Impact of injectable chitosan cryogel microspherescaffolds on differentiation and proliferation of adiposederived mesenchymal stem cells into fat cells.

Difficulty in the clinical practice of stem cell therapy is often experienced in achieving desired target tissue cell differentiation and migration of stem cells to other tissue compartments where they are destroyed or die. This study was performed to evaluate if mesenchymal stem cells (MSCs) may differentiate into desired cell types when injected after combined with an injectable cryogel scaffold and to investigate if this scaffold may help in preventing cells from passing into different tissue compartments. MSCs were obtained from fat tissue of the rabbits as autografts and nuclei and cytoplasms of these cells were labeled with BrdU and PKH26. In Group 1, only-scaffold; in Group 2, only-MSCs; and in Group 3, combined stem cell/scaffold were injected to the right malar area of the rabbits. At postoperative 3 weeks, volumes of the injected areas were calculated by computer-tomography scans and histopathological evaluation was performed. The increase in the volume of the right malar areas was more in Group 3. In histopathological evaluation, chitosan cryogel microspheres were observed microscopically within the tissue and the scaffold was only partially degraded. Normal tissue form was seen in Group 2. Cells differentiated morphologically into fat cells were detected in Groups 2 and 3. Injectable chitosan cryogel microspheres were used in vivo for the first time in this study. As it was demonstrated to be useful in carrying MSCs to the reconstructed area, help cell differentiation to desired cells and prevent migration to other tissue compartments, it may be used for reconstructive purposes in the future.

Nonodontogenic mandibular lesions: differentiation based on CT attenuation.

Mandibular lesions are classified as odontogenic and nonodontogenic based on the cell of origin. Odontogenic lesions are frequently encountered at head and neck imaging. However, several nonodontogenic pathologies may also involve mandible and present further diagnostic dilemma. Awareness of the imaging features of nonodontogenic lesions is crucial in order to guide clinicians in proper patient management. Computed tomography (CT) may provide key information to narrow diagnostic considerations. Nonodontogenic mandibular lesions may have lytic, sclerotic, ground-glass, or mixed lytic and sclerotic appearances on CT. In this article, our aim is to present various nonodontogenic lesions of the mandible by categorizing them according to their attenuations on CT.

Abdominal nonparenchymatous cystic lesions and their mimics in children.

Abdominal cystic lesions in children may originate from parenchymatous organs or from nonparencyhmatous structures. Although these lesions have well-described imaging features, proper diagnosis usually depends on the accurate determination of the origin of the lesion. Because large lesions may resemble each other it is difficult to identify the site of origin, which results in a diagnostic dilemma. In this pictorial essay we describe abdominal nonparenchymatous cystic lesions and their mimics arising from parenchymatous organs in children.

An uncommon case of neurofibromatosis type 2: a tribute to the intracranial calcifications.

Neurofibromatosis Type 2 (NF2) is a genetic disorder associated with schwannomas, meningiomas, and ependymomas. Intracranial calcifications, either tumoral or non-tumoral, are relatively lesser known features of NF2. Here, we present a case of NF2, in which the diagnosis was suspected due to the presence of choroid plexus and subependymal calcifications, although no obvious schwannoma or meningioma was detected initially on standard computed tomography or magnetic resonance imaging. This case highlights the importance of further evaluation with appropriate imaging techniques.

Radioguided occult lesion localization versus wire-guided localization for non-palpable breast lesions: randomized controlled trial.

AIM: This prospective randomized clinical study was conducted to compare radioguided occult lesion localization (ROLL) with wire-guided localization to evaluate optimum localization techniques for non-palpable breast lesions. METHODS: A total of 108 patients who were undergoing an excisional biopsy for non-palpable breast lesions requiring pathologic diagnosis were randomly assigned to the ROLL group (n = 56) and wire-guided localization group (n = 52). In the study, patients' characteristics, radiological abnormalities, radiological technique of localization, localization time, operation time, weight of the excised specimen, clearance margins, pathological diagnosis and perioperative complications were assessed. RESULTS: There were no differences between the two groups in terms of age, radiological abnormalities and localization technique (p = non-significant for all). ROLL techniques resulted in 100% retrieval of the lesions; for the wire-guided localization technique, 98%. Both localization time and operation time were significantly reduced with the ROLL technique (p = significant for all). The weight of the specimen was significantly lower in the ROLL group than in the wire-guided localization group (p = significant). The overall complication rate and pathological diagnosis were similar for both groups (p = non-significant for all). Clear margins were achieved in 91% of ROLL patients and in 53% of wire-guided localization patients, and the difference was significant. CONCLUSIONS: The present study indicated that the ROLL technique is as effective as wire-guided localization for the excision of non-palpable breast lesions. In addition, ROLL improved the outcomes by reducing localization and operation time, preventing healthy tissue excision and achieving clearer margins.

Radioguided occult lesion localization versus wire-guided localization for non-palpable breast lesions: randomized controlled trial

AIM: This prospective randomized clinical study was conducted to compare radioguided occult lesion localization (ROLL) with wire-guided localization to evaluate optimum localization techniques for non-palpable breast lesions. METHODS: A total of 108 patients who were undergoing an excisional biopsy for non-palpable breast lesions requiring pathologic diagnosis were randomly assigned to the ROLL group (n = 56) and wire-guided localization group (n = 52). In the study, patients' characteristics, radiological abnormalities, radiological technique of localization, localization time, operation time, weight of the excised specimen, clearance margins, pathological diagnosis and perioperative complications were assessed. RESULTS: There were no differences between the two groups in terms of age, radiological abnormalities and localization technique (p = non-significant for all). ROLL techniques resulted in 100 percent retrieval of the lesions; for the wire-guided localization technique, 98 percent. Both localization time and operation time were significantly reduced with the ROLL technique (p = significant for all). The weight of the specimen was significantly lower in the ROLL group than in the wire-guided localization group (p = significant). The overall complication rate and pathological diagnosis were similar for both groups (p = non-significant for all). Clear margins were achieved in 91 percent of ROLL patients and in 53 percent of wire-guided localization patients, and the difference was significant. CONCLUSIONS: The present study indicated that the ROLL technique is as effective as wire-guided localization for the excision of non-palpable breast lesions. In addition, ROLL improved the outcomes by reducing localization and operation time, preventing healthy tissue excision and achieving clearer margins.

Choanal polyp originating from the cribriform plate.

A choanal polyp (CP) can be defined as a solitary soft tissue lesion that passes through the sinus ostia and extends toward the choana. Although a CP usually originates from the maxillary sinus, unusual origins have been reported. Diagnosis of a CP is made by endoscopic and radiologic examinations. Computed tomography and magnetic resonance imaging are very helpful to detect the origin and the extent of the polyp. Endoscopic examination may as well demonstrate the exact site of CP origin. Functional endoscopic surgery is the treatment of choice. Excision of the CP at the exact location of the origin is generally satisfactory. The prognosis after the surgery is good, and recurrence rate is low. Herein, we present a case of a CP originating from the cribriform plate with its radiologic and surgical findings.

Bronchoscopy is associated with decreased mesenteric arterial flow.

BACKGROUND: We hypothesized that fiberoptic bronchoscopy can contribute to mesenteric ischemia and bacterial translocation. OBJECTIVE: To test this hypothesis we investigated in patients undergoing bronchoscopy mesenteric blood flow and markers in association with ischemia reperfusion injury. PATIENT: Forty-seven consecutive patients requiring diagnostic fiberoptic bronchoscopy were studied. MEASUREMENTS: Parameters evaluated were superior mesenteric artery Doppler sonography, oxidative stress mediators, arterial blood gases, blood cultures pre-fiberoptic bronchoscopy, and 1st, 4th, and 24th hr post-fiberoptic bronchoscopy. MAIN RESULTS: After bronchoscopy; PaO2 decreased by 21.8% +/- 1.5% (range 6-40), and remained low at all time points (p = 0.0001, p = 0.0001, p = 0.008). Flow volume decreased by 38.8% +/- 14.9% (range 6-72), and remained low at 1st and 4th hr (p = 0.0001, p = 0.01). Resistive and pulsatile index increased at 1st hr (p = 0.0001, p = 0.001) and 4th hr (p = 0.018, p = 0.045). Myeloperoxidase and malondialdehyde increased at 1st hr (p = 0.0001) and 4th hr (p = 0.037, p = 0.028). Corresponding glutathione and catalase decreased at 1st hr (p = 0.0001), and glutathione remained significant at 4th and 24th hr (p = 0.0001, p = 0.003). Correlation between flow volume and PaO2 (r = .71, p = 0.0001), myeloperoxidase (r = -.39, p = 0.05), glutathione (r = .41, p = 0.03) was significant. Nine of 47 (19.1%) had fever, and 3 of 47 (6.4%) had gram-negative bacteremia. CONCLUSION: Fiberoptic bronchoscopy is associated with decreased mesenteric blood flow, which may place the patient at risk for mesenteric ischemia and gastrointestinal bacterial translocation.

Choanal polyp originating from the middle turbinate.

Choanal polyps usually originate from the maxillary sinus. Unusual origins such as the sphenoid sinus, ethmoid sinus, nasal septum and hard and soft palate have been reported in the literature. Herein, we report a rare case of choanal polyp originating from the middle turbinate that was removed by an endoscopic surgery technique. The computed tomographic findings are described and the literature is reviewed.

Open-mouth versus closed-mouth radiographs of the nasopharynx in the evaluation of nasopharyngeal airway obstruction.

The open-mouth and closed-mouth nasopharyngeal airway radiographs of 53 children, whose symptomatology score was concordant with nasopharyngeal airway obstruction that may be due to adenoidal enlargement, were taken and, for each radiograph, nasopharyngeal airway/soft palate (NA/SP) ratio was measured and graded using the method of Cohen and Konak. According to the statistical analysis, since closed-mouth views correlated better with the symptomatology score than the open-mouth views, if a radiological measurement is needed to evaluate the nasopharyngeal airway obstruction, closed-mouth views can be chosen.

Comparison of reliabilities of the delayed images of helical renal CT in detecting small renal masses.

The reliabilities of the delayed images of helical computed tomography (CT) in detecting renal mass lesions of 30 mm or less in diameter was compared. Nephrographic, excretory and nephrographic+excretory phase images of all patients were evaluated separately to detect mass lesions of < or = 5 and 5-30 mm. There was not any statistically significant difference in the results of three groups. Nephrographic, excretory and nephrographic + excretory phase images are not different from or superior to each other in lesion detection.

Arachnoid granulations in the transverse sinuses of a patient with ocular melanoma.

Arachnoid granulations show typical imaging features that allow their distinction from dural sinus thrombosis and intrasinus tumor. These features include a mid-lateral transverse sinus location, focality, common adjacent entering superficial veins, origin of attachment, low density on computed tomography (CT), isointensity-hypointensity on T1-weighted magnetic resonance imaging (MRI) and hyperintensity on T2-weighted MRI. We report the CT and MRI findings of incidentally detected bilateral arachnoid granulations in the transverse sinuses of a patient with ocular melanoma.

A case of missing mitral valve leaflet: radiological detection.

Intravascular foreign bodies may be introduced into the circulation as a complication of minimally invasive or interventional techniques, or during cardiac valve surgery. Prosthetic heart valve leaflets have been rarely described as intravascular foreign bodies. Herein we report a case of prosthetic heart valve leaflet embolization to the aortic bifurcation with computed tomography and ultrasonography findings, and the importance of radiographic imaging in the localization of missing leaflet fragment is pointed out.

A case of missing mitral valve leaflet: radiological detection.

Intravascular foreign bodies may be introduced into the circulation as a complication of minimally invasive or interventional techniques, or during cardiac valve surgery. Prosthetic heart valve leaflets have been rarely described as intravascular foreign bodies. Herein we report a case of prosthetic heart valve leaflet embolization to the aortic bifurcation with computed tomography and ultrasonography findings, and the importance of radiographic imaging in the localization of missing leaflet fragment is pointed out.

Disseminated pneumocephalus secondary to an unusual facial trauma.

Pneumocephalus can be secondary to a postintrathecal procedure, sinus fracture, basilar skull fracture, congenital skull defect, neoplasm, gas producing organism, barotrauma, neurosurgery, paranasal sinus surgery, mask or nasal continuous positive-airway pressure. Unusual facial traumas can also be rare causes of pneumocephalus. Here, we present such a case in whom an air compressor tip injury to both eyes led to the disseminated pneumocephalus. We report this rare case with the computed tomography findings and try to explain the possible mechanism of the pnemocephalus.