Multidetector computed tomographic urography for evaluation of vascular and ureteric anomalies associated with ectopic kidneys

Background: The purpose of this study is to evaluate the vascular and ureteric anomalies associated with ectopic kidneys with multidetector computed tomography (MDCT). Methods: The 40 patients with pre-diagnosed ectopic kidney undergoing MDCT urography (Contrast study) and KUB (Plain study) were included in this cross-sectional observational study. The location and number of bilateral kidneys were assessed. The number and origin of the renal arteries and renal veins were noted. Their relationship with each other and possible complications in surgical handling analysed. Data collected was analysed using descriptive and inferential statistics.Results: The renal artery originated from suprarenal aorta in 2 cases, normal origin in 10 cases, infrarenal aorta in 12 cases, aortic bifurcation in 19 cases, common iliac artery in 6 cases and iliac artery bifurcation in 2 cases. The renal vein was of normal origin in 8 cases, originated from infrarenal inferior vena cava (IVC) in 16 cases, IVC bifurcation in 14 cases, common iliac vein in 9 cases, internal iliac vein in 2 cases and external iliac vein in 1 case. There was a significant correlation between the level of ectopic kidneys (abdominal, iliac and pelvis) and level of origin of arteries (p<0.001) and veins (p<0.001). In addition, significant correlation was found between the origins of arteries and veins of ectopic kidneys (p<0.001).Conclusions: A knowledge of the possible variations in renal vasculature and ureter associated with ectopic kidneys can play a key role in preventing iatrogenic hemorrhage during surgery

Neuroimaging in paediatric patients with developmental delay

Background: Aim and objectives of the study were to radiologically evaluate paediatric patients with developmental delay (DD), assess the relative prevalence of abnormal brain MRI, further categorize them based on the abnormal imaging findings and structures affected. The purpose of this study is to diagnose the underlying etiology that helps in early treatment and amelioration of the condition, parental counselling regarding the outcome of the child, providing an estimate of child’s developmental potential and the recurrence risk in siblings.Methods: 135 paediatric patients of the age 3 months to 15 years with DD referred to department of radiology were investigated with MRI scans of the brain via 1.5T Siemens scanner after making the child sleep or sedated. The sequences used were: axial T1, axial T2, axial FLAIR, axial DWI, axial ADC, axial SWI, axial PHASE, sagittal T1 and coronal FLAIR. CT scan of the brain was done only when indicated on 128 slice Siemens Somatom perspective scanner. Informed consent shall be taken from patient’s parents. Clinical and demographic details of the enrolled patients were noted in the Performa. Data collected was analysed using descriptive and inferential statistics.Results: Out of 135 children with DD, 69.1% (n=92) were male and 31.9% (n=43) were female. Majority of these children belonged to 3 months to 1 year and 2 to 5 years of age group. About 81.4% (n=110) of children with DD had abnormal findings in MRI. Among children with abnormal MRI findings, 42.9% had hypoxic ischemic changes, 6.6% had congenital malformations and non-specific causes, respectively 4.4% had neurodegenerative and occlusive neurovascular conditions, respectively 3.7% had CSF disorders and neoplasms, respectively 2.9% had infection associated changes and non-traumatic intracranial bleed, respectively 2.2% had metabolic disorders and 0.7% had demyelination. Majority of cases had ventricular abnormality, followed by the corpus callosum.Conclusions: DD presents with a wide spectrum of etiologies, clinical findings and MRI features ranging from completely normal to abnormal. The present study could establish the various morphological appearances of DD on MRI and further categorize them into various subgroups be effective in diagnosis, management and prognosis determination processes

FADD phosphorylation is critical for cell cycle regulation in breast cancer cells

Anti-oestrogen therapy is effective for control of hormone receptor-positive breast cancers, although the detailed molecular mechanisms, including signal transduction, remain unclear. We demonstrated here that long-term tamoxifen treatment causes G2/M cell cycle arrest through c-jun N-terminal kinase (JNK) activation, which is dependent on phosphorylation of Fas-associated death domain-containing protein (FADD) at 194 serine in an oestrogen (ER) receptor-positive breast cancer cell line, MCF-7. Expression of a dominant negative mutant form of MKK7, a kinase upstream of JNK, or mutant FADD (S194A) in MCF-7 cells suppressed the cytotoxicity of long-term tamoxifen treatment. Of great interest, similar signallings could be evoked by paclitaxel, even in an ER-negative cell line, MDA-MB-231. In addition, immunohistochemical analysis using human breast cancer specimens showed a close correlation between phosphorylated JNK and FADD expression, both being significantly reduced in cases with metastatic potential. We conclude that JNK-mediated phosphorylation of FADD plays an important role in the negative regulation of cell growth and metastasis, independent of the ER status of a breast cancer, so that JNK/FADD signals might be promising targets for cancer therapy