Accuracy of non-gated low-dose non-contrast chest CT with tin filtration for coronary artery calcium scoring.

Objective: The study investigated the accuracy of coronary artery calcium scores (CACS) and the potential for reducing radiation dose using non-gated low-dose non-contrast chest computed tomography (CT) scanning with tin filtration for one-stop screening of the lungs and heart. Methods: A prospective study was conducted,193 Patients received two scans for determining CACS, including an ECG-gated CT at 120 kV (ECG-gated CT), followed by a non-gated low-dose chest CT using 100 kV with tin filtration (non-gated Sn100 kV-LDCT). The Agatston score (AS), risk stratification, and radiation dose were compared between the scan types. Results: There was good consistency in the AS from both an ECG-gated CT and a non-gated low-dose chest CT scan, which had a high correlation (r = 0.970). The Kappa value of risk stratification of the two scan types was 0.549. The area under the ROC curve (AUC) of the CACS was used to develop a new risk stratification standard for non-gated Sn100 kV-LDCT evaluation of CACS. In comparison to the CACS measured by ECG-gated CT, non-gated Sn100 kV-LDCT had an AUC of 0.951 and an optimal critical value of 4.6 in the low-risk category. The AUC of low-medium risk was 0.966, and the optimal critical value was 41.2. The AUC of the medium-high risk category was 0.968, and the optimal critical value was 230. The consistency in CACS measured by ECG-gated CT and non-gated Sn100 kV-LDCT had a Kappa value of 0.831. The Effective dose (ED) of non-gated Sn100 kV-LDCT and ECG-gated CT was 0.056 ± 0.017 mSv and 0.685 ± 0.455 mSv, respectively (p < 0.05). Conclusion: The Agatston score of CACS using non-gated low-dose chest CT was accurate, but there was an underestimation in risk stratification. This study developed a new risk stratification standard for non-gated Sn100 kV-LDCT evaluation of CACS, which is in closer agreement with CACS derived from ECG-gated CT scans.

Follicular thyroid carcinoma presenting with multiple skull metastases on CT and MRI: A case report and literature review.

Although the incidence of thyroid carcinoma has increased in recent years, follicular thyroid carcinoma with bone metastasis as the first symptom remains rare. Here, we report a case of occult follicular thyroid carcinoma in a 65-year-old female patient admitted to hospital with cerebrovascular disease. Computed tomography findings suggested a diagnosis of meningioma; however, magnetic resonance imaging results showed multiple skull bone destruction with soft tissue masses on the left side of the skull. After surgical resection, the pathology results revealed skull metastasis of follicular thyroid carcinoma. We present this case not only because of the diagnostic challenge it posed, but also because the patient had multiple skull metastases from follicular thyroid carcinoma.

The association of inhibitor of Growth 4 with its prognostic value in osteogenic sarcoma.

BACKGROUND: Osteosarcoma is one of the first two cause of cancer-related death in children and young adolescents. Inhibitor of Growth 4 (ING4) is a member of the ING tumor suppressor family and play an important role in many cellular processes. The purpose of this study was to explore the correlation between ING4 expression and the prognosis of osteosarcoma patients. METHODS: ING4 mRNA and protein expressions in osteosarcoma and normal tissues were detected by quantitative real-time transcriptase polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) method, respectively. Chi-square test was adopted to estimated the relationship of ING4 expression and clinical parameters of osteosarcoma patients. Besides, the overall survival of osteosarcoma patients was evaluated by Kaplan-Meier method. The potential of ING4 as a prognostic marker gene was addressed by Cox regression analysis. RESULTS: Down-regulated expression of ING4 mRNA and protein were observed in osteosarcoma tissues. ING4 expression was significantly associated with metastasis (P = 0.030) and recurrence (P = 0.008), but not other clinical features (P > 0.05). Cox regression analysis indicated that ING4 can be used as an independent prognotic biomarker for osteosarcoma, in univariate and multivariate analysis (P = 0.004, HR = 3.945, 95 % CI = 1.565-9.940; P = 0.001, HR = 4.213, 95 % CI = 1.747-10.161). CONCLUSION: Taken together, ING4 was down-regulated in osteosarcoma tissues. ING4 can act as an independent prognostic factor for osteosarcoma.

Age-related reduction of adaptive brain response during semantic integration is associated with gray matter reduction.

While aging is associated with increased knowledge, it is also associated with decreased semantic integration. To investigate brain activation changes during semantic integration, a sample of forty-eight 25-75 year-old adults read sentences with high cloze (HC) and low cloze (LC) probability while functional magnetic resonance imaging was conducted. Significant age-related reduction of cloze effect (LC vs. HC) was found in several regions, especially the left middle frontal gyrus (MFG) and right inferior frontal gyrus (IFG), which play an important role in semantic integration. Moreover, when accounting for global gray matter volume reduction, the age-cloze correlation in the left MFG and right IFG was absent. The results suggest that brain structural atrophy may disrupt brain response in aging brains, which then show less brain engagement in semantic integration.

[Comparative study on closed reduction with elastic intramedullary nailing and open reduction with Kirschner wire fixations in treatment of radial neck fractures in children].

OBJECTIVE: To analyze and compare the effectiveness of the closed reduction with elastic intramedullary nailing and open reduction with Kirschner wire fixations in the treatment of O'Brien type III radial neck fractures in children. METHODS: Between November 2007 and November 2010, 31 children with O'Brien type III radial neck fractures were treated by the closed reduction with elastic intramedullary nailing fixation (closed reduction group, n=18) and by the open reduction with Kirschner wire fixation (open reduction group, n=13). There was no significant difference in age, gender, disease duration, and fracture classification between 2 groups (P > 0.05). RESULTS: The incisions of 2 groups healed primarily. All the patients were followed up 1-2 years (mean, 1.5 years). Limitation of the elbow extension occurred in 2 cases of the closed reduction group, limitations of the elbow extension, flexion, and forearm pronation in 6 cases of the open reduction group. There was no significant difference in elbow flexion, extension, pronation, and supination between affected side and normal side in the closed reduction group (P > 0.05). Except in supination (P > 0.05), there were significant differences in flexion, extension, and pronation between affected side and normal side in the open reduction group (P < 0.05). According to Metaizeau's grading criterion, excellent results were achieved in 16 cases and good in 2 cases in the closed reduction group; excellent results were achieved in 4 cases, good in 4 cases, fair in 3 cases, and poor in 2 case in the open reduction group; and there was significant difference between 2 groups (Z=3.435, P=0.001). The X-ray films showed anatomical reduction in 2 groups before removal of internal fixation; redisplacement occurred in 4 cases after removal of internal fixation in the open reduction group, no redisplacement occurred in the closed reduction group. There was no avascular necrosis of radial head and epiphyses during follow-up. CONCLUSION: Comparison with the open reduction with Kirschner wire fixation, the closed reduction with elastic intramedullary nailing fixation is a reliable and good treatment for O'Brien type III radial neck fractures in children, because it has the advantages of minimal invasion, easy operation, stable fixation, early mobilization, and less complication.