Intracranial dermoid cyst ruptured into the membranous labyrinth causing sudden sensorineural hearing loss: CT and MR imaging findings

A ruptured dermoid cyst is rare and can present with various symptoms. We report imaging findings of an intracranial dermoid cyst that ruptured into the endolymphatic sac, causing sudden sensorineural hearing loss.

Cross-sectional study on the correlation of serum uric acid with disease severity in Korean patients with psoriasis

BACKGROUND

Hyperuricaemia is a common finding in patients with psoriasis. However, previous studies have reported inconsistent results about the association between serum uric acid concentration (SUAC) and psoriasis severity. Recent studies have also reported that SUAC is associated with metabolic dysregulation.

AIM

To assess any association between SUAC and clinical features of psoriasis, and to investigate the characteristics of patients with psoriasis with hyperuricaemia compared with similar patients with normouricaemia.

METHODS

Cross-sectional data from 198 Korean patients with psoriasis who visited our clinic were analysed. Association of SUAC with clinical features of psoriasis, body mass index (BMI) and various laboratory values was assessed in both genders separately.

RESULTS

The average uric acid concentration of patients with psoriasis was not significantly different from that of the healthy population, for both genders (P > 0.05). There was a positive correlation between SUAC and Psoriasis Area and Severity Index (PASI) and BMI in patients with psoriasis (P < 0.05). There was no association with age of disease onset, family history of psoriasis, or other laboratory values (P > 0.05), in either gender. Of the other factors of disease severity, the extent of body surface involvement was correlated with uric acid concentration (P < 0.05) although there was no significant relationship with activity of individual lesions (P > 0.05). Mean PASI and extent of psoriasis were increased in hyperuricaemic compared with normouricaemic patients (P < 0.05).

CONCLUSIONS

SUAC in patients with psoriasis is positively associated with PASI, extent of skin involvement and BMI for both genders independently.

Fiber system degradation, and periostin and connective tissue growth factor level reduction, in the periodontal ligament of teeth in the absence of masticatory load

BACKGROUND AND OBJECTIVE

The periodontal ligament (PDL), which is interposed between the alveolar bone and roots, supports teeth against mechanical stress. Periostin and connective tissue growth factor (CTGF) might play essential roles in maintaining PDL fiber integrity under mechanical stress. However, this relationship has not been studied at the protein and gene levels. Therefore, the aim of this study was to assess the PDL fiber system without masticatory load to determine the structural changes in the PDL in the absence of mechanical stress.

MATERIAL AND METHODS

The study included 45 Wistar male rats (12 wk of age) whose upper-right first molars were relieved from occlusion for 24 h, 72 h, 7 d or 21 d. The PDL was examined histologically, and changes in the gene and protein levels of periostin and CTGF were investigated.

RESULTS

The PDL space width was reduced significantly. Histologically, an initial reduction in the fiber number and thinning of PDL fibers were observed, followed by disarrangement of the PDL fibers and their attachments to the alveolar bone; finally, the PDL fibers lost their meshwork structure. Real-time RT-PCR results revealed sharp down-regulation of the periostin and CTGF mRNA levels at 24 and 72 h, respectively, which continued throughout the experiment. Immunohistochemical analysis revealed that periostin localized to both the cellular elements and the extracellular matrix, whereas CTGF localized only to the cellular elements. Periostin and CTGF immunoreactivities became very weak without masticatory load.

CONCLUSION

In the absence of mechanical stress, the PDL fiber system undergoes degradation concomitantly with a reduction in the periostin and CTGF levels in the PDL.

The objective evaluation of the severity of psoriatic scales with desquamation collecting tapes and image analysis

BACKGROUND

Assessment of psoriatic scales is important to determine the severity of psoriasis. However, there are very limited numbers of objective, quantitative and observer-independent tools for measuring the severity of psoriasis.

OBJECTIVE

To determine whether the bioengineering parameters of the psoriatic scale can be used to assess the severity of psoriasis instead of the psoriatic severity index of scales (PSIs) score.

METHODS

Thirty-four patients with psoriasis were included. A representative lesion from each patient was selected and bioengineering parameters were measured using the Corneofix(®). Simultaneously, the severity of the scales was assessed by the PSIs score using clinical photographs of the lesions. In addition, skin color and elasticity parameters were also measured using the Colorimeter(®), the Mexameter(®) and the Cutometer(®).

RESULTS

Statistical differences in the scale parameters were observed between the PSIs 2 and 3 scores. Among the scale parameters, the percent area and area in μm(2) were negatively correlated with the PSIs score. In addition, the Colorimeter(®) a, b parameters and the Cutometer(®) R9 parameters were significantly correlated with the PSIs score.

CONCLUSIONS

The results of this study showed that the severity of psoriatic scales could be measured objectively using the Corneofix(®).

Hippocampal shape deformation in female patients with unremitting major depressive disorder

BACKGROUND AND PURPOSE

The hippocampal atrophy of MDD has been known, but the region shape contractions of the hippocampus in MDD were inconsistent. Spheric harmonic shape analysis was applied to the hippocampus in female patients with unremitting MDD to evaluate morphometric changes of the hippocampus.

MATERIALS AND METHODS

Shape analysis was performed by using T1-weighted MR imaging in 21 female patients with MDD and 21 age- and sex-matched healthy controls. Manually segmented hippocampi were parameterized, and the point-to-point-based group difference was compared by using the Hotelling T-squared test. The partial correlation analyses were tested between clinical variables and shape changes.

RESULTS

Both hippocampal volumes were small in patients with MDD compared with healthy controls, and the right hippocampal volume was negatively correlated with the number of episodes at marginal significance. Regional shape contractions were found in the ambient gyrus, basal hippocampal head, posterior subiculum, and dorsal hippocampus of the left hemisphere. The right hippocampus showed a similar pattern but was less atrophic compared with the left hippocampus. A negative correlation was found between the HDRS and shape deformation in the CA3, ambient gyrus, posterior subiculum, and gyrus fasciolaris of the left hippocampus.

CONCLUSIONS

We showed atrophy and regional shape contractions in the hippocampi of patients with MDD, which were more dominant on the left side. The causes of hippocampal damage could be the hypersecretion of glucocorticoids contributing to neuronal death or the failing of adult neurogenesis in the dentate gyrus.

Regional volume analysis of the Parkinson disease brain in early disease stage: gray matter, white matter, striatum, and thalamus

BACKGROUND AND PURPOSE

Loss of dopaminergic neurons in the nigrostriatal pathway is well-documented in PD, whereas neuronal changes beyond the nigrostriatal pathway are uncertain. The purpose of our study was to estimate volume changes in the striatum and thalamus, which are areas of the basal ganglia, as well as in GM and WM located beyond the nigrostriatal pathway, in early-stage PD.

MATERIALS AND METHODS

We enrolled 30 participants (15 healthy controls and 15 patients with PDND with H & Y stage I or II). Cognitive function was assessed by using the MMSE. ICV and the volumes of the caudate nucleus, putamen, thalamus, GM, and WM were calculated via 3D volume analysis by using MR imaging.

RESULTS

A comparison of the PD group with the control group revealed an absence of significant differences between them regarding age and MMSE scores. Comparison of the volumes of regional brain structures of patients with PD with those of controls revealed the presence of significant differences in the caudate nucleus, thalamus, and WM (P<.05) between the groups. However, there were no significant differences in the volumes of the putamen and GM or in ICV between patients with PD and controls. The results of ANCOVA by using the covariates of age and ICV showed a significant difference in the caudate nucleus, thalamus, and WM between patients with PD and controls (P<.05).

CONCLUSIONS

We suggest that loss of WM volume may occur in early disease stages and that variation of the volumes of the caudate nucleus and thalamus may be an early phenomenon of disease progression.

Development of adsorbent for the simultaneous removal of organic and inorganic contaminants from aqueous solution

In this study, a modified adsorbent, alginate complex beads, was prepared and applied to the removal of mixed contaminants from wastewater. The alginate complex beads were generated by the immobilization of powdered activated carbon and synthetic zeolites onto alginate gel beads, which were then dried at 110 °C for 20 h until the diameter had been reduced to 1 mm. This dry technique increased the hardness of the adsorbent to assure its durability and application. The adsorption onto the alginate complex beads of organic and inorganic compounds, as target contaminants, was investigated by performing both equilibrium and kinetic batch experiments. From the adsorption isotherms, according to the Langmuir equation, the alginate complex bead was capable of effectively removing benzene, toluene, zinc and cadmium. From kinetic batch experiments, the removal efficiencies of benzene, toluene, zinc and cadmium were found to be 66.5, 92.4, 74.1 and 76.7%, respectively, for initial solution concentrations of 100 mg L(-1). The results indicated that the adsorbent developed in this study has the potential to be a promising material for the removal of mixed pollutants from industrial wastewater or contaminated groundwater.

Improvement in high-temperature thermoelectric properties by adding Mn for Co in Ca3Co4O9

Nano-sized Ca3Co(4-x)Mn(x)O9 (0 < or = x < or = 0.6) thermoelectric powders were synthesized by solution combustion method, using aspartic acid as fuel. The microstructure and high-temperature (500-800 degrees C) thermoelectric properties of the Ca3Co(4-x)Mn(x)O9 were investigated. The addition of Mn for Co in Ca3Co(4-x)Mn(x)O9 resulted in a decrease of the electrical conductivity and a significant increase of the Seebeck coefficient. Consequently, the power factor was remarkably enhanced by the addition of Mn. Ca3Co(3.7)Mn(0.3)O9 sample showed the highest value of the power factor (1.24 x 10(-4) Wm(-1) K(-2)) at 800 degrees C. We believe that the Ca3Co(4-x)Mn(x)O9 is strongly desirable as a novel high-temperature thermoelectric material for power generation.

Synthesis of nanocrystalline Ce(0.8)Gd(0.2)O(2-delta) electrolyte materials for IT-SOFC

We successfully synthesized nano-sized Ce(0.8)Gd(0.2)O(2-delta) powders by combustion method, using gelatin as fuel. The calcined powders showed high-quality characteristics, i.e., nano-scale size (14-35 nm) and narrow size distribution. The structural, morphological, and electrical characteristics of the sintered Ce(0.8)Gd(0.2)O(2-delta) were studied systematically, depending on sintering temperature. The crystal structure of the Ce(0.8)Gd(0.2)O(2-delta) belonged to the cubic fluorite structure. The gelatin-assisted combustion synthesized Ce(0.8)Gd(0.2)O(2-delta) powders allowed to sinter well at low temperature for dense and ultra-fine Ce(0.8)Gd(0.2)O(2-delta) electrolyte with good electrical conductivity. The sintering temperature of the Ce(0.8)Gd(0.2)O2 powder was approximately 300 degrees C lower than that of conventional solid-state synthesized powder. The nanopowder produced was sintered into pellets with relative densities over 99.1% of the theoretical value even at 1400 degrees C. The Ce(0.8)Gd(0.2)O(2-delta) sintered at 1400 degrees C exhibited a conductivity of 0.101 S/cm at 800 degrees C in air.

Electrical properties of nanocrystalline Ce(0.8)Sm(0.2)O(2-delta) and Ce(1-x)Gd(x)O(2-delta) (0.1 < or = x < or = 0.3) ceramics for IT-SOFC

Ce(0.8)Sm(0.2)O(2-delta) and Ce(1-x)Gd(x)O(2-delta) (0.1 < or = x < or = 0.3) nano-sized powders were successfully synthesized by the solution combustion synthesis process. The calcined nanopowders showed a ceria-based single phase with a cubic fluorite structure. In this study, we discussed the structural and electrical characteristics of the sintered Ce(0.8)Sm(0.2)O(2-delta) and Ce(1-x)Gd(x)O(2-delta). We obtained high-quality Ce(0.8)Sm(0.2)O(2-delta) and Ce(1-x)Gd(x)O(2-delta) ceramics with a high density, ultra-fine grain size, and high electrical conductivity even at low sintering temperature using the nanosized powders. The electrical conductivities at 800 degrees C for the Ce(0.8)Sm(0.2)O(2-delta) sintered at 1400 degrees C and the Ce(0.8)Gd(0.2)O(2-delta) sintered at 1350 degrees C were 0.110 and 0.104 Scm(-1), respectively.

Synthesis and characterization of nanocrystalline Gd and Tb co-doped ceria-based electrolyte materials for IT-SOFC

Gd and Tb co-doped Ce0.8Gd0.2-xTb(x)O2-delta (0 < or = x < or = 0.09) nanopowders were synthesized by the combustion method using aspartic acid as fuel. The calcined powders formed a ceria-based single phase with a cubic fluorite structure. In addition, the powders were pure, homogeneous, and nanocrystalline nature, i.e., 20.1-23.4 nm in the calculated crystallite size. The partial incorporation of Tb for Gd caused a decrease in the average grain size of the sintered bodies. The high-quality nanosized Ce0.8Gd0.17Tb0.03O2-delta powders provided a high density, ultra-fine grain size, and high electrical conductivity even at the low sintering temperature of 1300 degrees C. The grain size and density of the Ce0.8Gd0.17Tb0.03O2-delta were approximately 146 nm and approximately 99% of the theoretical density, respectively, allowing enhanced electrical conductivity (0.106 Scm(-1) at 800 degrees C).

Comparison of Stress Hormone Response, Interleukin-6 and Anaesthetic Characteristics of Two Anaesthetic Techniques: Volatile Induction and Maintenance of Anaesthesia using Sevoflurane versus Total Intravenous Anaesthesia using Propofol and Remifentanil

This prospective randomized study compared the effects of two types of anaesthesia on peri-operative anaesthetic profiles from induction to recovery and on immunological and neurohormonal responses to anaesthesia and surgical stress. Forty patients were assigned to undergo either volatile induction and maintenance of anaesthesia (VIMA) with sevoflurane or total intravenous anaesthesia (TIVA) with propofol and remifentanil. Plasma adrenaline, noradrenaline, cortisol, glucose and interleukin-6 (IL-6) levels were measured at baseline, induction, incision and extubation. TIVA produced a significantly lower intubation score, shorter time to intubation and faster waking time than VIMA, but recovery profiles did not differ. Adrenaline, noradrenaline, cortisol and glucose levels were significantly lower with TIVA than VIMA, but there was no difference in IL-6 levels between the two groups. TIVA with propofol and remifentanil may be preferable to VIMA with sevoflurane alone because it leads to smoother, more rapid induction, more rapid awakening and lower stress responses to surgical stimuli.

Effects of systemic transplantation of adipose tissue-derived stem cells on olfactory epithelium regeneration

OBJECTIVE/HYPOTHESIS

The purpose of the study was to investigate the effect of intravenous adipose tissue-derived stem cell (ADSC) transplantation on olfactory epithelium regeneration following transection of the olfactory nerve in rats.

STUDY DESIGN

This was a experimental study using primary cultures of mesenchymal stem cells derived from animal adipose tissue with histological analysis of animal olfactory tissue.

METHODS

All rats underwent unilateral transection of the olfactory nerve to induce degeneration of olfactory epithelium, and then were observed for regeneration according to time sequences. ADSCs were cultivated from neck adipose tissue of rats, and systemically injected into the experimental group. The control group was injected with phosphate buffered solution, instead of ADSCs. After 30 days, regeneration of olfactory epithelium was observed with olfactory marker protein (OMP) and proliferating cell nuclear antigen. To observe the characteristics of the transplanted ADSCs, olfactory epithelium was stained with von Willebrant factor and OMP.

RESULTS

After olfactory nerve transection, mature olfactory cells disappeared in 5 days, but gradually regained their thickness with increased cell numbers at approximately 10 to 15 days. By 30 days post-transection, the thickness and cellular composition of epithelium was almost restored to baseline levels pretransection. However, OMP expressions remained decreased compared with day 0 or 3. Systemically injected ADSCs were transplanted into the olfactory epithelium and survived beyond 4 weeks. The ADSCs promoted regeneration of olfactory epithelium in the animal model and differentiated into olfactory receptor neurons and endothelial cells.

CONCLUSIONS

Our findings suggest the feasibility of ADSC transplantation as a treatment for head trauma-related olfactory dysfunction.

Two-dimensional modelling of benzene transport and biodegradation in a laboratory-scale aquifer

In this study biodegradation of aqueous benzene during transport in a laboratory-scale aquifer model was investigated by conducting a 2-D plume test and numerical modelling. Benzene biodegradation and transport was simulated with the 2-D numerical model developed for solute transport coupled with a Haldane-Andrews type function for inclusion of an inhibition constant which is effective for high concentrations. Experimental data revealed that in the early stages the benzene plume showed a rather clear shape but lost its shape with increased travel time. The mass recoveries of benzene at 9, 16, and 22 h were 37, 13 and 8%, respectively, showing that a significant mass reduction of aqueous benzene occurred in the model aquifer. The major processes responsible for the mass reduction were biodegradation and irreversible sorption. The modelling results also indicated that the simulation based on the microbial parameters from the batch experiments slightly overestimated the mass reduction of benzene during transport. The sensitivity analysis demonstrated that the benzene plume was sensitive to the maximum specific growth rate and slightly sensitive to the half-saturation constant of benzene but almost insensitive to the Haldane inhibition constant. The insensitivity to the Haldane inhibition constant was due to the rapid decline of the benzene peak concentration by natural attenuation such as hydrodynamic dispersion and irreversible sorption. An analysis of the model simulation also indicated that the maximum specific growth rate was the key parameter controlling the plume behaviour, but its impact on the plume was affected by competing parameter such as the irreversible sorption rate coefficient.

Can a warning leak in a patient with unruptured aneurysm mask an underlying gastrointestinal pathology? A case report

Aggravating headache accompanied by nausea and epigastric discomfort suggesting a warning leak in a 39-year-old woman with a giant thrombosed intracranial aneurysm prompted us to undertake coiling of the aneurysm. After uneventful coil embolization of the aneurysm, collapse of the lung related to bronchospam developed, and was found to have a gastrointestinal pathology which had gone undetected before the procedure. Despite its rarity, gastrointestinal pathology mimicking warning leak should have been considered in a patient with a warning leak sign.

Comparison of Three Warming Devices for the Prevention of Core Hypothermia and Post-Anaesthesia Shivering

The efficacy of forced air warming with a surgical access blanket in preventing a decrease in core temperature during anaesthesia and post-anaesthesia shivering (PAS) was compared with two widely used interventions comprising forced air warming combined with an upper body blanket, and a circulating water mattress, in a prospective, randomized double-blind study. A total of 90 patients undergoing total abdominal hysterectomy were studied, 30 in each group. Core temperature was measured 15, 30, 45, 60, 90 and 120 min after induction of anaesthesia. PAS was evaluated every 5 min after emergence from anaesthesia over a period of 1 h. Core temperature fell in all three groups compared with the baseline, but forced air warming using a surgical access blanket was more effective than the other warming methods in ameliorating the temperature decrease. The surgical access blanket was also superior to the circulating water mattress in reducing PAS.

Iatrogenic ear lobule ischemic injury from pressure dressing as an unusual complication of parotidectomy

The use of compressive dressing is usually spread to enhance neovascularization of the dissected facial flap by elimination of dead space between the flap and the dermis in parotid surgery through facelift incision. The author reports a clinical case of compressive dressing after parotidectomy that was inappropriately performed to folding of the ear lobule, leading to ischemic injury. This iatrogenic complication resulted in the development of contracture of ear lobule and deformity of auricle. Consequently, careful compressive dressing after parotidectomy through facelift incision must be applied; and the wound must be inspected daily for early detection and prompt treatment of local complications.

Sialectasis of Stensen's duct: an unusual case of recurrent cheek swelling

Sialectasis of Stensen's duct is an uncommon condition of the salivary gland featuring dilation of the parotid duct. Various surgical and non-surgical treatment modalities have been reported as treatment for Stensen's duct stenosis. In this report, a rare case of sialectasis with fusiform dilatation of the parotid duct is presented, which was corrected by a simple and easy surgical technique creating a new opening in the buccal mucosa.

Intracranial stenting of severe symptomatic intracranial stenosis: results of 100 consecutive patients

BACKGROUND AND PURPOSE

There are a few reports regarding the outcome evaluation of balloon-expandable intracranial stent placement (BEICS). The purpose of our study was to evaluate the outcome and factors related to the adverse events (AEs) of BEICS.

MATERIALS AND METHODS

We evaluated 100 consecutive patients who underwent BEICS. We assessed the procedural success (residual stenosis < 50%), AEs (minor strokes, major strokes, and death), clinical outcome, and restenosis (> 50%) at 6 months. We also analyzed 18 factors including symptom patterns related to AE rate. Symptom patterns revealed 1) stable patients (n = 73) with improving, stationary, or resolved symptoms; and 2) unstable patients (n = 27) with gradual worsening or fluctuating symptoms (National Institutes of Health Stroke Scale [NIHSS] > or = 4) within 2 days before stent placement.

RESULTS

The procedural success rate was 99%. Overall, there were 10 (10%) AEs within the 6 months: 4 (4%) minor strokes, 3 (3%) major strokes, and 3 (3%) deaths including a death from myocardial infarction. AE rate was 4.1% in stable and 25.9% in unstable patients. Restenosis at 6 months revealed 0% (0/59). Good outcome (modified Rankin Scale < or = 2) at 6 months was 97% (71/73) in stable and 67% (18/27) in unstable patients. Stepwise logistic regression model revealed that symptom pattern (unstable versus stable) was the only significant risk factor (OR, 8.167; 95% CI, 1.933-34.500; P = .004).

CONCLUSION

BEICS revealed a low AE and good outcome rate at 6 months, especially in the stable patients. Midterm outcome was also favorable in the unstable patient group.

Dissecting aneurysm of the basilar arterial trunk presenting with pontine infarction. Coil obliteration of the dissecting aneurysm including the diseased basilar arterial segment

SUMMARY

Dissecting basilar aneurysms have rarely been reported but are associated with high morbidity and mortality. Therefore, controversy exists as to the proper management of such lesions because their natural course is not well understood. We describe a 50-year-old man with a dissecting aneurysm involving the lower basilar trunk who presented with pontine infarction corresponding to the aneurysmal sac location. We obliterated the dissecting basilar aneurysm by coil embolization of the aneurysmal sac as well as the diseased segment of the basilar trunk after confirmation of collateral filling of the basilar artery through the posterior communicating artery. The patient recovered without any procedural complication. Eight month follow-up revealed complete disappearance of the aneurysm without symptom recurrence together with preservation of collateral flow in the distal basilar artery. Obliteration of the parent artery as well as the aneurysmal sac with coils could be considered in a lower basilar aneurysm of a dissecting nature.

Detection of CSF leak in spinal CSF leak syndrome using MR myelography: correlation with radioisotope cisternography

BACKGROUND AND PURPOSE

Spinal CSF leak syndrome is a unique disorder caused by spinal CSF leak. In this study, we attempted to determine whether MR myelography (MRM) can detect the leakage site in the spine.

MATERIALS AND METHODS

We performed both MRM and radioisotope cisternography (RIC) in 15 patients with spinal CSF leak syndrome. Patients were included in this study if they had at least 2 of the following criteria: 1) orthostatic headache, 2) low CSF opening pressure, and 3) diffuse pachymeningeal enhancement on brain MR imaging. For comparison, we performed MRM in 15 subjects without symptoms of spinal CSF leak syndrome. MRM was performed with the 2D turbo spin-echo technique in the entire spine by using a 1.5T scanner. Two blinded radiologists evaluated the MRM findings in a total of 30 cases, composed of patient and control groups, with regard to the presence of leakage and the level of leakage if present. RIC was performed only in the patient group and was assessed by consensus among 3 physicians experienced in nuclear medicine. The diagnostic performance of MRM and RIC was evaluated on the basis of the clinical diagnosis of spinal CSF leak syndrome.

RESULTS

The sensitivity, specificity, and accuracy of MR myelography for detecting CSF leak was 86.7%, 86.7%, and 86.7% for reader 1, respectively, and 80.0%, 93.3%, and 86.7% for reader 2, respectively. The sensitivity of RIC was 93.3%. Agreement between the 2 techniques for the detection of CSF leak was substantial in reader 1 and moderate in reader 2 (kappa = 0.634 and 0.444, respectively).

CONCLUSION

MRM is an effective tool for detecting CSF leak in the spine in patients with spinal CSF leak syndrome.