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Background The objective of this article is to define the imaging characteristics of ancient schwannoma, which is a rare variant of benign schwannoma with degenerative changes, arising in the female pelvis simulating ovarian tumors.
Mayumi Takeuchi1 Email:mayumi@clin.med.tokushima-u.ac.jp Kenji Matsuzaki1 Hiromu Nishitani1 Hisanori Uehara2
[1] Department of Radiology, School of Medicine, University of Tokushima, 3-18-15, Kuramoto-cho, Tokushima 7708503, Japan ;[2] Department of Molecular; Environmental Pathology, School of Medicine, University of Tokushima, 3-18-15, Kuramoto-cho, Tokushima 7708503, Japan
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Objective-To investigate the relationship between preload and tricuspid valve annulus-derived tissue Doppler imaging (TDI) as an index of right ventricular (RV) filling in dogs. Animals-7 Beagles. Procedures-Peak systolic RV pressure and RV end-diastolic pressure (RVEDP) were measured in anesthetized dogs. Pulsed Doppler was used to measure tricuspid valve inflow and pulmonary valve outflow velocities. The TDI velocities were measured at the lateral corner of the tricuspid valve annulus. Lactated Ringer’s solution was infused at 200 mL/kg/h for 60 minutes via the cephalic vein. Results-IV infusion significantly increased heart rate, RV pressure, and RVEDP. Early diastolic flow (E-wave) and ejection time significantly increased. The myocardial performance index (MPI) significantly decreased. Intravenous infusion significantly increased the ratio of the E’-wave (peak myocardial velocity during early diastole) to the A’-wave (peak myocardial velocity during late diastole; E’:A’ ratio) and myocardial velocity during systole (S’), early diastole (E’), and late diastole (A’). The TDI-isovolumic relaxation time and TDI-MPI decreased significantly. The RVEDP was correlated with late diastolic flow (A-wave), ratio of the E-wave to the A-wave (E:A ratio), E’-wave, A’-wave, S’-wave (peak myocardial velocity during systole), TDI-isovolumic relaxation time, TDI-MPI, and ratio of the E-wave to the E’-wave (E: E’ ratio). The A-wave and E:A ratio and TDI-derived isovolumic relaxation time, S’ duration, and E’-wave could predict the RVEDP. Conclusions and Clinical Relevance-The TDI velocities were affected by RV filling pressure in healthy dogs, whereas other TDI profiles, such as MPI and E’:A’ ratio, were independent of acute filling abnormalities.
Hori Y Ukai Y Hoshi F Higuchi S
Department of Small Animal Internal Medicine, School of Veterinary Medicine, Kitasato University, Towada, Aomori 034-8628, Japan.
BACKGROUND: To review various portosystemic shunts (PS) and to evaluate their prevalence by CT during arterial portography (CTAP) using a multidetector-row CT (MDCT). METHODS: CTAP of 116 patients (liver cirrhosis 70 patients, non-liver cirrhosis 46 patients) was retrospectively reviewed. CTAP was performed with the catheter placed in the superior mesenteric artery using MDCT. Axial CT images of 0.625- and 3.75- or 2.5-mm thickness were obtained. Multiplanar reformation images and maximum intensity projection images were subjected to review. RESULTS: A part of the veins in the ileocecal region drained into the right renal vein or the inferior vena cava (IVC) via the right gonadal vein in 57 patients (81%). A part of the veins of the ascending colon drained via the right renal capsular vein into the IVC in 37 patients (53%). In 46 patients without liver cirrhosis, the right gonadal and right renal capsular veins were opacified on CTAP in 22 patients (48%) and 20 patients (43%), respectively. CONCLUSIONS: Portosystemic shunts in retroperitoneum were frequently recognized on CTAP images in patients with liver cirrhosis. The right gonadal vein and the right renal capsular vein were the most frequent routes of the portosystemic shunts. They may exist in physiological condition.
Terayama N Matsui O Kobayashi S Sanada J Gabata T Koda W Minami T
Department of Radiology, Kanazawa University, Graduate School of Medical Science , Kanazawa, 920-8641, Japan. tera@rad.m.kanazawa-u.ac.jp
BACKGROUND: The plicae palmatae is a developmental remnant of the Mullerian ductal fusion, which is demonstrated as a ridge of low intensity in the cervical canal on axial T2-weighted MR images. The identification of the plicae palmatae on MR imaging is beneficial for avoiding misinterpretation of this finding as anomalous uterine septum. The current study is performed to investigate the frequency of this finding and its variation among different age groups. METHODS: Axial T2-weighted images in 433 subjects were evaluated regarding the presence of the plicae palmatae and uterine anomaly. RESULTS: The frequency of the plicae palmatae was 47.5-53.2% in the third to fifth decade groups, but it was significantly lower in the sixth decade group (24.8%) than in the fifth decade group (53.2%). In three subjects with uterine anomalies, the plicae palmatae was recognized in a bicornuate uterus with single cervix, whereas it was not identified in unicornuate uterus and bicornuate uterus with duplicated cervices. CONCLUSION: The plicae palmatae is commonly encountered in routine MR images of normal uterus, especially in reproductive-aged women.
Takahata A Koyama T Kido A Kataoka M Umeoka S Nishizawa S Nishimura T Togashi K
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
BACKGROUND: The plicae palmatae is a developmental remnant of the Mullerian ductal fusion, which is demonstrated as a ridge of low intensity in the cervical canal on axial T2-weighted MR images. The identification of the plicae palmatae on MR imaging is beneficial for avoiding misinterpretation of this finding as anomalous uterine septum. The current study is performed to investigate the frequency of this finding and its variation among different age groups. METHODS: Axial T2-weighted images in 433 subjects were evaluated regarding the presence of the plicae palmatae and uterine anomaly. RESULTS: The frequency of the plicae palmatae was 47.5-53.2% in the third to fifth decade groups, but it was significantly lower in the sixth decade group (24.8%) than in the fifth decade group (53.2%). In three subjects with uterine anomalies, the plicae palmatae was recognized in a bicornuate uterus with single cervix, whereas it was not identified in unicornuate uterus and bicornuate uterus with duplicated cervices. CONCLUSION: The plicae palmatae is commonly encountered in routine MR images of normal uterus, especially in reproductive-aged women.
Takahata A Koyama T Kido A Kataoka M Umeoka S Nishizawa S Nishimura T Togashi K
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
BACKGROUND: Retroperitoneal endoscopic adrenalectomy (EA) is recognized as a principal procedure for benign adrenal tumors. However, a limited visual field and a narrow working space make this approach difficult, particularly in cases of obese patients or small tumors. Using multidetector row CT (MD-CT), this study investigated the use of preoperative virtual simulation (PVS) to identify tumor and central vein locations for EA, and verified these findings during EA surgery. PATIENTS AND METHODS: The study enrolled 11 cases comprising 10 adrenal adenomas and one ACTH-independent macronodular adrenal hyperplasia admitted to Jichi Medical University Hospital, Tochigi, Japan, between November 2003 and October 2006. Patients were evaluated in a lateral bending position using MD-CT. 3D PVS images of ribs, vertebrae, kidneys, and adrenal tumors were generated and compared with real images obtained during EA. RESULTS: The PVS images clearly showed the relative locations of the adrenal tumor, kidney, and adjacent anatomical structures. These locations were verified during EA. The central vein was identified in the PVS images in all cases. Information derived from the PVS images assisted in the performance of EA surgery. CONCLUSIONS: Preoperative 3D-simulation images using MD-CT contributed to the safety and efficiency of performing EAs.
Shiozawa M Sata N Endo K Koizumi M Yasuda Y Nagai H Takakusaki H
Department of Surgery, Jichi Medical University, 3311 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan, shiozawa@jichi.ac.jp.
BACKGROUND: To evaluate the imaging findings in patients with renal involvement of Polyarteritis nodosa (PN) to diagnose as early as possible. MATERIALS AND METHODS: Four patients diagnosed as having PN participated in the present study. Two patients underwent abdominal dynamic CT, one underwent only pre- and post-contrast CT, and the remaining patient underwent only noncontrast CT and MR imaging, including dynamic contrast study. RESULTS: The common findings of CT and MR imaging were diffuse enlargement, multiple small wedge-shaped less-enhanced areas on dynamic contrast study, and indistinctness of the margin between the cortex and medulla on equilibrium-phase CT. Renal arteriogram showed multiple microaneurysms on arterial phase image in all four cases, and PN was diagnosed. The common CT and MR findings of renal involvement of PN mimicked those of pyelonephritis, when microaneurysms were not demonstrated. CONCLUSION: The differentiation between PN and pyelonephritis on CT and MR imaging is difficult. Therefore, the radiologist should be familiar with the imaging findings of renal involvement of PN. When PN is suspected, angiography should be performed as early as possible to make a definite diagnosis.
Ozaki K Miyayama S Ushiogi Y Matsui O
Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8641, Japan, ozaki@rad.m.kanazawa-u.ac.jp.
The detection of microbial components by pattern recognition receptors (PRRs) and the subsequent triggering of innate immune responses constitute the first line of defense against infections. Recently, much attention has been focused on cytosolic nucleic acid receptors; the activation of these receptors commonly evokes a robust innate immune response, the hallmark of which is the induction of type I interferon (IFN) genes. In addition to receptors for RNA, receptors that detect DNA exposed in the cytosol and activate innate immune responses have long been thought to exist. Recently, DAI (DLM-1/ZBP1) has been identified as a candidate cytosolic DNA sensor. Cytosolic signaling by DNA-activated DAI (DLM-1/ZBP1) signaling results in activation of the two pathways of gene transcription critical to innate immune responses, the IRF and NF-κB pathways. In this review, we summarize our current view of activation mechanism and immunological roles of DAI (DLM-1/ZBP1) and related molecules. In addition, we also discuss the issue of self vs. non-self DNA recognition by DAI (DLM-1/ZBP1) and other DNA sensors in terms of the possible involvement in autoimmune abnormalities.
Akinori Takaokaa Email:takaoka@igm.hokudai.ac.jp Tadatsudu Taniguchib Email:tada@m.u-tokyo.ac.jp
[a]Division of Signaling in Cancer; Immunology, Institute for Genetic Medicine, Hokkaido University, Sapporo, Japan;[b]Department of Immunology, Graduate School of Medicine & Faculty of Medicine, University of Tokyo, Tokyo, Japan
Non-self RNA appearing in a cell as a result of viral replication is detected by a cytoplasmic sensor called RIG-I-like receptor (RLR). RLR consists of RIG-I, MDA5, and LGP2, which are DExD/H helicases. Domain structures of RLR for detecting non-self RNA and for relaying signals downstream have been elucidated. Different viruses produce structurally different RNA species and are sensed differentially by RLR molecules to initiate antiviral responses and subsequent antigen-specific adaptive immunity.
Mitsutoshi Yoneyamaa Koji Onomotoa Takashi FujitaaEmail:tfujita@virus.kyoto-u.ac.jp
[a]Laboratory of Molecular Genetics, Department of Genetics; Molecular Biology, Institute for Virus Research, Kyoto University, Kyoto, Japan;[b]Laboratory of Molecular Cell Biology, Division of Integrated Life Science, Graduate School of Biostudies, Kyoto University, Kyoto, Japan;[c]PRESTO, Japan Science; Technology Agency, 4-1-8 Honcho Kawaguchi, Saitama, Japan
Toll-like receptor 3 (TLR3) recognizes viral double-stranded RNA and its synthetic analog polyriboinosinic:polyribocytidylic acid (poly(I:C)) and induces type I interferon (IFN), inflammatory cytokine/chemokine production and dendritic cell (DC) maturation via the adaptor protein TICAM-1 (also called TRIF). TLR3 is expressed both intracellularly and on the cell surface of fibroblasts and epithelial cells, but is localized to the endosomal compartment of myeloid DCs. Several studies in TLR3-deficient mice demonstrate that TLR3 participates in the generation of protective immunity against some viral infections. Involvement of TLR3-TICAM-1 in activation of NK cells and CTLs by myeloid DCs suggests that TLR3 serves as an inducer of cellular immunity sensing viral infection rather than a simple IFN inducer. In this review, we summarize the current knowledge on TLR3 and discuss its possible role in innate and adaptive immunity.
Misako Matsumoto aEmail:matumoto@pop.med.hokudai.ac.jp Tsukasa Seyaa
[a]Department of Microbiology; Immunology, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan