Pulmonary abnormalities in ankylosing spondylitis: inspiratory and expiratory high-resolution CT findings in 17 patients

OBJECTIVE: The purpose of this study was to evaluate pulmonary manifestations of ankylosing spondylitis on inspiratory and expiratory high resolution CT. MATERIAL AND METHODS: The study included 17 patients ranging from 40 to 62 years in age. Fifteen patients were male, and 8 were smokers. All patients underwent chest radiography and high-resolution CT. High-resolution CT was obtained using 1 or 2 mm collimation scans at 10-mm intervals at the end of maximal inspiration and at 3 cm intervals at the end of maximal expiration. RESULTS: Pulmonary abnormalities were evident on chest radiography in 2 patients and on CT in 15 patients. The abnormalities on CT included evidence of airway disease in 14 (82%), interstitial abnormalities in 11 (65%), and emphysema in 6 (35%) patients. Airway abnormalities included bronchial wall thickening in 7 (41%), mosaic perfusion in 3 (18%), centrilobular nodules in 3, bronchiolectasis in 2, and air trapping on expiratory CT in 7 (41%) patients. Interstitial abnormalities included parenchymal bands in 7 (41%), intralobular linear opacities (n = 2), and 1 patient each with irregular thickening of interlobular septa, subpleural lines, and honeycombing. CONCLUSION: The majority of patients with ankylosing spondylitis have airway and interstitial abnormalities evident on high-resolution CT. These abnormalities are usually mild and therefore seldom evident on the chest radiograph.     

Relationship Between White Matter Integrity, Attention, and Memory in Schizophrenia: A Diffusion Tensor Imaging Study

Attention and memory deficits are among the most prominent cognitive disturbances observed in schizophrenia. It has been suggested that a disruption in anatomical connectivity between areas involved in attentional control might be responsible for these abnormalities. We used Diffusion Tensor Tractography and Color Stroop/Negative Priming(NP) paradigm to investigate integrity of the Cingulum Bundle(CB), the main white matter tract interconnecting these regions, and its relationship with executive functions in patients with schizophrenia and matched controls. The Fractional Anisotropy(FA), was calculated along the CB pathways, and correlated with reaction times for each Stroop item, and both Stroop, and NP effects. Patients with schizophrenia demonstrated decreased CB integrity and diminished NP effect, compared with controls, but both groups showed Stroop effect. For patients only, reaction times for every item, as well as for Stroop effect, correlated with left CB FA. These findings suggest that CB integrity disruptions might compromise the executive processes in schizophrenia.     

Gene-environment interactions in chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death throughout the world and is largely associated with cigarette smoking. Despite the appreciation of the central role of smoking in the development of COPD, only a relatively small number of smokers (15%–20%) develop COPD. Recent studies depicting familial aggregation suggest that some subjects may have a genetic predisposition to developing COPD. In this respect, a number of single nucleotide polymorphisms have been reported in association with different COPD features (subphenotypes), although much of this data remains controversial. Classical genetic studies (including twin and family studies) assume an “equal-environment” scenario, but as gene-environment interactions occur in COPD, this assumption needs revision. Thus, new integrated models are needed to examine the major environmental factors associated with COPD which include smoking as well as air pollution, and respiratory infections, and not only genetic predisposition. Revisiting this area, may help answer the question of what has more bearing in the pathogenesis of COPD—the environment or the genomic sequence of the affected subjects. It is anticipated that an improved understanding of this interaction will both enable improved identification of individuals susceptible to developing this disease, as well as improved future treatments for this disease.     

Clinical indications for digital imaging in dento-alveolar trauma. Part 2: root resorption

Abstract –  Common complications of dento-alveolar trauma are pulp necrosis, pulp canal obliteration, periapical pathosis and root resorption. Different types of root resorption have been identified with traumatic injuries. Repair-related (surface), infection-related (inflammatory), ankylosis-related (osseous replacement) or extraradicular invasive cervical resorption are among the most common. Recent developments in imaging systems have enabled clinicians to visualize structural changes effectively. The diagnosis and three-dimensional imaging assessment of the resorption is important in order to determine the treatment complexity and expected outcome based on the location and extension of the root defect. This article discusses and illustrates the clinical application of cone beam computed tomography for diagnosis and treatment plan of root resorption. Four clinical cases are presented to illustrate the potential use of the NewTom 3G for root resorption.     

Potentiation of Local Anesthetic Activity of Neosaxitoxin with Bupivacaine or Epinephrine: Development of a Long-Acting Pain Blocker

Local anesthetics effectively block and relieve pain, but with a relatively short duration of action, limiting its analgesic effectiveness. Therefore, a long-acting local anesthetic would improve the management of pain, but no such agent is yet available for clinical use. The aim of this study is to evaluate the potentiation of the anesthetic effect of neosaxitoxin, with bupivacaine or epinephrine in a randomized double-blind clinical trial. Ten healthy males were subcutaneously injected into the left and right forearms with a randomized pair of the following treatments: (i) bupivacaine (5 mg); (ii) neosaxitoxin (10 μg); (iii) neosaxitoxin (10 μg) plus bupivacaine (5 mg), and (iv) neosaxitoxin (10 μg) plus epinephrine (1:100.000), but all participant received all four formulations (in 2 ml; s.c.), with 1 month elapsing between the two round of experiments. A validated sensory and pain paradigm was used for evaluating the effect of the treatment 0–72 h after the injections, measuring sensory, pain, and mechanical touch perception threshold. The duration of the effect produced by combined treatments was longer than that by the single drugs. In conclusion, bupivacaine and epinephrine potentiate the local anesthetic effect of neosaxitoxin in humans when co-injected subcutaneously. The present results support the idea that neosaxitoxin is a new long-acting local pain blocker, with highly potential clinical use.     

Blocking EGFR in the liver improves the tumor-to-liver uptake ratio of radiolabeled EGF

Overexpression of epidermal growth factor receptor (EGFR) in several types of malignant tumors correlates with disease progression. EGFR could, therefore, be an excellent candidate for targeted radionuclide diagnostics. However, the high natural expression of EGFR in the liver may be problematic. The aim of this study was to improve the tumor-to-liver ratio of radiolabeled epidermal growth factor (EGF) by blocking its uptake by the liver with a nonradiolabeled EGFR-targeting molecule in tumor-bearing mice. Intraperitoneally injected nonradiolabeled EGF was first evaluated as a blocking agent, preadministered at various time intervals before intravenous injection of ¹²⁵I-labeled EGF. The anti-EGFR Affibody molecule (Z_EGFR:955)₂ was then assessed as a blocking agent of ¹¹¹In-labeled EGF in a dual isotope study (50, 100, and 200?µg, preadministered 30 or 60 min before ¹¹¹In-EGF). The 30-min preadministration of nonradiolabeled EGF significantly decreased ¹²⁵I-EGF uptake in the liver, whereas uptake in the tumor remained unchanged. Furthermore, preadministration of only 50?µg (Z_EGFR:955)₂ as a blocking agent 30 min before the ¹¹¹In-EGF decreased the uptake of ¹¹¹In-EGF by the liver and increased its uptake by the tumor, thereby increasing the tumor-to-liver ratio sixfold. We conclude that the Affibody molecule (Z_EGFR:955)₂ shows promise as a blocking agent that could enhance the outcome of radionuclide-based EGFR-expressing tumor diagnostics and imaging.