Vertigo as the sole complaint of tympanomastoid paraganglioma

Background: Tympanomastoid paragangliomas are usually benign, slowly growing, painless tumors. The common presenting symptoms of this tumor are pulsatile tinnitus and conductive hearing loss. Vertigo as the cardinal or initial symptom is extremely rare, especially in the early stages of the disease.Case presentation: A 53-year-old female patient presented only with intermittent recurrent vertigo and was later found to have a tympanomastoid paraganglioma. Her symptoms disappeared completely after resection of the tumor. This is the first report in literature of a case of tympanomastoid paraganglioma with vertigo as the single symptom.Conclusion: The tympanomastoid paraganglioma is rare and its clinical symptoms are nonspecific, so it is easy to be misdiagnosed or missed. It is worth noting that although clinically uncommon, vertigo can also be the first or sole symptom of tympanomastoid paraganglioma. Detailed physical examination and imaging examination of the ear are necessary and should be carried out meticulously.

The clinical rehabilitation of spine and spinal cord disorders: detection and evaluation using SPECT/CT

Spine-related disorders are caused by several factors including （1） spinal nerve/visceral nerve stimulation by perivertebral aseptic inflammation, （2） spinal nerve/visceral nerve compression by injured periverterbal soft tissue, dislocated perivertebral small joint, and proliferative/degenerative tissue and, （3） secondary damage to the spinal cord, peripheral nerve, vessels and autonomic nerve, which further stimulate nerve root sheath and surround- ing pain-carrying nerve fibers. In many cases, the source of pain cannot be detected by standard image modalities. Particularly in anatomically complex regions like the spine, SPECT/CT can be helpful for some aspects by intro- ducing a metabolical dimension to the classical way of morphology-based diagnostic. The aim of the present review was to give an overview of the adoption of SPECT/CT in a clinical spine-focused setting.

Characterization of the Long-Term Interaction between Intracellular Reactive Oxygen Species and Oxidative DNA Damage in Murine Lin^-/Sca-1⁺Cells Exposed to Ionizing Radiation

Mutations in the Sfpi1 gene are essential for the development of radia-tion-induced acute myeloid leukemia. In this study, we investigated long-term interaction among immature hematopoietic cell number, intra-cellular reactive oxygen species contents, and oxidative DNA damage fre-quency after irradiation. Lin-/Sca-1+ cells were isolated from C3H/HeN mice on days 1 - 400 after 0 - 3 Gy total body irradiation. On days 1 - 7, the number of surviving cells decreased and reached a minimum;however, the number of cells gradually recovered until day 200. Intracellular reactive oxygen species contents significantly increased from day 1 to day 30. In addition, the frequency of oxidative DNA damage tended to increase from day 1 and day 30, and that at day 30 was significantly increased in the 3 Gy group compared with that in the control group. In contrast, decreased cell number, increased intracellular reactive oxygen species content, and decreased oxidative DNA damage frequency were observed on day 400. These results suggested that oxidative DNA damage was involved in intracellular reactive oxygen species generation induced by cell proliferation to compensate for cell death after irradiation.

Color Fusion of Magnetic Resonance Images Improves Intracranial Volume Measurement in Studies of Aging

Background: Comparison of intracranial volume (ICV) measurements in different subpopulations offers insight into age-related atrophic change and pathological loss of neuronal tissue. For such comparisons to be meaningful the accuracy of ICV measurement is paramount. Color magnetic resonance images (MRI) have been utilised in several research applications and are reported to show promise in the clinical arena. Methods: We selected a sample of 150 older community-dwelling individuals (age 71 to 72 years) representing a wide range of ICV, white matter lesions and atrophy. We compared the extraction of ICV by thresholding on T2*-weighted MR images followed by manual editing (reference standard) done by an analyst trained in brain anatomy, with thresholding plus computational morphological operations followed by manual editing on a framework of a color fusion technique (MCMxxxVI) and two automatic brain segmentation methods widely used, these last three done by two image analysts. Results: The range of ICV was 1074 to 1921 cm3 for the reference standard. The mean difference between the reference standard and the ICV measured using the technique that involved the color fusion was 2.7%, while it was 5.4% compared with any fully automatic technique. However, the 95% confidence interval of the difference between the reference standard and each method was similar: it was 7% for the segmentation aided by the color fusion and was 7% and 8.3% for the two fully automatic methods tested. Conclusion: For studies of aging, the use of color fusion MRI in ICV segmentation in a semi-automatic framework delivered best results compared with a reference standard manual method. Fully automated methods, while fast, all require manual editing to avoid significant errors and, in this post-processing step color fusion MRI is recommended.

Prostate Cancer Diagnostic and Evaluation in Gaza-Strip, Palestine

Prostate cancer has the third highest cancer incidence in Palestinian men with incidence rate about 4.5/100,000, and an increase in new cases by 50% between 2000 and 2015. Prostate cancer death rates have been obviously decreased in many countries due to treatment, precise screening. The current study aims to review and evaluate the new diagnosed prostate cancer in the Gaza Strip, Palestine. As a cross-sectional, quantitative and analytical approach based on structured review, the current study was conducted at Al-Shifa and European hospitals (main oncology departments in governmental hospitals). Interviews with newly diagnosed cancer prostate patients were carried out during the period of March and June, 2014;a total of 41 newly diagnosed with primary cancer prostate. Furthermore, demographic, health status, medical investigations and tests are reported from oncologists and hospital archives over the last five years (2010-2014). The current study showed that there were 41 new prostate cancer cases in three months with incidence rate 5.1 per 100,000. The highest rate of incidence was among the patients above age of 70+, 70 - 74 (29.3%). The results showed that 58.1% of the patients were smokers, and 22.6% used to smoke, while 16.1% responded they don’t smoke at all. The most common type of treatment used by participants was chemotherapy therapy followed by hormonal therapy and prostatectomy. The least common methods used for treatment were radiation therapy and combination of hormonal, radiation, and chemotherapy as only 5 participants used each type of these treatment options. The prevalence of prostate cancer was higher among men who lived in Gaza Governorate compared to other governorates. Limited use of radiation therapy was due to the unavailability of this treatment in Gaza Strip.

上肢周围神经病变:MRI在治疗中的作用及影响

探讨MRI在评价上肢周围神经病变中的作用及其对治疗的影响。在1.5T MR设备上,对51例具有桡神经、正中神经和(或)尺神经损伤临床证据。

Clinical and laboratory survey of 65 Chinese patients with Leigh syndrome

Background Leigh syndrome is an inherited neurodegenerative disease that emerges in infancy and childhood and presents with a clinically heterogeneous variety of neuromuscular and non-neuromuscular disorders. It can result from the inheritance of mutations in either nuclear or mitochondrial DNA. In the current study, we performed a retrospective study in 65 patients in order to investigate the clinical and genetic characteristics of Leigh syndrome in Chinese patients. Methods Sixty-five unrelated cases （35 men and 30 women） who were hospitalized in the past 12 years were reviewed. Diagnosis was based on both the clinical presentation and the characteristic neuropathologic findings of bilateral symmetric necrotizing lesions in the basal ganglia and brain stem as detected using cranial computed tomography （CT） scan or magnetic resonance imaging （MRI）. The differential diagnosis of organic acidurias and fatty acid IS-oxidation defects were performed. Specific point mutations and deletions in mitochondrial DNA （T8993G, T8993C, T9176C, A8344G, A3243G） were screened by PCR-restriction analysis and Southern blot. The SURF1 gene was sequenced. Skeletal muscle biopsies were performed in 17 （26.2%） of the patients. The diagnosis was confirmed by autopsy in 6 （9.2%） patients. Results The patients had various forms of metabolic encephalomyopathy. Filly-nine （90.8%） of the patients had the typical neuroradiological features of Leigh syndrome, including symmetrical necrotizing lesions scattered within the basal ganglia, thalamus and brain stem. Twenty （30.8%） patients were confirmed by genetic, biochemical analysis and autopsy. Specific point mutations in mitochondrial DNA were found in 5 cases （7.7%）. Of these, the A8344G mutation was detected in 2 patients. The T8993G T8993C, and A3243G point mutations were identified in 3 other patients, respectively. SURF1 mutations associated with cytochrome c oxidase deficiency were identified in 8 （12.3%） families by DNA sequencing. A G604C mutation was identified in 6 （9.2%） patients. The genotypes of 52 patients remained unknown. Conclusions Leigh syndrome presents as a diverse array of clinical features and can result from specific mutations in nuclear or mitochondrial DNA. In this study, SURF1 mutations associated with cytochrome c oxidase deficiency were identified in 8 （12.3%） out of 65 patients with Leigh syndrome. It indicates that SURF1 mutations might be a common cause of Leigh syndrome in China. The etiology of Leigh syndrome in Chinese patients represents a persistent challenge to clinicians.

Evaluation on therapeutic effects of orthotopic liver transplantation by megnetic resonance imaging in patients with portal hypertension

Background Orthotopic liver transplantation （OLT） has become the therapeutic option of choice for end-stage liver disease. The aim of this study was to investigate the changes of splenic morphology, signal-to-noise ratio （SNR）, contrast- to-noise ratio （CNR）, apparent diffusion coefficient （ADC） values and explore their value in evaluating the therapeutic effects of orthotopic liver transplantation （OLT） on portal hypertension at 1.5 Tesla MRI. Methods Twenty patients with portal hypertension undergoing OLT were included in this study. Conventional MRI and diffusion-weighted image （DWI） （b value=600 s/mm2） sequences were applied on each patient before and after OLT, and these patients were referred to as the preoperative and postoperative groups. Twenty healthy individuals were selected as the normal group. After image acquisition, the splenic width （W）, thickness （T）, length （L）, the diameter of the portal vein （PD） and splenic vein （SD） were measured and the splenic volume （V） was calculated. The SNR and CNR were measured on T2WI. The ADC maps were calculated using the bs00 in DWIs and the ADC values were measured. Results Compared with the preoperative group, the splenic V, PD and SD decreased significantly in the postoperative group （P 〈0.05）. All splenic morphological values were significantly different between preoperative and normal groups （P 〈0.05）. The splenic L and V were significantly different （P 〈0.05） between postoperative and normal groups. The SNR and CNR values were 17.66＋4.62 and 13.18＋3.12, 11.50＋1.64 and 7.44＋4.32, 4.24＋1.24 and 3.03＋2.41 in the preoperative, postoperative and normal groups, respectively. Both SNR and CNR decreased after OLT, but they was still higher than the normal values. The SNR was significantly different between any two groups （P 〈0.05）. The CNR was significantly different （P 〈0.05） between the preoperative and postoperative groups, preoperative and normal groups. The splenic ADC values were （1.339＋0.482）×10^-3 mm2/s, （1.120±0.254）×10^-3 mm2/s and （0.997±0.447）×10^-3 mm2/s in the preoperative, postoperative and normal groups, respectively. The difference of ADC values were significant （P 〈0.05） between the preoperative and postoperative groups, and the preoperative and normal groups. Conclusions OLT is an effective method of treatment for portal hypertension. In addition to dramatically decreasing the splenic V, it can also decrease the splenic SNR, CNR and ADC values in patients with portal hypertension. The changes of splenic SNR, CNR and ADC after OLT may be helpful in providing noninvasive supplementary information in assessing the therapeutic effect of OLT on portal hypertension.