A 12-year-old female spayed dachshund was presented for emergency assessment of respiratory distress, characterized by inspiratory dyspnea with stridor. Percutaneous ultrasound-guided ethanol ablation of a functional parathyroid tumor was performed 72-h earlier for management of primary hyperparathyroidism. The dog was hypocalcemic (ionized calcium 0.7 mmol/L, reference interval: 0.9-1.3 mmol/L) at the time of presentation and had evidence of laryngospasm on a sedated oral exam. The dog was managed conservatively with supplemental oxygen, anxiolysis, and parenteral calcium administration. These interventions were associated with rapid and sustained improvement in clinical signs. The dog did not demonstrate any recurrence of signs afterwards. To the authors' knowledge, this is the first description of laryngospasm following ethanol ablation of a parathyroid nodule in a dog that developed hypocalcemia.
A 39-year-old female without any specific past history was scheduled to receive an operation for myoma uteri and ovarian cyst. She was premedicated with atropine. Anesthesia was induced with thiopental and was maintained with nitrous oxide and enflurane. Tachycardia shortly after premedication with atropine and remarkable sweat during the operation were observed. On the 1st postoperative day an outbreak of thyroid crisis as well tachycardia of 180.min-1 and fever (39.3 degrees C) were observed. Such outbreak of thyroid crisis indicated that the patient had been suffering from Grave disease. Pathological diagnosis of extirpated ovarian cyst was struma ovarii. It is, however, still uncertain whether struma ovarii induced thyroid crisis in this case. It might be concluded that screening of hyperthyroidism at preoperative rounds is essential for prevention of thyroid crisis.
This study aimed to compare diagnostic performance for tumor detection and for assessment of tumor aggressiveness in prostate cancer (PC) between amide proton transfer magnetic resonance imaging (MRI) with 3-dimensional acquisition (3DAPT) and diffusion-weighted imaging.The subjects were 23 patients with 27 pathologically proven PCs who underwent 3T multiparametric MRI. With reference to the pathology findings, 2 readers in consensus identified the location of PC on multiparametric MRI and measured APT signal intensity (APT SI [%]) and mean apparent diffusion coefficient (ADC) of the benign region and each PC lesion.The mean ADC showed a significant difference between benign regions and PC lesions (0.74 ± 0.15 vs 1.37 ± 0.21, P < 0.001), whereas APT SI did not ( P = 0.091). Lesion APT SI was significantly higher and lesion ADC was significantly lower in PCs with Gleason group (GG) ≥3 than in PCs with GG ≤2 (3.37 ± 1.30 vs 1.78 ± 0.67, P < 0.001, and 0.71 ± 0.18 vs 0.79 ± 0.10, P = 0.038, respectively). The APT SI was significantly higher in GG3 than in GG1, in GG3 than in GG2, and in GG4 than in GG2 ( P = 0.009, P = 0.001, and P = 0.006, respectively). The area under the curve for separating tumor lesions and benign regions was 0.601 for 3DAPT and 0.983 for ADC ( P < 0.001). The area under the curve for separating tumors with GG ≤2 from tumors with GG ≥3 was 0.912 for 3DAPT and 0.734 for ADC ( P = 0.172).In patients with PC, it might be preferable to use ADC to discriminate benign from malignant tissue and use APT SI for assessment of tumor aggressiveness.
Single-shot EPI (sshEPI) DWI still suffers from distortion and blurring. Multi-shot EPI (mshEPI) DWI called IRIS enables to reduce image distortion and blurring. A total of 142 patients with suspected prostate cancer (PC) underwent mpMRI including sshEPI DWI and IRIS under the same scan time. The image quality and diagnostic performance of the lesions were compared between sshEPI DWI and IRIS. IRIS improved image distortion and blurring compared to sshEPI DWI, and also suggested a similar or higher diagnostic performance compared to sshEPI DWI.
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease in humans and results in significant morbidity and mortality. Research over the past 25 years has contributed enormous insight into this inherited disease particularly in the areas of genetics, molecular mechanisms, and pathophysiology. Our understanding continues to be limited by the heterogeneity of clinical presentations with various genetic mutations associated with HCM. Transgenic mouse models have been utilized especially studying the genotypic and phenotypic interactions. However, mice possess intrinsic cardiac and hemodynamic differences compared to humans and have limitations preventing their direct translation. Other animal models of HCM have been studied or generated in part to overcome these limitations. HCM in cats shows strikingly similar molecular, histopathological, and genetic similarities to human HCM, and offers an important translational opportunity for the study of this disease. Recently, inherited left ventricular hypertrophy in rhesus macaques was identified and collaborative investigations have been conducted to begin to develop a non-human primate HCM model. These naturally-occurring large-animal models may aid in advancing our understanding of HCM and developing novel therapeutic approaches to this disease. This review will highlight the features of HCM in humans and the relevant available and developing animal models of this condition.
Motivation: T1 and PDFF mapping, which could serve as imaging biomarkers for liver disease, require breath-holds; T1 mapping commonly used in clinical practice, such as MOLLI, has limited spatial coverage. In addition, the presence of liver fat reduces T1 accuracy. Goal(s): Our goal is to enable simultaneous whole liver water/fat separated T1 and PDFF quantification with clinically acceptable accuracy without breath-holds. Approach: We introduced the 3D Radial DIXON LL sequence and validated in phantom and in vivo. Results: Free-breathing 3D Radial Dixon LL sequence results in a proportional bias for T1 measurement and the fixed bias for PDFF measurement compared to current standard techniques. Impact: The 3D Radial Dixon LL sequence did not result in sufficiently good agreement with reference methods for water/fat separated T1 and PDFF, suggesting that further technical validation and the optimization of imaging parameters will be needed.
Background Hypernatremia has been associated with substantial morbidity and death in human patients. The incidence and importance of hypernatremia in dogs and cats has not been determined. Hypothesis/Objectives To describe the incidence of and prognosis associated with hypernatremia in dogs and cats at a university teaching hospital. Animals A total of 16,691 dogs and 4,211 cats with measured blood or serum sodium concentration. Methods Retrospective study. Medical records of animals with a blood or serum sodium concentration measured during a 60-month period were reviewed to determine the severity of hypernatremia and its associated case fatality rate. Cases with moderate (11–15 mmol/L above the reference range) or severe hypernatremia (≥16 mmol/L above the reference range) were further reviewed. Results A total of 957 dogs (5.7%) and 338 cats (8.0%) were diagnosed with hypernatremia. Case fatality rates of dogs and cats with hypernatremia was 20.6 and 28.1%, respectively compared to 4.4 and 4.5% with a normal blood or serum sodium concentration (P < .0001). The magnitude of hypernatremia was linearly associated with a higher case fatality rate (P < .0001). Hypernatremia was associated with a higher case fatality rate than hyponatremia. Among the animals with moderate or severe hypernatremia, 50% of dogs and 38.5% of cats presented with community-acquired hypernatremia, and 50% of dogs and 61.5% of cats developed hospital-acquired hypernatremia. Conclusions and clinical importance Hypernatremia was found infrequently in this population but was associated with increased case fatality rates in dogs and cats. Presence and severity of hypernatremia might be useful as a prognostic indicator.
From October 1976 to June 1986, 12 patients with corrected transposition of the great arteries (c-TGA) underwent repair of associated intracardiac defects. Ventricular septal defect (VSD) was closed by the method of de Leval in 7 patients, pulmonary outflow tract obstruction was relieved by valvotomy in 2, and bypassed by an external valved conduit in 6. The systemic atrioventricular (A-V) valve was replaced in 2. There was one operative death, giving a mortality rate of 8%. None of the patients developed complete heart block. The ejection fraction of the systemic ventricle was impaired (29-38%), particularly after ventriculotomy of this chamber. Surgical repair of intracardiac defects associated with c-TGA currently can be performed with acceptable risk, and de Leval's method for VSD closure is recommended; but the possibility of the postoperative development of systemic ventricular dysfunction and A-V valve regurgitation necessitates careful follow-up.
