Chordoid Meningioma: Differentiating a Rare World Health Organization Grade II Tumor from Other Meningioma Histologic Subtypes Using MRI.

BACKGROUND AND PURPOSE: Meningiomas are very commonly diagnosed intracranial primary neoplasms, of which the chordoid subtype is seldom encountered. Our aim was to retrospectively review preoperative MR imaging of intracranial chordoid meningiomas, a rare WHO grade II variant, in an effort to determine if there exist distinguishing MR imaging characteristics that can aid in differentiating this atypical variety from other meningioma subtypes. MATERIALS AND METHODS: Ten cases of WHO grade II chordoid meningioma were diagnosed at our institution over an 11-year span, 8 of which had preoperative MR imaging available for review and were included in our analysis. Chordoid meningioma MR imaging characteristics, including ADC values and normalized ADC ratios, were compared with those of 80 consecutive cases of WHO grade I meningioma, 21 consecutive cases of nonchordoid WHO grade II meningioma, and 1 case of WHO grade III meningioma. RESULTS: Preoperative MR imaging revealed no significant differences in size, location, signal characteristics, or contrast enhancement between chordoid meningiomas and other meningiomas. There were, however, clear differences in the ADC values and normalized ADC ratios, with a mean absolute ADC value of 1.62 ± 0.33 × 10(-3) mm(2)/s and a mean normalized ADC ratio of 2.22 ± 0.47 × 10(-3) mm(2)/s in chordoid meningiomas compared with mean ADC and normalized ADC values, respectively, of 0.88 ± 0.13 × 10(-3) mm(2)/s and 1.17 ± 0.16 × 10(-3) mm(2)/s in benign WHO grade I meningiomas, 0.84 ± 0.11 × 10(-3) mm(2)/s and 1.11 ± 0.15 × 10(-3) mm(2)/s in nonchordoid WHO grade II meningiomas, and 0.57 × 10(-3) mm(2)/s and 0.75 × 10(-3) mm(2)/s in the 1 WHO grade III meningioma. CONCLUSIONS: Chordoid meningiomas have statistically significant elevations of ADC and normalized ADC values when compared with all other WHO grade I, II, and III subtypes, which enables reliable preoperative prediction of this atypical histopathologic diagnosis.

Creating a "health connection" between STD services and primary care.

Women's health nurse practitioners may find their practice includes men who present for treatment of sexually transmitted diseases (STD). In seven months, the women's health nurse practitioner at Temple Health Connection treated 70 African-American males for STDs. Seventeen males (24%) were diagnosed with hypertension. Nine of these patients returned for follow-up care with a primary care adult nurse practitioner. Our experience shows it is important to combine STD treatment with accessible primary health care.

The role of ultrasound-induced cavitation in the 'in vitro' stimulation of collagen synthesis in human fibroblasts.

Collagen synthesis by human embryonic fibroblasts in vitro was estimated using a collagenase-sensitivity assay. Collagen synthesis was stimulated by irradiation with ultrasound at a frequency of 3 MHz, a space-time peak intensity of 0.5 Wcm-2, pulsed at a mark-space ratio of 2:8 ms for 5 min at ambient pressure. This stimulation was suppressed by the application of a positive pressure of 2 atmospheres during irradiation of the cells. Increasing the pressure in the absence of ultrasound had no effect on the rate of collagen synthesis in control cells. This stimulation, therefore, appears to be due to ultrasound-induced cavitation, since it is unlikely that increasing the pressure could modify any other ultrasonic parameter. Collagen synthesis is apparently stimulated to the same extent as general protein synthesis.