Congenital anterior urethral diverticulum: sonographic diagnosis.
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Diverticulum↗
Biomedical subjects
M Goyal
Publications and source records attributed to M Goyal.
Mesenchymal hamartoma of the liver.
We present a multiseptated mesenchymal hamartoma of the liver in a 10-year-old male patient, a rare benign tumor of childhood. The characteristic ultrasound and CT appearances of this unusual tumor are reviewed. A single septal calcification associated with this tumor was demonstrated, an association which has not previously been reported. The differential diagnosis for cystic liver lesions is discussed in detail.
Calcinosis↗
Subdural empyema secondary to odontogenic masticator space abscess: detection by indium-111-labeled white cell scan.
Subdural empyema (SDE) is an extremely rare but serious complication of dental infection. A case is presented in which dental infection was complicated by a masticator space abscess and eventually led to a SDE. This report illustrates a rare sequence of events leading to SDE and its serendipitous detection by indium-111-labeled leucocyte scan.
Abscess↗
Can tamoxifen cause a significant mammographic density change in breast parenchyma?
To evaluate tamoxifen-induced glandular tissue density changes in women who are on an adjuvant tamoxifen therapy. We examined serial mammograms of 27 women (average age 67) who had surgery for unilateral breast carcinoma and were on tamoxifen for 5 years. Mammograms obtained at the beginning of treatment, within 2 or 3 years, at the end of 5 years and 1 year after cessation of tamoxifen treatment, were evaluated by two radiologists experienced in reading mammograms. Four 1-cm-diameter circular areas of the glandular tissue and retroglandular fat were sampled by a densitometer and a relative glandular density (glandular tissue/fat density) was used for comparison between serial mammograms. Most cases (79%) did not show tamoxifen-induced change in glandular density. Three patients (13%) showed an early and two (8%) a delayed mild reduction in glandular density as compared to baseline mammograms. No patient was found to have increased glandular density following the cessation of tamoxifen therapy (in subjective evaluation). Densitometer readings showed a mild reduction in glandular densities in 16 cases (60%) during treatment and a minimal increase in 13 cases (48%) following cessation of treatment. There was a slight decrease in breast density during treatment [relative density of 0.012+/-0.006 (standard error) per interval, P value:.06] and the difference between years 5 and 6 was nearly zero [relative density of 0.00042+/-0.01 (standard error), P value:.97]. Long-term use of tamoxifen may cause a mild reduction in breast glandular density, although this, in part, may be attributed to the age-related mammographic density change. Following cessation of tamoxifen, no significant increase in glandular density was observed. Therefore, any increase in mammographic density during or after tamoxifen treatment should be viewed with suspicion and further evaluated.
Aged↗
Podocyte phenotypes as defined by expression and distribution of GLEPP1 in the developing glomerulus and in nephrotic glomeruli from MCD, CNF, and FSGS. A dedifferentiation hypothesis for the nephrotic syndrome.
Glomerular epithelial protein 1 (GLEPP1) is a podocyte receptor membrane protein tyrosine phosphatase located on the apical cell membrane of visceral glomerular epithelial cell (VGEC) foot processes. Double label immunofluorescence, immunoelectron microscopy, and peroxidase immunohistochemistry were used to map the GLEPP1 distribution in the developing glomerulus and in minimal-change nephropathy (MCN), congenital nephrotic syndrome of the Finnish type, and focal-segmental glomerulosclerosis (FSGS). In MCN GLEPP1 was shifted away from the glomerular basement membrane on the apical cell membrane of effaced foot processes. These data are compatible with the previously suggested concept that MCN can be considered a form of dedifferentiation of the podocyte phenotype. Similarly, changes seen in congenital nephrotic syndrome of the Finnish type can be considered a consequence of failure to complete normal podocyte development. In FSGS glomeruli GLEPP1 was frequently absent from VGECs, even when no sclerosis was detectable in that glomerulus. Therefore, in FSGS, VGECs may lose GLEPP1, and this loss appears to occur in the absence of scarring and may, therefore, precede the scarring process. We speculate that a changed VGEC phenotype that does not express GLEPP1 might have properties similar to the early undifferentiated VGEC developmental phenotype. GLEPP1 distribution pattern and absence from glomeruli of individuals with nephrotic syndrome may, therefore, represent a useful phenotypic marker.
Animals↗
Tortuous, engorged pial veins in intracranial dural arteriovenous fistulas: correlations with presentation, location, and MR findings in 122 patients.
BACKGROUND AND PURPOSE: Tortuous, engorged veins can be identified on the venous phase of the brain circulation in patients with venous congestion related to an intracranial dural arteriovenous fistula (DAVF). The term pseudophlebitic pattern (PPP) has been used to describe this finding. The purpose of this study was to determine the prevalence of PPP in patients with intracranial DAVF and to analyze the relationship of this sign to presentation, location of the fistula, presence of retrograde leptomeningeal venous drainage, and MR findings. METHODS: We retrospectively reviewed the charts and imaging findings of 130 patients with intracranial DAVF. In 122 patients the venous phase of the brain circulation was adequately assessed. The PPP was graded as mild, moderate, or severe. RESULTS: PPP was found in 51 patients (42%). Thirty-two (73%) of the 44 patients who had a hemorrhage, neurologic deficit, or seizure had PPP as compared with 16 (21%) of the 75 who had a bruit or orbital signs. The three patients with either congestive heart failure or increasing head circumference had PPP. Fourteen (88%) of the 16 who had fistula of the superior sagittal sinus, straight sinus, or superior petrosal sinus had PPP. PPP was seen in 46 (81%) of 57 patients who had retrograde leptomeningeal venous drainage and in five (8%) of the 65 who had only sinosal drainage. Fourteen (88%) of the 16 who had white matter T2 hyperintensity on MR images had severe PPP. CONCLUSION: The PPP reflects venous congestion and is associated with an aggressive presentation with or without retrograde leptomeningeal venous drainage. PPP may be a useful prognostic indicator and should be considered in treatment decisions.
Adolescent↗
Alcohol ablation of symptomatic vertebral hemangiomas.
BACKGROUND AND PURPOSE: Many therapeutic techniques have been used for the treatment of symptomatic vertebral hemangiomas (SVH), and each has its own limitations. Our objective was to evaluate the therapeutic efficacy of alcohol ablation for treating these lesions. METHODS: Fourteen patients with SVH were treated by injection of absolute alcohol into the lesion via the percutaneous transpedicular route under CT guidance. Symptoms before treatment included neurologic deficit in 13 patients and debilitating pain in one. All patients underwent preprocedural MR imaging. All patients had clinical and MR imaging follow-up (14 patients at 48-96 hours and 2 months; six at 9-15 months). Results were divided into excellent (resumption of work, alleviation of pain), good (significant improvement), and failure of treatment categories on the basis of subjective assessment of clinical improvement. Clinical improvement/deterioration was correlated with MR-revealed changes. RESULTS: All patients showed transient deterioration of neurologic status after alcohol ablation. Subsequently, excellent results were seen in five patients and eight were in the good category. One patient in whom treatment failed also developed a complication (paravertebral abscess). Four of the eight patients with good results had preprocedural cord changes. Total follow-up ranged from 5 to 31 months, with 11 patients showing stable improvement. One patient developed recurrent hemangioma within a month. Another patient became symptomatic after initial good response, secondary to the collapse of the involved vertebral body. Good correlation was found between clinical improvement and reduction of epidural soft-tissue masses on MR images. Cord signal alteration seen on MR images in four treated patients, however, did not show any change after treatment. CONCLUSION: Alcohol ablation is an effective management option for symptomatic vertebral hemangiomas. Although encouraging results were seen in almost 86% of our patients, a longer follow-up period still is needed to assess the stability of improvement. Potential complications include vertebral collapse and infection.
Adolescent↗
Hypertrophic olivary degeneration: metaanalysis of the temporal evolution of MR findings.
BACKGROUND AND PURPOSE: Hypertrophic olivary degeneration (HOD) is usually caused by a lesion in the triangle of Guillain and Mollaret and presents clinically as palatal tremor. Although the imaging features have been well described, the temporal course of hypertrophy and T2 signal increase in the inferior olivary nucleus (ION) has not been fully characterized. Our purpose was to evaluate the time course of MR imaging features of HOD caused by a lesion within the triangle of Guillain and Mollaret. METHODS: The temporal progression of HOD in 45 patients with symptomatic palatal tremor was obtained by extrapolation of combined MR imaging data from six patients treated at our institution and 39 patients reported in the literature. The MR examinations and reports were reviewed for presence of hyperintense signal in the ION on T2-weighted images, hypertrophy of the ION, and an inciting lesion in the triangle of Guillain and Mollaret. The interval between the MR examination and the inciting lesion was determined. RESULTS: Increased olivary signal on T2-weighted images first appeared 1 month after the inciting lesion and persisted for at least 3 to 4 years. Olivary hypertrophy initially developed 6 months after the acute event and resolved by 3 to 4 years. CONCLUSION: Visible changes on MR images in the ION in patients with a lesion in the triangle of Guillain and Mollaret correlate well with the described sequential histopathologic findings.
Disease Progression↗
Multiple traumatic bone cysts of jaws. Report of a case.
An unusual case of bilateral traumatic bone cyst occurring simultaneously in both jaws is being reported. The clinical features and treatment plan for these cysts have been discussed. It has been seen that exploration of such cystic cavity results in a rapid healing of the defect in a short span of time.
Adult↗
Evolution and variability of pulmonary mechanics during postnatal transition in term infants.
This study was designed to assess whether progressive changes related to the transition to extrauterine life explain in part the interassay variability of pulmonary mechanics in the immediate postnatal period. We performed sequential pulmonary function tests in 21 normal term infants with the use of a pneumotachometer and an esophageal balloon. The average percent increase in values from the first period (2 to 10 hours) to the last period of study (66 to 78 hours) was 27% for tidal volume, 24% for minute ventilation, and 42% for dynamic compliance. The maximum difference between two pulmonary function measurements obtained within 30 minutes of each other ranged between 10% for dynamic compliance and 27% for minute ventilation. The coefficient of variation for dynamic compliance over a 2-hour period (12%) was less than half the 3-day coefficient of variation (31%). The reliability coefficient ranged between 0.72 for tidal volume and 0.92 for dynamic compliance. We conclude that dynamic compliance in term infants increases progressively during the first 3 days of life, whereas tidal volume and minute ventilation increase mostly during the first day. The variability of pulmonary mechanics reflects in part those progressive physiologic changes during postnatal transition.
Female↗