Marginal value of radiographs in the interpretation of MR images obtained for pediatric knee pain.

OBJECTIVE: Radiographs are often obtained before MRI in the evaluation of pediatric knee pain, but the value of these radiographs is undefined. The purpose of this study was to determine the marginal value of knee radiographs in the interpretation of knee MR images requested by pediatric sports medicine and orthopedic subspecialists. MATERIALS AND METHODS: Knee MRI examinations of 194 pediatric patients (mean age, 14 [SD, 3.1] years; range 4-18 years) performed over a 3-year period were reviewed retrospectively. Patients were separated into groups based on MRI findings: normal, ligamentous injury, osteochondral injury, or both ligamentous and osteochondral injury. Two pediatric radiologists blinded to the MRI findings reviewed the knee radiographs in consensus and categorized the findings into the same groups. Radiographic and MRI findings were compared, and the influence of radiographic findings on MRI interpretation was designated as noncontributory if radiographic findings did not aid MRI interpretation, erroneous for false-negative and false-positive radiographic findings, or helpful if radiographs aided MRI interpretation. RESULTS: Radiographic findings were normal in 166 of 194 cases (86%). Among the 166, MRI findings were normal in 73 (44%) cases and abnormal in 93 (56%). Twenty-five of 28 patients (89%) with abnormal radiographic findings had abnormal MRI findings. Radiographs were deemed helpful in 14 of the 25 cases (56%) and noncontributory in 11 (44%). Overall, radiographs were helpful in 14 of 194 cases (7%), noncontributory in 84 (43%), and erroneous in 96 (50%). CONCLUSION: In the interpretation of knee MRI studies requested by pediatric sports medicine and orthopedic subspecialists for knee pain, radiographs provide limited marginal value. Reliable clinical predictors are needed to identify which subset of pediatric patients with knee pain referred for MRI will benefit from the acquisition of knee radiographs.

Imaging of round pneumonia and mimics in children.

Various diseases in the pediatric age group can present as an intrathoracic rounded opacity on a chest radiograph. The purpose of this pictorial essay is to emphasize the imaging appearance of round pneumonia, an entity that occurs especially in the pediatric population. Additional pathologies with similar chest radiographic appearances are also presented. The diagnosis of round pneumonia should be made in children who have the typical clinical presentation along with chest radiographs demonstrating the characteristic findings.

Relevance of phenolic diterpene constituents to antioxidant activity of supercritical CO(2) extract from the leaves of rosemary.

Isolation of phenolic diterpene constituents from the freeze-dried leaves of Rosmarinus officinalis has been obtained by supercritical extraction with carbon dioxide. To determine the ideal conditions for the maximum yield of extract, nine different conditions using three levels of pressures (3000, 4000 and 5000 psi) in combination with three temperatures at 40, 60 and 80 degrees C, respectively, in combination with the analyses of the corresponding antioxidant activities and constituents which existed in extracts has been investigated. The antioxidant activity of each obtained extract was determined by using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals test. GC/MS method was used as an alternative to conventional HPLC method for the determination of the principal antioxidant constituents in extract, including phenolic diterpenes carnosic acid (CA) and carnosol (CAL). The confirmation of CA and CAL in extract was forward performed by subjecting HPLC isolates from extract into an ion trap mass spectrometer through an electrospray ionization (ESI) interface for MS/MS analysis. These results indicate that an ideal extraction process was obtained at 5000 psi and 80 degrees C with an extraction yield of 4.27% (w/w) and rich in phenolic antioxidants CA and CAL as contents of 35.23 and 0.46 mg g(-1) in extract, respectively.

Discovery of novel biomarkers by microarray analysis of peripheral blood mononuclear cell gene expression in benzene-exposed workers.

Benzene is an industrial chemical and component of gasoline that is an established cause of leukemia. To better understand the risk benzene poses, we examined the effect of benzene exposure on peripheral blood mononuclear cell (PBMC) gene expression in a population of shoe-factory workers with well-characterized occupational exposures using microarrays and real-time polymerase chain reaction (PCR). PBMC RNA was stabilized in the field and analyzed using a comprehensive human array, the U133A/B Affymetrix GeneChip set. A matched analysis of six exposed-control pairs was performed. A combination of robust multiarray analysis and ordering of genes using paired t-statistics, along with bootstrapping to control for a 5% familywise error rate, was used to identify differentially expressed genes in a global analysis. This resulted in a set of 29 known genes being identified that were highly likely to be differentially expressed. We also repeated these analyses on a smaller subset of 508 cytokine probe sets and found that the expression of 19 known cytokine genes was significantly different between the exposed and the control subjects. Six genes were selected for confirmation by real-time PCR, and of these, CXCL16, ZNF331, JUN, and PF4 were the most significantly affected by benzene exposure, a finding that was confirmed in a larger data set from 28 subjects. The altered expression was not caused by changes in the makeup of the PBMC fraction. Thus, microarray analysis along with real-time PCR confirmation reveals that altered expressions of CXCL16, ZNF331, JUN, and PF4 are potential biomarkers of benzene exposure.

Modulation of inflammation-related genes of polysaccharides fractionated from mycelia of medicinal basidiomycete Antrodia camphorata.

AIM: To investigate the effect of water soluble-ethanol precipitation fraction (AC-1) and alkaline extraction-isoelectric precipitation fraction (AC-2) from Antrodia camphorata (Polyporaceae, Aphyllophorales) on lipopolysaccharide (LPS)-induced gene activation in mouse macrophages. METHODS: The AC-1 and AC-2 fractions were prepared, and their effects on LPS-induced gene expression were monitored by Western blotting and RT-PCR. RESULTS: Our results indicated that AC-2, but not AC-1 dose-dependently (50-200 mg/L) inhibited LPS-induced nitric oxide production as well as the protein and the mRNA expression of the inducible nitric oxide synthase (iNOS) gene. Neither AC-1 nor AC-2 inhibited LPS-induced cyclooxygenase-2 gene expression. Using the cytokine array assay, it showed that AC-2 also had the ability to inhibit LPS-induced the protein expression of interleukin (IL)-6, IL-10, the monocyte chemoattractant protein (MCP)-5, and regulated upon activation, normal T-cell expressed, and presumably secreted (RANTES). Like iNOS, AC-2 inhibiting LPS-induced IL-6 and IL-10 secretion resulted from inhibiting their mRNA expression. CONCLUSION: It was suggested that alkaline extraction-isoelectric precipitated the polysaccharide fraction of A camphorata and had the ability to inhibit LPS-induced iNOS, IL-6, IL-10, MCP-5, and RANTES expression in mouse macrophages.

Cytogenetic damage in blood lymphocytes and exfoliated epithelial cells of children with inflammatory bowel disease.

This longitudinal, prospective study sought to establish whether pediatric Crohn's disease (CD) and ulcerative colitis (UC) are associated with increased levels of cytogenetic damage and whether folate supplementation in combination with other treatments mitigates cytogenetic damage in children with inflammatory bowel disease (IBD). After a 1-mo treatment and folate supplementation, all clinical tests in CD (n = 24) and UC (n = 17) patients improved. Patients with CD were comparable in the cytogenetic response with controls (n = 28) assessed by micronucleus (MN) assay, but both groups differed from the UC group. While the MN frequency in epithelial cells slightly decreased from first to second observations in CD patients (p = 0.05) and controls (p = 0.11), an increase was observed in UC patients (p = 0.001). Similar changes were observed in blood lymphocytes resulting in significantly higher levels of the MNs and chromosome bridges in UC patients. These preliminary findings of a difference in chromosome damage between pediatric UC patients compared with CD patients and healthy controls warrant confirmation and expansion to determine (1) the role of cytogenetic damage in the pathogenesis of these diseases, (2) relative contribution of treatment and folate supplementation, and (3) potential links to the eventual development of cancer in some patients.