MRI Evaluation of Lateral Geniculate Body in Normal Aging Brain Using Quantitative Susceptibility Mapping

Objective To investigate the changes of lateral geniculate body(LGB) in the normal aging brain using quantitative susceptibility mapping(QSM) technique. Methods Magnetic resonance(MR) phase and magnitude images were acquired from enhanced gradient echo T2 star weighted angiography sequence with 16 echoes on 3.0T MR system using the head coil with 32 channels. Morphology Enabled Dipole Inversion(MEDI) method was applied for QSM, and the susceptibility value of LGB was measured by region of interest(ROI) drawn manually on three orthogonal planes. Results LGB of the middle-aged group had a higher susceptibility value(0.16±0.05 ppm) than that of the youth group(0.12±0.05 ppm) and elderly group(0.13±0.03 ppm)(all P<0.05). Partial correlation analysis demonstrated that there was significantly positive correlation between susceptibility value and age in the youth group(r=0.71, P<0.05). Conclusion LGB could clearly be identified on QSM in the brain in vivo.     

Cribriform Morular Variant of Papillary Thyroid Carcinoma in a Patient with an Incidental Neck Lump: a Case Report and Review of the Literature

The cribriform morular variant of papillary thyroid carcinoma (CMV-PTC) is a rare morphologic entity that is associated with familial adenomatous polyposis (FAP). We report a case of a young lady with an incidentally discovered right-sided neck nodule on ultrasonography with a diagnosis of CMV-PTC confirmed on thyroidectomy and review the literature associated with the clinical presentation, imaging characteristics, pathological findings and the association with FAP.     

Epicardial adipose tissue is increased in patients with systemic lupus erythematosus

ObjectiveMorbidity and mortality secondary to premature cardiovascular disease (CVD) in systemic lupus erythematosus (SLE) remain significant issues. The pathogenesis of CVD in SLE patients has not been fully explored. Epicardial adipose tissue (EAT) is believed to contribute to atherosclerosis development, through a paracrine and systemic inflammatory effect. We measured EAT volume in 162 SLE patients and 86 matched controls to assess the association of EAT with markers of atherosclerosis, cardiovascular risk and immunoactivation.MethodsClinical and laboratory characteristics collected included anthropomorphic measures, disease activity and damage indices, blood pressure measurement, lipid profile, inflammatory indices, adipokine levels and measures of adiposity. Coronary artery calcium (CAC) and EAT volume were measured using non-contrast cardiac computed tomography.ResultsEAT volume was greater in patients with SLE [(mean ± SD) 96.8 ± 45.9 cm³] than controls (78.2 ± 40.7 cm³; P = 0.001). The EAT volume was 31% larger (95% CI, 16.5%–47.4%) in SLE patients than controls (P < 0.001 adjusted for age, sex, and race; after additional adjustment for waist circumference P = 0.007). Within SLE patients, after adjusting for age, race, sex, and waist circumference, EAT volume was associated with cumulative corticosteroid dose (P = 0.007), current corticosteroid use (P < 0.001), HDL cholesterol (P = 0.033), and triglycerides (P = 0.005). EAT was significantly correlated with CAC score (P < 0.001), but the association was attenuated after adjustment for Framingham risk score (P = 0.051).ConclusionThe increased EAT volume seen in SLE patients is associated with corticosteroid use. Corticosteroids could have adverse cardiovascular effects in SLE via an increase in EAT volume, a marker of risk in the general population.     

Bolton指数指导正畸的临床应用

正畸治疗的目标就是要达到口颌系统功能的平衡,以及实现牙齿、颅、面型的美观和理想的咬合。Bolton于20世纪提出前牙比和全牙比的概念,并被广泛采纳和接受,成为错畸形的诊断、设计和预测错畸形治疗的一个常规指标和重要方法。Bolton指数还受很多因素的影响,但其决定因素还有待研究。     

Serum uric acid: a marker of metabolic syndrome and subclinical atherosclerosis in Korean men

Serum uric acid (SUA) is a potential risk factor for atherosclerosis. We assessed the relationship between SUA and subclinical atherosclerosis in Korean men (n = 3010). Multidetector computed tomography (MDCT) and ultrasonographic measurements of coronary artery calcification (CAC) and carotid intima-media thickness (cIMT), respectively, are markers of subclinical atherosclerosis. Odds ratios (ORs) of CAC score and cIMT across SUA levels were 1.101 (P = .046) and 1.266 (P = .002), respectively, after adjustment for several variables. The independent association between CAC and cIMT was observed (OR = 1.231, P < .001). Serum uric acid was independently associated with metabolic syndrome (MetS) with an OR of 1.415 (P < .001). Metabolic syndrome was only independently associated with cIMT, with an OR of 2.103 (P = .003). High-sensitivity C-reactive protein was positively correlated with SUA (r = .125, P < .001). Serum uric acid level is independently associated with CAC, cIMT, and MetS in Korean men.     

The effectiveness of the TAX 327 nomogram in predicting overall survival in Chinese patients with metastatic castration-resistant prostate cancer

Based on the results of TAX 327, a nomogram was developed to predict the overall survival of metastatic castration-resistant prostate cancer （mCRPC） after first-line chemotherapy. The nomogram, however, has not been validated in an independent dataset, especially in a series out of clinical trials. Thus, the objective of the current study was to validate the TAX 327 nomogram in a community setting in China. A total of 146 patients with mCRPC who received first-line chemotherapy （docetaxel or mitoxantrone） were identified. Because clinical trials are limited in mainland China, those patients did not receive investigational treatment after the failure of first-line chemotherapy. The predicted overall survival rate was calculated from the TAX 327 nomogram. The validity of the model was assessed with discrimination, calibration and decision curve analysis. The median survival of the cohort was 21 months （docetaxel） and 19 months （mitoxantrone） at last follow-up. The predictive c-index of the TAX 327 nomogram was 0.66 （95% CI： 0.54-0.70）. The calibration plot demonstrated that the 2-year survival rate was underestimated by the nomogram. Decision curve analysis showed a net benefit of the nomogram at a threshold probability greater than 30%. In conclusion, the present validation study did not confirm the predictive value of the TAX 327 nomogram in a contemporary community series of men in China, and further studies with a large sample size to develop or validate nomograms for predicting survival and selecting therapies in advanced prostate cancer are necessary.     

Laparoscopic ampullectomy for an ampullarian adenoma

Lesions involving the ampulla of Vater are rare entities (0.1–0.2 %) with high malignant potential (90 %) [1]. As a treatment, the surgical procedure known as duodenopancreatectomy was the main option, whatever the tumor’s stage or nature. Yet with improvements of endoscopic diagnostic and therapeutic techniques, management of these lesions has been modified, enabling endoscopic removal of adenoma and adenocarcinoma-in situ. Thus, when endoscopic treatment is not possible, surgical ampullectomy is still an alternative option to duodenopancreatectomy [1, 2]. The continuous improvements in surgical techniques and instruments now allow the safe realization of laparoscopic ampullectomy, despite the few cases described in the literature [3, 4]. Here we present a surgical technique in a 52-year-old patient with an ampulloma. The ampulloma was discovered during a gastroscopy for abdominal pain. The endoscopic ultrasound with biopsy revealed a 15-mm adenoma with moderate-grade dysplasia. The thoracoabdominal CT scan was normal. The procedure was performed as shown. The tumor histology showed a R0 resection (5-mm surgical margin) of an adenoma with focal high-grade dysplasia. At 3-year follow-up, outcomes were unremarkable, without any complications.     

Surgical treatment of brain tumor coexisted with intracranial aneurysm—case series and review of the literature

Coexistence of brain tumor and intracranial aneurysm was previously considered as an uncommon phenomenon. Actually it is not rare in neurosurgical procedures, and its incidence rate may be underestimated. Furthermore, there remains a lack of consensus regarding numerous aspects of its clinical management. We performed a retrospective study of 12 cases of coexistent brain tumor and intracranial aneurysm in our database. Then a systematic PubMed search of English-language literature published between 1970 and 2012 was carried out using the keywords: “brain tumor” and “intracranial aneurysm” in combination with “associate” or “coexist.” A consensus panel of neurosurgeons, anesthetists, interventional neurologists, and intensivests reviewed this information and proposed a treatment strategy. In the majority of patients, clinical symptoms were caused by tumor growth, whereas aneurysm rupture was seen only in a few cases. Meningioma was the commonest tumor associated with aneurysm. In most patients, both lesions occurred within the adjacent area. Treatment of both pathologies in one session was performed in most patients. All of our patients were alive within the period of follow-up. Coexistence of brain tumor and intracranial aneurysm may be a coincidence. The treatment strategy should be designed according to the conditions of tumor and aneurysm, locations of both lesions, and pathologic nature of tumor.