Sonographic Imaging of Surgically Transpositioned Ovaries in the Treatment of Rectal Carcinoma

Pelvic radiation therapy in patients with advanced rectal carcinoma improves oncological outcomes, but often raises infertility concerns in reproductive-age patients. Laparoscopic ovarian transposition is a surgical method which may offer preservation of ovarian function during and after cancer treatment. Sonographic evaluation of the ovaries post transposition gives insight into their condition and the efficacy of ovarian transposition in the continuation of ovarian function after radiation. This case describes how sonography was used to identify and evaluate surgically transpositioned ovaries in a patient with rectal adenocarcinoma.

Sonographic Detection of Congenital Intestinal Malrotation: A Case Report

Intestinal malrotation is a rare fetal anomaly resulting from the failure of midgut rotation and fixation. Sonography is typically the first modality of choice for assessing pediatric pathology due to its high sensitivity, portability, real-time imaging capability, and non-ionizing technique; however, its role in diagnosing small bowel rotational anomalies remains limited and controversial. Fluoroscopic upper gastrointestinal imaging (UGI) is the primary diagnostic examination at most institutions. However, even on UGI, imaging findings may be equivocal. In such cases, sonography may provide additional information at facilities where it is not used as a primary diagnostic tool. This case report represents the first reported case showing how patient position is important as the typical vascular sonographic features of rotation were normal in one position but abnormal in another. In addition, this case shows how congenital intestinal malrotation was decisively diagnosed using sonographic imaging.

The Effectiveness of Identifying Primary Gallbladder Adenocarcinoma Utilizing Contrast-Enhanced Ultrasound: A Case Report

Gallbladder carcinoma is rare and difficult to detect in the early stages of the disease process, due to lack of symptoms. Sonography is typically the first modality of choice for assessing gallbladder pathology due to its high sensitivity, portability, real-time imaging capability, and non-ionizing technique. Conventional gray-scale and color Doppler sonographic imaging may be ambiguous for diagnosing solid tumors, such as gallbladder carcinoma. In this case, gallbladder carcinoma was definitively diagnosed utilizing contrast-enhanced ultrasound, allowing for quick patient treatment options and an optimal surgical outcome.

Characterizing the Mechanism of Action of Essential Oils on Skin Homeostasis—Data from Sonographic Imaging, Epidermal Water Dynamics, and Skin Biomechanics

Essential oils (EOs) have been recognized as materials of interest for dermatological applications, although some doubts remain regarding their safety and efficacy. We studied the action mechanisms of EOs from lavender and sage in human skin. Extracted EOs were incorporated (at 5% and 10%) in almond oil as a vehicle. Eleven healthy volunteers were selected and the prepared oils were tested on both forearms. All procedures respected the principles of good clinical practice. Effects were followed through high resolution sonography (HRS), epidermal water dynamics, and biomechanics. All variables were measured before and 30 min after application. Nonparametric statistical comparisons were applied (p < 0.05). HRS revealed a more echogenic epidermis, with a significant echogenicity decrease in the dermis (higher water retention) for all formulations. Significant TEWL decrease and an increase in superficial and deep epidermal hydration were also observed. These results indicate that EOs penetrate only into the most superficial layers of the skin, which is important for their safety profile. Furthermore, this “filmogenic” mechanism improving the epidermal water balance seems to connect directly with the observed biomechanical enhancement. These results confirm the clinical relevance of these compounds, in particular to restore the epidermal water content and prevent xerosis and other related disorders in sensitive (atopic, elderly) patients.

Sonography of Primary Cervical Neuroblastoma in the Infant

A palpable neck mass in a newborn or young child is overwhelmingly benign but can require additional evaluation to exclude the rare malignant etiology. We present a 10-month-old female with a non-tender, non-erythematous firm nodule in the left neck initially suspected to be enlarged lymph nodes. Sonographic imaging was concerning for a diagnosis of neuroblastoma confirmed by surgical resection and pathologic examination. The sonographic characteristics associated with neuroblastoma are important to recognize to accurately diagnose the neoplasm and improve patient management.

Prevalence and real-world management of vedolizumab-associated enthesitis in successfully treated IBD patients

Background Some studies have reported the development of moderate and severe de novo SpA-associated disease under vedolizumab (VDZ) treatment for IBD. Herein, we report a case series who developed severe enthesitis under VDZ therapy from a cohort of 90 treated cases. Methods In a single Italian IBD Unit in which 90 cases were on VDZ therapy, we identified 11 cases who developed severe enthesitis. The onset of disease in relationship to VDZ initiation, clinical and sonographic imaging features, and outcomes (including therapy switches) was described. Results A total of 11 cases, including 8 prior anti-TNF failures, with new-onset entheseal pathology were identified: multifocal (n = 4), unifocal (n = 6), and enthesitis/synovitis/dactylitis (n = 1). The mean duration of symptoms was 46 weeks (range 6–119), the mean CRP was 5.1 mg/dl, and the majority were HLA-B27 negative and showed good clinical response for gut disease. Clinical features and US showed severe enthesitis, including power Doppler change in 7 patients. All patients were initially treated with NSAIDs, and 5 patients underwent local steroid injections. At 12 months, 5/7 cases continued VDZ and 2 were switched to ustekinumab. At 12 months follow-up of 7 cases, 5 patients were in clinical remission and 2 patients had mild enthesitis with minimal increase of power Doppler signal. In addition, 4/7 severe patients developed marked post-inflammatory entheseal calcifications Conclusions A predominant isolated severe enthesitis pattern of SpA may develop under VDZ therapy with severe disease in 8% of cases. Most cases continued VDZ therapy.