Partial anomalous pulmonary venous return associated with vascular anomalies of the aorta: multidetector computed tomography findings

Partial anomalous pulmonary venous return (PAPVR) is a congenital anomaly that involves drainage of one to three pulmonary veins directly into the right heart or systemic venous system, creating a partial left-to-right shunt. This drainage is associated with cardiac abnormalities such as mitral stenosis and pulmonary stenosis, patent ductus arteriosus, and atrial septal defects. We report a case of PAPVR associated with vascular anomalies of the aorta by multidetector computed tomography in an adult female patient

The utility of multidetector computed tomography for evaluation of congenital heart disease

Background: Congenital heart diseases (CHD) are the leading cause of birthdefect-related deaths. Multidedector computed tomography (MDCT) plays animportant role for imaging CHD in addition to echocardiography and providesa comprehensive evaluation of complex heart malformations for the referringcardiologist. The aim of the study was to evaluate the utility of MDCT in theassessment of CHD.Materials and methods: A 102 patients with CHD were investigated after initialassessment by echocardiography. The information obtained by MDCT and findingsof echocardiography were reviewed together by paediatric cardiologistsand cardiac radiologists. Perioperative anatomic descriptions, wherever available(n = 34) formed the gold standard for the comparison.Results: The clinical consensus diagnosis defined 154 cardiovascular lesions inthe patients. The results were classified in groups. We present the appearanceof various congenital cardiac lesions seen in clinical practice.Conclusions: MDCT provides important information about anatomic details ofCHD for the referring cardiologist. The evaluation of different anatomic structuressuch as heart, great vessels, lungs and abdomen is possible in one acquisitionwith this technique

Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: Comparison with T2-weighted MR cholangiography

Objective: To evaluate the added role of T1-weighted (T1w) gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiography (MRC) compared with T2-weighted MRC (T2w-MRC) in the detection of biliary leaks. Methods: Ninety-nine patients with suspected biliary complications underwent routine T2w-MRC and T1w contrast-enhanced (CE) MRC using Gd-EOB-DTPA to identify biliary leaks. Two observers reviewed the image sets separately and together. MRC findings were compared with those of surgery and percutaneous transhepatic cholangiopancreatography. The sensitivity, specificity and accuracy of the techniques in identifying biliary leaks were calculated. Results: Accuracy of locating biliary leaks was superior with the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC (P < 0.05).The mean sensitivities were 79 % vs 59 %, and the mean accuracy rates were 84 % vs 58 % for combined CE-MRC and T2w-MRC vs sole T2w-MRC. Nineteen out of 21 patients with biliary-cyst communication, 90.4 %, and 12/15 patients with post-traumatic biliary extravasations, 80 %, were detected by the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC images, P < 0.05. Conclusions: Gd-EOB-DTPA-enhanced MRC yields information that complements T2w-MRC findings and improves the identification and localisation of the bile extravasations (84 % accuracy, 100 % specificity, P < 0.05). We recommend Gd-EOB-DTPA-enhanced MRC in addition to T2w-MRC to increase the preoperative accuracy of identifying and locating extravasations of bile. Key Points: • Magnetic resonance cholangiography (MRC) does not always detect bile leakage and cysto-biliary communications. • Gd-EOB-DTPA-enhanced MRC helps by demonstrating extravasation of contrast material into fluid collections. • Gd-EOB-DTPA-enhanced MRC also demonstrates the leakage site and bile duct injury type. • Combined Gd-EOB-DTPA-enhanced and T2w-MRC can provide comprehensive information about biliary system. • Gd-EOB-DTPA-enhanced MRC is non-invasive and does not use ionising radiation. © 2013 The Author(s)

Fluid Inclusions Usage for Assessing Oil Migration in Duhok, North of Iraq

Studies of primary and secondary fluid inclusions were done on epigenetic barite samples which collected from carbonates in Lower part of Sarmord Formation (Lower Cretaceous and Aqra-Bekhme Formations (Upper Cretaceous) in Duhok localities of North of Iraq. Lead isotopes composition in galena which associated barite that contained fluid inclusions helped the identification two events of fluid inclusions. These fluid inclusions contain brine water and hydrocarbons. Primary and secondary fluid inclusions in barite as well as lead isotopes composition in galena helped the interpretation of oil migration history and the pathway of oil migration. Ages of galena are syngronous with the events of oil and water trapping as inclusions within barite, and hence the interpreted galena generation could be assigned to the fluid inclusions age. Accordingly, the events are two phases of early and late generations that correspond to 120 m.y. and 30 m.y. respectively. Correlation with 10 PetroMod basin modeling of the generated oil from the Jurassic and Lower Cretaceous Formations fitted with the event of early galena generation, whereas the oil migration started before 70 m.y and continued to 30 m.y ago. Palynomorphs study confirms that the oil in source rocks is similar with the migrated oil

A novel approach to contrast-induced nephrotoxicity: the melatonergic agent agomelatine

OBJECTIVE: To study the potential nephroprotective role of agomelatine in rat renal tissue in cases of contrast-induced nephrotoxicity (CIN). The drug's action on the antioxidant system and proinflammatory cytokines, superoxide dismutase (SOD) activity, levels of glutathione (GSH) and malondialdehyde (MDA) and the gene expression of interleukin-6 (IL-6), tumour necrosis factor (TNF)-α and nuclear factor kappa B (NF-κB) was measured. Tubular necrosis and hyaline and haemorrhagic casts were also histopathologically evaluated. METHODS: The institutional ethics and local animal care committees approved the study. Eight groups of six rats were put on the following drug regimens: Group 1: healthy controls, Group 2: GLY (glycerol), Group 3: CM (contrast media—iohexol 10 ml kg(−1)), Group 4: GLY+CM, Group 5: CM+AGO20 (agomelatine 20 mg kg(−1)), Group 6: GLY+CM+AGO20, Group 7: CM+AGO40 (agomelatine 40 mg kg(−1)) and Group 8: GLY+CM+AGO40. The groups were evaluated by one-way analysis of variance and Duncan's multiple comparison test. RESULTS: Agomelatine administration significantly improved the serum levels of blood urea nitrogen (BUN) and creatinine, SOD activity, GSH and MDA. The use of agomelatine had substantial downregulatory consequences on TNF-α, NF-κB and IL-6 messenger RNA levels. Mild-to-severe hyaline and haemorrhagic casts and tubular necrosis were observed in all groups, except in the healthy group. The histopathological scores were better in the agomelatine treatment groups. CONCLUSION: Agomelatine has nephroprotective effects against CIN in rats. This effect can be attributed to its properties of reducing oxidative stress and inhibiting the secretion of proinflammatory cytokines (NF-κB, TNF-α and IL-6). ADVANCES IN KNOWLEDGE: CIN is one of the most important adverse effects of radiological procedures. Renal failure, diabetes, malignancy, old age and non-steroidal anti-inflammatory drug use pose the risk of CIN in patients. Several clinical studies have investigated ways to avoid CIN. Theophylline/aminophylline, statins, ascorbic acid and iloprost have been suggested for this purpose. Agomelatine is one of the melatonin ligands and is used for affective disorders and has antioxidant features. In this study, we hypothesized that agomelatine could have nephroprotective, antioxidant and anti-inflammatory effects against CIN in rats

Sildenafil citrate and sildenafil nitrate (NCX 911) are potent inhibitors of superoxide formation and gp91(phox) expression in porcine pulmonary artery endothelial cells

1. Acute respiratory distress syndrome (ARDS) is associated with increased superoxide (O(2)(•−)) formation in the pulmonary vasculature and negation of the bioavailability of nitric oxide (NO). Since NO inhibits NADPH oxidase expression through a cyclic GMP-mediated mechanism, sildenafil, a type V phosphodiesterase inhibitor, may be therapeutically effective in ARDS through an augmentation of NO-mediated inhibition of NADPH oxidase. Therefore, the effect of sildenafil citrate and NO-donating sildenafil (NCX 911) on O(2)(•−) formation and gp91(phox) (active catalytic subunit of NADPH oxidase) expression was investigated in cultured porcine pulmonary artery endothelial cells (PAECs). 2. PAECs were incubated with 10 nM TXA(2) analogue, 9,11-dideoxy-9α,11α-methanoepoxy-prostaglandin F(2α) (U46619) (±sildenafil or NCX 911), for 16 h and O(2)(•−) formation measured spectrophometrically and gp91(phox) using Western blotting. The role of the NO-cGMP axis was studied using morpholinosydnonimine hydrochloride (SIN-1), the diethylamine/NO complex (DETA-NONOate), the guanylyl cyclase inhibitor, 1H-{1,2,4}oxadiazolo{4,3-a}quinoxalin-1-one (ODQ), and the protein kinase G inhibitor, 8-bromoguanosine-3′,5′-cyclic monophosphorothioate, Rp-isomer (Rp-8-Br-cGMPS). NO release was studied using a fluorescence assay and O(2)(•−)–NO interactions by measuring nitrites. 3. After a 16-h incubation with 10 nM U46619, both NCX 911 and sildenafil elicited a concentration-dependent inhibition of O(2)(•−) formation and gp91(phox) expression, NCX 911 being more potent (IC(50); 0.26 nM) than sildenafil citrate (IC(50); 1.85 nM). These inhibitory effects were reversed by 1 μM ODQ and 10 μM Rp-8-Br-cGMPS. NCX 911 stimulated the formation of cGMP in PAECs and generated NO in a cell-free system to a greater degree than sildenafil citrate. The inhibitory effect of sildenafil was augmented by 1 μM SIN-1 and blocked partially by the eNOS inhibitor 10 μM N(5)-(1-iminoethyl)-ornithine (L-NIO). Acutely, sildenafil and NCX 911 also inhibited O(2)(•−) formation, again blocked by 1 μM ODQ. NCX 911 reacted with O(2)(•−) generated by xanthine oxidase, an effect that was inhibited by superoxide dismutase (500 U ml(−1)). 4. Since O(2)(•−) formation plays contributory role in ARDS, both sildenafil citrate and NCX 911 may be indicated for treating ARDS through suppression of NADPH oxidase expression and therefore of O(2)(•−) formation and preservation of NO bioavailability