Chondrosesamoidean ligament enthesopathy: Prevalence and findings in a population of lame horses imaged with positron emission tomography.
- 作者列表："Norvall A","Spriet M","Espinosa P","Ariño-Estrada G","Murphy BG","Katzman SA","Galuppo LD
BACKGROUND:Increased 18 F-Sodium Fluoride (18 F-NaF) uptake at the chondrosesamoidean ligament (ChSL) attachment on the distal phalanx was identified in an exploratory positron emission tomography (PET) study. The prevalence and significance of this lesion has not been previously investigated. OBJECTIVES:The goal of this study was to assess the prevalence of this lesion, its association with other imaging findings and with clinical signs. STUDY DESIGN:Retrospective cross-sectional analytical study. METHODS:All horses with 18 F-NaF PET and computed tomography (CT) imaging of the feet performed between October 2016 and December 2017 were included in the study. All PET scans were independently assessed by two radiologists for increased uptake at the ChSL attachment site and concurrent imaging was reviewed. Clinical findings, treatment and outcome were retrieved from the medical records. RESULTS:Fourteen of 30 horses (20/56 feet) had increased 18 F-NaF uptake in the region of interest. ChSL enthesopathy was the primary lesion in three horses. Other PET abnormalities included navicular bone uptake (13 feet) and ipsilateral palmar process uptake (9 feet). There was no significant association between ChSL enthesopathy and other lesions. ChSL enthesopathy was significantly associated with foot lameness. CT abnormalities at the ChSL attachment were initially identified in one foot, and retrospectively noted in another five following the results of PET imaging. MAIN LIMITATIONS:The study is retrospective and there was a limited sample size. CONCLUSIONS:PET led to identification of ChSL enthesopathy in a large proportion of horses with foot pain. This finding is most commonly associated with other lesions but may also represent the main abnormality. The axial border of the palmar processes of the distal phalanx should be carefully assessed on cross sectional imaging to identify this lesion. ChSL enthesopathy may be an important but previously not recognised component of foot pathology in horses.
背景: 在一项探索性的正电子发射断层扫描 (PET) 研究中发现，远端指骨软骨骨韧带 (ChSL) 附着处的18 F-氟化钠 (18 F-NaF) 摄取增加。以前没有研究过这种病变的患病率和意义。 目的: 本研究的目的是评估该病变的患病率，其与其他影像学表现和临床体征的相关性。 研究设计: 回顾性横断面分析研究。 方法: 所有在2016年10月至2017年12月期间进行了18 F-NaF PET和足部计算机断层扫描 (CT) 成像的马均纳入研究。由两名放射科医师独立评估所有PET扫描在ChSL附着部位的摄取增加，并审查同时成像。从医疗记录中检索临床发现、治疗和结果。 结果: 30匹马中的14匹 (20/56英尺) 在感兴趣区域中增加了18 F-NaF摄取。3匹马的原发病灶为ChSL病灶。其他PET异常包括舟状骨摄取 (13英尺) 和同侧掌突摄取 (9英尺)。ChSL病变与其他病变无明显相关性。ChSL病变与足部跛行显著相关。在1英尺中最初发现了ChSL附件处的CT异常，并在PET成像结果之后的另外五个中回顾性地注意到。 主要局限性: 本研究是回顾性研究，样本量有限。 结论: PET导致在大部分患有足部疼痛的马中鉴别出ChSL病变。这一发现最常与其他病变相关，但也可能代表主要异常。远端指骨掌突的轴向边界应在横断面成像上仔细评估以识别该病变。ChSL附件病可能是马足部病变的重要但以前未识别的组成部分。
METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.
METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.