The data demonstrate that rapid intervertebral disk degeneration occurs early in the degenerative cascade, between Pfirrmann grades II and III.

AimsTo evaluate the safety and efficacy of stereotactic radiotherapy (SRT, both stereotactic body RT [SBRT] and fractionated stereotactic RT [FSRT]) in the treatment of patients with recurrent or second primary mediastinal lymph node metastases (R/SP-MLNMs) originating from non-small cell lung cancer (NSCLC).MethodsBetween 10/2006 and 7/2013, patients with R/SP-MLNMsoriginating from NSCLC were enrolled and treated with SRT at our hospital; their data was stored in prospectively-collected database. The enrolled patients were divided into Group A (without prior RT) and Group B (with prior RT). The primary end-point was overall survival (OS). The secondary end-points were the MLNM local control (LC), the time to symptom alleviation, and toxicity using the Common Terminology Criteria for Adverse Events (CTCAE v4.0).ResultsThirty-three patients were treated (16 in Group A with 19 R/SP-MLNMs and 17 in Group B with 17 R/SP-MLNMs). For the entire cohort, the median OS was 25.5 months with a median follow-up of 20.9 months (range, 3.2-82). The 1-year and 3-year actuarial LC rates were 100% and 86%, respectively. Symptom alleviation was observed in 52% of patients, after a median of 6 days (range, 3-18). CTCAE v4.0 ≥ Grade 3 toxicities occurred in 5 patients (15%; all in Group B); among them, Grade 5 in 2 patients.ConclusionsWe recommend exercising extreme caution in using SRT for R/SP-MLNMs in patients who received prior RT (particularly to LN station 7). For patients without previous RT, SRT appears to be safe and efficacious treatment modality; prospective studies are warranted.

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PurposeTo evaluate retinal thickness (RT), retinal volume (RV) and choroidal thickness (ChT) in Chinese children using Cirrus-HD optical coherence tomography (OCT), and assess their associations with spherical equivalent (SE), age and gender.MethodsThis was a prospective study that recruited 193 healthy Chinese children (193 eyes) with no ophthalmic disease history between December 2012 and December 2013. RT and RV were acquired using OCT. Subfoveal ChT (SFCT) and ChT1-mm and 2-mm temporal, nasal, superior and inferior to the fovea were measured manually.ResultsRT in the inner temporal and nasal regionsdiffered significantly between refraction groups (both P<0.05). Significant differences were also found inSFCT andChT 1- and 2-mm inferior to the fovea (all P<0.05). RT differed significantly between males and females in the outer superior region in the emmetropia group (P<0.05). ChT differed significantly between males and females 2-mm temporal to the fovea in the emmetropia group (P<0.05), and 1-mm temporal to the fovea in the mild myopia group (P<0.05). SE correlated positively with RT in the inner temporal (r = 0.230),nasal (r = 0.252) and inferior (r = 0.149) regions (all P<0.05). Age correlated positively with foveolar (r = 0.169), total macular (r = 0.202), inner temporal (r = 0.237), inner nasal (r = 0.248), inner superior (r = 0.378) and inner inferior (r = 0.345) region thicknesses, and with RV (r = 0.207)(all P<0.05). SE correlated positively with SFCT (r = 0.195), and with ChT1-mm temporal (r = 0.167), 1- and 2-mm nasal (r = 0.144 and r = 0.162), 2-mm superior (r = 0.175), and 1- and 2-mm inferior (r = 0.207 and r = 0.238) to the fovea (all P<0.05). Age had no significant association with ChT.ConclusionsSE, age and gender did not influence macular RT and ChT in most regions, and correlations of RT with age and ChT with SE were weak.

WB-DWI is a sensitive, but less specific technique for diagnosis of lymphoma. It is difficult to differentiate lymphomatous from metastatic lymph nodes using WB-DWI. However, it is a valuable imaging modality for staging of patients with malignant lymphoma.