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11.
Imaging of acute mesenteric ischemia using multidetector CT and CT angiography in a porcine model 总被引:3,自引:0,他引:3
David E. Rosow M.D. Dushyant Sahani M.D. Oliver Strobel M.D. Sanjeeva Kalva M.D. Mari Mino-Kenudson M.D. Nagaraj S. Holalkere M.D. Guido Alsfasser M.D. Sanjay Saini M.D. Susanna I. Lee M.D. Peter R. Mueller M.D. Carlos Fernándezdel Castillo M.D. Andrew L. Warshaw M.D. Sarah P. Thayer M.D. Ph.D. 《Journal of gastrointestinal surgery》2005,9(9):1262-1275
Acute mesenteric ischemia, a frequently lethal disease, requires prompt diagnosis and intervention for favorable clinical
outcomes. This goal remains elusive due, in part, to lack of a noninvasive and accurate imaging study. Traditional angiography
is the diagnostic gold standard but is invasive and costly. Computed tomography (CT) is readily available and noninvasive
but has shown variable success in diagnosing this disease. The faster scanning time of multidetector row CT (M.D.CT) greatly
facilitates the use of CT angiography (CTA) in the clinical setting. We sought to determine whether M.D.CT-CTA could accurately
demonstrate vascular anatomy and capture the earliest stages of mesenteric ischemia in a porcine model. Pigs underwent embolization
of branches of the superior mesenteric artery, then imaging by M.D.CT-CTA with three-dimensional reconstruction protocols.
After scanning, diseased bowel segments were surgically resected and pathologically examined. Multidetector row CT and CT
angiography reliably defined normal and occluded mesenteric vessels in the pig. It detected early changes of ischemia including
poor arterial enhancement and venous dilatation, which were seen in all ischemic animals. The radiographic findingsd—compared
with pathologic diagnosesd—predicted ischemia, with a positive predictive value of 92%. These results indicate that M.D.CT-CTA
holds great promise for the early detection necessary for successful treatment of acute mesenteric ischemia.
Presented at the Forty-Sixth Annual Meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 14–18,
2005 (oral presentation).
Supported by the Karin Grunebaum Research Fellowship, Harvard Medical School (D.E.R.), the German Research Fellowship, German
Research Foundation STR 690/1-1 (O.S.), and the Phillip H. Meyers Grant from the Society of Gastrointestinal Radiologists
(S.P.T.). 相似文献
12.
P Pillai J S Saini 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》1988,23(4):177-180
The authors present a case of histopathologically proved bilateral idiopathic inflammatory pseudotumour of the orbits with involvement of the paranasal sinuses in a child. Clinically, the bilateral proptosis was manifest at the age of 5 years. While extraorbital manifestations are rare, orbital pseudotumour should be considered in such cases. 相似文献
13.
Daniel L. Rubin Karen L. Falk Malcolm J. Sperling Michael Ross Sanjay Saini Barry Rothman Frank Shellock Elias Zerhouni David Stark Eric K. Outwater Udo Schmiedl Louis C. Kirby Judith Chezmar Terry Coates Miles Chang Jeffery M. Silverman Neil Rofsky Keith Burnett Julie Engel Stuart W. Young 《Journal of magnetic resonance imaging : JMRI》1997,7(5):865-872
The purpose of this study was to assess the effectiveness and safety of Gadolite Oral Suspension as a gastrointestinal (GI) contrast agent for MRI in a phase II and two phase III multicenter clinical trials. Gadolite was administered to 306 patients with known or suspected abdominal and/or pelvic disease. MRI with T1- and T2-weighted sequences was performed before and after ingestion. Efficacy was evaluated by having two masked readers rate the certainty of their MR diagnosis (0 = uncertain, 1 = probable, 2 = definite) on randomly presented pre- and post-Gadolite Oral Suspension enhanced images. Principal investigators also evaluated the images and established the final diagnosis. Vital signs, clinical chemistries, and adverse events were documented. Blood and urine samples were analyzed for gadolinium content to determine whether Gadolite Oral Suspension was absorbed systemically. Certainty in MR diagnosis increased significantly (P < .001) for both blinded readers between pre- and post-Gadolite images (.49–1.18 for reader 1; .46–1.53 for reader 2). Sensitivity, specificity, and accuracy also increased for both masked readers. No gadolinium was detected in blood or urine samples. There were no serious adverse events and no apparent drug-related trends in mean vital signs or laboratory values. Gadolite is a highly effective, safe, and well tolerated contrast agent for clinical use with MRI. 相似文献
14.
F A Pirzada J W McDowell E M Cohen V K Saini R L Berger 《The New England journal of medicine》1974,291(17):892-895
15.
John G. Guccion Debra A. Benator Jack Zeller Basel Termanini Nirmal Saini 《Ultrastructural pathology》1995,19(1):15-22
Two cases of intestinal spirochetosis (IS) with acquired immunodeficiency syndrome are reported. In case 1, a 48-year-old homosexual black man presented with a 1-month history of alternating watery diarrhea and constipation, which dissipated following the removal of two colonic hyperplastic polyps containing IS. In case 2, a 26-year-old homosexual black man presented with a 3-month history of persistent bloody diarrhea and was found to have chronic shigellosis and IS. Pathologic findings of IS were similar in both cases. Basophilic fringes typical of IS covered the surfacing colonic epithelium and consisted of dense growths of spirochetes adherent to and oriented perpendicular to the plasma membranes of the surfacing epithelium. The spirochetes measured 3 to 5 μm in length and 0.2 (im in width, contained four to eight axial fibrils, and closely resembled Brachyspira aalborgi ultrastructurally. These cases are notable because the histopathologic changes of IS were more extensive than generally described. There was involvement of both the right colon and rectum by IS in case 2, and in both cases there was extension of the IS down into the crypts of Lieberkiihn, spirochetal invasion of the colonic mucosa, and a conspicuous inflammatory response by macrophages in the underlying lamina propria. 相似文献
16.
Selenium improves cardiac function by attenuating the activation of NF-kappaB due to ischemia-reperfusion injury 总被引:1,自引:0,他引:1
Turan B Saini HK Zhang M Prajapati D Elimban V Dhalla NS 《Antioxidants & redox signaling》2005,7(9-10):1388-1397
Although selenium, an essential trace element and a component of glutathione peroxidase, is known to protect the heart from ischemia-reperfusion (I/R)-induced injury, the mechanisms of this protection are not fully understood. For this purpose, isolated rat hearts were subjected to 30 min of global ischemia followed by 30 min of reperfusion; sodium selenite (25-1,000 nM) was added in the perfusion medium 10 min prior to ischemia, as well as during reperfusion. Selenium caused a dose-dependent improvement in cardiac performance and attenuated the decrease in the ratio of reduced glutathione to oxidized glutathione, as well as the increased level of malondialdehyde in I/R heart. Elevated ratios of nuclear factor-kappaB (NF-kappaB) in particulate and cytosolic fraction and of phosphorylated NF-kappaB and total NF-kappaB in I/R hearts were reduced by selenium. Cardiac dysfunction in hearts perfused with xanthine plus xanthine oxidase mixture, as well as hydrogen peroxide, or subjected to Ca2+ paradox was also attenuated by selenium. These data suggest that selenium protects the heart against I/R injury due to its action on the redox state and deactivation of NF-kappaB in I/R hearts. 相似文献
17.
Saini S;Aparna Gupta N Mahajan A Arora DR 《Indian journal of medical microbiology》2003,21(2):111-114
The present study was carried out to compare the normal aerobic and anaerobic bacterial oral flora with flora from deep seated dental caries, gingivitis and adult periodontitis. All the samples belonging to both the control and study groups yielded microbes. Aerobe / Anaerobe ratio was high in normal flora (1.48) as compared to dental caries (0.9), gingivitis (0.72) and periodontitis (0.56). Ninety seven percent of orodental infections were polymicrobial and three or more microbes were found in 84% cases of study group as compared to 28% in controls. Streptococcus mutans and anaerobic lactobacilli were common in dental caries, Actinomyces and Peptostreptococcus spp. in gingivitis, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in periodontitis. 相似文献
18.
Involvement of JC virus-infected mononuclear cells from the bone marrow and spleen in the pathogenesis of progressive multifocal leukoencephalopathy 总被引:18,自引:0,他引:18
19.
We describe a case of euthyroid hyperthyroxinemia in whom clinical and laboratory investigations strongly supported the diagnosis of generalised thyroid hormone resistance. 相似文献
20.