Features of Neurotoxicity on Brain CT of Acutely Intoxicated Unconscious Patients

Diagnostic imaging is a valuable device in clinical management of poisoned patients presenting to emergency units in a comatose state. Some toxic agents have adverse effects on the central nervous system (CNS). Non-contrast computed tomography (CT) of the brain, as an available diagnostic method with a high resolution, can provide useful information about structural disturbances of unconscious patients with suspected drug or chemical intoxication. The authors would describe various presentations of toxic substances detected on the brain CT scans of ten patients with acute intoxication. While non-specific, CT findings of low-attenuation lesions in the basal ganglia, infarctions in young patients, or diffuse edema should raise suspicion for poisoning or overdose

Diagnostic performance of 64-row coronary CT angiography in detecting significant stenosis as compared with conventional invasive coronary angiography

BACKGROUND: The aim of the present study is to evaluate the accuracy of 64-multidetector-row computed tomography angiography (CTA) in comparison to conventional invasive angiography (CIA) in the diagnosis of significant stenosis (≥ 50) of coronary artery tree. METHODS: Assessment of CTA in the detection of coronary artery disease (CAD) was performed in patients referred because of symptoms or stress studies suggestive of ischemia. For this purpose, among more than 1000 cases of coronary CTA in a 20 months period a study population of 54 patients suspected to have significant stenosis of the coronary artery tree was investigated. The CIA procedure was performed in these patients one month after CTA. The accuracy of CTA in detecting significant stenosis was compared to CIA. RESULTS: For vessel based analysis of 179 coronary vessels, CTA had a sensitivity of 96, specificity of 87.5, positive predictive value of 90.5, and negative predictive value of 94.6. For patient-base analysis, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CTA were 97.9, 28.6, 66.6, and 90.2, respectively. CONCLUSION: The findings of this study reveal that CT angiography with 64-slice scanner could be considered as a suitable technique for rapid triage of patients presenting to hospitals with chest pain. High values of sensitivity and PPV reveal the good performance of CTA in detecting CAD

Thyroid-like Follicular Carcinoma of the Right Kidney: A Case Report

Renal cell carcinoma is responsible for approximately 80% of malignant tumors of the kidney. Clear cell, papillary, and chromophobe forms comprise the most frequent histological subtypes of renal cell carcinoma. Thyroid-like follicular renal cell carcinoma is an extremely rare subtype of renal cell carcinoma that resembles thyroid follicular neoplasms. Histologic findings should not be confused with chronic pyelonephritis with thyroidization or renal metastasis of thyroid cell carcinoma. There are few reports of thyroid-like follicular renal cell carcinoma. Here, we report a new case of thyroid -like follicular carcinoma of the kidney diagnosed in a partial nephrectomy specimen in a 62-year-old man

Hepatic Artery Aneurysms as a Rare but Important Cause of Abdominal Pain; a Case Series

Hepatic artery aneurysm (HAA) is the common visceral aneurysms with the highest reported rate of rupture. The clinical manifestations depending on the size of the aneurysm include epigastric pain, obstruction of biliary tract, rupture and death. Imaging modalities like computed tomography (CT) scan and CT-angiography have a valuable role in the early detection of HHAs. Complications and selecting appropriate treatments depending on the size and location of the aneurysms. This article aimed to report clinical presentation, imaging finding and treatment of some patients presenting with HAAs to emergency department

Mimicry and well known genetic friends: molecular diagnosis in an Iranian cohort of suspected Bartter syndrome and proposition of an algorithm for clinical differential diagnosis.

BACKGROUND: Bartter Syndrome is a rare, genetically heterogeneous, mainly autosomal recessively inherited condition characterized by hypochloremic hypokalemic metabolic alkalosis. Mutations in several genes encoding for ion channels localizing to the renal tubules including SLC12A1, KCNJ1, BSND, CLCNKA, CLCNKB, MAGED2 and CASR have been identified as underlying molecular cause. No genetically defined cases have been described in the Iranian population to date. Like for other rare genetic disorders, implementation of Next Generation Sequencing (NGS) technologies has greatly facilitated genetic diagnostics and counseling over the last years. In this study, we describe the clinical, biochemical and genetic characteristics of patients from 15 Iranian families with a clinical diagnosis of Bartter Syndrome. RESULTS: Age range of patients included in this study was 3 months to 6 years and all patients showed hypokalemic metabolic alkalosis. 3 patients additionally displayed hypercalciuria, with evidence of nephrocalcinosis in one case. Screening by Whole Exome Sequencing (WES) and long range PCR revealed that 12/17 patients (70%) had a deletion of the entire CLCNKB gene that was previously identified as the most common cause of Bartter Syndrome in other populations. 4/17 individuals (approximately 25% of cases) were found to suffer in fact from pseudo-Bartter syndrome resulting from congenital chloride diarrhea due to a novel homozygous mutation in the SLC26A3 gene, Pendred syndrome due to a known homozygous mutation in SLC26A4, Cystic Fibrosis (CF) due to a novel mutation in CFTR and apparent mineralocorticoid excess syndrome due to a novel homozygous loss of function mutation in HSD11B2 gene. 1 case (5%) remained unsolved. CONCLUSIONS: Our findings demonstrate deletion of CLCNKB is the most common cause of Bartter syndrome in Iranian patients and we show that age of onset of clinical symptoms as well as clinical features amongst those patients are variable. Further, using WES we were able to prove that nearly 1/4 patients in fact suffered from Pseudo-Bartter Syndrome, reversing the initial clinical diagnosis with important impact on the subsequent treatment and clinical follow up pathway. Finally, we propose an algorithm for clinical differential diagnosis of Bartter Syndrome

Mechanisms of microRNA turnover

MicroRNAs (miRNAs) are 20-24 nucleotide (nt) RNAs that regulate gene expression by guiding Argonaute (AGO) proteins to specific target RNAs to cause their degradation or translational repression. The abundance of miRNAs is strictly controlled at the transcriptional or post-transcriptional levels. miRNA turnover is presumably a necessary means to regulate miRNA levels in response to physiological, developmental, and environmental changes. miRNA 3' end methylation, 3' end nucleotide addition, AGO and complementary target transcripts are known or probable processes/factors that affect miRNA stability and turnover. Here we discuss the mechanisms that control miRNA turnover in plants and, where applicable, make references to similarities and differences in these mechanisms between plants and animals

Surgical Endodontic Parameters in the Mandibular Premolars Area: An Anatomic Evaluation with Cone -Beam Computed Tomography

Introduction: This study aimed to evaluate the relationship between mandibular premolars and the surrounding critical anatomical structures for endodontic surgery using cone-beam computed tomography (CBCT). Materials and Methods: In this cross sectional study, 170 CBCT images were evaluated in the sagittal, coronal, and axial planes to measure the buccal bone thickness (BBT) covering each root, the diameter of the premolars in the buccolingual and mesiodistal dimensions, besides the total amount of tissue needed to be resected for endodontic surgery; these measurements were performed at the 3mm level of the apex. Also, the distances from the superior border of mental foramen (MF) to premolars apex and alveolar crest (AC) were measured. Moreover, the position of MF in relation to adjacent teeth was evaluated. Descriptive statistics, independent-sample T-test and Wilcoxon test were used in the SPSS 26 to analysis of the data (α=.05). Results: The mean values of BBT for the first and second premolars were measured 1.18 mm and 1.57 mm, respectively. The root diameters of the first and second premolars were measured 4.02 mm and 3.98 mm in the buccolingual dimension, and 2.74 mm and 2.98 mm in the mesiodistal dimension. The total amount of tissue needed to be resected for endodontic surgery in the second premolar has a higher amount with a mean of 5.55 mm. The second premolar was recorded as the tooth with the closest root apex to MF with a mean value of 3.97 mm. The mean distance between MF and AC was measured 13.88 mm, and MFs in most cases (44.11 %) were positioned in line with the second premolar long axis. Conclusion: According to findings of the present study, the CBCT imaging evaluation is recommended for each patient before the surgical endodontic operation

Mutuality of epigenetic and nanoparticles: two sides of a coin

Nowadays nanoparticles (NPs) due to their multidimensional applications in enormous different fields, has become an exciting research topic. In particular, they could attract a noticeable interest as drug deliver with increased bioavailability, therapeutic efficacy and drug specificity. Epigenetic can be considered as a complex network of molecular mechanism which are engaged in gene expression and have a vital role in regulation of environmental effects on ethology of different disorders like neurological disorders, cancers and cardiovascular diseases. For many of them epigenetic therapy was proposed although its application accompanied with limitations, due to drug toxicity. In this review we evaluate two aspects to epigenetic in the field of NPs: firstly, the role of epigenetic in regulation of nanotoxicity and secondly application of NPs as potential carriers for epidrugs

Comparative evaluation of root canal morphology of mandibular premolars using clearing and cone beam computed tomography

Background: Different techniques are used to evaluate the anatomy of root canal system. The present study was aimed to evaluate the root canal morphology of mandibular premolars using clearing and cone beam computed tomography (CBCT) techniques. Materials and Methods: A total of 182 mandibular first and second premolars were evaluated in vitro using 100 μm CBCT cross sections. The root canal morphology of the teeth was determined based on Vertucci classification in relation to the prevalence of C-shaped canals, lateral canals, and furcation location. Having removed the pulp tissue with NaOCl solution and staining the root canals with India ink, the samples were decalcified with 5% nitric acid and dehydrated with isopropyl alcohol. Finally, the samples were cleared with methyl salicylate. Data were analyzed by SPSS 16 software using McNamara, t-test, and Kappa coefficient. Results: After Type I, the most frequent morphologies in both first and second premolars were Type V followed by Type IV. The prevalence rates of C-shaped morphology in first premolars using clearing and CBCT were 4.4% and 6.6%, respectively. However, no C-shaped morphology was found in second premolars. The maximum and minimum levels of agreement between the two techniques were observed in Type IV and Type V root canal morphologies, respectively. Extra root canals were identified in 25% and 13% of the first and second premolars, respectively. Conclusion: CBCT showed a higher accuracy in determining C-shaped root canal morphology than the clearing technique. It also showed the least accuracy in diagnosing lateral root canals