Benefit of dual-layer spectral CT in emergency imaging of different organ systems

2020 ◽  
Vol 75 (12) ◽  
pp. 886-902
Author(s):  
B. Demirler Simsir ◽  
E. Danse ◽  
E. Coche
Author(s):  
Benjamin F. Trump ◽  
Irene K. Berezesky ◽  
Raymond T. Jones

The role of electron microscopy and associated techniques is assured in diagnostic pathology. At the present time, most of the progress has been made on tissues examined by transmission electron microscopy (TEM) and correlated with light microscopy (LM) and by cytochemistry using both plastic and paraffin-embedded materials. As mentioned elsewhere in this symposium, this has revolutionized many fields of pathology including diagnostic, anatomic and clinical pathology. It began with the kidney; however, it has now been extended to most other organ systems and to tumor diagnosis in general. The results of the past few years tend to indicate the future directions and needs of this expanding field. Now, in addition to routine EM, pathologists have access to the many newly developed methods and instruments mentioned below which should aid considerably not only in diagnostic pathology but in investigative pathology as well.


Author(s):  
T. L. Benning ◽  
P. Ingram ◽  
J. D. Shelburne

Two benzofuran derivatives, chlorpromazine and amiodarone, are known to produce inclusion bodies in human tissues. Prolonged high dose chlorpromazine therapy causes hyperpigmentation of the skin with electron-dense inclusion bodies present in dermal histiocytes and endothelial cells ultrastructurally. The nature of the deposits is not known although a drug-melanin complex has been hypothesized. Amiodarone may also cause cutaneous hyperpigmentation and lamellar lysosomal inclusion bodies have been demonstrated within the cells of multiple organ systems. These lamellar bodies are believed to be the product of an amiodarone-induced phospholipid storage disorder. We performed transmission electron microscopy (TEM) and energy dispersive x-ray microanalysis (EDXA) on tissue samples from patients treated with these drugs, attempting to detect the sulfur atom of chlorpromazine and the iodine atom of amiodarone within their respective inclusion bodies.A skin biopsy from a patient with hyperpigmentation due to prolonged chlorpromazine therapy was fixed in 4% glutaraldehyde and processed without osmium tetroxide or en bloc uranyl acetate for Epon embedding.


2000 ◽  
Vol 5 (5) ◽  
pp. 4-5

Abstract Spinal cord (dorsal column) stimulation (SCS) and intraspinal opioids (ISO) are treatments for patients in whom abnormal illness behavior is absent but who have an objective basis for severe, persistent pain that has not been adequately relieved by other interventions. Usually, physicians prescribe these treatments in cancer pain or noncancer-related neuropathic pain settings. A survey of academic centers showed that 87% of responding centers use SCS and 84% use ISO. These treatments are performed frequently in nonacademic settings, so evaluators likely will encounter patients who were treated with SCS and ISO. Does SCS or ISO change the impairment associated with the underlying conditions for which these treatments are performed? Although the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) does not specifically address this question, the answer follows directly from the principles on which the AMA Guides impairment rating methodology is based. Specifically, “the impairment percents shown in the chapters that consider the various organ systems make allowance for the pain that may accompany the impairing condition.” Thus, impairment is neither increased due to persistent pain nor is it decreased in the absence of pain. In summary, in the absence of complications, the evaluator should rate the underlying pathology or injury without making an adjustment in the impairment for SCS or ISO.


2010 ◽  
Vol 15 (3) ◽  
pp. 1-7
Author(s):  
Richard T. Katz

Abstract This article addresses some criticisms of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) by comparing previously published outcome data from a group of complete spinal cord injury (SCI) persons with impairment ratings for a corresponding level of injury calculated using the AMA Guides, Sixth Edition. Results of the comparison show that impairment ratings using the sixth edition scale poorly with the level of impairments of activities of daily living (ADL) in SCI patients as assessed by the Functional Independence Measure (FIM) motor scale and the extended FIM motor scale. Because of the combinations of multiple impairments, the AMA Guides potentially overrates the impairment of paraplegics compared with that of quadriplegics. The use and applicability of the Combined Values formula should be further investigated, and complete loss of function of two upper extremities seems consistent with levels of quadriplegia using the SCI model. Some aspects of the AMA Guides contain inconsistencies. The concept of diminishing impairment values is not easily translated between specific losses of function per organ system and “overall” loss of ADLs involving multiple organ systems, and the notion of “catastrophic thresholds” involving multiple organ systems may support the understanding that variations in rating may exist in higher rating cases such as those that involve an SCI.


2020 ◽  
Vol 7 (3) ◽  
pp. 5-19
Author(s):  
Nikhil Nair ◽  
Ronith Chakraborty ◽  
Zubin Mahajan ◽  
Aditya Sharma ◽  
Sidarth Sethi ◽  
...  

Tuberous sclerosis complex (TSC) is a genetic condition caused by a mutation in either the TSC1 or TSC2 gene. Disruption of either of these genes leads to impaired production of hamartin or tuberin proteins, leading to the manifestation of skin lesions, tumors and seizures. TSC can manifests in multiple organ systems with the cutaneous and renal systems being the most commonly affected. These manifestations can secondarily lead to the development of hypertension, chronic kidney disease, and neurocognitive declines. The renal pathologies most commonly seen in TSC are angiomyolipoma, renal cysts and less commonly, oncocytomas. In this review, we highlight the current understanding on the renal manifestations of TSC along with current diagnosis and treatment guidelines.


Author(s):  
Dariya Aleksandrovna Gavrilova ◽  
Maria Pavlovna Grushko

The aim of this work was to study peculiarities of mullet morphological organization during early ontogeny. Sample selection was made on board Caspian research and development Institute of Fisheries’ research vessel in period from June to September, 2015 in Russian waters of the Caspian Sea. Larvae aged 10 days could be characterized by heterochrony in the development of major organ systems. Nervous system and sense organs were well developed. The eyeball had all membranes well-differentiated, in the retina all the layers were formed. The olfactory fossae had cells of 3 types: olfactory receptor cells, supporting cells and basal cells. There was observed intensive formation of respiratory, cardiovascular, excretory and digestive systems. The early development of the nervous system and sensory organs of the larvae indicated adaptation of mullet to active life.


Author(s):  
E. K. Rakhmatullin ◽  
O. D. Sklyarov

Preclinical study of the drugs toxicity was analysed it allows predicting the safety of veterinary drugs in laboratory animals. The fundamental normative instruments in the field of preclinical study of drugs for veterinary medicine and animal husbandry are Order of the Ministry of Agriculture of the Russian Federation dated 06.03.2018 N 101 and GOST 33044-2014 Principles of Good Laboratory Practice. An important indicator of the preclinical study of the veterinary drugs is the determination (calculation) of median lethal dose value (lethal dose for half of the animals tested) or concentration (LD50 or LC50). Existing methods for determining this indicator make it possible at the initial study stage to determine the degree and class the drug of toxicity. Studying the symptoms of intoxication in the analysis of pharmacological substances one obtains significant information about the nature of the action of the future drug. The clinical manifestations of intoxication with damage to various organ systems are presented. As criteria for assessing the toxic effects of veterinary drugs it is recommended to determine LD50, cumulation coefficient, latitude index of therapeutic effects, dose level of toxic effects in the experiment which allows predicting the nature and degree of toxic effects of the drug even at the stage of preclinical veterinary drugs study.


2018 ◽  
pp. 52-58
Author(s):  
Le Thuan Nguyen ◽  
Bui Bao Hoang

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. The kidney appears to be the most commonly affected organ, especially nephrotic is a serious kidney injury. The clinical, laboratory manifestations and histopathology are very useful for diagnosis, provide the means of predicting prognosis and guiding therapy in nephrotic patients with lupus nephritis. Methods: Descriptive cross-sectional study of nephrotic patients with lupus treated in the Department of Nephrology Trung Vuong Hospital and Cho Ray Hospital between May/2014 and May/2017. Renal histopathological lesions were classified according to International Society of Nephrology/Renal Pathology Society - ISN/RPS ’s 2003. The clinical, laboratory manifestations and histopathological features were described. Results: Of 32 LN with nephritic range proteinuria cases studied, 93.7% were women. The 3 most common clinical manifestations were edema (93.8%), hypertension (96.8%) and pallor (68.9%), musculoskeletal manifestions (46.9%), malar rash (40.6%). There was significant rise in laboratory and immunological manifestions with hematuria (78.1%), Hb < 12g/dL (93.5%), increased Cholesterol (100%), and Triglycerid (87.5%), Creatinine > 1.4 mg/dL (87.5%), increased BUN 71.9%, ANA (+) 93.8%, Anti Ds DNA(+) 96.9%, low C3: 96.9%, low C4: 84.4%. The most various and severe features were noted in class IV with active tubulointerstitial lesions and high activity index. Conclusion: Lupus nephritis with nephrotic range proteinuria has the more severity of histopathological feature and the more severity of the more systemic organ involvements and laboratory disorders were noted. Key words: Systemic lupus, erythematosus (SLE) lupus nepphritis, clinical


Author(s):  
Ольга Александровна Судакова ◽  
Михаил Вадимович Фролов ◽  
Алина Сергеевна Позднякова ◽  
Евгений Владимирович Белов ◽  
Данаил Красимирович Назлиев

Статья посвящена изучению сопутствующей патологии, у женщин репродуктивного возраста, обращающихся в стационар с жалобами на нарушения менструального цикла (НМЦ). Актуальность данной тематики не вызывает сомнения, так как с каждым годом в России и во всем мире регистрируется все большее количество случаев НМЦ. По мнению ряда авторов, данные нарушения могут составлять до 50% всех патологий женской половой сферы. Большой интерес представляет и изучение ряда сопутствующих заболеваний, которые могут отягощать течение НМЦ или наоборот, приводить к их развитию. Целью работы стал анализ разнообразной сопутствующей патологии при НМЦ, с выявлением основных причин нарушений менструального цикла у женщин фертильного возраста. Объектами исследования стали 300 пациенток, с диагнозом НМЦ, которые были разделены на 3 группы, в зависимости от уровня лечебного учреждения, где они проходили обследование - по 100 пациенток: проходивших обследование в больнице скорой медицинской помощи, обследующиеся в женской консультации и проходящие лечение сопутствующей онкопатологии в областном онкологическом диспансере. В дальнейшем проводилась дополнительное деление в каждой группе на 2 подгруппы, в зависимости от того был ли НМЦ впервые выявленным или повторно выявленным. В самой работе проводился подробный анализ сопутствующей патологии у женщин в зависимости от группы и их возраста. Определялись не только «пораженные» системы органов, но и проводился углубленный анализ по нозологиям. Работа интересна еще и тем, что в ней у всех пациенток на протяжении исследования определялся уровень стресса и наличие возможных депрессивных состояний. Определение наиболее вероятных причин НМЦ стало завершающим этапом исследования. Полученные данные могут приблизить практикующих акушеров-гинекологов к более полному пониманию различных нарушений менструального цикла, что в целом, положительно скажется на качестве и эффективности оказываемой медицинской помощи The article is devoted to the study of concomitant pathology in women of reproductive age who go to the hospital with complaints of menstrual irregularities (NMC). The relevance of this topic is beyond doubt, since every year in Russia and around the world an increasing number of cases of NMC are registered. According to a number of authors, these violations can account for up to 50% of all pathologies of the female genital area. Of great interest is the study of a number of concomitant diseases that can aggravate the course of NMC or, conversely, lead to their development. The aim of the work was to analyze a variety of concomitant pathologies in NMC, with the identification of the main causes of menstrual irregularities in women of fertile age. The objects of the study were 300 patients diagnosed with NMC, who were divided into 3 groups, depending on the level of the medical institution where they were examined - 100 patients each: who were examined in an emergency hospital, examined in an antenatal clinic and undergoing treatment for concomitant oncopathology in the regional oncological dispensary. Subsequently, an additional division was carried out in each group into 2 subgroups, depending on whether the NMC was newly detected or re-identified. In the work itself, a detailed analysis of comorbidities in women was carried out, depending on the group and their age. Not only the "affected" organ systems were identified, but an in-depth analysis of nosologies was also carried out. The work is also interesting in that during the study the level of stress and the presence of possible depressive states were determined in all patients. Determination of the most probable causes of NMC was the final stage of the study. The data obtained can bring practicing obstetricians and gynecologists closer to a more complete understanding of various menstrual irregularities, which, in general, will have a positive effect on the quality and effectiveness of medical care


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