Subcutaneous Tissue Thickness is an Independent Predictor of Image Noise in Cardiac CT

Background: Few data on the definition of simple robust parameters to predict image noise in cardiac computed tomography (CT) exist. Objectives: To evaluate the value of a simple measure of subcutaneous tissue as a predictor of image noise in cardiac CT. Methods: 86 patients underwent prospective ECG-gated coronary computed tomographic angiography (CTA) and coronary calcium scoring (CAC) with 120 kV and 150 mA. The image quality was objectively measured by the image noise in the aorta in the cardiac CTA, and low noise was defined as noise < 30HU. The chest anteroposterior diameter and lateral width, the image noise in the aorta and the skin-sternum (SS) thickness were measured as predictors of cardiac CTA noise. The association of the predictors and image noise was performed by using Pearson correlation. Results: The mean radiation dose was 3.5 ± 1.5 mSv. The mean image noise in CT was 36.3 ± 8.5 HU, and the mean image noise in non-contrast scan was 17.7 ± 4.4 HU. All predictors were independently associated with cardiac CTA noise. The best predictors were SS thickness, with a correlation of 0.70 (p < 0.001), and noise in the non-contrast images, with a correlation of 0.73 (p < 0.001). When evaluating the ability to predict low image noise, the areas under the ROC curve for the non-contrast noise and for the SS thickness were 0.837 and 0.864, respectively. Conclusion: Both SS thickness and CAC noise are simple accurate predictors of cardiac CTA image noise. Those parameters can be incorporated in standard CT protocols to adequately adjust radiation exposure.

The swelling behaviour of polyelectrolyte networks

Being basic ingredients of numerous daily-life products with significant industrial importance as well as basic building blocks for biomaterials, charged hydrogels continue to pose a series of unanswered challenges for scientists even after decades of practical applications and intensive research efforts. Despite a rather simple internal structure it is mainly the unique combination of short- and long-range forces which render scientific investigations of their characteristic properties to be quite difficult. Hence early on computer simulations were used to link analytical theory and empirical experiments, bridging the gap between the simplifying assumptions of the models and the complexity of real world measurements. Due to the immense numerical effort, even for high performance supercomputers, system sizes and time scales were rather restricted until recently, whereas it only now has become possible to also simulate a network of charged macromolecules. This is the topic of the presented thesis which investigates one of the fundamental and at the same time highly fascinating phenomenon of polymer research: The swelling behaviour of polyelectrolyte networks. For this an extensible simulation package for the research on soft matter systems, ESPResSo for short, was created which puts a particular emphasis on mesoscopic bead-spring-models of complex systems. Highly efficient algorithms and a consistent parallelization reduced the necessary computation time for solving equations of motion even in case of long-ranged electrostatics and large number of particles, allowing to tackle even expensive calculations and applications. Nevertheless, the program has a modular and simple structure, enabling a continuous process of adding new potentials, interactions, degrees of freedom, ensembles, and integrators, while staying easily accessible for newcomers due to a Tcl-script steering level controlling the C-implemented simulation core. Numerous analysis routines provide means to investigate system properties and observables on-the-fly. Even though analytical theories agreed on the modeling of networks in the past years, our numerical MD-simulations show that even in case of simple model systems fundamental theoretical assumptions no longer apply except for a small parameter regime, prohibiting correct predictions of observables. Applying a "microscopic" analysis of the isolated contributions of individual system components, one of the particular strengths of computer simulations, it was then possible to describe the behaviour of charged polymer networks at swelling equilibrium in good solvent and close to the Theta-point by introducing appropriate model modifications. This became possible by enhancing known simple scaling arguments with components deemed crucial in our detailed study, through which a generalized model could be constructed. Herewith an agreement of the final system volume of swollen polyelectrolyte gels with results of computer simulations could be shown successfully over the entire investigated range of parameters, for different network sizes, charge fractions, and interaction strengths. In addition, the "cell under tension" was presented as a self-regulating approach for predicting the amount of swelling based on the used system parameters only. Without the need for measured observables as input, minimizing the free energy alone already allows to determine the the equilibrium behaviour. In poor solvent the shape of the network chains changes considerably, as now their hydrophobicity counteracts the repulsion of like-wise charged monomers and pursues collapsing the polyelectrolytes. Depending on the chosen parameters a fragile balance emerges, giving rise to fascinating geometrical structures such as the so-called pear-necklaces. This behaviour, known from single chain polyelectrolytes under similar environmental conditions and also theoretically predicted, could be detected for the first time for networks as well. An analysis of the total structure factors confirmed first evidences for the existence of such structures found in experimental results.

Functional polymer coatings — My-Patterning and My-Analysis

In dieser Arbeit werden Strukturen beschrieben, die mit Polymeren auf Oberflächen erzeugt wurden. Die Anwendungen reichen von PMMA und PNIPAM Polymerbürsten, über die Restrukturierung von Polystyrol durch Lösemittel bis zu 3D-Strukturen, die aus PAH/ PSS Polyelektrolytmultischichten bestehen. Im ersten Teil werden Polymethylmethacrylat (PMMA) Bürsten in der ionischen Flüssigkeit 1-Butyl-3-Methylimidazolium Hexafluorophospat ([Bmim][PF6]) durch kontrollierte radikalische Polymerisation (ATRP) hergestellt. Kinetische Untersuchungen zeigten ein lineares und dichtes Bürstenwachstum mit einer Wachstumsrate von 4600 g/mol pro nm. Die durchschnittliche Pfropfdichte betrug 0.36 µmol/m2. Als Anwendung wurden Mikrotropfen bestehend aus der ionischen Flüssigkeit, Dimethylformamid und dem ATRP-Katalysator benutzt, um in einer definierten Geometrie Polymerbürsten auf Silizium aufzubringen. Auf diese Weise lässt sich eine bis zu 13 nm dicke Beschichtung erzeugen. Dieses Konzept ist durch die Verdampfung des Monomers Methylmethacrylat (MMA) limitiert. Aus einem 1 µl großen Tropfen aus ionischer Flüssigkeit und MMA (1:1) verdampft MMA innerhalb von 100 s. Daher wurde das Monomer sequentiell zugegeben. Der zweite Teil konzentriert sich auf die Strukturierung von Oberflächen mit Hilfe einer neuen Methode: Tintendruck. Ein piezoelektrisch betriebenes „Drop-on-Demand“ Drucksystem wurde verwendet, um Polystyrol mit 0,4 nl Tropfen aus Toluol zu strukturieren. Die auf diese Art und Weise gebildeten Mikrokrater können Anwendung als Mikrolinsen finden. Die Brennweite der Mikrolinsen kann über die Anzahl an Tropfen, die für die Strukturierung verwendet werden, eingestellt werden. Theoretisch und experimentell wurde die Brennweite im Bereich von 4,5 mm bis 0,21 mm ermittelt. Der zweite Strukturierungsprozess nutzt die Polyelektrolyte Polyvinylamin-Hydrochlorid (PAH) und Polystyrolsulfonat (PSS), um 3D-Strukturen wie z.B. Linien, Schachbretter, Ringe, Stapel mit einer Schicht für Schicht Methode herzustellen. Die Schichtdicke für eine Doppelschicht (DS) liegt im Bereich von 0.6 bis 1.1 nm, wenn NaCl als Elektrolyt mit einer Konzentration von 0,5 mol/l eingesetzt wird. Die Breite der Strukturen beträgt im Mittel 230 µm. Der Prozess wurde erweitert, um Nanomechanische Cantilever Sensoren (NCS) zu beschichten. Auf einem Array bestehend aus acht Cantilevern wurden je zwei Cantilever mit fünf Doppelschichten PAH/ PSS und je zwei Cantilever mit zehn Doppelschichten PAH/ PSS schnell und reproduzierbar beschichtet. Die Massenänderung für die individuellen Cantilever war 0,55 ng für fünf Doppelschichten und 1,08 ng für zehn Doppelschichten. Der daraus resultierende Sensor wurde einer Umgebung mit definierter Luftfeuchtigkeit ausgesetzt. Die Cantilever verbiegen sich durch die Ausdehnung der Beschichtung, da Wasser in das Polymer diffundiert. Eine maximale Verbiegung von 442 nm bei 80% Luftfeuchtigkeit wurde für die mit zehn Doppelschichten beschichteten Cantilever gefunden. Dies entspricht einer Wasseraufnahme von 35%. Zusätzlich konnte aus den Verbiegungsdaten geschlossen werden, dass die Elastizität der Polyelektrolytmultischichten zunimmt, wenn das Polymer gequollen ist. Das thermische Verhalten in Wasser wurde im nächsten Teil an nanomechanischen Cantilever Sensoren, die mit Poly(N-isopropylacrylamid)bürsten (PNIPAM) und plasmapolymerisiertem N,N-Diethylacrylamid beschichtet waren, untersucht. Die Verbiegung des Cantilevers zeigte zwei Bereiche: Bei Temperaturen kleiner der niedrigsten kritischen Temperatur (LCST) ist die Verbiegung durch die Dehydration der Polymerschicht dominiert und bei Temperaturen größer der niedrigsten kritischen Temperatur (LCST) reagiert der Cantilever Sensor überwiegend auf Relaxationsprozesse innerhalb der kollabierten Polymerschicht. Es wurde gefunden, dass das Minimum in der differentiellen Verbiegung mit der niedrigsten kritischen Temperatur von 32°C und 44°C der ausgewählten Polymeren übereinstimmt. Im letzten Teil der Arbeit wurden µ-Reflektivitäts- und µ-GISAXS Experimente eingeführt als neue Methoden, um mikrostrukturierte Proben wie NCS oder PEM Linien mit Röntgenstreuung zu untersuchen. Die Dicke von jedem individuell mit PMMA Bürsten beschichtetem NCS ist im Bereich von 32,9 bis 35,2 nm, was mit Hilfe von µ-Reflektivitätsmessungen bestimmt wurde. Dieses Ergebnis kann mit abbildender Ellipsometrie als komplementäre Methode mit einer maximalen Abweichung von 7% bestätigt werden. Als zweites Beispiel wurde eine gedruckte Polyelektrolytmultischicht aus PAH/PSS untersucht. Die Herstellungsprozedur wurde so modifiziert, dass Goldnanopartikel in die Schichtstruktur eingebracht wurden. Durch Auswertung eines µ-GISAXS Experiments konnte der Einbau der Partikel identifiziert werden. Durch eine Anpassung mit einem Unified Fit Modell wurde herausgefunden, dass die Partikel nicht agglomeriert sind und von einer Polymermatrix umgeben sind.

Functional dextran-based hydrogels

Dextran-based polymers are versatile hydrophilic materials, which can provide functionalized surfaces in various areas including biological and medical applications. Functional, responsive, dextran based hydrogels are crosslinked, dextran based polymers allowing the modulation of response towards external stimuli. The controlled modulation of hydrogel properties towards specific applications and the detailed characterization of the optical, mechanical, and chemical properties are of strong interest in science and further applications. Especially, the structural characteristics of swollen hydrogel matrices and the characterization of their variations upon environmental changes are challenging. Depending on their properties hydrogels are applied as actuators, biosensors, in drug delivery, tissue engineering, or for medical coatings. However, the field of possible applications still shows potential to be expanded. rnSurface attached hydrogel films with a thickness of several micrometers can serve as waveguiding matrix for leaky optical waveguide modes. On the basis of highly swelling and waveguiding dextran based hydrogel films an optical biosensor concept was developed. The synthesis of a dextran based hydrogel matrix, its functionalization to modulate its response towards external stimuli, and the characterization of the swollen hydrogel films were main interests within this biosensor project. A second focus was the optimization of the hydrogel characteristics for cell growth with the aim of creating scaffolds for bone regeneration. Matrix modification towards successful cell growth experiments with endothelial cells and osteoblasts was achieved.rnA photo crosslinkable, carboxymethylated dextran based hydrogel (PCMD) was synthesized and characterized in terms of swelling behaviour and structural properties. Further functionalization was carried out before and after crosslinking. This functionalization aimed towards external manipulation of the swelling degree and the charge of the hydrogel matrix important for biosensor experiments as well as for cell adhesion. The modulation of functionalized PCMD hydrogel responses to pH, ion concentration, electrochemical switching, or a magnetic force was investigated. rnThe PCMD hydrogel films were optically characterized by combining surface plasmon resonance (SPR) and optical waveguide mode spectroscopy (OWS). This technique allows a detailed analysis of the refractive index profile perpendicular to the substrate surface by applying the Wentzel Kramers Brillouin (WKB) approximation. rnIn order to perform biosensor experiments, analyte capturing units such as proteins or antibodies were covalently coupled to the crosslinked hydrogel backbone by applying active ester chemistry. Consequently, target analytes could be located inside the waveguiding matrix. By using labeled analytes, fluorescence enhancement was achieved by fluorescence excitation with the electromagnetic field in the center of the optical waveguide modes. The fluorescence excited by the evanescent electromagnetic field of the surface plasmon was 2 3 orders of magnitude lower. Furthermore, the signal to noise ratio was improved by the fluorescence excitation with leaky optical waveguide modes.rnThe applicability of the PCMD hydrogel sensor matrix for clinically relevant samples was proofed in a cooperation project for the detection of PSA in serum with long range surface plasmon spectroscopy (LRSP) and fluorescence excitation by LRSP (LR SPFS). rn

Influence of ice crystal habit and cirrus spatial inhomogeneities on the retrieval of cirrus optical thickness and effective radius

Diese Dissertation untersucht den Einfluss von Eiskristallform und räumlicher Inhomogenität von Zirren auf das Retrieval von optischer Wolkendicke und effektivem Eispartikelradius. Zu diesem Zweck werden flugzeuggetragene spektrale Messungen solarer Strahlung sowie solare und langwellige Strahlungstransfersimulationen durchgeführt. Flugzeuggetragene spektrale aufwärtsgerichtete Radianzen (Strahldichten) sind mit dem SMART-Albedometer (Spectral Modular Airborne Radiation measurement sysTem) während des CIRCLE-2 (CIRrus CLoud Experiment-2) Feldexperiments im Mai 2007 gemessen worden. Basierend auf diesen Radianzdaten werden mittels eines Wolkenretrievalalgorithmus optische Wolkendicken und effektive Eispartikelradien anhand von eindimensionalen Strahlungstransferrechnungen bestimmt. Die Auswirkung der Annahme unterschiedlicher Eiskristallformen auf die retrievten Parameter wird durch Variation der Einfachstreueigenschaften der Eispartikel untersucht. Darüber hinaus wird mittels Strahlungstransferrechnungen auch der Einfluss der Eiskristallform auf den Strahlungsantrieb von Eiswolken ermittelt. Die Frage nach dem relativen Einfluss von räumlicher Wolkeninhomogenität und Eiskristallform wird anhand von dreidimensionalen und independent pixel approximation (IPA) Strahlungssimulationen untersucht. Die Analyse basiert auf einer Modelleiswolke, die aus Daten des NASA (National Aeronautics and Space Administration) TC4 (Tropical Composition, Cloud, and Climate Coupling) Feldexperiments im Sommer 2007 in Costa Rica erzeugt wurde. Lokal gesehen können beide Effekte - Eiskristallform und räumliche Eiswolkeninhomogenität - die gleiche Grössenordnung haben und zu einer Unter- bzw. Überschätzung der retrievten Parameter um 40 – 60% führen. Gemittelt über die ganze Wolke ist jedoch der Einfluss der Eiskristallform viel bedeutender als der von räumlichen Inhomogenitäten.

New biosensor applications of surface plasmon and hydrogel optical waveguide spectroscopy

Rapid and sensitive detection of chemical and biological analytes becomes increasingly important in areas such as medical diagnostics, food control and environmental monitoring. Optical biosensors based on surface plasmon resonance (SPR) and optical waveguide spectroscopy have been extensively pushed forward in these fields. In this study, we combine SPR, surface plasmon-enhanced fluorescence spectroscopy (SPFS) and optical waveguide spectroscopy with hydrogel thin film for highly sensitive detection of molecular analytes.rnrnA novel biosensor based on SPFS which was advanced through the excitation of long range surface plasmons (LRSPs) is reported in this study. LRSPs are special surface plasmon waves propagating along thin metal films with orders of magnitude higher electromagnetic field intensity and lower damping than conventional SPs. Therefore, their excitation on the sensor surface provides further increased fluorescence signal. An inhibition immunoassay based on LRSP-enhanced fluorescence spectroscopy (LRSP-FS) was developed for the detection of aflatoxin M1 (AFM1) in milk. The biosensor allowed for the detection of AFM1 in milk at concentrations as low as 0.6 pg mL-1, which is about two orders of magnitude lower than the maximum AFM1 residue level in milk stipulated by the European Commission legislation.rnrnIn addition, LRSPs probe the medium adjacent to the metallic surface with more extended evanescent field than regular SPs. Therefore, three-dimensional binding matrices with up to micrometer thickness have been proposed for the immobilization of biomolecular recognition elements with large surface density that allows to exploit the whole evanescent field of LRSP. A photocrosslinkable carboxymethyl dextran (PCDM) hydrogel thin film is used as a binding matrix, and it is applied for the detection of free prostate specific antigen (f-PSA) based on the LRSP-FS and sandwich immunoassay. We show that this approach allows for the detection of f-PSA at low femto-molar range, which is approximately four orders of magnitude lower than that for direct detection of f-PSA based on the monitoring of binding-induced refractive index changes.rnrnHowever, a three dimensional hydrogel binding matrix with micrometer thickness can also serve as an optical waveguide. Based on the measurement of binding-induced refractive index changes, a hydrogel optical waveguide spectroscopy (HOWS) is reported for a label-free biosensor. This biosensor is implemented by using a SPR optical setup in which a carboxylated poly(N-isoproprylacrylamide) (PNIPAAm) hydrogel film is attached on a metallic surface and modified by protein catcher molecules. Compared to regular SPR biosensor with thiol self-assembled monolayer (SAM), HOWS provides an order of magnitude improved resolution in the refractive index measurements and enlarged binding capacity owing to its low damping and large swelling ratio, respectively. A model immunoassay experiment revealed that HOWS allowed detection of IgG molecules with a 10 pM limit of detection (LOD) that was five-fold lower than that achieved for SPR with thiol SAM. For the high capacity hydrogel matrix, the affinity binding was mass transport limited.rnrnThe mass transport of target molecules to the sensor surface can play as critical a role as the chemical reaction itself. In order to overcome the diffusion-limited mass transfer, magnetic iron oxide nanoparticles were employed. The magnetic nanoparticles (MNPs) can serve both as labels providing enhancement of the refractive index changes, and “vehicles” for rapidly delivering the analytes from sample solution to an SPR sensor surface with a gradient magnetic field. A model sandwich assay for the detection of β human chorionic gonadotropin (βhCG) has been utilized on a gold sensor surface with metallic diffraction grating structure supporting the excitation of SPs. Various detection formats including a) direct detection, b) sandwich assay, c) MNPs immunoassay without and d) with applied magnetic field were compared. The results show that the highly-sensitive MNPs immunoassay improves the LOD on the detection of βhCG by a factor of 5 orders of magnitude with respect to the direct detection.rn

The thickness of the gaseous layer in disk galaxies

il profilo verticale del gas dipende sia dal potenziale galattico, e quindi dalla distribuzione di materia, sia dalla dispersione di velocit`a del gas La nostra analisi teorica ha mostrato che l’altezza scala dell’idrogeno gassoso ad un certo raggio `e fortemente legata alla componente di massa dominate: nelle parti centrali, dove domina la materia barionica, il disco gassoso incrementa il suo spessore esponenzialmente con una lunghezza scala pari al doppio di quella del disco stellare; dalle zone intermedie fino alla fine del disco, il profilo verticale del gas `e influenzato dalla distribuzione di DM. In queste zone lo spessore del disco gassoso cresce con il raggio in maniera circa lineare. Tale fenomeno viene definito gas flaring. Lo scopo principale di questa tesi `e la ricerca di una nuova tecnica per poter stimare il profilo vertical del gas in galassie con inclinazione intermedia.

A simple voltage/mass index increases the suspicion of amyloidotic cardiomyopathy: an electrocardiographic and echocardiographic study of 767 patients with increased left ventricular wall thickness due to different causes

Background-Amyloidotic cardiomyopathy (AC) can mimic true left ventricular hypertrophy (LVH), including hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD). We assessed the diagnostic value of combined electrocardiographic/echocardiographic indexes to identify AC among patients with increased echocardiographic LV wall thickness due to either different etiologies of amyloidosis or HCM or HHD. Method-First, we studied 469 consecutive patients: 262 with biopsy/genetically proven AC (with either AL or transthyretin (TTR)-related amyloidosis); 106 with HCM; 101 with HHD. We compared the diagnostic performance of: low QRS voltage, symmetric LVH, low QRS voltage plus interventricular septal thickness >1.98 cm, Sokolow index divided by the cross-sectional area of LV wall, Sokolow index divided by body surface area indexed LV mass (LVMI), Sokolow index divided by LV wall thickness, Sokolow index divided by (LV wall/height^2.7); peripheral QRS score divided by LVMI, Peripheral QRS score divided by LV wall thickness, Peripheral QRS score divided by LV wall thickness indexed to height^2.7, total QRS score divided by LVMI, total QRS score divided by LV wall thickness; total QRS score divided by (LV wall/height^2.7). We tested each criterion, separately in males and females, in the following settings: AC vs. HCM+HHD; AC vs. HCM; AL vs. HCM+HHD; AL vs. HCM; TTR vs. HCM+HHD; TTR vs. HCM. Results-Low QRS voltage showed high specificity but low sensitivity for the identification of AC. All the combined indexes had a higher diagnostic accuracy, being total QRS score divided by LV wall thickness or by LVMI associated with the best performances and the largest areas under the ROC curve. These results were validated in 298 consecutive patients with AC, HCM or HHD. Conclusions-In patients with increased LV wall thickness, a combined ECG/ echocardiogram analysis provides accurate indexes to non-invasively identify AC. Total QRS score divided by LVMI or LV wall thickness offers the best diagnostic performance.

Numerical evaluation of material model and thickness effect on LSP induced residual stresses

Laser Shock Peening (LSP) is a technological process used to improve mechanical properties in metallic components. When a short and intense laser pulse irradiates a metallic surface, high pressure plasma is generated on the treated surface; elasto-plastic waves, then, propagate inside the target and create plastic strain. This surface treatment induces a deep compressive residual stresses field on the treated area and through the thickness; such compressive residual stress is expected to increase the fatigue resistance, and reduce the detrimental effects of corrosion and stress corrosion cracking.

Influence of adhesive thickness on adhesively bonded joints under fatigue loading

Research on adhesive joints is arousing increasing interest in aerospace industry. Incomplete knowledge of fatigue in adhesively bonded joints is a major obstacle to their application. The prediction of the disbonding growth is yet an open question. This thesis researches the influence of the adhesive thickness on fatigue disbond growth. Experimental testing on specimens with different thickness has been performed. Both a conventional approach based on the strain energy release rate and an approach based on cyclic strain energy are provided. The inadequacy of the former approach is discussed. Outcomes from tests support the idea of correlating the crack growth rate to the cyclic strain energy. In order to push further the study, a 2D finite element model for the prediction of disbond growth under quasi-static loading has been developed and implemented in Abaqus. Numerical simulations have been conducted with different values of the adhesive thickness. The results from tests and simulations are in accordance with each other. According to them, no dependence of disbonding on the adhesive thickness has been evidenced.

Palatal swelling as the first and only manifestation of extranodal follicular non-Hodgkin lymphoma: a case presentation

Non-Hodgkin lymphomas (NHLs) in the head and neck region are malignant lymphoid neoplasms that usually originate from B-lymphocytic cell lines. Primary extranodal manifestations of this hematolymphoid tumor in the oral cavity are rare and involve the maxillary jaw including the palatal soft tissues, the mandible, and gingival tissues in patients between 60 and 70 years of age without sex predilection. This case report of an extra-nodal NHL in the palate of a 75-year-old patient emphasizes the importance of accurate clinical, radiographic, and histologic diagnostic procedures to avoid delayed diagnosis or inappropriate treatment strategies. Chemotherapy, radiotherapy, or a combination of the two with a regular clinical and hemic follow-up is recommended.

Reproducibility of retinal thickness measurements in patients with age-related macular degeneration using 3D Fourier-domain optical coherence tomography (OCT) (Topcon 3D-OCT 1000)

Conventional time-domain optical coherence tomography (OCT) has become an important tool for following dry or exudative age-related macular degeneration (AMD). Fourier-domain three-dimensional (3D) OCT was recently introduced. This study tested the reproducibility of 3D-OCT retinal thickness measurements in patients with dry and exudative AMD.

Thickness of softened human enamel removed by toothbrush abrasion: an in vitro study

The aim of the study was to assess the thickness of softened enamel removed by toothbrushing. Human enamel specimens were indented with a Knoop diamond. Softening was performed with citric acid or orange juice. The specimens were brushed in a brushing machine with a manual soft toothbrush in toothpaste slurry or in artificial saliva. Enamel loss was calculated from the change in indentation depth of the same indent before and after abrasion. Mean surface losses (95% confidence interval) were recorded in treatment groups (in nanometers): (1) citric acid, abrasion with slurry = 339 (280-398); (2) citric acid, abrasion with artificial saliva = 16 (5-27); (3) orange juice, abrasion with slurry = 268 (233-303); (4) orange juice, abrasion with artificial saliva = 14 (5-23); (5) no softening, abrasion with slurry = 28 (10-46). The calculated thickness of the softened enamel varied between 254 and 323 nm, depending on the acid used.

Diffuse swelling of the buccal mucosa and palate as first and only manifestation of an extranodal non-Hodgkin 'double-hit' lymphoma: report of a case

Most of the lymphomas arising in the oral cavity are of B-cell origin. Among these, diffuse large B-cell lymphomas are the most common. Diffuse large B-cell lymphomas may exhibit more than one chromosomal rearrangement and are then referred to as 'double-hit' or 'triple-hit' lymphomas.