Development of a Large Pneumatocele in a Patient Recovering from COVID-19 Pneumonitis.

Unlabelled: A 39-year-old man presented with severe COVID-19 pneumonitis requiring hospital admission. He represented three days following discharge with sudden onset breathlessness and chest pain. Initial imaging suggested the presence of a left pneumothorax.

Respiratory disease in common variable immunodeficiency and other primary immunodeficiency disorders.

Respiratory disease is a significant cause of morbidity and mortality amongst patients with primary immunodeficiency disorders. Computed tomography (CT) plays an important role in the multidisciplinary approach to these conditions, in detecting, characterizing, and quantifying the extent of lung damage and in directing treatment. The aim of this review is to classify the primary immunodeficiency disorders and describe the thoracic complications and the associated CT findings whilst discussing the role of radiology in diagnosis and surveillance.

The surgical management of obesity with emphasis on the role of post operative imaging.

The role of surgery in the morbidly obese is becoming more prominent. There are a variety of surgical approaches which can be used and radiology plays a crucial role in post operative follow up, particularly in the management of complications. Many general radiologists remain unfamiliar with both the normal and abnormal appearances after bariatric surgery and this pictorial review aims to bridge this gap.

Pancreatic transplantation: surgical technique, normal radiological appearances and complications.

Pancreas transplantation is a surgical treatment for diabetes mellitus. More than 23,000 pancreas transplants have now been reported to the International Transplant Registry (IPTR). Early diagnosis and therapy for graft-related complications are essential for graft survival.

Alginate-antacid combinations: raft formation and gastric retention studies.

Background: Alginate-based gastroesophageal reflux disease treatments have been used extensively and fall into two main categories. Those containing alginate as the principle active agent and those containing alginate in combination with a significant amount of antacid.

Method: The effectiveness of the raft formed by a new alginate/antacid suspension (Gaviscon Double Action Liquid, GDAL), in which calcium carbonate was the main antacid ingredient, was compared with those of existing alginate/antacid suspensions.

Urinary reflux from ileal neobladder into a non-functioning kidney: detection during diuretic renography.

The importance of monitoring renal function in patients undergoing cystectomy and urinary diversion is well established. Dynamic renography using Tc-99m MAG3 in combination with furosemide challenge has been widely used to determine the differential function of the kidneys, occurrence of reflux as well as the patency of the outflow tract in this context. The authors have described here a patient in whom significant urinary reflux from the neo-bladder into the nonfunctioning kidney was demonstrated during MAG3 diuretic renography.

Imaging the lungs in patients treated for lymphoma.

The lymphomas are a heterogeneous group of malignancies, which exhibit a range of different molecular features, genetics, and clinical presentations. Consequently, therapeutic approaches and clinical outcomes differ greatly. Following therapy, the thorax may be a site of disease recurrence, but infection, drug reactions, and radiation pneumonitis are commonly encountered.

The role of a consultant radiologist--are patients still in the dark?

Little is known regarding public awareness of the roles and responsibilities of a consultant radiologist. Between 1 April and 20 May 2008, 916 outpatients attending our radiology department completed a questionnaire addressing this issue. We found public perception variable.

Computed tomography after radical pancreaticoduodenectomy (Whipple's procedure).

Whipple's procedure (radical pancreaticoduodenectomy) is currently the only curative option for patients with periampullary malignancy. The surgery is highly complex and involves multiple anastomoses. Complications are common and can lead to significant postoperative morbidity.

M-band nonlinear subband decompositions with perfect reconstruction.

We investigate nonlinear multirate filterbanks with maximal decimation and perfect reconstruction. Definitions of the desired properties of such structures are given for general nonlinear filterbanks. We then consider a triangular representation of linear filterbanks and see that it may be easily extended to the nonlinear case.

Response assessment in lymphoma.

The lymphomas are a heterogeneous group of malignant diseases. They are divided into two broad groups: Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). Patients suffering from HD and NHL can be cured by appropriate chemotherapy and/or radiotherapy.

The suppression of gastro-oesophageal reflux by alginates.

Aims: The aim of this study was to compare alginate products with the same amount of active ingredients but different dosage forms, in the suppression of reflux provoked by a standard meal in healthy human volunteers, using ambulatory oesophageal pH monitoring.

Methods: This was a single centre, randomised, open, three-period crossover, controlled study comparing Gaviscon Advance (10 ml) with a control (10 ml water) and with a new tablet product containing the same active ingredients as Gaviscon Advance. Volunteers who had oesophageal pH < 4 for at least 2% of the 4-h period after ingestion of a test meal followed by control at a reflux screening visit were included in the study.

Administration of an alginate based gastric reflux suppressant on the bioavailability of omeprazole.

Background & Objective: Omeprazole treats gastro-oesophageal reflux disease (GORD) by inhibition of acid secretion whereas alginate based reflux suppressants work by forming a low density raft of near neutral pH which floats on the stomach contents and physically impedes gastro-oesophageal reflux. There is limited pharmacokinetic information regarding possible drug interaction between these two types of products, although these may be frequently co-prescribed to improve symptom control in GORD patients. This study was designed to determine whether the administration of a 10 per cent w/v liquid alginate suspension affected the pharmacokinetic profile of omeprazole.

A fatal case of disseminated zygomycosis associated with the use of blood glucose self-monitoring equipment.

We report a fatal case of disseminated zygomycosis due to Cunninghamella bertholletiae in a 68-year-old man with myelodysplasia and type II diabetes mellitus, receiving desferrioxamine therapy for iron overload secondary to multiple transfusions. It is thought that he acquired the infection through the use of blood glucose self-monitoring equipment.

Alginate rafts and their characterisation.

Alginate/antacid anti-reflux preparations are designed to provide symptom relief by forming a physical barrier on top of the stomach contents in the form of a neutral floating gel or raft. This study tested the in vitro effectiveness of a range of liquid products in forming rafts that were cohesive, buoyant, voluminous, resistant to reflux and durable under conditions of movement (resilient). The products tested had a wide range of acid neutralising capacities (ANCs).

Oesophageal bioadhesion of sodium alginate suspensions 2. Suspension behaviour on oesophageal mucosa.

Sodium alginate suspensions in a range of water miscible vehicles were investigated as novel bioadhesive liquids for targeting the oesophageal mucosa. Such a dosage form might be utilised to coat the oesophageal surface and provide a protective barrier against gastric reflux, or to deliver therapeutic agents site-specifically. Alginate suspensions swelled and formed an adherent viscous layer on contact with the mucosa.

Oesophageal bioadhesion of sodium alginate suspensions: particle swelling and mucosal retention.

This paper describes a prospective bioadhesive liquid dosage form designed to specifically adhere to the oesophageal mucosa. It contains a swelling polymer, sodium alginate, suspended in a water-miscible vehicle and is activated by dilution with saliva to form an adherent layer of polymer on the mucosal surface. The swelling of alginate particles and the bioadhesion of 40% (w/w) sodium alginate suspensions were investigated in a range of vehicles: glycerol, propylene glycol, PEG 200 and PEG 400.

Microscopic techniques as potential tools to quantify the extent of bioadhesion of liquid systems.

This work demonstrates the potential of fluorescence and confocal microscopy as techniques to quantify both the extent and duration of bioadhesion of alginate solutions to porcine oesophageal tissue using an in vitro model. The retention of low (40 kDa), medium (240 kDa) and high (416 kDa) MW alginates was quantified via three methods of analysis. Fluorimetric analysis of the dose removed from the oesophageal surface suggested that the percentage of the original dose retained at 30 min was 7.

Localised mapping of water movement and hydration inside a developing bioadhesive bond.

Few studies have investigated the internal processes involved in bioadhesive bond formation, particularly where mucus and hydrated polymer contribute jointly to bond structure. This paper reports the first study to spatially map the internal environment within a developing bioadhesive bond, utilising nuclear magnetic resonance (NMR) microscopy to measure localised water self-diffusion coefficients (SDC) and confocal laser scanning microscopy (CLSM) to estimate mucin concentration. In a model bioadhesive bond formed between an alginate matrix and mucin gel, characteristic profiles were observed in which fluorescence measurements showed a region of increasing mucin concentration in the mucus layer region adjacent to the matrix, corresponding closely with a zone of restricted water SDC in the diffusion profiles.

A simple, high throughput method for the quantification of sodium alginates on oesophageal mucosa.

Sodium alginate is a potential bioadhesive, but the lack of a convenient and suitable method for its quantification on the mucosal surface complicates the evaluation of its mucosal retentive properties. This paper develops and evaluates a spectrophotometric method for the rapid quantification of a range of sodium alginates differing in chemical composition, and investigates how quantification was influenced by the presence of oesophageal mucosa. The method, based on dye complexation with 1,9-dimethyl methylene blue (DMMB) was sensitive to alginate molecular weight and uronic acid composition, however, no significant correlations between assay performance and alginate molecular characteristics were demonstrated.

Feasibility of a bioadhesive drug delivery system targeted to oesophageal tissue.

This contribution examines the feasibility of utilising an oesophageal-adhesive alginate layer to support model drug particles. Such a bioadhesive system offers the prospect of local drug delivery to the oesophagus, which in turn has applications in the treatment of conditions including gastro-oesophageal reflux disease and oesophageal cancer. Surface-modified (amine, carboxylate and sulfate) as well as neutral fluorescent beads were investigated as model drug particles.