[POSTRESUSCITATION CICATRICIAL TRACHEAL STENOSIS. CURRENT STATE OF THE PROBLEM - THE SUCCESSES, THE HOPES AND DISAPPOINTMENTS.

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Parshin, V D; Vyzhigina, M A; Rusakov, M A; Parshin, V V; Titov, V A; Starostin, A V

2016-09-01

Currently, the trend continues to increase the number ofpatients with cicatricial tracheal stenosis (CTS). Therefore, prevention and treatment ofthis disease remains topical. The main cause ofcicatricial tracheal stenosis is damaging the trachea during mechanical ventilation. The scheme ofprevention of this disease in Russia hasn't brought the desired results. to clarify the modern etiology of cicatricial tracheal stenosis, to identify the trend in incidence rates, to determine whether there is an optimal safe alternative to tracheostomy including the use of minimally invasive techniques, to improve diagnostic and therapeutic algorithm at various stages of assistance, and also to study the results of innovative operations and new ways of maintaining gas exchange. 1128 patients with cicatricial tracheal stenosis was treated from 1963 to 2015 in Petrovsky National Research Centre of Surgery and IMSechenov First Moscow State Medical University. Over time methods of di- agnosis, methods of anesthesia and operations have been varied. In this regard all patients were divided into two groups depending on the period of time from 1963 to 2000 (297 patients) andfrom 2001 to 2015 (831 patients). In recent decades there is a steady increase in the number of treated patients. So, if in the first group during the year operational treatment about the CTS 8,0 patients were underwent, in the second - to 55.4. Cicatricial tracheal stenosis appeared after lung mechanical ventilation at 1025 (for 90.9%) patients. They have undergone both radical one-stage treatment and multi-stage and sequential intraluminal procedures. In general there is a clear trend towards more aggressive surgical tactics. So, if in thefirst group, the tracheal resection with anastomosis was performedin 59 patients only, the second-330. Thefrequency ofpostoperative complications and mortality in the second group ofpatients was 12.9 and 0.7 %, respectively. Only a reasonable combination of all treatment methods

TGF-β1 induces an age-dependent inflammation of nerve ganglia and fibroplasia in the prostate gland stroma of a novel transgenic mouse.

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David A Barron

2010-10-01

Full Text Available TGF-β1 is overexpressed in wound repair and in most proliferative disorders including benign prostatic hyperplasia and prostate cancer. The stromal microenvironment at these sites is reactive and typified by altered phenotype, matrix deposition, inflammatory responses, and alterations in nerve density and biology. TGF-β1 is known to modulate several stromal responses; however there are few transgenic models to study its integrated biology. To address the actions of TGF-β1 in prostate disorders, we targeted expression of an epitope tagged and constitutively active TGF-β1 via the enhanced probasin promoter to the murine prostate gland epithelium. Transgenic mice developed age-dependent lesions leading to severe, yet focal attenuation of epithelium, and a discontinuous basal lamina. These changes were associated with elevated fibroplasia and frequency of collagenous micronodules in collapsed acini, along with an induced inflammation in nerve ganglia and small vessels. Elevated recruitment of CD115+ myeloid cells but not mature macrophages was observed in nerve ganglia, also in an age-dependent manner. Similar phenotypic changes were observed using a human prostate epithelium tissue recombination xenograft model, where epithelial cells engineered to overexpress TGF-β1 induced fibrosis and altered matrix deposition concurrent with inflammation in the stromal compartment. Together, these data suggest that elevated TGF-β1 expression induces a fibroplasia stromal response associated with breach of epithelial wall structure and inflammatory involvement of nerve ganglia and vessels. The novel findings of ganglia and vessel inflammation associated with formation of collagenous micronodules in collapsed acini is important as each of these are observed in human prostate carcinoma and may play a role in disease progression.

Retinopathy of Prematurity: Clinical Features, Classification, Natural History, Management and Outcome.

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Shah, Parag K; Prabhu, Vishma; Ranjan, Ratnesh; Narendran, Venkatapathy; Kalpana, Narendran

2016-11-07

Retinopathy of prematurity is an avoidable cause of childhood blindness. Proper understanding of the classification and treatment methods is a must in tackling this disease. Literature search with PubMed was conducted covering the period 1940-2015 with regards to retinopathy of prematurity, retrolental fibroplasia, its natural history, classification and treatment. The clinical features, screening and staging of retinopathy of prematurity according to International classification of retinopathy of prematurity (ICROP) has been included with illustrations. The standard current treatment indications, modalities and outcomes from landmark randomized controlled trials on retinopathy of prematurity have been mentioned. This review would help pediatricians to update their current knowledge on classification and treatment of retinopathy of prematurity. Screening for retinopathy of prematurity, in India, should be performed in all preterm neonates who are born <34 weeks gestation and/or <1750 grams birthweight; as well as in babies 34-36 weeks gestation or 1750-2000 grams birthweight if they have risk factors for ROP. Screening should start by one month after birth.

Central centrifugal cicatricial alopecia: challenges and solutions

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Herskovitz I

2016-08-01

Full Text Available Ingrid Herskovitz, Mariya Miteva Department of Dermatology and Cutaneous Surgery, University of Miami L Miller School of Medicine, Miami, FL, USA Abstract: Central centrifugal cicatricial alopecia (CCCA is the most common scarring alopecia among African American women. Data about epidemiology, etiology, genetic inheritance, and management are scarce and come from individual reports or small series. CCCA has been associated with hot combing and traumatic hair styling for years; however, studies fail to confirm it as the sole etiologic factor. It has been shown in a small series that CCCA can be inherited in an autosomal dominant fashion, with a partial penetrance and a strong modifying effect of hairstyling and sex. CCCA presents clinically as a central area of progressive irreversible hair loss that expands to the periphery. A patchy form has also been described. Dermoscopy is helpful to identify the optimal site for the biopsy, which establishes the diagnosis. Well-designed randomized controlled trials are needed to discover the optimal management. At this point, patients are advised to avoid traction and chemical treatments; topical and intralesional steroids, calcineurin inhibitors, and minoxidil can be helpful in halting the progression. Keywords: hair loss, alopecia, dermatoscopy, dermoscopy, trichoscopy, black scalp, African American, scarring alopecia

Central centrifugal cicatricial alopecia amalgamated with alopecia areata: immunologic findings

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Ana Maria Abreu Velez

2014-07-01

Full Text Available Introduction: Both scarring and non-scarring alopecias exist; however, rare cases demonstrate features of both classes. Case Report: We describe an interesting alopecia case with amalgamated clinical, histologic and immunopathologic features of scarring and non-scarring alopecia. Specifically, the case displays combined features of alopecia areata (AA and of central centrifugal cicatricial alopecia (CCCA. A 36 year old female presented with symmetric, round, patchy hair loss on her scalp. Methods: Biopsies for hematoxylin and eosin (H&E examination, as well as for special stains, direct immunofluorescence (DIF and immunohistochemistry (IHC were performed. Results: The H&E biopsy revealed focally diminished hair follicular units, and sebaceous gland damage. Perifollicular concentric fibrosis was confirmed by Verhoeff elastin special staining. Antibodies to micelles were noted. Positive IHC staining for CD4, CD8, CD45 and multiple proteases and protease inhibitors was noted around selected follicular unit remnants. Conclusion: We present a rare alopecia, combining histologic features of CCCA with additional, selected immunologic features of AA.

Shrimp diet and skin healing strength in rats Dieta com camarão e resistência cicatricial da pele, em ratos

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Elizabeth Lage Borges

2007-06-01

Full Text Available OBJECTIVE: Surgical scar tensile strength may be influenced by several factors such as drugs, hormones and diet. The purpose of the present study was to determine the influence of a shrimp-enriched diet on the tensile strength of rat scars. METHODS: Forty male Wistar rats were submitted to a 4 cm dorsal skin incision and the wounds were sutured with 5-0 nylon interrupted suture. The animals were divided into two groups: Group 1 (control received a regular diet, and Group 2 (experimental received a shrimp-enriched diet. The two diets contained the same amounts of proteins, lipids and carbohydrates. The rats in each group were divided into two subgroups according to the time of assessment of the scar tensile strength: subgroup A, studied on the 5th postoperative day, and subgroup B, studied on the 21st postoperative day. RESULTS: The tensile strength of the scar on the 5th postoperative day was lower in the animals that received the shrimp-enriched-diet (303.0, standard error of mean= 34.1 than in the control group (460.1, SEM = 56.7 (pOBJETIVO: A resistência cicatricial da pele pode ser influenciada por diversos fatores como medicamentos, hormônios e dieta. Este trabalho foi delineado para determinar a influência da dieta com camarão na resistência cicatricial na pele. MÉTODOS: Quarenta ratos machos Wistar foram submetidos a incisão (4cm e suturas interrompidas da pele dorsal, com fio de nylon 5-0, e foram divididos em dois grupos: o Grupo 1 (controle recebeu uma dieta convencional e Grupo 2 (experimental, recebeu dieta com adição de com camarão. As duas dietas continham quantidades semelhantes de proteína, lipídeos, e carboidratos. Os ratos de cada grupo foram divididos em dois subgrupos de acordo com os distintos períodos pós-operatórios de avaliação da resistência tecidual: subgrupo A, estudado no 5° dia pós-operatório, e subgrupo B, estudado no 21° dia pós-operatório. RESULTADOS: A resistência cicatricial da pele no 5

Application of paclitaxel as adjuvant treatment for benign cicatricial airway stenosis.

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Qiu, Xiao-Jian; Zhang, Jie; Wang, Juan; Wang, Yu-Ling; Xu, Min

2016-12-01

Benign cicatricial airway stenosis (BCAS) is a potentially life-threatening disease. Recurrence occurs frequently after endoscopic treatment. Paclitaxel is known to prevent restenosis, but its clinical efficacy and safety is undetermined. Therefore, in this study, we investigated the efficacy and associated complications of paclitaxel as adjuvant treatment for BCAS of different etiologies. The study cohort included 28 patients with BCAS resulting from tuberculosis, intubation, tracheotomy, and other etiologies. All patients were treated at the Department of Respiratory Diseases, Beijing Tian Tan Hospital, Capital Medical University, China, between January 2010 and August 2014. After primary treatment by balloon dilation, cryotherapy, and/or high-frequency needle-knife treatment, paclitaxel was applied to the airway mucosa at the site of stenosis using a newly developed local instillation catheter. The primary outcome measures were the therapeutic efficacy of paclitaxel as adjuvant treatment, and the incidence of complications was observed as well. According to our criteria for evaluating the clinical effects on BCAS, 24 of the 28 cases achieved durable remission, three cases had remission, and one case showed no remission. Thus, the durable remission rate was 85.7%, and the combined effective rate was 96.4%. No differences in outcomes were observed among the different BCAS etiologies (P=0.144), and few complications were observed. Our results indicated that paclitaxel as an adjuvant treatment has greater efficacy than previously reported BCAS treatment methods.

Retinopathy of prematurity: Past, present and future

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Shah, Parag K; Prabhu, Vishma; Karandikar, Smita S; Ranjan, Ratnesh; Narendran, Venkatapathy; Kalpana, Narendran

2016-01-01

Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina occurring principally in new born preterm infants. It is an avoidable cause of childhood blindness. With the increase in the survival of preterm babies, ROP has become the leading cause of preventable childhood blindness throughout the world. A simple screening test done within a few weeks after birth by an ophthalmologist can avoid this preventable blindness. Although screening guidelines and protocols are strictly followed in the developed nations, it lacks in developing economies like India and China, which have the highest number of preterm deliveries in the world. The burden of this blindness in these countries is set to increase tremendously in the future, if corrective steps are not taken immediately. ROP first emerged in 1940s and 1950s, when it was called retrolental fibroplasia. Several epidemics of this disease were and are still occurring in different regions of the world and since then a lot of research has been done on this disease. However, till date very few comprehensive review articles covering all the aspects of ROP are published. This review highlights the past, present and future strategies in managing this disease. It would help the pediatricians to update their current knowledge on ROP. PMID:26862500

Influence of local or systemic corticosteroids on skin wound healing resistance Influência de corticosteróide local e sistêmico no processo cicatricial cutâneo

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Luiz Ronaldo Alberti

2012-04-01

Full Text Available PURPOSE: To compare the resistance of skin wound healing of mice submitted to local or systemic hydrocortisone administration, in different postoperative periods. METHODS: An incision and suture was performed on the thoracic skin of 130 male mice: Group 1 (n = 10 resistance of the integer skin; Group 2 (n = 30 submitted only to skin incision and suture; Group 3 (n = 30 skin incision and suture followed by administration of saline fluid; Group 4 (n = 30 skin incision and suture followed by administration of local hydrocortisone; Group 5 (n = 30 skin incision and suture followed by administration of systemic hydrocortisone. The resistance of the wound healing and the weight of the animals were studied on the seventh, 14th and 21st postoperative days. Histological examination was also performed. RESULTS: The mice that received corticoid (groups 4 and 5 presented significant decreasing on their weight (p = 0.02. The Groups 3, 4 and 5 showed lower scar resistance than Group 2 on the seventh postoperative day (p 0.05. CONCLUSION: Administration of hydrocortisone in mice is responsible for weight decreasing and reduction of the skin wound healing resistance during the first postoperative week.OBJETIVO: Comparar a resistência cicatricial cutânea de camundongos submetidos a administração de hidrocortisona por diferentes vias e em distintos períodos pós-operatórios. MÉTODOS: Foram estudados 130 camundongos machos submetidos à incisão e sutura de pele da região dorsal do tórax: Grupo 1 (n = 10 resistência da pele íntegra; Grupo 2 (n = 30 incisão da pele e sutura, sem administração de corticóide; Grupo 3 (n = 30 incisão da pele e sutura, seguidas de injeção local de solução salina; Grupo 4 (n = 30 incisão da pele e sutura, seguidas de injeção local de hidrocortisona e Grupo 5 (n = 30 incisão da pele e sutura, seguidas de injeção intraperitoneal de hidrocortisona. Foram avaliadas a resistência cicatricial da pele e a varia

Nonstent Combination Interventional Therapy for Treatment of Benign Cicatricial Airway Stenosis.

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Qiu, Xiao-Jian; Zhang, Jie; Wang, Ting; Pei, Ying-Hua; Xu, Min

2015-08-20

Benign cicatricial airway stenosis (BCAS) is a life-threatening disease. While there are numerous therapies, all have their defects, and stenosis can easily become recurrent. This study aimed to investigate the efficacy and complications of nonstent combination interventional therapy (NSCIT) when used for the treatment of BCAS of different causes and types. This study enrolled a cohort of patients with BCAS resulting from tuberculosis, intubation, tracheotomy, and other origins. The patients were assigned to three groups determined by their type of stenosis: Web-like stenosis, granulation stenosis, and complex stenosis, and all patients received NSCIT. The efficacy and complications of treatment in each group of patients were observed. The Chi-square test, one-factor analysis of variance (ANOVA), and the paired t -test were used to analyze different parameters. The 10 patients with web-like stenosis and six patients with granulation stenosis exhibited durable remission rates of 100%. Among 41 patients with complex stenosis, 36 cases (88%) experienced remission and 29 cases (71%) experienced durable remission. When five patients with airway collapse were eliminated from the analysis, the overall remission rate was 97%. The average treatment durations for patients with web-like stenosis, granulation stenosis, and complex stenosis were 101, 21, and 110 days, respectively, and the average number of treatments was five, two, and five, respectively. NSCIT demonstrated good therapeutic efficacy and was associated with few complications. However, this approach was ineffective for treating patients with airway collapse or malacia.

[Segmental tracheal resection and anastomosis for the treatment of cicatricial stenosis in cervical tracheal].

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Cui, P C; Luo, J S; Liu, Z; Bian, K; Guo, Z H; Ma, R N

2016-02-01

To evaluate the efficacy of segmental tracheal resection with end-to-end anastomosis for cicatricial cervical tracheal stenosis. The clinical outcomes of 40 patients treated with tracheal resection were retrospectively reviewed. There were 28 male patients and 12 female patients with the age ranged from 6 to 64 years (mean 33.7 years). The degree of stenosis was classified according to Myer-Cotton classification as follows: grade Ⅱ (n=7), grade Ⅲ (n=22) and grade Ⅳ (n=11). The stenosis extension ranged from 1.0 to 4.3 cm (mean 2.5 cm). The causes of the stenosis were postintubation (n=33), cervical trauma (n=6) and resection of tracheal neoplasm (n=1). Thirty-four(85.0%) patients were decannulated and 6 failed. Of the 6 patients failed, 4 were decannulated after reoperation with the sternohyoid myocutaneous flap or thyroid alar cartilage graft. Complications occurred in 10 patients. In 8 patients granulation tissues formed at the site of the tracheal anastomosis, which needed endoscopic resction, and in 2 patients anastomosic dehiscence occurred. No injury to recurrent laryngeal nerve or trachoesophageal fistula occurred. Segmental tracheal resection with end-to-end anastomosis is an effective surgical method for tracheal stenosis, which has a higher successful rate for primary operation and shorter therapeutic period.

Central Centrifugal Cicatricial Alopecia in Children: A Case Series and Review of the Literature.

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Eginli, Ariana N; Dlova, Ncoza C; McMichael, Amy

2017-03-01

Central centrifugal cicatricial alopecia (CCCA) is a form of scarring hair loss most commonly seen in middle-aged African and African American women. It is rarely reported in children. The objective of the current study was to document the presence of CCCA in children and to encourage physicians to recognize early signs of CCCA in children of affected adults. Six children presented with biopsy-proven CCCA to the Department of Dermatology at Wake Forest Baptist Health and the Nelson R. Mandela School of Medicine from 2012 to 2015. Demographic characteristics, hair styling history, and family history of CCCA were noted. Examination included complete history, skin and scalp examination, photographs of the scalp, and scalp biopsies. Patient ages ranged from 14 to 19 years (mean age at onset 14 years). Five patients reported scalp symptoms such as tender papules, pruritus, and scaling. Four patients reported appreciable hair loss on the vertex of the scalp. One patient had used chemical relaxers and hair dyes in the past. Five patients had a known family history of CCCA. Because CCCA is not typically seen or suspected in children, it is likely to be misdiagnosed or underreported. The findings in these cases add weight to the concept that genetic susceptibility rather than hair care practices may play a significant role in causing CCCA. © 2016 Wiley Periodicals, Inc.

Riesgo de daño renal cicatrizal después de infección del tracto urinario en recién nacidos Risk of cicatricial renal damage after urinary tract infection in newborns

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Manuel Díaz Alvarez

2007-03-01

Full Text Available El presente trabajo se realizó con el objetivo de determinar la prevalencia de daño renal cicatrizal e identificar los factores de riesgo a él contribuyentes en niños recién nacidos con la primera infección del tracto urinario. Se llevó a cabo un estudio analítico de factores de riesgo, caso-control, con regresión logística binominal, en recién nacidos con infección del tracto urinario de localización alta, adquirida en la comunidad, que fueron ingresados consecutivamente en el Hospital Pediátrico Universitario «Juan M. Márquez», entre febrero de 1992 y diciembre de 2004. Se realizó gammagrafía renal con DMSA para identificar cicatrices renales. Las pruebas de chi cuadrado y regresión logística se aplicaron para identificar factores de riesgo independientes. La prevalencia de daño renal cicatrizal fue de 25,4 %. En el modelo de regresión se incluyeron para análisis multivariado los factores de riesgo: ultrasonido prenatal con pielectasia, microorganismo diferente de Escherichia coli, ultrasonido renal posnatal con anomalías, presencia de reflujo vesicoureteral de cualquier grado, reinfección en los primeros 3 meses de vida, sexo masculino, retardo en inicio del tratamiento antibiótico ≥ 4 d, leucocituria ≥ 10 000/mL, respuesta desfavorable al tratamiento inicial y bacteriemia al mismo microorganismo de la infección urinaria. Finalmente solo resultaron significativos (p The present paper was aimed at determining the prevalence of cicatricial renal damage and to identify the risk factors contributing to it in newborns with urinary tract infection for the first time. An analytical case-control study of the risk factors was conducted by binominal logistic regression in newborns with an upper urinary tract infection acquired in the community that were consecutively admitted in “ Juan Manuel Márquez” University Children Hospital from February 1992 to December 2004. A renal scintigraphy with DMSA was performed to

Morfometria de fibroblastos e fibrócitos durante o processo cicatricial na pele de coelhos da raça Nova Zelândia Branco tratados com calêndula Morphometry of fibroblasts and fibrocytes during wound healing in the skin of rabbits of the New Zeland White breed treated with marigold

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Leonardo de Oliveira Pagnano

2008-09-01

Full Text Available O objetivo deste estudo foi avaliar a capacidade cicatrizante da calêndula (Calendula officinalis L. sobre feridas cutâneas experimentais, em 15 coelhos, distribuídos em três grupos denominados: excipiente, calêndula e controle. Cada animal foi submetido à uma incisão cirúrgica de 6cm de comprimento, lateral à coluna vertebral e suturada no padrão U. Os produtos avaliados foram colocados sobre as incisões durante sete dias na quantidade de 0,1ml (loção cremosa não-iônica - grupo excipiente; tintura de calêndula a 5% - grupo calêndula e nos animais do grupo controle não se utilizou nenhum produto. A biópsia de pele foi realizada no 1°, 3°, 5° e 7° dia após a incisão cirúrgica para avaliação morfométrica do processo cicatricial, analisando-se o número de fibroblastos e fibrócitos. A morfometria foi realizada por meio de microscópio óptico adaptado a um sistema computadorizado de análise de imagens. De acordo com os resultados, a calêndula propiciou obtenção dos maiores valores médios das células envolvidas no processo cicatricial, os fibroblastos, deduzindo que a mesma, inferiu uma resposta mais satisfatória na cicatrização em relação aos demais tratamentos.The aim of this study was to evaluate the scarring capability of marigold (Calendula officinalis L. on experimental skin wounds in 15 rabbits, distributed in three groups: excipient, marigold and control. Each animal was subjected to a surgical incision measuring 6cm in length, laterally to the spinal column and sutured in U-shape. Products evaluated were placed on the incisions for 7 days, at a rate of 0.1ml (nonionic creamy lotion - excipient group; 5% marigold extract and no treatment was provided to control animals. Skin biopsy was performed on 1, 3, 5, and 7 days after wounding, for morphometric and cicatricial process evaluations. The morphometry was performed with an optical microscope adapted to a computadorized picture analysis system. The

Hypoxia-induced retinal neovascularization in zebrafish embryos: a potential model of retinopathy of prematurity.

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Wu, Yu-Ching; Chang, Chao-Yuan; Kao, Alex; Hsi, Brian; Lee, Shwu-Huey; Chen, Yau-Hung; Wang, I-Jong

2015-01-01

Retinopathy of prematurity, formerly known as a retrolental fibroplasia, is a leading cause of infantile blindness worldwide. Retinopathy of prematurity is caused by the failure of central retinal vessels to reach the retinal periphery, creating a nonperfused peripheral retina, resulting in retinal hypoxia, neovascularization, vitreous hemorrhage, vitreoretinal fibrosis, and loss of vision. We established a potential retinopathy of prematurity model by using a green fluorescent vascular endothelium zebrafish transgenic line treated with cobalt chloride (a hypoxia-inducing agent), followed by GS4012 (a vascular endothelial growth factor inducer) at 24 hours postfertilization, and observed that the number of vascular branches and sprouts significantly increased in the central retinal vascular trunks 2-4 days after treatment. We created an angiography method by using tetramethylrhodamine dextran, which exhibited severe vascular leakage through the vessel wall into the surrounding retinal tissues. The quantification of mRNA extracted from the heads of the larvae by using real-time quantitative polymerase chain reaction revealed a twofold increase in vegfaa and vegfr2 expression compared with the control group, indicating increased vascular endothelial growth factor signaling in the hypoxic condition. In addition, we demonstrated that the hypoxic insult could be effectively rescued by several antivascular endothelial growth factor agents such as SU5416, bevacizumab, and ranibizumab. In conclusion, we provide a simple, highly reproducible, and clinically relevant retinopathy of prematurity model based on zebrafish embryos; this model may serve as a useful platform for clarifying the mechanisms of human retinopathy of prematurity and its progression.

Effects of Vitamin E in Neonates and Young Infants

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Gian Maria Pacifici

2016-05-01

Full Text Available Vitamin E (alpha-tocopherol is a potent and natural antioxidant. Vitamin E is concentrated from soybean oil. The Committee on Fetus and Newborn of the Academy of the American of Pediatrics endorsed 1 to 2 mg/dl as the normal range of serum tocopherol level. Human infants are born with low stores of vitamin E, thus they require an adequate intake of vitamin E soon after birth. The optimum intravenous dose of vitamin E is 2.8 mg/kg per day (maximum 7 mg/kg per day. Treating very-low-birth-weight infants with 100 mg/kg vitamin E for >1 week results in levels >3.5 mg/dl and significantly reduces the risks of severe retinopathy, intracranial hemorrhage, hemolytic anemia, chronic lung disease, retrolental fibroplasia and incidence and severity of intraventricular hemorrhage, but increases the risks of sepsis, necrotizing enterocolitis and can cause retinal hemorrhage in very-low-birth-weight infants. Vitamin E supplementation prevents the isolated vitamin E deficiency that causes spinocerebellar symptoms. The major benefits arising from elevated dosages of vitamin E have been the relief of symptoms of vitamin E deficiency in infants with abetalipoproteinamia and chronic cholestasis. Excessive doses of vitamin E may result in side effects and careful monitoring of vitamin E is thus essential. Neonates born to mothers treated with high doses of vitamin E have significantly lower birth weight compared to neonates born to untreated mothers. Vitamin E is not teratogenic. The aim of this study was to review the effects of vitamin E in neonates and young infants.

Estudo morfométrico e morfológico da cicatrização após uso do laser erbium: YAG em tecidos cutâneos de ratos Morphometrical and morphological study of cicatricial effects caused by application of laser erbium: YAG on the skin of rats

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Lúcia de Noronha

2004-02-01

Full Text Available Este trabalho analisa o efeito da reparação cutânea do laser erbium:yttrium aluminunn garnet (YAG (Er:YAG em pele de ratos através de estudo histológico e morfométrico. Tatuaram-se duas figuras no dorso de cada animal (n = 35, denominadas controle e experimento. Na figura experimento, aplicaram-se três passadas de laser Er:YAG com parâmetros padronizados. Cinco animais foram eutanasiados nos dias 0, 7, 14, 28, 56, 84 e 112 de pós-operatório. O estudo histológico demonstrou no dia 0 dano de ablação médio de 215,24 micrômetros (mm, sendo homogêneo com vaporização da epiderme e porções superficiais da derme. O dano térmico residual foi pequeno (média de 41,45mm, observando-se áreas onde estava praticamente ausente. A fibroplasia cicatricial já estava presente no dia 7 (média de 55,58mm, aumentando rapidamente até o dia 28 (média de 209,49mm, quando atingiu um platô e se manteve até o dia 112. Não houve sinais de processo inflamatório agudo no dia 7 e a reepitelização já estava completa. Concluiu-se que a aplicação de laser na pele de ratos induz reparação cutânea ao longo de 112 dias nas condições do experimento.This study analyses the skin contracture effect of the erbium:YAG (Er:YAG laser on the skin of rats by light microscopic histological and morphometrical evaluations. Two squares of back skin were precision tattooed on each of the animals (n = 35, that were termed control and experimental skin. The experimental skin was treated with three passes of the Er:YAG laser with standardized parameters. Five animals were killed and skin specimens were analyzed at 00, 07, 14, 28, 56, 84 and 112 days. Histologic examination demonstrated a mean of 215.24 micrometers ablative damage that was homogeneous with complete vaporization of the epidermis and superficial dermis. The residual thermal damage was small (mean of 41.45 micrometers observing areas where it was absent. The cicatritial fibroplasy was present at

Adiaspiromicose humana: lesões cicatriciais em linfonodos do mediastino Human adiaspiromycosis: cicatricial lesions in mediastinal lymph nodes

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Mário A.P. Moraes

2004-03-01

Full Text Available Em paciente de 60 anos, sexo masculino, com diagnóstico radiográfico de massa tumoral no pulmão direito - depois reconhecida, por meio de biópsia transbrônquica, como de natureza maligna -, não se descobriu qualquer evidência tomográfica de metástases a distância. Resolveu-se então, para fins de estadiamento da neoplasia, obter material de linfonodos mediastinais. O exame microscópico desse material não demonstrou invasão neoplásica, mas revelou a presença de granulomas em avançado estádio de fibrose, contendo raras estruturas redondas, vazias, de parede espessa e, quase sempre, colapsada, que foram reconhecidas como adiaconídios de Emmonsia crescens. Havia ainda, nos cortes histológicos, grande quantidade de pigmento antracótico.Chest roentgenogram of a sixty-year-old male patient, revealed a tumoral mass in the right lung, that was later demonstrated by transbronchial biopsy, to be a bronchogenic adenocarcinoma. There was no tomographic evidence of distant metastasis, however, in order to assess the mediastinal involvement for staging of the tumor, biopsies from the regional lymph nodes were obtained. Microscopic examination of the sample tissues failed to show any metastatic lesion, but, unexpectedly, revealed the presence of cicatricial granulomas in an advanced stage of fibrosis. They contained a few round, empty and collapsed corpuscles, limited by a thick PAS-positive, membrane. These structures were identified as adiaconidia of Emmonsia crescens, the etiological agent of human adiaspiromycosis. In the tissue sections, a large amount of carbon dust (anthracosis was also seen.

Neocolagenização induzida pelo resurfacing com laser erbium:YAG isolado e associado a lifting cutâneo: estudo morfométrico comparativo em ratos Comparison of single erbium:YAG laser resurfacing to a combination with cutaneous lifting: a morphometric study of neocollagenization in rats

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Lucia Noronha

2005-10-01

Full Text Available INTRODUÇÃO: Diferente do lifting, cuja tração mecânica é a responsável pelo efeito clínico de rejuvenescimento sobre rugas profundas, a fibroplasia (ou neocolagenização é a responsável direta pelo resultado final da ação do laser sobre a pele com rugas superficiais, conferindo-lhe aparência mais jovem. O uso combinado dessas duas técnicas pode ser vantajoso, pois permite um resultado estético melhor com um único procedimento anestésico e cirúrgico em um curto período de recuperação. OBJETIVOS: O presente estudo morfométrico se propõe a avaliar se ocorre alguma alteração na espessura da fibroplasia induzida pelo resurfacing a laser erbium:YAG quando este se associa ao lifting cutâneo. MÉTODO: Foram utilizados 50 ratos da linhagem Wistar, divididos em dois grupos de 25, sendo que o primeiro grupo foi submetido à aplicação exclusiva de laser erbium:YAG no dorso de cada animal e o outro sofreu a aplicação de laser Erbium: YAG combinada ao lifting, o qual foi representado, no animal de experimentação, por retalho cutâneo dorsal pediculado. A fibroplasia foi avaliada nos dois grupos com medidas morfométricas lineares realizadas após o sacrifício dos animais nos dias 14, 28, 56, 84 e 112 do pós-operatório. RESULTADO: Foi observado aumento da fibroplasia em ambos os grupos estudados, porém o crescimento do colágeno foi superior no grupo submetido à terapia isolada com laser Erbium: YAG. CONCLUSÃO: A espessura da fibroplasia induzida pelo resurfacing a laser Erbium: YAG foi influenciada pela associação de um segundo procedimento cirúrgico no mesmo tempo operatório, neste caso, o lifting cutâneo.INTRODUCTION: The fibroplasia is the responsible for the final aesthetic results induced by laser resurfacing upon skin with superficial wrinkles. On the other hand, the lifting is responsible for the deeper wrinkles removal, produced by mechanic results. The use of the combination of these two rejuvenation

Percutaneous transhepatic cholangiobiopsy to determine the pathological cause of anastomotic stenosis after cholangiojejunostomy for malignant obstructive jaundice

International Nuclear Information System (INIS)

Li, T.-F.; Ren, K.-W.; Han, X.-W.; Li, W.-C.; Ren, J.-L.; Jiao, D.-C.; Li, Z.; Ma, J.

2014-01-01

Aim: To investigate the feasibility and advantages of cholangiobiopsy during percutaneous transhepatic cholangiography in the histopathological diagnosis of anastomotic stenosis after cholangiojejunostomy for malignant obstructive jaundice. Materials and methods: Using biopsy forceps, specimens were collected from the site of stenosis in patients with recurrent jaundice (n = 24) who had previously undergone cholangiojejunostomy for malignant obstructive jaundice. Results: Stenosis occurred in all patients at the biliary–enteric anastomosis based on percutaneous transhepatic cholangiography, and was the location of the biopsy. Satisfactory specimens were obtained from 22 out of 24 patients. The sensitivity was 91.7% (22/24). Tumour tissue was obtained in 18 cases, confirming disease recurrence. Histopathological changes in four patients were diagnosed as fibroplasia and/or inflammation. These were considered cicatricial stenoses based on histopathological, imaging, and laboratory findings. The remaining two histopathology-negative patients were proven to have recurrent tumour based on imaging, laboratory, and follow-up data. No complications occurred during biopsy, including gastrointestinal haemorrhage or perforation. Either cholangial drainage and/or an inner stent was used following biopsy, which resulted in a noticeable decrease in jaundice postoperatively (p < 0.05). Conclusion: Percutaneous transhepatic cholangiobiopsy using biopsy forceps for the diagnosis of anastomotic stenosis after cholangiojejunostomy for malignant biliary obstructive jaundice is easy to perform and safe, with a high level of sensitivity. Interventional therapies, such as percutaneous transhepatic cholangial drainage and stent placement, can be performed concurrently, markedly improving the symptoms of patients with obstructive jaundice

Pharmacological consequences of oxidative stress in ocular tissues

International Nuclear Information System (INIS)

Ohia, Sunny E.; Opere, Catherine A.; LeDay, Angela M.

2005-01-01

The eye is a unique organ because of its constant exposure to radiation, atmospheric oxygen, environmental chemicals and physical abrasion. That oxidative stress mechanisms in ocular tissues have been hypothesized to play a role in diseases such as glaucoma, cataract, uveitis, retrolental fibroplasias, age-related macular degeneration and various forms of retinopathy provides an opportunity for new approaches to their prevention and treatment, In the anterior uvea, both H 2 O 2 and synthetic peroxides exert pharmacological/toxicological actions tissues of the anterior uvea especially on the sympathetic nerves and smooth muscles of the iris-ciliary bodies of several mammalian species. Effects produced by peroxides require the presence of trace amounts of extracellular calcium and the functional integrity of mitochondrial calcium stores. Arachidonic acid metabolites appear to be involved in both the excitatory action of peroxides on sympathetic neurotransmission and their inhibitory effect on contractility of the iris smooth muscle to muscarinic receptor activation. In addition to the peroxides, isoprostanes (products of free radical catalyzed peroxidation of arachidonic acid independent of the cyclo-oxygenase enzyme) can also alter sympathetic neurotransmission in anterior uveal tissues. In the retina, both H 2 O 2 and synthetic peroxides produced an inhibitory action on potassium depolarization induced release of [ 3 H] D-aspartate, in vitro and on the endogenous glutamate and glycine concentrations in vivo. Effects caused by peroxides in the retina are mediated, at least in part, by second messengers such as nitric oxide, prostaglandins and isoprostanes. The ability of H 2 O 2 to alter the integrity of neurotransmitter pools from sympathetic nerves in the anterior uvea and glutaminergic nerves in the retina could underlie its role in the etiology of glaucoma

Pharmacological consequences of oxidative stress in ocular tissues

Energy Technology Data Exchange (ETDEWEB)

Ohia, Sunny E. [Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, 141 Science and Research Building 2, University of Houston, Houston, TX 77204 (United States)]. E-mail: seohia@uh.edu; Opere, Catherine A. [Department of Pharmacy Sciences, School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, NE 68178 (United States); LeDay, Angela M. [Professional and Scientific Relations, Procter and Gamble Pharmaceuticals Inc., Mason, OH 45040 (United States)

2005-11-11

The eye is a unique organ because of its constant exposure to radiation, atmospheric oxygen, environmental chemicals and physical abrasion. That oxidative stress mechanisms in ocular tissues have been hypothesized to play a role in diseases such as glaucoma, cataract, uveitis, retrolental fibroplasias, age-related macular degeneration and various forms of retinopathy provides an opportunity for new approaches to their prevention and treatment, In the anterior uvea, both H{sub 2}O{sub 2} and synthetic peroxides exert pharmacological/toxicological actions tissues of the anterior uvea especially on the sympathetic nerves and smooth muscles of the iris-ciliary bodies of several mammalian species. Effects produced by peroxides require the presence of trace amounts of extracellular calcium and the functional integrity of mitochondrial calcium stores. Arachidonic acid metabolites appear to be involved in both the excitatory action of peroxides on sympathetic neurotransmission and their inhibitory effect on contractility of the iris smooth muscle to muscarinic receptor activation. In addition to the peroxides, isoprostanes (products of free radical catalyzed peroxidation of arachidonic acid independent of the cyclo-oxygenase enzyme) can also alter sympathetic neurotransmission in anterior uveal tissues. In the retina, both H{sub 2}O{sub 2} and synthetic peroxides produced an inhibitory action on potassium depolarization induced release of [{sup 3}H] D-aspartate, in vitro and on the endogenous glutamate and glycine concentrations in vivo. Effects caused by peroxides in the retina are mediated, at least in part, by second messengers such as nitric oxide, prostaglandins and isoprostanes. The ability of H{sub 2}O{sub 2} to alter the integrity of neurotransmitter pools from sympathetic nerves in the anterior uvea and glutaminergic nerves in the retina could underlie its role in the etiology of glaucoma.

Intraocular pressure control with Ahmed glaucoma drainage device in patients with cicatricial ocular surface disease-associated or aniridia-related glaucoma.

Science.gov (United States)

Almousa, Radwan; Lake, Damian B

2014-08-01

To analyze the control of intraocular pressure (IOP) with an Ahmed glaucoma drainage device (AGDD) in two groups of glaucoma patients--one with cicatricial ocular surface disease (COSD) and one with aniridia. This is a retrospective comparative case series of nine patients (11 eyes) with COSD and six patients (8 eyes) with aniridia who underwent AGDD surgery to control IOP. The main outcome measure in both groups was stability of IOP between 6 and 21 mmHg. Mean IOP decreased significantly in both groups after AGDD surgery (29.6 ± 8.7 vs 14.7 ± 2.5, p = 0.008 in the COSD group; 26.3 ± 8.2 vs 15.3 ± 5.8, p = 0.008 in the aniridia group). Over a mean post-surgery follow-up of 37.1 months in the COSD group, we managed to control IOP in nine eyes; IOP control was successful in 87 % of eyes at 12 months and 58 % of eyes at 26 months. Over a mean post-surgery follow-up of 37.4 months in the aniridia group, we managed to control the IOP in seven eyes; IOP control was successful in 87 % of eyes at 12 months. AGDD surgery had no significant deleterious effect on visual acuity in either group. A severe complication occurred in one eye (1/8) in the aniridia group (lost vision due to retinal detachment) and in one eye (1/11) in the COSD group (tube exposure). AGDD surgery is effective in controlling IOP and has a low complication rate in COSD and aniridia patients; however, some of the complications are severe and prompt management is needed to prevent deleterious results.

Neutrophil Collagenase, Gelatinase and Myeloperoxidase in Tears of Stevens-Johnson Syndrome and Ocular Cicatricial Pemphigoid Patients

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Arafat, Samer N.; Suelves, Ana M.; Spurr-Michaud, Sandra; Chodosh, James; Foster, C. Stephen; Dohlman, Claes H.; Gipson, Ilene K.

2013-01-01

Objective To investigate the levels of matrix metalloproteinases (MMPs), myeloperoxidase (MPO) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in tears of patients with Stevens-Johnson syndrome (SJS) and ocular cicatricial pemphigoid (OCP). Design Prospective non-interventional cohort study. Participants Four SJS patients (7 eyes), 19 OCP patients (37 eyes) and 20 post-phacoemulsification healthy controls (40 eyes). Methods Tear washes were collected from all patients and were analyzed for levels of MMP-2, -3, -7, -8, -9, -12, MPO and TIMP-1 using multi-analyte bead-based enzyme-linked immunosorbent assays (ELISA). Total MMP activity was determined using a fluorimetric assay. Correlation studies were performed between the various analytes within study groups. Main Outcome Measures Levels of MMP-2, -3, -7, -8, -9, -12, MPO and TIMP-1 (in ng/µg protein), total MMP activity (in relative fluorescent units/min/µg protein) in tears, MMP-8/TIMP-1, MMP-9/TIMP-1 ratios and the correlations between MMP-8 and MMP-9 and each MMP and MPO. Results MMP-8, MMP-9 and MPO levels were significantly elevated in SJS and OCP tears (SJS > OCP) when compared to controls. MMP activity was highest in SJS while OCP and controls showed lower and similar activities. TIMP-1 levels were decreased in SJS and OCP when compared to controls with OCP levels reaching significance. MMP-8/TIMP-1 and MMP-9/TIMP-1 ratios were markedly elevated in SJS and OCP tears (SJS > OCP) when compared to controls. Across all study groups, MMP-9 levels correlated strongly with MMP-8 and MPO levels and MMP-8 correlated with MPO but did not reach significance in SJS. There was no relationship between MMP-7 and MPO. Conclusions Since MMP-8 and MPO are produced by inflammatory cells, particularly neutrophils, the correlation data indicate that they may be the common source of elevated enzymes including MMP-9 in SJS and OCP tears. Elevated MMP/TIMP ratios and MMP activity suggest an imbalance in tear MMP regulation

Cicatricial Alopecia

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... this research; and the dissemination of information on research progress in these diseases. Contact Us NIAMS Archive Viewers and Players Social Media Moderation Policy FOIA Privacy Statement Accessibility Disclaimer Digital Strategy ...

Cicatricial Pemphigoid

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... can usually prevent blindness. © 2005 American Academy of Oral and Maxillofacial Pathology 214 North Hale Street Wheaton, IL 60187 Tel.: 630-510-4552 Fax: 630-510-4501 Toll Free: 888-552-2667 Email: ... mucous membranes, that is, the moist linings of the mouth, the eyes, the nose and throat, and the ...

Identification of epitopes within integrin β4 for binding of auto-antibodies in ocular cicatricial and mucous membrane pemphigoid: preliminary report.

Science.gov (United States)

Rashid, Khwaja Aftab; Foster, C Stephen; Ahmed, A Razzaque

2013-11-19

To identify the epitopes on human β4 integrin to which the sera of patients with ocular cicatricial pemphigoid (OCP) and mucous membrane pemphigoid (MMP) without ocular involvement bind. Fragments of the intracellular domain of the β4 molecule were cloned, expressed, purified and peptides were synthesized. Antibodies to various fragments and peptides were produced in rabbits. Binding specificity was determined via Western blot and blocking experiments. Test sera and controls were injected into neonatal BALB/c mice for in vivo passive transfer. Sera from patients with OCP, MMP, and both OCP and MMP were bound to cloned fragments of IC3.0. Its subcloned fragments IC3.4 (1489 aa-1572 aa) and IC3.4.1 (1489 aa-1510 aa) were bound with the sera from patients with OCP only. Subcloned fragments IC3.6 (1573 aa-1822 aa) and IC3.6.1 (1689 aa-1702 aa) were bound with MMP sera only. No cross-reactivity in binding was observed. Immuno-affinity-purified sera from patients with OCP, MMP, and rabbit antibodies to IC3.0, IC3.4, IC3.4.1, IC3.6, and IC3.6.1, when injected in neonatal BALB/c mice, produced subepidermal blisters in their skin. These preliminary observations identified IC3.4.1 as the possible epitope for the binding of OCP auto-antibody and IC3.6.1 as the possible epitope for the binding of MMP auto-antibody without ocular disease. Antibodies specific to these peptides produced blisters when injected in mice. Still-unidentified epitopes may exist. These observations may enhance our understanding of the role of β4 integrin in the pathobiology of OCP and MMP. Early diagnosis may be possible if serologic tests with specificity and sensitivity can be developed.

Neutrophil collagenase, gelatinase, and myeloperoxidase in tears of patients with stevens-johnson syndrome and ocular cicatricial pemphigoid.

Science.gov (United States)

Arafat, Samer N; Suelves, Ana M; Spurr-Michaud, Sandra; Chodosh, James; Foster, C Stephen; Dohlman, Claes H; Gipson, Ilene K

2014-01-01

To investigate the levels of matrix metalloproteinases (MMPs), myeloperoxidase (MPO), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in tears of patients with Stevens-Johnson syndrome (SJS) and ocular cicatricial pemphigoid (OCP). Prospective, noninterventional cohort study. Four SJS patients (7 eyes), 19 OCP patients (37 eyes), and 20 healthy controls who underwent phacoemulsification (40 eyes). Tear washes were collected from all patients and were analyzed for levels of MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-12, MPO, and TIMP-1 using multianalyte bead-based enzyme-linked immunosorbent assays. Total MMP activity was determined using a fluorometric assay. Correlation studies were performed between the various analytes within study groups. Levels of MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-12, MPO, and TIMP-1 (in nanograms per microgram of protein) and total MMP activity (in relative fluorescent units per minute per microgram of protein) in tears; MMP-8-to-TIMP-1 ratio; MMP-9-to-TIMP-1 ratio; and the correlations between MMP-8 and MMP-9 and both MMP and MPO. MMP-8, MMP-9, and MPO levels were elevated significantly in SJS and OCP tears (SJS>OCP) when compared with controls. The MMP activity was highest in SJS patients, whereas OCP patients and controls showed lower and similar activities. The TIMP-1 levels were decreased in SJS and OCP patients when compared with those in controls, with levels in OCP patients reaching significance. The MMP-8-to-TIMP-1 and MMP-9-to-TIMP-1 ratios were markedly elevated in SJS and OCP tears (SJS>OCP) when compared with those of controls. Across all study groups, MMP-9 levels correlated strongly with MMP-8 and MPO levels, and MMP-8 correlated with MPO, but it did not reach significance in SJS patients. There was no relationship between MMP-7 and MPO. Because MMP-8 and MPO are produced by inflammatory cells, particularly neutrophils, the correlation data indicate that they may be the common source of elevated enzymes, including MMP-9

O polissacarídeo do Anacardium occidentale L. na fase inflamatória do processo cicatricial de lesões cutâneas

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Schirato Giuliana Viegas

2006-01-01

Full Text Available O efeito do polissacarídeo de Anacardium occidentale L. (POLICAJU foi avaliado na fase inflamatória do processo cicatricial em camundongos (Mus musculus Swiss (n=90, organizados de acordo com o tratamento empregado: Grupo I (NaCl 150mM, Grupo II (ácido ascórbico 75mg ml-1 e Grupo III (emulsão contendo POLICAJU 150mg ml-1 preparado em ácido ascórbico 75mg ml-1. As lesões cutâneas foram realizadas assepticamente na região torácica dorsal e cada ferida foi tratada em dose única (200ml imediatamente após a cirurgia. As feridas foram avaliadas diariamente sob o ponto de vista clínico e histopatológico até o 6degrees dia de pós-operatório (PO. No 5degrees dia PO, observou-se um menor percentual de edema e hiperemia no Grupo III em relação aos grupos controle, ao passo que os valores de área da ferida e do percentual de contração não foram estatisticamente significativos. A avaliação histopatológica do grupo tratado com POLICAJU demonstrou a presença de tecido de granulação fibrovascular no 6degrees dia PO, enquanto os grupos controle apresentavam tecido de granulação com padrão vascular. O tratamento proposto propiciou sinais flogísticos menos acentuados (edema e hiperemia durante o período inflamatório, compatível com o processo de reparação mais avançado do ponto de vista histopatológico, sugerindo a possível utilização clínica da emulsão contendo POLICAJU.

[Treatment of postburn and postoperative cicatrices using karipaine cream preparations and karipaine ultra gel].

Science.gov (United States)

Zhernov, O A; Osadcha, O I; Zhernov, A O; Nazarenko, V M; Staskevych, S V

2011-07-01

Peculiarities of the burn wound course and the cicatricial tissue formation are shown. Clinical efficacy of application of cream Karipaine and gel Karipaine Ultra was proved, witnessed by improvement of the cell to tissue interaction as well as the connective tissue metabolism and the cicatricial tissue reconstruction.

[A treatment to serious esophageal cicatrices stenosi by metal and silica gel dilator].

Science.gov (United States)

Li, J; Chen, X; Sun, C; Liu, H

1999-12-01

To find an effective method of treating the esophageal cicatricial stenosis. Six cases with esophageal cicatricial stenosis were treated by mental and silica gel dilator. The effects in all six cases were satisfactory and no any complications were finded. The method is safe, effective and of no complications, the treatment time is shorter also.

IMPORTANCE OF THE TRICHOSCOPY IN SCALP DYSESTHESIA

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Maria Bibiana Leroux

2013-10-01

Full Text Available The trichoscopy has been incorporated as a first hand method in patients consulting for scalp problems. Magnifying glass or digital microscope that permit the direct visualization of the hair shaft and the perifolicullar skin are utilized to diagnose cicatricial and non-cicatricial alopecia. A female patient with an alopecia plaque associated with a scalp dysesthesia in which trichoscopy was very useful in its diagnosis is presented.

The informative value of MR tomography using gadolinium-DTPA in the diagnosis of the lumbar post-discotomy syndrome

International Nuclear Information System (INIS)

Beyer, H.K.; Hoetzinger, H.; Toedt, C.; Oppel, U.

1989-01-01

Our results have shown that MR tomography - especially if gadolinium-DTPA is used as a contrast medium - is an excellent method to differentiate between the various possible causes of the post-discotomy syndrome. In particular, it is definitely possible to differentiate between a relapsed hernia of an intervertebral dis and a postoperative development of cicatricial tissue which is practically inevitable. This differentiation is of vital importance to the clinician, because a second operation should be performed only in case of a relapse, whereas cicatricial tissue is best left alone, because no matter how carefully the operation is performed with preparation of the neural structures, even more extensive cicatricial plates are bound to develop. Instability of the vertebral column in the operated disc segment, or other causes of complaints, can be identified via MR equally well if not better than by other means. Hence, the method should be the method of choice in postdiscotomy syndrome, since it facilitates the difficult choice between conservative therapy and reoperation. (orig.) [de

Informative value of MR tomography using gadolinium-DTPA in the diagnosis of the lumbar post-discotomy syndrome

Energy Technology Data Exchange (ETDEWEB)

Beyer, H.K.; Hoetzinger, H.; Toedt, C.; Oppel, U.

1989-03-01

Our results have shown that MR tomography - especially if gadolinium-DTPA is used as a contrast medium - is an excellent method to differentiate between the various possible causes of the post-discotomy syndrome. In particular, it is definitely possible to differentiate between a relapsed hernia of an intervertebral dis and a postoperative development of cicatricial tissue which is practically inevitable. This differentiation is of vital importance to the clinician, because a second operation should be performed only in case of a relapse, whereas cicatricial tissue is best left alone, because no matter how carefully the operation is performed with preparation of the neural structures, even more extensive cicatricial plates are bound to develop. Instability of the vertebral column in the operated disc segment, or other causes of complaints, can be identified via MR equally well if not better than by other means. Hence, the method should be the method of choice in postdiscotomy syndrome, since it facilitates the difficult choice between conservative therapy and reoperation.

[Changes in clinical indices in patients in predisposition for pathological cicatrices formation].

Science.gov (United States)

Avetikov, D S; Skrypnyk, V M; Pronina, O M; Stavyts'kyĭ, S O; Boĭko, I V

2015-01-01

Prophylaxis of ocurrence of pathological cutaneous cicatrices is one of actual problems of plastic surgery of head and neck. Cicatricial changes of tissues, as a consequence of operative interventions and various damaging causes (mechanical, thermal and chemical impact, ionizing irradiation, deep destructive inflammation), were depicted. Propensity for formation of pathological cicatrices we consider as the organism state, in which cicatricial changes occur as an answer for minimal trauma or spontaneously. Detailed analysis of fundamental issues and periodical scientific publications witness the insufficient substantiation of this issue.

The presence of dysplastic nevus remnants in malignant melanomas. A population-based study of 551 malignant melanomas.

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Hastrup, N; Osterlind, A; Drzewiecki, K T; Hou-Jensen, K

1991-08-01

We examined 512 malignant melanomas, representing all newly diagnosed cutaneous malignant melanomas, excluding lentigo maligna melanomas, from the period October 1, 1982 to March 31, 1985 occurring in the region of eastern Denmark in patients aged 20-79 years for the presence of dysplastic nevus remnants. Criteria for the diagnosis of a dysplastic nevus remnant include all the following changes (a) lentiginous or epithelioid melanocyte hyperplasia, (b) cytologic melanocyte atypia, (c) eosinophilic fibroplasia, (d) lamellar fibroplasia, and (e) lymphocytic infiltration in the dermis. Dysplastic nevus remnants were found in association with 34 (7%) of the evaluable 512 malignant melanomas. Fourteen (41%) of the remnants were of compound nevus type. In nine (27%) of the remnants, atypia was pronounced. Most (62%) dysplastic nevus remnants were contiguous to thin superficial spreading melanomas. We conclude from this population-based study that about 7% of malignant melanomas arise in prior dysplastic nevi.

Estudo histológico do tecido conjuntivo areolar perifascial implantado em pregas vocais de coelhos

OpenAIRE

Adriana Hachiya

2009-01-01

Apesar do grande avanço da laringologia nas últimas décadas, o tratamento da rigidez da prega vocal continua sendo um desafio. A rigidez da prega vocal pode estar associada a alterações estruturais mínimas como no sulco vocal profundo ou decorrente da fibrose cicatricial como nos casos de cicatriz pós-operatória. Em ambos os casos, há perda dos elementos da matriz extracelular da camada superficial da lâmina própria (Espaço de Reinke) que se encontra substituída por tecido cicatricial. O obje...

Effect of D-penicillamine on the concentration of reduced glutathione in the liver of irradiated rats

International Nuclear Information System (INIS)

Oroszlan, Gyoergy; Buzasi, Edit; Szabo, Terez; Lakatos, Lajos; Karmazsin, Laszlo

1984-01-01

Rats received whole-body sup(60)Co-irradiation of 10 Gy total dose with a dose-rate of 0.6 Gy per min. The concentration of reduced glutathione increased upon irradiation; this increase was diminished by D-penicillamine pretreatment in newborn but not in adult rats. The age-dependent effects of D-penicillamine might explain the clinical observation that the frequency of retrolental fibrosis is decreased by D-penicillamine in small-weight pre-term neonates. (L.E.)

Clinical effects of non-ablative and ablative fractional lasers on various hair disorders: a case series of 17 patients.

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Cho, Suhyun; Choi, Min Ju; Zheng, Zhenlong; Goo, Boncheol; Kim, Do-Young; Cho, Sung Bin

2013-04-01

Both ablative and non-ablative fractional lasers have been applied to various uncommon hair disorders. The purpose of this study was to demonstrate the clinical effects of fractional laser therapy on the course of primary follicular and perifollicular pathologies and subsequent hair regrowth. A retrospective review of 17 patients with uncommon hair disorders - including ophiasis, autosomal recessive woolly hair/hypotrichosis, various secondary cicatricial alopecias, pubic hypotrichosis, frontal fibrosing alopecia, and perifolliculitis abscedens et suffodiens - was conducted. All patients had been treated with non-ablative and/or ablative fractional laser therapies. The mean clinical improvement score in these 17 patients was 2.2, while the mean patient satisfaction score was 2.5. Of the 17 subjects, 12 (70.6%) demonstrated a clinical response to non-ablative and/or ablative fractional laser treatments, including individuals with ophiasis, autosomal recessive woolly hair/hypotrichosis, secondary cicatricial alopecia (scleroderma and pressure-induced alopecia), frontal fibrosing alopecia, and perifolliculitis abscedens et suffodiens. Conversely, patients with long-standing ophiasis, surgical scar-induced secondary cicatricial alopecia, and pubic hypotrichosis did not respond to fractional laser therapy. Our findings demonstrate that the use of non-ablative and/or ablative fractional lasers promoted hair growth in certain cases of uncommon hair disorders without any remarkable side effects.

Computed tomography in the evaluation of patients with persistent hyperplastic primary vitreous (PHPV)

International Nuclear Information System (INIS)

Mafee, M.F.; Goldberg, M.F.; Valvassori, G.E.; Capek, V.

1982-01-01

The computed tomographic (CT) findings in 5 patients with proven persistent hyperplastic primary vitreous (PHPV) are described. PHPV arises when the embryonic hyaloid vascular system fails to regress normally. Clinically, this condition usually manifests an unilateral or bilateral leukokoria and is one of the more important and frequent conditions mimicking retinoblastoma. The spectrum of CT findings include: (a) soft-tissue replacement (infiltration) of the vitreous body; (b) retrolental soft tissue along the Cloquet canal; (c) absence of abnormal calcification within the orbit; (d) microphthalmus; (e) retrohyaloid layered blood; and (f) hypervascularity in the vitreous humor

Cellular events in adhesion formation due to thermal trauma.

Science.gov (United States)

Kaplun, A; Aronson, M; Halperin, B; Griffel, B

1984-01-01

Consequent to thermal traumatization of the intestinal wall of the mouse, histopathological events ensue which lead to peritoneal adhesion formation. In the first 48 h, the main pathological findings are of a necrotic and inflammatory nature, but subsequently fibroplasia is the main feature, as evidenced by the appearance of spindle-shaped cells followed by fibroblasts. Factors essential for and contributing to the formation of adhesions are described.

HISTOPATHOLOGICAL DETECTION OF THE LARVAL STAGE OF TAENIA TAENIAEFORMIS (STROBILOCERCI AND ITS ASSOCIATED LESIONS IN LIVER OF LABORATORY RATS: CASE REPORT

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Remigius Ibe Onoja

2017-06-01

Full Text Available Histopathological examination of liver tissues of rats maintained in laboratory condition showed the presence of strobilocerci of Taenia taeniaformis. Infiltration of mononuclear cells such as plasma cells, lymphocytes, macrophages and occasional eosinophils were seen. Active fibroplasia was found in the surrounding tissues. The finding is having importance in zoonatic effects and also for possibility of alteration of result of biomedical research works.

Long-term remission of folliculitis decalvans after treatment with the long-pulsed Nd:YAG laser

NARCIS (Netherlands)

Meesters, Arne A.; van der Veen, J. P. Wietze; Wolkerstorfer, Albert

2014-01-01

Folliculitis decalvans (FD) is a rare inflammatory scalp disorder presenting with tufted folliculitis, follicular papules and pustules, progressing to cicatricial alopecia. Current treatments mainly consist of antibiotic and immunomodulatory therapies and are often disappointing. FD has previously

Short term results of pterygium surgery with adjunctive amniotic ...

African Journals Online (AJOL)

2012-11-30

Nov 30, 2012 ... Results: Thirty eyes of 30 consecutive patients were operated on. There were 14 ... prevalent in tropical Africa[2] as a result of its warm and dry climates. ... syndrome, ocular cicatricial pemphigoid, coverage of conjunctival ...

Use of bilidase for the treatment of experimental hypertrophic postburn cicatrices.

Science.gov (United States)

Loladze, M; Alibegashvili, M; Turmanidze, Ts; Iashvili, B; Kutivadze, D; Chanishvili, T

2005-01-01

The efficiency of bilidase (hyaluronidase preparation) was studied in guinea pigs with experimental postburn cicatrices. Bilidase promoted normalization of the structure and histochemical picture of new cicatricial tissue. The drug can be used for the treatment of hypertrophic postburn cicatrices.

Plutonium-induced lymphadenitis in beagles

International Nuclear Information System (INIS)

Dagle, G.E.; Park, J.F.

1976-01-01

Plutonium oxide particles accumulate in the tracheobronchial lymph nodes of beagles exposed by inhalation and in the popliteal lymph nodes after subcutaneous injection in the hind paws. The sequence of histopathologic changes after phagocytosis of particles included necrosis, increased numbers of macrophages, and fibroplasia. Scar tissue eventually replaced the normal architecture of the lymph nodes and sequestered the plutonium particles from surrounding parenchyma. Electron microscopy showed that plutonium particles were aggregated in phagolysosomes of macrophages

The large eyes of Wolfgang Amadeus Mozart. (On the occasion of the 250th Mozart anniversary year)

NARCIS (Netherlands)

Zegers, Richard H. C.; Saeed, Peerooz; Wiersinga, Wilmar M.

2005-01-01

This article discusses the eyes of Wolfgang Amadeus Mozart (1756-1791) which, based on portraits, can be said to have a certain noticeable feature--some degree of exophthalmos. In fact, even contemporary observers made particular mention of Mozart's eyes being large. Although cicatricial ectropion,

Systemic sarcoidosis with necrobiosis lipoidica-like scalp lesions

DEFF Research Database (Denmark)

Andersen, Klaus Ejner

1977-01-01

A 78-year-old woman is described, having systemic sarcoidosis for 15 years, involving the lungs, lymph nodes and the skin. Over the last 6 years she developed a progressive cicatricial alopecia with histologic changes of the granulomatous type of necrobiosis lipoidica surrounded by sarcoid...

Active disease and residual damage in treated Wegener's granulomatosis: an observational study using pulmonary high-resolution computed tomography

International Nuclear Information System (INIS)

Komocsi, Andras; Reuter, Michael; Heller, Martin; Murakoezi, Henriette; Gross, Wolfgang L.; Schnabel, Armin

2003-01-01

The purpose of this study was to determine to what extent high-resolution computed tomography (HRCT) of the lungs can distinguish active inflammatory disease from inactive cicatricial disease in patients treated for Wegener's granulomatosis (WG). Twenty-eight WG patients with active pulmonary disease underwent a first HRCT examination immediately before standard immunosuppressive treatment and a second examination after clinical remission had been achieved. Lesions remaining after treatment were categorized as residual damage and were compared with findings during active disease to see by what features active and cicatricial disease can be distinguished. During active disease 17 patients had nodules/masses, 12 had ground-glass opacities, 6 had septal lines and 6 had non-septal lines. After treatment, ground-glass opacities had resolved completely. Nodules/masses had resolved in 8 patients and had diminished in 7 patients. Residual nodules were distinguished from nodules/masses in active disease by lack of cavitation and a diameter of mostly <15 mm. In one-third of patients lines resolved, but in 8 instances new lines evolved during immunosuppression. During a follow-up period of a median 26.5 months (range 20.0-33.8), patients with residual nodules or lines had no more relapses than patients with completely cleared lungs. Treated pulmonary WG leaves substantial residual damage. High-resolution CT does assist in the distinction between active and inactive lesions. Ground-glass opacities, cavitating nodules/masses and masses measuring more than 3 cm represent active disease ordinarily. Non-cavitary small nodules and septal or non-septal lines can be either active or cicatricial lesions. The nature of these lesions needs to be clarified by longitudinal observation. (orig.)

Hipertensi Sekunder akibat Perubahan Histologi Ginjal

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Bernadetha Nadeak

2016-11-01

Full Text Available Ginjal merupakan organ yang berperan penting dalam mengatur tekanan darah. Hipertensi merupakan penyakit kardiovaskular degeneratif dengan insidens yang meningkat dari tahun ke tahun. Sel juksta glomerular di dalam ginjal berperan penting dalam terjadinya hipertensi karena dalam juksta glomerulus dihasilkan renin. Renin berfungsi mengubah angiotensinogen menjadi angiotensinogen I, dan oleh pengaruh enzim proteolitik konvertase diubah menjadi angiotensin II yang berfungsi sebagai vasokonstriktor. Selanjutnya korteks kelenjar adrenal untuk melepaskan aldosteron yang mempengaruhi tubulus kontortus distalis untuk mereabsorbsi NaCl dan air. Kelainan pada sel juksta glomerular dapat mengakibatkan hipersekresi renin, sehingga mempengaruhi tekanan darah sistemik. Kelainan pembuluh darah yang sering menimbulkan hipertensi adalah stenosis (penyempitan karena aterosklerosis, displasia (stenosis non aterosklerosis dinding arteri di lapisan intima, lapisan media dan adventisia juga turut berperan. Di dalam lapisan intima terjadi fibroplasia intima, yaitu penimbunan jaringan fibrous sehingga lumen arteri menyempit. Pada lapisan media terjadi fibroplasia media, yaitu penimbunan jaringan fibrous dan atrofi otot polos, sehingga lumen arteri menyempit. Pada lapisan adventisia, terjadi penggantian dengan jaringan kolagen yang meluas ke jaringan ikat sehingga menjadi kaku dan sempit. Kelainan pada parenkim ginjal dapat berupa proliferasi sel dan jaringan parut. Jaringan parut itu akan menarik jaringan sekitarnya termasuk jaringan vaskular arteri interlobaris yang akan mengganggu vaskularisasi ginjal. Semua kelainan ini akan menimbulkan hipoksia ginjal, sehingga merangsang pelepasan renin yang berkibat terjadinya hipertensi renoparenkim dan renovaskular.

KERATOSIS FOLLICULARIS SPINULOSA DECALVANS: REPORT OF A CASE AND LITERATURE REVIEW

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P. Mansouri.

1999-07-01

Full Text Available Keratosis follicularis spinulosa decalvans (KFSD represents a rare, probably X-linked recessive genodermatosis, characterized by keratosis pilaris of face, trunk and extremities, followed by atrophy, cicatricial alopecia of the scalp, eyebrows and eyelashes, photophobia and corneal abnormalities. We report a rare case of KFSD and review the literature.

The diagnostic value and histologic correlate of distinct patterns of shiny white streaks for the diagnosis of melanoma: A retrospective, case-control study.

Science.gov (United States)

Verzi, Anna Eliza; Quan, Victor L; Walton, Kara E; Martini, Mary C; Marghoob, Ashfaq A; Garfield, Erin M; Kong, Betty Y; Isales, Maria Cristina; VandenBoom, Timothy; Zhang, Bin; West, Dennis P; Gerami, Pedram

2018-05-01

Shiny white streaks (SWSs) are best visualized with polarized dermoscopy and correlate with dermal fibroplasia histopathologically. SWSs have been described at higher frequencies in melanomas than in benign nevi. We assessed the diagnostic value of different patterns of SWSs and their histologic correlate in melanocytic lesions. Polarized dermoscopic images of 1507 histopathologically diagnosed melanocytic neoplasms were analyzed for presence and pattern of SWSs. Histology was also reviewed for correlation. Among 1507 melanocytic neoplasms, SWSs were observed in 31 of 144 melanomas (22%) and 22 of 1363 benign neoplasms (1.6%) (P < .001). The sensitivity and specificity of SWSs for melanoma were 22% and 98%, respectively. Diffuse SWSs exhibited the greatest diagnostic value for melanoma, with sensitivity of 11.8% and specificity of 99.5%. Focal central and peripheral SWSs were comparable in diagnostic significance. The presence of SWSs was highly uncommon in dysplastic nevi, whereas in certain benign subgroups of nevi such as Spitz nevi and atypical genital special site nevi, SWSs were not uncommon. Diffuse SWSs correlated with greater breadth of deep fibroplasia than focal SWSs (P = .009), and SWSs correlated with greater Breslow depth among melanomas (P = .007). This study was retrospective. Polarized dermoscopy is a valuable diagnostic tool in the identification of SWSs, a feature that is highly specific for melanoma. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

A large unilateral renal artery aneurysm in a young child

International Nuclear Information System (INIS)

Robitaille, P.; Lord, H.; Dubois, J.; Rypens, F.; Oligny, L.L.

2004-01-01

The case of a 13-month-old boy with fibromuscular dysplasia (FMD) presenting with a large saccular aneurysm of the left renal artery and renovascular hypertension is reported. Renal and intrarenal arteries showed numerous small aneurysms alternating with stenoses. All arterial lesions were localized to the left kidney. After left nephrectomy, the patient's blood pressure normalized. Histopathologic examination of the arteries disclosed changes typical of medial fibroplasias, the most frequently described form of FMD in children. This diagnosis is rewarding as it represents a surgically curable cause of severe hypertension. (orig.)

[Circular tracheal resection for cicatrical stenosis and functioning tracheostomy].

Science.gov (United States)

Parshin, V D; Titov, V A; Parshin, V V; Parshin, A V; Berikkhanov, Z; Amangeldiev, D M

To analyze the results of tracheal resection for cicatricial stenosis depending on the presence of tracheostomy. 1128 patients with tracheal cicatricial stenosis were treated for the period 1963-2015. The first group consisted of 297 patients for the period 1963-2000, the second group - 831 patients for the period 2001-2015. Most of them 684 (60.6%) were young and able-bodied (age from 21 to 50 years). In the first group 139 (46.8%) out of 297 patients had functioning tracheostomy. For the period 2001-2015 tracheostomy was made in 430 (51.7%) out of 831 patients with cicatricial stenosis. Time of cannulation varied from a few weeks to 21 years. Re-tracheostomy within various terms after decanulation was performed in 68 (15.8%) patients. Tracheal resection with anastomosis was performed in 59 and 330 in both groups respectively. At present time these operations are performed more often in view of their standard fashion in everyday practice. In the second group tracheal resection followed by anastomosis was observed in 110 (25.6%) out of 430 patients with tracheostomy that is 4.4 times more often than in previous years. In total 2 patients died after 330 circular tracheal resections within 2001-2015 including one patient with and one patient without tracheostomy. Mortality was 0.6%. Moreover, this value was slightly higher in patients operated with a functioning tracheostomy compared with those without it - 0.9 vs. 0.5% respectively. The causes of death were bleeding into tracheobronchial lumen and pulmonary embolism. The source of bleeding after tracheal resection was innominate artery. Overall incidence of postoperative complications was 2 times higher in tracheostomy patients compared with those without it - 22 (20%) vs. 26 (11.8%) cases respectively. Convalescence may be achieved in 89.8% patients after circular tracheal resection. Adverse long-term results are associated with postoperative complications. So their prevention and treatment will improve the

Vertical vs. transverse sections of scalp biopsy specimens: a pilot study on the comparison of the diagnostic value of two techniques in alopecia.

Science.gov (United States)

Özcan, D; Özen, Ö; Seçkin, D

2011-12-01

Using both vertical and transverse sections is preferred for histopathological diagnosis of alopecia. However, in cases in which only a single biopsy is taken, it is not clear which type of sectioning is better. To compare the diagnostic value of transverse and vertical sections. In total, 53 patients with alopecia were enrolled in the study. Two biopsies were taken from each patient, and cut into either transverse or vertical sections. The clinical and histopathological findings were evaluated together for the definitive diagnosis. After the study period, a pathologist randomly re-evaluated the sections. We compared the histopathological diagnoses with the definitive diagnoses, and determined the sensitivity and specificity of each method. A definitive diagnosis was made for 47 patients (88.7%). Of these, 30 (63.8%) had noncicatricial and 17 (36.2%) had cicatricial alopecia, and the diagnosis was made by transverse and vertical sections for 43 (91.5%) and 39 (88%), respectively (P > 0.05; sensitivity; 91.5% vs. 82%). All 30 patients with noncicatricial alopecia were diagnosed by transverse sections, and 25 (83.3%) of the 30 were diagnosed with vertical sections (P = 0.05; sensitivity 100% vs. 83.3%). Of the 17 patients with cicatricial alopecia, 13 (76.5%) and 14 (82.4%) patients were diagnosed by transverse and vertical sections, respectively (P > 0.05; sensitivity 76.5% vs. 82.4%). Five patients with lichen planopilaris were diagnosed by vertical sections, and one by transverse sections. There were several limitations to the study: (i) statistical subtype analysis could be performed only for alopecia areata; (ii) no conclusion could be drawn about the interobserver reliability of two sections; and (iii) having the pathologist-blinded study performed retrospectively might have caused a recall bias. If only a single biopsy specimen is available, it may be preferable to have transverse sections in cases of suspected noncicatricial alopecia, and vertical sections in

The Rationale for Treating the Nodule in Dupuytren’s Disease

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Lynn D. Ketchum, MD

2014-12-01

Conclusions: The most effective management of Dupuytren’s disease is early recognition and treatment of the nodule, before the development of a joint contracture, particularly of a proximal interphalangeal joint. As there is evidence of a significant inflammatory role in the development of the nodule, the process of fibroplasia can be minimized by altering the macrophage > fibroblast > collagen cascade by the intralesional injection of a potent anti-inflammatory agent such as triamcinolone, which also blocks tissue inhibitors of collagenase, thus enhancing the action of native collagenase, and reduces the size and firmness of nodules and, at least temporarily, arrests their progression.

Long-term remission of folliculitis decalvans after treatment with the long-pulsed Nd:YAG laser.

Science.gov (United States)

Meesters, Arne A; Van der Veen, J P Wietze; Wolkerstorfer, Albert

2014-04-01

Folliculitis decalvans (FD) is a rare inflammatory scalp disorder presenting with tufted folliculitis, follicular papules and pustules, progressing to cicatricial alopecia. Current treatments mainly consist of antibiotic and immunomodulatory therapies and are often disappointing. FD has previously shown to respond to treatment with neodymium:yttrium aluminium garnet (Nd:YAG) laser in one case. We present a case of recalcitrant FD, successfully treated with a long-pulsed Nd:YAG laser.

Early serum biomarker networks in infants with distinct retinochoroidal lesion status of congenital toxoplasmosis.

Science.gov (United States)

de Araújo, Thádia Evelyn; Coelho-Dos-Reis, Jordana Grazziela; Béla, Samantha Ribeiro; Carneiro, Ana Carolina Aguiar Vasconcelos; Machado, Anderson Silva; Cardoso, Ludmila Melo; Ribeiro, Ágata Lopes; Dias, Michelle Hallais França; Queiroz Andrade, Gláucia Manzan; Vasconcelos-Santos, Daniel Vitor; Januário, José Nélio; Teixeira-Carvalho, Andréa; Vitor, Ricardo Wagner Almeida; Ferro, Eloisa Amália Vieira; Martins-Filho, Olindo Assis

2017-07-01

The present study characterized the early changes in the serum chemokines/cytokine signatures and networks in infants with congenital-toxoplasmosis/(TOXO) as compared to non-infected-controls/(NI). TOXO were subgrouped according to the retinochoroidal lesion status as no-lesion/(NL), active-lesion/(ARL), active/cicatricial-lesion/(ACRL) and cicatricial-lesion/(CRL). The results showed that TOXO display prominent chemokine production mediated by IL-8/CXCL8, MIG/CXCL9, IP-10/CXCL10 and RANTES/CCL5. Additionally, TOXO is accompanied by mixed proinflammatory/regulatory cytokine pattern mediated by IL-6, IFN-γ, IL-4, IL-5 and IL-10. While TNF appears as a putative biomarker for NL and IFN-γ/IL-5 as immunological features for ARL, IL-10 emerges as a relevant mediator in ACRL/CRL. IL-8/CXCL8 and IP-10/CXCL10 are broad-spectrum indicators of ocular disease, whereas TNF is a NL biomarker, IFN-γ and MIG/CXCL9 point out to ARL; and IL-10 is highlighted as a genuine serum biomarker of ACRL/CRL. The network analysis demonstrated a broad chemokine/cytokine crosstalk with divergences in the molecular signatures in patients with different ocular lesions during congenital toxoplasmosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Keratosis follicularis spinulosa decalvans in a 15 months Cypriot girl

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Asli Kaptanoglu

2016-01-01

Full Text Available Keratosis follicularis spinulosa decalvans (KFSD is a rare disease with unknown etiology. It clinically presents with diffuse follicular hyperkeratosis of scalp which progress to atrophy, cicatricial alopecia, and photophobia. The lesions start in chilhood and an aggrevasion occurs after puberty by the development of scalp pustules with bacterial infection and causes both functional and cosmetic discomfort. Here, we report a Cypriot girl that diagnosed KFSD that do not have any family history.

Chapitre 9. How can the rate of avoidable blindness through treatment of trichiasis be evaluated?[Comment évaluer le taux de cécité évitable par cure de trichiasis ?

OpenAIRE

Lietman, Thomas

2013-01-01

Although individuals with trachoma may occasionally lose vision from pannus (a superficial fibrovasular proliferation) over the pupil, a more frequent cause of blindness is from a corneal ulcer caused by superinfection with a bacteria or a fungus. These ulcers frequently leave a corneal scar over the pupil and result in markedly decreased vision. People with cicatricial trachoma are at a higher risk for corneal ulcers for several reasons: dry eye from scarred tear glands, recurrent dacryocyst...

Dense pigmentation of the posterior lens capsule associated with the pigment dispersion syndrome.

Science.gov (United States)

Lin, Danny Y; Volpicelli, Mark; Singh, Kuldev

2003-12-01

To report an unusual case of pigment dispersion syndrome associated with unilateral dense pigmentation of the posterior lens capsule. Case report. A 59-year-old male with bilateral pigment dispersion syndrome presented with progressive decrease in visual acuity in the left eye over the past 10 to 20 years. Clinical examination revealed the typical findings of pigment dispersion syndrome including the presence of bilateral Krunkenberg spindles, iris transillumination defects, and heavy trabecular meshwork pigmentation. Of note, there was remarkably dense pigmentation of the posterior lens capsule in the eye with decreased visual acuity. Pigmentation of the posterior lens capsule may be a rare finding associated with pigment dispersion syndrome. Such a finding suggests that there may be aqueous flow into the retrolental space in some patients with this condition. The optimal treatment of this unusual condition remains undetermined.

Trachoma among the Yanomami Indians

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J.S. Paula

2002-10-01

Full Text Available The Yanomami are one of the last primitive groups of Indians living in Brazil. They have almost no contact with other cultures. The epidemiology of eye disease among Yanomami is virtually unknown. For the first time, a trachoma survey was conducted among Yanomami Indians in the State of Amazonas near the Venezuelan border of the Brazilian rain forest. Ophthalmic examination was carried out on a total of 613 individuals (338 males and 275 females from eight Yanomami villages along the Marauiá River located in the upper Rio Negro Basin. Age was classified into three categories (children, adults, and elderly and trachoma was classified into five grades: follicular, inflammatory intense, cicatricial, trichiasis, and corneal opacity. Trachoma was endemic in all villages visited. Overall, 30.3% of the subjects had trachoma. Females were significantly more affected (37.4% than males (23.9%. The inflammatory trachoma rate reached 24.9% in children and the cicatricial form increased with age, reaching 13.9% among adults and 35.21% among the elderly. Trichiasis or corneal opacities were not detected and treatment of the entire population was initiated with 1 g azithromycin. The detection of endemic trachoma among the Yanomami is relevant for the understanding of the epidemiology of this disease in the Brazilian rain forest and underscores the necessity for a program of trachoma control in this region.

Trachoma among the Yanomami Indians.

Science.gov (United States)

Paula, J S; Medina, N H; Cruz, A A V

2002-10-01

The Yanomami are one of the last primitive groups of Indians living in Brazil. They have almost no contact with other cultures. The epidemiology of eye disease among Yanomami is virtually unknown. For the first time, a trachoma survey was conducted among Yanomami Indians in the State of Amazonas near the Venezuelan border of the Brazilian rain forest. Ophthalmic examination was carried out on a total of 613 individuals (338 males and 275 females) from eight Yanomami villages along the Maraui River located in the upper Rio Negro Basin. Age was classified into three categories (children, adults, and elderly) and trachoma was classified into five grades: follicular, inflammatory intense, cicatricial, trichiasis, and corneal opacity. Trachoma was endemic in all villages visited. Overall, 30.3% of the subjects had trachoma. Females were significantly more affected (37.4%) than males (23.9%). The inflammatory trachoma rate reached 24.9% in children and the cicatricial form increased with age, reaching 13.9% among adults and 35.21% among the elderly. Trichiasis or corneal opacities were not detected and treatment of the entire population was initiated with 1 g azithromycin. The detection of endemic trachoma among the Yanomami is relevant for the understanding of the epidemiology of this disease in the Brazilian rain forest and underscores the necessity for a program of trachoma control in this region.

Deep erosions of the palmar aspect of the navicular bone diagnosed by standing magnetic resonance imaging.

Science.gov (United States)

Sherlock, C; Mair, T; Blunden, T

2008-11-01

Erosion of the palmar (flexor) aspect of the navicular bone is difficult to diagnose with conventional imaging techniques. To review the clinical, magnetic resonance (MR) and pathological features of deep erosions of the palmar aspect of the navicular bone. Cases of deep erosions of the palmar aspect of the navicular bone, diagnosed by standing low field MR imaging, were selected. Clinical details, results of diagnostic procedures, MR features and pathological findings were reviewed. Deep erosions of the palmar aspect of the navicular bone were diagnosed in 16 mature horses, 6 of which were bilaterally lame. Sudden onset of lameness was recorded in 63%. Radiography prior to MR imaging showed equivocal changes in 7 horses. The MR features consisted of focal areas of intermediate or high signal intensity on T1-, T2*- and T2-weighted images and STIR images affecting the dorsal aspect of the deep digital flexor tendon, the fibrocartilage of the palmar aspect, subchondral compact bone and medulla of the navicular bone. On follow-up, 7/16 horses (44%) had been subjected to euthanasia and only one was being worked at its previous level. Erosions of the palmar aspect of the navicular bone were confirmed post mortem in 2 horses. Histologically, the lesions were characterised by localised degeneration of fibrocartilage with underlying focal osteonecrosis and fibroplasia. The adjacent deep digital flexor tendon showed fibril formation and fibrocartilaginous metaplasia. Deep erosions of the palmar aspect of the navicular bone are more easily diagnosed by standing low field MR imaging than by conventional radiography. The lesions involve degeneration of the palmar fibrocartilage with underlying osteonecrosis and fibroplasia affecting the subchondral compact bone and medulla, and carry a poor prognosis for return to performance. Diagnosis of shallow erosive lesions of the palmar fibrocartilage may allow therapeutic intervention earlier in the disease process, thereby preventing

First report of in a feral domestic shorthair cat in North America

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Nicholas A Crossland

2015-07-01

Full Text Available Case summary A feral domestic shorthair cat was euthanized owing to acute onset and progression of neurological signs attributed to ethylene glycol toxicity. At post-mortem examination two nodules were identified within the fundus of the stomach. Examination of the gastric nodules revealed an intact mucosal surface, each with multiple red slender nematodes extending through an individual central pore. Histopathological evaluation of the nodules highlighted unique reactive fibroplasia, mimicking feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF, encasing numerous nematodes with females possessing gravid uteri containing abundant larvated eggs. The latter findings were highly suggestive of the Cylicospirura genus, further supported by an en face evaluation of the buccal cavity, highlighting a distinctive trifid tooth appearance. Together, these findings are consistent with Cylicospirura felineus . PCR for the COX-1 gene was unsuccessful on formalin-fixed specimens, attributed to nucleic acid and protein crosslinking. Relevance and novel information This represents the first documented case of Cylicospirura species in a feral domestic shorthair cat in North America. This particular cat lived in the highly urban environment of New Orleans, Louisiana. Identification of this case demonstrates the potential for feral cats to serve as reservoir hosts and ultimately support transmission of Cylicospirura species into domesticated cat populations. Gastric cylicospiruriasis may present clinically as a firm abdominal mass, potentially with a history of chronic vomiting. The latter emphasizes the importance of differentiating this condition from a neoplastic process such as alimentary lymphoma and adenocarcinoma. Histologically, the unique thick anastomosing collagenous cords encasing nematodes represent a stereotypical response observed in a broad array of gastrointestinal inflammation in felines, including intralesional bacteria, fungal

Calciphylaxis

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Nicolás Raimondi

2017-08-01

Full Text Available Calciphylaxis is vasculopathy characterized by ischemia and painful skin necrosis due to calcification and intimal fibroplasia of thrombosis of the panicular arterioles. It most frequently compromises patients with terminal chronic renal failure and has a high mortality rate. Biopsy of skin lesions is used as a diagnostic method. No specific laboratory findings have been recorded. Skin lesions usually begin in the extremities like a painful purplish mottling similar to "livedo reticularis". The natural evolution is to ulcers and bedsores. The first line of treatment involves the care of skin lesions and antibiotic therapy. Sodium thiosulfate is used as treatment due to its antioxidant activity and as a chelating. Two clinical cases are here reported

An unusual case of intestinal leiomyositis in a Bernese mountain dog.

Science.gov (United States)

Gianella, P; Tecilla, M; Bellino, C; Buracco, R; Martano, M; Zanatta, R; Cagnasso, A; D'angelo, A

2015-10-01

A 1-year-old, female Bernese mountain dog was presented to the Veterinary Teaching Hospital of Turin University with a 3-month history of weight loss, intermittent anorexia, vomiting, constipation, and abdominal distension. Full-thickness biopsies from the stomach, duodenum, jejunum and ileum were collected for histological and immunohistochemical examination. Microscopic lesions displayed severe diffuse degeneration and loss of leiomyocytes, with lymphocytic leiomyositis, fibroplasia, angiogenesis, severe diffuse neuronal atrophy, and ganglioneuritis in the myenteric (Auerbach's) plexus. A diagnosis of chronic idiopatic intestinal pseudo-obstruction was made. Response to immunosuppressive therapy was poor and the dog was humanely euthanized. Unique findings were mononuclear infiltration composed predominantly of B-cell, angiogenesis and weak immunoreactivity for neuron-specific enolase.

Chrysalis and negative pigment network in Spitz nevi.

Science.gov (United States)

Botella-Estrada, Rafael; Requena, Celia; Traves, Victor; Nagore, Eduardo; Guillen, Carlos

2012-04-01

Chrysalis, also named shiny white streaks, are white, linear structures only visible with polarized dermoscopy. They have been reported in several tumors included melanomas and Spitz nevi, and their histological substrate is believed to be dermal fibrosis. We have performed a correlation study between the dermoscopic and the histopathological features of 9 Spitz nevi. Chrysalis were present in 4 Spitz nevi (44%) and in all of them there was a high degree of fibroplasia. In one case, chrysalis, evident at the center of the lesion, progressively merged with negative pigment network at the periphery. We suggest that chrysalis and negative pigment network are manifestations of the same histopathological finding: increased collagen occurring at different levels of the dermis.

Uses and complications of mitomycin C in ophthalmology.

Science.gov (United States)

Mearza, Ali A; Aslanides, Ioannis M

2007-01-01

Mitomycin C is a chemotherapeutic agent that acts by inhibiting DNA synthesis. Its use and application in ophthalmology has been increasing in recent years because of its modulatory effects on wound healing. Current applications include pterygium surgery, glaucoma surgery, corneal refractive surgery, cicatricial eye disease, conjunctival neoplasia and allergic eye disease. Although it has been used successfully in these conditions, it has also been associated with significant complications. This article reviews the current trends and uses of mitomycin C in the eye and its reported complications.

Myopia in premature babies with and without retinopathy of prematurity.

OpenAIRE

Nissenkorn, I; Yassur, Y; Mashkowski, D; Sherf, I; Ben-Sira, I

1983-01-01

One hundred and fifty-five premature infants weighing 600-2000 g were followed up during 1974-80 for the presence of retinopathy of prematurity (ROP) and for the existence of myopia. 50% of the premature infants who had ROP were myopic, while only 16% myopic premature infants were found among those who did not have ROP. There was a positive correlation between the degree of myopia and the severity of cicatricial ROP. No difference existed in the frequency and degree of myopia between prematur...

Multilayered pigment epithelial detachment in neovascular age-related macular degeneration

DEFF Research Database (Denmark)

Rahimy, Ehsan; Freund, K Bailey; Larsen, Michael

2014-01-01

, hyperreflective bands, termed a "multilayered PED," which is often seen in conjunction with neovascular tissue adherent to the undersurface of the retinal pigment epithelium monolayer. On the basis of previous histopathologic correlations, these bands may represent a fibrous tissue complex with contractile...... properties. An associated hyporeflective space, termed a "pre-choroidal cleft," separates the fusiform complex from the underlying choroid and may be due to contraction, the exudation of fluid, or both. Many of these eyes maintain good visual acuity, presumably because the neovascular and cicatricial process...

A influência da calcitonina sintética de salmão na cicatrização cutânea de ratos

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José Neiva Eulálio

Full Text Available OBJETIVO: O presente trabalho tem como objetivo investigar a influência da calcitonina sintética do salmão no processo cicatricial da pele da região dorsal em ratos, analisando parâmetros bioquímicos, biomecânicos e histológicos, e suas possíveis interrelações. MÉTODO: Setenta e dois (72 ratos machos adultos foram submetidos, sob anestesia geral inalatória a uma incisão linear na pele que foi, subseqüentemente, suturada. Metade dos ratos (grupo teste foi tratada no pós-operatório com calcitonina sintética do salmão, e a outra metade, sem tratamento, constituiu o grupo controle. Os animais, em pares de nove ratos cada (teste e controle, foram sacrificados no 5º, 10º, 15º e 20º dias pós-operatório para a remoção dos fragmentos de pele com cicatriz para as análises bioquímicas, biomecânicas e histológicas. Utilizou-se o teste "t" de Student para a comparação de médias de amostras independentes e o teste de correlação de Pearson para verificar o grau de associação entre as médias das variáveis. RESULTADOS: A calcitonina sintética de salmão acelerou o processo cicatricial da pele, mas não de maneira linear e constante. Em comparação com os animais não-tratados, houve aumento significativo tanto do conteúdo de hidroxiprolina nas fases de proliferação inicial e tardia da cicatrização, quanto da carga máxima de ruptura na fase de proliferação tardia. Os resultados histológicos corroboram os resultados bioquímicos e biomecânicos, sugerindo uma correlação entre conteúdo de colágeno, resistência à tração e histologia da cicatriz. CONCLUSÃO: A calcitonina sintética de salmão acelerou o processo cicatricial da pele, modificando significativamente o conteúdo de colágeno e a carga máxima de ruptura, mas não de maneira linear e constante.

Cutaneous injuries of complicated herpes zoster in an elderly immunocompetent patient

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Luis Arthur Brasil Gadelha Farias

2017-10-01

Full Text Available A 81-years-old caucasian man presented with acute burning pain in external auricular region and inside the auditory canal of right ear, associated with vesicular lesions on face, jugal and lingual mucosa. Physical examination revealed vesicular lesions in external auricular region and inside the auditory canal. Red blood cell count, leukocytes and platelets were normal. Presented HIV-1 and 2 both negative. Patient denied previous history of Diabetes and Hypertension. Treatment was initiated with Ceftriaxone 2g, Acyclovir 250mg, Prednisone 60mg and Bicarbonate Water for rinsing. After eight days of hospitalization, patient reported hearing loss in the right ear, chewing difficulty and mild pain in face. Auditory hearing loss and hypoacusis may suggest involvement of vestibulocochlear nerve. Figure 1 shows cicatricial crusted lesions following trigeminal nerve mandibular branch trajetory. Figure 2 reveals cicatricial crusted lesions following trigeminal nerve maxilar branch, trigeminal branch and erythematous scarring lesions in tongue, hypoglossal nerve region. Figure 3 reveals small crusted lesions following the trigeminal ophthalmic branch. Herpes zoster is caused by Varicella zoster virus (VZV reactivation in individuals who had Varicella in childhood or who were vaccinated. The presence of more than one dermatome affected is rare in immunocompetent individuals, being more prevalent in immunosuppressed individuals such as HIV positive and transplanted patients.1Disseminated herpes zoster can occur in any immunocompetent patient but predominates in elderly due to factors that compromise cellular immune response. 2,3

Perda pilosa por líquen plano pilar após transplante capilar: relato de dois casos e revisão da literatura Hair loss due to lichen planopilaris after hair transplantation: a report of two cases and a literature review

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Márcio Rocha Crisóstomo

2011-04-01

Full Text Available Alopecia androgenética é tratada com frequência por meio de microtransplante capilar, téc nica em que os fios transplantados geralmente não caem, pois mantêm características da área doadora, mais resistente. O líquen plano pilar é uma alopecia cicatricial com permanente destruição pilosa. Este artigo relata dois casos de lesões compatíveis com líquen plano pilar em áreas receptora e doadora póstransplante. A dominância da área doadora foi aparentemente sobrepujada pelo líquen plano pilar, que deve ter gerado a queda dos fios. Relatos semelhantes são raros. À suspeita de líquen plano pilar, devese biopsiar o couro cabeludo e evitar o transplante durante a atividade da doença.Androgenetic alopecia is often treated by follicular unit transplantation, a technique that involves minimal risk of hair loss because of the more resistant nature of the donor area. Lichen planopilaris is a cicatricial alopecia that causes permanent destruction of hair follicles. We report two cases of post-transplantation lesions compatible with lichen planopilaris in both recipient and donor areas. The quality of the hair follicles in the donor area was apparently compromised by lichen planopilaris, the probable cause of hair loss. Similar reports are rare. When lichen planopilaris is suspected, a biopsy of the scalp must be performed to avoid transplantation during disease activity.

Alopecia frontal fibrosante: una enfermedad en auge

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Quintana-Sancho, A. de; Piris-García, X.; Valle-García, N.; Hierro-Cámara, M.

2016-01-01

La alopecia frontal fibrosante (AFF) es un tipo de alopecia cicatricial cuya incidencia está aumentando de forma significativa en nuestro país. Se caracteriza por un retroceso en la línea de implantación del pelo a nivel frontotemporal que afecta mayoritariamente a mujeres postmenopaúsicas, con un impacto negativo en su calidad de vida. Se asocia a menopausia precoz en un 14% de los casos y a hipotiroidismo en un 15%. Con respecto al tratamiento, son los inhibidores de la 5alfa-reductasa, los...

[The endoscopic therapy of benign stenoses of the esophagus and cardioesophageal junction using Eder-Puestow instrumentation].

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Donev, Sht; Bosekert, N; Belchev, B

1995-01-01

The results of palliative endoscopic treatment by bougienage using Eder-Puestow instrumentation, performed in a limited contingent of patients presenting benign esophageal strictures, are analyzed. It is underscored that the method is readily carried out and effective, and seldom leads to noteworthy complications, such as esophageal perforations--one patient alone presenting cicatricial stricture out of the total of 42 cases given treatment with bougienage over a 10-year period. The commonest cause of benign strictures of the esophagus in the series being examined is reflux (peptic) esophagitis against the background of hiatus hernia.

Annular and central heavy pigment deposition on the posterior lens capsule in the pigment dispersion syndrome: pigment deposition on the posterior lens capsule in the pigment dispersion syndrome.

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Turgut, Burak; Türkçüoğlu, Peykan; Deniz, Nurettin; Catak, Onur

2008-12-01

To report annular and central heavy pigment deposition on the posterior lens capsule in a case of pigment dispersion syndrome. Case report. A 36-year-old female with bilateral pigment dispersion syndrome presented with progressive decrease in visual acuity in the right eye over the past 1-2 years. Clinical examination revealed the typical findings of pigment dispersion syndrome including bilateral Krunkenberg spindles, iris transillumination defects, and dense trabecular meshwork pigmentation. Remarkably, annular and central dense pigmentation of the posterior lens capsule was noted in the right eye. Annular pigment deposition on the posterior lens capsule may be a rare finding associated with pigment dispersion syndrome. Such a finding suggests that there may be aqueous flow into the retrolental space in some patients with this condition. The way of central pigmentation is the entrance of aqueous to Berger's space. In our case, it is probable that spontaneous detachment of the anterior hyaloid membrane aided this entrance.

Enhanced electroscalpel incisional wound healing potential of honey in wistar rats

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David O. Eyarefe

2017-12-01

Full Text Available Electrosurgery reduces surgical bleeding, and delayed wound healing. This study evaluated comparative incisional wound healing potential of honey in wound created with electroscalpel and cold scalpel. The study used twelve (12 adult male albino rats (130 ± 20 g, randomly grouped into Electro-cautery (n = 6 and Cold scalpel (n = 6. Each rat had three full thickness (6 mm diameter skin wounds (a, b and c created on its dorsum with either Electroscalpel (ES or Cold blade scalpel (CS, and treated topically with Silver sulphadiazine (SSD, wound a, untreated (control, wound b and Bee honey (H, wound c. The wounds were evaluated for gross (exudation, edema, hyperemia, contraction, histologic (granulation, angiogenesis, fibroplasia, epithelialization and immunologic healing indices using standard techniques. Data were analyzed with Chi-square, Two-way Analysis of Variance (ANOVA and Duncan Multiple Range tests (DMRT at α = 0.05. Wound hyperemia and edge edema were prominent in the ES group from day 4 to 6 (P = .000. Percentage wound contraction was higher in the CS than ES group from days 5 to 7 (P = .006 and in the CS treated with honey than ES treated with honey from days 7 to 14 (P = .000. Granulation tissue reduced in ES group treated with SSD than in honey and control wounds. Fibroelastic tissue increased in SSD and honey treated wounds of ES group, and higher in honey treated wounds of CS group (P < .05. Fibroplasia was sustained in honey and SSD treated wounds than control. Honey can be applied to electroscalpel surgical wound to facilitate rapid healing during surgical management of tumours having vascular network. Keywords: Incisional methods, Honey, Silver sulphadiazide, Wound management

[Self-expanding nitinol stents in proximal tracheal stenosis].

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Hafner, B; Mann, W; Heussel, C P; Scherhag, A; Schlegel, J; Kauczor, H U

2000-03-01

The use of silicone- or metal stents in stenosis of the distal trachea and the bronchial system is a customary procedure [1-4], for example after tumor invasion or cicatricial stenosis after transplantation. In the proximal part of the trachea, on smaller, short and soft strictures we try to stabilise the trachea by the implantation of rings. Other methods are tracheal plasty or transverse tracheal resectomy [5-7]. In the case of longer or nearer subglottal stenoses the positioning of self-expanding nitinol stents has proven a simple, gentle and well-tolerated alternative procedure even in very serious disorders [1, 8, 9]. These stents can be placed in short narcosis under endoscopic control without great strain on the patient. We placed nitinol-stents in the proximal part of the trachea in eleven cases. In five cases dyspnoea caused by a tracheal collapse improved. In two further cases a tracheal stenosis with massive granulation tissue and cicatricial pull under an inlaid tracheal cannula was removed and the tracheostoma was closed. In four cases a solid, scarred and cartilaginous stenosis in the area of the cricoid and the upper tracheal rings was widened with laser and later on stented. Over an observation time of two years no complications showed safe one case in which a directly postoperative dislocation was repositioned quickly. The patients live without restrictions through the tracheal stenosis or a tracheostoma. In the best possible case epithelialization over the metal meshes develops so that a nearly normal mucus transportation is possible [1, 10-12].

Effects of preoperative pelvic irradiation on colonic anastomosis healing: an experimental study in rats Efeito da radioterapia pélvica pré-operatória na cicatrização de anastomoses colônicas: estudo experimental em ratos

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Alexandre Franca

2008-01-01

Full Text Available PURPOSE: Colorectal anastomosis is a constant worry-issue among surgeons because of high rates of complications, specially the dehiscence. The preoperative irradiation on cancer surgeries might interfere in the healing process, leading to an unfavorable outcome. METHODS: In the present study, two groups of rats were irradiated previously to a colorectal anastomosis surgery, with intervals of 4 and 8 weeks between the procedures. Seven days after the surgery, healing process was evaluated for dehiscence presence and histologic inflammatory characteristics. Also, levels of hydroxyproline, metalloproteinases and vascular endothelial growth factor were measured. RESULTS: Our results showed a higher incidence of dehiscences on the animals submitted to irradiation, compared to controls, with a reduced inflammatory activity in the healing tissue. DISCUSSION: Comparing both irradiated groups, those irradiated 8 weeks before surgery showed higher levels of hydroxyproline and metalloproteinases, indicating higher efficiency of the healing process. In conclusion, preoperative irradiation interferes with intestinal anastomosis healing and a larger time interval between both procedures is safer in terms of the healing quality.INTRODUÇÃO: As anastomoses colorretais são motivos constante de preocupação por parte dos cirurgiões, em virtude do alto índice de complicações, principalmente as deiscências. O uso da radioterapia previamente à cirurgia, nos casos de doença neoplásica, pode interferir no processo cicatricial das anastomoses, e levar a uma evolução desfavorável. MÉTODOS: Os autores estudaram dois grupos de ratos, submetidos a radioterapia e à confecção de uma anastomose no cólon, com intervalo de 04 e de 08 semanas entre os dois procedimentos, comparando com um grupo controle. Após 07 dias da cirurgia, estudaram-se vários aspectos do processo cicatricial: presença de deiscência, características inflamatórias do tecido, dosagem

[Expanded scalp flap in cicatricial areas affected by burns sequelae - an observation].

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El Mazouz, S; Hafidi, J; Fejjal, N; Mejjati, H; Cherkab, L; Gharib, N; Abbassi, A

2010-03-31

Les séquelles esthétiques des alopécies cicatricielles sur séquelles de brûlures sont responsables de préjudices empêchant parfois la réinsertion sociale du patient, surtout chez les sujets de sexe féminin. Le cuir chevelu permet la réalisation de lambeaux permettant de couvrir ces alopécies. Les Auteurs décrivent le cas d'une jeune patiente victime d'une alopécie cicatricielle sur séquelles de brûlures chez qui ils ont réalisé un lambeau expansé du cuir chevelu et mettent le point sur la prise en charge de ces lésions à travers ce cas clinique et une revue de littérature.

Fractional nonablative laser resurfacing: is there a skin tightening effect?

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Kauvar, Arielle N B

2014-12-01

Fractional photothermolysis, an approach to laser skin resurfacing that creates microscopic thermal wounds in skin separated by islands of spared tissue, was developed to overcome the high incidence of adverse events and prolonged healing times associated with full coverage ablative laser procedures. To examine whether fractional nonablative laser resurfacing induces skin tightening. A literature review was performed to evaluate the clinical and histologic effects of fractional nonablative laser resurfacing and full coverage ablative resurfacing procedures. Fractional nonablative lasers produce excellent outcomes with minimal risk and morbidity for a variety of clinical conditions, including photodamaged skin, atrophic scars, surgical and burn scars. Efforts to induce robust fibroplasia in histologic specimens and skin tightening in the clinical setting have yielded inconsistent results. A better understanding of the histology of fractional laser resurfacing will help to optimize clinical outcomes.

A phytomodulatory hydrogel with enhanced healing effects.

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Vasconcelos, Mirele S; Souza, Tamiris F G; Figueiredo, Ingrid S; Sousa, Emília T; Sousa, Felipe D; Moreira, Renato A; Alencar, Nylane M N; Lima-Filho, José V; Ramos, Márcio V

2018-04-01

The healing performance of a hydrogel composed of hemicelluloses extracted from seeds of Caesalpinia pulcherrima (Fabaceae) and mixed with phytomodulatory proteins obtained from the latex of Calotropis procera was characterized on excisional wounds. The hydrogel did not induce dermal irritability. When topically used on excisional wounds, the hydrogel enhanced healing by wound contraction. Histology and the measurement of inflammatory mediators (myeloperoxidase, interleukin-1β, and interleukin-6) suggested that the inflammatory phase of the healing process was intensified, stimulating fibroplasia and neovascularization (proliferative phase) and tissue remodeling by increasing new collagen fiber deposition. In addition, reduction on levels of malondialdehyde in the groups that the hydrogel was applied suggested that the oxidative stress was reduced. The hydrogel performed better than the reference drug used, as revealed by the extended thickness of the remodeled epithelium. Copyright © 2018 John Wiley & Sons, Ltd.

Acne keloidalis nuchae: prevalence, impact, and management challenges.

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Ogunbiyi, Adebola

2016-01-01

Acne keloidalis nuchae (AKN) also known as folliculitis keloidalis nuchae (FKN) is a chronic form of scarring folliculitis seen mostly in men of African descent. The term AKN is commonly used even though the condition is not a keloid, and the affected individuals do not have a tendency to develop keloids in other areas of the body. It is seen in post pubertal men and is rare after the age of 55 years. A few cases have been reported in females. which has been classified as a primary cicatricial alopecia since the exact cause of acne keloidalis (AK) remains unknown. However, a few inciting agents have been suggested which include androgens, inflammation, infection, trauma, genetics, and ingrowing hairs. AK shares some similar features with other forms of cicatricial alopecia and may occur together. Papules, pustules, and sometimes tumorous masses in the nuchal or occipital regions of the scalp hence the name "bumps" evolved in the environment. Despite its common occurrence, only a few seek help in hospital when lesions start to unsightly affect the individual's quality of life. The presences of the keloidal lesions are more stressful compared to the resulting alopecia. Various attempts to reduce the bumps with corrosives, acids, and car engine oils lead to larger lesions or unsightly scars. Active lesions produce bleeding during haircuts. This is worrisome as a couple of individuals with active AK share shaving instruments at the barber shop and are at risk of acquiring or transmitting blood-borne infections. There is an urgent need to encourage safe shaving habits and treatment of lesions at onset so as to prevent unsightly lesions.

Graham-Little Piccardi Lassueur Syndrome: case report Síndrome de Graham-Little Piccardi Lassueur: relato de caso

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Raquel Bissacotti Steglich

2012-10-01

Full Text Available A 33-year-old woman presented with a 3-year history of progressive alopecia of the scalp. Past treatment with hydroxicloroquine did not show improvement. Physical examination revealed multiple areas of alopecia with atrophic aspect of the scalp, and axillary and pubic hypotrichosis. Dermoscopy showed hyperkeratosis and accentuation of follicular ostia. Anatomopathological examination revealed decrease in the number of hair follicles, upper perifollicular infiltrate and areas with fibrosis. The Piccardi-Lassueur-Graham-Little syndrome is a rare disorder, characterized by the triad of multifocal scarring alopecia of the scalp, keratotic follicular eruption and hypotrichosis of axillary and pubic regions. Management is a challenge and many medications tried have controversial results. We report a case of this rare syndrome which improved with corticoids.Mulher, 33 anos, apresenta quadro de alopecia progressiva do couro cabeludo há 3 anos. Tratamento com hidroxicloroquina há 12 meses, sem apresentar melhora. Ao exame físico exibe múltiplas áreas de alopecia cicatricial no couro cabeludo, além de hipotricose axilar e pubiana. A dermatoscopia evidencia hipercetose folicular e acentuação dos óstios foliculares. O exame anatomopatológico revela diminuição do número de folículos pilosos, infiltrado perifolicular e fibrose. A síndrome de Graham-Little Piccardi Lassueur é uma dermatose rara, caracterizada pela tríade de alopecia cicatricial multifocal do couro cabeludo, ceratose folicular disseminada e hipotricose das regiões axilares e pubianas. A terapêutica desta dermatose é um desafio, muitas medicações relatadas tem resultados controversos. Relatamos o caso desta síndrome rara que apresentou melhora com corticoterapia.

Intracapsular lens extraction for the treatment of pupillary block glaucoma associated with anterior subluxation of the crystalline lens.

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Kim, Yong Joon; Ha, Seung Joo

2013-01-01

To report a case of pupillary block glaucoma associated with spontaneous crystalline lens subluxation into the anterior chamber in a 34-year-old man. Dry vitrectomy was performed for securing enough retrolental space, and an intracapsular lens extraction was then performed via a corneolimbal incision. Additional endothelial cell damage was avoided with an injection of viscoelastics and gentle extraction of the crystalline lens. After deepening of the anterior chamber, scleral fixation of the intraocular lens was performed with an ab externo technique. Two months after the operation, a well-fixated intraocular lens was observed and intraocular pressure was stable. The postoperative corneal astigmatism was -3.5 dpt, and the patient had a best-corrected visual acuity of 20/25. Postoperative complications included decreased endothelial cell count and sector iris paralysis near the incision site. An anteriorly subluxated crystalline lens can cause pupillary block glaucoma in healthy young adults. To prevent intraoperative complications, intracapsular lens extraction with dry vitrectomy can be a good surgical option. The endothelial cell density should be closely monitored after surgery.

An animal model for Norrie disease (ND): gene targeting of the mouse ND gene.

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Berger, W; van de Pol, D; Bächner, D; Oerlemans, F; Winkens, H; Hameister, H; Wieringa, B; Hendriks, W; Ropers, H H

1996-01-01

In order to elucidate the cellular and molecular processes which are involved in Norrie disease (ND), we have used gene targeting technology to generate ND mutant mice. The murine homologue of the ND gene was cloned and shown to encode a polypeptide that shares 94% of the amino acid sequence with its human counterpart. RNA in situ hybridization revealed expression in retina, brain and the olfactory bulb and epithelium of 2 week old mice. Hemizygous mice carrying a replacement mutation in exon 2 of the ND gene developed retrolental structures in the vitreous body and showed an overall disorganization of the retinal ganglion cell layer. The outer plexiform layer disappears occasionally, resulting in a juxtaposed inner and outer nuclear layer. At the same regions, the outer segments of the photoreceptor cell layer are no longer present. These ocular findings are consistent with observations in ND patients and the generated mouse line provides a faithful model for study of early pathogenic events in this severe X-linked recessive neurological disorder.

[Two cases of Kniest dysplasia--ocular manifestations].

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Kagotani, Y; Takao, K; Nomura, K; Okubo, K

1995-03-01

We report ocular findings from 2 children with Kniest dysplasia. Both eyes of the 2 patients had abnormal long axial length causing high myopia, and vitreoretinal degeneration. The vitreous cavity of case 1 (a 15-year-old boy) which contained fibrous clouded membranous structures floating in the retrolental space and dense opacity at the temporal-inferior portion, was optically empty. Case 2 (a 7-year-old boy) had cortical and posterior subcapsular opacity of the lens, and also veil-like vitreous opacity in the periphery. Their common retinal changes were characterized as perivascular lattice degeneration and white without pressure in various degrees. They have not yet shown cataract or retinal detachment which needs surgical treatment, but close ophthalmological follow up will be necessary for their favorable prognosis. The literature on vitreoretinal degeneration such as Wagner's disease or Stickler syndrome may indicate the relation of Kniest dysplasia to similar diseases. Because they might have different clinical courses and visual prognosis according to the original biosynthetic disorders, we emphasized the importance of orthopedic diagnosis regarding such vitreoretinal degeneration with constitutional bone diseases.

The effect of soft-laser (diodes radiation on wound healing in cats

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Julia Maria Matera

1994-03-01

Full Text Available Verificou-se o valor do emprego do laser diodo Ga-As-SHLD para auxiliar o processo de cicatrizarão cutânea em felinos. Utilizaram-se 21 animais que foram submetidos à ovariohisterectomia, 9 pertencendo ao grupo controle e 12 submetidos à laserterapia. Os exames anatomopatológicos foram realizados nos dias 2, 4 e 8 de pós-operatório, juntamente com avaliação macroscópica. Concluiu-se que a aplicação do laser diodo Ga-As-SHLD auxiliou o processo cicatricial da ferida cirúrgica por aumento de resistência à tensão.

Bronchial asthma: correlation of high resolution computerized tomography findings with clinical data

International Nuclear Information System (INIS)

Mogami, Roberto; Marchiori, Edson; Kirk, Kennedy; Capone, Domenico; Daltro, Pedro

1999-01-01

In this work we did a sectional study of 31 asthmatic patients with several levels of disease severity, which were submitted to high resolution computed tomography of the thorax and spirometry, between the months of July, 1995 and August, 1997. The tomographic findings were correlated with the clinical classification of the patients and the most frequent tomographic findings were bronchial wall thickening, bronchial dilatation, air trapping, centrilobular opacities, cicatricial linear shadows, mucoid impaction, emphysema and atelectasis. In asthmatic patients of long duration we observed small airway disease and irreversible lesions as the predominant findings. In smoking patients there was no high frequency of emphysema. (author)

Bronchial asthma: correlation of high resolution computerized tomography findings with clinical data; Asma bronquica: correlacao de achados em tomografia computadorizada de alta resolucao com dados clinicos

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Mogami, Roberto [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Servico de Radiologia; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Kirk, Kennedy; Capone, Domenico [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Servico de Pneumologia; Daltro, Pedro [Instituto Fernandes Figueira, Rio de Janeiro, RJ (Brazil). Servico de Radiologia

1999-04-01

In this work we did a sectional study of 31 asthmatic patients with several levels of disease severity, which were submitted to high resolution computed tomography of the thorax and spirometry, between the months of July, 1995 and August, 1997. The tomographic findings were correlated with the clinical classification of the patients and the most frequent tomographic findings were bronchial wall thickening, bronchial dilatation, air trapping, centrilobular opacities, cicatricial linear shadows, mucoid impaction, emphysema and atelectasis. In asthmatic patients of long duration we observed small airway disease and irreversible lesions as the predominant findings. In smoking patients there was no high frequency of emphysema. (author)

Emprego da submucosa de intestino delgado na correção de estenose esofágica em cães Small intestinal submucosa for reconstruction of esophageal stricture in a dog model

OpenAIRE

Zacarias Alves de Souza Filho; Fernando Hintz Greca; João Ricardo Duda; Guilherme Zicarelli Cravo; Sérgio Ossamu Ioshii

2004-01-01

OBJETIVO: Pesquisar a eficácia da Submucosa de lntestino Delgado (SID) porcina na correção de estenoses esofágicas cervicais em cães. MÉTODOS: Para produzir estenose, 12 animais foram submetidos a ressecções de porção elíptica de 3,5X2,0 cm, na parede anterior do esôfago cervical, suturado por pontos de fio de algodão. O processo evolui por 90 dias, atingindo a estenose desejada e comprovada por esofagograma. Na seqüência, a lesão cicatricial produzida foi ressecada e substituída por enxerto ...

The large eyes of Wolfgang Amadeus Mozart. (On the occasion of the 250th Mozart anniversary year).

Science.gov (United States)

Zegers, Richard H C; Saeed, Peerooz; Wiersinga, Wilmar M

2005-12-01

This article discusses the eyes of Wolfgang Amadeus Mozart (1756-1791) which, based on portraits, can be said to have a certain noticeable feature--some degree of exophthalmos. In fact, even contemporary observers made particular mention of Mozart's eyes being large. Although cicatricial ectropion, caused by infectious disease, cannot be excluded, mild myopia, in combination with shallow orbits or combined with a genetic predilection, would be one possible explanation for Mozart's large eyes. Graves' orbitopathy, the ophthalmic manifestation of hyperthyroidism, or hypothyroidism have both been suggested to be the cause of Mozart's large eyes. However, these diseases are unlikely causes given their topical and systemic features.

Estudo histológico comparativo de implantes (ímãs em órbitas de coelhas Comparative histologic study of implants (magnets in orbits of female rabbits

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Elcio Roque Kleinpaul

2005-10-01

Full Text Available OBJETIVOS: Avaliação microscópica dos sinais da reação inflamatória causada pela fixação de implante orbitário (ímã, recoberto por ouro. MÉTODOS: Estudo experimental em 54 coelhas adultas, divididas em três grupos de 18, com 3 subgrupos de 6, avaliação com uma, três e seis semanas de pós-operatório. Fixação, no rebordo inferior da órbita, de implante (ímã e ouro por meio de cola, parafuso ou fio inabsorvível (Mersilene 5.0®. As órbitas contralaterais (sem implante compuseram o grupo-controle. RESULTADOS: Sinais histológicos de reação inflamatória à fixação orbitária do implante foram observados, com cianoacrilato, parafuso, ou sutura inabsorvível (Mersilene 5.0®, até a sexta semana pós-operatória, com predomínio do processo inflamatório crônico e fibrótico cicatricial, sem demonstrar diferenças estatisticamente significativas na maior parte dos casos. CONCLUSÃO: O exame histopatológico demonstrou, na maior parte das órbitas com e sem implante, presença de reação inflamatória aguda e crônica até a sexta semana pós-operatória, com predomínio de processo inflamatório crônico e fibrótico cicatricial, sem demonstrar, na maior parte dos casos, diferenças estatisticamente significante entre os grupos experimental e controle.PURPOSE: To evaluate microscopically the signs of inflammatory reaction due to the fixation of an orbitary implant (magnet, covered by gold. METHODS: An experimental study was performed in 54 adult female rabbits, divided into 3 groups of eighteen with 3 subgroups of 6; an evaluation at 1, 3 and 6 postoperative weeks was performed. An implant (magnet, covered by gold was fixed in the inferior orbital rim using biologic glue, screw or unabsorbable suture (Mersilene 5.0®. The opposite orbits (without implants represented the control group. RESULTS: Microscopic signs of inflammatory reaction due to orbitary fixation of the implant were observed with the use of the three

Penis invalidating cicatricial outcomes in an enlargement phalloplasty case with polyacrylamide gel (Formacryl).

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Parodi, P C; Dominici, M; Moro, U

2006-01-01

The present article reports the case of a patient subjected to polyacrylamide polymers-composed gel cutaneous infiltration in the penis for cosmetic purposes, resulting in severe invalidating outcomes. A significant tissue reaction to the subcutaneous injection of polyacrylamide gel for the penis enlargement purpose resulted in permanent and invalidating scars both on the esthetic and functional levels. Such a result must be simply taken into account both singly and in the light of the international literature to exclude this method as standard uro-andrologic activity.

Melanocytic lesions in a private pathology practice. Comparison of histologic features in different tumor types with particular reference to dysplastic nevi.

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Hastrup, N; Hou-Jensen, K

1993-11-01

This study reviews a total of 1000 melanocytic lesions--two separate 500 consecutive sample groupings from 1980 and 1989, respectively--diagnosed in a private non-hospital-associated pathology practice. Lesions were classified as lentigo simplex, congenital nevus, "common" nevus, dysplastic nevus, blue nevus, Spitz's nevus or malignant melanoma. A comparison of the two periods reveals an increase in dysplastic nevi from one in 1980 to nine in 1989. The histologic changes in these nevi were compared to those of the other tumors. Pronounced cytologic atypia was seen in the melanocytes of a few "common" nevi, but more often in the dysplastic nevi and in all of the melanomas. Slight nuclear atypia was usual in "common" nevi and lentigines, and also fibroplasia, lymphocytic infiltration, vessel proliferation and pigment incontinence were seen in both "common" nevi and dysplastic nevi. It is concluded that no single histologic variable was specific for dysplastic nevi.

Etiologic analysis of 100 anatomically failed dacryocystorhinostomies

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Dave, Tarjani Vivek; Mohammed, Faraz Ali; Ali, Mohammad Javed; Naik, Milind N

2016-01-01

Background The aim of this study was to assess the etiological factors contributing to the failure of a dacryocystorhinostomy (DCR). Patients and methods Retrospective review was performed in 100 consecutive patients who were diagnosed with anatomically failed DCR at presentation to a tertiary care hospital over a 5-year period from 2010 to 2015. Patient records were reviewed for demographic data, type of past surgery, preoperative endoscopic findings, previous use of adjuvants such as intubation and mitomycin C, and intraoperative notes during the re-revision. The potential etiological factors for failure were noted. Results Of the 100 patients with failed DCRs, the primary surgery was an external DCR in 73 and endoscopic DCR in 27 patients. Six patients in each group had multiple revisions. The mean ages at presentation in the external and endoscopic groups were 39.41 years and 37.19 years, respectively. All patients presented with epiphora. The most common causes of failure were inadequate osteotomy (69.8% in the external group and 85.1% in the endoscopic group, P=0.19) followed by inadequate or inappropriate sac marsupialization (60.2% in the external group and 77.7% in the endoscopic group, P=0.16) and cicatricial closure of the ostium (50.6% in the external group and 55.5% in the endoscopic group, P=0.83). The least common causes such as ostium granulomas and paradoxical middle turbinate (1.37%, n=1) were noted in the external group only. Conclusion Inadequate osteotomy, incomplete sac marsupialization, and cicatricial closure of the ostium were the most common causes of failure and did not significantly differ in the external and endoscopic groups. Meticulous evaluation to identify causative factors for failure and addressing them are crucial for subsequent successful outcomes. PMID:27555748

Acne keloidalis nuchae: prevalence, impact, and management challenges

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Ogunbiyi A

2016-12-01

Full Text Available Adebola Ogunbiyi Dermatology Unit, Department of Medicine, College of Medicine, University of Ibadan, University College Hospital Ibadan, Oyo State, Nigeria Abstract: Acne keloidalis nuchae (AKN also known as folliculitis keloidalis nuchae (FKN is a chronic form of scarring folliculitis seen mostly in men of African descent. The term AKN is commonly used even though the condition is not a keloid, and the affected individuals do not have a tendency to develop keloids in other areas of the body. It is seen in post pubertal men and is rare after the age of 55 years. A few cases have been reported in females. which has been classified as a primary cicatricial alopecia since the exact cause of acne keloidalis (AK remains unknown. However, a few inciting agents have been suggested which include androgens, inflammation, infection, trauma, genetics, and ingrowing hairs. AK shares some similar features with other forms of cicatricial alopecia and may occur together. Papules, pustules, and sometimes tumorous masses in the nuchal or occipital regions of the scalp hence the name “bumps” evolved in the environment. Despite its common occurrence, only a few seek help in hospital when lesions start to unsightly affect the individual’s quality of life. The presences of the keloidal lesions are more stressful compared to the resulting alopecia. Various attempts to reduce the bumps with corrosives, acids, and car engine oils lead to larger lesions or unsightly scars. Active lesions produce bleeding during haircuts. This is worrisome as a couple of individuals with active AK share shaving instruments at the barber shop and are at risk of acquiring or transmitting blood-borne infections. There is an urgent need to encourage safe shaving habits and treatment of lesions at onset so as to prevent unsightly lesions. Keywords: scarring alopecia, clinical features, treatment challenges 

Standardization of SMP procedure and its impact on outcome

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Rachita S Dhurat

2017-01-01

Full Text Available Background: Cosmetic deformities can result from various types of alopecia or even post hair transplantation procedures. Patients with such deformities seek aesthetically appealing longer-lasting options. Scalp concealers are commonly used by men and women to camouflage these deformities. Scalp micropigmentation (SMP is one of the concealers recently gaining popularity. Objectives: SMP is a novel technique wherein microdot tattoos are placed in a stippling pattern to mimic hair follicles that are cut close to the scalp and various variables affecting its outcome were evaluated. Methods: Forty-five subjects were recruited for the study. The various factors affecting outcome of SMP—angle of needle against the scalp, depth of needle into the scalp, time of the needle contact in scalp, speed of the rotor, resistance of scalp, color of pigment, viscosity of dye, needle number, needle thickness, and pattern of dot placement—were systematically studied in 15 patients through clinical photographs and trichoscopy. Ideal depth of pigment deposition was assessed through histopathological examination. After using these optimum variables, standardized SMP was performed in 30 patients with hair loss (3 patients with cicatricial and 27 patients with diffuse non-cicatricial alopecia. SMP was also used to create an aesthetically denser hairline. The outcome of the procedure was evaluated using standardized global photographs. Results: The ideal parameters were established to achieve standard reproducible results. There were great patient satisfaction and acceptance of the procedure. All the patients showed moderate to great improvement after the procedure with satisfactory scalp coverage. Adverse events were transient which were seen in the form of edema and redness. Conclusion: SMP offers a non-medical, tattoo-based cosmetically appealing and effective “cover-up” that hides the unsightly conditions. The cosmetic tattoo placement creates an illusion of

Computed tomography for sequelae of brain contusions

International Nuclear Information System (INIS)

Aminov, M.

1995-01-01

Follow-up clinical and computed tomographic (CT) studies were performed in 140 patients with focal brain contusions at the acute stage of brain injury (BI). A total of 133 victims were followed up and the time course of CT changes were examined in the intervening and late BI periods. Despite the favourable natural history of acute BI, mild, moderate, and severe posttraumatic changes were shown to appear as cicatricial-adhesive and atrophic processes, intracerebral cysts, porencephalies, which result in posttraumatic epilepsy, hydrocephalus and others. The magnitude of diffuse changes rather than focal changes in the area of the prior medullary lesion was found to play the leading role in the victims disability [ru

Ophthalmic manifestations in Rothmund–Thomson syndrome: Case report and review of literature

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J T Chinmayee

2017-01-01

Full Text Available A 24-year-old male patient presented to us with diminution of vision in both eyes with watering and photophobia for the past 8 years. General physical examination showed short stature and poikiloderma. Ocular findings include photophobia with reflex tearing, dry eye, cicatricial ectropion, symblepharon approaching pupillary area of cornea, and multiple superficial punctuate erosions on the cornea. Both eyelids showed scanty meibomian glands on infrared meibography. The rest of the anterior and posterior segment was normal. The patient was treated with topical lubricants which reduced photophobia and corneal erosions. He then underwent symblepharon release with buccal mucosal grafting, which improved ectropion. Patient improved symptomatically with reduction of photophobia and improvement in vision as well.

A case of radiation hemorrhagic gastritis successfully treated by endoscopic argon plasma coagulation

International Nuclear Information System (INIS)

Furukawa, Koichi; Ho, Nichyau; Kuroda, Ken; Ikarashi, Kentarou; Hata, Koujirou; Tukioka, Satosi

2003-01-01

A 72-year-old woman underwent irradiation of 46 Grey in total dose, for lumbago of the advanced pancreatic cancer in August 2000. She was admitted to our hospital due to severe anemia in February 2001 with occasionally positive fecal occult blood. Endoscopy revealed erosive gastric mucosa diffuse in the lower body of the stomach, which resulted from radiation. We applied argon plasma coagulation (APC) in March 2001 and succeeded in hemostasis of the widely spreading radiation hemorrhagic gastritis. The progress of the severe anemia improved without cicatricial stenosis. As the coagulation of the APC is limited in the surface mucosa, APC is an easy and effective treatment for radiation hemorrhagic gastritis. (author)

The role of nuclear hormone receptors in cutaneous wound repair.

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Rieger, Sandra; Zhao, Hengguang; Martin, Paige; Abe, Koichiro; Lisse, Thomas S

2015-01-01

The cutaneous wound repair process involves balancing a dynamic series of events ranging from inflammation, oxidative stress, cell migration, proliferation, survival and differentiation. A complex series of secreted trophic factors, cytokines, surface and intracellular proteins are expressed in a temporospatial manner to restore skin integrity after wounding. Impaired initiation, maintenance or termination of the tissue repair processes can lead to perturbed healing, necrosis, fibrosis or even cancer. Nuclear hormone receptors (NHRs) in the cutaneous environment regulate tissue repair processes such as fibroplasia and angiogenesis. Defects in functional NHRs and their ligands are associated with the clinical phenotypes of chronic non-healing wounds and skin endocrine disorders. The functional relationship between NHRs and skin niche cells such as epidermal keratinocytes and dermal fibroblasts is pivotal for successful wound closure and permanent repair. The aim of this review is to delineate the cutaneous effects and cross-talk of various nuclear receptors upon injury towards functional tissue restoration. Copyright © 2014 John Wiley & Sons, Ltd.

Vascular abnormalities of the distal deep digital flexor tendon in 8 draught horses identified on histological examination.

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Crişan, Melania Ioana; Damian, Aurel; Gal, Adrian; Miclăuş, Viorel; Cernea, Cristina L; Denoix, Jean-Marie

2013-08-01

The purpose of this study was to provide a detailed description of the vascular changes in the distal part of deep digital flexor tendon (DDFT). Eight isolated forelimbs were collected from 8 horses with DDF tendinopathy diagnosed post-mortem by ultrasound and gross anatomopathological examination. The samples were fixed in 10% neutral buffered formalin, softened in 4% phenol and dehydrated with ethylic alcohol. Goldner's Trichrome staining method was used. The histopathological examination revealed vascular proliferation associated with structural disorders of blood vessels. Angiogenesis, fibroplasia and consecutive hypertrophy of the vascular wall with or without vascular occlusion were the most common findings. Other histopathological findings were: endothelial cell edema, progressive metaplasia from squamous to cubic cells, vascular wall hyalinization, endothelial cells apoptosis/necrosis and endothelial desquamation. These results demonstrated damage of the distal deep digital flexor tendon vasculature which may progressively alter the structural integrity of the tendon and contribute to degenerative lesions. Copyright © 2013 Elsevier Ltd. All rights reserved.

The prevalence of glaucoma in patients undergoing surgery for eyelid entropion or ectropion

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Golan S

2016-10-01

Full Text Available Shani Golan, Gilad Rabina, Shimon Kurtz, Igal Leibovitch Division of Orbital and Ophthalmic Plastic Surgery, Department of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Purpose and design: The aim of this study was to establish the prevalence of known glaucoma in patients undergoing ectropion or entropion surgical repair. In this study, retrospective review of case series was performed.Participants: All patients who underwent ectropion or entropion surgery in a tertiary medical center between 2007 and 2014 were included. The etiology of eyelid malpositioning was involutional or cicatricial.Methods: The medical files of the study participants were reviewed for the presence and type of glaucoma, medical treatment, duration of treatment, and the amount of drops per day. These data were compared to a matched control group of 101 patients who underwent blepharoplasty for dermatochalasis in the same department during the same period.Main outcome measure: In this study, the prevalence of glaucoma in individuals with ectropion or entropion was the main outcome measure.Results: A total of 227 patients (57% men, mean age: 79.2 years who underwent ectropion or entropion surgery comprised the study group and 101 patients who underwent upper blepharoplasty for dermatochalasis comprised the control group. Compared to four patients in the control group (4%, P=0.01, 30 of the study patients (13.2% had coexisting glaucoma. Of 30 glaucomatous patients, 25 had primary open-angle glaucoma for a mean duration of 10.3 years. The glaucomatous patients were treated with an average of 2.7 antiglaucoma medications.Conclusion: An increased prevalence of known glaucoma in patients undergoing ectropion or entropion repair surgery was found. This observation may indicate that the chronic usage of topical anti-glaucoma eyedrops may lead to an increased risk of developing eyelid malpositions, especially in

Control of the skin scarring response

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Lydia M. Ferreira

2009-09-01

Full Text Available There comes a time when the understanding of the cutaneous healing process becomes essential due to the need for a precocious tissue repair to reduce the physical, social, and psychological morbidity. Advances in the knowledge on the control of interaction among cells, matrix and growth factors will provide more information on the Regenerative Medicine, an emerging area of research in medical bioengineering. However, considering the dynamism and complexity of the cutaneous healing response, it is fundamental to understand the control mechanism exerted by the interaction and synergism of both systems, cutaneous nervous and central nervous, via hypothalamus hypophysis-adrenal axis, a relevant subject, but hardly ever explored. The present study reviews the neuro-immune-endocrine physiology of the skin responsible for its multiple functions and the extreme disturbances of the healing process, like the excess and deficiency of the extracellular matrix deposition.Aproxima-se uma época na qual é fundamental a compreensão do processo cicatricial cutâneo frente à necessidade da restauração tecidual precoce, visando a diminuição das morbidades física, social e psicológica. O avanço no conhecimento acerca do controle das interações entre as células, a matriz e os fatores de crescimento dará maiores informações à Medicina Regenerativa, área de pesquisa emergente da bioengenharia médica. Entretanto, diante do dinamismo e complexidade da resposta cicatricial cutânea torna-se indispensável o entendimento do mecanismo de controle exercido pela interação e sinergismo do sistema nervoso cutâneo e o sistema nervoso central, via eixo hipotálamo-hipófise-adrenal, tema relevante, porém, pouco abordado. O presente estudo revisa a fisiologia neuro-imuno-endócrina da pele, responsável por suas múltiplas funções, e os distúrbios extremos do processocicatricial, como o excesso e deficiência de deposição da matriz extracelular.

Ultra-som terapêutico na cicatrização tecidual Therapeutic ultrasound in the tissue healing

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Débora Cristina Olsson

2008-08-01

Full Text Available Visando a minimizar o período de tratamento cicatricial em diversos tecidos, buscam-se alternativas à terapia convencional que colaborem com o processo reparativo criando um microambiente ideal para sua ocorrência. Dentre os inúmeros benefícios das técnicas aplicáveis à medicina regenerativa, o ultra-som terapêutico (UST é prática adjuvante cada vez mais freqüente. Os modelos experimentais de terapia sonora em animais têm propiciado informações relevantes para o tratamento de vários tipos de lesões; todavia, apesar de serem muito utilizados, ainda existem controvérsias em relação aos seus potenciaia biológicos de acordo com a modalidade e a dosimetria indicadas para cada caso. Os efeitos biofísicos do ultra-som (US sobre o reparo tecidual são pouco compreendidos, sendo seu uso muitas vezes negligenciado ou fundamentado na experiência prática, o que resulta em procedimentos errôneos. O objetivo desta revisão bibliográfica é apresentar informações sobre o UST, relatar a existência de riscos de danos celulares decorrentes da inadequada aplicação e revelar a importância de seus mecanismos de ação nos tecidos, tanto no sentido físico, como nos seus aspectos biológicos.Aiming to minimize the cicatricial treatment period, alternatives have been searched to conventional therapy, among which the therapeutic ultrasound is a practice more and more frequent. However, despite of being used in the treatment of various lesions types, there are still controversies related to its real therapeutical value and the indicated dosimetry for each case. The ultrasound effect on the tissue repair is little understood, and its use is seldom based on the practical experience, what sometimes results in wrong procedures. This review has the objective to show the therapeutic ultrasound information and to reveal the importance of its mechanisms in the tissues in the physical and biological aspects.

Alopecia secondary to mesotherapy.

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Duque-Estrada, Bruna; Vincenzi, Colombina; Misciali, Cosimo; Tosti, Antonella

2009-10-01

Mesotherapy has recently become an advertised method for the treatment of different types of alopecia despite the lack of any data regarding its efficacy and possible side effects. The substances injected into the scalp include "cocktails" of natural plant extracts, homoeopathic agents, vitamins, vasodilators, and drugs that may stimulate hair growth, such as finasteride and minoxidil. We report two cases of patchy alopecia that developed after mesotherapy for the treatment of androgenetic alopecia. In the first patient, alopecia developed after injections of the heparinoid vasodilator mesoglycan; the 3-month follow-up examination revealed a small residual area of cicatricial alopecia. The second patient developed reversible alopecia after multiple scalp injections of homeopathic agents. These cases underline the possible risks of mesotherapy as a therapeutic technique for hair loss.

RETINOPATHY OF PREMATURE INFANTS AS A MAIN PROBLEM OF NEONATAL OPHTHALMOLOGY

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P. V. Rozental’

2014-01-01

Full Text Available During more than 70 years retinopathy of premature infants (previously — retrolental retinopathy has been one of the main problems in neonatology practice. This is caused firstly by the high risk of blindness development and visual disability and secondly — by the steady increase of health care allowing infants previously believed to be incurable to survive. Success in prevention of development of severe forms of this disorder nowadays depends not only on knowledge and experience of pediatric ophthalmologists. To the great extent it is associated to efforts and awareness of all levels of medical care participating in management of premature infants: from maternity hospitals, including departments of intensity care and neonatology, to out-patients clinics. According to the review of modern literature the article contains the main data on etiology, risk factors, pathogenesis, classification, clinical manifestation, diagnostics, prophylaxis and treatment of retinopathy of premature infants. The author also noted the tendencies to reveal the disease in the modern history of the Russian Federation. It is important to say, that urgency of this problem in the Russian Federation has significantly raised during the last years due to switch since the 1st January 2012 to the live birth criteria recommended by the World Health Organization.

Repair of Total Tractional Retinal Detachment in Norrie Disease: Report of Technique and Successful Surgical Outcome.

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Todorich, Bozho; Thanos, Aristomenis; Yonekawa, Yoshihiro; Capone, Antonio

2017-03-01

Norrie disease is a rare, but devastating cause of pediatric retinal detachment, universally portending a poor visual prognosis. This paper describes successful surgical management of an infant with total retinal detachment associated with Norrie disease mutation. The infant was a full-term white male who presented with bilateral total funnel retinal detachments (RDs). He underwent genetic testing, which demonstrated single-point mutation 133 G>A transition in exon 2 of the NDP gene. The retinal detachment was managed with translimbal iridectomy, lensectomy, capsulectomy, and vitrectomy. Careful dissection of the retrolental membranes resulted in opening of the funnel. Single-stage surgery in this child's eye achieved re-attachment of the posterior pole with progressive reabsorption of subretinal fluid and cholesterol without the need for external drainage. Fluorescein angiography, performed at 2 months postoperatively, demonstrated perfusion of major vascular arcades, but with significant abnormalities and aneurysmal changes of higher-order vessels, suggestive of retinal and vascular dysplasia. The child has maintained brisk light perception vision. Early surgical intervention with careful dissection of tractional tissues can potentially result in good anatomic outcomes in some patients with Norrie disease-associated retinal detachment. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:260-262.]. Copyright 2017, SLACK Incorporated.

Histological changes to the skin of Merino sheep following deep dermal and subcutaneous injections of sodium lauryl sulfate.

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Lee, E J; Rothwell, J T

2010-04-01

To characterise the changes caused to sheep skin by deep dermal and subcutaneous injections of sodium lauryl sulfate (SLS) and describe the subsequent healing process. On 6 sheep 20 small areas of skin were each given deep dermal and subcutaneous injections of 0.2 mL of 7% SLS. Biopsies were collected at intervals up to 28 days after treatment and the histological changes in each of the treated skin samples were assessed and graded. There was no evidence of alterations in behaviour, weight gain or appetite of the sheep following the injections. Initial swelling of the treated site subsided by day 14, leaving a firm, slightly raised crust. At day 21, the treated area was depressed and covered by a scab, which sloughed completely by day 28. There was necrosis of the subcutis and deep dermis 2 min after treatment, followed by inflammation, fibroplasia, angiogenesis and tissue remodelling. Injection of SLS caused almost immediate local necrosis followed by eschar formation, sloughing and scarring of treated skin. Deep dermal and subcutaneous SLS is potentially useful as a chemical alternative to mulesing.

Tissue reactions induced by nylon cable tie used to clamp ovarian pedicles

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Luiz Fernando Moraes Moreira

2018-03-01

Full Text Available The aim of this study was to evaluate the tissue reactions induced by nylon cable tie by using macroscopic and histological evaluations. Forty-five clinically healthy crossbreed female dogs, 31.11 ± 14.26 months old and with a body weight of 11.26 ± 4.7 kg, underwent ovariohysterectomy using a minimally invasive procedure. The dogs were randomly divided into three groups of 15 animals each and were evaluated preoperatively, and at 30 (G1, 60 (G2 and 90 days (G3 after surgery. The histological examination of the pedicles containing the nylon cable ties, collected from five animals in each group, showed a chronic inflammatory reaction with the presence of macrophages, giant cells and fibroplasia on the 30th postoperative day. Well-organized connective tissue and presence of lymphocytes and polymorphonuclear leukocytes were seen on the 60th postoperative day, and mature connective tissue and presence of macrophages and lymphocytes were seen at 90 days. Nylon cable ties induce an inflammatory reaction, which should be considered due to the risk of interference with surrounding structures.

Pathology of gastric lesions in donkeys: A preliminary study.

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Al-Mokaddem, A K; Ahmed, K A; Doghaim, R E

2015-11-01

Donkeys (Equus africanus asinus) are important working animals, particularly in countries where the majority of the population lives below the poverty line. Gastric ulceration has been shown to be common in British donkeys but donkeys from other parts of the world have not been as extensively researched. This study was performed as a preliminary overview of the severity and distribution of gastric lesions in mature donkeys and to document which parasites were present. Descriptive study of pathological findings. Stomachs of 35 mature draught donkeys were examined grossly and histopathology samples taken from 5 regions of the gastric mucosa. Gross examination revealed hyperaemia, oedema, erosions and ulcers in addition to parasitic lesions. Histopathological examination revealed hyperkeratosis, acanthosis, vacuolar degeneration of stratified squamous cells, gastritis, erosions, ulcerations, scarring, hyperactivity of mucus glands, periglandular fibroplasia and parasitic granulomes with infestation by Gasterophilus spp. larvae, Habronema spp. and Draschia megastoma. In donkeys, ulceration of the nonglandular regions of the stomach is more prominent than the glandular regions and parasitic infestations were frequent. © 2014 EVJ Ltd.

Focal intramural pericardial effusion and cardiac tamponade associated with necrotic adipose tissue in a dog.

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Krentz, Terence A; Schutrumpf, Robert J; Zitz, Julie C

2017-07-15

CASE DESCRIPTION A 1-year-old castrated male German Shepherd Dog was examined because of an acute onset of lethargy, tachypnea, and inappetence. CLINICAL FINDINGS On initial physical examination, the dog was tachypneic with muffled heart sounds on thoracic auscultation and a palpable abdominal fluid wave. Transthoracic echocardiography revealed focal intramural pericardial effusion and cardiac tamponade. TREATMENT AND OUTCOME The patient underwent emergency therapeutic pericardiocentesis, followed by right lateral intercostal thoracotomy and subtotal pericardiectomy. A 3 × 5-cm mass located between the parietal and visceral layers of the pericardium was resected. The histologic diagnosis was necrotic adipose tissue with granulomatous inflammation and fibroplasia. The patient also underwent exploratory laparotomy and umbilical herniorrhaphy during the same anesthetic episode and recovered from surgery without apparent complications. There were no further clinical signs of cardiac disease. CLINICAL RELEVANCE The patient described in the present report underwent successful subtotal pericardiectomy for treatment of a benign focal lesion causing recurrent pericardial effusion and cardiac tamponade. Prompt diagnosis and intervention may have contributed to the positive outcome in this case.

Diffuse scarring alopecia in a female pattern hair loss distribution.

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Fergie, Bonnie; Khaira, Gurpreet; Howard, Vicki; de Zwaan, Sally

2018-02-01

We describe three cases of hair loss in a female pattern hair loss (FPHL) distribution with histologic features of lichen planopilaris (LPP). All patients had a history of diffuse, gradual hair loss in a Christmas tree pattern that clinically presented as FPHL on gross and dermoscopic examination. Notably, there were no characteristic clinical signs of LPP and no histologic features of FPHL. These cases are most consistent with cicatricial pattern hair loss (CPHL). This relatively new entity is similar to fibrosing alopecia in a pattern distribution (FAPD) in that they are both scarring alopecias confined to a FPHL distribution, but CPHL lacks the clinical signs of perifollicular erythema and perifollicular keratosis seen in FAPD. These three cases may present an early, subtle form of CPHL and will be of interest to clinicians and histopathologists alike. © 2017 The Australasian College of Dermatologists.

Estudo comparativo entre anastomoses intestinais com sutura manual e com anel biofragmentável em cães sob a administração de corticosteróides Comparative study of intestinal anastomoses with manual suture and biofragmentable ring in dogs under corticosteroid administration

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L. C. Fernandes

2000-06-01

Full Text Available OBJETIVO: Este estudo analisou anastomoses intestinais por sutura manual e por compressão com anel biofragmentável, sob retardo cicatricial pela administração parenteral de corticosteróides. MATERIAL E MÉTODOS: Vinte cães, entre 15 e 20 kg, foram divididos em grupos controle e teste, este submetido à administração intramuscular de hemissuccinato de hidrocortisona, de 25 a 33 mg/kg/dia, do 30º dia pré-operatório ao 7º dia pós-operatório. Em ato cirúrgico, cada animal foi submetido a duas secções cólicas, com anastomoses por sutura manual em plano único extramucoso e por compressão com anel biofragmentável. Os espécimes foram sacrificados sete dias após o procedimento para avaliação das anastomoses. RESULTADOS: No pós-operatório ocorreram um óbito no grupo teste e dois óbitos no grupo controle por fístula não bloqueada nas anastomoses por compressão com anel. Houve, estatisticamente, incidência semelhante de aderências, fístulas, dilatação aferente e obstrução, nos métodos em comparação. À microscopia, houve deficiência de regeneração mucosa nas anastomoses por compressão. Análise histológica por computador evidenciou nas anastomoses por compressão, maior reação inflamatória, maior edema de submucosa e formação de cicatrizes alargadas. CONCLUSÕES: Com o anel biofragmentável, em anastomoses colocólicas sob retardo de cicatrização induzido por corticosteróides, foram obtidos resultados semelhantes aos da sutura manual quanto à incidência de complicações pós-operatórias; o anel, entretanto, determinou pior regeneração mucosa e maior reação inflamatória cicatricial.BACKGROUND: This study analyzed intestinal anastomoses by manual suture and by compression with biofragmentable ring under delay of cicatrization administering parenteral corticoids. MATERIAL AND METHODS: Twenty dogs were divided into two groups: control and test, the latter submitted to intramuscular administration

The Role of Tracheal Stenting As an Alternative Treatment in Cicatricial and Non-Operable Tracheal Stenosis

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Reza Bagheri

2013-05-01

Full Text Available Introduction: Tracheal stenosis is normally caused by trauma, infection, benign and malignant tumors, prolonged intubation or tracheostomy. The best treatment for tracheal stenosis is resection and anastomosis of trachea. Yet the major surgical complication of tracheal surgery is postoperative stenosis. The goal of this paper is to study the result of tracheal stenting as a replacement therapy for patients suffering from tracheal stenosis who are not good candidates for surgery. Materials and Methods: This study presents the results of stenting in patients with: Inoperable tumoral stenosis,Non-tumoral stenosis being complicated due to prior surgeries,Inability to undergo a major surgery.The study was performed between September 2002 and July 2011 and poly flex stents were used by means of rigid bronchoscopy. Results: A total of 25 patients received stents during this study. Among them 15 patients suffered from benign and 10 suffered from malignant tracheal stenosis. The patients were followed up for at most 12 months after the stenting operation. The mean age of the patients was 35 years. The most common cause of stenosis was prolonged intubation (75%. The most common indication for stenting was the history of multiple tracheal operations. The most common complication of stenting and cause of stent removal was formation of granulation tissue. 30% of patients with benign tracheal stenosis were cured and about 10% improved until they could stand a major operation. Ten patients in benign group and 2 patients in malignant group (20% needed T-Tube insertion after stent removal but other patientcure by stenting. Conclusions: In benign cases stenting is associated with recurrence of symptoms which requires other therapeutic techniqus, so the stenting may not be named as a final solution in benign cases. However, this technique is the only method with approved efficacy for malignant cases with indication.

Squamous cell carcinoma complicating an hereditary epidermo-lysis bullosa

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Mseddi, M.; Turki, H.; Marrekchi, S.; Abdelmaksoud, W.; Masmoudi, A.; Bouassida, S.; Zahaf, A.

2004-01-01

The dystrophic form of hereditary epidermo-lysis bullosa is associated with an increased frequency of squamous cell carcinoma. We report a new case. An 18-year-old patient, carrying a Hallopeau Siemens hereditary epidermo-lysis bullosa, presented a subcutaneous nodular lesion, for 1 year that ulcerated and budded with inguinal lymphadenopathy. The histological study ted to the conclusion of a well differentiated squamous cell carcinoma. The patient was treated surgically. Tumor and metastatic lymph nodes were excised. A radiotherapy was decided but the postoperative course was fatal due to an infection and to a deterioration of her general condition. Squamous cell carcinoma frequently occurs on the cicatricial lesion of hereditary epidermo-lysis bullosa and usually affects males with recessive hereditary epidermo-lysis bullosa. Metastases are frequent, precocious and multiple. The treatment may be surgical. The particularities of our observation are the young age of patient and the localization. (author)

OPTIMIZATION OF RESULTS AND TREATMENT TIMING OF DEEP DERMAL BURNS IN CHILDREN

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Konstantin Aleksandrovich Afonichev

2014-06-01

Full Text Available Untreated deep dermal burns in children are the cause of long-term treatment and severe cicatricial deformities, resulting in poor cosmetic results and greatly impairing functional outcome. The problem of optimizing the results and timing of treatment of deep burns in children in recent years has become particularly urgent. We observed 1853 children with III-A degree burns. Some of the children's burns healed spontaneously, which led to the development of scar deformities during the first six months after injury. Risk factors for their development, depending on the patient's age and location of the lesion, are pointed out. Other children underwent early tangential excision of eschar. The analysis of the treatment results showed that the use of early surgery in children with deep dermal burns can reduce treatment time, as well as significantly to improve the cosmetic and functional outcomes of trauma.

Clinical and morphological evaluation of snake venom derived fibrin glue on the tendon healing in dogs

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G. C. Ferraro

2005-12-01

Full Text Available The aim of this study was to evaluate the effect of snake venom derived fibrin glue on the healing of the deep digital flexor tendon, during three periods. The tendon of the 2nd digit of 30 thoracic limbs of dogs was partially sectioned for glue application. Biopsies were performed 7, 15, and 30 days post surgery for the clinical and morphological study of tendons. Analysis of the results showed that 73.3% of the tendons showed stump retraction and 16.6% moderate to excessive adherence, which affected sliding. There was a significant difference in the number of inflammatory cells among the three studied periods, being the highest on day 15. The morphological analysis revealed a typical tendon healing process with a lower level of inflammation in the acute phase, facilitating the cicatricial maturation phase. Snake venom derived fibrin glue promotes the healing in dog flexor tendon.

Serous Retinal Detachments Complicating Interferon-α and Ribavirin Treatment in Patients with Hepatitis C

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Giulio Modorati

2011-03-01

Full Text Available Purpose: To report the cases of two patients with chronic hepatitis C infection showing serous retinal detachments similar to Vogt-Koyanagi-Harada (VKH disease. Methods: We reviewed the clinical records of two patients who were diagnosed with VKH-like disease during combined interferon-α (IFNα and ribavirin treatment. Results: Interruption of IFNα and ribavirin treatment in association with oral corticosteroids resulted in a favorable visual outcome in the case of diffuse retinal detachment (case 1. On the contrary, visual acuity did not improve when late cicatricial stage disease was already present (case 2. Conclusion: There is increasing evidence of a link between hepatitis C virus infection treated with pegylated IFNα-2b and the development of VKH-like disease. Knowing the potential side effects of IFNα and ribavirin administration is fundamentally important, as is the need to closely follow up those patients that need to undergo this treatment.

Occasional head of flexor pollicis longus muscle: a study of its morphology and clinical significance.

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Hemmady M

1993-01-01

Full Text Available A cadaveric dissection study of 54 upper extremities to determine the incidence of occurrence, morphology and relations of the occasional head of the flexor pollicis longus muscle is presented. The occasional head of the flexor pollicis longus muscle was found to be present more frequently (66.66% than absent. It mainly arose from the medical epicondyle of the humerus (55.55% and the medial border of the coronoid process of the ulna (16.66%. It was found to be in close association with the median nerve (anteriorly and the anterior interosseous nerve (posteriorly. The clinical implications of these findings are discussed viz. entrapment neuropathies of the median and anterior interosseous nerves, cicatricial contraction of the occasional head leading to flexion deformity of the thumb and the likely necessity to lengthen/release the occasional head in spastic paralysis of the flexor pollicis longus muscle.

CALCINOSIS CIRCUMSCRIPTA IN A COHORT OF RELATED JUVENILE AFRICAN LIONS (PANTHERA LEO).

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Bauer, Kendra L; Sander, Samantha J; Steeil, James C; Walsh, Timothy F; Neiffer, Donald L

2017-09-01

Three juvenile, genetically related African lions (Panthera leo) were evaluated for discrete dome-shaped subcutaneous masses present over the proximal lateral metatarsal-tarsal area. The lesions measured 3-8 cm in diameter, were fluctuant to firm, nonulcerated, and attached to underlying structures. On radiographic evaluation, the lesions were characterized by well-circumscribed punctate mineralizations in the soft tissue surrounded by soft tissue swelling without evidence of adjacent bony involvement. On cut surface, the lesions were made of numerous loculi containing 2-5-mm round-to-ovoid, white-to-gray, firm structures interspersed with fibrous tissue and pockets of serosanguinous fluid. Hematology, serum biochemistry, serum thyroid screening (including total thyroxine, total triiodothyronine, free thyroxine, and free triiodothyronine), and serum vitamin D panels (including parathyroid hormone, ionized calcium, and 25-hydroxyvitamin D) were unremarkable. Histopathologic evaluation of the lesions was consistent with calcinosis circumscripta with fibroplasia, chronic inflammation, and seroma formation. An additional two genetically related lions were considered suspect for calcinosis circumscripta based on presentation, exam findings, and similarity to the confirmed cases. All masses self-regressed and were not associated with additional clinical signs other than initial lameness in two cases.

Articular lesion in experimental infeccion with avian reovirus in broiler (Gallus gallus

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Simone Bertozi de Souza Vasconcelos

2001-01-01

Full Text Available Este trabalho descreve as lesões articulares induzidas pela inoculação oral e podal de uma amostra de reovírus aviário (S-1133 em pintos de corte de um dia de idade. Realizou-se o exame histopatológico de fragmentos da articulação tibiotársica utilizando-se cinco aves dos grupos inoculados e grupo controle nos períodos de 24, 48, 72 horas e semanalmente até a oitava semana após a inoculação. A primeira alteração observada foi um infiltrado inflamatório misto nas bainhas tendinosas uma semana após a inoculação. Na segunda semana após a inoculação, houve fibroplasia, formação de folículos linfóides e hiperplasia das células da membrana sinovial, alterações progressivas observadas até o final do período experimental. As lesões articulares foram similares, ocorrendo simultaneamente nos dois grupos inoculados, contudo as alterações foram mais severas no grupo inoculado no coxim plantar.

Wound healing in the jugal mucosa of rats with a cold blade scalpel and an ultrasonic harmonic scalpel.

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De Masi, Elen Carolina David João; Rocha, Sergio Luis; Mocellin, Marcos; Faria, João Luis Garcia de

2009-01-01

Ultrasound harmonic scalpel has been recently introduced in otorhinolaryngological procedures. to assess macro and microscopic evolution of the healing process of wounds created in the jugal mucosa of rats by the use of ultrasound scalpel. we used 30 Wistar rats in which we made mucosal incisions on the right jugal mucosa with the ultrasound harmonic scalpel (USHS) and on the left side with the cold blade scalpel (CBS). Macroscopic and microscopic evaluations were carried out on the third, seventh and fourteenth days of postoperative. For the microscopic evaluation we used HE to asses the inflammatory process and the Sirius Red approach for collagens type I and III. Anti-CD 3 antibodies and anti-factor VIII assessed the concentration of T-lymphocytes and neovessels. the USHS caused greater cell damage with reepitelization delay. Microscopy showed more intense inflammatory reactions and a loss in collagen build up, delay in scar maturation and a greater vessel neoformation. USHS brings about a greater lesion in the incision area; delayed regeneration; promotes greater inflammatory process and angiogenic activity; delays in fibroplasia and scar tissue maturation on the rats' jugal mucosa when compared to cold blade scalpel.

Diagnostic and clinical observation on the infectious bronchitis virus strain Q1 in Italy

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Anna Toffan

2013-12-01

Full Text Available This paper describes the diagnostic and clinical observations of an infectious bronchitis virus (IBV variant, referred to as Q1, in clinically ill chickens in Italy. This IBV variant was described for the first time in 1998 in China. In the autumn of 2011 it caused a small-scale epidemic in non-vaccinated meat chickens in farms located in Northern Italy. The disease was characterized by increased mortality, kidney lesions and proventriculitis. Histopatological observations confirmed the nephritis and described an unusual erosive/necrotic proventriculitis with infiltration of lymphocytes, plasma cells and heterophils, as well as fibroplasia in the lamina propria. Despite these findings and the isolation of the Q1 IB virus directly from proventricular tissue, further studies are necessary to confirm the role of this IBV strain in the development of proventricular lesions. Phylogenetic analysis revealed that all the IBV isolates were very similar and probably had a common origin. The IBV Q1 variant appears to be now endemic in the North of Italy and at times it is detected in vaccinated backyard and commercial broiler farms. The importance of continuous monitoring in controlling the spread of known or emerging IBV variants is underlined.

[Severe iatrogenic airway obstruction due to lingual lymphangioma].

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Segado Arenas, A; Flores González, J-C; Rubio Quiñones, F; Quintero Otero, S; Hernández González, A; Pantoja Rosso, S

2011-09-01

Lymphangioma of the tongue is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. Treatment modalities include surgery and a large number of different intralesional injections of sclerosing agents. Presently, OK-432 (Picibanil(®)) is the preferred sclerosant and when administered intralesionally will result in inflammation, sclerosis, and cicatricial contraction of the lesion. We report a case of microcystic lymphangioma of the tongue in a 5-year-old boy treated with an intralesional injection of OK-432. In the immediate postoperative period, the patient suffered severe diffuse swelling, progressive upper airway obstruction with inspiratory stridor, and respiratory distress requiring emergency fiberoptic nasotracheal intubation. Although OK-432 injections are found to be safe and effective as a first line of treatment for lymphangiomas, local swelling with potentially life-threatening airway compromise should be anticipated, especially when treating lesions near the upper airway. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Clinical And Morphological Androgenic Status Characteristics At Children Suffering From Hypospadias And Its Influence On Results Of Surgical Correction

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F.K. Napolnikov

2009-09-01

Full Text Available The goal of this article is to estimate the androgenic status and analyze its influence on the surgical treatment of hypospadias. From 2000 till 2008 there were 209 children under treatment, whose age varied from 8 months till 15 years old (average age — 4,5+ 1,5. 49 patients were subjected to clinical, humoral and morphological study. Preoperational preparation was carried out by testosterone medications. The comparison group consisted of 10 boys with cicatricial phimosis. The patients with the medium and back forms of hypospadias suffered from the androgenic deficit characterized by proximal level of meatus ectopia, diminution of penis length and prostate volume, decrease of blood vessels in deep layers of penis skin. The testosterone pre-operational medication of patients makes possible to improve the results of surgical correction due to blood supply of plastic material. On the basis of recieved data logistically regressive model has been worked out and the prognosis of results has been estimated

Overlap Between Ulerythema Ophryogenes and Keratosis Follicularis Spinulosa Decalvans: a Case Report

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Stojanović Slobodan

2015-09-01

Full Text Available Ulerythema ophryogenes and keratosis follicularis spinulosa decalvans are rare folliculocentric keratotic disorders, from the group of follicular genokeratoses, characterized by keratosis pilaris atrophicans: follicular keratotic papules, sometimes with surrounding erythema, which eventually result in fibrosis, atrophy, progressive scarring and permanent hair loss. Ulerythema ophryogenes begins at birth or soon thereafter; it involves the lateral eyebrows, spreads medially and eventually affects the entire eyebrows, cheeks, and less frequently, forehead and asjecebt scalp. Involvement of the scalp has apparently not been reported in cases in which the eyebrows were predominantly involved. In addition to sporadic cases, ulerythema ophryogenes has been reported among relatives. Keratosis follicularis spinulosa decalvans is also a genetically heterogeneous syndrome which begins in infancy or childhood by involving hair bearing skin, especially the scalp; rarely it is confined to the face involving only eyebrows and eyelashes, but affects predominantly the scalp, leading to severe progressive cicatricial alopecia. Both conditions tend to progress until puberty.

An unusual complication after craniofacial surgery for Apert syndrome

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Abhay A Lune

2014-01-01

A case of Apert syndrome who had undergone craniofacial surgery elsewhere 4 years back presented to us with purulent discharge near the lateral orbital margin of right orbit, watering and redness of the right eye. He had telltale signs of this syndrome in the form of skull deformities such as brachycephaly, frontal bony prominence, mid-face hypoplasia, proptosis and syndactyly of both hands and feet. There was a surgical scar of previous craniofacial surgery over the bi-coronal region. He had a discharging granuloma over the lateral orbital margin and the adjacent lower eyelid had developed cicatricial ectropion. X-ray and computed tomography scan orbit confirmed the clinical suspicion of osteomyelitis of the underlying zygomatic bone at the site of miniplate and screw fixation of the earlier surgery. He was treated with excision of granuloma and extraction of loose screw and infected miniplate while ectropion was corrected by rotation advancement of temporal skin flap.

OUTCOMES AFTER LASER VERSUS COMBINED LASER AND BEVACIZUMAB TREATMENT FOR TYPE 1 RETINOPATHY OF PREMATURITY IN ZONE I.

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Yoon, Je Moon; Shin, Dong Hoon; Kim, Sang Jin; Ham, Don-Il; Kang, Se Woong; Chang, Yun Sil; Park, Won Soon

2017-01-01

To investigate the anatomical and refractive outcomes in patients with Type 1 retinopathy of prematurity in Zone I. The medical records of 101 eyes of 51 consecutive infants with Type 1 retinopathy of prematurity in Zone I were analyzed. Infants were treated by conventional laser photocoagulation (Group I), combined intravitreal bevacizumab injection and Zone I sparing laser (Group II), or intravitreal bevacizumab with deferred laser treatment (Group III). The proportion of unfavorable anatomical outcomes including retinal fold, disc dragging, retrolental tissue obscuring the view of the posterior pole, retinal detachment, and early refractive errors were compared among the three groups. The mean gestational age at birth and the birth weight of all 51 infants were 24.3 ± 1.1 weeks and 646 ± 143 g, respectively. In Group I, an unfavorable anatomical outcome was observed in 10 of 44 eyes (22.7%). In contrast, in Groups II and III, all eyes showed favorable anatomical outcomes without reactivation or retreatment. The refractive error was less myopic in Group III than in Groups I and II (spherical equivalent of -4.62 ± 4.00 D in Group I, -5.53 ± 2.21 D in Group II, and -1.40 ± 2.19 D in Group III; P prematurity in Zone I, intravitreal bevacizumab with concomitant or deferred laser therapy yielded a better anatomical outcome than conventional laser therapy alone. Moreover, intravitreal bevacizumab with deferred laser treatment resulted in less myopic refractive error.

Sensitivity of direct immunofluorescence in oral diseases. Study of 125 cases.

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Sano, Susana Mariela; Quarracino, María Cecilia; Aguas, Silvia Cristina; González, Ernestina Jesús; Harada, Laura; Krupitzki, Hugo; Mordoh, Ana

2008-05-01

Direct immunofluorescence (DIF) is widely used for the diagnosis of bullous diseases and other autoimmune pathologies such as oral lichen planus. There is no evidence in the literature on how the following variants influence the detection rate of DIF: intraoral site chosen for the biopsy, perilesional locus or distant site from the clinical lesion, number of biopsies and instrument used. to determine if the following variants influenced the sensitivity (detection rate): intraoral site chosen for the biopsy, perilesional or distant site from the clinical lesion, number of biopsies and instrument used (punch or scalpel). A retrospective study was done at the Cátedra de Patología y Clínica Bucodental II at the Facultad de Odontología, Universidad de Buenos Aires; 136 clinical medical histories were revised for the period March 2000 - March 2005 corresponding to patients with clinical diagnosis of OLP and bullous diseases (vulgar pemphigus, bullous pemphigoid and cicatricial pemphigoid). DIF detection rate was 65.8% in patients with OLP, 66.7% in cicatricial pemphigoid patients, in bullous pemphigoid 55.6%, in pemphigus vulgaris 100%, and in those cases in which certain diagnosis could not be obtained, the DIF positivity rate was 45.5% (Pearson chi(2) (4)= 21.5398 Pr= 0.000). There was no statistically significant difference between the different sites of biopsy (Fisher exact test: 0.825). DIF detection rate in perilesional biopsies was 66.1% and in those distant from the site of clinical lesion was 64.7% (Pearson chi(2) v1)= 0.0073 Pr= 0.932. When the number of biopsies were incremented, DIF detection rate also incremented (Pearson chi(2) = 8.7247 Pr= 0.003). The biopsies taken with punch had a higher detection rate than those taken with scalpel (39.1% versus 71.7%) (Pearson chi(2) = 49.0522 Pr= 0.000). While not statistically significant, the tendency outlined in this study indicates there are intraoral regions in which the detection rate of the DIF technique is

Seaweed flour (“Lithothamnium calcareum” as a mineral supplement in the bone healing of a cortical autograft in dogs Farinha de algas marinhas (“Lithothamnium calcareum” como suplemento mineral na cicatrização óssea de autoenxerto cortical em cães

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Emanoel Ferreira Martins Filho

2010-03-01

Full Text Available The influence of the seaweed flour (Lithothamnium calcareum was evaluated as a mineral supplement in during healing of bone failure reconstructed with a cortical autograft. Ten adult male mongrel dogs, weighing between 10 and 15kg, were used. The graft made of a cilinder block of the cortical bone was obtained by the ulna proximal diaphysis by ostectomy with a trephine of eight millimeters. In the same way, it was created a bone failure located in the middle-skull region of the proximal diaphysis of the ipsolateral tibia, and it served as a receptor bed. Two experimental groups were formed randomly, with five animals each. One group received a daily mineral supplement of seaweed flour for 30 consecutive days, and the other served as a control group. Clinical, radiological, and histopatological evaluations of bone healing were performed. Mineral supplementation with seaweed flour (Lithothamnium calcareum contributed to a better cicatricial performance, since both the degree of radiopacity and the number of osteoclasts were higher in treated animals.Foi avaliada, em cães, a influência da farinha de algas marinhas (Lithothamnium calcareum como suplemento mineral na cicatrização de falha óssea cortical reconstituída com autoenxerto cortical. Foram utilizados dez cães adultos, machos, sem raça definida, com peso entre 10 e 15kg. O enxerto, constituído de um bloco cilíndrico de osso cortical foi obtido da diáfise proximal da ulna, mediante ostectomia com trefina de oito milímetros de diâmetro. Igualmente criada, a falha óssea, localizada na região crânio-medial da diáfise proximal da tíbia ipsolateral, serviu como leito receptor. Efetuou-se separação aleatória em dois grupos experimentais, com cinco animais cada. Um grupo recebeu suplementação mineral diária à base de farinha de algas marinhas por 30 dias consecutivos, e o outro serviu como controle. Foram feitas avaliações clínicas, radiográficas e histopatológicas da

Dendritic cells limit fibroinflammatory injury in nonalcoholic steatohepatitis in mice.

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Henning, Justin R; Graffeo, Christopher S; Rehman, Adeel; Fallon, Nina C; Zambirinis, Constantinos P; Ochi, Atsuo; Barilla, Rocky; Jamal, Mohsin; Deutsch, Michael; Greco, Stephanie; Ego-Osuala, Melvin; Bin-Saeed, Usama; Rao, Raghavendra S; Badar, Sana; Quesada, Juan P; Acehan, Devrim; Miller, George

2013-08-01

Nonalcoholic steatohepatitis (NASH) is the most common etiology of chronic liver dysfunction in the United States and can progress to cirrhosis and liver failure. Inflammatory insult resulting from fatty infiltration of the liver is central to disease pathogenesis. Dendritic cells (DCs) are antigen-presenting cells with an emerging role in hepatic inflammation. We postulated that DCs are important in the progression of NASH. We found that intrahepatic DCs expand and mature in NASH liver and assume an activated immune phenotype. However, rather than mitigating the severity of NASH, DC depletion markedly exacerbated intrahepatic fibroinflammation. Our mechanistic studies support a regulatory role for DCs in NASH by limiting sterile inflammation through their role in the clearance of apoptotic cells and necrotic debris. We found that DCs limit CD8(+) T-cell expansion and restrict Toll-like receptor expression and cytokine production in innate immune effector cells in NASH, including Kupffer cells, neutrophils, and inflammatory monocytes. Consistent with their regulatory role in NASH, during the recovery phase of disease, ablation of DC populations results in delayed resolution of intrahepatic inflammation and fibroplasia. Our findings support a role for DCs in modulating NASH. Targeting DC functional properties may hold promise for therapeutic intervention in NASH. Copyright © 2013 American Association for the Study of Liver Diseases.

Dendritic Cells Limit Fibro-Inflammatory Injury in NASH

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Henning, Justin R.; Graffeo, Christopher S.; Rehman, Adeel; Fallon, Nina C.; Zambirinis, Constantinos P.; Ochi, Atsuo; Barilla, Rocky; Jamal, Mohsin; Deutsch, Michael; Greco, Stephanie; Ego-Osuala, Melvin; Saeed, Usama Bin; Rao, Raghavendra S.; Badar, Sana; Quesada, Juan P.; Acehan, Devrim; Miller, George

2013-01-01

Non-alcoholic steatohepatitis (NASH) is the most common etiology of chronic liver dysfunction in the United States and can progress to cirrhosis and liver failure. Inflammatory insult resulting from fatty infiltration of the liver is central to disease pathogenesis. Dendritic cells (DC) are antigen presenting cells with an emerging role in hepatic inflammation. We postulated that DC are important in the progression of NASH. We found that intrahepatic DC expand and mature in NASH liver and assume an activated immune-phenotype. However, rather than mitigating the severity of NASH, DC depletion markedly exacerbated intrahepatic fibro-inflammation. Our mechanistic studies support a regulatory role for DC in NASH by limiting sterile inflammation via their role in clearance of apoptotic cells and necrotic debris. We found that DC limit CD8+ T cell expansion and restrict Toll-like receptor expression and cytokine production in innate immune effector cells in NASH, including Kupffer cells, neutrophils, and inflammatory monocytes. Consistent with their regulatory role in NASH, during the recovery phase of disease, ablation of DC populations results in delayed resolution of intrahepatic inflammation and fibroplasia. Conclusion Our findings support a role for DC in modulating NASH. Targeting DC functional properties may hold promise for therapeutic intervention in NASH. PMID:23322710

Bubaline Cholecyst Derived Extracellular Matrix for Reconstruction of Full Thickness Skin Wounds in Rats

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Poonam Shakya

2016-01-01

Full Text Available An acellular cholecyst derived extracellular matrix (b-CEM of bubaline origin was prepared using anionic biological detergent. Healing potential of b-CEM was compared with commercially available collagen sheet (b-CS and open wound (C in full thickness skin wounds in rats. Thirty-six clinically healthy adult Sprague Dawley rats of either sex were randomly divided into three equal groups. Under general anesthesia, a full thickness skin wound (20 × 20 mm2 was created on the dorsum of each rat. The defect in group I was kept as open wound and was taken as control. In group II, the defect was repaired with commercially available collagen sheet (b-CS. In group III, the defect was repaired with cholecyst derived extracellular matrix of bovine origin (b-CEM. Planimetry, wound contracture, and immunological and histological observations were carried out to evaluate healing process. Significantly (P<0.05 increased wound contraction was observed in b-CEM (III as compared to control (I and b-CS (II on day 21. Histologically, improved epithelization, neovascularization, fibroplasia, and best arranged collagen fibers were observed in b-CEM (III as early as on postimplantation day 21. These findings indicate that b-CEM have potential for biomedical applications for full thickness skin wound repair in rats.

Transforming growth factor-beta stimulates wound healing and modulates extracellular matrix gene expression in pig skin. I. Excisional wound model.

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Quaglino, D; Nanney, L B; Kennedy, R; Davidson, J M

1990-09-01

The effect of transforming growth factor-beta 1 (TGF-beta 1) on matrix gene expression has been investigated during the process of wound repair, where the formation of new connective tissue represents a critical step in restoring tissue integrity. Split-thickness excisional wounds in the pig were studied by in situ hybridization in order to obtain subjective findings on the activity and location of cells involved in matrix gene expression after the administration of recombinant TGF-beta 1. Data focus on the stimulatory role of this growth factor in granulation tissue formation, on the enhanced mRNA content of collagen types I and III, fibronectin, TGF-beta 1 itself, and on the reduction in stromelysin mRNA, suggesting that increased matrix formation measured after treatment with TGF-beta 1 is due to fibroplasia regulated by the abundance of mRNAs for several different structural, matrix proteins as well as inhibition of proteolytic phenomena elicited by metalloproteinases. These studies reveal elastin mRNA early in the repair process, and elastin mRNA expression is enhanced by administration of TGF-beta 1. Moreover, we show that TGF-beta 1 was auto-stimulating in wounds, accounting, at least in part, for the persistent effects of single doses of this multipotential cytokine.

Relationship of creatine kinase, aspartate aminotransferase, lactate dehydrogenase, and proteinuria to cardiomyopathy in the owl monkey (Aotus vociferans)

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Gozalo, Alfonso S.; Chavera, Alfonso; Montoya, Enrique J.; Takano, Juan; Weller, Richard E.

2008-02-01

The purpose of this study was to determine serum reference values for crea- tine kinase (CK), aspartate aminotransferase (AST), and lactate dehydroge- nase (LDH) in captive-born and wild-caught owl monkeys to assess their usefulness for diagnosing myocardial disease. Urine samples were also collected and semi-quantitative tests performed. There was no statistically significant difference between CK, AST, and LDH when comparing both groups. However, when comparing monkeys with proteinuria to those without proteinuria, a statistically significant difference in CK value was observed (P = 0.021). In addition, the CK/AST ratio revealed that 29% of the animals included in this study had values suggesting cardiac infarction. Grossly, cardiac concentric hypertrophy of the left ventricle and small, pitted kidneys were the most common findings. Microscopically, myocardial fibrosis, contraction band necrosis, hypertrophy and hyperplasia of coronary arteries, medium-sized renal arteries, and afferent glomerular arteriolae were the most significant lesions, along with increased mesangial matrix and hypercellularity of glomeruli, Bowman’s capsule, and peritubular space fibroplasia. These findings suggest that CK, AST, and LDH along with urinalysis provide a reliable method for diagnosing cardiomyopathies in the owl monkey. In addition, CK/AST ratio, proteinuria, and the observed histological and ultrastructural changes suggest that Aotus vociferans suffer from arterial hypertension and chronic myocardial infarction.

Wound healing in the jugal mucosa of rats with a cold blade scalpel and an ultrasonic harmonic scalpel Cicatrização de feridas realizadas na mucosa jugal de ratos com bisturi com lâmina fria e com bisturi harmônico ultrassônico

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Elen Carolina David João De Masi

2009-06-01

Full Text Available Ultrasound harmonic scalpel has been recently introduced in otorhinolaryngological procedures. AIM: to assess macro and microscopic evolution of the healing process of wounds created in the jugal mucosa of rats by the use of ultrasound scalpel. METHOD: we used 30 Wistar rats in which we made mucosal incisions on the right jugal mucosa with the ultrasound harmonic scalpel (USHS and on the left side with the cold blade scalpel (CBS. Macroscopic and microscopic evaluations were carried out on the third, seventh and fourteenth days of postoperative. For the microscopic evaluation we used HE to asses the inflammatory process and the Sirius Red approach for collagens type I and III. Anti-CD 3 antibodies and anti-factor VIII assessed the concentration of T-lymphocytes and neovessels. RESULTS: the USHS caused greater cell damage with reepitelization delay. Microscopy showed more intense inflammatory reactions and a loss in collagen build up, delay in scar maturation and a greater vessel neoformation. CONCLUSION: USHS brings about a greater lesion in the incision area; delayed regeneration; promotes greater inflammatory process and angiogenic activity; delays in fibroplasia and scar tissue maturation on the rats' jugal mucosa when compared to cold blade scalpel.O bisturi harmônico ultrassônico foi introduzido recentemente em operações otorrinolaringológicas. ObJETIVO: Avaliar a evolução macro e microscópica do processo de cicatrização de feridas realizadas na mucosa jugal de ratas com uso de bisturi ultrassônico. MÉTODO: Foram utilizadas 30 ratas Wistar com incisões na mucosa, no lado direito com bisturi harmônico ultrassônico (BHU e à esquerda com bisturi com lâmina fria (BLF. As avaliações macroscópicas e microscópicas foram realizadas no terceiro, sétimo e décimo quarto dias pós-operatório. Na análise microscópica utilizou-se coloração HE para avaliar o processo inflamatório e a técnica de Sirius red para os colágenos I

Barreira cutânea na dermatite atópica Skin barrier in atopic dermatitis

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Flavia Alvim Sant'Anna Addor

2010-04-01

Full Text Available O estudo da barreira cutânea e de suas propriedades ganhou impulso a partir da década de 60, com estudos que apontaram sua resistência de forma isolada e suas propriedades com relação à permeação cutânea. Paralelamente, a descrição dos corpos de Odland auxiliou a compreensão da manutenção da estabilidade da camada córnea. O modelo brick & mortar, em que os corneócitos são os tijolos e o cimento são os lipídeos intercelulares, é o mais aceito, até o momento. Atualmente, há evidências consistentes de que o estrato córneo é uma estrutura metabolicamente ativa e exerce funções adaptativas. A barreira cutânea também tem um papel na resposta inflamatória, com ativação de melanócitos, angiogênese e fibroplasia, cuja intensidade depende, basicamente, da intensidade da agressão. As anormalidades da barreira cutânea da dermatite atópica são clinicamente observáveis pela presença de pele seca, achado muito frequente e significativo, que constitui parâmetro iagnóstico e de acompanhamento. O grau de hidratação da camada córnea, assim como a perda de água transepidérmica (transepidermal water loss - TEWL, estão relacionados com o grau de dano à barreira, constituindo parâmetros biofísicos que permitem acompanhar os pacientes de maneira não invasiva e com maior grau de sensibilidade.Research about the skin barrier and its properties has increased significantly since the 60s, with studies that indicated its resistance when isolated, as well as its particularities in relation to skin permeability. At the same time, description of Odland bodies helped to understand how stratum corneum stability is maintained. The “brick and mortarâ€� model is the most accepted so far. In this analogy, the corneocytes are the bricks and the intercellular lipids are the mortar. Currently, there is concrete evidence that the stratum corneum is an active metabolic structure that holds adaptive functions, interacting

Autologous orbicularis muscle for filling facial folds-an experimental and clinical study.

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Schellini, Silvana Artioli; Hirai, Flavio Eduardo; Hoyama, Erika; Mattos, Maila Karina; Chaves, Fernando Rodrigo; Pellizon, Claudia Helena; Padovani, Carlos Roberto

2009-01-01

To present a technique for filling facial folds by using autologous orbicularis oculi muscle, based on an experimental model. two studies are presented: (1) an experimental study using 15 albino guinea-pigs from which a strip of the sural triceps muscle was removed and implanted in the subcutaneous tissue of the dorsal area. The animals were sacrificed 7, 30 and 60 days after the implantation, and the material was histologically evaluated. And (2) an interventional prospective clinical trial carried out on 20 patients referred to blepharoplasty surgery. They received autologous preseptal orbicularis muscle for filling facial folds. The results where evaluated by patients satisfaction and clinical exam. the sural tricep muscle, when implanted in the subcutaneous tissue, resulted in fibrosis. The patients whom received autologous orbicularis muscle implanted for filling facial folds showed that the procedure can be successfully carried out. autologous preseptal orbicularis muscle is a good material for filling facial folds. Cicatricial tissue will be formed on its implantation site, filling the tissue gap that forms the folds on the skin.

Free-flap surgical correction of facial deformity after anteromedial maxillectomy.

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Sarukawa, Shunji; Kamochi, Hideaki; Noguchi, Tadahide; Sunaga, Ataru; Uda, Hirokazu; Mori, Yoshiyuki; Nishino, Hiroshi; Yoshimura, Kotaro

2017-09-01

Anteromedial maxillectomy is typically performed in conjunction with low-dose radiotherapy and intraarterial chemotherapy. In doing so, the extent of surgical defects is reduced. However, nasal deviation and oral incompetence may ensue, due to cicatricial contracture of wounds, and may be distressing to these patients. Herein, we report a series of eight free perforator flap procedures (anterolateral thigh [ALT] flap, 6; thoracodorsal artery perforator [TAP] flap, 2) used to correct such deformities. The TAP flap was combined with scapular tip [ST] osseous flap in patients with added zygomatic prominence defects. Three adipocutaneous parts developed from each perforator flap were applied as follows: two to reconstruct nasal lining and oral vestibule, and one to augment cheek volume. All aesthetic results proved satisfactory, although orbital dystopia and contracture of mimic muscles were not resolved completely. These secondary interventions are suitable for sequelae of simple anteromedial maxillectomy. Immediate reconstruction should be considered if orbital floor and mimic muscles are involved. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Clinicoepidemiological Observational Study of Acquired Alopecias in Females Correlating with Anemia and Thyroid Function

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Kirti Deo

2016-01-01

Full Text Available Alopecia can either be inherited or acquired; the latter, more common, can be diffuse, patterned, and focal, each having cicatricial and noncicatricial forms. This observational study of 135 cases in a semiurban Indian population aimed to detect the prevalence of various forms of acquired alopecia in females and correlate the same with levels of hemoglobin, serum ferritin, triiodothyronine, thyroxin, and thyroid stimulating hormone. The majority (84, 62.2% of our cases of alopecia had telogen effluvium followed by female pattern alopecia (32, 23.7%. Stress (86, 63.7%, topical application of chemicals (72, 53.3%, systemic medications for concurrent illnesses (62, 5%, and pregnancy (14, 10.3% were the common exacerbating factors. Neither low hemoglobin (12 μg/L. Though lack of vitamin B12 testing was a limitation of our study, its deficiency could be the probable cause of iron deficiency as the majority (58, 64.4% of these cases, as indeed majority (89, 65.4% of our study population, were vegetarians. Thyroid disorders (23, 17%, including 9 newly diagnosed were not of significance statistically.

Trichoscopy in pediatric age group

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Subrata Malakar

2018-01-01

Full Text Available Approach to trichology in the pediatric age group is based on the clinical expertise of the dermatologist and investigative techniques. Currently, the trichoscope is an indispensible, noninvasive tool in the diagnosis of trichological disorders. It not only highlights the subtle tricoscopic points invisible to the naked eye but also serves as a prognostic and monitoring tool in therapeutic management. Trichoscopy goes a long way in improving the diagnostic and clinical acumen of the physician. In the pediatric age group, trichoscopy deals with pattern analysis ranging from hair shaft patterns to follicular, perifollicular, and interfollicular patterns. It not only describes the key trichoscopic features of noncicatricial alopecias, cicatricial alopecias, and genetic hair shaft defects but also helps to delineate various trichological mimics from each other. For compiling data, all trichology cases presenting to a tertiary care center were examined and photographed with a Fotofinder, DermLite Foto II Pro, and DermLite DL 3N. All trichological data were analyzed, and interpretations were based on the literature available.

Early vitrectomy effective for bilateral combined anterior and posterior persistent fetal vasculature syndrome.

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Walsh, Mark K; Drenser, Kimberly A; Capone, Antonio; Trese, Michael T

2010-04-01

The purpose of this study was to review our surgical experience with patients with bilateral combined anterior and posterior persistent fetal vasculature syndrome (PFVS). We retrospectively reviewed the charts of all patients seen in our tertiary care pediatric retinal practice from 1988 to 2008 with a potential diagnosis of bilateral PFVS with posterior involvement. Clinical diagnosis required the presence of either bilateral persistent hyaloidal stalk tissue with retinal involvement or bilateral dense retrolental fibrovascular plaques (usually with no posterior view preoperatively) without a family history or genetic testing consistent with Norrie disease or familial exudative vitreoretinopathy. Chart review showed 22 vitrectomized patients with clinical findings consistent with bilateral PFVS with posterior involvement who did not have a family history or genetic testing consistent with Norrie disease or familial exudative vitreoretinopathy. All 22 of these patients with posterior retinal involvement also had anterior findings and thus can be classified as combined anterior and posterior PFVS. Of the 13 patients with visual acuity follow-up data, 9 patients (69%) maintained at least light perception vision in at least 1 eye at last follow-up. Of the 28 operated eyes in 16 patients with follow-up data, 3 eyes (11%) were phthisical at last follow-up. Children with bilateral PFVS with posterior retinal involvement have a dismal visual prognosis if left unoperated. In this relatively large series of a rare condition, we find that vitrectomy with or without lensectomy is beneficial in bilateral combined anterior and posterior PFVS in two regards: maintenance or restoration of vision and avoidance of phthisis bulbi.

Radio-induced superficial fibrosis: investigation of the activation mechanisms of the myo-fibroblast and characterization of the cicatricial epidermis

International Nuclear Information System (INIS)

Sivan, Virginie

2001-01-01

Whereas radio-induced cutaneous fibrosis is one of the frequent after-effects of accidental and therapeutic irradiations, this research thesis addresses the mechanisms which govern the activation of the myo-fibroblast. After some results obtained on cells from a radio-induced fibrosis on swine cells, the author proposes a signalling alteration as a mechanism. In a model a reconstructed skin, the author shows that myo-fibroblasts are a direct target of Superoxide Dismutase (SOD), and respond to this anti-fibrosis agent by a phenotype reversion. She reports the molecular characterization of epidermis of fibro-necrosis human lesions induced by an accidental or therapeutic irradiation. This leads to a better understanding of the role of the myo-fibroblast during the development and regression of fibrosis. Besides, the author shows that an alteration of the epidermis adjacent to dermis is developing in parallel with the fibrosis process. This suggests an active contribution of keratinocytes during the development of this radio-induced after-effect [fr

The influence of low-level laser therapy on biomodulation of collagen and elastic fibers A influência da terapia a laser de baixa densidade de energia na biomodulação das fibras colágenas e elásticas

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Lívia Souza Pugliese

2003-12-01

Full Text Available The study of low-level laser therapy upon extracellular matrix elements is important to understand the wound healing process under this agent. However, little is known about the interference of laser light in relation to collagen and elastic fibers. Cutaneous wounds were performed on the back of 72 Wistar rats and a Ga-Al-As low-level laser was punctually applied with different energy densities. The animals were killed after 24, 48, 72 hours and 5, 7 and 14 days. Tissues were stained with hematoxilin-eosin, sirius red fast green and orcein and then analyzed. It was observed that the treated group exhibited larger reduction of edema and inflammatory infiltrate. The treated animals presented a larger expression of collagen and elastic fibers, although without statistical significance (p > 0.05. Treatment with a dosage of 4 J/cm² exhibited more expressive results than that with 8 J/cm². In this study, the authors concluded that low-level laser therapy contributed to a larger expression of collagen and elastic fibers during the early phases of the wound healing process.O estudo da terapia a laser de baixa densidade de energia sobre os diversos constituintes da matriz extracelular é crucial para o entendimento do processo cicatricial sob esse agente. Todavia, pouco se sabe sobre a interferência do laser em relação às fibras colágenas e elásticas. Realizaram-se ferimentos cutâneos padronizados no dorso de setenta e dois ratos Wistar e, em seguida, aplicação pontual do raio laser de baixa potência do tipo Arseneto de Gálio-Alumínio (Ga-Al-As com diferentes densidades de energia. Os animais foram sacrificados com 24, 48 e 72 horas e aos 5, 7 e 14 dias. Procedeu-se à análise das secções teciduais coradas por hematoxilina-eosina, sírius vermelho e orceína. Observou-se, que nos grupos submetidos à terapia a laser, houve maior redução do edema e infiltrado inflamatório. Os animais tratados apresentaram uma maior expressão de fibras

Pathology of ear hematomas in swine.

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Drolet, Richard; Hélie, Pierre; D'Allaire, Sylvie

2016-05-01

The objectives of our study were to describe the pathology of ear hematomas in swine and to add to the comprehension of the pathogenesis of this condition. The pathogenesis of aural hematomas has been studied mainly in dogs; however, disagreements exist about the precise anatomic location of the hemorrhage. Sixteen pigs with ear hematoma at various stages of development were included in this study. The pigs were submitted for routine autopsy for various and unrelated reasons over a period of several years. Based on gross examination, the 16 cases of aural hematomas were subjectively classified as acute (n = 6), subacute (n = 3), and chronic (n = 7). The age of the animals at the time of autopsy ranged from 2 weeks to adulthood, with all acute cases being hematoma developed predominantly in a subperichondral location on both sides of the cartilaginous plate simultaneously. Within these same cases, there were also some areas in which blood-filled clefts had formed within the cartilage itself. Besides fibroplasia, neoformation of cartilage was found to represent a significant part of the repair process. All chronic cases were characterized on cross-section of the ear by the presence of at least 2 distinct, wavy, focally folded, and roughly parallel plates of cartilage separated from each other by fibrous tissue. © 2016 The Author(s).

Tissue injuries of wistar rats treated with hydroalcoholic extract of Sonchus oleraceus L.

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Franciele Carla Prichoa

2011-09-01

Full Text Available The use of plant species is emerging as an important alternative in the treatment of injuries. Therefore, the extract of Sonchus oleraceus 10% was employed in the repair of skin lesions. A total of 36 male Wistar rats were subjected to a punch injury and divided into three groups: a negative control, receiving no treatment, a positive control, treated with Dersani, and the experimental group treated with the extract. The injury was assessed macroscopically and microscopically. Morphometric data was collected at the 3rd, 5th and 7th postoperative day, and the experimental group showed greater changes in shrinkage of the lesion compared to control groups. On the 3rd postoperative day, the injury in the experimental group showed less necrotic tissue, lower slough and more granulation tissue in relation to the positive control group. On the 7th and 10th postoperative day, the injury in the experimental group showed lower slough compared to the positive control group. Microscopic analysis of lesions on the 5th postoperative day revealed increased fibroplasia in the experimental group compared to control groups, while on the 14th postoperative day less neovascularization was evident in the experimental group and increased formation of hair follicles in the negative control group. The extract of S. oleraceus provided tissue repair in accordance with normal physiological patterns thus confirming empirical evidence for its use.O emprego de espécies vegetais vem surgindo como alternativa no tratamento de lesões. Dessa forma, foi utilizado o extrato hidroalcoólico de Sonchus oleraceus a 10% na reparação de lesões cutâneas. Trinta e seis ratos machos Wistar, foram submetidos a uma lesão com "punch" e distribuídos em três grupos: controle negativo, não recebeu tratamento; controle positivo, tratado com Dersani; e o experimental, tratado com extrato. A lesão foi avaliada macroscopicamente e microscopicamente. Os dados morfométricos mostraram que

Bicyclist's vulva: diagnostic and therapeutic aspects.

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Grouin, A; Rouquette, S; Saïdani, M; Henno, S; Lavoué, V; Levêque, J

2018-04-16

The authors report a case of a rare vulvar condition in a young cyclist, known as bicyclist's vulva. The diagnosis was based on the clinical context (intensive cycling training with repeated saddle sores, responsible for painless unilateral swelling of the labium majus to a significant size and functional discomfort). Imaging examinations were used to characterise the lesion and its relationship with the pelvic organs. The lesion was composed of connective tissue, poorly demarcated and heavily collagenised without necrotic or haemorrhagic areas. Large cicatricial collagen bundles were observed. The fibroblasts revealed no atypia and just a few scattered undilated vessels ere noted. Special staining did not reveal any amyloid deposits. A complementary immunohistochemical analysis with anti-CD 34 antibody showed vascularisation that was homogeneous and morphologically normal. The treatment was surgery, and in our case the cosmetic and functional impact of wide surgical excision of the lesion was improved by in situ injection of autologous fat. The pathology findings enabled us to rule out other perineal tumours such as aggressive angiomyxoma of the vulva and to describe the lesion microscopically. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Clinical analysis of bronchoscopic electrocoagulation in pediatric patients

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Ni, Caiyun; Yu, Huafeng; Han, Xiaorong; Meng, Chen; Zhang, Yanqing

2014-01-01

This study is to explore the efficacy and safety of bronchoscopic electrocoagulation treatment for pediatric disease of poor ventilation. Seventy pediatric patients of airway stenosis and obstruction as well as pharyngeal and laryngeal cysts received bronchoscopic electrocoagulation treatment, including 15 cases of epiglottic cyst, 13 cases of cicatricial hyperplasia of fibrous tissue after trachea intubation, 5 cases of foreign body in bronchus and 37 cases of endobronchial tuberculosis. Before and after the last electrocoagulation treatment, treatment efficacy was evaluated by examining the patients’ clinical presentations and lesions in airway under bronchoscope, examining chest CT and pulmonary function, and estimating pulmonary atelectasis and ventilation function. Seventy cases of pediatric patients were treated by bronchoscopic electrocoagulation, with the total treatment number of 106 times. Among them, 66 cases were treated with marked efficacy and 4 cases were with effective treatment. There was no invalid treatment. The treatment efficacy was 100% without complications. Bronchoscopic electrocoagulation treatment is a fast, effective and safe therapeutic method in treating airway stenosis and obstruction, such as foreign body in bronchus, granulation tissue hyperplasia, and epiglottic cysts. It is worthy of being widely applied in clinic. PMID:25664086

[Analysis of sequelae of the latissimus dorsi flap removal. Report of 44 cases reviewed and tested].

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Legré, R; Boghossian, V; Servant, J M; Magalon, G; Bureau, H

1990-01-01

Since Tanzini, the latissimus dorsi muscle flap has been widely used in plastic surgery. Based on the experience of two plastic surgery units, we decided to try to define the sequelae of this operation. In order to simplify our analysis we only considered free flaps. Out study is based on 42 patients (26 pure muscular flaps and 16 musculo-cutaneous flaps). The sequelae were analysed in terms of aesthetic and functional criteria. The aesthetic sequelae appeared to be minima in the case of pure muscular flaps, but more severe in the case of musculo-cutaneous flaps. Functional sequelae in the shoulder were observed on muscle testing in 30% of cases, although there were no repercussions on sport or work activities. Analysis of spinal posture demonstrated a modification in the frontal plane in 40% of cases although this could not be clearly attributed to the donor site. On the basis of this study, we can conclude that the latissimus dorsi flap retains an important place in the therapeutic arsenal of plastic surgery due to its reliability and its minor cicatricial and functional sequelae at the donor site.

The osteo-odonto-keratoprosthesis (OOKP).

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Liu, Christopher; Paul, Bobby; Tandon, Radhika; Lee, Edward; Fong, Ken; Mavrikakis, Ioannis; Herold, Jim; Thorp, Simon; Brittain, Paul; Francis, Ian; Ferrett, Colin; Hull, Chris; Lloyd, Andrew; Green, David; Franklin, Valerie; Tighe, Brian; Fukuda, Masahiko; Hamada, Suguru

2005-01-01

The osteo-odonto-keratoprosthesis (OOKP), although described over 40 years ago, remains the keratoprosthesis of choice for end-stage corneal blindness not amenable to penetrating keratoplasty. It is particularly resilient to a hostile environment such as the dry keratinized eye resulting from severe Stevens-Johnson syndrome, ocular cicatricial pemphigoid, trachoma, and chemical injury. Its rigid optical cylinder gives excellent image resolution and quality. The desirable properties of the theoretical ideal keratoprosthesis is described. The indications, contraindications, and patient assessment (eye, tooth, buccal mucosa, psychology) for OOKP surgery are described. The surgical and anaesthetic techniques are described. Follow-up is life-long in order to detect and treat complications, which include oral, oculoplastic, glaucoma, vitreo-retinal complications and extrusion of the device. Resorption of the osteo-odonto-lamina is responsible for extrusion, and this is more pronounced in tooth allografts. Regular imaging with spiral-CT or electron beam tomography can help detect bone and dentine loss. The optical cylinder design is discussed. Preliminary work towards the development of a synthetic OOKP analogue is described. Finally, we describe how to set up an OOKP national referral center.

Pemphigus vulgaris localized to the vagina presenting as chronic vaginal discharge.

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Batta, K; Munday, P E; Tatnall, F M

1999-05-01

Involvement in pemphigus vulgaris of the female genital tract including the vulva, vagina and cervix has previously been described. In all these cases other cutaneous and mucosal sites have also been affected at some time. We describe a case of pemphigus vulgaris which only involved the vaginal mucosa. The patient presented with a persistent vaginal discharge and examination showed extensive vaginal erosions. Histology of vaginal biopsies was non-diagnostic. The recognition that the vaginal changes may represent an immunobullous disease led to further vaginal biopsies on which direct immunofluorescence studies were performed. These biopsies showed IgG and C3 in the intercellular epidermis, suggesting a diagnosis of pemphigus vulgaris. During the 3-year period that the patient has been under review there have never been any other cutaneous or mucosal lesions. To our knowledge, this is the first case of pemphigus vulgaris localized exclusively to the vaginal mucosa. There was considerable delay in diagnosis and this case highlights how important it is to recognize that chronic mucosal lesions at genital sites may be caused by immunobullous diseases such as cicatricial pemphigoid and pemphigus, and to institute appropriate investigations.

Necrosis of the femoral head after /sup 60/Co radiation therapy

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Maruno, H; Kawai, K [Kobe Univ. (Japan). School of Medicine

1978-10-01

A patient (50-year-old woman) received 10500 rad of skin dose and 630 rad of tumor dose for treatment of cervical cancer 15 years ago. The depth dose at the hip-joint was 3590 rad at the right hip-joint and 4315 rad at the left. Hip-joint pain occurred about 15 years after the irradiation, and one more year later she could not walk because of severe pain. X-ray films revealed great bone destruction at the both hip-joints as well as necrosis of the femoral head and arthropathy. The same findings were seen at the ilium, ischium, and pubis. Histologically, the synovial membrane was highly thick, fibrotic, and cicatricial. Obstructive changes were observed also in the small arteries. A severe narrowing or obstruction was observed in the Harversian canal at the bone cortex. The femoral head at the whole area was necrotic. The trabeculae were entirely thinned and were partially thickened by appositional bone formation. This new bone was also necrotic. Edematous fibrous-fatty tissues predominated the bone marrow. There was no proliferation of fibrous cell or new bone formation at the sites other than the margin.

Effect of laser treatment on first-intention incisional wound healing in ball pythons (Python regius).

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Cole, Grayson L; Lux, Cassie N; Schumacher, Juergen P; Seibert, Rachel L; Sadler, Ryan A; Henderson, Andrea L; Odoi, Agricola; Newkirk, Kim M

2015-10-01

To evaluate effects of laser treatment on incisional wound healing in ball pythons (Python regius). 6 healthy adult ball pythons. Snakes were sedated, a skin biopsy specimen was collected for histologic examination, and eight 2-cm skin incisions were made in each snake; each incision was closed with staples (day 0). Gross evaluation of all incision sites was performed daily for 30 days, and a wound score was assigned. Four incisions of each snake were treated (5 J/cm(2) and a wavelength of 980 nm on a continuous wave sequence) by use of a class 4 laser once daily for 7 consecutive days; the other 4 incisions were not treated. Two excisional skin biopsy specimens (1 control and 1 treatment) were collected from each snake on days 2, 7, 14, and 30 and evaluated microscopically. Scores were assigned for total inflammation, degree of fibrosis, and collagen maturity. Generalized linear models were used to investigate the effect of treatment on each variable. Wound scores for laser-treated incisions were significantly better than scores for control incisions on day 2 but not at other time points. There were no significant differences in necrosis, fibroplasia, inflammation, granuloma formation, or bacterial contamination between control and treatment groups. Collagen maturity was significantly better for the laser-treated incisions on day 14. Laser treatment resulted in a significant increase in collagen maturity at day 14 but did not otherwise significantly improve healing of skin incisions.

Reparación quirúrgica de fístula traqueocutánea y de cicatriz postraqueotomía mediante colgajo dermograso de rotación Reparação cirúrgica de fístula traqueocutânea e de cicatriz pós-traqueostomia com rotação de retalho dermoadiposo Surgical repair of tracheocutaneous fistulae and postracheotomy scar using a dermoadipose turn-over flap

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F. Passos da Rocha

2009-03-01

Full Text Available La fístula traqueocutánea y la retracción cicatricial son las complicaciones postraqueotomía más frecuentes. El objetivo del presente trabajo es el presentar una técnica quirúrgica de fácil ejecución para la reparación de los defectos estéticos y funcionales creados por estas patologías. Presentamos el caso de un varón de 61 años que había sufrido traqueotomía. Tras la decanulación, la cicatrización cursó con retracción, adherencia a planos profundos y aparición de fístula traqueocutánea. El cierre de la fístula se hizo reparando el defecto funcional mediante la técnica de rotación de colgajos dermograsos en "hoja de libro", logrando el cierre del área de retracción y reparando el defecto estético. La retracción cutáneo-hipodérmica es un defecto inestético, incómodo y estigmatizante. Las fístulas traqueocutáneas con escape de aire son desagradables tanto desde el punto de vista funcional como estético. El método que presentamos logró corregir la fístula y la depresión provocada por la traqueotomía mediante un procedimiento simple, rápido y efectivo. Este método evita las dificultades encontradas en otras técnicas y garantiza la corrección funcional y estética empleando un método simple con baja morbilidad.Tracheocutaneous fistulas and scar retraction are frequent complications of the tracheotomy. The objective of the present manuscript is to present an easy execution surgical technique to restore tracheocutaneous fistula and cutaneous retraction. We present the clinical case of a 61 years old man who had suffered tracheotomy. After decannulation, the scar became retracted and adhered to deep tissues, developing into a tracheocutaneous fistula. The fistula was closed repairing the functional defect and a turn-over hinge flap of dermoadipose tissue was used to fill the retracted area, correcting the aesthetic abnormality. Correction of cicatricial retraction and of tracheocutaneous fistula using the

Pengaruh Cairan Cultur Filtrate Fibroblast (CFF Terhadap Penyembuhan Luka; Penelitian eksperimental pada Rattus Norvegicus Galur Wistar

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Oky Masir

2012-11-01

Full Text Available AbstrakLatar belakang:Metode penyembuhan luka telah mengalami perkembangan, baik berupa suatu produk atau stimulan terhadap proses biologis tubuh dalam menkompensasi luka. Fibroblas merupakan salah satu komponen penyembuhan yang berperan penting dalam proses fibroplasia. Culture Filtrate Fibroblast (CFF merupakan hasil kultur fibroblas yang akan dibuktikan efeknya terhadap proses percepatan penyembuhan luka pada penelitian ini. Metode. Penelitian ini menggunakan desain eksperimental dengan metode post test only control group design dan rancangan acak kelompok (RAK dengan menggunakan tikus putih wistar. Hewan coba dibagi menjadi 4 kelompok, yaitu 2 kelompok perlakuan yang diberikan CFF ke area eksisi luka dan kelompok kontrol yang diberikan larutan NaCl 0,9% ke area eksisi luka. Data diolah dengan SPSS 16.0. Data Kategori dianalisa dengan Chi-squared dan data numerik dengan Independent T-test. Hasil. Dari tingkat penyembuhan tidak ditemukan perbedaan pada kedua kelompok, namun perubahan restriksi jaringan lebih besar pada kelompok perlakuan. Pada skor pembentukan kolagen, derajat epitelisasi serta jumlah pembentukan pembuluh darah baru pada hari ke-3 tidak ditemukan perbedaan antara kedua kelompok. Namun pada pengamatan hari ke-7 memperlihatkan pembentukan kolagen, derajat epitelisasi serta jumlah pembentukan pembuluh darah baru lebih banyak pada kelompok perlakuan. Pada fibrosis hari ke-3 dan hari ke-7 memperlihatkan terjadinya fibrosis lebih banyak pada kelompok perlakuan dibanding kontrol. Pada pengamatan terjadinya infeksi hari ke-3 memperlihatkan infeksi lebih sedikit pada kelompok perlakuan dan terjadinya infeksi sama pada hari ke-7. Kesimpulan. CFF memberikan tingkat penyembuhan luka yang lebih baik dibanding NaCl.Kata kunci: CFF, NaCl 0,9 %, tingkat penyembuhan luka.Abstract Background: Wound healing methods have been developed, either a product or a stimulant to the body's biological processes in wound compensation. Fibroblasts is one

Developmental abnormalities of the vitreous in mouse fetuses caused by simultaneous irradiation of x-rays and ultrasound

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Shirai, S; Yuguchi, S; Majima, A [Nagoya City Univ. (Japan). Faculty of Medicine

1980-10-01

Eye abnormalities in mouse fetuses caused by irradiation of X-rays alone, or simultaneous irradiation of X-rays and ultrasound on day 7 of gestation were histologically studied on day 18 of gestation. Developmental abnormalities of the vitreous were examined in the present experiment, and the following results were obtained. 1. Developmental abnormalities of the vitreous were observed in 23 fetuses, and unilateral cases were 15 of 23 fetuses. In 31 eyes with these abnormalities, much more abundant mesenchymal tissue of components of primary vitreous was found in the retrolental vitreous cavity than in the normal eyes. 2. The above 31 eyes were also accompanied by a variety of ocular abnormalities such as microphthalmia, faulty closure of the fetal fissure, aplasia and hypoplasia of the optic nerve, goniodysgenesis, and corneolenticular adhesion. Complications observed to be associated with developmental abnormalities of the vitreous were lens abnormalities, retinal traction and fold, fibrovascular anastomosis between mesenchymal tissues of the chamber angle and vitreous cavity, retinal rosette, and anomalies of the optic nerve head. 3. The histological findings of 17 eyes corresponded to anterior persistent hyperplastic primary vitreous (PHPV) encountered clinically, those of 3 eyes to posterior PHPV, those of 6 eyes to mixed type of both anterior and posterior types, and those of 5 eyes to PHPV of the optic nerve head. In 3 bilateral cases, the type was different for either eye. 4. From these results, it was considered that the pathogenesis of PHPV of Reese and congenital retinal fold of Mann consists of the maldevelopment of the components of the primary vitreous, and that the type of defect depends on the portion involved and the degree depends on the time at which the maldevelopment occurs.

Developmental abnormalities of the vitreous in mouse fetuses caused by simultaneous irradiation of x-rays and ultrasound

International Nuclear Information System (INIS)

Shirai, Shoichiro; Yuguchi, Shuji; Majima, Akio

1980-01-01

Eye abnormalities in mouse fetuses caused by irradiation of X-rays alone, or simultaneous irradiation of X-rays and ultrasound on day 7 of gestation were histologically studied on day 18 of gestation. Developmental abnormalities of the vitreous were examined in the present experiment, and the following results were obtained. 1. Developmental abnormalities of the vitreous were observed in 23 fetused, and unilateral cases were 15 of 23 fetuses. In 31 eyes with these abnormalities, much more abundant mesenchymal tissue of components of primary vitreous was found in the retrolental vitreous cavity than in the normal eyes. 2. The above 31 eyes were also accompanied by a variety of ocular abnormalities such as microphthalmia, faulty closure of the fetal fissure, aplasia and hypoplasia of the optic nerve, goniodysgenesis, and corneolenticular adhesion. Complications observed to be associated with developmental abnormalities of the vitreous were lens abnormalities, retinal traction and fold, fibrovascular anastomosis between mesenchymal tissues of the chamber angle and vitrious cavity, retinal rosette, and anomalies of the optic nerve head. 3. The histological findings of 17 eyes corresponded to anterior persistent hyperplastic primary vitreous (PHPV) encountered clinically, those of 3 eyes to posterior PHPV, those of 6 eyes to mixed type of both anterior and posterior types, and those of 5 eyes to PHPV of the optic nerve head. In 3 bilateral cases, the type was different for either eye. 4. From these results, it was considered that the pathogenesis of PHPV of Reese and congenital retinal fold of Mann consists of the maldevelopment of the components of the primary vitreous, and that the type of defect is depends on the portion involved and the degree depends on the time at which the maldevelopment occurs. (author)

LASERTERAPIA NA INFLAMAÇÃO PULMONAR EXPERIMENTAL EM RATTUS NORVEGICUS OCASIONADO PELA PAPAÍNA

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Diego Rodrigues Pessoa

2017-01-01

Full Text Available Resumo: A Doença Pulmonar Obstrutiva Crônica (DPOC é caracterizada pela limitação do fluxo aéreo decorrente da dilatação dos espaços aéreos distais aos bronquíolos terminais. Analisar os efeitos da laserterapia quanto ao processo cicatricial na lesão pulmonar experimental em Rattus Novergicus. Utilizaram-se trinta animais agrupados em três grupos de dez animais: grupo controle (GC (não recebeu nada, grupo DPOC (GD (foi pulverizado 3 doses de papaína 3mg/kg e grupo DPOC + Laser (GDL (após 7 dias da indução da lesão com papaína foi tratado com laser de 660 nm durante 15 dias.Para analise dos resultados foi realizado o lavado broncoalveolar. Quanto ao Lavado: GC (número de células normais, GD (aumento de células inflamatórias e GDL (diminuição de células inflamatórias. A laserterapia diminui o numero de células inflamatórias, entretanto, não possui efeito reconstrutor do parênquima pulmonar apenas estabiliza a lesão comprovando sua ação anti-inflamatória.

Customized Hinged Covered Metallic Stents for the Treatment of Benign Main Bronchial Stenosis.

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Han, Xinwei; Al-Tariq, Quazi; Zhao, Yanle; Li, Lei; Cheng, Zhe; Wang, Huaqi; Liu, Chao; Jiao, Dechao; Wu, Gang

2017-08-01

To address the limitations of silicone stents, we designed a hinged self-expandable covered metallic stent. The aim of this study was to evaluate the safety and efficacy of the customized stents in clinical applications. This was a retrospective analysis. Under conscious sedation and local anesthesia, the stents were implanted or removed by interventional radiologists, with fluoroscopic guidance. Of 24 patients with benign main bronchial stenosis, stents were successfully placed in 21 (87.5%). The low-pressure balloon before dilation failed in 1 case (4.17%) of left main bronchial cicatricial stenosis. In 2 other cases (8.33%), stent placement was abandoned. Stents were successfully removed between 29 and 103 days after the procedure. After stent removal, the follow-up lasted for at least 12 months. Restenosis occurred only in 1 case (4.55%) owing to bronchial collapse 3 days after stent removal. Dyspnea occurred in another case (4.55%) at 2 months after retrieval; recurrence was confirmed using bronchoscopy, leading to a left pneumonectomy. The described procedure is safe and easy to be performed and avoids the use of intubation, bronchoscopy, and general anesthesia. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Penfigoide de membranas mucosas com estenose esofágica grave Mucous membrane pemphigoid with severe esophageal stricture

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Lívia do Nascimento Barbosa

2011-06-01

Full Text Available O penfigoide de membranas mucosas é entidade nosológica encarada como um fenótipo, que engloba várias dermatoses autoimunes com lesões bolhosas subepidérmicas, ocorrendo predominantemente nas membranas mucosas, com êxito cicatricial. O acometimento esofágico no penfigoide de membranas mucosas é raro e observado em pacientes com lesão disseminada. As alterações mais comuns são múltiplas membranas ou constrições esofagianas. No presente relato, os autores apresentam paciente com PMM sem lesões cutâneas e estenose esofágica grave, que entrou em remissão após uso de imunoglobulina venosaMucous membrane pemphigoid (MMP is a rare nosological entity. MMP consists of a clinical phenotype in which several autoimmune subepidermal bullous diseases are classified. It occurs predominantly in the mucous membranes and usually results in scarring. Esophageal involvement in MMP is rare and is generally seen in patients in whom lesions are widespread. The most common alterations are multiple esophageal membranes or strictures. In the present case, the authors report on a patient with MMP without any skin lesions and with severe esophageal strictures who went into remission following use of intravenous immunoglobulin

Pomada orgânica natural ou solução salina isotônica no tratamento de feridas limpas induzidas em ratos

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Rahal Sheila Canevese

2001-01-01

Full Text Available Foram utilizados 40 ratos Wistar, machos, com peso inicial médio de 225 gramas, separados em dois grupos. Após serem anestesiados com éter, foi induzida uma ferida limpa na região torácica dorsal cranial, mediante a utilização de molde metálico de 2,0 x 1,5cm. No grupo I, foi utilizada pomada contendo óleo de fígado de bacalhau, extrato de confrei, extrato cítrico, óxido de zinco e veículo (Creamex®; no grupo II, a ferida foi apenas limpa com solução salina isotônica. Para a avaliação histológica, foram submetidos à eutanásia cinco animais de cada grupo no 3º, 7º, 14º e 21º dia de pós-operatório. O grupo tratado com a pomada orgânica apresentou padrão cicatricial de qualidade superior em relação ao grupo tratado com salina isotônica, representado por formação de fibras colágenas, neoformação de vasos e reepitelização completa da epiderme.

Anila Hanxhari (Durrës, 1974

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María Antonia Blat Mir

2017-01-01

Full Text Available Anila Hanxhari nació en Durrës (Albania y vive en Lanciano (Italia. Es poetisa, pintora, narradora, traductora y presidenta de la asociación cultural Italfida, con la que ha ideado y organizado diversas actividades culturales y congresos internacionales. Actualmente es directora responsable del sector cultural de Ascom Abruzzo ocupándose de la iniciativa “Poesia e Impresa”. Ha publicado las antologías de poesía Io tu e l’Anima (Ianieri, 1997, Assopita erba dell’est (Noubs, 2002, Cicatrici d’acqua (Noubs, 2007, con prólogo de Giuseppe Conte, Brindisi degli angeli (La Vita Felice, 2012, con prólogo de Maurizio Cucchi, Tiro a sorte la libertà (Tabula Fati, 2016, con prólogo de Davide Rondoni y Rolando D’Alonzo. Sus poemas han aparecido, entre otras, en las antologías Nuovissima poesia italiana (Oscar Mondadori, 2005, editada por Antonio Riccardi y Maurizio Cucchi, La parola che ricostruisce. Poeti italiani per l’Aquila (Tracce, 2009, además de en la colección Specchio de La Stampa y en numerosas revistas. Ha ganado diferentes premios, como el Premio Camaiore-Proposta (2002, el Premio Matacotta a la opera prima 2003, el Premio Valle Senio o el premio Poesia nella vita (2011.

[Comparative study of intestinal anastomosis with manual suture and biofragmentable ring in dogs under corticosteroid administration].

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Fernandes, L C; Matos, D; Novelli, M D; Kim, S B

2000-01-01

This study analyzed intestinal anastomoses by manual suture and by compression with biofragmentable ring under delay of cicatrization administering parenteral corticoids. Twenty dogs were divided into two groups: control and test, the latter submitted to intramuscular administration of hydrocortisone hemisuccinate, 25 to 33 mg/kg/day, on the 30th preoperative and 7th postoperative days. During surgery, each animal underwent two colon sections with anastomosis by manual suture in a single extramucous plane and compression with biofragmentable ring. The animals were sacrificed 7 days after the procedure to evaluate the anastomoses. In the postoperative period, one death occurred in the test group and two in the control group, caused by nonblocked fistula in the anastomoses by ring compression. Statistically, there was a similar incidence of adherences, fistulas, afferent dilatation and obstruction using comparison methods. On microscopy, deficiency in mucous regeneration of the anastomoses by compression was observed. Computerized histological analysis evidenced in the anastomoses by compression, a greater inflammatory reaction, greater edema of the submucous membrane and enlarged scars. It was concluded that, with the biofragmentable ring, in colonic anastomosis under delay of cicatrization induced by corticoids, similar results to manual suture regarding to postoperative complications incidence were obtained; ring, however, determined worse mucous regeneration and greater cicatricial inflammatory reaction.

[Dynamic concept of oral lichen planus. The diagnosis easy at early stages may become difficult in ancient lichen planus].

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Lombardi, Tommaso; Küffer, Roger

2016-02-01

Dynamic concept of oral lichen planus. The diagnosis easy at early stages may become difficult in ancient lichen planus. Lichen planus is a chronic inflammatory dermatosis of the skin, skin appendages and mucous membranes, which frequently affects the oral mucosa. Its aetiology still remains unknown, and currently accepted pathogenesis is that of an autoimmune cell-mediated disease. To the contrary of skin lichen planus, oral lichen planus is a long-term chronic disease with dynamic evolution, in which progressive and profound changes of the clinical and histopathological aspects occur over time and under the influence of various exogenous factors. By convention, in the history of the oral lichen planus four successive stages can be distinguished without well-defined boundaries between them. These stages can be defined as an initial phase; a long intermediate phase with alternating periods of activity and quiescence, which has a gradually increasing risk of malignant transformation; a late stage which activity is traditionally diminished; and a post-lichen cicatricial stage with an absent or negligible and undetectable activity, often undiagnosed because clinically unrecognized; in this stage, the lesion does not respond to usual treatments, but retains the same risk of malignant transformation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Vulval lichen planus-lichen sclerosus overlap.

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Howard, Matthew; Hall, Anthony

2018-01-01

Vulval lichen planus-lichen sclerosus overlap is an emerging observation. Few clinical reports exist with no reviews of literature. We present a focused update of this phenomenon and discuss a clinical case. We report a 63-year-old woman with a 20-year history of ulcerative vulvo-vaginitis, initially diagnosed as benign mucous membrane (cicatricial) pemphigoid. This led to prolonged treatment with oral corticosteroids with minimal improvement in symptoms. Subsequent complications of long-term use of systemic corticosteroid ensued. A clinico-pathological diagnosis of severe erosive lichen planus was made on clinical findings and on non-specific biopsy changes of ulceration and inflammation. Treatment with topical clobetasol propionate 0.05% ointment twice daily led to dramatic improvement of ulceration, easing of discomfort and marked improvement in quality of life. Clinical examination revealed Wickham's striae on the labia majora supporting the diagnosis. Six years after commencement of topical clobetasol, white plaques were noticed on the labia majora, perineum and peri-anal region consistent with lichen sclerosus, confirmed by repeat vulval skin biopsy and on vulvectomy. This case highlights the challenge of diagnosis of extensive vulvo-vaginal ulceration and the necessity to re-examine a previous diagnosis if there is poor response to treatment.

Traction alopecia: the root of the problem.

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Billero, Victoria; Miteva, Mariya

2018-01-01

Traction alopecia (TA) affects one-third of women of African descent who wear various forms of traumatic hairstyling for a prolonged period of time. The risk of TA is increased by the extent of pulling and duration of traction, as well as the use of chemical relaxation. The frequent use of tight buns or ponytails, the attachment of weaves or hair extensions, and tight braids (such as cornrows and dreadlocks) are believed to be the highest risk hairstyles. TA can also occur in the setting of religious and occupational traumatic hairstyling. In its later stages, the disease may progress into an irreversible scarring alopecia if traumatic hairstyling continues without appropriate intervention. The most common clinical presentation includes marginal alopecia and non-marginal patchy alopecia. A clue to the clinical diagnosis is the preservation of the fringe sign as opposed to its loss in frontal fibrosing alopecia (FFA). Dermoscopy can be helpful in the diagnosis and can detect the ongoing traction by the presence of hair casts. Histopathology can distinguish TA from alopecia areata, FFA, and patchy central centrifugal cicatricial alopecia. Currently, there is no cure. Therefore, it is imperative that clinicians educate high-risk populations about TA and those practices that may convey the risk of hair loss.

Localized lymphedema (elephantiasis): a case series and review of the literature.

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Lu, Song; Tran, Tien Anh; Jones, David M; Meyer, Dale R; Ross, Jeffrey S; Fisher, Hugh A; Carlson, John Andrew

2009-01-01

Lymphedema typically affects a whole limb. Rarely, lymphedema can present as a circumscribed plaque or an isolated skin tumor. To describe the clinical and pathologic characteristics and etiologic factors of localized lymphedema. Case-control study of skin biopsy and excision specimens histologically diagnosed with lymphedema and presenting as a localized skin tumor identified during a 4-year period. We identified 24 cases of localized lymphedema presenting as solitary large polyps (11), solid or papillomatous plaques (7), pendulous swellings (4), or tumors mimicking sarcoma (2). Patients were 18 females and 6 males with a mean age of 41 years (range 16-74). Anogenital involvement was most frequent (75%)--mostly vulva (58%), followed by eyelid (13%), thigh (8%) and breast (4%). Causative factors included injury due to trauma, surgery or childbirth (54%), chronic inflammatory disease (rosacea, Crohn's disease) (8%), and bacterial cellulitis (12%). Eighty-five percent of these patients were either overweight (50%) or obese (35%). Compared with a series of 80 patients with diffuse lymphedema, localized lymphedema patients were significantly younger (41 vs. 62 years old, p = 0.0001), had no history of cancer treatment (0% vs. 18%, p = 0.03), and had an injury to the affected site (54% vs. 6%, p = 0.0001). Histologically, all cases exhibited dermal edema, fibroplasia, dilated lymphatic vessels, uniformly distributed stromal cells and varying degrees of papillated epidermal hyperplasia, inflammatory infiltrates and hyperkeratosis. Tumor size significantly and positively correlated with history of cellulitis, obesity, dense inflammatory infiltrates containing abundant plasma cells, and lymphoid follicles (p elephantiasis.

Pathologic effects of fractionated fast neutrons or photons on canine liver

International Nuclear Information System (INIS)

Zook, B.C.; Bradley, E.W.; Casarett, G.W.; Hitzelberg, R.A.; Rogers, C.C.

1981-01-01

Thirty-nine adult male purebred beagles received either fast neutron or photon irradiation to the right thorax to determine the effects on pulmonary tissue. The right half of the liver was included in the field of radiation. Twenty-four dogs (six/group) received fast neutrons with a mean energy of 15 MeV to total doses of 1000, 1500, 2250, or 3375 rads in four fractions per week for 6 weeks. Fifteen dogs received 3000, 4500, or 6750 total rads of photons (five dogs/group) in an identical fractionation pattern. All neutron-irradiated dogs receiving 3375 and 2250 rads and one receiving 1500 rads developed clinical signs, hepatic enzyme, and bilirubin elevations, and the dogs died or were euthanized in extremis on postirradiation day 47-291. Signs of liver injury, other than enzyme changes, have not developed to date (1200 to 1300 days) in the remaining dogs, except in one 6750-rad photon dog that died of hepatic failure on postirradiation day 708. At necropsy, the irradiated right lobes of the liver were atrophic and the nonirradiated left lobes underwent compensatory hypertrophy. Hepatic arterioles and bile ducts were injured in every dog, but no obstructive lesions were observed in hepatic veins. Portal fibroplasia, bile retention, and proliferation of bile ductules was common; the latter two changes also occurred in the nonirradiated lobes. No qualitative differences were observed between hepatic lesions in neutron-versus photon-irradiated dogs. The relative biological effectiveness of fast neutrons for liver damage appears to be no less than 4.5

Pathologic effects of fractionated fast neutrons or photons on canine liver

International Nuclear Information System (INIS)

Zook, B.C.; Bradley, E.W.; Casarett, G.W.; Hitzelberg, R.A.; Rogers, C.C.

1981-01-01

Thirty-nine adult male purebred beagles received either fast neutron or photon irradiation to the right thorax to determine the effects on pulmonary tissue. The right half of the liver was included in the field of radiation. Twenty-four dogs (six/group) received fast neutrons with a mean energy of 15 MeV to total doses of 1000, 1500, 2250, or 3375 rads in four fractions per week for 6 weeks. Fifteen dogs received 3000, 4500, or 6750 total rads of photons (five dogs/group) in an identical fractionation pattern. All neutron-irradiated dogs receiving 3375 and 2250 rads and one receiving 1500 rads developed clinical signs, hepatic enzyme, and bilirubin elevations, and the dogs died or were euthanized in extremis on postirradiation day 47-291. Signs of liver injury, other than enzyme changes, have not developed to date (1200-1300 days) in the remaining dogs, except in one 6750-rad photon dog that died of hepatic failure on postirradiation day 708. At necropsy, the irradiated right lobes of the liver were atrophic and the nonirradiated left lobes underwent compensatory hypertrophy. Hepatic arterioles and bile ducts were injured in every dog, but no obstructive lesions were observed in hepatic veins. Portal fibroplasia, bile retention, and proliferation of bile ductules was common; the latter two changes also occurred in the nonirradiated lobes. No qualitative differences were observed between hepatic lesions in neutron- versus photon-irradiated dogs. The relative biological effectiveness of fast neutrons for liver damage appears to be no less than 4.5

Comparison of first-intention healing of carbon dioxide laser, 4.0-MHz radiosurgery, and scalpel incisions in ball pythons (Python regius).

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Hodshon, Rebecca T; Sura, Patricia A; Schumacher, Juergen P; Odoi, Agricola; Steeil, James C; Newkirk, Kim M

2013-03-01

To evaluate first-intention healing of CO(2) laser, 4.0-MHz radiowave radiosurgery (RWRS), and scalpel incisions in ball pythons (Python regius). 6 healthy adult ball pythons. A skin biopsy sample was collected, and 2-cm skin incisions (4/modality) were made in each snake under anesthesia and closed with surgical staples on day 0. Incision sites were grossly evaluated and scored daily. One skin biopsy sample per incision type per snake was obtained on days 2, 7, 14, and 30. Necrotic and fibroplastic tissue was measured in histologic sections; samples were assessed and scored for total inflammation, histologic response (based on the measurement of necrotic and fibroplastic tissues and total inflammation score), and other variables. Frequency distributions of gross and histologic variables associated with wound healing were calculated. Gross wound scores were significantly greater (indicating greater separation of wound edges) for laser incisions than for RWRS and scalpel incisions at all evaluated time points. Necrosis was significantly greater in laser and RWRS incisions than in scalpel incision sites on days 2 and 14 and days 2 and 7, respectively; fibroplasia was significantly greater in laser than in scalpel incision sites on day 30. Histologic response scores were significantly lower for scalpel than for other incision modalities on days 2, 14, and 30. In snakes, skin incisions made with a scalpel generally had less necrotic tissue than did CO(2) laser and RWRS incisions. Comparison of the 3 modalities on the basis of histologic response scores indicated that use of a scalpel was preferable, followed by RWRS and then laser.

Circumscribed cicatricial alopecia due to localized sarcoidal granulomas and single-organ granulomatous arteritis: a case report and systematic review of sarcoidal vasculitis.

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Yazdani Abyaneh, Mohammad-Ali; Raghu, Preethi; Kircher, Kenneth; Kutzner, Heinz; Kortz, Alison; Carlson, John Andrew

2015-10-01

Vasculitis associated with sarcoid granulomas is an uncommon phenomenon. A 72-year-old female presented with an expanding region of circumscribed alopecia and scalp atrophy of 2 months duration. Biopsy showed non-caseating granulomas, dermal thinning, loss of follicles, fibrosis and muscular vessels disrupted by mixed lymphocyte, macrophage and giant-cell infiltrates. Affected vessels had loss and fragmentation of the elastic lamina, fibrous replacement of their walls and luminal stenosis (endarteritis obliterans). Dermal and vascular advential intralymphatic granulomas and lymphangiectases were found by D2-40 expression, suggesting lymphatic obstruction and poor antigen clearance. No evidence of a post-zoster eruption, systemic sarcoidosis or systemic giant-cell arteritis was found. Two years later, prednisone had halted - but not reversed - progression of her alopecia. Review of the literature showed two types of vasculitis associated with sarcoid granulomas: (i) acute, self-limited leukocytoclastic vasculitis and (ii) chronic granulomatous vasculitis (GV). Persistence of non-degradable material or antigen contributes to the pathogenesis of granulomatous inflammation. In this case, lymphatic obstruction probably impeded clearance of nonimmunologic and/or immunologic stimuli permitting and sustaining the development of sarcoid granulomas and sarcoid GV, ultimately causing scarring alopecia and cutaneous atrophy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Aspectos clínicos e macroscópicos da palatoplastia imediata com implante de cartilagem da pina articular, conservada em glicerina a 98%, após indução experimental de fenda palatina em cães Clinic and macroscopic view of immediate palatoplasty with auricular pinna cartilage preserved in 98% glycerin in canine experimental palat cleft

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Emerson Antônio Contesini

2003-02-01

Full Text Available Os defeitos de espessura completa do palato que resultam em comunicação oro-nasal raramente cicatrizam espontaneamente. Eles requerem reparo cirúrgico, porém, pode ser difícil obter cicatrização satisfatória devido às condições próprias das cavidades nasal e oral. Neste experimento, foram utilizados 14 cães, reunidos em dois grupos de igual número. Todos animais foram submetidos à indução de fenda palatina experimental. O grupo G1 foi o controle, cuja palatoplastia foi realizada a partir da confecção de "flap" muco-periósteo. No grupo G2, foi utilizada cartilagem da pina auricular conservada em glicerina a 98% entre o osso palatino e o muco-periósteo. Os animais foram avaliados macroscopicamente quanto ao processo cicatricial, por radiografias para a regeneração óssea e por rinoscopia para observar a regeneração da mucosa nasal. Foi observada a cicatrização da mucosa oral a partir do 10º dia, com deiscência de sutura em dois animais do grupo G1. A radiografia demonstrou evolução na cicatrização óssea, num processo mais acelerado no grupo G2 quando comparado ao grupo G1. A rinoscopia revelou, aos 60 dias, completa regeneração da mucosa nasal em ambos os grupos. Ao final do período de avaliação foi observada macroscopicamente, completa fusão óssea nos animais do grupo G2 e incompleta nos do grupo G1, o que demonstrou a interferência benéfica do implante no processo cicatricial do grupo G2.The incomplete defects of hard palate result in oro-nasal fistula seldom cure themselves in a spontaneous way, due to limited condition in oral and nasal cavity it may be difficult to obtain satisfactory cicatrization, requiring surgery to interfere in the healing process. Fourteen dogs arranged in two groups were submitted to experimental hard palate cleft. The G1 group was the control group, in which palatoplasty was achieved with mucous-periosteum flap. In the G2 group, a preserved at 98% glycerin auricular pinna

Advanced nail surgery

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Eckart Haneke

2011-01-01

Full Text Available Six techniques not yet widely known or used in the dermatologic surgery of the nails are briefly described. Small-to-medium-sized tumours of the proximal nail fold (PNF can be excised and the defect repaired with advancement or rotation flaps. A superficial biopsy technique of the matrix for the diagnosis of longitudinal brown streaks in the nail, which allows rapid histological diagnosis of the melanocyte focus to be performed, is described here. Because the excision is very shallow and leaves the morphogenetic connective tissue of the matrix intact, the defect heals without scarring. Laterally positioned nail tumours can be excised in the manner of a wide lateral longitudinal nail biopsy. The defect repair is performed with a bipedicled flap from the lateral aspect of the distal phalanx. Malignant tumours of the nail organ often require its complete ablation. These defects can be covered by a full-thickness skin graft, reversed dermal graft, or cross-finger flap. The surgical correction of a split nail is often difficult. The cicatricial tissue of the matrix and PNF have to be excised and the re-attachment of these wounds prevented. The matrix defect has to be excised and sutured or covered with a free matrix graft taken either from the neighbouring area or from the big toe nail.

Oral and maxillofacial surgeons' role in the first successful modified osteo-odonto-keratoprosthesis performed in the United States.

Science.gov (United States)

Sawatari, Yoh; Perez, Victor L; Parel, Jean-Marie; Alfonso, Eduardo; Falcinelli, Giancarlo; Falcinelli, Johnny; Marx, Robert E

2011-06-01

Corneal disease constitutes the second most common cause of blindness and often leads to corneal damage or scarring. Several corneal scarring is a complex and difficult condition for ophthalmologists to manage. In the most severe cases, the scarring is accompanied by excessive dryness and keratinization of the ocular surface. Certain etiologies, including Stevens-Johnson syndrome, cicatricial pemphigoid, Lyell's syndrome, and chemical trauma to the surface of the eye, are responsible for the most severe cases. Traditional allogeneic corneal transplantation is not effective because of the significant scarring and dryness of the eye. To allow light and images to be focused on the retina, a keratoprosthesis is required to position a lens on the surface of the eye. One of the oldest and most effective types of keratoprosthesis, the osteo-odonto-keratoprosthesis (OOKP), was first described and documented in 1963 by Strampelli and subsequently modified by Falcinelli et al. The modified OOKP (MOOKP) is a unique prosthesis consisting of a lens fabricated from a polymethylmethacrylate (PMMA) cylinder and cemented to an autogenous graft composed of tooth and bone, traditionally termed the osteo-odonto lamina. In this context, lamina refers to a thin rectangular plate of tooth and bone (Fig 1). The MOOKP involves 4 procedures performed in 3 surgical stages. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Osteo-odonto-keratoprosthesis - a maxillofacial perspective.

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Narayanan, Vinod; Nirvikalpa, Natarajan; Rao, Srinivas K

2012-12-01

The OOKP (osteo-odonto-keratoprosthesis) is the treatment of choice for conditions like Stevens-Johnson syndrome, ocular cicatricial pemphigoid, trachoma, multiple failed grafts and chemical burns which are not amenable to penetrating keratoplasty. The OOKP is an autograft which replaces the cornea with a polymethacrylate cylinder mounted on a tooth-bone complex. The aim of this paper was to retrospectively analyze the records in 26 patients undergoing OOKP surgery between 2007 and 2011. The paper describes our experience with the procedure, with emphasis on its oral and maxillofacial aspects and management of associated complications. The aetiology of blindness in 23 patients was Stevens-Johnson's syndrome and chemical burns in three. Twenty-two patients had their maxillary canines, two had mandibular canines and two had maxillary first premolars as the choice of donor tooth. An oroantral fistula developed in four patients. One patient needed to undergo a surgical procedure for closure of the same. Roots of adjacent teeth were exposed in 12 patients. Twenty-four patients underwent both stages of the procedure with 19 being visually rehabilitated successfully. There was no improvement in the vision of four patients. One patient was lost to follow-up. Two patients have yet to undergo Stage 2. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Absence of catagen/telogen phase and loss of cytokeratin 15 expression in hair follicles in lichen planopilaris.

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Habashi-Daniel, Arlette; Roberts, Janet L; Desai, Nisha; Thompson, Curtis T

2014-11-01

Lichen planopilaris (LPP) is a lymphocyte-mediated cicatricial alopecia mostly involving the bulge region of the hair follicle. The origin of LPP is unknown. Therapy for LPP often does not prevent disease progression. We describe histologic and immunohistologic features that aid in diagnosis and provide an explanation for disease progression in LPP. We sought to demonstrate a decrease in the number of catagen-/telogen-phase follicles and to confirm the loss of cytokeratin 15 (CK15) expression in the stem cells of LPP-affected follicles. In all, 144 LPP cases were retrieved; 55 cases were stained immunohistochemically, targeting the CK15 antigen with 40 cases ultimately analyzed for CK15 expression. Catagen/telogen phase was significantly decreased or absent in all cases of LPP, a novel clue useful in histologic diagnostics. The loss of CK15+ stem cells in most affected follicles in LPP was also confirmed, with unaffected follicles retaining CK15+ stem cells. Limited tissue for analysis remained in the clinical sample tissue blocks. Damaged follicles that have lost their CK15+ stem cells disappear when they enter catagen phase. CK15+ stem cell loss explains the clinical observation that LPP progresses despite immunosuppressive therapies. Finally, the absence of catagen/telogen hair follicles is a helpful diagnostic clue for LPP. Published by Elsevier Inc.

JAW CYSTS AND GUIDED BONE REGENERATION (a late complication after enucleation

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Hristina Lalabonova

2013-10-01

Full Text Available Maxillary jaw bone possesses a high regenerative capacity. Yet sometimes the defects enucleation of jaw cysts leaves may regenerate only partially or not at all. For this reason some researchers advise treatment of the residual cavities after cystectomy using bone regeneration stimulation methods. We report a case of an atypical complication after enucleation of a maxillary cyst manifesting itself eight years after the initial treatment. The symptoms the patient reported were at first periodic sweating on the left sides of face and head. This was followed by a piercing pain in the left palpebral fissure radiating to the middle of the palate and felt in the left cheekbone, left eye and left supraorbital ridge. The patient has a history of maxillary cysts recurring three times and of three operations she had 20, 12 and 8 years previously. The multiple recurrences of the cysts after their enucleation indicates poor regenerative capacity of the body which resulted in the formation of cicatricial tissue. It is most probably this tissue that was responsible for the disruption of the nerve conduction capacity which can account for the reported symptoms. We filled the cavity with bone graft material which boosted the bone structure regeneration. Although maxillary jaws possess high regenerative capacity we advise the use of guided bone regeneration in cases of large bone defects that usually occur after enucleation of jaw cysts.

Outcomes with the Boston Type 1 Keratoprosthesis at Instituto de Microcirugía Ocular IMO.

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Güell, Jose L; Arcos, Edilio; Gris, Oscar; Aristizabal, Diego; Pacheco, Miguel; Sanchez, Claudia L; Manero, Felicidad

2011-07-01

To report the outcomes on the Boston Type 1 Keratoprosthesis at our institution. Retrospective analysis case series. We analyzed 54 eyes of 53 patients who previously underwent Boston Type 1 Keratoprosthesis surgery at our institution from July 2006 to March 2011. Preoperative and postoperative parameters were collected and analyzed. Visual acuity and keratoprosthesis stability. Common preoperative diagnoses were penetrating keratoplasty failure in 49 eyes (90.7%), chronic keratitis in 2 eyes (3.7%), ocular cicatricial pemphigoid in 1 eye (1.85%), Stevens Johnson syndrome in 1 eye (1.85%) and corneal vascularization in 1 eye (1.85%). Additionally, 40 eyes (74%) had preoperative glaucoma, and an Ahmed valve was implanted in 55% of them. Preoperative BCVA ranged from 20/200 to light perception. At an average follow-up of 20.15 months ± 12.7 (range, 1-56), postoperative vision improved to ⩾20/200 in 18 eyes (33.3%) and ⩾20/50 in 4 eyes (7.4%). The graft retention was 96%. The Boston Type 1 keratoprosthesis is a valid option for high-risk patients. The design improvements in the Boston keratoprosthesis, as well as the daily implementation of the therapeutic methods, have notably diminished occurrence of the most serious complications, such as corneal necrosis and endophthalmitis. As such, glaucoma and its subsequent complications now stand as the most prevalent prognostic factor in the long term.

Estudio microbiológico y anatomopatológico de bronquiectasias sangrantes en piezas de resección pulmonar

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Alfonzo Uribe-Barreto

2009-01-01

Full Text Available La hemoptisis periódica o recurrente en los pacientes con bronquiectasias sangrantes constituyen un factor de alto riesgo de muerte, asimismo, existe un alto desconocimiento de la comunidad médica acerca de la existencia de otros agentes oportunistas, ajenos a la tuberculosis pulmonar, que pueden producirlas. Objetivos. Describir las características microbiológicas y anatomopatológicas de una serie de pacientes con bronquiectasias sangrantes que fueron negativos a tuberculosis, HIV y neoplasias, en estudios preliminares. Materiales y métodos. Se desarrolló una evaluación microbiológica y anatomopatológica en búsqueda de hongos, tuberculosis, gérmenes comunes y neoplasia pulmonar, sobre 24 piezas operatorias de pacientes con hemoptisis por bronquiectasias sangrantes con antecedente de tuberculosis pulmonar o de contacto con personas que padecían esa enfermedad. Resultados. El hongo Aspergillus fue hallado en 20 de los 24 pacientes estudiados. No se reportó resultados positivos en los exámenes realizados para gérmenes comunes aerobios y tuberculosis. El estudio anatomopatológico, confirmó la presencia de micetoma y Aspergillus. El tejido cicatricial invadido está altamente vascularizado con predisposición a hemorragia y a un acto operatorio de tiempo prolongado. Conclusiones. El hongo Aspergillus es el principal y único agente infeccioso presente en pacientes con bronquiectasia sangrante en esta serie.

Avaliação do uso de pomada à base de sementes de jaqueira (Artocarpus heterophyllus Lam na terapêutica tópica de feridas