Primary Adrenal Epithelioid Angiosarcoma: A Case Report.

Primary adrenal angiosarcomas are exceedingly rare with a rapidly progressive clinical course and a poor outcome. Establishing the diagnosis can be challenging, and it is complicated by the fact that there are no characteristic clinical or imaging features that are pathognomonic for angiosarcoma. Histologically, they can overlap with other more commonly encountered adrenal tumors. Herein, we present an otherwise healthy 41-year-old woman diagnosed with a primary adrenal epithelioid angiosarcoma. We aim to expand the knowledge of the sparse literature existing on primary adrenal angiosarcomas to help better understand the diagnostic features, clinical behavior, and management of these rare tumors.

Multidetector CT Imaging of Bowel and Mesenteric Injury: Review of Key Signs.

In contemporary practice, multidetector computed tomography plays a critical role in the diagnostic evaluation of patients with suspected acute mesenteric and bowel trauma. Although less common than solid organ injuries, it may be seen in up to 5% of blunt trauma patients. Evaluation with CT remains challenging even with improvements in technology. The major imaging signs of mesenteric and bowel trauma and what is known about their applicability in clinical practice are reviewed here. Examples illustrate both the subtlety and variable significance of many of the key signs as well as how these are typically integrated into clinical practice.

Imaging features of bariatric surgery and its complications.

Diagnostic imaging features of the most commonly performed types of bariatric surgery, which are gastric banding, sleeve gastrectomy, and Roux-en-Y gastric bypass, are reviewed as well as imaging diagnosis of their complications. Although upper gastrointestinal series remains the first-line imaging test for assessing postoperative anatomy and complications, the important role of multidetector computed tomography in diagnosis of serious complications is highlighted.

Diagnostic radiology of transjugular intrahepatic portosystemic shunts.

Transjugular intrahepatic portosystemic shunts (TIPS) are an effective method for treating the complications of portal hypertension. Specific indications for TIPS include secondary prevention of variceal bleeding and refractory ascites. The purpose of this review is to summarize the role of diagnostic radiology in the creation and assessment of TIPS, to highlight the complications that can occur post-TIPS, and to critically evaluate the literature regarding ultrasound evaluation of TIPS.

Imaging of liver transplant and its complications.

The role of diagnostic imaging in liver transplantation is reviewed with a focus on assessing for postoperative complications after adult orthotopic transplant. The normal postoperative appearance after liver transplant and imaging appearances of both vascular and nonvascular complications are discussed. The key role of Doppler ultrasound as the first-line imaging modality is highlighted.

Dynamic thiolation-thioesterase structure of a non-ribosomal peptide synthetase.

Non-ribosomal peptide synthetases (NRPS) and polyketide synthases (PKS) produce numerous secondary metabolites with various therapeutic/antibiotic properties. Like fatty acid synthases (FAS), these enzymes are organized in modular assembly lines in which each module, made of conserved domains, incorporates a given monomer unit into the growing chain. Knowledge about domain or module interactions may enable reengineering of this assembly line enzymatic organization and open avenues for the design of new bioactive compounds with improved therapeutic properties. So far, little structural information has been available on how the domains interact and communicate. This may be because of inherent interdomain mobility hindering crystallization, or because crystallized molecules may not represent the active domain orientations. In solution, the large size and internal dynamics of multidomain fragments (>35 kilodaltons) make structure determination by nuclear magnetic resonance a challenge and require advanced technologies. Here we present the solution structure of the apo-thiolation-thioesterase (T-TE) di-domain fragment of the Escherichia coli enterobactin synthetase EntF NRPS subunit. In the holoenzyme, the T domain carries the growing chain tethered to a 4'-phosphopantetheine whereas the TE domain catalyses hydrolysis and cyclization of the iron chelator enterobactin. The T-TE di-domain forms a compact but dynamic structure with a well-defined domain interface; the two active sites are at a suitable distance for substrate transfer from T to TE. We observe extensive interdomain and intradomain motions for well-defined regions and show that these are modulated by interactions with proteins that participate in the biosynthesis. The T-TE interaction described here provides a model for NRPS, PKS and FAS function in general as T-TE-like di-domains typically catalyse the last step in numerous assembly-line chain-termination machineries.

Correlative anatomy of the anus and rectum.

An overview of the normal anatomy of the anus and rectum is provided with an emphasis on correlative imaging, including computed tomography, magnetic resonance, and ultrasound. The major clinically important structures that can be assessed with these imaging modalities are reviewed.

Broadband 13C-13C adiabatic mixing in solution optimized for high fields.

Experiments which require mixing among spins with large frequency differences are generally performed with sequences based on composite pulses or computer-optimized cycles. Adiabatic pulses generally offer several advantages over other approaches, including greater single spin inversion bandwidths and tolerance to RF inhomogeneity. Here, a novel theoretical framework is presented in order to understand how spin-spin interactions are influenced by adiabatic inversion pulses, and insights from this approach are used to design more efficient adiabatic coherence exchange experiments. For very large frequency differences, this new approach generally offers improved results over previously applied mixing sequences, as applied to 13C-13C experiments which are the basis of modern sidechain assignment techniques in proteins. It is also anticipated that the approach presented here will be applicable to the analysis of various alternative approaches to adiabatic mixing.