ABSTRACT
Early differential diagnosis and timely follow-up are advantageous in the management of Angiostrongylus cantonensis infection. This study aimed to characterize angiostrongyliasis in the rat brain for an 8-week period using magnetic resonance imaging (MRI) with contrast-enhanced T1-weighted images (T1WI), T2-weighted imaging (T2WI), fluid attenuation inversion recovery (FLAIR) and R2 mapping sequences. The data were analysed with Mathematica and Matlab software programs for weekly changes in each brain following the infection of 20, 50, 100 and 300 third-stage larvae (L3), respectively. The results showed that the average subarachnoid space detected by T2WI technique was peaked up to 10% increase of original size on day 35 after 100 or 300 larvae infection, while those infected with 20 or 50 larvae showed less than 4% increase during the entire course of observation. This increase was relevant to the mortality of the infected rats, because those with 100 or 300 larvae infections showed a sharp decrease in survival rate before day 40. After day 40, the average subarachnoid space was decreased, but the average ventricle size was persistently increased, with the highest increase observed in the group infected with 300 larvae on day 56. Furthermore, the R2 mapping mean and R2 mapping size were significantly different between the brains with severe infection (100 and 300 larvae groups together) and those with mild infection (20 and 50 larvae groups together) on day 49, but not on day 35. Our results showed that diagnosis for different quantity of larvae infection using MRI is possible and follow-up characterization is informative in revealing the effects of angiostrongyliasis on different brain areas. In conclusion, our results support the use of MRI as a non-invasive diagnostic technique for eosinophilic meningitis caused by A. cantonensis infection.
Subject(s)
Angiostrongylus cantonensis/isolation & purification , Magnetic Resonance Imaging/methods , Meningitis/diagnosis , Strongylida Infections/diagnosis , Animals , Brain/diagnostic imaging , Brain/parasitology , Contrast Media , Disease Models, Animal , Eosinophilia , Follow-Up Studies , Humans , Larva , Male , Meningitis/diagnostic imaging , Meningitis/mortality , Meningitis/parasitology , Radiography , Rats , Rats, Wistar , Sensitivity and Specificity , Strongylida Infections/diagnostic imaging , Strongylida Infections/mortality , Strongylida Infections/parasitology , Subarachnoid Space , Survival RateABSTRACT
Laser-assisted uvulopalatoplasty has been introduced as an alternative to uvulopalatopharyngoplasty for treatment of snoring and potentially of obstructive sleep apnea syndrome. Between July 1994 and June 1996, 192 patients underwent 227 laser-assisted uvulopalatoplasty procedures. Loud habitual snoring was evaluated in 42 women (21.8%) and 150 men (78.2%), who were then treated with laser-assisted uvulopalatoplasty. Among the 192 patients (227 procedures), with ages from 18 to 81 years (mean 42.6 years), 15.6% (30 patients) had more than one laser-assisted uvulopalatoplasty treatment. In our series, 80 patients (42.1%) had a history of obstructive sleep apnea syndrome in addition to snoring. Laser-assisted uvulopalatoplasty treatment in patients with loud snoring resulted in elimination of snoring in 61%, partial improvement of snoring in 26%, and no improvement in 13%. The overall success rate was 87%. The mean body mass index was significantly higher in the patients with no response after the operation (27.9 kg/m2) compared with that in the patients with a good response (25.9 kg/m2). Obese (body mass index >30 kg/m2) patients were more likely to have no response to laser-assisted uvulopalatoplasty treatment of snoring than patients with an ideal body weight (body mass index <25 kg/m2) (p < 0.01). We conclude that the body mass index may be of significant value in the postoperative success rate of laser-assisted uvulopalatoplasty for the treatment of snoring.
