Biomedical subjects
Publications and source records attributed to E Rodríguez.
Macrodystrophia lipomatosa is a congenital form of localized gigantism characterized by an overgrowth of all mesenchymal elements with a disproportionate increase of adipose tissue. We describe a patient with macrodystrophia lipomatosa affecting the foot who exhibited characteristic MR findings that distinguish the lesion from other conditions associated with localized gigantism.
BACKGROUND: Patients with pheochromocytoma have been reported to show high plasmatic atrial natriuretic factor (ANF) levels. Its source may not be the atrium because blood volume, the most important physiological stimulus for ANF release, is usually reduced in these patients. METHODS: To evaluate ANF secretion functional integrity, we studied three patients with pheochromocytoma before and after surgical removal of the tumor. Extracellular fluid (ECF) volume, plasmatic ANF levels, and plasmatic renin activity (PRA) were measured. ANF was measured before and after an acute saline load of 1.5L in 90 min. RESULTS: Before surgery, ECF volume was normal or reduced, and PRA was normal but decreased after the saline load. By contrast, ANF was elevated and did not change after the saline load. After surgery ANF decreased, ECF volume rose, and the saline load induced a significant increase of plasma ANF and reduction of PRA. ANF was present in significant amounts in tumoral tissue homogenates. CONCLUSIONS: These data suggest that the tumor was the source of ANF in these patients with pheochromocytoma because high levels of ANF, despite reduced or normal ECF volume, as well as unresponsiveness to acute saline infusion, were found before surgery with subsequent normalization after tumor removal.
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The sylvian fissure bifurcates posteriorly into ascending and descending rami. The diversity in the specific arrangement of these rami and in the length of a more anterior segment of the fissure, between the bifurcation point and Heschl's gyrus (segment H-B), was analyzed qualitatively and quantitatively, in both left and right hemispheres and in both males and females. Qualitatively, four basic patterns of bifurcation appeared: (A) the ascending ramus is larger than the descending one (61.25% of the cases). In half of these cases segment H-B was very short (designated as 'short H-B'). The other patterns were: (B) the descending ramus is larger than the ascending one (7.5% of the total); (C) both rami are of approximately equal size (10% of the cases); and (D) both are of approximately equal size but the ascending ramus is oriented frontally instead of caudally as in the other cases (21.25% of the cases). Type D has not been reported before, and may be considered a new variant of bifurcating rami that in many cases corresponds to what other authors have referred to as the absence of an ascending ramus. We found a biased distribution of the fissure types according to hemispheres and also sex, with type A being more common in males and in the right hemisphere, and type D more common in females and in the left hemisphere. When the two hemispheres of each subject were matched, no correspondence was observed between the fissurization pattern of one hemisphere and that of the other, indicating that fissurization develops independently in each hemisphere. Quantitative analyses confirmed these findings and showed some new relations between components of the sylvian fissure. For example, when pooling together all fissure types a negative correlation between segment H-B and the ascending ramus was observed in males but not in females. On average, segment H-B was larger on the left side while the ascending ramus was larger on the right, confirming previous reports. Since earlier studies indicate that the planum temporale is larger on the left side, we suggest that the latter usually corresponds to segment H-B. However, the 'short H-B' cases described above have an unusually long and deep ascending branch, indicating that the planum temporale may run into the latter in these cases. The present classification of fissure types therefore describes a new variant of fissurization patterns in the sylvian fissure, which is asymmetrically distributed across the hemispheres and is perhaps sexually dimorphic. Furthermore, our analysis of fissure morphology and asymmetry is of direct relevance to the definition and location of the planum temporale in the sylvian fossa. Finally, our quantitative analyses are amenable to the use of morphometric techniques in the study of variability in fissurization patterns.
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OBJECTIVE: The purpose of this study was to determine the utility of CT in distinguishing peritoneal tuberculosis (PT) from peritoneal carcinomatosis (PC). MATERIALS AND METHODS: CT scans were retrospectively reviewed in 19 patients known to have PT and compared with scans in 19 patients known to have PC. CT images were evaluated for thickening (smooth versus irregular), enhancement, presence of nodules, and site of involvement on the parietal peritoneum. The existence of omental caking, nodules, and smudged patterns in the omentum, mesentery, and gastrocolic ligament was noted. The presence, distribution, and loculation of ascites were also evaluated. RESULTS: Ascites was present in all cases of PT and PC, loculated in 10 cases (PT = 4, PC = 6), and located in the greater peritoneal sac (PT = 15, PC = 10) or in the greater and lesser sacs (PT = 4, PC = 9). Slight smooth thickening and pronounced enhancement of the parietal peritoneum were seen in 15 of 19 PT patients and in 5 of 19 PC patients (p<0.001), whereas irregular thickening was found in only 9 of 19 PC patients (p <0.001). Peritoneal nodules were present exclusively in PC (7/19) (p <0.01). The sites of the parietal peritoneum involvement were the pelvic (PT = 9, PC = 3) (p <0.05), paracolic gutters (PT = 5, PC = 6), juxtadiaphragmatic (PT = 0, PC = 9) (p <0.001), and perihepatic (PT = 6, PC = 8) regions. Omental cakes were found in 4 of 19 PT and in 7 of 19 PC patients. The smudged pattern was the most common abnormality in the omentum (PT = 9/19, PC = 11/19), gastrocolic ligament (PT = 5/19, PC = 11/19) (p <0.01), and mesentery (PT = 7/19, PC = 11/19). Isolated and discrete well defined nodules were exclusively found in the mesentery (PT = 5/19, PC = 3/19). CONCLUSION: The most useful CT findings for distinguishing PT from PC were observed in the parietal peritoneum. The presence of a smooth peritoneum with minimal thickening and pronounced enhancement suggests PT, whereas nodular implants and irregular peritoneal thickening suggest PC.
UNLABELLED: Lipoma arborescens (LA) is a rare, poorly understood intraarticular lesion, with few cases reported in the imaging literature. Our purpose was to describe on MR the different morphologic appearances of LA of the knee and to investigate the incidence of associated anomalies. METHOD: The medical records and MR findings of 12 patients with proven LA in 13 knee joints were retrospectively reviewed with particular emphasis on the shape of the lesion, location, signal intensity, and past clinical history. RESULTS: We found three common morphological patterns of presentation: multiple villous lipomatous synovial proliferations (n = 6), isolated frond-like fat subsynovial mass (n = 2), and mixed pattern (n = 5). Multiple villous lipomatous synovial proliferations and mixed pattern were usually associated with a history of trauma and/or chronic inflammatory diseases. However, the least frequent isolated frond-like fat subsynovial mass appears to originate without antecedent. The durations of symptoms were 1-7 months (multiple villous lipomatous synovial proliferations), 1-20 years (mixed pattern) and 6-7 years (isolated frond-like subsynovial fat mass). CONCLUSION: Our study suggest that LA can present with a variety of morphological appearances on MR that may depend on the previous clinical history and duration of the disease.
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PURPOSE: The goals of this work were to evaluate the practical utility of MRI to quantify myocardial mass in patients with hypertrophic cardiomyopathy (HCM), define the differences in myocardial mass measurements obtained with three-dimensional and geometric MR methods in patients with normal left ventricular morphology and in patients with wall thickening, and establish the correlation between the two MR methods and the geometric echocardiographic method (GEM). METHOD: The same protocol was followed to conduct prospective MR examinations on 72 patients. In 60 of the subjects suspected to have HCM, imaging was performed to confirm or rule out the preliminary clinical diagnosis; the other 12 were healthy volunteers. Multislice SE, single slice multiphase, and multislice multiphase GRE sequences were performed in all cases. Left ventricle mass was calculated using formulas that assume an ellipsoid geometry for the left ventricle (geometric method), and the results were compared with the mass found using the three-dimensional method and subsequent application of Simpson rule. Tests were run to evaluate intraobserver variability in the MR data obtained with the three-dimensional method. The measurements obtained with the two MR methods were compared with the results obtained with GEM. RESULTS: Although the mean left myocardial mass values obtained using the three-dimensional MR method were smaller than the mean values found with the geometric MR method in all patients, the difference was significant only in patients with HCM. The correlation between the geometric MR method and GEM was very good both in patients with HCM and in those with normal wall thickening. The correlation between the three-dimensional MR method and GEM was good in patients whose left ventricle morphology was normal and poor in patients with HCM. Intraobserver agreement for three-dimensional mass values was excellent. CONCLUSION: MR examinations should be a standard technique for calculating myocardial ventricular mass. In patients with normal ventricle wall thickness, the geometric method can be used to calculate myocardial mass because it is less time consuming. However, in patients with abnormal morphology of the left ventricle and/or asymmetric wall thickening such as found in HCM, in whom the geometric method overestimates myocardial mass, measurements should be made using the three-dimensional method.
PURPOSE: The aim of this study was to describe the MR findings in extraspinal musculoskeletal tuberculosis (EMT). METHOD: A retrospective review was conducted of the MR findings of 18 patients with microbiologically and/or pathologically proven EMT. All MR studies were performed using T1-and T2-weighted spin echo sequences. T1-weighted spin echo sequences after Gd-DTPA injection were obtained for 12 patients. The MR images were evaluated for abnormalities in joints, bones, and soft tissues, and the results were grouped by anatomic localization, frequency distribution of structures affected, and morphologic patterns of involvement. RESULTS: Isolated soft tissue tuberculosis was found in 10 (55.5%) patients and involvement of more than one structure in 8 (44.4%). Pyomyositis (n = 6) and arthritis with involvement of adjacent soft tissues (n = 7) were the most common forms of presentation. One patient presented with isolated fascial superficial tissue involvement in one leg. Isolated pyomyositis involving one (n = 3) or two (n = 3) muscles was homogeneous in six cases and showed intermediate (n = 6), low (n = 2), or high (n = 1) signal intensity on T1-weighted images and a high and very hyperintense signal on T2-weighted images. The tenosynovitis synovial fluid was homogeneous (n = 1) or heterogeneous with multiple tiny hypointense nodules (n = 1) on T2-weighted images. The subdeltoid bursitis fluid was characterized by homogeneous low signal intensity with a hyperintense rim (n = 2) on T1-weighted images and homogeneous (n = 1) or heterogeneous hyperintense signals with areas of low signal intensity (n = 1) on T2-weighted images. In tuberculous arthritis, the synovial joint fluid (n = 7) showed heterogeneous (n = 4) or homogeneous (n = 3) low signal intensity on T1-weighted images and high or very high signal intensity on T2-weighted images. Where involved, the adjacent muscle(s) (n = 8) were usually hypointense on T1-weighted images and very hyperintense on T2-weighted images. Associated cellulitis was found in arthritis with involvement of neighboring soft tissues (n = 5), pyomyositis (n = 2), and tenosynovitis (n = 1). The images obtained after Gd-DTPA showed peripheral (n = 10) or heterogeneous (n = 1) enhancement or no enhancement (n = 1). CONCLUSION: The MR findings for EMT are variable. Although diagnosis is dependent largely on prior presumption and clinical context, MRI provides valuable guidelines in defining the extent of the lesions to select the appropriate treatment and for follow-up of abnormalities.
Tuberculosis can involve a multitude of organ tissues but generally affects the respiratory tract. Heart tuberculosis is rare, and the pericardium is the most common location reported in the literature, accounting for 0.5% of extrapulmonary tuberculosis. Isolated myocardial tuberculosis is a very unusual occurrence, with only a few case reports in the literature, usually diagnosed at necropsy. Findings of myocardial tuberculoma on cross-sectional images previously have not been reported. We present computed tomography and magnetic resonance imaging findings of an isolated calcified myocardial tuberculoma.
PURPOSE: This study was designed to evaluate the efficacy of a combined treatment, previously used to prevent fibrosis after glaucoma surgery, to inhibit an experimental model of proliferative vitreoretinopathy (PVR). METHODS: Two groups of albino rabbits were used. In the control group (group 1, n = 14), experimental PVR was induced using vitrectomy, retinotomies, cryotherapy and intraocular injection of platelet-rich plasma. In the experimental group (group 2, n = 15), after PVR was induced, the following treatment was administered for 4 weeks: systemic methylprednisolone, sodium diclofenac and colchicine combined with topical atropine 1%, adrenaline 10% and dexamethasone phosphate 0.1%. Follow- up consisted of fundus examination for 4 weeks. Results were classified according to Fastenberg's classification. Only retinal detachments were considered to compare the two groups. Nonparametric test was used. RESULTS: Retinal detachments were observed in 85.7% of group 1 and 33.3% of group 2 at the end of the follow-up (p<0.01). No major systemic complications were observed. CONCLUSIONS: Combined therapy seems to be useful for treating experimental PVR.
BACKGROUND: To evaluate clinical and microbiological characteristics of sepsis due to Corynebacterium amycolatum, because few cases have been reported in human infections by this bacteria. METHODS: We report two cases of sepsis due to Corynebacterium amycolatum, the patients were diagnosed as having leukaemia. The identification procedures are discussed. RESULTS: We describe 2 patients with sepsis in neutropenic phase. Antibiotic treatment was successful in both cases. Clinical isolates were classified as Corynebacterium xerosis by the Api Coryne system Version 1.0. The chemotaxonomic characteristics of the isolates were determined by thin-layer chromatographic analysis. Isolates did not contain mycolic acids, they were identified as Corynebacterium amycolatum. CONCLUSIONS: Sepsis due to Corynebacterium amycolatum is a rare disorder. A test for mycolic acid could be sufficient to make a distinction between Corynebacterium amycolatum and other diphteroid bacteria. Such a test involves thin-layer chromatography.
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Plasmatic and cerebrospinal fluid levels of beta-endorphin and plasmatic concentration of ACTH, cortisol, and prolactin were investigated in 10 healthy volunteers free of pain and in a group of 38 patients who presented moderate or intense postoperative pain. The analgesic technique was transcutaneous neural stimulation. In 28 patients the stimulation was delivered at 40-80 Hz (high frequency) whereas in the remaining 10 patients it was administered in a placebo form. Measurements of hormone concentrations were performed using radioimmunoassay techniques. In patients free of pain hormone analysis was done at once, whereas in patients with pain this analysis was performed before and one hour after transcutaneous neural stimulation. We compared data obtained in control subjects with data collected in patients before and one hour after high frequency and placebo transcutaneous neural stimulation. Levels of beta-endorphin were comparable in patients with and without pain. However, ACTH, cortisol, and prolactin were increased in patients with pain. High frequency stimulation induced greater beta-endorphin levels than placebo neural stimulation and slightly lower concentration of prolactin. There were no significant differences in ACTH and cortisol levels.
The scientific evidences on the relationship between food and health have given place to a new food market of rapid growth in the last years: the market of the functional food. Though the interest of maintaining or improving the state of health by means of the consumption of traditional food with bioactive ingredients added is undoubtedly high, the Spanish population, increasingly formed and informed, is unwilling to consume functional food, until these possess a scientific rigorous base. This article presents a review of the scientific bases that support the development of functional meat products with balanced ratio omega-6/omega-3 and a combination of synergic antioxidants, among them an extract of rosemary obtained by means of extraction with supercritical CO2.
Authors present their experiences during 10 years (1980-89) with the treatment of peripheral arteriopathies with the ATP. Between a total of 455 procedures, an accumulative permeability of 82% in the iliac sector and 71% in the femoro-popliteal sector in elective indications was reached. The total availability of this therapeutic method, the accurate selection of indications and the valious cooperation between Angioradiology and Vascular Surgery Departments should be noted.