Assessments of inclinations of the mandibular fossa by computed tomography in an Asian population.

This study aims to evaluate the inclinations of right and left sides the mandibular fossa in Asian population using computed tomography (CT) images and determine its effects according to the parameters of gender, age, and asymmetry. CT images of the heads of 198 Asian subjects [95 females aged 44.2 ± 20.7 years, range 11-88 years; and 103 males aged 44.5 ± 19.7 years, range 15-98 years] were selected. The following eight parameters characterizing the inclinations of the mandibular fossa were measured by medical imaging software: anterior and posterior inclinations on the left and right sides on a sagittal view, and medial and lateral inclinations on the left and right sides on a coronal view. The anterior inclination was significant steeper in males than in females on both the left and right sides. A moderate positive correlation was found between age and anterior inclinations on the left and right sides. None of the other parameters were significantly affected by age or gender. None of the parameters differed significantly between the right and left sides of the mandibular fossa in males, females, or all subjects. The anterior inclination of the mandibular fossa was affected by aging and gender becoming steeper in Asians males than females. Besides, there were no asymmetry in the right and left side inclinations of the mandibular fossa.

Using anti-malondialdehyde-modified peptide adduct autoantibodies in serum of taiwanese women to diagnose primary Sjogren's syndrome.

BACKGROUND: Sjogren's syndrome (SS) is a systemic autoimmune disease featured with a dry mouth and dry eyes. Several autoantibodies, including anti-SSA, anti-SSB, antinuclear antibodies can be detected in patients with SS. Oxidation-specific epitopes (OSEs) can be formed from malondialdehyde (MDA)-modified protein adducts and trigger chronic inflammation. In this study, our purposes were used serum levels of anti-MDA-modified peptide adducts autoantibodies to evaluate predictive performance by machine learning algorithms in primary Sjögren's syndrome (pSS) and assess the association between pSS and healthy controls. METHODS: Three novel MDA-modified peptide adducts, including immunoglobulin (Ig) gamma heavy chain 1 (IGHG1)102-131, complement factor H (CFAH)1045-1062, and Ig heavy constant alpha 1 (IGHA1)307-327 were identified and validated. Serum levels of protein, MDA-modified protein adducts, MDA, and autoantibodies recognizing unmodified peptides and MDA-modified peptide adducts were measured. Statistically significance in correlations and odds ratios (ORs) were estimated. RESULTS: The random forest classifier utilized autoantibodies combination composed of IgM anti-IGHG1102-131, IgM anti-IGHG1102-131 MDA and IgM anti-IGHA1307-327 achieved predictive performance as an accuracy of 88.0%, a sensitivity of 93.7%, and a specificity of 84.4% which may be as potential diagnostic biomarkers to differentiate patients with pSS from rheumatoid arthritis (RA), and secondary SS in RA and HCs. CONCLUSIONS: Our findings imply that low levels of IgA anti-IGHG1102-131 MDA (OR = 2.646), IgA anti-IGHG1102-131 (OR = 2.408), IgA anti-CFAH1045-1062 (OR = 2.571), and IgA anti-IGHA1307-327 (OR = 2.905) may denote developing risks of pSS, respectively.

Primary Sjogren syndrome increases the risk of bisphosphonate-related osteonecrosis of the jaw.

The risk of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in primary Sjogren syndrome (pSS) has rarely been explored. To explore the association between BRONJ and pSS, we conducted a population-based propensity-score-matched cohort study using Taiwan's National Health Insurance Research Database, including pSS patients receiving antiosteoporotic therapy and patients without pSS receiving antiosteoporotic therapy. A 1:4 matched-pair cohort based on propensity score was created. The stratified Cox proportional hazards model compared the risk of BRONJ in the pSS and non-pSS groups. In the study, 23,280 pSS patients and 28,712,152 controls were enrolled. After matching, 348 patients with pSS receiving antiosteoporotic drugs and 50,145 without pSS receiving antiosteoporotic drugs were included for analysis. The risk of developing BRONJ was 1.96 times higher in pSS patients compared with non-pSS patients after adjustment for age, sex, and comorbidities. No dose-response effect was observed in the bisphosphonate-treated pSS cohorts, documented as the cumulative defined daily doses of either < 224 or ≥ 224 (hazard ratio [HR]: 2.407, 95% confidence interval [CI] 1.412-7.790; HR: 2.143, 95% CI 1.046-4.393, respectively) increased risk of developing osteonecrosis of the jaw. In conclusion, the risk of BRONJ is significantly higher in patients with pSS compared with the general population.

Correlation between imaging characteristics and microbiology in patients with deep neck infections: a retrospective review of one hundred sixty-one cases.

BACKGROUND: This study reviews our recent experience with deep neck infections in order to propose recommendations in selecting presumptive antibiotics according to imaging characteristics and identifying predisposing factors of life-threatening complications. METHODS: The records of 161 patients treated for deep neck infections at the Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital from 2002 to 2012 were reviewed retrospectively. The demographic data, comorbidities, source of infections, complications, duration of hospital stay, imaging characteristics, and bacteriologic studies were evaluated. The involved neck space was determined by computed tomography (CT) scan with contrast. Complications included mortality and life-threatening conditions. RESULTS: The most common cause of deep neck infections in our study was odontogenic infection (20.5%), followed by pharyngo-tonsillitis (18.6%), and lymphadenitis (10.5%). The most commonly involved neck space was the submandibular space (40.9%), followed by the carotid space (37.2%), and the para-pharyngeal space (33.5%). Gas formation was detected in 31 (19.3%) cases. Infections of the different neck spaces and patients with gas formation noted on CT scan showed a specific distribution of common microorganisms. Streptococcus spp. was the most common pathogen in submandibular/sublingual space infections. Klebsiella pneumoniae infection accounted for 53.1% of peri-tonsillar/para-pharyngeal space infections, and 40% of carotid space infections. When gas formation was noted on CT imaging, anaerobic infection was the most common pathogen. Chronic kidney disease, diabetes mellitus (DM), multiple space infection, and gas formation present on CT scan were independent predictors of complications (p<0.05). CONCLUSION: The imaging characteristics and microbiology of patients with deep neck infections are correlated and can facilitate the optimal selection of antibiotics. We can administer more precise presumptive antibiotics according to the identified involved neck space on CT scan. Patients with predisposing factors of life-threatening complications require early aggressive multi-disciplinary management to prevent severe sequelae.

The Chinese Visible Human (CVH) datasets incorporate technical and imaging advances on earlier digital humans.

We report the availability of a digitized Chinese male and a digitzed Chinese female typical of the population and with no obvious abnormalities. The embalming and milling procedures incorporate three technical improvements over earlier digitized cadavers. Vascular perfusion with coloured gelatin was performed to facilitate blood vessel identification. Embalmed cadavers were embedded in gelatin and cryosectioned whole so as to avoid section loss resulting from cutting the body into smaller pieces. Milling performed at -25 degrees C prevented small structures (e.g. teeth, concha nasalis and articular cartilage) from falling off from the milling surface. The male image set (.tiff images each of 36 Mb) has a section resolution of 3072 x 2048 pixels ( approximately 170 micro m, the accompanying magnetic resonance imaging and computer tomography data have a resolution of 512 x 512, i.e. approximately 440 micro m). The Chinese Visible Human male and female datasets are available at http://www.chinesevisiblehuman.com. (The male is 90.65 Gb and female 131.04 Gb). MPEG videos of direct records of real-time volume rendering are at: http://www.cse.cuhk.edu.hk/~crc