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Radiobiology of Normal Tissues
Published in W. P. M. Mayles, A. E. Nahum, J.-C. Rosenwald, Handbook of Radiotherapy Physics, 2021
Most tissues consist of a complex variety of cell types. Often, there is a principal functional cell type that is referred to as the parenchymal component of the tissue. Invariably, there is also a connective-tissue component made up of fibroblasts, blood vessels, nerve cells and mobile cells such as macrophages. The epithelial tissues that cover the outside of the body (i.e. epidermis) and the lining of the gut are structurally the easiest to understand. Here, the parenchymal component is a sheet of cells, one or more cells thick, lying on supportive connective-tissue structures. When this type of tissue is exposed to radiation, all cell types are damaged, and this damage may be expressed in different ways. Some epithelial tissues are in a state of rapid cell turnover in which the structure shown schematically in Figure 7.1 can clearly be seen. There are stem cells that have the dual ability to renew themselves and also to differentiate into mature cells. Differentiation means changing into a special type of cell with the ability to perform a specialised function. In the small intestine, this function is to absorb nutrients from the gut; in the skin, the function is to act as a waterproof and physical barrier.
Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
If the choice is made to treat a patient with neurocysticercosis using an antihelminthic medication, the preferred agents are albendazole and/or praziquantel. Recent evidence suggests that combined therapy may be more efficacious in parenchymal disease.13 Albendazole is typically given at a dose of 15 mg/kg/day in two divided doses, and praziquantel is given at 50 mg/kg/day in three divided doses.
Entamoeba histolytica
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
William A. Petri, Jonathan I. Ravdin
Complications of Liver Abscess. Extension of an amebic liver abscess to the thorax or peritoneum results in more severe disease with increased mortality. Serous pleural effusion, elevation of the right hemidiaphragm, and atelectasis, which occur in up to 75% of patients with amebic liver abscess (215,218,219), do not represent direct extension of disease but can lead to the misimpression that the patient has primary pulmonary disease (215). Empyema due to rupture of the abscess into the pleural cavity presents with sudden respiratory distress and pain. In addition to antiamebic chemotherapy, these patients require adequate drainage either by repeated aspiration (220) or thoracotomy (221). The lung parenchyma is usually infected by direct extension from the liver, with hematogenous infection uncommon (222). Hepatobronchial fistulas occur and have been associated with spontaneous cure (211,222).
Treatment efficacy of low-dose 5-fluorouracil with ultrasound in mediating 5-fluorouracil-loaded microbubble cavitation in head and neck cancer
Published in Drug Delivery, 2023
Ai-Ho Liao, Yu-An Lee, Dao-Lung Lin, Ho-Chiao Chuang, Jehng-Kang Wang, Ching-En Chang, Hsiang-Tzu Li, Ting-Yi Wu, Cheng-Ping Shih, Chih-Hung Wang, Yueng-Hsiang Chu
The light-microscope images of H&E-stained tumors (histopathological examinations) after 34 days in Figure 9 indicate that tumor cells were closely arranged with complete and atypical structures in control group. In the 5-FU chemotherapy groups, we observed greater tumor cell apoptosis, which was characterized by incomplete cell membranes (red arrows), condensed cytoplasm, nuclear condensation and nuclear fragmentation (green arrows). Vacuolated cells, intercellular edema, and multiple cyst formation (red arrows) were more commonly observed in the 5-FU-MBs + US group. The systemic cytotoxicity of 5-FU chemotherapy in the nontarget liver tissue indicated that low-dose 5-FU treatment resulted in the development of slight liver steatosis, increased hepatocellular lipid content (red arrows), and irreversible hepatocellular damage via inflammatory cell recruitment, especially in the 5-FU treatment group. Histological analysis of control renal parenchyma indicated that kidney function and architecture were normal. In contrast, administration of 5-FU alone resulted in more-obvious disruption of the normal renal architecture (red arrows) than in the other treatment groups, which was evident through blood sinusoids, interstitial hemorrhages (green arrows), glomerular congestion, atrophy, and inflammatory cell infiltration (black arrow).
Recent innovations in the screening and diagnosis of systemic sclerosis-associated interstitial lung disease
Published in Expert Review of Clinical Immunology, 2023
Ashima Makol, Vivek Nagaraja, Chiemezie Amadi, Janelle Vu Pugashetti, Elaine Caoili, Dinesh Khanna
Lung ultrasound (LUS) for assessment of ILD was described as early as 2009 [38] and its usage has dramatically increased in the last decade [39–47]. Advantages of LUS include its smaller footprint improving patient accessibility as well as the lack of ionizing radiation. Aerated lung has a large acoustic impedance making it a strong acoustic reflector. Therefore, LUS assesses the parenchyma by means of imaging artifacts. A-lines, commonly seen in healthy lungs, are reverberation artifacts and are reproductions of the pleural line (Figures 4A and B). These A lines manifest as equidistant echogenic lines parallel to the pleural line. In contradistinction, B-lines have been described with various diseased conditions such as pulmonary edema, consolidation seen with pneumonia, or fibrosis. B-lines are vertical artifacts which arise from the pleural line that extend to the image edge (Figures 5A and B). These echogenic lines move with the underlying parenchyma during respiration. There is no definite anatomic correlate for B-lines but several studies have suggested that it is caused by structural alterations in the subpleural parenchyma causing discontinuity of the pleural surface [48]. This can be caused by several pathologies such as fluid within the interlobular septa or thickening of the interstitium seen with fibrosis. B- lines can have varied appearances and can be sharp and thin or may be coalescent and thick [48].
Role of endoscopic ultrasound-guided liver biopsy: a meta-analysis
Published in Scandinavian Journal of Gastroenterology, 2022
Keyu Zeng, Zhenpeng Jiang, Jie Yang, Kefei Chen, Qiang Lu
We identified 1992 records. A total of 33 studies were enrolled in this meta-analysis, which included 21 on liver parenchymal diseases [2,11,17,18,24–40], 11 on focal liver lesions [14–16,41–48] and 1 on both of the diseases [49]. The selection process is shown in Figure 1. Of the 33 studies, 10 of them were prospective observational studies, 18 of them were retrospective observational studies, 2 of them were randomized controlled trials, and 3 of them were randomized crossover studies. The pooled number of patients was 2098. Mean age across studies ranged between 44 and 61 years. The pathological diagnosis of liver parenchymal diseases included nonalcoholic fatty liver diseases, viral hepatitis, cirrhosis, drug-induced liver injury, nonspecific cholestasis, nonspecific mild inflammation, autoimmune hepatitis, granulomatous hepatitis, and primary sclerosing cholangitis. The pathological diagnosis of focal liver lesions included primary liver malignancies (hepatocellular carcinoma and cholangiocarcinoma), metastatic liver tumors (pancreatic, pulmonary, mammary, colon, gastric, prostate, and endometrial carcinoma) and benign masses. Table 1 shows the characteristics of the included studies.