Acute epiploic appendagitis: CT findings in 33 cases.

Acute epiploic appendagitis (AEA) is a benign self-limiting process presenting with acute abdominal pain often misdiagnosed clinically as either diverticulitis or appendicitis, but which has a pathognomonic CT appearance. The CT findings in 33 adult patients diagnosed by CT over a 33-month period as having AEA were retrospectively reviewed. The study group included 24 men and 9 women, with a mean age of 44.

Pulmonary embolism-the initial manifestation of renal cell carcinoma in a young woman.

We report a case of massive pulmonary embolus demonstrated on CT in a young woman presenting with dyspnea, with no known risk factors for embolism. Abdominal CT on further investigation showed a renal tumor invading the left renal vein and the inferior vena cava as the cause of the pulmonary embolus. In a patient presenting with pulmonary artery embolism without venous thrombosis, the differential diagnosis should include an occult tumor as the cause of the embolus.

Vascular lesions of the renal sinus.

The renal sinus contains within it the collecting system of the kidney as well as lymphatics, nerves, and renovascular structures. This area may be affected by a large variety of pathological conditions arising from the various tissues in this site. Vascular lesions of the renal sinus are uncommon and may present clinically with acute symptoms and on imaging as a mass lesion.

Dense ascites: CT manifestations and clinical implications.

Ascites is a not infrequent finding on CT. Causes of ascites include congestive heart failure, hypoalbuminemia, cirrhosis, inflammation, and neoplasm. In most cases the attenuation of ascites is that of clear fluid, measuring around 0 HU.

Postoperative pneumoperitoneum: prevalence, duration, and possible significance.

Free intraperitoneal air after abdominal surgery is a confounding finding with uncertain significance. A diagnostic dilemma often arises as to its origin: does it merely represent residual postoperative pneumoperitoneum (PP), which will need no intervention, or does it indicate a complication such as an anastomotic leak or a perforation of the gastrointestinal tract. Residual PP is usually well tolerated, as it will be absorbed over time and requires no therapy.

Ureteral injuries: CT diagnosis.

Ureteral injury is a rare, yet very serious, complication of various abdominal, pelvic, and even spinal procedures. It is often clinically unsuspected as symptoms are nonspecific and the patient may present weeks and even months after the injury. Therefore the diagnosis of ureteral injury is often delayed, leading to more serious morbidity.

Surrogate markers and risk factors for chronic lung allograft dysfunction.

Obliterative bronchiolitis (OB) is the histologic correlate of chronic allograft dysfunction in pulmonary transplantation. The histologic diagnosis of OB is challenging, therefore a physiologic definition, bronchiolitis obliterans syndrome (BOS) based on pulmonary function tests has been used as a surrogate marker for OB for the last decade. BOS has proven to be the best available surrogate marker for OB and is predictive of the ultimate endpoints of graft and patient survival.

Mindfulness meditation to reduce symptoms after organ transplant: a pilot study.

Context: Solid organ transplant patients require life-long immune suppression that can produce distressing side effects and complications.

Objective: To evaluate the potential of Mindfulness-Based Stress Reduction (MBSR) to reduce symptoms of depression, anxiety, and sleep disturbance and improve quality of life after solid organ transplantation.

Design: Longitudinal with evaluations at baseline, postcourse and 3-month follow-up.

Indirect minor histocompatibility antigen presentation by allograft recipient cells in the draining lymph node leads to the activation and clonal expansion of CD4+ T cells that cause obliterative airways disease.

Ag recognition by OVA-reactive OT-II (I-Ab restricted) and DO11.10 (I-Ad restricted) TCR-Tg CD4+ T cells after heterotopic transplantation of OVA transgene-expressing tracheal grafts was examined as a model of minor histocompatibility Ag (mHAg)-induced chronic allograft rejection. In response to airway allotransplantation with grafts expressing the OVA transgene, these TCR-Tg CD4+ T cells expressed the activation markers CD69 and CD44, demonstrated evidence of blastogenesis, underwent multiple rounds of cell division leading to their clonal expansion in the draining lymph node, and proceeded to differentiate to a effector/memory T cell phenotype based on a reduction in the expression of CD45RB.

Tolerance-induced receptor selection: scope, sensitivity, locus specificity, and relationship to lymphocyte-positive selection.

Receptor editing is a mode of immunological tolerance of B lymphocytes that involves antigen-induced B-cell receptor signaling and consequent secondary immunoglobulin light chain gene recombination. This ongoing rearrangement often changes B-cell specificity for antigen, rendering the cell non-autoreactive and sparing it from deletion. We currently believe that tolerance-induced editing is limited to early stages in B-cell development and that it is a major mechanism of tolerance, with a low-affinity threshold and the potential to take place in virtually every developing B cell.

Trachea allograft class I molecules directly activate and retain CD8+ T cells that cause obliterative airways disease.

Human T cells responding against transplanted allogeneic lung tissue have been implicated in late graft failure secondary to obliterative bronchiolitis. This obliterative airways disease (OAD) also develops in heterotopic murine tracheal allografts in association with graft infiltration by both CD8(+) and CD4(+) T cells. To date, there has been little evidence to suggest that directly alloreactive CD8(+) T cells either promote chronic rejection or lead to the development of OAD following airway allotransplantation.

CT findings of intussusception in adults.

Intussusception is rare in adults, in contrast to its frequent occurrence in infants. The clinical presentation is variable, consisting mainly of abdominal pain that may be chronic, intermittent, or acute. The classic triad of nausea and vomiting, bloody diarrhea, and an abdominal mass typically present in children with intussusception does not usually appear in adults.

Home monitoring for lung transplant candidates.

Home monitoring by lung transplant recipients has been effective for early detection of clinical problems. This study used an electronic diary for home monitoring by lung transplant candidates to improve communication between candidates and the transplant team. Candidates were randomized into control (52 subjects following standard telephone reporting procedures) and intervention (67 subjects using an electronic diary to record and transmit a range of health-related measures) groups.

Mesenteric lymphadenopathy in children examined by US for chronic and/or recurrent abdominal pain.

Background: Children with recurrent abdominal pain often undergo US to confirm or exclude organic disease.

Objective: To assess the prevalence of mesenteric lymphadenopathy on US in these children.

Materials And Methods: We prospectively studied 189 children with recurrent abdominal pain with US of the abdomen, using graded compression.

Recent trends in lung transplantation: the University of Minnesota experience.

The number of transplants performed at our center continues to grow--partly as a result of the use of expanded donors and partly as a result of referrals from programs that have closed. We also anticipate having a more active living-donor lobar transplant program. The major acute problems that we encounter after transplantation are reperfusion injury and pneumonia.

Gene expression profiling of bronchoalveolar lavage cells in acute lung rejection.

Lung transplantation is effective for many diseases that are unresponsive to other therapy. However, long-term survival of recipients is limited by the development of bronchiolitis obliterans syndrome. Acute rejection is a major risk factor for bronchiolitis obliterans syndrome, but noninvasive biomarkers have not been identified.

Mechanical Circulatory Support device database of the International Society for Heart and Lung Transplantation: first annual report--2003.

Over the last 2 decades, mechanical circulatory support devices have been developed with the goal of supporting patients with advanced heart failure as a bridge to cardiac transplantation, a bridge to recovery, and an alternative to transplantation (also called chronic or destination therapy). The current generation of devices provides a differentiated spectrum of circulatory support. The major limitations of mechanical circulatory support devices are infection, coagulopathies and device dysfunction.

Airway anastomotic dehiscence associated with use of sirolimus immediately after lung transplantation.

Goal: The goal of this study was to assess the efficacy of sirolimus in lung-transplant recipients.

Methods: The study was designed as a single center, consecutive case study of lung-transplant recipients treated with sirolimus, tacrolimus, and prednisone. All study subjects also received an HMG-CoA reductase inhibitor, and prophylaxis for cytomegalovirus and Pneumocystis carinii.