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To compare observer performance of detecting bone metastases between bone scintigraphy, including planar scan and single-photon emission computed tomography, and computed tomography (CT) temporal subtraction (TS). Data on 60 patients with cancer who had undergone CT (previous and current) and bone scintigraphy were collected. Previous CT images were registered to the current ones by large deformation diffeomorphic metric mapping; the registered previous images were subtracted from the current ones to produce TS. Definitive diagnosis of bone metastases was determined by consensus between two radiologists. Twelve readers independently interpreted the following pairs of examinations: NM-pair, previous and current CTs and bone scintigraphy, and TS-pair, previous and current CTs and TS. The readers assigned likelihood levels to suspected bone metastases for diagnosis. Sensitivity, number of false positives per patient (FPP), and reading time for each pair of examinations were analysed for evaluating observer performance by performing the Wilcoxon signed-rank test. Figure-of-merit (FOM) was calculated using jackknife alternative free-response receiver operating characteristic analysis. The sensitivity of TS was significantly higher than that of bone scintigraphy (54.3% vs. 41.3%, p = 0.006). FPP with TS was significantly higher than that with bone scintigraphy (0.189 vs. 0.0722, p = 0.003). FOM of TS tended to be better than that of bone scintigraphy (0.742 vs. 0.691, p = 0.070). Sensitivity of TS in detecting bone metastasis was significantly higher than that of bone scintigraphy, but still limited to 54%. TS might be superior to bone scintigraphy for early detection of bone metastasis. • Computed tomography temporal subtraction was helpful in early detection of bone metastases. • Sensitivity for bone metastasis was higher for computed tomography temporal subtraction than for bone scintigraphy. • Figure-of-merit of computed tomography temporal subtraction was better than that of bone scintigraphy.

To assess whether temporal subtraction (TS) images of brain CT improve the detection of suspected brain infarctions. Study protocols were approved by our institutional review board, and informed consent was waived because of the retrospective nature of this study. Forty-two sets of brain CT images of 41 patients, each consisting of a pair of brain CT images scanned at two time points (previous and current) between January 2011 and November 2016, were collected for an observer performance study. The 42 sets consisted of 23 cases with a total of 77 newly developed brain infarcts or hyperdense artery signs confirmed by two radiologists who referred to additional clinical information and 19 negative control cases. To create TS images, the previous images were registered to the current images by partly using a non-rigid registration algorithm and then subtracted. Fourteen radiologists independently interpreted the images to identify the lesions with and without TS images with an interval of over 4 weeks. A figure of merit (FOM) was calculated along with the jackknife alternative free-response receiver-operating characteristic analysis. Sensitivity, number of false positives per case (FPC) and reading time were analyzed by the Wilcoxon signed-rank test. The mean FOM increased from 0.528 to 0.737 with TS images (p < 0.0001). The mean sensitivity and FPC improved from 26.5% and 0.243 to 56.0% and 0.153 (p < 0.0001 and p = 0.239), respectively. The mean reading time was 173 s without TS and 170 s with TS (p = 0.925). The detectability of suspected brain infarctions was significantly improved with TS CT images. • Although it is established that MRI is superior to CT in the detection of strokes, the first choice of modality for suspected stroke patients is often CT. • An observer performance study with 14 radiologists was performed to evaluate whether temporal subtraction images derived from a non-rigid transformation algorithm can significantly improve the detectability of newly developed brain infarcts on CT. • Temporal subtraction images were shown to significantly improve the detectability of newly developed brain infarcts on CT.

A case of exostosis at the inferior border of the mandible was reported. The patient was a 66-year-old woman who complained chiefly of painless swelling at the inferior border of the left mandible. Physical examination disclosed a firm and hard mass, adhering to the inferior surface of the mandible. Roentogenograms of the mandible disclosed a cylindric, radiopaque appearance, which extended outward beyond the normal inferior border of the left mandible. The clinical diagnosis was exostosis. Surgical removal of the bony mass was done under local anestl-esia. The bony mass was about 6 mm in diameter and 12 mm in length. Its histopathological diagnosis was also exostosis. Generally, exostosis is not a rare disease, but such cylinder shaped exostosis occurring at the inferior border of the mandible as seen in this case was extremely rare. And we could not find out the cause of the lesion in this case.The patient was last seen about two years after the operation and no evidence of further trouble was found clinically and roentogenologically at that time.

Pycnodysostosis first described by Aoike (1954) and named by Marouteaux and Lamy (1962), is a rare skeletal bone disease. This disease is characterized by dwarfism, failure of closure of cranial sutures, obliquity of mandibular angle and defects of the terminal phalanges.A rare case of pycnodysostosis in 42 year-old woman complicated with maxillary and mandibular osteomye-litis for a long time was reported. This patient suffered severe osteomyelitis following a tooth extraction because of extremely high bone density and abnormal dentition. We discussed the treatment of osteomyelitis associated with pycnodysostosis.

Secondary bone grafting of alveolar clefts has been performed in 109 cleft palate patients, 55 boys and 54 girls, using the autogenous particulate cancellous bone and marrow of the iliac bone. The patients age range was 8 years 2 months to 28 years 8 months, with a mean age of 12 years 11 months.Before the bone grafting, any malocculusion of the maxillary segments were corrected with orthodontic treatment. Operation was done with simultaneous correction of alveolar clefts and oral-nasal fistulas.The incision made along the clefts margin of the labial site, mucoperiosteal flap was developed.Mucoperiosteum of the fistula was dissected and separated the palatal and nasal portion with scissors. The mucoperiosteum were closed with stiches in each.At this point, nasal and palatal layers of mucoperiosteum had been created. Cancellous bone and marrow were packed into any spaces, and placed in the area of the alar base. After an adequate osseous form was obtained, the labial mucoperiosteum was undermined and relaxed, and closed with stiches. But, the cases of great oral-nasal fistulas, labial sulcus flap used closure of the labial and palatal portion of oral-nasal fistula.Secondary bone grafting of alveolar clefts has following benefits to cleft palate patients.1) Stabilization of the maxillary segment.2) Closure of oral-nasal fistulas.3) Support of the slumping alar base of the nose.4) Restoration of alveolar process and dental arch.5) Provision of bone support for unerupted canine.These advantages of secondary bone grafting were results of short term observation, but, in the future, long term observation is necessary.

The development of immune response in rats directed toward EL4 cells, after the injection of EL4 cells suspended in a saline/oil emulsion, was enhanced by the incorporation of Mycobacterium into the saline/oil emulsion; the incorporation of type II collagen into the saline-acetic acid/oil emulsion in concentrations ranging from 0.5-25 micrograms/ml had no apparent effect on the development of immune response. The incorporation of type II collagen into the saline-acetic acid/oil emulsion at higher concentrations (100 micrograms and 1.0 mg/ml) significantly suppressed both the humoral and the cell-mediated immune response. Pretreatment of rats with the maximal subarthritiogenic dose of complete Freund's adjuvant prevented the development of arthritis in response to a subsequent injection of an arthritogenic dose of the same adjuvant, but had no effect on the development of type II collagen-induced arthritis. These observations suggest that adjuvant arthritis and the type II collagen-induced arthritis are distinctly different diseases.

The severity of type II collagen-induced arthritis was found to correlate with the serum titers of anti-type II collagen antibody, but not with cell-mediated immunity to type II collagen. In contrast, no significant levels of either the humoral or the cell-mediated immunity to type II collagen were found in rats with Freund's complete adjuvant-induced arthritis. Pre-treatment of young rats with an oily preparation of type II collagen prevented the development of arthritis in these animals in response to a subsequent injection of oily preparation of type II collagen, but had no effect on the development of arthritis in response to a subsequent injection of Freund's complete adjuvant. It is concluded that while an immune response directed toward the injected type II collagen is responsible for the development of type II collagen arthritis, it does not play an important role in the induction of Freund's adjuvant-induced arthritis.

[(Cycloalkylmethyl)phenyl]acetic acid derivatives and related compounds were synthesized to test their antiinflammatory and analgesic activities. Some of the compounds in this series were found to have good activity in the carrageenan edema test. Among them, sodium 2-[4-[(2-oxocyclopentyl)methyl] phenyl]propionate dihydrate (15) and 2-[4-[(2-oxocyclohexylidene)methyl]phenyl]propionic acid (13b) showed potent analgesic and antiadjuvant arthritis activities with excellent antipyretic properties.

The immunomodulatory properties of RS-2131, 2-[4-(2-oxocyclohexylidenemethyl)phenyl]propionic acid, were studied using normal and autoimmune mice. RS-2131 suppressed the Arthus-type footpad reaction in BALB/c mice when administered orally at the time of immunization with sheep red blood cells, in contrast to indomethacin. This drug also suppressed the direct plaque-forming cell response against sheep erythrocytes in BALB/c mice. Under the same experimental conditions, the percentage ratio of Lyt 2+ cells to Thy 1.2+ cells were increased in the spleen cells. When used in non-immunized normal BALB/c mice, however, RS-2131 produced no effect on the ratio of Lyt 2+ cells to Thy 1.2+ cells in the spleen cells and on the percent distribution of T lymphocyte subsets. In MRL/Mp-lpr/lpr (MRL/lpr) mice, which have been known as a model of autoimmune disease, Lyt 2 cells in the thymus and the lymph node increased on oral treatment with RS-2131. These findings suggest that this drug may induce suppressor T cells only when the immune response in host animals is increased and then results in inhibition of immune responses in mice.