RESUMO
OBJECTIVE: To review the complications of bariatric surgery and their diagnosis with intravenous contrast-enhanced multidetector computed tomography (MDCT). MATERIAL AND METHODS: We retrospectively studied all patients who underwent gastric bypass or sleeve gastrectomy at our center during 2013 or 2014. We classified complications into early complications (appearing within 30 days of the intervention) and late complications. RESULTS: We reviewed 155 cases and found 24 complications in 22 patients: 16 early complications (7 intraperitoneal hematomas, 5 anastomotic dehiscences, 2 intestinal obstructions, and 2 external hernias) and 8 late complications (3 internal hernias, 3 intestinal perforations, and 2 marginal ulcers). Two patients died. All of these complications were diagnosed with intravenous contrast-enhanced MDCT, except one, which required a barium transit study. CONCLUSION: The rate of complications in bariatric surgery is high and the associated mortality is not negligible. Radiologists need to know the normal findings in these patients so they can quickly identify possible complications, most of which can be diagnosed with intravenous contrast-enhanced MDCT.
Assuntos
Cirurgia Bariátrica/efeitos adversos , Meios de Contraste , Tomografia Computadorizada Multidetectores , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Administração Intravenosa , Meios de Contraste/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores/métodos , Complicações Pós-Operatórias/epidemiologia , Estudos RetrospectivosRESUMO
PURPOSE: To determine whether human corneal epithelial cells and keratocytes produce chemokines regulated upon activation, normal T-cell expressed and secreted (RANTES) protein and monocyte chemotactic protein-1 (MCP-1) after exposure to proinflammatory cytokines interleukin-1 alpha (IL-1 alpha) and tumor necrosis factor-alpha (TNF-alpha). METHODS: Pure cultures of human corneal epithelial cells and keratocytes were exposed to increasing concentrations of either human recombinant IL-1 alpha or TNF-alpha. At selected time intervals after exposure, culture supernatants were removed and assayed for RANTES and MCP-1 by the enzyme-linked immunosorbent assay. Total RNA was extracted from the cell cultures, and steady state mRNA levels were measured by reverse transcriptase-polymerase chain reaction. RESULTS: Exposure to keratocytes to either IL-1 alpha or TNF-alpha resulted in > 100-fold increases in RANTES protein secretion and > 150-fold increases in MCP-1 protein secretion, as well as in rapid sustained increases in intracellular levels of their corresponding mRNAs. Exposure of corneal epithelial cells to IL-1 alpha and TNF-alpha did not stimulate MCP-1 secretion nor intracellular levels of MCP-1 mRNA. Epithelial cells also failed to secrete RANTES protein even through the two inducing cytokines did stimulate increased expression of RANTES mRNA. CONCLUSIONS: These results suggest that RANTES and MCP-1 gene expression in human keratocytes differs markedly from their expression in human corneal epithelial cells and that the stroma of the cornea may be more important than the epithelium in recruitment of mononuclear leukocytes responsible for cell-mediated immunity.
Assuntos
Quimiocina CCL2/biossíntese , Quimiocina CCL5/biossíntese , Córnea/metabolismo , Interleucina-1/farmacologia , Fator de Necrose Tumoral alfa/farmacologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Sequência de Bases , Células Cultivadas , Quimiocina CCL2/genética , Quimiocina CCL5/genética , Quimiocinas/biossíntese , Córnea/citologia , Córnea/efeitos dos fármacos , Citocinas/farmacologia , Primers do DNA/química , Ensaio de Imunoadsorção Enzimática , Células Epiteliais , Epitélio/efeitos dos fármacos , Epitélio/metabolismo , Feminino , Fibroblastos/citologia , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Regulação da Expressão Gênica/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , RNA/isolamento & purificação , RNA Mensageiro/análise , Proteínas Recombinantes/farmacologiaRESUMO
Objetivo. Revisar las complicaciones de la cirugía bariátrica y su diagnóstico mediante tomografía computarizada multidetector con contraste intravenoso (TCMDcCIV). Material y métodos. Estudio retrospectivo de los pacientes intervenidos mediante by-pass gástrico o gastrectomía tubular en nuestro centro durante 2013 y 2014. Las complicaciones se dividieron en precoces (durante el primer mes) y tardías. Resultados. Se revisaron 155 casos y se diagnosticaron 24 complicaciones en 22 pacientes: 16 precoces (7 hematomas intraperitoneales, 5 dehiscencias anastomóticas, 2 obstrucciones intestinales y 2 hernias externas) y 8 tardías (3 hernias internas, 3 perforaciones intestinales y 2 úlceras en boca anastomótica). Dos pacientes fallecieron. Todas las complicaciones se diagnosticaron mediante TCMDcCIV, excepto una que requirió un tránsito baritado. Conclusión. La tasa de complicaciones en la cirugía bariátrica es elevada y su mortalidad no es despreciable. Deben reconocerse los hallazgos normales en estos pacientes para identificar rápidamente las posibles complicaciones, diagnosticadas en su mayoría mediante TCMDcCIV
Objective. To review the complications of bariatric surgery and their diagnosis with intravenous contrast-enhanced multidetector computed tomography (MDCT). Material and methods. We retrospectively studied all patients who underwent gastric bypass or sleeve gastrectomy at our center during 2013 or 2014. We classified complications into early complications (appearing within 30 days of the intervention) and late complications. Results. We reviewed 155 cases and found 24 complications in 22 patients: 16 early complications (7 intraperitoneal hematomas, 5 anastomotic dehiscences, 2 intestinal obstructions, and 2 external hernias) and 8 late complications (3 internal hernias, 3 intestinal perforations, and 2 marginal ulcers). Two patients died. All of these complications were diagnosed with intravenous contrast-enhanced MDCT, except one, which required a barium transit study. Conclusion. The rate of complications in bariatric surgery is high and the associated mortality is not negligible. Radiologists need to know the normal findings in these patients so they can quickly identify possible complications, most of which can be diagnosed with intravenous contrast-enhanced MDCT
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Cirurgia Bariátrica/efeitos adversos , Tomografia Computadorizada Multidetectores/instrumentação , Meios de Contraste/administração & dosagem , Complicações Pós-Operatórias/diagnóstico por imagem , Estudos Retrospectivos , Derivação Gástrica/métodosRESUMO
We present the magnetic resonance imaging (MRI) findings in two males clinically diagnosed with iliotibial band friction syndrome (IBFS), a frequent cause of pain in the lateral compartment of the knee. Coronal T2-weighted images with fat saturation show an ill-defined area of high signal intensity in the soft tissues situated immediately below the iliotibial band lateral to the external condyle of the femur. No thickening of the iliotibial band or changes in its signal intensity were observed. Osseous edema and subchondral osseous erosion in the external condyle of the femur were observed in both cases. Pain in the lateral compartment of the knee might be due to multiple causes that should be included in the differential diagnosis and MRI can play a significant role in reaching the definitive diagnosis.
Assuntos
Artropatias/diagnóstico , Articulação do Joelho/patologia , Imageamento por Ressonância Magnética , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , SíndromeRESUMO
Sarcoidosis is a multisystemic granulomatose disease of unknown origin that most often affects the lung parenchyma and the mediastinal lymph nodes. Although less common, involvement of the abdominal organs and the central nervous is also possible. We present the radiological findings observed in two patients diagnosed with sarcoidosis with systemic involvement. In one case, the disease affected the lung, spleen, mediastinal and abdominal lymph nodes, whereas in the other case it affected the lung, spleen, abdominal lymph nodes and central nervous system. The aim of this report is to review the radiologic manifestations of this disease.
Assuntos
Sarcoidose/diagnóstico , Adulto , Feminino , Humanos , MasculinoRESUMO
We present an 8-year-old boy with thyroid follicular carcinoma. Differentiated thyroid follicular carcinoma is very uncommon in childhood and is not usually suspected as the explanation of a thyroid nodule during infancy. The purpose of our paper is to demonstrate the imaging findings in a child and to emphasise the importance of including this tumour in the differential diagnosis of thyroid nodules in children.
Assuntos
Adenocarcinoma Folicular , Neoplasias da Glândula Tireoide , Adenocarcinoma Folicular/diagnóstico por imagem , Adenocarcinoma Folicular/terapia , Criança , Terapia Combinada , Diagnóstico Diferencial , Humanos , Masculino , Prognóstico , Cintilografia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/terapia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Presentamos los hallazgos realizados en la resonancia magnética (RM) de dos varones diagnosticados clínicamente de síndrome de fricción de la banda iliotibial (SFBIT), una causa frecuente de dolor en el compartimento lateral de la rodilla. En las imágenes coronales potenciadas en T2 con saturación de la grasa se muestra un área mal definida de alta intensidad de señal en el tejido de partes blandas situado en el plano inmediatamente en profundidad a la banda iliotibial (BIT), lateral al cóndilo femoral externo. La BIT no aparece engrosada ni se observan alteraciones en la intensidad de señal. Se observa en ambos casos un edema óseo y erosión ósea subcondral en el cóndilo femoral externo. El dolor en el compartimento lateral de la rodilla puede deberse a múltiples causas que deben incluirse en el diagnóstico diferencial, por lo que la RM tiene un importante papel para llegar a un diagnóstico definitivo (AU)
We present the magnetic resonance imaging (MRI) findings in two males clinically diagnosed with iliotibial band friction syndrome (IBFS), a frequent cause of pain in the lateral compartment of the knee. Coronal T2-weighted images with fat saturation show an ill-defined area of high signal intensity in the soft tissues situated immediately below the iliotibial band lateral to the external condyle of the femur. No thickening of the iliotibial band or changes in its signal intensity were observed. Osseous edema and subchondral osseous erosion in the external condyle of the femur were observed in both cases. Pain in the lateral compartment of the knee might be due to multiple causes that should be included in the differential diagnosis and MRI can play a significant role in reaching the definitive diagnosis (AU)
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética/métodos , Meniscos Tibiais/patologia , Meniscos Tibiais , /métodos , Fêmur/patologia , Fêmur , Joelho/patologia , Joelho , Tíbia/patologia , Tíbia , Corticosteroides/uso terapêutico , Esteroides/uso terapêuticoRESUMO
La sarcoidosis es una enfermedad granulomatosa multisistémica de etiología desconocida que afecta con mayor frecuencia al parénquima pulmonar y a los ganglios linfáticos mediastínicos. Aunque menos frecuente, la afectación de órganos abdominales y del sistema nervioso central también es posible. Presentamos los hallazgos radiológicos observados en dos pacientes diagnosticados de sarcoidosis con afectación sistémica, en uno de ellos la enfermedad afecta a pulmón, bazo, ganglios linfáticos mediastínicos y abdominales y en el otro a pulmón, bazo, ganglios linfáticos abdominales y sistema nervioso central. Nuestro objetivo es revisar las manifestaciones radiológicas de esta enfermedad
Sarcoidosis is a multisystemic granulomatose disease of unknown origin that most often affects the lung parenchyma and the mediastinal lymph nodes. Although less common, involvement of the abdominal organs and the central nervous is also possible. We present the radiological findings observed in two patients diagnosed with sarcoidosis with systemic involvement. In one case, the disease affected the lung, spleen, mediastinal and abdominal lymph nodes, whereas in the other case it affected the lung, spleen, abdominal lymph nodes and central nervous system. The aim of this report is to review the radiologic manifestations of this disease