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Sample records for acute retinal necrosis

  1. [Acute retinal necrosis].

    Lucke, K; Reinking, U; el-Hifnawi, E; Dennin, R H; Laqua, H

    1988-12-01

    The authors report on three patients with acute retinal necrosis who were treated with the virostatic agent Acyclovir and who underwent vitreoretinal surgery with silicone oil filling for total retinal detachment. In two eyes the retina was reattached, but useful vision was only preserved in one patient. Titers from blood and the vitreous, as well as microscopic findings in retinal biopsies, support the view that the necrosis is caused by a herpes simplex virus infection. After therapy with Acyclovir was instituted no further progression on the necrosis was observed. However, the development of retinal detachment could not be prevented. Early diagnosis and antiviral therapy are essential to improve the otherwise poor prognosis in this rare syndrome. PMID:3221657

  2. Acute Retinal Necrosis in Childhood

    Yoav Y. Pikkel

    2014-05-01

    Full Text Available Background: Acute retinal necrosis (ARN is a viral syndrome consisting of uveitis/vitritis, occlusive vasculitis and peripheral necrosis. Few incidents are reported in children. The etiology is reactivated herpes simplex virus (HSV or varicella-zoster virus (VZV. Treatment with acyclovir is often used. The administration of oral glucocorticosteroids is of unproven benefit. Prognosis is variable but poor. Methods: Three weeks after contracting mild chickenpox, a healthy 4-year-old girl developed blurred vision in her right eye. Severely reduced visual acuity was noted, together with anterior uveitis, ‘mutton-fat' precipitates and vitral flare. Retinal vasculitis with necrosis was present. Serology for toxoplasma, cytomegalovirus and HIV was negative, while HSV and VZV IgG antibodies were positive. She was treated with 30 mg/kg of intravenous methylprednisolone (3 days, 30 mg of oral prednisone (3 days, and tapering for 8 weeks. Intravenous acyclovir was given for 10 days, followed by oral acyclovir for 4 months. Aspirin (100 mg/day was given for 4 months. Results: At 12 months, the girl felt good. Her right eye acuity was 6/9, with an intraocular pressure of 17 mm Hg. The peripheral retina showed scarring but no detachment. Conclusions: This is the first report of a once-daily high-dose methylprednisolone pulse therapy in one of the youngest known ARN cases. Pulsed steroid therapy was based on its known effectiveness in vasculitis, which is the main pathophysiology in ARN. There was no evidence of steroid-related viral over-replication. Our case achieved an excellent clinical and ophthalmic recovery in spite of the poor prognosis. The positive result of this case report provides a basis for further evaluation of high-dose steroid pulse therapy in ARN.

  3. Bilateral acute retinal necrosis after herpetic meningitis

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  4. Valacyclovir in the treatment of acute retinal necrosis

    Taylor Simon RJ

    2012-09-01

    Full Text Available Abstract Background To report the outcome of oral valacyclovir as the sole antiviral therapy for patients with acute retinal necrosis (ARN. Methods This study reports a retrospective, interventional case series of nine consecutive patients with ten eyes with newly diagnosed ARN treated with oral valacyclovir as the sole antiviral agent. Eight patients received oral valacyclovir 2 g tid (Valtrex, GlaxoSmithKline and one patient with impaired renal function received oral 1 g tid. The main outcome measures were response to treatment, time to initial response to treatment, time to complete resolution of retinitis, best corrected visual acuity (BCVA at final follow-up, retinal detachment and development of recurrent or second eye disease. Results Retinitis resolved in ten of ten (100% affected eyes. The median time to initial detectable response was seven days and the median time to complete resolution was 21 days. A final BCVA of 20/40 or better was achieved in 6/10 (60% of eyes. 3/10 eyes (30% developed a retinal detachment. No patients developed either disease reactivation or second eye involvement over the course of the study (mean follow up 31 weeks, range 7 to 104 weeks. Conclusions Treatment with oral valacyclovir as the sole antiviral therapy resulted in complete resolution of retinitis. Final BCVA and retinal detachment rate were comparable with previously reported outcomes for intravenous acyclovir.

  5. INTRAOCULAR AND SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN ACUTE RETINAL NECROSIS AND OCULAR TOXOPLASMOSIS

    Wiertz, Karin; De Visser, Lenneke; Rijkers, Ger; De Groot-Mijnes, Jolanda; Los, Leonie; Rothova, Aniki

    2010-01-01

    Purpose: To determine the intraocular and serum vascular endothelial growth factor (VEGF) levels in patients with acute retinal necrosis (ARN) and compare those with VEGF levels found in patients with ocular toxoplasmosis (OT). Methods: Paired intraocular fluid and serum samples of 17 patients with

  6. Kyrieleis plaques associated with Herpes Simplex Virus type 1 acute retinal necrosis

    Neha Goel

    2016-04-01

    Full Text Available We report the case of a 55-year-old immunocompetent male who presented with features typical of acute retinal necrosis (ARN. Polymerase chain reaction of the aqueous tap was positive for Herpes Simplex Virus (HSV – 1. Following therapy with intravenous Acyclovir, followed by oral Acyclovir and steroids, there was marked improvement in the visual acuity and clinical picture. At one week after initiation of treatment, Kyrieleis plaques were observed in the retinal arteries. They became more prominent despite resolution of the vitritis, retinal necrosis and vasculitis and persisted till six weeks of follow-up, when fluorescein angiography was performed. The appearance of this segmental retinal periarteritis also known as Kyrieleis plaques has not been described in ARN due to HSV-1 earlier.

  7. Neonatal herpes simplex virus type-1 central nervous system disease with acute retinal necrosis.

    Fong, Choong Yi; Aye, Aye Mya Min; Peyman, Mohammadreza; Nor, Norazlin Kamal; Visvaraja, Subrayan; Tajunisah, Iqbal; Ong, Lai Choo

    2014-04-01

    We report a case of neonatal herpes simplex virus (HSV)-1 central nervous system disease with bilateral acute retinal necrosis (ARN). An infant was presented at 17 days of age with focal seizures. Cerebrospinal fluid polymerase chain reaction was positive for HSV-1 and brain magnetic resonance imaging showed cerebritis. While receiving intravenous acyclovir therapy, the infant developed ARN with vitreous fluid polymerase chain reaction positive for HSV-1 necessitating intravitreal foscarnet therapy. This is the first reported neonatal ARN secondary to HSV-1 and the first ARN case presenting without external ocular or cutaneous signs. Our report highlights that infants with neonatal HSV central nervous system disease should undergo a thorough ophthalmological evaluation to facilitate prompt diagnosis and immediate treatment of this rapidly progressive sight-threatening disease. PMID:24378951

  8. Acute Retinal Necrosis: A Report of 18 Cases%急性视网膜坏死18例临床分析

    李军; 曲新英

    2009-01-01

    Objective To investigate the early diagnosis and treatment of acute retinal necrosis (ARN).Methods The clinical manifestations and therapeutic measures in 18 patients (21eyes) with ARN were studied retrospectively.Results Seventeen eyes of ARN patients were subjected to vitreetomy combined tamponade with silicone oil.Retinal reattachment achieved in 14 eyes (82.35%) after operation.The opposite eyes in single-eye involved patients were not suffered from the attack of acute retinal necrosis following early sufficient dose of antiviral therapy.Conelusions Earlier adminiswation of antiviral drugs in large dose coordinated with prophylactic vitrectomy can improve the therapeutic efficacy of ARN and simultaneously reduce the morbidity of opposite eyes.%目的 探讨急性视网膜坏死(acute retinal necrosis,ARN)的早期诊断和治疗方法.方法 回顾性研究18例21只眼急性视网膜坏死患者的临床表现和治疗方法.结果 17只眼玻璃体切除联合眼内硅油填充术,术后视网膜复位14只眼(82.35%),早期大剂量抗病毒药物治疗后单眼发病者未发现对侧眼发病.结论 尽早诊断和应用足量的抗病毒药物,结合预防性视网膜激光光凝和玻璃体切除术可提高急性视网膜坏死的治疗效果,同时减少对侧眼的发病率.

  9. Tratamento da necrose aguda de retina: revisão sistemática Treatment of acute retinal necrosis: systematic review

    Moysés Eduardo Zajdenweber

    2005-08-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi pela realização de revisão sistemática, determinar o melhor tratamento para a necrose aguda de retina. MÉTODOS: Seguindo a orientação metodológica da Colaboração Cochrane e de seu subgrupo editorial "Eye and Vision Group", o autor, por meio de mecanismos de busca, selecionou trabalhos sobre o tratamento da necrose aguda de retina. RESULTADO: Foram selecionadas 146 referências bibliográficas, sendo considerados como relevantes 13 estudos. Destes estudos 2 foram considerados como preenchendo os critérios de inclusão. O primeiro estudo aponta a possibilidade de o tratamento para necrose aguda de retina, com aciclovir endovenoso associado a corticóide sistêmico, proteger o olho contralateral de acometimento. Foram estudados 54 pacientes, 31 tratados e 23 não tratados, sendo observada incidência de doença no olho contralateral de 12,9% no grupo tratado e de 69,5% no grupo não tratado. O segundo estudo incluído mostra 19 olhos acometidos com necrose aguda de retina, sendo que 12 destes olhos foram submetidos à fotocoagulação com laser de argônio, com o objetivo de prevenir o descolamento de retina. Dos 12 olhos, 2 desenvolveram descolamento de retina (16,6% ao passo que, no grupo não tratado, composto por 7 olhos, 4 desenvolveram descolamento de retina (57,1%. CONCLUSÃO: O autor conclui que os dois tipos de intervenção propostos se mostraram eficazes, porém, como os estudos são metodologicamente fracos, torna-se necessária a realização de estudos clínicos randomizados para que se possa estabelecer o melhor tratamento para a necrose aguda de retina.PURPOSE: The purpose of this study was to identify, according to an sistematic review, the best treatment for acute retinal necrosis. METHODS: Following the methodologic guidance of the Cochrane Collaboration and its editorial subgroup "Eye and Vision Group", using search strategy for study identification, articles about the treatment

  10. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-01-01

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids. PMID:27511757

  11. Etiological study of acute retinal necrosis%急性视网膜坏死的病原学研究

    徐海燕; 叶俊杰; 耿爽

    2015-01-01

    目的 探讨急性视网膜坏死(ARN)病原学研究在临床治疗中的价值.方法 回顾性系列病例研究.总结分析1996年1月至2012年12月在北京协和医院眼科诊断为ARN的39例(45眼)患者(ARN组)的临床资料.所有患者均行常规眼部检查.39例患者均抽取静脉血行血清TORCH检测,其中22例患者行血清总IgG检测.15眼于玻璃体切除术中抽取玻璃体液,行玻璃体液总TORCH及IgG检测.对照组为2006年6月至2008年11月因非感染性视网膜疾病而行玻璃体切除手术的患者15例(15眼).15例患者术前均行血清总IgG检测,术中抽取玻璃体液,行玻璃体液总TORCH及IgG检测.数据采用独立样本t检验进行分析.结果 对照组患者血清总IgG含量为(10.02±2.69) g/L,ARN组为(10.10±2.38)g/L,2组差异无统计学意义.对照组玻璃体液总IgG为(135.3±178.0)mg/L;ARN患眼玻璃体液中检测出HSV-IgG、CMV-IgG,玻璃体液总IgG含量为(2 949.2±1 845.1)mg/L,2组患者的玻璃体液总IgG的差异有统计学意义(t=6.024,P<0.01).对照组血清HSV-IgG的几何平均滴度为86.10-62.02,ARN组为86.30-±-65.31,2组差异无统计学意义.ARN组患者7眼HSV的Goldmann-Witmer系数C值(CWC)>6,提示为HSV感染;1眼CMV的CWC值>6,提示CMV感染.结论 ARN患者玻璃体液的特异性病毒抗体检测可提示感染病原体,对因治疗可提高ARN的治疗效果.%Objective To investigate the importance of etiological research in clinical therapy of acute retinal necrosis (ARN).Methods Retrospective cases-series study.Analyzed the clinical data of 45 eyes (39 cases) of ARN patients who were diagnosised in the Department of Ophthalmology of PUMCH during January 1996 to December 2012.All patients underwent routine eye examination.Blood samples were taken from 39 patients for serum TORCH test,22 patients underwent total serum IgG detection.15 eyes underwent the TORCH and total IgG detection of vitreous humor.The control group:15 patients (15 eyes

  12. Analysis of 9 Cases Misdiagnosed as Acute Retinal Necrosis Syndrome%急性视网膜坏死综合征九例误诊分析

    金绘祥; 黄宝玲; 吴昌凡; 郎平; 梅立新

    2012-01-01

    目的 提高对急性视网膜坏死综合征(acute retinal necrosis syndrome,ARNs)的认识,以避免或减少误诊.方法 对2007年6月-2011年10月在我院误诊的9例(9眼)ARNs的诊疗过程进行回顾性分析,内容包括主诉、眼部体征、检查项目和初始诊断.结果 本组分别误诊为虹膜睫状体炎4例,全葡萄膜炎2例,急性结膜炎、青光眼睫状体炎综合征及视网膜血管炎各1例.误诊时间为3 ~28 d,平均(15.0±9.5)d;就诊次数为2~6次,平均(3.7±1.2)次.本组9例中有7例眼压升高,范围在22~ 38 mmHg,6例系统应用了糖皮质激素,平均(8.2±2.4)d.确诊后所有病例均予抗病毒治疗,同时3例实施外路视网膜光凝术,5例行玻璃体切割术.随访3个月~2年,2例发生视网膜脱离,4例视力恢复,3例视力下降.结论 ARNs易误诊为葡萄膜炎等,临床接诊眼压增高、系统应用糖皮质激素治疗后眼部病情仍加重者,应警惕ARNs的可能.%Objective To improve cognitive level of acute retinal necrosis syndrome (ARNs) in order to avoid misdiagnosis. Methods A retrospective analysis was performed on clinical data of 9 patients (9 eyes) with acute retinal necrosis syndrome admitted in our department during June 2007 and October 2011 , including analysis of complain, signs of ocular region , examination items and incipient diagnosis. Results There were misdiagnosed as iridocyclitis (4 cases) , panuveitis (2 cases), acute conjunctivitis (1 case) , glaucomato cyclitic syndrome (1 case) and retinal vasculitis (1 case). Misdiagnosed times were 3-28 days and the average times were (15 ±9.5)days. The patients paid 2 ~6 visits with an average of (3.7 ±1.2)visits. Elevated intraocular pressure (ranging from 22 to 38 mmHg) developed in 7 eyes out of 9 cases before final diagnosis, and 6 patients had been treated with glucocorti-coid (an average of 8.2 ±2.4 days). All the patients received systemic antiviral agents after final diagnosis, 3 eyes were treated

  13. Clinical analysis of 27 cases of acute retinal necrosis syndrome%27例急性视网膜坏死综合征的临床分析

    汪静; 柯根杰

    2012-01-01

    To analyze the treatment effect of 27 cases ( 29 eyes ) of acute retinal necrosis syndrome ( ARNS ) with antivirus drugs, laser treatment, vitreous and retinal surgery retrospectively. Inflammations were all controlled, their visual acuity improved in 16 eyes ( 55. 2% ). The retinas of 28 eyes were successfully recovery except one refused the surgery. Although the prognosis of ARNS is poor, it is very important to get correct diagnosis and antivirus drugs, laser treatment, laser photocoagulation and vitrectomy in time can improve the prognosis obviously.%回顾性分析采用抗病毒药物、眼内激光光凝及玻璃体视网膜联合手术综合治疗27例急性视网膜坏死综合征(ARNS)的效果.29眼炎症均得到有效控制,视力提高16眼(55.2%),除1例拒绝手术外,视网膜均恢复良好.ARNS的预后较差,明确诊断后使用抗病毒药物,及时施行预防性眼内激光光凝和玻璃体视网膜手术可明显改善预后.

  14. 急性视网膜坏死综合征15例临床研究%The Clinical Analysis of Acute Retinal Necrosis in 15 Cases

    任丹; 陈莲

    2012-01-01

    Objective To observe the treatment of acute retinal necrosis syndrome (ARNS). Methods The treatment experiences of 16 eyes with ARNS in 15 patients during January 2008 to December 2010 were reviewed. The preoperative vision was 0.01 ~0. 1 in 10 eyes(62. 50% ) , 0. 2 in 2 eyes( 12. 50% ) , 0. 3 in 1 eye (6.25%) , 0.4 in 2 eyes(12.50% ) , 0.5 in 1 eye(6.25%). Results Postoperative vision was improved by different degree in 15 cases of 16 eyes diagnosed ARNS- The vision was 0. 01 ~0. 1 in 5 eyes(31. 25% ) , 0. 2 in 1 eye(6.25%), 0.3 in 4 eyes(25.00%), 0.4 in 3 eyes(18.75%) , 0. 5 in 1 eyes(6. 25%), 0. 6 in 2 eyes( 12. 50% ). The condition of all patients was effectively controlled when discharged from hospital. The vision was corrected more than 0. 2 in 5 eyes (31. 25% ) , more than 0.1 in 6 eyes{37. 50% ), and was not obviously improved in 5 eyes(31. 25% ). The best vision was 0.6. Conclusion If necessary, vitrectomy is a useful treatment for ARNS in most cases and anti-virus medicine may be used at least 2 weeks before operation.%目的 探讨急性视网膜坏死综合征(acute retinal necrosis syndrome,ARNS)的有效治疗方法. 方法 研究15例(16眼)ARNS患者的临床表现和治疗方法.术前视力光感0.1以下者10眼(62.50%),0.2者2眼(12.50%),0.3者l眼(6.25%),0.4者2眼(12.50%),0.5者1眼(6.25%).结果 15例(16眼)ARNS术后视力均有不同程度提高,治疗3个月后视力0.01~0.1者5眼(31.25%);0.2者1眼(6.25%);0.3者4眼(25.00%);0.4者3跟(18.75%);0.5者1眼(6.25%);0.6者2眼(12.50%).其中矫正视力0.2以上者5眼(31.25%);矫正视力0.1以上者6眼(37.5%);5眼(31.25%)视力无明显改变;最好视力达0.6. 结论 所有病人出院时病情都得到有效控制,对大部分病例而言,术前至少需2周抗病毒治疗;必要时行玻璃体切除手术,效果较好.

  15. Research advance in mechanism of acute retinal necrosis%急性视网膜坏死发病机制的研究进展

    刘鑫

    2014-01-01

    Acute retinal necrosis (ARN) syndrome is a kind of rare eye infectious disease caused by herpetic virus primarily.Visual prognosis of ARN patient is poor because of a high rate of complications including retinal detachment.The infection and antiinfection runs through the pathological process in ARN,such as invasion and dissemination of virus as well as the immunologic response of body.The multiple mechanisms are associated with the entry and spread of virus,including binding of viral surface protein and host receptor.Establishment of latency of the virus relies on access to related neuron,ganglion,ocular tissue which may occur after initial entry and replication.Activation of the immunologic system makes it possible to eliminate the virus and control infection.The relationship of viral invasion,dissemination and immune response with ARN pathogenesis and progression were reviewed.%急性视网膜坏死(ARN)是一种少见的病毒感染性疾病,其致病病毒主要是疱疹病毒,易引起视网膜脱离等并发症,故视力预后较差.ARN的发生和发展主要为感染与抗感染的过程,包括病毒入侵、播散、潜伏活化及机体免疫应答等方面.病毒进入宿主细胞是病毒表面蛋白与宿主细胞表面受体结合的过程,病毒感染后可潜伏于眼部相关的神经组织及眼内组织中.研究表明,病毒感染后可活化机体的免疫系统,诱发免疫细胞吞噬病毒、活化其他免疫细胞、产生细胞因子并介导炎症反应等,从而起到清除病毒、控制感染的目的,这些免疫细胞及细胞因子相互作用,共同参与ARN的发病过程.就病毒入侵、播散及机体免疫等与ARN发生和发展的关系进行综述.

  16. 十九例急性视网膜坏死临床分析%Acute Retinal Necrosis:A Report of 19 Cases

    郭梦翔; 易长贤

    2004-01-01

    目的:探讨提高对急性视网膜坏死(acute retinal necrosis,ARN)的临床诊治水平的有效方法.方法:回顾性分析本院1996年1月至2003年11月以来19例ARN患者的临床表现、检查、诊治及预后.结果:19例患者中除1例元眼前段表现外,其余18例(23只眼)都表现为不同程度的眼前段炎症、玻璃体炎、坏死性视网膜炎和闭塞性视网膜血管炎.19例患者中5例(5只眼)HSV-1阳性.治疗后视力提高共11只眼(45.8%).最终视力≤0.05者11只眼(45.8%).随访期内21只眼(87.5%)病变控制.结论:ARN的诊断以临床表现为主.早期、足量的抗病毒、皮质类固醇激素的应用以及预防性视网膜光凝、必要时玻璃体手术是控制病变的关键.

  17. Time profile of viral DNA in aqueous humor samples of patients treated for varicella-zoster virus acute retinal necrosis by use of quantitative real-time PCR.

    Bernheim, D; Germi, R; Labetoulle, M; Romanet, J P; Morand, P; Chiquet, C

    2013-07-01

    The objective of this study was to evaluate the kinetics of varicella-zoster virus (VZV) loads using quantitative PCR (qPCR) in patients treated for acute retinal necrosis (ARN). Six patients (52 ± 13 years old) with ARN syndrome were consecutively studied. Aqueous humor (AH) was sampled from both eyes of all patients for qPCR evaluation. The patients were treated with intravenous acyclovir and intravitreal injections of antiviral drugs. The mean follow-up time was 17.6 ± 16.4 months. Main outcome measures were the numbers of viral genome copies in the AH, assessed using real-time qPCR with hydrolysis probe technology with a threshold of detection of 200 copies/ml. Two main portions of the viral load curves were observed for each patient: a plateau phase (27.8 ± 24.9 days) and a decrease in the number of viral genome copies. The mean baseline viral load was 3.4 × 10(7) ± 4.45 × 10(7) copies/ml (6 × 10(6) to 1.2 × 10(8) copies/ml). The viral load decreased according to a logarithmic model, with a 50% reduction obtained in 3 ± 0.7 days. There was a significant viral load (>102 copies/ml) at 50 days after the onset of treatment, despite antiviral drugs. qPCR use demonstrated reproducible VZV DNA kinetics with a two-phase evolution: a plateau followed by a logarithmic decrease. These data suggest that high-dosage antiviral therapy administered for the conventional 10-day duration is insufficient for most patients. This series of patients responded with a similar decrease in viral load once treatment was initiated, and the data from these patients may be used to predict the responses of future patients. PMID:23637296

  18. Clinical observation the effects of combination application of salvia miltiorrhiza and acyclovir (ACV) on acute retinal necrosis (ARN)%丹参、无环鸟苷联合治疗急性视网膜坏死

    蒋美峰; 方春庭

    2000-01-01

    目的:为了探讨急性视网膜坏死(acute retinal necrosis,ARN)的有效疗法.方法:对6例(8只眼)ARN患者采用丹参、无环鸟苷(acyclovir,ACV)联合治疗.结果:随访6~18个月,7只眼视力有不同程度提高,视力提高达88.8%.结论:丹参、ACV联合应用是治疗ARN的一种有效方法.

  19. Clinical analysis on acute retinal necrosis syndrome%急性视网膜坏死综合征的临床分析

    周旻; 高巧云; 徐格致; 王文吉

    2009-01-01

    Objective To observe the clinical features of acute retinal necrosis syndrome (ARN).Methods The clinical data of 84 patients (98 eyes) with ARN were retrospective analyzed.The patietns had undergone the examinations of best visual acuity,intraocular pressure,B-scanning,slit-lamp biomicroscope,preset lens,direct and (or) indirect ophthalmolscope,and trihedral reflector;fundus fluorecein angiography had been performed on the patients with clear refracting media.Some of the patients had undergone polymerase chain reaction (PCR) to dectet the types of the causative virus.Medication,laser photocoagulation,and vitreous surgery had been performed on the patients after the diagnosis was confirmed.The visual acuity and the change of ocular fundus had been followed up;the average follow-up was 24.1 months.Results The average age of the patients at the onset was 42.8 years with the bilateraleye rate of 16.6% and retinal-detachment rate of 57.1%.There were 53.5% and 35.5% patients had the final visual acuity of>0.02 after 6 and 12 months,respectively.Better prognosis was found in patients diagnosed within 2 weeks and second involved eye.Varicella zoster virus DNA was identified in 15 patients and herpes simplex virus 1 was found in 3.Conclusions ARN is an acute disease with high incidence of retinal detachment.Serious retinal vasculopathy always happens at the late stage,and the prognosis is poor.Diagnosis in early stage is important and application of PCR will do contribution to the right diagnosis.%目的 观察急性视网膜坏死综合征(ARN)的临床特征.方法 回顾性分析84例98只眼ARN患者的临床资料.患者进行了最佳矫正视力、眼压、B型超声检查、裂隙灯生物显微镜、前置镜、直接和(或)间接检眼镜结合三面镜检查,屈光间质清楚者行荧光素眼底血管造影.部分患者行聚合酶链反应(PCR)检查鉴定致病病毒种类,明确诊断ARN后抗病毒、选择性激光和玻璃体手术治疗.并对视力

  20. Acute oesophageal necrosis syndrome

    Garas, George; Wou, Constance; Sawyer, Joseph; Amygdalos, Iakovos; Gould, Stuart

    2011-01-01

    An 89-year-old woman with a known hiatus hernia presented to the accident and emergency department with acute onset epigastric pain. CT of the thorax and abdomen revealed a large hiatus hernia with mesentero-axial volvulus but no evidence of strangulation. A large aneurysmal aortic arch and descending aorta were visible with associated mural thrombus. As the pain was worsening, following discussion with the patient, the decision to operate was taken. The hiatus hernia was successfully reduced...

  1. Progressive Outer Retinal Necrosis and Immunosuppressive Therapy in Myasthenia Gravis

    Solène Coisy

    2014-04-01

    Full Text Available Introduction: Progressive outer retinal necrosis (PORN is a rare but devastating infectious retinitis associated with varicella zoster virus (VZV and responsible for severe visual loss. Case Report: A 59-year-old man treated for generalized myasthenia with oral azathioprine and prednisone presented with severe unilateral necrotizing retinitis. Polymerase chain reaction of the aqueous and vitreous humors was diagnostic for VZV PORN. Conclusion: VZV PORN is a severe potential ocular complication of immunosuppression, prompting urgent diagnosis and appropriate treatment.

  2. Progressive Outer Retinal Necrosis and Immunosuppressive Therapy in Myasthenia Gravis

    Coisy, Solène; Ebran, Jean-Marc; Milea, Dan

    2014-01-01

    Introduction Progressive outer retinal necrosis (PORN) is a rare but devastating infectious retinitis associated with varicella zoster virus (VZV) and responsible for severe visual loss. Case Report A 59-year-old man treated for generalized myasthenia with oral azathioprine and prednisone presented with severe unilateral necrotizing retinitis. Polymerase chain reaction of the aqueous and vitreous humors was diagnostic for VZV PORN. Conclusion VZV PORN is a severe potential ocular complication...

  3. Progressive outer retinal necrosis: manifestation of human immunodeficiency virus infection.

    Lo, Phey Feng; Lim, Rongxuan; Antonakis, Serafeim N; Almeida, Goncalo C

    2015-01-01

    We present the case of a 54-year-old man who developed progressive outer retinal necrosis (PORN) as an initial manifestation of HIV infection without any significant risk factors for infection with HIV. PORN is usually found as a manifestation of known AIDS late in the disease. Our patient presented with transient visual loss followed by decrease in visual acuity and facial rash. Subsequent investigation revealed anterior chamber tap positive for varicella zoster virus (VZV), as well as HIV positivity, with an initial CD4 count of 48 cells/µL. Systemic and intravitreal antivirals against VZV, and highly active antiretroviral therapy against HIV were started, which halted further progression of retinal necrosis. This case highlights the importance of suspecting PORN where there is a rapidly progressive retinitis, and also testing the patient for HIV, so appropriate treatment can be started. PMID:25948844

  4. A case of atypical progressive outer retinal necrosis after highly active antiretroviral therapy.

    Woo, Se Joon; Yu, Hyeong Gon; Chung, Hum

    2004-06-01

    This is a report of an atypical case of progressive outer retinal necrosis (PORN) and the effect of highly active antiretroviral therapy (HAART) on the clinical course of viral retinitis in an acquired immunodeficiency syndrome (AIDS) patient. A 22-year-old male patient infected with human immunodeficiency virus (HIV) presented with unilaterally reduced visual acuity and a dense cataract. After cataract extraction, retinal lesions involving the peripheral and macular areas were found with perivascular sparing and the mud-cracked, characteristic appearance of PORN. He was diagnosed as having PORN based on clinical features and was given combined antiviral treatment. With concurrent HAART, the retinal lesions regressed, with the regression being accelerated by further treatment with intravenous acyclovir and ganciclovir. This case suggests that HAART may change the clinical course of PORN in AIDS patients by improving host immunity. PORN should be included in the differential diagnosis of acute unilateral cataract in AIDS patients. PMID:15255240

  5. Demarcation laser photocoagulation induced retinal necrosis and rupture resulting in large retinal tear formation.

    Quezada, Carlos; Pieramici, Dante J; Matsui, Rodrigo; Rabena, Melvin; Graue, Federico

    2015-06-01

    Retinal tears after laser photocoagulation are a rare complication that occurs after intense laser. It is talked about among retina specialist occurring particularly at the end of a surgical case while applying endophotocoagulation; to the best our knowledge, there are no reports in the literature of a large retinal tear induced after attempted in-office demarcation laser photocoagulation (DLP) that simulated a giant retinal tear. DLP has been employed in the management of selected cases of macula sparring rhegmatogenous retinal detachment (RRD). Even though extension of the retinal detachment through the "laser barrier" is considered a failure of treatment, few complications have been described with the use of this less invasive retinal detachment repair technique. We describe a case of a high myopic woman who initially was treated with demarcation laser photocoagulation for an asymptomatic retinal detachment associated with a single horseshoe tear and a full thickness large retinal tear was created where the laser was placed. Intense laser photocoagulation resulted in abrupt laser induced retinal necrosis and rupture creating this large retinal break. Proper laser technique should reduce the risks associated with this procedure. PMID:25770055

  6. The clinical effects and the selectiori of juncture for the integrated treatment of acute retinal necrosis%急性视网膜坏死综合治疗的时机选择及疗效分析

    许立帅; 李文生; 吴荣瀚; 郑钦象; 赵立娟

    2008-01-01

    目的 探讨急性视网膜坏死(acute retinal necrosis,ARN)综合治疗时机选择及疗效.方法 ARN患者15例(18只眼),病程1周至6月,初诊视力:光感、手动和数指各2只眼,0.02~0.1者4只眼,0.12~0.4者6只眼,0.5、0.6各1只眼.所有患者确诊后均全身使用抗病毒药物阿昔洛韦或更昔洛韦,并根据病情不同采用玻璃体腔注药、激光光凝及玻璃体切割术等治疗方法 ,随访3~26月,平均(14.3±6.5)月.结果 14只眼在单纯全身抗病毒治疗后5只眼视力提高,8只眼经玻璃体腔注药后视力提高4只眼,行玻璃体切割术9只眼,术后均视网膜在位,7只眼视力提高,2只眼无提高.结论 ARN患者早期诊断是治疗的关键,早期全身抗病毒治疗是基础,玻璃体腔注药联合预防性眼内激光光凝及适时的玻璃体切割术是治疗ARN的有效手段.%Objective To discuss the clinical effects and the selection of methods and juncture for thetreatment of acute retinal necrosis (ARN).Methods Fifteen cases (18eyes)of ARN.Course of disease was 1week to 6 months.Preoperative visual acuity were light perception (LP) ,hand movement (HM)and countingfingers(CF) ,each in 2 eyes,0.02~0.1 in 4 eyes,0.12~0.4 in 6 eyes,0.5 and 0.6 in each 1 eye.All of the patientstreated with antivirus drug by intervenous drop infusion,then they were treated with Ganciclovir which wasinjected into vitreous cavity, Endophotocoagulation or vitrectomy based on those eunditions.Followed up from3 to 26 months.Results After the treatment of antivirus drug intervenous drop infusion, 5 of the 14 eyes hadelevated visual acuity.4 eyes visual acuity increased after treated with Ganciclovir which was injected intovitreous cavity in 8 eyes.All of 9 eyes obtained anatomic success after vitreetomy,and 7 eyes of 9 eyes aftersurgery had up visual acuity.Conclusions Early diagnosis is the key of the treatment of ARN, antivirus drugby intervenous drop infusion in earlier period is basal therapy

  7. Analysis of the misdiagnosis and missed diagnosis of Acute Retinal Necrosis syndrome in China%急性视网膜坏死综合征的误诊分析

    王绍伟; 张少冲; 李梅; 曾骏文

    2008-01-01

    Objective To investigate the present status in the diagnosis of Acute Retinal Necrosis syndrome in China.Methods Clinic data of 114 in-patients with ARN syndrome from January 1998 to October 2006 in Zhongshan Ophthalmic Center were retrospectively analyzed,especially with respects to the former misdiagnosis and missed diagnosis.Results Blindness occurred in 29.79% of these investigated patients.Misdiagnosis or missed diagnosis occurred in 87.14%,93.0% and 73.68% of these patients respectively in Ⅰ,Ⅱ and Ⅲ-Ⅳ stage.The average duration between ARN onset and the time to make correct diagnosis was 46.16 days.Conclusions The misdiagnosis or missed diagnosis of ARN syndrome is very common in China.It is absolutely necessary to improve earlier diagnosis rate and recover some useful vision.%目的 分析急性视网膜坏死综合征(Acute retinal necrosis syndrome,ARN)临床诊断中存在的问题.方法 收集1998年1月至2006年10月中山眼科中心确诊住院治疗、以往资料完整的114例ARN病人的临床资料,重点分析初诊时误诊、漏诊原因,发病至确诊时间、确诊前诊断、治疗等情况.结果 114例(141眼)ARN病人的盲目率(42/141)为29.79%;初诊时,Ⅰ、Ⅱ、Ⅲ-Ⅳ期误诊率分别为61/70(87.14%)、23/25(93.0%)、13/19(73.68%),发病至确诊时间最短为3 d,最长为420 d,平均为46.16 d.结论 ARN综合征漏诊、误诊率较高,急需提高ARN的早期确诊率使病人保存部分有用视力.

  8. A 5-Case report of treating acute retinal necrosis syndrome with operation%手术治疗急性视网膜坏死5例报告

    李达璟; 张皙; 李佩娟; 蔡文泉

    2004-01-01

    目的通过5例病例总结,探讨手术治疗急性视网膜坏死综合征(acute retinal necrosis,ARN)的临床效果.方法应用巩膜环扎联合玻璃体切除加气/硅油交换手术治疗ARN. 结果 5例患者(5只眼)均视网膜复位,裂孔封闭,视力提高至0.1~0.15.结论对急性视网膜坏死综合征(ARN)后期致视网膜裂孔、脱离者,应用巩膜环扎联合玻璃体切除加气/硅油交换手术治疗,可以解除玻璃体对视网膜的牵引,封闭视网膜裂孔,使脱离的视网膜复位,最大限度地挽救患眼视功能.

  9. 病毒性脑炎合并急性视网膜坏死10例的临床特征%The clinical features of 10 cases of acute retinal necrosis complicated by viral encephalitis

    孙冉; 彭晓燕; 侯明勃

    2015-01-01

    Objective To investigate the clinical features of acute retinal necrosis (ARN) complicated by viral encephalitis.Methods Ten cases of ARN complicated by viral encephalitis were treated in the Department of Ophthalmology,Beijing Tongren Hospital from November 2013 to August 2014.Clinical manifestation,especially the fundus characteristics,was summarized.Results In thel0 patients (19 eyes ;6 men and 4 women)with an age of (40.1 ± 13.44)years,1 patients had unilateral ARN,and 9 patients had bilateral ARN.The visual acuity was no light perception in 9 eyes,light perception to hand motion in 7 eyes,0.05 in 1 eye,0.2 in 1 eye,and 0.3 in 1 eye.Seven cases suffered ARN during the onset of viral encephalitis,and other cases suffered ARN at 2 to 3 months after the recovery of viral encephalitis.Seventeen eyes had mild to moderate vitreous opacity,and 2 eye shad severe vitreous opacity.Sixteen eyes had focal (1 or 2quadrants)retinal necrosis,and 2 eyes had massive(> 2 quadrants) retinal necrosis.Occlusive vasculitis obviously occurred in 18 eyes.Sixteen eyeshad retinal detachment.All affected eves had early optic nerve atrophy.Conclusion ARN can occur during the onset of viral encephalitis or after the recovery of viral encephalitis.The clinical features of ARN complicated by viral encephalitis may be generally mild to moderate vitreous opacity,small range retinal necrosis foci,early and severe optic atrophy,and occlusive retinal vasculitis.%目的 探讨病毒性脑炎合并急性视网膜坏死(ARN)的临床特征.方法 回顾2013年11月至2014年8月北京同仁眼科中心收治的10例病毒性脑炎合并ARN的患者,其中男性6例,女性4例,年龄(40±13)岁.总结其临床发病、眼底表现特点.结果 10例患者中单眼发病1例,双眼发病9例,共19只眼患病.视力检查:9只眼无光感,7只眼光感至手动,1只眼0.05,1只眼0.2,1只眼0.3;7例病毒性脑炎发病期间并发ARN,3例病毒性脑炎后2~3个月ARN发病;眼底表现:玻璃

  10. Analysis of the causes of misdiagnosis of acute retinal necrosis syndrome and our measure in preventing it%急性视网膜坏死综合征误诊原因分析

    吴红云; 易长贤; 杨莎莎; 练苹

    2013-01-01

    Objective To analyze the causes of misdiagnosis of acute retinal necrosis syndrome (ARN),and possible critical points in preventing misdiagnosis.Methods Clinical data of 81 cases (93 eyes) in-patients with ARN from May 2006 to May 2012 in Zhongshan Ophthalmic Center,Sun Yat-sen University were retrospectively analyzed.Results The average time of first visit after appearance of ocular symptoms was 7.03 days (1 to 21 days),86 eyes (91.36%) was misdiagnosed in total.There were only 7 eyes that were correctly diagnosed at initial ophthalmic consultation.It took 31.11 days (ranging from 5 to 280 days) to reach the correct diagnose.Among the misdiagnosed eyes,22 eyes (29.73%) experienced one time misdiagnosis,35 eyes (47.3%) twice and 17 eyes (22.97%) had correctly diagnosis after three or even more time of ophthalmic examinations.Of the 86 misdiagnosed eye,55 eyes (63.95%) was labeled as uveitis,27 eyes (31.40.%) as kidocyclitis,28 eyes (32.55%) as other without explicit type of uveitis.Fifteen eyes (17.44%) were as conjunctivitis and 3 eyes (3.49%) as glaucoma and 13 eyes (15.12%) as others such as retinitis,Eales disease,retinal artery occlusion and retinal hemorrhage.Conclusions ARN is a easily misdiagnosed severe eye diseases.Ophthalmic professional have be alert when come across various uveitis and retinal diseases.%目的 分析急性视网膜坏死综合征(Acute retinal necrosis syndrom,ARN)误诊的原因,探讨防止误诊的对策.方法 收集2006年5月至2012年5月在中山大学中山眼科中心确诊并住院治疗81例(93只眼)ARN患者的临床病史资料,并对临床资料进行回顾性分析.结果 81例患者发病至初诊时间1~21天不等,平均7.03天,发病至正确诊断为ARN的时间为5~280天不等,平均31.11天;初次就诊确诊病例7例7只眼,多次就诊后确诊病例74例86只眼,误诊率91.36%; 74例误诊病例中1次误诊后确诊病例22例,占29.73%,2次误诊后确诊病例35例,占47.30

  11. Comparison of two different drug therapies for acute retinal necrosis syndrome%对比两种给药方案治疗急性视网膜坏死综合征患者的效果

    袁菁; 胡维琨

    2016-01-01

    AIM: To investigate clinical efficacy of two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin) for acute retinal necrosis syndrome. METHODS: Thirty patients (40 eyes) with acute retinal necrosis syndrome in our hospital were randomly divided into group A and B. Group A was treated with acyclovir with prednisone acetate tablets, and group B was given ganciclovir with prednisone acetate tablets and aspirin. Clinical effects in the two groups were observed and compared. RESULTS: After treatment, the overall response rate in group B (90%) was obviously higher than that in group A (70%), both of two regimens were effective, without significant difference (P>0. 05). There was no significant difference on the pre - treatment visual acuity between the two groups (P>0. 05). After different treatments, the visual acuity in group B was ≥0. 5 in 12 eyes, 0. 1≤and CONCLUSION: Two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin ) both have positive therapeutic effect, but the latter can better restore visual acuity and decrease the complications.%目的:探讨阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+醋酸泼尼松片+阿司匹林两种给药方案治疗急性视网膜坏死综合征的临床疗效。  方法:采用随机数字表法将我院急性视网膜坏死综合征患者30例40眼分为 A、B 两组,其中 A 组采用阿昔洛韦+醋酸泼尼松片的给药方案,B 组采用丙氧鸟苷+醋酸泼尼松片+阿司匹林的给药方案,观察并比较两组患者治疗后的临床效果。  结果:经过治疗后,B 组总有效率(90%)明显高于 A 组(70%),两种给药方案均有效,差异无统计学意义( P>0.05);两组患者在治疗前视力情况差异无统计学意义(P>0.05);经不同给药方案治疗后,A 组视力≥0.5者9眼,视力0.1~  结论:阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+

  12. Analysis of causes of misdiagnosis and treatment effects of acute retinal necrosis syndrome%急性视网膜坏死综合征的误诊原因分析及治疗效果

    闫焱; 沈玺; 张琼; 李娜

    2011-01-01

    目的 探讨急性视网膜坏死综合征(ARN)的误诊原因及治疗效果.方法 回顾性分析7例(7眼)ARN患者的误诊原因及治疗效果.结果 7例患者中3例误诊为虹膜睫状体炎,2例误诊为全葡萄膜炎,1例误诊为青光眼-睫状体炎综合征,1例误诊为视网膜出血.确诊后,7眼中4眼给予抗病毒药物及玻璃体手术治疗,3眼予抗病毒药物及眼底激光治疗.随访3~39个月,6例治疗后视力比治疗前有明显改善,治疗后最佳矫正视力从眼前指数至0.6不等.2例玻璃体手术患者取硅油后,均出现低眼压,视力下降.结论 ARN的早期诊断至关重要,如误诊会失去最佳治疗机会.早期、足量药物治疗联合眼内激光,必要时行玻璃体手术,可挽救ARN患者的残存视力.%Objective To investigate the causes of misdiagnosis and treatment effects of acute retinal necrosis syndrome (ARN). Methods The causes of misdiagnosis and treatment effects of 7 patients (7 eyes) with ARN were retrospectively analysed. Results Three patients were misdiagnosed as iridocyclitis, 2 as panuveitis, 1 as Posner-Schlossman Syndrome and 1 as retinal hemorrhage. After the diagnosis was confirmed, antiviral medications and vitrectomy were administered to 4 patients, and antiviral medications and prophylactic laser were performed in the other 3 cases. During the follow up, visual acuity significantly improved in 6 patients. Ocular hypotony and decreased visual acuity took place in 2 patients after oil removal in vitrectomy. Conclusion The early diagnosis of ARN is of great significance, and best treatment opportunity may be missed due to misdiagnosis. As soon as the diagnosis is confirmed, the early management with sufficient medications and prophylactic laser, with vitrectomy if necessary, may preserve the residual visual acuity of patients with ARN.

  13. Gastrointestinal stromal tumor: acute liquefaction necrosis

    Stromal tumors, together with leiomyomas and schwannomas, constitute the sol-called mesenchymal tumors of the intestinal wall. Stromal tumors are histologically differentiated from other mesenchymal tumors in that they are derived from the interstitial cell of Cajal. These tumors can be encountered at any point throughout the entire digestive tract, by usually develop in stomach or small bowel. the clinical presentation in anemia secondary to gastrointestinal bleeding. Acute abdomen due to perforation or necrosis is rare. We present a case of jejunal stromal tumors with massive liquefaction necrosis, a circumstance that resulted in the peculiar radiological features observed. (Author) 9 refs,

  14. Progressive outer retinal necrosis in immunocompromised kidney allograft recipient.

    Turno-Kręcicka, A; Boratyńska, M; Tomczyk-Socha, M; Mazanowska, O

    2015-06-01

    Ocular complications in patients who underwent renal transplantation are attributed to side effects of the immunosuppressive regimen. Progressive outer retinal necrosis (PORN) syndrome is a clinical variant of necrotizing herpetic retinopathy and it occurs almost exclusively in patients with acquired immunodeficiency syndrome. We present a case of a human immunodeficiency virus-negative patient who underwent renal transplant and, after a few years, developed bilateral PORN associated with viral infections. Varicella zoster virus (VZV) and BK virus were identified by polymerase chain reaction from the vitreous fluid. It is unclear which of the viruses identified had the dominant role in the pathogenesis of PORN and other organ damage, or whether their actions were synergistic. Adequate antiviral immune surveillance, as well as pre-transplant vaccination against VZV, may reduce the incidence of VZV infection and its complications. PMID:25846017

  15. The Effects of Combination of Traditional Chinese Medicine, Acyclovir (ACV) and Corticosteroid on Acute Retinal Necrosis (ARN)%中药、无环鸟苷、皮质激素联合治疗急性视网膜坏死

    陈卫玲; 杨志坤; 滕颖; 马晓萍

    2001-01-01

    目的:为了探讨急性视网膜坏死(acute retinal necrosis,ARN)的有效疗法.方法:对8例(11只眼)ARN患者用中药、无环鸟苷(acyclovir,ACV)、激素联合治疗.结果:随访3~36个月,10只眼视力有不同程度提高,视力提高达90.9%结论:中药、ACV、激素联合应用是治疗ARN的一种有效方法.

  16. Progressive Outer Retinal Necrosis Combined with Vitreous Hemorrhage in a Patient with Acquired Immunodeficiency Syndrome

    You, Yong Sung; Lee, Sung Jin; Lee, Sung Ho; Park, Chang Hyun; Kwon, Oh Woong

    2007-01-01

    Purpose To describe an unusual case of rapidly progressive outer retinal necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from what was probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes simplex type 1,2, as proven by the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). Methods This study is a case report detailing clinical follow-up and ...

  17. Gastric Necrosis due to Acute Massive Gastric Dilatation

    Ibrahim Aydin

    2013-01-01

    Full Text Available Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

  18. Progressive outer retinal necrosis: a missed diagnosis and a blind, young woman.

    Parekh, Parth; Oldfield, Edward C; Marik, Paul E

    2013-01-01

    We present a 33-year-old woman with a history significant for HIV/AIDS (CD4 count of 17) and diabetes mellitus who was diagnosed as having progressive outer retinal necrosis (PORN) after presenting with peripheral vision loss. This case provided a diagnostic challenge and demonstrates the devastating effects of a misdiagnosis as it pertains to PORN. PMID:23608868

  19. Progressive outer retinal necrosis: a missed diagnosis and a blind, young woman

    Parekh, Parth; Oldfield, Edward C; Marik, Paul E

    2013-01-01

    We present a 33-year-old woman with a history significant for HIV/AIDS (CD4 count of 17) and diabetes mellitus who was diagnosed as having progressive outer retinal necrosis (PORN) after presenting with peripheral vision loss. This case provided a diagnostic challenge and demonstrates the devastating effects of a misdiagnosis as it pertains to PORN.

  20. 急性视网膜坏死患者玻璃体MMP-2和MMP-9活性研究%Investigation of the activity of matrix metalloproteinases 2 and 9 in vitreous of patients with acute retinal necrosis

    顾永昊; 石磊; 柯根杰

    2009-01-01

    目的 检测急性视网膜坏死(acute retinal necrosis,ARN)患者玻璃体内基质金属蛋白酶(matrix metallopreteinases,MMPs)2和9的活性.方法 6例ARN患者行玻璃体切割术抽取玻璃体液,6例单纯孔源性视网膜脱离(rhegmatogenous detachment,RD)患者作为对照.采用明胶酶谱法进行MMP-2和MMP-9活性检测.结果 RD患者玻璃体标本显示72kDaMMP-2酶原和62kDa MMP-2活性酶条带,无明显MMP-9条带成分,ARN患者标本可见到92kDaMMP-9酶原、82kDaMMP-9活性酶、72kDaMMP-2酶原和62kDa MMP-2活性酶条带,ARN组所有条带的表达都要显著高于RD组(P<0.01).结论 MMP-2和MMP-9可能在ARN的玻璃体视网膜炎症反应中起到非常重要的作用.%Objective To detect the activity of matrix metalloproteinases (MMP) 2 and 9 in vitreous of patients with acute retinal necrosis (ARN). Methods Vitreous samples from 6 cases with ARN were obtained in process of vitrectomy. Samples from 6 cases of rheg-matogenous detachment of retina (RD) without PVR were set as control. Activities of MMP-2 and-9 were detected by gelatin zymography. Re-stilts Only 72kDa zemogen and 62 active enzyme of MM-2 could be detected in control, while 92kDa zemogen and 82 active enzyme of MM-9 and 72kDa zemogen and 62 active enzyme of MM-2 could be detected in vitreous of ALAN. Concentrations of all four bands were significantly higher in ARN patients than that in control (P<0.01). Conclusion Gelatinase A (MMP-2) and B (MMP-9) might play important roles in in-flammatory responses of ALAN patients.

  1. Bisphosphonate-induced bilateral acute renal cortical necrosis

    Sema Aksoy, MD; Elif Hocaoglu, MD; Aylin Karahasanoglu, MD; Behlul Igus, MD; Mehtap Beker Acay, MD; Ercan Inci, MD

    2015-01-01

    Renal cortical necrosis (RCN), a rare cause of renal failure in which there is death of the renal cortex but sparing of the medulla, is a catastrophic entity with high mortality. Its incidence and severity are higher in developing countries, mostly due to pregnancy-related complications. This paper presents the case of a 65-year-old woman who had bilateral renal cortical necrosis caused by bisphosphonate medication that was diagnosed by CT scan during the acute initial phase of the disease.

  2. Cytomegalovirus implicated in a case of progressive outer retinal necrosis (PORN).

    Sfeir, Maroun

    2015-08-01

    Progressive outer retinal necrosis, also known as PORN, has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with acquired immune deficiency syndrome (AIDS). Although the etiologic organism has been reported to be Varicella-zoster virus, cytomegalovirus (CMV) can be an etiologic agent. Our case illustrates the occurrence of two opportunistic infections: PORN associated with CMV and Mycobacterium avium intracellulare duodenitis in a patient with uncontrolled HIV infection. PMID:26209386

  3. Association of progressive outer retinal necrosis and varicella zoster encephalitis in a patient with AIDS.

    van den Horn, G. J; Meenken, C; D. Troost

    1996-01-01

    BACKGROUND: A patient with AIDS who developed the clinical picture of bilateral progressive outer retinal necrosis (PORN) in combination with varicella zoster encephalitis is described. The picture developed more than 2 years after an episode of ophthalmic zoster infection, and following intermittent exposure to oral acyclovir because of recurrent episodes of cutaneous herpes simplex infection. METHODS: Aqueous humour, obtained by paracentesis of the anterior chamber, was analysed using immun...

  4. Quantification of retinal layer thickness changes in acute macular neuroretinopathy

    Munk, Marion R; Beck, Marco; Kolb, Simone;

    2016-01-01

    PURPOSE: To quantitatively evaluate retinal layer thickness changes in acute macular neuroretinopathy (AMN). METHODS: AMN areas were identified using near-infrared reflectance (NIR) images. Intraretinal layer segmentation using Heidelberg software was performed. The inbuilt ETDRS -grid was moved ...

  5. Acute Tubuler Necrosis Related to Rhabdomyolysis

    Fatma Sarı DOĞAN

    2014-05-01

    Full Text Available Rhabdomyolysis is a clinical and laboratory syndrome due to traumatic or non-traumatic injury that leads muscle cell contents participation into circulation. Dehydration and acidosis may cause myoglobinuric acute renal failure in patient with rhabdomyolysis. This case presents a 27-year-old male referred to emergency unit with weakness and abdominal ache who has a story of urine decrease and trauma exposure. Diagnosis of rhabdomyolysis in this case highlights the importance of anamnesis in early diagnosis and treatment.

  6. Bisphosphonate-induced bilateral acute renal cortical necrosis

    Sema Aksoy, MD

    2015-01-01

    Full Text Available Renal cortical necrosis (RCN, a rare cause of renal failure in which there is death of the renal cortex but sparing of the medulla, is a catastrophic entity with high mortality. Its incidence and severity are higher in developing countries, mostly due to pregnancy-related complications. This paper presents the case of a 65-year-old woman who had bilateral renal cortical necrosis caused by bisphosphonate medication that was diagnosed by CT scan during the acute initial phase of the disease.

  7. A Rare Cause of Acute Abdomen: Idiopathic Isolated Cecal Necrosis

    Ender Özer

    2015-03-01

    Full Text Available Idiopathic isolated cecal necrosis is a clinical problem characterized by right-sided inferior abdominal pain. It is rarely seen, develops due to decreased blood flow to the colon and, imitates acute appendicitis. Its clinical signs are similar to many illnesses causing sensitivity in the right inferior quadrant and, the diagnosis is generally determined during surgery. An 86-year-old male patient presented with the complaints of abdominal pain, trichiniasis, nausea and vomiting. Surgical intervention was decided when physical examination and laboratory results were taken into consideration. After diagnostic laparoscopy, right hemicolectomy was performed because of cecal necrosis. While the mortality and morbidity rates for ischemic bowel disease are high, prognosis for early diagnosed patients with isolated cecal necrosis is better, provided that timely surgical treatment is decided.

  8. Contemporary management of infected necrosis complicating severe acute pancreatitis

    Jamdar, Saurabh; Siriwardena, Ajith K

    2006-01-01

    Pancreatic necrosis complicating severe acute pancreatitis is a challenging scenario in contemporary critical care practice; it requires multidisciplinary care in a setting where there is a relatively limited evidence base to support decision making. This commentary provides a concise overview of current management of patients with infected necrosis, focusing on detection, the role of pharmacologic intervention, and the timing and nature of surgical interventions. Fine-needle aspiration of necrosis remains the mainstay for establishment of infection. Pharmacological intervention includes antibiotic therapy as an adjunct to surgical debridement/drainage and, more recently, drotrecogin alfa. Specific concerns remain regarding the suitability of drotrecogin alfa in this setting. Early surgical intervention is unhelpful; surgery is indicated when there is strong evidence for infection of necrotic tissue, with the current trend being toward 'less drastic' surgical interventions. PMID:16356213

  9. Expression of matrix metalloproteinases and tissue inhibitors of metalloproteinases in epiretinal membranes of proliferative diabetic retinopathy,proliferative vitreoretinopathy and acute retinal necrosis patients%三种视网膜病视网膜前膜中基质金属蛋白酶及其天然抑制分子的表达

    顾永昊; 石磊; 柯根杰; 孙思勤

    2008-01-01

    Objective To examine the expression of matrix metalloproteinases (MMPs)and tissueinhibitors of metalloproteinases (TIMPs)in epiretinal membranes of proliferative diabetic retinopathy(PDR),proliferative vitreoretinopathy (PVR)and acute retinal necrosis (ARN)patients.Methods Epiretinalmembranes were obtained from PVR, PDR and ARN patients undergoing pars plana vitrectomy.Normal retinaobtained from donor eyes were used as control.Results MMP-1, MMP-3,TIMP-1 and TIMP-2 were stainedin normal retina.For PVR, PDR and ARN specimens, the increase portion of all iMPs and TIMPs stainingwere observed,especially MMP-2,MMP-7 and MMP-9.Conelusions There are MMPs and TIMPs existed innormal retina to balance the integrity of extracellular matrix.lncreased expression of MMPs, such as MMP-2,iMP-7 and iMP-9, might play the important roles in pathologic processes of PVR, PDR and AKN.%目的 研究增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)、增殖性玻璃体视网膜疾病(proliferative vitreoretinopathy,PVR)和急性视网膜坏死(acute retinalnecrosis,ARN)患者视网膜前膜中基质金属蛋白酶(matrixmetalloproteinases:MMPs)及其天然抑制物(tissueinhibitorsofmetalloproteinages,TIMPs)的表达情况.方法 玻璃体手术中剥取PVR、PDR和ARN患者的视网膜前膜,同供体眼视网膜作为正常对照,冰冻切片后进行免疫组织化学染色,包括:MMP-1,MMP-2,MMP-3,MMP-7,MMP-9,TIMP-1和TIMP-2.结果 正常视网膜中能够观察到MMP-1,MMP-3,TIMP-1和TIMP-2的表达,在PVR、PDR和ARN患者标本中各种分子的表达都增强,尤以MMP-2,MMP-3和MMP-7明显.结论 正常视网膜中存在MMPs和TIMPs分子维持着细胞外基质动态的平衡,在PVR,PDR和ARN患者中MMP-2,MMP-3和MMP-7等MMPs分子表达增强,在其病变过程中可能起重要作用.

  10. Retrobulbar optic neuritis and meningoencephalitis following progressive outer retinal necrosis due to CMV in a patient with AIDS.

    Park, K H; Bang, J H; Park, W B; Kim, H B; Kim, N J; Ahn, J K; Chang, K H; Oh, M D; Choe, K W

    2008-10-01

    We report on a 34-year-old male patient with AIDS who developed retrobulbar optic neuritis and meningoencephalitis following bilateral progressive outer retinal necrosis (PORN) caused by cytomegalovirus (CMV). This case documents the presumed association of PORN with retrobulbar optic neuritis, and CMV meningoencephalitis in an AIDS patient. PMID:18574556

  11. Acute tubular necrosis in a patient with paroxysmal nocturnal hemoglobinuria

    Eranga S Wijewickrama

    2013-01-01

    Full Text Available Acute renal failure (ARF is a well-recognized complication of paroxysmal nocturnal hemoglobinuria (PNH. The predominant mechanism is intravascular hemolysis resulting in massive hemoglobinuria ARF. We report a case of acute tubular necrosis (ATN developed in the absence of overwhelming evidence of intravascular hemolysis in a 21-year-old man with anemia, who was eventually diagnosed to have PNH. The patient presented with rapidly deteriorating renal functions in the background of iron deficiency anemia, which was attributed to reflux esophagitis. There was no clinical or laboratory evidence of intravascular hemolysis. Renal biopsy revealed ATN with deposition of hemosiderin in the proximal tubular epithelial cells. Diagnosis of PNH was confirmed with a positive Ham′s test and flow cytometry. Our case emphasizes the need to consider ATN as a possible cause for ARF in patients suspected to have PNH even in the absence of overwhelming evidence of intravascular hemolysis.

  12. Peripancreatic fat necrosis worsens acute pancreatitis independent of pancreatic necrosis via unsaturated fatty acids increased in human pancreatic necrosis collections

    Noel, Pawan; Patel, Krutika; Durgampudi, Chandra; Trivedi, Ram N; de Oliveira, Cristiane; Crowell, Michael D; Pannala, Rahul; Lee, Kenneth; Brand, Randall; Chennat, Jennifer; Slivka, Adam; Papachristou, Georgios I; Khalid, Asif; Whitcomb, David C; DeLany, James P; Cline, Rachel A; Acharya, Chathur; Jaligama, Deepthi; Murad, Faris M; Yadav, Dhiraj; Navina, Sarah; Singh, Vijay P

    2016-01-01

    Background and aims Peripancreatic fat necrosis occurs frequently in necrotising pancreatitis. Distinguishing markers from mediators of severe acute pancreatitis (SAP) is important since targeting mediators may improve outcomes. We evaluated potential agents in human pancreatic necrotic collections (NCs), pseudocysts (PCs) and pancreatic cystic neoplasms and used pancreatic acini, peripheral blood mononuclear cells (PBMC) and an acute pancreatitis (AP) model to determine SAP mediators. Methods We measured acinar and PBMC injury induced by agents increased in NCs and PCs. Outcomes of caerulein pancreatitis were studied in lean rats coadministered interleukin (IL)-1β and keratinocyte chemoattractant/growth-regulated oncogene, triolein alone or with the lipase inhibitor orlistat. Results NCs had higher fatty acids, IL-8 and IL-1β versus other fluids. Lipolysis of unsaturated triglyceride and resulting unsaturated fatty acids (UFA) oleic and linoleic acids induced necro-apoptosis at less than half the concentration in NCs but other agents did not do so at more than two times these concentrations. Cytokine coadministration resulted in higher pancreatic and lung inflammation than caerulein alone, but only triolein coadministration caused peripancreatic fat stranding, higher cytokines, UFAs, multisystem organ failure (MSOF) and mortality in 97% animals, which were prevented by orlistat. Conclusions UFAs, IL-1β and IL-8 are elevated in NCs. However, UFAs generated via peripancreatic fat lipolysis causes worse inflammation and MSOF, converting mild AP to SAP. PMID:25500204

  13. Detection of acute hepatopancreatic necrosis disease (AHPND) in Mexico.

    Nunan, Linda; Lightner, Donald; Pantoja, Carlos; Gomez-Jimenez, Silvia

    2014-08-21

    Acute hepatopancreatic necrosis disease (AHPND), which has also been referred to as early mortality syndrome (EMS), initially emerged as a destructive disease of cultured shrimp species in Asia in 2009. The pathogen associated with the disease, Vibrio parahaemolyticus, subsequently spread to the Western Hemisphere and emerged in Mexico in early 2013. The spread to the Western Hemisphere is a major concern to shrimp producers in the region. To date, the only peer-reviewed published method for determining whether mortalities are due to AHPND is through histological examination. A novel PCR detection method was employed to assess samples from Mexico in order to confirm the presence of the pathogen in this country. This manuscript details the detection methods used to confirm the presence of AHPND in Mexico. Both immersion and per os challenge studies were used to expose the Penaeus vannamei to the bacteria in order to induce the disease. Histological analysis confirmed AHPND status following the challenge studies. Also provided are the details of the molecular test by PCR that was used for screening candidate V. parahaemolyticus isolates. A rapid PCR assay for detection of AHPND may help with early detection and help prevent the spread of AHPND to other countries. PMID:25144120

  14. Use of drug therapy to manage acute cutaneous necrosis of the skin.

    Wallace, Jill S; Hall, John C

    2010-04-01

    Acute cutaneous necrosis is defined as a sudden onset of gangrenous skin changes in the skin, associated with significant morbidity and mortality. The following diseases are included in this discussion: coumadin necrosis, heparin necrosis, brown recluse spider bite, necrotizing fasciitis, vasculitis, pyoderma gangrenosum, calciphylaxis, clotting abnormalities and embolic phenomena. The importance of early diagnosis, early distinction and early drug therapy or drug withdrawal must match the diagnosis for maximal preservation of the skin and underlying tissue. PMID:20514791

  15. Pathogenesis of acute hepatopancreatic necrosis disease (AHPND) in shrimp.

    Lai, Hung-Chiao; Ng, Tze Hann; Ando, Masahiro; Lee, Chung-Te; Chen, I-Tung; Chuang, Jie-Cheng; Mavichak, Rapeepat; Chang, Sheng-Hsiung; Yeh, Mi-De; Chiang, Yi-An; Takeyama, Haruko; Hamaguchi, Hiro-o; Lo, Chu-Fang; Aoki, Takashi; Wang, Han-Ching

    2015-12-01

    Acute hepatopancreatic necrosis disease (AHPND), also called early mortality syndrome (EMS), is a recently emergent shrimp bacterial disease that has resulted in substantial economic losses since 2009. AHPND is known to be caused by strains of Vibrio parahaemolyticus that contain a unique virulence plasmid, but the pathology of the disease is still unclear. In this study, we show that AHPND-causing strains of V. parahaemolyticus secrete the plasmid-encoded binary toxin PirAB(vp) into the culture medium. We further determined that, after shrimp were challenged with AHPND-causing bacteria, the bacteria initially colonized the stomach, where they started to produce PirAB(vp) toxin. At the same early time point (6 hpi), PirB(vp) toxin, but not PirA(vp) toxin, was detected in the hepatopancreas, and the characteristic histopathological signs of AHPND, including sloughing of the epithelial cells of the hepatopancreatic tubules, were also seen. Although some previous studies have found that both components of the binary PirAB(vp) toxin are necessary to induce a toxic effect, our present results are consistent with other studies which have suggested that PirB(vp) alone may be sufficient to cause cellular damage. At later time points, the bacteria and PirA(vp) and PirB(vp) toxins were all detected in the hepatopancreas. We also show that Raman spectroscopy "Whole organism fingerprints" were unable to distinguish between AHPND-causing and non-AHPND causing strains. Lastly, by using minimum inhibitory concentrations, we found that both virulent and non-virulent V. parahaemolyticus strains were resistant to several antibiotics, suggesting that the use of antibiotics in shrimp culture should be more strictly regulated. PMID:26549178

  16. Coagulopathy and encephalopathy in a dog with acute hepatic necrosis.

    Strombeck, D R; Krum, S; Rogers, Q

    1976-10-15

    Disseminated intravascular coagulation developed secondary to hepatic necrosis in a 5-year-old Saint Bernard. Although the coagulopathy responded to treatment with heparin, the dog died from the combined effects of gastric hemorrhage and encephalopathy, both of which are complications of hepatic necrosis. PMID:977448

  17. Case of severe acute pancreatitis with near total pancreatic necrosis diagnosed by dynamic CT scanning

    Takeda, Kazunori; Kakugawa, Yoichiro; Amikura, Katsumi; Miyagawa, Kikuo; Matsuno, Seiki; Sato, Toshio

    1987-09-01

    A 42 year-old woman with severe acute pancreatitis had drainage of the pancreatic bed, cholecystostomy and jejunostomy on admission, but symptoms were not improved. Fourteen days after admission, clinical sepsis and septisemia were recognized. Dynamic CT scanning of the pancreas showed near total pancreatic necrosis. Symptoms were improved after necrosectomy of the pancreas and debridement of the peripancreatic necrotic tissue were performed. Our experience suggests the usefulness of dynamic CT scanning for detection of pancreatic necrosis in severe acute pancreatitis.

  18. Macular function and morphology in acute retinal pigment epithelitis

    Fatih C Gundogan

    2014-01-01

    Full Text Available A 20-year-old man applied with vision loss in the left eye. Right eye examination was unremarkable. Best-corrected visual acuity (BCVA in the left eye was 20/200. Fundus examination revealed a few yellow spots within a round-shaped macular lesion. Autofluorescence imaging showed hyperautofluorescence in the lesion. Central amplitudes in multifocal electroretinogram (mfERG were depressed. The patient reported a rhinopharyngitis 7-10 days before the visual loss. The patient was diagnosed as acute retinal pigment epithelitis. BCVA improved gradually up to 20/20 in 4 weeks. mfERG amplitudes returned to normal. A slight pigmentary distortion was the only residual fundus finding.

  19. Diabetes-Enhanced Tumor Necrosis Factor-α Production Promotes Apoptosis and the Loss of Retinal Microvascular Cells in Type 1 and Type 2 Models of Diabetic Retinopathy

    Behl, Yugal; Krothapalli, Padmaja; Desta, Tesfahun; DiPiazza, Amanda; Roy, Sayon; Graves, Dana T.

    2008-01-01

    Retinal microvascular cell loss plays a critical role in the pathogenesis of diabetic retinopathy. To examine this further, type 1 streptozotocin-induced diabetic rats and type 2 Zucker diabetic fatty rats were treated by intravitreal injection of the tumor necrosis factor-specific inhibitor pegsunercept, and the impact was measured by analysis of retinal trypsin digests. For type 2 diabetic rats, the number of endothelial cells and pericytes positive for diabetes-enhanced activated caspase-3...

  20. Can deconvolution of renal transplant curves discriminate acute necrosis for acute rejection?

    Full text: The management of allogeneic renal transplants in the acute post-operative period is diagnostically challenging when there is poor or no function of the graft, which occurs in about 10-15% of cases. Although acute tubular necrosis (ATN) is most common, acute transplant rejection remains a possibility in 25% of cases. Radionuclide renography (RRG) allows a non invasive assessment of graft perfusion and function. However, the ability to differentiate ATN from acute rejection, in particular mild cellular type, is quite limited. Thus we sought to improve the diagnostic value of RRG. From a pool of 137 renal transplant recipients from 1997 to 1998, we studied 21 subjects who had had a renal transplant biopsy with a tissue diagnosis of ATN (13) or rejection (8). They were chosen because they had also had serial RRG done at day + 1 and another close to the day of biopsy (day X). For each study, using deconvolution analysis of the input iliac artery bolus as reference, and comparing it with the dispersion of radioactivity over time in the whole graft, which corresponds to the initial iliac artery bolus, we derived a graft delay index (GDI). We then compared the GDIs of day + 1 vs day X, as a simple subtraction and as a linear ratio. In 1 of 13 subjects with ATN, we found that the GDI decreased at day X compared with day + 1. In 7 of 8 with rejection, the GDI increased at day X. Thus by comparing the graft delay index of a study done at some point in the acute post-operative period with day + 1, we can discriminate between ATN and rejection. It is our intention to apply our method in a prospective study

  1. Tumor Necrosis Factor Receptor 2: Its Contribution to Acute Cellular Rejection and Clear Cell Renal Carcinoma

    Jun Wang; Al-Lamki, Rafia S.

    2013-01-01

    Tumor necrosis factor receptor 2 (TNFR2) is a type I transmembrane glycoprotein and one of the two receptors that orchestrate the complex biological functions of tumor necrosis factor (TNF, also designed TNF- α ). Accumulating experimental evidence suggests that TNFR2 plays an important role in renal disorders associated with acute cellular rejection and clear cell renal carcinoma but its exact role in these settings is still not completely understood. This papers reviews the factors that may...

  2. [Acute hemorrhagic necrosis of the breast following treatment with Cumarin].

    Lüchtrath, H; Walkowsky, A

    1983-08-01

    A case of hemorrhagic necrosis of the breast is reported in a thirty-four year old woman who received Cumarin treatment for deep leg vein thrombosis and pulmonary embolism. It was necessary to remove the breast. The microscopic examination showed complete blockage of the vessels by fibrin thrombi in almost all veins. The cause of this venous thrombosis was explained as a Shwartzman-Sanarelli-Phenomenon. PMID:6555120

  3. Colonic Necrosis in a 4-Year-Old with Hyperlipidemic Acute Pancreatitis.

    Patton, Tiffany J; Sentongo, Timothy A; Mak, Grace Z; Kahn, Stacy A

    2016-01-01

    Here we report the case of a 4-year-old male with severe acute pancreatitis due to hyperlipidemia, who presented with abdominal pain, metabolic abnormalities, and colonic necrosis. This colonic complication was secondary to the extension of a large peripancreatic fluid collection causing direct serosal autodigestion by pancreatic enzymes. Two weeks following the initial presentation, the peripancreatic fluid collection developed into a mature pancreatic pseudocyst, which was percutaneously drained. To our knowledge, this is the youngest documented pediatric case of colonic necrosis due to severe pancreatitis and the first descriptive pediatric case of a colonic complication due to hyperlipidemia-induced acute pancreatitis. PMID:26925282

  4. Colonic Necrosis in a 4-Year-Old with Hyperlipidemic Acute Pancreatitis

    Tiffany J. Patton

    2016-01-01

    Full Text Available Here we report the case of a 4-year-old male with severe acute pancreatitis due to hyperlipidemia, who presented with abdominal pain, metabolic abnormalities, and colonic necrosis. This colonic complication was secondary to the extension of a large peripancreatic fluid collection causing direct serosal autodigestion by pancreatic enzymes. Two weeks following the initial presentation, the peripancreatic fluid collection developed into a mature pancreatic pseudocyst, which was percutaneously drained. To our knowledge, this is the youngest documented pediatric case of colonic necrosis due to severe pancreatitis and the first descriptive pediatric case of a colonic complication due to hyperlipidemia-induced acute pancreatitis.

  5. Ten years of experience with transgastric necrosectomy for walled-off necrosis in acute pancreatitis

    Busse, Malene Just; Ainsworth, Alan Patrick

    2015-01-01

    INTRODUCTION: The aim of this study was to report our results with open transgastric necrosectomy for walled-off necrosis in acute pancreatitis over a period of ten years. METHODS: Patients operated at the department from 2003 until 2012 were studied retrospectively. RESULTS: A total of 50 patients......: Acute pancreatitis with walled-off necrosis has a high mortality rate. Need for additional therapy following necrosectomy was associated with fatal outcome. Endocrine and exocrine insufficiency was often seen at follow-up. FUNDING: none. TRIAL REGISTRATION: The study was approved by the Danish Data...

  6. Acute hepatic encephalopathy presenting as cortical laminar necrosis: Case report

    Choi, Jong Mun; Kim, Yoon Hee; Roh, Sook Young [Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam (Korea, Republic of)

    2013-04-15

    We report on a 55-year-old man with alcoholic liver cirrhosis who presented with status epilepticus. Laboratory analysis showed markedly elevated blood ammonia. Brain magnetic resonance imaging (MRI) showed widespread cortical signal changes with restricted diffusion, involving both temporo-fronto-parietal cortex, while the perirolandic regions and occipital cortex were uniquely spared. A follow-up brain MRI demonstrated diffuse cortical atrophy with increased signals on T1-weighted images in both the basal ganglia and temporal lobe cortex, representing cortical laminar necrosis. We suggest that the brain lesions, in our case, represent a consequence of toxic effect of ammonia.

  7. Changes in the retinal veins in acute optic neuritis

    Engell, T; Sellebjerg, F; Jensen, C

    1999-01-01

    retinae (PR) and 2 had venous sheathing (VS). Probable MS was found in 15 patients without prior symptoms of MS. One had PR and VS, and 2 had VS. Twenty patients had mono-symptomatic ON, none had retinal changes. CONCLUSION: Changes of the retinal veins should alert the clinician to a probable diagnosis...

  8. Esofagitis necrosante aguda: análisis retrospectivo Acute esophageal necrosis: a retrospective case series

    R. Ramos

    2008-09-01

    Full Text Available Introducción: la esofagitis necrosante aguda es una entidad rara. Se reconoce por el aspecto negro difuso del esófago a la endoscopia. Su incidencia e patogénesis se desconoce. Pacientes y métodos: se analizaron retrospectivamente 11 pacientes con esofagitis necrosante aguda desde el punto de vista de los datos clínicos, de laboratorio y endoscopicos en 2 años. Resultados: se analizaron las endoscopias realizadas a 3.976 pacientes, observándose esofagitis necrosante aguda en 11 pacientes. El estado nutricional era malo en 6 pacientes. La resolución completa de la esofagitis se observó en cuatro pacientes. Durante el seguimiento se observó una estenosis en un paciente y un nuevo episodio de esofagitis necrosante aguda en otro paciente. Siete pacientes fallecieron, pero esta elevada mortalidad parece deberse a las enfermedades de base y no es atribuible a las lesiones de la esofagitis necrosante. Conclusiones: la incidencia de esofagitis necrosante aguda en nuestra serie fue 0,28%. La esofagitis necrosante aguda tiene una elevada mortalidad.Background: acute esophageal necrosis has been considered a rare event. It is defined as the presence of diffuse dark pigmentation of the esophagus on upper endoscopy. Its incidence has not yet been established. The pathogenesis remains unknown. Patients and methods: a retrospective analysis of clinical, laboratory, endoscopic, and histological data, and of the clinical course of 11 patients with acute necrotizing esophagitis was carried out over a 2-year period. Results: among 3,976 patients who underwent upper endoscopy, 11 (0.28% with acute esophageal necrosis were identified. Nutritional status was poor for 6 patients. Complete resolution of acute esophageal necrosis without further recurrence was observed in 4. One stricture appeared during follow-up and other patient developed new-onset acute esophageal necrosis. Seven patients died, but no death was directly related to acute esophageal necrosis

  9. Binge Eating Leading to Acute Gastric Dilatation, Ischemic Necrosis and Rupture –A Case Report

    Khare, Manish Kumar; Mishra, Sumanta; Marhual, Jogesh Chandra

    2016-01-01

    Acute gastric dilatation is a rarely encountered clinical scenario in our day to day practice. This is very rapidly progressing condition and can lead to ischemic necrosis and perforation/rupture of the stomach. It could be fatal if not timely intervened. We report such a case of a 17-year-old, otherwise healthy boy, who presented with pain and distension of abdomen following binge eating episode after 24 hours of prolonged fasting. On exploration, stomach was dilated with necrosis and perforation at fundus near greater curvature. He was managed with excision of all the devitalized area and primary repair with feeding jejunostomy. The case is presented due to its rarity. Acute gastric dilatation (AGD) leading to ischemic necrosis and perforation because of binge eating episode in an otherwise healthy person is an exceptional occurrence with only few cases reported in literature. The clinician should be aware of this condition for prompt and appropriate management. PMID:27134932

  10. Current perspectives of herpesviral retinitis and choroiditis.

    Madhavan, H N; Priya, K; Biswas, J

    2004-10-01

    Vision-threatening viral retinitis are primarily caused by members of the herpesvirus family. The biology and molecular characterization of herpesviruses, clinical presentations of retinopathies, pathology and pathogenesis including the host responses, epidemiology and the laboratory methods of aetiological diagnosis of these diseases are described. Clinical syndromes are acute retinal necrosis (ARN), progressive outer retinal necrosis (PORN), cytomegalovirus (CMV) retinitis, multifocal choroiditis and serpiginous choroiditis besides other viral retinopathies. Herpes simplex virus (HSV) retinitis is more common in immunocompetent persons while varicella zoster virus (VZV) affects both immunocompetent and immunosuppressed patients equally. CMV retinitis is most common among patients with AIDS. The currently employed laboratory methods of antigen detection, virus isolation and antibody detection by enzyme linked immuno-sorbent assay (ELISA) have low sensitivity. Polymerase chain reaction (PCR) has increased the value of diagnosis due to its high clinical sensitivity and absolute specificity in detection of herpesviruses in intraocular specimens. PMID:16295367

  11. Necrosis-Induced Sterile Inflammation Mediated by Interleukin-1α in Retinal Pigment Epithelial Cells.

    Yang Liu

    Full Text Available Endogenous danger signals released from necrotic cells contribute to retinal inflammation. We have now investigated the effects of necrotic cell extracts prepared from ARPE-19 human retinal pigment epithelial cells (ANCE on the release of proinflammatory cytokines and chemokines by healthy ARPE-19 cells. ANCE were prepared by subjection of ARPE-19 cells to freeze-thaw cycles. The release of various cytokines and chemokines from ARPE-19 cells was measured with a multiplex assay system or enzyme-linked immunosorbent assays. The expression of interleukin (IL-1α and the phosphorylation and degradation of the endogenous nuclear factor-κB (NF-κB inhibitor IκB-α were examined by immunoblot analysis. Among the various cytokines and chemokines examined, we found that ANCE markedly stimulated the release of the proinflammatory cytokine IL-6 and the chemokines IL-8 and monocyte chemoattractant protein (MCP-1 by ARPE-19 cells. ANCE-induced IL-6, IL-8, and MCP-1 release was inhibited by IL-1 receptor antagonist and by an IKK2 inhibitor (a blocker of NF-κB signaling in a concentration-dependent manner, but was not affected by a pan-caspase inhibitor (Z-VAD-FMK. Recombinant IL-1α also induced the secretion of IL-6, IL-8, and MCP-1 from ARPE-19 cells, and IL-1α was detected in ANCE. Furthermore, ANCE induced the phosphorylation and degradation of IκB-α in ARPE-19 cells. Our findings thus suggest that IL-1α is an important danger signal that is released from necrotic retinal pigment epithelial cells and triggers proinflammatory cytokine and chemokine secretion from intact cells in a manner dependent on NF-κB signaling. IL-1α is therefore a potential therapeutic target for amelioration of sterile inflammation in the retina.

  12. Precursor T-cell acute lymphoblastic leukemia presenting with bone marrow necrosis: a case report

    Khoshnaw Najmaddin SH

    2012-10-01

    Full Text Available Abstract Introduction Bone marrow necrosis is a clinicopathological condition diagnosed most often at postmortem examination, but it is also seen during the course of malignancy and is not always associated with a poor prognosis. The morphological features of bone marrow necrosis are disruption of the normal marrow architecture and necrosis of myeloid tissue and medullary stroma. Non-malignant conditions associated with bone marrow necrosis are sickle cell anemia, infections, drugs (sulfasalazine, interferon α, all-trans retinoic acid, granulocyte colony-stimulating factor and fludarabine, disseminated intravascular coagulation, antiphospholipid antibody syndrome and acute graft versus host diseases. The malignant causes are leukemia, lymphoma and metastatic carcinomas. Herein we report the case of a patient with precursor T-cell acute lymphoblastic leukemia and bone marrow necrosis at initial presentation. Case presentation A 10-year-old Kurdish boy was presented with generalized bone pain and fever of 1 month’s duration which was associated with sweating, easy fatigability, nose bleeding, breathlessness and severe weight loss. On examination, we observed pallor, tachypnea, tachycardia, low blood pressure, fever, petechial hemorrhage, ecchymoses, tortuous dilated veins over the chest and upper part of abdomen, multiple small cervical lymph node enlargements, mildly enlarged spleen, palpable liver and gross abdominal distention. Blood analysis revealed pancytopenia and elevated lactate dehydrogenase and erythrocyte sedimentation rate. Imaging results showed mediastinal widening on a planar chest X-ray and diffuse focal infiltration of the axial bone marrow on magnetic resonance imaging of the lumbosacral vertebrae. Bone marrow aspiration and biopsy examination showed extensive bone marrow necrosis. Immunophenotyping analysis of the bone marrow biopsy confirmed T-cell acute lymphoblastic leukemia, as CD3 and terminal deoxynucleotidyl

  13. Acute onset of retinal detachment after posterior chamber phakic intraocular lens implantation

    Núria Planas Domènech

    2008-03-01

    Full Text Available Núria Planas Domènech, Luís Arias, Sergi Prades, Octavi Pujol, Marc Rubio, Jose M CaminalDepartment of Ophthalmology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, SpainCase report: A 34-year-old man with severe myopia, presented with acute visual loss in his right eye. This occurred 3 hours after a posterior chamber phakic (PCP intraocular lens (IOL implantation, and was associated with a rhegmatogenous retinal detachment. Retinal retachment surgery was performed without complications, with the outcome showing good anatomical and functional results during a 2-year follow-up period.Discussion: Despite the fact that several authors have described retinal detachments following PCP IOL implantation in highly myopic patients, there is no evidence that this procedure increases the risk of retinal detachment in these patients. The occurrence of the retinal detachment immediately after the phakic IOL implantation supports the hypothesis that the surgical procedure could induce iatrogenic changes in patients with high myopia, which could increase the incidence of retinal detachment. In contrast to other reports, the interval between the PCP IOL implantation and the retinal detachment was only 3 hours in our patient. We believe this demonstrates the importance of performing a complete preoperative vitreoretinal examination in patients with severe myopia.Keywords: retinal detachment, phakic intraocular lens, myopia

  14. Association between retinal hemorrhagic pattern and macular perfusion status in eyes with acute branch retinal vein occlusion

    Muraoka, Yuki; Uji, Akihito; Tsujikawa, Akitaka; Murakami, Tomoaki; Ooto, Sotaro; Suzuma, Kiyoshi; Takahashi, Ayako; Iida, Yuto; Miwa, Yuko; Hata, Masayuki; Yoshimura, Nagahisa

    2016-01-01

    This prospective study included 63 eyes with acute branch retinal vein occlusion (BRVO) to evaluate the retinal hemorrhagic patterns at the posterior poles and explore their clinical relevance in macular perfusion differentiation. Retinal hemorrhagic patterns and macular perfusion status were evaluated via fundus photography and fluorescein angiography, respectively. Macular perfusion was judged as nonischemic in 30, ischemic in 28, and undeterminable in 5 among the 63 eyes. Predominant hemorrhagic patterns were flame-shaped in 39 (67.2%) and non-flame-shaped in 19 (32.8%) eyes. All 39 eyes with a flame-shaped hemorrhage showed a nonischemic macula. Of the 19 eyes classified as having a non-flame-shaped hemorrhage, 13 (68.4%) had an ischemic macula and 6 (31.6%) had a nonischemic macula (P non-flame-shaped hemorrhage (P < 0.001), and in those with a nonischemic macula versus those with an ischemic macula (P < 0.001). The area under the curve for parallelism was 0.975 (P < 0.001), suggesting an accurate diagnostic parameter for macular perfusion differentiation. In conclusion, we objectively evaluated retinal hemorrhagic patterns at the posterior pole in BRVO using the parallelism method, which was useful in differentiating macular perfusion status. PMID:27334338

  15. Perfusion CT is superior to angiography in predicting pancreatic necrosis in patients with severe acute pancreatitis

    We performed perfusion computed tomography (P-CT) and angiography of the pancreas in patients with severe acute pancreatitis (SAP) and compared the usefulness of these two methods in predicting the development of pancreatic necrosis. We compared P-CT and angiography results taken within 3 days after symptom onset in 21 SAP patients. We divided the pancreas into three areas, the head, body, and tail, and examined each area for perfusion defects (via P-CT) and arterial vasospasms (by angiography). Three weeks later, all patients underwent contrast-enhanced CT to determine whether pancreatic necrosis had developed. Of the 21 SAP patients, 16 exhibited perfusion defects, while 17 proved positive for vasospasms in at least one area. Fourteen patients developed pancreatic necrosis. Of the 63 pancreatic areas from the 21 SAP patients, perfusion defects appeared in 25 areas (39.7%), 24 of which showed vasospasms (96.0%). Angiography showed 33 areas with vasospasms (52.4%), of which 24 showed perfusion defects (72.7%). Of the 25 areas with perfusion defects, 21 developed pancreatic necrosis (84.0%). Of the 33 areas with vasospasms, 21 developed necrosis (63.6%). Pancreatic necrosis developed only in the areas positive both for perfusion defects and for vasospasms. No areas without perfusion defect or vasospasms developed pancreatic necrosis. P-CT predicted the development of pancreatic necrosis with significantly higher accuracy than angiography. While both P-CT and angiography are useful in predicting the development of pancreatic necrosis in patients with SAP, P-CT appears to be more accurate for this purpose. (author)

  16. Role of procalcitonin and granulocyte colony stimulating factor in the early prediction of infected necrosis in severe acute pancreatitis

    Muller, C.; Uhl, W.; Printzen, G; Gloor, B; Bischofberger, H; Tcholakov, O; Buchler, M.

    2000-01-01

    BACKGROUND—Infected pancreatic necrosis (IPN) is the main cause of death in patients with severe acute pancreatitis. Therefore an early prediction of IPN is of utmost importance.
AIM—Analysis of new blood variables as potential early predictors to differentiate between IPN and sterile pancreatic necrosis (SPN).
PATIENTS—64 consecutive patients with acute pancreatitis were enrolled in this prospective study; 29 were suffering from acute oedematous pancreatitis (AIP), and 35 from necrotising di...

  17. Acute necrosis after Gamma Knife surgery in vestibular schwannoma leading to multiple cranial nerve palsies.

    Kapitza, Sandra; Pangalu, Athina; Horstmann, Gerhard A; van Eck, Albert T; Regli, Luca; Tarnutzer, Alexander A

    2016-08-01

    We discuss a rare acute complication after Gamma Knife therapy (Elekta AB, Stockholm, Sweden) in a single patient. A 52-year-old woman presented with vertigo, facial weakness and hearing loss emerging 48hours following Gamma Knife radiosurgery for a right-sided vestibular schwannoma. Neurological examination 6days after symptom onset showed right-sided facial palsy, spontaneous left-beating nystagmus and pathologic head-impulse testing to the right. Pure-tone audiogram revealed right-sided sensorineural hearing loss. A diagnosis of acute vestibulocochlear and facial neuropathy was made. Brain MRI demonstrated focal contrast sparing within the schwannoma, likely related to acute radiation necrosis. Acute multiple cranial neuropathies of the cerebellopontine angle after Gamma Knife treatment should raise suspicion of acute tissue damage within the schwannoma and should result in urgent MRI. Treatment with steroids may be considered based on accompanying swelling and edema. PMID:26947104

  18. Caspase-dependent retinal ganglion cell apoptosis in the rat model of acute diabetes

    2008-01-01

    Background Neural apoptosis is generally believed to be mediated by two distinct pathways, caspase-dependant and caspase-independent pathways. This study investigated the apoptotic pathways involved in retinal ganglion ceils in acute diabetes in rats. Methods Diabetes was induced in male Wistar rats by a peritoneal injection of streptozotocin (STZ). Expression and localization of caspase-3 and apoptosis-inducing factor (AIF) proteins in the retina of diabetic rats was examined by Western blotting and immunohistochemistry analyses. Terminal transferase dUTP nick end labeling (TUNEL) assay and immunofluorescent staining specific for caspase-3 and AIF were applied to analyze for apoptosis of retinal ganglion cells. In addition, a caspase-3 inhibitor DEVD-CHO was injected intravitreally to further determine the apoptotic pathways of retinal ganglion cells triggered in acute diabetes. Results Two weeks after induction of diabetes, a significant increase in caspase-3 protein expression and localization occurred in the nerve fiber layer, ganglion cell layer, and inner plexiform layer of the retina. Four weeks after the onset of diabetes, the increase in caspase-3 expression was profound eight weeks postinduction of diabetes (P<0.05). Meanwhile, no AIF protein expression was detected in this study. In addition, intravitreal administration of the caspase-3 inhibitor DEVD-CHO reduced apoptosis of retinal ganglion cells by its direct inhibitory action on caspase-3. Conclusion Caspase-dependent apoptotic pathways may be the main stimulant of STZ-induced retinal ganglion cell apoptosis in acute diabetes.

  19. Walled-off pancreatic necrosis and other current concepts in the radiological assessment of acute pancreatitis

    Acute pancreatitis is an inflammatory condition caused by intracellular activation and extravasation of inappropriate proteolytic enzymes determining destruction of pancreatic parenchyma and peripancreatic tissues. This is a fairly common clinical condition with two main presentations, namely, endematous pancreatitis - a less severe presentation - and necrotizing pancreatitis - the most severe presentation that affects a significant part of patients. The radiological evaluation, particularly by computed tomography, plays a fundamental role in the definition of the management of severe cases, especially regarding the characterization of local complications with implications in the prognosis and in the definition of the therapeutic approach. New concepts include the subdivision of necrotizing pancreatitis into the following presentations: pancreatic parenchymal necrosis with concomitant peripancreatic tissue necrosis, and necrosis restricted to peripancreatic tissues. Moreover, there was a systematization of the terms acute peripancreatic fluid collection, pseudocyst, post-necrotic pancreatic/peripancreatic fluid collections and walled-off pancreatic necrosis. The knowledge about such terms is extremely relevant to standardize the terminology utilized by specialists involved in the diagnosis and treatment of these patients. (author)

  20. Walled-off pancreatic necrosis and other current concepts in the radiological assessment of acute pancreatitis

    Cunha, Elen Freitas de Cerqueira [Image Memorial/DASA and Diagnoson Medicina Diagnostica, Salvador, BA (Brazil); Rocha, Manoel de Souza; Pereira, Fabio Payao; Blasbalg, Roberto; Baroni, Ronaldo Hueb [Universidade de Sao Paulo (FM/USPU), Sao Paulo, SP (Brazil). Faculdade de Medicina

    2014-05-15

    Acute pancreatitis is an inflammatory condition caused by intracellular activation and extravasation of inappropriate proteolytic enzymes determining destruction of pancreatic parenchyma and peripancreatic tissues. This is a fairly common clinical condition with two main presentations, namely, endematous pancreatitis - a less severe presentation - and necrotizing pancreatitis - the most severe presentation that affects a significant part of patients. The radiological evaluation, particularly by computed tomography, plays a fundamental role in the definition of the management of severe cases, especially regarding the characterization of local complications with implications in the prognosis and in the definition of the therapeutic approach. New concepts include the subdivision of necrotizing pancreatitis into the following presentations: pancreatic parenchymal necrosis with concomitant peripancreatic tissue necrosis, and necrosis restricted to peripancreatic tissues. Moreover, there was a systematization of the terms acute peripancreatic fluid collection, pseudocyst, post-necrotic pancreatic/peripancreatic fluid collections and walled-off pancreatic necrosis. The knowledge about such terms is extremely relevant to standardize the terminology utilized by specialists involved in the diagnosis and treatment of these patients. (author)

  1. Poloxamer 188 and antioxidants prevent acute radiation necrosis of adult skeletal muscle cells

    Full text: To date there are no effective therapeutic agents widely available for acute radiation sickness. Acute cellular necrosis occurring minutes to hours after exposure to high doses of ionizing radiation (IR) results from rapid membrane lipid peroxidation, blebbing and membrane breakdown. Not only can repairing the membrane prevent acute necrosis, but it can also provide a critical time period to address other mechanisms of cell death, such as apoptosis or mitotic arrest, which manifest over a longer time frame. We have previously shown that certain polymer surfactants can restore structural integrity and transport barrier function of cell membranes following high-dose IR. We now present data showing that the amphiphillic surfactant Poloxamer 188 (P188), a tri-block copolymer composed of two hydrocephalic blocks separated by a hydrophobic central block, has efficacy in preventing acute necrosis of adult rat skeletal muscle cells after high-dose IR and that at doses in which P188 is effective, adding the antioxidant ascorbate or n-acetyl cysteine further increases cell survival. Explanted rat flexor digitoum brevis muscle cells received 10, 40 or 40 Gy IR from Co 60 in a 21% oxygen atmosphere and their viability was determined using fluorometric probes (Calcein-AM and Ethidium homodimer) at 4 and 18 hours after IR. Compared to unirradiated cells, 10 Gy did not cause acute necrosis. Significant acute necrosis was observed after 40 and 80 Gy in a dose-dependent manner. Post-IR treatment with P188 significantly enhanced the cells' viability. By comparison, treating with 10 kDa neutral Dextran, a purely hydrophilic polymer, was not found to be effective. Despite progressive cell death over 18 h after high-dose IR, cells treated with P188 showed greater survival than cells grown only in media or Dextran-treated cells. Cells treated with 40 Gy survived better than those treated with 80 Gy, indicating some limits to the efficacy of treatment with P188. Cells

  2. Two sides of one coin: massive hepatic necrosis and progenitor cell-mediated regeneration in acute liver failure.

    Weng, Hong-Lei; Cai, Xiaobo; Yuan, Xiaodong; Liebe, Roman; Dooley, Steven; Li, Hai; Wang, Tai-Ling

    2015-01-01

    Massive hepatic necrosis is a key event underlying acute liver failure, a serious clinical syndrome with high mortality. Massive hepatic necrosis in acute liver failure has unique pathophysiological characteristics including extremely rapid parenchymal cell death and removal. On the other hand, massive necrosis rapidly induces the activation of liver progenitor cells, the so-called "second pathway of liver regeneration." The final clinical outcome of acute liver failure depends on whether liver progenitor cell-mediated regeneration can efficiently restore parenchymal mass and function within a short time. This review summarizes the current knowledge regarding massive hepatic necrosis and liver progenitor cell-mediated regeneration in patients with acute liver failure, the two sides of one coin. PMID:26136687

  3. Prognostic criteria in acute pancreatitis: importance of assessment of pancreatic necrosis by contrast-enhanced CT

    To compare the value of the clinical criteria of Ranson, the classical tomographic criteria of Balthzar and the severity of illness index according to CT in predicting the development of complications of acute pancreatitis. A retrospective study was performed in 100 patients with clinical and analytical evidence of acute pancreatitis. All patients were assessed according to Ranson score at admission and 48 hours later, and contrast-enhanced abdominal CT was carried out. The tomographic images were analyzed on the basis of the classical criteria of Balthazar and the new CT severity of illness index, which includes the assessment of pancreatic necrosis, identified as the areas of the pancreas that are not enhanced by the administration of the contrast material. These three criteria were then correlated with onset of medical and surgical implications. Our findings show that, of the three criteria analyzed, the CT severity of illness index presents the greatest specificity, sensitivity and positive and negative predictive values in the prediction of complications of acute pancreatitis. We conclude that the inclusion of pancreatic necrosis in the tomographic study improves the early assessment of the prognosis of acute pancreatitis. (Author) 20 refs

  4. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

    Justin L, Regner, E-mail: Justin.Regner@BSWHealth.org; Angela, Lomas [Department of Surgery, Baylor Scott and White Health and Texas A& M Health Science Center College of Medicine, Temple, TX (United States)

    2016-03-25

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet.

  5. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet

  6. A vascular necrosis of bone. A complication of agressive therapy for acute lymphoblastic leukemia

    Vaidya, S.; Saika, S.; Sirohi, B.; Pai, S.; Advani, S. [Tata Memorial Hospital, Bombay (India). Dept. of Medical Oncology

    1998-09-01

    The purpose of the present paper was to report cases of avascular necrosis of bone (AVNB) arising as a complication of chemotherapy for acute lymphoblastic leukemia (ALL). X-rays and {sup 99m}technicium-MDP bone scans were performed on patients with symptoms of bone pain, whereby five patients out of 850 patients were detected to have avascular necrosis of the femoral head. All had received aggressive chemotherapy with steroids. Two patients were still on therapy for the primary disease. In these patients further chemotherapy was continued without steroids. The medium period from diagnosis of ALL to development of AVNB was 29 months. Three patients underwent corrective surgical procedures. To conclude, the data suggest that patients receiving combination chemotherapy, especially those with high cumulative doses, run a risk of developing AVNB. Awarness of this complication is important in order to have an early diagnosis so as to limit disability. (orig.)

  7. Acutance, an objective measure of retinal nerve fibre image clarity

    Choong, Y F; Rakebrandt, F; North, R V; Morgan, J E

    2003-01-01

    Background/aims: The interpretation of high contrast retinal nerve fibre layer (RNFL) images in glaucoma can be confounded by the presence of image blur; it can be difficult to discern diffuse axon loss in a poor quality image. One solution is to provide an objective measure of the image quality based on features in the image other than the RNFL. In this study the authors have developed an objective method to quantify the clarity of RNFL images, comparing it with a subjective image grading sy...

  8. A patient with acute macular neuroretinopathy and central retinal vein occlusion

    Hirooka K

    2013-07-01

    Full Text Available Kiriko Hirooka,1 Wataru Saito,1,2 Kousuke Noda,1,2 Susumu Ishida1,21Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 2Department of Ocular Circulation and Metabolism, Hokkaido University Graduate School of Medicine, Sapporo, JapanPurpose: The precise mechanism causing acute macular neuroretinopathy (AMN is still unknown. A recent report suggested that choroidal circulation impairment correlates with its pathogenesis. We report a rare case with simultaneous onset of AMN and central retinal vein occlusion (CRVO, which is a retinal circulation disorder.Methods: Case report.Results: A 44-year-old woman complained of central visual loss of the left eye for the previous 2 weeks. The patient’s visual acuity was 0.5 in the left eye (OS. Fundoscopic examination revealed a wedge-shaped, dark reddish-brown lesion at the macula, and CRVO-like retinal hemorrhages OS. Fluorescein angiography revealed retinal vasculitis and hypofluorescence corresponding to the macular lesion. The patient’s scanning laser ophthalmoscopy infrared imaging result led to a diagnosis of AMN. Two weeks after corticosteroid pulse therapy, her visual acuity improved to 1.2 OS, with improvement of macular findings and Humphrey perimetry. When the dose of oral corticosteroid was decreased, the AMN lesion worsened, with recurrence of retinal hemorrhages. Visual functions improved again after an increased dose of corticosteroid.Conclusion: These results suggest that circulatory disorders almost simultaneously occurred in choroidal and retinal vessels, resulting in the onset of both AMN and CRVO.Keywords: choroidal circulation, optical coherence tomography, retinal circulation, systemic corticosteroid therapy

  9. Atypical manifestation of progressive outer retinal necrosis in AIDS patient with CD4+ T-cell counts more than 100 cells/microL on highly active antiretroviral therapy.

    Vichitvejpaisal, Pornpattana; Reeponmahar, Somporn; Tantisiriwat, Woraphot

    2009-06-01

    Typical progressive outer retinal necrosis (PORN) is an acute ocular infectious disease in acquired immunodeficiency syndrome (AIDS) patients with extremely low CD4+ T-cell counts. It is a form of the Varicella- zoster virus (VZV) infection. This destructive infection has an extremely rapid course that may lead to blindness in affected eyes within days or weeks. Attempts at its treatment have had limited success. We describe the case of a bilateral PORN in an AIDS patient with an initial CD4+ T-cell count >100 cells/microL that developed after initiation of highly active antiretroviral therapy (HAART). A 29-year-old Thai female initially diagnosed with human immunodeficiency virus (HIV) in 1998, presented with bilaterally decreased visual acuity after initiating HAART two months earlier. Multiple yellowish spots appeared in the deep retina without evidence of intraocular inflammation or retinal vasculitis. Her CD4+ T-cell count was 127 cells/microL. She was diagnosed as having PORN based on clinical features and positive VZV in the aqueous humor and vitreous by polymerase chain reaction (PCR). Despite combined treatment with intravenous acyclovir and intravitreous ganciclovir, the patient's visual acuity worsened with no light-perception in either eye. This case suggests that PORN should be included in the differential diagnosis of reduced visual acuity in AIDS patients initiating HAART with higher CD4+ T-cell counts. PORN may be a manifestation of the immune reconstitution syndrome. PMID:19702067

  10. Acute onset of retinal detachment after posterior chamber phakic intraocular lens implantation

    Núria Planas Domènech; Luí­s Arias; Sergi Prades; Octavi Pujol; Marc Rubio; Caminal, Jose M

    2008-01-01

    Núria Planas Domènech, Luís Arias, Sergi Prades, Octavi Pujol, Marc Rubio, Jose M CaminalDepartment of Ophthalmology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, SpainCase report: A 34-year-old man with severe myopia, presented with acute visual loss in his right eye. This occurred 3 hours after a posterior chamber phakic (PCP) intraocular lens (IOL) implantation, and was associated with a rhegmatogenous retinal detachme...

  11. Necrosis and myelomalaic lesions in acute experimental allergic encephalomyelitis in guinea pigs

    Mohamed Noorulla

    2014-06-01

    Results: The histological observation revealed two stages of EAE; an initial inflammatory stage followed by demyelination. The inflammatory lesions were focal and invariably related to blood vessels. The inflammatory lesions consisted of perivascular cuffings with lymphocytes and mononuclear cells in the perivascular space and surrounding parenchyma. Perivascular demyelination was restricted to that part of the white matter which was infiltrated by mononuclear cells. The fibres in demyelinating lesions were demyelinated. Perivascular demyelination is followed by patchy demyelination and large plaques of demyelination. Neuronal and axonal damage, necrosis, tissue degeneration and cavity formation were seen in those animals which died during the acute phase of the disease. These changes were found in the spinal cord, brainstem and cerebellum. Conclusion: The changes observed in results lead to the conclusion that the acute EAE with severity of disease is no more a primary demyelinating disease. [Int J Res Med Sci 2014; 2(3.000: 945-955

  12. Early magnetic resonance detection of cortical necrosis and acute network injury associated with neonatal and infantile cerebral infarction

    Okabe, Tetsuhiko; Aida, Noriko; Nozawa, Kumiko [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); Niwa, Tetsu [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); Tokai University School of Medicine, Department of Radiology, Isehara (Japan); Shibasaki, Jun [Kanagawa Children' s Medical Center, Department of Neonatology, Yokohama (Japan); Osaka, Hitoshi [Kanagawa Children' s Medical Center, Department of Neurology, Yokohama (Japan)

    2014-05-15

    Knowledge of MRI findings in pediatric cerebral infarction is limited. To determine whether cortical necrosis and network injury appear in the acute phase in post-stroke children and to identify anatomical location of acute network injury and the ages at which these phenomena are seen. Images from 12 children (age range: 0-9 years; neonates [<1 month], n=5; infants [1 month-12 months], n=3; others [≥1 year], n=4) with acute middle cerebral artery (MCA) cortical infarction were retrospectively analyzed. Cortical necrosis was defined as hyperintense cortical lesions on T1-weighted imaging that lacked evidence of hemorrhage. Acute network injury was defined as hyperintense lesions on diffusion-weighted imaging that were not in the MCA territory and had fiber connections with the affected cerebral cortex. MRI was performed within the first week after disease onset. Cortical necrosis was only found in three neonates. Acute network injury was seen in the corticospinal tract (CST), thalamus and corpus callosum. Acute network injury along the CST was found in five neonates and one 7-month-old infant. Acute network injury was evident in the thalamus of four neonates and two infants (ages 4 and 7 months) and in the corpus callosum of five neonates and two infants (ages 4 and 7 months). The entire thalamus was involved in three children when infarction of MCA was complete. In acute MCA cortical infarction, MRI findings indicating cortical necrosis or acute network injury was frequently found in neonates and early infants. Response to injury in a developing brain may be faster than that in a mature one. (orig.)

  13. Renal blood flow after transplantation: Effects of acute tubular necrosis, rejection, and cyclosporine toxicity

    The authors incorporated their recently developed radionuclide first pass-technique for the quantitative measurement of renal transplant perfusion into routine DTPA imaging. Using this technique they investigated the effects of acute tubular necrosis (ATN), rejection, and cyclosporing toxicity on renal blood flow in a series of 80 studies in 35 patients, with independent evaluation of renal function. Transplant flow values were as follows: normal functioning, 439 mL/min +-83; ATN 248 mL/min +-63; rejection, 128 mL/min +-58; cyclosporing toxicity, 284 mL/min +-97; (normal flow in nontransplanted kidneys, approximately 550 mL/min). Differences between normal functioning, ATN, and rejection were significant (P < .05). Interestingly, immediate postsurgical hyperemia frequently occurred, with flow values sometimes exceeding 700 mL/min

  14. Renal hyperconcentration of /sup 99m/Tc-HEDP in experimental acute tubular necrosis

    The effect of transient renal ischemia on renal concentration and distribution of /sup 99m/Tc-HEDP, /sup 99m/Tc-DMSA, and /sup 99m/Tc-DTPA was compared in rabbits with acute tubular necrosis. Scintigrams were obtained after injection in normal rabbits or ones with unilateral or bilateral ischemia. /sup 99m/Tc-HEDP concentration in ischemic tissue was 8 to 18 times normal 1 to 4 hrs after injection, and the resulting images delineated the morphological changes in the ischemic kidneys more accurately than those obtained with DMSA or DTPA. Calcium concentration in the ischemic kidneys increased sixfold. /sup 99m/Tc-HEDP may be useful in evaluation of renal failure secondary to tubular injury

  15. Acute retinal ischemia caused by controlled low ocular perfusion pressure in a porcine model. Electrophysiological and histological characterisation

    Kyhn, Maria Voss; Warfvinge, Karin; Scherfig, Erik;

    2009-01-01

    The purpose of this study was to establish, and characterize a porcine model of acute, controlled retinal ischemia. The controlled retinal ischemia was produced by clamping the ocular perfusion pressure (OPP) in the left eye to 5 mm Hg for 2 h. The OPP was defined as mean arterial blood pressure...... (MAP) minus the intraocular pressure (IOP). It was clamped to 0-30 mm Hg by continuous monitoring of MAP and adjustment of the IOP, which was controlled by cannulation of the anterior chamber. Inner retinal function was assessed by induced multifocal electroretinography (mfERG) with comparisons of the...

  16. Tumor Necrosis Factor, but Not Neutrophils, Alters the Metabolic Profile in Acute Experimental Arthritis

    Oliveira, Marina C.; Tavares, Luciana P.; Vago, Juliana P.; Batista, Nathália V.; Queiroz-Junior, Celso M.; Vieira, Angelica T.; Menezes, Gustavo B.; Sousa, Lirlândia P.; van de Loo, Fons A. J.; Teixeira, Mauro M.; Amaral, Flávio A.; Ferreira, Adaliene V. M.

    2016-01-01

    Metabolic alterations are associated with arthritis apart from obesity. However, it is still unclear which is the underlying process behind these metabolic changes. Here, we investigate the role of tumor necrosis factor (TNF) in this process in an acute model of antigen-induced arthritis (AIA). Immunized male BALB/c mice received an intra-articular injection of PBS (control) or methylated bovine serum albumin (mBSA) into their knees, and were also pre-treated with different drugs: Etanercept, an anti-TNF drug, DF2156A, a CXCR1/2 receptor antagonist, or a monoclonal antibody RB6-8C5 to deplete neutrophils. Local challenge with mBSA evoked an acute neutrophil influx into the knee joint, and enhanced the joint nociception, along with a transient systemic metabolic alteration (higher levels of glucose and lipids, and altered adipocytokines). Pre-treatment with the conventional biological Etanercept, an inhibitor of TNF action, ameliorated the nociception and the acute joint inflammation dominated by neutrophils, and markedly improved many of the altered systemic metabolites (glucose and lipids), adipocytokines and PTX3. However, the lessening of metabolic changes was not due to diminished accumulation of neutrophils in the joint by Etanercept. Reduction of neutrophil recruitment by pre-treating AIA mice with DF2156A, or even the depletion of these cells by using RB6-8C5 reduced all of the inflammatory parameters and hypernociception developed after AIA challenge, but could not prevent the metabolic changes. Therefore, the induction of joint inflammation provoked acute metabolic alterations which were involved with TNF. We suggest that the role of TNF in arthritis-associated metabolic changes is not due to local neutrophils, which are the major cells present in this model, but rather due to cytokines. PMID:26742100

  17. Functional role of MicroRNA-19b in acinar cell necrosis in acute necrotizing pancreatitis.

    Hu, Ming-Xing; Zhang, Hong-Wei; Fu, Qiang; Qin, Tao; Liu, Chuan-Jiang; Wang, Yu-Zhu; Tang, Qiang; Chen, Yu-Xin

    2016-04-01

    The expression of microRNA-19b (miR-19b) in acute necrotizing pancreatitis (ANP) and its functional role in acinar cell necrosis of SD rats were investigated. Twelve SD rats were divided into two groups randomly, including control group and ANP group. The rat ANP models were established by intraperitoneal injection of L-arginine (2400 mg/kg body weight), and equal volume of 0.9% NaCl was injected in the control group. MiRNA chip assay was performed to examine the expression of miRNAs in the pancreas in two different groups. Besides, to further explore the role of miR-19b in ANP in vitro, taurolithocholic acid 3-sulfate disodium salt (TLC-S) (200 μmol/L) was administrated to treat the rat pancreatic acinar cell line, AR42J, for establishing the ANP cells model. The quantitative real-time PCR (qRT-PCR) was adopted to measure the miR-19b expression. Moreover, the mimic miRNA, miRNA antisense oligonucleotide (AMO) and control vector were used to transfect AR42J cells, the expression of miR-19b was confirmed by qRT-PCR and the necrotizing rate of AR42J cells was detected with AO/EB method. The expression of miR-19b was significantly higher in ANP group than in control group as displayed by the miRNA chip assay. Furthermore, after inducing necrosis of AR42J cells in vitro, the expression of miR-19b was significantly increased by 2.51±0.14 times in comparison with the control group. As revealed by qRT-PCR assay, the expression of miR-19b was 5.94±0.95 times higher in the mimic miRNA group than in the control vector group, companied with an obviously increased acinar cell necrotizing rate (50.3%±1.5% vs. 39.6%±2.3%, P0.05). The expression of miR-19b was significantly induced in ANP. In addition, up-regulation of miR-19b could promote the necrosis of pancreatic acinar cells and miR-19b deficiency could decrease the rate of pancreatic acinar cell necrosis. PMID:27072966

  18. ACUTE BILATERAL VIRAL NECROTIZING RETINITIS : AN UNCOMMON CASE REPORT

    Rajendra Ku.

    2015-08-01

    Full Text Available A 22 year old male with a history of high grade fever 2 days, diarrhea 3 times and vomiting 2 times presented with diminution of vision in right eye of 1 days duration. His best corrected visual acuity (BCVA was counting finger 1 meter with no pin hole im provement and 20/20 ( S nellen ’ s in the right and left eye respectively. Fundus examination RE revealed white lesion in geographic fashion with clear edge involving macula and in left eye small peanut size white lesion present at paramacular area. Clinicall y a diagnosis of acute necrotizing was made. We started treatment by intra venous antiviral and systemic steroid. ELISA (serum and PCR (aqueous were positive for herpes simplex virus ( I ndex above 1.1 i.e. 1.54 . 1,2 The lesions showed a good response to t he above treatment. At 2 months follow - up, lesion had resolved well with BCVA of 20/40 and 20/20 in right and left eye respectively

  19. Sup(99m)Tc-MDP bone scan in the cases of muscle necrosis associated with acute renal failure

    We studied four patients with muscle necrosis associated with acute renal failure to evaluate the diagnostic value of the bone scan in this disease. The illness followed carbon monoxide poisoning in two patients, acute physical exertion in one and contaminated intramuscular injection in the other. Whole-body rectilinear bone scans using technetium 99m-methyldiphosphonate were done. In all patients, increased muscle labelling at the regions of suspected muscle injury was shown, and in one, it was after normalization of serum muscle enzym levels. In one patient, the bone scan was rechecked 8 months later and showed no residual abnormality. Above all, the site and precise extent of muscle injury could be detected and the degree of muscle labelling seemed to correlate with the severity of muscle injury. These findings suggest that isotope scanning may be useful in the diagnosis of patients with acute muscle necrosis. (author)

  20. Neuroprotective effect of astaxanthin against rat retinal ganglion cell death under various stresses that induce apoptosis and necrosis

    Yamagishi, Reiko; Aihara, Makoto

    2014-01-01

    Purpose Astaxanthin is a type of carotenoid known to have strong antioxidant effects. The purpose of this study was to investigate whether astaxanthin confers a neuroprotective effect against glutamate stress, oxidative stress, and hypoxia-induced apoptotic or necrotic cell death in primary cultures of rat retinal ganglion cells (RGCs). Methods Purified rat RGCs were exposed to three kinds of stressors induced by 25 μM glutamate for 72 h, B27 medium without an antioxidant for 4 h, and a reduc...

  1. Esofagitis necrotizante aguda: Una entidad inusual Acute esophageal necrosis: An unusual entity

    Silvana E. Pramparo

    2010-12-01

    Full Text Available La esofagitis necrotizante aguda (ENA, también denominada esófago negro, es una rara enfermedad poco descripta en la literatura médica. Describimos el caso de un hombre de 80 años, con hemorragia digestiva alta quien desarrolló un esófago negro luego de un episodio de hipotensión. La necrosis fue confirmada histológicamente. Los pacientes se presentan con hematemesis y melena en más del 70% de los casos. Los hallazgos endoscópicos muestran una coloración negruzca de la mucosa esofágica. El diagnóstico se realiza con endoscopia y confirmación histológica. La mortalidad es alta (más del 50% aunque relacionada a las enfermedades de base del paciente. Por último, podemos decir que la sospecha es muy importante en el diagnóstico de ENA, particularmente en pacientes ancianos con enfermedades asociadas y evidencia de hemorragia digestiva alta. En este trabajo describimos las características clínicas, endoscópicas e histopatológicas de un paciente con ENA.Acute esophageal necrosis (AEN, also designated black esophagus, is a rare disorder that is poorly described in the medical literature. We present the case of an 80 years old man, with upper gastrointestinal bleeding who developed a black esophagus after hypotensive episodes. Necrosis was confirmed histologically. Hematemesis and melena are present in more than 70% of the cases. Endoscopic findings show black discoloration of the distal esophagus with proximal extension ending sharply at the gastroesophageal junction. Diagnosis is reached endoscopically with histological support. Mortality is high (up to 50% even though related to the patient's underlying condition. Finally, we may say that to keep in mind the posibility of AEN is a key factor in its diagnosis, particularly in older patients with associated morbidity and evidence of upper gastrointestinal bleeding. In the present report we describe the clinical, endoscopic and histophatological characteristics of a patient with a

  2. Differentiation of acute untreated rejection from cyclosporine nephrotoxicity and acute tubular necrosis by indium-111 labeled platelet scintigraphy

    The authors have previously reported that unlike normal and nephrotic native kidneys, acutely rejecting kidney transplants show significant platelet uptake by Indium-111 labeled platelet scintigraphy (lPLS). To determine if lLPS can differentiate acute rejection (AR) from cyclosporine (CY) nephrotoxicity and acute tubular necrosis (ATN). The authors studied 5 groups of kidney transplant recipients. Group 1, n=6 (3 on Imuran, 3 on CY, CR=1.4 +- 0.6, mean +- SD) had no evidence for rejection (kidney biopsy in 2). Group 11, n=4(1 on Imuran, 3 on CY, Cr=2.8 +- 1.1) had ATN (biopsy in 2). Group 111, n=3(all on CY, Cr=2.3 +- 1.9) had suspected CY nephrotoxicity:all patients (pts) improved upon withdrawal of CY and biopsies were negative for rejection in 2. Group IV, n=11 (10 on Imuran 1 on CY, CR=5.6 +- 4.1) had acute rejection on biopsy. In group V, n=7 (3 on imuran 4 on CY, Cr=6.1 +- 3.4) pts were treated for rejection for 12 +- 4 days. All pts received Prednisone. The first image was obtained 6 +- 4 hrs after injection of 215 +- 30μ Ci of lN-111 and thereafter 1 to 3 times a day for a maximum of 6 days. Platelet Uptake Index (PUl) was calculated as the ratio of uptake over the transplant against a contralateral reference area. One way analysis of variance was carried out. PUIs from groups I, II, III and V were significantly different from groups IV: 1.1 +- .07 (p<0.004), 1.22 +- .09 (p<0.05), 1.14 +- .05 (p<0.04) and 1.21 +- .07 (p<0.004) versus 1.52 +- .17. The authors conclude that 1) ILP can be used for the diagnosis of untreated AR. 2) Untreated AR can be differentiated from CY nephrotoxicity and ATN

  3. Esofagitis necrotizante aguda: Una patología poco conocida Acute esophageal necrosis: An underdiagnosed disease

    L. Julián Gómez

    2008-11-01

    Full Text Available La esofagitis necrotizante aguda (ENA es una rara entidad cuya etiología es desconocida, siendo el mecanismo patogénico multifactorial, participando fundamentalmente el compromiso isquémico, la malnutrición y la obstrucción del tracto digestivo alto. Los hallazgos endoscópicos muestran una coloración negruzca de la mucosa esofágica con transición brusca a nivel de la unión esofagogástrica. El pronóstico depende de las enfermedades de base. Se revisan los casos de ENA, excluyendo los secundarios a caústicos, recogidos de forma retrospectiva durante los últimos 2 años. Se analizan los factores de riesgo, la presentación clínica, los hallazgos endoscópicos, la histología, el tratamiento y la evolución. En nuestro departamento, se han diagnosticado 7 casos de ENA en 6.003 gastroscopias realizadas en el periodo de estudio, representando así la ENA el 0,11% de la exploraciones.Acute esophageal necrosis is a rare disorder, and its etiology is unknown, the mechanism of damage being usually multifactorial and secondary to ischemic compromise, acute gastric outlet obstruction, and malnutrition. Endoscopic findings show circumferential black discoloration of the distal esophagus with proximal extension ending sharply at the gastroesophageal junction, which is the most common presentation. Prognosis depends on comorbid illnesses. In this study we analyze all cases reported in a retrospective analysis over a 2-year period to define risk factors, clinical presentation, endoscopic features, histological appearance, treatment and outcome. Our department has recorded 7 cases from 6,003 endoscopies performed in the last 2 years. The finding of a "black esophagus" represented 0.11% of cases.

  4. Plasmid mediated tetracycline resistance of Vibrio parahaemolyticus associated with acute hepatopancreatic necrosis disease (AHPND in shrimps

    Jee Eun Han

    2015-11-01

    Full Text Available Antimicrobial resistance is one of the most important problems in public health, veterinary medicine and aquaculture. Importantly, plasmid mediated antibiotic resistance of pathogenic Vibrio parahaemolyticus from shrimp can potentially be transferred through transposition, conjugation and plasmid uptake to different bacterial species in aquaculture systems. In this study, we evaluated the antibiotic resistance pattern in V. parahaemolyticus strains associated with acute hepatopancreatic necrosis disease (AHPND from penaeid shrimp and identified AHPND strains from Mexico showed a high level of resistance to tetracycline (≥5 μg/mL and have the tetB gene coding tetracycline resistance. In particular, the tetB gene was carried in a single copy plasmid (named as pTetB-VA1 comprising 5162-bp with 40% G + C content from the strain (13-511/A1. The plasmid pTetB-VA1 consists of 9 ORFs encoding tetracycline resistant and repressor proteins, transcriptional regulatory proteins and transposases and showed a 99% sequence identity to other tet gene plasmids (pIS04_68 and pAQU2.

  5. Acute hepatopancreatic necrosis disease (AHPND) outbreaks in Penaeus vannamei and P. monodon cultured in the Philippines.

    de la Peña, Leobert D; Cabillon, Nikko Alvin R; Catedral, Demy D; Amar, Edgar C; Usero, Roselyn C; Monotilla, Wilberto D; Calpe, Adelaida T; Fernandez, Dalisay Dg; Saloma, Cynthia P

    2015-10-27

    Acute hepatopancreatic necrosis disease (AHPND) has recently emerged as a serious disease of cultured shrimp. It has also been described as early mortality syndrome (EMS) due to mass mortalities occurring within 20 to 30 d after stocking of ponds with postlarvae. Here, Penaeus vannamei and Penaeus monodon from shrimp farms in the Philippines were examined for the toxin-producing strain of Vibrio parahaemolyticus due to AHPND-like symptoms occurring in marketable size shrimp. In the P. vannamei, histology revealed typical AHPND pathology, such as sloughing of undifferentiated cells in the hepatopancreatic tubule epithelium. Analysis using the IQ2000 AHPND/EMS Toxin 1 PCR test generated 218 bp and 432 bp amplicons confirmative of the toxin-producing strain of V. parahaemolyticus among shrimp sampled from 8 of 9 ponds. In the P. monodon, histology revealed massive sloughing of undifferentiated cells of the hepatopancreatic tubule epithelium in the absence of basophilic bacterial cells. PCR testing generated the 2 amplicons confirmatory for AHPND among shrimp sampled from 5 of 7 ponds. This study confirms the presence of AHPND in P. vannamei and P. monodon farmed in the Philippines and suggests that the disease can also impact late-stage juvenile shrimp. PMID:26503780

  6. Intratracheal administration of endotoxin and cytokines. IV. The soluble tumor necrosis factor receptor type I inhibits acute inflammation.

    Ulich, T R; Yin, S.; Remick, D G; Russell, D; Eisenberg, S P; Kohno, T

    1993-01-01

    Endotoxin lipopolysaccharide (LPS) administered intratracheally to rats causes pulmonary tumor necrosis factor alpha (TNF) and interleukin-1 (IL-1) production and results in acute broncho-alveolar neutrophilic inflammation. In the present study, the recombinant human TNF soluble receptor type I (sTNFrI) co-injected intratracheally with LPS is shown to inhibit significantly (P < 0.0001) the number of neutrophils in bronchoalveolar lavage specimens at 6 hours as compared to intratracheal inject...

  7. Endoscopic ultrasound-guided transmural drainage of infected pancreatic necrosis developing 2 years after acute pancreatitis

    Eliason, Kyle; Douglas G. Adler

    2015-01-01

    This is a case report of endoscopic ultrasound guided transmural drainage of a large infected pancreatic necrosis. The infected necrosis was treated by placement of a fully covered metal stent with subsequent endoscopic necrosectomy to remove solid debris. The case is notable for the fact that the patient developed infection of a long-standing and previously stable area of walled-off pancreatic necrosis 2 years after it formed. We believe this is the longest time ever reported between necroti...

  8. The protective or damaging effect of Tumor necrosis factor-α in acute liver injury is concentration-dependent

    Dong, Yulong; Liu, Yuzhou; Kou, Xingrui; Jing, Yingying; Sun, Kai; Sheng, Dandan; Yu, Guofeng; Yu, Dandan; Zhao, Qiudong; Zhao, Xue; Li, Rong; Wu, Mengchao; Wei, Lixin

    2016-01-01

    Background Inflammatory cytokine is important in modulating injured diseases. Tumor necrosis factor-α (TNF-α), one of potent inflammatory cytokines, plays a dominant role in host defense reaction. However, the concrete effect of TNF-α on acute liver injury is totally unclear. Here we reported the concrete effect and possible mechanisms of TNF-α on acute liver injury induced by carbon tetrachloride (CCl4). Methods SD male rats were equally divided into nine groups. CCl4 (1 ml/kg) was subcutane...

  9. Acute Retinal Pigment Epitheliitis: Spectral Domain Optical Coherence Tomography, Fluorescein Angiography, and Autofluorescence Findings

    Tuğba Aydoğan

    2015-01-01

    Full Text Available A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes’ best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF was slightly increased. Spectral domain optical coherence tomography (SD-OCT showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL. One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.

  10. Acute Central Retinal Artery Occlusion Associated with Intraocular Silicone Oil Tamponade

    Mehmet Yasin Teke

    2012-05-01

    Full Text Available Many systemic and ocular factors may cause acute central retinal artery occlusion (CRAO. Herein, we aimed to describe a case of CRAO due to intraocular silicone oil (SO tamponade. To the best of our knowledge, a case like our has not been reported previously. A 58-yearold male patient had undergone combined pars plana vitrectomy-lensectomy and intraocular SO for lens luxation and vitreus hemorrhage associated with a blunt ocular trauma in his right eye. Two weeks after the surgery, he presented with acute vision loss in the same eye. He was diagnosed with acute CRAO and it should be related with mechanical press or raised intraocular pressure (IOP associated with SO. He was treated by partial removal of SO immediately. In spite of the regression of retina edema, his visual acuity did not improve due to optic atrophy. SO may cause CRAO due to raised IOP and/or its mechanical pressure and this complication must be kept in mind. (Turk J Oph thal mol 2012; 42: 238-40

  11. Gastrointestinal Fistulas in Acute Pancreatitis With Infected Pancreatic or Peripancreatic Necrosis

    Jiang, Wei; Tong, Zhihui; Yang, Dongliang; Ke, Lu; Shen, Xiao; Zhou, Jing; Li, Gang; Li, Weiqin; Li, Jieshou

    2016-01-01

    Abstract Gastrointestinal (GI) fistula is a well-recognized complication of acute pancreatitis (AP). However, it has been reported in limited literature. This study aimed to evaluate the incidence and outcome of GI fistulas in AP patients complicated with infected pancreatic or peripancreatic necrosis (IPN). Between 2010 and 2013 AP patients with IPN who diagnosed with GI fistula in our center were analyzed in this retrospective study. And we also conducted a comparison between patients with and without GI fistula regarding the baseline characteristics and outcomes. Over 4 years, a total of 928 AP patients were admitted into our center, of whom 119 patients with IPN were diagnosed with GI fistula and they developed 160 GI fistulas in total. Colonic fistula found in 72 patients was the most common form of GI fistula followed with duodenal fistula. All duodenal fistulas were managed by nonsurgical management. Ileostomy or colostomy was performed for 44 (61.1%) of 72 colonic fistulas. Twenty-one (29.2%) colonic fistulas were successfully treated by percutaneous drainage or continuous negative pressure irrigation. Mortality of patients with GI fistula did not differ significantly from those without GI fistula (28.6% vs 21.9%, P = 0.22). However, a significantly higher mortality (34.7%) was observed in those with colonic fistula. GI fistula is a common finding in patients of AP with IPN. Most of these fistulas can be successfully managed with different procedures depending on their sites of origin. Colonic fistula is related with higher mortality than those without GI fistula. PMID:27057908

  12. The relationship between tumor necrosis factor-α gene polymorphisms and acute severe pancreatitis

    张佃良; 黎介寿; 江志伟; 于宝军; 唐星明; 李维勤

    2003-01-01

    Objective To investigate the relationship between the presence of the TNF2 allele and plasma concentrations of tumor necrosis factor-α (TNFα) and soluble TNF receptor (Stnf-R) with the development of acute severe pancreatitis (ASP) and severe sepsis.Methods Genomic DNA was prepared from peripheral blood leukocytes. The TNF1 and TNF2 biallelic polymorphisms were identified by analyzing Ncol-digested DNA fragments obtained from PCR products. Plasma levels of TNFα and sTNF-R were measured by EASIA.Results The overall TNF2 allele frequency in ASP patients was comparable to that found in healthy volunteers (29. 2% vs. 29. 3%, P>0. 05). Severe sepsis occurred in 26 of 72 patients. Patients with severe sepsis showed a significantly higher prevalence of TNF2 than those without (46. 2% vs.19.6%, P<0.05). Plasma TNFα, sTNF-RI, and sTNF-RII levels were (36 ±31 ) pg/ml, (5.4 ±3.5) ng/ml, and (11.2 ±7. 8) ng/ml, respectively, in patients with severe sepsis, and (31 ±25)pg/ml, (4. 6 ± 3. 8) ng/ml, and (8. 8 ± 6.6) ng/ml in non-severe sepsis subjects. Differences in TNF levels were not statistically significant between patients with ASP and control group (P >0. 05).Moreover, there was no correlation between TNF2 allele frequency and TNFα levels [(37 ±31) pg/mlvs. (31 ±25) pg/ml in TNF2 group and TNF1 group, respectively, P>0. 05].Conclusions Our results suggest that there is no relationship between ASP and the TNF2 allele, but that the TNF2 allele is associated with a susceptibility to severe sepsis as a result of ASP.

  13. A case of acute retinal pigment epithelitis: spectral domain optical coherence tomography time course and physiopathologic hypothesis

    Nathalie Puche

    2010-09-01

    Full Text Available Nathalie Puche1, Olivier Offret1, Jean-Antoine Bernard1, Francine Behar-Cohen1,21Department of Ophthalmology, Hotel Dieu de Paris, AP-HP, Université Paris Descartes; 2Inserm UMRS872, Physiopathology of Ocular Diseases: Therapeutic Innovations, Centre de Recherche des Cordeliers, Université Paris Descartes, Paris, FrancePurpose: To report the time course of retinal morphologic changes in a patient with acute retinal pigment epithelitis (ARPE using spectral domain optical coherence tomography (SD-OCT.Methods: A 30-year old man was referred for blurred vision of his right eye after five days that appeared suddenly 15 days after recovery from a flu-like syndrome. SD-OCT was performed immediately, followed by fluorescein and infracyanine angiography at eight days and then at three weeks.Results: At presentation, a bubble of sub-macular deposit was observed on the right macula with central golden micronodules in a honeycomb pattern. SD-OCT showed an “anterior dislocation” of all the retinal layers up to the inner/outer segment (IS/OS line and irregular deposits at the OS level together with thickening of the retinal pigment epithelial (RPE layer. As visual acuity increased, eight days later, the OCT showed reduction of the sub-retinal deposits and an abnormal hyperflectivity of the sub-retinal and RPE layers was observed. The patient showed a positive serology for picornavirus.Discussion: The acute SD-OCT sections of this patient with ARPE were compared with histological sections of a 35 day old Royal College of Surgeons rat. Similar findings could be observed, with preservation of the IS/OS line and accumulation of debris at the OS level, suggesting that ARPE symptoms could result from a transient phagocytic dysfunction of the RPE at the fovea, inducing reversible accumulation of undigested OS. Picornaviruses comprising enterovirus and coxsachievirus described as being associated with acute chorioretinitis. In this case, it was responsible for

  14. Chickenpox Chorioretinitis with Retinal Exudates and Periphlebitis

    Hirokuni Kitamei

    2012-05-01

    Full Text Available Background: Chickenpox is rarely associated with posterior segment inflammation. We report on a case of unilateral chickenpox chorioretinitis with retinal exudates and periphlebitis. Case Presentation: A 21-year-old healthy man, who suffered from chickenpox 2 weeks prior to symptom development, exhibited mild anterior chamber cells, vitreous opacity, sheathing of retinal veins, and yellow-white exudates in his right eye. Varicella zoster virus DNA was detected by polymerase chain reaction in the aqueous humor. He was treated with intravenous acyclovir followed by oral prednisolone and valaciclovir. Aqueous cells quickly disappeared and retinal exudates diminished within 1 month, leaving faint retinal scarring. Retinal arteritis had never been observed in this patient. Conclusions: Although the ocular findings in this case were similar to acute retinal necrosis (ARN, the clinical features differed from ARN in the following points: (1 mild anterior chamber inflammation, (2 absence of retinal arteritis, and (3 prompt resolution of inflammatory findings. The distinctive clinical features indicated that chorioretinitis associated with chickenpox may not have the same pathological conditions as ARN.

  15. Myocardial uptake of indium-111-labeled antimyosin in acute subendocardial infarction: Clinical, histochemical, and autoradiographic correlation of myocardial necrosis

    Indium-111-labeled antimyosin has been utilized in the diagnosis and localization of acute transmural myocardial infarction. The present report describes a patient who presented with a massive subendocardial infarction. Two days after the injection of antimyosin, the patient's clinical status markedly deteriorated and he expired. Postmortem examination demonstrated severe three-vessel coronary artery disease with extensive myocyte death in the endocardium. Autoradiography and histochemical staining of the prosected heart demonstrated high correlation for myocardial necrosis and corresponded to clinical evidence for diffuse subendocardial infarction

  16. Myocardial uptake of indium-111-labeled antimyosin in acute subendocardial infarction: Clinical, histochemical, and autoradiographic correlation of myocardial necrosis

    Hendel, R.C.; McSherry, B.A.; Leppo, J.A. (Univ. of Massachusetts Medical Center, Worcester (USA))

    1990-11-01

    Indium-111-labeled antimyosin has been utilized in the diagnosis and localization of acute transmural myocardial infarction. The present report describes a patient who presented with a massive subendocardial infarction. Two days after the injection of antimyosin, the patient's clinical status markedly deteriorated and he expired. Postmortem examination demonstrated severe three-vessel coronary artery disease with extensive myocyte death in the endocardium. Autoradiography and histochemical staining of the prosected heart demonstrated high correlation for myocardial necrosis and corresponded to clinical evidence for diffuse subendocardial infarction.

  17. Intravitreal Triamcinolone for Acute Branch Retinal Vein Occlusion: a Randomized Clinical Trial

    Alireza Ramezani

    2011-01-01

    Full Text Available Purpose: To evaluate the therapeutic effect of intravitreal triamcinolone (IVT injection for recent branch retinal vein occlusion (BRVO. Methods: In a randomized controlled clinical trial, 30 phakic eyes with recent (less than 10 weeks′ duration BRVO were assigned to two groups. The treatment group (16 eyes received 4 mg IVT and the control group (14 eyes received subconjunctival sham injections. Changes in visual acuity (VA were the main outcome measure. Results: VA and central macular thickness (CMT changes were not significantly different between the study groups at any time point. Within group analysis showed significant VA improvement from baseline in the IVT group up to three months (P 0.05. Significant reduction in CMT was noticed only in the treatment group (‑172 ± 202 μm, P = 0.029 and at 4 months. Ocular hypertension occurred in 4 (25% and 2 (14.3% eyes in the IVT and control groups, respectively. Conclusion: A single IVT injection had a non-significant beneficial effect on VA and CMT in acute BRVO as compared to the natural history of the condition. The 3-month deferred treatment protocol advocated by the Branch Vein Occlusion Study Group may be a safer option than IVT injection considering its potential side effects.

  18. Involvement of All-trans-retinal in Acute Light-induced Retinopathy of Mice*S⃞

    MAEDA, Akiko; Maeda, Tadao; Golczak, Marcin; Chou, Steven; Desai, Amar; Hoppel, Charles L.; Matsuyama, Shigemi; Palczewski, Krzysztof

    2009-01-01

    Exposure to bright light can cause visual dysfunction and retinal photoreceptor damage in humans and experimental animals, but the mechanism(s) remain unclear. We investigated whether the retinoid cycle (i.e. the series of biochemical reactions required for vision through continuous generation of 11-cis-retinal and clearance of all-trans-retinal, respectively) might be involved. Previously, we reported that mice lacking two enzymes responsible for clearing all-tran...

  19. ApoSense: a novel technology for functional molecular imaging of cell death in models of acute renal tubular necrosis

    Damianovich, Maya; Ziv, Ilan; Aloya, Tali; Grimberg, Hagit; Levin, Galit; Reshef, Ayelet; Bentolila, Alfonso; Cohen, Avi; Shirvan, Anat [NeuroSurvival Technologies (NST) Ltd., Petah Tikva (Israel); Heyman, Samuel N.; Shina, Ahuva [Mt.Scopus and the Hebrew University Medical School, Department of Medicine, Hadassah Hospital, Jerusalem (Israel); Rosen, Seymour [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Pathology, Boston, MA (United States); Kidron, Dvora [Meir Hospital, Department of Pathology, Kfar-Saba (Israel)

    2006-03-15

    Acute renal tubular necrosis (ATN), a common cause of acute renal failure, is a dynamic, rapidly evolving clinical condition associated with apoptotic and necrotic tubular cell death. Its early identification is critical, but current detection methods relying upon clinical assessment, such as kidney biopsy and functional assays, are insufficient. We have developed a family of small molecule compounds, ApoSense, that is capable, upon systemic administration, of selectively targeting and accumulating within apoptotic/necrotic cells and is suitable for attachment of different markers for clinical imaging. The purpose of this study was to test the applicability of these molecules as a diagnostic imaging agent for the detection of renal tubular cell injury following renal ischemia. Using both fluorescent and radiolabeled derivatives of one of the ApoSense compounds, didansyl cystine, we evaluated cell death in three experimental, clinically relevant animal models of ATN: renal ischemia/reperfusion, radiocontrast-induced distal tubular necrosis, and cecal ligature and perforation-induced sepsis. ApoSense showed high sensitivity and specificity in targeting injured renal tubular epithelial cells in vivo in all three models used. Uptake of ApoSense in the ischemic kidney was higher than in the non-ischemic one, and the specificity of ApoSense targeting was demonstrated by its localization to regions of apoptotic/necrotic cell death, detected morphologically and by TUNEL staining. (orig.)

  20. Radiation-induced acute necrosis of the pancreatic islet and the diabetic syndrome in the golden hamster (Mesocricetus auratus)

    Tsubouchi, S.; Suzuki, H.; Ariyoshi, H. (Aichi Cancer Center, Nagoya (Japan)); Matsuzawa, T. (Tohoku Univ., Sendai (Japan). Research Inst. for Tuberculosis and Cancer)

    1981-07-01

    Exposure of golden hamsters to 35 000 rad of X-rays induced acute and specific necrosis of the cells of the islets of Langerhans of the pancreas within 4 hours, whereas no other tissue revealed any drastic changes which would lead to a critical illness until 36 hours. Animals began to show the characteristic signs of diabetes, that is, hyperglycaemia, hyperkalaemia, ketonemia, and acidosis at 12 hours and these continued until death, 56+-8 hours later. These were accompanied by the disappearance of ..beta..-cell granules and a decrease of plasma insulin. Treatment of irradiated animals with injections of insulin resulted in a reduction in high blood glucose and the prolongation of survival time up to 5 days, which is comparable to the survival time when the cause of death is gastrointestinal. It is concluded that this radiation-induced diabetic syndrome resulted from acute necrosis of the cells of the islets of Langerhans, a previously unreported lethal effect of radiation in golden hamsters.

  1. Radiation-induced acute necrosis of the pancreatic islet and the diabetic syndrome in the golden hamster (Mesocricetus auratus)

    Exposure of golden hamsters to 35 000 rad of X-rays induced acute and specific necrosis of the cells of the islets of Langerhans of the pancreas within 4 hours, whereas no other tissue revealed any drastic changes which would lead to a critical illness until 36 hours. Animals began to show the characteristic signs of diabetes, that is, hyperglycaemia, hyperkalaemia, ketonemia, and acidosis at 12 hours and these continued until death, 56+-8 hours later. These were accompanied by the disappearance of β-cell granules and a decrease of plasma insulin. Treatment of irradiated animals with injections of insulin resulted in a reduction in high blood glucose and the prolongation of survival time up to 5 days, which is comparable to the survival time when the cause of death is gastrointestinal. It is concluded that this radiation-induced diabetic syndrome resulted from acute necrosis of the cells of the islets of Langerhans, a previously unreported lethal effect of radiation in golden hamsters. (author)

  2. ApoSense: a novel technology for functional molecular imaging of cell death in models of acute renal tubular necrosis

    Acute renal tubular necrosis (ATN), a common cause of acute renal failure, is a dynamic, rapidly evolving clinical condition associated with apoptotic and necrotic tubular cell death. Its early identification is critical, but current detection methods relying upon clinical assessment, such as kidney biopsy and functional assays, are insufficient. We have developed a family of small molecule compounds, ApoSense, that is capable, upon systemic administration, of selectively targeting and accumulating within apoptotic/necrotic cells and is suitable for attachment of different markers for clinical imaging. The purpose of this study was to test the applicability of these molecules as a diagnostic imaging agent for the detection of renal tubular cell injury following renal ischemia. Using both fluorescent and radiolabeled derivatives of one of the ApoSense compounds, didansyl cystine, we evaluated cell death in three experimental, clinically relevant animal models of ATN: renal ischemia/reperfusion, radiocontrast-induced distal tubular necrosis, and cecal ligature and perforation-induced sepsis. ApoSense showed high sensitivity and specificity in targeting injured renal tubular epithelial cells in vivo in all three models used. Uptake of ApoSense in the ischemic kidney was higher than in the non-ischemic one, and the specificity of ApoSense targeting was demonstrated by its localization to regions of apoptotic/necrotic cell death, detected morphologically and by TUNEL staining. (orig.)

  3. Pancreatic necrosis

    Pancreatic necrosis is a possible complication of acute pancreatitis. It is characterized by diffuse inflammation associated with exudation or leakage of pancreatic juice with its proteolytic enzymes into the peripancreatic tissues. Colonic complications of acute pancreatitis are uncommon events. Tha main purpose of our study was to correlate radiological findings of pancreatic necrosis as observed during barium enema to CT patterns. A retrospective study was therefore carried out on 40 patients affected with acute pancreatitis with local and systemic complication. The analysis of the results allowed different patterns to be observed, with the two techniques, in the acute and in the chronich phases. In the acute phase, barium enema of the colon showed inflammatory extrinsic processes involving the wall, with a typical localization related to the spread of pancreatic enzymes along mesenteric pathways, as described by Meyers. CT allowed a thorough evaluation of both the pathologic process and its spatial balance. In the chronic phase, barium enema showed fibrotic trictures and fistulas. CT demonstrated pseudoeystic masses and irregular focal areas of decreased attenuation or irregular pancreatic margins. This correlation shows how an extrinsic inflammatory involvement of the colon with a characteristic tomography may help make a diagnosis and plan therapy

  4. Identification of pancreas necrosis in severe acute pancreatitis: imaging procedures versus clinical staging.

    Block, S; Maier, W.; Bittner, R.; Büchler, M; Malfertheiner, P; Beger, H G

    1986-01-01

    One hundred and five of 395 patients with acute pancreatitis were surgically treated in our clinic from 1981 to 1984. Ninety three of these patients were examined with contrast enhanced computed tomography and/or ultrasound and were clinically assessed according to Ranson's objective criteria before operation. At operation, 77 patients showed necrotising pancreatitis and 16 showed biliary acute interstitial pancreatitis. Ninety per cent of the cases with extensive and 79% of those with minor ...

  5. Esofagitis necrotizante aguda: Una entidad inusual Acute esophageal necrosis: An unusual entity

    Silvana E. Pramparo; Pablo M. Ruiz; Rogelio Flores Valencia; José Rodeyro (h)

    2010-01-01

    La esofagitis necrotizante aguda (ENA), también denominada esófago negro, es una rara enfermedad poco descripta en la literatura médica. Describimos el caso de un hombre de 80 años, con hemorragia digestiva alta quien desarrolló un esófago negro luego de un episodio de hipotensión. La necrosis fue confirmada histológicamente. Los pacientes se presentan con hematemesis y melena en más del 70% de los casos. Los hallazgos endoscópicos muestran una coloración negruzca de la mucosa esofágica. El d...

  6. Walled-off pancreatic necrosis and other current concepts in the radiological assessment of acute pancreatitis*

    Cunha, Elen Freitas de Cerqueira; Rocha, Manoel de Souza; Pereira, Fábio Payão; Blasbalg, Roberto; Baroni, Ronaldo Hueb

    2014-01-01

    Acute pancreatitis is an inflammatory condition caused by intracellular activation and extravasation of inappropriate proteolytic enzymes determining destruction of pancreatic parenchyma and peripancreatic tissues. This is a fairly common clinical condition with two main presentations, namely, endematous pancreatitis - a less severe presentation -, and necrotizing pancreatitis - the most severe presentation that affects a significant part of patients. The radiological evaluation, particularly...

  7. Heat Shock Protein 72 Protects Retinal Ganglion Cells in Rat Model of Acute Glaucoma

    Guoping Qing; Xuanchu Duan; Youqin Jiang

    2005-01-01

    Purpose: To investigate whether the induction of heat shock protein (HSP)72 by heat stress (HS) or zinc (Zn2+ ) administration can increase survival of retinal ganglion cells (RGC) in rat model of acute experimental glaucoma.Methods: Acute glaucoma model was made by intracameral irrigation with BSS at 102 mmHg for two hours in right eyes of male Wistar rats. Glaucoma model rats were treated with HS once a week (six rats) or intraperitoneal injection of zinc sulfate (24.6 mg/kg) every two weeks (six rats), and were referred to as HS group and zinc group, respectively. Untreated model rats served as damage group (six rats). In control groups, quercetin (400 mg/kg) was intraperitoneally injected to inhibit the induction of heat shock proteins 6 hours before HS or zinc administration, and were referred to as HS+que group (six rats) and zinc+que group (six rats), respectively. Subsequent to 16 days of IOP elevation, the rats were sacrificed. Eyes were quickly enucleated, and the retinas were dissected. RGC were labeled with Nissl staining and counted under microscope.Results: The average RGC density in normal Wistar rats was (2504±181) cells/mm2. In damage group, it decreased to (2015±111 ) cells/mm2. The RGC densities at 1,2, and 3 mm from the center of the optic nerve head were (2716±215), (2496±168), and (2317±171) cells/mm2, respectively, for normal rats and (2211±133), (1969±154),and (1872±68) cells/mm2, respectively, for damage group. The latter was significantly lower at all locations compared with the former (P=0.027 for each, Mann-Whitney test).The average RGC densities were (2207±200) cells/mm2 for HS group, (2272±155) cells/mm2 for zinc group, (1964±188) cells/mm2 for HS+que group, (2051 ±214) cells/mm2 for zinc+que group and (2015±111 ) cells/mm2 for damage group. There were significant differences in density of labeled RGCs among the five groups (P=0.040,Kruskal-Wallis test). Both HS and zinc group had higher RGC densities than damage group (P

  8. Draft Genome Sequence of Non-Vibrio parahaemolyticus Acute Hepatopancreatic Necrosis Disease Strain KC13.17.5, Isolated from Diseased Shrimp in Vietnam

    Kondo, Hidehiro; Van, Phan Thi; Dang, Lua T.; Hirono, Ikuo

    2015-01-01

    A strain of Vibrio (KC13.17.5) causing acute hepatopancreatic necrosis disease (AHPND) in shrimp in northern Vietnam was isolated. Normally, AHPND is caused by Vibrio parahaemolyticus, but the genomic sequence of the strain indicated that it belonged to Vibrio harveyi. The sequence data included plasmid-like sequences and putative virulence genes.

  9. Draft Genome Sequence of Non-Vibrio parahaemolyticus Acute Hepatopancreatic Necrosis Disease Strain KC13.17.5, Isolated from Diseased Shrimp in Vietnam

    Kondo, Hidehiro; Van, Phan Thi; Dang, Lua T.

    2015-01-01

    A strain of Vibrio (KC13.17.5) causing acute hepatopancreatic necrosis disease (AHPND) in shrimp in northern Vietnam was isolated. Normally, AHPND is caused by Vibrio parahaemolyticus, but the genomic sequence of the strain indicated that it belonged to Vibrio harveyi. The sequence data included plasmid-like sequences and putative virulence genes. PMID:26383659

  10. Serum-mucoid fraction content in development of skin acute radiation necrosis in rats

    Serum-mucoid fraction composition (in polyacrilamide gel) in rats during the different stages of local acute radiation injury of skin (6000 rad irradiation) has been studied. For this injury type during all the periods no appearance of new, unusual for the norm, fractions of serum-mucoids is noted. 2 stages of changes in serum-mucoid fractions have been revealed: the simultaneous increase in the content of all the serum-mucoid components is observed during acute period (bullous dermatitis); during a necrotic period of development of acute skin radiation injury the level of the third fraction increases, the number of the first fraction decreases, the content of the second and forth fractions changes slightly. The level of total serum-mucoids is predominantly determined by the changes of the third fraction, growth of which during the ulcer-necrotic period depends clearly on an injury degree. The determination of the third fraction containing, likely, low molecular haptoglobin in these cases can be of prognostic and diagnostic values

  11. Eugenol reduces acute pain in mice by modulating the glutamatergic and tumor necrosis factor alpha (TNF-α) pathways.

    Dal Bó, Wladmir; Luiz, Ana Paula; Martins, Daniel F; Mazzardo-Martins, Leidiane; Santos, Adair R S

    2013-10-01

    Eugenol is utilized together with zinc oxide in odontological clinical for the cementation of temporary prostheses and the temporary restoration of teeth and cavities. This work explored the antinociceptive effects of the eugenol in different models of acute pain in mice and investigated its possible modulation of the inhibitory (opioid) and excitatory (glutamatergic and pro-inflammatory cytokines) pathways of nociceptive signaling. The administration of eugenol (3-300 mg/kg, p.o., 60 min or i.p., 30 min) inhibited 82 ± 10% and 90 ± 6% of the acetic acid-induced nociception, with ID₅₀ values of 51.3 and 50.2 mg/kg, respectively. In the glutamate test, eugenol (0.3-100 mg/kg, i.p.) reduced the response behavior by 62 ± 5% with an ID₅₀ of 5.6 mg/kg. In addition, the antinociceptive effect of eugenol (10 mg/kg, i.p.) in the glutamate test was prevented by the i.p. treatment for mice with naloxone. The pretreatment of mice with eugenol (10 mg/kg, i.p.) was able to inhibit the nociception induced by the intrathecal (i.t.) injection of glutamate (37 ± 9%), kainic (acid kainite) (41 ± 12%), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) (55 ± 5%), and substance P (SP) (39 ± 8%). Furthermore, eugenol (10 mg/kg, i.p.) also inhibited biting induced by tumor necrosis factor alpha (TNF-α, 65 ± 8%). These results extend our current knowledge of eugenol and confirm that it promotes significant antinociception against different mouse models of acute pain. The mechanism of action appears to involve the modulation of the opioid system and glutamatergic receptors (i.e., kainate and AMPA), and the inhibition of TNF-α. Thus, eugenol could represent an important compound in the treatment for acute pain. PMID:22775297

  12. Fever and acute phase response induced in dwarf goats by endotoxin and bovine and human recombinant tumour necrosis factor alpha.

    van Miert, A S; van Duin, C T; Wensing, T

    1992-12-01

    Tumour necrosis factor (TNF), a polypeptide produced by mononuclear phagocytes, has been implicated as an important mediator of inflammatory processes and of clinical manifestations in acute infectious diseases. To study further the potential role of TNF in infectious diseases, recombinant Escherichia coli (E. coli) derived human (r.HuTNF-alpha) and bovine TNF (r.BoTNF-alpha) were intravenously (i.v.) administered in dwarf goats. Rectal temperature, heart rate, rumen motility, plasma zinc and iron concentrations, and certain other blood biochemical and haematological values were studied and compared with the changes seen after E. coli endotoxin (LPS) was administered (dose: 0.1 microgram/kg i.v.). Following a single injection of 4 micrograms/kg of r.BoTNF-alpha, shivering and biphasic febrile response were observed, accompanied by tachycardia, inhibition of rumen contractions, drop in plasma zinc and iron concentrations, lymphopenia, and neutropenia followed by neutrophilia. The i.v. administration of a single injection of 4 micrograms/kg r.HuTNF-alpha induced shivering and biphasic febrile responses, accompanied by anorexia and a similar drop in plasma trace metal concentrations when compared with r.BoTNF-alpha-treated goats. The TNF-alpha-induced symptoms were essentially the same as those that occurred after LPS administration. However, the time of onset of these changes after the injection of TNF-alpha was significantly shorter than after LPS. Moreover, the r.BoTNF-alpha induced a longer lasting neutrophilic leucopenia, less neutrophilia, and a more persistent lymphopenia than after LPS injection. Neither r.BoTNF-alpha nor LPS caused severe haemo-concentration. Furthermore, no cross-tolerance between r.BoTNF-alpha and LPS could be demonstrated. We conclude that both r.BoTNF-alpha and r.HuTNF-alpha induce many of the physiologic, haematologic and metabolic changes that characterize the acute phase response to LPS. The overlapping biological activities of r

  13. A comparative study of MRI findings of experimentally induced rapid progressive glomerulonephritis (RPGN) and acute tubular necrosis (ATN) in rabbits

    To evaluate the usefulness of MR imaging in the differential diagnosis of the underlying causes of early-stage acute renal failure (ARF) by comparing the MRI findings of experimentally-induced crescentic glomerulonephritis (CGN) and acute tubular necrosis (ATN) in rabbits. Experimental CGN was induced by injecting anti-glomerular basement membrane antibody into six rabbits, and ATN by injecting glycerol solution into six rabbits. A normal control group of three rabbits was also used. Renal MR imaging (T1-and T2-weighted coronal images and dynamic MRI : DMRI) was performed the day before, and one,four, and seven days after the induction of CGN; and immediately before, and four, and eight hours, and one, four, and seven days after the induction of ATN. Sequential renal gunbiopsies and blood sampling (serum creatinine, sCr) were performed. Renal area, corticomedullary differentiation (CMD), and the passage of Gd-DTPA (patter of dark band), as seen on MRI, were analyzed and correlated with serial change of sCr. In normal kidneys, CMD was clearly apparent on both T1-and T2-weighted images. DMRI demonstrated a progressively inwardly migrating dark band in the kidneys. CMD was relatively clearly demonstrated in the ATN group but less clearly identified in the CGN group. Renal size (area) and sCr gradually increased in both the CGN and ATN groups, and dark bands were moderately to poorly defined in both. We conclude that DMRI could be used to differentiate and evaluate disease processing and compromised renal function in cases of CGN and ATN. On T1-and T2-weighted images, CMD was relatively well preserved in the ATN group, but was less clear in the CGN group. These MRI findings may be helpful for differentiation of the underlying causes of early-stage ARF, particularly between CGN and ATN

  14. Membrane Type-1 Matrix Metalloproteinase Expression in Acute Myeloid Leukemia and Its Upregulation by Tumor Necrosis Factor-α

    Membrane type-1 matrix metalloproteinase (MT1-MMP) has been implicated in tumor invasion, as well as trafficking of normal hematopoietic cells, and acts as a physiologic activator of proMMP-2. In this study we examined MT1-MMP expression in primary acute myeloid leukemia (AML) cells. Because tumor necrosis factor (TNF)-α is known to be elevated in AML, we also investigated the effect of TNF-α on MT1-MMP expression. We found (i) MT1-MMP mRNA expression in 41 out of 43 primary AML samples tested; (ii) activation of proMMP-2 in co-cultures of AML cells with normal bone marrow stromal cells; and (iii) inhibition of proMMP-2 activation and trans-Matrigel migration of AML cells by gene silencing using MT1-MMP siRNA. Moreover, recombinant human TNF-α upregulated MT1-MMP expression in AML cells resulting in enhanced proMMP-2 activation and trans-Matrigel migration. Thus, AML cells express MT1-MMP and TNF-α enhances it leading to increased MMP-2 activation and most likely contributing to the invasive phenotype. We suggest that MT1-MMP, together with TNF-α, should be investigated as potential therapeutic targets in AML

  15. Membrane Type-1 Matrix Metalloproteinase Expression in Acute Myeloid Leukemia and Its Upregulation by Tumor Necrosis Factor-α

    Anna Janowska-Wieczorek

    2012-07-01

    Full Text Available Membrane type-1 matrix metalloproteinase (MT1-MMP has been implicated in tumor invasion, as well as trafficking of normal hematopoietic cells, and acts as a physiologic activator of proMMP-2. In this study we examined MT1-MMP expression in primary acute myeloid leukemia (AML cells. Because tumor necrosis factor (TNF-α is known to be elevated in AML, we also investigated the effect of TNF-α on MT1-MMP expression. We found (i MT1-MMP mRNA expression in 41 out of 43 primary AML samples tested; (ii activation of proMMP-2 in co-cultures of AML cells with normal bone marrow stromal cells; and (iii inhibition of proMMP-2 activation and trans-Matrigel migration of AML cells by gene silencing using MT1-MMP siRNA. Moreover, recombinant human TNF-α upregulated MT1-MMP expression in AML cells resulting in enhanced proMMP-2 activation and trans-Matrigel migration. Thus, AML cells express MT1-MMP and TNF-α enhances it leading to increased MMP-2 activation and most likely contributing to the invasive phenotype. We suggest that MT1-MMP, together with TNF-α, should be investigated as potential therapeutic targets in AML.

  16. Membrane Type-1 Matrix Metalloproteinase Expression in Acute Myeloid Leukemia and Its Upregulation by Tumor Necrosis Factor-α

    Marquez-Curtis, Leah A.; Shirvaikar, Neeta [Canadian Blood Services R& D, Edmonton, Alberta T6G 2R8 (Canada); Turner, A. Robert [Departments of Medicine and Oncology, University of Alberta, Edmonton, Alberta T6G 2G3 (Canada); Mirza, Imran [Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta T6G 2B7 (Canada); Surmawala, Amir; Larratt, Loree M. [Departments of Medicine and Oncology, University of Alberta, Edmonton, Alberta T6G 2G3 (Canada); Janowska-Wieczorek, Anna, E-mail: anna.janowska@blood.ca [Canadian Blood Services R& D, Edmonton, Alberta T6G 2R8 (Canada); Departments of Medicine and Oncology, University of Alberta, Edmonton, Alberta T6G 2G3 (Canada)

    2012-07-25

    Membrane type-1 matrix metalloproteinase (MT1-MMP) has been implicated in tumor invasion, as well as trafficking of normal hematopoietic cells, and acts as a physiologic activator of proMMP-2. In this study we examined MT1-MMP expression in primary acute myeloid leukemia (AML) cells. Because tumor necrosis factor (TNF)-α is known to be elevated in AML, we also investigated the effect of TNF-α on MT1-MMP expression. We found (i) MT1-MMP mRNA expression in 41 out of 43 primary AML samples tested; (ii) activation of proMMP-2 in co-cultures of AML cells with normal bone marrow stromal cells; and (iii) inhibition of proMMP-2 activation and trans-Matrigel migration of AML cells by gene silencing using MT1-MMP siRNA. Moreover, recombinant human TNF-α upregulated MT1-MMP expression in AML cells resulting in enhanced proMMP-2 activation and trans-Matrigel migration. Thus, AML cells express MT1-MMP and TNF-α enhances it leading to increased MMP-2 activation and most likely contributing to the invasive phenotype. We suggest that MT1-MMP, together with TNF-α, should be investigated as potential therapeutic targets in AML.

  17. Extensive Bone Marrow Necrosis and Osteolytic Lesions in a Case of Acute Myeloid Leukemia Transformed from Polycythemia Vera.

    Chambers, Isaac; Truong, Phu; Kallail, K James; Palko, William

    2016-01-01

    Acute myeloid leukemia (AML) is the most common leukemia in adults. In rare cases, bone marrow necrosis (BMN) and osteolytic lesions are presenting features of AML. The following case describes a patient with known polycythemia vera (PV) that presented with signs of multiple myeloma, including hypercalcemia, anemia, and lytic lesions of the thoracic spine and skull. Laboratory workup was not indicative of myeloma. A bone marrow biopsy was performed, which revealed extensive BMN and initial pathology was consistent with metastatic carcinoma. However, no immunohistochemical stains could be performed due to the extent of BMN; a repeat biopsy was therefore performed. Flow cytometry and CD45 staining were consistent with PV that had transformed to AML. Due to the patient's comorbidities, she was a poor candidate for stem cell transplant and did not wish to pursue chemotherapy. Ultimately, she pursued hospice care. Based on our literature review, both BMN and osteolytic lesions are rare manifestations of AML and have not been reported to occur simultaneously. These findings can lead to a diagnostic dilemma and suspicion of other malignancies. This case demonstrates that AML should remain in the differential diagnosis in those patients who present with BMN and osteolytic lesions. PMID:27433418

  18. Delayed diagnosis of ocular syphilis that manifested as retinal vasculitis and acute posterior multifocal placoid epitheliopathy

    Jong Hoon Park

    2013-01-01

    Full Text Available A 55-year-old female presented with bilateral progressive retinal vasculitis. She was on systemic and intravitreal steroids on the basis of uveitis work-up result (negative result including rapid plasma reagin, but her visual acuity continued to deteriorate to light perception only. Ocular examination showed retinal vasculitis, multiple yellow placoid lesions and severe macula edema in both eyes. Repeated work-up revealed positivity of fluorescent treponemal antibody-absorption in serum and subsequently in cerebrospinal fluid. Ocular syphilis was diagnosed. And intravenous penicillin G resulted in rapid resolution of vasculitis and macular edema. To avoid delay in the diagnosis of ocular syphilis, high index of suspicion and repeating serological tests (including both treponemal and non-treponemal tests are warranted.

  19. Field and Experimental Evidence of Vibrio parahaemolyticus as the Causative Agent of Acute Hepatopancreatic Necrosis Disease of Cultured Shrimp (Litopenaeus vannamei) in Northwestern Mexico

    Soto-Rodriguez, Sonia A.; Gomez-Gil, Bruno; Lozano-Olvera, Rodolfo; Betancourt-Lozano, Miguel; Morales-Covarrubias, Maria Soledad

    2014-01-01

    Moribund shrimp affected by acute hepatopancreatic necrosis disease (AHPND) from farms in northwestern Mexico were sampled for bacteriological and histological analysis. Bacterial isolates were molecularly identified as Vibrio parahaemolyticus by the presence of the tlh gene. The tdh-negative, trh-negative, and tlh-positive V. parahaemolyticus strains were further characterized by repetitive extragenic palindromic element-PCR (rep-PCR), and primers AP1, AP2, AP3, and AP and an ems2 IQ2000 det...

  20. Transcatheter thrombolysis combined with damage control surgery for treatment of acute mesenteric venous thrombosis associated with bowel necrosis: a retrospective study

    Liu, Kai; Meng, Jiaxiang; Yang, Shuofei; Liu, Baochen; Ding, Weiwei; Wu, Xingjiang; Li, Jieshou

    2015-01-01

    Objective This study aims to evaluate the clinical outcomes of transcatheter thrombolysis in acute superior mesenteric venous thrombosis (ASMVT) associated with bowel necrosis. Methods A retrospective study of six patients with ASMVT treated with catheter-directed thrombectomy/thrombolysis and damage control surgery at Jinling Hospital (Nanjing, China) between 2010 and 2013 was conducted. Demographics, past medical history, risk factors, therapeutic methods and effects, mortality, and follow-...

  1. Gastrointestinal Fistulas in Acute Pancreatitis With Infected Pancreatic or Peripancreatic Necrosis: A 4-Year Single-Center Experience.

    Jiang, Wei; Tong, Zhihui; Yang, Dongliang; Ke, Lu; Shen, Xiao; Zhou, Jing; Li, Gang; Li, Weiqin; Li, Jieshou

    2016-04-01

    Gastrointestinal (GI) fistula is a well-recognized complication of acute pancreatitis (AP). However, it has been reported in limited literature. This study aimed to evaluate the incidence and outcome of GI fistulas in AP patients complicated with infected pancreatic or peripancreatic necrosis (IPN).Between 2010 and 2013 AP patients with IPN who diagnosed with GI fistula in our center were analyzed in this retrospective study. And we also conducted a comparison between patients with and without GI fistula regarding the baseline characteristics and outcomes.Over 4 years, a total of 928 AP patients were admitted into our center, of whom 119 patients with IPN were diagnosed with GI fistula and they developed 160 GI fistulas in total. Colonic fistula found in 72 patients was the most common form of GI fistula followed with duodenal fistula. All duodenal fistulas were managed by nonsurgical management. Ileostomy or colostomy was performed for 44 (61.1%) of 72 colonic fistulas. Twenty-one (29.2%) colonic fistulas were successfully treated by percutaneous drainage or continuous negative pressure irrigation. Mortality of patients with GI fistula did not differ significantly from those without GI fistula (28.6% vs 21.9%, P = 0.22). However, a significantly higher mortality (34.7%) was observed in those with colonic fistula.GI fistula is a common finding in patients of AP with IPN. Most of these fistulas can be successfully managed with different procedures depending on their sites of origin. Colonic fistula is related with higher mortality than those without GI fistula. PMID:27057908

  2. Glycyrrhizin Protects against Acetaminophen-Induced Acute Liver Injury via Alleviating Tumor Necrosis Factor α-Mediated Apoptosis.

    Yan, Tingting; Wang, Hong; Zhao, Min; Yagai, Tomoki; Chai, Yingying; Krausz, Kristopher W; Xie, Cen; Cheng, Xuefang; Zhang, Jun; Che, Yuan; Li, Feiyan; Wu, Yuzheng; Brocker, Chad N; Gonzalez, Frank J; Wang, Guangji; Hao, Haiping

    2016-05-01

    Acetaminophen (APAP) overdose is the leading cause of drug-induced acute liver failure in Western countries. Glycyrrhizin (GL), a potent hepatoprotective constituent extracted from the traditional Chinese medicine liquorice, has potential clinical use in treating APAP-induced liver failure. The present study determined the hepatoprotective effects and underlying mechanisms of action of GL and its active metabolite glycyrrhetinic acid (GA). Various administration routes and pharmacokinetics-pharmacodynamics analyses were used to differentiate the effects of GL and GA on APAP toxicity in mice. Mice deficient in cytochrome P450 2E1 enzyme (CYP2E1) or receptor interacting protein 3 (RIPK3) and their relative wild-type littermates were subjected to histologic and biochemical analyses to determine the potential mechanisms. Hepatocyte death mediated by tumor necrosis factorα(TNFα)/caspase was analyzed by use of human liver-derived LO2 cells. The pharmacokinetics-pharmacodynamics analysis using various administration routes revealed that GL but not GA potently attenuated APAP-induced liver injury. The protective effect of GL was found only with intraperitoneal and intravenous administration and not with gastric administration. CYP2E1-mediated metabolic activation and RIPK3-mediated necroptosis were unrelated to GL's protective effect. However, GL inhibited hepatocyte apoptosis via interference with TNFα-induced apoptotic hepatocyte death. These results demonstrate that GL rapidly attenuates APAP-induced liver injury by directly inhibiting TNFα-induced hepatocyte apoptosis. The protective effect against APAP-induced liver toxicity by GL in mice suggests the therapeutic potential of GL for the treatment of APAP overdose. PMID:26965985

  3. A CMR study of the effects of tissue edema and necrosis on left ventricular dyssynchrony in acute myocardial infarction: implications for cardiac resynchronization therapy

    Manka Robert

    2012-07-01

    Full Text Available Abstract Background In acute myocardial infarction (AMI, both tissue necrosis and edema are present and both might be implicated in the development of intraventricular dyssynchrony. However, their relative contribution to transient dyssynchrony is not known. Cardiovascular magnetic resonance (CMR can detect necrosis and edema with high spatial resolution and it can quantify dyssynchrony by tagging techniques. Methods Patients with a first AMI underwent percutaneous coronary interventions (PCI of the infarct-related artery within 24 h of onset of chest pain. Within 5–7 days after the event and at 4 months, CMR was performed. The CMR protocol included the evaluation of intraventricular dyssynchrony by applying a novel 3D-tagging sequence to the left ventricle (LV yielding the CURE index (circumferential uniformity ratio estimate; 1 = complete synchrony. On T2-weighted images, edema was measured as high-signal (>2 SD above remote tissue along the LV mid-myocardial circumference on 3 short-axis images (% of circumference corresponding to the area-at-risk. In analogy, on late-gadolinium enhancement (LGE images, necrosis was quantified manually as percentage of LV mid-myocardial circumference on 3 short-axis images. Necrosis was also quantified on LGE images covering the entire LV (expressed as %LV mass. Finally, salvaged myocardium was calculated as the area-at-risk minus necrosis (expressed as % of LV circumference. Results After successful PCI (n = 22, 2 female, mean age: 57 ± 12y, peak troponin T was 20 ± 36ug/l and the LV ejection fraction on CMR was 41 ± 8%. Necrosis mass was 30 ± 10% and CURE was 0.91 ± 0.05. Edema was measured as 58 ± 14% of the LV circumference. In the acute phase, the extent of edema correlated with dyssynchrony (r2 = −0.63, p 2 = −0.19, p = 0.05. PCI resulted in salvaged myocardium of 27 ± 14%. LV dyssynchrony (=CURE decreased at 4 months from 0.91

  4. Photorhabdus insect-related (Pir) toxin-like genes in a plasmid of Vibrio parahaemolyticus, the causative agent of acute hepatopancreatic necrosis disease (AHPND) of shrimp

    Han, Jee Eun; Kathy F.J. Tang; Tran, Loc H.; Lightner, Donald V.

    2015-01-01

    The 69 kb plasmid pVPA3-1 was identified in Vibrio parahaemolyticus strain 13-028/A3 that can cause acute hepatopancreatic necrosis disease (AHPND). This disease is responsible for mass mortalities in farmed penaeid shrimp and is referred to as early mortality syndrome (EMS). The plasmid has a GC content of 45.9% with a copy number of 37 per bacterial cell as determined by comparative quantitative PCR analyses. It consists of 92 open reading frames that encode mobilization proteins, replicati...

  5. Retinal oximetry

    Sveinn Hákon Harðarson 1978

    2012-01-01

    Purpose Malfunction of retinal blood flow or oxygenation is believed to be involved in various diseases. Among them are retinal vessel occlusions, diabetic retinopathy and glaucoma. Reliable, non-invasive technology for retinal oxygen measurements has been scarce and most of the knowledge on retinal oxygenation comes from animal studies. This thesis describes human retinal oximetry, performed with novel retinal oximetry technology. The thesis describes studies on retinal vessel oxygen satu...

  6. Partial liquid ventilation decreases tissue and serum tumor necrosis factor-α concentrations in acute lung injury model of immature piglet induced by oleic acid

    ZHU Yao-bin; FAN Xiang-ming; LI Xiao-feng; LI Zhi-qiang; WANG Qiang; SUN Li-zhong; LIU Ying-long

    2012-01-01

    Background Pediatric patients are susceptible to lung injury.Acute lung injury in children often results in high mortality.Partial liquid ventilation (PLV) has been shown to markedly improve oxygenation and reduce histologic evidence of injury in a number of lung injury models.This study was designed to examine the hypothesis that PLV would attenuate the production of local and systemic tumor necrosis factor (TNF)-α in an immature piglet model of acute lung injury induced by oleic acid (OA).Methods Twelve Chinese immature piglets were induced acute lung injury by OA.The animals were randomly assigned to two groups of six animals,(1) conventional mechanical ventilation (MV) group and (2) PLV with 10 ml/kg FC-77 group.Results Compared with MV group,the PLV group had better cardiopulmonary variables (P <0.05).These variables included heart rate,mean blood pressure,blood pH,partial pressure of arterial oxygen (PaO2),PaO2/inspired O2 fraction (FiO2) and partial pressure of arterial carbon dioxide (PaCO2).PLV reduced TNF-α levels both in plasma and tissue compared with MV group (P <0.05).Conclusion PLV provides protective effects against TNF-a response in OA-induced acute lung injury in immature piglets.

  7. 99mTc-HDP Bone Scan Findings of Acute Rhabdomyolysis of Lumbar Multifidus and Thigh Muscles and Bone Scan and US Signs of Acute Tubular Necrosis in Excessive Rabbit's Leaping: A Case Report

    Marked rhabdomyolysis (RML) complicated by acute tubular necrosis is not a rare disease. It is characterized by disintegration of skeletal muscle fibers due to a variety of causes including excessive physical exercise, trauma, operation, infection, bed-ridden life, alcohol, drugs, toxins, exhaustion and others. We report a case of RML with acute renal failure studied using magnification bone scan which specifically identified the muscles injured by excessive rabbit's leap. The injured muscles recognized were the multifidus of the lumbar spine and the anterior and posterior muscle groups of the thigh. In addition, 99mTc-HDP bone scan findings of acute tubular necrosis correlated with that of the sonographic signs are described. Patient was treated simply with normal saline hydration and bed rest and uneventfully recovered to be discharged on the fourth hospital day. Lab data on the final hospital day: LDH=20 IU/L (normalized) and CPK=600 IU/L (still higher than normal), BUN=14.2 mg/dl (normalized) and creatinin=1.5 mg/dl (normalized) GOT=20 mg/dl (normalized) and GPT=72 mg/dl (higher than normal), respectively

  8. {sup 99m}Tc-HDP Bone Scan Findings of Acute Rhabdomyolysis of Lumbar Multifidus and Thigh Muscles and Bone Scan and US Signs of Acute Tubular Necrosis in Excessive Rabbit's Leaping: A Case Report

    Bahk, Yong Whee; Kim, Jang Min [Sung Ae Hospital, Seoul (Korea, Republic of)

    2008-06-15

    Marked rhabdomyolysis (RML) complicated by acute tubular necrosis is not a rare disease. It is characterized by disintegration of skeletal muscle fibers due to a variety of causes including excessive physical exercise, trauma, operation, infection, bed-ridden life, alcohol, drugs, toxins, exhaustion and others. We report a case of RML with acute renal failure studied using magnification bone scan which specifically identified the muscles injured by excessive rabbit's leap. The injured muscles recognized were the multifidus of the lumbar spine and the anterior and posterior muscle groups of the thigh. In addition, {sup 99}mTc-HDP bone scan findings of acute tubular necrosis correlated with that of the sonographic signs are described. Patient was treated simply with normal saline hydration and bed rest and uneventfully recovered to be discharged on the fourth hospital day. Lab data on the final hospital day: LDH=20 IU/L (normalized) and CPK=600 IU/L (still higher than normal), BUN=14.2 mg/dl (normalized) and creatinin=1.5 mg/dl (normalized) GOT=20 mg/dl (normalized) and GPT=72 mg/dl (higher than normal), respectively.

  9. Anti-tumor necrosis factor-a for the treatment of steroid-refractory acute graft-versus-host disease

    M.C. Nogueira

    2007-12-01

    Full Text Available Allogeneic stem cell transplantation has been increasingly performed for a variety of hematologic diseases. Clinically significant acute graft-versus-host disease (GVHD occurs in 9 to 50% of patients who receive allogeneic grafts, resulting in high morbidity and mortality. There is no standard therapy for patients with acute GVHD who do not respond to steroids. Studies have shown a possible benefit of anti-TNF-a (infliximabfor the treatment of acute GVHD. We report here on the outcomes of 10 recipients of related or unrelated stem cell transplants who received 10 mg/kg infliximab, iv, once weekly for a median of 3.5 doses (range: 1-6 for the treatment of severe acute GVHD and who were not responsive to standard therapy. All patients had acute GVHD grades II to IV (II = 2, III = 3, IV = 5. Overall, 9 patients responded and 1 patient had progressive disease. Among the responders, 3 had complete responses and 6 partial responses. All patients with cutaneous or gastrointestinal involvement responded, while only 2 of 6 patients with liver disease showed any response. None of the 10 patients had any kind of immediate toxicity. Four patients died, all of them with sepsis. Six patients are still alive after a median follow-up time of 544 days (92-600 after transplantation. Considering the severity of the cases and the bad prognosis associated with advanced acute GVHD, we find our results encouraging. Anti-TNF-a seems to be a useful agent for the treatment of acute GVHD.

  10. 急性胰周积液和胰腺坏死对急性胰腺炎预后的影响%Effect of acute peripancreatitc fluid collection and pancreatic necrosis to the prognosis of acute pancreatitis

    李能平; 杨欣; 顾永峰; 王华; 丛建农; 施玲华

    2009-01-01

    目的 探讨急性胰周积液和胰腺坏死对急性胰腺炎(AP)预后的影响.方法 回顾分析2003年1月至2007年12月收治的323例AP患者早期CT影像学表现,探讨急性胰周积液、胰腺坏死程度与全身炎症反应综合征(SIRS)、胰腺感染及病死率的关系.结果 发病5 d内出现SIRS并持续2 d或以上者97例(30%),12例(3.7%)在病程中、后期出现胰腺感染;病死14例(4.3%).有急性胰周积液者142例(44.0%).单个部位发生急性胰周积液者76例,其中31例发生SIRS,病死2例;多个部位急性胰周积液者66例,发生SIRS 62例,病死11例.急性胰周积液部位数量与早期SIRS发生及病死率显著相关(P<0.01).277例(85.8%)无胰腺坏死,均未继发胰腺感染,病死4例;46例(14.2%)有不同程度胰腺坏死.胰腺坏死面积≤30%32例,胰腺感染发生率12.5%,病死率15.6%;>30%~≤50%7例,感染发生率42.9%,病死率28.6%;>50%7例,感染发生率为71.4%,病死率42.9%,胰腺坏死的程度与胰腺感染的发生及病死率显著相关(P<0.05).结论 急性胰周积液和胰腺坏死对AP预后的影响不同.急性胰周积液与病程早期SIRS的发生及病死率相关;胰腺坏死与胰腺继发感染的发生及病死率有关,坏死面积越大,越容易发生胰腺感染,病死率越高.%Objective To study the Effect of acute peripancreatitc fluid collection and pancreatic necrosis to the prognosis of acute pancreatitis.Methods Retrospectively analyzing the prognostic effect of acute peripancreatitc fluid collection and pancreatic necrosis according to the early Computed-Tomograghy of 323 consecutive acute pancreatitis patients from Jan 2003 to Dec 2007,the end points are systemic inflammation response syndrome ( SIRS),pancreatic infection,and mortality.Results Within 5d after onset,97 of 323 cases (30%) presented with SIRS and lasted more than 2d,12 cases (3.7%) occurred pancreatic infection during middle or late phase,14 cases died,the mortality is 4

  11. Assessment of visual function and retinal structure following acute light exposure in the light sensitive T4R rhodopsin mutant dog.

    Iwabe, Simone; Ying, Gui-Shuang; Aguirre, Gustavo D; Beltran, William A

    2016-05-01

    The effect of acute exposure to various intensities of white light on visual behavior and retinal structure was evaluated in the T4R RHO dog, a naturally-occurring model of autosomal dominant retinitis pigmentosa due to a mutation in the Rhodopsin gene. A total of 14 dogs (ages: 4-5.5 months) were used in this study: 3 homozygous mutant RHO(T4R/T4R), 8 heterozygous mutant RHO(T4R/+), and 3 normal wild-type (WT) dogs. Following overnight dark adaptation, the left eyes were acutely exposed to bright white light with a monocular Ganzfeld dome, while the contralateral right eye was shielded. Each of the 3 homozygous (RHO(T4R/T4R)) mutant dogs had a single unilateral light exposure (LE) to a different (low, moderate, and high) dose of white light (corneal irradiance/illuminance: 0.1 mW/cm(2), 170 lux; 0.5 mW/cm(2), 820 lux; or 1 mW/cm(2), 1590 lux) for 1 min. All 8 heterozygous (RHO(T4R/+)) mutant dogs were exposed once to the same moderate dose of light. The 3 WT dogs had their left eyes exposed 1, 2, or 3 times to the same highest dose of light. Visual function prior to LE and at 2 weeks and 33 weeks after exposure was objectively assessed in the RHO(T4R/T4R) and WT dogs by using an obstacle-avoidance course. Transit time through the obstacle course was measured under different scotopic to photopic ambient illuminations. Morphological retinal changes were evaluated by non-invasive in vivo cSLO/sdOCT imaging and histology before and at several time-points (2-36 weeks) after light exposure. The analysis of the transit time through the obstacle course showed that no differences were observed in any of mutant or WT dogs at 2 weeks and 33 weeks post LE. The RHO(T4R/T4R) retina exposed to the lowest dose of white light showed no obvious changes in ONL thickness at 2 weeks, but mild decrease was noted 36 weeks after LE. The RHO(T4R/T4R) retina that received a moderate dose (showed an obvious decrease in ONL thickness along the superior and temporal meridians at 2

  12. The roles of tumor necrosis factor-alpha in colon tight junction protein expression and intestinal mucosa structure in a mouse model of acute liver failure

    Lv Sa

    2009-09-01

    Full Text Available Abstract Background Spontaneous bacterial peritonitis (SBP is a common clinical disease and one of the most severe complications of acute liver failure (ALF. Although the mechanism responsible for SBP is unclear, cytokines play an important role. The aim of this study was to investigate the effects of tumor necrosis factor-alpha (TNF-α on the structure of the intestinal mucosa and the expression of tight junction (Zona Occludens 1; ZO-1 protein in a mouse model of ALF. Methods We induced ALF using D-galactosamine/lipopolysaccharide (GalN/LPS or GalN/TNF-α and assessed the results using transmission electron microscopy, immunohistochemistry, Western blotting, ELISA and real-time quantitative PCR. The effects of administration of anti-TNF-α IgG antibody or anti-TNF-α R1 antibody before administration of GalN/LPS or GalN/TNF-α, respectively, on TNF-α were also assessed. Results Morphological abnormalities in the intestinal mucosa of ALF mice were positively correlated with serum TNF-α level. Electron microscopic analysis revealed tight junction (TJ disruptions, epithelial cell swelling, and atrophy of intestinal villi. Gut bacteria invaded the body at sites where TJ disruptions occurred. Expression of ZO-1 mRNA was significantly decreased in both ALF models, as was the level of ZO-1 protein. Prophylactic treatment with either anti-TNF-α IgG antibody or anti-tumor necrosis factor-a receptor1 (anti-TNF-α R1 antibody prevented changes in intestinal tissue ultrastructure and ZO-1 expression. Conclusion TNF-α affects the structure of the intestinal mucosa, decreases expression of ZO-1, and affects the morphology of the colon in a mouse model of ALF. It also may participate in the pathophysiological mechanism of SBP complicated to ALF.

  13. Inflammatory cascades driven by tumor necrosis factor-alpha play a major role in the progression of acute liver failure and its neurological complications.

    Anne Chastre

    Full Text Available BACKGROUND/AIMS: Acute liver failure (ALF due to ischemic or toxic liver injury is a clinical condition that results from massive loss of hepatocytes and may lead to hepatic encephalopathy (HE, a serious neuropsychiatric complication. Although increased expression of tumor necrosis factor-alpha (TNF-α in liver, plasma and brain has been observed, conflicting results exist concerning its roles in drug-induced liver injury and on the progression of HE. The present study aimed to investigate the therapeutic value of etanercept, a TNF-α neutralizing molecule, on the progression of liver injury and HE in mice with ALF resulting from azoxymethane (AOM hepatotoxicity. METHODS/PRINCIPAL FINDINGS: Mice were administered saline or etanercept (10 mg/kg; i.p. 30 minutes prior to, or up to 6 h after AOM. Etanercept-treated ALF mice were sacrificed in parallel with vehicle-treated comatose ALF mice and controls. AOM induced severe hepatic necrosis, leading to HE, and etanercept administered prior or up to 3 h after AOM significantly delayed the onset of coma stages of HE. Etanercept pretreatment attenuated AOM-induced liver injury, as assessed by histological examination, plasma ammonia and transaminase levels, and by hepatic glutathione content. Peripheral inflammation was significantly reduced by etanercept as shown by decreased plasma IL-6 (4.1-fold; p<0.001 and CD40L levels (3.7-fold; p<0.001 compared to saline-treated ALF mice. Etanercept also decreased IL-6 levels in brain (1.2-fold; p<0.05, attenuated microglial activation (assessed by OX-42 immunoreactivity, and increased brain glutathione concentrations. CONCLUSIONS: These results indicate that systemic sequestration of TNF-α attenuates both peripheral and cerebral inflammation leading to delayed progression of liver disease and HE in mice with ALF due to toxic liver injury. These results suggest that etanercept may provide a novel therapeutic approach for the management of ALF patients awaiting

  14. Retinitis Pigmentosa

    ... Congenital Amaurosis Macular Degeneration Retinitis Pigmentosa Stargardt Disease Usher Syndrome Other Retinal Diseases Glossary News & Research News & ... die. Forms of RP and related diseases include Usher syndrome, Leber’s congenital amaurosis, rod-cone disease, Bardet- ...

  15. Ischemic Retinal Vasculitis and Its Management

    Lazha Talat

    2014-01-01

    Full Text Available Ischemic retinal vasculitis is an inflammation of retinal blood vessels associated with vascular occlusion and subsequent retinal hypoperfusion. It can cause visual loss secondary to macular ischemia, macular edema, and neovascularization leading to vitreous hemorrhage, fibrovascular proliferation, and tractional retinal detachment. Ischemic retinal vasculitis can be idiopathic or secondary to systemic disease such as in Behçet’s disease, sarcoidosis, tuberculosis, multiple sclerosis, and systemic lupus erythematosus. Corticosteroids with or without immunosuppressive medication are the mainstay treatment in retinal vasculitis together with laser photocoagulation of retinal ischemic areas. Intravitreal injections of bevacizumab are used to treat neovascularization secondary to systemic lupus erythematosus but should be timed with retinal laser photocoagulation to prevent further progression of retinal ischemia. Antitumor necrosis factor agents have shown promising results in controlling refractory retinal vasculitis excluding multiple sclerosis. Interferon has been useful to control inflammation and induce neovascular regression in retinal vasculitis secondary to Behçet’s disease and multiple sclerosis. The long term effect of these management strategies in preventing the progression of retinal ischemia and preserving vision is not well understood and needs to be further studied.

  16. Field and Experimental Evidence of Vibrio parahaemolyticus as the Causative Agent of Acute Hepatopancreatic Necrosis Disease of Cultured Shrimp (Litopenaeus vannamei) in Northwestern Mexico

    Gomez-Gil, Bruno; Lozano-Olvera, Rodolfo; Betancourt-Lozano, Miguel; Morales-Covarrubias, Maria Soledad

    2014-01-01

    Moribund shrimp affected by acute hepatopancreatic necrosis disease (AHPND) from farms in northwestern Mexico were sampled for bacteriological and histological analysis. Bacterial isolates were molecularly identified as Vibrio parahaemolyticus by the presence of the tlh gene. The tdh-negative, trh-negative, and tlh-positive V. parahaemolyticus strains were further characterized by repetitive extragenic palindromic element-PCR (rep-PCR), and primers AP1, AP2, AP3, and AP and an ems2 IQ2000 detection kit (GeneReach, Taiwan) were used in the diagnostic tests for AHPND. The V. parahaemolyticus strains were used in immersion challenges with shrimp, and farmed and challenged shrimp presented the same clinical and pathological symptoms: lethargy, empty gut, pale and aqueous hepatopancreas, and expanded chromatophores. Using histological analysis and bacterial density count, three stages of AHNPD (initial, acute, and terminal) were identified in the affected shrimp. The pathognomonic lesions indicating severe desquamation of tubular epithelial cells of the hepatopancreas were observed in both challenged and pond-infected shrimp. The results showed that different V. parahaemolyticus strains have different virulences; some of the less virulent strains do not induce 100% mortality, and mortality rates also rise more slowly than they do for the more virulent strains. The virulence of V. parahaemolyticus strains was dose dependent, where the threshold infective density was 104 CFU ml−1; below that density, no mortality was observed. The AP3 primer set had the best sensitivity and specificity. Field and experimental results showed that the V. parahaemolyticus strain that causes AHPND acts as a primary pathogen for shrimp in Mexico compared with the V. parahaemolyticus strains reported to date. PMID:25548045

  17. Silencer of death domains controls cell death through tumour necrosis factor-receptor 1 and caspase-10 in acute lymphoblastic leukemia.

    Adam Cisterne

    Full Text Available Resistance to apoptosis remains a significant problem in drug resistance and treatment failure in malignant disease. NO-aspirin is a novel drug that has efficacy against a number of solid tumours, and can inhibit Wnt signaling, and although we have shown Wnt signaling to be important for acute lymphoblastic leukemia (ALL cell proliferation and survival inhibition of Wnt signaling does not appear to be involved in the induction of ALL cell death. Treatment of B lineage ALL cell lines and patient ALL cells with NO-aspirin induced rapid apoptotic cell death mediated via the extrinsic death pathway. Apoptosis was dependent on caspase-10 in association with the formation of the death-inducing signaling complex (DISC incorporating pro-caspase-10 and tumor necrosis factor receptor 1 (TNF-R1. There was no measurable increase in TNF-R1 or TNF-α in response to NO-aspirin, suggesting that the process was ligand-independent. Consistent with this, expression of silencer of death domain (SODD was reduced following NO-aspirin exposure and lentiviral mediated shRNA knockdown of SODD suppressed expansion of transduced cells confirming the importance of SODD for ALL cell survival. Considering that SODD and caspase-10 are frequently over-expressed in ALL, interfering with these proteins may provide a new strategy for the treatment of this and potentially other cancers.

  18. Silencer of Death Domains Controls Cell Death through Tumour Necrosis Factor-Receptor 1 and Caspase-10 in Acute Lymphoblastic Leukemia

    Khan, Naveed I.; Welschinger, Robert; Basnett, Jordan; Fung, Carina; Rizos, Helen; Bradstock, Kenneth F.; Bendall, Linda J.

    2014-01-01

    Resistance to apoptosis remains a significant problem in drug resistance and treatment failure in malignant disease. NO-aspirin is a novel drug that has efficacy against a number of solid tumours, and can inhibit Wnt signaling, and although we have shown Wnt signaling to be important for acute lymphoblastic leukemia (ALL) cell proliferation and survival inhibition of Wnt signaling does not appear to be involved in the induction of ALL cell death. Treatment of B lineage ALL cell lines and patient ALL cells with NO-aspirin induced rapid apoptotic cell death mediated via the extrinsic death pathway. Apoptosis was dependent on caspase-10 in association with the formation of the death-inducing signaling complex (DISC) incorporating pro-caspase-10 and tumor necrosis factor receptor 1 (TNF-R1). There was no measurable increase in TNF-R1 or TNF-α in response to NO-aspirin, suggesting that the process was ligand-independent. Consistent with this, expression of silencer of death domain (SODD) was reduced following NO-aspirin exposure and lentiviral mediated shRNA knockdown of SODD suppressed expansion of transduced cells confirming the importance of SODD for ALL cell survival. Considering that SODD and caspase-10 are frequently over-expressed in ALL, interfering with these proteins may provide a new strategy for the treatment of this and potentially other cancers. PMID:25061812

  19. MRI Findings of Pericardial Fat Necrosis: Case Report

    Lee, Hyo Hyeok; Ryu, Dae Shick; Jung, Sang Sig; Jung, Seung Mun; Choi, Soo Jung; Shin, Dae Hee [Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung (Korea, Republic of)

    2011-06-15

    Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging (MRI) findings of pericardial fat necrosis and this was correlated with the computed tomography (CT) findings. The MRI findings may be helpful for distinguishing pericardial fat necrosis from other causes of acute chest pain and from the fat-containing tumors in the cardiophrenic space of the anterior mediastinum.

  20. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and Procalcitonin in Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis

    Ajay K. Khanna

    2013-01-01

    Full Text Available Background. Multifactorial scorings, radiological scores, and biochemical markers may help in early prediction of severity, pancreatic necrosis, and mortality in patients with acute pancreatitis (AP. Methods. BISAP, APACHE-II, MOSS, and SIRS scores were calculated using data within 24 hrs of admission, whereas Ranson and Glasgow scores after 48 hrs of admission; CTSI was calculated on day 4 whereas IL-6 and CRP values at end of study. Predictive accuracy of scoring systems, sensitivity, specificity, and positive and negative predictive values of various markers in prediction of severe acute pancreatitis, organ failure, pancreatic necrosis, admission to intensive care units and mortality were calculated. Results. Of 72 patients, 31 patients had organ failure and local complication classified as severe acute pancreatitis, 17 had pancreatic necrosis, and 9 died (12.5%. Area under curves for Ranson, Glasgow, MOSS, SIRS, APACHE-II, BISAP, CTSI, IL-6, and CRP in predicting SAP were 0.85, 0.75, 0.73, 0.73, 0.88, 0.80, 0.90, and 0.91, respectively, for pancreatic necrosis 0.70, 0.64, 0.61, 0.61, 0.68, 0.61, 0.75, 0.86, and 0.90, respectively, and for mortality 0.84, 0.83, 0.77, 0.76, 0.86, 0.83, 0.57, 0.80, and 0.75, respectively. Conclusion. CRP and IL-6 have shown a promising result in early detection of severity and pancreatic necrosis whereas APACHE-II and Ranson score in predicting AP related mortality in this study.

  1. Sequential occlusion of the branch retinal artery and branch retinal vein in a patient with hypertension: an interventional case report

    Okamoto, Norio; Matsumoto, Chota; Shimomura, Yoshikazu

    2014-01-01

    Background There are some cases that reported central retinal vein occlusion accompanied by ciliary artery occlusion, however, combined branch retinal artery and vein occlusion is a rare condition that has been infrequently reported. We describe in this report one case of retinal vein occlusion and branch retinal artery occlusion occurring simultaneously. Case presentation A 50 year-old woman presented with acute visual loss in her right eye. Fundus photography showed retinal ischemia and tor...

  2. Photorhabdus insect-related (Pir) toxin-like genes in a plasmid of Vibrio parahaemolyticus, the causative agent of acute hepatopancreatic necrosis disease (AHPND) of shrimp.

    Han, Jee Eun; Tang, Kathy F J; Tran, Loc H; Lightner, Donald V

    2015-02-10

    The 69 kb plasmid pVPA3-1 was identified in Vibrio parahaemolyticus strain 13‑028/A3 that can cause acute hepatopancreatic necrosis disease (AHPND). This disease is responsible for mass mortalities in farmed penaeid shrimp and is referred to as early mortality syndrome (EMS). The plasmid has a GC content of 45.9% with a copy number of 37 per bacterial cell as determined by comparative quantitative PCR analyses. It consists of 92 open reading frames that encode mobilization proteins, replication enzymes, transposases, virulence-associated proteins, and proteins similar to Photorhabdus insect-related (Pir) toxins. In V. parahaemolyticus, these Pir toxin-like proteins are encoded by 2 genes (pirA- and pirB-like) located within a 3.5 kb fragment flanked with inverted repeats of a transposase-coding sequence (1 kb). The GC content of these 2 genes is only 38.2%, substantially lower than that of the rest of the plasmid, which suggests that these genes were recently acquired. Based on a proteomic analysis, the pirA-like (336 bp) and pirB-like (1317 bp) genes encode for 13 and 50 kDa proteins, respectively. In laboratory cultures of V. parahaemolyticus 13-028/A3, both proteins were secreted into the culture medium. We developed a duplex PCR diagnostic method, with a detection limit of 10(5) CFU ml(-1) and targeting pirA- and pirB-like genes in this strain of V. parahaemolyticus. This PCR protocol can reliably detect AHPND-causing strains of V. parahaemolyticus and does not cross react with non-pathogenic strains or with other species of Vibrio isolated from shrimp ponds. PMID:25667334

  3. C1q/Tumor Necrosis Factor-Related Protein 9 Protects against Acute Myocardial Injury through an Adiponectin Receptor I-AMPK-Dependent Mechanism.

    Kambara, Takahiro; Shibata, Rei; Ohashi, Koji; Matsuo, Kazuhiro; Hiramatsu-Ito, Mizuho; Enomoto, Takashi; Yuasa, Daisuke; Ito, Masanori; Hayakawa, Satoko; Ogawa, Hayato; Aprahamian, Tamar; Walsh, Kenneth; Murohara, Toyoaki; Ouchi, Noriyuki

    2015-06-01

    Obesity is a risk factor for cardiovascular disease. C1q/tumor necrosis factor-related protein 9 (CTRP9) is an adipokine that is downregulated by obesity. We investigated the role of CTRP9 in cardiac injury with loss-of-function genetic manipulations and defined the receptor-mediated signaling pathway downstream of this adipokine. CTRP9-knockout (CTRP9-KO) mice at the age of 12 weeks were indistinguishable from wild-type (WT) mice under basal conditions. CTRP9-KO mice had exacerbated contractile left ventricle dysfunction following intraperitoneal injection of lipopolysaccharide (LPS) compared to WT mice. Administration of LPS to CTRP9-KO mice also resulted in increased expression of proinflammatory cytokines and oxidative stress markers in the heart compared to WT mice. Likewise, CTRP9-KO mice showed increased myocardial infarct size and elevated expression of inflammatory mediators in ischemic heart following ischemia and reperfusion compared to WT mice. Treatment of cardiac myocytes with CTRP9 protein led to suppression of LPS-induced expression of proinflammatory genes, which was reversed by blockade of AMPK or ablation of adiponectin receptor I (AdipoR1). Systemic delivery of CTRP9 attenuated LPS-induced cardiac dysfunction in WT mice but not in muscle-specific transgenic mice expressing dominant-negative mutant form of AMPK or in AdipoR1-knockout mice. CTRP9 protects against acute cardiac damage in response to pathological stimuli by suppressing inflammatory reactions through AdipoR1/AMPK-dependent mechanisms. PMID:25870106

  4. Acute retinal necrosis: a report of 31 cases%急性视网膜坏死31例临床分析

    明月; 庞利民; 吴雅臻; 张晓光

    2002-01-01

    目的:探讨提高ARN视力预后的有效方法.方法:回顾性研究31例38只眼ARN患者的视力、眼部表现和治疗方针.结果:治疗后22只眼(57.9%)视力提高;单纯药物治疗后3只眼(60%)发生视网膜裂孔或脱离,明显高于预防性激光光凝治疗后(15.38%);玻璃体手术术后15只眼视网膜平复,2只眼未愈.结论:预防性激光光凝可减少ARN患者视网膜裂孔和脱离的发生率,预防性玻璃体切除术可稳定视网膜结构、保持并增进视力.

  5. 急性视网膜坏死9例临床分析%The clinical analysis of acute retinal necrosis in 9 cases

    郝宇

    2008-01-01

    目的 观察急性视网膜坏死综合征(ARN)的临床治疗效果.方法 回顾分析ARN 9例(12眼).分析治疗过程及预后.结果 9例(12眼)ARN 术后视力均有不同程度提高,数指/眼前者1眼,数指/20-40 cm者2眼,0.01者4眼,0.25者1眼,0.4者2眼,0.5者2眼.3例(5眼)予以玻璃体切除和光凝治疗,2例(2眼)给予氩激光光凝.经长期观察患眼视网膜均平复.结论 急性视网膜坏死综合征是一种严重损害视功能的眼内感染疾病,无并发症的出现可给予抗病毒、皮质类固醇等药物治疗,必要时行玻璃体切除手术治疗是行之有效的治疗方法.

  6. Minimally invasive treatment of infected pancreatic necrosis

    Wroński, Marek; Cebulski, Włodzimierz; Słodkowski, Maciej; Krasnodębski, Ireneusz W.

    2014-01-01

    Infected pancreatic necrosis is a challenging complication that worsens prognosis in acute pancreatitis. For years, open necrosectomy has been the mainstay treatment option in infected pancreatic necrosis, although surgical debridement still results in high morbidity and mortality rates. Recently, many reports on minimally invasive treatment in infected pancreatic necrosis have been published. This paper presents a review of minimally invasive techniques and attempts to define their role in t...

  7. Roles of PI3K and JAK pathways in viability of retinal ganglion cells after acute elevation of intraocular pressure in rats with different autoimmune backgrounds

    Wang Ningli

    2008-08-01

    Full Text Available Abstract Background We recently showed that whereas inhibition of PI3K/akt or JAK/STAT pathway promoted retinal ganglion cell (RGC survival after optic nerve (ON injury in Fischer 344 (F344 rats, the same inhibition resulted in aggravated RGC loss after acute intraocular pressure (IOP elevation in Sprague Dawley (SPD rats. In addition, the responses of macrophages to ON injury and acute IOP elevation were different between F344 and Lewis rats, i.e., different autoimmune profiles. Using an acute IOP elevation paradigm in this study, we investigated 1 whether autoimmune background influences PI3K/akt and JAK/STAT functions by examining the effect of PI3K/akt and JAK/STAT pathway inhibition on RGC survival in F344 and Lewis rats, and 2 whether differential actions of macrophages occur in PI3K/akt and JAK/STAT pathways-dependent modulation of RGC survival. IOP elevation was performed at 110 mmHg for 2 hours. PI3K/akt and JAK/STAT pathway inhibitors were applied intravitreally to block their respective pathway signaling transduction. Because macrophage invasion was seen in the eye after the pathway inhibition, to examine the role of these pathways independent of macrophages, macrophages in the retina were removed by intravitreal application of clodronate liposomes. Viable RGCs were retrogradely labelled by FluoroGold 40 hours before animal sacrifice. Results Similar to what was previously observed, significantly more RGCs were lost in Lewis than F344 rats 3 weeks after acute IOP elevation. As in SPD rats, inhibition of the PI3K/akt or JAK/STAT pathway increased the loss of RGCs in both F344 and Lewis rats. Removal of macrophages in the eye by clodronate liposomes reduced RGC loss due to pathway inhibition in both strains. Conclusion This study demonstrates that following acute IOP elevation 1 PI3K/akt and JAK/STAT pathways mediate RGC survival in both F344 and Lewis rats, 2 autoimmune responses do not influence the functions of these two pathways

  8. Retinal Detachment

    ... are three different types of retinal detachment: Rhegmatogenous [reg-ma-TAH-jenous]—A tear or break in the retina allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina. These types of ...

  9. GATA1 mutation negative acute megakaryoblastic leukemia with acquired trisomy 21 presenting with extensive bone marrow necrosis in an adult: A case report and review of the literature

    Todd P. Williams

    2016-03-01

    Conclusions: To our knowledge, this is the first reported case of an adult with AMKL with acquired trisomy 21 in which the GATA1 mutation was investigated and the second reported case of AMKL presenting with extensive bone marrow necrosis. We will present a diagnostic approach to AMKL in which extensive bone marrow necrosis renders examination of the bone marrow difficult. Furthermore, we will examine the absence of the GATA1 mutation in a case of AMKL with trisomy 21 in an adult.

  10. Cytomegalovirus retinitis mimicking intraocular lymphoma

    Patrick Gooi

    2008-12-01

    Full Text Available Patrick Gooi1, James Farmer2, Bernard Hurley3, Elliott Brodbaker41Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada; 2Department of Pathology and Lab Medicine University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada; 3Department of Ophthalmology, University of Ottawa Eye Institute and The Ottawa Hospital, Ottawa, Ontario, Canada; 4Faculty of Medicine, University of Ottawa, Ottawa, Ontario, CanadaAbstract: We present a case of an unusual retinal infiltrate requiring retinal biopsy for definitive diagnosis. A 62-year-old man with treated lymphoma presented with decreased vision in the right eye associated with a white retinal lesion, which extended inferonasally from an edematous disc. Intraocular lymphoma was considered as a diagnosis; thus, the patient was managed with vitrectomy and retinal biopsy. Cytological analysis of the vitreous aspirate could not rule out a lymphoproliferative disorder. The microbial analysis was negative. Histology of the lesion showed extensive necrosis and large cells with prominent nucleoli. To rule out lymphoma, a battery of immunostains was performed and all were negative. However the limited amount of tissue was exhausted in the process. Subsequently, a hematoxylin and eosin (H/E slide was destained, on which a CMV immunostain was performed. This revealed positivity in the nuclei and intranuclear inclusions within the large atypical cells. A diagnosis of CMV retinitis was made. Retinal biopsy may provide a definitive diagnosis and direct patient care toward intravenous gancyclovir in the case of CMV or toward radiation and chemotherapy for intraocular lymphoma. When faced with a limited amount of tissue, destaining regular H/E slides is a possible avenue to performing additional immunohistochemical studies.Keywords: CMV retinitis, retinal biopsy, immunohistochemistry, destaining

  11. Other Retinal Diseases

    ... Congenital Amaurosis Macular Degeneration Retinitis Pigmentosa Stargardt Disease Usher Syndrome Other Retinal Diseases Glossary News & Research News & ... affected by retinitis pigmentosa, age-related macular degeneration, Usher syndrome and the entire spectrum of retinal diseases. ...

  12. Concurrent central retinal artery occlusion and branch retinal vein occlusion in giant cell arteritis

    Chu, Edward

    2010-01-01

    Edward R Chu, Celia S ChenDepartment of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, SA, AustraliaAbstract: Ophthalmic involvement in giant cell arteritis can manifest in a number of ways. Central retinal artery occlusion is one of the common causes of visual loss in giant cell arteritis. On the contrary, branch retinal vein occlusion is rarely associated with the latter. We report an 89-year-old lady with acute left central retinal artery occlusion on a backg...

  13. Differential regulation of microRNA-146a and microRNA-146b-5p in human retinal pigment epithelial cells by interleukin-1β, tumor necrosis factor-α, and interferon-γ

    Kutty, R. Krishnan; Nagineni, Chandrasekharam N.; Samuel, William; Vijayasarathy, Camasamudram; Jaworski, Cynthia; Duncan, Todd; Cameron, Jennifer E; Flemington, Erik K.; Hooks, John J.; Redmond, T Michael

    2013-01-01

    Purpose The inflammatory response of the retinal pigment epithelium (RPE) is implicated in the pathogenesis of age-related macular degeneration. The microRNAs miR-146a and miR-146b-5p can regulate the inflammatory process by attenuating cytokine signaling via the nuclear factor-κB pathway. The aim of the present study is to investigate the expression of miR-146a and miR-146b-5p in human RPE cells and their response to proinflammatory cytokines. Methods Confluent cultures of RPE cells establis...

  14. Clinical and CT imaging features of abdominal fat necrosis

    Fat necrosis is a common pathological change at abdominal cross-sectional imaging, and it may cause abdominal pain, mimic pathological change of acute abdomen, or be asymptomatic and accompany other pathophysiologic processes. Fat necrosis is actually the result of steatosis by metabolism or mechanical injury. Common processes that are present in fat necrosis include epiploic appendagitis, infarction of the greater omentum, pancreatitis, and fat necrosis related to trauma or ischemia. As a common fat disease, fat necrosis should be known by clinicians and radiologists. Main content of this text is the clinical symptoms and CT findings of belly fat necrosis and related diseases. (authors)

  15. Metabolic effects of cachectin/tumor necrosis factor are modified by site of production. Cachectin/tumor necrosis factor-secreting tumor in skeletal muscle induces chronic cachexia, while implantation in brain induces predominantly acute anorexia.

    Tracey, K J; Morgello, S; Koplin, B; Fahey, T J; Fox, J; Aledo, A; Manogue, K R; Cerami, A

    1990-12-01

    We have developed a murine model of wasting by injecting intracerebrally cells which continuously secrete h-cachectin/TNF (CHO-TNF) to: (a) determine the effects of cachectin/TNF produced continuously in the central nervous system (CNS), and (b) compare the metabolic effects of cachectin/TNF-secreting tumor in the brain to the cachexia caused by CHO-TNF tumor in peripheral tissue (IM). Intracerebral CHO-TNF tumors produced increased serum h-cachectin/TNF levels with lethal hypophagia and weight loss (mean survival time of 11 d); these changes were not observed in association with nonsecretory control brain tumors. The metabolic consequences of intracerebral cachectin/TNF production were indistinguishable from acute, lethal starvation: whole-body lipid content was decreased significantly but protein was conserved. Although intramuscular cachectin/TNF-secreting tumors caused similar increases of serum h-cachectin/TNF levels, profound anorexia did not develop; wasting developed after a longer period of tumor burden (50 d) with classical signs of cachexia (i.e., anemia and depletion of both protein and lipid). These studies provide a reproducible animal model of site-specific cytokine production and suggest that, regardless of serum levels, cachectin/TNF produced locally in brain influences both the rate of development of wasting and its net metabolic effects. PMID:2254457

  16. C1q/Tumor Necrosis Factor-Related Protein 9 Protects against Acute Myocardial Injury through an Adiponectin Receptor I-AMPK-Dependent Mechanism

    Kambara, Takahiro; Shibata, Rei; Ohashi, Koji; Matsuo, Kazuhiro; Hiramatsu-Ito, Mizuho; Enomoto, Takashi; Yuasa, Daisuke; Ito, Masanori; Hayakawa, Satoko; Ogawa, Hayato; Aprahamian, Tamar; Walsh, Kenneth; Murohara, Toyoaki; Ouchi, Noriyuki

    2015-01-01

    Obesity is a risk factor for cardiovascular disease. C1q/tumor necrosis factor-related protein 9 (CTRP9) is an adipokine that is downregulated by obesity. We investigated the role of CTRP9 in cardiac injury with loss-of-function genetic manipulations and defined the receptor-mediated signaling pathway downstream of this adipokine. CTRP9-knockout (CTRP9-KO) mice at the age of 12 weeks were indistinguishable from wild-type (WT) mice under basal conditions. CTRP9-KO mice had exacerbated contract...

  17. Retinal vein occlusion

    Central retinal vein occlusion; Branch retinal vein occlusion; CRVO; BRVO ... Retinal vein occlusion is most often caused by hardening of the arteries ( atherosclerosis ) and the formation of a blood clot. Blockage ...

  18. Renal papillary necrosis

    ... your provider. Alternative Names Necrosis - renal papillae; Renal medullary necrosis Images Kidney anatomy Kidney - blood and urine flow References Ruggenenti P, Cravedi P, Remuzzi G. Microvascular and macrovascular diseases of the kidney. In: Taal MW, Chertow GM, ...

  19. Retinitis pigmentosa

    Hamel Christian

    2006-10-01

    Full Text Available Abstract Retinitis pigmentosa (RP is an inherited retinal dystrophy caused by the loss of photoreceptors and characterized by retinal pigment deposits visible on fundus examination. Prevalence of non syndromic RP is approximately 1/4,000. The most common form of RP is a rod-cone dystrophy, in which the first symptom is night blindness, followed by the progressive loss in the peripheral visual field in daylight, and eventually leading to blindness after several decades. Some extreme cases may have a rapid evolution over two decades or a slow progression that never leads to blindness. In some cases, the clinical presentation is a cone-rod dystrophy, in which the decrease in visual acuity predominates over the visual field loss. RP is usually non syndromic but there are also many syndromic forms, the most frequent being Usher syndrome. To date, 45 causative genes/loci have been identified in non syndromic RP (for the autosomal dominant, autosomal recessive, X-linked, and digenic forms. Clinical diagnosis is based on the presence of night blindness and peripheral visual field defects, lesions in the fundus, hypovolted electroretinogram traces, and progressive worsening of these signs. Molecular diagnosis can be made for some genes, but is not usually performed due to the tremendous genetic heterogeneity of the disease. Genetic counseling is always advised. Currently, there is no therapy that stops the evolution of the disease or restores the vision, so the visual prognosis is poor. The therapeutic approach is restricted to slowing down the degenerative process by sunlight protection and vitaminotherapy, treating the complications (cataract and macular edema, and helping patients to cope with the social and psychological impact of blindness. However, new therapeutic strategies are emerging from intensive research (gene therapy, neuroprotection, retinal prosthesis.

  20. Sequential bilateral retinal artery occlusion

    Padrón-Pérez N

    2014-04-01

    Full Text Available Noel Padrón-Pérez,1 Janny Rosario Aronés,2 Silvia Muñoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperança – Parc de Salut Mar, 3Institut Català de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic embolic event. Initially, she presented a superior branch retinal artery occlusion in her right eye followed by a central retinal artery occlusion with cilioretinal artery sparing in her left eye. Some conservative maneuvers performed did not improve visual acuity in the left eye. Supra-aortic Doppler ultrasonography revealed mild right internal carotid artery stenosis and moderate left internal carotid artery stenosis with a small, smooth, and homogeneous plaque. The transthoracic echocardiography showed a severe calcification of the mitral valve with a mild-moderate rim of stenosis. Central retinal artery occlusion and branch retinal artery occlusion are characterized by painless monocular loss of vision. Clinical approach and management attempt to treat the acute event, find the source of the vascular occlusion, and prevent further vascular events from occurring. Giant cell arteritis is a potentially treatable cause of central retinal artery occlusion and should be excluded in every single patient over 50 years old.Keywords: loss of vision, branch retinal artery occlusion, central retinal artery occlusion, Hollenhorst plaque

  1. [Digital necrosis in hand by uncommon mechanism].

    Leroux, Maria Bibiana; Lashak, Celina; Mazzurco, Martin

    2013-07-01

    A 43-year-old, non-smoking man presented with acute ischemic lesions of his left hand. He had been taking beta-blockers for his arterial hypertension. The day before the occurrence of these acute lesions, he self medicated with a drug containing ergotamine and caffeine because of a headache. About one hour after mild trauma to the hand, he noticed intense cyanosis accompanied by severe pain in the fingers that progressed to digital necrosis. Hematological tests, hand radiography, echo Doppler, and nailfold videocapillaroscopy were performed. Digital necrosis owing to an unusual combination of ischemic mechanisms is assumed. PMID:24010508

  2. Ketoconazole attenuates radiation-induction of tumor necrosis factor

    Previous work has demonstrated that inhibitors of phospholipase A2 attenuate ionizing radiation-induced arachidonic acid production, protein kinase C activation, and prevent subsequent induction of the tumor necrosis factor gene. Because arachidonic acid contributes to radiation-induced tumor necrosis factor expression, the authors analyzed the effects of agents which alter arachidonate metabolism on the regulation of this gene. Phospholipase A2 inhibitors quinicrine, bromphenyl bromide, and pentoxyfylline or the inhibitor of lipoxygenase (ketoconazole) or the inhibitor of cycloxygenase (indomethacine) were added to cell culture 1 h prior to irradiation. Radiation-induced tumor necrosis factor gene expression was attenuated by each of the phospholipase A2 inhibitors (quinicrine, bromphenylbromide, and pentoxyfylline). Furthermore, ketoconazole attenuated X ray induced tumor necrosis factor gene expression. Conversely, indomethacin enhanced tumor necrosis factor expression following irradiation. The finding that radiation-induced tumor necrosis factor gene expression was attenuated by ketoconazole suggests that the lipoxygenase pathway participates in signal transduction preceding tumor necrosis factor induction. Enhancement of tumor necrosis factor expression by indomethacin following irradiation suggests that prostaglandins produced by cyclooxygenase act as negative regulators of tumor necrosis factor expression. Inhibitors of tumor necrosis factor induction ameliorate acute and subacute sequelae of radiotherapy. The authors propose therefore, that ketoconazole may reduce acute radiation sequelae such as mucositis and esophagitis through a reduction in tumor necrosis factor induction or inhibition of phospholipase A2 in addition to its antifungal activity. 25 refs., 2 figs

  3. Retinal Photodamage Mediated by All-trans-retinal†

    Maeda, Tadao; Golczak, Marcin; Maeda, Akiko

    2012-01-01

    Accumulation of all-trans-retinal (all-trans-RAL), reactive vitamin A aldehyde, is one of the key factors in initiating retinal photodamage. This photodamage is characterized by progressive retinal cell death evoked by light exposure in both an acute and chronic fashion. Photo-activated rhodopsin releases all-trans-RAL which is subsequently transported by ATP–binding cassette transporter 4 and reduced to all-trans-retinol by all-trans-retinol dehydrogenases located in photoreceptor cells. Any...

  4. Pancreatic Necrosis Associated with Preeclampsia-Eclampsia

    Parmar MS

    2004-03-01

    Full Text Available CONTEXT: Acute pancreatitis during pregnancy is rare and commonly occurs in association with biliary disease. Preeclampsia is associated with microvascular abnormalities that may involve cerebral, placental, hepatic, renal and splanchnic circulation and rarely can cause acute pancreatitis. CASE REPORT: A case of acute pancreatitis in a patient with preeclampsia-eclampsia where the diagnosis was missed initially that resulted in a protracted course and development of organized pancreatic necrosis. The pancreatic necrosis resolved with conservative management over 8 weeks. CONCLUSIONS: The development of severe hypoalbuminemia, out of proportion to proteinuria, hypocalcemia and findings of capillary leak should alert the physician to search for other inflammatory causes, including acute pancreatitis so that early and effective management be given to avoid complications.

  5. Hypoplasia of exocrine pancreas with myocardial necrosis

    Xiang Sheng Zhang; Xin Xiu Xu; Yan Zhang; Sbu Hua Wu

    2000-01-01

    AIM To study the clinical and pathological features of hypoplasia of exocrine pancreas with myocardialnecrosis.METHODS One ease of hypoplasia of exocrine pancreas with myocardial necrosis was autopsied. Theclinical signs and pathological changes were analyzed.RESULTS A 15-month-old boy with hypoplasia of exocrine pancreas was reported. The main clinicalfeatures were steatorrhea and marked underdevelopment. He died of acute heart failure afterhospitalization. Autopsy showed that there were aplasia of exocrine portion and fatty metaplasia ofpancreas, the myocardium revealed focal necrosis and sear formation.CONCLUSION Atrophy of exocrine pancreas and myocardial necrosis exist at the same time, suggestingthat there may be some relationship between them. It was likely that the damaged pancreatic tissue releasedsome active materials that may harm the myocardium or decrease pancreatic juice that results in lack ofnutrient and myocardial necrosis.

  6. Draft genome sequence of pathogenic bacteria Vibrio parahaemolyticus strain Ba94C2, associated with acute hepatopancreatic necrosis disease isolate from South America.

    Restrepo, Leda; Bayot, Bonny; Betancourt, Irma; Pinzón, Andres

    2016-09-01

    Vibrio parahaemolyticus is a pathogenic bacteria which has been associated to the early mortality syndrome (EMS) also known as hepatopancreatic necrosis disease (AHPND) causing high mortality in shrimp farms. Pathogenic strains contain two homologous genes related to insecticidal toxin genes, PirA and PirB, these toxin genes are located on a plasmid contained within the bacteria. Genomic sequences have allowed the finding of two strains with a divergent structure related to the geographic region from where they were found. The isolates from the geographic collection of Southeast Asia and Mexico show variable regions on the plasmid genome, indicating that even though they are not alike they still conserve the toxin genes. In this paper, we report for the first time, a pathogenic V. parahaemolyticus strain in shrimp from South America that showed symptoms of AHPND. The genomic analysis revealed that this strain of V. parahaemolyticus found in South America appears to be more related to the Southeast Asia as compared to the Mexican strains. This finding is of major importance for the shrimp industry, especially in regards to the urgent need for disease control strategies to avoid large EMS outbreaks and economic loss, and to determine its dispersion in South America. The whole-genome shotgun project of V. parahaemolyticus strain Ba94C2 have been deposited at DDBJ/EMBL/GenBank under the accession PRJNA335761. PMID:27570736

  7. Peripancreatic fat necrosis mimicking pancreatic cancer

    A case of peripancreatic fat necrosis, after an episode of acute pancreatitis, which mimicked pancreatic cancer with lymph node metastases, is presented. We describe the imaging findings with helical CT scanning and with unenhanced and mangafodipir-enhanced MR imaging, with special emphasis on the differential diagnoses. (orig.)

  8. Peripancreatic fat necrosis mimicking pancreatic cancer

    Thurnher, M.M.; Schima, W.; Turetschek, K.; Thurnher, S.A. [Vienna Univ. (Austria). Inst. fuer Radiologie; Fuegger, R. [Dept. of Surgery, University of Vienna (Austria); Oberhuber, G. [Dept. of Pathology, University of Vienna (Austria)

    2001-06-01

    A case of peripancreatic fat necrosis, after an episode of acute pancreatitis, which mimicked pancreatic cancer with lymph node metastases, is presented. We describe the imaging findings with helical CT scanning and with unenhanced and mangafodipir-enhanced MR imaging, with special emphasis on the differential diagnoses. (orig.)

  9. The acute and sensitization effects of tumor necrosis factor-α: implications for immunotherapy as well as psychiatric and neurological conditions.

    Hayley, Shawn; Merali, Zul; Anisman, Hymie

    2002-12-01

    In addition to their role as signaling molecules of the immune system, cytokines may participate in central neurotransmission. Variations of the central and/or peripheral levels of the proinflammatory cytokines, tumor necrosis factor-α (TNF-α) and interleukin-β (IL-1β), impact on neuroendocrine processes as well as central neurotransmitter activity. To a considerable extent, these effects are reminiscent of those elicited by psychogenic stressors. The current review describes recent findings consistent with a role for these cytokines in the neurochemical and behavioral manifestations of clinical depression, as well as the cellular death associated with cerebral ischemia. Moreover, the increasing use of cytokines in the immunotherapeutic treatment of various autoimmune diseases (e.g. rheumatoid arthritis) and cancers prompted us to consider the potential role of central processes in subserving the mood-related side-effects elicited by these treatments. Finally, a single administration of TNF-α has been shown to elicit a time-dependent sensitization effect, wherein the behavioral and neurochemical responses elicited by later cytokine treatment are greatly enhanced. Thus, particular attention was devoted to the possibility that elevated levels of TNF-α, through either exogenous (e.g. immunotherapy) or endogenous (e.g. brain damage or stressors) means may sensitize neurotransmitter or second messenger pathways important for the pathology. Given the time-dependent nature of cytokine sensitization effects, the schedule of cytokine administration during immunotherapy, or the timing of cytokine up-regulation in response to traumatic or stressful events may favor the development of sensitized central processes, which may influence clinical outcome. PMID:26984578

  10. Effects of increased human tumor necrosis factor-like molecule 1A expression in peripheral blood of children with acute Guillain-Barre syndrome on interferon-gamma secretion

    Libin Yang; Shulei Li; Yan Tana; Shufen Xu; Xiumei Duan; Yanqiu Fang; Lihua Liu; Yuanyuan Che; Lei Liu

    2009-01-01

    BACKGROUND:Human tumor necrosis factor-like molecule 1A (hTL1A) is a strong T helper cell type 1 (Th1) co-stimulator.Guillain-Barre syndrome (GBS) is an autoimmune disorder of the nervous system,which is mediated by Th1 cells.OBJECTIVE:To determine hTL1A expression in peripheral blood T lymphocytes of acute GBS children and the effects of hTL1A on secretion of interferon-γ.DESIGN,TIME AND SETTING:A randomized,controlled,neuroimmunological in vitro study was performed at the Central Laboratory of First Hospital of Jilin University,China from November 2005 to November 2007.MATERIALS:Venous blood samples were obtained from 6 healthy donors,aged 6-12 years (all routine blood examination items were normal),and 6 additional children with acute GBS,aged 6-12years.The GBS children fell itl within 1 week and were not treated with hormones or immunoglobulin.Purified recombinant human soluble tumor necrosis factor-like molecule 1A (rhsTL1A,1 mg/mL,relative molecular mass 22 000,6×His tag,soluble form) was supplied by the Central Laboratory of First Hospital of Jilin University,China.METHODS:Peripheral blood mononuclear cells were isolated from healthy donors using the standard Ficoll gradient centrifugation and were incubated in 96-well culture plates.The cells were assigned to the following groups:control (2 μg/mL phytohemagglutinin),2 μg/mL phytohemagglutinin+25,100 and 400 ng/mL rhsTL1A.T cell proliferation was quantified using the tritiated thymidine (~3H-TdR) method.Serum interferon-γ levels in acute GBS children were detected by enzyme-linked immunosorbent assay (ELISA).The ratio of hTL1A-positive T cells to CD3-positive T cells in peripheral blood of acute GBS children was determined using flow cytometry.Following in vitro pre-activation of peripheral blood mononuclear cells by 2 μg/mL phytohemagglutinin,the peripheral blood mononuclear cells were treated with 400 ng/mL exogenous rhsTL1A.Finally,peripheral blood mononuclear cell-secreted interferon-γ levels were

  11. Metamorphopsia Associated with Branch Retinal Vein Occlusion

    Manabe, Koichiro; Tsujikawa, Akitaka; Osaka, Rie; Nakano, Yuki; Fujita, Tomoyoshi; Shiragami, Chieko; Hirooka, Kazuyuki; Uji, Akihito; Muraoka, Yuki

    2016-01-01

    Purpose To apply M-CHARTS for quantitative measurements of metamorphopsia in eyes with acute branch retinal vein occlusion (BRVO) and to elucidate the pathomorphology that causes metamorphopsia. Methods This prospective study consisted of 42 consecutive patients (42 eyes) with acute BRVO. Both at baseline and one month after treatment with ranibizumab, metamorphopsia was measured with M-CHARTS, and the retinal morphological changes were examined with optical coherence tomography. Results At baseline, metamorphopsia was detected in the vertical and/or horizontal directions in 29 (69.0%) eyes; the mean vertical and horizontal scores were 0.59 ± 0.57 and 0.52 ± 0.67, respectively. The maximum inner retinal thickness showed no association with the M-CHARTS score, but the M-CHARTS score was correlated with the total foveal thickness (r = 0.43, p = 0.004), the height of serous retinal detachment (r = 0.31, p = 0.047), and the maximum outer retinal thickness (r = 0.36, p = 0.020). One month after treatment, both the inner and outer retinal thickness substantially decreased. However, metamorphopsia persisted in 26 (89.7%) of 29 eyes. The posttreatment M-CHARTS score was not correlated with any posttreatment morphological parameters. However, the posttreatment M-CHARTS score was weakly correlated with the baseline total foveal thickness (r = 0.35. p = 0.024) and closely correlated with the baseline M-CHARTS score (r = 0.78, p < 0.001). Conclusions Metamorphopsia associated with acute BRVO was quantified using M-CHARTS. Initial microstructural changes in the outer retina from acute BRVO may primarily account for the metamorphopsia. PMID:27123642

  12. Fat Necrosis and Oil Cysts

    ... Granular cell tumors Fat necrosis and oil cysts Mastitis Duct ectasia Other non-cancerous breast conditions Summary ... References Previous Topic Granular cell tumors Next Topic Mastitis Fat necrosis and oil cysts Fat necrosis happens ...

  13. Choroidal mast cells in retinal pathology: a potential target for intervention.

    Bousquet, Elodie; Zhao, Min; Thillaye-Goldenberg, Brigitte; Lorena, Viera; Castaneda, Beatriz; Naud, Marie Christine; Bergin, Ciara; Besson-Lescure, Bernadette; Behar-Cohen, Francine; de Kozak, Yvonne

    2015-08-01

    Mast cells are important in the initiation of ocular inflammation, but the consequences of mast cell degranulation on ocular pathology remain uncharacterized. We induced mast cell degranulation by local subconjunctival injection of compound 48/80. Initial degranulation of mast cells was observed in the choroid 15 minutes after the injection and increased up to 3 hours after injection. Clinical signs of anterior segment inflammation paralleled mast cell degranulation. With the use of optical coherence tomography, dilation of choroidal vessels and serous retinal detachments (SRDs) were observed and confirmed by histology. Subconjunctival injection of disodium cromoglycate significantly reduced the rate of SRDs, demonstrating the involvement of mast cell degranulation in posterior segment disorders. The infiltration of polymorphonuclear and macrophage cells was associated with increased ocular media concentrations of tumor necrosis factor-α, CXCL1, IL-6, IL-5, chemokine ligand 2, and IL-1β. Analysis of the amounts of vascular endothelial growth factor and IL-18 showed an opposite evolution of vascular endothelial growth factor compared with IL-18 concentrations, suggesting that they regulate each other's production. These findings suggest that the local degranulation of ocular mast cells provoked acute ocular inflammation, dilation, increased vascular permeability of choroidal vessels, and SRDs. The involvement of mast cells in retinal diseases should be further investigated. The pharmacologic inhibition of mast cell degranulation may be a potential target for intervention. PMID:26166807

  14. Gastric volvulus with partial and complete gastric necrosis

    Ram Mohan Shukla

    2014-01-01

    Full Text Available Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature.

  15. Gastric volvulus with partial and complete gastric necrosis.

    Shukla, Ram Mohan; Mandal, Kartik Chandra; Maitra, Sujay; Ray, Amit; Sarkar, Ruchirendu; Mukhopadhyay, Biswanath; Bhattacharya, Malay

    2014-01-01

    Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature. PMID:24604987

  16. Gastric volvulus with partial and complete gastric necrosis

    Ram Mohan Shukla; Kartik Chandra Mandal; Sujay Maitra; Amit Ray; Ruchirendu Sarkar; Biswanath Mukhopadhyay; Malay Bhattacharya

    2014-01-01

    Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature.

  17. Robotic cystogastrostomy and debridement of walled-off pancreatic necrosis.

    Nassour, Ibrahim; Ramzan, Zeeshan; Kukreja, Sachin

    2016-09-01

    Walled-off pancreatic necrosis is a known complication of acute pancreatitis and requires intervention if symptomatic or complicated. Laparoscopic cystogastrostomy as a minimally invasive surgical intervention has been well-described in surgical literature but data on a robotic approach is limited. Here we report a case of robotic cystogastrostomy and debridement of walled-off pancreatic necrosis in a patient with a history of severe biliary pancreatitis. PMID:27039191

  18. Infectious Haematopoietic Necrosis

    Institute, Marine

    2011-01-01

    This leaflet gives information on infectious haematopoietic necrosis. This disease is caused by a single stranded RNA virus of the family Rhabdoviridae, genus Novirhabdoviridae. IHN is listed as a non-exotic disease under EU Directive 2006/88/EC, and is notifiable in Ireland, according to S.I. No. 261 of 2008.

  19. Modern retinal laser therapy

    Kozak, Igor; Luttrull, Jeffrey K.

    2014-01-01

    Medicinal lasers are a standard source of light to produce retinal tissue photocoagulation to treat retinovascular disease. The Diabetic Retinopathy Study and the Early Treatment Diabetic Retinopathy Study were large randomized clinical trials that have shown beneficial effect of retinal laser photocoagulation in diabetic retinopathy and have dictated the standard of care for decades. However, current treatment protocols undergo modifications. Types of lasers used in treatment of retinal dise...

  20. The retinal ciliopathies.

    Adams, N A; Awadein, Ahmed; Toma, Hassanain S

    2007-09-01

    While the functions of many of the proteins located in or associated with the photoreceptor cilia are poorly understood, disruption of the function of these proteins may result in a wide variety of phenotypes ranging from isolated retinal degeneration to more pleiotropic phenotypes. Systemic findings include neurosensory hearing loss, developmental delay, situs-inversus, infertility, disorders of limb and digit development, obesity, kidney disease, liver disease, and respiratory disease. The concept of "retinal ciliopathies" brings to attention the importance of further molecular analysis of this organelle as well as provides a potential common target for therapies for these disorders. The retinal ciliopathies include retinitis pigmentosa, macular degeneration, cone-dystrophy, cone-rod dystrophy, Leber congenital amaurosis, as well as retinal degenerations associated with Usher syndrome, primary ciliary dyskinesia, Senior-Loken syndrome, Joubert syndrome, Bardet-Biedl syndrome, Laurence-Moon syndrome, McKusick-Kaufman syndrome, and Biemond syndrome. Mutations for these disorders have been found in retinitis pigmentosa-1 (RP1), retinitis pigmentosa GTPase regulator (RPGR), retinitis pigmentosa GTPase regulator interacting protein (RPGR-IP), as well as the Usher, Bardet-Biedl, and nephronophthisis genes. Other systemic disorders associated with retinal degenerations that may also involve ciliary abnormalities include: Alstrom, Edwards-Sethi, Ellis-van Creveld, Jeune, Meckel-Gruber, Orofaciodigital Type 9, and Gurrieri syndromes. Understanding these conditions as ciliopathies may help the ophthalmologist to recognize associations between seemingly unrelated diseases and have a high degree of suspicion that a systemic finding may be present. PMID:17896309

  1. 复方樟柳碱联合无环鸟苷治疗急性视网膜坏死%Clinical effects of combination application of compound anisodin and acyclovir(ACV)on acute retinal necrosis(ARN)

    王涌; 邱颖杰

    2010-01-01

    目的 探讨急性视网膜坏死(ARN)的有效治疗方法.方法 将20例22眼随机分为治疗组和常规组两组,治疗组12眼采用复方樟柳碱联合无环鸟苷(ACV)治疗,与常规组10眼进行对比现察.结果 经3~15个月的观察随访,治疗组12眼中有10眼视力不同程度提高,提高率为83%.结论 复方樟柳碱联合无环鸟苷是治疗ARN的一种有效方法.

  2. 无环鸟苷、丹参联合治疗急性视网膜坏死的研究%Study of combination of acyclovir and salvia miltiorrhiza on acute retinal necrosis

    王圣祥; 丁波

    2004-01-01

    目的探讨急性视网膜坏死(ARN)的治疗方法.方法对8例(10眼)ARN患者采用无环鸟苷、丹参联合治疗.结果随访12~18个月,9眼视力有不同程度提高,视力提高率达90%.结论无环鸟苷、丹参联合治疗ARN是一种有效的方法.

  3. Dorzolamide increases retinal oxygen tension after branch retinal vein occlusion

    Noergaard, Michael Hove; Bach-Holm, Daniella; Scherfig, Erik;

    2008-01-01

    To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs.......To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs....

  4. Differential Diagnosis of Retinal Vasculitis

    Abu El-Asrar, Ahmed M.; Herbort, Carl P.; Tabbara, Khalid F.

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings. PMID:20404987

  5. Differential Diagnosis of Retinal Vasculitis

    Abu El-Asrar Ahmed; Herbort Carl; Tabbara Khalid

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein a...

  6. Differential diagnosis of retinal vasculitis

    Abu El-Asrar Ahmed

    2009-01-01

    Full Text Available Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  7. Hypoxia-ischemia and retinal ganglion cell damage

    Charanjit Kaur

    2008-08-01

    Full Text Available Charanjit Kaur1, Wallace S Foulds2, Eng-Ang Ling11Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 2Singapore Eye Research Institute, SingaporeAbstract: Retinal hypoxia is the potentially blinding mechanism underlying a number of sight-threatening disorders including central retinal artery occlusion, ischemic central retinal vein thrombosis, complications of diabetic eye disease and some types of glaucoma. Hypoxia is implicated in loss of retinal ganglion cells (RGCs occurring in such conditions. RGC death occurs by apoptosis or necrosis. Hypoxia-ischemia induces the expression of hypoxia inducible factor-1α and its target genes such as vascular endothelial growth factor (VEGF and nitric oxide synthase (NOS. Increased production of VEGF results in disruption of the blood retinal barrier leading to retinal edema. Enhanced expression of NOS results in increased production of nitric oxide which may be toxic to the cells resulting in their death. Excess glutamate release in hypoxic-ischemic conditions causes excitotoxic damage to the RGCs through activation of ionotropic and metabotropic glutamate receptors. Activation of glutamate receptors is thought to initiate damage in the retina by a cascade of biochemical effects such as neuronal NOS activation and increase in intracellular Ca2+ which has been described as a major contributing factor to RGC loss. Excess production of proinflammatory cytokines also mediates cell damage. Besides the above, free-radicals generated in hypoxic-ischemic conditions result in RGC loss because of an imbalance between antioxidant- and oxidant-generating systems. Although many advances have been made in understanding the mediators and mechanisms of injury, strategies to improve the damage are lacking. Measures to prevent neuronal injury have to be developed.Keywords: retinal hypoxia, retinal ganglion cells, glutamate receptors, neuronal injury, retina

  8. Necrosis digital en la mano por mecanismo infrecuente

    Leroux, Maria Bibiana; Lashak, Celina; Mazzurco, Martin

    2013-01-01

    A 43-year-old, non-smoking man presented with acute ischemic lesions of his left hand. He had been taking beta-blockers for his arterial hypertension. The day before the occurrence of these acute lesions, he self medicated with a drug containing ergotamine and caffeine because of a headache. About one hour after mild trauma to the hand, he noticed intense cyanosis accompanied by severe pain in the fingers that progressed to digital necrosis. Hematological tests, hand radiography, echo Doppler...

  9. Laser photocoagulation for retinal vein occlusion

    K. A. Mirzabekova

    2015-03-01

    Full Text Available Retinal vein occlusion (RVO is one of the leading causes of permanent vision loss. In adults, central retinal vein occlusion (CRVO occurs in 1.8% while branch retinal vein occlusion (BRVO occurs in 0.2%. Treatment strategy and disease prognosis are determined by RVO type (ischemic/non-ischemic. Despite numerous studies and many current CRVO and BRVO treatment approaches, the management of these patients is still being debated. Intravitreal injections of steroids (triamcinolone acetate, dexamethasone and vascular endothelial growth factor (VEGF inhibitors (bevacizumab, ranibizumab were shown to be fairly effective. However, it is unclear whether anti-VEGF agents are reasonable in ischemic RVOs. Laser photocoagulation remains the only effective treatment of optic nerve head and/or retinal neovascularization. Laser photocoagulation is also indicated for the treatment of macular edema. Both threshold and sub-threshold photocoagulation may be performed. Photocoagulation performed with argon (514 nm, krypton (647 nm, or diode (810 nm laser for macular edema provides similar results (no significant differences. The treatment may be complex and include medication therapy and/or surgery. Medication therapy includes anti-aggregant agents and antioxidants, i.e., emoxypine which may be used in acute RVO as well as in post-thrombotic retinopathy. 

  10. Retinal laser optical aids

    Das Traprasad

    1991-01-01

    Full Text Available Knowledge of optics, comparative magnification and working field of view is essential for rational use of ophthalmoscopic contact lenses for retinal photocoagulation. The three commonly used contact lenses are described and compared.

  11. Retinal Tears and Detachments

    ... does not cause retinal damage. However, inflammation or myopia (nearsightedness) may cause the vitreous to pull away ... repaired? If your retina is only torn, prompt treatment may prevent detachment. Your eye surgeon will discuss ...

  12. Intraocular retinal prosthesis.

    Humayun, M. S.

    2001-01-01

    PURPOSE: An electronic implant that can bypass the damaged photoreceptors and electrically stimulate the remaining retinal neurons to restore useful vision has been proposed. A number of key questions remain to make this approach feasible. The goal of this thesis is to address the following 2 specific null hypotheses: (1) Stimulus parameters make no difference in the electrically elicited retinal responses. (2) Just as we have millions of photoreceptors, so it will take a device that can gene...

  13. Warfarin-Induced Skin Necrosis

    Kakagia, Despoina D.; Papanas, Nikolaos; Karadimas, Efthimios; Polychronidis, Alexandros

    2014-01-01

    Warfarin-induced skin necrosis is an infrequent complication occurring in individuals under warfarin treatment who have a thrombophilic history or after administration of large loading doses of warfarin particularly without simultaneous initial use of heparin. A 62-year-old lady developed skin necrosis 4 days after initiating warfarin therapy of 5 mg daily without initial co-administration of heparin. The patient had a normal clotting profile. Skin necrosis progressed to eschar formation afte...

  14. Acute pancreatitis

    Al Mofleh Ibrahim

    1997-01-01

    Full Text Available The past few years have witnessed a tremendous progress in our knowledge regarding the pathogenesis, diagnosis, prognostic evaluation and classification of acute pancreatitis. The role of ischemia, lysosomal enzymes, oxygen free radicals, polymorphnuclear cells-byproducts and inflammatory mediators in the pathogenesis of pancreatic necrosis and multiple organ failure has been emphasized. Furthermore, the recent knowledge about agents infecting pancreatic necrosis, routes of infection, bacteriological examination of fine needle aspirate and appropriate antibiotics have changed the concept of acute pancreatitis. New diagnostic tests such as rapid urinary trypsinogen-2 test and inflammatory mediators including polymorphnuclear elastase, C-reactive protein and interleukin-6 contribute to early diagnosis, prognostic evaluation and initiation of an appropriate therapy.

  15. Acute Pancreatitis: Surgery, Pathophysiology and Probiotic Prophylaxis

    Minnen, L.P. van

    2006-01-01

    Acute pancreatitis is a challenging disease with a clinical course that is often difficult to predict. In severe acute pancreatitis, mortality increases significantly if intestinal bacteria translocate from the intestine and infect pancreatic necrosis. Surgical and prophylactic treatment strategies

  16. Retinal vein and artery occlusions

    Christiansen, Christine Benn; Lip, Gregory Y. H.; Lamberts, Morten;

    2013-01-01

    Retinal vascular occlusions may constitute an independent risk factor for stroke in patients with atrial fibrillation.......Retinal vascular occlusions may constitute an independent risk factor for stroke in patients with atrial fibrillation....

  17. Inhibition of the alternative complement pathway preserves photoreceptors after retinal injury.

    Sweigard, J Harry; Matsumoto, Hidetaka; Smith, Kaylee E; Kim, Leo A; Paschalis, Eleftherios I; Okonuki, Yoko; Castillejos, Alexandra; Kataoka, Keiko; Hasegawa, Eiichi; Yanai, Ryoji; Husain, Deeba; Lambris, John D; Vavvas, Demetrios; Miller, Joan W; Connor, Kip M

    2015-07-22

    Degeneration of photoreceptors is a primary cause of vision loss worldwide, making the underlying mechanisms surrounding photoreceptor cell death critical to developing new treatment strategies. Retinal detachment, characterized by the separation of photoreceptors from the underlying retinal pigment epithelium, is a sight-threatening event that can happen in a number of retinal diseases. The detached photoreceptors undergo apoptosis and programmed necrosis. Given that photoreceptors are nondividing cells, their loss leads to irreversible visual impairment even after successful retinal reattachment surgery. To better understand the underlying disease mechanisms, we analyzed innate immune system regulators in the vitreous of human patients with retinal detachment and correlated the results with findings in a mouse model of retinal detachment. We identified the alternative complement pathway as promoting early photoreceptor cell death during retinal detachment. Photoreceptors down-regulate membrane-bound inhibitors of complement, allowing for selective targeting by the alternative complement pathway. When photoreceptors in the detached retina were removed from the primary source of oxygen and nutrients (choroidal vascular bed), the retina became hypoxic, leading to an up-regulation of complement factor B, a key mediator of the alternative pathway. Inhibition of the alternative complement pathway in knockout mice or through pharmacological means ameliorated photoreceptor cell death during retinal detachment. Our current study begins to outline the mechanism by which the alternative complement pathway facilitates photoreceptor cell death in the damaged retina. PMID:26203084

  18. Analysis of 10 cases died from the acute infections disease with the severe adrenalitis, necrosis and hemorrhage%急性重症感染合并出血坏死性肾上腺炎死亡十例分析

    李品玉; 于晓军; 徐小虎; 刘卯阳

    2009-01-01

    Objective To discuss the potential mechanisms and the role of adrenaliris with extensive hemorrhage and necrosis in acute critical infectious diseases.Methods Forensic autopsy cases from 1998 to 2007 were retrospectively analyzed.And 10 cases of them were involved in the primary and critical infecfion with acute infiammation,hemorrhage and necrosis of adrenal glands.Results Clinical diagnoses of 10 Cases were respiratory tract infection(n=6),septic shock(n=2),acute esophagitis(n=1),and undefined causes(n=1),and the quickly aggravatinng conditions resulted in death ultimately.However,systematic autopsy confirmed that 7 cages died of acute lymphocytic pancarditis,2 cases acute and lymphocytic interstitial pneumonia and 1 cKse epidemic cerebrospinal meningitis with septicemia.And severe complications of all cases included hemorrhagic necmtizing adrenalitis,systemic inflammatory response syndrome and multiple organ failure(MOF).Conclusions Hemorrhagic necrotizing adrenalitis should be considered as one of the important pathological changes in fatal MOF resulting from severe infection and trauma etc.More attention should be paid in clinical treatment.%目的 探讨出血坏死性肾上腺炎在急性生症感染性疾病死亡中的作用.方法 回顾性分析1998至2007年系统法医病理学解剖案例中10例原发性重症感染性疾病合并严重出血坏死性肾上腺炎案例的临床病理资料.结果 10例中临床诊断上呼吸道感染6例,感染性休克2例,急性食管炎1例,诊断不明1例.均病情迅速恶化而死亡.尸检7例为急性淋巴细胞性全心炎,2例为急性淋巴细胞性间质性肺炎,1例为暴发性脑膜炎球菌败血症,均合并严重的出血坏死性肾上腺炎、全身炎症反应综合征和多器官衰竭.结论 肾上腺炎性出血坏死应属于常见的致死性多器官功能衰竭的重要器官病变之一,临床应予重视.

  19. Retinal oxygen extraction in humans

    René M. Werkmeister; Doreen Schmidl; Gerold Aschinger; Veronika Doblhoff-Dier; Stefan Palkovits; Magdalena Wirth; Gerhard Garhöfer; Linsenmeier, Robert A.; Rainer A. Leitgeb; Leopold Schmetterer

    2015-01-01

    Adequate function of the retina is dependent on proper oxygen supply. In humans, the inner retina is oxygenated via the retinal circulation. We present a method to calculate total retinal oxygen extraction based on measurement of total retinal blood flow using dual-beam bidirectional Doppler optical coherence tomography and measurement of oxygen saturation by spectrophotometry. These measurements were done on 8 healthy subjects while breathing ambient room air and 100% oxygen. Total retinal b...

  20. Consumption of Polyphenol-Rich Zingiber Zerumbet Rhizome Extracts Protects against the Breakdown of the Blood-Retinal Barrier and Retinal Inflammation Induced by Diabetes

    Thing-Fong Tzeng

    2015-09-01

    Full Text Available The present study investigates the amelioration of diabetic retinopathy (DR by Zingiber zerumbet rhizome ethanol extracts (ZZRext in streptozotocin-induced diabetic rats (STZ-diabetic rats. ZZRext contains high phenolic and flavonoid contents. STZ-diabetic rats were treated orally with ZZRext (200, 300 mg/kg per day for three months. Blood-retinal barrier (BRB breakdown and increased vascular permeability were found in diabetic rats, with downregulation of occludin, and claudin-5. ZZRext treatment effectively preserved the expression of occludin, and claudin-5, leading to less BRB breakdown and less vascular permeability. Retinal histopathological observation showed that the disarrangement and reduction in thickness of retinal layers were reversed in ZZRext-treated diabetic rats. Retinal gene expression of tumor necrosis factor-α, interleukin (IL-1β, IL-6, vascular endothelial growth factor, intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 were all decreased in ZZRext-treated diabetic rats. Moreover, ZZRext treatment not only inhibited the nuclear factor κB (NF-κB activation, but also downregulated the protein expression of p38 mitogen-activated protein kinase (MAPK in diabetic retina. In conclusion, the results suggest that the retinal protective effects of ZZRext occur through improved retinal structural change and inhibiting retinal inflammation. The antiretinopathy property of ZZRext might be related to the downregulation of p38 MAPK and NF-κB signal transduction induced by diabetes.

  1. Complete Penile Necrosis in a Patient With Heparin-induced Thrombocytopenia: A Case Report*

    Blais, Anne-Sophie; Deschênes Rompré, Marie-Pier; Lacombe, Louis

    2014-01-01

    Penile necrosis is a rare condition that has been mostly described in association with diabetes mellitus and end-stage renal disease. We report an unusual case of acute penile necrosis because of heparin-induced thrombocytopenia. A 75-year-old man presented with acute renal failure and experienced cardiac complications during the hospitalization. The patient was treated twice with intravenous heparin. He developed symptoms of penile necrosis 4 days after the reintroduction of heparin. At that moment, the platelet count dropped by 61%, and the analysis of heparin-pf4 antibodies was positive for heparin-induced thrombocytopenia. The patient underwent a total penectomy and a perineal urethrostomy. PMID:26954936

  2. Bullous lesions, sweat gland necrosis and rhabdomyolysis in alcoholic coma

    Neelakandhan Asokan

    2014-01-01

    Full Text Available A 42-year-old male developed hemorrhagic bullae and erosions while in alcohol induced coma. The lesions were limited to areas of the body in prolonged contact with the ground in the comatose state. He developed rhabdomyolysis, progressing to acute renal failure (ARF. Histopathological examination of the skin showed spongiosis, intraepidermal vesicles, and necrosis of eccrine sweat glands with denudation of secretory epithelial lining cells. With supportive treatment and hemodialysis, the patient recovered in 3 weeks time. This is the first reported case of bullous lesions and sweat gland necrosis occurring in alcohol-induced coma complicated by rhabdomyolysis and ARF.

  3. Probabilistic retinal vessel segmentation

    Wu, Chang-Hua; Agam, Gady

    2007-03-01

    Optic fundus assessment is widely used for diagnosing vascular and non-vascular pathology. Inspection of the retinal vasculature may reveal hypertension, diabetes, arteriosclerosis, cardiovascular disease and stroke. Due to various imaging conditions retinal images may be degraded. Consequently, the enhancement of such images and vessels in them is an important task with direct clinical applications. We propose a novel technique for vessel enhancement in retinal images that is capable of enhancing vessel junctions in addition to linear vessel segments. This is an extension of vessel filters we have previously developed for vessel enhancement in thoracic CT scans. The proposed approach is based on probabilistic models which can discern vessels and junctions. Evaluation shows the proposed filter is better than several known techniques and is comparable to the state of the art when evaluated on a standard dataset. A ridge-based vessel tracking process is applied on the enhanced image to demonstrate the effectiveness of the enhancement filter.

  4. Nonsurgical Treatment of Infected Pancreatic Necrosis: A Falling Myth or a Still Impassable Frontier?

    Generoso Uomo

    2007-07-01

    Full Text Available Acute pancreatitis is a disease of increasing annual incidence associated with significant morbidity and mortality and with an increasing consumption of health care resources [1]. In particular, patients suffering from acute necrotizing pancreatitis who develop infected necrosis present a severe prognosis with mortality ranging from 20% to 70% [2, 3]. The diagnosis of infected pancreatic necrosis is usually based on Gram stain and cultures of material obtained from the necrotic area by fine-needle aspiration. On a clinical basis, infected pancreatic necrosis should be suspected in the presence of worsening abdominal pain, fever, and leukocytosis, usually 1-2 weeks after disease onset. In accordance with the current recommendations [4], sterile necrosis should be managed conservatively, whereas the occurrence of infected pancreatic necrosis requires immediate surgery. The standard approach to infected pancreatic necrosis has been open surgical debridement with a variety of drainage and closure techniques (multiple drainages, marsupialization of the lesser sac, continuous or intermittent lavage, unique o repeated necrosectomy, etc. [5]. So, the paradigm “infected pancreatic necrosis = surgery” seems to be an accepted principle in clinical pancreatology. However, over the last ten years some controversies have arisen regarding this topic. In fact, some reports have shown that early surgical intervention for pancreatic necrosis could result in a worse prognosis in comparison with patients who underwent surgery in a later phase of the disease [6, 7]. In addition, some reports have shown surprisingly enough, the efficacy of nonsurgical management for infected pancreatic necrosis [8, 9, 10, 11].

  5. Risk factor profile in retinal detachment

    Azad Raj; Nayak B; Sharma Y; Tiwari Hem; Khosla P

    1988-01-01

    150 cases of retinal detachment comprising 50 patients each of bilateral retinal detachment, unilateral retinal detachment without any retinal lesions in the fellow eve and unilateral retinal detachment with retinal lesions in the fellow eye were studied and the various associated risk factors were statistically analysed. The findings are discussed in relation to their aetiological and prognostic significance in the different types of retinal detachment. Based on these observations certain gu...

  6. Retinal damage induced by commercial light emitting diodes (LEDs).

    Jaadane, Imene; Boulenguez, Pierre; Chahory, Sabine; Carré, Samuel; Savoldelli, Michèle; Jonet, Laurent; Behar-Cohen, Francine; Martinsons, Christophe; Torriglia, Alicia

    2015-07-01

    Spectra of "white LEDs" are characterized by an intense emission in the blue region of the visible spectrum, absent in daylight spectra. This blue component and the high intensity of emission are the main sources of concern about the health risks of LEDs with respect to their toxicity to the eye and the retina. The aim of our study was to elucidate the role of blue light from LEDs in retinal damage. Commercially available white LEDs and four different blue LEDs (507, 473, 467, and 449nm) were used for exposure experiments on Wistar rats. Immunohistochemical stain, transmission electron microscopy, and Western blot were used to exam the retinas. We evaluated LED-induced retinal cell damage by studying oxidative stress, stress response pathways, and the identification of cell death pathways. LED light caused a state of suffering of the retina with oxidative damage and retinal injury. We observed a loss of photoreceptors and the activation of caspase-independent apoptosis, necroptosis, and necrosis. A wavelength dependence of the effects was observed. Phototoxicity of LEDs on the retina is characterized by a strong damage of photoreceptors and by the induction of necrosis. PMID:25863264

  7. Retinal artery occlusion

    ... artery occlusion; Branch retinal artery occlusion; CRAO; BRAO Images Retina References Sanborn GE, Magargal LE. Arterial obstructive disease ... A.M. Editorial team. Related MedlinePlus Health Topics ... audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among ...

  8. Retinal tolerance to dyes

    Lüke, C; Lüke, M; Dietlein, T S; Hueber, A; Jordan, J; Sickel, W.; Kirchhof, B

    2005-01-01

    Background: Dye solutions for intraoperative staining of epiretinal membranes and the internal limiting membrane improve the visualisation of these thin structures and facilitate their removal. In the present study the authors investigated the effects of indocyanine green 0.05%, trypan blue 0.15%, and patent blue 0.48% on bovine retinal function.

  9. Transient osteoporosis or femoral head necrosis? Early diagnosis via MRI

    Transient osteoporosis of the hip is a syndrome that does not seem to be widely known; this is also true for its radiological appearance. It is often mistaken for avascular necrosis of the femoral head, metastatic or inflammatory disease. These differential diagnoses lead to more or less invasive procedures, although transient osteoporosis does not require more than immobilisation for complete remission. MRI was done in 38 patients with acute hip pain, 13 had femoral head necrosis and 8 transient osteoporosis. Follow-up studies via MRI in patients with transient osteoporosis revealed 3 stages (diffuse, focal, residual) during the clinical course of which stage II is similar to femoral head necrosis but always without the typical sclerotic rim. (orig.)

  10. Clinical and immunological features of retinal vasculitis in systemic diseases

    Paović Jelena

    2009-01-01

    Full Text Available Background/Aim. Vasculitis is a clinical, pathologic process characterized by inflammation and necrosis of blood vessel occurring anywhere in the body. The aim of the study was to present some clinical and immunologic features of retinal vasculitis in systemic diseases: systemic lupus erythematosus, multiple sclerosis, sarcoidosis, Behcet's diseases, and others. Methods. A total of 1 254 patients with uveitis were included in the study. The immunochemical diagnostic methods were used to determine the pathogenesis of ocular manifestations. Ocular manifestations were examined using biomicroscope, direct or indirect ophtalmoscopy. Results. Primary retinal vasculitis was diagnosed in 85/1254 (6.8% of total uveitis. In more than half of the cases of vasculitis (58.8%, both arteries and veins were involved in inflammatory process. Periphlebitis was diagnosed far more commonly (36.5% than periarteritis (4.7%. Retinal vasculitis associated with systemic lupus erythematosus was characterized by microinfarctions and the consequent foci of inflammatory cells or diseases of large arteries manifesting in vasospasm and occlusions. Cotton wool spots occurred in 38.3% and retinal hemorrhages in 34% of the cases. In this study periphlebitis of the retina was one of the less frequent ocular manifestations of multiple sclerosis. Comparing with the other changes of the retinal blood vessels, venous sheating occurred in 25.1% and occlusion and vein trombosis in 43.75% of the cases. Retinal vasculitis associated with chronic sarcoidosis occured in 37.5% of patients with sarcoidosis. The most frequent manifestation of ocular sarcoidosis was intermediary uveitis (43.75%. Anterior granulomatous uveitis occured in 37.5% of patients with sarcoidoses. Immune complexes occurred in 13/20 (65% of the patients. Antiretinal anti-S antibody in the serum occurred in 73% of the patients with retinal detachment as a complication of primary disease and in 25% those with vasculitis

  11. Discussion Tumor necrosis factor-Alpha and Interleukin-6 in acute pancreatitis diagnosis and early severity appraisal%探讨肿瘤坏死因子-a和白细胞介素-6在急性胰腺炎诊断及早期严重度评估的价值

    何晃养

    2012-01-01

    Objective:To explore the value dynamic changes of serum levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6)and to determine their predictive value for severity and prognosis of acute pancreatitis(AP).Methods 81 patients with acute pancreatitis were divided into mild acute pancreatitis group(MAP,n=57) and severe acute pancreatitis group(SAP,n=24),SAP and MAP Group at post admission 1h,24h,3d,dedicated TNF-a and IL-6,then analysed and contrasted the results.Results The chang of TNF-a and IL-6 levels at post-admission 1h、24h、2d、3d、5d between SAP and MAP duringhospitalization in patients were statistically significant difference(P<0.05).Conclusion Dynamic changes of the serum levels of TNF-α and IL-6 are related to the occurance and development of acute pancreatitis,and the serum levels of TNF-α and IL-6 on 3rd day may be a predictive index for severity and prognosis of acute pancreatitis.%目的探讨肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)在急性胰腺炎(AP)患者中诊断及早期病情严重度评估中的价值.方法选取81例AP患者,分为轻症急性胰腺炎(MAP)组57例和重症急性胰腺炎(SAP)组24例,对SAP组和MAP组在入院后1h、24h、2d、3d、5d抽血测定TNF-α和IL-6,并对结果进行分析.结果 SAP组和MAP组在入院后1h、24h、3d检测TNF-α和IL-6的水平比较差异有统计学意义(P<0.05).结论血清TNF-α和IL-6水平变化与AP的发生发展密切相关,可作为AP病情变化和程度判断的参考指标,对AP早期严重度具有良好的预测作用.

  12. Manifestaciones retinianas de las enfermedades infecciosas Retinal manifestations of infectious diseases

    M. Pérez de Arcelus

    2008-01-01

    important cause of choroidal neovascularisation. The viruses that most frequently affect the retina are of the herpes type and can produce devastating symptoms in immunoincompetent patients, named acute retinal necrosis syndrome. Retinitis due to cytomegalovirus is more frequent in immunodepressed patients, as in the case of AIDS, but it must also be contemplated in patients with lymphoma and immunomodulatory treatment. The most frequent bacterial diseases that affect the retina are syphilis and tuberculosis. Disease due to cat scratches, caused by a borrelia, can produce a neuroretinitis. Toxoplasmosis is the most common of the infectious diseases caused by a parasite and gives rise to chorioretinitis. Toxocariasis, also caused by a parasite, is second in importance, giving rise to choroidal granulomas and retinal tractions.

  13. Plasma cytokines in acute stroke

    Christensen, Hanne Krarup; Boysen, Gudrun; Christensen, Erik;

    2011-01-01

    months later plasma levels of interleukin 1 beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha), interleukin-1 receptor antagonist (IL-1RA), interleukin 6 (IL-6), interleukin 10 (IL-10), soluble tumor necrosis factor receptor 1 (sTNF-R1), and soluble tumor necrosis factor receptor 2 (sTNF-R2) were......GOALS: The aim of this study was to test the relations between plasma cytokines and the clinical characteristics, course, and risk factors in acute stroke. PATIENTS AND METHODS: The analysis was based on 179 patients with acute stroke included within 24 hours of stroke onset. On inclusion and 3...

  14. Neurogenic pulmonary edema due to delayed radiation necrosis

    Mani R

    2005-01-01

    Full Text Available Neurogenic pulmonary edema is oftten missed in the ICU setting as it is mistaken for pneumonia or ARDS. The case presented here illustrates how a high index of suspicion in the appropriate setting can lead to the diagnosis. The patient in this report developed acute-on-chronic cerebral edema due to radiation necrosis following gamma-knife radiation therapy for cerebral arteriovenous malformation.

  15. Cytotoxic effects of curcumin in human retinal pigment epithelial cells.

    Margrit Hollborn

    Full Text Available BACKGROUND: Curcumin from turmeric is an ingredient in curry powders. Due to its antiinflammatory, antioxidant and anticarcinogenic effects, curcumin is a promising drug for the treatment of cancer and retinal diseases. We investigated whether curcumin alters the viability and physiological properties of human retinal pigment epithelial (RPE cells in vitro. METHODOLOGY/PRINCIPAL FINDINGS: Cellular proliferation was investigated with a bromodeoxy-uridine immunoassay, and chemotaxis was investigated with a Boyden chamber assay. Cell viability was determined by trypan blue exclusion. Apoptosis and necrosis rates were determined with a DNA fragmentation ELISA. Gene expression was determined by real-time PCR, and secretion of VEGF and bFGF was examined with ELISA. The phosphorylation level of proteins was revealed by Western blotting. The proliferation of RPE cells was slightly increased by curcumin at 10 µM and strongly reduced by curcumin above 50 µM. Curcumin at 50 µM increased slightly the chemotaxis of the cells. Curcumin reduced the expression and secretion of VEGF under control conditions and abolished the VEGF secretion induced by PDGF and chemical hypoxia. Whereas low concentrations of curcumin stimulated the expression of bFGF and HGF, high concentrations caused downregulation of both factors. Curcumin decreased dose-dependently the viability of RPE cells via induction of early necrosis (above 10 µM and delayed apoptosis (above 1 µM. The cytotoxic effect of curcumin involved activation of caspase-3 and calpain, intracellular calcium signaling, mitochondrial permeability, oxidative stress, increased phosphorylation of p38 MAPK and decreased phosphorylation of Akt protein. CONCLUSION: It is concluded that curcumin at concentrations described to be effective in the treatment of tumor cells and in inhibiting death of retinal neurons (∼10 µM has adverse effects on RPE cells. It is suggested that, during the intake of curcumin as

  16. Small Animal Retinal Imaging

    Choi, WooJhon; Drexler, Wolfgang; Fujimoto, James G.

    Developing and validating new techniques and methods for small animal imaging is an important research area because there are many small animal models of retinal diseases such as diabetic retinopathy, age-related macular degeneration, and glaucoma [1-6]. Because the retina is a multilayered structure with distinct abnormalities occurring in different intraretinal layers at different stages of disease progression, there is a need for imaging techniques that enable visualization of these layers individually at different time points. Although postmortem histology and ultrastructural analysis can be performed for investigating microscopic changes in the retina in small animal models, this requires sacrificing animals, which makes repeated assessment of the same animal at different time points impossible and increases the number of animals required. Furthermore, some retinal processes such as neurovascular coupling cannot be fully characterized postmortem.

  17. Inherited Retinal Degenerative Disease Registry

    2016-03-21

    Eye Diseases Hereditary; Retinal Disease; Achromatopsia; Bardet-Biedl Syndrome; Bassen-Kornzweig Syndrome; Batten Disease; Best Disease; Choroidal Dystrophy; Choroideremia; Cone Dystrophy; Cone-Rod Dystrophy; Congenital Stationary Night Blindness; Enhanced S-Cone Syndrome; Fundus Albipunctatus; Goldmann-Favre Syndrome; Gyrate Atrophy; Juvenile Macular Degeneration; Kearns-Sayre Syndrome; Leber Congenital Amaurosis; Refsum Syndrome; Retinitis Pigmentosa; Retinitis Punctata Albescens; Retinoschisis; Rod-Cone Dystrophy; Rod Dystrophy; Rod Monochromacy; Stargardt Disease; Usher Syndrome

  18. Retinal flow cytometer

    Alt, C.; Veilleux, I.; Lee, H; Pitsillides, C. M.; D. Côté; Lin, C.P.

    2007-01-01

    The in vivo flow cytometer is an instrument capable of continuous, real-time monitoring of fluorescently labeled cells in the circulation without the need to draw blood samples. However, the original system probes a single vessel in the mouse ear; the small sample volume limits the sensitivity of the technique. We describe an in vivo retinal flow cytometer that simultaneously probes five artery–vein pairs in the mouse eye by circularly scanning a small laser spot rapidly around the optic nerv...

  19. Aphakic retinal detachment.

    Le Mesurier, R; Vickers, S; Booth-Mason, S; Chignell, A H

    1985-01-01

    A study of 132 cases of aphakic retinal detachment (ARD) following mainly intracapsular cataract surgery has been made. Forty-nine cases (37%) were found to have vitreous incarcerated into the cataract section out of a total of 54 (41%) cases who had suffered a vitreous complication during cataract surgery. A study of the characteristics of ARD reveals that those cases having had a vitreous complication in the management of their cataracts are more likely to develop detachment within three mo...

  20. [Renal ultrasound in fat necrosis].

    Tizki, S; Lasry, F; Elftoiki, F Z; Hadj Khalifa, H; Itri, M; Khadir, K; Benchikhi, H

    2013-07-01

    Subcutaneous fat necrosis is an uncommon disease that may be complicated with potentially fatal hypercalcemia or with nephrocalcinosis. We report on the case of a patient with a history of significant perinatal asphyxia, hospitalized for a urinary tract infection. Lesions of subcutaneous fat necrosis were noted, with asymptomatic hypercalcemia at 3.9mmol/L. A renal ultrasound was performed and showed echogenic medullary pyramids bilaterally, consistent with nephrocalcinosis and left nephrolithiasis. The treatment of hypercalcemia included hyperhydration, a diuretic and corticosteroids. Progression was characterized by the total regression of skin lesions and normalization of serum calcium. Hypercalcemia is a rare complication of subcutaneous fat necrosis. It develops within days to weeks after the appearance of skin lesions. Nephrocalcinosis appears after several weeks or months. Hypercalcemia must be treated in due time to avoid the impact on the kidney. PMID:23726682

  1. Retinal Thickening and Photoreceptor Loss in HIV Eyes without Retinitis.

    Cheryl A Arcinue

    Full Text Available To determine the presence of structural changes in HIV retinae (i.e., photoreceptor density and retinal thickness in the macula compared with age-matched HIV-negative controls.Cohort of patients with known HIV under CART (combination Antiretroviral Therapy treatment were examined with a flood-illuminated retinal AO camera to assess the cone photoreceptor mosaic and spectral-domain optical coherence tomography (SD-OCT to assess retinal layers and retinal thickness.Twenty-four eyes of 12 patients (n = 6 HIV-positive and 6 HIV-negative were imaged with the adaptive optics camera. In each of the regions of interest studied (nasal, temporal, superior, inferior, the HIV group had significantly less mean cone photoreceptor density compared with age-matched controls (difference range, 4,308-6,872 cones/mm2. A different subset of forty eyes of 20 patients (n = 10 HIV-positive and 10 HIV-negative was included in the retinal thickness measurements and retinal layer segmentation with the SD-OCT. We observed significant thickening in HIV positive eyes in the total retinal thickness at the foveal center, and in each of the three horizontal B-scans (through the macular center, superior, and inferior to the fovea. We also noted that the inner retina (combined thickness from ILM through RNFL to GCL layer was also significantly thickened in all the different locations scanned compared with HIV-negative controls.Our present study shows that the cone photoreceptor density is significantly reduced in HIV retinae compared with age-matched controls. HIV retinae also have increased macular retinal thickness that may be caused by inner retinal edema secondary to retinovascular disease in HIV. The interaction of photoreceptors with the aging RPE, as well as possible low-grade ocular inflammation causing diffuse inner retinal edema, may be the key to the progressive vision changes in HIV-positive patients without overt retinitis.

  2. Genomic Loci Modulating the Retinal Transcriptome in Wound Healing

    Félix R. Vázquez-Chona

    2007-01-01

    Full Text Available Purpose: The present study predicts and tests genetic networks that modulate gene expression during the retinal wound-healing response.Methods: Upstream modulators and target genes were defined using meta-analysis and bioinfor matic approaches. Quantitative trait loci (QTLs for retinal acute phase genes (Vazquez-Chona et al. 2005 were defi ned using QTL analysis of CNS gene expression (Chesler et al. 2005. Candidate modulators were defi ned using computational analysis of gene and motif sequences. The effect of candidate genes on wound healing was tested using animal models of gene expression.Results: A network of early wound-healing genes is modulated by a locus on chromosome 12. The genetic background of the locus altered the wound-healing response of the retina. The C57BL/6 allele conferred enhanced expression of neuronal marker Thy1 and heat-shock-like crystallins, whereas the DBA/2J allele correlated with greater levels of the classic marker of retinal stress, glial fibrillary acidic protein (GFAP. Id2 and Lpin1 are candidate upstream modula tors as they strongly correlated with the segregation of DBA/2J and C57BL/6 alleles, and their dosage levels correlated with the enhanced expression of survival genes (Thy1 and crystallin genes.Conclusion: We defined a genetic network associated with the retinal acute injury response. Using genetic linkage analysis of natural transcript variation, we identified regulatory loci and candidate modulators that control transcript levels of acute phase genes. Our results support the convergence of gene expression profiling, QTL analysis, and bioinformatics as a rational approach to discover molecular pathways controlling retinal wound healing.

  3. Genetics Home Reference: retinitis pigmentosa

    ... by the combination of vision loss and hearing loss beginning early in life. Retinitis pigmentosa is also a feature of several other genetic syndromes, including Bardet-Biedl syndrome ; Refsum disease ; and neuropathy, ... for retinitis pigmentosa lead to a gradual loss of rods and cones in the retina. The ...

  4. Retinal detachment surgery without cryotherapy.

    Chignell, A H; Markham, R H

    1981-01-01

    A series of cases of retinal detachment treated without the application of cryotherapy at the time of surgery has been studied. The omission of cryotherapy while not interfering with retinal reattachment, carries the risk of redetachment at a later date. Macular pucker may still occur in spite of the absence of cryotherapy.

  5. New Wrinkles in Retinal Densitometry

    Masella, Benjamin D.; Hunter, Jennifer J.; Williams, David R.

    2014-01-01

    Retinal densitometry has the potential to provide objective information about the function of the retina. However, a number of factors complicate the interpretation of retinal reflectance. We have discovered additional sources of reflectance change and have defined a method to minimize their impact.

  6. Prognostic value of CT in acute pancreatitis

    The presence and degree of pancreatic necrosis and peripancreatic phlegmon were evaluated by dynamic, bolus-contrast-enhanced CT in 88 patients with acute pancreatitis and were correlated with clinical evaluation; morbidity (infection, pseudocyst); and mortality. Patients with necrosis had a 23% mortality and 82% morbidity, compared with 0% mortality and 6% morbidity in patients without necrosis. Patients with peripancreatic phlegmons and necrosis had a 26% mortality and 84% morbidity compared with 0% mortality and 22% morbidity in individuals with phlegmons but without necrosis. In this study, the CT severity index, which combines necrosis and peripancreatic phlegmon into a grading system at the initial CT examination, was a good prognostic indicator of severity of acute pancreatitis

  7. [Latest advances in acute pancreatitis].

    de-Madaria, Enrique

    2015-09-01

    The present article analyses the main presentations on acute pancreatitis at Digestive Disease Week 2015. Arterial pseudoaneurysm is an uncommon complication of acute pancreatitis (incidence 0.7%) and mortality from this cause is currently anecdotal. Diabetes mellitus has little impact on the clinical course of acute pancreatitis, unlike cirrhosis, which doubles the risk of mortality. Intake of unsaturated fat could be associated with an increased severity of acute pancreatitis and is a confounding factor in studies evaluating the relationship between obesity and morbidity and mortality. PET-CT (positron emission tomography-computed tomography) could be a non-invasive tool to detect infection of collections in acute pancreatitis. Peripancreatic fat necrosis is less frequent than pancreatic fat necrosis and is associated with a better clinical course. If the clinical course is poor, increasing the calibre of the percutaneous drains used in the treatment of infected necrosis can avoid surgery in 20% of patients. The use of low molecular-weight heparin in moderate or severe pancreatitis could be associated with a better clinical course, specifically with a lower incidence of necrosis. In acute recurrent pancreatitis, simvastatin is a promising drug for prophylaxis of new episodes of acute pancreatitis. Nutritional support through a nasogastric tube does not improve clinical course compared with oral nutrition. PMID:26520203

  8. Acute pancreatitis : new frontiers in diagnosis and treatment

    van Santvoort, H.C.

    2010-01-01

    Acute pancreatitis is an acute inflammation of the pancreas mostly caused by gallstones and alcohol abuse. Around 15 to 20% of patients show a severe clinical course, which is characterised by multiple organ failure and necrosis of the pancreatic parenchyma and/ or peripancreatic fat tissue. In around 30% of patients with necrotising pancreatitis, secondary infection of necrosis occurs, probably due to bacterial translocation from the patient’s own gut. Infected necrosis is an indication for ...

  9. Neovascularização retiniana secundária a obstrução vascular em retinocoroidite por toxoplasmose em paciente HIV positivo: relato de caso Retinal vascular occlusion and neovascularization in acute toxoplasmic retinochoroiditis in a patient with AIDS: case report

    Vânia Ewert

    2004-08-01

    Full Text Available Apresentar e discutir o caso de paciente infectado pelo HIV, que desenvolveu quadro de obstrução vascular seguido de neovascularização retiniana e de papila, durante o tratamento específico para retinocoroidite por toxoplasmose e que evoluiu com resolução espontânea da neovascularização sem a necessidade de tratamento associado. Paciente com retinocoroidite por toxoplasmose, que após 4 semanas de tratamento específico (sulfadiazina e pirimetamina desenvolveu quadro de obstrução vascular, seguido de neovascularização retiniana, apresentou involução espontânea, não havendo necessidade de fotocoagulação a laser, ou de outro tratamento adicional. As lesões retinianas ativas de toxoplasmose podem cursar com complicações vasculares, mesmo na vigência de tratamento específico, e geralmente apresentam bom prognóstico com regressão espontânea dos neovasos, sem necessidade de tratamentos adicionais.To present a case of an HIV-infected patient, who presented with active chorioretinal inflammatory lesion suggestive of toxoplasmosis, that during the specific treatment developed a retinal vascular occlusion, and adjacent neovascularization. 35-year-old AIDS patient that, presented with toxoplasmic retinochoroiditis and after 4 weeks of the specific therapy (pyrimethamine and sulfadiazine developed a vascular occlusion and retinal neovascularization that healed without the need for phototocoagulation or other adjunctive therapy. This case demonstrates that acute toxoplasmic retinochoroiditis that develops vascular complications may present a good result with the specific treatment without the need for adjunctive therapy.

  10. Blood pressure modifies retinal susceptibility to intraocular pressure elevation.

    Zheng He

    Full Text Available Primary open angle glaucoma affects more than 67 million people. Elevated intraocular pressure (IOP is a risk factor for glaucoma and may reduce nutrient availability by decreasing ocular perfusion pressure (OPP. An interaction between arterial blood pressure and IOP determines OPP; but the exact contribution that these factors have for retinal function is not fully understood. Here we sought to determine how acute modifications of arterial pressure will affect the susceptibility of neuronal function and blood flow to IOP challenge. Anaesthetized (ketamine:xylazine Long-Evan rats with low (∼60 mmHg, sodium nitroprusside infusion, moderate (∼100 mmHg, saline, or high levels (∼160 mmHg, angiotensin II of mean arterial pressure (MAP, n = 5-10 per group were subjected to IOP challenge (10-120 mmHg, 5 mmHg steps every 3 minutes. Electroretinograms were measured at each IOP step to assess bipolar cell (b-wave and inner retinal function (scotopic threshold response or STR. Ocular blood flow was measured using laser-Doppler flowmetry in groups with similar MAP level and the same IOP challenge protocol. Both b-wave and STR amplitudes decreased with IOP elevation. Retinal function was less susceptible to IOP challenge when MAP was high, whereas the converse was true for low MAP. Consistent with the effects on retinal function, higher IOP was needed to attenuated ocular blood flow in animals with higher MAP. The susceptibility of retinal function to IOP challenge can be ameliorated by acute high BP, and exacerbated by low BP. This is partially mediated by modifications in ocular blood flow.