High-resolution MRI of the intraparotid facial nerve based on a microsurface coil and a 3D reversed fast imaging with steady-state precession DWI sequence at 3T

BACKGROUND AND PURPOSE

3D high-resolution MR imaging can provide reliable information for defining the exact relationships between the intraparotid facial nerve and adjacent structures. The purpose of this study was to explore the clinical value of using a surface coil combined with a 3D-PSIF-DWI sequence in intraparotid facial nerve imaging.

MATERIALS AND METHODS

Twenty-one healthy volunteers underwent intraparotid facial nerve scanning at 3T by using the 3D-PSIF-DWI sequence with both the surface coil and the head coil. Source images were processed with MIP and MPR to better delineate the intraparotid facial nerve and its branches. In addition, the SIR of the facial nerve and parotid gland was calculated. The number of facial nerve branches displayed by these 2 methods was calculated and compared.

RESULTS

The display rates of the main trunk, divisions (cervicofacial, temporofacial), and secondary branches of the intraparotid facial nerve were 100%, 97.6%, and 51.4% by head coil and 100%, 100%, and 83.8% by surface coil, respectively. The display rate of secondary branches of the intraparotid facial nerve by these 2 methods was significantly different (P < .05). The SIRs of the intraparotid facial nerve/parotid gland in these 2 methods were significantly different (P < .05) at 1.37 ± 1.06 and 1.89 ± 0.87, respectively.

CONCLUSIONS

The 3D-PSIF-DWI sequence combined with a surface coil can better delineate the intraparotid facial nerve and its divisions than when it is combined with a head coil, providing better image contrast and resolution. The proposed protocol offers a potentially useful noninvasive imaging sequence for intraparotid facial nerve imaging at 3T.

Schwannoma of the nose and paranasal sinuses

Sckhwannoma is a benign tumor arising from the Schwann cells of nerve sheath.Through they arise more commonly in the head and neck than other regions, a through search in the liturature including medline revealed only about 47 reported cases of schwannoma in the paranasal sinuses of which the maxillary sinus involvement is more common. We report three cases of schwannoma arising from unusual sites in the paranasal sinuses with different modes of presttation each requiring a specific approach for surgical excision Transnasal endoscopic approach in combination with vonventional approaches is of immense value in the surgical management of these benign lessions of the paranasal sinuses.

Rhinofacial zygomycosis caused by conidiobolus coronatus

Fungal infections are common in a tropical country like India. Among the Zygomycosis infections, those caused by Mucorales are more prevalent. However, there exists another order of zygomycetes, the Entomophthorales, which rarely cause clinical disease. We report a rare cause of fungal infection of the maxillo-facial region and the oropharynx in a previously healthly male adult caused by Conidiobolus coronata of the order Entomophthorales to highlight the clinical presentation and treatment of this rare, chronic, indolent form of fungal infection.

Quantitative assessment of chronic lung disease of infancy using computed tomography

The aims of this study were to determine whether infants and toddlers with chronic lung disease of infancy (CLDI) have smaller airways and lower lung density compared with full-term healthy controls. Multi-slice computed tomography (CT) chest scans were obtained at elevated lung volumes during a brief respiratory pause in sedated infants and toddlers; 38 CLDI were compared with 39 full-term controls. For CLDI subjects, gestational age at birth ranged from 25 to 29 weeks. Airway size was measured for the trachea and the next three to four generations into the right lower lobe; lung volumes and tissue density were also measured. The relationship between airway size and airway generation differed between the CLDI and full-term groups; the sizes of the first and second airway generations were larger in the shorter CLDI than in the shorter full-term subjects. The increased size in the airways in the CLDI subjects was associated with increasing mechanical ventilation time in the neonatal period. CLDI subjects had a greater heterogeneity of lung density compared with full-term subjects. Our results indicate that quantitative analysis of multi-slice CT scans at elevated volumes provides important insights into the pulmonary pathology of infants and toddlers with CLDI.

Isolated renal nocardiosis in a patient with AIDS: Unusual presentation

Disseminated or systemic infection with nocardiosis is an opportunistic infection that is seen in immunocompromised individuals and can involve any organ. The primary infection in systemic nocardiosis usually occurs in the lungs and subsequently hematogenous dissemination occurs in other organs of the body. Nocardia infection of the kidney usually manifests as multiple pyelonephritic abscesses. We report a case of isolated renal nocardiosis, without involvement of the lungs or other organs in a patient with AIDS who presented with symptoms of renal failure. The nephrectomy specimen showed multiple calculi in the calyceal system and a tumorous mass with necrotic areas, which histologically showed features of nocardiosis. The case is being presented as this is an unusual manifestation of renal nocardiosis.

Computed tomography score and pulmonary function in infants with chronic lung disease of infancy

Chronic lung disease of infancy (CLDI) remains a common outcome among infants born extremely prematurely. In older children and adults with lung disease, pulmonary function and computed tomography (CT) scores are used to follow up respiratory disease and assess disease severity. For infants and toddlers, however, these outcomes have been used very infrequently and most often, a dichotomous respiratory outcome (presence or absence of CLDI) is employed. We evaluated the performance of CT score and pulmonary function to differentiate infants and toddlers with CLDI from a control group. CT scans, forced expiratory flows and pulmonary diffusing capacity were obtained in 39 CLDI patients and 41 controls (aged 4-33 months). CT scans were quantified using a scoring system, while pulmonary function was expressed as Z-scores. CT score outperformed pulmonary function in identifying those with CLDI. There were no significant correlations between CT score and pulmonary function. CT score had a better performance than pulmonary function in differentiating individuals with CLDI; however, these outcomes may reflect differing components of the pulmonary pathophysiology of CLDI. This new information on pulmonary outcomes can assist in designing studies with these parameters. Future studies will be required to evaluate which of the outcomes can better detect improvement with therapeutic intervention and/or lung growth.

The role of 9qh+ in phenotypic and genotypic heterogeneity in a Van der Woude syndrome pedigree

Van der Woude syndrome (VWS) (OMIM 119300) is a dominantly inherited developmental disorder that is characterized by pits and/or sinuses of the lower lip and cleft lip and/or cleft palate. Mutations in the interferon regulatory factor 6 gene (IRF6) have been recently identified in patients with VWS, with more than 60 mutations reported. We report the phenotypic variants of the syndrome in a family and present the application of the multicolor chromosome banding (mBAND) analysis in the identification of complex intrachromosome rearrangements of chromosome 9 in a child with VWS. The authors conclude that increased heterochromatin on chromosome 9 did not have any effect on the phenotypic expression of the syndrome in the family that was studied.

Complexation of uranium(VI) with malonate at variable temperatures

The complexation between uranium(VI) and malonate in 1.05 mol kg−1 NaClO4 was studied at variable temperatures (25, 35, 45, 55 and 70 °C). The formation constants of three successive complexes, UO2(OOCCH2COO), UO2(OOCCH2COO)2 2− and UO2(OOCCH2COO)3 4−, and the molar enthalpies of complexation were determined by potentiometry and calorimetry. The heat capacity of the complexation, Δ Co p,m(MLj), is calculated to be 96 ± 12, 195 ± 15 and 267 ± 22 J K−1 mol−1 for j=1, 2 and 3, respectively. Extended X-ray Absorption Fine Structure Spectroscopy helped to characterize the coordination modes in the complexes in solution. UV/Vis absorption and luminescence spectra at different temperatures provided qualitative information on the temperature effect. The effect of temperature on the complexation between uranium(VI) and malonate is discussed in terms of the electrostatic model and compared with the complexation between uranium(VI) and acetate.

Serum paraoxonase activity and protein thiols in chronic renal failure patients

Serum paraoxonase is known to prevent low-density lipoprotein oxidation and atherogenesis. Association of paraoxonase with the oxidative status and lipid profile in chronic renal failure (CRF) patients on conservative management and those on chronic maintenance hemodialysis was analyzed in the present study. Serum paraoxonase, protein thiols, lipid hydroperoxides, lipid profile, creatinine and albumin levels were estimated by spectrophotometric methods in CRF patients on conservative management, those on hemodialysis and in healthy controls. Total cholesterol, triglycerides, low-density lipoprotein cholesterol, lipid hydroperoxides and creatinine levels were higher and high-density lipoprotein cholesterol, protein thiols, albumin levels and paraoxonase activity were lower in patients than in healthy controls. Paraoxonase activity correlated positively with protein thiols and high-density lipoprotein cholesterol and negatively with low-density lipoprotein cholesterol and lipid hydroperoxides. In conclusion, paraoxonase activity is decreased in CRF patients particularly on chronic maintenance hemodialysis and correlates well with the oxidative stress markers.

Downstaging for cervical cancer: a community-based study in the rural areas of Udupi district, Karnataka, India

The objective of this study is to determine the feasibility of utilizing trained auxiliary nurse midwives (ANMs) in downstaging for cancer cervix in a rural area. The study population included all married women in the age group of 35-59 years in two villages of the field practice area. It was a cross-sectional study. Two ANMs were trained in history taking, visual inspection of the cervix, using of speculum and collecting Papanicolaou smears. After training, they made home visits and identified women with gynaecological symptoms suggestive of cervical cancer. These women were asked to report to Rural Maternity and Child Welfare whom homes where the ANMs did a visual inspection of the cervix and made a cervical smear. A total of 1402 women were registered of the ANMs could identify 368 women (26%) with symptoms. Only 192 (52.2%) of these women reported for examination. Chronic cervicitis accounted for the largest proportion of the cases (44.8%). In all, three cases were diagnosed as suspected cases of cancer cervix. On cytology, three cases (1.5%) turned out to be malignant. When clinical findings of the ANM were compared with results of cytological examination, a high degree of sensitivity (78.4%) and positive predictive value (97.1%) were observed in diagnosing abnormal cytological findings. However, the sensitivity for detecting specific conditions was generally low. Sensitivity for detecting erosion was 45%, for chronic cervicitis 30%, and malignancies were totally missed. In conclusion, this study clearly shows that ANMs, if trained, would be capable of identifying symptomatic women, differentiating a normal cervix from an abnormal one and taking an adequate smear for cytological examination.