Comparison of microscopic and endoscopic view of the internal acoustic meatus: A cadaveric study

The endoscope is thought to provide an improved exposure of the internal acoustic meatus after retrosigmoid craniotomy for microsurgical resection of intrameatal tumors. The aim of this study is to quantify the differences in internal acoustic meatus (IAM) exposure comparing microscopic and endoscopic visualization. A retrosigmoid approach was performed on 5 cadaver heads. A millimeter gauge was introduced into the internal acoustic meatus, and examinations with a surgical microscope and 0°, 30° and 70° rigid endoscopes were performed. The extent of IAM depth visualized with the microscope and the different angled endoscopes were analyzed. The microscopic view allowed an average IAM depth visualization of 2.8 mm. The endoscope allowed an improved exposure of IAM in all cases. The 0°, 30° and 70° endoscopes permitted an exposure that was respectively 96% (5.5 mm), 139% (6.7 mm) and 200% (8.4 mm) more lateral than the microscopic view. Angled optics, however, provided an image distortion, specifically the 70° endoscope. The endoscope provides a superior visualization of the IAM compared to the microscope when using a retrosigmoid approach. The 30° endoscope represented an ideal compromise of superior visualization with marginal image distortion. Additional implementation of the endoscope into microsurgery of intrameatal tumors likely facilitates complete tumor removal and might spare facial and vestibulocochlear function. Clin. Anat. 31:398–403, 2018. © 2017 Wiley Periodicals, Inc.     

Utility of F-18 fluorodeoxyglucose pos?tron em?ss?on tomography/computed ?n carc?noma of unknown primary

Carcinoma of unknown primary (CUP) is a heterogeneous group of tumors with various clinical features causing diagnostic and therapeutic challenges. The aim of this study was to evaluate the ability of F-18 FDG PET/CT for localizing the primary tumor, disclosing additional metastases, and changing the treatment in patients with CUP. One hundred and twelve metastatic patients (female = 40, male = 72, median age = 60.5 years) in whom conventional diagnostic work-up failed to disclose the primary tumor were included in the study. F-18 FDG PET/CT imaging was performed in a standard protocol (patient supine, arms on patient’s side, vertex to thigh, 369.3 MBq (296-444 MBq) F-18 FDG, a 60-minute uptake period, 6-7 bed position). Histopathology was taken as the only reference standard. F-18 FDG PET/CT correctly detected primary tumor in 37 of 112 (33.03%) patients. The most common site of primary tumor detected by F-18 FDG PET/CT was lung (n = 18), which was followed by nasopharynx (n = 7), pancreas (n = 5), tonsil (n = 2), breast (n = 2), thyroid (n = 1), uterus (n = 1) and colon/rectum (n = 1). F-18 FDG PET/CT imaging disclosed additional previously undetected metastases in 32 (28.5%) and changed the treatment in 33 (29.4%) of 112 patients. There were false positive F-18 FDG PET/CT results in 21 (18.5%) patients. F-18 FDG PET/CT is able to disclose the primary tumor, disclose new metatases and change the treatment in about one third of patients with CUP.     

Extensive Tuberculous Lymphadenitis Mimicking Distant Lymph Node Metastasis on F-18FDG PET/CT in a Patient with a History of Malignant Melanoma

18-Fluoredeoxyglucose position emission tomography and computed tomography (F-18FDG PET/CT) scanning has been useful in the evaluation of malignant disorders and has been extensively used in cancer screening.1 However, F-18FDG uptake was not found to be specific for cancer diagnosis. Here, we describe increased F-18FDG uptake on PET/CT caused by extensive tuberculous lymphadenitis in a 62-year-old woman with malignant melanoma.     

Structure of the external auditory meatus of the Bowhead whale (Balaena mysticetus) and its relation to their seasonal migration

The external auditory meatus (EAM) in many species of mysticete whales is filled with a waxy ear plug. Though this lamellated structure is often used to age a whale, its formation and development remain undescribed. It is thought that growth layer groups (GLGs) are laid down annually, thereby increasing the size of this structure. Since some mysticete whales are migratory and many undergo molting, we hypothesized that the cyclical production of these GLGs may be related to these processes. The epithelia of both EAM and glove finger (a part of the tympanic membrane protruding into the EAM) of one juvenile and multiple adult bowhead whales from both fall (October: non‐molting) and spring (May: molting) seasons were dissected and examined anatomically and histologically. These tissue samples were compared with the adult oral epithelia at the same time periods. These epithelia shared a similar basic broad structure, though there were differences in thickness and presence of intraepithelial structures. All epithelia in the October specimens were rich in both glycogen and lipid. The parakeratinized epithelium of the oral cavity in the juvenile and some May specimens shed via the production of several superficial epithelial fissures. Other adult May specimens exhibited deep epithelial fissures, reminiscent of pressure ulcers, which would cause the detachment of the entire epithelium from the dermis. We propose that sloughed epithelial lining is the source of the GLGs in the ear plug. Correlating a potential molting sequence with these observations explained the presence of epidermal glycogen, deep epidermal fissures and dermal glycolipid, and to some extent calls into question the origin and structure of the ear plug itself. Further morphological characterization of ear plugs in bowheads is needed to better understand cell origin and ear plug formation.     

18F-FDG PET/CT与CT诊断胃癌淋巴结转移直接比较的系统评价

目的 采用Meta分析和直接比较方法系统评价18F-FDG PET/CT与CT对胃癌淋巴结转移的诊断价值.方法 使用计算机系统检索中国期刊全文数据库、中文科技期刊数据库、万方数据库、PubMed、Embase、The Cochrane Library,从建库至2016年11月,搜索直接比较18F-FDG PET/CT与CT诊断胃癌淋巴结转移的诊断性比较试验.用Meta-Disc1.4软件进行分析,计算两种影像学诊断方法的合并灵敏度(sensitivity,SEN)、合并特异性(specificity,SPE)、合并阳性似然比(positive likelihood ratio,+LR)、合并阴性似然比(negative likelihood ratio,-LR),诊断优势比(diagnostic OR,DOR),并绘制SROC (summary receiver operating characteristic)曲线,计算曲线下面积(area under curve,AUG).结果 最终共纳入9篇文章,Meta分析结果显示,18F-FDG PET/CT对胃癌淋巴结转移诊断的合并SEN为0.51(95％ CI =0.47～0.55),合并SPE为0.92(95％ CI =0.89 ～0.94),合并+LR为5.77(95％ CI =4.38 ～7.59),合并-LR为0.54(95％ CI =0.45 ～0.64),DOR为12.71(95％ CI =8.97～ 18.01),AUC为0.8101.CT诊断的合并SEN为0.71(95％ CI=0.67～ 0.74),合并SPE为0.82(95％ CI =0.78 ～0.84),合并+LR为3.52(95％ CI=2.52 ～4.93),合并-LR为0.37(95％CI=0.32～0.44),DOR为10.73(95％ CI =7.35 ～ 15.66),AUC为0.8176.结论 18F-FDG PET/CT显像诊断胃癌淋巴结转移的灵敏度比CT低,但其特异性较好,有更高的诊断价值,可作为胃癌淋巴结转移的临床诊断方法之一.     

The role of desmosomes in the ear plug formation in the bowhead whale (Balaena mysticetus)

The external acoustic meatus (EAM) of most baleen whales accumulates cellular debris annually in the lumen as whales age, forming a lamellated ear plug. The bowhead whale ear plug is formed from annually molting lining of the EAM as the entire epithelium releases at the level of the stratum basale during the spring migration. Epithelial regeneration is mostly completed by the fall migration, remaining intact for 6–7 months before being torn off the following spring. Desmosomes are integral to cell–cell adhesion with connecting desmosomal cadherins desmoglein (dsg) and desmocollin (dsc). Paraffin sections of the oral cavity and EAM lining of spring and fall adult bowhead whales, as well as the EAM of spring-caught juvenile, were immunohistochemically examined for the presence of these cadherins. In all fall specimens, both cadherins occurred in all layers except the superficial keratinous layer of the oral cavity. In spring, three different conditions existed: (a) oral cavity of spring-caught adults had reduced cadherins, with superficial fissuring in its keratinized layer and vacuolation in the upper stratum spinosum; (b) EAM of juvenile spring-caught whales displayed fissuring with accompanying reduction of both cadherins in its superficial lining; and (c) EAM lining of spring-caught adults displayed deep fissures, reduced cadherins, and absence of dsc1 in the fissuring zone. These results suggest that shedding of skin layers in mammals, whether normal molting, pathological, or the result of injury and wound repair all revolve around desmosome function. The specific role, structure, and location of these two cadherins need to be further addressed.     

Basal cell adenoma of nasal septum: report of a case and review of literature

Basal cell adenoma is an uncommon benign salivary gland neoplasm, presenting isomorphic basaloid cells with a prominent basal cell layer. Basal cell adenoma arising from the nasal septum is exceptionally rare. Reports on positron emission tomography with 2-deoxy-2-fluorine-18-fluoro-D-glucose (18FDG-PET) imaging for basal cell adenoma are limited. Here, we present the case of a 49-year-old man who had the symptoms of intermittent repeated bleeding from the left nose for half a year. 18FDG-PET scaning showed increased accumulation of 18FDG with its characteristic benign pathology has a potential to malignancy. After removal of the mass, the patient became symptom free. Pathology showed basal cell adenoma. The evidence of active and growing cells was present in the specimen.     

PET/CT在肿瘤疾病中的初步应用

目的回顾性探讨PET／CT对肿瘤的诊断价值。方法肿瘤病人200例，其中未治疗病人71例，已治疗病人129例。经静脉注射^18F-FDG 45min后，进行PET／CT扫描。结果未治疗病人71例中，PET／CT准确诊断有68例（95．7％），阴性3例，发现肿瘤转移54例，其中广泛转移30例。已治疗组129例中，提示肿瘤复发或／伴转移96例，其余33例在手术／放疗／化疗等治疗后未见肿瘤复发。结论PET／CT具有对病变部位进行精确定位和定性的优势，大大提高了诊断的准确率。对于肿瘤的早期诊断和分期、指导制定治疗方案、判断肿瘤有无复发与坏死及预后的估计均有重要的临床意义。     

Detecting the recurrence of gastric cancer after curative resection: comparison of FDG PET/CT and contrast-enhanced abdominal CT

The purpose of this study was to evaluate the value of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for detecting the recurrence of gastric cancer. We performed a retrospective review of 139 consecutive patients who underwent PET/CT and contrast-enhanced abdominal CT (CECT) for surveillance of gastric cancer after curative resection. Recurrence of gastric cancer was validated by histopathologic examination for local recurrence or serial imaging study follow-up with at least 1 yr interval for recurrence of distant metastasis form. Twenty-eight patients (20.1%) were confirmed as recurrence. On the patient based analysis, there was no statistically significant difference in the sensitivity, specificity and accuracy of PET/CT (53.6%, 84.7%, and 78.4%, respectively) and those of CECT (64.3%, 86.5%, and 82.0%, respectively) for detecting tumor recurrence except in detection of peritoneal carcinomatosis. Among 36 recurrent lesions, 8 lesions (22.2%) were detected only on PET/CT, and 10 lesions (27.8%) only on CECT. PET/CT had detected secondary malignancy in 8 patients. PET/CT is as accurate as CECT in detection of gastric cancer recurrence after curative resection, excepting detection of peritoneal carcinomatosis. Moreover, additional PET/CT on CECT could improve detection rate of tumor recurrence and provide other critical information such as unexpected secondary malignancy.     

18F-FDG PET/CT显像诊断结直肠癌术后复发和转移的价值

目的 探讨18F-FDG PET/CT显像在诊断结直肠癌术后复发和转移中的价值.方法 选取我院2012年10月至2014年12月期间的42例结直肠癌术后患者,对所有患者进行全身18F-FDG PET/CT检查与CT强化检查,依据PET/CT与强化CT图像对患者的术后吻合口是否复发及是否存在转移进行分析.最终以再次手术或活检病理学进行确诊,对比18F-FDG PET/CT检查与CT强化检查的灵敏度、特异性、准确性、阳性预测值及阴性预测值.结果 42例结直肠癌术后患者中,最终诊断2例有复发无转移,19例有转移无复发,11例既有复发又有转移,10例既无复发也无转移.PET/CT对诊断的准确率、特异性及阳性预测值虽高于强化CT检查,但差异无统计学意义(P＞0.05).PET/CT对诊断的准确率、灵敏度、特异性、阳性预测值及阴性预测值显著高于强化CT检查,差异有统计学意义(P＜0.05).结论 18F-FDG PET/CT显像在诊断结直肠癌术后复发和转移中的临床应用价值高于传统强化CT,有条件的医院可以推广应用.     

18氟-氟代脱氧葡萄糖正电子发射计算机断层扫描在肺部结节诊断中的临床应用

目的 探讨18氟-氟代脱氧葡萄糖（18F-FDG）正电子发射计算机断层扫描（PET/CT）在肺部结节诊断中的应用价值。方法 回顾性分析2016年6月~2017年12月常熟市中医院呼吸科收治的21例肺部结节病例资料,计算PET/CT在该类疾病中的诊断特异度及敏感度,评价PET/CT对肺部结节的诊断价值。结果 PET/CT诊断肺癌的特异度、敏感度分别为50.00%、94.10%;与血清肿瘤标志物检测相比,该检查的敏感度更高,差异具有统计学意义（P＜0.05）。结论 PET/CT相对于血清肿瘤标志物检测在诊断早期肺癌方面,其诊断敏感度更高,对肺部结节的诊断有较高的价值。     

Aortitis in giant cell arteritis: diagnosis with FDG PET/CT and agreement with CT angiography

Objectives

To assess the detection rate of aortitis in giant cell arteritis (GCA) with fluorodeoxyglucose positron emission tomography/computed tomography (PET) and to compare the findings with CT angiography (CTA).

Behavioral and [F-18] fluorodeoxyglucose micro positron emission tomography imaging study in a rat chronic mild stress model of depression

We investigated changes in behavior and brain glucose metabolism in a rat chronic mild stress (CMS) model of depression. The CMS model has been used to mimic depression in humans by using various chronic mild stressors in a 4 weeks period. In the present study, we have developed a combination of tests examining behavior (open field test) and hedonic measure (sucrose preference test) after exposure to CMS, and compared this to control non-stressed rats. We found that CMS induced behavioral changes, including decreased central and rearing activity, increased grooming and defecation, reduced body weight, and reduced relative sucrose intake. Moreover, our study suggests that CMS administered for 4 weeks activated left auditory cortex, while left piriform cortex, left inferior colliculus, septal nuclei and periaqueductal gray were deactivated. These changes in region of interest are left–right asymmetrical and lateralized in the left hemisphere. And activity deficits of depression are related with changes of brain activity in all brain regions showing significant changes by CMS in glucose metabolism. There are significant correlations for relative sucrose intake in left piriform cortex, left inferior colliculus and left auditory cortex, and for anxiety-related behavioral measures in septal nuclei and periaqueductal gray. There are lack of significant effects in the mean glucose metabolism of both hemispheres in hippocampus and amygdala induced by CMS possibly because of various reasons. Changes in glucose metabolism support the view that these significant brain regions are involved in chronic stress and depressive mood regulation. The results of this study might contribute to the awareness of changes in behavior and brain activity of depression induced by CMS.     

Role of 18F-FDG PET/CT in the Carcinoma of the Uterus: A Review of Literature

In the present review we reported the value of 18F-fluorodeoxyglucose (FDG) PET/CT in face of uterine cancer, in terms of sensitivity, specificity and accuracy. Moreover, we made a comparison with the other imaging techniques currently used to evacuate these tumors including contrast-enhanced CT, contrast enhanced-MRI and transvaginal ultrasonography. FDG PET/CT has been reported to be of particular value in detecting occult metastatic lesions, in prediction of response to treatment and as a pro-gnostic factor.     

Effects of fluoxetine on the rat brain in the forced swimming test: A [F-18]FDG micro-PET imaging study

We used the [F-18]FDG micro-PET neuroimaging to examine the effects of fluoxetine on brain activity in rats and on their behavioral response in the forced swimming test (FST). In the first experiment, the rats were administered doses of fluoxetine (10 or 20 mg/kg) 24, 19 and 1 h before the rat brains were scanned. Fluoxetine induced strong activation of the dorsal hippocampus and the deactivation of the inferior colliculus, medulla oblongata, and prelimbic cortex in a dose-dependent manner. These results seemed to be related with the changes in 5-HT (5-hydroxytryptamine, serotonin) levels after selective serotonin reuptake-inhibitor treatments. In the second experiment, the changes in glucose metabolism in the test session were measured after fluoxetine was given between pre-test and test sessions of the FST. Fluoxetine administration significantly decreased immobility behavior compared with saline administration. At the same time, the activity of the insular/piriform cortex decreased significantly. In contrast, the extent of cerebellar activation increased. The glucose metabolism of the dorsal hippocampus also increased, which suggests that post-stress changes in the facilitation of hippocampal serotonergic neurotransmission lead to decreased immobilization in the FST.     

正常人面神经管垂直部与外耳道解剖位置关系的影像与临床研究

目的 观察、测量面神经管垂直部毗邻解剖关系及乳突的形态学指标,分析面神经管垂直部和外耳道后壁、外耳门后缘位置变化的相关性,探讨乳突气化程度与面神经管垂直部之间的关系及临床意义。 方法 1. 评价CT影像测量相关结构的正确性,采用64层螺旋CT对4具干颅标本进行扫描,在横断位测量面神经管垂直部至外耳道后壁、外耳门后缘的距离,在矢状平面上测量乳突的前后径（外耳道下壁最低点至乳突后缘的水平距离）和高度（外耳道下壁至乳突尖的垂直距离）;按影像层面锯开标本,对上述距离行实体测量。影像测量均值与实体测量均值的差异行显著性检验。2. 在体研究：随机入选无耳部疾患的118人（236侧）,其中男性55例（110侧）,女性63例（126侧）,行颌面部CT扫描。如上选择层面,并测量面神经管垂直部至外耳道后壁、外耳门后缘及乳突前后径和高度的距离,以乳突前后径与高度乘积的1/2定义为乳突面积,以乳突面积的大小来定义乳突气化程度,同时将乳突面积分别与面神经管垂直部至外耳道后壁、外耳门后缘距离分别进行相关和回归分析。 结果 1. 标本部分：各项指标的影像测量值与实体测量值差异无统计学意义（P>0.05）。2. 在体研究：各项指标测量结果侧别差异无统计学意义（P>0.05）,性别差异有统计学意义（P<0.05）。乳突面积与面神经管垂直部至外耳道后壁距离之间呈负相关性,且相关性有统计学意义;乳突面积与面神经管垂直部至外耳门后缘有相关性,但相关性无统计学意义。 结论 乳突发育气化好,面神经垂直部位置偏前。 CT检查可以明确面神经管垂直部与外耳道后壁的关系,有助于耳外科手术术式的选择以及对术中重要结构损伤的控制。     

18F-FDG PET/CT在鼻咽癌分期中价值的研究

目的 探讨18F-氟代脱氧葡萄糖(18F-FDG) PET/CT在鼻咽癌分期中的价值.方法 回顾性分析35例鼻咽癌患者相关影像学检查资料,分别根据18F-FDG PET/CT与CT、MR对鼻咽癌患者进行治疗前分期、治疗后再分期,采用Spearman相关性分析全身病灶最大值SUVmax、鼻咽部SUVmax分别与T分期、临床分期的相关性.结果 18F-FDG PET/CT改变了12例治疗前患者的分期,9例治疗后患者的再分期.在再分期的评价中,18F-FDG PET/CT诊断复发转移的灵敏度为100％(9/9)、特异度55.6％ (5/9)、阳性预测值为69.2％ (9/13)、阴性预测值为100％ (5/5).全身最高SUVmax与T分期的相关性为0.677(P ＜0.05),与临床分期的相关性为0.667(P ＜0.05),鼻咽部SUVmax与T分期的相关性为0.71 (P ＜0.05),与临床分期的相关性为0.46(P ＜0.05).结论 18F-FDG PET/CT对鼻咽癌的分期、再分期与临床分期有一定的价值.     

The Role of Whole-Body FDG PET/CT, Tc 99m MDP Bone Scintigraphy, and Serum Alkaline Phosphatase in Detecting Bone Metastasis in Patients with Newly Diagnosed Lung Cancer

Bone scan (BS) and serum alkaline phosphatase (ALP) concentration are used to detect bone metastasis in malignancy, although whole-body fluoro-D-glucose positron emission tomography computed tomography (FDG PET/CT) is being used increasingly. But BS is still used for the detection of metastatic bone lesion. So we compared the usefulness of PET/CT, BS, and serum ALP in detecting bone metastases in patients with newly diagnosed lung cancer. The medical record database was queried to identify all patients with a new diagnosis of lung cancer between January 2004 and December 2005, who had a PET/CT, BS, and serum ALP before treatment. We retrospectively reviewed all patients'' records and radiological reports. One hundred eighty-two patients met the inclusion criteria. Bone metastases were confirmed in 30 patients. The sensitivity values were 93.3% for PET/CT, 93.3% for BS, 26.7% for serum ALP concentration, and 26.7% for BS complemented with serum ALP concentration. The respective specificity values were 94.1%, 44.1%, 94.1%, and 97.3%. The kappa statistic suggested a poor agreement among the three modalities. FDG PET/CT and BS had similar sensitivity, but PET/CT had better specificity and accuracy than BS. PET/CT is more useful than BS for evaluating bone metastasis. However, in the advanced stage, because of its high specificity, BS complemented with serum ALP is a cost-effective modality to avoid having to use PET/CT.