Congenital intrahepatic portosystemic shunts in the neonate: coil embolization via the umbilical vein.
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Embolization, Therapeutic↗
Biomedical subjects
Y S Do
Publications and source records attributed to Y S Do.
Sclerosing hemangiomas of the lung and interlobar fissures: CT findings.
OBJECTIVE: Sclerosing hemangioma is a rare pulmonary tumor. This article describes CT features of the tumor on the basis of CT-pathology correlation. MATERIALS AND METHODS: The CT features of eight patients with sclerosing hemangioma of the lung were studied retrospectively and were correlated with the pathologic findings of the resected specimens. All eight patients had an incidental lung mass found on chest radiographs. Seven patients were female. Contrast enhancement of the masses was assessed visually by two radiologists independently, and the density was measured before and after contrast enhancement by using a standard cursor in three patients. RESULTS: On CT, sclerosing hemangiomas appeared as well defined juxtapleural masses in all cases. The tumors enhanced by visual criteria in all but one patient with the smallest mass. The CT density of the enhancing mass ranged from 96 to 157 HU. Three patients had calcification and two had well defined areas of low attenuation. On CT-pathology correlation, the higher, iso-, and lower attenuation areas corresponded with angiomatous, solid and sclerotic, and cystic areas, respectively. CONCLUSION: A well defined juxtapleural mass with marked contrast enhancement coupled in select cases with foci of sharply marginated areas of low attenuation and calcification are characteristic CT findings of sclerosing hemangioma and should suggest this diagnosis especially in women with these findings.
Adult↗
CT findings in malignant tumors of thymic epithelium.
OBJECTIVE: Differentiation of invasive thymoma from thymic carcinoma is important because of their different clinical behaviors. Retrospectively, we evaluated the CT findings of invasive thymomas and thymic carcinomas to determine the differential points between them. MATERIALS AND METHODS: We reviewed the CT scans of 12 patients with invasive thymoma and 10 patients with thymic carcinoma that were confirmed by surgery or percutaneous needle aspiration. We analyzed CT scans, paying special attention to homogeneity, attenuation, invasion of adjacent mediastinal structures, pleural implants, mediastinal nodes, and extramediastinal metastases. RESULTS: Most of the invasive thymomas and thymic carcinomas were homogeneous and isodense with chest wall muscle. Irregular infiltration into the adjacent organ suggesting invasion was seen in 11 patients (92%) with invasive thymoma and 8 patients (80%) with thymic carcinoma. Pleural implants were observed in four patients (33%) with invasive thymoma and one patient (10%) with thymic carcinoma. Mediastinal lymphadenopathy was seen in one patient (8%) with invasive thymoma and four patients (40%) with thymic carcinoma. Metastases to the lung, adrenal glands, or liver were observed in four patients (40%) with thymic carcinoma but none with invasive thymoma. CONCLUSION: Despite the similarities of CT findings between invasive thymoma and thymic carcinoma, there are some differential points. Thymic carcinomas were infiltrating tumor and were more commonly associated with mediastinal nodes and extrathymic metastases, but less commonly associated with pleural implants than invasive thymoma.
Adult↗
Opacification of the intrahepatic portal veins during CT hepatic arteriography.
PURPOSE: The purpose of this study was to ascertain the cause of opacification of the portal veins during CT hepatic arteriography (CTHA). METHOD: A total of 155 consecutive patients with hepatocellular carcinoma were evaluated with CTHA as preoperative staging. The opacification of the portal veins during CTHA was categorized as opacification of the main portal vein, right or left branches of the main portal vein (generalized), and segmental or subsegmental portal veins (localized). Hepatic angiography was compared and possible causes were evaluated. RESULTS: One hundred eight (70%) of 155 patients showed intrahepatic portal vein opacification at CTHA: generalized in 60 patients (39%) and localized in 48 patients (31%). Intrahepatic causes were arterioportal shunts due to hepatocellular carcinoma in 20 (19% of 108 patients), previous liver biopsy in 9 (8%), and portal vein thrombosis in 4 (4%). Extrahepatic cause was counted in 57 cases (53%) and was due to inflow of contrast material via nonmesenteric portal circulation through the gastric antrum, duodenum, and/or pancreas. CONCLUSION: Intrahepatic portal veins are frequently opacified during CTHA, and the causes were arterioportal shunts through hepatocellular carcinoma, postbiopsy shunt, portal vein thrombosis, and inflow of contrast material via the nonmesenteric portal circulation.
Adult↗
Current concepts in lymphatic malformation.
A lymphatic malformation (LM) is the most common form of congenital vascular malformation (CVM). The new Hamburg classification of CVM distinguishes the truncular (T) form from the extratruncular (ET) form of LMs. Both are consequences of a developmental arrest at the different stages of lymphangiogenesis as a result of defective genes. The purpose of this review was to evaluate the current management results of both forms of LMs. A retrospective review of the clinical data of 315 patients with a diagnosis of LMs treated between September 1994 and December 2001 was performed. Lymphoscintigraphy was the most frequent diagnostic test. The patients with the ET form were treated with sclerotherapy with OK-432 and/or ethanol. Combinations of CDP (complex decongestive physiotherapy) and/or compressotherapy were used to treat all the T-form patients. In addition, surgery, either reconstructive or ablative, was offered to patients with the T form who failed to respond to the proper CDP. A multidisciplinary team performed the management of LM, and the results were evaluated every 6 months. Among 797 patients with CVM, 315 were confirmed to have LMs, either as the T form (226) or the ET form (89). Another 66 LMs were diagnosed with hemolymphatic malformations (HLM). Most of the ET forms (89/315) were the cystic type (70/89), while the T forms included aplasia and/or an obstruction (204/226). The ET form was most frequent in the head, neck, and thorax (69/89). The T form was located most frequently to the extremities (202/226), mostly to the lower limb (180/202). Two hundred and twenty-six T forms belonged to the various clinical stages: stages I-32, II-104, III-48, IV-18, and an unclear stage-24. The ET form was treated with sclerotherapy using OK-432 (108/120) and absolute ethanol (12/120). Among the 11 patients with the multiple ET form, 7 patients underwent perioperative sclerotherapy with OK-432 and a subsequent surgical excision. The clinical response of the T form at the extremity to CDP was excellent to good in a majority of clinical stages I to II (121/136) but decreased to a good to fair degree in stages III to IV (31/66). The additional surgical therapy, either reconstructive (10/19) or ablative (9/19), provided limited success in improving CDP efficacy, owing mainly to poor compliance. The long-term outcome of the initial success through self-motivated home-maintenance care during the follow-up period of up to 48 months was totally dependent on patient compliance. OK-432 sclerotherapy to 51 ET forms has shown excellent results on 88.9% of the cystic type (40/45) and 50% (3/6) of the cavernous type (minimum follow-up for 24 months). Seventeen ET forms in 7 patients were treated with a preoperative OK-432 sclerotherapy and a subsequent surgical excision, which provided good to excellent results in 14 for a minimum of 24 months. Primary lymphedema, which is the T form of LMs, can be managed safely by a combination of CDP with compressotherapy. Patients with good compliance can benefit from additional surgical therapy, either reconstructive or ablative. The ET form, particularly the cystic type, can be treated with various scleroagents that are preferably less toxic as the primary therapy. A surgical excision with or without perioperative sclerotherapy provides good results for patients with the localized cavernous type of the ET form. A multidisciplinary team approach is essential for the proper care of LM.
Adolescent↗
Correlation of human olfactory responses to airborne concentrations of malodorous volatile organic compounds emitted from swine effluent.
Direct multicomponent analysis of malodorous volatile organic compounds (VOCs) present in ambient air samples from 29 swine (Sus scrofa) production facilities was used to develop a 19-component artificial swine odor solution that simulated olfactory properties of swine effluent. Analyses employing either a human panel consisting of 14 subjects or gas chromatography were performed on the air stream from an emission chamber to assess human olfactory responses or odorant concentration, respectively. Analysis of the olfactory responses using Fisher's LSD statistics showed that the subjects were sensitive to changes in air concentration of the VOC standard across dilutions differing by approximately 16%. The effect of chemical synergisms and antagonisms on human olfactory response magnitudes was assessed by altering the individual concentration of nine compounds in artificial swine odor over a twofold concentration range while maintaining the other 18 components at a constant concentration. A synergistic olfactory response was observed when the air concentration of acetic acid was increased relative to the concentration of other VOC odorants in the standard. An antagonistic olfactory response was observed when the air concentration of 4-ethyl phenol was increased relative to the other VOC odorants in the standard. The collective odorant responses for nine major VOCs associated with swine odor were used to develop an olfactory prediction model to estimate human odor response magnitudes to swine manure odorants through measured air concentrations of indicator VOCs. The results of this study show that direct multicomponent analysis of VOCs emitted from swine effluent can be applied toward estimating perceived odor intensity.
Animals↗
Functional classification of swine manure management systems based on effluent and gas emission characteristics.
Gaseous emissions from swine (Sus scrofa) manure storage systems represent a concern to air quality due to the potential effects of hydrogen sulfide, ammonia, methane, and volatile organic compounds on environmental quality and human health. The lack of knowledge concerning functional aspects of swine manure management systems has been a major obstacle in the development and optimization of emission abatement technologies for these point sources. In this study, a classification system based on gas emission characteristics and effluent concentrations of total phosphorus (P) and total sulfur (S) was devised and tested on 29 swine manure management systems in Iowa, Oklahoma, and North Carolina in an effort to elucidate functional characteristics of these systems. Four swine manure management system classes were identified that differed in effluent concentrations of P and S, methane (CH4) emission rate, odor intensity, and air concentration of volatile organic compounds (VOCs). Odor intensity and the concentration of VOCs in air emitted from swine manure management systems were strongly correlated (r2 = 0.88). The concentration of VOC in air samples was highest with outdoor swine manure management systems that received a high input of volatile solids (Type 2). These systems were also shown to have the highest odor intensity levels. The emission rate for VOCs and the odor intensity associated with swine manure management systems were inversely correlated with CH4 and ammonia (NH3) emission rates. The emission rates of CH4, NH3, and VOCs were found to be dependent upon manure loading rate and were indirectly influenced by animal numbers.
Agriculture↗
Rhabdomyosarcoma of the head and neck in adults: MR and CT findings.
PURPOSE: To evaluate imaging findings of rhabdomyosarcoma of the head and neck in adults. METHODS: We examined 11 patients (seven men and four women; 17 to 73 years old) with pathologically proved rhabdomyosarcoma of the head and neck. The tumors originated in the paranasal sinuses (n = 6), cheek (n = 3), nasal cavity (n = 1), and infratemporal fossa (n = 1). Eight of the rhabdomyosarcomas were of the embryonal type, two were pleomorphic, and one was alveolar. Necrosis was seen in four patients, but calcification or intratumoral hemorrhage was not found. Two tumors had nodal extension. Contrast-enhanced CT was performed in 10 patients, and two patients had contrast-enhanced MR imaging. RESULTS: On CT scans, the masses enhanced to the same degree as adjacent muscle. The masses showed a homogeneous pattern in six cases and a heterogeneous pattern in four cases. The tumor margins were poorly defined in eight cases. On MR images, the masses were homogeneously isointense with muscle on T1-weighted studies and were hyperintense relative to muscle on T2-weighted studies. On both CT and MR images, 10 of 11 cases showed poorly defined, homogeneous masses destroying adjacent bony structures. CONCLUSIONS: MR imaging seems to be better than CT for initial and follow-up examination of patients with rhabdomyosarcoma because of its multiplanar capability and because it more precisely defines the extent of tumor.
Adolescent↗