RESUMEN
BACKGROUND AND PURPOSE: The image quality of neck CT is frequently disturbed by streak artifact from the shoulder girdles. Our aim was to determine the effects of an arm traction device on image quality and radiation exposure in neck CT. MATERIALS AND METHODS: Patients with lymphoma with complete remission who were scheduled to undergo 2 consecutive follow-up neck CT scans for surveillance within a 1-year interval were enrolled in this prospective study. They underwent 2 consecutive neck CT scans (intervention protocol: patients with an arm traction device; standard protocol: no positioning optimization) on the same CT system. The primary outcome measures were image noise in the lower neck and dose-length product. Secondary outcomes were streak artifacts in the supraclavicular fossa, volume CT dose index, and the extent of the biacromial line shift. RESULTS: Seventy-three patients were enrolled and underwent 2 consecutive CT scans with a mean interval of 155 days. In the intervention protocol, a mean noise reduction in the lower neck of 25.2%-28.5% (P < .001) was achieved, and a significant decrease in dose-length product (413 versus 397, P < .001) was observed. The intervention protocol significantly decreased streak artifacts (P < .001) and volume CT dose index (13.9 versus 13.4, P < .001) and could lower the biacromial line an average of 2.1 cm. CONCLUSIONS: An arm traction device can improve image quality and reduce radiation exposure during neck CT. The device can be simply applied in cooperative patients with suspected lower neck lesions, and the approach offers distinct advantages over the conventional imaging protocol.
Asunto(s)
Artefactos , Linfoma/diagnóstico por imagen , Exposición a la Radiación , Tomografía Computarizada por Rayos X/instrumentación , Tracción/instrumentación , Adulto , Anciano , Brazo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuello/diagnóstico por imagen , Estudios Prospectivos , Dosis de Radiación , Tomografía Computarizada por Rayos X/métodos , Tracción/métodosRESUMEN
OBJECTIVES: To report the multidetector-row computed tomography (MDCT) findings of small bowel obstruction (SBO) caused by Meckel's diverticulum. MATERIALS AND METHODS: Ten patients (9 men and 1 woman; age range, 2-44 years; median age, 21years) with surgical proven Meckel's diverticulum who presented SBO on the preoperative MDCT were included in the study. RESULTS: On MDCT, all patients presented with SBO, either high-grade (n=6) or low-grade obstruction (n=4). Meckel's diverticulum was identiï¬ed in five patients (n=5, 50%) on preoperative MDCT. In the five patients in whom a diverticulum was not seen on preoperative MDCT, MDCT showed a transition site on ileum with dilated proximal loops (n=3), pneumoperitoneum (n=1), jejuno-jejunal intussusception (n=1). Transition zone was located near midline in four patients (4/5, 80%). CONCLUSION: The diagnosis of Meckel's diverticulum complicated SBO can be made with certainty when the diverticulum is visualized on preoperative MDCT. However, the preoperative diagnosis is difficult if the Meckel's diverticulum is not noted on the MDCT. When the obstructive processes are visualized in the lower abdomen or pelvis, particularly near the midline, one should keep in mind that SBO may be caused by Meckel's diverticulum without prior surgical history.
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Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/etiología , Divertículo Ileal/complicaciones , Tomografía Computarizada Multidetector , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Estudios Retrospectivos , Adulto JovenRESUMEN
Synchronous bilateral ovarian cancer is extremely rare and there is no established guideline for management. A case of a 58-year-old multiparous woman with bilateral ovarian synchronous malignant tumors is presented. The clinical consideration and treatment of related cases are discussed.
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Cistadenocarcinoma Papilar/patología , Cistadenocarcinoma Seroso/patología , Tumor Mulleriano Mixto/patología , Neoplasias Primarias Múltiples/patología , Neoplasias Ováricas/patología , Cistadenocarcinoma Papilar/diagnóstico por imagen , Cistadenocarcinoma Papilar/cirugía , Cistadenocarcinoma Seroso/diagnóstico por imagen , Cistadenocarcinoma Seroso/cirugía , Resultado Fatal , Femenino , Humanos , Persona de Mediana Edad , Tumor Mulleriano Mixto/diagnóstico por imagen , Tumor Mulleriano Mixto/cirugía , Neoplasias Primarias Múltiples/diagnóstico por imagen , Neoplasias Primarias Múltiples/cirugía , Neoplasias Ováricas/diagnóstico por imagen , Neoplasias Ováricas/cirugía , RadiografíaRESUMEN
The synthesis and biological activity of a series of new 1beta-methylcarbapenems 1a-g containing 5'-isoxazolopyrrolidin-3'-ylthio derivatives as C-2 side chain are described. Most compounds exhibited potent and well-balanced antibacterial activity as well as high stability to DHP-I comparable to that of meropenem. 1e and 1c showed the best combination of antibacterial activity and stability to DHP-I, respectively.
Asunto(s)
Antibacterianos/síntesis química , Isoxazoles/síntesis química , Antibacterianos/farmacología , Carbapenémicos/síntesis química , Carbapenémicos/farmacología , Dipeptidasas/metabolismo , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/efectos de los fármacos , Isoxazoles/farmacología , Pruebas de Sensibilidad Microbiana , Estructura Molecular , EstereoisomerismoRESUMEN
A new series of 1beta-methylcarbapenems 1a-i bearing isoxazoloethenyl groups on the pyrrolidine ring has been prepared and evaluated for in vitro antibacterial activity and stability to DHP-I. Most compounds showed excellent antibacterial activity and high stability to DHP-I superior to that of meropenem. Of these new carbapenems, 1a,b,h exhibited the best combination of antibacterial activity and DHP-I stability.
Asunto(s)
Carbapenémicos/síntesis química , Carbapenémicos/farmacología , Isoxazoles/farmacología , Animales , Antibacterianos/síntesis química , Antibacterianos/metabolismo , Antibacterianos/farmacología , Carbapenémicos/metabolismo , Dipeptidasas/metabolismo , Estabilidad de Medicamentos , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/efectos de los fármacos , Meropenem , Pruebas de Sensibilidad Microbiana , Modelos Moleculares , Relación Estructura-Actividad , Porcinos , Tienamicinas/farmacologíaRESUMEN
The synthesis and biological activity of the novel series of 1 beta-methylcarbapenems 1a-f, bearing a variety of 3",4"-disubstituted pyrrolidinamides as substituents at C-2, are described. Of these carbapenems, diol 1a showed the most potent and well balanced antibacterial activity against Gram-positive and Gram-negative. 1a was also evaluated for pharmacokinetics and in vivo therapeutic efficacy in systemic infections.