Head trauma

Computed tomography is currently the modality of choice in imaging acutely traumatized patients. This is based upon CT's documented ability to detect surgically significant lesions. Furthermore, the use of MRI is limited by a lack of bone detail, the degradation of MR images in frequently uncooperative patients, and a limited supply of nonferromagnetic monitoring equipments. CT and MRI are largely equivalent in their ability to diagnose epidural hematoma, but CT is readily available and quick. MRI provides information in addition to that obtained by CT in many instances, such as subacute and chronic subdural hematomas, contusions, and intracerebral hematomas.     

MR imaging of neurocysticercosis

Magnetic resonance (MR) was performed in 50 patients with neurocysticercosis. Comparison was made with other neuroradiological imaging modalities including CT, myelography, CT ventriculography, and CT myelocisternography. Eighteen patients were found to have intraventricular cysts. In several patients, these were multiple and 22 intraventricular cysts were discovered. Although 4 of the 22 ventricular cysts were missed by MR, T1-weighted images can play a significant role in the early detection of intraventricular cysticercosis cysts, showing the cyst wall (9 of 22), a high intensity mural nodule (6 of 22), and increased signal intensity of the cyst fluid (5 of 22). Cisternal cysts (14 cysts in 10 patients) could be identified; they appear similar to intraventricular cysts, but mural nodules are infrequently seen (1 of 14). Twenty-nine patients had 69 parenchymal cysts. An attempt was made to assess the viability of these parenchymal lesions by matching the CT and MR findings with the Escobar pathologic staging system. Neuroimaging findings seemed compatible with early parenchymal lesions in the vesicular stage in 11 instances. Findings in cases with later stage cysts tend to support the concept that a dying larva provokes pronounced inflammatory reaction in the adjacent brain. Computed tomography remains the superior modality for depicting parenchymal calcifications within dead larvae. A case of a spinal cysticercosis cyst demonstrated with MR (in a patient with extensive intracranial cisternal cysts and a fourth ventricular cyst) is described.     

The comparative evaluation of uterine and cervical mucosa cytology with endometrial histopathology in cows

Reproductive tract abnormalities especially in the uterus and ovaries of cows often results in infertility. The object of this study was to determine the relationship between the cytology of uterine and cervical mucosa and endometrial histopathology in normal and endometritic cows. In this study, the genital tracts of 131 slaughtered cows were collected. According to macroscopic appearances and histopathological evaluation, reproductive tracts were divided into normal and abnormal. Cytological samples were obtained from the discharges of cervical mucosa and uterine fluid that were collected by wet cotton swab and gentle aspiration. Differential cellular counts were carried on Giemsa stained smears of the mucosa. Comparison of cell densities of normal cows with endometritic cows showed significant differences (P<0.05) in the macrophage presence both by swab (0.00±0.00) and aspiration (0.16±0.55) methods. Comparison of cell densities in different grades of endometritis showed a significant difference (P<0.05) in the neutrophil percentage in cervical mucosa between the swabbing and aspiration methods. In this study, there were no significant differences in cell densities between the two collection methods in cows affected with either acute or chronic endometritis. However, there was significant difference in the neutrophil density in aspirated cervical mucosa compared to the swab collection in cows affected with subacute endometritis. Cytological methods can be useful for the diagnosis of clinical and subclinical endometritis of cows.     

Preservation of hypervascularity in hepatocellular carcinoma after effective proton-beam radiotherapy--CT observation

AIM: The aim of this study was to describe persistence of hypervascularity in proton treated hepatocellular carcinoma at serial follow-up computed tomography (CT). METHODS: Four patients with unresectable solitary hypervascular hepatocellular carcinoma underwent 55-82 Gy proton-beam irradiation for a period of 15-47 days. Follow-up CT including plain, enhanced and dynamic imaging was performed for a period of 9-36 months. RESULTS: Good preservation of arterial blood supply while gradual decrease in tumour size was clearly depicted by dynamic CT. CONCLUSION: We believe that preservation of hypervascularity as judged by enhancement at CT and magnetic resonance imaging, does not necessarily mean that radiotherapy in hypervascular malignant tumours has been unsuccessful.     

Comparison of Diagnostic Interview Schedule to psychiatrist diagnoses of alcohol use disorder in psychiatric inpatients

This study provides data about the extent of alcohol use disorders among general adult psychiatric inpatients. The accuracy of alcohol use disorder diagnoses given by the lay-administered Diagnostic Interview Schedule (DIS) and by staff psychiatrists, as compared to each other, was investigated. From consecutive admissions to a private psychiatric hospital, 55 patients with alcohol use disorders were identified by trained research assistants using the DIS (n = 162). A comparison of DIS diagnoses to clinicians' diagnoses revealed that 66 patients (40.7% of all admissions) were given an alcohol diagnosis by the DIS or clinician, 35 patients (21.6%) by DIS and clinician, 20 (12.3%) by DIS only, and 11 (6.8%) by clinician only. The two diagnostic approaches were also compared using several accuracy measures (sensitivity and specificity ratios, percentage of agreement, and kappa). With psychiatrists' diagnoses as reference, the DIS sensitivity ratio was 76 and specificity ratio 83. There were 12.3% false positive and 6.8% false negative diagnoses assigned by the DIS. Kappa was .56 and percentage of agreement 80.9%. Recomputing accuracy measures for the psychiatrist, using the DIS as the reference, clinician assessment sensitivity was 64 and specificity 90. Compared to each other, the DIS "overdiagnosed" and the staff psychiatrists "underdiagnosed" by about 1 in 20 cases. Among those alcohol use diagnoses upon which both clinician and DIS agreed, alcohol abuse was the predominant diagnosis. Among all patients with an alcohol diagnosis, the main nonsubstance abuse diagnoses (as assigned by the clinician) were: major depressive, dysthymic, bipolar, schizophrenic, and personality disorders.     

Antitumor vaccination of patients with glioblastoma multiforme: a pilot study to assess feasibility, safety, and clinical benefit.

PURPOSE: Prognosis of patients with glioblastoma is poor. Therefore, in glioblastoma patients, we analyzed whether antitumor vaccination with a virus-modified autologous tumor cell vaccine is feasible and safe. Also, we determined the influence on progression-free survival and overall survival and on vaccination-induced antitumor reactivity. PATIENTS AND METHODS: In a nonrandomized study, 23 patients were vaccinated and compared with nonvaccinated controls (n = 87). Vaccine was prepared from patient's tumor cell cultures by infection of the cells with Newcastle Disease Virus, followed by gamma-irradiation, and applied up to eight times. Antitumor immune reactivity was determined in skin, blood, and relapsed tumor by delayed-type hypersensitivity skin reaction, ELISPOT assay, and immunohistochemistry, respectively. RESULTS: Establishment of tumor cell cultures was successful in approximately 90% of patients. After vaccination, we observed no severe side effects. The median progression-free survival of vaccinated patients was 40 weeks (v 26 weeks in controls; log-rank test, P = .024), and the median overall survival of vaccinated patients was 100 weeks (v 49 weeks in controls; log-rank test, P < .001). Forty-five percent of the controls survived 1 year, 11% survived 2 years, and there were no long-term survivors (> or = 3 years). Ninety-one percent of vaccinated patients survived 1 year, 39% survived 2 years, and 4% were long-term survivors. In the vaccinated group, immune monitoring revealed significant increases of delayed-type hypersensitivity reactivity, numbers of tumor-reactive memory T cells, and numbers of CD8(+) tumor-infiltrating T-lymphocytes in secondary tumors. CONCLUSION: Postoperative vaccination with virus-modified autologous tumor cells seems to be feasible and safe and to improve the prognosis of patients with glioblastomas. This could be substantiated by the observed antitumor immune response.     

Distinct histopathological phenotypes of severe alcoholic hepatitis suggest different mechanisms driving liver injury and failure

Intrahepatic neutrophil infiltration has been implicated in severe alcoholic hepatitis (SAH) pathogenesis; however, the mechanism underlying neutrophil-induced injury in SAH remains obscure. This translational study aims to describe the patterns of intrahepatic neutrophil infiltration and its involvement in SAH pathogenesis. Immunohistochemistry analyses of explanted livers identified two SAH phenotypes despite a similar clinical presentation, one with high intrahepatic neutrophils (Neu^hi), but low levels of CD8⁺ T cells, and vice versa. RNA-Seq analyses demonstrated that neutrophil cytosolic factor 1 (NCF1), a key factor in controlling neutrophilic ROS production, was upregulated and correlated with hepatic inflammation and disease progression. To study specifically the mechanisms related to Neu^hi in AH patients and liver injury, we used the mouse model of chronic-plus-binge ethanol feeding and found that myeloid-specific deletion of the Ncf1 gene abolished ethanol-induced hepatic inflammation and steatosis. RNA-Seq analysis and the data from experimental models revealed that neutrophilic NCF1-dependent ROS promoted alcoholic hepatitis (AH) by inhibiting AMP-activated protein kinase (a key regulator of lipid metabolism) and microRNA-223 (a key antiinflammatory and antifibrotic microRNA). In conclusion, two distinct histopathological phenotypes based on liver immune phenotyping are observed in SAH patients, suggesting a separate mechanism driving liver injury and/or failure in these patients.     

New‐onset pemphigus foliaceus following SARS‐CoV‐2 infection and unmasking multiple sclerosis: A case report

Development of pemphigus foliaceus (PF) following SARS‐CoV‐2 infection has only been reported in one patient who had received Bamlanivimab and thus might be considered as a drug‐induced case of PF. Here, we reported the first case of PF arising solely after COVID infection without taking any culprit drug.     

Comparison of silver nylon wound dressing and silver sulfadiazine in partial burn wound therapy

The study aims to perform a comparative assessment of two types of burn wound treatment. To do the assessment, patients with partial thickness burn wounds with total body surface area <40% were simple randomised to treat with nanocrystalline silver nylon wound dressing or silver sulfadiazine cream. Efficacy of treatment, use of analgesics, number of wound dressing change, wound infection and final hospitalisation cost were evaluated. The study showed silver nylon wound dressing significantly reduced length of hospital stay, analgesic use, wound infection and inflammation compared with silver sulfadiazine.