the control group, the average thickness of all quadrants of the retina in the parafoveal area except the nasal quadrant were significantly decreased in the study group (P < 0.05). Conclusions In this observational study, the retinal thickness of patients with high myopia during the third trimester of pregnancy was thinner than that of non-pregnant women with age-matched high myopia.

AbstractThis study was aimed to investigate the role of anatomic variations in patellofemoral alignment in patients with or without Osgood-Schlatter disease (OSD) and to determine the potential anatomic risk factors that may play role in the etiology. This prospective observational case-control study was conducted on two groups of adolescent patients. Group 1 comprised patients who were diagnosed as having OSD and group 2 consisted of an equal number of age-matched patients who presented to the outpatient clinic with traumatic knee injury and underwent knee radiographic examination but without a diagnosis of OSD. Age, height, weight, body mass index (BMI), dominant side, and level of sporting activity were recorded. Quadriceps (Q) angles were measured using a long-arm goniometer with patients lying in the supine position with their knees in full extension and contracting the Q muscles. On anteroposterior, lateral knee, and tangential patella (Merchant and Laurin views) radiographs, the following measurements were performed: Insall–Salvati (IS), Caton–Deschamps (CD), and Blackburne–Peel (BP) indexes, congruence angles, lateral patellofemoral angles, sulcus angles, and patella type according to Grelsamer's morphology classification. Both groups were similar in respect of age (p = 0.160), sex (p = 0.311), height (p = 0.326), weight (p = 0.596), BMI (p = 0.153), and dominancy (p = 0.500). The rate of patients engaged in sports activities was significantly greater in the OSD group (p = 0.003). No significant difference was determined between the groups in respect to IS index, CD index, BP index, sulcus angle, lateral patellofemoral angle, and congruence angle (p–values: 0.358, 0.995, 0.912, 0.802, 1.000, and 0.907, respectively). The mean Q angle was measured as 15.6 ± 2.2 degrees in the OSD group and 14.3 ± 2.5 degrees in the control group (p = 0.014). Despite the difference being statistically significant, it was clinically insignificant because the difference was only 1.3 degrees. The principle etiologic factor seems to be increased physical activity rather than subtle variations is patellofemoral anatomy and alignment of extensor mechanism.

Object. The angles of arterial bifurcations are governed by principles of work minimization (optimality principle). This determines the relationship between the angle of a bifurcation and the radii of the vessels. Nevertheless, the model is predicated on an absence of significant communication between these branches. The circle of Willis changes this relationship because the vessels proximal to the ring of vessels have additional factors that determine work minimization compared with more distal branches. This must have an impact on understanding of the relationship between shear stress and aneurysm formation. The authors hypothesized that normal bifurcations of cerebral arteries beyond the circle of Willis would follow optimality principles of minimum work and that the presence of aneurysms would be associated with deviations from optimum bifurcation geometry. Nevertheless, the vessels participating in (or immediately proximal to) the circle of Willis may not follow the geometric model as it is generally applied and this must also be investigated. Methods. One hundred seven bifurcations of the middle cerebral artery (MCA), distal internal carotid artery (ICA), and basilar artery (BA) were studied in 55 patients. The authors analyzed three-dimensional reconstructions of digital subtraction angiography images with respect to vessel radii and bifurcation angles. The junction exponent (that is, a calculated measure of the division of flow at the bifurcation) and the difference between the predicted optimal and observed branch angles were used as measures of deviation from the geometry thought best to minimize work. The mean junction exponent for MCA bifurcations was 2.9 ± 1.2 (mean ± standard deviation [SD]), which is close to the theoretical optimum of 3, but it was significantly smaller (p < 0.001; 1.7 ± 0.8, mean ± SD) for distal ICA bifurcations. In a multilevel multivariate logistic regression analysis, only the observed branch angles were significant independent predictors for the presence of an aneurysm. The odds ratio (OR) (95% confidence interval) for the presence of an aneurysm was 3.46 (1.02–11.74) between the lowest and highest tertile of the observed angle between the parent vessel and the largest branch. The corresponding OR for the smallest branch was 48.06 (9.7–238.2). Conclusions. The bifurcation beyond the circle of Willis (that is, the MCA) closely approximated optimality principles, whereas the bifurcations within the circle of Willis (that is, the distal ICA and BA) did not. This indicates that the confluence of hemodynamic forces plays an important role in the distribution of work at bifurcations within the circle of Willis. In addition, the observed branch angles were predictors for the presence of aneurysms.

Background: Several epidemiological studies have identified the association of abnormal ABPI with ischemic stroke. So the goal of this study was to determine the actual relationship of ABPI with ischemic stroke in the context of our country. Materials and Methods: This case control study was carried out in the Department of Neurology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh. ABPI was measured by Doppler ultrasound machine of 100 patients who were admitted to the Mitford Hospital during the study period. Among them 50 patients with Ischemic stroke, confirmed by CT/MRI scan of brain were considered as ‘case’ and 50 age- sex matched individuals with one or more vascular risk factors (VRF) but without stroke were considered as ‘control’. Then the results of ABPI were compared between the two groups. Results: Among the 50 patients with ischemic stroke (case group) , 74% had normal ABPI and 26% had ABPI< 0.9; on the other hand among 50 age and sex matched individuals (control group) 90% had normal ABPI and 10% had ABPI <0.9. The difference was statistically significant between two groups (p=<0.05).This association remained significant even after adjustment for potential confounders (age, gender, high BMI, hypertension, diabetes mellitus, hyperlipidemia, smoking, ischemic heart disease and family history) in a multiple logistic regression model. Conclusion: The incidence of low ABPI is significantly higher in ischemic stroke patients than the age- sex matched control. Bangladesh Journal of Neuroscience 2013; Vol. 29 (1) : 31-42

Little is known about the hemodynamic disturbances induced by the cerebral aneurysms in the parent artery and the effect of flow diverter stents (FDS) on these latter. A better understanding of the aneurysm-parent vessel complex relationship may aid our understanding of this disease and to optimize its treatment. The ability of volumetric flow rate (VFR) waveform to reflect the arterial compliance modifications is well known. By analyzing the VFR waveform and the pulsatility in the parent vessel, this study aimed to test the hypotheses that (1) intracranial aneurysms might disrupt the blood flow of the parent vessel and (2) the treatment by FDS might have measurable corrective effect on these changes. Ten patients followed for unruptured intracranial aneurysms treated by FDS and ten healthy volunteers as control group were included in this study. Two-dimensional quantitative phase-contrast magnetic resonance imaging (MRI) was performed on each patient on the ICA artery upstream and downstream to the aneurysm, and on each volunteer at similar locations. The aneurysms altered significantly the parent vessel pulsatility and this effect was correlated to their volume. The aneurysms treatment by FDS allowed for the restoration of a normally modulated flow and pulsatility correction in the parent vessel.

Abstract Background RANK is a candidate gene for osteoporosis on both functional and genetic grounds. The study is to investigate the relationships between the methylation of RANK and osteoporosis in aged general population. Methods On the basis of an epidemiological investigation, we detect for methylation CpGs in promoter of RANK in 32 aged subjects (16 males and 16 females) firstly. Secondly, after considering the relationships among osteoporosis and the methylation rate of identified CpGs in male and female subjects, the selected representatives CpGs were detected in 90 male aged general subjects (43 controls and 47 cases) by bisulfite sequencing. Then a case-control study is conducted. Results Age and the prevalence of diabetes were significantly difference between the case patients and control individuals (P = 0. 025, P = 0. 005)., There was no statistical significance between the case group and the control group for the following values: systolic blood pressure, diastolic blood pressure, body mass index, 25-dihydroxyvitaminD3, folic acid, testosterone, creatinine, serum calcium concentration, and the prevalence of smoking, drinking and hypertension (P > 0.05). The methylation rate of RANK in control group was significant higher than that in osteoporosis group (P < 0.001). In addition, by covariance analysis to adjust age, prevalence of smoking, drinking, hypertension, and diabetes, the methylation rate of RANK in control group was significant higher than that in osteoporosis group in male aged general population of Xinjiang (P = 0.001). After adjusting for confounding factors (age, smoking, drinking, and diabetes), multivariate logistic regression analysis also showed that lower methylation of RNAK gene were significantly associated with osteoporosis (OR = 0.930, 95% CI = 0.886–0.976) Conclusions The lower methylation rate of RANK was associated with osteoporosis in male aged general population of Xinjiang. This confirms that lower methylation of RANK might be involved in the pathogenesis of osteoporosis

Background. The incidence of thyroid nodules increases in the general population. Similarly, we have also seen a dramatic increase in the number of thyroid surgeries. However, the mortality rate of thyroid cancer remained stable or even decreased. The purpose of our study was to investigate whether thyroid cancer affects the malignant risk of the contralateral TI-RADS 3 and 4 nodules. Methods. We conducted a retrospective cohort study in our institution for all thyroid procedures due to nodules from December 2018 to December 2019. All eligible patients were divided into the experimental group (bilateral nodules) and the control group (unilateral nodules) to assess whether the proportion of malignant nodules was different between the two groups. Multivariate logistic regression analysis was used to control potential confounding factors to investigate whether their differences were statistically significant. Results. A total of 330 patients underwent thyroid surgery, of whom 137 were eligible, including 84 in the experimental group and 53 in the control group. The proportion of malignant nodules was significantly different between the experimental group and the control group (29.8% versus 58.5%, unadjusted OR 0.30, 95% CI: 0.17–0.82, p = 0.001 ). However, after controlling for potential confounding factors, including age ( p = 0.004 ), gender ( p = 0.775 ), and TI-RADS classification ( p ≤ 0.001 ), we found that the difference was not significant (adjusted OR 1.08, 95% CI: 0.39–3.01, p = 0.886 ). Conclusion. There is no evidence that thyroid cancer affects the malignant risk of the contralateral TI-RADS 3 and 4 nodules. This study has been registered with the Chinese Clinical Trial Registry (clinical trial registration number: ChiCTR2000038611, registration time: September 26, 2020).

Purpose. To evaluate the intima-media thickness (IMT) of the left and right common carotid arteries (CCA) as an indicator of subclinical atherosclerosis in patients with central serous chorioretinopathy (CSCR). Methods. This was a case-control study involving patients with CSCR and a matched healthy control group. The mean and difference of the left and right CCA IMT were determined and compared between the two groups using carotid duplex high-resolution B-mode ultrasound equipment. Results. The study enrolled 32 CSCR patients (68.8% female, mean age 38.22 ± 5.42 years) and 32 controls (65.6% female, mean age 39.56 ± 5.33 years). The difference in common carotid IMT between the right and left sides was significantly greater in the CSCR group than in the control group ( p < 0.001 ). Additionally, according to logistic regression analysis, patients with CSCR had a greater chance of having differences in IMT between the two sides when compared to the control group (OR: 1.29, 95% CI: 1.09–1.52). Conclusion. Our findings indicated that in the CSCR group, the difference between the right and left sides of CCA IMT was significantly greater than in the control group.

Background: Androgens play a role in the development of male phenotype and spermatogenesis during puberty, the function of which is regulated by the androgen receptor (AR) gene. There is a polymorphism site in exon 1 of the gene encoding this receptor that can have different frequencies of CAG trinucleotide repeats and leads to the formation of polyglutamine chains of different lengths in the N-terminal domain of the AR protein and reduced sperm production by affecting spermatogenesis. Objective: To investigate whether the cause of a group of unexplained infertilities could be the increased frequency of CAG repeats in the AR gene of patients with oligozoospermia and azoospermia. Materials and Methods: In this case-control study, 84 men including 42 with unexplained infertility As a case group and 42 fertile men as a control group were selected. The frequency of CAG repeats was determined by the polymerase chain reaction method and then the difference in the frequency of these repeats was determined based on the difference in band size on the agarose gel. Results: The mean CAG repeat length in the azoospermia and oligozoospermia group was 17.5 ± 0.63 and in the fertile group it was 16.11 ± 0.75 (p = 0.46). In addition, most men (88.1% in the case group and 71.41% in the control group) had 13-23 repeats. Conclusion: No significant correlation was found between CAG repeat length and the risk of male factor infertility in an ethnically defined population of Iranian men. The role of regulatory factors and epigenetic changes should be taken into account too. Key words: Infertility, Azoospermia, Androgens, X chromosome, Spermatogenesis.