Multiple bilateral submandibular gland sialolithiasis

Sialolithiasis accounts for the most common etiology of salivary gland obstruction which leads to recurrent painful swelling of the involved gland which often exacerbates while eating. Stones may be encountered in any of the salivary glands but most frequently in the submandibular gland and its duct. Simultaneous sialolithiasis in more than one salivary gland is rare, occurring in fewer than 3% of cases. Seventy to 80% of cases feature solitary stones; only about 5% of patients have three or more stones, the case report which we are presenting here had three submandibular sialoliths involving both the submandibular glands which were removed by intraoral approach and no post‑operative complications were noted.Key words: Bilateral, multiple, sialolithiasis, submandibula

Association between Variants of the Leptin Receptor Gene (LEPR) and Overweight: A Systematic Review and an Analysis of the CoLaus Study

BACKGROUND: Three non-synonymous single nucleotide polymorphisms (Q223R, K109R and K656N) of the leptin receptor gene (LEPR) have been tested for association with obesity-related outcomes in multiple studies, showing inconclusive results. We performed a systematic review and meta-analysis on the association of the three LEPR variants with BMI. In addition, we analysed 15 SNPs within the LEPR gene in the CoLaus study, assessing the interaction of the variants with sex. METHODOLOGY/PRINCIPAL FINDINGS: We searched electronic databases, including population-based studies that investigated the association between LEPR variants Q223R, K109R and K656N and obesity- related phenotypes in healthy, unrelated subjects. We furthermore performed meta-analyses of the genotype and allele frequencies in case-control studies. Results were stratified by SNP and by potential effect modifiers. CoLaus data were analysed by logistic and linear regressions and tested for interaction with sex. The meta-analysis of published data did not show an overall association between any of the tested LEPR variants and overweight. However, the choice of a BMI cut-off value to distinguish cases from controls was crucial to explain heterogeneity in Q223R. Differences in allele frequencies across ethnic groups are compatible with natural selection of derived alleles in Q223R and K109R and of the ancient allele in K656N in Asians. In CoLaus, the rs10128072, rs3790438 and rs3790437 variants showed interaction with sex for their association with overweight, waist circumference and fat mass in linear regressions. CONCLUSIONS: Our systematic review and analysis of primary data from the CoLaus study did not show an overall association between LEPR SNPs and overweight. Most studies were underpowered to detect small effect sizes. A potential effect modification by sex, population stratification, as well as the role of natural selection should be addressed in future genetic association studies

Sparse Representation of Brain Aging: Extracting Covariance Patterns from Structural MRI

An enhanced understanding of how normal aging alters brain structure is urgently needed for the early diagnosis and treatment of age-related mental diseases. Structural magnetic resonance imaging (MRI) is a reliable technique used to detect age-related changes in the human brain. Currently, multivariate pattern analysis (MVPA) enables the exploration of subtle and distributed changes of data obtained from structural MRI images. In this study, a new MVPA approach based on sparse representation has been employed to investigate the anatomical covariance patterns of normal aging. Two groups of participants (group 1∶290 participants; group 2∶56 participants) were evaluated in this study. These two groups were scanned with two 1.5 T MRI machines. In the first group, we obtained the discriminative patterns using a t-test filter and sparse representation step. We were able to distinguish the young from old cohort with a very high accuracy using only a few voxels of the discriminative patterns (group 1∶98.4%; group 2∶96.4%). The experimental results showed that the selected voxels may be categorized into two components according to the two steps in the proposed method. The first component focuses on the precentral and postcentral gyri, and the caudate nucleus, which play an important role in sensorimotor tasks. The strongest volume reduction with age was observed in these clusters. The second component is mainly distributed over the cerebellum, thalamus, and right inferior frontal gyrus. These regions are not only critical nodes of the sensorimotor circuitry but also the cognitive circuitry although their volume shows a relative resilience against aging. Considering the voxels selection procedure, we suggest that the aging of the sensorimotor and cognitive brain regions identified in this study has a covarying relationship with each other

Seizure prediction : ready for a new era

Acknowledgements: The authors acknowledge colleagues in the international seizure prediction group for valuable discussions. L.K. acknowledges funding support from the National Health and Medical Research Council (APP1130468) and the James S. McDonnell Foundation (220020419) and acknowledges the contribution of Dean R. Freestone at the University of Melbourne, Australia, to the creation of Fig. 3.Peer reviewe

Development of an integrated haptic system for simulating upper gastrointestinal endoscopy

Virtual reality together with haptics offers immersive and flexible platforms for training doctors in medical procedures. In this paper, we present mechanical design, control, integration, and user-studies of a virtual reality-based haptic simulator for Upper Gastrointestinal (GI) endoscopy. The design overcomes some of the limitations of the existing systems. First, there is an extra degree of freedom for simulating junctions controlled by sphincter muscles in addition to translational and rotational degrees of freedom along and about the axis of the endoscope-tube. Second, the force-feedback is continuous over a longer range in all three degrees of freedom. Third, multiple insertions and removals of the tube are made possible with a magnetically actuated snap-fit mechanism. A Dynamics based feed-forward control algorithm is developed and characterized for fidelity and transparency. The system provides continuous force up to 11 N in the axial direction and continuous torque up to 255 mN.m about the axial direction. The haptic device is integrated with a physics-based Virtual Reality (VR) interface. Furthermore, an immersion study was conducted using the integrated system with a cohort of novice and experienced clinicians. The haptic response and virtual model were rated high and improvements were suggested for graphical visualization and physical arrangement

Pyopneumothorax with Stocker type III congenital cystic adenomatoid malformation in a 5-month-old infant

Congenital cystic adenomatoid malformation (CCAM) is a rare, developmental, hamartomatous abnormality of the lung characterized by a cessation of normal bronchiolar maturation, resulting in cystic overgrowth of the terminal bronchioles. We report one such case of CCAM in a 5-month-old female infant who was in perfect health until she suffered from spontaneous pyopneumothorax with type III CCAM of the lung and recovered after lobectomy