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PubMed1993

CT of the mesocolon. Part 2. Pathologic considerations.

The anatomy of the mesocolon can be seen on computed tomographic (CT) scans, and its CT anatomy can be described by using the vessels in the mesocolon as anatomic landmarks. Knowledge of this anatomy is the basis to understanding pathologic processes involving the mesocolon. Common pathologic conditions usually occur due to spread of disease between organs to which the mesocolon is attached, primarily the colon and pancreas. The disease may be a malignant lesion, a benign inflammatory process, or, rarely, a primary tumor of the mesocolon; the mode of spread may be via the lymphatic vessels, direct extension, vascular invasion, or vascular involvement. The authors demonstrate various pathologic conditions and modes of spread, as seen on CT scans, with emphasis on disease of the colon and pancreas. The pathway for the spread of disease and its progression in these organs can be predicted in patients with a known disease. More important, identification of abnormalities in the mesocolon leads to careful evaluation of the organs to which the mesocolon is attached.

Colonic Diseases↗
PubMed1999

First trimester screening for structural fetal abnormalities: nuchal translucency sonography.

Nuchal translucency refers to the normal subcutaneous space, observed on first trimester ultrasound examination, between the skin and the cervical spine in the fetus. Increased nuchal translucency is known to be associated with an increased risk of aneuploidy, particularly Down syndrome. In addition to this association with aneuploidy, multiple studies have now identified increased nuchal translucency as a nonspecific marker of a wide range of fetal structural abnormalities, to include congenital diaphragmatic hernia, cardiac defects, and various genetic syndromes. The degree of nuchal translucency is directly related to the prevalence of fetal anomalies and may have prognostic significance, especially when found in association with other anomalies. The pathophysiology of increased nuchal translucency is uncertain but may be the result of cardiac failure or alterations in lymphatic drainage. Increased nuchal translucency may identify pregnancies that require further assessment, to include additional sonographic evaluation and possible fetal echocardiography. Further evaluation is required to assess the role of nuchal translucency screening in the general population.

Congenital Abnormalities↗
PubMed1998

Bancroftian filariasis in Egypt: visualization of adult worms and subclinical lymphatic pathology by scrotal ultrasound.

The purpose of this study was to explore the value of scrotal ultrasound as a means of evaluating Bancroftian filariasis. Color Doppler ultrasound examinations were performed to look for subclinical hydroceles and motile adult filarial worms (dancing worms) in dilated lymphatics. Sixty-one male subjects from a filariasis-endemic area in Egypt were studied including 19 clinically normal microfilaria (MF) carriers (seven with dancing worms and eight with subclinical hydroceles), 13 MF-negative subjects with positive filarial antigen test results (three with dancing worms and seven with subclinical hydroceles), 22 exposed subjects with no MF and negative antigen test results (no dancing worms, four subclinical hydroceles), and seven subjects with clinical filariasis (no dancing worms, seven hydroceles). Thus, all men tested with clinical filariasis and most clinically normal subjects with either microfilaremia or filarial antigenemia had abnormal ultrasound examination results. Ultrasound findings often changed after therapy with diethylcarbamazine, with disappearance of dancing worms and development of new scrotal calcifications or hydroceles. This study confirms the value of scrotal ultrasound as a means of noninvasively visualizing adult filarial worms and assessing subclinical lymphatic damage in Bancroftian filariasis.

Adult↗
PubMed1986

Venous muscle pump function in patients with primary lymphoedema: assessment by ambulatory strain gauge plethysmography.

The musculovenous pump function was assessed by ambulatory strain gauge plethysmography in 11 patients with primary lymphoedema. The venous function was within the normal range regarding both venous reflux and expelled volume. The values were compared with ten patients with chronic venous insufficiency and oedema. The values for venous function were clearly abnormal for the patients with venous insufficiency and different from those with primary lymphoedema. Ambulatory strain gauge plethysmography may be a useful non-invasive method in distinguishing between oedema of lymphatic or venous origin.

Adult↗
PubMed1976

Lymphangiectasia of the small intestine: description and pathophysiology of the roentgenographic signs.

Waldmann in 1961 redefined primary protein-losing gastroenteropathy and renamed the condition "lymphangiectasia". This abnormality, usually seen in infancy, is characterized by enlargement of folds and signs of hypersecretion in the small bowel. Enlargement of folds occurs secondary to edema of the valvulvae conniventes and lymphatic dilatation. Hypersecretion may be the result of rupture of dilated lymphatics or transudation of protein across an intact capillary epithelium. The clinical, roentgenographic, and pathologic findings are described. The pathophysiology of this condition is discussed.

Diagnosis, Differential↗
PubMed2006

Purification of NADPH-P450 reductase (NPR) from Xenopus laevis and the developmental change in NPR expression.

NADPH-P450 reductase (NPR) was purified from hepatic microsomes of Xenopus laevis. The electron transfer activity of purified NPR was 23.8 units/min/mg with horse cytochrome c. The aminopyrine demethylation activity of rat CYP2B1 with Xenopus NPR was 58.1 nmol/min/nmol. The corresponding cDNA was isolated from Xenopus liver. The homology in amino acid sequence deduced from NPR cDNA isolated from Xenopus liver was 80%, 78%, and 81% with human, rat, and rabbit NPR, respectively. Antibody against Xenopus NPR was prepared. The expression of NPR was investigated in various tissues and in early development by Western blotting. NPR was most abundantly expressed in the kidney, followed by the liver, lung, and heart. The brain had very low levels of NPR. The level of NPR protein was almost the same at all stages, 2-cell stage (st. 2), blastula (st. 8), gastrula (st. 12), tail bud (st. 26) and larva (st.35), examined in this study. We further investigated the distribution of NPR using whole-mount in situ hybridization. NPR mRNA was expressed in cement gland, lens placode, ear vesicle, mesencephalon, rhombencephalon, lymphatic vessel, and heart anlage in the embryo at stage 29. Xenopus NPR has similar properties to mouse and rat NPRs. Localization of NPR in Xenopus embryo was consistent with the abnormal region caused by NPR deficiency in mice.

Animals↗
PubMed1992

Pediatric blunt abdominal trauma: periportal tracking at CT.

Periportal zones of decreased attenuation at computed tomography (CT) have been described in a variety of disorders. In the setting of blunt abdominal trauma, the zones have been attributed to dissection of blood along the portal tracts. Because of the observation of isolated periportal tracking (PPT) in children after blunt trauma, the authors retrospectively reviewed CT scans of the abdomen obtained in 114 children to determine the frequency of PPT, liver injury, and peritoneal fluid. PPT was present in 22% of patients (25 of 114); it was associated with liver injury in 10 and was the only liver abnormality in 15. Pathologic correlation was available in two patients: In one it revealed marked periportal lymphedema and in the other, PPT of blood. This study indicates that both hemorrhage and lymphatic edema may be represented as PPT in children after blunt abdominal injury.

Abdominal Injuries↗
PubMed2000

Oedema in childhood.

Oedema is a common childhood problem with important public health implications. It is an abnormal accumulation of fluid in the interstitial space which might result from a decrease in intravascular oncotic pressure, an increase in intravascular hydrostatic pressure, an increase in capillary permeability or impaired lymphatic drainage. Renal sodium retention is an important factor in generalised oedema. This article reviews the pathophysiology and aetiology of oedema in children and suggests an approach to evaluation, diagnosis and management of the problem.

Adolescent↗
PubMed2001

Color/power Doppler sonographic differential diagnosis of superficial lymphadenopathy: metastasis, malignant lymphoma, and benign process.

OBJECTIVE: Differentiation of lymph nodes as metastasis, malignant lymphoma, and benign lesions by gray scale and color/power Doppler ultrasonography has been reported. In this study we sought to determine patterns of abnormal vascularity, the relationship between diagnostic criteria and node size, and which vessel in the node was best suited for Doppler spectral analysis. Extrahilar vessels, defined as vessels entering through the lymphatic surface and not through the hilus, were also investigated. METHODS: One hundred twenty-nine nodes were examined by color/power Doppler ultrasonography. RESULTS: Extrahilar vessels were seen in 85.4% of metastatic, 40.5% of lymphomatous, and 7.7% of benign nodes regardless of node size. The mean pulsatility index and resistive index values of metastatic nodes were higher than those of benign nodes regardless of their size. Those of lymphoma were intermediate compared with the others. CONCLUSIONS: A pulsatility index greater then 1.3 and a resistive index greater than 0.72 suggested malignancy as measured from any vessel.

Breast Neoplasms↗
PubMed2002

Venomous snakebites in the United States: management review and update.

Venomous snakebites, although uncommon, are a potentially deadly emergency in the United States. Rattlesnakes cause most snakebites and related fatalities. Venomous snakes in the United States can be classified as having hemotoxic or neurotoxic venom. Patients with venomous snakebites present with signs and symptoms ranging from fang marks, with or without local pain and swelling, to life-threatening coagulopathy, renal failure, and shock. First-aid techniques such as arterial tourniquets, application of ice, and wound incisions are ineffective and can be harmful; however, suction with a venom extractor within the first five minutes after the bite may be useful. Conservative measures, such as immobilization and lymphatic constriction bands, are now advocated until emergency care can be administered. Patients with snakebites should undergo a comprehensive work-up to look for possible hematologic, neurologic, renal, and cardiovascular abnormalities. Equine-derived antivenin is considered the standard of care; however, a promising new treatment is sheep-derived antigen binding fragment ovine (CroFab), which is much less allergenic. Although there is no universal grading system for snakebites, a I through IV grading scale is clinically useful as a guide to antivenin administration. Surgical intervention with fasciotomy is now reserved for rare cases. Snakebite prevention should be taught to patients.

Animals↗
PubMed1992

Chronic intestinal lymphocytic microphlebitis.

The authors report two cases of a peculiar microphlebitis of the intestines, similar to that described by Saraga and Costa quite recently [5]. The patients had undergone hemicolectomy because of evolving ileus caused by cecal polyps or lipohyperplasia, respectively. Pseudomembranous-ulcerative inflammation of the cecum and variously intense lymphocytic infiltrates of numerous small submucosal veins and venules of the intestines were found in both cases. Thrombosis occurred very rarely in the affected vessels, although sometimes it was found in deeper and larger veins. Arteries, lymphatics, mesenterial veins and lymph nodes were normal. Parts of the distal ileum and ascending colon displayed the phlebitic changes without mucosal alterations. The authors hypothesize that it was not the abnormal local circulation, but some hitherto not fully clarified immunological disorder that resulted in the disease. In contrast to the claim of Saraga and Costa [5], it is suggested that thrombosis of the small veins does not have a significant role in the development of the lesions, but a complex process that includes the entry of antigens via the altered mucosa followed by an immunogenic inflammatory response of the small veins is responsible for the pathogenesis.

Adult↗
PubMed1976

Osteomyelitis and septic arthritis complicating hand injuries and infections: pathogenesis of roentgenographic abnormalities.

Osteomyelitis and pyarthrosis may complicate hand injuries and soft-tissue infections, resulting in characteristic radiographic findings. Evaluation of 78 patients revealed bone or joint abnormalities in 10% of individuals. Distinct pathways are available for spread of bacteria which become lodged in the soft tissues of the hand. Such routes include tendon sheaths, fascial planes and lymphatics. An understanding or pertinent anatomy allows the radiologist to predict the site and pattern of soft tissue, articular and osseous alterations.

Adolescent↗
PubMed1997

[Development and application of the method for controlling contamination of tumor samples with normal cells to detect deletion of P16 gene in primary lung carcinoma].

OBJECTIVE: The method is to be established to effectively promote the sensitivity of the detection of P16 gene deletion from tumor tissues mixed with normal cells and to determine the relationship between the gene alteration and the lung cancers. METHODS: The normal DNA and that of MCF-7 cells with P16 gene deletion was proportionally mixed and the mixture was limitedly diluted. The exon2 of P16 gene and internal control gene fragment were amplified with template of various amounts of DNA. And polymerase chain reaction (PCR) technique was used in the amplification of exon2 of P16 gene with certain amount of lung cancer DNA as the templates. The amplified fragment was analyzed with SSCP. RESULTS: Normal DNA did not contaminate P16 gene deletion when DNA template was 5 ng and normal cells less than 40%. No deletion and mutation of P16 gene was found in the small cell lung cancer and normal cancer-surrounding lung tissues, while P16 gene deletion and mutation were found respectively in 21 and 3 cases of 52 cases of non-small cell lung cancer. The rate of P16 gene deletion (72%) in lung cancer with lymphatic involvement was significantly higher than that in lung cancer without the metastasis (16.8%) (P < 0.05). It is found that P16 gene deletion was markedly associated with pathologic manifestation and prognosis of non-small cell lung cancer (P < 0.05). CONCLUSIONS: Controlling of the amount of template DNA in PCR helps to promote the sensitivity of detection of P16 gene deletion. The abnormality of P16 gene might relate to the malignant development of non-small cell lung cancer.

Carcinoma, Non-Small-Cell Lung↗