Seniors Walk Away From Sedentary Life

Here is a list of 22 organizations that provide outlets for people who want to get active. It's only a sample of what's available, but it's a place to start.     

心血管病介入诊疗程序中第一术者有效剂量估算方法的比较研究

目的 通过模拟实验测量,比较国际辐射防护委员会（ICRP）139号报告推荐的4种单双剂量计算法对估算心血管介入诊疗程序中第一术者有效剂量之间的差异,以探讨这4种算法对介入诊疗场景的适用性。方法 模拟第一术者的男性躯干模体穿戴铅衣和铅围脖,在其体内布放热释光探测器,在其铅衣内外布放热释光个人剂量计,模拟心血管病介入诊疗场景,通过模拟测量得到的器官剂量计算第一术者的有效剂量,与通过个人剂量计及4种单双剂量计算法得到的结果进行比较。结果 在本实验条件下,由模拟测量计算得到的有效剂量为0.581 mSv;而用Swiss ordinance法、McEwan法、Von Boetticher法与Martin-Magee法估算得到的有效剂量分别为0.667、0.484、0.485和0.726 mSv,与模拟测量得到的有效剂量的相对偏差分别为14.8%、-16.7%、-16.5%和24.9%。结论 4种计算方法得到第一术者有效剂量与模拟测量结果均有较大的差异;从辐射防护观点出发,推荐使用Swiss ordinance法开展心血管病介入诊疗程序中第一术者的个人剂量监测。     

ACTH-independent Cushing's syndrome due to bilateral adrenocortical adenoma: A case report

The chronic excess of glucocorticoids results in Cushing''s syndrome. Cushing''s syndrome presents with a variety of signs and symptoms including: central obesity, proximal muscle weakness, fatigue striae, poor wound healing, amenorrhea, and others.ACTHindependent Cushing''s syndrome is usually due to unilateral adenoma. A rare cause of it is bilateral adrenal adenomas.In this paper we report a case of a 43-year-old woman with Cushing''s syndrome due to bilateral adrenal adenoma.     

Sister Marie Joseph nodule and Krükenberg's tumor: rare association revealing a gastric adenocarcinoma

It was about a 61-year-old patient who presented an indurated and painless umbilical swelling surrounded by ulcerated plaque and an abdominal arch progressing for 8 months. Abdomino-pelvic ultrasound and abdominal-pelvic CT scan revealed in right ovarian the presence of a mass with a cystic''s tissue, a thickness with a subcutaneous infiltration of the umbilical region and the diffuse infiltration of gastric parietal mesenteric fat. Histology of the ovarian mass confirmed Krükenberg''s tumor and that of the Sister Marie-Joseph''s nodule confirmed umbilical skin metastasis. The primary was a well differentiated gastric adenocarcinoma. The death occurred after the first chemotherapy treatment. The association of Krükenberg''s tumor with Sister Marie-Joseph''s nodule, rare and unusual, has been revealing of a gastric adenocarcinoma which up to now was unknown and asymptomatic.     

Pacemaker implantation in a patient with a Behçet's disease associated with superior vena cava obstruction

A 65-year-old man with Behçet's disease developed transient complete A-V block with syncope. An attempt to implant a permanent transvenous endocardial electrode failed owing to obstructions in the subclavian, innominate, and superior vena cava veins demonstrated by angiography. Sutureless epicardial electrodes were successfully implanted through a subxyphoid approach. Obstruction in the great veins is a common feature in patients with Behçet's disease. We suggest that patients with this disorder, who require a permanent pacemaker, should be investigated by angiography prior to implant to rule out obstruction in the upper great veins.     

Ultrasound and Doppler findings in a rare case of Castleman's disease of the parotid

Castleman''s disease of the parotid gland is an extremely rare entity, with fewer than 20 cases reported in world literature so far and only 1 previous case report describing the ultrasound findings. The Doppler findings of parotid Castleman''s disease have never been described before to the best of the authors'' knowledge. This report describes the ultrasonographic and Doppler findings in a histopathologically proven case of Castleman''s disease of the left parotid gland in a young man.     

Skene's glands abscess an overlooked diagnosis in acute lower urinary symptoms

Skenitis refers to the infection of the Skene''s glands. Skene''s glands are paraurethral glands localized on the upper wall of the vagina. The diagnosis of Skene''s glands abscess or infection is usually made based on the history and physical examination, but half of women with para-urethral gland symptoms present with non-palpable lesions and necessitate further evaluation with imaging. Patients may present with chronic urethral pain, recurrent urinary tract infections, unexplained dyspareunia, and dysuria. At imaging Skene''s glands are typically located on the anterior vaginal wall, at symphysis level and paramedian to urethra. Clinicians should consider Skenitis in the differential diagnosis of lower urinary tract symptoms. We report a case of a 48-year-old woman with acute lower urinary tract symptoms with a final diagnosis of Skene''s glands abscess.     

Radiographic enlargement of mandibular canal as first feature of non-Hodgkin's lymphoma

Non-Hodgkin''s lymphoma has the propensity to affect non-lymphoid tissue including oral tissue. Primary non-Hodgkin''s lymphoma of the mandible mistreated as chronic periodontitis with diffuse enlargement of the mandibular canal and ice-cold numbness is very rarely described in English medical literature. A 57-year-old patient presented with a painful swelling on the left side of the mandible with a clinically chronic periodontitis associated with ice-cold numbness. A panoramic radiograph showed a diffuse uniform enlargement of the mandibular canal. Histological examination showed that the lesion was a primary intraosseous non-Hodgkin''s lymphoma of the mandible. Immunohistochemical examination showed a positive reaction for CD20+, Ki-67+. Seven months after chemotherapy the patient was observed for possible life-threatening propagation of the disease. In conclusion, primary (extra-nodal) non-Hodgkin''s lymphoma of the mandible usually clinically presents with bone swelling, teeth mobility and neurological disturbance. Radiographic features presenting as diffuse enlargement of the mandibular canal could be considered as non-Hodgkin''s lymphoma.     

Change of heart: Reverse takotsubo's cardiomyopathy – A case report

Reverse takotsubo's cardiomyopathy is a rare and relatively unknown variant of takotsubo's cardiomyopathy, also known as stress cardiomyopathy or broken heart syndrome. There are significant differences in the patient age and clinical profiles between classic and reverse takotsubo's cardiomyopathy. Classic takotsubo's cardiomyopathy has been extensively described. However, the little described literature related to reverse takotsubo's cardiomyopathy is limited to the cardiology speciality, with a relative paucity described in radiology. We describe a case report of a 73 year-old female who was diagnosed with reverse takotsubo's cardiomyopathy on the basis of Cardiac MRI. Herein, we hope to bring more awareness of this condition and describe its features on MRI.     

Radiological changes in the formation of Brodie's abscess by sequential magnetic resonance imaging: a case report

Brodie''s abscess is a relatively rare subacute form of osteomyelitis. Early diagnosis is challenging because of its insidious onset and vague symptoms. Magnetic resonance imaging is helpful in the diagnosis of Brodie''s abscess; however, to date, no study has described the imaging findings of this disease in the early stage. Here, we present the case of a 14 year-old boy with Brodie''s abscess in the proximal tibia. The lesion initially presented as a bone marrow edema in the proximal metaphysis of the left tibia on MRI and was misinterpreted as a bone bruise. Further radiological examination was performed 1 month later; this revealed the formation of an abscess cavity, which suggested Brodie''s abscess. The patient was referred to our hospital and underwent curettage and debridement, which led to the definitive diagnosis of Brodie''s abscess on histopathological findings and bacterial culture. On careful retrospective evaluation, the initial radiological findings suggested a microabscess on the metaphyseal side of the growth plate and bone marrow edema spreading from the lesion to the epiphysis. These radiological changes could be reliable evidence proving that the metaphyseal side of the growth plate is the origin of Brodie''s abscess. Moreover, bone marrow edema with suspected microabscess in the metaphysis of the long bones can be the initial stage of the formation of Brodie''s abscess and should be carefully followed up.     

Accuracy of estimation of dental age in comparison with chronological age in Indian population – A comparative analysis of two formulas

Demirjian's 8-teeth method widens the assessment in a wider age group, in comparison with the original 7-teeth method.Aim and objectiveEvaluate age in children, adolescents and young adults using Demirjian's 8-Teeth Method in an Indian population. Compare the effectiveness of existing Demirjian's formula with that of the Indian formula.Materials and methodPanoramic radiographs of 50 male and 50 female patients aged between 5 and 24 years were collected. The radiographs were interpreted using Demirjian's 8-teeth method and the dental age calculated using Demirjian's formula and the Indian formula. Both the formula's were compared using paired 't' test (SPSS Statistics 11.5).ResultsAmong the 100 samples the mean chronological age in 50 males was 13.44 years and mean chronological age in 50 females was 13.12 years. By using Demirjian's formula the mean dental age in male was 11.81 years and that in female was 11.58 years. By using Indian Formula the mean dental age in male was 13.54 years and that in female was 14.06 years. The mean dental age by both the formulas were compared with the corresponding chronological age. It was evaluated that the Demirjian's formula underestimated the mean dental age by 1.63 years in males and by 1.54 years in females, whereas a variation of 0.10 years in male and 0.94 years in female was found with the Indian formula. The mean dental age obtained using Indian formula was approximating with the chronological age in the male and female by a margin of 0.94 years.ConclusionAcharya's Indian formula is more effective in evaluating the dental age closer to the chronological age of an individual in an Indian population in comparison with the existing Demirjian's formula.     

Colorectal leiomyosarcoma: A case report

Leiomyosarcomas are rare aggressive smooth muscle tumors that represent 0.1% of all colorectal malignancies. The lack of literature available concerning leiomyosarcomas presents a challenge when diagnosing and treating these tumors, thus it is crucial that we differentiate them from gastrointestinal stromal tumors (GIST), the most common type of mesenchymal neoplasms of the gastrointestinal (GI) tract, especially when considering leiomyosarcoma''s high prevalence of recurrence and malignancy. In this article, we present a case of a 74-year-old male with a diagnosis of colonic leiomyosarcoma. We analyze the tumor''s CT imaging findings as well as correlation with the patient''s pathological findings including immunostains, size, and mitotic activity, as well as the patient''s risk for recurrence.     

三种双剂量计法估算介入术者有效剂量比较

目的 比较3种双剂量计算法估算介入术者有效剂量的优劣。方法 在仿真人体模内布放热释光剂量片并将体模置于介入术者位置,在体模外穿戴铅防护衣、铅围脖和铅帽,并在铅衣内左前胸和铅围脖外左侧放置个人剂量计,在手术台上放置散射模体,分别为CIRS放疗调强体模和CT剂量检测模体,模拟介入手术曝光条件曝光一定时间,通过器官组织吸收剂量估算有效剂量;以3种双剂量计法计算有效剂量并与体模法结果进行比较。结果 得到两组各4个有效剂量结果,即使用CIRS放疗调强体模时,体模法、NCRP法、Niklason法和Boetticher法分别为0.138、0.097、0.161和0.173 mSv;使用CT剂量检测模体时分别为0.018、0.013、0.019和0.026 mSv。其中,Niklason法与体模法最为接近。结论 对于估算介入术者的有效剂量,Niklason法更为准确和实用。     

MR appearance of the internal architecture of Ammon's horn.

PURPOSETo determine whether the four subdivisions of Ammon''s horn and six layers of CA1 seen histologically can be demonstrated with MR imaging.METHODSSpecimens of cadaver brains were imaged in a 3.0-T MR imager with a 3.0-cm solenoid coil. The specimens were sectioned, stained, and examined histologically. On anatomic sections, the four subdivisions of Ammon''s horn and six layers of CA1 were identified. The MR images were then compared with the anatomic sections.RESULTSUsing geographic characteristics, we identified the four subdivisions of Ammon''s horn. In CA1, the six layers could be identified by variations in signal intensity, width, and location.CONCLUSIONThis study suggests that, with MR imaging of sufficiently high resolution, the internal architecture of Ammon''s horn may be identified.     

Leigh's disease,a fatal finding in the common world: A case report

Leigh syndrome is a neurodegenerative mitochondrial disorder of childhood characterized by symmetrical spongiform lesions in the brain. The clinical presentation of Leigh''s syndrome can vary significantly. However, in the majority of cases, it usually presents as a progressive neurological disease involving motor and cognitive development. It is common to see signs and symptoms of the midbrain and brainstem involvement. Limited data are present on the brain processes occurring in Leigh''s syndrome which can be attributed to fatal respiratory failure. Raised lactate levels in the blood and/or cerebrospinal fluid are noted. Magnetic resonance imaging (MRI) findings such as necrotic, symmetrical lesions in the BG/brain stem are helpful in arriving at the diagnosis of Leigh''s syndrome. It''s of utmost importance to determine whether fatal respiratory failure can be predicted based on clinical characteristics and findings on MRI. In our report, we presented 3 cases from rural India, including a 2-year-old male child presenting with UMN lesion signs, a 3-month-old female infant with delayed developmental milestones with lab results suggestive of Leigh''s disease, and a 12-year-old female child with epistaxis and generalized weakness. As discussed above, all 3 cases presented differently with a variety of signs and symptoms and would have gone undiagnosed without the use of brain imaging. The study concluded with the impression that while MRI is essential to the initial diagnosis of Leigh''s disease, MRI alone cannot be used to predict fatal respiratory failure in patients with Leigh''s disease. In any dilemma regarding diagnosis even with MRI, molecular studies remain the gold standard.     

Manifestaciones radiológicas del síndrome de Baastrup en la edad pediátrica

Baastrup's disease is not usually considered among the possible causes of low back pain in children. Classically, Baastrup's disease is characterized by degenerative phenomena secondary to friction between adjacent spinous processes, with sclerosis of the margins and decrease in the interspinous space. Baastrup's disease becomes more prevalent with age and is usually accompanied by degenerative changes in the vertebral column, such as lumbar facet hypertrophy or disc disease. Certain activities like dance or gymnastics can make Baastrup's disease more likely to appear at an earlier age. In children, Baastrup's disease can manifest in a different way, with increased interspinous spaces and bone remodeling.     

Fahr's disease with an atypical onset of epileptic seizure

Fahr''s disease is a rare neurodegenerative disorder first described by Karl Theodor in 1930, defined by abnormal calcified deposits in the basal ganglia and cerebral cortex. Fahr''s disease commonly affects young to middle-aged adults with various clinical presentations, including endocrinologic, dermatologic, and neurologic problems, with extrapyramidal symptoms being the most common manifestation. In this case report, we present a case of an epileptic seizure as the first manifestation of Fahr''s disease in a 45-year-old male.     

Ludwig's angina: An alarming radiology challenge

Ludwig''s angina is a cellulitis that affects the submandibular, sublingual, and submental regions, fast-spreading along the fascial plane. Ludwig''s angina has been classified as a fast-moving, frequently fatal gangrenous cellulitis or necrotizing fasciitis of the neck and mouth floor over the previous 2 centuries. A 60-years old male patient came with a chief complaint of swelling and pain in the neck that radiated to the chest with fever, headache, nausea, and history of toothache, poor oral hygiene, and diabetes mellitus. Ludwig''s angina with mediastinitis complication was established by a computed tomography (CT) scan, which was promptly treated and he recovered completely. Imaging is used as one of the tools to help physicians diagnose Ludwig''s angina. A trained, multidisciplinary team is required for the treatment of Ludwig''s angina because it involves surgical and antibiotic treatment and also resuscitation. A more accurate and timely diagnosis can lead to a better prognosis. In an emergency, a CT scan may be the best imaging choice, although magnetic resonance imaging is superior to a CT scan since it evaluates soft tissue and compartment involvement better.