Search NEL Online

Case Reports 2014; 35(8): 673-675 PubMed PMID: 25702294 Citation  Keywords:  Adenocarcinoma:diagnostic imaging, Colonic Polyps:diagnostic imaging, Colonoscopy:instrumentation, Female, Humans, Middle Aged, Sigmoid Neoplasms:diagnostic imaging, Ultrasonography:instrumentation, Vagina:diagnostic imaging,.   

: Adenocarcinoma of the colon represents the third most frequent cause of death from cancer, being surpassed only by lung and stomach cancer. Early screening and diagnosis of polyps are important for a good prognosis. Based on a clinical case, a novel approach is presented for screening of sigmoidal polyps and neoplasia using transvaginal 2D, 3D mode in women. This novel and simple technique can be used to visualize the sigmoid diverticula during routine gynecological examination via 3D transvaginal ultrasound probe....

Read abstract  Full text PDF

Journal Article 2014; 35(7): 613-618 PubMed PMID: 25617885 Citation  Keywords:  Adult, Aged, Aged, 80 and over, Biopsy:adverse effects, Brain Neoplasms:mortality, Female, Humans, Lymphoma:mortality, Magnetic Resonance Imaging:methods, Male, Middle Aged, Morbidity, Retrospective Studies, Risk Factors, Stereotaxic Techniques:adverse ef.   

OBJECTIVES: Stereotactic biopsy is a suitable method for sampling intrinsic brain lesions. Although this method is considered to be a safe procedure, some risk of complications still exists. The aim of the study was to retrospectively assess the morbidity and mortality of MRI-guided stereotactic biopsy of lesions which were histologically proven to be brain lymphoma.

METHODS: We retrospectively studied all accessible medical records for patients who had undergone MRI-guided stereotactic biopsy of brain lesions with histologically proven brain lymphoma from January 2007 to December 2012. Our cohort included 45 patients, 27 males and 18 females, aged 23-84 (63±14) years.

RESULTS: Forty-nine biopsies were carried out on 45 patients; the average number of tissue specimens was 3±1. The diagnostic yield of the stereotactic biopsy was 92%. Overall major morbidity directly related to stereotactic biopsy of brain lymphoma was 6.1% (3 cases) including 4.1% mortality (2 cases). Both deaths after the stereotactic procedure were due to intracranial hemorrhage and subsequent complications and both these patients had a history of treatment of systemic lymphomas. In one patient the stereotactic biopsy was complicated by a brain abscess which was successfully treated.

CONCLUSION: Stereotactic biopsy is still a mandatory diagnostic procedure for primary brain lymphomas, with an acceptable risk of complications. However, according to our results, the risk of complications can be higher in patients who have previously been treated for secondary lymphomas....

Read abstract  Full text PDF

Journal Article 2014; 35(7): 608-612 PubMed PMID: 25617884 Citation  Keywords:  Animals, Brain:diagnostic imaging, Brain Edema:diagnostic imaging, Disease Models, Animal, Male, Rats, Wistar, Tomography, X-Ray Computed:methods, Water Intoxication:diagnostic imaging,.   

OBJECTIVES: The aim of this study was to determine whether water intoxication affects the radiodensity of brain tissue in CT scan examination in the rat model of brain oedema.

METHODS: A standard CT scan of the brain was obtained in a group of rats, first at control conditions (controls - CG) and then after hyperhydration (oedema model-EG) in the region of interest (ROI) corresponding to the area of coronary sections with pixel size 0.125 mm in position A (bregma +2.43 mm), position B (bregma -2.92 mm), position C (bregma -12.73 mm). Densitometrically determined mean values (MV), expressed in Hounsfield units (HU) were processed by standard statistical methods.

RESULTS: The average MV density was 120.49±6.79 HU for the control measurement and 88.01±4.72 HU after the hyperhydration, which represents decrease in the density by 32.48 HU (p<0.001). In the control measurement the average value of HU for the position A was 121.98, for position B 112.4 and for position C 127.08. In conditions of hyperhydration, the average MV density in position A was 89.95 HU in position B 84.67 HU and in position C 89.43 HU. The differences between the CG and EG were in all positions A, B, C statistically significant (p<0.001). In the control measurement, the differences between position A×B (p<0.05) and B×C (p<0.001) were statistically significant. After hyperhydration no significant difference between the position A, B, C was found.

CONCLUSION: water intoxication caused by hyperhydration in rats can induce diffuse brain oedema, which is reflected in the CT examination by the decrease of brain tissue density, expressed in HU. The value of the measured density depends on the location and size of the measured brain area....

Read abstract  Full text PDF

Journal Article 2014; 35(6): 481-489 PubMed PMID: 25433839 Citation  Keywords:  Adult, Aging:physiology, Elasticity, Elasticity Imaging Techniques, Female, Hair:anatomy & histology, Health Status, Humans, Middle Aged, Models, Biological, Stress, Mechanical, Tensile Strength:physiology,.   

OBJECTIVE: Hair quality and scalp characteristics are considered to be a significant marker of health. This marker is reflected in mechanical properties of hair. To investigate these properties, hair samples have been collected among women of different age and then analyzed. The thickness, Young's modulus of elasticity and ultimate strength limit were the main observed parameters.

METHODS: The diameter of each hair has been measured using an optical microscope equipped with a digital camera. The hair was then clipped into the uniaxial tensile testing device. Each sample has been stretched to failure at a speed of 2 mm/min and force vs. elongation was recorded. The mechanical results were converted with respect to the diameter and Stress-Strain curve was obtained for each sample. In addition, all the analyzed samples were divided into two groups in dependence on the age, namely samples from women younger than 35 and over 35 years of age. All the measured parameters were statistically evaluated.

RESULTS: Young's modulus, yield and elongation parameters showed no significant difference among samples. On the other hand there was a significant difference among the samples in ultimate strength values. Findings from group analysis showed that women under 35 years show about 5 times greater variability in hair strength than that of women above that age.

CONCLUSION: The results of our study indicate that hair tendency to grow persists up to 30 years of age, then slowly decreases and then achieves a steady state around 60 years of age....

Read abstract  Full text PDF

Case Reports 2014; 35(5): 352-354 PubMed PMID: 25275267 Citation  Keywords:  Empty Sella Syndrome:complications, Female, Heart Arrest:blood, Humans, Hypoglycemia:blood, Hypopituitarism:complications, Magnetic Resonance Imaging, Middle Aged, Potassium:blood,.   

: A 62-year-old woman was admitted to our hospital because of unconsciousness and hypoglycaemia. She had a history of weakness and fatigue after postpartum haemorrhage in 1983. Unfortunately, she was not diagnosed with Sheehan's syndrome and did not receive sufficient professional treatment due to the limited medical resources in her hometown. A laboratory examination at the local hospital revealed severe hypoglycaemia (1.8 mmol/L) with relatively low serum potassium (2.9 mmol/L). The woman appeared twice in the hospital with cardiac arrest, and her medical history, and the later laboratory investigations were consistent with Sheehan's syndrome. Empty sella was also found by magnetic resonance imaging (MRI). We conclude that Sheehan's syndrome may lead to cardiac arrest with the complication of hypokalaemia and deserves the vigilance of clinicians....

Read abstract  Full text PDF

Journal Article 2014; 35(5): 393-397 PubMed PMID: 25275264 Citation  Keywords:  Adrenal Cortex Hormones:therapeutic use, Arthralgia:diagnostic imaging, Combined Modality Therapy, Denervation:methods, Female, High-Energy Shock Waves:therapeutic use, Humans, Low Back Pain:diagnostic imaging, Lumbar Vertebrae:diagnostic imaging, Male, M.   

OBJECTIVE: Lumbar facet joints (FJ) is a common source of low back pain and contributes approximmately on one third of chronic low back pain. Medial branch radiofrequency neurotomy is considered as a gold standard in the treatment of facet joint pain. Corticosteroid injections have also presented effect in FJ pain. As an interventional procedures, they carry not-negligible risk of possible complications including infection, damage to nerve root or medial branch structures. Shockwave therapy (SWT) is a non-invasive method for treatment of various musculoskeletal disorders. Its effect is based on transduction of mechanical energy, transferred to cascade of various biochemical processes in target tissue. Its efficacy was proved in the treatment of different painful conditions. The efficacy of SWT was not yet studied in FJ pain. Aim of our work was to compare the efficacy of SWT against interventional treatment procedures - radiofrequency neurotomy and corticosteroid FJ injections.

METHODS: A retrospective study was done on 62 selected patients with unilateral chronic lumbar facet pain. There were 32 women and 30 men, divided into SWT group, corticosteroid injections group radiofrequency group. Nociceptive and neuropathic pain intensity and severity of pain were measured.

RESULTS: Shockwave therapy had shown better longterm results compared to FJ injections group and little inferior efficacy compared to RMBN. We did not observe any adverse effects and complications in SWT group. Moreover, in SWT and RMBN groups, significant longterm improvement in daily activities limitation, was observed.

CONCLUSIONS: SWT appears to be a safe and perspective option in the treatment of FJ pain with negligible side effects....

Read abstract  Full text PDF

Case Reports 2014; 35(5): 411-416 PubMed PMID: 25275259 Citation  Keywords:  ATP-Binding Cassette Transporters:genetics, Adolescent, Adrenal Insufficiency:diagnosis, Adrenoleukodystrophy:diagnosis, Amino Acid Sequence, Base Sequence, Brain:pathology, Cognition Disorders:diagnosis, Humans, Magnetic Resonance Imaging, Male, Middle A.   

OBJECTIVES: X-linked adrenoleukodystrophy is a genetically determined disorder that causes varying degrees of malfunction of the adrenal cortex and central nervous system. Our aim was to investigate the occurrence of known, or new, mutations in the ABCD1 gene in two unrelated patients with clinical suspicion of the adrenoleukodystrophy.

METHODS: Two unrelated patients - the first with behavioral changes, the second with progressive cognitive deficit - underwent a clinical and genetic examination in order to establish a diagnosis and discover a possible mutation.

RESULTS: In the first patient, a 47 year old man, the clinical examination showed dementia of the frontal type and spastic quadriparesis. The patient also suffered from adrenal insufficiency for 6 years. An MRI showed confluent hyperintensive lesions in FLAIR images in the frontal lobe of both hemispheres. The second patient, a 16 year old boy, suffered also from Addison's disease since the age of 9, and developed cognitive deficit in the course of one year. The MRI showed posterior atrophy and hyperintensive lesions in parietal and occipital lobes in T2WI. In both cases, genetic analyses showed a missense mutation at the codon 887 (A>G) in exon 1 of the ABCD1 gene, predicting the substitution Y296C in the ALD protein.

CONCLUSION: We detected the same mutation of the ABCD1 gene in two unrelated patients with ALD. In the first case there was frontal lobe involvement, in the second case parieto-occipital involvement. Both pathologic involvement and clinical presentation differed in two cases of the same mutation....

Read abstract  Full text PDF

Case Reports 2014; 35(5): 347-351 PubMed PMID: 25275257 Citation  Keywords:  Amelogenesis Imperfecta:diagnostic imaging, Child, Czech Republic, Dental Enamel:abnormalities, Family Health, Female, Humans, Male, Microscopy, Electron, Scanning, Pedigree, Radiography, Siblings,.   

: Amelogenesis imperfecta (AI) is an overarching term for a group of rare inherited disorders of hard tooth tissues. It is characterized by various defects in proper enamel formation. AI is a severe disorder that affects both the aesthetics and function of the dentition, with affected teeth increasingly suffering from dental caries. Therefore, early diagnosis and lifelong stomatological interventions are important. Due to the complex nature of AI family history, stomatological, radiographic, and molecular genetic examinations should be part of the diagnostic portfolio. Additionally, we utilized new visualization methods for the assessment of teeth demineralization. We present a case report of two affected Czech sisters (6 and 8 years old) with clinically defined AI. These are the first Czech cases in which comprehensive clinical and genetic analysis had been carried out and reflect the complex clinical nature, positive treatment options, and limitations of candidate-gene molecular genetic testing....

Read abstract  Full text PDF