人脑海马结构与杏仁体的典型相关分析

1 材料和方法1.1 标本制作 随机采用34例(男16例,女18例)经防腐固定之成人头颅标本,标出冠状线(经左、右外耳门)、正中矢状线和眦耳线后,-30℃低温冰冻一周。沿眦耳线切开头颅,并分别向上、向下作连续断片,片厚5 mm,片间耗损1 mm。选取海马结构、杏仁体外观最大的断面测量它们的最大横径和最大矢径,以及相应断面颞叶前端至枕叶后端(简称颞枕叶)的最大横径、矢径(分别与颅外标记之冠状线和正中矢状线平行)。     

基于人脑纹状体与海马结构的断层影像学研究

目的　探讨纹状体与海马结构的相关性,为临床影像诊断提供形态学依据和相关测值。 方法　采集100例经诊断无病变的成人头部磁共振图像,按照年龄16～25、26～35、36～45、46～55、 56～65岁进行分组,每组男、女各10例。观测纹状体与海马结构的面积、横径、矢径等线性指标,标准化前、后数据均进行相应统计学处理。 结果　数据经标准化处理后,运用单因素方差分析显示：纹状体面积无性差,尾状核头矢径、海马面积、海马横径、矢径存在性差(女性>男性),颞角宽度存在性差(女性<男性);尾状核头横径存在侧差（左>右）,壳面积、壳矢径存在侧差（左<右）。利用Pearson相关分析显示：纹状体面积与年龄、颞叶钩回间距呈负相关,与颞角宽度呈正相关;海马面积与尾状核头面积、颞角宽度呈正相关。 结论　成年人纹状体面积随着年龄增长而缩小;海马结构与纹状体在形态结构上具有相关性;壳面积右侧大于左侧;女性海马面积大于男性;颞角宽度可以作为研究纹状体与海马结构形态变化的共同参考指标。     

中央沟上段及其邻近沟回的体表定位及其临床意义

目的：探讨在MRI和CT图像上观测中央沟上段及其邻近沟回的特征，进行精确体表定位。方法：30例成人头颅和扫描无颅恼器质性病变10份CT，100份MRI片，在头颅正中欠状面上观测头颅外形和平行于耳眦线平而以上100mm内的前后正巾线的中点及中垂线。在横位图像上观测中央沟上段及其邻近沟回的特征和二维坐标参数。结果：成人头颅近似标准球形。住82％头颅卜平行耳眦线平面的正中点的的投影在垂直耳眦线过外耳道的直线卜，另外18％偏离基线面中垂线小于7mm。上段中央沟在耳眦线平面上70～95mm。84％额上沟与中央前沟相交呈倒T字征，交点住前后中线旁24～27mm，耳眦线平面的中垂线前2～6mm。中央沟上段起点前后中线旁1～15mm，耳眦线平而的中垂线后12～28mm，手结征98％。中央后沟在中央沟之后8～13mm与其平行。结论：每人上段中央沟及其邻近沟回的特征能被MRI精确体表定位。     

健康成人海马结构体积的磁共振测量

目的:探讨正常成人海马结构体积的平均值范围,为与海马结构形态改变相关的疾病提供线性测量指标。方法:使用GE3.0T核磁共振仪采集海马结构图像,观测海马结构体积、纵轴长度、宽度、高度等指标,分析各线性指标与海马结构体积的相关性及海马结构体积随年龄变化的规律。结果:健康成人海马结构的体积随着年龄的增长而减小。海马结构体积左、右侧差异有统计学意义(左侧右侧),性别差异亦有统计学意义(男性女性)。Pearson分析显示,海马结构纵轴长度、海马结构宽度、海马结构高度、侧脑室颞角间距与海马结构体积呈正相关,侧脑室颞角宽度与海马结构体积呈负相关。结论:海马结构体积随着年龄增长而减小,且存在侧别及性别上的差异。海马结构纵轴长度、海马结构宽度、海马结构高度、侧脑室颞角间距、侧脑室颞角宽度可作为海马结构形态变化的初筛指标。     

面神经颞骨内段在冠状薄层切片与高分辨率计算机断层摄影图像上的应用解剖

目的:为面神经及耳科病变的影像诊断和手术治疗提供解剖学基础.方法:15例成人头部标本,以与眦耳线(CML)相垂直的直线为基线,获得间隔为1.0mm,厚度为1.0mm的高分辨率计算机断层摄影术(HRCT)图像,扫描后的头部标本按原定位截取以耳颞区为中心的组织块并将其制成厚为1.0mm的连续冠状薄层切片.标本切片与HRCT图像对照,对颞骨内面神经、听小骨、骨半规管、前庭、耳蜗等结构进行观测.结果:颞骨冠状HRCT扫描,有30～32层,膝状神经节居第5～7层,面神经水平段起始部和面神经迷路段居第7～8层,面神经垂直段居第16～17层,面神经隐窝、锥隆起、锥隐窝三者在第14～15层从外向内呈"M"字型排列.结论:耳颞区火棉胶冠状薄层断面标本能良好显示面神经及其周围结构的解剖位置和毗邻关系,可直接与高分辨率CT冠状扫描图像进行对照研究,其结果对耳科疾病的影像诊断及手术治疗有参考价值.     

耳横断高分辨率CT中表盘定位的应用

目的:探讨耳颞区高分辩率体层摄影术(HRCT)横断扫描图像上表盘定位的可行性,为耳颞区病变的影像诊断和手术治疗提供一种新的定位方法。方法:30例无耳部病变的成人以眦耳线(CML)为基线,用GE Hispeed NX/i Sys#CT扫描,获得间隔为1·00mm,厚度为1·00mm的CT图像,在扫描图像上套用表盘,逐一对颞骨内各主要结构进行定位。结果:利用表盘法对外半规管上部、外半规管、锤砧关节、鼓岬和圆窗龛等5个横断层面内的面神经、中耳及内耳的各重要结构进行了定位。结论:耳颞区HRCT扫描图像用表盘法定位,其方法简单实用,在耳科的教学与科研、耳科病变的诊断与治疗等方面均具有广泛的应用前景。     

后鼓室颞骨切片与CT对照研究

目的：为后鼓室及耳科病变的影像诊断和手术治疗提供解剖学基础。方法：l5例成人头部标本，以眦耳线（cML）为基线，获得间隔为1．00mm，厚度为1．00mm的CT图像，扫描后的头部标本按原定位截取以耳颞区为中心的组织块并将其制成厚为1．00mm的连续横断薄层切片。标本切片与CT图像对照，对颞骨内砧骨窝、鼓索隆起、茎突隆起、面神经隐窝、鼓室窦、岬小桥、外耳道上棘等结构进行观察。结果：砧骨窝深度为1．49mm，至面神经锥曲的距离为5．67mm。后鼓室窦内侧壁至面神经水平部的距离为3．14mm。外耳道上棘至面神经垂直段、鼓索神经、鼓岬的距离分别为16．76mm、15．94mm和21．81mm。结论：耳颞区断面标本与CT图像进行对照研究，其结果对耳科疾病的影像诊断及手术治疗具有参考价值。     

颞区皮肤手术易损伤结构的应用解剖研究

目的:获得颞区解剖结构数据,分析颞区皮肤肿瘤活检和手术治疗的安全性.方法:经10%甲醛液固定的成人尸头标本5例10侧,行颞区层次解剖,观测耳前、后组血管神经的参数.结果:主要结构分布于颞浅筋膜层,耳前组由后向前为颞浅静脉、耳颞神经、颞浅动脉及面神经颞支,分别距耳屏(3.14±0.21)mm,(7.04±1.18) mm,(7.32±1.92) mm,(28.67±0.37) mm;面神经颞支最后侧在颧弓上缘处距耳屏(28.67±0.37)mm.耳后组由前向后依次为耳后动脉、枕小神经及耳后静脉,分别距耳廓后沟中部(6.55±0.23)mm,(40.41±1.37)mm,(41.18±1.57)mm.结论:颞区手术切口以耳尖为中心呈放射状,术后瘢痕最小;颞区活检或手术最易损伤面神经颞支,越近颧弓上缘越易损伤,其后果越严重;耳屏前28 mm范围内无面神经颞支,为手术相对安全区.     

颞骨冠状切片和高分辨率CT定位圆窗区的邻近结构

背景:作者前期实验曾探讨了圆窗区及周围结构在横断面上的配布特点,虽有资料对颞骨中耳及邻近解剖结构的冠状位影像学特点进行了描述,但由于无统一的冠状扫描基线,导致相关研究结果存在差异。目的:对比分析成人头部标本颞骨冠状切片和高分辨率CT冠状扫描图像上圆窗区及其周围结构的差异。方法:15例(30侧)成人头部标本,以与眦耳线相垂直的直线为基线,获得间隔为1.00mm,厚度为1.00mm的CT冠状扫描图像,扫描后的头部标本按原定位截取以耳颞区为中心的组织块,并制成厚为1.00mm的连续冠状薄层切片。标本切片与CT图像对照,对颞骨内听小骨、骨性半规管、前庭、耳蜗、圆窗、圆窗龛、蒲氏间隙以及面神经颞骨内段等结构进行观察。结果与结论:圆窗龛的内外径、深度分别为(1.36±0.26)和(1.55±0.26)mm,面神经迷路段至弓状隆起的距离为(4.19±0.52)mm,面神经水平段距鼓室盖、距耳蜗、距锤骨头、距盾板、距砧骨短脚间的距离分别为(5.27±0.92),(1.36±0.28),(3.19±0.85),(5.30±0.58)和(2.86±0.54)mm。提示耳颞区火棉胶冠状薄层断面标本能良好显示圆窗区及其周围结构的解剖位置和毗邻关系,可直接与高分辨率CT冠状`扫描图像进行对照分析,其结果对耳科疾病的影像诊断及手术治疗有参考价值。     

面神经额支的体表平面定位

目的：通过体表标志线对面神经额支进行平面区域定位，为相关手术预防额支损伤提供解剖学基础。方法：对16具防腐成人尸体显微解剖，观测跨经耳屏水平线、耳屏点-外木眦连线、耳上基点—眉外端连线的面神经额支数和位置。结果：额支在三条标志线上的分支数及最后支至最前支的位置分别为：经耳屏水平线2.7支，耳屏前21.2—30.1mm：耳屏点-外毗连线6.0支，耳屏点前24.5—39.9mm:耳上基点-耳外端连线5.5支，耳上基点前40.1mm.结论：面神经额支的颞部行程可通过体表标志线进行平面区域定位，并可针对手术解剖划分为“危险区”和“相对危险区”。     

Lack of adrenomedullin,but not complement factor H,results in larger infarct size and more extensive brain damage in a focal ischemia model

Adrenomedullin (AM) and its binding protein, complement factor H (FH), are expressed throughout the brain. In this study we used a brain-specific conditional knockout for AM and a complete knockout for FH to investigate the effect of these molecules on the pathophysiology of stroke. Following 48 h of middle cerebral artery permanent occlusion, there was a statistically significant infarct size increase in animals lacking AM when compared to their wild type littermates. In contrast, lack of FH did not affect infarct volume. To investigate some of the mechanisms by which lack of AM may augment brain damage, markers of nitrosative stress, apoptosis, and autophagy were studied at the mRNA and protein levels. There was a significant increase of inducible nitric oxide synthase (iNOS), matrix metalloproteinase-9 (MMP9), fractin, and Beclin-1 in the peri-infarct area of AM-deficient mice when compared to their wild type counterparts and to contralateral and sham-operated controls. These data suggest that AM exerts a neuroprotective action in the brain and that this protection may be mediated by regulation of iNOS, matrix metalloproteases, and inflammatory mediators. In the future, substances that increase AM actions in the central nervous system may be used as potential neuroprotective agents in stroke.     

Intima-media thickness in treated and untreated patients with and without familial hypercholesterolemia: A systematic review and meta-analysis

Familial hypercholesterolemia (FH) is a common genetic disorder of lipoprotein metabolism leading to premature atherosclerosis. From early onset, status and progression of atherosclerosis of the large peripheral arterial walls can be quantified by ultrasound intima-media thickness (IMT) measurements. Here we describe differences in IMT in treated and untreated FH patients versus unaffected controls over a broad age range. We conducted a systematic literature search using MEDLINE, EMBASE and Trials.gov up to April 2020 for studies addressing IMT in FH patients and controls. Our search yielded 558 articles of which 42 (6,143 participants) were included. Meta-analysis showed a mean (95%CI) difference between FH patients vs controls of 0.11 (95%CI 0.06-0.15) mm in carotid IMT (p<0.001), and 0.47 (0.19-0.74) mm in femoral IMT (p <0.001). We found a smaller mean (95%CI) difference in carotid IMT in treated FH patients vs controls: 0.05 (0.03-0.08) mm (p <0.001), than in untreated FH patients vs controls 0.12 (0.03-0.21) mm (p=0.009). When plotted against age, the mean (95%CI) difference in carotid IMT between FH patients vs controls increases with 0.0018 (-0.0007-0.0042) mm/year. This increase was smaller in treated vs untreated FH patients, when compared to controls (0.0023 (0.0021 to 0.0025) mm/year vs 0.0104 (0.0100-0.0108) mm/year, respectively). Our findings suggest that more robust earlier treatment initiation and achieving treatment targets could be beneficial to reduce cardiovascular risk in patients with FH.     

The effects of butterbur on the histamine and allergen cutaneous response.

BACKGROUND: Butterbur or Petasites hybridus is an herbal remedy that exhibits antihistamine and antileukotriene activity and has been shown to attenuate the response to adenosine monophosphate challenge in patients with allergic rhinitis and asthma. However, no data are available regarding its effects on the histamine and allergen cutaneous response. OBJECTIVE: To evaluate the effects of butterbur compared with fexofenadine and montelukast on the histamine and allergen wheal and flare cutaneous responses. METHODS: Atopic patients were randomized into a double-blind, double-dummy, crossover study to receive for 1 week butterbur, 50 mg twice daily (8 AM and 10 PM); fexofenadine, 180 mg once daily (10 PM), and placebo once daily (8 AM); montelukast, 10 mg once daily (10 PM), and placebo once daily (8 AM); or placebo twice daily (8 AM and 10 PM). Patients attended the department at 10 AM and had measurements of the cutaneous wheal and flare responses to histamine, allergen, and saline control at 10-minute intervals for 60 minutes. RESULTS: Twenty patients completed the study. The mean +/- SE histamine wheal and flare responses, respectively, were significantly attenuated (P < .05) by fexofenadine (9.4 +/- 1.8 mm2 and 13.5 +/- 3.2 mm2) compared with placebo (15.5 +/- 3.3 mm2 and 179.8 +/- 74.3 mm2) but not by butterbur (16.4 +/- 2.1 mm2 and 297.7 +/- 121.2 mm2) or montelukast (19 +/- 1.9 mm2 and 240.2 +/- 66.6 mm2). The allergen wheal and flare responses, respectively, were also significantly attenuated (P < .05) by fexofenadine (31.1 +/- 6.3 mm2 and 256.9 +/- 86.5 mm2) compared with placebo (65.4 +/- 15.2 mm2 and 1,014.5 +/- 250.0 mm2) but not by butterbur (50.4 +/- 9.2 mm2 and 1,110.3 +/- 256.1 mm2) or montelukast (58.8 +/- 9.1 mm2 and 1,463.6 +/- 295.6 mm2). CONCLUSIONS: Butterbur did not produce any significant effects on the histamine and allergen cutaneous response compared with placebo, whereas mediator antagonism with fexofenadine but not montelukast produced significant attenuation. This finding would suggest that butterbur may not be effective in allergic skin disease.     

Family history influences age of onset in bipolar I disorder in females but not in males.

Age of onset (AO) has been proposed as a promising criterion by which to select homogeneous subgroups for the genetic analysis of bipolar disorder. This is the first study to investigate the effect of the interaction between gender and family history (FH)-type on AO in bipolar disorder. In accordance with the literature, no difference in AO was observed between females and males in our sample of 264 Romanian bipolar I probands. Cox regression, however, showed a strong influence of FH-type on AO (P = 0.006). This was due to a significant variation in AO according to the type of FH in females (P = 0.002) but not in males (P = 0.64). Female bipolar disorder patients with a negative FH (FH(-)) had a later AO than females with either a FH of bipolar and/or schizoaffective disorder (P = 0.001) or a FH of recurrent unipolar major depression only (P = 0.04). Females with FH(-) had a later AO than males with FH(-) (P = 0.03). No sex difference was observed for AO in the group with a FH of recurrent unipolar depression. In the group with a FH of bipolar and/or schizoaffective disorder, females had an earlier AO than males (P = 0.01). A trend for support was observed in an independent sample of 217 German bipolar I patients for an influence of FH-type on AO in females (P = 0.09) but not in males (P = 0.15). Female bipolar disorder patients with FH(-) had a later AO than females with either a FH of bipolar and/or schizoaffective disorder (P = 0.04) or a FH of recurrent unipolar major depression only (P = 0.05). Females with FH(-) had a later AO than males with FH(-) (P = 0.05). Other comparisons were statistically not significant, which may be due to limited sample size. Our findings emphasize that the interaction between gender and FH-type is a source of heterogeneity for AO in bipolar disorder.     

In vitro and in vivo behaviour of Ca- and P-enriched anodized titanium.

The influence of different surface preparations on titanium biocompatibility and bone integration was evaluated. Commercially grade 2 titanium rods (diameter 2 mm, length: 3 mm), vacuum annealed and hydrofluoric acid etched was selected for its promising surface characteristics to achieve good direct osseointegration. Some rods were surface modified by Anodic Spark Discharge anodization and a thin layer (approximately 5 microm) of amorphous TiO2 containing Ca and P (Ti/AM) was obtained. Some of the Ti/AM specimens underwent a further hydrothermal treatment to produce a thin outermost layer (approximately 1 microm) of hydroxyapatite (Ti/AM/HA). Cytotoxicity tests (direct contact: ISO 10993-5) showed good cytocompatibility for all tested samples. Ti and tissue culture substrate + DMEM control, respectively, were associated with a significant higher proportion of attached cells than Ti/AM and Ti/AM/HA (P < 0.0005), but this was in the normal range of 10-20% of unattached cells for cytocompatible materials. Histomorphometric analysis conducted on samples inserted in the cancellous bone of distal femoral epiphysis of Sprague-Dawley rats gave the following results at 4 and 8 weeks: Affinity index (AI%) data proving the surface osteconductive properties of non-anodized acid etched Ti (AI-4 weeks: 67.1 +/- 17.0%; AI-8 weeks: 74.8 +/- 11.5%). Ti/AM samples showed the lowest values (AI-4 weeks: 45.8 +/- 15.9%; AI-8 weeks: 68.5 +/- 13.6%) while the best performances of the Ti/AM/HA samples (AI-4 weeks: 60.4 +/- 21.8%; AI-8 weeks: 79.5 + 9.37%) indicated that hydroxyapatite allowed a higher bone to implant contact respect to Ti only. Further investigations should be performed in order to better understand the mechanism of observed in vitro behaviour and to achieve information on long-term osseointegration process.     

Influence of LDL receptor gene mutations and the R3500Q mutation of the apoB gene on lipoprotein phenotype of familial hypercholesterolemic patients from a South European population

Few data are available on genotype-phenotype interactions among familial hypercholesterolemia (FH) patients in South European populations and there are no data about the influence of R3500Q mutation on lipoprotein phenotype compared to low-density lipoprotein receptor (LDLR) mutations. The objective of the study is to analyze the influence of mutations in the LDLR and apolipoprotein B (apoB) genes on lipoprotein phenotype among subjects clinically diagnosed of FH living in East Spain. In all, 113 FH index patients and 100 affected relatives were studied. Genetic diagnosis was carried out following a protocol based on Southern blot and PCR-SSCP analysis. A total of 118 FH subjects could be classified into three groups according to the type of LDLR mutations (null mutations, missense mutations affecting the ligand binding 3-5 repeat, and missense mutations outside this domain). In addition, the lipoprotein phenotype of these FH groups was compared with 19 heterozygous subjects with familial ligand-defective apoB (FDB), due to R3500Q mutation. FH patients carrying missense mutations affecting the ligand binding repeat 3-5 showed total and LDL cholesterol levels significantly higher than FH patients with missense mutations in other LDLR domains or FDB patients. FH subjects carrying null mutations showed lower high-density lipoprotein cholesterol plasma values compared to FH carrying missense mutations. FDB subjects showed the lowest total and LDL cholesterol plasma values. In conclusion, the type of LDLR gene mutation and R3500Q mutation influences the lipoprotein phenotype of FH population from East Spain.     

High social anxiety and low aggression in Fawn-Hooded rats

The Fawn-Hooded (FH) rat strain, with well-documented changes in their serotonergic and noradrenergic systems, is a putative genetic model for some neuropsychiatric disorders like depression, alcohol abuse, and anxiety. Because social phobia frequently occurs in combination with these disorders and there are no social anxiety-related data in FH rats in the literature, we measured the behavior of FH rats in the social interaction test. In addition, the effects of the anxiogenic Serotonin-2C (5-HT2C) receptor agonist, m-chlorophenylpiperazine (m-CPP), were studied. Male FH, Wistar (W), and Sprague-Dawley (SD) rats were used in two different test conditions of the social interaction test: the high light, unfamiliar arena, associated with high anxiety, and the low light, familiar arena, associated with low anxiety-like behavior. All social behaviors were markedly diminished in FH rats that suggested higher anxiety in these animals. Total social interaction time was reduced by 60-70% in FH rats compared either to W or SD rats under high light, unfamiliar or low light, familiar conditions, respectively. Aggressive behavior was reduced at least by 85% in FH rats. Locomotor activity and exploratory behavior were only minimally, in most comparisons, not significantly affected in FH rats. Total social interaction time, aggression, and locomotor activity were decreased, and self-grooming increased by m-CPP (0.5 mg/kg, ip) in all three strains. m-CPP decreased total social interaction time thus, caused anxiety most efficiently in FH rats (reduced by 69%, 50%, and 55% in FH, W, and SD rats, respectively), but other effects of the drug were similar in the three strains. Our studies provide evidence that the FH rat strain may be a genetic model of social phobia or other anxiety disorders with impaired social behavior.     

建立下肢形态学数据库为匹配术后即装假肢提供参考

文题释义： 术后假肢：现代截肢康复的方法包括手术后安装临时假体，即在完成截肢手术后，医生为患者佩戴合适的临时假体。 大腿影像数据：研究采集的大腿数据包括膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm处周径和膝上缘15 cm处周径，将大腿MRI数据导入3D重建软件，得到大腿截肢范围段表面积、体积。 大腿截肢范围段：为膝关节间隙上10-25 cm。 背景：目前假肢的制作是通过取型、修型、成型3个步骤完成的，由于修型过程是人工完成，与临床技师的经验技术密切相关，制作出来的假肢不美观，接受腔与残肢很难做到全接触。 目的：收集健康志愿者大腿MRI影像数据，评估成人大腿截肢范围段(膝关节间隙上10-25 cm)的对称性；将MRI影像数据建立成数据库，为下肢截肢患者匹配合适的术后即装假肢提供参考数据。 方法：招募40名健康志愿者，采集基本信息：年龄、身高、体质量、膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm处周径和膝上缘15 cm处周径。所有志愿者对试验方案均知情同意，且得到医院伦理委员会批准。对大腿截肢范围进行三维重建，以模型的表面积、体积为参数，对每一例志愿者大腿进行解剖测量，利用三维逆向工程软件对测量结果进行3D偏差分析，完成大腿形态对称性的定量化和可视化分析。 结果与结论：①同体分析：同一个体左右大腿截肢范围段表面积之间的最大百分差异比不超过0.56%(P=0.109)；左右大腿截肢范围段体积之间最大百分差异比不超过1.19%(P=0.182)；三维偏差分析结果显示，最大平均负偏差为-1.47 mm，最大平均正偏差为1.14 mm。40例受试者的3D偏差分布78.02%在2 mm以内，20.97%在2.1-3.0 mm，仅1.01%大于3 mm。②异体分析：三维偏差分析结果显示，最大平均负偏差为-1.97 mm，而最大平均正偏差为1.89 mm。③提示成人双侧大腿截肢范围具有高度的解剖学对称性；当2名成人的膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm周径和膝上缘15 cm处周径分别都相差在2 cm以内时，则认为这2名成人双侧大腿截肢范围段表面轮廓具有高度相似性，与性别、身高和体质量无关。 ORCID: 0000-0001-6838-3042(伍笑棋) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程     

TaqIB polymorphism in CETP gene: the influence on incidence of cardiovascular disease in statin-treated patients with familial hypercholesterolemia

The effects of TaqI restriction fragment length polymorphism of the CETP gene on the occurrence of cardiovascular disease (CVD) events were investigated in patients with familial hypercholesterolemia (FH). A total of 300 FH patients, of which 116 (39%) had CVD at the start of the study, were treated with statins during a mean period of 8.5 years. The distribution of Taq1B genotypes was 31% B1B1, 49% B1B2, and 20% B2B2. No differences were found at baseline between the three genotypes, except for an association of the B1 allele with lower high-density lipoprotein (HDL)-cholesterol levels (P=0.003). All patients were put on statins within 6-8 weeks after the first visit; about 60% received simvastatin (20-40 mg daily) and 40% either pravastatin (40 mg daily) or atorvastatin (20-40 mg daily). The different statin treatments were similar for all groups. The mean change of plasma HDL-cholesterol, low-density lipoprotein-cholesterol, and triglyceride concentration during statin therapy was similar for the three genotypes. During follow-up, new CVD events were recorded in 22 (37%) of the B2B2 patients (n=59) and in 67 (28%) of B1 allele carriers (n=241) (P=0.36). The relative risk for CVD events, after adjustment for age, gender, and CVD at intake, was 1.8 (CI: 1.1-3.0) for B2B2 carriers compared to B1 allele carriers. The Taq1B polymorphism is a significant predictor of future CVD events in statin-treated patients with FH. In spite of similar improvement of the lipoprotein profile during statin therapy, our FH patients with the B2B2 genotype may have a higher CVD risk in comparison with the B1 allele carriers.     

Evaluation of the mental foramen and accessory mental foramen in Turkish patients using cone-beam computed tomography images reconstructed from a volumetric rendering program

This study determined the occurrence and location of the mental foramen (MF) and accessory mental foramen (AMF) in Turkish patients using cone-beam computed-tomography (CBCT) with 3D-imaging software. CBCT scans of 386 sites in 193 (92 male, 101 female) patients were retrospectively analyzed to determine MF and AMF occurrence, sizes, and locations. Digital imaging and communications in medicine (DICOM) data were transferred to surface-rendering software to generate 3D images. Distances between the MF and AMF and from both foramina to the alveolar ridge and to the closest tooth were measured. Differences in AMF incidence by sex, side, and location were evaluated using chi-squared tests, and MF and AMF measurements were evaluated using Mann-Whitney U-tests. AMFs were observed in 6.5% of patients and were most commonly in an anteroinferior location. Mean AMF size did not differ significantly by sex or side [males: horizontal = 1.5 mm (1.0-2.4 mm), vertical = 1.4 mm (0.8-2.4 mm); females: horizontal = 1.5 mm (0.8-3 mm), vertical = 1.3 mm (0.8-2.1 mm); P > 0.05]. Males showed significantly greater mean vertical and horizontal MF dimensions compared with females [males: horizontal = 3.9 mm (1.0-7.0 mm), vertical = 3.6 mm (1.2-7.0 mm); females: horizontal = 3.5 mm (1.3-5.6 mm), vertical = 3.3 mm (0.8-5.8 mm); P < 0.05]. Awareness of the AMF is important to avoid mental nerve damage during surgical intervention and anesthetic applications. CBCT is useful for AMF detection, distributes less ionizing radiation, and allows 3D imaging.