Background/Aims: In this meta-analysis, we studied the safety and efficacy of endoscopic submucosal dissection (ESD) for colorectal dysplasia in patients with inflammatory bowel disease (IBD). Methods: Multiple databases were searched, and studies were retrieved based on pre-specified criteria until October 2022. The outcomes assessed were resection rates, procedural complications, local recurrence, metachronous tumors, and the need for surgery after ESD in IBD. Standard meta-analysis methods were followed using the random-effects model, and I2% was used to assess heterogeneity. Results: Twelve studies comprising 291 dysplastic lesions in 274 patients were included with a median follow-up of 25 months. The pooled en-bloc resection, R0 resection, and curative resection rates were 92.5% (95% confidence interval [CI], 87.9%–95.4%; I2=0%), 81.5% (95% CI, 72.5%–88%; I2=43%), and 48.9% (95% CI, 32.1%–65.9%; I2=87%), respectively. The local recurrence rate was 3.9% (95% CI, 2%–7.5%; I2=0%). The pooled rates of bleeding and perforation were 7.7% (95% CI, 4.5%–13%; I2=10%) and 5.3% (95% CI, 3.1%–8.9%; I2=0%), respectively. The rates of metachronous recurrence and additional surgery following ESD were 10% (95% CI, 5.2%–18.2%; I2=55%) and 13% (95% CI, 8.5%–19.3%; I2=54%), respectively. Conclusions ESD is safe and effective for the resection of dysplastic lesions in IBD with an excellent pooled rate of en-bloc and R0 resection.

Background: and Purpose Pathogenic variants in the myopalladin gene (MYPN) are known to cause mildly progressive nemaline/cap myopathy. Only nine cases have been reported in the English literature. Methods: A detailed evaluation was conducted of the clinical, muscle magnetic resonance imaging (MRI), and genetic findings of two unrelated adults with MYPN-related cap myopathy. Genetic analysis was performed using whole-exome sequencing. MRI was performed on a 1.5-T device in patient 1. Results: Two unrelated adults born to consanguineous parents, a 28-year-old male and a 23-year-old female, were diagnosed with pathogenic variants in MYPN that cause cap myopathy. Both patients presented with early-onset, insidiously progressive, and minimally disabling proximodistal weakness with mild ptosis, facial weakness, and bulbar symptoms. Patient 1 had a prominent foot drop from the onset. Both patients were followed up at age 30 years, at which point serum creatine kinase concentrations were minimally elevated. There were no cardiac symptoms; electrocardiograms and two-dimensional echocardiograms were normal in both patients. Muscle MRI revealed preferential involvement of the glutei, posterior thigh muscles, and anterior leg muscles. Whole-exome sequencing revealed significant homozygous splicesite variants in both of the probands, affecting intron 10 of MYPN: c.1973+1G>C (patient 1) and c.1974-2A>C (patient 2). Conclusions This study elaborates on two patients with homozygous MYPN pathogenic variants, presenting as slowly progressive congenital myopathy. These patients are only the tenth and eleventh cases reported in the English literature, and the first from South Asia. The clinical phenotype reiterates the mild form of nemaline rod/cap myopathy. A comprehensive literature review is presented.

Balloons are valuable tools in the armamentarium of a neurointerventionist. In this report, we describe 2 cases in which a balloon aided in the navigation of a second remodeling balloon through difficult vascular anatomy. The first case was a patient with a ruptured proximal posterior inferior cerebellar artery aneurysm and the second case was a patient with a ruptured anterior communicating artery aneurysm. In both cases, the coiling microcatheter and the remodeling balloon catheters were advanced through different vessels. The remodeling balloon reached the target location using a transcirculation approach, and the navigation of the remodeling balloon was aided by utilizing a second balloon. Challenging vascular anatomy is often encountered when performing neuroendovascular procedures. The strategy of using balloon assistance for the transcirculation access of a remodeling balloon can be used successfully in difficult situations to manage complex aneurysms.

Background: and Purpose Pathogenic variants in the myopalladin gene (MYPN) are known to cause mildly progressive nemaline/cap myopathy. Only nine cases have been reported in the English literature. Methods: A detailed evaluation was conducted of the clinical, muscle magnetic resonance imaging (MRI), and genetic findings of two unrelated adults with MYPN-related cap myopathy. Genetic analysis was performed using whole-exome sequencing. MRI was performed on a 1.5-T device in patient 1. Results: Two unrelated adults born to consanguineous parents, a 28-year-old male and a 23-year-old female, were diagnosed with pathogenic variants in MYPN that cause cap myopathy. Both patients presented with early-onset, insidiously progressive, and minimally disabling proximodistal weakness with mild ptosis, facial weakness, and bulbar symptoms. Patient 1 had a prominent foot drop from the onset. Both patients were followed up at age 30 years, at which point serum creatine kinase concentrations were minimally elevated. There were no cardiac symptoms; electrocardiograms and two-dimensional echocardiograms were normal in both patients. Muscle MRI revealed preferential involvement of the glutei, posterior thigh muscles, and anterior leg muscles. Whole-exome sequencing revealed significant homozygous splicesite variants in both of the probands, affecting intron 10 of MYPN: c.1973+1G>C (patient 1) and c.1974-2A>C (patient 2). Conclusions This study elaborates on two patients with homozygous MYPN pathogenic variants, presenting as slowly progressive congenital myopathy. These patients are only the tenth and eleventh cases reported in the English literature, and the first from South Asia. The clinical phenotype reiterates the mild form of nemaline rod/cap myopathy. A comprehensive literature review is presented.

Balloons are valuable tools in the armamentarium of a neurointerventionist. In this report, we describe 2 cases in which a balloon aided in the navigation of a second remodeling balloon through difficult vascular anatomy. The first case was a patient with a ruptured proximal posterior inferior cerebellar artery aneurysm and the second case was a patient with a ruptured anterior communicating artery aneurysm. In both cases, the coiling microcatheter and the remodeling balloon catheters were advanced through different vessels. The remodeling balloon reached the target location using a transcirculation approach, and the navigation of the remodeling balloon was aided by utilizing a second balloon. Challenging vascular anatomy is often encountered when performing neuroendovascular procedures. The strategy of using balloon assistance for the transcirculation access of a remodeling balloon can be used successfully in difficult situations to manage complex aneurysms.

Segmentation of fundamental heart sounds–S1 and S2 is important for automated monitoring of cardiac activity including diagnosis of the heart diseases. This pa-per proposes a novel hybrid method for S1 and S2 heart sound segmentation using group sparsity denoising and variation mode decomposition (VMD) technique. In the proposed method, the measured phonocardiogram (PCG) signals are denoised using group sparsity algorithm by exploiting the group sparse (GS) property of PCG signals. The denoised GS-PCG signals are then decomposed into subsequent modes with specific spectral characteristics using VMD algorithm. The appropriate mode for further processing is selected based on mode central frequencies and mode energy. It is then followed by the extraction of Hilbert envelope (HEnv) and a thresholding on the selected mode to segment S1 and S2 heart sounds. The performance advantage of the proposed method is verified using PCG signals from benchmark databases namely eGeneralMedical, Littmann, Washington, and Michigan. The proposed hybrid algorithm has achieved a sensitivity of 100%, positive predictivity of 98%, accuracy of 98% and detection error rate of 1.5%. The promising results obtained suggest that proposed approach can be considered for automated heart sound segmentation.
Benchmarking ; Diagnosis ; Heart Diseases ; Heart Sounds ; Heart ; Methods ; Michigan ; Washington

BACKGROUND AND OBJECTIVES: The present study aimed to investigate the effect of active listening and listening effort on the contralateral suppression of transient evoked otoacoustic emissions (CSTEOAEs). SUBJECTS AND METHODS: Twenty eight young adults participated in the study. Transient evoked otoacoustic emissions (TEOAEs) were recorded using ‘linear’ clicks at 60 dB peSPL, in three contralateral noise conditions. In condition 1, TEOAEs were obtained in the presence of white noise in the contralateral ear. While, in condition 2, speech was embedded into white noise at +3, −3, and −9 dB signal-to-noise ratio (SNR) and delivered to the contralateral ear. The SNR was varied to investigate the effect of listening effort on the CSTEOAE. In condition 3, speech was played backwards and embedded into white noise at −3 dB SNR. The conditions 1 and 3 served as passive listening condition and the condition 2 served as active listening condition. In active listening condition, the participants categorized the words in to two groups (e.g., animal and vehicle). RESULTS: CSTEOAE was found to be largest in the presence of white noise, and the amount of CSTEOAE was not significantly different between active and passive listening conditions (condition 2 and 3). Listening effort had an effect on the CSTEOAE, the amount of suppression increased with listening effort, when SNR was decreased from +3 dB to −3 dB. However, when the SNR was further reduced to −9 dB, there was no further increase in the amount of CSTEOAE, instead there was a reduction in the amount of suppression. CONCLUSIONS: The findings of the present study show that listening effort might affect CSTEOAE.
Animals ; Ear ; Humans ; Noise ; Signal-To-Noise Ratio ; Young Adult

BACKGROUND AND OBJECTIVES: The present study was carried out to investigate the effect of vowel context on the recognition of Kannada consonants in quiet for young adults. SUBJECTS AND METHODS: A total of 17 young adults with normal hearing in both ears participated in the study. The stimuli included consonant-vowel syllables, spoken by 12 native speakers of Kannada. Consonant recognition task was carried out as a closed-set (fourteen-alternative forced-choice). RESULTS: The present study showed an effect of vowel context on the perception of consonants. Maximum consonant recognition score was obtained in the /o/ vowel context, followed by the /a/ and /u/ vowel contexts, and then the /e/ context. Poorest consonant recognition score was obtained in the vowel context /i/. CONCLUSIONS: Vowel context has an effect on the recognition of Kannada consonants, and the vowel effect was unique for Kannada consonants.
Ear ; Hearing ; Humans ; Young Adult

BACKGROUND AND OBJECTIVES: The present study was carried out to investigate the effect of vowel context on the recognition of Kannada consonants in quiet for young adults. SUBJECTS AND METHODS: A total of 17 young adults with normal hearing in both ears participated in the study. The stimuli included consonant-vowel syllables, spoken by 12 native speakers of Kannada. Consonant recognition task was carried out as a closed-set (fourteen-alternative forced-choice). RESULTS: The present study showed an effect of vowel context on the perception of consonants. Maximum consonant recognition score was obtained in the /o/ vowel context, followed by the /a/ and /u/ vowel contexts, and then the /e/ context. Poorest consonant recognition score was obtained in the vowel context /i/. CONCLUSIONS: Vowel context has an effect on the recognition of Kannada consonants, and the vowel effect was unique for Kannada consonants.
Ear ; Hearing ; Humans ; Young Adult

In cytologic evaluation of body cavity effusions, the morphologic changes exhibited by reactive mesothelial cells often confound the diagnosis. This study investigates the role of DNA flow cytometry (DNA FCM) and image morphometry (IM) in improving diagnostic accuracy.