Enhanced solubility of methyl ester sulfonates below their Krafft points in mixed micellar solutions.

HYPOTHESIS: Methyl ester sulfonates (MES) show limited water solubility at lower temperatures (Krafft point). One way to increase their solubility below their Krafft points is to incorporate them in anionic surfactant micelles. The electrostatic interactions between the ionic surfactant molecules and charged micelles play an important role for the degree of MES solubility. EXPERIMENTS: The solubility and electrolytic conductivity for binary and ternary surfactant mixtures of MES with anionic sodium alpha olefin sulfonate (AOS) and sodium lauryl ether sulfate with two ethylene oxide groups (SLES-2EO) at 5 °C during long-term storage were measured. Phase diagrams were established; a general phase separation theoretical model for their explanation was developed and checked experimentally. FINDINGS: The binary and ternary phase diagrams for studied surfactant mixtures include phase domains: mixed micelles; micelles + crystallites; crystallites, and molecular solution. The proposed general phase separation model for ionic surfactant mixtures is convenient for construction of such complex phase diagrams and provides information on the concentrations of all components of the complex solution and on the micellar electrostatic potential. The obtained maximal MES mole fraction of transparent micellar solutions could be of interest to increase the range of applicability of MES-surfactants.

Endoscope-Controlled Microsurgery of a Ruptured Middle Fossa Arachnoid Cyst.

Arachnoid cysts are responsible for 1% of expansive lesions in the central nervous system. Usually, they do not cause neurologic symptoms unless they have expansion or hemorrhage. Intracystic bleeding is caused by trauma or may be spontaneous. There are few cases in the literature of spontaneous hemorrhage of arachnoid cysts. This 2-dimensional video (Video 1) demonstrates the case of a 6-year-old boy who presented with headache and diplopia. At the physical examination, he exhibited right sixth nerve palsy. The complementary examinations revealed a left middle fossa arachnoid cyst classified as Galassi 2. An urgent procedure was planned to fenestrate the cyst. Informed written consent was obtained from the patient's family. Due to the team experience, endoscope-controlled microsurgery was performed. The patient experienced remission of the headache and the diplopia. A CT scan was performed on the first postoperative day and revealed a lamina of acute blood at the subdural space. It was an asymptomatic thin lamina of blood; we opted to watch and follow. One month later, a control MRI revealed a left frontoparietal subdural hematoma. Despite being asymptomatic, the hematoma was determined to have significant mass effect; thus, it was evacuated by a parietal burr-hole. After 1 month, another MRI showed resolution of the frontoparietal hematoma and significant reduction in the arachnoid cyst. There are few cases described of spontaneous rupture of arachnoid cyst; beyond that, we would like to illustrate a step-by-step procedure that is not widely available as a video article.

The Anomalous Left Brachiocephalic Vein in Adults

PURPOSE@#To classify anomalous left brachiocephalic vein (LBCV) in adult without cardiac anomaly, and evaluate CT findings of anomalous LBCV.@*MATERIALS AND METHODS@#This study included 32 patients who were diagnosed anomalous LBCV using MDCT between March 2005 and August 2016. Subaortic LBCV divided into group I (with normal LBCV) and group II (without normal LBCV). We evaluated age, sex, diameters and diameter ratios of superior vena cava (SVC) and subaortic LBCV, the entering sites to SVC of subaortic LBCV and the azygos vein, and vascular tortuosity of subaortic LBCV.@*RESULTS@#There were included 29 subaortic LBCV and 3 retroesophageal LBCV. There were not statistically significant in age, sex, diameter of SVC between subaortic groups (p > 0.05). The diameters of subaortic LBCV were thinner in group I. Diameter ratios of subaortic LBCV were lower in group I. The entering site of subaortic LBCV was higher than azygos vein in group I (64%) and same as azygos vein in group II (67%). Vascular tortuosity of subaortic LBCV was in 7 cases of group I.@*CONCLUSION@#It is important for radiologists to be familiar with CT findings of anomalous LBCV, since the radiologists give information of uncommon or rare anomalous LBCV to clinician.

Pulmonary Comorbidities of Lung Emphysema

Pulmonary emphysema is defined as the “abnormal permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of the alveolar wall and without obvious fibrosis.” Pulmonary emphysema could result in various complications or comorbidities, many of which are interrelated. Pulmonary emphysema can result in a number of interrelated complications and comorbidities. When pulmonary emphysema is accompanied by comorbidities, it may exhibit different and unique radiologic findings, depending on the underlying lung condition. The purpose of this article was to review radiologic findings that have been reported in patients with underlying emphysema, as well as localized pulmonary comorbidities including infection, fibrosis, primary lung cancer, hemorrhage, and other rare conditions.

Spectrum of Multi-Detector Computed Tomography Findings that Alter Pulmonary Artery Diameters in Adults

Abnormalities in the anatomy of pulmonary arteries may have heritable or environmental causes and involve a reduction or enlargement in transverse diameters of the blood vessels eg, congenital and developmental disorders, acquired intrinsic causes, extrinsic compression, and constriction. Pulmonary hypertension, pulmonary artery aneurysm and pseudoaneurysm, and idiopathic dilatation can also increase the diameter of a pulmonary artery. Multi-detector computed tomography (CT) is useful to evaluate each pulmonary artery and to diagnose the conditions that alter the diameter of the pulmonary artery. It is important to be familiar with the CT features of a variety of disorders to allow for accurate diagnoses and appropriate therapeutic management.

Symmetrical brachydactyly in a dog.

Congenital malformations of the canine manus and pes are infrequently reported in the veterinary literature. This includes brachydactyly which is a general term used to indicate the shortening of digits due to abnormal development of the phalanges, metacarpals, or metatarsals. This case report describes isolated brachydactyly in a one-year-old male Maremma Sheepdog affecting all of the phalanges, metacarpals, and metatarsals of digits two through five. This condition was confirmed by determining the length of each phalanx, metacarpal, and metatarsal of the affected dog as well as an unaffected littermate. The affected dog's metacarpal, metatarsal, and phalanx lengths ranged from 50% to 77% of that of the unaffected sibling. Other abnormalities found on physical examination as well as on radiographic imaging are discussed.

Rigid urethrocystoscopy via a percutaneous fluoroscopic-assisted perineal approach in male dogs: 19 cases (2005-2014).

OBJECTIVE To describe the technique and outcome for male dogs undergoing rigid urethrocystoscopy via a novel percutaneous, fluoroscopic-assisted perineal approach. DESIGN Retrospective case series. ANIMALS 19 client-owned male dogs. PROCEDURES Medical records of male dogs that underwent urethrocystoscopy via a percutaneous perineal approach for treatment of a variety of conditions from 2005 through 2014 were reviewed. Signalment, history, pertinent diagnostic imaging results, endourologic and postprocedure details, duration of hospitalization, complications, and outcome (short-term, < 1 month; long-term, ≥ 1 month) were recorded. After flexible urethrocystoscopy, direct percutaneous perineal needle puncture and guidewire placement by means of fluoroscopic guidance (with or without ultrasonography) allowed access to the urethral lumen. The perineal tract was subsequently serially dilated to accommodate a peel-away sheath and rigid endoscope. Rigid urethrocystoscopy was performed, and on completion of endourologic procedures, the access site was left to heal by second intention. RESULTS 19 male dogs successfully underwent 20 procedures. No intraoperative complications were reported. Short-term outcome was good (ie, mild perineal urine leakage) for 3 dogs and excellent (ie, no abnormalities with urination) for 16. Long-term outcome was excellent for the 17 dogs for which follow-up information was available. CONCLUSIONS AND CLINICAL RELEVANCE A percutaneous fluoroscopic-assisted perineal approach (with or without ultrasonography) allowed access to the pelvic urethra with no major complications in the present series of patients. This minimally invasive approach may be a valuable tool for endourologic procedures in male dogs.

Congenital Paraesophageal Hernia in a Cat.

A 3 mo old male domestic shorthair weighing 2 kg was presented for acute onset of anorexia, lethargy, paradoxical breathing, and a palpable mass effect in the cranial abdomen. Initial diagnostics and imaging suggested a pleuroperitoneal or hiatal hernia. Emergency abdominal exploration was performed, and a complex type II paraesophageal hiatal hernia was identified. The entire stomach, greater and lesser omenta, spleen, left limb of the pancreas, and the proximal segment of the descending duodenum were herniated through a discrete defect in the phrenicoesophageal ligament. After reduction of the herniated organs back into the abdomen, a phrenicoplasty, esophagopexy, and left-sided fundic gastropexy were performed. The cat recovered uneventfully from the procedure and was free of any signs of disease for at least 30 mo postoperatively. This is the first detailed report of the findings and successful surgical treatment of a complex congenital, type II paraesophageal hiatal hernia with complete herniation of the stomach, omenta, and spleen in a cat.

Evaluation of percutaneously adjustable hydraulic urethral sphincters with and without induced mechanical failure.

OBJECTIVE: To describe (1) the radiographic appearance of intact hydraulic urethral sphincters (HUS) and (2) the success of leak detection using clinically feasible methods. STUDY DESIGN: Prospective, blinded in vitro study. SAMPLE POPULATION: Thirty HUS devices (10 each of 8, 10, and 12 mm diameter sizes). MATERIALS AND METHODS: All devices were inflated with saline (0.9% NaCl) solution to complete occlusion, inspected, and weighed over a 24-hour period for manufacturing defects. HUS phantoms were created to mimic surrounding soft tissues. One randomly selected HUS of each size was evaluated radiographically at different inflation volumes and angles. All HUS systems were then evaluated in random order before and after puncture with volumetry, manometry, radiography, and contrast fluoroscopy. Volumetry was the total volume (mL) retrieved from each HUS system. Manometry was the pressure (cm H2 O) within each HUS system. The HUS devices were filled to a known volume before each measurement. RESULTS: When all HUS sizes were considered, volumetry did not reveal significant differences before and after puncture, but manometry was significantly different (P < .001). Radiography was 63.8% sensitive and 88.3% specific for puncture diagnosis, with inter-observer agreement of 0.58. Contrast fluoroscopy was 78.4% sensitive and 100% specific, with inter-observer agreement of 0.97. CONCLUSIONS: Of those methods tested, contrast fluoroscopy was the most sensitive, specific, and consistent method of leak detection. Manometry was also helpful, but may be difficult to use clinically. Volumetry and radiography were relatively poor indicators of leakage in this model.

Perioperative outcome in dogs with hemoperitoneum: 83 cases (2005-2010).

OBJECTIVE: To characterize the clinical course of dogs with hemoperitoneum in the perioperative setting and to determine risk factors that may affect short-term outcome. DESIGN: Retrospective case series. ANIMALS: 83 client-owned dogs. PROCEDURES: The medical records of dogs with hemoperitoneum that underwent surgery between 2005 and 2010 were reviewed. Data were analyzed to determine risk factors associated with perioperative outcome. The perioperative period was defined as the time from admission to the hospital for treatment of hemoperitoneum until the time of discharge or euthanasia (within the same visit). RESULTS: 13 of 83 (16%) dogs died or were euthanized in the perioperative period. The median hospitalization time for surviving dogs was 2 days (range, 1 to 5 days). The requirement for a massive transfusion with blood products was a negative prognostic indicator for hospital discharge. The source of bleeding was isolated to the spleen in 75 of 83 (90%) dogs; a splenic source of hemorrhage was determined to be a positive predictor of survival to discharge from the hospital. CONCLUSIONS AND CLINICAL RELEVANCE: In the present study, factors associated with death and failure to be discharged from the hospital included tachycardia, a requirement for massive transfusion with blood products, and the development of respiratory disease secondary to suspected pulmonary thromboembolism or acute respiratory distress syndrome. The presence of disease within the spleen was positively associated with survival to discharge. Surgical intervention for treatment of hemoperitoneum, regardless of etiology, resulted in discharge from the hospital for 70 of the 83 (84%) dogs in this series.

Multiple Subcutaneous Abscesses Complicating Staphylococcus aureus Bacteremia associated with BCG Vaccination

We report a case of 42-day-old girl with multiple abscesses in soft tissue sites and osteomyelitis caused by Staphylococcus aureus after an intradermal Bacillus Calmette-Guerin (BCG) vaccination. This may be an unusual complication of intradermal BCG vaccination.

Clinical Manifestation of Necrotizing Pneumonia in Healthy Children

OBJECTIVE: Necrotizing pneumonia (NP) is a severe complication of lobar pneumonia caused by various pathogens. The immunopathogenesis and clinical characteristics of NP in children are not clearly understood. We wanted to evaluate the clinical characteristics and suggest in part the immunopathogenesis of NP. METHODS: We reviewed retrospectively the medical charts and radiographic materials of eight patients with NP, who were diagnosed by chest radiography and chest computed tomography at the Department of Pediatrics, Soonchunhyang University Hospitals at Cheonan and Bucheon from January 2002 to December 2011. RESULTS: They were previously healthy, 2.1 to 4.6 years of ages (mean, 2.8+/-1.0 years) and three boys and five girls. All of them had pleural effusion. Five patients had pneumonic consolidations in right upper lung field. Three patients had pneumatocele. They developed leukocytosis (mean, 19,400+/-6,400/mm3), higher C-reactive protein level (mean, 25.1+/-8.0 mg/dL). The etiologic agents were revealed in two patients; Streptococcus pneumonia (S. pneumonia) was revealed in one patient and S. pneumonia and Mycoplasma pneumonia in the other patient. Three patients were treated with additional intravenous immunoglobulin. Clinical improvement was prolonged: fever lasted 10 to 23 days, and length of hospitalization was 15 to 36 days. NP or pneumatocele were completely resolved on the follow-up radiographic studies in all of the patients. CONCLUSION: Although the previously healthy young children with NP had protracted clinical course, they recovered without any problematic sequelae. Our results suggest that the immunopathogenesis of NP in children may be associated with the exaggerated immune reaction of the host to insults from initial bacterial infections, rather than the pathogen-induced cytopathies.

The Effect of Post-Treatment N-Acetylcysteine in LPS-Induced Acute Lung Injury of Rats / 결핵및호흡기질환

BACKGROUND: Oxidation plays an important role in acute lung injury. This study was conducted in order to elucidate the effect of repetitive post-treatment of N-acetylcysteine (NAC) in lipopolysaccaride (LPS)-induced acute lung injury (ALI) of rats. METHODS: Six-week-old male Sprague-Dawley rats were divided into 4 groups. LPS (Escherichia coli 5 mg/kg) was administered intravenously via the tail vein. NAC (20 mg/kg) was injected intraperitoneally 3, 6, and 12 hours after LPS injection. Broncho-alveolar lavage fluid (BALF) and lung tissues were obtained to evaluate the ALI at 24 hours after LPS injection. The concentration of tumor necrosis factor alpha (TNF-alpha) and interleukin 1beta (IL-1beta) were measured in BALF. Nuclear factor kappaB (NF-kappaB), lipid peroxidation (LPO), and myeloperoxidase (MPO) were measured using lung tissues. Micro-computed tomography (micro-CT) images were examined in each group at 72 hours apart from the main experiments in order to observe the delayed effects of NAC. RESULTS: TNF-alpha and IL-1beta concentration in BALF were not different between LPS and NAC treatment groups. The concentration of LPO in NAC treatment group was significantly lower than that of LPS group (5.5+/-2.8 nmol/mL vs. 16.5+/-1.6 nmol/mL) (p=0.001). The activity of MPO in NAC treatment group was significantly lower than that of LPS group (6.4+/-1.8 unit/g vs. 11.2+/-6.3 unit/g, tissue) (p<0.048). The concentration of NF-kappaB in NAC treatment group was significantly lower than that of LPS group (0.3+/-0.1 ng/microL vs. 0.4+/-0.2 ng/microL) (p=0.0001). Micro-CT showed less extent of lung injury in NAC treatment than LPS group. CONCLUSION: After induction of ALI with lipopolysaccharide, the therapeutic administration of NAC partially attenuated the extent of ALI through the inhibition of NF-kappaB activation.

The Effect of Post-Treatment N-Acetylcysteine in LPS-Induced Acute Lung Injury of Rats / 결핵및호흡기질환

BACKGROUND: Oxidation plays an important role in acute lung injury. This study was conducted in order to elucidate the effect of repetitive post-treatment of N-acetylcysteine (NAC) in lipopolysaccaride (LPS)-induced acute lung injury (ALI) of rats. METHODS: Six-week-old male Sprague-Dawley rats were divided into 4 groups. LPS (Escherichia coli 5 mg/kg) was administered intravenously via the tail vein. NAC (20 mg/kg) was injected intraperitoneally 3, 6, and 12 hours after LPS injection. Broncho-alveolar lavage fluid (BALF) and lung tissues were obtained to evaluate the ALI at 24 hours after LPS injection. The concentration of tumor necrosis factor alpha (TNF-alpha) and interleukin 1beta (IL-1beta) were measured in BALF. Nuclear factor kappaB (NF-kappaB), lipid peroxidation (LPO), and myeloperoxidase (MPO) were measured using lung tissues. Micro-computed tomography (micro-CT) images were examined in each group at 72 hours apart from the main experiments in order to observe the delayed effects of NAC. RESULTS: TNF-alpha and IL-1beta concentration in BALF were not different between LPS and NAC treatment groups. The concentration of LPO in NAC treatment group was significantly lower than that of LPS group (5.5+/-2.8 nmol/mL vs. 16.5+/-1.6 nmol/mL) (p=0.001). The activity of MPO in NAC treatment group was significantly lower than that of LPS group (6.4+/-1.8 unit/g vs. 11.2+/-6.3 unit/g, tissue) (p<0.048). The concentration of NF-kappaB in NAC treatment group was significantly lower than that of LPS group (0.3+/-0.1 ng/microL vs. 0.4+/-0.2 ng/microL) (p=0.0001). Micro-CT showed less extent of lung injury in NAC treatment than LPS group. CONCLUSION: After induction of ALI with lipopolysaccharide, the therapeutic administration of NAC partially attenuated the extent of ALI through the inhibition of NF-kappaB activation.

Individual Pulmonary Vein Atresia in Adults: Report of Two Cases

We present two cases of individual pulmonary vein atresia without vestige of an involved pulmonary vein. On CT, we noted the absence or interruption of normal pulmonary venous structures, and the presence of abnormal vascular structures that represented collaterals for the involved lung parenchyma. On angiography, the atretic pulmonary vein was found to drain into the other ipsilateral pulmonary veins through the collaterals.

Coexistence of Intrapulmonary Bronchogenic Cyst and Congenital Cystic Adenomatoid Malformation: A Case Report

Congenital cystic lesions of the lung are uncommon and a conjunction of two or more lesions is very rare. We report here on a case of coexisting intrapulmonary bronchogenic cyst and congenital cystic adenomatoid malformation in a 13-year-old female with a cystic mass in the right upper lobe of the lung. Computed tomography showed a cystic lesion measuring 2.5 cm with an air fluid level and surrounding multicystic lesions in the right upper lobe. On gross examination, the cut surface showed a cystic mass containing inspissated mucinous material, and the cystic mass was surrounded by multiple small cysts. Microscopically, the larger cystic cavity was lined with pseudostratified ciliated columnar epithelium. The submucosal tissue contained mucinous glands and plates of cartilage. The surrounding smaller cysts or irregular spaces were lined with bronchiolar-type respiratory epithelium. We propose that this hybrid lung lesion may represent the missing link in a common embryologic pathway determined by the timing of mesenchymal and epithelial interactions.

CT Findings of Colonic Complications Associated with Colon Cancer

A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer.

Angiolipoma of the Breast: A Case Report / 한국유방암학회지

An angiolipoma is a common mixed connective tissue tumor that commonly occurs in the trunk and extremities, and has been rarely reported in the breast. It is a benign variant of a lipoma that shows various appearances on mammography. It is usually seen with a well circumscribed homogeneously hyperechoic pattern on ultrasound. We report a rare case of an angiolipoma of the breast with no definite abnormality on mammography, appearing as an irregular homogeneously hyperechoic lesion on ultrasound.

Marked Recovery From Paraquat-Induced Lung Injury During Long-Term Follow-up

BACKGROUND/AIMS: Paraquat-induced lung injury has been considered a progressive and irreversible disease. The purpose of this study was to report the long-term evolution of lung lesions in eight survivors with significant paraquat-induced lung injuries who could be followed-up for longer than 6 months. METHODS: We retrospectively examined high-resolution computed tomography and pulmonary function test of eight survivors with significant paraquat-induced lung injurys. RESULTS: High-resolution computed tomography revealed a predominant pattern of irregularly shaped consolidation with traction bronchiectasis at 1-2 months after paraquat poisoning, a mixed pattern of irregularly shaped consolidation and ground-glass opacity at 3-12 months, and a mixed pattern of consolidation, groundglass opacity, and honeycombing at 1-2 years. At 3-12 months after paraquat ingestion, the areas of consolidation had markedly decreased and the decreased lung volume had returned to normal. At 1-2 years after paraquat poisoning, the cystic changes had disappeared. At 2-3 years after paraquat poisoning, the decrease in forced vital capacity had greatly improved to the normal range. CONCLUSIONS: Recovery of nearly normal pulmonary structure and function may occur over several years following paraquat poisoning. Pulmonary function (both forced vital capacity and forced expiratory volume in 1 sec) evolved toward normal in the long-term survivors of paraquat poisoning with initial prominent lung injuries.