Objective To evaluate a noninvasive vessel encoded imaging for selective mapping of the flow territories of the left and right internal carotid arteries and vertebral-basilar arteries. Methods Seven volunteers [(33.5±4.1) years ; 3 men, 4 women] and 6 patients [(55.2 ± 3.2) years; 2 men,4women] were given written informed consent approved by the institutional review board before participating in the study. A pseudo-continuous tagging pulse train is modified to encode all vessels of interest. The selectivity of this method was demonstrated. Regional perfusion imaging was developed on the same arterial spin labeling sequence. Perfusion-weighted images of the selectively labeled cerebral arteries were obtained by subtraction of the labeled from control images. The CBF values of hemisphere, white matter, and gray matter of volunteers were calculated. The vessel territories on patients were compared with DSA. The low perfusion areas were compared with high signal areas on T2-FLAIR. Results High SNR maps of left carotid, right carotid, and basilar territories were generated in 8 minutes of scan time. Cerebral blood flow 100 g-1 were in agreement with data in the literature. Vessel encoded imaging in patients had a good agreement with DSA. The low perfusion areas were larger than high signal areas on T2-FLAIR. Conclusion We present a new method capable of evaluating both quantitatively and qualitatively the individual brain-feeding arteries in vivo.

INTRODUCTIONRoad traffic accidents (RTAs) in Singapore involving children were evaluated, with particular focus on the epidemiology, surrounding circumstances and outcomes of these accidents. Key factors associated with worse prognosis were identified. We proposed some measures that may be implemented to reduce the frequency and severity of such accidents.

METHODSThis was a retrospective study of RTAs involving children aged 0-16 years who presented to the Children's Emergency at KK Women's and Children's Hospital, Singapore, from January 2011 to June 2014. Data was obtained from the National Trauma Registry and analysed in tiers based on the Injury Severity Score (ISS).

RESULTSA total of 1,243 accidents were reviewed. RTA victims included motor vehicle passengers (60.4%), pedestrians (28.5%), cyclists (9.9%) and motorcycle pillion riders (1.2%). The disposition of emergency department (ED) patients was consistent with RTA severity. For serious RTAs, pedestrians accounted for 63.6% and 57.7% of Tier 1 (ISS > 15) and Tier 2 (ISS 9-15) presentations, respectively. Overall use of restraints was worryingly low (36.7%). Not restraining increased the risk of serious RTAs by 8.4 times. Young age, high ISS and low Glasgow Coma Scale score predicted a longer duration of intensive care unit stay.

CONCLUSIONThe importance of restraints for motor vehicle passengers or helmets for motorcycle pillion riders and cyclists in reducing morbidity requires emphasis. Suggestions for future prevention and intervention include road safety education, regulation of protective restraints, use of speed enforcement devices and creation of transport policies that minimise kerbside parking.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Automobiles ; Bicycling ; Child ; Child, Preschool ; Female ; Head Protective Devices ; Humans ; Infant ; Infant, Newborn ; Injury Severity Score ; Male ; Motorcycles ; Pedestrians ; Prognosis ; Registries ; Retrospective Studies ; Severity of Illness Index ; Singapore ; epidemiology ; Wounds and Injuries ; epidemiology

The mucosal immune system defends against a vast array of pathogens, yet it exhibits limited responses to commensal microorganisms under healthy conditions. The oral-pharyngeal cavity, the gateway for both the gastrointestinal and respiratory tracts, is composed of complex anatomical structures and is constantly challenged by antigens from air and food. The mucosal immune system of the oral-pharyngeal cavity must prevent pathogen entry while maintaining immune homeostasis, which is achieved via a range of mechanisms that are similar or different to those utilized by the gastrointestinal immune system. In this review, we summarize the features of the mucosal immune system, focusing on T cell subsets and their functions. We also discuss our current understanding of the oral-pharyngeal mucosal immune system.
Epithelium ; immunology ; Humans ; Immunity, Cellular ; Immunity, Mucosal ; immunology ; Mouth Diseases ; immunology ; Mouth Mucosa ; immunology ; Pharynx ; immunology ; T-Lymphocyte Subsets ; classification ; immunology

OBJECTIVE: Anger attacks have been observed in patients with obsessive-compulsive disorder (OCD), often triggered by obsessional triggers. However, few studies have reported the clinical characteristics and correlates of anger attacks among Chinese patients with OCD. METHODS: A total of 90 adults with a primary diagnosis of OCD, ranging from 15 to 78 years old, participated in the study. Participants were administered the Rage Outbursts and Anger Rating Scale (ROARS), Yale-Brown Obsessive-Compulsive Scale-Second Edition, and Brown Assessment of Beliefs Scale by a trained clinician. Patients completed the Obsessive-Compulsive Inventory-Revised and Depression Anxiety Stress Scale-21. RESULTS: A total of 31.3% of participants reported anger outbursts in the past week, and ROARS scores had no significant correlation with age, duration of illness, OCD severity, depression, or stress. However, ROARS scores were negatively related to education level, and positively related to obsessing symptoms and anxiety. CONCLUSIONS These data suggest that anger attacks are relatively common in Chinese patients with OCD. The severity of anger attacks is related to educational level, obsessing symptoms, and anxiety, which may be a latent variable reflecting executive functioning and emotion regulation skills.
Adolescent ; Adult ; Age Factors ; Anger ; China ; Depression/complications* ; Emotions ; Executive Function ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/psychology* ; Regression Analysis ; Severity of Illness Index ; Stress, Psychological ; Young Adult