Comparisons of diagnostic performance and the reliability in identifying ACL injury between two measuring protocols of anterior tibial subluxation on MR images.

OBJECTIVES: To evaluate the diagnostic performance in identifying an anterior cruciate ligament (ACL) injury and the reliability between two measuring protocols of anterior tibial subluxation (ATS). MATERIALS AND METHODS: A total of 165 patients with ACL injury and 157 ACL-intact patients were included in this study. Two different measuring protocols of ATS were performed on sagittal MR images, including the modified protocol using the longitudinal tibial axis (axis protocol) and the established protocol using a line perpendicular to the tibial plateau (plateau protocol). Receiver-operating characteristic (ROC) curves were calculated to evaluate the diagnostic performance in identifying an ACL injury, and areas under the curves (AUCs) were compared between the two protocols. Intra- and interobserver reliability tests were performed to evaluate the reliability of the measurements. RESULTS: Lateral ATS (P < 0.001) and medial ATS (P < 0.001) were increased in patients with ACL injury under both protocols. To identify an ACL injury, ATS measured under the axis protocol showed higher AUC values than the plateau protocol, including lateral ATS (AUC 0.828 vs. 0.688, P < 0.001), medial ATS (AUC 0.829 vs. 0.789, P = 0.013), and the combined indicator of lateral and medial ATS (AUC 0.885 vs. 0.810, P < 0.001). Reliability tests showed that both protocols were reliable. CONCLUSIONS: ATS measured under the modified protocol using the longitudinal tibial axis showed superior diagnostic performance in identifying an ACL injury compared to the established protocol, indicating that the modified protocol may better reflect the characteristics of an ACL-deficient knee.

Sebaceous carcinoma of the right palate: case report and literature review.

Considering the low incidence rates of primary sebaceous carcinoma (SC) of extraorbital sites, let alone those occur in intraoral sites, clinicopathological characteristics and histogenesis are not fully understood. In the present case, a maxillary mass was presented and a low-grade malignant tumor was suspected according to the CT scans, preoperative FNA, and clinical conditions. Other carcinomas, including acinar cell carcinoma (ACC), basaloid cell carcinoma (BCC), SCC, mucoepidermoid carcinoma, and epithelial-myoepithelial carcinoma (EMC), were also considered before surgery. Due to the rare occurrence of SC and no preoperative suspects, a fresh sample was not kept. Sadly, thus cause those special stains (e.g., Oil Red O and Sudan IV) which form the primary basis for a diagnosis of SC in academic circles were missing. A comprehensive literature review identified only 10 cases of intraoral SC, of which the primary sites reported in the English literature were the buccal mucosa, mouth floor, upper labial mucosa, and tongue. Due to an absence of specific biomarkers and simulated characters, histochemistry and immunohistochemistry such as PAS, CK, EMA, p63, p53, S-100, calponin, CD117, Ki-67, a-SMA, and AR form the diagnostic standard of SC. Postoperative immunohistochemistry of our case showed S100(-), Ki-67(-), calponin(-), CD117(-), CK20(-), PAS(-), AR(+), CK(+), CK5/6(+), P53(+), P63(+), a-SMA (+). Thus the diagnosis of SC was finally made. Through discussing the findings of our case and reviewing literature, we present the histological features and discuss possible outstanding biomarkers of this neoplasm.

Combination of liver graft sonographic grading and point shear wave elastography to reduce early allograft dysfunction after liver transplantation.

OBJECTIVE: To analyze the performance of a liver graft sonographic grading system and point shear wave elastography (PSWE) in predicting early allograft dysfunction (EAD) after liver transplantation (LT). METHODS: Successive brain-dead donors and liver recipients in our hospital from March 2017 to May 2018 were retrospectively recruited. All donors underwent PSWE examination, abdominal ultrasonography, and sonographic grading (grade 0 to grade 5). Donors with ≥ 10 valid PSWE examinations and a failure rate of < 60% were included. For all recipients, abdominal ultrasonography and blood tests for biologic parameters were performed preoperatively and daily postoperatively to screen for EAD. The recipients and their grafts were classified into EAD and non-EAD groups. Statistical analyses were performed to analyze the correlations among liver stiffness (LS), liver graft sonographic grading, and EAD. RESULTS: Thirty-two donors and 32 corresponding liver recipients were enrolled (15 cases in the EAD group; 17 in the non-EAD group). There were no grade 0, 1, or 2 cases in the two groups. For prediction of EAD in recipients after LT, the AUC for PSWE was 0.929 and the AUC for combination of PSWE and sonographic grading system was 0.935. CONCLUSIONS: Combination of PSWE and sonographic grading system can predict postoperative EAD in LT recipients with high sensitivity. Abnormal results may suggest a need for liver biopsy preoperatively, thus avoiding unnecessary surgical preparation for liver procurement. KEY POINTS: • Combination of PSWE with new sonographic grading system is useful for preoperative evaluation of liver grafts from brain-dead donors. • EAD is as a criterion for evaluating the diagnostic value of PSWE and sonographic grading system. • Combination of PSWE and sonographic grading system can predict postoperative EAD in LT recipients with high sensitivity.

[The protection effects of resveratrol on irradiated human pneumonic cell lines and its mechanism].

OBJECTIVE: This study was to explore whether resveratrol could protect human bronchial epithelial cells (HBE) and human fetal lung fibroblasts (MRC5) from radiation injury and to investigate its potential HBE and MRC5 were divided into four groups: Group 1 (Vehicle), control group, only mechanism. METHODS: treated with vehicle; Group 2 (resveratrol, Res), the resveratrol group, treated with 5 micromol/L resveratrol; Group 3 (RT+Vehicle), the X-ray irradiation group, only subjected to irradiation of 20 Gy X-ray; Group 4 (RT+Res), the combination therapy group, 2 hours before X-ray treatment (20 Gy, 8. 33 Gy/min for 144 s), 5 micromol/L resveratrol was added to the cells. Several experimental methods were used to observe cellular morphology, ultrastructure, viability, DNA damage, apoptosis, and to determine the change of oxidative stress indexes such as reactive oxygen species (ROS), malondialdehyde (MDA), total glutathione (GSH) and superoxide dismutase (SOD). RESULTS: X-ray could induce HBE and MRC5 cell injury. Resveratrol could significantly ease the morphological and ultrastructure injury, relieve the decrease of cellular viability and the damage of DNA, and reduce cellular apoptosis. Besides, oxidative stress indexes including ROS, MDA, GSH, SOD were improved by resveratrol after irradiation. CONCLUSION: Resveratrol protect HBE and MRC5 from radiation injury, which is related to the alleviation of oxidative stress injury.