Evaluation of femoral condyle volumes in patients with trochlear dysplasia: a pilot study.

AIM: To examine the volumes of the medial and lateral femoral condyles and the trochlear groove, and to determine their relationship with trochlear dysplasia. MATERIALS AND METHODS: Computed tomography images of the knees of 21 patients with trochlear dysplasia and 18 healthy individuals were analysed retrospectively. According to the modified Dejour classification, the degree of trochlear dysplasia was recorded, such as type A trochlea being low-grade dysplasia and types B, C, and D trochlea being high-grade dysplasia. Volume of the trochlear groove and medial and lateral femoral condyles were calculated using the three-dimensional (3D) volume-rendering method. RESULTS: The volumes of lateral condyle, medial condyle, and trochlear groove were statistically significantly lower in patients with trochlear dysplasia when compared to healthy participants. When compared according to Dejour types, all parameters were statistically significantly lower in both high- and low-grade dysplasia patients (p<0.05). The correlation between femoral condyle volumes and trochlear groove volume was low in the control group, but there was a moderate positive correlation in the patient group (r=0.50-0.75, p<0.05). CONCLUSION: In trochlear dysplasia, the volume of the trochlear groove decreases and hypoplasia may occur in both lateral femoral and medial femoral condyles. Therefore, hypoplasia of only one condyle should not be interpreted as trochlear dysplasia. A holistic approach to patients is required.

Can volumetric analysis of the brain help diagnose isolated optic neuritis?

Isolated optic neuritis is a single episode inflammatory optic neuropathy. This condition, which affects the optimal function of the optic nerve, is not associated with neurological or systemic diseases. Our study aimed to compare patients with isolated optic neuritis and normal healthy individuals in terms of the cerebrum, cerebellum and hippocampus volumes by using the "volBrain Online MRI Brain Volumetry System" program. Persons diagnosed with isolated optic neuritis (n = 16) and persons without any disease (n = 16) were included in the study. VolBrain was used to process the MRI data and, the findings were compared with Mann-Whitney U test. Values with a p-value <0.05 were considered statistically significant. The cerebrum white matter volumes in the total brain and in the right-left hemispheres of the brain were statistically significantly lower in the optic neuritis group (p = 0.029; p = 0.050; p = 0.029, respectively). In the segmental cerebellum analysis, the left side lobule VIIIB, the total and right-left side lobule IX volumes were statistically significantly higher (p = 0.022; p = 0.014; p = 0.029; p = 0.018, respectively). In total, lobule I-II volume was statistically significantly lower in the optic neuritis group (p = 0.046). In the segmental hippocampus analysis, the right side CA2-CA3, the total and right-left side SR-SL-SM volumes were statistically significantly lower in the optic neuritis group (p = 0.039; p = 0.050; p = 0.016, respectively). There are neurodegenerative changes in brain volume in patients with isolated optic neuritis. Although volBrain alone is not sufficient to diagnose isolated optic neuritis, it provides quantitative data that can be used as a complementary diagnostic method.

Management of esophageal gastrointestinal stromal tumor: review of one hundred seven patients.

Gastrointestinal stromal tumors (GIST) are the most common type of gastrointestinal mesenchymal tumor, but are rarely found in the thoracic esophagus. There is no clear consensus about the optimal treatment of this rare disease. A systematic search of the literature was performed for localized esophageal GIST that was resected between 2000 and 2015, and individual patients were included from two major academic institutions. We obtained information on demographics, tumor size and location, mitotic rate, treatment method, and time to recurrence or death. We performed univariate and multivariate Cox regression analyses to evaluate the factors associated with recurrence or death. A total of 28 studies met our inclusion and exclusion criteria, and with two patients from two academic institutions, we had a total of 107 patients in the study. Due to lack of uniformity among studies, there were several missing data for different variables. The average patient age was 56 (n = 98) with mostly males (60%, n = 91). The average tumor size on the CT scan was 7.9 ± 5.4 cm (n = 91), located mostly in the distal esophagus (81%, n = 74). A similar number of patients underwent enucleation (n = 47) compared to esophagectomy (n = 42). Approximately half of the patients had a mitotic rate of 0-4 mitosis per 50 high-powered field (48%, n = 80). The median survival time was 73 months with a 5-year disease free survival of 57% (n = 97). Univariate Cox regression analyses showed that a large tumor, undergoing esophagectomy, and a high mitotic rate were associated with poor survival or recurrence control. We found that patients with a lesion smaller than or equal to 5 cm on the CT scan had a better disease-free survival rate than those with a size greater than 5 cm (HR = 12.41, p = 0.014) and had a 5-year survival rate of 92% with 90% of those patients undergoing enucleation (n = 29). Esophageal GIST is a very rare malignancy. The tumor size and mitotic rate of the tumor are associated with poor survival. However, patients with esophageal GIST measuring 5 cm or smaller may be safely treated with esophageal enucleation.

Nitrogen and phosphorus retention and excretion in late-gestation dairy heifers.

The objectives of this study were to evaluate the effects of limit feeding diets containing concentrates or by-products in place of forages on manure and nutrient excretion in growing, gravid heifers. Eighteen Holstein heifers confirmed pregnant were grouped by due date and fed 1 of 3 diets (n = 6 per treatment) for the last 14 wk of pregnancy. Diets were high forage, fed ad libitum (HF); by-product based (BP), fed at the same rate as HF-fed heifers; or low forage (LF), fed at 86% of the HF diet. Diets were designed to supply equal quantities of P, N, and metabolizable energy. Total collection of feces and urine was conducted in wk 14, 10, 6, and 2 prepartum. The HF ration was 90.7% forage, 13.7% crude protein (CP), and contained orchardgrass hay, corn silage, corn grain, soybean meal 44%, and a vitamin-mineral premix. The BP diet was 46.2% forage and 14.0% CP, with 70% of the grain mix space replaced with soybean hulls and cottonseed hulls in a 1:1 ratio, with intake limited to 93% of the dry matter intake (DMI) of HF. The LF ration was 45.3% forage and 17.8% CP, with intake limited to 86% of the DMI of HF. The effect of diet was analyzed with repeated measures, using preplanned contrasts to compare HF with BP and LF with HF and BP. As designed, heifers fed HF and BP had greater DMI than the heifers limit-fed LF, and there was no effect of diet on average daily gain or BW. Intake and digestibility of N were lower, and fecal N excretion was higher, in heifers fed HF and BP than heifers fed LF. Mean feces excretion on both a wet and dry basis was greater for HF heifers compared with BP heifers and less for LF heifers than for HF and BP heifers. Despite differences in urinary output, diet had no effect on urea N excretion, but there was a trend for heifers fed HF and BP rations to excrete less urinary N compared with those fed LF. Compared with HF and BP heifers, LF heifers tended to have lower fecal P excretion and had higher urinary P excretion. Measured manure and urine excretion from heifers fed LF was greater than current American Society of Agricultural and Biological Engineers values, whereas heifers fed HF excreted less manure and urine than predicted. Heifers achieving similar rates of gain from diets differing in forage, grain, and by-product content excreted widely varying quantities of manure.