bluuebunny/crossref_metadata_2025 huggingface dataset:
Impiego della TC nella valutazione della patologia rinosinusale in pazienti con fibrosi cistica
Authors: Blandino A. , Ascenti G. , Longo M. , Pandolfo I. , Scribano E.
Published: April 2015

La sinusite cronica e la poliposi rinosinusale sono estremamente frequenti in pazienti affetti da fibrosi cistica. In questi il coinvolgimento delle cavità paranasali viene frequentemente valutato sulla base del solo esame radiografico diretto, con scarso utilizzo della TC, contrariamente a quanto avviene per lo studio delle alterazioni polmonari.

Dopo visita ORL ed endoscopia, 18 giovani pazienti affetti da fibrosi cistica sono stati studiati con TC in coronale dei seni paranasali a bassa dose. In tutti i 18 pazienti la TC ha documentato opacamento dei seni mascellari, con ispessimento mucoso e ristagno di secreti densi.

In 5 pazienti asintomatici e con visita ORL negativa, il meato medio è apparso normale mentre nei rimanenti 13, risultati positivi alla visita ORL e con sintomatologia compatibile con patologia flogistica rinosinusale, si è dimostrata costantemente la ostruzione dell'infundibolo (in 10 bilaterale ed in 3 monolaterale). Si è altresì rilevato opacamento dell'etmoide anteriore (9), dell'etmoide posteriore (4), del seno frontale (7) e di quello sfenoidale (4), tessuto patologico con aspetto polipoide nel meato medio (4), poliposi massiva (1). Non abbiamo riscontrato sclerosi ed ispessimento osseo delle pareti sinusali, cisti da ritenzione o mucoceli. Anche in ambito pediatrico la chirurgia endoscopica «funzionale» è indicata quale trattamento della poliposi e delle flogosi croniche o recidivanti ribelli alle comuni terapie farmacologiche.

Nei pazienti sintomatici, dopo valutazione endoscopica preliminare, trova giustificazione l'impiego della TC il cui triplice ruolo è di verificare l'esistenza di processi ostruttivi, di valutare l'estensione della patologia e di esplorare con elevata accuratezza le cavità rinosinusali e le strutture limitrofe al fine di ridurre i rischi operatori.
Decorso infraottico dell' arteria cerebrale anteriore
Authors: Mancuso P. , Chiaramonte I. , Alessandrello R. , Fricia M. , Pero G.
Published: April 2015

Gli autori riportano due casi di decorso infraottico di A1 associati ad aneurismi del poligono di Willis. L'anomalia fu diagnosticata dopo esame angiografico cerebrale eseguito in seguito ad emorragia subaracnoidea in ambedue i casi. Si sottolinea l'importanza della diagnosi preoperatoria dell'anomalia nel caso di approccio chirurgico a lesioni neoplastiche o vascolari parasellari. Si sottolinea infine l'elevata incidenza di aneurismi del poligono di Willis in soggetti portatori di tale variante anatomica.
La risonanza magnetica funzionale nello studio dell'ischemia cerebrale in fase iperacuta
Authors: Sparacia G. , Lagalla R. , De Maria M. , Cardinale A.E.
Published: April 2015

Nell'ambito delle potenzialità di studi funzionali con risonanza magnetica (fMRI), la tecnica «diffusion-weighted imaging» (DWI) – consentendo la misurazione «in vivo» delle alterazioni del coefficiente di diffusione apparente (ADC) delle molecole dell'acqua nel contesto del tessuto encefalico – riveste un ruolo di preminente importanza quale strumento di valutazione non invasivo del danno ischemico cerebrale in fase iperacuta.

Nei pazienti affetti da ictus cerebrale il focolaio ischemico si dimostra, sin dai primi minuti dalla sua insorgenza, come area di iperintensità di segnale nelle immagini DWI in relazione alla riduzione del coefficiente di diffusione apparente che consegue al deficit energetico indotto dall'ipossia ischemica e all'associata insorgenza dell'edema citotossico. Attraverso la tecnica DWI è pertanto possibile identificare il focolaio ischemico con netto anticipo rispetto alla comparsa di anomalie di segnale nelle immagini RM convenzionali T2 ponderate. In questo articolo vengono discussi i principi fisici e i preliminari riferimenti metodologici di questa tecnica funzionale, nonché le potenzialità diagnostiche nella valutazione dell'ischemia cerebrale. In particolare, l'utilizzo di sequenze Eco-Planari (EPI) «diffusion-weighted» consente di ipotizzare larghe prospettive di impiego della tecnica DWI nel monitoraggio dell'evoluzione dell'ischemia cerebrale, con riferimento anche all'avvento di nuove strategie terapeutiche che consentano di realizzare in ambito neurologico quanto, in ambito cardiologico, è già stato messo in atto per il trattamento precoce dell'ischemia miocardica.
I tumori extra-assiali della fossa posteriore in età pediatrica
Authors: Tortori-Donati P. , Fondelli M.P. , Rossi A. , Andreussi L.
Published: April 2015

La fossa posteriore costituisce la sede più frequente di neoplasie del SNC in età pediatrica. Su un totale di 231 casi da noi osservati, tuttavia, solo 13 (5,6%) avevano localizzazione extra-assiale, a differenza di quanto accade nell'adulto, in cui le neoplasie extra-assiali, in fossa cranica posteriore, predominano su quelle intra-assiali.

Nell'ambito di queste neoplasie, le più frequenti sono costituite dalle masse disontogenetiche (dermoide, lipoma e teratoma), di cui abbiamo osservato complessivamente 6 casi (40%); più rari il cordoma del clivus, il neurinoma (estremamente raro in forma isolata e più frequente nell'ambito della Neurofibromatosi tipo II, facomatosi peraltro poco comune in epoca infantile), l'angioma cavernoso, il sarcoma meningeo, il medulloblastoma desmoplastico, e il tumore teratoide/rabdoide atipico, neoplasia estremamente aggressiva la cui identificazione come entità autonoma è del tutto recente.

Di queste neoplasie vengono proposti i principali aspetti neuroradiologici, nell'ottica di una identificazione di parametri affidabili al fine di una diagnosi differenziale.
Ricostruzione tridimensionale dei vasi del collo
Authors: Razavi I. Shariat , Piovesana F. , Tarjan Z. , Mucelli F. Pozzi , Magnaldi S. , Mucelli R. Pozzi
Published: April 2015

L'obiettivo di questo lavoro è stato quello di valutare l'efficacia della Angiografia tridimensionale TC (3D-TCA) in pazienti con patologia a carico del distretto carotideo extracranico. Sono stati esaminati 15 pazienti con stenosi di natura arteriosclerotica (14 casi) o arteritica (1 caso) a livello della biforcazione carotidea. Tutti i casi erano stati precedentemente indagati con arteriografia che è stata considerata il test di confronto. Le immagini tridimensionali, presentano una qualità molto valida e sono paragonabili a quelle angiografiche nella maggioranza dei casi. La tecnica 3D-TCA presenta a suo favore alcuni vantaggi: scarsa invasività; semplicità e rapidità di esecuzione; buona dimostrazione delle placche calcifiche che possono essere rimosse mediante software. I limiti attuali sono rappresentati da: necessità di una adeguata concentrazione di mezzo di contrasto nei vasi: possibili artefatti da calcificazioni e strutture ossee: mancanza di informazioni sul flusso dei vasi; difficile separazione tra arterie e vene in alcuni distretti; scarsa panoramicità rispetto alla angiografia.
Contributo della risonanza magnetica alla diagnorsi di osteoma del condotto uditivo esterno (CUE)
Authors: Bartolo M. , De Vuono G. , Santoro G.
Published: April 2015

Osteoma of the external auditory canal is a benign slow-growing mass, usually solitary and obstructing the ear canal. We stress the importance of MR imaging in the diagnosis of these tumours; MR reveals the fibrovascular channels which are the histological hallmark of osteoma.
Distrofia muscolare congenita con deficit di merosina: Studio RM in 5 pazienti
Authors: Farina L. , Milanesi L. , Ciceri E. , Costa A. , Morandi L. , Uziel G. , Savoiardo M.
Published: April 2015

Recentemente in un certo numero di pazienti con distrofia muscolare congenita (CDM) classica è stato individuato un deficit di merosina, proteina che oltre ad essere responsabile del legame tra la distrofina e la matrice extracellulare sarebbe anche implicata nella crescita del neurite e nella migrazione delle cellule di Schwann.

In tutti questi pazienti è presente una grave compromissione della muscolatura scheletrica con ipotonia e impossibilità a raggiungere una deambulazione autonoma e, nonostante l'assenza di una sintomatologia riferibile a danno del SNC, sono state costantemente evidenziate alla RM alterazioni della sostanza bianca degli emisferi cerebrali.

Presentiamo i dati RM di 5 pazienti, di cui 2 fratelli, di età compresa tra 4 e 40 anni con CDM e deficit di merosina, in 1 caso totale e in 4 casi parziale. In 4 casi la RM ha dimostrato la presenza di un'alterazione alla sostanza bianca sovratentoriale, diffusa e simmetrica in 3 casi e costituita da piccole alterazioni peritrigonali isolate in 1 caso. In 1 paziente (con deficit parziale) la RM è risultata negativa e questo ci risulta essere il primo caso descritto.

L'alterazione interessa sia la sostanza bianca sottocorticale che quella profonda e periventricolare anche se sembra ci sia una certa tendenza al risparmio delle fibre a U, reperto che è meglio riconoscibile nelle sequenze T1 dipendenti.

Non è stata evidenziata nessuna alterazione del disegno corticale. Le lesioni da noi descritte sembrano simili a quelle riportate in letteratura nei pazienti con deficit totale e parziale di merosina. Il riscontro di alterazioni della sostanza bianca alla RM in pazienti con CMD deve indurre a dosare la merosina. L'assenza di tali alterazioni non sembra però escludere un deficit di merosina dato che in 1 paziente la RM è risultata essere negativa.
L'angio-RM nelle anomalie dei vasi epiaortici
Authors: Pardatscher K. , Fera F. , Donato G. , Bartone B. , Silvagni U. , Armentano A.
Published: April 2015

The role of MRA in the evaluation of abnormalities of the the brachiocephalic arteries is briefly discussed.

A rare case of agenesis of the left internal carotid associated with a complex malformation of the inominate artery is shown.
Ruolo della RM nella diagnosi dell'otite maligna
Authors: Manfrè L. , Angileri T. , Martino R. , Pappalardo S. , Sarno C.
Published: April 2015

L'otite maligna (MOE) costituisce una malattia rara, frequente in soggetti anziani immunocompromessi o diabetici. Malattia letale se non trattata, necessita dell'intervento combinato di chirurgia, camera iperbarica e farmacoterapia. Scopo del lavoro è stato valutare il ruolo della RM nella diagnosi di malattia.

5 pazienti affetti da MOE successivamente comprovata alla biopsia sono stati sottoposti a esame TC ed RM. In 2 pazienti (2/5, 40%) non erano presenti deficit dei nervi cranici, mentre 2/5 (60%) presentavano una paralisi del VII, IX, X ed XI nervo cranico.

L'esame RM è stato effettuato mediante apparecchiatura operante a medio campo e bobina in quadratura, con sequenze in tecnica Spin-Echo, prima e dopo somministrazione di mezzo di contrasto, e AngioRM in tecnica TOF.

Il canale acustico interno era coinvolto in tutti i pazienti (5/5, 100%); l'osteolisi era apprezzabile in 4/5 pazienti (80%). Il coinvolgimento dell'orecchio medio era evidente in 3/5 (60%) mentre solo 2/5 (40%) presentavano una infiltrazione dei muscoli pterigoidei ed un inglobamento della carotide. 3 pazienti dimostravano una diffusione intraarticolare temporomandibolare; 1 paziente presentava infiltrazione diploica del basicranio in assenza di osteolisi apprezzabile in TC.

L'indagine TC è limitata da una ridotta apprezzabilità delle parti molli infracraniche, dagli artefatti provenienti dalla piramide, da una scarsa dimostrazione di infiltrazione del basicranio in assenza di evidente osteolisi. Al contrario la RM permette una valutazione della diffusione inframastoidea, intraarticolare, intradiploica della malattia e consente di dimostrare la compromissione vascolare carotidea mediante AngioRM.

La MOE entra in diagnosi differenziale con il carcinoma, descritto in letteratura isointenso tessuto cerebrale in ponderazione T1- e T2 dipendente, a differenza dell'ipointensità apprezzata carico del tessuto flogistico nei pazienti da noi studiati.
Osteoporosi vertebrale: Confronto critico tra le tecniche diagnostiche quantitative ed interpretazione dei risultati
Authors: Simonetti L. , Capasso P. , Spadetta F. , Sabetta E. , Caranci F. , Elefante R.
Published: April 2015

L'aumento della popolazione anziana sta rendendo sempre più significativa l'incidenza dell'osteoporosi, sia come patologia in sé, sia come fattore di rischio di fratture patologiche.

La messa a punto di metodologie di mineralometria sui corpi vertebrali con TC, dà l'opportunità al neuroradiologo di confrontarsi con tale patologia, prima un po' negletta. Questo lavoro, attraverso la proposizione della personale esperienza, ha lo scopo di mettere a punto lo “stato dell'arte”, con particolare riguardo al confronto tra le varie tecniche di valutazione quantitativa e l'interpretazione nosologicamente e prognosticamente valida dei risultati.
Sclerosi temporale mesiale: Aspetti clinici e neuroradiologici
Authors: Arcuri T. , Mavilio N. , Capello D. , Schiavoni S. , Ballerini S. , Cossu M. , Rosa M.L.
Published: April 2015

Temporal Mesial Sclerosis is thought to be a leading cause of drug-resistent epilepsy. We report MRI findings in five subjects; MRI studies were performed with SE (T1 and DP-T2), GE T1 and IR tecniques by a high field strenght unit. Tipical lesions, including atrophy of the anterior part of the temporal lobe, dilatation of temporal horn and atrophy of the ippocampus were found in all the subjects; high signal iperintensity was found in two cases. Such findings were in keeping with the clinical manifestations of the disease in all subjects and have been confirmed by surgical histopathology in two of them.
Alcune considerazioni sulla ecografia transfontanellare nell'approccio diagnostico delle malattie cerebrali del neonato e del lattante
Authors: Vallone G. , Coppola V. , Gallo S. , Molese V. , Buonomo A. , Maraziti G.
Published: April 2015

Transfontanellar ultrasonography is the first methodology in the study of the central nervous system of the newborn, especially if the baby is premature and the checked pathologic picture is influenced by the pregnancy age of the little patient, as intracerebral haemorhagic lesions and hypoxic ischaemic lesions are much more frequent in the premature. In case of diseases not correlated with the pregnancy age, as congenital anomalies, and endocranial infections, haemorhagic and neoplasms, transfontanelle ultrasonography also shows its undisputed utility.

Transfontanellar ultrasonography with Color Doppler allows a further intensification of the investigation and the use of echographic contrast media will significantly help the vascular diagnosis.
L'esordio pseudo-ictale di patologia infiammatorio-infettiva encefalica: Presupposti e diagnosi neuroradiologica
Authors: Esposito F. , Siani A. , Cirillo S. , Andreula C. , Simonetti L. , Elefante R.
Published: April 2015

Gli autori pongono l'accento sul coinvolgi mento vascolare infiammatorio in corso di patologia infettiva, che condiziona, talvolta, l'esordio clinico ictale di questi pazienti.

Viene riportata la propria esperienza, riguardo tre gruppi di pazienti: pazienti con meningite TBC, pazienti con encefalite erpetica, pazienti con HIV.

Si analizzano e discutono i quadri neuroradiologici e i presupposti anatomo-patologici.
Degenerative Spondylolisthesis with Vacuum Facet Phenomenon
Authors: Muras I. , Rinaldi F. , Esposito D. , Scuotto A. , Bernini F.P.
Published: April 2015

Spondylolisthesis may be associated with degenerative disease of the spine and occurs even in the absence of spondylolysis.

In the presence of degenerative joint disease, the smooth pattern of spinal movement is transformed in to one that is irregular and either excessive or restricted. Consequently traction between opposing articular facets occurs, allowing a vacuum phenomenon to develop.

We report CT scans demonstration of a vacuum between lumbar facets due to their separation in degenerative spondylolisthesis.
MR Angiography in the Study of Brain Gliomas
Authors: Crecco M. , Occhipinti E. , Vidiri A. , Floris R. , Carapella C.M. , Squillaci S.
Published: April 2015

Magnetic Resonance and Magnetic Resonance Angiography (MRA) data, obtained from 44 patients with brain gliomas (13 low-grade astrocytoma [LGA], 6 anaplastic astrocytoma [AA], 25 glioblastoma [GBM]), were analysed to evaluate further relevant information linked to tumour malignancy grading and the potential role of MRA in the diagnostic work-up of neuroepithelial brain tumours.

MR scanning was performed with a 1.5 superconductive system utilising SE, T1 and SE T2 sequences; signal intensity, perilesional oedema, degenerative changes, tumour borders, enhancement after Gadolinium-DTPA (Gd-DTPA) infusion and the presence of haemorrhagic areas were considered.

Feeding vessels, venous drainage, tumour vascularity, displacement or encasement of the main vessels were considered in the analysis of MRA data, performed with the time-of-flight technique (3D and 2D sequences).

Oedema, degenerative changes and enhancement after Gd-DTPA were demonstrated only in AA and GBM; the margins of these tumours were irregular and signal intensity was dishomogeneous with haemorrhagic areas in two cases of GBM. In LGA oedema and enhancement were present in four out of 13 cases and degenerative changes only in one. Tumour margins were regular in nine cases and irregular in four; the signal intensity was always homogeneous.

Displacement and encasement of the main vessels were better demonstrated with MRA, above all for AA and GBM. Signs of neovascularity were demonstrated only in GBM, in particular the feeding vessels in 14 out of 25 cases, tumour vascularity in six and venous drainage in ten cases.
Diffuse Pachymeningeal Enhancement on Brain MRI: Spontaneous Intracranial Hypotension versus after Head Trauma
Authors: Ryu Chang Woo , Lee Byung Hee
Published: April 2015

We evaluated the MRI finding of pachymeningeal enhancement in patients with intracranial hypotension and after head trauma with particular attention to differential findings. Our results support current knowledge of the pathophysiology of each dural enhancement.
Grading of Astrocytomas Using Spectral Pattern Recognition Analysis of in Vivo Spectroscopic Data
Authors: Herminghaus S. , Möller-Hartmann W. , Wittsack J. , Labisch C. , Dierks T. , Marquardt G. , Lanfermann H. , Zanella F.E.
Published: April 2015

Spectral pattern recognition analysis of in vivo spectroscopic data was performed to predict histopathological tumour grade astrocytomas. Analysis of the spectral pattern of biochemical changes detected by 1HMRS significantly improved non-invasive tumour grading.
Investigation of False Positive and False Negative Signs in Methionine-PET
Authors: Tsuyuguchi N. , Sunada I. , Iwai Y. , Ohata K. , Matsuoka Y. , Tanaka K. , Hakuba A.
Published: April 2015

PET with L-methyl-11C-methionine (Met-PET) is a useful tool for differentiating cerebral tumor from normal brain tissue, but some observations showed a high accumulation of methionine in non-tumorous lesions.

We evaluated whether Met-PET was clinically useful in distinguishing tumor from non-tumor in intracranial lesions. We investigated 50 cases of brain lesions. We had four non-tumorous lesions with an accumulation (false positive) and five tumorous lesions with no accumulation (false negative) in Met-PET. It should be kept in mind that there is a possibility of tumorous or non tumorous lesions in the presence of a low or high accumulation of methionine.
2D Time-Resolved MR Technique for Catheter Visualization during Endovascular Procedures at 1.5 T
Authors: Unal O. , Frayne R. , Strother C.M. , Korosec F.R. , Mistretta C.A.
Published: April 2015

We describe a novel 2D MR imaging technique for catheter visualization which exploits the T1-shortening effect of paramagnetic contrast agents. We performed in vitro and in vivo animal experiments to test the technique. The new tecnique is a potential guiding tool for catheter movement during endovascular procedures.
3D Gadolinium-Enhanced and 3D TOF MRA of the Brain
Authors: Gagliardo O. , Gallucci M. , Cardone G. , Paluello G.B. Minio , Caulo M. , Micheli C. , Castrucci M.
Published: April 2015

We prospectively compared 3D Gadolinium-enhanced and 3D-TOF MR angiographic acquisition techniques on the main cerebral arteries and cortical branches.
Functional Circulation Time, rCBV and rCBF Images by Angio-CT in the Assessment of Altered Carotid Canalization
Authors: Bartolini A. , Gasparetto B. , Roncallo F. , Bisio N.
Published: April 2015

A conventional Angio-CT sequence was used to generate functional perfusional images by applying particular models to the contrast first pass curves. We calculated the first mathematical moment of monitored time-DH curves from the injection time and applied to the sequence the multiple time graph analysis described by Patlak. The former provides regional an Arm-Brain circulation time (rABCT) image, the latter two images, one related to vascular volume Vv, the other to the blood brain barrier permeability Ki. The Vv and rABCT images were subsequently uitilized to derive the rCBF image (ND-rCBF).

The rABCT, Vv and rCBF images were analyzed in a group of 48 patients with angiographically detected unilateral altered carotid canalization of various degrees and clinical pictures. Direct detection was possible in 37 out of 48 cases and a strong suggestion was derived in the remaining cases. Analysis of rABCT provided the maximal rate of detection and allowed us to derive haemodynamic considerations. Assessment of distribution of rABCT changes and Vv analysis discriminated fairly well between patients with relatively mild and severe clinical pictures.
Nasopharyngeal Carcinomas Part I: CT and MR Patterns of Spread
Authors: Roncallo E , Turtulici I. , Sanguineti G. , Margarino G. , Scala M. , Mereu P. , Tedeschi G. , Gasparetto B. , Bartolini A.
Published: April 2015

The aim of this study is to evaluate the impact of CT and MRI staging on the RT plan analyzing the patterns of spread of nasopharyngeal tumours.

Pre-treatment CT and MRI examinations of 28 patients (28–65 years old, mean age 42; 16 men, 12 women) with primary nasopharyngeal cancer were retrospectively evaluated.

CT and MRI in clinically known or suspected nasopharyngeal cancer showed in all cases the extent and spread of the pathologic tissue; consequently the Americal Joint Committee on Cancer (AJCC) staging system for primary nasopharyngeal tumours was strictly respected.

Imaging permitted in all cases a good evaluation of neck nodes; retropharyngeal, junctional, jugulo-digastric and accessory spinal lymph nodes were correctly staged on the basis of size, density-intensity, shape and contrast enhancement.

The impact of non- and minimally-invasive diagnostic imaging techniques on head and neck diseases is well known. Clinical evaluation of the nasopharynx and nearby deep fascial planes is hard and fiberoptic examination detects only mucosal surfaces of the organ. Consequently prognosis and therapy of nasopharyngeal carcinomas depend on CT and MR staging both of the primary site and neck nodes. The RT beam and portals are focused on the basis of imaging and the results of the therapy may be correctly investigated only by the comparative analysis of the first follow-up examination with pre-treatment morphological data.
Neurocisticercosi parenchimale
Authors: Andreula C.F. , Zaccheo N. , Margari L. , Vella G. , Giannella G. , Perniola T. , Garribba A.P. , Tirelli A.
Published: April 2015

La neurocisticercosi, sostenuta dalla la forma larvale della Tenia Solium, è la più frequente forma di parassitosi del sistema nervoso centrale dell'uomo, ma in Europa è eccezionale.

La diagnosi si basa su test sierologici e liquorali, che quando positivi, hanno elevata specificità, nei casi dubbi il suggerimento diagnostico fornito dalla neuroradiologia può essere molto importante.

Gli autori riportano un caso di neurocisticercosi parenchimale, a siero-liquorologia negativa, diagnosticato e monitorizzato in corso di terapia antiparassitaria con RM, con progressiva risoluzione del quadro clinico, fino a completa guarigione, e progressiva risoluzione neuroradiologia delle lesioni parenchimali.

I segni neuroradiologici sui quali articolare la diagnosi e corrispondenti alle lesioni del tessuto cerebrale nella loro evoluzione patologica sono: presenza di lesioni cistiche; contenuto delle cisti; eventale presenza di capsula, con impregnazione cercinata dopo mdc; eventuale nodulo murario, corrispondente allla testa del parassita; edema perilesionale ed effetto massa.
Neurocutaneous Melanosis
Authors: Shroff M.M. , Jhaverp K.S. , Verma A.B.
Published: April 2015

Neurocutaneous melanosis is a rare neuroectodermal dysplasia characterised by deposition of melanin in the leptomeninges. Classically it shows hyperintense meninges on T1 weighted images with post contrast enhancement in some cases. We describe CT and MR in the findings in a five-year-old boy with neurocutaneous melanosis.
Intrasellar Arachnoid Cysts
Authors: Patankar T. , Krishnan A. , Patkar D. , Prasad S. , Shah J. , Limdi J.
Published: April 2015

Intrasellar arachnoid cysts are distinctly rare. Few cases have been reported in the literature. We describe MR findings in three patients with sellar arachnoid cyst who presented with protean manifestations such as visual impairment and diabetes insipidus and discuss the pertinent literature.
Postmeningitic Sclerosing and Ossifying Labyrinthitis
Authors: Roncallo F. , Turtulici I. , Castellini P. , Dellepiane M. , Salami A. , Bartolini A.
Published: April 2015

A considerable proportion of the candidates for multichannel cochlear implantation consists of patients with profound bilateral hearing loss caused by sclerosing and/or ossifying labyrinthitis as a complication of meningitis. The spread of bacteria and viruses from the meninges to the inner ear is generally thought to be either via the subarachnoid sheaths following the nerves in the internal acoustic canal, or more directly through the cochlear aqueduct. The infective stage can be followed by fibrosis of the labyrinth and later by new bone formation which may proceed to almost complete obliteration of the labyrinth.

Computed tomography remains the first examination to perform in order to have a precise map of the inner ear and temporal bone anatomy as well as to depict any abnormality of the round window or calcification of the membranous labyrinth. In many centres CT is the first imaging modality chosen in the evaluation of cochlear-implant candidates, providing higher spatial resolution and unique information on skeletal structures. Temporal bone MR examination adds useful information before surgery because only thin T2-weighted sequences may depict focal or diffuse obliteration of the membranous labyrinth fluid space before calcification with a high degree of sensitivity.

Moreover, MR plays a role in planning surgery, because a remaining postmeningitis labyrinthitis enhancement seems to predict a rapid evolution towards labyrinthine calcification.
Hemorrhagic Complications following Percutaneous Transluminal Angioplasty for Carotid Stenosis
Authors: Masuo O. , Terada T. , Tsuura M. , Itakura T. , Yamaga H. , Maeshima S. , Ozaki F. , Moriwaki H. , Nakamura Y. , Kido T.
Published: April 2015

We report 2 cases with hemorrhagic complications following percutaneous transluminal angioplasty (PTA) for carotid stenosis. Computed tomography (CT) scanning of these cases demonstrated diffuse subarachnoid hemorrhage in 1 case, and intracerebral hemorrhage in the other case on the day after PTA. In the latter case, we measured cerebral blood flow velocity and mean transit time with transcranial doppler (TCD) and dynamic CT scan, and TCD and dynamic CT demonstrated a remarkable increase in blood flow velocity and peak height respectively. From these results, postoperative hyperperfusion was supposed to have caused the hemorrhagic complication.
2D and 3D-CISS Imaging of Cranial Nerves
Authors: Brechtelsbauer D. , Bendszus M. , Hofmann E. , Warmuth-Metz M. , Solymosi L.
Published: April 2015

We evaluated the cranial nerves with CISS imaging. Eleven volunteers and five patients were studied with two versions of the CISS sequence and variable imaging parameters. Three neuroradiologists analysed the images including multiplanar reconstructions for the best visibility of the cranial nerves. With optimised imaging parameters it is possible to reliably detect the cisternal portions of the cranial nerves on CISS images.
The growing fibroadenoma
Authors: Sanders Linda M , Sara Rana
Published: April 2015

Background

Fibroadenomas (FAs) are the most common tumors of the breast clinically and pathologically in adolescent and young women but may be discovered at any age. With increasing use of core biopsy rather than excision for diagnosis, it is now commonplace to follow these lesions with imaging.

Purpose

To assess the incidence of epithelial abnormalities (atypia, in situ or invasive, ductal or lobular malignancies) in FAs diagnosed by core biopsy and to re-evaluate the management paradigm for any growing FA.

Material and Methods

A retrospective review of the senior author’s pathology results over 19 years identified 2062 nodular FAs (biopsied by ultrasound or stereotactic guidance). Eighty-three core biopsied FAs were identified which subsequently enlarged.

Results

Twelve of 2062 of core biopsied nodules demonstrated atypia, in situ, or invasive malignancy (ductal or lobular) within or adjacent to the FA (0.58%). Eighty-three FAs enlarged and underwent either surgical excision ( n = 65), repeat core biopsy ( n = 9), or imaging follow-up ( n = 9). The incidence of atypia, in situ or invasive malignancy was 0/83 (0%). Two enlarging FAs were subsequently surgically diagnosed as benign phyllodes tumors (PT).

Conclusion

Malignancy in or adjacent to a core biopsied FA is rare. The risk of cancer in a growing FA is even rarer; none were present in our series. FAs with abnormal epithelial abnormalities require excision. Otherwise, FAs without epithelial abnormality diagnosed by core biopsy need no specific follow-up considering the negligible incidence of conversion to malignancy. The breast interventionalist must know how to manage discordant pathology results.
Development of alternative environment friendly nickel and gold plating baths
Authors: Gezerman A. O. , Çorbacıoğlu B. D.
Published: April 2015

In the metal plating industry, nickel and gold plating baths are used, which contain toxic materials and cause wastewater problems. Despite these disadvantages, there is a strong need for both these types of metal plating because of their aesthetic properties. However, until now, nickel plating has not been used in conjunction with gold plating because nickel plating baths contain sulphates. In this study, gold plating on a nickel plated surface is investigated using baths containing acetylacetonate salts. The physical parameters of the plated materials, which were favourable, were determined by hydrogen embrittlement tests, visible region spectrophotometry and the Charpy impact test.
FePt electrodeposited from ionic liquids on Si(111) substrate
Authors: Wei G. , Zhou H. , Ge H. , Dettinger H.
Published: April 2015

This work concerns FePt nanowires electrodeposited from electrolyte of E1 [ammonium hexachloroplatinate (25 mM L− 1), 1-ethyl-3-methylimidazolium chloride (25 mM L− 1)], iron dichloride (315 mM L− 1) and glycol (50 mL) at 393 K. FePt nanowires and films were electrodeposited by controlling the electrodeposited time under suitable potential in E1. FePt nanowires were prepared at different times of 600, 800 and 1000 s when deposition potential was − 2·0 V versus Ag/AgCl. The SEM patterns proved that FePt nanowires were prepared at suitable deposition time (600–1000 s). The X-ray diffraction pattern indicated that the face centre tetragonal structure of FePt nanowires was obtained. Magnetic hysteresis loops showed that aggregation could decrease the coercivity, and some nanowires were larger than the mean diameter, which exhibited a comparatively large ferromagnetic behaviour.
‘Abundantly replenisht with Books of his own purchasing and choyce’: Lord Herbert of Cherbury’s Library at Montgomery Castle
Authors: Roberts Dunstan
Published: April 2015

This article considers the library which Edward, first Lord Herbert of Cherbury (1582?–1648), established at Montgomery Castle, in the Welsh Marches. The library was built as part of a major renovation of the castle in 1622–25, during which part of the medieval fabric was replaced with a fashionable brick mansion. The castle was among the casualties of the Civil War, being surrendered to Parliamentarian forces in 1644 and was demolished in 1649. The article discusses the likely movements of the library’s contents following the castle’s destruction and especially how part of it reached Powis Castle, near Welshpool, in the eighteenth or nineteenth century. It then combines information about books still housed at Powis Castle with information gained from sale catalogues to establish the identities of around 250 of the books which were present at Montgomery Castle. It concludes with a summary description of the books, making particular reference to works of vernacular poetry and romance which may have influenced Lord Herbert in the composition of his famous autobiography.
A new era in idiopathic pulmonary fibrosis: considerations for future clinical trials
Authors: Collard Harold R. , Bradford Williamson Z. , Cottin Vincent , Flaherty Kevin R. , King Talmadge E. , Koch Gary G. , Kolb Martin , Martinez Fernando J. , Montgomery Bruce , Raghu Ganesh , Richeldi Luca , Rose Dan , Wells Athol U. , Brown Kevin K.
Published: April 2015

The past decade has seen substantial progress in understanding the pathobiology, natural history, and clinical significance of idiopathic pulmonary fibrosis (IPF), culminating in the establishment of two effective medical therapies. Now seems an important time to reconsider the design and conduct of future IPF clinical trials. Building on lessons learned over the past decade, we use this perspective to lay out four key considerations for moving forward effectively and efficiently with the next generation of clinical trials in IPF. These are: development of a coordinated IPF clinical trials network; establishment of expectations for early phase proof of concept studies; adaptation of late-phase efficacy trial designs to the emergence of approved therapies, and; agreement on primary end-points for late phase clinical trials. Continued progress in the field of IPF will require creativity and collaboration on the part of all stakeholders. We believe that addressing these four considerations will encourage and enable investment in this new era of drug development in IPF, and will lead to more rapid development of effective therapies.
A single preoperative FGF23 measurement is a strong predictor of outcome in patients undergoing elective cardiac surgery: a prospective observational study
Authors: Speer Timo , Groesdonk Heinrich V , Zapf Beate , Buescher Vanessa , Beyse Miriam , Duerr Laura , Gewert Stella , Krauss Patrizia , Poppleton Aaron , Wagenpfeil Stefan , Fliser Danilo , Schaefers Hans-Joachim , Klingele Matthias
Published: April 2015

Introduction

Several scoring systems have been developed to predict postoperative mortality and complications in patients undergoing cardiac surgery. However, these computer-based calculations are time- and cost-intensive. A simple but highly predictive test for postoperative risk would be of clinical benefit with respect to increasingly scarce hospital resources. We therefore assessed the predictive power of fibroblast growth factor 23 (FGF23) measurement compared with an established scoring system.

Methods

We conducted a prospective interdisciplinary observational study at the Saarland University Medical Centre that included 859 patients undergoing elective cardiac surgery between January 2010 and March 2011 with a median follow-up after discharge of 822 days. We compared a single preoperative measurement of FGF23 as a prognostic tool with the 18 parameters comprising EuroSCORE II with respect to postoperative mortality, acute kidney injury, non-occlusive mesenteric ischemia, clinical course and long-term outcome.

Results

Preoperative FGF23 levels were highly predictive of postoperative outcome and complications. The predictive value of FGF23 for mortality in the receiver operating characteristic curve was greater than the EuroSCORE II (area under the curve: 0.800 versus 0.725). Moreover, preoperative FGF23 independently predicted postoperative acute kidney injury and non-occlusive mesenteric ischemia comparably to the EuroSCORE II. Finally, FGF23 was found to be an independent predictor of clinical course parameters, including duration of surgery, ventilation time and length of stay.

Conclusions

In patients undergoing elective cardiac surgery, a simple preoperative FGF23 measurement is a powerful indicator of surgical mortality, postoperative complications and long-term outcome. Its utility compares to the widely used EuroSCORE II.
Small molecule inhibition of group I p21-activated kinases in breast cancer induces apoptosis and potentiates the activity of microtubule stabilizing agents
Authors: Ong Christy C , Gierke Sarah , Pitt Cameron , Sagolla Meredith , Cheng Christine K , Zhou Wei , Jubb Adrian M , Strickland Laura , Schmidt Maike , Duron Sergio G , Campbell David A , Zheng Wei , Dehdashti Seameen , Shen Min , Yang Nora , Behnke Mark L , Huang Wenwei , McKew John C , Chernoff Jonathan , Forrest William F , Haverty Peter M , Chin Suet-Feung , Rakha Emad A , Green Andrew R , Ellis Ian O , Caldas Carlos , O’Brien Thomas , Friedman Lori S , Koeppen Hartmut , Rudolph Joachim , Hoeflich Klaus P
Published: April 2015

Introduction

Breast cancer, the most common cause of cancer-related deaths worldwide among women, is a molecularly and clinically heterogeneous disease. Extensive genetic and epigenetic profiling of breast tumors has recently revealed novel putative driver genes, including p21-activated kinase (PAK)1. PAK1 is a serine/threonine kinase downstream of small GTP-binding proteins, Rac1 and Cdc42, and is an integral component of growth factor signaling networks and cellular functions fundamental to tumorigenesis.

Methods

PAK1 dysregulation (copy number gain, mRNA and protein expression) was evaluated in two cohorts of breast cancer tissues (n = 980 and 1,108). A novel small molecule inhibitor, FRAX1036, and RNA interference were used to examine PAK1 loss of function and combination with docetaxel in vitro. Mechanism of action for the therapeutic combination, both cellular and molecular, was assessed via time-lapse microscopy and immunoblotting.

Results

We demonstrate that focal genomic amplification and overexpression of PAK1 are associated with poor clinical outcome in the luminal subtype of breast cancer (P = 1.29 × 10−4 and P = 0.015, respectively). Given the role for PAK1 in regulating cytoskeletal organization, we hypothesized that combination of PAK1 inhibition with taxane treatment could be combined to further interfere with microtubule dynamics and cell survival. Consistent with this, administration of docetaxel with either a novel small molecule inhibitor of group I PAKs, FRAX1036, or PAK1 small interfering RNA oligonucleotides dramatically altered signaling to cytoskeletal-associated proteins, such as stathmin, and induced microtubule disorganization and cellular apoptosis. Live-cell imaging revealed that the duration of mitotic arrest mediated by docetaxel was significantly reduced in the presence of FRAX1036, and this was associated with increased kinetics of apoptosis.

Conclusions

Taken together, these findings further support PAK1 as a potential target in breast cancer and suggest combination with taxanes as a viable strategy to increase anti-tumor efficacy.
Cis-regulatory somatic mutations and gene-expression alteration in B-cell lymphomas
Authors: Mathelier Anthony , Lefebvre Calvin , Zhang Allen W , Arenillas David J , Ding Jiarui , Wasserman Wyeth W , Shah Sohrab P
Published: April 2015

Background

With the rapid increase of whole-genome sequencing of human cancers, an important opportunity to analyze and characterize somatic mutations lying within cis-regulatory regions has emerged. A focus on protein-coding regions to identify nonsense or missense mutations disruptive to protein structure and/or function has led to important insights; however, the impact on gene expression of mutations lying within cis-regulatory regions remains under-explored. We analyzed somatic mutations from 84 matched tumor-normal whole genomes from B-cell lymphomas with accompanying gene expression measurements to elucidate the extent to which these cancers are disrupted by cis-regulatory mutations.

Results

We characterize mutations overlapping a high quality set of well-annotated transcription factor binding sites (TFBSs), covering a similar portion of the genome as protein-coding exons. Our results indicate that cis-regulatory mutations overlapping predicted TFBSs are enriched in promoter regions of genes involved in apoptosis or growth/proliferation. By integrating gene expression data with mutation data, our computational approach culminates with identification of cis-regulatory mutations most likely to participate in dysregulation of the gene expression program. The impact can be measured along with protein-coding mutations to highlight key mutations disrupting gene expression and pathways in cancer.

Conclusions

Our study yields specific genes with disrupted expression triggered by genomic mutations in either the coding or the regulatory space. It implies that mutated regulatory components of the genome contribute substantially to cancer pathways. Our analyses demonstrate that identifying genomically altered cis-regulatory elements coupled with analysis of gene expression data will augment biological interpretation of mutational landscapes of cancers.
Susceptibility of murine induced pluripotent stem cell-derived cardiomyocytes to hypoxia and nutrient deprivation
Authors: Brodarac Andreja , Šarić Tomo , Oberwallner Barbara , Mahmoodzadeh Shokoufeh , Neef Klaus , Albrecht Julie , Burkert Karsten , Oliverio Matteo , Nguemo Filomain , Choi Yeong-Hoon , Neiss Wolfram F , Morano Ingo , Hescheler Jürgen , Stamm Christof
Published: April 2015

Introduction

Induced pluripotent stem cell-derived cardiomyocytes (iPS-CMs) may be suitable for myocardial repair. While their functional and structural properties have been extensively investigated, their response to ischemia-like conditions has not yet been clearly defined.

Methods

iPS-CMs were differentiated and enriched from murine induced pluripotent stem cells expressing enhanced green fluorescent protein (eGFP) and puromycin resistance genes under the control of an α-myosin heavy chain (α-MHC) promoter. iPS-CMs maturity and function were characterized by microscopy, real-time PCR, calcium transient recordings, electrophysiology, and mitochondrial function assays, and compared to those from neonatal murine cardiomyocytes. iPS-CMs as well as neonatal murine cardiomyocytes were exposed for 3 hours to hypoxia (1% O2) and glucose/serum deprivation, and viability, apoptosis markers, reactive oxygen species, mitochondrial membrane potential and intracellular stress signaling cascades were investigated. Then, the iPS-CMs response to mesenchymal stromal cell-conditioned medium was determined.

Results

iPS-CMs displayed key morphological and functional properties that were comparable to those of neonatal cardiomyocytes, but several parameters indicated an earlier iPS-CMs maturation stage. During hypoxia and glucose/serum deprivation, iPS-CMs exhibited a significantly higher proportion of poly-caspase-active, 7-aminoactinomycin D-positive and TUNEL-positive cells than neonatal cardiomyocytes. The average mitochondrial membrane potential was reduced in “ischemic” iPS-CMs but remained unchanged in neonatal cardiomyocytes; reactive oxygen species production was only increased in “ischemic” iPS-CMs, and oxidoreductase activity in iPS-CMs dropped more rapidly than in neonatal cardiomyocytes. In iPS-CMs, hypoxia and glucose/serum deprivation led to upregulation of Hsp70 transcripts and decreased STAT3 phosphorylation and total PKCε protein expression. Treatment with mesenchymal stromal cell-conditioned medium preserved oxidoreductase activity and restored pSTAT3 and PKCε levels.

Conclusion

iPS-CMs appear to be particularly sensitive to hypoxia and nutrient deprivation. Counteracting the ischemic susceptibility of iPS-CMs with mesenchymal stromal cell-conditioned medium may help enhance their survival and efficacy in cell-based approaches for myocardial repair.
Metabolically active tumour volume segmentation from dynamic [18F]FLT PET studies in non-small cell lung cancer
Authors: Hoyng Lieke L , Frings Virginie , Hoekstra Otto S , Kenny Laura M , Aboagye Eric O , Boellaard Ronald
Published: April 2015

Background

Positron emission tomography (PET) with 18F-3′-deoxy-3′-fluorothymidine ([18F]FLT) can be used to assess tumour proliferation. A kinetic-filtering (KF) classification algorithm has been suggested for segmentation of tumours in dynamic [18F]FLT PET data. The aim of the present study was to evaluate KF segmentation and its test-retest performance in [18F]FLT PET in non-small cell lung cancer (NSCLC) patients.

Methods

Nine NSCLC patients underwent two 60-min dynamic [18F]FLT PET scans within 7 days prior to treatment. Dynamic scans were reconstructed with filtered back projection (FBP) as well as with ordered subsets expectation maximisation (OSEM). Twenty-eight lesions were identified by an experienced physician. Segmentation was performed using KF applied to the dynamic data set and a source-to-background corrected 50% threshold (A50%) was applied to the sum image of the last three frames (45- to 60-min p.i.). Furthermore, several adaptations of KF were tested. Both for KF and A50% test-retest (TRT) variability of metabolically active tumour volume and standard uptake value (SUV) were evaluated.

Results

KF performed better on OSEM- than on FBP-reconstructed PET images. The original KF implementation segmented 15 out of 28 lesions, whereas A50% segmented each lesion. Adapted KF versions, however, were able to segment 26 out of 28 lesions. In the best performing adapted versions, metabolically active tumour volume and SUV TRT variability was similar to those of A50%. KF misclassified certain tumour areas as vertebrae or liver tissue, which was shown to be related to heterogeneous [18F]FLT uptake areas within the tumour.

Conclusions

For [18F]FLT PET studies in NSCLC patients, KF and A50% show comparable tumour volume segmentation performance. The KF method needs, however, a site-specific optimisation. The A50% is therefore a good alternative for tumour segmentation in NSCLC [18F]FLT PET studies in multicentre studies. Yet, it was observed that KF has the potential to subsegment lesions in high and low proliferative areas.