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Unconscious patients are frequently referred to radiology departments for computed tomography (CT) of the brain. The objectives of these examinations are to define the underlying cause of impaired consciousness and in some cases to determine the severity of associated brain injury. There is often little history available to guide the clinician or radiologist, particularly in patients referred from the casualty department. In this review, we present the typical CT appearances of adult patients presenting with loss of consciousness for CT examination. We focus on the most common abnormalities that are identified in everyday radiological practice, emphasize important diagnostic signs that may enable a confident diagnosis to be made and discuss when further imaging may be warranted. [Copyright &y& Elsevier]

Abstract Skeletal muscle differentiation is marked by enhanced myotube formation and increased cytoskeletal rearrangement. Actin, a cytoskeletal protein is involved in various cellular functions such as glucose transport, intracellular trafficking, cell shape, and coordinated cell movement in response to various extracellular signals. The present study reveals an association between actin and p38 MAPK only in differentiated myotubes, not in proliferating myoblasts. Actin filament disassembly caused by cytochalasinD can be reversed using the potent activator of p38 MAPK, anisomycin. Pretreatment of myotubes with anisomycin partially resisted the effect of cytochalasinD. However, inhibition of p38 MAPK completely abolished the anisomycin-mediated actin remodeling. Data suggests that p38 MAPK interacts with actin and modulates actin filament rearrangement in differentiated L6E9 skeletal muscle cells. [ABSTRACT FROM AUTHOR]

Abstract Previous reports suggest that PKC plays an important role in regulating myogenesis. However, the regulatory signaling pathways are not fully understood. We examined the effects of PKC downregulation on signaling events during skeletal muscle differentiation. We found that downregulation of PKC results in increased myogenesis in C2C12 cells as measured by creatine kinase activity and myogenin expression. We showed that, during differentiation, downregulation of PKC expression results in increased tyrosine phosphorylation of FAK, Cas, and paxillin, concomitant with enhanced Cas-CrkII complex formation, which leads to activation of JNK2. But in proliferated muscle cells, PKC inhibition results in FAK and Cas tyrosine dephosphorylation. Further, disruption of actin cytoskeleton by cytochalasin D prevents the activation of FAK and Cas as well as the formation of Cas-CrkII complex stimulated by PKC downregulation during muscle cell differentiation. Finally, we observed that PKC downregulation increases the tyrosine phosphorylation of focal adhesion associated proteins. Based on the above data, we propose that PKC downregulation results in enhanced tyrosine phosphorylation of FAK, Cas, and paxillin, thus promoting the establishment of Cas-CrkII complex, leading to activation of JNK and that these interactions are dependent upon the integrity of actin cytoskeleton during muscle cell differentiation. Data presented here significantly contribute to elucidating the regulatory role of PKC in myogenesis possibly through integrin signaling pathway. [ABSTRACT FROM AUTHOR]

Purpose To present our experience in transcatheter arterial embolization (TAE) for hemorrhage following blunt or penetrating chest wall trauma. We provide the reader with a pictorial summary of the full range of angiographic findings and embolization techniques utilized. Material and Methods We performed a retrospective review of all patients treated with TAE for this indication from August 2004 to August 2014 in our institution, a level I trauma center. Data were obtained from the electronic records, pre- and post-procedural imaging, procedure reports, and laboratory results. Results A total of 13 patients were treated during this period. Seven patients had blunt trauma to the chest wall. Four patients had penetrating injury (2 stabbings and 2 gunshot wounds). In 4 cases the injuries were iatrogenic (3 due to chest tube insertion and 1 blunt injury from cardiopulmonary resuscitation). Two patients were previously treated with thoracotomy, which failed to control the bleeding. Embolization of intercostal artery, internal mammary artery and branches of the lateral thoracic and axillary arteries were performed. In all cases, embolization was effective in controlling the hemorrhage. There were no complications related to the procedure. We discuss the spectrum of imaging findings in these cases. Technical aspects such as catheter and embolic material selection are also discussed with pictorial examples. Conclusions In our experience TAE is a safe and effective treatment option in the management of chest wall hemorrhage after blunt and penetrating trauma. This minimally invasive procedure is particularly valuable in patients with significant comorbidities and persistent hemorrhage. Interventionists working in a trauma setting must have a thorough knowledge of the anatomical features and collateral pathways of the chest wall vasculature. [ABSTRACT FROM AUTHOR]

Purpose: Retrospective study of positional changes of retrievable IVC filters between insertion and removal. The following parameters were recorded: changes in tilt angle, filter position and strut penetration. Materials and Methods: Retrospective review of the PACS at an academic medical center, was performed for IVC filter retrieval attempts from Jan 1 2010 to Dec 30 2012 identified 337 cases. Demographic information, insertion and retrieval parameters, and filters types were documented. Images were reviewed and the tilt and migration of the filters were measured from venograms performed post insertion and pre removal. Penetration of struts through the vessel wall was measured. Patients in which imaging was inadequate were excluded, leaving 262 patients in the final study group. Results: 262 filter retrievals were identified. 5 filter types were recorded: Cook Celect filter (187), Bard Recovery family (33), ALN (27), Cordis Optease (8), Cook Tulip (7)Comparative average values of filter tilt relative to IVC long axis, migration, and vessel wall penetration for the different brands are presented in the table. Conclusion: For the parameters measured, all filter types demonstrated similar changes in filter tilt, migration and penetration at the time of removal. To our knowledge this is the largest dataset of IVC filter retrieval comparing multiple filter types. We have measured IVC filter tilt, migration and strut penetration changes that occured between insertion and removal parameters that may influence the overall success of the retrieval procedure. Although no filter type is clearly superior to the others, each type has its own characteristics that should be taken into account at the time of insertion. This comparative data does not allow a determination of the superiority of any one filter. [Copyright &y& Elsevier]