The role of longitudinal shortening in the general pattern of heart left ventricle contraction

This paper constitutes a report of our experience in the assessment of left ventricle contraction using MRI (Philips 0,5T Gyroscan T5/II) and includes a suggestion of the study method directed towards establishing the role of different patterns of ventricle contraction in general ventricle function. In 29 patients, 22 men and 7 women, (average age 55.3) with history of myocardial infarction, electrocardiographically gated MR images encompassing the entire heart in the anatomic long and short axis planes were acquired. Significant positive correlations between long axis shortening and area length ejection fraction were found on four chamber view images: r = 0.605 at

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The aim of the study was to evaluate the usefulness of 18F-FLT PET/CT in the detection and differentiation of gastric cancers (GC). 104 consecutive patients (57 cases of adenocarcinoma tubulare (G2 and G3), 17 cases of mucinous adenocarcinoma, 6 cases of undifferentiated carcinoma, 14 cases of adenocarcinoma partim mucocellulare, and 10 cases of end stage gastric cancer) with newly diagnosed advanced gastric cancer were examined with FLT PET/CT. For quantitative and comparative analyses, the maximal standardized uptake value (SUVmax) was calculated for both the tumors and noninvaded gastric wall. Results. There were found, in the group of adenocarcinoma tubulare, SUVmax 1.5–23.1 (7.46±4.57), in mucinous adenocarcinoma, SUVmax 2.3–10.3 (5.5±2.4), in undifferentiated carcinoma, SUVmax 3.1–13.6 (7.28±3.25), in adenocarcinoma partim mucocellulare, SUVmax 2–25.3 (7.7±6.99), and, in normal gastric wall, SUVmax 1.01–2.55 (1.84±0.35). For the level of 2.6 cut-off value between the normal wall and neoplasm FLT uptake from ROC analysis, all but five gastric cancers showed higher accumulation of FLT than noninfiltrated mucosa. Conclusion. Gastric cancer presents higher accumulation of 18F-FLT than normal, distended gastric mucosa. Significantly higher accumulation was shown in cancers better differentiated and with higher cellular density

Gallstone ileus : a rare complication of cholecystolithiasis : a case report

Background: Gallstone ileus is a rare, serious and usually specific to elderly age complication of cholecystolithiasis associated with very high mortality. It occurs when a concrement from the gallbladder becomes incarcerated in the lumen of the digestive tract. In this report, a case of gallstone ileus is presented, where a concrement moved through a cholecystoduodenal fistula to the lumen of the small intestine. Case report: A 80-year-old woman who suffered from cholecystolithiasis and diabetes mellitus was admitted to hospital with abdominal pain, flatulence and loss of appetite which lasted a few days. In ultrasonography of the abdomen, a gallbladder hydrops was found and the patient was qualified to cholecystectomy. The night before the planned surgery, the patient reported her abdominal complaints to more intense, and vomiting occurred. Abdominal ultrasonography was repeated, revealing wide intestinal loops with the gallbladder poorly visible; the examiner also noticed a hyperechogenic shadow in the stomach and in conclusions suggested the possibility of perforation. In CT imaging, one concrement in the jejunum and several ones in the colon were found to confirm the diagnosis. During the surgery, perforations of the gallbladder and pylorus were found and a gallstone wedged in the lumen of the jejunum blocking the passage. Conclusions: Cholecystolithiasis, as a disorder common in our population, should be considered in differential diagnosis of intestinal obstruction. Gallstone ileus as a rare but highly dangerous complication of cholecystolithiasis is more often seen in elderly patients with rich medical past. None of radiological methods used separately is able to give a full diagnosis - only their combination leads to an accurate diagnosis. That is why only rapid and well selected path of imaging diagnostics (ultrasonography, plain abdominal radiogram, CT imaging), good anamnesis and cooperation with a clinician is the way to obtain a therapeutic success

Rapid progression of massive hepatic calcification visible by CT : the case of a dialyzed patient

Background: There have been single reported cases of patients with diffuse hepatic calcifications revealed 4-36 months after the first examination in the course of hemodialysis-treated renal failure, severe heart failure, shock liver, primary amyloidosis, or corticosteroid administration. In the presented case, many different factors for liver calcification and dynamic tomographic manifestation are seen. Case Report: A 23-year-old man who was on hemodialysis because of acute renal failure after a motor vehicle accident (multiorgan trauma) with occurrence of hypovolemic shock was admitted to the hospital's intensive care unit presenting with clostridial infection of the lower extremities. During his stay at a prior hospital, ultrasonography did not reveal hepatic lesions. He underwent 22 sessions of treatment with hyperbaric oxygen as well as several necrectomies and amputation of both lower limbs. Abdominal CT performed three weeks after the accident demonstrated diffuse hepatic calcification which was later confirmed during autopsy. Liver parenchymal calcifications may be related to elevated calcium-phosphorus products in the uremic state and after multiple bone fractures and possible ischemic liver injury. Although a definitive explanation for the unusually short time of the appearance of liver calcification was not obtained, it may be related to many factors acting synergistically. Hyperbaric oxygen treatment is of unknown significance in this process. Conclusions: CT plays a basic role in detecting and assessing liver calcifications forming both diffuse lesions and those with well-defined borders. Diffuse calcifications revealed by CT must be analyzed together with the patient's history, especially considering renal and heart failure, bone fractures, states of shock, and treatment. Diffuse liver calcifications in these patients after respiratory therapy and transfusions when no subcapsular hematoma is found should be considered of metabolic origin

When you hear hooves, you should look for... zebras

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Localisation of focal liver lesions to specific hepatic segments - comparison of multiphase spiral CT and MR imaging

The purpose of this study was an evaluation of the ability of the mulitiphase spiral CT and MR imaging to localise focal liver lesions referring to specific hepatic segments. The authors studied prospectively 26 focal liver lesions in 26 patients who had undergone spiral CT and MRI before surgery. Multiphase spiral CT included noncontrast scans, hepatic arterial-dominant phase, portal venous - dominant phase and equilibrium phase. MRI was performed in all cases. The following sequences were performed: SE and TSE T1- and T2-weighted images, STIR and dynamic T1-weighted FFE study after i.v. administration of gadolinium (Gd-DTPA). The CT and MR scans were prospectively and independently reviewed by three radiologists for visualisation of hepatic and portal veins and segmental localisation of hepatic lesions. The authors used the right and left main portal veins along with transverse fissura, hepatic veins and gallbladder fossa as landmarks for the tumour localisation to specific hepatic segments. The primary segmental locations of the lesions were correctly determined with CT in 22 of 26 focal liver lesions (85%) and with MR imaging in 24 of 26 lesions (92%). The full extent of lesions was correctly described with sCT in 19 of 26 focal lesions and with MR in 21 of 26 tumours. MRI and CT were helpful preoperative tools for determining the segmental location of focal liver lesions and for planning the surgical approach

Objawy uszne w przebiegu ziarniniaka Wegenera u 14-letniego chłopca — opis przypadku

Ziarniniak Wegenera (WG) jest rzadką chorobą u dzieci. Otolaryngologiczne objawychoroby najczęściej wiążą się z zapaleniem błony śluzowej nosa, gardła, krtani i uszu.Przedstawiono przypadek 14-letniego chłopca, u którego pierwszym objawem chorobybyło obustronne, przewlekłe zapalenie ucha środkowego z niedosłuchem. W krótkimokresie wystąpiły kłębuszkowe zapalenie nerek, zakrzepica żylna kończyn dolnychi zatorowość płucna. Chorego leczono antybiotykami, sulfonamidami, steroidami i lekamiimmunosupresyjnymi. Uzyskano poprawę stanu ogólnego, ustąpienie wyciekówz ucha oraz poprawę słuchu. W niektórych przypadkach zapaleń uszu niereagującychna standardowe leczenie w diagnostyce różnicowej należy uwzględnić WG

Guz Krukenberga – problem interdyscyplinarny – opis przypadku

Metastatic lesions within the ovary constitute a serious diagnostic problem in daily practice. We present an interesting case of Krukenberg tumor in a woman 13 years after partial gastrectomy due to stomach cancer. Our case confirms that every woman with history of cancer should remain under gynecological control. It is important due to a high risk of metastatic changes localized in the ovaries, regardless of the time elapsed since the diagnosis of the primary tumor.Ogniska przerzutowe w obrębie jajnika stanowią trudny interdyscyplinarny problem diagnostyczny. Część zmian wykrywana jest przypadkowo, a brak pełnych danych klinicznych może utrudnić rozpoznanie zarówno radiologowi analizującemu badania obrazowe jak również patomorfologowi oceniającemu materiał histopatologiczny. W pracy przedstawiono kazuistyczny przypadek pacjentki z guzem Krukenberga, rozpoznanym trzynaście lat po częściowej gastrektomii z powodu raka gruczołowego żołądka. Potwierdza on konieczność okresowej kontroli ginekologicznej pacjentek z przeszłością nowotworową ze względu na wysokie ryzyko wystąpienia zmian przerzutowych w obrębie jajników, niezależnie od okresu jaki upłynął od rozpoznania nowotworu pierwotnego

Pancreatic islet transplantation in a simultaneous pancreas and kidney transplant recipient — a case report

Beta cell replacement allows for adequate blood glucose control, reduced progression or even reversal of microvascular complications, and improves the quality of life. Simultaneous pancreas and kidney transplantation is the best therapeutic option for patients with type 1 diabetes and end-stage renal disease resulting from diabetic nephropathy. However, when pancreas transplantation is contraindicated or unavailable, pancreatic islet transplantation is an alternative minimally invasive procedure. We report a patient after earlier simultaneous kidney and pancreas transplantation with a failed pancreas graft, and no option for pancreas retransplantation. In this patient pancreatic islet transplantation was performed. The latter resulted in an improved blood glucose control, restoration of hypoglycaemia awareness, and improved quality of life with stable good function of the kidney allograft.Beta cell replacement allows for adequate blood glucosecontrol, reduced progression or even reversal ofmicrovascular complications, and improves the qualityof life. Simultaneous pancreas and kidney transplantationis the best therapeutic option for patients withtype 1 diabetes and end-stage renal disease resultingfrom diabetic nephropathy. However, when pancreastransplantation is contraindicated or unavailable, pancreaticislet transplantation is an alternative minimallyinvasive procedure. We report a patient after earliersimultaneous kidney and pancreas transplantationwith a failed pancreas graft, and no option for pancreasretransplantation. In this patient pancreatic islettransplantation was performed. The latter resultedin an improved blood glucose control, restoration ofhypoglycaemia awareness, and improved quality oflife with stable good function of the kidney allograft

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines