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Sample records for bony nodular sclerotic

  1. SCLEROTIC OSTEODYSPLASIAS

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    A. L. Petrushin

    2016-01-01

    Full Text Available Sclerotic osteodysplasias represent a group of relatively rare diseases; a common feature of them is the diffuse or local bone sclerosis. The reasons for their development are congenital abnormalities of endochondral and intramembranous bone formation either the hereditary nature or arising from spontaneous mutations. The main diagnostic problems arise when the differential diagnostic sclerotic dysplasias from various symptomatic osteopathies entailing bone sclerosis is needed. The aim of this research is the information about the group of rare congenital disorders characterized by diffuse and local osteosclerosis, and analysis of the literature on the diagnosis and differential diagnosis from other diseases and states, accompanied by compaction of bone tissue. A search of publications in English and Russian in electronic databases PUBMED, PUBMED CENTRAL, GOOGLE SHOLAR and eLIBRARY is performed. Keyword: sclerotic osteodisplasias, hyperostosis, osteopetrosis, osteopoikilosis, pyknodisostosis, melorheostosis, osteopathia striata, progressive diaphiseal dysplasia, diaphiseal sclerosis, enostosis and their Russian analogs for the period from 1953 to 2015. This clinical and radiological signs of osteopetrosis, osteopathia striata. osteopoikilosis, enostosis, piknodisostosis, progressive diaphyseal dysplasia, generalized hyperostosis cortical generalisata, melorheostosis and other forms of sclerotic osteodysplasias are presented. The main attention is paid to clinical and radiological diagnosis and differential diagnosis from osteoblastic metastases, primary benign and malignant bone tumors, chronic osteomyelitis and other diseases accompanied by local or diffuse osteosclerosis.

  2. Innumerable Small Bony Nodular Sclerotic Lesions with Negative Findings on Both Bone Scintigraphy and F-18 FDG PET: Osteopoikilosis a Patient of Breast Cancer

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    Jun, Sung Min; Kim, Yong Ki; Kim, In Ju; Nam, Hyun Yeol; Kim, Bum Soo [Pusan National University Hospital, Pusan (Korea, Republic of)

    2008-06-15

    Osteopoikilosis is a rare, benign hereditary disease, which presents multiple osteosclerotic, and small round nodules in the bone. It is usually detected incidentally by radiological examination. A radionuclide bone scintigraphy is essential in distinguishing osteopoikilosis from osteoblastic metastases, because scintigraphic findings are usually normal in patients with osteopoikilosis. However, there have been no reports about F-18 fluorodeoxyglucose (FDG) PET findings in osteopoikilosis. Herein, we wish to report a case of osteopoikilosis with breast cancer, which could not be seen in either bone scintigraphy or F-18 FDG PET/CT.

  3. Nodular Morphea

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    Kauer, Friederike; Simon, Jan C.; Sticherling, Michael

    2013-01-01

    Scleroderma may present as being strictly limited to the skin, as in morphea, or within a multiorgan disease, as in systemic sclerosis. Accordingly, cutaneous manifestations vary clinically. In nodular or keloidal scleroderma, patients develop lesions that are clinically indistinguishable from a keloid; however, the histopathological findings are more variable. We describe a 16-year-old girl with morpheic lesions for 3–4 years and additional development of keloidal nodules within these lesion...

  4. Sclerotic changes of the manubrium sterni

    International Nuclear Information System (INIS)

    Jurik, A.G.; Graudal, H.; De Carvalho, A.; Aarhus Univ.

    1985-01-01

    Six females with nearly identical sclerotic and hyperostotic changes of the manubrium sterni are reported. Malignancies, bacterial inflammatory processes, and Paget disease, which were first suspected, could be excluded. The youngest patients also had sclerotic changes of other bones, including the lumbar spine, the pubic bone, and the clavicle, and may be classified as having ''chronic recurrent multifocal osteomyelitis'' (CRMO). The two oldest patients had ossification of the costoclavicular ligament(s) and may be classified as having ''inter-sterno-costo-clavicular ossification'' (ISCCO). One had only hyperostotic and sclerotic changes as seen in ''sterno-costo-clavicular hyperostosis'' (SCCH). The pathogenesis of these uncommon diseases is unknown, but they are all frequently associated with pustulosis palmoplantaris and have similar clinical courses and laboratory abnormalities. None of the present patients had HLA-B 27 . The similarity of the radiological abnormalities of the manubrium sterni suggests that the diseases themselves may be similar, but with different courses depending on age, CRMO being present in children and young adults and ISCCO or SCCH in older adults. (orig.)

  5. CASE REPORT: NODULAR MELANOMA

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    Tina Zupančič

    2015-05-01

    Full Text Available Nodular melanoma is a rare type of cutaneous melanoma with an increased risk of death. It often mimics benign cutaneous tumors and inflammatory lesions. It has pronounced vertical growth phase and greater thickness at the time of diagnosis which caries ominous prognostic value. Nodular melanoma quickly develops metastases which are often present before the disease is clinically recognised. Here, we report a case of nodular melanoma clinically mimicking seborrheic keratosis. Therapy and 36 months follow-up after primal excision are also presented.

  6. Amiloidosis oral nodular Oral nodular amyloidosis

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    P. Martos Díaz

    2008-02-01

    Full Text Available Introducción. La amiloidosis constituye una entidad marcada por el depósito de amiloide en diferentes tejidos. En la cavidad oral se manifiesta habitualmente en forma de macroglosia, y más raramente, como nódulos dispuestos en la superficie. Caso clínico. Varón afecto de Mieloma Múltiple, que comienza con lesiones nodulares en labio inferior y lengua. A raíz de estas lesiones, mediante estudio histológico, es diagnosticado de Amiloidosis Sistémica. Discusión. Los nódulos amiloideos en la cavidad oral, constituyen una manifestación rara de la amiloidosis sistémica. Su aparición conlleva la necesidad de realizar un diagnostico diferencial con otras entidades y el diagnostico de certeza se obtiene mediante el análisis histológico.Introduction. Amyloidosis is a condition characterized by the deposit of amyloid in different tissues. In the oral cavity it is usually manifested as macroglossia and, more rarely, as nodules on the surface. Clinical case. A man had multiple myeloma that began with nodular lesions of the lower lip and tongue. As a result of these lesions, the patient was diagnosed of systemic amyloidosis by histological study. Discussion. Amyloid nodules in the oral cavity are a rare manifestation of systemic amyloidosis. Its appearance entails the necessity to make I diagnose differential with other organizations and I diagnose of certainty is obtained by means of the histological analysis.

  7. Scleroderma with Nodular Scleroderma

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    Chutika Srisuttiyakorn

    2016-11-01

    Full Text Available Background: Nodular scleroderma is a rare variant of scleroderma which can occur in connection with systemic sclerosis or morphea. A biopsy from the lesion can demonstrate the scleroderma pattern, i.e., keloid pattern or mixed type. Treatment is challenging, and several treatments modalities have been reported with unsatisfactory results. Main Observations: We present a case of systemic sclerosis in a 50-year-old female who developed nodular scleroderma in the absence of deterioration of the scleroderma condition. Although no additional treatment was given, the lesions remained stable without progression. Conclusions: Although this condition is rare, it has been reported sporadically, and clinicians should be able to recognize this variant in cases of scleroderma presenting with firm nodules or plaques.

  8. Vision in dinosaurs: Scaling effects in sclerotic rings

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    Lee, Scott

    Sclerotic rings are composed of bones found in the eyes of most vertebrates except mammals and crocodilians. They are believed to have a role in maintaining the shape of the eye. Their inner diameter is an upper limit for the effective diameter of the pupil and, therefore, provides a measure of the light-gathering ability of the eyes of extinct animals. Thirty-six different species of dinosaurs (from both the Saurischian and Ornithischian branches) have been studied. The smallest dinosaurs, with masses less than 1 kg, include Juravenator starki, Archaeopteryx lithographica, and Mei long while the largest dinosaurs, with masses on the order of 10,000 kg, include Diplodocus longus and Nemegtosaurus mongoliensis. The light-gathering properties of the eyes of the dinosaurs are studied as a function of the mass. The sclerotic ring diameter is found to increase with mass.

  9. Sclerotic rings in mosasaurs (Squamata: Mosasauridae): structures and taxonomic diversity.

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    Yamashita, Momo; Konishi, Takuya; Sato, Tamaki

    2015-01-01

    Mosasaurs (Squamata: Mosasauridae) were a highly diverse, globally distributed group of aquatic lizards in the Late Cretaceous (98-66 million years ago) that exhibited a high degree of adaptation to life in water. To date, despite their rich fossil record, the anatomy of complete mosasaur sclerotic rings, embedded in the sclera of the eyeball, has not been thoroughly investigated. We here describe and compare sclerotic rings of four mosasaur genera, Tylosaurus, Platecarpus, Clidastes, and Mosasaurus, for the first time. Two specimens of Tylosaurus and Platecarpus share an exact scleral ossicle arrangement, excepting the missing portion in the specimen of Platecarpus. Furthermore, the exact arrangement and the total count of 14 ossicles per ring are shared between Tylosaurus and numerous living terrestrial lizard taxa, pertaining to both Iguania and Scleroglossa. In contrast, two species of Mosasaurus share the identical count of 12 ossicles and the arrangement with each other, while no living lizard taxa share exactly the same arrangement. Such a mosaic distribution of these traits both among squamates globally and among obligatorily aquatic mosasaurs specifically suggests that neither the ossicle count nor their arrangement played major roles in the aquatic adaptation in mosasaur eyes. All the mosasaur sclerotic rings examined consistently exhibit aperture eccentricity and the scleral ossicles with gently convex outer side. Hitherto unknown to any squamate taxa, one specimen of Platecarpus unexpectedly shows a raised, concentric band of roughened surface on the inner surface of the sclerotic ring. It is possible that one or both of these latter features may have related to adaptation towards aquatic vision in mosasaurs, but further quantitative study of extant reptilian clades containing both terrestrial and aquatic taxa is critical and necessary in order to understand possible adaptive significances of such osteological features.

  10. Nodular scleritis following alendronate therapy.

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    Tabbara, Khalid F

    2008-01-01

    To report a case of nodular scleritis following alendronate sodium. A 54 year-old male was treated with alendronate sodium 70 mg orally once per week. Eight weeks later, he experienced pain and redness of the right eye. Biomicroscopy was performed. Patient was found to have inferonasal nodular scleritis. Laboratory work-up was unrevealing. Patient was given 4 mg of subtenon's triamcinolone acetate in the area of the nodular scleritis and had complete resolution. Two weeks following rechallenge with alendronate sodium resulted in recurrence of his scleritis. Alendronate led to nodular scleritis and rechallenge caused recurrence of scleritis.

  11. Post-aural Nodular Fasciitis

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    Mohammed Al Rahbi

    2015-01-01

    Full Text Available Nodular fasciitis is a rare benign lesion. Here we report a case of post-auricular nodular fasciitis, which was misdiagnosed by fine-needle aspiration cytology (FNAC as pleomorphic adenoma. An 18-year-old male presented at Al-Nahdha Hospital, physical examination revealed a right post aural firm immobile mass. Radiology suggested the presence of a hypo-dense to iso-dense subcutaneous mass. The swelling was excised and sent for histopathological examination which suggested the diagnosis of nodular fasciitis. FNAC reported pleomorphic adenoma of unusual location should raise the suspicion of nodular fasciitis.

  12. Nodular amelanotic melanoma

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    Nalamwar Rashmi

    2010-01-01

    Full Text Available We report a case of 65-year-old male patient who presented with multiple erythematous papules coalescing to form a nodular mass over posterior aspect of right thigh of six months duration. His general and systemic examinations were within normal range except for right inguinal lymphadenopathy. Biopsy from the lesion was done, which showed diffuse infiltrate of nests of atypical melanocytes extending upto reticular dermis. Malignant cells were positive for S100 and human melanin black 45(HMB 45. Hence, a diagnosis of amelanotic melanoma (AM - Clarke level IV and TNM stage III was reached. MRI of involved leg showed fungating soft tissue mass in the posterolateral aspect of right thigh and metastatic right inguinal adenopathy. Fine needle aspiration cytology (FNAC from the right inguinal nodes confirmed metastasis of melanoma. The patient was referred to oncosurgery department for further management.

  13. Malignant Nodular Hidradenoma of Face

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    Bansal N

    2014-10-01

    Full Text Available We report a case of malignant nodular hidradenoma in an old woman, who presented with a nodular swelling in the right side of nose near the medial canthus of the right eye. Wide excision of the nodular mass with a clear margin of healthy surrounding tissue was performed along with primary closure. Post operatively, adjuvant radiation therapy was given on a telecobalt machine due to the presence of high risk features. In general, malignant forms of hidradenomas are not usual and treatment strategies should be individualized.

  14. Phylogenetic classification of bony fishes.

    Science.gov (United States)

    Betancur-R, Ricardo; Wiley, Edward O; Arratia, Gloria; Acero, Arturo; Bailly, Nicolas; Miya, Masaki; Lecointre, Guillaume; Ortí, Guillermo

    2017-07-06

    Fish classifications, as those of most other taxonomic groups, are being transformed drastically as new molecular phylogenies provide support for natural groups that were unanticipated by previous studies. A brief review of the main criteria used by ichthyologists to define their classifications during the last 50 years, however, reveals slow progress towards using an explicit phylogenetic framework. Instead, the trend has been to rely, in varying degrees, on deep-rooted anatomical concepts and authority, often mixing taxa with explicit phylogenetic support with arbitrary groupings. Two leading sources in ichthyology frequently used for fish classifications (JS Nelson's volumes of Fishes of the World and W. Eschmeyer's Catalog of Fishes) fail to adopt a global phylogenetic framework despite much recent progress made towards the resolution of the fish Tree of Life. The first explicit phylogenetic classification of bony fishes was published in 2013, based on a comprehensive molecular phylogeny ( www.deepfin.org ). We here update the first version of that classification by incorporating the most recent phylogenetic results. The updated classification presented here is based on phylogenies inferred using molecular and genomic data for nearly 2000 fishes. A total of 72 orders (and 79 suborders) are recognized in this version, compared with 66 orders in version 1. The phylogeny resolves placement of 410 families, or ~80% of the total of 514 families of bony fishes currently recognized. The ordinal status of 30 percomorph families included in this study, however, remains uncertain (incertae sedis in the series Carangaria, Ovalentaria, or Eupercaria). Comments to support taxonomic decisions and comparisons with conflicting taxonomic groups proposed by others are presented. We also highlight cases were morphological support exist for the groups being classified. This version of the phylogenetic classification of bony fishes is substantially improved, providing resolution

  15. Nodular lesions in renal tuberculosis

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    Mizunuma, Kimiyoshi; Toyoda, Keiko; Tada, Shimpei; Kaneko, Kenji; Yamaguchi, Manabu [Jikei Univ., Tokyo (Japan). School of Medicine

    1994-11-01

    We retrospectively studied the CT findings of rental tuberculosis in 27 cases (32 kidneys). As a characteristic CT findings, nodular lesions were recognized in 20 kidneys. Low density nodules were found in three kidneys, isodensity nodules in seven, and high density nodules in 10. In a case examined by follow-up five years later, the low and isodensity nodules changed to high density nodules with decreasing volume. Ultrasound demonstrated the high density nodules as low-echo mass lesions. These nodular lesions corresponded with the localized foci in the renal parenchyma and/or pyocalyx. We consider that the density differences in nodular lesions reflect the process of water absorption from the caseous necrotizing materials of tuberculosis. (author).

  16. Dermoscopic evaluation of nodular melanoma.

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    Menzies, Scott W; Moloney, Fergal J; Byth, Karen; Avramidis, Michelle; Argenziano, Giuseppe; Zalaudek, Iris; Braun, Ralph P; Malvehy, Josep; Puig, Susana; Rabinovitz, Harold S; Oliviero, Margaret; Cabo, Horacio; Bono, Riccardo; Pizzichetta, Maria A; Claeson, Magdalena; Gaffney, Daniel C; Soyer, H Peter; Stanganelli, Ignazio; Scolyer, Richard A; Guitera, Pascale; Kelly, John; McCurdy, Olivia; Llambrich, Alex; Marghoob, Ashfaq A; Zaballos, Pedro; Kirchesch, Herbert M; Piccolo, Domenico; Bowling, Jonathan; Thomas, Luc; Terstappen, Karin; Tanaka, Masaru; Pellacani, Giovanni; Pagnanelli, Gianluca; Ghigliotti, Giovanni; Ortega, Blanca Carlos; Crafter, Greg; Ortiz, Ana María Perusquía; Tromme, Isabelle; Karaarslan, Isil Kilinc; Ozdemir, Fezal; Tam, Anthony; Landi, Christian; Norton, Peter; Kaçar, Nida; Rudnicka, Lidia; Slowinska, Monika; Simionescu, Olga; Di Stefani, Alessandro; Coates, Elliot; Kreusch, Juergen

    2013-06-01

    Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical. To determine the dermoscopy features of NM. Eighty-three cases of NM, 134 of invasive non-NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/hypomelanotic or pigmented to assess outcomes. Predominantly hospital-based clinics from 5 continents. Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma. Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, blue-white veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (>98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/hypomelanotic NM (84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM. When

  17. Bony sequestrum: A radiologic review

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    Jennin, Felicie; Bousson, Valerie; Parlier, Caroline; Jomaah, Nabil; Khanine, Vanessa; Laredo, Jean-Denis [Lariboisiere Hospital, Department of Radiology, Paris (France)

    2011-08-15

    According to a pathological definition, a bony sequestrum is defined as a piece of devitalized bone that has been separated from the surrounding bone during the process of necrosis. However, the radiological definition of a sequestrum is different and refers to an image of calcification visible within a lucent lesion, completely separated from the surrounding bone, without referring to the vascular status and histological nature of the calcified tissue. The term ''button sequestrum'' has been used in calvarial lesions. The prototype conditions that may present with a bony sequestrum are osteomyelitis and skeletal tuberculosis. Other conditions such as radiation necrosis, eosinophilic granuloma, metastatic carcinoma, primary lymphoma of bone, aggressive fibrous tumors may also manifest as osteolytic lesions containing a sequestrum. In addition, some primary bone tumors produce a matrix that may mineralize and sometimes simulate a bone sequestrum. These include osteoid tumors (osteoid osteoma, osteoblastoma), cartilaginous tumors (chondroma and chondroblastoma), lipomatous tumors (lipoma), and benign fibrous tumors (fibromyxoma, myxoma, and desmoplastic fibroma). Therefore, various conditions may present at imaging as a small area of osteolysis containing central calcifications. However, a careful analysis of the sequestrum as well as the associated clinical and radiological findings often enables to point toward a limited number of conditions. (orig.)

  18. Bony sequestrum: A radiologic review

    International Nuclear Information System (INIS)

    Jennin, Felicie; Bousson, Valerie; Parlier, Caroline; Jomaah, Nabil; Khanine, Vanessa; Laredo, Jean-Denis

    2011-01-01

    According to a pathological definition, a bony sequestrum is defined as a piece of devitalized bone that has been separated from the surrounding bone during the process of necrosis. However, the radiological definition of a sequestrum is different and refers to an image of calcification visible within a lucent lesion, completely separated from the surrounding bone, without referring to the vascular status and histological nature of the calcified tissue. The term ''button sequestrum'' has been used in calvarial lesions. The prototype conditions that may present with a bony sequestrum are osteomyelitis and skeletal tuberculosis. Other conditions such as radiation necrosis, eosinophilic granuloma, metastatic carcinoma, primary lymphoma of bone, aggressive fibrous tumors may also manifest as osteolytic lesions containing a sequestrum. In addition, some primary bone tumors produce a matrix that may mineralize and sometimes simulate a bone sequestrum. These include osteoid tumors (osteoid osteoma, osteoblastoma), cartilaginous tumors (chondroma and chondroblastoma), lipomatous tumors (lipoma), and benign fibrous tumors (fibromyxoma, myxoma, and desmoplastic fibroma). Therefore, various conditions may present at imaging as a small area of osteolysis containing central calcifications. However, a careful analysis of the sequestrum as well as the associated clinical and radiological findings often enables to point toward a limited number of conditions. (orig.)

  19. Idiopathic nodular glomerulosclerosis- a rare case

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    Jazmin I. Yepez Kuri

    2016-10-01

    Full Text Available Nodular glomerulosclerosis is considered a signature lesion of diabetes nephropathy, but when it occurs in the absence of diabetes, it is called Idiopathic Nodular Glomerulosclerosis (ING. Idiopathic nodular glomerulosclerosis is a very rare disease and has been associated with obesity, hypertension, and smoking. We report a case of ING presenting as end-stage renal failure requiring hemodialysis.

  20. Nodular hidradenoma of the caruncle

    DEFF Research Database (Denmark)

    Christakopoulos, Christos; Prause, Jan Ulrik; Heegaard, Steffen

    2013-01-01

    . Immunohistochemical staining of the tumor cells demonstrated positive staining with antibodies against CK-CAM 5.2, BER-EP4, p63, and smooth muscle actin-positive cells in some areas. The tumor was diagnosed as a nodular hidradenoma of the caruncle, which has never been reported before and should be included...

  1. Malignant nodular hidradenoma of scalp

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    Tanmoy Maiti

    2014-01-01

    Full Text Available Malignant nodular hidradenoma (MNH is a rare tumor of sweat gland known by many names in the literature. Scalp is a known and yet uncommon site of occurrence. We describe two patients with scalp MNH with brain parenchymal invasion. Both tumors recurred in spite of total excision and radiotherapy.

  2. Primary pigmented nodular adrenocortical disease

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    Marie T Manipadam

    2011-01-01

    Full Text Available Primary pigmented nodular adrenocortical disease (PPNAD is a rare cause of ACTH-independent Cushing′s syndrome and has characteristic gross and microscopic pathologic findings. We report a case of PPNAD in a 15-year-old boy, which was not associated with Carney′s complex. Bilateral adrenalectomy is the treatment of choice.

  3. Bony ankylosis of temporomandibular joint

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    Lee, Byeong Do; Yoon, Young Nam; Um, Ki Doo; Ra, Jong Ill; Lee, Wan [School of Dentistry, Wonkwang University, Iksan (Korea, Republic of)

    2002-06-15

    Ankylosis of joint is defined as limited movement due to infection, trauma, or surgical procedure. A 59-year-old female with a chief complaint of limited movements during mouth opening had a positive history of trauma to her right TMJ area about 5 years ago. From that time, progressive mouth opening limitation and intermittent pain have occurred. At the time of admission the patient showed mandibular deviation to the right side during mouth opening, with a maximum opening limited to 5 mm. On plain radiographs, right condylar enlargement and joint space reduction by newly formed bony tissues were observed. CT scans showed right condylar enlargement, cortical sclerosis, and thickening of the condyle, articular fossa and articular eminence.

  4. Bony ankylosis of temporomandibular joint

    International Nuclear Information System (INIS)

    Lee, Byeong Do; Yoon, Young Nam; Um, Ki Doo; Ra, Jong Ill; Lee, Wan

    2002-01-01

    Ankylosis of joint is defined as limited movement due to infection, trauma, or surgical procedure. A 59-year-old female with a chief complaint of limited movements during mouth opening had a positive history of trauma to her right TMJ area about 5 years ago. From that time, progressive mouth opening limitation and intermittent pain have occurred. At the time of admission the patient showed mandibular deviation to the right side during mouth opening, with a maximum opening limited to 5 mm. On plain radiographs, right condylar enlargement and joint space reduction by newly formed bony tissues were observed. CT scans showed right condylar enlargement, cortical sclerosis, and thickening of the condyle, articular fossa and articular eminence.

  5. Bony ankylosis following thermal and electrical injury

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    Balen, P.F.; Helms, C.A. [Dept. of Radiology, Duke University Medical Center, Durham, NC (United States)

    2001-07-01

    Objective. Bony ankylosis has been described following trauma, paralysis, psoriasis, Reiter's syndrome, ankylosing spondylitis, juvenile chronic arthritis and rheumatoid arthritis. Reports of bony ankylosis following thermal and electrical injury are limited.Design and patients. Thirteen cases of burn-related joint ankylosis in four patients are presented.Conclusion. Patients with burns from thermal or electrical injury may develop bony ankylosis among other radiographic manifestations. This bony ankylosis may result either from bridging extra-articular heterotopic ossification with preservation of the underlying joint or from intra-articular fusion due to joint destruction. (orig.)

  6. Post Pelvic Radiotherapy Bony Changes

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    Huh, Seung Jae [Samsung Medical Center, Seoul (Korea, Republic of)

    2009-03-15

    There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as 8.2{approx}20% after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

  7. Sclerotic bone lesions at abdominal magnetic resonance imaging in children with tuberous sclerosis complex

    International Nuclear Information System (INIS)

    Boronat, Susana; Barber, Ignasi; Pargaonkar, Vivek; Chang, Joshua; Thiele, Elizabeth A.

    2016-01-01

    Sclerotic bone lesions are often seen on chest CT in adults with tuberous sclerosis complex. To characterize bone lesions at abdominal MRI in children with tuberous sclerosis complex. This retrospective review included 70 children with tuberous sclerosis complex who had undergone abdominal MRI for renal imaging. An additional longitudinal study was performed in 50 children who had had two or more MRI scans. Abdominal CT (eight children) and radiographs (three children) were reviewed and compared with MRI. A total of 173 sclerotic bone lesions were detected in 51/70 children (73%; 95% confidence interval: 0.61-0.82) chiefly affecting vertebral pedicles. New lesions appeared in 20 children and growth of previous sclerotic bone lesions was documented in 14 children. Sclerotic bone lesions were more frequent in girls and in children with more extensive renal involvement. Sclerotic bone lesions are commonly detected by abdominal MRI in children with tuberous sclerosis complex. They usually affect posterior vertebral elements and their number and size increase with age. As current recommendations for tuberous sclerosis complex surveillance include renal MR performed in childhood, recognition of these lesions is useful. (orig.)

  8. Sclerotic bone lesions at abdominal magnetic resonance imaging in children with tuberous sclerosis complex

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    Boronat, Susana [Massachusetts General Hospital, Department of Neurology, Boston, MA (United States); Universitat Autonoma de Barcelona, Department of Pediatric Neurology, Vall d' Hebron Hospital, Barcelona (Spain); Barber, Ignasi [Universitat Autonoma de Barcelona, Department of Pediatric Radiology, Vall d' Hebron Hospital, Barcelona (Spain); Pargaonkar, Vivek [Massachusetts General Hospital, Department of Radiology, Boston, MA (United States); Chang, Joshua; Thiele, Elizabeth A. [Massachusetts General Hospital, Department of Neurology, Boston, MA (United States)

    2016-05-15

    Sclerotic bone lesions are often seen on chest CT in adults with tuberous sclerosis complex. To characterize bone lesions at abdominal MRI in children with tuberous sclerosis complex. This retrospective review included 70 children with tuberous sclerosis complex who had undergone abdominal MRI for renal imaging. An additional longitudinal study was performed in 50 children who had had two or more MRI scans. Abdominal CT (eight children) and radiographs (three children) were reviewed and compared with MRI. A total of 173 sclerotic bone lesions were detected in 51/70 children (73%; 95% confidence interval: 0.61-0.82) chiefly affecting vertebral pedicles. New lesions appeared in 20 children and growth of previous sclerotic bone lesions was documented in 14 children. Sclerotic bone lesions were more frequent in girls and in children with more extensive renal involvement. Sclerotic bone lesions are commonly detected by abdominal MRI in children with tuberous sclerosis complex. They usually affect posterior vertebral elements and their number and size increase with age. As current recommendations for tuberous sclerosis complex surveillance include renal MR performed in childhood, recognition of these lesions is useful. (orig.)

  9. Nodular Melanoma Mimicking Keratoacanthoma: Lessons to learn.

    Science.gov (United States)

    Muthupalaniappen, Leelavathi; Das, Srijit; Md Nor, Norazirah; Ali, Siti A M

    2012-08-01

    A 67-year-old man of Chinese descent presented with a painless nodular lesion that had been present on his right forearm for the previous 3 months. A single, well-defined, dome-shaped, firm nodule with a central keratin plug surrounded by erythema was noted. Keratoacanthoma with secondary bacterial infection was suspected and the patient underwent an excision biopsy. Biopsy of the nodule and immunohistochemical staining supported a diagnosis of nodular malignant melanoma. It should be noted both that nodular malignant melanoma may present with a wide variety of clinical appearances, and that the lack of melanin pigment in nodular malignant melanoma may hinder the diagnosis of this aggressive tumour.

  10. Nodular lymphocyte predominant Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Siddiqui, Neelam; Al-Diab, Abdulrahman I.

    2005-01-01

    To describe the clinicopathological features, treatment, treatment outcome and sequelae of patients with nodular lymphocyte, predominant Hodgkin's lymphoma (NLPHL) in Saudi population. This is a retrospective review of 29 patients with lymphocyte predominant Hodgkin's lymphoma treated at two major hospitals (King Khalid University Hospital and Security Forces Hospital) in Riyadh, Kingdom of Saudi Arabia from 1985 to 2000. Histological subtypes were confirmed by review of hematoxylin and eosin paraffin sections and immunochemistry. Details of clinical presentation, stage, treatment and results of treatment were analyzed. On pathological reappraisal of the 29 cases, 3 patients had nodular sclerosis Hodgkin's lymphoma and 4 patients were reclassified as lymphocyte rich classical Hodgkin's lymphoma. Twenty-two patients were identified to have nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL). These patients comprised of 18 mails and 4 female patients with a median age at presentation of 25 years. Nineteen (86%) patients had an early stage (Ann Arbor stage I and II) disease, 2 had stage III and one patient had stage IV. The majority of patients presented with peripheral lymphadenopathy and long duration of symptoms. For 16 patients, details of treatment and follow-up were available. All of these achieved a complete response to initial treatment. Four patients relapsed following the primary therapy. Our results are consistent with the previous series reported from Western countries and confirmed that the patients with NLPHL have characteristic clinical and pathological profile that distinguish it from other types of Hodgkin's lymphoma. The disease tends to run an unusual course and although most patients achieve an excellent response to therapy there is a tendency to replace. treatment remains controversial; however, recent understanding of the molecular pathogenesis of NLPHL could lead to modification of current therapeutic approach to this disease. (author)

  11. Bony Regrowth After Deep Lateral Orbital Decompression.

    Science.gov (United States)

    Ramesh, Sathyadeepak; Eichhorn, Knut; Leibowitz, Steven; Goldberg, Robert

    2018-01-25

    To report on 2 cases of late bony regrowth with clinically apparent proptosis after deep lateral orbital decompression for thyroid orbitopathy. A retrospective review of 2 cases identified by the authors as having late bony regrowth. The authors review the clinical, historical, radiologic, and anatomical findings and discuss the significance thereof. Bony regrowth with bowing toward the middle cranial fossa is observed at postoperative month 8 in the first case. Cortical bone and marrow was observed to regrow at 2 years postoperatively in the second case. Both patients underwent successful repeat deep lateral orbital decompression with resolution of proptosis and clinical symptoms. Late bony regrowth should be considered as a possible cause of recurrent proptosis after orbital decompression in thyroid eye disease.

  12. Focal nodular hyperplasia in children

    International Nuclear Information System (INIS)

    Mancheva, Ts.; El Shemeri, S.; Balev, B.; Rasheva, N.; Georgieva, M.

    2016-01-01

    Focal nodular hyperplasia (FNH) is a rare benign tumor of the liver, which is extremely rare reported in children. We present a case of 6-month-old female. The infant was referred to the hospital for further investigation of incidentally established heterodense mass in the liver. Ultrasound and CT examinations were performed. They were combined with laboratory and viral serologic tests. The liver function tests were normal, except AFP. Viral serologic tests for hepatitis B and C were negative. Abdominal ultrasound revealed a heterodense mass, well-defined from the surrounding liver tissue. On Doppler examination, the blood supply is proven to be from a large artery. The findings on CT imaging include a solitary, homogeneous, and slightly hypoattenuating mass compared to the surrounding liver on unenhanced CT. After administration of i.v. contrast the lesion demonstrates rapid homogeneous contrast enhancement at the arterial phase (except for the central scar). On venous phase, the mass becomes isotense as compared to the surrounding liver. Although the diagnosis of FNH in children can be challenging for the radiologist, different imaging modalities like ultrasound, CT and MRI all offer specific advantages in the detection. Key words: FOCAL Nodular Hyperplasia. Imaging Diagnostic. Pediatric. Tumours In Children

  13. Nodular malignant melanoma - Secondary to carcinoma rectum

    Directory of Open Access Journals (Sweden)

    Chopra Adarsh

    1997-01-01

    Full Text Available A 45-year female presented with a sudden eruption of multiple brownish black nodular lesions since 5 months over the face, trunk and extremities which were clinically diagnosed as a case of nodular malignant melanoma. Histopathologically, they revealed the secondaries from carcinoma rectum.

  14. Nodular skin melanomas and dermatoscopic diagnostic therein

    Directory of Open Access Journals (Sweden)

    M. V. Zhuchkov

    2016-01-01

    Full Text Available Aim. The study of dermatoscopic pattern characteristics of nodular melanoma with the use of modified Kittler’s pattern analysis. Materials and methods. Clinical and dermatoscopis images of 127 patients with histologically distinctive nodular form of skin melanoma were examined. Nonpolarized dermoscopy of nodular melanoma foci was carried out to patients. Interpretation of obtained dermatoscopic images was performed with the use of pattern analysis modified by Harold Kittler. Main results. The two most important dermatoscopic features of nodular melanoma that distinguish it from other clinical types of this malignant tumor were revealed in our investigation: 1 the prevalence of dermatoscopis images with one pattern (structureless; 2 the prevalence of “grey dots, circles, clods” and “black peripheral dots and clods” as main features of nodular melanoma.

  15. [Quantification of sclerotic renal glomeruli during the aging process in humans].

    Science.gov (United States)

    Stojanović, Vesna; Jovanović, Ivan; Ugrenović, Sladana; Pavlović, Snezana

    2010-01-01

    The aim of our research was to quantify the presence of totally sclerotized glomeruli during the aging process. The study material were kidney tissue samples taken from fifty-six cadavers, their age ranging from 20 to over 70 years. They were classified in six age groups: I (20-29), II (30-39), III (40-49); IV (50-59); V (60-69) and VI (older than 70). The tissue samples were routinely histologically processed and then cut into the slices 5 mm thick, which were then stained and stereologically analyzed under the microscope with a projection screen (Reichert Visopan) with 10 x lens magnification and multipurpose test system M42 application. The analysis was carried out on 20 fields of vision per one sample. The numerical density of completely sclerotic and other glomeruli was measured, and the resulting percentages were obtained from this parameter. Completely sclerotic glomeruli were not found in the first group. They were observed in the II aging group (5%) for the first time. Their numerical density and percentage increased during the aging process and was 18% in the IV, 25% in the V and maximally 37.5% in the VI aging group. Finally, the above cited results pointed to the increase of completely sclerotized and the decreased presence of normal glomeruli during the aging process.

  16. Perianal nodular hidradenocarcinoma. Case report.

    Science.gov (United States)

    Sierra Montenegro, Ernesto; Sierra Luzuriaga, Gastón; Leone Stay, Gaetano; Salazar Menéndez, Vilma; Quiñonez Auria, Carlos

    2010-01-01

    Eccrine glands (sweat glands) appear in all sites of the skin and are more abundant in hands and feet. Nodular hidradenocarcinoma (NH) is a rare malignant and aggressive tumor of the eccrine glands. The objective of this study is to report a case of perianal hidradenocarcinoma. We present the case of a 75-year-old female with diabetes, hypertension, and hypothyroidism. Physical examination revealed a small perianal tumor that was palpated near the anal canal. Biopsy was done. Pathology report revealed perianal hidradenoma. Rectosigmoidoscopy was normal. Computed tomography showed 1-cm adenopathies in inguinal and right iliac regions. Extensive resection of the tumor was done. Definitive pathology report was malignant eccrine acrospiroma. The patient underwent adjuvant chemotherapy in the Oncology Service and died 1 month later. In patients with a first symptom of metastases in the inguinal region, suspicion must be directed to the anal canal.

  17. Comparative histopathology of scabies versus nodular scabies

    Directory of Open Access Journals (Sweden)

    Mittal R

    1997-01-01

    Full Text Available Comparative histopathology was studied in 25 cases of scabies versus 25 cases of nodular scabies which were selected from Dermato-Venereology out patients. Salient differences observed were that in scabies lifting of stratum corneum at places was seen in all 100% cases, spongiosis in 100%, spongiotic vesicles in 28%, burrows in 56%, mite in 40% and vasculitis in 28% whereas in nodular scabies acanthosis was seen in 100%, pseudo epitheliomatous hyperplasia in 8%, burrows in 48%, mite in 24% and vasculitis in 84%. In nodular scabies, dermal infiltrate in 32% cases was arranged as lymphoid follicles with admixture of plasma cells and eosinophils.

  18. Tubercular Nodular Episcleritis: A Case Report

    OpenAIRE

    Yadav, Sankalp; Rawal, Gautam

    2015-01-01

    Tuberculosis (TB) is an infectious disease caused by the acid-fast bacillus Mycobacterium tuberculosis and is an important cause of death worldwide. Tuberculosis most commonly affects the lungs, but has many extrapulmonary manifestations as well, including intraocular involvement. Tubercular nodular episcleritis is a very rare presentation and no such case in an adult male has been reported in the literature. Herein, we present the very first case of tubercular nodular episcleritis in a 30-ye...

  19. Sclerotic fibroma (storiform collagenoma)-like stroma in a fibroadenoma of axillary accessory breast tissue.

    Science.gov (United States)

    Val-Bernal, José Fernando; González-Vela, María Carmen; De Grado, Mauricio; Garijo, María Francisca

    2012-08-01

    Accessory breast tissue is a subcutaneous remnant persisting after normal embryological development of the breast. It occurs most frequently in the axilla. Fibroadenomas in axillary breast tissue are rare. We report the case of a 29-year-old female patient who presented a fibroadenoma arising in the accessory breast tissue of the right axillary fossa. The neoplasm showed foci of sclerotic fibroma-like stroma. The patient had no signs of Cowden's syndrome. To the best of our knowledge, a lesion of this kind has not been previously reported. This stromal change suggests an uncommon involutional phase of the fibroadenoma with production of sclerotic and hypocellular collagen. The lesion should be differentiated from extraneural perineuroma, from the changes in fibroadenomas in Cowden's syndrome, from sclerosing lobular hyperplasia (fibroadenomatoid mastopathy) and from pseudoangiomatous stromal hyperplasia. Copyright © 2012 John Wiley & Sons A/S.

  20. Irreversible subacute sclerotic combined degeneration of the spinal cord in a vegan subject.

    Science.gov (United States)

    Brocadello, Filippo; Levedianos, Giorgio; Piccione, Francesco; Manara, Renzo; Pesenti, Francesco Francini

    2007-01-01

    We describe a case of irreversible subacute sclerotic combined degeneration of the spinal cord in a Western vegan subject. A 57-y-old man, member of a vegan cult for 13 y, developed weakness, paraplegia, hyper-reflexia, distal symmetric muscular hypotrophy, impairment of superficial sensation in the hands and feet, loss of deep sensation in the lower limbs, and neurogenic bladder and bowel. Magnetic resonance imaging of the cervical and dorsal spine disclosed abnormally increased signal intensity on T(2)-weighted sections in the posterior and lateral columns. Subacute sclerotic combined degeneration of the spinal cord was diagnosed and treatment with cobalamin was started. Despite rehabilitative treatment, the patient developed spastic hypertonia with mild improvement of paresthesias. Six months later, vitamin B12 plasma levels and hematological analysis were normal. One year later, spastic paraplegia was still present and the patient was unable to walk despite improvement on magnetic resonance imaging. Irreversible subacute sclerotic combined degeneration of the spinal cord is a rare but possible effect of a strict vegetarian diet.

  1. Incomplete sclerotization and phylogeny: The phylogenetic classification of Plastocerus (Coleoptera: Elateroidea).

    Science.gov (United States)

    Bocak, Ladislav; Motyka, Michal; Bocek, Matej; Bocakova, Milada

    2018-01-01

    The relationships of the monogeneric family Plastoceridae Crowson, 1972 (Coleoptera: Elateroidea) have remained contentious due to its modified morphology, incorrect information on incomplete metamorphosis of females and the absence of molecular data. We produced the sequences for P. angulosus (Germar, 1844) (the type-species of Plastocerus Schaum, 1852) and performed molecular phylogenetic analyses to estimate its position. The analyses of Elateroidea (186 spp.) and Elateridae (110 spp.) molecular datasets of two mitochondrial and two nuclear gene fragments repeatedly placed Plastocerus Schaum, 1852 in relationships with the elaterid genera Oxynopterus Hope, 1842 and Pectocera Hope, 1842. Alternative topologies were rejected by likelihood tests. Therefore, Plastoceridae Crowson, 1972 are down-ranked to the subfamily Plastocerinae in Elateridae Leach, 1815. We suggest that the morphology-based placement and high rank for some elateroid lineages were inferred from the presence of homoplasies which evolved due to incomplete sclerotization. Distantly related soft-bodied elateroids share freely movable and transverse coxae, a shortened prosternum, and a weakly sclerotized abdomen with free ventrites. Importantly, the apomorphic structures characteristic for their closest relatives, such as the prosternal process, mesoventral cavity, and intercoxal keel in the first abdominal ventrite are regularly absent. Consequently, morphology-based phylogenetic analyses suggest deeply rooted positions for lineages without expressed apomorphic character states. Molecular data represent an independent character system that is not affected by the convergent morphological evolution, and therefore molecular phylogenies can elucidate the relationships of incompletely sclerotized lineages.

  2. Congenital Generalized Lipodystrophy in a Youth Presented with Sclerotic and Lytic Bone Lesions; a Family with AGPAT2 Mutation

    Directory of Open Access Journals (Sweden)

    Shirin Hasani-Ranjbar

    2017-02-01

    Full Text Available BackgroundCongenital generalized lipodystrophy (CGL is a rare disease. It is associated with near total fat loss, severe insulin resistance and hypoleptinemia leading to metabolic derangements.Case PresentationWe report a 25- year- old female with 1-Acylglycerol-3-phosphate-O-acyltransferase 2 (APGAT2 mutation, and both sclerotic and lytic bone lesions together for the first time. Bone cyst is one of the manifestations of CGL with AGPAT2 mutation. Patients usually have sclerotic bone lesions before and lytic bone lesions after puberty. Our patient had lytic bone lesions in (femur long bones and also sclerotic lesions in the pelvic which was related to AGPAT2 mutation.ConclusionThe young female hadacral enlargement, hepatomegaly and both sclerotic and cystic bone lesions with AGPAT2 mutation.

  3. Primary bony Hodgkin’s lymphoma

    OpenAIRE

    Binesh, Fariba; Mirjalili, Mohammad Reza; Akhavan, Ali; Navabii, Hossein

    2012-01-01

    Hodgkin’s lymphoma most commonly presents with progressive painless enlargement of peripheral lymph nodes, especially around the cervical region. At the time of diagnosis osseous involvement is uncommon and even in the late stages only 9–35% of cases have any bony involvement. Rarely Hodgkin’s lymphoma presents as an osseous lesion without involvement of lymph nodes, therefore the histological diagnosis of osseous Hodgkin’s lymphoma can be problematic. Here, the authors present a rare case of...

  4. Outcomes and prognostic factors in nodular melanomas.

    Science.gov (United States)

    Egger, Michael E; Dunki-Jacobs, Erik M; Callender, Glenda G; Quillo, Amy R; Scoggins, Charles R; Martin, Robert C G; Stromberg, Arnold J; McMasters, Kelly M

    2012-10-01

    The nodular subtype of cutaneous melanoma has a more pronounced vertical phase and less of a radial growth phase compared with other histologic subtypes. This study was performed to determine prognostic factors and outcomes for nodular melanomas. A post hoc analysis of a prospective clinical trial was performed in all patients with nodular histologic subtype. Univariate and multivariate analyses of factors associated with disease-free survival (DFS), overall survival (OS), and local and in-transit recurrence-free survival (LITRFS) were performed. Kaplan-Meier survival analyses were performed. There were 736 patients available for analysis, and 189 (25.7%) were sentinel lymph node (SLN) positive. Breslow thickness of ≥2.3 mm, presence of ulceration, nonextremity tumor location, positive SLN, and non-SLN-positive status were independent risk factors for worse OS and DFS. Kaplan-Meier analysis demonstrated that ulceration predicted worse OS and DFS in all nodular melanoma patients, and in both SLN-positive and -negative subsets. The presence of ulceration and a positive SLN together predicted significantly worse DFS and OS. The most important risk factors that determine prognosis in nodular melanomas are SLN status and ulceration. The presence of both a positive SLN and ulceration significantly affect DFS and OS, and to a lesser degree LITRFS. Copyright © 2012 Mosby, Inc. All rights reserved.

  5. The Sclerotic Scatter Limbal Arc Is More Easily Elicited under Mesopic Rather Than Photopic Conditions.

    Directory of Open Access Journals (Sweden)

    Eric Denion

    Full Text Available We aimed to determine the limbal lighting illuminance thresholds (LLITs required to trigger perception of sclerotic scatter at the opposite non-illuminated limbus (i.e. perception of a light limbal scleral arc under different levels of ambient lighting illuminance (ALI.Twenty healthy volunteers were enrolled. The iris shade (light or dark was graded by retrieving the median value of the pixels of a pre-determined zone of a gray-level iris photograph. Mean keratometry and central corneal pachymetry were recorded. Each subject was asked to lie down, and the ALI at eye level was set to mesopic values (10, 20, 40 lux, then photopic values (60, 80, 100, 150, 200 lux. For each ALI level, a light beam of gradually increasing illuminance was applied to the right temporal limbus until the LLIT was reached, i.e. the level required to produce the faint light arc that is characteristic of sclerotic scatter at the nasal limbus.After log-log transformation, a linear relationship between the logarithm of ALI and the logarithm of the LLIT was found (p<0.001, a 10% increase in ALI being associated with an average increase in the LLIT of 28.9%. Higher keratometry values were associated with higher LLIT values (p = 0.008 under low ALI levels, but the coefficient of the interaction was very small, representing a very limited effect. Iris shade and central corneal thickness values were not significantly associated with the LLIT. We also developed a censored linear model for ALI values ≤ 40 lux, showing a linear relationship between ALI and the LLIT, in which the LLIT value was 34.4 times greater than the ALI value.Sclerotic scatter is more easily elicited under mesopic conditions than under photopic conditions and requires the LLIT value to be much higher than the ALI value, i.e. it requires extreme contrast.

  6. Fatigue behaviour of synthetic nodular cast irons

    Directory of Open Access Journals (Sweden)

    A. Vaško

    2015-01-01

    Full Text Available The paper shows the influence of charge composition on microstructure, fatigue properties and failure micromechanisms of nodular cast irons. The additive of metallurgical silicon carbide (SiC in analysed specimens increases the content of ferrite in the matrix, decreases the size of graphite and increases the average count of graphitic nodules per unit of area. Consequently, the mechanical and fatigue properties of nodular cast iron are improved. The best fatigue properties (fatigue strength were reached in the melt which was created by 60 % of steel scrap and 40 % of pig iron in the basic charge with SiC additive.

  7. Nodular Scleroderma - Successful Treatment With Extracorporeal Photochemotherapy

    Directory of Open Access Journals (Sweden)

    Wollina U

    2001-01-01

    Full Text Available Nodular seleroderma is rare variant of circumscribed scleroderma (morphea. Treatment is often unsatisfactory. This report is on the use of extracorporeal photochemotherapy. A 12 year old girl and a 49 year old woman have been treated once a month on two consecutive days. A complete remission was achieved in one patient after 10 months and an almost complete remission in the young girl after 6 months. The treatment was well-tolerated and no severe side â€" effects occurred. In contrast to previous attempts in treating nodular scleroderma with different modalities, ECP seems to be an effective therapy.

  8. Superficially located enlarged lymphoid follicles characterise nodular gastritis.

    Science.gov (United States)

    Okamura, Takuma; Sakai, Yasuhiro; Hoshino, Hitomi; Iwaya, Yugo; Tanaka, Eiji; Kobayashi, Motohiro

    2015-01-01

    Nodular gastritis is a form of chronic Helicobacter pylori gastritis affecting the gastric antrum and characterised endoscopically by the presence of small nodular lesions resembling gooseflesh. It is generally accepted that hyperplasia of lymphoid follicles histologically characterises nodular gastritis; however, quantitative analysis in support of this hypothesis has not been reported. Our goal was to determine whether nodular gastritis is characterised by lymphoid follicle hyperplasia.The number, size, and location of lymphoid follicles in nodular gastritis were determined and those properties compared to samples of atrophic gastritis. The percentages of high endothelial venule (HEV)-like vessels were also evaluated.The number of lymphoid follicles was comparable between nodular and atrophic gastritis; however, follicle size in nodular gastritis was significantly greater than that seen in atrophic gastritis. Moreover, lymphoid follicles in nodular gastritis were positioned more superficially than were those in atrophic gastritis. The percentage of MECA-79 HEV-like vessels was greater in areas with gooseflesh-like lesions in nodular versus atrophic gastritis.Superficially located hyperplastic lymphoid follicles characterise nodular gastritis, and these follicles correspond to gooseflesh-like nodular lesions observed endoscopically. These observations suggest that MECA-79 HEV-like vessels could play at least a partial role in the pathogenesis of nodular gastritis.

  9. Radiology of nodular lesions of the lung parenchyma

    International Nuclear Information System (INIS)

    Meschan, I.; Pugatch, R.D.

    1987-01-01

    The authors have arbitrarily classified these nodular lesions as (1) single, (2) coarsely nodular throughout one or both lungs, and (3) finely granular and irregularly or homogeneously distributed throughout both lungs. They have further classified pulmonary and nodular lesions as being most likely single as against those that may be either single or multiple throughout the lung fields

  10. Dermoscopy as a Valuable Tool in Diagnosis of Nodular Amelanotic Melanoma and Nodular Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Smolarova M.

    2017-04-01

    Full Text Available Nodular amelanotic melanoma has been always a great challenge in dermatology. Because of lack of melanin pigment, tumors are diagnosed usually in advanced stage. Amelanotic melanoma can mimic basal cell carcinoma. Knowledge of typical dermoscopic structures helps to establish diagnosis and to plan surgery with appropriate safety margins. In amelanotic melanoma we can see typical vessels, white streaks or milky red globules on pink-reddish background. Vessels are typically thin and polymorphous in thick amelanotic melanoma. We had a case when vessels were polymorphous but thick. It can be confusing with nodular basal cell carcinoma where vessels are typically thick and arborizing. Nodular basal cell carcinoma is the most common form of basal cell carcinoma. Dermoscopy is a valuable tool for the diagnosis of basal cell carcinoma. Typical dermoscopic structures are arborizing vessels, possible sites of ulceration and/or pigmentation. We describe a case report of patient with typical dermoscopic structures seen in nodular basal cell carcinoma.

  11. Unilateral nodular adrenal hyperplasia: Case series

    African Journals Online (AJOL)

    A.F. Kotb

    2016-07-26

    Jul 26, 2016 ... Abstract. Introduction: Nodular adrenal hyperplasia is one of rare causes of adrenocortical hyperplasia. The disease usually presents bilaterally. Few publications discussed the possibility of unilateral disease, in association with hyperaldosteronism or Cushing syndrome. Case series: We are reporting 3 ...

  12. A sclerotic rim provides mechanical support for the femoral head in osteonecrosis.

    Science.gov (United States)

    Yu, Tong; Xie, Limin; Chu, Fulei

    2015-05-01

    Osteonecrotic collapse of the femoral head is a common refractory disease in orthopedics, and the occurrence of collapse is an important factor in the prognosis of this condition. Osteonecrotic collapse of the femoral head can be delayed or prevented by the formation of a sclerotic rim. This study used finite element analysis to evaluate the mechanical role of a proximal sclerotic rim on stress on the femoral head. The study used a healthy man who underwent computed tomography of both hips to generate 3-dimensional finite element models with different proportions of proximal rim sclerosis (0%, 30%, 50%, and 100%). Using a negative directional mechanical load of 400 N along the Z-axis, total deformation, deformation in the negative Z-axial direction (ie, direction of longitudinal compression), maximum principal stress, minimum principal stress, and contact pressure on necrotic tissue were evaluated. For 0%, 30%, 50%, and 100% rim sclerosis, total femoral head deformation was 0.21, 0.205, 0.20, and 0.19 mm, respectively, and maximum principal stress in compression was 9.83, 9.67, 9.16, and 9.05 MPa, respectively. Increases in proximal rim sclerosis decreased all of the measured outcomes. These results suggest that proximal rim sclerosis provides effective mechanical support for the femoral head, offers mechanical protection for necrotic tissue, decreases deformation of the femoral head, and delays or prevents collapse in osteonecrosis. Copyright 2015, SLACK Incorporated.

  13. Is endoscopic nodular gastritis associated with premalignant lesions?

    Science.gov (United States)

    Niknam, R; Manafi, A; Maghbool, M; Kouhpayeh, A; Mahmoudi, L

    2015-06-01

    Nodularity on the gastric mucosa is occasionally seen in general practice. There is no consensus about the association of nodular gastritis and histological premalignant lesions. This study is designed to investigate the prevalence of histological premalignant lesions in dyspeptic patients with endoscopic nodular gastritis. Consecutive patients with endoscopic nodular gastritis were compared with an age- and sex-matched control group. Endoscopic nodular gastritis was defined as a miliary nodular appearance of the gastric mucosa on endoscopy. Biopsy samples of stomach tissue were examined for the presence of atrophic gastritis, intestinal metaplasia, and dysplasia. The presence of Helicobacter pylori infection was determined by histology. From 5366 evaluated patients, a total of 273 patients with endoscopic nodular gastritis and 1103 participants as control group were enrolled. H. pylori infection was detected in 87.5% of the patients with endoscopic nodular gastritis, whereas 73.8% of the control group were positive for H. pylori (p gastritis were significantly higher than in the control group. Prevalence of atrophic gastritis and complete intestinal metaplasia were also more frequent in patients with endoscopic nodular gastritis than in the control group. Dysplasia, incomplete intestinal metaplasia and H. pylori infection are significantly more frequent in patients with endoscopic nodular gastritis. Although further studies are needed before a clear conclusion can be reached, we suggest that endoscopic nodular gastritis might serve as a premalignant lesion and could be biopsied in all patients for the possibility of histological premalignancy, in addition to H. pylori infection.

  14. Computed tomography findings of bony regeneration after radiotherapy for nasopharyngeal carcinoma with skull base destruction: implications for local control

    International Nuclear Information System (INIS)

    Fang Fumin; Leung, Stephen Wan; Wang Chongjong; Su Chihying; Lui Chunchung; Chen Huichun; Sun Limin; Lin Tsungmin

    1999-01-01

    Purpose: To evaluate the response of bony destruction (BD) of the skull base following radiotherapy in nasopharyngeal carcinoma (NPC) and investigate the implications of bony regeneration (BR) on local control and its related factors. Methods and Materials: Ninety patients with NPC with skull base destruction clearly demonstrated on computed tomography (CT) were reviewed. These patients have completed the prescribed treatment and received regular CT follow-up. A total of 338 sets of CT images of the head and neck were reviewed. The tumor response and the appearance of BR in the previous destructive part of the skull base were recorded and analyzed. The tumor response was divided into complete, partial, or no response. BR was defined as recalcification or sclerotic change with partial or complete healing in the previous osteolytic bony defect. Local failure was confirmed either by pathological or merely by imaging studies showing progression of tumor in consecutive radiological pictures. Results: The distribution of specific sites of bony destruction (BD) in these patients included the sphenoid bone (68%), paracavernous sinus area (48%), petrous apex (47%), clivus (44%), pterygoid plates (20%), and others (7%). The CT showed 57 patients (63%) had BR. All were observed within 1 year after treatment. Sixty-two patients (69%) had complete tumor response after treatment. Analyzed by logistic regression method, tumor response after treatment was found to have a statistically significant correlation with BR (p = 0.0004). Most BR (55/57) was demonstrated in patients with complete tumor response. The 3-year actuarial local control rate was 54 % in these patients. The local control was quite different in the comparison of patients with BR versus those with persistent BD (77% vs. 21%, p < 0.0001). Multivariate analysis showed that patients with complete tumor response or with BR on imaging had statistically better local control than those without either of the two findings (p

  15. Effect of noise on the development of induced sclerotic processes in the rat aorta.

    Science.gov (United States)

    Antov, G; Ivanovich, E; Kazakova, B; Goranova, L

    1985-01-01

    The authors studied the effect of 95 and 85 dB noise on the aortic wall of white rats fed for a period of 6 weeks an atherogenic diet (cholesterol + cholic acid + vitamin D2). Noise alone did not cause significant changes in the metabolism and structure of the aorta. The atherogenic diet alone caused segmental enlargement of the intercellular substance, disorganization of tissue elements, and destruction of smooth-muscle cells with marked activation of anaerobic processes, an increase in collagen content and a decrease in globular proteins and elastin. Simultaneous action of noise and of the atherogenic diet produced more pronounced biochemical and morphological alterations in the aortic wall than the diet alone. Noise not only contributes to the development of sclerotic processes but causes also complicated lesions of the aortic wall.

  16. Directional Solidification of Nodular Cast Iron

    Science.gov (United States)

    Curreri, P. A.; Stefanescu, D. M.; Hendrix, J. C.

    1987-01-01

    Cerium enhances formation of graphite nodules. Preliminary experiments in directional solidification of cast iron shows quantitative correlation of graphite microstructure with growth rate and thermal gradient, with sufficient spheroidizing element to form spheroidal graphite under proper thermal conditions. Experimental approach enables use of directional solidification to study solidification of spheriodal-graphite cast iron in low gravity. Possible to form new structural materials from nodular cast iron.

  17. Nodular calcified neurocysticercosis with signs of reactivation

    Energy Technology Data Exchange (ETDEWEB)

    Coeli, Gustavo Nunes Medina; Tiengo, Rodrigo Ribeiro; Silva, Guilherme Carlos da; Silva, Leandro Urquiza Marques Alves da, E-mail: gustavonmc@yahoo.com.br [Department of Radiology and Imaging Diagnosis, Hospital Escola de Itajuba, MG (Brazil); Silva, Afonso Carlos da [Medical Practice, Hospital Escola de Itajuba, MG (Brazil); Fernandes, Jose Otavio Meyer [Clinica Sul Mineira Tomosul and Clinica Magsul, Itajuba, MG (Brazil)

    2012-09-15

    Neurocysticercosis is a disease characterized by the involvement of the central nervous system by the intermediate larval stage of the parasite Taenia solium. The larva degeneration process and the inflammatory reaction of the body cause clinical symptoms. The authors report a case of clinical and radiological reactivation of nodular calcified neurocysticercosis in a patient who was asymptomatic for more than 20 years. Antiparasitic treatment showed a good response (author)

  18. Total thyroidectomy for multi - nodular goiter

    International Nuclear Information System (INIS)

    Ali, M.A.; Raziq, S.R.; Khan, W.A.; Majeed, S.

    2011-01-01

    Objective: To assess the efficacy and safety of total thyroidectomy for benign multi-nodular goiter. Study design: Descriptive study Place and Duration of Study: The study was conducted in the Department of General Surgery, Combined Military Hospital Kharian from January 2004 to December 2008. Materials and Methods: A total of 66 patients with bilateral benign multi-nodular goiter (61 females and 5 males) underwent total thyroidectomy. Sixty two cases were euthyroid while 4 had hyperthyroidism. Surgical dissection techniques involved identifying both recurrent laryngeal nerves through out their course, securing of parathyroid glands with their intact blood supply and ligation of inferior thyroid artery branches close to the thyroid capsule. All the patients were evaluated post operatively for signs of recurrent laryngeal nerve injury and hypoparathyroidism and other complications. All patients were put on thyroxin replacement therapy post-operatively and were followed for 9 to 12 months. There was no injury to the recurrent laryngeal nerves. One case of injury to external laryngeal nerve was found. Transient hypocalcaemia occurred in 4 patients without permanent hypoparathyroidism. All cases of transient hypocalcaemia recovered fully within 3 months. Four patients had occult malignancy diagnosed post-operatively on histo-pathology. In experienced hands, total thyroidectomy is an effective and relatively safe operation for benign multi-nodular goitre and its complication rate is same as that of a sub-total thyroidectomy. (author)

  19. Metastatic amelanotic nodular melanoma during pregnancy.

    Science.gov (United States)

    Jasaitiene, Daiva; Valiukeviciene, Skaidra; Makstiene, Jurgita; Juodzbaliene, Edita Brone

    2008-01-01

    This case report presents a very aggressive course of amelanotic nodular melanoma during pregnancy resulting in death five months after delivery. A 34 year-old Caucasian woman at 19th week of the second pregnancy was diagnosed having amelanotic nodular melanoma (tumor thickness - 2.5 mm) with metastases to the regional right inguinal lymph node. Amelanotic nodular melanoma represents malignant melanocytic tumor of the skin, which clinically mimics a variety of benign and malignant skin conditions and therefore commonly leads to delayed diagnosis. Though primary tumor was excised immediately, other treatment procedures as radical lymphadenectomy and chemotherapy were delayed, and immunotherapy was not given totally. At the 29th week of pregnancy, the woman via naturalem delivered a healthy female child, and the chemotherapy was started. Since pregnancy limits the prescription of immunotherapy and chemotherapy, the prognosis for melanoma during pregnancy detected later than in the second stage is poor and can be illustrated by our reported case. Such patients seems to be at higher risk to develop metastasis of melanoma in the internal organs and occasionally even in the fetus; therefore, they should be timely informed about that.

  20. STRUCTURE OF THE NODULAR GOITER IN CHILDREN

    Directory of Open Access Journals (Sweden)

    O. S. Rogova

    2015-01-01

    Full Text Available For today the question of early diagnosis of nosological variants, the method of treatment and prevention of nodular goiter in children is still not fully resolved. There is a few available literature data about study of this problem in children. Objective: to study morphofunctional structure of thyroid nodules in children.The article provides information consisting of the results of a retrospective analysis of case histories of 73 patients, operated with nodular goiter in Z.A. Bashlyaeva Children’sCityClinicalHospital(Moscow from 2003 to May 2015. The examination included an evaluation of the functional status of the pituitary-thyroid system: there were investigated serum thyroxine, triiodothyronine and thyroid stimulating hor-mone, also was performed thyroid scintigraphy 99mТc. In the postoperative period, there was carried out a final verification of the diagnosis according to the results of the histological conclusion. The histologi-cal type of nodal disease was defined by the WHO classification of 2004. It was established that in the structure of a single-node goiter in children prevail nodular colloid goiter with equal frequency in boys and girls, with the same frequency occurs thyroid adenoma, but more often in girls than in boys. The multinodular goiter equally often detected in girls and boys both nodular goiter colloidal with varying degree of proliferation and colloid in combination with follicular thyroid adenoma. "Hot" nodes in the multinodular goiter are more common than in the single-node goiter and more fre-quently in girls than in boys. The half of children with nodular pathology have "hot" nodes and one out of every three – decompensated form of functional autonomy. Decompensated form of functional autonomy of the thyroid gland in children with "hot" nodes detects regardless of the number of nodes. Papillary thyroid cancer occurs not only in patients with a single-node, but with a multinodular goiter. The results allow to

  1. Bony orbital distances among the Filipino population.

    Science.gov (United States)

    Barone, Constance M; Jimenez, David F; Laskey, Antoinette; Alcantara, Briccio G; Braddock, Stephen R

    2002-03-01

    Six hundred and seventy seven radiographs were selected from the logs of films taken in a major hospital in Metro Manila, Philippines over the course of the previous year. Two hundred and eighty-eight female and 389 male, healthy Filipinos between the ages of birth and twenty years were selected based on the availability of a modified Waters' projection and lateral skull film taken at the same time. Measurements for the lateral orbital wall were made at the site of the suture on the medial surface of the zygomatic bone. The medial orbital wall measurement was the distance between the dacrya using a correction factor formula of CF = D-d/D where D is the target film distance and d is the object film distance (1). The actual bony measurements were calculated. The data was gathered and plotted according to sex and in age in years. Graphs were generated using SAS over a graph software. Lines were smooth using cubic spline technique developed by Reinsch with the smoothest value of 75 (2). The mean plus two, four, and six standard deviations were included in each of the curves.

  2. [Nodular gastritis and gastric cancer in young adult].

    Science.gov (United States)

    Kamada, Tomoari; Shiotani, Akiko; Haruma, Ken

    2012-10-01

    Nodular gastritis is a popular endoscopic gastritis in H. pylori-positive children and young adults. The endoscopic findings of nodular gastritis were mainly characterized by a unique, small granulated pattern in the antrum of the stomach. The cases of gastric cancer with nodular gastritis showed the same characteristics: all were diagnosed histologically as the diffuse-type and were located in the corpus with H. pylori infection. We recommended that endoscopists should carefully examine not only the antrum but also the corpus in patients with nodular gastritis, and H. pylori should be eradicated as soon as possible to prevent gastric cancer.

  3. Pigmented poroid neoplasm mimicking nodular melanoma.

    Science.gov (United States)

    Mitsuishi, Tsuyoshi; Ansai, Shin-ichi; Ueno, Takashi; Kawana, Seiji

    2010-06-01

    We reported the case of a 92-year-old woman with a pigmented and non-pigmented surface of the pedunculated nodule on her lower leg. Microscopic examination revealed that this nodule consisted of a component of small, dark, homogenous, poroid cells and cuticular cells in the dermis. The histopathological features of the lesion were consistent with poroid neoplasm. Immunohistochemistry showed that HMB-45 and Melan-A were positive in malanocytes and melanophages of the pigmented areas. Unlike most poroid neoplasms, this case showed pigmented lesion mimicked nodular melanoma.

  4. Antifibrotic effects of crocetin in scleroderma fibroblasts and in bleomycin-induced sclerotic mice

    Directory of Open Access Journals (Sweden)

    Yinghua Song

    2013-10-01

    Full Text Available OBJECTIVE: To investigate the antifibrotic effects of crocetin in scleroderma fibroblasts and in sclerotic mice. METHODS: Skin fibroblasts that were isolated from three systemic scleroderma (SSc patients and three healthy subjects were treated with crocetin (0.1, 1 or 10 μM. Cell proliferation was measured with an MTT assay. Alpha-smooth muscle actin was detected via an immunohistochemical method. Alpha 1 (I procollagen (COL1A1, alpha 1 (III procollagen (COL3A1, matrix metalloproteinase (MMP-1 and tissue inhibitor of matrix metalloproteinase (TIMP-1 mRNA levels were measured using real-time PCR. SSc mice were established by the subcutaneous injection of bleomycin. Crocetin (50 mg/kg/d was injected intraperitoneally for 14 days. Dermal thickness and lung fibrosis were assessed with Masson's trichrome staining. Plasma ET-1 was detected with an enzyme-linked immunosorbent assay (ELISA. Skin and lung ET-1 and COL1A1 mRNA levels were measured via real-time PCR. RESULTS: Crocetin inhibited the proliferation of SSc and normal fibroblasts, an effect that increased with crocetin concentration and incubation time. Crocetin decreased the expression of α-SMA and the levels of mRNA for COL1A1, COL3A1 and matrix metalloproteinase-1, while crocetin increased TIMP-1 mRNA levels in both SSc and normal fibroblasts. Skin and lung fibrosis was induced, and the levels of ET-1 in the plasma, skin and lungs were elevated in bleomycin-injected mice. Crocetin alleviated the thickening of the dermis and lung fibrosis; decreased COL1A1 mRNA levels in the skin and lung; and simultaneously decreased ET-1 concentrations in the plasma and ET-1 mRNA levels in the skin and lungs of the bleomycin-induced sclerotic mice, especially during the early phase (weeks 1-3. CONCLUSION: Crocetin inhibits cell proliferation, differentiation and collagen production in SSc fibroblasts. Crocetin alleviates skin and lung fibrosis in a bleomycin-induced SSc mouse model, in part due to a

  5. Nodular Epiescleritis Granulomatous Canine. Case Report

    Directory of Open Access Journals (Sweden)

    Camilo Guarín Patarroyo

    2011-12-01

    Full Text Available Granulomatous epiescleritis nodular disease in canines is a very unusual presentation that affects or external fibrous tunic of the eyeball and conjunctiva, which was an increase similar to a unilateral or bilateral tumor. Suspected immune-mediated disease due to lack of identification of an etiologic agent and the response to treatment with immunosuppressive drugs (Couto, 1992. The ideal therapy is the application of steroids via intralesional, topical or systemic, or other immunosuppressants such as cyclosporine and azathioprine; it is still advisable to apply antibiotic is the ideal combination of tetracycline and neomycin (Gilger & Whitley, 1999. The diagnostic method of episcleritis is made by histopathology, which is evident in changes similar to chronic granulomatous inflammation. Are claiming a racial bias in Alsatian, Shepherd Collie Shetland Shepherd, Coker Spaniel, Rottweiler and Labrador Retriever (Gough & Thomas, 2004. The following case is a report of a nodular epiescleritis affecting the cornea, sclera, and the corneoscleral limbus, which describes the diagnosis, signology and treatment.

  6. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

    Science.gov (United States)

    Thyroid proliferative lesions are rather common in bony fishes but disagreement exists in the fish pathology community concerning diagnostic criteria for hyperplastic versus neoplastic lesions. To simplify the diagnosis of proliferative thyroid lesions and to reduce confusion reg...

  7. Thyroid Cancers in Nodular Goiters in Kano, Nigeria | Edino ...

    African Journals Online (AJOL)

    Cancer is an occasional incidental finding in nodular goiter, but there has been no formal study on this disease in our locality. To determine the occurrence of histologically diagnosed malignancy in patients who presentwith nodular goiters. This is a 7- year (2000-2006) retrospective study of all histologically diagnosed ...

  8. Conservative Treatment for Bony Healing in Pediatric Lumbar Spondylolysis.

    Science.gov (United States)

    Sakai, Toshinori; Tezuka, Fumitake; Yamashita, Kazuta; Takata, Yoichiro; Higashino, Kosaku; Nagamachi, Akihiro; Sairyo, Koichi

    2017-06-15

    A retrospective review of prospectively collected data. The aim of this study was to investigate recent outcomes of conservative treatment for bony healing in pediatric patients with lumbar spondylolysis (LS) and to identify the problems that need to be resolved. Several diagnostic and therapeutic techniques for LS have been developed recently, leading to better outcomes for bony healing. Overall, 63 consecutive pediatric patients (53 boys and 10 girls) with LS (average age: 13.8 years; range: 6-17 years) were analyzed. Diagnosis and staging (very early, early, progressive, and terminal) were based on multidetector computed tomography (CT) scans and magnetic resonance imaging (MRI). For all patients except those with terminal-stage pars defect, conservative treatment included rest, avoidance of sports, and the use of a thoraco-lumbo-sacral-type trunk brace. Follow-up MRI was performed monthly. When the signal changes resolved, CT scans were obtained to assess bony healing. Three patients dropped out during the study period. A total of 60 patients were included (50 boys and 10 girls) in this study (follow-up rate: 95.2%), with 86 instances of LS (very early: 36, early: 16, progressive: 15, terminal: 19) in 65 laminae. In the very early stage, the bony healing rate was 100%, and average treatment period was 2.5 months (range: 1-7 months). In the early stage, the bony healing rate was 93.8%, and the average treatment period was 2.6 months (range: 1-6 months). In the progressive stage, the bony healing rate was 80.0%, and the average treatment period was 3.6 months (range: 3-5 months). The average overall recurrence rate was 26.1%. All patients showing recurrence eventually achieved bony healing. High bony healing rates and short treatment periods were observed with conservative treatment in pediatric patients with LS. However, the recurrence rates were relatively high. This issue should be targeted in future studies. 2.

  9. Selected case from the Arkadi M. Rywlin International Pathology Slide Seminar: sclerotic (fibroma-like) lipoma, dorsum of right hand.

    Science.gov (United States)

    Allen, Philip W

    2013-01-01

    Approximately 26 sclerotic lipomas have been reported since Zelger and colleagues' 1997 report of 5 cases involving the scalp and hands. In 2006, Laskin and colleagues published 21 sclerotic lipomas in a study restricted to tumors of the hands and feet. Patients' ages ranged from 7 to 72 years (mean and median 39 y); there were 12 males and 9 females; the masses, which were mostly asymptomatic and solitary, ranged from 0.6 to 2.2 cm (median 1.2 cm, mean 1.3 cm) and involved fingers (N=17), hands or wrists (N=3), and toes (N=1). Microscopically, lesions were well circumscribed, of low cellularity, and consisted of cytologically bland spindle and stellate-shaped cells with a minor component of randomly dispersed adipocytes embedded in a collagenous to myxocollagenous stroma. Eight tumors were fibroma-like with dense fibrosclerotic stroma and inconspicuous blood vessels. One tumor exhibited features of spindle cell/pleomorphic lipoma, whereas another displayed a vague onion skin-like arrangement of collagen reminiscent of a sclerotic (storiform) fibroma. The mitotic activity was negligible. Nonlipogenic cells were immunoreactive for CD99 (6/6) CD34 (6/8), S100 (4/7), and smooth muscle actin (2/6). Follow-up on 8 patients (range, 1 to 20 y, median 9.5 y) revealed no recurrence in 6 and possible persistent tumor in 2 after simple excision. The slide circulated to club members was from a 35-mm tumor on the dorsum of the right hand of a male aged 75. Club members generally agreed with a diagnosis of sclerotic lipoma but opinions differed as to whether it is a specific entity or a variant of spindle cell lipoma or dendritic fibromyxolipoma.

  10. Nodular melanoma serendipitously detected by airport full body scanners.

    Science.gov (United States)

    Mayer, Jonathan E; Adams, Brian B

    2015-01-01

    Nodular melanoma is the most dangerous form of melanoma and often evades early detection. We present a frequently traveling businessman whose nodular melanoma was detected by airport full body scanners. For about 20 flights over 2 months, the airport full body scanners singled out an area on his left lower leg for a pat-down. Dermatologic examination discovered a nodular melanoma in this area, and after surgical excision, the man traveled without incident. This case raises the possibility of using full body imaging in the detection of melanomas, especially of the nodular subtype. In its current form, full body scanning would most likely not be sensitive or specific enough to become a recommended screening tool. Nonetheless, for travelers with areas repeatedly singled out by the machines without a known justification, airport scanners could serve as incidental free screening for suspicious nodular lesions that should prompt dermatologist referral. © 2014 S. Karger AG, Basel.

  11. Relationship of bony trabecular characteristics and age to bone mass

    International Nuclear Information System (INIS)

    Choi, Dong Hoon; Song, Young Han; Yoon, Young Nam; Lee, Wan; Lee, Byung Do

    2006-01-01

    Bony strength is dependent on bone mass and bony structure. So this study was designed to investigate the relationship between the bone mass and bony mass and bony trabecular characteristics. Study subjects were 51 females (average age 68.6 years) and 20 males (average age 66.4 years). Bony mineral density (BMD, grams/cm 2 ) of proximal femur was measured by a dual energy X-ray absorptiometry (DEXA). Regions of interest (ROIs) were selected from the digitized radiographs of proximal femur. A customized computer program processed morphologic operations (MO) of ROIs. 44 skeletal variables of MO were calculated from ROIs on the Ward's triangle and greater trochanter of femur. WHO BMD classes were predicted by MO variables of the same ROI. Classification and Regression Tree analysis was used for calculating weighted kappa values, sensitivity and specificity of MO. The discriminating factors of morphologic operation were branch point, branch point [per cm sq]. Age also played important role in distinguishing osteoporotic classes. The sensitivity of MO at Ward's triangle and Greater Trochanter was 91.8%, 65.6%, respectively. The specificity of MO was 100% at Ward's triangle and Greater Trochanter. Bony trabecular characteristics obtained using radiological bone morphometric analysis seem to be related to bone mass

  12. Periorbital nodular fasciitis arising during pregnancy

    Directory of Open Access Journals (Sweden)

    Brandon N Phillips

    2014-01-01

    Full Text Available Nodular fasciitis (NF is a benign proliferation of fibroblasts and myofibroblasts that rarely occurs in the periorbital region. We report what we believe to be the first case of periorbital NF associated with pregnancy. A case of intravascular fasciitis, a NF variant, has been reported during pregnancy, but it was not located in the periorbital region. A weak presence of estrogen receptors has been reported in NF. This may make it more susceptible to the hormone-related changes during pregnancy and contribute to the development of the lesion by stimulating fibroblasts and smooth muscle cell types. Although rare, NF should be considered in the differential diagnosis of periorbital soft-tissue masses arising during pregnancy.

  13. Medulloblastoma with Excessive Nodularity: Radiographic Features and Pathologic Correlate

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    L. A. Yeh-Nayre

    2012-01-01

    Full Text Available Medulloblastoma with extensive nodularity is a rare subtype of the most common malignant childhood brain tumor and has been associated with more favorable prognosis. The authors report the case of a 10-month-old girl with a posterior fossa tumor of excessive nodularity with decreased diffusivity on diffusion-weighted magnetic resonance imaging sequences and robust grape-like postgadolinium contrast enhancing features. The unique neuroradiographic features were confirmed by histopathology and a diagnosis of medulloblastoma with extensive nodularity was made. This case highlights the importance of recognizing this unique medulloblastoma subtype preoperatively, as the more favorable outcome may preclude less aggressive medical management.

  14. Nodular Fasciitis of the Chest in a Young Woman

    Directory of Open Access Journals (Sweden)

    Hong Joo Seo

    2016-02-01

    Full Text Available Nodular fasciitis is a benign reactive proliferation that usually involves the deep fascia. Although it is relatively common in the adult population, it is often misdiagnosed as sarcoma due to its rapid growth and pathological features. It rarely presents as a chest wall tumor in young patients. Here, we report a case of nodular fasciitis involving the chest wall of an 18-year-old woman and its surgical management. This case underscores the need to consider nodular fasciitis in the differential diagnosis of chest wall tumors in young patients.

  15. A Rare Case of Medulloblastoma with Excessive Nodularity: Imagistic Features

    Directory of Open Access Journals (Sweden)

    Tascu A.

    2014-10-01

    Full Text Available Medulloblastoma is the most common malignant tumor of childhood. Neuroimaging can play a role in the diagnosis of medulloblastoma, however atypical features do exist [2]. We report the case of a 1 year and 10- month-old infant diagnosed with a medulloblastoma with what we term “excessive” nodularity based on neuroimaging features and confirmed by neuropathology. CT-scan (CT and magnetic resonance imaging (MRI examination of the brain revealed a very large posterior fossa tumor attached to tentorium. On T2-weighted and post-gadolinium sequences, the tumor shows an extensive nodular grape-like appearance. Initial the patient was underwent a ventriculo-peritoneal shunt. The second operative procedure was tumour resection. Histology examen revealed a diagnosis of medulloblastoma desmoplastic with extensive nodularity. The neuroradiographic features of this medulloblastoma with what we describe as “excessive” nodularity are important to recognize as these children may be cured with chemotherapy alone.

  16. Nodular smooth muscle metaplasia in multiple peritoneal endometriosis

    OpenAIRE

    Kim, Hyun-Soo; Yoon, Gun; Ha, Sang Yun; Song, Sang Yong

    2015-01-01

    We report here an unusual presentation of peritoneal endometriosis with smooth muscle metaplasia as multiple protruding masses on the lateral pelvic wall. Smooth muscle metaplasia is a common finding in rectovaginal endometriosis, whereas in peritoneal endometriosis, smooth muscle metaplasia is uncommon and its nodular presentation on the pelvic wall is even rarer. To the best of our knowledge, this is the first case of nodular smooth muscle metaplasia occurring in peritoneal endometriosis. A...

  17. Dermoscopy of eccrine acrospiroma masquerading as nodular malignant melanoma.

    Science.gov (United States)

    Gatti, A; di Meo, N; Trevisan, G

    2010-12-01

    Eccrine acrospiroma, better known as eccrine poroma, is a benign adnexal neoplasm of the skin. Its clinical aspect can masquerade as some other nodular and cystic lesions. The current dermoscopy literature offers very few case studies. Moreover, these very few examples present a totally different appearance pattern compared to the one we examined. Its homogeneous blue pattern suggested the better-known nodular malignant melanoma; in fact, this dermoscopic appearance was due to the Tyndall effect.

  18. Ultrasonic inspection of nodular cast iron

    International Nuclear Information System (INIS)

    Hersh, S.; Zhang, Yingda

    1990-01-01

    On the basis of experimental results collected from several nodular cast iron (NCI) specimens, Amdata, Inc., has developed a tentative procedure for performing ultrasonic testing (UT) preservice inspection of NCI casks and qualifying personnel and equipment. The authors anticipate that this procedure will be a component in a comprehensive program to certify that casks are free from critical flaws prior to their introduction into service, with testing being performed on a production line basis by UT inspection personnel. The tentative procedure was applied to inspection of NCI block SGR-483-001 manufactured by Siempelkamp Giesserei GmbH and Co. of West Germany. This block is 59 by 39.5 by 13.8 inches and weighs 5.2 tons. Several indications were detected with the I/98, in accordance with the tentative procedure, and they were analyzed using two-dimensional synthetic aperture technique (Line-SAFT). When compared with conventional sizing methods that may confound the effects of beam spread with flaw size, Line-SAFT significantly improved sizing accuracy. SAFT is an electronic simulation of a lens and has the property of reducing the effect of beam spread on the resultant indication sizes. Although a higher-precision 3-D SAFT option was also available, it would necessitate data transfer to a separate VAX computer and lengthy calculations. As an alternative, Line-SAFT, a faster but less precise 2-D simplification, was implemented on the I/98 data acquisition system

  19. The spectrum of allergy to South African bony fish (Teleosti ...

    African Journals Online (AJOL)

    Volunteer population-based cohort in the Western Cape. Participants. 105 volunteer subjects with suspected fish allergy were recruited by advertising in the local press. Main outcome. Species-specific bony fish allergy was confirmed or refuted by DBPCFC. Results. The four most common seafood species reported to cause ...

  20. Comparative Ecology Of The African Bony Tongue Fish Heterotis ...

    African Journals Online (AJOL)

    The ecology of sympatric African bony tongue fish, Heterotis niloticus and the catfish, Clarias gariepinus were compared during the dry and rainy conditions in the lower Oluwa River and its adjacent floodplains. Both species are common economic fish in Nigeria. There was no significant difference in the mean sizes of H.

  1. Arthroscopic treatment of bony loose bodies in the subacromial space

    Directory of Open Access Journals (Sweden)

    Wei Li

    2015-01-01

    Conclusion: The mechanism of formation of bony loose bodies is not clear, may be associated with synovial cartilage metaplasia. Arthroscopic removal of loose bodies and bursa debridement is a good option for treatment of the loose body in the subacromial space, which can receive good function.

  2. Cranial bony decompressions in the management of head injuries ...

    African Journals Online (AJOL)

    2012-09-22

    Sep 22, 2012 ... Conclusion: Bony decompression is useful in the management of head trauma. Careful selection of cases and appropriate radiological assessment are important and will guide decision for either craniotomy or craniectomy. Key words: Craniectomy, craniotomy, trauma flap, traumatic brain injury.

  3. Avifauna of Boni-Dodori National Reserves, Lamu and Garissa ...

    African Journals Online (AJOL)

    Summary. A comprehensive avian survey was conducted between April 2012 and November. 2013 in Boni and Dodori National reserves, the connecting Aweer Community. Conservancy corridor, and the adjacent forests. Survey methods were Timed Species. Counts (TSCs), mist netting and opportunistic observations.

  4. Pigmented Nodular Basal Cell Carcinomas in Differential Diagnosis with Nodular Melanomas: Confocal Microscopy as a Reliable Tool for In Vivo Histologic Diagnosis

    International Nuclear Information System (INIS)

    Casari, A.; Pellacani, G.; Seidenari, S.; Pepe, P.; Longo, C.; Cesinaro, A. M.; Beretti, F.

    2011-01-01

    Nodular basal cell carcinoma, especially when pigmented, can be in differential diagnosis with nodular melanomas, clinically and dermoscopically. Reflectance confocal microscopy is a relatively new imaging technique that permits to evaluate in vivo skin tumors with a nearly histological resolution. Here, we present four cases of challenging nodular lesions where confocal microscopy was able to clarify the diagnosis.

  5. [Ultrastructure of granulocytes of bony fishes (orders Salmoniformes, Cypriniformes, Perciformes)].

    Science.gov (United States)

    Flerova, E A; Balabanova, L V

    2013-01-01

    Analysis of data on utrastructure of granulocytes of freshwater and marine bony fish of orders Salmoniformes, Cypriniformes, and Perciformes showed that in all studied species there were revealed two types of granulocytes - neutrophils and eosinophils. The exception was the bluefish Pomatomus saltatrix L. whose pronephros hemopoietic tissue was found to contain one type of the granulocytic line - neutrophils. The identification parameters of granular leukocytes are specific granules filling the cytoplasm. The main form of specific granules in neutrophils of bony fish of various phylogenetic groups is an elongated granule with different distribution of fibrils or a granule that has crystalloid formed from fibrils. The main form of eosinophil granules - large, electron-dense, homogenous.

  6. Imaging of the hip and bony pelvis. Techniques and applications

    Energy Technology Data Exchange (ETDEWEB)

    Davies, A.M. [Royal Orthopaedic Hospital, Birmingham (United Kingdom). MRI Centre; Johnson, K.J. [Princess of Wales Birmingham Children' s Hospital (United Kingdom); Whitehouse, R.W. (eds.) [Manchester Royal Infirmary (United Kingdom). Dept. of Clinical Radiology

    2006-07-01

    This is a comprehensive textbook on imaging of the bony pelvis and hip joint that provides a detailed description of the techniques and imaging findings relevant to this complex anatomical region. In the first part of the book, the various techniques and procedures employed for imaging the pelvis and hip are discussed in detail. The second part of the book documents the application of these techniques to the diverse clinical problems and diseases encountered. Among the many topics addressed are congenital and developmental disorders including developmental dysplasia of the hip, irritable hip and septic arthritis, Perthes' disease and avascular necrosis, slipped upper femoral epiphysis, bony and soft tissue trauma, arthritis, tumours and hip prostheses. Each chapter is written by an acknowledged expert in the field, and a wealth of illustrative material is included. This book will be of great value to musculoskeletal and general radiologists, orthopaedic surgeons and rheumatologists. (orig.)

  7. The micro-mechanisms of failure of nodular cast iron

    Directory of Open Access Journals (Sweden)

    Alan Vaško

    2014-12-01

    Full Text Available The contribution deals with a comparison of the micro-mechanisms of failure of nodular cast irons at static, impact and fatigue stress. Several specimens of ferrite-pearlitic nodular cast irons with different content of ferrite in a matrix were used for metallographic analysis, mechanical tests and micro-fractographic analysis. Mechanical properties were found by static tensile test, impact bending test and fatigue tests. The micro-fractographic analysis was made with use of scanning electron microscope VEGA II LMU on fracture surfaces of the specimens fractured by these mechanical and fatigue tests. Fracture surfaces of analysed specimens are characteristic of mixed mode of fracture. Micro-mechanism of failure of nodular cast irons is dependent on the method of stress.

  8. Giant hidradenocarcinoma: a report of malignant transformation from nodular hidradenoma.

    Science.gov (United States)

    Lim, S C; Lee, M J; Lee, M S; Kee, K H; Suh, C H

    1998-10-01

    A giant hidradenocarcinoma presented by a 75-year-old female is reported. The patient had a malignant transformation within a nodular hidradenoma involving the right postauricular area, which was treated by mass removal and a right radical neck dissection with a free-flap covering. Malignant hidradenocarcinoma is the least common adnexal tumor of uncertain origin. They are usually malignant from their inception, but some develop from a benign counterpart. To the authors' knowledge, only three cases have been reported previously. Two histologically distinct components were seen in this tumor: (i) typical nodular hidradenoma, which constituted a small part of the tumor; and (ii) carcinoma with areas of transition. The secretory cells of hidradenocarcinoma showed decapitation secretion on light and electron microscopic observations, which is evidence of apocrine differentiation. Histologically, this case was concluded as a hidradenocarcinoma arising from a long-standing nodular hidradenoma. A literature review is presented and the histological, immunohistochemical and ultrastructural features are described.

  9. Nodular Fasciitis of the Breast Mimicking Breast Cancer

    Directory of Open Access Journals (Sweden)

    Shinya Yamamoto

    2014-01-01

    Full Text Available Nodular fasciitis is a benign proliferative lesion that is usually found in the soft tissue of the upper extremity and trunk in young to middle-aged persons. It has rarely been described in the breast. A 35-year-old woman had noticed a mass in her left breast. It was elastic-hard, 13 mm in size, and located mainly in the upper inner quadrant of the left breast. Mammography did not detect the mass. Ultrasonography revealed a hypoechoic lesion with an irregular margin. Neither fine-needle aspiration cytology nor core needle biopsy established a definitive diagnosis. Excisional biopsy was therefore performed. Histologically, the excised tumor tissue results were consistent with a diagnosis of nodular fasciitis of the breast. We report a case of nodular fasciitis of the breast, a rare histological type of breast tumor.

  10. Between Organism and Sky: Oscar Bony, 1965-1976

    Directory of Open Access Journals (Sweden)

    Daniel Quiles

    2014-06-01

    Full Text Available Oscar Bony was a key figure in the generation of avant-garde artists who famously broke with the Instituto Torcuato Di Tella in the wake of censorship at Experiencias ’68. He was also the official photographer for RCA’s affiliate record label in Argentina between 1967 and 1973, producing publicity for a new wave of rock n’ roll bands and solo popular music acts including Los Gatos and Arco Iris. Attending to key phases in his artistic oeuvre as well as close readings of his expertly crafted popular images, this article attempts to bridge these seemingly irreconcilable aspects of Bony’s practice. At first glance, his rock photography, known as el estilo Bony, has little relation to his art, and is perhaps even its political antithesis: “creative” work in the service of a top-down business model. Yet a closer look at both endeavors yields a lasting interplay between flesh and concept—at the grain of the work, a dialectic between incontrovertible index and crafted, calculated image—that was the artist’s central preoccupation in the fraught decade between the military coups. As such, Bony provides an opportunity to recover a category often absent from the Argentine art of this moment: the body, factual and libidinal.

  11. Canine hip dysplasia: significance of early bony spurring

    International Nuclear Information System (INIS)

    Morgan, J.P.

    1987-01-01

    It is the purpose of this study to call attention to new bone production that often occurs early in the sequence of pathological changes associated with canine hip dysplasia. New bone production extending to bony remodeling, as well as femoral head subluxation, both occur in the sequence of pathologic changes associated with canine hip dysplasia. Subluxation is considered primary, while osteoarthrosis is a secondary feature, and both are used in the diagnosis of canine hip dysplasia. This report concerns the significance of the presence of a solitary bony osteophyte, or spur, that is frequently evident on the caudal aspect of the femoral neck as viewed on the conventional ventrodorsal projection. This report utilizes findings from pelvic radiographs of 605 dogs (five breeds). There was a greater frequency (54%)of this bony change in cases diagnosed radiographically as dysplastic than in cases diagnosed as normal(15%).Thus, it is suggested that this minimal radiographic change can be used as an indicator of early canine hip dysplasia, especially in the absence of subluxation of the femoral head

  12. The clinical and radiologic features of nodular pulmonary sarcoidosis.

    Science.gov (United States)

    Malaisamy, Subramanian; Dalal, Bhavinkumar; Bimenyuy, Christian; Soubani, Ayman O

    2009-01-01

    Nodular sarcoidosis is an uncommon presentation of sarcoidosis. Our objective was to describe the clinical characteristics of a large cohort of patients with nodular sarcoidosis. We performed a retrospective study of patients with nodular sarcoidosis diagnosed at an urban teaching hospital over a 10-year period. Thirty-three patients with nodular sarcoidosis were identified. All patients were African-American. The mean age was 35 and the female-to-male ratio was 5:1. Twenty-six patients were current or former smokers. All patients had chest CT scan and/or chest radiograph evidence of pulmonary masses. Twenty-seven patients had multiple pulmonary masses/nodules and six had solitary pulmonary nodules/masses. The upper lobes were involved in 27 patients. Mediastinal lymphadenopathy and pleural-based masses were present in 30 and 20 patients, respectively. Extrapulmonary manifestations were present in 14 patients. All patients had tissue diagnosis of noncaseating granulomas with negative culture. Twenty-two patients underwent bronchoscopy with transbronchial biopsies, which were diagnostic in 19. Follow-up data were available on 27 patients: complete or nearly complete resolution of the pulmonary masses--either spontaneously or with systemic treatment--was documented for 19 patients, no change in the radiologic findings for 7 patients, and progression to pulmonary fibrosis for 1 patient. Nodular sarcoidosis is a rare presentation of pulmonary sarcoidosis. It usually presents with multiple pulmonary masses that tend to be peripheral and are associated with mediastinal lymphadenopathy. Bronchoscopy with transbronchial biopsies has high diagnostic yield. Despite its ominous presentation, nodular sarcoidosis has favorable prognosis.

  13. RSK1 activation promotes invasion in nodular melanoma.

    Science.gov (United States)

    Salhi, Amel; Farhadian, Joshua A; Giles, Keith M; Vega-Saenz de Miera, Eleazar; Silva, Ines P; Bourque, Caitlin; Yeh, Karen; Chhangawala, Sagar; Wang, Jinhua; Ye, Fei; Zhang, David Y; Hernando-Monge, Eva; Houvras, Yariv; Osman, Iman

    2015-03-01

    The two major melanoma histologic subtypes, superficial spreading and nodular melanomas, differ in their speed of dermal invasion but converge biologically once they invade and metastasize. Herein, we tested the hypothesis that distinct molecular alterations arising in primary melanoma cells might persist as these tumors progress to invasion and metastasis. Ribosomal protein S6 kinase, 90 kDa, polypeptide 1 (RSK1; official name RPS6KA1) was significantly hyperactivated in human melanoma lines and metastatic tissues derived from nodular compared with superficial spreading melanoma. RSK1 was constitutively phosphorylated at Ser-380 in nodular but not superficial spreading melanoma and did not directly correlate with BRAF or MEK activation. Nodular melanoma cells were more sensitive to RSK1 inhibition using siRNA and the pharmacological inhibitor BI-D1870 compared with superficial spreading cells. Gene expression microarray analyses revealed that RSK1 orchestrated a program of gene expression that promoted cell motility and invasion. Differential overexpression of the prometastatic matrix metalloproteinase 8 and tissue inhibitor of metalloproteinases 1 in metastatic nodular compared with metastatic superficial spreading melanoma was observed. Finally, using an in vivo zebrafish model, constitutive RSK1 activation increased melanoma invasion. Together, these data reveal a novel role for activated RSK1 in the progression of nodular melanoma and suggest that melanoma originating from different histologic subtypes may be biologically distinct and that these differences are maintained as the tumors invade and metastasize. Copyright © 2015 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  14. Effects of altered catecholamine metabolism on pigmentation and physical properties of sclerotized regions in the silkworm melanism mutant.

    Directory of Open Access Journals (Sweden)

    Liang Qiao

    Full Text Available Catecholamine metabolism plays an important role in the determination of insect body color and cuticle sclerotization. To date, limited research has focused on these processes in silkworm. In the current study, we analyzed the interactions between catecholamines and melanin genes and their effects on the pigmentation patterns and physical properties of sclerotized regions in silkworm, using the melanic mutant melanism (mln silkworm strain as a model. Injection of β-alanine into mln mutant silkworm induced a change in catecholamine metabolism and turned its body color yellow. Further investigation of the catecholamine content and expression levels of the corresponding melanin genes from different developmental stages of Dazao-mln (mutant and Dazao (wild-type silkworm revealed that at the larval and adult stages, the expression patterns of melanin genes precipitated dopamine accumulation corresponding to functional loss of Bm-iAANAT, a repressive effect of excess NBAD on ebony, and upregulation of tan in the Dazao-mln strain. During the early pupal stage, dopamine did not accumulate in Dazao-mln, since upregulation of ebony and black genes led to conversion of high amounts of dopamine into NBAD, resulting in deep yellow cuticles. Scanning electron microscope analysis of a cross-section of adult dorsal plates from both wild-type and mutant silkworm disclosed the formation of different layers in Dazao-mln owing to lack of NADA, compared to even and dense layers in Dazao. Analysis of the mechanical properties of the anterior wings revealed higher storage modulus and lower loss tangent in Dazao-mln, which was closely associated with the altered catecholamine metabolism in the mutant strain. Based on these findings, we conclude that catecholamine metabolism is crucial for the color pattern and physical properties of cuticles in silkworm. Our results should provide a significant contribution to Lepidoptera cuticle tanning research.

  15. Label-free quantitative proteomic analysis reveals strong involvement of complement alternative and terminal pathways in human glomerular sclerotic lesions.

    Science.gov (United States)

    Zhang, Ying; Xu, Bo; Kinoshita, Naohiko; Yoshida, Yutaka; Tasaki, Masayuki; Fujinaka, Hidehiko; Magdeldin, Sameh; Yaoita, Eishin; Yamamoto, Tadashi

    2015-06-18

    Since glomerular sclerosis frequently accompanies various glomerular diseases at the end stages, it is challenging to differentiate ubiquitous biological processes underlying this pathology from those critically involved in specific diseases. Furthermore, in-depth proteomic profile of human glomerular sclerosis remains limited. In this study, human glomeruli with intermediate (i-GS) and advanced (GS) sclerotic lesions, which were excluded from specific renal diseases and assumed to be aging-related, were laser captured from macroscopically normal cortex distant from urological carcinoma, and subjected to label-free quantitative proteomic analysis. We explicate an evident increase of membrane attack complex in i-GS and GS with an up-going tendency, which is accompanied by increasing of inhibitory regulators of alternative and terminal pathways. GO annotation and IPA pathway analysis agree to these results. Proteomic findings are validated by immunohistochemical studies which indicate that alternative and terminal pathways are positively involved in the glomerular sclerosis seen in distinct renal diseases. Furthermore, proteomic analysis also demonstrates remarkable increases of complement factor B in GS and TGF-ß1 in both GS and i-GS. Identification of complement factor B implicates that on-site activation of alternative pathway may occur in injured glomeruli and stepwise increase of TGF-ß1 suggests its contribution to the progression of glomerulosclerosis. This study provides in-depth quantitative proteomic profiles of human glomeruli with intermediate and advanced sclerotic lesions. It reveals that the over-expression of alternative and terminal pathway components is significantly involved in human glomerulosclerosis seen in distinct renal diseases. Proteomic identification of the increased TGF-ß1 provides supporting evidence for the role of podocyte apoptosis leading to human glomerulosclerosis. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Pulmonary leukemia in a child presenting with infiltrative and nodular lesions

    International Nuclear Information System (INIS)

    Corbaton, J.; Munoz, A.; Madero, L.; Camarero, C.

    1984-01-01

    A leukemic child developed a pulmonary leukemic infiltration, confirmed by open lung biopsy. His radiograph showed a mixed interstitial and nodular pattern. Nodular lung lesions are rare in pediatric patients and exceptionally may represent leukemic invasion. (orig.)

  17. Dermoscopy of Nodular Melanoma: Review of the Literature and Report of 3 Cases.

    Science.gov (United States)

    Đorđević Brlek, Zorica; Jurakić Tončić, Ružica; Radoš, Jaka; Marinović, Branka

    2016-08-01

    Nodular melanoma is the most aggressive subtype of melanoma, with rapid growth rate and metastatic potential. It is usually diagnosed at a locally advanced stage (Breslow thickness Nodular melanoma often does not fit the classic clinical ABCD criteria, but rather the EFG rule or 3 Cs criteria. Missing the diagnosis of nodular melanoma is a dermatologist's worst nightmare, especially since nodular melanomas can have a non-alarming clinical appearance and imitate a wide range of benign lesions. All evolving nodular lesions, despite their size, symmetry, and color, which cannot be confidently diagnosed as benign, should be excised in order to rule out nodular melanoma. Almost all melanoma-specific dermoscopic criteria are described in context of superficial spreading melanoma. Thus, physicians are not familiar and aware enough of dermoscopic features for early detection of nodular melanomas. Herein we present 3 cases of nodular melanomas from our Department and give a review of the current literature.

  18. Dermoscopy of Nodular Melanoma: Review of the Literature and Report of 3 Cases

    OpenAIRE

    Zorica Đorđević Brlek; Ružica Jurakić Tončić; Jaka Radoš; Branka Marinović

    2016-01-01

    Nodular melanoma is the most aggressive subtype of melanoma, with rapid growth rate and metastatic potential. It is usually diagnosed at a locally advanced stage (Breslow thickness <2 mm) and is therefore associated with a poor prognosis. Nodular melanoma often does not fit the classic clinical ABCD criteria, but rather the EFG rule or 3 Cs criteria. Missing the diagnosis of nodular melanoma is a dermatologist’s worst nightmare, especially since nodular melanomas can have a non-alarming cl...

  19. Clinical surgical and pathological characterization of nodular thyroid disease

    International Nuclear Information System (INIS)

    Gonzalez Mendoza, Dayanis Ceila; Rodriguez Valdes, Adriana; Bejerano Garcia, Ramiro Julio

    2012-01-01

    Nodular thyroid disease is a worrisome endocrine problem due to its association with cancer. To characterize patients hospitalized with this condition according to clinical surgical and pathological aspects, as well as to determine the effectiveness of the cytology by fine-needle aspiration biopsy for diagnosis

  20. Unilateral nodular adrenal hyperplasia: Case series | Kot | African ...

    African Journals Online (AJOL)

    Introduction: Nodular adrenal hyperplasia is one of rare causes of adrenocortical hyperplasia. The disease usually presents bilaterally. Few publications discussed the possibility of unilateral disease, in association with hyperaldosteronism or Cushing syndrome. Case series: We are reporting 3 cases of radiologically ...

  1. Multifocal nodular episcleritis and scleritis with undiagnosed Hodgkin's lymphoma.

    Science.gov (United States)

    Thakker, Manoj M; Perez, Victor L; Moulin, Alexandre; Cremers, Sandra L; Foster, C Stephen

    2003-05-01

    To report the case of a patient with undiagnosed Hodgkin's lymphoma who presented with coexistent unilateral nodular episcleritis and scleritis. Interventional case report and literature review Review of clinical history, laboratory findings, histology of episcleral and cervical lymph node biopsies, and follow-up. A 20-year-old female presented with a 5-month history of redness and pain in her left eye, with associated symptoms of dyspnea, malaise, and fever. The patient was found to have multifocal nodular episcleritis and scleritis that was not responsive to topical steroids or systemic nonsteroidal anti-inflammatory treatment. Laboratory tests subsequently revealed evidence of systemic inflammation, and radiologic studies showed extensive mediastinal and cervical adenopathy. A cervical lymph node biopsy showed Reed-Sternberg cells and a chronic lymphocytic infiltrate consistent with nodular sclerosing Hodgkin's lymphoma. Histopathologic analysis of an episcleral nodule revealed a necrotizing granuloma with vasculitis. Systemic chemotherapy was instituted for the Hodgkin's disease; this therapy abolished the nodular scleritis. This case raises the possibility of concurrent undiagnosed systemic vasculitis with only an ocular manifestation with Hodgkin's lymphoma, either as a coincidence or as a paraneoplastic syndrome. Moreover, it emphasizes the important role of tissue biopsy in establishing diagnosis and directing treatment. Copyright 2003 by the American Academy of Ophthalmology.

  2. Nodular smooth muscle metaplasia in multiple peritoneal endometriosis.

    Science.gov (United States)

    Kim, Hyun-Soo; Yoon, Gun; Ha, Sang Yun; Song, Sang Yong

    2015-01-01

    We report here an unusual presentation of peritoneal endometriosis with smooth muscle metaplasia as multiple protruding masses on the lateral pelvic wall. Smooth muscle metaplasia is a common finding in rectovaginal endometriosis, whereas in peritoneal endometriosis, smooth muscle metaplasia is uncommon and its nodular presentation on the pelvic wall is even rarer. To the best of our knowledge, this is the first case of nodular smooth muscle metaplasia occurring in peritoneal endometriosis. As observed in this case, when performing laparoscopic surgery in order to excise malignant tumors of intra-abdominal or pelvic organs, it can be difficult for surgeons to distinguish the metastatic tumors from benign nodular pelvic wall lesions, including endometriosis, based on the gross findings only. Therefore, an intraoperative frozen section biopsy of the pelvic wall nodules should be performed to evaluate the peritoneal involvement by malignant tumors. Moreover, this report implies that peritoneal endometriosis, as well as rectovaginal endometriosis, can clinically present as nodular lesions if obvious smooth muscle metaplasia is present. The pathological investigation of smooth muscle cells in peritoneal lesions can contribute not only to the precise diagnosis but also to the structure and function of smooth muscle cells and related cells involved in the histogenesis of peritoneal endometriosis.

  3. The age of the Nodular Limestone Formation (Late Cretaceous ...

    Indian Academy of Sciences (India)

    67

    2016-05-23

    May 23, 2016 ... Stratigraphy and Invertebrate Palaeontology Laboratory, Center of Advanced Study, Department of Geology, Banaras Hindu University, Varanasi 221005, India. *corresponding author - email: dbpathak@yahoo.com. Abstract. The age of the marine Nodular Limestone Formation of the Bagh Group is refined ...

  4. Nodular Lymphangitis in HIV-Infected Patients in Tanzania | Mapesi ...

    African Journals Online (AJOL)

    Early diagnosis, biopsy or culture of skin lesions and treatment are essential for improving outcomes. However, this is challenging in resource-limited settings. We present two HIV-infected patients with nodular lymphangitis treated with ketoconazole in the absence of itraconazole or amphotericin B with good initial response ...

  5. Nodular Purpura and Intracranial Bleeding due to Late Onset ...

    African Journals Online (AJOL)

    She developed nodular purpuric spots for about three days prior to the intracranial bleeding. She was unconscious and responding only to pain, and was severely pale. She was transfused with two units of whole blood and underwent a craniotomy for draining the hemorrhage. She was treated with Vitamin K supplements.

  6. Sonographic Findings of Hashimoto's Thyroiditis and Associated Nodular Lesions

    International Nuclear Information System (INIS)

    Kang, Bong Joo; Park, Young Ha; Jung, So Lyung; Chung, Soo Kyo

    2007-01-01

    To evaluate the sonographic findings of Hashimoto's thyroiditis and associated nodular lesions. We retrospectively reviewed the sonographic findings of twenty patients who had surgically confirmed Hashimoto's thyroiditis between 1 March 2005, and 26 November 2005. In these patients, we reviewed the sonographic findings of the associated focal nodular lesion. Assessed were size, homogeneity, and echogenicity of the diseased thyroid gland and shape, echogenicity, margin, rim, microcal cification of the associated nodules. Without knowledge of the pathological diagnosis of the nodular lesions, based on the sonographic criteria, the nodules were classified as either malignant or benign. Hashimoto's thyroiditis demonstrates a variety of sonographic findings for size, homogeneity, and echogenicity. Among the nineteen nodules that were sonographically diagnosed and pathologically confirmed, nine papillary cancers, seven nodular hyperplasias, two Huthle cell adenomas, and one focal hyalinized fibrosing nodule were included. All of the nine papillary cancers showed more than one malignant finding such as marked hypoechogenicity, an irregular shape, a taller than wide shape, a spiculated margin, or microcalcifications that were classified as malignant nodulea, and all of the ten benign nodules showed no malignant findings. Circumscribed isoechoic, hyperechoic, or hypoechoic nodules without calcification were classified as bending nodules. Hashimoto's thyroiditis demonstrates various findings on a sonographic examination,and associated various benign and malignant lesions. Moreover, a sonographic examination is helpful to differentiate between malignant and benign lesions in Hashimoto's thyroiditis as in the normal thyroid

  7. Medulloblastoma with extensive nodularity: US, CT and MRI findings

    International Nuclear Information System (INIS)

    Bekiesinska-Figatowska, M.; Uliasz, M.; Roszkowski, M.

    2008-01-01

    Medulloblastoma accounts for up to 25% of all paediatric CNS tumours. According to WHO classification (2007) medulloblastoma with extensive nodularity (MBEN) is a separate rare entity associated with younger age and better prognosis. A 9-month-old girl was admitted and examined because of macrocephaly and disturbed psychomotor development. Transfontanel ultrasound revealed dilated ventricular system and hyperechoic mass in the posterior cranial fossa. Computed tomography showed hyperdense mass in the cerebellum. Magnetic resonance imaging revealed a mass with gyriform pattern and strong contrast enhancement after gadolinium administration. Differential diagnosis included dysplastic heterotopic cortex, Lhermitte-Duclos disease, atypical teratoid/rhabdoid tumour (AT/RT), and medulloblastoma (MB). The patient was operated on. Medulloblastoma with extensive nodularity (MBEN) was finally diagnosed. The authors present and discuss three other cases of this rare entity.Transfontanel sonografic examination is capable of detection of the posterior fossa tumour as a cause of hydrocephalus and macrocephaly. The mass in a child's posterior cranial fossa that is hyperdense on unenhanced CT and gyriform, nodular, and markedly enhancing on MRI may strongly suggest medulloblastoma with extensive nodularity (MBEN). (authors)

  8. The role of sclerotic changes in the starting mechanisms of collapse: A histomorphometric and FEM study on the femoral head of osteonecrosis.

    Science.gov (United States)

    Karasuyama, Kazuyuki; Yamamoto, Takuaki; Motomura, Goro; Sonoda, Kazuhiko; Kubo, Yusuke; Iwamoto, Yukihide

    2015-12-01

    To assess the distributions of stress, strain, and fractured areas using a finite element model (FEM), and examine the osteoclastic activity histopathologically in osteonecrosis of the femoral head. Three femoral heads were obtained during hip arthroplasty for femoral head osteonecrosis. One sample with a normal area, two samples with a non-sclerotic boundary without collapse (Type 1), two samples with a non-collapsed sclerotic boundary (Type 2), and two samples with a collapsed sclerotic boundary (Type 3) were collected from each femoral head for the FEM and histopathological analyses. FEM was performed using CT data, and the distributions of von Mises equivalent stress, octahedral shear stress, octahedral shear strain, and simulated fractured area were evaluated. Furthermore, the osteoclast count at the boundary was compared for each type. In normal and Type 1 samples, the distributions of von Mises equivalent stress, octahedral shear stress, octahedral shear strain, and the fractured area were equally concentrated along the whole analytical range; however, in the Type 2 and 3 samples, they were concentrated along the thickened bone trabeculae at the boundary, which corresponded to the fractured area. Histopathologically, a significantly increased osteoclast number was observed only at the collapsed sclerotic boundary. These results demonstrated that both shear stress and shear strain tend to be concentrated on thickened bone trabeculae at the boundary. Fracture analyses revealed that the boundary of sclerotic changes, which results from the repair process, may be the starting point of the fracture. Additionally, the osteoclastic activity increases after collapse. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Idiopathic nodular glomerulosclerosis: Report of two cases and review of literature

    Directory of Open Access Journals (Sweden)

    S Chandragiri

    2016-01-01

    Full Text Available Nodular glomerulosclerosis, a pathological finding characterized by areas of marked mesangial expansion with accentuated glomerular nodularity can be seen in a number of conditions including diabetic nephropathy, amyloidosis, light chain deposition disease, fibrillary and immunotactoid glomerulopathy, collagen type III disease, nodular membranoproliferative glomerulonephritis, and Takayasu′s arteritis. Idiopathic nodular glomerulosclerosis is a diagnosis of exclusion and is reported in patients with hypertension, smoking, chronic obstructive pulmonary disease, obesity, metabolic syndrome, etc. We report two cases of idiopathic nodular glomerulosclerosis, one in obese hypertensive male and the other in nonhypertensive, nonobese female patient.

  10. Allergenicity of bony and cartilaginous fish - molecular and immunological properties.

    Science.gov (United States)

    Stephen, J N; Sharp, M F; Ruethers, T; Taki, A; Campbell, D E; Lopata, A L

    2017-03-01

    Allergy to bony fish is common and probably increasing world-wide. The major heat-stable pan-fish allergen, parvalbumin (PV), has been identified and characterized for numerous fish species. In contrast, there are very few reports of allergic reactions to cartilaginous fish despite widespread consumption. The molecular basis for this seemingly low clinical cross-reactivity between these two fish groups has not been elucidated. PV consists of two distinct protein lineages, α and β. The α-lineage of this protein is predominant in muscle tissue of cartilaginous fish (Chondrichthyes), while β-PV is abundant in muscle tissue of bony fish (Osteichthyes). The low incidence of allergic reactions to ingested rays and sharks is likely due to the lack of molecular similarity, resulting in reduced immunological cross-reactivity between the two PV lineages. Structurally and physiologically, both protein lineages are very similar; however, the amino acid homology is very low with 47-54%. Furthermore, PV from ancient fish species such as the coelacanth demonstrates 62% sequence homology to leopard shark α-PV and 70% to carp β-PV. This indicates the extent of conservation of the PV isoforms lineages across millennia. This review highlights prevalence data on fish allergy and sensitization to fish, and details the molecular diversity of the two protein lineages of the major fish allergen PV among different fish groups, emphasizing the immunological and clinical differences in allergenicity. © 2017 John Wiley & Sons Ltd.

  11. Bleomycin-induced epithelial–mesenchymal transition in sclerotic skin of mice: Possible role of oxidative stress in the pathogenesis

    International Nuclear Information System (INIS)

    Zhou, Cheng-Fan; Zhou, Deng-Chuan; Zhang, Jia-Xiang; Wang, Feng; Cha, Wan-Sheng; Wu, Chang-Hao; Zhu, Qi-Xing

    2014-01-01

    Epithelial–mesenchymal transition (EMT) derived myofibroblasts are partly responsible for the increased collagen synthesis and deposition that occur in tissue fibrosis; however EMT occurrence in skin fibrosis and its mechanism remain unknown. The aim of this study was to investigate whether epithelial cells undergo EMT and determine the role of oxidative stress in this process. BALB/c mice were subcutaneously injected with bleomycin (BLM) or phosphate buffer saline (PBS) into the shaved back daily for 2, 3, and 4 weeks. Skin collagen deposition was evaluated by histopathology and Western blotting. EMT characteristics in the skin were determined by histopathology and immunofluorescent staining for E-cadherin and vimentin, which were further evaluated by Western blotting and reverse transcriptase polymerase chain reaction (RT-PCR). To investigate the role of oxidative stress in EMT, the antioxidant N-acetylcysteine (NAC) was intraperitoneally (100 mg/kg body weight/day) injected daily for 3 weeks. The epithelial suprabasal cells were detached from the basement membrane zone (BMZ) in the sclerotic skin treated with BLM. Immunofluorescent staining indicated vimentin-positive epithelial cells frequently occurring in the thickened epidermis of BLM-treated mice. Western blotting and RT-PCR showed that the expression of E-cadherin was significantly decreased but that of vimentin significantly increased in the skin treated with BLM. NAC attenuated BLM induced oxidative damage, changes in E-cadherin and vimentin expressions and collagen deposition in the sclerotic skin of mice. This study provides the first evidence that BLM induces the EMT of the epithelial cells superficial to the basement membrane zone in the skin fibrosis. Oxidative stress may contribute, at least in part, to BLM induced EMT and skin fibrosis in mice. - Highlights: • We provided the first evidence that EMT occurred in BLM-induced skin fibrosis. • Epithelial cells superficial to the BMZ underwent

  12. Bleomycin-induced epithelial–mesenchymal transition in sclerotic skin of mice: Possible role of oxidative stress in the pathogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Cheng-Fan, E-mail: zhouchengfan@sohu.com [Institute of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui 230022 (China); Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui 230032 (China); Zhou, Deng-Chuan [Department of Emergency Medicine and Critical Care Medicine, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui 230022 (China); Zhang, Jia-Xiang; Wang, Feng; Cha, Wan-Sheng [Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui 230032 (China); Wu, Chang-Hao [Department of Biochemistry and Physiology, Faculty of Health and Medical Sciences, University of Surrey (United Kingdom); Zhu, Qi-Xing, E-mail: zqxing@yeah.net [Institute of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui 230022 (China); Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, Hefei, Anhui 230032 (China)

    2014-06-15

    Epithelial–mesenchymal transition (EMT) derived myofibroblasts are partly responsible for the increased collagen synthesis and deposition that occur in tissue fibrosis; however EMT occurrence in skin fibrosis and its mechanism remain unknown. The aim of this study was to investigate whether epithelial cells undergo EMT and determine the role of oxidative stress in this process. BALB/c mice were subcutaneously injected with bleomycin (BLM) or phosphate buffer saline (PBS) into the shaved back daily for 2, 3, and 4 weeks. Skin collagen deposition was evaluated by histopathology and Western blotting. EMT characteristics in the skin were determined by histopathology and immunofluorescent staining for E-cadherin and vimentin, which were further evaluated by Western blotting and reverse transcriptase polymerase chain reaction (RT-PCR). To investigate the role of oxidative stress in EMT, the antioxidant N-acetylcysteine (NAC) was intraperitoneally (100 mg/kg body weight/day) injected daily for 3 weeks. The epithelial suprabasal cells were detached from the basement membrane zone (BMZ) in the sclerotic skin treated with BLM. Immunofluorescent staining indicated vimentin-positive epithelial cells frequently occurring in the thickened epidermis of BLM-treated mice. Western blotting and RT-PCR showed that the expression of E-cadherin was significantly decreased but that of vimentin significantly increased in the skin treated with BLM. NAC attenuated BLM induced oxidative damage, changes in E-cadherin and vimentin expressions and collagen deposition in the sclerotic skin of mice. This study provides the first evidence that BLM induces the EMT of the epithelial cells superficial to the basement membrane zone in the skin fibrosis. Oxidative stress may contribute, at least in part, to BLM induced EMT and skin fibrosis in mice. - Highlights: • We provided the first evidence that EMT occurred in BLM-induced skin fibrosis. • Epithelial cells superficial to the BMZ underwent

  13. A case of giant nodular posterior scleritis mimicking choroidal malignancy.

    Science.gov (United States)

    Liu, Andrea T; Luk, Fiona O; Chan, Carmen K

    2015-12-01

    To report a case of giant nodular posterior scleritis mimicking a choroidal tumor. A 42-year-old lady with systemic hypertension presented with a 1-week history of unilateral visual loss, pain and redness in her left eye. Examination showed sectoral anterior episcleritis in her left eye as well as a dome-shaped choroidal mass at the inferior-temporal periphery, associated with retinal hemorrhages and subretinal fluid. Systemic evaluation and imaging of the choroidal mass were performed and could not rule out amelanotic choroidal melanoma. At the same time, she was prescribed a 2-week course of oral nonsteroidal anti-inflammatory drug (NSAID) for her sectoral anterior episcleritis. The choroidal mass was found to have resolved completely right before her scheduled fine needle biopsy. Diagnosis of nodular posterior scleritis and a trial of oral NSAID can be considered in patients presenting with a choroidal mass before any invasive procedure.

  14. Multiple Focal Nodular Hyperplasia and Steatohepatitis: Atypical Imaging Characteristics

    Directory of Open Access Journals (Sweden)

    Robert P Myers

    2001-01-01

    Full Text Available Focal nodular hyperplasia is a rare, benign condition of the liver. A 28-year-old woman with malignant melanoma, mild liver enzyme abnormalities, steatohepatitis and newly documented hepatic lesions is described. Ultrasound, computed tomography and magnetic resonance imaging suggested only areas of focal fatty sparing but could not eliminate the concern for metastases. A 99mtechnetium-labelled sulphur colloid scan, however, revealed areas of increased uptake consistent with multiple focal nodular hyperplasia. This diagnosis was ultimately confirmed with a liver biopsy. The investigation of a patient with a malignancy and expanding hepatic lesions is challenging. This case illustrates the usefulness of the 99mtechnetium-labelled sulphur colloid scan in the evaluation of patients with hepatic lesions.

  15. A case of giant nodular posterior scleritis mimicking choroidal malignancy

    Directory of Open Access Journals (Sweden)

    Andrea T Liu

    2015-01-01

    Full Text Available To report a case of giant nodular posterior scleritis mimicking a choroidal tumor. A 42-year-old lady with systemic hypertension presented with a 1-week history of unilateral visual loss, pain and redness in her left eye. Examination showed sectoral anterior episcleritis in her left eye as well as a dome-shaped choroidal mass at the inferior-temporal periphery, associated with retinal hemorrhages and subretinal fluid. Systemic evaluation and imaging of the choroidal mass were performed and could not rule out amelanotic choroidal melanoma. At the same time, she was prescribed a 2-week course of oral nonsteroidal anti-inflammatory drug (NSAID for her sectoral anterior episcleritis. The choroidal mass was found to have resolved completely right before her scheduled fine needle biospy. Diagnosis of nodular posterior scleritis and a trial of oral NSAID can be considered in patients presenting with a choroidal mass before any invasive procedure.

  16. Nodular goiter after occupational accidental exposure to radiation

    Energy Technology Data Exchange (ETDEWEB)

    Pisarev, M.A. [Radiobiology, National Atomic Energy Commission, Buenos Aires (Argentina); Human Biochemistry, Uninversity of Buenos Aires, School of Medicine, Buenos Aires (Argentina); Schnitman, M. [Center of Endocrinology and Metabolism, French Hospital C.Milstein, Buenos Aires (Argentina)

    2012-07-01

    In the present paper we present the consequences of an accidental occupational radiation exposure at a local hospital in Buenos Aires. Control at a local radiology service showed the lack of correct shielding in the X-ray equipment. The physicians and technicians (14 persons) exposed to radiation during 12 months were examined. The survey shows that: a) In 11 out of 14 radiation-exposed patients nodular goiter developed and an additional patient had diffuse goiter which means a goiter incidence of 85.7%; b) In 5 of the nodular goiter patients an increase in the size or the appearance of new nodules was observed along the follow-up period. No cancer was detected by FNA; c) Hypothyroidism was observed in 3/14 patients, and an additional patient had an abnormal TRH-TSH test, suggesting subclinical hypothyroidism; and d) Increased circulating antithyroid antibodies were found in one of the hypothyroid patients

  17. {sup 131}I treatment of nodular non-toxic goitre

    Energy Technology Data Exchange (ETDEWEB)

    Nygaard, B.; Faber, J.; Hegdeues, L.; Hansen, J.M. [Herlev Hospital (Denmark)

    1996-01-01

    The traditional treatment of a growing nodular non-toxic goitre has for many years been surgical resection or levothyroxine suppressive treatment. During recent years, several studies have reported promising results of {sup 131}I treatment in terms of thyroid size reduction. This review outlines the different treatment modalities on non-toxic nodular goitre with special emphasis on {sup 131}I treatment. By the term nodular goitre the authors include glands with solitary or multiple thyroid nodules with uptake on a scintiscan. At what point of the natural history of non-toxic multinodular goitre {sup 131}I therapy should be used is not clear. In principle, the best result is obtained in smaller goitres and it is possible that the best effect of {sup 131}I is seen if treatment is given to patients with diffuse goitre before these become nodular. However, then there is a potential risk to swing in the direction to where {sup 131}I is used in an indiscriminate way, since the prevalence of non-toxic multinodular goitre is much higher than that of hyperthyroidism. Although we have data on the long-term hazards of {sup 131}I treatment in hyperthyroidism in terms of risk of cancer, we have only follow-up periods of 5 to 10 years for non-toxic goitres in small groups of patients and no data regarding the long-term risk of high-dose {sup 131}I treatment (>600 MBq) for this condition. Ideally, long term randomized studies comparing the effect, side effect and cost-benefit of surgery as opposed to {sup 131}I treatment should be performed. Awaiting this, it is at present mandatory that each individual patient be given a choice of treatment after proper information. 44 refs.

  18. Bilateral periventricular nodular heterotopia – neonatal cranial ultrasound.

    Directory of Open Access Journals (Sweden)

    A R Horn

    2010-03-01

    Full Text Available A female neonate was delivered at 30 weeks’ gestation to a mother with suspected bilateral periventricular nodular heterotopia (PNH on computed tomography brain scan. Antenatal ultrasound (US performed at 28 weeks’ gestation showed mild lateral cerebral ventricle dilatation, but no other fetal anomalies. Clinical examination revealed mild dysmorphic features: facial and skull asymmetry, square-shaped ears, and long tapering fingers. Chromosomal analysis showed a 46XX karyotype.

  19. Nodular hidradenoma and hidradenocarcinoma. A 10-year review.

    Science.gov (United States)

    Hernández-Pérez, E; Cestoni-Parducci, R

    1985-01-01

    We studied eighty-nine nodular hidradenomas (NHs) and six clear cell hidradenocarcinomas (CCHs) reported in a 10-year period. NHs were more commonly seen in women (ratio of 1.7 to 1); the average age was 37.2 years, and they were located mainly on the head. One CCH had widely disseminated metastasis that led to death. Other CCHs underwent spontaneous regression.

  20. Nodular Prurigo Associated with Mycosis Fungoides - Case Report

    OpenAIRE

    Sandra Jerković Gulin; Romana Čeović; Davorin Lončarić; Ivana Ilić

    2015-01-01

    Mycosis fungoides (MF) is the most common type of cutaneous lymphoma and accounts for approximately 50% of all lymphomas arising primarily in the skin. The three types of MF lesions are patches, plaques, and tumors, according to which the disease is traditionally divided into three clinical stages. The clinical course can be protracted and take years or decades. In the final stage, MF evolves to a systemic form of the disease. Nodular prurigo (NP) is still a condition of unknown etiology char...

  1. Morpho-histodifferentiation of Billbergia Thunb. (Bromeliaceae) nodular cultures.

    Science.gov (United States)

    de Souza, Thaysi Ventura; Thiesen, Julia Faillace; Lando, Ana Paula; Guerra, Miguel Pedro; Santos, Marisa

    2017-01-01

    Nodule cultures are formed through an intermediate morphogenetic route that lies between organogenesis and somatic embryogenesis. Although well described in many species, different aspects of the morphological and histological development of nodules remain to be clarified. Based on their threatened status and high ornamental value, Billbergia alfonsi-joannis and Billbergia zebrina, two epiphytic bromeliad species endemic to the South American Atlantic Forest, were studied. Nodular cultures were induced to grow from nodal segments taken from etiolated seedlings grown in vitro for 12 weeks in the dark on MS medium supplemented with 1 μM TDZ. Samples were taken for analysis weekly over 8 weeks of growth and analyzed under light, transmission electron, and scanning electron microscopes. Morphological and histological analysis showed that nodular clusters originated from stem pericycles and consisted of a polycenter, cambial tissue, cortical parenchyma, and a covering tissue. The polycenter consisted of an organizational center dispersed in parenchymal tissue. Each organizational center was formed by a vascular system surrounded by a bundle sheath. A cambial tissue surrounded these polycenters, promoting the regeneration of new nodules and leading to the formation of buds and roots. Primary nodules could generate secondary nodules in a repetitive process. Thus, histological analysis revealed the origin and formation of nodular cultures. These new data will support the establishment of micropropagation protocols and regeneration on a large scale for these species.

  2. 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.

  3. Neck dissection for oral mucosal melanoma: caution of nodular lesion.

    Science.gov (United States)

    Wu, Yunteng; Zhong, Yi; Li, Chaojun; Song, Hao; Guo, Wei; Ren, Guoxin

    2014-04-01

    Oral mucosal melanoma (OMM) often metastasizes to cervical nodes. A great number of studies have been conducted to evaluate the efficacy of neck dissection in the treatment of OMM, but considerable controversy remains in this field. The clinical features, treatments, and outcomes of 254 OMM patients were retrospectively analyzed from Jan. 1998 to Jul. 2012. Multivariate analysis was performed to identify the variables related to overall survival (OS). Tumor size greater than 4 cm (p=0.01) and nodular types (pnodular melanomas were more likely to have distant metastases than those with macular melanomas (pnodular melanomas; whereas radical neck dissection (p=0.03) in patients with positive CLN. Patients undergoing functional neck dissection were more likely to have neck recurrence (pNodular type is a dangerous signal to OMM. It is advisable for patients with cN0 nodular melanomas to have prophylactic neck dissection, close observation is recommended for patients with cN0 macular melanomas, and patients with positive CLN should undergo radical neck resection. Copyright © 2014. Published by Elsevier Ltd.

  4. Nodular Hepatic Tuberculosis Masquerading as a Seminoma Liver Metastasis.

    Science.gov (United States)

    Harbi, Houssem; Chaabouni, Amine; Kallel, Rim; Toumi, Nozha; Fendri, Sami; Krichene, Jihene; Boujelbene, Salah; Mzali, Rafik

    2018-04-01

    Isolated macro-nodular liver tuberculosis is a very rare condition. It may mimic primitive or secondary tumors of the liver. This could delay or mislead the therapeutic management. An immunocompetent 48-year-old man with a history of non-metastatic seminoma was treated with right orchidectomy followed by 20 Gy radiotherapy. The discovery, 8 months later, of a 2 cm nodule of the hepatic dome evoked a liver metastasis. Percutaneous biopsy was not feasible. Wedge resection was performed whereas medical treatment would have sufficed, as pathologic examination of the resected specimen showed a macro-nodular hepatic tuberculosis. The patient received anti-tuberculosis drugs for 9 months. The diagnosis of isolated macro-nodular liver tuberculosis is frequently misleading, particularly in immunocompetent and paucisymptomatic patients. Thus percutaneous biopsy is mandatory for diagnosis and also prior to any major surgeries. © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  5. Inverted 'V' osteotomy excision arthroplasty for bony ankylosed elbows

    Directory of Open Access Journals (Sweden)

    Rex Chadrabose

    2011-12-01

    Full Text Available Abstract Background Bony ankylosis of elbow is challenging and difficult problem to treat. The options are excision arthroplasty and total elbow replacement. We report our midterm results on nine patients, who underwent inverted 'V' osteotomy excision arthroplasty in our hospital with good functional results. Materials Our case series includes 9 patients (seven males and two females with the mean age of 34 years (13-56 years. Five patients had trauma, two had pyogenic arthritis, one had tuberculous arthritis, and one had pyogenic arthritis following surgical fixation. Results The average duration of follow up is 65 months (45 months-80 months. The mean Mayo's elbow performance score (MEPS preoperatively was 48 (35-70. The MEPS at final follow up was 80 (60-95. With no movement at elbow and fixed in various degrees of either flexion or extension preoperatively, the mean preoperative position of elbow was 64°(30°to 100°. The mean post operative range of motion at final follow up was 27°of extension (20-500, 116°of flexion (1100-1300, and the arc of motion was 88°(800-1000. One patient had ulnar nerve neuropraxia and another patient developed median nerve neuropraxia, and both recovered completely in six weeks. No patient had symptomatic instability of the elbow. All patients were asymptomatic except one patient, who had pain mainly on heavy activities. Conclusion We conclude that inverted 'V' osteotomy excision arthroplasty is a viable option in the treatment of bony ankylosis of the elbow in young patients.

  6. Imatinib mesylate for the treatment of steroid-refractory sclerotic-type cutaneous chronic graft-versus-host disease.

    Science.gov (United States)

    Baird, Kristin; Comis, Leora E; Joe, Galen O; Steinberg, Seth M; Hakim, Fran T; Rose, Jeremy J; Mitchell, Sandra A; Pavletic, Steven Z; Figg, William D; Yao, Lawrence; Flanders, Kathleen C; Takebe, Naoko; Sarantopoulos, Stefanie; Booher, Susan; Cowen, Edward W

    2015-06-01

    Sclerotic skin manifestations of chronic graft-versus-host disease (ScGVHD) lead to significant morbidity, including functional disability from joint range of motion (ROM) restriction. No superior second-line therapy has been established for steroid-refractory disease. Imatinib mesylate is a multikinase inhibitor of several signaling pathways implicated in skin fibrosis with in vitro antifibrotic activity. We performed an open-label pilot phase II trial of imatinib in children and adults with corticosteroid-refractory ScGVHD. Twenty patients were enrolled in a 6-month trial. Eight received a standard dose (adult, 400 mg daily; children, 260 mg/m(2) daily). Because of poor tolerability, 12 additional patients underwent a dose escalation regimen (adult, 100 mg daily initial dose up to 200 mg daily maximum; children, initial dose 65 mg/m(2) daily up to 130 mg/m(2) daily). Fourteen patients were assessable for primary response, improvement in joint ROM deficit, at 6 months. Primary outcome criteria for partial response was met in 5 of 14 (36%), stable disease in 7 of 14 (50%), and progressive disease in 2 of 14 (14%) patients. Eleven patients (79%), including 5 with partial response and 6 with stable disease, demonstrated a positive gain in ROM (range of 3% to 94% improvement in deficit). Of 13 patients with measurable changes at 6 months, the average improvement in ROM deficit was 24.2% (interquartile range, 15.5% to 30.5%; P = .011). This trial is registered at http://clinicaltrials.gov as NCT007020689. Published by Elsevier Inc.

  7. Radiographic Study on the Bony Changes of Mandibular Condyle Head in Temporomandibular Disorder Patients

    International Nuclear Information System (INIS)

    Park, Moo Soon; You, Dong Soo

    1989-01-01

    The author has studied radiographic bony changes of mandibular condyle head in temporomandibular disorder patients using Oblique lateral transcranial projection, Orthopantomography, and Tomography. The bony change types and the frequencies of occurrence and the incidences of bony changes in three different radiographic techniques were examined. The coincidences of body change types between the Oblique lateral transcranial projection and the lateral part of Tomogram, the Orthopantomogram and the medial part of Tomogram were also examined. The results were as follows: 1. The mean age of patients was 31.7 years and under 40 years were 24 patients, women were 27 patients, men were 4 patients. 2. The observable cases of bony changes in all three radiographic techniques were 19 cases (50%) of 38 cases and the observable cases of bony changes in only Tomography were 5 cases (13.2%). 3. The most frequent radiographic bony change type was osteophyte and next orders were flattening, erosion, concavity. 4. The positional incidences of bony changes in Tomogram were 31 cases in lateral part and 27 cases in central part. 5. The coincidence of bony change types between the oblique lateral transcranial projection and the lateral part of Tomogram was 80%, and the coincidence between the Orthopantomogram and the medial part of Tomogram was 76.9%.

  8. Quantitative computed tomography as a test of endurance for evaluation of bony plates

    International Nuclear Information System (INIS)

    Melo Filho, E.V.; Costa, L.A.V.S.; Oliveira, D.C.; Freitas, P.M.C.; Teixeira, M.W.; Costa, F.S.

    2012-01-01

    Quantitative computed tomography was used to determine the radiodensity of bony plates. The CT scans provided information regarding radiodensity of bony plates and allowed to verify the uniformity of bone mineral density in their scope. The proposed methodology should be considered as another tool for determining the resistance of these biomaterials. (author)

  9. Patterns of detection of superficial spreading and nodular-type melanoma: a multicenter Italian study.

    Science.gov (United States)

    Carli, Paolo; De Giorgi, Vincenzo; Palli, Domenico; Maurichi, Andrea; Mulas, Patrizio; Orlandi, Catiuscia; Imberti, Gianlorenzo; Stanganelli, Ignazio; Soma, Pierfranco; Dioguardi, Domenico; Catricalá, Caterina; Betti, Roberto; Paoli, Simone; Bottoni, Ugo; Lo Scocco, Giovanni; Scalvenzi, Massimiliano; Giannotti, Benvenuto

    2004-11-01

    Nodular histotype represents the condition that is mostly associated with diagnosis of thick melanoma. The objectives were to evaluate variables associated with and pattern of detection of nodular melanomas and to investigate variables associated with early diagnosis in accordance with histotype (nodular vs. superficial spreading melanomas). From the original data set of 816 melanomas, all the invasive lesions classified as superficial spreading (n=500) and nodular (n=93) melanomas were considered for the study. A multivariate logistic analysis was performed. Results. Nodular melanomas did not significantly differ from superficial spreading melanomas regarding sex, anatomic site, number of whole-body nevi, and the presence of atypical nevi. As expected, nodular melanomas were represented by a higher percentage of thick (>2 mm) lesions compared to superficial spreading melanomas (64.5% vs. 9.6%, pnodular and superficial spreading melanomas, the former being more frequently self-detected (44.1% vs. 38.0%) or detected by the family doctor (34.4% vs. 11.4%). Female sex, high level of education, and detection made by a dermatologist had an independent, protective effect against late (>1 mm in thickness) diagnosis in superficial spreading melanomas. No protective variable associated with nodular melanomas was found. Patterns of detection for nodular melanomas significantly differ from those for superficial spreading melanomas. For superficial spreading, but not for nodular, melanomas, variables associated with protective effect against late diagnosis can be identified.

  10. Carbides in Nodular Cast Iron with Cr and Mo

    Directory of Open Access Journals (Sweden)

    S. Pietrowski

    2007-07-01

    Full Text Available In these paper results of elements microsegregation in carbidic nodular cast iron have been presented. A cooling rate in the centre of the cross-section and on the surface of casting and change of moulding sand temperature during casting crystallization and its self-cooling have been investigated. TDA curves have been registered. The linear distribution of elements concentration in an eutectic grain, primary and secondary carbides have been made. It was found, that there are two kinds of carbides: Cr and Mo enriched. A probable composition of primary and secondary carbides have been presented.

  11. Cavitation Erosion of Nodular Cast Iron − Microstructural Effects

    Directory of Open Access Journals (Sweden)

    Orłowicz A.W.

    2017-12-01

    Full Text Available The paper deals with susceptibility of nodular cast iron with ferritic-pearlitic matrix on cavitation erosion. Cavitation tests were carried out with the use of a cavitation erosion vibratory apparatus employing a vibration exciter operated at frequency of 20 kHz. The study allowed to determine the sequence of subsequent stages in which microstructure of cast iron in superficial regions is subject to degradation. The first features to be damaged are graphite precipitates. The ferritic matrix of the alloy turned out to be definitely less resistant to cavitation erosion compared to the pearlitic matrix component.

  12. Nodular cast iron fatigue lifetime in cyclic plane bending

    Directory of Open Access Journals (Sweden)

    Marian Kokavec

    2012-05-01

    Full Text Available The fatigue behavior of a component is strongly dependent on the material and its surface condition. Therefore, the manner in which the surface is prepared during component manufacturing (surface roughness, residual stresses etc. has a decisive role in dictating the initiation time for fatigue cracks. The fatigue behavior of the same material, a nodular cast iron, with three different surface conditions (fine ground, sand blast and as-cast has been investigated under cyclic plane bending. The results show differences in fatigue strength, which are associated with the surface conditions. The characteristics of the surface layers of the different test specimens were examined by metallography.

  13. A Case Report: Krukenberg Tumour with Nodular Skin Lesions

    Directory of Open Access Journals (Sweden)

    Özden Demir

    2017-03-01

    Full Text Available The Krukenberg tumor is a rare variety of metastatic cancer to the ovary. The stomach is the most common site for the primary tumor, followed by the breast, gall bladder, colon and pancreas. It is not always possible to distinguish ovarian metastasis from primary ovarian masses in patients in whom the malignancy center is unidentified. This case report firstly aims to present a patient who presented with common nodular skin lesions, migrating arthritis and severe clinical characteristics, and diagnosed with Krukenberg tumor with further examinations.

  14. Viral vaccines for bony fish: past, present and future.

    Science.gov (United States)

    Salgado-Miranda, Celene; Loza-Rubio, Elizabeth; Rojas-Anaya, Edith; García-Espinosa, Gary

    2013-05-01

    Since 1970, aquaculture production has grown. In 2010, it had an annual average rate of 6.3% with 59.9 million tons of product and soon could exceed capture fisheries as a source of fishery products. However, the occurrence of viral diseases continues to be a significant limiting factor and its control is important for the development of this sector. In aquaculture farms, fish are reared under intensive culture conditions, and the use of viral vaccines has enabled an increase in production. Several types of vaccines and strategies of vaccination have been developed; however, this approach has not reached the expected goals in the most susceptible stage (fingerlings). Currently, there are inactivated and recombinant commercial vaccines, mainly for salmonids and cyprinids. In addition, updated genomic and proteomic technology has expedited the research and expansion of new vaccine models, such as those comprised of subunits or DNA. The objective of this review is to cover the various types of viral vaccines that have been developed and are available for bony fishes, as well as the advantages and challenges that DNA vaccines present for massive administration in a growing aquaculture, possible risks for the environment, the controversy regarding genetically modified organisms and possible acceptance by consumers.

  15. Thyroid nodular disease: their usefulness of diagnostic methods

    International Nuclear Information System (INIS)

    Mendez Ayala, Irene Maria; Sanchez Luthard, Maria de los Angeles; Martins Schmitz; Gomez, Silvia

    2009-01-01

    The thyroid nodular disease is defined by the presence of nodules of thyroid of solid, liquid or mixed consistency, they are or non concrete. Solitary nodule thyroid, diffuse and multinodular goiter forms can be presented in. The thyroid nodule is a frequent clinical problem, the clinical prevalence in adult population is of 4%. Objective: to make a bibliographical revision to near the utility of the different methods available for the thyroid nodular pathology diagnosis and determining which of them turns out more specific to differentiate benignancy from malignancy in the found nodules. Materials and Methods: the bibliographical search was made in the data base Medline (Pubmed), in scientific magazines of the region and text books. Criteria of inclusion: bibliographical references pertaining to medical magazines and free full text with an antiquity nongreater to 8 years were included. Conclusion: the presence of thyroid nodules constitutes a reason for frequent consultation, the main diagnostic method at the moment is the fine needle aspiration cytology, due to its simple accomplishment, low cost, not requiring the hospitalization of the patient, and being fundamental in the decision making of the doctor. This diagnostic method is, in addition, the one that with greater certainty allows to differentiate benign from malignant nodules. (authors) [es

  16. Historical, clinical, and dermoscopic characteristics of thin nodular melanoma.

    Science.gov (United States)

    Kalkhoran, Sara; Milne, Olivia; Zalaudek, Iris; Puig, Susana; Malvehy, Josep; Kelly, John W; Marghoob, Ashfaq A

    2010-03-01

    Nodular melanoma (NM), representing 15% to 30% of all melanomas, constitutes nearly half of all melanomas thicker than 2 mm. Nodular melanoma frequently lacks clinical features seen in other melanoma subtypes and has a faster growth rate. We reviewed a series of cases of NM that was less than 1.3 mm thick to identify historical, clinical, and dermoscopic factors that may facilitate earlier diagnosis of NM, with the hope of reducing its associated morbidity and mortality. The thin NM lesions we analyzed had a rather subtle clinical appearance, often lacking the ABCD (asymmetry, border irregularity, color variegation, and diameter greater than 6 mm) criteria. On dermoscopy, most lesions had a homogeneous disorganized asymmetric pattern or a featureless pattern with atypical vessels. Although many dermoscopic features seen in other melanoma subtypes were frequently absent, some features such as a blue-white veil, structureless areas, and atypical vascular structures were often identified. The often unremarkable clinical presentation of NM necessitates physicians and patients to be wary of new or changing lesions. Dermoscopy may help increase suspicion in early NM because dermoscopic features are typically more suggestive of malignancy than clinical ones. We hope that secondary prevention efforts combined with prompt dermatologic consultations will allow for the timely diagnosis and management of NM.

  17. Guided tissue regeneration for periodontal infra-bony defects.

    Science.gov (United States)

    Needleman, I G; Worthington, H V; Giedrys-Leeper, E; Tucker, R J

    2006-04-19

    Conventional treatment of destructive periodontal (gum) disease arrests the disease but does not usually regain the bone support or connective tissue lost in the disease process. Guided tissue regeneration (GTR) is a surgical procedure that specifically aims to regenerate the periodontal tissues when the disease is advanced and could overcome some of the limitations of conventional therapy. To assess the efficacy of GTR in the treatment of periodontal infra-bony defects measured against conventional surgery (open flap debridement (OFD)) and factors affecting outcomes. We conducted an electronic search of the Cochrane Oral Health Group Trials Register, MEDLINE and EMBASE up to April 2004. Handsearching included Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and bibliographies of all relevant papers and review articles up to April 2004. In addition, we contacted experts/groups/companies involved in surgical research to find other trials or unpublished material or to clarify ambiguous or missing data and posted requests for data on two periodontal electronic discussion groups. Randomised, controlled trials (RCTs) of at least 12 months duration comparing guided tissue regeneration (with or without graft materials) with open flap debridement for the treatment of periodontal infra-bony defects. Furcation involvements and studies specifically treating aggressive periodontitis were excluded. Screening of possible studies and data extraction was conducted independently. The methodological quality of studies was assessed in duplicate using individual components and agreement determined by Kappa scores. Methodological quality was used in sensitivity analyses to test the robustness of the conclusions. The Cochrane Oral Health Group statistical guidelines were followed and the results expressed as mean differences (MD and 95% CI) for continuous outcomes and risk ratios (RR and 95% CI) for dichotomous outcomes calculated using

  18. Extraspinal Percutaneous Osteoplasty for the Treatment of Painful Bony Metastasis.

    Science.gov (United States)

    Lee, Jae Heon; Kim, Su Young; Ok, Hwoe Gyeong; Kim, Tae Kyun; Kim, Kyung Hoon

    2018-02-19

    Extraspinal percutaneous osteoplasties (POPs) are novel techniques for the treatment of painful bony metastasis, which is often the cause of both persistent and incidental breakthrough pain. This retrospective study explored the efficacy and complications of extraspinal POPs. The origin of the cancer metastasis, performed POP sites, necessity of adjacent joint injections, pain and Karnofsky Performance Scale (KPS) scores, complications related to the POPs, and life expectancy were evaluated from the medical records from 2009 to 2016. A total of 47 (M/F = 28/19) patients had received 54 POPs, including costoplasty, scapuloplasty, ilioplasty, humeroplasty, ischioplasty, femoroplasty, sternoplasty, and puboplasty, in order of frequency. The most common sites for the origin of the cancer, in order of frequency, were the lung, liver, breast, colon, and kidney. All patients receiving POPs including scapuloplasty, ilioplasty, humeroplasty, and femoroplasty needed adjacent joint injections before or after the POPs. Pain due to metastatic lesions was reduced significantly immediately after the POPs and the reduction was sustained until the end of their lives. The median KPS was increased from 35.4% to 67.7% immediately after the POPs. There were no complications related to the procedures. The mean life expectancy after performing the POPs, for 35 patients which died afterwards, was 99.3 days, ranging from 1 to 767 days. Even though pain in the isolated POP sites may be difficult to measure due to overlapping systemic pain, the POPs provided immediate local pain relief, and the patients showed better physical performance without procedure-related complications. © 2018 The Korean Academy of Medical Sciences.

  19. Injury of anterior cruciate ligament with associated bony lesions: MR image

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soon; Oh, Yeon Hee; Lee, Chang Wook [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Yong Min [Chungbuk Univ. College of Medicine, Chongju (Korea, Republic of); Lee, Hyeon Kyeong; Kim, Seung Hyeon; Lee, Sung Woo [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-05-01

    To evaluate the characteristic MR findings in injury of the anterior cruciate ligament (ACL) with associated bony lesions. We reviewed MR findings and the corresponding arthroscopic or operative results of 48 patients with ACL injuries, and evaluated ACL signal intensity and contour. In associated bony lesions, we determined the location of avulsion fracture and bony bruise. Complete ACL tears were seen in 27 cases, partial tears in 13, and avulsion injury in eight. Complete tears showed heterogeneously increased signal intensity with contour bulging in ten cases (37%), and combined bony lesion in 14 (52%). ACL with a thin continous low signal intensity band surrounding heterogeneously-increased signal intensity suggested partial tears, and was seen in three of 13 proven cases (23%) of partial ACL tears;combined bony lesion was seen in four such cases(31%). There were eight cases of avulsion fracture;the most frequent site was the anterolateral portion of the tibial spine (n=6). The most frequent sites of bony lesion were at the midportion of the lateral femoral condyle (n=6), and the posterior portion of the lateral tibial plateau (n=6);the next most frequent site was the anterior portion of the lateral tibial plateau (n=5). Tearing of the ACL was seen on MRI as ligament discontinuity, and heterogeneously increased signal intensity with ACL contour bulging. The most frequent sites of associated bony lesions were the midportion of the lateral femoral condyle, and the posterior portion of the lateral tibial plateau. In associated bony lesions, bony contusion suggested ACL tearing, but avulsion fracture suggested ligament avulsion injury without tear.

  20. Nodular Hyperplasia Arising from the Lateral Aberrant Thyroid Tissue: A Case Report

    International Nuclear Information System (INIS)

    Jeong, Min Hye; Park, Jeong Seon; Lee, Young Jun

    2012-01-01

    The presence of aberrant thyroid tissue in the lateral neck is very rare. In addition, nodular hyperplasia in ectopic thyroid has rarely been reported. Due to the unusual location, the presence of lateral aberrant thyroid tissue could be misdiagnosed as a lymphadenopathy, neurogenic tumor, etc. We report on a case of nodular hyperplasia arising from the right lateral aberrant thyroid tissue.

  1. The neutron irradiation influence on the nodular corrosion development of zirconium RBMK-1000 tubes

    International Nuclear Information System (INIS)

    Shinakov, A.A.; Chirko, L.I.; Grinik, E.U.

    1994-01-01

    Microstructure examinations were carried out on nodular corrosion in zirconium tubes by metallography and X-ray methods. Observations show that the mono-nodules core contains secondary phase separations such as carbides, intermetallics, hydrides, etc., induced by radiation swelling. A model of the nodular corrosion development under irradiation is proposed. 10 refs., 4 figs

  2. Nodular fasciitis: A pseudomalignant clonal neoplasm characterized by USP gene rearrangements and spontaneous regression

    LENUS (Irish Health Repository)

    Hennebry, Jennifer

    2017-01-01

    Introduction: Nodular fasciitis (NF) is a rapidly growing, self-limited, myofibroblastic neoplasm that typically arises in subcutaneous tissues of young adults and regresses spontaneously. Nodular fasciitis mimics sarcoma on clinical, radiological, and histological grounds and is usually, diagnosed following excision.\\r\

  3. Algodystrophy in children and young adults with isotopic bony hypofixation. A propos of 5 observations

    Energy Technology Data Exchange (ETDEWEB)

    Doury, P.; Pattin, S.; Eulry, F.; Granier, R.; Gaillard, F.

    1986-12-01

    The authors report 5 observations of young adults 3 teen-agers and 2 children suffering from algodystrophy, and in whom isotopic exploration of the skeleton disclosed a clear bony hypofixation during the entire evolution. These observations confirm their 1981 work concerning a young adult suffering from algodystrophy with isotopic bony hypofixation. Recent Canadian and American studies emphasize also the frequency of isotopic hypofixation in children algodystrophy. It seems, therefore, that isotopic bony hypofixation (linked perhaps to a decreased blood flow), is rather specific of algodystrophy in young subjects.

  4. [A patient with muscular torticollis caused by nodular fasciitis in the sternocleidomastoid muscle (SCM)].

    Science.gov (United States)

    Hemmi, Shoji; Murakami, Tatufumi; Shirabe, Teruo; Sunada, Yoshihide

    2002-09-01

    Nodular fasciitis is a benign pseudosarcomatous proliferative lesion which is frequently misdiagnosed as malignant tumor clinically and microscopically. It usually occurs as a rapidly enlarging subcutaneous mass on the upper extremities, especially on the forearm. Here we report a patient showing muscular torticollis caused by nodular fasciitis in the sternocleidomastoid muscle (SCM). A 17-year-old woman was hospitalized because of rapidly progressive torticollis. The right SCM was markedly enlarged and firm on palpation. Muscle biopsy taken from the right SCM revealed massive proliferation of spindle shaped fibroblasts infiltrating into the endomysium. These findings coincided with the intramuscular nodular fasciitis. However, different from typical nodular fasciitis, no apparent nodule formation was found in this patient. Instead, diffuse proliferative lesion extended widely into the neck soft tissue. To our knowledge, this is the first report of muscular torticollis caused by nodular fasciitis involving the SCM.

  5. Diagnostic accuracy of nodular gastritis for H. pylori infection

    Directory of Open Access Journals (Sweden)

    Romero-Flores JL

    2016-12-01

    Full Text Available Juan L Romero-Flores,1 Justo A Fernandez-Rivero,1 Erika Marroquín-Fabian,1 Félix I Téllez-Ávila,2 Beatriz A Sánchez-Jiménez,1 Eva Juárez-Hernández,3 Misael Uribe,1 Norberto C Chávez-Tapia1,3 1Obesity and Digestive Diseases Unit, Medica Sur Clinic & Foundation, 2Department of Gastrointestinal Endoscopy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 3Translational Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico Background: The term nodular is not included in the Sydney classification and there is no widely accepted histopathological definition. It has been proposed that the presence of antral nodularity could predict Helicobacter pylori (H. pylori infection. The aim of this study was to determine the diagnostic accuracy of nodular gastritis (NG for H. pylori infection after a rigorous standardization process, and to describe the associated histopathological characteristics. Materials and methods: Endoscopic images of patients submitted to endoscopy with biopsy sampling were included. Endoscopic images were distributed among six endoscopists. The analysis was performed sequentially in three rounds: the first round assessed the interobserver variability, the second evaluated the intraobserver variability, and the third calculated the interobserver variability after training. A correlation analysis between endoscopic and histopathological findings was performed. Results: A total of 917 studies were included. In the first analysis of interobserver variability, a poor kappa value (0.078 was obtained. The second evaluation yielded good intraobserver variability, with kappa values of 0.62–0.86. The evaluation of interobserver variability after training revealed an improvement in the kappa value of 0.42. A correlation was found between endoscopic images and histopathological reports. Conclusion: There was a strong correlation between NG and H. pylori, but only after rigorous evaluation. The use of

  6. Detection of bony metastases of androgen-independent prostate cancer by PET-FDG

    International Nuclear Information System (INIS)

    Yeh, Samuel D. J.; Imbriaco, Massimo; Larson, Steven M.; Garza, Dahlia; Zhang Jiaju; Kalaigian, Hovanes; Finn, Ronald D.; Reddy, David; Horowitz, Steven M.; Goldsmith, Stanley J.; Scher, Howard I.

    1996-01-01

    Fourteen F-18 fluorodeoxyglucose (FDG) studies were carried out in 13 patients known to have bony metastases from carcinoma of the prostate. One patient was newly diagnosed. The remaining patients had various types of therapy and were considered hormonally resistant. The average age was 67. All patients had extensive bony metastases shown on the conventional Tc99m-MDP bone scans. Only about 18% of bony lesions apparent on the conventional bone scans showed corresponding increase of FDG uptake. Anatomical correlation was performed by using co-registered images of SPECT and PET in the same area. The positive FDG uptake was not related to the duration of illness, level of PSA, previous therapy, and magnitude of disease involvement. It appears that only a small percentage of bony metastases is associated with increased glycolysis. It is possible that other metabolic processes are more important than glycolysis for providing prostate cancer with a source of energy and nutrients

  7. Detection of bony metastases of androgen-independent prostate cancer by PET-FDG

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, Samuel D. J.; Imbriaco, Massimo; Larson, Steven M.; Garza, Dahlia; Zhang Jiaju; Kalaigian, Hovanes; Finn, Ronald D.; Reddy, David; Horowitz, Steven M.; Goldsmith, Stanley J.; Scher, Howard I

    1996-08-01

    Fourteen F-18 fluorodeoxyglucose (FDG) studies were carried out in 13 patients known to have bony metastases from carcinoma of the prostate. One patient was newly diagnosed. The remaining patients had various types of therapy and were considered hormonally resistant. The average age was 67. All patients had extensive bony metastases shown on the conventional Tc99m-MDP bone scans. Only about 18% of bony lesions apparent on the conventional bone scans showed corresponding increase of FDG uptake. Anatomical correlation was performed by using co-registered images of SPECT and PET in the same area. The positive FDG uptake was not related to the duration of illness, level of PSA, previous therapy, and magnitude of disease involvement. It appears that only a small percentage of bony metastases is associated with increased glycolysis. It is possible that other metabolic processes are more important than glycolysis for providing prostate cancer with a source of energy and nutrients.

  8. Results of Bony Chest Wall Reconstruction with Expanded Polytetrafluoroethylene Soft Tissue Patch

    OpenAIRE

    Huang, Haibo; Kitano, Kentaro; Nagayama, Kazuhiro; Nitadori, Jun-ichi; Anraku, Masaki; Murakawa, Tomohiro; Nakajima, Jun

    2015-01-01

    Purpose: The early and long-term outcomes of bony chest wall reconstruction with expanded polytetrafluoroethylene (Gore-Tex) soft tissue patch remain a concern. No clinical study has reported the shrinkage of Gore-Tex following reconstruction to date.

  9. Esclerite nodular e poliangiite granulomatosa (Wegener mimetizando tuberculose

    Directory of Open Access Journals (Sweden)

    Cybelle Moreno Luize Franco

    2015-04-01

    Full Text Available Poliangiite granulomatosa é uma doença sistêmica que afeta qualquer órgão, com predileção pelo trato respiratório superior, pulmões e rins. Este artigo tem como objetivo relatar um caso atípico de uma paciente com esclerite nodular como manifestação inicial da poliangiite granulomatosa (Wegener, mimetizando um quadro de tuberculose. A paciente apresentou hiperemia ocular e baixa acuidade visual progressiva por 1,5 anos, seguido por dor ocular por dois meses. A paciente possuía nódulos subpleurais com densidade de partes moles, linfonodomegalia em janela aorto-pulmonar e espessamento pleural bilateral discreto, negativo para bacilos álcool-ácido resistentes (BAAR. O diagnóstico histológico revelou uma vasculite granulomatosa sugestiva de vasculite não infecciosa (poliangiite granulomatosa. Foi iniciada pulsoterapia com ciclofosfamida.

  10. Nodular hidradenocarcinoma over the parotid gland: a pathologic presentation.

    Science.gov (United States)

    Verret, D J; Kabbani, Wareef; DeFatta, Robert J

    2007-02-01

    Nodular hidradenocarcinoma (NHAC), an eccrine carcinoma, has been reported in the dermatology and pathology literature, but few references have been made in the otolaryngology literature even though the head and neck is a common site of occurrence. A case report of a 37-year-old Hispanic man with a right-sided neck mass diagnosed preoperatively as a parotid mass by imaging and fine-needle aspiration is presented. After presentation at our multidisciplinary tumor board, excision of the mass was undertaken. Final pathology revealed a NHAC, which is presented in our report. NHAC is an aggressive malignant tumor that is often misdiagnosed preoperatively and that must be treated with aggressive multimodality therapy for increased survival.

  11. Periventricular nodular heterotopia in Smith-Magenis syndrome.

    Science.gov (United States)

    Capra, Valeria; Biancheri, Roberta; Morana, Giovanni; Striano, Pasquale; Novara, Francesca; Ferrero, Giovanni Battista; Boeri, Luca; Celle, Maria Elena; Mancardi, Maria Margherita; Zuffardi, Orsetta; Parrini, Elena; Guerrini, Renzo

    2014-12-01

    Smith-Magenis syndrome (SMS) is caused by an interstitial microdeletion of chromosome 17p11.2. A few patients with the typical SMS phenotype have RAI1 gene mutations. The syndrome is characterized by minor craniofacial anomalies, short stature, sleep disturbances, behavioural and neurocognitive abnormalities, as well as variable multisystemic manifestations. Periventricular nodular heterotopia (PNH) is a genetically heterogeneous neuronal migration disorder characterized by subependymal heterotopic nodules, and is variably associated with other brain malformations, epileptic seizures and intellectual disability. Here we report on two patients harboring deletions of the 17p11.2 region in whom the SMS typical phenotype was associated with bilateral PNH. Our observations expand the spectrum of chromosomal rearrangements associated with PNH and indicate that abnormal neuronal migration may contribute to the neurocognitive phenotype of SMS. © 2014 Wiley Periodicals, Inc.

  12. [Nocardia brasiliensis leg ulcer and nodular lymphangitis in France].

    Science.gov (United States)

    Hamm, M; Friedel, J; Siré, C; Semon, J

    2005-01-01

    Nocardia brasiliensis is a very rarely reported cause of chronic phagedenic ulcerations. We report the case of an elderly woman who developed such an infection after falling on her right leg on the road in the Bresse country (an essentially agricultural and bovine-cattle breading region) and developed a chronic phagedenic ulcer secondarily complicated by nodular lymphangitis of the thigh. A 75 year-old woman fell on her right leg on the side of the main road outside her hamlet in the Bresse country and secondarily developed a chronique phagedenic ulceration. We first considered her as suffering from pyoderma gangrenosum. A complete scanning only revealed an autoimmune thyroiditis and a rapidly healing gastric ulceration, and none of the treatments, either local or systemic, helped the skin condition to heal. After 3 weeks of application of a local corticoid ointment, the patient developed fever, general malaise, an exacerbation of her wound and an infiltration of the skin round her knee, together with nodular lymphangitic dissemination. A supplementary bacterial swab disclosed massive proliferation of a slow-growing Gram-positive bacillus, which proved to be Nocardia brasiliensis, together with a methicillino-sensitive Staphylococcus aureus. The treatment with sulfamethoxazole-trimetoprim gave a rash after 12 hours and was changed to amoxicillin and clavulanic acid, which rapidly proved to be permanently effective. The revelation of this particular slow-growing bacteria is difficult and requires bacterial swabs. Nocardia brasiliensis is relatively rare in primary skin ulcerations and we discuss the reasons why an elderly women should find this bacteria on the road outside her hamlet in the French countryside. This particular infectious condition requires general scanning, to make sure that the primary skin condition does not extend to other organs. We review the therapeutical options for patients who exhibit allergic reactions to the classically effective

  13. Suppressive therapy for radiation-associated nodular thyroid disease

    International Nuclear Information System (INIS)

    Tamura, Kazuo; Shimaoka, Katsutaro; Tsukada, Yoshiaki; Razack, M.S.; Sciasicia, Michael.

    1981-01-01

    A thyroid screening program for individuals who had irradiation to the head and neck areas was started at Roswell Park Memorial Institute in February 1977 and by June 1979, 1,071 patients were seen in the clinic. Three hundred and ninety-six patients were found to have palpable abnormalities of the thyroid, and following pretreatment evaluation, suppressive therapy with triiodothyronine (T3) (50 μg/day) or DT (desiccated thyroid) (120 mg/day) was administered in a double-blind fashion. Two hundred fifty patients with nodular disease completed 6 mo of treatment and are analyzed in this paper. Pretreatment thyroid function tests showed that two patients had hypothyroidism with a high thyroid-stimulating hormone (TSH) and a low thyroxine level. A high incidence of thyroid autoantibodies was also noted and surgical findings confirmed a high incidence of chronic thyroiditis. Complete disappearance of the nodules was seen in 29% of the patients, and in addition, 38% of the patients were seen to have significant shrinkage of the nodules, indicating that radiation-associated thyroid nodules were as sensitive to the thyroactive agents as nonirradiated nodular thyroid disease. There was little difference in the response rate between T3 and DT. Both agents suppressed circulating TSH levels to an unmeasurable level in 76% of the patients. There was no correlation between scan findings and response rates. Thyroid carcinoma was found in 19% of the patients who underwent surgery; although all were well-differentiated carcinomas, two-thirds of the patients already had evidence of dissemination and/or invasion suggesting the aggressive nature of postirradiation thyroid carcinoma. (author)

  14. Quantitative assessment of corpus callosum morphology in periventricular nodular heterotopia

    Science.gov (United States)

    Pardoe, Heath R.; Mandelstam, Simone A.; Hiess, Rebecca Kucharsky; Kuzniecky, Ruben I.; Jackson, Graeme D.

    2014-01-01

    We investigated systematic differences in corpus callosum morphology in periventricular nodular heterotopia (PVNH). Differences in corpus callosum mid-sagittal area and subregional area changes were measured using an automated software-based method. Heterotopic gray matter deposits were automatically labeled and compared with corpus callosum changes. The spatial pattern of corpus callosum changes were interpreted in the context of the characteristic anterior-posterior development of the corpus callosum in healthy individuals. Individuals with periventricular nodular heterotopia were imaged at the Melbourne Brain Center or as part of the multi-site Epilepsy Phenome Genome project. Whole brain T1 weighted MRI was acquired in cases (n = 48) and controls (n = 663). The corpus callosum was segmented on the mid-sagittal plane using the software “yuki”. Heterotopic gray matter and intracranial brain volume was measured using Freesurfer. Differences in corpus callosum area and subregional areas were assessed, as well as the relationship between corpus callosum area and heterotopic GM volume. The anterior-posterior distribution of corpus callosum changes and heterotopic GM nodules were quantified using a novel metric and compared with each other. Corpus callosum area was reduced by 14% in PVNH (p = 1.59 × 10−9). The magnitude of the effect was least in the genu (7% reduction) and greatest in the isthmus and splenium (26% reduction). Individuals with higher heterotopic GM volume had a smaller corpus callosum. Heterotopic GM volume was highest in posterior brain regions, however there was no linear relationship between the anterior-posterior position of corpus callosum changes and PVNH nodules. Reduced corpus callosum area is strongly associated with PVNH, and is probably associated with abnormal brain development in this neurological disorder. The primarily posterior corpus callosum changes may inform our understanding of the etiology of PVNH. Our results suggest that

  15. The paediatric wrist revisited - findings of bony depressions in healthy children on radiographs compared to MRI

    International Nuclear Information System (INIS)

    Avenarius, Derk M.F.; Eldevik, Petter; Ording Mueller, Lil-Sofie; Owens, Catherine M.; Rosendahl, Karen

    2012-01-01

    The presence of erosions is used for diagnosis and monitoring of disease activity in juvenile idiopathic arthritis (JIA). Assessment of carpal bone erosions in children is challenging due to lack of normal references. To define normal appearances of bony depressions in the wrist on radiographs and MRI. MRI and radiography of the wrist were performed in 88 healthy children, 5-15 years of age. We assessed the number of bony depressions within the carpals/proximal metacarpals on both modalities, separately and combined. A total of 75 carpal depressions were identified on radiography compared to 715 on MRI. The number of bony depressions identified radiographically showed no statistically significant difference across age-groups. Within the metacarpals, there was no significant difference between bony depressions identified by MRI or radiography, except at the bases of the second metacarpal. Bony depressions that resemble erosions are normal findings in the wrist in children. MRI identifies more depressions than radiographs in the carpus. Some bony depressions occur at typical locations and should be accounted for when assessing the wrist in JIA to avoid overstaging. (orig.)

  16. [Histopathological Study of the Relationship between Lymphoid Follicles and Different Endoscopic Types of Nodular Gastritis].

    Science.gov (United States)

    Nagata, Takuo; Ishitake, Hisahito; Shimamoto, Fumio; Tamura, Tadamasa; Matsumura, Kazunori; Sumii, Masaharu; Nakai, Shirou

    2014-11-01

    Nodular gastritis is characterized histologically by hyperplasia and enlargement of lymphoid follicles in the lamina propria. With the objective of elucidating the relationship between different endoscopic types of nodular gastritis and lymphoid follicles, distributions of lymphoid follicles in the lamina propria were investigated in young gastric cancer patients with nodular gastritis. For the study, whole-mucosal step sectioning of each resected stomach was performed, the densities of lymphoid follicles of all specimens were measured microscopically, and the horizontal and depth distributions were calculated. For assessment in the horizontal direction, density distribution diagrams of lymphoid follicles were created. For assessment in the depth direction, the different endoscopic types of nodular gastritis were compared in the five different analysis sites. In the assessment of the horizontal distribution, no characteristic distribution tendencies were observed in either the granular type group or the scattered type group; however, it was found that areas with relatively high densities of lymphoid follicles generally coincided with the areas where nodular gastritis was observed endoscopically. These results suggested that hyperplasia and aggregation of lymphoid follicles in the lamina propria are involved at the sites where nodular gastritis is observed endoscopically. In the assessment of the depth distribution, lymphoid follicles tended to be more unevenly distributed in the upper lamina propria in the granular type group than in the scattered type at the three different analysis sites where nodular gastritis was observed endoscopically. These results suggested the possibility of a granular type characteristic.

  17. What are the clinical implications of nodular gastritis? Clues from histopathology.

    Science.gov (United States)

    Sokmensuer, Cenk; Onal, Ibrahim Koral; Yeniova, Ozgur; Ersoy, Osman; Aydinli, Musa; Yonem, Ozlem; Harmanci, Ozgur; Onal, Eda Demir; Altinok, Gulcin; Batman, Figen; Bayraktar, Yusuf

    2009-10-01

    There is no widely accepted histopathological definition for nodular gastritis. In this study we aim to uncover the pathologic entity responsible for the nodular appearance and to find clues about the clinical implications of nodular gastritis. Antral biopsy specimens of 160 patients with nodular gastritis and 133 patients without nodular gastritis were examined by an experienced pathologist for dysplasia, foveolar hyperplasia, inflammatory activity, intraepithelial lymphocytosis, intestinal metaplasia, and lymphoid follicle/aggregate formation, and comparative analysis was performed between the two groups of patients. The presence of intraepithelial lymphocytosis was more frequent in patients with nodular gastritis (P < 0.05). There was no difference between the two groups regarding the other pathological features such as presence of dysplasia, inflammatory activity, intestinal metaplasia, lymphoid hyperplasia, and Helicobacter pylori (H. pylori) infection. Increase of intraepithelial lymphocytes may contribute to formation of macroscopical nodules in this peculiar type of gastritis. Nodular gastritis would not indicate a new therapeutic approach in addition to the current measures for Helicobacter pylori infection.

  18. Focal nodular hyperplasia of the liver in longterm survivors of neuroblastoma

    International Nuclear Information System (INIS)

    Benz-Bohm, Gabriele; Hero, Barbara; Gossmann, Axel; Simon, Thorsten; Koerber, Friederike; Berthold, Frank

    2010-01-01

    Objectives: Focal nodular hyperplasia of the liver is a tumor-like lesion, uncommon in children, but it has recently been more frequently observed in children treated for malignant diseases, especially neuroblastoma. The aetiology is unclear, the pathogenesis remains controversial. Focal nodular hyperplasia of the liver is suspected to be a sequela of tumor therapy. Methods: Besides the clinical data we evaluated the imaging modalities needed to diagnose focal nodular hyperplasia of the liver in children with neuroblastoma who have been followed in our institution for more than 5 years. Results: Out of 60 children six developed focal nodular hyperplasia at a median time of 10.5 years after diagnosis of neuroblastoma and 9.4 years after the end of treatment. The diagnosis of focal nodular hyperplasia was based on imaging criteria which are variable in ultrasonography and specific in MRI. Only one child underwent surgical biopsies to rule out liver metastases. Conclusions: Longterm survivors of neuroblastoma are at risk of developing focal nodular hyperplasia, especially if they underwent toxic chemotherapy and/or radiotherapy to the liver during initial treatment. The recommended diagnostic imaging tools are ultrasonography for detecting liver lesions and MRI for confirming and characterizing these lesions as focal nodular hyperplasia.

  19. Procesos linfoides B cutáneos con patrón nodular Cutaneous B cell processes with nodular pattern

    Directory of Open Access Journals (Sweden)

    Ana M. Chirife

    2006-08-01

    Full Text Available Los linfomas B cutáneos son neoplasias de bajo grado de malignidad y de pronóstico favorable. Aquellos con patrón nodular pueden ser: linfomas foliculares(LFC o linfomas marginales extranodales(LMC. Son difíciles de diferenciar entre sí y de procesos reactivos, como hiperplasias linfoides cutáneas(HLC. Nuestro objetivo fue determinar su incidencia y el valor de la histología e inmunomarcación en el diagnóstico diferencial. Se estudiaron 56 pacientes con procesos linfoides cutáneos, entre los años 1995-2004. Las biopsias fueron estudiadas con hematoxilina-eosina e inmunomarcación. De los 56 procesos linfoides cutáneos, 32 fueron de origen T (57.1% y 24 de origen B (42.8%. De estos últimos, diez (17.8% fueron procesos linfoides con patrón nodular. Se diagnosticaron cuatro LFC, tres LMC y tres HLC. Se observaron folículos confluentes con escaso manto y centros germinales con celularidad monomorfa en los LFC. En los LMC se vieron folículos con manto prominente y nidos de células monocitoides en el manto, zona interfolicular y en los centros germinales. En las HLC se observaron macrófagos con detritus en los centros germinales. En los LFC observamos CD20(+, CD10(+, bcl-2(+ ó (-, y bcl-6(+ en el F y en el área (IF. Los LMC fueron CD20(+, bcl-2(-, CD10(-/+ y bcl-6(+ en el F, y en el área IF fueron bcl-2(+, CD10(-/+ y bcl-6(-. Las HLC resultaron bcl-2(-, bcl-6(+ y CD10(- en el F y bcl-2(+, bcl-6(- y CD10(- en la zona interfolicular. Concluimos que los procesos linfoides B nodulares son infrecuentes. La histología y la inmunomarcación demostraron tener valor en el diagnóstico diferencial de estos linfomas y de lesiones hiperplásicas no tumorales reactivas.Cutaneous lymphomas are low grade malignant neoplasms with favourable prognosis. Those related to the germinal centre with nodular pattern may be: follicular lymphomas (LFC or extranodal marginal zone B-cell lymphomas (LMC. They are difficult to tell apart, and from reactive

  20. Feasibility and practice of nodular iron casting feeder-less production

    Directory of Open Access Journals (Sweden)

    ZHOU Gen

    2006-02-01

    Full Text Available The volumetric changes of castings and dimension changes of mould cavity occurring during liquid cooling and solidification of nodular iron castings were described. The feasibility and prerequisites to realize feeder-less production of nodular iron castings was analyzed and proved with practical examples. It was pointed out that the feeder-less foundry method is by no means a feeding-less method, and it was emphasized that adopting high carbon equivalent, high rigidity mould, simultaneous and synchronous solidification, and intensifying cooling capacity of the mould to increase feeding effect of the gating system are important to successfully realize feeder-less production of nodular iron castings.

  1. Nodular Fasciitis of the Posterior Chest Wall With Bone Invasion Mimicking a Malignant Neoplasm.

    Science.gov (United States)

    Olson, Nicholas J; Finley, David J; Tsapakos, Michael J; Wong, Sandra L; Linos, Konstantinos

    2017-05-01

    Nodular fasciitis is a self-limiting benign fibroblastic/myofibroblastic proliferation, which typically presents as a rapidly growing mass resembling an aggressive lesion clinically. It can also mimic a sarcoma histologically, hence the frequent characterization as "pseudosarcoma." We describe a case of a 53-year-old man who presented with a posterior chest wall mass that on imaging showed erosion into the adjacent ribs. After resection, the diagnosis of nodular fasciitis was rendered. Bone erosion by nodular fasciitis is extremely rare and can resemble a malignant neoplasm radiologically. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Effect of Er,Cr:YSGG Laser at Different Output Powers on the Micromorphology and the Bond Property of Non-Carious Sclerotic Dentin to Resin Composites.

    Directory of Open Access Journals (Sweden)

    Xiang Sun

    Full Text Available The objective of this study was to investigate the influence of Er,Cr:YSGG laser irradiated at different powers on the micromorphology and the bonding property of non-carious sclerotic dentin to resin composites.Two hundred bovine incisors characterized by non-carious sclerotic dentin were selected, and the seventy-two teeth of which for surface morphological analysis were divided into nine groups according to various treatments (A: the control group, B: only treated with the adhesive Adper Easy One, C: diamond bur polishing followed by Adper Easy One, D-I: Er,Cr:YSGG laser irradiating at 1W, 2W, 3W, 4W, 5W, 6W output power, respectively, followed by Adper Easy One. The surface roughness values were measured by the non-contact three-dimensional morphology scanner, then the surface micromorphologies of surfaces in all groups were assessed by scanning electron microscopy (SEM; meanwhile, Image Pro-Plus 6.0 software was used to measure the relative percentage of open tubules on SEM images. The rest, one hundred twenty-eight teeth for bond strength test, were divided into eight groups according to the different treatments (A: only treated with the adhesive Adper Easy One, B: diamond bur polishing followed by the above adhesive, C-H: Er,Cr:YSGG laser irradiating at 1 W, 2 W, 3 W, 4 W, 5 W, 6 W output power, respectively, followed by the above adhesive, and each group was subsequently divided into two subgroups according to whether aging is performed (immediately tested and after thermocycling. Micro-shear bond strength test was used to evaluate the bond strength.The 4W laser group showed the highest roughness value (30.84±1.93μm, which was statistically higher than the control group and the diamond bur groups (p<0.05. The mean percentages ((27.8±1.8%, (28.0±2.2%, (30.0±1.9% of open tubules area in the 4W, 5W, 6W group were higher than other groups (p<0.05. The 4W laser group showed the highest micro-shear bond strength not only in immediately

  3. Multiple focal nodular hyperplasia of the liver associated with hemihypertrophy and vascular malformations.

    Science.gov (United States)

    Haber, M; Reuben, A; Burrell, M; Oliverio, P; Salem, R R; West, A B

    1995-04-01

    A case of multiple focal nodular hyperplasia of the liver occurring in a 22-year-old woman with musculoskeletal hemihypertrophy and anomalous vascular supply to the liver is described. The patient had Klippel-Trénaunay-Weber syndrome and abdominal pain and tender massive hepatomegaly. Visceral angiography showed marked dilatation of the celiac axis and both the main trunk and peripheral branches of the hepatic artery. Large abdominal veins drained from the dome of the liver into the hepatic veins. The vascular anomalies were evident on contrast-enhanced computed tomography and magnetic resonance imaging. Multiple focal nodular hyperplasia was confirmed by laparoscopic liver biopsy. The findings in this patient support the concept that multiple focal nodular hyperplasia characteristically occurs in a syndromic form and is induced by an irregular arterial supply in the liver, with localized hyperfusion that leads to nodular areas of hepatocyte hyperproliferation.

  4. Infantile nodular fasciitis of the hand: A case report and literature review

    Directory of Open Access Journals (Sweden)

    I Weng Lao

    2016-09-01

    Full Text Available Pediatric nodular fasciitis is uncommon and has a preference for the head and neck region. Occurrence in other anatomic locations is uncommon. We describe here a case of nodular fasciitis that arose in the hand of a newborn infant who presented with a rapidly growing mass. On MRI, it was heterogeneous isointense on T1-weighted and hyperintense on T2-weighted images. Histological examination showed short intersecting fascicles of uniform spindled myofibroblasts embedded in a myxoid to collagenous stroma, consistent with a nodular fasciitis. However, the lesion was initially diagnosed as an infantile fibrosarcoma due to the rapid growth, brisk mitotic activity and focally infiltrative architecture. This study illustrates that unusual presentation of nodular fasciitis may cause diagnostic confusion.

  5. Bony injuries in homicide cases (1994-2014). A retrospective study.

    Science.gov (United States)

    Flieger, Alexander; Kölzer, Sarah C; Plenzig, Stefanie; Heinbuch, Sara; Kettner, Mattias; Ramsthaler, Frank; Verhoff, Marcel A

    2016-09-01

    Even when human skeletal remains are found in contexts indicative of body disposal after homicide, none of the bones may manifest injuries. When skeletons are incomplete, there are two possibilities, the injured bones are missing or none were injured. This leads to the question how frequently bones are injured during homicide, where the injuries tend to be placed, and whether the frequency of injury is related to the type of homicide. To answer these questions, the postmortem reports from all autopsies performed for homicide victims at the Institute of Legal Medicine at the University Hospital in Frankfurt am Main, Germany, between 1994 and 2014, were retrospectively evaluated for bony injuries discovered during autopsy. In 90 cases, a preliminary postmortem computed tomography (pmCT) examination had been performed. The cases were categorized into the following five groups by type of fatal trauma: blunt force, sharp force, gunshot injury, strangulation, or other. In total, the postmortem reports for 897 homicides (527 male, 370 female) were evaluated. The number of victims per trauma category were sharp force, 309; blunt force, 179; gunshot injury, 242; strangulation, 92; and other, 75. Bony injuries had been reported in 70.9 % of the homicides. The "gunshot" category contained the highest proportion of victims with bony injuries (92.6 %). With 80.4 %, the second-highest proportion of victims with bony injuries was in the "blunt force" category, followed by 66.3 % of victims in the "sharp force" group. In contrast, with 53.3 %, the second-lowest proportion of victims with bony injuries was in the "strangulation" category, which contained a preponderance of female victims, followed by 17.3 % of victims with bony injuries in the "other" category. Bony injuries thus occurred in the majority of homicides. Forensic osteological analysis should, therefore, always be performed on badly decomposed human remains. Where necessary, the additional use of visualization

  6. Henoch–Schonlein purpura presenting sequentially as nodular rash, erythema nodosum, and palpable purpura

    Science.gov (United States)

    Balamurugesan, Kandan; Viswanathan, Stalin

    2014-01-01

    We describe a 26-year-old woman who presented with a nodular rash on the elbows following an insect bite. Two days later, she developed erythema nodosum. Both these lesions were treated symptomatically. One week later, she had purpura, abdominal pain, hematuria, and arthralgias, following which steroids were administered. Her investigations revealed only microscopic hematuria that disappeared with therapy. This pattern of sequential appearance of rash and a nodular morphology are both unique features not previously reported. PMID:24696039

  7. The Effect of Nodular Cast Iron Metal Matrix on the Wear Resistance

    OpenAIRE

    G. Gumienny

    2012-01-01

    The paper presents results of studies on the effect of the nodular cast iron metal matrix composition on the abrasive and adhesive wear resistance. Nodular cast iron with different metal matrix obtained in the rough state and ADI were tested. To research of abrasive and adhesive wear the pearlitic and bainitic cast iron with carbides and without this component were chosen. The influence of the carbides amount for cast iron wear resistance was examined. It was found, that the highest abrasive ...

  8. Open questions in the management of nodular lymphocyte predominant hodgkin lymphoma.

    Science.gov (United States)

    Tyran, Marguerite; Gonzague, Laurence; Bouabdallah, Reda; Resbeut, Michel

    2014-01-01

    Localized Nodular Lymphocyte Predominant Hodgkin Lymphoma is a rare disease with an overall good prognosis but frequent late relapses. Due to it's rarity there is no standard therapeutic approach and pathological diagnosis may be hard. In this paper we discuss the technical aspects of the radiation therapy and histological issues. The new fields reductions proposed for classical Hodgkin lymphoma cannot be applied to early stages Nodular Lymphocyte Predominant Hodgkin lymphomas which are usually treated with radiation therapy without systemic chemotherapy.

  9. Malignant nodular hidradenoma of the eyelid: a rare sweat gland tumor.

    Science.gov (United States)

    Al Baghli, Abdulla; Reddy, Suresh S; Reddy, Maragaret A

    2010-10-01

    We report a case of malignant nodular hidradenoma in a middle-aged man, who presented with a nodular swelling in the eyelid. The tumor was similar to its benign counterpart but had additional features such as surface ulceration, numerous mitiotic figures, and an infiltrative growth pattern. Malignant forms of hidradenomas are unusual and the possibility this variant should be considered in the differential diagnosis of eyelid tumors.

  10. An extensive primary nodular melanoma of the foot with associated distant metastases: a case report.

    Science.gov (United States)

    Malone, M; Gannass, Al; Binahmed, A; Bowling, F L; Boulton, A J

    2012-09-01

    A Nodular Melanoma of the foot is a relatively uncommon disease, which accounts for the dearth of literature. The anatomical location of a primary malignant melanoma is of prognostic importance as primary lesions of the foot and ankle have poorer prognostic outcomes. This single case reports a life-threatening presentation, of a primary nodular melanoma of the foot with associated distant metastases of the skeletal system, organs and lymph nodes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Canine sterile nodular panniculitis: a retrospective study of 39 dogs.

    Science.gov (United States)

    Contreary, Caitlin L; Outerbridge, Catherine A; Affolter, Verena K; Kass, Philip H; White, Stephen D

    2015-12-01

    Canine sterile nodular panniculitis (SNP) is an inflammatory disease of the panniculus that is typically managed with immunomodulatory or immunosuppressive treatments. It has been reported to be a cutaneous marker of an underlying systemic disease. To assess the presence or absence of concurrent systemic diseases associated with canine SNP and to document breed predispositions. Thirty nine dogs presented to a veterinary teaching hospital from 1990 to 2012 which met inclusion criteria. Inclusion in this retrospective study required a diagnosis of SNP via histopathological analysis and negative special stains for infectious organisms. Breed distributions of affected dogs were compared to all other dogs examined at this hospital during the study period. Correlations between the histological pattern of panniculitis and the histological presence of dermatitis, clinical presentation of lesions, dog breed and therapeutic outcomes were assessed. Australian shepherd dogs, Brittany spaniels, Dalmatians, Pomeranians and Chihuahuas were significantly over-represented, but correlations between inflammatory patterns of panniculitis and other histological and clinical factors were not identified. Based on the information available in medical records, 32 dogs (82.1%) had no concurrent systemic diseases identified. Four dogs had concurrent polyarthritis, which may be related to SNP through unknown mechanisms. This study identified several novel breed predilections for SNP; it failed to find any clear correlations with associated systemic diseases other than polyarthritis. The histological inflammatory pattern of SNP does not predict therapeutic outcome. © 2015 ESVD and ACVD.

  12. MRI findings of multiple focal nodular hyperplasia of the liver

    International Nuclear Information System (INIS)

    Wang Xin; Yu Qingtai; Jing Yu; Wang Haiyi; Pan Jingjing; Duan Weidong; Wang Dianjun; Ye Huiyi

    2010-01-01

    Objective: To assess the diagnostic value of MRI on multiple focal nodular hyperplasia (FNH) of the liver. Methods: MR images of 9 cases with pathological-confirmed multiple FNH were retrospectively analyzed. MRI features of the lesions were correlated with pathological findings. Results: Multiple FNH was considered in all these 9 cases. Among them, the primary diagnosis was FNH in 5, hepatic adenoma in 3 and fibrolamellar hepatocellular carcinoma in 1 case. A total of 31 lesions were detected in the 9 cases. On T 2 WI, 19 lesions presented slightly high-signal intensity, and the other 12 presented iso-signal intensity. On T 1 WI, 12 lesions presented slightly low-signal intensity, 7 presented iso-signal intensity, and the other 12 presented high-signal intensity. On opposed-phase, the signal intensity of 1 lesion dropped unevenly. After bolus injection of contrast agent Gd-DTPA, in hepatic arterial phase 18 lesions showed mild to marked heterogeneous enhancement, 11 showed marked homogeneous enhancement, 1 showed moderate ring-like enhancement, and the last one did not have obvious enhancement. In portal venous and delayed phase, all the lesions turned to iso- or slightly high-signal intensity gradually. Sixteen of 31 lesions presented central scar, which demonstrated mild star-like enhancement in delayed phase. Conclusion: Multiple FNH presented certain MRI features, which contributed to the preoperative diagnosis. (authors)

  13. Progressive nodular histiocytosis associated with eale′s disease

    Directory of Open Access Journals (Sweden)

    Abhilasha Williams

    2015-01-01

    Full Text Available Progressive nodular histiocytosis (PNH is a rare normolipemic macrophage disorder and belongs to a subgroup of non-Langerhans cell histiocytosis (LCHs which is characterized by a progressive course with no sign of spontaneous resolution but without systemic involvement. We report a 30-year-old gentleman who presented with skin lesions all over the body associated with gradual bilateral painless loss of vision. On examination, approximately 30 to 40, skin-colored, firm, non-tender papules and nodules were noted over the body especially on the face and trunk. A skin biopsy revealed a cellular tumor in the dermis composed of oval to spindle-shaped cells, positive for CD68 but negative for S-100, CD34, CD21, CD35 and HMB45, supporting a diagnosis of spindle cell histiocytic tumor. Ophthalmic examination revealed a generalized arteriolar attenuation in both eyes. He received Tab Imatinib 400 mg OD for 5 months followed by Tab Pazopanib 800 mg OD for 4 months and both the drugs were stopped due to lack of any response in the skin lesions. We report this case due to its rarity, characteristic clinical presentation, and its association with Eale′s disease. Primary treatment remains surgical excision of bothersome lesions and optimal systemic treatment is still unknown.

  14. Performance of the "if in doubt, cut it out" rule for the management of nodular melanoma.

    Science.gov (United States)

    Moscarella, Elvira; Lallas, Aimilios; Longo, Caterina; Zalaudek, Iris; Caccavale, Stefano; Gambardella, Alessio; Lupoli, Amalia; Alfano, Roberto; Argenziano, Giuseppe

    2017-07-01

    The recognition of nodular melanoma is clinically challenging, and the diagnostic accuracy of dermoscopy and confocal microscopy is lower than for superficial spreading melanoma. To test a management strategy consisting in the excision of any nodular lesion that cannot be confidently and precisely classified as a benign tumor after clinical and dermoscopic examination. Clinical and dermoscopic images of excised nodular lesions were retrospectively collected and evaluated. The evaluators were asked to record the level of diagnostic confidence for each lesion, by declaring if they were confident or doubtful about the given diagnosis. The NNE (number needed to excise) value was used to evaluate the efficacy of the proposed method. A total of 1,319 excised nodular lesions formed the study set. The NNE for any malignancy was 3.9 (634/164), while the NNE for melanoma was 13.2 (634/48). NNE for hypo and amelanotic melanoma was 27.3 (327/12). Excising doubtful nodular lesions seems to be an effective management strategy not to miss nodular melanoma, resulting in an acceptable rate of unnecessary excision of benign lesions.

  15. Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ji Young [Dept. of Oral and Maxillofacial Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Seong Gon; Choi, Hang Moon [School of Dentistry, Gangneung-Wonju National University, Gangneung (Korea, Republic of); Kim, Hyun Jung [Dept. of Anesthesiology and Pain Medicine, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2015-06-15

    Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence.

  16. Bilateral bony fusion around the supraspinatus muscle inducing muscle hypoplasia and shoulder pain.

    Science.gov (United States)

    Son, YeNa; Ryu, Kyung Nam; Jin, Wook; Park, Ji Seon; Park, So Young

    2017-03-01

    We describe the case of a 30-year-old man who developed chronic bilateral shoulder pain that relapsed and remitted over the course of 1 year. The patient was diagnosed with congenital shoulder fusion anomalies. The right shoulder showed anomalous accessory articulation between the distal third of the clavicle and the acromion along with normal articulation of the shoulder on CT. At the left shoulder, bony fusions were present between the distal portion of the clavicle, the acromion, and the coracoid process, and between the coracoid process, upper portion of the glenoid, and upper body of the scapula, which formed a bony canal and was responsible for hypoplasia of the supraspinatus muscle on CT and MRI. To our knowledge, this is the first description of such congenital shoulder anomalies with extreme bony fusion and is an illustrative example of how imaging may be used to differentiate fusion from other congenital abnormalities of the shoulder to aid diagnosis.

  17. Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report

    International Nuclear Information System (INIS)

    Song, Ji Young; Kim, Seong Gon; Choi, Hang Moon; Kim, Hyun Jung

    2015-01-01

    Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence

  18. Bilateral bony fusion around the supraspinatus muscle inducing muscle hypoplasia and shoulder pain

    Energy Technology Data Exchange (ETDEWEB)

    Son, YeNa; Jin, Wook; Park, So Young [Kyung Hee University Hospital at Gangdong, Department of Radiology, 892, Dongnam-ro, Gangdong-gu, Seoul (Korea, Republic of); Ryu, Kyung Nam; Park, Ji Seon [Kyung Hee University Hospital, Department of Radiology, 23 Kyunghee-daero, Dongdaemun-gu, Seoul (Korea, Republic of)

    2017-03-15

    We describe the case of a 30-year-old man who developed chronic bilateral shoulder pain that relapsed and remitted over the course of 1 year. The patient was diagnosed with congenital shoulder fusion anomalies. The right shoulder showed anomalous accessory articulation between the distal third of the clavicle and the acromion along with normal articulation of the shoulder on CT. At the left shoulder, bony fusions were present between the distal portion of the clavicle, the acromion, and the coracoid process, and between the coracoid process, upper portion of the glenoid, and upper body of the scapula, which formed a bony canal and was responsible for hypoplasia of the supraspinatus muscle on CT and MRI. To our knowledge, this is the first description of such congenital shoulder anomalies with extreme bony fusion and is an illustrative example of how imaging may be used to differentiate fusion from other congenital abnormalities of the shoulder to aid diagnosis. (orig.)

  19. An Unusual Presentation of Frontal Bony Defect with Pneumocephalus and its Management in an Elderly Patient

    Directory of Open Access Journals (Sweden)

    Shih-Tong Chen

    2015-03-01

    Full Text Available Pneumocephalus can be caused by neurosurgical procedures, endoscopic sinus surgery, craniofacial trauma, tumors of the skull base, frontal sinus cranialization, and can rarely occur spontaneously. The treatment options are conservative treatment, craniotomy, osteoplastic flap surgery of the frontal sinus, and endoscopic endonasal surgery. We herein present the case of a 61-year-old man with a frontal sinus bony defect with pneumocephalus caused by craniotomy who presented atypically with left facial cellulitis, followed by meningitis and seizures. This bony defect was successfully repaired with endoscopic modified Lothrop procedure (EMLP. At 18 months' follow-up after the surgery, neither obvious postoperative complications nor signs of pneumocephalus were noted. EMLP offered a less invasive, safer, and effective way to repair the frontal bony defect in our elderly patient.

  20. Patterns of congenital bony spinal deformity and associated neural anomalies on X-ray and magnetic resonance imaging

    OpenAIRE

    Trenga, Anthony P.; Singla, Anuj; Feger, Mark A.; Abel, Mark F.

    2016-01-01

    Purpose Congenital malformations of the bony vertebral column are often accompanied by spinal cord anomalies; these observations have been reinforced with the use of magnetic resonance imaging (MRI). We hypothesized that the incidence of cord anomalies will increase as the number and complexity of bony vertebral abnormalities increases. Methods All patients aged ?13 years (n?=?75) presenting to the pediatric spine clinic from 2003?2013 with congenital bony spinal deformity and both radiograph...

  1. Bony morphology of the hip in professional ballet dancers compared to athletes.

    Science.gov (United States)

    Mayes, Susan; Ferris, April-Rose; Smith, Peter; Garnham, Andrew; Cook, Jill

    2017-07-01

    To compare hip bony morphology between ballet dancers and a sporting control group and to determine the relationship with hip pain. Thirty-three professional ballet dancers and 33 age- and sex-matched athletes completed questionnaires, including the Copenhagen Hip and Groin Outcome Score (HAGOS), and underwent clinical testing and 3.0-T magnetic resonance imaging to measure acetabular coverage with lateral centre edge angles, femoral head-neck junction concavity with alpha angles at anterior and superior positions, femoral neck-shaft angles, and acetabular version angles. Bony morphological measures fell within normal ranges. Dancers had higher neck-shaft angles (dancers 134.6 ± 4.6°/athletes130.8 ± 4.7°, p = 0.002), lower acetabular version angles (13.5 ± 4.7°/17.1 ± 4.7°, p = 0.003), lower superior alpha angles (38.9 ± 6.9°/46.7 ± 10.6°, p ballet dancers have hip bony morphology that differentiates them from athletes. Hip pain correlated poorly with bony morphology. • Ballet dancers have hip bony morphology that may allow extreme hip motion. • Morphological parameter means fell within normal reference intervals in dancers. • Bony morphology correlates poorly with hip pain. • The risk of hip injury due to abnormal morphology requires prospective studies.

  2. Compromiso nodular hepático secundario a mieloma múltiple Nodular hepatic lesions secondary to multiple myeloma

    Directory of Open Access Journals (Sweden)

    Fernando J. Vázquez

    2010-08-01

    Full Text Available El mieloma múltiple (MM es una enfermedad maligna caracterizada por una proliferación clonal de células plasmáticas atípicas en la médula ósea, que produce una inmunoglobulina (Ig con estructura homogénea en la sangre y/o en la orina (cadenas livianas. El compromiso del parénquima hepático con masa ocupante en los pacientes con MM es excepcional. Describimos 3 casos clínicos confirmados histológicamente. La ecografía y la tomografía computarizada tienen una sensibilidad intermedia y las imágenes no son patognomónicas, por lo tanto es necesaria la confirmación a través de la biopsia. Se desconoce la implicancia pronóstica de este hallazgo.Multiple myeloma is characterized by the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. Myelomatous nodular lesions of the liver are infrequent. We describe 3 cases with histological confirmation and we review the bibliography.

  3. Melorheostosis of the hand with complicating bony spur formation and bursal inflammation: diagnosis and treatment

    International Nuclear Information System (INIS)

    Ameen, S.; Anderson, S.E.; Nagy, L.; Gerich, U.

    2002-01-01

    A 37-year old woman presented with intolerable pain associated with a slowly growing mass on the dorsum of the right hand. The radiographs were characteristic of melorheostosis involving the third and fourth metacarpals, with a cortical bony projection extending from the base of the third metacarpal eroding slightly into the fourth metacarpal, associated with bursal formation. Magnetic resonance imaging (MRI) demonstrated an inflamed bursal collection adjacent to the spur. This region corresponded to the patient's severe clinical, focal pain. To our knowledge, this is the first case report in which melorheostosis of the hand has been associated with bony spur formation and complicated by an inflamed bursa. (orig.)

  4. Embryonic vasculogenesis in nodular melanomas and tumour differentiation.

    Science.gov (United States)

    Iyengar, Bhanu; Singh, Avantika V

    2011-09-01

    The relationship of vasculogenic mimicry to pigment in nodular vertical growth phase [VGP] cutaneous melanomas is assessed in this study. 10 nodules each from 27 tumors, 15 pigmented and 12 amelanotic were sampled in proportion to the pigment level. Serial frozen and paraffin sections subjected to HE, Reticulin, PAS to assess the vascular pattern; Dopa Oxidase and Immunopositivity for HMB45, LN5 [laminin 5] & integrin[α(5)β(1)], and EM [electron microscopy] to identify Weibel-Palade bodies within endothelial cells. The vascular pattern, pigment and the immunopositivity was mapped to assess the percentage VM [vasculogenic sinusoids] vs INC [incorporated microvasculature]. In pigmented melanomas, INC from pre-existing stromal vessels is predominant. Amelanotic melanomas show embryonic vasculogenic mimicry, a self-propagating system of spaces within the sheets of tumors cells. Both INC and VM co-exist in tumors with both amelanotic and melanotic nodules. In areas with VM, loci of LN5 and α(5)β(1) integrin positive cells appear within the proliferating columns, positivity in these cells suggesting a switch to a more aggressive form. Irregular spaces appear lined by tumor cells, with initial hemopoeitic activity, coalesce and interlink into tubular networks. Spaces lined by tumor cells extend into an intricate network which then connects with the angiogenetic system. The tumor cells lining the vasculogenic spaces are positive for LN5, α(5)β(1) integrin. Statistically, INC is significantly higher in pigmented melanomas, whereas amelanotic melanomas show significantly higher VM. Pigmentation is correlated positively with INC and negatively with VM. INC and VM are negatively correlated with each other.

  5. Effectiveness of Radioiodine Treatment for Toxic Nodular Goiter

    Directory of Open Access Journals (Sweden)

    Hatice Şakı

    2015-10-01

    Full Text Available Objective: The aim of this retrospective study is to evaluate the treatment outcomes in patients with toxic nodular goiter (TNG that received radioiodine treatment (RAIT and to determine the influence of age, gender, nodule size, I-131 dose, underlying etiology and antithyroid drugs on the outcomes of RAIT. Methods: Two hundred thirty three patients (mean 64±10 years old with TNG that received RAIT were included in the study. Treatment success was analyzed according to demographic (age and gender and clinical data (thyroid function tests before and after RAIT, thyroid sonography and scintigraphy, I-131 dose, antithyroid drugs. A fixed dose of 555 MBq was administered to patients with nodules smaller than 2 cm in diameter and of 740 MBq to patients with nodules larger than 2 cm. Hyperthyroidism treatment success was defined as achieving hypothyroidism or euthyroidism six months after RAIT. Results: In our study, the cure rate was 93.9% six months after RAIT. Hypothyroidism was observed in 74 (31.7% patients, and euthyroidism was achieved in 145 (62.2% patients while 14 (6% patients remained in hyperthyroid state. Age and gender did not affect treatment outcomes. No correlation was found between underlying etiology or antithyroid drugs and therapeutic effectiveness. The effectiveness of RAIT was better in patients with nodules smaller than 2 cm. Conclusion: We observed that high cure rates were obtained in patients with TNG with 555 MBq and 740 MBq doses of I-131. While nodule diameter and RAI dose are important factors for treatment efficacy; age, gender, underlying etiology and antithyroid drugs do not affect the outcome of RAIT.

  6. Toxic nodular goiter and cancer: a compelling case for thyroidectomy.

    Science.gov (United States)

    Smith, J Joshua; Chen, Xi; Schneider, David F; Nookala, Ratnam; Broome, James T; Sippel, Rebecca S; Chen, Herbert; Solorzano, Carmen C

    2013-04-01

    Recent American Thyroid Association guidelines call for thyroidectomy or (131)I (Recommendation 31) in managing hyperthyroidism due to toxic nodular goiter (TNG). Concern for concomitant malignancy favors surgery. A 3 % thyroid cancer incidence in TNG patients has been reported, yet recent studies suggest this rate is underestimated. This multi-institutional study examined cancer incidence in TNG patients referred to surgery. Patients referred for thyroidectomy at three tertiary-care institutions were included (2002-2011). Patients with concurrent indeterminate or malignant diagnosis by fine-needle aspiration (FNA) were excluded. Cancer incidence in TNG patients was determined. Fisher's exact and chi-square tests and nonparametric t tests were used. Among 2,551 surgically treated patients, 164 had TNG (6.4 %). Median age at presentation was 49.7 years, and 86 % were female. Overall cancer incidence was 18.3 % (30 of 164), and rates were not significantly different between institutions. A significantly greater cancer rate was noted in toxic multinodular goiter versus single toxic nodule patients (21 vs. 4.5 %, P  0.05). No significant cancer association was noted with age, preoperative dominant nodule size, lymphocytic thyroiditis or preoperative FNA (P > 0.05). These data demonstrate a higher than expected incidental cancer rate in TNG patients compared to historical reports (18.3 vs. 3 %). This higher cancer incidence may alter the risk/benefit analysis regarding TNG treatment. This information should be provided to TNG patients before decision making regarding treatment.

  7. Feasibility of Sentinel Lymph Node Detection in Nodular Thyroid Disease

    International Nuclear Information System (INIS)

    Abdalla, H.M.

    2006-01-01

    Background and purpose: Sentinel lymph node biopsy has been proven to be successful and accurate in predicting the nodal status in melanoma and breast cancer. Occult lymph node metastases are common in well differentiated thyroid cancer (WDTC). Although the prognostic significance of these occult lymph node metastases remains controversial, identifying these patients may help direct therapy. The purpose of the study was to assess the technical feasibility and the safety of the sentinel lymph node biopsy in uni-nodular thyroid disease. Methods: Patients of previously untreated benign solitary thyroid nodule, diagnosed preoperatively by fine needle aspiration cytology without any palpable cervical lymph node were prospectively studied. The nodule was injected with iso sulfan blue vital dye. Blue stained lymphatics were traced. Then, hemi thyroidectomy was per-formed. Results: A total of 30 patients underwent sentinel lymph node biopsy; lymph tics were observed in 23 patients and sentinel lymph nodes were found in 18. In 5 patients, blue stained lymphatics were traced to the outside of the central compartment but no sentinel lymph node was identified. Sentinel lymph nodes were located in the central compartment in 14 cases, in the lateral compartment in 3 cases and in one patient 2 sentinel lymph nodes were found in both the central and the lateral compartments. Overall detection of sentinel lymph nodes was possible in 60% of cases. There were no intra or postoperative complications. Conclusions: The role of sentinel lymph node biopsy has yet to be determined in the thyroid setting. Certainly the technique can be performed safely, but its accuracy needs further refinement and investigation on larger series of patients before it can be recommended in the routine management of thyroid neoplasia. Key Words: Sentinel node - Biopsy - Solitary thyroid nodule

  8. Duodenal nodularity in children: A clinical and pathologic study of 17 cases

    Directory of Open Access Journals (Sweden)

    Çaltepe Dinler Gönül

    2011-01-01

    Full Text Available Aims: Duodenal nodularity is an uncommon endoscopic appearance of numerous visible mucosal nodules in the proximal duodenum. In this retrospective study we aimed to determine the clinical significance and histopathologic features of duodenal nodularity in children. Materials and Methods: The medical records of the patients who were defined to have duodenal nodularity by endoscopy were reviewed. Statistical Analysis Used: The data were expressed as mean ± SD and percentages (%. Results: Seventeen patients with endoscopically defined duodenal nodularity were chosen. The mean age at diagnosis was 12.1 years (range: 6-17 years, 9 males. Abdominal pain (47% was the most common clinical symptom and antral nodularity (41% was the most common endoscopic finding in children with duodenal nodularity. Histopathologic evaluation of duodenal nodules revealed chronic inflammation in all patients, increased intercryptal and intraepithelial numbers of eosinophils in 70.5%, and villous atrophy in 47% of patients. Giardia infestation was demonstrated in 6 patients by histologic examination and/or Giardia lamblia-specific antigen positivity in stools. The clinical diagnoses of the patients have shown variations, such as celiac disease, giardiasis, secretory IgA deficiency, and Helicobacter pylori gastritis, and some of them were associated with the others. Conclusions: Although the endoscopic appearance is similar, clinical spectrum and pathologic features are not so similar and there are no specific histomorphologic findings for nodularity. The most demonstrative findings we observed in children were increased lymphocyte and/or eosinophil infiltration in the duodenal mucosa. We suggested that care should be taken in the evaluation of microbiological and immunologic etiologies causing this prominent inflammatory reaction.

  9. Correlation between bony changes measured with cone beam computed tomography and clinical dysfunction index in patients with temporomandibular joint osteoarthritis.

    Science.gov (United States)

    Su, Naichuan; Liu, Yan; Yang, Xianrui; Luo, Zhiqiang; Shi, Zongdao

    2014-10-01

    To investigate the correlation between clinical dysfunction index (Di) and condylar bony changes, glenoid fossa bony changes and joint space changes. Clinical data and cone beam computed tomography (CBCT) images of 240 patients with temporomandibular joint osteoarthritis (TMJ OA) were analyzed. The patients were assigned a score of Helkimo's clinical Di ranging from 1 to 25 and thereafter divided into 3 groups by the degree of Helkimo's Di. The condylar bony changes observed with CBCT were graded by the classification method of Koyama et al. Glenoid fossa bony changes and joint space changes were both classified as "positive" or "negative". Spearman's rank correlation test was used to correlate the score or degree of Helkimo's Di with the maximum condylar bony changes, glenoid fossa bony changes, and joint space changes. There was a significant correlation between the Helkimo's Di score and the maximum condylar bony changes (P ≤ 0.0001) and glenoid fossa bony changes (P ≤ 0.0001), and there was a poor correlation between the Helkimo's Di score and joint space changes (P = 0.184). Furthermore, there was a significant correlation between the degree of Helkimo's Di and the maximum condylar bony changes (P ≤ 0.0001) and glenoid fossa bony changes (P ≤ 0.0001), but there was a poor correlation between the degree of Helkimo's Di and joint space changes (P = 0.346). Both the score and degree of Helkimo's Di were highly correlated with maximum condylar changes and glenoid fossa bony changes, but not with joint space changes. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  10. Boni Mores and Consent for Child Research in South Africa | Strode ...

    African Journals Online (AJOL)

    The article concludes by stating that simply requiring proxy consent for non therapeutic health research with children is insufficient as it cannot always be assumed that proxy consenters will act in the best interests of the child. Thus the boni mores principle acts as a limit on autonomy in order to protect the child participant.

  11. Syngnathia-congenital unilateral bony fusion of the maxilla and mandible

    Directory of Open Access Journals (Sweden)

    G V Ramachandra Reddy

    2008-01-01

    Full Text Available Congenital disorders involving orofacial region represents approximately 20% of all birth defects. Out of these disorders, congenital bony fusion of the maxilla and mandible (syngnathia is rare. Usually syngnathia is associated with other anomalies and syndromes. This case report presents a unilateral fusion of maxilla and mandible with no other anomalies.

  12. The bony manifestation of Rickets. A case report | Leon | Journal of ...

    African Journals Online (AJOL)

    This paper describes a case of the bony manifestation of Rickets. Although vitamin D deficiency has become less common, Rickets still is seen among the Eritrean pediatric population. Rickets is an entity in which mineralization is decreased at the level of the growth plates, resulting in growth retardation and delayed ...

  13. Natural resources utilization by the Aweer in Boni-lungi and Dodori ...

    African Journals Online (AJOL)

    A study was conducted to record the utilization of Boni-Lungi and Dodori National Reserves by the Aweer community. Results indicate the procuring of a wide gamut of provisional, regulatory, cultural and supportive services from these reserves by the community ranging from wood forest products utilized in construction to ...

  14. Value of diffusion weighted MRI in differentiating benign from malignant bony tumors and tumor like lesions

    Directory of Open Access Journals (Sweden)

    Samir Zaki Kotb

    2014-06-01

    Conclusion: DWI has been proven to be highly useful in the differentiation of benign, malignant bone tumors and tumor like bony lesions. Measurement of ADC values improves the accuracy of the diagnosis of bone tumors and tumor like lesions. Moreover, measurement of ADC values can be used in the follow up of tumors and their response to therapy.

  15. Comparison of megavoltage position verification for prostate irradiation based on bony anatomy and implanted fiducials

    NARCIS (Netherlands)

    Nederveen, Aart J.; Dehnad, Homan; van der Heide, Uulke A.; van Moorselaar, R. Jeroen A.; Hofman, Pieter; Lagendijk, Jan J. W.

    2003-01-01

    PURPOSE: The patient position during radiotherapy treatment of prostate cancer can be verified with the help of portal images acquired during treatment. In this study we quantify the clinical consequences of the use of image-based verification based on the bony anatomy and the prostate target

  16. [Inconformity between soft tissue defect and bony defect in incomplete cleft palate].

    Science.gov (United States)

    Zhou, Xia; Ma, Lian

    2014-12-01

    To evaluate the inconformity between soft tissue defect and bony defect by observing the cleft extent of palate with complete secondary palate bony cleft in incomplete cleft palate patient. The patients with incomplete cleft palate treated in Hospital of Stomatology Peking University from July 2012 to June 2013 were reviewed, of which 75 cases with complete secondary palate bony cleft were selected in this study. The CT scan and intraoral photograph were taken before operation. The patients were classified as four types according to the extent of soft tissue defect. Type 1: soft tissue defect reached incisive foremen region, Type 2 was hard and soft cleft palate, Type 3 soft cleft palate and Type 4 submucous cleft palate. Type 1 was defined as conformity group (CG). The other three types were defined as inconformity group (ICG) and divided into three subgroups (ICG-I), (ICG-II) and (ICG-III). Fifty-seven patients were in ICG group, and the rate of inconformity was 76% (57/75). The percentage of ICG-I, ICG-II and ICG-III was 47% (27/57), 23% (13/57) and 30% (17/57), respevtively. There are different types of soft tissue deformity with complete secondary palate bony cleft. The inconformity between soft tissue and hard tissue defect exits in 3/4 of isolated cleft palate patients.

  17. Computer-guided technique evaluation of the bony palate for planning individual implant placement.

    Science.gov (United States)

    Cagimni, Pinar; Govsa, Figen; Ozer, Mehmet Asim; Kazak, Zuhal

    2017-05-01

    Different clinical problems may require a surgical approach to the dental arch, such as dentofacial orthopedics, implant-supported dental prothesis, maxillary orthodontics protraction, removable appliances, and posttraumatic dental reconstruction. The aim of this study is to analyze the dental arch size and type for supporting individual dental protheses. In this study, the reference measurements on the length of the bony palate, maxillary intercanine width, maxillary intermolar width, and the ratio of the maxillary to the palatinal surface were studied in 120 bony palates using a computer software program. The average length of the bony palate, maxilla, and palatine was measured as 104.4 ± 30.3, 40.05 ± 4.05, and 15.00 ± 3.03 mm, respectively. The right and left sides of average width of intermaxillary distances were measured as 13.75 ± 1.50 and 12.51 ± 1.50 mm, respectively. The average width of intermolar distance was calculated as 19.82 ± 1.61 mm (right side) and 18.89 ± 1.69 mm (left side), respectively. The maxillary dentitions were classified as square (17%), round-square (63.5%), round (14.4%), and round V-shaped arches (5.1%). The round-square ones showed no prominent principal component. Among the maxillary arches, the round arches were characterized by small values and round V-shaped ones with the largest values. Asymmetry between the right and the left bony palate was observed. The areas with equal bony palate on both sides were present in 64.4% of the cases, and in 33.1% of the cases, bony palate was dominant on the right. The primary principle in reconstructive treatment should be describing geometrical forms and mathematical details of the bony palate. Three-dimensional reference values relative to the dental arch may increase the success of individual treatment of surgical procedures and reduce possible complications. With the help of certain software, this research has made possible to investigate the variability of the

  18. Morphology filter bank for extracting nodular and linear patterns in medical images.

    Science.gov (United States)

    Hashimoto, Ryutaro; Uchiyama, Yoshikazu; Uchimura, Keiichi; Koutaki, Gou; Inoue, Tomoki

    2017-04-01

    Using image processing to extract nodular or linear shadows is a key technique of computer-aided diagnosis schemes. This study proposes a new method for extracting nodular and linear patterns of various sizes in medical images. We have developed a morphology filter bank that creates multiresolution representations of an image. Analysis bank of this filter bank produces nodular and linear patterns at each resolution level. Synthesis bank can then be used to perfectly reconstruct the original image from these decomposed patterns. Our proposed method shows better performance based on a quantitative evaluation using a synthesized image compared with a conventional method based on a Hessian matrix, often used to enhance nodular and linear patterns. In addition, experiments show that our method can be applied to the followings: (1) microcalcifications of various sizes in mammograms can be extracted, (2) blood vessels of various sizes in retinal fundus images can be extracted, and (3) thoracic CT images can be reconstructed while removing normal vessels. Our proposed method is useful for extracting nodular and linear shadows or removing normal structures in medical images.

  19. Decreased tumor-infiltrating lymphocytes in nodular melanomas compared with matched superficial spreading melanomas.

    Science.gov (United States)

    Lin, Richard L; Wang, Thomas J; Joyce, Cara J; Mihm, Martin C; Murphy, George F; Lian, Christine G; Lin, Jennifer Y

    2016-10-01

    Melanoma causes over 9000 deaths annually in the USA. Among its subtypes, nodular melanoma leads to a disproportionate number of fatalities compared with superficial spreading melanoma, the most common subtype. Recent breakthroughs in melanoma research have indicated a strong connection between melanoma virulence and the immune system. We hypothesize that the aggression of nodular melanoma may, in part, be because of decreased recognition by the immune system, as represented by a decreased presence of tumor-infiltrating lymphocytes (TILs), compared with its superficial spreading counterpart. Indeed, TILs on a primary melanoma have been used as a marker for immune response and have prognostic value for survival and sentinel lymph node status. After matching melanoma cases by age, sex, and Breslow thickness, we found significantly fewer TILs in nodular melanomas than in superficial spreading melanomas. This association was prominent in thin (≤2 mm) melanomas and was no longer significant in thick (>2 mm) melanomas. In addition, this difference in TILs was only present in men and not in women. Our finding suggests that nodular melanomas are more frequently associated with absent TILs, providing an avenue for further investigation into differences in immunogenicity of the primary melanoma and whether they underlie the unique virulence of nodular melanoma.

  20. First record of eocene bony fishes and crocodyliforms from Canada's Western Arctic.

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    Jaelyn J Eberle

    Full Text Available BACKGROUND: Discovery of Eocene non-marine vertebrates, including crocodylians, turtles, bony fishes, and mammals in Canada's High Arctic was a critical paleontological contribution of the last century because it indicated that this region of the Arctic had been mild, temperate, and ice-free during the early - middle Eocene (∼53-50 Ma, despite being well above the Arctic Circle. To date, these discoveries have been restricted to Canada's easternmost Arctic - Ellesmere and Axel Heiberg Islands (Nunavut. Although temporally correlative strata crop out over 1,000 km west, on Canada's westernmost Arctic Island - Banks Island, Northwest Territories - they have been interpreted as predominantly marine. We document the first Eocene bony fish and crocodyliform fossils from Banks Island. PRINCIPAL FINDINGS: We describe fossils of bony fishes, including lepisosteid (Atractosteus, esocid (pike, and amiid, and a crocodyliform, from lower - middle Eocene strata of the Cyclic Member, Eureka Sound Formation within Aulavik National Park (∼76°N. paleolat.. Palynology suggests the sediments are late early to middle Eocene in age, and likely spanned the Early Eocene Climatic Optimum (EECO. CONCLUSIONS/SIGNIFICANCE: These fossils extend the geographic range of Eocene Arctic lepisosteids, esocids, amiids, and crocodyliforms west by approximately 40° of longitude or ∼1100 km. The low diversity bony fish fauna, at least at the family level, is essentially identical on Ellesmere and Banks Islands, suggesting a pan-High Arctic bony fish fauna of relatively basal groups around the margin of the Eocene Arctic Ocean. From a paleoclimatic perspective, presence of a crocodyliform, gar and amiid fishes on northern Banks provides further evidence that mild, year-round temperatures extended across the Canadian Arctic during early - middle Eocene time. Additionally, the Banks Island crocodyliform is consistent with the phylogenetic hypothesis of a Paleogene divergence

  1. First record of eocene bony fishes and crocodyliforms from Canada's Western Arctic.

    Science.gov (United States)

    Eberle, Jaelyn J; Gottfried, Michael D; Hutchison, J Howard; Brochu, Christopher A

    2014-01-01

    Discovery of Eocene non-marine vertebrates, including crocodylians, turtles, bony fishes, and mammals in Canada's High Arctic was a critical paleontological contribution of the last century because it indicated that this region of the Arctic had been mild, temperate, and ice-free during the early - middle Eocene (∼53-50 Ma), despite being well above the Arctic Circle. To date, these discoveries have been restricted to Canada's easternmost Arctic - Ellesmere and Axel Heiberg Islands (Nunavut). Although temporally correlative strata crop out over 1,000 km west, on Canada's westernmost Arctic Island - Banks Island, Northwest Territories - they have been interpreted as predominantly marine. We document the first Eocene bony fish and crocodyliform fossils from Banks Island. We describe fossils of bony fishes, including lepisosteid (Atractosteus), esocid (pike), and amiid, and a crocodyliform, from lower - middle Eocene strata of the Cyclic Member, Eureka Sound Formation within Aulavik National Park (∼76°N. paleolat.). Palynology suggests the sediments are late early to middle Eocene in age, and likely spanned the Early Eocene Climatic Optimum (EECO). These fossils extend the geographic range of Eocene Arctic lepisosteids, esocids, amiids, and crocodyliforms west by approximately 40° of longitude or ∼1100 km. The low diversity bony fish fauna, at least at the family level, is essentially identical on Ellesmere and Banks Islands, suggesting a pan-High Arctic bony fish fauna of relatively basal groups around the margin of the Eocene Arctic Ocean. From a paleoclimatic perspective, presence of a crocodyliform, gar and amiid fishes on northern Banks provides further evidence that mild, year-round temperatures extended across the Canadian Arctic during early - middle Eocene time. Additionally, the Banks Island crocodyliform is consistent with the phylogenetic hypothesis of a Paleogene divergence time between the two extant alligatorid lineages Alligator

  2. Association between condylar morphology and changes in bony microstructure and subsynovial inflammation in experimental temporomandibular joint arthritis

    DEFF Research Database (Denmark)

    Kristensen, Kasper Dahl; Hauge, Ellen Margrethe; Dalstra, Michel

    2010-01-01

    Association between condylar morphology and changes in bony microstructure and subsynovial inflammation in experimental temporomandibular joint arthritis. 86. Congress of the European Orthodontic Society, Slovenien, 2010.......Association between condylar morphology and changes in bony microstructure and subsynovial inflammation in experimental temporomandibular joint arthritis. 86. Congress of the European Orthodontic Society, Slovenien, 2010....

  3. Impingement-type bony morphology was related to cartilage defects, but not pain in professional ballet dancers' hips.

    Science.gov (United States)

    Mayes, Susan; Smith, Peter; Cook, Jill

    2018-03-03

    Professional ballet dancers may have hip bony morphology that predisposes them to cartilage or labral injury. However, the relationship between bony morphology and pathology has not been investigated in ballet. This study investigates associations between bony morphology, chondrolabral defects and hip pain in ballet dancers. Cross-sectional study. 33 male and female professional ballet dancers, (mean age 27 years (range 19-39)), completed questionnaires with hip pain measured on a visual analogue scale; and underwent 3.0-T magnetic resonance imaging (3T MRI) to measure lateral centre edge angles (LCEA), alpha angles in the anterior and superior position, femoral neck-shaft angles (NSA) and acetabular version angles; and to detect acetabular labral tear and articular cartilage defects. Seventeen dancers (51.5%) had impingement-type (alpha angle>50.5° or acetabular version 20°) and 19 (58%) had instability-type (LCEA135°) bony morphology. Cartilage defect prevalence was higher in dancers with impingement-type bony morphology (n=14) compared to those without impingement-type morphology (n=4, p=0.001). There was no relationship between instability-type bony morphology and cartilage defects (p>0.05). There was no relationship between labral tears and bony morphology (p>0.05). Neither chondrolabral pathology nor any morphological feature were associated with hip pain (p>0.05 for all). Impingement-type bony morphology was related to cartilage defects, but not labral tear. Hip pain was not associated with pathology or bony morphology. Longitudinal studies are warranted to determine if bony features, such as cam morphology, acetabular retroversion or anteversion, are precursors to symptomatic hip joint injury or osteoarthritis. Copyright © 2018 Sports Medicine Australia. All rights reserved.

  4. Association of Helicobacter pylori infection with nodular antritis and follicular gastritis

    Directory of Open Access Journals (Sweden)

    Tomašević Ratko

    2006-01-01

    Full Text Available Introduction. Helicobacter pylori (H. pylori infection is known to be the must common cause of chronic gastritis having some endoscopic and pathologic characteristies as determinated by the Sydney System for Gastritis Classification. The aim of our case report was to point out the relationship between an endoscopic finding of nodular antritis and the presence of H. pylori infection and active chronic gastritis. Case report. Our patient underwent upper gastrointestinal endoscopy for dyspeptic complaints and was diagnosed as having nodular antritis, but also underwent urease test and hystopathologic examination of antral mucosa, to determine the presence and density of H. pylori infection and the presence and severity of gastritis. After a course of anti H. pylori treatment, dyspepsia improved and new biopsy specimens obtained two months and six months afterwards revealed no pathological findings. Conclusion. The case report supported the association of H. pylori infection of lymphoid follicles with nodular gastric mucosis.

  5. Focal nodular hyperplasia of the liver: The role of Nuclear Medicine

    International Nuclear Information System (INIS)

    Von Wenzel, K.S.; Ellmann, A.; Rubow, S.M.

    2002-01-01

    Focal nodular hyperplasia (FNH) is a rare benign hepatic tumour of unknown etiology. Clinically it is described in middle aged females, but it can occur at any age and has been described in children and males. Usually these tumours are asymptomatic and are detected incidentally during ultrasonographic or other diagnostic examinations or at autopsy. FNH may however present with vague or even severe abdominal pain. Histologically a FNH is composed of Kupffer cells, hepatocytes, bile duct elements and fibrous connective tissue. Other types of benign hepatic tumours like hepatic adenomas (HA) need to be distinguished from FNH, as their management differs. Two patients recently presented at Windhoek Hospital with abdominal pain. In both cases Nuclear Medicine investigations, namely Tc-99m colloid liver scintigraphy and hepatobiliary scanning with Tc-99m DISIDA, aided in the diagnosis of focal nodular hyperplasia. This poster will demonstrate the value of Nuclear Medicine investigations in the evaluation of patients with focal nodular hyperplasia

  6. The clinical application of percutaneous auto-biopsy of small lung nodular under CT-Guided

    International Nuclear Information System (INIS)

    Zhou Yuanmin; Ye Genxin; Zhang Chenghui; Wang Yu; Chen Wei

    2008-01-01

    Objective: To evaluated the clinical value of technology of petcutaneous auto-biopsy of small lung nodular under CT- Guide. Methods: 44 cases of small single lung nodular were underwent biopsy with 20G auto-biopsy needle under CT guidance. All cases underwent pathological diagnosis. Results: All 44 cases were punctured successfully. 41 cases were succeeded in first puncturation. The success ratio was 93.02%. Other 3 cases needed second puncturation. 39 of 44 cases pathological diagnosis were malignant. Only 1 case could not be diagnosed. 6 patients had lightly pneumatothorax after biopsy. 10 cases had mild pneumonorrhagia after biopsy. 2 of them had haemptysis. All cases had no complication such as infection, needle track implantation. Conclusion: The technology of CT Guidance auto-biopsy of small lung nodular is safe and effective; it has extreme diagnostic ratio and less complication. (authors)

  7. Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma with a Nodular Opacity: Report of a Case.

    Science.gov (United States)

    Yoshino, Naoyuki; Hirata, Tomomi; Takeuchi, Chie; Usuda, Jitsuo; Hosone, Masaru

    2017-01-01

    Herein, we describe our experience in treating a case of primary pulmonary mucosa-associated lymphoid tissue lymphoma detected as a nodular opacity. A 79-year-old man was referred to our hospital. Computed tomography showed a nodular opacity measuring 20 mm in diameter with regular margins in segment 5 of the right middle lobe of the lung. Although the bronchoscopic brush cytology result was class III, the patient was tentatively diagnosed with suspected mucosa-associated lymphoid tissue lymphoma. A thoracoscopic right middle lobectomy was performed. The pathological findings showed nodular proliferation of small to medium-sized, mature-appearing atypical lymphoid cells, lymphoepithelial lesions, and vague follicles suggesting follicular colonization in some areas. The patient was diagnosed with low-grade small B-cell lymphoma and mucosa-associated lymphoid tissue lymphoma. He has remained well to date, 23 months after surgery, without evidence of recurrence.

  8. Intra-articular Nodular Fasciitis: An Unexpected Diagnosis for a Joint Lesion: A Case Report

    Directory of Open Access Journals (Sweden)

    MF Michelle Chan

    2014-07-01

    Full Text Available Pathological lesions in and around a joint can arise from underlying dermis, subcutis, deep muscle, bone or synovium. Clinical presentation can include joint pain, joint swelling, palpable masses and mechanical restriction. Whilst giant cell tumour of tendon sheath, pigmented villonodular synovitis, synovial chondromatosis, lipoma arborescens, juxta articular myxomas and inflammatory arthritis are the better-known conditions of the joint. Intra-articular nodular fasciitis, on the other hand, is less well recognized both clinically and radiologically. It is rarely seen in routine practice and is only described in case reports in the literature. Due to the non-specific clinical and radiological findings as well as the unfamiliarity with the entity, the diagnosis of intra-articular nodular fasciitis is usually clinched only after histological examination. We present a case of intra-articular nodular fasciitis arising in the knee joint which was not suspected clinically or radiologically.

  9. Nodular hidradenocarcinoma on the scalp of a young woman: case report and review of literature.

    Science.gov (United States)

    Ohta, Masayoshi; Hiramoto, Michiaki; Fujii, Miki; Togo, Takeshi

    2004-09-01

    Nodular hidradenocarcinoma was first reported as clear-cell eccrine carcinoma by Keasby and Hadley in 1954 (Cancer 1954;7:934-52) and rare malignant tumor. Several synonyms and related terms for nodular hidradenocarcinoma have appeared in the literature. They have potential for uncontrollable local recurrence, tend to metastasize, and often cause death. Most cases have been reported in the pathology literature with limited clinical information. We report a 27-year-old woman with nodular hidradenocarcinoma on the scalp. The management of rare cases is not well defined. In our case, she was only treated with a wide local excision, and no recurrence was observed 2 years after excision. Most authors have concluded that early wide surgical excision of the tumor is the treatment of choice. The efficiency of adjuvant therapy generally has not established.

  10. Nodular melanoma presenting with rapid progression and widespread metastases: a case report

    Directory of Open Access Journals (Sweden)

    Erkurt Mehmet

    2009-02-01

    Full Text Available Abstract Introduction Melanoma is responsible for 1% to 2% of all cancer deaths around the world. Nodular melanoma often carries a poor prognosis because of no prodromal radial growth phase, early distant metastasis and significant tumor volume. Case presentation We present a case of progressive melanoma. A 51-year-old man was admitted to our hospital with dyspnea and skin lesions. These were multiple, dark colored, firm, and nodular and varied in size. He was diagnosed with melanoma. Temozolomide was administered, but he died of respiratory failure within a week after diagnosis. Conclusion Nodular melanoma tends to spread rapidly and eventually metastasize to vital organs. It may be fatal within months of recognition.

  11. Nodular Gastritis and Pathologic Findings in Children and Young Adults with Helicobacter pylori Infection

    Science.gov (United States)

    Koh, Hong; Noh, Tae-Woong; Baek, Seoung-Yon

    2007-01-01

    Purpose The aim of this study was to investigate the pathologic characteristics of nodular gastritis in children and young adults infected with Helicobacter pylori (H. pylori). Materials and Methods A total of 328 patients were enrolled in this study, and the diagnosis of H. pylori infection was done with gastroduodenal endoscopy concomitant with a CLO™ test and pathologic analysis of the biopsy specimens. Diagnoses of normal, superficial gastritis, nodular gastritis, and peptic ulcer disease were made from the gastroduodenal endoscopic findings. The density of H. pylori organisms in the gastric mucosa was rated as normal, mild, moderate, or marked. The pathologic findings of nodular gastritis were based on the histopathologic findings of inflammation, immune activity, glandular atrophy and intestinal metaplasia. Each of these findings was scored as either normal (0), mild (1), moderate (2), or marked (3) according to the updated Sydney system and using visual analog scales. The gastritis score was the sum of the four histopathologic scores. Results In this study, nodular gastritis (50.6%) was most common, and mild density (51.5%) H. pylori infection was also common upon microscopic examination. Intestinal metaplasia occurred in 9 patients (2.7%). Conclusion Logistic regression revealed a significant increase in the incidence of nodular gastritis with gastritis score (p = 0.008), but not an association with sex, age, or H. pylori density. Gastritis score was the only significant factor influencing the occurrence of nodular gastritis. Intestinal metaplasia, which was originally thought to be a pre-malignant lesion, occurred in 2.7% of the patients with H. pylori infection. PMID:17461522

  12. Is confocal microscopy a valuable tool in diagnosing nodular lesions? A study of 140 cases.

    Science.gov (United States)

    Longo, C; Farnetani, F; Ciardo, S; Cesinaro, A M; Moscarella, E; Ponti, G; Zalaudek, I; Argenziano, G; Pellacani, G

    2013-07-01

    Nodular lesions pose diagnostic challenges because nodular melanoma may simulate all kinds of melanocytic and nonmelanocytic lesions. Reflectance confocal microscopy (RCM) is a novel technique that allows visualization of the skin at nearly histological resolution although limited laser depth penetration hampers visualization of the deep dermis. We sought to assess whether the diagnostic accuracy of RCM was comparable to histopathology for the diagnosis of nodular lesions, and to identify possible limitations of this technique. We retrospectively evaluated 140 nodules by means of RCM while blinded from the histopathological diagnosis. At the end of the study the patient codes were broken and the evaluations were matched with histopathological diagnosis before performing statistical analysis. The study consisted of 140 nodular lesions (23 'pure' nodular melanomas, nine melanoma metastases, 28 BCCs, six invasive SCCs, 32 naevi, 14 seborrhoeic keratoses, 17 dermatofibromas, five vascular lesions and six other lesions). RCM correctly diagnosed 121 of 140 lesions (86.4%); eight of 140 (5.7%) lesions revealed discordance between histopathology and confocal microscopy. Eight of the 140 (5.7%) cases were not evaluable by means of RCM due to the presence of ulceration or hyperkeratosis and three cases showed a nonspecific pattern. Interestingly, confocal microscopy reached a 96.5% sensitivity and 94.1% specificity (area under curve 0.970) (95% CI 0.924-1.015) (P melanoma. The study is retrospective and lesions were not included on the basis of their diagnostic difficulty. Despite the limited laser depth penetration of RCM, this imaging tool represents an effective instrument in diagnosing nodular lesions; however, for fully ulcerated lesions or when a marked hyperkeratosis is present, biopsy should always be performed. Prospective studies on difficult-to-diagnose nodules should be performed to analyse further the pros and cons of RCM in skin cancer diagnosis. © 2013 The

  13. Nodular hidradenoma: A rare diagnosis to keep in mind in differential diagnosis of dermal nodules

    Directory of Open Access Journals (Sweden)

    Seval Doğruk Kaçar

    2014-12-01

    Full Text Available Nodular hidradenoma is a rare benign tumor of skin appendages. It mainly occurs in adults with a slight female predominance. Typical lesions are localized in the scalp, face and the upper extremities. Clinically it presents as a slowly progressive, solitary, hard, mobile dermal and subcutaneous nodule. Total surgical excision is suggested due to the risk of malignant transformation. We, herein, present a 60-year-old male patient whose slow growing subcutaneous nodule on his back was diagnosed as nodular hidradenoma after histopathologic examination.

  14. Giant Solitary Nodular Trichoepithelioma: A Case Report and Review of Literature

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    Sunder Goyal

    2012-02-01

    Full Text Available A giant solitary nodular trichoepithelioma (GST is a rare trichogenic tumor, which may present as a pigmented lesion. A 45-year-old female was diagnosed as having a giant solitary nodular trichoepithelioma on her right forearm. About 11 cases have been reported in literature. Our case is the 2nd largest of all reported cases and, so far, GST of the forearm has not been reported in literature. The recognition of GST is important because of its close resemblance to basal cell carcinoma and other skin adnexal tumors, both clinically and histopathologically. [Arch Clin Exp Surg 2012; 1(1.000: 58-60

  15. Focal nodular hyperplasia in a child with hemihypertrophy and multiple cutaneous vascular malformations.

    Science.gov (United States)

    Al-Attar, M; Verma, R; Shannon, R S; McKeever, P A; Rickett, A

    2004-03-01

    A case of focal nodular hyperplasia of the liver occurring in a 9-year-old girl with musculoskeletal hemihypertrophy and multiple cutaneous capillary haemangiomata is described. The child presented because of limb length discrepancy and was found to have a large mass in the liver. Imaging showed a mass of similar characteristics to normal liver tissue. Prominent vascular supply to the liver was also seen. We present this case to emphasize the important diagnosis of focal nodular hyperplasia, which may occur in syndromic form in children with typical cutaneous and skeletal manifestations.

  16. Nodular hidradenocarcinoma with prominent squamous differentiation: case report and immunohistochemical study.

    Science.gov (United States)

    Park, H J; Kim, Y C; Cinn, Y W

    2000-09-01

    We report the case of a 24-year-old woman with nodular hidradenocarcinoma on the scalp. While histopathology of the tumor showed a circumscribed, lobulated intradermal mass with prominent squamous differentiation, the immunohistochemical study with antibodies to cytokeratins, CAM 5.2 and 19, epithelial membrane antigen, carcinoembryonic antigen, S-100 protein and p53 all demonstrated positivity. These findings confirmed that the tumor was of eccrine sweat gland origin and it was thought to be a nodular hidradenocarcinoma differentiating toward the eccrine duct and/or secretory portions. She was treated with a wide local excision and no recurrence was observed 18 months after excision.

  17. Nodular glomerulosclerosis in patients’ without history of diabetes mellitus: a case report

    Science.gov (United States)

    Goucha, Rym; Karoui, Cyrine; Abderrahim, Ezzedine; Hamida, Fethi Ben; Elyounsi, Fethi; Maiz, Hedi Ben; Abdallah, Taieb Ben; Kheder, Adel

    2009-01-01

    Introduction Diabetic nephropathy can occur during the course of both type1 and type 2 diabetes mellitus. The characteristic lesions are diffuse or nodular (Kimmelsteil-Wilson) diabetic glomerulosclerosis. The reported cases represent unusual presentations of diabetes mellitus. Case presentation We report the case of a 49-year-old man without prior history of diabetes mellitus who presented with rapidly progressive renal failure and whose renal biopsy revealed nodular (Kimmelsteil-Wilson) glomerulosclerosis lesions characteristic of diabetes. Conclusion Renal manifestations of diabetes mellitus may antedate other more common presenting symptoms of this disease and we critically review the literature on this subject. PMID:19918545

  18. Superficial spreading and nodular melanoma are distinct biological entities: a challenge to the linear progression model.

    Science.gov (United States)

    Greenwald, Holly S; Friedman, Erica B; Osman, Iman

    2012-02-01

    The classification of melanoma subtypes into prognostically relevant and therapeutically insightful categories has been a challenge since the first description of melanoma in the 1800s. One limitation has been the assumption that the two most common histological subtypes of melanoma, superficial spreading and nodular, evolve according to a linear model of progression, as malignant melanocytes spread radially and then invade vertically. However, recent clinical, pathological, and molecular data indicate that these two histological subtypes might evolve as distinct entities. Here, we review the published data that support distinct molecular characterization of superficial spreading and nodular melanoma, the clinical significance of this distinction including prognostic relevance and the therapeutic implications.

  19. Key points in the dermoscopic diagnosis of hypomelanotic melanoma and nodular melanoma.

    Science.gov (United States)

    Moloney, Fergal J; Menzies, Scott W

    2011-01-01

    Nodular melanoma (NM) and amelanotic/hypomelanotic melanoma (AHM) often present a challenge to the diagnosing clinician. A significant proportion of AHM are nodular in nature. Such tumors may lack features of asymmetry and altered peripheral pigmentation routinely observed in other melanoma subtypes. This lack of distinguishing clinical features can potentially result in delayed diagnosis or inappropriate treatment. This review highlights the key points in evaluating the range of lesions where AHM or NM are considered in the differential diagnosis and summarizes current evidence in relation to pigmented and vascular dermoscopic diagnostic criteria for both. © 2011 Japanese Dermatological Association.

  20. The importance of a proper selection area to be biopsied in nodular leukoplakia: a case report.

    Science.gov (United States)

    Pagin, Otávio; Santos, Paulo Sérgio da Silva; Del Neri, Nathalia Bigelli; Gustavo de Lima, Heliton; Lara, Vanessa Soares

    2014-03-01

    Nodular leukoplakia is a non-homogeneous type of oral leukoplakia presenting a white surface with verrucous, nodular, ulcerated or erythematous features with a greater risk of malignant transformation when compared to the homogeneous type. Common sites of involvement include lip commissures, buccal mucosa and soft palate. It is often associated with epithelial dysplasia or carcinoma and requires detailed microscopic assessment and regular follow-up. The importance of a proper selection of the area to be biopsied and the close teamwork between a dentist and oral pathologist is the basis of providing an accurate final diagnosis.

  1. Medial depression with bony dehiscence of lamina papyracea as an anatomic variation: CT evaluation

    International Nuclear Information System (INIS)

    Na, Sun Young; Lee, Young Uk; Youn, Eun Kyung; Suh, Sang Gyung; Kim, Dong Hyun

    1994-01-01

    To evaluate the incidence and CT findings of the medial depression and bony dehiscence of lamina papyracea as an anatomic variation. 1472 PNS CTs of the patients with symptoms of chronic sinusitis were retrospectively evaluated. The total incidence of depressed lamina papyracea as an anatomic variation was 3.5%(52/1472) on PNS CT. There was a statistically significant correlation between the increasing age and the incidence of depressed lamina papyracea. Depression of lamina papyracea anterior to the basal lamella were more common than those of the posterior depression. Associated findings were herniation of adjacent fatty tissue in all cases and the medial bowing and hypertrophied configuration of the medial rectus muscle without significant herniation in 19 cases(34%). Nontraumatic, asymptomatic depression with bony dehiscence of lamina papyracea as an anatomic variation is not uncommon with the incidence of 3.5%. Recognition of its existence and degree may be helpful in avoiding various ocular complication during ethmoid surgery

  2. On the biology of the bony otic capsule and the pathogenesis of otosclerosis

    DEFF Research Database (Denmark)

    Bloch, Sune Land

    2012-01-01

    In human otosclerosis, focal pathological bone remodeling occurs in significant amounts inside the normally anti-resorptive perilabyrinthine domain of the bony otic capsule. Otosclerosis causes hearing loss in 0.2-0.5% of the population by ankylosis of the footplate. The disease cannot be predicted......, avoided or medically reversed as the pathogenesis remains unknown. Previously genetic research has failed to identify a specific otosclerosis-gene and earlier theories of virus infections, autoimmunity or association to generalized bone diseases have been unable to explain why otosclerosis only occurs...... in the bony otic capsule while the rest of the skeleton remains completely normal. Studies from the otopathological laboratory (RH) have revealed how the bone turnover rates increase centrifugally from a sub-normal 0.1% adjacent to the inner ear space towards a normal 10% per year at the capsular periphery...

  3. Valor predicts the thyroid hormones in the evolution the transplant bony marrow

    International Nuclear Information System (INIS)

    Alonso, C.A.; Carnot, J.; De Castro, R.; Morera, M.L.; Garcia, I.

    1998-01-01

    In this work you values the valor I predict the thyroid hormones in the bony marrow transplant evolution as factors the metabolisms oxidative and the synthesis albumins. The patients received conditioning treatments to the transplant and in the postoperational. The received radiations were 1000 cGy lateral cube, with blocking lung, to those that were subjected 3 sessions irradiation, they are practiced a transplant marrow allogeneic

  4. First Record of Eocene Bony Fishes and Crocodyliforms from Canada’s Western Arctic

    OpenAIRE

    Eberle, Jaelyn J.; Gottfried, Michael D.; Hutchison, J. Howard; Brochu, Christopher A.

    2014-01-01

    BACKGROUND: Discovery of Eocene non-marine vertebrates, including crocodylians, turtles, bony fishes, and mammals in Canada's High Arctic was a critical paleontological contribution of the last century because it indicated that this region of the Arctic had been mild, temperate, and ice-free during the early - middle Eocene (∼53-50 Ma), despite being well above the Arctic Circle. To date, these discoveries have been restricted to Canada's easternmost Arctic - Ellesmere and Axel Heiberg Island...

  5. Effect of antiresorptive drugs on bony turnover in the jaw: denosumab compared with bisphosphonates.

    Science.gov (United States)

    Ristow, Oliver; Gerngroß, Carlos; Schwaiger, Markus; Hohlweg-Majert, Bettina; Kehl, Victoria; Jansen, Heike; Hahnefeld, Lilian; Koerdt, Steffen; Otto, Sven; Pautke, Christoph

    2014-04-01

    Osteonecrosis of the jaw as a result of treatment with receptor activators of nuclear factor kappa-B ligand (RANKL) inhibitors (denosumab) is a new type of bony necrosis, the exact pathogenesis of which is unknown. Our aim was to find out whether the turnover of bone in the jaw is increased after denosumab has been given compared with other skeletal sites, and if that turnover might have a role in denosumab-related osteonecrosis of the jaw (DRONJ). Bone scintigraphic images of 45 female patients with breast cancer and bone metastases were analysed retrospectively, and divided into 3 groups: those given denosumab, those given a bisphosphonate, and a control group (n=15 in each). All patients had bone scintigraphy before treatment (T0) and during the course of treatment after 12 (T1) and 24 (T2) months. The data were analysed quantitatively using 6 preset bony regions of interest. There was similar turnover of bone in the mandible compared with other skeletal sites (such as the femur), while the maxilla showed significantly higher turnover. None of the bony regions investigated showed any significant changes after the bisphosphonate had been given. There was a tendency to increase bone turnover in those patients taking denosumab. The bone turnover of the jawbone is not overtly changed either by a bisphosphonate or denosumab, so it seems unlikely that oversuppression of bony turnover in the jawbones plays an important part either in the pathogenesis of DRONJ or in the bisphosphonate-related osteonecrosis of the jaw (BRONJ). Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Bony defect of palate and vomer in submucous cleft palate patients.

    Science.gov (United States)

    Ren, S; Ma, L; Zhou, X; Sun, Z

    2015-01-01

    The aim of this study was to visualize bony defects of the palate and vomer in submucous cleft palate patients (SMCP) by three-dimensional (3D) computed tomography (CT) reconstruction and to classify the range of bony defects. Forty-eight consecutive non-operated SMCP patients were included. Diagnosis was based on the presence of at least one of three classical signs of SMCP: bifid uvula, a translucent zone in the midline of the soft palate, and a palpable 'V' notch on the posterior border of the bony palate. Patients were imaged using spiral CT. 3D reconstruction models were created of the palate and vomer. The sagittal extent of the bony cleft in SMCP was classified into four types: type I, no V-shaped hard palate cleft (8.3%); type II, cleft involving the partial palate (43.8%); type III, cleft involving the complete palate and extending to the incisive foramen (43.8%); type IV, cleft involving the complete palate and the alveolar bone (4.2%). The extent of the vomer defect was classified into three types: type A, vomer completely fused with the palate (8.3%); type B, vomer partially fused with the palate (43.8%); type C, vomer not fused with the palate up to the incisive foramen (47.9%). Significant variability in hard palate defects in SMCP is the rule rather than the exception. The association of velopharyngeal insufficiency with anatomical malformations may be complex. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Coronectomy of lower third molars with and without guided bony regeneration: a pilot study.

    Science.gov (United States)

    Leung, Yiu Yan

    2016-02-01

    This pilot study for a split-mouth, randomised, clinical trial compared the incidence of postoperative complications, root migration, and adjacent second molar periodontal attachment after coronectomy of the lower third molars with or without guided bony regeneration. Six patients (three men and three women, mean (range) age 27 (21-44) years), each with bilateral lower third molars in close proximity to the inferior alveolar nerve, were recruited. One third molar of each patient was randomised to be treated by coronectomy with guided bony regeneration, and the other side coronectomy alone. All subjects were reviewed for 12 months. No neurosensory deficit was noted in either group. We found no significant differences between the two groups in postoperative morbidity. Mean (SD) root migration after coronectomy with guided bony regeneration at postoperative 2 weeks, 3 months, 6 months, and 12 months were 0.14 (0.34), 0.56 (0.68), 0.63 (0.83), and 0.63 (0.83) mm, respectively. These were significantly less than the results in the control group from postoperative 3 months onwards (3 months p=0.01, 6 months p=0.004, and 12 months p=0.003). There was a trend towards reduced periodontal depth at the adjacent second molar in the study group compared with that in the control group, but not significantly so. These results show that coronectomy of lower third molars with guided bony regeneration has low morbidity and seems to reduce root migration. A full-scale randomised clinical trial will show the effect on root migration and periodontal attachment of the adjacent second molar. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Reliability of the bony anatomy in image-guided stereotactic radiotherapy of brain metastases.

    Science.gov (United States)

    Guckenberger, Matthias; Baier, Kurt; Guenther, Iris; Richter, Anne; Wilbert, Juergen; Sauer, Otto; Vordermark, Dirk; Flentje, Michael

    2007-09-01

    To evaluate whether the position of brain metastases remains stable between planning and treatment in cranial stereotactic radiotherapy (SRT). Eighteen patients with 20 brain metastases were treated with single-fraction (17 lesions) or hypofractionated (3 lesions) image-guided SRT. Median time interval between planning and treatment was 8 days. Before treatment a cone-beam CT (CBCT) and a conventional CT after application of i.v. contrast were acquired. Setup errors using automatic bone registration (CBCT) and manual soft-tissue registration of the brain metastases (conventional CT) were compared. Tumor size was not significantly different between planning and treatment. The three-dimensional setup error (mean +/- SD) was 4.0 +/- 2.1 mm and 3.5 +/- 2.2 mm according to the bony anatomy and the lesion itself, respectively. A highly significant correlation between automatic bone match and soft-tissue registration was seen in all three directions (r >/= 0.88). The three-dimensional distance between the isocenter according to bone match and soft-tissue registration was 1.7 +/- 0.7 mm, maximum 2.8 mm. Treatment of intracranial pressure with steroids did not influence the position of the lesion relative to the bony anatomy. With a time interval of approximately 1 week between planning and treatment, the bony anatomy of the skull proved to be an excellent surrogate for the target position in image-guided SRT.

  9. Bony surface registration of navigation system in the lateral or prone position: technical note.

    Science.gov (United States)

    Ogiwara, Toshihiro; Goto, Tetsuya; Aoyama, Tatsuro; Nagm, Alhusain; Yamamoto, Yasunaga; Hongo, Kazuhiro

    2015-11-01

    Navigation systems have become essential tools in neurosurgery. Precise registration is indispensable for the accuracy of navigation. The rapid and precise registration by surface matching on the facial skin is possible using the landmarks of the face in the supine position. On the other hand, incomplete registration often occurs in the lateral or prone position due to the direction of the face and displacement of the skin by headpins and obscuring of the skin by the bispectral index monitor and many electrodes on the forehead as well as the eye patch. Surface matching on the occipital scalp is not suitable for registration because the shape of the occipital scalp is flat and it is compressed in the supine position when obtaining preoperative neuroimaging. To overcome this problem, the authors have developed a new method of registration designated as "bony surface registration" in which surface matching is achieved using the bony surface of the skull after exposure. Between June and December 2014, this technique was used in 23 patients and its effectiveness was examined. Registration time was markedly shortened and useful navigation was achieved due to accurate registration in all patients. This is the first report of a registration methodology for a navigation system in the lateral or prone position. This bony surface registration method is useful for navigation system image-guided surgery in the lateral or prone position.

  10. Solute segregation to ferrite grain boundaries in nodular cast iron: experiment and prediction

    Czech Academy of Sciences Publication Activity Database

    Lejček, Pavel; Konečná, R.; Janovec, J.

    2008-01-01

    Roč. 40, 3-4 (2008), s. 503-506 ISSN 0142-2421 R&D Projects: GA ČR(CZ) GA202/06/0004 Institutional research plan: CEZ:AV0Z10100521 Keywords : nodular cast iron * concentration heterogeneity * impurity segregation * AES * fracture Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 1.272, year: 2008

  11. Bainitic nodular cast iron with carbides obtaining with use of Inmold method

    OpenAIRE

    G. Gumienny

    2009-01-01

    In these paper bainitic nodular cast iron with carbides as-cast obtaining has been presented. This cast iron has been obtained with use of Inmold method. It was shown, that there is the possibility of bainite and carbides obtaining in cast iron with Mo and Ni for studied chemical composition.

  12. Cervical nodular fasciitis in a 10-year-old girl: a case report of a rare ...

    African Journals Online (AJOL)

    Nodular fasciitis (NF) is a benign fibroblastic proliferation that usually involves superficial fascia in the subcutaneous tissue or muscle. The rapid growth, high cellularity and mitotic activity can simulate sarcoma. Thus, as clinical and morphologic characteristics are similar to those of malignant tumours, this entity is often ...

  13. Cushing syndrome in a young woman due to primary pigmented nodular adrenal disease.

    Science.gov (United States)

    Hackman, Kathryn L; Davis, Anna L; Curnow, Paul A; Serpell, Jonathan W; McLean, Catriona A; Topliss, Duncan J

    2010-01-01

    To report a case of Cushing syndrome due to apparently sporadic primary pigmented nodular adrenal disease in a young woman. We describe the clinical, biochemical, radiologic, and histologic findings of Cushing syndrome due to the rare condition of primary pigmented nodular adrenal disease. A 30-year-old woman presented with a 2-year history of worsening itch without rash over her shoulders and arms and weight gain, particularly around the abdomen and face. Careful questioning did not elicit any history of exogenous glucocorticoid use (systemic or topical), including hydrocortisone. On examination, the patient had a slightly rounded and plethoric face, a small buffalo hump, central adiposity, and thin skin with a few small striae on her inner thighs. No features of the Carney complex were observed. Investigations showed hypercortisolism with suppressed corticotropin and normal adrenal imaging despite documentation of enlarged adrenal glands at removal. High-dose dexamethasone administration was followed by a decrease in urinary free cortisol excretion rather than a paradoxical rise as previously reported in primary pigmented nodular adrenal disease. No mutations were detected in the PRKAR1A gene. Primary pigmented nodular adrenal disease should be suspected in patients with corticotropin-independent Cushing syndrome who have normal adrenal imaging. The role of genetic testing in apparently sporadic cases is not established, but cumulative experience may be helpful in defining the frequency of PRKAR1A mutations.

  14. Metastatic ocular melanoma to the liver exhibits infiltrative and nodular growth patterns

    DEFF Research Database (Denmark)

    Grossniklaus, Hans E; Zhang, Qing; You, Shuo

    2016-01-01

    We examined liver specimens from 15 patients with uveal melanoma (UM) who had died of their disseminated disease. We found 2 distinct growth patterns of UM metastasis: infiltrative (n = 12) and nodular (n = 3). In the infiltrative pattern, individual UM cells with a CD133+ cancer stem cell-like p...

  15. Thyroidectomy improves tracheal anatomy and airflow in patients with nodular goiter. A prospective cohort study

    DEFF Research Database (Denmark)

    Sørensen, Jesper Roed; Lauridsen, Jeppe Killerich; Døssing, Helle

    Background: A large goiter may cause compression of the trachea and lead to respiratory insufficiency. We aimed at investigating the effects of thyroidectomy on tracheal anatomy and airflow in patients with benign nodular goiter, employing a prospective observational study. Methods: Magnetic reso...... improvement in tracheal compression, but only minor improvements in tracheal airflow. This information is pertinent when counselling patients before choice of treatment....

  16. Von Meyenburg complexes mimicking metastatic disease at laparotomy for focal nodular hyperplasia

    NARCIS (Netherlands)

    Bieze, Matthanja; Verheij, Joanne; Phoa, Saffire S.; van Gulik, Thomas M.

    2014-01-01

    A 44-year-old woman presented with symptoms of fatigue and increasing abdominal discomfort. MRI with the hepatobiliary contrast Gd-EOB-DTPA (Primovist) was performed showing a 6 cm lesion in segment 2/3 of the liver typical for focal nodular hyperplasia (FNH). Because of severe complaints attributed

  17. Synthesis of nanoparticles of vanadium carbide in the ferrite of nodular cast iron

    CERN Document Server

    Fras, E; Guzik, E; Lopez, H

    2005-01-01

    The synthesis method of nanoparticles of vanadium carbide in nodular cast iron is presented. After introduction of this method, the nanoparticles with 10-70 nm of diameter was obtained in the ferrite. The diffraction investigations confirmed that these particles are vanadium carbides of type V/sub 3/C/sub 4/.

  18. Nestin is expressed in HMB-45 negative melanoma cells in dermal parts of nodular melanoma.

    Science.gov (United States)

    Kanoh, Maho; Amoh, Yasuyuki; Tanabe, Kenichi; Maejima, Hideki; Takasu, Hiroshi; Katsuoka, Kensei

    2010-06-01

    Nestin, a marker of neural stem cells, is expressed in the stem cells of the mouse hair follicle. The nestin-expressing hair follicle stem cells can differentiate into neurons, glia, keratocytes, smooth muscle cells and melanocytes in vitro. These pluripotent nestin-expressing stem cells are keratin 15 (K15)-negative, suggesting that they are in a relatively undifferentiated state. Recent studies suggest that the epithelial stem cells are important in tumorigenesis, and nestin expression is thought to be important in tumorigenesis. In the present study, we examined the expression of the hair follicle and neural stem cell marker nestin, as well as S-100 and HMB-45, in melanoma. Nestin immunoreactivity was observed in the HMB-45-negative melanoma cells in all five cases of amelanotic nodular melanomas. Moreover, nestin immunoreactivity was observed in the dermal parts in seven of 10 cases of melanotic nodular melanomas. Especially, nestin immunoreactivity was observed in the HMB-45-negative melanoma cells in the dermal parts of all 10 cases of HMB-45-negative amelanotic and melanotic nodular melanomas. On the other hand, nestin expression was negative in 10 of 12 cases of superficial spreading melanoma. These results suggest that nestin is an important marker of HMB-45-negative melanoma cells in the dermal parts of patients with nodular melanoma.

  19. Detailed dosimetry and clinical outcome analysis for the argentine BNCT trials of cutaneous nodular melanomas

    International Nuclear Information System (INIS)

    Gonzalez, S.J.; Santa Cruz, G.A.; Casal, M.R.

    2006-01-01

    Three female patients with biopsy-proven nodular melanoma were treated to six separate sites as part of the Phase I/II BNCT clinical trial conducted at the Comision Nacional de Energia Atomica (CNEA) and the Instituto A. Roffo, Argentina. This work reports on the detailed dosimetry for the clinical trials, and presents a preliminary analysis to investigate the possible influence of tumor size and total equivalent dose on the observed local tumor response. Also, the appropriateness of applying 3.5 tumor-to-blood 10 B concentration ratio for the BPA compound in nodular melanoma cases is discussed. The statistical analysis showed that tumor response depends not only on the dose but also, and highly, on the tumor size. For these three patients, there was no significant difference between minimum and mean equivalent doses as explicative for tumor response. The collection of sixteen experimental-based tumor-to-blood ratios determined by CNEA in nodular melanoma patients derived an average value and standard deviation of 2.5 ± 0.6. This result suggests that a lower ratio could be more suitable for estimating the clinical dosimetry. It is also consistent with the worse tumor control rate in nodular melanomas observed by other researchers. (author)

  20. Metastatic ocular melanoma to the liver exhibits infiltrative and nodular growth patterns.

    Science.gov (United States)

    Grossniklaus, Hans E; Zhang, Qing; You, Shuo; McCarthy, Conni; Heegaard, Steffen; Coupland, Sarah E

    2016-11-01

    We examined liver specimens from 15 patients with uveal melanoma (UM) who had died of their disseminated disease. We found 2 distinct growth patterns of UM metastasis: infiltrative (n = 12) and nodular (n = 3). In the infiltrative pattern, individual UM cells with a CD133+ cancer stem cell-like phenotype were present and formed aggregates of stage I 500μm-diameter metastases, which were encapsulated by collagenized fibrous septae. In the nodular growth pattern, CD133+ melanoma cells aggregated adjacent to portal venules and subsequently appeared to grow and efface the adjacent hepatocytes to form stage II 51- to 500-μm-diameter nodules that surrounded the portal venule. These avascular nodules appeared to further expand to form stage III >500-μm-diameter nodules that exhibited vascularization with minimal fibrosis. The tumor stem cell-like phenotype seen in individual UM cells was lost as the tumors progressed. There were CD56+ natural killer cells in sinusoidal spaces and CD3+ lymphocytes in periportal areas. The nodular growth pattern showed UM cells expressing MMP9 and VEGF. UM cells in both above-described growth patterns exhibited variable BAP1 expression. We propose that changes in the liver microenvironment are related to metastatic UM growth. We hypothesize that these changes include immune regulation within the sinusoidal space for the infiltrative pattern and changes in the VEGF/PEDF ratio for the nodular pattern. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. CYTOGENETIC STUDY OF A NODULAR HYPERPLASIA OF THE THYROID AFTER IRRADIATION FOR HODGKINS-DISEASE

    NARCIS (Netherlands)

    VANDENBERG, E; VANDOORMAAL, JJ; OOSTERHUIS, JW; DEJONG, B; BUIST, J; VOS, AM; VERMEIJ, A; Dam, A.

    We describe cytogenetics of a case of nodular hyperplasia of the thyroid with papillary microcarcinoma following radiotherapy for Hodgkin's disease. The chromosomal pattern found was very heterogeneous with a clonal abnormality of chromosome 10, among others. Together with some recent data from the

  2. Cervical nodular fasciitis in a 10-year-old girl: a case report of a rare ...

    African Journals Online (AJOL)

    Thus, as clinical and morphologic characteristics are similar to those of malignant tumours, this entity is often misdiagnosed, with a few cases described in the literature. We present a case of nodular fasciitis involving the retropharynx and hypopharynx of a 10-year-old girl and discuss the importance of considering this rare ...

  3. Part 1: MRI features of focal nodular hyperplasia with an emphasis on hepatobiliary contrast agents

    International Nuclear Information System (INIS)

    Sutherland, Tom; Seale, Melanie; Yap, Yap

    2014-01-01

    Focal nodular hyperplasia (FNH) is the second most common benign liver tumour and typically do not require any treatment. An accurate non-invasive diagnosis is therefore vital to avoid unnecessary intervention and to reassure patients. This article discusses the demographics and pathology of FNH and reviews the appearance of FNH at MRI using liver-specific contrast agents.

  4. Ethnic Differences in Bony Hip Morphology in a Cohort of 445 Professional Male Soccer Players.

    Science.gov (United States)

    Mosler, Andrea B; Crossley, Kay M; Waarsing, Jan H; Jomaah, Nabil; Weir, Adam; Hölmich, Per; Agricola, Rintje

    2016-11-01

    Participation in high-impact athletic activities has recently been associated with a higher prevalence of cam deformity. Bony hip morphology has also emerged as an important factor in the development of hip osteoarthritis. However, it is unknown whether bony morphology differs between ethnicities in athletes participating in high-impact sports. To investigate whether the prevalence of specific bony hip morphological abnormalities differed between professional male soccer players of diverse ethnic backgrounds. Cross-sectional study; Level of evidence, 3. Professional male soccer players from an entire league attending preparticipation screening were invited to participate in this study. Ethnicity was registered, and standardized radiographs of anteroposterior pelvic and Dunn views were obtained. Cam and pincer deformity, and acetabular dysplasia were quantified using the alpha angle, triangular index, and lateral center-edge angle (LCEA). Regression analyses with generalized estimating equations were used to determine prevalence differences in bony hip morphology. A total of 445 male soccer players (890 hips; mean age ± SD, 25 ± 4.9 years) participated in the study, representing the following ethnic groups: Arabic (59%), black (24%), Persian (7%), white (6%), East Asian (2%), and other (2%). The prevalence of cam deformity (alpha angle >60°) ranged from 57.5% to 71.7% across 4 of the groups, but East Asians had a significantly lower prevalence (18.8%; P ≤ .032). A large cam deformity (alpha angle >78°) was more prevalent in white (33.3%) compared with black soccer players (17.8%; P = .041) and was absent in East Asian players. Pincer deformity (LCEA >40°) was uncommon (3%) in all ethnicities. The prevalence of acetabular dysplasia (LCEA <20°) ranged from 8.0% to 16.7%, apart from the white group, in which prevalence was only 1.9% (P = .03). The prevalence of a cam deformity and acetabular dysplasia differed between ethnicities in this cohort of professional

  5. Nodular-Deep: Classification of Pulmonary Nodules using Deep Neural Network

    Directory of Open Access Journals (Sweden)

    Qaisar Abbas

    2017-08-01

    Full Text Available Pulmonary nodules represent higher malignancy rate and an accurate detection is very crucial when clinically diagnosis by radiologists from high-resolution computed tomography (HRCT images. At an early stage, if lung cancer is not diagnosis then it leads toward death. In the past studies, it noticed that many computer-aided diagnostic (CADe system for classification of lung nodules are developed but tested on the limited dataset and focused on domain expert knowledge. Therefore, those CADx systems were not suitable for large-scale environments. To address these issues, an efficient and effective CADe system is developed to classify the pulmonary lung nodules into benign and malignant classes. In this paper, a new CADe system is implemented through the integration of variants of advanced deep learning algorithms known as Nodular-Deep. Convolutional neural network (CNN and recurrent neural network (RNN algorithms are combined with softmax linear classifier without using hand-crafted features and any pre- or post-processing steps. The Nodular-Deep system is tested on the 1200 scans obtained from LIDC-IDRI database covers a set of 2600 pulmonary nodules. This dataset contains an equal number of benign (non-cancerous and malignant (cancerous nodules. The performance of nodular-deep system is evaluated through 10-fold cross validation test through the statistical metrics such as sensitivity (SE, Specificity (SP and area under the receiver operating curve (AUC. On this 2600 pulmonary nodules, the Nodular-Deep system is achieved on average result such as 94% of SE, 96% of SP and 0.95 of AUC. This obtained results demonstrate that this nodular-Deep system outperforms compared to manual segmentation by a radiologist.

  6. Iodinated Contrast Media-Induced Thyroid Dysfunction in Euthyroid Nodular Goiter Patients.

    Science.gov (United States)

    Kornelius, Edy; Chiou, Jeng-Yuan; Yang, Yi-Sun; Lo, Shih-Chang; Peng, Chiung-Huei; Lai, Yung-Rung; Huang, Chien-Ning

    2016-08-01

    The risks of thyroid dysfunction after iodinated contrast media exposure in patients with euthyroid nodular goiter are largely unknown. This observational, retrospective cohort study included a random selection of one million people in Taiwan. All patients with iodinated contrast media exposure during this study period were selected. Patients with euthyroid nodular goiter were identified as cases, while patients without thyroid nodule were selected as controls. We followed these patients until the first event of thyroid dysfunction including hyperthyroidism or hypothyroidism after iodinated contrast media exposure. A total of 334 cases and 2672 matched controls were selected in this study. The mean age of cases and controls were 58.6 and 58.4 years old, and mean follow-up durations were 2.1 and 2 years respectively. After adjustment, patients with euthyroid nodular goiter had a higher risk of thyroid dysfunction (hazard ratio 5.43, [confidence interval (CI) 3.01-9.80]) compared with controls after iodinated contrast media exposure. In the subgroup analysis, the risks of hyperthyroidism and hypothyroidism in cases compared with controls were 5.77 [CI 2.64-12.62] and 4.95 [CI 2.15-11.40] respectively. Half of the euthyroid nodular goiter cases developed thyroid dysfunction within one year after iodinated contrast media exposure. Interestingly, all thyroid-related comorbidities and drug prescriptions did not increase the risk of thyroid dysfunction. Presence of euthyroid nodular goiter was associated with higher risk of thyroid dysfunction including hyperthyroidism and hypothyroidism after iodinated contrast media exposure.

  7. The contribution of nodular subtype to melanoma mortality in the United States, 1978 to 2007.

    Science.gov (United States)

    Shaikh, Waqas R; Xiong, Michael; Weinstock, Martin A

    2012-01-01

    To gain insight into reducing melanoma mortality by examining epidemiologic trends by subtype with emphasis on the contribution of each subtype to melanoma-related death. Retrospective population-based cohort study. Original 9 registries of the Surveillance, Epidemiology, and End Results Program from 1978 to 2007. A total of 111,478 patients with histologically confirmed invasive melanoma. Proportion of ultimately fatal melanomas by subtype. Among melanomas of known subtype, superficial spreading melanoma comprised 66% of incident melanomas and 46% of ultimately fatal melanomas; nodular melanoma comprised 14% of incident melanomas and 37% of ultimately fatal melanomas. For superficial spreading melanoma, overall incidence per 100,000 per year increased (from 4.28 to 6.63), ultimately fatal incidence remained stable (at 0.56 to 0.51), and 10-year relative survival increased (from 90.6% to 96.5%) when comparing successive 5-year intervals. In contrast, for nodular melanoma, the overall incidence (1.30-1.32), ultimately fatal incidence (0.46-0.44), and 10-year relative survival rate (61.8%-61.5%) remained stable. Epidemiologic trends of melanoma, not otherwise specified, were similar to superficial spreading melanoma. There was a strong negative correlation between the proportion of melanoma, not otherwise specified, among all melanomas, and the proportion of superficial spreading melanoma, among melanomas of known subtype (r = -0.80; P = .01), across the registries. Superficial spreading and nodular melanoma constitute similar proportions of ultimately fatal melanomas. Although incidence of and survival from superficial spreading melanoma have increased from 1978 to 2007, neither the incidence of nor survival from nodular melanoma has changed. Public health efforts should include a focus on nodular melanoma for maximum reduction of melanoma mortality.

  8. Nodular melanoma is less likely than superficial spreading melanoma to be histologically associated with a naevus.

    Science.gov (United States)

    Pan, Yan; Adler, Nikki R; Wolfe, Rory; McLean, Catriona A; Kelly, John W

    2017-10-16

    To determine the frequency of naevus-associated melanoma among superficial spreading and nodular subtypes; and to investigate associations between naevus-associated melanoma and other clinico-pathological characteristics. Cross-sectional study of all patients with nodular and superficial spreading melanomas diagnosed between 1994 and 2015 at the Victorian Melanoma Service, Melbourne. Clinical and pathological characteristics of naevus-associated and de novo melanomas were assessed in univariable and multivariable logistic regression analyses. Of 3678 primary melanomas, 1360 (37.0%) were histologically associated with a naevus and 2318 (63.0%) were de novo melanomas; 71 of 621 nodular (11.4%) and 1289 of 3057 superficial spreading melanomas (42.2%) were histologically associated with a naevus. In multivariable analyses, the odds of being associated with a naevus were higher for melanomas located on the trunk (v head and neck: adjusted odds ratio [OR], 2.27; 95% CI, 1.73-2.96; P melanomas (adjusted OR, 0.68; 95% CI, 0.48-0.97; P = 0.035), and older age (patients 70 years or older v patients under 30 at diagnosis: adjusted OR, 0.28; 95% CI, 0.20-0.40; P melanomas as for nodular melanomas (adjusted OR, 3.05; 95% CI, 2.24-4.17; P Melanomas are most likely to arise in the absence of a pre-existing naevus, particularly nodular melanomas. Public health campaigns should therefore emphasise the detection of suspicious de novo lesions, as well as of changing lesions.

  9. Mucosal surface nodularity on upper gastrointestinal series (UGIS) : prospective analysis of its primary cause and prevalence of gastric malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soo Youn; Kim, Sun Mi; Kim, Ah Young; Kim, Tae Kyoung; Kim, Pyo Nyun; Ha, Hyun Kwon [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2001-10-01

    Mucosal surface nodularity was defined as present at UGIS when multiple nodular defects larger than 5 mm were scattered in the gastric mucosa in an area greater than 5 x 5 cm. The purpose of this study was to determine the primary causes of this radiographic finding and to assess the incidence of gastric malignancy in these patients. During a one-year period were prospectively collected among patients who underwent UGIS, data for 51 [aged 30-78 (mean, 51) years] above who met the criteria of mucosal surface nodularity. Whether or not this was present was decided by two radiologists who in reaching a consensus excluded the possibility of erosive gastritis, indicated by central barium collection in the nodular defects. The primary causes of mucosal nodularity and associated gastric pathologies were determined by the histopathological results obtained from the specimens after surgery (n=18) or endoscopic biopsy (n=33). Pathological examinations revealed that the primary causes of the mucosal nodularity in these 51 patients were intestinal metaplasia in 28 (54.9%), MALT lymphoma in seven (13.7%), early gastric cancer in six (11.8%), chronic gastritis in five (9.8%), low grade dysplasia in four (7.8%), and gastritis cystica profunda in one (2%). Gastric malignancy was present either in or outside the area of mucosal nodularity in 34 (66/7%) of the 51 (27 carcinomas and 7 MALT lymphomas). No different patterns of mucosal surface nodularity were noted between the groups of each disease entity. Mucosal surface nodularity is observed at UGIS in various gastric pathologies. Because of the high incidence of gastric malignancy in these patients, close follow-up or gastrofiberscopic biopsy is mandatory.

  10. Mucosal surface nodularity on upper gastrointestinal series (UGIS) : prospective analysis of its primary cause and prevalence of gastric malignancy

    International Nuclear Information System (INIS)

    Park, Soo Youn; Kim, Sun Mi; Kim, Ah Young; Kim, Tae Kyoung; Kim, Pyo Nyun; Ha, Hyun Kwon

    2001-01-01

    Mucosal surface nodularity was defined as present at UGIS when multiple nodular defects larger than 5 mm were scattered in the gastric mucosa in an area greater than 5 x 5 cm. The purpose of this study was to determine the primary causes of this radiographic finding and to assess the incidence of gastric malignancy in these patients. During a one-year period were prospectively collected among patients who underwent UGIS, data for 51 [aged 30-78 (mean, 51) years] above who met the criteria of mucosal surface nodularity. Whether or not this was present was decided by two radiologists who in reaching a consensus excluded the possibility of erosive gastritis, indicated by central barium collection in the nodular defects. The primary causes of mucosal nodularity and associated gastric pathologies were determined by the histopathological results obtained from the specimens after surgery (n=18) or endoscopic biopsy (n=33). Pathological examinations revealed that the primary causes of the mucosal nodularity in these 51 patients were intestinal metaplasia in 28 (54.9%), MALT lymphoma in seven (13.7%), early gastric cancer in six (11.8%), chronic gastritis in five (9.8%), low grade dysplasia in four (7.8%), and gastritis cystica profunda in one (2%). Gastric malignancy was present either in or outside the area of mucosal nodularity in 34 (66/7%) of the 51 (27 carcinomas and 7 MALT lymphomas). No different patterns of mucosal surface nodularity were noted between the groups of each disease entity. Mucosal surface nodularity is observed at UGIS in various gastric pathologies. Because of the high incidence of gastric malignancy in these patients, close follow-up or gastrofiberscopic biopsy is mandatory

  11. Characterization and growth mechanism of a peculiar nodular structure in shale: Comprehensive study over the Sitakund anticline, Bengal basin.

    Science.gov (United States)

    Gazi, M. Y.; Kabir, S. M. M.; Imam, M. B.

    2017-12-01

    Nodular shales commonly occur in comparatively older and silty shales near the axial (proximity to core) region of Sitakund Anticline (Study area), Sitapahar Anticline, Patharia Structure, Sylhet Anticline and Mirinja Anticline as observed. Stratigraphically, they are pronounced in the Surma group of Neogene succession. They are less abundant in limb portion. In many outcrop, they are found in the incompetent bed with the obliterated bedding bounded by well bedded competent beds. Their occurrence are sporadic rather than continuous along and across the strike of the bed. At some places huge number cluster of small and big nodular shales occur while in the other places, they occur as isolated mass in the highly disturbed or obliterated beds. The Surma group is the prime startigraphic unit in Bangladesh with major economic and academic importance. Yet there is a lack of comprehensive characterization of mudrocks of Surma group. This has prompted the present research to be undertaken. An initial field based study has been followed by detail textural, mineralogical, petrological and geochemical by using upscale laboratory techniques that include Thin Section Microscopy, Laser Particle Size Analyses, X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), and X-ray Florescence (XRF). From laser diffraction analysis, it is evident that nodular shales are silty in nature containing approximately 60% silt (Mainly quartz). XRD pattern shows that Nodular shale contains clay minerals, predominantly illite, Kaolinite, Chlorite and expandable mixed layer clay mineral. Detail geochemical analysis of some nodular shale samples shows that there are no significant variation from other samples in major and trace element concentration. Microcrack's within the quartz grains were observed in nodular shale. Projection of 15 nodular shale long axes in outcrop shows their orientation in NNW-SSE that is parallel to the fold axis. The study suggests a new name of conventionally called

  12. Computed tomographic features of the bony canal of the cochlear nerve in pediatric patients with unilateral sensorineural hearing loss

    International Nuclear Information System (INIS)

    Kono, Tatsuo

    2008-01-01

    The aim of this study was to evaluate the diameters of the various bony canals of the inner ear in patients with sensorineural hearing loss (SNHL) and establish criteria for detecting hypoplasia of the bony canal of the cochlear nerve. Measurements obtained in 118 patients without inner ear malformations among 160 patients with unilateral SNHL were analyzed. The diameters of the internal auditory canal and the bony canals of the cochlear, vestibular, and facial nerves were measured on transverse or coronal computed tomographic images. Mean values (±standard deviation (SD)) were compared between the affected and unaffected ears, and statistical analysis was done. The diameter of the bony canal of the cochlear nerve was significantly smaller in affected ears than in unaffected ears (P<0.01). The affected ears could be divided into groups with (72 ears) and without (46 ears) bony canal stenosis. Most (60%) of the patients with unilateral SNHL showed a significant difference in the diameters of the bony canals of the cochlear nerve between the affected and unaffected sides; moreover, the mean value was significantly smaller in affected ears. The diameter of <1.7 mm on transverse images or <1.8 mm on coronal images suggests hypoplasia. (author)

  13. Nodular sclerosing Hodgkin's lymphoma presenting with a pseudo-breast mass extending from a necrotizing granulomatous mediastinal tumor.

    Science.gov (United States)

    Tantisattamo, Ekamol; Bello, Erlaine F; Acoba, Jared D

    2012-08-01

    Nodular sclerosing Hodgkin's lymphoma commonly presents with a mediastinal mass, but it rarely compresses or invades mediastinal structures or the anterior chest wall. Histologically, it can cause necrotizing granulomatous inflammation. A woman with a right breast mass extending from an asymptomatic large mediastinal mass selectively compressing the trachea is presented. A computed tomography-guided core needle biopsy from the anterior chest wall mass revealed necrotizing granulomatous inflammation. Finally, the diagnosis of nodular sclerosing Hodgkin's lymphoma was made by incisional biopsy. Clinical suspicion of nodular sclerosing Hodgkin's lymphoma is crucial since an adequate tissue diagnosis is needed when the initial less invasive diagnostic testing is inconclusive.

  14. Lymphoid nodular hyperplasia in a patient with severe combined immunodeficiency disease; Hiperplasia nodular linfoide en un paciente con inmunodeficiencia combinada grave

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez-Alegre, M. L.; Casanova, A.; Delgado, J.; Relanzon, S. [Hospital General Universitario Gregorio Maranon. Madrid (Spain)

    2001-07-01

    We describe a case of lymphoid nodular hyperplasia in a woman with severe combined immunodeficiency disease. the patient complained of constipation and episodes of abdominal pain, and examination revealed the presence of a large abdominal mass. The diagnosis was suspected on the basis of the initial radiological studies, but intestinal biopsy was necessary to rule out lymphomatous involvement. We point out the radiological features of this entity which, despite the fact that it may be a chance finding of no pathological significance, requires special attention, especially in immuno deficient individuals. (Author) 10 refs.

  15. Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report

    International Nuclear Information System (INIS)

    Bagewadi, Shivanand B.; Awasthi, Ujjwala Rastogi; Mody, Bharat M.; Suma, Gundareddy N.; Garg, Shruti

    2015-01-01

    Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma

  16. Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report

    Energy Technology Data Exchange (ETDEWEB)

    Bagewadi, Shivanand B.; Awasthi, Ujjwala Rastogi; Mody, Bharat M.; Suma, Gundareddy N.; Garg, Shruti [Dept. of Medicine and Radiology, ITS Center for Dental Studies and Research, Ghaziabad, Uttar Pradesh (Korea, Republic of)

    2015-09-15

    Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma.

  17. Anatomical study of suboccipital vertebral arteries and surrounding bony structures using virtual reality technology.

    Science.gov (United States)

    Ha, Wenbo; Yang, DeLin; Gu, Shixin; Xu, Qi-Wu; Che, Xiaoming; Wu, Jin-Song; Li, Wensheng

    2014-05-15

    This work aimed to evaluate the efficacy of virtual reality (VR) technology in neurosurgical anatomy through a comparison of the virtual 3D microanatomy of the suboccipital vertebral arteries and their bony structures as part of the resection of tumors in the craniovertebral junction (CVJ) of 20 patients compared to the actual microanatomy of the vertebral arteries of 15 cadaveric headsets. The study was conducted with 2 groups of data: a VR group composed of 20 clinical cases and a physical body group (PB group) composed of 15 cadaveric headsets. In the VR group, the dissection and measurements of the vertebral arteries were simulated on a Dextroscope. In the PB group, the vertebral arteries in the cadaver heads were examined under a microscope and anatomical measurements of VA and bony structures were performed. The length and course of the vertebral arteries and its surrounding bony structures in each group were compared. The distances from the inferior part of the transverse process foramen (TPF) of C1 to the inferior part of TPF of C2 were 17.68±2.86 mm and 18.4±1.82 mm in the PB and VR groups, respectively. The distances between the middle point of the posterior arch of the atlas and the medial intersection of VA on the groove were 17.35±2.23 mm in the PB group and 18.13±2.58 mm in the VR group. The distances between the middle line and the entrance of VA to the lower rim of TPF of Atlas were 28.64±2.67 mm in PB group and 29.23±2.89 mm in VR group. The diameters of the vertebral artery (VA) at the end of the groove and foramen of C2 transverse process were 4.02±046 mm and 4.25±0.51 mm, respectively, in the PB group and 3.54±0.44 mm and 4.47±0.62 mm, respectively, in VR group. The distances between the VA lumen center and midline of the foramen magnum at the level of dural penetration was 10.4±1.13 mm in the PB group and 11.5±1.34 mm in the VR group (P>0.05). VR technology can accurately simulate the anatomical features of the suboccipital

  18. The Effects of Latarjet Reconstruction on Glenohumeral Instability in the Presence of Combined Bony Defects

    Science.gov (United States)

    Patel, Ronak Maneklal; Walia, Piyush; Gottschalk, Lionel; Jones, Morgan H.; Fening, Stephen D.; Miniaci, Anthony

    2015-01-01

    Objectives: Recurrent glenohumeral instability is often as a result of underlying bony defects in the glenoid and/or humeral head. Anterior glenoid augmentation with a bone block (i.e. Latarjet) has been recommended for glenoid bone loss in the face of recurrent instability. However, no study has investigated the effect of Latarjet augmentation in the setting of both glenoid and humeral head defects (Hill-Sachs Defects (HSD)). The purpose of this study was to evaluate the stability achieved through a Latarjet procedure in the presence of combined bony defects. Methods: Eighteen fresh-frozen cadaveric specimens were tested at all combinations of glenohumeral abduction (ABD) angles of 20°, 40°, and 60° and three external rotation (ER) levels (0°, 40°, and 80°). Each experiment comprised of anterior dislocation by translating the glenoid under a 50N medial load applied on the humerus, simulating the static load of soft tissues. Translational distance and medial-lateral displacement of the humeral head, along with horizontal reaction forces were recorded for every trial. Specimens were tested in an intact condition (no defect), different combinations of defects, and with Latarjet augmentation. The Latarjet was performed for 20% and 30% glenoid defects by transferring the specimen's coracoid process anterior to the glenoid flush with the articulating surface. Four different humeral head defects were created of sizes 6%, 19%, 31%, and 44% of humeral diameter. Repeated measures analysis of variance (ANOVA) was performed with statistical significance set at p Latarjet augmentation (Fig. 1A). However, at an arm position of 60° ABD and 80° ER increasing HSD size led to a decrease in stability for both the defect state and post-Latarjet trials (Fig. 1B). Nevertheless, Latarjet augmentation helped in regaining stability for every combination of bony defects. With a HSD size of 44% the defect state had 0% intact translation for all 18 specimens. Conclusion: Clinically

  19. Diffuse Muscular Pain, Skin Tightening, and Nodular Regenerative Hyperplasia Revealing Paraneoplastic Amyopathic Dermatomyositis due to Testicular Cancer

    Directory of Open Access Journals (Sweden)

    Sarah Norrenberg

    2012-01-01

    Full Text Available Paraneoplastic dermatomyositis (DM associated with testicular cancer is extremely rare. We report the case of a patient with skin tightening, polymyalgia, hypereosinophilia, and nodular regenerative hyperplasia revealing seminoma and associated paraneoplastic DM.

  20. Long-term results in patients with low-grade nodular non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Aviles, A.; Diaz-Maqueo, J.C.; Sanchez, E.; Cortes, H.D.; Ayala, J.R.; Oncology Hospital, Mexico City; National Medical Center, Mexico City

    1991-01-01

    One hundred and eighteen patients with nodular non-Hodgkin's lymphoma were randomized to receive either chemotherapy alone or chemotherapy plus radiotherapy (total nodal or involved field irradiation). Although the complete remission rate was similar in the three programs (about 90%) the relapse-free survival rate (RFS) among patients with complete remission was significantly higher in the groups treated with chemotherapy plus radiotherapy than among those treated with chemotherapy alone. The 7-year RFS in the groups treated with total node irradiation and involved field irradiation was 71% and 66% respectively, compared to only 33% in the group treated by chemotherapy alone (p<0.01). The results suggest that combined chemoradiotherapy may achieve complete long-term remission and potential cure in more than 60% of patients with nodular low-grade non-Hodgkin's lymphoma. Toxicity was moderate in all three arms. Bulky disease and a high level of lactic dehydrogenase were associated with a poor prognosis. (orig.)

  1. Papulo-Nodular Reactions in Black Tattoos as Markers of Sarcoidosis

    DEFF Research Database (Denmark)

    Sepehri, Mitra; Hutton Carlsen, Katrina; Serup, Jørgen

    2016-01-01

    BACKGROUND/AIMS: Sarcoidosis is, from historical data, suggested to be more prevalent among patients with tattoo reactions. We aimed to evaluate this association in a systematic study. METHODS: This is a consecutive study of patients with tattoo complications, diagnosed in the "Tattoo Clinic......" at Bispebjerg University Hospital in Copenhagen, Denmark, from 2008 to 2015, based on clinical assessment and histology. From the overall group of 494 tattoo complications in 406 patients, 92 reactions in 72 patients showed a papulo-nodular pattern studied for local and systemic sarcoidosis, since sarcoidosis...... phenomenon" with concomitant reaction in many other black tattoos, triggered by a recent tattoo with a papulo-nodular reaction, was observed in 70% in the sarcoidosis group and 28% in the non-sarcoidosis group, indicating a predisposing factor which may be autoimmune and linked with sarcoidosis. Agglomerates...

  2. Nodular melanoma in trophic ulceration of a leprosy patient: a case study.

    Science.gov (United States)

    Zhu, J; Shi, C; Jing, Z; Liu, Y

    2016-05-01

    Non-healing chronic trophic ulceration is very common in leprosy patients. Marjolin's ulcer consists of the malignant transformation of a chronic ulcerative lesion. Nodular melanoma developing from Marjolin's ulcer, caused by a trophic ulceration of a leprosy patient, is very rare with only a few cases reported in the literature. Due to the disguised presentation of these malignancies within trophic ulceration lesions in leprosy, neoplastic transformation is frequently overlooked, leading to misdiagnosed and delayed treatment. This paper reports a case of an 83-year-old man with lepromatous leprosy and chronic ulceration on the foot for 22 years. Over a period of 2 months, the ulcer enlarged, turned black, and became more painful. The patient underwent regional excision and immunotherapy after the diagnosis of malignant nodular melanoma. After 9 months follow-up, no metastasis was found. There were no external sources of funding for this study. The authors have no conflicts of interest to declare.

  3. Nodular progression of lentigo malignant melanoma during a treatment with tocilizumab: cause or coincidence?

    Science.gov (United States)

    Finet, A; Amini-Adle, M; Balme, B; Colson, F; Thomas, L

    2013-02-01

    Tocilizumab is an anti-interleukin (IL)-6 receptor monoclonal antibody, used since 2010 for the treatment of severe rheumatoid arthritis (RA). It is known to induce infection, similarly to other biotherapies which modulate immune response and cytokines. Few cases of malignancy, however, have as yet been reported. We describe here the case of a patient with severe RA, previously treated with prednisolone, methotrexate, leflunomide, etanercept, and rituximab, who, after 8 months of treatment with tocilizumab, developed rapidly progressive nodular melanoma on a preexisting pigmented lesion on her left cheek. Recently, another case of nodular melanoma under tocilizumab has been published. The possible causative role of tocilizumab and other immunomodulatory agents in the development of this malignancy is discussed. Based on the present case, dermatologic screening is recommended before initiation of tocilizumab.

  4. Role of composition heterogeneity on fracture micromechanism of nodular cast iron

    Czech Academy of Sciences Publication Activity Database

    Konečná, R.; Lejček, Pavel; Nicoletto, G.; Bartuška, Pavel

    2006-01-01

    Roč. 22, č. 12 (2006), s. 1415-1421 ISSN 0267-0836 Grant - others:Slovak-Czech projects(SK) 063/117(2002-2003 a 144(2004-2005) Institutional research plan: CEZ:AV0Z1010914; CEZ:AV0Z10100520 Keywords : nodular cast iron * concentration heterogenity * finite element method * deformation heterogenity * fracture micromechanismus Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 0.677, year: 2006

  5. Atypical Pneumocystis jiroveci pneumonia with multiple nodular granulomas after rituximab for refractory nephrotic syndrome.

    Science.gov (United States)

    Sato, Mai; Ito, Shuichi; Ogura, Masao; Kamei, Koichi; Miyairi, Isao; Miyata, Ippei; Higuchi, Masataka; Matsuoka, Kentaro

    2013-01-01

    Rituximab, an anti-CD20 antibody that targets B cells, is a promising agent against steroid-dependent and steroid-resistant nephrotic syndrome in children. We report a 3-year-old boy who presented with atypical Pneumocystis jiroveci pneumonia (PCP) following administration of rituximab for refractory nephrotic syndrome. He had received cyclosporine and daily prednisolone for over 1 year. Following rituximab therapy, a hazy shadow was observed on his chest X-ray. Chest-computed tomography revealed multiple nodular lesions in bilateral lungs, although his clinical symptoms were subtle. PCR analysis demonstrated the presence of Pneumocystis DNA in his bronchoalveolar lavage. Lung wedge resection of the nodular lesion exhibited granulomas containing a few cysts of P. jiroveci that primarily consisted of T cells and histiocytes and lacked B cells. A deficiency of B cells following rituximab treatment suggests a dramatic effect on the immune response and, therefore, could result in granulomatous PCP. Nodular granulomatous lesions of PCP comprise an emerging concept previously reported in adults with hematological disease, bone marrow transplant, or treatment with rituximab. We report the first pediatric case of nodular PCP. Granulomatous PCP can be life-threatening. Moreover, bronchoalveolar lavage often fails to demonstrate the presence of P. jiroveci DNA. Wedge biopsy is warranted for definitive diagnosis. Our patient fully recovered with sulfamethoxazole/trimethoprim treatment because of early detection. The indication of rituximab for refractory nephrotic syndrome has increased recently. Therefore, recognition of the risk of atypical PCP is important. Our findings suggest that PCP prophylaxis should be considered following rituximab therapy.

  6. Thyroidectomy improves tracheal anatomy and airflow in patients with nodular goiter

    DEFF Research Database (Denmark)

    Sørensen, Jesper Roed; Lauridsen, Jeppe Killerich; Døssing, Helle

    Objectives: A large goiter may cause compression of the trachea and lead to respiratory insufficiency. We aimed at investigating the effects of thyroidectomy on tracheal anatomy and airflow in patients with benign nodular goiter, employing a prospective observational study. Methods: Magnetic reso...... to substantial improvement in tracheal compression, but only minor improvements in tracheal airflow. This information is pertinent when counselling patients before choice of treatment....

  7. Periventricular nodular heterotopia and bilateral intraventricular xanthogranulomas in 22q11.2 deletion syndrome

    Directory of Open Access Journals (Sweden)

    Moogeh Baharnoori

    2017-09-01

    Full Text Available 22q11.2 deletion syndrome (22q11DS is the most common pathogenic copy number variant in humans. Neuropsychiatric phenotypes, including schizophrenia, are prominent. Imaging studies of individuals with this syndrome show a variety of abnormalities that may indicate abnormal neuronal migration. Here we present the neuroimaging and neuropathologic features of a 22q11DS patient with bilateral periventricular nodular heterotopias (PNH and intraventricular xanthogranulomas that were identified by post-mortem examination.

  8. The importance of anti peroxidase antibodies in patients with nodular thyroid goiter

    Directory of Open Access Journals (Sweden)

    Medenica Sanja

    2012-01-01

    Full Text Available Introduction: Thyroid nodular goiter Nodular goiter is clinically recognizable restricted structure changes of the thyroid gland. Numerous studies show the relationship between thyroid autoimmunity and differentiated thyroid cancer in patients with nodular thyroid goiter. One of the important clinical marker in defining thyroid autoimmunity are antibodies to thyroid peroxidase. Objective: The aim of this study was to analyze the relationship between antibodies anti peroksidaznih ii thyroid malignancies in patients with thyroid altered thyroid. Material and Methods: We retrospectively reviewed the 248 reports of thyroid FNA cytology of samples obtained by puncture of patients with nodular thyroid goiter, at Department of thyroid gland, Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia in the period from October 2007. by January 2010. year. We analyzed the relationship between findings of cytopathological diagnostic categories and serum concentrations of anti peroxidase antibodies. The data were statistically processed using the computer program SPSS 12.0 software package. Results: Of total 248 patients, 148 patients (59.7% had anti-TPO antibody values in a reference limits (30 IU/ml, and 40.3% elevated anti-TPO antibodies (over 30 IU/ml. In the group of patients with elevated values of anti-TPO antibodies 7% (7/100 of patients had malignant cytologic findings, and in the group of patients with anti-TPO antibody values in the normal range only 1.4% (2/148 of patients had malignant cytologic findings. Conclusion: Defining the relationship between thyroid autoimmune disease and differentiated thyroid cancer, providing new insights in the field of immunotherapy of thyroid carcinoma. Enlightening the molecular mechanisms link autoimmune thyroid disease and thyroid cancer development in patients with thyroid nodule help find new therapeutic strategies against thyroid cancer.

  9. New data on aetiology of nodular gill disease in rainbow trout, Oncorhynchus mykiss

    Czech Academy of Sciences Publication Activity Database

    Dyková, Iva; Kostka, Martin; Wortberg, F.; Nardy, E.; Pecková, Hana

    2010-01-01

    Roč. 57, č. 3 (2010), s. 157-163 ISSN 0015-5683 R&D Projects: GA ČR GA524/09/0137; GA MŠk LC522 Institutional research plan: CEZ:AV0Z60220518 Keywords : nodular gill disease * aetiological study * amoebae * Naegleria sp. * fish diseases * aquaculture * Oncorhynchus mykiss Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 1.533, year: 2010

  10. Bony manifestation of rickets in a sunny city - a case report from Yazd, Iran

    Directory of Open Access Journals (Sweden)

    Mohammadhosain Afrand

    2014-01-01

    Full Text Available Rickets is disease that occurs in growing bones in which defective mineralization occurs in both the bone and the cartilage of the epiphyseal growth plate, resulting in the retardation of growth and skeletal deformities. Rickets is more common in areas with less sunlight. However, this case report presents a case of the bony manifestation of rickets with the intake of vitamin D supplements in Yazd, a city in central Iran that has sunshine almost every day. A patient was referred to an out-patient general pediatric clinic for deformities of the legs and growth disturbance, with his height far below the normal range. The changes that were most evident in his X-rays were the bowing of the long bones of the legs and forearms and the cupping of the wrist metaphyseal region. In summary, we present a patient with bony manifestation of rickets despite living in a sunny area and taking vitamin D supplements. Thus, it is important to remember that rickets is still a common disease among children in Iran. More studies of this issue should be conducted, including the identification of abnormal cases and rescheduling vitamin D supplementation programs.

  11. Bony manifestation of rickets in a sunny city - a case report from Yazd, Iran

    Directory of Open Access Journals (Sweden)

    Mohammadhosain Afrand

    2014-02-01

    Full Text Available Rickets is disease that occurs in growing bones in which defective mineralization occurs in both the bone and the cartilage of the epiphyseal growth plate, resulting in the retardation of growth and skeletal deformities. Rickets is more common in areas with less sunlight. However, this case report presents a case of the bony manifestation of rickets with the intake of vitamin D supplements in Yazd, a city in central Iran that has sunshine almost every day. A patient was referred to an out-patient general pediatric clinic for deformities of the legs and growth disturbance, with his height far below the normal range. The changes that were most evident in his X-rays were the bowing of the long bones of the legs and forearms and the cupping of the wrist metaphyseal region. In summary, we present a patient with bony manifestation of rickets despite living in a sunny area and taking vitamin D supplements. Thus, it is important to remember that rickets is still a common disease among children in Iran. More studies of this issue should be conducted, including the identification of abnormal cases and rescheduling vitamin D supplementation programs

  12. Results of Bony Chest Wall Reconstruction with Expanded Polytetrafluoroethylene Soft Tissue Patch

    Science.gov (United States)

    Huang, Haibo; Kitano, Kentaro; Nagayama, Kazuhiro; Nitadori, Jun-ichi; Anraku, Masaki; Murakawa, Tomohiro

    2015-01-01

    Purpose: The early and long-term outcomes of bony chest wall reconstruction with expanded polytetrafluoroethylene (Gore-Tex) soft tissue patch remain a concern. No clinical study has reported the shrinkage of Gore-Tex following reconstruction to date. Methods: Thirty-seven patients who underwent bony chest wall reconstruction from 1994 to 2012 were retrospectively reviewed. Postoperative chest computed tomography images of 17 patients were examined, and shrinkage of reconstruction materials was measured and compared. Results: Gore-Tex was used for reconstruction in 18 patients, autologous materials were used in 14, Marlex mesh was used in four, and Medifit felt was used in one. No surgery-related deaths were observed. Twenty patients experienced early postoperative complications. Four patients experienced local infection. One patient with Marlex-mesh experienced empyema 33 days postoperatively. Chest drainage time in the Gore-Tex patients was significantly lower than in patients with other types of prosthetic reconstruction. No dislocation or dehiscence was found. Shrinkage of Gore-Tex was absent in 4 patients and acceptable in seven patients. No granulation formation was evident around the Gore-Tex, No significant difference in shrinkage was seen between the different materials used. Conclusion: Chest wall reconstruction with Gore-Tex was feasible with favorable early and long-term results. PMID:25641033

  13. An alternative treatment option for a bony defect from large odontoma using recycled demineralization at chairside

    Science.gov (United States)

    2015-01-01

    Odontoma is the most common odontogenic benign tumor, and the treatment of choice is generally surgical removal. After excision, bone grafts may be necessary depending on the need for further treatment, or the size and location of the odontoma. Although the osteogenic capacity of a demineralized tooth was verified as early as 1967 by Urist and many other investigators, the cumbersome procedure, including a long demineralization time, may be less than comfortable for clinicians. A modified ultrasonic technology, with periodic negative pressure and temperature control, facilitated rapid and aseptic preparation of demineralized teeth for bone grafts. This approach reduces the demineralization time dramatically (≤80 minutes), so that the graft material can be prepared chairside on the same day as the extraction. The purpose of this article is to describe two cases of large compound odonotomas used as graft material prepared chairside for enucleation-induced bony defects. These two clinical cases showed favorable wound healing without complications, and good bony support for future dental implants or orthodontic treatment. Finally, this report will suggest the possibility of recycling the benign pathologic hard tissue as an alternative treatment option for conventional bone grafts in clinics. PMID:25922824

  14. Results of bony chest wall reconstruction with expanded polytetrafluoroethylene soft tissue patch.

    Science.gov (United States)

    Huang, Haibo; Kitano, Kentaro; Nagayama, Kazuhiro; Nitadori, Jun-ichi; Anraku, Masaki; Murakawa, Tomohiro; Nakajima, Jun

    2015-01-01

    The early and long-term outcomes of bony chest wall reconstruction with expanded polytetrafluoroethylene (Gore-Tex) soft tissue patch remain a concern. No clinical study has reported the shrinkage of Gore-Tex following reconstruction to date. Thirty-seven patients who underwent bony chest wall reconstruction from 1994 to 2012 were retrospectively reviewed. Postoperative chest computed tomography images of 17 patients were examined, and shrinkage of reconstruction materials was measured and compared. Gore-Tex was used for reconstruction in 18 patients, autologous materials were used in 14, Marlex mesh was used in four, and Medifit felt was used in one. No surgery-related deaths were observed. Twenty patients experienced early postoperative complications. Four patients experienced local infection. One patient with Marlex-mesh experienced empyema 33 days postoperatively. Chest drainage time in the Gore-Tex patients was significantly lower than in patients with other types of prosthetic reconstruction. No dislocation or dehiscence was found. Shrinkage of Gore-Tex was absent in 4 patients and acceptable in seven patients. No granulation formation was evident around the Gore-Tex, No significant difference in shrinkage was seen between the different materials used. Chest wall reconstruction with Gore-Tex was feasible with favorable early and long-term results.

  15. Selected ophthalmic diagnostic tests, bony orbit anatomy, and ocular histology in sambar deer (Rusa unicolor).

    Science.gov (United States)

    Oriá, Arianne P; Gomes Junior, Deusdete C; Oliveira, Alberto Vinícius D; Curvelo, Victor P; Estrela-Lima, Alessandra; Pinna, Melissa H; Meneses, Íris D S; Filho, Emanoel F M; Ofri, Ron

    2015-01-01

    The purpose of this study was to establish reference values for diagnostic ophthalmic tests in sambar deer (Rusa unicolor) as well as to describe the most relevant features of the bony orbital anatomy and ocular histology. Twenty healthy animals, free living in a forest reserve, that were captured for clinical evaluation as part of a health survey were evaluated. Schirmer tear test-1 (STT1), conjunctival microbiota, intraocular pressure (IOP), conjunctival cytology, anatomy of the bony orbit, and ocular histology were studied. Mean ± SD STT1 and IOP values were 18.8 ± 4.7 mm and 11.4 ± 2.8 mmHg, respectively. IOP was significantly higher in adult (4-8 years) animals (P = 0.04). Bacterial growth was present in 100% of the samples, with a prevalence for Staphylococcus sp. and Bacillus sp. The conjunctival cytology revealed predominance of columnar epithelial cells with mild pigmentation. The sambar deer orbit is completely encompassed by bone. The ocular histology was very similar to most mammalians. The findings in this study will be useful in the diagnosis of ocular diseases in Rusa unicolor. © 2014 American College of Veterinary Ophthalmologists.

  16. [Percutaneous ethanol injection in combination with euthyrox suppressive therapy in the treatment of benign nodular goiter].

    Science.gov (United States)

    Meskhi, I A; Sikharulidze, E N; Natmeladze, K V

    2007-05-01

    This study was designed to clarify the efficacy of combination of thyroid hormone (euthyrox) therapy and percutaneous ethanol injection (PEI) in benign nodular thyroid diseases. 55 patients with benign nodular goiter after the first PEI session during the whole study period (from 3 till 12 months after PEI) daily received euthyrox in a dosage - 50 mkg. 48 women and 7 men with thyroid nodules of the various sizes, structures and echogenecity have been included in the study group. The control group consisted of 32 patients: 29 women and 3 men in the same age range as in the study group. In both groups PEI procedure was performed but in the control group no thyroid hormone was added. In patients who were receiving 50 mkg daily after 3 months of PEI progressive reduction of the nodule sizes was registered, the volume of a thyroid gland has decreased and approached to normal parameters (15,79+/-1,21 ml), and in 6-2 months the normal volume of the thyroid gland was registered. Thus, combination of thyroid hormone therapy and percutaneous ethanol injection (PEI) in treatment of patients with benign nodular goiter normalizes the size of a thyroid gland. Euthyrox is the additional factor causing reduction of thyroid nodules and constraining occurrence of new nodules in a thyroid gland.

  17. Nestin expression is associated with aggressive cutaneous melanoma of the nodular type.

    Science.gov (United States)

    Ladstein, Rita G; Bachmann, Ingeborg M; Straume, Oddbjørn; Akslen, Lars A

    2014-03-01

    The intermediate filament nestin, a neural stem-cell marker, is reported to be expressed more strongly in melanomas compared with benign melanocytic lesions, and increasingly expressed in advanced melanoma stages. However, the prognostic impact of nestin on melanoma has not been well elucidated. The aim of the present study was to evaluate the prognostic influence of nestin expression in cutaneous melanoma in comparison with standard clinico-pathologic variables. In a large series of nodular cutaneous melanoma (n=348), nestin expression was assessed by immunohistochemistry using tissue microarray (TMA) sections. For comparison, nestin staining in corresponding metastases as well as in superficial spreading melanomas and benign nevi was also examined. Nestin was expressed to varying degrees in a majority of nodular melanomas (92%), and was significantly associated with increased tumor thickness, high mitotic count, and the presence of ulceration and tumor necrosis. Also, expression was stronger in the nodular type than in superficial spreading melanomas and benign nevi, but without significant difference when compared with matched metastases from the former. Importantly, strong expression of nestin was significantly associated with reduced survival in multivariate analysis. In conclusion, increased nestin expression was associated with aggressive melanoma features, with independent prognostic impact on multivariate survival analysis when compared with clinico-pathologic factors.

  18. Performance of the “if in doubt, cut it out” rule for the management of nodular melanoma

    Science.gov (United States)

    Moscarella, Elvira; Lallas, Aimilios; Longo, Caterina; Zalaudek, Iris; Caccavale, Stefano; Gambardella, Alessio; Lupoli, Amalia; Alfano, Roberto; Argenziano, Giuseppe

    2017-01-01

    Background The recognition of nodular melanoma is clinically challenging, and the diagnostic accuracy of dermoscopy and confocal microscopy is lower than for superficial spreading melanoma. Objectives To test a management strategy consisting in the excision of any nodular lesion that cannot be confidently and precisely classified as a benign tumor after clinical and dermoscopic examination. Methods Clinical and dermoscopic images of excised nodular lesions were retrospectively collected and evaluated. The evaluators were asked to record the level of diagnostic confidence for each lesion, by declaring if they were confident or doubtful about the given diagnosis. The NNE (number needed to excise) value was used to evaluate the efficacy of the proposed method. Results A total of 1,319 excised nodular lesions formed the study set. The NNE for any malignancy was 3.9 (634/164), while the NNE for melanoma was 13.2 (634/48). NNE for hypo and amelanotic melanoma was 27.3 (327/12). Conclusions Excising doubtful nodular lesions seems to be an effective management strategy not to miss nodular melanoma, resulting in an acceptable rate of unnecessary excision of benign lesions. PMID:29085713

  19. Patterns of congenital bony spinal deformity and associated neural anomalies on X-ray and magnetic resonance imaging.

    Science.gov (United States)

    Trenga, Anthony P; Singla, Anuj; Feger, Mark A; Abel, Mark F

    2016-08-01

    Congenital malformations of the bony vertebral column are often accompanied by spinal cord anomalies; these observations have been reinforced with the use of magnetic resonance imaging (MRI). We hypothesized that the incidence of cord anomalies will increase as the number and complexity of bony vertebral abnormalities increases. All patients aged ≤13 years (n = 75) presenting to the pediatric spine clinic from 2003-2013 with congenital bony spinal deformity and both radiographs and MRI were analyzed retrospectively for bone and neural pathology. Chi-squared analysis was used to compare groups for categorical dependent variables. Independent t tests were used for continuous dependent variables. Significance was set at p formation had a higher incidence of cord anomalies (73 %) than failures of formation (50 %) or segmentation (45 %) alone (p = 0.065). Deformities in the sacrococcygeal area had the highest rate of spinal cord anomalies (13 of 15 patients, 87 %). In 35 cases (47 %), MRI revealed additional bony anomalies that were not seen on the radiographs. As the number of bony malformations increased, we found a higher incidence of cord anomalies. Clinicians should have increased suspicion of spinal cord pathology in the presence of mixed failures of segmentation and formation.

  20. Repair of pars defects by segmental transverse wiring for athletes with symptomatic spondylolysis: relationship between bony union and postoperative symptoms.

    Science.gov (United States)

    Hioki, Akira; Miyamoto, Kei; Sadamasu, Aya; Nozawa, Satoshi; Ogawa, Hiroyasu; Fushimi, Kazunari; Hosoe, Hideo; Shimizu, Katsuji

    2012-04-20

    Retrospective study of surgery for spondylolysis patients. To assess clinical outcome of bony union using multislice computed tomography after segmental wiring fixation. How bony union affects surgical outcome of spondylolysis repair is unclear. Forty-four athletes with symptomatic spondylolysis (33 men and 11 women; mean age, 24.2 ± 5.4 years) who underwent segmental wiring fixation were evaluated retrospectively at a mean follow-up of 85 ± 17 months. The level of spondylolysis was L5 in 42 cases, and both L4 and L5 in 2 cases, giving a total of 46 operative levels of vertebrae. Bony union using axial and sagittal reconstruction images of computed tomography, the Japanese Orthopaedic Association (JOA) score for back pain, and complications were reviewed. State of bony union was classified as bilateral union, unilateral union, or nonunion. The total score and the improvement ratio of the JOA score were compared among the 3 groups. Bilateral bony union was obtained in 29 cases (31 of 46 vertebrae, 67.4%). Six cases (13%) showed unilateral union, and 9 cases (19.6%) showed nonunion. JOA score increased significantly after surgery in all groups, average improvement rate was 78.9% in the bilateral group, 63.6% in the unilateral group, and 29.8% in the nonunion group; differences among the 3 groups were significant (P spondylolysis repair.

  1. The bony labyrinth of the middle Pleistocene Sima de los Huesos hominins (Sierra de Atapuerca, Spain).

    Science.gov (United States)

    Quam, Rolf; Lorenzo, Carlos; Martínez, Ignacio; Gracia-Téllez, Ana; Arsuaga, Juan Luis

    2016-01-01

    We performed 3D virtual reconstructions based on CT scans to study the bony labyrinth morphology in 14 individuals from the large middle Pleistocene hominin sample from the site of the Sima de los Huesos (SH) in the Sierra de Atapuerca in northern Spain. The Atapuerca (SH) hominins represent early members of the Neandertal clade and provide an opportunity to compare the data with the later in time Neandertals, as well as Pleistocene and recent humans more broadly. The Atapuerca (SH) hominins do not differ from the Neandertals in any of the variables related to the absolute and relative sizes and shape of the semicircular canals. Indeed, the entire Neandertal clade seems to be characterized by a derived pattern of canal proportions, including a relatively small posterior canal and a relatively large lateral canal. In contrast, one of the most distinctive features observed in Neandertals, the low placement of the posterior canal (i.e., high sagittal labyrinthine index), is generally not present in the Atapuerca (SH) hominins. This low placement is considered a derived feature in Neandertals and is correlated with a more vertical orientation of the ampullar line (LSCm  PPp), and third part of the facial canal (LSCm < FC3). Some variation is present within the Atapuerca (SH) sample, however, with a few individuals approaching the Neandertal condition more closely. In addition, the cochlear shape index in the Atapuerca (SH) hominins is low, indicating a reduction in the height of the cochlea. Although the phylogenetic polarity of this feature is less clear, the low shape index in the Atapuerca (SH) hominins may be a derived feature. Regardless, cochlear height subsequently increased in Neandertals. In contrast to previous suggestions, the expanded data in the present study indicate no difference across the genus Homo in the angle of inclination of the cochlear basal turn (COs < LSCm). Principal components analysis largely confirms these observations. While not

  2. Syringocystadenoma Papilliferum of the Bony External Auditory Canal: A Rare Tumor in a Rare Location

    Directory of Open Access Journals (Sweden)

    Anastasija Arechvo

    2013-01-01

    Full Text Available Tumors originating from ceruminous glands are rare lesions of the external auditory canal. The lack of specific clinical and radiological signs makes their diagnosis challenging. We report the case of an exceptionally rare benign tumor, a syringocystadenoma papilliferum (SCAP, in an atypical location in the bony segment of the external auditory canal with uncommon clinical signs. The special traits of the case included the following: the most lateral component of the tumor was macroscopically cystic and a granular myringitis with an obstructing keratin mass plug was observed behind the mass. The clinical, audiological, radiological, and histological characteristics of the neoplasm are consequently presented. Intraoperative diagnosis of the epidermal cyst was proposed. The final diagnosis of SCAP was determined only by histological analysis after the surgical excision. The educational aspects of the case are critically discussed.

  3. Bony cranial ornamentation linked to rapid evolution of gigantic theropod dinosaurs

    Science.gov (United States)

    Gates, Terry A.; Organ, Chris; Zanno, Lindsay E.

    2016-09-01

    Exaggerated cranial structures such as crests and horns, hereafter referred to collectively as ornaments, are pervasive across animal species. These structures perform vital roles in visual communication and physical interactions within and between species. Yet the origin and influence of ornamentation on speciation and ecology across macroevolutionary time scales remains poorly understood for virtually all animals. Here, we explore correlative evolution of osseous cranial ornaments with large body size in theropod dinosaurs using a phylogenetic comparative framework. We find that body size evolved directionally toward phyletic giantism an order of magnitude faster in theropod species possessing ornaments compared with unadorned lineages. In addition, we find a body mass threshold below which bony cranial ornaments do not originate. Maniraptoriform dinosaurs generally lack osseous cranial ornaments despite repeatedly crossing this body size threshold. Our study provides novel, quantitative support for a shift in selective pressures on socio-sexual display mechanisms in theropods coincident with the evolution of pennaceous feathers.

  4. Control de Sclerotinia sclerotiorum (lib. de Bary en Crisantemo y Habichuela con diferentes aislamientos de Trichoderma y con fungicidas Control of Sclerotínía sclerotíorum (lib de Bary in Chrysanthemum and snap bean with different isolates of Tríchoderma and with fungicides

    Directory of Open Access Journals (Sweden)

    Delgado de Kallman Liliana

    1990-12-01

    Full Text Available

    El trabajo consistió en seleccionar, incrementar, aplicar y evaluar la actividad antagónica de algunos aislamientos· del género Tríehoderma sobre el patógeno Scterotinía scterotiorum in vitro y en el campo en cultivos de crisantemo y habichuela, así como evaluar la eficiencia de algunos fungicidas en el control de las mismas enfermedades. Los aislamientos T10 de Tríchoderma víríde y T12 de Tríehoderma hamatúm se seleccionaron como los mejores antagonistas
    del patógeno por su mayor inhibición del crecimiento del micelio, sobre la formaéión de esclerociós y la mayor esporulación sobre el patógeno. Los aislamientos con mayor
    capacidad antagonista se evaluaron en el campo. Se evidenció la existencia de diferencias marcadas en el antagonismo entre los aislamientos de Tríehoderma utilizados. En los ensayos de campo se estableció que la
    enfermedad se presentó en el primero y segundo
    tercio de la planta, lo que indica que el control con fungicidas debe ir dirigido preferencialmente a esas partes de la planta. Se evalu6 además la eficiencia de las aplicaciones de los fungicidas Ferbam, Carbendazim y Vinclozolin y·se observo que en el ensayo de crisantemo bajo invernadero, el mejor control se logr6 cuando· se aplicó Carbendazim al suelo durante la primera semana de siembra combinado con cinco aspersiones sucesivas de Vinclozolin al follaje cada siete días a partir de la sexta semana. Al comparar el mejor tratamiento químico con el mejor antagonista biológico no se obtuvieron diferencias significativas entre ambos tipos de tratamíento.

    The objetive of this study was to select. increase and apply sorne isolates of Tríchoderma, and to evaluate their antagonistic activity against Sclerotínía sclerotíorum in vitro and in the field in chrysanthemum and snap beans. It was also intended to evaluate the efficiency of some fungicides in the control of those diseases. The isolates T10 of Tríchoderma v

  5. PrimaryiIntraosseousm meningioma in the orbital bony wall: A case report and review of the literature review

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Jae; Ryu, Ji Hwa; Kim, Hong Dae; Lee, Kwang Hwi; Baek, Hye Jin; Kim, Ok Hwa; Yoon, Jung Hee; Kim, Ji Yeon [Dept. of Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Park, Young Mi; Kim, Dong Wook [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2015-01-15

    Meningiomas arising outside the intracranial compartment are known as extradural meningiomas. Extradural meningiomas are rare conditions, accounting for less than 2% of all meningiomas. Primary intraosseous meningioma is used to describe a subset of extradural meningiomas arising from bone. A 46-year-old woman presented with left exophthalmos. Computed tomography and magnetic resonance images revealed an expansile bony lesion in the orbital lateral wall of the left sphenoid bone. The patient underwent craniotomy for excision of the bony lesion. Pathologic examination revealed an intraosseous meningioma.

  6. A clinico-radiologic study of bony remodeling of the fractured condyles in children

    International Nuclear Information System (INIS)

    Cho, Jeong Shin; Park, Chang Seo

    1995-01-01

    Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age, They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group (83%). 2. Fallen down (54%) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to palpation (19 cases). Mouth opening limitation (17 cases), swelling (7 cases), malocclusion (3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients (44%). Condyle fractures with symphysis fracture (9 patients, 39%), condyle fractures with ascending ramus fracture (2 patients, 9%), condyle fracture with mandibular body fracture (1 patient, 4%), and condyle fractures with mandibular angle fracture (1 patient, 4%) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, displacement (17 cases, 66%) was most common. Dislocation (5 cases, 19%) and deviation (4 cases, 15%) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual congealer shape in 23

  7. Human bony labyrinth is an indicator of population history and dispersal from Africa.

    Science.gov (United States)

    Ponce de León, Marcia S; Koesbardiati, Toetik; Weissmann, John David; Milella, Marco; Reyna-Blanco, Carlos S; Suwa, Gen; Kondo, Osamu; Malaspinas, Anna-Sapfo; White, Tim D; Zollikofer, Christoph P E

    2018-04-17

    The dispersal of modern humans from Africa is now well documented with genetic data that track population history, as well as gene flow between populations. Phenetic skeletal data, such as cranial and pelvic morphologies, also exhibit a dispersal-from-Africa signal, which, however, tends to be blurred by the effects of local adaptation and in vivo phenotypic plasticity, and that is often deteriorated by postmortem damage to skeletal remains. These complexities raise the question of which skeletal structures most effectively track neutral population history. The cavity system of the inner ear (the so-called bony labyrinth) is a good candidate structure for such analyses. It is already fully formed by birth, which minimizes postnatal phenotypic plasticity, and it is generally well preserved in archaeological samples. Here we use morphometric data of the bony labyrinth to show that it is a surprisingly good marker of the global dispersal of modern humans from Africa. Labyrinthine morphology tracks genetic distances and geography in accordance with an isolation-by-distance model with dispersal from Africa. Our data further indicate that the neutral-like pattern of variation is compatible with stabilizing selection on labyrinth morphology. Given the increasingly important role of the petrous bone for ancient DNA recovery from archaeological specimens, we encourage researchers to acquire 3D morphological data of the inner ear structures before any invasive sampling. Such data will constitute an important archive of phenotypic variation in present and past populations, and will permit individual-based genotype-phenotype comparisons. Copyright © 2018 the Author(s). Published by PNAS.

  8. Papulo-Nodular Reactions in Black Tattoos as Markers of Sarcoidosis: Study of 92 Tattoo Reactions from a Hospital Material.

    Science.gov (United States)

    Sepehri, Mitra; Hutton Carlsen, Katrina; Serup, Jørgen

    2016-01-01

    Sarcoidosis is, from historical data, suggested to be more prevalent among patients with tattoo reactions. We aimed to evaluate this association in a systematic study. This is a consecutive study of patients with tattoo complications, diagnosed in the "Tattoo Clinic" at Bispebjerg University Hospital in Copenhagen, Denmark, from 2008 to 2015, based on clinical assessment and histology. From the overall group of 494 tattoo complications in 406 patients, 92 reactions in 72 patients showed a papulo-nodular pattern studied for local and systemic sarcoidosis, since sarcoidosis is expected to be nodular. Of the 92 reactions with a papulo-nodular pattern, 27 (29%) reactions in 19 patients were diagnosed as cutaneous or systemic sarcoidosis, supported by histology; 65 (71%) were diagnosed as non-sarcoidosis due to histology and no clinical sarcoid manifestations. "Rush phenomenon" with concomitant reaction in many other black tattoos, triggered by a recent tattoo with a papulo-nodular reaction, was observed in 70% in the sarcoidosis group and 28% in the non-sarcoidosis group, indicating a predisposing factor which may be autoimmune and linked with sarcoidosis. Agglomerates of black pigment forming foreign bodies may in the predisposed individual trigger widespread reaction in the skin and internal organs. Black tattoos with papulo-nodular reactions should be seen as markers of sarcoidosis. Papulo-nodular reactions may, as triggers, induce widespread reactions in other black tattoos - a "rush phenomenon" - depending on individual predisposition. Sarcoidosis is estimated to be 500-fold increased in papulo-nodular reactions compared to the prevalence in the general population, and the association with black tattoos is strong. © 2017 S. Karger AG, Basel.

  9. Factors related to the presentation of thin and thick nodular melanoma from a population-based cancer registry in Queensland Australia.

    Science.gov (United States)

    Geller, Alan C; Elwood, Mark; Swetter, Susan M; Brooks, Daniel R; Aitken, Joanne; Youl, Philippa H; Demierre, Marie-France; Baade, Peter D

    2009-03-15

    Worldwide, the incidence of thick melanoma has not declined, and the nodular melanoma (NM) subtype accounts for nearly 40% of newly diagnosed thick melanoma. To assess differences between patients with thin (or=2.01 mm) nodular melanoma, the authors evaluated factors such as demographics, melanoma detection patterns, tumor visibility, and physician screening for NM alone and compared clinical presentation and anatomic location of NM with superficial spreading melanoma (SSM). The authors used data from a large population-based study of Queensland (Australia) residents diagnosed with melanoma. Queensland residents aged 20 to 75 years with histologically confirmed first primary invasive cutaneous melanoma were eligible for the study, and all questionnaires were conducted by telephone (response rate, 77.9%). During this 4-year period, 369 patients with nodular melanoma were interviewed, of whom 56.7% were diagnosed with tumors nodular tumors of greater thickness. Thickest nodular melanoma (4 mm+) was also most common in persons who had not been screened by a physician within the past 3 years (odds ratio, 3.75; 95% confidence interval, 1.47-9.59). Forty-six percent of patients with thin nodular melanoma (nodular melanoma (>2.00 mm). Awareness of factors related to earlier detection of potentially fatal nodular melanomas, including the benefits of a physician examination, should be useful in enhancing public and professional education strategies. Particular awareness of clinical warning signs associated with thin nodular melanoma should allow for more prompt diagnosis and treatment of this subtype. Copyright (c) 2009 American Cancer Society.

  10. Thyroid nodularity and chromosome aberrations among women in areas of high background radiation in China

    International Nuclear Information System (INIS)

    Wang, Z.Y.; Boice, J.D. Jr.; Wei, L.X.; Beebe, G.W.; Zha, Y.R.; Kaplan, M.M.; Tao, Z.F.; Maxon, H.R. III; Zhang, S.Z.; Schneider, A.B.

    1990-01-01

    Thyroid nodularity following continuous low-dose radiation exposure in China was determined in 1,001 women aged 50-65 years who resided in areas of high background radiation (330 mR/yr) their entire lives, and in 1,005 comparison subjects exposed to normal levels of radiation (114 mR/yr). Cumulative doses to the thyroid were estimated to be of the order of 14 cGy and 5 cGy, respectively. Personal interviews and physical examinations were conducted, and measurements were made of serum thyroid hormone levels, urinary iodine concentrations, and chromosome aberrations in circulating lymphocytes. For all nodular disease, the prevalences in the high background and control areas were 9.5% and 9.3%, respectively. For single nodules, the prevalences were 7.4% in the high background area and 6.6% in the control area (prevalence ratio = 1.13; 95% confidence interval = 0.82-1.55). There were no differences found in serum levels of thyroid hormones. Women in the high background region, however, had significantly lower concentrations of urinary iodine and significantly higher frequencies of stable and unstable chromosome aberrations. Increased intake of allium vegetables such as garlic and onions was associated with a decreased risk of nodular disease, which seems consistent with experimental studies suggesting that allium compounds can inhibit tumor growth and proliferation. The prevalence of mild diffuse goiter was higher in the high background radiation region, perhaps related to a low dietary intake of iodine. These data suggest that continuous exposure to low-level radiation throughout life is unlikely to appreciably increase the risk of thyroid cancer. However, such exposure may cause chromosomal damage

  11. Fatigue strength of nodular cast iron with regard to heavy-wall applications

    Energy Technology Data Exchange (ETDEWEB)

    Bleicher, Christoph; Wagener, Rainer; Kaufmann, Heinz [Fraunhofer-Institut fuer Betriebsfestigkeit und Systemzuverlaessigkeit LBF, Darmstadt (Germany); Melz, Tobias [Fraunhofer-Institut fuer Betriebsfestigkeit und Systemzuverlaessigkeit LBF, Darmstadt (Germany); TU Darmstadt (Germany). Faculty of Mechanical Engineering

    2015-11-01

    For a proper estimation of the fatigue life of a heavy-walled cast component made of nodular cast iron, sufficient knowledge regarding the cyclic properties of the material is necessary. Based on the material parameters at hand for component design, different fatigue analysis procedures can be used. Elastic and elastic-plastic approaches can be adopted, with the latter being reserved only for local approaches. The present publication summarizes the cyclic material parameters gained during a research project by extensive material tests under stress and strain controlled cyclic loading at different load ratios for three nodular cast iron grades. In addition to an improved knowledge of the cyclic material behavior, the notch, the size effects and the mean stress sensitivity were of special concern during the investigations in order to provide an entire overview of the tested materials and thus input information for both stress and strain based design approaches. Tests were performed for specimens taken from large cast blocks of the nodular cast iron grades EN-GJS-400-18U-LT and EN-GJS-450-18, both with ferritic matrices, and EN-GJS-700-2 with a pearlitic matrix. For some of these materials, mean stress sensitivities above 0.5 were obtained during the investigations. These values are not covered by the common standards, which calculate lower values for the mean stress sensitivity. Cyclic material parameters for stress and strain controlled tests are given in this paper as well as values for the size effect, based on the concept of the highly stressed volume. The effect of different specimen sizes could be shown not only by stress but also by strain controlled tests.

  12. Nodular melanoma: a distinct clinical entity and the largest contributor to melanoma deaths in Victoria, Australia.

    Science.gov (United States)

    Mar, Victoria; Roberts, Hugh; Wolfe, Rory; English, Dallas R; Kelly, John W

    2013-04-01

    There is a growing body of evidence that nodular melanoma (NM), because of its association with increased growth rate and thickness at diagnosis, accounts for a substantial proportion of melanoma deaths. We sought to assess the contribution of NM to melanoma deaths in comparison with other tumor subtypes. Four cohorts were established comprising 5775 cases of invasive primary cutaneous melanoma reported to the Victorian Cancer Registry during 1989, 1994, 1999, and 2004. Original pathology reports were reviewed. Age-standardized melanoma incidence rates were compared from 1989 to 2004 with annual percentage change using Poisson regression. The incidence of thick tumors (>4 mm) increased by 3.8% (95% confidence interval 1.4 to 6.2) and 2.5% (95% confidence interval -0.5 to 5.5) per year for male and female patients, respectively. The median thickness of NM at diagnosis was 2.6 mm compared with 0.6 mm for superficial spreading melanoma. A third of patients who died from melanoma during the follow-up period had thick tumors (>4 mm), most of which were nodular subtype (61%). NM accounted for 14% of invasive melanomas, but was responsible for 43% of melanoma deaths in a total of 57,461 person-years of follow-up. By comparison, superficial spreading melanoma contributed 56% of invasive melanoma but only 30% of deaths. Pathology review was limited to reports only. Mortality information relied mostly on death certificate information. The incidence of thick melanomas continues to increase. Nodular melanoma is clinically distinct and the predominant contributor to melanoma-related deaths, representing a public health challenge in reducing skin cancer mortality. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  13. Pigmented nodular melanoma: the predictive value of dermoscopic features using multivariate analysis.

    Science.gov (United States)

    Pizzichetta, M A; Kittler, H; Stanganelli, I; Bono, R; Cavicchini, S; De Giorgi, V; Ghigliotti, G; Quaglino, P; Rubegni, P; Argenziano, G; Talamini, R

    2015-07-01

    Nodular melanoma (NM), representing 10-30% of all melanomas, plays a major role in global mortality related to melanoma. Nonetheless, the literature on dermoscopy of NM is scanty. To assess odds ratios (ORs) to quantify dermoscopic features of pigmented NM vs. pigmented superficial spreading melanoma (SSM), and pigmented nodular nonmelanocytic and benign melanocytic lesions. To assess the presence or absence of global patterns and dermoscopic criteria, digitized images of 457 pigmented skin lesions from patients with a histopathological diagnosis of NM (n = 75), SSM (n = 93), and nodular nonmelanocytic and benign melanocytic lesions (n = 289; namely, 39 basal cell carcinomas, 85 seborrhoeic keratoses, 81 blue naevi, and 84 compound/dermal naevi) were retrospectively collected and blindly evaluated by three observers. Multivariate analysis showed that ulceration (OR 4.07), homogeneous disorganized pattern (OR 10.76), and homogeneous blue pigmented structureless areas (OR 2.37) were significantly independent prognostic factors for NM vs. SSM. Multivariate analysis of dermoscopic features of NM vs. nonmelanocytic and benign melanocytic lesions showed that the positive correlating features leading to a significantly increased risk of NM were asymmetric pigmentation (OR 6.70), blue-black pigmented areas (OR 7.15), homogeneous disorganized pattern (OR 9.62), a combination of polymorphous vessels and milky-red globules/areas (OR 23.65), and polymorphous vessels combined with homogeneous red areas (OR 33.88). Dermoscopy may be helpful in improving the recognition of pigmented NM by revealing asymmetric pigmentation, blue-black pigmented areas, homogeneous disorganized pattern and abnormal vascular structures, including polymorphous vessels, milky-red globules/areas and homogeneous red areas. © 2015 British Association of Dermatologists.

  14. Blue-black rule: a simple dermoscopic clue to recognize pigmented nodular melanoma.

    Science.gov (United States)

    Argenziano, G; Longo, C; Cameron, A; Cavicchini, S; Gourhant, J-Y; Lallas, A; McColl, I; Rosendahl, C; Thomas, L; Tiodorovic-Zivkovic, D; Zaballos, P; Zalaudek, I

    2011-12-01

    Dermoscopy improves melanoma recognition, but most criteria were described in the context of superficial spreading melanoma. To test whether pigmented nodular melanoma could be recognized dermoscopically by the presence of a combination of blue and black colour within the lesion. Dermoscopic images of histopathologically diagnosed pigmented nodular tumours with no (or only minimal) flat component were evaluated for the presence of standard melanoma criteria and for the presence of a new feature named blue-black (BB) colour. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for standard criteria and BB feature in relation to the diagnosis of melanoma and to diagnosis of malignancy. Of 283 lesions, 160 were malignant, including 78 (27·6%) melanomas, and 123 were benign. The BB feature and the standard criteria had 78·2% and 43·6% sensitivity for melanoma, respectively, whereas a combined method based on the presence of either the BB feature or one (or more) of the standard criteria reached 84·6% sensitivity, with 80·5% specificity and 93·2% negative predictive value. Sensitivity values for malignant lesions were only 24·4%, 56·9% and 60% for standard criteria, BB feature and the combined method, respectively. However, the combined method gave 91·9% specificity and 90·6% positive predictive value for malignancy. Using a method based on the BB feature or one of the standard melanoma criteria, only 9·4% of positive pigmented nodular lesions were found to be benign and only 6·8% of negative lesions were found to be melanoma histopathologically. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

  15. Routine calcitonin measurement in nodular thyroid disease management: is it worthwhile?

    Science.gov (United States)

    Turk, Yigit; Makay, Ozer; Ozdemir, Murat; Ertunc, Gozde; Demir, Batuhan; Icoz, Gokhan; Akyildiz, Mahir; Yilmaz, Mustafa

    2017-04-01

    To evaluate the diagnostic accuracy of routine calcitonin measurement in patients with nodular thyroid disease. Consecutive patients with nodular thyroid disease (n = 640) were studied. Serum calcitonin levels were measured under basal conditions, and when basal values were between 10-100 pg/mL, testing was repeated after pentagastrin (PG) stimulation. Patients with previously diagnosed or familial medullary thyroid cancer (MTC) were excluded. Patients were operated on when basal or stimulated calcitonin >100 pg/mL or when other surgical indications were present. Four cases of MTC were identified. MTC was diagnosed in 75% of patients with basal calcitonin >100 pg/mL. One out of 11 patients with basal calcitonin between 10-100 pg/mL was diagnosed with MTC. PG stimulation resulted in elevation in 4 cases, where 1 case was diagnosed with MTC. Positive predictive value for basal calcitonin levels in the preoperative diagnosis of MTC was 5% for values between 10-100 pg/mL and 100% for values >100 pg/mL. Possible reasons for false positivity were papillary thyroid cancer in 17%, renal insufficiency in 8.3%, Hashimoto thyroiditis in 17% and β-blocker use in 33%. Positive predictive value for the PG test (>100 pg/mL) was 25% in the entire series. The cost of adding calcitonin measurement (±PG stimulation) to the preoperative work-up, resulted in €912.68 per MTC patient to detect the disease. Basal calcitonin measurement together with PG stimulation in cases of basal calcitonin >10 pg/mL detects MTC in 0.62% of patients with nodular thyroid disease.

  16. New Experimental Technique for Nodularity and Mg Fading Control in Compacted Graphite Iron Production on Laboratory Scale

    Science.gov (United States)

    Hernando, Juan Carlos; Domeij, Björn; González, Daniel; Amieva, José Manuel; Diószegi, Attila

    2017-11-01

    The narrow production window for compacted graphite iron material (CGI) drastically reduces the possibilities to produce it in small batches outside an industrial environment. This fact hinders laboratory-scale investigations on CGI solidification. This work presents a solution to that issue by introducing an experimental technique to produce graphitic cast iron of the main three families. Samples of a base hypereutectic spheroidal graphite iron (SGI) were re-melted in a resistance furnace under Ar atmosphere. Varying the holding time at 1723 K (1450 °C), graphitic irons ranging from spheroidal to lamellar were produced. Characterization of the graphite morphology evolution, in terms of nodularity as a function of holding time, is presented. The nodularity decay for the SGI region suggests a linear correlation with the holding time. In the CGI region, nodularity deterioration shows a slower rate, concluding with the sudden appearance of lamellar graphite. The fading process of magnesium, showing agreement with previous researchers, is described by means of empirical relations as a function of holding time and nodularity. The results on nodularity fade and number of nodules per unit area fade suggest that both phenomena occur simultaneously during the fading process of magnesium.

  17. Small nodular melanoma: the beginning of a life-threatening lesion. A clinical study on 11 cases.

    Science.gov (United States)

    Bono, Aldo; Tolomio, Elena; Carbone, Antonino; Moglia, Daniele; Crippa, Federica; Tomatis, Stefano; Santinami, Mario

    2011-01-01

    Because of its high thickness, nodular melanoma often bears a poor prognosis. Thus, an earlier diagnosis of this type of lesion while it is still thin would be an important step in secondary prevention. The principal aim of the present study was to better define the initial clinical features of nodular melanoma to allow an early diagnosis. A secondary aim was to establish the prognosis of this type of lesion. We retrospectively studied and illustrated the clinical features of 11 small (nodular melanomas seen and treated during a 10-year period. Prognostic characteristics of the various lesions were also described. The results of the study help to describe a small nodular melanoma as a dark and/or pink/red raised lesion, which may be evenly or unevenly colored, with well-defined borders, that often appears de novo. A correct clinical diagnosis was made in 7 of the cases. During a median follow-up of 6 years, none of the patients had local or distant relapses. Detection of small nodular melanoma is feasible by accurate visual inspection, provided that physicians are aware of this type of lesion and maintain the index of suspicion at a high level to bring about curative surgery.

  18. Genetic and non-iodine-related factors in the aetiology of nodular goitre

    DEFF Research Database (Denmark)

    Knudsen, Nils; Brix, Thomas Heiberg

    2014-01-01

    factors should be made with caution. Smoking seems to be an established risk factor for nodular goitre, possibly with effect modification from iodine intake, as the risk associated with smoking is smaller or absent in areas with sufficient iodine intake. The use of oral contraceptives might have...... protective effects against goitre, and childbirth is an increased risk factor for goitre in areas with non-optimal iodine intake. Insulin resistance is a recently investigated risk factor, and the risk of goitre may be reversible with metformin treatment. Iodine remains the major environmental risk factor...

  19. Nodular regenerative hyperplasia of the liver in an infant: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ho Kyun; Lee, Young Hwan; Chung, Duck Soo; Kim, Ok Dong; Park, Jae Bok [Catholic University School of Medicine, Daegu (Korea, Republic of); Whang, Jin Bok [Hanyoung Pediatric Clinic, Daegu (Korea, Republic of)

    2002-12-01

    Nodular regenerative hyperplasia (NRH) of the liver is an uncommon disease entity, especially in the pediatricage group. A few cases have been reported in the radiologic literature, but follow-up imaging studies are rare. We describe a case of NRH, disgnosed by ultrasound-guided needle biopsy, in a seven-month-old infant with cri-du-chat syndrome. Initial ultrasound revealed several small hypoechogenic nodules in the liver, but CT and MR failed to demonstrate their presence. Two follow-up sonographic examinations were performed 7 and 20 months later, revealing increases in the size number of the nodules.

  20. Relations between various measures of iodine intake and thyroid volume, thyroid nodularity, and serum thyroglobulin

    DEFF Research Database (Denmark)

    Rasmussen, Lone Banke; Ovesen, L.; Bulow, I.

    2002-01-01

    sought to identify, if possible, groups at risk of thyroid disease because of their food choices. Design: This cohort study included 4649 randomly selected subjects with mild-to-moderate iodine deficiency; the subjects lived in 2 cities in Denmark. Iodine intake was estimated by using a food-frequency...... questionnaire and by measuring iodine excretion in spot urine samples. Thyroid volume and nodularity were measured with ultrasonography. Results: In multiple linear regression models, significant inverse relations were found between thyroid volume and estimated 24-h iodine excretion, iodine intake from diet...

  1. Focal nodular hyperplasia. /sup 99m/Tc-EHIDA hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fujimori, Kenji; Saito, Hiroya; Itoh, Kazuo; Furudate, Masayori

    1987-09-01

    One case of focal nodular hyperplasia of the liver was reported. Time activity curves of the hepatobiliary scintigraphy were evaluated. The peak time, T1/2 in excretion phase and mean transit time of the FNH were longer than the normal liver and 13.8 min, 41.8 min and 22.7 min, respectively. Proliferation of the bile duct cell and stenosis of the bile duct were not shown pathologically. Dysfunction of the hepatocytes may cause retention of the /sup 99m/Tc-EHIDA in this case.

  2. Nodular regenerative hyperplasia of the liver in an infant: case report

    International Nuclear Information System (INIS)

    Kim, Ho Kyun; Lee, Young Hwan; Chung, Duck Soo; Kim, Ok Dong; Park, Jae Bok; Whang, Jin Bok

    2002-01-01

    Nodular regenerative hyperplasia (NRH) of the liver is an uncommon disease entity, especially in the pediatricage group. A few cases have been reported in the radiologic literature, but follow-up imaging studies are rare. We describe a case of NRH, disgnosed by ultrasound-guided needle biopsy, in a seven-month-old infant with cri-du-chat syndrome. Initial ultrasound revealed several small hypoechogenic nodules in the liver, but CT and MR failed to demonstrate their presence. Two follow-up sonographic examinations were performed 7 and 20 months later, revealing increases in the size number of the nodules

  3. Late diagnosis of nodular melanoma of the foot in a 74-year-old Brazilian man.

    Science.gov (United States)

    Santos, Vitorino M; Leal, Cristina T; Vasconcellos, Martha J M

    2011-11-01

    The incidence and mortality of malignant melanoma is increasing. Its early diagnosis can contribute to a favorable prognosis. We report a 74-year-old black man with a dark brown mole in the right plantar area, that grew slowly in the last decade. A biopsy of the lesion revealed a nodular malignant melanoma. A wide excision of the tumor was performed 18 months ago, followed by chemotherapy for nine months. At admission, the patient was debilitated, and presented with numerous nodules in the lower limb and suprapubic area. Imaging studies disclosed chest and abdominal nodules. The patient died 13 days after admission.

  4. Ultrasonic features and radionuclide correlation in liver cell adenoma and focal nodular hyperlasia.

    Science.gov (United States)

    Sandler, M A; Petrocelli, R D; Marks, D S; Lopez, R

    1980-05-01

    Ultrasonic features of three cases of liver cell adenoma (LCA) and two cases of focal nodular hyperplasia (FNH) are presented. These tumors have similar sonographic appearances presenting either as solid masses or containing sonolucent areas due to hemorrhage or necrosis. Although these ultrasonic features in patients with an area of decreased activity on 99mTc-sulfur colloid (Tc-SC) liver scans are not specific for LCA or FNH, such findings in the appropriate clinical setting are suggestive of these lesions. The combination of a solid mass on ultrasonography and a normal Tc-SC radioisotope liver study may be relatively specific for uncomplicated FNH.

  5. Ultrasonic features and radionuclide correlation in liver cell adenoma and focal nodular hyperplasia

    International Nuclear Information System (INIS)

    Sandler, M.A.; Petrocelli, R.D.; Marks, D.S.; Lopez, R.

    1980-01-01

    Ultrasonic features of three cases of liver cell adenoma (LCA) and two cases of focal nodular hyperplasia (FNH) are presented. These tumors have similar sonographic appearances presenting either as solid masses or containing sonolucent areas due to hemorrhage or necrosis. Although these ultrasonic features in patients wth an area of decreased activity on /sup 99m/Tc-sulfur colloid (Tc-SC) liver scans are not specific for LCA or FNH, such findings in the appropriate clinical setting are suggestive of these lesions. The combination of a solid mass on ultrasonography and a normal Tc-SC radioisotope liver study may be relatively specific for uncomplicated FNH

  6. Nodular Esophageal Xanthoma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ahmed Dirweesh

    2017-01-01

    Full Text Available Xanthomas are localized nonneoplastic lesions within tissues that may manifest as papules, plaques, or nodules. These lesions can be found anywhere along the gastrointestinal tract, commonly in the stomach and colon, and rarely in the small intestine and esophagus. Esophagogastroduodenoscopy (EGD with biopsy is the gold standard tool for diagnosis. Here, we report a rare case of a lower solitary nodular esophageal xanthoma in an elderly black female. Correspondingly, all cases of esophageal xanthomas reported in the English medical literature were reviewed and presented with the reported case.

  7. Lymphoid nodular hyperplasia in a patient with severe combined immunodeficiency disease

    International Nuclear Information System (INIS)

    Sanchez-Alegre, M. L.; Casanova, A.; Delgado, J.; Relanzon, S.

    2001-01-01

    We describe a case of lymphoid nodular hyperplasia in a woman with severe combined immunodeficiency disease. the patient complained of constipation and episodes of abdominal pain, and examination revealed the presence of a large abdominal mass. The diagnosis was suspected on the basis of the initial radiological studies, but intestinal biopsy was necessary to rule out lymphomatous involvement. We point out the radiological features of this entity which, despite the fact that it may be a chance finding of no pathological significance, requires special attention, especially in immuno deficient individuals. (Author) 10 refs

  8. [Analysis of predictors of malignancy of nodular goiters: about 500 cases].

    Science.gov (United States)

    Bouaity, Brahim; Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Ammar, Haddou

    2016-01-01

    Thyroid nodules are very common and less than 10% of them are malignant. They pose a serious diagnostic and therapeutic problem with respect to their benign or malignant nature. The study of some clinical and paraclinical factors for presumed malignancy makes it possible to codify appropriate therapeutic strategy. The aim of this study was to investigate predictors of malignancy in nodular goiters and to compare our results with those reported in the literature. This retrospective study consisted of 500 cases of nodular goiter operated in the Department of Otorhinolaryngology (ear, nose and throat or ENT) and Head and Neck Surgery at Avicenne military hospital in Marrakech between 2006 and 2012. The percentage of cancers was 6,8%. The average age of our patients was 46 years, with a sex-ratio of 5 (F/H). The hard nature of the nodule was present in 94,4% of the cases of cancer by palpation; irregular boundaries were present in 64.70% of the cases of cancer. Three nodules were fixed and malignant. Cervical lymphadenopathy were observed in 8 patients, 7 of which had cancer. Ultrasound examination showed hypoechoic appearance in 61,8% of the malignant nodules, with smooth-edges in 88,24% of the cases. Intranodular vascularization was found in 35,3% of the cases of cancers, with microcalcifications in 55,9% of the cases. Perinodular hypoechoic halo was incomplete in 73,5% of the cases of cancer. Our patients were euthyroid in 84,6% of the cases. Predictors of malignancy in nodular goiters were present in our first clinical study: patients over the age of 60 years, hard consistency of nodule, fixity, irregular and poorly defined character by palpation, as well as presence of cervical adenopathy on examination; and echographic features: hypoechoic character, smooth-edges, presence of microcalcifications and visualization of intranodular vascularization with or without peri-nodular vascularization. Although some of these factors are highly predictive of malignancy, only

  9. Segmentation of Craniomaxillofacial Bony Structures from MRI with a 3D Deep-Learning Based Cascade Framework

    Science.gov (United States)

    Nie, Dong; Wang, Li; Trullo, Roger; Li, Jianfu; Yuan, Peng; Xia, James

    2017-01-01

    Computed tomography (CT) is commonly used as a diagnostic and treatment planning imaging modality in craniomaxillofacial (CMF) surgery to correct patient’s bony defects. A major disadvantage of CT is that it emits harmful ionizing radiation to patients during the exam. Magnetic resonance imaging (MRI) is considered to be much safer and noninvasive, and often used to study CMF soft tissues (e.g., temporomandibular joint and brain). However, it is extremely difficult to accurately segment CMF bony structures from MRI since both bone and air appear to be black in MRI, along with low signal-to-noise ratio and partial volume effect. To this end, we proposed a 3D deep-learning based cascade framework to solve these issues. Specifically, a 3D fully convolutional network (FCN) architecture is first adopted to coarsely segment the bony structures. As the coarsely segmented bony structures by FCN tend to be thicker, convolutional neural network (CNN) is further utilized for fine-grained segmentation. To enhance the discriminative ability of the CNN, we particularly concatenate the predicted probability maps from FCN and the original MRI, and feed them together into the CNN to provide more context information for segmentation. Experimental results demonstrate a good performance and also the clinical feasibility of our proposed 3D deep-learning based cascade framework. PMID:29417097

  10. Comparison of carina-based versus bony anatomy-based registration for setup verification in esophageal cancer radiotherapy.

    Science.gov (United States)

    Machiels, Mélanie; Jin, Peng; van Gurp, Christianne H; van Hooft, Jeanin E; Alderliesten, Tanja; Hulshof, Maarten C C M

    2018-03-21

    To investigate the feasibility and geometric accuracy of carina-based registration for CBCT-guided setup verification in esophageal cancer IGRT, compared with current practice bony anatomy-based registration. Included were 24 esophageal cancer patients with 65 implanted fiducial markers, visible on planning CTs and follow-up CBCTs. All available CBCT scans (n = 236) were rigidly registered to the planning CT with respect to the bony anatomy and the carina. Target coverage was visually inspected and marker position variation was quantified relative to both registration approaches; the variation of systematic (Σ) and random errors (σ) was estimated. Automatic carina-based registration was feasible in 94.9% of the CBCT scans, with an adequate target coverage in 91.1% compared to 100% after bony anatomy-based registration. Overall, Σ (σ) in the LR/CC/AP direction was 2.9(2.4)/4.1(2.4)/2.2(1.8) mm using the bony anatomy registration compared to 3.3(3.0)/3.6(2.6)/3.9(3.1) mm for the carina. Mid-thoracic placed markers showed a non-significant but smaller Σ in CC and AP direction when using the carina-based registration. Compared with a bony anatomy-based registration, carina-based registration for esophageal cancer IGRT results in inadequate target coverage in 8.9% of cases. Furthermore, large Σ and σ, requiring larger anisotropic margins, were seen after carina-based registration. Only for tumors entirely confined to the mid-thoracic region the carina-based registration might be slightly favorable.

  11. Quantitative computed tomography as a test of endurance for evaluation of bony plates; Utilizacao da tomografia computadorizada quantitativa como teste de resistencia para avaliacao de placas osseas

    Energy Technology Data Exchange (ETDEWEB)

    Melo Filho, E.V.; Costa, L.A.V.S.; Oliveira, D.C. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil); Freitas, P.M.C. [Escola de Veterinaria - Universidade Federal de Minas Gerais - Belo Horizonte, MG (Brazil); Teixeira, M.W.; Costa, F.S. [Universidade Federal Rural de Pernambuco - Recife, PE (Brazil)

    2012-06-15

    Quantitative computed tomography was used to determine the radiodensity of bony plates. The CT scans provided information regarding radiodensity of bony plates and allowed to verify the uniformity of bone mineral density in their scope. The proposed methodology should be considered as another tool for determining the resistance of these biomaterials. (author)

  12. Factors related to the incidence of anterior disc displacement without reduction and bony changes of the temporomandibular joint in patients with anterior open bite.

    Science.gov (United States)

    Ooi, Kazuhiro; Yura, Shinya; Inoue, Nobuo; Totsuka, Yasunori

    2014-12-01

    We aimed to investigate factors related to the prevalence of anterior disc displacement without reduction (ADDwoR) and bony changes of the condylar head (bony changes) in the temporomandibular joints (TMJs) of patients with anterior open bite. Subjects are comprised of 36 preoperative patients (72 joints) with skeletal anterior open bite without facial asymmetry who had undergone orthognathic surgery at the Hokkaido University Hospital; magnetic resonance imaging of the TMJ and cephalometric analysis were performed before treatment. Logistic regression analysis was performed to clarify relationships among age, overbite, overjet, ANB angle, sella to nasion (SN) to mandibular plane angle (SN-MP angle), SN to ramus plane angle (GZN angle), gonial angle, and incidence of ADDwoR or bony changes in patients with anterior open bite. Fifteen patients had bilateral ADDwoR, and five patients had unilateral ADDwoR; 17 patients had bilateral bony changes, and five patients had unilateral bony changes. SN-MP angle was greater in 20 patients with ADDwoR than that in 16 patients without ADDwoR (p < 0.05). GZN angle was greater in the 20 patients showing bony changes than that in the 16 patients without bony changes (p < 0.05). In terms of dentofacial morphology, SN-MP angle appears to be associated with the incidence of ADDwoR, and GZN angle appears to be associated with bony changes in the TMJ.

  13. Is radiographic measurement of bony landmarks reliable for lateral meniscal sizing?

    Science.gov (United States)

    Yoon, Jung-Ro; Kim, Taik-Seon; Lim, Hong-Chul; Lim, Hyung-Tae; Yang, Jae-Hyuk

    2011-03-01

    The accuracy of meniscal measurement methods is still in debate. The authors' protocol for radiologic measurements will provide reproducible bony landmarks, and this measurement method of the lateral tibial plateau will correlate with the actual anatomic value. Controlled laboratory study. Twenty-five samples of fresh lateral meniscus with attached proximal tibia were obtained during total knee arthroplasty. Each sample was obtained without damage to the meniscus and bony attachment sites. The inclusion criterion was mild to moderate osteoarthritis in patients with mechanical axis deviation of less than 15°. Knees with lateral compartment osteoarthritic change or injured or degenerated menisci were excluded. For the lateral tibial plateau length measurements, the radiographic beam was angled 10° caudally at neutral rotation, which allowed differentiation of the lateral plateau cortical margins from the medial plateau. The transition points were identified and used for length measurement. The values of length were then compared with the conventional Pollard method and the anatomic values. The width measurement was done according to Pollard's protocol. For each knee, the percentage deviation from the anatomic dimension was recorded. Intraobserver error and interobserver error were calculated. The deviation of the authors' radiographic length measurements from anatomic dimensions was 1.4 ± 1.1 mm. The deviation of Pollard's radiographic length measurements was 4.1 ± 2.0 mm. With respect to accuracy-which represents the frequency of measurements that fall within 10% of measurements-the accuracy of authors' length was 98%, whereas for Pollard's method it was 40%. There was a good correlation between anatomic meniscal dimensions and each radiologic plateau dimensions for lateral meniscal width (R(2) = .790) and the authors' lateral meniscal length (R(2) = .823) and fair correlation for Pollard's lateral meniscal length (R(2) = .660). The reliability of each

  14. INSULIN LIKE GROWTH FACTOR 1 POSSIBLE DEPENDENCE IN PATIENTS WITH METABOLIC SYNDROME OF NODULAR PATHOLOGY OF THE THYROID GLAND.

    Science.gov (United States)

    Rekvava, M; Dundua, T; Kobulia, M; Javashvili, L; Giorgadze, E

    2017-09-01

    Metabolic syndrome and nodular pathology of the thyroid gland is a widespread problem nowadays. Recently there has been a notable coincidence between metabolic syndrome and nodular pathology of thyroid gland. Hence, it is interesting to reveal the connection between these two diseases. It is possible that insulin-like growth factor system (IGF), namely IGF 1 is connecting link between metabolic syndrome and nodular pathology of thyroid gland, because IGF1 stimulates growth and proliferation of cells in the body. We have investigated18-82 years of age 71 patients. group 1 n27- subjects with thyroid nodular disease, and metabolic syndrome, group 2 n31- subjects with thyroid nodular disease and without metabolic syndrome. group 3 n13 - subjects with metabolic syndrome and no thyroid pathology. In all groups were assessed thyroid structural data, defined parameters of carbohydrate metabolism, thyroid function and blood concentration of IGF1. In patients with hyperinsulinemia IGF 1 was noted in normal or reduced concentration. In I group IGF1 was normal in 70,4% (n=19), decreased in 29,6% (n=8), In II group was normal in 77,4 % (n=24), decreased in 22,6% (n=7) and in III group was normal in 76,9% (n=10), decreased in 23,1% (n=3). Increase of IGF 1 in patients with thyroid nodular disease patients was not noted. Statistically significant connection between IGF1 and thyroid nodules was not revealed. For the further investigation of this connection we plan to measure IGF1 in the thyroid histological samples in the future studies.

  15. Sentinel lymph node biopsy: is it possible to reduce false negative rates by excluding patients with nodular melanoma?

    Science.gov (United States)

    Corrigan, M A; Coffey, J C; O'Sullivan, M J; Fogarty, K M; Redmond, H P

    2006-06-01

    The aim of this study was to review the outcome of sentinel lymph node biopsy (SLNB) in patients with melanoma and to delineate whether patients with nodular melanoma are more likely to develop nodal recurrence despite negative SLNB. Consecutive patients with cutaneous melanoma undergoing SLNB were identified from a departmental database between 1997 and 2005. Factors including demographic data, site, histological subtype, depth and outcome were examined. Of 131 patients, 103 were node negative and eligible for study. The median age was 53 (16-82) years with 46 patients being male (45%) and 57 female (55%). Primary melanoma sites included lower limb (49; 48%), upper limb (29; 28%), head (12; 11%), trunk (7; 7%) and back (6; 6%). The median Breslow thickness was 2mm. Superficial spreading accounted for 43% of melanoma with nodular accounting for 42%. Median follow-up was 40 (3-90) months. Of 20 relapses, seven recurred in the same nodal basin, three were satellite recurrences, one recurred with both satellite and nodal lesions simultaneously, and nine experienced haematogenous spread. Of the eight patients who developed recurrence in the same nodal basin, four were of nodular histological subtype (p=NS). All of the three patients with satellite lesions had nodular melanoma histologically (p=0.02). When nodal and satellite recurrences were combined, eight of 11 were histologically nodular (p=0.01). This study indicates that lymphatic recurrence occurs more often in SLNB negative patients with nodular melanoma. Further evaluation of the inclusion criteria for sentinel node biopsy is warranted.

  16. Sentinel lymph node biopsy: is it possible to reduce false negative rates by excluding patients with nodular melanoma?

    LENUS (Irish Health Repository)

    Corrigan, M A

    2012-02-03

    OBJECTIVE: The aim of this study was to review the outcome of sentinel lymph node biopsy (SLNB) in patients with melanoma and to delineate whether patients with nodular melanoma are more likely to develop nodal recurrence despite negative SLNB. METHODS: Consecutive patients with cutaneous melanoma undergoing SLNB were identified from a departmental database between 1997 and 2005. Factors including demographic data, site, histological subtype, depth and outcome were examined. RESULTS: Of 131 patients, 103 were node negative and eligible for study. The median age was 53 (16-82) years with 46 patients being male (45%) and 57 female (55%). Primary melanoma sites included lower limb (49; 48%), upper limb (29; 28%), head (12; 11%), trunk (7; 7%) and back (6; 6%). The median Breslow thickness was 2mm. Superficial spreading accounted for 43% of melanoma with nodular accounting for 42%. Median follow-up was 40 (3-90) months. Of 20 relapses, seven recurred in the same nodal basin, three were satellite recurrences, one recurred with both satellite and nodal lesions simultaneously, and nine experienced haematogenous spread. Of the eight patients who developed recurrence in the same nodal basin, four were of nodular histological subtype (p=NS). All of the three patients with satellite lesions had nodular melanoma histologically (p=0.02). When nodal and satellite recurrences were combined, eight of 11 were histologically nodular (p=0.01). CONCLUSIONS: This study indicates that lymphatic recurrence occurs more often in SLNB negative patients with nodular melanoma. Further evaluation of the inclusion criteria for sentinel node biopsy is warranted.

  17. Nodular lymphoid hyperplasia of the intestinal tract in infancy and childhood.

    Science.gov (United States)

    Atwell, J D; Burge, D; Wright, D

    1985-02-01

    Over an 18-year period we have diagnosed nodular lymphoid polyposis of the intestinal tract in 6 patients. The site of the polyposis, which was due to prominent lymphoid hyperplasia, was ileal (3), colonic (2), and rectal (1). The diagnosis was made following complications arising from the polyps, which included recurrent intussusception (2), rectal prolapse (1), intestinal or pseudointestinal obstruction (2), and rectal bleeding (1). Immunoglobulin staining was performed on all the bowel specimens and in every case secretory IgA was present on the mucosal surfaces and IgG and IgA were seen in the lamina propria, thus excluding immunodeficiency in these patients. Viral studies were performed in 3 patients and all were positive. In one patient Echovirus II was seen in tissue homogenate from a mesenteric lymph node and in another, adenovirus type II was cultured from lymphoid polyps of the rectum. A further patient had positive serological tests for adenovirus. Thus it appears that nodular lymphoid hyperplasia is part of the generalized lymphoid hyperplasia associated with viral infections in infancy and childhood. Immunodeficiency states as a cause of the lymphoid hyperplasia should always be excluded by estimation of serum immunoglobulins.

  18. Nodular corrosion resistance of zircaloy-2 in relation to second-phase particle distribution

    International Nuclear Information System (INIS)

    Andersson, T.; Thorvaldsson, T.

    1987-01-01

    A large number of Zircaloy-2 standard tube lots and tube lots beta-quenched in intermediate size were corrosion tested in steam at 490 to 515 0 C. In addition, specimens heat treated in the temperature range 675 to 850 0 C were corrosion tested in steam at 500 0 C. To study the correlation between nodular corrosion susceptibility and type and size distribution of second phases, specimens from one beta-quenched and two standard tube lots, one with high resistance and one with low resistance to nodular corrosion, were examined by optical and electron microscopy. In addition, specimens from the heat treatment program were studied in order to investigate heat treatment effects. For quantitative analysis, a JEOL 200 CX scanning transmission electron microscope (STEM) equipped with a Link Systems energy dispersive X-ray spectrometer (EDX) was used. The STEM studies showed that two main types of second phases exist irrespective of heat treatment. These are hexagonal Zr(Cr,Fe) 2 and tetragonal Zr 2 (Ni,Fe). Of the different microstructural features studied, the size distribution of particles was found to be the main factor distinguishing the different materials. In the low susceptibility standard tube lot, the particles were smaller than in the high susceptibility lot. The smallest particles were found in the beta-quenched lot, where no particles coarser than about 0.2 μm could be seen

  19. A report of unusual diffuse nodular lesions in intestines of lambs with coccidiosis

    Directory of Open Access Journals (Sweden)

    a.r Taghavi Razavizadeh

    2016-11-01

    Full Text Available Ovine and caprine coccidiosis has always been regarded as one of the important diseases with high morbidity and economic losses such as weight loss, death and costs of treatment and control. In a sheep farm, 4 sick newborn lambs (out of 10 lambs with the age of 1 to 2 months died with clinical signs of weight loss, loss of appetite, yellowish diarrhea, fever, ruffled wool, contamination of tail and perineal area to diarrheic stool and abdominal pain at the touch of abdomen. At necropsy on one lamb, multiple and diffuse nodular hyperplastic lesions yellowish-white in color were seen in the mucosal surface of jejunum. Microscopically, in addition to hyperplasia of the small intestinal villi, various developmental stages of Eimeria were observed. Based on morphological characteristics and presence of numerous polyp like formations in small intestine, the involved protozoan species was determined as Eimeria bakuensis. The relatively high case fatality rate in this flock could be related to sever nodular lesions in the small intestines, age and immune status of the affected animals.

  20. Investigations of Ferritic Nodular Cast Iron Containing About 5-6% Aluminium

    Directory of Open Access Journals (Sweden)

    Soiński M.S.

    2016-12-01

    Full Text Available The work presents results of investigations concerning the production of cast iron containing about 5-6% aluminium, with the ferritic matrix in the as-cast state and nodular or vermicular graphite precipitates. The examined cast iron came from six melts produced under the laboratory conditions. It contained aluminium in the amount of 5.15% to 6.02% (carbon in the amount of 2.41% to 2.87%, silicon in the amount of 4.50% to 5.30%, and manganese in the amount of 0.12% to 0.14%. After its treatment with cerium mixture and graphitization with ferrosilicon (75% Si, only nodular and vermicular graphite precipitates were achieved in the examined cast iron. Moreover, it is possible to achieve the alloy of pure ferritic matrix, even after the spheroidizing treatment, when both the aluminium and the silicon occur in cast iron in amounts of about 5.2÷5.3%.

  1. CD56, HBME-1 and cytokeratin 19 expressions in papillary thyroid carcinoma and nodular thyroid lesions

    Science.gov (United States)

    Erdogan-Durmus, Senay; Ozcan, Deniz; Yarikkaya, Enver; Kurt, Ali; Arslan, Aynur

    2016-01-01

    Background: Carcinomas of the thyroid follicular epithelium are the most common cancers of the endocrine system. In the diagnosis of thyroid nodules and tumors, the gold standard is histological evaluation. In cases which have morphological overlap, immunohistochemistry is needed for differential diagnosis. The purpose of this study is to investigate the expressions of CD56, HBME-1, cytokeratin 19 (CK19) antibodies in papillary thyroid carcinoma (PTC) and thyroid nodular lesions and their contributions to differential diagnosis. Materials and Methods: In this study, 47 PTCs (26 follicular variant, 21 classic type) and 26 benign thyroid lesions (15 nodular hyperplasia, 10 follicular adenomas, 1 Hurtle cell adenoma) were analyzed retrospectively. HBME-1, CK19, and CD56 antibodies were performed with immunohistochemical methods. The results were evaluated statistically. Results: +3 staining with HBME-1 and CK19 was observed in 72.3% and 83% of patients with PTC. In 95.7% of PTC cases, loss of CD56 expressions in various degrees was identified. A statistically significant difference was detected in HBME-1, CK19, and CD56 expressions between PTCs and benign lesions (P < 0.001). Conclusion: In our study, positive staining of HBME-1, CK19, and loosing expression of CD56 that supports malignancy was found and concluded that CD56 is a helpful antibody for the differential diagnosis of benign and malignant lesions and may increase the diagnostic accuracy when used with HBME-1 and CK19. PMID:27904595

  2. Prevalence of malignancy in resected specimen of patients operated for benign nodular goitre

    International Nuclear Information System (INIS)

    Moosa, F.A.; Junaid, M.; Khan, F.W.; Afzal, Y.

    2006-01-01

    To determine the frequency of malignancy on histopathology amongst resected specimen of thyroid gland in patients, who had no evidence of malignancy pre-operatively on clinical grounds and investigations. A total of 190 patients who were operated for benign nodular thyroid disease during the study period; 100 cases had multinodular goitre and 90 solitary nodules. Biodata, clinical features, investigations, diagnosis, details of surgery, complications and histopathology reports of all the patients were reviewed and analyzed. Amongst the 190 patients the mean age was 33.42+-12.4 years (range 17-45 years), while the male: female ratio was 1:6.6. Seven (3.6%) cases were found to be malignant on histopathology, with a frequency of 3% (3/100) amongst multinodular cases and 4.4% (4/90) amongst solitary nodules. Prevalence of malignancy in multinodular goitre does not differ significantly from solitary nodules. Hence, multinodularity should no longer be considered as an indicator of benign disease. Both varieties of nodular goitres should be considered for surgery even if there is no suspicion of malignancy. (author)

  3. Standard test method for determining nodularity and nodule count in ductile iron using image analysis

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2011-01-01

    1.1 This test method is used to determine the percent nodularity and the nodule count per unit area (that is, number of nodules per mm2) using a light microscopical image of graphite in nodular cast iron. Images generated by other devices, such as a scanning electron microscope, are not specifically addressed, but can be utilized if the system is calibrated in both x and y directions. 1.2 Measurement of secondary or temper carbon in other types of cast iron, for example, malleable cast iron or in graphitic tool steels, is not specifically included in this standard because of the different graphite shapes and sizes inherent to such grades 1.3 This standard deals only with the recommended test method and nothing in it should be construed as defining or establishing limits of acceptability or fitness for purpose of the material tested. 1.4 The values stated in SI units are to be regarded as standard. No other units of measurement are included in this standard. 1.5 This standard does not purport to address al...

  4. Comprehensive histopathological comparison of epidermotropic/dermal metastatic melanoma and primary nodular melanoma.

    Science.gov (United States)

    Skala, Stephanie L; Arps, David P; Zhao, Lili; Cha, Kelly B; Wang, Min; Harms, Paul W; Andea, Aleodor A; Fullen, Douglas R; Chan, May P

    2018-02-01

    Metastatic melanoma involving the epidermis and/or upper dermis may show significant histological overlap with primary cutaneous melanoma, especially the nodular subtype. Proper histopathological classification is crucial to appropriate staging and management, but is often challenging. The aim of this study was to identify helpful histopathological features for differentiating epidermotropic/dermal metastatic melanoma (EDMM) and primary nodular melanoma (PNM). A cohort of EDMMs (n = 74) and PNMs (n = 75) was retrospectively reviewed for various histopathological features, and the data were compared between groups by the use of univariate analysis. Features significantly associated with EDMM included a tumour size of 10 mm, ulceration, epidermal collarettes, a higher mitotic rate, necrosis, multiple phenotypes, significant pleomorphism, and lichenoid inflammation. In multivariate analysis, a logistic regression model including large tumour size, ulceration, prominent TIPs, lichenoid inflammation and epidermal collarettes was highly predictive of PNM. Six (8%) EDMMs from three patients showed an 'epidermal-only' or 'epidermal-predominant' pattern closely simulating in-situ or microinvasive melanoma. Two of these cases were tested by fluorescence in-situ hybridisation, which confirmed clonal relationships with their corresponding primary melanomas. This is the first comprehensive histopathological comparison of EDMM and PNM. Recognition of the above histopathological associations should aid in the correct classification and staging of cutaneous melanoma. Epidermotropic metastatic melanomas may occasionally show an epidermal-only/epidermal-predominant pattern; accurate diagnosis requires prudent clinical correlation and, when necessary, ancillary molecular tests. © 2017 John Wiley & Sons Ltd.

  5. Nodular fasciitis: an uncommon disease with common medical management challenges at a remote Naval Hospital.

    Science.gov (United States)

    Spinelli, Nicholas; Khorassani, Nima

    2013-09-01

    Nodular fasciitis is a rare benign soft tissue lesion that is often confused with malignant sarcoma, which can make management of this pathology challenging. We present here a case of head and neck nodular fasciitis that was managed at a remote U.S. Naval Hospital with limited diagnostic and therapeutic resources. The aim of this article is to bring to light this uncommon pathology so that it can be given its due consideration in the differential diagnosis from both a clinical and pathologic perspective. However, the more important purpose of this article is to highlight the complex decision-making process that sometimes occurs when evaluating patients within a medical infrastructure that is significantly less than that of a typical military treatment facility or U.S. hospital. Young surgeons and other providers may find this discussion useful before deploying, whether it be to a remote land-based facility or to an aircraft carrier. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  6. MRI-findings of nodular lesions in an enlarged spleen, associated with visceral Leishmaniasis

    Energy Technology Data Exchange (ETDEWEB)

    Raeymaeckers, Steven, E-mail: Steven.Raeymaeckers@vub.ac.be [ZNA Middelheim, Lindendreef 1, 2020 Antwerpen (Belgium); Docx, Martine; Demeyere, Nathan [ZNA Middelheim, Lindendreef 1, 2020 Antwerpen (Belgium)

    2012-10-15

    Highlights: ► We confirm a previous report that infection with Leishmania can manifest multiple nodular lesions of the spleen. ► We confirm these lesions to be readily detectable with present imaging modalities. ► We affirm the fact that these lesions are hypoechoic on ultrasound, though in our case no hypoechoic halo was observed. ► We found these lesions to be hypodense on CT in the delayed phase after intravenous contrast administration. ► In addition to these previous findings we found that the spleen showed an inhomogeneous intensity on MRI; upon closer examination whilst scrolling through the T2-weighted sequences we can note multiple ill-defined and heterogeneous hypointense nodules. -- Abstract: We present a case of a 15-month-old Moroccan girl with fever of unknown origin, hepatosplenomegaly and multiple hypoechoic nodular splenic lesions that appear hypodense on CT. T2-weighted MRI sequences show a markedly inhomogeneous intensity of the parenchyma, seemingly caused by multiple ill-defined and heterogeneous hypointense nodules. Laboratory tests confirmed a recent infection with Leishmania, a parasite endemic to (sub)tropic regions. During and after therapy these lesions gradually resolved. To our knowledge this is the second published case in which different imaging modalities were able to demonstrate organ lesions associated with Leishmania. It is also the first report of MRI-findings associated with these lesions.

  7. De Morsier syndrome associated with periventricular nodular heterotopia: case reporte Síndrome de De Morsier associada a heterotopia nodular periventricular: relato de caso

    Directory of Open Access Journals (Sweden)

    Mônica Jaques Spinosa

    2007-09-01

    Full Text Available INTRODUCTION: Septo-optic dysplasia (De Morsier syndrome is defined as the association between optic nerve hypoplasia, midline central nervous system malformations and pituitary dysfunction. CASE REPORT: Third child born to nonconsanguineous parents, female, adequate pre-natal medical care, cesarean term delivery due to breech presentation, Apgar score 3 at the first minute and 8 at 5 minutes, symptomatic hypoglycemia at 18 hours. Neurological follow-up identified a delay in acquisition of motor and language developmental milestones. Epileptic generalized seizures began at 12 months and were controlled with phenobarbital. EEG was normal. MRI revealed agenesis of the pituitary stalk, hypoplasia of the optic chiasm and periventricular nodular heterotopia. Ophthalmologic evaluation showed bilateral optic disk hypoplasia. Endocrine function laboratory tests revealed primary hypothyroidism and hyperprolactinemia. CONCLUSION: The relevance of this case report relies on its uniqueness, since periventricular heterotopia had not been described in association with septo-optic dysplasia until 2006.INTRODUÇÃO: Displasia septo-óptica (síndrome de De Morsier é definida como a associação entre hipoplasia do nervo óptico, malformações de linha média do sistema nervoso central e disfunção pituitária. RELATO DE CASO: Terceiro filho, pais não consangüíneos, sexo feminino, pré-natal adequado, parto cesário a termo por apresentação pélvica, Apgar 3 no primeiro minuto e 8 no quinto minuto, hipoglicemia sintomática com 18 horas de vida. Durante o acompanhamento neurológico identificou-se atraso na aquisição dos marcos de desenvolvimento motor e linguagem. Crises epilépticas generalizadas iniciaram com 12 meses de vida sendo controladas com fenobarbital. EEG era normal. Ressonância magnética revelou agenesia de haste pituitária, hipoplasia de quiasma óptico e heterotopia nodular periventricular. Avaliação oftalmológica demonstrou

  8. Unexpected detection of nodular melanoma of the skin on the scalp by I-123 IBZM brain SPECT.

    Science.gov (United States)

    Booij, Jan; Boot, Erik; van Eeden, Susanne; van Amelsvoort, Thérèse

    2011-02-01

    Melanocytes and dopaminergic neurons share the same ectodermal origin and can both produce melanin. Indeed, in vivo studies have shown that the radiopharmaceutical iodine-123-iodobenzamide (I-123 IBZM), which binds in vivo to dopamine D(2/3) receptors, is also able to detect melanoma, and particularly melanotic melanoma. We report a case of intense IBZM uptake in nodular melanoma of the skin on the scalp. The presence of unexpected focal IBZM uptake of the skin justified histologic examination, which revealed nodular melanoma. Melanoma should be considered when one is confronted with atypical focal uptake of benzamide derivatives like IBZM, in or outside the brain.

  9. Application of computer-aided designed/computer-aided manufactured techniques in reconstructing maxillofacial bony structures.

    Science.gov (United States)

    Rustemeyer, Jan; Busch, Alexander; Sari-Rieger, Aynur

    2014-12-01

    Today, virtually planned surgery and computer-aided designed/computer-aided manufactured (CAD/CAM) tools to reconstruct bony structures are being increasingly applied to maxillofacial surgery. However, the criteria for or against the usage of the CAD/CAM technique are disputable, since no evidence-based studies are available. Theoretically, the CAD/CAM technique should be applied to complex cases. In this case report, we present our experiences and discuss the criteria for application. Three cases are reported in which subjects received an osseous reconstruction using CAD/CAM techniques. In the first case, resection of the mandibular body and ramus was carried out, and reconstruction with a vascularised iliac bone transplant was performed. During surgery, a repositioning of the ipsilateral condyle was necessary. The second case comprised a wide mandibular reconstruction together with a repositioning of the condyles and the soft tissue chin using a two-segment osteomyocutaneous fibula flap. In the third case, a two-flap technique consisting of a double-barrelled osseous fibula flap and a radial forearm flap was applied to cover a wide palatine defect. Our experience suggests that the CAD/CAM technique provides an accurate and useful treatment not only in complex cases, but also in simpler ones, to achieve an anatomically correct shape of the bone transplant and to reposition adjacent structures.

  10. Orbital Tumors Excision without Bony Marginotomy under Local and General Anesthesia

    Directory of Open Access Journals (Sweden)

    Robert A. Goldberg

    2014-01-01

    Full Text Available To present our experience of removing middle to deep orbital tumors using a combination of minimally invasive soft tissue approaches, sometimes under local anesthesia. Methods. In this retrospective case series, 30 patients (13 males and 17 females underwent tumor removal through eyelid crease (17 eyes, conjunctival (nine eyes, lateral canthal (two eyes, and transcaruncular (two eyes approaches. All tumors were located in the posterior half of the orbit. Six cases were removed under monitored anesthesia care with local block, and 24 were under general anesthesia. Results. The median (range age and follow-up duration were 48.5 (31–87 years old and 24.5 (4–375 weeks, respectively. Visual acuity and ocular motility showed improvement or no significant change in all but one patient at the latest followup. Confirmed pathologies revealed cavernous hemangioma (15 cases, pleomorphic adenoma (5 cases, solitary fibrous tumor (4 cases, neurofibroma (2 cases, schwannoma (2 cases, and orbital varix (1 case. None of the patients experienced recurrence. Conclusions. Creating a bony marginotomy increases intraoperative exposure of the deep orbit but adds substantial time and morbidity. Benign orbital tumors can often be removed safely through small soft-tissue incisions, without bone removal and under local anesthesia.

  11. Automated bony region identification using artificial neural networks: reliability and validation measurements

    International Nuclear Information System (INIS)

    Gassman, Esther E.; Kallemeyn, Nicole A.; DeVries, Nicole A.; Shivanna, Kiran H.; Powell, Stephanie M.; Magnotta, Vincent A.; Ramme, Austin J.; Adams, Brian D.; Grosland, Nicole M.

    2008-01-01

    The objective was to develop tools for automating the identification of bony structures, to assess the reliability of this technique against manual raters, and to validate the resulting regions of interest against physical surface scans obtained from the same specimen. Artificial intelligence-based algorithms have been used for image segmentation, specifically artificial neural networks (ANNs). For this study, an ANN was created and trained to identify the phalanges of the human hand. The relative overlap between the ANN and a manual tracer was 0.87, 0.82, and 0.76, for the proximal, middle, and distal index phalanx bones respectively. Compared with the physical surface scans, the ANN-generated surface representations differed on average by 0.35 mm, 0.29 mm, and 0.40 mm for the proximal, middle, and distal phalanges respectively. Furthermore, the ANN proved to segment the structures in less than one-tenth of the time required by a manual rater. The ANN has proven to be a reliable and valid means of segmenting the phalanx bones from CT images. Employing automated methods such as the ANN for segmentation, eliminates the likelihood of rater drift and inter-rater variability. Automated methods also decrease the amount of time and manual effort required to extract the data of interest, thereby making the feasibility of patient-specific modeling a reality. (orig.)

  12. Three-dimensional shape differences in the bony pelvis of women with pelvic floor disorders.

    Science.gov (United States)

    Brown, Kirsten M; Handa, Victoria L; Macura, Katarzyna J; DeLeon, Valerie B

    2013-03-01

    The objective of this study was to determine whether the three-dimensional shape of the bony pelvis differs between women with and without pelvic floor disorders (PFDs). We predict that the levator ani attachment points for the pelvic floor are further displaced from one another in affected relative to unaffected women. Pelvic shape was quantified by collecting coordinate data from landmarks located on three-dimensional reconstructions of magnetic resonance images of 19 PFD cases and 16 matched controls. Euclidean distance matrix analysis (EDMA) was used to quantify and compare pelvic shape using these landmark data. There were no significant group differences in age, parity, body mass, racial attribution, cesarean section, or hysterectomy status. After controlling for size as a confounding factor, EDMA results identified significant differences (p = 0.05) in the bispinous diameter (4 % proportionally larger) and distances defining lateral displacement of ischia from pubis (5-6 % proportionally larger) in cases compared to controls. Pelvic shape in women with PFDs is characterized by the proportional mediolateral enlargement of the pelvic midplane and ischial eversion near the subpubic arch, consistent with inferolateral migration of the attachment points for the levator ani and correspondingly lateral displacement. These movements may result in increased strain on the pelvic floor's muscular and connective tissues, increasing the risk of failure over a woman's lifetime.

  13. Primary bony non-Hodgkin lymphoma of the cervical spine: a case report

    Directory of Open Access Journals (Sweden)

    Sedrak Mark F

    2010-02-01

    Full Text Available Abstract Introduction Non-Hodgkin lymphoma primarily originating from the bone is exceedingly rare. To our knowledge, this is the first report of primary bone lymphoma presenting with progressive cord compression from an origin in the cervical spine. Herein, we discuss the unusual location in this case, the presenting symptoms, and the management of this disease. Case presentation We report on a 23-year-old Caucasian-American man who presented with two months of night sweats, fatigue, parasthesias, and progressive weakness that had progressed to near quadriplegia. Magnetic resonance (MR imaging demonstrated significant cord compression seen primarily at C7. Surgical management, with corpectomy and dorsal segmental fusion, in combination with adjuvant chemotherapy and radiation therapy, halted the progression of the primary disease and preserved neurological function. Histological analysis demonstrated an aggressive anaplastic large cell lymphoma. Conclusion Isolated primary bony lymphoma of the spine is exceedingly rare. As in our case, the initial symptoms may be the result of progressive cervical cord compression. Anterior corpectomy with posterolateral decompression and fusion succeeded in preventing progressive neurologic decline and maintaining quality of life. The reader should be aware of the unique presentation of this disease and that surgical management is a successful treatment strategy.

  14. Amiloidose pulmonar: relato de caso de achado radiológico da apresentação nodular em grande fumante Pulmonary amyloidosis: radiographic finding of nodular opacities in a heavy smoker

    Directory of Open Access Journals (Sweden)

    Jorge Montessi

    2007-06-01

    Full Text Available A amiloidose pulmonar é uma doença rara, caracterizada pelo depósito extracelular de proteínas fibrilares no pulmão. Amiloidose é um termo genérico para grupos heterogêneos de doenças, incluindo doença de Alzheimer e diabetes mellitus tipo II. Apresenta-se no aparelho respiratório sob as formas traqueobrônquica, nodular pulmonar e septal alveolar (parenquimatosa difusa. Relata-se o caso de uma mulher, tabagista (20 anos/maço, portadora de amiloidose nodular pulmonar, diagnosticada através de exames pré-operatórios à realização de colecistectomia videolaparoscópica.Pulmonary amyloidosis is a rare disease, characterized by extracellular deposition of fibrillary protein in the lungs. Amyloidosis is a generic term for a heterogeneous group of diseases, including Alzheimer's disease and type 2 diabetes mellitus. In the respiratory system, it appears in various forms: tracheobronchial; nodular pulmonary; and alveolar septal (diffuse parenchymal. We present the case of a woman who was a 20 pack-year smoker and had nodular pulmonary amyloidosis, as diagnosed through tests performed prior to laparoscopic cholecystectomy.

  15. Pre-transplantation risk factors to develop sclerotic chronic GvHD after allogeneic HSCT: a multicenter retrospective study from the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC).

    Science.gov (United States)

    Detrait, M Y; Morisset, S; Peffault de Latour, R; Yakoub-Agha, I; Crocchiolo, R; Tabrizi, R; Bay, J-O; Chevalier, P; Barraco, F; Raus, N; Vigouroux, S; Magro, L; Mohty, M; Milpied, N; Blaise, D; Socié, G; Michallet, M

    2015-02-01

    Sclerotic chronic GvHD (cGvHD) is one of the most severe complications after allo-hematopoietic stem cell transplantation (HSCT). Risk factors associated with this complication remain not very well defined. With the aim to define a pre-transplantation risk profile, we have conducted a French retrospective analysis in 705 consecutive patients between 2005 and 2010. Analyses to determine pre-transplantation risk factors included as variables: patient and donor age, kind of donor, HLA matching, ABO matching, sex-matching, diagnosis, stem cell source, gender, GvHD prophylaxis and antithymocyte globulin (ATG) in the conditioning regimen. The cumulative incidence of sclerotic cGvHD was 18% (95% CI, 16.6-19.6) 3 years after onset of cGvHD. In univariate analysis, we found a significantly lower number of sclerotic cGvHD form in patients transplanted from cord blood cells (P=0.0021), in patients with a one mismatched donor (P=0.041) and in patients who had received ATG in the conditioning regimen (P=0.002). In multivariate analysis, factors associated with an increased risk of sclerotic cGvHD were young patient age, multiple myeloma and PBSC as the stem cell source. ATG in conditioning regimen and cord blood unit as the stem cell source were associated with a lower risk.

  16. Perturabation of nodular operation under salt and water deficit stress in rhizobium common bean symbiosis

    International Nuclear Information System (INIS)

    Harzalli Jebara, Salwa

    2006-01-01

    This work aims at the search for markers of tolerance to the osmotic stress and nodular efficiency of symbiosis Haricot Rhizobium. Thus, after having fixed the best period of hydroponic culture, we showed that a severe salt treatment generated an inhibition of the parameters of growth and nodulation. These inhibitions are accompanied by an inhibition of the enzymatic activities: ascorbate peroxidase (APX) and catalase (CAT), but an activation of peroxidase (POX) and superoxide dismutase (SOD), suggesting that these two antioxydants can be biochemical markers of the tolerance to salinity. To check the validity of these markers and to see the participation of the vegetable genotype in the response to the stress, we compared the effect of two concentrations salt 25 and 50 mM NaCe at two contrasting genotypes BAT477 tolerant and sensitive COCOT. This study illustrates the role of the vegetable genotype in the tolerance and efficiency and emphasize a significant result that SOD and POX constitute biochemical markers of tolerance to salinity. In order to ensure itself of the validity of this assumption in the event of water deficit stress, a treatment of 50 mM mannitol is applied to 16 symbioses formed by four genotypes of bean BAT477, COCOT, Flamingo and BRB17 inoculated by four strains of rhizobium CIAT899, 12 to 3, 1 to 6 and 8 to 3. This study permits us to make a screening of these symbioses according to their efficiency and their tolerance based on parameters of growth, of fixing and extent of the antioxydant enzymatic activities. It gets clear that the response of enzymatic antioxydants is in relation to the intrinsic potentialities of the partners of symbioses and appears to act as of the first stages of recognition plants bacterium. It will be retained that activities POX and SOD are markers of nodular tolerance. The CAT is the enzyme most connected to each partner of symbiosis and the APX would play a rather functional role. The heterogeneity of found answer

  17. A bony-crested Jurassic dinosaur with evidence of iridescent plumage highlights complexity in early paravian evolution.

    Science.gov (United States)

    Hu, Dongyu; Clarke, Julia A; Eliason, Chad M; Qiu, Rui; Li, Quanguo; Shawkey, Matthew D; Zhao, Cuilin; D'Alba, Liliana; Jiang, Jinkai; Xu, Xing

    2018-01-15

    The Jurassic Yanliao theropods have offered rare glimpses of the early paravian evolution and particularly of bird origins, but, with the exception of the bizarre scansoriopterygids, they have shown similar skeletal and integumentary morphologies. Here we report a distinctive new Yanliao theropod species bearing prominent lacrimal crests, bony ornaments previously known from more basal theropods. It shows longer arm and leg feathers than Anchiornis and tail feathers with asymmetrical vanes forming a tail surface area even larger than that in Archaeopteryx. Nanostructures, interpreted as melanosomes, are morphologically similar to organized, platelet-shaped organelles that produce bright iridescent colours in extant birds. The new species indicates the presence of bony ornaments, feather colour and flight-related features consistent with proposed rapid character evolution and significant diversity in signalling and locomotor strategies near bird origins.

  18. Study on the Influence of Nano-SiC on the Structure and Properties of Nodular Cast Iron

    Science.gov (United States)

    Zhu, Ruixiang; SU, Yong; Qin, Xinyu

    2017-10-01

    In this paper, the effect of adding Nano-SiC on the structure and mechanical properties of nodular cast iron during inoculation and spheroidizing process is mainly studied. Three sets of samples were set up: one group is without adding Nano-SiC, and the other two groups are adding Nano-SiC in the spheroidizing process and inoculation step. The three groups of castings were sampled from the core and 1/4 respectively and treated by isothermal quenching. The influences of Nano-SiC and heat treatment process on the microstructure and mechanical properties of nodular cast iron were discussed through the observation of impact work, hardness and metallographic structure of Vivtorinox. The experimental results show that with the addition of Nano-SiC, the spheroidization rate, spheroidization degree and graphitization of the graphite in casting structure are improved. In mechanical properties, the impact toughness of the samples with adding Nano-SiC during inoculation is the best, and the hardness of nodular cast iron can be improved. After heat treatment, the impact toughness of nodular cast iron samples increased obviously, but the hardness decreased generally.

  19. Computed radiography (FCR) with a dual side reading system. Comparison with conventional radiography for visualization of nodular lung cancers

    Energy Technology Data Exchange (ETDEWEB)

    Ha-kawa, Shangkil; Yoshida, Tsunetaka; Sougawa, Mitsuharu; Harima, Yohko; Sawada, Satoshi [Kansai Medical Univ., Moriguchi, Osaka (Japan)

    2003-02-01

    To assess the diagnostic capability Fuji computed radiography (FCR) using a dual side reading system was compared to the conventional radiography using a film-screen system. Twenty-eight patients with lung cancer were examined with a new FCR system (FCR 5501D) and a conventional screen-film system concurrently. FCR utilizes a reading system that detects emissions from dual sides of imaging plate. Chest X-rays were obtained with same exposure factors in both systems. Image qualities of both systems were compared by two radiologists using a five-level score. There were no lesion that FCR images were inferior to film-screen images. The frequency of score +1 or +2 that FCR images were superior to film-screen images was 31% in large nodular shadows, 40% in accompanying shadows with a nodule, 67% of small nodular shadows, and 43% of the lymph node swelling in the hilum of the lung or mediastinum. In large nodular shadows which were the most frequent abnormality score +1 or +2 were observed in 43% of adenocarcinoma and 26% of squamous cell lung cancer. FCR with the dual side reading system is superior to the conventional screen-film system for visualization of nodular lung cancers. (author)

  20. CD57+ T-cells are a subpopulation of T-follicular helper cells in nodular lymphocyte predominant Hodgkin lymphoma

    NARCIS (Netherlands)

    Sattarzadeh, Ahmad; Diepstra, Arjan; Rutgers, Bea; van den Berg, Anke; Visser, Lydia

    2015-01-01

    BACKGROUND: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is characterized by lymphocyte-predominant (LP) cells in a background of CD4+ CD57+ T-cells. These cells are normally present in the germinal center of lymphoid tissues. The cells rosetting LP cells are described to be PD-1 and

  1. Radiological Findings in a Case of Multiple Focal Nodular Hyperplasia Associated with Portal Vein Atresia and Portopulmonary Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Joon; Jeong, Sook Hyang; Choi, Jin Woo; Park, Hee Sun; Lee, Kyoung Ho; Kim, Hae Ryoung [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)

    2008-08-15

    We present here the radiological findings of a rare case of multiple focal nodular hyperplasia that was associated with portal vein atresia and portopulmonary hypertension in a young woman. This case illustrates and supports the pathophysiological hypotheses that were previously proposed for the coexistence of these three abnormalities

  2. 18F-FDG PET demonstrates previously unvisualised bony metastases in a lung cancer patient

    International Nuclear Information System (INIS)

    Bradley, J.; Rowe, C.; Scott, A.M.

    2002-01-01

    Full text: A 59-year-old male, presented to his local doctor with the trivial complaint of a persistent dry cough. On clinical examination he was found to have an enlarged right supraclavicular lymph node. He was investigated with chest X-ray, Computerised Tomography (CT) and Fine Needle Aspiration Cytology (FNAC) of the palpable node CT showed a right lung mass, bulky hilar, mediastinal, supraclavicular and cervical lymph nodes FNAC was inconclusive due to an insufficient tissue sample, but suggestive of non-Hodgkin's Lymphoma. Hence excisional node biopsy was required which revealed non-small cell lung cancer (NSCLC). Subsequent CT scans of the abdomen and pelvis for staging revealed no distant involvement. Therefore radical radiotherapy was planned to treat the locally advanced disease. Prior to treatment a Positron Emission Tomography (PET) scan was organised by his specialist as a baseline study to monitor therapy progress. Non-Attenuation corrected images of the chest, abdomen and pelvis were obtained 40 minutes post administration of 394 MBq 18 F-FDG, on a Siemens 951/3IR PET scanner. The images were reconstructed using both Filtered Back Projection (FBP) and Ordered Subsets-Expectation Maximization (OSEM) algorithms. The images revealed extensive metastases particularly in the spine and pelvis, besides the known locally advanced thoracic disease A 99m Tc MDP bone scan and plain film radiographs aimed at confirming bony metastases were negative, even though the bone scan noted a slight focus in the right fourth rib. The appearance suggested trauma, but a solitary bone metastasis could not be ruled out MRI of the spine confirmed the PET scan findings. Mr RD was to have curative radical radiotherapy, but after the PET results, it was decided to treat him palliatively. The value of 18 F-FDG PET in staging some cancers such as NSCLC is widely accepted, in this case it was pivotal in altering the patient's management. Copyright (2002) The Australian and New

  3. Morphoscopic analysis of experimentally produced bony wounds from low-velocity ballistic impact.

    Science.gov (United States)

    Kieser, Jules A; Tahere, Joy; Agnew, Caitlin; Kieser, David C; Duncan, Warwick; Swain, Michael V; Reeves, Matthew T

    2011-12-01

    Understanding how bone behaves when subjected to ballistic impact is of critical importance for forensic questions, such as the reconstruction of shooting events. Yet the literature addressing microscopic anatomical features of gunshot wounds to different types of bone is sparse. Moreover, a biomechanical framework for describing how the complex architecture of bone affects its failure during such impact is lacking. The aim of this study was to examine the morphological features associated with experimental gunshot wounds in slaughtered pig ribs. We shot the 4th rib of 12 adult pigs with .22 mm subsonic bullets at close range (5 cm) and examined resultant wounds under the light microscope, scanning electron microscope SEM and micro tomograph μCT. In all cases there was a narrow shot channel followed by spall region, with evidence of plastic deformation with burnishing of the surface bone in the former, and brittle fracture around and through individual Haversian systems in the latter. In all but one case, the entrance wounds were characterized by superficially fractured cortical bone in the form of a well-defined collar, while the exit wounds showed delamination of the periosteum. Inorganic residue was evident in all cases, with electron energy dispersive spectroscopy EDS confirming the presence of carbon, phosphate, lead and calcium. This material appeared to be especially concentrated within the fractured bony collar at the entrance. We conclude that gunshot wounds in flat bones may be morphologically divided into a thin burnished zone at the entry site, and a fracture zone at the exit.

  4. Three-Dimensional Reconstruction of the Bony Nasolacrimal Canal by Automated Segmentation of Computed Tomography Images.

    Directory of Open Access Journals (Sweden)

    Lucia Jañez-Garcia

    Full Text Available To apply a fully automated method to quantify the 3D structure of the bony nasolacrimal canal (NLC from CT scans whereby the size and main morphometric characteristics of the canal can be determined.Cross-sectional study.36 eyes of 18 healthy individuals.Using software designed to detect the boundaries of the NLC on CT images, 36 NLC reconstructions were prepared. These reconstructions were then used to calculate NLC volume. The NLC axis in each case was determined according to a polygonal model and to 2nd, 3rd and 4th degree polynomials. From these models, NLC sectional areas and length were determined. For each variable, descriptive statistics and normality tests (Kolmogorov-Smirnov and Shapiro-Wilk were established.Time for segmentation, NLC volume, axis, sectional areas and length.Mean processing time was around 30 seconds for segmenting each canal. All the variables generated were normally distributed. Measurements obtained using the four models polygonal, 2nd, 3rd and 4th degree polynomial, respectively, were: mean canal length 14.74, 14.3, 14.80, and 15.03 mm; mean sectional area 15.15, 11.77, 11.43, and 11.56 mm2; minimum sectional area 8.69, 7.62, 7.40, and 7.19 mm2; and mean depth of minimum sectional area (craniocaudal 7.85, 7.71, 8.19, and 8.08 mm.The method proposed automatically reconstructs the NLC on CT scans. Using these reconstructions, morphometric measurements can be calculated from NLC axis estimates based on polygonal and 2nd, 3rd and 4th polynomial models.

  5. Endocrine and Local IGF-I in the Bony Fish Immune System.

    Science.gov (United States)

    Franz, Anne-Constance; Faass, Oliver; Köllner, Bernd; Shved, Natallia; Link, Karl; Casanova, Ayako; Wenger, Michael; D'Cotta, Helena; Baroiller, Jean-François; Ullrich, Oliver; Reinecke, Manfred; Eppler, Elisabeth

    2016-01-26

    A role for GH and IGF-I in the modulation of the immune system has been under discussion for decades. Generally, GH is considered a stimulator of innate immune parameters in mammals and teleost fish. The stimulatory effects in humans as well as in bony fish often appear to be correlated with elevated endocrine IGF-I (liver-derived), which has also been shown to be suppressed during infection in some studies. Nevertheless, data are still fragmentary. Some studies point to an important role of GH and IGF-I particularly during immune organ development and constitution. Even less is known about the potential relevance of local (autocrine/paracrine) IGF-I within adult and developing immune organs, and the distinct localization of IGF-I in immune cells and tissues of mammals and fish has not been systematically defined. Thus far, IGF-I has been localized in different mammalian immune cell types, particularly macrophages and granulocytes, and in supporting cells, but not in T-lymphocytes. In the present study, we detected IGF-I in phagocytic cells isolated from rainbow trout head kidney and, in contrast to some findings in mammals, in T-cells of a channel catfish cell line. Thus, although numerous analogies among mammals and teleosts exist not only for the GH/IGF-system, but also for the immune system, there are differences that should be further investigated. For instance, it is unclear whether the primarily reported role of GH/IGF-I in the innate immune response is due to the lack of studies focusing on the adaptive immune system, or whether it truly preferentially concerns innate immune parameters. Infectious challenges in combination with GH/IGF-I manipulations are another important topic that has not been sufficiently addressed to date, particularly with respect to developmental and environmental influences on fish growth and health.

  6. Platelet-Rich Fibrin with Bone Grafts for Regeneration of Bony Defect following Extraction of Supernumerary Teeth: A Case Report.

    Science.gov (United States)

    Chandrasekaran, Balamanikandasrinivasan; Suresh, Nanditha; Muthusamy, Senthilkumar

    Supernumerary teeth are hyperdontic variants due to abnormalities during tooth development. Here, we report a case on regeneration of bony defect, which ensued following extraction of two supernumerary teeth in the mandibular premolar region, using a combination of bone grafts and platelet-rich fibrin. To the best of our knowledge, it is the first time synergistic use of biomaterials with bone grafts have been used for this type of management.

  7. Nodular Regenerative Hyperplasia and Portal Hypertension in a Patient with Coeliac Disease

    Directory of Open Access Journals (Sweden)

    Erwin Biecker

    2011-01-01

    Full Text Available Nodular regenerative hyperplasia (NRH of the liver is often associated with rheumatologic or lymphoproliferative disorders and a cause of portal hypertension in some patients. We report the case of a 71-year-old patient with celiac disease and unexplained portal hypertension. Biopsy of the liver revealed NRH as the underlying cause. The patient did not suffer from an autoimmune, rheumatologic or lymphoproliferative disease. A thrombophilic disorder that might cause NRH was ruled out. Celiac disease is often associated with mild elevation of liver enzymes and steatosis of the liver, but the association with NRH was described in only a few patients. We discuss the possible relationship of celiac disease and NRH.

  8. Nodular immunocyte-derived (AL) amyloidosis in the trachea of a dog.

    Science.gov (United States)

    Besancon, M Faulkner; Stacy, Brian A; Kyles, Andrew E; Moore, Peter F; Vernau, William; Smarick, Sean D; Rasor, Liberty A

    2004-04-15

    A 7-year-old castrated male Miniature Schnauzer was examined because of labored breathing and episodes of respiratory distress that progressed to collapse. On cervical radiographs, a focal soft tissue mass in the caudal cervical portion of the trachea was observed, and during tracheoscopy, a 1 x 1 cm, pedunculated, multinodular, pink, intraluminal mass extending from the dorsal tracheal membrane and obstructing approximately 80% of the tracheal lumen was seen. Tracheal resection and anastomosis was performed to remove the mass, and the dog recovered without complications. On histologic examination, the mass consisted of a large accumulation of homogeneous, faintly fibrillar eosinophilic material admixed with a predominantly plasma cell infiltrate; examination of sections stained with thioflavin T and Congo red stain confirmed that the eosinophilic material was amyloid. A diagnosis of nodular, immunocyte-derived (AL) amyloidosis was made. Seventeen months after surgery, the dog had a relapse of respiratory distress because of an extramedullary plasmacytoma involving the trachea.

  9. Ultrasonic cavitation erosion of nodular cast iron with ferrite-pearlite microstructure.

    Science.gov (United States)

    Mitelea, Ion; Bordeaşu, Ilare; Pelle, Marius; Crăciunescu, Corneliu

    2015-03-01

    The cavitation erosion of ductile cast iron with ferrite-pearlite microstructure was analyzed based on ultrasonic experiments performed according to ASTM G32-2010 and the resistance was compared to the C45 steel with similar hardness. The microstructural observation of the surface for different exposure times to the ultrasonic cavitation reveals the fact that the process initiates at the nodular graphite-ferrite interface and is controlled by micro-galvanic activities and mechanical factors. The cavitation erosion resistance was evaluated based on the evolution of the mean depth erosion and the mean depth erosion rate as a function of the cavitation time. The cavitation erosion rate of the cast iron is up to 1.32 times higher than the one of the C 45 steel with similar hardness. This is explained by the occurrence of stress concentrators due to the expulsion of the graphite from the metallic matrix.

  10. The unique entity of nodular lymphocyte-predominant Hodgkin lymphoma: current approaches to diagnosis and management.

    Science.gov (United States)

    Hawkes, Eliza A; Wotherspoon, Andrew; Cunningham, David

    2012-03-01

    Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare disease constituting only 3-8% of all Hodgkin lymphoma. It has a distinct histological and clinical presentation as well as significantly different natural history compared to the classical form of Hodgkin lymphoma. Presenting most often as early-stage disease, NLPHL is characterized by frequent relapses, but paradoxically an overall good prognosis. The approach to management should therefore reflect this pattern and focus on attaining prolonged remissions, with long-term follow-up paramount. Due to the rarity of the disease, few prospective data exist. Options for treatment include radiotherapy, chemotherapy or combined chemotherapy plus radiotherapy and targeted anti-CD20 antibody therapy, as well as observation in selected patients.

  11. Salt iodization in Denmark and individual changes in thyroid size, thyroid nodularity and serum thyroglobulin

    DEFF Research Database (Denmark)

    Krejbjerg, Anne

    in the year 2000. A monitoring program entitled the Danish Investigation on Iodine Intake and Thyroid Diseases (DanThyr) was initiated before any iodization of salt had begun to improve knowledge on how to evaluate iodine status in a population and to study the effects of an increase in iodine intake. The aim......Iodine is an essential mineral for the synthesis of thyroid hormones. Low iodine intake levels are associated with goitre and other iodine deficiency-related disorders that have affected billions of people worldwide. Until recently the iodine intake of many European populations was below...... of this PhD thesis was to evaluate individual changes in thyroid related variables associated with iodine fortification. We chose thyroid volume, thyroid nodularity and serum thyroglobulin as indicators of impact and evaluated possible changes in an 11-year follow-up investigation performed before and after...

  12. [Immunity of a leguminous plant infected by nodular bacteria Rhizobium spp. F.

    Science.gov (United States)

    Glyan'ko, A K; Ischenko, A A

    2017-01-01

    Recent studies of the immune system of leguminous plants infected with nodular bacteria (rhizobia) are summarized. The possibility of blocking the invasion of rhizobia into plant organs not affected by the primary infection is discussed. The concept of local and systemic resistance of the leguminous plant to rhizobial infection is introduced. The Nod factors of rhizobia are considered, as well as the plant receptors that interact with these factors upon the formation of symbiosis of the plant and bacteria. The role of bacterial surface exopolysaccharides in the suppression of the protective system of the plants is discussed. The innate immunity of leguminous plant cells is assumed to affect the formation and functioning of the symbiosis of the plant and the bacteria.

  13. Reduction of Nodular Growth Pattern of Metastatic Uveal Melanoma after Radioembolization of Hepatic Metastases.

    Science.gov (United States)

    Halenda, Kevin M; Kudchadkar, Ragini R; Lawson, David H; Kies, Darren D; Zhelnin, Kristen E; Krasinskas, Alyssa M; Grossniklaus, Hans E

    2016-04-01

    The aim of this study was to report a case of metastatic uveal melanoma in which radioembolized nodular liver metastases decreased in size while infiltrative sinusoidal metastases progressed, leading to jaundice without obstruction of the biliary ducts. The relevant clinical features, imaging, and histopathologic findings of this case are reviewed. A 61-year-old Caucasian male with a history of uveal melanoma of the left eye status post plaque brachytherapy developed numerous liver metastases. After progression on systemic therapies, he underwent palliative radioembolization. Despite some radiographic improvement in the liver metastases, he developed hyperbilirubinemia without biliary tract obstruction or signs of liver failure. A biopsy of radiographically normal liver demonstrated extensive sinusoidal infiltration with melanoma. Distinct angiographic and histopathologic growth patterns of metastatic uveal melanoma differ in their amenability to radioembolization. Sinusoidal infiltration may lead to hyperbilirubinemia in the absence of overt obstruction or liver failure.

  14. Individual and ecological factors associated with early detection of nodular melanoma in the United States.

    Science.gov (United States)

    Moreau, Jacqueline F; Weinstock, Martin A; Geller, Alan C; Winger, Daniel G; Ferris, Laura K

    2014-04-01

    The aim of the study was to identify individual and ecological factors associated with early diagnosis of nodular melanoma (NM). Using cross-sectional, prospective data from 18 Surveillance, Epidemiology, and End Results registries, we performed multiple logistic regression to generate odds of thick (>4 mm) versus thin (≤2 mm) NM using patient-level demographics and tumor characteristics as well as county-level socioeconomic status, healthcare access, and preventive service use as predictors. We identified 10 475 patients with NM. Divorced, separated, and widowed individuals had increased odds of thick versus thin NM compared with married individuals [odds ratio (OR): 1.47, Pmelanoma, NM thickness at diagnosis is not associated with the socioeconomic environment in one's area of residence. Instead, it is related to factors associated with incidental or formal detection. This information should be used to better target melanoma education and early detection programs.

  15. Nodular malignant melanoma and multiple cutaneous neoplasms under immunosuppression with azathioprine.

    Science.gov (United States)

    Guenova, Emmanuella; Lichte, Verena; Hoetzenecker, Wolfram; Woelbing, Florian; Moehrle, Matthias; Roecken, Martin; Schaller, Martin

    2009-08-01

    Immunosuppressed patients are at increased risk of skin cancer. A 67-year-old renal transplant recipient developed a nodular malignant melanoma after 30 years of immunosuppression with azathioprine and prednisolone. The patient died of metastatic disease 3 months after the diagnosis was made. The function of the renal graft was not affected at all. Renal transplant recipients are at high risk of developing nonmelanocytic skin tumors when on immunosuppressive therapy with cyclosporine A. Less common is the development of skin cancer during immunosuppression with azathioprine. Latest reports show the increased incidence of malignant melanoma in immunosuppressed patients. Our case illustrates the necessity of close dermatological surveillance of allograft recipients, to assure an early recognition of any malignant skin tumor and to reduce the risk of systemic metastatic disease.

  16. Reactive Retinal Astrocytic Tumor (Focal Nodular Gliosis): Report of the Clinical Spectrum of 3 Cases.

    Science.gov (United States)

    Singh, Arun D; Soto, Hansell; Bellerive, Claudine; Biscotti, Charles V

    2017-09-01

    To report 3 cases providing insight into clinical progression of reactive retinal astrocytic tumor. The clinical, imaging, and when available, the cytologic features of 3 cases of reactive retinal astrocytic tumor (focal nodular gliosis) were reviewed. A 6-year-old female, a 49-year-old man, and a 39-year-old man each developed a white retinal mass associated with laser photocoagulation, lattice degeneration, and treatment of a presumed vascular tumor, respectively. All tumors were white, circumscribed retinal masses that tended to be associated with exudation and either initially or eventually minimal vascularity. Reactive retinal astrocytic tumor can be observed in response to a degenerative, inflammatory, or ischemic retinal insult. Such tumors may progress after therapeutic intervention.

  17. Cerebellopontine angle medulloblastoma with extensive nodularity in a child: case report and review of the literature.

    Science.gov (United States)

    Noiphithak, Raywat; Yindeedej, Vich; Thamwongskul, Chatchai

    2017-05-01

    Cerebellar medulloblastomas (MBs) are one of the most common posterior fossa tumors in children but rarely occur in the cerebellopontine angle (CPA). Only 39 cases of CPA MBs were reported in the literature, and most of them were classic and desmoplastic MBs. A 22-month-old girl presented with progressive cerebellar ataxia. Magnetic resonance imaging showed a large tumor in the right CPA and obstructive hydrocephalus. Surgical resection was performed and achieved total tumor removal. Microscopic examination and immunohistochemical staining revealed the diagnosis of MB with extensive nodularity. The patient recovered from her symptoms during follow-up and was transferred for adjuvant chemotherapy. MB should be considered as a differential diagnosis of a lesion in the CPA. The treatment and outcome of CPA MBs are similar to cerebellar MBs.

  18. Early-stage focal nodular hyperplasia: US/CT/MR features correlated with histology

    International Nuclear Information System (INIS)

    Golfieri, R.; Giampalma, E.; Berardi, R.; Caputo, M.; Lalli, A.; Grazi, G.; Mazziotti, A.; Gozzetti, G.; D'Errico, A.; Grigioni, W.; Gavelli, G.

    1994-01-01

    Two cases of focal nodular hyperplasia (FNH), in which ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MR) studies detected an atypical hemorrhagic pattern associated with an intrahepatic arterio venous malformation (AVM) around the growths, are presented. In both cases, histology demonstrated a very early regenerative stage and necrotic-hemorrhagic areas within the lesions. In these cases, the analysis of radiological findings, surgical specimens and histology seemed to confirm the pathogenetic hypothesis suggested by Wanless: in normal liver parenchyma, a ''blood steal'' phenomenon due to congenital or acquired intrahepatic AVM could cause ischemic damage, appearing as a hemorrhagic necrotic area, the extent of which depends on the degree of residual portal supply. (orig.)

  19. Comparison of bony dimensions at the level of the pelvic floor in women with and without pelvic organ prolapse

    Science.gov (United States)

    Stein, Tamara A.; Kaur, Gurpreet; Summers, Aimee; Larson, Kindra A.; Delancey, John O. L.

    2010-01-01

    Objective Compare bony pelvis dimensions at the level of pelvic support in women with and without pelvic organ prolapse (POP). Study Design Pelvic floor dimensions of 42 Caucasian women with POP ≥ 1cm beyond the hymen were compared to 42 age and parity-matched women with normal support. Bony landmarks relevant to connective tissue and levator attachments were identified on MRI. Dimensions were independently measured by two examiners and averaged for each subject. Results Measurements (cms) for cases and controls are as follows: Interspinous Diameter, 11.2±0.8 vs. 11.1±0.7, p=0.19; Anterior-Posterior Outlet Diameter, 11.7±0.7 vs. 11.7±0.8, p=0.71; Pubic Symphysis to Ischial Spine - Left, 9.5±0.5 vs. 9.5±0.4, p=0.91; -Right, 9.5±0.4 vs. 9.5±0.5, p=0.81; Sacrococcygeal junction to Ischial Spine - Left, 7.0±0.6 vs. 7.0±0.5, p=0.54; - Right, 7.0±0.6 vs. 6.9±0.4, p=0.32. Conclusion Bony pelvis dimensions are similar at the level of the muscular pelvic floor in Caucasian women with and without POP. PMID:19254580

  20. BRAF and NRAS mutations are heterogeneous and not mutually exclusive in nodular melanoma.

    Science.gov (United States)

    Chiappetta, Caterina; Proietti, Ilaria; Soccodato, Valentina; Puggioni, Chiara; Zaralli, Roberto; Pacini, Luca; Porta, Natale; Skroza, Nevena; Petrozza, Vincenzo; Potenza, Concetta; Della Rocca, Carlo; Di Cristofano, Claudio

    2015-03-01

    Inhibitors of RAF inhibit the MAPK pathway that plays an important role in the development and progression of those melanoma carrying the V600E BRAF mutation, but there's a subset of such patients who do not respond to the therapy. Various mechanisms of drug resistance have been proposed which include the clonal heterogeneity of the tumor. We have studied a population of nodular melanoma to investigate the intratumor and intertumor heterogeneity by Laser Capture Microdissection (LCM) analysis. Our results showed that BRAF and NRAS mutations were detected in 47% and 33% of nodular melanoma, respectively, and that there is a discrepancy in mutational pattern of tumoral sample because in the 36% of patients a different mutation, in at least 1 area of the tumor, was found by LCM analysis, giving evidence of the presence of different clonal cells populations. Moreover, we found that mutations in BRAF and NRAS are not mutually exclusive because they were simultaneously present in the same tumor specimens and we observed that when the 2 different mutations were present one is a high-frequency mutation and the other is a low-frequency mutation. This was more evident in lymphonodal metastasis that resulted from wild type to mutational analysis, but showed different mutations following LCM analysis. Therefore, we believed that, when primary tumoral sample results negative to mutational analysis, if it is possible, metastases should be investigated to verify the presence of mutations. Generally, it should be searched for other mutations, in addition to BRAF V600E, so as to better understand the mechanism of drug resistance.

  1. Fascitis nodular en región facial en edades pediátricas Nodular fasciitis present in facial area in children

    Directory of Open Access Journals (Sweden)

    Dadonim Vila Morales

    2009-09-01

    Full Text Available Propósito: Presentar 3 casos de fascitisnodular de región facial. Método: Se realizó un estudio de los pacientes que comprendió examen físico, análisis de laboratorio y radiológico. Se describió la conducta quirúrgica o médica realizada en cada caso y su diagnóstico anatomopatológico. Resultados: Se mostró el método científico como única vía de llegar al diagnóstico certero, a pesar de enfrentar el reto de diagnosticar una entidad nosológica inusual en la cirugía maxilofacial. Se discutió la evolución de cada paciente y la literatura consultada. Conclusiones: Resulta muy útil la presentación de estos casos, pues esta tumoración presenta una localización muy poco frecuente en cara y su rápido crecimiento y evolución clínica son habitualmente difíciles de interpretar.Aim: To present 3 cases of nodular fasciitis in facial area. Method: A study was carried out in patients including physical examination, laboratory and radiologic analysis. Surgical or medical behavior was described present in each case with an anatomical and the pathological diagnosis was made. Results: Scientific method was the only route to achieve an accurate diagnosis despite the challenge of diagnosing an uncommon disease entity in maxillofacial surgery. In each patient the course was discussed as well as a literature review. Conclusions: The presentation of these cases is very essential since this tumor has a not much location in the face and its fast developmental and clinical course are often difficult to interpret.

  2. Proportional evaluation of anterior cruciate ligament footprint size and knee bony morphology.

    Science.gov (United States)

    Iriuchishima, Takanori; Ryu, Keinosuke; Aizawa, Shin; Fu, Freddie H

    2015-11-01

    The purpose of this study was to reveal the correlation in size between the native anterior cruciate ligament (ACL) footprint and the femoral intercondylar notch and the tibia plateau, and to calculate the proportion in size between the ACL footprint and knee bony morphology. Twenty-six non-paired human cadaver knees were used. All soft tissues around the knee were resected except the ACL. The ACL was cut in the middle, and the femoral bone was cut at the most proximal point of the femoral notch. The ACL was carefully dissected, and the periphery of the ACL insertion site was outlined on both the femoral and tibial sides. An accurate lateral view of the femoral condyle and an axial view of the tibial plateau were photographed with a digital camera, and the images were downloaded to a personal computer. The size of the femoral and tibial ACL footprints and the area of the lateral wall of the intercondylar notch and the tibia plateau were measured with Image J software (National Institution of Health). The sizes of the native femoral and tibial ACL footprints were 69.8 ± 25 and 133.8 ± 31.3 mm(2), respectively. The areas of the lateral wall of the intercondylar notch and the tibia plateau were 390.5 ± 70.5 and 2,281.7 ± 377.3 mm(2), respectively. The femoral ACL footprint area and the area of the lateral wall of the femoral intercondylar notch (Pearson's correlation coefficient = 0.603, p = 0.001), and the tibial ACL footprint area and the area of the tibia plateau (Pearson's correlation coefficient = 0.452, p = 0.02) both showed significant correlation. The femoral ACL footprint was 17.8 ± 4.9 %, the size of the lateral wall of the femoral intercondylar notch, and the tibial ACL footprint was 5.9 ± 1.3 %, the size of the tibia plateau. For clinical relevance, the femoral ACL footprint is approximately 18 %, the size of the intercondylar notch, and the tibial ACL footprint is approximately 6 %, the size of the tibia plateau. It might be possible to predict the

  3. Surgically Relevant Bony and Soft Tissue Anatomy of the Proximal Femur

    Science.gov (United States)

    Philippon, Marc J.; Michalski, Max P.; Campbell, Kevin J.; Goldsmith, Mary T.; Devitt, Brian M.; Wijdicks, Coen A.; LaPrade, Robert F.

    2014-01-01

    Background: Hip endoscopy facilitates the treatment of extra-articular disorders of the proximal femur. Unfortunately, current knowledge of proximal femur anatomy is limited to qualitative descriptions and lacks surgically relevant landmarks. Purpose: To provide a quantitative and qualitative analysis of proximal femur anatomy in reference to surgically relevant bony landmarks. Study Design: Descriptive laboratory study. Methods: Fourteen cadaveric hemipelvises were dissected. A coordinate measuring device measured dimensions and interrelationships of the gluteal muscles, hip external rotators, pectineus, iliopsoas, and joint capsule in reference to osseous landmarks. Results: The vastus tubercle, superomedial border of the greater trochanter, and femoral head-neck junction were distinct and reliable osseous landmarks. The anteroinferior tip of the vastus tubercle was 17.1 mm (95% CI: 14.5, 19.8 mm) anteroinferior to the center of the gluteus medius lateral insertional footprint and was 22.9 mm (95% CI: 20.1, 25.7 mm) inferolateral to the center of the gluteus minimus insertional footprint. The insertions of the piriformis, conjoint tendon of the hip (superior gemellus, obturator internus, and inferior gemellus), and obturator externus were identified relative to the superomedial border of the greater trochanter. The relationship of the aforementioned footprints were 49% (95% CI: 43%, 54%), 42% (95% CI: 33%, 50%), and 64% (95% CI: 59%, 69%) from the anterior (0%) to posterior (100%) margins of the superomedial border of the greater trochanter, respectively. The hip joint capsule attached distally on the proximal femur 18.2 mm (95% CI: 14.2, 22.2 mm) from the head-neck junction medially on average. Conclusion: The vastus tubercle, superomedial border of the greater trochanter, and the femoral head-neck junction were reliable osseous landmarks for the identification of the tendinous and hip capsular insertions on the proximal femur. Knowledge of the

  4. Permian-Triassic Osteichthyes (bony fishes): diversity dynamics and body size evolution.

    Science.gov (United States)

    Romano, Carlo; Koot, Martha B; Kogan, Ilja; Brayard, Arnaud; Minikh, Alla V; Brinkmann, Winand; Bucher, Hugo; Kriwet, Jürgen

    2016-02-01

    The Permian and Triassic were key time intervals in the history of life on Earth. Both periods are marked by a series of biotic crises including the most catastrophic of such events, the end-Permian mass extinction, which eventually led to a major turnover from typical Palaeozoic faunas and floras to those that are emblematic for the Mesozoic and Cenozoic. Here we review patterns in Permian-Triassic bony fishes, a group whose evolutionary dynamics are understudied. Based on data from primary literature, we analyse changes in their taxonomic diversity and body size (as a proxy for trophic position) and explore their response to Permian-Triassic events. Diversity and body size are investigated separately for different groups of Osteichthyes (Dipnoi, Actinistia, 'Palaeopterygii', 'Subholostei', Holostei, Teleosteomorpha), within the marine and freshwater realms and on a global scale (total diversity) as well as across palaeolatitudinal belts. Diversity is also measured for different palaeogeographical provinces. Our results suggest a general trend from low osteichthyan diversity in the Permian to higher levels in the Triassic. Diversity dynamics in the Permian are marked by a decline in freshwater taxa during the Cisuralian. An extinction event during the end-Guadalupian crisis is not evident from our data, but 'palaeopterygians' experienced a significant body size increase across the Guadalupian-Lopingian boundary and these fishes upheld their position as large, top predators from the Late Permian to the Late Triassic. Elevated turnover rates are documented at the Permian-Triassic boundary, and two distinct diversification events are noted in the wake of this biotic crisis, a first one during the Early Triassic (dipnoans, actinistians, 'palaeopterygians', 'subholosteans') and a second one during the Middle Triassic ('subholosteans', neopterygians). The origination of new, small taxa predominantly among these groups during the Middle Triassic event caused a

  5. Hiperplasia nodular focal do fígado: apresentação de um caso e revisão da literatura Focal nodular hyperplasia of the liver: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Marise Silva Teixeira

    2007-08-01

    Full Text Available Neste trabalho apresentamos um caso de hiperplasia nodular focal que foi diagnosticado aos seis anos de idade e que está sendo acompanhado até o momento presente. Para o diagnóstico foram imprescindíveis as técnicas de imagem, tendo importância de realce a cintilografia hepatoesplênica e a tomografia computadorizada. Apresentamos, também, revisão da literatura sobre o assunto.In this case report we discuss a focal nodular hyperplasia diagnosed in a female, six-year old patient, as well as her follow-up from the diagnosis to the present time. Imaging techniques, particularly hepatosplenic scintigraphy and computed tomography, are essential for the diagnosis. Also, a literature review is presented.

  6. Ring and nodular multiple sclerosis lesions: a retrospective natural history study.

    Science.gov (United States)

    Davis, M; Auh, S; Riva, M; Richert, N D; Frank, J A; McFarland, H F; Bagnato, F

    2010-03-09

    In patients with multiple sclerosis (MS), contrast-enhancing lesions (CELs) on postcontrast MRI are considered markers of the inflammatory responses associated with blood-brain barrier breakdown. Based upon shape, CELs may be defined as nodular (nCEL) or ring (rCEL) lesions. Several short-term studies pointed towards the assumption that rCELs represent areas of a more aggressive inflammatory process. In the present long-term (i.e., 2 years) retrospective natural history study, we used monthly imaging to follow rCEL and nCELs evolution in 16 patients with MS during the natural history. New CELs were identified monthly on month 4-9 MRIs, using month 1-3 MRIs to ensure that all CELs were not previously enhancing. Chronic black holes (cBHs) were counted monthly upon CEL disappearance up to the 24th MRI. Generalized estimating equation methods investigated within-patient differences between rCELs and nCELs in volume and likelihood to convert into cBHs. Kaplan-Meier survival curves estimated differences in the length of persistence between cBHs originating from nCELs and cBHs deriving from rCELs. Fifty-two new rCELs and 281 nCELs were identified. rCELs had larger mean (z = 5.06, p < or = 0.0001) volumes than nCELs. The proportion of cBHs from rCELs was similar (z = 1.81, p = 0.0710) to the proportion of cBHs from nCELs. Likewise, the length of persistence of cBHs deriving from rCELs was similar (chi(1)(2) = 2.339, p = 0.1262) to the duration of cBHs from nCELs. Our data suggest that worse radiologic characteristics associated with the acute phase of ring contrast-enhancing lesions and nodular contrast-enhancing lesions do not necessarily reflect a poorer lesion outcome over time.

  7. Minimally Invasive Surgery Combined with Regenerative Biomaterials in Treating Intra-Bony Defects: A Meta-Analysis

    Science.gov (United States)

    Zhang, Yuanyuan; Li, Wenyang; Song, Jinlin

    2016-01-01

    Background With the popularity of minimally invasive surgery (MIS) in periodontics, numerous publications have evaluated the benefits of MIS with or without various regenerative biomaterials in the treatment of periodontal intra-bony defects. However, it is unclear if it is necessary to use biomaterials in MIS. Thus, we conducted a meta-analysis of randomized clinical trials in patients with intra-bony defects to compare the clinical outcomes of MIS with regenerative biomaterials for MIS alone. Methods The authors retrieved English publications on relevant studies from Cochrane CENTRAL, PubMed, Medline, Embase, Clinical Evidence, and ClinicalTrails.gov (up to June 30, 2015). The main clinical outcomes were the reduction of probing pocket depths (PPDs), gain of clinical attachment level (CAL), recession of gingival margin (REC) and radiographic bone fill. Review Manager 5.2 (Cochrane Collaboration, Oxford, England) was used to calculate the heterogeneity and mean differences of the main clinical outcomes. Results In total, 464 studies in the literature were identified but only four were ultimately feasible. The results showed no significant difference regarding CAL gain (P = 0.32) and PPD reduction (P = 0.40) as well as REC increase (P = 0.81) and radiographic bone fill (P = 0.64) between the MIS plus biomaterials group and the MIS alone group. Conclusions The meta-analysis suggested no significant difference in treatment of intra-bony defects between the MIS plus biomaterials group and the MIS alone group, indicating that it is important to take costs and benefits into consideration when a decision is made about a therapeutic approach. There needs to be an in-depth exploration of the induction of intrinsic tissue healing of MIS without biomaterials to achieve optimal outcomes. PMID:26785405

  8. [Bony pathologies of the metacarpophalangeal joints in early rheumatoid arthritis: comparison of MRI and high-resolution SPECT].

    Science.gov (United States)

    Scherer, A; Wirrwar, A; Mattes-György, K; Blondin, D; Reichelt, D; Müller, H-W; Schneider, M; Mödder, U; Ostendorf, B

    2009-09-01

    Comparison of MRI with a newly developed high-resolution multi-pinhole single photon emission computed tomography (MPH-SPECT) regarding the detection of bony pathologies of the metacarpophalangeal (MCP) joints in patients with early rheumatoid arthritis (ERA). The clinically dominant hand of 15 patients with ERA (disease duration 6 months) was examined using MRI and MPH-SPECT. The evaluation of MRI was achieved according to RAMRIS criteria and for the MPH SPECT regarding pathological tracer uptake and distribution. Image fusions of MRI and MPH-SPECT were provided and the two methods were compared. In MRI 12 of 15 patients showed arthritic joint pathologies, while 8 patients exhibited soft tissue and bony changes. 4 patients had only soft tissue inflammation (synovitis) with a normal bone signal. In MPH-SPECT 10 of 15 patients showed pathologically increased bone metabolism. The fusion images presented a high agreement of the pathological changes in both methods, while areas with increased bone metabolism were not only present in the case of erosions, but also in the case of bone edema. In 2 patients increased bone metabolism was detectable in areas of MR tomographic normal bone, while a clear surrounding synovitis was present in each case here. The comparison of MPH-SPECT with MRI proves that the latter is a sensitive procedure for the detection of bony pathologies of MCP joints in ERA. A normal bone signal in MRI does not exclude early changes in bone metabolism in cases of severe synovialitis. Georg Thieme Verlag KG Stuttgart, New York.

  9. Anxiety and Depression Are More Prevalent in Patients with Graves' Disease than in Patients with Nodular Goitre

    DEFF Research Database (Denmark)

    Bové, Kira Bang; Watt, Torquil; Vogel, Asmus Mejling

    2014-01-01

    ' disease versus 4% in nodular goitre (p = 0.038), anxiety was 18 versus 13% (p = 0.131). Symptoms of anxiety (p = 0.04) and depression (p = 0.01) increased with comorbidity. Anxiety symptoms increased with duration of Graves' disease (p = 0.04). Neither thyroid function nor autoantibody levels were...... associated with anxiety and depression symptoms.CONCLUSIONS: Anxiety and depression symptoms were more severe in Graves' disease than in nodular goitre. Symptoms were positively correlated to comorbidity and duration of Graves' disease but neither to thyroid function nor thyroid autoimmunity.......BACKGROUND AND OBJECTIVE: Graves' disease has been associated with an increased psychiatric morbidity. It is unclarified whether this relates to Graves' disease or chronic disease per se. The aim of our study was to estimate the prevalence of anxiety and depression symptoms in patients with Graves...

  10. Vitamin K deficiency bleeding presenting as nodular purpura in infancy: A rare and life-threatening entity

    Directory of Open Access Journals (Sweden)

    Pratik Gahalaut

    2013-01-01

    Full Text Available Vitamin K deficiency bleeding (VKDB disorder is an uncommon entity, which occurs due to inadequate activity of vitamin K-dependant coagulation factors. An 8-months-old exclusively breast-fed male infant presented with multiple, purpuric and nodular non-collapsible swellings on trunk of 4 days duration. Investigations revealed raised activated partial thromboplastin time and prothrombintime. Fibrinogen level and platelet counts were normal. Late VKDB usually presents as intra-cranial or mucosal hemorrhages. [1] Though skin and mucosal bleeding may occur in 1/3 rd of infants with VKDB, ′nodular purpura′ is not the common presenting feature. Earlier recognition of VKDB and immediate investigation/treatment helps prevent the potentially fatal outcome of the disease. Very little is mentioned about this entity in dermatology literature.

  11. Quality-of-Life Impairments Persist Six Months After Treatment of Graves' Hyperthyroidism and Toxic Nodular Goiter

    DEFF Research Database (Denmark)

    Cramon, Per; Winther, Kristian Hillert; Watt, Torquil

    2016-01-01

    in toxic nodular goiter. In Graves' hyperthyroidism, large treatment effects were observed on three ThyPRO scales (Hyperthyroid Symptoms, Tiredness, Overall HRQoL) and moderate effects on three scales (Anxiety, Emotional Susceptibility, Impaired Daily Life), while moderate effects were seen in two Thy......Background: The treatment of hyperthyroidism is aimed at improving health-related quality of life (HRQoL) and reducing morbidity and mortality. However, few studies have used validated questionnaires to assess HRQoL prospectively in such patients. The purpose of this study was to assess the impact...... of hyperthyroidism and its treatment on HRQoL using validated disease-specific and generic questionnaires. Methods: This prospective cohort study enrolled 88 patients with Graves' hyperthyroidism and 68 with toxic nodular goiter from endocrine outpatient clinics at two Danish university hospitals. The patients were...

  12. Clinical features, diagnosis, treatment and molecular studies in paediatric Cushing's syndrome due to primary nodular adrenocortical hyperplasia

    DEFF Research Database (Denmark)

    Storr, Helen L; Mitchell, J H; Swords, F M

    2004-01-01

    BACKGROUND: Primary nodular adrenocortical hyperplasia (PNAH) is a well recognized, but infrequently studied cause of paediatric Cushing's syndrome (CS). OBJECTIVE: To assess presentation, diagnosis, radiological imaging, treatment and molecular analysis of patients with childhood-onset CS due...... to PNAH. PATIENTS: Four males and two females (median age 12.9 years, range 10.9-16.9 years) were studied. RESULTS: All had growth failure (mean height SDS -1.2; range -2.5-0.0), weight gain [mean body mass index (BMI) SDS 3.5; range 2.5-4.6] and clinical virilization, while five had hypertension [mean...... systolic blood pressure (SBP) 130 mmHg, diastolic blood pressure (DBP) 83 mmHg]. One patient had generalized lentigines, one had a tibial chondromyxomatous cyst and two had facial freckling. One patient had a family history of primary nodular adrenocortical disease. The diagnosis of CS was based...

  13. Sub-crestal positioning of implants results in higher bony crest resorption: an experimental study in dogs.

    Science.gov (United States)

    Cesaretti, Gianfranco; Lang, Niklaus P; Salata, Luiz A; Schweikert, Michael T; Gutierrez Hernandez, Maria Elena; Botticelli, Daniele

    2015-12-01

    To compare peri-implant soft- and hard-tissue integration at implants installed juxta- or sub-crestally. Furthermore, differences in the hard and soft peri-implant tissue dimensions at sites prepared with drills or sonic instruments were to be evaluated. Three months after tooth extraction in six dogs, recipient sites were prepared in both sides of the mandible using conventional drills or a sonic device (Sonosurgery(®)). Two implants with a 1.7-mm high-polished neck were installed, one with the rough/smooth surface interface placed at the level of the buccal bony crest (control) and the second placed 1.3 mm deeper (test). After 8 weeks of non-submerged healing, biopsies were harvested and ground sections prepared for histological evaluation. The buccal distances between the abutment/fixture junction (AF) and the most coronal level of osseointegration (B) were 1.6 ± 0.6 and 2.4 ± 0.4 mm; between AF and the top of the bony crest (C), they were 1.4 ± 0.4 and 2.2 ± 0.2 mm at the test and control sites, respectively. The top of the peri-implant mucosa (PM) was located more coronally at the test (1.2 ± 0.6 mm) compared to the control sites (0.6 ± 0.5 mm). However, when the original position of the bony crest was taken into account, a higher bone loss and a more apical position of the peri-implant mucosa resulted at the test sites. The placement of implants into a sub-crestal location resulted in a higher vertical buccal bone resorption and a more apical position of the peri-implant mucosa in relation to the level of the bony crest at implant installation. Moreover, peri-implant hard-tissue dimensions were similar at sites prepared with either drills or Sonosurgery(®). © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. SU-E-J-94: Positioning Errors Resulting From Using Bony Anatomy Alignment for Treating SBRT Lung Tumor

    International Nuclear Information System (INIS)

    Frame, C; Ding, G

    2014-01-01

    Purpose: To quantify patient setups errors based on bony anatomy registration rather than 3D tumor alignment for SBRT lung treatments. Method: A retrospective study was performed for patients treated with lung SBRT and imaged with kV cone beam computed tomography (kV-CBCT) image-guidance. Daily CBCT images were registered to treatment planning CTs based on bony anatomy alignment and then inter-fraction tumor movement was evaluated by comparing shift in the tumor center in the medial-lateral, anterior-posterior, and superior-inferior directions. The PTV V100% was evaluated for each patient based on the average daily tumor displacement to assess the impact of the positioning error on the target coverage when the registrations were based on bony anatomy. Of the 35 patients studied, 15 were free-breathing treatments, 10 used abdominal compression with a stereotactic body frame, and the remaining 10 were performed with BodyFIX vacuum bags. Results: For free-breathing treatments, the range of tumor displacement error is between 1–6 mm in the medial-lateral, 1–13 mm in the anterior-posterior, and 1–7 mm in the superior-inferior directions. These positioning errors lead to 6–22% underdose coverage for PTV - V100% . Patients treated with abdominal compression immobilization showed positional errors of 0–4mm mediallaterally, 0–3mm anterior-posteriorly, and 0–2 mm inferior-superiorly with PTV - V100% underdose ranging between 6–17%. For patients immobilized with the vacuum bags, the positional errors were found to be 0–1 mm medial-laterally, 0–1mm anterior-posteriorly, and 0–2 mm inferior-superiorly with PTV - V100% under dose ranging between 5–6% only. Conclusion: It is necessary to align the tumor target by using 3D image guidance to ensure adequate tumor coverage before performing SBRT lung treatments. The BodyFIX vacuum bag immobilization method has the least positioning errors among the three methods studied when bony anatomy is used for

  15. SU-E-J-94: Positioning Errors Resulting From Using Bony Anatomy Alignment for Treating SBRT Lung Tumor

    Energy Technology Data Exchange (ETDEWEB)

    Frame, C; Ding, G [Vanderbilt University, Nashville, TN (United States)

    2014-06-01

    Purpose: To quantify patient setups errors based on bony anatomy registration rather than 3D tumor alignment for SBRT lung treatments. Method: A retrospective study was performed for patients treated with lung SBRT and imaged with kV cone beam computed tomography (kV-CBCT) image-guidance. Daily CBCT images were registered to treatment planning CTs based on bony anatomy alignment and then inter-fraction tumor movement was evaluated by comparing shift in the tumor center in the medial-lateral, anterior-posterior, and superior-inferior directions. The PTV V100% was evaluated for each patient based on the average daily tumor displacement to assess the impact of the positioning error on the target coverage when the registrations were based on bony anatomy. Of the 35 patients studied, 15 were free-breathing treatments, 10 used abdominal compression with a stereotactic body frame, and the remaining 10 were performed with BodyFIX vacuum bags. Results: For free-breathing treatments, the range of tumor displacement error is between 1–6 mm in the medial-lateral, 1–13 mm in the anterior-posterior, and 1–7 mm in the superior-inferior directions. These positioning errors lead to 6–22% underdose coverage for PTV - V100% . Patients treated with abdominal compression immobilization showed positional errors of 0–4mm mediallaterally, 0–3mm anterior-posteriorly, and 0–2 mm inferior-superiorly with PTV - V100% underdose ranging between 6–17%. For patients immobilized with the vacuum bags, the positional errors were found to be 0–1 mm medial-laterally, 0–1mm anterior-posteriorly, and 0–2 mm inferior-superiorly with PTV - V100% under dose ranging between 5–6% only. Conclusion: It is necessary to align the tumor target by using 3D image guidance to ensure adequate tumor coverage before performing SBRT lung treatments. The BodyFIX vacuum bag immobilization method has the least positioning errors among the three methods studied when bony anatomy is used for

  16. SU-E-J-33: Comparison Between Soft Tissue Alignment and Bony Alignment for Pancreatic Cancer Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Y; Crane, C; Krishnan, S; Das, P; Koay, E; Beddar, S [UT MD Anderson Cancer Center, Houston, TX (United States)

    2015-06-15

    Purpose An IGRT modality for pancreatic cancer treatment with dose escalation at our institution is in-room daily CT imaging. The purpose of this study is to assess the difference between soft tissue alignment and bony alignment for pancreatic tumor localization. Methods Eighteen patients with pancreatic tumors who underwent IMRT treatment with an inspiration breath-hold technique between July 2012 and February 2015 are included in this study. Prior to each treatment, a CT scan was acquired. The CT image guidance started with auto-alignment to either the bony anatomy (vertebral bodies) or fiducials (for the six patients with the stent in/near the tumor) and then, when necessary, manual adjustments were made based on soft tissue alignment using clinical software (CT-Assisted Targeting system). The difference between soft tissue alignment and bony/fiducial alignment was evaluated. Results Of all 380 treatments, manual adjustment was made in 225 treatments, ranging from 11% (3 treatments out of 28) to 96% (27 treatments out of 28) per patient. The mean of the difference between soft tissue alignment and bony/fiducial alignment per patient ranged from −3.6 to 0.3 mm, −1.5 to 2.8 mm, and −3.3 to 3.4 mm in the AP, SI, and RL directions, respectively. The maximum difference over all treatments was −9.5, −14.6, and −14.6 mm in the AP, SI, and RL directions, respectively. Conclusion About 60% of the time, manual adjustment based on soft tissue alignment was required. The extent of manual adjustment was usually small but varied significantly from patient to patient. The ultimate goal of the IGRT modality using daily CT imaging is not to fully cover the target but to spare organs-at-risk as much as possible to avoid them moving into higher dose gradients than accepted in the treatment plan. To this end, manual adjustment based on soft tissue alignment is critically important.

  17. Gastric outlet obstruction caused by focal nodular hyperplasia of the liver: A case report and literature review.

    Science.gov (United States)

    Eris, Cengiz; Yildiz, Mehmet Kamil; Odabasi, Mehmet; Akbulut, Sami; Abuoglu, Hasan; Ozkan, Erkan

    2013-01-01

    Here, we present a case of gastric outlet obstruction due to focal nodular hyperplasia of the liver. A 23-year-old female presented to our emergency clinic with nausea, vomiting, and abdominal pain. Endoscopy showed that the prepyloric region of the stomach was externally compressed by a lesion. Computed tomography and magnetic resonance imaging revealed a 70mm solid mass originating from the liver, extending caudally in an exophytic manner, and compressing the stomach. Laparotomy revealed an irregular and exophytic mass originating from the liver, which caused gastric outlet obstruction. The mass was resected with a 10mm safety margin. The histopathology report of the mass returned as focal nodular hyperplasia. Gastric outlet obstruction is a clinical syndrome characterized by abdominal pain, nausea, and postprandial vomiting. This clinical condition frequently develops as a result of peptic ulcer disease, pyloric stenosis, and obstruction of pylorus by foreign bodies including phytobezoars, congenital duodenal webs, malignant disorders, and various lesions externally compressing the stomach. Gastric outlet obstruction due to hepatic lesions is extremely rare; few cases have been reported. This is the first reported case of gastric outlet obstruction that developed due to focal nodular hyperplasia of the liver. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Ultrasound-based scores as predictors for nodular hyperplasia in patients with secondary hyperparathyroidism: a prospective validation study.

    Science.gov (United States)

    Gwiasda, Jill; Kaltenborn, Alexander; Müller, Jörg A; Serttas, Michaela; Scheumann, Georg W F; Schrem, Harald; Jäger, Mark D

    2017-03-01

    Former studies evaluated echostructural and vascular patterns in ultrasound of the parathyroid gland to identify nodular hyperplasia in patients with secondary hyperparathyroidism due to chronic kidney disease. This prospective study aims to externally validate suggested ultrasound classifications. Parathyroid glands of 27 patients with secondary hyperparathyroidism undergoing parathyroidectomy were prospectively analyzed. Ultrasound including Doppler imaging was performed 1 day prior to surgery. Ultrasound data were available for 70 parathyroid glands. Echostructural and vascular scores according to previous studies were applied calculating the area under the receiver operating characteristic curve (AUROC). Overall correctness, sensitivity, and specificity of the investigated scores were assessed with the Youden index method. The Doppler score introduced by Vulpio and colleagues based on characteristic blood flow patterns in parathyroid glands showed an AUROC of 0.749 for the prediction of nodular hyperplasia with an overall correctness of 72.8%. Other ultrasound classifications based on blood flow patterns, as well as echostructure of the parathyroid gland displayed AUROCs of secondary hyperparathyroidism was externally validated for the first time. Other ultrasound scores fail as prognostic models in this study population. Doppler sonography of the parathyroid gland has prognostic capability to identify nodular hyperplasia as surrogate marker for patients with secondary hyperparathyroidism indicating the need for ablative or surgical treatment when failing conservative therapy.

  19. Variable MR imaging appearances of focal nodular hyperplasia in pediatric cancer patients.

    Science.gov (United States)

    Do, Richard K G; Shaylor, Sara D; Shia, Jinru; Wang, Amy; Kramer, Kim; Abramson, Sara J; Price, Anita P; Schwartz, Lawrence H

    2011-03-01

    Focal nodular hyperplasia (FNH) is rare in the general pediatric population but is increasingly found in treated pediatric cancer patients. FNH can be incidentally found on CT and MRI and can be misdiagnosed as liver metastasis in patients with an oncological history. To describe the MR imaging findings of FNH in pediatric cancer patients. Ten children who had been treated for a primary malignancy and who were diagnosed with FNH from 2003 to 2010 were identified from a search for FNH in our pathology and radiology databases. Patients were included if they were treated for a primary malignancy and had undergone MR imaging of the liver including T1-weighted, T2-weighted and dynamic contrast-enhanced T1-weighted sequences. FNH from all patients (n=10) demonstrated typical homogeneous arterial enhancement on MRI. The FNH was often multiple and small (7/10 patients), lacking a central scar, with variable imaging characteristics including signal hyperintensity on both T1- and T2-weighted images (4/10 patients), especially in the setting of hepatic hemosiderosis. FNH has a variable MR appearance in pediatric cancer patients and should be considered in the differential diagnosis of hypervascular liver lesions.

  20. OBSERVATION OF FATIGUE CRACK PATHS IN NODULAR CAST IRON AND ADI MICROSTRUCTURES

    Directory of Open Access Journals (Sweden)

    Lukáš Bubenko

    2009-07-01

    Full Text Available When speaking about quality of construction materials, fatigue crack propagation resistance is one of the most important considered properties. That is essentially influenced by character of matrix. Here presented contribution deals with the fatigue crack propagation mode through the matrix of as-cast nodular cast iron (NCI and austempered ductile iron (ADI, whereas influence of microstructure has been considered and discussed. Experimental materials used in presented contribution were pearlitc-ferritic NCI and heat treated ADI 800. Pearlitic-ferritic NCI was used as the base for ADI production. Experiments were performed on mini round compact tension (RCT specimens using an Amsler vibrophore. Fatigue crack paths in both materials were investigated and compared. Light microscopy was used to analyze the microstructure, crack initiation and propagation within broken specimens. In both tested materials fatigue cracks always initiated at graphite-matrix interface, while graphite nodules remained generally unbroken, eventually only surface of nodules was damaged. Though, comparing two materials with different microstructures, the diversity of fatigue crack propagation modes at high deltaK and low deltaK was observed.

  1. An Electron Microscopy Study of Graphite Growth in Nodular Cast Irons

    Science.gov (United States)

    Laffont, L.; Jday, R.; Lacaze, J.

    2018-04-01

    Growth of graphite during solidification and high-temperature solid-state transformation has been investigated in samples cut out from a thin-wall casting which solidified partly in the stable (iron-graphite) and partly in the metastable (iron-cementite) systems. Transmission electron microscopy has been used to characterize graphite nodules in as-cast state and in samples having been fully graphitized at various temperatures in the austenite field. Nodules in the as-cast material show a twofold structure characterized by an inner zone where graphite is disoriented and an outer zone where it is well crystallized. In heat-treated samples, graphite nodules consist of well-crystallized sectors radiating from the nucleus. These observations suggest that the disoriented zone appears because of mechanical deformation when the liquid contracts during its solidification in the metastable system. During heat-treatment, the graphite in this zone recrystallizes. In turn, it can be concluded that nodular graphite growth mechanism is the same during solidification and solid-state transformation.

  2. Benign Hepatocellular Tumors in Children: Focal Nodular Hyperplasia and Hepatocellular Adenoma

    Directory of Open Access Journals (Sweden)

    Stéphanie Franchi-Abella

    2013-01-01

    Full Text Available Benign liver tumors are very rare in children. Most focal nodular hyperplasia (FNH remain sporadic, but predisposing factors exist, as follows: long-term cancer survivor (with an increasing incidence, portal deprivation in congenital or surgical portosystemic shunt. The aspect is atypical on imaging in two-thirds of cases. Biopsy of the tumor and the nontumoral liver is then required. Surgical resection will be discussed in the case of large tumors with or without symptoms. In the case of associated vascular disorder with portal deprivation, restoration of the portal flow will be discussed in the hope of seeing the involution of FNH. HepatoCellular Adenoma (HCA is frequently associated with predisposing factors such as GSD type I and III, Fanconi anemia especially if androgen therapy is administered, CPSS, and SPSS. Adenomatosis has been reported in germline mutation of HNF1-α. Management will depend on the presence of a predisposing factor and may include metabolic control, androgen therapy withdrawn, or closure of the shunt when appropriate. Surgery is usually performed on large lesions. In the case of adenomatosis or multiple lesions, surgery will be adapted. Close followup is required in all cases.

  3. Calorimetric analysis of heating and cooling process of nodular cast iron

    Directory of Open Access Journals (Sweden)

    Bińczyk F.

    2007-01-01

    Full Text Available The study presents the results of investigations of the thermal effects which take place during heating and cooling of samples of the nodular graphite cast iron taken from the stepped test casting of the wall thicknesses amounting to 5, 10, 15 and 20 mm. For investigations, a differential scanning calorimeter, type Multi HTC S60, was used. During heating, three endothermic effects related with pearlite decomposition, phase transformation α → γ, and carbon dissolution in austenite were observed on a DSC diagram. During cooling, two exothermic effects related with phase transformation γ→ α and pearlite formation were observed to consecutively take place on a DSC diagram. The values of the enthalpy of these processes differ and depend on the initial microstructure of the examined samples. The metallic matrix in 5 mm sample after the process of heating and cooling changes totally in favour of ferrite. The same effect, though less advanced in intensity, takes place in 10 mm sample, while in 15 and 20 mm samples the matrix constitution remains unchanged. The higher is the content of ferrite in samples, the stronger is the endothermic effect of the α → γ transformation and the weaker is the endothermic effect related with carbon dissolution in austenite. The total of the endothermic effects (heating is reduced, while that of the exothermic effects (cooling increases along with the increasing thickness of walls in a stepped test casting, from which samples for the investigations were taken.

  4. Optimizing the effect of electric-field enhancement in nodular defects

    Science.gov (United States)

    He, Tao; Cheng, Xinbin; Zhang, Jinlong; Jiao, Hongfei; Ma, Bin; Wang, Zhanshan

    2017-05-01

    It has been verified that a broadband high-reflection (HR) film could restrain electric-field intensity (EFI) enhancement effect in the nodular defects at normal incidence. However, it's impossible to design an omnidirectional HR coatings to avoid the light penetration from all incident angles at oblique incidence. In this paper, the EFI enhancement is simulated by using a three-dimensional finite-difference time-domain (FDTD) code. Two types of polarizers that prevent light penetration at low and high incident angular range (IAR) are proposed to explore the influence of transmission band at different angles in the case of oblique incidence. The damage morphologies of nodules initiating from different diameter silica microspheres in polarizers reproduce the simulated EFI distributions very well. These results indicate that light penetration at high IAR rather than at low IAR contributes mostly to EFI enhancement. Then, the conclusion is proved further by the films with low and high IAR at normal incidence. Controlling the angle position of transmission band at small angle can reduce the EFI enhancement in the usual case and increase the laser-induced damage threshold (LIDT) of films.

  5. Contrast-enhanced ultrasound of focal nodular hyperplasia: a matter of size

    Energy Technology Data Exchange (ETDEWEB)

    Bertin, Caroline [Hopital Beaujon APHP, Radiology Department, Clichy (France); Egels, Sophie; Huynh-Charlier, Isabelle [Hopital Pitie-Salpetriere APHP, Radiology Department, Paris (France); Wagner, Mathilde [Hopital Pitie-Salpetriere APHP, Radiology Department, Paris (France); Universite Paris Diderot, INSERM, UMR 1149, Laboratoire IPMA, Centre de Recherche sur l' Inflammation, Faculte de Medecine X Bichat, Paris (France); Vilgrain, Valerie [Hopital Beaujon APHP, Radiology Department, Clichy (France); Universite Paris Diderot, INSERM, UMR 1149, Laboratoire IPMA, Centre de Recherche sur l' Inflammation, Faculte de Medecine X Bichat, Paris (France); Lucidarme, Olivier [Hopital Pitie-Salpetriere APHP, Radiology Department, Paris (France); Sorbonne Universites, UPMC Univ Paris 06, CNRS UMR 7371, INSERM UMRS 1146, Laboratoire d' Imagerie Biomedicale, Paris (France); Groupe Hospitalier Pitie-Salpetriere - Charles Foix, Service de Radiologie Polyvalente et Oncologique, Paris (France)

    2014-10-15

    To assess the contrast-enhanced ultrasound (CEUS) frequencies of centrifugal enhancement, spoke-wheel sign and central scar in focal nodular hyperplasia (FNH) as a function of lesion size. Ninety-four FNHs were retrospectively reviewed to assess their largest diameter and enhancement pattern, including centrifugal enhancement from one central artery, spoke-wheel sign, diffuse or centripetal enhancement, central scar and late-phase washout. Mean FNH-lesion size was 3.7 ± 2.1 cm. Only 43.6 % of FNHs had centrifugal enhancement, with a spoke-wheel pattern (23.4 %) or without (20.2 %), while 56.4 % showed diffuse or centripetal enhancement. Centrifugal enhancement was observed in 73.9 % of FNHs ≤3.1 cm and 14.6 % of FNHs >3.1 cm (P < 10{sup -4}). Size and frequency of centrifugal enhancement were negatively correlated (r = -0.57, P < 10{sup -4}). The spoke-wheel pattern was also seen more frequently in smaller (37 %) than in larger FNHs (10.4 %) (P < 10{sup -3}). Late-phase washout was described in 5.3 % of FNHs and was not size-dependent. Lesions with a central scar were larger than those without, respectively, 5.7 ± 1.7 and 3.6 ± 2.0 cm (P = 0.012). Typical centrifugal enhancement yielding a confident FNH diagnosis is seen significantly more frequently when the lesion is ≤3.1 cm. (orig.)

  6. Correlation between serum lead and thyroid diseases: papillary thyroid carcinoma, nodular goiter, and thyroid adenoma.

    Science.gov (United States)

    Li, Hui; Li, Xiang; Liu, Jie; Jin, Langping; Yang, Fan; Wang, Junbo; Wang, Ouchen; Gao, Ying

    2017-10-01

    Studies have showed that lead was associated with human health. However, the effects of lead on thyroid functions are inconsistent, and studies based on Chinese population are fragmentary. To evaluate the correlation between lead and thyroid functions of Chinese with different thyroid diseases, we conducted a hospital-based study. Ninety-six papillary thyroid carcinoma (PTC), 10 nodular goiter (NG), and 7 thyroid adenoma (TA) patients were recruited from the First Affiliated Hospital of Wenzhou Medical University, China. Serum triiodothyronine (T3), free triiodothyronine (FT3), free thyroxin (FT4), and thyroid stimulating hormone (TSH) were evaluated with chemiluminescent microparticle immunoassay. Serum lead was assessed with ICP-MASS. Partial correlation was used to explore the correlations of serum lead and thyroid diseases. Compared to PTC, the level of lead was significantly higher in TA, and lower in NG (p lead was negatively correlated with TSH (r s  =  - 0.27, p lead at quartile4 (r s  = 0.61, p lead and FT3 or FT4 in any group. The results suggested that lead might have different etiological roles in these three thyroid diseases.

  7. Nodular Regenerative Hyperplasia Secondary to Neoadjuvant Chemotherapy for Colorectal Liver Metastases

    Directory of Open Access Journals (Sweden)

    Maartje A. J. van den Broek

    2009-01-01

    Full Text Available Liver resection is the only curative treatment for patients with colorectal liver metastases (CLMs. Neoadjuvant chemotherapy can improve resectability but has a potential harmful effect on the nontumorous liver. Patients with chemotherapy-induced hepatic injury undergoing liver surgery have higher risks of post-resectional morbidity. We present two cases of patients without pre-existent liver disease treated with oxaliplatin-based chemotherapy followed by surgical resection of their CLMs. Their intra-operative liver specimen showed morphologic abnormalities characteristic of nodular regenerative hyperplasia (NRH. NRH led to portal hypertension in both patients that resulted in deleterious post-resectional complications and death of one patient. Interestingly, the other patient underwent two repeat nonanatomic liver resections because of recurrent CLMs. The intra-operative liver specimen still showed signs of NRH and sinusoidal congestion, but the post-resectional courses were uneventful. Nevertheless, caution is recommended in patients with suspected NRH. Careful volumetric analysis should guide the operative strategy. When future remnant liver volume is regarded insufficient, portal vein embolization or restrictive surgery should be considered.

  8. Variable MR imaging appearances of focal nodular hyperplasia in pediatric cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Do, Richard K.G.; Abramson, Sara J.; Price, Anita P. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Shaylor, Sara D. [NYU Cancer Center, Department of Radiology, New York, NY (United States); Shia, Jinru [Memorial Sloan-Kettering Cancer Center, Department of Pathology, New York, NY (United States); Wang, Amy [Mattel Children' s Hospital at UCLA, Department of Pediatrics, Los Angeles, CA (United States); Kramer, Kim [Memorial Sloan-Kettering Cancer Center, Department of Pediatrics, New York, NY (United States); Schwartz, Lawrence H. [Columbia University Medical Center, Department of Radiology, New York, NY (United States)

    2011-03-15

    Focal nodular hyperplasia (FNH) is rare in the general pediatric population but is increasingly found in treated pediatric cancer patients. FNH can be incidentally found on CT and MRI and can be misdiagnosed as liver metastasis in patients with an oncological history. To describe the MR imaging findings of FNH in pediatric cancer patients. Ten children who had been treated for a primary malignancy and who were diagnosed with FNH from 2003 to 2010 were identified from a search for FNH in our pathology and radiology databases. Patients were included if they were treated for a primary malignancy and had undergone MR imaging of the liver including T1-weighted, T2-weighted and dynamic contrast-enhanced T1-weighted sequences. FNH from all patients (n = 10) demonstrated typical homogeneous arterial enhancement on MRI. The FNH was often multiple and small (7/10 patients), lacking a central scar, with variable imaging characteristics including signal hyperintensity on both T1- and T2-weighted images (4/10 patients), especially in the setting of hepatic hemosiderosis. FNH has a variable MR appearance in pediatric cancer patients and should be considered in the differential diagnosis of hypervascular liver lesions. (orig.)

  9. Sixth nerve palsy associated with obstruction in Dorello's canal, accompanied by nodular type muscular sarcoidosis.

    Science.gov (United States)

    Shioya, Ayako; Takuma, Hiroshi; Shiigai, Masanari; Ishii, Akiko; Tamaoka, Akira

    2014-08-15

    A 52-year-old Japanese woman complaining of horizontal double vision for 10 days was admitted to our hospital. Neurological examination revealed left abducent nerve palsy and muscle swelling in her thighs. Brain MRI showed obstruction in the spinal fluid space of the left Dorello's canal, which transmits a portion of the abducent nerve. In Ga-67-enhanced citrate scintigraphy, wide accumulation was seen in her bilateral thighs, lower legs, and gluteus muscles. Muscular MRI showed a star-shaped central structure on short tau inversion recovery (STIR) images, and the three stripes sign on T2-weighted images. These MRI findings indicated nodular-type muscular sarcoidosis. A muscle biopsy from the quadriceps femoris showed granulomatous epithelioid giant cells and non-necrotizing chronic lymphadenitis, which also indicate sarcoidosis. Her condition was considered to be caused by sarcoid granulomas obstructing Dorello's canal. She was treated with oral prednisolone (1 mg·kg(-1)·day(-1)) and her symptoms and MRI findings improved. This is the first known report of abducent nerve impairment in Dorello's canal, other than fetal hypoplasia. Brain MRI, muscular MRI, and muscle biopsy are useful for the diagnosis of abducent nerve palsy, and it is important to consider Dorello's canal obstruction by sarcoidosis. Complete remission can be achieved with proper treatment. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Treatment of regional cutaneous nodular metastases from melanoma using high-dose rate mould brachytherapy.

    Science.gov (United States)

    Chaudhuri, Anupam; De-Groot, Charles; Seel, Matthew; Jolly, Mike; Cameron, Tina

    2011-04-01

    The involvement of a wide body surface area by regional cutaneous nodular metastases (RCNM) from melanoma poses a significant therapeutic challenge. We report our experience from Waikato Hospital, Hamilton, New Zealand in successfully treating this condition with high-dose rate (HDR) surface mould brachytherapy (BT). We analysed six patients who had surgery and then developed RCNM, which was treated in our department by HDR mould BT using Iridium 192. Five out of six patients were treated with a dose of 30 Gy in five fractions to wide field with a further 6 Gy boost to tumour nodules. Our first patient received a higher dose of 36 Gy in six fractions followed by 6 Gy boost to tumour nodules. All patients experienced a complete response (CR). Median follow up was 23 months and side effects were minimal, only Radiation Therapy Oncology Group (RTOG) grade I/II early and late toxicity. To date, no in-field recurrence has been observed. Two patients died from metastatic disease at 33 and 34 months of follow up. There was a CR in all cases without in-field recurrence. To our knowledge, this is the first reported experience in treating skin melanoma with a BT surface mould. We recommend that BT surface mould should be considered when treating patients with RCNM. © 2011 The Authors. Journal of Medical Imaging and Radiation Oncology © 2011 The Royal Australian and New Zealand College of Radiologists.

  11. Treatment of regional cutaneous nodular metastases from melanoma using high-dose rate mould brachytherapy

    International Nuclear Information System (INIS)

    Chaudhuri, Anupam; De-Groot, Charles; Seel, Matthew; Jolly, Mike; Cameron Tina

    2011-01-01

    Full text: The involvement of a wide body surface area by regional cuta neous nodular metastases (RCNM) from melanoma poses a significant thera peutic challenge. We report our experience from Waikato Hospital, Hamilton, New Zealand in successfully treating this condition with high-dose rate (HDR) surface mould brachytherapy (BT). Methods: We analysed six patients who had surgery and then developed RCNM, which was treated in our department by HDR mould BT using Iridium 192. Five out of six patients were treated with a dose of 30 Gy in five fractions to wide field with a further 6 Gy boost to tumour nodules. Our first patient received a higher dose of 36 Gy in six fractions followed by 6 Gy boost to tumour nodules. Results: All patients experienced a complete response (CR). Median follow up was 23 months and side effects were minimal, only Radiation Therapy Oncol ogy Group (RTOG) grade I/ll early and late toxicity. To date, no in-field recurrence has been observed. Two patients died from metastatic disease at 33 and 34 months of follow up. Conclusion: There was a CR in all cases without in-field recurrence. To our knowledge, this is the first reported experience in treating skin melanoma with a BT surface mould. We recommend that BT surface mould should be considered when treating patients with RCNM.

  12. Case report of nodular melanoma within congenital melanocytic nevus- primary closure challenge.

    Science.gov (United States)

    Eljuga, Domagoj; Milas, Ivan; Kirac, Iva; Stanec, Mladen; Vrdoljak, Danko Velimir

    2016-01-01

    Congenital melanocytic nevi (CMN) are present in 1-2% of newborn infants. The size of CMN defines the risk of developing melanoma which is estimated from 5-10%, especially in lesions that are located across the spine. Herein we report a case where nodular melanoma was discovered on the periphery of medium sized CMN in a high risk patient. After complete excision, the defect was reconstructed with random pattern, triple rhomboid flap. Melanoma that arose within medium sized CMN would leave a complex posterior lower trunk defect. We used a triple Limberg flap which was proven to be straightforward and simple method when large defects are to be covered with vital tissue. We have also showed that this type of reconstruction is suitable for high risk patients that could not withstand any complex procedures. In our case, the method we choose to reconstruct the defect proved to be simple, safe and easy, especially when surgery is performed in a high risk patient. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Cellular localization of CIP2A determines its prognostic impact in superficial spreading and nodular melanoma

    International Nuclear Information System (INIS)

    Flørenes, Vivi Ann; Emilsen, Elisabeth; Dong, Hiep Phuc; Førsund, Mette; Holm, Ruth; Slipicevic, Ana

    2015-01-01

    Cancerous inhibitor of protein phosphatase 2A (CIP2A) is an important oncogene contributing to cancer progression partially by regulating cMYC and AKT. We examined CIP2A expression in cutaneous melanomas, its association with clinicopathological parameters and mapped molecular mechanisms regulated by CIP2A in vitro. CIP2A expression was analyzed by immunohistochemistry in 17 nevi, 132 primary melanomas and 49 metastases. Effects of siRNA-mediated down-regulation on proliferation, apoptosis and signaling pathways were assessed in melanoma cell lines. In superficial spreading melanomas (SSM), high nuclear CIP2A expression was associated with poor overall survival (OS) (P = 0.0018). Surprisingly, high cytoplasmic expression was related to improved relapse-free (P = 0.031) and OS (P = 0.014) in nodular melanomas (NM). In vitro experiments revealed that CIP2A can regulate proliferation and/or apoptosis partially through the PI3K/AKT pathway but also independently. In summary, CIP2A could represent a potential therapeutic target in SSM. However, in NM cytoplasmic CIP2A is associated with improved prognosis indicating that CIP2A has distinct, complex functions dependent on the molecular context and histological subtype. As seen in other cancer types, CIP2A can influence cMYC and AKT, but our data also suggest that in melanoma it has additional targets which need to be identified

  14. Cellular localization of CIP2A determines its prognostic impact in superficial spreading and nodular melanoma.

    Science.gov (United States)

    Flørenes, Vivi Ann; Emilsen, Elisabeth; Dong, Hiep Phuc; Førsund, Mette; Holm, Ruth; Slipicevic, Ana

    2015-06-01

    Cancerous inhibitor of protein phosphatase 2A (CIP2A) is an important oncogene contributing to cancer progression partially by regulating cMYC and AKT. We examined CIP2A expression in cutaneous melanomas, its association with clinicopathological parameters and mapped molecular mechanisms regulated by CIP2A in vitro. CIP2A expression was analyzed by immunohistochemistry in 17 nevi, 132 primary melanomas and 49 metastases. Effects of siRNA-mediated down-regulation on proliferation, apoptosis and signaling pathways were assessed in melanoma cell lines. In superficial spreading melanomas (SSM), high nuclear CIP2A expression was associated with poor overall survival (OS) (P = 0.0018). Surprisingly, high cytoplasmic expression was related to improved relapse-free (P = 0.031) and OS (P = 0.014) in nodular melanomas (NM). In vitro experiments revealed that CIP2A can regulate proliferation and/or apoptosis partially through the PI3K/AKT pathway but also independently. In summary, CIP2A could represent a potential therapeutic target in SSM. However, in NM cytoplasmic CIP2A is associated with improved prognosis indicating that CIP2A has distinct, complex functions dependent on the molecular context and histological subtype. As seen in other cancer types, CIP2A can influence cMYC and AKT, but our data also suggest that in melanoma it has additional targets which need to be identified. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  15. Prognostic importance of the mitotic marker phosphohistone H3 in cutaneous nodular melanoma.

    Science.gov (United States)

    Ladstein, Rita G; Bachmann, Ingeborg M; Straume, Oddbjørn; Akslen, Lars A

    2012-04-01

    Mitotic count is a known prognostic predictor in cutaneous melanoma, and is included in the current American Joint Committee on Cancer tumor-node-metastasis (TNM) staging system. The mitotic marker phosphohistone H3 (PHH3) is considered to facilitate counting of mitosis, and the purpose of this study was to evaluate the prognostic significance and strength of PHH3 in comparison with standard mitotic counting in cutaneous malignant melanoma. A total of 457 consecutive cases of nodular cutaneous melanoma were initially included in this series. The mitotic count was assessed on hematoxylin and eosin sections, and PHH3 was then examined by immunohistochemistry on standard sections of paraffin-embedded tumor tissue. Both the mitotic count and the number of PHH3-stained mitotic figures were recorded in a minimum area of 1 mm(2). Increased mitotic count and PHH3 value were both associated with unfavorable features like tumor thickness and presence of ulceration. Univariate survival analysis showed a highly significant prognostic impact of mitotic count and PHH3, whereas multivariate analysis indicated PHH3 to be a stronger prognostic indicator than mitotic count. Assessment of mitotic activity by PHH3 immunostaining might have important practical advantages, and should be further studied to consider a place in routine examination of all cutaneous melanomas.

  16. Hepatocellular carcinoma and focal nodular hyperplasia of the liver in a glycogen storage disease patient.

    Science.gov (United States)

    Mikuriya, Yoshihiro; Oshita, Akihiko; Tashiro, Hirotaka; Amano, Hironobu; Kobayashi, Tsuyoshi; Arihiro, Kouji; Ohdan, Hideki

    2012-06-27

    Glycogen storage disease type Ia (GSD-Ia; also called von Gierke disease) is an autosomal recessive disorder of carbohydrate metabolism caused by glucose-6-phosphatase deficiency. There have been many reports describing hepatic tumors in GSD patients; however, most of these reports were of hepatocellular adenomas, whereas there are only few reports describing focal nodular hyperplasia (FNH) or hepatocellular carcinoma (HCC). We report a case with GSD-Ia who had undergone a partial resection of the liver for FNH at 18 years of age and in whom moderately differentiated HCC had developed. Preoperative imaging studies, including ultrasonography, dynamic computer tomography (CT) and magnetic resonance imaging, revealed benign and malignant features. In particular, fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT revealed the atypical findings that FDG accumulated at high levels in the non-tumorous hepatic parenchyma and low levels in the tumor. Right hemihepatectomy was performed. During the perioperative period, high-dose glucose and sodium bicarbonate were administered to control metabolic acidosis. He had multiple recurrences of HCC at 10 mo after surgery and was followed-up with transcatheter arterial chemoembolization. The tumor was already highly advanced when it was found by chance; therefore, a careful follow-up should be mandatory for GSD-I patients as they are at a high risk for HCC, similar to hepatitis patients.

  17. Cavernous angioma after chemotherapy for desmoplastic/nodular medulloblastoma associated with anhidrotic ectodermal dysplasia.

    Science.gov (United States)

    Yamasaki, Fumiyuki; Takayasu, Takeshi; Nosaka, Ryo; Kawaguchi, Hiroshi; Sugiyama, Kazuhiko; Kobayashi, Masao; Kurisu, Kaoru

    2016-02-01

    While cavernous angioma (CVA) after cranial irradiation has been documented, its development after high-dose chemotherapy with autologous peripheral blood stem cell transplantation (PBSCT) has not. We present a patient with desmoplastic/nodular medulloblastoma (DNMB) associated with anhidrotic ectodermal dysplasia (AED) who developed CVA 2 years after high-dose chemotherapy and PBSCT. A 1-year-old boy with ingravescent vomiting was admitted to our institute. He presented with a large head, a depressed nasal bridge, low-set ears, thick lips with peg-shaped teeth, hypohidrosis, sparse hair, thin atrophic skin, scaly dermatitis with frontal bossing, and a bulging anterior fontanel. Neuroradiological examination revealed multiple cerebellar masses with heterogeneous enhancement and speckled calcifications and severe obstructive hydrocephalus. The histological diagnosis of surgical specimens was DNMB, and he underwent postoperative multiple-drug chemotherapy with autologous PBSCT. The outcome was favorable and he did not undergo radiotherapy. After 2 years, intracranial hemorrhage was detected at his regular radiological check-up and he again underwent surgery. The histological diagnosis was CVA. To our knowledge, this is the first report of AED-associated DNMB and CVA.

  18. Ghrelin and obestatin in thyroid gland - immunohistochemical expression in nodular goiter, papillary and medullary cancer.

    Science.gov (United States)

    Gurgul, Edyta; Kasprzak, Aldona; Blaszczyk, Agata; Biczysko, Maciej; Surdyk-Zasada, Joanna; Seraszek-Jaros, Agnieszka; Ruchala, Marek

    2015-01-01

    Previous studies analyzing ghrelin and obestatin expression in thyroid gland tissue are not unanimous and are mostly related to ghrelin. The role of ghrelin and obestatin in the thyroid gland appears very interesting due to their probable involvement in cell proliferation. Furthermore, since the thyroid gland is associated with the maintenance of energy balance, the relationship between ghrelin, obestatin and thyroid function is worthy of consideration. The aim of the study was to assess ghrelin and obestatin immunocytochemical expression in nodular goiter (NG), papillary cancer (PTC) and medullary cancer (MTC). Analyzed samples included 9 cases of NG, 8 cases of PTC and 11 cases of MTC. The analysis of ghrelin and obestatin expression was performed by use of the immunohistochemical (IHC) EnVision system and evaluated with filter HSV software (quantitative morphometric analysis). Quantitative ghrelin expression in MTC cells was higher than in NG (p = 0.013) and correlated negatively with the size of the tumor (r= -0.829, p thyroid cell proliferation. The differences between ghrelin and obestatin immunoreactivity in benign and malignant thyroid tumors could support the theory of alternative transcription of the preproghrelin gene and independent production of ghrelin and obestatin.

  19. Coexisting Sclerosing Angiomatoid Nodular Transformation of the Spleen with Multiple Calcifying Fibrous Pseudotumors in a Patient

    Directory of Open Access Journals (Sweden)

    Jen-Chieh Lee

    2007-01-01

    Full Text Available Primary tumor or tumor-like lesions of the spleen are rare. Among them, vascular lesions are the most common. Vascular tumor of the spleen is different from the usual hemangioma of soft tissue because the vascular structure of the spleen is unique. Sclerosing angiomatoid nodular transformation (SANT is a recently described vascular lesion of the spleen. Grossly, it is a multinodular, well-circumscribed tumor containing a hypervascular core. Microscopically, it comprises three types of vessels, and each type recapitulates the immunohistochemical characteristics of the normal vascular elements of the splenic red pulp, i.e. capillaries, sinusoids, and small veins, respectively. Because of the rarity of this entity, its actual pathogenesis is still unknown. In this study, we report a case of SANT occurring in a 43-year-old woman, in whom there were also multiple calcifying fibrous pseudotumors (CFPTs in the abdominal cavity. Both SANT and CFPT are thought to be variants of inflammatory pseudotumor. Coexistence of these two rare entities in a patient has never been reported, and this fact suggests that there might be a common mechanism contributing to the formation of these two types of lesions. [J Formos Med Assoc 2007;106(3:234-239

  20. Fracture toughness in the transition region of a carbon steel and a ferritic nodular cast iron

    International Nuclear Information System (INIS)

    Nakano, Keishi; Yasunaka, Takashi

    1995-01-01

    In order to characterize the fracture toughness in the ductile-brittle transition region for thick-walled cylinders of ASME SA350 Gr.LF5 carbon steel and JIS FCD300LT ferritic nodular cast iron, elastic-plastic fracture toughness tests were carried out. The specimens were fatigue precracked compact tension (CT) specimens of 25mm in thickness. The tensile testing machines used were Instron type, electrohydraulic type and drop-weight type ones. In the static fracture toughness test on a FCD300LT cast iron, CT specimens were often fractured at somewhat higher loads after the initiation of pop-in cracks. Although the scatter of pop-in fracture toughness was small, the values of critical J-integral at the unstable brittle fracture scattered largely. In the transition region of SA350 steel, the initiation of pop-in crack was not observed, and fracture toughness scattered largely. At the propagation of the unstable crack near the transition temperature, the Weibull distribution provides good fits for the critical CTOD and the critical J-integral. This distribution can be mainly interpreted by the scatter of the distance between the precrack tip and the origin of unstable brittle fracture. (author)

  1. Periventricular nodular and subcortical neuronal heterotopia in adult epileptic patients Heterotopía neuronal nodular y subcortical en pacientes adultos con epilepsia

    Directory of Open Access Journals (Sweden)

    Damián E. Consalvo

    2006-04-01

    Full Text Available Developmental malformations are brain abnormalities that occur during embryogenesis. Neuronal migration disorders, including heterotopic lesions, constitute one type of such abnormalities. The aim of the study was to compare the epileptic clinical patterns of patients with periventricular nodular heterotopia (PNH (G1 with those affected by subcortical heterotopia (SCH (G2 looking for differences between both groups which, eventually, might suggest the type of the underlying malformation. The variables studied in both groups were: type of the heterotopia depicted on MRI studies, sex, age, age at seizure onset, annual seizure frequency, localization of the ictal symptomatogenic zone, characteristics of the EEG, other associated anomalies on the magnetic resonance images (MRI besides the heterotopia, and response to treatment. The only difference found between both groups was the type of heterotopia as shown by MRI studies. The other assessed variables did not significantly (p>0.05 differ between groups. No differences in the clinical features characterizing epilepsy could be found in patients with PNH or SCH, being the images the only tool able to differentiate them.Las malformaciones de la corteza cerebral son un grupo de entidades que se producen durante las etapas del desarrollo embrionario y cuya manifestación clínica puede ser la epilepsia. Estas malformaciones pueden ser diagnosticadas in vivo a través de las imágenes por resonancia magnética (IRM. Un subtipo particular de éstas lo constituyen los trastornos en la migración neuronal, dentro de los cuales se ubican las heterotopías (HT. El objetivo del estudio fue comparar enfermos portadores de HT periventriculares (G1 con aquellos portadores de HT subcorticales (G2. Se analizaron las variables sexo, edad y edad de inicio de la epilepsia (EI en años, antecedentes familiares (AF o prenatales (AP, frecuencia anual de crisis (FAC y características semiológicas de las crisis

  2. Daily online bony correction is required for prostate patients without fiducial markers or soft-tissue imaging.

    Science.gov (United States)

    Johnston, M L; Vial, P; Wiltshire, K L; Bell, L J; Blome, S; Kerestes, Z; Morgan, G W; O'Driscoll, D; Shakespeare, T P; Eade, T N

    2011-09-01

    To compare online position verification strategies with offline correction protocols for patients undergoing definitive prostate radiotherapy. We analysed 50 patients with implanted fiducial markers undergoing curative prostate radiation treatment, all of whom underwent daily kilovoltage imaging using an on-board imager. For each treatment, patients were set-up initially with skin tattoos and in-room lasers. Orthogonal on-board imager images were acquired and the couch shift to match both bony anatomy and the fiducial markers recorded. The set-up error using skin tattoos and offline bone correction was compared with online bone correction. The fiducial markers were used as the reference. Data from 1923 fractions were analysed. The systematic error was ≤1 mm for all protocols. The average random error was 2-3mm for online bony correction and 3-5mm for skin tattoos or offline-bone. Online-bone showed a significant improvement compared with offline-bone in the number of patients with >5mm set-up errors for >10% (P20% (Pmarkers or daily soft-tissue imaging. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  3. Primary flap closure combined with Emdogain alone or Emdogain and Cerasorb in the treatment of intra-bony defects.

    Science.gov (United States)

    Bokan, Ivan; Bill, Josip S; Schlagenhauf, Ulrich

    2006-12-01

    To compare clinical outcomes of three different modalities of treatment for deep intra-bony defects. Fifty-six patients were paralleled for clinical parameters and randomly assigned to treatment. They displayed one angular defect each with an intra-bony component > or =3 mm, probing pocket depth (PPD) and probing attachment level (PAL) > or =7 mm, and plaque index (PI) <1. Nineteen defects were treated, respectively, with enamel matrix derivative (EMD)+tricalcium phosphate (TCP) or EMD alone and 18 defects with modified Widman flap (MWF). Primary flap closure was used in all three groups. PI, gingival index, bleeding on probing, PPD, PAL, and recession (REC) were measured before and 12 months after treatment. Treatment with EMD alone yielded a 3.9+/-1.3 mm PPD decrease and a 3.7+/-1.0 mm PAL gain (p<0.001), whereas EMD+beta-TCP produced a 4.1+/-1.2 mm PPD reduction and a 4.0+/-1.0 mm PAL gain (p<0.001). These outcome parameters did not differ between the two groups. REC increased by 0.7+/-1.3 mm. After MWF treatment, attachment gain was 2.1+/-1.4 mm (p<0.001) and PPD reduction was 3.8+/-1.8 mm, whereas REC increased by 1.5+/-0.7 mm (p=0.042 versus EMD). Both EMD treatments showed similar clinical effects, with significant PAL gain and a significantly lower REC increase in comparison with MWF treatment.

  4. Computed tomographic findings of skull base bony changes after radiotherapy for nasopharyngeal carcinoma: implications for local recurrence.

    Science.gov (United States)

    Xie, Chuan-Miao; Liu, Xue-Wen; Li, Hui; Zhang, Rong; Mo, Yun-Xian; Li, Jian-Peng; Geng, Zhi-Jun; Zheng, Lie; Lv, Yan-Chun; Wu, Pei-Hong

    2011-08-01

    To evaluate bony changes in the skull base after radiotherapy by computed tomography (CT) and their correlation with local recurrence in patients with nasopharyngeal carcinoma (NPC) without previous involvement of the skull base. Retrospective study. Sun-Yat Sen University Cancer Center. The records of 80 patients with NPC during the period from January 1992 to December 2005 were reviewed. All patients had been treated with radical radiotherapy or chemoradiotherapy at standard doses and were followed up with plain and contrast-enhanced CT every 6 months for 45.5 (range 12-108) months. The types, areas, time of the first occurrence after radiotherapy and development of the postradiation bony changes of the skull base, and local recurrence rates of NPC were measured. Eighteen patients (22.5%) had sclerosis in some area of the skull base, and the sclerosis in 5 (27.8%) of these patients changed into osteoporosis in 1 to 5 years after its appearance. Seventeen patients (21.3%) had osteolysis. The local recurrence rate of patients with osteolysis was observed to be significantly higher than that of patients with sclerosis (p < .0001). The appearance of osteolytic changes in the skull base during follow-up of patients with NPC who had normal skull base morphology before treatment was associated with tumour recurrence.

  5. Nodular lymphocyte-predominant Hodgkin lymphoma: a unique disease deserving unique management.

    Science.gov (United States)

    Eichenauer, Dennis A; Engert, Andreas

    2017-12-08

    Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare lymphoma entity with an incidence of 0.1 to 0.2/100 000/y. Compared with the more common subtypes of classical Hodgkin lymphoma, NLPHL is characterized by distinct pathological and clinical features. Histologically, the disease-defining lymphocyte predominant cells consistently express CD20 but lack CD30. Clinically, NLPHL mostly has a rather indolent course, and patients usually are diagnosed in early stages. The prognosis of early-stage NLPHL is excellent, with progression-free survival and overall survival rates exceeding 90% after involved-field radiotherapy (IF-RT) alone (stage IA) or combined modality treatment consisting of a brief chemotherapy with 2 cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy followed by IF-RT (early stages other than stage IA). In contrast, patients with advanced disease at diagnosis tend to relapse either with NLPHL histology or with histological transformation into aggressive B-cell non-Hodgkin lymphoma despite more aggressive first-line treatment with 6 to 8 cycles of multiagent chemotherapy. However, even NLPHL patients with multiple relapses successfully respond to salvage therapy in many cases. Salvage therapies range from single-agent anti-CD20 antibody treatment to high-dose chemotherapy followed by autologous stem cell transplantation. Treatment at disease recurrence should be chosen on the basis of various factors, including histology at relapse, time to relapse, extent of disease at relapse, and prior treatment. Because death among NLPHL patients is more often caused by therapy-related late effects than lymphoma-related complications, optimizing the risk-benefit ratio of treatment by decreasing toxicity whenever possible is the major goal of clinical research in this disease. © 2016 by The American Society of Hematology. All rights reserved.

  6. Radiological features of focal nodular hyperplasia of the liver in children

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, J.E.; Kim, I.O.; Yeon, K.M. [Department of Radiology and the Institute of Radiation Medicine, Seoul National Univ. (Korea, Republic of); Kim, W.S. [Department of Radiology and the Institute of Radiation Medicine, Seoul National Univ. (Korea, Republic of)]|[Department of Radiology, Seoul National University Children`s Hospital (Korea, Republic of); Jang, J.J. [Department of Pathology, Seoul National Univ. (Korea, Republic of); Seo, J.K. [Department of Paediatrics, Seoul National Univ. (Korea, Republic of)

    1998-11-01

    Background. Focal nodular hyperplasia (FNH) is an unusual hepatic tumour in children and should be distinguished from other hepatic lesions. Objective. To describe the imaging characteristics of FNH in children. Materials and methods. We examined five patients (three boys and two girls, mean age 9.4 years) with pathologically confirmed FNH. The diagnosis was obtained by tumour resection (n = 4) and percutaneous needle biopsy (n = 1). One patient with multiple FNHs showed recurrent lesions after tumour resection. All patients were studied with US (including colour and power Doppler US [n = 3]) and CT. Dynamic enhanced CT scans were available in three patients. MRI (n = 2) or coeliac angiography (n = 1) was performed in three patients. Results. Seven of eight FNH lesions in five patients were demonstrated by imaging. The average size of the lesions was 6.5 cm. Six lesions detected on US showed variable echogenicity with a central hyperechoic scar (n = 2). On Doppler examination, central or peripheral hypervascular areas were seen (n = 3). Six lesions detected on contrast-enhanced CT showed high attenuation (n = 4) or iso-attenuation (n = 2). On early phase scans, all the lesions (n = 3) showed high attenuation. Irregular linear or ovoid central scars were detected in two patients on CT. MR demonstrated three lesions in two patients, one of which had not been detected by US or CT. A central low signal intensity scar (n = 1) was seen on T2-weighted MRI. Coeliac angiography performed in one patient showed a hypervascular mass with homogeneous staining. Conclusion. FNH in children shows a wide spectrum of imaging findings on various radiological examinations and the typical central scar was not always seen on imaging studies. Dynamic enhanced CT obtained in the early phase and colour Doppler studies may be helpful in the diagnosis of FNH by allowing characterisation of tumour vascularity. FNH should be included in the differential diagnosis of liver mass in children

  7. EGFR and cyclin D1 in nodular melanoma: correlation with pathohistological parameters and overall survival.

    Science.gov (United States)

    Katunarić, Miljenko; Jurišić, Davor; Petković, Marija; Grahovac, Maja; Grahovac, Blaženka; Zamolo, Gordana

    2014-12-01

    Considering that nodular melanoma (NM) has the potential to show an early distant metastasis, there is an urgent need for the discovery and evaluation of new diagnostic and prognostic biomarkers. We aimed to investigate the protein expression of membrane and nuclear epidermal growth factor receptor (EGFR), cyclin D1, and the corresponding gene status in NM samples and correlate the results obtained with clinicopathological parameters and overall survival of patients. Immunohistochemical and fluorescence in-situ hybridization analyses were carried out on tissue microarrays constructed from 110 NM samples, 30 compound nevi, and 38 dysplastic nevi. NM samples showed 24% strong cyclin D1 and 37% strong Ki67 protein expression compared with 3 and 0% strong cyclin D1 and Ki67 expression in the control group. Membrane EGFR expression was detected in 50% of NM cases, whereas EGFR gene amplification was detected in only 4% of NM cases. Multiple NM samples presented simultaneous membrane and nuclear EGFR expression. We found a negative correlation between tumor thickness and membrane EGFR expression. It was also observed that membrane EGFR 3+ NM samples presented ulceration significantly more often than membrane EGFR-negative (0) NM samples. In univariate analysis, carried out on 44 patients with follow-up data, both nuclear and membrane EGFR overexpression showed a correlation with a shorter overall survival. Nuclear EGFR (++, +++) showed 3.06 and membrane EGFR (2+, 3+) showed 2.76 higher risk of mortality compared with patients with low and negative nuclear and membrane EGFR expression (P<0.05).

  8. Primary dermal melanoma: distinct immunohistochemical findings and clinical outcome compared with nodular and metastatic melanoma.

    Science.gov (United States)

    Cassarino, David S; Cabral, Erik S; Kartha, Reena V; Swetter, Susan M

    2008-01-01

    To provide an updated and expanded analysis of clinical outcome and immunohistochemical (IHC) findings unique to primary dermal melanoma (PDM) that may be used to differentiate this entity from primary nodular melanoma (PNM) and cutaneous metastatic melanoma (MM). Cohort analysis and extensive IHC panel comparing PDM with PNM and cutaneous MM. Melanoma clinics and pathology departments of academic and VA medical centers. Thirteen patients with a solitary dermal or subcutaneous nodule of histologically proven melanoma, prospectively followed through April 30, 2007. Clinical, pathologic, and IHC assessment of patients diagnosed as having PDM. Long-term clinical outcome and determination of unique clinical and IHC features in the study cohort compared with other melanoma subtypes. Histologically, there was no evidence of an overlying in situ component, ulceration, or regression, and there was no associated nevus in any cases. Clinical history and findings from workup, including imaging studies, skin examination, and sentinel lymph node biopsy, were negative for evidence of melanoma elsewhere. The mean Breslow depth was 9.6 mm. Two patients developed satellite or in-transit recurrences, 1 developed pulmonary metastasis, and another died of liver metastases. Overall, the cohort showed a 92% melanoma-specific survival rate at a mean duration of follow-up of 44 months. The IHC findings showed that PDM exhibited lower levels of staining for the antigens p53 (P = .02), Ki-67 (Mib-1) (P = .002), cyclin D1 (P = .001), and podoplanin (recognized by D2-40 antibody) lymphovascular staining (P <.001) compared with MM and PNM. All other markers were comparable. Patients with PDM have remarkably prolonged survival compared with patients with MM or PNM of similar thickness. Preliminary results suggest that PDM may be characterized by lower levels of p53, Ki-67, cyclin D1, and D2-40 compared with histologically similar MM and PNM.

  9. Contrast-enhanced ultrasonographic spoke-wheel sign in hepatic focal nodular hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Yen, Y.-H. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Wang, J.-H. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China)]. E-mail: wajing@adm.cgmh.org.tw; Lu, S.-N. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Chen, T.-Y. [Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, College of Medicine, Chang Gung University, Taoyuan, Taiwan (China); Changchien, C.-S. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Chen, C.-H. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Hung, C.-H. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China); Lee, C.-M. [Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Kaohsiung 833, Taiwan (China)

    2006-12-15

    Background: To determine the utility of contrast-enhanced ultrasonography (CEUS) in assessing hepatic tumors with central feeding arteries found by color/power Doppler ultrasonograophy (CDUS/PDUS). Methods: We prospectively studied 37 hepatic tumors (34 patients), with a mean size of 2.9 cm and each having a central feeding artery, by CDUS/PDUS. The CEUS was performed with a galactose-based microbubble contrast agent. The detection of a spoke-wheel sign was interpreted as evidence of focal nodular hyperplasia (FNH). All patients underwent tumor biopsies or surgical resection. Results: CEUS showed a central feeding artery with a spoke-wheel sign in 36 tumors, including 34 FNHs and 2 hepatocellular carcinomas. The remaining tumor was demonstrated to be FNH despite the absence of a spoke-wheel sign as detected by CEUS. The sensitivity of the spoke-wheel sign or central scar for FNH was 97.1% (34/35), 40% (14/35), 28.6% (10/35), 50% (8/16) and 0% (0/15) for CEUS, CDUS/PDUS, dynamic computed tomography (CT) or magnetic resonance imaging (MRI), hepatic angiography and liver scintigraphy, respectively. The two hepatocellular carcinomas showed scirrhous changes histologically. Conclusions: CEUS is more sensitive than CDUS/PDUS, dynamic CT, MRI, hepatic angiography and liver scintigraphy in the detection of the spoke-wheel sign or central scar in FNH. Scirrhous hepatocellular carcinoma should be included in the differential diagnosis for liver tumors with spoke-wheel sign detected by CEUS.

  10. Contrast-enhanced ultrasonographic spoke-wheel sign in hepatic focal nodular hyperplasia

    International Nuclear Information System (INIS)

    Yen, Y.-H.; Wang, J.-H.; Lu, S.-N.; Chen, T.-Y.; Changchien, C.-S.; Chen, C.-H.; Hung, C.-H.; Lee, C.-M.

    2006-01-01

    Background: To determine the utility of contrast-enhanced ultrasonography (CEUS) in assessing hepatic tumors with central feeding arteries found by color/power Doppler ultrasonograophy (CDUS/PDUS). Methods: We prospectively studied 37 hepatic tumors (34 patients), with a mean size of 2.9 cm and each having a central feeding artery, by CDUS/PDUS. The CEUS was performed with a galactose-based microbubble contrast agent. The detection of a spoke-wheel sign was interpreted as evidence of focal nodular hyperplasia (FNH). All patients underwent tumor biopsies or surgical resection. Results: CEUS showed a central feeding artery with a spoke-wheel sign in 36 tumors, including 34 FNHs and 2 hepatocellular carcinomas. The remaining tumor was demonstrated to be FNH despite the absence of a spoke-wheel sign as detected by CEUS. The sensitivity of the spoke-wheel sign or central scar for FNH was 97.1% (34/35), 40% (14/35), 28.6% (10/35), 50% (8/16) and 0% (0/15) for CEUS, CDUS/PDUS, dynamic computed tomography (CT) or magnetic resonance imaging (MRI), hepatic angiography and liver scintigraphy, respectively. The two hepatocellular carcinomas showed scirrhous changes histologically. Conclusions: CEUS is more sensitive than CDUS/PDUS, dynamic CT, MRI, hepatic angiography and liver scintigraphy in the detection of the spoke-wheel sign or central scar in FNH. Scirrhous hepatocellular carcinoma should be included in the differential diagnosis for liver tumors with spoke-wheel sign detected by CEUS

  11. Fascitis nodular cervical en paciente gestante: revisión de la literatura y presentación de un caso Cervical nodular fasciitis in a pregnant woman: Review of the literature and presentation of a new case

    Directory of Open Access Journals (Sweden)

    Manuel Acosta-Feria

    2010-09-01

    Full Text Available La fascitis nodular es una lesión benigna rara, de crecimiento rápido, cuya patogenia es aún desconocida. Si bien a nivel de cabeza y cuello aparece en un 20% de los casos, su aparición en pacientes gestantes es extremadamente rara. Presentamos el segundo caso descrito en la literatura en el cual está presente dicha asociación. Mujer de 25 años y gestante de 13 semanas, con una tumoración retroauricular derecha de 3 cm de diámetro, 3 meses de evolución y rápido crecimiento. No presentaba parálisis facial ni dolor en la exploración inicial. Tras la exéresis quirúrgica de la lesión, el diagnóstico anatomopatológico definitivo de ésta, fue de fascitis nodular. Tras 2 años desde la intervención quirúrgica no se ha evidenciado recidiva de la tumoración, llevándose el embarazo a término sin presentar complicaciones ni para la madre ni para el feto.The nodular fasciitis is a rare benign lesion of rapid growth, whose pathogenesis is still unknown. While at the head and neck appeared in 20% of cases, its occurrence in pregnant patients is extremely rare. We report the second case described in the literature in which this association is present. Woman of 25 years and 13 weeks pregnant, who had a right auricular tumour 3 cm in diameter, 3 months of development and rapid growth. No facial paralysis or pain in the initial exploration. After surgical resection of the lesion, the final pathological diagnosis of the same was nodular fasciitis. After two years since the surgery, there was no evidence of recurrence of the tumour, taking ad términun pregnancy without complications or the mother or the fetus.

  12. Essential, trace and toxic element concentrations in the liver of the world's largest bony fish, the ocean sunfish (Mola mola).

    Science.gov (United States)

    Perrault, Justin R; Buchweitz, John P; Lehner, Andreas F

    2014-02-15

    No studies document essential (calcium, magnesium, phosphorus, potassium, sodium), trace (barium, boron, chromium, cobalt, copper, iron, manganese, molybdenum, selenium, zinc) or toxic element (antimony, arsenic, cadmium, lead, mercury, thallium) concentrations in any members of the family Molidae, including the world's largest bony fish, the ocean sunfish (Mola mola). Here, we analyzed 21 elements in the liver of one M. mola. These values were compared to liver concentrations in multiple species with spatial and dietary overlap. Concentrations of calcium (3339 ppm wet weight) and iron (2311 ppm wet weight) were extremely elevated in comparison to a number of other fish species, indicating that calcium and/or iron toxicity may have occurred in this animal. Concentrations of toxic elements were generally low, with the exception of cadmium (3.5 ppm). This study represents the first report of essential, trace and toxic elements in this species. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. A carapace-like bony 'body tube' in an early triassic marine reptile and the onset of marine tetrapod predation.

    Directory of Open Access Journals (Sweden)

    Xiao-hong Chen

    Full Text Available Parahupehsuchus longus is a new species of marine reptile from the Lower Triassic of Yuan'an County, Hubei Province, China. It is unique among vertebrates for having a body wall that is completely surrounded by a bony tube, about 50 cm long and 6.5 cm deep, comprising overlapping ribs and gastralia. This tube and bony ossicles on the back are best interpreted as anti-predatory features, suggesting that there was predation pressure upon marine tetrapods in the Early Triassic. There is at least one sauropterygian that is sufficiently large to feed on Parahupehsuchus in the Nanzhang-Yuan'an fauna, together with six more species of potential prey marine reptiles with various degrees of body protection. Modern predators of marine tetrapods belong to the highest trophic levels in the marine ecosystem but such predators did not always exist through geologic time. The indication of marine-tetrapod feeding in the Nanzhang-Yuan'an fauna suggests that such a trophic level emerged for the first time in the Early Triassic. The recovery from the end-Permian extinction probably proceeded faster than traditionally thought for marine predators. Parahupehsuchus has superficially turtle-like features, namely expanded ribs without intercostal space, very short transverse processes, and a dorsal outgrowth from the neural spine. However, these features are structurally different from their turtle counterparts. Phylogeny suggests that they are convergent with the condition in turtles, which has a fundamentally different body plan that involves the folding of the body wall. Expanded ribs without intercostal space evolved at least twice and probably even more among reptiles.

  14. A carapace-like bony 'body tube' in an early triassic marine reptile and the onset of marine tetrapod predation.

    Science.gov (United States)

    Chen, Xiao-hong; Motani, Ryosuke; Cheng, Long; Jiang, Da-yong; Rieppel, Olivier

    2014-01-01

    Parahupehsuchus longus is a new species of marine reptile from the Lower Triassic of Yuan'an County, Hubei Province, China. It is unique among vertebrates for having a body wall that is completely surrounded by a bony tube, about 50 cm long and 6.5 cm deep, comprising overlapping ribs and gastralia. This tube and bony ossicles on the back are best interpreted as anti-predatory features, suggesting that there was predation pressure upon marine tetrapods in the Early Triassic. There is at least one sauropterygian that is sufficiently large to feed on Parahupehsuchus in the Nanzhang-Yuan'an fauna, together with six more species of potential prey marine reptiles with various degrees of body protection. Modern predators of marine tetrapods belong to the highest trophic levels in the marine ecosystem but such predators did not always exist through geologic time. The indication of marine-tetrapod feeding in the Nanzhang-Yuan'an fauna suggests that such a trophic level emerged for the first time in the Early Triassic. The recovery from the end-Permian extinction probably proceeded faster than traditionally thought for marine predators. Parahupehsuchus has superficially turtle-like features, namely expanded ribs without intercostal space, very short transverse processes, and a dorsal outgrowth from the neural spine. However, these features are structurally different from their turtle counterparts. Phylogeny suggests that they are convergent with the condition in turtles, which has a fundamentally different body plan that involves the folding of the body wall. Expanded ribs without intercostal space evolved at least twice and probably even more among reptiles.

  15. A comparison of microRNA expression profiles from splenic hemangiosarcoma, splenic nodular hyperplasia, and normal spleens of dogs.

    Science.gov (United States)

    Grimes, Janet A; Prasad, Nripesh; Levy, Shawn; Cattley, Russell; Lindley, Stephanie; Boothe, Harry W; Henderson, Ralph A; Smith, Bruce F

    2016-12-03

    Splenic masses are common in older dogs; yet diagnosis preceding splenectomy and histopathology remains elusive. MicroRNAs (miRNAs) are short, non-coding RNAs that play a role in post-transcriptional regulation, and differential expression of miRNAs between normal and tumor tissue has been used to diagnose neoplastic diseases. The objective of this study was to determine differential expression of miRNAs by use of RNA-sequencing in canine spleens that were histologically confirmed as hemangiosarcoma, nodular hyperplasia, or normal. Twenty-two miRNAs were found to be differentially expressed in hemangiosarcoma samples (4 between hemangiosarcoma and both nodular hyperplasia and normal spleen and 18 between hemangiosarcoma and normal spleen only). In particular, mir-26a, mir-126, mir-139, mir-140, mir-150, mir-203, mir-424, mir-503, mir-505, mir-542, mir-30e, mir-33b, mir-365, mir-758, mir-22, and mir-452 are of interest in the pathogenesis of hemangiosarcoma. Findings of this study confirm the hypothesis that miRNA expression profiles are different between canine splenic hemangiosarcoma, nodular hyperplasia, and normal spleens. A large portion of the differentially expressed miRNAs have roles in angiogenesis, with an additional group of miRNAs being dysregulated in vascular disease processes. Two other miRNAs have been implicated in cancer pathways such as PTEN and cell cycle checkpoints. The finding of multiple miRNAs with roles in angiogenesis and vascular disease is important, as hemangiosarcoma is a tumor of endothelial cells, which are driven by angiogenic stimuli. This study shows that miRNA dysregulation is a potential player in the pathogenesis of canine splenic hemangiosarcoma.

  16. Lesion guided radiofrequency thermocoagulation (L-RFTC) for hypothalamic hamartomas, nodular heterotopias and cortical dysplasias: Review and perspective.

    Science.gov (United States)

    Wellmer, Jörg; Voges, Jürgen; Parpaley, Yaroslav

    2016-10-01

    Lesion guided radiofrequency thermocoagulation (L-RFTC) via stereotactically inserted coagulation probes is a further development of stereotactic thermocoagulation thalamotomy and stereo-EEG guided RFTC. In this method epileptogenic lesions detected via magnetic resonance imaging (MRI) move to the center of coagulation planning. Two surgical strategies can be applied: lesion disconnection and lesion destruction. This focused review collects all data published until January 2016 on L-RFTC for the indications hypothalamic hamartoma, periventricular nodular heterotopia and focal cortical dysplasia and describes technical issues, surgical objectives and outcomes. Special attention is given to the aspect of presurgical MRI requirements. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  17. Familial isolated primary pigmented nodular adrenocortical disease associated with a novel low penetrance PRKAR1A gene splice site mutation

    DEFF Research Database (Denmark)

    Storr, Helen L; Metherell, Louise A; Dias, Renuka

    2010-01-01

    Primary pigmented nodular adrenocortical disease (PPNAD) is associated with inactivating germline protein kinase A regulatory subunit type 1-alpha (PRKAR1A) mutations and loss of heterozygosity at the 17q22-24 locus in approximately 50% patients. PRKAR1A mutations are observed in both isolated PP...... PPNAD (iPPNAD) and Carney complex (CNC). Most mutations result in a functionally null-allele and exhibit high penetrance. We genotyped members of an extended family for a novel PRKAR1A mutation and undertook detailed phenotyping for CNC in the affected individuals....

  18. Sclerosing angiomatoid nodular transformation of the spleen mimicking metastasis of melanoma: a case report and review of the literature.

    Science.gov (United States)

    Demirci, Ilhan; Kinkel, Horst; Antoine, Dirk; Szynaka, Marc; Klosterhalfen, Bernd; Herold, Susanne; Janßen, Hermann

    2017-09-03

    Sclerosing angiomatoid nodular transformation is a benign disorder of splenic tissue and is often mistaken as a potentially malignant entity in the diagnostic process. To the best of our knowledge, this is the first report of sclerosing angiomatoid nodular transformation mimicking metastasis of melanoma in the literature. A 43-year-old white man presented with a newly found splenic mass 4 years ago to our Department of Gastroenterology. He was diagnosed as having a superficial spreading malignant melanoma localized at his left instep 7 years ago and was successfully treated with radical local resection. Several diagnostic procedures were conducted. Ultrasound showed a hypoechoic lesion in the inferior pole of his spleen with a diameter of 2 cm, blurred boundaries, and inhomogeneous interior pattern. Contrast-enhanced ultrasound was inconclusive and showed only discrete contrast enhancement of the lesion with accentuated nodule-like enrichment of the boundaries in the arterial phase. Computed tomography and magnetic resonance imaging scans showed two splenic lesions which were highly suspicious of metastasis. Magnetic resonance imaging of his head was inconspicuous. Bone scintigraphy showed no abnormal results. Fine-needle aspiration indicated metastasis of the above-mentioned malignant melanoma. We conducted a laparoscopic splenectomy. His intraoperative and postoperative course were uneventful. In contrast to the result of the fine-needle aspiration, the presence of metastasis of melanoma could not be confirmed. Histological analysis revealed nodule-like arrangement of fibroblasts with low cell density and a predominance of dilated capillaries, indicating sclerosing angiomatoid nodular transformation of the spleen. There are no preoperative diagnostic imaging procedures which can definitely differentiate sclerosing angiomatoid nodular transformation from malignancies in cases of morphological and immunophenotypic variations of the specimen. Morphological and

  19. Systemic oxidative stress to nucleic acids is unaltered following radioiodine therapy of patients with benign nodular goiter

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Stovgaard, Elisabeth S; Fast, Søren

    2015-01-01

    BACKGROUND: Little is known about the whole body oxidative stress burden following radioactive iodine ((131)I) therapy of thyroid diseases. METHODS: We studied 17 patients with benign nodular goiter treated with (131)I therapy. The targeted thyroid dose was 50 Gy in 11 patients pretreated with 0...... MBq; 8-oxoGuo: p = 0.66, 8-oxodG: p = 0.71). CONCLUSION: Systemic oxidative stress, as detected by nucleic acids metabolites in the urine, is not increased after thyroid stimulation with 0.1 mg of rhTSH, or after (131)I therapy. Our method cannot quantify the oxidative stress induced locally...

  20. Management of Nodular Lymphocyte Predominant Hodgkin Lymphoma in the Modern Era

    Energy Technology Data Exchange (ETDEWEB)

    King, Martin T., E-mail: mking1@stanford.edu [Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California (United States); Donaldson, Sarah S. [Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California (United States); Link, Michael P. [Department of Pediatrics, Stanford Cancer Institute, Stanford, California (United States); Natkunam, Yasodha [Department of Pathology, Stanford Cancer Institute, Stanford, California (United States); Advani, Ranjana H. [Department of Medicine, Stanford Cancer Institute, Stanford, California (United States); Hoppe, Richard T. [Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California (United States)

    2015-05-01

    Purpose: To analyze treatment outcomes for nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) at a single institution. Patients and Methods: Patients with newly diagnosed NLPHL between 1996 and 2013 were reviewed retrospectively. Patients treated before 1996 were excluded because the majority received extended field radiation therapy (RT) alone. Results: Fifty-five patients (22 ≤ 21 years old) were identified. The median follow-up time was 6.8 years. Among 37 patients with limited-stage (I-II) disease, treatments included involved field RT at a median dose of 36 Gy (n=9), rituximab monotherapy (n=9), observation (n=3), and response-adaptive therapy (n=16), in which the RT dose was reduced from 25.5 Gy to 15 Gy or was eliminated based on interim imaging after chemotherapy. The 5-year progression-free survival (PFS) was 76.4% (95% confidence interval [CI], 63.1-92.4). Nine patients experienced progression, including 5 receiving rituximab, 2 undergoing observation, and 2 receiving response-adaptive therapy. Rituximab was associated with an inferior PFS compared with RT alone (P=.02). The difference in PFS between response-adaptive therapy and RT alone was not statistically significant (P=.39). Among 18 patients with advanced-stage (III-IV) disease, treatments included chemotherapy alone (n=3), combined modality therapy (CMT) (n=2), response-adaptive therapy (n=2), rituximab (n=7), and observation (n=4). The 5-year PFS was 29.9% (CI, 13.3-67.4). Twelve patients experienced progression, including 1 receiving chemotherapy, 1 receiving CMT, 6 receiving rituximab, and 4 undergoing observation. There was no significant PFS difference between rituximab and non-rituximab therapies (P=.19) within the caveat of small sample sizes. In the entire cohort, 9 patients (3 with limited disease, 6 with advanced disease) experienced large cell transformation (LCT). Seven patients died; of those, 5 died with LCT. Conclusions: For limited disease, response-adaptive therapy

  1. Thyroid Nodularity and cancer in Chernobyl clean-up workers from Latvia

    International Nuclear Information System (INIS)

    Kurjane, N.; Farbtuha, T.; Matisane, L.

    2004-01-01

    The Chernobyl nuclear reactor accident on April 26, 1986, resulted in massive radioactive contamination of the surrounding area. Radiation exposure was from rapidly decaying radioactive iodines, as well as from 137 CS and other long-lived radioisotopes. About 6000 clean-up workers of the Chernobyl Power Plant accident were from Latvia. External radiation exposure was defined for 40% of them and the doses were 0.01-0.5 Grey (Gy). Although according to conclusions of authoritative experts of different countries, the actual doses of radiation might be at least 3-4 times higher. Because the thyroid is highly susceptible to cancer induction by ionizing radiation, our examination was conducted in 2001 to determine the prevalence of thyroid tumors in 1990-2000 and other nodular thyroid disease 14 years after the accident in Latvia's Chernobyl clean-up workers. The Latvian State Register for persons who have received ionising radiation in Chernobyl and Latvia's Cancer Register were used in this work as well as 1000 Chernobyl accident clean-up workers medical ambulatory cards were analysed. We have received that occurrence of thyroid cancer in Chernobyl clean-up workers was 10,6 times higher than in Latvia's population (men) in 1990-2000 and also it occurs at earlier age in comparison with population data (40-50 and 55-65 accordingly). This can be explained in two ways: either due to effect of the short-term or long-term external and internal radiation exposure (including, from the incorporated 131 I) on the thyroid tissue, or due to a better dispensarisation (obligatory thyroid ultrasound examination once per year) of the examined group. The first thyroid cancer was discovered in 1996 -after ten years of latent period. The relative risk of thyroid cancer in Chernobyl clean-up workers in 1996 was 33.27, and in 1997 -42.64. Then, the morbidity of the thyroid cancer exhibits tendency to decrease (RR 18.27 in 1998, and 9.42 in 1999). The presence of thyroid benign nodules was

  2. Exostoses of the Bony Pyramid of the Nose : A Review About an Adaptive Response to Mechanical Stimuli Exerted by In-Flight Oxygen Masks

    NARCIS (Netherlands)

    Schreinemakers, J. Rieneke C; Klein-Nulend, J.; van Lotten, M. L.; Nolte, P. A.; Kon, M.

    2015-01-01

    This review addresses thickening of the bony pyramid of the nose, a condition that is caused by in-flight oxygen masks in otherwise healthy Royal Netherlands Air Force (RNLAF) F-16 pilots. The overlying skin may show temporary or permanent reddening, irritation, thickening and may become painful.

  3. The Natural History of Soft Tissue Hypertrophy, Bony Hypertrophy, and Nodule Formation in Patients With Untreated Head and Neck Capillary Malformations.

    Science.gov (United States)

    Lee, Jeong Woo; Chung, Ho Yun; Cerrati, Eric W; O, Teresa M; Waner, Milton

    2015-11-01

    A percentage of patients with capillary malformation (CM) develop soft tissue hypertrophy, bony hypertrophy, and/or nodule formation. To determine the incidence, age of onset, anatomic distribution of soft tissue/bony hypertrophy, and nodule formation in patients with untreated CM. A retrospective medical records review of head and neck CM patients presenting to a tertiary referral center over a 7-year period (2004-2011) was performed. Of the 160 patients with CM, 96 demonstrated progression of disease to include either soft tissue/bony hypertrophy or nodule formation. Of these, 87 patients had not received previous treatment and met the inclusion criteria for analysis. On average, soft tissue hypertrophy began at 9 years of age. The V2/maxillary segment was most commonly involved with upper lip hypertrophy being the most prominent. Fourteen percent of the patients also presented with bony hypertrophy, which began at an average age of 15 years. Nodules were present in 38/87 (44%) of patients with an average age of onset of 22 years. This study demonstrates the nature progression of CM and quantifies the clinical characteristics of hypertrophy and nodule formation with untreated head and neck CM. Early and continuous treatment is recommended in hopes of preventing CM progression.

  4. Nodular lymphoid hyperplasia complicated with ileal Burkitt's lymphoma in an adult patient with selective IgA deficiency.

    Science.gov (United States)

    Hanich, Toni; Majnarić, Ljiljana; Janković, Dragan; Šabanović, Šefket; Včev, Aleksandar

    2017-01-01

    Primary lymphomas of the small intestine are rare. Burkitt's lymphoma (BL) occurs sporadically in adults. Nodular lymphoid hyperplasia (NLH) is a rare disorder characterized by diffuse nodular lesions, which represent hyperplastic lymphoid follicles, and it is often associated with immunodeficiency syndromes. We present a 38-year-old male patient in a state of surgical emergency, suspected of Crohn's disease, who had an unusual combination of NLH and BL of the proximal ileum. Furthermore, retrospectively analyzed documentation revealed selective IgA deficiency. Association between NLH and intestinal lymphomas in patients with immunodeficiency syndromes was indicated before. This case report supports the notion on NLH as a transition state between immunodeficiency and intestinal lymphomas. This is one of the first case reports which presents the combination of NHL and BL. The awareness of the existence of this rare combination, especially in young adult males, can improve the diagnostic accuracy and the treatment management. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Nodular melanoma: five consecutive cases in a general practice with polarized and non-polarized dermatoscopy and dermatopathology.

    Science.gov (United States)

    Rosendahl, Cliff; Hishon, Matthew; Cameron, Alan; Barksdale, Sarah; Weedon, David; Kittler, Harald

    2014-04-01

    The incidence of nodular melanoma (NM) has been consistently described as at least 10-15% of total melanomas for over 15 years despite advances in diagnostic algorithms and medical technology. NMs are strongly correlated with faster rates of growth and poorer prognosis and thus provide clinicians with a challenge for early recognition. To evaluate diagnostic clues of consecutive histopathologically proven NMs in one general practice with particular emphasis on dermatoscopic characteristics and compare this to the published literature. A retrospective observational study was performed of five consecutive histologically proven NM, from a total of 212 consecutive melanomas from a general practice in Brisbane, Queensland, Australia. Dermatoscopic images, both polarized and non-polarized, which appears to be a unique resource, and dermatopathologic slides were available for all lesions. All of the NMs in this series were pigmented although one was hypomelanotic. Two of them were symmetrical. The most highly sensitive clues to NM were gray or blue structures and polarizing-specific white lines. Due to the small number of NMs in this report no statistical significance can be attributed to the observational findings. THIS SMALL SERIES SUPPORTS WHAT IS ALREADY KNOWN: that a significant proportion of NMs may be dermatoscopically symmetrical but that known clues to melanoma are frequently present. Nodular lesions, pigmented or non-pigmented, should be excised to exclude NM if there is any clue to malignancy, regardless of symmetry, unless a confident specific benign diagnosis can be made.

  6. Distribution of thermal neutron dose in nodular melanoma. Preclinical test by using animals and analysis of human clinical data

    International Nuclear Information System (INIS)

    Hiratsuka, Junichi; Karashima, Hiroshi; Fukuda, Hiroshi; Honda, Chihiro; Wadabayashi, Nobutoshi; Furubayashi, Toru; Kanda, Keiji; Mishima, Yutaka.

    1995-01-01

    There is the thermal neutron capture therapy that uses the thermal neutrons from nuclear reactors for the radiation treatment of malignant tumors, and because it can irradiate high LET radiation in large amount limiting to diseased parts, now the clinical research is in progress as an effective treatment. In the case of malignant melanoma, boron neutron capture treatment was attempted in 18 cases so far, and the local suppression was obtained in most cases. Recently, nodular melanoma was treated by the BNCT, but it was very difficult to forecast the dose distribution inside a tumor. The data on the thermal neutron dose distribution in this human case was compared with the preclinical test on the pig having spontaneous melanoma, and the countermeasures of hereafter were investigated. The objects and the methods of the preclinical test and the human medical irradiation, and the results of dose distribution in both cases and the countermeasures to nodular melanoma are reported. The factors that exert influence to the dose in depth are pointed out. (K.I.)

  7. Distribution of thermal neutron dose in nodular melanoma. Preclinical test by using animals and analysis of human clinical data

    Energy Technology Data Exchange (ETDEWEB)

    Hiratsuka, Junichi [Kawasaki Medical School, Kurashiki, Okayama (Japan); Karashima, Hiroshi; Fukuda, Hiroshi; Honda, Chihiro; Wadabayashi, Nobutoshi; Furubayashi, Toru; Kanda, Keiji; Mishima, Yutaka

    1995-03-01

    There is the thermal neutron capture therapy that uses the thermal neutrons from nuclear reactors for the radiation treatment of malignant tumors, and because it can irradiate high LET radiation in large amount limiting to diseased parts, now the clinical research is in progress as an effective treatment. In the case of malignant melanoma, boron neutron capture treatment was attempted in 18 cases so far, and the local suppression was obtained in most cases. Recently, nodular melanoma was treated by the BNCT, but it was very difficult to forecast the dose distribution inside a tumor. The data on the thermal neutron dose distribution in this human case was compared with the preclinical test on the pig having spontaneous melanoma, and the countermeasures of hereafter were investigated. The objects and the methods of the preclinical test and the human medical irradiation, and the results of dose distribution in both cases and the countermeasures to nodular melanoma are reported. The factors that exert influence to the dose in depth are pointed out. (K.I.).

  8. A Novel PRKAR1A Mutation Identified in a Patient with Isolated Primary Pigmented Nodular Adrenocortical Disease

    Directory of Open Access Journals (Sweden)

    Sira Korpaisarn

    2017-08-01

    Full Text Available Primary pigmented nodular adrenocortical disease (PPNAD is a rare cause of Cushing syndrome, especially the isolated form without Carney complex, associated with germline mutations in PRKAR1A, the protein kinase A regulatory subunit type 1 alpha gene. We report a 31-year-old female who presented with secondary amenorrhea, cushingoid appearance, and hypertension without Carney complex. Biochemical laboratory examinations confirmed the ACTH-independent adrenal Cushing syndrome with negative Liddle test. A small right adrenal adenoma of 0.8 cm was shown on computed tomography while magnetic resonance imaging revealed nodularity of both adrenal glands. The histological report confirmed PPNAD using laparoscopic right adrenalectomy, and subsequent left adrenalectomy was performed 6 months later. She had inherited heterozygosity of a novel germline mutation of the PRKAR1A gene (g.114213T>G or c.709-5T>G. This splice site mutation results in exon 8 skipping. Her father carrying the same mutation had no clinical features of either PPNAD or Carney complex. This novel PRKAR1A gene mutation, c.709-5T>G, is reported here for the first time manifesting as an incomplete clinical expression of the isolated form of PPNAD and being inherited with low penetrance unlike other inherited mutations of the Carney complex which have a penetrance of almost 100%.

  9. Radioiodine therapy for combined disseminated and nodular thyroid autonomy. Results after using a correction term for the disseminated part

    International Nuclear Information System (INIS)

    Vogt, H.; Dorn, R.; Otto, I.; Sciuk, J.; Wengenmair, H.; Kopp, J.

    2006-01-01

    Aim: in combined focal and disseminated thyroid autonomy a variety of concepts in the treatment with radioiodine are used. The difference lies mainly in the calculation of the autonomous volume. This retrospective study shows a new method of calculating the autonomous volume. Patients and methods: in 398 patients with combined thyroid autonomy and good correlation of scintigraphically hot nodules and lesions defined by ultrasound the volume of the nodules is ascertained from scintigraphic and ultrasound parameters and the volume of the disseminated autonomous tissue is assessed with a weighting factor (VF). This factor is the ratio of impulse density in a ROI over the disseminated volume divided by the corresponding impulse density over the nodular volume of the thyroid scintigraphy. The sum of nodular volume and weighted perinodular volume gives the total autonomous volume. A standard radioiodine test gives the maximum iodine-131-uptake and effective half-life to calculate the activity to obtain a treatment dose of 400 Gy. Results: the rate of success with and without thyrostatic medication was 97% with an 18.6% rate of hypothyroidism observed from 4 months post therapy onwards. Conclusion: the use of the weighting factor VF in the treatment of combined autonomy leads to an excellent rate of success in patients with good correlation of functional imaging and ultrasound findings. (orig.)

  10. Cistadenocarcinoma renal e dermatofibrose nodular em cães pastor alemão: 4 casos

    Directory of Open Access Journals (Sweden)

    Langohr Ingeborg Maria

    2002-01-01

    Full Text Available São descritos quatro casos da síndrome cistadenocarcinoma renal-dermatofibrose nodular em Pastor Alemão. Todos eram cães machos, com idades entre 6 e 10 anos. Os aspectos clínicos incluíam hematúria e retenção urinária, emagrecimento progressivo, anorexia, vômito, polidipsia e dificuldade respiratória. Em um animal, foram observados múltiplos nódulos recidivantes na pele. Três cães tiveram morte espontânea e um foi submetido à eutanásia. Os principais achados de necropsia incluíram nódulos multifocais ou coalescentes na pele e múltiplos nódulos, muitas vezes císticos, em ambos os rins. Na avaliação histológica, observaram-se dermatofibrose nodular na pele e cistos, hiperplasia, displasia e neoplasia de células epiteliais dos túbulos renais. As neoplasias foram classificadas como cistadenoma em um dos casos e como cistadenocarcinoma nos outros três. Metástases foram observadas em dois casos: no fígado, no baço e no pulmão em um cão e no linfonodo renal em outro.

  11. FDG PET/CT Findings of Nodular Sclerosis-Subtype Classic Hodgkin Lymphoma Presented as Mediastinal Nodal Lesions at Onset But as Predominant Osseous Disease at Relapse.

    Science.gov (United States)

    Zheng, Kun; Zhuang, Hongming

    2017-06-01

    Nodular sclerosis-subtype classic Hodgkin lymphoma in general manifests as bulky mediastinal lymphadenopathy but very rarely involves bones. We report FDG PET/CT findings of a 19-year-old man with pathology-proven, nodular sclerosis-type classic Hodgkin lymphoma. His initial FDG PET/CT scan at the diagnosis showed only hypermetabolic lymphadenopathy in the mediastinum. However, the FDG PET/CT acquired when the disease recurred 20 months later showed predominant osseous disease without additional nodal lesions outside the mediastinum.

  12. Comportamiento del hierro nodular austemperizado en condiciones de corrosión y desgaste // Behavior of austempered ductile iron under wear and corrosion conditions

    Directory of Open Access Journals (Sweden)

    L. Goyos Pérez

    1999-07-01

    Full Text Available Los hierros nodulares en general y los austemperizados en particular han sido usados con cada vez mayor frecuencia debido asus relevantes propiedades mecánicas en comparación con su costo.En el presente trabajo se valora el comportamiento del hierro nodular ante el trabajo en condiciones de desgaste y corrosión,luego de ser sometido a diferentes tratamientos de austemperizado.Fueron usados un hierro nodular aleado con níquel y molibdeno y otro no aleado. Ambos hierros fueron sometidos a diferentestratamientos de austemperización con mantenimientos isotérmicos a temperaturas entre 250°C y 425°C por tiempos entre 15 y180 minutos.Las muestras tratadas fueron sometidas a ensayos de desgaste por fricción en condiciones no lubricadas determinando laspendientes de desgaste uniforme para cada caso. La resistencia a la corrosión fue determinada mediante el métodopotenciométrico usando como medio el jugo de caña sintético.A partir de los resultados obtenidos se valora la influencia de los diferentes tratamientos sobre las propiedades estudiadas y sedeterminan los más efectivos desde el punto de vista técnico económico.Palabras claves: Hierro nodular, corrosión, desgaste, austemperizado.____________________________________________________________________________AbstractNodular irons and particularly austempered ductile iron has been used more and more due to their excellent mechanicalproperties in comparison with their cost.Presently work deals on behavior of nodular iron working under wear and corrosion conditions, after being submitted todifferent austempered treatments.A nodular iron alloyed with nickel and molybdenum were used as well as a not alloyed one. Both irons were treated underdifferent austempered treatment combinations using isothermal maintenance to temperatures between 250°C and 425°C andspending times between 15 and 180 minutes.Samples were submitted to non-lubricated wear using a “pin on disk” method evaluating the

  13. The Effects of Latarjet Reconstruction on Glenohumeral Kinematics in the Presence of Combined Bony Defects: A Cadaveric Model.

    Science.gov (United States)

    Patel, Ronak M; Walia, Piyush; Gottschalk, Lionel; Kuklis, Matthew; Jones, Morgan H; Fening, Steve D; Miniaci, Anthony

    2016-07-01

    Recurrent glenohumeral instability is often a result of underlying bony defects in the glenoid and/or humeral head. Anterior glenoid augmentation with a coracoid bone block (ie, Latarjet procedure) has been recommended for glenoid bone loss in the face of recurrent instability. However, no study has investigated the effect of Latarjet augmentation in the setting of both glenoid and humeral head defects (Hill-Sachs defects). To evaluate the glenohumeral kinematics of the Latarjet procedure in the presence of combined bony defects. Controlled laboratory study. Eighteen fresh-frozen cadaveric specimens void of all surrounding soft tissue were tested at all combinations of glenohumeral abduction (ABD) angles of 20°, 40°, and 60° and 3 external rotation (ER) levels of 0°, 40°, and 80°. Each experiment comprised anterior dislocation by translating the glenoid under a 50-N medial load applied on the humerus, simulating the static load of soft tissue. The primary outcome measurement was defined as the percentage of intact translation (normalized distance to dislocation). Specimens were tested in an intact condition (no defect), with different combinations of defects, and with Latarjet augmentation. The Latarjet procedure was performed for 20% and 30% glenoid defects by transferring the specimen's coracoid process anterior to the glenoid so that it was flush with the articulating surface. Results depended on the position of the arm. At 20° of ABD and 0° of ER, a 20% glenoid defect decreased the percentage of intact translation regardless of the humeral head defect size (P ≤ .0001). In this same setting, Latarjet reconstruction restored translation to dislocation greater than the native intact joint for all sizes of humeral head defects. At 60° of ABD and 80° of ER, a 20% glenoid defect led to an overall decrease in translation to dislocation with increasing humeral head defects. While Latarjet augmentation resulted in increased translation to dislocation for all

  14. Sutural expansion osteogenesis for management of the bony-tissue defect in cleft palate repair: experimental studies in dogs.

    Science.gov (United States)

    Liu, C; Song, R; Song, Y

    2000-05-01

    A series of experimental studies on sutural expansion osteogenesis for management of the bony-tissue defect in cleft palate repair was performed between 1995 and 1997. Forty-five young dogs in weaning were used in four experiments that were divided into two parts. Part I probed the possibility of closing the surgically constructed hard palate cleft not only with mucoperiosteum but also with bony tissue by the technique of sutural expansion of lateral palatine sutures. Part II explored the possibility of pushing the palatine bone posteriorly and advancing the maxillary segment anteriorly by transverse palatine suture expansion. In Part I, a ring-shaped suture expander made of nickel-titanium shape memory alloy was used to expand the lateral suture of palatine bones. Expansion forces of 200 G, 360 G, and 480 G were used for the first experiment. A force of 360 G was chosen for two other experiments; this force is equivalent to the distraction rate of 0.5 mm per day of a jackscrew device. The ring-shaped suture expander was opened and its two feet were fixed in the medial sides of residual horizontal plates of the palatine bones immediately after a hard palate cleft was constructed surgically under endotracheal general anesthesia. At the eighth postoperative day, under the traction of 360 G, the two sides of the 8-mm-wide hard palate cleft were brought into contact with each other, and 8 or 9 days later the closed palatal cleft had healed completely with mucosal tissue. This experiment was repeated twice and yielded the same results. Sutural expansion osteogenesis was evaluated physically, fluorescently, histologically, and ultrastructurally to examine the deposition of the regenerated bone in the suture areas. Additionally, the influence of sutural expansion osteogenesis of the palatal bones on other facial bones was also studied cephalometrically. In Part II, a bow-shaped suture expander made of nickel-titanium shape memory alloy was applied to expand either the

  15. Allergy to fish collagen: Thermostability of collagen and IgE reactivity of patients' sera with extracts of 11 species of bony and cartilaginous fish.

    Science.gov (United States)

    Kobayashi, Yukihiro; Kuriyama, Takuma; Nakagawara, Ryoko; Aihara, Michiko; Hamada-Sato, Naoko

    2016-10-01

    Parvalbumin was identified as a major fish allergen, and has been well investigated. Collagen was identified as a second allergen; however, its allergenic properties remain uncharacterized. Although fish is an important staple in coastal countries, its thermostability is unknown. Therefore, we aimed to determine the thermostability of fish collagen as an allergen. Meat of seven bony and four cartilaginous fishes was heated at various temperatures and times, and extracts were analyzed using SDS-PAGE, IgE-ELISA, and SPTs. Collagen was dissolved from heated meat of Pacific mackerel into a crude extract. Collagen in the extracts was degraded at a high heating load-140 °C (10 min) or 100 °C (320 min). However, ELISA revealed the IgE reactivities of patients' sera with the extracts were unchanged even after heating the samples. Patients strongly reacted to extract proteins of other bony fish, which were detected by patients' IgE even after heating at 100 °C (320 min). In contrast, reactivities of the extracts of cartilaginous fish were lower than those of bony fish. SPTs in one patient revealed that all bony and cartilaginous fish extracts prepared from heated meat elicited allergic reactions. The IgE reactivity of patients' sera to fish collagen in extracts was retained even when fish meat was treated by a high heating load. As for the fish collagen, the IgE reactivities to cartilaginous fish were lower than that to bony fish. Reducing IgE reactivity to fish meat using heat is difficult, and other modalities will be required to produce hypoallergenic fish meat. Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  16. Focal nodular hyperplasia and hepatocellular adenoma; Fokale nodulaere Hyperplasie und hepatozellulaeres Adenom

    Energy Technology Data Exchange (ETDEWEB)

    Bastati-Huber, N.; Poetter-Lang, S.; Ba-Ssalamah, A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Abteilung fuer Allgemeine Radiologie und Kinderradiologie, Department of Biomedical Imaging and Image-guided Therapy, Wien (Austria)

    2015-01-01

    Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are liver lesions of hepatocellular origin. The FNH is a commonly occurring hepatic lesion whereas HCA is very rare. Non-invasive differentiation between HCA subtypes and atypical FNH may pose a diagnostic challenge as both entities predominantly occur in middle-aged female patients. The conventional imaging modalities include ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). Distinguishing FNH from HCA is of great importance clinically as FNH is considered to be a benign lesion and needs no further management. In contrast HCA is considered to be a borderline tumor due to the risk of hemorrhage, growth and even malignant transformation and requires individualized management. The abovementioned radiological procedures usually enable an accurate and certain diagnosis of a typical FNH to be achieved. In cases of atypical FNH, particularly in patients with a clinical history of malignancy, these imaging modalities are insufficient to establish a clear diagnosis. In this scenario, the use of modern hepatobiliary contrast-enhanced MRI will enable a differentiation between FNH and metastasis with a high sensitivity and specificity. Furthermore, it allows a differentiation of FNH from 90 % of adenoma subtypes. This article describes the histopathological and radiological features of these lesions and explains the advantages and limitations of various imaging modalities used for the diagnosis and differentiation of these entities. The new classification of HCAs according to phenotype and genotype and their imaging features, as well as different enhancement patterns, are described. The correlation between HCA subtypes and their individual management are also discussed. (orig.) [German] Die fokale nodulaere Hyperplasie (FNH) und das hepatozellulaere Adenom (HCA) sind Leberlaesionen hepatozellulaeren Ursprungs. Die FNH ist eine sehr haeufige, das HCA eine sehr seltene Leberlaesion

  17. Full-field displacement and strain measurement of small complex bony structures with digital speckle pattern interferometry and shearography

    Science.gov (United States)

    Soons, Joris; Dirckx, Joris J. J.

    2010-09-01

    We have developed a simple digital speckle pattern interferometry (DSPI) and shearography setup to measure the displacement and the corresponding strains of small complex bony structures. We choose both optical techniques because we want to obtain very small deformations (+/- 20 μm) of small objects (+/- 1cm). Furthermore full field and in situ measurements are preferred. We first use a Michelson DSPI arrangement with phase shifting. In this way we can obtain the out-of-plane displacements precisely. Second, shearography is introduced to measure the derivative of the out-ofplane displacement. In this way some intrinsic disadvantages of DSPI can be overcome. We have developed these setups to measure the out-of-plane deformations of (small) bird beaks when realistic external forces are applied. In this way, we have a full field validation measurement to which we can compare the outcome of realistic finite element models. The aim is to determine whether the shape, and not only the size, of the bird beaks are optimized to deal with the biting forces that a species encounters. This quantitative analysis will help biologists to investigate if beak morphology is adapted to feeding habits. Applying the method to the famous evolution model of the Darwin's finches will provide scientific proof of functional evolution. In this paper we will present both the DSPI and shearography setup, a comparison of the performance of both techniques on a simple deflection of a cantilever beam and the first results obtained on loaded bird beaks.

  18. A clinical study on the efficacy of hydroxyapatite - Bioactive glass composite granules in the management of periodontal bony defects

    Directory of Open Access Journals (Sweden)

    Tirthankar Debnath

    2014-01-01

    Full Text Available Background: In periodontal regeneration, several alloplastic materials are being used with a goal to reconstruct new osseous tissue in the infrabony defect sites. The present study was undertaken to evaluate the efficacy of hydroxyapatite-bioactive glass (HA:BG composite granules in the management of periodontal bony defects. Materials and Methods: A randomized control study was conducted. Subjects with infrabony defects were divided into three groups. Test Group 1 (n = 10: Defect site was treated with HA:BG, with a biodegradable membrane. Test Group 2 (n = 10: Defect site was treated with HAP, with a biodegradable membrane. Control group (n = 10: Defect site was treated with open flap debridement with a biodegradable membrane Results: The healing of defects was uneventful and free of any biological complications. The gain in clinical attachment level, reduction of probing pocket depth, and defect fill were statistically significant in all three groups. TG1 sites showed significant defect fill than TG2 and CG sites. Conclusion: The performance of HA:BG was better compared to HAP and open flap debridement for the reconstruction of infrabony defects.

  19. Bony reconstruction of hip in cerebral palsy children Gross Motor Function Classification System levels III to V: a systematic review.

    Science.gov (United States)

    El-Sobky, Tamer A; Fayyad, Tamer A; Kotb, Ahmed M; Kaldas, Beshoy

    2018-05-01

    Hip dislocation is a common source of disability in cerebral palsy children. It has been remedied by various reconstructive procedures. This review aims at providing the best evidence for bony reconstructive procedures in cerebral palsy hip migration. The literature extraction process yielded 36 articles for inclusion in this review. There is fair evidence to indicate that the comparative effectiveness of femoral versus combined pelvifemoral reconstruction favours pelvifemoral reconstruction. All except one were retrospective articles with a significant degree of selection and performance bias and confounding variables that limited the validity and generalizability of the conclusions. The findings of this systematic review provide fair evidence for the use of adequate soft tissue and combined pelvifemoral reconstruction in the management of hip migration in none and minimally ambulatory cerebral palsy children in the short and long term. This has been shown in studies with a summed sizable patient population. There is limited evidence available that would support the use of soft-tissue and isolated femoral reconstruction. In the context of these retrospective and biased studies, it is extremely difficult to identify, with great precision, predictors of surgical success. Future studies should consider prospective designs that allow for bias control, strict patient selection criteria and incorporation of validated quality-of-life scales.

  20. Influencia del nódulo de grafito en la rotura por fatiga de contacto de una fundición nodular. // influence of the graphite nodule in the contact fatigue failure of nodular foundry.

    Directory of Open Access Journals (Sweden)

    C. Figueroa

    2005-01-01

    Full Text Available El presente trabajo muestra una metodología para calcular el número de ciclos necesarios durante la formación de grietassubsuperficiales, en las fundiciones nodulares sometidas a fatiga de contacto.En esta metodología se tuvo en consideración que para calcular el número de ciclos totales hasta la rotura eraimprescindible tener en cuenta la cantidad de ciclos hasta que la grieta se iniciara. En este sentido se utilizó la expresiónpropuesta por Tanaka donde se toma en cuenta la geometría de un defecto y la energía de deformación alrededor de este, lacual puede ser determinada por la expresión de Petch.Las variaciones dimensionales que sufre el nódulo de grafito bajo la acción de las cargas de contacto fueron determinadascon precisión utilizando el método de los elementos finitos (EF.Para determinar la cantidad de ciclos durante la propagación de la grieta se utilizó la expresión de Paris y se consideró elmaterial con propiedades isotrópicas. El factor de intensificación de tensiones se determinó a partir de la expresión deMurakami, aquí se tuvo en cuenta que la grieta se propagaría en una dirección y ángulo determinado. Durante los cálculosse consideró que en el mecanismo de iniciación de grietas estuvo presente el movimiento de las dislocaciones cuyo factorde irreversibilidad tiene una influencia significativa.Palabras claves: Fundiciones nodulares, elementos finitos, rotura.____________________________________________________________________________AbstractThe present paper states a methodology that allows to calculate the number of necessary cycles during theformation of undersurface cracks in nodular foundries subjected to contact fatigue.In this methodology it was indispensable to keep in mind the quantity of cycles in order to calculate thenumber of total cycles until the crack began. In this sense the expression proposed by Tanaka was usedwhere its takes into account the geometry of a defect and the

  1. Influencia de los factores microestructurales en la resistencia al desgaste por deslizamiento de las fundiciones nodulares austemperadas

    Directory of Open Access Journals (Sweden)

    C. J. Diez Cicero

    2008-09-01

    Full Text Available Entre los materiales metálicos de mayor demanda, el hierro dúctil con grafito esferoidal o nodular ocupa en la actualidad uno de los lugares más importantes entre los hierros fundidos de alta resistencia. Desde hace unos veinticinco años la introducción del hierro nodular austemperado significó de hecho una revolución en el campo de las aleaciones ferrosas. En el presente trabajo se realiza un estudio de la influencia del conteo de nódulos de grafito del hierro nodular en el proceso de austemperado, a partir de las características de las estructuras obtenidas, por la variación de la cantidad de nódulos de grafito y de las variables de tratamiento térmico. Dichas estructuras son sometidas a la acción del desgaste, en este caso a un desgaste por deslizamiento mediante un ensayo típico disco-zapata. Con los resultados obtenidos, se realiza un análisis estadístico de la influencia del conteo de nódulos en dichas propiedades y de las causas de este comportamiento, tomando en consideración la interrelación del conteo de nódulos con las variables de tratamiento térmico utilizadas en las muestras ensayadas y su incidencia en el mecanismo de desgaste.A study about the influence of the graphite nodules quantity and some heat treatment parameters in the characteristic of cast ductile iron is presented. Experimental investigation of wear resistance by sliding is applied to specimens tested of austempered ductile irons using a test machine based in the disc- plate system. Statistical analysis about the influence of the graphite nodule quantity in the wear resistance properties, so as well as, the causes of this behaviour taking into account the graphite nodule count and some heat treatment variables is don.

  2. Células dendríticas foliculares: imunofenotipagem no linfoma de Hodgkin clássico esclerose nodular Dendritic follicular cells: immunophenotyping in classic Hodgkin’s lymphoma nodular sclerosis

    Directory of Open Access Journals (Sweden)

    Julieta M. M. F. Almeida

    2006-03-01

    Full Text Available O linfoma de Hodgkin clássico esclerose nodular (LHCEN, de origem linfóide da célula B do centro germinativo (CG, apresenta agregados de células dendríticas foliculares (CDF, célula Hodgkin/Reed Sternberg e variantes, células B formando complexos relacionados ao CG, sugerindo uma associação entre esclerose nodular e formação do centro germinativo. O objetivo desse estudo foi avaliar a célula dendrítica folicular, por imunofenotipagem com o anticorpo fascina, em biópsia de linfonodo periférico ou massa do mediastino de pacientes com LHCEN previamente diagnosticados, procurando identificar critérios como fatores prognósticos. Foram selecionados 38 pacientes, 55,2% do sexo masculino com relação M:F de 1,23: 1 e a idade com média de 29,3 anos; 52,6% em estádios clínicos I-II, sendo 68,4% com sintomas B. Foram analisados 38 espécimes de biópsias, sendo 57,9% do subtipo esclerose nodular II. O estudo imuno-histoquímico mostrou 100% de positividade para o CD30 e 68,4% para o CD15. As CDFs foram identificadas pelo anticorpo fascina, considerado padrão-ouro, através da técnica imunoenzimática indireta peroxidase-anti-peroxidase estreptavidina-avidina-biotina (PAP-Strept ABC, realizada em lâminas pré-tratadas do material de biópsia incluído em blocos de parafina. Foi evidenciado padrão CDF1 em 7,9%, CDF2 em 47,4% e CDF3 em 44,7%. Não houve relação entre a presença da CDF e sexo, idade, estádio clínico e resposta ao tratamento, mas foi demonstrada uma tendência para associação (p=0,056 entre CDF os subtipos LHCEN. Os pacientes com presença de célula dendrítica folicular foram acompanhados por maior período, com média de 32,9 meses, com associação estatisticamente significativa (p=0,001.Classic nodular sclerosis Hodgkin’s lymphoma (CNSHL is a lymphoid neoplasm of germinal center (GC B cells, presenting with aggregates of follicular dendritic cells (FDC, Hodgkin/Reed Sternberg cells and variants and B cells

  3. Prospective differentiation of clinically difficult to distinguish nodular basal cell carcinomas and intradermal nevi by non-invasive Reflectance Confocal Microscopy: a case series study

    NARCIS (Netherlands)

    Hoogedoorn, L.; Peppelman, M.; Blokx, W.A.M.; Erp, P.E.J. van; Gerritsen, M.J.P.

    2015-01-01

    BACKGROUND: Clinical differentiation between a nodular basal cell carcinoma (nBCC) and a benign intradermal nevus can be difficult. Even with additional dermoscopic evaluation, a correct diagnosis may be difficult. Currently, histopathological examination of a biopsy is the gold standard to

  4. Cytokine gene expression profile distinguishes CD4+/CD57+T cells of the nodular lymphocyte predominance type of Hodgkin's lymphoma from their tonsillar counterparts

    NARCIS (Netherlands)

    Atayar, Cigdem; Poppema, Sibrand; Visser, Lydia; van den Berg, Anke

    Little is known about the cytokine profile of nodular lymphocyte predominance Hodgkin's lymphoma (NLPHL) and the significance of the characteristic rosetting CD4(+)/CD57(+) T cells. We analysed the T lymphocyte populations isolated from lymph node suspensions from five patients with NLPHL, two with

  5. Perineal nodular indurations ("accessory testicles") in cyclists. Fine needle aspiration cytologic and pathologic findings in two cases.

    Science.gov (United States)

    Vuong, P N; Camuzard, P; Schoonaert, M F

    1988-01-01

    The cytologic and histologic findings from two cases of perineal nodular indurations observed in two cyclists are reported. These lesions, also referred to as "accessory testicles" or "third testicle" or "ischial hygromas" of cyclists, consist of a localized aseptic area of necrosis with pseudocyst formation involving connective tissue in the superficial fascia of the perineum. These histologic findings, which were seen in the subsequent surgical specimens in these two cases, were reflected in the fine needle aspiration findings. The aspirates contained few cellular elements, mainly a few vacuolated histiocytes, against a background of fibrinous material. These indurations, which develop as a result of repeated, chronic microtrauma to the perineum impressed by the vibration of the saddle of the bicycle, constitute an authentic handicap for the professional cyclist and are a contraindication to cycling for amateur cyclists.

  6. Perineal nodular induration ("Biker's nodule"): report of two cases with fine-needle aspiration cytology and immunohistochemical study.

    Science.gov (United States)

    Khedaoui, Radia; Martín-Fragueiro, Luz M; Tardío, Juan C

    2014-02-01

    Perineal nodular induration (PNI) is a fibroblastic pseudotumor that presents almost exclusively in male cyclists. It develops in the soft tissues of the perineum immediately posterior to the scrotum, as a bilateral or single, central or lateralized mass. Although well known to sport medicine specialists, it is a scarcely documented entity in the pathology literature. We present 2 cases of PNI with fine-needle aspiration cytology and immunohistochemistry. They consisted of a paucicellular fibroblastic proliferation containing CD34-reactive spindle and epithelioid cells, small foci of fibrinoid degeneration, numerous blood vessels, and entrapped groups of mature fat cells. Our cases show that the histopathological features of PNI are more varied than those previously described and its immunohistochemical profile is wider. A central cystic focus and a zonal pattern are not consistent features of this entity. The lesional cells can express CD34, a hitherto unreported immunohistochemical finding.

  7. MRI of hepatic focal nodular hyperplasia: A report of two new cases in the pediatric age group

    International Nuclear Information System (INIS)

    Toma, P.; Taccone, A.; Martinoli, C.

    1990-01-01

    At present, magnetic resonance is a useful modality for the diagnostic assessment of focal nodular hyperplasia of the liver. In the pediatric age group, diagnosis for this kind of pathology is more effective and conclusive when performed by MR, because of the limited variety and the restricted expression of primary hepatic tumors. MR diagnosis is based on the presence of a central connective tissue that is scar hyperintense on T2-weighted sequences, which can be regarded as a typical finding, though not specific. The other criteria used to differentiate it from primary malignant tumors on MRI are the homogeneity of the tissue surrounding the scar and its signal intensity, which is similar to that of adjacent normal hepatic parenchyma. (orig.)

  8. Benign nodular hyperplasia of the liver-pedunculated form: diagnostic contributions of ultrasonography and consideration of exophytic liver tumors.

    Science.gov (United States)

    Badea, Radu; Meszaros, Magdalena; Al Hajjar, Nadim; Rusu, Ioana; Chiorean, Liliana

    2015-01-01

    Focal nodular hyperplasia (FNH) is an asymptomatic benign liver tumor that may be detected accidentally during an abdominal ultrasound examination; it is associated with unspecific complaints, sometimes painful. Diagnosis can be precise using imaging techniques like ultrasonography. The diagnostic criteria are represented by the spatial display of the tumoral vessels and their hemodynamic characteristics. Sometimes differential diagnostic issues occur with other benign or malignant liver tumors. We present the case of a young female patient without a personal pathological history, who complained of intense, diffuse, intermittent, non-systematic abdominal pain and who underwent ultrasound examination, followed by contrast-enhanced ultrasound. With this technique, we evidenced a solid extrahepatic tumor, which was mobile at the patient's change of position and had the hemodynamic features of FNH. The article also tackles the problem of intra-abdominal pedunculated tumors.

  9. Oral Nodular Lesions in Patients with Sjögren's Syndrome: Unusual Oral Implications of a Systemic Disorder.

    Science.gov (United States)

    Pinheiro, Juliana Barchelli; Tirapelli, Camila; Silva, Claudia Helena Lovato da; Komesu, Marilena Chinali; Petean, Flávio Calil; Louzada Junior, Paulo; León, Jorge Esquiche; Motta, Ana Carolina Fragoso

    2017-01-01

    Sjögren's syndrome (SS) is a systemic chronic autoimmune disorder affecting the lacrimal and salivary glands. SS may manifest as primary SS (pSS) or secondary SS (sSS), the latter occurring in the context of another autoimmune disorder. In both cases, the dry eyes and mouth affect the patient's quality of life. Late complications may include blindness, dental tissue destruction, oral candidiasis and lymphoma. This paper reports two cases of SS, each of them presenting unusual oral nodular lesion diagnosed as relapsed MALT lymphoma and mucocele. The importance of the diagnosis, treatment and management of the oral lesions by a dentist during the care of SS patients is emphasized, as the oral manifestations of SS may compromise the patient's quality of life.

  10. Portal Hypertension, Nodular Regenerative Hyperplasia of the Liver, and Obstructive Portal Venopathy due to Metastatic Breast Cancer

    Directory of Open Access Journals (Sweden)

    Andrew T. Turk

    2013-01-01

    Full Text Available Nodular regenerative hyperplasia (NRH of the liver is associated with noncirrhotic portal hypertension, rheumatologic and hematologic disorders, administration of certain drugs, and other underlying conditions. This report describes a 64-year-old man with clinically presumed cirrhosis who presented to our institution with coffee-ground emesis, esophageal varices, ascites, and encephalopathy. Eleven years earlier he had been treated for breast cancer with mastectomy and chemo-radiotherapy. He died suddenly, and the autopsy showed no evidence of cirrhosis but instead demonstrated NRH with extensive emboli of recurrent breast carcinoma within the portal vein and its intrahepatic branches. Neoplastic occlusion of the portal vein as a cause of presinusoidal noncirrhotic portal hypertension has not previously been reported for metastatic breast carcinoma. This case highlights the importance of obstructive portal venopathy in the pathogenesis of NRH as well as the diagnostic difficulties that may be encountered in determining the cause of portal hypertension.

  11. Combination of microscopic model and VoF-multiphase approach for numerical simulation of nodular cast iron solidification

    Science.gov (United States)

    Subasic, E.; Huang, C.; Jakumeit, J.; Hediger, F.

    2015-06-01

    The ongoing increase in the size and capacity of state-of-the-art wind power plants is highlighting the need to reduce the weight of critical components, such as hubs, main shaft bearing housings, gear box housings and support bases. These components are manufactured as nodular iron castings (spheroid graphite iron, or SGI). A weight reduction of up to 20% is achievable by optimizing the geometry to minimize volume, thus enabling significant downsizing of wind power plants. One method for enhancing quality control in the production of thick-walled SGI castings, and thus reducing tolerances and, consequently, enabling castings of smaller volume is via a casting simulation of mould filling and solidification based on a combination of microscopic model and VoF-multiphase approach. Coupled fluid flow with heat transport and phase transformation kinetics during solidification is described by partial differential equations and solved using the finite volume method. The flow of multiple phases is described using a volume of fluid approach. Mass conservation equations are solved separately for both liquid and solid phases. At the micro-level, the diffusion-controlled growth model for grey iron eutectic grains by Wetterfall et al. is combined with a growth model for white iron eutectic grains. The micro-solidification model is coupled with macro-transport equations via source terms in the energy and continuity equations. As a first step the methodology was applied to a simple geometry to investigate the impact of mould-filling on the grey-to-white transition prediction in nodular cast iron.

  12. Tumor necrosis is associated with increased alphavbeta3 integrin expression and poor prognosis in nodular cutaneous melanomas

    International Nuclear Information System (INIS)

    Bachmann, Ingeborg M; Ladstein, Rita G; Straume, Oddbjørn; Naumov, George N; Akslen, Lars A

    2008-01-01

    Tumor necrosis and apoptotic activity are considered important in cancer progression, but these features have not been much studied in melanomas. Our hypothesis was that rapid growth in cutaneous melanomas of the vertical growth phase might lead to tissue hypoxia, alterations in apoptotic activity and tumor necrosis. We proposed that these tumor characteristics might be associated with changes in expression of cell adhesion proteins leading to increased invasive capacity and reduced patient survival. A well characterized series of nodular melanoma (originally 202 cases) and other benign and malignant melanocytic tumors (109 cases) were examined for the presence of necrosis, apoptotic activity (TUNEL assay), immunohistochemical expression of hypoxia markers (HIF-1 α, CAIX, TNF-α, Apaf-1) and cell adhesion proteins (α v β 3 integrin, CD44/HCAM and osteopontin). We hypothesized that tumor hypoxia and necrosis might be associated with increased invasiveness in melanoma through alterations of tumor cell adhesion proteins. Necrosis was present in 29% of nodular melanomas and was associated with increased tumor thickness, tumor ulceration, vascular invasion, higher tumor proliferation and apoptotic index, increased expression of α v β 3 integrin and poor patient outcome by multivariate analysis. Tumor cell apoptosis did also correlate with reduced patient survival. Expression of TNF-α and Apaf-1 was significantly associated with tumor thickness, and osteopontin expression correlated with increased tumor cell proliferation (Ki-67). Tumor necrosis and apoptotic activity are important features of melanoma progression and prognosis, at least partly through alterations in cell adhesion molecules such as increased α v β 3 integrin expression, revealing potentially important targets for new therapeutic approaches to be further explored

  13. Study of factors that influence the outcome of131I treatment in hyperthyroidism secondary to nodular goitre.

    Science.gov (United States)

    Tabuenca-Dopico, O; Boente-Varela, R; Lamas-Ferreiro, J L

    To assess the outcome after 131 I treatment in patients with multinodular (MNG) and nodular toxic goitre (NTG) according to the administered dose and other factors related to the patient, pathology, or previous treatments. A retrospective study was conducted on 108 patients (67 MNG and 41 NTG) treated in our department, with a follow-up period of at least 2 years. Development of hypothyroidism and treatment failure were evaluated along with their relationship with the administered dose and other factors such as age, sex, grade of hyperthyroidism, type of goitre, presence of autoimmunity, or previous antithyroid medication. More than one-third (36.9%) of MNG patients, and even higher proportion of NTG patients (51.2%) developed non-transient hypothyroidism, particularly in those receiving 740MBq (66.7%). No relationship was found with any other variable. The development of early hypothyroidism (before one year) was also not related to any variable. Treatment failure was not related to the dose, but in MNG there was a relationship with male gender, presence of autoimmunity, or previous antithyroid drugs use. The high rate of hypothyroidism obtained with high doses of 131 I in hyperthyroidism secondary to nodular goitre treatment suggests that lower doses might be sufficient to control the disease without an increase in treatment failures. Only patients with positive autoimmunity, in previous anti-thyroid medication, and perhaps male gender in MNG might be given higher doses, as the failure rate increases, but further studies are required. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  14. Expression of claudin, paxillin and FRA-1 in non-nodular breast lesions in association with microcalcifications

    Directory of Open Access Journals (Sweden)

    José David Kandelman

    Full Text Available CONTEXT AND OBJECTIVE The possible role of adhesion molecules in early breast carcinogenesis has been shown in the literature. We aimed to analyze early adhesion imbalances in non-nodular breast lesions and their association with precursor lesions, in order to ascertain whether these alterations exist and contribute towards early carcinogenesis. DESIGN AND SETTING Retrospective cross-sectional study based on medical records at a private radiological clinic in São Paulo, Brazil. METHODS We retrospectively reviewed the medical records of all consecutive women attended between August 2006 and July 2007 who presented mammographic evidence of breast microcalcifications classified as Breast Imaging Reporting and Data System Atlas (BI-RADS type 4. These women underwent stereotaxic biopsy. Clinical, radiological and pathological data were collected, and immunohistochemical assays searched for claudin, paxillin, FRA-1 and HER-2. RESULTS Over this period, 127 patients were evaluated. Previous BI-RADS diagnoses showed that 69 cases were in category 4A, 47 in 4B and 11 in 4C. Morphological assessment showed benign entities in 86.5%. Most of the benign lesions showed preserved claudin expression, associated with paxillin (P < 0.001. Paxillin and HER-2 expressions were correlated. FRA-1 expression was also strongly associated with HER-2 expression (P < 0.001. CONCLUSIONS Although already present in smaller amounts, imbalance of adhesion molecules is not necessarily prevalent in non-nodular breast lesions. Since FRA-1 expression reached statistically significant correlations with radiological and morphological diagnoses and HER-2 status, it may have a predictive role in this setting.

  15. Likelihood ratio-based differentiation of nodular Hashimoto thyroiditis and papillary thyroid carcinoma in patients with sonographically evident diffuse hashimoto thyroiditis: preliminary study.

    Science.gov (United States)

    Wang, Liang; Xia, Yu; Jiang, Yu-Xin; Dai, Qing; Li, Xiao-Yi

    2012-11-01

    To assess the efficacy of sonography for discriminating nodular Hashimoto thyroiditis from papillary thyroid carcinoma in patients with sonographically evident diffuse Hashimoto thyroiditis. This study included 20 patients with 24 surgically confirmed Hashimoto thyroiditis nodules and 40 patients with 40 papillary thyroid carcinoma nodules; all had sonographically evident diffuse Hashimoto thyroiditis. A retrospective review of the sonograms was performed, and significant benign and malignant sonographic features were selected by univariate and multivariate analyses. The combined likelihood ratio was calculated as the product of each feature's likelihood ratio for papillary thyroid carcinoma. We compared the abilities of the original sonographic features and combined likelihood ratios in diagnosing nodular Hashimoto thyroiditis and papillary thyroid carcinoma by their sensitivity, specificity, and Youden index. The diagnostic capabilities of the sonographic features varied greatly, with Youden indices ranging from 0.175 to 0.700. Compared with single features, combinations of features were unable to improve the Youden indices effectively because the sensitivity and specificity usually changed in opposite directions. For combined likelihood ratios, however, the sensitivity improved greatly without an obvious reduction in specificity, which resulted in the maximum Youden index (0.825). With a combined likelihood ratio greater than 7.00 as the diagnostic criterion for papillary thyroid carcinoma, sensitivity reached 82.5%, whereas specificity remained at 100.0%. With a combined likelihood ratio less than 1.00 for nodular Hashimoto thyroiditis, sensitivity and specificity were 90.0% and 92.5%, respectively. Several sonographic features of nodular Hashimoto thyroiditis and papillary thyroid carcinoma in a background of diffuse Hashimoto thyroiditis were significantly different. The combined likelihood ratio may be superior to original sonographic features for

  16. Bony landmark between the attachment of the medial meniscus posterior root and the posterior cruciate ligament: CT and MR imaging assessment

    Energy Technology Data Exchange (ETDEWEB)

    Fujii, Masataka; Furumatsu, Takayuki; Miyazawa, Shinichi; Kodama, Yuya; Hino, Tomohito; Kamatsuki, Yusuke; Ozaki, Toshifumi [Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama (Japan)

    2017-08-15

    (1) To reveal the prevalence of the bony recess (posterior dimple) and (2) to determine the position of the posterior dimple on the tibial plateau using three-dimensional computed tomography (3DCT). In this study, a retrospective review of 112 patients was performed to identify the posterior dimple and to evaluate its position on 3DCT. Magnetic resonance images (MRIs) were also used to determine the positional relationship among the posterior cruciate ligament (PCL), medial meniscus posterior insertion (MMPI), and posterior dimple. The posterior dimple was observed in 100 of 112 knees (89.3%) on 3DCT. The center of the posterior dimple was 13.6 ± 0.8 mm from the medial tibial eminence apex. MRI showed that the posterior dimple separated the tibial attachment of the PCL and MMPI. This is the first study to discuss the prevalence and position of the bony recess in the posterior intercondylar fossa. (orig.)

  17. Clinical and Radiologic Evaluation of Regenerative Potential of NHA Paste and DBM in the Treatment of Periodontal Intra-bony Defects -A Randomized Control Trial.

    Science.gov (United States)

    Jain, Deepti; Sawhney, Anshul; Gupta, Bharat; Sharma, Saurabh; Juneja, Saurabh; Juneja, Manjushree; Sharma, Shruti; Patil, Neha

    2016-09-01

    Previous studies have shown that Hydroxyapatite (HA) has shown good results in the treatment of intra-osseous periodontal defects. A newer variety of HA has been designed over a period of research which has nano-sized particles and is availed in a paste consistency called Nanocrystalline Hydroxyapatite paste (NHA paste). This variation in size and surface area of NHA paste can provide better results when used in intra-bony defects. The purpose of this study was to compare the clinical and radiographic outcomes obtained with usage of NHA paste to those obtained with Demineralized Bone Matrix (DBM) in the treatment of periodontal intra-bony defects. A clinical trial was carried out for a period of 12 months. A total of 26 intra-bony defects in 10 patients were divided into experimental and control sites. The experimental sites were debrided and grafted with NHA paste. The control sites were debrided and grafted with DBM-Xenograft. Probing Depth, Clinical Attachment Level (DCAL) and Gingival Margin (GM) position were recorded at baseline 3, 6, 9 and 12 months. Standardized radiographs were also documented at these recalls. The results were averaged (mean± standard deviation) for each parameter and Student t-test was used to determine intra-group statistical difference and One way analyses of variance (ANOVA) to test the difference between groups using Excel and SPSS (SPSS Inc, Chicago) software packages. On completion of 12 months, the mean percentage of PD reduction achieved in the experimental and control sites was 67.45% and 69.03% respectively (pperiodontal intra-bony defects.

  18. Bony Maturity of the Tibial Tuberosity With Regard to Age and Sex and Its Relationship to Pathogenesis of Osgood-Schlatter Disease: An Ultrasonographic Study.

    Science.gov (United States)

    Kaneuchi, Yoichi; Otoshi, Kenichi; Hakozaki, Michiyuki; Sekiguchi, Miho; Watanabe, Kazuyuki; Igari, Takahiro; Konno, Shinichi

    2018-01-01

    Although tensile force on an immature tibial tuberosity is considered the main cause of Osgood-Schlatter disease (OSD), the relationship between bony maturity and the pathogenesis of OSD remains obscure. To survey the bone maturation process of the tibial tuberosity by age and sex and clarify its relationship to OSD. Cross-sectional study; Level of evidence, 3. A total of 731 Japanese basketball players aged 6 to 14 years were enrolled in this study. Ultrasonographic examination was performed in all participants (1462 knees) to evaluate the bony maturity of the tibial tuberosity by use of the Ehrenborg classification. The age- and sex-specific prevalence of each stage was investigated, and the prevalence of symptomatic OSD and its relationship with bony maturity were also assessed. The process of bone maturation occurred 1 to 2 years earlier in female participants compared with male participants. Among female participants, 59.2% were already at the epiphyseal stage (stage E) by 10 years of age, and 47.4% were skeletally mature by 14 years. Among male participants, conversely, only 8.0% were at stage E by 10 years of age, and only 13.8% were skeletally mature by 14 years. The overall prevalence of symptomatic OSD was 6.8% (males, 6.4%; females, 7.2%), and the onset was 1 year earlier in the female participants. The prevalence of symptomatic OSD tended to increase with age and bony maturity, significantly increasing from the cartilaginous stage (stage C) to the apophyseal stage (stage A) (odds ratio, 9.48) and from stage A to stage E (odds ratio, 2.22). The tibial tuberosity matures earlier in female participants. The risk of OSD is greater in stage A than stage C and in stage E than stage A. The risk of OSD increases with age in males but not in females.

  19. Hard and soft tissue changes around implants installed in regular-sized and reduced alveolar bony ridges. An experimental study in dogs.

    Science.gov (United States)

    Baffone, Gabriele; Lang, Niklaus P; Pantani, Fabio; Favero, Giovanni; Ferri, Mauro; Botticelli, Daniele

    2015-01-01

    To study bony and soft tissue changes at implants installed in alveolar bony ridges of different widths. In 6 Labrador dogs, the mandibular premolars and first molars were extracted, and a buccal defect was created in the left side at the third and fourth premolars by removing the buccal bone and the inter-radicular and interdental septa. Three months after tooth extraction, full-thickness mucoperiosteal flaps were elevated, and implants were installed, two at the reduced (test) and two at the regular-sized ridges (control). Narrow or wide abutments were affixed to the implants. After 3 months, biopsies were harvested, and ground sections prepared for histological evaluation. A higher vertical buccal bony crest resorption was found at the test (1.5 ± 0.7 mm and 1.0 ± 0.7 mm) compared to the control implants (1.0 ± 0.5 mm and 0.7 ± 0.4 mm), for both wide and narrow abutment sites. A higher horizontal alveolar resorption was identified at the control compared to the test implants. The difference was significant for narrow abutment sites. The peri-implant mucosa was more coronally positioned at the narrow abutment, in the test sites, while for the control sites, the mucosal adaptation was more coronal at the wide abutment sites. These differences, however, did not reach statistical significance. Implants installed in regular-sized alveolar ridges had a higher horizontal, but a lower vertical buccal bony crest resorption compared to implants installed in reduced alveolar ridges. Narrow abutments in reduced ridges as well as wide abutments in regular-sized ridges yielded less soft tissue recession compared to their counterparts. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. MULTILEVEL SOFT TISSUE WITH BONY CORRECTIVE SURGERY IN LOWER LIMB DEFORMITIES AS ONE SITTING PROCEDURE IN SPASTIC CEREBRAL PALSY: AN EXPERIENCE FROM FREE DISABLED SURGICAL CAMPS

    OpenAIRE

    Antony R; Bajpai; Atul Manoharrao; Bhanu Pratap; Archana; Vibha; Himanshu; Santosh

    2015-01-01

    The study was intended to assess the results of multilevel soft tissue with bony corrective surgery as one sitting procedure on static deformities and contractures in lower limbs with patients of spastic cerebral palsy at free disabled surgical camps at Chhattisgarh state. In our study 30 patients were included with sixty percent male and forty percent female , within 4 - 16 years age group. Almost all patients had diplegia and only ...

  1. Allergy to fish collagen: Thermostability of collagen and IgE reactivity of patients' sera with extracts of 11 species of bony and cartilaginous fish

    Directory of Open Access Journals (Sweden)

    Yukihiro Kobayashi

    2016-10-01

    Conclusions: The IgE reactivity of patients' sera to fish collagen in extracts was retained even when fish meat was treated by a high heating load. As for the fish collagen, the IgE reactivities to cartilaginous fish were lower than that to bony fish. Reducing IgE reactivity to fish meat using heat is difficult, and other modalities will be required to produce hypoallergenic fish meat.

  2. The significance of a hypoplastic bony canal for the cochlear nerve in patients with sensorineural hearing loss: CT and MRI findings

    International Nuclear Information System (INIS)

    Choi, Yoon Jung; Park, Sang Yoo; Kim, Myung Soon; Sung, Ki Jun

    2004-01-01

    The purpose of this study is to evaluate the significance of the hypoplastic canal for the cochlear nerve in patients with sensorineural hearing loss (SNHL) and the relationship between the hypoplastic bony canal and aplasia or hypoplasia of the cochlear nerve. A retrospective review of high resolution temporal CT(HRCT) and MRI findings was conducted. The narrow bony canal of the cochlear nerve and the relative size of the internal auditory canal were correlated with the cochlear nerve deficiency on MRI. The comparative size of the component nerves (facial, cochlear, superior vestibular, inferior vestibular nerve), and the relative size of the internal auditory canal and the bony canal of the cochlear nerve were measured. The clinical history and the results of the clinical examination were reviewed for each patient. High resolution MRI showed aplasia of the common vestibulocochlear nerve in one patient and a deficiency of the cochlear nerve in 9 patients. These abnormalities occurred in association with a prominent narrowing of the canal for the cochlear nerve and a stenosis of the internal auditory canal, which was observed on temporal bone CT in 9 patients with congenital SNHL. Three patients had normal IAC, despite the presence of a hypoplastic cochlear nerve on the side on which they had SNHL. In one patient, the narrowing of the canal for the cochlear nerve and internal auditory canal were not found to be associated with acquired SNHL. The hypoplastic bony canal for the cochlear nerve might be more highly indicative of congenital cochlear nerve deficiency than that of the narrow internal auditory canal, and the position of the crista falciformis should also be carefully

  3. A new alternative for bony chest wall reconstruction using biomaterial artificial rib and pleura: animal experiment and clinical application.

    Science.gov (United States)

    Zhang, Lan-jun; Wang, Wu-ping; Li, Wei-yang; Hao, Chong-li; Li, Zhe; Wu, Qiu-liang; Wu, Rao-pan; Rong, Tie-hua

    2011-10-01

    artificial chest wall to repair bony chest defects. The clinical results corresponded well with those of animal experiments, and thus confirmed the safety and feasibility of this new alternative of chest wall reconstruction. However, a long-term study in a large number is needed due to the small number of animals in this study. Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  4. The anterior cruciate ligament: a study on its bony and soft tissue anatomy using novel 3D CT technology.

    Science.gov (United States)

    Tampere, Thomas; Van Hoof, Tom; Cromheecke, Michiel; Van der Bracht, Hans; Chahla, Jorge; Verdonk, Peter; Victor, Jan

    2017-01-01

    The purpose of this study is twofold: first, to visualize both the tibial and femoral bony insertion surfaces and second, to describe the anterior cruciate ligament (ACL) geometrically, using novel 3D CT imaging. In addition, new concepts of best-fit cylinder and central axis are introduced and evaluated. Eight unpaired knees of embalmed cadavers were used in this study. Following the dissection process, the ACL was injected with a contrast medium for CT imaging. The obtained CT images in extension, 45°, 90° and full flexion were segmented and rendered in 3D allowing morphological and morphometric analysis of the ACL. Anatomical footprint centres, femoral and tibial footprint surface area, best-fit ACL-cylinder intersection area, best-fit ACL-cylinder/footprint coverage ratio, best-fit ACL-cylinder central axis projections at the tibial and femoral footprint in the four positions were used to describe the anatomy of the ACL, based on the Bernard, Hertel and Amis grid. Based on these parameters, with the best-fit cylinder representing the bulk of the ACL, a changing fibre-recruitment pattern was seen with a moving position of the central axis from posterior to anterior on the femoral and tibial footprint, going from extension to flexion. Furthermore, the numerical data show an increase in tibial footprint coverage by the best-fit cylinder through the ACL when the knee is progressively flexed, whereas an inverse relationship was seen on the femoral side. This study is the first to describe the detailed anatomy of the human ACL with respect to its course and footprints using a 3D approach. It confirms the large difference and inter-patient variability between the tibial and femoral footprint area with the former being significantly smaller. The best-fit cylinder concept illustrates the recruitment pattern of the native ACL where in extension the postero-lateral fibres are recruited and in flexion rather the antero-medial bundle, which can be valuable information in

  5. Tracheobronchial puncture-site nodular reaction (TPNR following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA: Systematic review of case reports

    Directory of Open Access Journals (Sweden)

    Karan Madan

    2017-01-01

    Full Text Available Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA is a minimally invasive and efficacious diagnostic modality for lung cancer staging and evaluation of undiagnosed mediastinal lymphadenopathy. Procedure-related complications are uncommon. We herein report an infrequently described phenomenon following EBUS-TBNA in which two patients developed nodular granulation tissue at the tracheobronchial puncture site. On systematic review, we found description of such phenomena by terminologies such as endobronchial inflammatory polyp, granuloma, and endobronchial mass. The endobronchial inflammatory polyp has been one of the most commonly used terminologies for these; but in most cases, the classical features of an inflammatory polyp are lacking. We propose the term, tracheobronchial puncture-site nodular reaction (TPNR with further classification into granulomatous and nongranulomatous subtypes, for standardized reporting of such reactions following transbronchial needle aspiration procedures. Knowledge of this entity and standardized nomenclature shall help in better characterization of the outcomes and risk factors for the occurrence of these reactions.

  6. Oral doxycycline, niacinamide and prednisolone used to treat bilateral nodular granulomatous conjunctivitis of the third eyelid in an Australian Kelpie dog.

    Science.gov (United States)

    Hurn, Simon; Mc Cowan, Christina; Turner, Andrew

    2005-01-01

    A 5-year-old, female neutered, Australian Kelpie presented with a 2-month history of dramatic bilateral erythematous thickening of the third eyelids. Ophthalmic examination demonstrated raised, pink to red, irregular thickening of the entire palpebral surface of both third eyelids. There were no other ocular abnormalities. A surgical biopsy was taken from each third eyelid. Histopathologic examination revealed sheets of macrophages, plasma cells, lymphocytes, and occasional fibroblasts and neutrophils infiltrating the third eyelid stroma. A diagnosis of chronic granulomatous conjunctivitis was made. Grossly and histopathologically this case closely resembles previously described cases of nodular granulomatous conjunctivitis involving the third eyelids of Collie dogs. This report describes an unusual case of nodular granulomatous conjunctivitis isolated to the third eyelids in an Australian Kelpie. Resolution of the condition was achieved with a combination of oral doxycycline, niacinamide and prednisolone.

  7. Tracheobronchial puncture-site nodular reaction (TPNR) following endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): Systematic review of case reports

    Science.gov (United States)

    Madan, Karan; Tiwari, Pavan; Arava, Sudheer; Hadda, Vijay; Mohan, Anant; Guleria, Randeep

    2017-01-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive and efficacious diagnostic modality for lung cancer staging and evaluation of undiagnosed mediastinal lymphadenopathy. Procedure-related complications are uncommon. We herein report an infrequently described phenomenon following EBUS-TBNA in which two patients developed nodular granulation tissue at the tracheobronchial puncture site. On systematic review, we found description of such phenomena by terminologies such as endobronchial inflammatory polyp, granuloma, and endobronchial mass. The endobronchial inflammatory polyp has been one of the most commonly used terminologies for these; but in most cases, the classical features of an inflammatory polyp are lacking. We propose the term, tracheobronchial puncture-site nodular reaction (TPNR) with further classification into granulomatous and nongranulomatous subtypes, for standardized reporting of such reactions following transbronchial needle aspiration procedures. Knowledge of this entity and standardized nomenclature shall help in better characterization of the outcomes and risk factors for the occurrence of these reactions. PMID:29098999

  8. [AGE FEATURES OF PREVALENCE, LOCALISATION AND CLINICAL COURSE OF SOME NODULAR-ULCER FORMS OF BASAL CELL SKIN CANCER OF FACE AND HEAD].

    Science.gov (United States)

    Balakhonov, S I; Iordanishvili, A K

    2015-01-01

    During carrying out clinical trial on the base of Leningrad regional clinical hospital the incidence of basal cell skin cancer of the face and scalp has been studied in adults of different age groups, as well as peculiarities of clinical course of this disease in elderly and senile age. The most commonly encountered clinical form of basal cell cancer of the face and scalp in the Leningrad region was nodular-ulcerative, which was diagnosed in clinical practice in 38.3% of cases. The features of clinical course of superficial, nodular and destruida forms in people of middle, elderly and senile age are given. It is shown that the highest frequency of occurence of these clinical forms were in age of 61-70 years.

  9. Excision of nodular basal cell carcinoma involving the lower eyelid tarsal skin using a grey line-splitting, posterior lamella-sparing technique.

    Science.gov (United States)

    Qin, Vincent; Paridaens, Dion

    2018-02-20

    To describe a posterior lamella-sparing technique to resect nodular basal cell carcinoma involving the inferior part of the tarsal skin of the lower eyelid. Excision of nodular basal cell carcinoma of the tarsal skin using a grey-line-splitting technique with preservation of the posterior lamella. Specimen was sent for frozen section control. Additional excision was performed in caseof irradicality. The defect was closed with a free skin graft from the ipsi- or contralateral upper eyelid. We show a case series of three patients with lower eyelid basal cell carcinoma and investigated radicality on histology, aesthetic outcome and clinical recurrence during a follow-up of 18 months. Pre, intra, and postoperative photographs were obtained. In all cases radicality was reached. In all patients, the skin graft was viable, with no recurrence after 18 months. Excellent aesthetic results were obtained. Anterior lamellar resection of nodular basal cell carcinomas involving the tarsal lower eyelid skin using a grey line lid-splitting technique is a simple and one-step technique with good clinical outcome. It may avoid the morbidity associated with full thickness eyelid resection and might be useful for other, nonmalignant eyelid lesions.

  10. Influence of molding sand on the number of grains graphite and on the rate of thin ferrite in pieces in a nodular iron ferritic matrix

    Directory of Open Access Journals (Sweden)

    B. Khatemi

    2010-07-01

    Full Text Available The nodular cast irons are characterized by high mechanical properties compared to cast iron with lamellar graphite or vermiculargraphite. The ductile iron has already been the subject of many studies especially since the literature is rich on them, and sources of information are different. The fact is that the mechanical properties of nodular cast iron (FGS depend on the number of graphitegrains, their roundness, the solidification rate and nature of the matrix [3]. Many studies of nodular cast irons showed that the morespherical particles of graphite, the higher the mechanical properties are high. In gray cast irons, the graphite spheroids have anticrackingand give the ductile iron ductility. Note in this connection that the higher the number of graphite grains, the higher theductile iron has better mechanical properties. In cast iron, the nature of the matrix is depending on several parameters including thecooling rate of molten metal, the thickness, shape and dimensions of parts. The faster cooling is slow over rate of ferrite is important[3, 4]. In this paper, we tested three types of sand casting: sand –based sodium silicate, furan resin and green sand on samplesspherical graphite cast iron of different thickness. The objective in this article is to determine the number of grains of graphite andferrite for each type of sand casting under the same experimental conditions including the cooling rate and chemical composition ofthe liquid metal.

  11. Nodular malignant melanoma with Spitz nevus-like pathological features finally confirmed by the pathological feature of the sentinel lymph node.

    Science.gov (United States)

    Murakami, Masamoto; Wada, Takashi; Kashiwagi, Takayuki; Ishida-Yamamoto, Akemi; Iizuka, Hajime

    2007-12-01

    The clinical and histopathological similarities of nodular melanoma and Spitz nevus currently still make a definitive diagnosis difficult. We report here a case of nodular melanoma that was extremely difficult to diagnose both clinically and histopathologically. The primary tumor was a blackish nodule on the scalp and biopsy was performed for pathological diagnosis. Although our first impression was malignant melanoma, we asked two dermatopathologists for second opinions; however, one diagnosed a melanoma and the other a Spitz nevus. Faced with this clinical dilemma, an operation was performed with sentinel node biopsy. Only one sentinel node suggested a metastasis. Histopathological diagnosis to establish whether it was a melanoma metastasis or nodal nevi was also difficult, and we again asked for second opinions from another dermatopathologist in the USA. According to its clinical course and the histopathology of the sentinel lymph node with additional immunohistochemistry, this case was finally diagnosed as a nodular melanoma (T4aN1aM0, stage IIIA). To date, the patient has been given five courses of chemotherapy at 6-month intervals, with no local recurrence or distant metastases so far.

  12. Fascitis nodular en la región frontal: a propósito de un caso excepcional y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Fátima Martínez Pérez

    2015-07-01

    Full Text Available La fascitis nodular es una entidad excepcional en el territorio maxilofacial, consiste en una proliferación benigna del tejido fibroblástico, de etiología desconocida y con características clínicas e histopatológicas similares a los sarcomas. La clínica habitual consiste en una masa de consistencia dura, indolora y de rápido crecimiento. Su diagnóstico se realiza mediante una biopsia y un estudio histopatológico. El tratamiento consiste en la exéresis quirúrgica completa de la lesión. El diagnóstico diferencial es esencial dado el alto potencial de confusión diagnóstica con lesiones sarcomatosas debido a la similitud de sus características clínicas e histopatológicas. Se presenta el segundo caso clínico en la literatura de fascitis nodular en la región frontal, un varón de 43 años de edad, sin sufrir traumatismo previo en dicha localización. Se procedió a la biopsia-exéresis de la lesión con el diagnóstico histológico de fascitis nodular. Sin evidencia de recurrencia del tumor y un resultado estético excelente.

  13. Contrast-enhanced ultrasound features of histologically proven focal nodular hyperplasia: diagnostic performance compared with contrast-enhanced CT

    International Nuclear Information System (INIS)

    Wang, Wei; Chen, Li-Da; Liu, Guang-Jian; Xu, Zuo-Feng; Xie, Xiao-Yan; Wang, Yan; Zhou, Lu-Yao; Lu, Ming-De; Shen, Shun-Li

    2013-01-01

    To investigate and compare contrast-enhanced ultrasound (CEUS) in the characterisation of histologically proven focal nodular hyperplasia (FNH) with contrast-enhanced computed tomography (CECT). CEUS was performed in 85 patients with 85 histologically proven FNHs. Enhancement, centrifugal filling, spoke-wheel arteries, feeding artery and central scarring were reviewed and correlated with lesion size or liver background. Independent factors for predicting FNH from other focal liver lesions (FLLs) were evaluated. Forty-seven FLLs with CECT were randomly selected for comparison of diagnostic performance with CEUS. Centrifugal filling was more common (P = 0.002) and the significant predictor (P = 0.003) in FNHs ≤3 cm. Lesion size or liver background has no significant influence on the detection rate of the spoke-wheel arteries and feeding artery (P > 0.05). Central scarring was found in 42.6 % of FNHs ≥3 cm (P = 0.000). The area under the ROC curve, sensitivity and specificity showed no significant differences between CEUS and CECT (P > 0.05), except that the sensitivity of CEUS was better for reader 1 (P = 0.041). CEUS is valuable in characterising centrifugal filling signs or spoke wheels in small FNHs and should be employed as the first-line imaging technique for diagnosis of FNH. (orig.)

  14. Hemangiomas and focal nodular hyperplasia images in contrast-enhanced, wide-band phase-inversion harmonic power Doppler imaging.

    Science.gov (United States)

    Janica, Jacek; Serwatka, Wojciech; Polaków, Jerzy; Ustymowicz, Andrzej; Łebkowska, Urszula; Kordecki, Kazimierz; Walecki, Jerzy; Polaków, Piotr; Dobrzycki, Sławomir

    2004-06-01

    Contrast-enhanced, wide-band, phase inversion power Doppler sonography in the depiction of vasculature in hemangioma and focal nodular hyperplasia. Fifty-one patients with liver lesions (40 FNHs,37 hemangiomas) were prospectively evaluated with conventional, color, power Doppler sonography, tissue harmonic, phase-inversion sonography and helical CT. Levovist was the standard contrast agent used and all examinations were performed on Siemens SONOLINE Elegra equipped with Ensemble Contrast Imaging (ECI) software. Color and power Doppler scans were frequently not specific for these highly vasularized lesions. Images were not suggestive in 15 out of 40 FNHs and not positive in all of 37 hemangiomas). If peripheral enhancement in form of puddle enhancement, 'bloo pools' or rimlike followed by a slow centripetal fill-in is regarded as a positive finding for hemangiomas all lesions were depicted confidently with wide-band, phase inversion, contrast enhanced power Doppler scans. Moreover, all typical vascularity features of FNHs confluence firstly the feeding artery then centrifugal spread of contrast later forming wheel like pattern was obvious in all cases of diagnosed FNHs. Contrast-enhanced, wide-band, PI ,power Doppler imaging is useful method for diagnosing the vascularity of FNHs and hemangiomas. Not only it overcomes the low prediction rate which was the main obstacle for routine use of sonography but it is cheap, portable, and free also from contrast media and radiation.

  15. Performance of FDG PET/CT at initial diagnosis in a rare lymphoma: nodular lymphocyte-predominant Hodgkin lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Grellier, Jean Francois; Weinmann, Pierre [AP-HP- Hopital Europeen Georges Pompidou, Service de medecine nucleaire, Paris (France); Vercellino, Laetitia; Merlet, Pascal; Toubert, Marie-Elisabeth; Berenger, Nathalie [AP-HP- Hopital Saint-Louis, Service de medecine nucleaire, Paris (France); Leblanc, Thierry [Hopital Saint-Louis, Service d' immuno-hematologie, Paris (France); Thieblemont, Catherine [Universite Paris Diderot, Sorbonne Paris Cite - INSERM UMR-S1165, AP-HP- Hopital Saint-Louis, Service d' hemato-Oncologie, Paris (France); Briere, Josette [AP-HP- Hopital Saint-Louis, Service de pathologie, Paris (France); Brice, Pauline [AP-HP- Hopital Saint-Louis, Service d' hemato-Oncologie, Paris (France)

    2014-11-15

    Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare Hodgkin lymphoma distinguished from classical Hodgkin lymphoma (cHL) by the nature of the neoplastic cells which express B-cell markers. We wanted to determine the diagnostic performance of FDG PET/CT in initial assessment and its therapeutic impact on staging. We retrospectively studied a population of 35 patients with NLPHL (8 previously treated for NLHPL, 27 untreated). All patients underwent an initial staging by pretherapeutic FDG PET/CT. The impact on initial stage or relapse stage was assessed by an independent physician. In a per-patient analysis, the sensitivity of the pretherapeutic FDG PET/CT was 100 %. In a per-site analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pretherapeutic FDG PET/CT were 100 %, 99 %, 97 %, 100 % and 99 %, respectively. Pretherapeutic FDG PET/CT led to a change in the initial stage/relapse stage in 12 of the 35 patients (34 %). In contrast to previous results established without FDG PET/CT, 20 % of patient had osteomedullary lesions. Pretherapeutic FDG PET/CT has excellent performance for initial staging or relapse staging of NLPHL. (orig.)

  16. Nodular lymphocyte predominant Hodgkin lymphoma in Sweden between 2000 and 2014: an analysis of the Swedish Lymphoma Registry.

    Science.gov (United States)

    Molin, Daniel; Linderoth, Johan; Wahlin, Björn E

    2017-05-01

    Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is an indolent CD20 + lymphoma. Its scarcity has made clinical trials difficult and there is no consensus on first-line treatment. We conducted a population-based study of all patients diagnosed with NLPHL in Sweden between 2000 and 2014 (N = 158; 41 women and 117 men), focusing on clinical features, therapy and overall survival. The median female and male age was 59 and 44 years, respectively (P = 0·002). In early-stage disease, there was little mortality and no survival differences between therapies. In patients with advanced-stage disease, mortality was relatively high in patients who did not receive first-line rituximab but absent in those who did (10-year survival, 55% vs. 100%; P = 0·033); there were no imbalances of prognostic factors between those two groups. In advanced stages, first-line rituximab use increased markedly between 2000-2004 and 2005-2014 (7% vs. 67%; P < 0·00005), as did 10-year survival, 53% vs. 72% (multivariate P = 0·027). Although all patients were diagnosed in the 2000s, this is the longest-followed (and largest) population-based cohort. We report a hitherto unreported 15-year median age difference between sexes, increasing rituximab use and improved survival. © 2017 John Wiley & Sons Ltd.

  17. [Analysis of 9 cases of nodular type of pulmonary cryptococcosis with coexisting lung cancer confirmed by pathological examinations].

    Science.gov (United States)

    Li, H Y; Lan, C Q; Weng, H; Chen, S X; Lin, Q H; Huang, J B

    2017-11-12

    Objective: To describe the characteristics of the nodular type of pulmonary cryptococcosis (PC) with coexisting lung cancer. Methods: A total of 9 cases of PC with coexisting lung cancer, admitted to Fuzhou Pulmonary Hospital of Fujian from 1st January 2009 to 31th December 2016, and confirmed by pathological examinations, were studied and the related literature were reviewed. Results: The patients consisted of 1 male and 8 females, with a mean age of (53±10) years (range, 38 to 68 years). Four patients (44.4%) had underlying diseases, 3 with diabetes mellitus and 1 with gastric cancer surgery. The main clinical manifestations of most cases were cough and phlegm. The lesions of PC on chest CT were mostly solitary or multiple nodules with a diameter death due to lung cancer metastasis and 1 case with lung cancer recurrence. Conclusions: Coexistence of PC and lung cancer is rare and the clinical symptoms are not specific. When PC coexists with carcinoma and manifests as pulmonary nodule, it mimics malignant lesions and is extremely easy to be misdiagnosed. Therefore PC must be considered in the differential diagnosis of pulmonary nodules.

  18. Statistical Study to Evaluate the Effect of Processing Variables on Shrinkage Incidence During Solidification of Nodular Cast Irons

    Science.gov (United States)

    Gutiérrez, J. M.; Natxiondo, A.; Nieves, J.; Zabala, A.; Sertucha, J.

    2017-04-01

    The study of shrinkage incidence variations in nodular cast irons is an important aspect of manufacturing processes. These variations change the feeding requirements on castings and the optimization of risers' size is consequently affected when avoiding the formation of shrinkage defects. The effect of a number of processing variables on the shrinkage size has been studied using a layout specifically designed for this purpose. The β parameter has been defined as the relative volume reduction from the pouring temperature up to the room temperature. It is observed that shrinkage size and β decrease as effective carbon content increases and when inoculant is added in the pouring stream. A similar effect is found when the parameters selected from cooling curves show high graphite nucleation during solidification of cast irons for a given inoculation level. Pearson statistical analysis has been used to analyze the correlations among all involved variables and a group of Bayesian networks have been subsequently built so as to get the best accurate model for predicting β as a function of the input processing variables. The developed models can be used in foundry plants to study the shrinkage incidence variations in the manufacturing process and to optimize the related costs.

  19. Nodular inflammatory foci are sites of T cell priming and control of murine cytomegalovirus infection in the neonatal lung.

    Directory of Open Access Journals (Sweden)

    Felix R Stahl

    Full Text Available Neonates, including mice and humans, are highly susceptible to cytomegalovirus (CMV infection. However, many aspects of neonatal CMV infections such as viral cell tropism, spatio-temporal distribution of the pathogen as well as genesis of antiviral immunity are unknown. With the use of reporter mutants of the murine cytomegalovirus (MCMV we identified the lung as a primary target of mucosal infection in neonatal mice. Comparative analysis of neonatal and adult mice revealed a delayed control of virus replication in the neonatal lung mucosa explaining the pronounced systemic infection and disease in neonates. This phenomenon was supplemented by a delayed expansion of CD8(+ T cell clones recognizing the viral protein M45 in neonates. We detected viral infection at the single-cell level and observed myeloid cells forming "nodular inflammatory foci" (NIF in the neonatal lung. Co-localization of infected cells within NIFs was associated with their disruption and clearance of the infection. By 2-photon microscopy, we characterized how neonatal antigen-presenting cells (APC interacted with T cells and induced mature adaptive immune responses within such NIFs. We thus define NIFs of the neonatal lung as niches for prolonged MCMV replication and T cell priming but also as sites of infection control.

  20. BRAF-V600E expression in primary nodular melanoma is associated with aggressive tumour features and reduced survival.

    Science.gov (United States)

    Hugdahl, Emilia; Kalvenes, May Britt; Puntervoll, Hanne E; Ladstein, Rita G; Akslen, Lars A

    2016-03-29

    Around 50% of primary melanomas harbour BRAF mutations, but their prognostic impact has not been clear. Recently, a BRAF-V600E mutation-specific antibody has become available for immunohistochemistry. Here, we investigated for the first time the prognostic impact of BRAF-V600E protein expression in primary melanoma. In a patient series of 248 nodular melanomas, BRAF-V600E and total BRAF expression were assessed by immunohistochemistry using tissue microarray sections of paraffin-embedded archival tissue. Mutation status was assessed by real-time PCR in cases with sufficient tumour tissue (n=191). Positive BRAF-V600E expression was present in 86 (35%) of the cases, and was significantly associated with increased tumour thickness, presence of tumour ulceration and reduced survival. Further, BRAF-V600E expression was an independent prognostic factor by multivariate analysis, whereas BRAF mutation status was not significant. There was 88% concordance between BRAF-V600E expression and mutation status. Our findings indicate that BRAF-V600E expression is a novel prognostic marker in primary melanoma.

  1. An assessment of clinical pathways and missed opportunities for the diagnosis of nodular melanoma versus superficial spreading melanoma.

    Science.gov (United States)

    Cicchiello, Mark; Lin, Matthew J; Pan, Yan; McLean, Catriona; Kelly, John W

    2016-05-01

    Missed opportunities in the diagnosis of nodular melanoma (NM) carry high prognostic penalties due to the rapid rate of NM growth. To date, an assessment of the pathways to diagnosis of NM versus superficial spreading melanoma (SSM) specifically comparing numbers of opportunities missed to undertake biopsy has not been performed. A retrospective questionnaire of 120 patients (60 NM patients, age and sex matched to 60 SSM patients) from the Victorian Melanoma Service (VMS) database was undertaken to assess pathways to diagnosis. The numbers of opportunities missed to undertake a biopsy and doctor behaviour at such encounters were recorded. Diagnostic delay (overall, patient's and doctor's delay) in terms of time was assessed. Significant differences in opportunities missed to make a diagnosis of NM compared to SSM were found. In all, 43% of NM were biopsied at a first encounter compared to 70% of SSM. All SSM were diagnosed within three reviews. Overall, 33% of NM required at least three and up six reviews until biopsy. Patients with NM were more likely than those with SSM to be reassured that their lesions were benign. No significant differences in terms of time delay to diagnosis between NM and SSM were found. NM contributes disproportionately to melanoma mortality in Australia. Addressing earlier diagnosis of NM with renewed focus may make the biggest impact on the overall mortality of melanoma. The message that a period of observation is not appropriate for patients re-presenting with lesions of concern must be more effectively communicated. © 2015 The Australasian College of Dermatologists.

  2. "The malignant wart": a review of primary nodular melanoma of the foot and report of two cases.

    Science.gov (United States)

    Schade, Valerie L; Roukis, Thomas S; Homann, Joseph F; Brown, Tommy

    2010-01-01

    The reported incidence of melanoma is rapidly rising and second only to lung cancer. Primary melanoma of the lower extremity accounts for approximately 30% of all cases reported, with half of these cases localized to the foot itself. Unfortunately, melanoma can be misdiagnosed and treatment delayed, as they are usually not painful. The overall 5- and 10-year survival rates improve with early diagnosis and aggressive treatment. This is a report of 2 cases of primary nodular melanoma of the foot initially misdiagnosed as a "wart." Following confirmation with biopsy, definitive surgical intervention in both cases consisted of resection of the primary malignancy and ipsilateral superficial inguinal lymph node basin resection using a multidisciplinary approach to patient care. Given the rapid increase in incidence of melanoma in the general population, one must have a high index of suspicion and low threshold for excisional biopsy of concerning dermatopathology on the foot and lower extremity. Early detection and combined appropriate surgical resection and adjunctive chemotherapeutic treatment of melanoma in a multidisciplinary setting are paramount in decreasing mortality rates. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  3. A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Chong Hyun [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, Seoul (Korea, Republic of); Namwon Medical Center, Department of Radiology, Namwon-si (Korea, Republic of); Kim, Kyung Won [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, Seoul (Korea, Republic of); Harvard Medical School, Department of Imaging, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, MA (United States); Park, Seong Ho [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, Seoul (Korea, Republic of); Shin, Sangjin; Ahn, Jeonghoon [National Evidence-based Healthcare Collaborating Agency, Division of Healthcare Technology Assessment Research, Department of Economic Evaluation, Seoul (Korea, Republic of); Pyo, Junhee [Utrecht University, Collaborating Center for Pharmaceutical Policy and Regulation, Department of Pharmaceutical Science, Utrecht (Netherlands); Shinagare, Atul B.; Krajewski, Katherine M.; Ramaiya, Nikhil H. [Harvard Medical School, Department of Imaging, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, MA (United States)

    2018-01-15

    We evaluated the cost-effectiveness of a gadoxetic acid-enhanced MRI (EOB-MRI) strategy compared with conventional MRI strategy and biopsy to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). A decision tree model was constructed to compare the cost-effectiveness of EOB-MRI, conventional MRI with extracellular contrast agents, and biopsy as the initial diagnostic modality in patients with incidentally detected focal liver lesions suspected of being FNH or HCA. We analysed the cost and effectiveness, i.e. probability of successful diagnosis of each strategy. Costs were based on utilisation rates and Medicare reimbursements in the USA and South Korea. In the base case analysis of our decision tree model, the effectiveness of the three strategies was similar. The cost of the EOB-MRI strategy ($1283 in USA, $813 in South Korea) was lowest compared with the biopsy strategy ($1725 in USA, $847 in South Korea) and the conventional MRI strategy ($1750 in USA, $962 in South Korea). One-way, two-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range. EOB-MRI strategy is the most cost-effective strategy for differentiating FNH from HCA in patients with incidentally detected focal liver lesions in a non-cirrhotic liver. (orig.)

  4. [Trace elements storage peculiarities and metallothionein content in human thyroid gland under iodine deficiency euthyroid nodular goiter].

    Science.gov (United States)

    Fal'fushins'ka, H I; Hnatyshyna, L L; Osadchuk, O Ĭ; Shydlovs'kyĭ, V O; Stoliar, O B

    2014-01-01

    Accumulation of iodine and copper in the node, paranodular and contralateral (not affected tissue by node) tissues of thyroid gland in relation to the level of metal-binding proteins, potential antioxidants and oxidative changes in tissue was investigated. To assess the severity of the pathological process the molecular markers of cytotoxicity were used. The reduction of total iodine (by 19.5%), increase of inorganic iodine fraction (by 82.4%) and total copper content (twice) in paranodular and nodular tissues compared with contrlateral part have been established. Excess of copper in goitrous-changes tissue was partially accumulated in the metallothioneins. The level of metal-binding form of metallothioneins and reserve of free thiols of these proteins was higher two-three times and lower content of reduced glutathione in node-affected tissue compared to the contralateral part. Signs of cytotoxicity among them: higher cathepsine D free activity (up to 84.6% and 134.4% in paranodular tissue and node respectively) and higher level of DNA strand breaks in the node (up to 22.6%) were observed. In paranodular tissue the range of indices variability compared with parenchyma of contralateral part is shorter than in the node. Thus, under low level of iodine organification and high copper level in goitrous-modified tissue of thyroid gland metallothionein may provide a partial compensatory effect on prooxidative processes.

  5. A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma

    International Nuclear Information System (INIS)

    Suh, Chong Hyun; Kim, Kyung Won; Park, Seong Ho; Shin, Sangjin; Ahn, Jeonghoon; Pyo, Junhee; Shinagare, Atul B.; Krajewski, Katherine M.; Ramaiya, Nikhil H.

    2018-01-01

    We evaluated the cost-effectiveness of a gadoxetic acid-enhanced MRI (EOB-MRI) strategy compared with conventional MRI strategy and biopsy to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). A decision tree model was constructed to compare the cost-effectiveness of EOB-MRI, conventional MRI with extracellular contrast agents, and biopsy as the initial diagnostic modality in patients with incidentally detected focal liver lesions suspected of being FNH or HCA. We analysed the cost and effectiveness, i.e. probability of successful diagnosis of each strategy. Costs were based on utilisation rates and Medicare reimbursements in the USA and South Korea. In the base case analysis of our decision tree model, the effectiveness of the three strategies was similar. The cost of the EOB-MRI strategy ($1283 in USA, $813 in South Korea) was lowest compared with the biopsy strategy ($1725 in USA, $847 in South Korea) and the conventional MRI strategy ($1750 in USA, $962 in South Korea). One-way, two-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range. EOB-MRI strategy is the most cost-effective strategy for differentiating FNH from HCA in patients with incidentally detected focal liver lesions in a non-cirrhotic liver. (orig.)

  6. Unsharp masking technique as a preprocessing filter for improvement of 3D-CT image of bony structure in the maxillofacial region

    International Nuclear Information System (INIS)

    Harada, Takuya; Nishikawa, Keiichi; Kuroyanagi, Kinya

    1998-01-01

    We evaluated the usefulness of the unsharp masking technique as a preprocessing filter to improve 3D-CT images of bony structure in the maxillofacial region. The effect of the unsharp masking technique with several combinations of mask size and weighting factor on image resolution was investigated using a spatial frequency phantom made of bone-equivalent material. The 3D-CT images were obtained with scans perpendicular to and parallel to the phantom plates. The contrast transfer function (CTF) and the full width at half maximum (FWHM) of each spatial frequency component were measured. The FWHM was expressed as a ratio against the actual thickness of phantom plate. The effect on pseudoforamina was assessed using sliced CT images obtained in clinical bony 3D-CT examinations. The effect of the unsharp masking technique on image quality was also visually evaluated using five clinical fracture cases. CTFs did not change. FWHM ratios of original 3D-CT images were smaller than 1.0, regardless of the scanning direction. Those in scans perpendicular to the phantom plates were not changed by the unsharp masking technique. Those in parallel scanning were increased by mask size and weighting factor. The area of pseudoforamina decreased with increases in mask size and weighting factor. The combination of mask size 3 x 3 pixels and weighting factor 5 was optimal. Visual evaluation indicated that preprocessing with the unsharp masking technique improved the image quality of the 3D-CT images. The unsharp masking technique is useful as a preprocessing filter to improve the 3D-CT image of bony structure in the maxillofacial region. (author)

  7. Scales and dermal skeletal histology of an early bony fish Psarolepis romeri and their bearing on the evolution of rhombic scales and hard tissues.

    Directory of Open Access Journals (Sweden)

    Qingming Qu

    Full Text Available Recent discoveries of early bony fishes from the Silurian and earliest Devonian of South China (e.g. Psarolepis, Achoania, Meemannia, Styloichthys and Guiyu have been crucial in understanding the origin and early diversification of the osteichthyans (bony fishes and tetrapods. All these early fishes, except Guiyu, have their dermal skeletal surface punctured by relatively large pore openings. However, among these early fishes little is known about scale morphology and dermal skeletal histology. Here we report new data about the scales and dermal skeletal histology of Psarolepis romeri, a taxon with important implications for studying the phylogeny of early gnathostomes and early osteichthyans. Seven subtypes of rhombic scales with similar histological composition and surface sculpture are referred to Psarolepis romeri. They are generally thick and show a faint antero-dorsal process and a broad peg-and-socket structure. In contrast to previously reported rhombic scales of osteichthyans, these scales bear a neck between crown and base as in acanthodian scales. Histologically, the crown is composed of several generations of odontodes and an irregular canal system connecting cylindrical pore cavities. Younger odontodes are deposited on older ones both superpositionally and areally. The bony tissues forming the keel of the scale are shown to be lamellar bone with plywood-like structure, whereas the other parts of the base are composed of pseudo-lamellar bone with parallel collagen fibers. The unique tissue combination in the keel (i.e., extrinsic Sharpey's fibers orthogonal to the intrinsic orthogonal sets of collagen fibers has rarely been reported in the keel of other rhombic scales. The new data provide insights into the early evolution of rhombic (ganoid and cosmoid scales in osteichthyans, and add to our knowledge of hard tissues of early vertebrates.

  8. Bone fragment union and remodeling after arthroscopic bony bankart repair for traumatic anterior shoulder instability with a glenoid defect: influence on postoperative recurrence of instability.

    Science.gov (United States)

    Nakagawa, Shigeto; Ozaki, Ritsuro; Take, Yasuhiro; Mae, Tatsuo; Hayashida, Kenji

    2015-06-01

    Although good clinical outcomes have been reported after arthroscopic bony Bankart repair, the extent of bone union is still unclear. To investigate bone union after arthroscopic bony Bankart repair and its influence on postoperative recurrence of instability. Cohort study; Level of evidence, 3. Among 113 consecutive shoulders that underwent arthroscopic bony Bankart repair, postoperative evaluation of bone union by computed tomography (CT) was performed at various times in 81 shoulders. Bone union was investigated during 3 periods: 3 to 6 months postoperatively (first period), 7 to 12 months postoperatively (second period), and 13 months or more postoperatively (third period). The influence of the size of the preoperative glenoid defect and the size of the bone fragment on bone union was investigated, as well as the influence of bone union on postoperative recurrence of instability. In shoulders with bone union, bone fragment remodeling and changes in the glenoid defect size were also investigated. The bone union rate was 30.5% in the first period, 55.3% in the second period, and 84.6% in the third period. Among 53 shoulders with CT evaluation in the second period or later and follow-up for a minimum of 1 year, there was complete union in 33 shoulders (62.3%), partial union in 3 (5.7%), nonunion in 8 (15.1%), and no fragment on CT in 9 (17.0%). The complete union rate was 50% for 22 shoulders with small bone fragments (10%). The recurrence rate for postoperative instability was only 6.1% for shoulders with complete union, while it was 50% for shoulders with partial union, nonunion, no fragment, and no fragment on CT. The recurrence rate was significantly higher (36.4%) in shoulders with small fragments, but it was significantly lower in shoulders with bone union. In shoulders with bone union, the bone fragment frequently became larger over time, while the size of the glenoid defect decreased significantly from 18.6% preoperatively to 4.7% postoperatively. Bone

  9. Comparison of prostate set-up accuracy and margins with off-line bony anatomy corrections and online implanted fiducial-based corrections.

    Science.gov (United States)

    Greer, P B; Dahl, K; Ebert, M A; Wratten, C; White, M; Denham, J W

    2008-10-01

    The aim of the study was to determine prostate set-up accuracy and set-up margins with off-line bony anatomy-based imaging protocols, compared with online implanted fiducial marker-based imaging with daily corrections. Eleven patients were treated with implanted prostate fiducial markers and online set-up corrections. Pretreatment orthogonal electronic portal images were acquired to determine couch shifts and verification images were acquired during treatment to measure residual set-up error. The prostate set-up errors that would result from skin marker set-up, off-line bony anatomy-based protocols and online fiducial marker-based corrections were determined. Set-up margins were calculated for each set-up technique using the percentage of encompassed isocentres and a margin recipe. The prostate systematic set-up errors in the medial-lateral, superior-inferior and anterior-posterior directions for skin marker set-up were 2.2, 3.6 and 4.5 mm (1 standard deviation). For our bony anatomy-based off-line protocol the prostate systematic set-up errors were 1.6, 2.5 and 4.4 mm. For the online fiducial based set-up the results were 0.5, 1.4 and 1.4 mm. A prostate systematic error of 10.2 mm was uncorrected by the off-line bone protocol in one patient. Set-up margins calculated to encompass 98% of prostate set-up shifts were 11-14 mm with bone off-line set-up and 4-7 mm with online fiducial markers. Margins from the van Herk margin recipe were generally 1-2 mm smaller. Bony anatomy-based set-up protocols improve the group prostate set-up error compared with skin marks; however, large prostate systematic errors can remain undetected or systematic errors increased for individual patients. The margin required for set-up errors was found to be 10-15 mm unless implanted fiducial markers are available for treatment guidance.

  10. Comparison of prostate set-up accuracy and margins with off-line bony anatomy corrections and online implanted fiducial-based corrections

    International Nuclear Information System (INIS)

    Greer, P. B.; Dahl, K.; Ebert, M. A.; Wratten, C.; White, M.; Denham, K. W.

    2008-01-01

    Full text: The aim of the study was to determine prostate set-up accuracy and set-up margins with off-line bony anatomy-based imaging protocols, compared with online implanted fiducial marker-based imaging with daily corrections. Eleven patients were treated with implanted prostate fiducial markers and online set-up corrections. Pretreatment orthogonal electronic portal images were acquired to determine couch shifts and verification images were acquired during treatment to measure residual set-up error. The prostate set-up errors that would result from skin marker set-up, off-line bony anatomy-based protocols and online fiducial marker-based corrections were determined. Set-up margins were calculated for each set-up technique using the percentage of encompassed isocentres land a margin recipe. The prostate systematic set-up errors in the medial-lateral, superior-inferior and anterior-I posterior directions for skin marker set-up were 2.2, 3.6 and 4.5 mm (1 standard deviation). For our bony anatomy-I based off-line protocol the prostate systematic set-up errors were 1.6, 2.5 and 4.4 mm. For the online fiducial based set-up the results were 0.5, 1.4 and 1.4 mm. A prostate systematic error of 10.2 mm was uncorrected by the off-line bone protocol in one patient. Set-up margins calculated to encompass 98% of prostate set-up shifts were 111-14 mm with bone off-line set-up and 4-7 mm with online fiducial markers. Margins from the van Herk margin I recipe were generally 1-2 mm smaller. Bony anatomy-based set-up protocols improve the group prostate set-up error compared with skin marks; however, large prostate systematic errors can remain undetected or systematic (errors increased for individual patients. The margin required for set-up errors was found to be 10-15 mm unless I implanted fiducial markers are available for treatment guidance.

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

    Directory of Open Access Journals (Sweden)

    Luís Fernando Pracchia

    2005-10-01

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

  12. Standalone Anterior Cervical Discectomy and Fusion Versus Combination with Foraminotomy for the Treatment of Cervical Spondylotic Radiculopathy Secondary to Bony Foraminal Stenosis.

    Science.gov (United States)

    Guo, Qunfeng; Wang, Liang; Zhang, Bangke; Jiang, Jiayao; Guo, Xiang; Lu, Xuhua; Ni, Bin

    2016-11-01

    To compare the results of anterior cervical discectomy and fusion (ACDF) combined with anterior cervical foraminotomy (ACF) and standalone ACDF for the treatment of cervical spondylotic radiculopathy (CSR). The data of 24 consecutive patients who underwent ACDF combined with ACF for significant bony foraminal stenosis were reviewed. The clinical outcomes, including visual analog scale (VAS) scores for neck pain and arm pain and Neck Disability Index, were evaluated by questionnaires. Radiologic outcomes as manifested by C2-7 angle and surgical segmental angle were recorded. The outcomes were compared with outcomes of standalone ACDF for CSR secondary to posterolateral spurs. At the final follow-up evaluation, all patients obtained bone fusion. No patient developed adjacent segment disease. Operative time was longer and blood loss was more in the ACDF combined with ACF group than in the ACDF group (all P 0.05). For CSR with foraminal stenosis secondary to significant bony pathology that cannot be managed with standalone ACDF, ACDF combined with ACF is an effective and safe treatment strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Prevalence of bony septa, antral pathology, and dimensions of the maxillary sinus from a sinus augmentation perspective: A retrospective cone-beam computed tomography study

    International Nuclear Information System (INIS)

    Tadinada, Aditya; Jalali, Elnaz; Al Salman, Wesam; Jambhekar, Shantanu; Katechia, Bina; Almas, Khalid

    2016-01-01

    Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy

  14. Prevalence of bony septa, antral pathology, and dimensions of the maxillary sinus from a sinus augmentation perspective: A retrospective cone-beam computed tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Tadinada, Aditya; Jalali, Elnaz; Al Salman, Wesam; Jambhekar, Shantanu; Katechia, Bina [University of Connecticut, School of Dental Medicine, Farmington (United States); Almas, Khalid [Div. of Periodontology, University of Dammam, College of Dentistry, Dammam (Saudi Arabia)

    2016-06-15

    Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy.

  15. Evaluation by biphotonic absorbtiometry of the bony mineral content and determination of the fracture threshold in a population of patients between the ages of 60 and 75 years

    Energy Technology Data Exchange (ETDEWEB)

    Duquesnoy, B.; Ythier, H.; Thevenon, A.; Cantegrit, F.; Tison-Muchery, F.; Marchandise, X.; Delcambre, B.

    1987-01-01

    A measurement of the bony density of vertebrae and femur was carried out, in the course of a prospective study, in 99 patients between the ages of 60 and 75 years, living in northern France. 76 patients had no recognized problem of demineralization and 23 others were consulting for an evaluation of vertebral compression. The measurement of the bony density was done by biphotonic absorbtiometry with a source of labelled Gadolinium. In women, a significant difference in the values obtained by absorbtiometry in terms of the existence of vertebral compressions, symptomatic or not, is noted. A statistical study using the ROC curves method (Receiver Operating System) has enabled us to determine a threshold of high risk of vertebral fracture measured at 31 g or 0.85 g/cm/sup 2/ in women, and 35 g or 0.85 g/cm/sup 2/ in men. In addition, there is a significant correlation with the vertebral radiographical index as defined by Meunier. Among the various factors of influence which were studied, only the size and the morphotype seem to play an essential role in our study group. The comparative study of the densities measured in the femoral neck and the lumbar spine enabled us to find a very significant correlation in patients with as well as without compression. Biphotonic absorbtiometry proves therefore to be a method which may be used to define a group with a high fracture risk permitting to determine, as early as possible, therapeutic, curative and preventive measures.

  16. Detection of nodular pulmonary amyloid by PET positive scan—Deception for lung cancer

    Directory of Open Access Journals (Sweden)

    A.M. Khan

    2012-11-01

    pulmão tanto em formas localizadas como sistémicas da doença. As manifestações da doença pulmonar relacionadas com a AL variam desde nódulos identificados em incidências de raio-X do tórax até à deposição septal, simulando malignidade, e/ou em danos difusos alveolares. Keywords: Amyloidosis, Nodular, Local, PET scan, Tracheobronchial amyloidosis, Lung diseases, Palavras-chave: Amiloidose, Nodular, Local, Tomografia de emissão positrónica (TEP, Amiloidose traqueobrônquica, Doenças pulmonares

  17. The relationship between iron deficiency in patients with Helicobacter pylori-infected nodular gastritis and the serum prohepcidin level.

    Science.gov (United States)

    Sato, Yuichi; Yoneyama, Osamu; Azumaya, Masaki; Takeuchi, Manabu; Sasaki, Syun-ya; Yokoyama, Junji; Shioji, Kazuhiko; Kawauchi, Yusuke; Hashimoto, Satoru; Nishigaki, Yuuki; Kobayashi, Masaaki; Sugimura, Kazuhito; Honma, Terasu; Narisawa, Rintaro; Aoyagi, Yutaka

    2015-02-01

    Helicobacter pylori (H. pylori) is recognized as a causative agent for unexplained iron-deficiency anemia (IDA). We evaluated many background factors influencing an iron-deficiency state in adult patients with various H. pylori-infected upper gastrointestinal tract diseases. Study 1: H. pylori-infected 121 patients (nodular gastritis (NG) (n = 19), duodenal ulcer (DU) (n = 30), or gastric ulcer (GU) (n = 47), or gastric hyperplastic polyp (GHP) (n = 25)) were enrolled. The RBC count and hemoglobin, iron, ferritin, pepsinogen (PG) I, PG II, gastrin, and anti-H. pylori antibody (Ab) levels in the serum were measured. Study 2: H. pylori-infected 105 patients (NG, n = 19; DU, n = 43; GU, n = 32; GHP, n = 11) and non-H. pylori-infected individuals (n = 35) were examined for the levels of prohepcidin, ferritin, and iron in the serum. In addition, we measured the data before and after the H. pylori eradication. In the patients with GHP and NG, hypoferritinemia was observed in comparison with the GU and DU patients. In the GHP patients, low levels of PG I, a decreased PG I/II ratio, and hypergastrinemia were observed. The levels of serum prohepcidin in the patients with H. pylori-associated disease were higher than those in the uninfected adults. In the patients with NG, the serum prohepcidin levels were higher than those in the other H. pylori-infected patient groups and decreased after the eradication. H. pylori-related iron-deficiency state might be associated with several factors, such as hypochlorhydria and hepcidin, in patients with GHP or NG. © 2014 John Wiley & Sons Ltd.

  18. An unusual case of left hepatectomy for Focal Nodular Hyperplasia (FNH) linked to the use of Anabolic Androgenic Steroids (AASs).

    Science.gov (United States)

    Romano, Angela; Grassia, Michele; Esposito, Giuseppe; Petrillo, Marianna; Pezzella, Modestino; Romano, Francesco Maria; Esposito, Francesco; Torelli, Francesco; Di Martino, Natale

    2017-01-01

    Focal Nodular Hyperplasia (FNH) is the second most common benign tumor of the liver. Clinically FNH is asymptomatic and discovered incidentally . The pathogenesis is unclear; FNH is usually asymptomatic. When the tumor is large, it may be painful. Surgery is recommended only in the case of complications such as compression of adjacent organs, lesion progression with tumor size >5cm and presence of symptoms. A 30 years old man, was evaluated during a routine visit, for diffuse abdominal pain and weight loss; Abdominal ultrasound showed no evidence of biliary obstruction but the US shows a hypoechoic, well defined focal lesion in the left liver. For a more accurate diagnosis a Magnetic Resonance detected a focal area about 14×9 cm in diameter, hypointense. Liver biopsy was not done.We could not diagnose it definitively as FNH from the results of imaging studies; so for the size of symptomatic lesion, the undefined diagnosis of FNH ,and due to the great increase in the size of the mass located in the left lobe, during such a short period , the surgery was been recommended. FNH is the second most common hepatic lesion, but clinically relevant cases of FNH are rare with a reported prevalence in US studies of 0,03%. In our case the young patient was taking dietary supplements including anabolic androgenic steroids (AASs), carnitine and l-arginine. The particularity of our case is the increasing of the lesion in two years in which the patient made use of anabolic steroids. under use of . This could be the explanation for increasing of nodule. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. The role of diagnostic imaging and liver biopsy in the diagnosis of focal nodular hyperplasia in children.

    Science.gov (United States)

    Valentino, Pamela L; Ling, Simon C; Ng, Vicky L; John, Philip; Bonasoni, Paola; Castro, Denise A; Taylor, Glenn; Chavhan, Govind B; Kamath, Binita M

    2014-02-01

    Focal nodular hyperplasia (FNH), a benign liver tumour, has a characteristic appearance on diagnostic imaging (DI) and histology. The role of liver biopsy in children for the diagnosis of FNH is unclear. This study investigates the diagnostic accuracy of DI for FNH in children without comorbidities, compared to liver biopsy. A total of 304 consecutive patients (age liver mass were retrospectively ascertained (1990-2010). Individuals with a history of malignancy, liver disease or syndromes with increased malignancy risk were excluded. DI and biopsy data were reviewed. After excluding 205 cases, 99 liver masses were studied. Based on histology, the most common diagnosis was hepatoblastoma (46/99, 44%) followed by FNH (23/99, 23%). The mean age at FNH diagnosis was 11.1 ± 5.2 years, with female preponderance (78%), and a median follow-up of 1.35 years (interquartile range 0.54, 4.20 years). 19/23 biopsy-proven FNH met standard criteria for FNH on DI. In 4/23 cases of biopsy-proven FNH, imaging did not suggest FNH. Two false positive cases included adenoma and fibrolamellar hepatocellular carcinoma. On review of original reports, DI had 82.6% sensitivity and 97.4% specificity for the diagnosis of FNH. On blind review, the sensitivity of DI for FNH diagnosis was 81.3% for MRI (13/16), and 53.3% for CT (8/15). In this cohort of children with liver masses and no comorbidities, a diagnosis of FNH by imaging was highly specific, and MRI was the most sensitive study for its diagnosis. Liver biopsy may be deferred in selected children if the DI, particularly MRI, is indicative of FNH. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Preoperative TSH level and risk of thyroid cancer in patients with nodular thyroid disease: nodule size contribution.

    Science.gov (United States)

    Zafón, Carles; Obiols, Gabriel; Mesa, Jordi

    2015-01-01

    Many reports have supported the relationship between high preoperative TSH levels and risk of thyroid cancer in nodular thyroid disease (NTD). We investigated whether TSH levels are related to the risk of differentiated thyroid carcinoma (DTC) in patients who have undergone total thyroidectomy for NTD. The relationship between TSH and size of malignant nodule was investigated. Finally, we assessed whether TSH levels are related to DTC and presence of additional benign nodules. A retrospective study of 980 patients was conducted. Variables included age at diagnosis, TSH level, nodule size, gender, final histology (benign versus DTC), and type of malignancy. Malignancy was present in 261 (26.6%) patients. These patients had higher median TSH levels as compared to those with no malignancy (1.61 mU/L (0.9-2.5) versus 0.9 mU/L (0.3-1.6); p-value<0.001). TSH was higher in patients with DTC in whom the largest nodule was malignant than in patients in whom the largest nodule was benign (1.80 mU/L (1.1-2.6) versus 1.38 mU/L (0.7-2.1) respectively; p-value=0.025). A significant correlation was seen between malignant nodule size and TSH level, but not between TSH levels and size of the largest benign nodule. Our study supported an association between preoperative TSH levels and risk of DTC in patients with NTD. There was also a direct relationship between malignant nodule size and TSH levels. By contrast, no relationship was found between the size of benign nodules and TSH levels. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.