Lesions associated with mineral deposition in the lymph nodes and lungs of cattle: a case-control study of environmental health hazard.

This report focuses on the state of health of the cattle raised in the district of Taranto - city of Italy rated as environmentally at risk. Representative samples of lungs, bronchial and mediastinal lymph nodes of cattle from district of Taranto's slaughterhouses were collected. After a macroscopic examination, samples with marked lesions were processed for light microscopy. Samples were also observed with polarized light microscopy, scanning electron microscopy and with microanalysis. The macroscopic examination revealed that 60 out of 183 samples showed marked lesions. Lung alterations were characterized by thickening of the alveolar septa and by the latter's modifying action on the alveolar spaces, foci of fibrosis and bronchopulmonary inflammation. For 51 out of the 60 samples observed, the histological examination confirmed the presence of pneumoconiosis and lymph nodal anthracosis. Energy-dispersive X-ray microanalysis of lung samples identified a wide range of elements including silicon, aluminium, titanium, iron, carbon and small amount of the other metals. In the lymph-nodes the same kind of metals with a different levels of distribution was observed. Our survey on cattle farmed in areas at high risk of pollution may be helpful to the estimation of the exposure risk for man to environmental contaminants and to the evaluation of the occurrence of the pathological manifestations as well.

White matter hyperintensities on brain magnetic resonance in systemic sclerosis.

OBJECTIVE: To evaluate the brain status of patients with systemic sclerosis (SSc). METHODS: Fourteen female patients with SSc aged 24-74, with a disease duration of 1-12 years and without other relevant systemic diseases, were enrolled. All patients and an age matched female control group (CG) of 14 clinically normal subjects, underwent brain magnetic resonance examination at 1.5 T; spin echo proton density weighted images were evaluated. Mann-Whitney U and Spearman rank correlation tests were used for statistical analysis. RESULTS: 170 white matter hyperintensities >/=2 mm in diameter were counted in the patient group (range 0-75, mean 12.1, median 4.5), only 13 in the CG (0-2, 0.9, 1, respectively), with a significant difference (p = 0.011). Moreover, 208 white matter hyperintensities <2 mm were found in the patient group (0-38, 14.9, 8, respectively), only 31 in the CG (0-7, 2.0, 1, respectively), with a significant difference (p = 0.006). No statistically significant correlation between the number of hyperintensities and either patient's age or disease duration was observed. CONCLUSION: White matter hyperintensities are more common in patients with SSc than in a CG. These findings might be related to obliterative microvascular processes due to the disease. Early brain involvement in patients with SSc may occur.

Evaluation of Gd-enhancement in brain MR of multiple sclerosis: image subtraction with and without magnetization transfer.

The aim of our study was to test the possibility of using image subtraction in detecting enhancing lesions in brain MR scans with and without magnetization transfer (MT) in multiple sclerosis (MS). Ten MS patients underwent 1.5-T MR imaging of the brain with spin-echo T1-weighted sequences with and without MT, repeated after 0.1 mmol/kg of an usual two-compartment paramagnetic contrast agent (Gadoteridol, Gd-HP-DO3A). Precontrast images were subtracted from postcontrast. Enhancing lesions were counted on the postcontrast images only (post-Gd), comparing pre- and postcontrast images by direct visual control (pre/post-Gd), and on the subtracted images (SI) only. Without MT, 36 enhancing lesions were counted on post-Gd, 36 on pre/post-Gd, and 59 on SI; using MT, 69, 52, and 50, respectively. Significant differences were found for pre/post-Gd without MT vs SI without MT ( p=0.028) and vs pre/post-Gd with MT ( p=0.012) as well as for pre/post-Gd with MT vs post-Gd with MT ( p=0.028). With pre/post-Gd, MT allowed the detection of 1.6 enhancing lesions per patient more than without MT. Whereas the SI without MT allow the detection of an increased number of enhancing lesions, SI with MT do not. An off-site final assessment allowed calculation of sensitivity and positive predictive value as follows: without MT were 63 and 94% (post-Gd), 67 and 100% (pre/post-Gd), 96 and 88% (SI); and with MT were 93 and 73% (post-Gd), 96 and 100% (pre/post-Gd), 91 and 98% (SI), respectively. Thus, SI seem to increase the sensitivity without MT; moreover, they could be used to correct the pseudoenhancement that impair post-Gd images with MT.

[Brain magnetic resonance with magnetization transfer in multiple sclerosis. Lesion hyperintensity before and after intravenous gadolinium administration]. / Risonanza Magnetica encefalica con trasferimento della magnetizzazione nella sclerosi multipla. Iperintensità lesionale prima e dopo somministrazione endovenosa di Gadolinio.

PURPOSE: To evaluate lesion contrast enhancement in brain magnetic resonance (MR) images with and without magnetization transfer pulse (MT) in patients affected with multiple sclerosis (MS). MATERIAL AND METHODS: Ten patients affected with relapsing-remitting MS underwent a 1.5-T (Magnetom Vision, Siemens) MR examination with T1-weighted spin-echo sequences without MT (TR/TE = 630/14 ms) and with MT (840/14 ms) using the following common parameters: 21 para-axial slices (thickness 5 mm, 10% gap); matrix 256 x 256; field of view 25 cm (rectangular 5/8); 2 excitations. The postcontrast sequences with and without MT were acquired in a randomized order, starting 5 minutes after the intravenous injection of 0.1 mmol/kg Gadoteridol (ProHance, Bracco). The images were blindly evaluated in four separate sessions: only the postcontrast images with MT (post-Gd with MT); only the postcontrast images without MT (post-Gd without MT); comparing the pre- and postcontrast images with MT (pre/post-Gd with MT); comparing the pre- and postcontrast images without MT (pre/post-Gd without MT). The number of hyperintense areas referred to contrast enhancement and the evaluation time were measured for each session. The Wilcoxon test was used for statistical analysis. RESULTS: The number of areas referred to lesion contrast enhancement per patient were as follows: post-Gd with MT, 6.9 +/- 6.8 (mean +/- standard deviation) (range 1-24); post-Gd without MT, 3.6 +/- 4.3 (0-14); pre/post-Gd with MT, 5.2 +/- 6.1 (1-21); pre/post-Gd without MT, 3.6 +/- 4.9 (0-16). A nonsignificant difference was found for the comparison between post-Gd without MT and pre/post-Gd without MT while significant differences were found between post-Gd with MT and pre/post-Gd with MT (p = .028), pre/post-Gd without MT and pre/post-Gd with MT (p = .012), as well as between post-Gd without and post-Gd with MT (p = .008). The mean evaluation time for the different sessions was always less than a minute, ranging from 33 seconds for pre/post-Gd without MT to 51 seconds for post-Gd with MT. CONCLUSIONS: The postcontrast sequence obtained with the MT pulse detects more active lesions than the postcontrast sequence without MT. However, the comparison with the plain images with the MT pulse is mandatory to exclude pseudoenhancement foci, i.e. hyperintense areas already present in the precontrast images with the MT pulse, without disruption of the blood-brain barrier. The post-Gd without MT sequence needs not be compared with the precontrast images without MT. Differences in evaluation time are practically negligible.