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Abstract Background This study aims to investigate whether the neurometabolites of the anterior cingulate cortex (ACC) were distinct in patients with active and inactive juvenile idiopathic arthritis (JIA) using the proton magnetic resonance spectroscopy. Methods We measured the levels of total N-acetylaspartate (tNAA), choline (Cho), myo-inositol (ml), glutamate (Glu) and the complex of glutamate and glutamine (Glx) relative to total creatine (tCr) in ACC of each participant. Results Compared with the healthy controls, a significant decrease of total Cho/tCr and Glx/tCr ratio in ACC occurred in active and inactive JIA group. The tCho/Cr level was negatively associated with the serum level of ESR in active JIA patients. There was no difference in NAA/tCr ratio among the three groups, which may imply that no neuron and axonal losses occurred in either active or inactive JIA patients. Conclusions The abnormal neurometabolites in tCho/tCr and Glx/tCr in ACC may indicate that persistent dysfunction of glial cell, while neither neuron nor axonal losses occurred in active and inactive JIA patients.

Due to the low incidence of rare EGFR mutation, its response to EGFR-TKI has not been fully investigated. L747P is a rare EGFR mutation in EGFR exon 19. Previous case reports showed that patients with EGFR L747P mutation responded to afatinib treatment. However, we encountered a patient with EGFR L747P who was resistant to afatinib but responded to dacomitinib. It is the first case report of the effective application of dacomitinib in a patient with L747P mutation and BMS, and the efficacy of BMS achieved PR.

OBJECTIVES: 1) To deduce T2, the inverse of the transverse relaxation rate (R2), in the hippocampus of healthy adults; 2) to investigate the brain iron deposition in Alzheimer's disease (AD) patients and age-matched healthy controls using T2-values. METHODS: T2-weighted data from the bilateral-hippocampi of ten AD patients and sixty healthy controls were collected at six echo time points using multi-slice multi-echo turbo spin echo (MSME-TSE) imaging on a 3.0 T MR-scanner, followed by the neuropsychological testing. The correlations between T2-values and Mini-Mental State Examination (MMSE) scores were investigated on group-wise basis (covariates in the group-wise analyses: gender, age, side and healthy/AD). RESULTS: There were no significant differences in hippocampal T2-values on intra-gender and inter-gender basis (P > 0.05). Hippocampal T2-values of both sides were similar (right: 85.2±2.4 milliseconds; left: 85.3±2.5 milliseconds). The bilateral hippocampal T2 values correlated moderately with age (right: r = -0.59; left: -0.58; P < 0.001). The AD-group had significantly lower T2-values in the hippocampus when compared to normal controls (P < 0.001) and such low T2-values had a strong positive correlation with the MMSE score (R (2) = 0.97; P < 0.05). CONCLUSION: Patients with AD showed significantly lower T2 values, which can be attributed to the increased iron depositions in the hippocampus. A positive correlation between T2-values and cognition scores suggests that quantitative T2 can be used in the early diagnosis of AD and in the monitoring of the treatment response.