elastography in primary open-angle glaucoma

Objective: The aim of this study was to compare sonoelastographic findings in the retina-choroid-sclera (RCS) complex and vitreous in glaucomatous and healthy eyes.Methods: For this cross-sectional comparative study, 20 patients with primary open-angle glaucoma and 20 healthy volunteers were recruited. Ultrasound elastography measurements were taken with a sonographic scanner of the RCS complex, anterior vitreous (AV), posterior vitreous (PV), retrobulbar fat tissue (RFT), optic disc (OD) and optic nerve (ON) in each eye.Results: The elasticity index of the RCS complex, RFT, OD, ON, AV and PV was similar in both groups (p > 0.05), although the AV/PV strain ratio in the group of patients with glaucoma was significantly higher (p = 0.04).Conclusion: Glaucoma increases the AV/PV strain ratio. In providing reproducible and consistent values, the real-time elastography (RTE) technique may be helpful in elucidating the mechanisms of glaucoma in some aspects.Advances in knowledge: This study can help to evaluate the elasticity of the RCS complex and vitreous in glaucomatous eyes with RTE

The volume fraction of brain ventricles to total brain volume: a computed tomography stereological study

This study has been designed to estimate the volume fraction of the brain ventricles volume to total brain volume and to correlate them with gender and age in normal subjects. Cranial computed tomography (CT) images of 80 normally evaluated subjects (five female and five male for each decade) were selected from 1,073 CT examinations. The volumes of total brain, cerebral aqueduct, fourth, third, and lateral ventricles and their ratios were estimated using the Cavalieri method and volume fraction-stereological methods. The ratio of total brain ventricle volume to total brain volume was comparable between the two genders (p > 0.05, independent t test). Mean volume fraction of total ventricle volume to total brain volume was found to be 1.21% in the first and 3.37% in the last decades. Mean volume fraction was found to increase significantly with age (p < 0.01, r = 0.630, Pearson). In conclusion, the mean percentage of total ventricle volume within the total brain volume was found to be 2%. We demonstrated the volume fraction of total ventricle to total brain in normal subjects. Total ventricle volume to total brain volume fractions can be important tools in determining ventricle volumes, which denote variability in some diseases (Alzheimer, schizophrenia, neurodegenerative disorders, etc.) and can be estimated by stereological methods. (Folia Morphol 2010; 69, 4: 193-200

Neurochemical metabolites in prefrontal cortex in patients with mild/moderate levels in first-episode depression

Background: Previous studies have determined the neurochemical metabolite abnormalities in major depressive disorder (MDD). The results of studies are inconsistent. Severity of depression may relate to neurochemical metabolic changes. The aim of this study is to investigate neurochemical metabolite levels in the prefrontal cortex (PFC) of patients with mild/moderate MDD. Methods: Twenty-one patients with mild MDD, 18 patients with moderate MDD, and 16 matched control subjects participated in the study. Patients had had their first episode. They had not taken treatment. The severity of depression was assessed by the Hamilton Rating Scale for Depression (HAM-D). Levels of N-acetyl aspartate (NAA), choline-containing compounds (Cho), and creatine-containing compounds (Cr) were measured using proton magnetic resonance spectroscopy (1H-MRS) at 1.5 T, with an 8-cm3 single voxel placed in the right PFC. Results: The moderate MDD patients had lower NAA/Cr levels than the control group. No differences were found in neurochemical metabolite levels between the mild MDD and control groups. No correlation was found between the patients' neurochemical metabolite levels and HAM-D scores. Conclusion: Our findings suggest that NAA/Cr levels are low in moderate-level MDD in the PFC. Neurochemical metabolite levels did not change in mild depressive disorder. Our results suggest that the severity of depression may affect neuronal function and viability. Studies are needed to confirm this finding, including studies on severely depressive patients. © 2013 Sözeri-Varma et al, publisher and licensee Dove Medical Press Ltd

Diagnostic tools in Rhinology EAACI position paper

This EAACI Task Force document aims at providing the readers with a comprehensive and complete overview of the currently available tools for diagnosis of nasal and sino-nasal disease. We have tried to logically order the different important issues related to history taking, clinical examination and additional investigative tools for evaluation of the severity of sinonasal disease into a consensus document. A panel of European experts in the field of Rhinology has contributed to this consensus document on Diagnostic Tools in Rhinology

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Public Health Rep

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CT features of intrathoracic gossypiboma (textiloma)

Here, we present chest radiography and computed tomography (CT) findings for three cases of mediastinal and pleural gossypiboma. Radiological manifestations varied according to the locations and chronicities of the gauze sponges and the types of reactions that they caused. CT analysis readily diagnosed gossypibomas in the early postoperative period by showing well-defined mediastinal- or pleural-based masses with hyperdense rims and central air bubbles. However, one patient presented in the late postoperative period, and a CT scan revealed a well-defined, solid pleural mass that was devoid of air bubbles; a correct diagnosis could not be established and the patient had to be reoperated on. Radiologists should be aware of different manifestations of this rare condition in cases of prior thoracic surgery and persistent respiratory symptoms

and MR imaging features (2008 : 1b)

Laparoscopic cholecystectomy has rapidly become the preferred treatment for symptomatic cholecystolithiasis. However, the procedure is associated with a number of complications, one of which is the spillage of gallstones into the peritoneal cavity. Unretrieved gallstones may cause a wide variety of complications such as abscess, adhesion and small-bowel obstruction, or they may remain asymptomatic and harmless. In the latter case, spilled gallstones in the peritoneal spaces may cause diagnostic difficulty or mimic peritoneal metastasis. We present the computed tomography (CT) and magnetic resonance (MR) imaging features of intra-abdominal gallstone spillage in a case with head and neck neoplasm. Awareness of radiologic features of dropped intraperitoneal gallstones is necessary as they may be mistaken for peritoneal metastases

infections regarding etiopathogeneses

Neuroimaging constitudes an important component in the diagnosis of the underlying infectious agents in central nervous system (CNS) infections. Despite the recent advances in neuroimaging evaluation, the diagnosis of unclear infectious CNS diseases remains a challenge. Conventional magnetic resonance imaging (MRI) is used in routine practice to identify abnormal areas involved in CNS infections. More recent MRI techniques, such as diffusion-weighted imaging (DWI), provide additional helpful information in the assessment of CNS infectious lesions compared with conventional MRI. This pictorial essay summarizes the clinical role of DWI in the demonstration of CNS infections including meningitis, encephalitis and pyogenic infections, and determination of the lesions compared with conventional MRI on the basis of physiopathologic phases of the infections