RESUMEN
BACKGROUND AND GOALS: Magnetic resonance (MR) enterography provides the advantages of conventional enteroclysis and those of cross-sectional imaging. Adequate luminal distension, combined with ultrafast sequences, results in excellent delineation of mural and extramural manifestations of Crohn's disease. Recent technical advances, including ultra-high-field strength MR with its capability to provide fast multiplanar images with excellent soft tissue contrast, are only rarely included in abdominal studies. STUDY: One hundred four consecutive patients with a proved or suspected diagnosis of ileitis terminalis were prospectively selected for MR imaging studies and ileocolonoscopy. The final diagnosis was based on histopathological findings or based on a combined endpoint of clinical, laboratory, endoscopic, and imaging findings. RESULTS: According to the endoscopic examination, stenosis was present in 26 patients (25%) and could be ruled out in 78 patients (75%). Total agreement between MR and endoscopy could be reached in 74 patients (71%). Histology indicated absence of inflammation in 50 patients (48%). MR and endoscopic findings were concordant in 38 patients (76%) and 37 patients (74%), respectively. Corresponding results by ileocolonoscopy were 37 true negative, 29 true positive, 4 false positive, and 12 false negative (sensitivity, 70.7%; specificity, 74%). CONCLUSIONS: MR enterography with a 3.0-T scanner is a powerful tool in the evaluation of ileal diseases, and has therefore made MR enterography the first-line modality at our institution in patients with suspected inflammatory bowel disease.
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Colonoscopía/métodos , Enfermedad de Crohn/diagnóstico , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Anciano , Enfermedad de Crohn/patología , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sensibilidad y Especificidad , Adulto JovenRESUMEN
Natural light with ultraviolet spectrum (UV) influences the birds´ perception, the reflectivity of their plumage and affects bird behavior. Therefore, in Germany, laying hens kept in barns should be provided with daylight inlets. Nevertheless, lighting in laying hen houses with a UV proportion is not common practice and little is known about the detailed effects of UV-A lighting during the entire rearing and production period. The present on-farm study examines the impact of light quality on plumage loss, skin injuries and production parameters of laying hens. Therefore, about 92,000 Lohmann Brown hens with untrimmed beaks were kept on a farm in two different groups. Half of them were housed in a barn containing 10 pens illuminated by additional UV-A light (simulate "daylight spectrum"). The other half in the second barn were equally grouped, but exposed to standard lighting for poultry houses. Health, production parameters and plumage condition were monitored during rearing and production. The study results reveal that additional UV-A light is associated with the occurrence of plumage damage and cannibalistic injuries during production. In all groups, the plumage condition of the hens was intact when the hens started laying and declined with age. Therefore, complex interactions alongside UV illumination, environmental enrichment, feed and feeding strategies as well as other management factors that possibly affected both feather damage and skin injuries must also be taken into account.
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Diabetic retinopathy is a leading cause of adult vision loss and blindness. Much of the retinal damage that characterizes the disease results from retinal vascular leakage and nonperfusion. Diabetic retinal vascular leakage, capillary nonperfusion, and endothelial cell damage are temporary and spatially associated with retinal leukocyte stasis in early experimental diabetes. Retinal leukostasis increases within days of developing diabetes and correlates with the increased expression of retinal intercellular adhesion molecule-1 (ICAM-1) and CD18. Mice deficient in the genes encoding for the leukocyte adhesion molecules CD18 and ICAM-1 were studied in two models of diabetic retinopathy with respect to the long-term development of retinal vascular lesions. CD18-/- and ICAM-1-/- mice demonstrate significantly fewer adherent leukocytes in the retinal vasculature at 11 and 15 months after induction of diabetes with STZ. This condition is associated with fewer damaged endothelial cells and lesser vascular leakage. Galactosemia of up to 24 months causes pericyte and endothelial cell loss and formation of acellular capillaries. These changes are significantly reduced in CD18- and ICAM-1-deficient mice. Basement membrane thickening of the retinal vessels is increased in long-term galactosemic animals independent of the genetic strain. Here we show that chronic, low-grade subclinical inflammation is responsible for many of the signature vascular lesions of diabetic retinopathy. These data highlight the central and causal role of adherent leukocytes in the pathogenesis of diabetic retinopathy. They also underscore the potential utility of anti-inflammatory treatment in diabetic retinopathy.
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Retinopatía Diabética/etiología , Retinopatía Diabética/patología , Inflamación/complicaciones , Inflamación/patología , Animales , Antígenos CD18/genética , Antígenos CD18/metabolismo , Modelos Animales de Enfermedad , Células Endoteliales/metabolismo , Células Endoteliales/patología , Galactosa/sangre , Galactosa/metabolismo , Molécula 1 de Adhesión Intercelular/genética , Molécula 1 de Adhesión Intercelular/metabolismo , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Retina/metabolismo , Retina/patología , Factores de TiempoRESUMEN
BACKGROUND: Highly toxic antimetabolites have gained access to routine clinical use to modulate and reduce the amount of postoperative scarring following glaucomatous filtering procedures. It could be speculated that by combining two different antiproliferative substances with different mechanisms of action total amounts of the substances could be decreased and side effects reduced. METHODS: Twenty-two substances were tested that had antiproliferative effects by acting cytotoxically, inhibiting growth factors, or inducing apoptosis. With combinations of each two substances, cell culture experiments using 3T3 and human Tenon's capsule fibroblasts were performed evaluating cell toxicity, proliferation and migration, the extent of free radicals, and the amount of apoptosis (TUNEL, electron microscopy). The five most potent combinations were used in an animal experiment with rabbits performing filtering procedures. The extent of episcleral scarring was evaluated by histopathology. RESULTS: The results of the various assays revealed consistently strong effects in 5 of the 462 combinations. Of these five combinations, two were highly effective in the rabbit model. Substances with strong effects when applied in combination included staurosporine, mitomycin, and CD95L. CONCLUSIONS: We found synergistic effects in assays that evaluated different aspects of cell function. The amount of scarring in an animal experiment was inhibited to a level comparable with a high single dose of mitomycin. Combination therapy of two antiproliferative acting substances may be a promising concept.