Primary diaphragmatic schwannoma with a typical target appearance: Correlation of CT and MR imagings and histologic findings

A rare case of benign diaphragmatic schwannoma in a 38-year-old female is reported. Precontrast computed tomography (CT) showed an encapsulated well-defined round homogeneous tumor with central calcification, measuring approximately 5 cm in diameter, arising from the left diaphragm. Contrast-enhanced CT and gadolinium-enhanced T1-weighted magnetic resonance (MR) imaging showed focal enhancement in the central portion of the tumor. The tumor showed a typical target appearance of increased peripheral signal intensity and decreased central signal intensity on unenhanced T2-weighted images. Pathological examination of resected specimens of the tumor showed two zonal histological components: a hypercellular portion of spindle cells with nuclear palisading (Antoni A tissue) and a hypocellular portion of cells with cystic degeneration, together with focal calcification and hemangeomatous vascular changes (Antoni B tissue). We consider the radiological characteristics of diaphragmatic schwannoma on CT and MR imagings to represent the geographic difference between the histologic zones of the tumor.     

Effects of focused force angioplasty: pre-clinical experience and clinical confirmation

Balloon angioplasty results in a combination of plaque compression and fracture, creation of intimal flaps and localized medial dissection, as well as the stretching and remodeling of the arterial wall. The application of eccentric pressure to the vessel wall allows for the balloon force to be focused along a specified line resulting in a reduction in vessel resistance with an improved or equivalent result at a lower pressure. The FX miniRAIL is a novel balloon angioplasty catheter that has two external wires that are compressed by the inflating balloon into the vessel wall. It was tested in comparison to conventional balloon injury in a porcine coronary model. At equivalent balloon artery ratios no increase in the length of dissections occurred, but a characteristic longitudinal "cut" was noted in the presence of the FX miniRAIL. A similar finding was demonstrated in sample human cases when interrogated by IVUS and OCT.     

Clinical significance of loss of heterozygosity for M6P/IGF2R in patients with primary hepatocellular carcinoma

AIM：To investigate the relationship between loss of heterozygosity （LOH） for mannose 6-phosphate/insulin- like growth factor 2 receptor （M6P/IGF2R） and the outcomes for primary HCC patients treated with partial hepatectomy.
METHODS： The LOH for M6P/IGF2R in primary HCC patients was assessed using six different gene-specific nucleotide polymorphisms. The patients studied were enrolled to undergo partial hepatectomy.
RESULTS： M6P/IGF2R was found to be polymorphic in 73.3% （22/30） of the patients, and of these patients, 50.0% （11/22） had tumors showing LOH in M6P/IGF2R. Loss of heterozygosity in M6P/IGF2R was associated with significant reductions in the two year overall survival rate （24.9% vs 65.5%; P = 0.04） and the disease-free survival rate （17.8% vs 59.3%; P = 0.03）.
CONCLUSION： These results show M6P/IGF2R LOH predicts poor clinical outcomes in surgically resected primary HCC patients.     

Normative data on functional grip strength of elderly in Singapore

Study Design

Cross-sectional study for clinical measurement.

Resistance training using a novel robotic walker for over-ground gait rehabilitation: a preliminary study on healthy subjects

Strength training is an aspect of gait rehabilitation, which complements balance control and weight-bearing training. However, conventional strength training does not show positive gait outcomes, due to lack of task specificity. Therefore, the aims of this study were to investigate the effects of a resistance force applied at the center of mass (CoM) and to investigate whether this exercise can be used for effective task-specific gait training. Using a novel robotic walker, a consistent resistive force was applied to the CoM of subjects in the posterior direction. Eleven healthy subjects were instructed to walk under five walking conditions with increasing forces, based on each subject’s body weight (BW), at 0, 2.5, 5, 7.5, and 10% BW. Joint kinematics and mean amplitude and frequency of electromyography signals from nine major muscles were measured. The application of resistance resulted in significantly increased flexion angles at ankle, knee, and hip joints. A large amount of motor unit activation with lower firing rates was found at knee and hip joints, indicating that this type of resistance training can improve muscular strength and endurance in a task-specific manner. The long-term effects of the resistance training on neurologically challenged patients will be investigated in the future.