Postoperative spino-pelvic stereoradiography to predict adjacent segment disease.

PURPOSE: The purpose of this study was to identify sagittal spinopelvic parameters predictive of adjacent segment disease (ASD) on postoperative whole spine weight-bearing stereoradiography. MATERIALS AND METHODS: A total of 84 patients with previous spinal fusion surgery and documented radiological follow-up with early weight-bearing postoperative whole spine stereoradiography (EOS® Imaging System) were retrospectively included. A pathological group of 42 patients (9 men, 33 women; mean age, 63.1±11.5 [SD] years) who developed documented ASD (mean follow-up, 76.75 months; range: 31.5-158.5 months) was compared with a control group of 42 asymptomatic patients (7 men, 35 women; mean age, 60.9±11.8 [SD] years) (mean follow-up, 115 months; range: 60-197 months) based on sagittal balance evaluation and routinely used spino-pelvic parameters. Comparisons were made using uni- and multivariate analyses. RESULTS: At univariate analysis, patients with ASD had an anteriorly displaced sagittal vertical axis (CAM plumb line) and an inadequate lumbar lordosis (LL) in reference to pelvic incidence (PI) compared to controls. They also had higher C7 slope and C2-C7 offset. At multivariate analysis, C2-C7 offset (OR=1.152; 95% CI: 1.056-1.256; P=0.001) and a lack of LL (OR=5.063; 95% CI: 1.139-22.498; P=0.033) were significantly associated with ASD. CONCLUSION: Anterior cervical imbalance, reflected by an increase in C2-C7 offset and insufficient restoration of LL are postoperative predictive factors of ASD on stereoradiography.

Parametric techniques for characterizing myocardial tissue by magnetic resonance imaging (part 1): T1 mapping. / Técnicas paramétricas de caracterización tisular del miocardio mediante resonancia magnética (parte 1): mapas de T1.

The development of myocardial fibrosis is a common process in the appearance of ventricular dysfunction in many heart diseases. Magnetic resonance imaging makes it possible to accurately evaluate the structure and function of the heart, and its role in the macroscopic characterization of myocardial fibrosis by late enhancement techniques has been widely validated clinically. Recent studies have demonstrated that T1-mapping techniques can quantify diffuse myocardial fibrosis and the expansion of the myocardial extracellular space in absolute terms. However, further studies are necessary to validate the usefulness of this technique in the early detection of tissue remodeling at a time when implementing early treatment would improve a patient's prognosis. This article reviews the state of the art for T1 mapping of the myocardium, its clinical applications, and its limitations.

Parametric methods for characterizing myocardial tissue by magnetic resonance imaging (part 2): T2 mapping.

Cardiac magnetic resonance imaging is considered the reference technique for characterizing myocardial tissue; for example, T2-weighted sequences make it possible to evaluate areas of edema or myocardial inflammation. However, traditional sequences have many limitations and provide only qualitative information. Moreover, traditional sequences depend on the reference to remote myocardium or skeletal muscle, which limits their ability to detect and quantify diffuse myocardial damage. Recently developed magnetic resonance myocardial mapping techniques enable quantitative assessment of parameters indicative of edema. These techniques have proven better than traditional sequences both in acute cardiomyopathy and in acute ischemic heart disease. This article synthesizes current developments in T2 mapping as well as their clinical applications and limitations.

Hepar lobatum carcinomatosum associated with liver metastases from breast cancer: report of five cases.

BACKGROUNDS AND AIMS: Hepar lobatum carcinomatosum (HLC) is an exceptional acquired hepatic distortion which consists in irregularly lobulated hepatic contours seen in patients with known liver metastases, usually from breast carcinoma. We aimed to describe and analyze five similar cases of HLC resulting from metastatic mammary carcinoma in the liver and associated with rapid hepatic failure. METHODS: Five cases of HLC were investigated. Medical (including blood liver tests), radiological and histological data (2 cases) were collected and retrospectively analyzed. All patients were followed up for metastatic invasive ductal carcinoma of the breast and had a common pattern of treatment with combination of targeted therapies (bevacizumab, AVASTIN) and chemotherapy (paclitaxel, TAXOL). RESULTS: All the patients showed rapid hepatic failure after a mean of 9 courses of bevacizumab/paclitaxel. In all cases, liver imaging revealed liver capsule retraction and an irregular lobular margin. An apparent tumor regression of all liver metastases was showed in two cases. Biopsies were consistent with sinusoidal obstruction syndrome (SOS) and, surprisingly, no tumoral cells were found. CONCLUSION: Although rare, such an unusual pattern of liver metastasis may mimick acute cirrhosis and cause rapid hepatic failure in patients, despite possible apparent tumor regression on imaging. The etiology of this pathology is unclear, and may involve multiple pathogenic factors. Direct or indirect vascular injury plays an important role in the development of HLC.

Interest of contrast-enhanced sonography to identify focal nodular hyperplasia with sinusoidal dilatation.

BACKGROUND AND AIMS: Focal nodular hyperplasia with major sinusoidal dilatation (FNH-sd) is a misleading entity, with some features resembling inflammatory hepatocellular adenoma (HCA). We aimed to assess the performance of contrast-enhanced ultrasound (CEUS) for the diagnosis of FNH-sd. METHODS: Four histologically proven FNH-sd nodules in four patients were investigated with both MRI and CEUS imaging. Sinusoidal dilatation was focally visible in all cases in histology. RESULTS: In MRI, in all the four cases, lesions were hypervascular in arterial phase, with high intensity in T2-weighted sequence imaging and persistent enhancement in the delayed gadolinium-enhanced phase. These MRI features were more indicative of HCA than FNH. On the other hand, CEUS showed a very specific centrifugal filling followed by a strong, homogeneous enhancement of the whole lesion. CONCLUSION: CEUS seems to be an essential step for the diagnosis of non-typical FNH, such as FNH-sd. This small series highlights the interest of performing both CEUS and MRI for the diagnosis of atypical focal liver lesions, such as FNH-sd.

Utilización de bolos ruminales de liberación de sulfametazina sódica en el control de la coccidiosis ovina / The use of sodium sulfamethazine sustained-release ruminal bolus in the control of ovine coccidiosis / Utilização de bolos ruminais de liberação de sulfametazina sódica para ocontrole de coccidiose ovina

Se evaluó el efecto de bolos intrarruminales de liberación de sulfametazina sódica en el control de la coccidiosis ovina. Se utilizaron 60 corderos machos y hembras en dos sistemas de alimentación: pastoreo intensivo con encierro nocturno en corral y engorda en corral con granos. Los animales se dividieron en 4 grupos: Corral-Bolo (CB, n=20); Corral-Sin Bolo (CSB, n=l0); Pastoreo-Bolo (PB, n=20) y Pastoreo-Sin Bolo (PSB, n= 10). Se evaluó quincenalmente el efecto del tratamiento sobre la ganancia promedio de peso (GP), la eliminación de ooquistes y se identificaron las especies de Eimeria involucradas. No se demostraron diferencias en la GP entre los animales de los grupos PB= 0.32kg y PSB= 0.2kg (p< 0.65) y sí en los grupos CB= 3.3lkg y CSB= 4.28kg (P<0.02). La eliminación de ooquistes fue menor en los grupos que recibieron el bolo: CB:428 y PB:844 ooq./g que en los grupos CSB:2l69 y PSB:1533 ooq./g heces (P<0.009), lo que indica que el bolo logró controlar la parasitosis. Las especies de Eimeria presentes en los animales de corral fueron: E. ovina 30%, E. ovinoidalis 24%, E. granulosa 16% y E. parva 15%, otras especies 7%. En los animales en pastoreo E. ovinoidalis 28%, E. ovina 22%, E. granulosa 15% y E. parva 10%, otras especies 8%. Al final del experimento se presentaron diferencias relativas en las especies identificadas en los diferentes grupos, indicando que la condición de alimentación y el tratamiento con el bolo afectó cuantitativamente la parasitosis y la proporción de las especies involucradas

ABSTRACT: The effect of the sodium intraruminal bolus of sulphamethazine release was evaluated in the control of ovine coccidiosis. Sixty Columbia breed lambs, males and females, were employed in two feed condition systems: intensive grazing withnight coffi n and grain fattening yard system. The animals were divided in four groups: grain yard with bolus (CB, n=20); grain yard without bolus (CSB, n=10); grazing with bolus (PB, n=20) and grazing without bolus (PSB, n=10). Lambs were weighed and fecal samples were taken at the beginning of the experiment and four times afterward fortnightly. Body weight gain (BWG) and oocysts elimination were measured in treated and control animals and Eimeria species were characterized. BWG differences were demonstrated between CB= 3.31kg and CSB= 4.28kg groups (P<0.02); no differences occurred between grazing groups PB=0.32kg and PSB=0.2kg (p<0.65). Oocysts elimination was minor in bolus treated animals in the two conditions, CB:428and PB:844 ooq./g against CSB:2169 and PSB:1533 ooq./g feces (P<0.009), indicating a benefi cial effect of bolus treatment over parasitoids. Eimeriaspecies identifi ed before the treatment in yard lambs were: E. ovina 30%, E. ovinoidalis 24%, E. granulosa 16% and E. parva 15%, other species 7%. In grazing animals were: E. ovinoidalis 28%, E. ovina 22%, E. granulosa 15% and E. parva 10%, other species 8%. At the end of the experiment changes in these relatives proportion were observed suggesting that alimentation conditions and treatment modify quantitatively and qualitatively the parasite.

RESUMO: Avaliou-se o efeito de bolos intrarruminais de liberação de sulfametazina sódica no controle de coccidiose ovina. Foram utilizados 60 cordeiros machos e fêmeas em dois sistemas de alimentação: pastoreio intensivo diurno com recolhimento noturno em aprisco e engorda em confi namento, com grãos. Os animais foram divididos em quatro grupos: Confi namento-Bolo (CB, n=20); Confi namento-Sem Bolo (CSB, n=10); Pastoreio-Bolo (PB, n=20) e Pastoreio-Sem Bolo (PSB, n=10). Avaliou-se quinzenalmente o efeito do tratamento sobre o ganho médio de peso (GP), a eliminação de oocistos e identifaram-se as espécies de Eimeria envolvidas. Não se demostraram diferenças no GP entre os animais dos grupos PB= 0,32kg e PSB= 0,2kg (p< 0,65), e sim nos grupos CB= 3,31kg e CSB= 4,28kg (P<0,02). A eliminação de oocistos foi menor nos grupos que receberam o bolo: CB: 428e PB:844 ooc/g que nos grupos CSB:2169 e PSB:1533 ooq/g de fezes (p<0,009), indicando que o bolo controlou a parasitose. As espécies de Eimeria presentes nos animais confi nados foram: E. ovina 30%, E. ovinoidalis 24%, E. granulosa 16% e E. parva 15%, outras espécies 7%. Nos animais em pastoreio E. ovinoidalis 28%, E. ovina 22%, E. granulosa 15% e E. parva 10%, outras espécies 8%. Ao fi nal do experimento, observaram-se diferenças relativas nas espécies identifi cadas nos diferentes grupos, indicando que a condição de alimentação e o tratamento com o bolo afetou quantitativamente a parasitose e a proporção de espécies envolvidas

Immunochemical analysis of vesicular monoamine transporter (VMAT2) protein in Parkinson's disease.

The vesicular monoamine transporter (VMAT2) has been suggested to be an excellent marker of presynaptic dopaminergic nerve terminals in the striatum of Parkinson's disease patients based on its high level of expression and insensitivity to drugs used to treat the disease. Previous in vivo imaging and postmortem binding studies have detected a loss in striatal VMAT2 binding in Parkinson's diseased (PD) brain; however, these techniques have poor spatial resolution and may suffer from nonspecific binding of some ligands. In this study, we use novel polyclonal antibodies to distinct regions of human VMAT2 to quantify and localize the protein. Western blot analysis demonstrated marked reductions in VMAT2 immunoreactivity in putamen, caudate, and nucleus accumbens of PD brain compared to control cases. Immunohistochemistry revealed VMAT2 immunoreactive fibers and puncta that were dense throughout the striatum of control brains, but which were drastically reduced in putamen of PD brains. In PD brains the caudate showed a significant degree of sparing along the border of the lateral ventricle and the nucleus accumbens was relatively preserved. The distribution of VMAT2 in striatum and its loss in PD paralleled that of the dopamine transporter (DAT), a phenotypic marker of dopamine neurons. Thus, immunochemical analysis of VMAT2 protein provides novel and sensitive means for localizing and quantifying VMAT2 protein and nigrostriatal dopamine terminals in PD. Furthermore, the relative expression of VMAT2 compared to that of DAT may predict the differential vulnerability of dopamine neurons in PD.

[In vitro comparison of antifungal activity of oxiconazole and econazole against yeast.]. / Comparación in vitro de la acción antifúngica del oxiconazol y el econazol frente a levaduras.

Oxiconazole was compared in vitro with econazole in tests with 400 yeasts strains. Tests were performed by measurement of growth inhibition by both microdilution in Sabouraud broth and a Shadomy' agar diffusion systems. The sensitivity/resistance percentages were similar in Candida albicans strains. Oxiconazole showed a higher activity than that of econazole in Candida spp. and yeasts other than Candida.

Immunochemical analysis of dopamine transporter protein in Parkinson's disease.

The plasma membrane dopamine transporter (DAT) is considered to be a reliable marker of presynaptic dopaminergic terminal loss. Previous in vivo imaging and postmortem binding studies have detected a loss in striatal DAT binding in Parkinson's diseased (PD) brain; however, these techniques have poor spatial resolution and may suffer from nonspecific binding of some ligands. In this study, we use novel highly specific monoclonal antibodies to distinct epitopes of human DAT to quantify and localize the protein. Western blot analysis revealed marked reductions in DAT immunoreactivity in putamen, caudate, and nucleus accumbens of PD brain compared with control cases, and the reductions were significantly correlated to disease duration. Immunohistochemistry revealed DAT-immunoreactive fibers and puncta that were dense throughout the striatum of control brains but that were drastically reduced in putamen of PD brains. Caudate from PD brains showed a significant degree of sparing along the border of the ventricle, and the nucleus accumbens was relatively preserved. An unexpected finding was that discrete islands of DAT immunoreactivity were preserved within the matrix of PD putamen. Thus, immunological analysis of DAT protein provides novel and sensitive means for localizing and quantifying DAT protein in PD and other neurological disorders involving dopaminergic systems.