scholarly journals Diagnosis of Fibrotic Distal Ileum Stenosis after Ischemic Enteritis Using Transabdominal Ultrasonography

2021 ◽  
pp. 568-577
Author(s):  
Ryo Katsumata ◽  
Noriaki Manabe ◽  
Masaki Matsubara ◽  
Jun Nakamura ◽  
Kazuma Kawahito ◽  
...  

Ischemic enteritis (IE) is a rare disorder which is caused by inadequate blood flow to small intestine. The diagnostic procedure of this disease has not sufficiently established because of its rarity. Here, we report a case of IE in a hemodialysis-dependent 70-year-old man and summarize the diagnostic options for IE. The patient was admitted to our hospital because of acute abdominal distention and vomiting. He presented with mild tenderness in the lower abdomen and slightly elevated C-reactive protein level as revealed by blood tests. Radiographic imaging showed small bowel obstruction due to a stricture in the distal ileum. Contrast-enhanced abdominal ultrasonography revealed a 7-cm stenotic site with increased intestinal wall thickening, which preserved mucosal blood perfusion. Elastography revealed a highly elastic alteration of the stenotic lesion, indicating benign fibrotic changes resulting from chronic insufficient blood flow. Based on a clinical diagnosis of IE with fibrous stenosis, a partial ileostomy was performed. After surgical treatment, oral intake was initiated without recurrence of intestinal obstruction. Pathological findings revealed deep ulceration with inflammatory cell infiltration at the stenotic site. Occlusion and hyalinization of the venules in the submucosal layer indicated IE. In addition to current case, we reviewed past case reports of IE. Through this case presentation and literature review, we summarize the usefulness and safety of transabdominal ultrasonography for diagnosing IE.

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Mawuli F. Attipoe ◽  
Charles D. Sturgis

Definitive cytomorphologic diagnosis of small cell carcinoma of the uterine cervix is possible but can be challenging in routine cervicovaginal cancer screening specimens. Several small series of reported cases of cervical small cell carcinoma have shown this uncommon malignancy to represent fewer than 2% of all invasive cervical cancers. This tumor type is associated with poor prognosis and rapid disease progression and can develop to an advanced stage in the interval between screening visits. Only rare case reports of small cell carcinoma arising in gravid cervices are known. In the current case a 29-year-old, gravida 6, para 2, pregnant (10-week gestation) female presented with postcoital bleeding. A definitive diagnosis of small cell carcinoma of the cervix was made possible by liquid based Pap testing with ancillary cell block preparation allowing for immunocytochemical characterization of the lesional cell population.


2021 ◽  
Vol 14 (1) ◽  
pp. e237017
Author(s):  
Yara Z Feliciano ◽  
Rochelle Freire ◽  
Jose Net ◽  
Monica Yepes

The diagnosis via core needle biopsy of concurrent ductal carcinoma in situ and lobular carcinoma in situ within an enlarging previously biopsied benign fibroadenoma in women in their 40s is rare. Several case reports have described the occurrence of malignant changes within fibroadenomas, usually as an incidental finding following excision, and few reports have documented the transition of a fibroadenoma to malignancy. The current case report emphasises the importance of re-biopsying enlarging fibroadenomas, even with otherwise maintained benign appearing features on imaging, in women in their 40s, in order to exclude the possibility of malignancy.


Author(s):  
L. Brull ◽  
E. Nizet ◽  
E. B. Verney

Lophius kidneys perfused with the heparinized blood (venous) of the fish secrete urine in which total non-protein nitrogen is concentrated, magnesium highly concentrated, and chloride only slightly so or not at all. Oxygenation of the blood, or lowering the temperature of the perfusate from c. 20° to c. 5° C. does not appear to influence secretion. The blood flow through the kidneys increases with the perfusion pressure, the increase often becoming disproportionately large. The urine flow, on the other hand, above a certain critical level is largely independent of changes in perfusion pressure.


2008 ◽  
Vol 130 (3) ◽  
Author(s):  
O. Ley ◽  
C. Deshpande ◽  
B. Prapamcham ◽  
M. Naghavi

Vascular reactivity (VR) denotes changes in volumetric blood flow in response to arterial occlusion. Current techniques to study VR rely on monitoring blood flow parameters and serve to predict the risk of future cardiovascular complications. Because tissue temperature is directly impacted by blood flow, a simplified thermal model was developed to study the alterations in fingertip temperature during arterial occlusion and subsequent reperfusion (hyperemia). This work shows that fingertip temperature variation during VR test can be used as a cost-effective alternative to blood perfusion monitoring. The model developed introduces a function to approximate the temporal alterations in blood volume during VR tests. Parametric studies are performed to analyze the effects of blood perfusion alterations, as well as any environmental contribution to fingertip temperature. Experiments were performed on eight healthy volunteers to study the thermal effect of 3min of arterial occlusion and subsequent reperfusion (hyperemia). Fingertip temperature and heat flux were measured at the occluded and control fingers, and the finger blood perfusion was determined using venous occlusion plethysmography (VOP). The model was able to phenomenologically reproduce the experimental measurements. Significant variability was observed in the starting fingertip temperature and heat flux measurements among subjects. Difficulty in achieving thermal equilibration was observed, which indicates the important effect of initial temperature and thermal trend (i.e., vasoconstriction, vasodilatation, and oscillations).


2021 ◽  
Vol 36 (6) ◽  
pp. 1132-1132
Author(s):  
D'anna Sydow ◽  
Daniel Amen ◽  
Kristen Willeumier ◽  
Brittny Arias ◽  
Charles J Golden ◽  
...  

Abstract Objective To identify regional cerebral blood flow (rCBF) differences between individuals with DSM-IV diagnosis of Cluster B Personality Disorders (PDB) and healthy controls. Method Healthy controls (n = 81, Mage = 41.9, 53.0% female, 42.0% Caucasian) and persons diagnosed by psychiatric examination with PDB (n=, Mage = 34.12, 71.5% female, 69.8% Caucasian) were selected from a deidentified adult clinical outpatient database. Those with comorbid diagnoses were included. Significant differences (alpha = 0.005) were found for age [t(195) = −3.62], gender [χ2(2) = 7.1], and race [χ2(12) = 23.82] between groups. Mean age [t(523) = 2.09, p = 0.037) and gender [t(532) = −2.653, p = 0.008] different significantly between groups. No significant mean difference was found for education [t(523) = 0.832, p = 0.406]. Results Significant rCBF differences were noted in the cerebellum [left:F(1,192) = 10.5; right:F(1,192) = 4.6], limbic system [left:F(1,192) = 7.8; right:F(1,192) = 5.0], and basal ganglia [left:F(1,192) = 12.3; right:F(1,192) = 6.7]. Group means comparisons indicated higher perfusion in the cerebellum for the PDB group. Lower perfusion was found in the limbic system and basal ganglia in the PDB group. Conclusion Results observed in this study are concurrent with previous literature. PDB demonstrates higher activity in the cerebellum which contains inhibitory neurotransmitters, like Purkinje cells. The increased blood flow to cerebellar circuits may be related to the explicit self-recognition of negative emotion reported in PDB. Hypoperfusion found in the limbic system could be linked to impaired emotional responses. Apathy experienced in PDB may be accounted for by the low perfusion in the highly dopaminergic pathway in the basal ganglia. Further research should assess how different comorbidities with PDB affect perfusion.


2020 ◽  
Vol 31 (05) ◽  
pp. 2050064
Author(s):  
Lanhua Zhang ◽  
Tao Wang ◽  
Mingfeng Yang ◽  
Shaowei Xue ◽  
Yujuan Li ◽  
...  

Quantitative analysis is vital for blood perfusion in ischemic stroke validating and predicting blood trend to refer and remedy on selection, operation and intervention. We leveraged the complex network modeling blood perfusion to pursue the changes and trends of blood flow in ischemic stroke. According to conversion of the flow chart from laser Doppler perfusion images of rats into the correlation matrix, the blood perfusion networks were formed and topology characters were quantitatively analyzed. The results verified the steal phenomenon and the compensatory ability in the vessel injury in accord with clinical indexes by the basic characters and efficiency, especially the interesting local efficiency. In addition, the outcomes exhibited consistently the small-world characters in the brain of rats. This computational model strengthened the new way of blood perfusion and potential predictions for stroke’s assessment, operation and prevention from the basic vascular dynamic indexes and complex networks.


1992 ◽  
Vol 263 (1) ◽  
pp. E57-E63 ◽  
Author(s):  
L. Jansson ◽  
S. Sandler

It has recently been shown that selective B-cell toxins alloxan and streptozotocin (STZ) possess marked effects also on the vascular system. To evaluate to what extent changes in blood perfusion of islets induced by alloxan or STZ could be of importance for diabetogenic action of these compounds, we first investigated acute effects of alloxan (75 mg/kg body wt iv) and STZ (40 mg/kg body wt iv) on both whole pancreatic blood flow (PBF) and islet blood flow (IBF) in adult rats. Alloxan caused a marked increase in IBF, which was most pronounced 3 min after administration and remained for 30 min. PBF, however, was decreased 3 min after alloxan administration but was similar to that of control animals from 10 min and onward. These two opposite effects on IBF and PBF caused the fraction of whole PBF diverted through islets to increase from approximately 10 to 50%. Pretreatment with glucose (2 g/kg body wt iv), indomethacin (3.5 mg/kg body wt iv), dimethyl sulfoxide (10 ml/kg body wt ip of a 33% solution), superoxide dismutase (SOD, 1,000 kU/kg body wt iv), NG-methyl-L-arginine (30 mg/kg body wt iv), theophylline (7 mg/kg body wt iv), or terbutaline (1 mg/kg body wt iv) failed to affect stimulation of IBF by alloxan observed at 3 min. SOD was found to exert a marked stimulation of IBF both when given alone and together with alloxan. Alloxan increased IBF and decreased PBF also in a syngeneic pancreaticoduodenal graft in rats but did not affect flow distribution in a perfused pancreas-duodenum preparation.(ABSTRACT TRUNCATED AT 250 WORDS)


1987 ◽  
Vol 109 (3) ◽  
pp. 218-225 ◽  
Author(s):  
R. Kress ◽  
R. Roemer

The object of this study was to devise a unified method for comparing different thermal techniques for the estimation of blood perfusion rates and to perform a comparison for several common techniques. The approach used was to develop analytical models for the temperature response for all combinations of five power deposition geometries (spherical, one- and two-dimensional cylindrical, and one- and two-dimensional Gaussian) and three transient heating techniques (temperature pulse-decay, temperature step function, and constant-power heat-up) plus one steady-state heating technique. The transient models were used to determine the range of times (the time window) when a significant portion of the transient temperature response was due to blood perfusion. This time window was defined to begin when the difference between the conduction-only and the conduction-plus-blood flow transient temperature (or power) responses exceeded a specified value, and to end when the conduction-plus-blood flow transient temperature (or power) reached a specified fraction of its steady-state value. The results are summarized in dimensionless plots showing the size of the time windows for each of the transient perfusion estimation techniques. Several conclusions were drawn, in particular: (a) low perfusions are difficult to estimate because of the dominance of conduction, (b) large heated regions are better suited for estimation of low perfusions, (c) noninvasive heating techniques are superior because they have the potential to minimize conduction effects, and (d) none of the transient techniques appears to be clearly superior to the others.


1988 ◽  
Vol 255 (3) ◽  
pp. H525-H533 ◽  
Author(s):  
Y. T. Shen ◽  
D. R. Knight ◽  
S. F. Vatner ◽  
W. C. Randall ◽  
J. X. Thomas

The extent to which cardiac denervation alters responses to myocardial ischemia remains controversial. This study compared responses to 24-h coronary artery occlusion (CAO) on measurements of wall thickness (ultrasonic crystals), regional myocardial blood flow (microspheres), and infarct size (triphenyltetrazolium chloride technique) in three groups of conscious dogs with 1) selective posterior left ventricular (LV) wall denervation, 2) selective ventricular denervation, or in 3) intact dogs. After CAO, hemodynamic changes were not different among the three groups. Wall thickening in the ischemic zone became akinetic or paradoxical early after CAO and did not recover in any group over the 24-h monitoring period. Blood flow in the area at risk fell similarly in all groups. Infarct size, as a percentage of the area at risk, was 45 +/- 7% in intact, 48 +/- 6% in posterior LV wall-denervated, and 48 +/- 8% in ventricular-denervated group. There was, however, a lower (P less than 0.05) frequency of arrhythmic beats per minute after 3 h of CAO in the ventricular-denervated group (3.2 +/- 1.4) compared with the intact (11.3 +/- 4.1) or posterior wall-denervated (12.6 +/- 3.2) group. An additional group of ventricular-denervated dogs was studied to determine the effects of sequential, brief 2-min CAO at 2, 4, and 8 wk after denervation. Responses of regional wall thickening to CAO were not affected significantly even after 8 wk following ventricular denervation. Thus, in conscious dogs, neither selective ventricular denervation nor selective denervation of the posterior LV wall improved collateral blood flow, affected regional function favorably, or reduced infarct size after CAO.


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