Magnetic resonance imaging of the left wrist: assessment of the bone age in a sample of healthy Iraqi adolescent males

Background: Use of magnetic resonance imaging (MRI) to calculate skeletal age is a novel idea. MRI provides excellent soft-tissue contrast and multiplanar cross-sectional imaging capability. It could be used as an alternative method of skeletal age determination. Objectives: To study the value of MRI in estimating the age of healthy Iraqi adolescent males and to compare the obtained results with other countries records. Population and methods: This cross sectional study was applied on 179 healthy adolescent males between the ages of 13 to18 years in MRI unit at radiology institute in medical city, Baghdad – Iraq. This study was carried out from November 2011 to December 2012. Magnetic resonance imaging of the left wrist was performed by using a 1.5Tesla machine with surface coil. The sequence used was coronal T1weighted images (WI). The degree of fusion of the left distal radial physis was determined by a newly developed grading system. Results: There is high correlation between chronological age and degree of fusion of distal radius within the participant population. Most adolescent boys in the age group between 13 and 14 years presented as grade I and II, while the complete fusion was found at the age of 17and18 years, the mean age of participants was 17.5 years. Degree of fusion of the distal radius in the sample of the study was almost approaching the obtained values in the Algeria and Malaysia as comparative countries. Conclusion: MRI offers an alternative; non-invasive method of examination of the epiphysial fusion, which eliminates any risk associated with standard radiographic rating. The grading system can accurately identify the variable degrees of epiphysial fusion in an objective teachable manner

Abdominal computed tomography findings in patients with exudative ascites

Background: peritoneal cavity can be involved in inflammatory and malignant diseases and using computed tomography (CT) findings of exudative ascites may help in the differentiation. Objectives: 1-Describe CT features in patients with exudative ascites.2-Obtain useful CT findings to differentiate between tuberculous (TB) peritonitis and peritoneal carcinomatosis. Patients &methods: A cross sectional study conducted in Medical City Teaching Complex from September 2009 to September 2010 studied patients with exudative ascites using CT scan and confirmed later with histopathology examination. CT scan results were presented according to cytology examination and biochemical analysis. Results: 35 patients with exudative ascites were studied, including 19 males &16 females, age varied from 20 to73 years. While the amount of ascites(large or small) did not show statistically significant association with malignant disease, the density of ascitic fluid was slightly higher in TB[range(18-22)Hounsfield Unit(HU),mean is 20HU]compared to malignant ascites [range(15-20)HU ,mean is 18HU].Right subphrenic ascitic collections are associated with malignant disease (12 or 60% compared to 2 or 13.3% in TB) and pelvic ascitic collections were associated with TB disease (8 or 53.3% compared to 3 or 15% in malignant disease). Conclusion: In addition to omental cake &thickened bowel wall, malignant exudative ascites on CT scan is likely to have lower density, located in the right subphrenic space than in the pelvic region compared to benign (tuberculous) exudative ascites المقدمة :هذه الدراسة للتفريق بين مسببات الاستسقاء النضحي الحميدة والخبيثة باستخدام المفراس الحلزوني. الاهداف: وصف مشاهدات المفراس الحلزوني في الاستسقاء النضحي، استخدام مشاهدات المفراس الحلزوني للتفريق بين مسببات الاستسقاء النضحي الحميدة والخبيثة المرضى والطرائق: لقد تم دراسة 35 مريض يعانون من استسقاء البطن عن طريق الاختيار العشوائي للمرضى في وحدة المفراس لمستشفيات مدينة الطب التعليمية للفترة من ايلول 2009 الى ايلول 2010, وتم تأكيد النتيجة من الفحص المختبري,هؤلاء المرضى مكونين من 19 ذكر و16 أنثى .وكانت أعمار المرضى تتراوح بين 20-73. النتائج: وجدنا ان كثافة سائل الاستسقاء كانت مرتفعة عند مرضى التدرن البريتوني (20 وحدة هاونسفيلد) بالمقارنة مع المسسببات الخبيثة للاستسقاء النضحي (15 وحدة هاونسفيلد) يكون تجمع الاستسقاء في الناحية تحت الحجاب اليمنى في المسببات الخبيثة (12 او 60% بالمقارنة مع 2 او 13.3% في المسببات الحميدة ) والتجمع في الناحية الحوضية اكثر في مرضى التدرن (8 او 53.3% بالمقارنة مع 3 او 15 % في المسببات الخبيثة). الاستنتاج: اضافة الى الكعكة الثربية والتثخن في جدار الامعاء, يكون الاستسقاء النضحي ذو المسببات الخبيثة بكثافة اقل ويكثر تواجده في الناحية تحت الحجاب اليمنى بالمقارنة مع المسببات الحميدة للاستسقا

Low temperature decreases bone mass in mice: Implications for humans

ObjectivesHumans exhibit significant ecogeographic variation in bone size and shape. However, it is unclear how significantly environmental temperature influences cortical and trabecular bone, making it difficult to recognize adaptation versus acclimatization in past populations. There is some evidence that cold‐induced bone loss results from sympathetic nervous system activation and can be reduced by nonshivering thermogenesis (NST) via uncoupling protein (UCP1) in brown adipose tissue (BAT). Here we test two hypotheses: (1) low temperature induces impaired cortical and trabecular bone acquisition and (2) UCP1, a marker of NST in BAT, increases in proportion to degree of low‐temperature exposure.MethodsWe housed wildtype C57BL/6J male mice in pairs at 26 °C (thermoneutrality), 22 °C (standard), and 20 °C (cool) from 3 weeks to 6 or 12 weeks of age with access to food and water ad libitum (N = 8/group).ResultsCool housed mice ate more but had lower body fat at 20 °C versus 26 °C. Mice at 20 °C had markedly lower distal femur trabecular bone volume fraction, thickness, and connectivity density and lower midshaft femur cortical bone area fraction versus mice at 26 °C (p < .05 for all). UCP1 expression in BAT was inversely related to temperature.DiscussionThese results support the hypothesis that low temperature was detrimental to bone mass acquisition. Nonshivering thermogenesis in brown adipose tissue increased in proportion to low‐temperature exposure but was insufficient to prevent bone loss. These data show that chronic exposure to low temperature impairs bone architecture, suggesting climate may contribute to phenotypic variation in humans and other hominins.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146428/1/ajpa23684.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146428/2/ajpa23684_am.pd

Outcome after pancreaticoduodenectomy for T3 adenocarcinoma: a multivariable analysis from the UK Vascular Resection for Pancreatic Cancer Study Group

This study on T3 adenocarcinoma of the head of the pancreas suggests that IHM is strongly associated with perioperative complications whilst OS is affected by histological parameters. Detailed pre-operative disease evaluation and advances in oncological treatment have the potential to improve OS