Exosomes in neurological disease,neuroprotection, repair and therapeutics: problems and perspectives

<正>Exosomes:Exosomes are a sub-population of micro-vesicles ranging from 40–100 nm that were earlier thought as artefacts under electron microscope.They recently came into attention for their storage of biological information,cell-to-cell communication,serving as biomarkers and potential use in neural     

MRI predictors of treatment response for perianal fistulizing Crohn disease in children and young adults

Background

Magnetic resonance imaging (MRI) is considered the imaging standard for diagnosis and characterization of perianal complications associated with Crohn disease in children and adults.

Objective

To define MRI criteria that could act as potential predictors of treatment response in fistulizing Crohn disease in children, in order to guide more informed study interpretation.

Materials and methods

We performed a retrospective database query to identify all children and young adults with Crohn disease who underwent serial MRI studies for assessment of perianal symptoms between 2003 and 2010. We examined imaging features of perianal disease including fistula number, type and length, presence and size of associated abscess, and disease response/progression on follow-up MRI. We reviewed imaging studies and electronic medical records. Statistical analysis, including logistic regression, was performed to associate MR imaging features with treatment response and disease progression.

Results

We included 36 patients (22 male, 14 female; age range 8–21 years). Of these, 32 had a second MRI exam and 4 had clinical evidence of complete response, obviating the need for repeat imaging. Of the parameters analyzed, presence of abscess, type of fistula according to the Parks classification, and multiplicity were not predictors of treatment outcome. Maximum length of the dominant fistula and aggregate fistula length in the case of multiple fistulae were the best predictors of treatment outcome. Maximum fistula length <2.5 cm was a predictor of treatment response, while aggregate fistula length ≥2.5 cm was a predictor of disease progression.

Conclusion

Perianal fistula length is an important imaging feature to assess on MRI of fistulizing Crohn disease.     

Epilepsy and dental procedures. A review

This paper is a review of the dental management of patients with epilepsy. It includes discussion of the effects anti-epileptic drugs have on dental procedures and addresses complications and side effects of these drugs. A clinical case photo is presented to show gingival hyperplasia, along with four tables on which common antiepileptic medications are enumerated.     

Arrowhead elastic for simultaneous correction of overjet and overbite

Arrowhead elastic may be integrated with fixed appliances to achieve rapid correction of increased overjet and overbite during comprehensive orthodontic treatment. This technique is applicable in routine class II cases involving deep bite, during retention phase in growing children treated with twin block and postsurgically in adult hypodivergent cases.