Neuralgia del trigémino: estudio funcional mediante tensor de difusión de alta densidad como herramienta diagnóstica

Objetivo: El objetivo del presente artículo es demostrar la alteración de la fracción de anisotropía (FA) en la neuralgia esencial del trigémino (NET). Materiales y métodos: Se evaluaron 10 pacientes con diagnóstico de neuralgia esencial del trigémino mediante secuencias de tensor de difusión de alta densidad e imágenes anatómicas 3D en un resonador de alto campo 3 Tesla. En todos los casos se localizaron los nervios. Las imágenes obtenidas se posprocesaron para realizar la tractografía y medir la FA en 20 nervios. Resultados: Se correlacionaron los hallazgos patológicos entre la medición de la FA y la clínica de los pacientes. De los 10 casos, 6 presentaron compresión neurovascular de lado con neuralgia y un valor de FA descendido con respecto al contralateral en rango normal; mientras que 2 mostraron compresión neurovascular bilateral, pero solo descenso del valor de FA del lado afectado clínicamente. En los otros 2 pacientes no se determinó compresión neurovascular, aunque en el lado con manifestación clínica neurálgica la FA se encontraba descendida. Conclusión: La realización de la difusión anisotrópica de alta densidad y la medición de la FA pueden ser una herramienta en la evaluación de la neuralgia esencial del trigémino, ya que es un método reproducible y seguro que permite estudiar la función del nervio.(AU)

Objective: The objective of this article is to demonstrate the alteration of the anisotropy factor (FA) in essential trigeminal neuralgia. Materials and methods: Ten patients with essential trigeminal neuralgia were studied with sequences of high density diffusion tensor and anatomic 3D images with a high-field 3 Tesla resonator. The nerves were located in all cases studied. The obtained images were post-processed to perform tractography and FA was measured in 20 nerves. Results: There was correlation of pathological findings between measuring FA and clinical presentation of the patients. Six of the ten patients studied with neurovascular compression at the neuralgia side had decreased FA values compared to contralateral normal range. Two of the ten patients showed bilateral neurovascular compression, but only abnormal values of FA were found at the clinically affected side. In the remaining two patients no neurovascular compression was determined; however the FA was lower at the clinical manifestation neuralgic side. Conclusión: The performing of high density anisotropic diffusion and the measurement of the FA may be useful in the evaluation of Trigeminal neuralgia, since it is a safe and reproducible method that allows the study of nerve function.(AU)

Neuralgia del trigémino: estudio funcional mediante tensor de difusión de alta densidad como herramienta diagnóstica / Trigeminal Neuralgia: functional study using high density diffusion tensor imaging as a diagnostic tool

Objetivo: El objetivo del presente artículo es demostrar la alteración de la fracción de anisotropía (FA) en la neuralgia esencial del trigémino (NET). Materiales y métodos: Se evaluaron 10 pacientes con diagnóstico de neuralgia esencial del trigémino mediante secuencias de tensor de difusión de alta densidad e imágenes anatómicas 3D en un resonador de alto campo 3 Tesla. En todos los casos se localizaron los nervios. Las imágenes obtenidas se posprocesaron para realizar la tractografía y medir la FA en 20 nervios. Resultados: Se correlacionaron los hallazgos patológicos entre la medición de la FA y la clínica de los pacientes. De los 10 casos, 6 presentaron compresión neurovascular de lado con neuralgia y un valor de FA descendido con respecto al contralateral en rango normal; mientras que 2 mostraron compresión neurovascular bilateral, pero solo descenso del valor de FA del lado afectado clínicamente. En los otros 2 pacientes no se determinó compresión neurovascular, aunque en el lado con manifestación clínica neurálgica la FA se encontraba descendida. Conclusión: La realización de la difusión anisotrópica de alta densidad y la medición de la FA pueden ser una herramienta en la evaluación de la neuralgia esencial del trigémino, ya que es un método reproducible y seguro que permite estudiar la función del nervio.

Objective: The objective of this article is to demonstrate the alteration of the anisotropy factor (FA) in essential trigeminal neuralgia. Materials and methods: Ten patients with essential trigeminal neuralgia were studied with sequences of high density diffusion tensor and anatomic 3D images with a high-field 3 Tesla resonator. The nerves were located in all cases studied. The obtained images were post-processed to perform tractography and FA was measured in 20 nerves. Results: There was correlation of pathological findings between measuring FA and clinical presentation of the patients. Six of the ten patients studied with neurovascular compression at the neuralgia side had decreased FA values compared to contralateral normal range. Two of the ten patients showed bilateral neurovascular compression, but only abnormal values of FA were found at the clinically affected side. In the remaining two patients no neurovascular compression was determined; however the FA was lower at the clinical manifestation neuralgic side. Conclusión: The performing of high density anisotropic diffusion and the measurement of the FA may be useful in the evaluation of Trigeminal neuralgia, since it is a safe and reproducible method that allows the study of nerve function.

DFT study of the energetic and noncovalent interactions between imidazolium ionic liquids and hydrofluoric acid.

In this work, we evaluated the energetic interactions between imidazolium ionic liquids (ILs) and hydrofluoric acid, as well as the cation-anion interactions in ILs. We used DFT calculations that include dispersion corrections employing the PBE and M06 functionals. We tested 22 ILs, including [C4MIM][PF6], [C4MIM][NTf2], and [C4MIM][CH3COO], obtaining interaction energies in the range of -27 to -13 kcal/mol with the PBE functional. The NCI (noncovalent interaction) index developed by Yang and collaborators ( J. Am. Chem. Soc. 2010 , 132 , 6498 - 6506 ; J. Chem. Theory Comput. 2011 , 7 , 625 - 632 ) also was used for mapping the key noncovalent interactions (hydrogen bonds, van der Waals, and steric repulsions) between the anions and cations of ILs and also for interactions of ILs with hydrofluoric acid (HF). The results obtained show that the anions have a stronger effect with respect to cations in their capacity for interacting with hydrofluoric acid, and the strongest interaction energies occur in systems where the key noncovalent interactions are mainly hydrogen bonds. The [C4MIM][PF6], [C4MIM][NTf2], and [C4MIM][BF4] ionic liquids displayed the weakest cation-anion interactions.

Identificación prequirúrgica de pares craneales en tumores de la base del cráneo mediante la técnica de tensor de difusión

Objetivo: El objetivo de este trabajo es demostrar la utilidad de las técnicas de tensor de difusión de alta densidad (DTI 32 direcciones) para visualizar el trayecto de los pares craneales antes de la cirugía en pacientes con patología tumoral de la base del cráneo. Materiales y métodos: Se estudiaron 26 pacientes con patología tumoral de la base del cráneo con secuencias de tensor de difusión de alta densidad. Los resultados imagenológicos fueron correlacionados con los hallazgos intraoperatorios. Resultados: En todos los pacientes estudiados fue posible la identificación prequirúrgica del recorrido de los nervios involucrados por las lesiones de la base del cráneo y también hubo una correlación entre los datos obtenidos mediante las imágenes y los hallazgos intraoperatorios. Conclusión: La visualización del recorrido de los nervios craneales mediante la difusión de alta densidad demostró ser segura y reproducible para identificar los pares y su recorrido.(AU)

Objective: The objective of this work is to demonstrate the usefulness of high density diffusion tensor imaging techniques (HD-DTI 32 directions), to visualize the course of the cranial nerves prior to surgery in patients with skull base tumor disease. Materials and methods: Twenty-six patients with skull base tumor disease were studied with sequences of high density diffusion tensor imaging. The imaging results were correlated with the intra-operative fi ndings. Results: Pre-surgical identifi cation of the course of the nerves affected by the injuries of the skull base was possible in all the studied patients, with the imaging results correlating with the intraoperative fi ndings. Conclusion: The visualization of the course of the cranial nerves with high density diffusion tensor imaging was shown to be safe and reproducible for the identifi cation of cranial nerves and their course.(AU)

Identificación prequirúrgica de pares craneales en tumores de la base del cráneo mediante la técnica de tensor de difusión / Diffusion tensor technique as a preoperative identification of cranial nerves in skull base tumors

Objetivo: El objetivo de este trabajo es demostrar la utilidad de las técnicas de tensor de difusión de alta densidad (DTI 32 direcciones) para visualizar el trayecto de los pares craneales antes de la cirugía en pacientes con patología tumoral de la base del cráneo. Materiales y métodos: Se estudiaron 26 pacientes con patología tumoral de la base del cráneo con secuencias de tensor de difusión de alta densidad. Los resultados imagenológicos fueron correlacionados con los hallazgos intraoperatorios. Resultados: En todos los pacientes estudiados fue posible la identificación prequirúrgica del recorrido de los nervios involucrados por las lesiones de la base del cráneo y también hubo una correlación entre los datos obtenidos mediante las imágenes y los hallazgos intraoperatorios. Conclusión: La visualización del recorrido de los nervios craneales mediante la difusión de alta densidad demostró ser segura y reproducible para identificar los pares y su recorrido...

Objective: The objective of this work is to demonstrate the usefulness of high density diffusion tensor imaging techniques (HD-DTI 32 directions), to visualize the course of the cranial nerves prior to surgery in patients with skull base tumor disease.Materials and methods: Twenty-six patients with skull base tumor disease were studied with sequences of high density diffusion tensor imaging. The imaging results were correlated with the intra-operative fi ndings.Results: Pre-surgical identifi cation of the course of the nerves affected by the injuries of the skull base was possible in all the studied patients, with the imaging results correlating with the intraoperative fi ndings.Conclusion: The visualization of the course of the cranial nerves with high density diffusion tensor imaging was shown to be safe and reproducible for the identifi cation of cranial nerves and their course...

Incidence of tumoral pathology according to study using capsule endoscopy for patients with obscure gastrointestinal bleeding.

BACKGROUND: Capsule endoscopy has involved a significant advance in techniques for imaging of the small bowel. Its most frequent indication is for studying patients with obscure gastrointestinal bleeding (OGIB). Small bowel tumors are infrequent, representing only 1% to 3% of all malignant gastrointestinal tumors. This study aimed to assess retrospectively the occurrence and characteristics of tumoral pathology diagnosed by means of capsule endoscopy in patients with OGIB. METHODS: A retrospective review analyzed the first 320 patients submitted to capsule endoscopy because of OGIB (166 with obscure overt bleeding and 154 with obscure occult bleeding) at a single center. The patients with a tumor diagnosis were analyzed in terms of incidence, characteristics, and treatment of OGIB pathology. RESULTS: Tumor incidence was of 7.18% (23/320), with 65.2% of the cases supported with histologic confirmation (15/23). Obscure overt bleeding was the most frequent form of presentation, with the jejunum as the most frequent location (65.2%). For 16 patients, an intervention was conducted with a healing intent. Capsule endoscopy allowed the diagnosis of two cecal adenocarcinomas missed by colonoscopy. CONCLUSIONS: Small bowel tumors are not an infrequent cause of OGIB. Capsule endoscopy, even if it does not allow determination of the benign or malignant nature or the histologic type of the tumor, is a useful tool for the diagnosis and early management of these tumors.

Prevalence of human immunodeficiency virus (HIV) antibody in critically ill emergency patients in Gijón, Spain.

The objective of this study was to find out the prevalence of infection by the human immunodeficiency virus (HIV) in critically ill patients treated in the resuscitation room of the emergency department of Cabueñes Hospital (Gijón, Spain) and to stress the need to adopt universal preventative measures. This was a prospective study that included all the patients treated in the resuscitation room during 1994. It contains a protocolized collection of clinical-epidemiological variables and HIV serology respecting anonymity. The number of accidents with potential risk of contagion and use of preventative measures was directly observed. A total of 202 patients were treated. The prevalence of HIV positive was 4%. Seventy per cent were male and the average age was 31 years. In all the cases drug-taking through the parenteral route was suspected as a possible risk factor for infection. No accidents with risk of contagion were recorded and preventative measures were adopted in all the cases. It is concluded that the prevalence of HIV positive figures detected did not differ from previous studies. Although the profile of the HIV positive patients was well defined in this study, we must insist on the need to take preventative measures with all patients.

Immunocytochemical evidence for extra-cellular initiation of elastase-induced bronchial secretory cell metaplasia in hamsters.

The bronchus is the only region of the hamster conducting airways to develop secretory cell metaplasia after an intratracheal instillation of human neutrophil elastase (HNE). We tested the hypothesis that this pathological change occurs because of cellular uptake of the enzyme that is specific to this region. HNE, dissolved in saline, was instilled into the trachea of hamsters, that were sacrificed 5, 15, 30 or 60 min later for immunocytochemical localization of the enzyme. Saline-treated animals served as controls. By light microscopy, HNE was evident only in the lumen and upon the epithelial surface in all airways, at all time points. Saline control tissues were negative. Electron microscopic immunogold staining revealed HNE within luminal macrophages and associated with mucus and, to a limited extent, upon the apical cell surface both in trachea and bronchus. A small amount of HNE staining occurred in the intercellular space and lamina propria of bronchi. Cytoplasmic gold particles were sparse both in treated and control animals. We conclude that instilled neutrophil elastase is excluded from the epithelial cytoplasm regardless of region. We thus reject the hypothesis of airway cellular uptake of HNE and suggest that stimulation of bronchial secretory cells to accumulate mucin granules is initiated at the cell surface, possibly by unmasking or altering region-specific receptors involved in signal transduction pathways governing mucin granule synthesis.