Radiografía lateral de tórax. Anatomía radiográfica / Lateral chest X-rays. Radiographic anatomy

La radiografía lateral forma parte esencial del estudio radiográfico del tórax, y el conocimiento anatómico es fundamental para poder detectar las variaciones que en ella producen las diferentes enfermedades. El objetivo de este trabajo es realizar una revisión anatómica de esta proyección, así como de las principales variantes normales. Para ello, y con fines únicamente didácticos, se ha dividido el tórax en diferentes espacios que se analizarán de manera ordenada, haciendo especial hincapié en los detalles anatómicos que más pueden ayudar a localizar lesiones ya detectadas en la proyección posteroanterior, o a detectar lesiones que pueden pasar desapercibidas en esa proyección (AU)

Lateral chest views constitute an essential part of chest X-ray examinations, so it is fundamental to know the anatomy on these images and to be able to detect the variations manifested on these images in different diseases. The aim of this article is to review the normal anatomy and main normal variants seen on lateral chest views. For teaching purposes, we divide the thorax into different spaces and analyze each in an orderly way, especially emphasizing the anatomic details that are most helpful for locating lesions that have already been detected in the posteroanterior view or for detecting lesions that can be missed in the posteroanterior view (AU)

Tomografía computarizada multicorte para el estudio de complicaciones de la funduplicatura gástrica / Multislice computed tomography for the study of complications of gastric fundoplication

La técnica de imagen tradicionalmente empleada para valorar a los pacientes con cirugía de funduplicatura y sospecha de complicación es el tránsito esofagogastroduodenal con fluoroscopia. En este artículo describimos una nueva técnica mediante tomografía computarizada multicorte, que puede ser una herramienta útil para estudiar las funduplicaturas con sospecha de complicación o fallo tardío (AU)

The traditional approach to the imaging evaluation of patients after gastric fundoplication is an upper gastrointestinal series obtained by fluoroscopy. In this article, we describe a new technique using multislice computed tomography that we think can be useful to evaluate patients with suspected complications or late failure after gastric fundoplication (AU)

[Lateral chest X-rays. Radiographic anatomy]. / Radiografía lateral de tórax. Anatomía radiográfica.

Lateral chest views constitute an essential part of chest X-ray examinations, so it is fundamental to know the anatomy on these images and to be able to detect the variations manifested on these images in different diseases. The aim of this article is to review the normal anatomy and main normal variants seen on lateral chest views. For teaching purposes, we divide the thorax into different spaces and analyze each in an orderly way, especially emphasizing the anatomic details that are most helpful for locating lesions that have already been detected in the posteroanterior view or for detecting lesions that can be missed in the posteroanterior view.

Multislice computed tomography for the study of complications of gastric fundoplication.

The traditional approach to the imaging evaluation of patients after gastric fundoplication is an upper gastrointestinal series obtained by fluoroscopy. In this article, we describe a new technique using multislice computed tomography that we think can be useful to evaluate patients with suspected complications or late failure after gastric fundoplication.

Miocarditis: diagnóstico y seguimiento con resonancia magnética / Myocarditis: magnetic resonance imaging diagnosis and follow-up

La miocarditis consiste en la inflamación del miocardio, producida la mayoría de las veces por una infección viral. La confirmación diagnóstica en la práctica clínica habitual es difícil porque la historia clínica y la exploración física, las alteraciones en el electrocardiograma, la determinación de las enzimas cardiacas y el ecocardiograma ofrecen escasa precisión diagnóstica, y no es infrecuente que se plantee el diagnóstico diferencial con el infarto agudo de miocardio. La resonancia magnética (RM) cardiaca se ha convertido en el método de imagen de elección para el diagnóstico de la miocarditis. En este trabajo se describen los hallazgos de imagen en la RM en el momento del diagnóstico y en el seguimiento de los pacientes con miocarditis, el diagnóstico diferencial con otros procesos agudos como el infarto de miocardio, y los factores pronósticos estudiados mediante RM (AU)

Myocarditis, inflammation of the myocardium, is usually due to viral infection. Diagnostic confirmation in ordinary clinical practice is difficult because the findings on the clinical history, physical examination, electrocardiogram, and laboratory tests offer scant diagnostic accuracy, and the differential diagnosis is often done with acute myocardial infarction. Cardiac magnetic resonance imaging (CMR) has become the method of choice for the diagnosis of myocarditis. In this article, we describe the CMR findings at diagnosis and during the follow-up of patients with myocarditis, the differential diagnosis with other acute processes like myocardial infarction, and the prognostic factors studied with CMR (AU)

[Myocarditis: magnetic resonance imaging diagnosis and follow-up]. / Miocarditis: diagnóstico y seguimiento con resonancia magnética.

Myocarditis, inflammation of the myocardium, is usually due to viral infection. Diagnostic confirmation in ordinary clinical practice is difficult because the findings on the clinical history, physical examination, electrocardiogram, and laboratory tests offer scant diagnostic accuracy, and the differential diagnosis is often done with acute myocardial infarction. Cardiac magnetic resonance imaging (CMR) has become the method of choice for the diagnosis of myocarditis. In this article, we describe the CMR findings at diagnosis and during the follow-up of patients with myocarditis, the differential diagnosis with other acute processes like myocardial infarction, and the prognostic factors studied with CMR.

Functional and structural characterization of two populations of human monocyte-derived dendritic cells.

BACKGROUND: The characterization of human monocyte-derived dendritic cells (HM-DC) subsets have been a very difficult and elusive task because of the lack of appropriate reagents. We, therefore utilized several diverse approaches to evaluate two populations of HM-DC including flow cytometry, ultra-structural evaluation by electron microscopy, and functional assays. In addition, we studied the kinetics of the expression of antigens on HM-DC at diverse intervals of time and identify surface markers and functional differences of these two HM-DC subsets. RESULTS: This study identified that a phenotype of HM-DC as defined by CD11c+, CD86+, and CD40+ could be separated in the presence or absence of TGF-beta1 into two different subsets of DC: (i) HM-DC without Birbeck granuli (Mo-DC) and (ii) HM-DC with Birbeck granuli (Mo-LC). Furthermore, the functional studies showed that the HM-DC treated with TGF-beta1 (Mo-LC) exhibited the presence of Birbeck granuli and could actively divide. In addition, after undergoing more than four cell divisions, these cells split into at least two additional subsets of Mo-LC: (iia) Mo-LC with high forward scatter (FSC) and (iib) Mo-LC with normal FSC. In contrast, the Mo-DC cultured in absence of TGF-beta1 did not exhibit Birbeck granuli, showed reduced ability to divide, and kept the normal FSC when analyzed. CONCLUSIONS: This study enabled us to determine in HM-DC: (i) the existence of antigenic and functional differences between various subpopulations of Mo-DC and Mo-LC; (ii) the existence of differences in the kinetics of antigens expression among the subsets of Mo-DC and Mo-LC; (iii) the existence of specific markers for each of the subpopulations of HM-DC.

Description of a flow cytometry approach based on SYBR-14 staining for the assessment of DNA content, cell cycle analysis, and sorting of living normal and neoplastic cells.

RATIONALE: This study aimed to expand the utilization of a simplified flow cytometric approach that employing SYBR-14/PI staining into broader flow cytometry applications, including (i) measurement of the DNA content; (ii) performing cell cycle analysis on mammalian cells; and (iii) sorting of live SYBR-14-stained mammalian cells based on DNA content. MATERIAL AND METHODS: Cell lines of human origin were stained with SYBR-14 and propidium iodide (PI) and assessed by a dual-color flow cytometry. Finally, sorting of living SYBR-14-stained human cell lines was performed. RESULTS: Dual staining with SYBR-14 and PI of human cells followed by flow cytometry analysis demonstrates that in addition to quality assessment, this staining could be utilized to determinate the DNA content on mammal cells. In addition, it resolves the diploid, tetraploid, and aneuploid DNA content. Furthermore, the SYBR-14-stained mammal cells were efficiently sorted based on DNA content and live cells were obtained. All these features have not been previously described with the utilization of this staining approach. CONCLUSIONS: Results of this study demonstrate that this flow cytometric approach not only allows assessment of the viability of cells, but also the DNA content of mammal cells. In addition, this approach allows one to sort viable cells stained with SYBR-14. These findings open-up unexpected and unrestricted avenues for sorting of living mammal cells and provide significant advantages over the traditionally cumbersome sorting approaches for living cells, which demand very specialized and expensive UV light sources as well as sophisticated sorting procedures.

[Pyomyositis in Zamora]. / Piomiositis en Zamora.

BACKGROUND: Pyomyositis is a purulent infection involving the skeletal muscle. Although it was initially described in tropical countries, is it ever more frequently found in warm climates. METHODS: A review of the clinical histories of the admission of patients in the Internal and Infectious Medicine Units over the period from May 1992 to April 1994 (1818 admissions) was carried out analyzing those in whom the diagnosis was of pyomyositis. This diagnosis was performed by clinical data and radiologic and microbiologic confirmation. RESULTS: Five patients diagnosed with pyomyositis were found. Of the five cases, four were men with ages ranging from 27 to 64 years. In most of the cases more than one muscle group was involved and only two cases showed predisposing factors (history of injury and DM). The existence of abscesses was shown by echography in 3 cases and by CAT in 2 cases. Staphylococcus aureus was the most frequently isolated microorganism. The five patients underwent medical treatment and surgical treatment was also performed in 2 achieving satisfactory evolution. CONCLUSIONS: Imaging techniques (echography and CAT) effectively contribute to the diagnosis of pyomyositis. Medical treatment, associated with surgery in some cases, achieved satisfactory evolution. The incidence of pyomyositis is probably greater than what has been recognized to date.

The effect of upright tilt on nifedipine-induced natriuresis.

Calcium channel blockers are antihypertensive agents with diuretic actions. Yet edema occurs in some patients receiving long-term treatment with these drugs. As with other vasodilators, stimulation for fluid retention could result from systemic vasodilation. We speculated that the upright posture could enhance sodium retention. To test this hypothesis, we studied the effect of upright tilt in 10 patients before and after the oral administration of 20 mg nifedipine. Before nifedipine upright tilt caused a 41% drop in the sodium excretion rate, from 0.27 +/- 0.04 to 0.16 +/- 0.03 meq/min (p less than 0.05). Fractional sodium excretion decreased by 46%, from 2.4 +/- 0.5 to 1.3 +/- 0.3% (p less than 0.01). Urinary volume and renal plasma flow also decreased (p less than 0.05). Plasma renin activity (PRA) rose by 46% (p less than 0.005). With the patients in the supine posture nifedipine increased the sodium excretion rate to 0.49 +/- 0.09 meq/min (p less than 0.05). Fractional sodium excretion was 3.1 +/- 0.6 meq/min (p = 0.2). The natriuresis took place despite a fall in mean blood pressure and a significant rise in PRA (up 115% from prenifedipine supine values, p less than 0.005). Renal plasma flow also increased (p less than 0.01). The upright tilt caused a reversal of the nifedipine-induced natriuresis. The sodium excretion rate dropped to 0.23 +/- 0.05 meq/min and fractional sodium excretion to 1.3 +/- 0.2% (both not different from control). This drop in natriuresis occurred while mean blood pressure was at its lowest and PRA was 254% above the initial levels (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)