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1.
Am J Physiol Endocrinol Metab ; 281(4): E848-56, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11551863

ABSTRACT

Hepatic glucose synthesis from glycogen, glycerol, and the tricarboxylic acid (TCA) cycle was measured in five overnight-fasted subjects by (1)H, (2)H, and (13)C NMR analysis of blood glucose, urinary acetaminophen glucuronide, and urinary phenylacetylglutamine after administration of [1,6-(13)C(2)]glucose, (2)H(2)O, and [U-(13)C(3)]propionate. This combination of tracers allows three separate elements of hepatic glucose production (GP) to be probed simultaneously in a single study: 1) endogenous GP, 2) the contribution of glycogen, phosphoenolpyruvate (PEP), and glycerol to GP, and 3) flux through PEP carboxykinase, pyruvate recycling, and the TCA cycle. Isotope-dilution measurements of [1,6-(13)C(2)] glucose by (1)H and (13)C NMR indicated that GP in 16-h-fasted humans was 10.7 +/- 0.9 micromol.kg(-1).min(-1). (2)H NMR spectra of monoacetone glucose (derived from plasma glucose) provided the relative (2)H enrichment at glucose H-2, H-5, and H-6S, which, in turn, reflects the contribution of glycogen, PEP, and glycerol to total GP (5.5 +/- 0.7, 4.8 +/- 1.0, and 0.4 +/- 0.3 micromol.kg(-1).min(-1), respectively). Interestingly, (13)C NMR isotopomer analysis of phenylacetylglutamine and acetaminophen glucuronide reported different values for PEP carboxykinase flux (68.8 +/- 9.8 vs. 37.5 +/- 7.9 micromol.kg(-1).min(-1)), PEP recycling flux (59.1 +/- 9.8 vs. 27.8 +/- 6.8 micromol.kg(-1).min(-1)), and TCA cycle flux (10.9 +/- 1.4 vs. 5.4 +/- 1.4 micromol.kg(-1).min(-1)). These differences may reflect zonation of propionate metabolism in the liver.


Subject(s)
Acetaminophen/analogs & derivatives , Blood Glucose/metabolism , Citric Acid Cycle , Gluconeogenesis , Glucose/metabolism , Glutamine/analogs & derivatives , Liver/metabolism , Acetaminophen/urine , Adult , Carbon Isotopes , Deuterium , Female , Glutamine/urine , Humans , Hydrogen , Kinetics , Liver Glycogen/metabolism , Magnetic Resonance Spectroscopy , Male , Models, Biological , Phosphoenolpyruvate/metabolism , Propionates/metabolism , Reference Values , Time Factors , Water/metabolism
2.
Am J Cardiol ; 84(8): 941-3, A7, 1999 Oct 15.
Article in English | MEDLINE | ID: mdl-10532519

ABSTRACT

In 29 patients with advanced heart failure, therapy tailored to hemodynamic goals was attempted using an initial infusion of dobutamine and nitroglycerin (the latter in those with pulmonary hypertension) followed by escalating doses of oral vasodilators. In the 23 patients who were weaned from inodilator therapy, significant improvements in hemodynamic parameters and a low 90-day hospital readmission rate were documented.


Subject(s)
Cardiotonic Agents/therapeutic use , Dobutamine/therapeutic use , Heart Failure/drug therapy , Hemodynamics/drug effects , Nitroglycerin/therapeutic use , Vasodilator Agents/therapeutic use , Adult , Aged , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Cardiotonic Agents/administration & dosage , Dobutamine/administration & dosage , Female , Heart Failure/complications , Humans , Hypertension, Pulmonary/drug therapy , Hypertension, Pulmonary/etiology , Infusions, Intravenous , Infusions, Parenteral , Isosorbide Dinitrate/administration & dosage , Male , Middle Aged , Nitroglycerin/administration & dosage , Retrospective Studies , Treatment Outcome , Vasodilator Agents/administration & dosage
3.
Am J Physiol ; 275(5): E843-52, 1998 11.
Article in English | MEDLINE | ID: mdl-9815005

ABSTRACT

Anaplerotic, pyruvate recycling, and gluconeogenic fluxes were measured by 13C isotopomer analysis of plasma glucose, urinary phenylacetylglutamine, and urinary glucuronide in normal, 24-h-fasted individuals after ingestion of [U-13C]propionate, phenylacetate, and acetaminophen. Plasma glucose isotopomer analysis reported a total anaplerotic flux of 5.92 +/- 1.03 (SD) relative to citrate synthase. This was not significantly different from glucuronide and phenylacetylglutamine analyses (6.08 +/- 1.16 and 7. 14 +/- 1.94, respectively). Estimates of pyruvate recycling from glucose and glucuronide isotopomer distributions were almost identical (3.55 +/- 0.99 and 3.66 +/- 1.11, respectively), whereas phenylacetylglutamine reported a significantly higher estimate (5.74 +/- 2.13). As a consequence, net gluconeogenic flux reported by phenylacetylglutamine (1.41 +/- 0.28) was significantly less than that reported by glucose (2.37 +/- 0.64) and glucuronide (2.42 +/- 0. 76). This difference in fluxes detected by analysis of phenylacetylglutamine vs. hexose is likely due to compartmentation of hepatic metabolism of propionate. Net gluconeogenic flux estimates made by use of this stable isotope method are in good agreement with recent measurements in humans with [14C]propionate.


Subject(s)
Acetaminophen/pharmacokinetics , Blood Glucose/metabolism , Gluconeogenesis , Phenylacetates/metabolism , Propionates/metabolism , Acetaminophen/blood , Acetaminophen/urine , Adult , Carbon Isotopes , Female , Glucuronates/metabolism , Glutamine/analogs & derivatives , Glutamine/pharmacokinetics , Humans , Magnetic Resonance Spectroscopy/methods , Male , Pyruvates/metabolism
4.
J Comput Assist Tomogr ; 21(6): 969-73, 1997.
Article in English | MEDLINE | ID: mdl-9386292

ABSTRACT

PURPOSE: Our goal was to describe the MR findings of volume overload (VO) in the lower extremities. METHOD: Fifteen individuals were studied, including eight healthy controls and seven patients with VO (four cardiac, three renal). MR evaluation included various SE techniques. Edema detection, localization, and symmetry were assessed subjectively. Relaxation time estimates were also made of the subcutaneous tissue, marrow, and three muscles. RESULTS: Subcutaneous tissue was markedly edematous in seven of seven patients and asymmetric in four of seven, whereas marrow was normal in all patients. Muscle edema was mild and asymmetric in six and two of seven patients, respectively. Perifascial fluid collections were identified in six of seven patients. CONCLUSION: Subcutaneous tissue edema is the dominant feature of VO in the lower extremities. Perifascial fluid is common but does not necessarily distribute symmetrically. Muscle edema is relatively mild. These findings should aid in identifying VO as the potential cause of swelling in patients with swollen legs.


Subject(s)
Edema/diagnosis , Leg/pathology , Magnetic Resonance Imaging , Adult , Aged , Edema/etiology , Female , Humans , Male , Middle Aged
5.
Magn Reson Med ; 35(6): 820-6, 1996 Jun.
Article in English | MEDLINE | ID: mdl-8744008

ABSTRACT

Several substrates are available in vivo for oxidation by the myocardium. Although substrate selection has been studied extensively in normoxic myocardium, relatively little is known about substrate preference very early during reperfusion after ischemia. Carbon-13 isotopomer analysis was used to study substrate usage by nonischemic and reperfused-ischemic myocardium in a working heart that was subjected to 15 min or regional ischemia and reperfused for 5 min. Compared with nonischemic myocardium, the contribution of acetoacetate to acetyl coenzyme A was increased in the reperfused-ischemic region, and the contribution of exogenous lactate was decreased. Free fatty acid oxidation, however, was not different in the two regions. These results indicate that (1) early during reperfusion, ketone body oxidation may be more significant than has been emphasized, (2) the relative contribution of fatty acids to acetyl coenzyme A is not sensitive to ischemia followed by reperfusion, and (3) Carbon-13 magnetic resonance spectroscopy methods may be used for analysis of spatial heterogeneity of metabolism in the heart.


Subject(s)
Magnetic Resonance Spectroscopy , Myocardial Reperfusion , Myocardium/metabolism , Acetoacetates/metabolism , Acetyl Coenzyme A/metabolism , Animals , Butyrates/metabolism , Fatty Acids, Nonesterified/metabolism , Glucose/metabolism , Glutamates/metabolism , In Vitro Techniques , Lactates/metabolism , Lactic Acid , Male , Rabbits
7.
J Am Coll Surg ; 180(3): 286-92, 1995 Mar.
Article in English | MEDLINE | ID: mdl-7874338

ABSTRACT

BACKGROUND: We examined whether or not continuous arteriovenous hemofiltration (CAVH), in the absence of renal failure, would improve either hemodynamic abnormalities or survival in a canine model of septic shock. STUDY DESIGN: Escherichia coli 0111, as an intraperitoneal clot, was surgically implanted into 21 one- to two-year-old purpose-bred beagles. The dogs were randomized to no CAVH (control group, n = 7), sham CAVH (extracorporeal circulation without hemofiltration, n = 7), or true CAVH (hemofiltration with removal of 600 mL/hour of ultrafiltrate, n = 7). Hemofiltration began one hour after clot implantation and continued for six hours. All dogs received antibiotics and had serial hemodynamic and laboratory evaluations. RESULTS: During the first seven hours of the study, all dogs displayed a progressive, significant decrease in mean arterial pressure, cardiac index, left ventricular ejection fraction, and serum pH (all p < 0.05). Two of seven dogs in the control group, one of seven dogs in the sham CAVH group, and one of seven dogs in the true CAVH group survived seven days after clot implantation. True CAVH, which included fluid replacement with lactated Ringer's solution, significantly increased serum lactate and decreased serum bicarbonate levels after six hours (both p < 0.05). However, pH did not differ between the three treatment groups (p > 0.20). Continuous arteriovenous hemofiltration therapy had no significant effect on cardiovascular abnormalities or survival. CONCLUSIONS: The results of this study suggest that CAVH would be unlikely to provide benefit to patients with gram-negative septic shock, in the absence of renal failure.


Subject(s)
Escherichia coli Infections/therapy , Hemofiltration , Shock, Septic/therapy , Animals , Bicarbonates/blood , Blood Pressure/physiology , Cardiac Output/physiology , Disease Models, Animal , Dogs , Escherichia coli Infections/blood , Escherichia coli Infections/physiopathology , Extracorporeal Circulation , Fluid Therapy , Hydrogen-Ion Concentration , Isotonic Solutions/therapeutic use , Lactates/blood , Prospective Studies , Pulmonary Wedge Pressure/physiology , Ringer's Lactate , Shock, Septic/blood , Shock, Septic/physiopathology , Stroke Volume/physiology , Survival Rate , Thrombosis/microbiology , Ventricular Function, Left/physiology
8.
J Infect Dis ; 169(3): 553-61, 1994 Mar.
Article in English | MEDLINE | ID: mdl-7512609

ABSTRACT

Monoclonal antibodies (MAbs) specific for O polysaccharide or core oligosaccharide/lipid A of Escherichia coli O111:B4 lipopolysaccharide (LPS) were compared in canine septic shock. Animals received O-specific, core-specific, or control murine IgG2a MAbs (or saline) before intraperitoneal implantation of an E. coli O111:B4-infected clot. Animals were further randomized to ceftriaxone or saline. O-specific MAb significantly reduced bacteremia and endotoxemia but not serum tumor necrosis factor. Core-specific MAb significantly increased mean arterial pressure from day 4 to 28 (P = .02). In dogs not receiving ceftriaxone, survival was enhanced by O-specific MAb (4/5) compared with core-specific MAb (0/5) and control (1/8) (P = .03). Survival rates were similar (P = .22) but survival was prolonged in antibiotic-treated animals also receiving O-specific MAb (P = .02 vs. core-specific MAb and controls) or core-specific MAb (P = .08 vs. controls). These data support the complex role of LPS in sepsis and the discrete functional effects of MAbs specific for different elements of LPS.


Subject(s)
Antibodies, Monoclonal/immunology , Endotoxins/immunology , Escherichia coli/immunology , Lipopolysaccharides/immunology , Shock, Septic/immunology , Animals , Bacteremia/immunology , Body Temperature , Body Weight , Ceftriaxone/therapeutic use , Disease Models, Animal , Dogs , Escherichia coli/isolation & purification , Hemodynamics , O Antigens , Polysaccharides, Bacterial/immunology , Shock, Septic/blood , Shock, Septic/drug therapy , Tumor Necrosis Factor-alpha/analysis
9.
Am J Physiol ; 266(2 Pt 2): H757-68, 1994 Feb.
Article in English | MEDLINE | ID: mdl-8141377

ABSTRACT

The mechanism responsible for sepsis-induced myocardial depression is not known. To determine if sepsis-induced myocardial depression is caused by inadequate free energy available for work, we studied myocardial energy metabolism in a canine model of sepsis. Escherichia coli-infected (n = 18) or sterile (n = 16) fibrin clots were implanted intraperitoneally into beagles. Myocardial function and structure was assessed using radionuclide ventriculograms, echocardiograms, and light and electron microscopy. The adequacy of energy metabolism was evaluated by comparing catecholamine-induced work increases [myocardial O2 consumption (MVO2) and rate pressure product (RPP)] with a simultaneously obtained estimate of intracellular free energy [phosphocreatine-to-adenosine triphosphate ratio (PCr:ATP)] determined by 31P-magnetic resonance spectroscopy. When compared with control animals, septic animals had a decrease in left ventricular ejection fraction (EF, P < 0.0001) on day 1 and fractional shortening (FS, P < 0.0003) on day 2 after clot implantation. On day 2, neither septic nor control animals had statistically significant decreases in PCr:ATP, despite catecholamine-induced increases in MVO2 and RPP (mean maximal increases in septic animals 135 +/- 31 and 51 +/- 10%, respectively). Light and electron microscopic findings showed that hearts of septic animals, compared with control animals, had a greater degree of morphological abnormalities. Thus, in a canine model of sepsis with alterations in myocyte ultrastructure and documented myocardial depression (decreased EF and FS), intracellular free energy levels (PCr:ATP) were maintained despite catecholamine-induced increases in myocardial work (increased MVO2 and RPP), suggesting high-energy synthetic capabilities are not limiting cardiac function.


Subject(s)
Bacteremia/metabolism , Bacteremia/physiopathology , Energy Metabolism/physiology , Escherichia coli Infections/metabolism , Escherichia coli Infections/physiopathology , Heart/physiology , Myocardium/metabolism , Myocardium/pathology , Adenosine Triphosphate/metabolism , Animals , Bacteremia/pathology , Disease Models, Animal , Dogs , Endothelium, Vascular/pathology , Energy Metabolism/drug effects , Epinephrine/pharmacology , Escherichia coli Infections/pathology , Heart/drug effects , Mitochondria, Heart/pathology , Mitochondrial Swelling , Myocardium/cytology , Myofibrils/pathology , Myofibrils/ultrastructure , Oxygen Consumption/drug effects , Phenylephrine/pharmacology , Phosphocreatine/metabolism , Reference Values , Time Factors , Ventricular Function, Left/drug effects
10.
West J Med ; 159(5): 625, 1993 Nov.
Article in English | MEDLINE | ID: mdl-8279179
11.
J Exp Med ; 176(4): 1175-82, 1992 Oct 01.
Article in English | MEDLINE | ID: mdl-1383377

ABSTRACT

Inhibitors of nitric oxide synthase (NOS) have been reported to increase mean arterial pressure in animal models of sepsis and recently have been given to patients in septic shock. However, controlled studies to determine the effects of these agents on cardiovascular function and survival in awake animal models of sepsis have not been reported. To examine the therapeutic potential of NOS inhibition in septic shock, we challenged canines with endotoxin (2 or 4 mg/kg i.v.) and treated them with either normal saline or N omega-amino-L-arginine (10 or 1 mg/kg/h), the most specific inhibitor available for the isoform of NOS implicated in septic shock. Endotoxemic animals treated with N omega-amino-L-arginine (n = 11) had higher systemic and pulmonary vascular resistance indices (SVRI and PVRI, p less than or equal to 0.033) and decreased heart rates (p = 0.009), cardiac indices (CI, p = 0.01), oxygen delivery indices (p = 0.027), and oxygen consumption indices (p = 0.046) compared with controls (n = 6). Moreover, N omega-amino-L-arginine increased mortality rates after endotoxin challenge (10 of 11 vs. 1 of 6 controls, p = 0.005). Administration of L-arginine did not improve survival or alter the cardiopulmonary effects of N omega-amino-L-arginine, which suggests that inhibition of NOS may not have been competitive. In normal animals, N omega-amino-L-arginine alone (n = 3) increased SVRI (p = 0.0008) and mean arterial pressure (p = 0.016), and decreased CI (p = 0.01) compared with saline-treated controls (n = 3), but, at the high dose, also produced neuromuscular rigidity and seizure-like activity that was not apparent in the endotoxemic model. Thus, the mortality rate from endotoxemia increased either because of NOS inhibition per se or because of properties unique to N omega-amino-L-arginine, or both.


Subject(s)
Amino Acid Oxidoreductases/antagonists & inhibitors , Arginine/analogs & derivatives , Endotoxins/toxicity , Shock, Septic/physiopathology , Vascular Resistance/drug effects , Analysis of Variance , Animals , Arginine/pharmacology , Arginine/toxicity , Dogs , Heart/drug effects , Heart Rate/drug effects , Nitric Oxide Synthase , Oxygen Consumption/drug effects , Pulmonary Circulation/drug effects , Shock, Septic/blood , Time Factors
13.
Clin Podiatr Med Surg ; 5(4): 931-44, 1988 Oct.
Article in English | MEDLINE | ID: mdl-3071415

ABSTRACT

Computed tomography (CT) has become the gold standard for cross-sectional imaging in the foot and ankle. The literature is full of studies and case reports where CT has definately elucidated osseous and soft-tissue pathology.


Subject(s)
Ankle/diagnostic imaging , Foot/diagnostic imaging , Tomography, X-Ray Computed , Humans , Tomography, X-Ray Computed/methods
14.
Clin Podiatr Med Surg ; 5(4): 945-65, 1988 Oct.
Article in English | MEDLINE | ID: mdl-3071416

ABSTRACT

The first image obtained in a live human with MR was performed in July 1977. It took 4 hours and 45 minutes to produce a single slice. Imaging devices became available routinely in late 1982 and early 1983. Since that time, dramatic technologic growth and improvement has brought MR to the forefront of radiology. It is now believed to be the modality of choice for delineating and staging soft-tissue abnormalities and also shows great promise for evaluating marrow replacing processes. Recently, hyaline cartilage has been identified with MR. Previously in radiology, hyaline cartilage could only be identified when it was outlined by contrast material. Cartilage per se is not a radiographic density. MRI therefore offers potential hope as a cartilage-imaging modality. In addition, the synovium is well delineated with MRI, and it is conceivable that in the future we will use MRI to quantitate synovial proliferation and to monitor response to therapy. The future is quite bright. Currently, spatial resolutions below 1 mm are common with slice thicknesses available at 2 to 2.5 mm. In the future, however, sections will become thinner, spatial resolution will become greater, and localized radiofrequency coils will be developed for specific anatomic regions. Practicing podiatrists should now consider MR a useful tool in the imaging armamentarium.


Subject(s)
Ankle/pathology , Foot/pathology , Magnetic Resonance Imaging , Ankle/anatomy & histology , Foot/anatomy & histology , Foot Diseases/diagnosis , Humans , Physical Phenomena , Physics
15.
Clin Podiatr Med Surg ; 5(1): 25-36, 1988 Jan.
Article in English | MEDLINE | ID: mdl-2962725

ABSTRACT

The radiographic modalities discussed in this article are useful adjunctive techniques in the evaluation of arthritic disease. None of these modalities should be considered for baseline study. Rather, they should be considered following plain film examination when further information is required. The one modality that may be considered for a screening examination is radionuclide imaging. It is most useful when early diagnostic information regarding the extent of pathology is required. A pattern of activity can provide important information to the clinician, enabling an accurate diagnosis. Arthrography is best reserved for the evaluation of articular cartilage of a particular joint. A double-contrast arthrogram should be performed in this case. The technique has little application in the evaluation of polyarticular disease. Tenography is most useful in differentiating tenosynovitis from stenosing tenosynovitis. The differentiation is important because a diagnosis of stenosing tenosynovitis usually necessitates surgical intervention. Spontaneous rupture can be evaluated with tenography, but is is probably best evaluated with MRI. CT may be used in the evaluation of both soft-tissue and articular pathology. It is perhaps best employed in the evaluation of articular pathology of the rearfoot. This technique should not be used as a screening examination for vague foot pain. MRI is the newest and most exciting imaging modality available. The excellent soft-tissue contrast provides an accurate means of evaluating the extraarticular manifestations of arthritic disease. MRI may aid in differentiating rheumatoid nodules from neuromas in rheumatoid patients with excessive forefoot disease. It is also useful in the evaluation of tendon pathology, particularly spontaneous ruptures. This technique is only in its infancy, but technologic advances are rapidly making it a major force in the field of diagnostic imaging.


Subject(s)
Arthritis/diagnosis , Foot Diseases/diagnosis , Ankle Joint/diagnostic imaging , Arthritis/diagnostic imaging , Arthrography , Bone and Bones/diagnostic imaging , Foot Diseases/diagnostic imaging , Humans , Magnetic Resonance Imaging , Radionuclide Imaging , Tendons/diagnostic imaging , Tomography, X-Ray Computed
16.
Neurology ; 37(9): 1566-7, 1987 Sep.
Article in English | MEDLINE | ID: mdl-3627465
17.
Thorax ; 42(6): 457-61, 1987 Jun.
Article in English | MEDLINE | ID: mdl-3660305

ABSTRACT

The particle size of bronchodilator aerosols may be important in determining the site of deposition in the lung and their therapeutic effect. The distribution of aerosols (labelled with technetium-99m diethylene triamine pentacetic acid) of two different particle sizes has been studied by gamma camera imaging. The particles had mass median aerodynamic diameters (geometric standard deviations) of 1.4 (1.4) and 5.5 (2.3) micron, and they were administered from a jet nebuliser to eight patients with chronic severe stable asthma. There was no significant difference in peripheral lung deposition with the two aerosols in any patient. The bronchodilator effect of the two aerosols was determined from cumulative dose-response studies. To avoid large doses that might mask possible differences in effect due to aerosol size, small, precisely determined incremental amounts of salbutamol (25-250 micrograms total lung dose) were used. The two doses were given via a nebuliser on separate occasions and the bronchodilator response was measured from FEV1, forced vital capacity, and peak expiratory flow 30 minutes after each dose. Bronchodilatation was similar with the two aerosols at each dose of salbutamol. There was therefore no difference in distribution within the lung or any difference in bronchodilator effect between an aerosol of small (1.4 micron) particle size and an aerosol of 5.5 microns in patients with severe but stable asthma.


Subject(s)
Asthma/physiopathology , Lung/physiopathology , Nebulizers and Vaporizers , Albuterol/administration & dosage , Albuterol/therapeutic use , Asthma/drug therapy , Dose-Response Relationship, Drug , Female , Humans , Lung/drug effects , Male , Middle Aged
18.
Radiographics ; 6(5): 891-911, 1986 Sep.
Article in English | MEDLINE | ID: mdl-3685515

ABSTRACT

Many types of artifacts may occur in magnetic resonance imaging. These artifacts may be related to extrinsic factors such as patient motion or metallic artifacts; they may be due specifically to the MR system such as power gradient drop off and chemical shift artifacts; they may occur as a consequence of general image processing techniques, as in the case of truncation artifacts and aliasing. Change in patient position, pulse sequence, or other imaging variables may improve some artifacts. Although reduction of some artifacts may require a service engineer, the radiologist has the responsibility to recognize MR imaging problems. The radiologist's knowledge of MR imaging artifacts is important to the continued maintenance of high image quality and is essential if one is to avoid confusing artifactual appearances with pathology.


Subject(s)
Magnetic Resonance Imaging , Diagnostic Errors , Humans , Magnetic Resonance Imaging/methods , Metals , Movement
20.
AJNR Am J Neuroradiol ; 7(4): 623-7, 1986.
Article in English | MEDLINE | ID: mdl-3088940

ABSTRACT

Eight patients with Sturge-Weber disease were evaluated by CT (six patients), MR (one patient), or both (one patient). CT scans of five of seven patients showed enlargement and increased enhancement of the choroid plexus on the same side as the facial and intracranial lesions. MRI showed similar findings in both patients examined. This enlargement, seen in six of eight cases of Sturge-Weber disease, is compatible with the presence of angiomatous malformations of the choroid plexus. It appears to be a common finding in this disease.


Subject(s)
Angiomatosis/diagnosis , Choroid Plexus/pathology , Magnetic Resonance Spectroscopy , Sturge-Weber Syndrome/diagnosis , Tomography, X-Ray Computed , Adult , Choroid Plexus/diagnostic imaging , Female , Humans , Infant , Male , Sturge-Weber Syndrome/diagnostic imaging
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