ABSTRACT
It has been demonstrated that melatonin plays important roles in memory improvement and promotes neurogenesis in experimental animals. We examined effects of melatonin on cognitive deficits, neuronal damage, cell proliferation, neuroblast differentiation and neuronal maturation in the mouse dentate gyrus after cotreatment of scopolamine (anticholinergic agent) and melatonin. Scopolamine (1 mg/kg) and melatonin (10 mg/kg) were intraperitoneally injected for 2 and/or 4 weeks to 8-week-old mice. Scopolamine treatment induced significant cognitive deficits 2 and 4 weeks after scopolamine treatment, however, cotreatment of scopolamine and melatonin significantly improved spatial learning and short-term memory impairments. Two and 4 weeks after scopolamine treatment, neurons were not damaged/dead in the dentate gyrus, in addition, no neuronal damage/death was shown after cotreatment of scopolamine and melatonin. Ki67 (a marker for cell proliferation)- and doublecortin (a marker for neuroblast differentiation)-positive cells were significantly decreased in the dentate gyrus 2 and 4 weeks after scopolamine treatment, however, cotreatment of scopolamine and melatonin significantly increased Ki67- and doublecortin-positive cells compared with scopolamine-treated group. However, double immunofluorescence for NeuN/BrdU, which indicates newly-generated mature neurons, did not show double-labeled cells (adult neurogenesis) in the dentate gyrus 2 and 4 weeks after cotreatment of scopolamine and melatonin. Our results suggest that melatonin treatment recovers scopolamine-induced spatial learning and short-term memory impairments and restores or increases scopolamine-induced decrease of cell proliferation and neuroblast differentiation, but does not lead to adult neurogenesis (maturation of neurons) in the mouse dentate gyrus following scopolamine treatment.
Subject(s)
Cognition/drug effects , Dentate Gyrus/drug effects , Melatonin/pharmacology , Neurogenesis/drug effects , Scopolamine/pharmacology , Animals , Cell Differentiation/drug effects , Cell Proliferation/drug effects , Cognitive Dysfunction/drug therapy , Dentate Gyrus/cytology , Male , Memory/drug effects , Mice , Neurogenesis/physiology , Neurons/drug effectsABSTRACT
Selective neuronal death or loss in certain brain regions has been well characterized in animal models of transient global cerebral ischemia. However, selective neuronal death in transient focal cerebral ischemia needs more investigation. Therefore, in this study, we studied selective neuronal death in the striatum (caudate putamen) of rats subjected to 15 or 30 min middle cerebral artery occlusion (MCAO). Neuronal death occurred in the dorsolateral field, not in the medial field in 30 min, not 15 min, MCAO-operated rats 5 days after MCAO using neuronal nuclear antigen immunohistochemistry and Fluoro-Jade B histofluorescence staining. In this group, immunoreactivity of glial fibrillary acidic protein in astrocytes was hardly shown in the dorsolateral field, although the immunoreactivity increased in the medial field. In addition, immunoreactivity of ionized calcium binding adapter molecule 1 in microglia was dramatically increased in the dorsolateral, not in the medial, field only in 30 min MCAO-operated rats. Briefly, these results show that at least 30 min of MCAO can evoke selective neuronal death, astrocytic dysfunction and microglial activation in the dorsolateral field of the rat striatum and suggest that a rat model of 30 min MCAO can be used to investigate mechanisms of neuronal death and gliosis following brief transient focal cerebral ischemic events for acute transient ischemic attack.
Subject(s)
Cell Death/physiology , Corpus Striatum/metabolism , Gliosis/metabolism , Infarction, Middle Cerebral Artery/pathology , Microglia/metabolism , Animals , Astrocytes/metabolism , Astrocytes/pathology , Disease Models, Animal , Infarction, Middle Cerebral Artery/metabolism , Ischemic Attack, Transient/metabolism , Male , Microglia/pathology , Neostriatum/metabolism , Neurons/metabolism , Neurons/pathology , Rats, Sprague-DawleyABSTRACT
Glycogen synthase kinase 3ß (GSK-3ß) is a key downstream protein in the PI3K/Akt pathway. Phosphorylation of serine 9 of GSK-3ß (GSK-3ß activity inhibition) promotes cell survival. In this study, we examined changes in expressions of GSK-3ß and phosphorylation of GSK-3ß (p-GSK-3ß) in the gerbil hippocampal CA1 area after 5 min of transient cerebral ischemia. GSK-3ß immunoreactivity in the CA1 area was increased in pyramidal cells at 6 h after ischemia-reperfusion. It was decreased in CA1 pyramidal cells from 12 h after ischemia-reperfusion, and hardly detected in the CA1 pyramidal cells at 5 days after ischemia-reperfusion. p-GSK-3ß immunoreactivity was slightly decreased in CA1 pyramidal cells at 6 and 12 h after ischemia-reperfusion. It was significantly increased in these cells at 1 and 2 days after ischemia-reperfusion. Five days after ischemia-reperfusion, p-GSK-3ß immunoreactivity was hardly found in CA1 pyramidal cells. However, p-GSK-3ß immunoreactivity was strongly expressed in astrocytes primarily distributed in strata oriens and radiatum. In conclusion, GSK-3ß and p-GSK-3ß were significantly changed in pyramidal cells and/or astrocytes in the gerbil hippocampal CA1 area following 5 min of transient cerebral ischemia. This finding indicates that GSK-3ß and p-GSK-3ß are closely related to delayed neuronal death.
Subject(s)
Astrocytes/enzymology , Brain Ischemia/enzymology , CA1 Region, Hippocampal/enzymology , Gene Expression Regulation, Enzymologic , Glycogen Synthase Kinase 3 beta/biosynthesis , Pyramidal Cells/enzymology , Animals , Astrocytes/chemistry , Astrocytes/pathology , Avoidance Learning/physiology , Brain Ischemia/pathology , CA1 Region, Hippocampal/chemistry , CA1 Region, Hippocampal/pathology , Cell Death/physiology , Gerbillinae , Glycogen Synthase Kinase 3 beta/analysis , Glycogen Synthase Kinase 3 beta/genetics , Male , Pyramidal Cells/chemistry , Pyramidal Cells/pathologyABSTRACT
PURPOSE: The aim of the study was to evaluate the acute adverse events rate and enhancement properties of gadoterate meglumine (Dotarem(®)) and gadobenate dimeglumine (MultiHance(®)) in a small-scale controlled double-blinded study, using inter- and intra-individual comparisons. MATERIALS AND METHODS: Forty-one randomly selected patients were scanned with Dotarem(®). The rate of adverse reactions, qualitative and quantitative image evaluation was performed vs. a control group of 46 patients who underwent MultiHance(®) over the same 1-month time period (population 1), and 27 patients who underwent both Dotarem(®) and MultiHance(®)-enhanced body MRI studies within an 18-month period (population 2). Data were subjected to statistical analysis. RESULTS: Only 1 mild acute adverse event (vomiting) was observed in population 1 (with Dotarem(®)). Blinded assessment of image quality was good for both agents in all patients. Population 1 showed significantly higher liver percentage enhancement with MultiHance(®) (p < 0.0001). There was a trend to higher pancreas-to-liver enhancement with Dotarem(®), significant in population 2 (p = 0.0333). CONCLUSION: This small-scale multi-blinded study characterizes a strategy to objectively assess intravenous contrast agents, which may be an ideal method to evaluate whether a new contrast agent should be introduced for clinical use at any institution, and to re-evaluate the agent in standard use. Whenever available, intra-individual assessment may be ideal.
Subject(s)
Image Enhancement/methods , Magnetic Resonance Imaging , Meglumine/analogs & derivatives , Organometallic Compounds/administration & dosage , Organometallic Compounds/adverse effects , Aorta/anatomy & histology , Contrast Media/administration & dosage , Contrast Media/adverse effects , Double-Blind Method , Feasibility Studies , Female , Humans , Imaging, Three-Dimensional , Liver/anatomy & histology , Male , Meglumine/administration & dosage , Meglumine/adverse effects , Middle Aged , Observer Variation , Pancreas/anatomy & histology , Pilot Projects , Reproducibility of Results , Sensitivity and Specificity , Vomiting/chemically inducedABSTRACT
OBJECTIVE: The aims of this study were to identify the characteristic ultrasound (US) findings of the first metatarsophalangeal joint (MTPJ1) in acute gout attack and to evaluate the efficacy and safety of US-guided intraarticular corticosteroid injection of the MTPJ1. METHODS: We enrolled 21 patients with acute gout attack involving the MTPJ1 unilaterally. US evaluation of each affected MTPJ1 was compared with radiographic features. US-guided intraarticular corticosteroid (0.5 ml [20 mg] of triamcinolone mixed with 0.5 ml of 2% lidocaine) was injected into the affected MTPJ1s. Pain, general disability, and walking disability were assessed at baseline, 24 hours, 48 hours, and 7 days after injection with visual analog scales. RESULTS: The characteristic US findings of MTPJ1 were erosion, joint effusion, synovial hypertrophy, tophus-like lesion, double contour, hyperechoic spots, and increased power Doppler signal in acute gout attack. US was more sensitive than conventional radiograph in detecting erosion and tophus-like lesion. The reductions of mean visual analog scale scores in pain, general disability, and walking disability were 48 mm (SD, 27), 35 mm (SD, 26) and 39 mm (SD, 26), respectively, 48 hours after US-guided intraarticular corticosteroid injection. There were no adverse events. CONCLUSIONS: US is a sensitive tool to evaluate joint abnormality of the MTPJ1 in acute gout attack and US-guided intraarticular corticosteroid injection to this joint is effective and safe.
Subject(s)
Glucocorticoids/therapeutic use , Gout/drug therapy , Metatarsophalangeal Joint/diagnostic imaging , Triamcinolone/therapeutic use , Ultrasonography, Interventional , Acute Disease , Female , Follow-Up Studies , Glucocorticoids/administration & dosage , Gout/complications , Humans , Injections, Intra-Articular , Male , Metatarsophalangeal Joint/drug effects , Middle Aged , Pain/drug therapy , Pain/etiology , Sensitivity and Specificity , Treatment Outcome , Triamcinolone/administration & dosageABSTRACT
OBJECTIVE: To evaluate on magnetic resonance imaging (MRI) the occurrence rate of temporal perilesional parenchymal enhancement (PPE) associated with hepatic hemangiomas in a large consecutive series and to determine which aspects are associated with this observation. MATERIALS AND METHODS: Institutional review board approved this retrospective study. A computerized search of the MRI database was performed for consecutive patients between January 2008 and January 2012. The study population included 513 liver hemangiomas in 224 patients (104 males and 120 females; mean age of 55.2 ± 13.5 years; age range 24-89 years). Two readers independently reviewed the frequency of PPE, size, speed of enhancement and location of each hemangioma. Marginal models with generalized estimating equation were used. Wald test was applied to verify if the model coefficients were significant. RESULTS: 80/513 (15.6%) hemangiomas showed PPE. The incidence of PPE was significantly higher (p < 0.05) in hemangiomas with Type1 speed of enhancement (51/80, 63.8%) than in those with Type2 or Type3. 66/80 (82.5%) hemangiomas with PPE were subcapsular (p < 0.05). Conversely, the majority (280/433, 64.7%) of hemangiomas without PPE were deep in location (p < 0.001). Lesser proportion of hemangiomas with PPE was located in segment IVa (p < 0.05). CONCLUSION: PPE is not uncommonly seen along with hepatic hemangiomas. This appearance is most frequently observed in rapidly enhancing small lesions with a subcapsular location.
Subject(s)
Hemangioma, Cavernous/diagnosis , Liver Neoplasms/diagnosis , Liver/pathology , Magnetic Resonance Imaging , Adult , Aged , Aged, 80 and over , Contrast Media , Diagnosis, Differential , Female , Humans , Image Enhancement , Image Processing, Computer-Assisted , Male , Meglumine , Middle Aged , Observer Variation , Organometallic Compounds , Reproducibility of Results , Retrospective Studies , Young AdultABSTRACT
To determine which Breast Imaging Reporting and Data System (BI-RADS) descriptors for ultrasound are predictors for breast cancer using logistic regression (LR) analysis in conjunction with interobserver variability between breast radiologists, and to compare the performance of artificial neural network (ANN) and LR models in differentiation of benign and malignant breast masses. Five breast radiologists retrospectively reviewed 140 breast masses and described each lesion using BI-RADS lexicon and categorized final assessments. Interobserver agreements between the observers were measured by kappa statistics. The radiologists' responses for BI-RADS were pooled. The data were divided randomly into train (n = 70) and test sets (n = 70). Using train set, optimal independent variables were determined by using LR analysis with forward stepwise selection. The LR and ANN models were constructed with the optimal independent variables and the biopsy results as dependent variable. Performances of the models and radiologists were evaluated on the test set using receiver-operating characteristic (ROC) analysis. Among BI-RADS descriptors, margin and boundary were determined as the predictors according to stepwise LR showing moderate interobserver agreement. Area under the ROC curves (AUC) for both of LR and ANN were 0.87 (95% CI, 0.77-0.94). AUCs for the five radiologists ranged 0.79-0.91. There was no significant difference in AUC values among the LR, ANN, and radiologists (p > 0.05). Margin and boundary were found as statistically significant predictors with good interobserver agreement. Use of the LR and ANN showed similar performance to that of the radiologists for differentiation of benign and malignant breast masses.
Subject(s)
Breast Neoplasms/diagnostic imaging , Database Management Systems , Image Interpretation, Computer-Assisted , Logistic Models , Neural Networks, Computer , Ultrasonography, Mammary/methods , Adult , Aged , Breast Neoplasms/pathology , Databases, Factual , Female , Humans , Middle Aged , Observer Variation , ROC Curve , Republic of Korea , Retrospective Studies , Young AdultABSTRACT
In recent years, radiotherapy (RT) has been used to treat hepatocellular carcinoma (HCC) at each stage. This clinical trend has developed with the increasing improvement of RT techniques, which show clinical results comparable to those of other treatment modalities. Intensity-modulated radiotherapy uses a high radiation dose to improve treatment effectiveness. However, the associated radiation toxicity can damage adjacent organs. Radiation-induced gastric damage with gastric ulcers is a complication of RT. This report presents a novel management strategy for preventing post-RT gastric ulcers. We present the case of a 53-year-old male patient diagnosed with HCC, who experienced gastric ulcer after RT. Before the second round of RT, the patient was administered a gas-foaming agent, which was effective in preventing RT complications.
ABSTRACT
Elderly patients with a history of chronic alcoholism presented to our hospital with episodes of melena, abdominal pain, and anemia. During admission, hemorrhagic cystic lesion at the pancreas was observed on abdominal CT. Transcatheter angiography confirmed active bleeding foci and arterial embolization was performed. After the procedure, the bleeding was resolved. The authors report two cases of hemosuccus pancreaticus and pancreaticocolic fistula associated with pancreatitis, a rare cause of gastrointestinal bleeding, treated with vascular intervention.
ABSTRACT
OBJECTIVE: The objective of our study was to evaluate the frequency and types of incidental findings of the lumbar spine during MR evaluation for herniated intervertebral disk disease. MATERIALS AND METHODS: A total of 1268 patients (male-to-female ratio, 421:847; age range, 1-97 years) with clinically suspected herniated intervertebral disk disease underwent MRI of the lumbar spine. Musculoskeletal radiologists evaluated the MR examinations for the presence of incidental findings. We defined incidental finding as any abnormal finding not related to the chief complaint. Vertebral hemangioma, Tarlov cyst, fibrolipoma, synovial cyst, and sacral meningocele were included. Frequency distributions of the assessed imaging characteristics were calculated. For analysis of the relationship of incidental findings with patient characteristics, the chi-square test was used. RESULTS: Overall, 107 patients (8.4%) had incidental findings. Fibrolipoma was most common (41 cases, 3.2%), followed by Tarlov cyst (27 cases, 2.1%) and vertebral hemangioma (19 cases, 1.5%). Fibrolipoma and sacral meningocele were more common in males (p < 0.05). There was no difference in the incidence between the sexes in the other incidental findings (p = 0.26-0.96). Four of the five incidental findings were significantly more frequent in individuals younger than 50 years (p < 0.05), whereas the incidence of vertebral hemangioma did not differ by patient age (p = 0.32). CONCLUSION: Incidental findings at MRI of the lumbar spine were common and associated with age and sex. Most were benign findings. An awareness of the prevalence of the incidental findings detected at MRI of the lumbar spine is helpful for diagnosing lesions not related to symptoms.
Subject(s)
Incidental Findings , Intervertebral Disc Displacement/complications , Intervertebral Disc Displacement/pathology , Lumbar Vertebrae , Magnetic Resonance Imaging , Spinal Neoplasms/pathology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Child , Child, Preschool , Cohort Studies , Female , Humans , Incidence , Infant , Intervertebral Disc Displacement/diagnostic imaging , Male , Middle Aged , Radiography , Retrospective Studies , Sex Factors , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/epidemiology , Young AdultABSTRACT
BACKGROUND: To evaluate the sonographic findings of soft-tissue nonsubungual glomus tumors. METHODS: The sonographic appearances of nine histologically proven soft-tissue glomus tumors of nonsubungual location in nine patients (mean age, 49 years; M:F = 7:2) were reviewed retrospectively. Doppler examination and surgical excision were performed in all cases. RESULTS: The mean size of the lesions was 1 cm. The margins of the lesions were relatively well-circumscribed in eight of nine patients (89%) with an ovoid shape in seven of nine patients (78%). The vascularity was moderate to rich in all cases, with an arterial flow pattern but no arteriovenous shunt patterns. The "vascular stalk sign" was noted in six cases (67%). CONCLUSIONS: Nonsubungual glomus tumors are rare soft-tissue tumors with abundant vascularity and arterial flow pattern.
Subject(s)
Glomus Tumor/diagnostic imaging , Soft Tissue Neoplasms/diagnostic imaging , Ultrasonography, Doppler, Color , Ultrasonography, Doppler , Diagnosis, Differential , Female , Humans , Male , Retrospective StudiesABSTRACT
We compared the diagnostic performance of ferucarbotran-enhanced magnetic resonance imaging (MRI) with that of gadoxetic acid-enhanced MRI for the preoperative detection of hepatocellular carcinoma (HCC) of 27 consecutive patients (male-female, 21:6; 33-76 years) with 38 surgically proven HCCs (mean diameter, 2.8 cm; range, 0.8-10.2 cm) on a 3.0-T unit. Three observers independently reviewed each MR image in a random order on a tumor-by-tumor basis. The diagnostic accuracy of these techniques for the detection of HCC, sensitivity, positive and negative predictive values was evaluated. For each observer, the values of the area under the receiver operating characteristic curve (Az) were 1.000, 1.000, and 0.974 for ferucarbotran-enhanced MRI and 1.000, 0.987, and 1.000 for gadoxetic acid-enhanced MRI, and the differences were not statistically significant between 2 techniques for each observer (P > 0.05). For each observer, sensitivities were 100%, 100%, and 92.1% for ferucarbotran-enhanced MRI and 100%, 94.7%, and 100% for gadoxetic acid-enhanced MRI with no statistical significance (P > 0.005). The differences of the positive and negative predictive values of 2 techniques for each observer were not statistically significant (P > 0.05). Ferucarbotran-enhanced MRI and gadoxetic acid-enhanced MRI show a similar diagnostic performance for the preoperative detection of HCCs.
Subject(s)
Carcinoma, Hepatocellular/diagnosis , Ferrosoferric Oxide , Gadolinium DTPA , Image Enhancement/methods , Liver Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Preoperative Care/methods , Adult , Aged , Contrast Media , Dextrans , Female , Humans , Liver/pathology , Magnetite Nanoparticles , Male , Middle Aged , Observer Variation , Predictive Value of Tests , ROC Curve , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
This study evaluates the effectiveness of CT and MR imaging in differentiating intradural extramedullary spinal schwannomas and meningiomas in a large group of patients. In addition, the study correlates tumour location, morphologic characteristics and enhancement pattern. From January 2000 to June 2007, we retrospectively reviewed 128 consecutive patients (51 male, 77 female; mean age at admission 53.8 years; range 17-83 years) with spinal intradural extramedullary tumours (92 schwannomas, 36 meningiomas) at our institution. Fifty-one of ninety-two schwannomas (55.4%) showed fluid signal intensity on T2-weighted MR images. Twenty-two of thirty-six meningiomas (61.1%) showed hyperintense signal intensity and thirteen of thirty-six meningiomas (36.1%) showed isointense signal on T2-weighted MR images. Fifty-four schwannomas (58.7%) showed rim enhancement and thirty-three meningiomas (91.7%) showed diffuse enhancement on contrast-enhanced T1-weighted MR imaging. Twenty-one meningiomas (58.3%) showed dural tail sign in contrast-enhanced T1-weighted MR imaging. Twenty-one meningiomas (58.3%) showed calcification on CT images. MR and CT imaging results are therefore useful for the differentiation of schwannomas from meningiomas of the spine.
Subject(s)
Magnetic Resonance Imaging/methods , Meningioma/diagnostic imaging , Meningioma/diagnosis , Neurilemmoma/diagnostic imaging , Neurilemmoma/diagnosis , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/diagnosis , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Reproducibility of Results , Retrospective StudiesABSTRACT
OBJECTIVE: We compared the diagnostic performance of gadoxetic acid-enhanced MRI with that of triple-phase 16-, 40-, and 64-MDCT in the preoperative detection of hepatocellular carcinoma (HCC). SUBJECTS AND METHODS: Sixty-two consecutively registered patients (54 men, eight women; age range, 31-67 years) with 83 HCCs underwent triple-phase (arterial, portal venous, equilibrium) CT at 16-, 40-, or 64-MDCT and gadoxetic acid-enhanced 3-T MRI. The diagnosis of HCC was established after surgical resection. Three observers independently and randomly reviewed the MR and CT images on a tumor-by-tumor basis. The diagnostic accuracy of these techniques in the detection of HCC was assessed with alternative free response receiver operating characteristic (ROC) analysis. Sensitivity, positive and negative predictive values, and sensitivity according to tumor size were evaluated. RESULTS: For each observer, the areas under the ROC curve were 0.971, 0.959, and 0.967 for MRI and 0.947, 0.950, and 0.943 for CT. The differences were not statistically significant between the two techniques for each observer (p > 0.05). The differences in sensitivity and positive and negative predictive values between the two techniques for each observer were not statistically significant (p > 0.05). Among 10 HCCs 1 cm in diameter or smaller, each of the observers detected seven tumors with MRI. With CT, one observer detected five, one observer detected four, and one observer detected three HCCs with no statistically significant difference (p > 0.05). CONCLUSION: Gadoxetic acid-enhanced MRI and triple-phase MDCT have similar diagnostic performance in the preoperative detection of HCC, but MRI may be better than MDCT in the detection of HCC 1 cm in diameter or smaller.
Subject(s)
Carcinoma, Hepatocellular/diagnosis , Carcinoma, Hepatocellular/surgery , Gadolinium DTPA , Image Enhancement/methods , Liver Neoplasms/diagnosis , Liver Neoplasms/surgery , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Adult , Aged , Contrast Media , Female , Humans , Male , Middle Aged , Preoperative Care/methods , Prognosis , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
BACKGROUND: Most patients whose lung cancers are resected have a local or distant recurrence, as determined postoperatively, or show residual or local disease at the time of autopsy. There are few reports that have described a relationship between tumor recurrence and variable factors such as stage, pathology, surgical method, and mode of recurrence. PURPOSE: To determine factors associated with tumor recurrence after resection of lung cancer. MATERIAL AND METHODS: A total of 124 patients who underwent surgical resection of lung cancer also underwent follow-up with computed tomography (CT) imaging (6, 12, and 24 months after surgery) for the surveillance of tumor recurrence. The CT images were retrospectively reviewed, focusing on the hilar or mediastinal lymph nodes, surgical margin, lung parenchyma, pleura, chest wall, and the presence of distant metastasis. The rate, mode, and time to recurrence after surgery were compared with the tumor stage, pathology, and operative method to identify factors associated with tumor recurrence. The correlation between survival and tumor stage was also evaluated. RESULTS: For 112 cases, a tumor recurred in 52 (41.0%) cases. The recurrence rate was lower for patients with stage IA (n=5, 9.6%) as compared to patients with stage IB (n=18, 34.6%), stage II (n=11, 21.1%), or stage IIIA (n=18, 34.6%). The differences in the recurrence rate between patients with stage IA and stage IB, stage IA and stage II, and stage IA and stage IIIA were statistically significant (P<0.05). The mode of recurrence in the 52 cases was local recurrence (n=31, 59.6%), distant metastasis (n=17, 32.7%), and combined lesions (n=4, 7.7%). The variations in survival rate were statistically significant between patients with stage IA and stage IB (P<0.05) and between patients with stage IA and stage IIIA (P<0.01). Other factors such as pathology and operative method did not correlate with tumor recurrence or patient survival. CONCLUSION: The tumor stage was the only factor associated with tumor recurrence and survival after resection of lung cancer.
Subject(s)
Lung Neoplasms/mortality , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Neoplasm Metastasis/diagnostic imaging , Neoplasm Recurrence, Local/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Chi-Square Distribution , Contrast Media , Female , Humans , Iohexol/analogs & derivatives , Male , Middle Aged , Neoplasm Staging , Retrospective Studies , Risk Factors , Survival RateABSTRACT
We measured changes in sonographic findings of patients with clonorchiasis after a treatment in a highly endemic area. A total of 347 residents showed positive stool results for Clonorchis sinensis eggs in a village in northeastern China, and were treated with praziquantel. Of them, 132 patients underwent abdominal sonography both before and 1 year after treatment, and the changes in sonographic findings of 83 cured subjects were compared. Diffuse dilatation of intrahepatic bile ducts (DDIHD) was found in 82 patients (98.2%) before and 80 (96.4%) after treatment, which was improved in 3, aggravated in 1, and unchanged in 79 patients. Increased periductal echogenicity (IPDE) was observed in 42 patients (50.6%) before and 45 (54.2%) after treatment, which was improved in 5, aggravated in 8, and unchanged in 70 patients. Floating echogenic foci in the gallbladder (FEFGB) was detected in 32 patients (38.6%) before and 17 (20.5%) after treatment, which was improved in 20, aggravated in 5, and unchanged in 58 patients. Improvement of FEFGB only was statistically significantly (P = 0.004). The present results confirm that DDIHD and IPDE persist but FEFGB decreases significantly at 1 year after treatment. In a heavy endemic area, the sonographic finding of FEFGB may suggest active clonorchiasis 1 year after treatment.
Subject(s)
Clonorchiasis/diagnostic imaging , Clonorchiasis/drug therapy , Endemic Diseases , Praziquantel/therapeutic use , Adolescent , Adult , Aged , Aged, 80 and over , Bile Ducts, Intrahepatic/diagnostic imaging , Bile Ducts, Intrahepatic/parasitology , Child , China/epidemiology , Clonorchiasis/complications , Clonorchiasis/epidemiology , Female , Gallbladder/diagnostic imaging , Gallbladder/parasitology , Humans , Male , Middle Aged , Treatment Outcome , Ultrasonography , Young AdultABSTRACT
PURPOSE: This study evaluated whether or not patterns of emphysema and their qualitative and quantitative severity can predict the risk of complications with post-computed tomography (CT)-guided transthoracic lung biopsy (TTLB). MATERIALS AND METHODS: Three hundred and ninety-seven patients who underwent CT-guided TTLB in 2010-2018 were retrospectively reviewed. The severity of emphysema and presence of perilesional emphysema were assessed visually using the Fleischner Society classification. Ninety seven of the 397 patients underwent quantitative analysis of emphysema. Complications, including pneumothorax, chest tube insertion, and hemorrhage, were assessed by post-TTLB CT and radiographic imaging. The grade of hemorrhage was categorized into three groups. Independent risk factors for pneumothorax and hemorrhage were assessed by univariate and multivariate logistic regression analyses. RESULTS: Pneumothorax occurred in 48.6% of cases and hemorrhage in 70.5%. Perilesional emphysema was significantly associated with pneumothorax (odds ratio 6.720; 95% confidence interval 3.265-13.831, p < 0.001) and hemorrhage (odds ratio 3.877; 95% confidence interval 1.796-8.367; p = 0.001). The severity of visual and quantitative emphysema was not a significant risk factor for pneumothorax or hemorrhage (p > 0.05). Perilesional emphysema was significantly associated with the grade of hemorrhage (p < 0.001). CONCLUSION: Perilesional emphysema can estimate the risk of iatrogenic complications from CT-guided TTLB.
Subject(s)
Emphysema/complications , Hemorrhage/etiology , Lung/pathology , Pneumothorax/etiology , Radiography, Interventional/methods , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Needle/adverse effects , Female , Humans , Image-Guided Biopsy/adverse effects , Male , Middle Aged , Retrospective Studies , Risk Factors , Severity of Illness Index , Young AdultABSTRACT
Pancreatic metastasis from cervical cancer is extremely rare. We report a case of metastatic adenocarcinoma of the pancreas from uterine cervical cancer. A 70-year-old woman was referred because of a pancreatic mass detected by CT. She had been diagnosed with uterine cervical adenocarcinoma 20 months previously. After concurrent chemoradiotherapy, CT showed no evidence of the cervical mass, and follow-up showed no evidence of recurrence. Endoscopic ultrasound-guided fine needle aspiration biopsy of the pancreatic mass resulted in a diagnosis of metastatic adenocarcinoma from uterine cervix.
Subject(s)
Adenocarcinoma/pathology , Pancreatic Neoplasms/diagnosis , Uterine Neoplasms/pathology , Adenocarcinoma/drug therapy , Adenocarcinoma/radiotherapy , Aged , Combined Modality Therapy , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Female , Humans , Magnetic Resonance Imaging , Pancreas/pathology , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/secondary , Tomography, X-Ray Computed , Uterine Neoplasms/drug therapy , Uterine Neoplasms/radiotherapyABSTRACT
To examine the effects of Populus tomentiglandulosa (PT) extract on the expressions of antioxidant enzymes and neurotrophic factors in the cornu ammonis 1 (CA1) region of the hippocampus at 5 min after inducing transient global cerebral ischemia (TGCI) in gerbils, TGCI was induced by occlusion of common carotid arteries for 5 min. Before ischemic surgery, 200 mg·kg-1 PT extract was orally administrated once daily for 7 d. We performed neuronal nuclear antigen immunohistochemistry and Fluoro-Jade B staining. Furthermore, we determined in situ production of superoxide anion radical, expression levels of SOD1 and SOD2 as antioxidant enzymes and brain-derived neurotrophic factor (BDNF) and insulin-like growth factor I (IGF-I) as neurotrophic factors. Pretreatment with 200 mg·kg-1 PT extract prevented neuronal death (loss). Furthermore, pretreatment with 200 mg·kg-1 PT extract significantly inhibited the production of superoxide anion radical, increased expressions of SODs and maintained expressions of BDNF and IGF-I. Such increased expressions of SODs were maintained in the neurons after IRI. In summary, pretreated PT extract can significantly increase levels of SODs and protect the neurons against TGCI, suggesting that PT can be a useful natural agent to protect against TGCI.
Subject(s)
Brain-Derived Neurotrophic Factor/metabolism , CA1 Region, Hippocampal/drug effects , Insulin-Like Growth Factor I/metabolism , Plant Extracts/administration & dosage , Populus/chemistry , Pyramidal Cells/drug effects , Reperfusion Injury/drug therapy , Superoxide Dismutase/metabolism , Animals , Brain-Derived Neurotrophic Factor/genetics , CA1 Region, Hippocampal/metabolism , Gerbillinae , Humans , Insulin-Like Growth Factor I/genetics , Male , Neuroprotective Agents/administration & dosage , Pyramidal Cells/metabolism , Reperfusion Injury/genetics , Reperfusion Injury/metabolism , Superoxide Dismutase/genetics , Up-Regulation/drug effectsABSTRACT
OBJECTIVE: The purpose of our study was to evaluate the histopathologic changes of gallbladder wall surrounding radiofrequency ablation zones in pig livers and to assess the risk factors for thermal injury of gallbladder wall in terms of distance of the electrode, electrode direction in relation to the gallbladder wall, and time of sacrifice of the animal. MATERIALS AND METHODS: The study was performed in 15 pigs using an internally cooled single electrode with a 1-cm electrically active tip under sonographic guidance. Twenty-three hepatic ablation zones abutting the gallbladder were analyzed in three phases on the basis of the distance of the electrode (group A, 0.5 cm; group B, 1.0 cm), electrode direction (perpendicular or parallel), and time of sacrifice (immediate or delayed [7 days after radiofrequency ablation]). We evaluated the gross changes, the depth of thermal injury, and the grade of abnormal microscopic changes in the gallbladder wall. Data analysis was performed on the basis of the Fisher's exact test. RESULTS: Discoloration and perforation were more frequent in group A (60%, 6/10, and 20%, 2/10, respectively) than in group B (25%, 2/8, and 0%, respectively, p > 0.05). Perforation was more frequent in the parallel direction and delayed phase (33.3%, 1/3, and 40%, 2/5, respectively) compared with the perpendicular direction and immediate phase (14.3%, 1/7, and 0%, respectively, p > 0.05). Depth of thermal injury showed a significant difference between group A and group B for full-thickness involvement (53.8%, 7/13, versus 0%, respectively, p < 0.05). Abnormal microscopic changes showed that parallel direction and immediate phase were more frequent with full-thickness involvement (71.4%, 5/7, and 71.4%, 5/7, respectively) compared with perpendicular direction and delayed phase (33.3%, 2/6, and 33.3%, 2/6, respectively, p > 0.05). CONCLUSION: Hepatic radiofrequency ablation abutting the gallbladder can produce substantial thermal injury of the gallbladder wall, including perforation, especially when performed without a safe distance.