Malignant Transformation of a Lipomyelocele into a Rhabdomyosarcoma?

SUMMARY: We report the unusual transformation of a lipomyelocele to a rhabdomyosarcoma in a 3-year-old boy. A lipomyelocele is not considered pre-malignant, but the possibility of developing such a tumor may represent another reason for close neurological follow-up in patients with spinal dysraphism.     

The development of a curriculum—a case study of six centres providing courses in radiographic reporting

Aim: To analyse the content of the curricula of radiographic reporting courses in six established sites.Methods: The structures of the six courses were examined by analysis of course materials from the educational institutions. Two sample course documents were scrutinized initially in order to identify major themes. From the information gathered a 27-point questionnaire was developed and distributed to the six educational sites.Results: The data showed the institutions to be placing great importance on meeting the needs of the clinical departments and their patients. Variations were noted in course content, award and measurement of competence.Conclusions: The paper provides an overview of an important paradigm shift in the role of diagnostic radiographers. It is clear that the development of reporting courses should involve close links between academic and clinical sites, with an emphasis on team work.     

An analysis of a health professions appeal board--should a mediational style of hearing matters be adopted?

The Ontario Health Professions Board is a statutory Board that carries out a supervisory function and review function of certain matters arising from twenty-three health professions in the province. This paper examines the board, how it functions, and the nature and type of disputes, which come before it. Having regard to key concepts in the areas of conflict analysis and process design, the paper critically discusses whether the Board ought to adopt a mediational style of hearing matters. The conclusions are that there are very real dangers that the current practices of the Board may contribute to conflict rather than resolve it, that there is no legal impediment to the Board adopting a mediational style of hearing matters, and that such an approach would contribute to the Board effectively carrying out its statutory functions.     

Fatal combination of mitragynine and quetiapine – a case report with discussion of a potential herb-drug interaction

Forensic Science, Medicine and Pathology - Kratom is a plant with dose-dependent mixed stimulant and opioid properties whose pharmacologic characteristics and social impact continue to be...     

Efficacy of CBCT for assessment of impacted mandibular third molars: a review – based on a hierarchical model of evidence

A radiographic examination of mandibular third molars is meant to support the surgeon in establishing a treatment plan. For years panoramic (PAN) imaging has been the first choice method; however, where an overprojection is observed between the third molar and the mandibular canal and when specific signs suggest a close contact between the molar and the canal, CBCT may be indicated. The present review provides an evaluation of the efficacy of CBCT for assessment of mandibular third molars using a six-tiered hierarchical model by Fryback and Thornbury in 1991. Levels 1–3 include studies on low evidence levels mainly regarding the technical capabilities of a radiographic method and the diagnostic accuracy of the related images. Levels 4–6 include studies on a higher level of evidence and assess the diagnostic impact of a radiographic method on the treatment of the patient in addition to the outcome for the patient and society including cost calculations. Only very few high-evidence studies on the efficacy of CBCT for radiographic examination of mandibular third molars exist and, in conclusion, periapical or PAN examination is sufficient in most cases before removal of mandibular third molars. However, CBCT may be suggested when one or more signs for a close contact between the tooth and the canal are present in the two-dimensional image—if it is believed that CBCT will change the treatment or the treatment outcome for the patient. Further research on high-evidence levels is needed.     

Is MIBG a substrate of P-glycoprotein?

Purpose Radionuclide therapy with ¹³¹I-labelled meta-iodobenzylguanidine ([¹³¹I]MIBG) is effective in cases where it is difficult to carry out surgical resection or debulking of neuroendocrine tumours (NETs). However, it has recently been reported that P-glycoprotein (P-gp) is expressed in these NETs. Therefore, it is important to clarify whether MIBG is a substrate of P-gp or not. In this study, using a human cell line which overexpresses P-gp, LLC-GA5-COL150, we investigated this question. Methods The transcellular transport and accumulation of [¹²⁵I]MIBG were measured using monolayer cultures grown in Transwell chambers. [¹²⁵I]MIBG was added to either the basolateral or the apical side, aliquots of the incubation medium on the other side were taken at specified times, and the radioactivity was measured. For accumulation experiments, the cells on the filters were solubilised and the radioactivity in aliquots was measured. Results There were no significant differences in the transport of MIBG between LLC-PK₁ and LLC-GA5-COL150 monolayers in either direction until 60 min. With respect to the accumulation of MIBG, there were no significant differences between LLC-PK₁ and LLC-GA5-COL150 cells in either direction. Conclusion MIBG is not a substrate of P-gp. Therefore, radionuclide therapy with MIBG would be useful in the treatment of NETs expressing P-gp.     

Traumatic detachment of the inferior angle of the scapula in a 5-year-old boy—a sonographic diagnosis

A complete slip of the cartilage of the inferior angle of the scapula was diagnosed in a 5-year-old boy who fell inside a wooden construction at a kindergarten playground. Radiographs of the scapula were normal, and ultrasound demonstrated complete cartilage detachment, which was displaced deep and laterally. Computed tomography (CT) additionally demonstrated a thin rim of bone displaced along with the detached cartilage. Radiologic findings were confirmed during surgery. We report what we believe to be the first published case of traumatic detachment of the cartilaginous lower angle of the scapula in a child demonstrated by ultrasound.     

Combined action of açai and aerobic exercise training on the development of NAFLD induced by a high-fat diet: a preliminary exploration

Sport Sciences for Health - Non-alcoholic fatty liver disease (NAFLD) is a metabolic condition that comprises a spectrum of liver diseases. Non-pharmacological treatments such as functional food...     

A forensic autopsy case of death in a patient with pseudoxanthoma elasticum – Dermatopathologic findings as a clue of the cause of death

Pseudoxanthoma elasticum (PXE) is an autosomal recessive disorder, characterized by papular skin lesions and cutaneous laxity caused by fragmentation and mineralization of elastic fibers. Although vascular and retinal aspects of this disease and their associated complications are well characterized, few authors have focused on the increased incidence of epilepsy in patients with PXE. A 28-year-old Korean male was found dead in his work place with bloody-foamy discharge from his mouth and nostrils. He reportedly had a convulsive episode 5 days prior to his death in the work place. The skin showed generalized laxity and many creases with maculopapular pigmentations. A histopathologic examination of the skin revealed Pseudoxanthoma elasticum. Based on the histopathological findings and medical history, death was postulated to be due to ‘an internal cause, possibly related to a seizure attack’. Our findings suggest that histopathologic examinations of any lesions found during the forensic autopsy should be encouraged.     

Accuracy assessment of a potential clinical use of navigation-guided intra-operative liver metastasis brachytherapy—a planning study

For patients with inoperable liver metastases, intra-operative liver high dose-rate brachytherapy (HDR-BT) is a promising technology enabling delivery of a high radiation dose to the tumor, while sparing healthy tissue. Liver brachytherapy has been described in the literature as safe and effective for the treatment of primary or secondary hepatic malignancies. It is preferred over other ablative techniques for lesions that are either larger than 4?cm or located in close proximity to large vessels or the common bile duct. In contrast to external beam radiation techniques, organ movements do not affect the size of the irradiated volume in intra-operative HDR-BT and new technical solutions exist to support image guidance for intra-operative HDR-BT. We have retrospectively analyzed anonymized CT datasets of 5 patients who underwent open liver surgery (resection and/or ablation) in order to test whether the accuracy of a new image-guidance method specifically adapted for intra-operative HDR-BT is high enough to use it in similar situations and whether patients could potentially benefit from navigation-guided intra-operative needle placement for liver HDR-BT.     

Analysis of taxine B/isotaxine B in a plasma specimen by LC–MS/MS in a case of fatal poisoning: concealed suicide by ingestion of yew (Taxus L.) leaves of a patient with a long-term history of borderline personality disorder

Forensic Toxicology - This case report deals with a 25-year-old woman who suffered from a long-term borderline personality disorder and from acute suicidal tendencies, including the intentional...