ABSTRACT
OBJECTIVE: To determine the changes in basal ganglia iron content associated with various stages of idiopathic Parkinson's disease. DESIGN: Prospective magnetic resonance imaging study using a 2-T magnet. SETTING: Ambulatory care referral center. PATIENTS AND PARTICIPANTS: Forty-five patients suffering from levodopa-responsive Parkinson's disease and 45 age-matched controls. MAIN OUTCOME MEASURES: The T2 relaxation time calculated in various regions of the basal ganglia, the duration of Parkinson's disease, and the age of subjects. RESULTS: Patients with Parkinson's disease exhibited significantly decreased T2 relaxation time in the pars compacta of the substantia nigra compared with controls (P < .01), regardless of disease duration. Patients with a duration of illness above 10 years (n = 12) exhibited significantly increased T2 relaxation time in the anterior and posterior putamen (P < .005 and P < .01, respectively) and in the pallidum (P < .05) compared with age-matched controls. Putamental T2 relaxation time positively correlated with disease duration (P < .05). CONCLUSION: These results suggest that more complex brain iron changes than those previously reported are associated with idiopathic Parkinson's disease, including increased nigral iron content and decreased putamenal and pallidal iron concentration in patients with a duration of illness above 10 years.
Subject(s)
Iron/metabolism , Parkinson Disease/diagnosis , Parkinson Disease/metabolism , Putamen/metabolism , Adult , Aged , Basal Ganglia/metabolism , Basal Ganglia/pathology , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Prospective Studies , Putamen/pathologySubject(s)
Carcinoma, Squamous Cell/diagnosis , Mouth Neoplasms/diagnosis , Tongue Neoplasms/diagnosis , Adult , Carcinoma, Squamous Cell/radiotherapy , Diagnosis, Differential , Female , Fibrosis/diagnosis , Humans , Mouth Floor/pathology , Mouth Neoplasms/radiotherapy , Neoplasm Recurrence, Local , Tongue/pathology , Tongue Neoplasms/radiotherapyABSTRACT
Magnetic resonance imaging is rapidly becoming the study of choice for evaluating tumors of the larynx and pharynx. It is superior to computed tomography because of its multiplanar imaging capability and greater soft tissue contrast resolution. Other advantages are that it is a noninvasive procedure, gives three-dimensional images that are not degraded by bony or overshoot reconstruction artifacts, and is sensitive to flowing blood, thus obviating the use of x-ray techniques with IV contrast agents. MRI is particularly well suited to laryngeal and nasopharyngeal malignancies because the deep extent of these tumors is difficult to assess by clinical examination alone.
Subject(s)
Head and Neck Neoplasms/diagnosis , Magnetic Resonance Imaging , Follow-Up Studies , Humans , Recurrence , Tomography, X-Ray ComputedABSTRACT
Two cases of uretero-arterial fistulas are reported occurring in two patients after pelvic exenteration for cancer with cutaneous ureterostomy. In the first case a pelvic irradiation has been performed before surgery; in the other case a high degree of atherosclerosis was noted. Iliac artery-ureteral fistulas are uncommon and they are generally associated with several underlying pathogenic factors such as: arterial pathology, surgical complications, septis, prior x-ray therapy. It is not doubtfull that the use of a long term ureteral stenting contribute to the development of the fistula. The constant pulsation of the artery transmitted through the ureteral and the arterial wall to a stiff intraluminal stent produces a necrosis then a fistula between them. Retrograde uretero-pyelography seems the better diagnostic test. Treatment of these fistulas is always complex because operation should manage both vascular and ureteral injuries. Embolisation is a less invasive method of treatment but it needs a particular technics. Prognosis of such fistulas is poor and some precautions should be taken to prevent these accidents. When ureteral catheterization is needed for a long term one should assess the arterial conditions and during an operation catheterized ureter should be put far from the artery or an attempt for an epiplooplasty should be performed.
