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1.
Acad Radiol ; 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31300356

RESUMO

RATIONALE AND OBJECTIVES: To evaluate the influence of throwing activity on shoulder morphology and the difference in shoulder morphology on MRI between asymptomatic professional baseball players and volunteers who play baseball as a recreational activity. MATERIALS AND METHODS: This retrospective case-control study included 68 asymptomatic professional baseball players (32 pitchers, 36 batters) and 30 male volunteers. Morphologic changes in the following shoulder structures were assessed on MRI: rotator cuff, glenoid labrum, humeral head, subacromial-subdeltoid bursa, subcoracoid bursa, long head of the biceps tendon, deltoid muscle, acromion, and clavicle. RESULTS: Partially torn supraspinatus, posterior glenoid or labral lesions, bone marrow edema, intraosseous cysts of the humeral head, and edematous subacromial-subdeltoid bursa were significantly more commonly observed in players (p = 0.01, p < 0.001, p = 0.03, p< 0.001, and p < 0.001). Players with more than 10 years of experience had a significantly higher incidence of patchy intermediate signal abnormality (odds ratio: 3.73, p = 0.03), partial tear in the supraspinatus tendon (odds ratio: 6.20, p = 0.03), and edematous change in the subacromial-subdeltoid bursa (odds ratio: 2.96, p = 0.03). CONCLUSION: The results from our study showed that repetitive throwing activities cause macroscopic structural lesions of the shoulder joints in asymptomatic baseball players. Significance of these lesions is to be determined.

3.
Radiol Case Rep ; 14(6): 734-739, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30988866

RESUMO

Background: Lhermitte-Duclos disease (LDD) stems from the development of a rare benign lesion of uncertain pathogenesis that distorts the normal cerebellar laminar cytoarchitecture. We explored the lesion's appearance on conventional magnetic resonance imaging (MRI) combined with susceptibility-weighted imaging, diffusion-weighted imaging, perfusion imaging, or arterial spin labeling. Although many cases of LDD have been previously reported in the literature, the radiologic-pathologic correlation has been described in only a few of these cases. To the best of our knowledge, this is the first case report to provide detailed information about the radiologic-pathologic correlation of LDD. Case Report: A 48-year-old woman presented with left facial tics, occipital headache, and dizziness for 1 month. MRI revealed a left cerebellar lesion with hypointensity on T1-weighted images. On T2-weighted images, the mass was hyperintense with tigroid appearance due to alternating high and normal signal intensities. High signal intensity was noted on fluid-attenuated inversion recovery images. Magnetic resonance spectroscopy indicated decreased level of choline (Cho), N-acetyl aspartate, and myoinositol with elevated level of lactate on the affected side. The lesion showed a bright signal on diffusion-weighted images, whereas apparent diffusion coefficient mapping revealed no disturbance of diffusion. The pathology of the excised lesion was consistent with LDD. Conclusion: MRI with advanced techniques can provide not only preoperative diagnosis but also better pathologic correlation.

4.
J Pediatr ; 203: 330-335.e3, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30195556

RESUMO

OBJECTIVE: To investigate the familial risk of appendicitis in the general population. STUDY DESIGN: A nationwide, cross-sectional study consisting of 24 349 599 Taiwan National Health Insurance beneficiaries in 2015 was conducted. Among them, 788 042 individuals had at least 1 first-degree relative with appendicitis. The familial relative risks (RRs) of appendicitis and familial transmission were estimated. RESULTS: The overall RR (95% CI) of appendicitis in individuals with any affected first-degree relatives was 1.67 (1.64-1.71) compared with the general population. The RRs for individuals with an affected twin, sibling, offspring, and parent were 3.40 (2.66-4.35), 1.98 (1.92-2.04), 1.55 (1.51-1.59), and 1.54 (1.50-1.58), respectively. The RRs for individuals with 1, 2, 3 or more affected first-degree relatives were 1.65 (1.62-1.68), 2.63 (2.37-2.91), and 6.70 (4.22-10.63), respectively. Furthermore, there was an age-dependent trend of the RRs, with the greatest RR in the youngest group. The estimated familial transmission (genetic plus shared environmental contribution to the total phenotypic variance of appendicitis) was 23.2%. CONCLUSION: Individuals with a family history of appendicitis have an increased risk of appendicitis. This risk is age-dependent and related to the genetic distance and numbers of affected relatives.


Assuntos
Apendicite/diagnóstico , Apendicite/genética , Predisposição Genética para Doença , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Saúde da Família , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Sistema de Registros , Fatores de Risco , Taiwan/epidemiologia , Adulto Jovem
5.
BMC Cancer ; 17(1): 274, 2017 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-28415974

RESUMO

BACKGROUND: To investigate the relationship between mammographic density measured in four quadrants of a breast with the location of the occurred cancer. METHODS: One hundred and ten women diagnosed with unilateral breast cancer that could be determined in one specific breast quadrant were retrospectively studied. Women with previous cancer/breast surgery were excluded. The craniocaudal (CC) and mediolateral oblique (MLO) mammography of the contralateral normal breast were used to separate a breast into 4 quadrants: Upper-Outer (UO), Upper-Inner (UI), Lower-Outer (LO), and Lower-Inner (LI). The breast area (BA), dense area (DA), and percent density (PD) in each quadrant were measured by using the fuzzy-C-means segmentation. The BA, DA, and PD were compared between patients who had cancer occurring in different quadrants. RESULTS: The upper-outer quadrant had the highest BA (37 ± 15 cm2) and DA (7.1 ± 2.9 cm2), with PD = 20.0 ± 5.8%. The order of BA and DA in the 4 separated quadrants were: UO > UI > LO > LI, and almost all pair-wise comparisons showed significant differences. For tumor location, 67 women (60.9%) had tumor in UO, 16 (14.5%) in UI, 7 (6.4%) in LO, and 20 (18.2%) in LI quadrant, respectively. The estimated odds and the 95% confidence limits of tumor development in the UO, UI, LO and LI quadrants were 1.56 (1.06, 2.29), 0.17 (0.10, 0.29), 0.07 (0.03, 0.15), and 0.22 (0.14, 0.36), respectively. In these 4 groups of women, the order of quadrant BA and DA were all the same (UO > UI > LO > LI), and there was no significant difference in BA, DA or PD among them (all p > 0.05). CONCLUSIONS: Breast cancer was most likely to occur in the UO quadrant, which was also the quadrant with highest BA and DA; but for women with tumors in other quadrants, the density in that quadrant was not the highest. Therefore, there was no direct association between quadrant density and tumor occurrence.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Mama/citologia , Mama/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Mama/patologia , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Mamografia/métodos , Pessoa de Meia-Idade , Estudos Retrospectivos
6.
Medicine (Baltimore) ; 96(51): e9100, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29390438

RESUMO

Sacral insufficiency fractures (SIFs) are easily neglected by clinical physicians.The incidence of SIFs remains unclear in patients with symptomatic osteoporotic compression fractures of the lumbar-sacral area.This retrospective study was conducted by reviewing the medical records and radiological reports and by reading magnetic resonance (MR) images from August 2013 to July 2016. We identified 1233 cases with symptomatic vertebral compression fractures for which surgical interventions were performed. A total of 1144 cases were eligible for this study. Neglected diagnoses by radiologists and clinical physicians were calculated, respectively.The MR imaging (MRI) findings of SIFs were divided into the body (S1, S2, S3, and S4 levels) and alar areas (unilateral, bilateral, transverse, and none).A total of 34 (3.00%) cases with SIFs were identified through MRI. A significant difference was observed between 19 (6.53%) patients aged >80 years and 15 (1.76%) aged <80 years (P < .0001). Eight (23.53%) and 26 (76.47%) cases of SIFs were neglected by radiologists and clinical physicians, respectively. The S2 and S3 levels were the predominantly involved area (23/34; 67.65%). Furthermore, the bilateral alar area was the most commonly involved (19/34; 55.88%), as observed in coronal views of MRI.While treating other levels of osteoporotic compression fractures, radiologists and clinical physicians should be aware of SIFs, particularly when the patients are aged >80 years. The coronal oblique MR images of the thoracolumbar region should be carefully read to avoid neglecting SIFs.


Assuntos
Erros de Diagnóstico/estatística & dados numéricos , Fraturas por Compressão/diagnóstico por imagem , Fraturas por Osteoporose/diagnóstico por imagem , Sacro/diagnóstico por imagem , Sacro/lesões , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Estudos Retrospectivos
7.
Am J Med ; 130(1): 54-60.e5, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27555093

RESUMO

OBJECTIVE: The incidence and association between appendicitis and barium examination (BE) remain unclear. Such potential risk may be omitted. We conducted a longitudinal, nationwide, population-based cohort study to investigate the association between BE and appendicitis risk. METHODS: From the Taiwan National Health Insurance Research Database, a total of 24,885 patients who underwent BE between January 1, 2000 and December 31, 2010 were enrolled in a BE cohort; an additional 98,384 subjects without BE exposure were selected as a non-BE cohort, matched by age, sex, and index date. The cumulative incidences of subsequent appendicitis in the BE and non-BE cohorts were assessed using the Kaplan-Meier curves and log-rank test. Cox proportional hazards regression analyses were employed to calculate the appendicitis risk between the groups. RESULTS: The cumulative incidence of appendicitis was higher in the BE cohort than in the non-BE cohort (P = .001). The overall incidence rates of appendicitis for the BE and non-BE cohorts were 1.19 and 0.80 per 1000 person-years, respectively. After adjustment for sex, age, and comorbidities, the risk of appendicitis was higher in the BE cohort (adjusted hazard ratio = 1.46, 95% confidence interval = 1.23-1.73) compared with the non-BE cohort, especially in the first 2 months (adjusted hazard ratio = 9.72, 95% confidence interval = 4.65-20.3). CONCLUSIONS: BE was associated with an increased, time-dependent appendicitis risk. Clinicians should be aware of this potential risk to avoid delayed diagnoses.


Assuntos
Apendicite/etiologia , Bário/efeitos adversos , Meios de Contraste/efeitos adversos , Trato Gastrointestinal/diagnóstico por imagem , Adolescente , Adulto , Fatores Etários , Apendicite/epidemiologia , Bário/uso terapêutico , Meios de Contraste/uso terapêutico , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Radiografia/efeitos adversos , Radiografia/métodos , Fatores de Risco , Fatores Sexuais , Taiwan/epidemiologia , Adulto Jovem
8.
Medicine (Baltimore) ; 95(5): e2616, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26844473

RESUMO

The aim of the present study was to compare differential impacts of bariatric surgery and exercise-induced weight loss on excessive abdominal and cardiac fat deposition.Excessive fat accumulation around the heart may play an important role in the pathogenesis of cardiovascular disease. Recent evidences have suggested that bariatric surgery results in relatively less decrease in epicardial fat compared with abdominal visceral fat and paracardial fat.Sixty-four consecutive overweight or obese subjects were enrolled in the study. Clinical characteristics and metabolic profiles were recorded. The volumes of abdominal visceral adipose tissue (AVAT), abdominal subcutaneous adipose tissue (ASAT), epicardial (EAT), and paracardial adipose tissue (PAT) were measured by computed tomography in the bariatric surgery group (N = 25) and the exercise group (N = 39) at baseline and 3 months after intervention. Subjects in both the surgery and exercise groups showed significant reduction in body mass index (15.97%, 7.47%), AVAT (40.52%, 15.24%), ASAT (31.40, 17.34%), PAT (34.40%, 12.05%), and PAT + EAT (22.31%, 17.72%) (all P < 0.001) after intervention compared with baseline. In both the groups, the decrease in EAT was small compared with the other compartments (P < 0.01 in both groups). Compared with the exercise group, the surgery group had greater loss in abdominal and cardiac visceral adipose tissue (AVAT, ASAT, PAT, EAT+PAT) (P < 0.001), but lesser loss in EAT (P = 0.037).Compared with the exercise group, bariatric surgery results in significantly greater percentage loss of excessive fat deposits except for EAT. EAT, but not PAT, was relatively preserved despite weight reduction in both the groups. The physiological impact of persistent EAT deserves further investigation.


Assuntos
Adiposidade , Cirurgia Bariátrica/estatística & dados numéricos , Terapia por Exercício/estatística & dados numéricos , Gordura Intra-Abdominal/patologia , Obesidade Mórbida/terapia , Pericárdio , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Obesidade Mórbida/patologia , Pericárdio/patologia , Gordura Subcutânea Abdominal/patologia , Perda de Peso
9.
PLoS One ; 11(1): e0146913, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26812647

RESUMO

PURPOSE: To assess the inter session reproducibility of automatic segmented MRI-derived measures by FreeSurfer in a group of subjects with normal-appearing MR images. MATERIALS AND METHODS: After retrospectively reviewing a brain MRI database from our institute consisting of 14,758 adults, those subjects who had repeat scans and had no history of neurodegenerative disorders were selected for morphometry analysis using FreeSurfer. A total of 34 subjects were grouped by MRI scanner model. After automatic segmentation using FreeSurfer, label-wise comparison (involving area, thickness, and volume) was performed on all segmented results. An intraclass correlation coefficient was used to estimate the agreement between sessions. Wilcoxon signed rank test was used to assess the population mean rank differences across sessions. Mean-difference analysis was used to evaluate the difference intervals across scanners. Absolute percent difference was used to estimate the reproducibility errors across the MRI models. Kruskal-Wallis test was used to determine the across-scanner effect. RESULTS: The agreement in segmentation results for area, volume, and thickness measurements of all segmented anatomical labels was generally higher in Signa Excite and Verio models when compared with Sonata and TrioTim models. There were significant rank differences found across sessions in some labels of different measures. Smaller difference intervals in global volume measurements were noted on images acquired by Signa Excite and Verio models. For some brain regions, significant MRI model effects were observed on certain segmentation results. CONCLUSIONS: Short-term scan-rescan reliability of automatic brain MRI morphometry is feasible in the clinical setting. However, since repeatability of software performance is contingent on the reproducibility of the scanner performance, the scanner performance must be calibrated before conducting such studies or before using such software for retrospective reviewing.


Assuntos
Encéfalo/anatomia & histologia , Imagem por Ressonância Magnética/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
Comput Methods Programs Biomed ; 122(1): 76-88, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26198131

RESUMO

This study applied a simulation method to map the temperature distribution based on magnetic resonance imaging (MRI) of individual patients, and investigated the influence of different pelvic tissue types as well as the choice of thermal property parameters on the efficiency of endorectal cooling balloon (ECB). MR images of four subjects with different prostate sizes and pelvic tissue compositions, including fatty tissue and venous plexus, were analyzed. The MR images acquired using endorectal coil provided a realistic geometry of deformed prostate that resembled the anatomy in the presence of ECB. A single slice with the largest two-dimensional (2D) cross-sectional area of the prostate gland was selected for analysis. The rectal wall, prostate gland, peri-rectal fatty tissue, peri-prostatic fatty tissue, peri-prostatic venous plexus, and urinary bladder were manually segmented. Pennes' bioheat thermal model was used to simulate the temperature distribution dynamics, by using an in-house finite element mesh based solver written in MATLAB. The results showed that prostate size and periprostatic venous plexus were two major factors affecting ECB cooling efficiency. For cases with negligible amount of venous plexus and small prostate, the average temperature in the prostate and neurovascular bundles could be cooled down to 25 °C within 30 min. For cases with abundant venous plexus and large prostate, the temperature could not reach 25 °C at the end of 3 h cooling. Large prostate made the cooling difficult to propagate through. The impact of fatty tissue on cooling effect was small. The filling of bladder with warm urine during the ECB cooling procedure did not affect the temperature in the prostate or NVB. In addition to the 2D simulation, in one case a 3D pelvic model was constructed for volumetric simulation. It was found that the 2D slice with the largest cross-sectional area of prostate had the most abundant venous plexus, and was the most difficult slice to cool, thus it may provide a conservative prediction of the cooling effect. This feasibility study demonstrated that the simulation tool could potentially be used for adjusting the setting of ECB for individual patients during hypothermic radical prostatectomy. Further studies using MR thermometry are required to validate the in silico results obtained using simulation.


Assuntos
Hipotermia Induzida , Imagem por Ressonância Magnética/métodos , Modelos Anatômicos , Pelve , Humanos , Masculino , Próstata/anatomia & histologia , Próstata/cirurgia , Prostatectomia/métodos , Bexiga Urinária/anatomia & histologia
11.
Surg Obes Relat Dis ; 11(1): 181-5, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25701961

RESUMO

BACKGROUND: Studies have reported decreased bone mineral density (BMD) after laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Laparoscopic adjustable gastric banded plication (LAGBP) is a novel procedure resulting in a dual restrictive mechanism of weight loss without altering gastrointestinal anatomy. The objectives of this study were to compare the BMD changes at 1 year after LAGBP, LSG, and LRYGB. METHODS: The sample included 120 patients (40 patients [13 men/27 premenopausal women] each in LAGBP, LSG, and LRYGB groups). The mean preoperative age and body mass index were 30.0±6.5 years and 39.5±3.8 kg/m2, respectively. BMD was measured using dual energy X-ray absorptiometry at the lumbar anteroposterior spine and total hip preoperatively and 1 year postoperatively. RESULTS: The mean percentage of excess weight loss was 61.9%±16.8%, 77.1%±12.3%, and 72.7%±17.4% at 1 year after LAGBP, LSG, and LRYGB, respectively. The mean BMD at the lumbar anteroposterior spine remained unchanged in the LSG and LRYGB groups, but significantly increased in the LAGBP group. The mean BMD at the total hip significantly decreased in all groups compared to the preoperative values. However, the mean BMD was significantly higher in the LRYGB than in the LAGBP group. CONCLUSION: Bone loss at the hips was observed in all patients, including those with adequate micronutrient supplementation. LRYGB caused significantly greater bone loss than the other procedures.


Assuntos
Cirurgia Bariátrica/métodos , Densidade Óssea , Absorciometria de Fóton , Adulto , Feminino , Articulação do Quadril/diagnóstico por imagem , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino
12.
Obes Surg ; 24(9): 1585, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25012768

RESUMO

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the gold standard procedure in bariatric surgery but requires 4-7 ports. We have reported the first single incision transumbilical Roux-en-Y gastric bypass (SITU-RYGB) in 2009 (Huang et al. Obes Surg 19:1711-1715, 2009). Over the years, we have standardized our procedure and this video highlights the same by showing both inside and outside views. This video was shot from outside as well to give better understanding of the procedure. A 4.5-cm incision was made according to the contour of umbilicus and space was created over the sheath to give more range of movement to the instruments. The procedure was carried out using conventional laparoscopic instruments and replicating all the steps of the procedure under adequate visualization. Picture-in-picture effect has been used at important steps. Findings were recorded. The procedure took 96 min without any intraoperative complication. Blood loss was 20 cc. The incision was hardly noticeable at the end of the procedure. We have previously compared our results of SITU-RYGB with that of our multiport RYGB where operative time was longer for SITU-RYGB versus multiport technique (101.1 vs. 81.1 min, P = 0.001) (Huang et al. Surg Obes Relat Dis 8:201-207, 2012). No difference in complications was observed. The SITU-LRYGB patients reported greater satisfaction related to scarring than those who had undergone five-port surgery (P = 0.005). Difference in analgesia requirement was not statistically significant. There was no mortality. Compared with conventional LRYGB, SITU-RYGB resulted in acceptable complications, the same recovery, comparative weight loss, and better patient satisfaction related to scarring.


Assuntos
Derivação Gástrica/métodos , Obesidade Mórbida/cirurgia , Cicatriz/prevenção & controle , Humanos , Laparoscopia/métodos , Satisfação do Paciente , Umbigo , Perda de Peso
13.
Abdom Imaging ; 38(1): 180-3, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22450723

RESUMO

Angiomyolipoma (AML) is known as the most common benign mesenchymal tumor of kidney. Usually AMLs present as benign lesions without local invasion or complication. However, few cases of renal AML have been reported with complications such as tumor thrombus extension into inferior vena cava (IVC) or hemorrhagic aneurysm formation. We report a complicated case of renal AML with CT and angiography evidence of hemorrhagic aneurysm formation and IVC thrombus, treated by a combination of selective arterial embolization, radical nephrectomy and thrombectomy. Radiologists and clinicians should be aware that AMLs could have such aggressive behaviors.


Assuntos
Aneurisma/complicações , Aneurisma/diagnóstico por imagem , Angiomiolipoma/complicações , Angiomiolipoma/diagnóstico por imagem , Neoplasias Renais/complicações , Neoplasias Renais/diagnóstico por imagem , Trombose/complicações , Trombose/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Veia Cava Inferior , Adulto , Aneurisma/cirurgia , Angiomiolipoma/cirurgia , Feminino , Humanos , Neoplasias Renais/cirurgia , Trombose/cirurgia
14.
Clin Imaging ; 36(6): 797-802, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23154012

RESUMO

Posterior limbus vertebra (PLV) is the retropulsion of the vertebral ring apophysis resulting from disc herniation through posterior ring physis. Large PLV can cause spinal stenosis, and small PLV can be mistaken as intraspinal disc herniation. Although the clinical presentations were similar, the surgery was quite different. We had experienced preoperative misdiagnosed cases and the surgery could not be finished. Therefore we analyzed the imaging features of PLV in 34 patients in order to prompt appropriate preoperative diagnosis and surgical planning.


Assuntos
Deslocamento do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/diagnóstico , Imagem por Ressonância Magnética/métodos , Coluna Vertebral/anormalidades , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/patologia , Adulto Jovem
15.
ScientificWorldJournal ; 2012: 907062, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22701374

RESUMO

PURPOSE: Coronary artery calcification (CAC) scores are widely used to determine risk for Coronary Artery Disease (CAD). A CAC score does not have the diagnostic accuracy needed for CAD. This work uses a novel efficient approach to predict CAD in patients with low CAC scores. MATERIALS AND METHODS: The study group comprised 86 subjects who underwent a screening health examination, including laboratory testing, CAC scanning, and cardiac angiography by 64-slice multidetector computed tomographic angiography. Eleven physiological variables and three personal parameters were investigated in proposed model. Logistic regression was applied to assess the sensitivity, specificity, and accuracy of when using individual variables and CAC score. Meta-analysis combined physiological and personal parameters by logistic regression. RESULTS: The diagnostic sensitivity of the CAC score was 14.3% when the CAC score was ≤30. Sensitivity increased to 57.13% using the proposed model. The statistically significant variables, based on beta values and P values, were family history, LDL-c, blood pressure, HDL-c, age, triglyceride, and cholesterol. CONCLUSIONS: The CAC score has low negative predictive value for CAD. This work applied a novel prediction method that uses patient information, including physiological and society parameters. The proposed method increases the accuracy of CAC score for predicting CAD.


Assuntos
Calcinose/complicações , Calcinose/diagnóstico por imagem , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/etiologia , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Intensificação de Imagem Radiográfica/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
16.
Cytokine ; 57(1): 74-80, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22137121

RESUMO

Visfatin is a cytokine that is expressed in many tissues, including the heart, and has been proposed to play a role in plaque destabilization leading to acute myocardial injury. The present study evaluates plasma levels of visfatin in acute ST-elevation myocardial infarction (STEMI) patients and examines the temporal changes in visfatin levels from the acute period to the subacute period to determine a correlation with the degree of myocardial ischemia. We evaluated 54 patients with STEMI. Circulating levels of visfatin and brain natriuretic peptide (BNP) were measured by ELISA. In addition, local expression of visfatin and BNP were detected by quantitative real-time polymerase chain reaction and immunohistochemical (IHC) analysis of left ventricular myocytes in a mouse model of myocardial infarction (MI). Plasma levels of visfatin were significantly increased in patients with STEMI on admission, relative to controls (effort angina patients and individuals without coronary artery disease). The visfatin levels reached a peak 24h after percutaneous coronary intervention (PCI) and then decreased toward the control range during the first week after PCI. The basal plasma visfatin levels were found to correlate with peak troponin-I, peak creatine kinase-MB, total white blood cell count, and BNP levels. Trend analyses confirmed that visfatin levels correlated with the number of diseased coronary arteries. Further, in MI mice, mRNA levels of visfatin and BNP were found to be higher than in sham-treated mice. IHC analysis showed that visfatin and BNP immunoreactivity was diffusely observable in left ventricular myocytes of the MI mice. This study indicates that plasma visfatin levels are significantly higher in STEMI patients and that these higher visfatin levels correlate with elevated levels of cardiac enzymes, suggesting that increased plasma visfatin may be closely related to the degree of myocardial damage.


Assuntos
Eletrocardiografia , Infarto do Miocárdio/sangue , Infarto do Miocárdio/fisiopatologia , Nicotinamida Fosforribosiltransferase/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Feminino , Hospitalização , Humanos , Imuno-Histoquímica , Contagem de Leucócitos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/metabolismo , Nicotinamida Fosforribosiltransferase/metabolismo , Estatísticas não Paramétricas
17.
J Chin Med Assoc ; 74(2): 91-4, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21354087

RESUMO

Substantial intraoperative bleeding during surgical removal of carotid body tumor may be a major problem in the management of these highly vascularized tumors. Traditional preoperative embolization via a transarterial access has proved effective but is often limited by complex vascular anatomy and small feeding vessels that is difficult to catheterize. We report two cases of carotid body tumor treated with direct puncture and intratumoral injection of N-butyl cyanoacrylate glue (NBCA) assisted with balloon protection technique for preoperative devascularization. The result was impressive and minimal bleeding loss during surgery was observed.


Assuntos
Tumor do Corpo Carotídeo/terapia , Embolização Terapêutica/métodos , Embucrilato/administração & dosagem , Adulto , Feminino , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Punções
18.
Radiology ; 260(1): 192-8, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21436088

RESUMO

PURPOSE: To review the magnetic resonance (MR) imaging findings in eight patients who developed marrow lesions after undergoing physiotherapy with use of ultrasound diathermy. MATERIALS AND METHODS: The authors retrospectively reviewed the medical charts and MR images of eight patients (six women and two men aged 22-69 years) who received ultrasound diathermy treatment for a variety of soft tissue injuries involving primarily the knee, shoulder, and wrist. All patients underwent MR imaging without the use of intravenous gadolinium-based contrast material. The institutional review board approved the study, and the requirement to obtain informed consent was waived. RESULTS: MR imaging of all patients revealed subcortical rim or arc lesions with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, without involvement of the deeper aspect of the bone marrow. The imaging features of the lesions were similar to those of focal osteonecrosis. Follow-up MR imaging performed in three patients approximately 2-3 months after cessation of ultrasound therapy revealed resolution of the bone lesions. Symptoms resolved in all patients. CONCLUSION: This study demonstrated that ultrasound diathermy may produce an osseous injury. The abnormality itself was usually mild and transient, with apparent full recovery after termination of therapy.


Assuntos
Doenças da Medula Óssea/etiologia , Doenças da Medula Óssea/patologia , Imagem por Ressonância Magnética , Lesões por Radiação/etiologia , Lesões por Radiação/patologia , Terapia por Ultrassom/efeitos adversos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
19.
Atherosclerosis ; 211(2): 579-83, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20427046

RESUMO

OBJECTIVE: p-Cresylsulphate (PCS), a protein-bound uraemic retention solute, is known to cause endothelial dysfunction and possibly plays a role in coronary atherosclerosis. We aimed to investigate the relationship of total PCS with traditional biomarkers associated with chronic coronary atherosclerosis. In addition, the relationship between serum total PCS levels and the severity of coronary artery stenosis was also explored. METHODS AND RESULTS: Serum total PCS concentrations were measured by using the Ultra Performance LC System in 202 consecutive stable angina patients, and their associations with angiographic indexes of the number of diseased vessels and modified Gensini score were estimated. Patients with significant coronary artery stenosis have higher median serum total PCS levels than patients with normal coronary arteries. Statistically significant associations were observed between the serum total PCS levels and the number of diseased vessels (beta=0.261, p=0.0002), and modified Gensini score (beta=0.171, p=0.016). Using multivariate analysis, serum total PCS level was independently associated with the presence and severity of CAD. CONCLUSIONS: This study indicates that serum total PCS levels are significantly higher in the presence of CAD and are correlated with the severity of the disease, which suggest that increased serum total PCS may be involved in the pathogenesis of coronary atherosclerosis.


Assuntos
Angina Pectoris/sangue , Angiografia Coronária/métodos , Doença da Artéria Coronariana/sangue , Cresóis/sangue , Regulação da Expressão Gênica , Insuficiência Renal/sangue , Idoso , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão , Insuficiência Renal/complicações , Ésteres do Ácido Sulfúrico
20.
Diagn Interv Radiol ; 15(3): 193-9, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19728266

RESUMO

PURPOSE: Special radiographic projections were evaluated in two cadaveric specimens for depicting postoperative changes after five different lower lumbar surgical procedures. Available literature concerning special radiographic projections of the lumbar spine is limited. The objective of this study was to establish a special radiographic projection that is useful for depicting postoperative changes after lumbar surgical procedures. MATERIALS AND METHODS: Five different procedures were performed on two cadaveric lumbar spines: laminotomy, total laminectomy, foraminotomy, surgical creation of pars interarticularis defect, and partial facetectomy. A series of radiographs, including routine views and combinations of various obliquity and cephalad angulation, were obtained preoperatively and after each operation. Film analysis was done using a four-point rating system to document the degree of visualization of the postsurgical bone defect at each stage of surgery at each lumbar segment. The best projections were determined by summation of the rating scores of the three lumbar segments. The scores of each projection in different procedures were also summed to determine the best view for clinical use. RESULTS: The laminotomy defects were more obvious on the shallow-obliquity and low-angulation radiographs. The postoperative changes of total laminectomy were almost equally identified on the AP and lateral views and most of the compound views. The bone changes of foraminotomy were best identified on the 45 degrees routine view. The 30 degrees-15 degrees and 45 degrees-15 degrees compound views were best for depicting a postoperative pars defect. None of the projections delineated the bone changes of partial facetectomy. The 30 degrees-15 degrees compound view had the highest summation of rating scores of the five surgical procedures. CONCLUSION: The results of this study suggest that the 30 degrees-15 degrees compound view could be useful for the assessment of the postoperative lumbar spine. Further verification of its value requires a large clinical study.


Assuntos
Vértebras Lombares/anormalidades , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Coluna Vertebral/diagnóstico por imagem , Cadáver , Humanos , Laminectomia , Procedimentos Ortopédicos , Radiografia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Articulação Zigapofisária/cirurgia
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