Case Report: Adrenal Oncocytoma Associated with Markedly Increased FDG Uptake and Immunohistochemically Positive for GLUT1

Usually, benign tumors are not associated with an increased F-18 fluorodeoxyglucose (F-18 FDG) uptake on positron emission tomography (PET), although some exceptions have been reported in adrenal neoplasms. We present a rare case of adrenocortical oncocytoma associated with markedly increased FDG uptake, demonstrating a maximum standardized uptake value of 46.8. Histological examination demonstrated diffuse proliferation of tumor cells with eosinophilic and granular cytoplasm that were diffusely immunopositive for mitochondria and glucose transport protein 1, with focal and weak immunopositivity for 3β-hydroxysteroid dehydrogenase. Ultrastructural examination also revealed abundant mitochondria in the tumor cells. The tumor was diagnosed as adrenocortical oncocytoma and was considered benign according to Lin-Weiss-Bisceglia criteria. Diagnosis of adrenocortical oncocytoma can pose difficulties during both preoperative radiological and postoperative histopathological investigations.     

Association between hippocampal volume and serum adiponectin in patients with type 2 diabetes mellitus

Type 2 diabetes mellitus (DM) is associated with cognitive dysfunction and hippocampus volume. The aim of the present study was to test the hypothesis that the level of the adipocytokine adiponectin correlates with hippocampus volume and insulin resistance in patients with type 2 DM. A total of 45 patients with type 2 DM were divided into two groups: a low adiponectin group and a normal adiponectin group. Hippocampus volume was measured by computer-assisted analysis using a magnetic resonance imaging (MRI) voxel-based specific regional analysis system developed for the study of Alzheimer's disease as the end point for assessment of hippocampus volume. Mean hippocampus volume was lower in the low adiponectin group than in the normal adiponectin group (P<.0001). Fasting serum concentrations of glucose (P<.05) and insulin (P<.0001), and homeostasis model assessment index (P<.0001), were all higher in the low adiponectin group than in the normal adiponectin group. Multiple regression analysis showed that hippocampus volume independently predicted serum adiponectin level. These results suggest that circulating levels of adiponectin are related to hippocampus volume in patients with type 2 DM.     

A multi-centered epidemiological study evaluating the reliability of the treatment difficulty indices developed by the Japan Prosthodontic Society

BackgroundThe diagnostic assessment of the level of difficulty in treating patients who need prosthodontic care is useful to establish a medico-economically efficient system with primary care dentists and prosthodontic specialists.Materials and methodsA multi-axis assessment protocol was established using the newly established treatment difficulty indices. The protocol contains Axis I: oral physiological conditions (e.g., teeth damage and/or missing teeth); Axis II: general health and sociological conditions (e.g., medical disorders); Axis III: oral health-related quality of life (OHRQOL; e.g., oral health impact profile: OHIP); and Axis IV: psychological health (e.g., mood, anxiety, somatoform disorders). A preliminary study on the test–retest consistency of the protocol was conducted to check the levels of reliability of the indices prior to a large-scale, multi-center cohort study on the validity of the protocol.ResultsThe test–retest consistency in terms of the oral physiological condition (Axis I) after data reduction was 0.63 for patients with teeth problems, 0.95 for partially edentulous patients, and 0.62 for edentulous patients. The reliability for general health and sociological conditions (Axis II), OHRQOL (Axis III), and psychological health (Axis IV) were 0.88, 0.74, and 0.61, respectively. These values reflect either “sufficient agreement” or “excellent agreement” in accordance with the criteria established by Landis and Koch (1977) [1].ConclusionThis protocol is the first multi-axis assessment scheme introduced for prosthodontic treatment with sufficient reliability. This new system is therefore expected to have a significant impact on future dental diagnostic nomenclature systems.     

Computer-aided measurement of mandibular cortical width on dental panoramic radiographs for identifying osteoporosis

Aim: To develop a computer‐aided diagnosis system to continuously measure mandibular inferior cortical width on dental panoramic radiographs and evaluate the system’s efficacy in identifying postmenopausal women with low‐skeletal bone mineral density. Methods: Mandibular inferior cortical width was continuously measured by enhancing the original X‐ray image, determining cortical boundaries, and evaluating all distances between the upper and lower boundaries in the region of interest. The system’s efficacy in identifying osteoporosis at the lumbar spine and the femoral neck was evaluated for 100 women (≥50 years): 50 in the development of the tool and 50 in its validation. Results: The sensitivity and specificity of the cortical measurements for identifying the development patients were 90% (95% confidence interval shown in parentheses) (63.0–87.0) in women with low spinal bone mineral density, and 81.8% (70.1–91.8) and 69.2% (56.2–81.8) in those with low femoral bone mineral density, respectively. Corresponding values in the validation patients were 93.3% (85.9–100) and 82.9% (71.4–92.7) at the lumbar spine, and 92.3% (84.5–99.5) and 75.7% (63.0–87.0) at the femoral neck, respectively. Conclusion: Our new computer‐aided diagnosis system is a useful procedure in triage screening for osteoporosis.