RESUMEN
OBJECTIVES: Sugar consumption has been decreasing in Japan, suggesting higher rates of sucrose-independent supragingival plaque formation. For developing an in vitro biofilm model of sucrose-independent supragingival plaque, this study aimed to investigate the compositions and functions on contributing to cariogenicity in comparison with sucrose-dependent biofilm. MATERIALS AND METHODS: An in vitro multispecies biofilm containing Actinomyces naeslundii, Streptococcus gordonii, S. mutans, Veillonella parvula and Fusobacterium nucleatum was formed on 24-well plates in the absence or presence of 1% sucrose. Compositions were assessed by plate culture, scanning electron microscopy and confocal laser scanning microscopy after fluorescent in situ hybridisation or labelling of extracellular polymeric substances (EPS). Functions were assessed by acidogenicity, adherence strength and sensitivities to anticaries agents. RESULTS: Although both biofilms exhibited a Streptococcus predominant bacterial composition, there were differences in bacterial and EPS compositions; in particular, little glucan EPS was observed in sucrose-independent biofilm. Compared with sucrose-dependent biofilm, acidogenicity, adherence strength and antimicrobial resistance of sucrose-independent biofilm were only slightly lower. However, dextranase degradation was substantially lower in sucrose-independent biofilm. CONCLUSION: Our findings suggest that sucrose-independent biofilm may have cariogenicity as with sucrose-dependent biofilm. These in vitro models can help further elucidate plaque-induced caries aetiology and develop new anticaries agents.
Asunto(s)
Fenómenos Fisiológicos Bacterianos , Biopelículas/efectos de los fármacos , Placa Dental/etiología , Modelos Biológicos , Actinomyces , Caries Dental/microbiología , Fusobacterium nucleatum , Concentración de Iones de Hidrógeno , Hibridación Fluorescente in Situ , Técnicas In Vitro , Microscopía Confocal , Microscopía Electrónica de Rastreo , Streptococcus gordonii , Streptococcus mutans , Sacarosa/farmacología , Edulcorantes/farmacología , VeillonellaRESUMEN
Luseogliflozin, a selective inhibitor of sodium glucose co-transporter 2 (SGLT2), was previously shown to improve the blood glucose and hemoglobin A1c (HbA1c) levels of patients with type 2 diabetes in a clinical setting. Although patients with type 2 diabetes often have hepatic impairment, few reports have been published concerning the influence of luseogliflozin on HbA1c and hepatic function in patients with type 2 diabetes accompanied by hepatic impairment. The present study was undertaken to evaluate the influence of luseogliflozin on HbA1c and hepatic function in patients with type 2 diabetes divided into 2 groups according to hepatic function parameters (a normal group and an elevated group). In this study, luseogliflozin significantly improved both HbA1c and body weight to similar extents in both the normal group and the elevated group, accompanied by marked reductions in the aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyl transpeptidase (γ-GTP) levels. These results suggested that luseogliflozin can be safely used in patients with type 2 diabetes who also exhibit hepatic impairment. The results additionally suggest the possibility that luseogliflozin might be capable of alleviating hepatic impairment in patients with type 2 diabetes.
Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Hepatopatías/tratamiento farmacológico , Hepatopatías/etiología , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Sorbitol/análogos & derivados , Pueblo Asiatico , Glucemia/efectos de los fármacos , Peso Corporal/efectos de los fármacos , Diabetes Mellitus Tipo 2/metabolismo , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Hígado/efectos de los fármacos , Hígado/metabolismo , Hepatopatías/metabolismo , Pruebas de Función Hepática/métodos , Masculino , Estudios Retrospectivos , Transportador 2 de Sodio-Glucosa , Sorbitol/uso terapéuticoRESUMEN
It has been reported that dipeptidyl peptidase-4 (DPP-4) inhibitors improve hemoglobin A1c (HbA1c) levels in diabetic patients and may also improve the serum lipids. However, few studies have examined relationship between the effects of the DPP-4 inhibitor and the pretreatment HbA1c levels in diabetic patients. Furthermore, it has been reported that prolonged treatment with DPP-4 inhibitors may make glycemic control difficult in some patients. In the present study, we investigated (1) the effect of the DPP-4 inhibitor alogliptin on HbA1c, blood glucose (BG), and serum lipid in Japanese patients with type 2 diabetes, (2) the relationship between the HbA1c levels at baseline and the effects of alogliptin, and (3) the effects of switching of the DPP-4 inhibitor to alogliptin after 12 months' administration of sitagliptin on glycemic control and serum lipids. After 6-months' treatment with alogliptin, we found reductions of HbA1c, BG, and serum total cholesterol, and LDL cholesterol levels. Pretreatment level of HbA1c was well correlated with the degree of reduction of both HbA1c and BG levels after the treatment. Also, alogliptin kept levels of HbA1c and BG reduced by sitagliptin for 12 months, and relapsing of these levels and serum lipids were not observed. This study revealed that alogliptin improved HbA1c, BG, and serum lipid profiles in type 2 diabetic patients, and the effect of alogliptin on HbA1c and BG levels was correlated with HbA1c level at pretreatment. Furthermore, long-term treatment with alogliptin did not cause relapsing of glycemic control and serum lipids.
Asunto(s)
Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/metabolismo , Dipeptidil Peptidasa 4/metabolismo , Inhibidores de la Dipeptidil-Peptidasa IV/uso terapéutico , Hemoglobina Glucada/metabolismo , Lípidos/sangre , Piperidinas/uso terapéutico , Uracilo/análogos & derivados , Pueblo Asiatico , Glucemia/efectos de los fármacos , Femenino , Humanos , Hipoglucemiantes/uso terapéutico , Masculino , Persona de Mediana Edad , Fosfato de Sitagliptina/uso terapéutico , Uracilo/uso terapéuticoRESUMEN
Dipeptidyl peptidase-4 (DPP-4) inhibitors have been reported to improve the glycemic control and blood hemoglobin A1c (HbA1c) concentrations. However, there are few reports as yet suggesting that DPP-4 inhibitors may also improve insulin resistance and the serum lipid profile in the clinical setting. This study was aimed at investigating the effect of 14-week treatment with teneligliptin (20 mg/day) on the homeostasis model assessment ratio (HOMA-R), an indicator of insulin resistance, and serum lipid profile in 9 patients with type 2 diabetes. The treatment produced a significant decrease of the blood glucose and HbA1c concentration (blood glucose: p=0.008; HbA1c: p=0.038), and also improved HOMA-R (p=0.039). Furthermore, the patients showed elevation of the serum HDL-cholesterol level (p=0.032), and a tendency towards reduction of the serum triglyceride level. The results indicate that teneligliptin acts not only to improve the blood glucose control, but also to improve the insulin resistance and serum lipid profile in Japanese type 2 diabetes patients.
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Diabetes Mellitus Tipo 2/tratamiento farmacológico , Resistencia a la Insulina , Lípidos/sangre , Pirazoles/farmacología , Tiazolidinas/farmacología , Anciano , Pueblo Asiatico , Glucemia/efectos de los fármacos , Diabetes Mellitus Tipo 2/sangre , Inhibidores de la Dipeptidil-Peptidasa IV/farmacología , Inhibidores de la Dipeptidil-Peptidasa IV/uso terapéutico , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Hipoglucemiantes/farmacología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Pirazoles/uso terapéutico , Tiazolidinas/uso terapéutico , Resultado del TratamientoRESUMEN
It has anatomically been revealed that the rostral part of the rat primary somatosensory cortex (S1) directly projects to the dorsal part of the trigeminal oral subnucleus (dorVo) and the dorsal part of juxtatrigeminal region (dorVjuxt), and that the dorVo and dorVjuxt contain premotoneurons projecting directly to the jaw-opening or jaw-closing motoneurons in the trigeminal motor nucleus (Vmo). However, little is known about how the rostral S1 regulates jaw movements in relation to its corticofugal projections. To address this issue, we performed intracortical microstimulation of the rat rostral S1 by monitoring jaw movements and electromyographic (EMG) activities. We for the first time found that low-frequency long-train stimulation of the rostral S1 induced single sustained opening of the jaw with elevated EMG activities of the anterior digastric muscles (jaw-opener). The effective sites for the low-frequency long-train stimulation overlapped the S1 sites where traditional high-frequency short-train stimulation was effective to induce single twitch-like jaw movement. We also found that the effective sites for the two kinds of train stimuli were included in the rostral S1 area, which has previously been identified to send direct projections to the dorVo or the dorVjuxt. Specifically, the most effective stimulation sites for the two kinds of train stimuli were located in the rostralmost part of S1 which has been reported to emanate strong direct projections to the dorVjuxt but less to the dorVo. Therefore, the present study suggests that the rat rostral S1, especially its rostralmost part, plays an important role in controlling jaw movements by activation of direct descending projections from the rostral S1 to the trigeminal premotoneuron pools, especially to the dorVjuxt.
Asunto(s)
Potenciales Evocados Somatosensoriales/fisiología , Maxilares/fisiología , Movimiento/fisiología , Corteza Somatosensorial/fisiología , Animales , Mapeo Encefálico , Estimulación Eléctrica , Electromiografía , Lateralidad Funcional , Peroxidasa de Rábano Silvestre/metabolismo , Masculino , Ratas , Ratas WistarRESUMEN
ß-Conglycinin, a major component of seed storage protein in soybean, comprises three subunits: α, α' and ß. The expression of genes for these subunits is strictly controlled during embryogenesis. The proximal promoter region up to 245 bp upstream of the transcription start site of the α subunit gene sufficiently confers spatial and temporal control of transcription in embryos. Here, the binding profile of nuclear proteins in the proximal promoter region of the α subunit gene was analysed. DNase I footprinting analysis indicated binding of proteins to the RY element and DNA regions including box I, a region conserved in cognate gene promoters. An electrophoretic mobility shift assay (EMSA) using different portions of box I as a probe revealed that multiple portions of box I bind to nuclear proteins. In addition, an EMSA using nuclear proteins extracted from embryos at different developmental stages indicated that the levels of major DNA-protein complexes on box I increased during embryo maturation. These results are consistent with the notion that box I is important for the transcriptional control of seed storage protein genes. Furthermore, the present data suggest that nuclear proteins bind to novel motifs in box I including 5'-TCAATT-3' rather than to predicted cis-regulatory elements.
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Antígenos de Plantas/genética , Regulación de la Expresión Génica de las Plantas , Globulinas/genética , Glycine max/genética , Proteínas de Almacenamiento de Semillas/genética , Proteínas de Soja/genética , Antígenos de Plantas/metabolismo , Secuencia de Bases , Cotiledón/metabolismo , Huella de ADN , Ensayo de Cambio de Movilidad Electroforética , Perfilación de la Expresión Génica , Regulación del Desarrollo de la Expresión Génica , Globulinas/metabolismo , Glucuronidasa/metabolismo , Datos de Secuencia Molecular , Proteínas Nucleares , Plantas Modificadas Genéticamente , Regiones Promotoras Genéticas/genética , Unión Proteica , Subunidades de Proteína , Proteínas de Almacenamiento de Semillas/metabolismo , Análisis de Secuencia de ADN , Proteínas de Soja/metabolismo , Glycine max/embriología , Glycine max/metabolismoRESUMEN
The evolution of electronic (spin and charge) excitations upon carrier doping is an extremely important issue in superconducting layered cuprates and the knowledge of its asymmetry between electron- and hole-dopings is still fragmentary. Here we combine X-ray and neutron inelastic scattering measurements to track the doping dependence of both spin and charge excitations in electron-doped materials. Copper L3 resonant inelastic X-ray scattering spectra show that magnetic excitations shift to higher energy upon doping. Their dispersion becomes steeper near the magnetic zone centre and they deeply mix with charge excitations, indicating that electrons acquire a highly itinerant character in the doped metallic state. Moreover, above the magnetic excitations, an additional dispersing feature is observed near the Γ-point, and we ascribe it to particle-hole charge excitations. These properties are in stark contrast with the more localized spin excitations (paramagnons) recently observed in hole-doped compounds even at high doping levels.
RESUMEN
This study has revealed direct projections from the dorsal peduncular cortex (DP) in the medial prefrontal cortex (mPfC) to the trigeminal brainstem sensory nuclear complex and other lower brainstem areas in rats. We first examined the distribution of mPfC neurons projecting directly to the medullary dorsal horn (trigeminal subnucleus caudalis [Vc]) and trigeminal subnucleus oralis (Vo) which are known to receive direct projections from the lateral prefrontal cortex (insular cortex). After injections of the retrograde tracer Fluorogold (FG) into the rostro-dorsomedial part of laminae I/II of Vc (rdm-I/II-Vc), many neurons were labeled bilaterally (with an ipsilateral predominance) in the rostrocaudal middle level of DP (mid-DP) and not in other mPfC areas. After FG injections into the lateral and caudal parts of laminae I/II of Vc, or the Vo, no neurons were labeled in the mPfC. We then examined projections from the mid-DP by using the anterograde tracer biotinylated dextranamine (BDA). After BDA injections into the mid-DP, many axons and terminals were labeled bilaterally (with an ipsilateral predominance) in the rdm-I/II-Vc, periaqueductal gray and solitary tract nucleus, and ipsilaterally in the parabrachial nucleus and trigeminal mesencephalic nucleus. In addition, the connections of the mid-DP with the insular cortex were examined. Many BDA-labeled axons and terminals from the mid-DP were also found ipsilaterally in the caudalmost level of the granular and dysgranular insular cortex (GI/DI). After BDA injections into the caudalmost GI/DI, many axons and terminals were labeled ipsilaterally in the mid-DP. The projections from the mid-DP to the rdm-I/II-Vc and other brainstem nuclei suggest that mid-DP neurons may regulate intraoral and perioral sensory processing (including nociceptive processing) of rdm-I/II-Vc neurons directly or indirectly through the brainstem nuclei. The reciprocal connections between the mid-DP and caudalmost GI/DI suggest that this regulation may involve mid-DP interactions with the caudalmost GI/DI neurons.
Asunto(s)
Tronco Encefálico/anatomía & histología , Vías Nerviosas/anatomía & histología , Corteza Prefrontal/anatomía & histología , Animales , Masculino , Ratas , Ratas WistarRESUMEN
BACKGROUND AND OBJECTIVE: L-Ascorbic acid 2-phosphate magnesium salt (APM) is an L-ascorbic acid (AsA) derivative developed to improve AsA stability and display effective biochemical characteristics. This study aimed to investigate the effects of APM on the functions and properties of human gingival fibroblasts with respect to the prevention of periodontal disease in comparison with those of AsA. MATERIAL AND METHODS: Human gingival fibroblasts were incubated in the presence or absence of APM or L-ascorbic acid sodium salt (AsANa). Intracellular AsA was analysed by HPLC. Collagen synthesis was measured by ELISA and real-time RT-PCR. Intracellular reactive oxygen species (ROS) induced by hydrogen peroxide (H(2)O(2)) were quantified using a fluorescence reagent, and cell damage was estimated with calcein acetoxymethyl ester. Furthermore, intracellular ROS induced by tumor necrosis factor-α (TNF-α) were quantified, and expression of TNF-α-induced interleukin-8 expression, which increases due to inflammatory reactions, was measured by ELISA and real-time RT-PCR. RESULTS: APM remarkably and continuously enhanced intracellular AsA and promoted type 1 collagen synthesis and mRNA expression. Furthermore, APM decreased cell damage through the suppression of H(2)O(2)-induced intracellular ROS and inhibited interleukin-8 production through the suppression of TNF-α-induced intracellular ROS. These effects of APM were superior to those of AsANa. CONCLUSION: These results suggest that APM is more effective than AsANa in terms of intake, collagen synthesis, decreasing cell damage and inhibiting interleukin-8 expression in human gingival fibroblasts. This suggests that local application of APM can help to prevent periodontal disease.
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Antioxidantes/farmacología , Ácido Ascórbico/análogos & derivados , Fibroblastos/efectos de los fármacos , Encía/efectos de los fármacos , Antiinflamatorios/farmacología , Antioxidantes/farmacocinética , Ácido Ascórbico/análisis , Ácido Ascórbico/farmacocinética , Ácido Ascórbico/farmacología , Línea Celular , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Cromatografía Líquida de Alta Presión , Colágeno Tipo I/biosíntesis , Colágeno Tipo I/efectos de los fármacos , Fibroblastos/metabolismo , Fluoresceínas , Colorantes Fluorescentes , Depuradores de Radicales Libres/farmacología , Encía/citología , Encía/metabolismo , Humanos , Peróxido de Hidrógeno/antagonistas & inhibidores , Peróxido de Hidrógeno/farmacología , Interleucina-8/análisis , Interleucina-8/antagonistas & inhibidores , Interleucina-8/efectos de los fármacos , Especies Reactivas de Oxígeno/análisis , Especies Reactivas de Oxígeno/antagonistas & inhibidores , Especies Reactivas de Oxígeno/farmacología , Factor de Necrosis Tumoral alfa/farmacologíaRESUMEN
Previous studies have demonstrated the presence of sperm dimorphism in the Mantispidae Perlamantispa perla. We extended the study on several other mantidflies. In all the examined species the occurrence of euspermatozoa (typical) and paraspermatozoa (atypical) was established. The euspermatozoa are characterized by the presence of a cylindrical nucleus surrounded by an envelope that fans out laterally into two thin wings of different length. The acrosome seems to be missing. The nucleus is surrounded by extracellular material. The flagellum is provided with a 9+9+2 axonemal pattern; the accessory tubules contain 16 protofilaments and the intertubular material has the distribution typical of the taxon. Two elongated accessory bodies flank partially the axoneme and connect this structure with the mitochondrial derivatives. The flagellar axoneme of paraspermatozoa consists of an axoneme and two giant mitochondrial derivatives filled with large globular units. The axoneme exhibits a 9+9+2 pattern, in which the central 9+2 units have a normal structure, in that the microtubular doublets are provided with both dynein arms and radial links. On the contrary, the nine accessory microtubules have a large diameter and their tubular wall consists of 40 protofilaments. This comparative study provided evidences about the uniformity of sperm ultrastructure in Mantispidae. The function of non-fertilizing giant sperm in mantidflies is discussed.
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Dípteros/ultraestructura , Espermatogénesis/fisiología , Espermatozoides/ultraestructura , Testículo/ultraestructura , Animales , Axonema/fisiología , Axonema/ultraestructura , Evolución Biológica , Diferenciación Celular/fisiología , Movimiento Celular/fisiología , Forma de la Célula/fisiología , Tamaño de la Célula , Dípteros/fisiología , Femenino , Fertilización/fisiología , Masculino , Microscopía Electrónica de Rastreo , Microscopía Electrónica de Transmisión , Microtúbulos/fisiología , Microtúbulos/ultraestructura , Mitocondrias/fisiología , Mitocondrias/ultraestructura , Filogenia , Especificidad de la Especie , Cola del Espermatozoide/fisiología , Cola del Espermatozoide/ultraestructura , Espermatozoides/fisiología , Testículo/fisiologíaRESUMEN
Refractory strictures of esophagogastric anastomosis caused by leakage following an esophagectomy are a severe complication, for which either repeated balloon dilations or bougies are not necessarily effective. In such a case, surgical repair is quite difficult because the esophageal substitute such as the stomach or colon is usually located in the mediastinum and severely adhesive to the neighboring organs. Furthermore, in case the resected stricture is too long for direct re-anastomosis to be performed, a free jejunal graft or a new esophageal substitute should be prepared. This paper proposes a procedure for the re-reconstruction of refractory stricture in the case of a retrosternal reconstruction with a gastric conduit, which frequently employs pull-up route. The anterior plate of the manubrium was divided medially from the notch to the symphysis with the sternal saw. The manubrium is then removed, bite by bite, like breaking up rocks, with a bone rongeur forceps, starting with the anterior plate, then the posterior plate, from upper median part to the lower and lateral part of the sternum until it reaches the symphysis and the sternoclavicular and the sternocostal joints. It is safer to destroy the manubrium little by little from the anterior side so that the posterior periosteum, which is likely to adhere tightly to the gastric conduit, can be preserved. After the manubrium is almost completely resected and the posterior periosteum of the manubrium is preserved, a median longitudinal incision is carefully made on the periosteum so as not to damage the gastric conduit that may be adhesive to the periosteum. The periosteum was gradually opened bilaterally separating the periostium and the gastric conduit. Although gastroenterological surgeons may hesitate to remove the manubrium, removing the manubrium and preserving the posterior periosteum make it possible to avoid injuring the gastric conduit and to provide a wide view around the stenosis for safely resecting the anastomotic stricture. Furthermore, this procedure allows direct re-anastomosis between the cervical esophagus and the gastric conduit without a complicated reconstruction such as a free jejunal graft. This procedure is strongly recommended as an alternative option so that a second reconstruction can be performed both safely and steadily.
Asunto(s)
Anastomosis Quirúrgica/efectos adversos , Estenosis Esofágica/cirugía , Esofagectomía , Procedimientos de Cirugía Plástica/efectos adversos , Complicaciones Posoperatorias , Cateterismo/métodos , Neoplasias Esofágicas/cirugía , Esofagoscopía , Esófago/cirugía , Humanos , Masculino , Manubrio/cirugía , Microcirugia/métodos , Persona de Mediana Edad , Periostio/cirugía , Complicaciones Posoperatorias/cirugía , Procedimientos de Cirugía Plástica/métodos , Recurrencia , Reoperación , Costillas/cirugía , Articulación Esternoclavicular/cirugía , Esternón/cirugía , Estómago/cirugía , Adherencias Tisulares/etiología , Adherencias Tisulares/cirugíaAsunto(s)
Adenocarcinoma/terapia , Drenaje/métodos , Neoplasias de la Vesícula Biliar/terapia , Enfermedad Iatrogénica , Stents , Adenocarcinoma/diagnóstico , Anciano , Bilis , Colangiopancreatografia Retrógrada Endoscópica/métodos , Terapia Combinada , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapéutico , Diagnóstico por Imagen/métodos , Estudios de Seguimiento , Neoplasias de la Vesícula Biliar/diagnóstico , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Medición de Riesgo , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , GemcitabinaAsunto(s)
Colestasis Extrahepática/cirugía , Endoscopía Gastrointestinal/métodos , Endosonografía/métodos , Neoplasias Pancreáticas/cirugía , Stents , Anciano , Colestasis Extrahepática/diagnóstico por imagen , Drenaje , Duodeno/patología , Electrocirugia , Femenino , Humanos , Invasividad Neoplásica , Neoplasias Pancreáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos XAsunto(s)
Oclusión con Balón , Embolización Terapéutica/instrumentación , Urgencias Médicas , Várices Esofágicas y Gástricas/terapia , Cuerpos Extraños/diagnóstico , Fundus Gástrico/irrigación sanguínea , Hemorragia Gastrointestinal/terapia , Gastroscopía , Escleroterapia , Anciano , Terapia Combinada , Estudios de Seguimiento , Humanos , Masculino , Portografía , Tomografía Computarizada por Rayos X , Venas/patologíaAsunto(s)
Neoplasias de los Conductos Biliares/terapia , Colangiocarcinoma/terapia , Colangiopancreatografia Retrógrada Endoscópica/instrumentación , Colestasis Intrahepática/terapia , Cuidados Paliativos , Stents , Neoplasias de los Conductos Biliares/diagnóstico por imagen , Conductos Biliares Intrahepáticos/diagnóstico por imagen , Colangiocarcinoma/diagnóstico por imagen , Colestasis Intrahepática/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Adenoma/diagnóstico , Colangiopancreatografia Retrógrada Endoscópica , Pancreatocolangiografía por Resonancia Magnética , Endosonografía , Conductos Pancreáticos , Neoplasias Pancreáticas/diagnóstico , Adenoma/patología , Adenoma/cirugía , Anciano , Diagnóstico Diferencial , Humanos , Masculino , Conductos Pancreáticos/patología , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/cirugía , PancreaticoduodenectomíaAsunto(s)
Ampolla Hepatopancreática , Tumor Carcinoide/diagnóstico , Colangiopancreatografia Retrógrada Endoscópica , Neoplasias del Conducto Colédoco/diagnóstico , Endoscopía del Sistema Digestivo , Endosonografía , Tamizaje Masivo , Anciano , Ampolla Hepatopancreática/patología , Ampolla Hepatopancreática/cirugía , Biomarcadores de Tumor/análisis , Tumor Carcinoide/patología , Tumor Carcinoide/cirugía , Neoplasias del Conducto Colédoco/patología , Neoplasias del Conducto Colédoco/cirugía , Estudios de Seguimiento , Humanos , Masculino , Somatostatina/análisisRESUMEN
PURPOSE: To determine whether the signal changes on magnetic resonance imaging (MRI), including fluid attenuated inversion recovery (FLAIR), T2*-weighted gradient echo (GE) imaging, and diffusion-weighted imaging (DWI) in diffuse axonal injury (DAI) patients correlate with the clinical outcome. MATERIAL AND METHODS: We diagnosed patients with DAI based on the following criteria: 1) a loss of consciousness from the time of injury that persisted beyond 6 h; 2) no apparent hemorrhagic contusion on computed tomography (CT); 3) the presence of white matter injury on MRI. Twenty-one DAI patients were analyzed (19 M, 2 F, mean age 34 years) with MRI (FLAIR, T2*-weighted GE imaging, and DWI). RESULTS: 325 abnormalities were detected by MRI within a week after injury. The T2*-weighted GE imaging was significantly more sensitive than FLAIR and DWI in diagnosing DAI. DWI detected only 32% of all lesions, but could depict additional shearing injuries not visible on either T2*-weighted GE imaging or FLAIR. The mean number of lesions in brainstem detected by DWI in the favorable group (good recovery/moderately disabled) was significantly smaller than in the unfavorable group (severely disabled/vegetative survival/death). This trend was not observed on the T2*-weighted GE imaging and FLAIR findings. CONCLUSION: DWI cannot detect all DAI-related lesions, but is a potentially useful imaging modality for both diagnosing and assessing patients with DAI.
Asunto(s)
Lesión Axonal Difusa/diagnóstico , Imagen de Difusión por Resonancia Magnética , Traumatismos Cerrados de la Cabeza/diagnóstico , Adolescente , Adulto , Anciano , Niño , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y Especificidad , Estadísticas no ParamétricasRESUMEN
BACKGROUND AND PURPOSE: Although dynamic contrast-enhanced MR angiography studies for arteriovenous malformations (AVFs) and brain tumors have shown promising results, no formal attempt has yet been made to similarly evaluate dural AVFs. To assess the practical applicability of 2D thick-section contrast enhanced MR digital subtraction angiography (MRDSA) for the diagnosis and management of dural AVFs, MRDSA and intra-arterial digital subtraction angiography (IADSA) were comparatively evaluated. METHODS: We performed 80 consecutive MRDSA studies for 25 dural AVFs, including 11 cavenous sinuses, 9 sigmoid sinuses, 2 tentorial sinuses, one anterior condylar vein, one craniocervical junction, and one spine. MR images were continuously obtained following the initiation of a bolus injection of gadrinium chelates and subtraction images were constructed. We thereafter evaluated the imaging quality and hemodynamic information from all 46 MRDSA images performed in parallel with IADSA in either perioperative or follow-up studies. RESULTS: Most MRDSA images detected early venous filling, sinus occlusion, leptomeningeal venous drainage, and varices. It was difficult, however, to identify the feeding arteries because of both the partial volume effect and a low spatial resolution. Most important, MRDSA accurately detected aggressive lesions with leptomeningeal venous drainage and varices. CONCLUSION: Our MRDSA technique was found to have limited value for depicting all the anatomic details of dural AVFs, though it was able to identify important hemodynamic abnormalities related to the risk of hemorrhaging. MRDSA is therefore useful as a less invasive, dynamic angiographic tool, not only for perioperative studies but also for follow-up studies.