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Imaging with bone scans plays an important role in the diagnostic path of patients with unilateral condylar hyperactivity or unilateral condylar hyperplasia (UCH). The aim of this study is to perform a systematic review of the diagnostic performance of the bone SPECT and SPECT/CT scan for the diagnosis of UCH. PubMed, SCOPUS and EMBASE were searched electronically to identify diagnostic accuracy studies that assessed the diagnostic value of bone SPECT and SPECT/CT for the diagnosis of UCH, Meta-analyses were performed with Metadisc 1.4 and 2.0. A total of 14 studies, with a total number of 887 patients, were included in the qualitative analysis and 11 studies qualified for meta-analyses. The pooled sensitivity and specificity for the SPECT scan were 0.814 (95 % CI: 0.639-0.915) and 0.774 (95 % CI: 0.655-0.861), for the SPECT/CT scan these were 0.818 (95 % CI: 0.749-0.874) and 0.901 (95 % CI: 0.840-0.945). The summary receiver operating characteristics of the SPECT scan showed an area under the curve of 0.847 (95 % CI: 0.722-0.972) and that of the SPECT/CT scan was 0.928 (95 % CI: 0.876-0.980). CONCLUSION: Both bone SPECT scan and SPECT/CT scan provide a high diagnostic accuracy for UCH. The added value of the SPECT/CT scan is questionable and given the potential disadvantages of the SPECT/CT scan, including the increased radiation dose and costs, the diagnostic modality of first choice in patients with UCH should be a SPECT scan., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The role of low-dose computed tomography (LDCT) in surgical planning can be assessed based on the correlation among bone density (BD/HU), radiographic values, and the histopathological appearance of hyperplastic overgrowth in mandibular condyles (hemimandibular hyperplasia/osteochondroma). The aim of this study was to evaluate the correlation between LDCT indices of bone-density measurements in surgical planning and histopathological specimens. The patients incuded in this study underwent detailed radiological evaluation as preparation for further clinical procedures. Excised condyles were evaluated in terms of bone density index using LDCT, and then histopathologically to investigate the accuracy of surgical procedures and set the basis for future surgical planning. An index value between both condyles' bone densities represented the relative difference between the healthy condyle and the side with hemimandibular hyperplasia (HH). Patients with unilateral condylar hyperplasia (UCH) showed a statistical correlation between condyle heads with increased bone density (BD) and scintigraphic (SCI) values (p < 0.001). On the other hand, correlation between BD and histopathological studies alone was significant (p < 0.001). With the increase in BD measured in HU in UCH condyles, the overall value of fibrous cartilage layer thickness decreased (p < 0.001). Furthermore, histopathological evaluation indicated that increased bone density on the UCH side resulted in increased total thickness (p > 0.001). The proposed index measurements in the mandibular condyles based on LDCT/BD can be used to estimate the degree of required surgical resection. Results from LDCT radiographic studies correlate with histopathological specimens more than scintigraphy., (Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: When needle core biopsy (NCB) of the breast yields atypical ductal hyperplasia (ADH), excision is typically recommended. The natural history of ADH undergoing active surveillance (AS) is not well described. We investigate the rates of upgrade to malignancy of excised ADH and the rates of radiographic progression under AS., Materials and Methods: We retrospectively reviewed records of 220 cases of ADH on NCB. Of patients who had surgery within 6 months of NCB, we examined the malignancy upgrade rate. In the AS cohort, we examined rates of radiographic progression on interval imaging., Results: The malignancy upgrade rate among patients who underwent immediate excision (n = 185) was 15.7%: 14.1% (n = 26) ductal carcinoma in situ (DCIS) and 1.6% (n = 3) invasive ductal carcinoma (IDC). Upgrade to malignancy was less common in lesions <4 mm in size (0%) or with focal ADH (5%), and more common among lesions presenting with a radiographic mass (26%). Among the 35 patients who underwent AS, median follow-up was 20 months. Two lesions progressed on imaging (incidence 3.8% at 2 years). One patient without radiographic progression was found to have IDC at delayed surgery. The remaining lesions remained stable (46%), decreased in size (11%), or resolved (37%)., Conclusions: Our findings suggest that AS is a safe approach to managing ADH on NCB for most patients. This could spare many patients with ADH from unnecessary surgery. Given that AS is being investigated for low-risk DCIS in multiple international prospective trials, these results suggest that AS should also be investigated for ADH., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The aim of this study was to assess the diagnostic accuracy of single photon emission tomography (SPECT) in unilateral condylar hyperplasia (UCH). To this end, 3D morphometric changes of the mandibles in one year were assessed (T0 vs. T1) and compared over SPECT results in T1, in a sample of 40 patients. A contingency table was constructed based on these results for SPECT diagnostic accuracy evaluation, classifying patients as SPECT true-positive, true-negatives, false positives and false-negatives. Additionally, the morphometric analysis was used to describe the presentation of mandibular changes using principal component analysis (PCA) and non-parametric statistics. We obtained diagnostic accuracy results of sensitivity 81%, specificity 63%, positive predictor value (PPV) 59%, negative predictor value (NPV) 83% and accuracy 70%, showing that SPECT yields poor results regarding accuracy diagnostic performance. The morphometric analysis showed that individuals without progress of asymmetry and those with more progress differ particularly in a group of landmarks representing the mental region and the right mandibular body. Based on these landmarks, difference among the four SPECT-accuracy groups was statistically significant (p < 0.001), where the landmark showing the largest change within a year had a mean increase of 1.13 + 0.66 mm. Within the limitations of the study, it seems that SPECT alone is not suitable for making surgical decisions regarding condylectomy in active UCH. Follow up with morphological assessment methods are recommended for confirming an active UCH in combination with SPECT., Competing Interests: Declaration of competing interest None., (Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Introduction: Unilateral condylar hyperplasia (UCH) is a progressive, nonneoplastic overgrowth of the condyle of the temporomandibular joint. For treating active UCH, a popular method combines orthognathic surgery with high condylectomy and orthodontic treatment. The goal of this study was to introduce a new method to correct asymmetry for active UCH., Methods: Retrospectively, 47 patients with active UCH were divided into horizontal-type, vertical-type, and combined-type. All patients were treated with condylectomy plus postsurgery standard orthodontics (CPSO) with applied miniscrews implanted in infrazygomatic crest and hard palate to intrude affected side of maxillary molars and apply intermaxillary traction for contralateral molars. Cone-beam computed tomography was taken at presurgery, postsurgery, and the end of orthodontics (T3)., Results: In the vertical (n = 10) and combined (n = 28) types, deviation of the chin and the canting of the mandible and maxillary occlusal plane were significantly reduced at T3. A difference in the torque of bilateral maxillary first molar (U6) and bilateral mandibular first molar (L6) was significantly reduced at T3. The anterior, superior, and posterior joint spaces in the vertical-type and combined-type were significantly decreased at T3 compared with postsurgery. In contrast, in the horizontal-type group (n = 9), the deviation of the chin was corrected; however, the canting of the mandible and maxillary occlusal plane was significantly increased at T3 compared with presurgery., Conclusions: CPSO restored facial and occlusal symmetry for vertical-type and combined-type active UCH and returned affected-side condyle to the glenoid fossa. However, CPSO was not suitable for treating the horizontal-type UCH., (Copyright © 2021 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: Venous hypertension associated with a primitive basal vein of Rosenthal (BVR) has been noted as the most likely cause of idiopathic subarachnoid hemorrhage (iSAH). Other types of venous drainage variations have been scarcely studied but may further explain the cases not associated with a BVR anomaly. Our aim was to investigate if dural venous sinus (DVS) anomalies are related with iSAH., Methods: A total of 76 patients diagnosed with iSAH were identified from a prospectively maintained database and their angiographic findings compared with 76 patients diagnosed with aneurysmal subarachnoid hemorrhage., Results: On top of the BVR variations, our data showed a higher prevalence of transverse sinus hypoplasia (47.4% vs. 28.9%; P = 0.019), superior petrosal sinus hypoplasia (32.9% vs. 13.2%; P = 0.003), and clival plexus hyperplasia (65.8% vs. 43.4%; P = 0.005) in patients with iSAH. Analyzing by total number of angiograms, the iSAH group showed also a higher prevalence of inferior petrosal sinus hyperplasia (36.2% vs. 25%; P = 0.003). Of the patients with iSAH without a primitive BVR, 84% harbored ≥1 perimesencephalic DVS variation and the overall number of venous drainage variations was significantly higher in patients with iSAH., Conclusions: In addition to the well-documented BVR anomalies, there seems to be a significant relationship of other DVS variations in patients with iSAH. Transverse sinus hypoplasia, superior petrosal sinus hypoplasia, inferior petrosal sinus hyperplasia, and clival plexus hyperplasia were significantly more frequent in patients with iSAH. The presence of ≥3 of those variations would increase the suspicion of a nonaneurysmatic subarachnoid hemorrhage and could help avoid a second angiogram., (Copyright © 2021 Elsevier Inc. All rights reserved.)

MRI features are presented in a multicenter retrospective series of five patients with a unilateral masslike lesion seen in the genitourinary diaphragm at MRI performed for known or suspected prostate cancer. In all cases, the lesion appeared as an encapsulated 1.3 to 3.0 cm mass of heterogeneous low or intermediate T2 signal intensity in the genitourinary diaphragm, and targeted biopsy demonstrated benign Cowper's gland tissue. This entity is a potential imaging pitfall that could result in a diagnosis of an exophytic nodule of benign prostatic hyperplasia or local spread of prostate cancer. We present these cases to facilitate correct identification of Cowper's gland hyperplasia as an occasional finding at MRI of the prostate., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Introduction: The objectives of this study were to evaluate postsurgical condylar remodeling using a radiographical interpretation, quantify condylar volumetric asymmetry, and assess soft tissue symmetry after simultaneous unilateral high condylectomy and bimaxillary osteotomies., Methods: Sixteen patients diagnosed with unilateral condylar hyperplasia underwent unilateral high condylectomy and orthognathic surgery to correct skeletal and facial asymmetries. Cone-beam computed tomography scans were acquired before and 1-year after surgery. A radiographic consensus was evaluated for signs of reparative or degenerative changes. The condyles were mirrored and registered for assessment of volumetric and morphologic asymmetry. Soft tissue symmetry was evaluated by measurement of the distance of soft tissue pogonion from the skeletal midsagittal plane., Results: Patients who undergo unilateral high condylectomy and orthognathic surgery present radiographic signs suggestive of degenerative changes, including sclerosis, osteophytes, flattening, and erosion in both the surgical and nonsurgical condyles (P ≤0.01). There was an average volumetric improvement of 531.9 ± 662.3 mm 3 1-year postsurgery (P = 0.006). Soft tissue symmetry improved in all patients, with an average improvement of 65.8% (4.0 mm ± 2.6 mm, P ≤ 0.01). There was no correlation between the change in condylar volumetric asymmetry and the stability of the soft tissue correction., Conclusions: High condylectomy for the correction of a skeletal asymmetry in patients with condylar hyperplasia successfully reduces the volumetric asymmetry between the condyles. Postsurgical dysmorphic remodeling and degenerative changes were noted in both the surgical and nonsurgical condyles. Despite remarkable changes and remaining joint asymmetry, the soft tissue correction is stable 1-year postsurgery., (Copyright © 2021 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Background: Intracoronary imaging enables an early detection of intimal changes. To what extend the development of absolute and relative intimal hyperplasia in intracoronary imaging differs depending on age and post-transplant time is not known., Methods: Aim of our retrospective study was to compare findings between 24 pediatric (cohort P) and 21 adult HTx patients (cohort A) using optical coherence tomography (OCT) at corresponding post-transplant intervals (≤5 years: P1 (n = 11) and A1 (n = 10); >5 and ≤ 10 years: P2 (n = 13) and A2 (n = 11),. Coronary intima thickness (IT), media thickness (MT) and intima to media ratio (I/M) were assessed per quadrant. Maximal IT >0.3 mm was considered absolute, I/M > 1 relative intimal hyperplasia., Results: Compared to A1, I/M was significantly higher in P1 (maximal I/M: P1: 5.41 [2.81-13.39] vs. A1: 2.30 [1.55-3.62], p = 0.005), whereas absolute IT values were comparable. In contrast, I/M was comparable between P2 and A2, but absolute IT were significantly higher in A2 (maximal IT: P2: 0.16 mm [0.11-0.25] vs. A2: 0.40 mm [0.30-0.71], p < 0.001). A2 presented with higher absolute IT (maximal: A1: 0.16 mm [0.12-0.44] vs. A2: 0.40 mm [0.30-0.71], p = 0.02) and I/M (maximal I/M A1: 2.30 [1.55-3.62] vs. A2: 3.79 [3.01-5.62], p = 0.04)., Conclusion: Our results suggest an age- and time-dependent difference in the prevalence of absolute and relative intimal hyperplasia in OCT, with an early peak in children and a progressive increase in adults., Competing Interests: Declaration of competing interest Dr. S. Ulrich used retrospectively some OCT data that had also been previously used in a prospective study supported by Novartis Pharma GmbH. Novartis Pharma GmbH was not involved in the development, realization and data analysis of this study. Dr. S. Ulrich has also received financial research support from Astellas Pharma GmbH, “Verein zur Förderung von Wissenschaft und Forschung“(medical faculty of Ludwig-Maximilians-University Munich, Germany) and currently receives financial research support from Gerd-Killian Projektförderung (DGPK, “Deutsche Herzstiftung”, Germany). Dr. Braun reports speaker honoraria from Abbott Vascular. Dr. Hausleiter reports grants and personal fees from Abbott Vascular, grants and personal fees from Edwards Lifesciences, outside the submitted work. Dr. Massberg reports grants from German Federal Ministry of Education and Research (BMBF)/German Center for Cardiovascular Research (DZHK), grants from German Research Foundation (DFG), grants from Boston scientific, grants from Foundation Leduq Transatlantic Network of Excellence, outside the submitted work. Dr. Mehilli received funding of German Centre for Cardiovascular Research (DZHK) for material costs of optical coherence tomography and image analysis. The authors report no relationships that could be construed as a conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular lesion that is uncommon in the central nervous system. To our knowledge, there has been only one previous report of occurrence in the pineal region. We present a second case and a review of the literature., Case Description: A 28-year-old woman presented with 1 month of headaches and visual auras. Brain magnetic resonance imaging scan demonstrated a 2.6- × 1.8- × 1.3-cm nonenhancing T1-hypointense, T2-/fluid-attenuated inversion recovery-hyperintense pineal region mass with cerebral aqueduct obstruction and hydrocephalus. She underwent placement of a right extraventricular drain followed by complete surgical resection. Histologic analysis was consistent with IPEH., Conclusions: Although rare, IPEH is an entity that should be considered in the differential diagnosis for intracranial masses with radiographic features characteristic of vascular lesions. Tissue sampling is imperative for distinction from more malignant entities. Complete resection is curative and is the standard of care when feasible. Given the risk of local progression and neurologic compromise with subtotal resection of central nervous system lesions, further study regarding adjuvant treatment options is warranted., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Extravascular papillary endothelial hyperplasia (EPEH) is an extremely uncommon form of papillary endothelial hyperplasia characterized by an exuberant reactive endothelial proliferation in areas of extravascular hemorrhage rather than within the vascular lumen. Intracranial EPEH is known to develop after radiosurgery in patients with intracranial neoplasms, suggesting a causative relationship between radiotherapy and the development of EPEH. Intracranial EPEH is typically treated with surgical resection; to date, there have been no reported cases of EPEH recurrence after gross total resection., Case Description: A 75-year-old man with a history of atypical meningioma presented to our hospital with progressive right upper and lower extremity weakness. Eight and a half years before admission, he had undergone surgical resection and stereotactic radiosurgery for a World Health Organization grade II meningioma. Several years later, he experienced a mass in the prior resection cavity and was subsequently treated with gross total resection and cesium-131 brachytherapy seeds. Postoperative pathologic examination of the resected tissue at that time showed EPEH with no evidence of recurrent atypical meningioma. On this admission, magnetic resonance imaging showed a recurrent mass in the area of prior resection, at which time the patient underwent a third craniotomy and gross total resection. Postoperative histopathologic examination showed findings consistent with the diagnosis of recurrent EPEH., Conclusions: This case report is the first known recurrence of intracranial EPEH occurring after gross total resection and brachytherapy., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Although a prospective randomized control study revealed that 3-month dual anti-platelet therapy (DAPT) is safe and does not compromise the efficacy of everolimus-eluting stent (EES) in selected patients, detailed vessel healing at early phase after EES implantation has yet to be investigated in Japanese patients., Methods and Results: A total of 27 lesions in 19 patients treated with EES were serially evaluated by using optical coherence tomography (OCT) at 3, 6, and 12 months after stent implantation. In addition to standard quantitative OCT parameters, the percentage of stents with peri-strut low-intensity area (PLIA, a region around stent struts homogenously showing lesser intensity than the surrounding tissue, suggesting fibrin deposition or impaired neointima maturation) and that with in-stent thrombi were evaluated. There was a significant, but small increase in neointimal thickness (63±17μm; 83±30μm; and 111±44μm, respectively; p=0.006) and small decrease in average lumen area (6.80±2.57mm 2 , 6.62±2.58mm 2 , 6.33±2.58mm 2 , p=0.038) from the 3- to the 12-month follow-up. The incidences of uncovered and malapposed struts were low at 3 months and did not significantly change at 6 months and 12 months (3.01±4.43; 2.45±3.75; and 1.47±3.16, p=0.143, and 0.75±0.65; 0.63±0.73; and 0.58±1.42, p=0.162, respectively). Also, frequency of struts with PLIA was already low at three months and significantly decreased during the follow-up (6.4±6.5; 4.6±5.4; and 2.3±3.3, respectively; p=0.001)., Conclusion: Favorable vessel healing was achieved at 3 months after EES implantation without neointimal hyperplasia which was persistently suppressed up to 12 months., (Copyright © 2018. Published by Elsevier Ltd.)

Purpose: Facial asymmetries due to unilateral condylar hyperactivity are often a challenge both for maxillo-facial surgeons and for orthodontists; the current literature shows different opinions about aetiology, classification, treatment approach and timing. We made a retrospective study on patients suffering from unilateral condylar hyperactivity between 1997 and 2015 in our Department; clinical features and treatment options were grouped and compared with literature., Methods: The descriptive analysis investigated variables like sex, age, side and direction of the asymmetry, condylar activity and type of intervention., Results: The population was composed of 128 patients. The hemimandibular hyperactivity occurs equally in both sexes around the second decade, although the range of the first consultation goes from 7 to 49 y.o. The vertical hyperdevelopment group is almost equal to the horizontal. All the patients with horizontal hyperactivity showed negative scintigraphy and were treated with pre-surgical orthodontics and orthognathic surgery; patients with vertical hyperactivity and positive scintigraphy were treated with condylectomy and post-surgical orthodontics., Conclusion: In our group of patients, direction of the hyperactivity and results of the scintigraphy lead to treatment choice and timing. Further studies are necessary to explain why, in our group, all the patients with horizontal involvement are negative to scintigraphy., (Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Introduction: The full epidemiology and etiology of hemimandibular hyperplasia (HH) has not yet been clarified. In most cases it starts before puberty and results in various forms of dento-alveolar and skeletal discrepancies. This study is the first attempt at evaluating and describing some of the authors' key experiences, clinical philosophical approach, and gathered demographic data on hemimandibular hyperplasia and hemimandibular elongation (HE) among the Polish population., Material and Method: A total of 45 patients (M = 8; F = 37; p < 0.05) with HE (n = 16; 35.6%; p < 0.05), HH (n = 28; 62.2%; p < 0.05), or HH + HE (n = 1; 2.2%; p > 0.05) had been diagnosed and treated. Epidemiological, geographical, and clinical data concerning the occurrence and treatment protocols in these mandibular malformations were measured in the Polish study groups., Results: Women more often suffered from these mandibular malformations (82-87%). The occurrence of the first symptoms was highest at the age of 13-15 years and was statistically significant for both sides (p < 0.05). The disorders were found earlier in young girls, therefore an early compensatory orthodontic treatment in some cases had been used with a limited degree of success (p > 0.05). All values of bone scintigraphy were significant (p < 0.001)., Conclusions: A very fast growth with visible major asymmetry and enlarged condylar head should be an indication for condylectomy. Women's expectations from surgery and treatment are more demanding than men's, a fact that is connected with the predominance of females in the study group. Almost all possible treatment alternatives are not only related with the degree of skeletal deformity, but also with the patient's willingness to undergo any necessary treatment protocols, which in most cases involve more than one stage. Skeletal scintigraphy tests are an important factor in estimating bone growth and possible surgical approaches in these disorders., (Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Objective: The pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with cerebral arteriovenous malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age., Methods: All patients with an AVM seen at our institution between 1990 and 2016 who underwent a diagnostic cerebral angiogram were retrospectively reviewed. Draining vein stenosis was measured from angiograms before any treatment. The relationship between venous stenosis and age was assessed., Results: We included 281 patients (mean age 39 years, age range 3-83 years, 55% male). Venous stenosis measuring ≥50% was present in 59 patients (21% of cohort). Peak age at presentation was 25-29 years, whereas peak frequency of venous stenosis ≥50% was 50-54 years. Venous stenosis was present in a significantly higher proportion of patients ≥50 years versus <50 years (P = 0.03). Mean percentage stenosis was significantly higher in patients ≥50 years versus <50 years (32% vs. 22%, P = 0.001)., Conclusions: Clinically significant cerebral AVM draining vein stenosis appears to be associated with older age, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. These results should be confirmed with a population-based longitudinal study., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: We sought to describe the novel technique and report the outcomes of cervical spondylotic radiculopathy caused by facet joint hyperplasia treated with minimally invasive surgery by laminar and lateral mass screw cofixations., Method: In this retrospective study, patients with spondylotic radiculopathy caused by facet joint hyperplasia underwent this technique in our unit between January 2010 and June 2015. Hospital charts, magnetic resonance imaging studies, and follow-up records for all the patients were reviewed. Outcomes were assessed on the basis of neurologic status, magnetic resonance imaging, and visual analog scale for neck and radicular pain and by the short form-36 health survey questionnaire., Results: Thirteen men and 5 women, aged 47-73 years (mean, 61.8 years), were included in this study. The follow-up time ranged from 19-50 months (mean, 32.4 months). The mean visual analog scale scores for radicular pain and neck pain, as well as the scores for all 8 domains of the short form-36 health survey questionnaire, showed significant improvements (P < 0.05). Cervical lordosis showed bending, whereas the height of the targeted disk segment showed no change (P > 0.05). Complications included 2 cases of neck pain that lasted for 3 months., Conclusion: Minimally invasive surgery by lamina and lateral mass screw cofixation is safe and effective for the treatment of cervical spondylotic radiculopathy caused by facet joint hyperplasia. In addition to sufficient decompression, this technique provides relative stability to the cervical spine., (Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: The clinical significance of the extent of tissue prolapse (TP) after percutaneous coronary intervention (PCI) for long-term outcomes remains undetermined. This study investigated the relationship between the quantities of TP immediately after PCI and neointimal hyperplasia (NIH) at follow-up on serial optical coherence tomography (OCT) examination., Methods: We evaluated 145 native coronary lesions (89 lesions with stable angina pectoris [SAP] and 56 with acute coronary syndrome [ACS]). OCT was performed to examine pre-PCI plaque morphologies at the narrowest culprit sites, post-PCI TP area in each cross-sectional area (CSA) and TP volume throughout the stented segments, 9-month follow-up NIH area in each CSA and NIH volume throughout the stented segments. We investigated the relationships between the quantities of TP and NIH and their differences according to clinical presentation., Results: ACS lesions had a larger TP area at the narrowest culprit sites (0.39 [0.14-0.85] vs. 0.11 [0.00-0.32] mm 2 , P<0.001) and at the most protruding sites (0.51 [0.24-1.08] vs. 0.21 [0.10-0.52] mm 2 , P<0.001) compared with SAP lesions. In ACS lesions, TP area was correlated with NIH area at the culprit sites (r=0.283, P=0.042) and at the most protruding sites (r=0.288, P=0.038). In SAP lesions, TP area was correlated with NIH area at the most protruding sites (r=0.244, P=0.030), but not at the culprit sites., Conclusions: The extent of TP immediately after PCI was quantitatively related to the degree of NIH at 9-month follow-up on serial OCT examination. The quantities of TP might influence long-term stent outcomes., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Several investigations have been conducted to evaluate the off-target effects of ticagrelor. The aim of the present study was to evaluate the off-target effects of ticagrelor such as neointimal formation and endothelial function after drug-eluting stent implantation in a porcine restenosis model., Methods: A total of 30 pigs were randomly allocated based on the following P2Y 12 inhibitor: (1) clopidogrel 300mg loading plus 75mg maintenance (n=10); (2) prasugrel 60mg loading plus 10mg maintenance (n=10); (3) ticagrelor 180mg loading plus 180mg maintenance (n=10). In each group, zotarolimus-eluting stents were implanted in the proximal portion of the left anterior descending artery and left circumflex artery. One month after stenting, the animals underwent follow-up angiography, endothelial function assessment, optical coherence tomography (OCT) and histopathological analysis., Results: Regarding vasomotor responses to acetylcholine infusion, there were significant vasoconstrictions to maximal acetylcholine infusion in the clopidogrel and prasugrel group compared with those in the ticagrelor group. The mean neointimal area were significantly lower in the ticagrelor group (1.0±0.3 by OCT, 0.9±0.3 by histology), than in the clopidogrel (1.8±0.7, p=0.003, 1.6±0.8, p=0.030) and prasugrel (1.8±0.5, p=0.001, 1.5±0.5, p=0.019) groups. Percentages of moderate to dense peri-strut inflammatory cell infiltration were significantly lower in the ticagrelor group (9.0%) compared with the clopidogrel (17.3%, p<0.001) and prasugrel groups (15.7%, p=0.002). There were no significant differences in all findings between clopidogrel and prasugrel groups., Conclusions: Compared to clopidogrel and prasugrel, ticagrelor reduced neointimal formation, endothelial dysfunction, and peri-strut inflammation., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Purpose: To analyse the correlation between the level of activity measured in the single photon emission computed tomography (SPECT) and the pathological findings in patients with condylar hyperplasia (CH)., Materials and Methods: All patients evaluated in our department between 2007 and 2014 with a diagnosis of condylar hyperplasia who had undergone SPECT, evidenced signs of activity, and had undergone surgery were included. We included 28 patients, of whom 20 were women and 8 men., Results: The male:female ratio was 2,5:1. The mean age of the subjects was 24.4 years at the time of diagnosis (with a range between 14 and 42 years). In 19 cases the affected condyle was the right, and in the remaining 9 it was the left (ratio R:L 2,1:1). On the SPECT, in 16 patients a high level of activity was identified (57.1%) and in the remaining 12 a low level (42.9%). Only 13 patients (6 in the low-activity group and 7 in the high-activity group) presented with islands of cartilage. When comparing the results between the two groups, the main differences were observed in the parameters related to the islands of cartilage. These were more frequent in the group with high activity compared with low activity (5.5 versus 0 per mm 2 of median). Besides being more frequent, these islands were larger (more than double) in the high-activity group (385.1 μm versus 169.7 μm of median). This is the only statistically significant difference found, a fact that can be explained by the small sample size in the study., Conclusion: Radioisotope tests are the best indicator of the level of activity in condylar hyperplasia, which seems to be directly related to the intensity signal collection., (Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Objective: The objectives of this study were to investigate the application and differential diagnostic value of safranin O staining, safranin-fast green staining, and Runt-related transcription factor 2 (Runx2) immunohistochemistry with regard to condylar hyperplasia and condylar osteochondroma., Study Design: Histopathologic presence was evaluated by using hematoxylin and eosin staining, safranin O staining, safranin-fast green staining, and immunohistochemistry of Runx2 in postoperative specimens of normal condyle (control), condylar hyperplasia, and condylar osteochondroma., Results: Safranin O staining clearly highlighted the tissue structure of the condylar cartilage, especially the hypertrophic layer. The safranin-fast green method showed a contrast in staining between cartilage and subchondral cancellous bone in the condyle specimens. Both methods were better than hematoxylin and eosin staining for morphologically distinguishing condylar hyperplasia and condylar osteochondroma. The expression of Runx2 in condylar hyperplasia was significantly greater than that in condylar osteochondroma., Conclusions: This study indicated that safranin O staining and safranin-fast green staining are effective staining methods to differentiate between condylar hyperplasia and condylar osteochondroma. Immunohistochemistry findings suggested that Runx2 is valuable in the differential diagnosis of these two diseases., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: Three-dimensional quantification of asymmetry in UCH has not been reported yet, but would be useful for diagnosing and evaluating the degree of deformity in this disease. It enables profound decision-making and timing of surgery. Unilateral condylar hyperplasia (UCH) can subjectively be classified in hemimandibular elongation (HE), hemimandibular hyperplasia (HH) and a combination of these two (hybrid form). The main purpose of this study was to quantify mandibular asymmetry in UCH patients with a reliable and reproducible method. Secondly, it was evaluated whether the existing classification can be confirmed., Materials and Methods: 37 UCH-patients with progressive mandibular asymmetry, supported by a positive bone scan and/or such clinical progression that condylectomy was performed, were included in this retrospective study. A group of healthy subjects, matched for age and gender, was used as the control group. Cone-beam computed tomography (CBCT) scans were imported in Maxilim ® software. Each mandibular half was divided into three skeletal segments (condyle, ramus, and body). Linear and volumetric measurements were calculated for these skeletal units on the affected and unaffected side, for both patients and controls., Results: Significant differences between affected and unaffected sides in the patient group were found in condylar, ramus, and body segments for linear (p < 0.01) as well as for volumetric quantitative measurements (p < 0.0040). A mean linear difference between affected and unaffected sides in the condylar region of the UCH patient group was found of 3.6 mm (sd 2.9) versus 0.2 mm (sd 1.5) in controls. For volumetric measurements there was a mean difference between the left and right condyle of 718 mm 3 (sd 638) in the patient group versus 8 mm 3 (sd 225) difference in the control group. The condyle was the most affected segment. Differences between sides were significantly larger in the patient group than in the control group (p < 0.001). It was not possible to objectify differences between HE and HH., Conclusion: CBCT is a useful and accurate modality for quantification and evaluation of mandibular asymmetry in UCH. It enables objective monitoring. The existing classification in HE and HH could not be confirmed., (Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: Management recommendations for lobular neoplasia (LN) including lobular carcinoma-in-situ (LCIS) and atypical lobular hyperplasia (ALH) diagnosed in core biopsies (CB) are controversial. Our aim was to prospectively identify a subset of patients who do not require subsequent surgical excision (SE)., Patients and Methods: All patients diagnosed with LN on CB were enrolled and referred for SE. Cases with coexistent ductal carcinoma-in-situ or invasive carcinoma were excluded. Cases with coexistent ductal atypia (LN-DA) and LCIS variants (LN-V) were separated from pure classic LN (LN-C). Dedicated breast pathologists and radiologists reviewed cases with careful imaging/pathology correlation., Results: Of 13,772 total percutaneous breast CB procedures, 302 of 370 patients diagnosed with LN underwent SE. Upgrade to carcinoma was present in 3.5% (8/228) LN-C, 26.7% LN-V (4/15), and 28.3% LN-DA (15/53). Calcifications were the imaging target for 180 (79%) of 228 LN-C cases; 7 were associated with upgrade (3.9%). Upgrades were rare for mass lesions (1/32) and magnetic resonance imaging-targeted lesions (0/14). Upgrades were similar for ALH and LCIS (3.4% vs. 4.5%). During postsurgical follow-up (mean, 34.5 months), 6.5% LN-C patients developed carcinoma in either breast., Conclusion: Although LN with nonclassic morphology or with associated ductal atypia requires SE, this can be avoided in LN-C diagnosed on CB targeting calcifications when careful imaging/pathology correlation is applied. Until larger numbers are studied, excising LN-C diagnosed as masses or magnetic resonance imaging-detected lesions may be prudent. Regardless of their selection for surgical management, LN patients need close surveillance in view of their long-term risk of breast cancer., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To evaluate outcomes of benign concordant magnetic resonance imaging (MRI)-guided breast biopsy., Methods: We retrospectively reviewed 611 consecutive MRI-guided breast core biopsies at our institution from 2005 to 2012. Benign concordant cases with MRI follow-up constituted the study group. Lesion appearance on follow-up MRI was assessed and the false-negative rate was calculated., Results: Eighty-four lesions in 68 women underwent benign concordant MRI-guided biopsy with subsequent MRI follow-up. Mean time to first follow-up MRI was 10.5 months. Two false negatives were identified on follow-up at 8 and 26 months., Conclusions: We report a false-negative rate of MRI-guided breast biopsy of 2.4%., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) is a rare condition of the rectosigmoid colon that primarily affects middle-aged men. IMHMV typically presents as proctosigmoiditis and often requires surgical resection due to complications throughout the protracted clinical course. It can be differentiated from idiopathic chronic inflammatory bowel disease by histopathologic examination of surgically resected colon specimens. This report describes a rare case of IMHMV presenting as left hemicolitis in a 64-year-old male. We also describe potentially distinguishing computed tomographic and angiographic findings that may aid in the diagnosis of IMHMV., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: Lobular intraepithelial neoplasia (LIN) diagnosed on image-guided biopsy may be associated with an undiagnosed cancer. This is called under-diagnosis. The consequence is that management of these lesions is often surgical. But many surgeries finally are unnecessary. The aim of our study was to define criteria to avoid unnecessary surgery., Materials and Methods: This is a single-center, retrospective after a database collected prospectively study. Fourteen thousand biopsies were analyzed, including 456 diagnosed NLI. Under-diagnosis rates were analyzed according to many criteria. The average duration of following was 45 months., Results: For atypical lobular hyperplasia (ALH), we obtained 7.6% under-diagnosis and combining several criteria, we got a low risk of cancer (2%). For LCIS, this rate was 23% and any low-risk group could be identified., Conclusion: ALH with calcifications≤20 mm, without any atypical lesion associated, histologically focal and whose removal is representative may be safely observed. For other LIN, surgery remains indicated., (Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Background: Pulmonary involvement in tuberous sclerosis complex (TSC) includes lymphangioleiomyomatosis (LAM) and multifocal micronodular pneumocyte hyperplasia (MMPH). This retrospective study investigated pulmonary involvement in Japanese TSC patients and pulmonary function testing in TSC-LAM., Methods: The study subjects included 59 TSC patients (age range: 13-66, 15 males and 44 females). Female patients were divided into 3 groups (Group 1: symptomatic LAM, Group 2: asymptomatic LAM, Group 3: without LAM) and 3 cystic grades according to increasing cyst numbers on computed tomography images (patients without LAM, Grade 1 patients, and Grade 2+Grade 3 patients). The results of pulmonary function tests were compared among the groups and the grades., Results: One male (6.7%) patient and 19 female (43.2%) patients were diagnosed with LAM and 7 male (43.2%) and 23 female (52.3%) patients were diagnosed with MMPH. Patients with multiple pulmonary nodules had higher rates of renal angiomyolipoma and history of seizures than patients without nodules. Although all 6 adolescent patients displayed no pulmonary symptoms, MMPH was found in 3 patients and LAM was found in a 13-year-old girl. Carbon monoxide diffusing capacity (DLco) differed significantly among the 3 groups and DLco and carbon monoxide diffusing capacity divided by the alveolar volume (DLco/VA) differed significantly among the 3 cystic grades., Conclusions: There was no difference in the prevalence of pulmonary involvement in TSC patients among countries. LAM and MMPH occur even during adolescence in TSC patients. DLco and the number of cysts are useful predictors of onset and progression of TSC-LAM., (Copyright © 2015 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.)

Purpose: The aim of this study was to compare the reliability and correlations with age and gender of two nuclear medicine tests used for diagnosis of active condylar hyperplasia, namely, planar bone scintigraphy versus single photon emission computed tomography (SPECT)., Material and Method: This was a descriptive observational study carried out in 61 patients (38 women and 23 men) clinically diagnosed as having facial asymmetry and suspected unilateral condylar hyperplasia. The patients had both planar bone scintigraphy and SPECT diagnostic imaging as well as reference data of the percentage of (99)Tc(m) MDP (methylenediphosphonate) uptake in the condyle, clivus, and fourth lumbar vertebra (L4), respectively, for SPECT and planar scintigraphy calculations. Radioactive counts were measured per region of interest and the respective ratios were calculated. The age range of the patients was 13-50 years (mean ± standard deviation = 21.16 ± 8.75). The two groups were compared by a nonparametric (Mann-Whitney U test. Uptake percentage and delta values had normal distribution and consequently were compared by a Student t test., Results: A total of 61 anterior planar images and 61 SPECT images were compared. Eight patients presented high uptake in planar bone scintigraphy images (13.11%), while 32 patients (52.46%) had high uptake with SPECT. The prevalence of condylar hyperactivity was higher in women than in men both for right condyle (ratio 4:3) and for left condyle (10:1) and the prevalence was significantly higher for the right condyle., Conclusion: The study indicates that SPECT is more sensitive to identify condylar hyperactivity as compared to planar bone scintigraphy in patients with clinical presumptive diagnostic of condylar hyperplasia., (Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: Gallbladder adenoma is a pre-cancerous neoplasm and needs surgical resection. It is difficult to differentiate adenoma from other gallbladder polyps using imaging examinations. The study aimed to illustrate characteristics of contrast-enhanced ultrasound (CEUS) and its diagnostic value in gallbladder adenoma., Methods: Thirty-seven patients with 39 gallbladder adenomatoid lesions (maximal diameter ≥10 mm and without metastasis) were enrolled in this study. Lesion appearances in conventional ultrasound and CEUS were documented. The imaging features were compared individually among gallbladder cholesterol polyp, gallbladder adenoma and malignant lesion., Results: Adenoma lesions showed iso-echogenicity in ultrasound, and an eccentric enhancement pattern, "fast-in and synchronous-out" contrast enhancement pattern and homogeneous at peak-time enhancement in CEUS. The homogenicity at peak-time enhancement showed the highest diagnostic ability in differentiating gallbladder adenoma from cholesterol polyps. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Youden index were 100%, 90.9%, 92.9%, 100%, 95.8% and 0.91, respectively. The characteristic of continuous gallbladder wall shown by CEUS had the highest diagnostic ability in differentiating adenoma from malignant lesion (100%, 86.7%, 86.7%, 100%, 92.9% and 0.87, respectively). The characteristic of the eccentric enhancement pattern had the highest diagnostic ability in differentiating adenoma from cholesterol polyp and malignant lesion, with corresponding indices of 69.2%, 88.5%, 75.0%, 85.2%, 82.1% and 0.58, respectively., Conclusions: CEUS is valuable in differentiating gallbladder adenoma from other gallbladder polyps (≥10 mm in diameter). Homogeneous echogenicity on peak-time enhancement, a continuous gallbladder wall, and the eccentric enhancement pattern are important indicators of gallbladder adenoma on CEUS.

Objective: The objective of the study was to describe the imaging appearances of diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) on computed tomography (CT)., Materials and Methods: Electronic medical records were searched for patients with pathology-proven DIPNECH who had a CT available for review. Eleven patients were included., Results: The most common finding on CT was small pulmonary nodules which were present in all patients and were multiple (≥5) in 7/11 patients. Other CT findings included mosaic pattern attenuation and bronchial wall thickening/bronchiectasis., Conclusion: DIPNECH should be considered as a diagnostic possibility when multiple small pulmonary nodules are identified on CT, particularly if there is an associated carcinoid tumor., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objectives: Breast hamartoma is an uncommon breast tumor that accounts for approximately 4.8% of all benign breast masses. The pathogenesis is still poorly understood and breast hamartoma is not a well-known disorder, so its diagnosis is underestimated by clinicians and pathologists. This study was designed to present our experience with breast hamartoma, along with a literature review., Method: We reviewed the demographic data, pathologic analyses and imaging and results of patients diagnosed with breast hamartoma between December 2003 and September 2013., Results: In total, 27 cases of breast hamartoma operated in the Ankara University Medicine Faculty's Department of General Surgery were included in the study. All patients were female and the mean age was 41.8±10.8 years. The mean tumor size was 3.9±2.7 cm. Breast ultrasound was performed on all patients before surgery. The most common additional lesion was epithelial hyperplasia (22.2%). Furthermore, lobular carcinoma in situ was identified in one case and invasive ductal carcinoma was observed in another case. Immunohistochemical staining revealed myoid hamartoma in one case (3.7%)., Conclusion: Breast hamartomas are rare benign lesions that may be underdiagnosed because of the categorization of hamartomas as fibroadenomas by pathologists. Pathologic examinations can show variability from one case to another. Thus, the true incidence may be higher than the literature indicates.

Diagnostics of high-risk breast lesions have increased these last years with the augmentation of breast percutaneous biopsies. They are lesions that confer an enlarged risk of breast cancer, either because of an increased probability of finding cancer after open surgery, a possible evolution toward in situ or invasive cancer, or because of an increased probability of developing breast cancer over the long term. Much progress has been made these last years in their histological diagnostic, classification and pathogenesis. Nevertheless, no consensus exists to date on the management of these "high-risk" lesions. In particular, surgical indications and follow-up modalities remain controversial for each histological type. In this review, the principal factors that could impact surgical decision and long-term follow-up are discussed with areas of controversy highlighted.

Intravascular papillary endothelial hyperplasia was a rare benign vascular proliferative process as a result of papillary proliferation of the endothelial cells within the vessels. To our knowledge, we reported the second case occurring in the madibule, and the first reported in 1984 in the literature. We discussed manifestations of multislice computed tomography and panoramic radiography about the lesion and relevant literature was reviewed., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: This study aimed to establish if women with a diagnosis of flat epithelial atypia (FEA) without residual microcalcifications at stereotactic vacuum-assisted breast biopsy (VABB) could be managed with mammographic follow-up (FU) instead of surgery and to compare 9-gauge and 11-gauge devices., Patients and Methods: From October 2003 to January 2011, 2382 VABB procedures were performed (1373 with 11-gauge and 1009 with 9-gauge). We found 121 cases of pure FEA that were surgically treated: 57 with a 9-gauge device (group 1) and 64 with an 11-gauge device (group 2). The underestimation rate (UR) of malignancy for patients without and those with residual microcalcifications for each VABB device was calculated. Differences between groups were analyzed with the Fischer exact test., Results: The overall UR of FEA was 4% (2 of 57) with the 9-gauge device and 8% (5 of 64) with the 11-gauge device. With a 9-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 46), and the UR for patients with residual microcalcifications was 18% (2 of 11). With an 11-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 39), the UR for patients with residual microcalcifications at post-biopsy mammograms was 16% (5 of 25). With a 9-gauge device, 80% (46 of 57) of patients did not have residual microcalcifications after VABB. With an 11-gauge device, 60% (39 of 64) of patients had no residual microcalcifications after VABB. Differences between the 9-gauge and 11-gauge devices were statistically significant (P < .05)., Conclusion: Women with FEA without residual microcalcifications after VABB can be managed conservatively. Nine-gauge VABB is associated with a lower percentage of residual microcalcifications compared with an 11-gauge device, but it is safe to follow patients with FEA if all calcifications are removed with the core biopsy., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to define the coronoid-condylar index (CCI)., Materials and Methods: The material for studies comprised 26 patients. Thirteen patients were treated for bilateral coronoid hyperplasia. The remaining 13 patients were included in the control group. Based on 3D CT measurements, the coronoidcondylar index (CCI) was calculated and assessed statistically., Results: In patients with coronoid hyperplasia mean CCI was 1.25, while in the control group it was 1.00., Conclusion: The proposed CCI can be used for the evaluation of anomalies of the mandibular coronoid processes.

Objectives: The present study aimed to investigate the effect of smoking on thyroid nodule formation and goiter development in healthy subjects living in Istanbul, an iodine-sufficient region. This study was designed as a prospective, randomized, and observational study., Methods: Included in the study were voluntary hospital staff and relatives of patients between the ages of 28 and 71 who had no known disease or drug use, who have been living in Istanbul and had been smoking more than 10 cigarettes per day for at least 10years. Nonsmoker volunteers (45) shared similar demographic characteristics and were matched for age to the (46) smokers. By means of thyroid ultrasounds performed in all participants, volumes of the right and left lobes of the thyroid gland, and number, diameter and characteristics of nodules were evaluated., Results: Comparing the smokers and nonsmokers, no statistically significant difference was determined in terms of presence of nodules and volumes of the left and right thyroid lobes (P=0.68, P=0.09, and P=0.63, respectively). Making enhanced diffuse enlargement of the thyroid gland, but not to a statistically significant degree. Smoking was observed to have no effect on non-toxic nodules, or the levels of thyroid-stimulating hormone, free thyroxin, free triiodothyronine, anti-thyroid peroxidase, or anti-thyroglobulin antibodies., Conclusions: Smoking does not effect, to a statistically significant degree goiter development thyroid nodule formation in iodine-sufficient regions like Istanbul., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Introduction: From 1998 to 2002, we performed a trial of prospective limited resection for pulmonary ground-glass opacity lesions 2 cm or smaller. This is the second report on the long-term outcome., Methods: The enrollment criteria of the trial were as follows: pulmonary peripheral nodule less than 2 cm, diagnosis or suspected diagnosis of clinical T1N0M0 carcinoma with ground-glass opacity and lack of evident pleural indentations or vascular convergence on high-resolution computed tomography. Limited-resection (wedge or segment) specimens were intraoperatively examined by frozen section. If the nodule was confirmed as Noguchi type A or B with a resection margin of greater than 1 cm, the incision was sutured and the patient followed up. The median surveillance period was 10 years., Results: In a total of 50 enrolled participants, there were two Noguchi type A, 23 type B and 15 type C adenocarcinomas; five atypical adenomatous hyperplasias, four fibroses, and one granuloma. Although there were no patients with recurrence within the first 5 years, in four patients who underwent limited-resection pulmonary adenocarcinoma developed more than 5 years after the initial resection, of either cut-end recurrence or metachronous primary disease., Conclusions: Of 26 patients who underwent limited resection, adenocarcinoma developed in four after more than 5 years. These were possibly cut-end recurrences. We concluded that 5 years is not a sufficient period for follow-up, and that limited resection should still be done only in a trial setting, even for small ground-glass opacity lesions.

Background: Changes in out-stent plaque volume can be related to in-stent intimal hyperplasia. However, few data exist regarding the impact of out-stent plaque volume on in-stent intimal hyperplasia., Methods: We prospectively performed volumetric intravascular ultrasound in 46 stable coronary patients (34 males, mean age of 66 years) immediately as well as 18 months after stenting. From the high-gain ultrasound images, out-stent plaque volume was calculated by extracting the stent volume from the external elastic membrane volume. Volumes of in-stent intimal hyperplasia and reference plaque were also evaluated., Results: Out-stent plaque volume increased from 177.3 ± 100.8mm(3) to 190.7 ± 111.1mm(3) (p<0.05) in correlation with increases in-stent intimal hyperplasia (r=0.536, p<0.05). Under these conditions, changes in reference plaque volume correlated with those in LDL-C, which decreased from 121.2 ± 48.0mg/dl to 103.3 ± 48.9 mg/dl (r=0.43, p<0.05). Interestingly, increases in out-stent plaque volume in the silorimus-eluting stent (2.7 ± 1.2%) were lesser than those in the bare-metal stent (14.0 ± 11.0%, p<0.05)., Conclusions: These results indicate that irrespective of LDL-C level, changes in out-stent plaque volume correlate with those in in-stent intimal hyperplasia. We suggest that silorimus-eluting stent can suppress in-stent intimal hyperplasia partially by affecting out-stent plaque, although further large-scale studies are required to define the role of out-stent plaque in the occurrence of in-stent intimal hyperplasia., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Sonographic texture analysis can reflect histopathological components and their arrangement in metastatic and common benign lymph nodes. It is helpful in differentiation between metastatic and benign lymph node lesions for target selection during biopsy of multiple lymph nodes and the strategy of the management. Two ultrasound systems, 107 sonographic regions of interest (ROIs) of metastases and 174 sonographic ROIs of common benign lymph nodes, were recruited in the study. Thirteen texture features derived from co-occurrence matrix were used in characterization of above ROI ultrasound images. Support vector machine (SVM) was used as a classifier and a feature selector. The experimental results show that the entropy gains the best cross-validation accuracy of 94.66% and 87.73% in both ultrasound systems 1 and 2 for the classification of metastatic and benign lymph nodes disease. The accuracy can be further increased to 97.86% and 100% by the combination of the sum average in the study. There are significantly higher entropy and sum average values of the metastatic lymph nodes than of the benign lymph nodes, which are due to the heterogeneous compositions and arrangement of larger cancer cells, lymphocytes, and stroma in metastatic lymph nodes that contrast with simple inflammatory cells infiltration in common benign lymph nodes., (Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.)

Background: Recombinant granulocyte-colony stimulating factor (G-CSF) mobilized pluripotent cells from the bone marrow are proposed to have a regenerative potential. Though, a report of excessive instent restenosis, in patients treated with G-CSF before percutaneous coronary intervention (PCI) warrants caution., Methods: Patients (n=59) enrolled in the STEMMI trial, a randomized and double blind study, comparing G-CSF and placebo after large ST-elevation myocardial infarctions, had an intracoronary ultrasound imaging at 6 months follow-up with a quantitative analysis of instent neointimal hyperplasia., Results: During G-CSF treatment leukocyte counts, and CD34+ and CD45-/CD34- cell fractions in peripheral blood increased markedly (p<0.0001 vs. placebo). At follow-up, there were no differences in intracoronary late lumen loss, expressed as neointima volume per mm of stent (1.6 mm(3)± 1.2 [G-CSF group] vs. 1.9 mm(3)± 1.3 [placebo group]; p=0.38), and in minimal instent lumen area (5.4 mm(2)± 2.4 vs. 5.3 mm(2)± 2.6, p=0.90). In the placebo group, plasma concentration of stromal cell-derived factor-1 (SDF-1) increased significantly after STEMI. This SDF-1 response was completely suppressed during G-CSF treatment. A rebound increase of SDF-1 was observed after withdrawal of G-CSF (p=0.001). Plasma concentration of SDF-1 at the time of stent implantation correlated positively to neointimal hyperplasia (p=0.025)., Conclusions: G-CSF treatment, initiated after PCI, does not lead to excessive instent neointimal hyperplasia or restenosis in patients with STEMI. The timing of G-CSF, in relation to the PCI, might be important, as G-CSF influences SDF-1., (Copyright © 2008 Elsevier Ireland Ltd. All rights reserved.)

Background: Mucosal thickening and mucosal antral cyst (MAC) in the maxillary sinus are incidental findings in panoramic radiographs., Methods: The study sample consisted of 5021 participants in a nationally representative Health 2000 Health Examination Survey using panoramic radiography., Results: The prevalence of mucosal thickening was 12% and of MACs 7%, both being twice as frequent in men as in women. Mucosal thickening was most common in the 40- to 49-year age group, whereas MACs were most often seen in younger age groups. Pathologic dental findings and root canal treatments were significantly associated with mucosal thickening but not with MACs. The odds ratios of vertical infrabony pockets were 5.2-fold compared with edentulous., Conclusion: This nationally representative study indicates that dental infections are etiologic for antral mucosal thickening, but not for MACs., (Copyright 2010 Mosby, Inc. All rights reserved.)

Introduction: No standard guidelines detailing recommendations for the selection and treatment for multiple lung nodules with ground-glass opacity (GGO) have been established. For treatment decision, we analyzed epidermal growth factor receptor (EGFR)/K-ras somatic aberrations and pathologic-radiologic correlation in multiple lung nodules presented as GGO to differentiate multifocal lesions from intrapulmonary spread., Methods: Twenty-four patients with multiple lung nodules presented as GGO were identified to investigate somatic mutations of EGFR (exon 18-21) and K-ras (codons 2, 13, and 61). This series included 18 atypical adenomatous hyperplasias (AAH), 15 bronchioloalveolar carcinomas (BAC), and 23 adenocarcinomas (ADC) obtained from 24 patients., Results: High frequency of discordant EGFR mutations (17 of 24, 70.8%) could discriminate tumor clonality (18 of 24, 75%) of multiple lung neoplastic nodules presented as GGO. EGFR mutations were common in AAH (38.9%), BAC (46.7%), and ADC (39.1%). In case 4, AAH and BAC had different mutational changes, and in case 10, the BAC lesion contains EGFR mutation that is not in the invasive ADC. In case 17, the BAC had more mutational changes than the carcinoma. The pure GGO appearance in the radiologic examination corresponded preinvasive pathologic change., Conclusions: This study showed that synchronous BAC and/or ADC can have different EGFR or K-ras mutational profiles suggesting these lesions arise as independent events rather than intrapulmonary spread or systemic metastasis. This has significant implication in staging and treatment. These findings might be a clue to establish guidelines of the multiple neoplastic lung nodules with GGO.

Introduction: Cephalometric radiography is the main investigation used in the diagnosis of maxillofacial deformities. Three-dimensional (3-D) computed tomography (3-D CT) imaging has recently been used in the diagnosis and treatment planning of craniofacial morphology. The purpose of this report was to present the diagnosis and treatment planning of a hemimandibular hyperplasia case by using conventional radiographs and 3-D cephalometric analysis., Methods: A 24-year-old girl presented with hemimandibular hyperplasia and the main complaint was her facial appearance. Conventional cephalometric analysis including lateral and frontal cephalograms were traced by hand and evaluated by the same clinician. Twenty-one measurements on the lateral cephalograms and 13 measurements on the frontal cephalograms were performed. In addition, axial images were reconstructed into a 3-D model by using medical image processing software. Linear and angular measurements were presented in coronal and sagittal planes., Results: The 3-D CT analysis has a superior image quality when compared with conventional cephalograms., Conclusions: The 3-D CT analysis provides more advanced diagnostic image information in evaluating craniofacial morphology. We conclude that 3-D CT images can facilitate the diagnosis, treatment planning, and outcome evaluation of severe asymmetry cases.

Objective: This study compares quantitative analysis of planar bone scintigrams with visual interpretation in patients having unilateral condylar hyperplasia (UCH) and normal control subjects. The possibility of using a bony structure in a region near the condyle as an objective measurement of bone activity is assessed., Study Design: Planar bone scintigrams from 20 subjects suspected of having active UCH were analyzed both qualitatively and quantitatively. Bone activity was assessed in both condyles as well as in reference sites in the cervical spine and the skull. Percentile activities for both condyle regions and ratios using condyle activity versus reference regions were assessed., Results: All UCH patients had unilateral increased activity on qualitative visual interpretation of the bone scan. The mean percentile activities of the affected and unaffected condyles in the UCH group were significantly different at 55.3% and 44.7%, respectively (P < .001). No significant difference was found in the control group, with the ratios between left and right condyle being 49.5% and 50.5%, respectively (P = .46). In the ratios between the region of interest (ROI) in the condyles versus the ROIs selected for the cervical spine and the skull, a significant difference was noticed in the UCH group; however, there was a considerable overlap between condyle and reference ROI ratios. Symmetrical uptake of diphosphonate reliably excluded continued asymmetrical growth of the condyles., Conclusions: Quantitative analysis of planar scintigrams in unilateral condylar hyperplasia patients was not found to be superior to qualitative visual interpretation of the scans. Because of a considerable overlap in condyle/reference ROI ratios, quantified ratios did not seem to be clinically helpful in the differentiation of a hyperplastic condyle from a normal condyle. In the case of unilateral increased condylar uptake of diphosphonate, clinical assessment is mandatory.

We evaluated the ultrasonographic findings and performed ultrasonography-guided fine-needle aspiration biopsy of a newly detected nodule in the thyroid bed of 38 patients with postoperative thyroid carcinoma. Detection of a marginal irregularity, microcalcification, or a shape not parallel to the surrounding tissue plane might allow the identification of recurrent thyroid carcinoma from other benign pathologies mimicking local tumor recurrence.

It is difficult to distinguish multiple primary lung cancers from pulmonary metastasis. We experienced a case of surgically resected lung tumors that showed multiple ground-glass opacities on thoracic computed tomographic scan. There were eight nonsolid and two part-solid ground-glass opacities in the bilateral lungs. Surgical resection was performed because all tumors had a ground-glass opacity appearance on computed tomographic scan, which is compatible with a finding of primary lung adenocarcinoma. The postoperative pathologic diagnoses were two cases of invasive adenocarcinoma, six cases of bronchioloalveolar carcinoma, and eight cases of atypical adenomatous hyperplasia. The patient remains alive without any evidence of recurrence 40 months after surgery. A ground-glass opacity appearance on computed tomographic scan could be interpreted as supportive evidence for multiple primary lung adenocarcinoma rather than pulmonary metastases.