White matter abnormalities associated with ADHD outcomes in adulthood.

It remains unclear if previously reported structural abnormalities in children with ADHD are present in adulthood regardless of clinical outcome. In this study, we examined the extent to which focal-rather than diffuse-abnormalities in fiber collinearity of 18 major white matter tracts could distinguish 126 adults with rigorously diagnosed childhood ADHD (ADHD; mean age [SD] = 34.3 [3.6] years; F/M = 12/114) from 58 adults without ADHD histories (non-ADHD; mean age [SD] = 33.9 [4.1] years; F/M = 5/53) and if any of these abnormalities were greater for those with persisting ADHD symptomatology. To this end, a tract profile approach was used. After accounting for age, sex, handedness, and comorbidities, a MANCOVA revealed a main effect of group (ADHD < non-ADHD; F[18,155] = 2.1; p = 0.007) on fractional anisotropy (FA, a measure of fiber collinearity and/or integrity), in focal portions of white matter tracts involved in visuospatial processing and memory (i.e., anterior portion of the left inferior longitudinal fasciculus, and middle portion of the left and right cingulum angular bundle). Only abnormalities in the anterior portion of the left inferior longitudinal fasciculus distinguished probands with persisting versus desisting ADHD symptomatology, suggesting that abnormalities in the cingulum angular bundle might reflect "scarring" effects of childhood ADHD. To our knowledge, this is the first study using a tract profile approach to identify focal or widespread structural abnormalities in adults with ADHD rigorously diagnosed in childhood.

Metastatic adenocarcinoma from the colon to the mandible.

Published reports of metastatic adenocarcinoma from the colon or rectum to the mandible are extremely rare. Only eight cases had been reported from 1884 to the time this article was written. A case is presented where a metastatic lesion was found to be histologically similar to the known primary tumor in the cecum. The patient first noted dental pain, isolated to his mandibular left second bicuspid, 10 months after a primary tumor was diagnosed. Subsequently, the tooth was extracted, and it was only after the extraction site failed to heal that a biopsy was performed which confirmed a metastatic lesion. Retrospective study of the preextraction radiograph confirmed the presence of a suspicious area in the osseous structure of the mandible at the time of extraction. It must be emphasized that in patients with a positive history of malignancy, metastatic disease must be considered in the differential diagnosis of oral and dental symptoms, and that need for biopsy should be considered with all surgical procedures, including simple extractions.