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Sample records for linfoma intravascular tratado

  1. Estado de salud bucodental de los pacientes con linfoma que van a ser tratados en la Región de Murcia

    Gallego Martínez, Juan

    2016-01-01

    Objetivos: Establecer el estado de salud oral de los pacientes que van a ser tratados por un linfoma; mediante un estudio descriptivo y analítico de la prevalencia de caries, xerostomía, estado periodontal, higiene oral y otras patologías bucodentarias, en este grupo de población. Estudiar la posible existencia de asociaciones o relaciones entre las distintas variables; y comparar estos resultados con los obtenidos por otros autores, mediante la revisión de la literatura. Averiguar las necesi...

  2. Primary lymphoma of the liver treated by extended hepatectomy and chemotherapy: a case report Linfoma primário do fígado tratado por hepatectomia ampliada e quimioterapia: relato de caso

    Eleazar Chaib

    2002-09-01

    Full Text Available Primary lymphoma of the liver is an extremely rare entity. A case of anaplastic large B-cell (both CD-20 and lambda positive non-Hodgkin's lymphoma that was confined to the liver in a 33-year-old man is reported. The patient was treated with an extended right hepatectomy and combination chemotherapy: cyclophosphamide, adriamycin, vincristine, and prednisone. The patient was disease free 24 months after the procedure.O linfoma primário do fígado é uma entidade extremamente rara. Os autores relatam um caso de linfoma não-Hodgkin de células B grandes anaplásicas (positivo para CD-20 e Lambda em um paciente do sexo masculino de 33 anos. O tumor estava localizado no lobo hepático direito e foi tratado por hepatectomia direita ampliada e quimioterapia pós-operatória com ciclofosfamida, adriamicina, vincristina e prednisone. Vinte quatro meses de seguimento o paciente encontra-se sem recidiva tumoral.

  3. Advanced Hodgkin's lymphoma: results in 216 patients treated with ABVD in Brazil Linfoma de Hodgkin em estádio avançado: resultados do tratamento em 216 pacientes tratados com ABVD no Brasil

    Luciana Britto

    2010-01-01

    Full Text Available The outcome of Hodgkin's lymphoma (HL has markedly improved over the last few decades, placing HL among the human cancers with highest cure rates. However, data about treatment outcomes in developing countries are scarce. From 1996 to 2005, 370 consecutive patients with HL treated in three public institutions in Rio de Janeiro were identified. A total of 216 patients who presented with advanced stage (IIB-IV HL were selected for the present analysis. Patients with advanced disease were treated with ABVD, complemented or not by radiation therapy. The median follow-up time of survivors was 6.3 years (1-11.8. Fifteen patients died during first-line treatment. The complete remission rate was 80%. The 5-year progression-free survival (PFS and the 5-year overall survival (OS probabilities were 69% and 83%, respectively. The 5-year PFS in low-risk and high-risk patients were 81% and 62% (p=0.003, respectively. The 5-year OS in low-risk and high-risk International Prognostic Score patients were 89% and 78% (p=0.02, respectively. The present study provides a representative estimate of current treatment results for advanced HL in public institutions in an urban area in Brazil. It is clear that full treatment can be given to most patients, although those with very low socio-economic status might require special attention and support. Since Brazil is a large country, with substantial interregional heterogeneity, a nationwide registry of HL patients is currently being implemented.Os resultados do tratamento do linfoma de Hodgkin (LH melhoraram substancialmente ao longo das últimas décadas e tornaram o LH uma das neoplasias humanas com maior chance de cura. Entretanto, os dados sobre tratamento em países em desenvolvimento são escassos. Entre 1996 e 2005, 370 pacientes consecutivos com LH tratados em três instituições públicas no Rio de Janeiro foram identificados. Destes, 216 em estádio avançado (IIB-IV foram selecionados para esta análise. Os

  4. Linfoma de Burkitt oral: relato de caso Oral Burkitt's lymphoma: case report

    Roseana de Almeida Freitas; Simone Souza Lobão Veras Barros; Lêda Bezerra Quinderé

    2008-01-01

    O linfoma de Burkitt é um raro e agressivo tipo de linfoma não-Hodgkin pobremente diferenciado. O presente relato trata de uma criança do sexo masculino, com sete anos de idade, que foi examinada na Clínica de Odontopediatria do Departamento de Odontologia da UFRN, exibindo uma massa tumoral na região de pré-molares mandibulares com mobilidade dentária. O exame radiográfico revelou uma área radiolúcida difusa e o diagnóstico histopatológico foi de linfoma de Burkitt. O paciente foi tratado po...

  5. Intravascular Ultrasound

    ... Nuclear Ventriculography Optical Coherence Tomography Positron Emission Tomography (PET) Stress Echocardiography Transesophageal Echocardiography Intravascular Ultrasound | Share Intravascular ultrasound ( ...

  6. Linfoma óseo primario

    Onilda Labrada Silva

    2014-08-01

    Full Text Available El linfoma primario de hueso es definido histológicamente como un linfoma extra ganglionar, afecta los huesos y puede ser desarrollado por una enfermedad sistémica. Se presentó un caso de linfoma óseo primario en el Hospital General Docente “Ernesto Guevara de la Serna” de las Tunas en el año 2013, descrito como una forma muy rara de manifestación de los linfomas. Paciente masculino de 72 años de edad, con dolor a nivel del calcáneo derecho, inflamación e impotencia funcional. Se realizaron estudios imaginológicos que revelaron la existencia de osteoporosis y un tumor óseo primario de tipo linfomatoso

  7. Linfoma malt primario de la lengua

    Goreti, Gaia; Ascani, Giuliano; Filosa, Alessandra; Rubini, C.; Olay, Sonsoles

    2004-01-01

    Los linfomas derivados de los tejidos linfoides asociados a las mucosas (MALT) primarios de la lengua son infrecuentes. Se documenta el caso de una paciente de 80 años de edad, con un tumor en el dorso de la lengua filiado histológicamente como linfoma extranodal de células B. Se sugiere como posible origen del linfoma un proceso reactivo de origen desconocido, al presentar las glándulas salivales menores adyacentes al tumor un cuadro compatible con una sialadenitis mioep...

  8. Linfoma de Burkitt oral: relato de caso Oral Burkitt's lymphoma: case report

    Roseana de Almeida Freitas

    2008-06-01

    Full Text Available O linfoma de Burkitt é um raro e agressivo tipo de linfoma não-Hodgkin pobremente diferenciado. O presente relato trata de uma criança do sexo masculino, com sete anos de idade, que foi examinada na Clínica de Odontopediatria do Departamento de Odontologia da UFRN, exibindo uma massa tumoral na região de pré-molares mandibulares com mobilidade dentária. O exame radiográfico revelou uma área radiolúcida difusa e o diagnóstico histopatológico foi de linfoma de Burkitt. O paciente foi tratado por poliquimioterapia e obteve completa remissão da patologia.Burkitt's lymphoma is a poorly differentiated rare and aggressive type of non-Hodgkin's lymphoma. This article reports the case of a male child aged seven years, who was examined at the Odontopediatric Clinic of the UFRN Dentistry Department. The patient presented a tumor in the premolar region of the mandible; teeth were mobile in this region. Radiology revealed a diffuse radioluscent area which was diagnosed histopathologically as Burkitt's lymphoma. The patient was treated with polychemotherapy; complete remission of the disease was attained.

  9. Linfoma de ovario Ovarian lymphoma

    Iván Bonet Fonseca

    2012-09-01

    Full Text Available Introducción: el 50 % de la patología oncológica en pediatría corresponde a masas o tumores sólidos, alrededor del 20 % del total se ubica en abdomen. Los tumores que se presentan con mayor frecuencia en el abdomen son el nefroblastoma o tumor de Wilms, el linfoma tipo Burkitt, el neuroblastoma y los tumores germinales de ovario. Objetivo: presentar un caso pediátrico con tumor abdominal. Caso clínico: se presenta un caso de una niña de 8 años de edad con antecedentes de salud aparente, atendida en el Hospital Público de la Universidad de Mbarara, Uganda. Resultado: paciente pediátrica que fue ingresada con una historia de 3 meses de dolor abdominal, pérdida ligera de peso y masa abdominal de crecimiento rápido, fue sometida a una laparotomía exploradora donde se resecó la masa tumoral, la que histológicamente arrojó ser un linfoma ovárico, como hallazgo durante la intervención quirúrgica se diagnosticó una agenesia de útero. Conclusión: la paciente se encuentra después del tratamiento con quimioterapia en seguimiento, lleva aparentemente hace 5 meses una vida normal (noviembre 2011.Introduction: 50 % of pediatric oncologic pathology corresponds to mass or solid tumors, reaching about 20 % of total abdomen. The tumors that most frequently occur in the abdomen are nephroblastoma or Wilms tumor, Burkitt's lymphoma, neuroblastoma, and ovarian germ cell tumors. Objective: to present a pediatric case with abdominal tumor. Case report: we report a case of an 8 year old girl with a history of apparent good health. This patient was assisted the Public Hospital of Mbarara University, Uganda. Result: a female pediatric patient was admitted with a 3-month history of abdominal pain, mild weight loss, and rapid growth of an abdominal mass. This patient underwent an exploratory laparotomy where the tumor mass was removed. It was histologically confirmed as an ovarian lymphoma. It was diagnosed uterus agenesis. Conclusion: after

  10. Amiloidosis sistémica y linfoma no Hodgkin

    Daniel V. Drake Sosa

    2014-08-01

    Full Text Available La amiloidosis sistémica se caracteriza por el depósito extracelular de proteína amiloide en uno o más órganos. Se presenta el caso de un hombre de 62 años de edad, con antecedentes de lesiones papulosas, amarillentas y brillantes, fundamentalmente en el tronco y las extremidades; con formación de placas profundas y dolorosas de más de un año de evolución, así como lesiones papulosas purpúricas en el abdomen y muslos. El paciente también refirió dolores abdominales y articulares. Los exámenes complementarios demostraron anemia, una eritrosedimentación acelerada, eosinofilia y trastornos de la función hepática. El ultrasonido abdominal informó hepatomegalia, mientras que el medulograma reveló una médula ósea infiltrada por linfocitos pequeños, con depresión del sistema eritropoyético y ligero aumento de mielocitos eosinófilos del sistema granulopoyético, sugestivos de un Linfoma No Hodgking. La biopsia cutánea demostró el depósito de sustancia amiloide en la dermis superior y en las paredes vasculares. El paciente fue tratado con prednisona y ciclofosfamida, obteniéndose una mejoría de su cuadro clínico

  11. Instantánea del linfoma

    Información sobre las tendencias de incidencia, mortalidad y financiamiento del NCI sobre el linfoma; así como ejemplos de actividades del NCI y adelantos en la investigación de este tipo de cáncer.

  12. Linfoma esplénico de la zona marginal

    Ariel Bello; Fernando De La Vega; Katherine Redondo; Karina Riuz; Liney Mendoza; Mario Lora

    2015-01-01

    Los linfomas no Hodgkin son un grupo de neoplasias que afectan los ganglios linfáticos y/o el tejido linfoide extraganglionar. Su frecuencia ha ido en ascenso en los últimos años. Según la clasificación de la OMS para los linfomas no Hodgkin, los linfomas esplénicos de la zona marginal (LEZM) son neoplasias de las células B maduras que constituyen menos de 2% de todos estos tipos de linfomas. Se presenta el caso de un paciente de 58 años, quien consultó por presentar fiebre prolongada, asocia...

  13. Estudo prospectivo e randomizado de pacientes tratados com e sem stents revestidos com carbeto de silício amorfo para a prevenção da reestenose coronariana. Avaliação ultra-sonográfica Randomized intravascular ultrasound comparison between endoprostheses with and without amorphous silicon-carbide

    Luiz Fernando Leite Tanajura

    2004-12-01

    Full Text Available OBJETIVO: A reestenose intra-stent é a maior limitação das intervenções coronárias percutâneas. O carbeto de silício amorfo (SiC-a, substância antitrombótica e antiinflamatória capaz de reduzir a deposição de fibrina, plaquetas e leucócitos sobre o stent, apresenta potencial de prevenir a hiperplasia neo-intimal e a reestenose. MÉTODOS: Estudo prospectivo, randomizado e tipo rótulo aberto comparando pacientes com doença coronariana tratados com e sem stents revestidos com o SiC-a, utilizando a angiografia quantitativa e o ultra-som intracoronário. Foram incluídos 100 pacientes (50 em cada grupo a fim de mensurar o volume de hiperplasia neo-intimal intra-stent/extremidades. Como os stents comparados apresentavam extensões diferentes, o volume de hiperplasia foi analisado em valores absolutos (por paciente e relativos (por milímetro de extensão do stent. Avaliaram-se ainda os eventos cardíacos maiores e os resultados da angiografia quantitativa. RESULTADOS: Os grupos apresentaram características de base semelhantes. Todos os pacientes foram tratados com sucesso. No 6° mês de evolução foram reestudados 94% dos casos dos dois grupos, obtendo-se ultra-som em 92%. O volume de hiperplasia neo-intimal absoluto foi significativamente maior nos tratados com os stents revestidos (51.2 DP 18.8 mm³ vs 41.9 DP 16.4 mm³; p=0.014, porém o relativo foi semelhante (2.9 DP 1.0 mm³/mm stent vs 2.5 DP 0.9 mm³/mm stent; p=0.108. A obstrução volumétrica da luz também foi similar (36.4 DP 11.1% vs 37.9 DP 10.9%; p=0.505. O diâmetro mínimo da luz (1.9 DP 0.7 mm vs 1.8 DO 0.6 mm; p=0.552, a reestenose (19.1% vs 17%; p>0.999 e a revascularização do vaso-alvo (16% vs 14%; p>0.999 não diferiram. CONCLUSÃO: Os stents revestidos apresentaram resultados clínicos, angiográficos e ultra-sonográficos similares aos controles.OBJECTIVE: In-stent restenosis remains a major limitation following coronary stent implantation. Amorphous

  14. É possível diferenciar derrames pleurais linfocíticos secundários a tuberculose ou linfoma através de variáveis clínicas e laboratoriais? Differentiating between tuberculosis-related and lymphoma-related lymphocytic pleural effusions by measuring clinical and laboratory variables: Is it possible?

    Leila Antonangelo; Francisco Suso Vargas; Eduardo Henrique Genofre; Caroline Maris Neves de Oliveira; Lisete Ribeiro Teixeira; Roberta Karla Barbosa de Sales

    2012-01-01

    OBJETIVO: Descrever características clínicas e laboratoriais em pacientes com derrames pleurais linfocíticos secundários a tuberculose ou linfoma, a fim de identificar as variáveis que possam contribuir no diagnóstico diferencial dessas doenças. MÉTODOS: Estudo retrospectivo com 159 pacientes adultos HIV negativos com derrame pleural linfocítico secundário a tuberculose ou linfoma (130 e 29 pacientes, respectivamente) tratados no Ambulatório da Pleura, Instituto do Coração, Hospital das Clíni...

  15. Primary Non-Hodgkins lymphoma of the parotid gland Linfomas malignos primários nas glandulas salivares

    Francesco Dispenza

    2011-10-01

    Full Text Available Primary malignant lymphomas in the salivary glands are relatively rare. Clinical presentation is not characteristic and the disease is often overlooked resulting in diagnosis and treatment delays. AIM: To stress the importance of the diagnostic process and combined management, we present a series of eight patients with malignant lymphoma of the parotid who were diagnosed only after surgery and managed with radiation and chemotherapy. METHODS: Retrospective series of patients with primary malignant lymphoma of the parotid gland managed with radiotherapy and diagnostic surgical partial resection. RESULTS: After treatment completion we achieved a loco-regional control rate of 87.5%. Toxicity was charted according to the Common Toxicity Criteria and it was seen in six patients (75%. Six patients are still alive without evidence of recurrent disease in their last follow-up. CONCLUSION: Our study confirms that primary early stage Non-Hodgkin Lymphoma of the parotid gland is a disease with an excellent prognosis and a good local control rate, with minimal morbidity.Linfomas primários das glândulas salivares são relativamente raros. Sua apresentação clínica não écaracterística e, frequentemente, a doença passa despercebida, resultando em atrasos no diagnóstico e tratamento. OBJETIVO: Enfatizar a importância do diagnóstico e tratamento combinado. Apresentamos uma casuística de oito pacientes com linfoma maligno da parótida, que foram diagnosticados somente após a cirurgia e tratados com radio e quimioterapia. MÉTODOS: Estudo retrospectivo de pacientes com linfoma maligno primário da glândula parótida, tratados com radioterapia e ressecção cirúrgica parcial diagnóstica. RESULTADOS: Após a conclusão do tratamento, atingimos uma taxa de controle loco-regional de 87,5%. A toxicidade foi classificada de acordo com os Critérios Comuns de Toxicidade e afetou seis pacientes (75%. Seis pacientes ainda estão vivos, sem evidência de

  16. Linfoma do sistema nervoso central: ensaio iconográfico

    Fabiano Reis

    2013-04-01

    Full Text Available Ilustramos este ensaio iconográfico de linfoma do sistema nervoso central com imagens de ressonância magnética obtidas em nosso serviço nos últimos 13 anos e discutimos algumas das principais características radiológicas deste tipo de linfoma, primário e secundário. O linfoma sistema nervoso central é um tumor relativamente infrequente, mas alguns achados na ressonância magnética podem sugerir este diagnóstico.

  17. Linfoma do sistema nervoso central: ensaio iconográfico

    2013-01-01

    Ilustramos este ensaio iconográfico de linfoma do sistema nervoso central com imagens de ressonância magnética obtidas em nosso serviço nos últimos 13 anos e discutimos algumas das principais características radiológicas deste tipo de linfoma, primário e secundário. O linfoma sistema nervoso central é um tumor relativamente infrequente, mas alguns achados na ressonância magnética podem sugerir este diagnóstico.

  18. Linfoma não Hodgkin gástrico Gastric non-Hodgkin Lymphoma

    Renata O. Costa; Abrahão E. Hallack Neto; Dalton A.F. Chamone; Vera Lúcia Aldred; Luis F. Pracchia; Juliana Pereira

    2010-01-01

    Os linfomas extralinfonodais representam aproximadamente 1/3 de todos os linfomas não Hodgkin (LNH) e, embora possam ter início em qualquer tecido, mais frequentemente acometem o trato gastrointestinal, sendo o estômago o órgão responsável pela grande maioria dos casos. Os linfomas primários gástricos são comumente LNH, sendo representados em mais de 95% dos casos pelo linfoma difuso de grandes células B e pelo linfoma MALT (mucosa associated lymphoid tissue). De evolução indolente, o linfoma...

  19. Linfoma hepático primario: Evolución favorable con quimioterapia combinada con rituximab Primary hepatic lymphoma: favorable outcome with chemotherapy plus rituximab

    I. Serrano-Navarro

    2008-11-01

    Full Text Available Comunicamos el caso de una paciente con un linfoma hepático primario tratado con éxito con quimioterapia combinada con rituximab. Utilizando los "encabezamientos estándar para búsquedas bibliográficas informatizadas" (Medical Subject Heading revisamos los casos publicados hasta la fecha de esta infrecuente entidad.This article describes the case of a patient with a non-Hodgkin primary hepatic lymphoma who was successfully treated with chemotherapy combined with rituximab. Using the Medical Subject Headings the published reports of this rare entity were reviewed.

  20. Mucormicosis yeyunal en paciente con linfoma de Hodgkin Jejunal mucormycosis in a patient with Hodgkin's lymphoma

    B. Madrigal

    2008-08-01

    Full Text Available Comunicamos un caso de mucormicosis intestinal en un hombre de 46 años de edad, diagnosticado de enfermedad de Hodgkin clásica, estadio IV-B. Durante la primera fase de la quimioterapia, sufrió una hemorragia digestiva masiva secundaria a una úlcera yeyunal por zigomicosis tipo mucor, diagnosticada por biopsia endoscópica. El paciente fue tratado con antifúngicos y resección quirúrgica del intestino afectado. En la cirugía, se apreció una doble perforación yeyunal cubierta. El estudio anatomopatológico de la pieza confirmó el diagnóstico previo. Tras un año de seguimiento, el paciente está recuperado y su linfoma de Hodgkin en remisión completa. Tras una extensa revisión de la literatura, según nuestro conocimiento, este es el segundo caso publicado en la literatura de mucormicosis intestinal en un paciente con linfoma de Hodgkin.We report a case of intestinal mucormycosis in a 46-year-old male diagnosed with classical Hodgkin's disease, IV-B stage. During the first phase of chemotherapy he had a massive digestive bleeding event secondary to a jejunal ulcer, and zygomicosis mucor-type was diagnosed by endoscopic biopsy. The patient was treated with antifungal drugs and surgical resection of the intestine involved. At surgery a double covered perforation of the jejunum was seen. Pathological examination confirmed the previous diagnosis. After one year of follow-up the patient is doing well, and his lymphoma is on remission. To our best knowledge this is the second case of intestinal mucormycosis in a patient with Hodgkin's lymphoma reported in the medical literature.

  1. Intravascular "mulberry-like" bodies

    Sørensen, Flemming Brandt; Klebe, J G; Henriques, U V

    1988-01-01

    Intravascular "mulberry-like" bodies in a stillborn female infant with moderate maceration are reported. The histogenesis of these structures is discussed based on light-microscopic, immunohistochemical and ultrastructural findings. No demonstrable causal relation between the intravascular lesions...

  2. Intravascular synovial sarcoma.

    Robertson, N. J.; Halawa, M H; Smith, M E

    1998-01-01

    A case of intravascular biphasic synovial sarcoma arising from the wall of the left femoral vein in a 34 year old woman is described. This is the third case of an intravascular synovial sarcoma known to be reported in the medical literature. The two previous cases arose from the left femoral vein and inferior vena cava in women of 34 and 31 years old, respectively. A characteristic clinical pattern appears to be emerging--that is, location in large veins of the lower extremity and trunk in yo...

  3. Linfoma esplénico de la zona marginal

    Ariel Bello

    2015-01-01

    Full Text Available Los linfomas no Hodgkin son un grupo de neoplasias que afectan los ganglios linfáticos y/o el tejido linfoide extraganglionar. Su frecuencia ha ido en ascenso en los últimos años. Según la clasificación de la OMS para los linfomas no Hodgkin, los linfomas esplénicos de la zona marginal (LEZM son neoplasias de las células B maduras que constituyen menos de 2% de todos estos tipos de linfomas. Se presenta el caso de un paciente de 58 años, quien consultó por presentar fiebre prolongada, asociado a pérdida de peso, pancitopenia y esplenomegalia masiva no dolorosa. Después de realizar múltiples estudios, los cuales resultaron negativos, se decide realizar esplenectomía diagnóstica y terapéutica. Se obtiene en resultado de histología resultado compatible con linfoma esplénico de la zona marginal. Posteriormente, paciente presenta mejoría exitosa de todos sus síntomas y es dado de alta del hospital. (Acta Med Colomb 2015; 40: 62-65.

  4. Harmonic Intravascular Ultrasound

    M.E. Frijlink (Martijn)

    2006-01-01

    textabstractMedical ultrasound is a popular imaging modality in cardiology. Harmonic Imaging is a technique that has been shown to increase the image quality of diagnostic ultrasound at frequencies below 10 MHz. However, Intravascular Ultrasound, which is a technique to acoustically investigate arte

  5. Intravascular Ultrasonic Imaging

    Tobis, JM; Mahon, D.; Moriuchi, M; Mallery, JA; Lehmann, K; Griffith, J.; Gessert, J; Zalesky, P; McRae, M; Dwyer, ML; Henry, WL

    1990-01-01

    Because conventional imaging methods are inadequate for evaluating human coronary arteries in vivo, an intravascular ultrasonic imaging catheter was developed that allows the arterial wall to be studied in cross-section from within the artery. The catheter incorporates a mechanically rotating 20-MHz transducer, which is designed so that the ringdown occurs within the catheter and imaging is permitted up to the catheter's surface. The device rotates at 1800-rpm within a plastic sleeve and prov...

  6. Linfoma de Burkitt en un portador de granulomatosis de Wegener

    Kryssia Rodríguez-Castro

    2005-10-01

    Full Text Available Se reporta el caso de un paciente costarricense portador de granulomatosis de Wegener, en tratamiento con ciclofosfamida y prednisona, quien desarrolla un linfoma de Burkitt que lo lleva a la muerte. Se menciona la posible relación entre estas dos patologías.

  7. Comprometimento medular por linfoma tipo Burkitt: relato de um caso

    Murillo Côrtes Drummond

    1985-06-01

    Full Text Available Registro de caso de linfoma tipo Burkitt com comprometimento intrarraqueano em criança de três anos de idade. Considerações sobre esse tipo de tumor são feitas em função do caso observado e de dados da literatura.

  8. How Is Disseminated Intravascular Coagulation Treated?

    ... the NHLBI on Twitter. How Is Disseminated Intravascular Coagulation Treated? Treatment for disseminated intravascular coagulation (DIC) depends ... and treat the underlying cause. Acute Disseminated Intravascular Coagulation People who have acute DIC may have severe ...

  9. LINFOMA T DE TIPO ANGIOINMUNOBLASTICO: ESTUDIO CLÍNICO-PATOLÓGICO DEL GRUPO DE ESTUDIO DE LINFOMAS DE JUJUY (GELJ

    Ana Carolina Ituarte

    2005-01-01

    Full Text Available ABSTRACTJujuy have a high incidence of lymphomas and among these a high number of T-cell lymphomas is observed. However the Angioimmunoblastic T-cell Lymphoma once a best characterized T-cell lymphomas, was not studied in Jujuy in both, incidence and clinicopathologic features. These lymphoma present a characteristic clinical findings and a distinctive histopathological picture with T-cell immunophenotype that permit a clear differentiation from other peripheral T-cell lymphomas.Angioimmunoblastic Peripheral T-cell lymphoma represent the 9,1% of our cases of lymphomas, registered between 1985 and July 2004, when we consider nodal and extranodal cases, but represent 18% among the nodal lymphomas. All the cases studied presenting the distinctive histopathologic picture, with effacement of the lymph node architecture, absence of germinal centers, polymorphic cytology, marked increase of arborizing vessel PAS-positive and accumulations of Follicular Dendritic Reticular Cells, CD21+. Clinically we observed generalized lymphadenopaty, skin lesions, pulmonary manifestations, systemic symptoms and aggressive behavior.RESUMEN:Jujuy es una zona de alta incidencia de linfomas y entre ellos se registra un elevado número de linfomas de células T. Pese a esto el linfoma T tipo linfadenopatía Angioinmunoblastica, uno de los mejor caracterizados linfomas de células T, no ha sido estudiado, tanto en su incidencia, como en sus caracteres clínico-patológicos. Estos linfomas presentan un cuadro clínico característico y un distintivo cuadro histopatológico e inmunofenotípico, que permiten su diferenciación de otros tipos de linfomas T.Este linfoma representa el 9,1% de los casos registrados en nuestro hospital entre 1985 y julio de 2004, cuando se consideran casos ganglionares y extraganglionres y el 18% de los casos ganglionares. Presentan el característico cuadro histopatológico con borramiento de la histoarquitectura ganglionar linfática, citolog

  10. Linfoma não-Hodgkin de órbita: relato de caso Non-Hodgkin orbital lymphoma: case report

    Cristiane do Prado Silva

    2008-04-01

    Full Text Available O objetivo é relatar manifestação incomum de linfoma não-Hodgkin de órbita. Paciente masculino, de 75 anos, se apresentou com queixa de lacrimejamento crônico bilateral. Havia feito dacriocistorrinostomia endonasal à direita e à esquerda por duas vezes, sem sucesso. Ao exame, massas de consistência fibroelástica, em topografia das "bolsas" de gordura das pálpebras inferiores e proptose axial. O paciente negava outros sintomas ou sinais sistêmicos. Hemograma sem alteração, hormônios tireoidianos normais. A tomografia computadorizada mostrava infiltrado difuso na órbita e proptose axial. Biópsia de gordura orbitária e de medula óssea diagnosticaram linfoma não-Hodgkin. O paciente foi tratado com quimioterapia, sendo em seguida submetido à cirurgia da via lacrimal bilateral, com resolução do quadro. A doença sistêmica que exigia diagnóstico e tratamento adequados para que se tivesse bom prognóstico estava mascarada pelo quadro de epífora bilateral.The purpose is to report an unusual case of orbital non-Hodgkin lymphoma. A 75-year-old man presented with bilateral chronic epiphora complaint and inferior eyelid tumors, axial proptosis, without previous systemic manifestation. The patient was submitted to bilateral endonasal dacryocystorhinostomy twice and the epiphora complaint persisted. The inferior eyelid and bone marrow biopsy revealed non-Hodgkin lymphoma. The patient was treated with systemic chemotherapy and dacryocystorhinostomy with good resolution. The precise diagnosis and the treatment were very important to reach a good resolution of the bilateral epiphora complaint.

  11. Disseminated intravascular coagulation.

    Gando, Satoshi; Levi, Marcel; Toh, Cheng-Hock

    2016-01-01

    Disseminated intravascular coagulation (DIC) is an acquired syndrome characterized by widespread intravascular activation of coagulation that can be caused by infectious insults (such as sepsis) and non-infectious insults (such as trauma). The main pathophysiological mechanisms of DIC are inflammatory cytokine-initiated activation of tissue factor-dependent coagulation, insufficient control of anticoagulant pathways and plasminogen activator inhibitor 1-mediated suppression of fibrinolysis. Together, these changes give rise to endothelial dysfunction and microvascular thrombosis, which can cause organ dysfunction and seriously affect patient prognosis. Recent observations have pointed to an important role for extracellular DNA and DNA-binding proteins, such as histones, in the pathogenesis of DIC. The International Society on Thrombosis and Haemostasis (ISTH) established a DIC diagnostic scoring system consisting of global haemostatic test parameters. This scoring system has now been well validated in diverse clinical settings. The theoretical cornerstone of DIC management is the specific and vigorous treatment of the underlying conditions, and DIC should be simultaneously managed to improve patient outcomes. The ISTH guidance for the treatment of DIC recommends treatment strategies that are based on current evidence. In this Primer, we provide an updated overview of the pathophysiology, diagnosis and management of DIC and discuss the future directions of basic and clinical research in this field. PMID:27250996

  12. Linfoma de celulas B de la zona marginal extraganglionar del tejido linfoide asociado a mucosa (linfoma MALT) de pulmón

    Carlos Vergara-Uzcategui; Melizabeth Ruiz

    2014-01-01

    Los Linfomas Pulmonares Primarios son extremadamente raros (0,4% de los linfomas extraganglionares), y generalmente son de tejido linfoide asociado a mucosas (tipo MALT), con ocasionales linfomas de células grandes difusos. Los síntomas son inespecíficos, y casi la mitad de los pacientes son asintomáticos. Se presenta el caso de un paciente masculino de 56 años de edad, quien presentó durante 7 meses accesos diarios de tos seca, de predominio nocturno, asociados en el último mes a fiebre de 3...

  13. Linfoma de Burkitt en un portador de granulomatosis de Wegener

    Kryssia Rodríguez-Castro; Henry Zamora-Barquero

    2005-01-01

    Se reporta el caso de un paciente costarricense portador de granulomatosis de Wegener, en tratamiento con ciclofosfamida y prednisona, quien desarrolla un linfoma de Burkitt que lo lleva a la muerte. Se menciona la posible relación entre estas dos patologías.This is a report of a costarrican male with Wegener' s granulomatosis undergoing treatment with prednisone and cyclophosphamide, he developed a fatal Burkitt' s lymphoma. The possible relationship between these two disorders is addressed.

  14. Linfoma de Burkitt en un portador de granulomatosis de Wegener

    Kryssia Rodríguez-Castro

    2005-10-01

    Full Text Available Se reporta el caso de un paciente costarricense portador de granulomatosis de Wegener, en tratamiento con ciclofosfamida y prednisona, quien desarrolla un linfoma de Burkitt que lo lleva a la muerte. Se menciona la posible relación entre estas dos patologías.This is a report of a costarrican male with Wegener' s granulomatosis undergoing treatment with prednisone and cyclophosphamide, he developed a fatal Burkitt' s lymphoma. The possible relationship between these two disorders is addressed.

  15. Dosimetry in intravascular brachytherapy

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing 32 P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  16. Actualidad clínica-biológica de los linfomas T cutáneos

    María E. Faxas García

    2003-01-01

    Los linfomas cutáneos resultan modelos útiles para el estudio de los mecanismos patogénicos de las enfermedades linfoproliferativas dado que para el diagnóstico y el seguimiento, las muestras de tejido se obtienen a través de métodos no invasivos. Aunque los linfomas T cutáneos se desarrollan a partir de los linfocitos T residentes en la piel, otras células y diversos factores asociados al tejido linfoide participan en la linfomagénesis. La aparición de estos linfomas en la piel no excluye la...

  17. Linfoma primario de hueso con afectación multicéntrica

    Marcelo Graziadio; Natalia Medina; Marcelo Amato; María del Carmen Ardaiz; Santiago Ilutovich; Marcelo Torino

    2012-01-01

    El linfoma primario de hueso es una enfermedad infrecuente, que tiene una presentación y evolución diferente a los linfomas de otras localizaciones. Se presenta un caso de linfoma primario de hueso de localización craneana y esternal de rápido crecimiento. En su evolución, realizada la exéresis de la lesión primaria de calota, presentó aparición de nuevas lesiones de rápido crecimiento a nivel craneano y fémur y progresión de lesión preesternal que, con anatomía patológica de linfoma no Hodgk...

  18. Intravascular Stenting in Microvascular Anastomoses

    Assersen, Kristine; Sørensen, Jens

    2015-01-01

    Background The effect of intravascular stenting (IVaS) on microvascular anastomoses has given adverse results. For experienced microsurgeons the benefit of IVaS is doubtful. We have investigated the potential benefit of the IVaS technique for two groups of inexperienced microsurgeons with differe...

  19. Linfoma não Hodgkin gástrico Gastric non-Hodgkin Lymphoma

    Renata O. Costa

    2010-02-01

    Full Text Available Os linfomas extralinfonodais representam aproximadamente 1/3 de todos os linfomas não Hodgkin (LNH e, embora possam ter início em qualquer tecido, mais frequentemente acometem o trato gastrointestinal, sendo o estômago o órgão responsável pela grande maioria dos casos. Os linfomas primários gástricos são comumente LNH, sendo representados em mais de 95% dos casos pelo linfoma difuso de grandes células B e pelo linfoma MALT (mucosa associated lymphoid tissue. De evolução indolente, o linfoma MALT destaca-se por ser um modelo de câncer secundário à estimulação antigênica crônica exercida por uma bactéria denominada Helicobacter pylori (HP. No outro polo, situa-se o linfoma difuso de células B (LDGCB, que, de patogênese duvidosa, pode tratar-se de uma transformação de LNH MALT ou ainda se caracterizar por um linfoma "de novo". Neste estudo, revisamos a literatura, enfatizando aspectos importantes à prática clínica destes linfomas.Extranodal lymphomas account for about 30% of all non-Hodgkin lymphomas (NHL, and although they can originate in any tissue, the gastrointestinal tract is the most commonly affected structure with the stomach being the most common subtype. Diffuse Large B cell lymphoma (DLBCL and MALT (mucosa associated lymphoid tissue lymphoma account for more than 95% of the cases of gastric lymphoma. The indolent development of MALT lymphoma stands out as it is a type of cancer subject to chronic antigen stimulation by the Helicobacter pylori bacteria. Conversely, diffuse large B cell lymphomas, whose pathogenesis is uncertain, can be a transformation from MALT NHL or perhaps a new type of lymphoma. In this study we carried out a review of the literature, stressing the key aspects of these lymphomas in the clinical practice.

  20. Linfoma de celulas B de la zona marginal extraganglionar del tejido linfoide asociado a mucosa (linfoma MALT de pulmón

    Carlos Vergara-Uzcategui

    2014-09-01

    Full Text Available Los Linfomas Pulmonares Primarios son extremadamente raros (0,4% de los linfomas extraganglionares, y generalmente son de tejido linfoide asociado a mucosas (tipo MALT, con ocasionales linfomas de células grandes difusos. Los síntomas son inespecíficos, y casi la mitad de los pacientes son asintomáticos. Se presenta el caso de un paciente masculino de 56 años de edad, quien presentó durante 7 meses accesos diarios de tos seca, de predominio nocturno, asociados en el último mes a fiebre de 39ºC, disnea a medianos esfuerzos y expectoración verduzca. Los exámenes de laboratorio fueron normales. La radiografía de tórax mostró el mediastino ensanchado, un proceso en lóbulo medio con efecto atelectásico, y un nódulo en hemitórax izquierdo. La tomografía computarizada (TC torácica de alta resolución evidenció proceso alveolar derecho en lóbulo medio y un nódulo pulmonar izquierdo calcificado de tipo inespecífico. El estudio inmunohistoquímico de la biopsia pulmonar fue compatible con Linfoma de Células B de la zona marginal extraganglionar del tejido linfoide asociado a mucosa (Linfoma MALT de pulmón. La TC corporal y la Tomografía por Emisión de Positrones (PET evidenciaron importantes hallazgos complementarios para determinar la extensión de la enfermedad. El paciente se trato con quimioterapia y actualmente se encuentra en buenas condiciones, sin recidiva de la sintomatología. Dado lo infrecuente de la patología se presenta este caso y se hace una revisión de la literatura

  1. Spontaneous intravascular platelet aggregation in angiographic studies

    The process of intravascular platelet aggregation is activated in angiographic clinical studies using 76% Verografin solution. It has been shown in experiments op rats that verografin (2 ml/kg) and iodamide (2 ml/ kg) together with the activation of intravascular platelet aggregation inhibit antiaggregation properties of the vascular wall

  2. Linfoma primario bilateral de la glándula parótida

    Mena Domínguez, Eduardo Antonio; Torres Morientes, Luis M.; Millás Gómez, Teresa; Tavárez Rodríguez, Juan José; Bauer, Michael; Morais Pérez, Darío

    2012-01-01

    [ES] Los linfomas primarios de las glándulas salivales representan menos del 1% de todos los linfomas no Hodgkin (LNH). Se presentan entre los 50 y 80 años, con predominio claro en mujeres y en la glándula parótida. La mayoría de los casos son localizados (estadios I-II: 75- 100%), y presentan síntomas debido a la aparición de una tumoración en la glándula afectada, generalmente indolora. [EN] Primary Lymphoma of the salivary glands represent less than 1% of all non-Hodgkin's ...

  3. Tejido linfoide y linfomas gástricos Lymphoid tissue and gastric lymphomas

    Rocío del Pilar López P

    Full Text Available En este artículo hemos realizado una amplia revisión de los linfomas primarios gástricos, su clasificación y aspectos clínico-patológicos más importantes, haciendo énfasis especial en los linfomas MALT o asociados a las mucosas y su relación con la infección por Helicobacter pylori.In this review we describe various aspects of the primary gastric lymphomas, the classification, and the most important clinico-pathological aspects, with emphasis in mucosa associated lymphoma (MALT and the Helicobacter pylori infection.

  4. Coagulación intravascular diseminada = Disseminated intravascular coagulation

    Arango Barrientos, Marcos

    2010-01-01

    La coagulación intravascular diseminada (CID) es una entidad clínica frecuente que se presenta como fenómeno secundario a diversas enfermedades entre las cuales se destacan las infecciones graves, las neoplasias y las catástrofes obstétricas. Se caracteriza por una activación difusa y simultánea de los sistemas endógenos de la coagulación y la fibrinólisis. El depósito de pequeños trombos en la circulación conduce finalmente a disfunción orgánica múltiple y en algunos casos a la muerte. Las m...

  5. 21 CFR 870.3375 - Cardiovascular intravascular filter.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiovascular intravascular filter. 870.3375... Cardiovascular intravascular filter. (a) Identification. A cardiovascular intravascular filter is an implant that... and Revision of 2/12/90 (K90-1)” and (ii) “Guidance for Cardiovascular Intravascular Filter...

  6. Linfoma primário de cavidade pleural em paciente imunocompetente Primary effusion lymphoma in an immunocompetent patient

    Leila Antonangelo

    2005-12-01

    Full Text Available O linfoma primário de cavidade é um tipo raro de linfoma não-Hodgkin que acomete principalmente pacientes imunocomprometidos e, mais raramente, pacientes imunocompetentes. Neste relato de caso são apresentados os achados clínicos e laboratoriais de um paciente imunocompetente com derrame pleural diagnosticado como linfoma primário de cavidade pleural.Primary effusion lymphoma is an unusual non-Hodgkin's lymphoma rarely seen in immunocompetent patients. Herein, we present clinical and biochemical data obtained from an immunocompetent patient diagnosed with primary effusion lymphoma.

  7. Linfoma primário de cavidade pleural em paciente imunocompetente Primary effusion lymphoma in an immunocompetent patient

    Leila Antonangelo; Francisco S. Vargas; Lisete Ribeiro Teixeira; Marcelo A.C. Vaz; Maria Mirtes Sales; Luis C Moreira; Roberta Karla Barbosa de Sales

    2005-01-01

    O linfoma primário de cavidade é um tipo raro de linfoma não-Hodgkin que acomete principalmente pacientes imunocomprometidos e, mais raramente, pacientes imunocompetentes. Neste relato de caso são apresentados os achados clínicos e laboratoriais de um paciente imunocompetente com derrame pleural diagnosticado como linfoma primário de cavidade pleural.Primary effusion lymphoma is an unusual non-Hodgkin's lymphoma rarely seen in immunocompetent patients. Herein, we present clinical and biochemi...

  8. CNS Intravascular Lymphoma: A Case Report

    Amer Awad

    2011-01-01

    Full Text Available Intravascular lymphoma is a rare but well-described entity. The clinical manifestations are heterogeneous. We report a case of a 59-year-old woman who presented initially with syncope followed by subacute cognitive decline that progressed to minimally conscious state. Shortly after the transfer to our tertiary center the patient died. Brain autopsy disclosed the diagnosis of B-cell intravascular lymphoma. We speculate that syncope could be the first manifestation of central nervous system intravascular lymphoma and should be considered in the differential diagnosis of unexplained syncope. In addition, we stress the importance of early brain biopsy in unexplained white matter disease.

  9. Iatrogenic intravascular pneumocephalus secondary to intravenous catheterization

    The presence of pneumocephalus without a history of intracranial or intrathecal procedures is a significant radiographic finding. Although pneumocephalus means a violation of the dural barrier or the presence of infection, intravascular pneumocephalus is different from intraparenchymal pneumocephalus and its benign nature must be known in the presence of intravenous catheterization. Herein, we present a case of iatrogenic intravascular pneumocephalus with CT findings. To our knowledge, there are only a few reported cases of iatrogenic intravascular pneumocephalus in the literature. Careful intravenous catheterization and diagnosis of the condition on imaging helps to prevent unnecessary treatment procedures. (orig.)

  10. Linfoma primario de hueso con afectación multicéntrica

    Marcelo Graziadio

    2012-10-01

    Full Text Available El linfoma primario de hueso es una enfermedad infrecuente, que tiene una presentación y evolución diferente a los linfomas de otras localizaciones. Se presenta un caso de linfoma primario de hueso de localización craneana y esternal de rápido crecimiento. En su evolución, realizada la exéresis de la lesión primaria de calota, presentó aparición de nuevas lesiones de rápido crecimiento a nivel craneano y fémur y progresión de lesión preesternal que, con anatomía patológica de linfoma no Hodgkin difuso de células grandes B, inició R-CHOPP (ciclofosfamida, doxorrubicina, vincristina, prednisona y rituximab con rápida disminución de todas las lesiones sin evidencia de progresión al cabo de los seis ciclos.

  11. Efectos tardíos y el linfoma de Hodgkin en estadio inicial

    Los pacientes con linfoma de Hodgkin en estadio inicial que recibieron varios fármacos de quimioterapia como único tratamiento, tenían más probabilidad de sobrevivir 12 años después que los pacientes que recibieron tratamiento que incluía radioterapia.

  12. Disseminated Intravascular Coagulation in Infectious Disease

    M. Levi; M. Schultz; T. van der Poll

    2010-01-01

    Severe infection and inflammation almost invariably lead to hemostatic abnormalities, ranging from insignificant laboratory changes to severe disseminated intravascular coagulation. Systemic inflammation as a result of severe infection leads to activation of coagulation, due to tissue factor-mediate

  13. Linfoma renal: espectro de imagens na tomografia computadorizada Renal lymphoma: spectrum of computed tomography findings

    Carol Pontes de Miranda Maranhão

    2005-04-01

    Full Text Available O acometimento renal no linfoma é raro, uma vez que o rim não possui tecido linfóide. O envolvimento secundário é mais freqüente, ocorrendo em até um terço das autópsias dos portadores de linfoma. Alguns autores acreditam que esta seja a única forma de acometimento renal, questionando a existência do linfoma primário. O linfoma renal representaria metástases hematogênicas ou invasão direta do tumor ocorrendo no espaço perirrenal. A partir destes tipos de envolvimento decorrem as formas de apresentação do linfoma renal: múltiplos nódulos, massa solitária, invasão renal por doença retroperitoneal contígua, doença perirrenal e infiltração difusa. Neste trabalho são discutidas e apresentadas imagens destas diferentes formas de acometimento.Isolated renal lymphoma is rare due to the absence of lymphoid tissue in kidneys. Secondary involvement occurs more frequently and is reported in up to 1/3 of the autopsies of patients who died from lymphoma. Some authors believe this is actually the only existing form of renal lymphoma. The involvement of the kidney by lymphoma would occur through hematogenic metastasis or direct tumor invasion of the perirenal space. These different types of involvement determine the several forms of renal lymphoma presentation: multiple nodules, solitary mass, renal invasion from contiguous retroperitoneal disease, perirenal disease and diffuse infiltration. In this study the imaging findings features of the different forms of involvement are presented and discussed.

  14. Intravascular ultrasound imaging following balloon angioplasty.

    Tobis, J M; Mahon, D J; Moriuchi, M; Honye, J; McRae, M

    1991-01-01

    Despite its long history and reliability, contrast angiography has several inherent limitations. Because it is a two-dimensional projection image of the lumen contour, the wall thickness cannot be measured and the plaque itself is not visualized. This results in an underestimation of the amount of atherosclerotic disease by angiography. An assessment of atherosclerosis could be improved by an imaging modality: (1) that has an inherent larger magnification than angiography and (2) that directly visualizes the plaque. Intravascular ultrasound fulfils these criteria. This presentation will provide evidence that intravascular ultrasound may prove complimentary or even superior to angiography as an imaging modality. Intravascular ultrasound demonstrates excellent representations of lumen and plaque morphology of in vitro specimens compared with histology. There is very close intraobserver and interobserver variability of measurements made from intravascular ultrasound images. Phantom studies of stenoses in a tube model demonstrate that angiography can misrepresent the severity of stenosis when the lumen contour is irregular and not a typical ellipse, whereas intravascular ultrasound reproduces the cross-sectional morphology more accurately since it images the artery from within. In vitro studies of the atherosclerotic plaque tissue characteristics compare closely with the echo representation of fibrosis, calcification, and lipid material. In addition, in vitro studies of balloon angioplasty demonstrate that intravascular ultrasound accurately represents the changes in the structure of artery segments following balloon dilatation. PMID:1833473

  15. Dosimetric calculus in intravascular brachytherapy

    Among the cardiovascular diseases, the most common is acute myocardial infarction, which occurs because of the occlusion of one or more coronary arteries. Balloon angioplasty has been a popular treatment which is less invasive than surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment). Known as Intravascular Brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis. In order to study the radiation dosimetry in the patient and radiological protection for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, 0.30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several radionuclides. Two stent sources employing 32P are also simulated. Advantages and disadvantages of the radionuclides and source geometries are discussed and the dosimetry developed here will aid in the realization of the benefits obtained in patients. (author)

  16. Dosimetry in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

    Campos, Laelia Pumilla Botelho

    2000-03-01

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing {sup 32} P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  17. Coagulación intravascular diseminada = Disseminated intravascular coagulation

    Arango Barrientos, Marcos

    2010-12-01

    Full Text Available La coagulación intravascular diseminada (CID es una entidad clínica frecuente que se presenta como fenómeno secundario a diversas enfermedades entre las cuales se destacan las infecciones graves, las neoplasias y las catástrofes obstétricas. Se caracteriza por una activación difusa y simultánea de los sistemas endógenos de la coagulación y la fibrinólisis. El depósito de pequeños trombos en la circulación conduce finalmente a disfunción orgánica múltiple y en algunos casos a la muerte. Las manifestaciones clínicas pueden incluir fenómenos trombóticos y hemorrágicos. Se ha propuesto un puntaje de fácil aplicación para simplificar el diagnóstico de la entidad. El tratamiento incluye el control específico de la causa subyacente que favorece la aparición de la CID, el soporte con hemoderivados en pacientes con manifestaciones de sangrado y la anticoagulación terapéutica en pacientes con trombosis mayores. El desarrollo de CID es un factor pronóstico adverso que aumenta significativamente la tasa de mortalidad. En este artículo de revisión se incluyen los siguientes aspectos de la CID: historia, epidemiología, clasificación, entidades asociadas, fisiopatología, clínica, diagnóstico, tratamiento y pronóstico.

  18. T-lymphoblastic lymphoma in adults Linfoma linfoblástico-T em adultos

    Gino Santini

    2009-08-01

    Full Text Available In this short opinion review we discuss recent aspects of T-lymphoma lymphoblastic adults, like the evolution of the knowledge of classification, prognostic factors and the patients management.Nesta breve revisão os autores apresentam diversos aspectos de evolução dos conhecimentos na classificação e no manuseio dos pacientes portadores de linfoma linfoblástico-T em adultos.

  19. 21 CFR 880.5440 - Intravascular administration set.

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intravascular administration set. 880.5440 Section... Therapeutic Devices § 880.5440 Intravascular administration set. (a) Identification. An intravascular administration set is a device used to administer fluids from a container to a patient's vascular system...

  20. Simultaneous occurrence of follicular lymphoma and mixed-cellularity Hodgkin's lymphoma: lymph node and extranodal involvement Ocorrência simultânea de linfoma folicular e linfoma de Hodgkin celularidade mista: envolvimento nodal e extranodal

    Maria do Patrocínio F. Grangeiro

    2004-02-01

    Full Text Available An unusual and well-characterised case of composite lymphoma in the spleen and lymph node is presented. The simultaneous occurrence of mixed-cellularity Hodgkin's lymphoma (HL and follicular non-Hodgkin's lymphoma (NHL was demonstrated in a 66-year-old man admitted in our Service with anaemia, hepatosplenomegaly and multiple abdominal lymph nodes. The morphological study of the spleen and lymph node of the splenic hilum showed an infiltrate composed of two distinct neoplasias. The liver was involved by NHL infiltrate and the peripancreatic lymph node exhibited HL. The Reed-Sternberg (RS cells expressed CD 15 and CD 30, whereas the NHL cells presented standard immunohistochemical features of follicular lymphoma. To our knowledge, this is the fifth case report of concurrent spleen involvement by composite lymphoma. The incidence, clinicopathological and immunohistochemical features of this rare association are discussed.Os autores apresentam um caso raro e bem caracterizado de linfoma composto no baço e linfonodos. A ocorrência simultânea de um linfoma de Hodgkin e um linfoma não-Hodgkin foi demonstrada em um homem de 66 anos admitido com anemia, hepatosplenomegalia e múltiplos linfonodos abdominais. O estudo morfológico do baço e linfonodo do hilo esplênico mostrou infiltração por duas neoplasias distintas. O fígado estava envolvido por linfoma não-Hodgkin e o linfonodo peripancreático mostrava um linfoma de Hodgkin. As células de Reed-Sternberg (RS expressaram CD 15 e CD 30, enquanto as células do linfoma não-Hodgkin apresentaram os aspectos imunoistoquímicos clássicos do linfoma folicular. Na literatura médica, este é o quinto caso descrito de envolvimento do baço por linfoma composto. A incidência, aspectos clínicos e imunoistoquímicos desta rara associação são discutidos.

  1. Biópsia estereotáxica para linfomas primários do sistema nervoso central

    MURILO S. MENESES; Brian P. O'Neill; Kelly, Patrick J.

    1992-01-01

    Os linfomas primários do SNC são raros, mas sua incidência tem aumentado nos últimos anos, Estes tumores frequentemente se localizam nos gânglios da base e tálamo ou se apresentam de forma multifocal. O tratamento atual para eles é a radioterapia, associada ou não a quimioterapia. Devido à sua extremamente baixa morbidade, a biópsia estereo-táxica é o método ideal para determinar o diagnóstico histológico em pacientes com suspeita de linfomas do SNC. Os autores apresentam estudo de 49 casos d...

  2. Intravascular photoacoustic imaging of human coronary atherosclerosis

    Jansen, Krista; van der Steen, Antonius F. W.; Springeling, Geert; van Beusekom, Heleen M. M.; Oosterhuis, J. Wolter; van Soest, Gijs

    2011-03-01

    We demonstrate intravascular photoacoustic imaging of human coronary atherosclerotic plaque. We specifically imaged lipid content, a key factor in vulnerable plaques that may lead to myocardial infarction. An integrated intravascular photoacoustics (IVPA) and ultrasound (IVUS) catheter with an outer diameter of 1.25 mm was developed. The catheter comprises an angle-polished optical fiber adjacent to a 30 MHz single-element transducer. The ultrasonic transducer was optically isolated to eliminate artifacts in the PA image. We performed measurements on a cylindrical vessel phantom and isolated point targets to demonstrate its imaging performance. Axial and lateral point spread function widths were 110 μm and 550 μm, respectively, for PA and 89 μm and 420 μm for US. We imaged two fresh human coronary arteries, showing different stages of disease, ex vivo. Specific photoacoustic imaging of lipid content, is achieved by spectroscopic imaging at different wavelengths between 1180 and 1230 nm.

  3. Temporary intravascular shunts for peripheral vascular trauma.

    Husain A

    1992-04-01

    Full Text Available Polyvinylchloride (PVC disposable endotracheal suction catheters were successfully used as temporary intravascular shunts in 5 patients of popliteal artery trauma. These simple shunts should be used routinely in such conditions to immediately re-establish blood supply to the ischaemic limb particularly in patients of polytrauma where systemic anticoagulation is contraindicated. This avoids the inherent delay prior to vascular repair and reduces the incidence of irreversible ischemia.

  4. The natural history of intravascular lymphomatosis

    Fonkem, Ekokobe; Lok, Edwin; Robison, David; Gautam, Shiva; Wong, Eric T

    2014-01-01

    Intravascular lymphomatosis (IVL) is a rare and clinically devastating form of extranodal B-cell non-Hodgkin's lymphoma. We performed a comprehensive analysis of the literature on IVL's published between 1959 and 2011 and evaluated the natural history as well as identified prognostic and predictive factors in patients. Nonparametric two-tailed Mann–Whitney U-test and Mantel–Cox log rank test were used to evaluate the survival intervals and prognostic factors. Multivariate analysis of variance...

  5. The basics of intravascular optical coherence tomography

    Roleder, Tomasz; Jąkała, Jacek; Kałuża, Grzegorz L.; Partyka, Łukasz; Proniewska, Klaudia; Pociask, Elżbieta; Zasada, Wojciech; Wojakowski, Wojciech; Gąsior, Zbigniew; Dudek, Dariusz

    2015-01-01

    Optical coherence tomography (OCT) has opened new horizons for intravascular coronary imaging. It utilizes near-infrared light to provide a microscopic insight into the pathology of coronary arteries in vivo. Optical coherence tomography is also capable of identifying the chemical composition of atherosclerotic plaques and detecting traits of their vulnerability. At present it is the only tool to measure the thickness of the fibrous cap covering the lipid core of the atheroma, and thus it is ...

  6. Actualidad clínica-biológica de los linfomas T cutáneos

    María E. Faxas García

    2003-03-01

    Full Text Available Los linfomas cutáneos resultan modelos útiles para el estudio de los mecanismos patogénicos de las enfermedades linfoproliferativas dado que para el diagnóstico y el seguimiento, las muestras de tejido se obtienen a través de métodos no invasivos. Aunque los linfomas T cutáneos se desarrollan a partir de los linfocitos T residentes en la piel, otras células y diversos factores asociados al tejido linfoide participan en la linfomagénesis. La aparición de estos linfomas en la piel no excluye la presencia de células malignas en la circulación y su desarrollo en otros órganos. Actualmente, la posibilidad de detectar las lesiones en estadios tempranos y la precisión de alteraciones en el receptor de células T permite ampliar el estudio de esta enfermedad.The cutaneous lymphomas are useful models for studying the etiopathogenic mechanisms of the lymphoproliferative diseases, since the samples of tissue are obtained through non invasive methods for the diagnosis and follow-up. Although the cutaneous T-cell lymphomas are developed from the T lymphocytes existing in the skin, other cells and diverse factors associated with the lymphoid tissues take part in the lymphomagenesis. The appearance of these lymphomas in the skin does not exclude the presence of malignant cells in the circulation and their development in other organs. Nowadays, the possibility of detecting the injuries in early stages and the accuracy of alterations in the T-cell receptor allows to extend the study of this disease.

  7. Intravascular iodinated contrast media and the anaesthetist.

    Dickinson, M C; Kam, P C A

    2008-06-01

    The use of intravascular iodinated contrast media (ICM) in radiological investigations is common. Increasingly, anaesthetists and intensivists are involved in the care of patients undergoing these investigations. Whilst the use of ICM is generally safe there are important adverse effects that need to be recognised and measures instigated to prevent or treat these effects. In patients at risk of developing adverse reactions it is important to consider alternative modes of imaging so that ICM can be avoided. Strategies for the prevention of ICM nephropathy should be considered in all patients receiving ICM. Currently intravascular volume expansion with 0.9% saline has the strongest evidence base. The use of isotonic sodium bicarbonate combined with N-acetylcysteine appears promising in providing further benefits. Although the use of N-acetylcysteine alone has not been shown to significantly reduce the incidence of ICM nephropathy it is cheap, has few adverse effects and it would seem reasonable to continue its use in conjunction with intravascular volume expansion. The routine use of corticosteroid and antihistamine premedication is not always effective in preventing general adverse reactions. PMID:18477275

  8. Linfoma primario del sistema nervioso central en una paciente con lupus eritematoso sistémico

    C. N. Pisoni; A. R. Grinberg; J. L. Plana; R. D. Freue; J. A. Manni; Paz, L.

    2003-01-01

    Se presenta una paciente de 36 años con diagnóstico de lupus eritematoso sistémico tratada con prednisona y ciclofosfamida que se internó por cefalea, hemiparesia y hemianestesia braquiocrural derecha de dos semanas de evolución. Se realizó una tomografía computada y una resonancia magnética nuclear de cerebro que mostraron una lesión nodular frontal izquierda. Se efectuó una biopsia a cielo abierto de la lesión cerebral cuyo diagnóstico histopatológico fue linfoma B de celulas grandes, difus...

  9. Actividad laboral en una cohorte de pacientes con linfoma non Hodgkin

    R. Molina Villaverde; J. Feliu Batle; A. Villalba Yllan; A.M. Jiménez Gordo; B. San José Valiente; González Barón, M

    2008-01-01

    Introducción. La actividad laboral en el cáncer es un aspecto psicosocial que ha recibido poca atención hasta el momento actual, a pesar de considerarse una dimensión de la calidad de vida para estos pacientes. Objetivos. La reinserción y adaptación al entorno laboral fueron investigados en una cohorte de pacientes con linfoma no Hodgkin para describir los factores que influyen en la vuelta al trabajo de estos enfermos. Pacientes y métodos. El estudio incluyó 37 pacientes consecutivos diagnos...

  10. Linfoma cutáneo de células B grande de las piernas: presentación de un caso

    Idalmis Campollo Rodríguez; Mauricio Socarrás Laborda; Patricia Alejandra Castro Sánchez

    2011-01-01

    Introducción: los linfomas cutáneos primarios de células B se definen como una proliferación neoplásica de células B que se originan en la piel. El linfoma de células B grande de las piernas, es un linfoma agresivo con un predominio de células B grande que se presenta en las extremidades inferiores. Existen múltiples clasificaciones con diferentes nomenclaturas; debido a la accesibilidad de la piel resulta relativamente sencillo tomar una biopsia, con lo que se obtienen muestras de lesiones p...

  11. Estratificação de risco em linfoma difuso de grandes células B Risk stratification of large B-cell lymphomas

    Abrahão E. Hallack Neto; Juliana Pereira; Rosaura Saboya; Beatriz Beitler; Luis Fernando Pracchia; Frederico L. Dulley; Dalton A. F. Chamone

    2006-01-01

    O linfoma difuso de grandes células B (LDGCB) é uma entidade clínico-patológica heterogênea que corresponde de 30% a 35% dos casos de linfoma não-Hodgkin (LNH). É considerado como agressivo porque a sobrevida é curta na ausência de tratamento adequado. Desde 1993 o tratamento deste linfoma passou a ser direcionado pelo índice internacional de prognóstico (IPI) validado em vários estudos. Entretanto, diante das diferentes respostas à mesma terapêutica para pacientes de mesmo IPI houve necessid...

  12. Esquistossomose: 1.000 pacientes tratados

    Pedro Aquino Noleto

    1974-12-01

    Full Text Available Os autores relatam sua experiência com o hycanthone em 1.000 pacientes de esquistossomose mansônica, até agora tratados no Hospital de Clínicas da Universidade do Estado da Guanabara. São pacientes oriundos de áreas endêmicas do País, especialmente do nordeste e sudeste, 53,9% do sexo masculino e 46,1% do sexo feminino, de idade entre 5 e 63 anos. A forma clínica predominante da parasitose foi a hépato-intestinal (96,8%. O medicamento foi administrado em dose única, na razão de 3 mg/kg de peso corporal, a 33.6% de pacientes internados e a 66 4% em regime de tratamento ambulatorial. Os níveis séricos das transaminases, determinados, para confronto, antes e depois do uso do produto, em 60 dos pacientes internados, não se alteraram, ou apenas sofreram elevações inexpressivas. Não houve efeitos colateriais em 42,3% dos pacientes. Nos demais, esses efeitos foram de pequena e média intentidade, duraram apenas o 19 dia, na maioria das vezes, e consisfram, especialmente, de náuseas e de vômitos. O controle de cura parasitária estabelecido compreendeu 4 exames de fezes - aos 30, 60, 90 e 120 dias do emprego do medicamento, o que já se fez em 330 pacientes (33%, com 99% de cura. Incluída a biópsia retal, sempre que foi possivel, por ocasião do 4º exame de fezes, o esquema funcionou até agora em 97 pacientes (9,7%, dos quais 92 (94% estão curados, segundo esse critério. O presente trabalho confirma a ação esquistossomicida do hycanthone, bem como sua boa tolerabilidade, inclusive no que se refere ao hepatócito. Os doentes, entretanto, devem ser criteriosamente selecionados, tendo-se em vista as contra-indicações conhecidas, de modo especial em relação ao fígado.

  13. Risk stratification for indolent lymphomas Estratificação de risco dos linfomas indolentes

    Abrahão Elias Hallack Neto

    2010-01-01

    Full Text Available Indolent B-cell lymphomas account for approximately 40% of all non-Hodgkin lymphomas (NHLs. Advances in technology have contributed to improvements in the diagnosis and classification of indolent non-Hodgkin lymphomas. Follicular Lymphomas are the most common although the frequency varies significantly throughout the world. The description of the Follicular Lymphoma International Prognostic Index (FLIPI was an important step in identifying patient subgroups, but its use in the clinical practice has not been established yet. The use of a larger number of paraffin active monoclonal antibodies for immunohistochemistry, molecular cytogenetic studies including standard cytogenetics, multi-color fluorescence in-situ hybridization (FISH, polymerase chain reaction and locus-specific fluorescence insitu hybridization as well as developments in high-resolution techniquesincluding microarray gene expression profiling allow more accurate diagnosis andprecise definition of biomarkers of value in risk stratification. The identification ofdiseasespecific gene lists resulting from expression profiling provides a number ofpotential protein targets that can be validated using immunohistochemistry. Analysesof gene expression profiles or constitutive gene variations may also provide additional insight for prognostication in the near future. A comprehensive understanding of the biology of these distinct lymphoid tumors will allow us to identify novel diseaserelated genes and should facilitate the development of improved diagnosis, outcome prediction, and personalized approaches to treatment.Os linfomas de células B indolentes representam aproximadamente 40% do total de linfomas não Hodgkin (LNHs. O avanço das tecnologias novas tem contribuído para a melhora no diagnóstico e classificação dos LNH indolentes. O linfoma folicular é o mais comum e sua frequência varia significantemente pelo mundo. Adescrição do Índice Internacional de Prognóstico dos

  14. Hepatitis C: crioglobulinemia y linfoma no-Hodgkin Hepatitis C: cryoglobulinemia and non-Hodgkin lymphoma

    M. Romero-Gómez

    2008-03-01

    Full Text Available La infección por el virus de la hepatitis C juega un papel principal en la patogénesis de la crioglobulinemia mixta, promoviendo la activación y expansión de las células B. Estos reajustes moleculares inducen la síntesis de crioglobulinas y la aparición de la vasculitis crioglobulinémica. El aclaramiento del virus provoca la resolución de las manifestaciones clínicas y de las alteraciones inmunológicas observados en la crioglobulinemia mixta en un alto porcentaje de los pacientes, pero no en todos. En algunos casos, la crioglobulinemia puede aparecer tras la respuesta virológica sostenida. Muchos mecanismos de la patogénesis de la crioglobulinemia mixta están fuertemente relacionados con la infección por VHC y, cuando el virus es eliminado, hay una mejoría en el curso de la enfermedad. Aun así, los pasos independientes relacionados con otros factores no mejoran tras la erradicación del virus. En algunos tipos de linfomas no-Hodgkin de bajo grado (linfoma linfoplasmocítico y linfoma de la zona marginal la respuesta sostenida tras el aclaramiento viral induce una remisión de la neoplasia. El VHC tiene un papel secundario en los linfomas agresivos y el aclaramiento del virus puede no inducir la remisión, pero puede disminuir la hepatotoxicidad asociada a la quimioterapia. Por tanto, en la hepatitis C crónica, la combinación de interferón pegilado y ribavirina es altamente recomendable en el tratamiento de la crioglobulinemia mixta sintomática y los linfomas no-Hodgkin asociados al VHC.Hepatitis C virus infection plays a major role in the pathogenesis of mixed cryoglobulinemia, promoting activation and expansion of B cells. These molecular rearrangements induce synthesis of cryoglobulins and the appearance of cryoglobulinemic vasculitis. Clearance of the virus promotes resolution of the clinical manifestations and immunological disorders seen in mixed cryoglobulinemia in a large percentage of patients, but not in all. In

  15. Positron autoradiography for intravascular imaging: feasibility evaluation

    Approximately 70% of acute coronary artery disease is caused by unstable (vulnerable) plaques with an inflammation of the overlying cap and high lipid content. A rupturing of the inflamed cap of the plaque results in propagation of the thrombus into the lumen, blockage of the artery and acute ischaemic syndrome or sudden death. Morphological imaging such as angiography or intravascular ultrasound cannot determine inflammation status of the plaque. A radiotracer such as 18F-FDG is accumulated in vulnerable plaques due to higher metabolic activity of the inflamed cap and could be used to detect a vulnerable plaque. However, positron emission tomography (PET) cannot detect the FDG-labelled plaques because of respiratory and heart motions, small size and low activity of the plaques. Plaques can be detected using a miniature particle (positron) detector inserted into the artery. In this work, a new detector concept is investigated for intravascular imaging of the plaques. The detector consists of a storage phosphor tip bound to the end of an intravascular catheter. It can be inserted into an artery, absorb the 18F-FDG positrons from the plaques, withdrawn from the artery and read out. Length and diameter of the storage phosphor tip can be matched to the length and the diameter of the artery. Monte Carlo simulations and experimental evaluations of coronary plaque imaging with the proposed detector were performed. It was shown that the sensitivity of the storage phosphor detector to the positrons of 18F-FDG is sufficient to detect coronary plaques with 1 mm and 2 mm sizes and 590 Bq and 1180 Bq activities in the arteries with 2 mm and 3 mm diameters, respectively. An experimental study was performed using plastic tubes with 2 mm diameter filled with an FDG solution, which simulates blood. FDG spots simulating plaques were placed over the surface of the tube. A phosphor tip was inserted into the tube and imaged the plaques. Exposure time was 1 min in all simulations and

  16. Positron autoradiography for intravascular imaging: feasibility evaluation

    Shikhaliev, Polad M [Department of Radiological Sciences, University of California at Irvine, Irvine, CA 92697 (United States); Xu, Tong [Department of Radiological Sciences, University of California at Irvine, Irvine, CA 92697 (United States); Ducote, Justin L [Department of Radiological Sciences, University of California at Irvine, Irvine, CA 92697 (United States); Easwaramoorthy, Balasubramaniam [Department of Psychiatry and Human Behavior, University of California at Irvine, Irvine, CA 92697 (United States); Mukherjee, Jogeshwar [Department of Psychiatry and Human Behavior, University of California at Irvine, Irvine, CA 92697 (United States); Molloi, Sabee [Department of Radiological Sciences, University of California at Irvine, Irvine, CA 92697 (United States)

    2006-02-21

    Approximately 70% of acute coronary artery disease is caused by unstable (vulnerable) plaques with an inflammation of the overlying cap and high lipid content. A rupturing of the inflamed cap of the plaque results in propagation of the thrombus into the lumen, blockage of the artery and acute ischaemic syndrome or sudden death. Morphological imaging such as angiography or intravascular ultrasound cannot determine inflammation status of the plaque. A radiotracer such as 18F-FDG is accumulated in vulnerable plaques due to higher metabolic activity of the inflamed cap and could be used to detect a vulnerable plaque. However, positron emission tomography (PET) cannot detect the FDG-labelled plaques because of respiratory and heart motions, small size and low activity of the plaques. Plaques can be detected using a miniature particle (positron) detector inserted into the artery. In this work, a new detector concept is investigated for intravascular imaging of the plaques. The detector consists of a storage phosphor tip bound to the end of an intravascular catheter. It can be inserted into an artery, absorb the 18F-FDG positrons from the plaques, withdrawn from the artery and read out. Length and diameter of the storage phosphor tip can be matched to the length and the diameter of the artery. Monte Carlo simulations and experimental evaluations of coronary plaque imaging with the proposed detector were performed. It was shown that the sensitivity of the storage phosphor detector to the positrons of 18F-FDG is sufficient to detect coronary plaques with 1 mm and 2 mm sizes and 590 Bq and 1180 Bq activities in the arteries with 2 mm and 3 mm diameters, respectively. An experimental study was performed using plastic tubes with 2 mm diameter filled with an FDG solution, which simulates blood. FDG spots simulating plaques were placed over the surface of the tube. A phosphor tip was inserted into the tube and imaged the plaques. Exposure time was 1 min in all simulations and

  17. Intravascular imaging with a storage phosphor detector

    Shikhaliev, Polad M.; Petrek, Peter; Matthews, Kenneth L., II; Fritz, Shannon G.; Bujenovic, L. Steven; Xu, Tong

    2010-05-01

    The aim of this study is to develop and test an intravascular positron imaging system based on a storage phosphor detector for imaging and detecting vulnerable plaques of human coronary arteries. The radiotracer F18-FDG accumulates in vulnerable plaques with inflammation of the overlying cap. The vulnerable plaques can, therefore, be imaged by recording positrons emitted from F18-FDG with a detector inserted into the artery. A prototype intravascular detector was constructed based on storage phosphor. The detector uses a flexible storage phosphor tube with 55 mm length, 2 mm diameter and 0.28 mm wall thickness. The intravascular detector is guided into the vessel using x-ray fluoroscopy and the accumulated x-ray signal must be erased prior to positron imaging. For this purpose, a light diffuser, 0.9 mm in diameter and 55 mm in length, was inserted into the detector tube. The light diffuser was connected to a laser source through a 2 m long optical fiber. The diffuser redirected the 0.38 W laser light to the inner surface of the phosphor detector to erase it. A heart phantom with 300 cm3 volume and three coronary arteries with 3.2 mm diameter and with several plaques was constructed. FDG solution with 0.5 µCi cm-3 activity concentration was filled in the heart and coronary arteries. The detector was inserted in a coronary artery and the signal from the plaques and surrounding background activity was recorded for 2 min. Then the phosphor detector was extracted and read out using a storage phosphor reader. The light diffuser erased the signal resulting from fluoroscopic exposure to level below that encountered during positron imaging. Vulnerable plaques with area activities higher than 1.2 nCi mm-2 were visualized by the detector. This activity is a factor of 10-20 lower than that expected in human vulnerable plaques. The detector was able to image the internal surface of the coronary vessels with 50 mm length and 360° circumference. Spatial resolution was 0

  18. Los tratados de libre comercio: instrumentos para controlar la biodiversidad

    Rodríguez Cervantes, Silvia

    2013-01-01

    La soberanía de cada Estado para regular la Bioprospección y utilización de la biodiversidad contenida en sus fronteras, fue un derecho reforzado por el Convenio de Diversidad Biológica de 1994 y diez años más tarde por el Tratado conocido como Tratado de la Semilla. Sin embargo, sus alcances se han visto obstaculizados por diversos pactos comerciales y sus respectivas políticas de propiedad intelectual. Algunos son de carácter multilateral; otros son re...

  19. Fast integrated intravascular photoacoustic/ultrasound catheter

    Choi, Changhoon; Cho, Seunghee; Kim, Taehoon; Park, Sungjo; Park, Hyoeun; Kim, Jinmoo; Lee, Seunghoon; Kang, Yeonsu; Jang, Kiyuk; Kim, Chulhong

    2016-03-01

    In cardiology, a vulnerable plaque is considered to be a key subject because it is strongly related to atherosclerosis and acute myocardial infarction. Because conventional intravascular imaging devices exhibit several limitations with regard to vulnerable plaque detection, the need for an effective lipid imaging modality has been continuously suggested. Photoacoustic (PA) imaging is a medical imaging technique with a high level of ultrasound (US) resolution and strong optical contrast. In this study, we successfully developed an integrated intravascular photoacoustic/ultrasound (IV-PAUS) imaging system with a catheter diameter of 1.2 mm for lipid-rich atherosclerosis imaging. An Nd:YAG pulsed laser with an excitation wavelength of 1064 nm was utilized. IV-PAUS offers 5-mm depth penetration and axial and lateral PA imaging resolutions of 94 μm and 203 μm, respectively, as determined by imaging a 6-μm carbon fiber. We initially obtained 3-dimensional (3D) co-registered PA/US images of metal stents. Subsequently, we successfully obtained 3D coregistered PA/US ex vivo images using an iliac artery from a rabbit atherosclerosis model. Accordingly, lipid-rich plaques were sufficiently differentiated from normal tissue in the ex vivo experiment. We validated these findings histologically to confirm the lipid content.

  20. Linfoma Extranodal de Células NK/T tipo Nasal Extranodal Nasal type NK/T-Cell Lymphoma

    Carlos S. Chiattone

    2009-08-01

    Full Text Available O Linfoma Extranodal de Células NK/T tipo Nasal tem uma distribuição geográfica peculiar, ocorrendo mais frequentemente em países orientais e na população nativa de alguns países da América Central e da América do Sul. Sua localização preferencial é na cavidade nasal e nos seios paranasais, mas pode acometer outras estruturas da chamada região médio-facial. Tem um padrão de disseminação com "homing" característico, incluindo pele, testículo, SNC e trato digestivo. Este linfoma, menos frequentemente, pode acometer primariamente estas regiões. A maioria destas neoplasias apresenta um fenótipo NK, mas alguns poucos casos podem ter sua origem em células T verdadeiras, por este motivo é designado "linfoma NK/T". O genoma do vírus Epstein-Barr é detectado na maioria dos casos, sugerindo uma relação etiológica. Embora este linfoma seja sensível à radioterapia, apresenta mais frequentemente resistência a agentes quimioterápicos que outros linfomas. Uma possível explicação para a resistência é a usual expressão de glicoproteína-p. O prognóstico destes linfomas é pobre, sendo necessária a investigação de novas modalidades terapêuticas.Extranodal Nasal type NK/T-Cell Lymphoma has a peculiar geographic distribution, occurring more frequently in Eastern countries and in the native populations of some Central and South American countries. It is commonly found in the nasal cavity and paranasal sinuses, but may also compromise other structures in the mid-facial region. The disease has a characteristic homing dissemination pattern, including skin, testis, CNS and digestive tract. This lymphoma can, less frequently, primarily compromise these regions. The majority of these neoplastic diseases present an NK phenotype, but a few cases can be truly of T-cell origin, because of which it is designed "NK/T-cell lymphoma". The Epstein-Barr virus genome can be detected in most of the cases, suggesting an etiological

  1. Ventricular metastasis resulting in disseminated intravascular coagulation

    Davis Ian D

    2005-05-01

    Full Text Available Abstract Background Disseminated Intravascular Coagulation (DIC complicates up to 7% of malignancies, the commonest solid organ association being adenocarcinoma. Transitional Cell Carcinoma (TCC has rarely been associated with DIC. Case presentation A 74-year-old woman with TCC bladder and DIC was found to have a cardiac lesion suspicious for metastatic disease. The DIC improved with infusion of plasma and administration of Vitamin K, however the cardiac lesion was deemed inoperable and chemotherapy inappropriate; given the patients functional status. We postulate that direct activation of the coagulation cascade by the intraventricular metastasis probably triggered the coagulopathy in this patient. Conclusion Cardiac metastases should be considered in cancer patients with otherwise unexplained DIC. This may influence treatment choices.

  2. Intravascular Ultrasound Image Segmentation Using Morphological Snakes

    Hamdi Mohamed Ali

    2012-06-01

    Full Text Available From the first use of the technics of intravascular ultrasound (IVUS as an imaging technique for the coronary artery system at the 70th century until now , the segmentation of the arterial wall boundaries still an important problem . Much research has been done to give better segmentation result for better diagnostics , evaluation and therapy planning. In this paper we present a new segmentation technics based on Morphological Snakes which developed by Luis Álvarez used for the first time for IVUS segmentation. It is a simple , fast and stable approach of snakes evolution algorithm. Results are presented and discussed in order to demonstrate the effectiveness of this approach in IVUS segmentation.

  3. Education and Propagation of Intravascular Surgery in Okinawa

    Harakuni, T.; Hyodo, A; Shingaki, T.; Kugai, M.; Kinjyo, T.; Tsuchida, H.; Sugimoto, K.; Yoshii, Y.

    2004-01-01

    Okinawa is an island located on the southwest edge of the Japanese Islands in which about 1,300,000 people live, and is an area where self-conclusion type medical treatment is desired. In this area, intravascular surgery was only performed for several cases per year until 1998. From May 1999, intravascular surgery started being performed in earnest, and 140 or more cases of intravascular surgery per year were performed in 2002. In the meantime, various measures for the propagation and develop...

  4. Linfoma Extranodal de Células NK/T tipo Nasal Extranodal Nasal type NK/T-Cell Lymphoma

    Carlos S. Chiattone

    2009-01-01

    O Linfoma Extranodal de Células NK/T tipo Nasal tem uma distribuição geográfica peculiar, ocorrendo mais frequentemente em países orientais e na população nativa de alguns países da América Central e da América do Sul. Sua localização preferencial é na cavidade nasal e nos seios paranasais, mas pode acometer outras estruturas da chamada região médio-facial. Tem um padrão de disseminação com "homing" característico, incluindo pele, testículo, SNC e trato digestivo. Este linfoma, menos frequent...

  5. Apresentação cutânea inicial de linfomas na infância Initial cutaneous manifestation of lymphomas in children

    Maria Christina Lopes Araujo de Oliveira

    2011-08-01

    Full Text Available Os linfomas cutâneos compreendem um grupo heterogêneo de desordens linfoproliferativas que envolvem a pele e são classificados como um subgrupo dos linfomas não Hodgkin. No período de 1981 a 2007, 100 casos de linfomas em crianças foram admitidos no Serviço de Hematologia, do Hospital das Clínicas da Universidade Federal de Minas Gerais, sendo que nove apresentaram manifestação cutânea inicial. Três pacientes foram classificados como linfoma cutâneo primário e seis como sistêmicos. Sete pacientes apresentaram linfoma de células T, um, linfoma linfoblástico B e um, imunofenótipo indefinido. Nenhum óbito ocorreu nos pacientes com linfoma cutâneo primárioCutaneous lymphomas comprise a heterogeneous group of lymphoproliferative disorders with skin involvement and are classified as a subgroup of non-Hodgkin lymphomas. From 1981 to 2007, 100 children with non-Hodgkin lymphomas were admitted to the Hematology Unit of the Federal University of Minas Gerais Teaching Hospital. In nine of these children, the skin was involved at the onset of the disease. Three patients were classified as having primary cutaneous lymphoma, while in six the disease was systemic with cutaneous involvement. In seven patients, the immunophenotype was T-cell, in one it was B-cell, and in the remaining case the immunophenotype was indefinable. No deaths occurred in any of the children with primary cutaneous lymphoma

  6. Primary pulmonary AIDS-related lymphoma Linfoma primario de pulmón en un paciente con sida

    Marcelo Corti

    2005-08-01

    Full Text Available Extranodal involvement is common in lymphomas associated with human immunodeficiency virus infection (HIV and acquired immunodeficiency syndrome (AIDS. However, primary pulmonary AIDS-related non-Hodgkin's lymphoma is very rare and only few reports were published in the medical literature. Clinical presentation is nonspecific, with "B" and respiratory symptoms. Also, patients were with advanced immunodeficiency at the time of diagnosis. Generally, chest radiography showed peripheral nodules or cavitary masses. Primary pulmonary lymphoma associated with AIDS is generally a high-grade B-cell non-Hodgkin lymphoma and Epstein-Barr virus is strongly associated with the pathogenesis of these tumors. We report a patient with AIDS and primary pulmonary lymphoma which clinical presentation was a total atelectasis of the left lung.El compromiso extranodal es frecuente en los linfomas asociados con la enfermedad debida al virus de la inmunodeficiencia humana y su consecuencia, el síndrome de inmunodeficiencia adquirida. Sin embargo, el linfoma pulmonar primario es muy raro y solo existen pocos casos publicados en la literatura. La presentación clínica de esta complicación es inespecífica, con síntomas "B" y manifestaciones respiratorias. Generalmente, la radiografía de tórax muestra nódulos periféricos o masas que pueden cavitarse y los pacientes presentan inmunodeficiencia severa al momento del diagnóstico. El linfoma pulmonar primario asociado con el sida es un tumor de alto grado, de células B y asociado en su patogenia con el virus de Epstein-Barr. Se relata un caso de linfoma primario de pulmón que se presentó bajo la forma radiológica de una atelectasia global del pulmón izquierdo.

  7. Linfoma primario de hueso con afectación multicéntrica Primary bone lymphoma with multicentric involvement

    Marcelo Graziadio

    2012-10-01

    Full Text Available El linfoma primario de hueso es una enfermedad infrecuente, que tiene una presentación y evolución diferente a los linfomas de otras localizaciones. Se presenta un caso de linfoma primario de hueso de localización craneana y esternal de rápido crecimiento. En su evolución, realizada la exéresis de la lesión primaria de calota, presentó aparición de nuevas lesiones de rápido crecimiento a nivel craneano y fémur y progresión de lesión preesternal que, con anatomía patológica de linfoma no Hodgkin difuso de células grandes B, inició R-CHOPP (ciclofosfamida, doxorrubicina, vincristina, prednisona y rituximab con rápida disminución de todas las lesiones sin evidencia de progresión al cabo de los seis ciclos.Primary bone lymphoma is a rare disease, which usually has a different presentation and evolution than lymphomas of other locations. We are presenting a case of primary bone lymphoma of rapid growth, in cranial and sternal locations. In its evolution, once the excision of the primary lesion of the skull was performed, the patient presented new lesions of rapid growth at the skull and femur level, and progression of pre-sternal lesion. With large B-cell diffuse non-Hodgkin lymphoma pathology, the patient initiated R-CHOPP (cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab with rapid reduction of all lesions without evidence of progression after the six cycles.

  8. Burkitt's lymphoma of the duodenum in a patient with AIDS Linfoma de Burkitt do duodeno em um paciente com AIDS

    Marcelo Corti

    2007-06-01

    Full Text Available Non-Hodgkin's lymphoma of B-cell type is the second most common neoplasm after Kaposi's sarcoma, among patients with human immunodeficiency virus infection. Most non-Hodgkin's lymphoma cases that are associated with acquired immunodeficiency syndrome involve extranodal sites, especially the digestive tract and the central nervous system. We report a case of primary lymphoma of the duodenum in a patient with AIDS. Upper gastrointestinal endoscopy revealed pseudopolypoid masses found in the second portion of the duodenum. A complete diagnostic study including histological, immunohistochemical and virological analyses showed high-grade B-cell Burkitt's lymphoma. The Epstein-Barr virus genome was detected in biopsies by immunohistochemical and in situ hybridization.O linfoma não-Hodgkin de células B é a segunda neoplasia mais comum em pacientes com infecção pelo vírus da imunodeficiência humana depois do sarcoma de Kaposi. A maioria dos casos de linfoma não-Hodgkin associados com a síndrome da imunodeficiência adquirida envolve locais extraganglionares, especialmente o trato digestivo e o sistema nervoso central. Nós relatamos um caso de linfoma primário do duodeno em um paciente com AIDS. Uma endoscopia digestiva alta mostrou massas pseudopolipóides encontradas na segunda porção do duodeno. Um estudo diagnóstico completo incluindo exames histológicos, imunohistoquímicos e virológicos mostrou um linfoma de células B tipo Burkitt. Detectou-se genoma do vírus Epstein-Barr em biópsias por hibridização in situ e imuno-histoquímica.

  9. Leucemia / Linfoma T del Adulto Gástrico: Reporte de cuatro casos y Revisión de la Literatura

    Brady Beltrán; Eugenio Palomino; Pilar Quiñones; Domingo Morales; Esther Cotrina

    2010-01-01

    Leucemia / Linfoma T del Adulto (ATLL) es una enfermedad agresiva asociada con el virus linfotrópico de células T tipo I (HTLV-1) con presentación y curso clínico heterogéneo. El reporte describe cuatro casos con compromiso gástrico, considerando características clínicas y hallazgos endoscópicos, con la respectiva revisión de la literatura.

  10. Intravascular lymphomatosis of central nervious system - case report

    Jović Jasmina; Ercegovac Marko; Dožić Branko; Cvetković Dubravka; Živković Miroslava; Beslać-Bumbaširević Ljiljana G.

    2003-01-01

    Intravascular lymphomatosis is an uncommon lymphoproliferative disorder characterised by intravascular distribution of neoplastic lymphoid cells (B- or T- lymphocites), what leads to occlusion of small vessels and causes signs and simptoms of disorder. Its initial predilection sites are the brain or the skin, and hematopoetic organs are usually spared. The signs and symptoms of the disorder are attributed to vascular occlusion. Clinical course is fatal, besides therapy. In our case disorder h...

  11. Linfoma não-Hodgkin em crianças com imunodeficiência: relato de cinco casos Non-Hodgkin's lymphoma in children with immunodeficiency: report of five cases

    Oliveira, Maria Christina L A; Rodrigues, Adriana R.; Keyla C. Sampaio; Ana Cecília S. C. Gomes; Marcos B. Viana

    2008-01-01

    Neste estudo é relatado o quadro clínico de cinco crianças com linfoma não-Hodgkin secundário a imunodeficiência ou imunossupressão: três portadoras do vírus da imunodeficiência humana, uma com imunodeficiência primária e uma após transplante hepático. De acordo com a classificação atual, os tipos histológicos foram: linfoma linfoblástico de células B precursoras (2), linfoma cutâneo de grandes células anaplásico (1), linfoma de células B periféricas, sugestivo de Burkitt (1), e linfoma linfo...

  12. Hiperplasia endotelial papilar intravascular oral: uma entidade rara Intravascular papillary endothelial hyperplasia: a rare entity

    João Augusto Vianna Goulart Filho; Karuza Maria Alves Pereira; Hébel Cavalcanti Galvão

    2006-01-01

    A hiperplasia endotelial papilar intravascular (HEPI) é uma lesão vascular reativa caracterizada pela proliferação endotelial excessiva localizada no interior de vasos sangüíneos comumente dilatados, associada a trombos em organização, ou secundária a outras lesões vasculares, como hemangiomas e granulomas piogênicos. A HEPI é um achado incomum na cavidade oral, onde os lábios são o principal sítio de acometimento, e surge clinicamente sob a forma de nódulos azulados de aspecto clínico semelh...

  13. Actividad laboral en una cohorte de pacientes con linfoma non Hodgkin

    R. Molina Villaverde

    2008-03-01

    Full Text Available Introducción. La actividad laboral en el cáncer es un aspecto psicosocial que ha recibido poca atención hasta el momento actual, a pesar de considerarse una dimensión de la calidad de vida para estos pacientes. Objetivos. La reinserción y adaptación al entorno laboral fueron investigados en una cohorte de pacientes con linfoma no Hodgkin para describir los factores que influyen en la vuelta al trabajo de estos enfermos. Pacientes y métodos. El estudio incluyó 37 pacientes consecutivos diagnosticados de un linfoma no Hodgkin y empleados en el momento del diagnóstico. El cuestionario incluyó aspectos epidemiológicos, clínicos y laborales (32 variables en total. El estudio fue aprobado por el Comité Ético y de Investigación Cínica del Hospital La Paz. Todos los pacientes dieron su consentimiento para participar en el estudio y para la utilización de los datos de su historia clínica. Resultados. El 86,5% de los pacientes pasaron a inactivos tras comenzar el tratamiento de la enfermedad y un 32,5% lo seguían estando tras éste. No hubo diferencias en la influencia de las distintas variables analizadas con respecto a la actividad laboral tras el diagnóstico. Sin embargo, el realizar un trabajo predominantemente físico y la presencia de secuelas derivadas del tumor o del tratamiento de éste, sí influyeron en la reinserción laboral una vez finalizado el tratamiento específico. La mayoría de los pacientes no creían que el tener la enfermedad les perjudicaría en su puesto de trabajo y, en casi todos los casos, tanto sus compañeros como sus jefes conocían que tenían un tumor. Conclusiones. Éste es el primer estudio exploratorio en nuestro país acerca de la reinserción laboral de los pacientes diagnosticados de un linfoma. Son necesarios más trabajos para establecer las dificultades que tienen este tipo de enfermos en la reinserción laboral y establecer las medidas adecuadas para la mejora de este proceso

  14. Cardiac phase detection in intravascular ultrasound images

    Matsumoto, Monica M. S.; Lemos, Pedro Alves; Yoneyama, Takashi; Furuie, Sergio Shiguemi

    2008-03-01

    Image gating is related to image modalities that involve quasi-periodic moving organs. Therefore, during intravascular ultrasound (IVUS) examination, there is cardiac movement interference. In this paper, we aim to obtain IVUS gated images based on the images themselves. This would allow the reconstruction of 3D coronaries with temporal accuracy for any cardiac phase, which is an advantage over the ECG-gated acquisition that shows a single one. It is also important for retrospective studies, as in existing IVUS databases there are no additional reference signals (ECG). From the images, we calculated signals based on average intensity (AI), and, from consecutive frames, average intensity difference (AID), cross-correlation coefficient (CC) and mutual information (MI). The process includes a wavelet-based filter step and ascendant zero-cross detection in order to obtain the phase information. Firstly, we tested 90 simulated sequences with 1025 frames each. Our method was able to achieve more than 95.0% of true positives and less than 2.3% of false positives ratio, for all signals. Afterwards, we tested in a real examination, with 897 frames and ECG as gold-standard. We achieved 97.4% of true positives (CC and MI), and 2.5% of false positives. For future works, methodology should be tested in wider range of IVUS examinations.

  15. Toward a Continuous Intravascular Glucose Monitoring System

    Pedro Irazoqui

    2010-12-01

    Full Text Available Proof-of-concept studies that display the potential of using a glucose-sensitive hydrogel as a continuous glucose sensor are presented. The swelling ratio, porosity, and diffusivity of the hydrogel increased with glucose concentration. In glucose solutions of 50, 100, 200, and 300 mg/dL, the hydrogel swelling ratios were 4.9, 12.3, 15.9, and 21.7, respectively, and the swelling was reversible. The impedance across the hydrogel depended solely on the thickness and had an average increase of 47 W/mm. The hydrogels exposed to a hyperglycemic solution were more porous than the hydrogels exposed to a normal glycemic solution. The diffusivity of 390 Da MW fluorescein isothiocyanate in hydrogels exposed to normal and hyperglycemic solutions was examined using fluorescence recovery after photobleaching and was found to be 9.3 × 10−14 and 41.4 × 10−14 m2/s, respectively, compared to 6.2 × 10−10 m2/s in glucose solution. There was no significant difference between the permeability of hydrogels in normal and hyperglycemic glucose solutions with averages being 5.26 × 10−17 m2 and 5.80 × 10−17 m2, respectively, which resembles 2–4% agarose gels. A prototype design is presented for continuous intravascular glucose monitoring by attaching a glucose sensor to an FDA-approved stent.

  16. Disseminated intravascular coagulation following administration of sunitinib

    OLIVO, ANAËLLE; NOËL, NICOLAS; BESSE, BENJAMIN; TABURET, ANNE-MARIE; LAMBOTTE, OLIVIER

    2016-01-01

    Sunitinib is an increasingly used, orally administered targeted therapy, approved by the European Medicines Agency for the treatment of various types of cancer, including gastrointestinal stromal tumor unresectable or metastatic disease, following disease progression or intolerance to imatinib, and advanced or metastatic renal cell carcinoma, progressive well-differentiated pancreatic neuroendocrine tumors in patients with unresectable, locally advanced or metastatic disease. Sunitinib inhibits several tyrosine kinases, including the vascular endothelial growth factor receptor and the platelet-derived growth factor receptor. Tyrosine kinases inhibitor therapies are generally well-tolerated; nonetheless, they are not void of side effects. The majority of patients reported are grade 1 or 2, and include common and unspecific adverse events, including fatigue, gastrointestinal disorders, skin discoloration, altered taste, cough and dyspnea. Grade 3 or 4 adverse events, including bleeding and hemorrhage, are less frequent. The present study presented the first case of disseminated intravascular coagulation associated with the administration of sunitinib, shortly following the increase of sunitinib dosage. PMID:27330781

  17. Disseminated intravascular coagulation in solid tumors

    It is estimated that 20-25% of cases of disseminated intravascular coagulation (DIC) relate to an underlying neoplasia primarily hematologic. It is estimated that about 5% of patients with solid tumors have CID clinic, although the incidence of subclinical alterations is much higher. The CID is not limited to the activation of the coagulation cascade, which leads to bleeding micro thrombosis and consumption of coagulation factors. Solid tumors are frequently associated adenocarcinomas producers mucin (especially gastric), usually in the context of a disseminated disease. The mucin may act as a promoter of the cascade, but probably it is a multi-event. High levels of TNF to produced by the tumor mass and chemotherapy-induced cell lysis have Also linked. Although the bleeding is usually oriented diagnosis, the most frequent cause of death is thrombosis. There are no specific tests for diagnosis. Elevated levels of D-dimer and products oriented fibrinogen degradation diagnosis. No reduction fibrinogen and almost always, one thrombocytopenia consumption. Treatment is complex and there is no consensus on many points. To recover the lost factors for consumption, it is recommended to use fresh frozen plasma and / or washed red blood cells. the heparin anticoagulation low dose is indicated since the disease causal can not be controlled quickly, but should not be initiated if there thrombocytopenia 50.000.El under profuse bleeding can require the use of tranexamic acid or EACA. Acute DIC, the case of our patient, is rare and very serious

  18. A quality management program in intravascular brachytherapy.

    Chakri, Abderrahim; Thomadsen, Bruce

    2002-12-01

    While simple, intravascular brachytherapy (IVB) presents a considerable potential for harm to the patient. The medical physicist maintains the responsibility to minimize the likelihood of operational problems or dosimetric errors. The principals for safe operation remain the same as with any radiotherapy treatment: to deliver the correct dose, to the correct location, safety. To develop an effective and comprehensive quality management (QM) program for IVB, a physicist should utilize proven risk assessment techniques rather than simply thinking of things to check, and follow guidances such as ISO9001:2000. The proposed QM program includes the following: Procedures designed to assure the safety of the patient. Identification of the patient; tests of the integrity and patency for the delivery catheter, operation of the source train, and patency of the catheter in the treatment position; a check for recovery preparations; and verification of source recovery. Procedures to assure positional accuracy of the treatment: Verification of the positioning the catheter in the artery and of the sources in the catheter. Procedures to assure dosimetry accuracy: Acceptance testing of the device, including verification of the source strength and uniformity, and of the treatment duration tables; verification of the treatment prescription and duration for each patient; and control measures that minimize the likelihood of errors removing the source at the correct time. PMID:12512720

  19. Linfomas plasmoblásticos del tracto gastrointestinal en pacientes con sida

    Alejandro Avilés-Salas

    2011-12-01

    Full Text Available Los pacientes con infección por el virus de inmunodeficiencia humana (HIV tienen 200 veces más riesgo de desarrollar un linfoma no Hodgkin (LNH con respecto a la población general. El linfoma plasmoblástico (LP representa menos del 3% de todos los LNH asociados con el HIV. El objetivo de este estudio es informar las características clínico-patológicas de 5 pacientes con enfermedad HIV/sida y LP del tracto gastrointestinal. Se revisaron de forma retrospectiva los casos de LP del tracto gastrointestinal diagnosticados en el Instituto Nacional de Cancerología de la Ciudad de México en el periodo comprendido entre los años 2000 al 2009. Se analizaron las características clínico-patológicas y se realizaron cortes de bloques de tejidos embebidos en parafina para reacciones de inmunohistoquímica. La presencia del virus de Epstein Barr (VEB se examinó por reacción en cadena de la polimerasa (PCR in situ. De los cinco pacientes, cuatro fueron hombres y una mujer, con una mediana de edad de 29 años. Tres tumores se localizaron en la región anorrectal, uno en colon ascendente y el restante en el estómago. Histológicamente, todos los tumores se caracterizaron por una proliferación difusa de células grandes de aspecto plasmoblástico. Las células neoplásicas fueron CD 138/MUM-1 positivas y CD 20 / PAX-5 negativas. En cuatro pacientes se detectó el genoma del VEB en las células neoplásicas mediante PCR in situ. La mediana de seguimiento fue 18 meses; tres pacientes estaban vivos con enfermedad y dos sobreviven sin evidencias de la neoplasia. El diagnóstico precoz de LP como una entidad clínico-patológica es importante para establecer el tratamiento correcto y mejorar el pronóstico de estos pacientes.

  20. Linfoma nasal de células T/NK Nasal T/NK cell lymphoma

    A. Torre Iturraspe

    2005-04-01

    Full Text Available El linfoma nasal de células T/ natural killer (NK (LNT/NK, tras haber recibido múltiples denominaciones, ha sido definido y caracterizado en el año 2001 por la Organización Mundial de la Salud (OMS, basándose en una clasificación previa de la Revised European-American Lymphoma Classification (REAL, de la manera en que se le conoce actualmente. Su incidencia en el mundo occidental es baja, mientras que en Asia supone el segundo grupo de linfomas más frecuente, tras los gastrointestinales. Se localiza preferentemente en las fosas nasales y senos maxilares, mostrando un curso clínico agresivo, definido por una destrucción de los tejidos circundantes. Su diagnóstico definitivo se realiza por medio de técnicas de hibridación in situ, llegando a la determinación de su inmunofenotipo. Se ha observado una frecuente asociación con el virus de Epstein-Barr (VEB. El pronóstico de esta enfermedad viene definido por el índice pronóstico internacional (IPI y por el volumen alcanzado por el tumor. A pesar de ser radiosensible, su pronóstico es infausto, aconteciendo la muerte del paciente poco tiempo después del diagnóstico, generalmente como consecuencia de las complicaciones del tratamiento.Nasal T-cell and Natural Killer cell lymphoma (NT/NKL, having been given many names, was defined and described in the year 2001 by the World Health Organization (WHO, on the basis of a previous classification by the Revised European-American Lymphoma Classification (REAL as it is known today. Its incidence in the western world is low, while in Asia it represents the second most frequent group of lymphomas, followed by the gastrointestinal [lymphoma]. It is typically located in the nasal cavity and maxillary sinuses. It is associated with an aggressive clinical course, characterized by the destruction of surrounding tissue. The definitive diagnosis is made by means of in situ hybridization techniques, in order to determine the immunophenotype. Its

  1. Estudo dos efeitos dos fármacos anti-neoplásicos em cães com linfoma e osteossarcoma

    Gonçalves, Carla Isabel Esteves

    2010-01-01

    Dissertação de Mestrado em Medicina Veterinária A utilização da quimioterapia oncológica no tratamento do linfoma canino e do osteossarcoma constitui uma opção terapêutica cada vez mais utilizada com resultados favoráveis. Contudo esta abordagem terapêutica está associada a diversos efeitos adversos em vários parâmetros fisiológicos do animal. Durante este estudo foram sujeitos a tratamento de quimioterapia oncológica 9 cães com linfoma e 3 animais com osteossarcoma. O presente estudo pret...

  2. Linfoma de Hodgkin em baixa faixa etária: relato de dois casos Hodgkin's lymphoma in young children: two cases report

    Silvia M. Luporini; Maria Pizza; Helena R. M. Silva; Maria Luisa Borsato; Helaine C. Castro; Alessandra C. O. Borges; Roberto A. P. Paes; Paula Bruniera

    2006-01-01

    Relato de dois casos de pacientes do sexo masculino com linfoma de Hodgkin (LH) e idades inferiores a 5 anos apresentando linfonodomegalias com evolução de alguns meses e seguimento em nosso serviço. Os estudos imuno-histopatológicos do tumor confirmaram linfoma de Hodgkin, esclerose nodular e positividade para o vírus Epstein-Barr (EBV) em material tumoral, em ambos os casos. Após período de 13 meses em remissão completa houve recidiva em um dos pacientes, mostrando doença agressiva. A análi...

  3. El Tratado de Lisboa (Un juego de espejos rotos

    Juan Manuel de Faramiñán Gilbert

    2009-01-01

    Full Text Available El fracaso del Tratado por el que se establece una Constitución para Europa produjo un periodo de incertidumbre y perplejidad del que ha costado mucho sobreponerse. Por un momento, todo parecía resquebrajarse y se tuvo la sensación de que la imagen de unidad en la diversidad, que con tanta dificultad se había forjado, se partía hecha añicoscomo un espejo roto. No obstante, como en un “juego de espejos rotos”, el ideal europeísta se ha ido recomponiendo con un gran esfuerzo, dando lugar a un texto, el Tratado de Lisboa, que encierra una solución de compromiso con el fin de saldar la crisis cuando el futuro de la Unión Europea parecía oscurecerse. Como en los poemas de Alejandra Pizarnik, “cuando el palacio de la noche encierra su hermosura, pulsaremos los espejos hasta que nuestros rostros canten como ídolos” y, así fue como con un esfuerzo milimetrado se ha ido recomponiendo este rompecabezas de cristales con el fin de que en él se refleje, otra vez, la ansiada imagen global. Como se señala enPreámbulo del Tratado de Lisboa, deberemos estar resueltos a salvar una nueva etapa en proceso de integración europea y habrá que recordar “la importancia histórica de que la división del continente europeo haya tocado a su fin y la necesidad de sentar unas bases firmes para la construcción de la futura Europa”.

  4. El Tratado de Asunción y el Mercosur

    Miguel Berthet

    2015-10-01

    Full Text Available Texto de la conferencia pronunciada por el Embajador Dr. Miguel Berthet -Director de Relaciones Económicas Internacionales Y de Comercio Exterior de los Ministerios'de Relaciones Exteriores y de Economía y Finaszas- en nuestra Facultad. el 25 de abril de 1991, explicando el significado y alcance del Tratado de Asunción. ,suscrito pocos dias antes de esta exposición. La conferencia estuvo principalmente orientada a dar nociones básicas para los estudiantes

  5. El Tratado De Dilectione Dei de Balduino de Ford

    Carlos Hallet

    2004-01-01

    Figura relevante de la Orden del Císter, Balduino de Ford es un autor que se distingue por la originalidad de su espiritualidad. Su tratado De dilectione Dei es una meditación sobre el Primer Mandamiento, que nos invita a amar a Dios "con todo el corazón en sus beneficios, con toda el alma en sus promesas, con todas las fuerzas en sus juicios y con toda la mente en sus preceptos". Su reflexión, nutrida de la Biblia y expresada en un lenguaje marcado por la retórica latina, insiste en que el a...

  6. Intravascular Ultrasound and its Use in Vascular Interventional Radiology

    Intravascular ultrasound has become in invasive vascular radiology in the last decade the important part of diagnostic and also therapeutic procedures in management of vascular diseases. The basic possibilities for the use of IVUS include diagnostic procedures in vascular pathology assessment and therapeutic indications in the field of peripheral vascular interventions (PVI). Unlike other image modalities (CT, MRI, ultrasound) IVUS enables gather unique image in real timeright from the vessel lumen, what helps to add important information regarding vessel wall, plate morphology, thrombi and cross-sectional vessel area. After initial use of intravascular ultrasound in coronary circulation, using IVUS is nowadays widely extended especially in aortic diseases, carotid and renal arteries and arteries of the lower extremities. This review article summarizes possibilities of intravascular ultrasound utilization in diagnostic process and therapy from peripheral vascular diseases up to thoracoabdominal aorta diseases and our experience with this new diagnostic modality. (author)

  7. Ictericia febril colestásica como forma de presentación de linfoma de Hodgkin

    Max Schindler

    2014-02-01

    Full Text Available La ictericia febril colestásica como forma de presentación de los linfomas de Hodgkin es un cuadro muy infrecuente. Describimos aquí un caso de síndrome febril prolongado asociado a ictericia progresiva, en el que el diagnóstico de la enfermedad se realiza a través de la biopsia hepática, dada la ausencia de afectación ganglionar que caracteriza a esta enfermedad. Destacamos asimismo el cuadro clínico avanzado y el compromiso multisistémico de una enfermedad rápidamente evolutiva.

  8. Avaliação do efeito da associação do Rituximab ao protocolo de quimioterapia ciclofosfamida, doxorrubicina, vincristina e prednisolona (CHOP) no tratamento de linfomas Não-Hodgkin

    Fuste, P.; Pereira, C; A Reis; V. Serrano; Caetano, Liliana Aranha; Costa, Ana Margarida

    2010-01-01

    O protocolo de quimioterapia ciclofosfamida, doxorrubicina, vincristina e prednisolona (CHOP) e, posteriormente, rituximab, ciclofosfamida, doxorrubicina, vincristina e prednisolona (RCHOP) têm sido utilizados como terapêutica em Linfomas não-Hodgkin (LNH) como o Linfoma Difuso de Grandes Células B (LDGCB) e o Linfoma Folicular (LF). O LDGCB constitui o tipo de LNH mais frequente, com uma incidência de 40% e o LF representa cerca de 25% de todos os LNH-B. O anticorpo monoclonal rituximab foi ...

  9. Linfoma MALT de parótida, presentación de un caso clínico y revisión del tema Parotid MALT lymphoma, presentation of a clinical case and review of subject

    Francisca Fernández A; Carlos Espinoza N; Víctor Mercado M; Humberto Vallejos A

    2012-01-01

    Los linfomas de las glándulas salivales son una entidad poco frecuente, estimándose una incidencia del 5%. La localización más habitual es la glándula parótida, seguida de la submaxilary la sublingual. La mayoría de los linfomas parotídeos son linfomas no Hodgkin (LNH) y se consideran derivados del tejido linfoide asociado a mucosas (MALT). Infrecuentemente se han reportado estos casos y suelen ser subdiagnosticados por su presentación relativamente benigna, comportándose de forma localizada,...

  10. Primary MALT lymphomas of the stomach: A pathological study of 18 cases Linfomas gástricos primarios tipo MALT: un estudio patológico de 18 casos

    I. Venizelos

    2007-05-01

    . Material y métodos: se analizó una cohorte de 18 pacientes. Diez huéspedes tenían linfoma gástrico de tipo MALT y se trataron con resección gástrica como tratamiento inicial. Ocho recibieron antibióticos frente a Helicobacter pylori como tratamiento inicial. En los 18 pacientes se evaluaron la presencia de Helicobacter pylori, los hallazgos endoscópicos y los rasgos patológicos. Se realizó una inmunohistoquímica para valorar el bcl-2 y el p53. Resultados: los pacientes con linfoma MALT de grado bajo: a dieron positivo a Helicobacter pylori (5 de 5; b tenían una lesión superficial (5 de 5; c no tenían afectados los ganglios linfáticos (5 de 5; y d se estadificaron a la baja por comparación con los pacientes con tumores de grado alto. El bcl-2 fue positivo en 4 de los 5 tumores de grado bajo y el p53 fue positivo en 12 de 13 de los de grado alto. El estudio de los pacientes durante un seguimiento de 5 años (n = 18 reveló que todos los tumores menos uno de grado bajo siguieron siendo superficiales sin progresión. Estos tumores eran bcl-2+/p53-, mientras que el único con inmunofenotipo bcl-2+/p53+ progresó hasta convertirse en un tumor de bajo grado ulcerado tras la desaparición de Helicobacter pylori. Se observó una regresión completa en 6 de los 8 pacientes del grupo no tratado con cirugía (n = 8 tras la erradicación de Helicobacter pylori. Estos tumores eran superficiales, de bajo grado, con ganglios negativos y bcl-2+/p53 no concluyente (n = 2; superficiales, de bajo grado, con ganglios negativos y bcl-2+/p53- (n = 2, y ulcerativos, de grado alto, con ganglios negativos y bcl-2+/p53- (n = 2. Los dos tumores persistentes eran ulcerativos, de grado alto con ganglios negativos y bcl-2+/p53+. Conclusión: el linfoma gástrico de tipo MALT, Helicobacter pylori-positivo, superficial, de grado bajo y bcl-2+/p53- desaparece tras la erradicación de Helicobacter pylori.

  11. The Present Situation on Disseminated Intravascular. Coagulation Studies

    刘泽霖

    2001-01-01

    @@ DIC is not a clinical entity in itself. Instead, it always occurs secondary to a broad spectrum of various diseases. DIC may be defined as an acquired syndrome characterized by the activation of intravascular coagulation up to intravascular fibrin formation. Although the trigger for the activation of the coagulation system may vary depending on the underlying condition, it is usually mediated by several cytokines. Thrombin generation proceeds via the (extrinsic) tissue factor/factor Ⅶ a route and simultaneous depression of inhibitory mechanisms, such as the protein C and protein S system. In addition, impaired fibrin degradation, dur to high circulating levels of PAI-1, contributes to enhanced introvascular fibrin deposition.

  12. Linfoma tonsilar em crianças com assimetria tonsilar Linfoma tonsilar en niños con asimetría tonsilar Tonsillar lymphoma in children with unilateral tonsillar enlargement

    Alexandre Caixeta Guimarães

    2012-06-01

    Full Text Available OBJETIVO: Demonstrar a importância do exame físico com ênfase nas alterações das tonsilas palatinas (TP e na anamnese direcionada para a identificação precoce de pacientes com linfoma de TP. DESCRIÇÃO DO CASO: Caso 1 - Menina de cinco anos com voz abafada, observada pela mãe, e "sensação de algo estranho na garganta" há duas semanas. Foi atendida em outro serviço no início do quadro, sendo medicada com amoxicilina, sem melhora. Apresentava aumento importante da TP direita com superfície lisa e ausência de criptas. Após cirurgia, foi confirmado o diagnóstico de linfoma não Hodgkin (LNH. Na investigação também foi identificado acometimento dos linfonodos mesentéricos pelo linfoma. Caso 2 - Menina de 11 anos procurou o pronto-socorro para investigar nódulo em TP esquerda, indolor, de crescimento progressivo há um ano, sem outras queixas. Já havia passado por consultas médicas anteriores, não tendo sido valorizada a queixa da paciente. A TP esquerda encontrava-se aumentada, ultrapassando a linha média e com nódulo no polo superior. Também foi diagnosticado LNH após exame anatomopatológico. COMENTÁRIOS: Um exame minucioso da cavidade oral e do pescoço é essencial para identificar alterações suspeitas de linfoma tonsilar. Pacientes com assimetria tonsilar e outros achados sugestivos de malignidade devem ser submetidos à tonsilectomia.OBJETIVO: Demostrar la importancia de un examen físico con énfasis en las alteraciones de las tonsilas palatinas (TP y en la anamnesis dirigida a la identificación temprana de pacientes con linfoma de TP. DESCRIPCIÓN DEL CASO: Caso 1 - Niña de cinco años, con voz velada, observada por la madre, y «sensación de algo extraño en la garganta» hace dos semanas. Fue atendida en otro servicio en el inicio del cuadro, siendo medicada con amoxicilina, sin mejora. Presentaba aumento importante de la TP derecha con superficie lisa y ausencia de criptas. Después de la cirugía, se

  13. Infiltración meningea por leucemia a celulas plasmáticas y por linfoma no Hodgkin: estudio citomorfologico en el liquido cefalo-raquideo

    Arnaldo Tabares Olives

    1982-06-01

    Full Text Available Son presentadas las características citomorfológicas anormales encontradas en el LCR de dos pacientes, uno de ellos sufriendo de leucemia aguda a células plasmáticas y otro de linfoma mixto no Hodgkin. Se enfatiza la importancia del estudio del LCR en estas patologias.

  14. Primary diffuse large B-cell lymphoma of the oral cavity Linfoma difuso de grandes células B primário de boca

    Bruno Correia Jham

    2007-10-01

    Full Text Available Lymphomas arising within the oral cavity account for only 3.5% of all oral malignancies. Diffuse large B-cell lymphoma is a non-Hodgkin lymphoma subtype characterized by diffuse proliferation of large neoplastic B lymphoid cells. This paper reports a case of diffuse large B-cell lymphoma affecting the oral cavity of a Brazilian woman, along with its clinical, microscopical, immunohistochemical, and molecular features.Linfomas correspondem a 3,5% de todos os casos de lesões malignas de boca. O linfoma difuso de grandes células B é um subtipo de linfoma não-Hodgkin caracterizado pela proliferação difusa de células linfóides B. Este artigo relata um caso de linfoma difuso de grandes células B localizado na cavidade bucal de uma mulher brasileira, incluindo os achados clínicos, microscópicos, imuno-histoquímicos e moleculares.

  15. Infiltración meningea por leucemia a celulas plasmáticas y por linfoma no Hodgkin: estudio citomorfologico en el liquido cefalo-raquideo

    Arnaldo Tabares Olives

    1982-01-01

    Son presentadas las características citomorfológicas anormales encontradas en el LCR de dos pacientes, uno de ellos sufriendo de leucemia aguda a células plasmáticas y otro de linfoma mixto no Hodgkin. Se enfatiza la importancia del estudio del LCR en estas patologias.

  16. Do current indications for surgery of primary gastric lymphoma exist? ¿Existen indicaciones actuales para la cirugía en el linfoma gástrico?

    J. C. Rodríguez-Sanjuán

    2006-03-01

    Full Text Available Objective: to analyze the results of our series in order to assess whether surgical excision is still a valid therapeutic option in case the patient needs surgery. Secondarily, to analyze Helicobacter pylori infection rate. Patients and method: a retrospective study of 69 consecutive patients having stage IE-IIE primary gastric lymphoma; of these, 65 were treated by gastrectomy between 1974 and 1999. Mean age: 62.6 years (28-85. New staining of paraffin-embedded samples from the surgical specimen were carried out (hematoxiline-eosine, Giemsa, immunohistochemistry and reviewed. The histological classification was performed according to Isaacson's criteria. The statistical analysis was done by Chi-squared and Fisher's exact tests, as well as Kaplan-Meier and Log-Rank tests. Results: mortality was 9.2%. There were non-fatal complications in 10.8%. Helicobacter pylori was identified in 62.7%. Seven patients (11.9% suffered a relapse. The 5-year survival probability was 87%. The statistical analysis did not show any influences of Ann Arbor stage, gastric wall invasion, Helicobacter pylori infection, histological type, or margin resection involvement on survival. Conclusions: surgical excision provides a high rate of complete remissions and excellent long-term survival with acceptable mortality. Therefore it appears to be a valid treatment in case of emergency surgery, incidental finding, or lack of histological diagnosis.Objetivo: analizar los resultados de nuestra serie a fin de establecer si la extirpación quirúrgica continúa siendo una opción terapéutica válida para las situaciones en las que pudiera precisarse cirugía. Como objetivo secundario, analizar la prevalencia de infección por Helicobacter pylori. Pacientes y método: estudio retrospectivo de 69 pacientes consecutivos diagnosticados de linfoma gástrico primario, en estadio I E y II E de Ann Arbor, 65 de los cuales fueron tratados mediante gastrectomía entre 1974 y 1999. Edad

  17. LINFOMAS PULMONARES: CORRELAÇÃO DA TOMOGRAFIA COMPUTADORIZADA DE ALTA RESOLUÇÃO COM A ANATOMOPATOLOGIA

    Marchiori Edson

    2002-01-01

    Full Text Available Neste trabalho são descritos os aspectos tomográficos de alta resolução dos linfomas pulmonares e feita correlação com os achados anatomopatológicos. Com este objetivo, foram revisados as tomografias computadorizadas de alta resolução do tórax e os dados histopatológicos de dez pacientes com diagnóstico confirmado de linfoma não-Hodgkin ou de doença de Hodgkin. Os resultados obtidos foram confrontados com os descritos na literatura. Os achados radiológicos mais comumente vistos neste estudo foram as consolidações parenquimatosas, localizadas, com broncogramas aéreos de permeio (n = 8. Em menor freqüência, foram encontrados múltiplos nódulos parenquimatosos (n = 4, espessamento peribroncovascular (n = 3 e opacidades em vidro fosco (n = 2. Na correlação com a anatomia patológica, as consolidações corresponderam a preenchimento alveolar por células neoplásicas, o espessamento peribroncovascular se deveu a infiltração das bainhas peribroncovasculares por células linfomatosas e a atenuação em vidro fosco se associou com infiltração dos septos alveolares por tais células.

  18. Linfoma não-Hodgkin endobrônquico Endobronchial involvement in non-Hodgkin’s lymphoma

    Mauro Zamboni

    2004-02-01

    Full Text Available Os linfomas não-Hodgkin fazem parte de um grupo de doenças malignas linfoproliferativas com diferentes padrões de comportamento, de tratamento e de prognóstico. Eles podem comprometer as estruturas intratorácicas, particularmente o mediastino e o parênquima pulmonar, em alguma fase do curso da doença. Entretanto, o envolvimento endobrônquico é extremamente raro, mesmo na presença de doença avançada. Os autores relatam um caso de linfoma não-Hodgkin endobrônquico e fazem revisão da literatura.Non-Hodgkin’s lymphomas belong to a group of lymphoproliferative malignancies with different behavior, treatment and prognostic patterns. During the course of the disease, they may affect the thoracic structures - especially the mediastinum and the pulmonary parenchyma. However endobronchial involvement is extremely uncommon, even in presence of advanced disease. Here, we report a case of non-Hodgkin’s endobronchial lymphoma and make a review of the literature.

  19. Linfoma não-Hodgkin em adultos: perfil proteico do LCR e do soro de 25 doentes

    MIELLI SYLVIA REGINA

    1998-01-01

    Full Text Available Vinte e cinco pacientes com linfoma não-Hodgkin estudados para detecção de sinais e sintomas de comprometimento neurológico foram investigados quanto ao perfil proteico do líquido cefalorraqueano (LCR. Amostras de LCR e de soro sanguíneo colhidas no mesmo período foram estudadas comparativamente para analisar a barreira hemato-encefálica e a produção intratecal de IgG .Em 48% dos doentes foram registradas queixas e/ou sinais ao exame neurológico. A análise demonstrou: aumento das proteínas totais no LCR em 52%; imunoliberação local em um paciente HIV soropositivo; aumento de globulinas gama no LCR de dois pacientes na ausência de células neoplásicas no LCR e melhora clínica pós-quimioterapia; e registro de banda oligoclonal apenas no LCR em um doente HTLV-I soropositivo. Esses dados mostram que o estudo do perfil proteico no LCR contribui para a caracterização das manifestações do linfoma não-Hodgkin no sistema nervoso.

  20. Deformable templates for plaque thickness estimation of intravascular ultrasound sequences

    Escolano Ruiz, Francisco; Cazorla Quevedo, Miguel Ángel; Gallardo López, Domingo; Rizo Aldeguer, Ramón

    1997-01-01

    Deformable Template models are first applied to estimate the wall of coronary arteries in intravascular ultrasound sequences. Two circular templates (inner and outer) are used to localize and track an image zone that contains the atheroma plaque. Moreover robust wall thickness estimations are derived from this analysis.

  1. Disseminated intravascular coagulopathy in dengue:a brief review

    Viroj Wiwanitkit

    2009-01-01

    Dengue infection is an arboviral infection with a very high prevalence in tropical Southeast Asia.This infection presents as a clinical illness comprising of very high fever with several hematologic aberrations.In this article, the author briefly reviewed the report on disseminated intravascular coagulopathy (DIC),a severe complica-tion,in dengue.

  2. Estratificação de risco em linfoma difuso de grandes células B Risk stratification of large B-cell lymphomas

    Abrahão E. Hallack Neto

    2006-12-01

    Full Text Available O linfoma difuso de grandes células B (LDGCB é uma entidade clínico-patológica heterogênea que corresponde de 30% a 35% dos casos de linfoma não-Hodgkin (LNH. É considerado como agressivo porque a sobrevida é curta na ausência de tratamento adequado. Desde 1993 o tratamento deste linfoma passou a ser direcionado pelo índice internacional de prognóstico (IPI validado em vários estudos. Entretanto, diante das diferentes respostas à mesma terapêutica para pacientes de mesmo IPI houve necessidade de se instituírem novos marcadores de prognóstico para pacientes com LDGCB. Com os avanços do conhecimento biológico destes linfomas, outras variáveis começam a ser utilizadas na estratificação de risco destes linfomas. Nesta revisão abordamos os principais marcadores biológicos utilizados como fatores de prognóstico para o tratamento de pacientes com LDGCB.Diffuse large B-cell lymphoma is a heterogeneous clinical pathological entity which accounts for about 30% to 35% of all non-Hodgkin's lymphoma cases. It is considered to be aggressive due to the patient's short survival time when incorrect treatment is provided. Since 1993, treatment has been carried out according to IPI, which has been validated in several studies. However, since there are different responses from patients with the same IPI submitted to similar therapies, new prognostic markers are needed for these patients. As the biological nature of such lymphomas is becoming better known, other variables are starting to be used in order to stratify risk. In this review we will approach the key biological markers used as prognostic factors to treat diffuse Large B-Cell Lymphoma patients.

  3. Hiperplasia endotelial papilar intravascular oral: uma entidade rara Intravascular papillary endothelial hyperplasia: a rare entity

    João Augusto Vianna Goulart Filho

    2006-02-01

    Full Text Available A hiperplasia endotelial papilar intravascular (HEPI é uma lesão vascular reativa caracterizada pela proliferação endotelial excessiva localizada no interior de vasos sangüíneos comumente dilatados, associada a trombos em organização, ou secundária a outras lesões vasculares, como hemangiomas e granulomas piogênicos. A HEPI é um achado incomum na cavidade oral, onde os lábios são o principal sítio de acometimento, e surge clinicamente sob a forma de nódulos azulados de aspecto clínico semelhante ao de lesões como hemangioma, mucocele e varicosidades. Sob o aspecto histopatológico, observam-se projeções papilares de tecido conjuntivo fibroso revestidas por uma ou duas camadas de células endoteliais no interior de um lúmen vascular. A principal peculiaridade da HEPI reside em sua semelhança histológica com o angiossarcoma e na possível interpretação errônea como neoplasia maligna. Neste artigo, os autores descrevem um caso de HEPI oral e realizam uma breve revisão da literatura, enfatizando suas características histopatológicas e o diagnóstico diferencial.Intravascular papillary endothelial hyperplasia (IPEH is a reactive vascular lesion characterized by excessive endothelial proliferation within a vascular lumen of commonly dilated vessels, associated to organizing thrombi or even secondary to other vascular lesions, such as hemagiomas and pyogenic granulomas. Oral lesions of IPEH are uncommon, being lips the most frequent site, followed by, in decreasing frequency, tongue and buccal mucosa. Clinically, IPEH appears as bluish nodules that resembles clinical features of lesions as hemangioma, mucocele and varice. On histopathological examination, IPEH presents as papillary projections composed by a fibrous core lined by one or two layers of plump endothelial cells, without evidence of celullar pleomorphism, mitotic activity or necrosis. The mean peculiarity of IPEH is its histologic similarity to angiosarcoma and

  4. El tratado de Derecho Administrativo del Profesor Rodolfo Carlos Barra

    Daniel Hugo Martins

    2014-06-01

    Full Text Available En el "Tratado" cuyos primeros dos tomos han sido públicados recientemente, Barra se propone aplicar la "tesis cuatripartita" al derecho administrativo, con base en la "filosofía perenne" y la interpretación tomista del derecho."Este trabajo -dice- propugna la sistematización y mediatización del Derecho Administrativo, como rama del derecho público que garantiza el cumplimiento del acto justo en las relaciones de justicia distributiva y está referido a la regulación de la relación jurídica Estado (Administración Pública - administrado"

  5. Theoretical model of intravascular paramagnetic tracers effect on tissue relaxation

    Kjølby, Birgitte Fuglsang; Østergaard, Leif; Kiselev, Valerij G

    2006-01-01

    that the relaxivity of intravascular contrast agents depends significantly on the host tissue. This agrees with experimental data by Johnson et al. (Magn Reson Med 2000;44:909). In particular, the present results suggest a several-fold increase in the relaxivity of Gd-based contrast agents in brain tissue compared......The concentration of MRI tracers cannot be measured directly by MRI and is commonly evaluated indirectly using their relaxation effect. This study develops a comprehensive theoretical model to describe the transverse relaxation in perfused tissue caused by intravascular tracers. The model takes...... into account a number of individual compartments. The signal dephasing is simulated in a semianalytical way by embedding Monte Carlo simulations in the framework of analytical theory. This approach yields a tool for fast, realistic simulation of the change in the transverse relaxation. The results indicate...

  6. Intravascular papillary endothelial hyperplasia of the mandibular lingual mucosa

    Benay Tokman; (S)ebnem (S)im(s)ek; Erkan Erkmen; Tülin Oygur

    2004-01-01

    @@ In 1923, Masson1 described an unusual papillary endothelial proliferation that he named as "hemangioendotheliome vegetant intravasculaire". In 1976, Clearkin and Enzinger2 coined the term intravascular papillary endothelial hyperplasia (IPEH) that is now in use. This term refers to the presence of endothelium lined papillary projections within a vascular space. Characteristically, the papillary structures are composed of a single layer of swollen or plump endothelial cells without cellular pleomorphism, mitotic activity or necrosis.

  7. Biochemistry and pathophysiology of intravascular and intracellular lipolysis

    Young, Stephen G.; Zechner, Rudolf

    2013-01-01

    Triglcyerides must be degraded by an enzymatic process called lipolysis before they can cross cellular membranes. This wide-ranging and authoritative review by Young and Zechner surveys the current state of affairs regarding intravascular and cellular lipolysis and focuses on the recently discovered key proteins involved, including CPIHBPI, adipose triglyceride lipase, and GCI-58. Extensive discussion is also given over to the role of lipolysis in human disease.

  8. Look away: arterial and venous intravascular embolisation following shotgun injury

    Vedelago, John; Dick, Elizabeth; Thomas, Robert; Jones, Brynmor; Kirmi, Olga; Becker, Jennifer; Alavi, Afshin; Gedroyc, Wladyslaw

    2014-01-01

    We describe two cases of intravascular embolization of shotgun pellets found distant to the entry site of penetrating firearm injury. The cases demonstrate antegrade embolization of a shotgun pellet from neck to right middle cerebral artery, and antegrade followed by retrograde venous embolization through the left lower limb to pelvis. Radiologists and Trauma Physicians should be aware that post shotgun injury, the likelihood of an embolised shot pellet is increased compared to other types of...

  9. Design of low noise transimpedance amplifier for intravascular ultrasound

    Reda, Dina

    2009-11-01

    In this paper, we study transimpedance amplifiers for capacitive sensing applications with a focus on Intravascular Ultra Sound (IVUS). We employ RF noise cancellation technique on capacitive feedback based transimpedance amplifiers. This technique eliminates the input-referred noise of TIAs completely and enhances the dynamic range of front-end electronics. Simulation results verify the proposed technique used in two different TIA topologies employing shunt-shunt feedback. ©2009 IEEE.

  10. Cutaneous collagenous vasculopathy associated with intravascular occlusive fibrin thrombi.

    Salama, Samih; Chorneyko, Kathy; Belovic, Brian

    2014-04-01

    Cutaneous collagenous vasculopathy (CCV) is a rare cutaneous microangiopathy that clinically resembles generalized essential telangiectasia with only 12 cases reported to date. The perivascular fibrosis is thought to be due to production of abnormal collagen by veil cells in the outer vessel walls as a result of unknown factors. This report is of an 84-year-old male with progressive telangiectasia. Biopsies showed characteristic features of CCV. In addition, there were multiple intravascular fibrin thrombi, some organizing and associated with endothelial cell hyperplasia with recanalization reminiscent of glomeruloid bodies and simulating reactive angioendotheliomatosis (RAE). Histochemically and ultrastructurally fibrin was noted within the vessel walls integrating into the fibrous tissue around the vessels; however, the patient had no evidence of coagulation disorder, cryoglobulinemia or cold agglutinemia. Immunofluorescence showed fibrinogen within the vessel walls but no immunoglobulins or C3. As well, there were minimal inflammatory cells. This suggests pauci-inflammatory injury to the endothelial cells by unknown angiogenic factors causing local intravascular fibrin thrombi with fibrin leaking and incorporating into the vessel walls, eventually leading to reparative perivascular fibrosis. This case suggests that some cases of CCV are related to a primary local intravascular occlusive thrombotic microangiopathy. However, the primary triggering factor causing the endothelial cell damage has yet to be elucidated. PMID:24350781

  11. Identificación del gen MALT1 como oncogén dominante en el linfoma MALT.

    Sánchez Izquierdo, Maria Dolores

    2005-01-01

    RESUMEN En los linfomas no Hodgkin (LNH), las traslocaciones primarias características dan lugar a la desregulación de un protooncogén (debido en un gran número de casos al reordenamiento con el gen de las inmunoglobulinas) y cuya consecuencia funcional es la alteración de la expresión génica con potencial neoplásico. Otro tipo de lesión genética frecuente es la delección cromosómica que inactiva genes supresores tumorales, por ejemplo p53 ó p16. Estas anomalías se identifican junto a las ...

  12. Linfoma primario de páncreas en un paciente de 27 anos de edad. Reporte de un caso

    Andrea Fargier Paoli

    2013-01-01

    Full Text Available Los linfomas representan una pequeña fracción de todas las neoplasias malignas de páncreas, siendo inferior al 1 o 2%, y es aún más extremadamente extraño en individuos menores de 35 años, por lo que presentamos caso de linfoma primario de páncreas en un paciente de 27 años de edad, que presentó ictericia y dolor abdominal, como única sintomatología. El ultrasonido abdominal solo reportó litiasis biliar mixta, por lo que se programó cirugía electiva para colecistectomía y exploración biliar. El hallazgo intraoperatorio inesperadamente indicó una tumoración a nivel de cabeza del páncreas, y se procedió a realizar una biopsia de la lesión, colecistectomía e inserción de tubo de Kher en la vía biliar principal, ante la imposibilidad de manejo endoscópico posterior con endoprotesis. Adicionalmente, se inicio un protocolo de estudio postoperatorio, hacia la búsqueda de marcadores tumorales y tomografía axial computarizada (TAC abdomino-pélvica, esta última evidenció tumoración en cabeza de páncreas sin infiltración a órganos vecinos o estructuras vasculares. El estudio histopatológico mostro un linfoma de páncreas, por lo que se complementaron los estudios de extensión e inició tratamiento a base de quimioterapia. En la actualidad tiene 6 meses de tratamiento con adecuada respuesta al mismo, dada por una disminución en el tamaño del tumor corroborada por tomografía y desaparición de la ictericia. Debido a los pocos casos reportados de linfoma primario de páncreas en individuos menores de 35 años, decidimos reportar este caso a fin evidenciar la importancia de un diagnóstico preoperatorio correcto, para evitar terapéuticas inadecuadas. Primary Lymphoma of Pancreas in a 27 year-old patient. A case report Abstract Pancreatic lymphomas is a rare (less than 1-2% pancreatic malignant neoplasms, but is extremely rare in under 35 yearsold. A rare case of Primary Lymphoma of Pancreas in a 27 years old patient is

  13. Contribuição da medicina nuclear para a avaliação dos linfomas

    Sapienza Marcelo T.

    2001-01-01

    Full Text Available A medicina nuclear permite a caracterização funcional de tecidos, acrescentando dados à avaliação anatômica realizada por outros métodos de imagem, como a tomografia computadorizada, ressonância magnética ou ultra-som. Além do diagnóstico e estadiamento, as informações funcionais fornecidas pela medicina nuclear são particularmente úteis no seguimento e avaliação de resposta terapêutica dos pacientes com linfoma. A presença de massa residual após quimioterapia ou a infiltração de linfonodos de pequenas dimensões são exemplos de situações nas quais a avaliação isolada de características anatômicas é insuficiente. Os principais métodos utilizados são a cintilografia com gálio-67, traçador com alta afinidade por transferrina e receptores de ferro, e os estudos com flúor-deoxiglicose, emissor de pósitron que permite a caracterização do metabolismo de glicose nos tecidos. Outros traçadores, como o tálio-201, sestamibi-Tc99m e octreotide-In111, também são utilizados em menor escala na avaliação dos pacientes com linfoma. Os mecanismos de captação, principais indicações dos estudos, limitações e resultados de literatura serão revistos.

  14. El Tratado De Dilectione Dei de Balduino de Ford

    Carlos Hallet

    2004-01-01

    Full Text Available Figura relevante de la Orden del Císter, Balduino de Ford es un autor que se distingue por la originalidad de su espiritualidad. Su tratado De dilectione Dei es una meditación sobre el Primer Mandamiento, que nos invita a amar a Dios "con todo el corazón en sus beneficios, con toda el alma en sus promesas, con todas las fuerzas en sus juicios y con toda la mente en sus preceptos". Su reflexión, nutrida de la Biblia y expresada en un lenguaje marcado por la retórica latina, insiste en que el amor perfecto exige del creyente amar lo que a Dios le agrada porque a Él le agrada. Termina identificando prácticamente amor con obedienciaFamous figure of the cistercian order, Baldwin of Ford is an author who stands out for the originality of his spirituality. His treatise "De dilectione Dei" is a meditation about the First Comandment, which is an invitation to love God "with all the heart in His benefits, with all the soul in His promises, with all the forces in His judgements and with all the mind in His precepts". According to his reflection, fed with the Bible and expressed in a language marked by the latin rhetoric, the perfect love requires to love what is pleasing to God because it pleases Him. Baldwin practically identifies love with obedience

  15. Design, construction, and validation of a rotary multifunctional intravascular diagnostic catheter combining multispectral fluorescence lifetime imaging and intravascular ultrasound

    Bec, Julien; Xie, Hongtao; Yankelevich, Diego R.; Zhou, Feifei; Sun, Yang; Ghata, Narugopal; Aldredge, Ralph; Marcu, Laura

    2012-10-01

    We report the development and validation of an intravascular rotary catheter for bimodal interrogation of arterial pathologies. This is based on a point-spectroscopy scanning time-resolved fluorescence spectroscopy technique enabling reconstruction of fluorescence lifetime images (FLIm) and providing information on arterial intima composition and intravascular ultrasound (IVUS) providing information on arterial wall morphology. The catheter design allows for independent rotation of the ultrasonic and optical channels within an 8 Fr outer diameter catheter sheath and integrates a low volume flushing channel for blood removal in the optical pathways. In the current configuration, the two channels consist of (a) a standard 3 Fr IVUS catheter with single element transducer (40 MHz) and (b) a side-viewing fiber optic (400 μm core). Experiments conducted in tissue phantoms showed the ability of the catheter to operate in an intraluminal setting and to generate coregistered FLIm and IVUS in one pull-back scan. Current results demonstrate the feasibility of the catheter for simultaneous bimodal interrogation of arterial lumen and for generation of robust fluorescence lifetime data under IVUS guidance. These results facilitate further development of a FLIm-IVUS technique for intravascular diagnosis of atherosclerotic cardiovascular diseases including vulnerable plaques.

  16. Primary liver AIDS-related lympoma Linfoma não-Hodgkin primário do fígado em paciente com SIDA

    María Florencia Villafañe

    2006-08-01

    Full Text Available Non-Hodgkin's lymphomas (NHL are the second most frequent malignancies in AIDS patients. The majority of NHL associated with AIDS involves extranodal sites, especially the digestive tract and the central nervous system. Primary liver lymphoma (PLL is an uncommon neoplasm among these patients. Ultrasonography and computed tomography scans may be helpful in the diagnosis of focal hepatic lymphoma. Image-guided fine-needle biopsy with histopathology of the liver lesions is the gold standard for the diagnosis of hepatic lymphoma. We report a case of PLL as the initial manifestation of AIDS in a patient without any previous infection by hepatitis C or B virus, presented as multiple and large hepatic masses.Os linfomas não-Hodgkin (LNH são as segundas neoplasias mais freqüentes nos pacientes com síndrome da imunodeficiência adquirida (SIDA. A maioria dos LNH associados à AIDS envolvem locais extra-ganglionares, especialmente o trato digestivo e o sistema nervoso central. O linfoma não-Hodgkin primário do fígado (LPF é uma neoplasia incomum nestes pacientes. A ultrassonografia (US e a tomografia computadorizada (TC podem ser úteis no diagnóstico de linfoma não-Hodgkin hepático apresentando-se como lesões multifocais. A biópsia com agulha fina guiada por imagens (US, TC juntamente com a histopatologia das lesões do fígado constitui o padrão-ouro para o diagnóstico de linfoma hepático. Este trabalho relata um caso de LPF como manifestação inicial de AIDS em um paciente sem infecção prévia pelo vírus da hepatite C e B, que se apresentou como massas hepáticas múltiplas e de grandes dimensões.

  17. Significado prognóstico dos graus histológicos do linfoma de Hodgkin do tipo esclerose nodular Prognostic significance of histopathological grading of nodular sclerosing Hodgkin’s lymphoma

    Luís Fernando Pracchia

    2005-10-01

    Full Text Available INTRODUÇÃO: A esclerose nodular (EN, do tipo histológico freqüente do linfoma de Hodgkin (LH, apresenta grande variabilidade em sua composição celular. Na década de 80, pesquisadores do British National Lymphoma Investigation (BNLI propuseram uma subclassificação histológica do LH EN. Eles identificaram dois graus histológicos - o LH EN grau I (LH EN I e o LH EN grau II (LH EN II - e demonstraram que os portadores de LH EN II apresentavam menor sobrevida em comparação aos portadores de LH EN I. Outros estudos, entretanto, não reproduziram esses achados. OBJETIVO: Avaliar o significado prognóstico da graduação histológica proposta pelo BNLI. MATERIAIS E MÉTODOS: Estudo retrospectivo que incluiu 69 casos de LH EN. Mais de 90% dos casos foram tratados com terapia combinada ou quimioterapia exclusiva, não havendo diferença no tipo de tratamento oferecido a depender do grau histológico. RESULTADOS: Trinta e cinco casos (51% foram classificados com EN I e 34 (49% como EN II. Não observamos diferenças na distribuição de outros fatores prognósticos entre os portadores dos dois graus. Remissão completa após o tratamento inicial foi obtida em 85,7% dos casos de EN I e em 82,4% dos casos de EN II (p = 0,75. A probabilidade estimada de sobrevida global em cinco anos foi de 67% para EN I e de 83,5% para EN II (p = 0,13 e a taxa de sobrevida livre de doença em cinco anos foi de 85,2% versus 87%, respectivamente (p = 0,72. CONCLUSÃO: Nesta população de pacientes uniformemente tratados a graduação histológica BNLI não esteve associada com o prognóstico do LH EN.BACKGROUND: Nodular sclerosis (NS, a frequent histological subtype of Hodgkin’s lymphoma (HL, presents great variability in its cellular composition. In the 80's, researchers of the British National Lymphoma Investigation (BNLI proposed a histological-based subclassification for NS HL. They identified two histological grades - NS HL grade I (NS HL I and NS HL grade

  18. Protection against high intravascular pressure in giraffe legs

    Petersen, Karin Kastberg; Hørlyck, Arne; Østergaard, Kristine Hovkjær;

    2013-01-01

    The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination....... All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure....... revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along the...

  19. Brachytherapy optimal planning with application to intravascular radiation therapy

    Sadegh, Payman; Mourtada, Firas A.; Taylor, Russell H.; Anderson, James H.

    1999-01-01

    We have been studying brachytherapy planning with the objective of manimizing the maximum deviation of the delivered dose from prescribed dose bounds for treatment volumes. A general framework for optimal treatment planning is presented and the minmax optimization is formulated as a linear program....... Dose rate calculations are based on the sosimetry formulation of the American Association of Physicists in Medicine, Task Group 43. We apply the technique to optimal planning for intravascular brachytherapy of intimal hyperplasia using ultrasound data and 192Ir seeds. The planning includes...

  20. Method for Observing Intravascular BongHan Duct

    Jiang, X; Shin, H; Lee, B; Choi, C; Soh, K; Cheun, B; Baik, K; Soh, K; Jiang, Xiaowen; Kim, Hee-kyeong; Shin, Hak-soo; Lee, Byong-chon; Choi, Chunho; Soh, Kyung-soon; Cheun, Byeung-soo; Baik, Ku-youn; Soh, Kwang-sup

    2002-01-01

    A method for observing intra blood vessel ducts which are threadlike bundle of tubules which form a part of the BongHan duct system. By injecting 10% dextrose solution at a vena femoralis one makes the intravascular BongHan duct thicker and stronger to be easily detectable after incision of vessels. The duct is semi-transparent, soft and elastic, and composed of smaller tubules whose diameters are of 10$\\mu$m order, which is in agreement with BongHan theory.

  1. Disseminated Intravascular Coagulation after Surgery for Facial Injury

    Tachibana, Hirohiko; Ishikawa, Shigeo; Yusa, Kazuyuki; Kitabatake, Kenichirou; Iino, Mitsuyoshi

    2016-01-01

    A case of disseminated intravascular coagulation (DIC) presenting after surgery for facial trauma associated with multiple facial bone fractures is described. With regard to the oral and maxillofacial region, DIC has been described in the literature following head trauma, infection, and metastatic disease. Until now, only 5 reports have described DIC after surgery for facial injury. DIC secondary to facial injury is thus rare. The patient in this case was young and had no medical history. Preoperative hemorrhage or postoperative septicemia may thus induce DIC. PMID:27313913

  2. Histamine release and endothelial leakage from an intravascular contrast medium

    Raininko, R.

    1981-04-01

    The endothelial injury produced by meglumine iodamide was studied in the rat aorta. A mixture of blood and contrast medium was more toxic to the endothelium than the pure contrast agent. This difference disappeared after premedication with antihistamine, which did not affect the injury produced by the pure contrast agent. Meglumine iodamide appears to cause a release of histamine from blood but not from the aortic endothelium nor from surrounding tissues in amounts demonstrable by this method. Leucocytes are a source of histamine after intravascular contrast medium administration.

  3. Primary Intrarenal Neuroblastoma with Hypertension and Disseminated Intravascular Coagulation

    Bibi Shahin Shamsian

    2013-01-01

    Full Text Available The primary intrarenal neuroblastoma (IRNB is a rare condition. Intrarenal neuroblastoma typically results from direct renal invasion from an adrenal neuroblastoma, but true intrarenal neuroblastoma originates either sequestered adrenal rests during the fetal life or intrarenal sympathetic ganglia. Clinical, radiological, and pathological correlation is very essential for diagnosis and appropriate management of this type of unusual cases. The distinction of this rare tumor from Wilms’ tumor is an important challenge since both tumors have major differences in prognostic and therapeutic response. We present a 3-year-old boy of primary intrarenal neuroblastoma with extensive abdominal and mediastinal mass, persistent hypertension, and disseminated intravascular coagulation (DIC.

  4. Plasma fibronectin concentrations in dogs with disseminated intravascular coagulation.

    Feldman, B F; Thomson, D B; O'Neill, S

    1985-05-01

    Plasma fibronectin concentrations were significantly (P less than 0.001) below the reference range in dogs with disseminated intravascular coagulation (DIC) secondary to nonlymphomatous neoplasia, acute necrotizing pancreatitis, sepsis, chronic active hepatitis, and heat stroke. There was no statistical evidence of a group effect. Decrease in fibronectin concentration was associated with severe DIC, although no attempt was made to correlate fibronectin concentration with prognosis. These findings parallel those reported for severely ill human beings with diseases associated with DIC. They exemplify the potential of spontaneous diseases in animals as models for the study of human disease. PMID:4003893

  5. Intravascular Papillary Endothelial Hyperplasia(Masson's Tumor) of the Chest Wall: A Case Report

    Kim, Ga Ram [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Joo, Seung Ho; Kie, Jeong Hae; Hong, Ki Pyo; Shim, Joo Eun [NHIC Ilsan Hospital, Ilsan (Korea, Republic of)

    2009-12-15

    Intravascular papillary endothelial hyperplasia is a rare tumor-like lesion caused by hyperplastic proliferation of endothlial cells that is usually an incidental findings within thrombosed dilated blood vessels or vascular tumor. We report the sonographic appearance and pathological correlation of intravascular papillary endothelial hyperplasia that presented as an intramuscular solitary mass in chest wall

  6. 76 FR 77834 - Scientific Information Request on Intravascular Diagnostic and Imaging Medical Devices

    2011-12-14

    ... Intravascular Diagnostic and Imaging Medical Devices AGENCY: Agency for Healthcare Research and Quality (AHRQ... intravascular diagnostic and imaging medical devices, including: Fractional Flow Reserve (FFR), Coronary Flow... medical devices, including those that describe adverse events, as specified in the key questions...

  7. Linfoma T subcutâneo do tipo paniculite: relato de um caso acometendo paciente pediátrico Subcutaneous panniculitic T cell lymphoma: a case report affecting a child

    Lúcia de Noronha

    2001-01-01

    Full Text Available Os autores relatam um caso de linfoma T subcutâneo do tipo paniculite em uma paciente feminina de 3 anos, apresentando havia um mês múltiplos nódulos subcutâneos, indolores, disseminados no abdome, região peitoral e cervical. Ao exame histopatológico, evidenciou-se um linfoma T infiltrando tecido adiposo subcutâneo. Os linfomas T subcutâneos representam uma entidade clinicopatológica distinta, sendo raro o acometimento pediátrico.We report a case of lypotrophic lymphoma affecting a 3-year-old child with 1-month history of nontender subcutaneous nodules disseminated throughout the abdomen, chest and cervical region. Histological examination showed a T-cell lymphoma affecting the subcutaneous tissue. Subcutaneous panniculitis-like T-cell lymphoma is an unusual cutaneous T-cell lymphoma that rarely affects pediatric patients.

  8. An Implantable Intravascular Pressure Sensor for a Ventricular Assist Device

    Luigi Brancato

    2016-08-01

    Full Text Available The aim of this study is to investigate the intravascular application of a micro-electro-mechanical system (MEMS pressure sensor to directly measure the hemodynamic characteristics of a ventricular assist device (VAD. A bio- and hemo-compatible packaging strategy is implemented, based on a ceramic thick film process. A commercial sub-millimeter piezoresistive sensor is attached to an alumina substrate, and a double coating of polydimethylsiloxane (PDMS and parylene-C is applied. The final size of the packaged device is 2.6 mm by 3.6 mm by 1.8 mm. A prototype electronic circuit for conditioning and read-out of the pressure signal is developed, satisfying the VAD-specific requirements of low power consumption (less than 14.5 mW in continuous mode and small form factor. The packaged sensor has been submitted to extensive in vitro tests. The device displayed a temperature-independent sensitivity (12 μ V/V/mmHg and good in vitro stability when exposed to the continuous flow of saline solution (less than 0.05 mmHg/day drift after 50 h. During in vivo validation, the transducer has been successfully used to record the arterial pressure waveform of a female sheep. A small, intravascular sensor to continuously register the blood pressure at the inflow and the outflow of a VAD is developed and successfully validated in vivo.

  9. Fatal Cryocrystalglobulinemia With Intravascular and Renal Tubular Crystalline Deposits.

    DeLyria, Paul A; Avedschmidt, Sarah E; Yamada, Chisa; Farkash, Evan A

    2016-05-01

    Cryocrystalglobulinemia is a rare variant of cryoglobulinemia in which monoclonal immunoglobulins self-assemble into crystalline arrays. We report a case of a 53-year-old man who presented with systemic thrombotic microangiopathy causing multiorgan failure, including decreased kidney, lung, and gastrointestinal function; skin necrosis; and mental status changes. Skin and kidney biopsy specimens showed intravascular thrombi, along with intravascular, intratubular, and periglomerular crystalline deposits. Typical morphologic features of cryoglobulinemia, such as a leukocytoclastic vasculitis and pseudothrombi, were absent. Spindled crystals precipitated in the cryoglobulin assay, and immunofixation showed them to be composed of monoclonal immunoglobulin G κ light chains. Ultrastructural analysis demonstrated deposits to have an array-like substructure. The patient was successfully treated with a combination of plasmapheresis, steroids, and bortezomib, but experienced a relapse and died 12 months after his initial diagnosis. Cryocrystalglobulinemia causes significant morbidity and mortality and should be classified as a monoclonal gammopathy of renal significance when it occurs in patients not meeting diagnostic criteria for multiple myeloma. PMID:26775022

  10. Dominant neurologic symptomatology in intravascular large B-cell lymphoma.

    Kubisova, K; Martanovic, P; Sisovsky, V; Tomleinova, Z; Steno, A; Janega, P; Rychly, B; Babal, P

    2016-01-01

    Intravascular large B-cell lymphoma (IVLBCL) is a rare variant of extranodal large B-cell lymphoma and it is characterized by selective intravascular proliferation of malignant cells. Typical features of the disease include aggressive behavior, rapid and frequently fatal course. Clinical picture is non-specific and heterogeneous, depending on the affected organ. It is not uncommon that this unique type of lymphoma is diagnosed post mortem. Herein, we report two cases of IVLBCL with neurologic symptomatology. In our clinical study patient 1 was an 80-year-old male with mixed paraparesis of lower extremities and difficulties with sphincter control. Patient 2 (56-year-old male) had vision malfunction, mental status changes and defect in phatic and motor functions. In both cases definite diagnosis was established by histological examination of necroptic material. We propose to include IVLBCL in differential diagnostic considerations in patients presenting with gradually impairing neurological status and spinal cord damage of unknown etiology (Fig. 2, Ref. 9). PMID:27546361

  11. Focused intravascular ultrasonic probe using dimpled transducer elements.

    Chen, Y; Qiu, W B; Lam, K H; Liu, B Q; Jiang, X P; Zheng, H R; Luo, H S; Chan, H L W; Dai, J Y

    2015-02-01

    High-frequency focused intravascular ultrasonic probes were fabricated in this study using dimple technique based on PMN-PT single crystal and lead-free KNN-KBT-Mn ceramic. The center frequency, bandwidth, and insertion loss of the PMN-PT transducer were 34 MHz, 75%, and 22.9 dB, respectively. For the lead-free probe, the center frequency, bandwidth, and insertion loss were found to be 40 MHz, 72%, and 28.8 dB, respectively. The ultrasonic images of wire phantom and vessels with good resolution were obtained to evaluate the transducer performance. The -6 dB axial and lateral resolutions of the PMN-PT probe were determined to be 58 μm and 131 μm, respectively. For the lead-free probe, the axial and lateral resolutions were found to be 44 μm and 125 μm, respectively. These results suggest that the mechanical dimpling technique has good potential in preparing focused transducers for intravascular ultrasound applications. PMID:25108608

  12. Intravascular lymphomatosis of central nervious system - case report

    Jović Jasmina

    2003-01-01

    Full Text Available Intravascular lymphomatosis is an uncommon lymphoproliferative disorder characterised by intravascular distribution of neoplastic lymphoid cells (B- or T- lymphocites, what leads to occlusion of small vessels and causes signs and simptoms of disorder. Its initial predilection sites are the brain or the skin, and hematopoetic organs are usually spared. The signs and symptoms of the disorder are attributed to vascular occlusion. Clinical course is fatal, besides therapy. In our case disorder has started with partial epileptic seizures with secondary generalisation, and after that with motor aphasia, right hemi paresis, urinary incontinence and cognitive changes. She was hospitalized for several times, completely investigated, but with no conclusion. Seven months after appearance of symptoms, she died. And diagnosis was determined at autopsy. A myriad of neurological and systemic manifestations are putting us in an unequal position with this fatal disease. Early diagnosis can increase survival and decrease intensity of symptoms. So every new case is important as warning that we must not forget about this disease.

  13. Late adverse reactions to intravascular iodinated contrast media

    Webb, Judith A.W. [Department of Diagnostic Imaging, St. Bartholomew' s Hospital, London EC1A 7BE (United Kingdom); Stacul, Fulvio [Institute of Radiology, Ospedale di Cattinara, 34149 Trieste (Italy); Thomsen, Henrik S. [Department of Diagnostic Radiology 54E2, Copenhagen University Hospital at Herlev, Herlev Ringvej 75, 2730 Herlev (Denmark); Morcos, Sameh K. [Department of Diagnostic Imaging, Northern General Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield S5 7AU (United Kingdom)

    2003-01-01

    Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 8th European Symposium on Urogenital Radiology in Genoa. Late adverse reactions after intravascular iodinated contrast medium include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. A significant proportion of these reactions is unrelated to the contrast medium; however, allergy-like skin reactions are well-documented side effects of contrast media with an incidence of approximately 2%. Late reactions appear to be commoner after non-ionic dimers. The majority of late skin reactions after contrast medium exposure are probably T-cell-mediated allergic reactions. Patients at increased risk of late skin reactions are those with a history of previous contrast medium reaction and those on interleukin-2 treatment. Most skin reactions are self-limiting and resolve within a week. Management is symptomatic and similar to the management of other drug-induced skin reactions. (orig.)

  14. Late adverse reactions to intravascular iodinated contrast media

    Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 8th European Symposium on Urogenital Radiology in Genoa. Late adverse reactions after intravascular iodinated contrast medium include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. A significant proportion of these reactions is unrelated to the contrast medium; however, allergy-like skin reactions are well-documented side effects of contrast media with an incidence of approximately 2%. Late reactions appear to be commoner after non-ionic dimers. The majority of late skin reactions after contrast medium exposure are probably T-cell-mediated allergic reactions. Patients at increased risk of late skin reactions are those with a history of previous contrast medium reaction and those on interleukin-2 treatment. Most skin reactions are self-limiting and resolve within a week. Management is symptomatic and similar to the management of other drug-induced skin reactions. (orig.)

  15. Linfoma no Hodgkin difuso de células grandes B del sistema nervioso central con afectación cerebral en pacientes inmunocompetentes e inmunodeprimidos. Características en neuroimagen. Estudio de supervivencia

    Sobrido Sampedro, Carolina

    2013-01-01

    El linfoma primario del sistema nervioso central (LPSNC) es un linfoma no Hodgkin, agresivo que se origina más frecuentemente en el cerebro pero puede envolver las leptomeninges, ojos y médula espinal, y no presenta evidencia de infiltración linfomatosa en otra localización en el momento del diagnóstico. La etiopatogenia es desconocida. La incidencia del LPSNC aumentó significativamente en las décadas anteriores, en la actualidad parece haberse estabilizado o aumentado discretamente. ...

  16. TRATADOS INTERNACIONALES DE DERECHOS HUMANOS BAJO EL ORDENAMIENTO JURÍDICO ALEMÁN

    Roland Bank

    2003-01-01

    Full Text Available En el presente artículo el autor analiza la posición de los tratados internacionales en general, como asimismo, los tratados de derechos humanos y de integración en el sistema jurídico alemán, considerando la posición de la doctrina y la jurisprudencia emanada de la Corte Constitucional Alemana.The article analyzes the status in the German legal system of international treaties in general, and treaties on human rights and integration in particular, from the point of view of legal scholarship and the decisions of the German Constitutional Court.

  17. Intravascular ultrasound imaging of peripheral arteries as an adjunct to balloon angioplasty and atherectomy.

    Korogi, Y; Hirai, T; Takahashi, M

    1996-01-01

    This article reviews many of the applications of intravascular ultrasound (US) imaging for peripheral arterial diseases. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque cross-sectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Intravascular US imaging can provide valuable information on the degree, eccentricity, and histologic type of stenosis before intervention, and on the morphological changes in the arterial wall and the extent of excision after intervention. Intravascular US may also serve as a superior index for gauging the diameter of balloon, stent, laser probe, and/or atherectomy catheter appropriate for a proposed intervention. Significant new insights into the mechanisms of balloon angioplasty and atherectomy have been established by intravascular US findings. Intravascular US imaging has been shown to be a more accurate method than angiography for determining the cross-sectional area of the arterial lumen, and for assessing severity of stenosis. Quantitative assessment of the luminal cross-sectional area after the balloon dilatation should be more accurate than angiography as intimal tears or dissections produced by the dilatation may not be accurately evaluated with angiography. At the present time, intravascular US is still a controversial imaging technique. Outcome studies are currently being organized to assess the clinical value and cost effectiveness of intravascular ultrasound in the context of these interventional procedures. PMID:8653738

  18. Expresión del factor de transcripción SOX11: Su implicancia en el linfoma de células del manto

    Alejandro Roisman

    2014-04-01

    Full Text Available El gen SOX11, perteneciente a la familia de genes SOXC, es un factor de transcripción involucrado en la neurogénesis embrionaria y el remodelado tisular, participando asimismo en el control de la proliferación celular. Su rol en la linfomagénesis es desconocido. Estudios recientes han mostrado expresión proteica nuclear aberrante y sobreexpresión de los niveles de transcripto de SOX11 en pacientes con linfoma de células del manto (LCM. Si bien la mayoría de estos linfomas presentan un curso clínico agresivo, existe un subgrupo de pacientes con enfermedad indolente, sugiriendo una mayor heterogeneidad de esta patología. Actualmente, existen contradicciones respecto de la asociación entre la expresión del gen SOX11 y la evolución clínica del LCM; mientras algunos autores relacionan la ausencia de expresión de SOX11 con buen pronóstico, otros lo encuentran asociado a un curso clínico adverso. Esta diferencia en la expresión estaría relacionada a mecanismos epigenéticos, metilación del ADN y modificaciones a nivel de histonas, que permitirían la expresión aberrante de este gen en algunas neoplasias linfoides, incluyendo LCM. La profundización del conocimiento del gen SOX11 en LCM hará factible, sin duda, lograr una mayor comprensión de los mecanismos involucrados en la patogénesis y/o progresión de este linfoma, así como del rol de SOX11 en estos procesos.

  19. Linfoma cutâneo de células B: relato de caso Cutaneous B-cell lymphoma: a case report

    Mariana de Gusmão Nunes

    2004-12-01

    Full Text Available Os linfomas cutâneos são classificados em linfomas de células B ou de células T, sendo os primeiros menos freqüentes. O linfoma cutâneo de células B (LCCB pode ser primário ou secundário, tendo o último história natural mais agressiva, com pior prognóstico. Os autores apresentam um caso de LCCB secundário com três anos de evolução, curso indolente, sem envolvimento de outros órgãos além da pele, com ótima resposta ao tratamento quimioterápico. A distinção entre LCCB primário e secundário é muito difícil de ser realizada, uma vez que eles são clínica e histopatologicamente indistinguíveis. Deve-se sempre pesquisar o acometimento de órgãos internos para então definir o prognóstico.Cutaneous lymphomas are classified as either type B cell or T cell lymphoma, the former type being less frequent. Cutaneous B cell lymphoma (CBCL may be primary or secondary. The latter has a more aggressive natural history with a worse prognostic. In this paper, the authors present a secondary CBCL case with a three-year evolution, indolent course, without involvement of other organs beside the skin and with optimal response to chemotherapeutic treatment. The distinction between primary and secondary CBCL is very difficult to determine insofar as they are clinically and histopathologically indistinguishable. It is always necessary to investigate whether internal organs have been affected prior to defining the prognosis.

  20. Spectroscopic intravascular photoacoustic imaging of neovasculature: phantom studies

    Su, Jimmy L.; Wang, Bo; Emelianov, Stanislav Y.

    2009-02-01

    An acceleration of angiogenesis in the adventitial vasa-vasorum is usually associated with vulnerable, thin-cap fibroatheroma in atherosclerotic plaques. Angiogenesis creates microvasculature too small to be detected and differentiated using conventional imaging techniques. However, by using spectroscopic photoacoustic imaging, we take advantage of the wavelength-dependent optical absorption properties of blood. We used a vessel-mimicking phantom with micro blood vessels. The phantom was imaged with intravascular photoacoustic imaging across a range of wavelengths. The image intensities were cross-correlated with the known absorption spectra of blood. The resulting cross-correlation image was able to reveal the location of the artificial blood vessels differentiated from non-blood vessel components.

  1. Evaluation of Disseminated Intravascular Coagulation in the Craniocerebral Traumas

    Faruk Altinel

    2014-06-01

    Full Text Available Traumatic injury is one of the most important cause of disseminated intravascular coagulation (DIC. It occurs because of blood loss and hemodilution due to fluid resuscitation. The incidence of trauma associated DIC is mainly higher in the craniocerebral traumas. Even though craniocerebral trauma related DIC is well defined, the pathophysiology has been poorly characterized in the literature. Due to the fact that brain tissue is highly significant for procoagulant molecules, craniocerebral traumas are closely related to DIC. In the current study, 30 patients admitted to emergency room have been considered on the first and fifth day of admission to the hospital for the coagulation tests to evaluate DIC in both two groups. [Cukurova Med J 2014; 39(3.000: 488-495

  2. Design and implementation of an intravascular brachytherapy installation in cardiology

    Intravascular Brachytherapy (IVB) is a very promising technique for reducing restenosis rates. However, neither the exact absolute dose needed nor the optimal spatial and temporal distribution of dose inside the vessel wall for a successful treatment, nor the physical dosimetry of the various radioactive sources and devices for dose delivery, are well known. In this paper, an overview will be given of the design strategy, the dosimetric and radiation protection-related problems that we have met during the implementation of this technique at San Carlos hospital, adopted or foreseen solutions, and future research fields that we intend to carry out in order to reduce uncertainties and to achieve a deeper knowledge of the parameters that have an influence on the treatment. (author)

  3. Pulmonary intravascular macrophages and lung health: what are we missing?

    Schneberger, David; Aharonson-Raz, Karin; Singh, Baljit

    2012-03-15

    Pulmonary intravascular macrophages (PIMs) are constitutively found in species such as cattle, horse, pig, sheep, goat, cats, and whales and can be induced in species such as rats, which normally lack them. It is believed that human lung lacks PIMs, but there are previous suggestions of their induction in patients suffering from liver dysfunction. Recent data show induction of PIMs in bile-duct ligated rats and humans suffering from hepato-pulmonary syndrome. Because constitutive and induced PIMs are pro-inflammatory in response to endotoxins and bacteria, there is a need to study their biology in inflammatory lung diseases such as sepsis, asthma, chronic obstructive pulmonary diseases, or hepato-pulmonary syndrome. We provide a review of PIM biology to make an argument for increased emphasis and better focus on the study of human PIMs to better understand their potential role in the pathophysiology and mechanisms of pulmonary diseases. PMID:22227203

  4. Basic studies on intravascular low-intensity laser therapy

    Liu, Timon Cheng-Yi; Duan, Rui; Wang, Shuang-Xi; Liu, Jiang; Cui, Li-Ping; Jin, Hua; Liu, Song-Hao

    2006-09-01

    Intravascular low intensity laser therapy (ILILT) was originally put forward in USA in 1982, but popularized in Russia in 1980s and in China in 1990s, respectively. A randomized placebo-controlled study has shown ILILT clinical efficacy in patients suffering from rheumatoid arthritis. As Chinese therapeutic applications of ILILT were the most widely in the world, its basic research, such as intracellular signal transduction research, blood research in vitro, animal blood research in vivo, human blood research in vivo and traditional Chinese medicine research, was also very progressive in China. Its basic studies will be reviewed in terms of the biological information model of photobiomodulation in this paper. ILILT might work in view of its basic studies, but the further randomized placebo-controlled trial and the further safety research should be done.

  5. Influência do tratamento quimioterápico para linfoma na dinâmica de infecção pelo parvovírus canino

    Elias, Marta Alexandra Ochoa de Pereira

    2013-01-01

    Dissertação de Mestrado Integrado em Medicina Veterinária A melhoria dos programas vacinais e nutricionais em medicina veterinária, bem como o desenvolvimento de novas técnicas de diagnóstico e tratamento, têm aumentado a esperança média de vida dos nossos pacientes. Em contrapartida, existe uma maior probabilidade de desenvolvimento de doenças geriátricas, especialmente do foro oncológico. O linfoma é a neoplasia hematopoiética mais frequente no cão e apresenta um excelente paralelismo co...

  6. Infiltração do sistema nervoso central e das meninges nos linfomas com representação leucemica

    Marcos R. G.de Freitas; Pedro F. Moreira Filho; Herbert Praxedes; Myriam D. Hahn

    1981-01-01

    Os autores fazem referência a 4 pacientes com representação leucêmica no decurso de linfomas malignos que apresentaram infiltração de células neoplasicas no sistema nervoso central e meninges. É feito o estudo anatomopatoló-gico, encontrando-se em 2 deles a formação de nódulos leucêmicos no parênquima nervoso. Nos outros dois, houve regressão total de sintomatologia neurológica com o uso do metotrexate por via intratecal.

  7. Una nota sobre los tratados de libre comercio y la productividad en el Perú

    Aquije, María; Céspedes, Nikita; Sánchez, Alan

    2014-01-01

    Presenta una breve reseña de los resultados de Céspedes y otros (2014), en donde se estudia la relación entre la productividad de las empresas y los Tratados de Libre Comercio para el caso de la economía peruana.

  8. El avance del derecho a la buena Administración en el Tratado de Lisboa

    Guillem Carrau, Javier

    2010-01-01

    El Tratado de Lisboa liga directamente el derecho a la buena administración con los principios de trasparencia y participación. Este avance debe garantizar que el derecho a la buena administración no quede limitado por un excesivo carácter programá

  9. Intravascular radiation for restenosis prevention: could it be the holy grail?

    King, S.B. [Emory Univ., Atlanta, GA (United States)

    1996-08-01

    This brief editorial discusses the use of intravascular radiation in preventing restenosis after angioplasty in coronary interventions. Results in porcine coronary arteries and clinical applications are briefly reported. (UK).

  10. Intravascular radiation for restenosis prevention: could it be the holy grail?

    This brief editorial discusses the use of intravascular radiation in preventing restenosis after angioplasty in coronary interventions. Results in porcine coronary arteries and clinical applications are briefly reported. (UK)

  11. The use of intravascular ultrasound as control procedure for the deployment of endovascular stented grafts

    Vogt, K C; Brunkwall, J; Malina, M; Ivancev, K; Lindblad, B; Risberg, B; Schroeder, T V

    1997-01-01

    OBJECTIVE: To assess whether intravascular ultrasound (IVUS), used systematically in a series of patients with abdominal aortic aneurysms (AAA), is a feasible control procedure to ensure correct transfemoral placement of endovascular stent grafts (TPEG). DESIGN: Descriptive study. MATERIALS AND M...

  12. Comparison of external and intravascular cooling to induce hypothermia in patients after CPR

    Strasser, Ruth H; Wunderlich, Carsten; Gildemeister, Ramona; Diewok, Claudia; Ziegs, Enrico; Simonis, Gregor; Flemming, Kerstin

    2006-01-01

    Objective: Hypothermia has been shown to reduce neurologic deficits in patients after cardiopulmonary resuscitation (CPR). It was not clear if intravascular cooling is superior to standard external cooling in inducing hypothermia. Goal of this study was to compare intravascular cooling with an automated cooling device with external cooling in everyday practice on a cardiac-care ICU (intensive care unit). Methods: Patients after successful CPR for unwitnessed cardiac arrest were subjected to c...

  13. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    Koo, Kevin S.H. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Dowd, Christopher F.; Hess, Christopher P. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Mathes, Erin F.; Frieden, Ilona J. [University of California, San Francisco, Department of Dermatology, San Francisco, CA (United States); Rosbe, Kristina W. [University of California, San Francisco, Department of Otolaryngology, San Francisco, CA (United States); Hoffman, William Y. [University of California, San Francisco, Department of Surgery, San Francisco, CA (United States)

    2015-10-15

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  14. Intravascular Large B-Cell Lymphoma: A Difficult Diagnostic Challenge.

    Khan, Maria S; McCubbin, Mark; Nand, Sucha

    2014-01-01

    Case Presentation. A 69-year-old Hispanic male, with a past history of diabetes and coronary disease, was admitted for fever, diarrhea, and confusion of 4 weeks duration. Physical examination showed a disoriented patient with multiple ecchymoses, possible ascites, and bilateral scrotal swelling. Hemoglobin was 6.7, prothrombin time (PT) 21.4 seconds with international normalized ratio 2.1, partial thromboplastin time (PTT) 55.6 seconds, fibrin split 10 µg/L, and lactate dehydrogenase (LDH) 1231 IU/L. Except for a positive DNA test for Epstein-Barr virus (EBV) infection, extensive diagnostic workup for infections, malignancy, or a neurological cause was negative. Mixing studies revealed a nonspecific inhibitor of PT and PTT but Factor VIII levels were normal. The patient was empirically treated with antibiotics but developed hypotension and died on day 27 of admission. At autopsy, patient was found to have intravascular diffuse large B-cell lymphoma involving skin, testes, lung, and muscles. The malignant cells were positive for CD20, CD791, Mum-1, and Pax-5 and negative for CD3, CD5, CD10, CD30, and Bcl-6. The malignant cells were 100% positive for Ki-67. Discussion. Intravascular large cell B-cell lymphoma (IVLBCL) is rare form of diffuse large B-cell lymphoma and tends to proliferate within small blood vessels, particularly capillaries and postcapillary venules. The cause of its affinity for vascular bed remains unknown. In many reports, IVLBCL was associated with HIV, HHV8, and EBV infections. The fact that our case showed evidence of EBV infection lends support to the association of this diagnosis to viral illness. The available literature on this subject is scant, and in many cases, the diagnosis was made only at autopsy. The typical presentation of this disorder is with B symptoms, progressive neurologic deficits, and skin findings. Bone marrow, spleen, and liver are involved in a minority of patients. Nearly all patients have elevated LDH, and about 65% are

  15. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  16. Aspectos epidemiológicos, clínicos e anatomopatológicos do linfoma em bovinos: 128 casos (1965-2013

    Welden Panziera

    2014-09-01

    Full Text Available Por meio de um estudo retrospectivo, os aspectos epidemiológicos, clínicos e anatomopatológicos de 128 casos de linfoma bovino são descritos. Dos protocolos que informavam o sexo (n=111, 84,7% correspondiam a fêmeas e 15,3% a machos. Dos protocolos em que constava a raça (n=108, a mais prevalente foi a holandesa (63%. Em relação à idade (n=107, houve uma variação entre um e 14 anos. A maioria dos bovinos era adulta (89,7% e a maior concentração dos casos ocorreu ao redor de 5-8 anos (57,9%. Em relação aos sinais clínicos (n=89, linfadenomegalia foi o achado mais frequentemente observado (74,1%. Outros sinais clínicos, principalmente aqueles relacionados com os sistemas respiratório (dispneia, estertoração pulmonar e taquipneia, cardiovascular (taquicardia, edema subcutâneo e pulso venoso positivo, digestório (atonia ruminal, timpanismo e diarreia e nervoso (paresia dos membros pélvicos e andar cambaleante, foram pouco prevalentes. Na necropsia (n=125, 71,2% dos bovinos apresentavam aumento de volume dos linfonodos; essa linfadenomegalia foi classificada como localizada em 89,6% dos casos e generalizada em 10,3% dos casos. Dos protocolos que informavam os linfonodos acometidos (n=58, a distribuição foi a seguinte: mesentéricos (51,7%, mediastínicos (37,9%, pré-escapulares (29,3%, ilíacos internos (27,6%, inguinais superficiais (25,8% e traqueobrônquicos (18,9%. Além dos linfonodos, outros órgãos comumente afetados pelo linfoma neste estudo incluíram: coração (40%, fígado (15,2%, rim (14,4%, abomaso (12,8%, útero (11,2%, intestino (10,4% e pulmão (7,2%. A presença de massas tumorais no canal vertebral foi observada em poucos casos (3,2%. Com base na epidemiologia e na localização das lesões, a maioria dos casos (96% foi classificada como linfoma enzoótico e o restante (4% como linfoma esporádico. Os resultados encontrados neste estudo irão auxiliar clínicos de grandes animais e patologistas veterin

  17. Análisis químico del esmalte dental humano tratado con una sustancia remineralizante experimental

    González García, Jennifer

    2015-01-01

    El objetivo de este trabajó fue analizar químicamente el efecto de la aplicación de una sustancia remineralizante experimental (SRM) sobre el esmalte dental humano. Se tomaron 40 molares humanos repartidos aleatoriamente en 4 grupos, cada uno de 10 especímenes. Grupo 1: grupo sin tratamiento, Grupo 2: grupo tratado con peróxido de hidrógeno al 35%, Grupo 3. Grupo tratado con la sustancia remineralizante experimental, Grupo 4: grupo tratado con peróxido de hidrógeno al 35% y después con la sus...

  18. Disseminated intravascular coagulation in cattle with abomasal displacement.

    Irmak, K; Turgut, K

    2005-01-01

    The purpose of the study was to evaluate haemostatic function in cattle with abomasal displacement (AD) and to reflect the occurrence of disseminated intravascular coagulation (DIC). Ten adult cattle with left displacement of abomasum (LDA) (group I), 10 adult cattle with right displacement of abomasum with volvulus (RDA) (group II) and 10 clinically healthy adult cattle (control group) were used as material. Numbers of platelets (PLT) and coagulation tests (activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), serum fibrin/fibrinogen degradation products (FDPs), fibrinogen) were measured before the surgical treatment of cattle with LDA and RDA. APTT was prolonged only in group II compared with the control and group I (pcattle in group I and three cattle in group II had at least three abnormal coagulation profiles, which reflect the occurrence of DIC. These cattle died after surgical treatment. The two cattle with LDA had abnormal APTT, FDPs and PLT values; three cattle with RDA had abnormal APTT, PT, TT, FDPs and PLT values. APTT (5 cases), FDPs (5 cases) and thrombocytopenia (5 cases) were the three most common abnormal tests on coagulation profile in the cattle with LDA and RDA. The results of the study indicate that cattle with AD had a spectrum of haemostatic dysfunction and that DIC was a significant risk factor for mortality. PMID:15727292

  19. Effects of intravascular contrast media on blood-brain barrier

    The effects upon the rabbit blood-brain barrier after intracarotid injection of two non-ionic contrast media, iopentol (a monomer) and iodixanol (a dimer) were compared. Iothalamate and iohexol were used as reference substances. 99Tcm-DTPA, 125I-HSA and Trypsin blue were used as tracers in order to demonstrate various degrees of damage to the barrier. Injection of iothalamate led to large extravasation of 99Tcm-DTPA, 125I-HSA and Trypan blue which means severe damage of the blood-brain barrier. Injection of iopentol and iohexol resulted in some extravasation of all three tracers used, whereas injection of iodixanol only led to extravasation of the small molecule tracer 99Tcm-DTPA demonstrating minor changes of the barrier. At computed tomography of the brain with intravascular contrast medium enhancement it is safer to use iodixanol than iothalamate. Iodixanol is expected to cause even less adverse effects to the brain after intraarterial injection than iopentol and iohexol. (orig.)

  20. [Aneurysm of the abdominal aorta and preoperative disseminated intravascular coagulation].

    Chauvet, V; Bussac, J J; Jullian, H; Juhan-Vague, I; Branchereau, A

    1991-01-01

    A case of abdominal aortic aneurysm associated with preoperative signs of disseminated intravascular coagulation is reported. The 69-year-old female patient presented with spontaneously appearing petechiae and bruising. She had 0.95 g.l-1 fibrinogen, 105 G.l-1 platelets, and 100 micrograms.ml-1 fibrin and fibrinogen degradation products. Investigations revealed an 80 mm diameter aneurysm of the abdominal aorta, extending from the coeliac trunk to the iliac arteries. Heparin 7,000 IU.day-1 resulted in a biological improvement for a week only. At that time, levels of coagulation factors were: 92% factor II, 88% factor V, 100% factors VII and X, 100% antithrombin III. Surgical cure of the aneurysm was nevertheless carried out. Twenty standard units of platelets, 8 g fibrinogen, four units of fresh frozen plasma, five homologous and two autologous red cell units were transfused during the procedure. No coagulation factors were necessary during the postoperative course, which was uneventful. The management of coagulation factor infusions, before or after aortic cross-clamping, is discussed. PMID:2058833

  1. Meta-analysis on intravascular low energy laser therapy

    Zhao, Shu-Dong; Liu, Timon Cheng-Yi; Wang, Yan-Fang; Liu, Song-Hao

    2008-12-01

    Intravascular low energy laser therapy (ILELT) was put forward for cardiocirculatory diseases in USA in 1982, was popular in Russia in 1980s, and then in China in 1990s. The therapeutic effects of ILELT and drugs in comparison with drugs only on Chinese patients and their blood parameters were analyzed with meta-analyses and reported as (OR, 95%CI) for patient improvement and (WMD, 95% CI) for blood parameter improvement, where 95%CI, OR and WMD denoted 95% confidence intervals, odds ratio and weighted mean difference, respectively. It was found that the patients of cerebral infarction (2.39, 2.09~2.74) and cerebrovascular diseases (2.97, 1.69~2.53) were cured, respectively, (P cerebrovascular diseases and diabetes were significant (3.13, 2.79~3.51), (4.92, 3.39~7.14) , and (3.80, 2.79~5.18), and mild (3.66, 3.15~4.24), (4.95, 2.77~8.84), and (7.11, 4.54~11.13), respectively, (P cerebrovascular diseases and diabetes might be improved with ILELT, which might be mediated by blood parameter improvement.

  2. Heartbeat OCT: in vivo intravascular megahertz-optical coherence tomography.

    Wang, Tianshi; Pfeiffer, Tom; Regar, Evelyn; Wieser, Wolfgang; van Beusekom, Heleen; Lancee, Charles T; Springeling, Geert; Krabbendam, Ilona; van der Steen, Antonius F W; Huber, Robert; van Soest, Gijs

    2015-12-01

    Cardiac motion artifacts, non-uniform rotational distortion and undersampling affect the image quality and the diagnostic impact of intravascular optical coherence tomography (IV-OCT). In this study we demonstrate how these limitations of IV-OCT can be addressed by using an imaging system that we called "Heartbeat OCT", combining a fast Fourier Domain Mode Locked laser, fast pullback, and a micromotor actuated catheter, designed to examine a coronary vessel in less than one cardiac cycle. We acquired in vivo data sets of two coronary arteries in a porcine heart with both Heartbeat OCT, working at 2.88 MHz A-line rate, 4000 frames/s and 100 mm/s pullback speed, and with a commercial system. The in vivo results show that Heartbeat OCT provides faithfully rendered, motion-artifact free, fully sampled vessel wall architecture, unlike the conventional IV-OCT data. We present the Heartbeat OCT system in full technical detail and discuss the steps needed for clinical translation of the technology. PMID:26713214

  3. Intravascular ultrasound assessed incomplete stent apposition and stent fracture in stent thrombosis after bare metal versus drug-eluting stent treatment the Nordic Intravascular Ultrasound Study (NIVUS)

    Kosonen, Petteri; Vikman, Saila; Jensen, Lisette Okkels; Lassen, Jens Flensted; Harnek, Jan; Olivecrona, Göran K; Erglis, Andrejs; Fossum, Eigil; Niemelä, Matti; Kervinen, Kari; Ylitalo, Antti; Pietilä, Mikko; Aaroe, Jens; Kellerth, Thomas; Saunamäki, Kari; Thayssen, Per; Hellsten, Lars; Thuesen, Leif; Niemelä, Kari

    2012-01-01

    This prospective multicenter registry used intravascular ultrasound (IVUS) in patients with definite stent thrombosis (ST) to compare rates of incomplete stent apposition (ISA), stent fracture and stent expansion in patients treated with drug-eluting (DES) versus bare metal (BMS) stents. ST is a...

  4. Linfoma difuso primario de hígado: Presentación de un caso Diffuse primary hepatic lymphoma: Case report

    Silvana I. Romero Vidomlansky

    2011-06-01

    Full Text Available El linfoma primario de hígado (LPH es un tumor raro y representa menos del 1% de los linfomas no Hodgkin extranodales de células B. Se reporta un caso de LPH en un paciente de sexo masculino de 32 años de edad, sin enfermedad hepática crónica, que ingresa a nuestra institución por sospecha de síndrome mononucleósico. La serología para Virus Epstein Barr fue positiva. Se observó mediante ecografía hepatoesplenomegalia con parénquima hepático heterogéneo en forma difusa. La RM demostró hepatoesplenomegalia y alteraciones en lóbulo derecho hepático, compatibles con infiltración linfoproliferativa. Se realizó biopsia hepática con guía ecográfica y el estudio histopatológico reveló un linfoma no Hodgkin difuso de células grandes con inmunofenotipo B. Se presentan las características clínicas y patológicas del caso, así como una revisión de los aspectos clínicos, hallazgos patológicos y radiológicos.Primary hepatic lymphoma (PHL is a rare tumor that represents less than 1% of extranodal non-Hodgkin B-cell lymphoma. We report a case of PHL in a 32 year-old male patient without chronic liver disease, who was admitted into our institution for suspected mononucleosis syndrome. Serology for Epstein-Barr virus was positive. Ultrasound revealed hepatosplenomegaly with diffuse heterogeneous liver parenchyma. The MRI showed hepatosplenomegaly and alterations in the right lobe of the liver compatible with lymphoproliferative infiltration. Liver biopsy was performed under ultrasound guidance, and histopathologic examination revealed a diffuse non-Hodgkin lymphoma of large cells with immunophenotype B. A clinical and a pathological case as well as a review of the clinical, pathological and radiological findings of this disease are presented.

  5. Imminent Cardiac Risk Assessment via Optical Intravascular Biochemical Analysis

    Wetzel, D.; Wetzel, L; Wetzel, M; Lodder, R

    2009-01-01

    Heart disease is by far the biggest killer in the United States, and type II diabetes, which affects 8% of the U.S. population, is on the rise. In many cases, the acute coronary syndrome and/or sudden cardiac death occurs without warning. Atherosclerosis has known behavioral, genetic and dietary risk factors. However, our laboratory studies with animal models and human post-mortem tissue using FT-IR microspectroscopy reveal the chemical microstructure within arteries and in the arterial walls themselves. These include spectra obtained from the aortas of ApoE-/- knockout mice on sucrose and normal diets showing lipid deposition in the former case. Also pre-aneurysm chemical images of knockout mouse aorta walls, and spectra of plaque excised from a living human patient are shown for comparison. In keeping with the theme of the SPEC 2008 conference Spectroscopic Diagnosis of Disease this paper describes the background and potential value of a new catheter-based system to provide in vivo biochemical analysis of plaque in human coronary arteries. We report the following: (1) results of FT-IR microspectroscopy on animal models of vascular disease to illustrate the localized chemical distinctions between pathological and normal tissue, (2) current diagnostic techniques used for risk assessment of patients with potential unstable coronary syndromes, and (3) the advantages and limitations of each of these techniques illustrated with patent care histories, related in the first person, by the physician coauthors. Note that the physician comments clarify the contribution of each diagnostic technique to imminent cardiac risk assessment in a clinical setting, leading to the appreciation of what localized intravascular chemical analysis can contribute as an add-on diagnostic tool. The quality of medical imaging has improved dramatically since the turn of the century. Among clinical non-invasive diagnostic tools, laboratory tests of body fluids, EKG, and physical examination are

  6. Dose effect of guidewire position in intravascular brachytherapy

    It has been reported that the dose effects of metallic guidewires are significant in intravascular brachytherapy (IVBT) using a beta source. The purpose of this work is to investigate the dependence of these dose effects on guidewire position. The EGS4 Monte Carlo codes were used to perform the dose calculations for the 90Sr (NOVOSTE), 32P (Guidant) and 192Ir (BEST Ind.) sources with and without a guidewire in place. Guidewires were placed at various distances from the central axes of the sources. Due to the attenuation by the guidewires, a dose reduction of up to 70% behind a guidewire was observed for the beta sources, while the dose perturbation was found to be negligible for the gamma source. The dose reduction for the beta sources was found to be dependent on the guidewire location. For example, the dose reduction was 10% higher for a stainless steel guidewire located at 0.5 mm than that for the guidewire at 2 mm from the central axis of the source. The portion of the target volume affected (shadowed) dosimetrically by the guidewire was reduced when the guidewire was positioned farther away from the source. The shadow volume (in which the dose reduction occurs) can be reduced by up to 45% as the guidewire is moved away from the source axis from 0.5 mm to 2 mm. The dosimetric perturbations due to the presence of a metallic guidewire as well as their dependence on guidewire location should be considered in designing a new IVBT delivery device, in analysing the treatment efficacy, and/or in dose prescription for a beta source. (author)

  7. Intravascular papillary endothelial hyperplasia: magnetic resonance imaging of finger lesions

    Sung, Jinkyeong; Kim, Jee-Young [The Catholic University of Korea, Department of Radiology, St. Vincent' s Hospital, College of Medicine, Suwon, Gyeonggi-do (Korea, Republic of); Yoo, Changyoung [The Catholic University of Korea, Department of Hospital Pathology, St. Vincent' s Hospital, College of Medicine, Suwon, Gyeonggi-do (Korea, Republic of)

    2016-02-15

    To describe magnetic resonance imaging (MRI) features of intravascular papillary endothelial hyperplasia (IPEH), to identify findings differentiating IPEH of the finger from that of other locations, and to correlate these with pathology. Nineteen patients with 20 I.E. masses of the finger (n = 13) and other locations (n = 7) were evaluated. All patients underwent MRI, and the results were correlated with pathology. Seventeen IPEHs, including all IPEHs of the finger, were located in the subcutis, the three other lesions in the muscle layer. On T1WI, all masses were isointense or slightly hyperintense. IPEHs of the finger (n = 13) revealed focal hyperintense nodules (n = 2) or central hypointensity (n = 2) on T1WI, hypointensity with a hyperintense rim (n = 7), hyperintensity with hypointense nodules (n = 5), or isointensity with a hypointense rim (n = 1) on T2WI, and rim enhancement (n = 5), heterogeneous enhancement with nodular nonenhanced areas (n = 6), peripheral nodular enhancement (n = 1), or no enhancement (n = 1) on gadolinium-enhanced T1WI. IPEHs of other locations (n = 7) demonstrated focal hyperintense nodules (n = 5) on T1WI, hyperintensity with hypointense nodules (n = 5) or heterogeneous signal intensity (n = 2) on T2WI, and rim or rim and septal enhancement (n = 6) or peripheral nodular enhancement (n = 1). Microscopically, IPEHs were composed of thrombi that were hypointense on T2WI and papillary endothelial proliferations that showed T2 hyperintensity and enhancement. MRI of finger IPEH reveals well-demarcated subcutaneous masses with hypointensity or hypointense nodules with peripheral hyperintensity on T2WI, as well as peripheral enhancement. T1 hyperintense nodules, internal heterogeneity on T2WI, and septal enhancement are more common in IPEH of other locations. (orig.)

  8. Endoscopic staging of low-grade gastric malt lymphoma Estadificación por ecoendoscopia en el linfoma gástrico tipo malt de bajo grado

    M. J. Varas

    2006-03-01

    Full Text Available Introduction: endoscopic ultrasonography (EUS has already proven useful in the assessment of submucosal lesions, and the staging of gastrointestinal cancer, particularly gastric MALT-type lymphoma. The goal of this paper was EUS staging. Patients and method: 24 patients (10 females, 14 males with a median age of 56 years and possibly gastric MALT lymphoma (25 cases were studied using videoendoscopy, biopsies, and echoendoscopy with 7.5- and 20-MHz radial EUS, and also with 12- and 20-MHz miniprobes (MPs. Nineteen patients were definitely evaluated (7 females, 12 males as having 20 MALT-type lymphomas, as five patients were post-hoc disregarded when an invasive, high-grade gastric lymphoma (3c or plasmocytoma (2c was subsequently demonstrated. Of these 19 patients, all had T1 lesions except for two with T2 lesions; one patient had a gastroduodenal T1 lymphoma. Echographic findings with MPs were compared to EUS (gold standard and histology both before and after eradication. Then, patients were followed up every 1-3-6 months using videoendoscopy and MPs. Results: echoendoscopy correctly identified T stages in 90% of cases. MPs identified T stages in 88% of cases, and N stages in 33% of cases, with results being slightly inferior to those obtained with conventional EUS (91 vs. 45%; they were consequently used for follow-up. After eradication, all but two patients are in complete remission and have been followed every 1-3-6 months using MPs without echographic abnormalities, except for a patient who relapsed.Introducción: la ultrasonografía endoscópica (USE ha demostrado ya su utilidad en la evaluación de las lesiones submucosas, en la estadificación del cáncer digestivo en general, y del linfoma gástrico tipo MALT en particular. El objetivo de este trabajo fue la estadificación por USE. Pacientes y método: veinticuatro enfermos (10 mujeres y 14 varones con edad media de 56 años y con posible linfoma gástrico tipo MALT (25 casos fueron

  9. Linfoma adrenal primário bilateral com envolvimento do sistema nervoso central: relato de caso Bilateral primary adrenal lymphoma with central nervous system involvement: a case report

    Marcelo Souto Nacif; Gustavo Federico Jauregui; Ricardo Andrade Fernandes de Mello; Márcia Heizer; Carolina Benvegnu Nahime; Alair Augusto Sarmet Moreira Damas dos Santos

    2005-01-01

    Os autores demonstram os principais achados do linfoma adrenal primário nas tomografias computadorizadas (TC) de abdome e crânio e na ressonância magnética (RM) do crânio, apresentando um caso raro de um paciente do sexo masculino, 72 anos de idade, com progressiva deterioração do estado mental, evoluindo, num período de dois meses, com perda da memória recente, desorientação e, finalmente, franco quadro demencial. O paciente foi submetido a investigação por métodos de imagem com TC de crânio...

  10. Linfoma não-Hodgkin apresentando-se como massa hepática única Non-Hodgkin's lymphoma presenting as a single liver mass

    Mila Correia Góis Peixoto

    2009-02-01

    Full Text Available OBJETIVO: Descrever as principais características de imagem do linfoma não-Hodgkin apresentando-se como massa hepática única. MATERIAIS E MÉTODOS: Realizamos estudo retrospectivo mediante análise de casos de pacientes com massa hepática única aos exames de ultrassonografia, tomografia computadorizada e ressonância magnética, com diagnóstico histológico de linfoma não-Hodgkin. Esses exames foram analisados por dois examinadores em consenso. RESULTADOS: Identificamos três pacientes, todos do sexo masculino, na quinta década de vida, com quadro clínico inespecífico e que apresentavam massa hepática única e com diagnóstico de linfoma não-Hodgkin. Na ultrassonografia a lesão hepática apresentava-se como massa com aspecto "em alvo" nos três casos estudados. Na tomografia computadorizada observou-se massa hipodensa e heterogênea, com realce anelar em todos os casos. Na ressonância magnética as lesões apresentavam-se heterogêneas, hipointensas em T1 e hiperintensas em T2, e também com realce anelar após a injeção do contraste. Nenhum paciente apresentava linfonodomegalia ou comprometimento de outras vísceras sólidas no momento do diagnóstico. CONCLUSÃO: Na presença de massa hepática solitária e com aspecto "em alvo" deve-se considerar, entre as hipóteses, o diagnóstico de linfoma.OBJECTIVE: To describe the main imaging findings of non-Hodgkin's lymphoma presenting as a single liver mass. MATERIALS AND METHODS: A retrospective study was developed with analysis of cases where a single liver mass was observed at ultrasonography, computed tomography and magnetic resonance imaging, and histologically diagnosed as non-Hodgkin's lymphoma. The studies were reviewed by two observers in consensus. RESULTS: Three male patients in the fifth decade of life, with non-specific clinical manifestations and single liver mass diagnosed as non-Hodgkin's lymphoma were identified. A hepatic lesion with target sign was observed at

  11. Costo-efectividad de 18fdg-pet/ct vs ct al final del tratamiento en pacientes pediátricos con linfoma hodgkin

    García Molina, Mario; Chicaiza-Becerra, Liliana; Moreno-Calderón, Alexánder; Prieto Martínez, Víctor; Sarmiento Urbina, Isabel; Linares Ballesteros, Adriana

    2014-01-01

    Objetivo Estimar la costo-efectividad de 18FDG-PET/CT comparado con CT seguido de 18FDG-PET/CT como prueba confirmatoria de un caso positivo en la evaluación al final del tratamiento en pacientes menores de 18 años con Linfoma Hodgkin (LH).Métodos Se construyó un árbol de decisión donde se comparó el uso de 18FDGPET/CT con CT seguido de 18FDG-PET/CT como prueba confirmatoria de un caso positivo en la detección de lesión residual. El resultado se midió en Años de Vida Ganados (AVG). Se calculó...

  12. Identificación de marcadores de utilidad diagnóstica y pronóstica en linfoma b de célula grande agresivo.

    Montes Moreno, Santiago

    2015-01-01

    El objetivo fundamental de la presente tesis es la identificación de marcadores biológicos de utilidad diagnóstica y pronóstica en Linfoma B Difuso de Célula Grande (LBDCG). Se identifican 2 proteínas de interés diagnóstico y pronóstico, GCET1 y PRDM1/Blimp1. La expresión inmunohistoquimica de GCET1 se restringe a neoplasias linfoides de línea B que muestran un estadio de diferenciación centrogerminal. La expresión de PRDM1/Blimp1 se encuentra en neoplasias que muestran diferenciación termina...

  13. Identificación de marcadores de utilidad diagnóstica y pronóstica en linfoma B de célula grande agresivo

    Montes Moreno, Santiago

    2015-01-01

    RESUMEN: El objetivo fundamental de la presente tesis es la identificación de marcadores biológicos de utilidad diagnóstica y pronóstica en Linfoma B Difuso de Célula Grande (LBDCG). Se identifican 2 proteínas de interés diagnóstico y pronóstico, GCET1 y PRDM1/Blimp1. La expresión inmunohistoquimica de GCET1 se restringe a neoplasias linfoides de línea B que muestran un estadio de diferenciación centrogerminal. La expresión de PRDM1/Blimp1 se encuentra en neoplasias que muestran diferenciació...

  14. Effect of catecholamines and insulin on plasma volume and intravascular mass of albumin in man

    Hilsted, J; Christensen, N J; Larsen, S

    1989-01-01

    significantly; intravenous noradrenaline at 0.5 microgram/min had no effect on packed cell volume, whereas packed cell volume increased significantly at 3 micrograms of noradrenaline/min. No significant change in packed cell volume was found during saline infusion. 3. During adrenaline infusion at 6 micrograms......1. The effect of intravenous catecholamine infusions and of intravenous insulin on plasma volume and intravascular mass of albumin was investigated in healthy males. 2. Physiological doses of adrenaline (0.5 microgram/min and 3 microgram/min) increased peripheral venous packed cell volume....../min, packed cell volume increased, plasma volume decreased and intravascular mass of albumin decreased significantly. During noradrenaline infusion at 6 micrograms/min, packed cell volume increased and plasma volume decreased, but intravascular mass of albumin did not change. 4. Application of a...

  15. A case of giant cavernous hemangioma of the liver complicated by intravascular coagulopathy.

    Watanabe,Makoto

    1978-04-01

    Full Text Available A case of liver hemangioma complicated by intravascular coagulopathy is presented because of the rarity of the association. Hemangioma of the liver was suspected by palpation of the liver tumor, scintigraphy and x-ray examination, and confirmed by selective hepatic arteriography in combination with exploratory laparotomy. Intravascular coagulopathy was established by demonstrating secondary fibrinolysis and consumption of platelets and coagulation factors. Unconjugated hyperbilirubinemia due to micro-angiopathic hemolytic anemia was also present. The clinical course of the clotting abnormalities was basically a chronic one with an occasional acute or subacute defibrination process associated with further enlargement of the hepatic tumor. These provide sufficient evidence that the intravascular coagulopathy was closely related with the hemangioma in the liver. Neither ligation of a presumed nutritional artery of the hemangioma nor radiation therapy caused any demonstrable reduction in the tumor size.

  16. Linfoma primário de células T no líquido cefalorraquidiano de cão: relato de caso

    L.F. Moraes

    2012-12-01

    Full Text Available Relata-se o diagnóstico de linfoma primário no sistema nervoso central em um cão Labrador Retrievier, de 10 anos de idade, que apresentava episódios convulsivos, incoordenação nos membros posteriores, head tilt, ataxia e sensibilidade diminuída no lado esquerdo. Constataram-se alterações laterais esquerdas, como ausências de propriocepção e de posicionamento tátil, alterações posteriores nas provas de carrinho de mão e de reação ao pulo e diminuição da extensão da postura e hemilocomoção. No líquido cefalorraquidiano (LCR, houve predomínio de linfócitos atípicos, caracterizados pela presença de anisocitose e anisocariose, nucléolos evidentes e anisonucleose, basofilia e microvacuolização citoplasmáticas, mitoses atípicas e corpúsculos linfoglandulares, compatíveis com linfoma, confirmado pelo exame histológico e imunocitoquímico, o qual revelou origem T, com expressão CD3+ e CD79-. A tomografia computadorizada não foi conclusiva e evidenciou diversas áreas hipodensas e intensificação de contraste na região de sulcos e giros do parênquima encefálico. A coleta do LCR foi essencial na rapidez do diagnóstico definitivo, indicando a natureza rara desta lesão primária.

  17. Linfoma de Hodgkin em baixa faixa etária: relato de dois casos Hodgkin's lymphoma in young children: two cases report

    Silvia M. Luporini

    2006-12-01

    Full Text Available Relato de dois casos de pacientes do sexo masculino com linfoma de Hodgkin (LH e idades inferiores a 5 anos apresentando linfonodomegalias com evolução de alguns meses e seguimento em nosso serviço. Os estudos imuno-histopatológicos do tumor confirmaram linfoma de Hodgkin, esclerose nodular e positividade para o vírus Epstein-Barr (EBV em material tumoral, em ambos os casos. Após período de 13 meses em remissão completa houve recidiva em um dos pacientes, mostrando doença agressiva. A análise laboratorial do tumor mostrou as mesmas características da doença inicial, e mantendo a positividade ao EBV. Uma exposição mais precoce e intensa ao EBV poderia aumentar o risco para formas muito precoces da doença e a inesperada evolução poderia estar ligada à associação do subtipo histológico e positividade ao EBV.The cases of two male under five-year-olds diagnosed with Hodgkin's lymphoma presenting as lymphadenopathy in evolution for some months and treated in our hospital are reported. Immunohistopathological findings of the tumors proved the existence of Hodgkin's lymphoma nodular sclerosis and positive Epstein-Barr virus in tumoral material in both cases. After 13 months of complete remission one of the patients relapsed and presented aggressive disease. Laboratorial analyses of the tumor showed the same characteristics as the initial disease including positive Epstein-Barr virus. Early and intense exposure to Epstein-Barr virus may increase the risk related to the very early development of the disease and the unexpected evolution may be connected to the association of the histological subtype and the positive Epstein-Barr virus.

  18. Neuroimágenes estructurales y funcionales en la caracterización del linfoma del SNC Structural and functional imaging for the characterization of CNS lymphomas

    Cristina Besada

    2010-06-01

    Full Text Available Objetivo: Mostrar los hallazgos en imágenes del compromiso primario o secundario del Sistema Nervioso Central (SNC por el linfoma, haciendo énfasis en el aporte de la espectroscopía. Material y métodos: Se estudiaron en forma retrospectiva con un equipo de resonancia magnética (RM de 1.5T 25 casos (16 hombres y 9 mujeres con diagnóstico histológico de linfoma no Hodgkin y compromiso del SNC. Se destacaron los distintos tipos de presentación en imágenes convencionales con contraste y funcionales en espectroscopía. Se utilizaron técnicas multivoxel con tiempos de eco intermedio y corto. Resultados: Se detectaron 3 patrones principales de presentación de esta patología: parenquimatosa, meníngea y de pares craneanos. Además, se destacaron algunos hallazgos característicos, como compromiso de los espacios perivasculares. La resonancia magnética convencional no fue concluyente en la caracterización del tumor en varios de los casos. En dichos pacientes, el aporte de la espectroscopía fue de gran utilidad. El hallazgo más significativo tanto para los linfomas primarios como para los secundarios fue el aumento de los picos de lípidos y colina. El pico de lípido fue en algunos casos identificado como el metabolito dominante, especialmente en tiempos de eco (TE corto. No se encontraron diferencias en el patrón espectroscópico entre linfomas primarios y sistémicos. Conclusión: La afectación del SNC por los linfomas presenta una gran variedad de manifestaciones radiológicas, con diferentes patrones de presentación. Esta característica hace difícil la correcta caracterización de estos tumores en forma prequirúrgica sólo con RM convencional. La espectroscopía por RM puede ser de gran utilidad en estas situaciones, demostrando la presencia del pico de lípido. Este hallazgo, presente en un tumor sólido intraxial con realce post contraste sugiere la posibilidad de un linfoma y podría promover la modificación de la estrategia

  19. [Intravascular decompressive aerogenesis ultrasonography in a practice of diving medical physician].

    Miasnikov, A A; Goloviashkin, G V; Shitov, A Iu; Motasov, G P; Chumakov, A V; Sukhoroslova, I E; Bobrov, Iu M

    2014-06-01

    The aim of research was substantiation of necessity and accessibility of acoustic indication of intravascular decompressive aerogenesis in a practice of diving medical. Authors define possibilities of portable ultrasound blood flow indicator for location of decompressive gas bubbles. It was found that acoustic indication of intravascular decompressive gas bubbles made by simple portable ultrasonic blood flow meter allows to reveal moving gas bubble in blood flow. Authors came to conclusion that it is necessary to include portable ultrasonic diagnostic equipment into the norms of medical supply for ships, vessels and military units of the Armed Forces of the Russian Federation. PMID:25286575

  20. Avaliação morfológica e imuno-histoquímica de linfomas gástricos primários Morphologic and immunohistochemical evaluation of primary gastric lymphomas

    Jorge Alberto Thomé; Agnes Cristina Fett-Conte; José Antonio Cordeiro

    2005-01-01

    INTRODUÇÃO: Os linfomas gástricos primários representam cerca de 50% dos linfomas não-Hodgkin extranodais e de 2% a 8% das neoplasias malignas do estômago. A maioria é formada pela proliferação de linfócitos B, que ocorre a partir do tecido linfóide associado à mucosa. Esse tecido, inexistente no estômago em condições normais, surge como conseqüência de gastrite crônica, na maioria das vezes associada à bactéria Helicobacter pylori. A inflamação crônica provocada pela infecção bacteriana pare...

  1. Intravascular Ultrasound in Percutaneous Coronary Intervention for Chronic Total Occlusion

    M Mohandes

    2010-09-01

    Full Text Available Background: Percutaneous coronary intervention (PCI of chronic total occlusion (CTO is one of the most challenging procedures in interventional cardiology. New techniques and devices have made possible to face these complex procedures. Intravascular ultrasound (IVUS reveals special features and contributes greatly to procedural success.Method: We analysed retrospectively IVUS contribution and findings in 23 cases of a total 46 CTOs PCI from February 2009 to August 2010 in our cath lab. Both true and functional CTO were included in this study. The procedure was considered successful when a TIMI III flow was reached in the occluded vessel after stent implantation with a residual stenosis less than 30%. IVUS features and contribution in CTO-PCI were analysed. All data were introduced in SPSS version 15 (SPSS Inc. Chicago, Illinois, USA. Continuous variables were described by mean ± SD and categorical variables were expressed as percentage. A P<0.05 was considered statistically significant.Results: 46 PCIs in 34 patients were performed during 19 months in our centre. The procedure was successful in 28 cases (60.9%.. IVUS was performed in 23 (82.1% of successful procedures. IVUS revealed calcium somewhere in 17 (73.9%. Despite wire angiographic verification in true lumen distally IVUS showed subintimal wire position in part of CTO segment in 6(26.1%. In 22(95.7% of cases IVUS allowed both the wire position verification in true lumen and the vessel measurement before stent implantation. In 1(4.3% case a second wire was introduced into true lumen guided by IVUS after realising that the first wire was in false lumen. We could not find significant relation between calcium presence and subintimal wire penetration in CTO segment (p: 0.14 Conclusions: IVUS showed calcium in CTO segment in a high percentage of cases. It is not unusual to find wire penetration in subintimal space in part of CTO segment. IVUS has a key contribution in the step by step

  2. Linfoma de células fusiformes: relato anatomopatológico de um caso com apresentação pulmonar Spindle cell lymphoma: a case with pulmonary presentation

    Túlio Geraldo de Souza e Souza

    2006-02-01

    Full Text Available São raros os linfomas que se apresentam com padrão histológico de células fusiformes. Relatamos um caso de tumor pulmonar isolado em homem de 74 anos, diagnosticado em biópsia de agulha como neoplasia maligna de células fusiformes. Na ocasião, o estudo imuno-histoquímico favoreceu pseudotumor inflamatório. Sete meses após, o paciente foi laparotomizado devido a tumor perfurado intestinal. Os estudos anatomopatológico e imuno-histoquímico estabeleceram o diagnóstico de linfoma B difuso de grandes células. A revisão do tumor pulmonar revelou positividade franca para CD45 e CD20, confirmando o diagnóstico de Linfoma B de células fusiformes. Esta publicação visa a alertar para essa incomum apresentação dos linfomas, que necessita ser considerada, no diagnóstico diferencial de neoplasias de células fusiformes.This paper reports a rare malignant lymphoma with histological spindle-cell pattern. Seventy four year-old man presented with lung tumor. A diagnostic of spindle-cell malignant neoplasia was made and immunohistochemical studies were suggestive of inflammatory pseudotumor. Three months later, the patient returned to our service with acute abdomen. The surgery showed small Intestinal perforation associated with tumor. Microscopic examination and immunohistochemical studies revealed Diffuse B-large cell lymphoma. After the diagnostic of the intestinal tumor, the lung tumor was reviewed, showing positivity for CD45 and CD20 antibodies. This result supports the diagnostic of Spindle B-cell lymphoma, in the lung tumor. The aim of this report is to alert pathologists about this rare spindle cell pattern presentation of lymphomas, that must be differentiated from true sarcomas and others spindle-cell neoplasias.

  3. Linfoma MALT de parótida, presentación de un caso clínico y revisión del tema Parotid MALT lymphoma, presentation of a clinical case and review of subject

    Francisca Fernández A

    2012-04-01

    Full Text Available Los linfomas de las glándulas salivales son una entidad poco frecuente, estimándose una incidencia del 5%. La localización más habitual es la glándula parótida, seguida de la submaxilary la sublingual. La mayoría de los linfomas parotídeos son linfomas no Hodgkin (LNH y se consideran derivados del tejido linfoide asociado a mucosas (MALT. Infrecuentemente se han reportado estos casos y suelen ser subdiagnosticados por su presentación relativamente benigna, comportándose de forma localizada, de lento crecimiento, con varios años de evolución. Presentamos un caso clínico de linfoma tipo MALT de parótida de acuerdo a las características clínicas, histológicas e inmunohistoquímicas de este tumor. Además una revisión de la literatura de este caso.Lymphomas of the salivary glands are a rare entity, with an estimated incidence of 5%. The most frequent location is parotid gland, followed by the submandibular and sublingual. The majority of parotid lymphomas are non-Hodgkin's lymphoma NHL and are considered derived from mucosa-associated lymphoid tissue (MALT. Infrequently these cases have been reported and are often underdiagnosed for their presentation is relatively benign, localized behaving, slow growing, with several years of evolution. We report a case of parotid MALT lymphoma according to the clinical, histological and immunohistochemical characteristics of this tumor. In addition, a literature review of this case.

  4. Modificaciones del timo de becerros tratados con clenbuterol para el consumo humano

    Villar Pastor, Carlos Manuel

    2005-01-01

    Se estudian los efectos sobre el timo del P..2-agonistaclenbuterol utilizado ilegalmente como sustancia finalizadora en el engorde del ganado;considerando tanto su administración en solitario como asociado a la dexametasona. Para ello se utilizaron 18 terneros machos, Charolais x Retinto, de 12-14 meses de edad, que se asignan aleatoriamente en tres grupos experimentales: Grupo tratado con Clenbuterol (A, n=6); Grupo con clenbuterol más dexametasona (B, n=6); Grupo Control (n=6). Los efectos ...

  5. LAS INSTITUCIONES DE LOS TRATADOS ESTABLECIDAS EN LA CONSTITUCIÓN MEXICANA

    Olguín-Torres, Antonio

    2015-01-01

    Derivado de la reforma constitucional de junio del 2011 y el resurgimiento de la importancia de los tratados en el sistema jurídico mexicano, se analizan los artículos 76 fracción I y 89 fracción X de la Constitución Política de los Estados Unidos Mexicanos en lo relacionado con las figuras del derecho internacional ampliamente desarrolladas en la doctrina como: terminación, denuncia, suspensión, modificación, enmienda, declaración interpretativa y reservas, con la finalidad de precisar tanto...

  6. Processos linfoproliferativos da pele: parte 2 - linfomas cutâneos de células T e de células NK Processos linfoproliferativos da pele: part 2 - cutaneous T-cell and NK-cell lymphomas

    José Antonio Sanches Jr

    2006-02-01

    Full Text Available Os linfomas cutâneos de células T/NK constituem um grupo de doenças linfoproliferativas extranodais atualmente classificadas e subdivididas de acordo com o comportamento clínico segundo consenso da Organização Mundial de Saúde e da Organização Européia para Pesquisa e Tratamento do Câncer. Os linfomas cutâneos de células T/NK de comportamento clínico indolente compreendem a micose fungóide clássica, a micose fungóide foliculotrópica, a reticulose pagetóide, a cútis laxa granulomatosa, o linfoma cutâneo primário de grande célula anaplásica, a papulose linfomatóide, o linfoma subcutâneo de célula T paniculite-símile e o linfoma cutâneo primário de pequena e média célula T CD4+ pleomórfica. Os linfomas cutâneos de células T/NK de comportamento agressivo incluem a síndrome de Sézary, o linfoma extranodal de célula T/NK, tipo nasal, o linfoma cutâneo primário agressivo de célula T CD8+ epidermotrópica, o linfoma cutâneo de célula T gd e o linfoma cutâneo primário de célula T periférica, não especificado. O linfoma-leucemia de células T do adulto e a neoplasia hematodémica CD4+CD56+, embora considerados linfomas sistêmicos, são aqui abordados por apresentarem-se inicialmente na pele em significativo número de pacientes. O diagnóstico desses processos é realizado pelo exame histopatológico complementado pela análise do fenótipo das células neoplásicas, imprescindível no processo classificatório. O estadiamento para a avaliação da extensão anatômica da doença considera além do envolvimento cutâneo, o estado clínico e histológico dos linfonodos e das vísceras. Avaliação hematológica é fundamental na caracterização da síndrome de Sézary. Os tratamentos preconizados incluem terapêuticas dirigidas exclusivamente à pele, modificadores da resposta biológica e quimioterapia sistêmica.The cutaneous NKT/cell lymphomas are a group of extranodal lymphoproliferative disorders

  7. Linfoma não-Hodgkin bilateral do seio cavernoso como manifestação inicial da síndrome de imunodeficiência adquirida: relato de caso

    Alan Kardec Barreira Junior

    2011-04-01

    Full Text Available Relato de caso com acometimento bilateral do seio cavernoso causado por linfoma não-Hodgkin em um paciente com síndrome da imunodeficiência adquirida. Paciente de 51 anos infectado pelo vírus da imunodeficiência adquirida há dois anos, sem terapia antirretroviral, apresentou-se com acometimento dos V e VI nervos cranianos bilateralmente. Exame de tomografia computadorizada de órbitas mostrou-se dentro da normalidade. Como a hipótese diagnóstica principal era afecção do ápice orbitário ou do seio cavernoso, foi realizado exame de imagem por ressonância magnética que evidenciou lesão compatível com linfoma acometendo os seios cavernosos. Apesar da raridade dos linfomas primários do sistema nervoso central, essa condição deve ser considerada entre os diagnósticos diferenciais nos pacientes imunodeprimidos que apresentem oftalmoplegia e sinais radiológicos sugestivos de lesão infiltrativa do seio cavernoso.

  8. Identification of atherosclerotic plaque components with intravascular ultrasound elastography in vivo: a Yucatan pig study.

    Korte, C.L. de; Sierevogel, M.J.; Mastik, F.; Strijder, C.; Schaar, J.A.; Velema, E.; Pasterkamp, G.; Serruys, P.W.; Steen, A.F.W. van der

    2002-01-01

    BACKGROUND: Intravascular ultrasound elastography assesses the local strain of the atherosclerotic vessel wall. In the present study, the potential to identify different plaque components in vivo was investigated. METHODS AND RESULTS: Atherosclerotic external iliac and femoral arteries (n=24) of 6 Y

  9. Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? A prospective observational study

    Johansson, Per Ingemar; Sorensen, Anne Marie; Perner, Anders; Welling, Karen-Lise; Wanscher, Michael; Larsen, Claus F; Ostrowski, Sisse R

    2011-01-01

    ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated the...

  10. Gender differences in exercise--induced intravascular haemolysis during race training in thoroughbred horses.

    Cywinska, Anna; Szarska, Ewa; Kowalska, Agnieszka; Ostaszewski, Piotr; Schollenberger, Antoni

    2011-02-01

    Exercise-induced intravascular haemolysis and "sport anemia" are widely reported in human sports medicine. It has been recognized also in horses, however, the clinical importance and the onset of this condition seem different than in human. In this study we investigated the episodes of intravascular haemolysis, indicated by the increase in plasma haemoglobin and the decrease in serum haptoglobin levels, after routine training sessions in race horses. Heart rate and changes in haematological parameters confirmed, that the exertion was relatively high. Intravascular haemolysis did not appear in stallions but was detected in mares after two training sessions. It has been determined that serum haptoglobin levels were higher in mares than in stallions before and after all training sessions. It is postulated that intravascular haemolysis induced by training is of limited clinical importance because it occurred only in mares which are better adapted due to higher haptoglobin level at rest, and it had no cumulative effect. Therefore gender differences should be taken into consideration in experiments with athletic horses. PMID:20553886

  11. Comparison of external and intravascular cooling to induce hypothermia in patients after CPR

    Strasser, Ruth H.

    2006-06-01

    Full Text Available Objective: Hypothermia has been shown to reduce neurologic deficits in patients after cardiopulmonary resuscitation (CPR. It was not clear if intravascular cooling is superior to standard external cooling in inducing hypothermia. Goal of this study was to compare intravascular cooling with an automated cooling device with external cooling in everyday practice on a cardiac-care ICU (intensive care unit. Methods: Patients after successful CPR for unwitnessed cardiac arrest were subjected to cooling with an automated cooling system (CoolGard, Alsius after initial hemodynamic stabilization. Goal was to achieve a core temperature of 33°C. Monitored were the time intervals from admission to begin of cooling and from begin of cooling to target temperature. Data were compared retrospectively with those from patients subjected to external cooling. Results: 31 consecutive patients treated with intravascular cooling were analyzed. Cooling was initiated at a mean time of 58 min after admission, and the target temperature of 33°C was achieved after a mean of 3.48 hours after the begin of cooling. In contrast, 49 patients treated with external cooling achieved a minimum temperature of 34.8°C only 9.2 hours after admission. Conclusion: In everyday practice, intravascular cooling using an automated cooling system is superior for a rapid induction of hypothermia after cardiac arrest.

  12. Thrombocytopenia in the experimental leptospirosis of guinea pig is not related to disseminated intravascular coagulation

    HU, Bao-Yu; Li, Wen-Jun; Zhang Xiang-Yan; Jiang Xu-Cheng; Yang Hong-Liang; Zhao Guo-Ping; Guo Xiao-Kui

    2006-01-01

    Abstract Background Thrombocytopenia is commonly observed in severe leptospirosis. However, previous studies on coagulation alterations during leptospirosis resulted in inconsistent conclusions. Some findings showed that the prominent levels of thrombocytopenia observed in severe leptospirosis did not reflect the occurrence of disseminated intravascular coagulation (DIC) syndrome, while the others reached the conclusion that the hemorrhages observed in leptospirosis were due to DIC. The aim o...

  13. Microfluidics in the Undergraduate Laboratory: Device Fabrication and an Experiment to Mimic Intravascular Gas Embolism

    Jablonski, Erin L.; Vogel, Brandon M.; Cavanagh, Daniel P.; Beers, Kathryn L.

    2010-01-01

    A method to fabricate microfluidic devices and an experimental protocol to model intravascular gas embolism for undergraduate laboratories are presented. The fabrication process details how to produce masters on glass slides; these masters serve as molds to pattern channels in an elastomeric polymer that can be adhered to a substrate, resulting in…

  14. Linfoma de Hodgkin na infância e adolescência: 15 anos de experiência com o protocolo DH-II-90 Hodgkin's lymphoma in children and adolescents: 15 years of experience with the DH-II-90 protocol

    Luciana N. S. Souza

    2010-01-01

    Full Text Available O desafio do tratamento do linfoma de Hodgkin na infância reside na redução da toxicidade aguda e tardia sem afetar os bons resultados terapêuticos. Crianças e adolescentes portadores de linfoma de Hodgkin recém-diagnosticado foram tratados com o protocolo institucional DH-II-90. Os objetivo deste trabalho foram: 1avaliar as taxas de sobrevida global (SG e livre de eventos (SLE do protocolo DH-II-90 aplicado a portadores de LH; 2avaliar as taxas de SG e SLE conforme estádio, idade, tumor "bulky", massa mediastinal, sintomas B, dose de radioterapia e 3descrever os efeitos tardios. Sessenta e oito pacientes portadores de LH recém-diagnosticado, com idade entre 0 e 21 anos (idade mediana 9 anos, 20F:48M, foram tratados com quimioterapia (baixo risco:ABVD; alto risco:ABVD+MOP/COP e radioterapia. O estadiamento foi distribuído desta forma: nove (13,2% estádio I A; 29 (42,6% II A; cinco (7,4% II B; nove (13,2% III A; dez (14,7% III B; dois (2,9% IV A e quatro (5,9% IV B. A SG em dez anos foi de 96,1% ± 3,8 para o grupo de baixo risco e 93,3% ± 4,5 para o de alto risco (p:0,402. A SLE foi de 88,9% ± 5,2 em dez anos para o de alto risco e 86,5% ± 6,3 para o de baixo risco (p: 0,969. A presença de massa mediastinal e doses de radioterapia maiores que 2100 cGy (p= 0,020 e p= 0,014, respectivamente apresentam impacto negativo na SLE e a doença estádio I tem impacto positivo na SLE. Disfunção e carcinoma de tireoide são os efeitos tardios mais frequentes neste grupo de doentes. O protocolo DH-II-90 obteve resultados terapêuticos favoráveis, porém as taxas de complicações tardias, embora aceitáveis, demandam revisão do programa terapêutico.The challenge of new protocols for Hodgkin's lymphoma (HL treatment is to decrease the toxicity without impairing the results. The DH-II-90 protocol was designed to treat children and adolescents with HL. The objectives of this work were: 1 to assess the overall and event free survival of

  15. Un regimen sanitatis contra la peste: el tratado del licenciado Vázquez

    de la Peña Barroso, Efrén

    2012-12-01

    Full Text Available The regimina pestis or plague treatises are the main literary genre where late medieval doctors reflected their medical concern about plague and pestilences. These medical texts, in which some practical recommendations were given to people to avoid and/or cure the effects of epidemic disease of high letality, were developed since the outbreak of the epidemic in 1348. The text now presented is a treatise on plague written by the «licenciado Vázquez», a converso from the archbishopric of Toledo who was tried by the Inquisition at the beginning of the 16th Century.Los regimientos o tratados contra la peste o pestilencia son expresión del modo en que los médicos universitarios bajomedievales hicieron frente a la enfermedad epidémica de alta letalidad. Estos textos médicos, que consistían en un repertorio más o menos amplio de recomendaciones prácticas para prevenir y/o tratar dicha enfermedad, experimentaron un notable desarrollo a partir de la peste negra de 1348. El texto que se ofrece a continuación es un tratado inédito contra la peste escrito por el licenciado Vázquez, un judeoconverso toledano que fue procesado por el Tribunal de la Inquisición a principios del siglo XVI.

  16. EL SISTEMA EUROPEO DE DERECHOS FUNDAMENTALES TRAS LA ENTRADA EN VIGOR DEL TRATADO DE LISBOA

    Lorenzo Martín-Retortillo Baquer

    2011-07-01

    Full Text Available Resumen: En 1947 se pusieron las bases de lo que llegaría a ser la Unión Europea, a modo de organización comercial para sectores concretos, complejo que iría creciendo, ampliándose los fines y la organización, a la par que se fraguaba un complejo ordenamiento jurídico. Se hizo necesario alcanzar una declaración de derechos que incluyera los modernos derechos sociales. En el trabajo se estudia la compleja historia de la obtención de la declaración, la “Carta de Derechos Fundamentales de la Unión Europea”, que, al fin, entraría en vigor el 1.XII.2009, a la par que el último de los Tratados de la Unión, el Tratado de Lisboa.Abstract: The European Union was founded in 1947 as a concrete trade organization but it started to grown. The aims and the organization had increased and in the meantime a complex law system was set up. It was convenient to get a solid bill of rights including the modern social rights. The paper studies the complicate story of how to obtain the bill of rights –the “Carta of Fundamentals Rights of the European Union”- which formally came into effect the 1.XII.2099 at the same time that the last Treaty of the Union, the Treaty of Lison.

  17. Linfoma não-Hodgkin em crianças com imunodeficiência: relato de cinco casos Non-Hodgkin's lymphoma in children with immunodeficiency: report of five cases

    Maria Christina L. A. Oliveira

    2008-01-01

    Full Text Available Neste estudo é relatado o quadro clínico de cinco crianças com linfoma não-Hodgkin secundário a imunodeficiência ou imunossupressão: três portadoras do vírus da imunodeficiência humana, uma com imunodeficiência primária e uma após transplante hepático. De acordo com a classificação atual, os tipos histológicos foram: linfoma linfoblástico de células B precursoras (2, linfoma cutâneo de grandes células anaplásico (1, linfoma de células B periféricas, sugestivo de Burkitt (1, e linfoma linfoblástico de células T precursoras (1. Todos os pacientes foram submetidos a quimioterapia, sendo que dois estão em remissão clínica, dois morreram e um continua em tratamento. Após a introdução da terapia anti-retroviral combinada e o aumento dos transplantes de órgãos sólidos ocorre maior risco de neoplasia nesses pacientes. Desse modo, é importante o seguimento desses pacientes para determinar os fatores de risco para o desenvolvimento de neoplasias e definir adequada estratégia de tratamento.The outcomes of five children with non-Hodgkin's lymphomas associated with immunodeficiency or immunosuppression is reported: three children with HIV, one with primary immunodeficiency and one after liver transplantation. According to the REAL classification, two patients had precursor B-lymphoblastic lymphomas, one had an anaplastic large cell lymphoma, one had a peripheral B-cell neoplasm suggestive of Burkitt's lymphoma, and one had precursor T-lymphoblastic lymphoma. All patients received chemotherapy. Two are in complete remission, two died and one remains under treatment. There has been an increasing awareness of the risk of non-Hodgkin's lymphoma and lymphoproliferative disorders after active antiretroviral therapy and with the expansion of solid organ transplant programs in the pediatric setting. Thus, for these patients it is important to establish risk factors for hematological disorders and determine the optimal and safest

  18. El Tratado de no Proliferación Nuclear: la vigencia de la norma en América Latina

    Adela Cubillos Meza

    2005-01-01

    RESUMEN En este artículo se analiza la posición de los países de América Latina frente al Tratado de No Proliferación Nuclear TNP. Este Tratado entró en vigencia el año 1968 al que se adhirió una gran cantidad de países. Los artífices del TNP fueron las potencias nucleares, Estados Unidos y la ex Unión Soviética, para controlar la proliferación nuclear. Este Tratado ha sido objeto de grandes críticas porque discrimina entre Estados Poseedores de Armas Nucleares y Estados No Poseedores de Arma...

  19. Legitimidad y finalidad de los capítulos de propiedad intelectual en los tratados de libre comercio (TLC)

    Susy Frankel

    2011-01-01

    Una visión analítica de la realidad actual permite apreciar un auge de los Tratados de Libre Comercio, mientras se presenta un estancamiento en las negociaciones multilaterales de comercio. Si bien la negociación de los TLC no se limita a los países desarrollados, los negociados por los países en desarrollo no tienden a contemplar mejoras en los estándares de propiedad intelectual. Algunos de los capítulos relativos a la propiedad intelectual incluidos en los Tratados de Libre Comercio simple...

  20. LOS TRATADOS INTERNACIONALES SOBRE DERECHOS HUMANOS Y SU UBICACIÓN EN EL ORDEN NORMATIVO INTERNO

    Emilio Pfeffer Urquiaga

    2003-01-01

    Full Text Available El artículo analiza la precariedad de la normativa constitucional chilena en materia de incorporación del derecho convencional internacional, tanto en común como específicamente en materia de derechos humanos, pronunciándose sobre la jerarquía de los tratados que contienen derechos humanos de acuerdo con la doctrina y la jurisprudencia, abogando por un pronto desarrollo de normas constitucionales al efecto.This work highlights the precariousness of Chilean Constitutional Law with respect to the incorporation of international conventional Law, both in general and specifically in the area of human rights. The status accorded to human rights treaties by legal scholarship and judicial decisions is examined, and advocacy is advanced for further development of constitutional norms on the matter of incorporation of international treaties on human rights.

  1. Solubilidade de metais pesados em solos tratados com lodo de esgoto enriquecido

    Oliveira, C.; N. M. B. Amaral Sobrinho; Mazur, N.

    2003-01-01

    Os lodos de esgoto são materiais orgânicos ricos em nutrientes com potencial para o uso agrícola. A utilização desses materiais, no entanto, pode ser limitada pela presença de metais pesados na sua composição. Esta pesquisa teve por objetivos: (a) avaliar a solubilidade de Cd, Pb e Zn em dois tipos de solos tratados com lodo de esgoto enriquecido com esses metais; (b) verificar o efeito do tempo de contato nas mudanças da distribuição de Cd, Pb e Zn nas diferentes formas químicas de dois solo...

  2. Neoliberalismo y Tratado de Libre Comercio: ¿hacia ciclos de guerra civil?

    John Saxe-Fernández

    1999-12-01

    Full Text Available El tratado de libre comercio TLC, es la formalización de una relación subordinada de México con Estados Unidos. El aperturismo mexicano ha sido marcado con mayor énfasis por los gobiernos de Porfirio Díaz y de Carlos Salinas de Gortari. El modelo económico derivado ha provocado la desviación de inversión pública al gasto no productivo, como el pago del servicio de la deuda, la liberación de precios junto al control salarial para reducir la inflación, con el propósito de "aumentar competitividad internacional" de los productos mexicanos de exportación.

  3. DERECHOS HUMANOS Y TRATADOS QUE LOS CONTIENEN EN EL DERECHO CONSTITUCIONAL Y LA JURISPRUDENCIA DE ECUADOR

    Marco A. Morales Tobar

    2003-01-01

    Full Text Available El artículo analiza los derechos humanos en la Carta Fundamental del Ecuador y sus garantías, considerando la situación de los tratados internacionales en general y los derechos humanos en particular, estableciendo su procedimiento de incorporación, ubicando su posición entre las fuentes del derecho y considerando su aplicación por la jurisdicción constitucional ecuatoriana.The present article analizes Human Rights and their guarantees in the Constitution of Ecuador, considering the situation of international treaties in general and human rights in particular. Attention turns then to procedures for their incorporation, placing international treaties within the system of law and considering their application by the Ecuadorian constitutional jurisdiction.

  4. Nordic group on X-ray diagnostics: Intravascular brachytherapy - what it is and what the Nordic authorities demand

    Intravascular brachytherapy is radiotherapy of the blood vessel to prevent it from re-narrowing after angioplasty. Angioplasty is a treatment for coronary artery disease where the artery that supplies the heart muscle with blood is blocked or narrowed. The radiotherapy is performed to decrease the growth of normal tissue and thus prevent the risk of restenosis, i.e. prevent it from renarrowing. Intravascular brachytherapy after angioplasty has decreased the restenosis with more than 60%. (orig.)

  5. La PAC tras el Tratado de Lisboa : procesos legislativos ordinarios y actos de ejecución

    Guillem Carrau, Javier

    2011-01-01

    El objetivo básico de este estudio es dejar patente que el Derecho agrario de la UE es especial y autónomo. Tras el Tratado de Lisboa, el procedimiento legislativo ordinario presupone una PAC más cercana al agricultor y al medio por el incremento de

  6. Linfomas asociados con la infección por el virus de la inmunodeficiencia humana: subtipos histológicos y asociación con los virus de Epstein Barr y Herpes-8 AIDS related lymphomas: Histopathological subtypes and association with Epstein Barr virus and Human Herpes virus type-8

    Marcelo Corti; Marcela de Dios Soler; Patricia Bare; María F Villafañe; Miguel de Tezanos Pinto; Raúl Pérez Bianco; Marina Narbaitz

    2010-01-01

    Los linfomas no Hodgkin (LNH) constituyen la segunda neoplasia definitoria de Sida más frecuente. En el presente trabajo se evaluaron 48 casos de linfomas asociados con la enfermedad debida al virus de la inmunodeficiencia humana (HIV) diagnosticados en la División Histopatología del Instituto de Investigaciones Hematológicas de la Academia Nacional de Medicina. Se incluyeron en la investigación 5 mujeres y 43 hombres con una mediana de edad al momento del diagnóstico de la neoplasia de 37 añ...

  7. Impacto pronóstico de la evaluación precoz con tomografía por emisión de positrones (PET) en el tratamiento ajustado al riesgo de los linfomas no Hodgkin B de célula grande

    Pardal de la Mano, Emilia

    2014-01-01

    [ES]Los pacientes diagnosticados de linfoma B difuso de célula grande (LBDCG) forman un grupo heterogéneo dentro de los linfomas. El Indice Pronóstico Internacional (IPI) nos permite clasificar a estos pacientes en grupos con distinta supervivencia. En los pacientes jóvenes con IPI elevado, el tratamiento convencional no consigue buenos resultados, por lo que el trasplante autólogo de progenitores hematopoyéticos (TAPH) puede ser una opción para estos pacientes. Por otro lado, la tomografía p...

  8. Thrombotic Occlusion during Intravascular Ultrasonography-Guided Percutaneous Coronary Intervention of Stumpless Chronic Total Occlusion

    Lee, Un Joo; Kim, Hyun Soo; Lee, Cheolhyun; Kim, Kwang-yeol; Kim, Weon

    2014-01-01

    Percutaneous coronary intervention (PCI) of stumpless chronic total occlusion (CTO) lesions with a side branch stemming from the occlusion have a significantly lower treatment success rate because physicians cannot identify an accurate entry point with only conventional angiographic images. An intravascular ultrasonography (IVUS)-guided wiring technique might be useful for the penetration of stumpless CTO. We recently experienced thrombotic occlusion during an IVUS-guided stumpless CTO proced...

  9. Intravascular activation of complement and acute lung injury. Dependency on neutrophils and toxic oxygen metabolites.

    Till, G O; Johnson, K J; R. Kunkel; Ward, P. A.

    1982-01-01

    Intravascular activation of the complement system with cobra venom factor results in acute lung injury, which has been quantitated by increases in lung vascular permeability. Cobra venom factor preparations devoid of phospholipase A2 activity retain full lung-damaging capacity. The lung injury is associated with the preceding appearance of chemotactic activity in the serum coincident with the development of a profound neutropenia. The chemotactic activity is immunochemically related to human ...

  10. Disseminated Intravascular Coagulation (DIC) Accompanied by Acute Rejection in a Post Renal Transplant Recipient

    Dohi, Kiyohiko; Eto, Takaaki; Ono, Eiji; Fukuda, Yasuhiko; Takenaka, Masaharu; Yahata, Hiroshi; Asahara, Toshimasa; Tabe, Yasuji; Marubayashi, Seiji; Ezaki, Haruo

    1984-01-01

    A kidney transplant recipient with disseminated intravascular coagulation (DIC) accompanied by acute rejection was described. The principal symptome of the patient was massive gross hematuria. She showed thrombocytopenia, marked decrease of fibrinogen and elevation of fibrinogen degradation products (FDP) level. The patient was treated by continuous intravenous heparin infusion (total dose was 85, 800 units), and it was very effective. The symtoms due to DIC were improved on the 9th day after...

  11. Acute kidney injury and disseminated intravascular coagulation due to mercuric chloride poisoning

    Dhanapriya, J.; Gopalakrishnan, N; Arun, V.; Dineshkumar, T.; Sakthirajan, R.; Balasubramaniyan, T.; Haris, M

    2016-01-01

    Mercury is a toxic heavy metal and occurs in organic and inorganic forms. Inorganic mercury includes elemental mercury and mercury salts. Mercury salts are usually white powder or crystals, and widely used in indigenous medicines and folk remedies in Asia. Inorganic mercury poisoning causes acute kidney injury (AKI) and gastrointestinal manifestations and can be life-threatening. We describe a case with unknown substance poisoning who developed AKI and disseminated intravascular coagulation (...

  12. P11.09A NEUROLOGIC PRESENTATION OF INTRAVASCULAR LARGE B-CELL LYMPHOMA

    Matas, A.F.M.R.; Veiga, A.S.B.T.; Gabriel, J.P.M.S.; Silva, M. R.

    2014-01-01

    INTRODUCTION: Intravascular large B-cell lymphoma is a rare and fatal disease that can have central nervous system manifestations. Given its rarity and the multiplicity of presentations, diagnosis is extremely difficult. We report a case that presented with neurological manifestations and which diagnosis was made ante mortem. CASE REPORT: A 74-year-old man, with a background of hypertension and dyslipidemia was referred to our neurology department with a history of speech difficulties and wal...

  13. Local hemostasis, immunothrombosis, and systemic disseminated intravascular coagulation in trauma and traumatic shock

    Gando, Satoshi; Otomo, Yasuhiro

    2015-01-01

    Knowing the pathophysiology of trauma-induced coagulopathy is important for the management of severely injured trauma patients. The aims of this review are to provide a summary of the recent advances in our understanding of thrombosis and hemostasis following trauma and to discuss the pathogenesis of disseminated intravascular coagulation (DIC) at an early stage of trauma. Local hemostasis and thrombosis respectively act to induce physiological wound healing of injuries and innate immune resp...

  14. Analysis of Plaque Composition in Coronary Chronic Total Occlusion Lesion Using Virtual Histology-Intravascular Ultrasound

    Park, Yo-Han; Kim, Yong-Kyun; Seo, Duck-Jun; Seo, Young-Hoon; Lee, Chung-Seop; Song, In-Geol; Yang, Dong-Ju; Kim, Ki-Hong; Park, Hyun-Woong; Kim, Wan-Ho; Bae, Jang-Ho

    2016-01-01

    Background and Objectives Success rates of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have recently been reported to range from 80% to 90%. A better understanding of the pathologic characteristics of the CTO lesion may helpful to improving CTO PCI success rates. We evaluated the CTO lesion in patients with stable angina (SA) by virtual histology-intravascular ultrasound (VH-IVUS). Subjects and Methods The study population consisted of 149 consecutive patients with ...

  15. Distribution of [35S] taurine in mouse retina after intravitreal and intravascular injection

    The distribution of [35S] taurine in mouse retinae was studied by autoradiographic techniques after either intravitreal or intravascular injection. The route of injection did not affect the final localization. The major sites of label accumulation were the outer nuclear layer, the inner nuclear layer, and Mueller cell processes adjacent to the vitreal surface. The distribution was consistent with the interpretation that taurine was localized within two cellular compartments of mouse retina, photoreceptor cells and Mueller cells. (author)

  16. Assessment of normal and atherosclerotic arterial wall thickness with an intravascular ultrasound imaging catheter.

    Mallery, JA; Tobis, JM; Griffith, J.; Gessert, J; McRae, M; Moussabeck, O; Bessen, M; Moriuchi, M; Henry, WL

    1990-01-01

    A prototype intravascular ultrasound imaging catheter with a 20 MHz transducer was used to obtain 59 cross-sectional images in 14 segments of human atherosclerotic arteries. Three distinct components of the arterial wall were visualized on the ultrasound images: a highly reflective intima, an echolucent media, and a moderately reflective adventitia. Images were obtained at 1 mm increments in vitro and were compared with histologic sections at the same levels. Measurements of the arterial laye...

  17. Intravascular large B-cell lymphoma complicated by invasive pulmonary aspergillosis: a rare presentation

    Mahasneh, Tamadur; Harrington, Zinta; Williamson, Jonathan; Alkhawaja, Darweesh; Duflou, Jo; Shin, Joo-Shik

    2014-01-01

    We describe a patient with persisting fevers, a progressive pulmonary infiltrate, and high levels of serum lactate dehydrogenase. No underlying cause for these changes was found prior to her death despite extensive investigations. Postmortem tissue revealed invasive pulmonary aspergillosis and subsequent brain examination revealed vascular changes in keeping with intravascular large B-cell lymphoma (IVLBCL). On review, subtle yet extensive lymphomatous infiltrates involved the vasculature of ...

  18. A new approach for improving coronary plaque component analysis based on intravascular ultrasound images

    Taki, Arash; Hetterich, Holger; Roodaki, Alireza; Setarehdan, S.K.; Ünal, Gözde; UNAL, GOZDE; Rieber, Johannes; Navab, Nassir; König, Andreas; Konig, Andreas

    2010-01-01

    Virtual histology intravascular ultrasound (VH-IVUS) is a clinically available technique for atherosclerosis plaque characterization. It, however, suffers from a poor longitudinal resolution due to electrocardiogram (ECG)-gated acquisition. This article presents an effective algorithm for IVUS image-based histology to overcome this limitation. After plaque area extraction within an input IVUS image, a textural analysis procedure consisting of feature extraction and classification steps is pro...

  19. Colonization of bacteria on polyvinyl chloride and Teflon intravascular catheters in hospitalized patients.

    Sheth, N. K.; Franson, T R; Rose, H. D.; Buckmire, F L; Cooper, J. A., Jr.; Sohnle, P G

    1983-01-01

    During an 8-month period all intravascular catheters were removed by sterile technique upon completion of use and submitted to the hospital microbiology laboratory. All catheters were routinely cultured by the semiquantitative culture technique, with greater than or equal to 15 colonies being defined as a positive result. Of the 687 Teflon catheters cultured, 6.9% were positive by culture, compared with 24.6% of 77 polyvinyl chloride catheters (P less than 0.001). Also, colonization of coagul...

  20. Stiff fingers as an unwanted side effect of intravascular tadalafil gel abuse

    Vaughan, EM; Yeung, D; West, CC; Tadros, A; Curnier, A

    2014-01-01

    The internet provides the public with unregulated access to a wide range of medications. We present the case of a 43-year-old man who purchased oral tadalafil gel on the internet and injected it into his left radial artery. He presented 48 hours after injection with signs of ischaemia distal to the injection site requiring a combination of medical and surgical treatment. This unique case highlights the potential dangers of unregulated access to medication and the consequences of intravascular...

  1. A novel dual-frequency imaging method for intravascular ultrasound applications.

    Qiu, Weibao; Chen, Yan; Wong, Chi-Man; Liu, Baoqiang; Dai, Jiyan; Zheng, Hairong

    2015-03-01

    Intravascular ultrasound (IVUS), which is able to delineate internal structures of vessel wall with fine spatial resolution, has greatly enriched the knowledge of coronary atherosclerosis. A novel dual-frequency imaging method is proposed in this paper for intravascular imaging applications. A probe combined two ultrasonic transducer elements with different center frequencies (36 MHz and 78 MHz) is designed and fabricated with PMN-PT single crystal material. It has the ability to balance both imaging depth and resolution, which are important imaging parameters for clinical test. A dual-channel imaging platform is also proposed for real-time imaging, and this platform has been proven to support programmable processing algorithms, flexible imaging control, and raw RF data acquisition for IVUS applications. Testing results show that the -6 dB axial and lateral imaging resolutions of low-frequency ultrasound are 78 and 132 μm, respectively. In terms of high-frequency ultrasound, axial and lateral resolutions are determined to be as high as 34 and 106 μm. In vitro intravascular imaging on healthy swine aorta is conducted to demonstrate the performance of the dual-frequency imaging method for IVUS applications. PMID:25454093

  2. Intravascular Glomus Tumor of the Forearm Causing Chronic Pain and Focal Tenderness

    Sang Ki Lee

    2014-01-01

    Full Text Available Introduction. A glomus tumor is a benign vascular tumor derived from glomus cells and occurs mainly in the subcutaneous layer of the subungual or digital pulp. Extradigital glomus tumors have been reported within the palm, wrist, forearm, foot, bone, stomach, colon, cervix, and mesentery. Glomus tumors can originate from the intraosseous, intramuscular, periosteal, intravascular, and intraneural layers. However, a glomus tumor originating from the intravascular layer of the forearm is a rare condition. Case Report. A 44-year-old woman had a 7-year history of chronic pain and focal tenderness of the forearm. No hypersensitivity or sensory alterations were observed. Contrast magnetic resonance imaging (MRI showed a mass measuring 5 × 3 × 2 mm leading to a vein. Surgical excision was performed, and the tumor was completely resected. Finding of gross examination revealed a dark-red, well-defined soft tissue tumor, and histologic examination confirmed that the mass was a glomus tumor. The patient’s symptoms were completely resolved postoperatively. Conclusion. Intravascular glomus tumors rarely occur in the forearm; therefore, a thorough physical exam, comprehensive medical history, in-depth imaging, and early surgical excision upon clinical suspicion may be helpful to prevent a delayed or incorrect diagnosis.

  3. A utilidade da citologia por punção com agulha fina aliada a imunofenotipagem no diagnóstico dos linfomas não-Hodgkin Diagnosis of non-Hodgkin's lymphoma combining immunophenotyping and fine needle aspiration

    Flávia P. S. Costa

    2005-03-01

    Full Text Available A classificação para linfomas não-Hodgkin (LNH proposta pela Organização Mundial da Saúde (OMS enfatiza a importância do imunofenótipo para o diagnóstico. O objetivo deste estudo foi avaliar a utilidade da citologia combinada a citometria de fluxo para o diagnóstico de LNH, utilizando um painel de anticorpos monoclonais e estudo do ciclo celular. O material foi obtido através de aspiração de linfonodos por agulha fina de 78 pacientes. O painel de anticorpos monoclonais para análise em citometria de fluxo foi o seguinte: CD19/CD10, CD20/CD5, CD23, CD38/CD7, CD3/CD4, CD3/CD8, kappa/lambda. O diagnóstico final foi confirmado pela histologia convencional, considerada gold standard. Em 85% dos casos a citologia associada a imunofenotipagem e porcentagem de células em fase S permitiram um diagnóstico correto. Nos demais casos foi possível diferenciar linfomas B ou T e estimar grau de agressividade. O painel, embora pequeno, foi suficiente exceto para os anaplásicos e subclassificação dos linfomas T. Nestes casos, a morfologia foi mais importante que imunofenótipo, sendo este seguro apenas para linfomas linfoblásticos. A fração de fase S mostrou-se importante para diferenciar linfomas indolentes e de alto grau. Concluímos que esta técnica é uma boa alternativa para o diagnóstico de linfomas não-Hodgkin. Permite um diagnóstico rápido, menos invasivo, podendo ser repetida quando necessário, agilizando o tratamento.The WHO classification of non-Hodgkin's lymphoma stresses the importance of the immunophenotype for diagnosis. The aim of our study was to evaluate the use of cytology together with flow cytometric examination using a panel of monoclonal antibodies including DNA S phase analysis. Material was obtained from lymph node aspiration of 78 patients. The panel for flow cytometric analysis comprised: CD19/CD10, CD20/CD5, CD23, CD3/CD4, CD3/CD8, CD38/CD7, kappa/lambda. The final diagnosis was confirmed by lymph node

  4. Linfoma do colo uterino: relato de dois casos e revisão da literatura Lymphoma of the uterine cervix: report of two cases and review of the literature

    Hugo Fontan Köhler

    2008-12-01

    Full Text Available A ocorrência de linfomas primários do trato genital feminino é rara. O diagnóstico normalmente não é possível pelo exame citológico, sendo necessária a biópsia do colo. Neste artigo, descrevemos duas pacientes encaminhadas ao nosso serviço por linfoma de colo uterino. Em uma delas, é claramente demonstrada a dificuldade diagnóstica que pode ocorrer nessa patologia. As duas pacientes foram tratadas com quimioterapia, apresentando evolução pós-operatória satisfatória. Não há um tratamento padrão para os linfomas de colo uterino. O tratamento local exclusivo é advogado por alguns estudos na literatura em estádio clínico IE, enquanto outros serviços optam pelo tratamento sistêmico em todos os estádios.The occurrence of primary lymphomas of the female genital tract is rare. The diagnosis is usually not possible by the cytological examination; a tissue biopsy is necessary. The present paper reports two patients referred to our service with a diagnosis of cervical lymphoma. In one of them, the diagnostic difficulties are demonstrated. Both patients were submitted to chemotherapy with satisfactory post-operatory period. There is no standard treatment for uterine lymphomas. Exclusive local treatment is supported by some reports in the literature in clinical stage IE, while others prefer systemic treatment irrespective of clinical stage.

  5. Non Hodgkin T cell lymphoma: an atypical clinical presentation Linfoma não Hodgkin de células T citotóxico: uma apresentação clínica atípica

    Paula Maio

    2013-04-01

    Full Text Available Cytotoxic lymphomas comprise a spectrum of peripheral T-cell lymphomas that can have a initial or late cutaneous presentation. We describe a 46-year-old man from Cape Verde, with a dermatosis involving his face and trunk, consisting of monomorphic papules with a smooth surface and both motor and sensory polyneuropathy.The hypothesis of leprosy was supported by the clinical and initial hystopathological findings and the patient was referred to our hospital with suspected Hansen's disease. In the new skin and lymph node biopsies a lymphocyte population was identified whose immunohystochemistry study allowed the diagnosis of T-cell lymphoma with expression of cytotoxic markers. The patient was started on chemotherapy with initial remission of the skin lesions but, subsequently, progression of systemic disease.Os linfomas citotóxicos compreendem um espectro de linfomas de células T periféricos e linfomas Natural Killer que podem ter expressão cutânea primária ou secundária. Descrevemos o caso de um homem com 46 anos de idade, natural de Cabo Verde,com dermatose envolvendo a face e tronco constituída por pápulas monomorfas superfície lisa e polineuropatia sensitivo motora.A hipótese de Hanseníase foi colocada suportada por achados histopatológicos sugestivos sendo o doente referenciado à consulta de Doença de Hansen do nosso hospital. Em biopsia de pele e de gânglio identificou-se proliferação linfocitária cujo estudo imunohistoquímico permitiu o diagnóstico de linfoma T com expressão de marcadores citotóxicos. Iniciou quimioterapia verificando-se inicialmente remissão parcial das lesões cutâneas mas posteriormente a progressão da doença sistémica.

  6. Insuficiência renal aguda como manifestação inicial de linfoma de Burkitt renal Acute renal failure as first clinical presentation of Burkitt’s renal lymphoma

    José Gastão Rocha de Carvalho

    2006-06-01

    Full Text Available Relatamos o caso de um jovem de 14 anos que procurou atendimento médico por edema e hipertensão, sendo insuficiência renal aguda secundária a linfoma de Burkitt renal diagnosticada após avaliação laboratorial, de imagem e biópsia de massa tumoral renal.This case report is from a 14-year-old boy who had edema and hypertension due to a primary renal Burkitt's lymphoma, diagnosed through laboratory and image evaluation and kidney tumor biopsy.

  7. Infección por el virus de epstein barr en pacientes pediátricos y adultos afectos de linfoma de hodgkin: estudio epidemiológico y alteraciones asociadas del ciclo celular y la apoptosis

    Almazán Castro, Francisco

    2014-01-01

    Introducción El linfoma de Hodgkin clásico (LHc) es un proceso neoplásico de características clínicas, epidemiológicas y biológicas únicas. Numerosos estudios epidemiológicos han analizado las características de la enfermedad, mostrando su diferente comportamiento en niños y en adultos, así como en función de factores y condiciones socioeconómicas. Hay muchas pruebas que demuestran importantes disregulaciones a nivel del ciclo celular y de la apoptosis, y apuntan a que el virus de Epstein...

  8. Avances en el diagnóstico y tratamiento, y significado pronóstico de la infiltración neuromeníngea en leucemias agudas y linfomas agresivos

    Sancho Cía, Juan-Manuel

    2011-01-01

    La infiltración del sistema nervioso central (SNC) en pacientes con hemopatías malignas conlleva un mal pronóstico, además de un deterioro en su calidad de vida. La presente Tesis Doctoral (“Avances en el diagnóstico y tratamiento, y significado pronóstico de la infiltración neuromeníngea en leucemias agudas y linfomas agresivos”) incluye artículos acerca de diferentes aspectos del diagnóstico, prevalencia y factores pronósticos de la meningosis leucémica y linfomatosa. En el artículo “Cen...

  9. Tratamiento terapéutico de leucemias linfoblásticas agudas T y B y linfomas humanos por inhibición del receptor de interleuquina-7 (IL-7R)

    Toribio, María Luisa; González-García, Sara; García-Peydró, Marina; Alcaín, Juan; Fuentes, Patricia

    2012-01-01

    La presente invención se refiere al tratamiento terapéutico de leucemias linfoblásticas agudas (LLA) humanas de células T y B (LLA-T y LLA-B) y linfomas humanos, por inhibición del receptor de interleuquina- 7 (IL-7R) humana. Un primer aspecto de la presente invención es un agente inhibidor o bloqueante, preferentemente un anticuerpo o un fragmento del mismo, capaz de bloquear la función de la cadena {al} del receptor de interleuquina 7 (IL-7R{al}) humano, para la p...

  10. Púrpura trombocitopênica idiopática e linfoma não-Hodgkin de células T na infância Idiopathic thrombocytopenic purpura and T-cell non-Hodgkin's lymphoma in childhood

    Alessandra C. Borges

    2006-03-01

    Full Text Available Os linfomas representam 10% de todos os tumores malignos da infância e, destes, os linfomas não-Hodgkin são os mais freqüentes. Crianças com doenças auto-imunes apresentam maior probabilidade de desenvolver doenças linfoproliferativas, podendo ocorrer antes, durante ou após o aparecimento da neoplasia. A associação de púrpura trombocitopênica idiopática e linfomas é infreqüente (3%, principalmente na faixa etária pediátrica. Duas teorias tentam explicar a origem desta associação. Na primeira, a trombocitopenia seria decorrente da produção de auto-anticorpos antiplaquetas pelo clone tumoral. Na segunda, a PTI seria resultado de um estímulo antigênico persistente, secundário a uma desordem na proliferação linfóide. O objetivo do presente trabalho foi relatar a associação infreqüente na infância entre púrpura trombo-citopênica idiopática e linfoma não-Hodgkin de células T.Lymphomas represent 10% of all malignant tumors in childhood and from these non-Hodgkin's lymphomas are the most frequent. Children who have autoimmune diseases have a higher probability of developing lymphoproliferative diseases, which can happen before, during or after the appearance of the neoplasia. The association between idiopathic thrombocytopenic purpura and lymphomas is not common (3% especially in children. Two theories try to explain the origin of this association. In the first one, the thrombocytopenia would be a result of an autoantibody anti-blood platelet production by the tumoral clone. In the second one, the idiopathic thrombocytopenic purpura would be a result of a persistent antigenic stimulus subordinate to a disorder in the lymphoid proliferation. The aim of this work is to report the unusual association between idiopathic thrombocytopenic purpura and T-cell non-Hodgkin's lymphoma in childhood.

  11. Linfoma no Hodgkin oral relacionado al sida (LNHORS): Actualización y presentación de un caso clínico Aids related oral no Hodgkin lymphoma (ARONHL): Up today and report of a case

    Z Casariego; S Micinquevich; Laufer, N; J. Ricar

    2006-01-01

    Introducción: Los linfomas No-Hodgkin presentan características propias cuando se asocian a la infección por el Virus de la Inmunodeficiencia Humana. La cavidad bucal es una de las localizaciones a tener en cuenta en pacientes con Sida (LNHORS) Si bien se registran casos en los primeros estadios de la infección, el diagnóstico previo diferencial estomatológico y su seguimiento no se realizan en nuestro medio con la frecuencia que esta enfermedad requiere. En los pacientes VIH positivos, las c...

  12. MORFOLOGIA DO TIMO DE COELHOS NOVA ZELÂNDIA BRANCO TRATADOS COM GENTAMICINA

    Matheus Henrique Magalhães Silva

    2013-06-01

    Full Text Available Considering the thymus importance for the immune system and the immunodepressive potential of gentamicin, this study aimed to evaluate the effects of this aminoglycoside on the thymus histology of New Zealand White rabbits. For this, it were used 20 adult rabbits, 10 males and 10 females with a mean weight of 2.5 kg, healthy, of the New Zealand White breed, which were divided into two groups (control and treated, with five males and five females each. After seven days of daily treatment with 4.4 mg/kg of gentamicin by subcutaneous injection, on the eighth day the animals were sacrificed and their thymuses, after collected, were fixed in Bouin solution for 24 hours and processed routinely for embedded in paraffin. After the semi-serial microtome with thickness of 5 µm at intervals of 1000 µm, the histological sections were stained using Masson’s Trichrome techniques. It were analyzed, by light microscopy, the morphological characteristics of cortical and medullary of thymic individualized lobes of these sections. It was not observed histological differences between sexes or between control and treated groups. The results showed that this antibiotic, used in therapeutic dosage and by the recommended period, did not alter the morphology of the thymus of treated animals.Considerando-se a importância do timo para o sistema imunológico e o potencial imunodepressor da gentamicina, este estudo objetivou avaliar os efeitos deste aminoglicosídeo sobre a histologia do timo de coelhos da raça Nova Zelândia Branco. Para isto, utilizou-se 20 coelhos adultos, 10 machos e 10 fêmeas, com peso médio de 2,5 kg, hígidos, da raça Nova Zelândia Branco, os quais foram divididos em dois grupos (controle e tratado com cinco machos e cinco fêmeas cada. Após sete dias de tratamento diário com 4,4 mg/kg de gentamicina por via subcutânea, no oitavo dia, os animais foram sacrificados e seus timos, após coletados, foram fixados em solução de Bouin por 24

  13. Perfil clínico epidemiológico de los pacientes con cáncer tratados en una institución de tercer nivel. Manizales, Colombia, 1995-2004

    Carlos Raúl Villegas

    2012-02-01

    Full Text Available Antecedentes: Los diagnósticos de cáncer son cada vez mayores y ello está asociado con el aumento de la expectativa de vida, la exposición a carcinógenos, la cobertura en salud, el tamizaje y la búsqueda activa de casos. En Estados Unidos se diagnostican 1’000,000 de casos nuevos y más de 500,000 muertes por año. Los costos de laatención y la incapacidad laboral son muy altos. En Colombia, el patrón de ocurrencia de esta enfermedad se constituye en un problema de salud pública. En Manizales, en el año 2004, se diagnosticaron 653 casos nuevos. Objetivo: Describir la población con diagnóstico de cáncer atendida en el Instituto Oncológico (ION SA de Manizales, Colombia, desde su fundación en el año 1995, hasta diciembre de 2004.Métodos: Se incluyeron 5,000 pacientes tratados durante 1995 a 2004. Las variables demográficas y clínicas se analizaron para establecer las frecuencias de presentación y los principales aspectos del manejo y los resultados del tratamiento.Resultados: Edad promedio 57 años +17.3; sexo femenino (65.6%; procedencia urbana (90.2%. La principal categoría ocupacional fue «Oficios varios» (61% seguida de «Técnico» (12.1%. Los diagnósticos con mayor frecuencia fueron cáncer de mama (18.7%, cáncer de cérvix (13.1%, linfomas (7.7%, cáncer colorectal (6.4% y cáncer gástrico (4.7%. La mayoría de los pacientes (69.1% consultó después de dos meses de presentar síntomas. Las etapas clínicas III y IV fueron las más frecuentes en el momento de la consulta. Según la escala de Karnofsky, la capacidad funcional era buena al inicio del tratamiento. El manejo general se hizo con cirugía, quimioterapia y radioterapia. La toxicidad medicamentosa se presentó en 11.3% (567/5,000. La supervivencia a 5 años para hombres y mujeres fue de 61.2% y 72.3%, respectivamente (p<0.05.Conclusión: El perfil clínico y epidemiológico de los pacientes atendidos en el ION SA, mantiene las tendencias mundialmente

  14. Perfil clínico epidemiológico de los pacientes con cáncer tratados en una institución de tercer nivel. Manizales, Colombia, 1995-2004

    Carlos Raúl Villegas

    2012-02-01

    Full Text Available Antecedentes: Los diagnósticos de cáncer son cada vez mayores y ello está asociado con el aumento de la expectativa de vida, la exposición a carcinógenos, la cobertura en salud, el tamizaje y la búsqueda activa de casos. En Estados Unidos se diagnostican 1’000,000 de casos nuevos y más de 500,000 muertes por año. Los costos de la atención y la incapacidad laboral son muy altos. En Colombia, el patrón de ocurrencia de esta enfermedad se constituye en un problema de salud pública. En Manizales, en el año 2004, se diagnosticaron 653 casos nuevos.Objetivo: Describir la población con diagnóstico de cáncer atendida en el Instituto Oncológico (ION SA de Manizales, Colombia, desde su fundación en el año 1995, hasta diciembre de 2004.Métodos: Se incluyeron 5,000 pacientes tratados durante 1995 a 2004. Las variables demográficas y clínicas se analizaron para establecer las frecuencias de presentación y los principales aspectos del manejo y los resultados del tratamiento.Resultados: Edad promedio 57 años +17.3; sexo femenino (65.6%; procedencia urbana (90.2%. La principal categoría ocupacional fue «Oficios varios» (61% seguida de «Técnico» (12.1%. Los diagnósticos con mayorfrecuencia fueron cáncer de mama (18.7%, cáncer de cérvix (13.1%, linfomas (7.7%, cáncer colorectal (6.4% y cáncer gástrico (4.7%. La mayoría de los pacientes (69.1% consultó después de dos meses de presentar síntomas.Las etapas clínicas III y IV fueron las más frecuentes en el momento de la consulta. Según la escala de Karnofsky, la capacidad funcional era buena al inicio del tratamiento. El manejo general se hizo con cirugía, quimioterapia yradioterapia. La toxicidad medicamentosa se presentó en 11.3% (567/5,000. La supervivencia a 5 años para hombres y mujeres fue de 61.2% y 72.3%, respectivamente (p<0.05.Conclusión: El perfil clínico y epidemiológico de los pacientes atendidos en el ION SA, mantiene las tendencias mundialmente

  15. Las aspiraciones cosmpolitas de la ciudadanía europea a la luz del Tratado de Lisboa

    Jose Antonio García Saez

    2010-01-01

     En octubre de 2009 se repetirá el referéndum irlandés sobre el Tratado de Lisboa. El accidentado proceso de gestación de este tratado, heredero a su vez de la non nata Constitución Europea, suscita algunas dudas en torno a la concepción de ciudadanía europea que vienen manejando las instituciones de la UE. En el presente artículo se intentará aportar algunos elementos de reflexión sobre esta concepción de ciudadanía tomando como referencia el ideal más amplio de la ciudadanía cosmopolita. Pa...

  16. MERCOSUL E DIREITOS HUMANOS NO QUADRO DO CONFLITO ENTRE A CONSTITUIÇÃO BRASILEIRA E OS TRATADOS INTERNACIONAIS

    Ana Paula Barbosa-Fohrmann

    2010-01-01

    I - Introdução; II - Um Panorama do Conflito de Fontes; 1. Lei Interna e Tratado Internacional; 1.1. A Posição da Doutrina; 1.2. A Posição do Supremo Tribunal Federal; 2. Constituição e Tratado Internacional; 2.1. Visão Normativa e Predominante; 2.2. Visão Moral e Alternativa; III - O Direito Constitucional e a sua Relação com o Direito da Integração e os Direitos Humanos; 1 - Direito da Integração: O MERCOSUL; 2 - A Questão do Conflito de Fontes no MERCOSUL; 3 - Os Direitos Humanos; IV - Con...

  17. Pretextos y contextos olvidados : arte, ciencia y técnica en algunos tratados contables de la Inglaterra Tudor

    Juan Lanero Fernández

    2009-06-01

    Full Text Available El presente estudio pretende ver, desde una perspectiva amplia, los dos tratados de James Peele (1553, 1569. The pathe waye (1569, en su conjunto, se aparta de forma considerable de los tratados publicados con anterioridad; y por lo que se refiere a su primer libro (1553, dispone de suficientes rasgos diferenciadores para que en el todo y en las partes sea una pieza bien distinta de tratados anteriores. Algunos detalles de The maner and fourme provienen directamente de Pacioli o a través del primer tratado inglés de partida doble, obra de Hugh Oldcastle (1543, o de Ympyn. La influencia de éste, por su tratado holandés/francés (1543 y la traducción inglesa (1547, se aprecia en The pathe waye en el cierre del Libro Mayor y en la forma que ambos tienen de tratar las operaciones de trueque. Es un hecho que Manzoni (1540 está presente en The moner and fourme en lo tocante a la numeración de las partidas en el Diario y a su referencia en el texto. Por lo que se refiere a la organización de los libros de cuentas, también existen resonancias de Weddington. La excelencia es la cualidad que destaca en los dos tratado, en particular en The pathe waye. Peele supo recoger en sus libros las tendencias más innovadoras de la partida doble provenientes de los autores que le precedieron. Está demostrado que Mellis manejó, aunque no siempre de forma apropiada, los tratados de Peele para su reedición de Oldcastle (1588. Y se puede decir lo mismo de John Carpenter (1632. Pele comprendió los verdaderos principios de la partida doble; pero sus excelentes tratados se quedaron injustamente olvidados en la penumbra de los pretextos, la competencia de los contextos y casi ningún paratexto que los valorara en su justiprecio que fue, y sigue siendo, elevado.The present paper tries to have a look, from a broad perspective, at James Peele's two treatises (1553, 1569. The pathe waye (1569, as a whole, drifts away considerably from the treatises previously

  18. Derecho aplicable al fondo de la controversia en arbitrajes surgidos de tratados de inversión

    Francisco Endara Flores

    2011-07-01

    Full Text Available En este trabajo se analizará cuál es el derecho aplicable al fondo de la controversia de un arbitraje surgido de un Tratado de Inversiones. A lo largo del artículo se tratará de demostrar que la fuente primaria aplicable al fondo de la controversia, será el mismo Tratado de Inversión, seguido por un análisis del rol que tendrá el derecho local al momento de resolver la controversia.Lo mismo se hará respecto al resto de normas del derecho internacional y la manera en como dichas normas se integran para ser aplicadas por los árbitros al momento de resolver la controversia.

  19. Hemangioma infantil tratado com propranolol Propranolol treatment for hemangioma of infancy

    Flavia Kakiuti Bonini

    2011-08-01

    Full Text Available O hemangioma infantil é o tumor mais comum da infância, com grande variabilidade de apresentação clínica. A maioria das lesões regride espontaneamente e o tratamento está indicado para casos específicos que possam gerar ulceração, disfunção ou desfiguração. O tratamento baseia-se, principalmente, no uso de corticosteroides, seja por via sistêmica, tópica ou intralesional. Recentemente, o propranolol foi descrito como nova opção terapêutica para os hemangiomas, com resultados satisfatórios, permanentes e menos efeitos indesejáveis que os corticosteroides. É relatado o caso de uma criança com hemangioma periorbital e frontoparietal extenso, tratado com propranololInfantile hemangioma or hamangioma of infancy is the most common tumor in children, with great variability of presentation. Most cases resolve spontaneously and treatment is usually indicated for specific cases where injury has a high rate of morbidity or disfigurement after regression. The treatment is based on the use of systemic corticosteroids, which can also be used topically or by intralesional injections. Propranolol has been used recently as a new therapeutic option for the treatment of hemangiomas, with satisfactory, permanent results and fewer adverse effects than corticosteroids. This is a report of the case where a child presenting extensive periorbital and frontoparietal hemangioma was treated with propranolol

  20. Implicaciones de la firma del Tratado de Libre Comercio entre Colombia y los Estados Unidos.

    Olivier Guyottot

    2010-05-01

    Full Text Available Este artículo trata de mostrar que, más allá de su dimensión económica, el Tratado de Libre Comercio entre Estados Unidos y Colombia supone grandes retos políticos y geopolíticos para los dos países. En primera instancia, el TLC le permitiría a los Estados Unidos ampliar su red de acuerdos económicos bilaterales y constituye para Colombia una posibilidad de mejorar su presencia en el mercado norteamericano. Desde la perspectiva estadounidense, Colombia se convierte en un aliado y en un elemento crucial de influencia pro-norteamericana en Suramérica, en un contexto de inestabilidad; además de ser un apoyo en la lucha contra el terrorismo. Del lado colombiano, el Estado necesita la ayuda económica, financiera y logística de Estados Unidos para financiar su guerra contra el narcotráfico y los grupos armados. No obstante, el gobierno colombiano debe tener en cuenta los procesos regionales de integración económica, en los cuales está activamente involucrado, y favorecer las relaciones diplomáticas y comerciales con sus vecinos.

  1. El individuo ante la biopolítica: Tratado de Libre Comercio Colombia-EE.UU.

    Martha Isabel Gómez Lee

    2009-11-01

    Full Text Available El problema de las patentes de biotecnología puede ser visto como un asunto de política de ciencia y tecnología, en la que el contexto de la globalización y de la sociedad del conocimiento cruza la política de la vida o biopolítica. En los Estados Unidos se considera un asunto de política pública del conocimiento, mientras que en Colombia es una cuestión de política social y ambiental. Los ciudadanos colombianos tienen mucho que decir y controlar en la revolución biotecnológica y comercial que redimensiona la extracción de renta de la tierra y reconfigura a la biodiversidad colombiana como nueva renta de germoplasma global. Los individuos están llamados a actuar de manera creativa en tres dimensiones: como agentes políticos y fuente de razones y acciones políticas, como objetivo último de las decisiones y las acciones de la biopolítica y como interfase entre las políticas públicas globales y las sociales. En esta última dimensión, el individuo colombiano es un actor político fundamental en las negociaciones del Tratado de Libre Comercio entre Estados Unidos y Colombia por ser él un actor activo de la sociedad civil en defensa de la vida.

  2. Linfoma adrenal primário bilateral com envolvimento do sistema nervoso central: relato de caso Bilateral primary adrenal lymphoma with central nervous system involvement: a case report

    Marcelo Souto Nacif

    2005-06-01

    Full Text Available Os autores demonstram os principais achados do linfoma adrenal primário nas tomografias computadorizadas (TC de abdome e crânio e na ressonância magnética (RM do crânio, apresentando um caso raro de um paciente do sexo masculino, 72 anos de idade, com progressiva deterioração do estado mental, evoluindo, num período de dois meses, com perda da memória recente, desorientação e, finalmente, franco quadro demencial. O paciente foi submetido a investigação por métodos de imagem com TC de crânio (sem administração venosa de contraste iodado, tórax e abdome (sem e com administração venosa de contraste iodado, e RM de crânio (antes e após a administração venosa de gadolínio. Na TC de crânio observaram-se áreas nodulares levemente hiperdensas, adjacentes aos ventrículos laterais. A TC de tórax não mostrou alterações relevantes. Na TC do abdome foram demonstrados nódulos sólidos em ambas as adrenais. A RM de crânio evidenciou impregnação difusa e nodular do epêndima do IV ventrículo, III ventrículo, cornos anteriores e temporais, átrios e corpo dos ventrículos laterais. O diagnóstico definitivo foi realizado através do estudo imuno-histoquímico da peça após biópsia da adrenal. Os autores concluíram, após revisão atualizada da literatura, que a TC e a RM são métodos essenciais na detecção e melhor avaliação de linfomas adrenais primários, principalmente quando associados a envolvimento do sistema nervoso central, e a RM mostra-se mais sensível para a detecção de lesões extracerebrais nos espaços epidural e subdural, principalmente após a administração venosa de gadolínio.The authors review the main findings of primary adrenal lymphoma on abdominal and brain computed tomography (CT scans and brain magnetic resonance imaging (MRI, and report a rare case of a 72-year-old male patient with deterioration in mental status progressing from recent memory loss to disorientation and ultimately

  3. Linfomas plasmoblásticos del tracto gastrointestinal en pacientes con sida Plasmablastic lymphoma of the gastrointestinal tract in AIDS patients

    Alejandro Avilés-Salas

    2011-12-01

    Full Text Available Los pacientes con infección por el virus de inmunodeficiencia humana (HIV tienen 200 veces más riesgo de desarrollar un linfoma no Hodgkin (LNH con respecto a la población general. El linfoma plasmoblástico (LP representa menos del 3% de todos los LNH asociados con el HIV. El objetivo de este estudio es informar las características clínico-patológicas de 5 pacientes con enfermedad HIV/sida y LP del tracto gastrointestinal. Se revisaron de forma retrospectiva los casos de LP del tracto gastrointestinal diagnosticados en el Instituto Nacional de Cancerología de la Ciudad de México en el periodo comprendido entre los años 2000 al 2009. Se analizaron las características clínico-patológicas y se realizaron cortes de bloques de tejidos embebidos en parafina para reacciones de inmunohistoquímica. La presencia del virus de Epstein Barr (VEB se examinó por reacción en cadena de la polimerasa (PCR in situ. De los cinco pacientes, cuatro fueron hombres y una mujer, con una mediana de edad de 29 años. Tres tumores se localizaron en la región anorrectal, uno en colon ascendente y el restante en el estómago. Histológicamente, todos los tumores se caracterizaron por una proliferación difusa de células grandes de aspecto plasmoblástico. Las células neoplásicas fueron CD 138/MUM-1 positivas y CD 20 / PAX-5 negativas. En cuatro pacientes se detectó el genoma del VEB en las células neoplásicas mediante PCR in situ. La mediana de seguimiento fue 18 meses; tres pacientes estaban vivos con enfermedad y dos sobreviven sin evidencias de la neoplasia. El diagnóstico precoz de LP como una entidad clínico-patológica es importante para establecer el tratamiento correcto y mejorar el pronóstico de estos pacientes.The risk of developing non-Hodgkin lymphoma (NHL is 200 times higher in HIV-positive patients than otherwise healthy persons. Plasmablastic lymphoma (PL represents < 3% of all NHL associated with HIV infection. The aim of this study

  4. Aspectos da tomografia computadorizada no linfoma em pacientes abaixo de 20 anos de idade Computed tomography findings in patients less than 20 years old with lymphoma

    Adriana Moreira Viana Borba

    2007-04-01

    Full Text Available OBJETIVO: Descrever os achados gerais do linfoma em pacientes abaixo de 20 anos de idade e por subtipo histológico. MATERIAIS E MÉTODOS: Estudo retrospectivo do arquivo digital de tomografia computadorizada do Centro de Controle do Câncer do Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro, no período de março de 2003 a julho de 2005. Dos 22 casos - 16 do sexo masculino e 6 do sexo feminino, com média de idade de 11,5 anos -, 12 eram do subtipo Hodgkin e 10 eram não-Hodgkin. RESULTADOS: Dos achados gerais, verificamos as linfonodomegalias mediastinais como o mais freqüente (59%, com predomínio no grupo Hodgkin (75%, seguido por hepatoesplenomegalia (50% e linfonodomegalias cervicais e retroperitoneais (27,3%. No subtipo Hodgkin houve predomínio do acometimento linfonodal, em sucessivas cadeias, seguido pela hepatoesplenomegalia (50%. Verificamos um caso de massa tonsilar unilateral, opacidade pulmonar em "vidro-fosco" e nódulos renais. No subtipo não-Hodgkin houve predomínio extranodal caracterizado por hepatoesplenomegalia (50%, espessamento de alça intestinal (40%, derrame pleural (30%, nódulo pulmonar (20%, ascite (10%, derrame pericárdico (10% e lesões ósseas mistas (10%. CONCLUSÃO: A tomografia computadorizada é de grande valia no diagnóstico, estadiamento e seguimento do linfoma, com achados de alerta como massa linfonodal, notadamente mediastinal, hepatoesplenomegalia, massa unilateral na tonsila e espessamento parietal de alça intestinal.OBJECTIVE: To describe the general findings of lymphoma and their histological patterns in patients less than 20 years old. MATERIALS AND METHODS: Twenty-two cases (16 male and 6 female, mean age 11.5 years from the digital archive of computed tomography at the Cancer Control Center of "Hospital Universitário Pedro Ernesto - Universidade do Estado do Rio de Janeiro", Rio de Janeiro, RJ, Brazil, were retrospectively analyzed in the period between

  5. Linfoma cerebral primario: revisión bibliográfica y experiencia en el Hospital de Navarra en los últimos 5 años (2000-2004 Primary CNS Lymphoma: bibliographical review and experience at the Hospital of Navarre in the last 5 years (2000-2004

    I. Zazpe

    2005-12-01

    Full Text Available El linfoma cerebral primario (PCNSL, "Primary CNS Lymphoma" es un linfoma no Hodgkin agresivo que se origina en el sistema nervioso central sin evidencia de linfoma en otra localización en el momento del diagnóstico. Los linfomas cerebrales primarios son menos conocidos y caracterizados que sus homólogos los linfomas sistémicos, por tratarse de una entidad poco frecuente hasta hace unas décadas. Sin embargo, el gran ascenso de incidencia que está experimentando esta patología en las últimas tres décadas y que aún no ha sido explicado, hace necesario la existencia de más estudios para conocer mejor la etiopatogenia de esta entidad. Gracias a los nuevos regímenes de tratamiento, el pronóstico de esta patología ha mejorado significativamente en los últimos años. Sin embargo, el tratamiento del linfoma cerebral primario continúa planteando numerosas controversias en la actualidad, debido a su elevada neurotoxicidad en los pacientes mayores de 60 años, grupo de pacientes frecuentemente afectado por esta patología. Para resolver éstas y otras cuestiones se precisa ahondar en el estudio del linfoma cerebral primario y la realización de potentes ensayos clínicos.Primary cerebral lymphoma (Primary CNS Lymphoma, PCNSL is an aggressive non-Hodgkin lymphoma that originates in the central nervous system without evidence of lymphoma in any other localization at the time of diagnosis. Primary cerebral lymphomas are less well-known and are characterized than their homologues the systemic lymphomas, as they are an entity whose frequency was scarce until a few decades ago. However, the great rise in incidence that this pathology has undergone over the last three decades, and which is still unexplained, makes more studies necessary to better understand the etiopathology of this entity. Thanks to the new systems of treatment, the prognosis of this pathology has improved significantly in recent years. Nonetheless, treatment of primary cerebral

  6. Linfoma subcutâneo de células T paniculite-símile Subcutaneous panniculitis-like T-cell lymphoma

    Renato Soriani Paschoal

    2009-08-01

    Full Text Available Linfoma subcutâneo de células T paniculite-símile foi recentemente reconhecido como entidade clínico-patológica. Paciente do sexo feminino, 17 anos, relatou nodosidades eritêmato-violáceas e depressões nos membros e abdome há três anos e discreta perda ponderal, sem outros sintomas gerais. Adenomegalia, visceromegalias e infiltração da medula óssea estavam ausentes, e a histopatologia da pele mostrou densa infiltração de linfócitos atípicos CD3/CD8 no subcutâneo. A quimioterapia interrompeu o surgimento de novas lesões com remissão das pré-existentes no seguimento de oito meses. Aspectos imunofenotípicos e moleculares são relevantes para elucidação diagnóstica e avaliação do prognóstico.Subcutaneous panniculitis-like T-cell lymphoma is extremely rare and has recently been recognized as a clinicopathological entity. Young female, 17 years old, has complained of subcutaneous nodules and plaques in the limbs and abdomen for three years, accompanied of mild weight loss without other constitutional symptoms. Nodal, visceral and bone marrow involvement was absent, and subcutaneous CD3/CD8 atypical lymphocyte infiltration was observed in the skin sample. Chemotherapy interrupted the onset of new lesions and led to remission in the 8-month follow-up. Immunophenotypic and molecular aspects were relevant to the diagnosis and as prognosis makers.

  7. Legitimidad y finalidad de los capítulos de propiedad intelectual en los tratados de libre comercio (TLC

    Susy Frankel

    2011-11-01

    Full Text Available Una visión analítica de la realidad actual permite apreciar un auge de los Tratados de Libre Comercio, mientras se presenta un estancamiento en las negociaciones multilaterales de comercio. Si bien la negociación de los TLC no se limita a los países desarrollados, los negociados por los países en desarrollo no tienden a contemplar mejoras en los estándares de propiedad intelectual. Algunos de los capítulos relativos a la propiedad intelectual incluidos en los Tratados de Libre Comercio simplemente reafirman los estándares del acuerdo sobre los ADPIC, mientras que otros se orientan a ampliar el cubrimiento y alcance de los derechos internacionales de propiedad intelectual. El presente artículo se concentra en estudiar la legitimidad y la finalidad de los capítulos de propiedad intelectual en los Tratados de Libre Comercio, así como la relación entre los capítulos sobre propiedad intelectual y el sistema multilateral de la Organización Mundial del Comercio (OMC que facilita los TLC y los límites racionales de la propiedad intelectual en el contexto comercial.

  8. Avaliação morfológica e imuno-histoquímica de linfomas gástricos primários Morphologic and immunohistochemical evaluation of primary gastric lymphomas

    Jorge Alberto Thomé

    2005-04-01

    Full Text Available INTRODUÇÃO: Os linfomas gástricos primários representam cerca de 50% dos linfomas não-Hodgkin extranodais e de 2% a 8% das neoplasias malignas do estômago. A maioria é formada pela proliferação de linfócitos B, que ocorre a partir do tecido linfóide associado à mucosa. Esse tecido, inexistente no estômago em condições normais, surge como conseqüência de gastrite crônica, na maioria das vezes associada à bactéria Helicobacter pylori. A inflamação crônica provocada pela infecção bacteriana parece sensibilizar linfócitos T, levando a estímulo constante de linfócitos B, que passam a proliferar inicialmente em padrão reacional. Posteriormente surgem alterações genômicas nessas células, que provocam ganho proliferativo, seleção clonal e transformação neoplásica, dando origem a linfoma de baixo grau. Alterações genéticas adicionais, como mutações em p53, podem induzir transformação para alto grau. MATERIAL E MÉTODOS: Foram estudados 32 casos de linfomas gástricos: 15 de baixo e 17 de alto grau. Foram investigados sexo e idade dos pacientes, características morfológicas das lesões,índice de proliferação celular e colonização pelo Helicobacter pylori. Verificou-se a expressão de CD20, Ki-67, p53, BCL-2 e BCL-6 por imuno-histoquímica. RESULTADOS: Os linfomas gástricos ocorreram mais freqüentemente em homens, e a faixa etária mais elevada foi observada no grupo de baixo grau. Lesões linfoepiteliais foram observadas em 93% dos linfomas desse grupo. O índice de proliferação celular e a expressão do p53 foram mais elevados no grupo de alto grau. A expressão do BCL-2 foi mais elevada nos linfomas de baixo grau. Não houve diferença significante quanto à expressão do BCL-6 nos dois grupos. CONCLUSÃO: Os resultados sugerem a participação dos genes p53 e BCL-2 na patogênese e na evolução dos linfomas gástricos.INTRODUCTION: Primary gastric lymphomas account for 50% of the extranodal non

  9. Management of subarachnoid hemorrhage classified grade V. Possibility of intravascular treatment

    Uzura, Masahiko; Oshima, Kousuke; Morishima, Hiroyuki; Uchida, Kazuyoshi; Watanabe, Hiroyuki; Nakamura, Homare; Tanaka, Katsuyuki; Sekino, Hiroaki; Akashi, Katsuya [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    2001-10-01

    Management outcomes in poor-grade patients (World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale Grade V) with ruptured cerebral aneurysms have historically been unsatisfactory. In the present study, we examined the possibility of intravascular treatment for ruptured aneurysm detected by 3-Dimensional CT angiography (3D-CTA) in poor-grade SAH patients. From April 1997 to July 2000, 3D-CTA was performed on 54 of 73 patients admitted with Grade V subarachnoid hemorrhage (SAH). Excluding 3 patients who underwent emergency surgery for ruptured aneurysms and intracerebral hematomas, CT findings from the remaining 51 patients were analyzed. The study included 23 men and 28 women, ranging in age from 28 to 91 with an average age of 63.6. The patients' initial scores on the Glasgow Coma Scale upon admission were 3 in 36 patients (including 19 patients who had undergone cardio-pulmonary arrest), 4 in 11 patients, 5 in 2 patients, and 6 in 2 patients. Ruptured aneurysms responsible for SAH were clearly delineated in 41 aneurysms from 39 patients, with 32 aneurysms in the anterior circulation and 9 in the posterior circulation. Patients with Glasgow Coma Scale of 4 or higher whose score did not progressively decrease for 12 hours after symptom onset were considered for intravascular treatment. In our study, 4 of 39 patients (10.3%) met these criteria. Glasgow Outcome Scale results were good recovery in 1 case, moderate disability in 1 case, severe disability in 1 case, and death in the remaining 48 cases. These results suggest that the management course for poor-grade (WFNS Grade V) SAH patients who retain brain stem reflexes contain the following: identification of aneurysms by 3D-CTA, maintenance of adequate sedation and external drainage to treat acute hydrocephalus, continued minimum 12-hour observation, monitoring levels of consciousness where possible, and consideration of aggressive therapy including

  10. All-optical pulse-echo ultrasound probe for intravascular imaging (Conference Presentation)

    Colchester, Richard J.; Noimark, Sacha; Mosse, Charles A.; Zhang, Edward Z.; Beard, Paul C.; Parkin, Ivan P.; Papakonstantinou, Ioannis; Desjardins, Adrien E.

    2016-02-01

    High frequency ultrasound probes such as intravascular ultrasound (IVUS) and intracardiac echocardiography (ICE) catheters can be invaluable for guiding minimally invasive medical procedures in cardiology such as coronary stent placement and ablation. With current-generation ultrasound probes, ultrasound is generated and received electrically. The complexities involved with fabricating these electrical probes can result in high costs that limit their clinical applicability. Additionally, it can be challenging to achieve wide transmission bandwidths and adequate wideband reception sensitivity with small piezoelectric elements. Optical methods for transmitting and receiving ultrasound are emerging as alternatives to their electrical counterparts. They offer several distinguishing advantages, including the potential to generate and detect the broadband ultrasound fields (tens of MHz) required for high resolution imaging. In this study, we developed a miniature, side-looking, pulse-echo ultrasound probe for intravascular imaging, with fibre-optic transmission and reception. The axial resolution was better than 70 microns, and the imaging depth in tissue was greater than 1 cm. Ultrasound transmission was performed by photoacoustic excitation of a carbon nanotube/polydimethylsiloxane composite material; ultrasound reception, with a fibre-optic Fabry-Perot cavity. Ex vivo tissue studies, which included healthy swine tissue and diseased human tissue, demonstrated the strong potential of this technique. To our knowledge, this is the first study to achieve an all-optical pulse-echo ultrasound probe for intravascular imaging. The potential for performing all-optical B-mode imaging (2D and 3D) with virtual arrays of transmit/receive elements, and hybrid imaging with pulse-echo ultrasound and photoacoustic sensing are discussed.

  11. Frequency-Domain Intravascular Optical Coherence Tomography of the Femoropopliteal Artery

    Purpose: Optical coherence tomography (OCT) is a catheter-based imaging method that employs near-infrared light to produce high-resolution intravascular images. The authors report the safety and feasibility and illustrate common imaging findings of frequency-domain OCT (FD-OCT) imaging of the femoropopliteal artery in a series of 20 patients who underwent infrainguinal angioplasty. Methods: After crossing the lesion of interest, OCT was performed with a dextrose saline flush technique with simultaneous obstructive manual groin compression. An automatic pullback FD-OCT device was employed (each scan acquiring 54 mm of vessel lumen in 271 consecutive frames). OCT images were acquired before and after balloon dilatation and following provisional stenting if necessary and were evaluated for baseline characteristics of plaque or in-stent restenosis (ISR), vessel wall trauma after angioplasty, presence of thrombus, stent apposition, and tissue prolapse. Imaging follow-up was not included in this study’s protocol. Results: Twenty-seven obstructive lesions (18 cases of de novo atherosclerosis and 9 of ISR) of the femoropopliteal artery were imaged and 148 acquisitions were analyzed in total. High-resolution intravascular OCT imaging with effective blood clearance was achieved in 93.9%. Failure was mainly attributed to preocclusive proximal lesions and/or collateral flow. Mixed features of lipid pool areas, calcium deposits, necrotic core, and fibrosis were identified in all of the imaged atherosclerotic lesions, whereas ISR was purely fibrotic. After balloon angioplasty, OCT identified extensive intimal tears in all cases and one case of severe dissection that biplane subtraction angiography failed to identify. Conclusions: Infrainguinal frequency-domain optical coherence tomography is safe and feasible and may provide intravascular high-resolution imaging of the femoropopliteal artery during infrainguinal angioplasty procedures.

  12. Effect of intravascular irradiation of He-Ne laser on cerebral infarction: Hemorrheology and apoptosis

    Zhu, Jian; Liang, Min-yi; Cao, Hao-cai; Li, Xiao-Yuan; Li, Shao-ming; Li, Shun-hao; Li, Wen-qi; Zhang, Jin-hong; Liu, Lei; Lai, Jian-hong

    2005-07-01

    Objective: To explore the efficacy of He-Ne laser intravascular irradiation on infarction and hemorrheology. To observe the effects of intravascular low level He-Ne laser irradiation (ILLLI) of blood on cell proliferation, apoptosis and chromosome in lymphocyte from cerebral infarction Methods: Seventy cases with cerebral infarction were randomly divided into groups control group (35 cases) treated only with common drugs and therapeutic group (35 cases) treated besides common drugs also by He-Ne laser intravascular irradiation. Their hemorrheology index and treatment results were observed and compared. The blood lymphocytes of cerebral infarction were cultured before and after treatment. After that, the mitosis index (MI), cell kinetics index (CKI), sister-chromatid exchanges (SCE) frequencies and apoptosis were determined. Results The therapeutic group was better than the control one. The effective rate in the therapeutic group was 88.6%, in the control one was 65.7%. The viscosity and fibrinogen, etc were better than that in the control group with significant difference (P0.05) in cerebral infarction patients after treatment; The CKI of lymphocytes had no obvious difference among groups (P>0.05) SCE frequencies of lymphocytes had no statistic significance between control group and ILLLI on (P>0.05). It showed the apoptosis rate of lymphocytes in cerebral infarction patients after ILLLI treatment increased significantly compared with the control group, (Pcerebral infarction patients than the control (Pcerebral infarction, the low level He-Ne by ILLLI can increase the proliferation of lymphocytes, and can induce lymphocytes to apoptosis, but has no mutagenicity of cells.

  13. Ischemia monitoring in off-pump coronary artery bypass surgery using intravascular near-infrared spectroscopy

    Zerkowski Hans-Reinhard

    2006-05-01

    Full Text Available Abstract Background In off-pump coronary artery bypass surgery, manipulations on the beating heart can lead to transient interruptions of myocardial oxygen supply, which can generate an accumulation of oxygen-dependent metabolites in coronary venous blood. The objective of this study was to evaluate the reliability of intravascular near-infrared spectroscopy as a monitoring method to detect possible ischemic events in off-pump coronary artery bypass procedures. Methods In 15 elective patients undergoing off-pump myocardial revascularization, intravascular near-infrared spectroscopic analysis of coronary venous blood was performed. NIR signals were transferred through a fiberoptic catheter for signal emission and collection. For data analysis and processing, a miniature spectrophotometer with multivariate statistical package was used. Signal acquisition and analysis were performed before and after revascularization. Spectroscopic data were compared with hemodynamic parameters, electrocardiogram, transesophageal echocardiography and laboratory findings. Results A conversion to extracorporeal circulation was not necessary. The mean number of grafts per patient was 3.1 ± 0.6. An intraoperative myocardial ischemia was not evident, as indicated by electrocardiogram and transesophageal echocardiography. Continuous spectroscopic analysis showed reproducible absorption spectra of coronary sinus blood. Due to uneventful intraoperative courses, clear ischemia-related changes could be detected in none of the patients. Conclusion Our initial results show that intravascular near-infrared spectroscopy can reliably be used for an online intraoperative ischemia monitoring in off-pump coronary artery bypass surgery. However, the method has to be further evaluated and standardized to determine the role of spectroscopy in off-pump coronary artery bypass surgery.

  14. Management of subarachnoid hemorrhage classified grade V. Possibility of intravascular treatment

    Management outcomes in poor-grade patients (World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale Grade V) with ruptured cerebral aneurysms have historically been unsatisfactory. In the present study, we examined the possibility of intravascular treatment for ruptured aneurysm detected by 3-Dimensional CT angiography (3D-CTA) in poor-grade SAH patients. From April 1997 to July 2000, 3D-CTA was performed on 54 of 73 patients admitted with Grade V subarachnoid hemorrhage (SAH). Excluding 3 patients who underwent emergency surgery for ruptured aneurysms and intracerebral hematomas, CT findings from the remaining 51 patients were analyzed. The study included 23 men and 28 women, ranging in age from 28 to 91 with an average age of 63.6. The patients' initial scores on the Glasgow Coma Scale upon admission were 3 in 36 patients (including 19 patients who had undergone cardio-pulmonary arrest), 4 in 11 patients, 5 in 2 patients, and 6 in 2 patients. Ruptured aneurysms responsible for SAH were clearly delineated in 41 aneurysms from 39 patients, with 32 aneurysms in the anterior circulation and 9 in the posterior circulation. Patients with Glasgow Coma Scale of 4 or higher whose score did not progressively decrease for 12 hours after symptom onset were considered for intravascular treatment. In our study, 4 of 39 patients (10.3%) met these criteria. Glasgow Outcome Scale results were good recovery in 1 case, moderate disability in 1 case, severe disability in 1 case, and death in the remaining 48 cases. These results suggest that the management course for poor-grade (WFNS Grade V) SAH patients who retain brain stem reflexes contain the following: identification of aneurysms by 3D-CTA, maintenance of adequate sedation and external drainage to treat acute hydrocephalus, continued minimum 12-hour observation, monitoring levels of consciousness where possible, and consideration of aggressive therapy including intravascular

  15. Endovascular Management of Lost or Misplaced Intravascular Objects: Experiences of 12 Years

    This paper reports our experience with endovascular techniques for the retrieval of lost or misplaced intravascular objects. Over 12 years, 78 patients were referred for interventional retrieval of intravascular foreign objects. In this retrospective study, radiological procedure records and patients' medical records were reviewed to determine the exact removal procedure in every case, to report success rates, and to identify significant procedure-related complications. Written, informed consent was obtained from all patients prior to the intervention; this retrospective analysis was performed according to the guidelines of the Institutional Review Board. Thirty-six of seventy-eight foreign objects (46%) were located in the venous system, 27 of 78 (35%) in the right heart, and 15 of 78 (19%) in the pulmonary arteries. For foreign object removal, in 71 of 78 (91%) cases a snare loop was used, in 6 of 78 (8%) cases a sidewinder catheter combined with a snare loop was used, and in 1 case (1%) a sidewinder catheter alone was used for foreign object removal. In 68 of 78 (87%) cases, primary success was achieved. In 3 of 78 cases (4%), foreign objects were successfully mobilized to the femoral vessels and surgically removed. In 7 of 78 cases (9%), complete removal of the foreign object was not possible. In 5 of 78 cases (6%), minor complications occurred during the removal procedure. In conclusion, endovascular retrieval of lost or misplaced intravascular objects is highly effective, with relatively few minor complications. On the basis of our findings, these techniques should be considered as the therapy of choice

  16. Thrombotic Occlusion during Intravascular Ultrasonography-Guided Percutaneous Coronary Intervention of Stumpless Chronic Total Occlusion.

    Lee, Un Joo; Kim, Hyun Soo; Lee, Cheolhyun; Kim, Kwang-Yeol; Kim, Weon

    2014-12-01

    Percutaneous coronary intervention (PCI) of stumpless chronic total occlusion (CTO) lesions with a side branch stemming from the occlusion have a significantly lower treatment success rate because physicians cannot identify an accurate entry point with only conventional angiographic images. An intravascular ultrasonography (IVUS)-guided wiring technique might be useful for the penetration of stumpless CTO. We recently experienced thrombotic occlusion during an IVUS-guided stumpless CTO procedure. The cause of the thrombosis is not completely understood; the thrombosis may have been associated with the long use of the IVUS catheter. Special precautions should be taken to prevent thrombus in such cases. PMID:25568847

  17. Fixed Coronary Artery Stenosis in Tunneled Coronary Artery Identified by Intravascular Ultrasound: A Case Report

    Yuxiang Dai

    2014-10-01

    Full Text Available Myocardial bridging is characterized as the compression of a segment of the coronary artery during systole. Significant atherosclerosis within the bridge is almost never seen at pathologic examination because of the absence of synthetic type smooth muscle cells in the intima of the tunneled artery. To date, there have been no reports of significant atherosclerosis at the site of myocardial bridging documented by angiography or intravenous ultrasound. We report a rare case of fixed coronary artery stenosis at the site of myocardial bridging identified by intravascular ultrasound.

  18. Micromachined PIN-PMN-PT Crystal Composite Transducer for High-Frequency Intravascular Ultrasound (IVUS) Imaging

    Li, Xiang; Ma, Teng; Tian, Jian; Han, Pengdi; Zhou, Qifa; Shung, K. Kirk

    2014-01-01

    In this paper, we report the use of micromachined PbIn1/2Nb1/2O3–PbMg1/3Nb2/3O3–PbTiO3 (PIN-PMN-PT) single crystal 1–3 composite material for intravascular ultrasound (IVUS) imaging application. The effective electromechanical coupling coefficient kt(eff) of the composite was measured to be 0.75 to 0.78. Acoustic impedance was estimated to be 20 MRayl. Based on the composite, needle-type and flexible-type IVUS transducers were fabricated. The composite transducer achieved an 86% bandwidth at ...

  19. Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? A prospective observational study

    Johansson, Per Ingemar; Sorensen, Anne Marie; Perner, Anders;

    2011-01-01

    ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated the...... prevalence of overt DIC and ACoTS in trauma patients and characterized these conditions based on their biomarker profiles. METHODS: Observational study at a single Level I Trauma Centre. Inclusion of 80 adult trauma patients ([greater than or equal to]18 years) who met criteria for full trauma team...

  20. Stiff fingers as an unwanted side effect of intravascular tadalafil gel abuse.

    Vaughan, E M; Yeung, D; West, C C; Tadros, A; Curnier, A

    2014-03-01

    The internet provides the public with unregulated access to a wide range of medications. We present the case of a 43-year-old man who purchased oral tadalafil gel on the internet and injected it into his left radial artery. He presented 48 hours after injection with signs of ischaemia distal to the injection site requiring a combination of medical and surgical treatment. This unique case highlights the potential dangers of unregulated access to medication and the consequences of intravascular injection of oral gels. PMID:24780660

  1. Rash, disseminated intravascular coagulation and legionella: Episode 10 and a rewind into the past

    Prashanth M. Thalanayar

    2015-01-01

    Full Text Available Legionella pneumophila is the most common cause of legionellosis and is one of the organisms causing atypical pneumonia. We report the presentation of disseminated intravascular coagulation (DIC and skin rash in a single case of severe Legionella pneumonia. The unique clinical presentation of a diffuse rash diagnosed as purpura fulminans and the unpredictable variations encountered during the diagnostic work-up of the case make this write-up crucial. This article synthesizes all reported cases of L. pneumonia associated with cutaneous manifestations as well as cases presenting with DIC. Furthermore, this manuscript illustrates the correlation between cutaneous and coagulopathic manifestations, and morbidity and mortality from L. pneumonia.

  2. An Elderly Lady with Fever of Unknown Etiology and Severe Pulmonary Hypertension: Intravascular Lymphoma—An Elusive Diagnosis

    Nupur Sinha

    2013-01-01

    Full Text Available Pulmonary hypertension (PH associated with malignancy, especially adenocarcinoma, is a well-known entity and is included in group V of the WHO classification. Intravascular lymphoma is a rare type of diffuse large B cell lymphoma, characterized by selective intravascular growth of malignant lymphocytes, aggressive behavior, and often a fatal course. Most of the time, diagnosis is postmortem due to the rarity and the protean manifestations of the disease. We present a rare case of an elderly patient presenting with severe pulmonary hypertension, fever of unknown etiology (FUO, and lymphadenopathy. Extensive evaluation searching for the etiology of her FUO and PH was noncontributory. The diagnosis of intravascular lymphoma was finally reached by the performance of a random abdominal fat pad biopsy and the patient was started on immunochemotherapy. She continues the follow up after 6 cycles of R-CHOP with no further febrile episodes and steady improvement in exercise tolerance.

  3. Solubilidade de metais pesados em solos tratados com lodo de esgoto enriquecido

    C. Oliveira

    2003-02-01

    Full Text Available Os lodos de esgoto são materiais orgânicos ricos em nutrientes com potencial para o uso agrícola. A utilização desses materiais, no entanto, pode ser limitada pela presença de metais pesados na sua composição. Esta pesquisa teve por objetivos: (a avaliar a solubilidade de Cd, Pb e Zn em dois tipos de solos tratados com lodo de esgoto enriquecido com esses metais; (b verificar o efeito do tempo de contato nas mudanças da distribuição de Cd, Pb e Zn nas diferentes formas químicas de dois solos tratados com lodo de esgoto enriquecido com esses metais; (c verificar a influência das frações inorgânicas e orgânicas do lodo na dinâmica destes metais no solo. O enriquecimento do lodo de esgoto consistiu em adicionar Cd, Pb e Zn a um lodo de esgoto urbano produzido na Estação de Tratamento da Ilha do Governador (ETIG, Rio de Janeiro (RJ. Após 20 dias de incubação, sob umidade constante (50 % g g-1, o lodo enriquecido foi utilizado para a instalação de experimentos em amostras de duas classes de solos: Latossolo Vermelho-Amarelo (LV e Argissolo Vermelho-Amarelo (PV. Em laboratório, as amostras dos solos foram incubadas com quantidades equivalentes a 0; 20; 40 e 80 t ha-1 de lodo de esgoto enriquecido. Nos tempos de contato solo-lodo enriquecido de 4, 12, 16, 24 e 160 semanas, amostras de solos foram retiradas e submetidas à extração seqüencial de Cd, Pb e Zn. Observou-se, através da extração seqüencial, que compostos orgânicos solúveis formaram complexos, principalmente com cádmio e zinco, mantendo teores elevados destes elementos associados à fração solúvel em água durante todo o período experimental. A incorporação de compostos inorgânicos de Fe e Mn, através do lodo de esgoto, permitiu que o Cd, Pb e Zn se ligassem em sua maior parte, à fração extraível com hidroxilamina. Com o tempo de incubação, observou-se decréscimo dessa fração com aumento da fração residual, indicando decréscimo na

  4. NIR fluorescence lifetime sensing through a multimode fiber for intravascular molecular probing

    Ingelberts, H.; Hernot, S.; Debie, P.; Lahoutte, T.; Kuijk, M.

    2016-04-01

    Coronary artery disease (CAD) contributes to millions of deaths each year. The identification of vulnerable plaques is essential to the diagnosis of CAD but is challenging. Molecular probes can improve the detection of these plaques using intravascular imaging methods. Fluorescence lifetime sensing is a safe and robust method to image these molecular probes. We present two variations of an optical system for intravascular near-infrared (NIR) fluorescence lifetime sensing through a multimode fiber. Both systems are built around a recently developed fast and efficient CMOS detector, the current-assisted photonic sampler (CAPS) that is optimized for sub-nanosecond NIR fluorescence lifetime sensing. One system mimics the optical setup of an epifluorescence microscope while the other uses a practical fiber optic coupler to separate fluorescence excitation and emission. We test both systems by measuring the lifetime of several NIR dyes in DMSO solutions and we show that these systems are capable of detecting lifetimes of solutions with concentrations down to 370 nM and this with short acquisition times. These results are compared with time-correlated single photon counting (TCSPC) measurements for reference.

  5. Development of sup 1 sup 9 sup 2 Ir radiation sources for intravascular irradiation

    Kogure, H; Iwamoto, S; Iwata, K; Kawauchi, Y; Nagata, Y; Sorita, T; Suzuki, K

    2003-01-01

    Intravascular brachytherapy is a novel therapy for preventing the restenosis of coronary artery by use of low-dose irradiation. JAERI and Kyoto University have been developing sup 1 sup 9 sup 2 Ir radiation sources by the cooperative research project entitled as 'The research on safety and effectiveness of the intravascular brachytherapy for preventing restenosis of the coronary artery disease' since 1998. The radiation source was introduced into the stenosis through a catheter (a guide-tube to insert directly into vascular) to irradiate the diseased part. Ten sup 1 sup 9 sup 2 Ir seed sources (phi 0.4 mm x 2.5 mm) were positioned between nylon spacers (phi 0.3 mm x 1.0 mm) in a flexible covering tube and the tube was plugged with a core-wire; the tube was shrunk to fix the inside materials and the size is 0.46 mm in diameter and 3 m in length. The physically optimal design was determined to insert the radiation source easily into vascular and to get the dose uniformity in the diseased part. The production me...

  6. Incompatibility of water soluble contrast media and intravascular pharmacologic agents: experimental study

    With the development of low osmolar and nonionic contrast media in clinical practice, radiologists have enjoyed increased clinical application along with other advantages such as improvement of patient comfort and safety. Recently, radiologists have introduced many intravascular pharmacologic agents to improve diagnostic quality and patient safety. Shortly after the introduction of these agents, however, it was observed that a precipitate results when a certain pharmacologic agent is mixed with a low osmolar contrast media. These observations have prompted testing of several other drugs used for incompatibility with contrast media. To verify these reports and to investigate other medications not previously tested, the authors analyzed mixtures of contrast agents and medications in vitro and observed them for visible precipitates after operating the high-speed centrifuge. The results were as fallows: The contrast media that produced incompatibilities with some pharmacologic agents were ioxaglate, diatrizote, and iothalamate in the order of frequency. The contrast media that produced no precipitate were iopromide and ioxithalamate. The pharmacologic agents that produced precipitate with some contrast media were Papaverine, Benadryl, Protamine, Cimetidine, Regitin, and Gentamicin. Therefore, we recommend that caution should be taken to recognize incompatibilities and avoid them when intravascular pharmacologic agents of any kind may be incompatible

  7. Design factors of intravascular dual frequency transducers for super-harmonic contrast imaging and acoustic angiography.

    Ma, Jianguo; Martin, K Heath; Li, Yang; Dayton, Paul A; Shung, K Kirk; Zhou, Qifa; Jiang, Xiaoning

    2015-05-01

    Imaging of coronary vasa vasorum may lead to assessment of the vulnerable plaque development in diagnosis of atherosclerosis diseases. Dual frequency transducers capable of detection of microbubble super-harmonics have shown promise as a new contrast-enhanced intravascular ultrasound (CE-IVUS) platform with the capability of vasa vasorum imaging. Contrast-to-tissue ratio (CTR) in CE-IVUS imaging can be closely associated with low frequency transmitter performance. In this paper, transducer designs encompassing different transducer layouts, transmitting frequencies, and transducer materials are compared for optimization of imaging performance. In the layout selection, the stacked configuration showed superior super-harmonic imaging compared with the interleaved configuration. In the transmitter frequency selection, a decrease in frequency from 6.5 MHz to 5 MHz resulted in an increase of CTR from 15 dB to 22 dB when receiving frequency was kept constant at 30 MHz. In the material selection, the dual frequency transducer with the lead magnesium niobate-lead titanate (PMN-PT) 1-3 composite transmitter yielded higher axial resolution compared to single crystal transmitters (70 μm compared to 150 μm pulse length). These comparisons provide guidelines for the design of intravascular acoustic angiography transducers. PMID:25856384

  8. A Broadband Polyvinylidene Difluoride-Based Hydrophone with Integrated Readout Circuit for Intravascular Photoacoustic Imaging.

    Daeichin, Verya; Chen, Chao; Ding, Qing; Wu, Min; Beurskens, Robert; Springeling, Geert; Noothout, Emile; Verweij, Martin D; van Dongen, Koen W A; Bosch, Johan G; van der Steen, Antonius F W; de Jong, Nico; Pertijs, Michiel; van Soest, Gijs

    2016-05-01

    Intravascular photoacoustic (IVPA) imaging can visualize the coronary atherosclerotic plaque composition on the basis of the optical absorption contrast. Most of the photoacoustic (PA) energy of human coronary plaque lipids was found to lie in the frequency band between 2 and 15 MHz requiring a very broadband transducer, especially if a combination with intravascular ultrasound is desired. We have developed a broadband polyvinylidene difluoride (PVDF) transducer (0.6 × 0.6 mm, 52 μm thick) with integrated electronics to match the low capacitance of such a small polyvinylidene difluoride element (capacitive load of the long cable (∼100 pF/m). The new readout circuit provides an output voltage with a sensitivity of about 3.8 μV/Pa at 2.25 MHz. Its response is flat within 10 dB in the range 2 to 15 MHz. The root mean square (rms) output noise level is 259 μV over the entire bandwidth (1-20 MHz), resulting in a minimum detectable pressure of 30 Pa at 2.25 MHz. PMID:26856788

  9. Lipid detection by intravascular photoacoustic imaging with flexible catheter at 20 fps (Conference Presentation)

    Wu, Min; Daeichin, Verya; Springeling, Geert; van der Steen, Antonius F. W.; van Soest, Gijs

    2016-02-01

    Intravascular Photoacoustic (IVPA) imaging is a promising new technology to assess lipid content of coronary atherosclerotic plaque, an important determinant of the risk associated with the plaque triggering a heart attack. Clinical translation of IVPA imaging requires real-time image acquisition, which has been a technological challenge. In this work, we demonstrate a high-speed, dual-wavelength IVPA imaging system at 1.7 µm wavelength, operating with a flexible catheter of 1.2 mm outer diameter (including outer sheath). The catheter was custom designed and fabricated, and used a 40 MHz transducer for intravascular ultrasound (IVUS) and IVPA imaging. The optical excitation is provided by a dual OPO system, pumped by CW diode-pumped Q-switched Nd:YAG lasers, with a repetition rate of 5 kHz. Each OPO can be tuned to a custom wavelength between 1690 and 1750 nm; two wavelengths only are needed to discriminate between plaque lipids and adipose tissue. The pulse energy is about 80 µJ. We tested the imaging performance of the presented system in a polyvinyl-alcohol (PVA) vessel mimicking phantom and human coronary arteries ex vivo. IVPA identified lipid deposits inside atherosclerotic plaque, while IVUS showed tissue structure. We demonstrated IVPA imaging at a speed of 20 frames per second, with 250 A-scans per frame. This is significantly faster than previous IVPA imaging systems, and will enable the translation of IVPA imaging into clinical practice.

  10. Chemical digestion and radionuclidic assay of TiNi-encapsulated 32P intravascular brachytherapy sources

    A very quantitative, destructive assay procedure was devised for accurately measuring the 32P activity content of TiNi-encapsulated intravascular brachytherapy sources and was applied to four different sources (termed 'seeds') which were developed and provided by Guidant Intravascular Intervention (formerly NeoCardia). These seeds are intended for use in the prophylactic treatment of restenosis following balloon angioplasty in heart-disease patients. The assays involved the dissolution of the TiNi jacket, extraction of the activity from the internal 32P-containing source material, quantitative solution transfers, and a gravimetrically-based dilution; followed by liquid scintillation (LS) spectrometry of the resulting master solution with 3H-standard efficiency tracing using composition-matched LS cocktails. The LS spectrometry utilized a previously-developed method for resolving the always-present 33P impurity. The protocol included provisions for accounting for all possible losses of 32P in the digestion procedure (based on radiochemical tracing experiments), for any unrecovered activity in the remaining source material, and for any residual activity in the solution-transfer and containing vessels. Sections of the TiNi jackets adjacent to the cut-off active seed portions were also assayed for any contained activity. Such destructive assays were required for relating measurements of the absorbed dose spatial distribution for the seeds to theoretic dose modelling and for establishing calibration factors for subsequent non-destructive radionuclidic measurements on the seeds

  11. Intravascular haemolysis during prolonged running on asphalt and natural grass in long and middle distance runners.

    Janakiraman, Kamal; Shenoy, Shweta; Sandhu, Jaspal Singh

    2011-09-01

    Surface features such as uneven playing surfaces, low impact absorption capacity and inappropriate friction/traction characteristics are connected with injury prevalence whereas force impact during foot strike has been suggested to be an important mechanism of intravascular haemolysis during running. We aimed to evaluate intravascular haemolysis during running and compare the effect of running on two different types of surfaces on haemolysis. We selected two surfaces (asphalt and grass) on which these athletes usually run. Participants were randomly assigned to group A (asphalt) or group B (grass) with 10 athletes in each group. Each athlete completed one hour of running at the calculated target heart rate (60-70%). Venous blood samples were collected before and immediately after running. We measured unconjugated bilirubin (UBR) (mg · dl(-1)), lactate dehydrogenase (LDH) (μ · ml(-1)), haemoglobin (g · l(-1)) and serum ferritin (ng · ml(-1)) as indicators of haemolysis. Athletes who ran on grass demonstrated an increase in the haematological parameters (UBR: P running. Furthermore, we conclude that uneven grass surface results in greater haemolysis compared to asphalt road. PMID:21751854

  12. Quantitative analysis for lumen and media-adventitia border detection in intravascular ultrasound images

    Wang, Ling; Yu, Daoyin; Chen, Xiaodong; An, Zhiyong

    2008-12-01

    Therosclerosis causes partial or total obstruction of human arteries. Early quantitative analysis and accurate assessment of plaque position and volume are essential for the selection of the appropriate treatment. Several imaging techniques can be used for the estimation of the severity of the disease in vivo. Intravascular ultrasound (IVUS) is a commonly used diagnostic tool, which provides real-time visualization of plaque morphology and detection of typical plaque components, such as calcium, quantification of plaque eccentricity and wall thickness. In this paper, we firstly used a spatio-temporal filter to reduce the effect of speckles and enhance the image. Then we translated the problem of image segmentation to the problem of the minimum resolution of energy function. using an improved deformable models, we detected the border of lumen and media-adventitia in sequential intravascular ultrasound frames, and optimized it by dynamic programming. Finally, through the identification of the internal and external elastic lamina and the plaque-lumen interface, we figured out the parameter of plaque load, maximal and minimal diameters of the internal and external elastic lamina and so on. The obtained results demonstrate that our method is statistically accurate, reproducible, and capable to identify the regions of interest in sequences of IVUS frames.

  13. Kasr El-Aini experience in radiation safety and quality management program in intravascular brachytherapy

    While simple, intravascular brachytherapy (IVB) presents a considerable potential for harm to the patient. The medical physicist maintains the responsibility to minimize the likelihood of operational problems or dosimetric errors. The principals for safe operation remain the same as with any radiotherapy treatment: to deliver the correct dose, to the correct location, safety. To develop an effective and comprehensive quality management QM program for IVB, a physicist should utilize proven risk assessment techniques rather than simply thinking of things to check, and follow guidances such as ISO9001:2000. Kasr El-Aini Hospital -Medical college-Cairo University installed intravascular Brach therapy treatment modality in 1999 so it was a must to proposed QM program includes the following: Procedures designed to assure the safety of the patient: Identification of the patient; tests of the integrity and patency for the delivery catheter, operation of the source train, and patency of the catheter in the treatment position; a check for recovery preparations; and verification of source recovery. Procedures to assure positional accuracy of the treatment: Verification of the positioning the catheter in the artery and of the sources in the catheter. Procedures to assure dosimetry accuracy: Acceptance testing of the device, including verification of the source strength and uniformity, and of the treatment duration tables; verification of the treatment prescription and duration for each patient; and control measures that minimize the likelihood of errors removing the source at the correct time. (author)

  14. Pressure-Flow Experimental Performance of New Intravascular Blood Pump Designs for Fontan Patients.

    Chopski, Steven G; Fox, Carson S; Riddle, Michelle L; McKenna, Kelli L; Patel, Jay P; Rozolis, John T; Throckmorton, Amy L

    2016-03-01

    An intravascular axial flow pump is being developed as a mechanical cavopulmonary assist device for adolescent and adult patients with dysfunctional Fontan physiology. Coupling computational modeling with experimental evaluation of prototypic designs, this study examined the hydraulic performance of 11 impeller prototypes with blade stagger or twist angles varying from 100 to 600 degrees. A refined range of twisted blade angles between 300 and 400 degrees with 20-degree increments was then selected, and four additional geometries were constructed and hydraulically evaluated. The prototypes met performance expectations and produced 3-31 mm Hg for flow rates of 1-5 L/min for 6000-8000 rpm. A regression analysis was completed with all characteristic coefficients contributing significantly (P impeller with 400 degrees of blade twist outperformed the other designs. The findings of the numerical model for 300-degree twisted case and the experimental results deviated within approximately 20%. In an effort to simplify the impeller geometry, this work advanced the design of this intravascular cavopulmonary assist device closer to preclinical animal testing. PMID:26333131

  15. An intravascular loopless monopole antenna for vessel wall MR imaging at 3.0 T.

    Yuan, Hongyang; Lv, Xing; Ma, Xiaohai; Zhang, Rui; Fu, Youyi; Yang, Xuedong; Wang, Xiaoying; Zhang, Zhaoqi; Zhang, Jue; Fang, Jing

    2013-01-01

    The purpose of this study was to develop a novel intravascular loopless monopole antenna (ILMA) design specifically for imaging of small vessel walls. The ILMA consisted of an unshielded, low-friction guide wire and a tuning/matching box. The material of the guide wire was nitinol and it was coated with polyurethane. Because the guide wire was unshielded, it could be made thinner than the coaxial cable-based loopless intravascular antenna design. The material of the box was aluminum. In this study, the diameter of the guide wire was 0.5 mm and the length was 58.7 mm. The ILMA was used as a receiving antenna and body coil for transmission. To verify the feasibility of the ILMA, in vitro and in vivo experiments were performed on a 3.0-T magnetic resonance (MR) scanner. In vitro tests using the ILMA indicated that the proposed design could be used to image target vessel walls with a spatial resolution of 313 μm at the frequency coding direction and more than 100 mm of longitudinal coverage. In vivo tests demonstrated that the images showed the vessel walls clearly by using the ILMA and also indicated that the ILMA could be used for small vessels. The proposed antenna may therefore be utilized to promote MR-based diagnoses and therapeutic solutions for cardiovascular atherosclerotic diseases. PMID:22902470

  16. Intravascular ultrasound

    ... IVUS may also be used to: View the aorta and structure of the artery walls (which can ... in people who already have kidney problems or diabetes) Stroke (this is rare) After the Procedure After ...

  17. Intravascular Biphasic Synovial Sarcoma: The Beneficial Role of Adjuvant Treatment Approach in the Pre-metastatic Stage.

    Chicas-Sett, Rodolfo; Farga-Albiol, Dolores; Collado, Erica; Pacheco, Ariel; Zac, Carlos; Diaz, Roberto; Celada, Francisco; Burgos, Javier; Perez, Maria Jose; Tormo, Alejandro

    2016-01-01

    Synovial sarcoma (SS) is a high-grade, rare variant of soft tissue sarcoma (STS). The biphasic subtype is less common than the monophasic subtype. SS is very common around joint cavities in the extremities, but can be present elsewhere in the body. Tumor staging and therapeutic management are usually clear for a localized disease, but the proper management at the metastatic stage can be unclear. According to the literature, the histologic presence of an SS tumor thrombus affects tumor staging, making it unclear whether the tumor stage corresponds to localized or metastatic disease. An intravascular SS tumor exhibiting high metastatic potential is a rare finding that warrants thorough investigation. A 49-year-old woman presented with a biphasic SS intravascular tumor of the left inguinal area with femoral vessels involvement. Ten cases of intravascular SS have been reported in the literature and contain little information regarding the proper management of a local metastatic disease. Ours is a rare case of SS with an intravascular tumor occupying the femoral-iliac vein (as seen in metastatic disease) that has been treated as a local disease with a multidisciplinary therapeutic approach. As a result, our patient has been disease-free for two years and, during that time, has achieved an acceptable quality of life. We discuss the pertinent clinical findings of this rare tumor and review the literature of tumor thrombus by SS. We also present the multidisciplinary therapeutic approach realized and the history of this disease. PMID:27190730

  18. Intravascular ultrasound radiofrequency analysis after optimal coronary stenting with initial quantitative coronary angiography guidance: An ATHEROREMO sub-study

    G. Sarno (Giovanna); S.A. Garg (Scot); J. Gomez-Lara (Josep); H.M. Garcia-Garcia (Hector); J.M.R. Ligthart (Jürgen); N. Bruining (Nico); Y. Onuma (Yosinobu); K. Witberg (Karen); R.J.M. van Geuns (Robert Jan); S.P.M. de Boer (Sanneke); J.J. Wykrzykowska (Joanna); C.J. Schultz (Carl); H.J. Duckers (Henricus); E.S. Regar (Eveline); P.P.T. de Jaegere (Peter); P.J. de Feyter (Pim); G.A. van Es (Gerrit Anne); H. Boersma (Eric); W.J. van der Giessen (Wim); P.W.J.C. Serruys (Patrick)

    2011-01-01

    textabstractAims: To investigate whether the use of intravascular ultrasound virtual histology (IVUS-VH) leads to any improvements in stent deployment, when performed in patients considered to have had an optimal percutaneous coronary intervention (PCI) by quantitative coronary angiography (QCA). Me

  19. Multicenter assessment of the reproducibility of volumetric radiofrequency-based intravascular ultrasound measurements in coronary lesions that were consecutively stented

    Huisman, Jennifer; Egede, Rasmus; Rdzanek, Adam;

    2012-01-01

    To assess in a multicenter design the between-center reproducibility of volumetric virtual histology intravascular ultrasound (VH-IVUS) measurements with a semi-automated, computer-assisted contour detection system in coronary lesions that were consecutively stented. To evaluate the reproducibility...

  20. Intravascular β-irradiation with a liquid 188Re-filled balloon for the prevention of restenosis in rabbit model

    Objective: To investigate the effects of intravascular β-irradiation with a liquid 188Re-filled balloon on restenosis in rabbit model, and to evaluate the feasibility of the intravascular irradiation. Methods: The bilateral iliac arteries of 14 rabbits were injured by catheter balloon overdilation. A random side iliac artery of the rabbit was irradiated by a liquid 188Re-filled balloon with the radioactivity of 15 Gy at a depth of 0.5 mm beneath the skin close to the artery, and the other iliac artery served as a control. At 12 weeks after operation, quantitative angiography, histopathology and immunohistochemistry analysis were performed in the injured iliac arteries to evaluate the effects of irradiation. Results: There was significant increase in iliac artery diameter [(1.94 +- 0.19) vs (1.77 +- 0.28) mm, P2, P188Re-filled balloon irradiation group compared with control group. Conclusions: Intravascular β-irradiation by a liquid 188Re-filled balloon with 15 Gy at 0.5 mm tissue depth beneath the skin close to the artery in rabbit model could inhibit neointimal proliferation and prevent restenosis. The intravascular brachytherapy with irradiation for prevention of restenosis is technically feasible

  1. Development Of A Laser Intravascular Fiber Optic Probe For The Treatment Of Superficial Telangiectasia Of The Lower Extremity In Man

    Goldman, Leon; Taylor, W. A.

    1984-10-01

    Because of the difficulty of laser treatment of superficial telangiectasia in man, a mini vascular fiberoptics probe has been developed for these vessels. Controls have included sclerotherapy, intravascular-galvanic current probes and direct impacts from 0.2 mm argon fiberoptics probes.

  2. Mineralização de nitrogênio em solo tropical tratado com lodos de esgoto

    Boeira Rita Carla

    2002-01-01

    Full Text Available A mineralização do N orgânico é um dos principais fatores que determinam as quantidades de lodos de esgoto (LE a aplicar em solos. O objetivo deste trabalho foi quantificar, em laboratório, o potencial de mineralização de N orgânico num Latossolo Vermelho distroférrico, tratado com dois LE anaeróbios, um de origem estritamente urbana (Franca, SP e outro com presença de despejos industriais (Barueri, SP. Os LE foram aplicados ao solo em doses de 1,5, 3, 6 e 12 g kg-1 (Franca e 4, 8, 16 e 32 g kg-1 (Barueri, e o tempo de incubação foi de 15 semanas. O acúmulo de N inorgânico no solo ao final da incubação foi proporcional às quantidades de N orgânico adicionadas. O potencial de mineralização estimado pelo modelo exponencial simples foi de 24 mg kg-1 de N no solo sem lodo, e variou entre 44 e 265 mg kg-1 de N no solo tratado com os lodos. A fração de mineralização potencial do N orgânico dos lodos foi estimada em 31%. A mineralização foi mais lenta no solo tratado com as duas maiores doses do LE de Barueri. Os dois lodos acidificaram o solo; o de Franca causou acidificação mais intensa que o de Barueri.

  3. Lixiviação de metais pesados em solos tratados com lodo de esgoto

    E. I. Bertoncini

    1999-09-01

    Full Text Available Foi realizado um experimento em tubos de percolação, utilizando-se três solos, classificados como Areia Quartzosa (AQ, Latossolo Vermelho-Amarelo (LV e Latossolo Vermelho-Escuro (LE, aos quais foram incorporadas sucessivas quantidades de lodo de esgoto, totalizando uma dose correspondente a 156,0 t ha-1 (base seca, num período de incubação de 310 dias. Após este período, os solos foram tratados com água ou com soluções de sais (KCl 0,9 mol L-1; KNO3 0,9 mol L-1; K2SO4 0,3 mol L-1 e Ca(NO32 0,3 mol L-1, adicionadas em quantidade correspondente a quatro vezes a capacidade de retenção de água dos solos. No líquido percolado pela passagem das soluções salinas, foram determinadas as quantidades de Cd, Cr, Cu, Ni e Zn presentes e, no percolado obtido com a passagem de água, além dos metais anteriormente citados, foram determinadas também as quantidades de Ca2+ e Mg2+. Os resultados permitiram observar que a adição de KCl provocou o arraste de 5% do Cd adicionado via lodo aos solos LV e LE; para os outros sais utilizados e para a água, esse arraste nunca foi superior a 2% do metal pesado adicionado via lodo. A retenção de Cd, Cu, Cr e Ni aumentou com a elevação dos teores de óxidos de Fe e Al presentes nos solos. Os elevados valores de pH e o aumento no teor de matéria orgânica proporcionado pela adição de lodo refletiram também na menor mobilidade dos metais. Os sais KCl e K2SO4 aumentaram a mobilidade de alguns dos metais estudados.

  4. Fracturas por fatiga del cuello femoral: A propósito de un caso tratado quirúrgicamente

    Arenas Planelles, Antonio; Arias Nieto, C.; Eslava Echavarren, E.; Tejero Ibáñez, Alberto; Garbayo Marturet, Antonio Jesús; Pablos Fernández, Julio de

    2000-01-01

    Se presenta un caso de fractura por fatiga de cuello femoral en un paciente de 26 años. Fue tratado quirúrgicamente realizándose osteosíntesis con 3 tornillos. La evolución fue satisfactoria, encontrándose el paciente sin dolor ni repercusión funcional a los 4 años de la lesión. A case of stress fracture of the femoral neck in a 26-year-old patient is presented. Surgical treatment was indicated by means of internal fixation with three screws. At four-year follow-up there was no pain or fun...

  5. Estudio prospectivo del funcionamiento cognitivo en pacientes de cáncer de colon tratados con quimioterapia

    López Santiago, Sonia

    2011-01-01

    El objetivo de esta tesis es investigar los cambios en rendimiento cognitivo de pacientes de cáncer de colon tratados con quimioterapia adyuvante. El método ha sido el estudio longitudinal unifactorial de tres medidas (T1: antes de la quimioterapia, T2: al finalizar el tratamiento y T3 seis meses después de T2); se explora: memoria verbal, función ejecutiva y habilidad psicomotora y variables moduladoras (ansiedad, depresión, astenia y calidad de vida). Muestra: 77 participantes, 63% varones,...

  6. Características de los pacientes tratados con Etanercept de un registro local de terapia biológica

    Rosas, J; Santos-Soler, G.; Senabre, J. M.; Santos-Ramírez, C.; Barber, X.; Sánchez Barrioluengo, Mabel; Salas, E; Llahí, N.; Cano, C.; Riestra, R.

    2011-01-01

    [Objetivos]: Conocer las características de los pacientes en tratamiento con etanercept (ETN), en seguimiento en la Sección de Reumatología del Hospial Marina Baixa. [Material y método]: Estudio prospectivo desde el año 2001, de los pacientes en tratamiento con ETN. Se compararon los resultados con el global de los pacientes tratados con fármacos anti-TNF. Se recogió el diagnóstico de la enfermedad, datos epidemiológicos generales (edad, sexo, nacionalidad), resultado de la prueba de Mantoux ...

  7. LOS TRATADOS INTERNACIONALES EN LA CONSTITUCIÓN DE 1980.: JURISPRUDENCIA EN LA DÉCADA DE 1981-1989

    Guillermo Bruna Contreras

    2003-01-01

    Full Text Available El presente artículo realiza un análisis de la doctrina y la jurisprudencia chilena respecto de la ubicación de los tratados internacionales en general dentro de la fuentes del derecho constitucional chileno, bajo el imperio de la Constitución de 1980, entre 1981 y 1989.Scholarship and the doctrine emanating from judicial decisions are considered here, with respect to the status of international treaties as sources of Chilean Constitutional Law under the provisions of the Constitution of 1980, between the years of 1981 and 1989.

  8. LOS DERECHOS HUMANOS Y LOS TRATADOS QUE LOS CONTIENEN EN EL DERECHO CONSTITUCIONAL Y LA JURISPRUDENCIA ARGENTINOS

    Ricardo Haro

    2003-01-01

    Full Text Available 1. Atento al texto de la Constitución 1853/60, la Corte Suprema de Justicia sostuvo inveteradamente la supremacía de la Constitución sobre los tratados, como así también la paridad de jerarquía jurídica entre éstos y las leyes, salvo a partir de 1992 en que otorgó prioridad a los Tratados de Derechos Humanos (TT.DD.HH. sobre las Leyes. 2. Un cambio fundamental se produce en el orden jurídico argentino a partir de la Reforma Constitucional de 1994: a Se receptaron nuevos derechos y garantías; b Por el art. 75 inc. 22, se incorporaron con jerarquía constitucional diez TT. DD. HH., y se otorgó la primacía de los tratados sobre las leyes; c Por el art. 75 inc. 24 se prevé la posibilidad de tratados de integración que deleguen competencias y jurisdicción a organizaciones supraestatales; d La CS ha reconocido expresamente la jurisdicción de la Corte Interamericana de Derechos Humanos en la interpretación y aplicación de la Convención Americana y ha declarado que su jurisprudencia debe servir de guía para la interpretación de los preceptos convencionales.Under the provisions of the Argentine Constitution of 1853/60, the Supreme Court always maintained the doctrine of the supremacy of the Constitution over international treaties, and the status of these as equal to Congress' laws, until the Court gave precedence to treaties on human rights over national laws in 1992. A fundamental change takes place in Argentine law with the constitutional amendment of 1994: a new rights and guarantees were received; b By the provisions of article 75 subsection 22, ten treaties were given constitutional status, and treaties were granted precedence over national laws; c Article 75 subsection 24 authorizes the delegation of power and jurisdiction to supranational organizations under the provisions of integration treaties; d The Supreme Court has accepted the jurisdiction of the Inter-American Court of Human Rights over the interpretation and

  9. Organizaciones internacionales y tratados asociativos: por una nueva clasificación de los sujetos de derecho internacional

    Raphael Carvalho de Vasconcelos

    2015-01-01

    La personalidad jurídica es elemento fundamental para la actuación de un sujeto en el orden internacional. La efectiva participación en el espacio global no depende, sin embargo, sólo del cumplimiento de este requisito. Doctrina y jurisprudencia reconocen la personificación de las organizaciones internacionales actualmente sin grandes reservas, pero, ¿correspondería entender que cualquier tratado dotado de personería jurídica debe ser considerado investido de poderes para actuar en el orden i...

  10. Intoxicação aguda por triclorfon em caprinos tratados com a dose terapêutica

    2014-01-01

    O presente estudo descreve um surto de intoxicação por triclorfon em caprinos, que receberam pela via oral, a dosagem terapêutica do princípio ativo em questão (100mg/kg), provenientes da Universidade Estadual de Maringá, campus de Umuarama, PR. Cinquenta e três ovinos foram tratados com a mesma formulação/solução e não se observou nenhum efeito colateral nos animais referente ao tratamento com triclorfon. Das 20 cabras medicadas, cerca de 40 minutos após a administração do triclorfon, oito a...

  11. Qualidade de caquis Fuyu tratados com cálcio em pré-colheita e armazenados sob atmosfera modificada

    FERRI VALDECIR CARLOS; RINALDI MARIA MADALENA; LUCHETTA LUCIANO; ROMBALDI CESAR VALMOR

    2002-01-01

    Avaliou-se a eficiência do cálcio (CaCl2) na conservação de caquis Fuyu armazenados em temperatura ambiente (TA), atmosfera refrigerada (AR) e modificada (AM). Utilizou-se um delineamento inteiramente casualizado, com quatro repetições. Os caquizeiros foram tratados com 1% de CaCl2, em pulverizações de cobertura total, a cada 15 dias, a partir de 90 dias antes da data prevista para a colheita. Para a testemunha, pulverizaram-se as plantas com água destilada. As frutas foram colhidas com 65-75...

  12. Characterization of signal properties in atherosclerotic plaque components by intravascular MRI.

    Rogers, W J; Prichard, J W; Hu, Y L; Olson, P R; Benckart, D H; Kramer, C M; Vido, D A; Reichek, N

    2000-07-01

    Magnetic resonance imaging (MRI) is capable of distinguishing between atherosclerotic plaque components solely on the basis of biochemical differences. However, to date, the majority of plaque characterization has been performed by using high-field strength units or special coils, which are not clinically applicable. Thus, the purpose of the present study was to evaluate MRI properties in histologically verified plaque components in excised human carotid endarterectomy specimens with the use of a 5F catheter-based imaging coil, standard acquisition software, and a clinical scanner operating at 0.5 T. Human carotid endarterectomy specimens from 17 patients were imaged at 37 degrees C by use of an opposed solenoid intravascular radiofrequency coil integrated into a 5F double-lumen catheter interfaced to a 0.5-T General Electric interventional scanner. Cross-sectional intravascular MRI (156x250 microm in-plane resolution) that used different imaging parameters permitted the calculation of absolute T1and T2, the magnetization transfer contrast ratio, the magnitude of regional signal loss associated with an inversion recovery sequence (inversion ratio), and regional signal loss in gradient echo (gradient echo-to-spin echo ratio) in plaque components. Histological staining included hematoxylin and eosin, Masson's trichrome, Kossa, oil red O, and Gomori's iron stain. X-ray micrographs were also used to identify regions of calcium. Seven plaque components were evaluated: fibrous cap, smooth muscle cells, organizing thrombus, fresh thrombus, lipid, edema, and calcium. The magnetization transfer contrast ratio was significantly less in the fibrous cap (0.62+/-13) than in all other components (Psmooth muscle cells) were not significantly different between groups. In vitro intravascular MRI with catheter-based coils and standard software permits sufficient spatial resolution to visualize major plaque components. Pulse sequences that take advantage of differences in biochemical

  13. Dose effects of guide wires for catheter-based intravascular brachytherapy

    Purpose: Guide wires with high torquability and steerability are commonly used to navigate through a tortuous and/or branching arterial tree in a catheter-based intravascular brachytherapy procedure. The dosimetric effects due to the presence of metallic guide wires have not been addressed. This work investigates these dose effects for the three most commonly used β and γ sources (90Sr, 32P, and 192Ir). Methods and Materials: The EGS4 Monte Carlo codes were used to calculate the dose distributions for the 90Sr(NOVOSTE), 32P (Guidant), and 192Ir (BEST Ind.) with and without a guide wire in place. Energy spectra for particles exiting the sources were calculated from the full phase-space data obtained from the Monte Carlo simulations of the source constructions. Guide wires of various thicknesses and compositions were studied. Results: The dose perturbations due to the presence of guide wires were found to be far more significant for the 90Sr/90Y and 32P beta sources than those for the 192Ir gamma source. Because of the attenuation by the guide wires, a dose reduction of up to 60% behind a guide wire was observed for the beta sources, whereas the dose perturbation was found to be negligible for the γ source. For a β source, the dose perturbations depend on the thickness and the material of the guide wire. When the region behind a guide wire is part of an intravascular brachytherapy target, the presence of the guide wire results in a significant underdosing for β sources. The underdosed region can extend a few mm behind the guide wire and up to 1 mm in other directions. Conclusion: Significant dose perturbations by the presence of a metallic guide wire have been found in catheter-based intravascular brachytherapy using β sources. The dose effects should be considered in the dose prescription and/or in analyzing the treatment outcome for β sources. Such precautions are not necessary if using a gamma source

  14. El Tratado Antártico, vehículo de paz en un campo minado

    M. Cristina Prieto Larrain

    2004-01-01

    Full Text Available El 99% de la superficie de la Antártica, esto es 14 millones de Km², está cubierta por hielos de unos 2 Km de profundidad. Además de ser el continente más frío, la Antártica es también el más seco, ventoso y alto del mundo, con una elevación media de 2.500 Mt. Tales características físicas explican la ausencia de población humana indígena en el área, así como lo tardío de su exploración y explotación por parte de estados europeos y americanos entre otros. Sólo a partir del siglo XVIII comienzan las expediciones al territorio antártico, con finalidades que van desde la investigación científica, pasando por la pesca de ballenas, hasta intentos de anexión territorial por parte de alguna nación. Conforme avanza el siglo XX, continúa la penetración del continente y los reclamos de soberanía sobre distintas áreas de la zona. Esto dio pie a disputas y choques entre estados. Durante la II Guerra Mundial amenazaba con transformarse en un nuevo escenario de enfrentamiento bélico entre las fuerzas enemigas. A lo largo de la Guerra Fría, se ve con temor que la Antártica podría ser tomada como centro de pruebas de armamento convencional y nuclear. A fin de evitar estos males y regularizar la explotación y exploración del continente, nació el Sistema del Tratado Antártico o STA. El régimen fue creado en 1958-1959 y pretendió detener las demandas de soberanía territorial además de salvaguardar el área de cualquier amenaza nuclear y militar. Aunque las partes signatarias tienen un evidente interés de futura anexión territorial, y el STA no ha logrado dar solución al problema de la soberanía sobre el continente, al menos ha congelado una peligrosa fuente de discordia e inestabilidad regional y mundial. Especialmente interesantes son los casos de Chile, Argentina y el Reino Unido, cuyas demandas territoriales sobrepuestas constituyen un buen ejemplo del choque de los títulos de soberanía esgrimidos por diversas

  15. The role of the adventitia in the arterial response to angioplasty: the effect of intravascular radiation

    Purpose: In the current series of experiments we have characterized cell proliferation leading to vascular lesion formation in a porcine model for post-angioplasty restenosis and examined the mechanism of action of intravascular beta irradiation in the prevention of lesion formation in this model. Methods and Materials: Juvenile male pigs were subjected to balloon overstretch injury of the left anterior descending and circumflex coronary arteries using clinical angioplasty catheters. Proliferating cells were labelled by injections of 50 mg/kg of bromo-deoxyuridine (BrDU) 24, 16 and 8 hrs prior to sacrifice and were detected by immunohistochemistry using a specific antibody to BrDU. In some cases, BrDU was given as a pulse 3 days after angioplasty and the animals sacrificed on day 14 to follow the migration of the cells which had proliferated earlier. Characterization of the proliferating cells was performed by immunohistochemistry using antibodies to specific cytoskeletal proteins specific for smooth muscle cells and myofibroblasts. Some vessels were treated at the time of angioplasty with 14 or 28 Gy (to a depth of 2 mm) intravascular irradiation using a flexible catheter with a pure beta emitter 90 SR/Y and the effect on cell proliferation and terminal transferase-mediated UTP nick-end labelling (TUNEL) examined 3 or 7 days later. Results: The first major site of cell proliferation between 2-3 days after angioplasty is the adventitia and not the medial wall. Seven days after angioplasty cell proliferation is predominant in the neointima and is reduced in the media and adventitia. Differential staining with antibodies directed against smooth muscle alpha actin and other cytoskeletal proteins indicates that the proliferating adventitial cells are myofibroblasts. Pulse label studies with BrDU indicates that the proliferating adventitial myofibroblasts migrate into the neointima and contribute to the mass of the restenosis lesion. Fourteen days after angioplasty the

  16. The use of intravascular ultrasound for intraoperative assessment during semiclosed thromboendarterectomy

    Vogt, K C; Sillesen, H; Schroeder, T V

    1998-01-01

    To evaluate the application of intravascular ultrasound (IVUS) for intraoperative assessment of semiclosed thromboendarterectomy (TEA), IVUS images of the iliofemoral segment in 20 patients were obtained. The configuration and size of residual atherosclerotic material were evaluated. Stenoses in...... the artery proximal to the endarterectomized area were measured and, along with any remaining material, related to patency. Patency was evaluated at clinical controls after 3, 6, 12 and 24 months with duplex scanning and ankle-brachial index. In 10 cases (50%), material left behind from the...... endarterectomy was detected in the artery by IVUS. The material was removed in five cases. The part of the iliac artery proximal to the endarterectomized segment was visualized in 14 cases and showed minor stenoses in 10 cases. After follow-up at a median of 8 months (range 1-24), occlusion had occurred in one...

  17. The cerebral intravascular enhancement sign is not specific: a contrast-enhanced MRI study

    Bakshi, R.; Kinkel, W.R.; Bates, V.E.; Mechtler, L.L.; Kinkel, P.R. [Lucy Dent Imaging Center, University at Buffalo, NY (United States)

    1999-02-01

    The intravascular enhancement (IVE) sign, also known as the ``arterial enhancement sign``, is an abnormal finding in the brain on contrast-enhanced MRI studies. IVE has been described in arterial cerebrovascular disorders, most commonly in acute or subacute arterial ischemic infarcts. However, the specificity of this sign has not been established. We describe four patients with disorders other than arterial strokes in whom gadolinium-enhanced high-field (1.5 T) MRI suggested IVE. The conditions were herpes simplex viral encephalitis, idiopathic cerebellitis, pneumococcal meningitis, and superior sagittal sinus thrombosis with venous infarction. IVE in these cases may be due to multiple factors, including arterial, venous, perivascular, and leptomeningeal or sulcal contrast medium accumulation. Our observations suggest that arterial ischemia, previously described as the cardinal cause of IVE, probably does not explain all instances, and urge caution in interpreting this sign as a specific MRI manifestation of acute arterial infarction or ischemia. (orig.) With 4 figs., 1 tab., 44 refs.

  18. Monte Carol-Based Dosimetry of Beta-Emitters for Intravascular Brachytherapy

    Choi, C.K.

    2002-06-25

    Monte Carlo simulations for radiation dosimetry and the experimental verifications of the simulations have been developed for the treatment geometry of intravascular brachytherapy, a form of radionuclide therapy for occluded coronary disease (restenosis). Monte Carlo code, MCNP4C, has been used to calculate the radiation dose from the encapsulated array of B-emitting seeds (Sr/Y-source train). Solid water phantoms have been fabricated to measure the dose on the radiochromic films that were exposed to the beta source train for both linear and curved coronary vessel geometries. While the dose difference for the 5-degree curved vessel at the prescription point of f+2.0 mm is within the 10% guideline set by the AAPM, however, the difference increased dramatically to 16.85% for the 10-degree case which requires additional adjustment for the acceptable dosimetry planning. The experimental dose measurements agree well with the simulation results

  19. [Chronic disseminated intravascular coagulopathy in a dog with lung worm infection].

    Schmitz, S; Moritz, A

    2009-06-01

    The clinical and laboratory findings in a 1-year-old male Jack Russel Terrier dog with lung worm induced coagulopathy are described. The diagnosis was based upon history, clinical findings, radiography, endoscopy, cytology and laboratory results. The presenting complaint was chronic cough. Radiographically, a diffuse interstitial to bronchial lung pattern was observed. Blood analysis revealed thrombocytopaenia and prolonged coagulation times. Disseminated intravascular coagulopathy (DIC) was diagnosed based on D-dimer and fibrinogen measurements, and by thrombelastogram results. After stabilisation of the patient, bronchoscopy with a bronchoalveolar lavage was performed, where large amounts of lung worm larvae were found cytologically. After treatment with fresh frozen plasma and fenbendazole, coagulation parameters improved and the cough resolved. PMID:19496048

  20. (100)-Textured KNN-based thick film with enhanced piezoelectric property for intravascular ultrasound imaging

    Zhu, Benpeng; Zhang, Zhiqiang; Ma, Teng; Yang, Xiaofei; Li, Yongxiang; Shung, K. Kirk; Zhou, Qifa

    2015-04-01

    Using tape-casting technology, 35 μm free-standing (100)-textured Li doped KNN (KNLN) thick film was prepared by employing NaNbO3 (NN) as template. It exhibited similar piezoelectric behavior to lead containing materials: a longitudinal piezoelectric coefficient (d33) of ˜150 pm/V and an electromechanical coupling coefficient (kt) of 0.44. Based on this thick film, a 52 MHz side-looking miniature transducer with a bandwidth of 61.5% at -6 dB was built for Intravascular ultrasound (IVUS) imaging. In comparison with 40 MHz PMN-PT single crystal transducer, the rabbit aorta image had better resolution and higher noise-to-signal ratio, indicating that lead-free (100)-textured KNLN thick film may be suitable for IVUS (>50 MHz) imaging.

  1. Intravascular papillary endothelial hyperplasia of the extremities: MR imaging findings with pathologic correlation

    We report the MRI findings of three cases of intravascular papillary endothelial hyperplasia (IPEH) of the extremities with correlation of the pathologic findings. The IPEH is a non-neoplastic reactive lesion within the vessels and is commonly associated with thrombi. Signal intensity of the IPEH is complex due to the thrombi and the PEH itself. The thrombi are characterized by a slightly hyperintense signal on T1- and T2-weighted images compared with that of muscle when it comes at the medium stage of hemorrhage. Papillary endothelial hyperplastic tissue appears either as iso- or hyperintense to the muscle on T2- and T1-weighted images and shows variable enhancement on Gd-DTPA-enhanced images. (orig.)

  2. Neuroendocrine and renal effects of intravascular volume expansion in compensated heart failure

    Gabrielsen, A; Bie, P; Holstein-Rathlou, N H;

    2001-01-01

    To examine if the neuroendocrine link between volume sensing and renal function is preserved in compensated chronic heart failure [HF, ejection fraction 0.29 +/- 0.03 (mean +/- SE)] we tested the hypothesis that intravascular and central blood volume expansion by 3 h of water immersion (WI) elicits...... (by sustained angiotensin-converting enzyme inhibitor therapy, n = 9) absolute and fractional sodium excretion increased (P < 0.05) to the level of control subjects (108 +/- 34 micromol/min and 0.70 +/- 0.23%, respectively). Renal free water clearance increased during WI in control subjects but not in...... HF, albeit plasma vasopressin concentrations were similar in the two groups. In conclusion, the neuroendocrine link between volume sensing and renal sodium excretion is preserved in compensated HF. The natriuresis of WI is, however, modulated by the prevailing ANG II and Aldo concentrations. In...

  3. The cerebral intravascular enhancement sign is not specific: a contrast-enhanced MRI study

    The intravascular enhancement (IVE) sign, also known as the ''arterial enhancement sign'', is an abnormal finding in the brain on contrast-enhanced MRI studies. IVE has been described in arterial cerebrovascular disorders, most commonly in acute or subacute arterial ischemic infarcts. However, the specificity of this sign has not been established. We describe four patients with disorders other than arterial strokes in whom gadolinium-enhanced high-field (1.5 T) MRI suggested IVE. The conditions were herpes simplex viral encephalitis, idiopathic cerebellitis, pneumococcal meningitis, and superior sagittal sinus thrombosis with venous infarction. IVE in these cases may be due to multiple factors, including arterial, venous, perivascular, and leptomeningeal or sulcal contrast medium accumulation. Our observations suggest that arterial ischemia, previously described as the cardinal cause of IVE, probably does not explain all instances, and urge caution in interpreting this sign as a specific MRI manifestation of acute arterial infarction or ischemia. (orig.)

  4. Intravascular large B-cell lymphoma complicated by invasive pulmonary aspergillosis: a rare presentation

    Mahasneh, Tamadur; Harrington, Zinta; Williamson, Jonathan; Alkhawaja, Darweesh; Duflou, Jo; Shin, Joo-Shik

    2014-01-01

    We describe a patient with persisting fevers, a progressive pulmonary infiltrate, and high levels of serum lactate dehydrogenase. No underlying cause for these changes was found prior to her death despite extensive investigations. Postmortem tissue revealed invasive pulmonary aspergillosis and subsequent brain examination revealed vascular changes in keeping with intravascular large B-cell lymphoma (IVLBCL). On review, subtle yet extensive lymphomatous infiltrates involved the vasculature of multiple other organs, including the lungs. Aspergillosis is a relatively rare presenting feature of lymphoproliferative disorders, and IVLBCL is a rare subtype of diffuse large B-cell non-Hodgkin's lymphoma with, to our knowledge, very few case reports to date. Lymphoma should be considered in patients presenting with pneumonitis with bilateral lung infiltrates on imaging, with a high serum level of lactate dehydrogenase. PMID:25473570

  5. Intravascular Large B-Cell Lymphoma Presenting as Interstitial Lung Disease

    Elham Vali Khojeini

    2014-01-01

    Full Text Available Intravascular large B-cell lymphoma (IVLBL is a rare subtype of diffuse large B-cell lymphoma that resides in the lumen of blood vessels. Patients typically present with nonspecific findings, particularly bizarre neurologic symptoms, fever, and skin lesions. A woman presented with shortness of breath and a chest CT scan showed diffuse interstitial thickening and ground glass opacities suggestive of an interstitial lung disease. On physical exam she was noted to have splenomegaly. The patient died and at autopsy was found to have an IVLBL in her lungs as well as nearly all her organs that were sampled. Although rare, IVLBL should be included in the differential diagnosis of interstitial lung disease and this case underscores the importance of the continuation of autopsies.

  6. JAK2 en el linfoma de Hodgkin: Impacto pronóstico de la regulación mediada por miR-135a y análisis in vitro de Lestaurtinib

    Díaz Sánchez, Tania

    2011-01-01

    El linfoma de Hodgkin es una neoplasia de células B caracterizada por la escasa presencia de células tumorales, células de Hodgkin/Reed-Sternberg, localizadas en un microambiente no tumoral. El comportamiento del LH se determina por las características intrínsecas de las células HRS y por las características de las células inflamatorias no neoplásicas del microambiente. Por eso, el análisis del papel pronóstico que juegan los miRNAs en el ganglio completo y no únicamente en las células tum...

  7. Insuficiência respiratória aguda causada por pneumonia em organização secundária à terapia antineoplásica para linfoma não Hodgkin

    Adriell Ramalho Santana; Fábio Ferreira Amorim; Paulo Henrique Alves Soares; Edmilson Bastos de Moura; Marcelo de Oliveira Maia

    2012-01-01

    Doenças difusas do parênquima pulmonar pertencem a um grupo de doenças de evolução geralmente subaguda ou crônica, mas que podem determinar insuficiência respiratória aguda. Paciente masculino, 37 anos, em terapia para linfoma não Hodgkin, admitido com tosse seca, febre, dispneia e insuficiência respiratória aguda hipoxêmica. Iniciadas ventilação mecânica e antibioticoterapia, porém houve evolução desfavorável. Tomografia computadorizada de tórax mostrava opacidades pulmonares em "vidro fosco...

  8. Multimodality Intravascular Imaging Assessment of Plaque Erosion versus Plaque Rupture in Patients with Acute Coronary Syndrome

    Kwon, Jee Eun; Mintz, Gary S.; Hong, Young Joon; Lee, Sung Yun; Kim, Ki Seok; Hahn, Joo-Yong; Kumar, Kaup Sharath; Won, Hoyoun; Hyeon, Seong Hyeop; Shin, Seung Yong; Lee, Kwang Je; Kim, Tae Ho; Kim, Chee Jeong; Kim, Sang Wook

    2016-01-01

    Background and Objectives We assessed plaque erosion of culprit lesions in patients with acute coronary syndrome in real world practice. Subjects and Methods Culprit lesion plaque rupture or plaque erosion was diagnosed with optical coherence tomography (OCT). Intravascular ultrasound (IVUS) was used to determine arterial remodeling. Positive remodeling was defined as a remodeling index (lesion/reference EEM [external elastic membrane area) >1.05. Results A total of 90 patients who had plaque rupture showing fibrous-cap discontinuity and ruptured cavity were enrolled. 36 patients showed definite OCT-plaque erosion, while 7 patients had probable OCT-plaque erosion. Overall, 26% (11/43) of definite/probable plaque erosion had non-ST elevation myocardial infarction (NSTEMI) while 35% (15/43) had ST elevation myocardial infarction (STEMI). Conversely, 14.5% (13/90) of plaque rupture had NSTEMI while 71% (64/90) had STEMI (p<0.0001). Among plaque erosion, white thrombus was seen in 55.8% (24/43) of patients and red thrombus in 27.9% (12/43) of patients. Compared to plaque erosion, plaque rupture more often showed positive remodeling (p=0.003) with a larger necrotic core area examined by virtual histology (VH)-IVUS, while negative remodeling was prominent in plaque erosion. Overall, 65% 28/43 of plaque erosions were located in the proximal 30 mm of a culprit vessel-similar to plaque ruptures (72%, 65/90, p=0.29). Conclusion Although most of plaque erosions show nearly normal coronary angiogram, modest plaque burden with negative remodeling and an uncommon fibroatheroma might be the nature of plaque erosion. Multimodality intravascular imaging with OCT and VH-IVUS showed fundamentally different pathoanatomic substrates underlying plaque rupture and erosion. PMID:27482258

  9. Penetration of an artificial arterial thromboembolism in a live animal using an intravascular therapeutic microrobot system.

    Jeong, Semi; Choi, Hyunchul; Go, Gwangjun; Lee, Cheong; Lim, Kyung Seob; Sim, Doo Sun; Jeong, Myung Ho; Ko, Seong Young; Park, Jong-Oh; Park, Sukho

    2016-04-01

    The biomedical applications of wireless robots are an active area of study. In addition to moving to a target lesion, wireless locomotive robots can deliver a therapeutic drug for a specific disease. Thus, they hold great potential as therapeutic devices in blood vessel diseases, such as thrombi and occlusions, and in other diseases, such as cancer and inflammation. During a percutaneous coronary intervention (PCI), surgeons wear a heavy shielding cloth. However, they cannot escape severe radiation exposure owing to unstable shielding. They may also suffer from joint pains because of the weight of the shielding cloth. In addition, the catheters in PCIs are controlled by the surgeon's hand. Thus, they lack steering ability. A new intravascular therapeutic system is needed to address these problems in conventional PCIs. We developed an intravascular therapeutic microrobot system (ITMS) using an electromagnetic actuation (EMA) system with bi-plane X-ray devices that can remotely control a robot in blood vessels. Using this proposed ITMS, we demonstrated the locomotion of the robot in abdominal and iliac arteries of a live pig by the master-slave method. After producing an arterial thromboembolism in a live pig in a partial iliac artery, the robot moved to the target lesion and penetrated by specific motions (twisting and hammering) of the robot using the proposed ITMS. The results reveal that the proposed ITMS can realize stable locomotion (alignment and propulsion) of a robot in abdominal and iliac arteries of a live pig. This can be considered the first preclinical trial of the treatment of an artificial arterial thromboembolism by penetration of a blood clot. PMID:26857290

  10. Intravascular large B-cell lymphoma of the kidney: A case report

    Jia Nan

    2011-09-01

    Full Text Available Abstract We report a 41-year-old Chinese woman with intravascular large B-cell lymphoma diagnosed by percutaneous renal biopsy. The patient was admitted to Nanfang Hospital of Southern Medical University, Guangzhou, China with complaints of high spiking fever for a month and bilateral lower limb fatigue with difficulty ambulating for the past 5 months. She had renal dysfunction with a total urinary protein of 5.61 g/dL (56.1 g/L, serum albumin of 2.89 g/dL (28.9 g/L, urea nitrogen of 2.24 mg/dL (1.6 mmol/L, and serum creatinine of 0.54 mg/dL (48 μmol/L. Bone marrow biopsy revealed myeloproliferative disorder without abnormal myeloid or lymphocytic proliferation. Positron Emission Tomography-Computed Tomography (PET-CT showed marked bilateral swelling and enlargement of the renal parenchyma with splenic enlargement and involvement of multiple vertebrae. Percutaneous renal biopsy showed island-like accumulations of medium to large lymphoid cells in many areas of the interstitium, with round vesicular nuclei containing distinct basophilic nucleoli. Immunohistochemical analysis together with other supportive investigation confirmed the diagnosis of intravascular large B-cell lymphoma. Ten days later, she was started on chemotherapy with CHOP (cyclophosphamide, doxorubicin, leurocristime and prednisone for a week. Palliative radiotherapy DT 40Gy/20F with other supportive treatment was provided for metastatic foci in the medullary cavity of the sternum, T1-T7. The patient regained muscle strength in both lower limbs and was able to walk again after three weeks. The patient was discharged after hepatic and renal function and proteinuria values had returned to normal. Follow-up data shows the patient to be alive nine months after discharge.

  11. Controlled pitch-adjustment of impeller blades for an intravascular blood pump.

    Throckmorton, Amy L; Sciolino, Michael G; Downs, Emily A; Saxman, Robert S; López-Isaza, Sergio; Moskowitz, William B

    2012-01-01

    Thousands of mechanical blood pumps are currently providing circulatory support, and the incidence of their use continues to increase each year. As the use of blood pumps becomes more pervasive in the treatment of those patients with congestive heart failure, critical advances in design features to address known limitations and the integration of novel technologies become more imperative. To advance the current state-of-the-art in blood pump design, this study investigates the inclusion of pitch-adjusting blade features in intravascular blood pumps as a means to increase energy transfer; an approach not explored to date. A flexible impeller prototype was constructed with a configuration to allow for a variable range of twisted blade geometries of 60-250°. Hydraulic experiments using a blood analog fluid were conducted to characterize the pressure-flow performance for each of these twisted positions. The flexible, twisted impeller was able to produce 1-25 mmHg for 0.5-4 L/min at rotational speeds of 5,000-8,000 RPM. For a given twisted position, the pressure rise was found to decrease as a function of increasing flow rate, as expected. Generally, a steady increase in the pressure rise was observed as a function of higher twisted degrees for a constant rotational speed. Higher rotational speeds for a specific twisted impeller configuration resulted in a more substantial pressure generation. The findings of this study support the continued exploration of this unique design approach in the development of intravascular blood pumps. PMID:22691415

  12. Linfoma no Hodgkin óseo primario multifocal en preadolescente: A propósito de un caso Primary multifocal non-Hodgkin's Lymphoma of the bone in the preadolescent: A case report

    A. Restrepo Rincón

    2012-01-01

    Full Text Available Los linfomas óseos primarios son tumores poco frecuentes en la edad pediátrica. Su presentación clínica es inespecífica, requiriéndose un alto nivel de sospecha clínica y el apoyo con diferentes pruebas complementarias para poder establecer el diagnóstico adecuado y así brindar un manejo integral. Se expone el caso de una paciente de 9 años, a quien a las 6,5 semanas de inicio de síntomas se diagnosticó un linfoma no Hodgkin Linfoblástico de células B óseo primario multifocal. Recibió tratamiento combinado según protocolo BFM (Berlín-Frankfurt-Munster, presentando una respuesta clínica satisfactoria y encontrándose en resmisión completa (RC a los 24 meses de seguimiento. Primary lymphoma of bone is rare in children and its non-specific clinical presentation requires a high clinical suspicion and paraclinical support to establish the diagnosis and provide a comprehensive approach. We report the case of 9 years-old patient who was diagnosed of multifocal primary B cell non-Hodgkin lymphoma of bone 6.5 weeks from symptoms onset. She received combined treatment based on BFM (Berlin-Frankfurt-Munster protocol with a good medical response. She remains in complete remission (CR after 24 months of follow-up.

  13. Las aspiraciones cosmpolitas de la ciudadanía europea a la luz del Tratado de Lisboa

    Jose Antonio García Saez

    2010-01-01

    Full Text Available  En octubre de 2009 se repetirá el referéndum irlandés sobre el Tratado de Lisboa. El accidentado proceso de gestación de este tratado, heredero a su vez de la non nata Constitución Europea, suscita algunas dudas en torno a la concepción de ciudadanía europea que vienen manejando las instituciones de la UE. En el presente artículo se intentará aportar algunos elementos de reflexión sobre esta concepción de ciudadanía tomando como referencia el ideal más amplio de la ciudadanía cosmopolita. Para determinar si la ciudadanía europea está avanzando o no hacia ese ideal cosmopolita se tendrán en cuenta tres cuestiones básicas: 1 la identidad europea, 2 el vínculo entre nacionalidad y ciudadanía y 3 los mecanismos de participación ciudadana y las garantías de legitimidad democrática.

  14. Las aspiraciones cosmpolitas de la ciudadanía europea a la luz del Tratado de Lisboa

    Jose Antonio García Saez

    2010-01-01

    Full Text Available En octubre de 2009 se repetirá el referéndum irlandés sobre el Tratado de Lisboa. El accidentado proceso de gestación de este tratado, heredero a su vez de la non nata Constitución Europea, suscita algunas dudas en torno a la concepción de ciudadanía europea que vienen manejando las instituciones de la UE. En el presente artículo se intentará aportar algunos elementos de reflexión sobre esta concepción de ciudadanía tomando como referencia el ideal más amplio de la ciudadanía cosmopolita. Para determinar si la ciudadanía europea está avanzando o no hacia ese ideal cosmopolita se tendrán en cuenta tres cuestiones básicas: 1 la identidad europea, 2 el vínculo entre nacionalidad y ciudadanía y 3 los mecanismos de participación ciudadana y las garantías de legitimidad democrática.

  15. O transplante de células-tronco hematopoéticas no tratamento dos linfomas não Hodgkin Hematopoietic stem cell transplantation for non-Hodgkin lymphomas

    Renata Baldissera

    2010-05-01

    Full Text Available No final da década de 70, ocorreu o primeiro relato de sucesso com a utilização de quimioterapia de alta dose, seguida de transplante de células-tronco hematopoéticas autólogo (TCTH auto, em pacientes com linfoma não Hodgkin (LNH. Desde então, o TCTH autólogo vem se constituindo em um importante instrumento na estratégia de tratamento dos LNH. Inúmeros estudos, em vários subtipos de linfomas, têm consolidado o papel do TCTH autólogo, principalmente como resgate em recidivas de doença. O melhor momento para a incorporação desta estratégia depende do subtipo do linfoma, do status de doença previamente ao transplante (sensível ou resistente e de fatores clínico-biológicos associados à doença. Em recidiva sensível de linfoma difuso de grandes células, o TCTH autólogo é a terapia de escolha. Nestes pacientes, o transplante promove taxas de resposta completa em até 50% dos casos, comparado a aproximadamente 15%, quando esse resgate é realizado com protocolos quimioterápicos convencionais. O seu papel como parte da terapia de indução de remissão não está totalmente estabelecido. Em linfomas indolentes, principalmente folicular, é a terapia de escolha nas recidivas sensíveis à quimioterapia de resgate. Em linfomas de células do manto, o TCTH autólogo tem se incorporado à terapia de primeira linha, como consolidação de remissão. As indicações de TCTH alogênico em LNH têm se limitado aos casos de refratariedade ao tratamento convencional e recidiva pós-transplante autólogo, em pacientes jovens e sem comorbidades, em decorrência da alta toxicidade associada à utilização de regimes de condicionamento mieloablativos. A utilização de regimes de condicionamento de intensidade reduzida tem reduzido a toxicidade e ampliado o seu uso nos LNH recidivados ou refratários.High-dose chemotherapy (HDT followed by autologous bone marrow transplantation (ABMT has proved to provide significant advantage regarding

  16. Valor pronóstico del análisis semicuantitativo del grado de fijación de la 2.[.[18f]fluoro-2-deoxi-d-glucosa mediante tomografía por emisión de positrones en pacientes pediátricos con linfoma

    Borrego Dorado, Isabel

    2016-01-01

    El linfoma es una neoplasia relativamente frecuente en niños y adolescentes jóvenes constituyendo del 10% al 15% de todas las neoplasias que aparecen durante la edad pediátrica1, 2. Su pronóstico ha mejorado gracias al desarrollo de nuevos tratamientos en las 2 últimas décadas3, presentando un amplio rango de supervivencia global a los 5 años, que varía desde el 75% en los linfoma no hodgkin (LNH) hasta el 90% en la en¬fermedad de Hodgkin (EH)4-6. Por otra parte, la duración e intensidad del ...

  17. Toxicidad cutánea a corto plazo de pacientes con cáncer de mama tratados con radioterapia hipofraccionada

    Rolando Loría-Ruiz; Rafael Lengua-Reyes; Erick Palacios-García; Adriana Fondevilla-Soler

    2013-01-01

    Antecedentes: reportar la factibilidad y resultados de toxicidad cutánea en una cohorte de pacientes portadores de cáncer de mama, tratados con un esquema de hipofraccionamiento de radioterapia externa, con un manejo multidisciplinario. Métodos: utilizando un software SPSS v18, se realizó un análisis retrospectivo de 299 pacientes (6 H y 293 M), tratados entre marzo de 2009 y diciembre de 2011, en el Instituto Oncológico del Sureste, Murcia, España. La mediana de edad fue de 54 años (rango, 3...

  18. Protección frente a la tinción dentaria en dientes tratados con tetraciclinas al aplicar un antioxidante (ácido ascórbico)

    Bermúdez Semprún, María Esther; Beltri Orta, Paola; Bartolomé Villar, Begoña

    2014-01-01

    En la presente investigación pretendemos optimizar los resultados, evitando la coloración coronal, en procedimientos odontológicos donde sea imprescindible el uso de tetraciclinas así como evaluar la disminución de las coloraciones coronales, al aplicar un antioxidante (Acido Ascórbico) en dientes tratados con tetraciclinas (Minociclina y Doxiciclina). En los dientes tratados con minociclina y doxiciclina observamos cambios en la coloración dentaria apreciables tanto en corona como en la raíz...

  19. Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis

    Hong, Young Joon; Jeong, Myung Ho; Choi, Yun Ha; Ko, Jum Suk; Lee, Min Goo; Kang, Won Yu; Lee, Shin Eun; Kim, Soo Hyun; Park, Keun Ho; Sim, Doo Sun; Yoon, Nam Sik; Youn, Hyun Ju; Kim, Kye Hun; Park, Hyung Wook; Kim, Ju Han

    2009-01-01

    Aims We used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relation between coronary plaque characteristics and no-reflow in acute coronary syndrome (ACS) patients. Methods and results A total of 190 consecutive ACS patients were imaged using VH-IVUS and analysed retrospectively. Angiographic no-reflow was defined as TIMI flow grade 0, 1, and 2 after stenting. Virtual histology-intravascular ultrasound classified the colour-coded tissue into four major components: fibro...

  20. Shelf life of peaches treated with 1-methylcyclopropene Vida útil de pêssegos tratados com 1-metilciclopropeno

    Ricardo Alfredo Kluge

    2002-03-01

    Full Text Available Peaches [Prunus persica (L. Bastch] present reduced post-harvest shelf life, partially, due to their high respiratory rate and fast ripening. These processes are related to ethylene production, as well as its action. Peaches, cv. Aurora-1, were picked at two different ripening stages (mature green and ripe and treated with 1-methylcyclopropene (1-MCP, the ethylene's competitive antagonist, at concentrations of 0, 100, 300 and 900 nL L-1 for 12 hours at 25ºC. After treatment, the fruits were stored at room temperature (25ºC for six days. Fruits treated with 1-MCP presented better firmness and less ground color loss than non-treated fruits. The 1-MCP antagonist reduced the development of fruit rot at the mature green stage, but not at the ripe one. The 1-MCP shows commercial application potential in the treatment of peaches in order to delay the ripening process and increase their shelf life.Pêssegos [Prunus persica (L. Bastch] apresentam reduzida vida útil pós-colheita devido, em parte, a sua alta taxa respiratória e amadurecimento rápido. Estes processos estão relacionados com a produção e a ação do etileno. Pêssegos cv. Aurora-1 foram colhidos em dois estádios de maturação (verde e maduro e tratados com o antagonista competitivo do etileno 1-metilciclopropeno (1-MCP nas concentrações de 0, 100, 300 e 900 nL L-1, durante 12 horas a 25ºC. Após o tratamentos os frutos foram armazenados em condições ambientais (25ºC durante seis dias. Os frutos tratados com 1-MCP apresentaram maior firmeza de polpa e menor perda de coloração de fundo se comparado com os frutos não tratados. O 1-MCP reduziu o desenvolvimento de podridões em frutos do estádio verde, mas não em frutos maduros. O 1-MCP apresenta potencial de aplicação comercial em pêssegos, visando retardar o amadurecimento e aumentar sua vida útil de prateleira.

  1. Acute Kidney Injury due to Menstruation-related Disseminated Intravascular Coagulation in an Adenomyosis Patient: A Case Report

    Son, Jungmin; Lee, Dong Won; Seong, Eun Young; Song, Sang Heon; Lee, Soo Bong; Kang, Jin; Yang, Byeong Yun; Lee, Su Jin; Choi, Jong-Ryeol; Lee, Kyu-Sup; Kwak, Ihm Soo

    2010-01-01

    The authors report a case of acute kidney injury (AKI) resulting from menstruation-related disseminated intravascular coagulation (DIC) in an adenomyosis patient. A 40-yr-old woman who had received gonadotropin for ovulation induction therapy presented with anuria and an elevated serum creatinine level. Her medical history showed primary infertility with diffuse adenomyosis. On admission, her pregnancy test was negative and her menstrual cycle had started 1 day previously. Laboratory data wer...

  2. Pulmonary intravascular macrophages in the pathogenesis of bovine pulmonary lesions caused by Actinomyces pyogenes

    Leifsson, Páll Skúli; Basse, A.; Jensen, Henrik Michael Elvang;

    1995-01-01

    Rabbit antisera raised against somatic antigens from two strains of Actinomyces pyogenes reacted specifically in a peroxidase anti-peroxidase technique which was developed for the location of the bacteria in formalin-fixed tissues. The technique was applied on experimental murine and spontaneous...... bovine lesions caused by A. pyogenes. By electron microscopy and immunohistochemistry it was demonstrated that pulmonary intravascular macrophages play a role in the uptake of A. pyogenes from the blood, and in the production of pyaemic pulmonary lesions...

  3. Intravascular Ultrasound Guidance to Minimize the use of Iodine Contrast in Percutaneous Coronary Intervention: The MOZART Randomized Controlled Trial

    Mariani, José; Guedes, Cristiano; Soares, Paulo; Zalc, Silvio; Campos, Carlos M.; Augusto C Lopes; Spadaro, André G.; Perin, Marco A.; Filho, Antonio Esteves; Takimura, Celso K.; Ribeiro, Expedito; Kalil-Filho, Roberto; Edelman, Elazer R.; Serruys, Patrick W.; Pedro A. Lemos

    2014-01-01

    Objectives: The aim of this study was to evaluate the impact of intravascular ultrasound (IVUS) guidance on the final volume of contrast agent used in patients undergoing percutaneous coronary intervention (PCI). Background: To date, few approaches have been described to reduce the final dose of contrast agent in PCIs. We hypothesized that IVUS might serve as an alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of iodine contrast. Methods: ...

  4. Effects of intravascular volume expansion on the cardiovascular response to naloxone in a canine model of severe endotoxin shock.

    Evans, S. F.; Hinds, C J; Varley, J. G.

    1984-01-01

    The specific opiate receptor antagonist, naloxone, can produce haemodynamic improvement and increased survival in experimental shock. The efficacy of naloxone therapy in a canine model of endotoxin shock has been evaluated both with and without intravascular volume replacement. Animals were anaesthetized with alpha-chloralose and allowed to breathe spontaneously. A large bolus dose of endotoxin was followed by a continuous infusion and treatment was instituted one hour after the endotoxin bol...

  5. Estudio del grado de satisfacción en pacientes edéntulos totales tratados con implantes

    Regina Mestre Aspa; Mª Àngels Sánchez Garcés; Leonardo Berini Aytés; Cosme Gay Escoda

    2001-01-01

    El objetivo de este estudio fue evaluar el grado de satisfacción de los pacientes edéntulos totales tratados en nuestro servicio mediante implantes dentales y la colocación posterior de una prótesis implantosoportada (sobre dentadura o prótesis fija). Para evaluar el grado de satisfacción se realizó una encuesta telefónica con seis preguntas: 1) ¿Siente algún tipo de dolor en los implantes? 2) ¿Tiene algún problema cuando habla? 3) ¿Se atreve a reír con esta prótesis? 4) ¿Puede comer cómodame...

  6. El tratado de paz de los Pirineos : una revisión historiográfica (1888-1988)

    Valladares Ramírez, Rafael Jesús

    1989-01-01

    Hace trescientos años y casi tres décadas se concluyó, en una isla del río Bidasoa, un tratado de paz —«perpetua», al decir de la época— entre las dos monarquías más poderosas de Europa. Con tales premisas, era de esperar que una concertación entre dos sistemas de fuerza (bélica y diplomática) tan considerables debía originar una tectónica de placas territoriales y políticas de no escasa relevancia. De entonces a esta parte, ningún autor que se haya aproximado al contencioso...

  7. Colombia & the New Global Economy: Implications of Tratado de Libre Comercio for Colombian Industry, Engineers and Engineering Educators

    Bopaya Bidanda

    2006-11-01

    Full Text Available The landscape of the world economy has changed significantly over the last twenty five years. The inter-connectedness of national economies, the rapid ascent of the BRIC countries (Brazil, Russia, India, China in the global engineering environment and the pro-active role of organizations such as the World Trade Organization, regional alliances such as the EU, and Mercosur are factors that have synergized this movement towards a new order. The completion of the Tratado de Libre Comercio (TLC agreement is a major milestone for the Colombian economy. These developments have serious and opportunistic implications for organizations, engineers, and engineering educators. We focus here on the drivers and consequences for engineering practitioners and educators. Corporate strategies, along with the need for engineering curriculum reform to ensure that Colombian engineers will effectively compete in the global marketplace, are detailed.

  8. Intravascular brachytherapy after percutaneous recanalization of occluded femoral artery: a case report

    The paper presents the use of introvascular brachytherapy after percutaneus recanalization and angioplasty of the femoral artery in a 65-year old patient with hypertension, a history of heavy smoking, and early stage diabetes. The patient was admitted to hospital with rest ischeamia of the right crus and trophic skin changes in that region. After primary pharmacological treatment angiography was performed revealing the femoro-popliteal artery to be occluded in the distal part of the adductor canal. The patency of the artery was established. Subsequently the occluded par of the artery was completely dilated without residual stenosis. Control angiography revealed good contrast flow through the dilated artery and correct configuration of the arteries below the open and dilated part of the femoro-popliteal artery. These arteries were, however, anatomically narrow. On clinical examination the pulse was present on peripheral arteries, while cyanosis of the right foot and the pain had disappeared. To prevent restenosis after angioplasty intravascular brachytherapy was performed with Microselectron192Ir. A PARIS catheter was used as the applicator. It was introduced into the artery using the same access as angiography and angioplasty. The target for irradiation was the dilated part of the artery with bilateral 1.5 cm margins - altogether 10 cm. One dose of 15 Gy was applied 2 mm from the inner surface of the arterial wall (2 mm from the applicator surface). There were no early side effects after the treatment. (author)

  9. A physics-based intravascular ultrasound image reconstruction method for lumen segmentation.

    Mendizabal-Ruiz, Gerardo; Kakadiaris, Ioannis A

    2016-08-01

    Intravascular ultrasound (IVUS) refers to the medical imaging technique consisting of a miniaturized ultrasound transducer located at the tip of a catheter that can be introduced in the blood vessels providing high-resolution, cross-sectional images of their interior. Current methods for the generation of an IVUS image reconstruction from radio frequency (RF) data do not account for the physics involved in the interaction between the IVUS ultrasound signal and the tissues of the vessel. In this paper, we present a novel method to generate an IVUS image reconstruction based on the use of a scattering model that considers the tissues of the vessel as a distribution of three-dimensional point scatterers. We evaluated the impact of employing the proposed IVUS image reconstruction method in the segmentation of the lumen/wall interface on 40MHz IVUS data using an existing automatic lumen segmentation method. We compared the results with those obtained using the B-mode reconstruction on 600 randomly selected frames from twelve pullback sequences acquired from rabbit aortas and different arteries of swine. Our results indicate the feasibility of employing the proposed IVUS image reconstruction for the segmentation of the lumen. PMID:27235803

  10. The clinical efficacy of extracorporeal and intravascular hemocorrection methods in psoriasis

    Baityakov V.V.

    2012-03-01

    Full Text Available Purpose. The study of the influence of extracorporeal and intravascular hemocorrection methods (plasmapheresis, ultraviolet blood radiation, ozonetherapy and its combination on skin process and life quality in patients with extensive psoriasis. Methods. 253 patients with extensive psoriasis from the age of 18 to 72 have been investigated. PASI (Psoriasis Area and Severity Index and dermatological index of life quality (DILQ have been used for treatment assessment. Results. The inclusion of efferent quantum and ozone therapy methods in the complex treatment of psoriasis has promoted to the more rapid and complete positive dynamics of skin process and the improvement of life quality. The use of plasmapheresis and its variations with photomodification or the ozone treatment of returning erythrocyte suspension has been the most effective. Plasmapheresis and its modifications are appropriateto be used in the complex treatment of the patients with severe forms of psoriasis. Conclusion: Further study of efferent quantum and ozone therapy methods and their wider use in psoriasis therapy and other chronic dermatosis seem to be promising.

  11. The potential value of intravascular ultrasound imaging in diagnosis of aortic intramural hematoma

    Wei Hu; Francois Schiele; Nicolas Meneveau; Marie-France Seronde; Pierre Legalery; Jean-Francois Bonneville; Sidney Chocron; Jean-Pierre Bassand

    2011-01-01

    Objective To evaluate the potential value of intravascular ultrasound (IVUS) imaging in the diagnosis of aortic intramural hematoma (AIH).Methods From September 2002 to May 2005,a consecutive series of 15 patients with suspected aortic dissection (AD) underwent both IVUS imaging and spiral computed tomography (CT).Six patients diagnosed as acute type B AIH by CT or IVUS composed the present study group.Results The study group consisted of five males and one female with mean age of 66 years old.All of them had chest or back pain.In one patient,CT omitted a localized AIH and an associated penetrating atherosclerotic ulcer (PAU),which were detected by IVUS.In another patient,CT mistaken a partly thrombosed false lumen as an AIH,whereas IVUS detected a subtle intimal tear and slow moving blood in the false lumen.In the four rest patients,both CT and IVUS made the diagnosis of AIH,however,IVUS detected three PAUs in three of them,only one of them was also detected by CT,and two of them escaped initial CT and were confirmed by follow up CT or magnetic resonance imaging.Conclusions IVUS imaging is a safe examination and has high accuracy in the diagnosis of AIH,particularly for diagnosing localized AIH,distinguishing AIH with thrombosed classic AD and detecting accompanied small PAUs.

  12. Imaging manifestations of intravascular leiomyoma involving the right atrium: a case report and literature review

    Ouyang, Aimei; Su, Xinyou; Li, Shujing; Li, Kun; Wang, Jian

    2015-01-01

    The aim of this study is to investigate the imaging features of intravascular leiomyoma (IVL) involving the heart and the imaging techniques in the diagnosis of this disease. The imaging features of contrast-enhanced computed tomography (CT), the clinical data and the pathological data of a case of IVL involving the right atrium were retrospectively analyzed and the literatures were reviewed. A 42-year-old woman was admitted to Jinan Central Hospital with a 7-day history of lower extremity weakness, chest tightness and short breath. Contrast-enhanced CT scanning revealed that there was a mass in the inferior vena cava and right atrium, which was heterogeneously enhanced. There was a gap between the vessel wall and the mass. Spiral CT scanning with multiplanner reformation (MPR) reconstruction revealed the morphology, scope and extension pathways of the tumor clearly. Ultrasonography (US) and magnetic resonance imaging (MRI) also played important roles in the diagnosis and differential diagnosis of IVL. To the patients with a history of uterine fibroids, spiral CT scanning, US and MRI could be used to improve the correct diagnosis rates of IVL before surgery. PMID:26379990

  13. The study of cardiovascular changes by intravascular injection of contrast media

    This investigation was aimed to study the effect of contrast media on the cardiovascular system. So in this study, pithed rats were used whether alteration in cardiovascular system by contrast media were controlled centrally. Furthermore, several hypertonic solutions were also used to clarify the effect of contrast media. The results are as follows: 1. Intravenous injection of contrast media in rats (2.5 ml/kg) caused hypotension and bradycardia. The effects were neither blocked by pretreatment of atropine nor pyribenzamine+atropine. 2. NaCI 4.7%, dextrose 24.8%, urea 9.0% and glycerol 10.1% (v/v) which were equiosmolar with contrast media, caused hypotension, but did not affect the heart rate. 3. In pithed rats, intravenous injection of Angiografin increased blood pressure in a dose-dependant manner, and caused decrease in heart rate compared with those of control rats. 4. In pithed rats, bradycardia by intravascular injection with Angiografin was partially blocked by atropine. 5. Metrizamide of which iodine content was adjusted to 280 mg/ml caused increased in blood pressure when was injected intravenously in pithed rats with little effect on heart rate. 6. When perfused with contrast media in rat hindlimb at 15 ml/min./kg speed both perfusion pressure and flow effluent increased, simultaneously. These results suggest that hypotension might be caused by the central effect due to hyperosmolarity of contrast media and bradycardia caused by both parasympathetic stimulation and direct inhibitory action on the cardiac conductive system.

  14. Pharmacokinetics and acetylation of sulfamethoxazole in turbot Scophthalmus maximus after intravascular administration

    Chang, Zhiqiang; Liu, Fei; Lian, Chun'ang; Zhai, Qianqian; Li, Jian

    2016-07-01

    The pharmacokinetic profiles and sulfamethoxazole (SMX) acetylation process in turbot reared at 18°C were investigated. Either SMX (parent drug) or its acetylized metabolite, N4-acetylsulfamethoxazole (AcSMX), was administered intravascularly to turbot at a dosage of 50 mg/kg BW. Serum concentrations of the parent drug and its metabolite were both measured by HPLC, and the changes in concentration over time were analyzed in two- and non-compartment models because SMX treatment produced multiple peaks. The results demonstrated that the elimination half-life of the parent drugs, SMX and AcSMX, were 159.2 and 5.9 h, respectively. The apparent volume of distribution was 0.2 and 0.8 L/kg, and the clearance was 0.038 and 0.222 L/(h·kg), for SMX and AcSMX, respectively. SMX acetylation in turbot was 2.8%, and the deacetylation of AcSMX was 0.2%. These findings may be useful in optimizing SMX dosage regimens in turbot aquaculture.

  15. Micromachined PIN-PMN-PT crystal composite transducer for high-frequency intravascular ultrasound (IVUS) imaging.

    Li, Xiang; Ma, Teng; Tian, Jian; Han, Pengdi; Zhou, Qifa; Shung, K Kirk

    2014-07-01

    In this paper, we report the use of micromachined PbIn1/2Nb1/2O3-PbMg1/3Nb2/3O3-PbTiO 3 (PIN-PMNPT) single crystal 1-3 composite material for intravascular ultrasound (IVUS) imaging application. The effective electromechanical coupling coefficient kt(eff) of the composite was measured to be 0.75 to 0.78. Acoustic impedance was estimated to be 20 MRayl. Based on the composite, needle-type and flexible-type IVUS transducers were fabricated. The composite transducer achieved an 86% bandwidth at the center frequency of 41 MHz, which resulted in a 43 μm axial resolution. Ex vivo IVUS imaging was conducted to demonstrate the improvement of axial resolution. The composite transducer was capable of identifying the three layers of a cadaver coronary artery specimen with high resolution. The PIN-PMN-PT-based composite has superior piezoelectric properties comparable to PMN-PT-based composite and its thermal stability is higher than PMN-PT. PIN-PMN-PT crystal can be an alternative approach for fabricating high-frequency composite, instead of using PMN-PT. PMID:24960706

  16. Current Pathological and Laboratory Considerations in the Diagnosis of Disseminated Intravascular Coagulation.

    Toh, Cheng Hock; Alhamdi, Yasir; Abrams, Simon T

    2016-11-01

    Systemically sustained thrombin generation in vivo is the hallmark of disseminated intravascular coagulation (DIC). Typically, this is in response to a progressing disease state that is associated with significant cellular injury. The etiology could be infectious or noninfectious, with the main pathophysiological mechanisms involving cross-activation among coagulation, innate immunity, and inflammatory responses. This leads to consumption of both pro- and anticoagulant factors as well as endothelial dysfunction and disrupted homeostasis at the blood vessel wall interface. In addition to the release of tissue plasminogen activator (tPA) and soluble thrombomodulin (sTM) following cellular activation and damage, respectively, there is the release of damage-associated molecular patterns (DAMPs) such as extracellular histones and cell-free DNA. Extracellular histones are increasingly recognized as significantly pathogenic in critical illnesses through direct cell toxicity, the promotion of thrombin generation, and the induction of neutrophil extracellular trap (NET) formation. Clinically, high circulating levels of histones and histone-DNA complexes are associated with multiorgan failure, DIC, and adverse patient outcomes. Their measurements as well as that of other DAMPs and molecular markers of thrombin generation are not yet applicable in the routine diagnostic laboratory. To provide a practical diagnostic tool for acute DIC, a composite scoring system using rapidly available coagulation tests is recommended by the International Society on Thrombosis and Haemostasis. Its usefulness and limitations are discussed alongside the advances and unanswered questions in DIC pathogenesis. PMID:27578502

  17. Intravascular Large B Cell Lymphoma as a Rare Cause of Reversed Halo Sign: A Case Report.

    Peng, Min; Shi, Juhong; Liu, Hongrui; Li, Guangxi

    2016-03-01

    Intravascular large B cell lymphoma (IVLBCL) is a rare type of extranodal diffused large B-cell lymphoma. IVLBCL with primary lung lesion is very rare and it is very difficult to diagnose. Radiographic findings of pulmonary IVLBCL are nonspecific and resembling interstitial lung diseases. Reversed halo sign (RHS) was initially reported in patients diagnosed with cryptogenic organizing pneumonia and then described in a variety of diseases with inflammatory, infectious, autoimmune, and malignant causes. This is the first case of IVLBCL that has presented with RHSs on CT scan.A 59-year-old Chinese man presented with a 4-month history of a nonproductive cough and a weight loss of 5 kg. Physical examination was unremarkable. High-resolution computed tomography scan of the chest showed bilateral patchy ground glass opacities (GGOs) and RHSs. Laboratory tests were unremarkable except elevated serum lactate dehydrogenase (LDH). Surgical lung biopsy was performed. Light microscopic examination of the specimen disclosed diffuse alveolar septal widening caused by neoplastic lymphocytes, which were positive for CD20 and infiltrated in the alveolar capillaries. The patient was diagnosed with IVLBCL and underwent chemotherapy and autologous blood stem cell transplantation. The patient is still alive 5 years after diagnosis.IVLBCL is a rare cause of RHS and should be considered in differential diagnosis of RHS. An increased serum LDH concentration is another important clue. PMID:27015192

  18. Paediatricians’ referral preference of patients with embolised intravascular foreign bodies: a survey-based study

    Shehla Jadoon

    2013-03-01

    Full Text Available Background: Central line insertion is a routine procedure in medical practice. Dislodgement of lines into the vascular system is a rare complication. We noticed that paediatric health care providers (PHCP contact the cardiac or general paediatric surgeon for extraction of dislodged lines more frequently than using the less invasive percutaneous approach. Aim: To study the referral preference of PHCP for patient with embolised intravascular foreign bodies. Methods: A questionnaire with three questions was distributed to PHCP of all paediatric subspecialties, including surgery, in two tertiary care centres. The questions were about the total number of patients seen with central line, experience with complications, and preferred specialty for removal of dislodged central lines. Results: The questionnaire was distributed to 128 professionals. The response rate was 79% (n=101. Incomplete answers (n=14 were excluded. The grades of responders were senior consultants 18%, junior consultants 38%, and residents 43%. Thirty nine percent of care providers experienced dislodgement or fragmentation of central lines. The majority (82% prefer to refer the patients for surgical removal. Conclusions: Most PHCP in the selected hospitals prefer to refer patients with embolised foreign bodies in the vascular system for surgical removal. The local health policy should be updated for the use of the alternative percutaneous approach.

  19. First clinical pilot study with intravascular polarization sensitive optical coherence tomography (Conference Presentation)

    Villiger, Martin; Karanasos, Antonios; Ren, Jian; Lippok, Norman; Shishkov, Milen; Daemen, Joost; Van Mieghem, Nicolas; Diletti, Roberto; Valgimigli, Marco; van Geuns, Robert-Jan; de Jaegere, Peter; Zijlstra, Felix; van Soest, Gijs; Nadkarni, Seemantini; Regar, Evelyn; Bouma, Brett E.

    2016-02-01

    Polarization sensitive (PS) OCT measures the polarization states of the light backscattered by tissue and provides measures of tissue birefringence and depolarization in addition to the structural OCT signal. Ex vivo studies have demonstrated that birefringence is increased in tissue rich in collagen and with elevated smooth muscle cell content. Preliminary data further suggests that depolarization can identify regions of macrophage infiltration, lipid, and irregularly arranged collagen fibers. These are important aspects of the mechanical integrity and vulnerability of atherosclerotic plaques. To evaluate the potential of PS-OCT in the clinical setting, we combined our custom PS-OCT system with commercially available OCT catheters (Fastview, Terumo Corporation) and performed a pilot study in 30 patients, scheduled to undergo percutaneous coronary intervention (PCI) on the grounds of stable or unstable angina. A total of 82 pullbacks in 39 vessels were performed, either in the native coronary arteries or post procedure. Comparing consecutive pullbacks of the same coronary artery, we found excellent agreement between the polarization features in the repeat pullbacks, validating the repeatability and robustness of PS-OCT in the clinical in vivo setting. In addition we observed that the birefringence and depolarization features vary significantly across lesions with identical structural OCT appearance, suggesting morphological subtypes. This first human pilot study proved the feasibility and robustness of intravascular PS-OCT. PS-OCT achieves improved tissue characterization and may help in identifying high-risk plaques, with the potential to ultimately improve risk stratification and help guiding PCI.

  20. Detection of coronary plaques using MR coronary vessel wall imaging: validation of findings with intravascular ultrasound

    Gerretsen, Suzanne; Engelshoven, Jos M.A. van; Kooi, M.E. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Kessels, Alfons G. [Maastricht University Medical Centre, Department of Clinical Epidemiology and Medical Technical Assessment, Maastricht (Netherlands); Nelemans, Patty J. [Maastricht University, Department of Epidemiology, Maastricht (Netherlands); Dijkstra, Jouke; Reiber, Johan H.C.; Geest, Rob J. van der [Leiden University Medical Centre, Department of Radiology, Division of image processing (LKEB), Leiden (Netherlands); Katoh, Marcus [HELIOS Clinic, Department of Diagnostic and Interventional Radiology, Krefeld (Germany); Waltenberger, Johannes [University of Muenster, Department of Cardiology and Angiology, Muenster (Germany); Botnar, Rene M. [King' s College, Imaging Sciences Division, London (United Kingdom); Leiner, Tim [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Utrecht University Medical Centre, Department of Radiology, Utrecht (Netherlands)

    2013-01-15

    Compared with X-ray coronary angiography (CAG), magnetic resonance imaging of the coronary vessel wall (MR-CVW) may provide more information about plaque burden and coronary remodelling. We compared MR-CVW with intravascular ultrasound (IVUS), the standard of reference for coronary vessel wall imaging, with regard to plaque detection and wall thickness measurements. In this study 17 patients with chest pain, who had been referred for CAG, were included. Patients underwent IVUS and MR-CVW imaging of the right coronary artery (RCA). Subsequently, the coronary vessel wall was analysed for the presence and location of coronary plaques. Fifty-two matching RCA regions of interest were available for comparison. There was good agreement between IVUS and MR-CVW for qualitative assessment of presence of disease, with a sensitivity of 94% and specificity of 76%. Wall thickness measurements demonstrated a significant difference between mean wall thickness on IVUS and MR-CVW (0.48 vs 1.24 mm, P < 0.001), but great heterogeneity between wall thickness measurements, resulting in a low correlation between IVUS and MR-CVW. MR-CVW has high sensitivity for the detection of coronary vessel wall thickening in the RCA compared with IVUS. However, the use of MRI for accurate absolute wall thickness measurements is not supported when a longitudinal acquisition orientation is used. (orig.)

  1. Detection of coronary plaques using MR coronary vessel wall imaging: validation of findings with intravascular ultrasound

    Compared with X-ray coronary angiography (CAG), magnetic resonance imaging of the coronary vessel wall (MR-CVW) may provide more information about plaque burden and coronary remodelling. We compared MR-CVW with intravascular ultrasound (IVUS), the standard of reference for coronary vessel wall imaging, with regard to plaque detection and wall thickness measurements. In this study 17 patients with chest pain, who had been referred for CAG, were included. Patients underwent IVUS and MR-CVW imaging of the right coronary artery (RCA). Subsequently, the coronary vessel wall was analysed for the presence and location of coronary plaques. Fifty-two matching RCA regions of interest were available for comparison. There was good agreement between IVUS and MR-CVW for qualitative assessment of presence of disease, with a sensitivity of 94% and specificity of 76%. Wall thickness measurements demonstrated a significant difference between mean wall thickness on IVUS and MR-CVW (0.48 vs 1.24 mm, P < 0.001), but great heterogeneity between wall thickness measurements, resulting in a low correlation between IVUS and MR-CVW. MR-CVW has high sensitivity for the detection of coronary vessel wall thickening in the RCA compared with IVUS. However, the use of MRI for accurate absolute wall thickness measurements is not supported when a longitudinal acquisition orientation is used. (orig.)

  2. Local hemostasis, immunothrombosis, and systemic disseminated intravascular coagulation in trauma and traumatic shock.

    Gando, Satoshi; Otomo, Yasuhiro

    2015-01-01

    Knowing the pathophysiology of trauma-induced coagulopathy is important for the management of severely injured trauma patients. The aims of this review are to provide a summary of the recent advances in our understanding of thrombosis and hemostasis following trauma and to discuss the pathogenesis of disseminated intravascular coagulation (DIC) at an early stage of trauma. Local hemostasis and thrombosis respectively act to induce physiological wound healing of injuries and innate immune responses to damaged-self following trauma. However, if overwhelmed by systemic inflammation caused by extensive tissue damage and tissue hypoperfusion, both of these processes foster systemic DIC associated with pathological fibrin(ogen)olysis. This is called DIC with the fibrinolytic phenotype, which is characterized by the activation of coagulation, consumption coagulopathy, insufficient control of coagulation, and increased fibrin(ogen)olysis. Irrespective of microvascular thrombosis, the condition shows systemic thrombin generation as well as its activation in the circulation and extensive damage to the microvasculature endothelium. DIC with the fibrinolytic phenotype gives rise to oozing-type non-surgical bleeding and greatly affects the prognosis of trauma patients. The coexistences of hypothermia, acidosis, and dilution aggravate DIC and lead to so-called trauma-induced coagulopathy. He that would know what shall be must consider what has been. The Analects of Confucius. PMID:25886801

  3. Intravascular optical imaging of high-risk plaques in vivo by targeting macrophage mannose receptors.

    Kim, Ji Bak; Park, Kyeongsoon; Ryu, Jiheun; Lee, Jae Joong; Lee, Min Woo; Cho, Han Saem; Nam, Hyeong Soo; Park, Ok Kyu; Song, Joon Woo; Kim, Tae Shik; Oh, Dong Joo; Gweon, DaeGab; Oh, Wang-Yuhl; Yoo, Hongki; Kim, Jin Won

    2016-01-01

    Macrophages mediate atheroma expansion and disruption, and denote high-risk arterial plaques. Therefore, they are substantially gaining importance as a diagnostic imaging target for the detection of rupture-prone plaques. Here, we developed an injectable near-infrared fluorescence (NIRF) probe by chemically conjugating thiolated glycol chitosan with cholesteryl chloroformate, NIRF dye (cyanine 5.5 or 7), and maleimide-polyethylene glycol-mannose as mannose receptor binding ligands to specifically target a subset of macrophages abundant in high-risk plaques. This probe showed high affinity to mannose receptors, low toxicity, and allowed the direct visualization of plaque macrophages in murine carotid atheroma. After the scale-up of the MMR-NIRF probe, the administration of the probe facilitated in vivo intravascular imaging of plaque inflammation in coronary-sized vessels of atheromatous rabbits using a custom-built dual-modal optical coherence tomography (OCT)-NIRF catheter-based imaging system. This novel imaging approach represents a potential imaging strategy enabling the identification of high-risk plaques in vivo and holds promise for future clinical implications. PMID:26948523

  4. Transcatheter Arterial Embolization for Postpartum Hemorrhage with Disseminated Intravascular Coagulation: Outcome Assessment

    We evaluated the efficacy and predictors of clinical outcome after transcatheter arterial embolization (TAE) for treatment of postpartum hemorrhage with disseminated intravascular coagulation (DIC). Of 127 patients who underwent TAE for postpartum hemorrhage, 46 progressed to DIC (group 1), 81 showed normal range hematological parameters (group 2). We retrospectively evaluated etiology, embolization methods and the efficacy of TAE for intergroup comparison Pearson Chi-Square test and logistic regression model. Overall TAE failed to control bleeding in 9 patients in spite of technical success. Lower bleeding control rate was found in group 2 (82.6%) relative to group 1 (98.8%, p = 0.001). And embolization methods were not statistically different between two groups no statistically significant predictors associated with failed hemostasis except the amount of transfusion in group 1. Although bleeding control rate is lower in postpartum hemorrhage with DIC than without DIC, we believe that TAE with correction of DIC is an effective method for postpartum hemorrhage with DIC.

  5. Fast retrieval of calcification from sequential intravascular ultrasound gray-scale images.

    Zheng, Sun; Bing-Ru, Liu

    2016-08-12

    Intravascular ultrasound (IVUS)-based tissue characterization is invaluable for the computer-aided diagnosis and interventional treatment of cardiac vessel diseases. Although the analysis of raw backscattered signals allows more accurate plaque characterization than gray-scale images, its applications are limited due to its nature of electrocardiogram-gated acquisition. Images acquired by IVUS devices that do not allow the acquisition of raw signals cannot be characterized. To address these limitations, we developed a method for fast frame-by-frame retrieval and location of calcification according to the jump features of radial gray-level variation curves from sequential IVUS gray-scale images. The proposed method consists of three main steps: (1) radial gray-level variation curves are extracted from each filtered polar view, (2) sequential images are preliminarily queried according to the maximal slopes of radial gray-level variation curves, and finally, (3) key frames that include calcification are selected through checking the gray-level features of successive pixel columns in the preliminary results. Experimental results with clinically acquired in vivo data sets indicate key frames that include calcification can be retrieved with the advantages of simplicity, high efficiency, and accuracy. Recognition results correlate well with manual characterization results obtained by experienced physicians and through virtual histology. PMID:27567774

  6. Microarterial anastomoses: A parameterised computational study examining the effect of suture position on intravascular blood flow.

    Wain, R A J; Hammond, D; McPhillips, M; Whitty, J P M; Ahmed, W

    2016-05-01

    This study investigates the extent to which individual aspects of suture placement influence local haemodynamics within microarterial anastomoses. An attempt to physically quantify flow characteristics of blood past microvascular sutures is made using computational fluid dynamics (CFD) software. Particular focus has been placed on increased shear strain rate (SSR), a known precipitant of intravascular platelet activation and thrombosis. Measurements were taken from micrographs of sutured anastomoses in chicken femoral vessels, with each assessed for bite width, suture angle and suture spacing. Computational geometries were then created to represent the anastomosis. Each suture characteristic was parameterised to allow independent or simultaneous adjustment. Flow rates were obtained from anonymised Doppler ultrasound scans of analogous vessels during preoperative assessment for autologous breast reconstruction. Vessel simulations were performed in 2.5mm ducts with blood as the working fluid. Vessel walls were non-compliant and a continuous Newtonian flow was applied, in accordance with current literature. Suture bite angle and spacing had significant effects on local haemodynamics, causing notably higher local SSRs, when simulated at extremes of surgical practice. A combined simulation, encompassing subtle changes of each suture parameter simultaneously i.e. representing optimum technique, created a more favourable SSR profile. As such, haemodynamic changes associated with optimum suture placement are unlikely to influence thrombus formation significantly. These findings support adherence to the basic principles of good microsurgical practice. PMID:26876115

  7. Vacuna idiotípica en el tratamiento del linfoma folicular: situación actual y perspectivas futuras Idiotype vaccines in the treatment of follicular lymphoma: current status and future perspectives

    N. Zabalegui

    2009-04-01

    Full Text Available El linfoma folicular (LF está considerado como el segundo tipo de linfoma no-Hodgkin más común, representando más del 20% del total de los linfomas. Es una enfermedad de progresión lenta y curso indolente en la que, a pesar de la buena respuesta al tratamiento, las recaídas son muy frecuentes y cada vez es más difícil conseguir respuestas completas. Por ello, se puede considerar que hasta el momento, el LF es incurable. La búsqueda continua de nuevas estrategias terapéuticas en enfermedades neoplásicas, junto con un mejor conocimiento del sistema inmunitario, ha llevado a la aparición de una nueva disciplina, conocida con el nombre de inmunoterapia, que aprovecha la capacidad del sistema inmunitario de atacar lo extraño sin dañar lo propio. El LF es un tumor muy apropiado para este tipo de tratamiento por presentar un antígeno específico de tumor: el idiotipo de la inmunoglobulina monoclonal expresada en la membrana de todas las células tumorales. Se han realizado diversos estudios en los que se ha probado la inmunoterapia como tratamiento complementario al tratamiento convencional. Recientemente, nuestro grupo ha publicado un estudio en el que se observa claramente que los resultados que se obtienen tras la vacunación idiotípica, cuando se consigue la inmunización adecuada del paciente, son mejores que los obtenidos con quimioterapia sola. En este sentido, es necesario seguir investigando para aclarar si la vacunación idiotípica pudiera no sólo mantener remisiones completas duraderas en los pacientes vacunados, sino incluso conseguir la curación de los mismos. Por ello, resulta interesante abordar un mejor planteamiento de los ensayos clínicos, la mejora de la producción de la vacuna y el estudio de mecanismos de la célula tumoral capaces de modificar la inmunoglobulina específica del tumor.Follicular lymphoma is the second most prevalent non-Hodgkin lymphoma, representing 20% of all lymphomas. Follicular lymphoma is

  8. Prevalencia de la infección por Helicobacter pylori en el linfoma MALT gástrico: una revisión sistemática Prevalence of Helicobacter pylori infection in gastric MALT lymphoma: a systematic review

    L. M. Asenjo

    2007-07-01

    Full Text Available Objetivo: realizar una revisión sistemática de los estudios que evalúan la prevalencia de H. pylori en los pacientes con linfoma MALT, así como analizar los factores de los que depende. Métodos: se efectuó una búsqueda bibliográfica en Pubmed seleccionando aquellos artículos en los que se estudiaba la prevalencia de H. pylori en pacientes con linfoma MALT. Resultados: se identificaron 38 estudios, incluyendo un total de 1.844 pacientes. La prevalencia media global de infección por H. pylori fue del 79%. En pacientes en los que se utilizaron 2 o más métodos para el diagnóstico de H. pylori la prevalencia fue del 85%, frente al 77% cuando se empleó un método diagnóstico (p Objective: to perform a systematic review of studies evaluating H. pylori prevalence in patients with MALT lymphoma, and to analyze predictive factors of response. Methods: a literature search in Pubmed was performed of papers studying H. pylori prevalence in patients with MALT lymphoma. Results: 38 studies were identified including 1,844 patients. The average prevalence of H. pylori infection was 79%. In patients diagnosed with H. pylori infection using 2 or more methods prevalence was 85%, whereas it was 77% when only one diagnostic method was used (p < 0.0001. H. pylori prevalence in patients diagnosed by histology was 75%, whereas it was 85% when serology was used (p < 0.0001. H. pylori prevalence in high-grade lymphomas was 60%, and 79% in low-grade lymphomas (p < 0.0001. H. pylori infection was detected in 74% of lymphomas confined to the submucosa, but only in 44% of those reaching deeper beyond the submucosa (p < 0.0001. Conclusions: H. pylori prevalence in patients with MALT lymphoma is variable, and seems to depend, at least partly, on the number and type of diagnostic methods used, histologic grade, and deep tumor invasion. If appropriate diagnostic methods are used, and if only low-grade lymphomas are considered, H. pylori prevalence is high, nearly

  9. Importância da análise da proteína Pax-5 no diagnóstico diferencial entre linfoma de Hodgkin e linfoma difuso de grandes células B em biópsias de mediastino The importance of Pax-5 protein immunostaining in the differential diagnosis between Hodgkin's lymphoma and diffuse large B-cell lymphoma in biopsies of the mediastinum

    Michelle M. Barcelos

    2009-01-01

    Full Text Available O linfoma de Hodgkin (LH e o linfoma difuso de grandes células B (LDGCB são neoplasias derivadas de células B, que apresentam marcadores imunofenotípicos em comum, e, por isso, em alguns casos onde ocorre sobreposição morfológica torna-se difícil o diagnóstico diferencial entre eles. O grau de dificuldade aumenta quando o tumor é localizado no mediastino. O fato de a biópsia de mediastino ser um procedimento ainda mais invasivo que a maioria das outras biópsias, muitas vezes faz com que sejam coletadas quantidades insuficientes de amostra, o que dificulta a análise das características morfológicas da linfoproliferação. Considerando tais dificuldades, neste trabalho investigaremos a expressão imuno-histoquímica da proteína Pax-5 no diagnóstico diferencial de LH e LDGCB. Foram analisadas amostras de 14 pacientes, sendo dez com LDGCB e quatro com LH. O estudo imuno-histoquímico com Pax-5 mostrou 100% de positividade nuclear para LDGCB. Porém, destes, 30% mostraram positividade forte (+++; 50% moderada (++; 20% fraca (+. Já nas amostras de LH, 50% obtiveram marcação focal e fraca nas células de Reed/Sternberg (CRS e 50% foram negativas. A marcação focal e fraca, ou até negativa, do Pax-5 em LH pode ser um ponto importante para o diagnóstico diferencial, uma vez que difere muito da marcação visualizada no LDGCB. Assim, é possível concluir que o anticorpo Pax-5 é um bom marcador para ser usado em conjunto com outros marcadores no painel de rotina e, quando associado à clínica, pode ser muito útil no diagnóstico diferencial entre LDGCB e LH em linfoma de mediastino.Hodgkin's Lymphoma (HL and diffuse large B-cell Lymphoma (DLBCL are neoplasias derived from B cells that present the same immunophenotypic markers, making the differential diagnosis between them very difficult particularly in cases where morphological overlapping occurs. An extra difficulty exists when the tumor is located in the mediastinum, thereby

  10. Qualidade pós-colheita de quivi 'Hayward' tratado com 1-MCP e armazenado sob diferentes atmosferas

    Marcelo José Vieira

    2012-06-01

    Full Text Available Este trabalho teve por objetivo avaliar o efeito do 1-MCP sobre o amadurecimento e a qualidade pós-colheita de quivi 'Hayward' armazenado sob diferentes atmosferas. Foram conduzidos dois experimentos, com frutos colhidos em pomar comercial localizado em Fraiburgo-SC. No experimento 1, os frutos foram tratados com três doses de 1-MCP (0,0; 0,5 ou 1,0 µL L-1 e armazenados sob atmosfera controlada (AC, contendo 2,0kPa de O2 + 4,5kPa de CO2, a 0ºC ± 0,5ºC, 92 ± 3% UR, e com <40 ηL L-1 de etileno no ambiente, durante 90 e 120 dias, mais sete dias de vida de prateleira a 23ºC. No experimento 2, os frutos foram tratados com 0,0 ou 0,7 µL L-1 de 1-MCP e armazenados sob atmosfera ambiente (AA, contendo 21 kPa de O2 + 0,03 kPa de CO2, a 0 ± 0,5ºC, 90 ± 3% UR, e com 200 a 250 ηL L-1 de etileno no ambiente, durante 30, 60, 90 e 120 dias, mais um e sete dias de vida de prateleira a 23ºC ou AC (contendo 2,0 kPa de O2 + 4,5 kPa de CO2, a 0ºC ± 0,5ºC, 92 ± 3% UR, e com <40 ηL L-1 de etileno no ambiente, durante 60, 90, 120 e 150 dias, mais um e sete dias de vida de prateleira a 23ºC. Os benefícios do tratamento com 1-MCP sobre a conservação da qualidade foram observados tanto para frutos armazenados sob AA quanto sob AC. No experimento 1, não houve diferença entre as doses de 1-MCP de 0,5 e 1,0 µL L-1 sobre o controle do amadurecimento e manutenção da qualidade dos frutos armazenados em AC. No experimento 2, o tratamento com 1-MCP retardou o aumento na taxa de produção de etileno após remoção de câmara fria. A redução da taxa de produção de etileno nos frutos tratados com 1-MCP foi associada ao aumento na conservação da firmeza da polpa sob AC e AA, e redução na incidência de pericarpo translúcido sob AA. O potencial de armazenamento foi aumentado pelo tratamento com 1-MCP em aproximadamente 60 e 30 dias, nos frutos armazenados sob AA e AC, respectivamente.

  11. A feasibility study in 3.0 T MR imaging using an improved intravascular coil

    Objective: The study was to investigate the feasibility of using an intravascular Loopless Monopole Antenna (ILMA) for 3.0 T MR imaging of water bath and deep-seated arterial walls of experimental animal. Methods: A novel intravascular loopless monopole antenna (ILMA) was developed, including a non-shield loach guide-wire and a matching circuit. The non-shield loach guide-wire is used as a receive antenna, with the diameter of 0.019 in (1 in=2.54 cm) and length of 23.11 in. During the MR scanning, the ILMA was used as a receive-only probe, while body coil was used to transmit the RF pulses. Utilizing the coil in water bath and in-vivo animal experiment, we measured signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of artery wall using the same scanning parameter compared with phased-array coil. Results: In the study, the developed novel ILMA conduced to improved SNR of imaging and much higher space resolution (313 μm). First, the feasibility of acquiring the wall images was demonstrated on phantoms. The SNRs map generated by the matlab software showed that in comparison with the phased-array coil, ILMA generated higher SNR of the phantom wall when using the same sequences, parameters, and slices (86.8 ±0.8 vs. 9.9 ±0.1, P<0.01). When imaging the aorta wall with the ILMA and phased-array coil,the SNRs of the arterial wall with the ILMA is 60.4 ±20.9, 61.3 ±22.5, 59.8 ±20.4, 32.3 ±22.6 (T1WI), 51.2 ±21.6, 49.8 ± 15.5, 50.4 ± 17.2, 22.4 ± 18.3 (T2WI), the CNRs of the aorta wall with the ILMA is 19.8±8.1, 18.9±9.2,19.6±11.8, 20.7 ± 13.3 (T1WI), 17.7±6.4, 18.6±6.9, 17.2 ± 6.4, 17.2 ± 6.4 (T2WI), compared with phased-array coil, t values SNR: 6.36, 3.84, 3.51, 6.92 (T1WI), 3.47, 4.89, 6.35, 4.21 (T2WI), CNR: 3.56, 3.97, -0.71, 4.74 (T1WI), 3.99, 3.01, 4.27, 5.03 (T2WI, P<0.05), respectively. Conclusion: The study demonstrates the capability of using an MR ILMA to generate 3.0 T MR in-vivo experiments, the developed novel ILMA conduces to

  12. Intravascular laser speckle imaging for the mechanical analysis of coronary plaques (Conference Presentation)

    Hosoda, Masaki; Wang, Jing; Tsikudi, Diane; Nadkarni, Seemantini

    2016-02-01

    Acute myocardial infarction is frequently caused by the rupture of coronary plaques with severely compromised viscoelastic properties. We have developed a new optical technology termed intravascular laser speckle imaging (ILSI) that evaluates plaque viscoelastic properties, by measuring the time scale (time constant, τ) of temporally evolving laser speckle fluctuations. To enable coronary evaluation in vivo, an optical ILSI catheter has been developed that accomplishes omni-directional illumination and viewing of the entire coronary circumference without the need for mechanical rotation. Here, we describe the capability of ILSI for evaluating human coronary atherosclerosis in cadaveric hearts. ILSI was conducted in conjunction with optical coherence tomography (OCT) imaging in five human cadaveric hearts. The left coronary artery (LCA), left anterior descending (LAD), left circumflex artery (LCx), and right coronary artery (RCA) segments were resected and secured on custom-developed coronary holders to enable accurate co-registration between ILSI, OCT, and histopathology. Speckle time constants, τ, calculated from each ILSI section were compared with lipid and collagen content measured from quantitative Histopathological analysis of the corresponding Oil Red O and Picrosirius Red stained sections. Because the presence of low viscosity lipid elicits rapid speckle fluctuations, we observed an inverse correlation between τ measured by ILSI and lipid content (R= -0.64, p< 0.05). In contrast, the higher viscoelastic modulus of fibrous regions resulted in a positive correlation between τ and collagen content (R= 0.54, p< 0.05). These results demonstrate the feasibility of conducting ILSI evaluation of arterial mechanical properties using a miniaturized omni-directional catheter.

  13. Angioplasty Guided by Intravascular Ultrasound: Meta-Analysis of Randomized Clinical Trials

    The impact of intravascular ultrasound (IVUS) use on stenting has shown inconclusive results. Systematic review and meta-analysis of the impact of IVUS on stenting regarding the clinical and angiographic evolution. A search was performed in Medline/Pubmed, CENTRAL, Embase, Lilacs, Scopus and Web of Science databases. It included randomized clinical trials (RCTs) that evaluated the implantation of stents guided by IVUS, compared with those using angiography alone (ANGIO). The minimum follow-up duration was six months and the following outcomes were assessed: thrombosis, mortality, myocardial infarction, percutaneous and surgical revascularization, major adverse cardiovascular events (MACE) and restenosis. The binary outcomes were presented considering the number of events in each group; the estimates were generated by a random effects model, considering Mantel-Haenszel statistics as weighting agent and magnitude of effect for the relative risk (RR) with its respective 95% confidence interval (95%CI). Higgins I2 test was used to quantify the consistency between the results of each study. A total of 2,689 articles were evaluated, including 8 RCTs. There was a 27% reduction in angiographic restenosis (RR: 0.73, 95% CI: 0.54-0.97, I2 = 51%) and statistically significant reduction in the rates of percutaneous revascularization and overall (RR: 0.88; 95% CI: 0.51 to 1.53, I2 = 61%, RR: 0.73, 95% CI: 0.54 to 0.99, I2 = 55%), with no statistical difference in surgical revascularization (RR: 0.95, 95% CI: 0.52-1.74, I2 = 0%) in favor of IVUS vs. ANGIO. There were no differences regarding the other outcomes in the comparison between the two strategies. Angioplasty with stenting guided by IVUS decreases the rates of restenosis and revascularization, with no impact on MACE, acute myocardial infarction, mortality or thrombosis outcomes

  14. Angioplasty Guided by Intravascular Ultrasound: Meta-Analysis of Randomized Clinical Trials

    Figueiredo, José Albuquerque Neto de, E-mail: jafneto@cardiol.br; Nogueira, Iara Antonia Lustosa [Universidade Federal do Maranhão, São Luiz, MA (Brazil); Figueiro, Mabel Fernandes; Buehler, Anna Maria; Berwanger, Otavio [Instituto de Ensino e Pesquisa do Hospital do Coração, São Paulo, SP (Brazil)

    2013-08-15

    The impact of intravascular ultrasound (IVUS) use on stenting has shown inconclusive results. Systematic review and meta-analysis of the impact of IVUS on stenting regarding the clinical and angiographic evolution. A search was performed in Medline/Pubmed, CENTRAL, Embase, Lilacs, Scopus and Web of Science databases. It included randomized clinical trials (RCTs) that evaluated the implantation of stents guided by IVUS, compared with those using angiography alone (ANGIO). The minimum follow-up duration was six months and the following outcomes were assessed: thrombosis, mortality, myocardial infarction, percutaneous and surgical revascularization, major adverse cardiovascular events (MACE) and restenosis. The binary outcomes were presented considering the number of events in each group; the estimates were generated by a random effects model, considering Mantel-Haenszel statistics as weighting agent and magnitude of effect for the relative risk (RR) with its respective 95% confidence interval (95%CI). Higgins I{sup 2} test was used to quantify the consistency between the results of each study. A total of 2,689 articles were evaluated, including 8 RCTs. There was a 27% reduction in angiographic restenosis (RR: 0.73, 95% CI: 0.54-0.97, I{sup 2} = 51%) and statistically significant reduction in the rates of percutaneous revascularization and overall (RR: 0.88; 95% CI: 0.51 to 1.53, I{sup 2} = 61%, RR: 0.73, 95% CI: 0.54 to 0.99, I{sup 2} = 55%), with no statistical difference in surgical revascularization (RR: 0.95, 95% CI: 0.52-1.74, I{sup 2} = 0%) in favor of IVUS vs. ANGIO. There were no differences regarding the other outcomes in the comparison between the two strategies. Angioplasty with stenting guided by IVUS decreases the rates of restenosis and revascularization, with no impact on MACE, acute myocardial infarction, mortality or thrombosis outcomes.

  15. Abnormal pulmonary artery stiffness in pulmonary arterial hypertension: in vivo study with intravascular ultrasound.

    Edmund M T Lau

    Full Text Available BACKGROUND: There is increasing recognition that pulmonary artery stiffness is an important determinant of right ventricular (RV afterload in pulmonary arterial hypertension (PAH. We used intravascular ultrasound (IVUS to evaluate the mechanical properties of the elastic pulmonary arteries (PA in subjects with PAH, and assessed the effects of PAH-specific therapy on indices of arterial stiffness. METHOD: Using IVUS and simultaneous right heart catheterisation, 20 pulmonary segments in 8 PAH subjects and 12 pulmonary segments in 8 controls were studied to determine their compliance, distensibility, elastic modulus and stiffness index β. PAH subjects underwent repeat IVUS examinations after 6-months of bosentan therapy. RESULTS: AT BASELINE, PAH SUBJECTS DEMONSTRATED GREATER STIFFNESS IN ALL MEASURED INDICES COMPARED TO CONTROLS: compliance (1.50±0.11×10(-2 mm(2/mmHg vs 4.49±0.43×10(-2 mm(2/mmHg, p<0.0001, distensibility (0.32±0.03%/mmHg vs 1.18±0.13%/mmHg, p<0.0001, elastic modulus (720±64 mmHg vs 198±19 mmHg, p<0.0001, and stiffness index β (15.0±1.4 vs 11.0±0.7, p = 0.046. Strong inverse exponential associations existed between mean pulmonary artery pressure and compliance (r(2 = 0.82, p<0.0001, and also between mean PAP and distensibility (r(2 = 0.79, p = 0.002. Bosentan therapy, for 6-months, was not associated with any significant changes in all indices of PA stiffness. CONCLUSION: Increased stiffness occurs in the proximal elastic PA in patients with PAH and contributes to the pathogenesis RV failure. Bosentan therapy may not be effective at improving PA stiffness.

  16. Coronary atheroma regression and plaque characteristics assessed by grayscale and radiofrequency intravascular ultrasound after aerobic exercise.

    Madssen, Erik; Moholdt, Trine; Videm, Vibeke; Wisløff, Ulrik; Hegbom, Knut; Wiseth, Rune

    2014-11-15

    The aim of the present study was to investigate effects of aerobic interval training (AIT) versus moderate continuous training (MCT) on coronary atherosclerosis in patients with significant coronary artery disease on optimal medical treatment. Thirty-six patients were randomized to AIT (intervals at ≈ 90% of peak heart rate) or MCT (continuous exercise at ≈ 70% of peak heart rate) 3 times a week for 12 weeks after intracoronary stent implantation. Grayscale and radiofrequency intravascular ultrasounds (IVUS) were performed at baseline and follow-up. The primary end point was the change in plaque burden, and the secondary end points were change in necrotic core and plaque vulnerability. Separate lesions were classified using radiofrequency IVUS criteria. We demonstrated that necrotic core was reduced in both groups in defined coronary segments (AIT -3.2%, MCT -2.7%, p <0.05) and in separate lesions (median change -2.3% and -0.15 mm(3), p <0.05). Plaque burden was reduced by 10.7% in separate lesions independent of intervention group (p = 0.06). No significant differences in IVUS parameters were found between exercise groups. A minority of separate lesions were transformed in terms of plaque vulnerability during follow-up with large individual differences between and within patients. In conclusion, changes in coronary artery plaque structure or morphology did not differ between patients who underwent AIT or MCT. The combination of regular aerobic exercise and optimal medical treatment for 12 weeks induced a moderate regression of necrotic core and plaque burden in IVUS-defined coronary lesions. PMID:25248813

  17. Classification of calcium in intravascular OCT images for the purpose of intervention planning

    Shalev, Ronny; Bezerra, Hiram G.; Ray, Soumya; Prabhu, David; Wilson, David L.

    2016-03-01

    The presence of extensive calcification is a primary concern when planning and implementing a vascular percutaneous intervention such as stenting. If the balloon does not expand, the interventionalist must blindly apply high balloon pressure, use an atherectomy device, or abort the procedure. As part of a project to determine the ability of Intravascular Optical Coherence Tomography (IVOCT) to aid intervention planning, we developed a method for automatic classification of calcium in coronary IVOCT images. We developed an approach where plaque texture is modeled by the joint probability distribution of a bank of filter responses where the filter bank was chosen to reflect the qualitative characteristics of the calcium. This distribution is represented by the frequency histogram of filter response cluster centers. The trained algorithm was evaluated on independent ex-vivo image data accurately labeled using registered 3D microscopic cryo-image data which was used as ground truth. In this study, regions for extraction of sub-images (SI's) were selected by experts to include calcium, fibrous, or lipid tissues. We manually optimized algorithm parameters such as choice of filter bank, size of the dictionary, etc. Splitting samples into training and testing data, we achieved 5-fold cross validation calcium classification with F1 score of 93.7+/-2.7% with recall of >=89% and a precision of >=97% in this scenario with admittedly selective data. The automated algorithm performed in close-to-real-time (2.6 seconds per frame) suggesting possible on-line use. This promising preliminary study indicates that computational IVOCT might automatically identify calcium in IVOCT coronary artery images.

  18. Interaction of an idealized cavopulmonary circulation with mechanical circulatory assist using an intravascular rotary blood pump.

    Bhavsar, Sonya S; Moskowitz, William B; Throckmorton, Amy L

    2010-10-01

    This study evaluated the performance of an intravascular, percutaneously-inserted, axial flow blood pump in an idealized total cavopulmonary connection (TCPC) model of a Fontan physiology. This blood pump, intended for placement in the inferior vena cava (IVC), is designed to augment pressure and blood flow from the IVC to the pulmonary circulation. Three different computational models were examined: (i) an idealized TCPC without a pump; (ii) an idealized TCPC with an impeller pump; and (iii) an idealized TCPC with an impeller and diffuser pump. Computational fluid dynamics analyses of these models were performed to assess the hydraulic performance of each model under varying physiologic conditions. Pressure-flow characteristics, fluid streamlines, energy augmentation calculations, and blood damage analyses were evaluated. Numerical predictions indicate that the pump with an impeller and diffuser blade set produces pressure generations of 1 to 16 mm Hg for rotational speeds of 2000 to 6000 rpm and flow rates of 1 to 4 L/min. In contrast, for the same flow range, the model with the impeller only in the IVC demonstrated pressure generations of 1 to 9 mm Hg at rotational speeds of 10,000 to 12,000 rpm. Influence of blood viscosity was found to be insignificant at low rotational speeds with minimal performance deviation at higher rotational speeds. Results from the blood damage index analyses indicate a low probability for damage with maximum damage index levels less than 1% and maximum fluid residence times below 0.6 s. The numerical predictions further indicated successful energy augmentation of the TCPC with a pump in the IVC. These results support the continued design and development of this cavopulmonary assist device. PMID:20964699

  19. Assessing intravascular volume by difference in pulse pressure in pigs submitted to graded hemorrhage.

    Pestel, Gunther J; Hiltebrand, Luzius B; Fukui, Kimiko; Cohen, Delphine; Hager, Helmut; Kurz, Andrea M

    2006-10-01

    We assessed changes in intravascular volume monitored by difference in pulse pressure (dPP%) after stepwise hemorrhage in an experimental pig model. Six pigs (23-25 kg) were anesthetized (isoflurane 1.5 vol%) and mechanically ventilated to keep end-tidal CO2 (etCO2) at 35 mmHg. A PA-catheter and an arterial catheter were placed via femoral access. During and after surgery, animals received lactated Ringer's solution as long as they were considered volume responders (dPP>13%). Then animals were allowed to stabilize from the induction of anesthesia and insertion of catheters for 30 min. After stabilization, baseline measurements were taken. Five percent of blood volume was withdrawn, followed by another 5%, and then in 10%-increments until death from exsanguination occurred. After withdrawal of 5% of blood volume, all pigs were considered volume responders (dPP>13%); dPP rose significantly from 6.1+/-3.3% to 19.4+/-4.2%. The regression analysis of stepwise hemorrhage revealed a linear relation between blood loss (hemorrhage in %) and dPP (y=0.99*x+14; R2=0.7764; P<.0001). In addition, dPP was the only parameter that changed significantly between baseline and a blood loss of 5% (P<0.01), whereas cardiac output, stroke volume, heart rate, MAP, central venous pressure, pulmonary artery occlusion pressure, and systemic vascular resistance, respectively, remained unchanged. We conclude that in an experimental hypovolemic pig model, dPP correlates well with blood loss. PMID:16980887

  20. Use of water-equivalent plastic scintillator for intravascular brachytherapy dosimetry.

    Geso, M; Robinson, N; Schumer, W; Williams, K

    2004-03-01

    Beta irradiation has recently been investigated as a possible technique for the prevention of restenosis in intravascular brachytherapy after balloon dilatation or stent implantation. Present methods of beta radiation dosimetry are primarily conducted using radiochromic film. These film dosimeters exhibit limited sensitivity and their characteristics differ from those of tissue, therefore the dose measurement readings require correction factors to be applied. In this work a novel, mini-size (2 mm diameter by 5 mm long) dosimeter element fabricated from Organic Plastic Scintillator (OPS) material was employed. Scintillation photon detection is accomplished using a precision photodiode and innovative signal amplification and processing techniques, rather than traditional photomultiplier tube methods. A significant improvement in signal to noise ratio, dynamic range and stability is achieved using this set-up. In addition, use of the non-saturating organic plastic scintillator material as the detector enables the dosimeter to measure beta radiation at very close distances to the source. In this work the plastic scintillators have been used to measure beta radiation dose at distances of less than 1 mm from an Sr-90 cardiovascular brachytherapy source having an activity of about 2.1 GBq beta radiation levels for both depth-distance and longitudinal profile of the source pellet chain, both in air and in liquid water, are measured using this system. The data obtained is compared with results from Monte Carlo simulation technique (MCNP 4B). Plastic scintillator dosimeter elements, when used in conjunction with photodiode detectors may prove to be useful dosimeters for cardiovascular brachytherapy beta sources, or other applications where precise near-source field dosimetry is required. The system described is particularly useful where measurement of actual dose rate in real time, a high level of stability and repeatability, portability, and immediate access to results are

  1. Protocatechuic aldehyde inhibits migration and proliferation of vascular smooth muscle cells and intravascular thrombosis

    Highlights: ► Protocatechuic aldehyde (PCA) inhibits ROS production in VSMCs. ► PCA inhibits proliferation and migration in PDGF-induced VSMCs. ► PCA has anti-platelet effects in ex vivo rat whole blood. ► We report the potential therapeutic role of PCA in atherosclerosis. -- Abstract: The migration and proliferation of vascular smooth muscle cells (VSMCs) and formation of intravascular thrombosis play crucial roles in the development of atherosclerotic lesions. This study examined the effects of protocatechuic aldehyde (PCA), a compound isolated from the aqueous extract of the root of Salvia miltiorrhiza, an herb used in traditional Chinese medicine to treat a variety of vascular diseases, on the migration and proliferation of VSMCs and platelets due to platelet-derived growth factor (PDGF). DNA 5-bromo-2′-deoxy-uridine (BrdU) incorporation and wound-healing assays indicated that PCA significantly attenuated PDGF-induced proliferation and migration of VSMCs at a pharmacologically relevant concentration (100 μM). On a molecular level, we observed down-regulation of the phosphatidylinositol 3-kinase (PI3K)/Akt and the mitogen-activated protein kinase (MAPK) pathways, both of which regulate key enzymes associated with migration and proliferation. We also found that PCA induced S-phase arrest of the VSMC cell cycle and suppressed cyclin D2 expression. In addition, PCA inhibited PDGF-BB-stimulated reactive oxygen species production in VSMCs, indicating that PCA’s antioxidant properties may contribute to its suppression of PDGF-induced migration and proliferation in VSMCs. Finally, PCA exhibited an anti-thrombotic effect related to its inhibition of platelet aggregation, confirmed with an aggregometer. Together, these findings suggest a potential therapeutic role of PCA in the treatment of atherosclerosis and angioplasty-induced vascular restenosis.

  2. Protocatechuic aldehyde inhibits migration and proliferation of vascular smooth muscle cells and intravascular thrombosis

    Moon, Chang Yoon [The Hotchkiss School, Lakeville, CT (United States); Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Ku, Cheol Ryong [Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Cho, Yoon Hee, E-mail: wooriminji@gmail.com [Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Eun Jig, E-mail: ejlee423@yuhs.ac [Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Endocrinology, Northwestern University Feinberg School of Medicine, Chicago, IL (United States)

    2012-06-22

    Highlights: Black-Right-Pointing-Pointer Protocatechuic aldehyde (PCA) inhibits ROS production in VSMCs. Black-Right-Pointing-Pointer PCA inhibits proliferation and migration in PDGF-induced VSMCs. Black-Right-Pointing-Pointer PCA has anti-platelet effects in ex vivo rat whole blood. Black-Right-Pointing-Pointer We report the potential therapeutic role of PCA in atherosclerosis. -- Abstract: The migration and proliferation of vascular smooth muscle cells (VSMCs) and formation of intravascular thrombosis play crucial roles in the development of atherosclerotic lesions. This study examined the effects of protocatechuic aldehyde (PCA), a compound isolated from the aqueous extract of the root of Salvia miltiorrhiza, an herb used in traditional Chinese medicine to treat a variety of vascular diseases, on the migration and proliferation of VSMCs and platelets due to platelet-derived growth factor (PDGF). DNA 5-bromo-2 Prime -deoxy-uridine (BrdU) incorporation and wound-healing assays indicated that PCA significantly attenuated PDGF-induced proliferation and migration of VSMCs at a pharmacologically relevant concentration (100 {mu}M). On a molecular level, we observed down-regulation of the phosphatidylinositol 3-kinase (PI3K)/Akt and the mitogen-activated protein kinase (MAPK) pathways, both of which regulate key enzymes associated with migration and proliferation. We also found that PCA induced S-phase arrest of the VSMC cell cycle and suppressed cyclin D2 expression. In addition, PCA inhibited PDGF-BB-stimulated reactive oxygen species production in VSMCs, indicating that PCA's antioxidant properties may contribute to its suppression of PDGF-induced migration and proliferation in VSMCs. Finally, PCA exhibited an anti-thrombotic effect related to its inhibition of platelet aggregation, confirmed with an aggregometer. Together, these findings suggest a potential therapeutic role of PCA in the treatment of atherosclerosis and angioplasty-induced vascular restenosis.

  3. Human neutrophil Fc receptor-mediated adhesion under flow: a hollow fibre model of intravascular arrest.

    D'Arrigo, C; Candal-Couto, J J; Greer, M; Veale, D J; Woof, J M

    1995-04-01

    Human polymorphonuclear cells (PMN) were found to adhere to a novel model of blood vessel wall-associated IgG. The internal surfaces of cellulose acetate hollow fibres, of comparable internal diameter to small blood vessels, were coated with normal serum human IgG, heat-aggregated IgG (HAIgG), laminin or fibrinogen. Under conditions of flow mimicking those in a small vessel, PMN were found to adhere markedly only to immunoglobulin-coated fibres. Arrest on HAIgG was inhibited by excess soluble IgG but not by bovine serum albumin (BSA), demonstrating that the adhesion was IgG-specific and presumably mediated by Fc gamma R on the PMN surface. Pre-adsorption of serum components onto HAIgG-coated fibres enhanced PMN arrest, due most probably to fixation of complement components by immobilized HAIgG, resulting in additional potential to entrap PMN via complement receptors such as CR3. Treatment of PMN with the regulatory neuropeptide substance P also enhanced adhesion to HAIgG-coated fibres and caused increased surface expression of Fc gamma RI, Fc gamma RII and Fc gamma RIII. A mouse cell line derived from L cells, hR4C6, stably transfected with human Fc gamma RII, was found to adhere under flow to HAIgG-coated fibres, whilst untransfected parent L cells did not. This adhesion was similarly inhibited by excess soluble IgG, confirming the capability of Fc gamma R to mediate cell arrest. The study strongly suggests that Fc gamma R may play an important role in intravascular PMN arrest and we speculate that in inflammatory diseases PMN may adhere via Fc gamma R to immobilized immunoglobulin on the vascular endothelium, with subsequent degranulation and tissue damage. PMID:7535210

  4. Lumen Segmentation in Intravascular Optical Coherence Tomography Using Backscattering Tracked and Initialized Random Walks.

    Guha Roy, Abhijit; Conjeti, Sailesh; Carlier, Stéphane G; Dutta, Pranab K; Kastrati, Adnan; Laine, Andrew F; Navab, Nassir; Katouzian, Amin; Sheet, Debdoot

    2016-03-01

    Intravascular imaging using ultrasound or optical coherence tomography (OCT) is predominantly used to adjunct clinical information in interventional cardiology. OCT provides high-resolution images for detailed investigation of atherosclerosis-induced thickening of the lumen wall resulting in arterial blockage and triggering acute coronary events. However, the stochastic uncertainty of speckles limits effective visual investigation over large volume of pullback data, and clinicians are challenged by their inability to investigate subtle variations in the lumen topology associated with plaque vulnerability and onset of necrosis. This paper presents a lumen segmentation method using OCT imaging physics-based graph representation of signals and random walks image segmentation approaches. The edge weights in the graph are assigned incorporating OCT signal attenuation physics models. Optical backscattering maxima is tracked along each A-scan of OCT and is subsequently refined using global graylevel statistics and used for initializing seeds for the random walks image segmentation. Accuracy of lumen versus tunica segmentation has been measured on 15 in vitro and 6 in vivo pullbacks, each with 150-200 frames using 1) Cohen's kappa coefficient (0.9786 ±0.0061) measured with respect to cardiologist's annotation and 2) divergence of histogram of the segments computed with Kullback-Leibler (5.17 ±2.39) and Bhattacharya measures (0.56 ±0.28). High segmentation accuracy and consistency substantiates the characteristics of this method to reliably segment lumen across pullbacks in the presence of vulnerability cues and necrotic pool and has a deterministic finite time-complexity. This paper in general also illustrates the development of methods and framework for tissue classification and segmentation incorporating cues of tissue-energy interaction physics in imaging. PMID:25700476

  5. Exogenous normal lymph alleviates microcirculation disturbances and abnormal hemorheological properties in rats with disseminated intravascular coagulation

    Niu, Chun-Yu; Zhao, Zi-Gang; Zhang, Yu-Ping [Institute of Microcirculation, Hebei North University, Zhangjiakou (China); Hou, Ya-Li [Department of Clinical Laboratory, First Affiliated Hospital, Hebei North University, Zhangjiakou (China); Li, Jun-Jie; Jiang, Hua; Zhang, Jing [Institute of Microcirculation, Hebei North University, Zhangjiakou (China)

    2013-02-01

    Disturbances of the microcirculation and abnormal hemorheological properties are important factors that play an important role in disseminated intravascular coagulation (DIC) and result in organ dysfunction or failure. In the present study, we established an animal model of DIC using intravenous Dextran 500 in rats, and used exogenous normal lymph corresponding to 1/15 of whole blood volume for injection through the left jugular vein. We found that normal lymph could improve the blood pressure and survival time of rats with DIC. The results regarding the mesenteric microcirculation showed that the abnormality of the diameter of mesenteric microvessels and micro-blood flow speed in the DIC+lymph group was significantly less than in the DIC+saline group. Whole blood viscosity, relative viscosity, plasma viscosity, hematocrit (Hct), erythrocyte sedimentation rate (ESR), and electrophoresis time of erythrocytes were significantly increased in the DIC+saline group compared to the control group. The electrophoretic length and migration of erythrocytes from the DIC+saline and DIC+lymph groups were significantly slower than the control group. Blood relative viscosity, Hct, ESR, and electrophoretic time of erythrocytes were significantly increased in the DIC+lymph group compared to the control group. Whole blood viscosity, relative viscosity and reduced viscosity were significantly lower in the DIC+lymph group than in the DIC+saline group, and erythrocyte deformability index was also significantly higher than in the DIC+saline and control groups. These results suggest that exogenous normal lymph could markedly improve the acute microcirculation disturbance and the abnormal hemorheological properties in rats with DIC induced by Dextran 500.

  6. Perfil eletrocardiográfico e conteúdo glicogênico muscular de ratos tratados com nandrolona

    Carlos Alberto da Silva

    2010-12-01

    Full Text Available FUNDAMENTO: Considerou-se o uso indiscriminado de esteroides tanto por atletas de elite quanto por praticantes de atividades físicas. OBJETIVO: Avaliar os efeitos do decanoato de nandrolona sobre o perfil eletrocardiográfico, conteúdo glicogênico e de proteínas totais dos músculos cardíacos e esqueléticos, bem como as concentrações plasmática de albumina. MÉTODOS: Os animais do grupo tratado receberam a droga na concentração 5 mg/kg pela via subcutânea, duas vezes por semana, durante três semanas. Uma vez por semana, os ratos foram anestesiados com Pentobarbital sódico (50 mg/kg, ip e submetidos à avaliação por meio do eletrocardiograma (ECG. Após o período experimental, amostras dos músculos cardíaco (ventrículo esquerdo - VE, sóleo (S, gastrocnêmio branco (GB, gastrocnêmio vermelho (GV, peitoral (P, intercostal (IC e diafragma (D foram prontamente coletadas e analisadas. Os dados (média ± epm foram avaliados de acordo com ANOVA, segundo teste de Tukey (p>0,05. RESULTADOS: Os ratos do grupo tratado apresentaram alterações nos seguintes parâmetros cardíacos: intervalo QRS, intervalo QTc e frequência cardíaca, caracterizados por um aumento desses, tendo o ápice no intervalo da semana de pré-tratamento para a primeira semana. As reservas de glicogênio no VE apresentaram aumento de 127%. Em relação à quantidade de proteínas totais, a diferença significativa foi constatada no S, GV e D. Quanto ao perfil bioquímico e ao hematócrito, foi observado um aumento na porcentagem de eritrócitos. CONCLUSÃO: O estudo mostra que importantes alterações cardíacas são deflagradas precocemente, sugerindo uma hierarquia na sequência de modificações que comprometem a homeostasia do organismo.

  7. Avaliação de parâmetros antioxidantes em ratos tratados com sevoflurano Evaluación de parámetros antioxidantes en ratones tratados con sevoflurano Evaluation of antioxidant parameters in eats treated with sevoflurane

    Francisco J. L Bezerra

    2010-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O sevoflurano é um éter halogenado com flúor que sofre biotransformação hepática através do citocromo P450 2E1. Éteres halogenados que sofrem biotransformação pelo P450 2E1 podem produzir espécies reativas do oxigênio (ERO e promover enfraquecimento do sistema de defesa antioxidante. O objetivo deste trabalho foi investigar a relação entre a atividade das enzimas antioxidantes eritrocitárias e o sevoflurano. MÉTODO: Os animais foram distribuídos em quatro grupos: Grupo 1 controle: apenas oxigênio a 100% (1 L.min-1 por 60 minutos durante 5 dias consecutivos; Grupo 2 - sevoflurane 4,0% em oxigênio a 100% (1 L.min-1 por 60 minutos durante 5 dias consecutivos; Grupo 3 - isoniazida (i.p., 50 mg.kg-1 de peso corporal /dia, durante 4 dias e em seguida tratados apenas com oxigênio a 100% (1 L.min-1 por 60 minutos durante 5 dias consecutivos; Grupo 4 - isoniazida por via intraperitoneal na dose de 50 mg.kg-1 de peso corporal, diariamente durante 4 dias, seguido da administração do sevoflurane a 4,0% em oxigênio a 100% (1 L.min-1 por 60 minutos durante 5 dias. Após 12 horas da última exposição ao sevoflurane, os animais foram sacrificados e o sangue foi coletado através da veia porta para análise da atividade das enzimas antioxidantes. RESULTADOS: Aumento da atividade específica da glicose-6-fosfato desidrogenase, diminuição da atividade específica da catalase, principalmente no grupo de animais pré-tratados com isoniazida e, em seguida, tratados com sevoflurano. A glutationa peroxidase não apresentou alteração na sua atividade. CONCLUSÕES: A interação do sevoflurano com indutores enzimáticos do citocromo P450 2E1 pode propiciar a instalação do estresse oxidativo caso a exposição se torne prolongada e repetitiva.JUSTIFICATIVA Y OBJETIVOS: El sevoflurano es un éter halogenado con flúor que sufre una biotransformación hepática a través del citocromo P450 2E1. Los

  8. Design, construction, and validation of a multimodal intravascular diagnostic catheter combining IVUS and fluorescence lifetime spectroscopy detection channels

    Bec, Julien; Xie, Hongtao; Yankelevich, Diego; Zhou, Feifei; Sun, Yang; Ghata, Narugopal; Aldredge, Ralph; Marcu, Laura

    2011-03-01

    We report the development and validation of an intravascular rotary catheter that enables bi-modal interrogation of arterial pathologies based on fast-frame time-resolved fluorescence spectroscopy (TRFS) and intravascular ultrasound (IVUS). The catheter is based on a parallel design that allows for independent rotation of the ultrasonic and optical channels within an 8 Fr outer diameter catheter sheath and integrates a low volume flushing channel for blood removal in the optical pathways. In current configuration, the two channels consist of a) a standard 8 Fr IVUS catheter with single element transducer (15 MHz) and b) a side-viewing UV-grade silica/silica fiber optic (400 μm core). The catheter is terminated by a small (0.82 mm internal diameter) polyimide tube to keep the fiber stable within the sheath. To clear the field of view from blood, a saline solution can be flushed in a sheath channel, concentric with the fiber optic, through the tube and in a radial opening aligned with the fiber's optical beam. The flushing function was optimized with a computational fluid dynamics (CFD) model pursued in a parallel study. The ability of the catheter to operate in intraluminal setting in blood flow, the effect of probe-to-tissue distance on optical signal and ability to generate co-registered TRFS and IVUS data were demonstrated in blood vessel phantoms. Current results demonstrate the feasibility of the described catheter for parallel interrogation of vessel walls based on TRFS and IVUS and to generate robust TRFS data. These results facilitate further development of a bi-modal TRFS-IVUS technique for intravascular diagnosis of atherosclerotic cardiovascular diseases including vulnerable plaques.

  9. Adult T-cell leukemia-lymphoma in a patient with HTLV-I/II associated myelopathy Leucemia - linfoma de células T do adulto em um paciente com mielopatia associada a HTLV-I/II

    Virgínia Freitas

    1997-06-01

    Full Text Available Chronic myelopathy associated with T-lymphotropic virus type I (HAM has been described as an endemic disease in several areas of the world, meanwhile there are few papers describing the association between HAM and adult T cell leukemia-lymphoma. We report the case of a man that, after four years of progressive spastic paraparesis and neurogenic bladder, developed a clinical picture of a lymphoproliferative disorder characterized by dermal and systemic envolvement, mimicking mycosis fungoides/Sézary syndrome.Apesar da infecção pelo HTLV-I ser endêmica em várias regiões do mundo, poucos são os relatos da associação entre leucemia-linfoma de células T do adulto (ATLL e encefalomieloneuropatia pelo HTLV-I. No presente artigo é descrito um paciente que no curso do comprometimento neurológico pelo HTLV-I desenvolveu quadro de leucemia com infiltração de tecido dérmico semelhante ao encontrado na micose fungóide/síndrome de Sézary.

  10. Linfoma no Hodgkin oral relacionado al sida (LNHORS: Actualización y presentación de un caso clínico Aids related oral no Hodgkin lymphoma (ARONHL: Up today and report of a case

    Z. Casariego

    2006-12-01

    Full Text Available Introducción: Los linfomas No-Hodgkin presentan características propias cuando se asocian a la infección por el Virus de la Inmunodeficiencia Humana. La cavidad bucal es una de las localizaciones a tener en cuenta en pacientes con Sida (LNHORS Si bien se registran casos en los primeros estadios de la infección, el diagnóstico previo diferencial estomatológico y su seguimiento no se realizan en nuestro medio con la frecuencia que esta enfermedad requiere. En los pacientes VIH positivos, las características generales están relacionadas con la edad de los pacientes, el estado de base inmunológico de la infección, la adherencia a los tratamientos, una historia de más de 35 años de drogadicción intravenosa y el tipo de linfoma. El presente trabajo tiene dos objetivos: 1 Presentar una actualización del tema ya que en los últimos años se han investigado los diferentes tipos y subtipos histológicos, su estratificación y tratamientos en forma intensa y 2 presentar un caso clínico de Linfoma no Hodgkin con localización en la cavidad bucal de evolución no frecuente. Desarrollo: Una paciente de 34 años de edad con una masa tumoral en el hueso maxilar mucosa gingival y paladar duro y blando. La lesión estaba ulcerada en la primera consulta y hacía protrusión a través de la cavidad bucal. Resultados: se realizaron estudios sistémicos, biopsias de las lesiones orales,. estudio histológico y marcación inmunohistoquímica,, búsqueda por diagnóstico por imágenes de otras manifestaciones y localizaciones de linfomas. Fueron establecidos tratamientos, seguimiento y evolución. Conclusiones: Un diagnóstico eficiente y temprano de los pacientes con LNHORS por un equipo de salud, puede incrementar las sobrevidas, en un marco, donde pueda ser posible la reconstitución de la función inmunológica y puedan ser aplicados los nuevos regímenes de infusión contínua con quimioterápicos.Introduction: Non-Hodgkin Lymphoma presents their

  11. Determination of regional flow by use of intravascular PET tracers: microvascular theory and experimental validation for pig livers

    Munk, O L; Bass, L; Feng, H;

    2003-01-01

    with the standard model in a pig liver study. METHODS: Eight pigs underwent a 5-min dynamic PET study after (15)O-carbon monoxide inhalation. Throughout each experiment, hepatic arterial blood and portal venous blood were sampled, and flow was measured with transit-time flow meters. The hepatic dual...... activity after an intravascular tracer bolus injection. The microvascular models include only parameters with a clear-cut physiologic interpretation and are applicable to capillary beds in any organ. In this study, the microvascular models were validated for the liver and provided quantitative regional...

  12. Developing cross-correlation as a method for microvessel imaging using clinical intravascular optical coherence tomography systems

    Joseph, Shiju; Adnan, Asif; Subhash, Hrebesh M.; Leahy, Martin; Adlam, David

    2015-01-01

    Current clinical intravascular optical coherence tomography (IV-OCT) imaging systems have limited in-vivo flow imaging capability because of non-uniform catheter rotation and inadequate A-line scan density. Thus any flow-localisation method that seeks to identify sites of variation within the OCT image data-sets, whether that is in amplitude or phase, produces non-representative correlation (or variance) maps. In this study, both mean and the variation within a set of cross-correlation maps, ...

  13. Relation between Anemia and Vulnerable Coronary Plaque Components in Patients with Acute Coronary Syndrome: Virtual Histology-Intravascular Ultrasound Analysis

    Hong, Young Joon; Jeong, Myung Ho; Choi, Yun Ha; Song, Jin A; Kim, Dong Han; Lee, Ki Hong; Yamanaka, Futoshi; Lee, Min Goo; Park, Keun Ho; Sim, Doo Sun; Yoon, Nam Sik; Yoon, Hyun Ju; Kim, Kye Hun; Park, Hyung Wook; Kim, Ju Han

    2012-01-01

    The aim of the present study was to evaluate the plaque components and the predictors of thin-cap fibroatheroma (TCFA) in anemic patients with acute coronary syndrome using virtual histology-intravascular ultrasound (VH-IVUS). Anemia was defined according to criteria of the World Health Organization, (i.e. , hemoglobin levels < 13 g/dL in men and < 12 g/dL in women) and we compared VH-IVUS findings between anemia group (171 patients, 260 lesions) and non-anemia group (569 patients, 881 lesion...

  14. Subacute fat-embolism-like syndrome following high-volume intramuscular and accidental intravascular injection of mineral oil

    Hjort, Mathias; Hoegberg, Lotte Christine Groth; Jansen, Tejs;

    2015-01-01

    infiltrations. Suspecting pneumonia, the patient was discharged with antibiotics. Unkown to the clinicians, the patient had self-administered a mineral oil with added anabolic steroids by intramuscular injections for cosmetic purposes. The patient had observed blood on aspiration, and then relocated the needle......Objective. We present a rare case of subacute fat-embolism-like syndrome (FES-like) following intravascular injection of mineral oil-steroid solution with delayed diagnosis, acute onset of pulmonary distress, and transient clinical deterioration. Case report. A 40-year-old man was admitted...

  15. Los impactos del Tratado de Libre Comercio de América del Norte en la producción de frijol de Zacatecas

    Elivier Reyes Rivas

    2007-01-01

    Full Text Available La apertura comercial total, prevista en el Tratado de Libre Comercio de América del Norte (TLCAN para 2008, puede afectar la agricultura y el empleo rural de Zacatecas, particularmente la producción de frijol, donde la entidad ocupa el primer lugar como productor nacional. Dicha leguminosa ocupa 57 por ciento del área sembrada en el estado y emplea a cerca de 70 mil personas. Al revisar los términos comerciales pactados, datos estadísticos y fuentes primarias, se concluye que la competitividad que genere la apertura comercial puede precipitar el abandono de los cultivos y el deterioro de las condiciones de vida de miles de agricultores. El gobierno mexicano debería reevaluar los términos del tratado para impulsar la producción agrícola y establecer políticas públicas nuevas generadoras de empleo.

  16. El Tratado de hechicerías y sortilegios (1553) que "avisa y no emponzoña" de fray Andrés de Olmos

    Ríos Castaño, Victoria

    2014-01-01

    En 1553 el franciscano e inquisidor fray Andrés de Olmos concluye el Tratado de hechicerías y sortilegios, una traducción al náhuatl del manual demonológico Tratado de las supersticiones y hechicerías, del también inquisidor fray Martín de Castañega, publicado en 1529. Los estudios que se han realizado al respecto se centran en el motivo por el cual Olmos elige esta obra y examinan brevemente las características de la traducción en comparación con el original. Este artículo pretende seguir co...

  17. La moneda castellana en los manuales de mercaderías y tratados de aritmética italianos bajomedievales (siglos XIII-XV)

    González Arévalo, Raúl

    2007-01-01

    El presente artículo analiza el conocimiento sobre la moneda y el sistema monetario vigentes en Castilla en la Baja Edad Media en los manuales de mercadería y los tratados de aritmética italianos de los siglos XIII al XV. The present paper analyzes the knowledge of money and money system in Castile in the Late Middle Ages in the Italian pratiche di mercatura and treaties of Arithmetics from the XIIIth to XVth Centuries.

  18. Evaluation of leukocyte count in dogs with lymphoma submitted to the Madison-Wisconsin protocol by conventional technique and flow cytometryAvaliação leucocitária de cães com linfoma submetidos ao protocolo de Madison-Wisconsin pela técnica convencional e citometria de fluxo

    Letícia Abrahão Anai

    2013-09-01

    Full Text Available Lymphoma is the most common hematopoietic tumor in dogs and one of the malignant tumors with higher occurrence in this species. It is a great experimental model due to its resemblance with the non- Hodgkin lymphoma in humans. Considering the importance of the overall changes that result from to this kind of neoplastic tumor and those due to polichemotherapy this study aimed to evaluate the absolute leukon count and the total count of CD45+ cells in the blood of 25 dogs with lymphoma. Findings were crosschecked since diagnose and then once weekly during the first eight sessions of the Madison-Wisconsin chemotherapic protocol. Total granulocyte, lymphocyte and monocyte counts obtained from a conventional automatic counter and by flow cytometry were compared. Results did not reveal statistically significant changes between the two techniques. O linfoma é o tumor de tecido hematopoético mais comum nos cães e um dos tumores malignos de maior ocorrência nesta espécie. É um ótimo modelo experimental para estudo devido a sua semelhança com o linfoma não-Hodgkin em humanos. Considerando a importância das alterações decorrentes da evolução desta neoplasia e aquelas ocorridas com o emprego da poliquimioterapia, avaliou-se o leucograma absoluto e a contagem de células CD45+ pela citometria de fluxo, no sangue de 25 cães com linfoma. Foram avaliados no momento do diagnóstico, uma vez por semana, durante as primeiras oito sessões quimioterápicas do protocolo de Madison-Wisconsin, e cujas contagens obtidas em contador automático convencional e por intermédio da citometria de fluxo, foram comparadas. Os resultados obtidos não revelaram diferenças estatisticamente significativas entre as duas técnicas utilizadas.

  19. Imaging findings of intravascular papillary endothelial hyperplasia presenting in extremities: correlation with pathological findings

    Lee, Sun Joo; Choo, Hye Jung; Park, Ji Sung; Park, Yeong-Mi; Eun, Choong Ki [Pusan Paik Hospital, Department of Radiology, College of Medicine, Inje University, Pusan (Korea); Hong, Sung Hwan [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Hwang, Ji Young [Ewha Womans University, Department of Radiology, School of Medicine, Seoul (Korea); Lee, In Sook [Pusan National University Hospital, Department of Radiology, Pusan National University School of Medicine, Pusan (Korea); Lee, Jongmin [Kyungpook National University, Department of Radiology, School of Medicine, Daegu (Korea); Jung, Soo-Jin [Pusan Paik Hospital, Department of Pathology, College of Medicine, Inje University, Pusan (Korea)

    2010-08-15

    To describe magnetic resonance imaging (MRI) and ultrasound (US) findings of intravascular papillary endothelial hyperplasia (IPEH) arising in extremities. Six patients with IPEH confirmed by surgical resection were reviewed retrospectively. Before resection, 3 patients underwent both MRI and US and 3 patients underwent only MRI. Two radiologists retrospectively reviewed MR/US imaging results and correlated them with pathological features. The 6 IPEHs were diagnosed as 4 mixed forms and 2 pure forms. The pre-existing pathology of four mixed forms was intramuscular or intermuscular hemangioma. By MRI, the mixed form of IPEH (n = 4) revealed iso- to slightly high signal intensity containing nodule-like foci of high signal intensity on T1-weighted images (T1WI) and high signal intensity-containing nodule-like foci of low signal intensity on T2-weighted images (T2WI). The pure form of IPEH (n = 2) showed homogeneous iso- signal intensity on T1WI and high and low signal intensity containing nodule-like foci of low signal intensity on T2WI. On gadolinium-enhanced fat-suppressed T1WI, 50% of cases (n = 3: mixed forms) revealed peripheral, septal, and central enhancement. The other IPEHs (n = 3: 1 mixed and 2 pure forms) showed peripheral and septal enhancement or only peripheral enhancement. By US, two mixed forms of IPEH showed well-defined hypoechoic masses containing hyperechoic septa and central portion with vascularities. One pure form of IPEH was a homogeneous hypoechoic mass with septal and peripheral vascularities on color Doppler imaging. The foci of high signal intensity on T1WI, foci of low signal intensity on T2WI, and non-enhancing portions on MRI and the hypoechoic portion on US were histopathologically correlated with thrombi and the peripheral/septal or central enhancing areas on MRI, hyperechoic septa and the central portion on US, and septal/central or peripheral vascularities on color Doppler imaging corresponded to hypertrophic papillary epithelium and

  20. Imaging findings of intravascular papillary endothelial hyperplasia presenting in extremities: correlation with pathological findings

    To describe magnetic resonance imaging (MRI) and ultrasound (US) findings of intravascular papillary endothelial hyperplasia (IPEH) arising in extremities. Six patients with IPEH confirmed by surgical resection were reviewed retrospectively. Before resection, 3 patients underwent both MRI and US and 3 patients underwent only MRI. Two radiologists retrospectively reviewed MR/US imaging results and correlated them with pathological features. The 6 IPEHs were diagnosed as 4 mixed forms and 2 pure forms. The pre-existing pathology of four mixed forms was intramuscular or intermuscular hemangioma. By MRI, the mixed form of IPEH (n = 4) revealed iso- to slightly high signal intensity containing nodule-like foci of high signal intensity on T1-weighted images (T1WI) and high signal intensity-containing nodule-like foci of low signal intensity on T2-weighted images (T2WI). The pure form of IPEH (n = 2) showed homogeneous iso- signal intensity on T1WI and high and low signal intensity containing nodule-like foci of low signal intensity on T2WI. On gadolinium-enhanced fat-suppressed T1WI, 50% of cases (n = 3: mixed forms) revealed peripheral, septal, and central enhancement. The other IPEHs (n = 3: 1 mixed and 2 pure forms) showed peripheral and septal enhancement or only peripheral enhancement. By US, two mixed forms of IPEH showed well-defined hypoechoic masses containing hyperechoic septa and central portion with vascularities. One pure form of IPEH was a homogeneous hypoechoic mass with septal and peripheral vascularities on color Doppler imaging. The foci of high signal intensity on T1WI, foci of low signal intensity on T2WI, and non-enhancing portions on MRI and the hypoechoic portion on US were histopathologically correlated with thrombi and the peripheral/septal or central enhancing areas on MRI, hyperechoic septa and the central portion on US, and septal/central or peripheral vascularities on color Doppler imaging corresponded to hypertrophic papillary epithelium and

  1. Reproducibility of volumetric intravascular ultrasound radiofrequency-based analysis of coronary plaque composition in vivo.

    Hartmann, Marc; Mattern, Eline S K; Huisman, Jennifer; van Houwelingen, Gert K; de Man, Frits H A F; Stoel, Martin G; Danse, Peter W; Louwerenburg, Hans W; von Birgelen, Clemens

    2009-01-01

    Intravascular ultrasound radiofrequency (RF-IVUS) data permit the analysis of coronary plaque composition in vivo and is used as an endpoint of ongoing pharmacological intervention trials. We assessed the reproducibility of volumetric RF-IVUS analyses in mild-to-moderately diseased atherosclerotic human coronary arteries in vivo. A total of 9,212 IVUS analyses on cross-sectional IVUS frames was performed to evaluate the reproducibility of volumetric RF-IVUS measurements in 33 coronary segments with a length of 27 +/- 7 mm. For vessel, lumen, and plaque + media volume the relative measurement differences (P = NS for all) were (A = intraobserver comparison, same pullback) -0.40 +/- 1.0%; -0.48 +/- 1.4%; -0.35 +/- 1.6%, (B = intraobserver comparison, repeated pullback) -0.42 +/- 1.2%; -0.52 +/- 1.8%; -0.43 +/- 4.5% (C = interobserver comparison, same pullback) 0.71 +/- 1.8%; 0.71 +/- 2.2%, and 0.89 +/- 5.0%, respectively. For fibrous, fibro-lipidic, calcium, and necrotic-core volumes the relative measurement differences (P = NS for all) were (A) 0.45 +/- 2.1%; -1.12 +/- 4.9%; -0.84 +/- 2.1%; -0.22 +/- 1.8%, (B) 1.40 +/- 4.1%; 1.26 +/- 6.7%; 2.66 +/- 7.4%; 0.85 +/- 4.4%, and (C) -1.60 +/- 4.9%; 3.85 +/- 8.2%; 1.66 +/- 7.5%, and -1.58 +/- 4.7%, respectively. Of note, necrotic-core volume showed on average the lowest measurement variability. Thus, in mild-to-moderate atherosclerotic coronary artery disease the reproducibility of volumetric compositional RF-IVUS measurements from the same pullback is relatively high, but lower than the reproducibility of geometrical IVUS measurements. Measurements from repeated pullbacks and by different observers show acceptable reproducibilities; the volumetric measurement of the necrotic-core shows on average the highest reproducibility of the compositional RF-IVUS measurements. PMID:18704753

  2. High beta and electron dose from 192Ir: implications for 'gamma' intravascular brachytherapy

    Purpose: Trains of multiple 192Ir seeds are used in many clinical trials for intravascular brachytherapy. 192Ir source is commonly considered as a gamma emitter, despite the understanding that this radionuclide also emits a wide range of electron and beta energies, with a similar range of energy. The high dose from betas and electrons in the submillimeter range due to unsealed ends of seed sources should be precisely quantified to fully understand the backdrop for complications associated with 192Ir coronary artery brachytherapy. Methods and Materials: Monte Carlo simulations (MCNP4C code) were performed for a model 5-seed 192Ir train used in SCRIPPS, GAMMA, and the Washington Radiation for In-Stent Restenosis (WRIST) randomized clinical trials. A stack of radiochromic films was also used to measure the dose distributions for an actual 6-seed train. Results: In the submillimeter range very close to the source, Monte Carlo results show that betas and electrons deposit a higher dose than 192Ir photons (gamma and X-rays) over the interseed gap. A high luminal dose from the combined effects of betas, electrons, and photons emitted from 192Ir can be deposited, particularly between seeds. When prescribing 15 Gy at 2 mm, the combined dose can be as high as 160 Gy at 0.5 mm. Different peak doses near the interseed gaps were noted, which may be due to variability of seed-end surfaces and nonuniformity of seed activity within a real multiseed train. Dose-volume histograms (DVH) of lumen surfaces were evaluated for an eccentric seed train. The DVH parameters indicating the extent of hot spots in the lumen wall, DV10, DV5, DV2, and DV1 (dose received by 10, 5, 2, 1% respectively of the total lumen surface), can be as high as 55, 76, 81, and 155 Gy for a lumen with 3-mm diameter, and 75, 80, 110, and 158 Gy for a narrow 2-mm lumen. Conclusion: 192Ir multiple seed trains used in the SCRIPPS, GAMMA, and WRIST trials can deposit a very high dose to the luminal wall. A particularly

  3. Thrombocytopenia in the experimental leptospirosis of guinea pig is not related to disseminated intravascular coagulation

    HU Bao-Yu

    2006-02-01

    Full Text Available Abstract Background Thrombocytopenia is commonly observed in severe leptospirosis. However, previous studies on coagulation alterations during leptospirosis resulted in inconsistent conclusions. Some findings showed that the prominent levels of thrombocytopenia observed in severe leptospirosis did not reflect the occurrence of disseminated intravascular coagulation (DIC syndrome, while the others reached the conclusion that the hemorrhages observed in leptospirosis were due to DIC. The aim of this study is to elucidate whether DIC is an important feature of leptospirosis. Methods The leptospirosis model of guinea pig was established by intraperitoneal inoculation of Leptospira interrogans strain Lai. Hematoxylin and eosin (HE staining, electron microscopy and immunohistochemistry staining were used to detect the pathologic changes. Platelet thrombus or fibrin thrombus was detected by HE, Martius Scarlet Blue (MSB staining and electron microscopy. Hemostatic molecular markers such as 11-dehydrogenate thromboxane B2 (11-DH-TXB2, thrombomodulin (TM, thrombin-antithrombin III complex (TAT, D-Dimer and fibrin (ogen degradation products (FDPs in the plasma were examined by quantitative enzyme-linked immunosorbent assay (ELISA to evaluate the hematological coagulative alterations in leptospirosis models. Results Pulmonary hemorrhage appeared in the model guinea pig 24 hours after leptospires intraperitoneal inoculation, progressing to a peak at 96 hours after the infection. Leptospires were detected 24 hours post-inoculation in the liver, 48 hours in the lung and 72 hours in the kidney by immunohistochemistry staining. Spiral form of the bacteria was initially observed in the liver, lung and kidney suggestive of intact leptospires, granular form of leptospires was seen as the severity increased. Platelet aggregation in hepatic sinusoid as well as phagocytosis of erythrocytes and platelets by Kupffer cells were both observed. Neither platelet thrombus

  4. Linfomas asociados con la infección por el virus de la inmunodeficiencia humana: subtipos histológicos y asociación con los virus de Epstein Barr y Herpes-8 AIDS related lymphomas: Histopathological subtypes and association with Epstein Barr virus and Human Herpes virus type-8

    Marcelo Corti

    2010-04-01

    Full Text Available Los linfomas no Hodgkin (LNH constituyen la segunda neoplasia definitoria de Sida más frecuente. En el presente trabajo se evaluaron 48 casos de linfomas asociados con la enfermedad debida al virus de la inmunodeficiencia humana (HIV diagnosticados en la División Histopatología del Instituto de Investigaciones Hematológicas de la Academia Nacional de Medicina. Se incluyeron en la investigación 5 mujeres y 43 hombres con una mediana de edad al momento del diagnóstico de la neoplasia de 37 años. La evaluación morfológica se realizó en cortes coloreados con hematoxilina-eosina, estudio inmunohistoquímico para la detección del virus de Epstein Barr (VEB en 48/48 casos, y mediante sonda oligonucleotídica biotinilada para la detección del ADN del Herpes virus humano tipo-8 (HHV-8 en 14/14 linfomas plasmoblásticos (LP. Todos fueron linfomas de fenotipo B, con un curso clínico agresivo y enfermedad neoplásica avanzada al momento del diagnóstico. Se pudo demostrar la fuerte asociación del VEB con los linfomas asociados al sida, con frecuencias que variaron según el subtipo histológico: 16/21 (76% para los linfomas difusos de grandes células; 1/3 casos (33% de linfomas de Burkitt y 3/4 (75% en los linfomas primarios del sistema nervioso central. Globalmente, el genoma del VEB se detectó en 20/28 (71% de las muestras de biopsias de LNH de esta serie. La detección del HHV-8 resultó negativa en los 14 LP. Los linfomas de Hodgkin fueron más frecuentes en varones,18/20 (90%, con un curso clínico agresivo y franco predominio de los subtipos histológicos de peor pronóstico (90% de casos. En estas neoplasias también se comprobó una frecuente asociación patogénica con el VEB (90% de casos.Non-Hodgkin lymphomas (NHL of the B-cell type are the second most common neoplasm among patients with human immunodeficiency virus (HIV infection and AIDS. Here, we evaluated 48 cases of AIDS-related lymphomas (ARL diagnosed at the

  5. Linfomas en pacientes con infección por el virus de la inmunodeficiencia humana. Influencia de la terapia antirretroviral de gran actividad en las características clinico-biológicas, la respuesta al tratamiento y la supervivencia

    Navarro Ferrando, José Tomás

    2004-01-01

    Introducción. Los linfomas son la segunda neoplasia en frecuencia, que afecta a los pacientes infectados por el virus de la inmunodeficiencia humana (VIH). Desde la aparición del tratamiento antirretroviral de gran actividad (TARGA) el pronóstico de los pacientes infectados por el VIH ha cambiado, y se ha observado una disminución en la incidencia de infecciones oportunistas y algunas neoplasias. El uso generalizado del TARGA ha determinado que los factores pronósticos de los pacientes con li...

  6. Disseminated intravascular coagulopathy caused by Kikuchi–Fujimoto disease resulting in death: first case report in Turkey

    Uslu E

    2014-02-01

    Full Text Available Emine Uslu,1 Sibel Gurbuz,2 Abdulsamet Erden,1 Fatma Aykas,1 Hatice Karagoz,1 Samet Karahan,1 Hatice Karaman,3 Ali Cetinkaya,1 Deniz Avci1 1Internal Medicine Department, 2Infection Disease Department, 3Clinical Pathology Department, Kayseri Training and Research Hospital, Kayseri, Turkey Abstract: Kikuchi disease, also called Kikuchi–Fujimoto disease or Kikuchi's histiocytic necrotizing lymphadenitis, is a rare, benign condition of unknown cause, usually characterized by cervical lymphadenopathy and fever. The diagnosis is based on histopathology. Our patient was a woman with bilateral cervical lymphadenopathy, fever, chest and abdominal pain, fatigue, maculopapular rash on her face, trunk, and upper and lower extremities. Immunological and rheumatological tests were negative. We took a cervical lymph node biopsy that showed a proliferative and necrotizing process centered in the paracortex characterized by patchy circumscribed or confluent areas of necrosis associated with karyorrhexis, and was remarkable by the absence of granulocytes and the paucity of plasma cells. These findings confirmed the diagnosis of Kikuchi's disease. The patient's hemoglobin values decreased, and the peripheral blood smear revealed schistocytes. Blood tests showed raised D-dimer, activated partial thromboplastin time, prothrombin time, and international normalized ratio with decreased fibrinogen. The patient's condition quickly worsened and disseminated intravascular coagulopathy eventually developed. Her initial management consisted of a corticosteroid and hydroxychloroquine. Keywords: disseminated intravascular coagulopathy, Kikuchi–Fujimoto disease, necrotizing lymphadenitis

  7. “ STUDY OF COAGULATION PROFILE IN CLINICALLY DIAGNOSED CASES OF ACUTE DISSEMINATED INTRAVASCULAR COAGULATION USING ISTH CRITERIA

    Chopade

    2013-10-01

    Full Text Available Disseminated Intravascular Coagulation (DIC is a pathological activation of coagulation (blood clotting mechanisms that happens in response to a variety of diseases. It involves the generation of intravascular fibrin (small blood c lots and the consumption of pro - coagulants and platelets. It results in the disruption of normal coagulation mechanism and abnormal bleeding occurs from the skin, the gastrointestinal tract, the respiratory tract and surgical wounds. It was the prospecti ve study of 60 patients of acute DIC, in which coagulation profile were studied from December 2010 to October 2012 . 40 controls were studied. Control group include healthy voluntary blood donors. The coagulation profile was studied and DIC scoring was p erformed using the International Society on Thrombosis and Haemostasis [ISTH] criteria. Among the coagulation profile, the sensitivity and specificity of the parameters to diagnose and to assess the severity of DIC, in the decreasing order of frequency wer e of platelet count, D - dimer, PT and APTT. Fibrinogen level was not depleted below the significant level (<1 gm/l in majority cases of DIC. According to the ISTH criteria, DIC scores among cases was ≥ 5.

  8. Qualidade de caquis Fuyu tratados com cálcio em pré-colheita e armazenados sob atmosfera modificada

    FERRI VALDECIR CARLOS

    2002-01-01

    Full Text Available Avaliou-se a eficiência do cálcio (CaCl2 na conservação de caquis Fuyu armazenados em temperatura ambiente (TA, atmosfera refrigerada (AR e modificada (AM. Utilizou-se um delineamento inteiramente casualizado, com quatro repetições. Os caquizeiros foram tratados com 1% de CaCl2, em pulverizações de cobertura total, a cada 15 dias, a partir de 90 dias antes da data prevista para a colheita. Para a testemunha, pulverizaram-se as plantas com água destilada. As frutas foram colhidas com 65-75mm de diâmetro, coloração verde-amarelada e armazenadas em: 1 - TA (23±3ºC e 75±5%; 2 - AR (0±0,5ºC e 90±5% de umidade relativa; e 3 - AM (filme de polietileno de baixa densidade 33µm, 29x46cm, 0±0,5ºC e umidade relativa 90±5%, durante 80 dias. As frutas foram submetidas a avaliações de perda de peso, firmeza de polpa, sólidos solúveis totais e escurecimento da epiderme. As avaliações foram efetuadas 24 e 96 horas após as frutas serem retiradas da câmara. Para as frutas armazenadas em TA, as análises foram realizadas a cada 4 dias, durante 20 dias. A aplicação de CaCl2 em pré-colheita melhorou o potencial de armazenamento, e a AM teve efeito sinérgico ao CaCl2 na melhoria do potencial de conservação dos caquis.

  9. Development of a model based scoring system for diagnosis of canine disseminated intravascular coagulation with independent assessment of sensitivity and specificity

    Wiinberg, Bo; Jensen, Asger Lundorff; Johansson, Per Ingemar; Kjelgaard-Hansen, Mads; Rozanski, Elizabeth; Tranholm, Mikael; Kristensen, Annemarie Thuri

    2010-01-01

    A template for a scoring system for disseminated intravascular coagulation (DIC) in humans has been proposed by the International Society on Thrombosis and Haemostasis (ISTH). The objective of this study was to develop and validate a similar objective scoring system based on generally available c...

  10. The Impact of the Acute Results on the Long - Term Outcome after the Treatment of In- stent Restenosis: A Serial Intravascular Ultrasound Study

    2002-01-01

    @@ Stenting reduces acute complications and restenosis compared to balloon angioplasty and other devices. However, in- stent restenosis (ISR) is an important clinical problem. The current serial intravascular ultrasound (IVUS)analysis was undertaken to determine whether the acute results obtained during the treatment of ISR influence the long term results and whether this is true for patients treated with and without adjunct brachytherapy.

  11. Autologous bone marrow transplantation in a dog with lymphoma: a clinical study Transplante autólogo de medula óssea em um cão com linfoma: ensaio clínico

    Maria Luísa Buffo de Cápua

    2009-04-01

    Full Text Available The objective of this study is to provide the first report of bone marrow transplantation (BMT in dogs in Brazil. A Rottweiler with cutaneous lymphoma was submitted to a twelve-week Madison-Wisconsin chemotherapy protocol followed by autologous bone marrow transplantation. For this, 10mL kg-1 of bone marrow was collected simultaneously from both iliac crests and cryopreserved in a freezer at -80°C. The conditioning step was performed by administering cyclophosphamide by intravenous route at 400mg m-2. Bone marrow was reinfused after defrosting in a water bath at 37°C. Bone marrow nucleated cell counts before and after freezing, showed a small relative loss of nucleated cells (35.10 and 31.80x10³µL-1 , respectively. Cyclophosphamide induced neutropenia which was reverted by a granulocyte colony-stimulating factor (G-CSF capable of stimulating hematopoetic reconstitution. On the day 360 after transplant the patient was found to be in complete remission. This study indicates that autologous BMT in a dog with lymphoma submitted to myelosuppressive chemotherapy was potentially safe and effective.Este estudo teve como objetivo descrever o primeiro relato de transplante de medula óssea (TMO em cães no Brasil. Para tanto, um rottweiller com linfoma cutâneo foi submetido ao protocolo quimioterápico de Madison-Wisconsin pelo período de 12 semanas, seguido pelo transplante autólogo de medula óssea. Para tanto, 10mL kg-1 de medula óssea foram coletados de ambas as cristas ilíacas do paciente, simultaneamente; sendo o volume final criopreservado em freezer a -80°C. A etapa de condicionamento foi realizada com a administração da ciclofosfamida, por via intravenosa, na dose de 400mg m-2. A reinfusão da medula óssea foi realizada após o descongelamento da bolsa em banho-maria a 37°C. As contagens de células nucleadas de alíquotas obtidas da bolsa de medula óssea antes do congelamento e após o descongelamento demonstram pequena perda

  12. Insuficiência respiratória aguda causada por pneumonia em organização secundária à terapia antineoplásica para linfoma não Hodgkin

    Adriell Ramalho Santana

    2012-12-01

    Full Text Available Doenças difusas do parênquima pulmonar pertencem a um grupo de doenças de evolução geralmente subaguda ou crônica, mas que podem determinar insuficiência respiratória aguda. Paciente masculino, 37 anos, em terapia para linfoma não Hodgkin, admitido com tosse seca, febre, dispneia e insuficiência respiratória aguda hipoxêmica. Iniciadas ventilação mecânica e antibioticoterapia, porém houve evolução desfavorável. Tomografia computadorizada de tórax mostrava opacidades pulmonares em "vidro fosco" bilaterais. Devido ao paciente ter feito uso de três drogas relacionadas à pneumonia em organização (ciclofosfamida, doxorrubicina e rituximabe e quadros clínico e radiológico serem sugestivos, iniciou-se pulsoterapia com metilprednisolona com boa resposta. Pneumonia em organização pode ser idiopática ou associada a colagenoses, drogas e neoplasias, e geralmente responde bem a corticoterapia. O diagnóstico é anatomopatológico, mas condições clínicas do paciente não permitiam a realização de biópsia pulmonar. Pneumonia em organização deve ser diagnóstico diferencial em pacientes com aparente pneumonia de evolução desfavorável ao tratamento antimicrobiano.

  13. Linfoma cutáneo de células T Revisión del tema con énfasis en la inmunopatogénesis = Cutaneous T-cell lymphoma: Review with emphasis on immunophatogenesis

    Duque Giraldo, Victoria Eugenia

    2011-12-01

    Full Text Available Bajo el término linfoma cutáneo de células T (LCCT se agrupa una serie de enfermedades que tienen en común la presencia de un clon maligno de células T y la afectación de la piel. La micosis fungoide (MF es la forma más común de LCCT, seguida por el síndrome de Sèzary (SS. La causa definitiva de la MF es desconocida. El inmunofenotipo de la mayoría de los casos de MF es de células T de memoria CD3+CD4+CD45RO+CLA+CD8-. Los linfocitos T CD4+ malignos migran hasta la epidermis y se localizan alrededor de las células de Langerhans (LC. En el SS las células pierden el epidermotropismo e infiltran extensamente la dermis, la sangre y otros tejidos; estas células presentan un inmunofenotipo predominante de células T neoplásicas CD3+CD4+CD8-CD7-CD26- CD158k+CD94-. El perfil Th2 y la supresión de respuestas Th1 son dos factores críticos en la progresión de la enfermedad. Se han evaluado muy poco las alteraciones en la regulación inmune en el LCCT. Un mejor entendimiento de la función de las células T y de la inmunobiología de los LCCT permitiría mejorar el pronóstico, el tratamiento y el seguimiento de los pacientes con estas neoplasias.

  14. Hyperinfection by Strongyloides stercoralis probably associated with Rituximab in a patient with mantle cell lymphoma and hyper eosinophilia Hiperinfección por Strongyloides stercoralis probablemente asociada con Rituximab en una paciente con linfoma e hipereosinofilia

    Renzo Nino Incani

    2010-08-01

    Full Text Available The first report to our knowledge, of hyperinfection by Strongyloides stercoralis (HS and hypereosinophilia, associated to immune suppression by Rituximab (the only drug received for the last one year and 10 months, in a patient with mantle-cell lymphoma (MCL, is presented. The patient has a 3-year history of MCL, and developed two accesses of HS during 2008, including meningitis, pneumonia and presence of larvae of S. stercoralis in the lungs. We had a unique chance to look at cytotoxicity of filariform larvae in the expectoration after Ivermectin treatment, showing immobilization and death of larvae, associated with eosinophils attached to the cuticle of the parasite.Se presenta el primer reporte, hasta donde tengamos información, de hiperinfección por Strongyloides stercoralis (HS e hipereosinofilia asociados a inmunosupresión por Rituximab (el único medicamento recibido durante 1 año y 10 meses, en un paciente con linfoma de células del manto (LCM. La paciente tuvo una historia de 3 años con LCM, y desarrolló 2 accesos de HS durante el 2008, incluyendo meningitis, neumonía y presencia de larvas de S. stercoralis en los pulmones. Se tuvo la oportunidad única de observar la citotoxicidad contra las larvas filariformes en la expectoración, luego del tratamiento con Ivermectina, mostrando la inmovilización y muerte de las larvas, asociada a la presencia de eosinófilos adheridos a la cutícula del parásito.

  15. Intravascular ultrasound observation of the mechanism of no-reflow phenomenon in acute myocardial infarction.

    Junxia Li

    Full Text Available To study the mechanism of the no-reflow phenomenon using coronary angiography (CAG and intravascular ultrasound (IVUS.A total of 120 patients with acute myocardial infarction (AMI who successfully underwent indwelling intracoronary stent placement by percutaneous coronary intervention (PCI. All patients underwent pre- and post-PCI CAG and pre-IVUS. No-reflow was defined as post-PCI thrombolysis in myocardial infarction (TIMI grade 0, 1, or 2 flow in the absence of mechanical obstruction. Normal reflow was defined as TIMI grade 3 flow. The pre-operation reference vascular area, minimal luminal cross-sectional area, plaque cross-sectional area, lesion length, plaque volume and plaque traits were measured by IVUS.The no-reflow group was observed in 14 cases (11.6% and normal blood-flow group in 106 cases (89.4% based on CAG results. There was no statistically significant difference in the patients' medical history, reference vascular area (no-flow vs. normal-flow; 15.5 ± 3.2 vs. 16.2 ± 3.3, p > 0.05 and lesion length (21.9 ± 5.1 vs. 19.5 ± 4.8, p > 0.05 between the two groups. No-reflow patients had a longer symptom onset to reperfusion time compared to normal blood-flow group [(6.6 ± 3.1 h vs (4.3 ± 2.7 h; p < 0.05] and higher incidence of TIMI flow grade < 3 (71.4% vs 49.0%, p < 0.05. By IVUS examination, the no-reflow group had a significantly increased coronary plaque area and plaque volume compared to normal blood-flow group [(13.7 ± 3.0 mm2 vs (10.2 ± 2.9 mm2; (285.4 ± 99.8 mm3 vs (189.7 ± 86.4 mm3; p < 0.01]. The presence of IVUS-detected soft plaque (57.1% vs. 24.0%, p < 0.01, eccentric plaque (64.2% vs. 33.7%, p < 0.05, plaque rupture (50.0% vs. 21.2%, p < 0.01, and thrombosis (42.8% vs. 15.3% were significantly more common in no-reflow group.There was no obvious relationship between the coronary risk factors and no-reflow phenomenon. The symptom onset to reperfusion time, TIMI flow grade before stent deployment, plaque area

  16. Compensation of spectral artifacts in dual-modality intravascular optical coherence tomography and near-infrared spectroscopy (Conference Presentation)

    Fard, Ali M.; Gardecki, Joseph A.; Ughi, Giovanni J.; Hyun, Chulho; Tearney, Guillermo J.

    2016-02-01

    Intravascular optical coherence tomography (OCT) is a high-resolution catheter-based imaging method that provides three-dimensional microscopic images of coronary artery in vivo, facilitating coronary artery disease treatment decisions based on detailed morphology. Near-infrared spectroscopy (NIRS) has proven to be a powerful tool for identification of lipid-rich plaques inside the coronary walls. We have recently demonstrated a dual-modality intravascular imaging technology that integrates OCT and NIRS into one imaging catheter using a two-fiber arrangement and a custom-made dual-channel fiber rotary junction. It therefore enables simultaneous acquisition of microstructural and composition information at 100 frames/second for improved diagnosis of coronary lesions. The dual-modality OCT-NIRS system employs a single wavelength-swept light source for both OCT and NIRS modalities. It subsequently uses a high-speed photoreceiver to detect the NIRS spectrum in the time domain. Although use of one light source greatly simplifies the system configuration, such light source exhibits pulse-to-pulse wavelength and intensity variation due to mechanical scanning of the wavelength. This can be in particular problematic for NIRS modality and sacrifices the reliability of the acquired spectra. In order to address this challenge, here we developed a robust data acquisition and processing method that compensates for the spectral variations of the wavelength-swept light source. The proposed method extracts the properties of the light source, i.e., variation period and amplitude from a reference spectrum and subsequently calibrates the NIRS datasets. We have applied this method on datasets obtained from cadaver human coronary arteries using a polygon-scanning (1230-1350nm) OCT system, operating at 100,000 sweeps per second. The results suggest that our algorithm accurately and robustly compensates the spectral variations and visualizes the dual-modality OCT-NIRS images. These

  17. Successful Control of Disseminated Intravascular Coagulation by Recombinant Thrombomodulin during Arsenic Trioxide Treatment in Relapsed Patient with Acute Promyelocytic Leukemia

    Motohiro Shindo

    2012-01-01

    Full Text Available Disseminated intravascular coagulation (DIC frequently occurs in patients with acute promyelocytic leukemia (APL. With the induction of therapy in APL using all-trans retinoic acid (ATRA, DIC can be controlled in most cases as ATRA usually shows immediate improvement of the APL. However, arsenic trioxide (ATO which has been used for the treatment of relapse in APL patients has shown to take time to suppress APL cells, therefore the control of DIC in APL with ATO treatment is a major problem. Recently, the recombinant soluble thrombomodulin fragment has received a lot of attention as the novel drug for the treatment of DIC with high efficacy. Here, we present a relapsed patient with APL in whom DIC was successfully and safely controlled by rTM during treatment with ATO.

  18. Contribution of intravascular versus interstitial purines and nitric oxide in the regulation of exercise hyperaemia in humans

    Hellsten, Ylva; Nyberg, Michael Permin; Mortensen, Stefan Peter

    2012-01-01

    concentration of NO metabolites (NOx) in interstitium and plasma does not change during exercise and is similar in the two compartments. Adenosine and NO have been shown to contribute to exercise hyperaemia whereas the role of ATP remains unclear due to lack of specific purinergic receptor blockers. The......Abstract The regulation of blood flow to skeletal muscle involves a complex interaction between several locally formed vasodilators that are produced both in the skeletal muscle interstitium and intravascularly. The gas nitric oxide (NO) and the purines ATP and adenosine, are potent vasodilators....... Adenosine originates primarily from extracellular degradation of ATP. During exercise the concentrations of ATP and adenosine increase markedly in the interstitium with smaller increases occurring in plasma, and thus the interstitial concentration during exercise is severalfold higher than in plasma. The...

  19. Review of the Ability of Optical Coherence Tomography to Characterize Plaque, Including a Comparison with Intravascular Ultrasound

    Over the last 50 years the introduction of several imaging technologies have been pivotal in reducing mortality associated with coronary artery disease. However coronary disease continues to be the leading cause of mortality in the industrialized world. Optical coherence tomography (OCT) has recently been introduced for micron scale intravascular imaging. It is analogous to ultrasound, measuring the intensity of back-reflected infrared light instead of sound. Some of the advantages of OCT include its resolution, which is higher than any currently available imaging technology and acquisition rates are near video speed. Unlike ultrasound, OCT catheters consist of simple fiber optics and contain no transducers within their frame, thereby making imaging catheters both inexpensive and small. Currently, the smallest catheters have a cross-sectional diameter of 0.014'. OCT systems are compact and portable and can be combined with a range of spectroscopic techniques. We review the application of OCT to intracoronary imaging

  20. Morphologic characteristics of pulmonary macrophages in cetaceans: particular reference to pulmonary intravascular macrophages as a newly identified type.

    Kawashima, M; Kuwamura, M; Takeya, M; Yamate, J

    2004-11-01

    We examined the morphologic characteristics of pulmonary macrophages in 42 specimens of Odontoceti (Globicephala macrorhynchus, Grampus griseus, Tursiops truncatus, Stenella attenuata, Stenella coeruleoalba, Berardius bairdii), using light and electron microscopes as well as immunohistochemistry with SRA-E5. SRA-E5-positive alveolar macrophages and pulmonary interstitial macrophages contained graphitic soots, indicating the clearance of airborne, aspirated foreign bodies. Pulmonary intravascular macrophages (PIMs), positive with SRA-E5, were present within pulmonary capillaries, attaching to applied endothelial cells by cell junctions. They showed cytoplasmic tubular structures of micropinocytosis vermiformis and erythrophagocytosis, indicating their contributory role in the clearance of blood-borne particles. The uptake of pathogens by PIMs may be associated with the inducement of acute lung injury, especially bacterial infectious pneumonia. This study revealed for the first time the presence of PIMs in cetaceans. PMID:15557077

  1. Optical Coherence Tomography Analysis of Attenuated Plaques Detected by Intravascular Ultrasound in Patients with Acute Coronary Syndromes

    Takashi Kubo

    2011-01-01

    Full Text Available Background. Recent intravascular ultrasound (IVUS studies have demonstrated that hypoechoic plaque with deep ultrasound attenuation despite absence of bright calcium is common in acute coronary syndrome. Such “attenuated plaque” may be an IVUS characteristic of unstable lesion. Methods. We used optical coherence tomography (OCT in 104 patients with unstable angina to compare lesion characteristics between IVUS-detected attenuated plaque and nonattenuated plaque. Results. IVUS-detected attenuated plaque was observed in 41 (39% patients. OCT-detected lipidic plaque (88% versus 49%, <0.001, thin-cap fibroatheroma (48% versus 16%, <0.001, plaque rupture (44% versus 11%, <0.001, and intracoronary thrombus (54% versus 17%, <0.001 were more often seen in IVUS-detected attenuated plaques compared with nonattenuated plaques. Conclusions. IVUS-detected attenuated plaque has many characteristics of unstable coronary lesion. The presence of attended plaque might be an important marker of lesion instability.

  2. A case of esophageal cancer with septic disseminated intravascular coagulation treated with recombinant human soluble thrombomodulin during chemoradiation therapy

    A 70-year-old woman was diagnosed with synchronous advanced esophageal cancer and early renal cancer. During chemo-radiation therapy for the esophageal cancer, she suffered from septic shock due to pneumonia. She got worse despite the administration of antibiotics and γglobulin. On the following day, she was diagnosed with septic disseminated intravascular coagulation (DIC) on the basis of the diagnostic criterion for acute DIC. Recombinant human soluble thrombomodulin (rTM) was administered to treat the DIC. The patient responded promptly to rTM treatment and recovered from the DIC in just 1 day. rTM is thought to be an effective drug for sepsis-induced DIC during chemoradiation therapy. (author)

  3. [Pulmonary embolism and disseminated intravascular coagulation after being bitten by a Bothrops lanceolatus snake. Apropos of a case].

    Estrade, G; Garnier, D; Bernasconi, F; Donatien, Y

    1989-11-01

    The authors report the case of a Bothrops lanceolatus snake bite complicated by severe pulmonary embolism a few hours after admission. This thromboembolic complication developed despite heparin therapy and was followed by disseminated intravascular coagulation (DIC). Vascular thrombosis and pulmonary embolism are rare after Bothrops lanceolatus snake bite as patients are usually hypocoagulable due to DIC. In this case, the thromboembolism was probably caused by the procoagulant effect of the thrombin-like enzymes of the snake venom which may have been injected directly into the vein of a young woman taking a contraceptive pill. A specific antivenin which has recently become available fort treatment may decrease the complications of Bothrops lanceolatus snake bite. PMID:2514645

  4. Behavior in Mus musculus of Schistosoma mansoni from mollusks treated with hydrocortisone Comportamento em Mus musculus do Schistosoma mansoni oriundo de moluscos tratados com hidrocortisona

    Deborah Regina Serrano

    2005-10-01

    Full Text Available Twenty mice were exposed to cercariae from mollusks treated with hydrocortisone and another 20 mice received cercariae from non-treated mollusks. The behavior of the parasites from the two groups of mollusks was compared based on the ability of cercariae to penetrate mice, on the total number of worms recovered after eight weeks of infection, on the relationship between the number of penetrating cercariae and the number of recovered worms and on the number of eggs in the feces. Treating the mollusks with hydrocortisone did not alter the ability of cercariae to penetrate mice nor did it affect the total number of worms recovered. The number of female worms, the number of coupled worms and the number of eggs in the feces were greater in mice infected by cercariae from mollusks treated with hydrocortisone.Vinte camundongos foram expostos a cercárias oriundas de moluscos tratados com hidrocortisona e outros vinte receberam cercárias de moluscos não tratados. O comportamento dos parasitas dos dois grupos foi comparado com base na habilidade das cercárias em penetrar nos camundongos, no número total de vermes recuperados, após oito semanas de infecção, na relação entre o número de cercárias penetrantes e o número de vermes recuperados e o número de ovos nas fezes. O tratamento dos moluscos com hidrocortisona não alterou a habilidade das cercárias em penetrar nos camundongos nem afetou o número total de vermes recuperados. O número de vermes fêmeas, o número de vermes acasalados e o número de ovos nas fezes aumentaram em camundongos infectados por cercárias de moluscos tratados com hidrocortisona.

  5. NUEVO CRITERIO INTERPRETATIVO DE LOS DERECHOS FUNDAMENTALES CONFORME A LOS TRATADOS INTERNACIONALES DE DERECHOS HUMANOS EN LA CONSTITUCIÓN ESPAÑOLA

    Alejandra Flores Martínez

    2011-12-01

    Full Text Available RESUMEN. En las siguientes líneas se pretende argumentar a la luz del ordenamiento jurídico español la existencia de razones jurídicas (válidas y suficientes para catalogar como “criterio interpretativo de los Derechos Fundamentales” a los Tratados Internacionales de Derechos Humanos, aportando cuatro tipos de argumentos: El primero, se deduce de la naturaleza jurídica de los tratados como fuentes del Derecho Internacional y como obligaciones internacionales para el Estado. El segundo, deriva de la incorporación automática de los Tratados al Derecho interno consolidándose como parte del ordenamiento jurídico. El tercero, es la pauta interpretativa que cuenta con respaldo constitucional en el artículo 10.2 de la Constitución Española. El cuarto, deriva de la insuficiencia de los criterios tradicionales al momento de interpretar las normas de los Derechos FundamentalesABSTRACT. The following lines pretend to argue in light of the Spanish law the existence of legal reasons (valid and sufficient to classify the international human rights treaties as "interpretive criteria for Fundamental Rights", providing four types of arguments: The first is inferred from the legal nature of treaties as sources of international law and international obligations for the State. The second derives from the automatic incorporation of treaties into national law establishing itself as part of the law. The third is the interpretative guidance that counts with constitutional support in Article 10.2 of the Spanish Constitution. The fourth derives from the failure of the traditional criteria when interpreting the rules of Fundamental Rights.

  6. Intoxicação aguda por triclorfon em caprinos tratados com a dose terapêutica

    Welber Daniel Zanetti Lopes

    2014-02-01

    Full Text Available O presente estudo descreve um surto de intoxicação por triclorfon em caprinos, que receberam pela via oral, a dosagem terapêutica do princípio ativo em questão (100mg/kg, provenientes da Universidade Estadual de Maringá, campus de Umuarama, PR. Cinquenta e três ovinos foram tratados com a mesma formulação/solução e não se observou nenhum efeito colateral nos animais referente ao tratamento com triclorfon. Das 20 cabras medicadas, cerca de 40 minutos após a administração do triclorfon, oito apresentaram os clássicos sinais clínicos de ataxia, decúbito externo-lateral, sialorreia, tremores, constrição das pupilas, dispneia com ruídos, micção e defecação involuntária, paresia espástica, timpanismo e lacrimejamento. Quase que imediatamente após a detecção destes sinais, as oito cabras foram medicadas com sulfato de atropina 1% 0,5mg/kg mais fluidoterapia. Cinco destes animais tiveram de receber nova dosagem de sulfato de atropina uma hora após a primeira aplicação, em função de alguns sinais clínicos, como tremores musculares, ainda estarem presentes. De 48 a 72 horas após a administração do triclorfon, três destes cinco animais vieram a óbito. Na necropsia, foi possível observar mucosas cianóticas, congestão de fígado, baço e rins, vasos mesentéricos congestos, vesícula biliar repleta, enfisema pulmonar, parênquima pulmonar avermelhado. Os resultados encontrados neste trabalho chamam atenção que o surto aconteceu em cabras adultas, que apresentavam boas condições clínicas e acima de tudo, receberam a dosagem terapêutica recomendada em bula pelo fabricante. Talvez isso possa indicar alguma sensibilidade mais elevada desta espécie animal à dosagem recomendada em bula do triclorfon (100mg/kg para caprinos.

  7. Lixiviação de nitrato de um substrato minerado tratado com lodo de esgoto doméstico

    Rodrigo Ávila de Paula

    2011-01-01

    Full Text Available Lodos de esgoto são fontes significativas de N, P, matéria orgânica e outros elementos necessários à nutrição de plantas. A aplicação desses resíduos em solos e substratos é um das mais eficientes maneiras de recuperação de nutrientes. Todavia, os benefícios obtidos com o uso de lodo de esgoto devem ser confrontados com riscos inerentes à sua utilização, tais como a lixiviação excessiva de nitrato, que pode contaminar aquíferos. Normas sanitárias e ambientais impedem o consumo humano de águas com concentrações de nitrato > 10 mg L-1. Dessa forma, este trabalho objetivou mensurar o risco de contaminação de águas subterrâneas por nitrato produzido em substrato exposto pela mineração, que foi tratado com a dose equivalente a 120 t ha-1 de lodo de esgoto, base úmida. O substrato liberou lixiviados com concentrações de até 78 mg L-1 de nitrato, que representam risco de contaminação de águas subterrâneas. Sob as condições testadas neste trabalho, o aquífero subterrâneo deve situar-se a pelo menos 4,5 m de profundidade, para que o lixiviado liberado da camada tratada com lodo de esgoto seja diluído ao longo do perfil de solo a concentrações < 10 mg L-1, caso a área permaneça sem cobertura vegetal. O estabelecimento de uma cobertura herbácea sobre o substrato reduziu em 40% a quantidade de nitrato liberada no lixiviado, permitindo que o aquífero esteja a 2,7 m de profundidade sem que haja aporte excessivo de nitrato proveniente da camada superficial tratada.

  8. Comparação das reservas glicogênicas em ratos jovens e envelhecidos tratados com picolinato de cromo

    Marcella Damas Rodrigues

    2014-10-01

    Full Text Available INTRODUÇÃO: Entre os suplementos utilizados no meio esportivo, o mineral cromo tem se destacado, principalmente por potencializar a ação da via insulínica, ação extremamente importante na manutenção da homeostasia metabólica. A ação do cromo parece ter ação importante como coadjuvante nas dinâmicas da ação insulínica. OBJETIVO: Avaliar o perfil glicogênico, bem como a sensibilidade tecidual à insulina e a pancreática à glicose em ratos jovens e envelhecidos tratados com picolinato de cromo. MÉTODO: Foram utilizados ratos Wistar, com idade de 3 e 24 meses, distribuídos em quatro grupos experimentais (n = 6, assim denominados: jovens (J, jovens suplementados com picolinato de cromo (JP, 80 µg/Kg, envelhecidos (E e envelhecidos suplementados com picolinato de cromo (EP, 80 µg/Kg. A sensibilidade à insulina foi avaliada através do teste de tolerância à insulina (ITT, 2 U/Kg e a sensibilidade pancreática, através do teste de tolerância à glicose (GTT, 2 g/Kg. Na análise estatística foi utilizado teste de normalidade de dados de Kolmogorov-Smirnov, seguido de ANOVA e o teste post-hoc de Tukey, p < 0,05. RESULTADOS: O grupo envelhecido apresentou menores reservas glicogênicas se comparado ao grupo jovem; por sua vez, o tratamento com picolinato promoveu elevação das reservas hepáticas de ratos jovens sem efeito nos envelhecidos. No mesmo perfil de análise, foi demonstrado que o tratamento com picolinato promoveu elevação das reservas glicogênicas musculares, efeito observado tanto nos jovens quanto nos envelhecidos. No grupo jovem, não foi observada diferença no ITT, porém houve redução da área sob a curva descrita no GTT. No grupo envelhecido, houve elevação da responsividade à insulina no ITT e redução da área sob a curva. CONCLUSÃO: O picolinato expressou ação de secretagogo e sensibilizador da ação insulínica, com expressão mais significativa nos músculos envelhecidos.

  9. Histological analysis on adhesive molecules of renal intravascular large B cell lymphoma treated with CHOP chemotherapy and rituximab.

    Kusaba, T; Hatta, T; Tanda, S; Kameyama, H; Tamagaki, K; Okigaki, M; Inaba, T; Shimazaki, C; Sasaki, S

    2006-03-01

    A 48-year-old man was admitted to our hospital for investigation of mild renal dysfunction. A blood examination revealed mild elevation of creatinine level (1.77 mg/dl). Urinary examination revealed mild protein excretion (0.54 g/day) and microhematuria; renal biopsy revealed the focal proliferation of large mononuclear cells with mitosis in glomerular capillaries. According to immunohistochemical analysis, the intravascular lymphomatous cells stained positively with anti-leukocyte common antigen (LCA: CD45) and CD20, indicating a B lymphocyte lineage. In electron microscopy, the glomerular capillary was filled with lymphoma cells and epithelial foot process fusion was noted. Immunohistochemical analysis on adhesive molecules revealed a lack of CD11a expression on lymphoma cells, but positive CD54 expression on endothelial cells. Systemic 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed no abnormal uptake of isotopes. On the basis of these findings, we diagnosed intravascular diffuse large B cell lymphoma localized in the kidney. Despite treatment with rituximab and CHOP (prednisolone, doxorubicin, vincristine, cyclophosphamide) for 3 cycles at 1-month intervals, the renal dysfunction did not change. In histopathological analysis of the second biopsy, lymphoma cells disappeared, but focal segmental glomerulosclerosis and moderate interstitial fibrosis were noted. Electron microscopic findings revealed severe subendothelial edema with mesangial interposition, indicating severe endothelial damage. Epithelial foot process fusion was improved. These pathological analyses let us conclude that a lack of CD11a could be a candidate factor for prevention of the extravasation of lymphoma cells from blood vessels in our patient. We also presumed that the intraglomerular endothelial damage occurred due to chemotherapy-associated cell injury. PMID:16550755

  10. 3D registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation

    Prabhu, David; Mehanna, Emile; Gargesha, Madhusudhana; Wen, Di; Brandt, Eric; van Ditzhuijzen, Nienke S.; Chamie, Daniel; Yamamoto, Hirosada; Fujino, Yusuke; Farmazilian, Ali; Patel, Jaymin; Costa, Marco; Bezerra, Hiram G.; Wilson, David L.

    2016-03-01

    High resolution, 100 frames/sec intravascular optical coherence tomography (IVOCT) can distinguish plaque types, but further validation is needed, especially for automated plaque characterization. We developed experimental and 3D registration methods, to provide validation of IVOCT pullback volumes using microscopic, brightfield and fluorescent cryoimage volumes, with optional, exactly registered cryo-histology. The innovation was a method to match an IVOCT pullback images, acquired in the catheter reference frame, to a true 3D cryo-image volume. Briefly, an 11-parameter, polynomial virtual catheter was initialized within the cryo-image volume, and perpendicular images were extracted, mimicking IVOCT image acquisition. Virtual catheter parameters were optimized to maximize cryo and IVOCT lumen overlap. Local minima were possible, but when we started within reasonable ranges, every one of 24 digital phantom cases converged to a good solution with a registration error of only +1.34+/-2.65μm (signed distance). Registration was applied to 10 ex-vivo cadaver coronary arteries (LADs), resulting in 10 registered cryo and IVOCT volumes yielding a total of 421 registered 2D-image pairs. Image overlays demonstrated high continuity between vascular and plaque features. Bland- Altman analysis comparing cryo and IVOCT lumen area, showed mean and standard deviation of differences as 0.01+/-0.43 mm2. DICE coefficients were 0.91+/-0.04. Finally, visual assessment on 20 representative cases with easily identifiable features suggested registration accuracy within one frame of IVOCT (+/-200μm), eliminating significant misinterpretations introduced by 1mm errors in the literature. The method will provide 3D data for training of IVOCT plaque algorithms and can be used for validation of other intravascular imaging modalities.

  11. Intravascular optical coherence tomography: differentiation of atherosclerotic plaques and quantification of vessel dimensions in crural arterial specimens

    Purpose: Intravascular optical coherence tomography (OCT) is a new technique based on infrared light that visualizes the arteries with a resolution of 10-20 μm. Intravascular ultrasound (IVUS) is the current in vivo reference standard and provides a resolution of 100-150 μm. This study compared OCT to IVUS and histopathology with respect to the ability to differentiate atherosclerotic plaques and quantify vascular dimensions in peripheral crural arteries ex vivo. Materials and Methods: 50 segments of atherosclerotic arteries derived from five amputated human lower extremities were examined. The different plaque types (fibrous, high-lipid content, calcified) were assigned by two independent examiners, and the sensitivity and specificity of OCT in comparison with histopathology as well as intra- and interobserver consensus were calculated. A comparison of OCT with IVUS addressed the parameters: luminal area (LA), vascular wall area (VA) and plaque area (PA). Results: When comparing OCT and histopathology with respect to the differentiation of various plaque types, sensitivities of 81% and specificities of 89% for fibrous plaques, of 100% and 93% for lipid-rich plaques and of 80% and 89% for calcified plaques were achieved (overall correlation 83%). Intra- and interobserver consensus was very high (κ=0.86 and κ=0.89, p2 accuracy ±1.8 mm2, r=0.95[p2 accuracy ±2.3 mm2, r=0.94[p2 accuracy ±2.3 mm2, r=0.80[p<0.01]). Conclusion: OCT allows the differentiation of atherosclerotic plaque types in crural arteries with high accuracy compared to histopathology. Quantitative measurements show a high correlation with IVUS, the current reference standard. (orig.)

  12. Stem cell impregnated nanofiber stent sleeve for on-stent production and intravascular delivery of paracrine factors.

    Hwang, Chao-Wei; Johnston, Peter V; Gerstenblith, Gary; Weiss, Robert G; Tomaselli, Gordon F; Bogdan, Virginia E; Panigrahi, Asmi; Leszczynska, Aleksandra; Xia, Zhiyong

    2015-06-01

    Stem cell therapies for atherosclerotic diseases are promising, but benefits remain modest with present cell delivery devices in part due to cell washout and immune attack. Many stem cell effects are believed mediated by paracrine factors (PFs) secreted by the stem cells which potentiate tissue repair via activation and enhancement of intrinsic host repair mechanisms We therefore sought to create an "intravascular paracrine factor factory" by harnessing stem cells on a stent using a nanofiber (NF) stent sleeve, and thus providing a sheltered milieu for cells to continuously produce PFs on-stent. The NF sleeve acts as a substrate on which stem cells grow, and as a semi-permeable barrier that protects cells from washout and host immune response while allowing free outward passage of PFs. NF stent sleeves were created by covering stents with electrospun poly-lactic-co-glycolic acid nanofibers and were then uniformly coated with mesenchymal stem cells (MSCs). NF sleeves blocked cell passage but did not hamper MSC attachment or proliferation, and did not alter MSC morphology or surface markers. NF sleeve MSCs continued to secrete PFs that were biologically active and successfully induced tubulogenesis in human endothelial cells. NF stent sleeves seeded with allogeneic MSCs implanted in pigs remained patent at 7 days without thrombotic occlusion or immune rejection. Our results demonstrate the feasibility of creating an intravascular PF factory using a stem cell impregnated NF stent sleeve, and pave the way for animal studies to assess the efficacy of local PF production to treat ischemic artery disease. PMID:25818438

  13. Lack of plasma albumin impairs intravascular lipolysis and explains the associated free fatty acids deficiency and hypertriglyceridemia

    Oliveira Helena CF

    2010-12-01

    Full Text Available Abstract Background Abnormalities in lipid metabolism and transport are hallmarks in analbuminemic Nagase rats (NAR and humans. Triglyceridemia is nearly 3- to 5-fold higher in female NAR than in control Sprague-Dawley rats (SDR. Also, NAR present with a severe plasma free fatty acid (FFA deficit. There are conflicting results regarding the mechanisms underlying NAR hypertriglyceridemia. Objective We aimed at investigating whether liver lipogenesis and triglyceride secretion rates into the plasma contribute to the hypertriglyceridemia in NAR. We also studied whether heparin or albumin administration would release the hypothesized lipolysis inhibition in NAR. Methods The incorporation of tritiated water into lipids and the linear accumulation rate of plasma triglycerides after Triton WR1339 injection were the measures of liver lipogenesis and triglyceride secretion rates. Results Lipogenesis (596 ± 40 vs. 929 ± 124 μmol 3H2O/g/h and triglyceride (4.25 ± 1.00 vs. 7.04 ± 1.68 mg/dL/min secretion rates were slower (P ≤ 0.05 in fasted NAR than in control SDR. The injection of either heparin or albumin elicited an increase in NAR plasma FFA levels over time. FFA levels reached control levels 90 min after the albumin administration, increasing from 0.36 ± 0.05 to 1.34 ± 0.16 mEq/L (P ≤ 0.05. These results indicate that the lack of plasma albumin inhibits intravascular lipolysis and causes the FFA deficit observed in NAR. Conclusion NAR hepatic triglyceride synthesis and output do not contribute to NAR hypertriglyceridemia. We propose that the lack of albumin diminishes intravascular lipolysis which reduces the plasma triglyceride removal rate and explain both NAR hypertriglyceridemia and FFA deficiency.

  14. Long-term complete remission in a patient with intravascular large B-cell lymphoma with central nervous system involvement

    Sawada T

    2014-11-01

    Full Text Available Takeshi Sawada,1 Yasushi Omuro,1 Takeshi Kobayashi,2 Tunekazu Hishima,3 Fumiaki Koizumi,4 Yusuke Kanemasa,1 Tatsu Shimoyama,1 Eisaku Sasaki,1 Yoshiharu Maeda1 1Department of Chemotherapy, 2Department of Hematology, 3Department of Pathology, 4Department of Laboratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-ku, Tokyo, Japan Abstract: This report describes a patient with intravascular large B-cell lymphoma (IVLBCL with central nervous system involvement at the time of diagnosis who achieved complete remission for over 5 years in response to therapy. The patient, a 71 year-old woman, was previously healthy with the exception of taking verapamil for paroxysmal supraventricular tachycardia. She had presented with pyrexia and gradually progressive anemia. Brain magnetic resonance imaging revealed an infarct-like lesion in the pons, although no paralysis was observed. She was diagnosed with IVLBCL on the basis of random skin biopsy. After eight cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, abnormal laboratory data had normalized, and no pontine lesion was evident on magnetic resonance imaging without receiving any intrathecal chemotherapy. IVLBCL is associated with poor prognosis, particularly in patients with central nervous system involvement. Early initiation of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone therapy and drug interactions between anticancer agents and verapamil as a p-glycoprotein inhibitor were considered the possible reasons for favorable outcome in the present case. Keywords: intravascular large B-cell lymphoma, random skin biopsy, CNS involvement, rituximab, verapamil, blood–brain barrier

  15. Metabolismo oxidativo dos neutrófilos de ovinos tratados com monensina sódica e experimentalmente submetidos à acidose ruminal

    Afonso José Augusto B.; Ciarlini Paulo C; Kuchembuck Márcio R.G.; Kohayagawa Aguemi; Feltrin Lúcia P.Z.; Ciarlini Luciana D.R. Pinoti; Laposy Cecília B.; Mendonça Carla L.; Takahira Regina K.

    2002-01-01

    A acidose láctica ruminal é causada pela ingestão excessiva de carboidratos de fermentação rápida sem uma prévia adaptação dos mocroorganismos, podendo com isso gerar distúrbios metabólicos graves aos ruminantes. Este trabalho tem por objetivo estudar o metabolismo oxidativo dos neutrófilos em ovinos tratados com a monensina sódica na acidose láctica ruminal induzida experimentalmente. Foram empregados 18 ovinos, machos, mestiços (Ideal x Merino), fistulados no rúmen; dos quais nove receberam...

  16. Los mecanismos de control de la aplicación y del cumplimiento de los tratados internacionales multilaterales de protección del medio ambiente

    Borràs Pentinat, Susana

    2007-01-01

    LOS MECANISMOS DE CONTROL DE LA APLICACIÓN Y DEL CUMPLIMIENTO DE LOS TRATADOS INTERNACIONALES MULTILATERALES DE PROTECCIÓN DEL MEDIO AMBIENTETesis presentada para aspirar al título de Doctor/a en Derecho por:Susana BORRÀS PENTINATRealizada bajo la dirección del Dr. Antoni Pigrau SoléCatedrático de Derecho Internacional Público yRelaciones Internacionales 2007Abstract:The PhD thesis, entitled "Control Mechanisms on the implementation and compliance with Multilateral Environmental Treaties",con...

  17. Cambios en la vía aérea superior en pacientes adultos tratados con ortodoncia con exodoncias de 4 premolares

    Riera Seguí, María

    2014-01-01

    El objetivo de este estudio fue investigar los cambios que se producen en las dimensiones de la vía aérea superior en pacientes tratados con o sin exodoncias utilizando mínimo y máximo anclaje. Se seleccionaron telerradiografías laterales de cráneo de 24 pacientes con Clase I, con discrepancia óseo-dentaria severa o con biprotrusión, y fueron divididos en tres grupos (cada uno de ellos formado por 3 hombres y 5 mujeres) según el tratamiento recibido: grupo 1- ocho pacientes tra...

  18. Fortalecimiento de la gestión ambiental para cumplimiento de compromisos ambientales en acuerdos multilaterales y tratados de libre comercio

    Jorge Quiroz

    2006-01-01

    Este estudio tuvo por objetivo principal realizar una revisión integral de un subconjunto de los acuerdos multilaterales ambientales (AMUMAs) y tratados de libre comercio (TLCs) ratificados por Chile. El énfasis del análisis estuvo en el grado de cumplimiento de los mismos y su efecto potencial sobre el mix exportador de Chile. Asimismo, interesaba conocer qué aspectos de políticas públicas pueden ser reforzados, precisamente a efectos de suavizar y mitigar el potencial impacto negativo que e...

  19. Los tratados ejecutivos en la doctrina argentina. Un recorrido a través de tres aportes doctrinarios clásicos

    Torres, Miguel Agustín

    2015-01-01

    La conclusión de tratados internacionales sin la intervención del Poder Legislativo Nacional constituye una práctica instalada en la política exterior del Estado argentino. Sin embargo a pesar de esta tendencia, el sistema jurídico argentino no ofrece referencias constitucionales precisas y específicas que contemplen esta modalidad de convenios de procedimiento abreviado. Por tal razón, el esclarecimiento de los efectos legales y la compatibilidad constitucional de esta clase d...

  20. LOS DERECHOS ESENCIALES O HUMANOS CONTENIDOS EN LOS TRATADOS INTERNACIONALES Y SU UBICACIÓN EN EL ORDENAMIENTO JURÍDICO NACIONAL: DOCTRINA Y JURISPRUDENCIA

    Humberto Nogueira Alcalá

    2003-01-01

    El presente artículo analiza la posición de los derechos humanos o fundamentales en el ordenamiento jurídico chileno, teniendo en consideración para ello el derecho constitucional positivo chileno y comparado, los tratados que contienen derechos esenciales ratificados por Chile y vigentes, la doctrina nacional y comparada, la jurisprudencia nacional, comparada e internacional. El artículo realiza un análisis crítico de la jurisprudencia nacional y plantea reformas necesarias para otorgar segu...

  1. Habla escénica en España : el siglo XIX y los tratados de declamación

    Varona Peña, Antonio

    2015-01-01

    Resumen: Esta tesis ha permitido conocer la parte de la educación teatral vinculada al Habla Escénica (un arte con principios, procesos y reglas), sus contenidos, los métodos didácticos, y las formulaciones disciplinares progresivamente emancipadas de la retórica, la oratoria, el canto, y las tradiciones de la declamación. Presenta un estudio de la voz y el habla a través de los manuales y tratados de declamación del siglo XIX en España. Pone la atención en el papel de esta disciplina...

  2. Evolución clínica de pacientes tratados con factor de transferencia Clinical evolution of patients treated with transfer factor

    María Aida Cruz Barrios; Blanca Nieves Rodríguez Montiel; Juan Antonio Furones Mourelle; Elisa Pérez Barrera; Alberto C Morris Abella; Santos Huete Ferreira

    2004-01-01

    La efectividad del factor de transferencia no ha sido evaluada en investigaciones poscomercialización. Realizamos un estudio transversal y descriptivo en 9 hospitales de Ciudad de La Habana, desde abril del 2001 hasta abril del 2002, para evaluar la evolución clínica de 280 pacientes tratados con este inmunoestimulante. Se midió el número de recurrencias de la enfermedad presentadas un año antes y las observadas un año después del tratamiento. Además, se obtuvo información sobre esquema terap...

  3. Estudio sobre la evolución de la atrofia retiniana en pacientes con coriorretinopatía serosa central tratados con terapia fotodinámica

    Sierra Rodríguez, María Ángeles

    2015-01-01

    Estudio sobre la evolución de la atrofia retiniana en pacientes con coriorretinopatía serosa central tratados con terapia fotodinámica. Quermos demostrar la correlación entre la atrofia retiniana posterior al tratamiento de la coriorretinopatía serosa central (CSC) con terapia fotodinámica (TFD) con verteporfina y los distintos factores asociados: edad del paciente, tiempo transcurrido desde el diagnóstico, dosis de verteporfina empleada, número de sesiones necesarias para la completa reab...

  4. ALTERAÇÕES ELETROQUÍMICAS E DINÂMICA DE NUTRIENTES NA SOLUÇÃO DO SOLO EM ARROZ IRRIGADO COM LIXIVIADO INDUSTRIAL TRATADO

    Filipe Selau Carlos

    2015-04-01

    Full Text Available A utilização de efluentes industriais tratados na irrigação do arroz por alagamento pode provocar alterações eletroquímicas e aumentar o teor de nutrientes na solução do solo. Para testar essa hipótese, este trabalho teve por objetivo avaliar a dinâmica dos atributos químicos e eletroquímicos da solução do solo sob cultivo de arroz irrigado com lixiviado industrial tratado, contendo 820 mg L-1 de Na. O experimento foi conduzido em casa de vegetação, utilizando-se como unidades experimentais vasos preenchidos com 20 kg de solo, em delineamento experimental em blocos casualizados, com três repetições. Os tratamentos foram: controle (irrigação com água destilada e quatro proporções do lixiviado (25, 50, 75 e 100 %. As coletas de solução do solo foram feitas semanalmente a partir do quarto dia após o início do alagamento (DAA até 84 DAA. A solução do solo foi amostrada na profundidade de 10 cm e analisada para os principais nutrientes e o Na, bem como para a demanda bioquímica de oxigênio (DBO5, relação de adsorção de sódio (RAS, condutividade elétrica (CE e potencial redox (EH. A irrigação com o lixiviado aumentou os teores de K, Ca, Mg, S, P, N-NH+4, N-NO−3 e Na, assim como os valores de RAS e CE, para valores considerados prejudiciais para as plantas. Foi observada diminuição do potencial redox na solução do solo pela irrigação com lixiviado industrial tratado. Os teores de DBO5 e o N-NH+4 diminuíram com o tempo de alagamento. Em proporções menores que 25 %, o lixiviado industrial tratado pode aumentar os teores de nutrientes em solução sem causar interferência do Na para as plantas.

  5. Variables predictoras del rechazo, abandono y fracaso terapéutico en hombres violentos contra su pareja tratados psicológicamente en un marco comunitario

    Enrique Echeburúa; Belén Sarasua; Irene Zubizarreta; Pedro J. Amor; Paz de Corral

    2010-01-01

    El objetivo de este estudio ex post facto fue determinar las variables predictoras del rechazo, abandono y fracaso terapéutico en hombres maltratadores tratados psicológicamente de forma voluntaria en un marco comunitario. La muestra constó de 451 sujetos que habían acudido en busca de tratamiento psicológico en los últimos diez años (1997-2007). La terapia ofrecida fue un programa estructurado cognitivo-conductual de veinte sesiones en un formato individual. Según el análisis de regresión lo...

  6. La concepción del sujeto en los tratados de DD. HH. : Implicancias para la psicología en el ámbito forense

    Angelini, Silvio O.

    2009-01-01

    El presente trabajo tiene por objetivo reflexionar sobre la concepción de sujeto que plantean los tratados internacionales de derechos humanos, el nuevo marco filosófico sobre el que se sustenta dicha concepción y las consecuencias que ello tiene para el ejercicio profesional de la psicología en el ámbito forense en particular. A los fines operativos se analizaron algunos que han sido sancionados por las NN.UU. y ratificados o en proceso de ratificación por la República Argentina.

  7. Remoción de color de lixiviados tratados biólogicamente mediante oxidación con permanganato de potasio

    Bastidas, Mónica Lorena; Castro Gómez, Julio Andrés

    2004-01-01

    En el presente trabajo se estudió la oxidación química con permanganato de potasio y un oxidante a base de manganato de nombre comercial manhídrox, del lixiviado tratado previamente en un reactor biológico anaerobio de flujo ascendente (UASB) en el Relleno Sanitario La Esmeralda, con el propósito central de remover el color de dichas aguas residuales y observar el efecto en la remoción de turbiedad, DQO y DBO5. Los ensayos realizados mostraron que el permanganato de potasio es más efectivo, c...

  8. CONTENIDO DE FENOLES TOTALES EN FRUTOS DE MANGO ′SUPER HADEN′ DAÑADOS POR ANTRACNOSIS Y TRATADOS EN POSCOSECHA

    Akira Pérez Márquez; Yamile Vidal Aguiar; Tania Mulkay Vitón

    2016-01-01

    El contenido de fenoles totales en el exocarpio de los frutos tiene relación con los mecanismos de defensa propios del fruto frente al ataque por patógenos fúngicos. Colletotrichum gloeosporioides (Penz.) Penz. & Sacc. es causante de la antracnosis en el mango (Mangifera indica L.) y ocasiona elevadas pérdidas en poscosecha. El objetivo de este trabajo fue evaluar el contenido de fenoles totales en frutos de mango ‘Super Haden’ dañados y tratados en poscosecha y evi...

  9. El Tratado de Lisboa. ¿Un paso adelante hacia la “parlamentarización” de la Unión Europea?

    Claudia Storini

    2012-06-01

    Full Text Available La interconexión y dependencia recíproca entre Derecho Comunitario y Constituciones nacionales están aceptadas en la actualidad como un lugar común en el Derecho Público europeo, resultando casi explícitas en conceptos ya acuñados como el de multilevel constítutíonalism de Pernice o el “constitucionalismo dual” de von Bogdandy. Este artículo se detiene en el análisis de las influencias y del complejo juego de relaciones entre Parlamentos Nacionales y Unión Europea, enmarcándose claramente en el nuevo constitucionalismo europeo “multinivel”. A la luz del tratado de Lisboa analiza la interdependencia entre Derecho Comunitario y Derechos nacionales en materia parlamentaria. Se adentra en el papel que los Parlamentos nacionales pueden y deben representar en el proceso de integración europea así como en la búsqueda de su mayor democratización y ofrece los elementos necesarios para valorar jurídicamente en qué medida el Tratado de Lisboa representa un paso adelante hacia la “parlamentarización” de la Unión Europea.

  10. Adsorção de ácidos húmicos em latossolo roxo natural e tratado com oxalato de amônio

    D. P. Dick

    2000-06-01

    Full Text Available A interação de substâncias húmicas com minerais no solo pode influir na dinâmica da decomposição da matéria orgânica e na sua estabilidade. A adsorção de dois ácidos húmicos em Latossolo Roxo natural (LR natural e tratado com oxalato de amônio (LR tratado foi efetuada, com vistas em investigar os mecanismos de adsorção e os principais grupos funcionais envolvidos, bem como relacionar a capacidade adsortiva de acordo com as características químicas e moleculares dos adsorbatos. Os ácidos húmicos extraídos com solução de NaOH 0,5 N de uma amostra de carvão (AHc e de um solo Brunizém (AHs foram caracterizados por análise elementar e espectroscopia de 13C-RMN. A parametrização dos dados experimentais das isotermas de adsorção foi do tipo y = A tanh Bx, e o modelo de Langmuir também foi aplicado. As amostras adsorvidas foram analisadas por espectroscopia no Infra-Vermelho por Reflectância Difusa com Transformada de Fourier (DRIFT. A adsorção dos ácidos húmicos no LR natural foi de natureza química, sendo evidenciado por DRIFT que a reação de troca de ligantes das carboxilas com a superfície dos minerais foi um mecanismo importante. O AHc, que apresentou caráter aromático mais elevado e maior teor de carboxilas na molécula, foi adsorvido em maior quantidade do que o AHs nos dois adsorventes, o que indica a possível participação de estruturas aromáticas na interação organomineral. No LR tratado, cuja área superficial específica foi superior (ASE = 140,9 m² g-1, a adsorção foi mais elevada do que no LR natural (ASE = 66,1 m² g-1. A maior ASE no LR tratado foi relacionada com o rompimento de microagregados no tratamento com oxalato de amônio que extraiu a porção cimentante dos óxidos de ferro que unia os minerais. A interação neste tipo de adsorvente, estimada segundo a equação y = A tanh Bx, foi mais forte do que na amostra natural, o que pode estar relacionado com a presença de sítios de

  11. Linfoma no Hodgkin centrofacial relacionado a VIH: Reporte de un caso y revisión de la literatura HIV-related centrofacial non-hodgkin lymphoma: Case report and literature review

    Karla Gabriela Ocampo-García

    2012-06-01

    Full Text Available El linfoma no Hodgkin (LNH ocupa el segundo lugar en frecuencia entre las neoplasias vinculadas con el sida, los senos maxilares, la cavidad nasal y el seno etmoidal son los sitios más comunes (33%. Aproximadamente el 3% de los casos definidos como sida presentan LNH en el inicio del curso de infección por VIH. Los LNH parecen el resultado de una proliferación incontrolada de precursores linfoides inmaduros que han perdido la capacidad de diferenciarse y que se acumulan progresivamente en el huésped. La mayoría de pacientes tienen conteo relativamente bajo de células CD4 (100-200 células/mm3. El VIH generalmente infecta a los linfocitos T, cuya pérdida de la función reguladora lleva a una hipergamaglobulinemia e hiperplasia policlonal de células B. El tratamiento de los LNH de cabeza y cuello normalmente consiste en radioterapia, quimioterapia y cirugía o una combinación de éstas. Cuando existen lesiones primarias en tejidos blandos orales, son generalmente asintomáticas, de carácter relativamente blando, aparecen como un aumento de volumen difuso y afectan principalmente mucosa yugal, encía y porción posterior del paladar duro.Non-Hodgkin lymphoma (NHL is the second most common AIDS-related malignancy. The maxillary sinuses, nasal cavity and ethmoid sinus are the most common sites of NHL (33%. In about 3% of cases defined as AIDS, NHL is present at the start of the course of HIV infection. NHL seems to result from uncontrolled proliferation of immature lymphoid precursors that have lost the ability to differentiate and thus accumulate progressively in the host. Most patients have a relatively low CD4 cell count (100-200 cells/mm3. HIV often infects T lymphocytes and the loss of T-cell regulatory function leads to hypergammaglobulinemia and polyclonal B-cell hyperplasia The treatment of head and neck NHL usually involves radiation, chemotherapy and surgery or a combination thereof. Primary NHL lesions in the oral soft tissues

  12. Qualidade seminal e histomorfometria dos órgãos reprodutivos de ovinos tratados com fluoreto de sódio Seminal quality and reproductive histomorphometry of ram lambs treated with sodium fluoride

    Andreane Filappi; Danívia Prestes; Ricardo Rocha; Deila Rosely Schosller; Carlos Bondan; José Francisco Bragança; Marcelo Cecim

    2008-01-01

    O presente estudo objetivou avaliar as características espermáticas, os indicadores do metabolismo oxidativo do sêmen, o diâmetro dos túbulos seminíferos e a altura do epitélio testicular, do epididimário e do canal deferente de ovinos tratados com fluoreto de sódio. Foram utilizados 12 ovinos, com idade aproximada de cinco meses. Os animais foram divididos em grupo controle, o qual recebeu diariamente sal iodado (5g de NaCl animal-1 + 0,2mg I kg-1 matéria seca), e tratado, que recebeu sal io...

  13. Comportamiento detersivo de las formulaciones ecológicas en la extracción de grasas y proteínas en tejido de algodón aprestado y tratado con diversos suavizantes

    Carrión Fité, Francisco Javier; Serra Gasol, Miquel

    2002-01-01

    En el presente trabajo se efectuó un estudio del comportamiento detersivo producido por una formulación ecológica, aplicada para el lavado de un tejido de algodón aprestado con una resina DMDHEU y tratado con diferentes suavizantes catiónicos, del tipo de amonio silicona y esterquat. A estos tejidos se aplicaron, antes del lavado, dos impurezas del tipo proteína y una tipo aceitosa. Los efectos del detergente, en la extracción de tales impurezas del tejido aprestado y tratado con los diferent...

  14. Linfoma cutâneo primário de grandes células B de apresentação atípica: relato de caso Primary cutaneous large B-cell lymphoma of atypical presentation: case report

    Antônio René Diógenes de Sousa

    2011-06-01

    Full Text Available Linfomas cutâneos primários são definidos como neoplasias linfocíticas que se apresentam clinicamente na pele sem doença extracutânea no momento do diagnóstico e até por 6 meses após. Os autores relatam o caso de um paciente masculino, idoso, com história de pápulas em axila, há 3 meses, que evoluíram para ulceração. Ao exame, úlcera profunda de bordos irregulares, infiltrados, em axila direita. Exames físico e complementares não evidenciaram doença à distância. O histopatológico mostra infiltrado dérmico denso e difuso de linfócitos atípicos. A imuno-histoquímica evidencia expressão de antígenos CD20 e bcl-2, com CD10 negativo, configurando diagnóstico de linfoma cutâneo difuso de grandes células B. Neste tipo de linfoma, é rara a manifestação cutânea primária, assim como a incidência é menor em homens e a localização, mais comum em membros inferioresPrimary cutaneous lymphomas are defined as lymphocytic neoplasias that present themselves clinically in the skin without extracutaneous disease at diagnosis and up to 6 months after it. The authors report the case of an elderly male patient, with a three- month-history of papules in the axilla which evolved into painful ulceration. Examination found deep ulcer with irregular borders ,infiltrates, in the right axilla. Physical and additional examinations did not evidence disease at distance. Histopathology revealed dense and diffuse dermic sample infiltrate of atypical lymphocytes. Imunohistochemistry shows expression of CD20 and bcl-2 antigens , with negative CD10, configuring diagnosis of cutaneous large B-cell lymphoma. In this type of cutaneous lymphoma, primary cutaneous manifestation is rare ,the incidence in men is lower and it is most commonly located in the lower limbs

  15. Relation between plaque type, plaque thickness, blood shear stress, and plaque stress in coronary arteries assessed by X-ray Angiography and Intravascular Ultrasound

    Balocco, Simone; Gatta, Carlo; Alberti, Marina; Carrillo, Xavier; Rigla, Juan; Radeva, Petia

    2012-01-01

    Purpose: Atheromatic plaque progression is affected, among others phenomena, by biomechanical, biochemical, and physiological factors. In this paper, the authors introduce a novel framework able to provide both morphological (vessel radius, plaque thickness, and type) and biomechanical (wall shear stress and Von Mises stress) indices of coronary arteries. Methods: First, the approach reconstructs the three-dimensional morphology of the vessel from intravascular ultrasound(IVUS) and Angiograph...

  16. Usefulness of circulating vascular endothelial growth factor and neutrophil elastase as diagnostic markers of disseminated intravascular coagulation in non-cancer patients

    Joo, Shin Young; Kim, Ji-Eun; Kim, Ju Young; Han, Kyou-Sup; Kim, Hyun Kyung

    2010-01-01

    Background Disseminated intravascular coagulation (DIC) is characterized by platelet and neutrophil activation. Platelets are the major source of circulating vascular endothelial growth factor (VEGF). Endostatin, an anti-angiogenic factor, is a fragment of collagen that is released from the extracellular matrix via the active cleavage of neutrophil elastase, thereby increasing the circulating level of endostatin. Hypercoagulable conditions such as DIC may induce the release of VEGF and neutro...

  17. Site requirements and kinetics of immune-dependent elimination of intravascularly administered lung stage schistosomula in mice immunized with highly irradiated cercariae of Schistosoma mansoni

    Experiments were performed to compare the migration and survival of 75Se-labeled schistosomes, introduced by percutaneous cercarial exposure or by intravascular administration of 7-day-old lung stage schistosomula, in control and irradiated cercaria-immunized mice. Schistosomula were intravascularly introduced into the lungs, systemic organs and liver by injection via the femoral vein (FV), left ventricle (LV), and superior mesenteric vein (SMV), respectively. The fate of challenge larvae was examined by autoradiography of host tissues and by recovery of adult worms. It was found that both normal and immune elimination were site-dependent. In control mice 45%-60% of cercarial penetrants and lung schistosomula injected into the FV and LV were recoverable as adult worms, while a significantly greater number (70%-85%) were recoverable when lung schistosomula were injected into the SMV. In immunized mice, parasites introduced as either cercariae or FV-injected schistosomula were both highly sensitive to immune elimination. LV-injected schistosomula were also sensitive but to a slightly lesser degree. In contrast, schistosomula placed directly in the liver by SMV injection were totally insensitive to immune elimination. It was concluded that elimination of schistosomula in irradiated cercaria-immunized mice occurs in the lungs and/or in the systemic organs, but not in the liver. Also, it was concluded that immune elimination is not a rapid process, since more than 7 days were required after intravascular challenge for the development of demonstrable differences between control and immunized mice

  18. Site requirements and kinetics of immune-dependent elimination of intravascularly administered lung stage schistosomula in mice immunized with highly irradiated cercariae of Schistosoma mansoni

    Mangold, B.L.; Dean, D.A.; Coulson, P.S.; Wilson, R.A.

    1986-03-01

    Experiments were performed to compare the migration and survival of 75Se-labeled schistosomes, introduced by percutaneous cercarial exposure or by intravascular administration of 7-day-old lung stage schistosomula, in control and irradiated cercaria-immunized mice. Schistosomula were intravascularly introduced into the lungs, systemic organs and liver by injection via the femoral vein (FV), left ventricle (LV), and superior mesenteric vein (SMV), respectively. The fate of challenge larvae was examined by autoradiography of host tissues and by recovery of adult worms. It was found that both normal and immune elimination were site-dependent. In control mice 45%-60% of cercarial penetrants and lung schistosomula injected into the FV and LV were recoverable as adult worms, while a significantly greater number (70%-85%) were recoverable when lung schistosomula were injected into the SMV. In immunized mice, parasites introduced as either cercariae or FV-injected schistosomula were both highly sensitive to immune elimination. LV-injected schistosomula were also sensitive but to a slightly lesser degree. In contrast, schistosomula placed directly in the liver by SMV injection were totally insensitive to immune elimination. It was concluded that elimination of schistosomula in irradiated cercaria-immunized mice occurs in the lungs and/or in the systemic organs, but not in the liver. Also, it was concluded that immune elimination is not a rapid process, since more than 7 days were required after intravascular challenge for the development of demonstrable differences between control and immunized mice.

  19. In Vitro Approach for Identification of the Most Effective Agents for Antimicrobial Lock Therapy in the Treatment of Intravascular Catheter-Related Infections Caused by Staphylococcus aureus.

    Hogan, S; Zapotoczna, M; Stevens, N T; Humphreys, H; O'Gara, J P; O'Neill, E

    2016-05-01

    Infection of intravascular catheters by Staphylococcus aureus is a significant risk factor within the health care setting. To treat these infections and attempt salvage of an intravascular catheter, antimicrobial lock solutions (ALSs) are being increasingly used. However, the most effective ALSs against these biofilm-mediated infections have yet to be determined, and clinical practice varies greatly. The purpose of this study was to evaluate and compare the efficacies of antibiotics and antiseptics in current clinical use against biofilms produced by reference and clinical isolates of S. aureus Static and flow biofilm assays were developed using newly described in vivo-relevant conditions to examine the effect of each agent on S. aureus within the biofilm matrix. The antibiotics daptomycin, tigecycline, and rifampin and the antiseptics ethanol and Taurolock inactivated established S. aureus biofilms, while other commonly used antistaphylococcal antibiotics and antiseptic agents were less effective. These findings were confirmed by live/dead staining of S. aureus biofilms formed and treated within a flow cell model. The results from this study demonstrate the most effective clinically used agents and their concentrations which should be used within an ALS to treat S. aureus-mediated intravascular catheter-related infections. PMID:26926633

  20. El Camino de Paikín: un acercamiento a los grupos mocoví del Chaco a través del tratado de 1774

    Florencia Nesis

    2008-07-01

    Full Text Available En 1774 y dentro de un programa que intentaba establecer paces con los grupos indígenas del Chaco se produjo el encuentro entre Jerónimo Matorras, gobernador del Tucumán y Paikín, líder Mocoví. Este encuentro, que tuvo lugar dentro del territorio chaqueño, dio lugar a la firma de un tratado que buscaba regular las relaciones entre ciertos grupos indígenas y el sector colonial La publicación de este tratado en varias obras de recopilación desde principios del siglo XX ayudó a crear una imagen acerca del comienzo del dominio político y territorial de los indígenas por parte de la sociedad hispanocriolla. En el presente trabajo proponemos releer el tratado de 1774 dentro del conjunto mayor de fuentes que se produjeron en torno a estas negociaciones para adentrarnos en las estrategias y prácticas políticas desplegadas, la modificación de las relaciones de alianza y enemistad y las condiciones de posibilidad de acción de cada uno de los sectores implicados.In 1774, in a program that tended to make peace with the Chaco aboriginal groups, a meeting was held between Jerónimo Matorras, governor of Tucumán, and Paikín, mocoví leader. This meeting, that took place inside the indigenous territory, gave rise to a treaty that looked to regulate different aspects of the interethnic relationships. The diffusion of this treaty in several compilation publications since the beginning of the XX century helped to create a concept of the colonial political and territorial domain over the indigenous groups. In this paper we propose to rethink the 1774 treaty putting it in relation with other documents that were also made on the basis of these negotiations. Through this analysis, we expect to delve into the political strategy, the change in the relationships of friendship and enmity between the indigenous groups and different colonial agents, and the action possibilities of each one.

  1. Prevalência de alta reatividade plaquetária em pacientes tratados com aspirina encaminhados para angiografia coronária

    André Manica

    2013-01-01

    Full Text Available FUNDAMENTO: A aspirina (Ácido Acetilsalicílico - AAS é capaz de reduzir eventos adversos cardiovasculares em pacientes portadores de Doença Arterial Coronariana (DAC através da inibição da atividade plaquetária. Alguns pacientes com DAC, apesar da terapia com AAS, apresentam Alta Reatividade Plaquetária (ARP, o que determina um maior risco para o desenvolvimento de eventos cardiovasculares. OBJETIVO: O objetivo deste estudo foi determinar a prevalência de ARP em pacientes tratados com AAS e encaminhados para cinecoronariografia, além de avaliar se existe uma possível correlação entre a gravidade da DAC e o desenvolvimento de ARP. MÉTODOS: Estudo de centro único onde foram incluídos 115 pacientes consecutivos, tratados com AAS e portadores de DAC estável. A reatividade plaquetária induzida pelo ADP e colágeno foram avaliadas através da Agregometria de Transmitância Luminosa (ATL. Pacientes com agregação plaquetária maior que 70%, induzida por ambos os reagentes, foram classificados como tendo ARP e, neste grupo, a adesão ao tratamento com AAS foi avaliada através da dosagem dos níveis séricos de salicilato. RESULTADOS: A média de idade foi de 60,9 anos e a dose média de AAS foi de 164,2 mg. Tabagismo e diabetes melito estavam presentes em 28,7% e 31,5% dos pacientes, respectivamente. Foi encontrada ARP em 14 pacientes (13%, entretanto, em sete indivíduos (50% com ARP observaram-se baixos níveis séricos de salicilato (< 2,0 µg/mL, sugerindo não adesão à terapia medicamentosa. Em 6,5% dos pacientes com ARP identificou-se níveis detectáveis de salicilato sérico, sugerindo uma eficácia reduzida do AAS. A ARP se correlacionou com o número e a gravidade das estenoses coronárias (p = 0,04. CONCLUSÃO: Em uma população de pacientes tratados com AAS e encaminhados para angiografia coronária, a reatividade plaquetária elevada é prevalente (13%, sendo 50% destes pacientes não aderentes à terapia farmacol

  2. Clinical feasibility of 3D automated coronary atherosclerotic plaque quantification algorithm on coronary computed tomography angiography: Comparison with intravascular ultrasound

    To evaluate the diagnostic performance of automated coronary atherosclerotic plaque quantification (QCT) by different users (expert/non-expert/automatic). One hundred fifty coronary artery segments from 142 patients who underwent coronary computed tomography angiography (CCTA) and intravascular ultrasound (IVUS) were analyzed. Minimal lumen area (MLA), maximal lumen area stenosis percentage (%AS), mean plaque burden percentage (%PB), and plaque volume were measured semi-automatically by expert, non-expert, and fully automatic QCT analyses, and then compared to IVUS. Between IVUS and expert QCT analysis, the correlation coefficients (r) for the MLA, %AS, %PB, and plaque volume were excellent: 0.89 (p < 0.001), 0.84 (p < 0.001), 0.91 (p < 0.001), and 0.94 (p < 0.001), respectively. There were no significant differences in the mean parameters (all p values >0.05) except %AS (p = 0.01). The automatic QCT analysis showed comparable performance to non-expert QCT analysis, showing correlation coefficients (r) of the MLA (0.80 vs. 0.82), %AS (0.82 vs. 0.80), %PB (0.84 vs. 0.73), and plaque volume (0.84 vs. 0.79) when they were compared to IVUS, respectively. Fully automatic QCT analysis showed clinical utility compared with IVUS, as well as a compelling performance when compared with semiautomatic analyses. (orig.)

  3. Renal small B-cell lymphoma with plasmacytic differentiation presenting with monoclonal gammopathy and disseminated intravascular coagulation syndrome

    Paula de Oliveira Pádua Prestes

    2013-10-01

    Full Text Available Primary renal lymphomas are very rare. However, the kidney may be a site of metastasis, usually from a disseminated aggressive lymphoma. A 58-year-old woman was brought to the medical facility due to acute mental confusion, severe hypotension, septic shock, and signs of disseminated intravascular coagulation. Laboratory tests showed severe leukopenia, renal failure, altered liver function, and elevated serum lactate dehydrogenase levels. Protein electrophoresis revealed hypergammaglobulinemia with a monoclonal peak of IgG lambda. The clinical outcome was fulminant and the patient died less than 24 hours after admission. Autopsy revealed an indolent B-cell lymphoma with extensive plasmacytic differentiation infiltrating the right renal sinus and involving the submandibular and sublingual glands, cervical and peri-aortic lymph nodes, multiple microscopic foci in pituitary and adrenal glands, lung, breast, liver, thyroid, and bone marrow. Numerous IgG4-positive plasma cells were detected by immunohistochemistry although other histological features of IgG4-related disease were missing. There was also extensive hemorrhagic necrosis of the adrenal glands and purulent cystitis, which was probably responsible for the septic shock. The authors concluded that the kidney was most likely the primary site of the indolent lymphoma, as that was the site with the largest tumor mass. Infiltration of other organs was considered as dissemination of the disease. The differential diagnosis with mucosa-associated lymphoid tissue and lymphoplasmacytic lymphoma is discussed.

  4. Measurement of the 3D arterial wall strain tensor using intravascular B-mode ultrasound images: a feasibility study

    Liang, Yun; Zhu, Hui; Friedman, Morton H.

    2010-11-01

    Intravascular ultrasound (IVUS) elastography is a promising tool for studying atherosclerotic plaque composition and assessing plaque vulnerability. Current IVUS elastography techniques can measure the 1D or 2D strain of the vessel wall using various motion tracking algorithms. Since biological soft tissue tends to deform non-uniformly in 3D, measurement of the complete 3D strain tensor is desirable for more rigorous analysis of arterial wall mechanics. In this paper, we extend our previously developed method of 2D arterial wall strain measurement based on non-rigid image registration into 3D strain measurement. The new technique registers two image volumes acquired from the same vessel segment under different levels of luminal pressure and longitudinal stress. The 3D displacement field obtained from the image registration is used to calculate the local 3D strain tensor. From the 3D strain tensor, radial, circumferential and longitudinal strain distributions can be obtained and displayed. This strain tensor measurement method is validated and evaluated using IVUS images of healthy porcine carotid arteries subjected to a luminal pressure increase and longitudinal stretch. The ability of the algorithm to overcome systematic noise was tested, as well as the consistency of the results under different longitudinal frame resolutions.

  5. Physics-driven impeller designs for a novel intravascular blood pump for patients with congenital heart disease.

    Chopski, Steven G; Fox, Carson S; McKenna, Kelli L; Riddle, Michelle L; Kafagy, Dhyaa H; Stevens, Randy M; Throckmorton, Amy L

    2016-07-01

    Mechanical circulatory support offers an alternative therapeutic treatment for patients with dysfunctional single ventricle physiology. An intravascular axial flow pump is being developed as a cavopulmonary assist device for these patients. This study details the development of a new rotating impeller geometry. We examined the performance of 8 impeller geometries with blade stagger or twist angles varying from 100° to 800° using computational methods. A refined range of blade twist angles between 300° and 400° was then identified, and 4 additional geometries were evaluated. Generally, the impeller designs produced 4-26mmHg for flow rates of 1-4L/min for 6000-8000 RPM. A data regression analysis was completed and found the impeller with 400° of blade twist to be the superior performer. A hydraulic test was conducted on a prototype of the 400° impeller, which generated measurable pressure rises of 7-28mmHg for flow rates of 1-4L/min at 6000-8000 RPM. The findings of the numerical model and experiment were in reasonable agreement within approximately 20%. These results support the continued development of an axial-flow, mechanical cavopulmonary assist device as a new clinical therapeutic option for Fontan patients. PMID:27129783

  6. Angiographically borderline left main coronary artery lesions: correlation of transthoracic doppler echocardiography and intravascular ultrasound: a pilot study

    Varga Albert

    2011-06-01

    Full Text Available Abstract Background the clinical decision making could be difficult in patients with borderline lesions (visually assessed stenosis severity of 30 to 50% of the left main coronary artery (LM. The aim of the study was to evaluate the relationship between transthoracic Doppler (TTDE peak diastolic flow velocity (PDV and intravascular ultrasound (IVUS measurements in the assessment of angiographically borderline LM lesions. Methods 27 patients (mean age 64 ± 8 years, 21 males with borderline LM stenosis referred for IVUS examination were included in the study. We performed standard IVUS with minimal lumen area (MLA and plaque burden (PB measurement and routine quantitative coronary angiography (QCA with diameter stenosis (%DS and area stenosis (%AS assessment in all. During TTDE, resting PDV was measured in the LM. Results interpretable Doppler signal could be obtained in 24 patients (88% feasibility; therefore these patients entered the final analysis. MLA was 7.1 ± 2.7 mm2. TTDE measured PDV correlated significantly with IVUS-derived MLA (r = -0.46, p 2 LM stenosis. Conclusion In angiographically borderline LM disease, resting PDV from transthoracic echocardiography is increased in presence of increased plaque burden by IVUS. TTDE evaluation might be a useful adjunct to other invasive and non-invasive methods in the assessment of borderline LM lesions. Further, large scale studies are needed to establish the exact cut-off value of PDV for routine clinical application.

  7. Danazol-induced peliosis hepatis accompanied by disseminated intravascular coagulation in a patient with myelodysplastic syndrome transformed from aplastic anemia.

    Tsukamoto, Yasuhiro; Kiyasu, Junichi; Utsunomiya, Hayato; Nakashima, Yasuhiro; Choi, Ilseung; Suehiro, Youko; Aratake, Yoshifusa; Abe, Yasunobu

    2016-08-01

    Peliosis hepatis (PH) is a condition involving benign tumors pathologically characterized by multiple blood-filled cavities, mostly affecting the liver and spleen. Androgenic-steroids are widely used in patients with bone marrow failure syndromes (e.g.: aplastic anemia) and these patients are at increased risk of developing PH. Although patients with PH are generally asymptomatic, PH can progress to liver failure and even fatal spontaneous intraabdominal hemorrhage. Therefore, early diagnosis is critical in order to prevent life-threatening complications of PH. We herein report a patient with PH which had been treated with danazol, who presented with liver dysfunction and multiple hepatic lesions on imaging studies at the time of diagnosis. Although the patient presented with disseminated intravascular coagulation (DIC), a bone marrow biopsy revealed no evidence of leukemic transformation. The patient was diagnosed as having danazol-induced PH, and these abnormalities spontaneously resolved after the discontinuation of danazol. PH is one of the most important complications of long-term administration of androgenic-steroids. Although the mechanisms remain unclear, the multiple blood-filled cavities characteristic of PH may be responsible for the development of DIC. Therefore, monitoring of coagulation markers might also be a key strategy for early diagnosis of PH. PMID:27599419

  8. Acute Onset of Vancomycin Anaphylaxis With Disseminated Intravascular Coagulation in an Orthopedic Patient Despite Prior Repeated Exposure.

    Adams, Brock; Roboubi, Babak; Henshaw, Robert

    2015-12-01

    Vancomycin is a glycopeptide antibiotic that exhibits bactericidal activity against gram-positive cocci. It is commonly recommended for surgical prophylaxis in cases of suspected bacterial resistance or penicillin allergy. There are 2 main types of hypersensitivity reactions associated with vancomycin. Red man syndrome is an anaphylactoid reaction caused by direct release of histamine. The second is an anaphylactic reaction, which is an immunoglobulin E-mediated response. We present the case of a 55-year-old woman with a history of metastatic giant cell tumor of the right proximal tibia. She had undergone multiple surgeries for this and other nonorthopedic conditions. The patient received vancomycin for the majority of these procedures and extended courses of vancomycin on 2 separate occasions. In the present case, the patient was taken to the operating room for a prosthetic infection, and vancomycin was given after cultures were taken. The patient immediately developed signs consistent with anaphylaxis and disseminated intravascular coagulation. This was treated acutely with hemodynamic resuscitation, replacement of blood components, steroids, and repeated boluses of epinephrine. She recovered and was taken back to the operating room during that same admission without incident. The patient has since been treated with systemic daptomycin and a tobramycin cement spacer without further incident. PMID:26665256

  9. The Precise Determination of Vascular Lumen and Stent Diameters: Correlation Among Calibrated Angiography, Intravascular Ultrasound, and Pressure-Fixed Specimens

    Purpose: Luminal diameters measured in vivo by calibrated-catheter angiography and by intravascular ultrasound were correlated with those obtained from pressure-fixed histologic cross-sections to determine the accuracy of both methods. Methods: Angiographic and endosonographic diameter measurements were performed in the center of stents placed in the iliac arteries of 10 miniature pigs and were compared with luminal and stent diameters in postmortem, pressure-fixed, histologic cross-sections from identical locations. Results: Compared with histologic diameters, magnification-corrected angiographic measurements still magnified vascular luminal diameters by 0.7 ± 0.71 mm (r= 0.41, Pearson; p 0.5, Wilcoxon, matched pairs). Similarly, stent diameters correlated well between endosonographic and histologic measurements (r= 0.91; p= 0.002), and less well between angiographic and histologic diameters (r= 0.62; p= 0.002). Conclusion: Since calibrated angiography still overestimates vascular lumina, endosonography is the preferred technique for accurate in vivo measurements

  10. Development of mussel adhesive polypeptide mimics coating for in-situ inducing re-endothelialization of intravascular stent devices.

    Yin, Min; Yuan, Yuan; Liu, Changsheng; Wang, Jing

    2009-05-01

    In this study, to improve the attachment, growth and adhesion of endothelial cells (ECs) and thus accelerate the re-endothelialization of stents, a synthesized mussel adhesive polypeptide mimics containing dihydroxyphenylalanine and L-lysine (MAPDL) was immobilized onto 316L stainless steel (316LSS) with polyethylene glycol (PEG) molecule as spacer arm by using cold plasma-induced grafting technique. To immobilize MAPDL effectively, ethylene vinyl acetate (EVA) was first coated onto 316LSS. Different molecular weights of PEG and grafting times were tested to obtain the optimal cell bioactivity. XPS and water contact angles measurement indicated the successful immobilization of MAPDL. In vitro cell culture results showed that compared with the control of 316LSS, the attachment, adhesion and growth of cells on the MAPDL-coated EVA surface, in particular with PEG as spacer arm, were significantly enhanced, and a confluent endothelial cells layer was formed after a 2-day culture. A platelet adhesion experiment revealed that the platelet adhesion was also reduced on the MAPDL-coated EVA surface. The in vitro inflammatory assessment showed that the MAPDL coating inhibited the TNF-alpha and IL-1beta release from monocyte cells, indicative of good anti-inflammation property. Therefore, it is concluded that the MAPDL coating developed here appeared to be a promising strategy for rapid re-endothelialization of intravascular stent devices. PMID:19223071

  11. Supervised domain adaptation of decision forests: Transfer of models trained in vitro for in vivo intravascular ultrasound tissue characterization.

    Conjeti, Sailesh; Katouzian, Amin; Roy, Abhijit Guha; Peter, Loïc; Sheet, Debdoot; Carlier, Stéphane; Laine, Andrew; Navab, Nassir

    2016-08-01

    In this paper, we propose a supervised domain adaptation (DA) framework for adapting decision forests in the presence of distribution shift between training (source) and testing (target) domains, given few labeled examples. We introduce a novel method for DA through an error-correcting hierarchical transfer relaxation scheme with domain alignment, feature normalization, and leaf posterior reweighting to correct for the distribution shift between the domains. For the first time we apply DA to the challenging problem of extending in vitro trained forests (source domain) for in vivo applications (target domain). The proof-of-concept is provided for in vivo characterization of atherosclerotic tissues using intravascular ultrasound signals, where presence of flowing blood is a source of distribution shift between the two domains. This potentially leads to misclassification upon direct deployment of in vitro trained classifier, thus motivating the need for DA as obtaining reliable in vivo training labels is often challenging if not infeasible. Exhaustive validations and parameter sensitivity analysis substantiate the reliability of the proposed DA framework and demonstrates improved tissue characterization performance for scenarios where adaptation is conducted in presence of only a few examples. The proposed method can thus be leveraged to reduce annotation costs and improve computational efficiency over conventional retraining approaches. PMID:27035487

  12. Developing cross-correlation as a method for microvessel imaging using clinical intravascular optical coherence tomography systems.

    Joseph, Shiju; Adnan, Asif; Subhash, Hrebesh M; Leahy, Martin; Adlam, David

    2015-03-01

    Current clinical intravascular optical coherence tomography (IV-OCT) imaging systems have limited in-vivo flow imaging capability because of non-uniform catheter rotation and inadequate A-line scan density. Thus any flow-localisation method that seeks to identify sites of variation within the OCT image data-sets, whether that is in amplitude or phase, produces non-representative correlation (or variance) maps. In this study, both mean and the variation within a set of cross-correlation maps, for static OCT imaging was used to differentiate flow from nonflow regions. Variation was quantified by use of standard deviation. The advantage of this approach is its ability to image flow, even in the presence of motion artifacts. The ability of this technique to suppress noise and capture flow maps was demonstrated by imaging microflow in an ex-vivo porcine coronary artery model, by nailfold capillary imaging and in-vivo microvessel imaging from within the human coronary sinus. PMID:25798295

  13. Clinical feasibility of 3D automated coronary atherosclerotic plaque quantification algorithm on coronary computed tomography angiography: Comparison with intravascular ultrasound

    Park, Hyung-Bok [Yonsei University Health System, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Seoul (Korea, Republic of); Myongji Hospital, Division of Cardiology, Cardiovascular Center, Goyang (Korea, Republic of); Lee, Byoung Kwon [Yonsei University College of Medicine, Division of Cardiology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Shin, Sanghoon [Yonsei University Health System, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Seoul (Korea, Republic of); National Health Insurance Corporation Ilsan Hospital, Division of Cardiology, Goyang (Korea, Republic of); Heo, Ran; Chang, Hyuk-Jae; Chung, Namsik [Yonsei University Health System, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Seoul (Korea, Republic of); Yonsei University Health System, Division of Cardiology, Severance Cardiovascular Hospital, Seoul (Korea, Republic of); Arsanjani, Reza [Cedars-Sinai Medical Center, Departments of Imaging and Medicine, Cedars-Sinai Heart Institute, Los Angeles, CA (United States); Kitslaar, Pieter H. [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Medis medical Imaging Systems B.V., Leiden (Netherlands); Broersen, Alexander; Dijkstra, Jouke [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Ahn, Sung Gyun [Yonsei University Wonju Severance Christian Hospital, Division of Cardiology, Wonju (Korea, Republic of); Min, James K. [New York-Presbyterian Hospital, Institute for Cardiovascular Imaging, Weill-Cornell Medical College, New York, NY (United States); Hong, Myeong-Ki; Jang, Yangsoo [Yonsei University Health System, Division of Cardiology, Severance Cardiovascular Hospital, Seoul (Korea, Republic of)

    2015-10-15

    To evaluate the diagnostic performance of automated coronary atherosclerotic plaque quantification (QCT) by different users (expert/non-expert/automatic). One hundred fifty coronary artery segments from 142 patients who underwent coronary computed tomography angiography (CCTA) and intravascular ultrasound (IVUS) were analyzed. Minimal lumen area (MLA), maximal lumen area stenosis percentage (%AS), mean plaque burden percentage (%PB), and plaque volume were measured semi-automatically by expert, non-expert, and fully automatic QCT analyses, and then compared to IVUS. Between IVUS and expert QCT analysis, the correlation coefficients (r) for the MLA, %AS, %PB, and plaque volume were excellent: 0.89 (p < 0.001), 0.84 (p < 0.001), 0.91 (p < 0.001), and 0.94 (p < 0.001), respectively. There were no significant differences in the mean parameters (all p values >0.05) except %AS (p = 0.01). The automatic QCT analysis showed comparable performance to non-expert QCT analysis, showing correlation coefficients (r) of the MLA (0.80 vs. 0.82), %AS (0.82 vs. 0.80), %PB (0.84 vs. 0.73), and plaque volume (0.84 vs. 0.79) when they were compared to IVUS, respectively. Fully automatic QCT analysis showed clinical utility compared with IVUS, as well as a compelling performance when compared with semiautomatic analyses. (orig.)

  14. Transjugular intravascular ultrasound for the evaluation of hepatic vasculature and parenchyma in patients with chronic liver disease

    De Gottardi Andrea

    2012-01-01

    Full Text Available Abstract Background The evaluation of the hepatic parenchyma in patients with chronic liver disease is important to assess the extension, localization and relationship with adjacent anatomical structures of possible lesions. This is usually performed with conventional abdominal ultrasound, CT-scan or magnetic resonance imaging. In this context, the feasibility and the safety of intravascular ultrasound in the liver have not been assessed yet. Methods We tested the safety and performance of an intracardiac echography (ICE catheter applied by a transjugular approach into the hepatic veins in patients with chronic liver disease undergoing hepatic hemodynamic measurements. Results Five patients were enrolled in this pilot study. The insertion of the ICE catheter was possible into the right and middle, but not into the left hepatic vein. The position of the ICE was followed using fluoroscopy and external conventional ultrasound. Accurate imaging of focal hepatic parenchymal lesions, Doppler ultrasound of surrounding blood vessels and assessment of liver surface and ascites were achieved without complications. Conclusions This study demonstrated that a diagnostic approach using an ICE device inserted in the hepatic veins is feasible, safe and well tolerated. However, it remains for the moment only an experimental investigative tool. Whether ICE adds further information regarding parenchymal lesions and associated vascular alterations as compared to other techniques, needs additional investigation.

  15. Factors influencing nurses' decision-making process on leaving in the peripheral intravascular catheter after 96 hours: a longitudinal study.

    Palese, Alvisa; Cassone, Andrea; Kulla, Annamaria; Dorigo, Sabrina; Magee, Jesse; Artico, Marco; Camero, Francesco; Cassin, Catia; Cialdella, Sandra; Floridia, Giuseppe; Nadlišek, Boris; Palcic, Annamaria; Valle, Giulia; Sclauzero, Paola

    2011-01-01

    The clinical and research debate on the peripheral intravascular (PIV) catheter length of stay in situ is ongoing. The principal aim of this study was to explore the factors behind a nurse's decision to leave a PIV in place for more than 96 hours. The study focused on 7 northern Italian hospitals in 2009. A consequent sample of 269 PIV catheters was included. Direct observation and interviews were adopted. The time of the expected PIV replacement was fixed at 96 hours after its positioning, in accordance with the international guideline. Several factors were taken into account in regard to replacement of the PIV catheters by nurses, ranging from analysis based on their own clinical experience with PIV complications and analysis of the patient's clinical situation to the critical analysis of their own work situation. This clinical decision-making process is valuable: leaving the PIV in place for more than 96 hours is a complex decision and not simply a guideline violation. PMID:21915006

  16. Aplicação da ressonância magnética de corpo inteiro para o estadiamento e acompanhamento de pacientes com linfoma de Hodgkin na faixa etária infanto-juvenil: comparação entre diferentes sequências

    Daniel Nava

    2011-02-01

    Full Text Available OBJETIVO: Comparar o desempenho das sequências T1, T2, STIR e DWIBS (difusão de corpo inteiro com supressão do sinal de fundo na identificação de sítios caracterizados como acometidos pelo linfoma de Hodgkin nas cadeias linfonodais, órgãos parenquimatosos e medula óssea, e avaliar a concordância entre os examinadores. MATERIAIS E MÉTODOS: Foram estudados 12 pacientes com diagnóstico confirmado de linfoma de Hodgkin. Os pacientes foram encaminhados para o exame de ressonância magnética, sendo realizadas as sequências ponderadas em T1, T2, STIR e DWIBS. RESULTADOS: O número de sítios linfonodais caracterizados como acometidos nas sequências ponderadas em T1 e T2 apresentaram resultados semelhantes (8 sítios, mas inferiores às sequências STIR e DWIBS (11 e 12 sítios, respectivamente. Quanto ao acometimento da medula óssea, observaram-se os mesmos valores para as sequências T1, T2 e DWIBS (17 lesões, superiores ao valor encontrado na sequência STIR (13 lesões. Quando realizada a comparação entre os examinadores, nota-se que há alta concordância entre as quatro sequências. CONCLUSÃO: As sequências STIR e DWIBS detectaram maior número de linfonodos caracterizados como acometidos. Todas as sequências apresentaram resultados semelhantes na avaliação dos órgãos parenquimatosos e medula óssea. Em todas as sequências analisadas houve alta concordância entre os examinadores.

  17. Síndrome de Guillain-Barré: a propósito de 5 casos tratados com ACTH e cortisona

    José Lamartine de Assis

    1953-12-01

    Full Text Available São registrados 5. casos de síndrome de Guillain-Barré (polirradiculoneurite tratados com ACTH ou cortisona. Foi observada melhora rápida em todos êles, em tempo variável de um para outro caso, mas menor que o tempo médio de evolução da moléstia quando tais hormônios não são empregados. Em vista da evolução observada é discutida a teoria da patogenia alérgica da doença e sua inclusão no grupo das doenças desmielinizantes do sistema nervoso.

  18. Biodistribution of samarium-153-EDTMP in rats treated with docetaxel Biodistribuição de EDTMP-153-samário em ratos tratados com docetaxel

    Arthur Villarim Neto

    2009-02-01

    Full Text Available PURPOSE: Many patients with metastatic bone disease have to use radiopharmaceuticals associated with chemotherapy to relieve bone pain. The aim of this study was to assess the influence of docetaxel on the biodistribution of samarium-153-EDTMP in bones and other organs of rats. METHODS: Wistar male rats were randomly allocated into 2 groups of 6 rats each. The DS (docetaxel/samarium group received docetaxel (15 mg/kg intraperitoneally in two cycles 11 days apart. The S (samarium/control group rats were not treated with docetaxel. Nine days after chemotherapy, all the rats were injected with 0.1ml of samarium-153-EDTMP via orbital plexus (25µCi. After 2 hours, the animals were killed and samples of the brain, thyroid, lung, heart, stomach, colon, liver, kidney and both femurs were removed. The percentage radioactivity of each sample (% ATI/g was determined in an automatic gamma-counter (Wizard-1470, Perkin-Elmer, Finland. RESULTS: On the 9th day after the administration of the 2nd chemotherapy cycle, the rats had a significant weight loss (314.50±22.09g compared (pOBJETIVO: Muitos pacientes com metástases ósseas são tratados com radiofármacos associados com quimioterapia para alívio da dor óssea. O objetivo do trabalho foi estudar a influência do docetaxel na biodistribuição do EDTMP-153-samário nos ossos e outros órgãos de ratos. MÉTODOS: Ratos Wistar foram aleatoriamente alocados em 2 grupos de 6 animais cada. O grupo DS (docetaxel/samário recebeu docetaxel (15 mg/kg intraperitoneal em dois ciclos com 11 dias de intervalo. Os ratos do grupo S (samário/controle não foram tratados com docetaxel. Nove dias após a quimioterapia, todos os animais receberam 0,1ml de EDTMP-153-samário via plexo orbital (25µCi. Após 2 horas, os animais foram mortos e feitas biópsias de cérebro, tireóide, pulmão, coração, estômago, cólon, fígado, rim e fêmures. O percentual de radioatividade por grama (%ATI/g de tecido de cada bi

  19. Función adrenal y metabolismo lipídico en niños asmáticos tratados con budesonida

    Paoli-de Valeri Mariela; Zerpa-de Miliani Yajaira; Valeri-Dávila Ezio G.; Bellabarba Gabriela

    1999-01-01

    Objetivo. Evaluar el efecto de bajas dosis de budesonida inhalado sobre la función adrenal y el metabolismo lipídico en niños asmáticos. Material y métodos. Se estudiaron: 10 niños asmáticos (edad promedio, 8.6 años) tratados con budesonida inhalado (200-300 µg/día) por un lapso mayor a tres meses (grupo A); 15 niños asmáticos (edad promedio, 7.8 años) sin tratamiento esteroideo (grupo B), y 10 niños no asmáticos (grupo C). Se determinaron los niveles de cortisol basal y postestímulo con ACTH...

  20. Severidade da antracnose e qualidade dos frutos de maracujá-amarelo tratados com produtos naturais em pós-colheita

    Antônio Jussiê da Silva Solino; Sebastião Elviro de Araújo Neto; Alisson Nunes da Silva; Ana maria Alves de Souza Ribeiro

    2012-01-01

    O objetivo do presente trabalho foi avaliar a qualidade pós-colheita de frutos de maracujá-amarelo tratados com óleo de soja, nim e de copaíba e com vinho de jatobá, visando à redução da severidade da Antracnose, causada pelo fungo Colletotrichum gloeosporioides. Um experimento in vitro foi instalado no delineamento inteiramente casualizado, em esquema fatorial 4 x 5, considerando os quatro referidos produtos em cinco concentrações: 0,0; 0,5; 1,0; 1,5 e 2,0 mL L-1, diluídos em meio BDA. Para ...

  1. Táticas e técnicas endovasculares para retirada de corpos estranhos intravenosos Endovascular techniques and procedures, methods for removal of intravascular foreign bodies

    Joaquim Maurício da Motta-Leal Filho

    2010-06-01

    Full Text Available INTRODUÇÃO: A incidência da embolização de cateteres intravenosos, na literatura mundial, é de 1% dentre todas as complicações descritas. Porém, possui taxa de mortalidade podendo variar de 24 a 60%. O não funcionamento do cateter é a suspeita diagnóstica principal da embolização, visto que, habitualmente, os pacientes são assintomáticos. OBJETIVO: Relatar o manejo na extração de corpos estranhos intravenosos, com o uso de táticas e técnicas endovasculares diversas. MÉTODOS: Estudo retrospectivo com 12 pacientes, no período de dois anos. Sete pacientes eram do sexo feminino e cinco do sexo masculino, com média de idade de 29 anos (dois meses a 65 anos. RESULTADOS: Sucesso técnico foi obtido em 100% dos casos. Foram extraídos 10 port-a-caths, um intra-cath e um PICC. Os locais mais frequentes de alojamento de uma das extremidades dos corpos estranhos intravenosos foram o átrio direito (41,6% e o ventrículo direito (33,3%. Em 100% dos casos se utilizou um único acesso venoso. O acesso femoral foi o mais utilizado, em 91,6% dos casos (11 cateteres. Utilizou-se o laço (loop-snare em 10 (83,3% casos. O motivo mais frequente da presença do corpo estranho intravascular foi a fratura do cateter, que ocorreu em 66,6% dos casos (oito pacientes. Houve uma complicação, fibrilação atrial (8,3%, relacionada à extração de corpo estranho intravenoso. A taxa de mortalidade em 30 dias foi igual a zero. CONCLUSÃO: A retirada de corpos estranhos intravenosos por via percutânea é considerada tratamento padrão ouro, por se tratar de procedimento minimamente invasivo, relativamente simples, seguro e com baixas taxas de complicações quando comparada ao tratamento cirúrgico convencional.INTRODUCTION: The incidence of intravascular embolization of venous catheters reported in the world medical literature corresponds to 1% of all the described complications. However, its mortality rate may vary between 24 to 60%. Catheter

  2. Suscetibilidade aos agentes quimioterápicos de isolados de Schistosoma mansoni oriundos de pacientes tratados com oxamniquine e praziquantel e não curados

    Neusa Araújo

    1996-10-01

    Full Text Available Foram estudados dez isolados de Schistosoma mansoni provenientes de pacientes residentes em Itaquara, Bahia, Brasil, tratados com oxamniquine eposteriormente com praziquantel, e ainda assim não curados. Caramujos (Biomphalaria glabrataj foram expostos a miracídios provenientes das fezes dos pacientes. Cercãrías eliminadas por estes caramujos e por moluscos coletados no peridomicílio dos pacientes foram utilizadas para infecção experimental de camundongos albinos. Os animais infectados foram tratados em dose única, via oral, com oxamniquine (25, 50 e 100 mg/kg ou praziquantel (100, 200 e 400mg/kg. Foram realizados estudos de análise e comparação de DNA de cercãrías de S. mansoni eliminadas pelos caramujos e de vermes adultos recolhidos de camundongos infectados experimentalmente com os isolados dos 10 pacientes e ainda de cercãrías de S. mansoni eliminadas por moluscos naturalmente infectados coletados em Itaquara. A cepa LE (mantida rotineiramente no laboratório foi usada como padrão de comparação da resposta aos agentes esquistossomicidas administrados. As respostas terapêuticas foram significativamente diferentes entre alguns dos isolados embora não fosse possível caracterizar nenhum como resistente. A análise dos perfis de amplificação de DNA nas cercãrías e nos vermes adultos dos isolados de S. mansoni demonstrou baixo grau de variabilidade indicando que estes são geneticamente próximos e revelando a ausência de rearranjos globais dentro dos genomas.

  3. Considerações sobre a prevalência dos tratados internacionais sobre a legislação tributária brasileira: o caso do MERCOSUL

    Maria de Fátima Ribeiro

    1997-12-01

    Full Text Available This is a study on the main aspects discussed in the Brazilian doctrine and the jurisprudence concerning the prevalence of international treaties and conventions for internal tax legislation. Considerations are made on the Brazilian federate and sovereignty principles and on the competence constitutionally established for all the political entities of the Brazilian State. Article 151, section III of the Federal Constitution must be pointed out for its purpose on stating that the Union shall not exempt the States, the Federal District and the Municipalities from respective taxes. Article 98 of the National Tax Code is also considered for its disposition concerning legislation from international treaties and agreements on tax norms of the positive system currently in force.Trata-se de estudo sobre os principais aspectos discutidos na doutrina e na jurisprudência brasileira sobre a prevalência dos tratados e convenções internacionais sobre a legislação tributária interna. Necessário se faz apresentar considerações sobre o princípio federativo brasileiro, o princípio da soberania e o da competência constitucionalmente estabelecida para todos os entes políticos do Estado brasileiro. Merece maior destaque o art. 151, inciso III da Constituição Federal ao enaltecer que a União não poderá conceder isenções de tributos de competência dos Estados, Distrito Federal e Municípios, bem como a análise do art. 98 do Código Tributário Nacional dispondo sobre as introduções legislativas provenientes de tratados e acordos internacionais sobre as normas tributárias do sistema positivo vigente.

  4. El lugar de la sátira en la poética: los tratados españoles del siglo XIX

    González Alcázar, Felipe

    2008-12-01

    Full Text Available This article aims to analyse the satirical genre and its connections with Poetics in the Spanish Poetry and Rhetoric precept treatises of the nineteenth century. Throughout that century, literary theory was subject to major changes, such as the success of Hegel’s postulates on literary genres. Satire faces these changes and its own evolution: it was first identified with the Roman satura and afterwards through its various forms, it became a mixed or transitional genre. Its fragile nature seems to confront directly the normative perpetuity of treatises that, in spite of their rupture with romanticism, may be considered inheritors of the classicist principles.Se propone en este artículo investigar el género satírico y sus relaciones con la Poética a través de los tratados poético-retóricos de preceptiva españoles del siglo XIX. A lo largo de toda esa centuria la teoría literaria estuvo sujeta a grandes transformaciones, entre ellas, el triunfo de los principios hegelianos acerca de los géneros literarios. La sátira se enfrenta a esas mismas transformaciones y a su propia evolución: primero, identificada con la satura romana, y luego, a través de sus numerosas formas, convertida en un género mixto o de transición. Su lábil naturaleza parece enfrentarse directamente con la perennidad normativa de los tratados que, a pesar de la ruptura romántica, pueden considerarse herederos de los principios clasicistas.

  5. Injeção intravascular acidental de ropivacaína a 0,5% durante a realização de anestesia peridural torácica: relato de casos Inyección intravascular accidental de ropivacaína a 0,5% durante la realización de anestesia peridural torácica: relato de casos Accidental intravascular injection of 0.5% ropivacaine during thoracic epidural anesthesia: case reports

    Fábio Geraldo Curtis

    2004-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A ropivacaína foi introduzida na prática clínica há pouco mais de dez anos, associando-se a baixo risco de complicações do sistema nervoso central e cardiovascular. O objetivo destes relatos é apresentar um caso de parada cardíaca e outro de toxicidade neurológica, após injeção intravascular acidental da ropivacaína, durante a realização de anestesias peridurais. RELATO DOS CASOS: Trata-se de duas pacientes submetidas a cirurgias plásticas estéticas sob anestesia peridural torácica com ropivacaína a 0,5%. Durante a realização da técnica, uma delas apresentou parada cardíaca em assistolia e a outra, toxicidade neurológica. Prontamente atendidas, ambas apresentaram rápida recuperação, tendo sido possível a realização dos respectivos atos cirúrgicos. CONCLUSÕES: O reconhecimento e o tratamento rápidos da injeção intravascular acidental, bem como as características farmacológicas da ropivacaína foram decisivos, em ambos os casos, na boa recuperação das pacientes.JUSTIFICATIVA Y OBJETIVOS: A ropivacaína fue introducida en la práctica clínica hace poco más de diez años, asociándose a bajo riesgo de complicaciones del sistema nervioso central y cardiovascular. Estos relatos tienen como objetivo presentar un caso de parada cardíaca y otro de toxicidad neurológica, después de inyección intravascular accidental de ropivacaína, durante la realización de anestesias peridurales. RELATO DE LOS CASOS: Se trata de dos pacientes sometidas a cirugías plásticas estéticas bajo anestesia peridural torácica con ropivacaína a 0,5%. Durante la realización de la técnica, una de ellas presentó parada cardíaca en asistolia y la otra, toxicidad neurológica. Prontamente atendidas, ambas presentaron rápida recuperación, habiendo sido posible la realización de los respectivos actos quirúrgicos. CONCLUSIONES: El reconocimiento y el tratamiento rápidos de la inyección intravascular

  6. Effect of leukocyte antibodies and HLA matching on the intravascular recovery, survival, and tissue localization of 111-indium granulocytes

    The effect of leukocyte antibodies detected under different conditions on the fate in vivo of granulocytes was studied using 111-indium-labeled granulocytes. Sera from patients were tested by granulocyte agglutination (GA), granulocytotoxicity (GC), granulocyte immunofluorescence (GIF), lymphocytotoxicity (LC), and antibody-dependent lymphocyte-mediated granulocytotoxicity. Granulocytes from donors to be studied were labeled with 111-indium and injected. Then the intravascular recovery and survival or tissue localization was determined in 93 studies. Antibodies detected by granulocyte agglutination were associated with a significant reduction in recovery (6.7% v 30.8% in controls; P less than .001) and t1/2 (0.3 hours v 5.6 hours in controls; P = .002). When all possible combinations of serum reactivity were considered, reactivity in the GA plus GIF assays had the best correlation with decreased recovery (R2 = .49; P less than .001) and t1/2 (R2 = .73; P less than .001). When the relationship between the strength of antibody reactivity and the recovery and t1/2 were analyzed, the best relationship was between the combination of LC and GIF with recovery (R2 = .62; P = .001). Because of the general availability of the HLA (LC) testing, the role of LC reactivity was investigated in other ways. There was a strong relationship between sera highly reactive by LC and those reactive by GIF. These highly reactive sera were also associated with reduced recovery and t1/2. The influence of specific HLA antigen mismatches was also studied

  7. Role of pulmonary intravascular macrophages in endotoxin-induced lung inflammation and mortality in a rat model

    Duke Tanya

    2008-10-01

    Full Text Available Abstract Background Bile-duct ligated (BDL rats recruit pulmonary intravascular macrophages (PIMs and are highly susceptible to endotoxin-induced mortality. The mechanisms of this enhanced susceptibility and mortality in BDL rats, which are used as a model of hepato-pulmonary syndrome, remain unknown. We tested a hypothesis that recruited PIMs promote endotoxin-induced mortality in a rat model. Methods Rats were subjected to BDL to induce PIM recruitment followed by treatment with gadolinium chloride (GC to deplete PIMs. Normal and BDL rats were treated intravenously with E. coli lipopolysaccharide (LPS with or without GC pre-treatment followed by collection and analyses of lungs for histopathology, electron microscopy and cytokine quantification. Results BDL rats recruited PIMs without any change in the expression of IL-1β, TNF-α and IL-10. GC caused reduction in PIMs at 48 hours post-treatment (P E. coli LPS died within 3 hours of the challenge while the normal LPS-treated rats were euthanized at 6 hours after the LPS treatment. GC treatment of rats 6 hours or 48 hours before LPS challenge resulted in 80% (1/5 and 100% (0/5 survival, respectively, at 6 hours post-LPS treatment. Lungs from BDL+LPS rats showed large areas of perivascular hemorrhages compared to those pre-treated with GC. Concentrations of IL-1β, TNF-α and IL-10 were increased in lungs of BDL+LPS rats compared to BDL rats treated with GC 48 hours but not 6 hours before LPS (P Conclusion We conclude that PIMs increase susceptibility for LPS-induced lung injury and mortality in this model, which is blocked by a reduction in their numbers or their inactivation.

  8. Repeat survey of current practice regarding corticosteroid prophylaxis for patients at increased risk of adverse reaction to intravascular contrast agents

    Radhakrishnan, S. [Department of Radiology, Wishaw General Hospital, Lanarkshire Acute Hospitals NHS Trust, 50, Netherton Street, Wishaw, Lanarkshire ML2 0DP (United Kingdom)]. E-mail: sureshradhakrish@hotmail.com; Manoharan, S. [Department of Radiology, Wishaw General Hospital, Lanarkshire Acute Hospitals NHS Trust, 50, Netherton Street, Wishaw, Lanarkshire ML2 0DP (United Kingdom); Fleet, M. [Department of Radiology, Wishaw General Hospital, Lanarkshire Acute Hospitals NHS Trust, 50, Netherton Street, Wishaw, Lanarkshire ML2 0DP (United Kingdom)

    2005-01-01

    AIM: To compare the findings of a survey undertaken by us in 2002 regarding steroid premedication given in radiology departments to reduce the risk of adverse reactions in patients at increased risk of intravascular contrast media reactions with a similar survey published in 1994 by R. Seymour et al. The high risk patients considered in our survey were patients with history of asthma, drug allergies, hay fever and eczema. MATERIALS AND METHODS: A total of 225 questionnaires were sent to the consultant in charge for audit for radiology departments from the list given by the Royal College of Radiologists. 175 of the 225 questionnaires were returned (response rate 77.8%) and of these 172 were analysed with respect to the type, dose and duration of steroids. RESULTS: Compared to the survey in 1994, it was found that the number of departments who use steroid cover for all category of risk factors had increased compared to previous survey (73.8% in 2002 versus 55.3% in 1994 (p=0.001). There is now almost universal use of non-ionic contrast 98.8% versus 82.4% in 1994 (p=0.001). There is no agreed policy among radiology departments for the need or the dose or duration of steroid cover. CONCLUSION: Despite the more widespread use of non-ionic contrast media, the use of steroid premedication has increased which is contrary to what is expected as the incidence of adverse reaction to non ionic media is less than ionic contrast media.

  9. Evaluation of EGS4/PRESTA multiple-scattering algorithms for 90Sr/90Y intravascular brachytherapy dosimetry

    The purpose of this work is to evaluate the EGS4/PRESTA electron multiple-scattering (MS) algorithms for dose calculation in intravascular brachytherapy (IVBT) using a 90Sr/90Y source. The small source size and the small volume of interest in IVBT require very fine spatial resolution, which may break down the constraints of Moliere's MS theory as implemented in EGS4. The theory is accurate only when the electron step sizes are large enough to allow the number of collisions Ω0 to be much greater than e = 2.7183. When step sizes are too small to allow at least 2.7183 collisions, as may be necessitated by the fine geometry, the algorithm may switch off MS, producing dosimetric artefacts. This study showed that switching off MS could produce a dose deviation of up to 6% when the half-thickness (d/2) of the dose scoring region is comparable with the Moliere minimum step size (tmin = 2.7183). The effect of switching off MS is negligible if d/2>>tmin. For the case of Ω0>e, if the electron step sizes are chosen to allow five to 40 collisions, with increasing step size, the doses surrounding the source increase and the error decreases. On the other hand, when larger step sizes are chosen, the dose calculation voxel size must also be increased in order for the calculations to converge. A good compromise between accuracy and applicability for IVBT simulation can be made, if the thickness of the scoring region is 0.1 mm and the electron step sizes are in the range allowing 10 to 30 collisions. (author)

  10. Evidence for Radiation-Induced Disseminated Intravascular Coagulation as a Major Cause of Radiation-Induced Death in Ferrets

    Purpose: The studies reported here were performed as part of a program in space radiation biology in which proton radiation like that present in solar particle events, as well as conventional gamma radiation, were being evaluated in terms of the ability to affect hemostasis. Methods and Materials: Ferrets were exposed to 0 to 2 Gy of whole-body proton or gamma radiation and monitored for 30 days. Blood was analyzed for blood cell counts, platelet clumping, thromboelastometry, and fibrin clot formation. Results: The lethal dose of radiation to 50% of the population (LD50) of the ferrets was established at ∼1.5 Gy, with 100% mortality at 2 Gy. Hypocoagulability was present as early as day 7 postirradiation, with animals unable to generate a stable clot and exhibiting signs of platelet aggregation, thrombocytopenia, and fibrin clots in blood vessels of organs. Platelet counts were at normal levels during the early time points postirradiation when coagulopathies were present and becoming progressively more severe; platelet counts were greatly reduced at the time of the white blood cell nadir of 13 days. Conclusions: Data presented here provide evidence that death at the LD50 in ferrets is most likely due to disseminated intravascular coagulation (DIC). These data question the current hypothesis that death at relatively low doses of radiation is due solely to the cell-killing effects of hematopoietic cells. The recognition that radiation-induced DIC is the most likely mechanism of death in ferrets raises the question of whether DIC is a contributing mechanism to radiation-induced death at relatively low doses in large mammals

  11. Relationship between changes in coronary atherosclerotic plaque burden measured by intravascular ultrasound and cardiovascular disease outcomes: a systematic literature review.

    Forbes, Carol; Quek, Ruben G W; Deshpande, Sohan; Worthy, Gill; Ross, Janine; Kleijnen, Jos; Gandra, Shravanthi R; Kassahun, Helina; Wong, Nathan D; Nicholls, Stephen J

    2016-06-01

    Objective Evidence from coronary imaging studies suggests an association between increased atherosclerotic plaque burden and cardiovascular disease (CVD) outcomes. A systematic review was performed to evaluate the relationship between coronary atherosclerotic plaque burden changes measured by intravascular ultrasound (IVUS) and CVD outcomes. Research design and methods Rigorous systematic review methodology was used to identify prospective studies of any design assessing the relationship between atherosclerotic plaque volume (percentage or total atheroma volume [PAV or TAV]) changes and CVD outcomes, using multivariable analyses. Main outcome measures CVD outcomes including major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs). Results Literature searches from inception to February 2015 retrieved 6958 records after de-duplication. From these four studies (14 papers) were included. One study reported a significantly lower rate of CVD outcomes associated with a greater reduction in PAV (hazard ratio [HR] 0.26, 95% confidence interval [CI] 0.07-0.83). One study reported that large plaque volume was significantly associated with a greater risk of major adverse cardiac events (MACEs) (HR 1.73, 95% CI: 1.02-2.96). Similarly, a third study reported a significant increase in MACE with an increase in baseline PAV (HR 1.51, 95% CI: 1.06-2.51). Only one potentially inadequately powered Japanese study did not find a statistically significant relationship between PAV changes and MACE. Conclusions The current evidence suggests an independent and statistically significant association between increases in coronary atherosclerotic plaque burden measured by IVUS and greater long-term risk of future CVD outcomes. However, this evidence comes from a limited number of studies which mainly focus on Japanese populations and populations after PCI. Further large prospective studies are required to confirm these findings. PMID:26949994

  12. Automatic segmentation and 3D reconstruction of intravascular ultrasound images for a fast preliminar evaluation of vessel pathologies.

    Sanz-Requena, Roberto; Moratal, David; García-Sánchez, Diego Ramón; Bodí, Vicente; Rieta, José Joaquín; Sanchis, Juan Manuel

    2007-03-01

    Intravascular ultrasound (IVUS) imaging is used along with X-ray coronary angiography to detect vessel pathologies. Manual analysis of IVUS images is slow and time-consuming and it is not feasible for clinical purposes. A semi-automated method is proposed to generate 3D reconstructions from IVUS video sequences, so that a fast diagnose can be easily done, quantifying plaque length and severity as well as plaque volume of the vessels under study. The methodology described in this work has four steps: a pre-processing of IVUS images, a segmentation of media-adventitia contour, a detection of intima and plaque and a 3D reconstruction of the vessel. Preprocessing is intended to remove noise from the images without blurring the edges. Segmentation of media-adventitia contour is achieved using active contours (snakes). In particular, we use the gradient vector flow (GVF) as external force for the snakes. The detection of lumen border is obtained taking into account gray-level information of the inner part of the previously detected contours. A knowledge-based approach is used to determine which level of gray corresponds statistically to the different regions of interest: intima, plaque and lumen. The catheter region is automatically discarded. An estimate of plaque type is also given. Finally, 3D reconstruction of all detected regions is made. The suitability of this methodology has been verified for the analysis and visualization of plaque length, stenosis severity, automatic detection of the most problematic regions, calculus of plaque volumes and a preliminary estimation of plaque type obtaining for automatic measures of lumen and vessel area an average error smaller than 1mm(2) (equivalent aproximately to 10% of the average measure), for calculus of plaque and lumen volume errors smaller than 0.5mm(3) (equivalent approximately to 20% of the average measure) and for plaque type estimates a mismatch of less than 8% in the analysed frames. PMID:17215103

  13. Recombinant human soluble thrombomodulin and mortality in sepsis-induced disseminated intravascular coagulation. A multicentre retrospective study.

    Hayakawa, Mineji; Yamakawa, Kazuma; Saito, Shinjiro; Uchino, Shigehiko; Kudo, Daisuke; Iizuka, Yusuke; Sanui, Masamitsu; Takimoto, Kohei; Mayumi, Toshihiko; Ono, Kota

    2016-06-01

    Recombinant human soluble thrombomodulin (rhTM) is a novel class of anticoagulants for treating disseminated intravascular coagulation (DIC). Although rhTM is widely used in clinical settings throughout Japan, there is limited clinical evidence supporting the use of rhTM in patients with sepsis-induced DIC. Furthermore, rhTM is not approved for DIC treatment in other countries. This study aimed to clarify the survival benefits of rhTM administration in critically ill patients. Data from 3,195 consecutive adult patients who were admitted to 42 intensive care units for the treatment of severe sepsis or septic shock between January 2011 and December 2013 were retrospectively analysed, and 1,784 patients were diagnosed with DIC based on the scoring algorithm from the Japanese Association for Acute Medicine DIC (n = 645, rhTM group; n = 1,139, control group). Propensity score matching created 452 matched pairs, and logistic regression analysis revealed a significant association between rhTM administration and lower in-hospital all-cause mortality in the propensity score-matched groups (odds ratio, 0.757; 95 % confidence interval, 0.574-0.999, p = 0.049). Inverse probability of treatment weighted and quintile-stratified analyses also revealed significant associations between rhTM administration and lower in-hospital all-cause mortality. Survival time in the propensity score-matched rhTM group was significantly longer than that in the propensity score-matched control group (hazard ratio, 0.781; 95 % confidence interval, 0.624-0.977, p = 0.03). Bleeding complications were not more frequent in the rhTM groups. In conclusion, this study demonstrated that rhTM administration is associated with reduced in-hospital all-cause mortality among patients with sepsis-induced DIC. PMID:26939575

  14. Role of particle size, shape, and stiffness in design of intravascular drug delivery systems: insights from computations, experiments, and nature.

    Sen Gupta, Anirban

    2016-03-01

    Packaging of drug molecules within microparticles and nanoparticles has become an important strategy in intravascular drug delivery, where the particles are designed to protect the drugs from plasma effects, increase drug residence time in circulation, and often facilitate drug delivery specifically at disease sites. To this end, over the past few decades, interdisciplinary research has focused on developing biocompatible materials for particle fabrication, technologies for particle manufacture, drug formulation within the particles for efficient loading, and controlled release and refinement of particle surface chemistries to render selectivity toward disease site for site-selective action. Majority of the particle systems developed for such purposes are spherical nano and microparticles and they have had low-to-moderate success in clinical translation. To refine the design of delivery systems for enhanced performance, in recent years, researchers have started focusing on the physicomechanical aspects of carrier particles, especially their shape, size, and stiffness, as new design parameters. Recent computational modeling studies, as well as, experimental studies using microfluidic devices are indicating that these design parameters greatly influence the particles' behavior in hemodynamic circulation, as well as cell-particle interactions for targeted payload delivery. Certain cellular components of circulation are also providing interesting natural cues for refining the design of drug carrier systems. Based on such findings, new benefits and challenges are being realized for the next generation of drug carriers. The current article will provide a comprehensive review of these findings and discuss the emerging design paradigm of incorporating physicomechanical components in fabrication of particulate drug delivery systems. WIREs Nanomed Nanobiotechnol 2016, 8:255-270. doi: 10.1002/wnan.1362 For further resources related to this article, please visit the WIREs

  15. Evidence for Radiation-Induced Disseminated Intravascular Coagulation as a Major Cause of Radiation-Induced Death in Ferrets

    Krigsfeld, Gabriel S.; Savage, Alexandria R.; Billings, Paul C.; Lin, Liyong; Kennedy, Ann R., E-mail: akennedy@mail.med.upenn.edu

    2014-03-15

    Purpose: The studies reported here were performed as part of a program in space radiation biology in which proton radiation like that present in solar particle events, as well as conventional gamma radiation, were being evaluated in terms of the ability to affect hemostasis. Methods and Materials: Ferrets were exposed to 0 to 2 Gy of whole-body proton or gamma radiation and monitored for 30 days. Blood was analyzed for blood cell counts, platelet clumping, thromboelastometry, and fibrin clot formation. Results: The lethal dose of radiation to 50% of the population (LD{sub 50}) of the ferrets was established at ∼1.5 Gy, with 100% mortality at 2 Gy. Hypocoagulability was present as early as day 7 postirradiation, with animals unable to generate a stable clot and exhibiting signs of platelet aggregation, thrombocytopenia, and fibrin clots in blood vessels of organs. Platelet counts were at normal levels during the early time points postirradiation when coagulopathies were present and becoming progressively more severe; platelet counts were greatly reduced at the time of the white blood cell nadir of 13 days. Conclusions: Data presented here provide evidence that death at the LD{sub 50} in ferrets is most likely due to disseminated intravascular coagulation (DIC). These data question the current hypothesis that death at relatively low doses of radiation is due solely to the cell-killing effects of hematopoietic cells. The recognition that radiation-induced DIC is the most likely mechanism of death in ferrets raises the question of whether DIC is a contributing mechanism to radiation-induced death at relatively low doses in large mammals.

  16. Comparative study on toxic effects induced by oral or intravascular administration of commonly used disinfectants and surfactants in rats.

    Xue, Yuying; Zhang, Shanshan; Tang, Meng; Zhang, Ting; Wang, Yiqing; Hieda, Yoko; Takeshita, Haruo

    2012-07-01

    Accidental ingestion or injection of household products sometimes occurs due to their accessibility, but the toxic manifestations have not been well characterized when they are internally administered. The aim of this study was to investigate the toxic effects induced by ingestion or injection of different ionic surfactants and disinfectants in rats. The test drugs involved benzalkonium and benzethonium (BZK and BZT, both cationic surfactants used as disinfectants), alkyldiaminoethylglycine (AEG, an amphoteric surfactant used as a disinfectant), linear alkylbenzenesulfonate (LAS, an anionic surfactant), polyoxyethylene cetylether (PEC, a nonionic surfactant), chlorhexidine (CHX, not a surfactant but a disinfectant) and saline (control). Male Sprague-Dawley rats were administered one of the test drugs orally (p.o.), intravenously (i.v.) or intraarterially (i.a.). The fatal effects appeared rapidly (5 h) in i.a./p.o.-administered rats after a dose of around LD(50) , although the progress and degree of toxic effects varied among the drugs tested. In intravascular administration, BZK and BZT were fatal at doses of 15-20 mg kg(-1) . Higher concentrations in lung and kidney than in blood were determined. CHX showed a high toxic effect compared with cationic surfactants. The rats administered anionic (LAS) or amphoteric (AEG) surfactant died in less than 24 h at doses over 100 mg kg(-1) . In p.o. administration, the toxic effects were concentration/dose-dependent, and all rats administered high doses of surfactants except for PEC died at 5-20 h. The overall toxic ranks could be: cationic surfactant/CHX> anionic/amphoteric surfactant > nonionic surfactant. PMID:21387348

  17. Relationship between Neutrophil-to-Lymphocyte Ratio and Plaque Components in Patients with Coronary Artery Disease: Virtual Histology Intravascular Ultrasound Analysis

    Choi, Yun Ha; Hong, Young Joon; Ahn, Youngkeun; Park, In Hyae; Jeong, Myung Ho

    2014-01-01

    The aim of this study was to evaluate the relation between neutrophil-to-lymphocyte ratio (NLR) and plaque components assessed by virtual histology-intravascular ultrasound in 399 coronary artery disease (CAD) patients with 471 coronary lesions. We classified the lesions into two groups according to the NLR on admission {low NLR group (NLR≤2.73 [n=370]) vs. high NLR group (NLR>2.73 [n=101])}. By volumetric analysis, total atheroma and the absolute necrotic core (NC) volumes were significantly...

  18. Local release of ATP into the arterial inflow and venous drainage of human skeletal muscle: insight from ATP determination with the intravascular microdialysis technique

    Mortensen, Stefan; Thaning, Pia; Nyberg, Michael Permin;

    2011-01-01

    Intraluminal ATP could play an important role in the local regulation of skeletal muscle blood flow, but the stimuli that cause ATP release and the levels of plasma ATP in vessels supplying and draining human skeletal muscle remain unclear. To gain insight into the mechanisms by which ATP is...... released into plasma, we measured plasma [ATP] with the intravascular microdialysis technique at rest and during dynamic exercise (normoxia and hypoxia), passive exercise, thigh compressions and arterial ATP, tyramine and ACh infusion in a total of 16 healthy young men. Femoral arterial and venous[ATP...

  19. A new method for real-time co-registration of 3D coronary angiography and intravascular ultrasound or optical coherence tomography

    We present a new clinically practical method for online co-registration of 3D quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) or optical coherence tomography (OCT). The workflow is based on two modified commercially available software packages. Reconstruction steps are explained and compared to previously available methods. The feasibility for different clinical scenarios is illustrated. The co-registration appears accurate, robust and induced a minimal delay on the normal cath lab activities. This new method is based on the 3D angiographic reconstruction of the catheter path and does not require operator’s identification of landmarks to establish the image synchronization

  20. A new method for real-time co-registration of 3D coronary angiography and intravascular ultrasound or optical coherence tomography

    Carlier, Stéphane, E-mail: sgcarlier@hotmail.com [Department of Cardiology, Universitair Ziekenhuis - UZ Brussel, Brussels (Belgium); Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels (Belgium); Didday, Rich [INDEC Medical Systems Inc., Santa Clara, CA (United States); Slots, Tristan [Pie Medical Imaging BV, Maastricht (Netherlands); Kayaert, Peter; Sonck, Jeroen [Department of Cardiology, Universitair Ziekenhuis - UZ Brussel, Brussels (Belgium); El-Mourad, Mike; Preumont, Nicolas [Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels (Belgium); Schoors, Dany; Van Camp, Guy [Department of Cardiology, Universitair Ziekenhuis - UZ Brussel, Brussels (Belgium)

    2014-06-15

    We present a new clinically practical method for online co-registration of 3D quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) or optical coherence tomography (OCT). The workflow is based on two modified commercially available software packages. Reconstruction steps are explained and compared to previously available methods. The feasibility for different clinical scenarios is illustrated. The co-registration appears accurate, robust and induced a minimal delay on the normal cath lab activities. This new method is based on the 3D angiographic reconstruction of the catheter path and does not require operator’s identification of landmarks to establish the image synchronization.