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Sample records for benign paroxysmal positional

  1. Benign paroxysmal positional vertigo in Parkinson's disease

    NARCIS (Netherlands)

    Wensen, E. van; Leeuwen, R.B. van; Zaag-Loonen, H.J. van der; Masius-Olthof, S.; Bloem, B.R.

    2013-01-01

    BACKGROUND: Dizziness is a frequent complaint of patients with Parkinson's disease (PD), and orthostatic hypotension (OH) is often thought to be the cause. We studied whether benign paroxysmal positional vertigo (BPPV) could also be an explanation. AIM: To assess the prevalence of benign paroxysmal

  2. Repositioning chairs in benign paroxysmal positional vertigo

    DEFF Research Database (Denmark)

    West, Niels; Hansen, Søren; Møller, Martin Nue;

    2016-01-01

    The objective was to evaluate the clinical value of repositioning chairs in management of refractory benign paroxysmal positional vertigo (BPPV) and to study how different BPPV subtypes respond to treatment. We performed a retrospective chart review of 150 consecutive cases with refractory vertigo...

  3. Vitamin D deficiency and benign paroxysmal positioning vertigo

    OpenAIRE

    Büki, Bela; Ecker, Michael; Jünger, Heinz; Lundberg, Yunxia Wang

    2012-01-01

    Benign paroxysmal positional vertigo is a common cause of disabling vertigo with a high rate of recurrence. Although connections between vitamin D deficiency and osteoporosis, as well as between osteoporosis and benign paroxysmal positional vertigo have been suggested respectively in the literature, we are not aware of any publication linking vitamin D and benign paroxysmal positional vertigo. As a hypothesis, we suggest that there is a relation between insufficient vitamin D level and benign...

  4. Benign Paroxysmal Positional Vertigo After Nonotologic Surgery: Case Series

    OpenAIRE

    Kansu, Leyla; Aydin, Erdinc; Gulsahi, Kamran

    2012-01-01

    Benign paroxysmal positional vertigo is one of the most common types of vertigo caused by peripheral vestibular dysfunction. Although head trauma, migraine, long-term bed rest, Ménière disease, viral labyrinthitis, and upper respiratory tract infections are believed to be predisposing factors, most cases of benign paroxysmal positional vertigo are idiopathic. Ear surgery is another cause, but after non-otologic surgery, attacks of benign paroxysmal positional vertigo are rare. We describe thr...

  5. Climatic variations and benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    Basil M.N. Saeed; Alyaa Farouk Omari

    2016-01-01

    Benign paroxysmal positional vertigo (BPPV) is probably the most common diagnosis at vertigo clinics. Seasonal cycles of several human illnesses could be attributed variously to changes in atmospheric or weather conditions. In this retrospective study, patients with BPPV from January 2010 to December 2012 were studied, and their charts were reviewed. Statistical analysis revealed a statistically significant difference in patients' numbers among different months of the year. Also there is a significant statistical correlation between the numbers of patients with climatic variations especially the temperature. The present paper discusses the possible explanations for these results which confirms the seasonal variations in BPPV, together with a review of literature to view the possible associations with other disorders that causes such sea-sonality.

  6. Benign Paroxysmal Positional Vertigo: An Integrated Perspective

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    Kourosh Parham

    2014-01-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV, the most common cause of dizziness, occurs in all age groups. It presents with vertigo on head movement, but in older patients presentation may be typical and thus accounting for a low recognition rate in the primary care setting. It may be recurrent in up to 50% of cases. BPPV is associated with displacement of fragments of utricular otoconia into the semicircular canals, most commonly the posterior semicircular canal. Otoconia are composed of otoconin and otolin forming the organic matrix on which calcium carbonate mineralizes. Otoconia may fragment with trauma, age, or changes in the physiology of endolymph (e.g., pH and calcium concentration. Presentation varied because otoconia fragments can be displaced into any of the semicircular canals on either (or both side and may be free floating (canalolithiasis or attached to the cupula (cupulolithiasis. Most cases of BPPV are idiopathic, but head trauma, otologic disorders, and systemic disease appear to be contributory in a subset. Positional maneuvers are used to diagnose and treat the majority of cases. In rare intractable cases surgical management may be considered. A strong association with osteoporosis suggests that idiopathic BPPV may have diagnostic and management implications beyond that of a purely otologic condition.

  7. Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo

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    Muhammed Dagkiran

    2015-12-01

    Full Text Available Benign paroxysmal positional vertigo is the cause of peripheral vertigo, which only takes seconds posed by certain head and body position and led to severe attacks of vertigo. Therefore, it is a disturbance that causes a continuous fear of fall and anxiety in some patients. Although benign paroxysmal positional vertigo is the most common cause of peripheral vertigo, it may cause unnecessary tests, treatment costs and the loss of labor due to the result of the delay in the diagnosis and treatment stages. Diagnosis and treatment of this disease is easy. High success rates can be achieved with appropriate repositioning maneuvers after taking a detailed medical history and accurate assessment of accompanying nystagmus. The aim of this paper was to review the updated information about benign paroxysmal positional vertigo. [Archives Medical Review Journal 2015; 24(4.000: 555-564

  8. Chiropractic management of a patient with benign paroxysmal positional vertigo

    DEFF Research Database (Denmark)

    Nørregaard, Anette R; Lauridsen, Henrik H; Hartvigsen, Jan

    2009-01-01

    OBJECTIVE: This article describes and discusses the case of a patient with benign paroxysmal positional vertigo (BPPV) characterized by severe vertigo with dizziness, nausea, and nystagmus, treated without the use of spinal manipulation by a doctor of chiropractic. CLINICAL FEATURES: A 46-year-ol...

  9. DIAGNOSIS AND MANAGEMENT BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV

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    Putu Prida Purnamasari

    2013-05-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Benign Paroxysmal Positional Vertigo (BPPV is one of the most frequent Neurotology disorders. Benign Paroxysmal Positional Vertigo is a vestibular disorder in which 17% -20% of patients complained of vertigo. In the general population the prevalence of BPPV is between 11 to 64 per 100,000 (prevalence 2.4%. Benign Paroxysmal Positional Vertigo is a disturbance in the inner ear with positional vertigo symptoms that occur repeatedly with the typical nystagmus paroxysmal. The disorders can be caused either by canalithiasis or cupulolithiasis and could in theory be about three semicircular canals, although superior canal (anterior is very rare. The most common is the form of the posterior canal, followed by a lateral. The diagnosis of BPPV can be enforced based on history and physical examination, including some tests such as Dix-Hallpike test, caloric test, and Supine Roll test. The diagnosis of BPPV is also classified according to the types of channels. Management of BPPV include non-pharmacological, pharmacological and operations. Treatment is often used non-pharmacological includes several maneuvers such as Epley maneuver, Semount maneuver, Lempert maneuver, forced prolonged position and Brandt-Daroff exercises. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  10. Ocular vestibular evoked myogenic potential in patients with benign paroxysmal positional vertigo

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    Mozhgan Masoom

    2014-06-01

    Full Text Available Background and Aim: Since utricle is the main damaged organ in benign paroxysmal positional vertigo (BPPV, ocular vestibular evoked myogenic potential (oVEMP may be an appropriate method to evaluate the utricule dysfunction and the effect of disease recurrence rate on it. This study aimed to record myogenic potential in patients with benign paroxysmal positional vertigo.Methods: In a cross-sectional study, ocular myogenic potential was recorded in 25 healthy subjects and 20 patients with benign paroxysmal positional vertigo using 500 Hz-tone bursts (95 dB nHL.Results: In the affected ear, mean amplitude was lower and mean threshold was higher than those in the unaffected ear and in the normal group (p<0.05. Mean amplitude asymmetry ratio of patients was more than the healthy subjects (p0.05. Frequencies of abnormal responses in the affected ears were higher than in unaffected ears and in the normal group (p<0.05. Furthermore, the patients with recurrent vertigo showed more abnormalities than the patients with non-recurrent (p=0.030.Conclusion: In the recurrent benign paroxysmal positional vertigo, ocular vestibular evoked myogenic potential showed more damage in the utricle, suggesting this response could be used to evaluate the patients with benign paroxysmal positional vertigo.

  11. Insights into horizontal canal benign paroxysmal positional vertigo from a human case report.

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    Aron, Margaret; Bance, Manohar

    2013-12-01

    For horizontal canal benign paroxysmal positional vertigo, determination of the pathologic side is difficult and based on many physiological assumptions. This article reports findings on a patient who had one dysfunctional inner ear and who presented with horizontal canal benign paroxysmal positional vertigo, giving us a relatively pure model for observing nystagmus arising in a subject in whom the affected side is known a priori. It is an interesting human model corroborating theories of nystagmus generation in this pathology and also serves to validate Ewald's second law in a living human subject.

  12. Benign positional vertigo

    Science.gov (United States)

    Vertigo - positional; Benign paroxysmal positional vertigo; BPPV: dizziness- positional ... Benign positional vertigo is also called benign paroxysmal positional vertigo (BPPV). It is caused by a problem in the inner ear. ...

  13. Direction-fixed paroxysmal nystagmus lateral canal benign paroxysmal positioning vertigo (BPPV): another form of lateral canalolithiasis.

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    Califano, L; Vassallo, A; Melillo, M G; Mazzone, S; Salafia, F

    2013-08-01

    Benign paroxysmal positioning vertigo (BPPV) is the most frequent vertiginous syndrome. It is caused either by free-floating otoliths in the semicircular canals (canalolithiasis) or by otoconial debris adhering to a canal cupula (cupulolithiasis). The posterior canal is the most frequently involved (80%), while the lateral canal is involved less frequently (15%), and the rarest conditions are anterior canalolithiasis and apogeotropic posterior canalolithiasis (5%). The main diagnostic sign of lateral canal BPPV is paroxysmal horizontal bidirectional positioning nystagmus evoked through Pagnini-McClure's test (head roll in the yaw plane in supine position). In the geotropic variant, which is more frequent, the fast phase of the nystagmus is directed towards the lowermost ear, when the patient lies on the affected side or on the healthy side; in the apogeotropic variant, which is less frequent, the fast phase is directed always toward the uppermost ear, regardless of which side the patient lies on. Paroxysmal nystagmus is more intense on the affected side in the geotropic form, and more intense on the healthy side in the apogeotropic form. The authors describe five cases of another primitive and rare form of lateral BPPV, defined as "direction-fixed paroxysmal nystagmus lateral canal BPPV", which has previously been described by other authors as a transitory step observed during the transformation from an apogeotropic into a geotropic form. It is characterized by typical BPPV symptoms and diagnosed by the presence of a paroxysmal horizontal unidirectional positioning nystagmus, evoked through Pagnini-McClure's test, which is apogeotropic on the affected side and geotropic on the healthy side. In the reported cases, direction-fixed horizontal paroxysmal nystagmus was always transformed into a typical geotropic form. The clinical features and pathophysiology of direction-fixed nystagmus lateral canal BPPV are discussed.

  14. Predictors for benign paroxysmal positional vertigo with positive Dix–Hallpike test

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    Noda K

    2011-12-01

    Full Text Available Kazutaka Noda, Masatomi Ikusaka, Yoshiyuki Ohira, Toshihiko Takada, Tomoko TsukamotoDepartment of General Medicine, Chiba University Hospital, Chiba, JapanObjective: Patient medical history is important for making a diagnosis of causes of dizziness, but there have been no studies on the diagnostic value of individual items in the history. This study was performed to identify and validate useful questions for suspecting a diagnosis of benign paroxysmal positional vertigo (BPPV.Methods: Construction and validation of a disease prediction model was performed at the outpatient clinic in the Department of General Medicine of Chiba University Hospital. Patients with dizziness were enrolled (145 patients for construction of the disease prediction model and 61 patients for its validation. This study targeted BPPV of the posterior semicircular canals only with a positive Dix–Hallpike test (DHT + BPPV to avoid diagnostic ambiguity. Binomial logistic regression analysis was performed to identify the items that were useful for diagnosis or exclusion of DHT + BPPV.Results: Twelve patients from the derivation set and six patients from the validation set had DHT + BPPV. Binomial logistic regression analysis selected a "duration of dizziness ≤15 seconds" and "onset when turning over in bed" as independent predictors of DHT + BPPV with an odds ratio (95% confidence interval of 4.36 (1.18–16.19 and 10.17 (2.49–41.63, respectively. Affirmative answers to both questions yielded a likelihood ratio of 6.81 (5.11–9.10 for diagnosis of DHT + BPPV, while negative answers to both had a likelihood ratio of 0.19 (0.08–0.47.Conclusion: A "duration of dizziness ≤15 seconds" and "onset when turning over in bed" were the two most important questions among various historical features of BPPV.Keywords: benign paroxysmal positional vertigo, likelihood ratio, diagnosis, screening, prediction rules

  15. Apogeotropic posterior semicircular canal benign paroxysmal positional vertigo: some clinical and therapeutic considerations

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    Paolo Vannucchi

    2015-03-01

    Full Text Available We lately reported the cases of patients complaining positional vertigo whose nystagmic pattern was that of a peripheral torsional vertical positional down beating nystagmus originating from a lithiasis of the non-ampullary arm of the posterior semicircular canal (PSC. We considered this particular pathological picture the apogeotropic variant of PSC benign paroxysmal positional vertigo (BPPV. Since the description of the pilot cases we observed more than 150 patients showing the same clinical sign and course of symptoms. In this paper we describe, in detail, both nystagmus of apogeotropic PSC BPPV (A-PSC BPPV and symptoms reported by patients trying to give a reasonable explanation for these clinical features. Moreover we developed two specific physical therapies directed to cure A-PSC BPPV. Preliminary results of these techniques are related.

  16. Efficacy of Epley maneuver in treatment of benign paroxysmal positional vertigo of the posterior semicircular canal

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    Babac Snežana

    2012-01-01

    Full Text Available Background/Aim. Benign paroxysmal positional vertigo is one of the most frequent peripheral vestibular system disorders. The aim of this study was to examine the efficacy of the Epley maneuver in treating benign paroxysmal positional vertigo of the posterior semicircular canal (p- BPPV and to discover possible causes of failure. Methods. This prospective study included 75 patients. In all the cases medical history showed and the positioning Dix-Hallpike test confirmed the diagnosis of p-BPPV. We also performed clinical ENT examination, searching for spontaneous nystagmus, vestibulospinal tests, caloric test, and audiometry. All the patients were treated by the modified Epley canalith repositioning maneuver. The patients were followed up at the intervals of seven and, fourteen days, and one, tree, and six months and one year. The maneuver was repeated if vertigo and nystagmus on control positioning test persisted. The transition from positive into negative Dix Hallpike test after one or two Epley maneuver was considered as success in treatment. Results. After the initial Epley maneuver the recovery rate was 90.7%, and after the second 96%. In three (4% patients with secondary p-BPPV, symptoms did not cease even after the second repositioning maneuver. The etiology of p-BPPV had a significant effect on the maneuver’s success rate (p < 0.01, whereas duration of symptoms, age and gender had no effect (p > 0.05. After a successful treatment 11 (14.66% patients had recurrent attack of BPPV during the first year. Conclusion. The Epley maneuver is very successful repositioning procedure in treating p- BPPV. The patients with idiopathic form p-BPPV showed higher success rate with Epley maneuver than those with secondary p-BPPV.

  17. Quantitative analysis of benign paroxysmal positional vertigo fatigue under canalithiasis conditions.

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    Boselli, F; Kleiser, L; Bockisch, C J; Hegemann, S C A; Obrist, D

    2014-06-01

    In our daily life, small flows in the semicircular canals (SCCs) of the inner ear displace a sensory structure called the cupula which mediates the transduction of head angular velocities to afferent signals. We consider a dysfunction of the SCCs known as canalithiasis. Under this condition, small debris particles disturb the flow in the SCCs and can cause benign paroxysmal positional vertigo (BPPV), arguably the most common form of vertigo in humans. The diagnosis of BPPV is mainly based on the analysis of typical eye movements (positional nystagmus) following provocative head maneuvers that are known to lead to vertigo in BPPV patients. These eye movements are triggered by the vestibulo-ocular reflex, and their velocity provides an indirect measurement of the cupula displacement. An attenuation of the vertigo and the nystagmus is often observed when the provocative maneuver is repeated. This attenuation is known as BPPV fatigue. It was not quantitatively described so far, and the mechanisms causing it remain unknown. We quantify fatigue by eye velocity measurements and propose a fluid dynamic interpretation of our results based on a computational model for the fluid-particle dynamics of a SCC with canalithiasis. Our model suggests that the particles may not go back to their initial position after a first head maneuver such that a second head maneuver leads to different particle trajectories causing smaller cupula displacements.

  18. Horizontal canal benign paroxysmal positional vertigo: diagnosis and treatment of 37 patients

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    Eliana Teixeira Maranhão

    2015-06-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV, the most frequent cause of vertigo is associated with high morbidity in the elderly population. The most common form is linked to debris in the posterior semicircular canal. However, there has been an increasing number of reported BPPV cases involving the horizontal canals. The purpose of this article is to highlight the clinical features, diagnosis, and treatment in 37 patients with horizontal canal BPPV; twenty-six with geotropic nystagmus, and eleven with the apogeotropic form. Treatment consisted of the Gufoni manoeuver in eighteen patients (48.6%, the barbecue 360° maneuver in twelve patients (32.4%, both manoeuvers in four patients (10.8%, both manoeuvers plus head shaking in one patient (2.7%, and the Gufoni maneuver plus head shaking in two patients. Cupulolithiasis patients were asked to sleep in a forced prolonged position. We obtained a complete resolution of vertigo and nystagmus in 30 patients (81.0% on the initial visit.

  19. Quick repositioning maneuver for horizontal semicircular canal benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    Jinrang Li; Pengfei Guo; Shiyu Tian; Keliang Li; Hao Zhang

    2015-01-01

    Objective:To investigate the efficacy of quick repositioning maneuver for horizontal semicircular canal benign paroxysmal positional vertigo (H-BPPV). Methods:Clinical data of 67 patients with H-BPPV who underwent quick repositioning maneuver in our hospital from July 2009 to November 2014 were retrospectively analyzed. The maneuver involved rotating the patient in the axial plane for 180? from the involved side towards contralateral side as quickly as possible. Results:Complete symptom resolution was achieved in 61 patients (91.0%) at one week and in 64 patients (95.5%) at 3 months post-treatment. During the repositioning maneuver process, there were no obvious untoward responses except transient nausea with or without vomiting in a few patients. Conclusion:The results indicate that the quick repositioning maneuver is an easy and effective alternative treatment in the management of H-BPPV. Copyright © 2015 The Authors. Production & hosting by Elsevier (Singapore) Pte Ltd On behalf of PLA General Hospital Department of Otolaryngology Head and Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  20. Image-based computer-assisted diagnosis system for benign paroxysmal positional vertigo

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    Kohigashi, Satoru; Nakamae, Koji; Fujioka, Hiromu

    2005-04-01

    We develop the image based computer assisted diagnosis system for benign paroxysmal positional vertigo (BPPV) that consists of the balance control system simulator, the 3D eye movement simulator, and the extraction method of nystagmus response directly from an eye movement image sequence. In the system, the causes and conditions of BPPV are estimated by searching the database for record matching with the nystagmus response for the observed eye image sequence of the patient with BPPV. The database includes the nystagmus responses for simulated eye movement sequences. The eye movement velocity is obtained by using the balance control system simulator that allows us to simulate BPPV under various conditions such as canalithiasis, cupulolithiasis, number of otoconia, otoconium size, and so on. Then the eye movement image sequence is displayed on the CRT by the 3D eye movement simulator. The nystagmus responses are extracted from the image sequence by the proposed method and are stored in the database. In order to enhance the diagnosis accuracy, the nystagmus response for a newly simulated sequence is matched with that for the observed sequence. From the matched simulation conditions, the causes and conditions of BPPV are estimated. We apply our image based computer assisted diagnosis system to two real eye movement image sequences for patients with BPPV to show its validity.

  1. Benign Paroxysmal Positional Vertigo Following Sinus Floor Elevation in Patient with Antecedents of Vertigo.

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    Akcay, Huseyin; Ulu, Murat; Kelebek, Seyfi; Aladag, Ibrahim

    2016-07-01

    Benign paroxysmal positional vertigo (BPPV) is an unfamiliar and rare complication occurring following osteotome sinus floor elevation (OSFE) and simultaneous implant placement. Etiology of this disorder is commonly displacement of otoliths by vibratory forces transmitted by osteotomes and mallet along with the hyperextension of the head during the operation, causing them to float around in the endolymph. This report presents a case of protracted BPPV following OSFE and simultaneous implant placement. A 43-year-old female suffered intense vertigo and nausea immediately after implant placement using an OSFE procedure. Upon further questioning after the procedure she gave an account of two times vertigo history within the last 9 years. Despite nootropic drug medication and canalith repositioning procedure applied by a specialist at operation night, the condition did not improve. Patient did not totally recover and was admitted again after 1 month. After repeated maneuvers, nine dosage intravenous serous fluid and piracetam administration the patient recovered. Duration of these procedures took 10 days and the patient was successfully treated with no recurrence of dizziness. Prevention and management of OSFE related BPPV are reviewed especially in patients having prior vertigo history in this report. PMID:27408469

  2. [Evaluation of the treatment of benign paroxysmal positional vertigo with the DHI-S questionnaire].

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    López-Escámez, J A; Gómez Fiñana, M; Fernández, A; Sánchez Canet, I; Palma, M J; Rodríguez, J

    2001-01-01

    Benign paroxysmal positional vertigo (BPPV) is a recurrent chronic disease and its handicap is usually underestimated. The aim of this study is to determine the impact of the treatment by Epley maneuver on short-term BPPV-related quality of life. Forty-two individuals with BPPV were included: 39 with posterior canal affected, 2 with the lateral canal and one with the anterior canal. Diagnosis was established if a consistent clinical history was found and Dix-Hallpike test (DHT) in cases with canal posterior involvement. Subjects with positive DHT were treated by a single Epley maneuver and were recommended to avoid supine for the next 48 hours. The BPPV relapses were investigated at 7th and 30th day post-treatment. BPPV-associated quality of life was evaluated by the Dizzness Handicap Inventory Short-form (DHI-S) at days 1st and 30th post-treatment. Total and partial scores for emotional, physical and functional subscales were compared by Wilcoxon test for paired samples. Dix-Hallpike test was found positive in el 59% individuals (23/39), and 41% cases did not required any treatment. Among 23 patients treated with Epley maneuver, DHT was found negative in 90% at 30th day follow-up. Mean and standard deviation of the total scores obtained in the DHI-S at the first day were 19.22 +/- 9.66 in the DHT positive-patients and 19.79 +/- 10.14 in the whole group (DHT positive or negative). These scores significantly decreased to 10.84 +/- 10.99 at 30 days post-treatment (p = 0.002 and p = 0.001, respectively). In conclusion, the DHI-S is a specific health questionnaire able to assess BPPV-related health and the effectiveness of treatment.

  3. The Effect of Vestibular Rehabilitation in the Treatment of Elderly Patients with Benign Paroxysmal Positional Vertigo

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    N. Saki

    2011-04-01

    Full Text Available Introduction & Objective: Vertigo in the elderly is relatively common, but only a few studies are available. Vestibular rehabilitation (VR therapy is an important therapeutic option in treating patients with significant balance deficits. The purpose of this study was to analyze the effect of vestibular rehabilitation on vertigo symptoms in elderly patients with benign paroxysmal positional vertigo (BPPV. Materials & Methods: In a cross sectional analytic design, 46 patients older than 60 years (aged 61 to 72 years with BPPV who referred to the ENT center of Imam Khomeini Hospital, Ahwaz, were studied. After an otologic evaluation, videonystagmography and dizziness handicap inventory (DHI evaluations were performed for each case. Then, vestibular rehabilitation (VR therapy was carried out by means of Epley maneuver. Efficacy of a VRT was tested by comparing pre-treatment with post-treatment VNG and DHI assessments. The data were analyzed by SPSS 16 software. Results: The average age of the patients was 67.28 ± 4.5 years. VR caused normal Hallpike findings in 31 (67.4 % and noticeable reduction in nystagmus amplitudes in 9 patients. We found a significant correlation between nystagmus amplitudes and DHI scores (r=0.77. The mean DHI scores decreased from 53.26±16.12 points to 15.36±9.23 points (p<0.001 at the end of the treatment course. Conclusion: Our investigation revealed that VR plays an important role in reducing vertigo in at-risk elderly patients. Lack of appropriate treatment in this population may cause a serious balance problem (such as bone fracture and long-term handicap that may interfere with their daily activities. (Sci J Hamadan Univ Med Sci 2011;18(1:33-36

  4. Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: A longitudinal clinical study

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    Sheikhzadeh, Mahboobeh; Lotfi, Yones; Mousavi, Abdollah; Heidari, Behzad; Monadi, Mohsen; Bakhshi, Enayatollah

    2016-01-01

    Background: Benign paroxysmal positional vertigo (BPPV) is linked to vitamin D deficiency. This clinical trial aimed to determine the influence of vitamin D supplementation on intensity of BPPV. Methods: The study population was selected consecutively and the diagnosis of BPPV was made by history and clinical examination and exclusion of other conditions. Intensity of BPVV was assessed based on VAS score (0-10). Serum 25-hydroxyvitamin D (25-OHD) was measured using ELISA method and levels < 20 ng/ml was considered a deficiency. All patients received rehabilitation treatment using Epley's maneuver one time per week for one month. Serum 25-OHD deficient patients were classified as treated and non-treated groups (rehabilitation with or without 50.000 IU cholecalciferol weekly for two months).The results of treatment were compared with vitamin D sufficient group as control. All patients were followed-up for 6 months. Results: After two months of treatment, in both vitamin D treated and non-treated groups the intensity of BPPV decreased significantly as compared with control (P=0.001 for both groups) but at endpoint, the intensity of BPPV aggravated and regressed to the baseline value in vitamin D deficient non-treated group (P=0.001) whereas, in vitamin D treated group, improvement of BPPV remained stable and unchanged over the study period. Conclusion: This study indicates that correction of vitamin D deficiency in BPPV provides additional benefit to rehabilitation therapy (Epley maneuver) regarding duration of improvement. These findings suggest serum 25-OHD measurement in recurrent BPPV. PMID:27386060

  5. Benign positional vertigo - aftercare

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    Vertigo - positional - aftercare; Benign paroxysmal positional vertigo - aftercare; BPPV - aftercare ... Your doctor may have treated your vertigo with the Epley maneuver. ... ear problem that causes BPPV. It usually works quickly. For ...

  6. Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo Presenting with Torsional Downbeating Nystagmus: An Apogeotropic Variant

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    Paolo Vannucchi

    2012-01-01

    Full Text Available The aim of this study is to verify the hypothesis that free-floating particles could sometimes localize into the distal portion of the non ampullary arm of the posterior semicircular canal (PSC so that assuming the Dix-Hallpike’s positions, the clot could move towards the ampulla eliciting a inhibitory torsional-down beating paroxysmal positional nystagmus (PPNy, instead of typical excitatory torsional-up beating PPNy. Among 45 patients with vestibular signs suggesting anterior semicircular canal paroxysmal positional vertigo (PPV, collected from February 2003 to August 2006, we detected a group of 6 subjects whose clinical findings showed a singular behaviour during follow-up. At the first check-up, all patients were submitted to different types of physical manoeuvres for ASC canalolithiasis. Patients were controlled during the same session and after one week. When we found that nystagmus was qualitatively changed we adopted the appropriate physical therapies for that sign. At a next check-up, after having performed some physical therapies, all patients had a typical PSC PPNy of the opposite side, with respect to that of the ASC initially diagnosed. Basing on these observations we conclude that PSC PPV, similarly to lateral semicircular canal PPV, could manifests in a apogeotropic variant.

  7. Benign paroxysmal torticollis in infancy

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    Dimitrijević Lidija

    2006-01-01

    Full Text Available Background. Benign paroxysmal torticollis (BPT is an episodic functional disorder of unknown etiology, characterized by the periods of torticollic posturing of the head, that occurs in the early months of life in healthy children. Case report. We reported two patients with BPT. In the first patient the symptoms were observed at the age of day 20, and disappeared at the age of 3 years. There were 10 episodes, of which 2 were followed by vomiting, pallor, irritability and the abnormal trunk posture. In the second patient, a 12-month-old girl, BPT started from day 15. She had 4 episodes followed by vomiting in the first year. Both girls had the normal psychomotor development. All diagnostical tests were normal. Conclusion. The recognition of BPT, as well as its clinical course may help to avoid not only unnecessary tests and the treatment, but also the anxiety of the parents.

  8. Single Treatment Approaches to Benign paroxysmal Positional Vertigo, Is It Enough?

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    Ahmed Abdel-Bassit* , Mohammed Elsaid

    2005-06-01

    Full Text Available Bening paroxysmal positional vertigo (B.P.P.V is one of the most common vestibular disorders.During the last years, it has been attributed to cupulolithiasis or canalithiasis of the posterior semicircular canal.This randomized study was done to determine the effectiveness of two different physical therapy approaches and to determine if a single treatment approaches is enough.In this prospective study 80 patients received either a single treatment based on the hypothesis that the vertigo and nystagmus of (B.P.P.V are due to debris adhering to the cupula of posterior semicircular canal (cupulolithiasis, Semont maneuver, or a single treatment based on the hypothesis that the debris is free floating in the long arm of the posterior semicircular canal (canalithiasis, Epley maneuver.Treatment outcome was classified as asymptomatic, improved and no change. Analysis of the results of this study revealed that at the end of the first session , out of 80 patients, 60(75% were asymptomatic ; 14(18% improved ;6(7% showed no change. Follow­up showed that 8 patients developed recurrence. After a second session to 22 patients (8 recurrences, 10 improved, 4 had no change ,17 became asymptomatic.This means that at the end of the seconed session ,69 (86% of 80 patients became asymptomatic ; 9(11% of 80 patients improved ; 2(3% of 80 patients showed no change. In conclusion , this study shows that 1 The success rate of Semont's maneuver was up to 80%, so it is much better than Epley maneuver 70% after the first session. 2Recurrent cases are best treated with second session.

  9. Assessment for benign paroxysmal positional vertigo in medical patients admitted with falls in a district general hospital.

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    Abbott, Joel; Tomassen, Sylvia; Lane, Laura; Bishop, Katie; Thomas, Nibu

    2016-08-01

    Having benign paroxysmal positional vertigo (BPPV) puts patients at a significantly higher risk of falling. It is poorly recognised and diagnosis is frequently delayed. BPPV has been studied in outpatient settings, but there have been no studies looking at the prevalence in patients admitted with falls. This study aims to establish how common BPPV is in these patients.For a 4-month period, patients admitted on an unselected medical take were screened for an admission precipitated by a fall. Patients who consented were assessed for BPPV using the Dix-Hallpike manoeuvre. Patients who tested positive were treated using the Epley manoeuvre. The assessments were carried out by specialist physiotherapists who were experienced at assessing and diagnosing patients with peripheral vestibular disorders. Out of the 111 patients initially identified, 37 (33%) were considered to be appropriate and consented to be part of the study. Of these, 20 patients (54%) had a positive Dix-Hallpike manoeuvre.Of the patients included in the study, over half tested positive for BPPV. This merits further study. Potentially, there is a proportion of patients admitted with falls who have an easily treatable contributing factor that is not being identified with standard practice. PMID:27481376

  10. Evaluation of the otolith function using sinusoidal off-vertical axis rotation in patients with benign paroxysmal positional vertigo.

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    Sugita-Kitajima, Akemi; Azuma, Miki; Hattori, Kosuke; Koizuka, Izumi

    2007-07-01

    The vestibulo-ocular reflex (VOR) was studied via sinusoidal off-vertical axis rotation (OVAR) to evaluate the otolith function in patients with benign paroxysmal positional vertigo (BPPV). Subjects were sinusoidally rotated with eyes open in complete darkness at frequencies of 0.4 and 0.8 Hz with a maximum angular velocity of 60 degrees s(-1) in earth-vertical axis rotation (EVAR) and OVAR. Twenty-three controls and 24 BPPV patients were investigated. Results showed that VOR gain during OVAR at 0.8 Hz in a 30 degrees nose-up position in BPPV patients was significantly less than the gain during EVAR, whereas the gain was not significantly different between EVAR and OVAR in the controls in each condition. In addition, to examine each type of BPPV, we also investigated whether there were any differences between the patients who suffered from dizziness and those who did not. VOR gain in OVAR of BPPV patients who were suffering from dizziness was significantly less than that of BPPV patients without dizziness. Not only cupulolithiasis or canalolithiasis, but also otolith dysfunction was considered to be the possible origin of BPPV. Because sinusoidal OVAR produced minimal nausea compared to constant velocity OVAR, the stimulation of 0.8 Hz nose-up in sinusoidal OVAR may be used to evaluate otolith function without discomfort for patients. PMID:17597299

  11. Curing a 96-year-old patient afflicted with benign paroxysmal positional vertigo on a motorized turntable

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    Bockisch CJ

    2014-04-01

    Full Text Available Christopher J Bockisch,1–3 Dominik Straumann,1,4 Konrad P Weber1,2 1Department of Neurology, University Hospital Zurich, 2Department of Ophthalmology, University Hospital Zurich, 3Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 4Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland Background: Dizziness in the elderly is a serious health concern due to the increased morbidity caused by falling. The most common cause of dizziness in the elderly, benign paroxysmal positional vertigo (BPPV, is frequently undiagnosed, and bedside treatment of these patients can be difficult due to neck and back stiffness, which makes repeated and accurate repositioning maneuvers difficult. Case presentation: After a fall, a 96-year-old woman was referred by a resident neurologist for intractable BPPV. The patient was placed on a motorized turntable and repositioned to remove the calcite particles from the affected posterior semicircular canal. Video monitoring of the eyes allowed confirmation of the diagnosis, as well as an immediate evaluation of the effectiveness of the maneuver. Conclusion: Every patient with dizziness or imbalance, even in the absence of typical complaints of BPPV, should be tested with provocation maneuvers, because the clinical picture of BPPV is not always typical. Even if elderly patients with dizziness are very frail, the completion of provocation maneuvers is imperative, since the therapeutic maneuvers are extremely effective. A motorized turntable is very helpful to perform the repositioning accurately and safely. Keywords: vestibulo ocular reflex, nystagmus, vertigo

  12. Significance of the 'bow and lean test' for the diagnosis of benign horizontal semicircular canal paroxysmal positional vertigo

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    Ying CHEN

    2012-10-01

    Full Text Available Objective To observe and assess the positive rate and accuracy of 'bow and lean test' in the horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV. Methods Ninety-two HSC-BPPV patients who were diagnosed by head roll test (HRT were enrolled, and then further tested with 'bow and lean test' (BLT between Oct 1, 2010 and Sep 30, 2011. They were treated by Barbecue maneuver or Brandt-Daroff exercise on the basis of HRT and BLT tests. The positive rate of BLT test was analyzed, and its accuracy for diagnosis and success rate for treatment of HSC-BPPV were compared between HRT and BLT. Results Among the 92 patients, 83(90.2% of them showed BLT nystagmus. Fifty-seven of 83 (68.7% patients showed both bowing nystagmus and leaning nystagmus, and 18(21.7% and 8(9.6% respectively showed bowing nystagmus alone or leaning nystagmus alone. Among 92 patients, 74(80.4% of them the affected side could be determined by HRT with 69 BLT positive and 5 BLT negative. Among the 69 BLT-positive patients, 60 patients showed the same result of HRT, and successful result was achieved by manipulation. 9 patients showed different result between BLT and HRT, in whom manipulation failed according to the result of HRT, but succeeded when manipulation was performed according to BLT. In 18 patients(19.6% it was not able to determine the affected side by HRT, but in 14 patients manipulation was successful when BLT result was applied. In 4 patients BLT failed to evoke nystagmus, but after practicing Brandt-Daroff exercise, vertigo and HRT nystagmus disappeared 3 days later. Among the 92 patients, 65(70.7% were cured according to HRT, while 83(90.2% got successful result according to BLT(P < 0.05. Conclusion The positive rate and accuracy for HSC-BPPV by BLT are high. It is a useful method for determining the affected side in HSC-BPPV, and to provide the basis for selecting effective manipulation treatment.

  13. Quedas em idosos com Vertigem Posicional Paroxística Benigna Elderly falls associated with benign paroxysmal positional vertigo

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    Fernando Freitas Ganança

    2010-02-01

    Full Text Available Vertigem Posicional Paroxística Benigna (VPPB pode causar quedas, principalmente em pacientes idosos. OBJETIVO: Verificar se o número de quedas em idosos com VPPB diminui após a realização de manobras de reposicionamento de partículas (MRP. MATERIAL E MÉTODO: Estudo retrospectivo em que foram incluídos idosos com VPPB que tenham apresentado queda no último ano. Todos os pacientes submeteram-se à MRP de acordo com o canal semicircular (CSC acometido. Após a abolição da vertigem e do nistagmo de posicionamento, os pacientes foram acompanhados ao longo de 12 meses e investigados em relação ao número de quedas neste período. Para comparar o número de quedas antes e após as MRP utilizou-se avaliação estatística por meio do teste de Wilcoxon. RESULTADOS: Foram incluídos 121 pacientes. Cento e um pacientes apresentaram acometimento do CSC posterior, 16 do lateral e quatro do anterior. Verificou-se redução do número de quedas após as MRP, com diferença estatisticamente significante na amostra geral (pBenign Paroxysmal Positional Vertigo (BPPV can cause falls, especially in the elderly. AIM: to study whether or not elderly patients with BPPV have a reduction on their falls after the particle repositioning maneuver (PRM. MATERIALS AND METHODS: retrospective study including elderly with BPPV who had fall(s during the last year. All patients were submitted to the PRM according to the affected semicircular canal (SCC. After the abolition of positioning vertigo and nystagmus, the patients were submitted to a 12 month follow-up and were investigated about the number of fall(s. Wilcoxon's test was performed to compare the number of fall(s before and after 12 months of the PRM. RESULTS: One hundred and twenty one patients were included in the study. One hundred and one patients presented involvement of the posterior SCC, 16 of the lateral and four of the anterior. We noticed a reduction on the number of falls, with statistically

  14. Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver.

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    Silva, Camila Nicácio da; Ribeiro, Karyna Myrelly O B de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Britho Macedo; Guerra, Ricardo Oliveira

    2016-01-01

    Introduction Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common and treatable causes of peripheral vestibular vertigo in adults. Its incidence increases with age, eventually leading to disability and a decreased quality of life. Objective The research aims to assess short-term effects of Otolith Repositioning Maneuver (ORM) on dizziness symptoms, quality of life, and postural balance in elderly people with Benign Paroxysmal Positional Vertigo. Methods A quasi-experimental study, which evaluated 14 elderly people that underwent the Otolith Repositioning Maneuver and reevaluation after one week. The authors performed statistical analysis by descriptive analysis of central tendency and dispersion; for pre- and post-treatment conditions, the authors used the Wilcoxon test. Results All aspects of the Dizziness Handicap Inventory (physical, functional, emotional, and total scores) as well as the Visual Analogue Scale (VAS) decreased after therapy (p balance, there were significant differences in some parameters of the modified Clinical Test of Sensory Interaction and Balance, Limits of Stability and gait assessment measured by the Dizziness Gait Index (p balance improved. Therefore, a longer follow-up period and a multidisciplinary team are required to establish comprehensive care for elderly patients with dizziness complaints. PMID:26722348

  15. Performance of DHI score as a predictor of benign paroxysmal positional vertigo in geriatric patients with dizziness/vertigo: a cross-sectional study.

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    Amrish Saxena

    Full Text Available BACKGROUND: Dizziness/vertigo is one of the most common complaint and handicapping condition among patients aged 65 years and older (Geriatric patients. This study was conducted to assess the impact of dizziness/vertigo on the quality of life in the geriatric patients attending a geriatric outpatient clinic. SETTINGS AND DESIGN: A cross-sectional study was performed in a geriatric outpatient clinic of a rural teaching tertiary care hospital in central India. MATERIALS AND METHODS: In all consecutive geriatric patients with dizziness/vertigo attending geriatric outpatient clinic, DHI questionnaire was applied to assess the impact of dizziness/vertigo and dizziness associated handicap in the three areas of a patients' life: physical, functional and emotional domain. Later, each patient was evaluated and underwent Dix-Hallpike maneuver by the physician who was blind of the DHI scoring of the patient. STATISTICAL ANALYSIS USED: We compared means and proportions of variables across two categories of benign paroxysmal positional vertigo (BPPV and non-BPPV. For these comparisons we used Student's t-test to test for continuous variables, chi-square test for categorical variables and Fisher's exact test in the case of small cell sizes (expected value<5. RESULTS: The magnitude of dizziness/vertigo was 3%. Of the 88 dizziness/vertigo patients, 19 (22% and 69(78% cases, respectively, were attributed to BPPV and non-BPPV group. The association of DHI score ≥50 with the BPPV was found to be statistically significant with x(2 value = 58.2 at P<0.01. CONCLUSION: DHI Score is a useful tool for the prediction of benign paroxysmal positional vertigo. Correct diagnosis of BPPV is 16 times greater if the DHI Score is greater than or equal to 50. The physical, functional and emotional investigation of dizziness, through the DHI, has demonstrated to be a valuable and useful instrument in the clinical routine.

  16. Evaluation of quality of life pre- and post-vestibular rehabilitation in patients with benign paroxysmal positional vertigo associated with Meniere's disease

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    Azzi, Viviane Jacintha Bolfe

    2012-01-01

    Full Text Available Introduction: Vertigo is a symptom that impacts the patients' quality of life and may force them to cease performing activities of daily living. Here, we discuss benign paroxysmal positional vertigo (BPPV and Meniere's disease (MD, which show exacerbated symptoms when they appear in association. Vestibular rehabilitation (VR is an effective treatment in reducing vertigo, especially in conjunction with other therapies. Aim: To evaluate the quality of life of patients with BPPV and MD before and after VR. Method: We conducted a descriptive observational qualitative and quantitative case study with 12 patients aged 35 to 86 years. All patients diagnosed with BPPV and MD received treatment in the ENT clinic. The Brazilian DHI questionnaire, which assesses the quality of life with a focus on physical, emotional, and functional aspects, was used for data collection, and was completed by patients before the first session and after the fifth session of VR. Data were tested using the Shapiro-Wilk normality test, followed by Wilcoxon, Friedman, and Spearman correlation tests (p < 0.05. Results: There were significant improvements in scores for all aspects, with median changes ranging from 12 to 0 in the physical, 6 to 1 in the emotional, and 11 to 1 in the functional aspect. There were no correlations between the scores and sample characteristics. Conclusion: VR was an effective method for the treatment of patients with BPPV and MD; it improves quality of life and shows the maximal influence on physical aspect scores, regardless of age or gender.

  17. Validation of 5-item and 2-item questionnaires in Chinese version of Dizziness Handicap Inventory for screening objective benign paroxysmal positional vertigo.

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    Chen, Wei; Shu, Liang; Wang, Qian; Pan, Hui; Wu, Jing; Fang, Jie; Sun, Xu-Hong; Zhai, Yu; Dong, You-Rong; Liu, Jian-Ren

    2016-08-01

    As possible candidate screening instruments for benign paroxysmal positional vertigo (BPPV), studies to validate the Dizziness Handicap Inventory (DHI) sub-scale (5-item and 2-item) and total scores are rare in China. From May 2014 to December 2014, 108(55 with and 53 without BPPV) patients complaining of episodic vertigo in the past week from a vertigo outpatient clinic were enrolled for DHI evaluation, as well as demographic and other clinical data. Objective BPPV was subsequently determined by positional evoking maneuvers under the record of optical Frenzel glasses. Cronbach's coefficient α was used to evaluate the reliability of psychometric scales. The validity of DHI total, 5-item and 2-item questionnaires to screen for BPPV was assessed by receiver operating characteristic (ROC) curves. It revealed that the DHI 5-item questionnaire had good internal consistency (Cronbach's coefficient α = 0.72). Area under the curve of total DHI, 5-item and 2-item scores for discriminating BPPV from those without was 0.678 (95 % CI 0.578-0.778), 0.873(95 % CI 0.807-0.940) and 0.895(95 % CI 0.836-0.953), respectively. It revealed 74.5 % sensitivity and 88.7 % specificity in separating BPPV and those without, with a cutoff value of 12 in the 5-item questionnaire. The corresponding rate of sensitivity and specificity was 78.2 and 88.7 %, respectively, with a cutoff value of 6 in 2-item questionnaire. The present study indicated that both 5-item and 2-item questionnaires in the Chinese version of DHI may be more valid than DHI total score for screening objective BPPV and merit further application in clinical practice in China. PMID:27071688

  18. New treatment strategy for cupulolithiasis associated with benign paroxysmal positional vertigo of the lateral canal: the head-tilt hopping exercise.

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    Yamanaka, Toshiaki; Sawai, Yachiyo; Murai, Takayuki; Okamoto, Hideyuki; Fujita, Nobuya; Hosoi, Hiroshi

    2014-12-01

    This study was performed to determine whether a novel treatment was effective against cupulolithiasis associated with benign paroxysmal positional vertigo (BPPV) of the lateral semicircular canal, which is characterized by apogeotropic direction-changing nystagmus. We herein describe our head-tilt hopping (HtH) exercise, which is designed to release otoconial debris strongly adhered to the cupula. The subjects were trained to hop while tilting their heads laterally. They completed 3 to 5 exercise sessions per day over a 4-week period. Each session ended with a 20-hop trial. The HtH exercises were performed by 27 patients with intractable lateral canal BPPV who exhibited positional vertigo and persistent nystagmus beating toward the uppermost ear for more than 4 weeks, despite performing therapeutic head shaking in the horizontal plane maneuver. All the patients were subjected to the supine roll test before and immediately after the first trial as well as after 1 and 4 weeks of the program to evaluate the effect of the treatment on their apogeotropic nystagmus. Nystagmus of 9 (33.3 %) patients disappeared immediately after the first training session. After 1 and 4 weeks of the training, the number of patients that had experienced either of these improvements had increased to 15 (55.6 %) and 19 (70.4 %) subjects, respectively. These results suggest that HtH exercises aimed at releasing otoconial debris from the cupula are feasible as a new therapy for cupulolithiasis associated with intractable lateral canal BPPV. However, further studies for comparison with control are required to confirm these preliminary results.

  19. Validation of 5-item and 2-item questionnaires in Chinese version of Dizziness Handicap Inventory for screening objective benign paroxysmal positional vertigo.

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    Chen, Wei; Shu, Liang; Wang, Qian; Pan, Hui; Wu, Jing; Fang, Jie; Sun, Xu-Hong; Zhai, Yu; Dong, You-Rong; Liu, Jian-Ren

    2016-08-01

    As possible candidate screening instruments for benign paroxysmal positional vertigo (BPPV), studies to validate the Dizziness Handicap Inventory (DHI) sub-scale (5-item and 2-item) and total scores are rare in China. From May 2014 to December 2014, 108(55 with and 53 without BPPV) patients complaining of episodic vertigo in the past week from a vertigo outpatient clinic were enrolled for DHI evaluation, as well as demographic and other clinical data. Objective BPPV was subsequently determined by positional evoking maneuvers under the record of optical Frenzel glasses. Cronbach's coefficient α was used to evaluate the reliability of psychometric scales. The validity of DHI total, 5-item and 2-item questionnaires to screen for BPPV was assessed by receiver operating characteristic (ROC) curves. It revealed that the DHI 5-item questionnaire had good internal consistency (Cronbach's coefficient α = 0.72). Area under the curve of total DHI, 5-item and 2-item scores for discriminating BPPV from those without was 0.678 (95 % CI 0.578-0.778), 0.873(95 % CI 0.807-0.940) and 0.895(95 % CI 0.836-0.953), respectively. It revealed 74.5 % sensitivity and 88.7 % specificity in separating BPPV and those without, with a cutoff value of 12 in the 5-item questionnaire. The corresponding rate of sensitivity and specificity was 78.2 and 88.7 %, respectively, with a cutoff value of 6 in 2-item questionnaire. The present study indicated that both 5-item and 2-item questionnaires in the Chinese version of DHI may be more valid than DHI total score for screening objective BPPV and merit further application in clinical practice in China.

  20. Benign Paroxysmal Positional Vertigo (BPPV)

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    ... Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2008;70:2067-74. Parnes LS, et al. ... Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2008;70:2067-74. Author: Sheelah Woodhouse, ...

  1. Manobras de reposicionamento no tratamento da vertigem paroxística posicional benigna Treatment of benign paroxysmal positional vertigo with repositioning manevers

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    Roberto A. Maia

    2001-09-01

    Full Text Available Introdução: Vertigem paroxística posicional benigna (VPPB é uma das mais freqüentes patologias do sistema vestibular. Caracteriza-se clinicamente pela presença de episódios recorrentes de tonturas rotatórias, tipicamente desencadeados por determinados movimentos cefálicos, realizados pelo paciente. A confirmação diagnóstica é obtida exclusivamente pela manobra de Dix-Hallpike. Nessa manobra, observa-se sistematicamente o desencadeamento de nistagmo. Forma de estudo: Prospectivo clínico não randomizado. Material e método: No total, sete pacientes com diagnóstico clínico de VPPB são submetidos a tratamento pela manobra de reposicionamento de Epley. Resultado: Desses sete pacientes avaliados, cinco apresentaram ótima recuperação; dois, com resultado bom; e um, com mau resultado; para este último caso, outras formas de tratamento são apresentadas. Conclusão: O exame otoneurológico, realizado em todos os pacientes, demonstrou ser de interessante valor prognóstico quanto ao resultado do tratamento proposto. A manobra de reposicionamento de Epley demonstrou ser um método de tratamento da VPPB simples, e eficaz na grande maioria dos pacientes aqui relatados.Introduction: Benign Paroxysmal Positional Vertigo (BPPV is among the most common vestibular disorders. It is characterized by recurrent episodes of vertigo induced by changes in head position. The condition is readly diagnosed by performing the Dix-Hallpike maneuver. Nystagmus is always present by this way. Study design: Prospective results clinical not randomized. Material and method: A total of seven patients diagnosed with BPPV received the repositioning maneuver of Epley. Five out of seven patients had excellent recovery, two patients had good results and one had a bad result. For this last one different treatments are discussed. Conclusion: We performed otoneurological examination in all patients; this test seems to be an intersting prognosis method for seeking the

  2. Efficacy of cervical and ocular vestibular-evoked myogenic potentials in evaluation of benign paroxysmal positional vertigo of posterior semicircular canal.

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    Singh, Niraj Kumar; Apeksha, Kumari

    2016-09-01

    Benign paroxysmal positional vertigo (BPPV) constitutes a major proportion of the population with peripheral vestibulopathies. Although the freely floating otoconia within the semicircular canals is responsible for the symptoms of BPPV, the source of the otoconia debris is mainly believed to be the otolith organs. Therefore, the pathology in either or both the otolith organs appears a logical proposition. Cervical and ocular vestibular-evoked myogenic potentials (cVEMP and oVEMP), being the tests for functional integrity of the otolith organs, appear promising for investigating otolith involvement in BPPV. While recent evidences are suggestive of equivocal findings for cVEMP, there are only a few studies on oVEMP. Additionally, both these potentials have never been explored in the same set of individuals with BPPV. Therefore, the present study aimed to evaluate the functional integrity of the otolith organs through cVEMP and oVEMP in individuals with posterior canal BPPV. Thirty-one individuals with unilateral posterior canal BPPV and 31 age- and gender-matched healthy controls underwent 500 Hz tone-burst-evoked cVEMP and oVEMP. The results demonstrated no significant group difference on any of the cVEMP parameters (p > 0.05). A similar trend was noticed for the latency-related parameters of oVEMP. However, the peak-to-peak amplitude was significantly smaller in the affected ears of individuals with BPPV than their unaffected ears and the ears of healthy controls (p < 0.05). The BPPV group showed significantly higher inter-aural amplitude difference ratio than the healthy controls (p < 0.05). Further, the sensitivity and specificity of oVEMP were also found to be far superior to those of cVEMP. Thus, the outcome of the present study revealed involvement of utricle rather than saccule in posterior canal BPPV, and therefore, oVEMP appears to be better suited to clinical investigation than cVEMP in individuals with posterior canal BPPV. PMID:26718546

  3. Analyze on Misdiagnosis and Mistherapy of Benign Paroxysmal Positional Vertigo%良性阵发性位置性眩晕的误诊漏诊研究

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    王洪娇; 陈学贤

    2015-01-01

    Objective To investigate the reason of misdiagnosis and wrong therapy for Benign paroxysmal positional vertigo,discuss how to improve its’diagnosis rate. Methods 86 patients were investigated and analyzed. Results 29 cases were diagnosed firstly(33.72%),mistherapy was 48 cases(55.81%), misdiagnosis 9 cases(10.47%). Using Dix-Hal pike and Rol test,posterior semicircular canal was 71 cases,horizontal semicircular canal was 13 cases and mixed type was 2 cases. Conclusion BPPV has typical symptoms and signs and has high misdiagnosis rate. It should be attented. Dix-Hal pike and Rol test is effective means.%目的:研究良性阵发性位置性眩晕(BPPV)误诊漏诊的原因,探讨如何提高良性阵发性位置性眩晕的确诊率。方法选取2012年10月~2014年6月在我院耳鼻喉科诊治的 BPPV 患者86例,调查分析所有患者的诊断经历,研究 BPPV 的误诊漏诊原因。结果86例患者中首次确诊患者29例(33.72%),误诊患者48例(55.81%),漏诊患者9例(10.47%)。采用 Dix-Hal pike 和 Rol test 检查方法,确诊后半规管 BPPV 71例,水平半规管 BPPV 13例,混合型 BPPV 2例。结论 BPPV 有典型的症状及体征,但误诊漏诊率却较高,应引起相关科室医生的重视,减少误诊漏诊情况的发生。Dix-Hal pike 和 Rol test 是明确诊断的有效手段。

  4. Active head rotation in benign positional paroxysmal vertigo Da rotação cefálica ativa na vertigem posicional paroxística benigna

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    Fernando Freitas Ganança

    2009-08-01

    Full Text Available Benign Positional Paroxysmal Vertigo (BPPV is one of the most common vestibular diseases and the active head rotation test one of the most modern methods of vestibular function assessment. AIM: this study aims to verify if the active head rotation test may reveal signs of horizontal and/or vertical vestibulo-ocular reflex dysfunction in vertigo patients suspected for BPPV. STUDY DESIGN: retrospective series study. MATERIALS AND METHOD: Neurotological evaluation including computerized electronystagmography and active head rotation on the horizontal and vertical axes were conducted in 100 patients suspected for BPPV patients. Results: Isolated or associated abnormalities of the horizontal and/or vertical vestibulo-ocular reflex gain, phase and symmetry were indicative of vestibular involvement and found in 77.0% of the BPPV patients. CONCLUSION: the active head rotation test revealed horizontal and/or vertical vestibulo-ocular reflex dysfunctions in a relevant number of BPPV patients.A vertigem posicional paroxística benigna (VPPB corresponde a uma das vestibulopatias mais comuns e a rotação cefálica ativa um dos métodos mais modernos de avaliação da função vestibular. OBJETIVO: O objetivo desta pesquisa foi verificar se a prova de rotação cefálica ativa pode revelar sinais de disfunção do reflexo vestíbulo-ocular horizontal e/ou vertical em pacientes vertiginosos com hipótese diagnóstica de VPPB. DESENHO DO ESTUDO: Estudo de série retrospectivo. MATERIAL E MÉTODO: Uma avaliação otoneurológica incluindo a eletronistagmografia computadorizada e a prova de rotação cefálica ativa, no plano horizontal e vertical foi conduzida em 100 pacientes com hipótese diagnóstica de VPPB. Resultados: Alterações isoladas ou associadas de ganho, fase e assimetria do reflexo vestíbulo-ocular horizontal e/ou vertical, foram os achados indicativos de comprometimento vestibular em 77,0% dos casos de VPPB. CONCLUSÃO: A prova de rota

  5. Benign paroxysmal positional vertigo recurrence and persistence Recorrência e persistência da vertigem posicional paroxística benigna

    Directory of Open Access Journals (Sweden)

    Ricardo S Dorigueto

    2009-08-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is one of the most common vestibular disorders. AIM: To study the recurrence and persistence of BPPV in patients treated with canalith repositioning maneuvers (CRM during the period of one year. STUDY DESIGN: longitudinal contemporary cohort series. MATERIALS AND METHODS: One hundred patients with BPPV were followed up during 12 months after a treatment with CRM. Patients were classified according to disease evolution. Aquatic physiotherapy for vestibular rehabilitation (APVR protocol was applied in cases of persistent BPPV. RESULTS: After CRM, 96% of the patients were free from BPPV's typical nystagmus and dizziness. During the follow up period of 1 year, 26 patients returned with typical BPPV nystagmus and vertigo. Nystagmus and vertigo were persistent in 4% of the patients. Persistent BPPV presented improvement when submitted to APVR. Conclusion: During the period of one year, BPPV was not recurrent in 70% of the patients, recurrent in 26% and persistent in 4%.A vertigem posicional paroxística benigna (VPPB é das vestibulopatias mais comuns. OBJETIVO: Verificar a recorrência e a persistência da VPPB no período de um ano em pacientes que foram tratados com manobras de reposicionamento de estatocônios (MRE. FORMA DE ESTUDO: coorte contemporânea longitudinal. MATERIAL E MÉTODO: Cem pacientes com VPPB foram acompanhados durante 12 meses após o tratamento com MRE. Os pacientes foram classificados de acordo com a evolução da doença no período de um ano. O protocolo de fisioterapia aquática para reabilitação vestibular (FARV foi aplicado nos pacientes com VPPB persistente. RESULTADOS: Após as MRE, 96% dos pacientes aboliram o nistagmo e a vertigem de posicionamento. Destes pacientes, 26 apresentaram recorrência da VPPB, no período de um ano. Em 4% dos pacientes, a VPPB foi persistente. Os pacientes com VPPB persistente apresentaram melhora clínica após a realização da FARV. CONCLUS

  6. Resultados do Balance Rehabilitation Unit na Vertigem Posicional Paroxística Benigna Results from the Balance Rehabilitation Unit in Benign Paroxysmal Positional Vertigo

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    Cristiane Akemi Kasse

    2010-10-01

    Full Text Available A posturografia é um instrumento útil e novo para o estudo da influência das doenças vestibulares no equilíbrio corporal. OBJETIVO: Comparar os resultados da posturografia estática do Balance Rehabilitation Unit (BRU em idosos com Vertigem Postural Paroxística Benigna (VPPB pré e pós a manobra de Epley. MATERIAL E MÉTODO: Estudo prospectivo de 20 pacientes idosos com diagnóstico de VPPB. Os pacientes foram submetidos à posturografia estática do BRU, e o limite de estabilidade (LE e a área de elipse foram medidos. Aplicou-se também o questionário "Dizziness Handicap Inventory" versão brasileira (DHI para verificar a eficácia do tratamento. RESULTADOS: 80% pacientes eram do gênero feminino, com a média etária de 68,15 anos. Após a manobra, o LE aumentou significantemente (p=0,001. A área de elipse nas condições de conflitos sensoriais, visuais e vestibulares da BRU (condições 2,7,8,9 e o escore do DHI diminuíram significantemente (pPosturography is a useful new tool to study the influence of vestibular diseases on balance. AIM: to compare the results from the Balance Rehabilitation Unit (BRU static posturography in elderly patients with Benign Paroxysmal Positional Vertigo (BPPV, before and after Epley's maneuver. MATERIALS AND METHODS: a prospective study of 20 elderly patients with a diagnosis of BPPV. The patients underwent static posturography and the limit of stability (LE and ellipse area were measured. We also applied the Dizziness Handicap Inventory (DHI questionnaire to study treatment effectiveness. RESULTS: 80% were females, with a mean age of 68.15 years. After the maneuver, the LE increased significantly (p=0.001. The elliptical area of somatosensory, visual and vestibular conflicts (2,7,8,9 situations in BRU and the DHI scores decreased significantly (p<0.05 after treatment. CONCLUSION: the study suggests that elderly patients with BPPV may present static postural control impairment and that the maneuver

  7. Vértigo posicional paroxístico benigno relacionado con los tratamientos dentales Benign paroxysmal positional vertigo related with dental work

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    R. Crovetto Martínez

    2012-08-01

    Full Text Available Introducción. El vértigo posicional paroxístico benigno (VPPB es el vértigo más frecuente, con una prevalencia anual del 1,6% en la población general. Puede ser causado por traumatismo craneal. El VPPB se desencadena con determinados movimientos cefálicos, como tumbarse en el sillón odontológico en posición supina. Los objetivos de este estudio son determinar la incidencia de presentación de VPPB durante los procedimientos dentales y analizar la incidencia de VPPB yatrógeno tras traumatismos craneales realizados con el osteótomo dental. Material y métodos. El estudio se ha realizado en un Centro Odontológico Integral, sobre pacientes consecutivos. Es un estudio observacional prospectivo. En cada paciente tratado, se investigó, por anamnesis y observación directa, temor a presentar vértigo al reclinar el sillón hasta la horizontal o desencadenamiento del mismo al hacerlo, o si hubo vértigo en los días ulteriores al uso el osteótomo. Se han excluido pacientes menores de 30 años y aquellos con antecedentes vestibulares. Resultados. Hemos encontrado que un 1,7% de pacientes mayores de 30 años tienen temor a presentar vértigo si van a ser tumbados en posición horizontal, pero sólo el 0,17% de los mismos han presentado un verdadero VPPB al hacerlo. 1.3% de los sujetos en los que se uso el osteótomo durante el procedimiento dental presentaron un VPPB yatrógeno. Discusión. El VPPB puede presentarse en los pacientes en el momento de tumbarles en situación horizontal para realizar trabajos dentales. Además, hemos encontrado que el uso del osteótomo en odontología puede ser un factor yatrógeno en el VPPB.Introduction. Benign paroxysmal positional vertigo (BPPV is the most common type of vertigo with an annual prevalence of 1.6% in the general population. It can be caused by head injury. BPPV are triggered when certain head movements, as happens to lie in supine during the dental encounter. The objetive of this study is to

  8. Benign infantile seizures and paroxysmal dyskinesia caused by an SCN8A mutation

    DEFF Research Database (Denmark)

    Gardella, Elena; Becker, Felicitas; Møller, Rikke S;

    2015-01-01

    OBJECTIVE: Benign familial infantile seizures (BFIS), paroxysmal kinesigenic dyskinesia (PKD), and their combination - known as infantile convulsions and paroxysmal choreoathetosis (ICCA) - are related autosomal dominant diseases. PRRT2 (proline-rich transmembrane protein 2 gene) has been...

  9. 突发性聋伴良性阵发性位置性眩晕的预后分析%Prognosis of Idiopathic Sudden Sensorineural Hearing Loss with Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    龚桃根; 郑铨艺; 柯朝阳; 曾凡倩; 廖志芳

    2016-01-01

    目的:探讨突发性聋伴良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的预后。方法回顾性分析105例突发性聋患者的临床资料,根据有无伴眩晕以及体位试验的结果分为三组:突发性聋伴BPPV组(13例)、突发性聋伴非BPPV眩晕组(27例)、突发性聋不伴眩晕组(65例),比较三组患者治疗前后的听力情况。结果突发性聋伴BPPV组与突发性聋伴非BPPV眩晕组听力损失较突发性聋不伴眩晕组重,且预后相对较差。结论BPPV是突发性聋的不良预后因素,耳石手法复位对BPPV治疗有效。%Objective To report treatment outcomes of idiopathic sudden sensorineural hearing loss (ISSNHL) with be-nign paroxysmal positional vertigo (BPPV). Methods Clinical data from 105 patients with ISSNHL were reviewed retro-spectively. Patients were divided into 3 groups based on vertigo symptoms and results of positional test, namely, ISSNHL with BPPV (n=13), ISSNHL with non BPPV vertigo (n=27) and ISSNHL without vertigo (n=65),for analysis of rela-tionship between hearing improvement and BPPV. Results Patients with ISSNHL and BPPV or non BPPV vertigo displayed worse hearing loss and had significantly less improvement as compared to those without vertigo. Conclusions BPPV is a poor prognostic factor in ISSNHL, but successful otolith repositioning can be achieved by proper canalith repositioning tech-niques.

  10. 上半规管良性阵发性位置性眩晕41例%Anterior semicircular canal benign paroxysmal positional vertigo in 41 patients

    Institute of Scientific and Technical Information of China (English)

    王学海; 张建新; 孟昭进; 刘秀玲

    2014-01-01

    Objective To explore the diagnosis and the efficacy of canalith respositioning procedure( CRP) in patients with paroxysmal positional vertigo ( BPPV) of anterior semicircular canal ( ASC) .Methods In this research, a retro-spective study of 41 patients with ASC-BPPV was performed, then the positioning tests and the CRP were analyzed. Results In 28 individuals (68.3%) presented typical positional nystagmus during the positioning test for PSC-BPPV under the BPPV diagnosis and therapy system, 19 individuals had torsional nystagmus component and 9 individuals only had pure positional down beat nystagmus.In 35 individuals (84.6%) presented typical positional nystagmus during the positioning test for SSC-BPPV, 30 individuals had torsional nystagmus component and 5 individuals only had pure posi-tional down beat nystagmus.In 38 patients had unilateral lesion, 30 were judged by torsional nystagmus component, 3 with pure positional down beat nystagmus but without torsional component were judged by the unilateral nystagmus and 5 with bilateral pure positional down beat nystagmus but without torsional component were judged by the obvious differ-ent strength of the vertigo and nystagmus, and 3 patients were difficult to judge the affected side.In 38 patients had uni-lateral lesion, 23 were with the left AC involvement and 15 were with the right AC involvement.By once treatment, 28 patients were cured, 12 were improved and 1 was invalid.Conclusion BPPV diagnosis and therapy system should be recommended for its exact curative effect in the process off diagnosis and treatment of BPPV.%目的:探讨上半规管良性阵发性位置性眩晕( BPPV)诊断和治疗的最佳方案。方法回顾性分析41例上半规管BPPV患者的病历资料,并对所有患者的诊断及复位进行评估分析。结果 SRM-Ⅳ模拟Dix-Hallpike试验诱发出典型垂直向下眼震28例(68.3%),其中眼震伴有向地扭转的成分19例,不伴有扭转成分9例;SRM-Ⅳ

  11. Cognitive Findings in Benign Childhood Epilepsy with Occipital Paroxysms

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    Ebru Kolsal

    2014-12-01

    Full Text Available Aim: The aim of this study was to evaluate the cognitive and visual perceptive functions in children with childhood epilepsy with occipital paroxysms (CEOP. Material and Method: Hospital charts of children ages 1 to 18 years who admitted to pediatric neurology out-patient clinic between 2009 and 2010 were reviewed. Twenty one children with a diagnosis of CEOP were identified. Sixteen of these children who accepted to include the study were evaluated with neuropsychological tests. Results: Two of five patients who were evaluated with Denver developmental screening test were found to have lower scores than their reference standards. Remaining 11 patients were evaluated with Wechsler Scales of Intelligence tests, 4 were mildly mental retarded and 1 had null intelligence. Eleven patients were also evaluated with Bender Gestalt Visual Motor Test and 7of them had disturbances in visual perception. Reading speed and writing norm tests were applied to 9 literate patients and 7 of them showed slower reading ability and writing ability was found worse in 6 patients. Discussion: The absence of neurological and neuropsylogical deficits has long been considered as a prerequisite for diagnosis of benign childhood partial epilepsies. However, only a few studies describing the cognitive profile of patients with CEOP have been published. The present study has demonstrated that the patients with CEOP had varying degree of cognitive dysfunction and disturbance in visual perception. In order to provide appropriate intervention, cognitive functions should be assessed in children with CEOP.

  12. Should the clinician do the tests for benign paroxysmal positional vertigo even in the presence of spontaneous nystagmus at primary gaze?

    Science.gov (United States)

    Yetiser, Sertac

    2016-07-01

    Different balance problems may occur in the same patient simultaneously, and the other problem may be overlooked if the clinician does not pay much attention. Spontaneous nystagmus of Meniere's disease and positional nystagmus of posterior canal BPPV in the same patient is presented. Positional tests must always be considered even in the presence of spontaneous nystagmus. PMID:27386136

  13. Evaluation of depression and anxiety in patients with benign paroxysmal positional vertigo%良性阵发性位置性眩晕患者抑郁焦虑状态评估

    Institute of Scientific and Technical Information of China (English)

    贾庆霞; 孙慧; 王艳; 赵仁亮

    2015-01-01

    Objective To explore the changes of depression and anxiety pre-and post-canalith repositioning procedure (CRP) in patients with benign paroxysmal positional vertigo (BPPV).Methods Fifty two cases with BPPV (patient group) pre-and post-CRP and fifty eight healthy people (control group) were evaluated by Hanmilton depression scale (HAMD), Hanmilton anxiety scale (HAMA) and dizziness handicap inventory (DHI). The correlations between DHI and HAMD were analyzed, as well as DHI and HAMA.Results (1)38.46% (20/52) of the cases were HAMD-abnormal (HAMD score≥8) and 48.08% (25/52) were HAMA-abnormal (HAMA score≥7). The scores of HAMD, HAMA, DHI and its subgroups in pre-CRP group were significantly higher than those in post-CRP and control group (P0.05); while the scores of DHI and its subgroups in post-CRP group were significantly higher than control group (P0.05);治疗后DHI及其分量表得分与对照组比较均有显著差异(P<0.05).(2)DHI与HAMD、HAMA得分之间呈线性相关(r=0.427, 0.556;均P<0.05).HAMD、HAMA得分越高者其DHI得分也越高,反之亦然.结论 (1)BPPV患者可合并抑郁焦虑,CRP能显著改善患者眩晕症状和情绪状态.(2)三种量表评分具有相关性,联合应用可能有助于BPPV患者的综合评估和治疗.

  14. Treatment of Semont maneuver for 38 patients with posterior semicircular canal benign paroxysmal positional vertigo%耳石复位Semont方法治疗良性位置性眩晕38例效果观察

    Institute of Scientific and Technical Information of China (English)

    于圣立

    2011-01-01

    目的 探讨Semont方法对良性位置性眩晕(BPPV)的治疗效果.方法 对38例(BPPV)患者按Semont方法进行治疗.结果 经一次Semont方法治疗后31例症状消失首次治疗成功率81.58%;3例经2次、2例经3次治疗后症状消失,总治疗成功率94.74%,2例无效.随访1年,4例复发,复发率11.11%,复发者再用同法治疗仍有效.结论 手法复位的Semont方法治疗BPPV安全有效.%Objective To evaluate the effectiveness of Semont maneuver for benign paroxysmal positional vertigo (BPPV). Methods Totally 38 patients with BPPV were treated with Semont maneuver. Results After a single treatment session of Semont maneuver, the symptoms disappeared completely in 31 patients, the first success rate was 81.58%. The symptoms disappeared in 3 patients after twice, 2 patients after 3 times of Semont maneuver sessions, the total success rate was 94.47%. No effectiveness was found 2 patients ;A year later, BPPV recurred in 4 patients during follow - up and the recurrent rate was 11.11%. It was still effective for another Semont maneuver therapy session. Conclusions The Semont maneuver therapy is safe and effective for BPPV. Repeated Semont maneuver therapy is still effective for them.

  15. Horizontal Canal Benign Positional Vertigo

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    Mohtaram Najafi

    1998-03-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a syndrome characterized by transient episodes of vertigo in association with rapid changes in head position in Dix-Halpike Maneuver. This kind of vertigo is thought to be caused by migration of otoconial debris into canals other than the posterior canal, such as the anterior or lateral canals. It is also theoretically possible for many aberrant patterns of BPPV to occur from an interaction of debris in several canals, location of debris within the canal, and central adaptation patterns to lesions. The symptoms of BPPV are much more consistent with free-moving densities (canaliths in the posterior SCC rather than fixed densities attached to the cupula. While the head is upright, the particles sit in the PSC at the most gravity-dependent position. The best method to induce and see vertigo and nystagmus in BPPV of the lateral semicircular canal is to rotate head 90°while patient is in the supine position, nystagmus would appear in the unaffected side weaker but longer than the affected side. canal paresis has been described in one third of the patients with BPPV. Adaptation which is one of the remarkable features of BPPV in PSC is rarely seen in LSC. Rotations of 270° or 360° around the yaw axis (the so-called barbecue maneuver toward the unaffected ear are popular methods for the treatment of geotropic HC-BPPV. These maneuvers consist of sequential head turning of 90° toward the healthy side while supine. With these maneuvers, the free-floating otoconial debris migrates in the ampullofugal direction, finally entering the utricle through the nonampullated end of the horizontal canal. This kind of vertigo recovers spontaneously more rapidly and suddenly.

  16. Factors associated with poor short-term outcomes following positional maneuvers in patients with benign paroxysmal positional vertigo%良性阵发性位置性眩晕复位短期疗效不佳的分析

    Institute of Scientific and Technical Information of China (English)

    熊彬彬; 赵晓明; 刘劲; 林春梅; 伍慧卿; 梁勇

    2016-01-01

    more than 3 sessions of posi-tional maneuvers during the first two weeks were more prevalent in patients older than 60 years of age. Cupulolithiasis, multiple-canal involvement, head trauma and inner ear ischemia may be factors that can lead to poor curative effect. It is difficult for these patients to recover through single repositioning maneuver. Most of them need several repositioning ma-neuver approaches, combined with postural training and drugs. Repositioning maneuver may not be effective in a small number of these patients. Even for some of these patients to whom repositioning maneuvers are effective, it is easy for BP-PV to reoccur.%目的:探讨短期内多次手法复位疗效不佳的良性阵发性位置性眩晕(benign paroxysmal positional vertigo, BPPV)的影响因素。方法回顾性分析2014年1月-2015年6月39例在本院耳鼻喉门诊首诊,2周以内经反复(3次以上)手法复位疗效不佳的BPPV患者其2周后的临床表现、治疗及随诊结果,探讨其影响因素。结果此类患者占同期全部BPPV患者的9.8%(39/396),其中,男15例,女24例,年龄26岁~81岁,平均63.0±14.5岁,60岁以上的28例,占71.8%。单侧后半规管BPPV 5例,单侧后半规管嵴顶BPPV 7例,单侧水平半规管BPPV 7例,单侧水平嵴顶BPPV 10例,上半规管BPPV 3例,混合型BPPV 7例。其中特发性的25例,继发性的14例(头部外伤7例,梅尼埃病2例,前庭神经炎1例,突发性耳聋1例,中耳炎1例,偏头痛2例)。所有患者均经过超过2周3次以上的手法复位,后半规管及后半规管壶腹嵴受累者采用Epley+Semont法,水平半规管及水平壶腹嵴顶受累者多采用Barbecue+Gufoni或Casani+强迫健侧卧位法,上半规管受累者采用Yacovino法进行复位,39例中28例结合Brandt-daroff体位训练及其药物辅助治疗。2周后-1个月内眩晕和变位性眼震能够完全缓解的19例,1个月后能够完全缓解的26

  17. Aspectos clínicos e funcionais do equilíbrio corporal em idosos com vertigem posicional paroxística benigna Clinical and functional aspects of body balance in elderly subjects with benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Daniela Patricia Vaz

    2013-04-01

    Full Text Available Vertigem Posicional Paroxística Benigna (VPPB pode alterar o equilíbrio corporal em pacientes idosos. OBJETIVO: Observar os efeitos da manobra de Epley em idosos com VPPB, avaliando os aspectos clínicos e funcionais do equilíbrio corporal. Forma de estudo: clínico e prospectivo. MÉTODO: Após o diagnóstico da doença (teste de DixHallpike, os testes Time Up and Go (TUGT, Clinical test of Sensory Interaction and Balance (CTSIB e o teste de membros inferiores (MMI foram realizados antes e após a manobra de reposicionamento de Epley modificada. RESULTADOS: O gênero feminino foi o mais prevalente e a média etária foi de 70,10 anos (DP = 7,00. Todos os pacientes apresentaram ductolitíase de canal posterior. Os seguintes sintomas melhoraram após a manobra: a instabilidade postural (p = 0,006, náusea e vômito (p = 0,021 e zumbido (p = 0,003. Em relação ao TUGT e o escore do teste de MMII, observou-se diminuição significante do tempo pós-manobra de Epley (p Benign paroxysmal positional vertigo (BPPV may compromise the balance of elderly subjects. OBJECTIVE: To observe the effects of the Epley maneuver in elderly subjects with BPPV and assess clinical and functional aspects of body balance. METHOD: This is a prospective clinical study. Patients diagnosed with BPPV (Dix-Hallpike test were submitted to the Timed Up & Go (TUG test, the Clinical Test of Sensory Interaction and Balance (CTSIB, and lower limb testing before and after they were repositioned using the modified Epley maneuver. RESULTS: Most subjects were females, and the group's mean age was 70.10 years (SD = 7.00. All patients had canalithiasis of the posterior canal. The following symptoms improved after the maneuver: postural instability (p = 0.006, nausea and vomiting (p = 0.021, and tinnitus (p = 0.003. Subjects improved their times significantly in the TUG and lower limb tests after the Epley maneuver (p < 0.001. Patients performed better on the CTSIB after the Epley

  18. The clinical characteristics of the benign paroxysmal positional vertigo associated with Meniere's disease%继发梅尼埃病良性阵发性位置性眩晕的临床特点

    Institute of Scientific and Technical Information of China (English)

    李鹏; 曾祥丽; 李永奇; 张革化; 叶进

    2010-01-01

    Objective To explore the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) associated with Meniere's disease (MD) in retrospect in an effort to improve the diagnosis and efficacy of treatment Method Fifteen cases (1 male and 14 female, aged 46 to 68 years old) of BPPV associated with MD from July 2007 to June 2009 were retrospectively analyzed. Patient clinically characterized with positional paroxysmal vertigo were diagnosed as MD by ECochG and glycerol test and were confirmed as BPPV associated with MD by Dix Hallpike test or roll test They were treated with Epley maneuver or Barbecue rol maneuver according to the type of BPPV, and the efficacy was evaluated. Result (1) Most cases involved female patients in this study; (2) BPPV occurred after MD in al of the cases, of which 13 cases were posterior semicircular canal lithiasis (9 cases in the same ear, 2 in the other and 2 in both) and 2 cases were horizontal semicircula canal lithiasis (cupula lithiasis in the same ear) ; (3) in this study, 10 patients were cured after 3-4 times of posture treatment (66.7% ), 4 patients were cured after 5 times and 1 patient received endolymphatic sac decompression because of recurrent vertigo. Conclusion (1) BPPV can result from MD, for which a possible mechanism may be the hydrolabyrinth that lead to eardust falling off. (2) Most cases of BPPV occurred in the posterior semicircular canal in the same ear. Most cases in incidence rate have obvious sexual bias in female. (3) Eardust reposition is an effective treatment for BPPV caused by MD; while it is refractory compared to ordinary BPPV and requiremultiple treatments, which may be related to the recurrence of hydrolabyrinth.%目的 回顾性分析继发于梅尼埃病(MD)的良性阵发性位置性眩晕(BPPV)的临床特点,并探讨该病的诊断与治疗特点.方法 自2007年7月至2009年6月于中山大学附属第三医院入院的梅尼埃病伴BPPV患者15例,男1例,女14例;年龄46~69

  19. The Application of DHI Scale to Evaluation of Quality of Life in Patients with Benign Paroxysmal Positional Vertigo%眩晕障碍量表在 BPPV 患者生活质量评估中的应用

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    修世国; 邢东升; 胡玮; 樊新; 张雪; 李东洙

    2014-01-01

    Objective This paper attempts to explore the application of dizziness handicap inventory (DHI) in evaluation of health -related quality of life (QOL ) changes of patients with benign paroxysmal positional vertigo (BPPV) before and after the treatment with canalith repositioning procedure (CRP) .Methods The DHI was em-ployed to investigate and evaluate the dizziness handicap of 120 patients with BPPV before and after 3 months of CRP treatment (treatment group) and 60 healthy controls (control group) ,while the DHI scoring results were com-pared .Results As indicated by DHI evaluation ,the scoring of each DHI items of patients with BPPV before treatment was higher than that of control group ,treatment group before treatment :functional score 22 .60 ± 6 .54 ,emotional score 18 .50 ± 8 .28 ,physical score 17 .90 ± 5 .05 ,total composite score 59 .00 ± 14 .32 .For the control group:functional score 1 .35 ± 1 .74 ,emotional score 1 .00 ± 1 .01 ,physical score 1 .37 ± 1 .86 ,total composite score 3 .72 ± 3 .46 ,with the differ-ence statistically significant (P0 .05) .Conclusion CRP is effective to treat BPPV .The DHI is available for the evaluation of QOL of BPPV patients .%目的:探讨眩晕障碍量表(dizziness handicap inventory ,DHI)对良性阵发性位置性眩晕(BPPV )患者健康相关生活质量(quality of life ,QOL)评估的意义。方法采用汉化的英文版DHI分别对120例施行管石复位法(canalith repositioning procedure ,CRP)治疗的BPPV患者(治疗组)治疗前及治疗后3个月和60名健康体检者(对照组)进行评估,比较两组患者功能、情感、躯体三个方面的得分及总分。结果治疗组治疗前功能、情感、躯体评分分别为22.60±6.54、18.50±8.28、17.90±5.0分,总分为59.00±14.32分,对照组功能、情感、躯体分别为1.35±1.74、1.00±1.01、1.37±1.86分,总分为3.72±3.46分,治疗前治疗组D H I各项

  20. Manobras para o tratamento da vertigem posicional paroxística benigna: revisão sistemática da literatura Maneuvers for the treatment of benign positional paroxysmal vertigo: a systematic review

    Directory of Open Access Journals (Sweden)

    Lázaro Juliano Teixeira

    2006-02-01

    Full Text Available A Vertigem Posicional Paroxística Benigna (VPPB é uma das mais freqüentes patologias do sistema vestibular e é caracterizada por episódios de vertigens recorrentes desencadeados por movimentos da cabeça ou mudanças posturais. Há várias opções para o seu tratamento, porém as efetividades terapêuticas das mesmas permanecem controversas. OBJETIVO: Avaliar a efetividade terapêutica das manobras específicas disponíveis para o tratamento da VPPB. METODOLOGIA: Realizou-se uma busca eletrônica nas principais bases de dados, selecionando-se estudos clínicos randomizados envolvendo adultos com diagnóstico de VPPB confirmado com o teste de Dix-Hallpike e tratamento com manobras específicas (Epley ou Semont, por exemplo. Considerou-se como desfecho clínico a negativação do teste de Dix-Hallpike e a melhora das queixas subjetivas. Agruparam-se em metanálise os estudos com Escala de Jadad igual ou superior a três. RESULTADOS: Cinco estudos clínicos preencheram os critérios de inclusão, ou seja, ensaios randomizados de fase I comparando a manobra de Epley com placebos e controles. A metanálise mostra evidência dos efeitos benéficos da manobra de Epley para o tratamento do canal semicircular posterior (magnitude do efeito de 0,11 [IC 95% 0.05, 0.26] de melhora objetiva (Dix-Halpike após uma semana, 0.24 [IC 95% 0.13, 0.45] após um mês e 0.16 [IC 95% 0.08, 0.33] de melhora referida pelos pacientes após a primeira semana. CONCLUSÃO: Evidencia-se boa eficácia clínica da manobra de Epley para o tratamento da VPPB do canal semicircular posterior. Contrariamente, trabalhos com a manobra de Semont e as propostas de manejo dos demais canais semicirculares não obtiveram qualidade metodológica satisfatória, não sendo possível demonstrar a efetividade dos mesmos.Benign Paroxysmal Positional Vertigo (BPPV is one of the most frequent diseases of the vestibular system and it is characterized by episodes of recurrent vertigo

  1. The treatment effect of different time of postural restriction therapy on posterior semicircular canal benign paroxysmal positional vertigo patients after Epley manual therapy%后半规管良性阵发性位置性眩晕Epley手法治疗后不同体位限制时间对疗效的影响

    Institute of Scientific and Technical Information of China (English)

    洪安辉; 雷伟东; 吴杰贤; 黄小良

    2015-01-01

    目的:探讨后半规管良性阵发性位置性眩晕Epley手法治疗后体位限制时间对治疗效果的影响。方法选取入院治疗的后半规管良性阵发性位置性眩晕(PC-BPPV)患者73例作为研究对象,根据体位限制时间分为对照组和观察组,对照组35例限制时间为72h,观察组38例限制时间为24h,观察两组临床疗效,行DARS评分(眩晕量表评分系统),随访9~12个月记录两组复发率及时间。结果观察组治疗有效率为84.21%与对照组82.86%比较差异无统计学意义(P>0.05)。两组复发率和中位复发时间差异无统计学意义(P>0.05),观察组DARS评分为(11.03±3.25)分显著低于对照组(16.69±2.15)分,差异具有统计意义(P<0.05)。结论 Epley手法治疗PC-BPPV后体位限制时间对临床疗效无明显影响,但短时间体位限制可提高舒适度。%Objective To investigate the effect of time limit of semicircular canal benign paroxysmal positional vertigo postural restriction therapy on posterior of different time patients after Epley manual therapy.Methods Selected 73 hospitalized patients of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) were randomly divided into a control group and a observation group according to the postural restriction time, the postural restriction time of the control group of 35 cases was 72h, the observation group of 38 cases was 24h, observed clinical curative effect of two groups and DARS score, followed up for 9 to 12 months recording recurrence rate.ResultsThe effective rate of observation group was 84.21%, compared with 82.86% of control group, differences had no statistically significant (P>0.05),the recurrence rate and median time of relapse had no significant difference (P>0.05), the DARS score of control group (16.69±2.15) was significantly higher than observation group (11.03±3.25), the difference was statistically significant (P<0

  2. 老年特发性良性阵发性位置性眩晕的复位治疗及其疗效的研究%Study of the Treatment Effectiveness of the Idiopathic Benign Paroxysmal Positional Vertigo of Elderly Patients

    Institute of Scientific and Technical Information of China (English)

    张永斌; 孙勍; 彭新; 周玲玲; 孙悍军; 单希征

    2015-01-01

    Objective To evaluate the treatment effectiveness of the idiopathic benign paroxysmal positional vertigo (BP⁃PV) of elderly patients with the automatic vestibular function diagnosis and therapy system(SRM—IV). Methods All of the 238 elderly idiopathic BPPV patients during October 2012 to October 2013 of the Armed Police General Hospital otolaryngology head and neck surgery were divided into two groups by age, and each one was divided into two subgroups by with or without un⁃derlying diseases (hypertension, diabetes, heart disease, cerebral infarction). Age 60 or more for the elderly group (n1=118), age<60 years old for young and middle-aged group (n=120), the therapeutic efficacy and the recurrence rate is used in the comparison. Results All patients were successfully cured, the curative effect of the two groups are similar, two groups of patients with or without underlying diseases had no effect on its curative effect (P equals 0.05 or higher).Respectively for 1 month, 3 months, 6 months, 12 months follow-up, BPPV recurrence rate difference between the two groups have statistical difference (P<0.05) .Conclusion The therapeutic efficacy of the elderly group and the young and middle-aged group are similar, but to the young and middle-aged group, elderly group BPPV patients have a higher recurrence rate.%目的:观察SRM-Ⅳ型良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)诊疗系统对老年特发性BPPV的诊疗效果。方法对武警总医院耳鼻咽喉头颈外科2012年10月至2013年10月期间238例特发性BPPV患者按年龄分成两组,年龄≥60岁为老年组(n1=118例),年龄<60岁为青中年组(n2=120例),每组按伴或不伴基础疾病(高血压、糖尿病、心脏病、脑梗塞等)分成两个亚组,对耳石复位疗效及其复发率进行比较(每组均评价伴或不伴基础疾病对疗效的影响)。结果所有患者均得到成功治愈。两组患者疗效相近,伴

  3. Clinical characteristics and observation of curative effect of benign paroxysmal positional vertigo after sudden hearing loss%突发性聋伴发良性阵发性位置性眩晕的临床特点及疗效观察

    Institute of Scientific and Technical Information of China (English)

    原红艳; 张淑香; 闫亚平; 韩倩

    2016-01-01

    目的:探讨突发性聋伴发良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特点,观察其疗效。方法观察2012年10月~2014年6月耳鼻咽喉科收治的36例突发性聋伴发BPPV发病情况,并与同期原发性BPPV患者40例及突发性聋不伴眩晕患者40例进行疗效比较。结果伴发BPPV的36例突发性聋患者,受累半规管均与突发性聋发病侧一致,其中水平半规管BPPV 6例,占16.7%(6/36);后半规管BPPV 27例,占75.0%(27/36);混合管BPPV 3例,占8.3%(3/36)。36例患者出现BPPV的时间均在突发性聋发病后数小时至数天(<10天)发生。突发性聋伴发BPPV组1次治愈率明显低于原发性BPPV组,但两种治疗方法的总治愈率均为100%。不伴眩晕突发性聋组的痊愈率、显效率及有效率均高于伴发BPPV组。结论伴发于突发性聋的BPPV以后半规管多见,与原发性BPPV经耳石复位治疗后均可取得较好疗效。而不伴眩晕的突发性聋其疗效优于伴发BPPV的突发性聋。%[ABSTRACT]OBJECTIVETo explore the clinical characteristics of benign paroxysmal positionalvertigo(BPPV) after sudden hearing loss and to observe the curative effect. METHODS36 patients with BPPV after sudden hearing loss were observed.And their therapeutic findings were compared with that of the 50 patients with primary BPPV and 40 patients of sudden hearing loss without vertigo. RESULTSBPPV after sudden hearing loss occurred in the hearing loss ears, of which 27 cases were posterior semicircular canal lithiasis and 3 cases were horizontal semicircular canal lithiasis. The 36 patients with BPPV after sudden hearing loss and 40 patients with primary BPPV were cured after several times of reposition maneuver treatment.The efficiency of 40 patients of sudden hearing loss without vertigo was higher than that of 36 patients with BPPV after sudden hearing loss.CONCLUSIONBPPV after the sudden hearing loss

  4. [Horizontal canal benign paroxysmal positional vertigo (HC-BPPV) with direction-changing apogeotropic nystagmus: a case with the more-triggering side altering over a short-term].

    Science.gov (United States)

    Takaya, Shigetoshi; Yamamoto, Toru

    2002-04-01

    We report a 44-year-old man who had apogeotropic nystagmus with the rotation of his head to either side from the supine position. His nystagmus lasted more than 2 minutes and was difficult to treat with. There were no neurological abnormalities except for the nystagmus and no findings suggesting intracranial disease on MRI. The head-position in which more intense nystagmus was evoked changed again and again in a short term. We diagnosed his illness as cupulolithiasis of horizontal canal, however, the affected ear could not be explained by any of the previously supposed mechanisms. In our case, we speculate the following mechanism. Otoliths were located on the right utricular side of the cupula. All of them were attached on the cupula at the beginning(attached phase) and then, some of them were detached from it(detached phase). The extent of the cupular deviation differed in each phase when the otoliths were beneath the cupula with his head turned to the left lateral position. According to Ewald's second law, more intense nystagmus is evoked when the cupula deviates toward the utricle than away from it. The patient's head-position in which more intense nystagmus was evoked changed according to the balance between the effect of Ewald's second law and the amount of otoliths detached from cupula. Our case showed that, in HC-BPPV with direction-changing apogeotropic nystagmus, we could not be certain about which ear was diseased. Therefore, it may be difficult to apply exercise therapy by determining the affected ear based on the head-position in which more intense nystagmus is evoked.

  5. Benign paroksysmal positionel vertigo kan opstå efter hovedtraumer hos børn

    DEFF Research Database (Denmark)

    Nørgaard, Maria Schøler; Rokkjær, Malene Sine; Berg, Jette;

    2015-01-01

    We present an eight-year-old boy with benign paroxysmal positional vertigo (BPPV) after a head trauma, successfully treated with Epley's manoeuvre. BPPV is a common cause of vestibular vertigo in adults, but it is rarely seen in children. Diagnostic work-up is challenging as children often lack...

  6. Paroxysmal cold hemoglobinuria (PCH)

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000557.htm Paroxysmal cold hemoglobinuria (PCH) To use the sharing features on this page, please enable JavaScript. Paroxysmal cold hemoglobinuria (PCH) is a rare blood disorder in ...

  7. The analysis of clinical and electroencephalographic features in patients with benign epilespy of children with occipital paroxysms%儿童良性枕叶癫(癎)47例临床及脑电图分析

    Institute of Scientific and Technical Information of China (English)

    梅珍; 杨朋范; 安榕榕; 刘海云; 林巧; 钟忠辉

    2011-01-01

    Objective:To summarize the clinical characteristics and electroencephalographic features in patients with benign epilespy of children with occipital paroxysms (BECOP) and to gain better understanding of it. Methods; The clinical data of 47 patients with BECOP referred and followed up in Epilepsy Center of Fuzhou General Hospital between January 2005 and December 2010 were analysed, to illustrate the difference between early onset benign occipital seizure susceptibility syndrome (EBOS) and late onset children idiopathic occipital seizures (LOS) with regard to the age of onset, the frequency and duration of seizures, symptoms and signs, EEG changes and therapeutic responses to AEDs. Results: The mean age of onset of patients with EBOS [(5. 2±2. 8) years] was significantly younger than that of patients with LOS[(10. 3±3. 2) years]. Compared with LOS patients, EBOS patients had remarkable paroxysmal autonomic symptoms, less frequent seizures, longer seizure duration and more nocturnal seizures. LOS patients had more visual symptoms including hallucinations and tended to secondary generalized tonic-clonic seizures that occurred mostly in daytime. The interictal EEG showed occipital or occipital predominance of spike- and sharp-slow waves, more typical and limited in EBOS patients than those in LOS ones. Ictal EEG showed the occipital or frontal predominance and generalized rhythmic spike-wavecomplex. EBOS was controlled well by AED monotherapy, with 23(92%) seizure free; Seizures ceased in 14(63. 6%) cases of LOS, and were partially controlled or unchanged in 5 and 3 cases respectively. Conclusion: It is essential to distinguish EBOS from LOS by comprehensive analysis of their features with regard to the age of onset, the frequency and duration of seizures, paroxysmal autonomic symptoms, visual symptoms, EEG changes and therapueutic responses to AEDs.%目的:探讨儿童良性枕叶癫(癎)(BECOP)的临床表现及脑电图(EEG)特点,以期提高对

  8. Nonepileptic paroxysmal sleep disorders.

    Science.gov (United States)

    Frenette, Eric; Guilleminault, Christian

    2013-01-01

    Events occurring during nighttime sleep in children can be easily mislabeled, as witnesses are usually not immediately available. Even when observers are present, description of the events can be sketchy, as these individuals are frequently aroused from their own sleep. Errors of perception are thus common and can lead to diagnosis of epilepsy where other sleep-related conditions are present, sometimes initiating unnecessary therapeutic interventions, especially with antiepileptic drugs. Often not acknowledged, paroxysmal nonepileptic behavioral and motor episodes in sleep are encountered much more frequently than their epileptic counterpart. The International Classification of Sleep Disorders (ICSD) 2nd edition displays an extensive list of such conditions that can be readily mistaken for epilepsy. The most prevalent ones are reviewed, such as nonrapid eye movement (NREM) sleep parasomnias, comprised of sleepwalking, confusional arousals and sleep terrors, periodic leg movements of sleep, repetitive movement disorders, benign neonatal myoclonus, and sleep starts. Apnea of prematurity is also briefly reviewed. Specific issues regarding management of these selected disorders, both for diagnostic consideration and for therapeutic intervention, are addressed. PMID:23622294

  9. PRRT2 phenotypes and penetrance of paroxysmal kinesigenic dyskinesia and infantile convulsions

    NARCIS (Netherlands)

    van Vliet, Rianne; Breedveld, Guido; de Rijk-van Andel, Johanneke; Brilstra, Eva; Verbeek, Nienke; Verschuuren-Bemelmans, Corien; Boon, Maartje; Samijn, Johnny; Diderich, Karin; van de Laar, Ingrid; Oostra, Ben; Bonifati, Vincenzo; Maat-Kievit, Anneke

    2012-01-01

    Objective: To describe the phenotypes and penetrance of paroxysmal kinesigenic dyskinesia (PKD), a movement disorder characterized by attacks of involuntary movements occurring after sudden movements, infantile convulsion and choreoathetosis (ICCA) syndrome, and benign familial infantile convulsions

  10. The relationship between malocclusion, benign joint hypermobility syndrome, condylar position and TMD symptoms.

    Science.gov (United States)

    Barrera-Mora, José Ma; Espinar Escalona, Eduardo; Abalos Labruzzi, Camilo; Llamas Carrera, José Ma; Ballesteros, Emilio Jiménez-Castellanos; Solano Reina, Enrique; Rocabado, Mariano

    2012-04-01

    The current study investigated the association between temporomandibular disorders, malocclusion patterns, benign joint hypermobility syndrome and the initial condylar position. One hundred sixty-two subjects were analyzed using the Rocabado Temporomandibular Pain Analysis; Helkimo Index parameters; the Carter-Wilkinson modified test; and a mounting cast with condylar position indicator registration (MPI). The study revealed a significant association between: 1. Delta H, skeletal pattern (p = 0.034); 2. Delta Y, transversal malocclusion (p = 0.04); 3. right and left, Delta Z, right and left posteroinferior synovial pain (p < 0.05); 4. hypermobility scale, gender (p < 0.001), malocclusion pattern (p = 0.021); 5. TMJ function impairment, gender (p = 0.043); 6. sagittal malocclusion pattern, right temporomandibular pain analysis joint (TPAJ) (p = 0.0034); 7. TMJ function impairment, left and right TPAJ (p = 0.007); and 8. mandibular motion, left and right TPAJ (p = 0.035, p = 0.015). The conclusion was that anterior crossbite and condylar displacements in the vertical plane are risk factors in developing TMJ symptoms.

  11. Left atrial myxoma presenting as paroxysmal supraventricular tachycardia.

    Science.gov (United States)

    Seol, Sang-Hoon; Kim, Doo-Il; Jang, Jae-Sik; Yang, Tae-Hyun; Kim, Dae-Kyeong; Kim, Dong-Soo

    2014-02-01

    Cardiac myxomas are benign intracavitary neoplasms. Their incidence in cardiac surgery is approximately 0.3%. Symptoms of cardiac myxomas are typically variable, from obstruction of mitral valve to coronary embolism resulting in acute myocardial infarction. In this case, left atrial myxoma is presented as paroxysmal supraventricular tachycardia.

  12. Dynamics of Paroxysmal Tachycardia

    Science.gov (United States)

    Glass, Leon

    2004-03-01

    Parosxysmal tachycardia refers to abnormally fast cardiac arrhythmias that suddenly start and stop. Paroxysmal tachycardias can occur in many regions of the heart and may be associated with many different mechanisms. In order to study paroxysmal tachycardias, we have analyzed tissue cultures of cells from embryonic chick heart that are imaged using calcium and voltage sensitive dyes. This model system displays a number of different types of dynamics including dynamics originating from pacemakers, triggered dynamics in which an excitation leads to the initiation of a sequence of waves originating from a single source, and spontaneously iniitiating and terminating rotating spiral waves. Theoretical models that include heterogeneity, spontaneous pacemaker activity, and fatigue or reduced excitability arising as a consequence of rapid excitation can be used to account for these behaviors.

  13. Paroxysmal tonic upgaze: physiopathological considerations in three additional cases.

    Science.gov (United States)

    Spalice, A; Parisi, P; Iannetti, P

    2000-01-01

    Paroxysmal tonic upgaze of childhood has been described as a benign distinctive syndrome of abnormal ocular movement, with or without concomitant ataxia. After the first observation of four children, a further 29 patients have been reported with a wide spectrum of neurologic abnormalities such as ataxia, unsteady of gait, learning disabilities and mental retardation at follow-up. Electroencephalograms were normal in all the subjects and magnetic resonance imaging showed deficient myelination in only one patient. Recently it has been suggested that paroxysmal tonic upgaze could be a heterogeneous syndrome, ranging from a simply age-dependent manifestation to a clinical appearance of a variety of disorders affecting the corticomesencephalic loop of vertical eye movement. Moreover, it also could be an early sign of more widespread neurologic dysfunction. We describe three patients who presented paroxysmal tonic upgaze; in one, ataxia was present; in the second child, ataxia and language disorder also were observed; and in the third patient paroxysmal tonic upgaze was associated with loss of muscle tone (drop-attack-like events). On magnetic resonance imaging, a pinealoma compressing the dorsal mesencephalic region was detected. On the basis of our observations, we suggest that any insult with periaqueductal mesencephalic gray-matter involvement could be considered the basic condition for this peculiar clinical manifestation. PMID:10641603

  14. Paroxysmal nocturnal hemoglobinuria in systemic lupus erythematosus: a case report

    Directory of Open Access Journals (Sweden)

    Nakamura Norio

    2011-11-01

    Full Text Available Abstract Introduction Paroxysmal nocturnal hemoglobinuria is an acquired disorder of hemopoiesis and is characterized by recurrent episodes of intravascular hemolysis due to an increased sensitivity to complement-mediated hemolysis. Systemic lupus erythematosus with paroxysmal nocturnal hemoglobinuria is very rare. We report a case of paroxysmal nocturnal hemoglobinuria that developed in a patient with systemic lupus erythematosus and lupus nephritis. Case presentation A 29-year-old Mongolian woman had systemic lupus erythematosus, which manifested only as skin lesions when she was 12 years old. She had leg edema and proteinuria when she was 23 years old, and a renal biopsy revealed lupus nephritis (World Health Organization type IV. She had been treated with steroids and immunosuppressant therapy. At 29, she had headaches, nausea, general fatigue, and severe pancytopenia and was admitted to our hospital. A laboratory evaluation showed hemolytic anemia. Further examination showed a neutrophil alkaline phosphatase score of 46 points, a CD55 value of 18%, and a CD59 value of 78.6%. The results of Ham test and sugar water tests were positive. The constellation of symptoms throughout the clinical course and the laboratory findings suggested paroxysmal nocturnal hemoglobinuria. Conclusions To the best of our knowledge, systemic lupus erythematosus with paroxysmal nocturnal hemoglobinuria is very rare. Clinicians should be aware of the association between autoimmune and hematological diseases.

  15. Immunogold TEM of otoconin 90 and otolin - relevance to mineralization of otoconia, and pathogenesis of benign positional vertigo.

    Science.gov (United States)

    Andrade, Leonardo R; Lins, Ulysses; Farina, Marcos; Kachar, Bechara; Thalmann, Ruediger

    2012-10-01

    interconnecting otoconia. Consequently, otoconia detached from each other may be released into the endolymphatic space by minor mechanical disturbances. In humans, benign positional vertigo (BPV) is believed to result from translocation of otoconia from the endolymphatic space into the semi-circular canals rendering their receptors susceptible to stimulation by gravity causing severe attacks of vertigo. The combinations of these observations in humans, together with the presented animal experiments, provide a tentative pathogenetic basis of the early stage of BPV. PMID:22841569

  16. 后半规管阻塞术治疗难治性阵发性位置性眩晕的围手术期护理%Perioperative nursing of 18 patients with refractory paroxysmal positional vertigo treated with posterior semicircular canal occlusion

    Institute of Scientific and Technical Information of China (English)

    李颖; 陈文; 陈晓芬

    2013-01-01

      目的探讨后半规管阻塞术治疗难治性阵发性位置性眩晕的围手术期护理方法。方法回顾性分析和总结18例行后半规管阻塞术患者的围手术期护理经验。结果术后发生眩晕2例,经处理眩晕症状缓解。术后随访1年,17例眩晕症状消失,1例仍有阵发性位置性眩晕发作。结论术前做好患者的心理护理,术后加强病情观察和指导对提高治疗效果具有重要意义。%Objective To explore the perioperative nursing of patients with refractory paroxysmal positional vertigo treated with posterior semicircular canal occlusion. Method A retrospective analysis was performed to the experience of nursing 18 patients with refractory paroxysmal positional vertigo treated with posterior semicircular canal occlusion.Results The treatments for 17 cases were effective.Two of them had postoperative vertigo and then cured after further treatments.During one year follow-up,17 of them reported no occurrence of vertigo except only one care reporting paroxysmal positional vertigo. Conclusion Preoperative mental care and postoperative observation of the disease are critical for the enhanced curative effects.

  17. Factitious psychogenic nonepileptic paroxysmal episodes

    Directory of Open Access Journals (Sweden)

    Alissa Romano

    2014-01-01

    Full Text Available Mistaking psychogenic nonepileptic paroxysmal episodes (PNEPEs for epileptic seizures (ES is potentially dangerous, and certain features should alert physicians to a possible PNEPE diagnosis. Psychogenic nonepileptic paroxysmal episodes due to factitious seizures carry particularly high risks of morbidity or mortality from nonindicated emergency treatment and, often, high costs in wasted medical treatment expenditures. We report a case of a 28-year-old man with PNEPEs that were misdiagnosed as ES. The patient had been on four antiseizure medications (ASMs with therapeutic serum levels and had had multiple intubations in the past for uncontrolled episodes. He had no episodes for two days of continuous video-EEG monitoring. He then disconnected his EEG cables and had an episode of generalized stiffening and cyanosis, followed by jerking and profuse bleeding from the mouth. The manifestations were unusually similar to those of ES, except that he was clearly startled by spraying water on his face, while he was stiff in all extremities and unresponsive. There were indications that he had sucked blood from his central venous catheter to expel through his mouth during his PNEPEs while consciously holding his breath. Normal video-EEG monitoring; the patient's volitional and deceptive acts to fabricate the appearance of illness, despite pain and personal endangerment; and the absence of reward other than remaining in a sick role were all consistent with a diagnosis of factitious disorder.

  18. Paroxysmal nocturnal hemoglobinuria and telomere length predicts response to immunosuppressive therapy in pediatric aplastic anemia.

    Science.gov (United States)

    Narita, Atsushi; Muramatsu, Hideki; Sekiya, Yuko; Okuno, Yusuke; Sakaguchi, Hirotoshi; Nishio, Nobuhiro; Yoshida, Nao; Wang, Xinan; Xu, Yinyan; Kawashima, Nozomu; Doisaki, Sayoko; Hama, Asahito; Takahashi, Yoshiyuki; Kudo, Kazuko; Moritake, Hiroshi; Kobayashi, Masao; Kobayashi, Ryoji; Ito, Etsuro; Yabe, Hiromasa; Ohga, Shouichi; Ohara, Akira; Kojima, Seiji

    2015-12-01

    Acquired aplastic anemia is an immune-mediated disease characterized by severe defects in stem cell number resulting in hypocellular marrow and peripheral blood cytopenias. Minor paroxysmal nocturnal hemoglobinuria populations and a short telomere length were identified as predictive biomarkers of immunosuppressive therapy responsiveness in aplastic anemia. We enrolled 113 aplastic anemia patients (63 boys and 50 girls) in this study to evaluate their response to immunosuppressive therapy. The paroxysmal nocturnal hemoglobinuria populations and telomere length were detected by flow cytometry. Forty-seven patients (42%) carried a minor paroxysmal nocturnal hemoglobinuria population. The median telomere length of aplastic anemia patients was -0.99 standard deviation (SD) (range -4.01-+3.01 SD). Overall, 60 patients (53%) responded to immunosuppressive therapy after six months. Multivariate logistic regression analysis identified the absence of a paroxysmal nocturnal hemoglobinuria population and a shorter telomere length as independent unfavorable predictors of immunosuppressive therapy response at six months. The cohort was stratified into a group of poor prognosis (paroxysmal nocturnal hemoglobinuria negative and shorter telomere length; 37 patients) and good prognosis (paroxysmal nocturnal hemoglobinuria positive and/or longer telomere length; 76 patients), respectively. The response rates of the poor prognosis and good prognosis groups at six months were 19% and 70%, respectively (Ptelomere length is an efficient predictor of poor immunosuppressive therapy response, which should be considered while deciding treatment options: immunosuppressive therapy or first-line hematopoietic stem cell transplantation. The trial was registered in www.umin.ac.jp with number UMIN000017972.

  19. Efeito da manobra de Epley na qualidade de vida dos pacientes com vertigem posicional paroxística benigna Effect of Epley's maneuver on the quality of life of paroxismal positional benign vertigo patients

    Directory of Open Access Journals (Sweden)

    Alcione Botelho Pereira

    2010-12-01

    Full Text Available A vertigem produz impactos significativos na qualidade de vida (QV. É necessário mensurar os efeitos das terapêuticas antivertiginosas na QV. OBJETIVO: Investigar o efeito da manobra de reposicionamento na qualidade de vida de pacientes com vertigem posicional paroxística benigna (VPPB. MATERIAL E MÉTODOS: Estudo retrospectivo, através da revisão dos prontuários de 21 pacientes com VPPB atendidos no serviço de Reabilitação Vestibular (RV de uma clínica escola de Belo Horizonte atendidos em 2007-2008. Foram analisados os escores físicos, funcionais e emocionais, pré e pós-terapia de RV com realização de manobras de reposicionamento de Epley, por meio do questionário Dizziness Handicap Inventory (DHI, específico para avaliação da interferência da tontura na QV. RESULTADOS: O intervalo mediano entre as avaliações foi de 21 dias. O número médio de manobras foi 2,3±1,1. A aplicação do DHI mostrou um significante impacto da VPPB na QV dos pacientes em todas as dimensões da vida diária, com os seguintes escores médios pré e pós-terapia: físico (17,5/3,7, funcional (17,3/3,9, emocional (13,2/3,2 e total (48,1/10,9, respectivamente (pQuality of life (QoL is significantly impaired by vertigo. The effect of specific treatments on QoL deserves investigation. AIM: To assess the effect of repositioning maneuvers on the QoL of benign paroxysmal positioning vertigo (BPPV patients. MATERIALS AND METHODS: A retrospective study design consiting of reviews of charts of BPPV patients in a vestibular rehabilitation unit at a teaching institution in Belo Horizonte, MG, Brazil, from 2007 to 2008. Pre- and post-therapy (Epley's repositioning maneuver scores on the physical, functional and emotional dimensions of the Dizziness Handicap Inventory (DHI were analyzed. RESULTS: Twenty-one patients were included, eighteen (86% were females; the average age was 53.2 years. Ten patients presented bilateral BPPV; in eleven it was unilateral

  20. Treatment of paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    I. A. Lisukov

    2014-07-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is a rare, life‑threatening clonal hematological disorder caused by an acquired mutation in the phosphatidylinositol glucan (PIG-A gene. PNH is characterized by chronic intravascular hemolysis, marrow failure, thrombophilia and other severe clinical syndromes. Until recently, the treatment of PNH has been symptomatic with blood transfusions, anticoagulation and supplementation with folic acid or iron. The only potentially curative treatment is allogeneic stem cell transplantation, but this has severe complications with high mortality rates. A new targeted treatment strategy is the inhibition of the terminal complement cascade with anti‑C5 monoclonal antibody (eculizumab. Eculizumab has shown significant efficacy in controlling of intravascular hemolysis resulting in improving quality of life and survival.

  1. Treatment of paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    I. A. Lisukov

    2012-01-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is a rare, life‑threatening clonal hematological disorder caused by an acquired mutation in the phosphatidylinositol glucan (PIG-A gene. PNH is characterized by chronic intravascular hemolysis, marrow failure, thrombophilia and other severe clinical syndromes. Until recently, the treatment of PNH has been symptomatic with blood transfusions, anticoagulation and supplementation with folic acid or iron. The only potentially curative treatment is allogeneic stem cell transplantation, but this has severe complications with high mortality rates. A new targeted treatment strategy is the inhibition of the terminal complement cascade with anti‑C5 monoclonal antibody (eculizumab. Eculizumab has shown significant efficacy in controlling of intravascular hemolysis resulting in improving quality of life and survival.

  2. Cisplatin induced paroxysmal supraventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Waseem Raja

    2013-01-01

    Full Text Available Cisplatin or cis-diamminedichloroplatinum (CDDP is the first member of a class of platinum-containing anti-cancer drugs that act by binding to and causing cross-linking of deoxyribonucleic acid, which ultimately triggers apoptosis. Cisplatin has a broad-spectrum antineoplastic activity against various types of human tumors. Unfortunately, the optimal usefulness of Cisplatin is limited secondary to its dose related toxicity especially nephrotoxicity. Cisplatin chemotherapy is also associated with cardiotoxic effects that may range from silent arrhythmias to heart failure and even sudden cardiac death. These effects are more pronounced when cisplatin is combined with other cardiotoxic drugs. Here, we report a case of patient of cancer lung who developed paroxysmal supraventricular tachycardia following administration of Cisplatin. A brief review of the literature follows.

  3. Cisplatin induced paroxysmal supraventricular tachycardia.

    Science.gov (United States)

    Raja, Waseem; Mir, M Hussain; Dar, Imtiyaz; Banday, Muzamil Ahmad; Ahmad, Irfan

    2013-10-01

    Cisplatin or cis-diamminedichloroplatinum (CDDP) is the first member of a class of platinum-containing anti-cancer drugs that act by binding to and causing cross-linking of deoxyribonucleic acid, which ultimately triggers apoptosis. Cisplatin has a broad-spectrum antineoplastic activity against various types of human tumors. Unfortunately, the optimal usefulness of Cisplatin is limited secondary to its dose related toxicity especially nephrotoxicity. Cisplatin chemotherapy is also associated with cardiotoxic effects that may range from silent arrhythmias to heart failure and even sudden cardiac death. These effects are more pronounced when cisplatin is combined with other cardiotoxic drugs. Here, we report a case of patient of cancer lung who developed paroxysmal supraventricular tachycardia following administration of Cisplatin. A brief review of the literature follows.

  4. Genetics Home Reference: paroxysmal extreme pain disorder

    Science.gov (United States)

    ... in temperature (such as a cold wind) and emotional distress as well as eating spicy foods and drinking cold drinks. Paroxysmal extreme pain disorder is considered a form of peripheral neuropathy because ...

  5. 原发性良性阵发性位置性眩晕与A型性格的关系%The relationship between the primary benign paroxysmal positional vertigo (BPPV) and the type A personality

    Institute of Scientific and Technical Information of China (English)

    何秋英; 张镭; 赵惠利; 程红武

    2014-01-01

    Objective: To investigate the relationship between the primary BPPV and type A personality, and give reference in preventive. Methods:52 patients with primary BPPV and 50 normal person were received the questionnaires of type A personality survey analysis. Results:In primary BPPV patients, the patients with type A personality were more than the patients with type B personality and the patients with type A personality in control group (P<0.05). Conclusion:Type A personality was related to primary BPPV, and might be one of pathogenic factor. Prevention and treatment of BPPV should be combined with psychological treatment.%目的:探讨原发性BPPV与心理因素的关系,为本病的防治提供参考。方法:对临床确诊的52例原发性BPPV患者以及健康对照组50例采用A型性格问卷法调查分析。结果:原发性BPPV患者中A型性格高于B型以及对照组中A型性格者(P<0.05)。结论:A型性格与原发性BPPV相关,可能是其致病原因之一,为防治原发性BPPV,应配合心理治疗。

  6. SRM-Ⅳ前庭功能治疗系统临床疗效评价%Evaluation of the therapeutic effect of an automatic vestibular function therapy system(SRM-Ⅳ) in benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    王健康; 董晓莉; 王恩彤; 谭祖林

    2012-01-01

    目的 评价SRM-Ⅳ前庭功能治疗系统对良性阵发性位置性眩晕的临床治疗效果.方法 采用开放、平行对照的试验方法,将60例诊断为良性阵发性位置性眩晕的受试者随机分为试验组和对照组,分别接受仪器复位治疗和手法复位治疗,并在治疗次日和治疗后1周对其疗效进行评价和比较.结果 Mann-Whitney分析结果表明试验组疗效明显优于对照组(P<0.05);Logistic分析结果表明,组间在访视时间上没有统计学差异,组间治疗效果有显著差异.结论 应用SRM-Ⅳ前庭功能系统治疗良性阵发性位置性眩晕临床效果优于常规手法复位,并可弥补其不足.

  7. [A case of prolonged paroxysmal sympathetic hyperactivity].

    Science.gov (United States)

    Yamamoto, Akiko; Ide, Shuhei; Iwasaki, Yuji; Kaga, Makiko; Arima, Masataka

    2016-03-01

    We report the case of a 4-year-old girl who presented with paroxysmal sympathetic hyperactivity (PSH), after developing severe hypoxic-ischemic-encephalopathy because of cardiopulmonary arrest. She showed dramatic paroxysmal sympathetic activity with dystonia. She was treated with wide variety of medications against PSH, which were found to be effective in previous studies. Among them, morphine, bromocriptine, propranolol, and clonidine were effective in reducing the frequency of her attacks while gabapentin, baclofen, dantrolene, and benzodiazepine were ineffective. Though the paroxysms decreased markedly after the treatment, they could not be completely controlled beyond 500 days. Following the treatment, levels of plasma catecholamines and their urinary metabolites decreased to normal during inter- paroxysms. However, once a paroxysm had recurred, these levels were again very high. This case study is considered significant for two rea- sons. One is that PSH among children have been rarely reported, and the other is that this case of prolonged PSH delineated the transition of plasma catecholamines during the treatment. The excitatory: inhibitory ratio (EIR) model proposed by Baguley was considered while dis- cussing drug sensitivity in this case. Accumulation of similar case studies will help establish more effective treatment strategies and elucidate the pathophysiology of PSH. PMID:27149743

  8. Paroxysmal discharges triggered by hearing spoken language.

    Science.gov (United States)

    Tsuzuki, H; Kasuga, I

    1978-04-01

    We examined the modality of EEG activation by various kinds of acoustic stimulation in a middle-aged Japanese female with epilepsy. Paroxysmal discharges were triggered in the right frontal area (F4) by verval stimulation. For the activation of EEG, concentration of attention on the stimulation was essential; therefore paroxysmal discharges were triggered most easily by verbal stimuli when someone spoke to the patient directly. Stronger responses than usual were triggered by specific words, and apparently reflected the interest and concern of the patient. The latency from stimulation to paroxysmal discharges ranged from 230 to 1,300 msec, suggesting that the responses may have been a function of the perception and recognition of acoustic stimuli. "Heard-word epilepsy" or "Angesprochene Epilepsie" is suggested in this case.

  9. PAROXYSMAL ATRIAL FIBRILLATION: CHOICE OF CARDIOVERSION THERAPY

    Directory of Open Access Journals (Sweden)

    B. A. Tatarskii

    2015-12-01

    Full Text Available Characteristics and classification of different patterns of paroxysmal atrial fibrillation are presented. Main indications to restoration of sinus rhythm are discussed. The features of main medications used to terminate of atrial fibrillation are given. The choice of antiarrhythmic drug is considerate. Necessity of individual approach to therapy tactics is proved.

  10. Clinical Practice Guidelines for paroxysmal supraventricular tachycardia.

    Directory of Open Access Journals (Sweden)

    Brandy Viera Valdés

    2009-03-01

    Full Text Available Clinical Practice Guidelines for paroxysmal supraventricular tachycardia. These are arrhythmias in which structures placed above the bifurcation of the bundle of His are involved; characterized by tachycardia with abrupt starting and ending. We comment its classification, common characteristics, general treatment and specific conduct for its different variables. It includes assessment guidelines focused on the most important aspects to be accomplished.

  11. Benign and Deleterious Cystic Fibrosis Transmembrane Conductance Regulator Mutations Identified by Sequencing in Positive Cystic Fibrosis Newborn Screen Children from California

    Science.gov (United States)

    Salinas, Danieli B.; Sosnay, Patrick R.; Azen, Colleen; Young, Suzanne; Raraigh, Karen S.; Keens, Thomas G.; Kharrazi, Martin

    2016-01-01

    Background Of the 2007 Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) mutations, 202 have been assigned disease liability. California’s racially diverse population, along with CFTR sequencing as part of newborn screening model, provides the opportunity to examine the phenotypes of children with uncategorized mutations to help inform disease liability and penetrance. Methods We conducted a retrospective cohort study based on children screened from 2007 to 2011 and followed for two to six years. Newborns that screened positive were divided into three genotype groups: those with two CF-causing mutations (CF-C); those with one mutation of varying clinic consequence (VCC); and those with one mutation of unknown disease liability (Unknown). Sweat chloride tests, pancreatic sufficiency status, and Pseudomonas aeruginosa colonization were compared. Results Children with two CF-causing mutations had a classical CF phenotype, while 5% of VCC (4/78) and 11% of Unknown (27/244) met diagnostic criteria of CF. Children carrying Unknown mutations 2215insG with D836Y, and T1036N had early and classical CF phenotype, while others carrying 1525-42G>A, L320V, L967S, R170H, and 296+28A>G had a benign clinical presentation, suggesting that these are non-CF causing. Conclusions While most infants with VCC and Unknown CFTR mutations do not meet diagnostic criteria for CF, a small proportion do. These findings highlight the range of genotypes and phenotypes in the first few years of life following CF newborn screening when CFTR sequencing is performed. PMID:27214204

  12. Benign and Deleterious Cystic Fibrosis Transmembrane Conductance Regulator Mutations Identified by Sequencing in Positive Cystic Fibrosis Newborn Screen Children from California.

    Directory of Open Access Journals (Sweden)

    Danieli B Salinas

    Full Text Available Of the 2007 Cystic Fibrosis Transmembrane Conductance Regulator (CFTR mutations, 202 have been assigned disease liability. California's racially diverse population, along with CFTR sequencing as part of newborn screening model, provides the opportunity to examine the phenotypes of children with uncategorized mutations to help inform disease liability and penetrance.We conducted a retrospective cohort study based on children screened from 2007 to 2011 and followed for two to six years. Newborns that screened positive were divided into three genotype groups: those with two CF-causing mutations (CF-C; those with one mutation of varying clinic consequence (VCC; and those with one mutation of unknown disease liability (Unknown. Sweat chloride tests, pancreatic sufficiency status, and Pseudomonas aeruginosa colonization were compared.Children with two CF-causing mutations had a classical CF phenotype, while 5% of VCC (4/78 and 11% of Unknown (27/244 met diagnostic criteria of CF. Children carrying Unknown mutations 2215insG with D836Y, and T1036N had early and classical CF phenotype, while others carrying 1525-42G>A, L320V, L967S, R170H, and 296+28A>G had a benign clinical presentation, suggesting that these are non-CF causing.While most infants with VCC and Unknown CFTR mutations do not meet diagnostic criteria for CF, a small proportion do. These findings highlight the range of genotypes and phenotypes in the first few years of life following CF newborn screening when CFTR sequencing is performed.

  13. Compare of internal rotation stretching and paroxysmal pulling manipulation with traction manipulation in supination position in the treatment of external humeral epicondylitis%旋后牵伸手法与内旋伸肘顿拉手法治疗肱骨外上髁炎的临床对比研究

    Institute of Scientific and Technical Information of China (English)

    傅瑞阳; 顾钟忠; 王宝虎; 沈新云; 王娅玲; 朱仡; 李烨; 王恩萍

    2011-01-01

    目的:比较旋后牵伸手法与传统内旋伸肘顿拉手法治疗肱骨外上髁炎的临床疗效.方法:将符合标准的126例肱骨外上髁炎患者随机分为2组.Ⅰ组64例,采用旋后牵伸手法治疗;Ⅱ组62例,采用内旋伸肘顿拉手法治疗.治疗1个疗程后参照verhaar网球肘疗效评分标准,从疼痛、压痛、握力、关节功能、患者满意度6个方面对患者的疗效进行评价.同时严格记录患者在治疗期间出现的各种不良反应.结果:①治疗后两组患者疼痛、压痛、握力、关节功能、患者满意度均较治疗前改善,且Ⅰ组改善情况优于Ⅱ组(P<0.01);②Ⅰ组总体疗效优于Ⅱ组,差异有统计学意义(Z=5.869,P=0.000);③Ⅱ组8例患者有一过性的轻度疼痛加重.经1~3 d休息或理疗后消失,其余患者未出现任何不良反应.结论:采用旋后牵伸手法治疗肱骨外上髁炎,疗效优于内旋伸肘顿拉手法.%Objective:To compare the therapeutic effect of the internal rotation stretching and paroxysmal pulling manipulation with that of traction manipulation in supination position on external humeral epicondylitis. Methods: 126 patients were randomly divided into 2 groups with 64 cases in Group Ⅰ and 62 cases in Group Ⅱ. Patients in Group Ⅰ were treated with traction manipulation in supination position while those in Group Ⅱ were treated with internal rotation stretching and paroxysmal pulling manipulation. The indexes involving pain, tendemess, the grip strength of the affected hand, the function of the arthrosis and the satisfaction degree of the patients were documented after the 20 - day course of treatment. Verhaar cure effect appraisal system of tennis - ball elbow were used to evaluate the therapeutic effects.Adverse reactions were documented during the 20 - day course of treatment. Results: The indexes improved after the treatment in two groups and the improvements in Group Ⅰ were superior to that in Group Ⅱ ( P < 0

  14. Paroxysmal nocturnal hemoglobinuria: rare cause of acute renal failure

    Directory of Open Access Journals (Sweden)

    Vilma Takayasu

    2012-12-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria is a rare acquired disease, characterized by hemolytic anemia, recurrent infections, cytopenias, and vascular thrombosis. It occurs by non-malignant clonal expansion of one or more hematopoietic stem cells that acquired somatic mutations in PIG-A gene linked to chromosome X. This mutation results in lower erythrocyte expression of CD55 and CD59 surface proteins and consequently increased susceptibility to the complement system. The renal involvement is generally benign, resulting in mild impairment in urinary concentration. Acute renal failure requiring hemodialytic support accompanying PNH is rarely observed. The authors report a case of a 37-year-old male who presented with bicytopenia (hemolytic anemia and thrombocytopenia associated with acute renal failure requiring dialysis. Diagnosis was challenging because of the rarity and unfamiliarity with this entity, but was confirmed by flow cytometry. In the course of the disease, acute pyelonephritis with multiple renal abscesses was diagnosed requiring prolonged antibiotic therapy. Patient outcome was favorable after the control of hemolysis and the infection treatment.

  15. [Initial evaluation and management of paroxysmal supraventricular tachycardia].

    Science.gov (United States)

    Rujic, Dragana; Sundbøll, Jens; Tofig, Bawer Jalal; Nielsen, Jens Cosedis; Pareek, Manan

    2016-01-18

    The paroxysmal supraventricular tachycardias (SVT) are commonly encountered arrhythmias and include atrioventricular nodal re-entrant tachycardia, atrioventricular reciprocating tachycardia, and focal atrial tachycardia. These tachycardias share several clinical features as well as similar management strategies. The probable mechanism of paroxysmal SVT can often be diagnosed from the clinical findings and a 12-lead ECG. This review describes the initial evaluation and treatment of patients with paroxysmal SVT, including distinctive features from the most important differential diagnoses.

  16. [Affective respiratory and reflex paroxysms--evaluation of anamnestic data, clinical manifestations and therapy].

    Science.gov (United States)

    Lnĕnicková, D; Makovská, Z; Lnĕnicka, J

    1993-08-01

    The authors elaborated data, using the retrospective method, of a group of 146 patients with affective respiratory and reflex paroxysms. They focused attention on clinical manifestations of the disease, anamnestic data suggesting possible damage or immaturity of stem structures, the influence of heredity and the family environment. They found that in 63.7% the disease was manifested before the age of 1 year, most frequently at the age of 9-12 months. The cyanotic type of paroxysms was found in 67.5% of the patients, the pallid type in 21% and 3.5% of the patients suffered from both types of paroxysms. In 27.4% perinatal risks were recorded. The influence of a family-history was statistically significant in relation to the patient's age during the first attack: in patients with a positive family-history the mean age being by 1.8 months lower. 82.9% of the patients had a normal neurological finding, the EEG was evaluated as normal in 89.6% of 125 thus examined children. Psychological examinations made in 12 children revealed in all instances anomalies of personality with a predominance of lack of compliance and adaptability to the environment. Deterioration of the health status as a result of affective respiratory and reflex paroxysms was not recorded in any of the patients.

  17. Is "Benign Childhood Epilepsy with Centrotemporal Spikes” Always Benign?

    Directory of Open Access Journals (Sweden)

    Muhammad SAEED

    2014-07-01

    epileptiform discharges are associated with mood and behavior problems. Epilepsy Behav. 2011;22 (2:298-303.Jones JE, Watson R, Sheth R, Caplan R, Koehn M, Seidenberg M, et al. Psychiatric comorbidity in children with new onset epilepsy. Dev Med Child Neurol. 2007;49:493-7.Austin JK, Harezlak J, Dunn DW, Huster GA, Rose DF, Ambrosius WT. Behavior problems in children before first recognized seizures. Pediatrics. 2001; 107:115-22.Bhise VV, Burack GD, Mandelbaum DE. Baseline cognition, behavior, and motor skills in children with new-onset, idiopathic epilepsy. Dev Med Child Neurol. 2010;52:22-6.Kavros PM, Clarke T, Strug LJ, Halperin JM, Dorta NJ, Pal DK. Attention impairment in rolandic epilepsy: systematic review. Epilepsia. 2008; 49:1570-80.Beaussart M. Benign epilepsy of children with Rolandic (centro-temporal paroxysmal foci: A clinical entity: Study of 221 cases. 1972. Epilepsia 13 (6: 795–811. 

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

    Directory of Open Access Journals (Sweden)

    Eranga S Wijewickrama

    2013-01-01

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

  19. Benign Multicystic Peritoneal Mesothelioma

    Science.gov (United States)

    ... Center (GARD) Print friendly version Benign multicystic peritoneal mesothelioma Table of Contents Overview Treatment Prognosis Living With ... Names for this Disease BMPM Benign cystic peritoneal mesothelioma Multilocular peritoneal inclusion cysts Multilocular peritoneal cysts About ...

  20. Mesothelioma - benign-fibrous

    Science.gov (United States)

    Mesothelioma - benign; Mesothelioma - fibrous; Pleural fibroma; Solitary fibrous tumor of the pleura ... other reasons. Other tests that may show benign mesothelioma include: CT scan of the chest Open lung ...

  1. Paroxysmal Supraventricular Tachycardia: Pathophysiology, Diagnosis, and Management.

    Science.gov (United States)

    Al-Zaiti, Salah S; Magdic, Kathy S

    2016-09-01

    Paroxysmal supraventricular tachycardia (PSVT) is a well-known and thoroughly studied clinical syndrome, characterized by regular tachycardia rhythm with sudden onset and abrupt termination. Most patients present with palpitations and dizziness, and their electrocardiogram demonstrates a narrow QRS complex and regular tachycardia with hidden or inverted P waves. PSVT is caused by re-entry due to the presence of inhomogeneous, accessory, or concealed conducting pathways. Hemodynamically stable patients are treated by vagal maneuvers, intravenous adenosine, diltiazem, or verapamil, hemodynamically unstable patients are treated by cardioversion. Patients with symptomatic and recurrent PSVT can be treated with long-term drug treatment or catheter ablation.

  2. The polyuria of paroxysmal atrial tachycardia

    Science.gov (United States)

    Kinney, M. J.; Stein, R. M.; Discala, V. A.

    1974-01-01

    Two patients with paroxysmal atrial fibrillation and an associated polyuria were studied to delineate the mechanism of the increase in urine flow. A striking saluresis was noted in both patients. The increased sodium excretion was probably due to decreased sodium reabsorption, perhaps at proximal tubular nephron sites. This inhibition of sodium reabsorption could explain both the saluresis and some part or all of the polyuria. Re-evaluation of earlier case reports reveals patterns of concomitant salt and water excretion consistent with this mechanism. The saluresis cannot be explained by the previously favored hypothesis of antidiuretic hormone inhibition.

  3. Entropy measurements in paroxysmal and persistent atrial fibrillation

    International Nuclear Information System (INIS)

    Recent studies on atrial fibrillation (AF) have identified different activation patterns in paroxysmal and persistent AF. In this study, bipolar intra-atrial registers from 28 patients (14 paroxysmal AF and 14 persistent AF) were analyzed in order to find out regional differences in the organization in both types of arrhythmias. The organization of atrial electrical activity was assessed in terms of nonlinear parameters, such as entropy measurements. Results showed differences between the atrial chambers with a higher disorganization in the left atrium in paroxysmal AF patients and a more homogenous behavior along the atria in persistent AF patients

  4. Idiopathic Paroxysmal Ventricular Tachycardia in Infants and Children

    Science.gov (United States)

    Hernandez, Antonio; And Others

    1975-01-01

    Laboratory tests including blood count serum electrolyte measures, and electroencephalograms were performed on seven children ages 1 day to 18 years with recurrent attacks of rapid heart action known as idiopathic paroxysmal ventricular tachycardia. (CL)

  5. Paroxysmal autonomic instability with dystonia in a patient with tuberculous meningitis: a case report

    Directory of Open Access Journals (Sweden)

    Ramdhani Navin A

    2010-09-01

    Full Text Available Abstract Introduction This case report describes an extremely rare combination of paroxysmal autonomic instability with dystonia and tuberculous meningitis. Paroxysmal autonomic instability with dystonia is normally associated with severe traumatic brain injury. Case presentation A 69-year-old man of Indonesian descent was initially suspected of having a community-acquired pneumonia, which was seen on chest X-ray and computed tomography of the chest. However, a bronchoscopy showed no abnormalities. He was treated with amoxicillin-clavulanic acid in combination with ciprofloxacin. However, nine days after admission he was disorientated and complained of headache. Neurological examination revealed no further abnormalities. A lumbar puncture revealed no evidence of meningitis. He was then transferred to our hospital. At that time, initial cultures of bronchial fluid for Mycobacterium tuberculosis turned positive, as well as polymerase chain reaction for Mycobacterium tuberculosis. Later, during his stay in our intensive care unit, he developed periods with hypertension, sinus tachycardia, excessive transpiration, decreased oxygen saturation with tachypnea, pink foamy sputum, and high fever. This constellation of symptoms was accompanied by dystonia in the first days. These episodes lasted approximately 30 minutes and improved after administration of morphine, benzodiazepines or clonidine. Magnetic resonance imaging showed an abnormal signal in the region of the hippocampus, thalamus and the anterior parts of the lentiform nucleus and caudate nucleus. Conclusions In patients with (tuberculous meningitis and episodes of extreme hypertension and fever, paroxysmal autonomic instability with dystonia should be considered.

  6. Plasmodium vivax: paroxysm-associated lipids mediate leukocyte aggregation

    Directory of Open Access Journals (Sweden)

    Mendis Kamini

    2007-05-01

    Full Text Available Abstract Background Paroxysms are recurrent febrile episodes, characteristic of Plasmodium vivax infections, which coincide with the rupture of schizont-infected erythrocytes in the patients' circulation. The present study describes the formation of prominent aggregates of leukocytes in vitro in the presence of parasite and host factors released during paroxysms. Methods Whole blood cells from uninfected malaria-naïve donors were incubated with plasma taken during a paroxysm or normal human plasma as a control and cell smears were observed under the microscope for the presence of leukocyte aggregates. Plasma factors involved in mediating the leukocyte aggregation were identified using immune depletion and reconstitution experiments. Furthermore, biochemical characterization was carried out to determine the chemical nature of the active moieties in plasma present during paroxysms. Results Leukocyte aggregates were seen exclusively when cells were incubated in plasma collected during a paroxysm. Immune depletion and reconstitution experiments revealed that the host cytokines TNF-alpha, GM-CSF, IL-6 and IL-10 and two lipid fractions of paroxysm plasma comprise the necessary and sufficient mediators of this phenomenon. The two lipid components of the paroxysm plasmas speculated to be of putative parasite origin, were a phospholipid-containing fraction and another containing cholesterol and triglycerides. The phospholipid fraction was dependent upon the presence of cytokines for its activity unlike the cholesterol/triglyceride-containing fraction which in the absence of added cytokines was much more active than the phospholipids fraction. The biological activity of the paroxysm plasmas from non-immune patients who presented with acute P. vivax infections was neutralized by immune sera raised against schizont extracts of either P. vivax or Plasmodium falciparum. However, immune sera against P. vivax were more effective than that against P. falciparum

  7. [Renal vein infarction, a complication of paroxysmal nocturnal hemoglobinuria].

    Science.gov (United States)

    de Charry, Charlotte; de Charry, Félicité; Lemoigne, François; Lamboley, Jean-Laurent; Pasquet, Florian; Pavic, Michel

    2012-12-01

    Paroxysmal nocturnal hemoglobinuria (Marchiafava-Micheli disease) is a rare acquired clonal disorder of the hematopoietic cell, to a somatic mutation in the phosphatidylinositol glycan (PIG-A). The most frequent clinical manifestations are hemolytic crisis and venous thrombosis of the mesenteric, hepatic, portal or cerebral territories. We report a case of paroxysmal nocturnal hemoglobinuria with renal vein thrombosis, a rare complication of this disease.

  8. Myocardial bridging as a cause of paroxysmal atrioventricular block

    Energy Technology Data Exchange (ETDEWEB)

    den Dulk, K.; Brugada, P.; Braat, S.; Heddle, B.; Wellens, H.J.

    1983-03-01

    Paroxysmal atrioventricular (AV) block was induced by exercise in an otherwise healthy young man. The only abnormalities demonstrated at comprehensive cardiac evaluation were: 1) angiographic systolic narrowing of the left anterior descending coronary artery, and 2) reversible radionuclide hypoperfusion of the septum during exercise. It is postulated that ischemia of the conduction system due to systolic milking of the left anterior descending coronary artery was responsible for the paroxysmal AV block in this patient.

  9. Optimizing Detection Rate and Characterization of Subtle Paroxysmal Neonatal Abnormal Facial Movements with Multi-Camera Video-Electroencephalogram Recordings.

    Science.gov (United States)

    Pisani, Francesco; Pavlidis, Elena; Cattani, Luca; Ferrari, Gianluigi; Raheli, Riccardo; Spagnoli, Carlotta

    2016-06-01

    Objectives We retrospectively analyze the diagnostic accuracy for paroxysmal abnormal facial movements, comparing one camera versus multi-camera approach. Background Polygraphic video-electroencephalogram (vEEG) recording is the current gold standard for brain monitoring in high-risk newborns, especially when neonatal seizures are suspected. One camera synchronized with the EEG is commonly used. Methods Since mid-June 2012, we have started using multiple cameras, one of which point toward newborns' faces. We evaluated vEEGs recorded in newborns in the study period between mid-June 2012 and the end of September 2014 and compared, for each recording, the diagnostic accuracies obtained with one-camera and multi-camera approaches. Results We recorded 147 vEEGs from 87 newborns and found 73 episodes of paroxysmal facial abnormal movements in 18 vEEGs of 11 newborns with the multi-camera approach. By using the single-camera approach, only 28.8% of these events were identified (21/73). Ten positive vEEGs with multicamera with 52 paroxysmal facial abnormal movements (52/73, 71.2%) would have been considered as negative with the single-camera approach. Conclusions The use of one additional facial camera can significantly increase the diagnostic accuracy of vEEGs in the detection of paroxysmal abnormal facial movements in the newborns.

  10. Chronic paroxysmal hemicrania in paediatric age: report of two cases.

    Science.gov (United States)

    Tarantino, Samuela; Vollono, Catello; Capuano, Alessandro; Vigevano, Federico; Valeriani, Massimiliano

    2011-04-01

    Chronic paroxysmal hemicrania (CPH) is a rare primary headache syndrome, which is classified along with hemicrania continua and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) as trigeminal autonomic cephalalgia (TACs). CPH is characterised by short-lasting (2-30 min), severe and multiple (more than 5/day) pain attacks. Headache is unilateral, and fronto-orbital-temporal pain is combined with cranial autonomic symptoms. According to the International Classification of Headache Disorders, 2nd edition, the attacks are absolutely responsive to indomethacin. CPH has been only rarely and incompletely described in the developmental age. Here, we describe two cases concerning a 7-year-old boy and a 11-year-old boy with short-lasting, recurrent headache combined with cranial autonomic features. Pain was described as excruciating, and was non-responsive to most traditional analgesic drugs. The clinical features of our children's headache and the positive response to indomethacin led us to propose the diagnosis of CPH. Therefore, our children can be included amongst the very few cases of this trigeminal autonomic cephalgia described in the paediatric age.

  11. Prognostic parameters in benign astrocytomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1993-01-01

    To elucidate the prognosis of different types of benign astrocytomas and to ascertain whether patients with partially resected benign astrocytomas, or any subtype of these, would benefit from postoperative radiotherapy, we studied retrospectively material comprising 300 patients with benign...

  12. Paroxysmal sympathetic hyperactivity in neurological critical care

    Directory of Open Access Journals (Sweden)

    Rajesh Verma

    2015-01-01

    Full Text Available Introduction: Paroxysmal sympathetic hyperactivity (PSH is a clinical disorder mainly caused by traumatic brain injury, stroke, encephalitis and other types of brain injury. The clinical features are episodes of hypertension, tachycardia, tachypnea, fever and dystonic postures. In this study, we described clinical profile and outcome of six patients of PSH admitted in neurocritical care unit. Materials and Methods: This was a prospective observational study conducted at neurology critical care unit of a tertiary care center. All patients admitted at neurology critical unit during 6-month period from August 2013 to January 2014 were screened for the occurrence of PSH. The clinical details and outcome was documented. Results: PSH was observed in 6 patients. Male to female ratio was 5:1. Mean age ± SD was 36.67 ± 15.19 years. The leading causes were traumatic brain injury (two patients, stroke (two patients and Japanese encephalitis (JE (one patient and tuberculous meningitis (one patient. Conclusion: PSH is an unusual complication in neurocritical care. It prolonged the hospitalization and hampers recovery. The other life-threatening conditions that mimic PSH should be excluded. The association with JE and tuberculous meningitis was not previously described in literature.

  13. Necrotizing Fasciitis in Paroxysmal Nocturnal Hemoglobinuria

    Directory of Open Access Journals (Sweden)

    Pusem Patir

    2015-01-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is a rare, progressive, and life-threatening hematopoietic stem cell disorder characterized by complement-mediated intravascular hemolysis and a prothrombotic state. Patients with PNH might have slightly increased risk of infections due to complement-associated defects subsequent to CD59 deficiency. Here, we report a rare case of a 65-year-old male patient with necrotic ulcers on both legs, where the recognition of pancytopenia and microthrombi led to the diagnosis of PNH based on FLAER (FLuorescent AERolysin flow cytometric analysis. He was subsequently started on eculizumab therapy, with starting and maintenance doses set as per drug labelling. Progression of the patient’s leg ulcers during follow-up, with fulminant tissue destruction, purulent discharge, and necrotic patches, led to a later diagnosis of necrotizing fasciitis due to Pseudomonas aeruginosa and Klebsiella pneumonia infection. Courses of broad-spectrum antibiotics, surgical debridement, and superficial skin grafting were applied with successful effect during ongoing eculizumab therapy. This case highlights the point that it is important to maintain treatment of underlying disorders such as PNH in the presence of life-threatening infections like NF.

  14. Benign prostate hyperplasia (BPH) - resources

    Science.gov (United States)

    Resources - benign prostatic hyperplasia (BPH); Prostate enlargement resources; BPH resources ... The following organizations provide information on benign prostatic hyperplasia ( prostate enlargement ... Urology Care Foundation -- www. ...

  15. Radiofrequency catheter ablation maintains its efficacy better than antiarrhythmic medication in patients with paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Raatikainen, M J Pekka; Hakalahti, Antti; Uusimaa, Paavo;

    2015-01-01

    BACKGROUND: The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) is a randomized trial comparing radiofrequency catheter ablation (RFA) to antiarrhythmic drugs (AADs) as first-line treatment of paroxysmal atrial fibrillation (PAF). In order...

  16. A case of congenital myopathy masquerading as paroxysmal dyskinesia

    Directory of Open Access Journals (Sweden)

    Harsh Patel

    2014-01-01

    Full Text Available Gastroesophageal reflux (GER disease is a significant comorbidity of neuromuscular disorders. It may present as paroxysmal dyskinesia, an entity known as Sandifer syndrome. A 6-week-old neonate presented with very frequent paroxysms of generalized stiffening and opisthotonic posture since day 22 of life. These were initially diagnosed as seizures and he was started on multiple antiepileptics which did not show any response. After a normal video electroencephalogram (VEEG was documented, possibility of dyskinesia was kept. However, when he did not respond to symptomatic therapy, Sandifer syndrome was thought of and GER scan was done, which revealed severe GER. After his symptoms got reduced to some extent, a detailed clinical examination revealed abnormal facies with flaccid quadriparesis. Muscle biopsy confirmed the diagnosis of a specific congenital myopathy. On antireflux measures, those episodic paroxysms reduced to some extent. Partial response to therapy in GER should prompt search for an underlying secondary etiology.

  17. Paroxysmal Hypnogenic Dyskinesia Responsive to Doxylamine: A Case Report

    Directory of Open Access Journals (Sweden)

    Daniel M. Williams

    2012-01-01

    Full Text Available Paroxysmal hypnogenic dyskinesia is a rare clinical entity characterized by intermittent dystonia and choreoathetoid movements that begin exclusively during sleep, often with consciousness preserved once the patient is awakened during the episodes. They occur almost every night and are often misdiagnosed as sleeping disorders. Paroxysmal hypnogenic dyskinesia is currently known to be a form of frontal lobe epilepsy, but not in all cases. We present a 19-year-old male patient with paroxysmal hypnogenic dyskinesia who responded to antihistamines. This supports an alternative theory from 1977 (before the cases had been adequately described that the disorder lies in dysregulation in the basal ganglia. This description now appears similar to acute dystonic reactions such as extrapyramidal symptoms from antipsychotic medications, which also respond to antihistamines.

  18. Paroxysmal supraventricular tachycardia: physiopathology and management

    Directory of Open Access Journals (Sweden)

    Paola Neroni

    2014-06-01

    Full Text Available Paroxysmal supraventricular tachycardia (PSVT is the most frequent arrhythmia in newborns and infants. Most supraventricular tachycardias affect structurally healthy hearts. Apart from occasional detection by parents, most tachycardias in this age group are revealed by heart failure signs, such as poor feeding, sweating and shortness of breath. The main symptom reported by school-age children is palpitations. The chronic tachycardia causes a secondary form of dilative cardiomyopathy. Treatment of acute episode usually has an excellent outcome. Vagal manoeuvres are effective in patients with atrioventricular reentrant tachycardia. Adenosine is the drug of choice at all ages for tachycardias involving the atrioventricular node. Its key advantage is its short half life and minimum or no negative inotropic effects. Verapamil is not indicated in newborns and children as it poses a high risk of electromechanical dissociation. Antiarrhythmic prophylaxis of PSVT recurrence is usually recommended in the first year of life, because the diagnosis of tachycardia may be delayed up to the appearance of symptoms. Digoxin can be administered in all forms of PSVT involving the atrioventricular node, except for patients with Wolff-Parkinson-White syndrome below one year of age. Patients with atrioventricular reentrant PSVT can be treated effectively by class Ic drugs, such as propaphenone and flecainide. Amiodarone has the greatest antiarrhythmic effect, but should be used with caution owing to the high incidence of side effects. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  19. The cost-effectiveness of radiofrequency catheter ablation as first-line treatment for paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Aronsson, Mattias; Walfridsson, Håkan; Janzon, Magnus;

    2014-01-01

    , based on MANTRA-PAF (Medical Antiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation) study data, was developed to study long-term effects and costs of RFA compared with AADs as first-line treatment. Positive clinical effects were found in the overall population, a gain...... in older patients is uncertain, and in most of these AADs should be attempted before RFA (MANTRA-PAF ClinicalTrials.gov number; NCT00133211)....

  20. Benign cystic peritoneal mesothelioma

    Directory of Open Access Journals (Sweden)

    Santhosh Shetty

    2014-04-01

    Full Text Available A well-defined but rare entity of Benign Cystic Peritoneal Mesothelioma (BCPM is reported. The aetiology of this neoplasm remains obscure. The presenting features make a precise preoperative diagnosis difficult but information provided by computed tomography and cytology may help. A firm diagnosis can only come from an electronic microscopy or immunohistological examination of the tumour. Diagnostic accuracy and diligent follow up are essential because, although the tumour is considered benign, it does tend towards local recurrence. [Int J Res Med Sci 2014; 2(2.000: 762-764

  1. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective: to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods: The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF). The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃. The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132±68 min for our patients. The average fluoroscopy time was 33±17 min. With a mean follow-up of 16±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion: Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  2. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective : to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods : The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF) . The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃ . The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132± 68 min for our patients. The average fluoroscopy time was 33 ±17 min. With a mean follow-up of 16 ±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion : Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  3. Paroxysmal Atrial Fibrillation in a Mission-Assigned Astronaut

    Science.gov (United States)

    Bauer, Peter A.; Polk, J. D.

    2010-01-01

    This presentation will explore the clinical and administrative conundrums faced by the flight surgeon upon discovering asymptomatic paroxysmal atrial fibrillation seven months prior to scheduled long duration spaceflight. The presenter will discuss the decision-making process as well as the clinical and operational outcomes.

  4. Paroxysmal kinesigenic dyskinesia : Cortical or non-cortical origin

    NARCIS (Netherlands)

    van Strien, Teun W.; van Rootselaar, Anne-Fleur; Hilgevoord, Anthony A. J.; Linssen, Wim H. J. P.; Groffen, Alexander J. A.; Tijssen, Marina A. J.

    2012-01-01

    Paroxysmal kinesigenic dyskinesia (PKD) is characterized by involuntary dystonia and/or chorea triggered by a sudden movement. Cases are usually familial with an autosomal dominant inheritance. Hypotheses regarding the pathogenesis of PKD focus on the controversy whether PKD has a cortical or non-co

  5. Paroxysmal Perceptual Alteration: Drug-Induced Phenomenon or Schizophrenic Psychopathology?

    Science.gov (United States)

    Praharaj, Samir Kumar; Kongasseri, Sreejayan; Acharya, Mahima

    2016-01-01

    Brief and repetitive episodes of perceptual changes, termed paroxysmal perceptual alteration (PPA), have been described in association with antipsychotic treatment. We report a case of paranoid schizophrenia who had such perceptual changes akin to PPA for 15 years, which was not related to antipsychotic treatment. There was a rapid resolution of PPA after treatment with low-dose clonazepam. PMID:26954463

  6. Paroxysmal nocturnal haemoglobinuria and Budd-Chiari syndrome.

    OpenAIRE

    Wyatt, H A; Mowat, A P; Layton, M.

    1995-01-01

    An 11 year old boy developed pancytopenia, haemolysis, and Budd-Chiari syndrome. The venous thrombosis extended to involve other intra-abdominal vessels before paroxysmal nocturnal haemoglobinuria was recognised as the underlying haematological abnormality. Earlier diagnosis would have made curative bone marrow transplantation a possibility.

  7. Benign chronic orofacial pain. Clinical criteria and therapeutic approaches.

    Science.gov (United States)

    Dworkin, S F

    1983-09-01

    Trigeminal neuralgia and temporomandibular joint (TMJ) pain-dysfunction syndrome are the most common benign orofacial pain disorders. Because orofacial pain can arise from many sources and can be exacerbated by emotional stress, diagnosis is complex. Primary trigeminal neuralgia (tic douloureux) is characterized by severe paroxysms of pain often initiated by stimuli applied to trigger zones. Atypical facial neuralgia is a more loosely defined collection of orofacial neuralgias with variable distribution of pain and age of onset. Treatment (ie, pharmacologic and surgical procedures, nerve blocks, alcohol injection) is often based on the theoretical biases of clinicians. The most common clinical findings in TMJ pain-dysfunction syndrome are localized facial pain, mandibular dysfunction, and joint sounds. Therapy includes use of drugs to relieve pain and relax muscles, elimination of occlusal discrepancies, and surgical procedures. Psychologic referral is usually considered a last resort. PMID:6889199

  8. Paroxysmal stabbing headache in the multiple dermatomes of the head and neck: a variant of primary stabbing headache or occipital neuralgia?

    Science.gov (United States)

    Shin, J H; Song, H K; Lee, J H; Kim, W K; Chu, M K

    2007-10-01

    A paroxysmal stabbing or icepick-like headache in the multiple nerve dermatomes, especially involving both trigeminal and cervical nerves, has not been fully explained or classified by the International Classification of Headache Disorder, 2(nd) Edition (ICHD-II). Of patients with acute-onset paroxysmal stabbing headache who had visited the Hallym University Medical Center during the last four years, 28 subjects with a repeated stabbing headache involving multiple dermatomes at the initial presentation or during the course were prospectively enrolled. All patients were neurologically and otologically symptom free. A coincidental involvement of both trigeminal and cervical nerve dermatomes included seven cases. Six cases involved initially the trigeminal and then cervical nerve dermatomes. Five cases showed an involvement of the cervical and then trigeminal nerve dermatomes. The remaining patients involved multiple cervical nerve branches (the lesser occipital, greater occipital and greater auricular). Pain lasted very shortly and a previous history of headache with the same nature was reported in 13 cases. Preceding symptom of an infection and physical and/or mental stress were manifested in seven and six subjects, respectively. All patients showed a self-limited benign course and completely recovered within a few hours to 30 days. Interestingly, a seasonal gradient in occurrence of a stabbing headache was found in this study. A paroxysmal stabbing headache manifested on multiple dermatomes can be explained by the characteristics of pain referral, and may be considered to be a variant of primary stabbing headache or occipital neuralgia. PMID:17725653

  9. Positioning.

    Science.gov (United States)

    Conone, Ruth M.

    The key to positioning is the creation of a clear benefit image in the consumer's mind. One positioning strategy is creating in the prospect's mind a position that takes into consideration the company's or agency's strengths and weaknesses as well as those of its competitors. Another strategy is to gain entry into a position ladder owned by…

  10. Benign pneumatosis in children

    Energy Technology Data Exchange (ETDEWEB)

    Fenton, L.Z.; Buonomo, C. [Department of Radiology, Children' s Hospital, Boston, MA (United States)

    2000-11-01

    Background. In pediatrics, pneumatosis intestinalis (PI) is usually due to necrotizing enterocolitis in premature newborns. Beyond infancy, PI is uncommon. ''Benign pneumatosis'' is PI in patients with few or no symptoms that resolves with conservative management. Objective. Our goal was to better characterize benign PI in children. Our investigation focused on identifying underlying risk factors, symptoms at time of diagnosis, management and outcome. Materials and methods. Available medical records and radiographs of children with pneumatosis intestinalis from 1990 to 1998 were reviewed for underlying conditions, symptoms at time of radiographs, management and outcome. Results. Thirty-seven children (mean age 4 years) were included. Thirty-two children had identifiable risk factors. Twenty -five children were immunocompromised by their underlying conditions or therapeutic regimen. Thirty-five children were managed conservatively with resolution of PI. Two patients, however, required surgery and one patient died. Conclusion. Benign pneumatosis does occur in children. The majority have underlying risk factors, most commonly related to immunosuppression. Clinical deterioration is the most useful indicator for surgical intervention. In most patients PI resolves with conservative management. (orig.)

  11. Mental Development of Children with Non-epileptic Paroxysmal States in Medical History

    Directory of Open Access Journals (Sweden)

    Turovskaya N.G.,

    2015-10-01

    Full Text Available The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders and intelligence in general. However, non-epileptic paroxysmal states as well as epileptic seizure associated with increasing activity exhaustion and abnormal function of the motor analyzer (dynamic and kinesthetic dyspraxia. Visual memory disorders and modal-nonspecific memory disorders have more pronounced importance in the mental ontogenesis structure in children with convulsive paroxysms compared to children with cerebral pathology without paroxysms history

  12. Paroxysmal hemicrania as the clinical presentation of giant cell arteritis

    Directory of Open Access Journals (Sweden)

    Jennifer L. Beams

    2011-11-01

    Full Text Available Head pain is the most common complaint in patients with giant cell arteritis but the headache has no distinct diagnostic features. There have been no published reports of giant cell arteritis presenting as a trigeminal autonomic cephalalgia. We describe a patient who developed a new onset headache in her fifties, which fit the diagnostic criteria for paroxysmal hemicrania and was completely responsive to corticosteroids. Removal of the steroid therapy brought a reemergence of her headaches. Giant cell arteritis should be considered in the evaluation of secondary causes of paroxysmal hemicrania; in addition giant cell arteritis needs to be ruled out in patients who are over the age of 50 years with a new onset trigeminal autonomic cephalalgia.

  13. Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke

    Directory of Open Access Journals (Sweden)

    Jason W. Siefferman

    2015-01-01

    Full Text Available Brain injury can lead to impaired cortical inhibition of the hypothalamus, resulting in increased sympathetic nervous system activation. Symptoms of paroxysmal sympathetic hyperactivity may include hyperthermia, tachycardia, tachypnea, vasodilation, and hyperhidrosis. We report the case of a 41-year-old man who suffered from a left middle cerebral artery stroke and subsequently developed central fever, contralateral temperature change, and hyperhidrosis. His symptoms abated with low-dose propranolol and then returned upon discontinuation. Restarting propranolol again stopped his symptoms. This represents the first report of propranolol being used for unilateral dysautonomia after stroke. Propranolol is a lipophilic nonselective beta-blocker which easily crosses the blood-brain barrier and may be used to treat paroxysmal sympathetic hyperactivity.

  14. Paroxysmal dystonic choreoathetosis: tight linkage to chromosome 2q.

    OpenAIRE

    Fink, J K; Rainer, S.; Wilkowski, J.; Jones, S. M.; Kume, A.; Hedera, P; Albin, R.; Mathay, J.; Girbach, L.; Varvil, T; Otterud, B; Leppert, M

    1996-01-01

    Paroxysmal dystonic choreoathetosis (PDC) is characterized by attacks of involuntary movements that last up to several hours and occur at rest both spontaneously and following caffeine or alcohol consumption. We analyzed a Polish-American kindred with autosomal dominant PDC and identified tight linkage between the disorder and microsatellite markers on chromosome 2q (maximum two-point LOD score 4.77; recombination fraction 0). Our results clearly establish the existence of a locus for autosom...

  15. Chronic paroxysmal hemicrania and hemicrania continua. Parenteral indomethacin: the 'indotest'.

    Science.gov (United States)

    Antonaci, F; Pareja, J A; Caminero, A B; Sjaastad, O

    1998-02-01

    The interval between indomethacin administration and clinical response may be clinically relevant in the assessment of chronic paroxysmal hemicrania and hemicrania continua and other unilateral headache disorders with which they can be confounded. Eight patients with chronic paroxysmal hemicrania (6 women and 2 men) and 12 patients with hemicrania continua (8 women and 4 men) were entered into the study. The patients were given 50 mg of indomethacin intramuscularly (i.m.) on day 1 and some of them 100 mg IM on day 2 in an open fashion. The usual attack pattern was reestablished prior to the second test. The mean interval between attacks before the two injections (51 +/- 18 minutes) in chronic paroxysmal hemicrania was significantly shorter than the mean after each of the two indomethacin injections (50 mg = 493 +/- 251 minutes; 100 mg = 668 +/- 211 minutes; P hemicrania continua, the time between 50-mg indomethacin injection and complete pain relief was 73 +/- 66 minutes. The pain-free period after indomethacin injection was around 13 hours (i.e., 13 +/- 8 hours after 50 mg and 13 +/- 10 hours after 100 mg). The use of a test dosage of 50 mg of indomethacin IM ('indotest') gives a clear-cut answer and may be a useful tool in the diagnostic arsenal in every unilateral headache for a proper clinical assessment. A diagnosis of chronic paroxysmal hemicrania or hemicrania continua is a serious matter because it may imply life-long treatment with a potentially noxious drug. It is, therefore, of the utmost importance that an 'indotest' is carried out in a standard fashion. In the future, the rules set forth in the present context should be followed, at least in scientific studies. Pain pressure thresholds at cranial and extracranial levels were not significantly modified after indomethacin injection in any of the headaches.

  16. Benign cephalic histiocytosis.

    Science.gov (United States)

    Gianotti, F; Caputo, R; Ermacora, E; Gianni, E

    1986-09-01

    Benign cephalic histiocytosis is a self-healing non-X, nonlipid cutaneous histiocytosis of children, characterized by a papular eruption on the head. Mucous membranes and viscera are always spared. In the 13 cases reported herein, the children were otherwise in good general health. The disease appeared during the first three years of life, and spontaneous regression was complete by the age of nine years in the four cases healed to date. The histiocytic infiltrate was localized in the upper and middle dermis and contained no lipids at any stage of evolution. All the histiocytes contained coated vesicles, and 5% to 30% also contained comma-shaped bodies in their cytoplasm.

  17. Benign occipital lobe seizures: Natural progression and atypical evolution

    Directory of Open Access Journals (Sweden)

    Prithika Chary

    2013-01-01

    Full Text Available Benign occipital seizure syndromes are benign childhood epilepsy syndromes and are mainly of two types, Panayiotopoulos syndrome, an autonomic epilepsy and idiopathic childhood occipital epilepsy of Gastaut (ICOE-G including the idiopathic photosensitive occipital lobe epilepsy. Although both these types are categorized as occipital seizures, they are distinct in presentation and management. They can also be tricky to diagnose as visual symptoms may not always be the presenting feature and it is also not very easy to elicit visual hallucinations during history taking. These seizures have a good response to treatment; however, there could be atypical evolution and refractoriness to treatment especially with ICOE-G. We describe three children who presented with visual and non-visual symptoms and the electroencephalography (EEG in all the three cases showed occipital paroxysms. We have emphasized the clues in the clinical history and EEG leading to the diagnosis of these distinct epilepsy syndromes. We have also discussed the natural course of these epilepsy syndromes with some atypical evolution, which clinicians need to be aware of during treatment of these children.

  18. 前庭功能诊治系统SRM-Ⅳ在良性阵发性位置性眩晕中的应用%Application of an automatic vestibular function diagnosis and therapy system in benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    孙勍; 马丽涛; 李娜; 彭新; 单希征

    2010-01-01

    目的 观察全自动前庭功能诊治系统(SRM-Ⅳ)诊治良性阵发性位置性眩晕的临床效果.方法 回顾分析了56例良性阵发性位置性眩晕患者,其中36例采用SRM-Ⅳ进行诊断和治疗,20例采用手法诊治,对其疗效进行比较.结果 采用SRM-Ⅳ治疗的患者中第1次治疗后有32例患者(89%)治愈,4例患者经过第2次治疗痊愈;采用手法复位的患者中第1次治疗后有17例患者(85%)治愈,3例患者经过第2次治疗痊愈.应用χ~2检验二者的差异没有统计学意义.结论 应用全自动前庭功能诊治系统诊治良性阵发性位置性眩晕临床效果可靠,弥补了手法复位的缺陷,效果直观,可重复性强.

  19. RADIOFREQUENCY CURRENT CATHETER ABLATION OF THE LEFT ATRIOVENTRICULAR ACCESSORY PATHWAYS WITH PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA

    Institute of Scientific and Technical Information of China (English)

    王静毅; 郭继鸿; 吴益明; 朱继红; 王伟民; 赵红; 刘喜荣; MichaelA.Lee

    1994-01-01

    Seventy patients with left atrioventricular accessory pathways and paroxysmal supraventricular tachycardia (PSVT) underwent radiofrequency catheter ablation (RFCA).The success rate was 94.3%.Among these pa-tients,26 had manifest preexcitation syndrome,and 44 had concealed preexcitation.Eighteen patients with con-cealed preexcitation underwent coronary sinus(CS) pacinga,and delta wave appeared in 15.The keys to successful RFCA were correct positioning of the radiofrequency (RF) catheter tip,A/V amplitude ratio,AV interval(in si-nus rhythm)and VA interval(during SVT or ventricular pacing).After 1-14 months of follow-up,two pa- tients had supraventricular tachycardia(SVT)recurrence.

  20. How benign is benign tertian malaria?

    Directory of Open Access Journals (Sweden)

    Archna Sharma

    2009-06-01

    Full Text Available Objective: This retrospective study was conducted to determine the incidence of variouscomplications of Plasmodium vivax malaria based on review of case records.Methods: The case records of all confirmed cases of malaria over the period of one year (September2005–August 2006 were studied. Complete blood count, peripheral blood findings, liver and kidneyfunctions were reviewed. The results of rapid diagnostic test for malaria (OptiMAL test, DiamedAG, Switzerland were correlated with the peripheral blood smear findings in the patients in whomit was requested. All abnormal results like a positive direct Coomb’s test were noted. Findingswere clinically correlated.Results: There were 265 confirmed cases by peripheral blood examination. Of these 221 were dueto Plasmodium vivax and 41 due to P. falciparum. Two cases had mixed infection and in one casethe species could not be identified as it showed only malarial pigment. The peak incidence ofmalaria was seen in September 2005 and August 2006. The complications in P. vivax werethrombocytopenia, biochemical evidence of hepatic dysfunction, renal damage, positive DCT anddeath due to ARDS. Thrombocytopenia was seen in 213 patients with counts 3 mg/dl with normal liver enzymes. Liver enzymeswere elevated in 60 patients with seven patients showing liver enzymes level, three times the normal.Renal dysfunction was seen in 17 patients with serum creatinine ranging from 1.3–10.65 mg/dl.One patient went into acute renal failure following quinine therapy and showed red cell fragmentsin the peripheral blood. In two children DCT was positive with the peripheral smear showing RBCagglutinates around the parasitised RBC. There were three maternal deaths at about 32 weeksgestation due to ARDS. The peripheral blood smear in these patients showed WBC agglutinates.Conclusion: This paper is presented to highlight that P. vivax malaria though considered to be abenign entity can also have a severe and complicated course

  1. Paroxysmal atrial fibrillation is uncommon in outpatients with chronic heart failure

    DEFF Research Database (Denmark)

    Corell, Pernille; Gustafsson, Finn; Mehlsen, Jesper;

    2008-01-01

    The objective was to evaluate the prevalence of paroxysmal atrial fibrillation (PAF) in patients with heart failure (HF) due to systolic dysfunction.......The objective was to evaluate the prevalence of paroxysmal atrial fibrillation (PAF) in patients with heart failure (HF) due to systolic dysfunction....

  2. Left Atrial Linear Ablation of Paroxysmal Atrial Fibrillation Guided by Three-dimensional Electroanatomical System

    DEFF Research Database (Denmark)

    Zhang, Dai-Fu; Li, Ying; Qi, Wei-Gang;

    2005-01-01

    Objective To investigate the safety and efficacy of Left atrial linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system. Methods 29 patients with paroxysmal atrial fibrillation in this study. A nonfluoroscopic mapping system was used to generate a 3D...

  3. Treatment of paroxysmal supraventricular tachycardia with intravenous injection of adenosine triphosphate.

    OpenAIRE

    Saito, D.; Ueeda, M; Abe, Y.; Tani, H; Nakatsu, T.; Yoshida, H.; Haraoka, S; Nagashima, H

    1986-01-01

    Intravenous adenosine triphosphate rapidly terminated all 11 episodes of paroxysmal supraventricular tachycardia in 10 patients. Eight patients reported side effects but these resolved within 20 seconds and did not require treatment. Adenosine triphosphate is a suitable agent for the rapid termination of paroxysmal supraventricular tachycardia.

  4. HEREDITARY MYOKYMIA AND PAROXYSMAL ATAXIA LINKED TO CHROMOSOME-12 IS RESPONSIVE TO ACETAZOLAMIDE

    NARCIS (Netherlands)

    LUBBERS, WJ; BRUNT, ERP; SCHEFFER, H; LITT, M; STULP, R; BROWNE, DL; VANWEERDEN, TW

    1995-01-01

    A sixth family with autosomal dominantly inherited myokymia and paroxysmal ataxia is described. The syndrome in this family is linked to the recently discovered locus for inherited myokymia and paroxysmal ataxia on the human chromosome 12p, and a missense mutation is shown in the KCNA1 gene. The att

  5. Pregnancy in a patient with paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    Anju Singh

    2014-02-01

    Full Text Available The occurrence of Paroxysmal Nocturnal Hemoglobinuria (PNH during pregnancy is very rare. It can cause significant fetomaternal morbidity and mortality due to associated complement mediated hemolysis and/or thrombosis. We report a case of PNH in a pregnant lady who presented to our antenatal clinic at 10th weeks of gestation. Her pregnancy was managed with multiple blood transfusions and steroid administration. During 3rd weeks postpartum period she developed sepsis with acute renal failure and posterior reversible encephalopathy syndrome requiring prolonged hospitalization. She was subsequently discharged from hospital in satisfactory condition. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 285-287

  6. Paroxysmal Autonomic Instability with Dystonia after Pneumococcal Meningoencephalitis

    Directory of Open Access Journals (Sweden)

    Layal Safadieh

    2012-01-01

    Full Text Available Streptococcus pneumoniae is a common cause of bacterial meningitis, frequently resulting in severe neurological impairment. A seven-month-old child presenting with Streptococcus pneumoniae meningoencephalitis developed right basal ganglia and hypothalamic infarctions. Daily episodes of agitation, hypertension, tachycardia, diaphoresis, hyperthermia, and decerebrate posturing were observed. The diagnosis of paroxysmal autonomic instability with dystonia was established. The patient responded to clonidine, baclofen, and benzodiazepines. Although this entity has been reported in association with traumatic brain injury, and as a sequel to some nervous system infections, this is the first case, to our knowledge, associated with pneumococcal meningoencephalitis.

  7. EGC diagnosis of paroxysmal supraventricular tachycardias in patients without preexcitation.

    Science.gov (United States)

    González-Torrecilla, Esteban; Arenal, Angel; Atienza, Felipe; Datino, Tomás; Atea, Leonardo F; Calvo, David; Pachón, Marta; Miracle, Angel; Fernández-Avilés, Francisco

    2011-01-01

    This review is aimed at discussing the diagnostic value of the different electrocardiographic criteria so far described in the differential diagnosis of the major forms of paroxysmal supraventricular tachycardias (PSVTs). The predictive value of different combinations of these independent electrocardiographic (ECG) signs in distinguishing atrioventricular reentrant tachycardias (AVRTs) through a concealed accessory pathway (AP) versus atrioventricular nodal reentrant tachycardias (AVNRTs) are discussed in detail. In addition, the adjunctive diagnostic value of simple, bedside clinical variables and their combinations to the ECG interpretation in differentiating both tachycardia mechanisms is also reviewed.

  8. Prognostic parameters in benign astrocytomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1993-01-01

    To elucidate the prognosis of different types of benign astrocytomas and to ascertain whether patients with partially resected benign astrocytomas, or any subtype of these, would benefit from postoperative radiotherapy, we studied retrospectively material comprising 300 patients with benign...... astrocytomas treated in the period 1956 to 1991. The pilocytic type of astrocytoma was found to have an outstandingly good prognosis and should be regarded as a distinct nosological entity. For the non-pilocytic supratentorial astrocytomas, a multivariate regression analysis showed that age, tumour site...... time of patients with non-pilocytic supratentorial benign astrocytomas. The study emphasizes the necessity of a prospective combined multicenter analysis of the effect of radiation on benign astrocytomas....

  9. 'Real-world' management and outcomes of patients with paroxysmal vs. non-paroxysmal atrial fibrillation in Europe

    DEFF Research Database (Denmark)

    Boriani, Giuseppe; Laroche, Cecile; Diemberger, Igor;

    2016-01-01

    -morbidities, as well as lower CHADS2, CHA2DS2-VASc, and HAS-BLED scores. Patients with first-detected AF (29.9%) had characteristics similar to persistent AF patients (25.9%), but lower use of oral anticoagulants. Patients with permanent AF represented 17.4% of the cohort. At 1 year, the rate of stroke...... during follow-up. Independent predictors of death were age, chronic heart failure, chronic kidney disease, diabetes, restrictive cardiomyopathy, and physical activity. CONCLUSION: In this 'real-world' contemporary observational registry, patients with non-paroxysmal AF had a worse outcome, in terms of...

  10. Nihilism: a benign denial.

    Science.gov (United States)

    Skandalakis, John E; Mirilas, Petros

    2003-06-01

    Nihilism is the belief that all possible knowledge on a given topic has been amassed and codified. Ranging from benign denial to deliberate attempts at excommunication, nihilism is often encountered in the history of medicine. Eustachius, Columbus, and Sylvius strongly criticized Vesalius and defended the authority of Galen. Riolan fervently rejected Harvey's monumental work on the circulation of blood. Gross stated that no honest and sensible surgeon would ever sanction thyroidectomy. Sandstrom's discovery of the parathyroids was met with silence. Transplantation of parathyroids by Mandl was not appreciated when announced. Aristotle's dictum that the heart cannot withstand serious injury led to Paget's statement that cardiac surgery had reached the limits set by nature, which no new techniques could overcome. The first Billroth I operation was welcomed as, "Hopefully, also the last." Pancreatic surgery was opposed because the organ was of no clinical interest and was impossible for surgeons to reach. Pancreatic transplantation was rejected for many years, despite good results. When Blundell used blood transfusion for postpartum hemorrhage, critics averred that his next exploit would be radical removal of the spleen. Bassini stated that it could be risky to publish more about radical treatment of inguinal hernias. Carcinomas of the lower sigmoid and upper rectum were deemed untreatable because of their inaccessibility. Colostomy during pediatric surgery was rejected many times. Although it is difficult for the human mind to move from a familiar point of view, this propensity should not infect science, thereby impeding advancement.

  11. Dual chamber pacemaker in the treatment of paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Rađen Goran

    2005-01-01

    Full Text Available Background. Atrial fibrillation is the most frequent cardiac dysrhythmia. The aim of this study was to show the role and the efficacy of a dual chamber pacemaker with the algorithm of atrial dynamic overdrive, in the suppression of paroxysmal atrial fibrillation. Case report. A woman with a classical bradycardia-tachycardia syndrome, and frequent attacks of atrial fibrillation, underwent the implantation of a single chamber permanent pacemaker (VVI. Pacemaker successfully treated the episodes of symptomatic bradycardia, but the patient had frequent attacks of atrial fibrillation, despite the use of different antiarrhythmic drugs, which she did not tolerate well. The decision was made to reimplant a permanent dual chamber pacemaker with the algorithm of atrial dynamic overdrive. The pacemaker was programmed to the basic rate of 75/min, while rate at rest was 55/min. In addition, sotalol was administered. After three months, the patient became asymptomatic with only 4 short − term episodes of atrial fibrillation, and a high level of atrial pacing (99%. Conclusion. In selected patients with bradycardia−tachycardia syndrome, atrial-based pacing seemed to be very effective in reducing the incidence of paroxysmal atrial fibrillation.

  12. Understanding paroxysmal sympathetic hyperactivity after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Kimberly S Meyer

    2014-01-01

    Full Text Available Background: Paroxysmal sympathetic hyperactivity (PSH is a condition occurring in a small percentage of patients with severe traumatic brain injury (TBI. It is characterized by a constellation of symptoms associated with excessive adrenergic output, including tachycardia, hypertension, tachypnea, and diaphoresis. Diagnosis is one of exclusion and, therefore, is often delayed. Treatment is aimed at minimizing triggers and pharmacologic management of symptoms. Methods: A literature review using medline and cinahl was conducted to identify articles related to PSH. Search terms included paroxysmal sympathetic hyperactivity, autonomic storming, diencephalic seizures, and sympathetic storming. Reference lists of pertinent articles were also reviewed and these additional papers were included. Results: The literature indicates that the understanding of PSH following TBI is in its infancy. The majority of information is based on small case series. The review revealed treatments that may be useful in treating PSH. Conclusions: Nurses play a critical role in the identification of at-risk patients, symptom complexes, and in the education of family. Early detection and treatment is likely to decrease overall morbidity and facilitate recovery. Further research is needed to establish screening tools and treatment algorithms for PSH.

  13. Radiation treatment of benign diseases

    International Nuclear Information System (INIS)

    The report deals with an estimation of the volume of radiation treatment of benign diseases in Norway and gives a survey of the subjective opinion of patients regarding the result of the treatment. Reported subjective recovery after radiation treatment seems to be at the same level as recovery without treatment. For an indication of the objective effect of radiation treatment of benign diseases, the subjective effect of this treatment has to be compared with objective findings

  14. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Walfridsson, H; Walfridsson, U; Nielsen, J Cosedis;

    2015-01-01

    on an intention-to-treat basis. Both randomization groups showed significant improvements in assessments with both SF-36 and EQ-5D, at 24 months. Patients randomized to RFA showed significantly greater improvement in four physically related scales of the SF-36. The three most frequently reported symptoms were......AIMS: The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial assessed the long-term efficacy of an initial strategy of radiofrequency ablation (RFA) vs. antiarrhythmic drug therapy (AAD) as first-line treatment for patients with PAF...... breathlessness during activity, pronounced tiredness, and worry/anxiety. In both groups, there was a significant reduction in ASTA symptom index and in the severity of seven of the eight symptoms over time. CONCLUSION: Both AAD and RFA as first-line treatment resulted in substantial improvement of HRQo...

  15. Paroxysmal vascular events in Sturge– Weber syndrome: Role of aspirin

    Directory of Open Access Journals (Sweden)

    Jyoti Sanghvi

    2014-01-01

    Full Text Available Sturge-Weber syndrome (SWS is a rare, sporadically occurring neurocutaneous disorder with a frequency of approximately 1 per 50,000. The hallmark is an intracranial leptomeningeal vascular angioma in association with a port wine nevus, usually involving ophthalmic or maxillary distribution of trigeminal nerve. Other clinical findings associated with SWS are seizures, glaucoma, hemiparesis and mental retardation. The radiological hallmark is "Tram-line" or "Gyri-form" calcification. 25 to 56% of patients experience recurrent episodes of paroxysmal focal neurological deficits in form of transient hemiparesis, which may be due to vascular ischemia or postictal in origin. EEG helps to differentiate the exact etiology, as it is normal in former. Aspirin prophylaxis in those, due to ischemia decreases their recurrences and improves overall neurological prognosis. We report a 25-month-old child of SWS with recurrent episodes of transient hemiparesis and atypical midline location of facial vascular nevus.

  16. [Paroxysmal supraventricular tachycardia-mechanisms, diagnostic, and treatment].

    Science.gov (United States)

    Tanner, Hildegard

    2014-02-01

    Paroxysmal supraventricular tachycardia have their origin above the His bundle. However, this definition has a historical origin and is imprecise regarding AV-reentry tachycardia using an accessory pathways since this tachycardia use the ventricule a part of the reentry-circuit. The most common supraventricular tachycardia is the atrioventricular nodal re-entry tachycardia, which is caused by a re-entrant tachycardia that involves the AV node and the atrial tissue followed by the atrioventricular re-entry tachycardia using an accessory pathway. More prevalent are sinus tachycardia, which is often physiologic and atrial fibrillation/flutter which are covered in detail by other articles within this issue of Therapeutischen Umschau. Therefore, the main topic of this review is the discussion of the mechanisms, diagnosis and treatment of AV nodal reentry tachycardia, AV reentry tachycardia using an accessory pathway and to a less extent focal atrial tachycardia.

  17. Paroxysmal atrial fibrillation occurs often in cryptogenic ischaemic stroke

    DEFF Research Database (Denmark)

    Christensen, L M; Krieger, D W; Højberg, S;

    2014-01-01

    BACKGROUND AND PURPOSE: Atrial fibrillation (AF) increases the risk of stroke fourfold and is associated with a poor clinical outcome. Despite work-up in compliance with guidelines, up to one-third of patients have cryptogenic stroke (CS). The prevalence of asymptomatic paroxysmal atrial...... patients (16.1%). In three patients PAF was detected by other methods before or after monitoring and was undiscovered due to device sensitivity in one case. The first event of PAF was documented at a mean of 109 days (SD ±48) after stroke onset. PAF was asymptomatic in all cases and occurred in episodes...... lasting predominantly between 1 and 4 h. Four recurrent strokes were observed, three in patients with PAF; all three patients were on oral anticoagulation (OAC). CONCLUSIONS: One in five patients with CS had PAF, which occurred at low burden and long after stroke. Future studies should determine the role...

  18. Radical pancreaticoduodenectomy for benign disease.

    LENUS (Irish Health Repository)

    Kavanagh, D O

    2008-01-01

    Whipple\\'s procedure is the treatment of choice for pancreatic and periampullary malignancies. Preoperative histological confirmation of malignancy is frequently unavailable and some patients will subsequently be found to have benign disease. Here, we review our experience with Whipple\\'s procedure for patients ultimately proven to have benign disease. The medical records of all patients who underwent Whipple\\'s procedure during a 15-year period (1987-2002) were reviewed; 112 patients underwent the procedure for suspected malignancy. In eight cases, the final histology was benign (7.1%). One additional patient was known to have benign disease at resection. The mean age was 50 years (range: 30-75). The major presenting features included jaundice (five), pain (two), gastric outlet obstruction (one), and recurrent gastrointestinal haemorrhage (one). Investigations included ultrasound (eight), computerised tomography (eight), endoscopic retrograde cholangiopancreatography (seven; of these, four patients had a stent inserted and three patients had sampling for cytology), and endoscopic ultrasound (two). The pathological diagnosis included benign biliary stricture (two), chronic pancreatitis (two), choledochal cyst (one), inflammatory pseudotumour (one), cystic duodenal wall dysplasia (one), duodenal angiodysplasia (one), and granular cell neoplasm (one). There was no operative mortality. Morbidity included intra-abdominal collection (one), anastomotic leak (one), liver abscess (one), and myocardial infarction (one). All patients remain alive and well at mean follow-up of 41 months. Despite recent advances in diagnostic imaging, 8% of the patients undergoing Whipple\\'s procedure had benign disease. A range of unusual pathological entities can mimic malignancy. Accurate preoperative histological diagnosis may have allowed a less radical operation to be performed. Endoscopic ultrasound-guided fine needle aspirate (EUS-FNA) may reduce the need for Whipple\\'s operation

  19. Radical Pancreaticoduodenectomy for Benign Disease

    Directory of Open Access Journals (Sweden)

    D. O. Kavanagh

    2008-01-01

    Full Text Available Whipple's procedure is the treatment of choice for pancreatic and periampullary malignancies. Preoperative histological confirmation of malignancy is frequently unavailable and some patients will subsequently be found to have benign disease. Here, we review our experience with Whipple's procedure for patients ultimately proven to have benign disease. The medical records of all patients who underwent Whipple's procedure during a 15-year period (1987–2002 were reviewed; 112 patients underwent the procedure for suspected malignancy. In eight cases, the final histology was benign (7.1%. One additional patient was known to have benign disease at resection. The mean age was 50 years (range: 30–75. The major presenting features included jaundice (five, pain (two, gastric outlet obstruction (one, and recurrent gastrointestinal haemorrhage (one. Investigations included ultrasound (eight, computerised tomography (eight, endoscopic retrograde cholangiopancreatography (seven; of these, four patients had a stent inserted and three patients had sampling for cytology, and endoscopic ultrasound (two. The pathological diagnosis included benign biliary stricture (two, chronic pancreatitis (two, choledochal cyst (one, inflammatory pseudotumour (one, cystic duodenal wall dysplasia (one, duodenal angiodysplasia (one, and granular cell neoplasm (one. There was no operative mortality. Morbidity included intra-abdominal collection (one, anastomotic leak (one, liver abscess (one, and myocardial infarction (one. All patients remain alive and well at mean follow-up of 41 months. Despite recent advances in diagnostic imaging, 8% of the patients undergoing Whipple'’s procedure had benign disease. A range of unusual pathological entities can mimic malignancy. Accurate preoperative histological diagnosis may have allowed a less radical operation to be performed. Endoscopic ultrasound–guided fine needle aspirate (EUS-FNA may reduce the need for Whipple's operation in

  20. Benign fibrous histiocytoma of the lumbar vertebrae

    Energy Technology Data Exchange (ETDEWEB)

    Demiralp, Bahtiyar; Oguz, Erbil; Sehirlioglu, Ali [Gulhane Military Medical Academy, Department of Orthopedics and Traumatology, Ankara (Turkey); Kose, Ozkan [Diyarbakir Education and Research Hospital, Department of Orthopedics and Traumatology, Diyarbakir (Turkey); Ataslar Serhat Evleri, Diclekent Bulvari, Diyarbakir (Turkey); Sanal, Tuba [Gulhane Military Medical Academy, Department of Radiology, Ankara (Turkey); Ozcan, Ayhan [Gulhane Military Medical Academy, Department of Pathology, Ankara (Turkey)

    2009-02-15

    Benign fibrous histiocytoma is an extremely rare spinal tumor with ten reported cases in the literature. Benign fibrous histiocytoma constitutes a diagnostic challenge because it shares common clinical symptoms, radiological characteristics, and histological features with other benign lesions involving the spine. We present a case of benign fibrous histiocytoma of the lumbar spine and discuss its differential diagnosis and management. (orig.)

  1. Benign mixed tumor of the lacrimal sac

    Directory of Open Access Journals (Sweden)

    Jong-Suk Lee

    2015-01-01

    Full Text Available Neoplasms of the lacrimal drainage system are uncommon, but potentially life-threatening and are often difficult to diagnose. Among primary lacrimal sac tumors, benign mixed tumors are extremely rare. Histologically, benign mixed tumors have been classified as a type of benign epithelial tumor. Here we report a case of benign mixed tumor of the lacrimal sac.

  2. Circulating Glutamate and Taurine Levels Are Associated with the Generation of Reactive Oxygen Species in Paroxysmal Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Shintaro Takano

    2016-01-01

    Full Text Available Atrial fibrillation (AF is the most common cardiac arrhythmia, but its proarrhythmic mechanism remains to be elucidated. Glutamate (Glu and taurine (Tau are present in the myocardium at substantially higher concentrations than in the plasma, suggesting their active role in myocardium. Here, we tested the hypothesis that the metabolism of Glu and Tau is altered in association with the generation of reactive oxygen species (ROS in patients with AF. Fifty patients with paroxysmal AF and 50 control subjects without a history of AF were consecutively enrolled. Circulating Glu and Tau levels were measured and correlations between Glu/Tau and ROS levels were examined. Glu/Tau content was significantly higher in patients with AF versus controls (Glu: 79.2±23.9 versus 60.5±25.2 nmol/L; Tau: 78.8±19.8 versus 68.5±20.8 nmol/L; mean ± standard deviation (SD, p<0.001 for both. Glu/Tau levels also showed an independent association with AF by multiple logistic regression analysis. Glu and Tau levels both showed significant positive associations with plasma hydroperoxide concentrations. These data suggest a novel pathophysiological role of Glu and Tau in association with ROS production in paroxysmal AF, providing new insights into the elevated amino acid content in cardiac disease.

  3. Impaired autonomic function predicts dizziness at onset of paroxysmal atrial fibrillation

    NARCIS (Netherlands)

    van den Berg, MP; Hassink, RJ; Tuinenburg, AE; Lefrandt, JD; de Kam, PJ; Crijns, HJGM

    2001-01-01

    Background: Paroxysmal atrial fibrillation is associated with various symptoms, including dizziness, which presumably reflects hemodynamic deterioration. Given the importance of the autonomic nervous system in mitigating the hemodynamic effect of atrial fibrillation, we hypothesized that autonomic f

  4. [Rare case of a pregnancy in a woman with paroxysmal nocturnal hemoglobinuria. Case report].

    Science.gov (United States)

    Horányi, Dániel; Várkonyi, Andrea; Nagy, Gyula Richárd; Bodó, Imre; Masszi, Tamás

    2016-06-01

    Paroxysmal nocturnal hemoglobinuria is a rare hematological disease. It is associated with increased maternal and fetal complications to such an extent that pregnancy has been considered relatively contraindicated in woman with paroxysmal nocturnal haemoglobinuria. Recently, eculizumab, a monoclonal antibody, has been shown to decrease complications during pregnancies. The highest risk is thromboembolic complication and, therefore, anticoagulant is a standard therapy during pregnancy. In the presented case, a 29-year-old woman with a 5-year history of paroxysmal nocturnal haemoglobinuria had a pregnancy. It was her first pregnancy and was complicated by a sinus thrombosis at the 11th gestational week. After the introduction of eculizumab treatment, the remaining period of pregnancy and delivery were uncomplicated. There are only a few cases in the literature about pregnancy in woman with paroxysmal nocturnal hemoglobinuria who are treated with eculizumab. This monoclonal antibody seems to be safe and it likely prevents many of the complications otherwise observed.

  5. Predictors and prognosis of paroxysmal atrial fibrillation in general practice in the UK

    Directory of Open Access Journals (Sweden)

    Wallander Mari-Ann

    2005-07-01

    Full Text Available Abstract Background Natural history of paroxysmal atrial fibrillation (AF is not very well documented. Clinical experience suggests that paroxysmal AF could progress to chronic AF with estimates ranging between 15 and 30% over a period of 1–3 years. We performed an epidemiologic study to elucidate the natural history of paroxysmal AF, this study estimated its incidence in a general practice setting, identified associated factors and analyzed the progression into chronic AF as well as the mortality rate. Methods Using the UK General Practice Research Database (GPRD, we identified patients aged 40–89 years with a first-recorded episode of paroxysmal AF during 1996. Risk factors were assessed using 525 incident paroxysmal AF cases confirmed by the general practitioner (GP and a random sample of controls. We follow-up paroxysmal AF patients and estimated their mortality rate and progression to chronic AF. Results The incidence of paroxysmal AF was 1.0 per 1,000 person-years. Major risk factors for paroxysmal AF were age and prior valvular heart disease, ischaemic heart disease, heart failure and hyperthyroidism. During a mean follow-up of 2.7 years, 70 of 418 paroxysmal AF patients with complete information progressed to chronic AF. Risk factors associated with progression were valvular heart disease (OR 2.7, 95% CI 1.2–6.0 and moderate to high alcohol consumption (OR 3.0, 95% CI 1.1–8.0. Paroxysmal AF patients did not carry an increased risk of mortality, compared to an age and sex matched sample of the general population. There was a suggestion of a small increased risk among patients progressing to chronic AF (RR 1.5, 96% CI 0.8–2.9. Conclusion Paroxysmal AF is a common arrhythmia in the general practice setting, increasing with age and commonly associated with other heart diseases. It sometimes is the initial presentation and then progress to chronic AF. A history of valvular heart disease and alcohol consumption are associated with

  6. Emergency cesarean delivery in a parturient who had an intractable paroxysmal supraventricular tachycardia -A case report-

    OpenAIRE

    Kim, Kyoung Ok; Chang, Eun-jung; Han, Jin; Cho, Hun

    2012-01-01

    Paroxysmal supraventricular tachycardia (SVT) is a common arrhythmia in the parturient and can occur with or without an underlying organic heart disease. A woman of 35 weeks' gestation, who had a paroxysmal SVT that was resistant to antiarrhythmic drugs and electric cardioversion, required emergency Cesarean delivery. The Cesarean delivery was performed under spinal anesthesia and a healthy baby was delivered uneventfully. SVT spontaneously converted to normal sinus rhythm right after deliver...

  7. Environmentally Benign Stab Detonators

    Energy Technology Data Exchange (ETDEWEB)

    Gash, A E

    2006-07-07

    The coupling of energetic metallic multilayers (a.k.a. flash metal) with energetic sol-gel synthesis and processing is an entirely new approach to forming energetic devices for several DoD and DOE needs. They are also practical and commercially viable manufacturing techniques. Improved occupational safety and health, performance, reliability, reproducibility, and environmentally acceptable processing can be achieved using these methodologies and materials. The development and fielding of this technology will enhance mission readiness and reduce the costs, environmental risks and the necessity of resolving environmental concerns related to maintaining military readiness while simultaneously enhancing safety and health. Without sacrificing current performance, we will formulate new impact initiated device (IID) compositions to replace materials from the current composition that pose significant environmental, health, and safety problems associated with functions such as synthesis, material receipt, storage, handling, processing into the composition, reaction products from testing, and safe disposal. To do this, we will advance the use of nanocomposite preparation via the use of multilayer flash metal and sol-gel technologies and apply it to new small IIDs. This work will also serve to demonstrate that these technologies and resultant materials are relevant and practical to a variety of energetic needs of DoD and DOE. The goal will be to produce an IID whose composition is acceptable by OSHA, EPA, the Clean Air Act, Clean Water Act, Resource Recovery Act, etc. standards, without sacrificing current performance. The development of environmentally benign stab detonators and igniters will result in the removal of hazardous and toxic components associated with their manufacturing, handling, and use. This will lead to improved worker safety during manufacturing as well as reduced exposure of Service personnel during their storage and or use in operations. The

  8. Surgery for Benign Salivary Neoplasms.

    Science.gov (United States)

    Gillespie, M Boyd; Iro, Heinrich

    2016-01-01

    Salivary neoplasms are relatively infrequent entities that account for only 4% of tumors of the head and neck. Although slow-growing lesions of the preauricular area and submandibular space are often confused with sebaceous cysts, lymph nodes, or lipomas by the non-otolaryngologist, otolaryngologists-head and neck surgeons recognize that all preauricular and submandibular masses should be considered a salivary neoplasm until proven otherwise. Surgery remains the treatment of choice for benign salivary gland neoplasms; however, techniques continue to evolve in order to preserve salivary function and reduce surgical morbidity. The goals of management of benign salivary neoplasms include accurate diagnosis of the lesion, complete surgical extirpation, and functional preservation of adjacent cranial nerves. Accurate diagnosis is aided by appropriate preoperative physical examination, imaging, and fine needle aspiration biopsy. Benign neoplasms typically present as slow-growing, painless, mobile masses without adverse features, such as tissue fixation, ulceration, a cranial nerve deficit, or regional lymphadenopathy. Preoperative imaging with ultrasonography, computed tomography, or magnetic resonance imaging reveals well-circumscribed lesions without an infiltrative growth pattern or associated adenopathy. Fine needle aspiration biopsy may favor a benign neoplasm, supporting the clinical presentation. Surgery for a benign or malignant salivary neoplasm is in essence a false dichotomy since the surgeon can never be completely confident of the diagnosis until the specimen is removed. The surgeon must recognize the significant overlap between benign and malignant salivary masses in terms of clinical presentation, imaging, and cytology, which requires the surgeon to remain vigilant and flexible at the time of surgery should tissue characteristics or frozen section analysis suggest a malignant process.

  9. Doppler radar retrievals from lava fountaining paroxysms generating tephra plumes at Mt. Etna

    Science.gov (United States)

    Valentin, Freret-Lorgeril; Franck, Donnadieu; Mauro, Coltelli; Simona, Scollo; Patrick, Fréville; Claude, Hervier; Michele, Prestifilippo

    2016-04-01

    Etna volcano is one of the most active European volcanoes. Between January 2011 and December 2013, a new crater called the New South East Crater (NSEC) was built during 46 eruptive episodes characterized by lava fountaining generating tephra plumes that reached up to 10 km (a.s.l). A 23 cm-wavelength Doppler radar (VOLDORAD 2B), located about 3 km from NSEC at the Montagnola station and integrated into the INGV-OE instrumental network, has been continuously monitoring the explosive activity of Mt. Etna's summit craters since 2009. We have studied these paroxysms by analyzing the radar echoes and Doppler signals coming from adjacent volumes of the fixed beam probing the lava fountains close to the eruptive crater, in combination with thermal and visible imagery. The range gating (150 m-deep probed volumes along-beam) allows us to discriminate the active summit craters and to roughly estimate the lava fountain width. The backscattered power, which is related to the erupted tephra mass load in the beam, and Doppler velocities help to mark the transition from Strombolian activity to lava fountaining, providing onset and end times of the fountain. Both radar parameters directly provide a proxy for the mass eruption rate, which is found to follow the time variations of tephra plume height. Oscillations of the echo power during lava fountaining indicate a pulsatile behavior likely originating in the magmatic conduit or deeper reservoir. Ejection velocities retrieved from positive along-beam velocities measured near the emission source, are found to range from 140 to almost 350 m/s during the climax. Maximum along-beam Doppler velocity components from fallouts allow us to infer maximum particle sizes (pluri-decimetric) in agreement with field observations. The mode of power spectral distribution could further be used to constrain the mean diameter of proximal fallout. A reliable quantification of the source mass loading parameters requires more stringent constraints on the

  10. CHRONIC HEPATITIS OR «DISGUISE» PAROXYSMAL NOCTURAL HEMOGLOBINURIA?

    Directory of Open Access Journals (Sweden)

    D. A. Dolgopolova

    2015-01-01

    Full Text Available Objective is description of a case of diagnostics of a paroxysmal nocturnal haemoglobinuria. Subjects and methods. The male patient of 50 years asked for medical care with complaints to emergence of yellowness a skin, urine darkening, not expressed general weakness. To the patient examination was conducted: clinical and biochemical blood tests, urine, miyelogramm, definition of an index of sphericity of erythrocytes, definition of free hemoglobin of plasma of blood, urine, gemosiderinuriya, flow citometry, immunological markers of rheumatic diseases, tool inspection, etc. Results. On the basis of complaints, a clinical picture of a disease, data of objective and tool inspections the final diagnosis is made: a paroxysmal nocturnal haemoglobinuria, a classical haemolytic form (on the International classification of diseases of the 10th revision – B 59.5. The comorbid diagnoses: anemia of heavy degree; transfusion dependence; thrombosis of a subclavial vein on the right (11.2011; cholelithiasis; chronic calculous cholecystitis in remission; chronic hepatitis of the mixed genesis (alcoholic, metabolic, moderate degree of activity. By the main diagnostic method which allowed to verify the diagnosis became flow citometry. According to an flow citometry erythrocytes I Tip (normal expression of CD59 – 87,0 %, II Type (partial deficiency of CD59 – 0,3 %, III Type (full deficiency of CD59 – 12,7 %; monocytes with deficiency of FLAER/CD14 – 93,3 %; granulocytes with deficiency of FLAER/CD24 – 97,7 %. Flow citometry was revealed by availability of APG-clone among erythrocytes, granulocytes and monocytes. Judging by the huge size of a clone (on granulocytes 97,7 %, it is possible to draw a conclusion that the patient was in the highest zone of risk of APG of crises. Conclusion. Practical interest of this supervision is caused by a rarity of this hematologic disease, the analysis of modern opportunities of diagnostics and complexity of a choice of

  11. Benign chondroblastoma (a case report)

    OpenAIRE

    Gulman, Birol; Ciray, Mevlut

    2004-01-01

    Chondroblastoma is a rare benign primary bone neoplasm. The clinical symptoms are generally including adjacent joint because of the lesion arises in the epiphysis of long bones. In this report; a case of chondroblastoma is discussed which was considered to be "Tear of Medial Meniscus" clinically.

  12. Benign concentric annular macular dystrophy

    Directory of Open Access Journals (Sweden)

    Luísa Salles de Moura Mendonça

    2015-06-01

    Full Text Available The purpose of the authors is to show clinical findings of a patient with benign concentric annular macular dystrophy, which is an unusual condition, and part of the "bull’s eye" maculopathy differential diagnosis. An ophthalmologic examination with color perception, fluorescein angiography, and ocular electrophysiology was performed.

  13. Familial benign pemphigus atypical localization

    OpenAIRE

    Reyes, Maria Veronica; Halac, Sabina; Mainardi, Claudio; Kurpis, Maria; Ruiz Lascano, Alejandro

    2016-01-01

    We present an atypical case of familial benign pemphigus (Hailey-Hailey disease), which presented as crusted, annular plaques limited to the back without intertriginous involvement. We could not find in the literature another patient with plaques located solely on the back without a prior history of classical disease.

  14. Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Yan Liu

    2013-01-01

    Full Text Available Paroxysmal sympathetic storming (PSS is a rare disorder characterized by acute onset of nonstimulated tachycardia, hypertension, tachypnea, hyperthermia, external posturing, and diaphoresis. It is most frequently associated with severe traumatic brain injuries and has been reported in intracranial tumors, hydrocephalous, severe hypoxic brain injury, and intracerebral hemorrhage. Although excessive release of catecholamine and therefore increased sympathetic activities have been reported in subarachnoid hemorrhage (SAH, there is no descriptive report of PSS primarily caused by spontaneous SAH up to date. Here, we report a case of prolonged PSS in a patient with spontaneous subarachnoid hemorrhage and consequent vasospasm. The sympathetic storming started shortly after patient was rewarmed from hypothermia protocol and symptoms responded to Labetalol, but intermittent recurrence did not resolve until 3 weeks later with treatment involving Midazolam, Fentanyl, Dexmedetomidine, Propofol, Bromocriptine, and minimizing frequency of neurological and vital checks. In conclusion, prolonged sympathetic storming can also be caused by spontaneous SAH. In this case, vasospasm might be a precipitating factor. Paralytics and hypothermia could mask the manifestations of PSS. The treatment of the refractory case will need both timely adjustment of medications and minimization of exogenous stressors or stimuli.

  15. Neurofeedback therapy in patients with non pain syndromes of chronic and paroxysmal character-literature review and own experience.

    Science.gov (United States)

    Kubik, Alicja; Kaciński, Marek

    2013-01-01

    Neurofeedback has been used in treatment of many other than pain clinical syndromes. This group includes chronic as well as paroxysmal syndromes previously treated pharmacologically. However due to non satisfactory results of this treatment introduction of non-pharmacological therapy has been examined. Observations from our 9-year experience of neurofeedback therapy used in children and adult patients with epilepsy, Asperger syndrome, depression, neurosis, personality disorders, drug addiction and other (not pain) syndromes have been presented in this paper. Positive influence of neurofeedback therapy on symptoms intensity, frequency, duration and social relations of treated patients has been confirmed by our own and other authors observations. Neurofeedback therapy has been tried by patients with other difficult life problems and has been effective in some of them. The effectiveness of the therapy has been confirmed by patients, their relatives and also by neurophysiological results. Additionally, preliminary results of neurofeedback therapy used in management of computer addiction in children and adolescents have been presented herein.

  16. Chronic paroxysmal hemicrania and hemicrania continua: lack of efficacy of sumatriptan.

    Science.gov (United States)

    Antonaci, F; Pareja, J A; Caminero, A B; Sjaastad, O

    1998-03-01

    Attacks of chronic paroxysmal hemicrania are prevented by the continuous administration of indomethacin. Sumatriptan, an agonist of 5-HT1-like receptors, has proven effective in the treatment of cluster headache attacks. There are clear clinical similarities between chronic paroxysmal hemicrania and cluster headache. A natural consequence of these considerations would be to establish whether chronic paroxysmal hemicrania also responds similarly to sumatriptan. Since hemicrania continua is another unilateral headache responsive to indomethacin, it would be meaningful to also include hemicrania continua in such a study. Sumatriptan, 6 mg subcutaneous, was tried in an open fashion in 7 patients (6 women and 1 man) with chronic paroxysmal hemicrania and 7 patients (5 women and 2 men) with hemicrania continua. In chronic paroxysmal hemicrania, the mean interval between the last three attacks prior to sumatriptan treatment (40 +/- 23 minutes) was not statistically different from the mean interval between the three attacks subsequent to sumatriptan treatment of an attack (32 +/- 20 minutes). In none of the patients did the mean duration of the "test attack" decrease as compared to the attacks antedating the test attack (25 +/- 11 minutes and 19 +/- 9 minutes, respectively) (P = 0.027, Wilcoxon). In 2 patients with chronic paroxysmal hemicrania, placebo (saline) administration did not lead to any change in the interval between attacks. There was a mild, but statistically significant reduction in visual analog scale values for headache intensity in hemicrania continua (P = 0.04, Wilcoxon). There was no clear, i.e., clinically meaningful, reduction in visual analog scale values in any particular patient with hemicrania continua. Taken together, these results seem to show that sumatriptan is of no benefit in chronic paroxysmal hemicrania, but may have a partial efficacy in hemicrania continua. However, the latter effect is clinically unimportant. This minor difference in

  17. Novel PRRT2 mutation in an African-American family with paroxysmal kinesigenic dyskinesia

    Directory of Open Access Journals (Sweden)

    Hedera Peter

    2012-09-01

    Full Text Available Abstract Background Recently, heterozygous mutations in PRRT2 (Chr 16p11.2 have been identified in Han Chinese, Japanese and Caucasians with paroxysmal kinesigenic dyskinesia. In previous work, a paroxysmal kinesigenic dyskinesia locus was mapped to Chr 16p11.2 - q11.2 in a multiplex African-American family. Methods Sanger sequencing was used to analyze all four PRRT2 exons for sequence variants in 13 probands (9 Caucasian, 1 Caucasian-Thai, 1 Vietnamese and 2 African-American with some form of paroxysmal dyskinesia. Results One patient of mixed Caucasian-Thai background and one African-American family harbored the previously described hotspot mutation in PRRT2 (c.649dupC, p.R217Pfs*8. Another African-American family was found to have a novel mutation (c.776dupG, p.E260*. Both of these variants are likely to cause loss-of-function via nonsense-mediated decay of mutant PRRT2 transcripts. All affected individuals had classic paroxysmal kinesigenic dyskinesia phenotypes. Conclusions Heterozygous PRRT2 gene mutations also cause paroxysmal kinesigenic dyskinesia in African-Americans. The c.649dupC hotspot mutation in PRRT2 is common across racial groups.

  18. Multiple chronic benign pulmonary nodules.

    Science.gov (United States)

    Kalifa, L G; Schimmel, D H; Gamsu, G

    1976-11-01

    Four cases are discussed in which were found unusual multiple chronic pulmonary nodules: leiomyomatous hamartomas, rheumatoid nodules, multiple histoplasmomas, and possible multiple plasma cell granulomas (hyalinizing pulmonary nodules). In each case the initial impression of metastic malignancy was countered by more than 2 years' observation, during which time the lesions appeared to be benign. Histologic examination is necessary to exclude malignancy, although a definitive diagnosis may be difficult to establish. PMID:981596

  19. Benign chondroblastoma - malignant radiological appearances

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, K.; Treugut, H.; Mueller, G.E.

    1980-04-01

    The very rare benign chondroblastoma occasionally invades soft tissues and may grow beyond the epiphysis into the metaphysis. In the present case such a tumour did not show the typical radiological appearances, but presented malignant features both on plain films and on the angiogram. The importance of biopsy of tumours which cannot be identified with certainty must be stressed before radical surgery is carried out.

  20. Benign Pediatric Salivary Gland Lesions.

    Science.gov (United States)

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions.

  1. BENIGN PROSTATIC HYPERPLASIA: UPDATED REVIEW

    OpenAIRE

    Praveen.R

    2013-01-01

    Benign Prostatic Hyperplasia (BPH) is one of the commonest medical conditions affecting the geriatric male population. The enlargement of prostate can lead to various clinical symptoms like difficulty in voiding, urinary retention etc. The symptoms are varied depending on the size of enlargement. The International Prostatic Symptom Score (IPSS) is the gold standard and first step in understanding and diagnosing the disease clinically, but in the recent past there are various other newer tools...

  2. Indeterminate cell histiocytosis that presented clinically as benign cephalic histiocytosis.

    Science.gov (United States)

    Haimovic, Adele; Chernoff, Karen; Hale, Christopher S; Meehan, Shane A; Schaffer, Julie V

    2014-12-16

    Indeterminate cell histiocytosis (ICH) is a rare, heterogeneous disorder that is characterized by immunophenotypic features of both Langerhans cell histiocytosis (LCH) and non-LCH. We describe a 12-month-old boy with a four-month history of asymptomatic, small, pink-tan papules on his face. Histopathologic evaluation showed a superficial, dermal infiltrate of histiocytes that was positive for S100, CD1a, CD68, and Factor XIIIa. To our knowledge, this represents the first report of the clinical presentation of benign cephalic histiocytosis with immunohistochemical findings of ICH. We review the classification of histiocytic disorders and the clinical and immunohistochemical features of both ICH and benign cephalic histiocytosis.

  3. Benign tumours of the vulva

    International Nuclear Information System (INIS)

    Objective: To present clinicopathological analysis of benign tumours of the vulva. Patients and Methods: Thirty cases of benign tumours of vulva were studied during 2 years research period. Detailed history along with complete local and general physical examination followed by all necessary pre-operative investigations were carried out. Excision surgery was the treatment of choice in majority of cases while marsupialization was done for Bartholin's cyst. Histopathology of tumours specimen was also collected. Results: A total of 30 cases were studied. Twenty-two were cystic and 8 were solid tumours. Aggressive angiomyxoma was 10% of solid tumours and Bartholin's cyst was 46.6% of cystic tumours. Most of the patients were multipara and between 21-30 years of age. The main site of tumour was labium majus. Excision surgery for all cases and marsupialization for Bartholin's cyst was treatment of choice. Conclusion: Aggressive angiomyxoma is the commonest solid benign vulval tumour. It should be considered in the differential diagnosis of vulval mass in women of reproductive age. (author)

  4. Histiocytic sarcoma that mimics benign histiocytosis.

    Science.gov (United States)

    Boisseau-Garsaud, A M; Vergier, B; Beylot-Barry, M; Nastasel-Menini, F; Dubus, P; de Mascarel, A; Eghbali, H; Beylot, C

    1996-06-01

    A 28-year-old man presented with a histiocytic sarcoma of a very uncommon origin, as it had developed for several years like a benign cutaneous histiocytosis resembling generalized eruptive histiocytoma before becoming acute, with nodal and massive pulmonary involvement. Despite various chemotherapies, the patient died within 8 months. Skin biopsies showed histiocytic proliferation in the dermis and node biopsies showed histiocytic proliferation with a sinusoidal pattern. Immunohistochemical analysis, performed on paraffin-embedded sections, demonstrated strong labeling of tumoral cells for CD68 and moderate labeling for CD3 and CD4. CD30 labeling was negative. S-100 protein was positive on a Langerhans' cell reactive subpopulation. Electron microscopy confirmed the histiocytic nature of malignant cells and showed cytoplasmic inclusions such as regularly laminated bodies, dense bodies and pleomorphic inclusions. No Birbeck granules were seen. A gene rearrangement study of T-cell receptor gamma and immunoglobulin heavy chain genes showed a germline configuration. Histiocytic sarcoma is an extremely rare true histiocytic malignancy, the existence of which has been recently debated since it has often been mistaken in the past for large cell lymphomas. Such a deceptive onset as benign cutaneous histiocytosis has not been described in the literature to our knowledge. PMID:8793665

  5. Histiocytic sarcoma that mimics benign histiocytosis.

    Science.gov (United States)

    Boisseau-Garsaud, A M; Vergier, B; Beylot-Barry, M; Nastasel-Menini, F; Dubus, P; de Mascarel, A; Eghbali, H; Beylot, C

    1996-06-01

    A 28-year-old man presented with a histiocytic sarcoma of a very uncommon origin, as it had developed for several years like a benign cutaneous histiocytosis resembling generalized eruptive histiocytoma before becoming acute, with nodal and massive pulmonary involvement. Despite various chemotherapies, the patient died within 8 months. Skin biopsies showed histiocytic proliferation in the dermis and node biopsies showed histiocytic proliferation with a sinusoidal pattern. Immunohistochemical analysis, performed on paraffin-embedded sections, demonstrated strong labeling of tumoral cells for CD68 and moderate labeling for CD3 and CD4. CD30 labeling was negative. S-100 protein was positive on a Langerhans' cell reactive subpopulation. Electron microscopy confirmed the histiocytic nature of malignant cells and showed cytoplasmic inclusions such as regularly laminated bodies, dense bodies and pleomorphic inclusions. No Birbeck granules were seen. A gene rearrangement study of T-cell receptor gamma and immunoglobulin heavy chain genes showed a germline configuration. Histiocytic sarcoma is an extremely rare true histiocytic malignancy, the existence of which has been recently debated since it has often been mistaken in the past for large cell lymphomas. Such a deceptive onset as benign cutaneous histiocytosis has not been described in the literature to our knowledge.

  6. Quality of life in patients with paroxysmal atrial fibrillation and its predictors : importance of the autonomic nervous system

    NARCIS (Netherlands)

    van den Berg, MP; Hassink, RJ; Tuinenburg, AE; van Sonderen, EFLP; Lefrandt, JD; de Kam, PJ; van Gelder, IC; Smit, AJ; Sanderman, R; Crijns, HJGM

    2001-01-01

    Aims To determine the impact of paroxysmal atrial fibrillation on quality of life and to determine the predictors of quality of life, particularly the role of symptomatology and autonomic function. Methods and Results The study group comprised 73 patients with paroxysmal atrial fibrillation (mean ag

  7. A three-pulmonary vein isolation approach to treat paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Lexin WANG; Jing ZHOU

    2004-01-01

    Objective To investigate the safety and efficacy of a 3-pulmonary vein (PV) isolation approach in treating paroxysmal atrial fibrillation (AF). Methods Radiofrequency catheter ablation was used to eliminate PV potential in 11 patterns with frequent paroxysmal AF refractory to anti-arrhythmic agents. During sinus rhythm, PV potential was mapped in the left and right superior PVs and left inferior PV. The procedural success was defined as the elimination of PV potential in the 3 PVs. Restults PV potential was identified and abolished in a total of 24 PVs, mostly in the left and right superior PV. There was no pulmonary stenosis or other complications during or after the procedures. AF recurred in one patient after an average of 12 ± 3 month follow-up. Conclusions PV potemials were present mostly in the left or right superior PV. The 3-PVs isolation approach is safe and effective in preventing drug-resistant paroxysmal AF.

  8. Pharmacologic Management of Paroxysmal Sympathetic Hyperactivity After Brain Injury.

    Science.gov (United States)

    Samuel, Sophie; Allison, Teresa A; Lee, Kiwon; Choi, Huimahn A

    2016-04-01

    Paroxysmal sympathetic hyperactivity (PSH) is a result of acute brain injury that has been well known for many decades. However, the evidence for management of PSH is almost entirely anecdotal in nature. We reviewed case reports or series of pharmacotherapy management of PSH. These studies mentioned treatment options, but few studies exist to guide treatment strategies. For many years, the syndrome was not clearly understood; therefore, the therapy has focused on control of symptoms. In 2014, a Steering Committee came together to develop a conceptual definition and produced a consensus set of diagnostic criteria. Although understanding the diagnostic criteria is very well needed in management of patients with PSH, pharmacologic management is also crucial. Data describing the drug choices, dosing, and duration of therapy are also sparse. Recognition of appropriate medications is important because PSH is associated with morbidity, longer hospitalization, delaying transfer to rehabilitation units, and increasing cost. In this review article, we discussed the common medications used in the treatment of PSH. Treatment should target symptom abortion, prevention of symptoms, and refractory treatment. Symptom-abortive medications are indicated to control discrete breakthrough episodes, using medications such as morphine and short-acting benzodiazepines. Other medications used for prevention of symptoms and refractory treatment include long-acting benzodiazepines, nonselective β-blockers, α2 agonists, opioids, and GABA agonists. The mechanisms by which these agents improve symptoms of PSH remain speculative. However, a combination of medications from different classes seems the most effective approach in managing PSH symptoms. There is wide variability in clinical practice with regard to drug choices, dosing, and duration of therapy. Future research needs to be conducted using the new PSH assessment measure to appropriately apply drug management. PMID:26954919

  9. Paroxysmal atrial fibrillation prediction method with shorter HRV sequences.

    Science.gov (United States)

    Boon, K H; Khalil-Hani, M; Malarvili, M B; Sia, C W

    2016-10-01

    This paper proposes a method that predicts the onset of paroxysmal atrial fibrillation (PAF), using heart rate variability (HRV) segments that are shorter than those applied in existing methods, while maintaining good prediction accuracy. PAF is a common cardiac arrhythmia that increases the health risk of a patient, and the development of an accurate predictor of the onset of PAF is clinical important because it increases the possibility to stabilize (electrically) and prevent the onset of atrial arrhythmias with different pacing techniques. We investigate the effect of HRV features extracted from different lengths of HRV segments prior to PAF onset with the proposed PAF prediction method. The pre-processing stage of the predictor includes QRS detection, HRV quantification and ectopic beat correction. Time-domain, frequency-domain, non-linear and bispectrum features are then extracted from the quantified HRV. In the feature selection, the HRV feature set and classifier parameters are optimized simultaneously using an optimization procedure based on genetic algorithm (GA). Both full feature set and statistically significant feature subset are optimized by GA respectively. For the statistically significant feature subset, Mann-Whitney U test is used to filter non-statistical significance features that cannot pass the statistical test at 20% significant level. The final stage of our predictor is the classifier that is based on support vector machine (SVM). A 10-fold cross-validation is applied in performance evaluation, and the proposed method achieves 79.3% prediction accuracy using 15-minutes HRV segment. This accuracy is comparable to that achieved by existing methods that use 30-minutes HRV segments, most of which achieves accuracy of around 80%. More importantly, our method significantly outperforms those that applied segments shorter than 30 minutes. PMID:27480743

  10. Somatosensory disinhibition in patients with paroxysmal kinesigenic dyskinesia

    Institute of Scientific and Technical Information of China (English)

    WEI Hua; SUN Ying; CHEN Hai; WANG De-quan; LI Li-ping; DING Yan; LIU Ai-hua; LU Chang-feng; WANG Yu-ping

    2012-01-01

    Background Paroxysmal kinesigenic dyskinesia (PKD) is characterized by recurrent brief episodes of chorea and dystonia induced by sudden movement.Whether the central nervous system is hyper- or hypoexcitable in PKD remains undetermined.The aim of our study was to compare the somatosensory evoked potential (SEP) recovery cycle,a marker of somatosensory system excitability,in PKD patients and controls.Methods Twenty-four PKD patients (mean age of (20.0±5.3) years; 21 males,3 females) and 18 control age-matched subjects (mean age of (22.0±5.0) years; 17 males,1 female) were studied.The stimuli were delivered to the median nerve in the affected dominant arm in patients and in the dominant arm in controls.The change in SEP amplitude was measured after paired electrical stimulation at interstimulus intervals (ISIs) of 5,20,and 40 ms.The SEPs evoked by S2 (test stimulus) were calculated by subtracting the response to S1 (the conditioning stimulus) from the response to a pair of stimuli (S1 + S2),and their amplitudes were compared with those of the control response (S1) at each ISI.Analysis of variance (ANOVA) or equivalent was used for non-parametric data.Results In patients,the P27 amplitude after the single stimulus (S1) was significantly larger than that after the control stimulus.The (S2/S1)x100 ratio for P14 and N30 SEPs did not differ significantly between PKD patients and normal subjects at ISI of 5 ms but were significantly higher in patients at ISIs of 20 and 40 ms (P<0.05).Conclusions Somatosensory system disinhibition takes place in PKD.The finding of reduced suppression of different SEPs,each thought to have a different origin,suggests an abnormality of intracortical and subcortical inhibitory circuits.

  11. Urine-derived induced pluripotent stem cells as a modeling tool for paroxysmal kinesigenic dyskinesia

    Directory of Open Access Journals (Sweden)

    Shu-Zhen Zhang

    2015-12-01

    Full Text Available Paroxysmal kinesigenic dyskinesia (PKD is a monogenic movement disorder with autosomal dominant inheritance. We previously identified the proline-rich transmembrane protein 2 (PRRT2 as a causative gene of PKD. However, the pathogenesis of PKD remains largely unknown so far. In addition, applicable modeling tools to investigate the underlying mechanisms of PKD are still lacking. The combination of disease-specific human induced pluripotent stem cells (iPSCs and directed cell differentiation offers an ideal platform for disease modeling. In this study, we generated two iPSC lines from the renal epithelial cells of one PKD patient with the hotspot c.649dupC mutation (PKD-iPSCs. These cell lines were positive for alkaline phosphatase Nanog, Tra-1-80, Tra-1-60, SSEA-3 and SSEA-4. Teratomas with three blastoderms including ectoderm, mesoderm, and endoderm were obtained two months after injection of PKD-iPSCs into NOD/SCID mice. The expression of PRRT2 mRNA was decreased in PKD-iPSCs compared with that of the control iPSCs. Furthermore, PKD-iPSCs possessed the differentiation potential of functional glutamatergic, dopaminergic and motor neurons in vitro. Electrophysiological examinations revealed that the current densities of fast activated and deactivated sodium channels as well as voltage gated potassium channels were not different between the neurons from PKD-iPSCs and control iPSCs. Thus, PKD-iPSCs are a feasible modeling tool to investigate the pathogenic mechanisms of PKD.

  12. Benign and malignant gastrointestinal stromal tumors: CT findings and pathology

    International Nuclear Information System (INIS)

    Objective: Through a study of CT findings and the corresponding pathology of gastrointestinal stromal tumors (GIST), to improve the differential diagnosis of benign and malignant GIST. Methods: CT was performed in 25 patients with GIST confirmed by pathohistology and the images were analyzed retrospectively. CT images were compared with the corresponding pathological results, in which the benign and the malignant CT features were concluded. Results In 6 cases of benign GIST, all lesions were oval-shaped and well-defined. 5 cases out of 6 were smaller than Scm in diameter. The CT value increased over 25HU during contrast-enhancement in 5 cases. And there was no central hemorrhage and necrosis or involvement of adjacent organs. In 12 cases of malignant GIST, all tumor's were oval-shaped or lobulated. 10 cases out of 12 were larger than 5 cm in diameter. CT value was elevated over 2$HU in 9 cases during contrast-enhancement. Central hemorrhage and necrosis were found in 7 cases. The involvement of adjacent organs or metastasis was revealed in 9 cases. 7 cases of low grade malignant GIST shared various CT findings with the malignant or benign GIST. The size, non-enhanced density, adjacent involvement, distal metastasis, central hemorrhage and necrosis between malignant tumor and benign tumor were statistically different (p<0.01), while no statistical difference was found in increased CT value during contrast-enhancement, positive rate of immuno-histochemistry, or cell type. Conclusion GIST is lack of clinical, pathological, and CT imaging characterizes, and final diagnosis should be made with immunohistochemistry. But CT reveals the details of GIST and involvement of adjacent organs, which plays an important role in differential diagnosis of benign or malignant GIST and post-operative follow-up. (authors)

  13. THE EFFECT OF CYCLOSPORINE ON HEMATOLOGICAL PARAMETERS IN PATIENTS WITH PAROXYSMAL-NOCTURNAL HEMOGLOBINURIA

    NARCIS (Netherlands)

    VANKAMP, H; VANIMHOFF, GW; DEWOLF, JTM; SMIT, JW; HALIE, MR; VELLENGA, E

    1995-01-01

    Four patients with paroxysmal nocturnal haemoglobinuria (PNH) were treated with cyclosporine. The treatment with cyclosporine was based on the hypothesis that immune-mediated bone-marrow damage is the common pathogenetic mechanism of aplasia and PNH, with lack of GPI-linked ligands for an immune att

  14. Benign Papules and Nodules of Oral Mucosa

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Gürel

    2012-12-01

    Full Text Available This article reviews some of the more common benign oral papules and nodules of oral mucosa with emphasis on their etiology, epidemiology, clinical presentation, histopathology, and treatment. These lesions include mucocele, traumatic fibroma, epulis, pyogenic granuloma, oral papilloma, oral warts, lymphangioma, hemangioma, lipoma, oral nevi and some soft tissue benign tumors. These benign lesions must be separated clinically and histologically from precancerous and malign neoplastic lesions. Accurate clinico-pathological diagnosis is mandatory to insure appropriate therapy.

  15. Benign fibroxanthoma of the mandible

    Directory of Open Access Journals (Sweden)

    L Zouloumis

    2011-01-01

    Full Text Available Histiocytomas constitute a large group of tumors, the classification of which created a lot of confusion in the past. For this reason, various attempts were carried out during the last years so that a widely accepted classification system could be defined. Fibroxanthomas, according to contemporary data, are classified into benign histiocytomas and they are mostly located at the skin of extremities. They are rarely localized in the area of the head and neck, where they are found commonly in soft tissue. Fibroxanthomas located at the bones of oral and maxillofacial region are extremely rare. The purpose of this paper is to present a case of a fibroxanthoma located at the mandible as well as to analyze the histological findings of the lesion on which the diagnosis and differential diagnosis were based.

  16. Benign communicating hydrocephalus in children

    Energy Technology Data Exchange (ETDEWEB)

    Kendall, B.; Holland, I.

    1981-03-01

    A review was performed of the computed tomograms (CTs) of 500 children which had been reported as showing widening of the supratentorial subarachnoid spaces with normal cerebral substance. On the basis of this a radiological diagnosis of cerebral atrophy had been made in all but five, who were said to have mengalencephaly. From these, the children with large or abnormally enlarging heads, but normal or only slightly enlarged ventricles, were selected; there were 40 such cases (8%). The clinical condition either improved or remained stable over a period of 2 years; in the majority the scan abnormality regressed (22.5%) or remained static (67.5%). In three cases there was slight progression of the CT changes before stabilisation, but only one case developed classical communicating hydrocephalus necessitating a shunt procedure. This condition is a generally benign and mild form of communicating hydrocephalus, for which an aetiological factor was apparent in about two-thirds of the cases studied.

  17. Design of environmentally benign processes

    DEFF Research Database (Denmark)

    Hostrup, Martin; Harper, Peter Mathias; Gani, Rafiqul

    1999-01-01

    This paper presents a hybrid method for design of environmentally benign processes. The hybrid method integrates mathematical modelling with heuristic approaches to solving the optimisation problems related to separation process synthesis and solvent design and selection. A structured method...... of solution, which employs thermodynamic insights to reduce the complexity and size of the mathematical problem by eliminating redundant alternatives, has been developed for the hybrid method. Separation process synthesis and design problems related to the removal of a chemical species from process streams...... because of environmental constraints are particularly suited for solution with the hybrid method. Application of the hybrid method is highlighted through two illustrative examples. The first example involves the determination of an optimal flowsheet for the removal of a chemical species from an azeotropic...

  18. [Radiotherapy of benign intracranial tumors].

    Science.gov (United States)

    Delannes, M; Latorzeff, I; Chand, M E; Huchet, A; Dupin, C; Colin, P

    2016-09-01

    Most of the benign intracranial tumors are meningiomas, vestibular schwannomas, pituitary adenomas, craniopharyngiomas, and glomus tumors. Some of them grow very slowly, and can be observed without specific treatment, especially if they are asymptomatic. Symptomatic or growing tumors are treated by surgery, which is the reference treatment. When surgery is not possible, due to the location of the lesion, or general conditions, radiotherapy can be applied, as it is if there is a postoperative growing residual tumor, or a local relapse. Indications have to be discussed in polydisciplinary meetings, with precise evaluation of the benefit and risks of the treatments. The techniques to be used are the most modern ones, as multimodal imaging and image-guided radiation therapy. Stereotactic treatments, using fractionated or single doses depending on the size or the location of the tumors, are commonly realized, to avoid as much a possible the occurrence of late side effects. PMID:27523417

  19. Differentiation between Benign and Malignant Solid Thyroid Nodules Using an US Classification System

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Hun; Kim, Dong Wook; In, Hyun Sin; Park, Ji Sung; Kim, Sang Hyo; Eom, Jae Wook; Kim, Bomi [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Lee, Eun Joo [Dongnam Institute of Radiological and Medical Science, Busan (Korea, Republic of); Rho, Myung Ho [Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-10-15

    To evaluate the diagnostic accuracy of a new ultrasound (US) classification system for differentiating between benign and malignant solid thyroid nodules. In this study, we enrolled 191 consecutive patients who received real-time US and subsequent US diagnoses for solid thyroid nodules, and underwent US-guided fine-needle aspiration. Each thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by real-time US: 'malignant,' 'suspicious for malignancy,' 'borderline,' 'probably benign,' and 'benign'. We evaluated the diagnostic accuracy of thyroid US and the cut-off US criteria by comparing the US diagnoses of thyroid nodules with cytopathologic results. Of the 191 solid nodules, 103 were subjected to thyroid surgery. US categories for these 191 nodules were malignant (n = 52), suspicious for malignancy (n = 16), borderline (n = 23), probably benign (n 18), and benign (n = 82). A receiver-operating characteristic curve analysis revealed that the US diagnosis for solid thyroid nodules using the 5-category US classification system was very good. The sensitivity, specificity, positive and negative predictive values, and accuracy of US diagnosis were 86%, 95%, 91%, 92%, and 92%, respectively, when benign, probably benign, and borderline categories were collectively classified as benign (negative). The diagnostic accuracy of thyroid US for solid thyroid nodules is high when the above-mentioned US classification system is applied.

  20. Emergency Treatment and Nursing of Paroxysmal Ventricular Tachycardia in Children%小儿阵发性室上性心动过速的急救与护理

    Institute of Scientific and Technical Information of China (English)

    侍海棠; 李月

    2015-01-01

    目的探讨小儿发生阵发性室上性心动过速时急救与护理措施。方法对28例阵发性室上性心动过速小儿入院后给予积极抢救、快速、准确用药,精心护理。结果28例阵发性室上性心动过速小儿全部痊愈出院,平均住院日为3d。结论及时、准确、有效地用药,积极、精心的护理,可减少阵发性室上性心动过速小儿心力衰竭等并发症的发生,促进其康复,减少住院天数。%Objective To investigate children paroxysmal supraventricular tachycardia occurs first aid and nursing.Methods 28 patients with paroxysmal supraventricular tachycardia in children admit ed to hospital after giving a positive rescue, rapid, accurate treatment, intensive care. Results 28 patients with paroxysmal supraventricular tachycardia in children al were discharged, average length of stay was three days. Conclusion Timely,accurate and ef ective medication,active,careful care,can reduce the occurrence of paroxysmal supraventricular tachycardia in children with heart failure and other complications,and to promote their recovery and reduce the length of hospital stay.

  1. Twenty-eight day Holter monitoring is poorly tolerated and insensitive for paroxysmal atrial fibrillation detection in cryptogenic stroke.

    Science.gov (United States)

    Tu, H T; Spence, S; Kalman, J M; Davis, S M

    2014-05-01

    This pilot study in a prospective cohort of 20 cryptogenic stroke patients showed that a significant proportion has paroxysmal atrial fibrillation undetected by 24-h Holter monitoring. However, longer monitoring with 28-day Holter was poorly tolerated and still insufficiently sensitive for paroxysmal atrial fibrillation detection. Further studies are urgently needed to elucidate the optimal timing, method and duration of cardiac rhythm monitoring following ischaemic stroke.

  2. Detection of helicobacter pylori in benign laryngeal lesions by polymerase chain reaction: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Izadi Farzad

    2012-04-01

    Full Text Available Abstract Background Although Helicobacter Pylori (HP was detected in some cases of chronic laryngitis, the results were not confirmed by polymerase chain reaction (PCR. By this time, it has not been found in laryngeal lesions by in house PCR, the most sensitive method for detecting the genome tracks. Regarding the previous results and also few numbers of studies about the presence of HP in benign laryngeal lesions, specifically by PCR, we aimed to investigate the presence of HP in benign laryngeal lesions by in-house PCR. Methods The samples were taken from 55 patients with benign laryngeal lesions and frozen in −20°C. One milliliter (ml of lysis buffer was added to 100 mg (mg of each sample and the tube was placed in 56°C overnight. Then DNA extraction was carried out. Results To find HP DNA, in-house PCR was performed that revealed 5 positive results among 55 patients with benign laryngeal lesions. Of them, 3 were polyp, 1 was nodule and 1 was papilloma. Conclusion Although the number of positive results was not a lot in this study, it was in contrast with previous studies which could not find any HP tracks in benign laryngeal lesions by other methods. More studies about the prevalence of HP in benign laryngeal lesions improve judging about the effect of this infection on benign laryngeal lesions.

  3. Recurrent Benign Salivary Gland Neoplasms.

    Science.gov (United States)

    Witt, Robert Lee; Nicolai, Piero

    2016-01-01

    The most important causes of recurrence of benign pleomorphic adenoma are enucleation with intraoperative spillage and incomplete tumor excision in association with characteristic histologic findings for the lesion (incomplete pseudocapsule and the presence of pseudopodia). Most recurrent pleomorphic adenomas (RPAs) are multinodular. MRI is the imaging method of choice for their assessment. Nerve integrity monitoring may reduce morbidity of RPA surgery. Although treatment of RPA must be individualized, total parotidectomy is generally recommended given the multicentricity of the lesions. However, surgery alone may be inadequate for controlling RPA over the long term. There is growing evidence from retrospective series that postoperative radiotherapy results in significantly better local control. A high percentage of RPAs are incurable. All patients should therefore be informed about the possibility of needing multiple treatment procedures, with possible impairment of facial nerve function, and radiation therapy for RPA. Reappearance of Warthin tumor is a metachronous occurrence of a new focus or residual incomplete excision of all primary multicentric foci of Warthin tumor. Selected cases can be observed. Conservative surgical management can include partial superficial parotidectomy or extracapsular dissection. Not uncommonly, other major and minor salivary gland neoplasms, including myoepithelioma, basal cell adenoma, oncocytoma, canalicular adenoma, cystadenoma, and ductal papilloma, follow an indolent course after surgical resection, with rare cases of recurrence.

  4. Nocturia and benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Laketić Darko

    2008-01-01

    Full Text Available Background/Aim. Nocturia often occurs in patients with benign prostate hyperplasia (BPH. The aim of the study was to investigate the frequency of nocturia in patients with BPH. Nocturia and other factors associated with it were also investigated. Methods. Forty patients with the confirmed diagnosis of BPH were studied. Transurethral and transvesical prostatectomy were performed in all the patients. Symptoms were evaluated with the International Prostate Symptom Score before, as well as three and six months after the surgery. All the results were compared with the control group. Results. There was no statistically significant difference between the patients before and after the surgery regarding nocturia. There was, however, a statistically significant difference between the operated patients and the control group regarding nocturia, as well as a statistically significant correlation between noctruia and the age of the patients in both the investigated and the control group. A correlation also existed between nocturia and the prostatic size. Conclusion. There was no statistically significant improvement in symptoms of nocturia after the surgery. It is necessary to be very careful in decision making in patients with nonabsolute indiction for surgery and isolated bothersome symptom of nocturia. Age of a patient should also be considered in the evaluation of favorable result of the surgery because of a significant correlation between noctura and the age of a patient.

  5. Prevalence of Helicobacter pylori in benign gastric ulcers in a cohort of Sri Lankan patients.

    Science.gov (United States)

    Wijetunge, S; Kotakadeniya, R; Noordeen, F; Buharideen, S M; Samarasinghe, B; Dharmapala, A; Galketiya, K B

    2015-12-01

    Helicobacter pylori prevalence is decreasing globally and prevalence of non H. pylori gastric ulcers is increasing. The following study was conducted to assess the prevalence of H. pylori in benign gastric ulcers in a sample of Sri Lankan patients. This was a cross-sectional study of 59 dyspeptic patients with benign gastric ulcers. Multiple endoscopic gastric biopsies were obtained and histology, immunohistochemistry and polymerase chain reaction were performed for H. pylori detection. An immunochromatography assay was performed to detect blood anti H. pylori antibodies. Four (6.8%) were positive for H. pylori. Therefore, it is likely that most benign gastric ulcers are of non-H. pylori aetiology.

  6. Gallium scanning in differentiating malignant from benign asbestos-related pleural disease

    International Nuclear Information System (INIS)

    In order to assess the utility of 67gallium citrate in delineating malignant pleural mesothelioma from benign asbestos-related pleural disease, 49 patients with malignant mesothelioma and 16 with benign asbestos-related pleural disease were studied. Seven patients with malignant mesothelioma had no history of asbestos exposure, while the remaining 58 patients were exposed. Forty-three of the 49 patients (88%) with malignant mesothelioma had a positive 67gallium scan including 36 of the 42 (86%) patients with asbestos exposure and all 7 patients without a history of asbestos exposure. Three of 16 patients (19%) with benign asbestos-related pleural disease had a positive scan. 67Gallium radionuclide imaging is nonspecific but may be valuable in noninvasive monitoring of asbestos-exposed populations, which have a high risk for the late development of benign and/or malignant pleural disease

  7. Simultaneous occurrence of ipsilateral cluster headache and chronic paroxysmal hemicrania: a case report.

    Science.gov (United States)

    Centonze, V; Bassi, A; Causarano, V; Dalfino, L; Centonze, A; Albano, O

    2000-01-01

    A 42-year-old man came to our headache unit in October 1995 complaining of recurrent attacks of headache, which had begun in February 1991. Chronic cluster headache was diagnosed, and he was given verapamil, 360 mg per day. The attacks ceased in the following months and verapamil was stopped in March 1996. In May 1997, a recurrence of the attacks required the readministration of verapamil, 360 mg per day. The attacks decreased (one to three per week), but after 2 months the patient reported a worsening in his condition due to the appearance of shorter attacks, which were diagnosed as chronic paroxysmal hemicrania. The administration of indomethacin, 225 mg per day, resulted in the disappearance of the short attacks. The concomitant occurrence of attacks of cluster headache and chronic paroxysmal hemicrania suggests the presence of shared factors in the pathophysiology of the two forms of headache. This hypothesis is supported by previous reports in the literature. PMID:10759906

  8. [Identification of paroxysmal, transient arrhythmias: Intermittent registration more efficient than the 24-hour Holter monitoring].

    Science.gov (United States)

    Hendrikx, Tijn; Rosenqvist, Mårten; Sandström, Herbert; Persson, Mats; Hörnsten, Rolf

    2015-01-06

    Many patients suffer from palpitations or dizziness/presyncope. These patients are often referred for Holter ECG (24 hour), although the sensitivity for detecting arrhythmias is low. A new method, short intermittent regular and symptomatic ECG registrations at home, might be a convenient and more sensitive alternative also suitable for primary health care. In this case report we present a patient who had contacted health care several times during a seven year period for paroxysmal palpitations. Routine examination with 24 hour Holter ECG and event recorder did not result in a diagnosis. Using intermittent handheld ECG registration at home, a paroxysmal supraventricular arrhythmia was diagnosed. Further investigation revealed that the patient had a concealed Wolff-Parkinson-White (WPW) syndrome.

  9. [Identification of paroxysmal, transient arrhythmias: Intermittent registration more efficient than the 24-hour Holter monitoring].

    Science.gov (United States)

    Hendrikx, Tijn; Rosenqvist, Mårten; Sandström, Herbert; Persson, Mats; Hörnsten, Rolf

    2015-01-01

    Many patients suffer from palpitations or dizziness/presyncope. These patients are often referred for Holter ECG (24 hour), although the sensitivity for detecting arrhythmias is low. A new method, short intermittent regular and symptomatic ECG registrations at home, might be a convenient and more sensitive alternative also suitable for primary health care. In this case report we present a patient who had contacted health care several times during a seven year period for paroxysmal palpitations. Routine examination with 24 hour Holter ECG and event recorder did not result in a diagnosis. Using intermittent handheld ECG registration at home, a paroxysmal supraventricular arrhythmia was diagnosed. Further investigation revealed that the patient had a concealed Wolff-Parkinson-White (WPW) syndrome. PMID:25584602

  10. [The clinical characteristics of endogenous mental diseases with paroxysm-like disorders].

    Science.gov (United States)

    Chikovani, G O

    1997-01-01

    Paroxysmal-like disorders (PLD) were observed in 11 patients with manic-depressive psychosis and in 34 ones with shift-like progredient schizophrenia. 8 variations of the fits were described by the author earlier and included the states from vegetative fits to complex psychotic ones with manifestations of Kandinsky-Clérambault syndrome. Clinical pattern of endogenous psychoses was characterized by considerable presence of affective disorders (both hypomanic and depressive), moreover depressive disturbances were observed more frequently. Debut of PLD was mentioned either before depressions' or in their structure: The appearance of psychotic symptoms in structure of affective phases does not change the character of paroxysmal-like states. It was supposed that endogenous diseases with PLD are the special variant of psychoses.

  11. [Benign prostatic hyperplasia: background and diagnosis].

    Science.gov (United States)

    Gratzke, C; Schlenker, B; Weidlich, P; Seitz, M; Reich, O; Stief, C G

    2007-08-16

    Lower UrinaryTracts Symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH) represent an increasing prevalent condition in ageing men. Patients often seek primarily consultation at their general practitioner. Aetiology and natural history of LUTS due to BPH have not been completely clarified. The development of symptomatic LUTS is age-dependent and determined to varying degrees by the presence of Benign Prostatic Hyperplasia (BPH), Benign Prostatic Enlargement (BPE) as well as Bladder Outlet Obstruction (BOO). A causal relationship does not always exist. Basis for a specific medical or surgical treatment in the individual patient with LUTS due to BPH is an exact diagnosis by the practising urologist. PMID:17912862

  12. [Anterior Mediastinal Bronchogenic Cyst Associated with paroxysmal supraventricular tachycardia ; Report of a Case].

    Science.gov (United States)

    Mega, Seiji

    2015-09-01

    We experienced a rare case of anterior mediastinal bronchogenic cyst. A 55-year-old female was admitted to our hospital because of paroxysmal supraventricular tachycardia (PSVT) and an abnormal shadow on the chest computed tomography. She had a 5.5 cm tumor at anterior mediastinum. The tumor was surgically removed completely by video assisted thoracoscopic surgery, and the diagnosis of bronchogenic cyst was established pathologically. After surgery, PSVT has disappeared.

  13. Short and middle term outcome of radiofrequency catheter ablation for paroxysmal and sustained atrial fibrillation

    International Nuclear Information System (INIS)

    The aim of this study was to assess short and middle term outcome of radiofrequency catheter ablation for drug-refractory paroxysmal and sustained atrial fibrillation. Subjects were 30 patients of atrial fibrillation (19 paroxysmal, 11 sustained) who underwent extensive pulmonary vein isolation from January 2007 to August 2009 in our department. Twenty three men and seven women, aged from 44 to 76 years, were enrolled. Follow-up period was one to 32 months. Drug free success was 33%, but symptoms and electrocardiogram (EGG) findings were improved in 93 % of the patients by administration of anti-arrhythmic agents. Five of the six patients with bradycardia-tachycardia syndrome was free from pacemaker implantation. Left ventricular ejection fraction was improved in two patients with dilated cardiomyopathy (DCM)-like left ventricular dysfunction. One case had cardiac tamponade and transient ST elevation due to right coronary air embolism were observed in two cases. There were no death and no cerebrovascular events during the procedures and follow-up periods. In conclusion, radiofrequency catheter ablation for paroxysmal and sustained atrial fibrillation in our department may be highly acceptable new method for improving the symptoms and clinical signs of the patients. (author)

  14. Hemicrania continua changed to chronic paroxysmal hemicrania after treatment with cyclooxygenase-2 inhibitor.

    Science.gov (United States)

    Müller, Kai Ivar; Bekkelund, Svein Ivar

    2011-02-01

    Remission of hemicrania continua (HC) and transformation from HC to chronic paroxysmal hemicrania (CPH) are unusual. We report a patient with left-sided HC who, after a period of remission, presented as CPH. The continuous HC headache disappeared completely after initiating treatment with cyclooxygenase (COX)-2 inhibitor, but reappeared on the same side after 14 months remission with paroxysmal, frequent, intense and short-lasting headache attacks accompanied by ipsilateral cranial autonomic symptoms. This happened shortly after the treatment was discontinued because of withdrawal of the COX-2 inhibitor from the market. The response to indomethacin was prompt, and the patient became completely free from her paroxysmal headache with a dose of 50 mg 2 times daily. This case questions a possible modification effect on the course of HC by use of COX-2 inhibitor, as well as further supporting that some aspects of the pathophysiology of HC may resemble those of CPH, and may argue for common biological mechanisms in HC and CPH.

  15. Benign Lesions of The Vocal Fold

    Directory of Open Access Journals (Sweden)

    Ozgur Surmelioglu

    2013-02-01

    Full Text Available Benign lesions of vocal folds are common disorders. Fifty percent of patients who have sound complaints are found to have these lesions after endoscopic and stroboscopic examinations. Benign vocal fold diseases are primarily caused by vibratory trauma. However they may also occur as a result of viral infections and congenital causes. These lesions are often presented with the complaints of dysphonia. [Archives Medical Review Journal 2013; 22(1.000: 86-95

  16. Intra-abdominal benign multicystic peritoneal mesothelioma.

    Science.gov (United States)

    Jouvin, I; Dohan, A; Gergi, P; Pocard, M

    2014-04-01

    Benign multicystic peritoneal mesotheliomas are rare: pre-operative diagnosis relies on proper imaging. The differential diagnosis includes pseudomyxoma peritonei and other peritoneal cysts. Absence of previous surgical resection offers the best chance of success when complete resection is performed in a specialized center. We report the case of a 43 year-old man with benign multicystic peritoneal mesothelioma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. PMID:24433857

  17. Current treatment of benign biliary strictures

    OpenAIRE

    Costamagna, Guido; Boškoski, Ivo

    2013-01-01

    Endoscopy is a widely used approach for the treatment of benign biliary strictures. Most common benign biliary strictures amandable to endoscopic treatment are post-cholecystectomy, dominant biliary strictures due to primary sclerosing cholangitis, biliary anastomotic strictures occurring after liver transplantation, and common bile duct strictures due to chronic pancreatitis. Surgery is a valid option in cases of complete transection or ligation of the common bile duct, in selected patients ...

  18. Computed tomographic findings of benign retroperitoneal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Matsuura, Takashi; Nakata, Hajime; Nakayama, Chikashi (Univ. of Occupational and Environmental Health School of Medicine, Kitakyushu, Fukuoka (Japan)); Nishitani, Hiroshi; Matsuura, Keiichi

    1983-07-01

    We have reviewed the computed tomographic (CT) findings of 8 cases of benign retroperitoneal tumors with histological proof. Two teratomas, two schwannomas, and one each of epidermoid cyst, simple cyst, bronchogenic cyst, and cystic lymphangioma were included. The most common CT appearance of these tumors was the solitary, round, well-demarcated, relatively low density mass. Capsule or calcification was demonstrated in some. CT is a highly valuable non-invasive examination method for a diagnosis of a benign retroperitoneal tumor.

  19. Natriuretic peptides for the detection of paroxysmal atrial fibrillation in patients with cerebral ischemia--the Find-AF study.

    Directory of Open Access Journals (Sweden)

    Rolf Wachter

    Full Text Available BACKGROUND AND PURPOSE: Diagnosis of paroxysmal atrial fibrillation (AF can be challenging, but it is highly relevant in patients presenting with sinus rhythm and acute cerebral ischemia. We aimed to evaluate prospectively whether natriuretic peptide levels and kinetics identify patients with paroxysmal AF. METHODS: Patients with acute cerebral ischemia were included into the prospective observational Find-AF study. N-terminal pro brain-type natriuretic peptide (NT-proBNP, brain-type natriuretic peptide (BNP and N-terminal pro atrial-type natriuretic peptide (NT-proANP plasma levels were measured on admission, after 6 and 24 hours. Patients free from AF at presentation received 7 day Holter monitoring. We prospectively hypothesized that patients presenting in sinus rhythm with NT-proBNP>median were more likely to have paroxysmal AF than patients with NT-proBNPmedian (239 pg/ml, 17.9% had paroxysmal AF in contrast to 7.4% with NT-proBNP<239 pg/ml (p = 0.025. The ratio of early (0 h to late (24 h plasma levels of NT-proBNP showed no difference between both groups. For the detection of paroxysmal atrial fibrillation, BNP, NT-proBNP and NT-proANP at admission had an area under the curve in ROC analysis of 0.747 (0.663-0.831, 0.638 (0.531-0.744 and 0.663 (0.566-0.761, respectively. In multivariate analysis, BNP was the only biomarker to be independently predictive for paroxysmal atrial fibrillation. CONCLUSIONS: BNP is independently predictive of paroxysmal AF detected by prolonged ECG monitoring in patients with cerebral ischemia and may be used to effectively select patients for prolonged Holter monitoring.

  20. Clinical and electroencephalographic characteristics of benign occipital epilepsy of childhood in two tertiary Brazilian hospitals

    Directory of Open Access Journals (Sweden)

    Soniza Vieira Alves-Leon

    2011-08-01

    Full Text Available This study intended to investigate the clinical and electroencephalographic benign occipital epilepsy of childhood (BOEC characteristics in a population sample of patients from two tertiary Brazilian hospitals. We analyzed retrospectively 4912 electroencephalograms (EEGs records, and the included patients were submitted to a new clinical and EEG evaluation. Were included 12 (0.92% patients; 4 (33.3% with criteria for early BOEC; 6 (50% for late form and 2 (16.7% with superimposed early and late onset forms. After new investigation, 2 (16.7% had normal EEG; 4 (33.3% had paroxysms over the occipital region; 3 (25% over the temporal posterior regions and 3 (25% over the posterior regions. Sharp waves were the predominant change, occurring in 8 (66.6%; spike and slow wave complexes in 1 (8.3% and sharp and slow wave complexes in 1 (8.3%. Vomiting, headache and visual hallucinations were the most common ictal manifestations, presented in 100% of patients with superimposed forms. Vomiting were absent in the late form and headache was present in all forms of BOEC.

  1. Benign multicystic peritoneal mesothelioma: a case report

    Directory of Open Access Journals (Sweden)

    Papapaulou Leonidas

    2010-11-01

    Full Text Available Abstract Introduction We report the case of a patient with a benign multicystic peritoneal mesothelioma and describe its appearance on computed tomography scans and ultrasonography, in correlation with gross clinical and pathological findings. Case presentation A 72-year-old Caucasian woman presented to our emergency department with acute abdomen signs and symptoms. A clinical examination revealed a painful palpable mass in her left abdomen. Abdominal ultrasonography and computed tomography demonstrated the presence of a large cystic mass in her left upper abdomen, adjacent to her left hemidiaphragm. The lower border of the mass extended to the upper margin of her pelvis. A complete resection of the lesion was performed. Pathological analysis showed a benign multicystic peritoneal mesothelioma. Conclusions Benign multicystic peritoneal mesothelioma is a rare lesion with a non-specific appearance on imaging. Its diagnosis always requires pathological analysis.

  2. Pharmacological treatment of the benign prostatic hyperplasia

    International Nuclear Information System (INIS)

    Benign prostatic hyperplasia is a common disease in over 50 years-old men consisting in uncontrolled and benign growth of prostatic gland that leads to lower urinary tract symptoms. The etiology of benign prostatic hyperplasia is multifactoral involving the increased conversion of testosterone in dihydrotestosterone by the prostatic 5α-reductase action, which brought about events that encourage the prostate growth (static component) and the increase of the bladder and prostate smooth muscle tone (dynamic component) regulated by the aα1 -adrenoceptors (ADR). The pharmacological treatment of the benign prostatic hyperplasia includes the prostatic 5aα-reductase inhibitors, the aα1-adrenoreceptor blockers, their combined therapy and the phytotherapy. This paper was aimed at presenting the most relevant aspects of the pharmacology of drugs used for treating the benign prostatic hyperplasia, and providing elements to analyze their efficacy, safety and tolerability. To this end, a review was made of the different drugs for the treatment of this pathology and they were grouped according to their mechanism of action. Natural products were included as lipid extracts from Serenoa repens and Pygeum africanum as well as D-004, a lipid extract from Roystonea regia fruits, with proved beneficial effects on the main etiological factors of benign prostatic hyperplasia. D-004 is a prostatic 5a-reductase inhibitor, an aα1-adrenoceptor antagonist, aα 5-lipooxygenase inhibitor and has antioxidant action, all of which reveals a multifactoral mechanism. The results achieved till now indicate that D-004 is a safe and well-tolerated product

  3. Treatment of paroxysmal atrial fibrillation in terms of mitral valve surgery – is ablation necessary?

    Directory of Open Access Journals (Sweden)

    Zheleznev S. I.

    2012-03-01

    Full Text Available Objective. The study aimed to analyze the results of different concomitant ablation techniques in patients with paroxysmal atrial fibrillation (AF and mitral valve disease according to data of continuous long-term rhythm monitoring. Material and methods. The study was performed between 2009 and 2011 and included 57 patients with mitral valve disease and paroxysmal AF. Patients were randomized in two groups: 31 patient (group I underwent concomitant ablation with defect correction, 26 patients (group II underwent isolated correction of defect. Left atrial (LA radiofrequency ablation was performed using only bipolar devices. All patients underwent implantation of apparatus for continuous heart rhythm monitoring after the primary stage of intervention. Patients with rate of AF less than 0.5% at every follow-up examination were considered to be responders to treatment. Evaluation of atrial transport function was based on analysis of transmitral diastolic flow (E-VTI and A-VTI peaks and pulmonary venous flow. Results. There were no deaths during in-hospital period. Absence of AF was noted in all cases in both groups after completion of surgery. AF paroxysm in early postoperative period required pharmacological (cordarone or electrical cardioversion in 6 patients (19.4% from group I and in 12 patients (46.2% from group II. Control examination was performed in 3, 6 and 12 months. 18 patients (58.1% from group I and 10 patients (38.5% from group II were shown to be free from AF on the first examination. 22 patients (71.0% from group I and only 8 patients (30.8% from group II did not have documented arrhythmia (rate of AF less than 0.5% in 12 months after surgery and were classified as responsive to treatment. 3 patients (11.5% from group II already had persistent AF. Left atrial flutter was noted in 1 patient (3.2% from group I and 1 patient (3.9% from group II had typical flutter. Both patients underwent catheter ablation for atrial flutter, after

  4. Successful treatment of paroxysmal tonic spasms with topiramate in a patient with neuromyelitis optica.

    Science.gov (United States)

    Iida, Shin; Nakamura, Masataka; Wate, Reika; Kaneko, Satoshi; Kusaka, Hirofumi

    2015-09-01

    A 49-year-old woman with neuromyelitis optica (NMO) developed severe quadriplegia and frequent paroxysmal tonic spasms (PTS). Carbamazepine, although initially effective against PTS, caused drug eruption and she was unable to continue. PTS re-emerged after discontinuation of carbamazepine and hindered rehabilitation. Then topiramate was started, and PTS promptly disappeared. The patient became able to resume rehabilitation and her activity of daily life improved significantly. Carbamazepine and topiramate have a common pharmacological action to block voltage-gated sodium channels. The action may have contributed to inhibition of ephaptic transmission in the demyelinating lesions by NMO and eventually improved PTS.

  5. Impaired growth and elevated Fas receptor expression in PIGA+ stem cells in primary paroxysmal nocturnal hemoglobinuria

    OpenAIRE

    Chen, Rui; Nagarajan, Shanmugam; Prince, Gregory M.; Maheshwari, Uma; Terstappen, Leon W. M. M.; Kaplan, David R.; Stanton L Gerson; Albert, Jeffrey M.; Dunn, Daniel E.; Lazarus, Hillard M.; Medof, M. Edward

    2000-01-01

    The genetic defect underlying paroxysmal nocturnal hemoglobinuria (PNH) has been shown to reside in PIGA, a gene that encodes an element required for the first step in glycophosphatidylinositol anchor assembly. Why PIGA-mutated cells are able to expand in PNH marrow, however, is as yet unclear. To address this question, we compared the growth of affected CD59–CD34+ and unaffected CD59+CD34+ cells from patients with that of normal CD59+CD34+ cells in liquid culture. One hundred FACS-sorted cel...

  6. Paroxysmal atrioventricular nodal reentrant tachycardias: epidemiology, clinical picture, diagnostics, treatment (review

    Directory of Open Access Journals (Sweden)

    Morozov I.A.

    2012-03-01

    Full Text Available Nowadays paroxysmal AV nodal reentrant tachycardia (AVNRT is one of the most widespread arrhythmias. In most cases AVRNT is a recurrent process, and it worsens the life quality of such patients, reduces their workability and increases the incidence of applying for medical help. Thus AVNRT today is of special attention among investigators. The interest of clinicians to the problem of cardiac arrhythmias is associated with permanent dissatisfaction with the results of antiarrhythmic therapy and also with the rapid development of the surgical methods of treatment, i.e. the use of radio frequency catheter ablation.

  7. [Myocardial damage and paroxysmal ventricular tachycardia in a dog after Albuterol intoxication].

    Science.gov (United States)

    Matos, J; Jenni, S; Fischer, N; Bienz, H; Glaus, T

    2012-07-01

    Intoxication with the beta2-agonist Albuterol may lead to immediate signs of beta-adrenergic stimulation like excitation, tachypnea and tachycardia. Furthermore, it typically causes severe hypokalemia, which then leads to muscle weakness and which predisposes to ventricular arrhythmias. We describe a dog where albuterol intoxication caused runs of fast paroxysmal ventricular tachycardia that persisted after normalization of the hypokalemia. Based on a markedly elevated serum troponin I level acute myocardial damage was identified as cause of the tachyarrhythmia. Repeated Troponin I measurements and Holter-ECGs were the means to document complete cure.

  8. Coincidence of paroxysmal supraventricular tachycardia and panic disorder: two case reports

    Directory of Open Access Journals (Sweden)

    Breithardt Günter

    2010-04-01

    Full Text Available Abstract Panic disorder (PD is characterised by sudden attacks of intense fear with somatic symptoms including palpitations and tachycardia. Reciprocally, palpitations caused by paroxysmal supraventricular tachycardia (PSVT are commonly associated with anxiety and may therefore be misdiagnosed as PD. As demonstrated by two case reports, PSVT and PD can occur comorbidly in a chronological sequence, with PSVT possibly precipitating and maintaining PD via interoceptive processes or, alternatively, with PD increasing the risk for PSVT by elevating stress levels. As both PSVT and PD require different treatments, potentially helpful differential clinical diagnostic criteria are proposed.

  9. Improving cytopenia with splenic artery embolization in a patient with paroxysmal nocturnal hemoglobinuria on eculizumab.

    Science.gov (United States)

    Krishnan, Suresh K; Hill, Anita; Hillmen, Peter; Arnold, Louise M; Brooksbank, Gemma L; Wood, Alex; Scarsbrook, Andrew; Davies, Mervyn H; Kelly, Richard J

    2013-12-01

    Paroxysmal nocturnal hemoglobinuria is a rare acquired stem cell disorder characterized by intravascular hemolysis, aplasia and an increased risk of thrombosis. We describe a patient under treatment with the anti-complement antibody eculizumab who developed pancytopenia, requiring blood transfusions, due to massive splenomegaly. The patient underwent two separate splenic embolizations, which reduced the size of the spleen and improved his blood count to the point that blood transfusions were no longer necessary. Splenic embolization was chosen over splenectomy due to the potential postoperative complications of splenectomy, especially that of thrombosis.

  10. Paroxysmal Atrial Fibrillation and Brain Freeze: A Case of Recurrent Co-Incident Precipitation From a Frozen Beverage

    Science.gov (United States)

    Lugovskaya, Nelya; Vinson, David R.

    2016-01-01

    Patient: Male, 29 Final Diagnosis: Paroxysmal atrial fibrillation • cold-stimulus headache Symptoms: Palpitations • headache Medication: Diltiazem • Ibutilide Clinical Procedure: None Specialty: Emergency Medicine • Internal Medicine Objective: Unknown ethiology • Rare disease Background: Episodes of paroxysmal atrial fibrillation may be precipitated by the rapid ingestion of ice-cold foods and beverages. This condition has received little research attention, and its true prevalence is poorly described. Treating physicians may not identify cold ingestion as a causal factor of paroxysmal atrial fibrillation, thus compromising both history taking and patient education. Case Report: We report a case of a healthy young-adult man who drank a slushed ice beverage that immediately induced atrial fibrillation and a brain freeze headache simultaneously. This occurred on two separate occasions, years apart. During both episodes, the acute brain freeze self-resolved quickly, but the new-onset palpitations occasioned a visit to the emergency department for diagnosis and treatment. The emergency physicians failed to make the causal link between the cold drink and the atrial dysrhythmia. Though the brain freeze headache and paroxysmal atrial fibrillation were both precipitated by rapid ingestion of an ice-cold beverage, the mediating mechanisms are distinct. We review these two cold-induced conditions, their prevalence, and their probable mechanisms. Conclusions: The recurrent simultaneous occurrence of brain-freeze headache with paroxysmal atrial fibrillation identifies the ingestion of a frozen beverage as the precipitant of the atrial dysrhythmia. Increasing physician awareness of cold ingestion as a cause of paroxysmal atrial fibrillation will improve history taking and patient education. PMID:26757615

  11. Diagnostik og behandling af benigne levertumorer

    DEFF Research Database (Denmark)

    Eriksen, Peter Lykke; Schultz, Nicolai Aagaard; Larsen, Lars Peter;

    2016-01-01

    Due to the expanding use of diagnostic imaging, an increasing number of liver tumours are discovered. Benign tumours are very common; they rarely cause symptoms and often they do not require any treatment. However, because of differences in the natural history including risk of complications and...... malignant transformation exact diagnosis is important. Dedicated radiological examinations serve as important diagnostic tools reducing the need for biopsy. In this review we provide an update on the diagnosis and treatment of benign liver tumours adding to existing recommendations on hepatocellular...

  12. The decline of hysterectomy for benign disease.

    LENUS (Irish Health Repository)

    Horgan, R P

    2012-01-31

    Hysterectomy is one of the most common gynaecological surgical procedures performed but there appears to be a decline in the performance of this procedure in Ireland in recent times. We set out to establish the extent of the decline of hysterectomy and to explore possible explanations. Data for hysterectomy for benign disease from Ireland was obtained from the Hospital In-Patient Enquiry Scheme (HIPE) section of the Economic and Social Research Institute for the years 1999 to 2006. The total number of hysterectomies performed for benign disease showed a consistent decline during this time. There was a 36% reduction in the number of abdominal hysterectomy procedures performed.

  13. Benign cephalic histiocytosis: report of four cases.

    Science.gov (United States)

    de Luna, M L; Glikin, I; Golberg, J; Stringa, S; Schroh, R; Casas, J

    1989-09-01

    We cared for four patients with benign cephalic histiocytosis, a self-healing non-X, nonlipid cutaneous histiocytosis of children. The age of onset of the disease was 5 to 9 months, with papules and erythematous macules involving the head (mainly the cheeks), and posterior spread to the trunk and limbs in three patients. Microscopic examination of skin biopsies revealed a histiocytic infiltrate in the superficial dermis that was S100 protein-negative by immunoperoxidase (PAP method). One patient showed comma-shaped bodies and desmosomelike junctions on electron microscopy. No Birbeck's granules were present. Benign cephalic histiocytosis is a self-limiting condition that requires no treatment.

  14. Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses

    Energy Technology Data Exchange (ETDEWEB)

    Thomassin-Naggara, Isabelle [Hopital Tenon, Assistance Publique Hopitaux de Pariss, Department of Radiology, Paris (France); Universite Rene Descartes, LRI-EA4062, Paris (France); Darai, Emile [Hopital Tenon, Assistance Publique Hopitaux de Pariss, Department of Gynecology-Obstetrics, Paris (France); Cuenod, Charles A.; Fournier, Laure [Universite Rene Descartes, LRI-EA4062, Paris (France); Hopital Europeen Georges Pompidou (HEGP), Assistance Publique Hopitaux de Paris, Department of Radiology, Paris (France); Toussaint, Irwin; Marsault, Claude; Bazot, Marc [Hopital Tenon, Assistance Publique Hopitaux de Pariss, Department of Radiology, Paris (France)

    2009-06-15

    The purpose of this study was to prospectively assess the contribution of diffusion-weighted MR imaging (DWI) for characterizing complex adnexal masses. Seventy-seven women (22-87 years old) with complex adnexal masses (30 benign and 47 malignant) underwent MR imaging including DWI before surgery. Conventional morphological MR imaging criteria were recorded in addition to b{sub 1,000} signal intensity and apparent diffusion coefficient (ADC) measurements of cystic and solid components. Positive likelihood ratios (PLR) were calculated for predicting benignity and malignancy. The most significant criteria for predicting benignity were low b{sub 1,000} signal intensity within the solid component (PLR = 10.9), low T2 signal intensity within the solid component (PLR = 5.7), absence of solid portion (PLR = 3.1), absence of ascites or peritoneal implants (PLR = 2.3) and absence of papillary projections (PLR = 2.3). ADC measurements did not contribute to differentiating benign from malignant adnexal masses. All masses that displayed simultaneously low signal intensity within the solid component on T2-weighted and on b{sub 1,000} diffusion-weighted images were benign. Alternatively, the presence of a solid component with intermediate T2 signal and high b{sub 1,000} signal intensity was associated with a PLR of 4.5 for a malignant adnexal tumour. DWI signal intensity is an accurate tool for predicting benignity of complex adnexal masses. (orig.)

  15. Diagnostic value of CD-10 marker in differentiating of papillary thyroid carcinoma from benign thyroid lesions

    Directory of Open Access Journals (Sweden)

    Mojgan Mokhtari

    2014-01-01

    Full Text Available Background: Using of CD10 in accordance with clinical and histological features of thyroid lesions could be used as both diagnostic and prognostic tool, which consequently influence the management and their prognosis for survival of patients with thyroid neoplasms especially papillary thyroid carcinoma (PTC. The aim of this study was to determine its expression in PTC and different benign thyroid lesions. Materials and Methods: In this descriptive-analytic, cross-sectional study, paraffin-embedded tissues of patients with definitive pathologic diagnosis of different benign thyroid lesions and PTC were retrieved. Immunostained sections of each slides was performed using immunohistochemistry methods and expression of CD10 was compared in two groups of benign thyroid lesions and PTC. Results: From selected cases 134 sections studied in two groups of PTC (n = 67 and benign thyroid lesions (n = 67. CD10 were immunohistochemically positive in 29.9% of PTC cases, but in none of the thyroid benign lesions (0% (P 0.05. Conclusion: The results of the current study indicate that due to the higher expression of CD10 in PTC than benign thyroid lesions it might be used for differentiating mentioned lesions. But for using it as a diagnostic tool further studies with larger sample size and determination of its sensitivity, specificity and cut-off point is necessary.

  16. Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses

    International Nuclear Information System (INIS)

    The purpose of this study was to prospectively assess the contribution of diffusion-weighted MR imaging (DWI) for characterizing complex adnexal masses. Seventy-seven women (22-87 years old) with complex adnexal masses (30 benign and 47 malignant) underwent MR imaging including DWI before surgery. Conventional morphological MR imaging criteria were recorded in addition to b1,000 signal intensity and apparent diffusion coefficient (ADC) measurements of cystic and solid components. Positive likelihood ratios (PLR) were calculated for predicting benignity and malignancy. The most significant criteria for predicting benignity were low b1,000 signal intensity within the solid component (PLR = 10.9), low T2 signal intensity within the solid component (PLR = 5.7), absence of solid portion (PLR = 3.1), absence of ascites or peritoneal implants (PLR = 2.3) and absence of papillary projections (PLR = 2.3). ADC measurements did not contribute to differentiating benign from malignant adnexal masses. All masses that displayed simultaneously low signal intensity within the solid component on T2-weighted and on b1,000 diffusion-weighted images were benign. Alternatively, the presence of a solid component with intermediate T2 signal and high b1,000 signal intensity was associated with a PLR of 4.5 for a malignant adnexal tumour. DWI signal intensity is an accurate tool for predicting benignity of complex adnexal masses. (orig.)

  17. Value of thyroid nodule ultrasonic strain elastography quantitative analysis in judging benignancy or malignancy of nodules

    Institute of Scientific and Technical Information of China (English)

    Hai-Yun Zhao; Hai-Xia Liu; Wei Tong; Jin-Zhong Huang; Chun Xiang

    2016-01-01

    Objective:To analyze the value of thyroid nodule ultrasonic strain elastography quantitative analysis in judging benignancy or malignancy of nodules.Methods: Patients diagnosed with thyroid nodule and receiving ultrasonic strain elastography quantitative analysis in our hospital were selected for study and divided into benign group and malignant group according to fine needle biopsy or the pathological results after surgical resection; mean strain values of quantitative indicators, blue region area and disorder of ultrasonic strain elastography, expression levels of malignant biological molecules in nodule tissue as well as the contents of serum tumor markers were detected.Results:Mean strain value of malignant group was lower than that of benign group, blue region area and disorder were higher than those of benign group, and standard deviation, complexity, kurtosis, skewness, contrast, equality, consistency and correlation were without significant differences; mRNA contents ofFascin-1, S100A4, STAT3, TC-1, MUC1 andMUC15 in thyroid nodules as well as serum Midkine, Galectin-3, CEACAM1 and TFF3 contents of malignant group were significantly higher than those of benign group, negatively correlated with mean strain value and positively correlated with blue region area and disorder.Conclusions:Mean strain values of quantitative indicators, blue region area and disorder of thyroid nodule ultrasonic strain elastography can judge benign or malignant nodules and assess the malignant degree.

  18. Benign prostatic hyperplasia: symptoms and objective interpretation

    DEFF Research Database (Denmark)

    Andersen, J T

    1991-01-01

    Considerable new knowledge about benign prostatic hyperplasia has been gained over the past two decades, particularly with regard to its natural history, hydrodynamic changes in the lower urinary tract, and the symptomatic and urodynamic results of treatment. A survey of the literature has been...

  19. Benign solitary solid cold thyroid nodules

    DEFF Research Database (Denmark)

    Døssing, Helle; Bennedbaek, Finn Noe; Karstrup, Steen;

    2002-01-01

    PURPOSE: To evaluate the effects of ultrasonography (US)-guided interstitial laser photocoagulation (ILP) on the volume of benign solitary solid cold thyroid nodules and any nodule-related symptoms. MATERIALS AND METHODS: ILP was performed in 16 patients with normal thyroid function and a solid...... solitary solid cold thyroid nodule in patients who cannot or will not undergo surgery....

  20. Urodynamic implications of benign prostatic hyperplasia

    DEFF Research Database (Denmark)

    Jensen, K M; Andersen, J T

    1990-01-01

    By the age of 60, about 70% of men have developed benign prostatic hyperplasia (BPH), and 85%-95% of these have symptomatic dysfunction of the lower urinary tract, 10%-20% undergoing prostatectomy. Although transurethral resection of the prostate is generally considered to be a safe and effective...

  1. Immunohistochemical Analysis of Omi/HtrA2 Expression in Prostate Cancer and Benign Prostatic Hyperplasia

    Institute of Scientific and Technical Information of China (English)

    HU Xiaoyong; CHEN Xiaochun; PING Hao; CHEN Zhaohui; ZENG Fuqing; LU Gongcheng

    2005-01-01

    To study the expression and significance of the serine protease Omi/HtrA2 in prostate cancer and benign prostatic hyperplasia. The expression of Omi/HtrA2 was assayed by means of immunohistochemical technique in 41 prostate cancer (Cap), 20 benign prostatic hyperplasia (BPH) and 10 normal prostate (NP) specimens. Omi/HtrA2 expression was positive in 30 (73.17%) prostate cancer specimens, and the positive rate of Omi/HtrA2 was lower in well differentiated than in poorly and moderately differentiated groups (P<0.05). By contrast, the cells in normal prostate and benign prostatic hyperplasia groups showed no or weak expression of Omi/HtrA2.Prostate cancer cells in vivo may need Omi/HtrA2 expression for apoptosis, and that Omi/HtrA2expression might be involved in prostate cancer development.

  2. Late onset of atypical paroxysmal non-kinesigenic dyskinesia with remote history of Graves′ disease

    Directory of Open Access Journals (Sweden)

    Abdul Qayyum Rana

    2013-01-01

    Full Text Available Paroxysmal non-kinesigenic dyskinesia (PNKD is a rare hyperkinetic movement disorder and falls under the category of paroxysmal movement disorders. In this condition, episodes are spontaneous, involuntary, and involve dystonic posturing with choreic and ballistic movements. Attacks last for minutes to hours and rarely occur more than once per day. Attacks are not typically triggered by sudden movement, but may be brought on by alcohol, caffeine, stress, fatigue, or chocolate. We report a patient with multiple atypical features of PNKD. She had a 7-year history of this condition with onset at the age of 59, and a remote history of Graves′ disease requiring total thyroidectomy. The frequency of attacks in our case ranged from five to six times a day to a minimum of twice per week, and the duration of episode was short, lasting not more than 2 min. Typically, PNKDs occur at a much younger age and have longer attack durations with low frequency. Administering clonazepam worked to reduce her symptoms, although majority of previous research suggests that pharmacological interventions have poor outcomes.

  3. DRUG THERAPY OF PAROXYSMAL ATRIAL FIBRILLATION IN THE ELDERLY OVER 75 YEARS OLD

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To investigate the effectiveness and safety of various agents on paroxysmal atrial fibrillation in the elderly over 75 years old.Methods Totally 264 in-patients (75-91 years old, 185 males and 79 females) with atrial fibrillation history of less than 7 days were enrolled in this study. A total of 611 atrial fibrillation episodes were recorded, but 130 episodes (22. 3% ) of atrial fibrillation were auto-converted to sinus rhythm. The rest 481 episodes of atrial fibrillation were divided into six groups based on the drug used. Results The cardioversion ratio of atrial fibrillation were 9. 5%, 46.9%, 71.7%, 55.9%, 32.7%, and73.6%in control, cedilanid, amiodarone, propafenone, verapamil, and quinidine groups, respectively. Ventricular rate control were 5.4%, 83.6%, 84. 9%, 77.9%, 78.8%, and 11.3% in those groups, respectively. The total effective rates of amiodarone and cedilanid groups were the highest. When the ventricular rate was controlled to below 90 bpm, the patients would almost complain of no discomfort. No severe side-effect was observed in each group. Conclusion Amiodarone and cedilanid may be the proper drugs for the treatment of paroxysmal atrial fibrillation in the elderly. The above antiarrhythmics in each therapeutic group were relatively safe and effective.

  4. Trigeminal autonomic cephalalgias: paroxysmal hemicrania, SUNCT/SUNA, and hemicrania continua.

    Science.gov (United States)

    Goadsby, Peter J; Cittadini, Elisabetta; Cohen, Anna S

    2010-04-01

    The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders that include cluster headache (CH), paroxysmal hemicrania (PH), and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing/cranial autonomic features (SUNCT/SUNA). Hemicrania continua (HC) is often included with this group, although the second edition of The International Classification of Headache Disorders did not link the entities. Trigeminal autonomic cephalalgias are generally characterized by relatively short-lasting attacks of severe pain and lateralized associated features including the pain, cranial autonomic symptoms, and where present, migrainous symptoms, such as photophobia. Paroxysmal hemicrania has intermediate duration and intermediate attack frequency. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing has the shortest attack duration and the highest attack frequency. Hemicrania continua has a continuous pain with exacerbations that can include cranial autonomic symptoms as part of the phenotype. The syndromes share much in their pathophysiology and investigation paths; however, their treatment is distinct, so that the accurate differentiation is important for optimal management.

  5. [Surgical management of trigeminal neuralgia, hemifacial spasm, paroxysmal tinnitus and nystagmus by neurovascular decompression].

    Science.gov (United States)

    Isu, T; Abe, H; Nakagawa, Y; Aida, T; Tsuru, M; Ito, T; Murai, H

    1983-11-01

    Trigeminal neuralgia, facial spasm, tinnitus, vertigo, and glossopharyngeal neuralgia are believed to be the symptoms complex of hyperactive dysfunction of the cranial nerve caused by vascular cross compression at the root entry (exit) zone of the appropriate nerve. Posterior cranial fossa approach for the neurovascular decompression was enhanced by Jannetta et al (1975). From their experiences of surgery, they emphasized that these symptoms were relieved by surgery. In this report, we will discuss the etiology of the disease, the neurotological examination, the angiographic findings, the operative findings and results in a series of 10 patients who have undergone neurovascular decompression. The series consisted of 4 cases with trigeminal neuralgia, 5 cases with facial spasm, and 1 case with paroxysmal tinnitus accompanied by facial spasm. The postoperative progress in these all patients was excellent and relieved of the symptoms. There was neither mortality nor any significant complication. We stress that the neurovascular decompression surgery is now well justified as the definite treatment for the trigeminal neuralgia and facial spasm, because the surgery can be performed easily and safely by the neurosurgeons. The indication of the neurovascular decompression for the acoustic nerve and glossopharyngeal nerve is still controversial. In our own case, tinnitus was paroxysmal and complicated with facial spasm, not synchronous with facial spasm, but with nystagmus. This selective synchronism between tinnitus and nystagmus is a particular feature of our clinical instance. This particular clinical experience may provide some highly significant suggestions in considering the applicability of neurovascular decompression to the acoustic nerve. PMID:6671636

  6. E-cadherin and calretinin as immunocytochemical markers to differentiate malignant from benign serous effusions

    Institute of Scientific and Technical Information of China (English)

    Dong-Nan He; Hua-Sheng Zhu; Kun-He Zhang; Wen-Jian Jin; Wei-Ming Zhu; Ning Li; Jie-Shou Li

    2004-01-01

    AIM: To investigate the expressions of E-cadherin and calretinin in exfoliated cells of serous effusions and evaluate their values in distinguishing malignant effusions from benign ones.METHODS: Fresh serous effusion specimens werecentrifuged and exfoliated cells were collected. Cells were then processed with a standardized procedure, including paraformaldehyde fixation, BSA-PBS solution washing and smears preparation. E-cadherin and calretinin were detected by immunocytochemistry (ICC).RESULTS: In the exfoliated cells of serous effusions, most of carcinoma cells only expressed E-cadherin, and most of mesothelial cells only expressed calretinin, and benign cells (lymphocytes and granulocytes) did not express either of them. For E-cadherin, 85.7% (30/35) of malignant effusions and 8.1% (3/37) of benign fluids were ICC-positive (P<0.001).The sensitivity of E-cadherin ICC in the diagnosis of malignant effusions was 85.7%, specificity 91.9%, and diagnostic rate 88.9%. For calretinin, 94.6% (35/37) of benign effusions and 11.4% (4/35) of malignant effusions were ICC-positive (P<0.001). The sensitivity of calretinin ICC in the diagnosis of benign effusions was 94.6%,specificity 88.6%, and diagnostic rate 91.7%. For diagnosis of benign and malignant effusions by combining E-cadherin ICC and calretinin ICC, the specificities were up to 100%and 97.1%, respectively.CONCLUSION: E-cadherin ICC and calretinin ICC are sensitive and specific in differential diagnosis of benign and malignant serous effusion specimens and specificities are evidently improved when both markers are combined.

  7. Natural history of benign prostate hyperplasia

    Institute of Scientific and Technical Information of China (English)

    WU Shi-liang; LI Ning-chen; XIAO Yun-xiang; JIN Jie; QIU Shao-peng; YE Zhang-qun; KONG Chui-ze; SUN Guang; NA Yan-qun

    2006-01-01

    Background Benign prostate hyperplasia is one of the most common diseases affecting the health of the aging males. Watchful waiting is an acceptable management strategy for benign prostate hyperplasia in which the patient is monitored by the physician but receives no active intervention. The epidemiological data on this are lacking in China. Our study was designed to evaluate the changes of signs and symptoms of patients with benign prostate hyperplasia during management by watchful waiting in China.Methods One hundred and forty-five patients with benign prostate hyperplasia aged > 50 years were enrolled in management by watchful waiting. All the patients were visited every 6 months and were given an International Prostate Symptom Score and Quality of Life questionnaire to complete. They also had uroflowmetry and were assessed using ultrasonography to get the volume of prostate, transition zone and amount of residual urine. The Student's t test, the Chi-square test, and variance analysis were used in the statistical analysis.Results All patients were visited after 6 months, the mean volume of transitional zone was found to haveincreased by 1.6 ml (P<0.01), International Prostate Symptom Score was increased by 0.8 (P<0.01) and Quality of Life was increased by 0.2 (P<0.01), and there was no statistical change in other data. Among these patients,17.9% (26/145) visited again after 12 months when the data failed to show a statistically significant difference among the three groups (0, 6, and 12 months).Conclusions After one year's follow-up, the progression of benign prostate hyperplasia was slow and the clinical data did not undergo much change.

  8. Prediction of paroxysmal atrial fibrillation using recurrence plot-based features of the RR-interval signal

    International Nuclear Information System (INIS)

    Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke. Predicting the onset of paroxysmal AF (PAF), based on noninvasive techniques, is clinically important and can be invaluable in order to avoid useless therapeutic intervention and to minimize risks for the patients. In this paper, we propose an effective PAF predictor which is based on the analysis of the RR-interval signal. This method consists of three steps: preprocessing, feature extraction and classification. In the first step, the QRS complexes are detected from the electrocardiogram (ECG) signal and then the RR-interval signal is extracted. In the next step, the recurrence plot (RP) of the RR-interval signal is obtained and five statistically significant features are extracted to characterize the basic patterns of the RP. These features consist of the recurrence rate, length of longest diagonal segments (Lmax ), average length of the diagonal lines (Lmean), entropy, and trapping time. Recurrence quantification analysis can reveal subtle aspects of dynamics not easily appreciated by other methods and exhibits characteristic patterns which are caused by the typical dynamical behavior. In the final step, a support vector machine (SVM)-based classifier is used for PAF prediction. The performance of the proposed method in prediction of PAF episodes was evaluated using the Atrial Fibrillation Prediction Database (AFPDB) which consists of both 30 min ECG recordings that end just prior to the onset of PAF and segments at least 45 min distant from any PAF events. The obtained sensitivity, specificity, positive predictivity and negative predictivity were 97%, 100%, 100%, and 96%, respectively. The proposed methodology presents better results than other existing approaches

  9. Endo-biliary stents for benign disease: not always benign after all!

    Directory of Open Access Journals (Sweden)

    Jo-Etienne Abela

    2011-11-01

    Full Text Available This case report describes the presentation, management and treatment of a patient who suffered small bowel perforation due to the migration of his biliary stent which had been inserted for benign disease.

  10. Tonic activation of peripheral chemosensory function modulates vagal heart rate control in heart failure patients with paroxysmal atrialfibrillation

    NARCIS (Netherlands)

    Drexel, T.; Eickholt, C.; Muehlsteff, J.; Ritz, A.; Siekiera, M.; Kirmanoglou, K.; Shin, D.I.; Balzer, J.; Rassaf, T.; Kelm, M.; Meyer, C.

    2012-01-01

    Tonic activation of peripheral chemosensory function modulates vagalheart rate control in heart failure patients with paroxysmal atrialfibrillation Thomas Drexel1, Christian Eickholt1, Jens Mühlsteff2,Anita Ritz1, Markus Siekiera1, Kiriakos Kirmanoglou1, Dong-In Shin1,Jan Balzer1, Tienush Rassaf1, M

  11. Incidence of paroxysmal atrial tachycardias in patients treated with cardiac resynchronization therapy and continuously monitored by device diagnostics

    NARCIS (Netherlands)

    Leclercq, C.; Padeletti, L.; Cihak, R.; Ritter, P.; Milasinovic, G.; Gras, D.; Paul, V.; Van Gelder, I. C.; Stellbrink, C.; Rieger, G.; Corbucci, G.; Albers, B.; Daubert, J. C.

    2010-01-01

    Little is known about the incidence of paroxysmal atrial tachycardias (PAT) in patients with heart failure (HF). The availability of cardiac resynchronization therapy (CRT) devices with extended diagnostics for AT enables continuous monitoring of PAT episodes. The aim of the study was to assess the

  12. On the origin of Mount Etna eruptive cycles and Stromboli volcano paroxysms: implications for an alternative mechanism of volcanic eruption

    CERN Document Server

    Nechayev, Andrei

    2014-01-01

    New mechanism of imbalance between magma column and fluid volume, accumulated in the magmatic system, is considered as a driving force of the volcanic eruption. Conditions of eruption based on this mechanism are used to explain main features of the volcanic activity (eruptive cycles and paroxysms) of the volcanoes Etna and Stromboli (Italy).

  13. Diagnosing Paroxysmal Atrial Fibrillation in Patients With Ischemic Strokes and Transient Ischemic Attacks Using Echocardiographic Measurements of Left Atrium Function

    DEFF Research Database (Denmark)

    Skaarup, Kristoffer Grundtvig; Christensen, Hanne; Høst, Nis;

    2016-01-01

    AF in patients with ischemic stroke (IS) and transient ischemic attack (TIA). We retrospectively analyzed 219 patients who after acute IS or TIA underwent a transthoracic echocardiographic examination. Patients were designated as patients with paroxysmal AF if they had one or more reported incidents...

  14. Benign Prostatic Hyperstatic Hyperplasia (BPH) (Beyond the Basics)

    Science.gov (United States)

    ... names for benign prostatic hyperplasia include benign prostatic hypertrophy, an enlarged prostate, and BPH. BPH occurs only ... prostatic hyperplasia" .) Alpha blockers — These medications relax the muscle of the prostate and bladder neck, which allows ...

  15. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2010-02-15

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman.

  16. Skeletal scintigraphy in benign and malignant disease

    International Nuclear Information System (INIS)

    This paper begins with a discussion of the technical factors in skeletal scintigraphy, including collimation, the use of three-phase bone scan, and single-photon emission computed tomography. Skeletal scintigraphy for benign conditions is commonly indicated for the patient presenting with pain (trauma, sports-related injury, posttraumatic pain syndrome, painful orthopedic prosthesis) and for the patient with abnormal laboratory test results (metabolic bone disease, Paget disease). For malignant conditions, the bone scan is useful in the evaluation of metastases in patients with extraosseous malignancies and primary bone tumors. The discussion addresses the various scan patterns seen in the more common tumors, such as prostate carcinoma, breast carcinoma, and lung carcinoma. Bone scintigraphy is an exquisitely sensitive modality. With some understanding of the techniques necessary for obtaining the optimal bone scan, and of the patterns that can be seen in various clinical conditions, the radiologist will find the bone scan a very specific tool for evaluating both benign and malignant diseases

  17. Idiopathic benign retroperitoneal cyst: a case report

    Directory of Open Access Journals (Sweden)

    Alzaraa Ahmed

    2008-02-01

    Full Text Available Abstract Introduction Retroperitoneal cysts are uncommon, with an estimated incidence of 1/5750 to 1/250,000. Case presentation A male patient was admitted with an abdominal pain, jaundice and fever. Clinical examination and investigations confirmed an idiopathic benign retroperitoneal cyst. He underwent surgery and was discharged after making good recovery. Conclusion Retroperitoneal cysts are very rare, and most of the time they are discovered incidentally. Patients may be asymptomatic or present with abdominal pain, referred pain to the legs or weight loss. Imaging may help diagnose these lesions, but surgery is the keystone in confirming the diagnosis. This case is very rare and very educational as it highlights an unusual presentation of a benign retroperitoneal cyst. In our patient, the course of the disease was unique as the patient presented with jaundice.

  18. Characteristics of benign lymphoadenosis of oral mucosa

    Institute of Scientific and Technical Information of China (English)

    Shu-Xia Li; Shi-Feng Yu; Kai-Hua Sun

    2005-01-01

    AIM: To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM).METHODS: The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemical SP staining in 64 paraffin-embedded tissue samples. Of them, 9 were from BLOM with dysplasia, 15 from BLOM without dysplasia,15 from oral squamous cell carcinoma (OSCC), 15 from oral precancerosis, and 10 from normal tissues. Cell proliferation, apoptosis and angiogenesis of tissue samples were also analyzed.RESULTS: The expression of Ki-67 in BLOM with dysplasia,oral precancerosis and OSCC was significantly higher than in BLOM without dysplasia and normal mucosa. The microvascular density (MVD) in BLOM with and without dysplasia, oral precancerosis, and OSCC was significantly higher than in normal mucosa. Apoptosis in BLOM and oral precancerosis was significantly higher than in OSCC and normal mucosa.CONCLUSION: Benign lymphoadenosis of oral mucosa has potentialities of cancerization.

  19. Endoscopic therapy of benign biliary strictures

    Institute of Scientific and Technical Information of China (English)

    Joel R Judah; Peter V Draganov

    2007-01-01

    Benign biliary strictures are being increasingly treated with endoscopic techniques. The benign nature of the stricture should be first confirmed in order to ensure appropriate therapy. Surgery has been the traditional treatment, but there is increasing desire for minimally invasive endoscopic therapy. At present, endoscopy has become the first line approach for the therapy of postliver transplant anastomotic strictures and distal (Bismuth Ⅰ and Ⅱ) post-operative strictures. Strictures related to chronic pancreatitis have proven more difficult to treat,and endoscopic therapy is reserved for patients who are not surgical candidates. The preferred endoscopic approach is aggressive treatment with gradual dilation of the stricture and insertion of multiple plastic stents. The use of uncovered self expandable metal stents should be discouraged due to poor long-term results. Treatment with covered metal stents or bioabsorbable stents warrants further evaluation. This area of therapeutic endoscopy provides an ongoing opportunity for fresh research and innovation.

  20. Serum uric acid levels correlate with recurrence of paroxysmal atrial fibrillation after catheter ablation

    Institute of Scientific and Technical Information of China (English)

    HE Xiao-nan; LI Song-nan; ZHAN Jin-liang; XIE Shuang-lun; ZHANG Zhi-jun; DONG Jian-zeng; YU Rong-hui

    2013-01-01

    Background Recently there has been a great deal of interest in the role of serum uric acid (SUA) in atrial fibrillation (AF).The objective of this study was to establish whether there is a relationship between levels of SUA and recurrence of paroxysmal AF after catheter ablation.Methods Three hundred and thirty patients diagnosed with paroxysmal AF were analyzed.Patients were categorized into quartiles on the basis of their pre-operative SUA measurement and follow-up,and Kaplan-Meier estimation with a Log-rank test was used for the analysis of the influence of SUA on the recurrence of AF.Pre-procedural clinical variables were correlated with the clinical outcome after ablation using multivariate Logistic analysis.A Cox proportional hazards model was used to estimate the relationship between SUA and the recurrence of AF.Results After a mean follow-up of (9.341±3.667) (range 3.0-16.3) months,recurrence rates from the lowest SUA quartile to the highest SUA quartile were 16.0%,26.4%,28.3%,and 29.3% respectively (P=0.014).After adjustment for gender,body mass index (BMI),hypertension,serum levels of high sensitivity C-reactive protein (hsCRP),triglyceride (TG),left atrial diameter (LA),estimated glomerular filtration rate (eGFR),and SUA,there was an increased risk of recurrence in subjects in the highest SUA quartile compared with those in the lowest quartile (hazard ratio 2.804,95% confidence interval 1.466-5.362,P=0.002).Following multivariate Logistical analysis,SUA was found to be an independent predictor of recurrence (hazard ratio 1.613,95% confidence interval 1.601-1.625,P=0.014).Conclusion In a retrospective study of patients with paroxysmal AF undergoing catheter ablation,elevated preoperative SUA levels were associated with a higher rate of recurrence of AF.

  1. Large Penile Mass With Unusual Benign Histopathology.

    Science.gov (United States)

    Johnson, Nate; Voznesensky, Maria; VerLee, Graham

    2015-09-01

    Pseudoepitheliomatous hyperplasia is an extremely rare condition presenting as a lesion on the glans penis in older men. Physical exam without biopsy cannot differentiate malignant from nonmalignant growth. We report a case of large penile mass in an elderly male with a history of lichen sclerosis, highly suspicious for malignancy. Subsequent surgical removal and biopsy demonstrated pseudoepitheliomatous hyperplasia, an unusual benign histopathologic diagnosis with unclear prognosis. We review the literature and discuss options for treatment and surveillance. PMID:26793536

  2. Large Penile Mass With Unusual Benign Histopathology

    Directory of Open Access Journals (Sweden)

    Nate Johnson

    2015-09-01

    Full Text Available Pseudoepitheliomatous hyperplasia is an extremely rare condition presenting as a lesion on the glans penis in older men. Physical exam without biopsy cannot differentiate malignant from nonmalignant growth. We report a case of large penile mass in an elderly male with a history of lichen sclerosis, highly suspicious for malignancy. Subsequent surgical removal and biopsy demonstrated pseudoepitheliomatous hyperplasia, an unusual benign histopathologic diagnosis with unclear prognosis. We review the literature and discuss options for treatment and surveillance.

  3. Case report: Benign porta hepatic schwannoma

    International Nuclear Information System (INIS)

    Schwannoma is a myelin sheath tumor that can occur almost anywhere in the body. The most common locations are the central nervous system, extremities, neck, mediastinum and retroperitoneum. Benign schwannomas in the porta hepatis are extremely rare and radiologically are diagnosed as either enlarged lymph nodes or bowel masses, such as gastrointestinal stromal tumors. In this location they usually produce symptoms by compressing adjacent structures and often present with obstructive jaundice. The preoperative diagnosis can be extremely difficult

  4. Percutaneous treatment of benign bile duct strictures

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)]. E-mail: martin.kocher@seznam.cz; Cerna, Marie [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Havlik, Roman [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Kral, Vladimir [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Gryga, Adolf [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Duda, Miloslav [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)

    2007-05-15

    Purpose: To evaluate long-term results of treatment of benign bile duct strictures. Materials and methods: From February 1994 to November 2005, 21 patients (9 men, 12 women) with median age of 50.6 years (range 27-77 years) were indicated to percutaneous treatment of benign bile duct stricture. Stricture of hepatic ducts junction resulting from thermic injury during laparoscopic cholecystectomy was indication for treatment in one patient, stricture of hepaticojejunostomy was indication for treatment in all other patients. Clinical symptoms (obstructive jaundice, anicteric cholestasis, cholangitis or biliary cirrhosis) have appeared from 3 months to 12 years after surgery. Results: Initial internal/external biliary drainage was successful in 20 patients out of 21. These 20 patients after successful initial drainage were treated by balloon dilatation and long-term internal/external drainage. Sixteen patients were symptoms free during the follow-up. The relapse of clinical symptoms has appeared in four patients 9, 12, 14 and 24 months after treatment. One year primary clinical success rate of treatment for benign bile duct stricture was 94%. Additional two patients are symptoms free after redilatation (15 and 45 months). One patient is still in treatment, one patient died during secondary treatment period without interrelation with biliary intervention. The secondary clinical success rate is 100%. Conclusion: Benign bile duct strictures of hepatic ducts junction or biliary-enteric anastomosis are difficult to treat surgically and endoscopically inaccessible. Percutaneous treatment by balloon dilatation and long-term internal/external drainage is feasible in the majority of these patients. It is minimally invasive, safe and effective.

  5. Paroxysmal Hemicrania

    Science.gov (United States)

    ... and trigeminal neuralgia (a condition of the 5th cranial nerve that causes sudden, severe pain typically felt on one side of the jaw or cheek) should receive treatment for each disorder. What is the prognosis? Many patients experience complete to near-complete relief of ...

  6. Environmentally benign silicon solar cell manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Tsuo, Y.S. [National Renewable Energy Lab., Golden, CO (United States); Gee, J.M. [Sandia National Labs., Albuquerque, NM (United States); Menna, P. [National Agency for New Technologies Energy and Environment, Portici (Italy); Strebkov, D.S.; Pinov, A.; Zadde, V. [Intersolarcenter, Moscow (Russian Federation)

    1998-09-01

    The manufacturing of silicon devices--from polysilicon production, crystal growth, ingot slicing, wafer cleaning, device processing, to encapsulation--requires many steps that are energy intensive and use large amounts of water and toxic chemicals. In the past two years, the silicon integrated-circuit (IC) industry has initiated several programs to promote environmentally benign manufacturing, i.e., manufacturing practices that recover, recycle, and reuse materials resources with a minimal consumption of energy. Crystalline-silicon solar photovoltaic (PV) modules, which accounted for 87% of the worldwide module shipments in 1997, are large-area devices with many manufacturing steps similar to those used in the IC industry. Obviously, there are significant opportunities for the PV industry to implement more environmentally benign manufacturing approaches. Such approaches often have the potential for significant cost reduction by reducing energy use and/or the purchase volume of new chemicals and by cutting the amount of used chemicals that must be discarded. This paper will review recent accomplishments of the IC industry initiatives and discuss new processes for environmentally benign silicon solar-cell manufacturing.

  7. Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix

    Science.gov (United States)

    Raś, Renata; Książek, Mariusz; Skręt-Magierło, Joanna; Kąziołka, Wojciech; Fudali, Ludmiła; Filipowska, Justyna; Skręt, Andrzej

    2016-01-01

    Benign metastasizing leiomyoma (BML) usually are situated in one organ, most often in lungs. BML patients typically have a history of uterine leiomyoma treated with hysterectomy, myomectomy or subtotal hysterectomy. The aim of the study was to present the case of a 53-year-old woman with triple location in the lungs, parametria and appendix. She had undergone a myomectomy 26 years earlier. In 2015, she was admitted to the surgical department because of abdominal pain, whereupon a cholecystectomy was performed. CT scans showed pelvic mass with pulmonary metastasis. Upon discharge the patient was referred to the Gynecology Clinic, where a laparotomy was performed. The intraoperative findings were: 1) uterus with multiple leiomyomas, 2) four tumors in the parametria, 3) tumor connected to the appendix. A subtotal hysterectomy, with a bilateral salpingo-oophorectomy, removal of the tumors from the parametria and appendectomy was performed. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining (strongly positive for estrogen receptors and SMA, while Ki67 was very low, below 1%). Upon postoperative recovery, the patient was referred to the Thoracic Surgery Department. During the thoracotomy, multiple nodes, surrounded by lung parenchyma, were revealed. Wedge resection was performed, for localized pulmonary lesions, and sent for pathological examination. The final pathological diagnosis was benign metastasizing leiomyomatosis. In conclusion, the triple location of BML could possibly be a result of a parallel different metastasizing mechanism, although it is impossible to exclude one mechanism, which may be the cause of the metastases in three locations.

  8. Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix

    Science.gov (United States)

    Raś, Renata; Książek, Mariusz; Skręt-Magierło, Joanna; Kąziołka, Wojciech; Fudali, Ludmiła; Filipowska, Justyna; Skręt, Andrzej

    2016-01-01

    Benign metastasizing leiomyoma (BML) usually are situated in one organ, most often in lungs. BML patients typically have a history of uterine leiomyoma treated with hysterectomy, myomectomy or subtotal hysterectomy. The aim of the study was to present the case of a 53-year-old woman with triple location in the lungs, parametria and appendix. She had undergone a myomectomy 26 years earlier. In 2015, she was admitted to the surgical department because of abdominal pain, whereupon a cholecystectomy was performed. CT scans showed pelvic mass with pulmonary metastasis. Upon discharge the patient was referred to the Gynecology Clinic, where a laparotomy was performed. The intraoperative findings were: 1) uterus with multiple leiomyomas, 2) four tumors in the parametria, 3) tumor connected to the appendix. A subtotal hysterectomy, with a bilateral salpingo-oophorectomy, removal of the tumors from the parametria and appendectomy was performed. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining (strongly positive for estrogen receptors and SMA, while Ki67 was very low, below 1%). Upon postoperative recovery, the patient was referred to the Thoracic Surgery Department. During the thoracotomy, multiple nodes, surrounded by lung parenchyma, were revealed. Wedge resection was performed, for localized pulmonary lesions, and sent for pathological examination. The final pathological diagnosis was benign metastasizing leiomyomatosis. In conclusion, the triple location of BML could possibly be a result of a parallel different metastasizing mechanism, although it is impossible to exclude one mechanism, which may be the cause of the metastases in three locations. PMID:27582687

  9. [Do envious people show better performance?: Focusing on the function of benign envy as personality trait].

    Science.gov (United States)

    Sawada, Masato; Fujii, Tsutomu

    2016-06-01

    This study focused on the differences between two, subtypes of envy known as "benign envy" and "malicious envy" as personality traits, and examined the effects of these traits on academic achievement. Two hundred fifty-one university students participated in the study. Both benign envy and malicious envy were found to be independent as also found in a previous study by Lange & Crusius (2015), and a high criterion-related validity was revealed by an association with characteristic variables such as dispositional envy and self-esteem. The students with higher levels of benign envy were found to set goals higher, and as a result achieved higher levels of academic performance. In contrast, no such effect was found for malicious envy. The importance of focusing more attention on the positive aspects of the emotion of envy is discussed. PMID:27476271

  10. Mutations in the Gene PRRT2 Cause Paroxysmal Kinesigenic Dyskinesia with Infantile Convulsions

    Directory of Open Access Journals (Sweden)

    Hsien-Yang Lee

    2012-01-01

    Full Text Available Paroxysmal kinesigenic dyskinesia with infantile convulsions (PKD/IC is an episodic movement disorder with autosomal-dominant inheritance and high penetrance, but the causative genetic mutation is unknown. We have now identified four truncating mutations involving the gene PRRT2 in the vast majority (24/25 of well-characterized families with PKD/IC. PRRT2 truncating mutations were also detected in 28 of 78 additional families. PRRT2 encodes a proline-rich transmembrane protein of unknown function that has been reported to interact with the t-SNARE, SNAP25. PRRT2 localizes to axons but not to dendritic processes in primary neuronal culture, and mutants associated with PKD/IC lead to dramatically reduced PRRT2 levels, leading ultimately to neuronal hyperexcitability that manifests in vivo as PKD/IC.

  11. Refractory Case of Paroxysmal Autonomic Instability With Dystonia Syndrome Secondary to Hypoxia.

    Science.gov (United States)

    Kern, John; Bodek, Daniel; Niazi, Osama Tariq; Maher, James

    2016-02-01

    Paroxysmal autonomic instability with dystonia (PAID) is a syndrome commonly related to traumatic brain injury (TBI) and rarely to anoxia associated with symptoms of dystonia, tachycardia, tachypnea, and diaphoresis. This is a case of a 20-year-old man who was stabbed in the heart. He underwent surgical repair of a ventricular septal defect and mitral valve replacement. Postoperatively, he developed dystonia with tachycardia and tachypnea consistent with PAID syndrome, secondary to prolonged hypoxia. Traditionally, this poorly understood syndrome is treated with morphine, clonazepam, and nonselective β-blockers. Second-line medications commonly used are baclofen, dantrolene, and gabapentin, which are aimed at the dystonia itself. In this case, both first- and second-line agents were ineffective. A 72-hour dexmedetomidine infusion resulted in complete resolution of symptoms. This is the first case of anoxia-induced PAID syndrome to be effectively treated with dexmedetomidine, which was previously used in a case induced by TBI. PMID:26867852

  12. [Anesthetic Management of a Patient who Developed Intraoperative Paroxysmal Supraventricular Tachycardia with Pulseless Electric Activity].

    Science.gov (United States)

    Hakone, Masako; Yamada, Tatsuya; Motoyasu, Akira; Kasuya, Youhei; Yorozu, Tomoko

    2016-06-01

    A 75-year-old woman was scheduled to undergo an ileus operation under general combined with epidural anesthesia. Preoperative electrocardiogram (ECG) showed first-degree atrioventricular block. The patient received no preoperative antiarrhythmic medication. During surgery, paroxysmal supraventricular tachycardia (PSVT) occurred unexpectedly with radial artery pulsation disappearing, indicating pulseless electric activity (PEA). After a five-second episode of PSVT, her sinus rhythm recovered spontaneously. However, the patient had repeated short duration of PSVT with PEA. Continuous infusion of ultra-short-acting β-blocker landiolol successfully terminated the PSVT, and sinus rhythm was restored. Postoperative ECG showed sinus rhythm. This case report indicates that β-blocker can be a drug of choice in patients with PSVT associated with PEA. PMID:27483664

  13. Eculizumab before and after allogeneic hematopoietic stem cell transplantation in a patient with paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    Hakan Göker

    2011-09-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is characterized by the triad of intravascular hemolysis, venous thrombosis, and cytopenia. Treatment of PNH is generally supportive. Bone marrow transplantation is the only curative therapy for PNH, but is associated with significant morbidity and mortality. Herein, we present a patient with PNH that received eculizumab, a humanized monoclonal antibody that blocks activation of the terminal complement at C5, before and immediately following allogeneic peripheral stem cell transplantation. Prior to hematopoietic stem cell transplantation eculizumab treatment markedly reduced hemolysis and transfusion requirement; however, 1 d post transplantation a hemolytic episode occured, which was successfully stopped with eculizumab re-treatment. Afterwards the patient did not require additional transfusions. The results of this study indicate that early administration of eculizumab may be a safe and effective therapy for hemolytic episodes associated with allogeneic peripheral stem cell transplantation in patients with PNH.

  14. Effects of Combination Therapy of Amiodarone and Bisoprolol in Patients With Paroxysmal Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    Rong-qiang YAN; Fang-sheng ZHENG; Qing-hai ZHANG

    2009-01-01

    Objectives To examine the long-term efficacy of combination therapy of amiodarone and bisoprolol in patients with paroxysmal atrial fibrillation (P-AF). Methods Eighty-eight patients with P-AF were divided into two groups: 44 pa-tients treated with bisoprolol and amiodarone were enrolled in group A; 44 patients treated with amiodarone alone were enrolled in group B. Survival rates, rates of conversing to permanent atrial fibrillation (AF), subjective symptom im-provement rates and secondary bradyarrhythmia rates of the two groups were measured and analyzed. Results At 12 and 24 months, the survival rates for patients free from atrial fibrillation recurrence were 75 % and 59. 1% in group A, and 54.5 % and 36.4 % in group B (P0.05, group A vs. Group B). Conclusions In patients with P-AF, bisoprolol appears to enhance the efficacy of amiodarone therapy in maintaining sinus rhythm and improving subjective symptoms.

  15. Shapiro's syndrome: Defining the clinical spectrum of the spontaneous paroxysmal hypothermia syndrome.

    Science.gov (United States)

    Tambasco, Nicola; Belcastro, Vincenzo; Prontera, Paolo; Nigro, Pasquale; Donti, Emilio; Rossi, Aroldo; Calabresi, Paolo

    2014-07-01

    Shapiro Syndrome (SS) is a rare condition of spontaneous periodic hypothermia, corpus callosum agenesis (ACC) and hyperhidrosis which can occur at any age. The variant form refers to the phenotypic SS without ACC. We reported the case of SS variant on a 4-year-old boy who presented from his first year frequent episodes of hypothermia lasting 2-3 h with core rectal temperatures Hyperhidrosis, another hallmark of SS, was present in only 42.3% of the cases and mainly in adult onset. The presence of SS in siblings of different genders suggests an autosomal recessive inheritance model, however a gonadic mosaicism responsible for an autosomal de novo mutation cannot be ruled out. From our review of well documented cases of SS, we conclude that only the episodic and spontaneous paroxysmal hypothermia should be considered the defining hallmark of typical and variant SS. This can be important to define the clinical manifestation of SS improving the early diagnosis. PMID:24594427

  16. The coexistence of paroxysmal hemicrania and temporomandibular disorder: Importance of multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    André Luís Porporatti

    2014-01-01

    Full Text Available Paroxysmal hemicrania (PH is a trigeminal autonomic cephalalgia, a rare primary headache characterized by unilateral periorbital and/or temporal attacks of severe intensity and short duration. In this situation, the determination of a correct diagnosis is crucial for the establishment of a proper management strategy. In the case of head and facial pain, this step is usually a big challenge since many conditions share the same features, as some primary headaches and temporomandibular disorders (TMD. The relationship between PH and TMD has not been determined. This paper describes a case of a female patient diagnosed with TMD and presenting concomitant headache attacks fulfilling the International Headache Society′s criteria for PH. It is also emphasized the importance of dentist in this scenario, for many times responsible for the initial diagnosis of facial/head pain. Moreover, it is presented an integrated and simultaneously approach of both conditions, PH and TMD.

  17. [Anesthetic Management of a Patient who Developed Intraoperative Paroxysmal Supraventricular Tachycardia with Pulseless Electric Activity].

    Science.gov (United States)

    Hakone, Masako; Yamada, Tatsuya; Motoyasu, Akira; Kasuya, Youhei; Yorozu, Tomoko

    2016-06-01

    A 75-year-old woman was scheduled to undergo an ileus operation under general combined with epidural anesthesia. Preoperative electrocardiogram (ECG) showed first-degree atrioventricular block. The patient received no preoperative antiarrhythmic medication. During surgery, paroxysmal supraventricular tachycardia (PSVT) occurred unexpectedly with radial artery pulsation disappearing, indicating pulseless electric activity (PEA). After a five-second episode of PSVT, her sinus rhythm recovered spontaneously. However, the patient had repeated short duration of PSVT with PEA. Continuous infusion of ultra-short-acting β-blocker landiolol successfully terminated the PSVT, and sinus rhythm was restored. Postoperative ECG showed sinus rhythm. This case report indicates that β-blocker can be a drug of choice in patients with PSVT associated with PEA.

  18. [About military medical examination of patients with paroxysmal supraventricular reciprocating tachycardia].

    Science.gov (United States)

    Simonenko, V B; Kuvshinov, K É; Steklov, V I; Gorbatov, E A; Morozov, D A; Emel'ianenko, M V

    2013-11-01

    140 patients with paroxysmal supraventricular reciprocating tachycardia were treated with the help of radio frequency ablation; results of treatment were analyzed. First group consisted of 76 patients with atrioventricular nodal reentrant tachycardia, second group--64 patients with atrioventricular reentrant tachycardia accompanied with WPW syndrome and preexcitation syndrome. In first group the operation ended up with success in 94.7%, in the second group--90.6%, after the second operation--100% and 96.1% relatively. Different complications in patients from the first group occured in 3.9%, in the second group--in 6.3%. Taking into account high effectivennes and safety of radio frequency ablation, it is recommended to reconsider principals of categorisation of fitness for service among conscripts and servicemen doing call-up and under the contract military service and also citizens, entering military educational institutions.

  19. Paroxysmal posterior variant alien hand syndrome associated with parietal lobe infarction: case presentation.

    Science.gov (United States)

    Demiryürek, Bekir Enes; Gündogdu, Aslı Aksoy; Acar, Bilgehan Atılgan; Alagoz, Aybala Neslihan

    2016-10-01

    Alien hand syndrome (AHS) is an involuntary and rare neurological disorder emerges at upper extremity. AHS is a disconnection syndrome with the symptoms of losing sense of agency and sense of ownership, and presence of involuntary autonomic motor activity. There are frontal, callosal and posterior types of AHS and each of them occurs depend on the lesions of different of the brain. Posterior variant is a rarely encountered AHS type compared to others. AHS, generally regarded as persistent, but rarely maybe observed as paroxysmal. In this article, we present 71 year old patient with right posterior parietal lobe infarction and developed posterior variant AHS on left arm 1 month after discharge from the hospital. To discriminate AHS from conditions such as extrapyramidal movement disorders and epileptic seizures that take part in differential diagnosis should be kept in mind by the clinicians. Wrong and unnecessary treatments could be prevented in this way. PMID:27668023

  20. Why Am I Dizzy?

    Medline Plus

    Full Text Available Video: "Why Am I Dizzy?" A few of the more common balance orders that affect older adults ... disease, and benign paroxysmal positional vertigo, or BPPV. Video excerpts courtesy of Johns Hopkins Center for Hearing ...

  1. Quantitative evaluation of benign meningioma and hemangiopericytoma with peritumoral brain edema by 64-slice CT perfusion imaging

    Institute of Scientific and Technical Information of China (English)

    REN Guang; CHEN Shuang; WANG Yin; ZHU Rui-jiang; GENG Dao-ying; FENG Xiao-yuan

    2010-01-01

    Background Hemangiopericytomas (HPCs) have a relentless tendency for local recurrence and metastases,differentiating between benign meningiomas and HPCs before surgery is important for both treatment planning and the prognosis appraisal.The purpose of this study was to evaluate the correlations between CT perfusion parameters and microvessel density (MVD) in extra-axial tumors and the possible role of CT perfusion imaging in preoperatively differentiating benign meningiomas and HPCs.Methods Seventeen patients with benign meningiomas and peritumoral edema, 12 patients with HPCs and peritumoral edema underwent 64-slice CT perfusion imaging pre-operation.Perfusion was calculated using the Patlak method.The quantitative parameters, include cerebral blood volume (CBV), permeability surface (PS) of parenchyma, peritumoral edema among benign meningiomas and HPCs were compared respectively.CBV and PS in parenchyma, peritumoral edema of benign meningiomas and HPCs were also compared to that of the contrallateral normal white matter respectively.The correlations between CBV, PS of tumoral parenchyma and MVD were examined.Results The value of CBV and PS in parenchyma of HPCs were significantly higher than that of benign meningiomas (P<0.05), while the values of CBV and PS in peritumoral edema of benign meningiomas and HPCs were not significantly different (P >0.05).MVD in parenchyma of HPCs were significantly higher than that of benign meningiomas (P<0.05).There were positive correlations between CBV and MVD (r=0.648, P<0.05), PS and MVD (r=0.541, P<0.05) respectively.Furthermore, the value of CBV and PS in parenchyma of benign meningiomas and HPCs were significantly higher than that of contrallateral normal white matter (P<0.05), the value of CBV in peritumoral edema of benign meningiomas and HPCs were significantly lower than that of contrallateral normal white matter (P<0.05), while the value of PS in peritumoral edema of benign meningiomas and HPCs were not

  2. An old male patient with paroxysmal chest distress,shortness of breath and edema of both lower extremities (the 27th case)

    Institute of Scientific and Technical Information of China (English)

    陈琪

    2008-01-01

    @@ The patient,a 78-year-old male,was admitted to the hospital on Nov.15,2007 because of paroxysmal chest distress and shortness of breath for 11years and edema of lower extremities for 3 days.The patient began to suffer from paroxysmal chest distress and shortness of breath after exertion in 1997,then these symptoms recurred frequently,which lasted 10 min to several hours.

  3. Inter-observer agreement of canine and feline paroxysmal event semiology and classification by veterinary neurology specialists and non-specialists

    DEFF Research Database (Denmark)

    Packer, Rowena M A; Berendt, Mette; Bhatti, Sofie;

    2015-01-01

    neurology specialists and non-specialists) on the description and classification of videos depicting paroxysmal events, without knowing any results of diagnostic workup. An online questionnaire study was conducted, where participants watched 100 videos of dogs and cats exhibiting paroxysmal events...... low levels of agreement described here highlight the need for further discussions between neurology experts regarding classifying and describing epileptic seizures, and additional training of non-specialists to facilitate accurate diagnosis. There is a need for diagnostic tools (e...

  4. Spatial contrast sensitivity in benign intracranial hypertension.

    Science.gov (United States)

    Bulens, C; Meerwaldt, J D; Koudstaal, P J; Van der Wildt, G J

    1988-01-01

    Spatial Contrast Sensitivity (CS) was studied in 20 patients with benign intracranial hypertension (BIH). At presentation CS loss was found in 43% of the eyes, and impairment of visual acuity attributed to BIH in only 16%. Nine patients had blurred vision or visual obscurations, all of whom had abnormal CS. The clinical application of CS measurement in BIH for monitoring the progression or regression of the disease is illustrated by serial measurements in 11 patients. Progressive visual loss in longstanding papilloedema and improvement of visual function in subsiding papilloedema can occur without any change in Snellen acuity or visual field charting. PMID:3225588

  5. Laser Applications for Benign Prostate Hyperplasia

    Directory of Open Access Journals (Sweden)

    Akyüz O.

    2012-02-01

    Full Text Available Transurethral prostate resection is still accepted as golden standard treatment modality for the management of benign prostate hyperplasia (BPH. Laser represents the most promising option among the minimal invasive alternatives. Laser with different wavelengths can provide coagulation, enucleation or vaporization on the target tissues. The significant advantages of laser applications are lesser complication rates of mainly retrograde ejaculation and erectile dysfunction, shorter hospitalization and catheterization times, and applicability in patients on anticoagulant treatment. However, further randomized multicenter trials are certainly required for laser to become a candidate for golden standard treatment for BPH.

  6. Endoscopic management of benign biliary strictures

    Institute of Scientific and Technical Information of China (English)

    Kavel; H; Visrodia; James; H; Tabibian; Todd; H; Baron

    2015-01-01

    Endoscopic management of biliary obstruction has evolved tremendously since the introduction of flexible fiberoptic endoscopes over 50 years ago. For the last several decades, endoscopic retrograde cholangiopancreatography(ERCP) has become established as the mainstay for definitively diagnosing and relieving biliary obstruction. In addition, and more recently, endoscopic ultrasonography(EUS) has gained increasing favor as an auxiliary diagnostic and therapeutic modality in facilitating decompression of the biliary tree. Here, we provide a review of the current and continually evolving role of gastrointestinal endoscopy, including both ERCP and EUS, in the management of biliary obstruction with a focus on benign biliary strictures.

  7. Spatial contrast sensitivity in benign intracranial hypertension.

    Science.gov (United States)

    Bulens, C; Meerwaldt, J D; Koudstaal, P J; Van der Wildt, G J

    1988-10-01

    Spatial Contrast Sensitivity (CS) was studied in 20 patients with benign intracranial hypertension (BIH). At presentation CS loss was found in 43% of the eyes, and impairment of visual acuity attributed to BIH in only 16%. Nine patients had blurred vision or visual obscurations, all of whom had abnormal CS. The clinical application of CS measurement in BIH for monitoring the progression or regression of the disease is illustrated by serial measurements in 11 patients. Progressive visual loss in longstanding papilloedema and improvement of visual function in subsiding papilloedema can occur without any change in Snellen acuity or visual field charting.

  8. Benign symmetric lipomatosis of the knees

    Institute of Scientific and Technical Information of China (English)

    Zhiqiang Yin; Di Wu; Yixin Ge; Meihua Zhang; Zhigang Bi; Dan Luo

    2008-01-01

    Benign symmetric lipomatosis(BSL) is a rare disease characterized by the presence of multiple, symmetric and nonencapsulated fat masses in the face, neck and other areas. It is commonly seen in middle-aged Caucasian Mediterranean males, while its etiology is still not clear. The majority of the patients with BSL have a history of alcohol abuse and hepatopathy. BSL of the limbs is very rare. This article reports a unique case of a 60-year-old Chinese woman with involvement of the knees confirmed by the results of magnetic resonance imaging(MRI) and histopathology, which was not described previously in published literatures.

  9. Clarithromycin Culprit of Benign Intracranial Hypertension

    Directory of Open Access Journals (Sweden)

    Habib Rehman Khan

    2015-01-01

    Full Text Available Benign intracranial hypertension is characterized with increase in CSF opening pressure with no specific etiology. It is predominantly found in women of child bearing age and particularly in individuals with obesity. Visual disturbances or loss and associated headaches are common and can lead to blindness if left untreated. Diagnosis can be achieved once other causes of visual loss, headaches and high opening pressures are excluded. Management consists of serial optic disc assessments although no specific treatment is available despite recent trials using carbonic anhydrase inhibitors. Diet modification and weight management can help in therapy.

  10. Benign intracranial hypertension diagnosed with bilateral papilloedema

    Directory of Open Access Journals (Sweden)

    K. C. Phillips

    2013-12-01

    Full Text Available This article presents a case of benign intracranial hypertension (BIH diagnosed from the presence of papilloedema. This potentially sight-threatening condition particularly affects younger obese females and can be idiopathic, caused by adverse reaction to certain prescription medications or by systemic disease. Prompt treatment is essentialto avoid optic atrophy and low energy diet and exercise forms part of long-term treatment to avoid relapse. Optometrists can play a critical primary health care role in the detection of papilloedema and referring appropriately.

  11. OTC tamsulosin for benign prostatic hyperplasia.

    Science.gov (United States)

    2010-10-01

    Earlier this year, tamsulosin, an alpha blocker previously only available on prescription, became available for sale by pharmacists as a treatment for functional symptoms of benign prostatic hyperplasia (BPH) in men aged 45-75 years (Flomax Relief MR - Boehringer Ingelheim). A television advert for the over-the-counter (OTC) product claims that it is a "simple and effective" treatment that can relieve symptoms within 1 week, allowing the user to "take control of your annoying pee problems".¹ Here we review the evidence on tamsulosin and assess whether its availability as an OTC product confers worthwhile advantages. PMID:20926447

  12. Expression and Clinical Significance of Vascular Endothelial Growth Factor in Benign and Malignant Tissues of Breast

    Institute of Scientific and Technical Information of China (English)

    XU Wei-gu; LIU Yang; WANG Gang; SONG Ji-ning; YANG Xiao-qing; WANG Wen-ya

    2008-01-01

    Objective:To detect the expression of vascular endothelial growth factor(VEGF)and microvessel density(MVD)count in breast benign affection,breast atypical hyperplasia and breast carcinoma in situ,and to clarify the relationship between VEGF expression,MVD and the clinicopathological features of these diseases. Methods:The expression of VEGF and MVD count in 115 cases breast benign diseases(including 40 breast fibroid tumor,40 breast cystic hyperplasia and 35 intraductal papilloma,19 breast atypical hyperplasias and 32 breast carcinomas in situ were examined by immunohistochemistry staining(SP-method). Results:The positive rate of VEGF in breast benign diseases,breast atypical hyperplasia and breast carcinoma in situ were 21.74%(25/115)、31.58.%(6/19)and 53.13%(17/32)respectively.It was the lowest in breast benign affection group,and was the highest breast carcinoma in situ group.The expression of VEGF increased gradually in the three groups(P<0.05).The MVD count of the three groups were 14.41±2.59,18.89±4.47 and 21.13±4.12 respectively,It was the lowest in breast benign affection group,and was the highest breast carcinoma in situ group.The MVD count of the three groups increased gradually(P<0.05).In VEGF positive group,MVD count was 19.41±4.78;In VEGF negative group,MVD count was 14.91±3.15.The MVD count was higher in VEGF positive group than that in VEGF negative group(P<0.05). Conclusion:The results of this study suggested that VEGF could promote microvessel growth in breast tumors.The occurrence and progression of breast cancer might be related with the expression of VEGF.

  13. Benign cementoblastoma (true cementoma in a cat

    Directory of Open Access Journals (Sweden)

    Lenin A Villamizar-Martinez

    2016-01-01

    Full Text Available Case summary A 10-year-old castrated male domestic shorthair cat was presented for assessment of a gingival mass surrounding the left maxillary third and fourth premolar teeth. The mass was surgically removed by means of a marginal rim excision, and the tissue was submitted for histological assessment. It was identified as a benign cementoblastoma (true cementoma. There was proliferation of mineralized eosinophilic material with multiple irregularly placed lacunae and reversal lines, reminiscent of cementum. The cat recovered uneventfully from the anesthesia, and there was no evidence of tumor recurrence 6 months after surgery. Relevance and novel information Cementoblastomas (true cementomas in domestic animals are rare, with just a few reports in ruminants, monogastric herbivores and rodents. Cementoblastoma is considered a benign tumor that arises from the tooth root. The slow, expansive and constant growth that characterizes these masses may be accompanied by signs of oral discomfort and dysphagia. This case report is intended to increase knowledge regarding this tumor in cats and also highlights the importance of complete excision of the neoplasm. To our knowledge, there are no previous reports in the literature of cementoblastoma in the cat.

  14. CT evaluation of primary benign retroperitoneal tumor

    Energy Technology Data Exchange (ETDEWEB)

    Hayasaka, Kazumasa; Yamada, Tomonori; Saitoh, Yasuhiro; Yoshikawa, Daihei; Aburano, Tamio; Hashimoto, Hiroshi; Yachiku, Sunao (Asahikawa Medical Coll., Hokkaido (Japan))

    We studied CT patterns in 21 cases of primary benign retroperitoneal tumor including teratoma in nine cases, schwannoma in six, leiomyoma in three, lipoma in one, lymphangioma in one, and neurofibroma in one. The tumors were analyzed for size, internal homogeneity, CT density, calcification, border with neighboring organs, and contrast enhancement (CE). The mean diameter of the tumors was 10.2 ([+-]4.8) cm. Internal homogeneous distribution was observed in 33%, calcification in 43%, and well-defined border in 86%. The CT density and calcification were compared according to histology, and the results were as follows: teratoma showed fat density in 78%, water density in 100%, and calcification in 89%; schwannoma showed water density in 100% and septal CE in 33%; leiomyoma showed soft tissue density in 100%, CE in 100%, and water density in 33%; lipoma showed fat density and calcification; and lymphangioma and neurofibroma showed water density. Internal homogeneity, fat density, cyst formation, and calcification are considered to be important predictors of primary benign retroperitoneal tumor on CT. (author).

  15. The role of MRS in the differentiation of benign and malignant soft tissue and bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Doganay, Selim, E-mail: selimdoganay@gmail.com [Erciyes University, Faculty of Medicine, Department of Radiology, Kayseri (Turkey); Altinok, Tayfun; Alkan, Alpay; Kahraman, Bayram; Karakas, Hakki Muammer [Inonu University, Faculty of Medicine, Department of Radiology, Malatya (Turkey)

    2011-08-15

    Objective: The aim of our study was to investigate the value of choline in the discrimination of benign and malignant soft tissue and bone tumors. Materials and methods: The study group consisted of thirty subjects with bone or soft tissue tumors larger than 1.5 cm in diameter. The experiments were performed in a 1.5 T MR scanner. Coils were selected according to specific locations. A single-voxel MRS was performed for three different TE (time to echo) (31, 136, 272 ms). The volume of interest was positioned on the brightest enhancement. The presence of a cholin peak on at least 2 of these spectrums was considered as the marker of malignancy. The sensitivity, specificity and accuracy of the MRS in the detection and diagnosis of malignant lesions were calculated. The reproducibility of MRS and histopathological results were tested with kappa statistics. Results: Histopathologically, 18 (60%) of the lesions were classed as malignant whereas 12 (40%) were classed as benign. With MRS, 15 (50%) of these lesions were classed as malignant and 15 (50%) as benign. Two patients who were found spectroscopically to have malignant tumors were shown histopathologically to have benign types. Five patients with an MRS showing a benign type were classed with malignant types in histopathological examinations. MRS had a sensitivity rate of 72.2%, specificity of 83.3%, and an accuracy rate of 76.6% in detecting malignant bone and soft tissue tumors. The interrater reliability of both techniques had a kappa value of 0.533. Conclusions: MRS may help in the differentiation of benign and malignant soft tissue and bone tumors.

  16. The application of nonlinear metrics to assess organization differences in short recordings of paroxysmal and persistent atrial fibrillation

    International Nuclear Information System (INIS)

    Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. In the first stages of the disease, AF may terminate spontaneously and it is referred to as paroxysmal AF. The arrhythmia is called persistent AF when external intervention is required to its termination. In the present work, a method to non-invasively assess AF organization has been applied to discern between paroxysmal and persistent AF episodes at any time. Previous works have suggested that the probability of AF termination is inversely related to the number of reentries wandering throughout the atrial tissue. Given that it has also been hypothesized that the number of reentries is directly correlated with AF organization, a fast and robust method able to assess organization differences in AF could be of great interest. In fact, the distinction between paroxysmal and persistent episodes in patients without previously known AF history, making use of short ECG recordings, could contribute to taking earlier decisions on AF management in daily clinical practice, without the need to require 24 h or 48 h Holter recordings. The method was based on a nonlinear regularity index, such as sample entropy (SampEn), and evidenced to be a significant discriminator of the AF type. Its diagnostic accuracy of 91.80% was demonstrated to be superior to previously proposed parameters, such as dominant atrial frequency (DAF) and fibrillatory waves amplitude, and to others analyzed for the first time in this context, such as atrial activity mean power, 3 dB bandwidth around the DAF, first harmonic frequency, harmonic exponential decay, etc. Additionally, according to previous invasive works, paroxysmal AF episodes (0.0716 ± 0.0143) presented lower SampEn values and, consequently, more organized activity, than persistent episodes (0.1080 ± 0.0145)

  17. No incremental benefit of multisite atrial pacing compared with right atrial pacing in patients with drug refractory paroxysmal atrial fibrillation

    OpenAIRE

    Levy, T; Walker, S; Rex, S; Rochelle, J; Paul, V.

    2001-01-01

    OBJECTIVE—To evaluate the incremental antifibrillatory effect of multisite atrial pacing compared with right atrial pacing in patients with drug refractory paroxysmal atrial fibrillation paced for arrhythmia prevention alone.
METHODS—In 20 of these patients (mean (SD) age 64 (8) years; 14 female, six male), a single blinded randomised crossover study was performed to investigate the incremental benefit of one month of multisite atrial pacing compared with one month of right atrial pacing. Out...

  18. Detection of somatic mutations of the PIG-A gene in Brazilian patients with paroxysmal nocturnal hemoglobinuria

    OpenAIRE

    R. Franco de Carvalho; Arruda, V R; S.T.O. Saad; F.F. Costa

    2001-01-01

    Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal syndrome characterized by intravascular hemolysis mediated by complement, thrombotic events and alterations in hematopoiesis. Basically, the molecular events which underlie the complexity of the syndrome consist of the absence of the glycosylphosphatidylinositol (GPI) anchor as a consequence of somatic mutations in the PIG-A gene, located on the X chromosome. The GPI group is responsible for the attachment of many proteins to the...

  19. Prolonged and fractionated right atrial electrograms during sinus rhythm in patients with paroxysmal atrial fibrillation and sick sinus node syndrome.

    Science.gov (United States)

    Tanigawa, M; Fukatani, M; Konoe, A; Isomoto, S; Kadena, M; Hashiba, K

    1991-02-01

    Intraatrial catheter mapping of the right atrium was performed during sinus rhythm in 92 patients: Group I = 43 control patients without paroxysmal atrial fibrillation or sick sinus node syndrome; Group II = 31 patients with paroxysmal atrial fibrillation but without sick sinus node syndrome; and Group III = 18 patients with both paroxysmal atrial fibrillation and sick sinus node syndrome. Atrial electrograms were recorded at 12 sites in the right atrium. The duration and number of fragmented deflections of the atrial electrograms were quantitatively measured. The mean duration and number of fragmented deflections of the 516 atrial electrograms in Group I were 74 +/- 11 ms and 3.9 +/- 1.3, respectively. The criteria for an abnormal atrial electrogram were defined as a duration of greater than or equal to 100 ms or eight or more fragmented deflections, or both. Abnormal atrial electrograms were observed in 10 patients (23.3%) in Group I, 21 patients (67.7%) in Group II and 15 patients (83.3%) in Group III (Group II versus Group I, p less than 0.001; Group III versus Group I, p less than 0.001). The mean number of abnormal electrograms per patient with an abnormal electrogram was 1.3 +/- 0.7 in Group I, 2.5 +/- 1.9 in Group II and 3.5 +/- 2.5 in Group III (Group I versus Group II, p less than 0.01; Group II versus Group III, p less than 0.05). A prolonged and fractionated atrial electrogram characteristic of paroxysmal atrial fibrillation can be closely related to the vulnerability of the atrial muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Polymorphism of the complement receptor 1 gene correlates with the hematologic response to eculizumab in patients with paroxysmal nocturnal hemoglobinuria

    Science.gov (United States)

    Rondelli, Tommaso; Risitano, Antonio M.; de Latour, Régis Peffault; Sica, Michela; Peruzzi, Benedetta; Ricci, Patrizia; Barcellini, Wilma; Iori, Anna Paola; Boschetti, Carla; Valle, Veronica; Frémeaux-Bacchi, Veronique; De Angioletti, Maria; Socie, Gerard; Luzzatto, Lucio; Notaro, Rosario

    2014-01-01

    Complement blockade by eculizumab is clinically effective in hemolytic paroxysmal nocturnal hemoglobinuria. However, the response is variable and some patients remain dependent on red blood cell transfusions. In 72 patients with hemolytic paroxysmal nocturnal hemoglobinuria on eculizumab we tested the hypothesis that response may depend on genetic polymorphisms of complement-related genes. We found no correlation between the complement component C3 genotypes and the need for blood transfusions. On the other hand, we found a significant correlation with the HindIII polymorphism of a complement regulatory gene, the complement receptor 1 (CR1) gene. At this locus two co-dominant alleles are known, of which H (common) is associated with high expression, whereas L (rare) is associated with low expression of CR1 on red blood cells. Patients who still needed blood transfusion on eculizumab accounted for 18% of the H/H homozygotes, 33% of the H/L heterozygotes and 68% of the L/L homozygotes (P=0.016). Thus, patients with paroxysmal nocturnal hemoglobinuria who have the L/L genotype are seven times more likely to be sub-optimal responders to eculizumab. Both in vitro and in vivo we found that the CR1 HindIII genotype correlates with the abundance of paroxysmal nocturnal hemoglobinuria red cells that have bound C3, and with the kinetics of C3 binding. These results are consistent with the notion that by affecting C3 binding the CR1 genotype influences the response to eculizumab treatment, and this emerges as a novel example of pharmacogenetics. PMID:24038027

  1. Alteration of the P-wave non-linear dynamics near the onset of paroxysmal atrial fibrillation.

    OpenAIRE

    A. Martínez; Abásolo, D; Alcaraz, R; Rieta, JJ

    2015-01-01

    The analysis of P-wave variability from the electrocardiogram (ECG) has been suggested as an early predictor of the onset of paroxysmal atrial fibrillation (PAF). Hence, a preventive treatment could be used to avoid the loss of normal sinus rhythm, thus minimising health risks and improving the patient's quality of life. In these previous studies the variability of different temporal and morphological P-wave features has been only analysed in a linear fashion. However, the electrophysiologica...

  2. Electrophysiological characteristics of paroxysmal atrial fibrillation originating from superior vena cava: a clinical analysis of 30 cases

    OpenAIRE

    Shi, Xiang-min; YUAN, HONG-TAO; Guo, Hong-Yang; Guo, Jian-Ping; Shan, Zhao-Liang; Wang, Yu-tang

    2015-01-01

    To analyze characteristics of electrocardiogram (ECG), electrophysiological intracardiac mapping and radiofrequency ablation (RF) of paroxysmal atrial fibrillation (PAF) originating from superior vena cava (SVC), aiming to investigate electrophysiological characteristics of PAF with SVC origin. Clinical data of 30 subjects (18 men and 12 women, aged, 58.6 ± 15.5 years) with PAF of SVC origin were retrospectively analyzed; All patients underwent RF during 2006.9-2012.7. ECG of AF and atrial pr...

  3. The 3 December 2015 paroxysm of Voragine crater at Etna: insights from Doppler radar measurements

    Science.gov (United States)

    Donnadieu, Franck; Freret-Lorgeril, Valentin; Gouhier, Mathieu; Coltelli, Mauro; Scollo, Simona; Fréville, Patrick; Hervier, Claude; Prestifilippo, Michele

    2016-04-01

    After a progressive intensification of Strombolian activity inside the Voragine crater in the evening of December 2 2015, Mount Etna produced a short but violent paroxysm in the night of 3 December 2015, the most intense of the last two decades at Voragine. Lava fountains, observed with the network of thermal and visible cameras of INGV-OE, reached well over 1 km in height with some jets of incandescent material reaching 3 km. A tephra column several kilometers high was produced and pyroclastic material was dispersed by winds in altitude to the NE, causing ash fallouts to affect many towns in Sicily and Reggio Calabria. A 23 cm-wavelength Doppler radar (VOLDORAD 2B), located about 3 km from NSEC at the Montagnola station and integrated into the INGV-OE instrumental network, has been continuously monitoring the explosive activity of Mt. Etna's summit craters since 2009. The radar beam probes 13 successive volumes 150 m deep aligned northward above the summit craters, providing two sets of parameters (echo power and velocity) at a rate of 0.2 s. We analyze the paroxysmal event of Voragine using the radar echoes and Doppler signals coming from volumes inside the lava fountain feeding the tephra column in combination with thermal and visible imagery and satellite data. The radar range gating allowed us to immediately discriminate the central craters as the source of the tephra emission and to estimate the lava fountain width between 300 and 450 m. The backscattered power, which is related to the erupted tephra mass load in the beam, and Doppler velocities help to mark the transition from Strombolian activity to lava fountaining, providing onset and end times of the fountain. The tephra flux into the radar beam started to increase after 02:00 UTC with a strong increase at 02:20 UTC marking the transition to continuous lava fountaining. The climax was reached between ca. 02:35 and 03:15 UTC with maintained high echo power and ejection velocities of 190 m/s in average

  4. Role of benign ovarian cysts in the development of adenomyosis

    Science.gov (United States)

    Alam, Sadaf; Ahmad, Sajjad; Khan, Muhammad M.; Nasir, Sabeen; Sharif, Naveed; Ziaullah, Sara; Khalid, Ahmareen; Rauf, Fozia

    2016-01-01

    Objectives: To assess the association of adenomyotic foci with co-existing benign ovarian cysts. Methods: This prospective cross-sectional study consisted of 100 consecutive hysterectomy specimens referred to Histopathology Section of Pathology Department, Peshawar Medical College, Peshawar, Pakistan by its attached teaching hospitals from January 2011 to December 2012. Hematoxylin and eosin stained sections were examined for adenomyotic foci and the presence of co-existent ovarian cysts. For evaluation of estrogen receptor (ER) status immunohistochemical stains were applied and H-scoring system was used with a score >50 as positive. Results: Out of the 100 hysterectomy specimens, 25 cases had both adenomyosis and ovarian cysts. The ER status of adenomyotic foci was positive in 20% cases and negative in 80% cases. The commonest type of ovarian cyst was hemorrhagic luteal cyst (28%), followed by serous and mucinous cystadenoma (20%) each. Out of the 28% cases of functional cysts, 71.5% were ER positive and 28.5% were ER negative. The p-value for association of ER status of adenomyotic foci with functional cysts was 0.0004; however, p-value was not significant in comparing cases with controls. All 72% cases of nonfunctional cysts were ER negative. However, 44% of functional cysts were not associated with adenomyotic foci. Conclusion: This study concludes that besides functional ovarian cysts, other local factors may be responsible for the development of adenomyosis. PMID:27570851

  5. Benign and malignant tumors of the foot and ankle

    International Nuclear Information System (INIS)

    Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed. (orig.)

  6. Benign and malignant tumors of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Singer, Adam D.; Datir, Abhijit; Langley, Travis [Emory University Hospital, Department of Radiology, Section of Musculoskeletal Imaging, Atlanta, GA (United States); Tresley, Jonathan [University of Wisconsin, Department of Radiology, Madison, WI (United States); Clifford, Paul D.; Jose, Jean; Subhawong, Ty K. [University of Miami, Department of Radiology, Miami, FL (United States)

    2016-03-15

    Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed. (orig.)

  7. Clustered microcalcifications without mass on mammography : benignancy vs. malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Han, Yoon Hee; Do, Young Soo; Oh, Hoon Il; Kim, Ki Hwan; Chin, Soo Yil [Korean Cancer Center Hostpital, Seoul (Korea, Republic of); Cho, Byung Jae [Chung Dam Radiologic Clinics, Seoul (Korea, Republic of); Han, Heon [Chungang Gil Hospital, Seoul (Korea, Republic of); Choi, Yeun Hyeun; Han, Boo Kyung [Sam Sung Medical Center, Seoul (Korea, Republic of); Park, Jung Mi [Asan Medical Center, Seoul (Korea, Republic of)

    1996-11-01

    The purpose of this study is to evaluate the accuracy of differentiation between benign and malignant clustered microcalcifications without mass on mammogram. Fourty six mammograms of 44 patients showing clustered microcalcifications without mass were interpreted blindly by five independent observers majoring in breast imaging from different institutions. Twenty two were malignant (10 infiltrating ductal carcinomas, 12 intraductal carcinomas) and 24 were benign (all fibrocystic disease). The observers judge benignancy or malignancy of microcalcifications. The authors assess the accuracy of differential diagnosis of clustered microcalcifications. Of 24 cases proved benign microcalcifications, five radiologists correctly interpreted 20 on average as benign and of malignant 22 cases, 16 on average were correctly interpreted as malignant. The diagnostic accuracy of malignant microcalcifications was 71.8% on average(63.6%{approx}81.8%) and the diagnostic accuracy for benign microcalcifications was 83% on average(71%{approx}92%). It was 9 among total 46 cases that were misinterpreted by more than three radiologists. Among these 9 cases, malignant microcalcifications that had been misinterpreted as benign were seven, benign microcalcifications misinterpreted as malignant were two. The diagnostic accuracy of clustered malignant microcalcifications(71.8%) without mass on mammogram was lower than that of benign microcalcifications(83.3%). So, in case of suspected malignant microcalcification on mammogram, it is preferable that along with magnification view, histopathologic confirmation by core biopsy must be obtained.

  8. Management of benign prostatic hyperplasia with silodosin

    Directory of Open Access Journals (Sweden)

    Tomonori Yamanishi

    2009-08-01

    Full Text Available Tomonori Yamanishi1, Tomoya Mizuno1, Takao Kamai1, Ken-ichiro Yoshida1, Ryuji Sakakibara2, Tomoyuki Uchiyama31Department of Urology, Dokkyo Medical University, Tochigi, Japan; 2Department of Neurology, Sakura Hospital, Toho University, Toho, Japan; 3Department of Neurology, Chiba University, Chiba, JapanAbstract: It has been reported that blockade of α1A-adrenoceptor (AR relieves bladder outlet obstruction, while blockade of α1D-AR is believed to alleviate storage symptoms due to detrusor overactivity. Silodosin, (--1-(3-hydroxypropyl-5-[(2R-2-({2-[2-(2,2,2trifluoroethoxy phenoxy]ethyl}aminopropyl]-2,3-dihydro-1H-indole-7- carboxamide, is a new α1A-AR selective antagonist. Silodosin is highly selective for the α1A-AR subtype, showing an affinity for the α1A-AR that is 583- and 55.5-fold higher than its affinity for the α1B- and α1D-ARs, respectively. In randomized, double-blind, placebo-controlled phase III studies performed in Japan and the United States, silodosin has been shown to be effective for both storage and voiding symptoms associated with benign prostatic hyperplasia. Early effects of silodosin (after 2–6 hours or day 1 on lower urinary tract symptoms have also been reported. In urodynamic studies, detrusor overactivity disappeared in 40% and improved in 35% of patients after administration. In pressure flow studies, the grade of obstruction on the International Continence Society nomogram showed improvement in 56% of patients. The rate of adverse events in the silodosin, tamsulosin and placebo groups was 88.6%, 82.3%, and 71.6%, respectively. The most common adverse event was (mostly mild abnormal ejaculation (28.1%. However, few patients (2.8% discontinued silodosin because of abnormal ejaculation. Orthostatic hypotension showed a similar incidence in the silodosin (2.6% and placebo (1.5% groups. In conclusion, silodosin improves detrusor overactivity and obstruction and thus may be effective for both storage and voiding

  9. Generalized epilepsy with spike-wave paroxysms as an epileptic disorder of the function of sleep promotion.

    Science.gov (United States)

    Halász, P

    1981-01-01

    A new hypothesis is offered regarding the pathomechanism of generalized epilepsy with spike-wave paroxysms (GESw) based on the pertaining literature and personal investigations. The first section is devoted to a critical overview of the development of theories regarding GESw. The centrencephalic theory, the debate on subcortical versus cortical origin, the "corticoreticular" hypothesis of Gloor and, finally, the "dyshormic" concept of Niedermeyer are outlined. In the next section it is shown that there is a particular optimum zone between sleep and wakefulness and between REM and slow wave sleep which highly favours the occurrence of spike-wave paroxysms. According to our investigations into the dynamics within this critical zone, the spike-wave paroxysms always appear with characteristic fluctuations of the level of consciousness where the changes towards awakening are always followed by rebounds towards sleep. Hence, the dynamic properties of this unstable border zone become especially interesting in the genesis of spike-wave paroxysms. It has been shown that even without epilepsy, a dynamics can be observed in the micro-oscillations in the depth of sleep which could be interpreted according to the reciprocal induction regulation model. In our concept the process of falling asleep emerges from rebounds of the sleep promoting system in response to sensory inputs streaming in from the external environment. According to this model, arousal influences in sleep have a sleep promoting effect. We interpret in this way all synchronized EEG reactions elicited by sensory stimuli and we consider K-complex type synchronization reactions as a "building stone" of the process of falling asleep which contains the whole process in concentrated form. The manifold similarities between the K-complex and the spike-wave pattern are demonstrated. On this basis spike-wave paroxysms can be regarded as an epileptic "caricature" of the sleep induction momentum reflected in the K

  10. Radioiodine therapy in benign thyroid diseases

    DEFF Research Database (Denmark)

    Bonnema, Steen Joop; Hegedüs, Laszlo

    2012-01-01

    from (131)I therapy. The individual radiosensitivity, still poorly defined and impossible to quantify, may be a major determinant of the outcome from (131)I therapy. Above all, the impact of (131)I therapy relies on the iodine-concentrating ability of the thyroid gland. The thyroid (131)I uptake (or......Radioiodine ((131)I) therapy of benign thyroid diseases was introduced 70 yr ago, and the patients treated since then are probably numbered in the millions. Fifty to 90% of hyperthyroid patients are cured within 1 yr after (131)I therapy. With longer follow-up, permanent hypothyroidism seems...... of an exact thyroid dose is error-prone due to imprecise measurement of the (131)I biokinetics, and the importance of internal dosimetric factors, such as the thyroid follicle size, is probably underestimated. Besides these obstacles, several potential confounders interfere with the efficacy of (131)I therapy...

  11. Endoscopic management of benign biliary strictures.

    Science.gov (United States)

    Rustagi, Tarun; Jamidar, Priya A

    2015-01-01

    Benign biliary strictures are a common indication for endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic management has evolved over the last 2 decades as the current standard of care. The most common etiologies of strictures encountered are following surgery and those related to chronic pancreatitis. High-quality cross-sectional imaging provides a road map for endoscopic management. Currently, sequential placement of multiple plastic biliary stents represents the preferred approach. There is an increasing role for the treatment of these strictures using covered metal stents, but due to conflicting reports of efficacies as well as cost and complications, this approach should only be entertained following careful consideration. Optimal management of strictures is best achieved using a team approach with the surgeon and interventional radiologist playing an important role.

  12. Palladium-Catalyzed Environmentally Benign Acylation.

    Science.gov (United States)

    Suchand, Basuli; Satyanarayana, Gedu

    2016-08-01

    Recent trends in research have gained an orientation toward developing efficient strategies using innocuous reagents. The earlier reported transition-metal-catalyzed carbonylations involved either toxic carbon monoxide (CO) gas as carbonylating agent or functional-group-assisted ortho sp(2) C-H activation (i.e., ortho acylation) or carbonylation by activation of the carbonyl group (i.e., via the formation of enamines). Contradicting these methods, here we describe an environmentally benign process, [Pd]-catalyzed direct carbonylation starting from simple and commercially available iodo arenes and aldehydes, for the synthesis of a wide variety of ketones. Moreover, this method comprises direct coupling of iodoarenes with aldehydes without activation of the carbonyl and also without directing group assistance. Significantly, the strategy was successfully applied to the synthesis n-butylphthalide and pitofenone. PMID:27377566

  13. A rare benign parotid gland tumor: angiomyolipoma.

    Science.gov (United States)

    Lu, Dan; Yang, Hui; Liu, Shi Xi; Zhao, Yu; Chen, Fei

    2013-11-01

    Angiomyolipomas are benign neoplasms composed of smooth muscle, vasculature, and mature adipose tissue, which most commonly occur in the kidney and located in the head and neck region. A very rare neoplasm, there are only 3 cases of angiomyolipoma in the parotid gland that have been reported to date. Here, we report a case of a 38-year-old man who had a slow-growing mass in the parotid gland for the past 7 years. The results of a physical examination revealed a rubbery mass that was 2.5 cm in diameter in the below superficial lobe of the left parotid gland. A computed tomographic scan showed a heterogeneous and lobulated nodule with a well-defined margin, which was resected through partial parotidectomy with preservation of the facial nerve. A histologic finding revealed an angiomyolipoma of the parotid gland. In conclusion, angiomyolipoma should be considered in the differential diagnosis of rubbery parotid gland masses.

  14. [Endoscopic surgery for benign esophageal diseases].

    Science.gov (United States)

    Ozawa, Soji

    2006-07-01

    Gastroesophageal reflux disease (GERD) and esophageal achalasia are common benign esophageal diseases. Today minimally invasive surgery is recommended to treat these diseases. Surgical indications for GERD are failure of medical management, medical complications attributable to a large hiatal hernia, 'atypical' symptoms (asthma, hoarseness, cough, chest pain, aspiration), etc. according to the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) guidelines. Laparoscopic Nissen fundoplication has emerged as the most widely accepted procedure for GERD patients with normal esophageal motility. Partial fundoplication (e.g., Toupet fundoplication) is also considered to decrease the possibility of postoperative dysphagia. Although pneumatic dilatation has been the first line treatment for esophageal achalasia, laparoscopic Heller myotomy and partial fundoplication (e.g., Dor fundoplication) to prevent reflux is preferred by most gastroenterologists and surgeons as the primary treatment modality. Laparoscopic surgery for GERD and esophageal achalasia are effective in most patients and safe in all patients. Finally, laparoscopic surgery should be performed only by skilled surgeons.

  15. The radiation therapy of benign diseases

    International Nuclear Information System (INIS)

    X-ray should only be applied when other forms of treatment of good-natured diseases do not provide equally good results. One should note that somatic lesion should be completely avoided and genetic lesion avoided to the greatest probability. One can distinguish according to ones aims between inflammation irradiation, pain irradiation, stimulation therapy and functional therapy. An indication for inflammation irradiation can be post-operative parotitis, furuncle in the face, mastitis puerperalis, panaritium ossale, recurrent sudoriparouns abscesses and repelling reactions after transplanting organs. Pain irradiation is indicated with degenerative diseases of the skeleton system. A further possible application is radiotherapy of hypotrophic processes and benign tumours. Functional radiotherapy is indicated with hyperendocrinism, neurovegetative disorders and allergies. (MG)

  16. Insights from radiation treatment for benign disease

    Energy Technology Data Exchange (ETDEWEB)

    Bleehen, N.M.

    1987-08-29

    This note compares mortality figures for patients treated with low dose ionizing radiation for benign conditions between the 1920's and 1950's with figures available from the Japanese A-bomb survivors. X radiation for ringworm, ankylosing spondylitis and post-partum mastitis are considered. Figures for leukemia are roughly comparable between radiotherapy groups and A-bomb survivors. Figures for the increased relative risk of breast cancer in spondylitis patients were in marked contrast to bomb survivors who received comparable doses, but compatible with the increase among women given x-rays for acute post-partum mastitis in the 1940's and 1950's. This study also suggests the possibility of different time patterns of risk between different cancers. (U.K.).

  17. Insights from radiation treatment for benign disease

    International Nuclear Information System (INIS)

    This note compares mortality figures for patients treated with low dose ionizing radiation for benign conditions between the 1920's and 1950's with figures available from the Japanese A-bomb survivors. X radiation for ringworm, ankylosing spondylitis and post-partum mastitis are considered. Figures for leukemia are roughly comparable between radiotherapy groups and A-bomb survivors. Figures for the increased relative risk of breast cancer in spondylitis patients were in marked contrast to bomb survivors who received comparable doses, but compatible with the increase among women given x-rays for acute post-partum mastitis in the 1940's and 1950's. This study also suggests the possibility of different time patterns of risk between different cancers. (U.K.)

  18. [Benign thyroid nodules: diagnostic and therapeutic approach].

    Science.gov (United States)

    Durante, Cosimo; Cava, Francesco; Paciaroni, Alessandra; Filetti, Sebastiano

    2008-05-01

    In the last years an increase in thyroid nodules detection has been reported from several epidemiological studies. This trend is largely due to the routine use of diagnostic sonography procedures in clinical practice. Thyroid nodules, both palpable or not palpable, rarely turn out to be malignant. Fine-needle aspiration cytology (FNAc) plays a central role in establishing the nature of the nodule. Excluded the presence of malignant lesions, which are generally treated with surgery, physicians are faced with a variety of therapeutic options, and choosing the optimal approach can be a difficult task. These include a periodic follow-up alone without treatment, the iodine supplementation, the thyroid-hormone suppressive therapy, the radioiodine administration, the percutaneous ethanol injections, and the new technique of laser photocoagulation. In all cases, decisions on the management of benign thyroid nodules should always be based on clinical target and a careful analysis of benefits and risks to the patient. PMID:18581970

  19. A rare case of benign omentum teratoma

    Directory of Open Access Journals (Sweden)

    Sforza Marcos

    2012-01-01

    Full Text Available Introduction. Mature teratomas (benign cystic teratomas or dermoid cysts are among the most common ovarian tumours; however, teratomas of the omentum and mesentery are extremely rare. Teratoma in the intraperitoneal cavity is uncommon and atypical, and it is even more uncommon in adulthood. Case Outline. An 82-year-old female was admitted to our department with clinical signs of abdominal tumour. The ultrasound scan and preoperative laboratory tests were done. Explorative laparotomy revealed tumour with torsion on its pedicle at the greater omentum. After removal of the mass and the incision a tooth and hair were found, characteristics of teratoma. Conclusion. The excision was very effective and also definitive treatment for this case. The patient recovered well and was discharged 3 days later. The patient probably carried the tumour all her life asymptomatically until admission.

  20. Benign Duodenocolic Fistula: a Case Report

    Directory of Open Access Journals (Sweden)

    Marzieh Soheili

    2015-10-01

    Full Text Available Benign duodenocolic fistula (DCF, known as a fistula between the duodenum and colon with orwithout cecum of nonmalignant origin, is an unusual complication of different gastrointestinal diseases. Thepresent paper records a case in which the patient presented with chronic diarrhea, abdominal pain, weight lossas well as having a history of gastric ulcer. Most frequently the condition presents with signs ofmalabsorption such as weight loss and diarrhea, but other symptoms include nausea, vomiting (sometimeswith fecal, and abdominal pain. Gastrointestinal inflammatory conditions are the usual causes. The mostcommon ones are perforated duodenal ulcer and Crohn’s disease. Barium enemas are usually diagnostic.Treatment consists of excising the fistula and repairing the duodenal and colonic defects. Closure of thefistula provides quick relief.

  1. The debate over robotics in benign gynecology.

    Science.gov (United States)

    Rardin, Charles R

    2014-05-01

    The debate over the role of the da Vinci surgical robotic platform in benign gynecology is raging with increasing fervor and, as product liability issues arise, greater financial stakes. Although the best currently available science suggests that, in the hands of experts, robotics offers little in surgical advantage over laparoscopy, at increased expense, the observed decrease in laparotomy for hysterectomy is almost certainly, at least in part, attributable to the availability of the robot. In this author's opinion, the issue is not whether the robot has any role but rather to define the role in an institutional environment that also supports the safe use of vaginal and laparoscopic approaches in an integrated minimally invasive surgery program. Programs engaging robotic surgery should have a clear and self-determined regulatory process and should resist pressures in place that may preferentially support robotics over other forms of minimally invasive surgery.

  2. Benign meningiomas: primary treatment selection affects survival

    International Nuclear Information System (INIS)

    Purpose: To examine the effect of primary treatment selection on outcomes for benign intracranial meningiomas at the University of Florida. Methods and Materials: For 262 patients, the impact of age, Karnofsky performance status, pathologic features, tumor size, tumor location, and treatment modality on local control and cause-specific survival was analyzed (minimum potential follow-up, 2 years; median follow-up, 8.2 years). Extent of surgery was classified by Simpson grade. Treatment groups: surgery alone (n = 229), surgery and postoperative radiotherapy (RT) (n = 21), RT alone (n = 7), radiosurgery alone (n = 5). Survival analysis: Kaplan-Meier method with univariate and multivariate analysis. Results: At 15 years, local control was 76% after total excision (TE) and 87% after subtotal excision plus RT (SE+RT), both significantly better (p = 0.0001) than after SE alone (30%). Cause-specific survival at 15 years was reduced after treatment with SE alone (51%), compared with TE (88%) or SE+RT (86%) (p = 0.0003). Recurrence after primary treatment portended decreased survival, independent of initial treatment group or salvage treatment selection (p = 0.001). Atypical pathologic features predicted reduced 15-year local control (54 vs. 71%) and cause-specific survival rates (57 vs. 86%). Multivariate analysis for cause-specific survival revealed treatment group (SE vs. others; p = 0.0001), pathologic features (atypical vs. typical; p = 0.0056), and Karnofsky performance status (≥80 vs. <80; p = 0.0153) as significant variables. Conclusion: Benign meningiomas are well managed by TE or SE+RT. SE alone is inadequate therapy and adversely affects cause-specific survival. Atypical pathologic features predict a poorer outcome, suggesting possible benefit from more aggressive treatment. Because local recurrence portends lower survival rates, primary treatment choice is important

  3. Petrological and seismic precursors of the paroxysmal phase of the last Vesuvius eruption on March 1944.

    Science.gov (United States)

    Pappalardo, Lucia; D'Auria, Luca; Cavallo, Andrea; Fiore, Stefano

    2014-01-01

    Abrupt transitions in style and intensity are common during volcanic eruptions, with an immediate impact on the surrounding territory and its population. Defining the factors trigger such sudden shifts in the eruptive behavior as well as developing methods to predict such changes during volcanic crises are crucial goals in volcanology. In our research, the combined investigation of both petrological and seismic indicators has been applied for the first time to a Vesuvius eruption, that of March 1944 that caused the present dormant state of the volcano. Our results contribute to elucidate the evolution of the conduit dynamics that generated a drastic increase in the Volcanic Explosivity Index, associated to the ejection of huge amount of volcanic ash. Remarkably, our study shows that the main paroxysm was announced by robust changes in petrology consistent with seismology, thus suggesting that the development of monitoring methods to assess the nature of ejected juvenile material combined with conventional geophysical techniques can represent a powerful tool for forecasting the evolution of an eruption towards violent behavior. This in turn is a major goal in volcanology because this evidence can help decision-makers to implement an efficient safety strategy during the emergency (scale and pace of evacuation). PMID:25199537

  4. Further evidence that paroxysmal nocturnal haemoglobinuria is a disorder of defective cell membrane lipid rafts.

    Science.gov (United States)

    Ratajczak, Mariusz Z; Borkowska, Sylwia; Mierzejewska, Kasia; Kucia, Magda; Mendek-Czajkowska, Ewa; Suszynska, Malwina; Sharma, Vivek A; Deptala, Andrzej; Song, Wechao; Platzbecker, Uwe; Larratt, Loree; Janowska-Wieczorek, Anna; Maciejewski, Jarek; Ratajczak, Janina

    2015-09-01

    The glycolipid glycosylphosphatidylinositol anchor (GPI-A) plays an important role in lipid raft formation, which is required for proper expression on the cell surface of two inhibitors of the complement cascade, CD55 and CD59. The absence of these markers from the surface of blood cells, including erythrocytes, makes the cells susceptible to complement lysis, as seen in patients suffering from paroxysmal nocturnal haemoglobinuria (PNH). However, the explanation for why PNH-affected hematopoietic stem/progenitor cells (HSPCs) expand over time in BM is still unclear. Here, we propose an explanation for this phenomenon and provide evidence that a defect in lipid raft formation in HSPCs leads to defective CXCR4- and VLA-4-mediated retention of these cells in BM. In support of this possibility, BM-isolated CD34(+) cells from PNH patients show a defect in the incorporation of CXCR4 and VLA-4 into membrane lipid rafts, respond weakly to SDF-1 stimulation, and show defective adhesion to fibronectin. Similar data were obtained with the GPI-A(-) Jurkat cell line. Moreover, we also report that chimeric mice transplanted with CD55(-/-)  CD59(-/-) BM cells but with proper GPI-A expression do not expand over time in transplanted hosts. On the basis of these findings, we propose that a defect in lipid raft formation in PNH-mutated HSPCs makes these cells more mobile, so that they expand and out-compete normal HSPCs from their BM niches over time.

  5. Cibenzoline versus flecainide in the prevention of paroxysmal atrial arrhythmias: a double-blind randomized study.

    Science.gov (United States)

    Babuty, D; D'Hautefeuille, B; Scheck, F; Mycinsky, C; Pruvost, P; Peraudeau, P

    1995-05-01

    In a randomized, double-blind, parallel clinical trial, the authors tested and compared flecainide and cibenzoline, a new antiarrhythmic drug, on atrial arrhythmias. Sixty-eight patients (36 men, 32 women, mean age 62.5 +/- 1.6 years) with documented symptomatic paroxysmal atrial arrhythmias (fibrillation in 56, flutter in 12) were recruited and received either cibenzoline 260 mg/day (n = 33) or flecainide 200 mg/day (n = 35). Patients were assessed with physical examination, resting ECG, 24-hour ambulatory ECG recording, two-dimensional echocardiography, and standard biologic titrations before the inclusion day, and 3 months and 6 months after the randomization day. Sixteen patients were withdrawn (7 were lost to follow-up, 7 had side effects, 2 had another medical event). Seventeen patients had documented recurrence of atrial arrhythmia (9 in the cibenzoline group, 8 in the flecainide group) during the study. The efficacy of cibenzoline and flecainide for preventing recurrence of atrial arrhythmias was not significantly different (62.5% versus 71.4%). Eleven patients complained of one or more side effects (cibenzoline, n = 6; flecainide, n = 5), justifying leaving the trial in 6 cases (cibenzoline, n = 3; flecainide, n = 3). Two ventricular proarrhythmic effects were observed. No atrial proarrhythmic effects were reported. The efficacy of cibenzoline and flecainide for preventing atrial arrhythmia is good and similar during a follow-up period of 6 months. In view of these results, cibenzoline may be administered first to prevent atrial arrhythmia. PMID:7657846

  6. [A Case of Neuromyelitis Optica with Relapse Symptoms from Paroxysmal Pruritus].

    Science.gov (United States)

    Matsuura, Jun; Kimura, Ayaka; Kasai, Takashi; Yoshida, Tomokatsu; Nakagawa, Masanori; Mizuno, Toshiki

    2015-08-01

    We report the case of a 34-year-old woman who presented with neuromyelitis optica and paroxysmal pruritus. She noticed an itching sensation with no obvious rash in the right postauricular region. Seven days later, the pruritus changed to an abnormal, painful sensation. One month after the onset of the painful sensation, she was hospitalized due to abnormal sensations that extended along the right side of her body and extremities. A hyperintense area on T2-weighted imaging was accompanied by partial enhancement that extended from the lower medulla oblongata to the upper cervical spinal cord. The anti-aquaporin (AQP)-4 antibody was detected in serum. The patient had a history of optic neuritis. Therefore, neuromyelitis optica (NMO) was diagnosed. Her symptoms improved after intravenous and oral corticosteroid treatment. Itching attacks have been occasionally reported with multiple sclerosis, but many of these cases were described before the discovery of the anti-AQP4 antibody. Information on pruritus in serologically confirmed NMO is lacking. We should be aware that patients with NMO can experience recurrence that develops as pruritus.

  7. Paroxysmal supraventricular tachycardia in an infant with hand, foot, and mouth disease.

    Science.gov (United States)

    Hu, Peng; Hou, Shu; Du, Peng-Fei; Li, Jia-Bin; Ye, Ying

    2012-05-01

    An 11-month-old male infant was admitted to our hospital with fever, fussiness, poor feeding, vomiting, and tachypnea for two days prior. Physical examination revealed sporadic papules and vesicles occurring on his hands, feet, face, and perianal mucosa. Enterovirus 71 was identified from both throat swab and vesicle fluid using virus isolation techniques. The patient's heart rate fluctuated in a very narrow range from 180~210/beats/min regardless of his physiologic state. An electrocardiogram showed P-waves buried within or occurring just after regular, narrow, QRS complexes. The patient was diagnosed as having hand, foot, and mouth disease in combination with paroxysmal supraventricular tachycardia (PSVT). The child recovered well with symptomatic treatment, including intravenous administration of acyclovir, glucocorticoids, immunoglobulin, adenosine, and sotalol. PSVT was terminated within 36 hours of hospitalization. The skin lesions became crusted on the third day, and then proceeded to heal spontaneously. Here we report on this unusual case and review the associated literature. PMID:22577272

  8. Electrophysiological Changes of the Atrium in Patients with Lone Paroxysmal Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Osmar Antonio Centurion, MD, PhD, FACC

    2010-06-01

    Full Text Available Introduction : Paroxysmal atrial fibrillation (PAF is a common arrhythmia, and it is associated with various cardiac conditions. On the other hand, lone PAF has no identifiable underlying cause, and can occur any time for no apparent reason. The underlying causes may modify the electrophysiological properties of the atrium in different ways and extent. However this setting may be different in patients with lone PAF. We sought to investigate the atrial electrophysiological properties in lone PAF. Material and Methods : This study included 62 control subjects (Control group and 58 patients with lone PAF (LAF group. The following atrial vulnerability parameters induced by programmed atrial stimulation were assessed and quantitatively measured: 1 the atrial effective refractory period (ERP, 2 the atrial conduction delay (CD zone, and 3 the maximum CD. Results : The mean atrial ERP of the Control group was 215±29 ms, and that of LAF group was 208±28 ms, p<0.05. The mean atrial CD zone of the LAF group was (50±28 ms significantly greater than that of controls (34±22 ms (p<0.01. The mean maximum CD of the LAF group (62±29 ms was also significantly greater than that of controls (43±20 ms (p<0.01. Conclusions : There is a greater conduction delay of the atrium and shorter refractoriness in patients with lone PAF. Patients without underlying causes for the development of PAF exhibit abnormalities in the electrophysiological properties of the atrium.

  9. Familial paroxysmal nonkinesigenic dyskinesia: clinical and genetic analysis of a Taiwanese family.

    Science.gov (United States)

    Yeh, Tu-Hsueh; Lin, Juei-Jueng; Lai, Szu-Chia; Wu-Chou, Yah-Huei; Chen, An-Chih; Yueh, Kuo-Chu; Chen, Rou-Shayn; Lu, Chin-Song

    2012-12-15

    Paroxysmal nonkinesigenic dyskinesia (PNKD) is a rare disorder in autosomal dominant inheritance. The clinical features and genetic findings of PNKD, rarely described in the Asians, were mostly delineated from European families. The present study characterized the clinical and genetic findings of a Taiwanese PNKD family. The clinical features of our five patients in successive three generations included onset age less than 10 years, attack duration between 3 min and 4h, and a variety of aura symptoms. The attacks were provoked not by sudden action but by emotional stress, caffeine, fatigue, heavy exercise and sleep deprivation. Sleep could abolish or diminish the attack and the attacks responded well to clonazepam. Sequencing the whole coding region of PNKD/MR-1 gene identified a heterozygous c.20 C>T (p.Ala7Val) mutation which was clearly segregated in the five affected patients. Comparing our patients with previously reported 18 families with PNKD/MR-1 mutations, the majority of the patients exhibited quite similar manifestations in attack patterns and precipitating factors. The recurrent conservative mutations in different ethnicities indicate importance in the pathogenesis of PNKD.

  10. : A Case of Acute Thromboembolic Renal Enfarction Associated with Paroxysmal Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Macit Kalcik; Mahmut Yesin; Lutfi Ocal; Taylan Akgun; Nursen Keles; Mustafa Ozan Gursoy; Mehmet Ozkan

    2014-06-01

    Full Text Available Infarction of the kidney is an uncommon condition that can result from obstruction or decrease of renal arterial flow. The diagnosis is often delayed because it can mimic many other pathologic states, including pyelonephritis, renal colic, acute abdomen, pancreatitis and more. A high index of suspicion is important for prompt diagnosis. We describe a 20-year-old man presented with abdominal and right flank pain and hematuria. A computed tomography scan with intravenous contrast showed partial infarction of right renal parenchyma and selective renal angiography showed complete occlusion of the right renal artery which was also supplied by an accessory renal artery. Electrocardiography showed normal sinus rhythm. Transthoracic and transesophageal echocardiographic findings were unremarkable except for mild spontaneous echo contrast (SEC in the left atrial appendage. Subsequent 48-hour holter monitorization revealed frequent premature atrial complexes and paroxysmal atrial fibrillation (PAF. Development of thromboembolic renal infarction was attributed to the presence of PAF and concurrent SEC in the left atrial appendage (LAA. Low molecular weight heparin(LMWH was followed by oral anticoagulant and an electrophysiologic study was planned for the management of PA

  11. Eculizumab in paroxysmal nocturnal hemoglobinuria with Budd-Chiari syndrome progressing despite anticoagulation

    Directory of Open Access Journals (Sweden)

    Brodsky Andrés

    2012-09-01

    Full Text Available Abstract Paroxysmal nocturnal hemoglobinuria (PNH is a progressive, life-threatening disorder characterized by chronic intravascular hemolysis caused by uncontrolled complement activation. Hepatic vein thrombosis (Budd-Chiari syndrome is common in PNH patients. This case report describes the response to eculizumab (a humanized monoclonal antibody that inhibits terminal complement activation in a 25-year-old male with progressive liver function deterioration despite standard anticoagulation therapy and transjugular intrahepatic porto-systemic shunt. The patient presented with anemia, severe thrombocytopenia, headache, abdominal pain, and distention. He was diagnosed with PNH, cerebral vein thrombosis, and Budd-Chiari syndrome. Despite adequate anticoagulation, diuretic administration, and placement of a transjugular shunt, additional thrombotic events and progressive liver damage were observed. Eculizumab therapy was initiated, resulting in rapid blockade of intravascular hemolysis, increased platelet counts, ascites resolution, and liver function recovery, all of which are presently sustained. Since starting eculizumab the patient has had no further thrombotic events and his quality of life has dramatically improved. This is the first report to confirm the role of complement-mediated injury in the progression of Budd-Chiari syndrome in a patient with PNH. This case shows that terminal complement blockade with eculizumab can reverse progressive thromboses and hepatic failure that is unresponsive to anticoagulation therapy and suggests that early initiation of eculizumab should be included in the therapeutic regimen of patients with PNH-related Budd-Chiari syndrome.

  12. Clinical Characteristics of Paroxysmal Kinesigenic Choreoathetosis:Diagnosis,Treatment and Prognosis

    Institute of Scientific and Technical Information of China (English)

    Huicong KANG; Qi HU; Xiaoyan LIU; Feng XU; Lin CHEN; Suiqiang ZHU

    2009-01-01

    The clinical characters,diagnosis and differential diagnosis of paroxysmal kinesigenic choreoathetosis (PKC),and efficacy of the anti-epileptic drugs (AEDs) were investigated.Thirty-one patients with PKC were collected,and the clinical characters and change of EEG were analyzed.The average age of the first attack was 16.8 years old and the pinnacle was 10 to 20 years old.There were definite causes for every attack and the sudden movement was the most common one (92%).Time for the whole attack was always less than 1 rain.The attack presented with muscle tension disturbance (83.9%),movement like dancing (16.1%),abnormal movement of mouth and face and other symp-toms (16.2%).The attack tended to be very frequent and 71% patients were beyond once per day.The EEG examination and image scan of primary PKC were normal in most patients.Low dosage of AEDs could control the attack of 50%-77.3% patients.It was concluded that PKC was a common disease of movement disorder.The therapy by AEDs was very effective.PKC should be differentiated from epilepsy and the relationship between PKC and epilepsy needs further research.

  13. Genetic alterations in benign, preneoplastic and malignant breast lesions

    Directory of Open Access Journals (Sweden)

    Mehmet Esref Kabalar

    2012-01-01

    Full Text Available Context: The c-erbB-2 proto-oncogene is a member of the epidermal growth factor receptor family and has been associated with a more aggressive breast tumor biology and resistance to some types of treatments. Aims: The aim is to investigate the correlation among bcl-2 and c-erbB-2 and the micronucleus (MN formation in patients with early breast cancer (BC. Materials and Methods: This study was conducted between May 2010 and December 2011. We analyzed the MN frequencies in 15 patients with invasive breast carcinoma (IBC, 13 patients with intraductal proliferative lesion (IDPL and 12 benign breast lesion (BBL. The sample consisted of 40 formalin-fixed, paraffin-embedded blocks of benign and malignant breast tissue. The specimens were evaluated for bcl-2 or c-erbB-2 immunoreactivity was semi-quantitatively evaluated in at least 1000 cells examined under the microscope at 40Χ magnification and recorded as the percentage of c-erbB-2 and bcl-2 positive tumor cells over the total number of cells examined in the same area. The percentage scores were subsequently categorized using the 5% cut-off point for positive staining. Results: The MN was significantly increased in IBC and in IDPL patients compared to BBL patients (3.82 ± 0.17 and 2.37 ± 0.52, respectively, vs. 1.61 ± 0.40, P < 0.001. On other hand, the MN frequencies in IBC patients were higher than those in IDPL patients (3.82 ± 0.17 vs. 2.37 ± 0.52, P < 0.01. c-erbB-2, had the highest record in IBC (60%, and the score was not observed in both IDPL and BBL: bcl-2 immunostaining was also assessed, the lowest recorded score was in IBC (46.66% and the highest in both BBL and IDPL (100%. Furthermore, there was a significantly difference in the mean MN frequency between c-erbB-2 positive IBC patients (4.06 ± 0.48 and c-erbB-2 negative IBC patients (3.44 ± 0.39 (P < 0.05. Conclusions: Our results suggest that increased chromosome / DNA instabilities may be associated with the pathogenesis of

  14. The differentiation of malignant and benign musculoskeletal tumors by F-18 FDG PET/CT studies-determination of maxSUV by analysis of ROC curve

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Eun Jung; Cho, Ihn Ho; Chun, Kyung Ah; Won, Kyu Chang; Lee, Hyung Woo; Choi, Jun Heok; Shin, Duk Seop [Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2007-12-15

    We evaluated the standard uptake value (SUV) of F-18 FDG at PET/CT for differentiation of benign from malignant tumor in primary musculoskeletal tumors. Forty-six tumors (11 benign and 12 malignant soft tissue tumors, 9 benign and 14 malignant bone tumors) were examined with F-18 FDG PET/CT (Discovery ST, GE) prior to tissue diagnosis. The maxSUV(maximum value of SUV) were calculated and compared between benign and malignant lesions. The lesion analysis was based on the transverse whole body image. The maxSUV with cutoff of 4.1 was used in distinguishing benign from malignant soft tissue tumor and 3.05 was used in bone tumor by ROC curve. There was a statistically significant difference in maxSUV between benign (n = 11; maxSUV 3.4 {+-} 3.2) and malignant (n = 12; maxSUV 14.8 {+-} 12.2) lesion in soft tissue tumor ({rho} = 0.001). Between benign bone tumor (n = 9; maxSUV 5.4 {+-} 4.0) and malignant bone tumor (n = 14; maxSUV 7.3 {+-} 3.2), there was not a significant difference in maxSUV. The sensitivity and specificity for differentiating malignant from benign soft tissue tumor was 83% and 91%, respectively. There were four false positive malignant bone tumor cases to include fibrous dysplasia, Langerhans-cell histiocytosis (n = 2) and osteoid osteoma. Also, one false positive case of malignant soft tissue tumor was nodular fasciitis. The maxSUV was useful for differentiation of benign from malignant lesion in primary soft tissue tumors. In bone tumor, the low maxSUV correlated well with benign lesions but high maxSUV did not always mean malignancy.

  15. Laparoscopic Splenectomy in the Management of Benign and Malignant Hematologic Diseases

    OpenAIRE

    Silecchia, Gianfranco; Boru, Cristian Eugeniu; Fantini, Aldo; Raparelli, Luigi; Greco, Francesco; RIZZELLO, MARIO; Pecchia, Alessandro; FABIANO, PAOLO; Basso, Nicola

    2006-01-01

    Objectives: The use of laparoscopy to treat malignant hematological diseases is not completely accepted. Our aim was to analyze operative and postoperative results of laparoscopic splenectomy performed for benign versus malignant hematological disorders. Methods: Between 1994 and 2003, 76 consecutive patients underwent laparoscopic splenectomy. The first 38 cases were performed by using an anterior approach, whereas in the remaining 38 cases a semilateral position was used. Results: Baseline ...

  16. Book review: Benign violence: education in and beyond the age of reason by Ansgar Allen

    OpenAIRE

    Kumar Jha, Mithilesh

    2016-01-01

    In Benign Violence: Education In and Beyond the Age of Reason, Ansgar Allen challenges the view that education is, at its core, an incontestable social good by outlining how its structures are underpinned by systemic violence. While Allen’s argument may not entirely sway readers away from the overarchingly positive value typically attributed to education, it nonetheless asks serious questions about the role that the education system and examinations have played in shaping us and our world, wr...

  17. Large mid-esophageal granular cell tumor: benign versus malignant

    Directory of Open Access Journals (Sweden)

    Prarthana Roselil Christopher

    2015-06-01

    Full Text Available Granular cell tumors are rare soft tissue neoplasms, among which only 2% are malignant, arising from nervous tissue. Here we present a case of a large esophageal granular cell tumor with benign histopathological features which metastasized to the liver, but showing on positron emission tomography-computerized tomography standardized uptake value suggestive of a benign lesion.

  18. [Treatment of benign laryngeal diseases using a CO2 laser].

    Science.gov (United States)

    Betka, J; Klozar, J; Kasík, P; Taudy, M; Tichý, S

    1989-05-01

    CO2 laser surgery is becoming a part of larynx surgery. The authors inform about their experience in benign larynx tumours treatment. They present analysis of concrete therapeutic procedures in individual larynx affections. They conclude that laser surgery is an advantegous method for benign larynx tumours treatment. PMID:2772545

  19. Perfusion MR imaging for differentiation of benign and malignant meningiomas

    NARCIS (Netherlands)

    Zhang, Hao; Rodiger, Lars A.; Shen, Tianzhen; Miao, Jingtao; Oudkerk, Matthijs

    2008-01-01

    Introduction Our purpose was to determine whether perfusion MR imaging can be used to differentiate benign and malignant meningiomas on the basis of the differences in perfusion of tumor parenchyma and/or peritumoral edema. Methods A total of 33 patients with preoperative meningiomas (25 benign and

  20. The effect of hyperbaric oxygenation on rehabilitation of paroxysmal deafness%高压氧对突发性耳聋的康复效果观察

    Institute of Scientific and Technical Information of China (English)

    孙春焕; 王庆霞; 刘怀芹; 秦军

    2001-01-01

    @@Background: The cause of paroxysmal deafness is unknown.It is a nerve deafness that has mostly hearing handicap and harried onset.At present,the disease is usually deemed incurable if it continues for three months.Many scholars consider that handicap of blood circulation in inner ear is an important factor leading to paroxysmal deafness.Hyperbaric oxygenation improves oxygenic content and press in blood. Objective: The effects of hyperbaric oxygenation on rehabilitation of paroxysmal deafness were investigated. Design: 105 patients with paroxysmal deafness were randomly divided into treatment group(n=41)and control group(n=43).Treatment group included 30 patients single ear with deafness of unilateral ear.Control group included 28 patients with deafness of unilateral ear. Unit: Liaocheng People's Hospital. Subject: We collected 105 patients with paroxysmal deafness from May 1999 to Dec 2000.84 patients were male,21 patients were female,aged 7~ 60 years(average 31.9 years).

  1. Thromboembolic event rate in patients with persistent or paroxysmal atrial fibrillation post circumferential pulmonary vein isolation:a single center experience in China

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jing-min; LIU Shao-wen; LIN Jia-xiong; NIE Zhen-ning; WU Hong-yi; ZHOU Jun; HAO Ying; CAI Nai-sheng; GE Jun-bo

    2007-01-01

    Background Pulmonary-vein isolation (PVI) is currently used for the treatment of chronic and paroxysmal atrial fibrillation and a major risk of PVI is thromboembolism. The purpose of this study was to observe embolic event rate in patients with persistent or paroxysmal atrial fibrillation (AF) undergone PVI.Methods Circumferential PVI (CPVI) was performed in 64 consecutive patients with persistent AF (42 men, aged (60.0±9.1) years) and in 84 consecutive patients with paroxysmal AF (53 men, aged (61.4±9.3) years). Warfarin was administrated in all patients before ablation for at least 3 weeks ((5.2±2.6) weeks) and continued for at least 3 months post ablation with international normalized ratio (INR) of 2.0-3.0. During CPVI, intravenous heparin was given at a dose of 5000-8000 U or 75-100 U/kg, followed by 1000 U or 12 U/kg per hour.Results In patients with persistent AF, 1 patient developed embolic event during ablation and 3 patients developed embolic events after ablation. In contrast, no thromboembolic event was observed in patients with paroxysmal AF (4/64vs 0/84, P=0. 033).Conclusion Thromboembolic event rate related to CPVI is significantly higher in patients with persistent AF than that in patients with paroxysmal AF.

  2. Comparison of Na{sup +}/I{sup -} symporter expression rate in malignant and benign thyroid diseases: immunohistochemical study

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Jeong, Young Jin; Lee, Kyung Eun; Park, Heon Soo; Yoo, Young Hyun; Roh, Mee Sook [Donga University College of Medicine, Busan (Korea, Republic of)

    2006-02-15

    Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyoid disease. Total patients were 119 cases (Men 15, 48{+-}13 yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was scored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of benign thyroid deceases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution or NIS expression, which was not correlated with that of primary lesion. In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease.

  3. Modern role and issues of radiation therapy for benign diseases

    Energy Technology Data Exchange (ETDEWEB)

    Miyashita, Tsuguhiro; Tateno, Atsushi; Kumazaki, Tatsuo [Nippon Medical School, Tokyo (Japan)

    1999-09-01

    Cases of radiation therapy for benign diseases have diminished in number because of recent alternative methods and knowledge about radiation carcinogenesis. In contrast to this tendency, our cases of benign diseases have recently increased. The facts made us reconsider today's radiation therapy of benign diseases. We reviewed 349 patients who were diagnosed as having benign tumors or non-neoplastic conditions and treated by radiation therapy in the past sixteen years. Analyzed items were the annual transition of treatment number, sorts of diseases, patients' age and sex, and the goal of therapy. Of all radiation therapy patients, benign diseases account for 9.26%. The annual percentages were 0.5%, 6.0%, 11.2% and 13.7% at intervals of five years since 1982. The majority was 246 post-operative irradiation for keloids (71%) and 41 pituitary adenomas (12%). Compared with malignant tumors, benign disease patients were statistically younger and female-dominant. Applications of radiation therapy in keloids and pituitary adenomas had definite goals, but were unclear in other rare diseases. Benign diseases should be treated by radiation therapy as the second or third option, provided the patients have serious symptoms and their diseases do not respond to other modalities. It seems to be widely accepted that favorite cases such as keloids and pituitary adenomas are treated by radiation therapy. But, optimal radiation therapies for other rare benign diseases have not been established. Therefore, the building of databases on radiation therapy on benign diseases should be pursued. Since benign disease patients were young and female-dominant and had many remaining years, their carcinogenicity potential should be considered. (author)

  4. Computerized classification of malignant and benign microcalcifications in mammograms: texture analysis using an artificial neural network

    Energy Technology Data Exchange (ETDEWEB)

    Chan Heangping; Sahiner, Berkman; Petrick, Nicholas; Helvie, Mark A.; Lam, Kwok Leung; Adler, Dorit D.; Goodsitt, Mitchell M. [Department of Radiology, University of Michigan, Ann Arbor, MI (United States)

    1997-03-01

    We investigated the feasibility of using texture features extracted from mammograms to predict whether the presence of microcalcifications is associated with malignant or benign pathology. Eighty-six mammograms from 54 cases (26 benign and 28 malignant) were used as case samples. All lesions had been recommended for surgical biopsy by specialists in breast imaging. A region of interest (ROI) containing the microcalcifications was first corrected for the low-frequency background density variation. Spatial grey level dependence (SGLD) matrices at ten different pixel distances in both the axial and diagonal directions were constructed from the background-corrected ROI. Thirteen texture measures were extracted from each SGLD matrix. Using a stepwise feature selection technique, which maximized the separation of the two class distributions, subsets of texture features were selected from the multi-dimensional feature space. A backpropagation artificial neural network ANN) classifier was trained and tested with a leave-one-case-out method to recognize the malignant or benign microcalcification clusters. The performance of the ANN was analysed with receiver operating characteristic ROC) methodology. It was found that a subset of six texture features provided the highest classification accuracy among the feature sets studied. The ANN classifier achieved an area under the ROC curve of 0.88. By setting an appropriate decision threshold, 11 of the 28 benign cases were correctly identified (39% specificity) without missing any malignant cases (100% sensitivity) for patients who had undergone biopsy. This preliminary result indicates that computerized texture analysis can extract mammographic information that is not apparent by visual inspection. The computer-extracted texture information may be used to assist in mammographic interpretation, with the potential to reduce biopsies of benign cases and improve the positive predictive value of mammography. (author)

  5. Thin section helical CT findings of klastskin tumor and benign stricture: cholangiographic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Guk Myeong; Han, Joon Koo; Kim, Tae Kyoung; Choi, Byung Ihn; Kim, Sun Whe; Cho, Yun Ku; Han, Man Chung; Yeon, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    The purpose of this study was (1) to describe the thin section helical CT findings of hilar cholangiocarcinoma and of benign strcture, and to discuss the differential points between the two disease entities and (2) using cholangiographic correlation, to evaluate the diagnostic accuracy of helical CT in determining the extent of hilar cholangiocarcinoma. Twenty-seven patients with hilar cholangiocarcinoma and eight with benign biliary dilatation were studied. All except four with hilar cholangiocarcinoma, who underwentCT using a conventional scanner, were studied with two-phase helical CT. In all patients, cholangiographs were obtained by digital fluoroscopy after the injection of contrast materials into PTBD catheters. The level of obstruction was classified according to Bismuth, and 35 CT scans were studied blindly and retrospectively by two radiologists. The findings were analyzed for the presence of tumor, and then divided into two groups(cholangiocarcinomas and benign strictures), and the positive predictive value was calculated. The CT images of klatskin tumor were analyzed with special emphasis on the level and shape of the hilar obstruction. The level of biliary obstruction and extent of the tumor were carefully correlated with the results of cholangiography. Thin-section spiral CT correctly identified all tumor mass as a focal wall thickening obliterating the lumen. On arterial/portal phase CT scanning, 81% of infilterative tumors showed high attenuation. In all patients, differentiation between benign stricture and klaskin tumor was possible;correct identification of the level of obstruction and extent of tumor, according to Bismuth's classification, was possible in 63% of cases. For correct diagnosis of hilar cholangiocarcinoma and differentiation of benign stricture, helical CT was highly accurate and effective. Because of limital Z-axis resolution, however, the exact intraductal extent of the tumor was less accorately diagnosed.=20.

  6. Virtual touch tissue quantifications in the differential diagnosis of benign and malignant thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Seung Mi; Cho, Seong Whi [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-06-15

    The aim of this study was to evaluate the diagnostic utility of the virtual touch tissue quantification (VTQ) technology for differentiating between benign and malignant thyroid nodules. 198 nodules (168 benign and 30 malignant nodules) identified in 164 patients with available VTQ velocity data and fine-needle aspiration cytology or post-surgical pathological results were included. The VTQ velocities of nodules and adjacent thyroid tissue were examined. Malignant nodules had a significantly higher VTQ velocity (3.06 ± 1.04 m/s, range: 1.90-6.46 m/s) than that of benign nodules (2.40 ± 0.85 m/s, range: 0.69-8.09 m/s) (p = 0.002). The VTQ velocity ratio between malignant nodules and adjacent thyroid tissue (1.39 ± 0.43, range: 0.89-2.65) was also statistically higher than that of benign nodules (1.15 ± 0.44, range: 0.26-3.47) (p = 0.008). The area under the receiver operating characteristic curve for the VTQ velocity was 0.72 with a cutoff point of 2.37 m/s and that of the VTQ velocity ratio was 0.68 with a cutoff point of 1.26. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the VTQ velocity were 86.7%, 50.6%, 23.9%, 95.5%, and 56.1%, respectively and 60.0%, 72.0%, 27.7%, 91.0%, and 70.2%, respectively for the VTQ velocity ratio. VTQ may be helpful in differentiating malignant and benign thyroid nodules with high negative predictive value.

  7. Benign Prostatic Hyperplasia: Health Seeking Behaviour of patients at a tertiary care hospital.

    Directory of Open Access Journals (Sweden)

    Aman Deep

    2010-03-01

    Full Text Available BackgroundBenign Prostatic Hyperplasia is a widely prevalent conditionaffecting elderly men throughout the world. With increasinglife expectancy, there has been a rise in the percentage ofelderly men and so for this disease across the globe. There islack of information about health seeking behaviour of patientswith Benign Prostatic Hyperplasia. Therefore the study wasdesigned with the objectives of assessing health-seekingbehaviour and the effect of literacy on it among adult andolder subjects suffering from Benign Prostatic Hyperplasiaattending a tertiary care hospital.MethodA series of 81 patients suffering from Benign ProstaticHyperplasia above the age of 50 years, attending surgical OutPatient Department of a tertiary care hospital in Delhi, wereassessed for their health seeking behaviour using a pre-testedand a modified questionnaire designed for assessing healthseeking behaviour.ResultsPositive health seeking behaviour of patients was observed in44%, who reported to a doctor within a month of noticingtheir problem. A greater proportion of the literates was awareabout the symptoms suggestive of enlarged prostate andconsulted a qualified health care practitioner as their firstaction. More literates approached the higher level of healthcare facility on being referred and had maximum faith inallopathic system of medicine. Also, lesser number of literateshad performed pooja (Hindi word for worship or othertraditional rituals for relief of their problems.ConclusionWe concluded that majority of subjects suffering fromBenign Prostatic Hypertrophy were not aware of theirdisease and their health-seeking behaviour was poor andcould be related to literacy. Our data highlights the needfor public awareness program targeting the younger malepopulation so that early detection and treatment can beoffered.

  8. Transurethral electrochemical treatment of benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    张民; 龚侃; 李宁; 曾荔; 那彦群

    2003-01-01

    Objective To study the mechanism and feasibility of transurethral electrochemical therapy for the treatment of benign prostatic hyperplasia (BPH). Methods Between March 1998 and March 2000, specifically designed devices and catheters for electrochemical therapy were applied to 6 prostate specimens obtained by suprapubic prostatectomy in order to treat BPH patients with urinary retention for whom surgery was contraindicated. Sixteen patients (with a mean age of 77.3 years old) underwent electrical treatment totaling 160-220 coulombs under topical urethral anesthesia for 68-132 min. The catheters remained inside the patient for 7-10 d. Results Irreversible destructive changes occurred within cathodal tissue, while carbonization occurred within anodic tissue. The radius of tissue change was 7-8 mm and 1-2 mm, respectively. In vivo trial: 11 (69%) patients could be weaned off the catheters with satisfactory urination. Three months after therapy, the mean international prostate symptom score (IPSS) was 14.5, mean peak flow rate was 10.5 ml/s, and mean residual urine was 39 ml. No serious complications were observed. Conclusion Transurethral electrochemical treatment is potentially a minimally invasive alternative for treatment of BPH, especially for elderly patients at high risk.

  9. Benign encephalopathy of pregnancy. Preliminary clinical observations.

    Science.gov (United States)

    Poser, C M; Kassirer, M R; Peyser, J M

    1986-01-01

    A survey of 67 pregnancies in 51 professional women (physicians, psychologists, nurses, administrators, etc.) revealed the occurrence of symptoms of cognitive dysfunction such as forgetfulness, disorientation, confusion and reading difficulties in 28 pregnancies occurring in 21 women. These were unrelated to such factors as age of delivery, percentage weight gain, the baby's sex or birth weight, alcohol consumption, smoking, a history of migraine or allergy or other symptoms occurring during pregnancy such as sleepiness and lack of concentration, irritability, loss of interest in job or nightmares. Nor was there any correlation with hypertension, proteinuria, glycosuria, ketonuria, anemia, or morning sickness. Furthermore, these cognitive disturbances were not related to depression or sleep deprivation. Despite these symptoms, none of the women suffering from them were forced to interrupt their professional activities during pregnancy. The syndrome of benign encephalopathy of pregnancy should be recognized so that simple precautions can be taken to prevent any interference with professional or other activities. The etiology of the syndrome is unknown.

  10. Benign disease of the common bile duct.

    Science.gov (United States)

    Saxena, R; Pradeep, R; Chander, J; Kumar, P; Wig, J D; Yadav, R V; Kaushik, S P

    1988-08-01

    The incidence of common bile duct (CBD) pathology in a group of patients with benign biliary disease (n = 505) was found to be 23.2 per cent. The spectrum included 111 patients (90.2 per cent) with CBD stones, 37 of whom (33.3 per cent) had no symptoms or findings pre-operatively indicating CBD involvement. Five patients had papillary stenosis, three had postoperative CBD strictures, one had a choledochal cyst and one had an external biliary fistula. Of the 100 CBDs measuring more than 10 mm in diameter, 90 harboured calculi. In the remaining 23 CBDs measuring less than 10 mm, calculi were present in 21. The presence of CBD calculi was demonstrated by intra-operative cholangiography in 49 patients. In the remaining patients (n = 74), the diagnosis of CBD pathology was made either by percutaneous transhepatic cholangiography, endoscopic retrograde cholangio-pancreatography, T-tube cholangiography or peroperative palpation. The surgical procedures performed included choledochotomy and T-tube drainage (n = 74), transduodenal sphincteroplasty (n = 27) and choledochoduodenostomy (n = 18). The overall mortality and morbidity of CBD exploration was 3.3 per cent and 24.4 per cent respectively, which was significantly greater than that for cholecystectomy alone (0.3 per cent and 8.6 per cent respectively). Transduodenal sphincteroplasty carried a much higher mortality (11 per cent) and morbidity (52 per cent) when compared with other procedures. PMID:3167536

  11. Benign and pathological electrocardiographic changes in athletes.

    Science.gov (United States)

    Machado, Marino; Vaz Silva, Manuel

    2015-12-01

    Sudden cardiac death is the leading cause of death in athletes during sport. It is a tragic event that generates significant media attention and discussion throughout society as to whether everything possible had been done to prevent it. Regular physical exercise causes cardiac remodeling at both the mechanical and electrical level, known as athlete's heart, resulting in an electrocardiogram (ECG) considered abnormal compared with the ECGs of the general population. Some of these electrocardiographic changes are considered normal or physiological in athletes, while others suggest underlying cardiac disease with the potential to cause sudden cardiac death. There is thus an urgent need to define the electrocardiographic patterns that allow or prohibit participation in sports, and to differentiate them in terms of gender, ethnicity and age. The purpose of this review is to present the latest data on the electrocardiographic changes considered benign or pathological that are typically found in athletes and to critically analyze the most recent criteria for classifying ECGs in this population (the Seattle criteria), comparing them with previous guidelines and with the latest studies on the subject. This article also examines the question of including ECGs in pre-participation screening programs, the US and European approaches to the subject, and the most up-to-date data on the sensitivity, specificity and cost-effectiveness of the ECG in athletes. PMID:26643438

  12. Treating benign prostatic hyperplasia with botulinum neurotoxin.

    Science.gov (United States)

    Brisinda, G; Vanella, S; Marniga, G; Crocco, A; Maria, G

    2011-01-01

    Botulinum toxin (BoNT) has been increasingly used in the interventional treatment of several disorders; the use of this agent has extended to a plethora of conditions including focal dystonia, spasticity, inappropriate contraction in most gastrointestinal sphincters, eye movement disorders, hyperhidrosis, genitourinary disorders and aesthetically undesirable hyperfunctional facial lines. In addition, BoNT is being investigated for the control of pain, and for the management of tension or migraine headaches and myofascial pain syndrome. Benign prostatic hyperplasia (BPH) is a common condition in ageing men; the goal of therapy is to reduce the lower urinary tract symptoms (LUTS) associated with BPH and to improve the quality of life. However, medical treatment, including drugs that relax smooth muscle within the prostate and drugs that shrink the gland are not totally effective or without complications. The standard surgical treatment for BPH is progressively changing to minimally invasive therapies, but none of them has provided clear results. The use of BoNT-A to inhibit the autonomic efferent effects on prostate growth and contraction, and inhibit the abnormal afferent effects on prostate sensation, might be an alternative treatment for BPH. BoNT injections have several advantages over drugs and surgical therapies in the management of intractable or chronic disease; systemic pharmacologic effects are rare, permanent destruction of tissue does not occur, and graded degrees of relaxation may be achieved by varying the dose injected. In this paper, clinical experience over the last years with BoNT in BPH impaired patients will be illustrated.

  13. Transurethral microwave thermotherapy for benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Rubeinstein Jonathan N.

    2003-01-01

    Full Text Available Transurethral resection of the prostate (TURP remains the gold standard for treatment of benign prostatic hyperplasia (BPH. In general, while this procedure is safe, patients require a spinal, epidural, or general anesthesia and often several days of hospital stay; the potential morbidity and mortality limits the use of TURP in high-risk patients. Pharmacotherapy has been recommended as a first-line therapy for all patients with mild to moderate symptoms. Patients are oftentimes enthusiastic if they are offered a one-time method to treat lower urinary tract symptoms secondary to BPH, provided that the method offers reduced risk and allows an efficacy equal to that of medical therapy. One such method is transurethral microwave thermotherapy (TUMT. TUMT involves the insertion of a specially designed urinary catheter with a microwave antenna, which heats the prostate and destroys hyperplastic prostate tissue. TUMT allows the avoidance of general or regional anesthesia, and results in minimal blood loss and fluid absorption. In this review, the authors discussed the current indications and outcome of TUMT, including the history of the procedure, the mechanism of action, the indications for TUMT, the pre-operative considerations, the patient selection, the results in terms of efficacy, by comparing TUMT vs. Sham, TUMT vs. Alpha-blocker and TUMT vs. TURP. Finally, the complications are presented, as well as other uses and future directions of the procedure. The authors concluded that TUMT is a safe and effective minimally invasive alternative to treatment of symptomatic BPH.

  14. Morphological variability of the P-wave for premature envision of paroxysmal atrial fibrillation events

    International Nuclear Information System (INIS)

    The present work introduces the first study on the P-wave morphological variability two hours preceding the onset of paroxysmal atrial fibrillation (PAF). The development of non-invasive methods able to track P-wave alterations over time is a clinically relevant tool to anticipate as much as possible the envision of a new PAF episode. This information is essential for further improvement of preventive and patient-tailored treatment strategies, which could avert the loss of sinus rhythm. In this way, risks for the patients could be minimized and their quality of life improved. Recently, the P-wave morphological analysis is drawing increasing attention because differences in morphology can reflect different atrial activation patterns. Indeed, the P-wave morphology study has recently proved to be useful for determining the presence of an underlying pathophysiological condition in patients prone to atrial fibrillation. However, the P-wave morphology variability over time has not been studied yet. In this respect, the present work puts forward some parameters related to the P-wave shape and energy with the ability to quantify non-invasively the notable atrial conduction alterations preceding the onset of PAF. Results showed that P-wave fragmentation and area presented higher variability over time as the onset of PAF approximates. By properly combining these indices, an average global accuracy of 86.33% was achieved to discern between electrocardiogram segments from healthy subjects, far from a PAF episode and less than one hour close to a PAF episode. As a consequence, the P-wave morphology long-term analysis seems to be a useful tool for the non-invasive envision of PAF onset with a reasonable anticipation. Nonetheless, further research is required to corroborate this finding and to validate the capability of the proposed P-wave metrics in the earlier prediction of PAF onset. (paper)

  15. Study on the P-wave feature time course as early predictors of paroxysmal atrial fibrillation

    International Nuclear Information System (INIS)

    Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice, increasing the risk of stroke and all-cause mortality. Its mechanisms are poorly understood, thus leading to different theories and controversial interpretation of its behavior. In this respect, it is unknown why AF is self-terminating in certain individuals, which is called paroxysmal AF (PAF), and not in others. Within the context of biomedical signal analysis, predicting the onset of PAF with a reasonable advance has been a clinical challenge in recent years. By predicting arrhythmia onset, the loss of normal sinus rhythm could be addressed by means of preventive treatments, thus minimizing risks for the patients and improving their quality of life. Traditionally, the study of PAF onset has been undertaken through a variety of features characterizing P-wave spatial diversity from the standard 12-lead electrocardiogram (ECG) or from signal-averaged ECGs. However, the variability of features from the P-wave time course before PAF onset has not been exploited yet. This work introduces a new alternative to assess time diversity of the P-wave features from single-lead ECG recordings. Furthermore, the method is able to assess the risk of arrhythmia 1 h before its onset, which is a relevant advance in order to provide clinically useful PAF risk predictors. Results were in agreement with the electrophysiological changes taking place in the atria. Hence, P-wave features presented an increasing variability as PAF onset approximates, thus suggesting intermittently disturbed conduction in the atrial tissue. In addition, high PAF risk prediction accuracy, greater than 90%, has been reached in the two considered scenarios, i.e. discrimination between healthy individuals and PAF patients and between patients far from PAF and close to PAF onset. Nonetheless, more long-term studies have to be analyzed and validated in future works. (paper)

  16. Integration of cardiac computed tomography into pulmonary vein isolation in patients with paroxysmal atrial fibrillation

    International Nuclear Information System (INIS)

    Purpose: Detailed anatomic information of the left atrium is necessary for securely performing radiofrequency ablation of atrial fibrillation-triggering ectopies in the pulmonary vein ostia. In this study the impact of a preinterventionally acquired cardiac computed tomography (CT) on pulmonary vein isolation (PVI) was assessed. Materials and methods: Examinations of 54 patients with paroxysmal atrial fibrillation undergoing PVI were analyzed. In 27 patients a supplementary cardiac CT was obtained prior to PVI (CT group, 12 women, 15 men, 59.7 ± 9.9 years of age): 16 x 1.5 mm collimation, 0.2 pitch, 120 kV tube voltage, 400 effective mAs. The fluoroscopy time, effective dose and quantity of radiofrequency (RF) pulses of the following catheter ablation were compared to 27 patients undergoing stand-alone PVI (11 women, 16 men, 62.0 ± 9.9 years of age). Mann-Whitney tests served for statistical comparison. Results: CT datasets were successfully integrated into the ablation procedure of each patient in the CT group. The mean quantity of RF pulses was significantly lower in the CT group (22.1 ± 8.0 vs. 29.1 ± 11.9, p = 0.030), and a significant reduction of fluoroscopy time was found (41.8 ± 12.0 min vs. 51.2 ± 16.0 min, p = 0.005). Effective doses of the catheter ablation differed in an equivalent dimension but altogether not significantly (14.9 ± 10.0 mSv vs. 20.0 ± 16.0 mSv, p = 0.203). The mean additive effective dose of the cardiac CT was 85 ± 0.3 mSv. (orig.)

  17. Case Report: Paroxysmal nocturnal hemoglobinuria in a woman heterozygous for G6PD A-.

    Science.gov (United States)

    Perdigones, Nieves; Morales, Mariela; Mason, Philip; Bessler, Monica

    2014-01-01

    We describe a case of paroxysmal nocturnal hemoglobinuria (PNH) in a woman who is heterozygous for the glucose-6-phosphate dehydrogenase A-   ( G6PDA-) allele. PNH is associated with one or more clones of cells that lack complement inhibition due to loss of function somatic mutations in the PIGA gene.  PIGA encodes the enzyme phosphatidylinositol glycan anchor biosynthesis, class A, which catalyses the first step of glycosylphosphatidylinisotol ( GPI)  anchor synthesis. Two GPI anchored red cell surface antigens regulate complement lysis. G6PD catalyses the first step of the pentose phosphate pathway and enzyme variants, frequent in some populations have been selected because they confer resistance to malaria, are associated with hemolysis in the presence of oxidizing agents including several drugs. The patient had suffered a hemolytic attack after taking co-trimoxazole, a drug that precipitates hemolysis in G6PD deficient individuals. Since both G6PD and PIGA are X-linked we hypothesized that the PIGA mutation was on the X-chromosome carrying the G6PDA- allele. Investigations showed that in fact the PIGA mutation was on the X-chromosome carrying the normal G6PD B allele. We speculate that complement activation on G6PD A- red cells exposed to Bactrim might have triggered complement activation inducing the lysis of G6PD B PNH Type II red blood cells or that the patient may have had a PNH clone expressing G6PDA- at the time of the hemolytic episode. PMID:25713697

  18. Atrial conduction delay predicts atrial fibrillation in paroxysmal supraventricular tachycardia patients after radiofrequency catheter ablation.

    Science.gov (United States)

    Xu, Zhen-Xing; Zhong, Jing-Quan; Zhang, Wei; Yue, Xin; Rong, Bing; Zhu, Qing; Zheng, Zhaotong; Zhang, Yun

    2014-06-01

    This study aimed to assess whether intra- and inter-atrial conduction delay could predict atrial fibrillation (AF) for paroxysmal supraventricular tachycardia (PSVT) patients after successful treatment by radiofrequency catheter ablation (RFCA). Echocardiography examination was performed on 524 consecutive PSVT patients (15 patients were excluded). Left atrial dimension, right atrial diameter and intra- and inter-atrial conduction delay were measured before ablation. Patients were divided into group A (n = 32): occurrence of AF after the ablation and group B (n = 477): remained in sinus rhythm during follow-up. Receiver operating characteristic (ROC) curve analysis was performed to estimate the predictive value of intra- and inter-atrial conduction delay. Both intra- and inter-atrial conduction delay were higher in group A than in group B (4.79 ± 0.30 msec vs. 4.56 ± 0.32 msec; 21.98 ± 1.32 msec vs. 20.01 ± 1.33; p < 0.05). Binary logistic regression analysis showed that intra- and inter-atrial conduction were significant influential factors for the occurrence of AF (odds ratio [OR] = 13.577, 95% confidence interval [CI], 3.469-48.914; OR = 2.569, 95% CI, 1.909-3.459, p < 0.05). The ROC cure analysis revealed that intra-atrial conduction delay ≥ 4.45 msec and inter-atrial conduction delay ≥ 20.65 were the most optimal cut-off value for predicting AF in PSVT patients after RFCA. In conclusion, this is the first study to show that the intra- and inter-atrial conduction delay could effectively predict AF in post-ablation PSVT patients.

  19. Efficacy and Mechanism of Intravenous Sotalol for Termination of Paroxysmal Supraventricular Tachycardia

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objectives To study the efficacy and mechanism of intravenous sotalol(Sol) for termination of paroxysmal supra-ventricular tachycardia ( SVT). Methods Sol or normal saline (NS) were administrated intravenously in patients with SVT induced by trans-esophagus left atrial stimulation. Results Conversion to sinus rhythm occurred in 65.2% (15/23) patients who received Sol (Sol group) at total dose of 1.5 mg/kg, the average conversion time being ( 10. 7 ± 11.6) min after the start of sotalol infusion. Conversion to sinus rhythm appeared in 4.8% (1/21) patients who were treated with NS (NS group). The efficacy between two groups was significantly different ( P <0. 01 ). The site of termination of tachycardia was predominantly at the antegrade atrioventricular node ( AV N ) in atrioventricular reentrant tachycardia ( AV RT ) (3/4) and at the retrograde fast pathway of AV N in atrioventricular nodal reentrant tachycardia ( AV N RT ) ( 4 / 6 ) . During the course of Sol infusion, both ventricular rate of SVT and systolic blood pressure ( SBP ) decreased. HR decreased from (173. 3±28. 4) min-1(before So l administration) to (159. 6-±-23. 8) and (152. 0±22. 2)min-1(3,5 minutes after the start of Sol infusion respectively, P < 0. 01) and SBP from (16.31-±-2.27) kPa to (14.82±2. 61) and (14. 61-±-2. 60) kPa(P<0. 01). Transient hypotension ( SBP < 10. 7 kPa ) occurred in 2 patients during the course of Sol administration. There were no significant changes of HR and blood pressure in the NS group. Conclusion It was safe and effective for sotalo l administration on SVT.

  20. Efficacy and Mechanism of Intravenous Sotalol for Termination of Paroxysmal Supraventricular Tachycardia

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objectives To study the efficacy and mechanism of intravenous sotalol(Sol) for termination of paroxysmal supra-ventricular tachycardia ( SVT). Methods Sol or normal saline (NS) were administrated intravenously in patients with SVT induced by trans-esophagus left atrial stimulation. Results Conversion to sinus rhythm occurred in 65.2% (15/23) patients who received Sol (Sol group) at total dose of 1.5 mg/kg, the average conversion time being ( 10. 7 ± 11.6) min after the start of sotalol infusion. Conversion to sinus rhythm appeared in 4.8% (1/21) patients who were treated with NS (NS group). The efficacy between two groups was significantly different ( P <0. 01 ). The site of termination of tachycardia was predominantly at the antegrade atrioventricular node ( AV N ) in atrioventricular reentrant tachycardia ( AV RT ) (3/4) and at the retrograde fast pathway of AV N in atrioventricular nodal reentrant tachycardia ( AV N RT ) ( 4 / 6 ) . During the course of Sol infusion, both ventricular rate of SVT and systolic blood pressure ( SBP ) decreased. HR decreased from (173. 3±28. 4) min-1(before So l administration) to (159. 6-±-23. 8) and (152. 0±22. 2)min-1(3,5 minutes after the start of Sol infusion respectively, P < 0. 01) and SBP from (16.31-±-2.27) kPa to (14.82±2. 61) and (14. 61-±-2. 60) kPa(P<0. 01). Transient hypotension ( SBP < 10. 7 kPa ) occurred in 2 patients during the course of Sol administration. There were no significant changes of HR and blood pressure in the NS group. Conclusion It was safe and effective for sotalo l administration on SVT.

  1. Responses of cardiac natriuretic peptides after paroxysmal supraventricular tachycardia: ANP surges faster than BNP and CNP.

    Science.gov (United States)

    Kuo, Jen-Yuan; Wang, An-Mei; Chang, Sheng-Hsiung; Hung, Chung-Lieh; Chen, Chun-Yen; Shih, Bing-Fu; Yeh, Hung-I

    2016-03-15

    Atrial natriuretic peptide (ANP) secretion increases after 30 min of paroxysmal supraventricular tachycardia (PSVT). Whether this phenomenon also applies to brain or C-type natriuretic peptides (BNP or CNP) remains unknown. Blood samples of 18 patients (41 ± 11 yr old; 4 men) with symptomatic PSVT and normal left ventricular systolic function (ejection fraction 65 ± 6%) were collected from the coronary sinus (CS) and the femoral artery (FA) before and 30 min after the induction, and 30 min after the termination of PSVT. The results showed that the ANP levels rose steeply after the PSVT and then reduced at 30 min after the termination (baseline vs. post-PSVT vs. posttermination: CS: 34.0 ± 29.6 vs. 74.1 ± 42.3 vs. 46.1 ± 32.9; FA: 5.9 ± 3.24 vs. 28.2 ± 20.7 vs. 10.0 ± 4.6 pg/ml; all P tachycardia (BNP, 10.2 ± 6.4 vs. 11.3 ± 7.1 vs. 11.8 ± 7.9; CNP, 4.5 ± 1.2 vs. 4.9 ± 1.4 vs. 5.0 ± 1.4 pg/ml; all P < 0.05). The rise of BNP and CNP in FA was similarly less sharp after the PSVT and remained stationary after the termination. PSVT exerted differential effects on cardiac natriuretic peptide levels. ANP increased greater after a 30-min induced PSVT, but dropped faster after termination of PSVT, compared with BNP and CNP.

  2. Excessive supraventricular ectopic activity is indicative of paroxysmal atrial fibrillation in patients with cerebral ischemia.

    Directory of Open Access Journals (Sweden)

    Mark Weber-Krüger

    Full Text Available BACKGROUND: Detecting paroxysmal atrial fibrillation (PAF in patients with cerebral ischemia is challenging. Frequent premature atrial complexes (PAC/h and the longest supraventricular run on 24-h-Holter (SV-run(24 h, summarised as excessive supraventricular ectopic activity (ESVEA, may help selecting patients for extended ECG-monitoring, especially in combination with echocardiographic marker LAVI/a' (left atrial volume index/late diastolic tissue Doppler velocity. METHODS: Retrospective analysis from the prospective monocentric observational trial Find-AF (ISRCTN-46104198. Patients with acute stroke or TIA were enrolled at the University Hospital Göttingen, Germany. Those with sinus rhythm at presentation received 7-day Holter-monitoring. ESVEA was quantified in one 24-hour interval free from PAF. Echocardiographic parameters were assessed prospectively. RESULTS: PAF was detected in 23/208 patients (11.1%. The median was 4 [IQR 1; 22] for PAC/h and 5 [IQR 0; 9] for SV-run(24 h. PAF was more prevalent in patients with ESVEA: 19.6% vs. 2.8% for PAC/h >4 vs. ≤ 4 (p5 vs. ≤ 5 beats (p = 0.003. Patients with PAF showed more supraventricular ectopic activity: 29 PAC/h [IQR 9; 143] vs. 4 PAC/h [1]; [14] and longest SV-run(24 h = 10 [5]; [21] vs. 0 [0; 8] beats (both p4 and abnormal LAVI/a' showed high PAF-rates. CONCLUSIONS: ESVEA discriminated PAF from non-PAF beyond clinical factors including LAVI/a' in patients with cerebral ischemia. Normal LAVI/a'+PAC/h ≤ 4 ruled out PAF, while prevalence was high in those with abnormal LAVI/a'+PAC/h >4.

  3. Significance of cardiac sympathetic nervous system abnormality for predicting vascular events in patients with idiopathic paroxysmal atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Akutsu, Yasushi; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Kawamura, Mitsuharu; Asano, Taku; Hamazaki, Yuji; Tanno, Kaoru; Kobayashi, Youichi [Showa University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo (Japan); Suyama, Jumpei; Shinozuka, Akira; Gokan, Takehiko [Showa University School of Medicine, Department of Radiology, Tokyo (Japan)

    2010-04-15

    Neuronal system activity plays an important role for the prognosis of patients with atrial fibrillation (AF). Using {sup 123}I metaiodobenzylguanidine ({sup 123}I-MIBG) scintigraphy, we investigated whether a cardiac sympathetic nervous system (SNS) abnormality would be associated with an increased risk of vascular events in patients with paroxysmal AF. {sup 123}I-MIBG scintigraphy was performed in 69 consecutive patients (67 {+-} 13 years, 62% men) with paroxysmal AF who did not have structural heart disease. SNS integrity was assessed from the heart to mediastinum (H/M) ratio on delayed imaging. Serum concentration of C-reactive protein (CRP) was measured before {sup 123}I-MIBG study. During a mean of 4.5 {+-} 3.6 years follow-up, 19 patients had myocardial infarction, stroke or heart failure (range: 0.2-11.5 years). SNS abnormality (H/M ratio <2.7) and high CRP ({>=}0.3 mg/dl) were associated with the vascular events (58.3% in 14 of 24 patients with SNS abnormality vs 11.1% in 5 of 45 patients without SNS abnormality, p < 0.0001, 52.4% in 11 of 21 patients with high CRP vs 16.7% in 8 of 48 patients without high CRP, p < 0.0001). After adjustment for potential confounding variables such as age, left atrial dimension and left ventricular function, SNS abnormality was an independent predictor of vascular events with a hazard ratio of 4.1 [95% confidence interval (CI): 1.3-12.6, p = 0.014]. Further, SNS abnormality had an incremental and additive prognostic power in combination with high CRP with an adjusted hazard ratio of 4.1 (95% CI: 1.5-10.9, p = 0.006). SNS abnormality is predictive of vascular events in patients with idiopathic paroxysmal AF. (orig.)

  4. Significance of cardiac sympathetic nervous system abnormality for predicting vascular events in patients with idiopathic paroxysmal atrial fibrillation

    International Nuclear Information System (INIS)

    Neuronal system activity plays an important role for the prognosis of patients with atrial fibrillation (AF). Using 123I metaiodobenzylguanidine (123I-MIBG) scintigraphy, we investigated whether a cardiac sympathetic nervous system (SNS) abnormality would be associated with an increased risk of vascular events in patients with paroxysmal AF. 123I-MIBG scintigraphy was performed in 69 consecutive patients (67 ± 13 years, 62% men) with paroxysmal AF who did not have structural heart disease. SNS integrity was assessed from the heart to mediastinum (H/M) ratio on delayed imaging. Serum concentration of C-reactive protein (CRP) was measured before 123I-MIBG study. During a mean of 4.5 ± 3.6 years follow-up, 19 patients had myocardial infarction, stroke or heart failure (range: 0.2-11.5 years). SNS abnormality (H/M ratio <2.7) and high CRP (≥0.3 mg/dl) were associated with the vascular events (58.3% in 14 of 24 patients with SNS abnormality vs 11.1% in 5 of 45 patients without SNS abnormality, p < 0.0001, 52.4% in 11 of 21 patients with high CRP vs 16.7% in 8 of 48 patients without high CRP, p < 0.0001). After adjustment for potential confounding variables such as age, left atrial dimension and left ventricular function, SNS abnormality was an independent predictor of vascular events with a hazard ratio of 4.1 [95% confidence interval (CI): 1.3-12.6, p = 0.014]. Further, SNS abnormality had an incremental and additive prognostic power in combination with high CRP with an adjusted hazard ratio of 4.1 (95% CI: 1.5-10.9, p = 0.006). SNS abnormality is predictive of vascular events in patients with idiopathic paroxysmal AF. (orig.)

  5. Dispersion of refractoriness in patients with paroxysmal atrial fibrillation. Evaluation with simultaneous endocardial recordings from both atria.

    Science.gov (United States)

    Li, Zhen; Hertervig, Eva; Carlson, Jonas; Johansson, Camilla; Olsson, S Bertil; Yuan, Shiwen

    2002-07-01

    This article studies the role of dispersion of atrial refractoriness (DAR) in the genesis of atrial fibrillation (AF). A 20-polar Halo catheter or a 40-polar basket catheter was placed in the right atrium and a 10-polar catheter in the coronary sinus in 21 patients with paroxysmal AF. Bipolar electrograms during AF were recorded from 7 to 16 sites in both atria. As control, electrograms during AF induced by extra-stimulation or burst pacing were also recorded from 4 to 14 sites in both atria in 12 patients with supraventricular tachycardias but without history of AF. The local atrial fibrillation intervals (AFI) during a period of 10 s or 20 s were measured and the mean, median and the 5th, 10th and 15th percentile AFIs at each site were calculated as estimates of the local effective refractory period (AERP). The maximum dispersion and variance of the estimated AERP among the 7-16/4-14 sites were used as measures of the DAR. The maximum dispersion and variance of the 5th and 10th percentile AFIs were significantly greater in the AF group than those in the control group, which were mainly due to the shortening of the minimum 5th and 10th percentile AFIs. No significant differences in dispersion and variance of the mean and median AFIs were shown between the 2 groups. The dispersion and variance of atrial refractoriness during AF estimated from the measurement of short AFIs were significantly greater in patients with paroxysmal AF than in those without clinical AF. The increased dispersion of refractoriness in patients with AF was mainly due to the shortening of the minimum AFIs. These findings suggest the involvement of an increased dispersion of atrial refractoriness in the genesis of paroxysmal AF. PMID:12122613

  6. Design and implementation of an electrocardiographical signal acquisition and digital processing system orientated to the detection of paroxysmal arrhythmias

    Science.gov (United States)

    Iriart Braceli, Agustín; Exequiel Morani, Jorge

    2011-12-01

    This article describes the design, technical aspects and implementation of a device capable of acquiring electrocardiograph signals; visualize them in real time over a graphic liquid crystal display (GLCD), and the storage of these ECG registers on a SD memory card. It also details a noise suppression algorithm using the Wavelet Transform. This system was specially developed to cover some bankruptcy that presents actual Holters or ECG regarding the detection of paroxysmal arrhythmias. The contribution of this work is settled on its portability and low production cost. The filtering method used provides an ECG signal without any significant noise and appropriate to the diagnosis of cardiac pathologies.

  7. Impact of the origin of sinus node artery on recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhi-jun; CHEN Ke; TANG Ri-bo; gANG Cai-hua; Edmundo Patricio Lopes Lao; YAN Qian; HE Xiao-nan

    2013-01-01

    Background Major atrial coronary arteries,including the sinus node artery (SNA),were commonly found in the areas involved in atrial fibrillation (AF) ablation and could cause difficulties in achieving linear block at the left atrial (LA) roof.The SNA is a major atrial coronary artery of the atrial coronary circulation.This study aimed to determine impact of the origin of SNA on recurrence of AF after pulmonary vein isolation (PVI) in patients with paroxysmal AF.Methods Seventy-eight patients underwent coronary angiography for suspected coronary heart disease,followed by catheter ablation for paroxysmal AF.According to the origin of SNA from angiographic findings,they were divided into right SNA group (SNA originating from the right coronary artery) and left SNA group (SNA originating from the left circumflex artery).Guided by an electroanatomic mapping system,circumferential pulmonary vein ablation (CPVA) was performed in both groups and PVI was the procedural endpoint.All patients were followed up at 1,3,6,9 and 12 months post-ablation.Recurrence was defined as any episode of atrial tachyarrhythmias (ATAs),including AF,atrial flutter or atrial tachycardia,that lasted longer than 30 seconds after a blanking period of 3 months.Results The SNA originated from the right coronary artery in 34 patients (43.6%) and the left circumflex artery in 44 patients (56.4%).Freedom from AF and antiarrhythmic drugs (AADs) at 1 year was 67.9 % (53/78) for all patients.After 1 year follow-up,79.4% (27/34) in right SNA group and 59.1% (26/44) in left SNA group (P=0.042) were in sinus rhythm.On multivariate analysis,left atrium size (HR=1.451,95%CI:1.240-1.697,P <0.001) and a left SNA (HR=6.22,95%CI:2.01-19.25,P=0.002)were the independent predictors of AF recurrence.Conclusions The left SNA is more frequent in the patients with paroxysmal AF.After one year follow-up,the presence of a left SNA was identified as an independent predictor of AF recurrence after CPVA in

  8. Paroxysmal supraventricular tachycardia as first manifestation of right atrial hemangioma during endovascular treatment of intracranial arteriovenous fistulas.

    Science.gov (United States)

    Spanò, Francesca; Cereda, Alberto; Moreo, Antonella; Bonacina, Edgardo; Peritore, Angelica; Roghi, Alberto; Giannattasio, Cristina; Pedrotti, Patrizia

    2015-06-10

    We report the description of a cardiac mass occupying almost the entire right atrium in a young man who developed paroxysmal supraventricular tachycardia during endovascular treatment of intracranial arteriovenous fistulas. The mass was detected at echocardiographic examination, its tissue characteristics were defined with cardiac magnetic resonance and it was successfully surgically removed. The histopathological findings were consistent with a mixed type cavernous-capillary hemangioma of the heart. The intriguing co-existence of cardiac hemangioma and cerebral arteriovenous fistulas, to the best of our knowledge, has not been previously reported in English Literature.

  9. Higher risk of death and stroke in patients with persistent vs. paroxysmal atrial fibrillation: results from the ROCKET-AF Trial

    Science.gov (United States)

    Steinberg, Benjamin A.; Hellkamp, Anne S.; Lokhnygina, Yuliya; Patel, Manesh R.; Breithardt, Günter; Hankey, Graeme J.; Becker, Richard C.; Singer, Daniel E.; Halperin, Jonathan L.; Hacke, Werner; Nessel, Christopher C.; Berkowitz, Scott D.; Mahaffey, Kenneth W.; Fox, Keith A.A.; Califf, Robert M.; Piccini, Jonathan P.

    2015-01-01

    Aim Anticoagulation prophylaxis for stroke is recommended for at-risk patients with either persistent or paroxysmal atrial fibrillation (AF). We compared outcomes in patients with persistent vs. paroxysmal AF receiving oral anticoagulation. Methods and results Patients randomized in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET-AF) trial (n = 14 264) were grouped by baseline AF category: paroxysmal or persistent. Multivariable adjustment was performed to compare thrombo-embolic events, bleeding, and death between groups, in high-risk subgroups, and across treatment assignment (rivaroxaban or warfarin). Of 14 062 patients, 11 548 (82%) had persistent AF and 2514 (18%) had paroxysmal AF. Patients with persistent AF were marginally older (73 vs. 72, P = 0.03), less likely female (39 vs. 45%, P < 0.0001), and more likely to have previously used vitamin K antagonists (64 vs. 56%, P < 0.0001) compared with patients with paroxysmal AF. In patients randomized to warfarin, time in therapeutic range was similar (58 vs. 57%, P = 0.94). Patients with persistent AF had higher adjusted rates of stroke or systemic embolism (2.18 vs. 1.73 events per 100-patient-years, P = 0.048) and all-cause mortality (4.78 vs. 3.52, P = 0.006). Rates of major bleeding were similar (3.55 vs. 3.31, P = 0.77). Rates of stroke or systemic embolism in both types of AF did not differ by treatment assignment (rivaroxaban vs. warfarin, Pinteraction = 0.6). Conclusion In patients with AF at moderate-to-high risk of stroke receiving anticoagulation, those with persistent AF have a higher risk of thrombo-embolic events and worse survival compared with paroxysmal AF. PMID:25209598

  10. Impact of radiation therapy for benign diseases; Role de la radiotherapie dans les affections benignes

    Energy Technology Data Exchange (ETDEWEB)

    Kantor, G. [Institut National de la Sante et de la Recherche Medicale (INSERM), Fondation Bergonie, 33 - Bordeaux (France); Van Houtte, P.; Beauvois, S.; Roelandts, M. [Institut Bordet, Brussels (Belgium)

    1997-12-31

    Radiation therapy of benign diseases represent a wide panel of indications. Some indications are clearly identified as treatment of arteriovenous malformations (AVM), hyperthyroid ophthalmopathy, postoperative heterotopic bone formations or keloid scars. Some indications are under evaluation as complications induced by neo-vessels of age-related macular degeneration or coronary restenosis after angioplasty. Some indications remain controversial with poor evidence of efficiency as treatment of bursitis, tendinitis or Dupuytren`s disease. Some indications are now obsolete such as warts, or contra-indicated as treatment of infant and children. (authors)

  11. Surgical Management of Benign and Borderline Phyllodes Tumors of the Breast.

    Science.gov (United States)

    Moutte, Amandine; Chopin, Nicolas; Faure, Christelle; Beurrier, Frédéric; Ho Quoc, Christophe; Guinaudeau, Florence; Treilleux, Isabelle; Carrabin, Nicolas

    2016-09-01

    Phyllodes tumors (PT) are uncommon fibroepithelial breast neoplasms and there is currently no clear consensual treatment for these tumors. The aim of our study was to evaluate the surgical management and outcome of benign and borderline PT. We retrospectively assessed 76 cases of benign or borderline PT managed at the Leon Berard comprehensive cancer center in Lyon, France between July 2003 and December 2013. The mean age at diagnosis was 37.9 years and the median follow-up was 58 months. Seventy-five patients (99%), with a mean tumor size of 27 mm, underwent a breast-conserving procedure. The tumor margins were considered positive (when the tumor was present at the inked surgical section) in seven of 76 cases (9%) and negative in 65 out of 76 cases (86%). We observed the presence of small negative surgical margins <10 mm in 89% and <1 mm in 71% of the patients. Although no re-excision was performed to increase these margins, we did not see any increase in the local recurrence rate (4%) when compared to recurrence rates reported in the literature. We thus suggest that systematic revision surgery for close or positive surgical margins for benign PT should not be systematically performed. However, as recurrences occur within 2 years of initial excision, we recommend a regular clinical and imaging follow-up especially during this period for which patient's compliance is essential.

  12. FDG PET/CT appearance of benign pilomatricoma.

    Science.gov (United States)

    Bhatt, Manoj Kumar; Sommerville, Ryan; Ravi Kumar, Aravind S

    2012-07-01

    A 56-year-old patient was referred for FDG PET/CT with a right preauricular lymph node fine-needle biopsy, suggesting poorly differentiated carcinoma and no obvious primary lesion. There was intense FDG uptake in the right preauricular nodule. The node was excised, and formal histology demonstrated a benign pilomatricoma rather than malignancy. Pilomatricoma is uncommon in adults and an unusual cause for marked FDG uptake, likely due to foreign body inflammation. Pilomatricoma can be either benign or malignant. The marked FDG uptake demonstrated in our patient with benign pilomatricoma also suggests that FDG PET cannot reliably grade this rare condition.

  13. A single microvascular decompression surgery cures a patient with trigeminal neuralgia, hemifacial spasm, tinnitus, hypertension, and paroxysmal supraventricular tachycardia caused by the compression of a vertebral artery.

    Science.gov (United States)

    Jia, Yin; Wenhua, Wang; Quanbin, Zhang

    2013-01-01

    This report presents a 72-year-old woman with posterior cranial fossa neurovascular compression syndrome that included paroxysmal supraventricular tachycardia. The patient underwent surgical exploration of the posterior cranial fossa, and a gross left vertebral artery was identified as the offending vessel. The neurovascular conflicts were associated with the cranial nerves V, VII, VIII, IX, and X. The patient experienced significant postoperative relief. Probably this is the first report of a single microvascular decompression, having cured such a high number of syndromes, including paroxysmal supraventricular tachycardia.

  14. Diagnostic Significance of Combining Telomerase Activity with CYFRA21-1 Level in Differentiating Malignant Pleural Effusion Caused by Lung Cancer from Benign Pleural Effusio

    OpenAIRE

    Li, Hongmei; Junhua FU; Yuande XIU; Zhou, Qinghua

    2010-01-01

    Background and objective Telomerase and CYFRA21-1 may be positively expressed in malignant pleural effusion, but the sensitivity and specificity of single tumor marker were low. The aim of this study is to investigate the diagnostic value of combining determination of telomerase activity and CYFRA21-1 levels in differentiating benign from malignant pleural effusion caused by lung cancer. Methods 80 patients with malignant and 50 patients with benign pleural effusion were enrolled into this st...

  15. Clinical research of benign infantile convulsions with mild gastroenteritis

    Directory of Open Access Journals (Sweden)

    Wei-bing LI

    2014-03-01

    Full Text Available Cases of benign infantile convulsions with mild gastroenteritis (BICE treated in our hospital from 2008 to 2012 were analyzed retrospectively. Among the 65 cases of convulsions with acute diarrhea, there were 18 cases of BICE, 15 cases of febrile seizures, 13 cases of epilepsy, 6 cases of viral encephalitis, 6 cases of hyponatremia encephalopathy, 3 cases of hypernatremia encephalopathy, 2 cases of toxic encephalopathy, and 2 cases of hypocalcemia convulsion. The convulsion occurred mostly during the first 2 d of the illness and was in a generalized tonic or tonic-clonic form. Positive rotavirus antigens in the BICE patients were detected in 83.33% (15/18. Phenobarbital was administered after the first convulsion (5-10 mg/kg, and diazepam was given intravenously in case of recurrence (0.10-0.30 mg/kg. BICE occurs frequently in infantile and controlling relapse is the main purpose. The prognosis is good. doi: 10.3969/j.issn.1672-6731.2014.03.019

  16. Hereditary benign telangiectasia: first case in Iran.

    Science.gov (United States)

    Javidi, Zari; Maleki, M; Mashayekhi, V; Nahidi, Y; Omidvar Borna, A

    2006-07-01

    A 14-year-old boy was referred to the Dermatology Clinic of the Medical University of Mashhad, Iran, with numerous cutaneous telangiectasias on the face, ears, lips, and back of the hands, with lesions in the temporal region being the first to appear (Figs 1-3). His mother stated that the lesions had been present for 10 years with an increase in the past 6 months. He had no history of bleeding from the nose, mouth, gastrointestinal tract, and other mucosal surfaces, and there was no sign of organ involvement. On inspection, no lesions were detected on the nasal mucosa, external ear, over the tympanic membrane, or mouth. The patient is one member of a family of six. His mother is healthy, but similar lesions were seen in his father, sister and one of his brothers with similar distributions. Lesions were also seen in his aunt and paternal grandmother, showing disease distribution in six members of this family from three generations. The oldest brother is 20 years of age and mentioned the onset of disease from the age of 10 years. The sister is 18 years of age and lesions started to appear 7 years ago; she claims that the lesions regress during her menstrual period. The youngest brother is 4 years of age and shows no sign of cutaneous lesions as yet. The parents are not consanguineous. Generalized telangiectasia with a predominant distribution on light-exposed skin, an autosomal dominant inheritance, and no sign of systemic or mucosal involvement and bleeding disorders indicates a diagnosis of hereditary benign telangiectasia. Our patient did not consent to biopsy. PMID:16863520

  17. [Interstitial laser coagulation of benign prostatic hyperplasia].

    Science.gov (United States)

    Muschter, R; Hessel, S; Hofstetter, A; Keiditsch, E; Rothenberger, K H; Schneede, P; Frank, F

    1993-07-01

    We report on the new method of interstitial laser coagulation for the treatment of benign prostatic hyperplasia (BPH). The procedure is based on the interstitial application of Nd:YAG laser irradiation, delivered through a new light guide system. Such light applicators coagulate constant tissue volumes in a homogeneous manner, as proven by in vitro studies in different tissues, including surgically removed prostate adenoma. The extent of the coagulation is determined by laser power and irradiation time. At 5 W, for example, and during a 10-min period, this zone reached a diameter of up to 20 mm. Temperatures generated in the process were over 100 degrees C, as measured by time/space resolution. These results were confirmed by in vivo studies in canine prostates. In the course of 7 weeks, the coagulated areas formed scars with degeneration and fibrosis, accompanied by marked shrinking. Neighbouring organs were not affected. The method was successfully transferred to clinical practice. The application of the light guides to the lateral lobes was performed percutaneously from the perineum under transrectal ultrasound guidance. The median lobe was punctured transurethrally under direct vision. Twenty-seven patients with an average age of 67.7 years were treated between July 1991 and March 1992. At the time of evaluation 15 patients had a follow-up of more than 2 months. They experienced a mean increase of peak flow rate from 6.6 to 15.2 ml/s and a mean decrease of residual volume from 206 to 38 ml. This was accompanied by a marked lessening of symptoms. The average prostate weight decreased from 63 to 44 g. Sexually active patients did not experience retrograde ejaculation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7690498

  18. ENVIROMENTALLY BENIGN MITIGATION OF MICROBIOLOGICALLY INFLUENCED CORROSION (MIC)

    Energy Technology Data Exchange (ETDEWEB)

    J. Robert Paterek; Gemma Husmillo; Amrutha Daram; Vesna Trbovic

    2003-10-31

    The overall program objective is to develop and evaluate environmentally benign agents or products that are effective in the prevention, inhibition, and mitigation of microbially influenced corrosion (MIC) in the internal surfaces of metallic natural gas pipelines. The goal is to develop one or more environmentally benign (a.k.a. ''green'') products that can be applied to maintain the structure and dependability of the natural gas infrastructure. The technical approach for this quarter includes the application of the method of fractionation of the extracts by high performance liquid chromatography (HPLC); determination of antimicrobial activities of the new extracts and fractions using a growth inhibition assay, and evaluation of the extracts' ability to inhibit biofilm formation. We initiated the delivery system for these new biocides in the test cell and in mixtures of foam components and biocides/anti-biofilms. A total of 51 fractions collected by HPLC from crude extracts that were obtained from three varieties of Capsicum sp. (Serrano, Habanero, Chile de Arbol) were subjected to growth inhibition tests against two SRB strains, D. vulgaris and D. desulfuricans. Five fractions showed growth inhibition against both strains while seven inhibited D. desulfuricans only. The crude extracts did not show growth inhibition on both strains but were proven to be potent in preventing the formation of biofilm. Growth inhibition tests of the same set of crude extracts against Comamonas denitrificans did not show positive results. The fractions will be subjected to biofilm inhibition and dissociation assay as well. The delivery system to be evaluated first was foam. The ''foam pig'' components of surfactants and water were tested with the biocide addition. The first chemical and physical parameters to be tested were pH and surfactants. Tests using the fractionated pepper extracts are progressing rapidly. Gas chromatographic analysis

  19. VIDEOLARYNGOSCOPIC SURGEY IN BENIGN LARYNGEAL LESIONS-OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Satheesh

    2015-11-01

    Full Text Available : Benign laryngeal lesions are commonly encountered causes of dysphonia and are often surgically correctable. A prospective study on 62 cases selected for videolaryngoscopic surgery was undertaken in a single unit in the department of ENT, Medical College Hospital, Thiruvananthapuram. The male: female ratio was 1.8:1 and the most common affected age group was 35-45 yrs. The most common benign lesion was vocal polyp. Preoperative voice assessment and 70 degree endoscopy was done. Follow up visits were done at 1 week, 3 weeks and 6 weeks and voice assessment and laryngoscopic appearances were noted. 98% reported excellent improvement of voice. The varieties of benign lesions which cause hoarseness are sources of concern and worry as it can affect the self esteem of a person. Thus videolaryngoscopic surgery (VLS coupled with voice therapy offers cost effective and safe management in benign laryngeal lesions

  20. Therapy: a new nonsurgical therapy option for benign thyroid nodules?

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo

    2009-01-01

    Despite the increasing implementation of iodization programs, benign nodular thyroid disease will remain a prevalent therapeutic concern for decades. recent research suggests that nonsurgical therapy, including radioactive iodine, radiofrequency thermal ablation and percutaneous laser ablation...

  1. Environmentally Benign Tribo-systems for Metal Forming

    DEFF Research Database (Denmark)

    Bay, Niels; Azushima, A.; Groche, P.;

    2010-01-01

    The growing awareness of environmental issues and the requirements to establish solutions diminishing the impact on working environment as well as external environment has initiated ever increasing efforts to develop new, environmentally benign tribological systems for metal forming. The present ...

  2. Radiofrequency ablation for treating paroxysmal supraventricular tachycardia complicated by atrial fibrillation: A single-center retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    WEI Zhan-yang; CHEN Li-hua; MO Jing-lan

    2016-01-01

    Background The effect of selective radiofrequency ablation for treating paroxysmal supraventricular tachycardia (PSVT) and its associated paroxysmal atrial fibrillation (PAF) was assessed.Methods Data were collected retrospectively from patients diagnosed of PSVT and subsequently treated with radiofrequency ablation.Regular monthly follow-up by dynamic electrocardiography (ECG) was performed.Incident rates of atrial fibrillation before and after ablation were compared.Results 382 PSVT patients with 58 having atrial fibrillation were enrolled.The order of complicated PAF from high to low in these patients was displayed as:atrial tachycardia (AT),atrioventricular reentrant tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT).Among AVRT patients,PAF was more frequent in patients having accessory pathways.AVNRT patients had significantly lower PAF rate comparing to other patients.PAF incident rate was significantly reduced by radiofrequency ablation therapy.Conclusion We advise regular dynamic ECG for PSVT patients,especially those with atrial flutter,AT or pre-excitation syndrome.Selective radiofrequency ablation is a feasible approach for treating AF complicated PSVT patients.

  3. Expression of Beta-Human Chorionic Gonadotropin Genes in Renal Cell Cancer and Benign Renal Disease Tissues

    Institute of Scientific and Technical Information of China (English)

    姜永光; 曾甫清; 肖传国; 刘俊敏

    2003-01-01

    To study the expression of beta-human chorionic gonadotropin (βhCG) genes in renal cellcarcinomas (RCC) and benign renal disease tissues, nested reverse transcription-polymerase chainreaction (RT-PCR) and restriction endonuclease analysis were employed to detect the expression ofβhCG genes in 44 cases of RCC tissues and 24 cases of benign renal disease tissues. It was foundthat 52% RCC samples revealed positive for βhCG mRNA expression. Positive rate in advancedstage and poorly differentiated RCC was higher, but there was no significant difference. The posi-tive rate of βhCG mRNA expression was 54% in 24 cases of benign renal tissues, including 3 casesout of 6 polycystic kidneys, 7 cases out of 13 renal atrophies, 2 cases out of 2 oncocytomas and 1case out of 2 pyonephrotic kidneys. β7 was most frequently transcribed subtype gene independent onthe histology. These findings suggested βhCG gene transcription is not only involved in RCC but al-so in benign renal diseases.

  4. Robotic-Assisted Surgery for Benign Urological Conditions

    OpenAIRE

    Murphy, Declan G; Ben J. Challacombe; Lail-U-Mah Zaheer; M. Shamim Khan; Prokar Dasgupta

    2006-01-01

    Robotic technology for use in surgery has advanced considerably in the past 10 years. This has become particularly apparent in urology where robotic-assisted radical prostatectomy using the da VinciTM surgical system (Intuitive Surgical, CA) has become very popular. The use of robotic assistance for benign urological procedures is less well documented. This article considers the current robotic technology and reviews the situation with regard to robotic surgery for benign urological conditions.

  5. Ultrasound image discrimination between benign and malignant adnexal masses

    OpenAIRE

    Aramendía Vidaurreta, Verónica

    2015-01-01

    This thesis deals with the discrimination between benign and malignant adnexal masses through ultrasound images. This task represents one of the most challenging problems in gynecological practice. Benign adnexal masses should be treated by minimally invasive surgery whereas patients with questionable adnexal masses should be referred for primary surgery. An accurate diagnosis is crucial in order to establish the optimal management for these patients. Therefore, it is essential ...

  6. Benign occipital lobe seizures: Natural progression and atypical evolution

    OpenAIRE

    Prithika Chary; Bhuvaneshwari Rajendran

    2013-01-01

    Benign occipital seizure syndromes are benign childhood epilepsy syndromes and are mainly of two types, Panayiotopoulos syndrome, an autonomic epilepsy and idiopathic childhood occipital epilepsy of Gastaut (ICOE-G) including the idiopathic photosensitive occipital lobe epilepsy. Although both these types are categorized as occipital seizures, they are distinct in presentation and management. They can also be tricky to diagnose as visual symptoms may not always be the presenting feature and i...

  7. Incidence of Benign Results After Laparoscopic Radical Nephroureterectomy

    OpenAIRE

    Hong, Sungwoo; Kwon, Taekmin; You, Dalsan; Jeong, In Gab; Hong, Bumsik; Hong, Jun Hyuk; Ahn, Hanjong; Kim, Choung-Soo

    2014-01-01

    Background and Objectives: Studies of patients with benign pathologic lesions who underwent laparoscopic radical nephroureterectomy (RNU) with preoperative suspicion of upper urinary tract urothelial carcinoma are lacking. The aim of this retrospective cross-sectional study was to evaluate the incidence of benign pathologic lesions on laparoscopic RNU for upper urinary tract tumors that are presumed to be urothelial carcinoma. The clinicopathologic characteristics of these lesions were also d...

  8. Lomber Disk Hernisi ve Benign Eklem Hipermobilite Sendromu

    OpenAIRE

    KARAKAŞLI, Sema; TÜFEKÇİ, Osman

    2013-01-01

    Objective: Benign joint hypermobility is a syndrome that it can be seen together with many other muscle-skeleton disorders. Lower backpain is an important result of hypermobility syndrome. The aim of this study is representing of whether there is a relation between lumbar disc hernia and benign hypermobility syndrome. Material and Methods: 133 patients who diagnosed with lumbar disc hernia was included in this study. By using of revised brighton criteria of these patients, hypermobility is ev...

  9. Benign joint hypermobility syndrome among children with inguinal hernia

    OpenAIRE

    Masoud Nazem; Peyman Mottaghi; Alireza Hoseini; Hesam-al-din Khodadadi

    2013-01-01

    Background: Benign joint hypermobility syndrome (BJHS) is a disorder due to laxity of supporting connective tissue of joints. Inguinal hernia is also proposed due to weak supporting tissue that may be a clinical presentation of a more widespread problem of connective tissue. Materials and Methods: In a cross-sectional study, prevalence of benign hypermobility joint syndrome (BHJS) was assessed among 100 children aged 2-12 year admitted with inguinal hernia during 2010-2011. Results: BJHS (Bei...

  10. Benign Proliferative Breast Lesions and Risk of Cancer

    OpenAIRE

    Serap Erel

    2010-01-01

    Benign breast lesions (BBL) includes a wide variety of histologic entities, which have been broadly classified into non-proliferative lesions, proliferative lesions without atypia, and hyperplasia with atypia. With the increased use of mammography, more benign lesions are being detected, and in order to estimate the risk of breast cancer for specific histologic categories is of great importance to guide clinical management. Women with proliferative lesions without atypia are at slightly incre...

  11. Memenin Benign Proliferatif Lezyonları ve Kanser Riski

    OpenAIRE

    Erel, Serap

    2010-01-01

    Benign breast lesions (BBL) includes a wide variety of histologic entities, which have been broadly classified into non-proliferative lesions, proliferative lesions without atypia, and hyperplasia with atypia. With the increased use of mammography, more benign lesions are being detected, and in order to estimate the risk of breast cancer for specific histologic categories is of great importance to guide clinical management. Women with proliferative lesions without atypia are at slightly incre...

  12. Diagnostic value of chemical shift artifact in distinguishing benign lymphadenopathy

    International Nuclear Information System (INIS)

    Purpose: Today, distinguishing metastatic lymph nodes from secondary benign inflammatory ones via using non-invasive methods is increasingly favorable. In this study, the diagnostic value of chemical shift artifact (CSA) in magnetic resonance imaging (MRI) was evaluated to distinguish benign lymphadenopathy. Subjects and methods: A prospective intraindividual internal review board-approved study was carried out on 15 men and 15 women having lymphadenopathic lesions in different locations of the body who underwent contrast-enhanced dynamic MR imaging at 1.5 T. Then, the imaging findings were compared with pathology reports, using the statistics analyses. Results: Due to the findings of the CSA existence in MRI, a total of 56.7% of the studied lesions (17 of 30) were identified as benign lesions and the rest were malignant, whereas the pathology reports distinguished twelve malignant and eighteen benign cases. Furthermore, the CSA findings comparing the pathology reports indicated that CSA, with confidence of 79.5%, has a significant diagnostic value to differentiate benign lesions from malignant ones. Conclusion: Our study demonstrated that CSA in MR imaging has a suitable diagnostic potential nearing readiness for clinical trials. Furthermore, CSA seems to be a feasible tool to differentiate benign lymph nodes from malignant ones; however, further studies including larger numbers of patients are required to confirm our results.

  13. Smoking habits and benign prostatic hyperplasia

    Science.gov (United States)

    Xu, Huan; Fu, Shi; Chen, Yanbo; Chen, Qi; Gu, Meng; Wang, Zhong

    2016-01-01

    Abstract Previous studies have warned against the promoting effects of cigarette smoking on benign prostatic hyperplasia (BPH). In contrast, some have argued that smoking confers a protective effect regarding BPH, while others have observed an aggravated effect. Thus, we performed this meta-analysis to determine whether cigarette use is associated with BPH risk. To identify articles from observational studies of relevance, a search was performed concurrent to March 21, 2016, on PubMed, Web of Science, Cochrane, EBSCO, and EMBASE databases. Random-effect model, according to the heterogeneity, was calculated to reveal the relative risks (RRs) and corresponding 95% confidence intervals (CIs). Eight articles were included in this meta-analysis, representing data for 44,100 subjects, of which 5221 (11.8%) had BPH as defined according to the criteria. Seven reports are concerned with analysis between nonsmokers and ex-smokers, in which no significant difference was observed (RR = 0.99, 95% CI 0.94–1.05). Another meta-analysis of 7 studies indicated an observable trend, but without significant difference between groups of nonsmokers and current smokers (RR = 1.17, 95% CI 0.98–1.41). Between groups of heavy (6 articles; RR = 1.02, 95% CI 0.84–1.24) and light smokers (5 articles; RR = 0.90, 95% CI 0.71–1.15), again no significant difference appears. Finally, we combined individuals as never-smokers and ever-smokers and still found no significant difference between the 2 groups of patients (RR = 1.03, 95% CI 0.92–1.15). Sensitivity analysis was displayed and confirmed the stability of the present results. Combined evidence from observational studies shows no significant association between cigarette smoking and BPH risk, either for ex-smokers or for current smokers. The trend of elevated BPH risk from smoking was observed only in current smokers compared with nonsmokers, while marginal significance was observed in comparing ever-smokers with

  14. Inter-observer agreement of canine and feline paroxysmal event semiology and classification by veterinary neurology specialists and non-specialists

    NARCIS (Netherlands)

    Packer, Rowena Ma; Berendt, Mette; Bhatti, Sofie; Charalambous, Marios; Cizinauskas, Sigitas; De Risio, Luisa; Farquhar, Robyn; Hampel, Rachel; Hill, Myfanwy; Mandigers, Paul Jj; Pakozdy, Akos; Preston, Stephanie M; Rusbridge, Clare; Stein, Veronika M; Taylor-Brown, Fran; Tipold, Andrea; Volk, Holger A

    2015-01-01

    BACKGROUND: Advances in mobile technology mean vets are now commonly presented with videos of paroxysmal events by clients, but the consistency of the interpretation of these videos has not been investigated. The objective of this study was to investigate the level of agreement between vets (both ne

  15. 胼胝体梗死所致的发作性拮抗性失用%Paroxysmal diagonistic ideomotor apraxia in ischemic infarction of the corpus callosum

    Institute of Scientific and Technical Information of China (English)

    王亭亭; 贾志荣; 孙葳; 潘涛

    2011-01-01

    Objectives To report the clinical features and treatment in a case with paroxysmal diagonistic ideomotor apraxia after ischemic infarction of the corpus callosum.Methods The neuropsychological tests,brain MRI,the TCD and carotid duplex sonography were carried out in the patient who is right handed and had had presentation of paroxysmal diagonistic ideomotor apraxia for ten days.Results Neuropsychological tests confirmed the diagnosis of paroxysmal diagonistic apraxia in this patient.MRI showed ischemic infarction in the right corpus callosum.The symptomsin the patient were improved after the treatment with aspirin for three months.Conclusion The infarction of corpus callosum may induce paroxysmal diagonistic apraxia.%目的 探讨胼胝体梗死引起拮抗性失用的特点和机制.方法 对1例表现为发作性拮抗性失用的患者,分别进行神经心理、头颅磁共振、颈CT血管成像检查.结果 神经心理检查提示为拮抗性失用,头MRI示右侧胼胝体梗死,予抗血小板,改善脑循环治疗后发作减少.结论 胼胝体梗死可以引起发作性拮抗性失用为特征的神经心理症状.

  16. Malignant and benign diseases of the breast in 41 male patients: mammography, sonography and pathological correlations

    International Nuclear Information System (INIS)

    Aim: The goal of our study was to evaluate findings in mammography and sonography in male patients with pathohistologically proven diseases of the breast. Material and Methods: Mammographies and sonographies, which were obtained in 41 male patients in a 6-year period, were retrospectively evaluated in accordance with the BI-RADS trademark classification. Results: Histologically 13 carcinomas, 21 gynecomastias, 3 pseudogynecomastias, 2 epithelial inclusion cysts and 2 other benign lesions were diagnosed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of mammography in differentiation of benign versus malignant disease were 92%, 89%, 80%, 96% and 90%, respectively. Additional sonography did not change these results. However, sonography increased diagnostic confidence in 18.2% (2/11) of suspicious lesions. Conclusion: In our study the invasive ductal carcinoma of male patients was a predominantly lobulated, ill-defined lesion in mammography and sonography. The differentiation of carcinoma to pseudogynecomastia and diffuse or dendritic gynecomastia was securely feasible. However, we could not reliably distinguish between carcinoma and some benign mass lesions. In cases of mammographically diagnosed masses or unclear mammography, additional sonography should be performed to increase the diagnostic confidence. (orig.)

  17. Temporary Placement of Stent Grafts in Postsurgical Benign Biliary Strictures: a Single Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Vellody, Ranjith; Willatt, Jnonathon M.; Arabi, Mohammad; Cwikiel, Wojciech B [Division of Interventional Radiology, University of Michigan, Ann Arbor (United States)

    2011-11-15

    To evaluate the effect of temporary stent graft placement in the treatment of benign anastomotic biliary strictures. Nine patients, five women and four men, 22-64 years old (mean, 47.5 years), with chronic benign biliary anastomotic strictures, refractory to repeated balloon dilations, were treated by prolonged, temporary placement of stent-grafts. Four patients had strictures following a liver transplantation; three of them in bilio-enteric anastomoses and one in a choledocho-choledochostomy. Four of the other five patients had strictures at bilio-enteric anastomoses, which developed after complications following laparoscopic cholecystectomies and in one after a Whipple procedure for duodenal carcinoma. In eight patients, balloon-expandable stent-grafts were placed and one patient was treated by insertion of a self-expanding stent-graft. In the transplant group, treatment of patients with bilio-enteric anastomoses was unsuccessful (mean stent duration, 30 days). The patient treated for stenosis in the choledocho-choledochostomy responded well to consecutive self-expanding stent-graft placement (total placement duration, 112 days). All patients with bilio-enteric anastomoses in the non-transplant group were treated successfully with stent-grafts (mean placement duration, 37 days). Treatment of benign biliary strictures with temporary placement of stent-grafts has a positive effect, but is less successful in patients with strictures developed following a liver transplant.

  18. Percutaneous expandable metallic stent biliary endoprostheses used inmalignant and benign obstructive jaundice

    Institute of Scientific and Technical Information of China (English)

    Hai Ying Liu; Wei Hua Tong; Wei Min Hu; Huai Ren Li; Zhe Sheng Wen; Jia Kang Wang; Wan Xi Huang; Shu Liu

    2000-01-01

    AIM To evaluate the effects of expandable metallic stent biliary endoprostheses (EMSBE) viaultrasonographic guided percutaneous transhepatic approach on the treatment of benign and malignantobstructive jaundice.METHODS Thirty-eight patients with obstructive jaundice (29 males and 9 females) aged 27 to 69 years(mean 54.7 years) were studied. Of them, 4 were benign and 34 malignant obstructions. Percutaneoustranshepatic cholangiography (PTC) was performed under ultrasonic guidance. A catheter was introducedinto the dilated bile duct via the introducer. A guide wire was inserted through the occlusive part of biliary duct after dilating with a double-lumen balloon catheter. A self-expandable metallic stent was inserted intcthe occlusive bile duct under fluoroscopic control.RESULTS The success rate of sonographic guided PTC was 100% (38/38) and the success rate of stentimplantation was 86.8% (33/ 38). Biliary obstruction was eliminated immediately, jaundice subsidedgradually and symptoms relieved after the procedure. During the 3 to 28 months fellow-up, re-occlusionoccurred in 4 malignant cases which were corrected by balloon catheter dilation and/or by stent, one patienthad secondary cholangitis and fifteen died without jaundice 6 - 28 months after the procedure. The otherswere alive with no jaundice. No severe complications or side effects were observed.CONCLUSION EMSBE via sonographic guided percutaneous transhepatic approach is a reliable and safepalliative therapy for malignant jaundice and an ideal nonoperative method for benign biliary obstruction. Ithas a definite positive impact on the quality of patient life.

  19. APOPTOTIC AND PROLIFERATIVE ACTIVITY IN OVARIAN BENIGN,BORDERLINE AND MALIGNANT TUMORS

    Institute of Scientific and Technical Information of China (English)

    刘爱军; 陈乐真; 颜婉嫦; 邱玮璇; 赵昀; 张雅贤

    2002-01-01

    Objective.To determine the apoptotic and proliferative activities in various ovarian epithelial tumors.Methods.Formalin fixed,paraffin embedded tissues of 86 ovarian epithelial tumors,including 52 adenocarcinomas,23 borderline tumors and 11 cystadenomas,were retrieved.Apoptotic (AI) and proliferative (PI) index were estimated using the monoclonal antibodies: M30,Ki 67 and Ki S1 in these tumors.Quantitative assessment of AI and PI was estimated by calculating the percentage of positive cells among no less than 1000 tumor cells.Results.Statistically significant difference in AI was found between benign and borderline tumors or carcinomas (P=0.028,0.001,respectively).Significant differences in PI,as assessed by both Ki 67 and topo IIα,were demonstrated between carcinomas and benign or borderline tumors (both P< 0.001).Benign tumors had both low PI and AI; borderline tumors had lower PI but higher AI,while adenocarcinomas had both high proliferative and high apoptotic rates.Among borderline tumors,serous tumors had significantly lower AI and higher PI than mucinous ones.Conclusions.The results suggest that apoptotic and proliferative activities play important roles in the pathogenesis and development of ovarian borderline and malignant tumors.The high apoptotic rate in borderline tumor may explain its relatively indolent behavior while the high proliferative rate in carcinomas tends to explain its aggressive behavior.

  20. "MONOCLONAL ANTIBODY HBME-1 USEFULNESS IN DIFFERENTIATION OF BENIGN NEOPLASM AND DIFFERENTIATED THYROID CARCINOMA"

    Directory of Open Access Journals (Sweden)

    M. Mokhtari

    2005-05-01

    Full Text Available HBME-l is an antimesothelial monoclonal antibody that recognizes an unknown antigen on microvilli of mesothelial cells. The antibody is only relatively specific for mesothelium and is used in the differential diagnosis of mesothelioma and adenocarcinoma within the context of an appropriate immuno-histochemical panel. HBME-l has also been reported to strongly and uniformly stain papillary and follicular carcinoma of the thyroid while benign disorders have been usually negative. We studied the immunoreactivity of HBME-l in 90 cases of benign and malignant thyroid lesions. We found strong positive staining in the majority of papillary carcinomas (28/31, in some of follicular carcinomas (4/6,and in a few follicular adenomas (2/17. Negative staining was found in oxyphilic cell adenoma (0/4, nodular goiter (0/13 and undifferentiated carcinoma. The results suggest that monoclonal antibody HBME-l is useful in differentiating papillary and follicular carcinoma of the thyroid from benign lesions, especially in more differentiated lesions. Strong and generalized immunoreactivity for HBME-l in a follicular lesion should raise the suspicion of malignancy, but negative staining specially in poorly differentiated lesion does not rule out malignancy.

  1. Differentiation of malignant and benign proximal bile duct strictures: The diagnostic dilemma

    Institute of Scientific and Technical Information of China (English)

    Jaap Jacob Kloek; Otto Marinus van Delden; Deha Erdogan; Fibo Jan ten Kate; Erik Anthoni Rauws; Olivier Robert Busch; Dirk Joan Gouma; Thomas Mathijs van Gulik

    2008-01-01

    AIM: To identify the criteria for the differentiation of hilar cholangiocarcinoma (HCCA) from benign strictures.METHODS: A total of 68 patients underwent resection of lesions suspicious for HCCA between 1998 and 2006. The results of laboratory investigations, imaging studies and brush cytology were collected. These findings were analyzed to obtain the final diagnosis. RESULTS: Histological examination of the resected specimens confirmed HCCA in 58 patients (85%, group Ⅰ) whereas 10 patients (15%, group Ⅱ)were diagnosed to have benign strictures. The most common presenting symptom was obstructive jaundice in 77% patients (79% group Ⅰ vs 60% group Ⅱ, P =0.23). Laboratory findings showed greater elevation of transaminase levels in group I compared to group Ⅱ. The various imaging modalities showed vascular involvement exdusively in the malignant group (36%,P < 0.05). Brush cytology was positive for malignant cells in only 50% patients in group Ⅰ whereas none in group Ⅱ showed malignant cells.CONCLUSION: Despite improvements in imaging techniques, 10 patients (15%) with a presumptive diagnosis of HCCA were ultimately found to have benign strictures. Except for vascular involvement which was associated significantly with malignancy,there were no conclusive features of malignancy on regular imaging modalities. This uncertainty should be taken into account when patients with a suspicious lesion at the liver hilum are considered for resection.

  2. p53 alteration in morphologically normal/benign breast tissue in patients with triple-negative high-grade breast carcinomas: breast p53 signature?

    Science.gov (United States)

    Wang, Xi; Stolla, Moritz; Ring, Brian Z; Yang, Qi; Laughlin, Todd S; Rothberg, Paul G; Skinner, Kristin; Hicks, David G

    2016-09-01

    p53 alterations have been identified in approximately 23% of breast carcinomas, particularly in hormone receptor-negative high-grade carcinomas. It is considered to be an early event in breast carcinogenesis. Nevertheless, the putative precursor lesion of high-grade breast carcinoma remains elusive. Breast excision specimens from 93 triple-negative high-grade invasive ductal carcinomas, 48 estrogen receptor (ER)-positive/progesterone receptor-positive/Her2-negative non-high-grade invasive ductal carcinomas, and 50 mammoplasty breasts were selected. At least 2 tissue blocks with tumor and adjacent benign tissue were sectioned and subjected to immunohistochemistry staining for p53. TP53 gene sequencing was performed on select tumors. Further immunohistochemistry staining for ER and Ki-67 was performed on consecutive sections of tissue with p53-positive normal/benign cells. Of the 93 high-grade carcinomas, 51 (55%) were positive for p53 alteration, whereas only 3 (6.25%) of the 48 non-high-grade carcinomas were p53 altered. Focal p53 positivity in adjacent normal/benign breast tissue was identified in 19 cases, and 18 of them also had p53 alteration in their carcinomas. Only 1 case had focal p53 staining in normal/benign tissue, but the tumor was negative for p53 alteration. No p53 staining positivity was identified in the mammoplasty specimens. The p53-stained normal/benign cells were ER negative and did not show an increase in the Ki-67 labeling index. These findings indicate that the p53 staining positivity in normal/benign breast tissue is not a random event. It could be considered as the "p53 signature" in breast and serve as an indicator for future potential risk of p53-positive high-grade breast carcinoma. PMID:27246177

  3. Role of diffusion MRI in characterizing benign and malignant breast lesions

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the role of MRI based diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) for characterizing breast lesions in Indian patients. This prospective analysis was performed between October 2006 and June 2008. It includes 200 patients between the ages of 16 and 80 years with solid breast lesions greater than 1 cm in diameter. Of these 200 patients, 80 underwent breast MRI with contrast and DWI. One hundred and twenty patients had only DWI as they had come only for sonomammography. A total of 280 lesions were detected. ADC values were calculated for all the lesions and the highest and lowest values of ADC for benign and malignant lesions were identified. Finally, we compared our findings with those of previous studies. Two hundred and eight lesions were categorized as benign and 72 lesions were categorized as malignant based on the ADC values. Based on previous data, lesions with ADC values from 1.3 to 1.5 mm2/s were considered benign where as lesions with ADC values ranging between 0.85 and 1.1 mm2/s were considered malignant. Two lesions whose ADC values were in the benign range were proven to be malignant tumors after surgery. This method of using ADC values for the detection of malignant lesions showed a sensitivity of 97.22% and a specificity of 100%. The positive predictive value was 100%. DWI is a useful technique for characterizing breast tumors, especially for lesions that cannot be adequately characterized by ultrasonography and routine magnetic resonance imaging

  4. Diffusion-weighted MRI for differentiation of benign from malignant lesions in the gallbladder

    International Nuclear Information System (INIS)

    Aim: To investigate the value of diffusion-weighted imaging (DWI) for differentiating benign from malignant gallbladder lesions. Materials and methods: One hundred and twenty-six patients who had undergone magnetic resonance imaging (MRI) with DWI, in whom the histopathological diagnosis of their gallbladder lesions was confirmed by biopsy or surgery were retrospectively analysed. Thirty-six malignant and 90 benign lesions were included. Two radiologists categorized gallbladder lesions into seven types on two imaging sets [T2-weighted imaging (WI) alone and combined T2WI and DWI (b = 800 s/mm2)] according to the presence of wall thickening, layered patterns, morphology of the mass, and diffusion restriction. Disagreements were resolved in consensus. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each imaging set for diagnosing gallbladder carcinoma were calculated. The diagnostic performance of each imaging set was calculated using receiver operating characteristic (ROC) curve analysis. Additionally, ADC values of malignant and benign gallbladder lesions were compared separately for 1.5 and 3 T MRI. Results: The sensitivity, specificity, PPV, and NPV of diagnosis at T2WI were 97.2%, 86.7%, 74.5%, and 98.7%, respectively. The sensitivity, specificity, PPV, and NPV using combined T2WI and DWI were 97.2%, 92.2%, 83.3%, and 98.8%, respectively. Diagnostic accuracy for gallbladder carcinoma slightly improved after adding DWI, from 0.92 to 0.95 (p −3 and 1.72 ± 0.56 × 10−3 mm2/s, respectively, at 1.5 T (p −3 and 2.2 ± 0.72 × 10−3 mm2/s, respectively, at 3 T (p < 0.001). Conclusion: DWI can improve diagnostic accuracy for differentiating benign from malignant gallbladder lesions

  5. Benign breast diseases. Radiology, pathology, risk assessment. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Chinyama, Catherine N. [Princess Elizabeth Hospital, Le Vauquiedor, St. Martin' s Guernsey, Channel Islands (United Kingdom); Brighton and Sussex Medical School, Brighton (United Kingdom)

    2014-04-01

    Radiological and pathological correlation of the full range of benign breast lesions, with emphasis on screen-detected lesions. Detailed discussion of risk assessment. Revised and updated edition, with a new chapter on gynaecomastia. Ideal aid to the management of patients with benign or indeterminate breast lesions in a multidisciplinary setting. The second edition of this book has been extensively revised and updated. There have been numerous scientific advances in the radiology, pathology and risk assessment of benign breast lesions since the publication of the first edition. The first edition concentrated on screen-detected lesions, which has since been rectified; new symptomatic and screen-detected lesions are discussed in the second edition and include: mastitis and breast abscesses, idiopathic granulomatous mastitis, diabetic mastopathy, phyllodes tumours, gynaecomastia and pseudoangiomatous stromal hyperplasia. The chapters on columnar cell lesions and mucocele-like lesions have been extensively updated. Where applicable, genetic analysis of the benign lesions, which is becoming part of personalised medicine in the field of breast cancer, has been included. The book also presents detailed analyses of the main models, such as the Gail Model, used to assess the subsequent risk of breast cancer in individuals. The current trend in the management of all cancers is preventative. Screening mammography detects early curable cancers as well as indeterminate lesions, the latter of which are invariably pathologically benign. The author has collated important benign lesions and, based on peer-reviewed publications, has documented the relative risk of subsequent cancer to allow the patient and the clinician to implement preventative measures where possible. This book will therefore serve as an essential component of multidisciplinary management of patients with symptomatic and screen-detected benign breast lesions.

  6. Benign breast diseases. Radiology, pathology, risk assessment. 2. ed.

    International Nuclear Information System (INIS)

    Radiological and pathological correlation of the full range of benign breast lesions, with emphasis on screen-detected lesions. Detailed discussion of risk assessment. Revised and updated edition, with a new chapter on gynaecomastia. Ideal aid to the management of patients with benign or indeterminate breast lesions in a multidisciplinary setting. The second edition of this book has been extensively revised and updated. There have been numerous scientific advances in the radiology, pathology and risk assessment of benign breast lesions since the publication of the first edition. The first edition concentrated on screen-detected lesions, which has since been rectified; new symptomatic and screen-detected lesions are discussed in the second edition and include: mastitis and breast abscesses, idiopathic granulomatous mastitis, diabetic mastopathy, phyllodes tumours, gynaecomastia and pseudoangiomatous stromal hyperplasia. The chapters on columnar cell lesions and mucocele-like lesions have been extensively updated. Where applicable, genetic analysis of the benign lesions, which is becoming part of personalised medicine in the field of breast cancer, has been included. The book also presents detailed analyses of the main models, such as the Gail Model, used to assess the subsequent risk of breast cancer in individuals. The current trend in the management of all cancers is preventative. Screening mammography detects early curable cancers as well as indeterminate lesions, the latter of which are invariably pathologically benign. The author has collated important benign lesions and, based on peer-reviewed publications, has documented the relative risk of subsequent cancer to allow the patient and the clinician to implement preventative measures where possible. This book will therefore serve as an essential component of multidisciplinary management of patients with symptomatic and screen-detected benign breast lesions.

  7. Benign Metastasizing Leiomyoma: A Rare Type of Lung Metastases—Two Case Reports and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Rokana Taftaf

    2014-01-01

    Full Text Available Benign metastasizing leiomyoma (BML is a rare disease that usually occurs in women of reproductive age. They typically have history of uterine leiomyoma treated with hysterectomy. BML can metastasize to distant organs, with the lung being the most common organ. We report two patients who presented with benign metastasizing leiomyoma to the lung. Our first case was a fifty-two-year-old female who presented with multiple lung masses, with a past medical history of uterine leiomyoma who underwent hysterectomy 17 years ago. A CT-guided biopsy showed benign appearing spindle cells and pathology confirmed her diagnosis with additional positive estrogen/progesterone receptor stains. Our second case was a fifty-six-year-old female who presented with multiple cavitary pulmonary nodules. She subsequently underwent a video-assisted thoracoscopic surgery (VATS with wedge resection of one of the nodules. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining strongly positive for estrogen/progesterone receptors. Benign metastasizing leiomyoma is a rare condition which may affect women of reproductive age. This should be considered in the differential in patients who present with multiple pulmonary nodules, especially with a history of uterine leiomyoma. Additional stains, such as estrogen/progesterone receptors, may need to be done to confirm the diagnosis.

  8. Radiofrequency Ablation Mapping with Circumferential Catheter for Paroxys-mal Atrial Fibrillation Originating From the Pulmonary Veins

    Institute of Scientific and Technical Information of China (English)

    刘震; 吴书林; 杨平珍; 方咸宏; 李海杰; 陈泗林; 詹贤章; 薛玉梅

    2002-01-01

    Objectives To assessed thefeasibility and effectiveness of electrophysiologicalmapping of pulmonary veins with a circumferential 10-electrode catheter and radiofrequency catheter abla-tion therapy for patients with paroxysmal atrial fibril-lation. Background Standard mapping and ablationof focal sources of atrial fibrillation are associated withvery long procedure times and low efficacy. Mappingand ablation pulmonary veins guide with a circularcatheter could overcome these limitations. Methods16 patients [male 11, female 5, mean age (51 +14.5) years] with paroxysmal atrial fibrillation refrac-tory to antiarrhythmic drugs were included in thisgroup. A circumferential 10-electrode catheter wasused to pulmonary vein mapping during sinus rhythm orCSd pacing to determine the origin of atrial prematurecontractions. When the ablative target pulmonary veinwas found, the pulmonary vein potentials' distributionand activation were assessment pulmonary veins' ostialablation was performed at the segments showing earliestactivation of pulnonary vein potentials. The end pointwas designed: 1 ) elimination of pulmonary vein po-tential; 2) pulmonary vein potential dissociation fromatrial waves; 3) atrial ectopic beats disappear. ResultsA total of 36 pulmonary veins were ablated, in-cluding 16 left superior, 12 right superior, 7 left in-ferior and 1 right inferior. 1 pulmonary vein in 2 pa-tients was ablated, 2 pulmonary veins in 8 patientswere ablated, 3 pulmonary veins were ablated in 5patients and 4 pulmonary veins were ablated in 1 pa-tient. Procedure duration and fluoroscopy time respec-tively were 186.7 _+ 63.8 min and 51.5 + 15.0 min.During the follow-up 1- 12 months, 11 patients(68.7 % ) were free of AF without any antiarrhythmicdrugs, 2 of them were reablation, effective in 3/16(18.7%) and unsuccessful in 2/16 (12.6%) . 2cases recurred with atrial premature, 1 was treated withamiodarone and the other was repeat electrophysiologi-cal mapping and ablation, 5 cases with

  9. Genetic alterations in benign lesions: Chronic gastritis and gastric ulcer

    Institute of Scientific and Technical Information of China (English)

    Ana Cristina Gobbo César; Marília de Freitas Calmon; Patrícia Maluf Cury; Alaor Caetano; Aldenis Albaneze Borim; Ana Elizabete Silva

    2006-01-01

    AIM: To investigate the occurrence of chromosome 3, 7,8, 9, and 17 aneuploidies, TP53 gene deletion and p53 protein expression in chronic gastritis, atrophic gastritis and gastric ulcer, and their association with H pylori infection.METHODS: Gastric biopsies from normal mucosa (NM,n = 10), chronic gastritis (CG,n =38), atrophic gastritis (CAG, n=13) and gastric ulcer (GU, n = 21) were studied using fluorescence in situ hybridization (FISH) and immunohistochemical assay. A modified Giemsa staining technique and PCR were used to detect H pylori. An association of the gastric pathologies and aneuploidies with H pylori infection was assessed.RESULTS: Aneuploidies were increasingly found from CG (21%) to CAG (31%) and to GU (62%), involving mainly monosomy and trisomy 7, trisomies 7 and 8, and trisornies 7, 8 and 17, respectively. A significant association was found between H pylori infection and aneuploidies in CAG (P= 0.0143) and GU (P= 0.0498). No TP53 deletion was found in these gastric lesions, but p53-positive immunoreactivity was detected in 45% (5/11) and 12% (2/17) of CG and GU cases, respectively. However, there was no significant association between p53 expression and H pylori infection.CONCLUSION: The occurrence of aneuploidies in benign lesions evidences chromosomal instability in early stages of gastric carcinogenesis associated with H pylori infection, which may confer proliferative advantage. The increase of p53 protein expression in CG and GU may be due to overproduction of the wild-type protein related to an inflammatory response in mucosa.

  10. Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hennedige, Tiffany P.; Hallinan, James Thomas Patrick Decourcy; Teo, Lynette Li San [National University Hospital, National University Health System, Department of Diagnostic Imaging, Singapore (Singapore); Leung, Fiona P. [National University Hospital, National University Health System, Department of Diagnostic Imaging, Singapore (Singapore); South West Radiology, Liverpool, NSW (Australia); Iyer, Sridhar; Chang, Stephen; Madhavan, Krishna Kumar [National University Health System, Department of Surgery, Singapore (Singapore); Wang, Gang [National University Hospital, National University Health System, Department of Diagnostic Imaging, Singapore (Singapore); University of Calgary, Alberta (Canada); Wee, Aileen [National University Hospital, National University Health System, Department of Pathology, Singapore (Singapore); Venkatesh, Sudhakar K. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2016-02-15

    Comparison of magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) for differentiating malignant and benign focal liver lesions (FLLs). Seventy-nine subjects with 124 FLLs (44 benign and 80 malignant) underwent both MRE and DWI. MRE was performed with a modified gradient-echo sequence and DWI with a free breathing technique (b = 0.500). Apparent diffusion coefficient (ADC) maps and stiffness maps were generated. FLL mean stiffness and ADC values were obtained by placing regions of interest over the FLLs on stiffness and ADC maps. The accuracy of MRE and DWI for differentiation of benign and malignant FLL was compared using receiver operating curve (ROC) analysis. There was a significant negative correlation between stiffness and ADC (r = -0.54, p < 0.0001) of FLLs. Malignant FLLs had significantly higher mean stiffness (7.9kPa vs. 3.1kPa, p < 0.001) and lower mean ADC (129 vs. 200 x 10{sup -3}mm{sup 2}/s, p < 0.001) than benign FLLs. The sensitivity/specificity/positive predictive value/negative predictive value for differentiating malignant from benign FLLs with MRE (cut-off, >4.54kPa) and DWI (cut-off, <151 x 10{sup -3}mm{sup 2}/s) were 96.3/95.5/97.5/93.3 % (p < 0.001) and 85/81.8/88.3/75 % (p < 0.001), respectively. ROC analysis showed significantly higher accuracy for MRE than DWI (0.986 vs. 0.82, p = 0.0016). MRE is significantly more accurate than DWI for differentiating benign and malignant FLLs. (orig.)

  11. Studies on SSTR2 mRNA expression and its correlation to steroid receptors in human benign and malignant breast lesions

    Institute of Scientific and Technical Information of China (English)

    ZENG Xizhi(曾希志); YAO Zhenxiang(姚榛祥)

    2002-01-01

    Objective:This sudy was designed to observe somatostatin receptor subtype 2 (SSTR2) Mrna expression, and investigate the correlations between SSTR2 Mrna expression and steroid receptors in benign and malignant lesions of the breast. Methods: A total of 23 breast carcinomas,16 mammary hyperplasia and 9 mammary adenofibroma samples were analysed. The SSTR2 Mrna expression was examined by in situ hybridization using multiphase oligoprobes.The ER and PR were detected by immunohistochemical staining. A computerized image analysis system was utilized to estimate the relative contents of SSTR2 Mrna. Results: The positive rates of expression (87.0%) and relative contents (0.47) of SSTR2 Mrna in breast cancer were higher than those in benign breast lesions(64%,0.26) respectively( P<0.05). SSTR2 Mrna expression was closely correlated with ER and PR in breast cancer( P<0. 05), A positive correlation between SSTR2 Mrna expression and ER was also found in benign breast lesions. Conclusions: SSTR2 Mrna expressed both in benign and in malignant breast lesions, but higher in malignant than in benign ones. There was a significant positive correlation of SSTR2 Mrna expression with ER or PR. The results suggest that conbined treatment with an antiestrogen and a somatostatin analogue for ER-positive breast cancer is feasible.

  12. Intraosseous Benign Lesions of the Jaws: A Radiographic Study

    International Nuclear Information System (INIS)

    Benign maxillo-mandibular tumors and cysts, which are relatively common findings on radiographs, namely the ubiquitous panoramic view, have to be dealt with by dentists on a daily basis. The aim of this study is to evaluate the panoramic radiographic findings pertaining to benign and tumoral lesions in the maxilla and mandible. Applying a case series method, panoramic images of 61 patients with cysts, benign tumors and tumor-like lesions in the jaws who were referred to Hamedan dental school between 2009 and 2011 were evaluated by two radiologists. They were both blind to histopathological results as well as the objectives of our study. Lesions were assessed based on their location, periphery, internal structure and impaction on the surrounding structures. Then the obtained data were analyzed using descriptive tables. Cysts were mostly more common in men despite the equal propensity of both genders to benign tumors. In contrast, women showed a higher frequency of tumor-like lesions. The most common site of involvement was the posterior mandible, with peri-apical tooth lesions as the most prevalent dental association. Radiographically, what we most encountered was unilocular radiolucency pertaining to cysts and benign tumors; nevertheless, tumor-like lesions tended to present with a well-defined radiopacity. Despite its known shortcomings, like every other diagnostic tool, panoramic radiography can contribute to the early detection of maxillary/mandibular lesions that in turn enable the dentist to devise an appropriate treatment plan

  13. Peritoneal benign cystic mesothelioma in a patient with presentation of ascites, a case report

    Directory of Open Access Journals (Sweden)

    S. Peyvandi

    2007-01-01

    Full Text Available Abstract Cystic mesotheloma is an uncommon lesion of the peritoneum occurring predominantly in women of reproductive age. The case was a 21 years girl presented with 4 years history of mild abdominal distension and periodic pain. The results of the clinical examinations were normal. Sonography and CT scan confirmed gross ascites. The results of paraclinical tests were normal without any positive findings for etiology of ascites. During laparoscopy multiple transparent cysts were found in pelvic and culdesac. All cysts were removed by laparoscopy. Histology confirmed benign cystic mesotheloma. Reviewing the records revealved that this case is the second case of mesothelial cysts that presented with ascites.

  14. A rare benign renal tumour presenting as polycythaemia in a teenage girl.

    LENUS (Irish Health Repository)

    Geoghegan, S

    2010-04-01

    We present the case of a 15-year-old girl who presented with polycythemia. CT abdomen revealed an enhancing mass in the upper pole of her left kidney with features suggestive of renal cell carcinoma. She underwent a laparoscopic radical nephrectomy. Histology demonstrated a well circumscribed, focally encapsulated, round blue cell tumour showing areas of microcalcifications and numerous psammoma bodies. Imunostaining showed diffuse positive staining for CD 57. This was consistent with a diagnosis of metanephric adenoma a rare benign epithelial renal tumour.

  15. Performance of short ECG recordings twice daily to detect paroxysmal atrial fibrillation in stroke and transient ischemic attack patients

    DEFF Research Database (Denmark)

    Poulsen, Mai B; Binici, Zeynep; Dominguez Vall-Lamora, Maria Helena;

    2016-01-01

    AIMS: Prolonged cardiac monitoring after stroke is recommended though there is no consensus on optimal methods. Short-term ECG recordings with a "thumb-ECG" device have shown promising preliminary results regarding effectiveness and cost benefit. We aimed to examine the performance of thumb-ECG...... and five days' Holter monitoring in a prospective trial. A secondary endpoint was the inter-observer agreement of the thumb-ECG. METHODS: Patients older than 65 years with no history of atrial fibrillation who suffered an acute stroke or transient ischemic attack of unknown origin were prospectively...... included. Patients were monitored for atrial fibrillation with five days' Holter and concurrent 30 s thumb-ECG twice daily, the latter continuing for 30 days. Inter-observer agreement for the thumb-ECG was determined. RESULTS: One hundred patients were included and 95 patients were analyzed. Paroxysmal...

  16. Alternating hemidystonia following traumatic brain injury as an unusual presentation of paroxysmal autonomic instability with dystonia syndrome.

    Science.gov (United States)

    Buerger, Kelly J; Salazar, Richard

    2014-01-01

    A 20-year-old man presented to the neurotrauma intensive care unit following blunt head injury. MRI revealed subarachnoid haemorrhage and multiple intraparenchymal haemorrhages suggesting severe brain injury. During recovery, the patient displayed intermittent episodes of alternating hemibody spasms with decerebrate/decorticate dystonic posturing. Episodes presented with autonomic dysregulation including hyperthermia, diaphoresis, tachypnoea, tachycardia and hypertension. Concern for seizure activity prompted simultaneous video monitoring and EEG testing. Results were without epileptiform activity suggesting against seizure as cause for alternating hemibody spasms. Paroxysmal autonomic instability with dystonia (PAID) was considered despite the unusual presentation. Intravenous hydromorphone was used for treatment, which relieved symptoms of autonomic dysregulation and dystonic posturing. PAID syndrome was diagnosed based on presentation with intermittent episodes of dystonia, autonomic dysregulation, absence of epileptiform activity and rapid response to opioid treatment. This case illustrates the clinical variability of this uncommon syndrome because alternating hemidystonia as main manifestation has not been previously described.

  17. Clinical and neurophysiologic characterization of an European family with hereditary sensory neuropathy, paroxysmal cough and gastroesophageal reflux

    Directory of Open Access Journals (Sweden)

    Pedro Barros

    2014-04-01

    Full Text Available In 2002, Spring et al reported a family with an autosomal dominant form of hereditary sensory neuropathy; patients also presented adult onset of gastroesophageal reflux and cough. Since then, no further families have been described. Objective: To study a new Portuguese family with these characteristics. Method: To describe the clinical and neurophysiologic characteristics of one family with features of sensory neuropathy associated with cough and gastroesophageal erflux. Results: Three of five siblings presented a similar history of paroxysmal cough (5th decade. About a decade later they experienced numbness and paraesthesia in the feets and in all cases there was evidence of an axonal sensory neuropathy. A history of gastroesophageal reflux of variable severity and age of onset was also present. Discussion: Molecular genetic studies have demonstrated genetic heterogeneity between the hereditary sensory neuropathy type 1 subtypes. The identification of these families is of major importance because further work is required to identify the underlying genetic defect.

  18. UreA and cagA genes of Helicobacter pylori in Egyptian patients with laryngeal squamous cell carcinoma and benign laryngeal polyps: a cohort study.

    Science.gov (United States)

    Barakat, Ghada; Nabiel, Yasmin; Ali, Omima; El-Nady, Ghada; Musaad, Ahmed; El-Sharkawy, Asser

    2016-10-01

    This work aims to estimate the prevalence of Helicobacter pylori ureA gene and evaluate cagA gene-positive strains in both patients of laryngeal squamous cell carcinoma (LSCC) and those with benign laryngeal polyps. This study included 49 patients confirmed pathologically to have LSCC and 15 patients with benign laryngeal polyps over a period from June 2013 to March 2015. Samples of laryngeal tissue were collected during direct laryngoscope under general anesthesia to be pathologically evaluated followed by analysis for H. pylori detection. Each laryngeal tissue sample was divided into three parts; one for bacteriological examination, the second for pathological examination and the third for PCR to detect both ureA and cagA genes. Out of 49 LSCC samples, 31 (64.6 %) was positive for ureA by PCR. Out of them, 29 samples (93.5 %) were cagA positive. Only three cases (20 %) of the benign laryngeal polyp were ureA positive by PCR and one of them was cagA positive by PCR. By the bacteriological culture, only eight samples (25.8 %) gave growth. All of them were ureA positive and only seven of them were cagA positive. There was a significant association between presence of H. pylori and LSCC as compared to benign laryngeal polyp which may contribute in the pathogenesis of laryngeal carcinoma. These results should be confirmed by further studies over larger number of cases.

  19. Benign Cystic Peritoneal Mesothelioma Revealed by Small Bowel Obstruction.

    Science.gov (United States)

    Bray Madoué, Kaimba; Boniface, Moifo; Annick Laure, Edzimbi; Pierre, Herve

    2016-01-01

    Benign cystic peritoneal mesothelioma is a rare tumor which frequently occurs in women of reproductive age. Abdominal pain associated with pelvic or abdominal mass is the common clinical presentation. We report the case of a 22-year-old woman with a pathological proved benign cystic mesothelioma of the peritoneum revealed by a small bowel obstruction and a painful left-sided pelvic mass with signs of psoitis. Contrast enhanced abdominal CT-scan demonstrated a large pelvic cystic mass with mass effect on rectosigmoid and pelvic organs. The patient underwent surgical removal of the tumor. Pathological examination revealed the diagnosis of benign cystic mesothelioma of the peritoneum. The outcome was excellent with a 12-month recoil.

  20. Benign cementoblastoma of the anterior mandible: an unusual case report

    Science.gov (United States)

    Karöz, Tuğçe Berre; Sumer, Mahmut; Açıkgöz, Aydan; Süllü, Yurdanur

    2016-01-01

    A benign cementoblastoma, which is another name for a true cementoma, is a rare neoplasm that develops from odontogenic ectomesenchyme. It is characterized by a mineralized mass attached to the apex of the root produced by neoplastic cementoblasts. More than 75% of cases arise in the mandible, with 90% of them manifesting in the molar and premolar regions. This neoplasm occurs most commonly in children and young adults, with males being affected slightly more than females. Radiographically, the tumor is observed as a well-defined radiopaque mass that is fused to a tooth root and is surrounded by a radiolucent rim. The treatment of benign cementoblastoma consists of removal of the lesion and extraction of the affected tooth. This report presents an unusual case of benign cementoblastoma in a 31-year-old female, presenting as a densely mineralized mass seen at the apex of the impacted right mandibular canine tooth on radiographs. PMID:27595092

  1. Risk of Local Recurrence of Benign and Borderline Phyllodes Tumors

    DEFF Research Database (Denmark)

    Borhani-Khomani, Kaveh; Talman, Maj-Lis Møller; Kroman, Niels;

    2016-01-01

    PURPOSE: To determine the recurrence rate of benign and borderline phyllodes tumors (PTs) of the breast, the association between the size of resection margin and risk of recurrence and the risk of progression of histological grading at recurrence. METHODS: Nationwide retrospective study on Danish...... women aged 18 years or older, operated from 1999 to 2014, with resected benign or borderline PTs. Information on age, size of primary tumor and recurrence, histological grade, surgical treatment, margin size, and local recurrence were collected from the national Danish Pathology Register. RESULTS......: A total of 479 cases were identified; 354 benign (74 %), 89 borderline (19 %), 6 uncertain histological grading (1.2 %), and 30 possibly PT (6 %). The mean age at presentation was 45.6 years (range 18-85), the mean tumor size was 3.5 cm (range 0.5-21), and the mean follow-up time was 98 months (range 1...

  2. Benign tumors of vulva: review and case report of achrocordon

    Directory of Open Access Journals (Sweden)

    Cuauhtémoc Galeana Castillo

    2014-02-01

    Full Text Available The vulvovaginal region is a very complex area because of its anatomy and the fact that it can be source of a large number of benign tumors and less frequent malignant tumors. In recent decades, there have been significant gains in the diagnosis and treatment of vulvovaginal tumors, thanks to the contributions of cellular and molecular biology. The purpose of this review article is to serve as a practical reference for clinical and pathological diagnosis as well as in the outpatient treatment and monitoring of these benign tumors.

  3. Management of benign biliary strictures: current status and perspective.

    Science.gov (United States)

    Kaffes, Arthur J

    2015-09-01

    Benign biliary strictures are common and occur either from hepato-biliary surgery or from diseases including chronic pancreatitis and primary sclerosing cholangitis, among others. The treatment of many such strictures is endoscopic with evolving new approaches especially with fully covered metal stents. The only classification system available is for postoperative strictures with the intention to guide surgical correction. There is no useful classification system to guide both assessment and management of benign biliary strictures. This proposed classification is relevant to patient care in assisting diagnosis and endoscopic management. PMID:26147976

  4. Benign adrenal hemangiomas may mimic metastases on PET.

    Science.gov (United States)

    Calata, Jed F; Sukerkar, Arun N; August, Carey Z; Maker, Ajay V

    2013-11-01

    CT or MRI are utilized in the initial evaluation of adrenal incidentalomas; however, overlap exists between benign and malignant lesions on these examinations. The American College of Radiology recommends PET scans to complement CT and MRI for patients with adrenal masses and a moderate-to-high likelihood of neoplastic disease. We present images of a PET-avid adrenal lesion in a patient with pulmonary and pancreatic neoplasms that mimicked metastasis, but was found to be a benign adrenal hemangioma on surgical resection. The use of PET for adrenal tumors, specifically adrenal hemangiomas, will be reviewed. PMID:24089061

  5. A Benign Cardiac Growth but Not So Indolent.

    Science.gov (United States)

    Wani, Adil S; Reddy, Sahadev T; Harinath, Lakshmi; Biederman, Robert W W

    2016-01-01

    Cardiac lipomatous hypertrophy is a rare benign condition that usually involves the interatrial septum. Due to its benign nature it rarely requires intervention. Its presence outside the interatrial septum is reported infrequently. We present a case of lipomatous hypertrophy in the intraventricular septum that was complicated by a severe, symptomatic, and disabling dynamic left ventricular outflow tract obstruction. The symptoms significantly improved following the excision of the mass. In our case transthoracic echocardiogram was used to visualize the mass and measure the severity of the obstruction; Cardiac Magnetic Resonance Imaging was used to characterize the mass and histopathology confirmed the diagnosis. PMID:27293911

  6. A Benign Cardiac Growth but Not So Indolent

    Directory of Open Access Journals (Sweden)

    Adil S. Wani

    2016-01-01

    Full Text Available Cardiac lipomatous hypertrophy is a rare benign condition that usually involves the interatrial septum. Due to its benign nature it rarely requires intervention. Its presence outside the interatrial septum is reported infrequently. We present a case of lipomatous hypertrophy in the intraventricular septum that was complicated by a severe, symptomatic, and disabling dynamic left ventricular outflow tract obstruction. The symptoms significantly improved following the excision of the mass. In our case transthoracic echocardiogram was used to visualize the mass and measure the severity of the obstruction; Cardiac Magnetic Resonance Imaging was used to characterize the mass and histopathology confirmed the diagnosis.

  7. Diagnostic and therapeutic pitfalls in benign vocal fold diseases

    Directory of Open Access Journals (Sweden)

    Bohlender, Jörg

    2013-12-01

    Full Text Available [english] More than half of patients presenting with hoarseness show benign vocal fold changes. The clinician should be familiar with the anatomy, physiology and functional aspects of voice disorders and also the modern diagnostic and therapeutic possibilities in order to ensure an optimal and patient specific management. This review article focuses on the diagnostic and therapeutic limitations and difficulties of treatment of benign vocal fold tumors, the management and prevention of scarred vocal folds and the issue of unilateral vocal fold paresis.

  8. Hereditary benign telangiectasia without family history in China

    Institute of Scientific and Technical Information of China (English)

    CAI Lin; SUN Qing-miao; ZANG Dong-jie; ZHANG Jian-zhong

    2011-01-01

    A case of hereditary benign telangiectasia without family history was reported. A 39-year-old woman presented with small and tiny telangiectases on the face, neck, upper trunk and forearms at birth. The numbers and sizes of the lesions increased gradually and she had no hemorrhagic diathesis and systemic diseases. No similar patients were found in her family. Upon physical examination, telangiectases were found on the face, neck, upper trunk and forearms; and a telangiectatic erythema was found on the right forearm 25 mm ×40 mm in size. Histopathology examination showed a normal epidermis and dilation of the capillaries at upper dermis. Hereditary benign telangiectasia without family history was diagnosed.

  9. The differentiation of benign from malignant soft tissue lesions using FDG-PET: comparison between semi-quantitative indices

    International Nuclear Information System (INIS)

    The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-EPT. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [18F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6 malignnant) followed by dynamic acquisition for 56 min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant ). The following indices were obtained: the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. (TBR51), tumor-to-background ratio of areas under time-activity curves (TBRarea) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T51/Tmax). The pSUV, aSUV, TBR51, and TBRarea in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR51, TBRarea and T51/max for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR51, 83.3%, 100%, 93.8% by TBRarea and 66.7%, 70.0%, 68.8% by T51/Tmax. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, aSUV TBR51, and TBRarea are

  10. Benign core biopsy of probably benign breast lesions 2 cm or larger: correlation with excisional biopsy and long-term follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hyun Kyung; Moon, Hee Jung; Kim, Min Jung; Kim, Eun Kyung [Dept. of Diagnostic Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    To evaluate the accuracy of benign core biopsy of probably benign breast lesions (category 3) 2 cm or larger on the basis of excisional biopsy and long-term follow-up. We retrospectively reviewed 146 category 3 lesions in 146 patients 2 cm or larger which were diagnosed as benign by ultrasound (US)-guided core biopsy. Patients were initially diagnosed as benign at core needle biopsy and then followed up with excisional biopsy (surgical excision, n=91; US-guided vacuum assisted excision, n=35) or breast ultrasonography (n=20). Of the 126 patients who underwent surgical excision or US-guided vacuum-assisted excision, 114 patients were diagnosed with benign lesions, 10 patients with borderline lesions (benign phyllodes tumor), and two patients with malignant phyllodes tumors. The probabilities of lesions being benign, borderline and malignant were 91.8% (134/146), 6.8% (10/146), and 1.4% (2/146), respectively. Of 13 patients who had growing masses on follow-up ultrasonography, three (23.1%) were non-benign (two benign phyllodes tumors and one malignant phyllodes tumor). US-guided core needle biopsy of probably benign breast mass 2 cm or larger was accurate (98.6%) enough to rule out malignancy. But, it was difficult to rule out borderline lesions even when they were diagnosed as benign.

  11. Benign colonic neoplasm at the site of ureterosigmoidostomy

    DEFF Research Database (Denmark)

    Qvist, N; Kronborg, O; Hage, E;

    1986-01-01

    A benign colonic polyp with epithelial dysplasia developed in a young male at the site of ureteral implantation in the sigmoid colon following ureterosigmoidostomy for urinary incontinence. Patients with ureterosigmoidostomy represent a high-risk cancer group, and a review of the literature sugge...

  12. BENIGN LESIONS OF THE VOCAL FOLDS - HISTOPATHOLOGY AND PHONOTRAUMA

    NARCIS (Netherlands)

    DIKKERS, FG; NIKKELS, PGJ

    1995-01-01

    Benign lesions of the vocal folds have various appearances. Histopathologic examination might provide the true diagnosis. Therefore, histologic slides of 74 patients (92 vocal folds) with clinically well-defined diagnoses were single-blind examined by a pathologist. Single histologic features did no

  13. Giant Benign Prostatic Hyperplasia in a Pakistani Patient *

    OpenAIRE

    Zafaruddin Khan; Muzamil Tahir; H. Shahzad Ashraf; FazaluRehman Khan Niazi; Munazza Khan; Sadaf Mustafa; Naseruddin Höti

    2014-01-01

    “Giant hyperplasia” of the prostate is a rare pathology of the prostate gland. We report one such case, in which a successful retropubic prostatectomy was performed on an elderly male patient in Pakistan. The weight of the resected prostate was 700 g, which is the eighth largest prostate with benign prostatic hyperplasia reported.

  14. ACUTE-PANCREATITIS IN A PATIENT WITH FAMILIAL BENIGN HYPERCALCEMIA

    NARCIS (Netherlands)

    VANHAEFTEN, TW; HOOGENBERG, K; VANESSEN, LH

    1994-01-01

    A patient with familial benign hypercalcaemia (FBH) who developed relapsing pancreatitis is presented. She underwent distal partial pancreas resection with surgical removal of pancreatic duct stones, and a pancreaticojejunostomy. No further causes for the pancreatitis were found. The present case is

  15. Persistent cellular metabolic changes after hemithyroidectomy for benign euthyroid goiter

    DEFF Research Database (Denmark)

    Toft Kristensen, Tina; Larsen, Jacob; Pedersen, Palle Lyngsie;

    2014-01-01

    , 3, 6 and 12 months after hemithyroidectomy for benign euthyroid goiter. In the hemithyroidectomy group, flow cytometry was used to measure the MMP of tetramethylrhodamine methyl ester (TMRM)- and MitoTracker Green (MTG)-stained PBMCs, and V˙O2 was measured by an Oxycon Pro apparatus. RESULTS: One...

  16. High rate of benign histology in radiologically suspect renal lesions

    DEFF Research Database (Denmark)

    Lindkvist Pedersen, Christina; Winck-Flyvholm, Lili; Dahl, Claus;

    2014-01-01

    INTRODUCTION: The objective of this study was to determine the incidence of benign renal lesions for clinically localised renal masses and the need for new diagnostic procedures to assess these lesions. MATERIAL AND METHODS: This retrospective study included patients who underwent partial or radi...

  17. Update in minimal invasive therapy in benign prostatic hyperplasia.

    NARCIS (Netherlands)

    Hest, P.J. van; Ancona, F.C.H. d'

    2009-01-01

    Last decade several new treatment modalities for minimal invasive therapy of benign prostatic hyperplasia have been developed, both ablative and non-ablative. In this review the authors describe the different techniques and clinical studies of bipolar transurethral resection of the prostate (TURP),

  18. Caveolin-1 overexpression in benign and malignant salivary gland tumors.

    Science.gov (United States)

    Jaafari-Ashkavandi, Zohreh; Ashraf, Mohammad Javad; Nazhvani, Ali Dehghani; Azizi, Zahra

    2016-02-01

    Caveolin-1, a tyrosine-phosphorylated protein, is supposed to have different regulatory roles as promoter or suppressor in many human cancers. However, no published study concerned its expression in benign and malignant salivary gland tumors. The aim of this study was to evaluate and compare the expression of Cav-1 in the most common benign and malignant salivary gland tumors and evaluate its correlation with proliferation activity. In this cross-sectional retrospective study, immunohistochemical expression of caveolin-1 and Ki67 were evaluated in 49 samples, including 11 normal salivary glands, 15 cases of pleomorphic adenoma (PA), 13 adenoid cystic carcinomas (AdCC), and 10 mucoepidermoid carcinomas (MEC). The expression of Cav-1 was seen in 18 % of normal salivary glands and 85 % of tumors. The immunoreaction in the tumors was significantly higher than normal tissues (P = 0.001), but the difference between benign and malignant tumors was not significant (P = 0.07). Expression of Cav-1 was correlated with Ki67 labeling index in PAs, but not in malignant tumors. Cav-1 expression was not in association with tumor size and stage. Overexpression of Cav-1 was found in salivary gland tumors in comparison with normal tissues, but no significant difference was observed between benign and malignant tumors. Cav-1 was inversely correlated with proliferation in PA. Therefore, this marker may participate in tumorigenesis of salivary gland tumors and may be a potential biomarker for cancer treatments.

  19. Radiological and histopathological study of benign tumors of the mandible

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Seon Young; Baek, Seung Yon; Choi, Kyung Hee; Suh, Jeung Soo; Rhee, Chung Sik; Kim, Hee Seup [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1984-06-15

    Benign tumors of the mandible are uncommon lesions. That were classified into odontogenic tumors and nonodontogenic tumors. Author reviewed the radiological evaluation and pathological microscopic finding from 33 benign tumors of the mandible that were confirmed by the biopsy during last 10 years in Dental Clinics, Ewha Womans University Hospital and Seoul National University Dental Hospital. Following results were obtained; 1. Benign tumors of the mandible were classified into odontogenic (66.7%) and non-odontogenic tumors (33.3%). 2. The range of the age distribution was between 6 years and 67 years old. The commonest age group was the second decade (39.4%). 3. There was no difference to sex distribution. 4. The most frequent location was the body of the mandible (42.4%). 5. Radiographic findings were relatively characteristic in odontogenic tumors rather than non-odontogenic tumors. 1) Radiolucent cystic lesions-ameloblastoma, odontogenic myxoma, odontogenic fibtoma, aneurysmal bone cyst and neurofibroma. 2) Radiopaque mass lesions-odontoma, cementoma and osteoma. 3) Mixed patterns-ossifying fibroma, cementifying fibroma, calcifying odontogenic epithelial tumor and hemangioma. It was concluded that the radiographic examination was of value to diagnose the benign tumors of the mandible in symptomless patients.

  20. Epidemiology and management of symptomatic benign prostatic hyperplasia

    NARCIS (Netherlands)

    K.M.C. Verhamme (Katia)

    2004-01-01

    textabstractBenign prostatic hyperplasia (BPH) is the most common non-cancerous form of cell growth in men and usually begins with the formation of microscopic nodules in younger men. As BPH progresses, overgrowth occurs in the central area of the prostate, called the transition zone, which wraps ar

  1. Current status of surgery for benign disorders of the esophagus

    NARCIS (Netherlands)

    Draaisma, Werner Adriaan

    2006-01-01

    This thesis aimed at exploring new techniques for the surgical treatment of benign disorders of the esophagus. Specifically, studies were performed on surgery for gastroesophageal reflux disease and large (type II-IV) hiatal hernia. The chapters presented in this thesis involve studies that have bee

  2. Quality of life in patients with benign nontoxic goiter

    DEFF Research Database (Denmark)

    Cramon, Per; Bonnema, Steen Joop; Bjørner, Jakob;

    2015-01-01

    BACKGROUND: While health-related quality of life (HRQoL) issues often prompt treatment of benign nontoxic goiter (NTG), few clinical studies have systematically assessed HRQoL in patients with this condition. The purpose of the present study was to evaluate thyroid-related and generic HRQo...

  3. Dosage assessment for radioiodine therapy in benign thyroid disorders

    NARCIS (Netherlands)

    Isselt, J.W. van

    2001-01-01

    The general aim of this thesis was to investigate the value and the shortcomings of the becquerel-per-gram method for radioiodine therapy in various benign thyroid disorders. The history of this treatment form, which goes back to the late 1940s, is described in Chapter 1. Almost fifty years after th

  4. Minimally Invasive Surgical Treatments for Benign Prostatic Hyperplasia

    NARCIS (Netherlands)

    V. Tzortzis; S. Gravas; J.J.M.C.H. de la Rosette

    2009-01-01

    Although transurethral resection of the prostate (TURP) is considered to be the reference standard for minimally invasive surgical treatment (MIST) of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO), it is associated with a noteworthy rate of complication. Transurethral

  5. Benign breast disease and consumption of beverages containing methylxanthines.

    Science.gov (United States)

    La Vecchia, C; Franceschi, S; Parazzini, F; Regallo, M; Decarli, A; Gallus, G; Di Pietro, S; Tognoni, G

    1985-05-01

    The relationship between methylxanthine (Mx) consumption and benign breast disease was evaluated in a case-control study of 288 women with histologically confirmed benign breast lumps (203 dysplastic lesions and 85 benign tumors) and 2 groups of control women--285 patients in the hospital for acute conditions apparently unrelated to the consumption of Mx-containing beverages and 291 outpatients. The relative risk estimates of dysplastic breast lesions (fibrocystic disease), with allowance for all identified potential distorting factors, for women who drank 1-2 or 3 or more cups of coffee per day were 4.1 and 6.4, respectively, when the hospital controls were the comparison group and 2.0 and 3.7, respectively, when the outpatient controls were the comparison group. The relationship was even stronger when the total consumption of Mx-containing beverages (coffee plus tea) was considered and increased with increasing duration of use. The association was not explained by any of the major risk factors for fibrocystic breast diseases or by differences in general characteristics or other lifestyle habits between cases and controls. Mx consumption was not related to the risk of benign breast tumors (fibroadenomas). These findings support the hypothesis that Mx consumption is related to the risk of dysplastic lesions of the breast. PMID:3858587

  6. KIT (CD117) Expression in Benign and Malignant Sweat Gland Tumors.

    Science.gov (United States)

    Nishida, Haruto; Daa, Tsutomu; Kashima, Kenji; Arakane, Motoki; Urabe, Shogo; Yoshikawa, Yasuji; Gamachi, Ayako; Yokoyama, Shigeo

    2015-12-01

    KIT (CD117, c-kit) is a receptor tyrosine kinase involved in the tumorigenesis of several neoplasms. KIT is expressed by the secretory cells of normal sweat glands. We studied the KIT expression and KIT mutational status in various benign and malignant tumors of eccrine and apocrine glands. We included a total of 108 cases comprising 10 benign and 6 malignant sweat gland tumors, and KIT expression was immunohistochemically detected (positive rate): 10 syringomas (0%), 8 poromas (25%), 20 mixed tumors (40%), 21 spiradenomas (43%), 1 cylindroma (0%), 5 hidradenomas (40%), 7 syringocystadenoma papilliferum cases (0%), 1 papillary hidradenoma (100%), 2 tubulopapillary hidradenomas (50%), 8 hidrocystomas (29%), 2 adenoid cystic carcinomas (100%), 5 porocarcinomas (20%), 6 apocrine carcinomas (33%), 10 extramammary Paget diseases (30%), 1 spiradenocarcinoma (100%), and 1 syringocystadenocarcinoma papilliferum (0%). Most KIT-positive cells were luminal cells, arising from glandular structures. We performed polymerase chain reaction-single-strand conformation polymorphism for detecting KIT mutational status. All cases showed no mutations at hot spots for KIT (exons 9, 11, 13, and 17). KIT mutation does not seem to be mechanism for KIT expression, but the expression may be from native sweat glands.

  7. Role of robotic-assisted surgery in benign esophageal diseases.

    Science.gov (United States)

    Saurabh, Shireesh; Unger, Eric; Grossman, Julie; Couto, Francisco; Singh, Namrata; Lind, David Scott; Panait, Lucian; Castellanos, Andres

    2014-06-01

    Laparoscopic treatment of benign esophageal conditions is technically complex with several inherent limitations. Robotic-assisted surgery provides technical improvement and helps to overcome some of these limitations. We therefore report a single surgeon's experience in management of benign esophageal diseases by robotic-assisted surgery. Over a period of 8 consecutive years, a retrospective chart review was performed of 105 patients who underwent robotic-assisted surgery for benign esophageal diseases by a single surgeon. Demographic data and outcome measures were studied. The robotic-assisted procedures included 85 Nissen fundoplications with and without mesh repair, 12 Heller myotomies and eight para-esophageal hernia repairs. The mean total operating time was lowest for the Nissen group (94 min) and highest for the para-esophageal group (183 min). Operating time decreased from a mean of 105 min in the first 20 cases to 84 min in the last 20 cases for the Nissen group (P = 0.014). The mean length of stay was 1.3, 1.6, 1.5 and 4.8 days for the groups, respectively. Persistent symptoms of dysphagia/reflux/dysphonia requiring further investigation were seen in nine (8 %) of these patients. Two of these patients required repeat Nissen fundoplication in the mesh group. Our complication rate, total operating time and length of stay for robotic-assisted benign esophageal surgery are comparable to those reported in the literature. When performed by an experienced surgeon, robotic-assisted surgery is safe and effective in the management of benign esophageal diseases.

  8. Gas burst vs. gas-rich magma recharge: A multidisciplinary study to reveal factors controlling triggering of the recent paroxysmal eruptions at Mt. Etna

    Science.gov (United States)

    Viccaro, Marco; Garozzo, Ileana; Cannata, Andrea; Di Grazia, Giuseppe; Gresta, Stefano

    2014-05-01

    Since January 2011, Mt. Etna volcano has been affected by more than forty paroxysmal eruptions at the summit (New South East Crater; NSEC). On the basis of their very variable duration, seven eruptions have been selected among the twenty-five of 2011-2012 in order to decipher potential differences in their triggering mechanism. Paroxysms have been investigated through a multidisciplinary approach that integrates data from volcanic tremor and petrology (textures and micro-analysis on plagioclase crystals). Our results lead to the conclusion that close relationships exist between the duration of the eruptions and the temporal evolution of the volcanic tremor amplitude, especially during the Strombolian phase preceding the paroxysmal activity. In this regard, we distinguished: 1) paroxysms preceded by long-lasting initial Strombolian phases, characterized by low rate of volcanic tremor amplitude increase; and 2) eruptions preceded by short initial Strombolian phases, showing high rate of volcanic tremor amplitude increase. Based on the pattern of volcanic tremor amplitude increase, the former mainly showed a ramp-shaped morphology, while the latter a bell-shaped trend. Location of the volcanic tremor centroid during the quiescent intervals between the paroxysmal eruptions has highlighted the presence of a magmatic volume at 1-2 km a.s.l. beneath the North East Crater (NEC). During the syn-eruptive Strombolian and lava fountaining phases, the centroid of volcanic tremor migrates below the NSEC. This leads to the consideration that the magma batch residing beneath NEC played an important role in the volcanic activity at NSEC during the considered period. Also the textures and compositional zoning (anorthite and iron variations) in selected plagioclase crystals of the analyzed lavas suggest relations between duration of the paroxysms and dynamics of pre-eruptive magmatic processes at depth. Particularly, two mechanisms have been accounted for triggering of eruptions at

  9. Paroxysmal exercise-induced dyskinesia, writer's cramp, migraine with aura and absence epilepsy in twin brothers with a novel SLC2A1 missense mutation.

    Science.gov (United States)

    Urbizu, Aintzane; Cuenca-León, Ester; Raspall-Chaure, Miquel; Gratacòs, Margarida; Conill, Joan; Redecillas, Susana; Roig-Quilis, Manuel; Macaya, Alfons

    2010-08-15

    We report two monochorionic twins that progressively developed, between ages 5 and 10, a combination of episodic neurological disorders including paroxysmal exercise-induced dyskinesia, migraine without or with aura, absence seizures and writer's cramp. CSF/serum glucose ratio was moderately decreased in both patients. Mutational analysis of SLC2A1 gene identified a de novo heterozygous missense mutation in exon 4. This novel mutation has been previously showed to disrupt glucose transport in vitro. Both patients showed immediate and near-complete response to ketogenic diet. This clinical observation suggests that a high index of suspicion for GLUT1 deficiency syndrome is warranted in evaluating patients with multiple neurological paroxysmal events.

  10. Cardiac tamponade and paroxysmal third-degree atrioventricular block revealing a primary cardiac non-Hodgkin large B-cell lymphoma of the right ventricle: a case report

    OpenAIRE

    Abdennadher Mohamed; Frikha Imed; Mallek Souad; Abid Dorra; Abid Leila; Frikha Zied; Rekik Noomen; Kammoun Samir

    2011-01-01

    Abstract Introduction Primary cardiac lymphoma is rare. Case Presentation We report the case of a 64-year-old non-immunodeficient Caucasian man, with cardiac tamponade and paroxysmal third-degree atrioventricular block. Echocardiography revealed the presence of a large pericardial effusion with signs of tamponade and a right ventricular mass was suspected. Scanner investigations clarified the sites, extension and anatomic details of myocardial and pericardial infiltration. Surgical resection ...

  11. Macro-reentrant atrial tachycardia conducting through a left superior vena cava after catheter ablation in a patient with paroxysmal atrial fibrillation.

    Science.gov (United States)

    Kurotobi, Toshiya; Kino, Naoto; Tonomura, Daisuke; Shimada, Yoshihisa

    2015-01-01

    A left superior vena cava can be a cause of cardiac rhythm or conduction abnormalities, and can also be the arrhythmogenic source of atrial fibrillation (AF) with connections to the coronary sinus and left atrium. In the present study, we report a case with a macro re-entrant atrial tachycardia that coursed through the left superior vena cava after a previous AF ablation, which successfully ablated paroxysmal AF.

  12. Comparison of Prolonged Atrial Electromechanical Delays with Different Definitions in the Discrimination of Patients with Non-Valvular Paroxysmal Atrial Fibrillation

    OpenAIRE

    Lee, Dong Hyun; Choi, Sun Young; Park, Jong Sung; Seo, Jeong-Min; Choi, Jae-Hyuk; Cho, Young-Rak; Park, Kyungil; Kim, Moo Hyun; Kim, Young-Dae

    2015-01-01

    Background and Objectives Previous studies have evaluated atrial electromechanical delays (AEMDs) with a number of different definitions to discriminate patients with paroxysmal atrial fibrillation (PAF) from controls without PAF. However, their discriminative values for PAF have not previously been directly compared. Subjects and Methods A total of 65 PAF patients and 130 control subjects matched for age, sex, history of hypertension, and diabetes mellitus were selected. The AEMDi and AEMDp ...

  13. Circulating Ki67 positive lymphocytes in multiple myeloma and benign monoclonal gammopathy.

    OpenAIRE

    Miguel-Garcia, A; Matutes, E.; Tarin, F; Garcia-Talavera, J; Miguel-Sosa, A; Carbonell, F.; Catovsky, D.

    1995-01-01

    AIMS--To estimate the proportion and nature of the proliferating (Ki67+) circulating lymphocytes in a series of patients with multiple myeloma and monoclonal gammopathy of unknown significance (MGUS) and to correlate this with other clinical and laboratory parameters, using blood from healthy adults as a control. To investigate the extent to which the B and T lymphoid components are involved in progression and/or control of disease. METHODS--Blood lymphocytes from 15 patients with multiple my...

  14. 常压高流量氧治疗胎儿阵发性室上性心动过速疗效观察%Effect of high-flow oxygen inhalation outside the chamber on fetal paroxysmal supraventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    卢晓欣; 王鸿; 彭慧平; 汤永建; 房卫红

    2014-01-01

    treatment.Cardiac fractional index and pulsation index of middle cerebral artery were significantly higher than those before treatment,with statistical significance (P < 0.Ol).Conclusions Hypoxia is possibly one of the causes that induce fetal SVT.High-flow oxygen inhalation outside the chamber is a positive,noninvasive and safe treatment method that could effectively inhibit fetal paroxysmal SVT.

  15. Comparison of stromal CD10 expression in benign, borderline, and malignant phyllodes tumors among Egyptian female patients

    Directory of Open Access Journals (Sweden)

    Wael S Ibrahim

    2011-01-01

    Full Text Available Background: Phyllodes tumors are group of biphasic fibroepithelial tumors of the breast of varying malignant potential, ranging from benign tumors to fully malignant sarcomas. According to the Egyptian National Cancer Institute, female malignant cases showed appreciable increase in the recent time period for breast cancer with the malignant phyllodes tumors representing 0.41% of cases in the year 2003-2004. Aims: This is an immunohistochemical study to compare CD10 expression in benign, borderline, and malignant phyllodes tumors, in order to highlight its diagnostic and prognostic values. Materials and Methods: This study conducted 34 Egyptian female cases of phyllodes tumors of different grades to be studied histologically and immunohistochemically using antibodies against CD10. Statistical Analysis: The Chi-square test was used to determine differences in CD10 expression between benign, borderline, and malignant tumors. One-way ANOVA test was used to determine whether the difference was significant. Significance was established at P<0.05. Results: In the 24 cases of benign phyllodes tumors, only four cases (16.7% showed positive CD10 reactivity. Three cases (60% out of five borderline phyllodes tumors showed positive CD10 reactivity, while four (80% out of five cases of malignant phyllodes tumors showed positive CD10 staining. Conclusion: From these highly significant results, we believe that there is a strong correlation between CD10 expression and tumor grade, which could be an important observation that may have both diagnostic and prognostic implications as well as promising potential target for development of novel therapies.

  16. Lamina propria of the mucosa of benign lesions of the vocal folds

    NARCIS (Netherlands)

    Dikkers, FG; Nikkels, PGJ

    1999-01-01

    Objective/Hypothesis: To demonstrate a correlation between the duration and specific pattern of trauma of benign lesions of the vocal folds and their histopathologic appearance, Benign lesions of the vocal folds have various macroscopic appearances. Investigations demonstrate characteristic histopat

  17. Long-term outcome following interstitial laser photocoagulation of benign cold thyroid nodules

    DEFF Research Database (Denmark)

    Døssing, Helle; Bennedbæk, Finn Noe; Hegedüs, Laszlo

    2011-01-01

    To evaluate the long-term efficacy of interstitial laser photocoagulation (ILP) in solitary benign thyroid nodules.......To evaluate the long-term efficacy of interstitial laser photocoagulation (ILP) in solitary benign thyroid nodules....

  18. First histologically confirmed case of a classic chordoma arising in a precursor benign notochordal lesion: differential diagnosis of benign and malignant notochordal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Takehiko [Department of Anatomic and Diagnostic Pathology, Dokkyo University School of Medicine, Mibu, Tochigi (Japan); Yamato, Minoru [Department of Radiology, International Catholic Hospital, Tokyo (Japan); Saotome, Koichi [Department of Orthopaedic Surgery, Dokkyo University School of Medicine, Mibu, Tochigi (Japan)

    2002-07-01

    The first histologically confirmed case of a classic chordoma arising in a precursor benign notochordal lesion is presented and the differential diagnosis between benign and malignant notochordal lesions is discussed. A 57-year-old man presented with a classic chordoma in the coccyx. The resected specimen demonstrated a small intraosseous benign notochordal lesion in the coccyx, which was adjacent to the classic chordoma. Also seen were two separate, similar benign lesions in the sacrum. The classic chordoma consisted of multiple lobules that were separated by thin fibrous septa and that showed cords or strands of atypical physaliphorous cells set within an abundant myxoid matrix. In contrast, the benign lesions consisted of intraosseous sheets of bland physaliphorous cells without any extracellular matrix. The affected bone trabeculae showed sclerotic reactions. It was concluded that benign and malignant notochordal lesions can be distinguished microscopically. (orig.)

  19. True cervicothoracic meningocele: a rare and benign condition

    Directory of Open Access Journals (Sweden)

    Bruno L. Pessoa

    2015-12-01

    Full Text Available Cervical meningoceles are rare spinal dysraphism, accounting for approximately 7% of all cystic spinal dysraphism. In spite of the rarity, the clinical course is most of the times benign. The surgical treatment includes resection of the lesion and untethering, when presented. We present a 14-day-old female child with true meningoceles who underwent to surgical excision and dura-mater repair. Retrospect analysis of the literature concerning true cervical meningocele is performed. By reporting this illustrative case, we focus on its classification and its differentiation from other types of cervical spinal dysraphism, such as myelocystocele and myelomeningocele. Although its course is benign, it is mandatory a continuum follow up with periodic magnetic resonance imaging of spinal cord, since late neurological deterioration has been described.

  20. Diagnosis and management of long-standing benign oral ulceration.

    Science.gov (United States)

    Birt, D; From, L; Main, J

    1980-05-01

    The authors formed a Mouth Clinic at Sunnybrook Hospital in 1973 since when there have been 3025 patient visits. Those patients with chronic ulceration present a challenge, the diagnosis sometimes being difficult and therapy not rapidly effective. The differential diagnosis includes lichen planus, pemphigus vulgaris, benign mucous membrane pemphigoid, discoid lupus erythematosus, erythema multiforme, aphthous ulcers, Behcets disease, periadenitis mucosa necrotica recurrens, specific infections and iatrogenic causes. It is possible to reach a definite diagnosis in virtually every case by means of a good history and careful clinical examination supplemented by biopsies and in some cases direct and indirect immunofluorescent studies. Treatment emphasizes scrupulous attention to oral hygiene with baking soda mouthwashes and careful teeth cleaning to minimize the accumulation of dental plaque. Specific therapy includes topical steroids in lichen planus, intra muscular gold in benign mucous membrane pemphigoid, a previously unreported treatment which considerably improved seven out of ten patients, and tetracycline mouthwashes in aphthous ulcers. PMID:6990140

  1. Management of Benign Prostatic Hyperplasia in Older Adults.

    Science.gov (United States)

    Woodard, Todd J; Manigault, Kendra R; McBurrows, Niesha N; Wray, Tiffany L; Woodard, Laresa M

    2016-01-01

    Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a nonmalignant adenomatous overgrowth of the periurethral prostate gland commonly seen in aging men. Historically, it has been assumed that the pathophysiology of lower urinary tract symptoms in men is the result of bladder outlet obstruction associated with prostate enlargement. Symptoms such as urinary hesitancy, incomplete bladder emptying, dribbling or prolonged urination, nocturia, urinary urgency, and/or urge incontinence are common. Understanding the differential diagnosis and ordering appropriate laboratory tests are essential in accurately identifying a BPH diagnosis. Management can be broken down into medical or pharmacological and surgical therapies. This article aims to provide an overview of BPH and its management in older adults. PMID:27535076

  2. Bone marrow oedema associated with benign and malignant bone tumours

    Energy Technology Data Exchange (ETDEWEB)

    James, S.L.J. [Department of Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP (United Kingdom)], E-mail: steven.james@roh.nhs.uk; Panicek, D.M. [Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021 (United States); Davies, A.M. [Department of Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP (United Kingdom)

    2008-07-15

    Bone marrow oedema is associated with a wide variety of pathological processes including both benign and malignant bone tumours. This imaging finding in relation to intraosseous tumours can aid in providing a more focused differential diagnosis. In this review, we will discuss the MR imaging of bone marrow oedema surrounding intraosseous neoplasms. The different pulse sequences used in differentiating underlying tumour from surrounding oedema are discussed along with the role of dynamic contrast enhanced MRI. Benign lesions commonly associated with bone marrow oedema include osteoid osteoma, osteoblastoma, chondroblastoma and Langerhan's cell histiocytosis. Metastases and malignant primary bone tumours such as osteosarcoma, Ewing's sarcoma and chondrosarcoma may also be surrounded by bone marrow oedema. The imaging findings of these conditions are reviewed and illustrated. Finally, the importance of bone marrow oedema in assessment of post chemotherapeutic response is addressed.

  3. An Infant with Benign Isolated Abducens Palsy After Vaccination

    Directory of Open Access Journals (Sweden)

    Celebi Kocaoglu

    2014-02-01

    Full Text Available Benign isolated abducens palsy is a self-improving clinical entity characterized by esotropia and diplopia led by the deficiency of abduction, and accompanied by no other neurological findings. The entity may occur after experiencing minor fever episodes, viral infection. The pathophysiological mechanism of cellular injury remains unclear. Hypotheses involve damage arising from autoimmune mediation or direct viral invasion causing demyelination, localized arteritis or genetic predisposition, which could increase susceptibility to such nerve palsies. Diagnosed with benign isolated abducens palsy, a 19-month-old girl infant admitted to our outpatient clinic with an acute onset of esotropia in the right eye developing two weeks after the vaccination of diphtheria, acellular pertussis, tetanus, inactivated polio and Haemophilus influenzae type b (DTPa-IP-Hib was presented in this report.

  4. The Role of Insulin-Like Growth Factor 1 in the Development of Benign and Malignant Thyroid Nodules

    Directory of Open Access Journals (Sweden)

    Ayşe Karadayı

    2012-06-01

    Full Text Available Objective: This study aims to investigate the role of IGF-1 in the development of nodular thyroid disease. Material and Methods: A total number of 100 consecutive patients operated for nodular thyroid disease in our institution were included in this prospective study. In addition to classical pathological examinations, nodules and extranodular healthy tissues were sampled and immunochemically stained for IGF-1. The materials were independently evaluated using an Allred Scoring System ranging from 0 to 8. If the score was ≥1, the tissue was accepted as IGF-1 positive.Results: IGF-1 positivity was observed in 88% and 58% of the samples obtained from nodules and extranodular healthy tissues, respectively. Allred 8-unit scores were higher in benign nodules (n=89; 4.1±2.3 and papillary carcinomas (n=7; 6.7±1.3, than in extranodular healthy tissues in the same patients (2.3±2.3 and 3.3±1.9, respectively; and higher in papillary carcinomas than in benign nodules, when the scores were compared to each other (p<0.01 for all comparisons. Conclusions: Allred 8-unit scores for IGF-1 increase in the presence of benign thyroid nodules, papillary cancer. The results of our study support the findings of previous studies demonstrating the role of IGF-1 in the development of thyroidal nodules.

  5. Circulating Prostate Cells Found in Men with Benign Prostate Disease Are P504S Negative: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Nigel P. Murray

    2013-01-01

    Full Text Available Introduction. Developments in immunological and quantitative real-time PCR-based analysis have enabled the detection, enumeration, and characterization of circulating tumor cells (CTCs. It is assumed that the detection of CTCs is associated with cancer, based on the finding that CTCs can be detected in all major cancer and not in healthy subjects or those with benign disease. Methods and Patients. Consecutive men, with suspicion of prostate cancer, had blood samples taken before prostate biopsy; mononuclear cells were obtained using differential gel centrifugation and CPCs detecting using anti-PSA immunocytochemistry. Positive samples underwent further classification with anti-P504S. Results. 329 men underwent prostate biopsy; of these men 83 underwent a second biopsy and 44 a third one. Of those with a biopsy negative for cancer, 19/226 (8.4% had CPCs PSA (+ P504S (− detected at first biopsy, 6/74 (8.1% at second biopsy, and 5/33 (15.2% at third biopsy. Men with cancer-positive biopsies did not have PSA (+ P504S (− CPCs detected. These benign cells were associated with chronic prostatitis. Conclusions. Patients with chronic prostatitis may have circulating prostate cells detected in blood, which do not express the enzyme P504S and should be thought of as benign in nature.

  6. Suppression of benign prostate hyperplasia by Kaempferia parviflora rhizome

    OpenAIRE

    Kazuya Murata; Hirotaka Hayashi; Shinichi Matsumura; Hideaki Matsuda

    2013-01-01

    Background: Kaempferia parviflora rhizome is used as a folk medicine in Thailand for the treatment of various symptoms. In the present study, the inhibitory activities of extract from K. parviflora rhizome against 5α-reductase (5αR) were subjected. Furthermore, the effects of the extract from K. parviflorar hizome in benign prostate hyperplasia (BPH) were studied using the model mice. Materials and Methods: Preparations of extracts from the rhizomes of K. parviflora, Curcuma zedoaria and Zing...

  7. Association of benign recurrent vertigo and migraine in 208 patients

    OpenAIRE

    Cha, Y-H; Lee, H.; Santell, LS; Baloh, RW

    2009-01-01

    The aim of this study was to determine the association of benign recurrent vertigo (BRV) and migraine, using standardized questionnaire-based interview of 208 patients with BRV recruited through a University Neurotology clinic. Of 208 patients with BRV, 180 (87%) met the International Classification of Headache Disorders 2004 criteria for migraine: 112 migraine with aura (62%) and 68 without aura (38%). Twenty-eight (13%) did not meet criteria for migraine. Among patients with migraine, 70% e...

  8. Magnetic Resonance Imaging of Benign Cardiac Masses: A Pictorial Essay

    Directory of Open Access Journals (Sweden)

    Thomas J Ward

    2013-01-01

    Full Text Available The differential diagnosis for a cardiac mass includes primary and metastatic neoplasms. While primary cardiac tumors are rare, metastatic disease to the heart is a common finding in cancer patients. Several "tumor-like" processes can mimic a true cardiac neoplasm with accurate diagnosis critical at guiding appropriate management. We present a pictorial essay of the most common benign cardiac masses and "mass-like" lesions with an emphasis on magnetic resonance imaging features.

  9. Benign Interaction Between Rural Information Service and Farmers' Income

    Institute of Scientific and Technical Information of China (English)

    HUANG Youlan; HE Yanqun

    2009-01-01

    Based on the improvement of interactive relationship between rural information service system and farmers' income, accompanied by the serious restriction to its mutual promotion caused by such problems as asymmetric information, focusing on introduction of rural information service infrastructure while ignored the application of them, shortage of human resource on information and so on, this paper proposed corresponding measures respectively to promote the benign interaction development between rural information service and farmers' income.

  10. Thermal Ablation for Benign Thyroid Nodules: Radiofrequency and Laser

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Jung Hwan; Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Valcavi, Roberto [Endocrinology Division and Thyroid Disease Center, Arcispedale Santa Maria Nuova, Reggio Emilia (Italy); Pacella, Claudio M. [Diagnostic Imaging and Interventional Radiology Department, Ospedale Regina Apostolorum, Albano Laziale-Rome (IT); Rhim, Hyun Chul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Na, Dong Kyu [Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of)

    2011-10-15

    Although ethanol ablation has been successfully used to treat cystic thyroid nodules, this procedure is less effective when the thyroid nodules are solid. Radiofrequency (RF) ablation, a newer procedure used to treat malignant liver tumors, has been valuable in the treatment of benign thyroid nodules regardless of the extent of the solid component. This article reviews the basic physics, techniques, applications, results, and complications of thyroid RF ablation, in comparison to laser ablation.

  11. [Benign recurring aseptic meningitis. What requires our attention?].

    Science.gov (United States)

    Kruis, T; Kredel, L; Nassir, M; Godbersen, M; Schneider, T

    2016-02-01

    Benign recurrent aseptic meningitis (BRAM) or Mollaret's meningitis is a rare disease characterized by recurrent episodes of aseptic meningitis followed by spontaneous recovery. Disease courses over several years have been reported. In most cases, BRAM is caused by HSV-2, less frequently by other viruses or autoimmune diseases. In up to 10 %, the aetiology remains unclear. We present a case of idiopathic BRAM and discuss clinical findings, diagnosis and therapeutic options of this rare illness.

  12. Benign retroperitoneal schwannoma presenting as colitis: A case report

    OpenAIRE

    Fass, Gary; Hossey, Didier; Nyst, Michel; Smets, Dirk; Saligheh, Esmail Najar; Duttmann, Ruth; Claes, Kathleen; da Costa, Pierre Mendes

    2007-01-01

    We report a case of a patient presenting with clinical , radiological and endoscopic features of colitis due to a compressive left para-aortic mass. Total open surgical excision was performed, which resulted in complete resolution of colitis. Histopathology and immunohistochemistry revealed benign retroperitoneal schwannoma. These neural sheath tumors rarely occur in the retroperitoneum. They are usually asymptomatic but as they enlarge they may compress adjacent structures, which leads to a ...

  13. Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

    Institute of Scientific and Technical Information of China (English)

    Tahsin COLAK; Tamer AKCA; Ozgur TURKMENOGLU; Hakan CANBAZ; Bora USTUNSOY; Arzu KANIK; Suha AYDI

    2008-01-01

    Objective: This prospective randomized clinical trial was conducted to evaluate the necessity of drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. Methods: A total of 116 patients who underwent total thyroidectomy or lobectomy for benign thyroidal disorders were randomly allocated to be drained or not. Operative and postoperative outcomes including operating time, postoperative pain assessed by visual analogue scale (VAS), total amount of intramuscular analgesic administration, hospital stay, complications, necessity for re-operation and satisfaction of patients were all assessed. Results: The mean operating time was similar between two groups (the drained and non-drained groups). The mean VAS score was found to be significantly low in the non-drained group patients in postoperative day (POD) 0 and POD 1. The mean amount of intramuscular analgesic requirement was significantly less in the non-drained group. One case of hematoma, two cases of seroma and three cases of transient hypoparathyroidism occurred in the non-drained group, whereas one case of hematoma, two cases of seroma, two cases of wound infections and two cases of transient hypoparathyroidism occurred in the drained group. No patient needed re-operation for any complication. The mean hospital stay was significantly shorter and the satisfaction of patients was superior in the non-drained group. Conclusion: These findings suggest that postoperative complications cannot be prevented by using drains after total thyroidectomy or lobectomy for benign thyroid disorders. Furthermore, the use of drains may increase postoperative pain and the analgesic requirement, and prolong the hospital stay. In the light of these findings, the routine use of drains might not be necessary after thyroid surgery for benign disorders.

  14. Recent advances in treatment for Benign Prostatic Hyperplasia

    OpenAIRE

    van Rij, Simon; Gilling, Peter

    2015-01-01

    Clinical benign prostatic hyperplasia (BPH), often identified as a worsening ability of a male to pass urine, is a significant problem for men in our society. In 2015, the use of personalised medicine is tailoring treatment to individual patient needs and to genetic characteristics. Technological advances in surgical treatment are changing the way BPH is treated and are resulting in less morbidity. The future of BPH treatments is exciting, and a number of novel techniques are currently under ...

  15. Benign Joint Hypermobility Syndrome – not so ‘Benign’

    OpenAIRE

    Yathish GC; Canchi Balakrishnan; Mangat Gurmeet; Taral Parikh; Sagdeo Parikshit; Girish Kakade

    2015-01-01

    Benign joint hypermobility syndrome (BJHS) was earlier considered as a mild or trivial entity, but nowadays it is reported as a multisystem hereditary connective tissue disorder with serious morbidities. In fact, the term ‘Benign’ has been removed, renaming the disease as ‘Joint Hypermobility Syndrome’ (JHS). In addition to the well-known musculoskeletal consequences of joint pain and instability, it can cause chronic widespread pain, gastrointestinal dysmotility, anxiety, phobic states and d...

  16. THYROID PAPILLARY MICROCARCINOMA INCIDENTALLY FOUND FOLLOWING THYROIDECTOMIES FOR BENIGNANT DISEASES

    OpenAIRE

    R. Dănilă; A. Grigorovici; Lidia Ionescu; Ramona Popovici; I. Huţanu; Maria Christina Ungureanu; Cristina Preda; Letiţia Leuştean

    2008-01-01

    Background: According to the 2004 WHO classification, thyroid papillary microcarcinoma (PMC) is defined as a papillary tumour with a diameter of maximum 1 cm, discovered incidentally. The aim of the study was to evaluate the clinical and pathological features as well as the treatment of PMC discovered following thyroidectomies for benign conditions. Material and method. A clinical retrospective study was carried out on a series of 17 cases of MCP, accounting for 1.22% of a total of 1393 resec...

  17. Thermal Ablation for Benign Thyroid Nodules: Radiofrequency and Laser

    OpenAIRE

    Baek, Jung Hwan; Lee, Jeong Hyun; Valcavi, Roberto; Pacella, Claudio M.; Rhim, Hyunchul; Na, Dong Gyu

    2011-01-01

    Although ethanol ablation has been successfully used to treat cystic thyroid nodules, this procedure is less effective when the thyroid nodules are solid. Radiofrequency (RF) ablation, a newer procedure used to treat malignant liver tumors, has been valuable in the treatment of benign thyroid nodules regardless of the extent of the solid component. This article reviews the basic physics, techniques, applications, results, and complications of thyroid RF ablation, in comparison to laser ablation.

  18. Argon Laser Photoablation for Treating Benign Pigmented Conjunctival Nevi

    Science.gov (United States)

    Alsharif, Abdulrahman M.; Al-Gehedan, Saeed M.; Alasbali, Tariq; Alkuraya, Hisham S.; Lotfy, Nancy M.; Khandekar, Rajiv

    2016-01-01

    Purpose: To evaluate the outcomes of argon laser photoablation of benign conjunctival pigmented nevi with different clinical presentations. Patients and Methods: This interventional case series was conducted between July 2014 and January 2015. Patients presenting with benign conjunctival nevi were included. Data were collected on the clinical features at presentation, argon laser photoablation, and follow-up at 8 and 24 weeks. Postoperative photography allowed recording of the success of each case and the overall success rate. Complete removal of conjunctival pigments was considered an absolute success. Partial pigmentation requiring repeat laser treatment was considered a qualified success. Results: There were 14 eyes (four right eyes and ten left eyes) with benign pigmented conjunctival nevi. There were three males and eight females in the study sample. The median age was 36 (25% percentile: 26 years). Three patients had bilateral lesions. The nevi were located temporally in nine eyes, nasally in three eyes, and on the inferior bulbar conjunctiva in two eyes. The mean horizontal and vertical diameters of nevi were 5 ± 2 mm and 4 ± 2.7 mm, respectively. The mean follow-up period was 5 months. Following laser treatment, no eyes had subconjunctival hemorrhage, infection, scarring, neovascularization, recurrence, or corneal damage. The absolute success rate of laser ablation was 79%. Three eyes with elevated nevi had one to three sessions of laser ablation resulting in a qualified success rate of 100%. Conclusions: Argon laser ablation was a safe and effective treatment for the treatment of selective benign pigmented conjunctival nevi in Arab patients. PMID:27555708

  19. Serenoa repens extract in the treatment of benign prostatic hyperplasia

    OpenAIRE

    Geavlete, Petrisor; Multescu, Razvan; Geavlete, Bogdan

    2011-01-01

    We are experiencing a revival of interest in phytotherapeutic agents, both in Europe and North America, especially as a consequence of patients’ dissatisfaction with the adverse effects of the medical alternatives. One of the most frequently prescribed and studied such agents is Serenoa repens extract, derived from the berry of the dwarf palm tree. We aimed to review the most important published data regarding this type of treatment for benign prostatic hyperplasia. A review of the existing a...

  20. Eutectic Salt Catalyzed Environmentally Benign and Highly Efficient Biginelli Reaction

    OpenAIRE

    Najmadin Azizi; Sahar Dezfuli; Mohmmad Mahmoodi Hahsemi

    2012-01-01

    A simple deep eutectic solvent based on tin (II) chloride was used as a dual catalyst and environmentally benign reaction medium for an efficient synthesis of 3,4-dihydropyrimidin-2(1H)-one derivatives, from aromatic and aliphatic aldehydes, 1,3-dicarbonyl compounds, and urea in good-to-excellent yields and short reaction time. This simple ammonium deep eutectic solvent, easily synthesized from choline chloride and tin chloride, is relatively inexpensive and recyclable, making it applicable f...

  1. Surgical treatment of benign nodular goiter; report of 72 patients

    Directory of Open Access Journals (Sweden)

    Ediz YORGANCILAR

    2009-03-01

    Full Text Available Surgical resection is usually prefered for the treatment of benign nodular goiter. But the extention of thyroidectomy in the surgical management of benign nodular goiter still remains controversial. Seventytwo patients underwent thyroid surgery between April 2002- July2007 in Kızıltepe State Hospital Otorhinolaryngology Service. Of the patients 63 were women (%87.5, 9 were man (%12.5. The range of age was between 15-62 years and mean age was 36,5. Thirtynine patients had unilateral total lobectomy+ istmusectomy (%54.2, 11 patients had unilateral lobectomy+ isthmusectomy+contralateral subtotal lobectomy (Dunhill Procedure (%15.3, 20 patients had nearly total thyroidectomy (%27.8, 2 patients had total thyroidectomy (% 2.7. Three patients had seroma (%4.1, 2 patients had hemorrhage requiring operative hemostasis (%2.7, 1 patient had suture reaction(%1.3. Patients have not had permanent or temporary nervus laryngeus recurrens injury, hypoparathyroidism and infection.As a result more extent surgical resections must be preferred by the surgeon for the treatment of benign nodular goiter. The preferable surgical treatment of solitary nodules is lobectomy+isthmusectomy. The multinodular goiter must be treated with unilateral lobectomy+ isthmusectomy+contralateral subtotal lobectomy (Dunhill procedure when the remnant thyroid tissue is normal; otherwise nearly total or total thyroidectomy is preferable.

  2. Restenosis following balloon dilation of benign esophageal stenosis

    Institute of Scientific and Technical Information of China (English)

    Ying-Sheng Cheng; Ming-Hua Li; Ren-Jie Yang; Hui-Zhen Zhang; Zai-Xian Ding; Qi-Xin Zhuang; Zhi-Ming Jiang; Ke-Zhong Shang

    2003-01-01

    AIM: To elucidate the mechanism of restenosis following balloon dilation of benign esophageal stenosis.METHODS: A total of 49 rats with esophageal stenosis were induced in 70 rats using 5 ml of 50 % sodium hydroxide solution and the double-balloon method, and an esophageal restenosis (RS) model was developed by esophageal stenosis using dilation of a percutaneous transluminal coronary angioplasty (PTCA) balloon catheter. These 49 rats were divided into two groups: rats with benign esophageal stricture caused by chemical burn only (control group, n=21) and rats with their esophageal stricture treated with balloon catheter dilation (experimental group, n=28). Imaging analysis and immunohistochemistry were used for both quantitative and qualitative analyses of esophageal stenosis and RS formation in the rats, respectively.RESULTS: Cross-sectional areas and perimeters of the esophageal mucosa layer, muscle layer, and the entire esophageal layers increased significantly in the experimental group compared with the control group. Proliferating cell nuclear antigen (PCNA) was expressed on the 5th day after dilation, and was still present at 1 month. Fibronectin (FN)was expressed on the 1st day after dilation, and was still present at 1 month.CONCLUSION: Expression of PCNA and FN plays an important role in RS after balloon dilation of benign esophageal stenosis.

  3. Glad to be sad, and other examples of benign masochism

    Directory of Open Access Journals (Sweden)

    Paul Rozin

    2013-07-01

    Full Text Available We provide systematic evidence for the range and importance of hedonic reversals as a major source of pleasure, and incorporate these findings into the theory of benign masochism. Twenty-nine different initially aversive activities are shown to produce pleasure (hedonic reversals in substantial numbers of individuals from both college student and Mechanical Turk samples. Hedonic reversals group, by factor analysis, into sadness, oral irritation, fear, physical activity/exhaustion, pain, strong alcohol-related tastes, bitter tastes, and disgust. Liking for sad experiences (music, novels, movies, paintings forms a coherent entity, and is related to enjoyment of crying in response to sad movies. For fear and oral irritation, individuals also enjoy the body's defensive reactions. Enjoyment of sadness is higher in females across domains. We explain these findings in terms of benign masochism, enjoyment of negative bodily reactions and feelings in the context of feeling safe, or pleasure at ``mind over body''. In accordance with benign masochism, for many people, the favored level of initially negative experiences is just below the level that cannot be tolerated.

  4. The spectrum of benign esophageal lesions: imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Kyung Mi; Lee, Kyung Soo; Lee, Soon Jin; Kim, Eun A; Kim, Tae Sung; Han, Dae Hee; Shim, Young Mog [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-09-01

    Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur.

  5. Gastropericardial fistula complicating benign gastric ulcer: case report

    Energy Technology Data Exchange (ETDEWEB)

    Simice, P.; Zwirewich, C.V. [Univ. of British Columbia, Vancouver General Hospital, Dept. of Radiology, Vancouver, BC (Canada)

    2000-08-01

    Pneumopericardium is a rare radiologic finding and is most commonly associated with esophageal ulceration or trauma. Benign ulcers of the distal esophagus are the most frequent source of non-traumatic perforation into the pericardial sac. Other etiologies include fistula formation from diseased subdiaphragmatic hollow viscera or subphrenic abscess, recent cardiac surgery, an extension of pneumomediastinum into the pericardium sac, and primary septic pericarditis from gasforming organisms. Pneumopericardium caused by the penetration of a benign gastric ulcer is a recognized but rare phenomenon. Intrathoracic gastric perforations are more commonly associated with pneumomediastium. Risk factors associated with an increased risk of penetration of gastric ulcers into the pericardium include the presence of a giant ulcer in the gastric fundus, an ulcer within a hiatus hernia, a history of hiatus hernia repair, concurrent use of non-steroidal anti-inflammatory drugs and the Zollinger-Ellison syndrome. Scar tissue formation at the site of previous hiatal surgery may result in the adherence of the gastric fundus or lower esophagus to the pericardium and produce a pathway for benign ulcers to erode into the pericardium.

  6. Oncogene activation in human benign tumors of the skin (keratoacanthomas): Is HRAS involved in differentiation as well as proliferation

    Energy Technology Data Exchange (ETDEWEB)

    Corominas, M.; Kamino, Hideko; Leon, J.; Pellicer, A. (New York Univ. Medical Center, New York, NY (USA))

    1989-08-01

    In vitro DNA amplification followed by oligonucleotide mismatch hybridization was used to study the frequency of HRAS mutations in the benign self-regressing skin tumors keratoacanthomas and in squamous cell carcinomas. The authors used freshly obtained keratoacanthomas as well as Formalin-fixed paraffin-embedded tissues from both types of tumors. DNA from 50 samples of each tumor type was analyzed for activating mutations involving codons 12 and 61. A relatively high percentage (30%) of HRAS mutations was found in the keratoacanthomas compared with 13% in the squamous cell carcinomas. The most frequent mutation identified is the A{center dot}T-to-T{center dot}A transversion in the second position of codon 61. The present findings demonstrate the involvement of the HRAS oncogene in human benign tumors. Moreover, they indicate that an activated HRAS oncogene is not sufficient to maintain a neoplastic phenotype and argue against a role of HRAS in the progression of skin tumorigenesis.

  7. Comparison of telomerase activity in prostate cancer, prostatic intraepithelial neoplasia and benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Soleiman Mahjoub

    2006-11-01

    Full Text Available BACKGROUND: Telomerase is a reverse transcriptase enzyme that synthesizes telomeric DNA on chromosome ends. The enzyme is important for the immortalization of cancer cells because it maintains the telomeres. METHODS: Telomerase activity (TA was measured by fluorescence-based telomeric repeat amplification protocol (FTRAP assay in prostate carcinoma and benign prostatic hyperplasia (BPH. RESULTS: TA was present in 91.4% of 70 prostate cancers, 68.8% of 16 prostatic intraepithelial neoplasia (PIN, 43.3% of 30 BPH*, 21.4% of 14 atrophy and 20% of 15 normal samples adjacent to tumor. There was not any significant correlation between TA, histopathological tumor stage or gleason score. In contrast to high TA in the BPH* tissue from the cancer-bearing gland, only 6.3% of 32 BPH specimens from patients only diagnosed with BPH were telomerase activity-positive. CONCLUSIONS: These results indicate that TA is present in most prostate cancers. The high rate of TA in tissue adjacent to tumor may be attributed either to early molecular alteration of cancer that was histologically unapparent, or to the presence of occult cancer cells. Our findings suggest that the re-expression of telomerase activity could be one step in the transformation of BPH to PIN. KEY WORDS: Telomerase activity, prostate cancer, prostatic intraepithelial neoplasia, benign prostatic hyperplasia.

  8. Stoichiometric expression of MMP-2/TIMP-2 in benign and malignant tumours of the salivary gland.

    Science.gov (United States)

    Kolude, Bamidele; Adisa, Akinyele Olumuyiwa; Lawal, Ahmed Oluwatoyin; Adeyemi, Bukola Folasade; Akinyamoju, Akindayo Olufunto

    2015-04-01

    The aim of this study was to determine the expression of matrix metalloproteinase 2 (MMP-2) and tissue inhibitors of matrix metalloproteinase 2 (TIMP-2) and the MMP-2/TIMP-2 expression ratio in salivary gland tumours (SGTs). Forty-three FFPE SGTs were prepared for antibody processing to MMP-2 and TIMP-2. Two investigators utilizing Sinicrope's method scored the uptake of immuno-stains. Cytoplasmic staining was considered as positive. Data was analysed using SPSS version 20. The significance level was set at p benign SGTs, the mean score for MMP-2 was not significantly lower than that of TIMP-2 (p = 0.37). However, the mean scores for MMP-2 stain intensity and proportion were significantly higher in malignant than benign SGTs (p = 0.01 and p = 0.02 respectively). There was no significant difference in the mean MMP-2/TIMP-2 expression ratio of the malignant SGTs according to histological grade and histogenesis (p = 0.4 and p = 0.19 respectively). The MMP-2/TIMP-2 expression ratio has a higher prognostic value than the separate expressions of MMP-2 and TIMP-2.

  9. Comparative Gene Expression Profiling of Benign and Malignant Lesions Reveals Candidate Therapeutic Compounds for Leiomyosarcoma

    Directory of Open Access Journals (Sweden)

    Badreddin Edris

    2012-01-01

    Full Text Available Leiomyosarcoma (LMS is a malignant, soft-tissue tumor for which few effective therapies exist. Previously, we showed that there are three molecular subtypes of LMS. Here, we analyzed genes differentially expressed in each of the three LMS subtypes as compared to benign leiomyomas and then used the Connectivity Map (cmap to calculate enrichment scores for the 1309 cmap drugs in order to identify candidate molecules with the potential to induce a benign, leiomyoma-like phenotype in LMS cells. 11 drugs were selected and tested for their ability to inhibit the growth of three human LMS cell lines. We identified two drugs with in vitro efficacy against LMS, one of which had a strongly negative enrichment score (Cantharidin and the other of which had a strongly positive enrichment score (MG-132. Given MG-132’s strong inhibitory effect on LMS cell viability, we hypothesized that LMS cells may be sensitive to treatment with other proteasome inhibitors and demonstrated that bortezomib, a clinically-approved proteasome inhibitor not included in the original cmap screen, potently inhibited the viability of the LMS cell lines. These findings suggest that systematically linking LMS subtype-specific expression signatures with drug-associated expression profiles represents a promising approach for the identification of new drugs for LMS.

  10. [Cardioversion for paroxysmal supraventricular tachycardia during lung surgery in a patient with concealed Wolff-Parkinson-White syndrome].

    Science.gov (United States)

    Sato, Yoshiharu; Nagata, Hirofumi; Inoda, Ayako; Miura, Hiroko; Watanabe, Yoko; Suzuki, Kenji

    2014-10-01

    We report a case of paroxysmal supraventricular tachycardia (PSVT) that occurred during video-assisted thoracoscopic (VATS) lobectomy in a patient with concealed Wolff-Parkinson-White (WPW) syndrome. A 59-year-old man with lung cancer was scheduled for VATS lobectomy under general anesthesia. After inserting a thoracic epidural catheter, general anesthesia was induced with intravenous administration of propofol. Anesthesia was maintained with inhalation of desfurane in an air/oxygen mixture and intravenous infusion of remifentanil. Recurrent PSVT occurred three times, and the last episode of PSVT continued for 50 minutes regardless of administration of antiarrhythmic drugs. Synchronized electric shock via adhesive electrode pads on the patient's chest successfully converted PSVT back to normal sinus rhythm. The remaining course and postoperative period were uneventful. An electrophysiological study performed after hospital discharge detected concealed WPW syndrome, which had contributed to the development of atrioventricular reciprocating tachycardia. Concealed WPW syndrome is a rare, but critical complication that could possibly cause lethal atrial tachyarrhythmias during the perioperative period. In the present case, cardioversion using adhesive electrode pads briefly terminated PSVT in a patient with concealed WPW syndrome.

  11. CHANGES OF PLASMA ENDOTHELIN AND ATRIAL NATRIURETIC PEPTIDE DURING THE ONSET AND AFTER TERMINATION OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA

    Institute of Scientific and Technical Information of China (English)

    李春盛; 田茹敏; 朱丽楠; 李丹宇; 冯启刚; 高秀兰

    1995-01-01

    Radioimmunoassays were used to measure the concentration changes of plasma endothelin (ET) and atrial natriuretic peptide (ANP) during the onset and after termination of paroxysmal supraventrieular taehyeardia (SVT). 30 cases were reviewed and comparisons with 42 normal subjects were made. There are very significant differences (P<0. 0001) in the concentration changes of both plasma ET and ANP during the onset and 30 minutes after the termination of SVT. During the offset period of SVT, the plas-ma ET and ANP were markedly elevated and 30 minutes after its termination they were lowered signifi-cantly, but their concentrations were still 2-fold higher than those of the control group. As the biological effects of ANP and ET are antagonistic to each other, their parallel elevation and lowering of plasma con-centratinns during and.after the termination oE SVT reveal that these 2 hormones participate in the patho-physiolngical process of SVT. This phenomenon is possibly one of the homeostatic regulatory functions in the organism.

  12. Paroxysmal supraventricular tachycardia in pregnant women and birth outcomes of their children: a population-based study.

    Science.gov (United States)

    Bánhidy, Ferenc; Ács, Nándor; Puhó, Erzsébet H; Czeizel, Andrew E

    2015-08-01

    The aim of the study was to estimate the possible association of pregnant women with paroxysmal supraventricular tachycardia (PSVT) with the possible risk for adverse birth outcomes, particularly different congenital abnormalities (CAs) in their children. Prospectively and medically recorded PSVT was evaluated in 103 pregnant women who later had offspring with CA (case group) and 149 pregnant women who later delivered newborn infants without CA (control group) and matched to cases in the population-based data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996. Of 252 pregnant women with PSVT, 115 (45.6%) had the onset of this condition before the study pregnancy, that is, their PSVT was a chronic condition, while the rest (N = 137) of PSVT was considered as new onset in the study pregnancy. The comparison of occurrence of PSVT in pregnant women who had offspring with different CA groups and in control mothers showed a higher risk for cardiovascular CAs (adjusted OR with 95% CI: 2.1, 1.1-3.8) explained mainly by secundum atrial septal defect. This association was confirmed in pregnant women with PSVT in the second and/or third gestational month, that is, critical period of cardiovascular CAs. In conclusion PSVT in pregnant women associates with a higher risk of secundum atrial septal defect in their children.

  13. Advanced Genetic Testing Comes to the Pain Clinic to Make a Diagnosis of Paroxysmal Extreme Pain Disorder

    Directory of Open Access Journals (Sweden)

    Ashley Cannon

    2016-01-01

    Full Text Available Objective. To describe the use of an advanced genetic testing technique, whole exome sequencing, to diagnose a patient and their family with a SCN9A channelopathy. Setting. Academic tertiary care center. Design. Case report. Case Report. A 61-year-old female with a history of acute facial pain, chronic pain, fibromyalgia, and constipation was found to have a gain of function SCN9A mutation by whole exome sequencing. This mutation resulted in an SCN9A channelopathy that is most consistent with a diagnosis of paroxysmal extreme pain disorder. In addition to the patient being diagnosed, four siblings have a clinical diagnosis of SCN9A channelopathy as they have consistent symptoms and a sister with a known mutation. For treatment, gabapentin was ineffective and carbamazepine was not tolerated. Nontraditional therapies improved symptoms and constipation resolved with pelvic floor retraining with biofeedback. Conclusion. Patients with a personal and family history of chronic pain may benefit from a referral to Medical Genetics. Pelvic floor retraining with biofeedback should be considered for patients with a SCN9A channelopathy and constipation.

  14. Indomethacin responsive headache syndromes: chronic paroxysmal hemicrania and Hemicrania continua. How they were discovered and what we have learned since.

    Science.gov (United States)

    Sjaastad, O; Vincent, Maurice

    2010-01-01

    In the indomethacin responsive headaches (IRHs), chronic paroxysmal hemicrania (CPH) and Hemicrania continua (HC), the indomethacin (INDO) response is swift, absolute, and permanent, with moderate doses. Traditionally, CPH has been linked to cluster headache (CH) due to clinical similarities: unilaterality, intensity, and some autonomic phenomena. However, other clinical features differ essentially between these two headaches: sex ratio, mean attack frequency (CPH: 13.6 versus CH: 1.7 attacks/day), and duration of attacks. The therapeutic profile in CPH (indomethacin effect: ++; triptan effect: generally non-existent) is reversed in CH. The autonomic phenomena also differ clearly, a forehead supersensitivity sweating pattern and Horner-like pupil being present only in CH. The chronic/non-chronic stage ratio is 3.9 in CPH, against 0.14 in CH, a >25 times difference. Conversely, CPH and HC are very similar, clinically speaking. Accordingly, we should probably sever the link between CH and CPH and favour, instead, a linking together of CPH and HC, the two principal IRHs.

  15. Serum protein fingerprinting coupled with artificial neural network distinguishes glioma from healthy population or brain benign tumor

    Institute of Scientific and Technical Information of China (English)

    LIU Jian; ZHENG Shu; YU Jie-kai; ZHANG Jian-min; CHEN Zhe

    2005-01-01

    To screen and evaluate protein biomarkers for the detection of gliomas (Astrocytoma grade Ⅰ-Ⅳ) from healthy individuals and gliomas from brain benign tumors by using surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) coupled with an artificial neural network (ANN) algorithm. SELDI-TOF-MS protein fingerprinting of serum from 105 brain tumor patients and healthy individuals, included 28 patients with glioma (Astrocytoma Ⅰ-Ⅳ), 37 patients with brain benign tumor, and 40 age-matched healthy individuals. Two thirds of the total samples of every compared pair as training set were used to set up discriminating patterns, and one third of total samples of every compared pair as test set were used to cross-validate; simultaneously, discriminate-cluster analysis derived SPSS 10.0 software was used to compare Astrocytoma grade Ⅰ-Ⅱ with grade Ⅲ-Ⅳ ones. An accuracy of 95.7%, sensitivity of 88.9%, specificity of 100%, positive predictive value of 90% and negative predictive value of 100% were obtained in a blinded test set comparing gliomas patients with healthy individuals; an accuracy of 86.4%, sensitivity of 88.9%, specificity of 84.6%, positive predictive value of 90% and negative predictive value of 85.7% were obtained when patient's gliomas was compared with benign brain tumor. Total accuracy of 85.7%, accuracy of grade Ⅰ-Ⅱ Astrocytoma was 86.7%, accuracy ofⅢ-Ⅳ Astrocytoma was 84.6% were obtained when grade Ⅰ-Ⅱ Astrocytoma was compared with grade Ⅲ-Ⅳ ones (discriminant analysis). SELDI-TOF-MS combined with bioinformatics tools, could greatly facilitate the discovery of better biomarkers. The high sensitivity and specificity achieved by the use of selected biomarkers showed great potential application for the discrimination of gliomas patients from healthy individuals and glioma from brain benign tumors.

  16. Clinical study of reducing the recurrence of Otolith disease by oral Betahistine and changing sleeping position%口服敏使朗及改变睡姿减少耳石症复发的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨钱红; 姜玉龙; 陈林; 陆丽霞; 刘亮贤; 赵君

    2015-01-01

    Objective To study the value of oral Betahistine combined with changing sleeping position in re-ducing the recurrence of a single-ear canal benign paroxysmal positional vertigo (BPPV) with successful Epley reposi-tion.Methods The sleep situation was retrospectively studied in 117 elderly patients with BPPV of single-ear posterior semicircular canal,aged (62.1±8.2) in mean.The patients were required to determine the dominant side of sleeping posi-tion.All the patients received detailed medical history enquiry and physical examination of the nervous system,includ-ing posture and gait,eye movements,Dix-Hallpike test,and supine roll test.The patients were randomly divided into three groups:the control group (35 patients,treated by improved Epley reposition),treatment group A (40 patients,im-proved Epley reposition and changing sleeping position),treatment group B (42 patients,improved Epley reposition com-bined with Betahistine and changing sleeping position).Then,the recurrence rates of the three groups were analyzed.Results Among the 117 patients,the right side of the Dix-Hallpike test was positive for 74 patients,and the left Dix-Hallpike test was positive for 43 patients.When they sleep,61 patients used to right lateral position,and 32 patients used to left lateral position,with 21 patients of customary supine position.In the 117 patients with unilateral Dix-Hall-pike test positive,the affected ear and sleeping position were on the same side in 80 patients,including 54 on the right side and 26 on the left side.The affected ear and sleeping position were in the different sides in 16 patients,in which 10 of right lateral position showed positive results in left Dix-Hallpike test,and 6 of left lateral position showed positive re-sults in right Dix-Hallpike test.Among 21 patients of supine position,14 were positive in Dix-Hallpike test of the right side,and 7 were positive in Dix-Hallpike test of the left side.The affected ear showed a positive correlation with the

  17. Relation between nodule size and 18F-FDG-PET SUV for malignant and benign pulmonary nodules.

    Directory of Open Access Journals (Sweden)

    Shao Yiping

    2008-09-01

    Full Text Available Abstract The most common semiquantitative method of evaluation of pulmonary lesions using 18F-FDG PET is FDG standardized uptake value (SUV. An SUV cutoff of 2.5 or greater has been used to differentiate between benign and malignant nodules. The goal of our study was to investigate the correlation between the size of pulmonary nodules and the SUV for benign as well as for malignant nodules. Methods Retrospectively, 173 patients were selected from 420 referrals for evaluation of pulmonary lesions. All patients selected had a positive CT and PET scans and histopathology biopsy. A linear regression equation was fitted to a scatter plot of size and SUVmax for malignant and benign nodules together. A dot diagram was created to calculate the sensitivity, specificity, and accuracy using an SUVmax cutoff of 2.5. Results The linear regression equations and (R2s as well as the trendlines for malignant and benign nodules demonstrated that the slope of the regression line is greater for malignant than for benign nodules. Twenty-eight nodules of group one (≤ 1.0 cm are plotted in a dot diagram using an SUVmax cutoff of 2.5. The sensitivity, specificity, and accuracy were calculated to be 85%, 36% and 54% respectively. Similarly, sensitivity, specificity, and accuracy were calculated for an SUVmax cutoff of 2.5 and found to be 91%, 47%, and 79% respectively for group 2 (1.1–2.0 cm; 94%, 23%, and 76%, respectively for group 3 (2.1–3.0 cm; and 100%, 17%, and 82%,, respectively for group 4 (> 3.0 cm. The previous results of the dot diagram indicating that the sensitivity and the accuracy of the test using an SUVmax cutoff of 2.5 are increased with an increase in the diameter of pulmonary nodules. Conclusion The slope of the regression line is greater for malignant than for benign nodules. Although, the SUVmax cutoff of 2.5 is a useful tool in the evaluation of large pulmonary nodules (> 1.0 cm, it has no or minimal value in the evaluation of small

  18. Immunohistochemical expression of the oncogenic molecules active Stat3 and survivin in benign and malignant salivary gland tumors

    Science.gov (United States)

    Nikitakis, Nikolaos G.; Scheper, Mark A.; Papanicolaou, Vasileios S.; Sklavounou, Alexandra; Sauk, John J.

    2009-01-01

    Objective Signal transducer and activator of transcription 3 (Stat3) and survivin have been shown to exert oncogenic effects in various human neoplasms. The purpose of this study was to evaluate the expression of the tyrosine phosphorylated (active) Stat3 and survivin in various benign and malignant salivary gland tumors (SGTs). Study design Eighty-six SGTs (65 malignant and 21 benign tumors of various histopathologic subtypes) were immunohistochemically stained with anti-survivin or anti-phosphorylated tyrosine-705 (p-tyr) Stat3 antibodies. Immunohistochemical reactivity was graded in a semi-quantitative manner; a combined score of immunohistochemical positivity (0–6) was calculated for each tumor by adding the individual scores for percentage of tumor cells (0–3) and intensity of staining (0–3). Results Survivin was immunohistochemically detected in all studied benign and malignant SGTs; p-tyr Stat3 was also detected in the majority (91%) of SGTs. The average combined scores for survivin and p-tyr Stat3 immunohistochemical expression in the studied malignant SGTs was 4.40 and 3.35, respectively; the corresponding combined scores for survivin and p-tyr Stat3 in the studied benign SGTs were 4.37 and 3.22, respectively. No statistically significant differences (p>0.05) in p-tyr Stat3 or survivin expression were detected between the benign and malignant groups, or among the various examined histopathological subtypes of SGTs. In contrast, normal salivary gland elements in the vicinity of the studied tumors revealed only weak and focal survivin or p-tyr Stat3 immunoreactivity, mainly localized to ductal and mucous cells. Conclusions Our data indicate an almost universal expression of activated Stat3 and survivin in benign and malignant SGTs. Considering the well-established proliferative and anti-apoptotic properties of these molecules and their functional interrelationship, selective targeting techniques against Stat3 and/or survivin may represent promising

  19. Predicting Paroxysmal Atrial Fibrillation in Cerebrovascular Ischemia Using Tissue Doppler Imaging and Speckle Tracking Echocardiography

    DEFF Research Database (Denmark)

    Olsen, Flemming Javier; Jørgensen, Peter Godsk; Møgelvang, Rasmus;

    2016-01-01

    , tissue Doppler imaging (TDI), and speckle tracking. TDI was performed to acquire myocardial peak velocities during systole/ventricular contraction (global s'), early diastole/ventricular filling (global e'), and late diastole/atrial contraction (global a'). Speckle tracking was performed for myocardial...... versus .76, P = .032). Cutoff values with the highest sensitivity and specificity for these 3 parameters improved the diagnostic accuracy (sensitivity = 97%, specificity = 32%, negative predictive value = 95%, and positive predictive value = 38%). CONCLUSIONS: Atrial contractile measures by advanced...

  20. Detection of benign prostatic hyperplasia nodules in T2W MR images using fuzzy decision forest

    Science.gov (United States)

    Lay, Nathan; Freeman, Sabrina; Turkbey, Baris; Summers, Ronald M.

    2016-03-01

    Prostate cancer is the second leading cause of cancer-related death in men MRI has proven useful for detecting prostate cancer, and CAD may further improve detection. One source of false positives in prostate computer-aided diagnosis (CAD) is the presence of benign prostatic hyperplasia (BPH) nodules. These nodules have a distinct appearance with a pseudo-capsule on T2 weighted MR images but can also resemble cancerous lesions in other sequences such as the ADC or high B-value images. Describing their appearance with hand-crafted heuristics (features) that also exclude the appearance of cancerous lesions is challenging. This work develops a method based on fuzzy decision forests to automatically learn discriminative features for the purpose of BPH nodule detection in T2 weighted images for the purpose of improving prostate CAD systems.