ABSTRACT
Objectives: Ankylosing spondylitis (AS) is a chronic inflammatory arthritis with characteristic involvement of the spine and sacroiliac joints. MRI may be the only indicator of disease activity or response. This study aimed to use a novel water fraction measurement technique on MRI as a biomarker to predict disease activity in patients with AS. Methods: We enrolled 39 patients (18 men [mean age, 38.6 years; range, 18−59 years] and 21 women [mean age, 39.3 years; range, 23−61 years]) who were clinically diagnosed with AS and underwent MRI, including mDixon sequences. Water fraction values of sacroiliac joint subchondral bone marrow were derived from the mDixon sequences. The Ankylosing Spondylitis Disease Activity Score (ASDAS) was recorded using clinical information and laboratory values from medical records. Multiple linear regression, Firth logistic regression, and intraclass correlation coefficients were used for the statistical analysis. Results: In multiple linear regression, water fraction, subchondral bone marrow edema, subchondral bone erosion, and subchondral bone marrow enhancements were significantly associated with ASDAS with C-reactive protein (ASDAS-CRP). The water fraction parameters showed a good linear correlation with ASDAS-CRP and ASDAS with erythrocyte sedimentation rate (ASDAS-ESR) (beta coefficient = 1.98, p < 0.001 and beta coefficient = 1.60, p = 0.003). Firth logistic regression showed that water fraction was a significant predictor of ASDAS-CRP but not ASDAS-ESR. The intraclass correlation coefficient showed excellent repeatability for the three repeated measures of the water fraction. Conclusion: Water fraction parameter could be a good imaging biomarker of disease activity status. The sacroiliac joint evaluated by mDixon MRI may be a promising biomarker of disease progression in patients with spondyloarthritis.
ABSTRACT
The anomalous retro-psoas iliac artery is an extremely rare congenital iliolumbar vascular anomaly. A 51-year-old woman presented to our emergency department with worsening right lower extremity pain and weakness for 3 months. CT angiography of the right lower extremity showed no evidence of stenosis in the lower extremity arteries and the incidental finding of an anomalous right retro-psoas iliac artery. Herein, we report a rare case of anomalous retro-psoas iliac artery. Surgeons and clinicians need to be aware of this rare congenital anomaly to avoid severe complications during pelvic or orthopedic surgery.
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[This corrects the article DOI: 10.1016/j.radcr.2020.01.036.].
ABSTRACT
Primary liposarcoma originating from the diaphragm is an extremely rare case. Seventy-four-year-old male presented to emergency department with worsening right upper quadrant abdominal pain with dyspnea. Contrast-enhanced computed tomography of the abdomen demonstrated lobulated mass in right hemidiaphragm exhibiting mass effects to adjacent structures compressing gall bladder. Magnetic resonance imaging of the abdomen showed diaphragmatic mass with heterogeneous signal intensities with partial diffusion restriction. Surgical removal was performed and histology confirmed dedifferentiated liposarcoma arising from the diaphragm with gall bladder invasion.
ABSTRACT
Spinal solitary fibrous tumors are extremely rare neoplasms and of those, intradural extramedullary location is even rarer. A 64-year-old male presented to the emergency department with worsening right leg pain over 1 month. Whole spine magnetic resonance imaging revealed a well-circumscribed mass with low T1 and markedly low T2 signal intensity at the level of T1-2. Spine computed tomography showed no evidence of calcification or acute hemorrhage. Surgical removal was performed and the final diagnosis was intradural extramedullary solitary fibrous tumor.
ABSTRACT
Primary peritoneal serous carcinoma (PPSC) is an epithelial tumor that arises from the peritoneum. On histopathologic analysis, it resembles a malignant ovarian surface epithelial stromal tumor. A 62-year-old woman visited the emergency room with low abdominal pain. Peritoneal carcinomatosis from ovarian cancer was initially suspected and underwent radical hysterectomy, both salpingo-oophorectomy and omentectomy. Both ovaries and uterus were intact, and ultimate diagnosis was PPSC. PPSC is a rare disease that is difficult to diagnose prior to surgery. We suspected peritoneal carcinomatosis due to the rarity of primary tumor originating from the peritoneum and overlooked PPSC, but when the primary site is not clear, we advise to consider the possibility of PPSC. Median survival time is 11-17 months with poor prognosis, and thus early diagnosis, treatment is important, and further imaging studies are warranted.
ABSTRACT
This study presents a first case of multiple peripheral typical carcinoid tumors associated with sclerosing hemangiomas in the lung. A 52-year-old male presented with incidentally detected multiple pulmonary nodules on a simple chest X-ray during routine health check-up. A computed tomography (CT) scan of the chest showed multiple nodular lesions in the middle and lower lobes of the right lung. These were initially suspected as inflammatory lesions due to miliary tuberculosis. However, possibility of malignancy could not be excluded and right lower lobe lobectomy was performed. Histopathologically, some nodules including two largest nodules were composed of small round to spindle shaped cells with fine chromatin pattern, whereas the rest of the sclerotic nodules were composed of two epithelial cell types- surface cells and round cells. The final diagnosis of this case was multiple peripheral typical carcinoid tumors associated with sclerosing hemangiomas of the lung. For past three years of post-surgery follow up period, no new lesions or changes in the right middle lobe have been identified.
Subject(s)
Carcinoid Tumor/pathology , Histiocytoma, Benign Fibrous/pathology , Lung Neoplasms/pathology , Carcinoid Tumor/diagnosis , Carcinoid Tumor/diagnostic imaging , Histiocytoma, Benign Fibrous/diagnosis , Histiocytoma, Benign Fibrous/diagnostic imaging , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Male , Middle Aged , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The shrub Thuja orientalis is extensively used as a herbal medicine in Korea and China. In the present study extracts of the plant were subjected to fractionation and purification, with seven compounds (myricitrin, isoquercitrin, hypoletin-7-O-ß-D-xylopyranoside, quercitrin, kaempferin, kaempferol, and amentoflavone) being isolated. Of these seven compounds, isoquercitrin was found to be the most effective at attenuating the death of RGC-5 cells in culture caused by exposure to hydrogen peroxide (H(2)O(2)). It was found that an insult of H(2)O(2) to RGC-5 cells caused them to die by apoptosis, demonstrated not only by staining dead cells for phosphatidylserine but also by the up-regulation (cleaved PARP, AIF, p53) and down-regulation (Bcl-2) of proteins associated with apoptosis and survival. Subsequent studies showed that isoquercitrin acts as a powerful antioxidant. It scavenges ROS generally as demonstrated by staining of cultures as well as the generation of individual radical species (H(2)O(2), OH* and O(2)(*-)). Moreover, isoquercitrin reduced the depletion of glutathione (GSH) caused by elevation of specific radical species (H(2)O(2), OH* and O(2)(*-)) in RGC-5 cells in culture and blunted the decrease in catalase and glutathione peroxidase 1 (Gpx-1) caused by exposure of RGC-5 cells to H(2)O(2). Furthermore, isoquercitrin potently attenuated the lipid peroxidation of rat brain homogenates initiated by nitric oxide, with an IC(50) value of 1.04 µM. Since isoquercitrin can be tolerated when taken orally it is suggested that this substance might reach the retina and therefore be potentially useful for treating glaucoma, in which oxidative stress is thought to play a major role in the demise of retinal ganglion cells.