Characterization of the bionano interface and mapping extrinsic interactions of the corona of nanomaterials.

Nanoparticles in physiological environments are known to selectively adsorb proteins and other biomolecules forming a tightly bound biomolecular 'corona' on their surface. Where the exchange times of the proteins are sufficiently long, it is believed that the protein corona constitutes the particle identity in biological milieu. Here we show that proteins in the corona retain their functional characteristics and can specifically bind to cognate proteins on arrays of thousands of immobilised human proteins. The biological identity of the nanomaterial is seen to be specific to the blood plasma concentration in which they are exposed. We show that the resulting in situ nanoparticle interactome is dependent on the protein concentration in plasma, with the emergence of a small number of dominant protein-protein interactions. These interactions are those driven by proteins that are adsorbed onto the particle surface and whose binding epitopes are subsequently expressed or presented suitably on the particle surface. We suggest that, since specific tailored protein arrays for target systems and organs can be designed, their use may be an important element in an overall study of the biomolecular corona.

The role of discography in lumbar disc disease: a comparative study of magnetic resonance imaging and discography.

This study reviews prospectively a series of 29 patients who were examined by magnetic resonance imaging (MRI) and discography for degenerative disc disease. All had persistent low-back pain and non-diagnostic initial investigations, including plain films, myelography and/or computed tomography (CT). The imaging characteristics for degenerative disc disease correlated in 65 out of 73 intervertebral levels. All symptomatic discs were degenerate on both MRI and discography. Features of degenerative disc disease on MRI were assessed retrospectively, with a view to identifying the symptomatic level as defined by discography. MRI could not reliably detect this level, particularly in those with multi-level degenerative disc disease. Positive reproduction of symptoms at discography was the criteria used for surgery. All 12 patients in this group had posterior spinal fusion performed. Nine improved and three were unchanged. Of the ancillary features associated with disc degeneration, only a bulging annulus fibrosis proved to be of any value on MRI. Nonetheless, MRI should be used as the primary investigation in this patient group as it can lead to a marked reduction in the number of disc levels requiring injection.

Duplex ultrasonography and selection of patients for carotid endarterectomy: plaque morphology or luminal narrowing?

Percentage of carotid stenosis and plaque morphology as determined by duplex scanning were correlated with symptoms and CT evidence of infarction in 108 patients. Severity of carotid stenosis less than 49% or greater than 50% narrowing was not associated with an increased risk of ipsilateral symptoms or CT infarction. However, a heterogeneous plaque appearance, suggesting intraplaque hemorrhage, did correlate with ipsilateral cerebral symptoms. Heterogeneous plaque appearance may be a more reliable indication for carotid endarterectomy than a hemodynamically significant stenosis.

The plain chest radiograph after acute smoke inhalation.

Serial chest radiographs of 45 patients from a major fire disaster were assessed for the effects of smoke inhalation injury. Thirty-three had abnormal chest radiographs on admission. Bronchial wall thickening was present in a total of 29 patients, subglottic oedema in 13, pulmonary oedema in seven, and patchy consolidation in three. Seven patients developed pulmonary oedema following initial exposure. This was the cause of death in two patients. Serial chest radiographs were useful in monitoring this very severe complication. Bronchial wall thickening and subglottic oedema were common early findings and thus may herald more serious subsequent respiratory embarrassment. Subglottic oedema is a previously undescribed finding. It not only indicates damage to the upper airways but may also indicate damage to the lung parenchyma. It may also make endotracheal intubation difficult. Therefore, the initial chest radiograph is an important predictor of significant smoke inhalation injuries enabling selection of patients likely to need ventilatory support.

The role of CT in the management of carcinoma of the oesophagus and cardia.

The role of computed tomography in assessing tumour spread and tumour resectability was evaluated in 50 patients with oesophageal carcinoma (17 middle third, 33 lower third). CT accurately identified all patients with tumour confined to the oesophagus (Stage I or II) but was limited in its ability to assess direct organ invasion (Stage III) with an overall accuracy for evaluating middle third lesions of 82% (aorta 70%, tracheobronchial tree 94%, other mediastinal structures 82%) compared to an overall accuracy for lower third lesions of 97% (aorta 97%, pancreas 100%, diaphragm 97%). Tumours deemed resectable on CT were always resectable at operation but two of seven middle third tumours and one of twelve lower third lesions deemed unresectable underwent curative resection. Preoperative CT evaluation of oesophageal tumours is useful in that it may reliably identify tumour lesions confined to the oesophagus and reliably identify distant metastases. Because of its limitations however in the assessment of organ invasion, particularly by middle third lesions, this study suggests that patients with oesophageal tumours with no evidence of distant metastases, who are otherwise fit to undergo tumour resection, should not be denied surgery on the sole basis of positive organ invasion on CT particularly if that organ is the aorta.

Solitary rectal ulcer syndrome: radiologic manifestations.

The solitary rectal ulcer syndrome is a distinct clinical entity occurring mainly in young patients who experience rectal bleeding. Solitary, and occasionally multiple, ulcers occur predominantly on the anterior or anterolateral aspects of the rectum. Current theories attribute this to pelvic muscle discoordination during defecation with partial rectal mucosal prolapse and traumatic ulceration. Classical histologic changes have been demonstrated that enable accurate diagnosis by the pathologist. Ten cases of biopsy-proven solitary rectal ulcer syndrome were reviewed. The radiographic abnormalities were: nodularity of the rectal mucosa (three cases), stricture formation (two cases), polypoid rectal masses (two cases), and ulceration (two cases). Radiologically this condition must be differentiated from other more serious entities such as carcinoma or inflammatory bowel disease.

Colitis of Behçet's syndrome--radiologic and pathologic features.

Three patients with Behçet's syndrome and colitis are described. The radiologic and histologic appearances of the colitis are discussed. The similarities of Behçet's colitis to Crohn's disease are outlined. The cases demonstrate the necessity to consider Behçet's syndrome in the differential diagnosis of inflammatory bowel disease.

Congenital intrathoracic bronchopulmonary foregut malformations in childhood.

Bronchopulmonary foregut malformations (BPFM) are a group of related disorders. They include tracheoesophageal fistula with or without atresia, bronchopulmonary sequestration, intestinal duplication cyst, bronchogenic cyst, aberrant systemic arterial supply to the lung, and bronchial mucosal rests in the esophagus. This paper describes 12 cases which illustrate the spectrum of clinical and radiographic features of these anomalies. The embryogenesis of these malformations is reviewed and appropriate radiographic investigation is discussed.

Intrathoracic rib: radiographic features of two cases.

Two cases of intrathoracic rib are presented. In one of these the anomalous rib was not supernumerary, and the investing layers of pleura caused the rib to appear abnormally dense. The relevant literature is briefly reviewed.

Arthritis of primary biliary cirrhosis.

We describe the clinical and roentgenographic findings in the hands of 13 patients with primary biliary cirrhosis. A nondeforming, generally asymptomatic erosive arthritis was present in 12 of 13 patients. The erosions were asymmetrically distributed and mainly involved the distal small joints of the hands. Seven patients had osteopenia due to hepatic osteodystrophy. Intraosseous lytic defects were present in three patients, chondrocalcinosis in two patients, and hypertrophic osteoarthropathy in one patient. We discuss the importance of the clinical and roentgenographic features of the arthritis of primary biliary cirrhosis.

Multicentric tracheobronchial and oesophageal granular cell myoblastoma.

Two patients with multiple intrathorcic granular cell myoblastomas are described. In one case multiple tumours were present in the major airways and oesophagus. The patient presented with recurrent pulmonary infections and stridor due to airway obstruction. In the other case dysphagia caused by multiple oesophageal granular cell myoblastomas was the major symptom. Granular cell myoblastoma is a rare tumour of neurogenic origin with a characteristic histological appearance. The pattern of multiple tracheobranchial and oesophageal tumours is uncommon and forms the basis of this report.

Hand changes in primary biliary cirrhosis.

The radiographic findings in the hands of 13 patients with primary biliary cirrhosis are described. Erosive arthritis was present in 12 of the 13 cases. Seven patients hand osteopenia due to hepatic osteodystrophy. Intraosseous lytic defects were present in 3 cases. Chondrocalcinosis, a previously unreported finding, was seen in 2 patients, and one exhibited hypertrophic osteoarthropathy. The significance of these radiographic findings is discussed.

The arthritis of mixed connective tissue disease.

Twenty patients with mixed connective tissue disease were followed for 5 years. Arthritis occurred in all 20 patients, being the presenting complaint in 11 patients. The joints most frequently involved were the proximal interphalangeal (PIP), metacarpophalangeal (MCP), wrists, metatarsophalangeal (MTP), and knee; the distribution tended to be symmetrical, mimicking early rheumatoid arthritis. Joint deformities occurred in 6 patients, but apart from 1 patient with arthritis mutilans, significant functional impairment was not encountered. Radiologically small punched out bone erosions, asymmetrically distributed, were the most characteristic finding; other notable changes were aseptic necrosis, tuft erosions, and periarticular calcification. Joint effusions were non-inflammatory, the cellular content was predominantly lymphocytic and the C3 level was normal. Most cases were controlled with non-steroidal anti-inflammatory agents and invariably responded to prednisone less than or equal to 7.5 mg/day.

Pneumatosis coli in non-Hodgkins lymphoma.

Two patients with poorly differentiated lymphoma who developed pneumatosis coli are described. In one case, the intramural gas was associated with diffuse nodular submucosal deposits of tumour. An annular stricture due to lymphoma was the underlying aetiology of the pneumatosis coli in the second case. The pathogenesis of pneumatosis coli in the context of malignant lymphoma is discussed.

Lymphoma of the colon: the spectrum of radiologic changes.

Primary lymphoma of the colon is rare and comprises less than 1% of large bowel malignancies. Secondary colonic involvement in patients with advanced lymphoma is not uncommon and is frequently undetected. The radiographic findings of 34 patients with colonic lymphoma were reviewed. Thirteen patients had primary tumors, while the remaining 21 had colonic involvement secondary to systemic disease. The radiologic features were classified as mucosal nodularity, endo-exoenteric mass, intraluminal mass, mural infiltration, and mesenteric invasion. One patient with diffuse mucosal nodularity developed acute colonic dilatation, while two other patients had pneumatosis coli secondary to local tumor depositions. Lymphoma is now a well-described complication of chronic ulcerative colitis, and a further case is described here. Although colonic lymphoma is a relatively rare tumor, the spectrum of radiologic changes reviewed here may enable a more accurate radiologic diagnosis.

Pneumatosis cystoides intestinalis and obstructing intussusception in celiac disease.

Spontaneous penumoperitoneum and pneumatosis cystoides intestinalis have been undescribed complications of celiac disease. In the case reported, small bowel gas cysts caused an obstructing intussusception. The etiology of the pneumatosis cystoides intestinalis is discussed.

Mixed connective tissue disease--clinical and radiological aspects of 20 cases.

The clinical and radiological features of 20 cases of mixed connective tissue disease (MCTD), a newly defined disorder, are described. MCTD shares a number of abnormalities with other collagen diseases, notably diffuse systemic sclerosis and systemic lupus erythematosus. However, patients with MCTD have a specific circulating antibody to extractable nuclear antigen (ENA). Most of the cases described exhibited multi-system involvement with radiological changes in the skeleton, chest, and gastro-intestinal tract. Twelve of the 20 cases had an erosive arthritis. This finding has not been previously noted in the radiological literature.