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@medicalresonance
Duodenal Atresia
affects 1:6,000 newborns
usually distal to ampulla of vater therefore bilious vomiting
vomiting from birth, possible abdominal distension
associated with down’s syndrome
AXR - "double bubble" sign, distended stomach and duodenum, little/absent air in distal bowel
Management - surgery (duodenojejunostomy with resection of atretic section)
CT scan of the thorax of a 15yo with staphylococcal endocarditis and multiple septic emboli, revealing multiple nodular infiltrates (some with cavitation) consistent with septic emboli, volume loss on the right, and pleural effusions
Mid-phase fluorescein angiogram in a 23yo man who was in a motor vehicle accident 2 months before his presentation, his visual acuity is 20/400, and an afferent pupillary defect is present, traumatic optic neuropathy and choroidal rupture are observed
Large field-of-view pulmonary MR angiography
Aggressive Lymphoma: Low Doses of Approved Drug Switches On Pathway That Allows Chemotherapy to Kill Cancer
Patients with an aggressive lymphoma that often relapses and kills within two years experienced a remission of their cancer and stayed disease-free as long as 28 months after taking a commercially-available drug that made chemotherapy more effective.
Researchers from Weill Cornell Medical College and NewYork-Presbyterian Hospital, who led the study published in Cancer Discovery, say their strategy has the potential to change the standard of care for patients with diffuse large B-cell lymphoma (DLBCL) — and possibly other kinds of tumors.
The targeted drug they used, azacitidine, is designed to reawaken molecular mechanisms that typically trigger cell death but are switched off as cancer — including lymphoma — progresses. The research team discovered that pretreating aggressive lymphoma with azacitidine enables the death signal to turn back on when chemotherapy triggers it. Read more at the source Photo credit: Wikimedia Commons
Aortic Coarctation.
These are MRI and MRA images of a 22-year-old man with aortic coarctation, a congenital condition whereby the aorta narrows in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts and it is considered when a section of the aorta is narrowed to an abnormal width.
Coarctation is a congenital anomaly of unknown etiology that results in a focal obstruction at the junction of the distal aortic arch and descending thoracic aorta. It is responsible for 6% of congenital cardiac anomalies. Although there is blood flow across the coarc segment, it is supplemented by collateral blood flow that bypasses the obstruction via intercostal, internal mammary, epigastric, spinal, and periscapular arteries.
It is rare before 10-years of age and is most pronounced along the posterior upper ribs. Prognosis is good with early surgical intervention, poor without surgical intervention; very high mortality rate by 6th decade of life in this subset of patients.
(Images and clinical informations via VCU Medical Center).
So the first branch of chemotherapeutics are called “Genotoxics”. Initially they were modelled on mustard gas (Shown above). So mustard gas gets into lungs and goes through an intermolecular cyclisation, the products of which are hydrochloric acid and a reactive polar species. In other words, you’ve got some pretty dangerous chemicals in a delicate soft-tissued organ. This was used in warfare and was pretty damn effective (depending on wind direction). It took an annoyingly long time (over 20 years) for scientists to recognise the significance of this chemical with regard to it’s other effects on the body and general biochemistry (haematology). I blame the lack of internet ¬_¬ So the sulfur species can be taken up by cells and intercalate with DNA (twice). By damaging the cells genetic information, genotoxic drugs are able to minimise the possibility of proliferation and continued growth. The drugs have been built upon over years of research. Being a highly reactive compound, the sulfur was changed for a nitrogen. Again, quite reactive but the cyclic aziridinium ion formed had been proven to bind well with N7 in guanine (A DNA base). The most well-honed drug was a phenyl analogue of chlormethine (because the body didn’t excrete it really fast), however uptake through membranes was terrible. Adding chunkier alkyl sections (increasing lipophilicity) encouraged uptake by membranes - so chlorambucil was born (image 2). As it was taken up by any cell it wasn’t specific enough, leading to over toxicity =/ This brings us to present day where we have S-Melphalan (image 3). This drug is the most apt because it is specific, lipophilic, soluble, carried well around the body, not destroyed by metabolism and a few other things. The structure mimics amino acid character and is therefore taken up by cells that are growing fast (cancers… and hair/nails). The same approach is followed when a cancer uses lots of hormones too! Cancers become targets and actively uptake their own poisons - good job medicinal chemists ^_^
[Sorry about the poor images, I’m trying to stop drawing out my reactions by hand]
‘Virtual autopsies’ using CT and MRI scans joining traditional dissection methods for post mortems
The scene plays out in autopsy rooms around the world, not to mention on any number of TV crime dramas: a scalpel-wielding pathologist calmly dissects a lifeless body for clues to an untimely death.
The chest and abdominal cavities are pried open, organs removed and the brain eased out through a sawn-off skull in a medical tradition as ancient as the Pharaohs.
It is a tradition, though, facing very modern competition. Led partly by a prominent Canadian pathologist, some specialists are pushing to augment, or on occasion even replace, those conventional post mortems with “virtual autopsies” that use CT and MRI scans to probe bloodlessly inside cadavers.
Ontario recently became the first jurisdiction in Canada to begin using imaging machines designed to diagnose the living as a tool to uncover the medical secrets of the dead. (Photo: Institute of Forensic Medicine, University of Zurich)
MRI Technique Reveals Low Brain Iron in ADHD Patients
Magnetic resonance imaging (MRI) provides a noninvasive way to measure iron levels in the brains of people with attention deficit hyperactivity disorder (ADHD), according to a study being presented today at the annual meeting of the Radiological Society of North America (RSNA). Researchers said the method could help physicians and parents make better informed decisions about medication.
ADHD is a common disorder in children and adolescents that can continue into adulthood. Symptoms include hyperactivity and difficulty staying focused, paying attention and controlling behavior. The American Psychiatric Association reports that ADHD affects 3 to 7 percent of school-age children.
Psychostimulant medications such as Ritalin are among the drugs commonly used to reduce ADHD symptoms. Psychostimulants affect levels of dopamine, a neurotransmitter in the brain associated with addiction.
"Studies show that psychostimulant drugs increase dopamine levels and help the kids that we suspect have lower dopamine levels," said Vitria Adisetiyo, Ph.D., postdoctoral research fellow at the Medical University of South Carolina in Charleston, S.C. "As brain iron is required for dopamine synthesis, assessment of iron levels with MRI may provide a noninvasive, indirect measure of dopamine."
Dr. Adisetiyo and colleagues explored this possibility by measuring brain iron in 22 children and adolescents with ADHD and 27 healthy control children and adolescents using an MRI technique called magnetic field correlation (MFC) imaging. The technique is relatively new, having been introduced in 2006 by study co-authors and faculty members Joseph A. Helpern, Ph.D., and Jens H. Jensen, Ph.D.
"MRI relaxation rates are the more conventional way to measure brain iron, but they are not very specific," Dr. Adisetiyo said. "We added MFC because it offers more refined specificity."
The results showed that the 12 ADHD patients who had never been on medication had significantly lower MFC than the 10 ADHD patients who had been on psychostimulant medication or the 27 typically developing children and adolescents in the control group. In contrast, no significant group differences were detected using relaxation rates or serum measures. The lower brain iron levels in the non-medicated group appeared to normalize with psychostimulant medication.
MFC imaging’s ability to noninvasively detect the low iron levels may help improve ADHD diagnosis and guide optimal treatment. Noninvasive methods are particularly important in a pediatric population, Dr. Adisetiyo noted.
"This method enables us to exploit inherent biomarkers in the body and indirectly measure dopamine levels without needing any contrast agent," she said.
If the results can be replicated in larger studies, then MFC might have a future role in determining which patients would benefit from psychostimulants—an important consideration because the drugs can become addictive in some patients and lead to abuse of other psychostimulant drugs like cocaine.
"It would be beneficial, when the psychiatrist is less confident of a diagnosis, if you could put a patient in a scanner for 15 minutes and confirm that brain iron is low," she said. "And we could possibly identify kids with normal iron levels who could potentially become addicts."
Along with replicating the results in a larger population of patients, the researchers hope to expand their studies to look at the relationship between cocaine addiction and brain iron.
The transition from anatomic MRI to functional MRI (fMRI) requires the measurement of some form of neuronal activity of a particular region at any given moment. There are many methods of measuring such activity, from electroencephalography (EEG) or magnetoencephalography (MEG), to deep tissue...
MRI scan #5:
So this is the last picture from my MRI scan. This is the most detailed picture, since it has the most layers.
Here you can both see tendons, muscle tissue, bones, wrinkels on my skin and even the veins in my fingers (the white contrasted picture it is in the last couple of frames, some black veins at the bottom of my fingers!)!
So now that you have seen my hand on the inside, I only have one question for you:
What looks wrong with my hand!?
Transparent MRI scan.
† GENESIS †
On the atomic level, there are two prerequisites for a particle to be imaged via MRI: a magnetic moment (μ) and an angular momentum (J). A magnetic moment is the torque on a magnet or charge when it is placed in a magnetic field, while the angular momentum is the mass of a spinning object...
An MRI scan reveals the gross anatomical structure of the human brain.
Credit: Courtesy FONAR Corporation
High resolution MRI images of adult zebrafish anatomy. Resolution 23 µm x 23 µm x 125 µm 9.4 Tesla (Avance 400 MHz) 1H Cryoprobe.
3D Load-Bearing CT Scans in the Management of Foot Problems.
As explained by Mr. Andy Goldberg, a consultant orthopaedic surgeon in the video above, 2D radiographs have traditionally been the modality of choice for assessing foot injuries. The Royal National Orthopaedic Hospital in conjunction with the Institute of Orthopaedics and Musculo-Skeletal Sciences at University College Londona are using a new load-bearing 3D scanning system to manage shoe-related issues.
With the new scanning technology, perhaps we can finally make better shoes of all kinds that conform to the needs of our feet and not the other way around.
A 34yo woman was admitted to the outpatient urology clinic for acute right lumber pain, her medical history revealed medical treatment for right lower back pain with no previous abdominal or urologic surgery, five years before, three years after her second delivery, she had undergone an IUD placement, there had been no further examinations from that time for the IUD’s location and the IUS had not been replaced or removed, she even got pregnant two years after the IUD insertion and had an abortion, she had no severe chronic or acute pelvic and/or abdominal pain during the past years; her physical examination was normal, routine laboratory investigations, including urinalysis, revealed normal findings; a plain x-ray of the abdomen demonstrated an opaque spiral shaped shadow, resembling an IUD, located in the right upper quadrant of the abdomen; computerized tomography of the pelvis and abdomen confirmed the IUD at the right half of the abdomen in the mesentery, to remove the intra abdominally far migrated IUD, we planned a laparoscopic removal of the apparatus, however, the patient didn’t want surgery since she had no severe symptoms over the past years following the IUD placement, this patient presented with a very rare far migrated intra abdominal IUD, clinicians should be mindful of asymptomatic patients with previously placed IUDs; periodic follow-up is mandatory, laparoscopic removal of the intra abdominal IUD or conservative management could be preferred based on the patient and the characteristics of the IUD
