Structure-function relationships of entheses in relation to mechanical load and exercise

Entheses are regions of high-stress concentration that are commonly affected by overuse injuries in sport. This review summarizes current knowledge of their structure-function relationships - at the macroscopic, microscopic and molecular levels. Consideration is given to how stress concentration is reduced at fibrocartilaginous entheses by various adaptations which ensure that stress is dissipated away from the hard-soft tissue interface. The fundamental question of how a tendon or ligament is anchored to bone is addressed - particularly in relation to the paucity of compact bone at fibrocartilaginous entheses. The concept of an "enthesis organ" is reviewed - i.e. the idea of a collection of tissues adjacent to the enthesis itself, which jointly serve a common function - stress dissipation. The archetypal enthesis organ is that of the Achilles tendon and the functional importance of its subtendinous bursa, with its fibrocartilaginous walls and protruding fat pad, is emphasized. The distribution of adipose tissue elsewhere at entheses is also explained and possible functions of insertion-site fat are evaluated. Finally, a brief consideration is given to enthesopathies, with attention drawn to the possibility of degenerative changes affecting other regions of an enthesis organ, besides the enthesis itself.     

Imaging diagnosis of the larynx. Normal anatomy and pathological changes

Summary The primary goal of diagnostic imaging of the larynx is analysis of submucosal structures that are not visible by clinical or endoscopic means. Therefore, image analysis of the larynx should only be performed under knowledge of the results of clinical diagnosis. The anatomic relationships of the laryngeal skeleton, the intrinsic structures, and the surrounding soft tissue are presented synoptically.      

Longitudinal changes of maximal short-term peak power in girls and boys during growth

PURPOSE: The aims of this study are twofold: first, to analyze the influence of age, body mass, and lean leg volume (LLV) on short-term leg peak power (Pmax) of young females and males during growth using multilevel regression analysis and, second, to compare the regression results of boys and girls. METHODS: The individuals were 100 girls and 109 boys aged 7.5-17.5 yr old. Pmax, LLV, and mass were determined on two occasions using the cycling force-velocity test. The optimal force (Fopt) and pedaling frequency (Vopt) corresponded to the force and pedaling frequency at Pmax. RESULTS: It was observed that the increase of Pmax doesn't depend on gender until the age of 14. From that age, Pmax values are significantly lower in girls than in boys. In girls, LLV is the main predictor of Pmax variance (68%; P < 0.001), whereas in boys it is age (57%; P < 0.001). Results of ANCOVA were that for the same leg length (LL), Vopt is significantly (P < 0.001) higher in boys than in girls. It also indicated that for the same LLV, there are no significant (P > 0.05) gender differences of Fopt. CONCLUSION: These results illustrated that during the growth period, the increase of Pmax is significantly higher in boys than in girls. Qualitative muscular factors (Type II fiber, glycolytic ability, motor coordination, and motor unit activation) may account for the significantly higher Pmax production in boys than in girls. Precisely, the gender differences might be explained by neuromuscular determinants of contraction velocity. In conclusion, children should develop their neuromuscular determinants of contraction velocity rather than their lean leg volume.     

In vivo imaging of changes in tumor oxygenation during growth and after treatment.

A novel procedure for in vivo imaging of the oxygen partial pressure (pO2) in implanted tumors is reported. The procedure uses electron paramagnetic resonance imaging (EPRI) of oxygen-sensing nanoprobes embedded in the tumor cells. Unlike existing methods of pO2 quantification, wherein the probes are physically inserted at the time of measurement, the new approach uses cells that are preinternalized (labeled) with the oxygen-sensing probes, which become permanently embedded in the developed tumor. Radiation-induced fibrosarcoma (RIF-1) cells, internalized with nanoprobes of lithium octa-n-butoxy-naphthalocyanine (LiNc-BuO), were allowed to grow as a solid tumor. In vivo imaging of the growing tumor showed a heterogeneous distribution of the spin probe, as well as oxygenation in the tumor volume. The pO2 images obtained after the tumors were exposed to a single dose of 30-Gy X-radiation showed marked redistribution as well as an overall increase in tissue oxygenation, with a maximum increase 6 hr after irradiation. However, larger tumors with a poorly perfused core showed no significant changes in oxygenation. In summary, the use of in vivo EPR technology with embedded oxygen-sensitive nanoprobes enabled noninvasive visualization of dynamic changes in the intracellular pO2 of growing and irradiated tumors.     

Efficacy of the spiral flow generating extended tube during paediatric CCTA

IntroductionTo compare the computed tomography (CT) number for paediatric cardiac computed tomography angiography (CCTA) and visualisation score of the three-dimensional (3D) images using the conventional T-shaped extended tube (T-tube) and spiral flow-generating extended tube (spiral-tube) connected between the contrast injector and cannula.MethodsIn total, 108 patients suspected to have congenital heart disease (CHD) were considered for inclusion. We utilised the T-tube for intravenous contrast and spiral-tube in 54 patients each. Observers individually inspected randomized volume rendering images of the internal thoracic artery, each acquired from the with or without spiral-tube groups, using a four-point scale. We compared the mean CT number of the ascending aorta (AAO) and pulmonary artery (PA), contrast noise ratio (CNR), CT number for the AAO and PA enhancement ratio, and the visualisation scores between the groups.ResultsThere were no significant differences in patient characteristics between the with or without spiral-tube groups (p > 0.05). The mean CT number ±standard deviation for the AAO and PA, and the CNR without or with spiral-tube groups were 441.2 ± 89.2 and 489.8 ± 86.1 HU for the AAO, 436.3 ± 100.6 and 475.3 ± 85.2 HU for the PA, and 9.5 ± 2.2 and 10.8 ± 2.4 for the CNR, respectively (p < 0.05). In the spiral-tube group, the CT number, CNR, and visualisations score of the 3D images were significantly higher for the AAO and PA than those in the T-tube group (p < 0.05).ConclusionThe spiral-tube proved to be beneficial in improving the CT number for the AAO and PA, CNR, and visualisation score compared with the conventional T-tube during paediatric CCTA.Implications for practiceThe spiral-tube may allow the visualisation of smaller blood vessels than those visualised by the conventional T-tube for paediatric patients in CCTA.     

Normal anatomy and pathologic changes of the small bowel mesentery: US appearance

The ultrasonographic (US) appearance of the normal small bowel mesenteric leaves was evaluated in two in vitro studies and in 30 patients. Such structures had an elongated shape, echogenic surfaces, and small vessels in their center and could be recognized in 28 of the 30 patients. They did not show active movements, and at their distal end, the small bowel loops could be seen and peristalsis detected. Doppler signals were obtained from the small vascular structures in their center in three additional cases. On the basis of these anatomic findings, pathologic changes such as lymphoma, desmoid tumor, metastatic lesions, dilated vessels, and edema could be detected in 15 patients. When examining with US patients with diseases prone to involve the mesentery, careful attention should be given to this structure, since useful information about the abdominal spread of the disease can be obtained.     

High-resolution computed tomography of the middle ear and mastoid. Part I: Normal radioanatomy including normal variations

Six cases of childhood renal tumor with extensive bone involvement are reported. The neoplasms had been classified originally as Wilms tumor with atypical clinical and pathologic features. Subsequent to a retrospective histologic analysis, the lesions were reclassified as follows: three cases as bone-metastasizing renal tumors of childhood, one case as rhabdomyosarcoma, one case as undifferentiated sarcoma, and one case as undifferentiated malignant neoplasm.     

Normal pituitary gland: changes in shape, size, and signal intensity during the 1st year of life at MR imaging

Magnetic resonance images of the pituitary glands in 48 endocrinologically normal neonates and infants were analyzed to determine the changes in pituitary gland size, shape, and signal intensity that occur during the 1st year of life. A progressive increase in the length--but not height--of the gland was seen throughout the 1st year. When corrections for total brain size were made, the pituitary gland was found to diminish in relative cross-sectional area throughout infancy. Upward convexity of the gland was seen in 63% of neonates less than 1 month of age, but in only 4% of infants older than 2 months. Hyperintensity of the adenohypophysis relative to the brain stem was visualized on T1-weighted images in 18 of the 24 (75%) neonates and infants less than 2 months old; this appearance was never seen in older infants. An area of high signal intensity was visualized in the posterior pituitary in 32 of 48 cases (67%), and its visualization was unrelated to age. The neonatal and young infant pituitary gland is thus significantly rounder, brighter, and relatively larger during the first 2 months of life than in later infancy.     

Dimensional changes cannot account for all differences in short-term cycling power during growth

The purpose of this study was to determine to what extent anthropometric characteristics account for cycling peak power during growth. Five hundred and six male subjects aged 7.5-18 years performed three brief maximal sprints on a friction-loaded cycle ergometer. Cycling peak power (CPP) was calculated including the flywheel inertia of the device. Fat-free mass (FFM) and lean leg volume (LLV) were assessed by anthropometry. Anthropometric characteristics increased significantly during growth (p<0.001) but plateaued from about 16 years of age (p > 0.3). The same pattern was observed for CPP, while the time to reach CPP decreased during growth. CPP correlated as highly with LLV as with FFM and both parameters may therefore be interchanged. However, in non weight-bearing exercises, such as cycling, it seems more relevant to "normalise" leg power for LLV. Multiple stepwise regression, using an allometric model, showed that a large part of the variance of CPP was explained by LLV (88.2%, p<0.001). However, age and time to reach peak power also contributed significantly (approximately 3 %, p < 0.001). The prediction of CPP revealed that FFM and age contributed to 92.2% of the total variance of CPP. Because of its practicability, fat-free mass is particularly useful in prospective studies. Although the effects of dimensional changes in CPP during growth are obvious, undetermined qualitative changes of muscle function during maturation must be considered.     

Looking back and looking forward: Normal lung growth and the pathophysiological consequences of ‘misplaced’ growth in disease

This tribute is dedicated to Lynne M. Reid, M.D. It is a précis of a special lecture given by her at the 4th International Workshop for Pulmonary Functional Imaging, held at Harvard Medical School in Boston, Sept. 24–26, 2009. Dr. Reid's remarks include those of an historical nature as well as thematic presentations of the growth and remodeling of pulmonary airways and vessels both physiologically and pathophysiologically. The role of hyperoxia and hypoxia in adaptive and pathological settings were emphasized. The theme throughout Dr. Reid's lecture was the relationship between structure and function, and how each serves and is consequent on the other.     

飞行员血小板的电子显微镜分型正常值及飞行后变化

用电子显微镜方法，将血小板（PC）分为圆、树突、过渡、展平和崩解五个型。对405例飞行员和550例地面工作人员，分别进行分型计数调查。发现36岁以上飞行员中树突型百分比明显高于同年龄地面人员，随着年龄增长，树突型和展平型均呈上升趋势，其余无差别；65岁以上树突型、展平和崩解型明显高于50岁以下者；飞行前后相比，飞行后PC各型均有不同程度改变。     

The third ventricle. Normal anatomy and changes in some pathological conditions

Summary An anatomical study of the normal anterior inferior part and the floor of the third ventricle has been made and its radiological appearance shown. Specimens and casts were analyzed and correlated with ventriculograms using watersoluble contrast media. The detailed appearance of the optic recess and sulcus of Monro, which has not been well described in the neuroradiological literature, is illustrated and detailed. The changes in the optic recess in hydrocephalus are discussed. Deformities of the different segments of the floor as a result of tumors of the posterior fossa and hydrocephalus are shown.     

Long-term hematologic changes caused by radioiodine treatment of thyroid cancer. II. Bone marrow changes including leukemia

59 post-therapeutic examinations of the bone marrow have been performed in 35 patients out of a group of 296 patients treated from 1969 through 1976 by postoperative iodine-131 irradiations for carcinoma of the thyroid gland. Seven patients had normal findings, twelve patients showed panmyelopathy as principal finding, and fourteen patients presented modifications of the three marrow systems in different degrees and combinations. Acute myeloid leukemia was demonstrated in two patients by examination of the bone marrow, in another case the same disease was diagnosed by an analysis of the peripheral blood count. Taking into account the dosimetric considerations of the authors and the three cases of leukemia observed within the total group of patients, a risk factor for leukemia of 7.0 X 10(-5) X rd-1 is calculated which is slightly higher than the leukemia induction rate communicated in literature (22/2646 patients; 1-2/100,000/rd/year).