Effects of radial shock waves therapy on osteoblasts activities

Radial shock waves therapy (RSWT) differs from extracorporeal shock waves therapy (ESWT) in that it produces a non-focused wave that is dissipated radially at the skin. Few studies have yet explored the effects of RSWT on bone tissue. Osteoblasts in culture flasks were studied by polymerase chain reaction after treatment with RSW (500 impulses, 0.05?mJ/mm²). An inhibited osteoblastogenesis was observed, with a statistically significant reduction in type 1 collagen, osterix, bone sialoprotein and receptor activator NF kappa ligand expression at 24 and 48?h, of osteocalcin at 24, 48 and 72?h, and osteopontin at 48 and 72?h. These findings show that RSWT is not indicated for treatment of delayed fracture union, pseudoarthrosis, and complex regional pain syndrome. The observed reduction in the receptor activator of nuclear factor-kB ligand/osteoprotegerin ratio suggests that it has an inhibiting effect on osteoclastogenesis, which could make it a useful tool for applications in proliferative diseases.     

Chromosome Changes and Their Evolution in Subjects With Past Exposure to Benzene

Chromosome studies of peripheral blood lymphocytes in 25 subjects who had recovered from benzene hemopathy, in four subjects with bone marrow toxicity from benzene, and in three subjects who had recovered from acute benzene poisoning revealed significantly increased rates of “unstable” and “stable” chromosome aberrations which, In most cases, were still present several years after cessation of exposure to the toxic agent and recovery from the poisoning. The follow-up cytogenetic studies showed a tendency toward a decrease in unstable chromosome changes and, generally, a persistence or an increase in stable changes. Bn some cases there was evidence of abnormal clone formation in peripheral blood lymphocytes. Chromosomes of the G group seemed to be involved in stable changes with a frequency higher than expected.     

Assessment of hyperemia in acute appendicitis: Comparison between power Doppler and color Doppler sonography

The purpose of our study was to compare power Doppler sonography (US) and conventional color Doppler US in the diagnosis of acute appendicitis by revealing local signs of hyperemia. One hundred consecutive patients (46 males and 54 females, ages 7–61 years; mean, 24.7 years) with clinically suspected acute appendicitis were prospectively examined with power Doppler US and conventional color Doppler US. Of 38 patients who subsequently underwent surgery, appendicitis was proven in 34. The remaining 62 patients who were not submitted to surgery had no clinical evidence of appendicitis over a 2- to 6-month follow-up. At gray-scale US, the appendix was visualized in 30 (88.2%) of the 34 cases with pathologically proven acute appendicitis. Power Doppler US depicted a moderate to marked hypervascularity of the appendiceal wall and surrounding mesoappendix in 28 (93.3%) of these 30 patients. At conventional color Doppler US, flow signal within the appendiceal wall and surrounding mesoappendix was shown in only 21 (70%) of 30 cases (P<0.05). No false-positive diagnosis was made at either power or color Doppler US among the 62 patients without appendicitis. Power Doppler US is more sensitive than conventional color Doppler imaging for revealing signs of local hyperemia in acute appendicitis.     

Arteriovenous brain malformations: is functional MR imaging reliable for studying language reorganization in patients? Initial observations

PURPOSE: To determine whether the blood flow abnormalities frequently associated with arteriovenous malformations (AVMs) can alter functional magnetic resonance (MR) imaging evaluation of language lateralization and whether reorganization of language function occurs in patients with brain AVMs. MATERIALS AND METHODS: Eleven patients with left-hemisphere brain AVMs and 10 age-matched control subjects were examined with 1.5-T blood oxygen level-dependent (BOLD) functional MR imaging. Verbal fluency, sentence repetition, and story listening tasks were performed. The functional MR imaging laterality index in the frontal and temporal lobes was defined as the (L - R)/(L + R) ratio, where L and R are the numbers of activated pixels in the left and right hemispheres, respectively. Statistical analyses were performed with Wilcoxon signed rank, Fisher exact, and Kruskal-Wallis tests. RESULTS: Control subjects had left-sided language dominance, although symmetric pixel counts were observed in the frontal lobes in two subjects and in the temporal lobes in one subject. Six patients had left-sided language dominance similar to that observed in control subjects. Five of these patients had AVMs outside frontal or temporal language areas, without flow abnormalities. Five patients had abnormally right-sided asymmetric indexes (below mean control subject value - 2 SDs), which suggested language reorganization (P <.05). Results of Wada examination and/or postembolization functional MR imaging performed in two of these patients showed that the abnormal laterality indexes were at least partly due to severe flow abnormalities that impaired detection of BOLD MR imaging signal intensity. CONCLUSION: These data suggest that flow abnormalities may interfere with language lateralization assessment with functional MR imaging.     

Spontaneity as predictive factor for well-being

The study discusses the construct of spontaneity and its causal relationship with psychological well-being. It develops a preview phase of validation of the SAI-R and its correlation with the Clinical Outcomes for Routine Evaluation-Outcome Measure (CORE-OM) and the Beck Depression Inventory (BDI-II) and assumes the hypothesis that a high level of spontaneity is correlated negatively with low level of well-being and positively with depression. The research involved Italian and Austrian participants, consisting of 166 Italian and 146 Austrian university students. The findings suggested a causal relationship between low spontaneity and psychological suffering. The results obtained confirm the hypothesized model, showing significant negative causal relationship. The verification of this theoretical model on non-clinical samples allows us to set the ground for future use in clinical samples. Furthermore, this result encourages the development of further research into the use of SAI-R.     

Giant earlobe epidermoid cyst

Epidermoid cysts represent the most common cutaneous cysts. They are usually small and benign; however, sometimes they can grow to giant epidermoid cists, and occasionally malignancies develop. Giant epidermoid cysts at the earlobe have never been described but in other locations. We describe a case of a giant epidermoid cyst at the earlobe, a location where such a large cyst has never been reported before. The mass was completely resected and the wound of the pedunculated base was sutured with four stitches of nylon 5/0. Histopathology confirmed the presumptive diagnosis of an epidermoid cyst. Six months after the resection, the patient did not have any relapse of the epidermoid cyst. The earlobe is a potential location for giant epidermoid cysts. Although the clinical diagnosis could be enough, due to the possibility of malignancy and to ensure appropriate diagnosis, we consider that all cysts should be sent to the anatomic pathology laboratory for histological evaluation.     

Pulmonary veno-occlusive disease: the role of CT

Objective

The authors sought to evaluate the diagnostic accuracy of high-resolution computed tomography (HRCT) in the detection of pulmonary veno-occlusive disease (PVOD) in patients with pre-capillary pulmonary arterial hypertension (PAH) of unknown aetiology, and to identify the role of CT in diagnosis and therapy.

Materials and methods

The CT scans of 96 patients were retrospectively reviewed and assessed for specific HRCT findings: ground-glass opacities, septal lines and mediastinal lymph nodal enlargement (short diameter ≥1 cm). According to the HRCT findings, patients were divided into PVOD-suspicious and not PVOD-suspicious. Subsequently, a clinical-instrumental evaluation was performed, and the response to therapy and histopathological reports were evaluated.

Results

Radiological evaluation based on HRCT findings revealed 29 patients as PVOD-suspicious and 67 as not PVOD-suspicious. The final diagnosis was PVOD in 22 patients and idiopathic PAH in 74 patients. The CT scan showed 95.5 % sensitivity, 89 % specificity, 72.5 % positive predictive value, and 98.5 % negative predictive value, with a diagnostic accuracy of 90.5 % in identifying patients with PVOD.

Conclusions

Chest CT can be considered a screening test in the assessment of patients with PAH of unknown aetiology, and the radiologist can help the clinician to identify patients with CT findings that make PVOD highly probable.