VideoEndocrinology™ High-Impact Videos

VideoEndocrinology™
The Official Journal of: American Thyroid Association

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Transoral Endoscopic Thyroidectomy Vestibular Approach: Technical Tips and Tricks
Gustavo G. Fernandez Ranvier, Patrick Neshiwat, William B. Inabnet III

Central Neck Dissection: The Five Key Steps
Nathaniel J. Walsh, Asif M. Talukder, David J. Terris 

Transoral and Submental Thyroidectomy
Yufei Chen, Kathryn H. Chomsky-Higgins, Iheoma Nwaogu, Carolyn D. Seib, Jessica E. Gosnell, Wen T. Shen, Quan-Yang Duh, Insoo Suh 

Robotic Resection of an 8 mm Nonexophitic Pancreatic Insulinoma
Colleen M. Kiernan, Paula Marincola Smith, Zuliang Feng, Carmen C. Solórzano 

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Venous Thromboembolism in Patients with Sarcoma: A Retrospective Study

AbstractBackground.Little has been published about the association of venous thromboembolism (VTE) and sarcoma. In this study, we sought to identify clinical features of patients with sarcoma presenting at least one VTE episode.Methods.Our study was a retrospective case–control study of a single‐institution database with univariate and multivariate analysis using chi‐square and Student's t test. A p value less than .05 was considered significant.Results.The overall incidence of VTE in patients with sarcoma was 7.9%. Predictive factors identified by multivariate analysis were metastatic disease and administration of chemotherapy. It was not statistically possible to correlate the risk of VTE with specific sarcoma subtypes, but observations suggested malignant peripheral nerve sheath tumor, osteosarcoma, and liposarcoma as having the highest propension.Conclusion.VTE is not infrequent in patients with sarcoma. Adoption of common guidelines for cancer‐associated thrombosis is recommended.

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Cosmetic Consequences of Breast‐Conserving Treatment for Breast Cancer: Something Worth Talking About

AbstractBackground.Breast‐conserving treatment (BCT) for breast cancer can lead to deformation of the treated breast, resulting in patient dissatisfaction with the final cosmetic outcome. Currently, literature on the specific information needs of patients concerning the cosmetic effects of BCT is lacking. The aim of the present study was to investigate the information needs of breast cancer patients regarding the long‐term cosmetic outcome after BCT.Subjects, Materials, and Methods.The data from 115 women who had undergone BCT in a general teaching hospital breast cancer unit in The Netherlands were studied. Structured questionnaires and semi‐structured interviews were conducted between October 2012 and April 2013. A mixed model of quantitative and qualitative research was used to explore patient‐reported information needs. A phenomenological approach was used to analyze the qualitative data.Results.This study shows that women undergoing BCT want to discuss long‐term cosmetic effects. Most patients appreciate such information immediately after the diagnosis. Patients indicated that it is also important to pay attention to the cosmetic effects during the follow‐up visits, because deformation of the breast can also occur at a later stage. Furthermore, half the patients indicated that they would not likely raise the subject of cosmetic effects of the treatment themselves.Conclusion.Breast cancer patients have a need for long‐term attention for cosmetic outcome of BCT, which should be tailored during the treatment and follow‐up process.Implications for Practice.Currently, no literature exists concerning patients' needs for information regarding the cosmetic effects of breast‐conserving therapy (BCT). Bringing up the cosmetic effects of BCT by health care professionals does not appear to be a standard part of treatment and follow‐up. It is expected that the quality of care and life will be improved by providing information and guidance regarding the cosmetic outcome of BCT within the existing structure of the breast cancer pathway. Discussion and visualization of the cosmetic effects prior to treatment will lead to more realistic expectations, and as a result, secondary interventions, such as partial prostheses and plastic surgery, may be easier to discuss and accept.

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A Longitudinal Study of the Association of Clinical Indices of Cardiovascular Autonomic Function with Breast Cancer Treatment and Exercise Training

AbstractBackground.Cardiovascular autonomic dysfunction is an early marker for cardiovascular disease. Anthracycline chemotherapy and left‐sided radiation for breast cancer are associated with negative autonomic function changes. This study's objectives were to characterize changes in, and the association of exercise training with, clinical indices of cardiovascular autonomic function across the trajectory of breast cancer therapy.Subjects, Materials, and Methods.Seventy‐three patients receiving adjuvant chemotherapy participated to varying degrees in supervised aerobic and resistance exercise during chemotherapy ± radiation and for 20 weeks after. Resting heart rate (HRrest) and blood pressure were measured weekly during chemotherapy. HRrest, exercise heart rate recovery (HRrecovery), and aerobic fitness were measured at enrollment, end of chemotherapy ± radiation, and 10 and 20 weeks after treatment.Results.During chemotherapy, HRrest increased in a parabolic manner within a single treatment and with increasing treatment dose, whereas systolic and diastolic blood pressure decreased linearly across treatments. Tachycardia and hypotension were present in 32%–51% of participants. Factors associated with weekly changes during chemotherapy included receiving anthracyclines or trastuzumab, days since last treatment, hematocrit, and exercise attendance. Receipt of anthracyclines, trastuzumab, and left‐sided radiation individually predicted impairments of HRrest and HRrecovery during chemotherapy ± radiation; however, aerobic fitness change and at least twice‐weekly exercise attendance predicted improvement. By 10 weeks after treatment, HRrest and blood pressure were not different from prechemotherapy.Conclusion.In this study, chemotherapy resulted in increased HRrest and tachycardia, as well as decreased blood pressure and hypotension. Anthracyclines, trastuzumab, and left‐sided radiation were associated with HRrest elevations and impairments of HRrecovery, but exercise training at least twice a week appeared to mitigate these changes.Implications for Practice.This study characterized changes in clinically accessible measures with well‐established prognostic value for cardiovascular disease, and investigated associations with cardiotoxic treatments and the positive influence of exercise. The chemotherapy‐related incremental increase in resting heart rate, with tachycardia occurring in one third of patients, and decrease in blood pressure, with hypotension occurring in one half of the patients, is relevant to oncology practitioners for clinical examination or patient report of related symptoms (i.e., dizziness). The weekly dose of two 60‐minute sessions of moderate‐intensity aerobic and resistance exercise that was identified as protective of cardiovascular autonomic impairments can easily be prescribed to patients by oncologists.

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Prognostic Nomogram Based on Histological Characteristics of Fibrotic Tumor Stroma in Patients Who Underwent Curative Resection for Intrahepatic Cholangiocarcinoma

AbstractBackground.Fibrotic tumor stroma (FTS) has been implicated in cancer promotion in several neoplasms. The histological features of FTS are convenient and easily accessible in clinical routine in intrahepatic cholangiocarcinoma (ICC) specimens. The goal of this study was to explore prognostic impacts of the quantity and maturity of FTS on surgical ICC patients. Moreover, we aimed to propose an efficient prognostic nomogram for postoperative ICC patients.Materials and Methods.The clinical profiles of 154 consecutive postoperative ICC patients were retrospectively analyzed. Tumor‐stroma ratio and morphological maturity of FTS were evaluated on hematoxylin and eosin‐stained tumor sections. CD3, CD8, and α‐smooth muscle actin (α‐SMA) staining were performed on corresponding tissue microarrays. The nomogram was established on variables selected by multivariate analyses and was validated in 10‐fold cross‐validation.Results.Rich tumor stroma and strong α‐SMA expression were associated with poor overall survival (OS). However, in multivariate analyses, these two biomarkers failed to stratify both OS and recurrence‐free survival (RFS). Immature FTS was correlated with tumor multiplicity, advanced clinical stage, and sparser CD3 and CD8 positive tumor‐infiltrating lymphocytes (TILs) and was identified as an independent prognostic indicator for both OS and RFS. The nomogram comprising FTS maturity, tumor number, microvascular invasion, and lymph node metastasis possessed higher predictive power relative to conventional staging systems.Conclusion.Immature FTS was an independent risk factor for survival and was associated with sparser CD3 and CD8 positive TILs in ICC. The prognostic nomogram integrating the maturity of FTS offers a more accurate risk stratification for postoperative ICC patients.Implications for Practice.Accumulating evidence has suggested that fibrotic components in tumor microenvironment (TME) play a complicated and vital role in TME reprogramming and cancer progression. However, in clinical practice, the evaluation of fibrotic tumor stroma (FTS) is still neglected to some extent. This study's findings indicated that, in intrahepatic cholangiocarcinoma (ICC), the histological maturity of FTS is a robust prognostic indicator for patients who underwent curative resection. Moreover, prognostic nomogram constructed on the maturity of FTS possessed higher predictive power relative to the conventional tumor‐node‐metastasis staging systems. Taken together, the evaluation of FTS should be emphasized in clinical routine for more accurate prognostic prediction in postoperative ICC patients.

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Cost‐Effectiveness of Osimertinib in Treating Newly Diagnosed, Advanced EGFR‐Mutation‐Positive Non‐Small Cell Lung Cancer

AbstractBackground.The objective of this study was to assess cost and effectiveness of osimertinib in treating newly diagnosed advanced non‐small cell lung cancer with an epidermal growth factor receptor (EGFR) mutation from a public payer's perspective in the U.S. and China.Materials and Methods.Markov models were developed to compare three treatment strategies: first‐line use of osimertinib, first‐line use of the standard first‐generation EGFR‐tyrosine kinase inhibitor (EGFR‐TKI) followed by the second‐line use of osimertinib, and the standard first‐generation EGFR‐TKI therapy (standard care [SOC]). Clinical data, cost, and utility data were mainly derived from published literatures. Deterministic and probabilistic sensitivity analyses were conducted to assess the robustness of the incremental cost per quality‐adjusted life year (QALY) between the treatments.Results.The resultant incremental cost per QALY gained for the first‐line osimertinib versus SOC was $312,903 in the U.S. and $41,512 in China. The incremental cost per QALY for the second‐line osimertinib versus SOC was $284,532 in the U.S. and $38,860 in China. The probability of the SOC strategy being cost‐effective is 1.0 if the willingness to pay threshold is below $150,000/QALY in the U.S. and below $30,000/QALY in China.Conclusion.Osimertinib as first‐line treatment could gain more health benefits in comparison with standard EGFR‐TKIs or second‐line use of osimertinib. However, because of the high cost of treatment, the cost‐effectiveness analyses were not in favor of the first‐line use of osimertinib from a public payer's perspective in the U.S. and China.Implications for Practice.Osimertinib as first‐line treatment yielded the greatest health outcomes but is not a cost‐effective strategy for lung cancer in the U.S. and China. The price of osimertinib has a substantial impact on economic outcomes.

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Tooth crown discoloration induced by endodontic sealers: a 3-year ex vivo evaluation

Abstract

Objectives

The aim of this study was to evaluate the tooth crown discoloration induced by commonly used and new-generation endodontic sealers after 1 month and 1 and 3 years.

Materials and methods

The crowns of 60 extracted incisors were cut and the pulp chambers were cleaned. The specimens were divided randomly into four groups (n = 15 each). Pulp chambers were filled with Pulpispad in group 1, AH26 in group 2, MTA Fillapex in group 3, and EndoREZ in group 4. Specimen color was measured with a spectrophotometer before and after sealer placement. Commission International de L'Eclairage's (CIE's) lighteness (L*), red-green (a*), yellow-blue (b*) color system values and color difference (ΔE) were recorded at 1 month and 1 and 3 years. Data were analyzed using repeated-measures analysis of variance and Tukey's honestly significant difference test (α = 0.05).

Results

All sealers caused discoloration. At 1 month, ΔE values were significantly higher in groups 1 and 2 than in groups 3 and 4 (p < 0.05). At 1 year, ΔE values were significantly lower in group 3 than in the other groups (p < 0.05). At 3 years, ΔE values were significantly higher in group 1 than in the other groups (p < 0.05).

Conclusions

All tested sealers induced varying chromatic alterations. After root canal obturation, thorough debridement of sealers from the pulp chamber is essential for the prevention of sealer-induced discoloration.

Clinical relevance

Tooth discoloration induced by endodontic materials is a problem for clinicians and patients and may impair the esthetic of endodontically treated teeth. Therefore, evaluation of long-term discoloration effects commonly used, and new-generation endodontic sealers were purposed in this study.

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Early Growth Hormone Intervention Improves Glucose Metabolism in Adult Rats Born Small for Gestational Age

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0723-3544

Background Small for gestational age (SGA) due to intrauterine malnourishment is closely related to metabolic syndrome and type 2 diabetes mellitus. Growth Hormone (GH) treatment has been demonstrated to influence metabolic parameters and islet function of SGA individuals. The present study demonstrates the effects of early GH treatment on glucose tolerance and expression of pancreatic duodenal homeobox 1 (Pdx1) of SGA rats during adulthood Methods SGA rat model was induced by restricting food intake during pregnancy. GH or normal saline was administered during postnatal days 21–35 of SGA rats and appropriate for gestational age (AGA) rats, respectively. Results In early adulthood (postnatal day 70), as compared to AGA rats, SGA rats showed: (1) decreased body weight; (2) increased postprandial blood glucose; and (3) down-regulated Pdx1 with increased histone deacetylase (HDAC) and down-regulated histone H3-lysine 4 methyltransferase SET7/9. Exogenous GH administration led to a restoration of body weight and normalized glucose tolerance due to an enhanced Pdx1 expression, accompanied by decreased HDAC and up-regulated SET7/9 in SGA rats in early adulthood. Conclusion Our results demonstrate positive effects on glucose metabolism by an early and short GH treatment in SGA adulthood.
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© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Consequences of the Adoption of the IADPSG versus Carpenter and Coustan Criteria to Diagnose Gestational Diabetes: A Before-After Comparison

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0735-9469

Aims To evaluate if the adoption of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria for Gestational Diabetes Mellitus (GDM) led to changes in the management and in the occurrence of pregnancy complications. Methods This was a retrospective study of women with GDM followed at a single university center, diagnosed in 2009–2010 using the Carpenter and Coustan criteria (period 1) and in 2012–2013 using the IADPSG criteria (period 2). Results We included 286 women with GDM, 129 in period 1 and 157 in period 2. Age, body mass index and weight gain during pregnancy were similar. There were less women requiring insulin therapy in period 2 than in period 1 (43.3% versus 55.0% respectively, p=0.048), but no significant difference in the number of cesarean section, in babies born large for gestational age and in the occurrence of preeclampsia. There was less neonatal hypoglycemia (<2.5 mmol/l) in period 2 versus period 1 (7 versus 23 neonates respectively, p<0.001). Conclusions When using the new IADPSG criteria, women with a less severe GDM are diagnosed, and fewer women require insulin. There was no difference in maternal outcomes, but less neonatal hypoglycemia during when using the IADPSG criteria.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Clinical Characteristics of Patients with co-Existent Diabetic Peripheral Neuropathy and Depression: A Systematic Review

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0741-6937

Objectives Both diabetic peripheral neuropathy and depression have significant implications on patients' quality of life, management and outcomes. We aimed to evaluate all available evidence concerning patients with co-existent diabetic peripheral neuropathy and depression, and describe their clinical characteristics, in order to promote early recognition and management. Methods Systematic search of PubMed for studies providing data on patients with diabetic peripheral neuropathy and depression. The primary outcome was to evaluate all available evidence related to characteristics of diabetes, diabetic peripheral neuropathy and depression. Secondary study outcomes included comorbid conditions and complications in these patients. Results Final analysis included 24 studies with data on 205 patients. Most patients were adults between 18–65 years of age. Mean HbA1c value was above 8% and most patients were treated with insulin. Neuropathy was predominantly painful and most patients with available data were considered to have major depressive disorder. In addition to diabetic peripheral neuropathy and depression, diabetes-related complications were recorded in 43 patients, the most common being autonomic neuropathy, retinopathy and nephropathy. The most frequently reported comorbidities were weight loss (72 patients), impotence (60 patients), hypertension (23 patients) and coronary artery disease (22 patients). Conclusions The present study describes the characteristics of patients with co-existent diabetic peripheral neuropathy and depression, aiming for prompt detection, prevention of further deterioration and improvement of patient outcomes. Available evidence shows that the majority of these patients are adults, with painful peripheral neuropathy and with insulin-treated and inadequately controlled diabetes.
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© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Angiopoietin-like 8 Improves Insulin Resistance and Attenuates Adipose Tissue Inflammation in Diet-Induced Obese Mice

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0725-7897

Angiopoietin-like 8 (ANGPTL8) is closely linked to obesity-associated metabolic diseases and insulin resistance. The aim of the current study was to investigate the ability of ANGPTL8 to reverse insulin resistance in obese mice. The administration of ANGPTL8 reduced weight gain and improved glucose tolerance in mice with diet-induced obesity. In addition, ANGPTL8 administration modified macrophage infiltration, reduced monocyte chemoattractant protein-1 (MCP-1) and interleukin-1β(IL-1β) levels, and increased adiponectin gene expression in inguinal white adipose tissue (iWAT). Moreover, the exposure of a cultured peritoneal macrophage line to ANGPTL8 reduced the mRNA expression of M1 macrophage markers (TNF-α and IL-1β) upon stimulation with lipopolysaccharides in a dose-dependent manner. By contrast, when incubated with IL-4, exposure of macrophages to ANGPTL8 increased the mRNA expression of M2 macrophage markers (Arg1 and Chi3l3) in a dose-dependent manner. Collectively, the results of the present study demonstrated that treatment with ANGPTL8 can attenuate adipose tissue inflammation through regulation of macrophage polarization, and thus, it could be useful for improving insulin resistance.
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© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Reply to: letter to the editor about the article published in Clinical Oral Investigations tilted: impacted and transmigrated mandibular canines: an analysis of 3D radiographic imaging data (Bertl MH, Frey C, Bertl K, Giannis K, Gahleitner A, Strbac GD (2018) Clin Oral Investig, doi: 10.1007/s00784-018-2342-0

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The Infraorbital Artery: Clinical Relevance in Esthetic Medicine and Identification of Danger Zones of the midface

Over the past decade, cosmetic injections of dermal fillers or fat have become a popular procedure in facial rejuvenation in an overconsuming society. However, complications such as arterial embolism and occlusion can occur even with experienced injectors, especially in high-risks zones namely the glabella, the nasal dorsum or the nasolabial fold. The aim of this study was to define the vascular danger zones of the infraorbital area in order to provide guidelines helping avoid them.

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Scholar : These new articles for Creative Industries Journal are available online

The online platform for Taylor & Francis Online content New for Creative Industries Journal and online now on Taylor & Francis Online: Articles Uncovering the influences on decision making in the popular music industry; intuition, networks and the desire for symbolic capital David Schreiber & Alison Rieple Pages: 1-18 | DOI: 10.1080/17510694.2018.1490146 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Endovascular management of a large retroperitoneal haemorrhage resulting from dual testicular and intra-renal arterial injury after renal biopsy

Munawwar Ahmed, Shyamkumar Nidugala Keshava, Vinu Moses, Anna T Valson

Indian Journal of Radiology and Imaging 2018 28(3):362-365

Percutaneous renal biopsy is a minimally invasive procedure in the work up of a chronic kidney disease patient. However, it is not free from the complications. Hematuria and abdominal haemorrhage due to intra-renal artery injury are the common complications. We report and discuss the management of a rare case of retroperitoneal haemorrhage resulting from dual arterial injury involving left testicular artery and intra-renal artery.

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Assessment of variations in sphenoid sinus pneumatization in Indian population: A multidetector computed tomography study

Shivaprakash B Hiremath, Amol A Gautam, Keerthy Sheeja, Geena Benjamin

Indian Journal of Radiology and Imaging 2018 28(3):273-279

Background and Purpose: The purpose of our study was to assess the prevalence of variations in the extent of sphenoid pneumatization in the Indian population and compare with existing literature. Materials and Methods: This retrospective study included 500 patients who underwent CT of the paranasal sinuses. The multiplanar reformations of paranasal sinus were assessed for the type of pneumatization of the sphenoid sinus and type of clival, lateral recess, lesser wing, and anterior recess extensions. Results: The conchal, presellar, incomplete sellar, and complete sellar types comprised 0%, 1.2%, 22.2%, and 76.6% of patients. The extensions of pneumatization subtypes in the study population were clival in 76.6% subjects; lateral recess, lesser wing, and anterior recess in 59.7%, 20.4%, and 20.4% of sinuses, respectively. The pure forms were seen in 25.4% and combined forms in 61% of sinuses. The presellar type (1.2%) was less common and sellar type (98.8%) being common in our population compared to the Caucasian and East Asian population. The sphenoid sinuses were extensively pneumatized in our population compared to the Chinese and Caucasian population, the prevalence being 76.6%, 68%, and 44.5% for clival; 59.7%, 46%, and 28.3% for lateral recess; 20.4%, 32%, and 12% for lesser wing extension, respectively. The pure forms were relatively less common and combined forms being more common compared to the Chinese and Caucasian population in our study. Conclusion: The extent of pneumatization of the sphenoid sinus has clinical and surgical implications in sellar and central skull base lesions, and variability in different populations confirms that ethnicity influences the differences in prevalence.

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Ergonomics in radiology – Time to revisit

Chander Mohan

Indian Journal of Radiology and Imaging 2018 28(3):271-272



https://ift.tt/2OUnPri

Plain CT vs MR venography in acute cerebral venous sinus thrombosis: Triumphant dark horse

Poornima Digge, Koteshwar Prakashini, KV Bharath

Indian Journal of Radiology and Imaging 2018 28(3):280-284

Context: Most patients with cerebral venous sinus thrombosis (CVST) present with nonspecific signs and symptoms and are likely to undergo nonenhanced head computed tomography (NCT) at presentation, which may show a normal report in up to two-thirds of patients. However, in case of acute thrombosis, sensitivity of diagnosing CVST is high as sinuses are hyperdense. Though magnetic resonance imaging (MRI) is considered the imaging modality of choice for diagnosing CVST, it is not universally available in an acute setting. Aims: To evaluate whether increased attenuation in cerebral venous sinuses in acute condition can be used to diagnose acute CVST and to determine its diagnostic value. Materials and Methods: The study involves two independent groups. One group of patients with sinus thrombosis were confirmed by MR venography (group A). The other group included patients without sinus thrombosis (group B). The HU (CT attenuation), hemoglobin (HGB), hematocrit (HCT), and H: H (HU: HCT) ratio of both groups were compared. Thirty-six patients (59 thrombotic sinuses) were studied in group A and 40 in group B. Statistical Analysis: Average HU and H: H ratio were compared using two-tailed t-test, and linear regression analysis was used to assess correlation between HCT and HU. Results: Average HU (73.7 vs 48.6) and H: H ratio values were higher in group A patients compared to group B (P < 0.05). Linear regression analysis showed positive correlation between HGB and HCT with HU among both the groups (P < 0.05). Conclusions: Our study demonstrates that acute CVST can be diagnosed using HU values in NCT.

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Impact of revised atlanta classification of acute pancreatitis on generation of a score employing modified CT severity index

Yashant Aswani, Prashant K Singh

Indian Journal of Radiology and Imaging 2018 28(3):374-375



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3T proton MR spectroscopy evaluation of spinal cord lesions

Babu Peter Sathyanathan, Bharathi Priya Raju, Kailasanathan Natarajan, Ravi Ranganathan

Indian Journal of Radiology and Imaging 2018 28(3):285-295

Objective: The objective of this study was to evaluate intramedullary spinal cord lesions using magnetic resonance spectroscopy and correlate the results with histo-pathological examination (HPE). Materials and Methods: Approval for this study was obtained from our institute ethical committee. Overall, 50 patients were recruited (29 male and 21 female), with a maximum age of 53 years and minimum age of 7 years. The mean age group of the study was 33 years. Standard magnetic resonance imaging (MRI) spine was done on a Siemens Skyra 3Tesla MRI scanner. MR Spectroscopy (MRS) was performed for all patients with intramedullary spinal lesions after getting written consent. It was performed using single-voxel method. The change in the metabolite peak was observed in each case and the results were compared with HPE. These collected data were analyzed using SPSS 16.0 version. Descriptive statistics, frequency analysis, and percentage analysis were used for categorical variables; and for continuous variables, mean and standard deviation were analyzed. McNemar's test was used to find the significance between conventional MRI MRS. In the above statistical tool, the probability value 0.05 is considered as significant level. Results: From our study, we observed that by applying routine MRI sequences alone, we could only detect around 58% of the cases correctly. However, when MRS was done along with the conventional MR imaging, the number of cases detected significantly increased to 84%. By applying McNemar's test and comparing the conventional MRI and MRS with HPE, it was found that statistically significant difference exists with P value of 0.007. Conclusion: MRS of the spinal cord is a promising tool for research and diagnosis because it can provide additional information complementary to other non-invasive imaging methods. It is an emerging tool and adds new biomarker information for characterization of spinal cord tumors, to differentiate benign from malignant lesions and to prevent unnecessary biopsies and surgeries.

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Interventional radiology-operated endoscopy using the LithoVue disposable endoscope: Approach, technical success, clinical outcomes, and complications

Nishant Patel, Jeffrey Forris Beecham Chick, Joseph Gemmete, Rudra Pampati, Evan Johnson, Ravi Srinivasa

Indian Journal of Radiology and Imaging 2018 28(3):350-353

Purpose: To report the approach, technical success, clinical outcomes, and complications of interventional radiology-operated endoscopy using the LithoVue disposable endoscope. Materials and Methods: 12 patients, 6 (50%) males and 6 (50%) females, underwent interventional radiology-operated endoscopy using the LithoVue disposable endoscope between April 2016 and August 2017. Presenting complaint, reason for endoscopic evaluation, technical success, clinical success, procedure time, fluoroscopy time, hospital length of stay, and complications were recorded. Results: Interventional radiology-operated endoscopy using the LithoVue disposable endoscope was used in 8 (67%) biliary, 2 (16.5%) urologic, and 2 (16.5%) gastrointestinal procedures. Five (42%) patients required endoscopy to locate an ostium that could not be cannulated under fluoroscopy. Five (42%) patients had a biliary-enteric anastomosis with postoperative anatomy of the bowel which precluded endoscopic retrograde cholangiopancreatography and underwent endoscopy for removal of calculi. One (8%) patient underwent treatment of a stricture and one (8%) underwent biopsy. Technical success was 92% (11/12). Clinical success was 83% (10/12). Two complications, a perinephric hematoma and sepsis, occurred. Conclusion: Disposable endoscopes, including the LithoVue, may be used in a variety of procedures to improve patient care and limit fluoroscopy.

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Myriad of MR imaging phenotypes of primary central nervous system lymphoma in a cohort of immunocompetent Indian patient population

Sankar Neelakantan, Sunitha P Kumaran, Sanjaya Viswamitra, Nandita Ghosal

Indian Journal of Radiology and Imaging 2018 28(3):296-304

PCNSL (primary central nervous system lymphoma) is a chemosensitive and radiosensitive tumor, and early diagnosis has a significant impact on management. Unlike many other brain tumors, radical surgical excision of PCNSLs is not indicated because these lesions are highly infiltrative and even partial resection leads to a bad prognosis. The goal of this study is to highlight the unusual radiological presentation of PCNSLs and increase the awareness, familiarity, and global database of our observations that pose a challenge on management.

https://ift.tt/2zwSwh9

Segmental dilatation of ileum in a young patient presenting with anemia

Neha Nischal, Deepak Balachandra, Anil Kumar Agarwal, Sunil Kumar Puri

Indian Journal of Radiology and Imaging 2018 28(3):369-372

Segmental dilatation of ileum (SDI) is a less known uncommon entity with a confusing clinical scenario and no definite etiopathogenesis. The preoperative diagnosis is of exclusion. However, it has an excellent prognosis after surgery. We describe a case of a young patient who presented with anemia without any overt gastrointestinal (GI) bleed. Thorough radiological examinations were needed to reach the diagnosis of SDI which was confirmed postoperatively.

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Conventional and advanced brain MR imaging in patients with sickle cell anemia

Pratibha Issar, Maya Nehra, Gurmeet Singh, SK Issar

Indian Journal of Radiology and Imaging 2018 28(3):305-311

Background: Sickle cell disease (SCD) is an autosomal recessive hemolytic disorder; its cerebrovascular complications include silent cerebral ischemia, infarct, and brain atrophy. Conventional magnetic resonance imaging (MRI) often underestimates the extent of injury. Diffusion tensor imaging (DTI) can demonstrate and quantify microstructural brain changes in SCD cases having normal routine MRI. Objective: To identify various neurological abnormalities in asymptomatic sickle cell patients using routine MRI and to evaluate the microstructure of various regions of the brain using DTI. Materials and Methods: A prospective, randomized case–control study was conducted over a period of 2 years. A total of 58 cases of SCD and 56 age- and sex-matched controls were included. Routine MRI and DTI were performed in both the groups following a standard protocol. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were calculated in certain pre-defined regions. Primary data were analyzed using MS excel version 17. Analysis of variance test was performed and statistical significance was set at P < 0.05. Results: Thirty regions of interest with 60 variables were included in the final analysis. Patients with SCD showed statistically significant reduced FA values, increased ADC values, or both, clustered in several brain areas, including pons, cerebral peduncle, corpus callosum, frontal, temporal, parietal white matter, centrum semiovale, periventricular areas, basal ganglia, and left thalamus (P < 0.05). Conclusion: DTI is a promising method for characterizing microstructural changes, when conventional MRI is normal.

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Mid-sagittal section of the fetal face: Still a showstopper

Divya Singh, Ladbans Kaur

Indian Journal of Radiology and Imaging 2018 28(3):376-377



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Magnetic resonance imaging findings in brain resulting from high-voltage electrical shock injury of the scalp

Dileep P Chandrasekhar, Mohan L Noone, S P Harish Babu, V T Chandra Bose

Indian Journal of Radiology and Imaging 2018 28(3):312-314

We report a case of high-voltage electrical injury to scalp, focusing on the magnetic resonance imaging (MRI) findings in brain. A 51-year-old male suffered burns to the right side of scalp and loss of consciousness following electric shock. Brain abnormalities were detected on MRI taken 4 days after the insult. Right parietal lobe neuroparenchyma beneath the scalp burn defect demonstrated homogeneous hypointensity on T1-weighted MR images, while T2-weighted images depicted hyperintensity mainly in white matter forming finger-like projections. Follow-up MRI showed that the abnormality had disappeared, indicating that the cerebral edema was reversible.

https://ift.tt/2zvVjaj

Magnetic resonance imaging as an adjunct to computed tomography in the diagnosis of pulmonary Hydatid cysts

Roopa Tandur, Aparna Irodi, Binita Riya Chacko, Leena Robinson Vimala, Devasahayam Jesudas Christopher, Birla Roy Gnanamuthu

Indian Journal of Radiology and Imaging 2018 28(3):342-349

Introduction: Although pulmonary hydatid cysts can be diagnosed on computed tomography (CT), sometimes findings can be atypical. Other hypodense infective or neoplastic lesions may mimic hydatid cysts. We proposed that magnetic resonance imaging (MRI) may act as a problem-solving tool, aiding the definite diagnosis of hydatid cysts and differentiating it from its mimics. The aim of this study is to assess the findings of pulmonary hydatid cysts on CT and MRI and the additional contribution of MRI in doubtful cases. Materials and Methods: This is a retrospective study of 90 patients with suspected hydatid cysts. CT and MRI findings were noted and role of MRI in diagnosing hydatid cysts and its mimics was studied. Descriptive statistics for CT findings and sensitivity and specificity of MRI were calculated using surgery or histopathology as gold standard. Results: Of the 90 patients with suspected pulmonary hydatid cysts, there were 52 true-positive and 7 false-positive cases on CT. Commonest CT finding was unilocular thick-walled cyst. In the 26 patients who had additional MRI, based on T2-weighted hypointense rim or folded membranes, accurate preoperative differentiation of 14 patients with hydatid cysts from 10 patients with alternate diagnosis was possible. There was one false-positive and one false-negative case on MRI. Conclusion: Although hydatid cyst can be diagnosed on CT on most occasions, sometimes there are challenges with certain mimics and atypical appearances. T2-weighted MRI can act as a problem solving tool to conclusively diagnose hydatid cyst or suggest an alternate diagnosis.

https://ift.tt/2OUnNQc

Triple-phase MDCT of liver: Scan protocol modification to obtain optimal vascular and lesional contrast

Sheoran Sween, Chatterjee Samar, Sekhar M Binu

Indian Journal of Radiology and Imaging 2018 28(3):315-319

Context: With advances in 16-slice multidetector computed tomography (MDCT), the entire liver can be scanned in 4–6 s and a single breath-hold dual-phase scan can be performed in 12–16 s. Consequently, optimizing the scan window has become critical. Aim: The purpose of our study was to optimize scan delays using bolus-tracking techniques for triple-phase CT of the liver. Settings and Design: Fifty patients with liver lesions were randomly divided into two groups with 25 patients each. The patients were subjected to triple-phase MDCT of liver with two different scan protocols. Materials and Methods: They were administered 1.5 mL/kg of 300 mg/mL of iohexol at a rate of 3.0 mL/s with a pressure injector. Using bolus-tracking program, scans were commenced at 4, 19, and 44 s and 8, 23, and 48 s for the first, second, and third phases, respectively. The mean CT values [Hounsfield unit (HU)] were measured in the aorta, hepatic artery, portal vein, hepatic vein, liver parenchyma, and lesion using circular region of interest cursor ranging in size from 5 to 20 mm in diameter on all phases. Statistical Analysis Used: Statistical analysis was carried out using paired Student's t-test. Results: In hepatic arterial phase, hepatic artery has shown better enhancement in Group B (8 s) (P = 0.0498) compared with Group A (4 s). In portal venous phase, there were no significant differences in contrast enhancement index (CEI) values at any of the six measured regions between the groups. In the hepatic venous phase, liver parenchyma has shown nearly significant (P = 0.0664) higher CEI values in Group B (48 s) when compared with Group A (44 s). Conclusion: A scan delay of 8 s, after trigger threshold (100 HU) is reached in the lower thoracic aorta, is optimal for the early arterial phase imaging, this phase being most helpful for assessment of hepatic arterial tree (CT angiography). The liver parenchyma showed maximum enhancement at 48 s scan delay.

https://ift.tt/2zx01UZ

Predicting the molecular subtype of breast cancer based on mammography and ultrasound findings

S Rashmi, S Kamala, S Sudha Murthy, Swapna Kotha, Y Suhas Rao, K Veeraiah Chaudhary

Indian Journal of Radiology and Imaging 2018 28(3):354-361

Aim: To determine the correlation between mammography and ultrasound features of breast cancer with molecular subtypes and to calculate the predictive value of these features. Materials and Method: This is a prospective study of consecutive patients with breast cancer presenting between January 2016 and July 2017, who underwent mammography and/or ultrasound of breast and excision of the breast mass. Patients with contralateral breast mass, metastases, h/o prior cancer treatment, and other malignancies were excluded. On mammography, the presence or absence of microcalcification was noted. On ultrasound examination size, margins, microcalcification, posterior acoustic features, vascularity, and axillary nodes were assessed. Margins were categorized into circumscribed and non-circumscribed. Posterior acoustic features were classified into four categories: shadowing, enhancement, mixed, and no changes. Vascularity was assessed based on Adler's index into grades 0, 1, 2, and 3. Grades 0 and 1 were considered low and 2 and 3 were high. Results: Tumors with non-circumscribed margins and posterior acoustic shadowing were likely to be luminal A or B subtype of breast cancer [odds ratio (OR) 5.78; 95% confidence interval (CI) 3.68–9.80; P < 0.0001]. Tumors with non-circumscribed margins, posterior acoustic shadowing, and high vascularity were more likely to be luminal B subtype (OR 2.88; 95% CI 2–4.14; P- <0.0001). Tumors with microcalcification and posterior mixed acoustic pattern were strongly associated to be HER2-positive (OR 5.48; 95% CI 3.06–9.80; P < 0.0001). Tumors with circumscribed margins and posterior acoustic enhancement were highly suggestive of triple-negative breast cancer (OR 7.06; 95% CI 4.64–10.73; P < 0.0001). Conclusion: Microcalcification detected on mammography and certain ultrasound features such as circumscribed or non-circumscribed margins, posterior acoustic features, and vascularity are strongly correlated in predicting the molecular subtypes of breast cancer, and thus may further expand the role of conventional breast imaging.

https://ift.tt/2OUw8mS

Characteristic changes of the ablation zone on contrast-enhanced computed tomography after radiofrequency ablation of hepatic metastases

Markus Zimmermann, Christiane Kuhl, Sebastian Keil

Indian Journal of Radiology and Imaging 2018 28(3):320-326

Purpose: Size and density measurements of the ablation zones on contrast-enhanced computed tomography (CT) after radiofrequency ablation (RFA) of hepatic metastases of primary breast or colorectal cancer were acquired over time. Materials and Methods: Twenty-five liver metastases [colorectal cancer (CRC): n = 16; mean size: 19.6 ± 8.5 mm; breast cancer (BC): n = 9; 27.9 ± 13.6 mm] in 15 patients (CRC: n = 11; age: 65.4 ± 6.5 years; BC: n = 4; 62.0 ± 13.8 years) treated by RFA were included in this retrospective study. All patients had undergone postinterventional serial follow-up using multidetector CT (MDCT) (1 day/1/4/7/10/14/18/23/>24 months) without evidence of local tumor recurrence during the follow-up. The ablation zones were evaluated using a commercial software tool (Syngo CT Oncology) in order to determine volumetric, RECIST-, WHO- and density changes over the course of time. Results were compared by applying repeated measures analysis of variance and displayed graphically. Results: The RF ablation zones demonstrated significant shrinkage (P ≤ 0.05) over the first 7 months (volume, RECIST, WHO) of the follow-up. Follow-up after 7 months did not show any significant changes in size (P > 0.05) (mean volume (ml): 55.2/34.7/26.3/16.5/12.7/10.0/8.9/8.1/7.5; RECIST (mm): 58.7/49.3/43.7/37.8/34.2/31.3/29.1/27.3/24.8; WHO (mm2): 2458.3/1769.3/1341.8/1027.1/870.1/720.2/649.0/570.4/511.3). Mean density values decreased significantly between 1 day (58.9 HU) and 1 month (47.5 HU) after the procedure. Conclusion: Typical changes in size and density values of RF-induced, recurrence-free ablation zones after RFA of hepatic metastases of colorectal and breast cancer were acquired, showing a significant decrease in density of the ablation zone within the first month and significant shrinkage within the first 7 months after RFA.

https://ift.tt/2zvViDh

Prenatal diagnosis of congenital high airway obstruction syndrome

Víctor Lago Leal, Luis Martínez Cortés, Carlos Seco Del Cacho

Indian Journal of Radiology and Imaging 2018 28(3):366-368

Congenital high airway obstruction syndrome (CHAOS) is a rare sequence due to a complete obstruction of the fetal airway that blocks the larynx or trachea, either intrinsic atresia or extrinsic compression (e.g., congenital neck mass). Despite the true incidence of CHAOS is unknown, an incidence of 1 per 50,000 newborns is described. If any obstruction occurs in the tracheobronchial airway, this secretion cannot be extricated. Because of this situation, a knock-on effect starts: the enlargement of the lungs squeezes the heart and great veins, what results in a replacement of the heart to the center of the chest becoming small and dysfunctional. Decreased venous return and the failure of cardiovascular system end in ascites and hydrops. The diaphragm planes or inverts according to the severity of the process. In case of unrecognized syndrome during the prenatal period, it usually results in stillbirth or death shortly after delivery. The overall prognosis remains fatal, and long-term medical and surgical challenges for survivors remain considerable even after overcoming fetal intervention.

https://ift.tt/2OUpSLR

Mucinous cystadenoma of pancreas with honeycombing appearance: Radiological-Pathological correlation

Beno Jefferson, Indiran Venkatraman, R Vinoth Kumar, Karkuzhali Ponnuswamy, Anbukkarasi , Prabakaran Maduraimuthu

Indian Journal of Radiology and Imaging 2018 28(3):327-329

Most mucinous cystadenomas of pancreas are solitary and multilocular with a few large compartments. Serous cystadenomas usually have a polycystic or microcystic (honeycomb) pattern consisting of collection of cysts (usually >6) that range from few millimetres up to 2 cm in size. Here we present a case of mucinous cystadenoma of pancreas showing an unusual appearance of honeycombing (which has not been described so far) using imaging studies such as endoscopic ultrasound and computed tomography with histopathological confirmation of the diagnosis.

https://ift.tt/2QbJOKx

Post radiation evolution of giant virchow-robin spaces in a case of pituitary macroadenoma

Manoj Gopinath, Chinmay Nagesh, Chandrasekhar Kesavadas

Indian Journal of Radiology and Imaging 2018 28(3):373-374



https://ift.tt/2Oexagl

Pica and the radiologist – beyond the radiology report … digging deeper

Sameer R Kalgaonkar, Ravi Ramakantan

Indian Journal of Radiology and Imaging 2018 28(3):330-332

Pica is a psychological disorder of intentional and craving consumption of non-nutritive substances over a period of time. This is seen at an age when such a behavior is developmentally inappropriate. Substances such as wall paint, soil, hair, and feces have been reported as being consumed. Complications of this condition may range from being self-limiting to life-threatening. Radiological examinations play a crucial role in the diagnosis and management of this condition. We present a case of a 9-year-old boy who presented with chronic abdominal pain with history of persistent consumption of pencil erasers. Abdominal radiographs showed radio-opaque foreign bodies, and etiological diagnosis was made when the radiologist obtained a detailed history from the patient's mother. We also discuss the radiographic evaluation of the pencil eraser and the reason why it is densely radio-opaque.

https://ift.tt/2QcFkDz

Scholar : These new articles for Critical Inquiry in Language Studies are available online

The online platform for Taylor & Francis Online content New for Critical Inquiry in Language Studies and online now on Taylor & Francis Online: Articles The practicality and relevance of peace in an EFL teacher training program: Applications and implications Gene Vasilopoulos, Gloria Romero, Reza Farzi, Mariana Shekarian & Douglas Fleming Pages: 1-20 | DOI: 10.1080/15427587.2018.1520599 BFLA Spanish-English Mexican American bilinguals Irdawati Bay Nalls Pages: 1-20 | DOI: 10.1080/15427587.2018.1520598 To update which email alerts you receive, manage your alerts within the My Account area. Unsubscribe from new content alerts for this journal (both new issue and latest article notifications) with one click. If you need any further help, please contact us at support@tandfonline.com Please do not reply to this email. To ensure that you receive your alerts and information from Taylor & Francis Online, please add "alerts@tandfonline.com" and "info@tandfonline.com" to your safe senders list. Taylor & Francis, an Informa business. Taylor & Francis is a trading name of Informa UK Limited, registered in England under no. 1072954. Registered office: 5 Howick Place, London, SW1P 1WG.

Agreement and illusion of disagreement: an ERP study on Basque

Publication date: Available online 26 September 2018

Source: Cortex

Author(s): S. Mancini, S. Massol, J.A. Duñabeitia, M. Carreiras, N. Molinaro

Abstract

Agreement is a syntactic relation involving a controller (e.g. a noun) and a target with matching inflectional morphology (e.g. a verb). Across languages, electrophysiological studies consistently report that the presence of a mismatch yields late positive effects (P600), often preceded by early negativities. The current study focuses on person agreement in Basque to investigate whether online processing routines are modulated by the relative semantic prominence of nominal and verbal person features. In an ERP experiment in Basque, we manipulated the semantic markedness of nominal and verbal person features, creating 1^st (marked) and 3^rd (unmarked) person correct and incorrect sentences [Japoniarrok_1pleuskara ikasi dugu_1pl/*dute_3plgustora (We Japanese have_1pl/*3pl learn Basque with pleasure); Japoniarrek_3pleuskara ikasi dute_3pl/*dugu_1pl gustora (The Japanese have_3pl/*1pl learnt Basque with pleasure)]. Both mismatches elicited an N400 effect, but only marked 1^st person mismatches (Japoniarrok_1pl … *dute_3.pl) generated a P600, suggesting that (i) mismatches with unmarked 3^rd person subjects (Japoniarrek_3.pl… *dugu_1.pl) are not treated as outright violations; (ii) the emergence of late positive effects is sensitive to fine-grained discourse information. Overall, these results call for a revision in the analysis of agreement relations from a theoretical and a processing perspective.

https://ift.tt/2IjSOdU

Endothelial Cells: New Players in Obesity and Related Metabolic Disorders

Publication date: Available online 25 September 2018

Source: Trends in Endocrinology & Metabolism

Author(s): Mariona Graupera, Marc Claret

Metabolic disorders such as obesity are accompanied by endothelial cell (EC) dysfunction and decreased vascular density. The current paradigm posits that metabolic alterations associated with obesity secondarily lead to EC dysfunction. However, in view of recent evidence reporting that EC dysfunction per se is able to cause metabolic dysregulation, this paradigm should be revisited and further elaborated. In this article we summarize current views and discuss evidence in favor of a causal role for ECs in systemic metabolic dysregulation. We also integrate and contextualize current research in a pathophysiological framework and discuss potential therapeutic strategies targeting angiogenesis to help to counteract obesity.

https://ift.tt/2xDlpa6

4D Flow MRI quantification of blood flow patterns, turbulence and pressure drop in normal and stenotic prosthetic heart valves

Publication date: Available online 26 September 2018

Source: Magnetic Resonance Imaging

Author(s): Hojin Ha, John-Peder Escobar Kvitting, Petter Dyverfeldt, Tino Ebbers

Abstract

Purpose

To assess valvular flow characteristics and pressure drop in a variety of normal and stenotic prosthetic heart valves (PHVs) using 4D Flow MRI.

Materials and methods

In-vitro flow phantoms with four different PHVs were studied: Medtronic-Hall tilting disc, St. Jude Medical standard bileaflet (STJM), Medtronic CoreValve Evolut R and Edwards SAPIEN 3. The valvular flow characteristics were investigated in normal and stenotic PHVs by using 4D Flow MRI.

Results

The results showed that each valve provided a different amount of signal loss in the 4D Flow MRI. The defect size of the signal loss from each valve was 37.5 mm, 39.0 mm, 37.5 mm and 51.0 mm for the Tilting disk, STJM, SAPIEN 3 and CoreValve, respectively. The 4D Flow MRI-based estimation of the elevation of the pressure drop through the stenotic PHV using both Bernoulli-based and turbulence-based methods correlated well with the true values for the Tilting disc, STJM and SAPIEN 3 valve. However, the obstructive hemodynamics in the stenotic CoreValve was not clearly identified due to the large signal void from the long struts, resulting in a severe underestimation of the pressure drop using 4D Flow MRI.

Conclusion

The Tilting disc, STJM and SAPIEN 3 valves provided reasonable estimates of peak velocity, turbulence production and the corresponding pressure drop. In contrast, the large strut of the CoreValve and corresponding signal void prevented accurate measurements of the velocity and turbulence production; therefore, 4D Flow MRI prediction of the pressure drop through the CoreValve was not feasible.

https://ift.tt/2ORm524

Simultaneous MR neurography and apparent T2 mapping in brachial plexus: Evaluation of patients with chronic inflammatory demyelinating polyradiculoneuropathy

Publication date: Available online 25 September 2018

Source: Magnetic Resonance Imaging

Author(s): Akio Hiwatashi, Osamu Togao, Koji Yamashita, Kazufumi Kikuchi, Daichi Momosaka, Hiroshi Nakatake, Ryo Yamasaki, Hidenori Ogata, Masami Yoneyama, Jun-ichi Kira, Hiroshi Honda

Abstract

Purpose

MR neurography is known to be useful to evaluate nerve pathology. The purpose of this study was to evaluate the usefulness of simultaneous apparent T2 mapping and neurography with nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (SHINKEI) to distinguish patients with chronic inflammatory demyelinating polyneuropathy (CIDP) from healthy subjects.

Materials and methods

This retrospective study included 13 patients with CIDP and five healthy subjects from 2015 to 2017. The T2 relaxation time and the size of the cervical ganglia and roots of the brachial plexus were measured. Statistical analyses were performed with the Mann-Whitney U test and receiver operating characteristics (ROC) analysis.

Results

The T2 relaxation times of the ganglia and roots were longer in patients with CIDP (119.31 ± 35.53 msec and 111.15 ± 33.82 msec) than in healthy subjects (101.42 ± 26.42 msec and 85.29 ± 13.22 msec, P = 0.0007 and P < 0.0001, respectively). The sizes of the ganglia and the roots were larger in patients with CIDP (6.25 ± 1.56 mm and 4.37 ± 1.71 mm) than in healthy subjects (5.59 ± 1.08 mm and 3.50 ± 0.62 mm, P = 0.0114 and P = 0.0014, respectively). ROC analysis revealed that T2 relaxation time of the roots was best at distinguishing CIDP patients from healthy subjects (the area under the curve = 0.748).

Conclusion

Patients with CIDP could be distinguished from healthy subjects using simultaneous apparent T2 mapping and neurography with SHINKEI.

https://ift.tt/2NHN1Vz

Cancer Chemoprevention by Metformin Hydrochloride Compared to Placebo in Oral Potentially Malignant Lesions

Condition:   Oral Cancer
Interventions:   Drug: Metformin Hcl 500Mg 24Hr Sa Tab;   Other: starch tablet
Sponsor:   Ain Shams University
Recruiting

https://ift.tt/2ORkqcQ

Sensitivity and Specificity of Serum and Salivary CYFRA21-1 in the Detection of Malignant Transformation in Oral Potentially Malignant Mucosal Lesions (Diagnostic Accuracy Study)

Condition:   Oral Potentially Malignant Leions, Oral Cancer
Intervention:   Diagnostic Test: Enzyme Linked Immunosorbent assay (ELISA)
Sponsor:   Cairo University
Not yet recruiting

https://ift.tt/2R0ANoL

A Phase 1b/2 Study of AST-008 Combined With Pembrolizumab in Patients With Advanced Solid Tumors

Conditions:   Advanced or Metastatic Solid Tumors;   Advanced or Metastatic Melanoma;   Advanced or Metastatic Head and Neck Squamous Cell Carcinoma;   Advanced or Metastatic Cutaneous Squamous Cell Carcinoma;   Advanced or Metastatic Merkel Cell Carcinoma
Interventions:   Drug: AST-008;   Biological: Pembrolizumab
Sponsor:   Exicure, Inc.
Not yet recruiting

https://ift.tt/2ORkeu8

CoreHip - Post Market Clinical Follow-Up Study

Conditions:   Degenerative Osteoarthritis;   Rheumatic Arthritis;   Fractures, Hip;   Necrosis, Femur Head
Intervention:   Device: CoreHip Total Hip Arthroplasty
Sponsor:   Aesculap AG
Not yet recruiting

https://ift.tt/2QXgLeW

Cancer Chemoprevention by Metformin Hydrochloride in Oral Potentially Malignant Lesions

Condition:   Oral Cancer
Interventions:   Drug: Metformin Hydrochloride 500 MG;   Drug: Placebo Oral Tablet
Sponsor:   Cairo University
Recruiting

https://ift.tt/2ORk71G

Mechanisms of Resistance to Immune Checkpoint Blockade

Abstract

The recent development of effective immune checkpoint inhibition (ICI), first demonstrated in melanoma, has revolutionized cancer treatment. Monoclonal antibodies blocking the immune checkpoints cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and programmed death 1 receptor (PD-1) have shown substantial clinical benefit in a subset of patients across tumor types and in both the metastatic and adjuvant settings. In this article, we review the interaction between the immune system and solid tumors, and describe modes of immune response failure and the physiologic role of immune checkpoints. We also review the known mechanisms of immune checkpoint inhibitors, focusing on US FDA-approved agents targeting CTLA-4 and PD-1. Within this framework, we classify hypothesized tumor intrinsic and extrinsic predictive markers for response and resistance to ICI, and map them to their putative underlying biological mechanism. Finally, we outline future directions in ICI, including the development of new therapeutic targets, rational combination therapies, integrated predictive models for individual patients to optimize therapy, and expansion into different disease types.

https://ift.tt/2zvbtke

Optimizing clinical images with a smartphone and light-emitting diode

Publication date: Available online 26 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Cheng Zhou, Man Li, Xi Chen, Bo Li, Xueyan Yao, Jianzhong Zhang

https://ift.tt/2Q9h7Od

Follicular Involvement is Frequent in Lentigo Maligna: Implications for Treatment

Publication date: Available online 26 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Karen L. Connolly, Cerrene Giordano, Stephen Dusza, Klaus J. Busam, Kishwer Nehal

Abstract

Background

Follicular involvement of lentigo maligna (LM) is considered a histopathologic hallmark, but its prevalence and characteristics have not been well-defined. The depth of intrafollicular extension by neoplastic melanocytes may have clinical importance in the treatment of lentigo maligna.

Objective

To describe the prevalence and features of follicular involvement in LM, including depth of follicular growth by melanocytes.

Methods & Materials

Single-center retrospective study of 100 consecutive cases of surgically excised LM treated from 2013 to 2015. Slide review for cases with residual LM on debulk specimen was performed by a dermatologic surgeon and dermatopathologist to characterize follicular involvement.

Results

Seventy-two of 100 specimens met inclusion criteria for histopathologic evaluation. Follicular involvement was seen in 95.8% of specimens (95% CI: 88.3%-99.1%), with a mean 68% of follicles involved in a single specimen. The mean depth of intrafollicular growth by lesional melanocytes was 0.45 mm (SD=0.23, range 0.1 mm to 1.1 mm). Tumor cells were confined to the infundibular portion of the hair follicle in 60.9% of specimens.

Conclusion

Superficial follicular involvement is a ubiquitous finding in LM. When considering treatment options for LM with a depth-dependent modality aiming for tumor clearance, mean and maximum depths of involvement should be considered.

https://ift.tt/2zvXM4q

Camp Sun Safe: A community level sun safety intervention

Publication date: Available online 26 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Virginia A. Tracey, Katharine P. Saussy, Jacqueline G. Witt, Alexandra M. Haugh, Brittany J. Stumpf

https://ift.tt/2Q3jOky

Treatment of oral mucosal neuromas with carbon dioxide laser

Publication date: Available online 26 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Emily A. Weig, Gretchen M. Roth, Karolyn A. Wanat, Nkanyezi N. Ferguson

https://ift.tt/2zw0x60

Patient‐reported outcomes: A 5‐year long study reveals previously unreported therapeutic, demographic, socio‐economic, and other correlations in vitiligo

Dermatologic Therapy, EarlyView.


https://ift.tt/2Ih0WM8

Efficacy of oral tranexemic acid in refractory melasma: A clinico–immuno‐histopathological study

Dermatologic Therapy, EarlyView.


https://ift.tt/2QYKS5C

Occlusion therapy in inflammatory cutaneous diseases

Dermatologic Therapy, EarlyView.


https://ift.tt/2Il6BRy

Efficacy of topical calcineurin inhibitors in pyoderma gangrenosum

Dermatologic Therapy, EarlyView.


https://ift.tt/2QYKynq

Sequential methyl‐aminolevulinate daylight photodynamic therapy and diclofenac plus hyaluronic acid gel treatment for multiple actinic keratosis evaluation

Dermatologic Therapy, EarlyView.


https://ift.tt/2Iitd5d

Remittive effect of Dupilumab in atopic dermatitis

Dermatologic Therapy, EarlyView.


https://ift.tt/2QXIPPc

Prevention and management of iatrogenic blindness associated with aesthetical filler injections

Dermatologic Therapy, EarlyView.


https://ift.tt/2IgFVkR

Efficacy, safety, and cost‐effectiveness of all‐trans retinoic acid/Clobetasol Propionate Compound Ointment in the treatment of mild to moderate psoriasis vulgaris: A randomized, single‐blind, multicenter clinical trial

Dermatologic Therapy, EarlyView.


https://ift.tt/2QZsolq

Use of botulinum toxin in the treatment of aquagenic keratoderma: One case report

Dermatologic Therapy, EarlyView.


https://ift.tt/2Ihyvhj

Controversies in the treatment of androgenetic alopecia: The history of finasteride

Dermatologic Therapy, EarlyView.


https://ift.tt/2QZmqRF

Solitary facial cutaneous chronic inflammatory lesions induced by anti‐tumour necrosis factor‐α antagonist

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2zu5JqX

Topical sodium thiosulfate for calcinosis cutis associated with autoimmune connective tissue diseases: the Mayo Clinic experience, 2012–2017

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2OObULK

Blaschkoid distribution of composite syringocystadenoma papilliferum and tubular apocrine adenoma without naevus sebaceous

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2zu6GiU

Effectiveness and safety of 0·5% colchicine cream vs. photodynamic therapy with methyl aminolaevulinate in the treatment of actinic keratosis and skin field cancerization of the forearms: a randomized controlled trial

British Journal of Dermatology, EarlyView.


https://ift.tt/2xDhhqz

Tangential Excision Followed by Secondary Intention Healing as a Treatment Method for Giant Rhinophyma—Simple, Safe, and Effective

No abstract available

https://ift.tt/2ObEGZz

Telogen hair loss and androgenetic‐like alopecia in GAPO syndrome

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2NJLcYb

Reply: Measurement of warping angle in human rib graft; Experimental study

No abstract available

https://ift.tt/2Q6WYZq