MRI estimates of brown adipose tissue in children – Associations to adiposity, osteocalcin, and thigh muscle volume

Publication date: Available online 8 February 2019

Source: Magnetic Resonance Imaging

Author(s): Jonathan Andersson, Josefine Roswall, Emma Kjellberg, Håkan Ahlström, Jovanna Dahlgren, Joel Kullberg

Abstract

Context

Brown adipose tissue is of metabolic interest. The tissue is however poorly explored in children.

Methods

Sixty-three 7-year old subjects from the Swedish birth-cohort Halland Health and Growth Study were recruited. Care was taken to include both normal weight and overweight children, but the subjects were otherwise healthy. Only children born full term were included.

Water-fat separated whole-body MRI scans, anthropometric measurements, and measurements of fasting glucose and levels of energy homeostasis related hormones, including the insulin-sensitizer osteocalcin, were performed. The fat fraction (FF) and effective transverse relaxation time (T₂*) of suspected brown adipose tissue in the cervical-supraclavicular-axillary fat depot (sBAT) and the FFs of abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) were measured. Volumes of sBAT, abdominal VAT and SAT, and thigh muscle volumes were measured.

Results

The FF in the sBAT depot was lower than in VAT and SAT for all children. In linear correlations including sex and age as explanatory variables, sBAT FF correlated positively with all measures of adiposity (p < 0.01), except for VAT FF and weight, positively with sBAT T₂* (p = 0.036), and negatively with osteocalcin (p = 0.017). When adding measures of adiposity as explanatory variables, sBAT FF also correlated negatively with thigh muscle volume (p < 0.01).

Conclusions

Whole-body water-fat MRI of children allows for measurements of sBAT. The FF of sBAT was lower than that of VAT and SAT, indicating presence of BAT. Future studies could confirm whether the observed correlations corresponds to a hormonally active BAT.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SCVkmX

Percutaneous CT guided bone biopsy for suspected osteomyelitis: diagnostic yield and impact on patient’s treatment change and recovery

Publication date: Available online 8 February 2019

Source: European Journal of Radiology

Author(s): Diana Hoang, Stephen Fisher, Orhan K. Oz, Javier La Fontaine, Avneesh Chhabra

ABSTRACT

Aim

To evaluate the utility of percutaneous CT guided bone biopsy (PCBB) for suspected osteomyelitis (OM) and its eventual impact on patient management and recovery.

Material and methods

Patients who received a PCBB for suspected osteomyelitis from years 2012-2018. Patient demographics, lesion location, ulcer grade, signs of toxemia, serology, wound and blood cultures, bone biopsy and cross-sectional imaging results were recorded. Diagnostic yield of the bone biopsy and its role in influencing the final treatment plan and patient recovery were evaluated. Chi-square test was used. P-value less than 0.05 was considered statistically significant.

Results

115 patients with mean age 50.86 ± 14.49 years were included. The common locations were sacrum/ischium (49/115, 43%) and spine (35/115, 30%). Clinically, 40/115 (35%) had toxemia and 67/115 (58%) had ulcers. Per serology, 17/111 (15%), 95/106 (90%), and 86/98 (88%) had an elevated WBC, CRP, and sedimentation rate, respectively. 22/91 (24%) had a positive blood culture and all 23/23 had a positive wound culture. On imaging, definitive and possible OM were reported in 84.1% and 14.2%, respectively, with 1.8% as no OM. Only 24/115 (21%) had a positive bone biopsy culture and only 10/24 (42%) total positive bone cultures impacted the treatment plan. There was no significant effect of antibiotics on the diagnostic yield of culture (p = 0.08). No statistical significance was found when comparing treatment change based on bone culture results versus all other factors combined (p = 0.33), or when comparing clinical improvement with and without positive bone cultures (p = 0.12).

Conclusion

Despite positive cross-sectional imaging findings of OM, bone biopsy yield of positive culture is low, and it leads to a small impact in changing the treatment plan or altering the course of patient recovery.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Bu6xwr

Percutaneous CT guided bone biopsy for suspected osteomyelitis: diagnostic yield and impact on patient’s treatment change and recovery

Publication date: Available online 8 February 2019

Source: European Journal of Radiology

Author(s): Diana Hoang, Stephen Fisher, Orhan K. Oz, Javier La Fontaine, Avneesh Chhabra

ABSTRACT

Aim

To evaluate the utility of percutaneous CT guided bone biopsy (PCBB) for suspected osteomyelitis (OM) and its eventual impact on patient management and recovery.

Material and methods

Patients who received a PCBB for suspected osteomyelitis from years 2012-2018. Patient demographics, lesion location, ulcer grade, signs of toxemia, serology, wound and blood cultures, bone biopsy and cross-sectional imaging results were recorded. Diagnostic yield of the bone biopsy and its role in influencing the final treatment plan and patient recovery were evaluated. Chi-square test was used. P-value less than 0.05 was considered statistically significant.

Results

115 patients with mean age 50.86 ± 14.49 years were included. The common locations were sacrum/ischium (49/115, 43%) and spine (35/115, 30%). Clinically, 40/115 (35%) had toxemia and 67/115 (58%) had ulcers. Per serology, 17/111 (15%), 95/106 (90%), and 86/98 (88%) had an elevated WBC, CRP, and sedimentation rate, respectively. 22/91 (24%) had a positive blood culture and all 23/23 had a positive wound culture. On imaging, definitive and possible OM were reported in 84.1% and 14.2%, respectively, with 1.8% as no OM. Only 24/115 (21%) had a positive bone biopsy culture and only 10/24 (42%) total positive bone cultures impacted the treatment plan. There was no significant effect of antibiotics on the diagnostic yield of culture (p = 0.08). No statistical significance was found when comparing treatment change based on bone culture results versus all other factors combined (p = 0.33), or when comparing clinical improvement with and without positive bone cultures (p = 0.12).

Conclusion

Despite positive cross-sectional imaging findings of OM, bone biopsy yield of positive culture is low, and it leads to a small impact in changing the treatment plan or altering the course of patient recovery.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Bu6xwr

Commentary on Jauhar and Hayes

Publication date: Available online 8 February 2019

Source: Addictive Behaviors

Author(s): Michael P. Hengartner

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SBf3DQ

Commentary on Jauhar and Hayes

Publication date: Available online 8 February 2019

Source: Addictive Behaviors

Author(s): Michael P. Hengartner

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SBf3DQ

Change in gray matter volume and cerebral blood flow in patients with burning mouth syndrome

Abstract

Background

The purpose of this study was to evaluate alterations in gray matter volume (GMV) and cerebral blood flow (CBF) using structural MRI and arterial spin labeling (ASL) perfusion MRI, respectively, in burning mouth syndrome (BMS) patients.

Methods

We prospectively enrolled 12 patients with BMS and 14 healthy controls. Volumetric T1‐weighted magnetization‐prepared rapid gradient‐echo imaging and pseudo‐continuous ASL were performed to obtain GMV and CBF, respectively. We analyzed differences in the GMV and CBF between the two groups, and their correlations with clinical parameters.

Results

The GMV was smaller in the left thalamus and left middle temporal gyrus in the BMS group when compared to controls. Regional CBF in the BMS group was significantly decreased in the left middle temporal gyrus, left insula, right middle temporal gyrus and right insula compared with controls. In BMS patients, there was a significant correlation between GMV and pain severity in the left middle temporal gyrus.

Conclusion

The reduced GMV seen in the thalami of BMS patients is consistent with the pattern observed in those with chronic pain disease, which implies that the pathogenesis of BMS may be associated with atrophy of the brain structures associated with thalamocortical processing. In addition, changes in CBF in the insula and middle temporal gyrus were also observed.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SjhqvJ

Stromal fibronectin expression in patients with resected pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is characterized by an extremely dense stroma, which has a fundamental role in tumor progression. Fibronectin (FN1) is the main constituent of the tumor stroma in pancre...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DkXFJK

Stromal fibronectin expression in patients with resected pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is characterized by an extremely dense stroma, which has a fundamental role in tumor progression. Fibronectin (FN1) is the main constituent of the tumor stroma in pancre...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DkXFJK

Plaque‐like myofibroblastic tumor, a rare entity of childhood: possible pitfalls in differential diagnosis

Plaque‐like myofibroblastic tumor is a rare and benign pediatric soft tissue tumor. It presents as a slowly growing plaque reaching several centimeters in diameter, made up of multiple nodules. The clinical and histological features of this benign entity are similar to other fibrohistiocytic or myofibroblastic tumors occuring in childhood, so the diagnosis can be difficult. The correlation between clinical data, histopathology and immunohistochemistry is necessary for the correct diagnosis.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UNKFDq

Clinical Factors Associated with Cutaneous Histopathologic Findings in Dermatomyositis

Background

Common histopathologic findings in cutaneous dermatomyositis include vacuolar interface with dyskeratosis, mucin, and perivascular inflammation. Data examining the relationships between these and other histologic abnormalities, or their dependence on biopsy site, and medications is limited.

Methods

Using 228 dermatomyositis skin biopsies and statistical analyses including Chi‐squared analyses, calculations of relative risk, and adjusted GEE regressions we investigated relationships between 14 histopathologic findings and the impact of clinical factors on these findings.

Results

In biopsies taken from sites of visible rash interface dermatitis was seen in 91% and 95% had at least one of perivascular inflammation, mucin or basal vacuolization. Vascular abnormalities were not closely associated with epidermal or inflammatory findings. Concomitant prednisone significantly decreased the odds of basal vacuolization (OR 0.34, 95% CI 0.12‐0.98, p‐value = 0.05), perivascular inflammation (OR 0.19, 95% CI 0.07‐0.53, p‐value = 0.002) and vessel damage (OR 0.81, 95% CI 0.68‐0.96, p‐value = 0.02).

Conclusions

Vasculopathy and classic findings of interface dermatitis may be driven by unique pathways in dermatomyositis. Corticosteroid use may impact skin biopsy findings. There is a need for clinicopathologic correlation when diagnosing dermatomyositis.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2tbW3xf

Plaque‐like myofibroblastic tumor, a rare entity of childhood: possible pitfalls in differential diagnosis

Plaque‐like myofibroblastic tumor is a rare and benign pediatric soft tissue tumor. It presents as a slowly growing plaque reaching several centimeters in diameter, made up of multiple nodules. The clinical and histological features of this benign entity are similar to other fibrohistiocytic or myofibroblastic tumors occuring in childhood, so the diagnosis can be difficult. The correlation between clinical data, histopathology and immunohistochemistry is necessary for the correct diagnosis.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UNKFDq

Clinical Factors Associated with Cutaneous Histopathologic Findings in Dermatomyositis

Background

Common histopathologic findings in cutaneous dermatomyositis include vacuolar interface with dyskeratosis, mucin, and perivascular inflammation. Data examining the relationships between these and other histologic abnormalities, or their dependence on biopsy site, and medications is limited.

Methods

Using 228 dermatomyositis skin biopsies and statistical analyses including Chi‐squared analyses, calculations of relative risk, and adjusted GEE regressions we investigated relationships between 14 histopathologic findings and the impact of clinical factors on these findings.

Results

In biopsies taken from sites of visible rash interface dermatitis was seen in 91% and 95% had at least one of perivascular inflammation, mucin or basal vacuolization. Vascular abnormalities were not closely associated with epidermal or inflammatory findings. Concomitant prednisone significantly decreased the odds of basal vacuolization (OR 0.34, 95% CI 0.12‐0.98, p‐value = 0.05), perivascular inflammation (OR 0.19, 95% CI 0.07‐0.53, p‐value = 0.002) and vessel damage (OR 0.81, 95% CI 0.68‐0.96, p‐value = 0.02).

Conclusions

Vasculopathy and classic findings of interface dermatitis may be driven by unique pathways in dermatomyositis. Corticosteroid use may impact skin biopsy findings. There is a need for clinicopathologic correlation when diagnosing dermatomyositis.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2tbW3xf

Involvement of hippocampal subfields and anterior-posterior subregions in encoding and retrieval of item, spatial, and associative memories: Longitudinal versus transverse axis

Publication date: Available online 8 February 2019

Source: NeuroImage

Author(s): Stanislau Hrybouski, Melanie MacGillivray, Yushan Huang, Christopher R. Madan, Rawle Carter, Peter Seres, Nikolai V. Malykhin

Abstract

The functional role of the hippocampal formation in episodic memory has been studied using functional magnetic resonance imaging (fMRI) for many years. The hippocampus can be segmented into three major anteroposterior sections, called head, body and tail, and into the Cornu Ammonis (CA), dentate gyrus (DG), and subiculum (Sub) subfields based on its transverse axis. However, the exact role of these subregions and subfields in memory processes is less understood. In the present study we combined ultra-high resolution structural Magnetic Resonance Imaging (MRI) at 4.7 T with an event-related high-resolution fMRI paradigm based on the 'Designs' subtest of the Wechsler Memory Scale to investigate how the hippocampal subfields and longitudinal subregions are involved in encoding and retrieval of item, spatial, and associative memories. Our results showed that during memory encoding, regardless of the type of memory being learned, all subregions and all subfields were active. During the retrieval phase, on the other hand, we observed an anterior to posterior gradient in hippocampal activity for all subfields and all types of memory. Our findings also confirmed presence of an anterior to posterior gradient in hippocampal activity during spatial learning. Comparing subfield activities to each other revealed that the DG was more active than the CA1-3 and Sub during both encoding and retrieval. Finally, our results showed that for every subfield, encoding vs. retrieval activity differences were larger in the hippocampal head than in the hippocampal body and tail. Furthermore, these encoding vs. retrieval activity differences were similar in all subfields, highlighting the importance of studying both the longitudinal and transverse axis specialization simultaneously. Current findings further elucidate the structure–function relationship between the human hippocampus and episodic memory.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2E1bNJK

Transcanal sound recordings as a screening tool in the clinical management of patients with pulsatile tinnitus. A pilot study of twenty patients with pulsatile tinnitus eligible for digital subtraction angiography

Abstract

In pulsatile tinnitus, the differential diagnosis includes neurovascular pathology, which can be occult on non‐invasive imaging techniques. Therefore, if a clear diagnosis is lacking, digital subtraction angiography (DSA) is indicated to rule out a potentially hazardous vascular lesion, particularly a dural arteriovenous fistula (dAVF). However, a DSA carries a procedural risk of 1‐2%.

In a tertiary care setting, the incidence of a dAVF in pulsatile tinnitus patients lacking a diagnosis after non‐invasive imaging is about 25‐35%. Therefore, the majority of this group of patients is unnecessarily exposed to the risks of DSA.

We report on 20 consecutive patients in a tertiary care setting with pulsatile tinnitus who were referred for DSA to rule out neurovascular pathology. We found that the absence of a pulsatile sound detected by transcanal sound recordings, excludes a dAVF (100% sensitivity).

Consequently, the use of transcanal sound recordings as a screening tool may prevent patients for the unnecessary risks of DSA in the diagnostic work‐up of pulsatile tinnitus.

Conventional peri‐auriculair and neck auscultation with stethoscope is not always sufficient to objectify the presence of a pulsatile tinnitus.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MXSV0X

The Effect of Polycythemia Vera on Hearing Functions: Evaluation of Twenty‐one Patients

Abstract

•Patients with PV may present with sensorineural hearing loss, acute hearing loss, and vertigo. The aim of this study was to determine the effect of Polycytemia vera (PV) on hearing functions.

•Patients with known PV (n=21) were compared to healthy controls with no history of otologic or neurologic disorders (n = 20). Cochlear impairment was found to be significantly increased in PV group (p=0,004). There was no statistically significant difference between the groups in means of Hgb and Htc (p=0,629). But

•Platelet count was found to be significantly higher in PV group (p<0,001). The relationship between high platelet counts and cochlear involvement in PV group was found to be statistically significant (p=0,005).

•The degree of cochlear involvement was higher in patients with Hgb value >15,5 g/dL, indicating that high Hgb/Hct levels may cause hearing loss related to cochlear involvement.

•Cochlear involvement was more common in the patients with high platelet counts. The management of PV treatment is important for hearing functions.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SCJw49

Involvement of hippocampal subfields and anterior-posterior subregions in encoding and retrieval of item, spatial, and associative memories: Longitudinal versus transverse axis

Publication date: Available online 8 February 2019

Source: NeuroImage

Author(s): Stanislau Hrybouski, Melanie MacGillivray, Yushan Huang, Christopher R. Madan, Rawle Carter, Peter Seres, Nikolai V. Malykhin

Abstract

The functional role of the hippocampal formation in episodic memory has been studied using functional magnetic resonance imaging (fMRI) for many years. The hippocampus can be segmented into three major anteroposterior sections, called head, body and tail, and into the Cornu Ammonis (CA), dentate gyrus (DG), and subiculum (Sub) subfields based on its transverse axis. However, the exact role of these subregions and subfields in memory processes is less understood. In the present study we combined ultra-high resolution structural Magnetic Resonance Imaging (MRI) at 4.7 T with an event-related high-resolution fMRI paradigm based on the 'Designs' subtest of the Wechsler Memory Scale to investigate how the hippocampal subfields and longitudinal subregions are involved in encoding and retrieval of item, spatial, and associative memories. Our results showed that during memory encoding, regardless of the type of memory being learned, all subregions and all subfields were active. During the retrieval phase, on the other hand, we observed an anterior to posterior gradient in hippocampal activity for all subfields and all types of memory. Our findings also confirmed presence of an anterior to posterior gradient in hippocampal activity during spatial learning. Comparing subfield activities to each other revealed that the DG was more active than the CA1-3 and Sub during both encoding and retrieval. Finally, our results showed that for every subfield, encoding vs. retrieval activity differences were larger in the hippocampal head than in the hippocampal body and tail. Furthermore, these encoding vs. retrieval activity differences were similar in all subfields, highlighting the importance of studying both the longitudinal and transverse axis specialization simultaneously. Current findings further elucidate the structure–function relationship between the human hippocampus and episodic memory.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2E1bNJK

A New Method Using Tissue Expander Makes Auricular Reconstruction Easier In 115 Microtia Patients

Abstract

1、New method using expander makes auricular reconstruction easier.

2、Most patients were satisfied with reconstructed ears.

3、Reconstructed ears showed good three‐dimensional shape with clear anatomical details and symmetric cranioauricular angle.

4、Retroauricular and chest scars were much smaller.

5、Compared with traditional method,new method takes shorter operation time in the second stage.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SF2ZBj

Transcanal sound recordings as a screening tool in the clinical management of patients with pulsatile tinnitus. A pilot study of twenty patients with pulsatile tinnitus eligible for digital subtraction angiography

Abstract

In pulsatile tinnitus, the differential diagnosis includes neurovascular pathology, which can be occult on non‐invasive imaging techniques. Therefore, if a clear diagnosis is lacking, digital subtraction angiography (DSA) is indicated to rule out a potentially hazardous vascular lesion, particularly a dural arteriovenous fistula (dAVF). However, a DSA carries a procedural risk of 1‐2%.

In a tertiary care setting, the incidence of a dAVF in pulsatile tinnitus patients lacking a diagnosis after non‐invasive imaging is about 25‐35%. Therefore, the majority of this group of patients is unnecessarily exposed to the risks of DSA.

We report on 20 consecutive patients in a tertiary care setting with pulsatile tinnitus who were referred for DSA to rule out neurovascular pathology. We found that the absence of a pulsatile sound detected by transcanal sound recordings, excludes a dAVF (100% sensitivity).

Consequently, the use of transcanal sound recordings as a screening tool may prevent patients for the unnecessary risks of DSA in the diagnostic work‐up of pulsatile tinnitus.

Conventional peri‐auriculair and neck auscultation with stethoscope is not always sufficient to objectify the presence of a pulsatile tinnitus.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MXSV0X

The Effect of Polycythemia Vera on Hearing Functions: Evaluation of Twenty‐one Patients

Abstract

•Patients with PV may present with sensorineural hearing loss, acute hearing loss, and vertigo. The aim of this study was to determine the effect of Polycytemia vera (PV) on hearing functions.

•Patients with known PV (n=21) were compared to healthy controls with no history of otologic or neurologic disorders (n = 20). Cochlear impairment was found to be significantly increased in PV group (p=0,004). There was no statistically significant difference between the groups in means of Hgb and Htc (p=0,629). But

•Platelet count was found to be significantly higher in PV group (p<0,001). The relationship between high platelet counts and cochlear involvement in PV group was found to be statistically significant (p=0,005).

•The degree of cochlear involvement was higher in patients with Hgb value >15,5 g/dL, indicating that high Hgb/Hct levels may cause hearing loss related to cochlear involvement.

•Cochlear involvement was more common in the patients with high platelet counts. The management of PV treatment is important for hearing functions.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SCJw49

Changes in Maxillary Sinus Volume and It’s Walls Thickness Due to Chronic Rhinosinusitis: A Prospective Study

Abstract

This is a prospective observational cross sectional study comprising of 57 patients who were having symptoms of chronic rhinosinusitis which were evaluated with the help of computed tomography scan (coronal and axial sections) to measure the thickness of all walls of maxillary sinus and it's volume. Computed tomographic imaging of sinonasal region has become the gold standard in the evaluation of patients with chronic sinusitis. The maxillary sinus is pyramidal in shape with lateral wall of nose forming its base and its apex is directed towards zygomatic process. All three dimensions of the maxillary sinus were measured and the volume of each maxillary sinus was also calculated. Hyperostosis of maxillary sinus tended to increase maxillary sinus walls thickness which ultimately results into decrease in maxillary sinus volume in chronic rhinosinusitis patients.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2tg2DTv