Asunto(s)
Hipercalcemia , Sarcoidosis , Calcio , Cara , Humanos , Hipercalcemia/etiología , Sarcoidosis/complicacionesRESUMEN
Dominant optic atrophy (DOA) arises from mutations in the OPA1 gene that promotes fusion of the inner mitochondrial membrane and plays a role in maintaining ATP levels. Patients display optic disc pallor, retinal ganglion cell (RGC) loss and bilaterally reduced vision. We report a randomized, placebo-controlled trial of idebenone at 2000 mg/kg/day in 56 Opa1 mutant mice (B6;C3-Opa1(Q285STOP)), with RGC dendropathy and visual loss, and 63 wildtype mice. We assessed cellular responses in the retina, brain and liver and RGC morphology, by diolistic labeling, Sholl analysis and quantification of dendritic morphometric features. Vision was assessed by optokinetic responses. ATP levels were raised by 0.57 nmol/mg (97.73%, p=0.035) in brain from idebenone-treated Opa1 mutant mice, but in the liver there was an 80.35% (p=0.011) increase in oxidative damage. NQO1 expression in Opa1 mutant mice was reduced in the brain (to 30.5%, p=0.002) but not in retina, and neither expression level was induced by idebenone. ON-center RGCs failed to show major recovery, other than improvements in secondary dendritic length (by 53.89%, p=0.052) and dendritic territory (by 2.22 × 10(4) µm(2) or 90.24%, p=0.074). An improvement in optokinetic response was observed (by 12.2 ± 3.2s, p=0.003), but this effect was not sustained over time. OFF-center RGCs from idebenone-treated wildtype mice showed shrinkage in total dendritic length by 2.40 mm (48.05%, p=0.025) and a 47.37% diminished Sholl profile (p=0.029). Visual function in wildtype idebenone-treated mice was impaired (2.9 fewer head turns than placebo, p=0.007). Idebenone appears largely ineffective in protecting Opa1 heterozygous RGCs from dendropathy. The detrimental effect of idebenone in wildtype mice has not been previously observed and raises some concerns.
Asunto(s)
Antioxidantes/farmacología , Atrofia Óptica Autosómica Dominante/patología , Células Ganglionares de la Retina/efectos de los fármacos , Ubiquinona/análogos & derivados , Agudeza Visual/efectos de los fármacos , Animales , Western Blotting , Dendritas/patología , Modelos Animales de Enfermedad , Femenino , GTP Fosfohidrolasas/genética , Inmunohistoquímica , Masculino , Ratones , Ratones Mutantes , Distribución Aleatoria , Células Ganglionares de la Retina/patología , Ubiquinona/farmacologíaRESUMEN
Liver calcifications have been extensively described on plain radiographs, either from KUB or angiography examinations. On the other hand, their characteristics are seldom reported on cross-sectional imaging: they are frequently considered as non-specific compared to multiple other imaging features. However, clinical practice demonstrates that in specific situations (such as parasitic infections and calcified metastases), the presence of calcifications may be a determining factor in avoiding misdiagnosis with potential deleterious effects to the patient. Both CT and US can detect a large number of "benign" calcifications without associated focal lesion and knowledge of their imaging features is useful to avoid unnecessary additional imaging work-up. A review of the literature and a series of 100 cases of liver calcifications on CT are presented to review the imaging features of calcified liver lesions and isolated liver calcifications without associated focal lesion.
Asunto(s)
Calcinosis/diagnóstico por imagen , Hepatopatías/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Calcinosis/epidemiología , Calcinosis/etiología , Calcinosis/patología , Femenino , Humanos , Incidencia , Hígado/patología , Hepatopatías/epidemiología , Hepatopatías/etiología , Hepatopatías/patología , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/secundario , Imagen por Resonancia Magnética , Masculino , Persona de Mediana EdadAsunto(s)
Blastoma Pulmonar , Adulto , Humanos , Masculino , Blastoma Pulmonar/diagnóstico por imagen , RadiografíaRESUMEN
For a long time, imaging of the biliary tract after surgical procedures was performed with invasive procedures such as endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography. Due to recent advances in diagnostic imaging, non-invasive techniques are now favored. While US remains the initial imaging modality, it is frequently followed by CT and/or MRCP. Image interpretation should always be performed in keeping with clinical and laboratory findings as well as the type of surgical procedure. The most appropriate imaging modality is selected based on these data. In patients with jaundice or biliary tract stenosis, MRCP, with use of an optimal technique and 3D acquisition, is the imaging modality of choice. In non-jaundiced patients with non-distended biliary tract and suspected bile leak, MRCP should be completed by the injection of a liver-specific contrast agent with biliary excretion to achieve non-invasive biliary tract opacification. In patients with malignancy, CT is preferred due to its high spatial resolution and ability to demonstrate small anastomotic tumor recurrences. CT should also be performed in patients with suspected hepatic artery or portal vein injury in addition to biliary tract injury or to detect distant complications.
Asunto(s)
Conductos Biliares/cirugía , Procedimientos Quirúrgicos del Sistema Biliar , Pancreatocolangiografía por Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Anastomosis Quirúrgica/efectos adversos , Colangiografía , Colecistectomía Laparoscópica , Colelitiasis/etiología , Conducto Colédoco/cirugía , Medios de Contraste , Ácido Edético/análogos & derivados , Femenino , Humanos , Trasplante de Hígado/efectos adversos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/diagnóstico por imagen , Fosfato de Piridoxal/análogos & derivados , ReoperaciónRESUMEN
We report the case of a 28 year-old female, who gave birth seven weeks previously, presenting with a pulmonary artery leiomyosarcoma discovered on a thoracic CT performed for clinical suspicion of pulmonary embolism. This case presents two major points of interest: on the first hand, it is a particular context (young post-partum patient), with classic symptoms of routine pulmonary embolism. On the other hand, the exam clearly demonstrates tumor enhancement, which is characteristic but rarely described.
Asunto(s)
Leiomiosarcoma/diagnóstico por imagen , Arteria Pulmonar , Tomografía Computarizada por Rayos X , Neoplasias Vasculares/diagnóstico por imagen , Adulto , Femenino , Humanos , Periodo PospartoRESUMEN
OBJECTIVE: To evaluate the prognostic value of an elevated CD8 lymphocyte count in the early stages of HIV infection. DESIGN: A prospective study ongoing since January 1986. METHODS: One hundred and fifty-two asymptomatic HIV-positive individuals with a CD4 lymphocyte count > 400 x 10(6)/l at enrollment were included. Disease progression was defined as a CD4 count < 200 x 10(6)/l. RESULTS: During the follow-up period, CD4 count decreased in 33 individuals; CD8 count increased to > 1500 x 10(6)/l in 38 individuals and doubled in 35. The risk of a decreasing CD4 count was estimated to be 1.7-fold higher, although not significantly so, after the elevation of the CD8 count to > 1500 x 10(6)/l than before or in the absence of such an increase. However, this predictive value disappeared when five baseline parameters found to predict the outcome (neopterin, beta 2-microglobulin, p24 antigen, anti-p18 antibody and immunoglobulin A) were adjusted. CONCLUSION: Elevated CD8 count appears to be a weak marker for disease progression.