Supratentorial ependymoma: CT appearance

The computed tomographic appearances of 22 biopsy-proved supratentorial ependymomas were analyzed. Supratentorial ependymomas were usually intraparenchymal, larger than 4 cm, and cystic. Contrast enhancement was moderate to intense, with homogeneous or ring-enhancement patterns commonly seen. Intratumoral calcification was present in one-third of the cases, while hydrocephalus and peritumoral edema were seen in 50%. Intratumoral hemorrhage was not a characteristic of the lesion. In contrast to cellular ependymomas, malignant ependymomas and ependymoblastomas demonstrate higher attenuation prior to administration of contrast material, more intense enhancement, lower frequency of calcification within the tumor, and less distinct margination.     

Patients’ preference for radiotherapy fractionation schedule in the palliation of symptomatic unresectable lung cancer†

The palliative radiotherapeutic management of unresectable non‐small‐cell lung cancer is controversial, with various fractionation (Fx) schedules available. We aimed to determine patient’s choice of Fx schedule after involvement in a decision‐making process using a decision board. A decision board outlining the various advantages and disadvantages apparent in the Medical Research Council study of Fx schedules (17 Gy in two fractions vs 39 Gy in 13 fractions) was discussed with patients who met Medical Research Council eligibility criteria. Patients were then asked to indicate their preferred Fx schedules, reasons and their level of satisfaction with being involved in the decision‐making process. Radiation oncologists (RO) could prescribe radiotherapy schedules irrespective of patients’ preferences. Of 92 patients enrolled, 55% chose the longer schedule. English‐speaking patients were significantly more likely to choose the longer schedule (P = 0.02, 95% confidence interval: 1.2–7.6). Longer Fx was chosen because of longer survival (90%) and better local control (12%). Shorter Fx was chosen for shorter overall treatment duration (80%), cost (61%) and better symptom control (20%). In all, 56% of patients choosing the shorter schedule had their treatment altered by the treating RO, whereas only 4% of patients choosing longer Fx had their treatment altered (P < 0.001). Despite this, all (100%) patients were satisfied with being involved in the decision‐making process. The decision board was useful in aiding decision‐making, with both Fx schedules being acceptable to patients. Interestingly, despite the longer average survival associated with longer Fx, nearly half of the patients believed that this was not as important as a shorter duration of treatment and lower cost. Despite patients’ preferences, there were significant alterations of preferred schedules because of RO’s own biases.     

The choroidal artery to the fourth ventricle and its radiological significance

The choroidal artery to the fourth ventricle has been studied in 25 brain specimens and 100 normal posterior fossa angiograms, including 25 angiotomograms. Its variable origin, course and radiological significance have been stressed.     

Increased height in diabetes mellitus corresponds to the predicted and the adult height

This study was conducted to analyse the effect of childhood-onset diabetes mellitus on adult height. The height at time of diagnosis of 35 children with insulin-dependent diabetes mellitus (IDDM) was compared with growth reference data. Predictions of the adult height were made at the time of diagnosis using the target height and the Tanner-Whitehouse II method. The adult height was compared with both the predicted values and the height of healthy adults. The height at time of diagnosis of the prepubertal children was increased compared with growth reference data, in contrast to pubertal children who had normal heights. Only the prepubertal boys were taller at time of diagnosis. The adult height of the prepubertal patients was taller than growth reference data. The mean adult height in all patients did not differ significantly from the predicted heights. In conclusion, the increased height at the start of IDDM in prepubertal children persists until adulthood.     

胰岛ε细胞的研究进展

胰腺由外分泌组织和内分泌组织2个部分所组成,两者在机体能量平衡和营养代谢调节中发挥重要的作用．胰岛是胰腺组织中重要的内分泌功能单位,胰岛的发育和分化过程涉及一个复杂而精细的分子调控网络体系,其中包括许多转录因子的参与．经典的胰岛内分泌细胞包括α细胞、β细胞、δ细胞及PP细胞,分别产生胰升糖素、胰岛素、生长抑素及胰多肽(PP),各种胰岛细胞之间的相互调节在维持血糖稳态中具有重要的意义．表达ghrelin 的ε细胞是一种新近发现和命名的胰岛细胞类型．现着重对胰岛ε细胞的发现过程、形态学特点及生物学作用进行介绍．     

Anterior commissure: anatomic-MR correlation and use as a landmark in three orthogonal planes

Correlation of cryomicrotomic and myelin-stained sections of human cadaver heads with spin-echo magnetic resonance (MR) images documents that MR imaging routinely displays the anterior commissure in three orthogonal planes as a distinct white-matter tract that resembles bicycle handlebars. The anterior commissure crosses the midline at the upper end of the lamina terminalis, just anterior to the anterior columns of the fornices. To each side of midline, it curves antero-inferolaterally and then postero-inferolaterally through the lateral nucleus of the globus pallidus to course with the white matter of the external and extreme capsules toward the middle and inferior temporal gyri. Because the anterior commissure is easily recognizable in all three planes at differing pulse sequences, the commissure has proved to be a major landmark for identification of the complex anatomy of this region, especially in sagittal sections.