Uso da proteção do complexo dentino-pulpar por discentes de odontologia

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Daiane Casarin

2016-10-01

Full Text Available A proteção do complexo dentino pulpar depende de vários fatores, dentre eles, a idade do paciente, a condição pulpar prévia e a profundidade da lesão cariosa ou mesmo do preparo cavitário. Os materiais utilizados para a proteção, por sua vez, devem ser biocompatíveis, ter capacidade de induzir a formação de dentina reparadora dentre outros requisitos. O objetivo deste estudo foi conhecer o material de proteção do complexo dentino pulpar utilizado pelos discentes de odontologia tanto em nível de graduação, bem como em nível de pós-graduação. A metodologia utilizada foi quantitativa observacional do tipo descritiva e não probabilística, a qual envolveu 125 estudantes do último ano de graduação em odontologia e cirurgiões dentistas cursando pós-graduação em Dentística Restauradora em centros de estudos da cidade de Passo Fundo. A coleta de dados foi realizada por meio de um questionário adaptado de Takanashi (4 e os resultados foram analisados descritivamente no Excel, sendo que para cavidades rasas 88,8 % dos profissionais usam técnica adesiva convencional, cavidades médias 60,8% também opta por técnica adesiva convencional, para cavidades profundas 50,4% usa Hidróxido de Cálcio e nos casos de exposição pulpar 59,2% faz uso de pó de Hidróxido de Cálcio. Pode-se concluir que o hidróxido de cálcio foi o material de proteção pulpar mais usado tanto nas cavidades profundas, bem como, nas com exposição pulpar, já em cavidades médias e rasas a maioria optou por técnica adesiva convencional.

Pulpotomía con electrocauterio en pacientes con hemofilia A

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Carbonell Rodriguez, Rosario

2017-01-01

Rehabilita la salud oral de un niños con Hemofilia A, empleando el Electrocauterio como una alternativa en la terapia pulpar, específicamente en la pulpotomía, para lo cual se realiza un minucioso examen clínico y anamnesis, que respaldados con exámenes complementarios, permite determinar el plan de tratamiento. La rehabilitación integral se llevó a cabo, previo consentimiento informado del padre, en sala de operaciones bajo anestesia general, debido a la condición sistémica del niño. Incl...

Fuerzas Ortodóncicas como Agentes Vulnerantes de la Salud Pulpar: Reporte de Dos Casos

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Fonseca, Gabriel M; Guzmán, Andrés E

2010-01-01

La literatura ya ha sugerido la implicancia del uso de fuerzas ortodóncicas como productoras de daño mecánico, reacción inflamatoria periodontal, lesión periapical y reabsorción radicular. Los parámetros más comúnmente explorados en investigaciones de la respuesta tisular a fuerzas ortodónticas consisten en medir los niveles de oxígeno pulpar, la vasculatura y los cambios en la circulación sanguínea. Se ha demostrado que la irrigación pulpar disminuye tempranamente cuando se realizan aplicaci...

Granuloma periapical: tratamiento convencional. Reporte de un caso

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Natalia Patricia Harris Ortega; Fernando Javier Guzman Lopez; Antonio Díaz Caballero

2014-01-01

Title: Periapical granuloma: conventional treatment. Case reportLos Granulomas radiculares son lesiones periapicales crónicas, consideradas secuelas directas de procesos infecciosos resultantes de la necrosis pulpar, extendiéndose hacia la región perirradicular. Los granulomas se pueden presentar por fallas en los tejidos duros, resultantes de caries, fracturas y procedimientos quirúrgicos. Se realizó tratamiento de endodoncia convencional con preparación invertida a paciente de 15 años con d...

Regeneración endodóntica con células madre

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Elizabeth Santiago Dager

2014-12-01

Full Text Available Los procedimientos de regeneración del complejo pulpar están dirigidos a controlar la infección con un mínimo de instrumentos y abundante irrigación, para lo cual se han propuesto varios protocolos con ligeras variantes, sin consenso entre los autores; en el presente artículo se describen y analizan los 3 principales, con especial énfasis en los aspectos menos esclarecidos de un tratamiento fascinante con células madre en la rama de la endodoncia y cuyos avances proporcionan beneficios inestimables a los pacientes en quienes se aplica

Alternativas de medicação intracanal em casos de necrose pulpar com lesão periapical = Intracanal medication indicated for pulpal necrosis with apical osteites

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Fachin, Elaine Vianna Freitas

2006-01-01

Trata-se de estudo in vivo em pacientes portadores de dentes monorradiculares apresentando necrose pulpar com lesão periapical. O objetivo foi avaliar radiograficamente a efetividade de 4 diferentes curativos de demora (PMCC, gel de clorexidina 2%, pasta de hidróxido de cálcio e hipoclorito de sódio1%). O tratamento endodôntico foi padronizado em todos os elementos através da técnica escalonada e irrigação com hipoclorito de sódio 1%. Para a medicação intracanal, os pacientes foram separados ...

Necrosis Avascular Bilateral de cadera en paciente con VIH y traumatismo de arma de fuego.

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Belkis J Menoni Blanco

2011-01-01

Full Text Available La Necrosis Avascular de Cadera (NAV es un proceso patológico infrecuente, originado por faltade irrigación de la articulación coxofemoral que implica necrosis y degeneración de los huesos que la conforman, causando dolor e impotencia funcional. Es más frecuente en varones jóvenes, pudiendo ser unilateral o bilateral. La etiología puede ser idiopática o estar relacionada a causas sistémicas como infección por VIH y su tratamiento depende de la severidad. En este reporte, se presenta un caso masculino de 35 años, seropositivo con tratamiento antirretroviral y antecedente de herida por arma de fuego de presentación inusual en cadera, sin lesión ósea aparente; quien refiere dolor de cadera izquierda, de fuerte intensidad, punzante, irradiado a rodilla izquierda, que produce limitación funcional. Al examen físico se evidencia marcha de Trendelemburg, con signos de Thomas y Patrick positivos. La radiografía demuestra NAV tipo Ficat-Arlet IV y es corregida mediante artroplastia total de cadera izquierda. Palabras claves: Necrosis Avascular de Cabeza de Fémur, VIH, Herida por arma de fuego.

Patologías pulpares y periapicales más frecuentes en urgencias en 2 clínicas estomatológicas

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Dinhora Quiñones Márquez

2000-01-01

Las patologías pulpares y periapicales son unas de las enfermedades que más llevan a los pacientes a acudir a una consulta de urgencia estomatológica debido a su sintomatología. Es de gran importancia realizar un correcto diagnóstico en este momento para brindar la terapeútica adecuada.La frecuencia de estas patologías en consulta de urgencia fue lo que nos motivó a la realización de este trabajo, el cual tuvo entre sus objetivo contribuir al conocimiento de las patologías pulpares y periapic...

Insuficiencia renal aguda con necrosis tubular aguda secundaria a picadura masiva de abejas

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Gustavo A. Aroca - Martínez

2006-01-01

Full Text Available Leñador de 46 años consulta al servicio de nefrología, de la Clínica Renal de la Costa en Barranquilla, con episodio de insuficiencia renal aguda 48 horas después de haber sufrido múltiples picaduras por abejas africanizadas. Durante su estancia hospitalaria presentó incremento de enzimas musculares (AST LDH, y de pruebas de función renal, motivo por el cual fue dializado en varias ocasiones. Con mejoría total, se decide egresar y manejar ambulatoriamente. Se concluye que el caso se trata de una insuficiencia renal por necrosis tubular aguda por rabdomiolisis debida a la picadura múltiple de abejas africanizadas.

Vitalidade pulpar em dentes portadores de brackets ortodônticos: apresentação de uma técnica = Pulp vitality test on teeth having orthodontics brackets: technique presentation

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Barletta, Fernando Branco

2007-01-01

Full Text Available O presente trabalho teve como objetivo avaliar a confiabilidade do teste de vitalidade pulpar com o gás refrigerante tetrafluoretano (CS 68 em dentes portadores de brackets ortodônticos. Foram selecionados 37 pacientes de clínica privada, com faixa etária entre 12 e 60 anos de idade. O teste de vitalidade pulpar foi realizado na face palatina ou lingual, na região de terço médio dos dentes, abaixo do cíngulo, nos grupos dentários dos incisivos, caninos e pré-molares superiores e inferiores, totalizando 402 dentes. Quando a resposta de sensibilidade pulpar era negativa ao teste, o mesmo era repetido; confirmando-se o resultado como negativo, realizavase uma tomada radiográfica pela técnica periapical do dente em questão. Os resultados evidenciaram 4 elementos dentários com resposta negativa ao teste de vitalidade pulpar, sendo 3 pré-molares e um incisivo central. A resposta dos demais foi positiva ao teste. Diante dos resultados, verificou-se que a aplicação do teste de vitalidade pulpar pela face palatina em pacientes portadores de brackets ortodônticos constitui-se em uma alternativa segura e confiável

Pulpar temperature changes during mechanical reduction of equine cheek teeth: comparison of different motorised dental instruments, duration of treatments and use of water cooling.

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O'Leary, J M; Barnett, T P; Parkin, T D H; Dixon, P M; Barakzai, S Z

2013-05-01

Although equine motorised dental instruments are widely used, there is limited information on their thermal effect on teeth. The recently described variation in subocclusal secondary dentine depth overlying individual pulp horns may affect heat transmission to the underlying pulps. This study compared the effect of 3 different equine motorised dental instruments on the pulpar temperature of equine cheek teeth with and without the use of water cooling. It also evaluated the effect of subocclusal secondary dentine thickness on pulpar temperature changes. A thermocouple probe was inserted into the pulp horns of 188 transversely sectioned maxillary cheek teeth with its tip lying subocclusally. Pulpar temperature changes were recorded during and following the continuous use of 3 different equine motorised dental instruments (A, B and C) for sequential time periods, with and without the use of water cooling. Using motorised dental instrument B compared with either A or C increased the likelihood that the critical temperature was reached in pulps by 8.6 times. Compared with rasping for 30 s, rasping for 45, 60 and 90 s increased the likelihood that the critical temperature would be reached in pulps by 7.3, 8.9 and 24.7 times, respectively. Thicker subocclusal secondary dentine (odds ratio [OR] = 0.75/mm) and water cooling (OR = 0.14) were both protective against the likelihood of the pulp reaching the critical temperature. Prolonged rasping with motorised dental instruments increased the likelihood that a pulp would be heated above the critical temperature. Increased dentinal thickness and water cooling had protective roles in reducing pulpar heating. Motorised dental instruments have the potential to seriously damage equine pulp if used inappropriately. Higher speed motorised dental instruments should be used for less time and teeth should be water cooled during or immediately after instrument use to reduce the risk of thermal pulpar damage. © 2012 EVJ Ltd.

Necrosis Avascular Bilateral de cadera en paciente con VIH y traumatismo de arma de fuego.

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Belkis J. Menoni Blanco

2009-01-01

Full Text Available La Necrosis Avascular de Cadera (NAV es un proceso patológico infrecuente, originado por falta de irrigación de la articulación coxofemoral que implica necrosis y degeneración de los huesos que la conforman, causando dolor e impotencia funcional. Es más frecuente en varones jóvenes, pudiendo ser unilateral o bilateral. La etiología puede ser idiopática o estar relacionada a causas sistémicas como infección por VIH y su tratamiento depende de la severidad. En este reporte, se presenta un caso masculino de 35 años, seropositivo con tratamiento antirretroviral y antecedente de herida por arma de fuego de presentación inusual en cadera, sin lesión ósea aparente, quien refiere dolor de cadera izquierda, de fuerte intensidad, punzante, irradiado a rodilla izquierda, que produce limitación funcional. Al examen físico se evidencia marcha de Trendelemburg, con signos de Thomas y Patrick positivos. La radiografía demuestra NAV tipo Ficat-Arlet IV y es corregida mediante artroplastia total de cadera izquierda.

Uso de novos materiais para o capeamento pulpar (hidroxiapatita - HAp e fosfato tricálcico - β-TCP The use of new materials for pulp capping (hydroxyapatite - HAp and tricalcium phosphate - β-TCP

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C. S. Delfino

2010-12-01

Full Text Available O capeamento pulpar é uma medida importante e muito usada no cotidiano da prática odontológica e, quando realizado de forma consciente, baseado em um bom diagnóstico da condição pulpar no momento da exposição, pode prevenir o dente de sofrer uma intervenção endodôntica. Além do hidróxido de cálcio, outros materiais vêm sendo testados quanto a sua ação em promover o reparo pulpar pela formação de ponte de dentina, após capeamento pulpar direto. Uma das alternativas de materiais viáveis para o capeamento pulpar são as cerâmicas à base de fosfatos de cálcio, destacando-se a hidroxiapatita (HAp e o fosfato tricálcico (β-TCP. Estes materiais não promovem a formação de área necrótica, característica da utilização do hidróxido de cálcio, são biocompatíveis e favorecem o reparo do tecido pulpar. Para avaliar os efeitos desses materiais no capeamento pulpar foi realizada esta revisão de literatura, abordando desde a resposta do tecido pulpar, até o protocolo para o uso clínico.Pulp capping is an important measure and one with a high rate of use in daily dental practice, and when it is conscientiously performed, based on good diagnosis of the pulp condition at the time of its exposure, it may prevent the tooth from requiring endodontic intervention. In addition to calcium hydroxide, other materials have been tested with regard to their action in promoting pulp repair by the formation of a dentin bridge after direct pulp capping. Some of the feasible alternative materials for pulp capping are calcium phosphate-based ceramics, with hydroxyapatite (HAp and tricalcium phosphate (β-TCP being outstanding. These materials do not promote formation of a necrotic area, characteristic of the use of calcium hydroxide, are biocompatible and favor pulp tissue repair. To evaluate the effects of these materials on pulp capping, this literature review was conducted, the approach being wide ranging in scope, from pulp response

MTA and calcium hydroxide for pulp capping MTA e hidróxido de cálcio para proteção pulpar direta

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Alexandra Mussolino de Queiroz

2005-06-01

Full Text Available This study evaluated the biocompatibility of mineral trioxide aggregate (MTA after direct capping of exposed pulp tissue in dog's teeth. Class I cavities were prepared in 26 teeth from 3 adult dogs. MTA was applied over the exposed pulp in 13 teeth and paste of calcium hydroxide plus distilled water (control was applied in the remaining 13 teeth. After 90 days, the animals were killed; the maxilla and mandible were dissected and sectioned to obtain individual roots. The samples were processed histologically. The pulp and periapical response observed with the use of MTA was similar to that of calcium hydroxide paste. In all specimens, there was a dentin bridge obliterating the exposure, an intact odontoblastic layer, no inflammatory cells, normal connective pulp tissue, normal apical and periapical regions and no bone tissue changes. Similar to calcium hydroxide, MTA presented excellent response when used for direct pulp capping.O objetivo deste trabalho foi avaliar a biocompatibilidade do agregado de trióxido mineral (MTA, após proteção pulpar direta em dentes de cães. Foram preparadas cavidades de Classe I, em 26 dentes de 3 cães adultos. O MTA foi aplicado sobre 13 dentes e a pasta de hidróxido de cálcio (grupo controle foi aplicada sobre os 13 dentes remanescentes. Após 90 dias, os animais foram mortos, a maxila e a mandíbula foram dissecadas e os dentes foram seccionados para obtenção de raízes individualizadas. Os espécimes foram processados histologicamente. A resposta do tecido pulpar e periapical foi semelhante para o MTA e o hidróxido de cálcio. Em todos os espécimes havia ponte de dentina obliterando o local da exposição pulpar, camada odontoblástica íntegra, ausência de células inflamatórias, tecido pulpar normal, e ausência de alterações na região periapical e óssea. Da mesma maneira que o hidróxido de cálcio, o MTA apresentou excelente biocompatibilidade quando usado para proteção pulpar direta.

Nuevo enfoque de la interpretación del dolor en una pulpitis aguda

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Andrés O Pérez Ruiz

2000-04-01

Full Text Available El dolor es probablemente el principal motivo de consulta en las urgencias estomatológicas y es precisamente el dolor de la pulpitis aguda el que comentamos en este trabajo. El dolor pulpar en sí mismo es similar al dolor que resulta por inflamación de los órganos viscerales y, por lo tanto, podrían ser inadecuados los intentos de explicarlos por comparación con los nociceptores de estructuras somáticas. Se propone analizar el comportamiento del dolor como consecuencia de una pulpitis aguda, con un nuevo enfoque, asimilándolo como el dolor proveniente de estructuras viscerales con manifestaciones dolorosas alejadas del sitio o zona dañada y en el propio diente en que el tejido ha sido injuriado y evoluciona rápidamente hacia la necrosis. Establecemos una analogía entre el dolor visceral como el generado de la pulpa y el del tipo somático profundo como el correspondiente a la afectación periapical por rápida evolución de la inflamación hacia la necrosis.Pain is probably the chief complaint in dental emergencies and this paper deals precisely with the pain caused by acute pulpitis. The pulpar pain itself is similar to the one resulting from inflammation of the visceral organs and, therefore, the attempts to explain these pains by comparing them with the nociceptors of somatic structures may be inappropiate. It is our objective to analyze the behaviour of pain caused by acute pulpitis with a new approach, assimilating it as the pain from visceral structures with painful manifestations far from the damaged site or zone and it is the own tooth whose tissue has been affected and evolves rapidly to necrosis.We establish an analogy between the visceral pain as the one generated by the pulpa and that of deep somatic type as the corresponding to the periapical affection by the fast evolution of inflammation to necrosis.

Tratamiento de necrosis plantar postsepsis neumocóccica con terapia V.A.C.® Treatment of post-pneumococcal plantar necrosis with VAC® therapy

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E. Guisantes

2011-12-01

Full Text Available La terapia VAC® es un dispositivo que favorece la curación de las heridas mediante un sistema cerrado que aplica presión negativa sobre el lecho. Este tratamiento favorece la cicatrización porque reduce el edema y el líquido intersticial, mejora la microcirculación, disminuye el riesgo de infección y favorece la granulación del tejido. Presentamos un caso clínico de un varón de 31 años con un defecto amplio plantar tras necrosis distal por sepsis neumocóccica. Tras 20 días de terapia VAC® la granulación fue adecuada y permitió la cobertura del defecto con un injerto de piel. La terapia VAC® es una opción útil para la reconstrucción de defectos plantares amplios de forma sencilla.VAC® Therapy is a device that lets promote wound healing through a closed system that applies negative pressure on the wound bed. This treatment promotes healing by reducing edema and interstitial fluid, improving microcirculation, reducing the risk of infection and promoting tissue granulation. We report the case of a 31 year old man with a large plantar defect due to distal necrosis after pneumococcal sepsis. After 20 days of VAC® therapy, the granulation was adequate and allowed the coverage of the defect with a skin graft. VAC® therapy is a useful and simple option for reconstruction of broad plantar defects.

Importancia de la semiología del dolor en el diagnóstico de un proceso inflamatorio pulpar Significance of pain's Symptomatology in the diagnosis of pulpal inflammatory process

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Andrés 0 Pérez Ruiz

2011-09-01

Full Text Available El dolor es un síntoma de extraordinaria importancia en la práctica estomatológica y particularmente en lo concerniente a las alteraciones de la pulpa dentaria. Con el objetivo de profundizar en el conocimiento de las fases por las que atraviesa un proceso inflamatorio pulpar, que permiten predecir sus manifestaciones dolorosas, se realizó una revisión bibliográfica sobre el tema con un enfoque multidisciplinario y básico-clínico. Se utilizó el método documental para el análisis y tratamiento de la información ofrecida por las fuentes teóricas. El sitio en Internet Google fue empleado como fundamental motor de búsqueda y Lilacs, Hinari, Medline y PubMed fueron las bases de datos más revisadas. La clasificación del estado de inflamación pulpar, que atiende a eventos histopatológicos que no se pueden visualizar, resulta más difícil. Se podría lograr mayor precisión en un diagnóstico basado en el curso que sigue el dolor, de acuerdo a la magnitud del compromiso inflamatorio y apoyado en la rica semiología que se puede obtener si se sigue la trayectoria de las variables del estímulo nociceptivo. El incremento y profundización de los conocimientos en este campo contribuiyó significativamente a un mejor diagnóstico y tratamiento de los procesos inflamatorios pulpares.Pain is a symptom very important in the stomatologic practice and particularly in that concerning to dental pulp alterations. To deep in the knowledge of phases crossed by a pulpal inflammatory process allowing predicting its painful manifestations, authors made a bibliographic review on this subject with a multidisciplinary and basic-clinical approach, using the documentary method for analysis and management of information offered by theoretical sources. Google was used as a fundamental search tool and LILACS, HINARI, Medline and PubMed were the more reviewed databases. The classification of pulpal inflammation state, taking into account non

Factor de necrosis tumoral alfa en una población infanto-juvenil con sobrepeso

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Teresita del R. Carrizo

2013-08-01

Full Text Available El sobrepeso infantil está asociado a sobrepeso/obesidad en la edad adulta. El tejido adiposo en obesos produce una cantidad incrementada de citoquinas proinflamatorias como el factor de necrosis tumoral alfa (TNF-a, ejerciendo un efecto deletéreo sobre la función vascular. El objetivo de este trabajo fue evaluar niveles de TNF-a en una población infantojuvenil con sobrepeso y su relación con otras variables. Se estudiaron 30 niños con sobrepeso (12 varones de edades entre 8-13 años, se midió circunferencia de cintura (CC e índice de masa corporal (IMC y fueron comparados con 20 controles de edad y sexo semejantes. Se consideró criterio de inclusión un IMC = 85 < 95 percentilo para edad y sexo. En ambos grupos se determinó: glucemia en ayunas (método glucosa oxidasa, insulina plasmática (ECLIA, fibrinógeno (Fg, método de Clauss, proteína C reactiva ultrasensible (uPCR, método inmunoturbidimétrico, TNF-a (ELISA, perfil lipídico (métodos enzimáticos, eritrosedimentación y se calculó el índice HOMA. Los datos se expresaron como mediana y rango intercuartil y con el coeficiente de Spearman se investigaron las correlaciones entre variables, considerándose significativo un p < 0.05. Los niveles de TNF-a fueron mayores en los sujetos con sobrepeso [15.4 (13.2-24.0 vs. 12.7 (11.2-14.8 pg/ml; p = 0.028]. También resultaron más elevados los valores de Fg, insulina plasmática, índice HOMA, uPCR y triglicéridos. El TNF-a se correlacionó con la CC (r = 0.654; p = 0.021. Los niveles elevados de TNF-a, uPCR y Fg encontrados confirman un estado proinflamatorio asociado a obesidad abdominal en la población estudiada.

Procesos pulpares y periapicales agudos como urgencias estomatológicas. Holguín 2009

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Carmen Graña Dorta; José López Clementes; Carlos Pacheco Pacheco

2009-01-01

Aborda un estudio observacional descriptivo de corte transversal en días comprendidos en Mayo y Junio del 2009. Se desarrolló en las consultas de urgencias de las clínicas ¨Manuel Angulo Farrán¨ y ¨Mario Pozo Ochoa¨ de la Provincia Holguín. La muestra estuvo constituida por 70 pacientes que presentaron patologías pulpares y periapicales agudas. Se Planteó como objetivo determinar las patologías más frecuente según grupos de edad y sexo, identificar las causas principales de estas afecciones y...

Alternativas de medicação intracanal em casos de necrose pulpar com lesão periapical = Intracanal medication indicated for pulpal necrosis with apical osteites

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Fachin, Elaine Vianna Freitas

2006-01-01

Full Text Available Trata-se de estudo in vivo em pacientes portadores de dentes monorradiculares apresentando necrose pulpar com lesão periapical. O objetivo foi avaliar radiograficamente a efetividade de 4 diferentes curativos de demora (PMCC, gel de clorexidina 2%, pasta de hidróxido de cálcio e hipoclorito de sódio1%. O tratamento endodôntico foi padronizado em todos os elementos através da técnica escalonada e irrigação com hipoclorito de sódio 1%. Para a medicação intracanal, os pacientes foram separados aleatoriamente em 4 grupos que receberam um dos medicamentos listados. Após 7 dias, os canais foram obturados e submetidos a controle radiográfico aos 3, 6 e 9 meses em que se mediu com precisão a diminuição do diâmetro radiolúcido apical. Os resultados mais satisfatórios ocorreram após o uso do PMCC, seguido pelo hidróxido de cálcio, clorexidina 2% e, por último, hipoclorito de sódio 1%

Tratamiento de Artritis reumatoide con antagonistas del factor de necrosis tumoral alfa y su asociación con el desarrollo de melanoma cutáneo: revisión sistemática de la literatura y meta-análisis.

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Aldana Silva, Carolina; Chaparro Reyes, Laura Daniela

2015-01-01

Introducción: El tratamiento con antagonistas del factor de necrosis tumoral alfa (anti TNF) ha impactado el pronóstico y la calidad de vida de los pacientes con artritis reumatoide (AR) positivamente, sin embargo, se interroga un incremento en el riesgo de desarrollar melanoma. Objetivo: Conocer la asociación entre el uso de anti TNF y el desarrollo de melanoma maligno en pacientes con AR. Metodología: Se realizó una búsqueda sistemática en MEDLINE, EMBASE, COCHRANE LIBRARY y ...

Efectos de los destartaradores de ultrasonidos sobre la vitalidad pulpar en los dientes del perro. Estudio Experimental

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Vérez Fraguela, José Luis

2013-01-01

Se plantea el estudio de las posibles lesiones pulpares inducidas por ultrasonidos de 29 KHz, que son los utilizados en la clínica. Se utilizaron 84 premolares, a los que se aplicaron los ultrasonidos durante 30, 60 y 90 segundos, a la par que se tomaba la temperatura de la pulpa dental, para ver su hipotético incremento. Además de las valoraciones cualitativas de las variaciones de temperatura, se realizaron estudios macroscópicos e histológicos para determinar la presencia de posi...

Apoptosis and necrosis increase antigenicity of proteins recognized by antinuclear antibodies

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J.J. Bollain-y-Goitia

2011-09-01

Full Text Available Obiettivo. Lo scopo di questo studio è quello di indagare se l’apoptosis e la necrosi aumentano l’antigenicità delle proteine riconosciute da anticorpi antinucleo. Materiale e metodi. Cellule HEp-2 sono state coltivate in condizioni standard; l’apoptosis è stata indotta con camptecina e la necrosi con cloruro di mercurio. L’antigenicità delle proteine estratte dalle cellule è stato testata su membrane di nitrocellulosa e sondata con sieri positivi o negativi per anticorpi antinucleo utilizzando un sistema ELISA a luminescenza (luminescent. Risultati. Le alterazioni apoptotiche nelle cellule HEp-2 sono apparse entro 24 ore dall’esposizione alla camptoicina, mentre i segni di necrosi si sono evidenziati più precocemente. La luminescenza si è dimostrata significativamente superiore nei sieri ANA positivi che nei controlli ANA negativi. Gli antcorpi antinucleari sieirici riconoscono meglio gli antigeni da cellule apoptotiche e necrotiche rispetto ai controlli che non hanno subito trattamenti chimici. Conclusioni. L’apoptosi e la necrosi incrementano la capacità legante degli ANA attraverso una migliore disponibilità di antigeni intracellulari o svelando epitopi criptici.

Microscopic analysis of dog dental pulp after pulpotomy and pulp protection with mineral trioxide aggregate and white Portland cement Análise microscópica da polpa dental de cães após pulpotomia e proteção pulpar com agregado de trióxido mineral e cimento Portland branco

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Renato Menezes

2004-06-01

Full Text Available Considering previous studies on the similarity between the chemical composition of the mineral trioxide aggregate and the Portland cement, the purpose of this study was to investigate the pulp response of dog's teeth after pulpotomy and direct pulp protection with MTA Angelus and white Portland cement. Thirty eight pulp remnants were protected with these materials. One hundred and twenty days after treatment, the animals were sacrificed and the specimens removed and prepared for histological analysis. Both materials demonstrated the same results when used as pulp capping materials, inducing hard tissue bridge formation and maintaining pulp vitality in all specimens. The MTA Angelus and the white Portland cement showed to be effective as pulp protection materials following pulpotomy.Considerando estudos anteriores sobre a similaridade entre a composição química do agregado de trióxido mineral e o cimento Portland, o objetivo deste estudo foi investigar a resposta pulpar de dentes de cães após pulpotomia e proteção pulpar direta com MTA Angelus e cimento Portland branco. Trinta e oito remanescentes pulpares foram recobertos com esses materiais. Cento e vinte dias após o tratamento, os animais foram sacrificados e os espécimes removidos e preparados para análise histológica. Ambos os materiais demonstraram os mesmos resultados quando utilizados como materiais de capeamento pulpar, induzindo a formação de ponte de tecido mineralizado e mantendo a vitalidade pulpar em todos os espécimes. Ambos matérias se mostraram efetivos como protetores pulpares após pulpotomia em dentes de cães.

Materiales de obturación radicular utilizados en dientes deciduos

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Trejo-A

2014-01-01

Full Text Available La caries y traumatismos son las principales causas de urgencias en odontología pediátrica. Estas afecciones pueden llegar a ejercer un daño irreversible en el tejido pulpar comprometiendo la permanencia de los órganos dentarios afectados. Para limitar el daño pulpar y evitar la extracción de piezas temporales se han diseñado distintas técnicas que van desde recubrimientos pulpares hasta un tratamiento más radical como la pulpectomía. Ésta última consiste en la extirpación del tejido pulpar, la limpieza y desinfección del sistema de conductos y la obturación de los mismos. Diversos autores han descrito las características ideales que debe presentar un material obturador de conductos de la dentición temporal, en los que se incluyen actividad bactericida y bacteriostática, adecuado sellado tridimensional, biocompatibilidad y reabsorción del material a una velocidad similar que las raíces. Desde hace largo tiempo se han desarrollado diversos materiales para cumplir con las exigencias que demanda la técnica. Dentro de los primeros materiales surgidos con éste propósito se encuentran el Óxido de Zinc con Eugenol, Hidróxido de Calcio y materiales a base de yodoformo, con el tiempo surgieron combinaciones de estos materiales para aumentar las ventajas y disminuir las desventajas. De éstos, las pastas yodoformadas con Hidróxido de Calcio son los que han tenido mayor aceptación.

Granuloma periapical: tratamiento convencional. Reporte de un caso

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Natalia Patricia Harris Ortega

2014-03-01

Full Text Available Title: Periapical granuloma: conventional treatment. Case reportLos Granulomas radiculares son lesiones periapicales crónicas, consideradas secuelas directas de procesos infecciosos resultantes de la necrosis pulpar, extendiéndose hacia la región perirradicular. Los granulomas se pueden presentar por fallas en los tejidos duros, resultantes de caries, fracturas y procedimientos quirúrgicos. Se realizó tratamiento de endodoncia convencional con preparación invertida a paciente de 15 años con diagnóstico de Granuloma periapical (periodontitis apical asintomáticay su posterior recuperación de la lesión de órgano dentario 36. (DUAZARY 2013 No. 2, 141 - 144AbstractRoot granulomas are chronic periapical lesions, considered direct sequels of infectious processes resulting from pulp necrosis, extending into the periradicular region. The granulomas can occur due to failures in hard tissues, resulting from caries, fractures and surgical procedures. A conventional endodontic treatment was done with crown down technique in a patient of 15 years old with a diagnosis of periapical granuloma (chronic nonsuppurative apical periodontitis and subsequent recovery from injury in tooth 36.Keywords: periapical granuloma; periapical periodontitis (MESH Database.

Transferencia microquirúrgica hemipulpar del hallux en la reconstrucción del pulgar

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José-Manuel Rodríguez-Vegas

Full Text Available Introducción y Objetivo. La transferencia hemipulpar del hallux permite excelentes reconstrucciones de pulgar porque ofrece tejidos blandos de alta calidad, contorno pulpar casi normal y recuperación sensitiva satisfactoria sin necesidad de reorientación cortical. Además, a diferencia de colgajos locales y regionales, evita la agresión adicional a una mano ya lesionada, optimizando así el período de rehabilitación y el resultado final. El artículo revisa la experiencia del autor en la técnica y compara el procedimiento con otras opciones reconstructivas. Material y Método. Realizamos una revisión retrospectiva de 16 pacientes sometidos a transferencia hemipulpar del hallux en el período 2007-2013. Todos los pacientes fueron varones, con una edad media de 34 años y una alta demanda funcional (trabajadores manuales con traumatismo laboral. La técnica fue indicada en defectos mayores del 50% de la superficie pulpar del pulgar en pacientes sin factores de riesgo asociados relevantes. En 3 de los casos el defecto pulpar asoció un defecto óseo de falange distal de tamaño suficiente para aconsejar la transferencia combinada osteo-pulpar. Resultados. Quince de los 16 colgajos sobrevivieron sin incidencias postoperatorias. Un colgajo sufrió trombosis arterial con retirada del colgajo y cirugía adicional de cobertura. En 2 pacientes se realizó revisión estética del colgajo de manera diferida. Excepto en el caso fallido, todos los pacientes volvieron a su actividad laboral previa con excelente recuperación funcional de la mano. El cierre de la zona donante se realizó mediante cierre directo (12 pacientes o injerto cutáneo (4 pacientes. Ninguno de los pacientes, independientemente del tipo de cierre del defecto en el pie, refirió problemas en la deambulación o apariencia estética del pie. Conclusiones. La reconstrucción de defectos pulpares del pulgar mediante transferencia hemipulpar del hallux permite un excelente resultado

Ventajas del mineral trióxido agregado y del hidróxido de calcio frente a patologías pulpares de tipo degenerativo

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Edison Gabriel Quintero Ricardo

2014-06-01

Full Text Available ResumenEl agregado de trióxido mineral (MTA es un material desarrollado para endodoncia. Las principales indicaciones del MTA, son el tratamiento pulpar en dientes vitales (pulpotomias, recubrimiento pulpar directo, apicoformaciones (barrera apical, cirugía endodóncica, reparación de perforaciones furcales, laterales y las provocadas por las reabsorciones. El MTA favorece la formación de hueso y cemento, y puede facilitar la regeneración del ligamento periodontal sin provocar inflamación; como un coadyuvante del MTA en los procesos de reparación tenemos el hidróxido de calcio que es un potente agente bacteriostático y bactericida que se utiliza para el control de microorganismos cuando es empleado como medicamento intraconducto, igualmente actúa como agente catalizador en la modificación del pH en los tejidos periapicales con el fin de favorecer el proceso de cicatrización, presenta excelentes propiedades higroscópica en cuanto al control del exudado en conductos radiculares de dientes con lesiones periapicales grandes los cuales muchas veces presentan humedad persistente en los canales radiculares asimismo actúa en la prevención o detención de procesos resortivos ejerciendo efectos moduladores en la actividad clástica. Por tales propiedades el artículo tiene como fin mostrar los efectos a corto plazo que ocurren en una reabsorción interna y lesión apical al momento de utilizar mineral trióxido agregado (MTA e hidróxido de calcio como material intracanal. (Duazary 2009-II 141-146AbstractMineral trioxide aggregate (MTA is a new material developed for endodontics. The principal indications of MTA are vital pulp therapy (pulpotomy, direct pulp capping, apexification (apical plug, endodontic surgery, and lateral, furcal and resorption perforations repair. The MTA induce the formation of cementum and bone, and it may facilitate the regeneration of the periodontal ligament without causing any inflammation; as a helping of the

Necrosis, a regulated mechanism of cell death La necrosis, un mecanismo regulado de muerte celular

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Mauricio Rojas López

2010-05-01

activity of different proteases, lipases and nucleases, indicate that each cell may have its own arsenal to trigger the events leading to necrosis. In this article we review some of the evidences on cellular regulation during necrosis.

Con base en criterios morfológicos y bioquímicos se han definido tres clases de muerte celular: apoptosis, autofagia y necrosis. La primera es una muerte celular regulada, mediada principalmente por caspasas; en la autofagia ocurre formación de vesículas que se fusionan con vacuolas hidrolíticas para degradar organelas intracelulares alteradas.

En cuanto a la necrosis, se la ha definido tradicionalmente por la ruptura de la membrana citoplasmática con salida del material intracelular lo que desencadena una reacción inflamatoria localizada; los mediadores pueden variar dependiendo del tejido: lipasas, proteasas y endonucleasas. Las actividades celulares intrínsecas y los eventos que preceden al colapso celular definen el tipo de daño. Pero el hecho de que los tres tipos de muerte celular puedan coexistir y la ocurrencia de necrosis incluso en presencia de ATP hacen pensar que esta es un evento menos pasivo y que hasta cierto punto se puede regular la inducción del daño.

Valoración histológica de la respuesta pulpar y hepática del formocresol y el hueso liofilizado en dientes de rata.

OpenAIRE

Alcaina Lorente, Mª Antonia

2003-01-01

Son varios los agentes que se han utilizado para las pulpotomías en dientes primarios, siendo el formocresol el más difundido. El objetivo de este estudio fue evaluar la respuesta pulpar en dientes de rata cuando el hueso liofilizado es usado como agente de pulpotomía y analizar los cambios histológicos del tejido hepático. La muestra de este estudio estaba formada por 60 ratas de raza Sprague-Dawley. El tratamiento se realizó en los primeros molares superiores, siendo un total de 120 d...

Necrosis de la cabeza femoral tras fractura del cuello femoral tratada mediante osteosíntesis

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Martínez Martín, Angel Antonio; Panisello Sebastiá, Juan José; Lallana Duplá, J.; Herrera Rodríguez, Antonio

2000-01-01

Se presenta un análisis retrospectivo de las necrosis aparecidas en 233 pacientes con fractura de cuello femoral fijada con tornillos de esponjosa. La edad media fue de 80,6 años. Setenta y un pacientes (26%) tuvieron una fractura no desplazada (Garden I o II) y 172 (74%) una fractura desplazada (Garden III o IV). Seis meses tras la cirugía 170 pacientes sobrevivían (72,9%). Treinta y cuatro de ellos (20%) habían desarrollado necrosis y 10 (5,9%) colapso. Tras un seguimiento de 12 meses 114 p...

Terapia celular en la necrosis aséptica de la cabeza del fémur en pacientes con drepanocitosis

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Aymara Maria Baganet-Cobas

2016-09-01

Full Text Available Introducción: La necrosis aséptica de la cabeza femoral (NACF es una causa importante de morbilidad en pacientes jóvenes con drepanocitosis. En su tratamiento ningún método es completamente satisfactorio. Investigaciones recientes sugieren que la terapia celular puede contribuir a la reparación de tejidos como el óseo resultando útiles en el proceso de osteogénesis y angiogénesis. Objetivo: evaluar la utilidad del implante de concentrado de células mononucleares autólogas de médula ósea (CMN-MO en el tratamiento de la NACF en pacientes con drepanocitosis. Método: se incluyeron 18 pacientes, con una edad promedio de 32,8 años (rango entre 21 y 46 años, con un seguimiento mínimo de dos años. A todos se les realizó descompresión de la cabeza femoral por perforación e implante de CMN-MO. A estas células se les cuantificó por citometría de flujo expresión de moléculas CD34, CD45, CD117, HLADR, CD29 y CD14. Resultados: el promedio de viabilidad del concentrado implantado fue del 97%. Fenotípicamente las CMN-MO mostraron un patrón de expresión asociado a poblaciones de células madre adherentes del estroma medular CD34-/CD45-/DR-/CD29+/CD14-/CD117-. Los mejores resultados clínicos y radiográficos se observaron en pacientes en estadios iniciales (I o II de la enfermedad. En 12 caderas (72,9 % tratadas, los pacientes no refirieron ningún dolor a los dos años posteriores al tratamiento. Se obtuvieron buenos resultados radiológicos en siete pacientes (41,2 %. Tres pacientes (17,6 % requirieron el remplazo total de cadera. Conclusiones:el implante de CMN-MO para los primeros estadios de la NACF, es un tratamiento útil en los pacientes con drepanocitosis. El método empleado es relativamente simple y poco costoso.

Targeting of regulated necrosis in kidney disease

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Diego Martin-Sanchez

2018-03-01

(p. ej., con determinados inhibidores de la caspasa pueden desencadenar una necrosis y, por lo tanto, una lesión renal mediada por inflamación. En segundo lugar, y lo que es más revolucionario, ha surgido el concepto de necrosis regulada. Se han descrito varias modalidades de necrosis regulada como necroptosis, ferroptosis, piroptosis y necrosis regulada por transición de permeabilidad mitocondrial. De forma análoga a la apoptosis, la necrosis regulada se modula a través de moléculas específicas que actúan como dianas terapéuticas. Al contrario que la apoptosis, la necrosis regulada puede ser extremadamente proinflamatoria y, lo que es importante para el trasplante renal, inmunogénica. Además, la necrosis regulada puede desencadenar una necrosis sincronizada, en la que todas las células del interior de un túbulo concreto mueren de manera sincronizada. Revisaremos las diferentes modalidades de necrosis regulada, la evidencia de una función en las diversas formas de lesión renal y las nuevas oportunidades de intervención terapéutica. Keywords: Apoptosis, Ferroptosis, Necroptosis, Kidney, Acute kidney injury, Chronic kidney disease, Transplantation, Acute rejection, Delayed graft function, Palabras clave: Apoptosis, Ferroptosis, Necroptosis, Riñón, Lesión renal aguda, Enfermedad renal crónica, Trasplante, Rechazo agudo, Función retardada del injerto

Periapical and pulp lesions in the stomatological emergency consultation at Felipe Soto dental clinic. 2010-2011

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Bertrán Herrero, Grethell; Rosales Alonso, José Luis

2014-01-01

Introducción: la mayoría de las urgencias estomatológicas se debe a enfermedades pulpares y periapicales. En nuestro país son pocos los estudios realizados en relación con la prevalencia de estas lesiones en la población, lo que motivó la realización de este trabajo. Objetivo: determinar el comportamiento de las lesiones pulpares y periapicales en pacientes de 19 a 59 años. Material y Método: se realizó un estudio descriptivo y transversal a pacientes comprendidos entre 19 y 59 años de edad q...

Is tumor necrosis factor - 376a promoter polymorphism associated with susceptibility to multiple sclerosis? ¿El polimorfismo-376A del promotor del gen del factor de necrosis tumoral se asocia con una mayor susceptibilidad a padecer esclerosis múltiple?

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Marcelo A. Kauffman

2007-10-01

Full Text Available A single nucleotide polymorphism (SNP at position -376 of the tumor necrosis factor á gene (TNFA has been associated with susceptibility to multiple sclerosis (MS in Spain. However, no association was found in populations from the USA and The Netherlands. Here we investigate the association between the TNFA - 376A SNP and MS susceptibility in Argentinean patients with MS. The A/G genotype was found in 4.4% of patients (n=90 and in 4.8% of healthy individuals (n=84; p=0.92; odds ratio=0.93; confidence interval: 0.23- 3.84. Thus, no significant differences in genotype and allele frequencies were found between healthy individuals and patients with MS in Argentina.Un polimorfismo de nucleótido único (SNP, por sus iniciales en inglés en la posición -376 del gen codificante del factor de necrosis tumoral á (TNFA ha sido asociado en España con un mayor riesgo a padecer esclerosis múltiple (EM. Sin embargo, esta asociación no fue encontrada en estudios hechos en poblaciones provenientes de los EE.UU. y Holanda. Aquí investigamos la asociación entre el SNP TNFA -376A y el desarrollo de EM en una población de pacientes argentinos con EM. El genotipo A/G fue encontrado en 4.4% de los pacientes (n=90 y en 4.8% de los controles sanos (n=84; p=0.92; odds ratio=0.93; intervalo de confianza: 0.23-3.84. En consecuencia, no encontramos diferencias en las frecuencias alélicas y genotípicas entre los sujetos enfermos y los controles sanos en Argentina.

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

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Silvana E. Pramparo

2010-12-01

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

Manejo clínico de la caries profunda

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María Elia Alonso

Full Text Available La lesión cariosa profunda por la posibilidad de afectación pulpar, es un cuadro clínico de especial significación y permanente vigencia. Su tratamiento requiere de protocolos bien establecidos, de manera que la técnica empleada pueda ser conservadora y proporcione una amplia cobertura asistencial. Es fundamental el conocimiento de la etiopatogenia, de los correctos diagnósticos de la salud pulpar, de las propiedades de bases y protectores, así como también del correcto sellado marginal de la restauración coronaria. El objetivo será siempre mantener de manera conservadora la salud pulpar, dejando a la pieza apta para su restauración en forma, función y estética. Este artículo recoge el trabajo de una comisión que sistematizó los protocolos clínicos para la Protección Pulpar Indirecta (PPI y para el Tratamiento Pulpar Indirecto (TPI, con eliminación de caries en forma diferida. Los mismos se utilizan actualmente en la Clínica Integrada de Adultos III, Facultad de Odontología, Universidad de la República (Uruguay. Se considera que el Hidróxido de Calcio (Ca(OH2 sigue manteniendo su vigencia, siendo condición necesaria de su uso una pulpa saludable y requerimientos de reacción defensiva por depósito de tejido mineralizado

Avaliação em MEV da fenda resultante da contração de polimerização da resina composta aplicada sobre diferentes materiais protetores pulpares = A sem evaluation of the gap resulting from the polymerization shrinkage of composite resins applied to different pulp protective materials

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Unfer, Daniele Taís

2006-01-01

Full Text Available Introdução: A resina composta sofre contração como resultado da reação de polimerização que pode deslocar os materiais protetores pulpares, caso estes apresentem deficiente ou nenhuma adesão a dentina. Objetivo: avaliar o comportamento de dois materiais de proteção pulpar (CIV e CaOH2 cement em relação presença de fenda, quando submetidos a estresse de contração da resina composta e avaliar a fenda resultante da contração de polimerização entre dentina e resina composta. Metodologia: Foram confeccionados preparos classe V nas faces vestibular e lingual de 12 dentes molares humanos os quais foram divididos em quatro grupos de estudo, conforme a técnica restauradora e os materiais utilizados: G1 (SA + RC; G2 (HC + SA + RC; G3 (CIV + SA + RC e G4 (HC + CIV + SA + RC. Os corpos de prova foram avaliados em MEV e os dados obtidos foram submetidos análise não-paramétrica. Resultados: Os resultados obtidos mostram que os materiais de proteção pulpar utilizados são deslocados pela contração gerada pela polimerização da resina composta. Os melhores resultados (não presença de fenda foram demonstrados no grupo em que o sistema adesivo foi o único material entre a dentina e a resina composta. Quando do uso do CIV e do HC, associados ou não, foi encontrado o maior percentual de fendas. Conclusão: Os materiais de proteção pulpar continuarão a ser deslocados pela contração de polimerização das resinas compostas enquanto sua união à estrutura dental não apresentar suficiente resistência ou não se evitar a contração da resina composta

Tuberculosis pleural asociada con adalimumab, en un paciente con artritis reumatoide Pleural tuberculosis associated with adalimumab in a patient with rheumatoid arthritis

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Patricia Hidalgo

2010-03-01

Full Text Available ResumenLa tuberculosis constituye, en nuestro medio, una de las enfermedades infecciosas endémicas. Con el advenimiento de las nuevas terapias para el control de la artritis reumatoide, como los inhibidores del factor de necrosis tumoral, la incidencia de casos de reactivación ha aumentado notoriamente.Se presenta el caso de una mujer de 42 años de edad, con disnea, dolor torácico, tos, derrame pleural con líquido pleural tipo exudado linfocítico, con deaminasa de adenosina (ADA de 55 U-L e identificación de granuloma en la biopsia pleural. Se revisa la literatura y se hacen recomendaciones.Tuberculosis (TB represents one of the endemic infectious diseases in our population. The incidence of reactivate TB cases has grown notoriously with the onset of new therapeutic options for controlling rheumatoid arthritis (RA, such as tumor necrosis factor (TNF inhibitors. The case of a 42 year old woman is highlighted. Her condition is characterized by shortness of breath, chest pain, cough, pleural effusion, linfocitic exudate pleural fluid, ADA 55 U-L and granuloma in pleural biopsy.A review of relevant literature and recommendations are presented.

Avascular Necrosis

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... Financial Reports Watchdog Ratings Feedback Contact Select Page Avascular Necrosis Home > Cancer Resources > Late Effects of Treatment > Avascular Necrosis Avascular necrosis (AVN) is a disorder resulting from ...

161. Necrosis por presión del septo de salida ventricular causado por dos implantes adyacentes

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A. González Calle

2012-04-01

Conclusiones: Esta complicación ilustra que los tejidos entre dos dispositivos duros y con movimiento uno conrespecto al otro pueden desarrollar necrosis por presión y fricción y, consecuentemente, perforación. Probablemente, hubiera sido preferible sustituir el homoinjerto pulmonar con stent en el momento de la sustitución valvular aórtica.

Study in vitro of dental enamel irradiated with a high power diode laser operating at 960 nm: morphological analysis of post-irradiation dental surface and thermal effect analysis in pulp chamber due to laser application; Estudo in vitro do esmalte dental irradiado com laser de diodo de alta potencia em 960 nm: analise morfologica da superficie dental pos-irradiada e analise do comportamento termico na camara pulpar devido a aplicacao laser

Energy Technology Data Exchange (ETDEWEB)

Quinto Junior, Jose

2001-07-01

Objectives: This study examines the structural and thermal modifications induced in dental enamel under dye assisted diode laser irradiation. The aim of this study is to verify if this laser-assisted treatment is capable to modify the enamel surface by causing fusion of the enamel surface layer. At the same time, the pulpal temperature rise must be kept low enough in order not to cause pulpar necrosis. To achieve this target, it is necessary to determine suitable laser parameters. As is known, fusion of the enamel surface followed by re-solidification produce a more acid resistant layer. This surface treatment is being researched as a new method for caries prevention. Method and Materials: A series of fourteen identically prepared enamel samples of human teeth were irradiated with a high power diode laser operating at 960 nm and using fiber delivery. Prior to irradiation, a fine layer of cromophorous ink was applied to the enamel surface. In the first part of the experiment the best parameter for pulse duration was determined. In the second part of the experimental phase the same energy density was used but with different repetition rates. During irradiation we monitored the temperature rise in the pulpal cavity. The morphology of the treated samples was analysed under SEM. Results: The morphology of the treated samples showed a homogeneously re-solidified enamel layer. The results of the temperature analysis showed a decrease of the pulpal temperature rise with decreasing repetition rate. Conclusion: With the diode laser it is possible to cause morphological alterations of the enamel surface, which is known to increase the enamel resistance against acid attack, and still maintain the temperature rise in the pulpar chamber below damage threshold. (author)

El factor de necrosis de los tumores o caquectina

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Jorge Eliécer Ossa Londoño

1988-02-01

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Se presenta una revisión de la literatura sobre el Factor de Necrosis de los Tumores o Caquectina, con base en artículos publicados durante los anos 1986-1987, haciendo hincapié en las diferencias funcionales y moleculares entre el FNT Alfa, la Linfotoxina o FNT Beta y la Caquectina. Se enfatizan los mecanismos del shock, de la necrosis tumoral y de la caquexia; se Indican las propiedades antitumorales del FNT in vivo e in vitro y se esbozan esquemas terapéuticos experimentales que permiten colegir que el FNT tendrá un papel Importante en la Inmunoterapia del cáncer en el hombre.

This is a review of the 1986-1987 Literature on the Tumor Necrosis Factor (TNF or Cachectin, emphasizing functional and molecular differences among TNF alpha, Iymphotoxin or TNF beta and Cachectin. Mechanisms of shock, tumor necrosis and cachexia are discussed. In vivo and ín vítro antitumoral properties of TNF are indicated, as well as some experimental therapeutic regimens. These facts allow the suggestion that TNF might become an Important aid for Immunotherapy of cancer In humans.

Deficiencia congénita de proteína C en un recién nacido con trombosis y necrosis de tejidos extensa

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Bárbara Acosta Batista

Full Text Available Uno de los trastornos hematológicos más graves del período neonatal es la deficiencia congénita de proteína C, de presentación muy rara, y causa de enfermedad tromboembólica severa y púrpura fulminante en recién nacidos. Se puede sintetizar como una entidad clínico-patológica, de aparición aguda, con trombosis de la vasculatura de la dermis, lo cual conduce a necrosis hemorrágica y progresiva de la piel, asociada a coagulación intravascular diseminada y hemorragia perivascular, que ocurre en el período neonatal. El paciente presentado exhibe los elementos clínico-patológicos que caracterizan la púrpura fulminante, cuyo origen se debe a una deficiencia hereditaria de proteína C, lo cual condujo a la aparición de complicaciones trombóticas severas.

Temperature variation in pulp chamber during dental bleaching in presence or absence of light activation = Variação da temperatura na câmara pulpar durante o clareamento dental na presença ou ausência de fotoativação

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Mollica, Fernanda Brandão

2010-01-01

Full Text Available Objetivo: Além da agressão química devido à penetração dos géis clareadores na polpa durante o clareamento de dentes com vitalidade pulpar, outro possível fator agressor pode ser o calor gerado pela reação de oxidação exotérmica do gel clareador, que pode também ser agravada pela fotoativação. Este estudo avaliou a variação da temperatura na câmara pulpar de dentes humanos, utilizando-se três diferentes géis clareadores, com ou sem fotoativação. Metodologia: Trinta pré-molares humanos foram cortados longitudinalmente para obtenção de duas metades: vestibular e lingual. Os 60 espécimes foram divididos em 3 grupos e os agentes clareadores utilizados variaram como segue: peróxido de hidrogênio 35% (WHP, peróxido de carbamida 37% (W e peróxido de hidrogênio 38% (OX. Metade dos espécimes foi submetida ao clareamento com fotoativação e, a outra metade, sem fotoativação. A fonte de luz utilizada foi o aparelho à base de diodo emissor de luz (LED, 3-Light, Clean Line e as temperaturas foram medidas por um termômetro digital. Os dados foram analisados por análise de variância e teste de Tukey (alfa=5%. Resultados: Os resultados de temperatura foram: sem fotoativação (WHP= 0. 68b; W= 0. 40b; OX= 0. 48b; com fotoativação (WHP= 2. 35a; W= 1. 60a; OX= 1. 80a. Conclusão: A fotoativação dos géis clareadores com LED contribuiu para um maior aumento de temperatura na câmara pulpar, mas não se atingiu a temperatura crítica de 5,5oC

Gross, computed tomographic and histological findings in mandibular cheek teeth extracted from horses with clinical signs of pulpitis due to apical infection.

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Casey, M B; Pearson, G R; Perkins, J D; Tremaine, W H

2015-09-01

The most prevalent type of equine dental pulpitis due to apical infection is not associated with coronal fractures or periodontal disease. The pathogenesis of this type of pulpitis is not fully understood. Computed tomography (CT) is increasingly used to investigate equine dental disorders. However, gross, tomographic and histopathological changes in equine dental pulpitis have not been compared previously. To compare gross, CT and histological appearances of sectioned mandibular cheek teeth extracted from horses with clinical signs of pulpitis without coronal fractures or periodontal disease. To contribute to understanding the pathogenesis of equine dental pulpitis. Descriptive study using diseased and healthy teeth. Mandibular cheek teeth extracted from horses with clinical signs of pulpitis (cases), and from cadavers with no history of dental disease (controls), were compared using CT in the transverse plane at 1 mm intervals. Teeth were then sectioned transversely, photographed and processed for histopathological examination. Tomographs were compared with corresponding gross and histological sections. Cement, dentine and bone had similar ranges of attenuation (550-2000 Hounsfield Units, HU) in tomographs but could be differentiated from pulp (-400 to 500 HU) and enamel (> 2500 HU). Twelve discrete dental lesions were identified grossly, 10 of which were characterised histologically. Reactive and reparative dentinogenesis and extensive pulpar mineralisation, previously undescribed, were identified. Pulpar oedema, neutrophilic inflammation, cement and enamel defects, and reactive cemental deposition were also observed. The CT and pathological findings corresponded well where there was mineralised tissue deposited, defects in mineralised tissue, or food material in the pulpar area. Pulpar and dentinal necrosis and cement destruction, evident grossly and histologically, did not correspond to CT changes. Computed tomography is useful for identifying deposition and

LA NECROSIS AVASCULAR EN LA DISPLASIA DE LA CADERA

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Valentín Malagón

1978-10-01

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Presentado en el III Congreso Nacional de la Sociedad Colombiana de Cirugía Infantil y XXIII Curso de Ortopedia para Post Graduados. Bogotá. Marzo 1978.

1. La Necrosis Avascular de la extremidad proximal del fémur es una de las complicaciones más frecuentes y temibles en el tratamiento de la displasia de la cadera.

2. Un mejor conocimiento de su etiopatogenia, de su historia natural, de su patología y
de su cuadro radiológico, aporta bases para prevenirla y tratarla en forma adecuada.

3. Por ser una lesión esencialmente iatrogénica relacionada con la aplicación de conductas
inapropiadas de tratamiento, la depuración de esas técnicas puede evitar su aparición.

4. Un diagnóstico precoz de la displasia de la cadera, un programa adecuado de tracción
previa a la reducción, con tenotomía de los músculos aductores, en el momento de la
reducción, maniobras suaves de reducción e inmovilización en una posición fisiológica
humana (flexión de 900, abducción de 450 reducen notablemente la frecuencia de la
necrosis avascular como complicación en el tratamiento de la displasia de la cadera.

5. La reducción abierta de la cadera, asociada a la osteotomía del hueso innominado, precedida de una tracción adecuada y en niños mayores de 18 meses, reduce igualmente en este tipo de pacientes el porcentaje de esta complicación.

El seguimiento de los principios enumerados en el Departamento de Ortopedia del Hospital
Infantil, ha conseguido en el curso de 20 años disminuir la incidencia de necrosis avascular
del 35 al 5.20/0.

Renal papillary necrosis

Science.gov (United States)

... asking your provider. Alternative Names Necrosis - renal papillae; Renal medullary necrosis Images Kidney anatomy Kidney - blood and urine flow References Bushinsky DA, Monk RD. Nephrolithiasis and nephrocalcinosis. ...

SEM - Morphological evaluation of the root apex in human primary teeth with different degrees of pulpal and periapical pathology

OpenAIRE

Patrícia Motta Fernandes

2007-01-01

O objetivo deste estudo foi avaliar a morfologia da superfície externa de ápices radiculares de dentes decíduos de humanos com necrose pulpar, com e sem lesão periapical visível radiograficamente, e de dentes com vitalidade pulpar, por meio da microscopia eletrônica de varredura (MEV). Dezenove dentes foram extraídos sendo cinco dentes com vitalidade pulpar (Grupo I), seis com necrose pulpar sem lesão periapical (Grupo II) e oito com necrose pulpar e lesão periapical (Grupo III). Os dentes (i...

Metaloproteinasas de la matriz extracelular (mmps en Odontología

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Vanesa Pereira Prado

Full Text Available Resumen La mayoría de los tejidos del organismo se encuentran en un constante proceso de renovación, modulado por una vasta cantidad de proteínas que inducen la síntesis y degradación tisular a lo largo del tiempo. Las metaloproteinasas de la matriz extracelular (MMPs son una familia de 25 endopeptidasas zinc dependientes encargadas de escindir los componentes inmediatos de la matriz extracelular (MEC. Ciertas metaloproteinasas de la matriz extracelular, especialmente MMP-2 y MMP-9, se ven implicadas en el desarrollo del germen dental así como con la proliferación e invasión de los tumores odontogénicos, siendo un factor a considerar sobre la posible agresividad tumoral y la base para el tratamiento de los mismos. A su vez, ambas MMPs actúan en la progresión de las lesiones cariosas así como en progresión de la periodontitis apical de pacientes con necrosis pulpar. Varios patógenos periodontales, promueven la secreción tanto de MMP-2 como MMP-9 favoreciendo la destrucción de los tejidos periodontales, íntimamente relacionadas con el avance de la enfermedad. En pacientes bajo tratamiento ortodóncico se encuentran altos niveles de estas MMPs, tanto en zonas de compresión como de tensión, relacionando los movimientos dentales con la renovación de los tejidos. Esta revisión analiza su expresión y utilidad relacionándolas con diferentes disciplinas en el área de las ciencias odontológicas, enfatizando su potencial como biomarcadores

Airway necrosis after salvage esophagectomy

International Nuclear Information System (INIS)

Tanaka, Norimitsu; Hokamura, Nobukazu; Tachimori, Yuji

2010-01-01

Salvage esophagectomy is the sole curative intent treatment for patients with persistent or recurrent locoregional disease after definitive chemoradiotherapy (CRT) for esophageal carcinoma. However, salvage esophagectomy is a very high-risk operation, and airway necrosis is a fatal complication. Between 1997 and 2007, 49 patients with thoracic esophageal cancer underwent salvage esophagectomy after definitive CRT. We retrospectively compared patients with and without airway necrosis, and investigated operative procedures related to airway necrosis. Airway necrosis occurred in five patients (10.2%), of four patients (80%) died during their hospitalization. Airway necrosis seemed to be closely related to operative procedures, such as resection of bronchial artery and cervical and subcarinal lymph node dissection. Bronchogastric fistula following necrosis of gastric conduit occured in 2 patients reconstructed through posterior mediastinal route. Airway necrosis is a highly lethal complication after salvage esophagectomy. It is important in salvage esophagectomy to take airway blood supply into consideration sufficiently and to reconstruct through retrosternal route to prevent bronchogastric fistula. (author)

Sperm immobilization by dental focus microorganisms.

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Linossier, A; Thumann, A; Bustos-Obregon, E

1982-01-01

Focal infections and their ability to produce alterations in different tissues have been in dispute for long time. The purpose of this work was to observe "in vitro" the effect of an Escherichia coli filtrate obtained from open pulpar necrosis on human sperm motility. It was observed that the E. coli filtrate produced a loss in sperm motility. The immobilizating factor was studied and characterized as a heat-stable, resistant to lyophilization and non-dializable substance, which could via blood stream reach the male reproductive system and affect sperm motility.

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

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R. Ramos

2008-09-01

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

Miocarditis de células gigantes con bloqueo AV completo persistente: respuesta al tratamiento con resincronizador cardiaco Giant cell myocarditis with complete persistent A-V block: treatment response with cardiac resynchronization

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Julián Aristizábal

2009-08-01

Full Text Available La miocarditis de células gigantes es una enfermedad grave y poco frecuente, cuya etiología, posiblemente autoinmune, se caracteriza por la presencia de células gigantes multinucleadas con infiltrado inflamatorio y necrosis extensa en la biopsia endomiocárdica. Es común su asociación con taquicardias ventriculares y con alteraciones de la conducción aurículo-ventricular, lo cual se resuelve algunas veces con tratamiento inmunosupresor. Dada la complejidad del pronóstico de esta entidad, el papel de los dispositivos de resincronización después de la estabilización de la falla cardíaca, no está claro. Aquí se reporta un caso en el cual el implante de uno de estos dispositivos fue parte fundamental de la terapia y recuperación del paciente.Giant cell myocarditis is an infrequent and serious illness, possibly of autoimmune etiology, characterized by the presence of multinucleated giant cells with inflammatory infiltrate and extensive necrosis in the endomyocardial biopsy. Its association with ventricular tachycardia is common and alterations in atrioventricular conduction are frequently solved through immunosuppressive treatment. Given the generally complex prognosis of this entity, the role of the resynchronization devices after the heart failure stabilization, is unclear. We reported a case in which the implant of one of these devices was a fundamental part of the therapy and patient recovery.

Monoartritis gotosa de muñeca asociada a necrosis del semilunar: a propósito de un caso clínico

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Olmedo García, N.; Mackenney Carrasco, Enrique

1994-01-01

Se presenta un caso de monoartritis de muñeca asociada a imágenes radiológicas de necrosis avascular del semilunar que, tras biopsia de la sinovial, se diagnostica de artritis gotosa. Esta asociación es rara. La alteración metabólica que se produce en la gota da lugar a una sinovitis, que provoca un aumento de presión intraarticular. Esta hiperpresión en el carpo podría determinar una necrosis isquémica del semilunar, pero con una evolución diferente a la enfermedad de Kienböck...

Pulpal response of dogs primary teeth to an adhesive system or to a calcium hydroxide cement Resposta pulpar de dentes decíduos de cães a um sistema adesivo ou ao cimento de hidróxido de cálcio

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Rosângela Almeida RIBEIRO

2000-03-01

Full Text Available The aim of this study was to evaluate the pulpal response of dogs primary teeth to an adhesive system or to a calcium hidroxide cement after mechanic exposure of the pulp. Three mongrel dogs were used and ten class V cavities were prepared on their teeth. A mechanic pulp exposure was produced with a sterile exploratory probe in the central portion of each cavity and bleeding was controlled with dry sterile cotton pellets. Enamel, dentin and the site of the pulp exposure of five teeth were etched with 35% phosphoric acid followed by the application of an adhesive system (Scotchbond Multi-Purpose - 3M. In the other five teeth, calcium hydroxide cement (Hydro C - Dentsply was applied on the site of the pulp exposition before application of the adhesive system (Scotchbond Multi-Purpose - 3M. All teeth were restored with a resin composite (Z-100 - 3M. After 7, 30 or 45 days the dogs were anesthetized and perfused with saline followed by a solution of neutral buffered formalin. Maxilla and mandible were sectioned into three parts and placed in a solution for demineralization. Following bone demineralization, all teeth were cut, trimmed, embedded in paraffin and longitudinally cut. Then, the teeth were stained with hematoxilin and eosin and observed under a light microscope. The results obtained with the treatments proposed in this study showed the presence and persistence of an inflammatory response of different intensities at the three experimental periods. There was no variation in the inflammatory response regarding the different treatments performed.O objetivo deste estudo foi de avaliar a resposta pulpar de dentes decíduos de cães à um sistema adesivo ou a um cimento de hidróxido de cálcio após exposição mecânica da polpa. Foram utilizados três cães sem raça definida, e nestes foram realizados dez preparos cavitários classe V. Uma exposição pulpar mecânica foi produzida com uma sonda exploradora esterilizada, na porção central

Retinitis por citomegalovirus en un paciente con VIH

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Alena de los Ángeles Vejerano Duany

Full Text Available La retinitis por citomegalovirus es la infección ocular más frecuente en pacientes con un recuento de linfocitos CD4 inferior a 200 por µL. El aspecto oftalmoscópico de las lesiones se caracteriza, en la mayoría de los casos, por infiltrados retinianos resultados de la necrosis retiniana producida por citomegalovirus y el edema en asociación con hemorragias. Estas lesiones se disponen, por lo general, siguiendo las arcadas vasculares temporales con invasión hacia la mácula. Se presentó una paciente de 24 años de edad, femenina, blanca, ama de casa, con antecedentes patológicos personales oculares sin datos de interés, y antecedentes patológicos personales generales de ser diagnosticadas con VIH. Hace cuatro años que comenzó con tratamiento antirretroviral, y tuvo cambios de tratamiento en dos ocasiones. El último fue impuesto en mayo del año 2011, con el cual presentó mala adherencia terapéutica, y comenzó desde entonces a presentar disminución de su peso corporal de forma marcada en breve período de tiempo. Refiere que desde hace unos meses comenzó a presentar una disminución progresiva de la agudeza visual en el ojo derecho, acompañado de visión borrosa. Adquiere gran importancia este caso, ya que ante la supervivencia de los pacientes con sida, va a ser cada vez más frecuente la aparición de las afecciones oculares relacionadas con esta enfermedad. Dentro de ellas se encuentran las infecciones oportunistas mayores como la retinitis por citomegalovirus.

SÍNTOMAS ASOCIADOS CON ALTAS CONCENTRACIONES DE BORO EN RAMBUTÁN (Nephelium lappaceum

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Alfonso Vargas-Calvo

2009-01-01

Full Text Available Lesiones foliares de diferente intensidad fueron observadas en una plantación comercial de rambután de dos a cuatro años de edad, en asocio con papa ya (Carica papaya, ubicada en la provincia de Heredia, cantón de Sa rapi quí, Costa Ri ca, en el año 2003. Como comparador se utilizaron muestras provenientes de plantas sin síntomas, con un rango de edad similar al de las plantas de Sa - rapi quí, y pertenecientes a la colección de frutales exóticos de la Corporación Bananera Na cional (COR BANA S.A, situada en la provincia de Limón, cantón de Pococí y distante 15 km de la plantación afectada. Con el objetivo de determinar el origen de las lesiones, el segundo y tercer par de hojas más jóvenes, de al menos cuatro ramas equidistantes de la parte media de la planta, fueron utilizados para análisis en el Laboratorio Químico de Suelos y Foliares en COR BANA S.A. El muestreo fue realizado una vez y cada muestra provino de cuatro a cinco plantas con cuatro repe ticiones. La muestra, previamente limpia , seca y molida, fue digerida en microondas y la lectura de todos los elementos, con excepción del nitrógeno que se determinó por combustión seca, se efectuó mediante un espectrofotómetro de plasma modelo Op tima 3000. Las plantas afectadas presentaron una necrosis marginal que se desarrolló del ápice hacia la base y del borde hacia el interior de la lámina foliar con moteados intervenales de apa riencia clorótica. En ocasiones, se observó un rizado de la sección api cal con necrosis ocasionado por la torsión hacia arriba de sus márgenes. El análisis foliar indicó una alta concentración de boro.

Urgencias por caries dental en pacientes de 4 a 12 años. Municipio Píritu, Venezuela. 2011

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Mirabal Peón, Magaly Sofía; Tabares Alonso, Yadelis; Duque Reyes, María Victoria; Alfonso Biart, Belkis; Reyes Martín, Belkis; Villegas Rojas, Ivernis

2014-01-01

Se realizó un estudio observacional, descriptivo y transversal en los pacientes que acudieron a la clínica odontológica de Píritu, estado Falcón, Venezuela, en el período de junio a diciembre de 2011, y resultaron ser urgencia por caries dental. Con el objetivo de identificar el comportamiento de la misma, en las edades de 4 a 12 años, se clasificó la caries dental según localización y profundidad de las lesiones, se diagnosticó las patologías pulpares agudas encontradas con mayor frecuencia,...

Dentine tubule infection and endodontic therapy implications.

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Oguntebi, B R

1994-07-01

A critical review of the literature suggests that the microenvironment of dentinal tubules appears to favour the selection of relatively few bacterial types irrespective of the aetiology of the infection process; coronal dental caries or pulpar necrosis. These bacteria may constitute an important reservoir from which root canal infection and reinfection may occur following pulp necrosis or during and after endodontic treatment. Previous studies of this microflora have utilized microbiological culture techniques which need to be supplemented by those that allow in situ demonstration as well as identification of the bacteria. Newer treatment strategies that are designed to eliminate this microflora must include agents that can penetrate the dentinal tubules and destroy these microorganisms, since they are located in an area beyond the host defence mechanisms where they cannot be reached by systemically administered antimicrobial agents.

MRI study of avascular necrosis of the knee

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Simizu, Koh; Suguro, Toru; Tsuchiya, Akihiro; Moriya, Hideshige; Nishikawa, Satoru; Arimizu, Noboru [Chiba Univ. (Japan). School of Medicine

1990-10-01

Magnetic resonance (MR) images of 70 joints were reviewed in 38 patients with avascular necrosis of the knee or hip joint, whose ages ranged from 19 to 62 years with an average of 41 years. According to causes, steroid induced avascular necrosis was the commonest, accounting for 87% of cases. The remainer of the cases were alcoholic avascular necrosis (8%) and idiopathic avascular necrosis (5%). Steroid induced avascular necrosis was greatly different from idiopathic avascular necrosis in view of clinical manifestations, common sites, and complications of femur head necrosis. Idiopathic avascular necrosis was common in the central part of internal condyle and was confined to one joint. Steroid induced avascular necrosis was common in the posterior part of external condyle and was frequently associated with multiple necroses of the diaphysis. Seventy five percent of the cases were associated with avascular necrosis of the knee. The diagnostic accuracy of the other imaging modalities in avascular necrosis was low (33% for plain roentgenography and 50% for RI examination). Thus, MR was the imaging procedure of choice for detecting avascular necrotic lesions. (N.K.).

MRI study of avascular necrosis of the knee

International Nuclear Information System (INIS)

Simizu, Koh; Suguro, Toru; Tsuchiya, Akihiro; Moriya, Hideshige; Nishikawa, Satoru; Arimizu, Noboru

1990-01-01

Magnetic resonance (MR) images of 70 joints were reviewed in 38 patients with avascular necrosis of the knee or hip joint, whose ages ranged from 19 to 62 years with an average of 41 years. According to causes, steroid induced avascular necrosis was the commonest, accounting for 87% of cases. The remainer of the cases were alcoholic avascular necrosis (8%) and idiopathic avascular necrosis (5%). Steroid induced avascular necrosis was greatly different from idiopathic avascular necrosis in view of clinical manifestations, common sites, and complications of femur head necrosis. Idiopathic avascular necrosis was common in the central part of internal condyle and was confined to one joint. Steroid induced avascular necrosis was common in the posterior part of external condyle and was frequently associated with multiple necroses of the diaphysis. Seventy five percent of the cases were associated with avascular necrosis of the knee. The diagnostic accuracy of the other imaging modalities in avascular necrosis was low (33% for plain roentgenography and 50% for RI examination). Thus, MR was the imaging procedure of choice for detecting avascular necrotic lesions. (N.K.)

Ischemic necrosis and osteochondritis

International Nuclear Information System (INIS)

Weissman, S.D.

1989-01-01

Osteonecrosis indicates that ischemic death of the cellular constituents of bone and marrow has occurred. Historically, this first was thought to be related to sepsis in the osseous segments. However, continued studies led to the use of the term aseptic necrosis. Subsequent observations indicated that the necrotic areas of bone were not only aseptic, but were also avascular. This led to the terms ischemic necrosis, vascular necrosis and bone infarction. Ischemic necrosis of bone is discussed in this chapter. It results from a significant reduction in or obliteration of blood supply to the affected area. The various bone cells, including osteocytes, osteoclasts, and osteoblasts, usually undergo anoxic death in 12 to 48 hours after blood supply is cut off. The infarct that has thus developed in three-dimensional and can be divided into a number of zones: a central zone of cell death; an area of ischemic injury, most severe near the zone of cell death, and lessening as it moves peripherally; an area of active hyperemia and the zone of normal unaffected tissue. Once ischemic necrosis has begun, the cellular damage provokes an initial inflammatory response, which typically is characterized by vasodilatation, transudation of fluid and fibrin, and local infiltration of flammatory cells. This response can be considered the first stage in repair of the necrotic area

Focos sépticos bucales en pacientes con uveítis Oral sepsis in patients with uveitis

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Maritza Peña Sisto

2012-12-01

Full Text Available Se realizó un estudio descriptivo y transversal de 26 pacientes con uveítis, atendidos en el Servicio de Estomatología del Hospital General Docente "Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde mayo hasta diciembre del 2011, con vistas a describir las infecciones bucales frecuentemente asociadas a dicha afección y la importancia del tratamiento estomatológico en estos enfermos. La información se obtuvo de las entrevistas y las historias clínicas; además, se realizó examen físico intrabucal y estudio radiográfico para diagnosticar y tratar la presencia de caries, procesos periapicales, procesos pulpares y enfermedades periodontales. Se empleó el programa SPSS versión 10.0 y como medidas de resumen, los índices y los porcentajes. Todos los afectados presentaron algún tipo de infección bucal, con mayor frecuencia de las periodontitis y los procesos periapicales en dientes posteriores del maxilar superior. La agudeza visual tuvo gran mejoría debido al tratamiento conjunto oftalmológico y estomatológico.A descriptive and cross-sectional study was carried out in 26 patients with uveitis, treated at the Stomatology Department of "Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba from May to December 2011, in order to describe oral infections often associated with this condition and the importance of dental treatment in these patients. Data were obtained from interviews and medical records. Moreover, oral examination and radiographic study were performed to diagnose and treat dental caries, periapical and pulpal conditions and periodontal diseases. The software SPSS version 10.0 and rates and percentages as summary measure were used. All patients had some type of oral infection with increased frequency of periodontitis and periapical conditions in posterior maxillary teeth. Visual acuity greatly improved due to combined dental and ophthalmological treatment.

Células madres pulpares: describiendo y descubriendo potencialidades

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Merino, Graciela Mónica; Dewey, Ricardo Alfredo; Mayocchi, Karina; Butler, Teresa Adela; Dorati, Pablo; Basal, Roxana Lía; Paggi, Ricardo; Cantarini, Luis Martín; Pinola, Lidia; Micinquevich, Susana

2015-01-01

La evidencia científica ha demostrado que las células madre (CM) ofrecen una importante innovación en la investigación odontológica. Ellas pueden diferenciarse posibilitando el reemplazo de tejidos afectados aunque sean de otros linajes celulares. Las de origen dental por su multipotencialidad pueden formar células con carácter osteo/odontogénico, adipogénico y neurogénico. La pulpa dental ofrece células madre en baja concentración, siendo más proliferativas aquellas que dan origen a la coron...

Genetic ablation of soluble tumor necrosis factor with preservation of membrane tumor necrosis factor is associated with neuroprotection after focal cerebral ischemia

DEFF Research Database (Denmark)

Madsen, Pernille M; Clausen, Bettina H; Degn, Matilda

2016-01-01

Microglia respond to focal cerebral ischemia by increasing their production of the neuromodulatory cytokine tumor necrosis factor, which exists both as membrane-anchored tumor necrosis factor and as cleaved soluble tumor necrosis factor forms. We previously demonstrated that tumor necrosis factor...... reduced infarct volumes at one and five days after stroke. This was associated with improved functional outcome after experimental stroke. No changes were found in the mRNA levels of tumor necrosis factor and tumor necrosis factor-related genes (TNFR1, TNFR2, TACE), pro-inflammatory cytokines (IL-1β, IL-6...... knockout mice display increased lesion volume after focal cerebral ischemia, suggesting that tumor necrosis factor is neuroprotective in experimental stroke. Here, we extend our studies to show that mice with intact membrane-anchored tumor necrosis factor, but no soluble tumor necrosis factor, display...

Avascular Necrosis of the Capitate

OpenAIRE

Bekele, Wosen; Escobedo, Eva; Allen, Robert

2011-01-01

Avascular necrosis of the capitate is a rare entity. The most common reported etiology is trauma. We report a case of avascular necrosis of the capitate in a patient with chronic wrist pain that began after a single episode of remote trauma.

Ketoconazole attenuates radiation-induction of tumor necrosis factor

Energy Technology Data Exchange (ETDEWEB)

Hallahan, D.E.; Virudachalam, S.; Kufe, D.W.; Weichselbaum, R.R. [Dana Farber Cancer Institute, Boston, MA (United States)

1994-07-01

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

Avascular Necrosis of the Capitate

Science.gov (United States)

Bekele, Wosen; Escobedo, Eva; Allen, Robert

2011-01-01

Avascular necrosis of the capitate is a rare entity. The most common reported etiology is trauma. We report a case of avascular necrosis of the capitate in a patient with chronic wrist pain that began after a single episode of remote trauma. PMID:22470799

Inhibition of the release of soluble tumor necrosis factor receptors in experimental endotoxemia by an anti-tumor necrosis factor-alpha antibody

NARCIS (Netherlands)

Jansen, J.; van der Poll, T.; Levi, M. [=Marcel M.; ten Cate, H.; Gallati, H.; ten Cate, J. W.; van Deventer, S. J.

1995-01-01

The role of tumor necrosis factor-alpha in the shedding of soluble tumor necrosis factor receptors in endotoxemia was investigated. The appearance of the soluble tumor necrosis factor receptors was assessed in four healthy volunteers following an intravenous injection of tumor necrosis factor-alpha

NecroQuant: quantitative assessment of radiological necrosis

Science.gov (United States)

Hwang, Darryl H.; Mohamed, Passant; Varghese, Bino A.; Cen, Steven Y.; Duddalwar, Vinay

2017-11-01

Clinicians can now objectively quantify tumor necrosis by Hounsfield units and enhancement characteristics from multiphase contrast enhanced CT imaging. NecroQuant has been designed to work as part of a radiomics pipelines. The software is a departure from the conventional qualitative assessment of tumor necrosis, as it provides the user (radiologists and researchers) a simple interface to precisely and interactively define and measure necrosis in contrast-enhanced CT images. Although, the software is tested here on renal masses, it can be re-configured to assess tumor necrosis across variety of tumors from different body sites, providing a generalized, open, portable, and extensible quantitative analysis platform that is widely applicable across cancer types to quantify tumor necrosis.

STUDY OF AGE INCIDENCE AND SYMMETRY IN NON - TRAUMATIC AVASCULAR NECROSIS OF FEMORAL HEAD

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Harinath

2015-10-01

Full Text Available INTRODUCION: Avascular necrosis of the femoral head is an increasingly common cause of musculoskeletal disability, and it poses a major diagnostic and therapeutic challenge. The aim of diagnostic imaging procedures in avascular femoral head necrosis is to provide the patient with a stage - adapted therapy. The aim of this paper is to present the age incidence and symmetricity of involvement of the non - traumatic avascular necrosis of femoral head. MATERIALS AND METHODS: This is a prospective observational study done durin g January 2013 to June 2013.The study included a total 30 patients referred to the Department of Radiology, Kurnool medical college, Kurnool, for X ray pelvis with both hips. 10 patients out of them were further investigated with MRI pelvis. RESULTS: More than half of the patients (72.6 % were within the age groups 30 - 50 years with male to female ratio of about 4:1. 60% of patients showed bilateral involvement, 20 % showed right femoral head and 20 % showed left femoral head involvement. CONCLUSION: We con clude that disease affects mostly adults within their 3rd and 5th decade and majority of the patients are being men with bilateral involvement. Our study results are comparable with previous studies. Hence we recommend MRI both hips for early identificatio n of AVN changes in asymptomatic contra-lateral hip or normal appearing hip on X-Ray.

Programmed necrosis and necroptosis – molecular mechanisms

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Agata Giżycka

2015-12-01

Full Text Available Programmed necrosis has been proven vital for organism development and homeostasis maintenance. Its regulatory effects on functional activity of the immune system, as well as on pathways regulating the death mechanisms in cells with diminished apoptotic activity, including malignant cells, have been confirmed. There is also increasing evidence indicating necrosis involvement in many human pathologies. Contrary to previous beliefs, necrosis is not only a passive, pathological, gene-independent process. However, the current knowledge regarding molecular regulation of programmed necrosis is scarce. In part this is due to the multiplicity and complexity of signaling pathways involved in programmed necrosis, as well as the absence of specific cellular markers identifying this process, but also the ambiguous and imprecise international terminology. This review presents the current state of the art on molecular mechanisms of programmed necrosis. In particular, its specific and frequent form, necroptosis, is discussed. The role of RIP1 and RIP3 kinases in this process is presented, as well as the diverse pathways induced by ligation of tumor necrosis factor α, to its receptor, TNFR1, i.e. cell survival, apoptosis or necroptosis.

Mastectomy skin necrosis after microsurgical breast reconstruction.

Science.gov (United States)

Vargas, Christina R; Koolen, Pieter G; Anderson, Katarina E; Paul, Marek A; Tobias, Adam M; Lin, Samuel J; Lee, Bernard T

2015-10-01

Mastectomy skin necrosis represents a significant clinical morbidity after immediate breast reconstruction. In addition to aesthetic deformity, necrosis of the native mastectomy skin may require debridement, additional reconstruction, or prolonged wound care and potentially delay oncologic treatment. This study aims to evaluate patient and procedural characteristics to identify predictors of mastectomy skin necrosis after microsurgical breast reconstruction. A retrospective review was performed of all immediate microsurgical breast reconstructions performed at a single academic center. Patient records were queried for age, diabetes, active smoking, previous breast surgery, preoperative radiation, preoperative chemotherapy, body mass index, mastectomy type, mastectomy weight, flap type, autologous flap type, and postoperative mastectomy skin flap necrosis. There were 746 immediate autologous microsurgical flaps performed by three plastic surgeons at our institution during the study period. The incidence of mastectomy skin flap necrosis was 13.4%. Univariate analysis revealed a significantly higher incidence of mastectomy skin necrosis in patients with higher mastectomy weight (P mastectomy type. Multivariate analysis demonstrated statistically significant associations between mastectomy skin necrosis and both increasing mastectomy weight (odds ratio 1.348 per quartile increase, P = 0.009) and diabetes (odds ratio 2.356, P = 0.011). Increasing mastectomy weight and coexisting diabetes are significantly associated with postoperative mastectomy skin necrosis after microsurgical reconstruction. These characteristics should be considered during patient counseling, procedure selection, operative planning, and intraoperative tissue viability assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

Valoración del tratamiento de la pulpotomía con MTA en dientes temporales vitales

OpenAIRE

Biedma Perea, María

2014-01-01

Texto completo descargado desde Teseo I. INTRODUCCIÓN La pérdida prematura de la pieza temporal puede conducir a maloclusiones, problemas estéticos, fonéticos y funcionales como hábitos, que pueden ser transitorios o permanentes.1 La pulpotomía es uno de los recursos para poder conservar los dientes deciduos, así estos actúan como mantenedores de espacios naturales hasta la erupción de la dentición permanente.2,3,4 El uso de materiales dentales como apósitos pulpares en el tratamiento de p...

Regulation of Tumor Progression by Programmed Necrosis

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Su Yeon Lee

2018-01-01

Full Text Available Rapidly growing malignant tumors frequently encounter hypoxia and nutrient (e.g., glucose deprivation, which occurs because of insufficient blood supply. This results in necrotic cell death in the core region of solid tumors. Necrotic cells release their cellular cytoplasmic contents into the extracellular space, such as high mobility group box 1 (HMGB1, which is a nonhistone nuclear protein, but acts as a proinflammatory and tumor-promoting cytokine when released by necrotic cells. These released molecules recruit immune and inflammatory cells, which exert tumor-promoting activity by inducing angiogenesis, proliferation, and invasion. Development of a necrotic core in cancer patients is also associated with poor prognosis. Conventionally, necrosis has been thought of as an unregulated process, unlike programmed cell death processes like apoptosis and autophagy. Recently, necrosis has been recognized as a programmed cell death, encompassing processes such as oncosis, necroptosis, and others. Metabolic stress-induced necrosis and its regulatory mechanisms have been poorly investigated until recently. Snail and Dlx-2, EMT-inducing transcription factors, are responsible for metabolic stress-induced necrosis in tumors. Snail and Dlx-2 contribute to tumor progression by promoting necrosis and inducing EMT and oncogenic metabolism. Oncogenic metabolism has been shown to play a role(s in initiating necrosis. Here, we discuss the molecular mechanisms underlying metabolic stress-induced programmed necrosis that promote tumor progression and aggressiveness.

Nuestra experiencia con el minivástago femoral de disco a compresión y el cotilo Hedrocel (tantalio)

OpenAIRE

Acosta Fle, José María; Alonso Barrio, José Antonio; Mencía Barrio, Ricardo; Fernández Hernández, O.; González Fernández, J.J.; Sánchez Herráez, S.

2005-01-01

Durante los años 2000 a 2002 intervinimos 18 pacientes de artrosis o necrosis sintomática de cadera, con minivástago de fijación metafisiaria de Disco a Compresión (Sulzer) y cotilo monobloque de tantalio Hedrocel (Zimmer), con par de fricción alúmina-polietileno. La edad media de los pacientes fue de 46,7 años (rango 35-61), y el seguimiento medio de 42 meses. La valoración clínica se realizó con la escala de Merle D'Augbigné Postel obteniendo 38,8% de resultados excelentes, 22,2 de resultad...

Antibacterial effect of root canal preparation and calcium hydroxide paste (Calen intracanal dressing in primary teeth with apical periodontitis Efeito antibacteriano do preparo biomecânico e do curativo de demora com pasta à base de hidróxido de cálcio (Calen em dentes decíduos com lesão periapical

Directory of Open Access Journals (Sweden)

Gisele Faria

2005-12-01

Full Text Available The aim of this study was to evaluate the antibacterial action of root canal mechanical preparation using 2.5% sodium hypochlorite as the irrigating solution and a calcium hydroxide paste as the antibacterial intracanal dressing in human primary teeth root canals with pulp necrosis and apical periodontitis by means of microbial culture. A total of 26 root canals of human primary teeth with pulp necrosis and apical periodontitis were used. Samples were collected before, 72h after biomechanical treatment and 72h after removal of the intracanal dressing. Comparison by Wilcoxon test showed that root canal mechanical preparation effectively eliminated all microorganisms in 20% of the root canals, and the intracanal dressing in 62.5%; however, the cumulative action of biomechanical treatment and intracanal dressing eliminated the microorganisms of 70% of the root canals (pO objetivo do presente estudo foi avaliar, por meio de cultura bacteriológica, a ação antibacteriana do preparo biomecânico utilizando como solução irrigadora o hipoclorito de sódio a 2,5% e da pasta Calen utilizada como curativo de demora em canais radiculares de dentes decíduos de humanos com necrose pulpar e lesão periapical. Foram selecionados 26 dentes decíduos de humanos portadores de necrose pulpar e lesão periapical. As colheitas microbiológicas foram efetuadas antes e 72 horas após o preparo biomecânico e 72 horas após a remoção do curativo de demora. A comparação por meio do teste de Wilcoxon mostrou que o preparo biomecânico foi eficaz na eliminação dos microrganismos dos canais radiculares em 20% dos casos e o curativo de demora em 62,5%, enquanto que a ação cumulativa do preparo biomecânico e do curativo de demora eliminou os microrganismos em 70,0% dos casos (p<0.001. Pôde-se concluir que o preparo biomecânico, isoladamente, apresentou resultados microbiológicos inferiores àqueles obtidos quando o mesmo foi associado ao curativo de demora

Histopathological investigation of radiation necrosis. Coagulation necrosis in the irradiated and non-irradiated brain tumors and in the normal brain tissue

Energy Technology Data Exchange (ETDEWEB)

Nakamura, N [Niigata Univ. (Japan). Brain Research Inst.

1977-01-01

Eighty four irradiated tumors (including 59 gliomas) and the surrounding brain tissue were analyzed. In 'normal' brain tissue, typical coagulation necrosis attributable to irradiation was observed in the cerebral white matter, presenting a whitish-yellow color but no remarkable changes in volume. Histologically there was complete desintegration of myelin and axon. Vascular changes included hyalinous thickening, concentric cleavage, fibrinoid degeneration, adventitial fibrosis and edema of small arteries, fibrin thrombi or occlusion of arterioles and capillaries, and telangiectasia of small veins and venules. While other tumors showed hyalinous or fibrous scar tissue and decrease in volume, the gliomas maintained their original volume without residual tumor cells. Massive coagulation necrosis was occasionally found even in full volume, non-irradiated gliomas (controls), although the changes were fewer and not so varied as in typical radiation necrosis. With small dosages, it was difficult to judge whether the necrosis was caused by irradiation or occurred spontaneously. Coagulation necrosis in tumor tissue was found in 25 of 59 cases (42%) of irradiated gliomas, but in only 2 of 49 cases (4%) of the nonirradiated gliomas. In 49 cases no coagulation necrosis of the surrounding tissue was found. Although histopathological judgement is difficult, it is suggested that there is a significant correlation between coagulation necrosis and irradiation. Discussion of the relationship between coagulation necrosis and NSD (nominal standard dose) led to the conclusion that coagulation necrosis will not be caused by irradiation of less than 1400 rets in NSD.

Clinical and CT imaging features of abdominal fat necrosis

International Nuclear Information System (INIS)

Zhao Jinkun; Bai Renju

2013-01-01

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

Histological and ultrastructural effect of an Nd:YAG pulsed laser beam on dental hard tissue and pulp

Science.gov (United States)

Vignato, Costantino; Vignato, Giuseppe; Nardelli, Antonella; Baldan, Arianna; Mason, Pier N.

1994-09-01

The purpose of this study was to determine histological and ultrastructural modifications produced by an Nd:YAG pulsed laser beam after an in vivo exposure of human molars. Using a Nd:YAG pulsed laser beam delivered by a 600 micrometers optical fiber and concurrent air and water cooling spray, 14 human third molars with artificial first class cavities were exposed at different power levels (6, 7, and 8 W). All the teeth were extracted at different time periods between 10 and 25 days and prepared for histological examination. The results of the histological examination showed no evidence of degeneration or necrosis of the pulpar tissue. Analysis of the dentinal surfaces after exposure demonstrated that the dentinal tubules are completely closed due to the melted dentin. In conclusion a Nd:YAG pulsed laser beam with an air and water cooling spray is safe for treatments of class I decay and no necrosis or degeneration of the pulp was found for laser powers of 6, 7, and 8 W.

Enucleación de quiste periapical simultáneo a la obturación del sistema de conductos radiculares

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Lida Velazque

Full Text Available Introducción: los quistes periapicales representan el tipo más frecuente dentro de los quistes odontogénicos. Su origen está relacionado con una necrosis pulpar y un consecuente estímulo de los restos epiteliales del ligamento periodontal (Malassez. Objetivo: describir un caso clínico de enucleación de quiste periapical simultáneo a la obturación del sistema de conductos radiculares. Presentación del caso: paciente de sexo femenino, 67 años de edad, sin alteraciones sistémicas; buscó atención odontológica por presentar dolor dental y acúmulo de alimentos en la región de molares inferiores del lado izquierdo. Al examen clínico se observó caries extensa en el segundo molar inferior izquierdo con compromiso de furca, ausencia de aumento de volumen vestibular, sin fistula; en la radiografía periapical se evidenció lesión cariosa extensa recidivante en el segundo molar inferior izquierdo, y primer molar inferior izquierdo con tratamiento endodóntico y presencia de área radiolúcida de contornos bien definidos en la región periapical compatible con quiste periapical. El tratamiento estuvo a cargo de un equipo multidisciplinario por lo que se decidió realizar exodoncia del segundo molar inferior izquierdo y cirugía paraendodóntica con enucleación quirúrgica simultánea a la obturación del sistema de conductos radiculares primer molar inferior izquierdo; el examen histopatológico de la muestra extraída comprobó tratarse de un quiste periapical. Se realizó seguimiento radiográfico dos años después y mostró un completo reparo óseo del área afectada. Conclusiones: se concluye que el tratamiento descrito constituye una alternativa válida para la resolución de casos donde la endodoncia convencional es limitada para mantener la función y estética de una pieza dentaria.

Indomethacin induced avascular necrosis of head of femur

Science.gov (United States)

Prathapkumar, K; Smith, I; Attara, G

2000-01-01

Chemically induced avascular necrosis of bone is a well documented entity. Indomethacin is one of the causes of this condition but is often difficult to recognise. Review of the literature shows that only one case of indomethacin induced avascular necrosis has been reported in the English language between 1966 and the present.
The case of a young healthy man, who developed avascular necrosis of head of femur after prolonged administration of indomethacin, is reported here.


Keywords: indomethacin; avascular necrosis PMID:10964124

Development of delayed radiation necrosis

International Nuclear Information System (INIS)

Ohara, ShigFeki; Takagi, Terumasa; Shibata, Taichiro; Nagai, Hajime.

1983-01-01

The authors discussed the developing process of delayed radiation necrosis of the brain from the case of a 42-year-old female who developed intracranial hypertension and left hemiparesis 5 and a half years after radiotherapy for pituitary adenoma. The initial sign of radiation necrosis was from a CT scan taken 3 and a half years after radiotherapy showing an irregular low density lesion in the right temporal lobe. CT scan 2 years later demonstrated displacement of the midline structures to the left and a larger low density lesion with partially high density in the right MCA territory that was enhanced with intravenous contrast medium. Recovery after a right temporal lobectomy and administration of steroid hormone were uneventful. Eight months later there were no signs of raised intracranial pressure nor of neurological deficits. Tissues obtained from the right temporal lobe at lobectomy revealed the characteristic changes of delayed radiation necrosis; a mixture of fresh, recent, and old vascular lesions in the same specimen. From these findings, it was speculated that delayed radiation necrosis might initially occur within several years after radiotherapy and might gradually take a progressive and extended course, even in cases whose clinical symptoms develop much later. (author)

Radiation necrosis of the mandible: a 10 year study. Part II. Dental factors; onset, duration and management of necrosis

International Nuclear Information System (INIS)

Murray, C.G.; Herson, J.; Daly, T.E.; Zimmerman, S.

1980-01-01

In a review of patients receiving radiation for cancer in the oral region the rate of radiation necrosis of the mandible was found to be similar for patients who had dental extractions before radiation therapy and for the remainder of the dentate population. It was suggested that diseased teeth should be removed prior to irradiation and sufficient healing time should be allowed. Teeth should not be extracted after irradiation. Dental prostheses can be provided for most irradiated patients if adequate care is exercised. The probability of necrosis commencing was highest three to twelve months after the start of therapy; it diminished gradually after that period. The duration of necrosis was depicted as an exponential curve with a constant probability of necrosis termination at each time point after onset. In 46.8% of the patients in study II (1971-1975), the necrosis was healed by conservative means. This was a significant increase over study I (1966-1969), and a complementary reduction in the necessity for surgical intervention was also found

Poblaciones linfocitarias, células dendríticas y perfil de citoquinas en ratones con melanoma tratados con Uncaria tomentosa

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Iván Lozada-Requena

Full Text Available Objetivos. Evaluar el efecto inmunomodulador sobre poblaciones linfocitarias, células dendríticas (DC, citoquinas Th1/Th2/Th17 (T-helper e inflamatorias en el ámbito sistémico y/o en el microambiente tumoral de ratones con o sin melanoma. Materiales y métodos. Se obtuvieron muestras de sangre periférica y/o de tumores primarios de ratones con melanoma B16 tratados o no con un extracto hidroalcohólico de Uncaria tomentosa (UT con 5,03% de alcaloides oxindólicos pentacíclicos (UT-POA obtenido de la corteza de la planta. Todos los ensayos de medición de células y citoquinas fueron realizados por citometría de flujo. Resultados. UT-POA a nivel sistémico incrementa la relación CD4/CD8a (Cluster of Differenciation, mientras que la activación celular es inversamente proporcional; incrementa la proporción de DCm (DC mieloides; induce un perfil Th1 proinflamatorio y reduce la respuesta Th17. TNF-a (tumor necrosis factor alpha y IL-17A (interleuquina correlacionan positiva y negativamente con la relación CD4/CD8a. Conclusiones. El incremento de Th1 (TNF-a puede tener como consecuencia el incremento de linfocitos CD4 o la activación de macrófagos M1. Aunque UT-POA muestra un incremento de DCm, este no es dosis-dependiente. La disminución de Th17 (IL-17A puede favorecer el funcionamiento de los linfocitos CD8a. UT-POA muestra mejores efectos inmunomoduladores en el ámbito sistémico que intratumoral

Avascular necrosis of bone complicating corticosteroid replacement therapy.

OpenAIRE

Williams, P L; Corbett, M

1983-01-01

Two patients who developed widespread severe avascular necrosis of bone while on steroid replacement therapy are described. One, a diabetic, underwent yttrium-90 pituitary ablation for retinopathy and developed avascular necrosis within 18 months of starting prednisolone. The other, who had Addison's disease, developed avascular necrosis within 14 months of starting cortisol replacement therapy. Both cases came to bilateral total hip replacement.

Tracheal stoma necrosis: a case repor

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Pak S

2017-04-01

Full Text Available Acute tracheal dilatation, due to an overinflated cuff, has been reported early in the course of mechanical ventilation through an endotracheal tube. Tracheal stoma necrosis is a rare complication, but such can accompany acute tracheal dilation. Herein, we report a case of tracheal necrosis 9 days following tracheostomy placement in a 71-year old woman associated with overinflation of the tracheal tube cuff. This case report aims to 1 add to the scant body of knowledge about the diagnosis and management for the patients with tracheal stoma necrosis and 2 raise awareness for error-traps in interpreting diagnostic images, specifically satisfaction of search error, inattentional blindness error, and alliterative error.

Skin Necrosis from Intra-articular Hyaluronic Acid Injection.

Science.gov (United States)

Kim, Whan B; Alhusayen, Raed O

2015-01-01

Tissue necrosis is a rare yet potentially serious complication of intra-articular (IA) hyaluronic acid (HA) injections for treatment of knee osteoarthritis. To report a case of a patient with cutaneous necrosis after IA HA injection for treatment of knee osteoarthritis, presenting as a livedoid violaceous patch on the right knee. We report a case of cutaneous necrosis as a rare complication of IA HA injection for treatment of knee osteoarthritis. A literature review was undertaken of similar cases. Use of HA IA injections in the treatment of osteoarthritis can result in similar skin necrosis at uncommon anatomic locations corresponding to the site of HA injection. Although tissue necrosis is a rare complication, physicians need to be aware of this possibility as a complication of HA IA injections in the treatment of osteoarthritis and should be mindful of potential treatment options to manage this adverse event. © 2014 Canadian Dermatology Association.

Uma abordagem sobre infecções endodônticas

OpenAIRE

Pinto, Sara Isabel Tavares

2016-01-01

As infeções endodônticas envolvem a invasão e multiplicação de microrganismos na polpa dentária e tecidos periapicais sendo responsáveis por dois tipos de patologias: as patologias pulpares e as patologias periapicais. Relativamente às patologias pulpares destacam-se a pulpite reversível, a pulpite irreversível e a necrose pulpar. Quanto às patologias periapicais, destacam-se o abcesso apical agudo, o abcesso apical crónico, a periodontite apical aguda, a periodontite apical crónica, o granul...

ROLE OF THE MITOCHONDRION IN PROGRAMMED NECROSIS

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Christopher eBaines

2010-11-01

Full Text Available In contrast to the programmed nature of apoptosis and autophagy, necrotic cell death has always been believed to be a random, uncontrolled process that leads to the accidental death of the cell. This dogma, however, is being challenged and the concept of necrosis also being programmed is gaining ground. In particular, mitochondria appear to play a pivotal role in the mediation of programmed necrosis. The purpose of this review, therefore, is to appraise the current concepts regarding the signaling mechanisms of programmed necrosis, with specific attention to the contribution of mitochondria to this process.

Piroxicam induced submassive necrosis of the liver.

Science.gov (United States)

Paterson, D; Kerlin, P; Walker, N; Lynch, S; Strong, R

1992-01-01

Several widely used non-steroidal anti-inflammatory drugs have been reported as causing severe hepatitis. Three cases of severe acute hepatitis have been reported in association with piroxicam. A fatal submassive necrosis that occurred in a 68 year old lady who had received piroxicam for 15 months is described. A 48 year old man who developed submassive hepatic necrosis six weeks after beginning piroxicam but was successfully treated with orthotopic liver transplantation is also reported. Piroxicam may induce submassive necrosis of the liver, probably as an idiosyncratic reaction. Images Figure 1 Figure 2 Figure 3 PMID:1446877

Predictive value of histologic tumor necrosis after radiation.

Science.gov (United States)

Chen, Y; Taghian, A G; Rosenberg, A E; O'Connell, J; Okunieff, P; Suit, H D

2001-12-20

Postsurgical evaluation of histologic changes of tumors after preoperative chemotherapy and/or radiotherapy has been a routine clinical practice of pathologists and oncologists. There appears to be secure evidence that the extent of tumor necrosis vs. viable tumor cells postchemotherapy is a clinically useful predictor of outcome. The significance of histologic tumor necrosis after radiotherapy, however, has not been clearly established and deserves further investigation. We investigated the correlation between histological extent of tumor necrosis, survival of tumor transplants, and radiation doses in an experimental model using three human tumor xenografts. Three human tumor cell lines were investigated: STS-26, SCC-21, and HGL-21. Tumors were grown subcutaneously in athymic nude mice and received external beam radiation of different doses. Tumors were excised 2 weeks postirradiation. One-half of the tumor was divided into 1-mm(3) fragments and transplanted to naive mice. The other half was examined for histologic tumor necrosis. Transplant survival was strongly correlated with radiation dose, TCD(p) (radiation dose that results in local tumor control in proportion, p, to irradiated tumors). In contrast, there was no clear association between transplant survival rate and the extent of tumor necrosis. The experimental model demonstrated a strong inverse correlation between radiation doses and tumor transplant survival. Histologic tumor necrosis did not correlate well with radiation doses or transplant survival rates. Despite common practices in histologic examination of tumors posttherapy, clinical interpretations and implications of histologic tumor necrosis after radiotherapy should be considered with caution. Copyright 2001 Wiley-Liss, Inc.

Widespread marrow necrosis during pregnancy

International Nuclear Information System (INIS)

Knickerbocker, W.J.; Quenville, N.F.

1982-01-01

Recently, a 22-year-old Caucasian female was referred to our Hospital two days post-partum. She had been feeling unwell during the last few days of her pregnancy and complained of multiple aches and pains, worst in the abdomen and lower back. Her admission platelet count was severely depressed and a bone biopsy showed extensive marrow necrosis with viable bony trabeculae. There was no evidence of vasculitis, vascular thrombosis, or malignancy. Widespread marrow necrosis in pregnancy followed by recovery, to our knowledge, has not been previously reported. (orig.)

Skin Flap Necrosis After Mastectomy With Reconstruction: A Prospective Study.

Science.gov (United States)

Matsen, Cindy B; Mehrara, Babak; Eaton, Anne; Capko, Deborah; Berg, Anastasia; Stempel, Michelle; Van Zee, Kimberly J; Pusic, Andrea; King, Tari A; Cody, Hiram S; Pilewskie, Melissa; Cordeiro, Peter; Sclafani, Lisa; Plitas, George; Gemignani, Mary L; Disa, Joseph; El-Tamer, Mahmoud; Morrow, Monica

2016-01-01

Rates of mastectomy with immediate reconstruction are rising. Skin flap necrosis after this procedure is a recognized complication that can have an impact on cosmetic outcomes and patient satisfaction, and in worst cases can potentially delay adjuvant therapies. Many retrospective studies of this complication have identified variable event rates and inconsistent associated factors. A prospective study was designed to capture the rate of skin flap necrosis as well as pre-, intra-, and postoperative variables, with follow-up assessment to 8 weeks postoperatively. Uni- and multivariate analyses were performed for factors associated with skin flap necrosis. Of 606 consecutive procedures, 85 (14 %) had some level of skin flap necrosis: 46 mild (8 %), 6 moderate (1 %), 31 severe (5 %), and 2 uncategorized (0.3 %). Univariate analysis for any necrosis showed smoking, history of breast augmentation, nipple-sparing mastectomy, and time from incision to specimen removal to be significant. In multivariate models, nipple-sparing, time from incision to specimen removal, sharp dissection, and previous breast reduction were significant for any necrosis. Univariate analysis of only moderate or severe necrosis showed body mass index, diabetes, nipple-sparing mastectomy, specimen size, and expander size to be significant. Multivariate analysis showed nipple-sparing mastectomy and specimen size to be significant. Nipple-sparing mastectomy was associated with higher rates of necrosis at every level of severity. Rates of skin flap necrosis are likely higher than reported in retrospective series. Modifiable technical variables have limited the impact on rates of necrosis. Patients with multiple risk factors should be counseled about the risks, especially if they are contemplating nipple-sparing mastectomy.

MRI Findings of Pericardial Fat Necrosis: Case Report

International Nuclear Information System (INIS)

Lee, Hyo Hyeok; Ryu, Dae Shick; Jung, Sang Sig; Jung, Seung Mun; Choi, Soo Jung; Shin, Dae Hee

2011-01-01

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

Implication of snail in metabolic stress-induced necrosis.

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Cho Hee Kim

2011-03-01

Full Text Available Necrosis, a type of cell death accompanied by the rupture of the plasma membrane, promotes tumor progression and aggressiveness by releasing the pro-inflammatory and angiogenic cytokine high mobility group box 1. It is commonly found in the core region of solid tumors due to hypoxia and glucose depletion (GD resulting from insufficient vascularization. Thus, metabolic stress-induced necrosis has important clinical implications for tumor development; however, its regulatory mechanisms have been poorly investigated.Here, we show that the transcription factor Snail, a key regulator of epithelial-mesenchymal transition, is induced in a reactive oxygen species (ROS-dependent manner in both two-dimensional culture of cancer cells, including A549, HepG2, and MDA-MB-231, in response to GD and the inner regions of a multicellular tumor spheroid system, an in vitro model of solid tumors and of human tumors. Snail short hairpin (sh RNA inhibited metabolic stress-induced necrosis in two-dimensional cell culture and in multicellular tumor spheroid system. Snail shRNA-mediated necrosis inhibition appeared to be linked to its ability to suppress metabolic stress-induced mitochondrial ROS production, loss of mitochondrial membrane potential, and mitochondrial permeability transition, which are the primary events that trigger necrosis.Taken together, our findings demonstrate that Snail is implicated in metabolic stress-induced necrosis, providing a new function for Snail in tumor progression.

In vivo evidence for a functional role of both tumor necrosis factor (TNF) receptors and transmembrane TNF in experimental hepatitis.

Science.gov (United States)

Küsters, S; Tiegs, G; Alexopoulou, L; Pasparakis, M; Douni, E; Künstle, G; Bluethmann, H; Wendel, A; Pfizenmaier, K; Kollias, G; Grell, M

1997-11-01

The significance of tumor necrosis factor receptor 1 (TNFR1) for TNF function in vivo is well documented, whereas the role of TNFR2 so far remains obscure. In a model of concanavalin A (Con A)-induced, CD4+ T cell-dependent experimental hepatitis in mice, in which TNF is a central mediator of apoptotic and necrotic liver damage, we now provide evidence for an essential in vivo function of TNFR2 in this pathophysiological process. We demonstrate that a cooperation of TNFR1 and TNFR2 is required for hepatotoxicity as mice deficient of either receptor were resistant against Con A. A significant role of TNFR2 for Con A-induced hepatitis is also shown by the enhanced sensitivity of transgenic mice overexpressing the human TNFR2. The ligand for cytotoxic signaling via both TNF receptors is the precursor of soluble TNF, i.e. transmembrane TNF. Indeed, transmembrane TNF is sufficient to mediate hepatic damage, as transgenic mice deficient in wild-type soluble TNF but expressing a mutated nonsecretable form of TNF developed inflammatory liver disease.

Acute Necrotizing Esophagitis Followed by Duodenal Necrosis

Science.gov (United States)

del Hierro, Piedad Magdalena

2011-01-01

Acute Necrotizing Esophagitis is an uncommon pathology, characterized by endoscopic finding of diffuse black coloration in esophageal mucosa and histological presence of necrosis in patients with upper gastrointestinal bleeding. The first case of acute necrotizing esophagitis followed by duodenal necrosis, in 81 years old woman with a positive history of Type 2 Diabetes Mellitus, Hypertension, and usual intake of Nonsteroidal Anti-inflammatory drugs, is reported. Although its etiology remains unknown, the duodenal necrosis suggests that ischemia could be the main cause given that the branches off the celiac axis provide common blood supply to the distal esophageal and duodenal tissue. The massive gastroesophagic reflux and NSAID intake could be involved. PMID:27957030

Intracellular serpins, firewalls and tissue necrosis.

Science.gov (United States)

Marciniak, Stefan J; Lomas, David A

2008-02-01

Luke and colleagues have recently attributed a new role to a member of the serpin superfamily of serine proteinase inhibitors. They have used Caenorhabditis elegans to show that an intracellular serpin is crucial for maintaining lysosomal integrity. We examine the role of this firewall in preventing necrosis and attempt to integrate this with current theories of stress-induced protein degradation. We discuss how mutant serpins cause disease either through polymerization or now, perhaps, by unleashing necrosis.

Necrosis de injerto de tejido conectivo subepitelial asociado a incompetencia labial: Reporte de un caso clínico

OpenAIRE

Basualdo,Javier; Niño,Ana Y

2015-01-01

Se describe el reporte del caso de una paciente sana con incompetencia labial portadora de un implante dental en la zona de 1.2, a la cual se le realizó un injerto de tejido conectivo utilizando la técnica del «sobre» para mejorar un leve defecto estético existente. El injerto sufrió una necrosis, posiblemente debido a la condición de deshidratación a la que están sometidos los tejidos en estos pacientes que presentan incompetencia labial y respiración bucal. Se describe la resolución quirúrg...

Desarrollo de infección tuberculosa latente y efectos adversos de la isoniazida durante tratamiento con biológico por Enfermedad de Crohn

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María Alejandra Arriola

2017-12-01

Full Text Available Los fármacos anti factor de necrosis tumoral alfa (TNF-a bloquean una de las citoquinas implicadas en la patogénesis de la Enfermedad Inflamatoria intestinal (EII. Su uso se relaciona con aumento de tuberculosis (TB, por lo que el despistaje previo es obligatorio. En la infección tuberculosa latente (ITBL se utiliza isoniazida como quimioprofilaxis, fármaco que no se encuentra libre de reacciones adversas. Se presenta y discute el caso de una paciente con reacción adversa en piel secundaria al uso de isoniazida.

Bilateral acute retinal necrosis after herpetic meningitis

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Katsura T

2012-04-01

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

Biomechanical comparisons between a new avascular necrosis of femaral head stem based on Chinese patients with avascular necrosis and two other designs.

Science.gov (United States)

Zhang, Qiang; Cheng, Cheng-Kung; Wei, Hung-Wen; Dong, Xiang; Chen, Yi-Ting; Lai, Yu-Shu; Wang, Yan

2013-01-01

There is a relatively high failure rate of the femoral component in patients with avascular necrosis at the intermediate-term follow-up. Improving the geometrical fit of the femoral stem against the medullary canal may help to provide long-term survivorship of the hip replacement for patients with avascular necrosis. We designed a specific stem, based on morphometric studies of proximal femoral canals in Chinese avascular necrosis patients and evaluated the stem by finite element analyses, comparing the novel stem with two commercially available and commonly used stems. The morphometric data from avascular necrosis patients showed specific geometric differences in the proximal femoral canal, including profile curves in both the sagittal and coronary planes than the patients with femoral neck fracture. The shorter stemmed prostheses (Fitmore(®) and our stem) performed better than the longer stemmed prosthesis (VerSys(®)). This is the first study to investigate the femoral geometries of Chinese avascular necrosis patients. Our stem provides better stability and is theoretically beneficial to bone ingrowth, which may increase the long-term stability and fixation of the implant.

Subcutaneous fat necrosis of the newborn.

Science.gov (United States)

Oswalt, G C; Montes, L F; Cassady, G

1978-08-01

Subcutaneous fat necrosis of the newborn (SFNN) developed in a 1-week-old black boy. His mother had received numerous medications for eclampsia. Birth was by Caesarean section and complicated by meconium aspiration. There were numerous nodules over the back, buttocks and extremities that yielded a caseous-like material. Microscopically, these nodules showed crystallization and necrosis of the fat. Hypoglycemia, pneumonia, oliguria, thrombocytopenia, seizures and urinary infection were associated with the cutaneous problem and led to a fatal outcome 2 weeks after birth.

'Femoral head necrosis' in metabolic and hormonal osteopathies

International Nuclear Information System (INIS)

Heuck, F.H.W.; Treugut, H.

1984-01-01

The pathogenesis of bone necrosis is discussed with special attention and with respect to metabolic, hormonal, and vascular factors. The influence of statics and dynamics of the hip joint bones for the development of aseptic necrosis are discussed. 45 patients with ''idiopathic femoral head necroses'' were observed, including 6 cases of renal osteopathy following renal transplantation and immune suppression therapy, 14 cases of long term corticoid therapy, and 11 cases of liver diseases of different genesis. The femoral head necrosis understood as complication of an osteopathy. In our patients there were 31 males and 14 females - which means higher involvement of males. Plain radiological findings and CT-findings of changes of the femoral heat structure in different stages of the disease are described. Early diagnosis of metabolic and hormonal osteopathies is demanded for a joint keeping therapy of the beginning femoral head necrosis. (orig.) [de

Development of delayed radiation necrosis. Case report

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Ohara, ShigFeki; Takagi, Terumasa [Meitetsu Hospital, Nagoya (Japan); Shibata, Taichiro; Nagai, Hajime

1983-04-01

The authors discussed the developing process of delayed radiation necrosis of the brain from the case of a 42-year-old female who developed intracranial hypertension and left hemiparesis 5 and a half years after radiotherapy for pituitary adenoma. The initial sign of radiation necrosis was from a CT scan taken 3 and a half years after radiotherapy showing an irregular low density lesion in the right temporal lobe. CT scan 2 years later demonstrated displacement of the midline structures to the left and a larger low density lesion with partially high density in the right MCA territory that was enhanced with intravenous contrast medium. Recovery after a right temporal lobectomy and administration of steroid hormone were uneventful. Eight months later there were no signs of raised intracranial pressure nor of neurological deficits. Tissues obtained from the right temporal lobe at lobectomy revealed the characteristic changes of delayed radiation necrosis; a mixture of fresh, recent, and old vascular lesions in the same specimen. From these findings, it was speculated that delayed radiation necrosis might initially occur within several years after radiotherapy and might gradually take a progressive and extended course, even in cases whose clinical symptoms develop much later.

Bevacizumab as a treatment option for radiation-induced cerebral necrosis

Energy Technology Data Exchange (ETDEWEB)

Matuschek, Christiane; Boelke, Edwin; Budach, Wilfried [Univ. Hospital Duesseldorf (Germany). Dept. of Radiation Oncology; Nawatny, Jens [Univ. Hospital Duesseldorf (Germany). Dept. of Radiology; Hoffmann, Thomas K. [Duisburg-Essen Univ., Essen (Germany). Dept. of Otorhinolaryngology; Peiper, Matthias; Orth, Klaus [Hospital Essen-Sued, Essen (Germany). Dept. of Surgery; Gerber, Peter Arne [Univ. Hospital Duesseldorf (Germany). Dept. of Dermatology; Rusnak, Ethelyn [State Univ. of New York, Buffalo, NY (United States). Dept. of Anesthesiology; Lammering, Guido [Univ. Hospital Duesseldorf (Germany). Dept. of Radiation Oncology; MAASTRO Clinic, Maastricht (Netherlands). Radiation Oncology

2011-02-15

Radiation necrosis of normal CNS tissue represents one of the main risk factors of brain irradiation, occurring more frequently and earlier at higher total doses and higher doses per fraction. At present, it is believed that the necrosis results due to increasing capillary permeability caused by cytokine release leading to extracellular edema. This process is sustained by endothelial dysfunction, tissue hypoxia, and subsequent necrosis. Consequently, blocking the vascular endothelial growth factor (VEGF) at an early stage could be an option to reduce the development of radiation necrosis by decreasing the vascular permeability. This might help to reverse the pathological mechanisms, improve the symptoms and prevent further progression. A patient with radiation-induced necrosis was treated with an anti-VEGF antibody (bevacizumab), in whom neurologic signs and symptoms improved in accordance with a decrease in T1-weighted fluid-attenuated inversion recovery signals. Our case report together with the current literature suggests bevacizumab as a treatment option for patients with symptoms and radiological signs of cerebral necrosis induced by radiotherapy. (orig.)

Bevacizumab as a treatment option for radiation-induced cerebral necrosis

International Nuclear Information System (INIS)

Matuschek, Christiane; Boelke, Edwin; Budach, Wilfried; Nawatny, Jens; Hoffmann, Thomas K.; Peiper, Matthias; Orth, Klaus; Gerber, Peter Arne; Rusnak, Ethelyn; Lammering, Guido; MAASTRO Clinic, Maastricht

2011-01-01

Radiation necrosis of normal CNS tissue represents one of the main risk factors of brain irradiation, occurring more frequently and earlier at higher total doses and higher doses per fraction. At present, it is believed that the necrosis results due to increasing capillary permeability caused by cytokine release leading to extracellular edema. This process is sustained by endothelial dysfunction, tissue hypoxia, and subsequent necrosis. Consequently, blocking the vascular endothelial growth factor (VEGF) at an early stage could be an option to reduce the development of radiation necrosis by decreasing the vascular permeability. This might help to reverse the pathological mechanisms, improve the symptoms and prevent further progression. A patient with radiation-induced necrosis was treated with an anti-VEGF antibody (bevacizumab), in whom neurologic signs and symptoms improved in accordance with a decrease in T1-weighted fluid-attenuated inversion recovery signals. Our case report together with the current literature suggests bevacizumab as a treatment option for patients with symptoms and radiological signs of cerebral necrosis induced by radiotherapy. (orig.)

A Case of Trapezium Avascular Necrosis Treated Conservatively.

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Petsatodis, Evangelos; Ditsios, Konstantinos; Konstantinou, Panagiotis; Pinto, Iosafat; Kostretzis, Lazaros; Theodoroudis, Ioannis; Pilavaki, Mayia

2017-01-01

Avascular necrosis (AVN) of the bones of the wrist most commonly involves the lunate followed by the proximal pole of the scaphoid and the capitate. Trapezium avascular necrosis is extremely rare with only two cases reported in the literature, both of which were treated surgically. In this article, we report a unique case of trapezium avascular necrosis treated conservatively. A 38-year-old man complaining of a 4-month history of mild pain on the base of his right thumb. MRI scan was performed. The clinical presentation and the imaging findings indicated avascular osteonecrosis of the trapezium. The patient was treated with immobilization of the wrist joint for a period of six weeks. Three months later, the patient was free of symptoms and the MRI scan revealed a normal trapezium. AVN of trapezium is extremely rare. Our case shows that immobilization of an early stage avascular necrosis of the trapezium might be a treatment option.

Pathological features of cerebral radiation necrosis - Part I

International Nuclear Information System (INIS)

Lefaix, J.L.

1992-01-01

Cerebral radiation necrosis is a major hazard of radiation therapy involving delivery of high doses of radiation to the brain. It is generally irreversible and frequently leads to death from brain necrosis. Necrosis has been reported with total doses of 50-60 Gy, delivered in conventional fractions of 1.7 to 2 Gy daily. Signs and symptoms depend upon the volume of brain irradiated and are frequently those of an intracranial mass. Injury tends to be more severe in white matter and may be present as an area of gliosis or frank necrosis. Possible causes include some direct effect of radiation on glial cells, vascular changes and the action of an immunological mechanism. The weight of evidence suggests that demyelination is important in the early delayed reaction, and that vascular changes gradually become more important in the late delayed reactions, several months to years after treatment. Late delayed radiation injuries of the brain and spinal cord are reviewed in man, dog, monkey and rat

A Case of Trapezium Avascular Necrosis Treated Conservatively

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Evangelos Petsatodis

2017-01-01

Full Text Available Introduction. Avascular necrosis (AVN of the bones of the wrist most commonly involves the lunate followed by the proximal pole of the scaphoid and the capitate. Trapezium avascular necrosis is extremely rare with only two cases reported in the literature, both of which were treated surgically. In this article, we report a unique case of trapezium avascular necrosis treated conservatively. Case Presentation. A 38-year-old man complaining of a 4-month history of mild pain on the base of his right thumb. MRI scan was performed. The clinical presentation and the imaging findings indicated avascular osteonecrosis of the trapezium. The patient was treated with immobilization of the wrist joint for a period of six weeks. Three months later, the patient was free of symptoms and the MRI scan revealed a normal trapezium. Conclusion. AVN of trapezium is extremely rare. Our case shows that immobilization of an early stage avascular necrosis of the trapezium might be a treatment option.

Identification of avascular necrosis in the dysplastic proximal femoral epiphysis

International Nuclear Information System (INIS)

Mandell, G.A.; Harcke, H.T.; MacKenzie, W.G.; Bassett, G.S.; Scott, C.I. Jr.; Wills, J.S.

1989-01-01

Bilateral radiographic irregularities and deformities of the proximal femoral epiphyses are features of both multiple epiphyseal dysplasia and bilateral idiopathic avascular necrosis. In the past these entities have been difficult to differentiate. This report documents radiographically the occurrence of avascular necrosis in 10 patients with multiple epiphyseal dysplasia by recognizing the superimposition of sclerosis and subchondral fissuring on pre-existing symmetrically irregular proximal femoral ossification centers. Scintigraphic (photopenia) or magnetic resonance (loss of signal) criteria of avascular necrosis confirm its added presence and help to establish an imaging scheme to identify avascular necrosis superimposed on multiple epiphyseal dysplasia. (orig.)

Identification of avascular necrosis in the dysplastic proximal femoral epiphysis

Energy Technology Data Exchange (ETDEWEB)

Mandell, G A; Harcke, H T [Alfred I. duPont Inst., Wilmington, DE (USA). Dept. of Medical Imaging; MacKenzie, W G; Bassett, G S [Alfred I. duPont Inst., Wilmington, DE (USA). Dept. of Orthopaedics; Scott, Jr, C I [Alfred I. duPont Inst., Wilmington, DE (USA). Dept. of Genetics; Wills, J S [Medical Center of Delaware, Newark, DE (USA). Dept. of Radiology

1989-07-01

Bilateral radiographic irregularities and deformities of the proximal femoral epiphyses are features of both multiple epiphyseal dysplasia and bilateral idiopathic avascular necrosis. In the past these entities have been difficult to differentiate. This report documents radiographically the occurrence of avascular necrosis in 10 patients with multiple epiphyseal dysplasia by recognizing the superimposition of sclerosis and subchondral fissuring on pre-existing symmetrically irregular proximal femoral ossification centers. Scintigraphic (photopenia) or magnetic resonance (loss of signal) criteria of avascular necrosis confirm its added presence and help to establish an imaging scheme to identify avascular necrosis superimposed on multiple epiphyseal dysplasia. (orig.).

Subcutaneous encapsulated fat necrosis

DEFF Research Database (Denmark)

Aydin, Dogu; Berg, Jais O

2016-01-01

We have described subcutaneous encapsulated fat necrosis, which is benign, usually asymptomatic and underreported. Images have only been published on two earlier occasions, in which the necrotic nodules appear "pearly" than the cloudy yellow surface in present case. The presented image may help...

Avascular necrosis of bone following renal transplantation | Naiker ...

African Journals Online (AJOL)

Alcohol conswnption and radiological evidence of osteoporosis were more prevalent in the avascular necrosis group (42,8% v. 29,0% and 28,5% v. 7,2% respectively). Avascular necrosis did not correlate with age, sex, renal function at 1 year or severe secondary hyperparathyroidism. This study suggests that corticosteroid ...

El estrés por temperatura provoca necrosis en tabaco negro; cuantificación por análisis de imágenes

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Eduardo Ortega

2008-07-01

de imágenes ImageJ. Este programa es capaz de adquirir, mostrar, editar, resaltar y analizar imágenes. Se demostró que las hojas sometidas a 4 ºC, independientemente del tiempo de exposición, presentaron una mayor área necrosada (35% en comparación con el resto de los tratamientos. Las áreas con acumulación de H2O2 in situ fueron mayores en los tratamientos de estrés por temperaturas altas (45 y 60 oC. La detección y cuantificación de la necrosis producida por temperaturas extremas, combinando el método del azul de tripano con el análisis de imágenes, es una herramienta útil para valorar los daños producidos por estrés de temperaturas y pudiera ser utilizado para valorar los daños celulares provocados por otros tipos de estrés.Palabras clave: variedad-Habana-2000; especies reactivas de oxígeno; H2O2;; Habana-2000-variety; reactive oxygen species.

[Acute unclassified leukemia with bone marrow necrosis].

Science.gov (United States)

Uoshima, N; Yamazaki, N; Iinuma, S; Kimura, S; Wada, K; Kobayashi, Y; Ozawa, M; Horiuchi, H; Maruo, N; Kondo, M

1991-01-01

Massive bone marrow necrosis was seen in a 42-year-old male with acute leukemia. In December, 1988, on admission, laboratory data revealed pancytopenia and a high level of serum LDH and ALKP. Bone marrow aspiration resulted in dry-tap and showed bone marrow necrosis in the bone marrow biopsy specimen. A bone marrow scintigraphy with 111In faintly visualized the bone marrow but visualized area was expanded in the extremities compared with normal subjects. The second bone marrow biopsy showed proliferation of blasts. In the middle of March, blasts began to appear in peripheral blood. The blasts were cytochemically negative for POX, Es, PAS, AcP, TdT and had surface markers CD3-, CD19-, CD33-, CD13-, LCA-, HLA-DR-. Even by investigation on rearrangement of the immunoglobulin heavy chain region, an origin of the blasts could not be determined. In April, the number of blasts in peripheral blood increased and hepatosplenomegaly developed rapidly. Therefore, he was put on the chemotherapy with vincristine and prednisolone, but he died of cerebral hemorrhage. The autopsy revealed widespread bone marrow necrosis. It has rarely been reported that massive bone marrow necrosis is found prior to the occurrence of acute unclassified leukemia.

Avascular necrosis of the trapezoid bone following carpometacarpal arthroplasty.

Science.gov (United States)

Kane, Patrick; Waryasz, Greg; Katarincic, Julie

2014-03-03

A 58-year-old female developed avascular necrosis of her trapezoid approximately 3 months after undergoing carpometacarpal arthroplasty. The patient was treated conservatively with immobilization and had complete resolution of her clinical symptoms during her year of follow-up. Additionally, radiographic examination showed complete restoration of the height of her trapezoid approximately 1 year after the index procedure. Avascular necrosis of the trapezoid is extremely rare with very few cases described in the literature. This is the first description of avascular necrosis following carpometacarpal arthroplasty.

Imaging of cavitary necrosis in complicated childhood pneumonia

International Nuclear Information System (INIS)

Hodina, M.; Schnyder, P.; Gudinchet, F.; Hanquinet, S.; Cotting, J.

2002-01-01

The aim of this study was to illustrate the chest radiographs (CR) and CT imaging features and sequential findings of cavitary necrosis in complicated childhood pneumonia. Among 30 children admitted in the Pediatric Intensive Care Unit for persistent or progressive pneumonia, respiratory distress or sepsis despite adequate antibiotic therapy, a study group of 9 children (5 girls and 4 boys; mean age 4 years) who had the radiographic features and CT criteria for cavitary necrosis complicated pneumonia was identified. The pathogens identified were Streptococcus pneumoniae (n=4), Aspergillus (n=2), Legionella (n=1), and Staphylococcus aureus (n=1). Sequential CR and CT scans were retrospectively reviewed. Follow-up CR and CT were evaluated for persistent abnormalities. Chest radiographs showed consolidations in 8 of the 9 patients. On CT examination, cavitary necrosis was localized to 1 lobe in 2 patients and 7 patients showed multilobar or bilateral areas of cavitary necrosis. In 3 patients of 9, the cavitary necrosis was initially shown on CT and visualization by CR was delayed by a time span varying from 5 to 9 days. In all patients with cavities, a mean number of five cavities were seen on antero-posterior CR, contrasting with the multiple cavities seen on CT. Parapneumonic effusions were shown by CR in 3 patients and in 5 patients by CT. Bronchopleural fistulae were demonstrated by CT alone (n=3). No purulent pericarditis was demonstrated. The CT scan displayed persistent residual pneumatoceles of the left lower lobe in 2 patients. Computed tomography is able to define a more specific pattern of abnormalities than conventional CR in children with necrotizing pneumonia and allows an earlier diagnosis of this rapidly progressing condition. Lung necrosis and cavitation may also be associated with Aspergillus or Legionella pneumonia in the pediatric population. (orig.)

Differential diagnosis of metastases in bone scans: chemotherapy induced bone necrosis

International Nuclear Information System (INIS)

Reuland, P.

1999-01-01

Aim: Influenced by the incorrect diagnosis of a bone metastasis caused by bone necrosis we evaluated reasons and frequency of bone necrosis in patients referred for bone scanning in follow-up of tumors. Methods: Bone scans performed within two years on patients with primary bone tumors or tumors metastatic to bone were reviewed in respect to the final diagnosis bone necrosis. Results: We found the cases of three young patients who presented the appearance of hot spots on bone scintigrams which were finally diagnosed as bone necrosis. In two cases the diagnosis was based on histological findings, in one case the diagnosis was made evident by follow-up. All the three patients had been treated by chemotherapy and presented no other reason for the development of bone necrosis. Enhanced tracer uptake in all sites decreased within eight weeks up to two years without therapy. Conclusion: Single and multiple hot spots after chemotherapy may be originated by bone necrosis but mimikry metastases. (orig.) [de

Management of infected pancreatic necrosis: state of the art

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Roberto Rasslan

Full Text Available ABSTRACT Pancreatic necrosis occurs in 15% of acute pancreatitis. The presence of infection is the most important factor in the evolution of pancreatitis. The diagnosis of infection is still challenging. Mortality in infected necrosis is 20%; in the presence of organic dysfunction, mortality reaches 60%. In the last three decades, there has been a real revolution in the treatment of infected pancreatic necrosis. However, the challenges persist and there are many unsolved questions: antibiotic treatment alone, tomography-guided percutaneous drainage, endoscopic drainage, video-assisted extraperitoneal debridement, extraperitoneal access, open necrosectomy? A step up approach has been proposed, beginning with less invasive procedures and reserving the operative intervention for patients in which the previous procedure did not solve the problem definitively. Indication and timing of the intervention should be determined by the clinical course. Ideally, the intervention should be done only after the fourth week of evolution, when it is observed a better delimitation of necrosis. Treatment should be individualized. There is no procedure that should be the first and best option for all patients. The objective of this work is to critically review the current state of the art of the treatment of infected pancreatic necrosis.

MR imaging of avascular necrosis of carpal bones

International Nuclear Information System (INIS)

Taniguchi, Yasunori; Funaoka, Nobuhiko; Yoshida, Munehito; Iwahashi, Toshiyuki; Egawa, Hiromitsu; Shima, Kimihiro; Tamaoki, Tetsuya.

1991-01-01

The usefulness of MRI in carpal avascular necrosis was investigated in 20 cases, 16 in lunates, 3 in scaphoids and 1 in triquetrum, with T1 and T2 weighted images of the spin echo and T2 weighted images of the field echo. Early diagnosis of carpal bone necrosis was possible when the T1 weighted image showed a moderate low intensity signal. A high intensity signal in the T2 weighted image indicated the onset of revascularization, and a favorable prognosis. A normal signal indicated healing of carpal avascular necrosis. MRI was found to be very useful in establishing the diagnosis and in determining the prognosis of carpal osteonecrosis. (author)

MR imaging of avascular necrosis of carpal bones

Energy Technology Data Exchange (ETDEWEB)

Taniguchi, Yasunori; Funaoka, Nobuhiko; Yoshida, Munehito [Kinan General Hospital, Wakayama (Japan); Iwahashi, Toshiyuki; Egawa, Hiromitsu; Shima, Kimihiro; Tamaoki, Tetsuya

1991-03-01

The usefulness of MRI in carpal avascular necrosis was investigated in 20 cases, 16 in lunates, 3 in scaphoids and 1 in triquetrum, with T1 and T2 weighted images of the spin echo and T2 weighted images of the field echo. Early diagnosis of carpal bone necrosis was possible when the T1 weighted image showed a moderate low intensity signal. A high intensity signal in the T2 weighted image indicated the onset of revascularization, and a favorable prognosis. A normal signal indicated healing of carpal avascular necrosis. MRI was found to be very useful in establishing the diagnosis and in determining the prognosis of carpal osteonecrosis. (author).

Research and advancement of treating avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Wang Kaibing; Bai Bin; Wang Honghui; Sui Hong

2006-01-01

To undertake retrospective analysis of the research and advancement of treating avascular necrosis of the femoral head. After comparing the superiority and inferiority of different treatments and the present therapeutic status many therapeutic methods for avascular necrosis of the femoral head have been performed, commonly according to the staging of necrosis. Conservative therapy is suitable for stage 0-I, interventional therapy is suitable for stage II-III, operation is adapted for stage II-III and femoral head collapse or degenerative changes. Avascular necrosis of the femoral head is a chronic and dysfunctional illness. Comprehensive treatment according to different stage is now the most popular. Interventional therapy is the study focus of the avascular necrosis of the femoral head meanwhile. (authors)

Atraumatic Pantalar Avascular Necrosis in a Patient With Alcohol Dependence.

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Callachand, Fayaz; Milligan, David; Wilson, Alistair

2016-01-01

In the United States, an estimated 10,000 to 20,000 new cases of avascular necrosis are diagnosed each year. We present an unusual case of atraumatic avascular necrosis with widespread hindfoot and midfoot involvement. A 62-year-old female with a history of alcohol dependence and smoking, who had previously been treated for avascular necrosis of the knee, presented with right-sided foot pain and difficulty weightbearing. Imaging studies revealed extensive avascular necrosis of the hindfoot and midfoot, which precluded simple surgical intervention. The patient was followed up for 18 months. In the last 8 months of the 18-month period, the patient managed her symptoms using an ankle-foot orthosis. A diagnosis of avascular necrosis should be considered in patients with atraumatic foot and ankle pain, especially in the presence of risk factors such as alcohol excess and smoking. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Mammographic and sonographic features of fat necrosis of the breast

International Nuclear Information System (INIS)

Upadhyaya, Vidya S; Uppoor, Raghuraj; Shetty, Lathika

2013-01-01

Imaging features of fat necrosis vary depending on its stage of evolution and can mimic malignancy in late stages. Imaging may suffice to differentiate fat necrosis in the early stages from malignancy and thus avoid unnecessary biopsy. In this pictorial essay, we present combination of benign features in mammography and/or ultrasonography (USG) that can lead to imaging diagnosis of fat necrosis. The follow-up imaging features of fat necrosis which mirror its pathophysiological evolution have also been demonstrated. To summarize, in the appropriate clinical setting, no mammographic features suspicious for malignancy should be present. When the typical mammographic features are not present, USG can aid with the diagnosis and follow up USG can confirm it

The Extracellular Matrix Regulates Granuloma Necrosis in Tuberculosis.

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Al Shammari, Basim; Shiomi, Takayuki; Tezera, Liku; Bielecka, Magdalena K; Workman, Victoria; Sathyamoorthy, Tarangini; Mauri, Francesco; Jayasinghe, Suwan N; Robertson, Brian D; D'Armiento, Jeanine; Friedland, Jon S; Elkington, Paul T

2015-08-01

A central tenet of tuberculosis pathogenesis is that caseous necrosis leads to extracellular matrix destruction and bacterial transmission. We reconsider the underlying mechanism of tuberculosis pathology and demonstrate that collagen destruction may be a critical initial event, causing caseous necrosis as opposed to resulting from it. In human tuberculosis granulomas, regions of extracellular matrix destruction map to areas of caseous necrosis. In mice, transgenic expression of human matrix metalloproteinase 1 causes caseous necrosis, the pathological hallmark of human tuberculosis. Collagen destruction is the principal pathological difference between humanised mice and wild-type mice with tuberculosis, whereas the release of proinflammatory cytokines does not differ, demonstrating that collagen breakdown may lead to cell death and caseation. To investigate this hypothesis, we developed a 3-dimensional cell culture model of tuberculosis granuloma formation, using bioelectrospray technology. Collagen improved survival of Mycobacterium tuberculosis-infected cells analyzed on the basis of a lactate dehydrogenase release assay, propidium iodide staining, and measurement of the total number of viable cells. Taken together, these findings suggest that collagen destruction is an initial event in tuberculosis immunopathology, leading to caseous necrosis and compromising the immune response, revealing a previously unappreciated role for the extracellular matrix in regulating the host-pathogen interaction. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Tumour Necrosis Factor-alpha and Nuclear Factor-kappa B Gene Variants in Sepsis.

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Acar, Leyla; Atalan, Nazan; Karagedik, E Hande; Ergen, Arzu

2018-01-20

The humoral system is activated and various cytokines are released due to infections in tissues and traumatic damage. Nuclear factor-kappa B dimers are encoded by nuclear factor-kappa B genes and regulate transcription of several crucial proteins of inflammation such as tumour necrosis factor-alpha. To investigate the possible effect of polymorphisms on tumour necrosis factor-alpha serum levels with clinical and prognostic parameters of sepsis by determining the nuclear factor-kappa B-1-94 ins/del ATTG and tumour necrosis factor-alpha (-308 G/A) gene polymorphisms and tumour necrosis factor-alpha serum levels. Case-control study. Seventy-two patients with sepsis and 104 healthy controls were included in the study. In order to determine the polymorphisms of nuclear factor-kappa B-1-94 ins/del ATTG and tumour necrosis factor-alpha (-308 G/A), polymerase chain reaction-restriction fragment length polymorphism analysis was performed and serum tumour necrosis factor-alpha levels were determined using an enzyme-linked immunosorbent assay. We observed no significant differences in tumour necrosis factor-alpha serum levels between the study groups. In the patient group, an increase in the tumour necrosis factor-alpha serum levels in patients carrying the tumour necrosis factor-alpha (-308 G/A) A allele compared to those without the A allele was found to be statistically significant. Additionally, an increase in the tumour necrosis factor-alpha serum levels in patients carrying tumour necrosis factor-alpha (-308 G/A) AA genotype compared with patients carrying the AG or GG genotypes was statistically significant. No significant differences were found in these 2 polymorphisms between the patient and control groups (p>0.05). Our results showed the AA genotype and the A allele of the tumour necrosis factor-alpha (-308 G/A) polymorphism may be used as a predictor of elevated tumour necrosis factor-alpha levels in patients with sepsis.

Cirrhosis is a risk factor for total hip arthroplasty for avascular necrosis

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Deleuran, Thomas; Overgaard, Søren; Vilstrup, Hendrik

2016-01-01

Background and purpose - There are limited data on risk factors for avascular necrosis of the hip, but cirrhosis has been proposed as a risk factor. We examined the association between cirrhosis and incidence of total hip arthroplasty for avascular necrosis. Methods - We used nationwide healthcare......,052 reference individuals. Their median age was 57 years, and 65% were men. 45 cirrhosis patients and 44 reference individuals underwent total hip arthroplasty for avascular necrosis. Cirrhosis patients' HR for a total hip arthroplasty for avascular necrosis was 10 (95% CI: 6-17), yet their 5-year risk...... of avascular necrosis was only 0.2%. For the reference individuals, the 5-year risk was 0.02%. Interpretation - Cirrhosis is a strong risk factor for avascular necrosis of the hip, but it is rare even in cirrhosis patients....

Mandibular bone necrosis after use of paraformaldehyde-containing paste

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Chi-hwan Lee

2016-11-01

Full Text Available Paraformaldehyde has been used in the past as a pulpotomy agent. However, it has a severe cytotoxic effect and may cause alveolar bone necrosis. Depulpin, a devitalizing agent containing 49% paraformaldehyde, is no longer used frequently due to its severe side effects. In the two cases described in the present study, Depulpin was used as a devitalizing agent during root canal treatment. It caused a gradual loss of sensibility in adjacent teeth, gingival necrosis, and osteomyelitis. This case report demonstrates the serious side effects of using a paraformaldehyde-containing paste as a devitalizing agent for pulp, particularly mandibular bone necrosis.

Breast necrosis associated with thromboembolic disorders

International Nuclear Information System (INIS)

Andersson, I.; Adler, D.D.; Ljungberg, O.; Malmoe Allmaenna Sjukhus; Michigan Univ., Ann Arbor

1987-01-01

Two obese women with thrombotic disease complicated by necrosis of the breast are described. In one patient the reaction started after a few days of coumarin treatment and progressed to severe necrosis requiring mastectomy. The other patient was not on anticoagulant therapy when the breast reaction started and the clinical course was less severe. The radiographic appearance was characterized by thickening of the breast trabeculae, increased density of the breast and skin thickening. Although the radiographic findings are non-specific, the correct diagnosis can be suggested if combined with appropriate clinical information. The disease process may mimic breast cancer of the inflammatory type, clinically as well as radiographically. (orig.)

Pancreatic Necrosis and Gas in the Retroperitoneum: Treatment with Antibiotics Alone.

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Rasslan, Roberto; da Costa Ferreira Novo, Fernando; Rocha, Marcelo Cristiano; Bitran, Alberto; de Souza Rocha, Manoel; de Oliveira Bernini, Celso; Rasslan, Samir; Utiyama, Edivaldo Massazo

2017-02-01

To present our experience in the management of patients with infected pancreatic necrosis without drainage. The records of patients with pancreatic necrosis admitted to our facility from 2011 to 2015 were retrospectively reviewed. We identified 61 patients with pancreatic necrosis. Six patients with pancreatic necrosis and gas in the retroperitoneum were treated exclusively with clinical support without any type of drainage. Only 2 patients had an APACHE II score >8. The first computed tomography scan revealed the presence of gas in 5 patients. The Balthazar computed tomography severity index score was >9 in 5 of the 6 patients. All patients were treated with antibiotics for at least 3 weeks. Blood cultures were positive in only 2 patients. Parenteral nutrition was not used in these patients. The length of hospital stay exceeded three weeks for 5 patients; 3 patients had to be readmitted. A cholecystectomy was performed after necrosis was completely resolved; pancreatitis recurred in 2 patients before the operation. No patients died. In selected patients, infected pancreatic necrosis (gas in the retroperitoneum) can be treated without percutaneous drainage or any additional surgical intervention. Intervention procedures should be performed for patients who exhibit clinical and laboratory deterioration.

Uterine Necrosis after Uterine Artery Embolization for Symptomatic Fibroids

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Steve Kyende Mutiso

2018-01-01

Full Text Available Introduction. Uterine artery embolization (UAE is a minimally invasive intervention that is used in the treatment of fibroids. UAE can lead to complications including postembolization syndrome, postprocedure pain, infection, endometrial atrophy leading to secondary amenorrhea, and uterine necrosis. Uterine necrosis after UAE is very rare and hence poses a clinical dilemma for any clinician in its identification and management. We document a case of uterine necrosis after UAE and conduct a literature review on its causation, clinical features, and management principles. Case. A patient presented one month after UAE with abdominal pain and abdominal vaginal discharge. Her work-up revealed features of possible uterine necrosis with sepsis and she was scheduled for a laparotomy and a subtotal hysterectomy was performed. She was subsequently managed with broad spectrum antibiotic and recovered well. Conclusion. Uterine necrosis after UAE is a rare occurrence and we hope the documentation of this case will add to the body of knowledge around it. Theories that explain its occurrence include the use of small particles at embolization, the use of Contour-SE a spherical poly-vinyl alcohol, and lack of collateral supply to the uterus. Its symptoms may be nonspecific but unremitting abdominal pain is invariably present. Finally although conservative management may be successful at times, surgical management with hysterectomy will be required in some cases. The prognosis is good after diagnosis and surgical management.

Gastric Necrosis due to Acute Massive Gastric Dilatation

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Ibrahim Aydin

2013-01-01

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

Gastric Necrosis due to Acute Massive Gastric Dilatation.

Science.gov (United States)

Aydin, Ibrahim; Pergel, Ahmet; Yucel, Ahmet Fikret; Sahin, Dursun Ali; Ozer, Ender

2013-01-01

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

Percentage tumor necrosis following chemotherapy in neuroblastoma correlates with MYCN status but not survival.

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Bomken, Simon; Davies, Beverley; Chong, Leeai; Cole, Michael; Wood, Katrina M; McDermott, Michael; Tweddle, Deborah A

2011-03-01

The percentage of chemotherapy-induced necrosis in primary tumors corresponds with outcome in several childhood malignancies, including high-risk metastatic diseases. In this retrospective pilot study, the authors assessed the importance of postchemotherapy necrosis in high-risk neuroblastoma with a histological and case notes review of surgically resected specimens. The authors reviewed all available histology of 31 high-risk neuroblastoma cases treated with COJEC (dose intensive etoposide and vincristine with either cyclophosphamide, cisplatin or carboplatin) or OPEC/OJEC (etoposide, vincristine and cyclophosphamide with alternating cisplatin [OPEC] or carboplatin [OJEC]) induction chemotherapy in 2 Children's Cancer & Leukaemia Group (CCLG) pediatric oncology centers. The percentage of postchemotherapy necrosis was assessed and compared with MYCN amplification status and overall survival. The median percentage of postchemotherapy tumor necrosis was 60%. MYCN status was available for 28 cases, of which 12 were amplified (43%). Survival in cases with ≥ 60% necrosis or ≥ 90% necrosis was not better than those with less necrosis, nor was percentage necrosis associated with survival using Cox regression. However, MYCN-amplified tumors showed a higher percentage of necrosis than non-MYCN-amplified tumors, 71.3% versus 37.2% (P = .006). This effect was not related to prechemotherapy necrosis and did not confer improved overall survival. Postchemotherapy tumor necrosis is higher in patients with MYCN amplification. In this study, postchemotherapy necrosis did not correlate with overall survival and should not lead to modification of postoperative treatment. However, these findings need to be confirmed in a larger prospective study of children with high-risk neuroblastoma.

Tumor necrosis factor alpha converting enzyme: an encouraging target for various inflammatory disorders.

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Bahia, Malkeet S; Silakari, Om

2010-05-01

Tumor necrosis factor alpha is one of the most common pro-inflammatory cytokines responsible for various inflammatory disorders. It plays an important role in the origin and progression of rheumatoid arthritis and also in other autoimmune disease conditions. Some anti-tumor necrosis factor alpha antibodies like Enbrel, Humira and Remicade have been successfully used in these disease conditions as antagonists of tumor necrosis factor alpha. Inhibition of generation of active form of tumor necrosis factor alpha is a promising therapy for various inflammatory disorders. Therefore, the inhibition of an enzyme (tumor necrosis factor alpha converting enzyme), which is responsible for processing inactive form of tumor necrosis factor alpha into its active soluble form, is an encouraging target. Many tumor necrosis factor alpha converting enzyme inhibitors have been the candidates of clinical trials but none of them have reached in to the market because of their broad spectrum inhibitory activity for other matrix metalloproteases. Selectivity of tumor necrosis factor alpha converting enzyme inhibition over matrix metalloproteases is of utmost importance. If selectivity is achieved successfully, side-effects can be over-ruled and this approach may become a novel therapy for treatment of rheumatoid arthritis and other inflammatory disorders. This cytokine not only plays a pivotal role in inflammatory conditions but also in some cancerous conditions. Thus, successful targeting of tumor necrosis factor alpha converting enzyme may result in multifunctional therapy.

Case report of radiation necrosis of the larynx

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Tanaka, Eiichi; Inouye, Tetsuzo; Hiraide, Fumihisa; Tsubaki, Yasukiyo; Miyakogawa, Norimasa; Sawada, Masamichi (National Defence Medical Coll., Tokorozawa, Saitama (Japan))

1983-02-01

A case of radiation necrosis of the larynx is reported. The patient was a 79-year-old man who was radiated with the dosis of 3900 rad for suspected carcinoma of the larynx in 1976 and 5300 rad for carcinoma of the larynx in 1980. After completion of radiation therapy, he started to have hoarseness. He was admitted to the hospital because of severe dyspnea. Fiberoptic examination revealed almost complete obstruction of the laryngeal lumen by necrotic tissues due to radiation necrosis. There was little space reserved for respiration. No motility of the vocal cords and arytenoids was observed. After tracheostomy, conservative local and systemic treatments and repeated removal of necrotic tissues through laryngomicrosurgery were performed. However, an advanced necrosis with infection could not be controlled. Therefore, total laryngectomy was performed. Microscopically, no malignant cells were noted in the larynx. As most soft tissues were degenerated into fibrosis, the pharynx was left open. When infection was entirely controlled, the lining flap method from the anterior chest was applied to close the pharynx. When severe radiation necrosis occurs in the larynx, laryngectomy is sometimes mandatory to be performed. It is important that infection should be controlled before and after laryngectomy. Delayed skin flap method is advised.

Bevacizumab for the Treatment of Gammaknife Radiosurgery-Induced Brain Radiation Necrosis.

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Ma, Yifang; Zheng, Chutian; Feng, Yiping; Xu, Qingsheng

2017-09-01

Radiation necrosis is one of the complications of Gammaknife radiosurgery. The traditional treatment of radiation necrosis carries a high risk of failure, Bevacizumab is an antiangiogenic monoclonal antibody against vascular endothelial growth factor, a known mediator of cerebral edema. It can be used to successfully treat brain radiation necrosis. Two patients with a history of small cell lung cancer presented with metastatic disease to the brain. They underwent Gammaknife radiosurgery to brain metastases. Several months later, magnetic resonance imaging showed radiation necrosis with significant surrounding edema. The patients had a poor response to treatment with dexamethasone. They were eventually treated with bevacizumab (5 mg/kg every 2 weeks, 7.5 mg/kg every 3 weeks, respectively), and the treatment resulted in significant clinical and radiographic improvement. Bevacizumab can be successfully used to treat radiation necrosis induced by Gammaknife radiosurgery in patients with cerebral metastases. It is of particular benefit in patients with poor reaction to corticosteroids and other medications.

Thrombo-ischaemic pinnal necrosis associated with fenbendazole treatment in a dog.

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Nuttall, T J; Burrow, R; Fraser, I; Kipar, A

2005-05-01

An 11-week-old, female West Highland white terrier was presented with necrosis of the distal third of both pinnae. Haematology, biochemistry and urinalysis, Coombs test, antinuclear antibody and cold autoagglutinin antibody tests were normal. A drug reaction to fenbendazole was diagnosed. The necrotic ear tips were surgically removed. Histopathology revealed extensive coagulative necrosis of the epidermis and superficial to mid-dermis, a moderate interstitial neutrophilic infiltrate and complete thrombotic occlusion and necrosis of blood vessels. There was also endothelial cell activation and proliferation with endothelial cell cushions protruding into the vascular lumen. Immunohistochemistry for factor VIII-related antigen confirmed endothelial cell involvement. This case represents an unusual, drug-induced, thrombo-ischaemic necrosis of the pinnae. It is also, to the authors' knowledge, the first report of fenbendazole sensitivity in a dog. The histopathology is similar to previous cases of proliferative thrombovascular pinnal necrosis, suggesting that drug reactions should be considered in this condition.

Magnetic resonance imaging of the femoral head necrosis

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Narita, Shinya; Asada, Kanji; Yoshida, Kenjiro and others

1986-06-01

Ten patients with avascular femoral head necrosis and four normal adults were examined by magnetic resonance imaging (MRI). In addition, the relationship between MRI and pathophysiology of three operated-on avascular femoral heads was evaluated. The medullary cavities of the normal femoral heads had a strong signal intensity on the saturation recovery (SR) image due to fat marrow, and the T/sub 1/ relaxation time was 160 +- 11 msec. In avascular femoral head necrosis, the necrotic area had a low signal intensity on the SR image and a prolonged T/sub 1/ relaxation time, while the reactive fibrous area had more prolonged T/sub 1/ relaxation time. For these reasons, MRI was found to show the pathological changes of avascular femoral head necrosis and can be expected to be useful for making early diagnoses and operation planning.

Magnetic resonance imaging of the femoral head necrosis

International Nuclear Information System (INIS)

Narita, Shinya; Asada, Kanji; Yoshida, Kenjiro

1986-01-01

Ten patients with avascular femoral head necrosis and four normal adults were examined by magnetic resonance imaging (MRI). In addition, the relationship between MRI and pathophysiology of three operated-on avascular femoral heads was evaluated. The medullary cavities of the normal femoral heads had a strong signal intensity on the saturation recovery (SR) image due to fat marrow, and the T 1 relaxation time was 160 ± 11 msec. In avascular femoral head necrosis, the necrotic area had a low signal intensity on the SR image and a prolonged T 1 relaxation time, while the reactive fibrous area had more prolonged T 1 relaxation time. For these reasons, MRI was found to show the pathological changes of avascular femoral head necrosis and can be expected to be useful for making early diagnoses and operation planning. (author)

Early Diagnosis of Avascular Necrosis of Bone Following Renal Transplantation By Bone Scan

International Nuclear Information System (INIS)

Shin, Hyun Ho; Kim, Han Su; Ihn, Chun Gyoo; Kim, Myung Jae

1982-01-01

Avascular necrosis of bone has become a well-recognized complication of renal transplantation. While preexisting metabolic bone disease, especially hyperparathyroidism, and metabolic disturbances induced by steroids have been implicated as etiological factors, the pathogenesis is controversial. The diagnosis of avascular necrosis of bone had been based on a history of joint pain and radiographic demonstration of bone necrosis. Recently the bone scan using 99m Tc-methylene diphosphonate is helpful in determining the early stage of bone necrosis. We report two cases of avascular necrosis of femur head, of which diagnosis was made by the bone scan using 99m Tc-methylene diphosphonate.

Gastric volvulus with partial and complete gastric necrosis

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

2014-01-01

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

Gastric volvulus with partial and complete gastric necrosis

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Ram Mohan Shukla

2014-01-01

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

Infección por Polyoma virus en un paciente con transplante renal: A propósito de un caso

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Reyner Loza Munarriz

2008-07-01

Full Text Available La nefropatia por polyoma virus (NVBK esta siendo reconocida como causa importante de falla del injerto, usualmente confundido con rechazo agudo. A la fecha, no se han reportado casos en el Perú. Se presenta el caso de un niño trasplantado, 17 años de edad, quien presentó elevación persistente de la creatinina sérica en el primer mes postrasplante. Fue tratado como rechazo agudo. Al no presentar mejoría se realizó biopsia renal que mostró marcado daño del epitelio tubular con necrosis parcial y desprendimiento hacia la luz tubular y la presencia de células atípicas con escaso citoplasma e inclusiones intranucleares basofilicas, hallazgos compatibles con infección por virus BK. No se evidenció signos de rechazo. Además, en el papanicolao de orina, se encontró Decoy cells. La carga viral de virus BK fue elevada en sangre y en orina. Se suspendió el tratamiento con mofetil micofenolato, se redujo la dosis de tacrolimus y se inició el tratamiento con leflunomide 40 mg/dia. Seis meses después la función renal del paciente se estabilizó, pero sin mejoría completa quedando con una depuración de creatinina de 30 ml/min/1,73 m² SC. (Rev Med Hered 2008;19:123-127

Bladder necrosis: 'A man without a bladder'.

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Bosschieter, Judith; Oudshoorn, Frederik H K; Meuleman, Eric J H; Nieuwenhuijzen, Jakko A

2018-02-17

Since the use of antibiotics, bladder necrosis has become a rare condition. We report a case of bladder necrosis in a 90-year-old man following urinary retention. After insertion of a transurethral catheter (TUC), 2 L of urine was evacuated. In the following days, the TUC became intermittently blocked. Adequate bladder drainage could not be obtained despite intensive rinsing and placement of a suprapubic catheter. On surgical exploration necrosis of almost the entire bladder wall, except for the trigone, was encountered. Surgical debridement of the non-viable bladder wall without opening the abdominal cavity was conducted, and a TUC was placed in the Retzius cavity to ensure evacuation of urine. Since the patient was haemodynamically unstable, construction of a urinary diversion was waived and urinary drainage of the Retzius cavity by the TUC was accepted, resulting in adequate urinary drainage without compromising renal function. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Biological response of pulps submitted to different capping materials Resposta biológica de polpas submetidas a diferentes materiais capeadores

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André Luiz Fraga Briso

2006-09-01

Full Text Available Pulp capping is a procedure that comprises adequate protection of the pulp tissue exposed to the oral environment, aiming at the preservation of its vitality and functions. This study evaluated the response of the dental pulps of dog teeth to capping with mineral trioxide aggregate (MTA or calcium hydroxide P.A. For that purpose, 37 teeth were divided into two groups, according to the capping material employed. Two dogs were anesthetized and, after placement of a rubber dam, their pulps were exposed in a standardized manner and protected with the experimental capping materials. The cavities were then sealed with resin-modified glass ionomer cement and restored with composite resin. After sixty days, the animals were killed and the specimens were processed in order to be analyzed with optic microscopy. It was observed that MTA presented a higher success rate compared to calcium hydroxide, presenting a lower occurrence of infection and pulp necrosis.O capeamento pulpar é um procedimento que consiste na adequada proteção do tecido pulpar exposto ao meio oral, objetivando a preservação de sua vitalidade e suas funções. O objetivo deste trabalho foi observar a resposta da polpa dental de cães ao capeamento com o agregado de trióxido mineral (MTA ou hidróxido de cálcio P.A. Para tanto, 37 dentes foram divididos em dois grupos, de acordo com o material capeador utilizado. Dois cães foram anestesiados e após o isolamento absoluto do campo operatório, realizou-se exposição padronizada da polpa, proteção com os materiais capeadores testados e selamento das cavidades com cimento modificado de ionômero de vidro. Os dentes foram então restaurados com resina composta. Após sessenta dias, os animais foram sacrificados e as peças foram processadas para a análise microscópica dos dentes. Observou-se que o MTA apresentou maior índice de sucesso em relação ao hidróxido de cálcio, evidenciando menor ocorrência de infecção e necrose

Delayed brain radiation necrosis: pathological review and new molecular targets for treatment.

Science.gov (United States)

Furuse, Motomasa; Nonoguchi, Naosuke; Kawabata, Shinji; Miyatake, Shin-Ichi; Kuroiwa, Toshihiko

2015-12-01

Delayed radiation necrosis is a well-known adverse event following radiotherapy for brain diseases and has been studied since the 1930s. The primary pathogenesis is thought to be the direct damage to endothelial and glial cells, particularly oligodendrocytes, which causes vascular hyalinization and demyelination. This primary pathology leads to tissue inflammation and ischemia, inducing various tissue protective responses including angiogenesis. Macrophages and lymphocytes then infiltrate the surrounding areas of necrosis, releasing inflammatory cytokines such as interleukin (IL)-1α, IL-6, and tumor necrosis factor (TNF)-α. Microglia also express these inflammatory cytokines. Reactive astrocytes play an important role in angiogenesis, expressing vascular endothelial growth factor (VEGF). Some chemokine networks, like the CXCL12/CXCR4 axis, are upregulated by tissue inflammation. Hypoxia may mediate the cell-cell interactions among reactive astrocytes, macrophages, and microglial cells around the necrotic core. Recently, bevacizumab, an anti-VEGF antibody, has demonstrated promising results as an alternative treatment for radiation necrosis. The importance of VEGF in the pathophysiology of brain radiation necrosis is being recognized. The discovery of new molecular targets could facilitate novel treatments for radiation necrosis. This literature review will focus on recent work characterizing delayed radiation necrosis in the brain.

Mucoperiosteal Flap Necrosis after Primary Palatoplasty in Patients with Cleft Palate

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Cotrina-Rabanal, Omar; Barrenechea-Tarazona, Luis; Vargas-Chanduvi, Roberto; Paredes-Aponte, Luis; Romero-Narvaez, Carolina

2017-01-01

Background The prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication. Methods In this case series, a 20-year retrospective analysis (1994–2014) identified patients from our records (medical records and screening day registries) with nonsyndromic cleft palate who underwent operations at 3 centers. All of these patients underwent operations using 2-flap palatoplasty and also underwent a physical examination with photographs and documentation of the presence of palatal flap necrosis after primary palatoplasty. Results Palatal flap necrosis was observed in 4 cases out of 1,174 palatoplasties performed at these centers. The observed prevalence of palatal flap necrosis in these groups was 0.34%. Conclusions The prevalence of flap necrosis can be reduced by careful preoperative planning, and prevention is possible. The scale proposed here may help to prevent this complication; however, further studies are necessary to validate its utility. PMID:28573096

Mucoperiosteal Flap Necrosis after Primary Palatoplasty in Patients with Cleft Palate

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Percy Rossell-Perry

2017-05-01

Full Text Available BackgroundThe prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication.MethodsIn this case series, a 20-year retrospective analysis (1994–2014 identified patients from our records (medical records and screening day registries with nonsyndromic cleft palate who underwent operations at 3 centers. All of these patients underwent operations using 2-flap palatoplasty and also underwent a physical examination with photographs and documentation of the presence of palatal flap necrosis after primary palatoplasty.ResultsPalatal flap necrosis was observed in 4 cases out of 1,174 palatoplasties performed at these centers. The observed prevalence of palatal flap necrosis in these groups was 0.34%.ConclusionsThe prevalence of flap necrosis can be reduced by careful preoperative planning, and prevention is possible. The scale proposed here may help to prevent this complication; however, further studies are necessary to validate its utility.

Ependimoma celular parcialmente resecado complicado con meningoependimocoroiditis bacteriana por Pseudomonas aeruginosa e infección sistémica por citomegalovirus

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Francisco Javier Otero-Mendoza

2017-06-01

Full Text Available Niño de 1 año 10 meses de edad, originario de Irapuato, Guanajuato, sin antecedentes de importancia para el padecimiento actual. Inició dos meses previos a su ingreso con crisis convulsivas tónico-clónicas generalizadas de 15 segundos de duración durante el sueño. Se realizó electroencefalograma que reportó actividad epileptiforme, por lo que se dio tratamiento con ácido valproico. Una semana previa al ingreso se agregó ataxia troncal impidiendo la marcha, por lo que se realizó una tomografía axial computarizada de cráneo en la que se observó un tumor en fosa posterior con densidad heterogénea y áreas de necrosis central que obliteraba el cuarto ventrículo, ocasionando efecto de masa y desplazamiento ventral del tallo cerebral. Por tal motivo, fue referido a nuestra institución.

[Effect of vascular endothelial growth factor and tumor necrosis factor receptor for treatment of avascular necrosis of the femoral head in rabbits].

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Hu, Zhi-ming; Zhou, Ming-qian; Gao, Ji-min

2008-12-01

To evaluate the therapeutic effect of vascular endothelial growth factor (VEGF) and tumor necrosis factor receptor (TNFR) on avascular necrosis of the femoral head in rabbits. Avascular necrosis of the femoral head was induced in 26 New Zealand white rabbits by injections of horse serum and prednisolone. The rabbits were then divided into VEGF/TNFR treatment group, VEGF treatment group, and untreated model group, with another 4 normal rabbits as the normal control group. In the two treatment groups, the therapeutic agents were injected percutaneously into the femoral head. Enzyme-linked immunosorbent assay was performed to determine the concentration of TNF-alpha in rabbit serum followed by pathological examination of the changes in the bone tissues, bone marrow hematopoietic tissue and the blood vessels in the femoral head. Compared with the model group, the rabbits with both VEGF and TNFR treatment showed decreased serum concentration of TNF-alpha with obvious new vessel formation, decreased empty bone lacunae in the femoral head and hematopoietic tissue proliferation in the bone marrow cavity. Percutaneous injection of VEGF and TNFR into the femoral head can significantly enhance bone tissue angiogenesis and ameliorate osteonecrosis in rabbits with experimental femoral head necrosis.

United Kingdom nationwide study of avascular necrosis of the jaws including bisphosphonate-related necrosis.

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Rogers, S N; Palmer, N O A; Lowe, D; Randall, C

2015-02-01

We aimed to record all new patients who presented to departments of oral surgery, oral medicine, and oral and maxillofacial surgery, and to dental hospitals in the UK, with avascular necrosis of the jaws including bisphosphonate-related necrosis (BRONJ) over a 2-year period (1 June 2009-31 May 2011). They were eligible irrespective of age, cause, or coexisting conditions. Data on incidence, clinical characteristics, risk factors, and coexisting conditions were collected. A total of 383 cases were registered: 369 were described as BRONJ, 5 as avascular necrosis, and 9 were unknown. Bisphosphonates had been given orally in 207 (56%), intravenously in 125 (34%), both orally and intravenously in 27 (7%), and was unknown in 9 (2%); one had been given denosumab. The main risk factor was dental extraction, and the mandible was commonly affected. The median duration of administration until onset of BRONJ was 3 years in those treated intravenously and 4 years in those treated orally. Levels of engagement with the study varied between regions, and extrapolation from the 2 most involved (Merseyside and Northern Ireland) found around 8.2-12.8 cases/million/year, which is 508-793 patients/year across the UK. To our knowledge this is one of the first studies to estimate national rates of BRONJ. It confirms that the risk and incidence are low. With changes in trends for antiresorptive bone medication, and increasing numbers of elderly people, it would be useful to repeat the registration in the future. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Effect of bevacizumab on radiation necrosis of the brain

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Gonzalez, Javier; Kumar, Ashok J.; Conrad, Charles A.; Levin, Victor A.

2007-01-01

Purpose: Because blocking vascular endothelial growth factor (VEGF) from reaching leaky capillaries is a logical strategy for the treatment of radiation necrosis, we reasoned that bevacizumab might be an effective treatment of radiation necrosis. Patients and Methods: Fifteen patients with malignant brain tumors were treated with bevacizumab or bevacizumab combination for their tumor on either a 5 mg/kg/2-week or 7.5 mg/kg/3-week schedule. Radiation necrosis was diagnosed in 8 of these patients on the basis of magnetic resonance imaging (MRI) and biopsy. MRI studies were obtained before treatment and at 6-week to 8-week intervals. Results: Of the 8 patients with radiation necrosis, posttreatment MRI performed an average of 8.1 weeks after the start of bevacizumab therapy showed a reduction in all 8 patients in both the MRI fluid-attenuated inversion-recovery (FLAIR) abnormalities and T1-weighted post-Gd-contrast abnormalities. The average area change in the T1-weighted post-Gd-contrast abnormalities was 48% (±22 SD), and the average change in the FLAIR images was 60% (±18 SD). The average reduction in daily dexamethasone requirements was 8.6 mg (±3.6). Conclusion: Bevacizumab, alone and in combination with other agents, can reduce radiation necrosis by decreasing capillary leakage and the associated brain edema. Our findings will need to be confirmed in a randomized trial to determine the optimal duration of treatment

Pathological investigation of radiation necrosis

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Nakamura, Nishio; Yoshimura, Noriaki; Ikuta, Fusahiro

1975-01-01

The brain and spinal cord of an 18-year-old male, who suffered from cerebellar medulloblastoma with subarachnoid spread, had been irradiated by a large amount of Linac X-ray: 14,450 rads to the lower thoracic segments and 7,400 rads to the lumbar segments. The tumor at the roof of the 4th ventricle had disseminated along the ventricular system but was limited to the subarachnoid space of the cervical spinal cord. No remarkable changes were found in the volume or consistency of the thoracic and lumbar cord. Elasticity of the lower thoracic segment was greatly diminished and the cut surfaces were yellowish white and fragile. Microscopically extensive coagulation necrosis was observed with complete disintegration of myelin and axon. Vascular changes were most prominent in the smaller vessels, eg. hyalinous thickening, concentric cleavage, adventitial fibrosis and edema of small artery perivascular spaces, fibrin thrombi occulusion of arterioles and capillaries, and telangiectasia. In the lumbar spinal cord, moderate neuronal degeneration and protoplasmic astrocytosis were observed. Changes in the lumbar posterior white column were considered to be not only secondary degeneration but also a primary lesion caused by irradiation. Liquefactive necrosis in the gray matter of the cervical cord was thought to be a nonspecific circulatory disturbance because of the absence of vascular changes. Vascular changes were thought to be very important in the histological diagnosis of radiation myelopathy and it was supposed that increased permeability of the vessel walls was a factor in coagulation necrosis. They considered this case to have typical histology of radiation myelopathy. (Evans, J.)

'Femoral head necrosis' in metabolic and hormonal osteopathies

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Heuck, F.H.W.; Treugut, H.

1984-07-01

The pathogenesis of bone necrosis is discussed with special attention and with respect to metabolic, hormonal, and vascular factors. The influence of statics and dynamics of the hip joint bones for the development of aseptic necrosis are discussed. 45 patients with ''idiopathic femoral head necroses'' were observed, including 6 cases of renal osteopathy following renal transplantation and immune suppression therapy, 14 cases of long term corticoid therapy, and 11 cases of liver diseases of different genesis. The femoral head necrosis understood as complication of an osteopathy. In our patients there were 31 males and 14 females - which means higher involvement of males. Plain radiological findings and CT-findings of changes of the femoral heat structure in different stages of the disease are described. Early diagnosis of metabolic and hormonal osteopathies is demanded for a joint keeping therapy of the beginning femoral head necrosis. 90 refs.

Early Diagnosis of Avascular Necrosis of Bone Following Renal Transplantation By Bone Scan

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Shin, Hyun Ho; Kim, Han Su; Ihn, Chun Gyoo; Kim, Myung Jae [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

1982-09-15

Avascular necrosis of bone has become a well-recognized complication of renal transplantation. While preexisting metabolic bone disease, especially hyperparathyroidism, and metabolic disturbances induced by steroids have been implicated as etiological factors, the pathogenesis is controversial. The diagnosis of avascular necrosis of bone had been based on a history of joint pain and radiographic demonstration of bone necrosis. Recently the bone scan using {sup 99m}Tc-methylene diphosphonate is helpful in determining the early stage of bone necrosis. We report two cases of avascular necrosis of femur head, of which diagnosis was made by the bone scan using {sup 99m}Tc-methylene diphosphonate.

Necrosis cutánea severa por picadura de raya en el miembro inferior: presentación de un caso y revisión de la literatura Stingray injury causing severe cutaneous necrosis: case report and literature review

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M.A. Hoyos Franco

2009-12-01

Full Text Available El propósito de este trabajo es presentar nuestra experiencia con un caso de picadura por raya en el área maleolar interna del pie derecho de un hombre de 25 años, que sufrió mientras pescaba. Inicialmente presentó dolor urente, seguido de edema severo, con necrosis de la piel suprayacente. Ingresa a nuestra institución 24 horas después y con edema, eritema y secreción purulenta en el sitio afectado. Se inicia tratamiento con antibióticos sistémicos y se realizan tres lavados y desbridamientos en días subsecuentes. Evolucionó con solución de continuidad y exposición ósea sobre el maléolo interno en un área de 7 x 5 cms que se cubrió con un colgajo safeno interno de flujo reverso que evolucionó satisfactoriamente. Las lesiones ocasionadas por la picadura de raya (Myliobatidae son escasamente referidas en Cirugía Plástica, pues la lesión tisular severa de las extremidades es poco frecuente. Revisamos la fisiopatología, los tipos de lesiones que se producen y los principios de tratamiento.The purpose of this paper is to present our experience with one case of stingray injury, in a 25 years old man, while he was fishing, compromising his right feet at the internal malleolus. At the beginning he had severe pain, and during the first hours after the accident progressive edema was evident. He arrived to our hospital 24 hours later, when purulent discharge and eritem was obvious. Intravenous antibiotics were initiated and three surgical debridements where performed during the following week. After the process was complete, a soft tissue defect was created on the internal malleolus (7 x 5 cm. Reconstruction was achieved using a reverse internal saphenous flap that evolved satisfactorily. Severe skin injuries caused by stingrays (Myliobatidae have been reported shortly in plastic surgery literature, because these lesions usually heal without surgical procedures. We review skin injury physiopathology, showing the different kind of

Study on radiation necrosis following intraoperative radiotherapy for brain tumors

International Nuclear Information System (INIS)

Tanaka, Yoshiaki; Takeshita, Nagayuki; Niwa, Kohkichi; Kamata, Noriko; Matsuda, Tadayoshi; Matsutani, Masao

1989-01-01

Ninety-five patients with primary or metastatic brain tumors were treated with the intraoperative radiotherapy (IORT). In seven cases, surgery was performed a second time because of suspected of tumor recurrence, later found to be a radiation necrosis. Tumorous lesions were irradiated by IORT in the range of 15 Gy to 20 Gy together with external radiotherapy in the 30 Gy to 72 Gy range. In follow-up postcontrast CT studies, irregularly-shaped lesions appeared at the IORT site and increased in size with the perifocal low density area on subsequent scans. The images resembled those seen in tumor recurrence. Histopathologic changes seen during the follow-up surgery were thought to be mainly the result of radiation necrosis, though viable tumor cells at the marginal tumor site were one possible etiology. A coagulation necrosis with a fibrin exudate was observed in the IORT portal area and the vascular walls exhibited marked degeneration which is symptomatic of delayed radiation necrosis. Thus, post-IORT radiation necrosis is thought to be a direct reaction to this technique, and the delayed absorption of necrotic tissue to be a direct reaction to this technique, and the delayed absorption of necrotic tissue clearly indicates the possibility of adverse effects in its use for treatment of brain tumors. (author)

Prevalence and distribution of odontogenic cysts in a Mexican sample. A 753 cases study.

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Villasis-Sarmiento, Luis; Portilla-Robertson, Javier; Melendez-Ocampo, Arcelia; Gaitan-Cepeda, Luis-Alberto; Leyva-Huerta, Elba-Rosa

2017-04-01

Odontogenic cysts (OC) are the most frequent lesions of the jaws and their constant epidemiological update is necessary and indispensable. Therefore the principal objective of this report was To determine prevalence and clinical-demographical characteristics of OC in a Mexican sample. 753 cases of OC coming from the archive of a head and neck histopathological teaching service, from January 2000 to December 2013, were included. OC cases were re-assessed according 2005 WHO classification. Chi square test was used to establish possible associations ( p pulpar necrosis and impacted teeth, radicular cyst and dentigerous cyst could be prevenible. Therefore, it is necessary to establish preventive strategies to diminish dental decay and programs of prophylactic extractions of impacted teeth, to in consequence decrease the prevalence of odontogenic cysts. Key words: Cyst, dentigerous cyst, mexican, odontogenic cyst, radicular cyst.

Experimental evaluation of radioiodinated sennoside B as a necrosis-avid tracer agent.

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Zhang, Dongjian; Huang, Dejian; Ji, Yun; Jiang, Cuihua; Li, Yue; Gao, Meng; Yao, Nan; Liu, Xuejiao; Shao, Haibo; Jing, Su; Ni, Yicheng; Yin, Zhiqi; Zhang, Jian

2015-02-01

Necrosis-avid agents are a class of compounds that selectively accumulate in the necrotic tissues after systemic administration, which can be used for in vivo necrosis imaging and targeted therapies. In order to search for a necrosis-avid tracer agent with improved drugability, we labelled iodine-131 on sennoside B (SB) as a naturally occurring median dianthrone compound. The necrosis targetability and clearance properties of (131)I-SB were evaluated in model rats with liver and muscle necrosis. On SPECT/CT images, a "hot spot" in the infarcted liver lobe and necrotic muscle was persistently observed at 24 h and 72 h post-injection (p.i.). Gamma counting of the tissues of interest revealed a radioactivity ratio of necrotic to viable liver at 4.6 and 3.4 and of necrotic to viable muscle at 7.0 and 8.8 at 24 h and 72 h p.i., respectively. The good match of autoradiographs and fluoromicroscopic images with corresponding histochemical staining suggested preferential uptake of (131)I-SB in necrotic tissue. Pharmacokinetic study revealed that (131)I-SB has an elimination half-life of 8.6 h. This study indicates that (131)I-SB shows not only prominent necrosis avidity but also favourable pharmacokinetics, which may serve as a potential necrosis-avid diagnostic agent for assessment of tissue viability.

Cirrhosis is a risk factor for total hip arthroplasty for avascular necrosis.

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Deleuran, Thomas; Overgaard, Søren; Vilstrup, Hendrik; Jepsen, Peter

2016-06-01

Background and purpose - There are limited data on risk factors for avascular necrosis of the hip, but cirrhosis has been proposed as a risk factor. We examined the association between cirrhosis and incidence of total hip arthroplasty for avascular necrosis. Methods - We used nationwide healthcare data to identify all Danish residents diagnosed with cirrhosis in 1994-2011, and matched them 1:5 by age and sex to non-cirrhotic reference individuals from the general population. We excluded people with a previous total hip arthroplasty, a previous hip fracture, or a previous diagnosis of avascular necrosis. We used stratified Cox regression to estimate the hazard ratio (HR) for cirrhosis patients relative to reference individuals, adjusting for potential confounders. We used the cumulative incidence function to compute 5-year risks. Results - We included 25,421 cirrhosis patients and 114,052 reference individuals. Their median age was 57 years, and 65% were men. 45 cirrhosis patients and 44 reference individuals underwent total hip arthroplasty for avascular necrosis. Cirrhosis patients' HR for a total hip arthroplasty for avascular necrosis was 10 (95% CI: 6-17), yet their 5-year risk of avascular necrosis was only 0.2%. For the reference individuals, the 5-year risk was 0.02%. Interpretation - Cirrhosis is a strong risk factor for avascular necrosis of the hip, but it is rare even in cirrhosis patients.

Prognostic value of tumor necrosis at CT in diffuse large B-cell lymphoma

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Adams, Hugo J.A., E-mail: h.j.a.adams@gmail.com [Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht (Netherlands); Klerk, John M.H. de [Department of Nuclear Medicine, Meander Medical Center, Amersfoort (Netherlands); Fijnheer, Rob [Department of Hematology, Meander Medical Center, Amersfoort (Netherlands); Dubois, Stefan V. [Department of Pathology, Meander Medical Center, Amersfoort (Netherlands); Nievelstein, Rutger A.J.; Kwee, Thomas C. [Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht (Netherlands)

2015-03-15

Highlights: •CT is compulsory for staging newly diagnosed DLBCL. •Approximately 13.7% of DLBCL patients have tumor necrosis at CT. •Tumor necrosis status at CT is not associated with any NCCN-IPI factor. •Patients with tumor necrosis at CT have a significantly worse outcome. -- Abstract: Objective: To determine the prognostic value of tumor necrosis at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Materials and methods: This retrospective study included 51 patients with newly diagnosed DLBCL who had undergone both unenhanced and intravenous contrast-enhanced CT before R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin and prednisolone) chemo-immunotherapy. Presence of tumor necrosis was visually and quantitatively assessed at CT. Associations between tumor necrosis status at CT and the National Comprehensive Cancer Network (NCCN) International Prognostic Index (IPI) factors were assessed. Cox regression analysis was used to determine the prognostic impact of NCCN-IPI scores and tumor necrosis status at CT. Results: There were no correlations between tumor necrosis status at CT and the NCCN-IPI factors categorized age (ρ = −0.042, P = 0.765), categorized lactate dehydrogenase (LDH) ratio (ρ = 0.201, P = 0.156), extranodal disease in major organs (φ = −0.245, P = 0.083), Ann Arbor stage III/IV disease (φ = −0.208, P = 0.141), and Eastern Cooperative Oncology Group (ECOG) performance status (φ = 0.015, P = 0.914). In the multivariate Cox proportional hazards model, only tumor necrosis status at CT was an independent predictive factor of progression-free survival (P = 0.003) and overall survival (P = 0.004). Conclusion: The findings of this study indicate the prognostic potential of tumor necrosis at CT in newly diagnosed DLBCL.

Intraductal membranous fat necrosis in a fibroadenoma of breast: a case report.

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Coyne, John D

2014-09-01

Membranous fat necrosis is an unusual type of fat necrosis occurring in the breast and normally involves the parenchyma. This report describes an apparently unique intraductal focus in a fibroadenoma following prior needling. Displacement of fatty tissue in the form of membranous fat necrosis within ducts could be added to the list of histological features following core biopsy. © The Author(s) 2013.

Cerebral radiation necrosis: limits and prospects of experimental models

International Nuclear Information System (INIS)

Lefaix, J.L.

1992-01-01

Cerebral radiation necrosis is the major CNS hazard of clinical treatment therapy involving delivery of high doses of radiation to the brain. It is generally irreversible and frequently leads to death from brain necrosis. Necrosis has been reported with total doses of 60 Gy, delivered in conventional fractions. Symptoms depend upon the volume of brain irradiated and are frequently those of an intracranial mass and may be present as an area of gliosis or frank necrosis. Possible causes include some direct effect of radiation on glial cells, vascular changes and the action of an immunological mechanism. The weight of evidence suggests that demyelination is important in the early delayed reaction, and that vascular changes gradually become more important in the late delayed reactions, from several months to years after treatment. The advent of sophisticated radiographic technologies such as computed tomography, magnetic resonance imaging and spectroscopy, and positron emission tomography have facilitated serial non invasive examination of morphologic or physiologic parameters within the brain after irradiation. Limits and prospects of these technologies are reviewed in experimental animal models of late radiation injuries of the brain, which were carried out in many species ranging from mouse to monkey

Morphometric findings in avascular necrosis of the femoral head.

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Kamal, Diana; Trăistaru, Rodica; Alexandru, D O; Kamal, C K; Pirici, D; Pop, O T; Mălăescu, D Gh

2012-01-01

Avascular necrosis of the femoral head is an illness with a controversial etiology, the trigger event being the suppression of blood flow to the femoral head. The disease affects mostly young adults within their third and fifth decade, the majority of the patients being men. The main risk factors are trauma, chronic alcohol consumption, smoking, corticotherapy. The main goal of our study is to describe the morphometric changes found in the bone tissue of patients diagnosed with avascular necrosis of the femoral head, with different risk factors, by comparing the area of bone trabeculae inside the area of necrosis with that from the adjacent viable tissue. The morphometric study used biological material from 16 patients with ages between 29 and 57 years, who underwent surgery for avascular necrosis of the femoral head. They were admitted in the Orthopedics Department at the Emergency County Hospital in Craiova between 2010 and 2011 and were split into four groups. Group I presented trauma as the main risk factor, Group II had corticotherapy as the defining risk factor, Group III presented chronic alcohol consumption and Group IV was represented by the patients who smoked and exhibited chronic alcohol consumption. There was not a significant statistical difference between the areas of bone trabeculae of the four groups when we compared viable bone tissue to the necrotized one. Knowing the risk factors of the avascular necrosis of the femoral head is critical to the management of the disease, because diagnosing it in an early stage is a necessity for obtaining a good result for conservative treatment.

Viral erythrocytic necrosis: Chapter 2.2.7

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Winton, James R.; Hershberger, Paul K.

2014-01-01

Viral erythrocytic necrosis (VEN), originally termed piscine erythrocytic necrosis, is a condition that has been reported to affect the red blood cells (RBCs) of many species of marine and anadromous fishes in both the Atlantic and Pacific Oceans (Nicholson and Reno 1981; Smail 1982; Wolf 1988; Dannevig and Thorud 1999). Fish with VEN may develop a severe anemia that can reduce their stamina, predispose them to other infections or increase the impact of other stressors (MacMillan et al. 1980; Nicholson and Reno 1981; Meyers et al. 1986; Haney et al. 1992) resulting in population-scale impacts in susceptible species (Hershberger et al. 2009).

Challenges With the Diagnosis and Treatment of Cerebral Radiation Necrosis

International Nuclear Information System (INIS)

Chao, Samuel T.; Ahluwalia, Manmeet S.; Barnett, Gene H.; Stevens, Glen H.J.; Murphy, Erin S.; Stockham, Abigail L.; Shiue, Kevin; Suh, John H.

2013-01-01

The incidence of radiation necrosis has increased secondary to greater use of combined modality therapy for brain tumors and stereotactic radiosurgery. Given that its characteristics on standard imaging are no different that tumor recurrence, it is difficult to diagnose without use of more sophisticated imaging and nuclear medicine scans, although the accuracy of such scans is controversial. Historically, treatment had been limited to steroids, hyperbaric oxygen, anticoagulants, and surgical resection. A recent prospective randomized study has confirmed the efficacy of bevacizumab in treating radiation necrosis. Novel therapies include using focused interstitial laser thermal therapy. This article will review the diagnosis and treatment of radiation necrosis

Avascular necrosis of the femoral head presenting as trochanteric bursitis.

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Mandell, B F

1990-01-01

Five patients are described with avascular necrosis of the femoral head who presented with ipsilateral trochanteric bursitis, in the absence of clearcut hip joint disease. Avascular necrosis was indicated by magnetic resonance imaging. It is suggested that clinical trochanteric bursitis, especially when refractory to local corticosteroid treatment, may be the initial sign of hip disease. In the patient with risk factor(s) for avascular necrosis that diagnosis should be considered and evaluated with appropriate studies, such as magnetic resonance imaging, to prevent weight bearing at an early stage and permit possible surgical decompression in the hope of postponing or obviating the need for total hip replacement. PMID:2241294

Contemporary management of infected necrosis complicating severe acute pancreatitis

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Jamdar, Saurabh; Siriwardena, Ajith K

2006-01-01

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

Nuclear grade and necrosis predict prognosis in malignant epithelioid pleural mesothelioma: a multi-institutional study.

Science.gov (United States)

Rosen, Lauren E; Karrison, Theodore; Ananthanarayanan, Vijayalakshmi; Gallan, Alexander J; Adusumilli, Prasad S; Alchami, Fouad S; Attanoos, Richard; Brcic, Luka; Butnor, Kelly J; Galateau-Sallé, Françoise; Hiroshima, Kenzo; Kadota, Kyuichi; Klampatsa, Astero; Stang, Nolween Le; Lindenmann, Joerg; Litzky, Leslie A; Marchevsky, Alberto; Medeiros, Filomena; Montero, M Angeles; Moore, David A; Nabeshima, Kazuki; Pavlisko, Elizabeth N; Roggli, Victor L; Sauter, Jennifer L; Sharma, Anupama; Sheaff, Michael; Travis, William D; Vigneswaran, Wickii T; Vrugt, Bart; Walts, Ann E; Tjota, Melissa Y; Krausz, Thomas; Husain, Aliya N

2018-04-01

A recently described nuclear grading system predicted survival in patients with epithelioid malignant pleural mesothelioma. The current study was undertaken to validate the grading system and to identify additional prognostic factors. We analyzed cases of epithelioid malignant pleural mesothelioma from 17 institutions across the globe from 1998 to 2014. Nuclear grade was computed combining nuclear atypia and mitotic count into a grade of I-III using the published system. Nuclear grade was assessed by one pathologist for three institutions, the remaining were scored independently. The presence or absence of necrosis and predominant growth pattern were also evaluated. Two additional scoring systems were evaluated, one combining nuclear grade and necrosis and the other mitotic count and necrosis. Median overall survival was the primary endpoint. A total of 776 cases were identified including 301 (39%) nuclear grade I tumors, 354 (45%) grade II tumors and 121 (16%) grade III tumors. The overall survival was 16 months, and correlated independently with age (P=0.006), sex (0.015), necrosis (0.030), mitotic count (0.001), nuclear atypia (0.009), nuclear grade (<0.0001), and mitosis and necrosis score (<0.0001). The addition of necrosis to nuclear grade further stratified overall survival, allowing classification of epithelioid malignant pleural mesothelioma into four distinct prognostic groups: nuclear grade I tumors without necrosis (29 months), nuclear grade I tumors with necrosis and grade II tumors without necrosis (16 months), nuclear grade II tumors with necrosis (10 months) and nuclear grade III tumors (8 months). The mitosis-necrosis score stratified patients by survival, but not as well as the combination of necrosis and nuclear grade. This study confirms that nuclear grade predicts survival in epithelioid malignant pleural mesothelioma, identifies necrosis as factor that further stratifies overall survival, and validates the grading system across multiple

Programmed Necrosis: A Prominent Mechanism of Cell Death following Neonatal Brain Injury

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Raul Chavez-Valdez

2012-01-01

Full Text Available Despite the introduction of therapeutic hypothermia, neonatal hypoxic ischemic (HI brain injury remains a common cause of developmental disability. Development of rational adjuvant therapies to hypothermia requires understanding of the pathways of cell death and survival modulated by HI. The conceptualization of the apoptosis-necrosis “continuum” in neonatal brain injury predicts mechanistic interactions between cell death and hydrid forms of cell death such as programmed or regulated necrosis. Many of the components of the signaling pathway regulating programmed necrosis have been studied previously in models of neonatal HI. In some of these investigations, they participate as part of the apoptotic pathways demonstrating clear overlap of programmed death pathways. Receptor interacting protein (RIP-1 is at the crossroads between types of cellular death and survival and RIP-1 kinase activity triggers formation of the necrosome (in complex with RIP-3 leading to programmed necrosis. Neuroprotection afforded by the blockade of RIP-1 kinase following neonatal HI suggests a role for programmed necrosis in the HI injury to the developing brain. Here, we briefly review the state of the knowledge about the mechanisms behind programmed necrosis in neonatal brain injury recognizing that a significant proportion of these data derive from experiments in cultured cell and some from in vivo adult animal models. There are still more questions than answers, yet the fascinating new perspectives provided by the understanding of programmed necrosis in the developing brain may lay the foundation for new therapies for neonatal HI.

Avascular necrosis of the femoral head after osteosynthesis of femoral neck fracture.

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Min, Byung-Woo; Kim, Sung-Jin

2011-05-18

The reported incidence of avascular necrosis after femoral neck fracture fixation varies widely, and there is no consensus regarding its risk factors. We evaluated the incidence of avascular necrosis of the femoral head with the use of contemporary techniques for femoral neck fracture fixation. We then sought to determine what potential risk factors influenced the development of avascular necrosis.Between 1990 and 2005, one hundred sixty-three intracapsular femoral neck fractures in 163 patients were treated with internal fixation at our level-I trauma center. All patients were monitored until conversion to total hip arthroplasty or for a minimum of 2 years postoperatively. Ten patients (10 hips) died and 7 patients (7 hips) were lost to follow-up. The remaining 146 patients (146 hips) had a mean 5.2 years of follow-up (range, 3 months to 17 years). The incidence of avascular necrosis was 25.3% (37 hips). The average time to diagnosis of avascular necrosis was 18.8 months (range, 3-47 months). Patient sex, age, interval from injury to surgery, and mechanism of injury were statistically not associated with the development of avascular necrosis. The quality of fracture reduction, adequacy of fixation, degree of displacement, and comminution of the posterior cortex were significantly associated. After we controlled for patient and radiographic characteristics, multivariate analyses indicated that the important predictors for avascular necrosis are poor reduction (odds ratio=13.889) and initial displacement of the fracture (odds ratio=4.693). Copyright 2011, SLACK Incorporated.

preescolares desnutridos con madres con obesidad y sin obesidad

Directory of Open Access Journals (Sweden)

Viridiana Vanessa Conzuelo-González

2009-01-01

Full Text Available El primer objetivo fue conocer cuántos menores de cinco años con diferentes grados de desnutrición tienen una madre con sobrepeso/obesidad/ en una comunidad indígena que vive en extrema pobreza y bajo condiciones de migración masculina internacional. El segundo fue comparar tres variables socionutricionales (ingreso familiar, educación de la madre y adecuación nutrimental de la dieta diaria entre estos hogares y los hogares con desnutrición infantil y madres sin obesidad. Se realizó un estudio transversal (2006-2007, en la comunidad mazahua de San Francisco Tepeolulco, Municipio de Temascalcingo; que incluyó a 85 hogares integrados por preescolares con desnutrición inscritos al programa Oportunidades. Se determinó el estado nutrición de los preescolares con indicadores antropométricos y se obtuvo el IMC de las madres de estos infantes. Se aplicó una encuesta socionutricional, incluida el recordatorio de 24 horas, y complementado con la observación participante (cualitativa. Se encontró que 83% de las madres mazahuas presentaron sobrepeso u obesidad. El estado de nutrición de los preescolares con madres con obesidad presentó un porcentaje mayor de desnutrición (76%. En la variable género, se encontró que 54% de los niños con madres con obesidad tenía baja talla. Al relacionar el nivel educativo de la madre, esta variable resultó ser estadísticamente significativa (p=0.015, donde el analfabetismo está más relacionado con la desnutrición infantil que tienen madres de bajo y/o peso normal. La elevada prevalencia de hogares conformados con preescolares con desnutrición y madres con obesidad, es un síntoma más de la pobreza en zonas indígenas en México, con bajo índice de desarrollo humano.

Femoral Head Avascular Necrosis Is Not Caused by Arthroscopic Posterolateral Femoroplasty.

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Rupp, Robert E; Rupp, Sasha N

2016-05-01

This study was conducted to identify the risk of avascular necrosis of the femoral head after arthroscopic femoroplasty extending to the posterolateral femoral neck, the source of the primary blood supply to the femoral head. Cam lesions of femoroacetabular impingement are typically anterior along the junction of the femoral head and neck. However, anatomic variations can involve the posterolateral vascular region of the femoral head and neck. Femoroplasty involving this vascular region can lead to injury to the blood supply to the femoral head, with subsequent avascular necrosis. If the posterolateral portion of the cam lesion is preserved, persistent femoroacetabular impingement may occur. A retrospective review identified 112 patients who underwent arthroscopic femoroplasty for femoroacetabular impingement over a 2-year period. Of these patients, 14 had femoroplasty that extended to the posterolateral femoral head. Of this group, 5 had undergone magnetic resonance imaging (MRI) after femoroplasty and the other 9 were contacted to undergo MRI of the hip to evaluate for avascular necrosis. A radiologist and the senior author evaluated all MRI scans specifically for avascular necrosis of the femoral head. All procedures were performed by the senior author. Mean age of the 14 patients (8 women and 6 men) with femoroplasty that extended into the posterolateral vascular region of the femoral head was 44 years (range, 23-69 years). All 14 patients underwent MRI evaluation of the affected hip a mean of 25 months (range, 7-44 months) after femoroplasty. No MRI scans showed evidence of avascular necrosis of the femoral head. Femoroplasty of the posterolateral vascular region of the femoral head is not associated with avascular necrosis. Patients with femoroacetabular impingement and a cam lesion extending to the posterolateral femoral head can undergo femoroplasty of this region without the development of avascular necrosis. [Orthopedics. 2016; 39(3):177-180.]. Copyright

Response-driven imaging biomarkers for predicting radiation necrosis of the brain

International Nuclear Information System (INIS)

Nazem-Zadeh, Mohammad-Reza; Chapman, Christopher H; Lawrence, Theodore S; Ten Haken, Randall K; Tsien, Christina I; Cao, Yue; Chenevert, Thomas

2014-01-01

Radiation necrosis is an uncommon but severe adverse effect of brain radiation therapy (RT). Current predictive models based on radiation dose have limited accuracy. We aimed to identify early individual response biomarkers based upon diffusion tensor (DT) imaging and incorporated them into a response model for prediction of radiation necrosis. Twenty-nine patients with glioblastoma received six weeks of intensity modulated RT and concurrent temozolomide. Patients underwent DT-MRI scans before treatment, at three weeks during RT, and one, three, and six months after RT. Cases with radiation necrosis were classified based on generalized equivalent uniform dose (gEUD) of whole brain and DT index early changes in the corpus callosum and its substructures. Significant covariates were used to develop normal tissue complication probability models using binary logistic regression. Seven patients developed radiation necrosis. Percentage changes of radial diffusivity (RD) in the splenium at three weeks during RT and at six months after RT differed significantly between the patients with and without necrosis (p = 0.05 and p = 0.01). Percentage change of RD at three weeks during RT in the 30 Gy dose–volume of the splenium and brain gEUD combined yielded the best-fit logistic regression model. Our findings indicate that early individual response during the course of RT, assessed by radial diffusivity, has the potential to aid the prediction of delayed radiation necrosis, which could provide guidance in dose-escalation trials. (paper)

Analysis of hip perfusion at early and reversible stages of aseptic hip necrosis

International Nuclear Information System (INIS)

Predic, P.; Dodig, D.; Karner, I.

2002-01-01

Aim: A proper early diagnosis of aseptic hip necrosis is very important for further therapy.Since there has always been a question of the amount of perfusion in hips at different stages of aseptic hip necrosis we tried to impartially examine the perfusion in hips at early and reversible stages of aseptic hip necrosis. Material and Methods:Study included 143 patients with aseptic hip necrosis.The 550-740 MBq of Tc-99m-DPD were on bolus injected.All patients were subjected to 3-phase scintigraphy of hips and quantitative calculation of relative perfusion in the artery phase (3T) at early and repeated at reversible stages of aseptic hip necrosis. Results: At the early stage of aseptic hip necrosis the obtained 3T was decreased from 0.94-0.69 (3T=0.80).Scintigrams showed a moderate increase or diffuse accumulation. At the reversible stages we obtained 3T decreased from 0.92-0.71 (3T=0.79) thus evidencing hypoperfusion.Scintigrams showed an diffuse increased accumulation. Conclusion: With the aseptic hip necrosis quantitative analysis of perfusion in the artery phase-3T indicates that the perfusion is decreased at all stages of the process which however shows a significantly falling trend with the progress of the disease

Serum and Urinary Levels of Tumor Necrosis Factor-Alpha in Renal Transplant Patients.

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Senturk Ciftci, Hayriye; Demir, Erol; Savran Karadeniz, Meltem; Tefik, Tzevat; Yazici, Halil; Nane, Ismet; Savran Oguz, Fatma; Aydin, Filiz; Turkmen, Aydin

2017-12-18

Allograft rejection is an important cause of early and long-term graft loss in kidney transplant recipients. Tumor necrosis factor-alpha promotes T-cell activation, the key reaction leading to allograft rejection. Here, we investigated whether serum and urinary tumor necrosis factor-alpha levels can predict allograft rejection. This study included 65 living related-donor renal transplant recipients with mean follow-up of 26 ± 9 months. Serum and urinary tumor necrosis factor-alpha levels were measured at pretransplant and at posttransplant time points (days 1 and 7 and months 3 and 6); serum creatinine levels were also monitored during posttransplant follow-up. Standard enzyme-linked immunoabsorbent assay was used to detect tumor necrosis factor-alpha levels. Clinical variables were monitored. Nine of 65 patients (13.8%) had biopsy-proven rejection during follow-up. Preoperative serum and urinary tumor necrosis factor-alpha levels were not significantly different when we compared patients with and without rejection. Serum tumor necrosis factor-alpha levels (in pg/mL) were significantly higher in the allograft rejection versus nonrejection group at day 7 (11.5 ± 4.7 vs 15.4 ± 5.8; P = .029) and month 1 (11.1 ± 4.8 vs 17.8 ± 10.9; P =.003). Urinary tumor necrosis factor-alpha levels (in pg/mL) were also elevated in the allograft rejection versus the nonrejection group at days 1 (10.2 ± 2.5 vs 14.1 ± 6.8; P = .002) and 7 (9.8 ± 2.2 vs 14.5 ± 2.7; P tumor necrosis factor-alpha has a role in diagnosing renal transplant rejection. Serum and urinary tumor necrosis factor-alpha levels may be a possible predictor for allograft rejection.

A case report of radiation necrosis of the larynx

International Nuclear Information System (INIS)

Tanaka, Eiichi; Inouye, Tetsuzo; Hiraide, Fumihisa; Tsubaki, Yasukiyo; Miyakogawa, Norimasa; Sawada, Masamichi

1983-01-01

A case of radiation necrosis of the larynx is reported. The patient was a 79-year-old man who was radiated with the dosis of 3900 rad for suspected carcinoma of the larynx in 1976 and 5300 rad for carcinoma of the larynx in 1980. After completion of radiation therapy, he started to have hoarseness. He was admitted to the hospital because of severe dyspnea. Fiberoptic examination revealed almost complete obstruction of the laryngeal lumen by necrotic tissues due to radiation necrosis. There was little space reserved for respiration. No motility of the vocal cords and arytenoids was observed. After tracheostomy, conservative local and systemic treatments and repeated removal of necrotic tissues through laryngomicrosurgery were performed. However, an advanced necrosis with infection could not be controlled. Therefore, total laryngectomy was performed. Microscopically, no malignant cells were noted in the larynx. As most soft tissues were degenerated into fibrosis, the pharynx was left open. When infection was entirely controlled, the lining flap method from the anterior chest was applied to close the pharynx. When severe radiation necrosis occurs in the larynx, laryngectomy is sometimes mandatory to be performed. It is important that infection should be controlled before and after laryngectomy. Delayed skin flap method is advised. (author)

Extent and distribution of skeletal muscle necrosis after graded periods of complete ischemia

International Nuclear Information System (INIS)

Labbe, R.; Lindsay, T.; Walker, P.M.

1987-01-01

The management of an acutely ischemic extremity requires knowledge of the response of skeletal muscle (the largest component of the lower limb) to prolonged periods of complete normothermic ischemia. We have used the canine gracilis muscle model to evaluate the extent and distribution of ischemic necrosis after 3 and 5 hours of ischemia and 48 hours of reperfusion. Each muscle was cut into six slices, and the extent and distribution of postischemic necrosis identified by means of nitroblue tetrazolium staining and 99mTc pyrophosphate uptake. After 3, 4, and 5 hours of ischemia the extent of necrosis was 2.0% +/- 0.9%, 30.3% +/- 6.0%, and 90.1% +/- 3.5% (mean +/- SEM), respectively. A statistically significant correlation exists between the extent of necrosis and the uptake of 99mTc pyrophosphate uptake per gram of tissue (y = 1574.9x - 8.4, r = 0.84, p less than 0.001). Most necrosis was centrally located and found in the thickest portion of the muscle. We conclude that there is a graded response in the extent of skeletal muscle necrosis related to the length of ischemic stress rather than an ''all-or-none'' phenomenon. This central distribution of necrosis makes the usual external evaluation of ischemic damage clinically unreliable. In addition, since there was no enveloping fascia in this model, a compartment release alone may not prevent the development of skeletal muscle necrosis. This knowledge of the response of skeletal muscle to ischemia may lead to an improved clinical approach to an extremity suffering a prolonged ischemic insult

Partial avascular necrosis after talar neck fracture.

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Babu, Nina; Schuberth, John M

2010-09-01

Recently, it has been shown that avascular necrosis of the talus can occur in only a portion of the talar body. There is little information regarding the geographic location of the avascular segment and the clinical significance of an incomplete avascular process. Seven patients with partial avascular necrosis after Hawkins type II or III fracture dislocations were evaluated with magnetic resonance scans. The precise anatomic location of the avascular segment was determined and assigned to a specific quadrant of the talar body. The operative exposure, incidence of collapse, and time to operative intervention was recorded. The avascular segment of the talar body was located predominantly in the anterior lateral and superior portion in six of the seven patients. Collapse occurred in three of the patients in the area of avascular process. There were no observable trends with regard to operative exposure, Hawkins classification, incidence of collapse, or time to operative intervention to the location of the avascular segment. Partial avascular necrosis can occur after fracture dislocation of the talus. The predominant location of the avascular segment was the anterior lateral and superior portion of the talar body. This observation corresponds to regional damage to the blood supply of the talus and may help clarify the pathogenesis of partial avascular process.

RIP3-dependent necrosis induced inflammation exacerbates atherosclerosis

Energy Technology Data Exchange (ETDEWEB)

Meng, Lingjun, E-mail: menglingjun@nibs.ac.cn [College of Biological Sciences, China Agricultural University, Beijing 100094 (China); National Institute of Biological Sciences, Beijing 102206 (China); Jin, Wei [Institute for Immunology, Tsinghua University, Beijing 100084 (China); Wang, Yuhui [Institute of Cardiovascular Sciences, Health Science Center, Peking University, Beijing 100191 (China); Huang, Huanwei; Li, Jia; Zhang, Cai [National Institute of Biological Sciences, Beijing 102206 (China)

2016-04-29

Atherothrombotic vascular disease is already the leading cause of mortality worldwide. Atherosclerosis shares features with diseases caused by chronic inflammation. More attention should concentrates on the innate immunity effect atherosclerosis progress. RIP3 (receptor-interacting protein kinase 3) act through the transcription factor named Nr4a3 (Nuclear orphan receptors) to regulate cytokine production. Deletion RIP3 decreases IL-1α production. Injection of anti-IL-1α antibody protects against the progress of atherosclerosis in ApoE −/− mice. RIP3 as a molecular switch in necrosis, controls macrophage necrotic death caused inflammation. Inhibiting necrosis will certainly reduce atherosclerosis through limit inflammation. Necrotic cell death caused systemic inflammation exacerbated cardiovascular disease. Inhibition of necrosis may yield novel therapeutic targets for treatment in years to come. - Highlights: • RIP3 regulate the Nr4a3 to control cytokine production. • Deletion RIP3 decreases IL-1a production. • Injection anti-IL-1a antibody protects against the progress of atherosclerosis. • RIP3 controls macrophage necrotic dead caused inflammation.

RIP3-dependent necrosis induced inflammation exacerbates atherosclerosis

International Nuclear Information System (INIS)

Meng, Lingjun; Jin, Wei; Wang, Yuhui; Huang, Huanwei; Li, Jia; Zhang, Cai

2016-01-01

Atherothrombotic vascular disease is already the leading cause of mortality worldwide. Atherosclerosis shares features with diseases caused by chronic inflammation. More attention should concentrates on the innate immunity effect atherosclerosis progress. RIP3 (receptor-interacting protein kinase 3) act through the transcription factor named Nr4a3 (Nuclear orphan receptors) to regulate cytokine production. Deletion RIP3 decreases IL-1α production. Injection of anti-IL-1α antibody protects against the progress of atherosclerosis in ApoE −/− mice. RIP3 as a molecular switch in necrosis, controls macrophage necrotic death caused inflammation. Inhibiting necrosis will certainly reduce atherosclerosis through limit inflammation. Necrotic cell death caused systemic inflammation exacerbated cardiovascular disease. Inhibition of necrosis may yield novel therapeutic targets for treatment in years to come. - Highlights: • RIP3 regulate the Nr4a3 to control cytokine production. • Deletion RIP3 decreases IL-1a production. • Injection anti-IL-1a antibody protects against the progress of atherosclerosis. • RIP3 controls macrophage necrotic dead caused inflammation.

Macroscopic and microscopic findings in avascular necrosis of the femoral head.

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Kamal, Diana; Alexandru, D O; Kamal, C K; Streba, C T; Grecu, D; Mogoantă, L

2012-01-01

The avascular necrosis of the femoral head is an illness induced by the cutoff of blood flow to the femoral head and it affects mostly young adults between the ages of 30 and 50 years, raising therapeutic and diagnostic issues. Many risk factors are incriminated in the development of avascular necrosis of the femoral head like: trauma, chronic alcohol consumption, smoking, administration of corticosteroid drugs, most of the cases are considered to be idiopathic. The main goal of our paper is to describe the macroscopic and microscopic variations of the bone structure, which occur in patients with avascular necrosis of the femoral head. The biological material needed for our study was obtained following hip arthroplasty surgery in 26 patients between the ages of 29 and 59 years, which previously were diagnosed with avascular necrosis of the femoral head and admitted in the Orthopedics Department of the Emergency County Hospital of Craiova (Romania) between 2010 and 2011. From a macroscopic point of view, we found well defined areas of necrosis, most of which were neatly demarcated of the adjacent viable tissue by hyperemic areas, loss of shape and contour of the femoral head and transformations of the articular cartilage above the area of necrosis. When examined under the microscope, we found vast areas of fibrosis, narrow bone trabeculae, obstructed blood vessels or blood vessels with clots inside, hypertrophic fat cells, bone sequestration but also small cells and pyknotic nuclei. The microscopic and macroscopic findings on the femoral head sections varied with the patients and the stage of the disease.

Avascular necrosis ofbone following renal transplantation

African Journals Online (AJOL)

and avascular necrosis was reported in 1957 in a patient ... Onset of pain ranged from 2 months to 36 months .... and corticosteroid-induced diabetes); (iv) severe sec- ... reponed in the shoulder and elbow joints, i.e. humeral head, distal ...

Colonic ischemic necrosis following therapeutic embolization

International Nuclear Information System (INIS)

Shenoy, S.S.; Satchidanand, S.; Wesp, E.H.; State Univ. of New York, Buffalo

1981-01-01

Transcatheter embolization of the middle colic artery for diverticular bleeding was followed by ischemic necrosis in the transverse colon at the site of previous anastomosis and stricture formation. This is a potential complication of intra-arterial embolization for colonic bleeding. (orig.)

Colonic ischemic necrosis following therapeutic embolization

Energy Technology Data Exchange (ETDEWEB)

Shenoy, S S; Satchidanand, S; Wesp, E H

1981-07-15

Transcatheter embolization of the middle colic artery for diverticular bleeding was followed by ischemic necrosis in the transverse colon at the site of previous anastomosis and stricture formation. This is a potential complication of intra-arterial embolization for colonic bleeding.

Tumor necrosis factor-alpha inhibits differentiation of myogenic cells in human urethral rhabdosphincter.

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Shinohara, Mayuka; Sumino, Yasuhiro; Sato, Fuminori; Kiyono, Tohru; Hashimoto, Naohiro; Mimata, Hiromitsu

2017-06-01

To examine the inhibitory effects of tumor necrosis factor-α on myogenic differentiation of human urethral rhabdosphincter cells. A rhabdosphincter sample was obtained from a patient who underwent total cystectomy. To expand the lifespan of the primary cultured cells, rhabdosphincter myogenic cells were immortalized with mutated cyclin-dependent kinase 4, cyclin D1 and telomerase. The differential potential of the cells was investigated. The transfected human rhabdosphincter cells were induced for myogenic differentiation with recombinant human tumor necrosis factor-α and/or the tumor necrosis factor-α antagonist etanercept at different concentrations, and activation of signaling pathways was monitored. Human rhabdosphincter cells were selectively cultured for at least 40 passages. Molecular analysis confirmed the expression of myosin heavy chain, which is a specific marker of differentiated muscle cells, significantly increased after differentiation induction. Although tumor necrosis factor-α treatment reduced the myosin heavy chain expression in a concentration-dependent manner, etanercept inhibited this suppression. Tumor necrosis factor-α suppressed phosphorylation of protein kinase B and p38, whereas etanercept pretreatment promoted phosphorylation and myosin heavy chain expression in a concentration-dependent manner. Tumor necrosis factor-α inhibits differentiation of urethral rhabdosphincter cells in part through the p38 mitogen-activated protein kinase and phosphoinositide 3-kinase pathways. Inhibition of tumor necrosis factor-α might be a useful strategy to treat stress urinary incontinence. © 2017 The Japanese Urological Association.

Apoptosis and Necrosis in the Liver

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Guicciardi, Maria Eugenia; Malhi, Harmeet; Mott, Justin L.; Gores, Gregory J.

2013-01-01

Because of its unique function and anatomical location, the liver is exposed to a multitude of toxins and xenobiotics, including medications and alcohol, as well as to infection by hepatotropic viruses, and therefore, is highly susceptible to tissue injury. Cell death in the liver occurs mainly by apoptosis or necrosis, with apoptosis also being the physiologic route to eliminate damaged or infected cells and to maintain tissue homeostasis. Liver cells, especially hepatocytes and cholangiocytes, are particularly susceptible to death receptor-mediated apoptosis, given the ubiquitous expression of the death receptors in the organ. In a quite unique way, death receptor-induced apoptosis in these cells is mediated by both mitochondrial and lysosomal permeabilization. Signaling between the endoplasmic reticulum and the mitochondria promotes hepatocyte apoptosis in response to excessive free fatty acid generation during the metabolic syndrome. These cell death pathways are partially regulated by microRNAs. Necrosis in the liver is generally associated with acute injury (i.e., ischemia/reperfusion injury) and has been long considered an unregulated process. Recently, a new form of “programmed” necrosis (named necroptosis) has been described: the role of necroptosis in the liver has yet to be explored. However, the minimal expression of a key player in this process in the liver suggests this form of cell death may be uncommon in liver diseases. Because apoptosis is a key feature of so many diseases of the liver, therapeutic modulation of liver cell death holds promise. An updated overview of these concepts is given in this article. PMID:23720337

Using computed tomography to assist with diagnosis of avascular necrosis complicating chronic scaphoid nonunion.

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Smith, Michael L; Bain, Gregory I; Chabrel, Nick; Turner, Perry; Carter, Chris; Field, John

2009-01-01

The primary aim of our study was to investigate use of long axis computed tomography (CT) in predicting avascular necrosis of the proximal pole of the scaphoid and subsequent fracture nonunion after internal fixation. In addition, we describe a new technique of measuring the position of a scaphoid fracture and provide data on its reproducibility. Thirty-one patients operated on by the senior author for delayed union or nonunion of scaphoid fracture were included. Preoperative CT scans were independently assessed for increased radiodensity of the proximal pole, converging trabeculae, degree of deformity, comminution, and fracture position. Intraoperative biopsies of the proximal pole were obtained and histologically assessed for evidence of avascular necrosis. The radiologic variables were statistically compared with the histologic findings. The presence of avascular necrosis was also compared with postoperative union status, identified on longitudinal CT scans. Preoperative CT features that statistically correlated with histologic evidence of avascular necrosis were increased radiodensity of the proximal pole and the absence of any converging trabeculae between the fracture fragments. The radiologic changes of avascular necrosis and the histologic confirmation of avascular necrosis were associated with persistent nonunion. Preoperative longitudinal CT of scaphoid nonunion is of great value in identifying avascular necrosis and predicting subsequent fracture union. If avascular necrosis is suspected based on preoperative CT, management options include vascularized bone grafts and bone morphogenic protein for younger patients and limited wrist arthrodesis for older patients. Diagnostic II.

Pravastatin Protects Against Avascular Necrosis of Femoral Head via Autophagy.

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Liao, Yun; Zhang, Ping; Yuan, Bo; Li, Ling; Bao, Shisan

2018-01-01

Autophagy serves as a stress response and may contribute to the pathogenesis of avascular necrosis of the femoral head induced by steroids. Statins promote angiogenesis and ameliorate endothelial functions through apoptosis inhibition and necrosis of endothelial progenitor cells, however the process used by statins to modulate autophagy in avascular necrosis of the femoral head remains unclear. This manuscript determines whether pravastatin protects against dexamethasone-induced avascular necrosis of the femoral head by activating endothelial progenitor cell autophagy. Pravastatin was observed to enhance the autophagy activity in endothelial progenitor cells, specifically by upregulating LC3-II/Beclin-1 (autophagy related proteins), and autophagosome formation in vivo and in vitro . An autophagy inhibitor, 3-MA, reduced pravastatin protection in endothelial progenitor cells exposed to dexamethasone by attenuating pravastatin-induced autophagy. Adenosine monophosphate-activated protein kinase (AMPK) is a key autophagy regulator by sensing cellular energy changes, and indirectly suppressing activation of the mammalian target of rapamycin (mTOR). We found that phosphorylation of AMPK was upregulated however phosphorylation of mTOR was downregulated in pravastatin-treated endothelial progenitor cells, which was attenuated by AMPK inhibitor compound C. Furthermore, liver kinase B1 (a phosphorylase of AMPK) knockdown eliminated pravastatin regulated autophagy protein LC3-II in endothelial progenitor cells in vitro . We therefore demonstrated pravastatin rescued endothelial progenitor cells from dexamethasone-induced autophagy dysfunction through the AMPK-mTOR signaling pathway in a liver kinase B1-dependent manner. Our results provide useful information for the development of novel therapeutics for management of glucocorticoids-induced avascular necrosis of the femoral head.

[Thoracic aortic dissection revealed by systemic cholesterol embolism].

Science.gov (United States)

Braem, L; Paule, P; Héno, P; Morand, J J; Mafart, B; La Folie, T; Varlet, P; Mioulet, D; Fourcade, L

2006-10-01

Systemic cholesterol embolism is a rare complication of atherosclerosis, and has various presentations. Arterial catheterisms are a common cause. However, the association with an aortic dissection has been exceptionally reported. We report the observation of a 70 year-old man, with coronary artery disease, hypertension, diabetes and dyslipidemia. Six months before hospitalization, a coronary angioplasty was performed due to recurrent angina. The association of purpuric lesions on the feet, with acute renal failure confirmed cholesterol embolism syndrome. Transoesophageal echocardiography showed a dissection of the descending thoracic aorta associated with complex atheroma. The evolution was marked by the pulpar necrosis of a toe and by a worsening of the renal failure, requiring definitive hemodialysis. Further echographic control highlighted the rupture of the intimal veil of the dissection. Cholesterol embolism syndrome may reveal an aortic dissection in patients without thoracic symptoms. In such cases, transoesophageal echocardiography is a useful and non-invasive examination.

Coupling of Rigor Mortis and Intestinal Necrosis during C. elegans Organismal Death

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Evgeniy R. Galimov

2018-03-01

Full Text Available Organismal death is a process of systemic collapse whose mechanisms are less well understood than those of cell death. We previously reported that death in C. elegans is accompanied by a calcium-propagated wave of intestinal necrosis, marked by a wave of blue autofluorescence (death fluorescence. Here, we describe another feature of organismal death, a wave of body wall muscle contraction, or death contraction (DC. This phenomenon is accompanied by a wave of intramuscular Ca2+ release and, subsequently, of intestinal necrosis. Correlation of directions of the DC and intestinal necrosis waves implies coupling of these death processes. Long-lived insulin/IGF-1-signaling mutants show reduced DC and delayed intestinal necrosis, suggesting possible resistance to organismal death. DC resembles mammalian rigor mortis, a postmortem necrosis-related process in which Ca2+ influx promotes muscle hyper-contraction. In contrast to mammals, DC is an early rather than a late event in C. elegans organismal death.

A case of systemic lupus erythematosus presenting as bilateral avascular necrosis of femur.

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Adikari, Madura; Gunawardane, Aloka; Illangantilaka, Sachithra; Atukorale, Himantha; Rubasinghe, Jeevanie

2016-08-05

Avascular necrosis occur as a result of diverse etiology. Chronic inflammatory conditions such as systemic lupus erythematosus considered as a recognize cause. Many cases were reported in systemic lupus erythematosus after treating with corticosteroids. We report a case of a corticosteroid naïve patient presented as bilateral avascular necrosis of femoral head and later progressed to a case of systemic lupus erythematosus. A 26 year old lady presented with right sided hip pain and diagnosed as avascular necrosis of the femoral head. After 6 months she presented a similar pain in left hip, which revealed avascular necrosis of left femoral head as well. A probable cause for her clinical presentation could not be found after extensive clinical and laboratory evaluation. Patient reported high erythrocyte sedimentation rate persistently, and over the next few years progressed as a case of systemic lupus erythematosus. Above case illustrated avascular necrosis could be an early musculoskeletal manifestation of systemic lupus erythematosus even in the absence of corticosteroid administration.

A Rare Cause of Acute Abdomen: Idiopathic Isolated Cecal Necrosis

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Ender Özer

2015-03-01

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

A Role of RIP3-Mediated Macrophage Necrosis in Atherosclerosis Development

Directory of Open Access Journals (Sweden)

Juan Lin

2013-01-01

Full Text Available Necrotic death of macrophages has long been known to be present in atherosclerotic lesions but has not been studied. We examined the role of receptor interacting protein (RIP 3, a mediator of necrotic cell death, in atherosclerosis and found that RIP3−/−;Ldlr−/− mice were no different from RIP3+/+;Ldlr−/− mice in early atherosclerosis but had significant reduction in advanced atherosclerotic lesions. Similar results were observed in Apoe−/− background mice. Bone marrow transplantation revealed that loss of RIP3 expression from bone-marrow-derived cells is responsible for the reduced disease progression. While no difference was found in apoptosis between RIP3−/−;Ldlr−/− and RIP3+/+;Ldlr−/− mice, electron microscopy revealed a significant reduction of macrophage primary necrosis in the advanced lesions of RIP3−/− mice. In vitro cellular studies showed that RIP3 deletion had no effect on oxidized low-density lipoprotein (LDL-induced macrophage apoptosis, but prevented macrophage primary necrosis occurring in response to oxidized LDL under caspase inhibition or RIP3 overexpression conditions. RIP3-dependent necrosis is not postapoptotic, and the increased primary necrosis in advanced atherosclerotic lesions most likely resulted from the increase of RIP3 expression. Our data demonstrate that primary necrosis of macrophages is proatherogenic during advanced atherosclerosis development.

Delayed cerebral radiation necrosis following treatment for a plasmacytoma of the skull.

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Chambless, Lola B; Angel, Federica B; Abel, Ty W; Xia, Fen; Weaver, Kyle D

2010-10-25

Cerebral radiation necrosis is a relatively common complication of radiation therapy for intracranial malignancies which can also rarely be encountered after radiation of extracranial lesions of the head and neck. We present the first reported case of cerebral radiation necrosis in a patient who underwent radiation therapy for a plasmacytoma of the skull. A 68-year-old male with multiple myeloma presented with an enhancing right frontal mass, 8 years after receiving radiation therapy for a plasmacytoma of the left frontal skull. The patient underwent a diagnostic and therapeutic craniotomy for a presumed neoplastic lesion. The pathologic diagnosis made in this case was delayed radiation necrosis. The patient was followed for over a year during which this process continued to evolve before the ultimate resolution of his clinical symptoms and radiographic abnormality. This case highlights the importance of considering radiation necrosis in the differential diagnosis of any patient with an intracranial mass and a history of radiation for an extracranial head and neck malignancy, regardless of timing and laterality. This case also provides unique insights into the ongoing debate regarding the role of the aberrant immune response in the pathogenesis of delayed cerebral radiation necrosis.

[RESEARCH PROGRESS OF EXPERIMENTAL ANIMAL MODELS OF AVASCULAR NECROSIS OF FEMORAL HEAD].

Science.gov (United States)

Yu, Kaifu; Tan, Hongbo; Xu, Yongqing

2015-12-01

To summarize the current researches and progress on experimental animal models of avascular necrosis of the femoral head. Domestic and internation literature concerning experimental animal models of avascular necrosis of the femoral head was reviewed and analyzed. The methods to prepare the experimental animal models of avascular necrosis of the femoral head can be mainly concluded as traumatic methods (including surgical, physical, and chemical insult), and non-traumatic methods (including steroid, lipopolysaccharide, steroid combined with lipopolysaccharide, steroid combined with horse serum, etc). Each method has both merits and demerits, yet no ideal methods have been developed. There are many methods to prepare the experimental animal models of avascular necrosis of the femoral head, but proper model should be selected based on the aim of research. The establishment of ideal experimental animal models needs further research in future.

Progressive skin necrosis of a huge occipital encephalocele

Science.gov (United States)

Andarabi, Yasir; Nejat, Farideh; El-Khashab, Mostafa

2008-01-01

Objects: Progressive skin necrosis of giant occipital encephalocoele is an extremely rare complication found in neonates. Infection and ulceration of the necrosed skin may lead to meningitis or sepsis. We present here a neonate with giant occipital encephalocoele showing progressive necrosis during the first day of his life. Methods: A newborn baby was found to have a huge mass in the occipital region, which was covered by normal pink-purplish skin. During the last hours of the first day of his life, the sac started becoming ulcerated accompanied with a rapid color change in the skin, gradually turning darker and then black. The neonate was taken up for urgent excision and repair of the encephalocele. Two years after the operation, he appears to be well-developed without any neurological problems. Conclusion: Necrosis may have resulted from arterial or venous compromise caused by torsion of the pedicle during delivery or after birth. The high pressure inside the sac associated with the thin skin of the encephalocoele may be another predisposing factor. In view of the risk of ulceration and subsequent infection, urgent surgery of the necrotizing encephalocele is suggested. PMID:19753210

Progressive skin necrosis of a huge occipital encephalocele

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Andarabi Yasir

2008-01-01

Full Text Available Objects: Progressive skin necrosis of giant occipital encephalocoele is an extremely rare complication found in neonates. Infection and ulceration of the necrosed skin may lead to meningitis or sepsis. We present here a neonate with giant occipital encephalocoele showing progressive necrosis during the first day of his life. Methods: A newborn baby was found to have a huge mass in the occipital region, which was covered by normal pink-purplish skin. During the last hours of the first day of his life, the sac started becoming ulcerated accompanied with a rapid color change in the skin, gradually turning darker and then black. The neonate was taken up for urgent excision and repair of the encephalocele. Two years after the operation, he appears to be well-developed without any neurological problems. Conclusion: Necrosis may have resulted from arterial or venous compromise caused by torsion of the pedicle during delivery or after birth. The high pressure inside the sac associated with the thin skin of the encephalocoele may be another predisposing factor. In view of the risk of ulceration and subsequent infection, urgent surgery of the necrotizing encephalocele is suggested.

A Case of Unresectable Rectal Necrosis

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Mohammed Nassif

2011-01-01

Full Text Available Introduction. Necrosis of the rectum is an uncommon finding due to abundant collateral vasculature. Its management remains challenging, without clear consensus in the literature. Case Report. We describe a case of a 53-year-old woman with multiple medical comorbidities that presented in septic shock and hematochezia. Colonoscopy revealed ischemic colitis. Conservative management was instituted. At two weeks, she presented evidence of peritonitis. Exploratory laparotomy revealed extensive necrosis of the left colon and rectum. Due to dense inflammation, resection was deemed unsafe. Therefore, a transverse ostomy with mucosal fistula was preformed. Multiple drains were left in place. The patient healed uneventfully. Conclusion. This case illustrates that, if extensive dissection of the distal colon and rectum is unsafe due to the patient's critical condition or technical feasibility, then a diverting ostomy of the proximal viable bowel along with a mucus fistula and good drainage of the abdomen represents an acceptable alternative.

ANÁLISIS DESCRIPTIVO DE LA RESPUESTA DEL COMPLEJO PULPO-DENTINAL DE ÓRGANOS DENTALES DE UNA POBLACIÓN PREHISPÁNICA CAZADORA-RECOLECTORA

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María Clemencia Vargas Vargas

2012-01-01

Full Text Available Antecedentes: El diente es de gran importancia cuando se trata de caracterizar individuos, poblaciones vivas o desaparecidas. Este componente es el que más resiste a la descomposición, debido a que al terminar su calcificación, el diente se conforma definitivamente y por tal razón no sufre ningún cambio. A excepción del desgaste mecánico o atrición y la acumulación de dentina secundaria. Objetivo: Deducir los posibles factores etiológicos que ocasionaron grandes desgastes dentales y condujeron a una rápida respuesta del complejo pulpo dentinal, en los individuos pertenecientes a una población prehispánica de cazadores-recolectores, del precerámico temprano y tardío cuya dieta era basada en alimentos fibrogénicos y abrasivos. Materiales y Métodos: Estudio descriptivo transversal donde se tomaron 15 piezas dentales, pertenecientes a dos poblaciones cazadoras-recolectoras: Precerámico temprano (Chequa y Precerámico tardío (Aguazuque.  A estos dos grupos se tomaron las muestras para realizar un análisis clínico, radiográfico y microscópico. Resultados: Disminución evidente en el tamaño de la corona clínica dental, se observaron diferentes grados de desgaste dental con exposición dentinaria delimitado por esmalte en su circunferencia. La dentina expuesta por el desgaste dental presenta un color amarillo, las superficies oclusales e incisales se presentan lisas. Ninguna de las piezas dentarias presentó signos clínicos de caries. Respecto al examen radiográfico, los datos obtenidos confirmaron los hallazgos clínicos. Conclusiones: El desgaste dental es la característica clínica que más se presentó, posiblemente asociado al consumo de alimentos fibrosos y a la fuerza imprimida en la acción masticatoria, además es agravado por partículas abrasivas que se adherían a los alimentos, durante la maceración con elementos líticos. Las estructuras dentales más afectadas por el desgaste dental corresponden al esmalte y

Avascular necrosis of the hip

International Nuclear Information System (INIS)

Lang, P.; Genant, H.K.; Lindquist, T.; Chafetz, N.; Steiger, P.; Sanny, J.; Rhodes, M.L.; Rothman, S.L.G.; Delamarter, R.; Kilgus, D.

1988-01-01

T1-weighted (repetition time [TR] = 450 msec, echo time [TE] = 20 msec), T2-weighted (TR = 1,800 msec, TE = 20 and 80 msec), and T2*-weighted gradient-echo gradient recalled acquisition in a steady state, TR = 70 msec, TE = 30 msec, theta = 15 0 ) MR images (General Electric Signa, 1.5 T) were generated in 11 patients with avascular necrosis of the hip. Three-dimensional MR image reconstruction was performed on an independent imaging system (IIS, Dimensional Medicine Inc). Pelvic and femoral bone contours were computed based on either the T1-weighted or the T2*-weighted images. Three-dimensional displays of necrotic zones and areas of granulation tissue were computed on the basis of the T2-weighted images. The tissues were simultaneously displayed in the three-dimensional images using different colors and transparencies. The three-dimensional MR images generated demonstrated the extent of the necrotic zone and adjacent granulation tissue and their position relative to the weight-bearing surface. They may soon prove to be useful in preoperative planning and intraoperative localization of complex surgical interventions in avascular necrosis of the hip

Hepatocellular carcinoma: IVIM diffusion quantification for prediction of tumor necrosis compared to enhancement ratios

International Nuclear Information System (INIS)

Kakite, Suguru; Dyvorne, Hadrien A.; Lee, Karen M.; Jajamovich, Guido H.; Knight-Greenfield, Ashley; Taouli, Bachir

2015-01-01

To correlate intra voxel incoherent motion (IVIM) diffusion parameters of liver parenchyma and hepatocellular carcinoma (HCC) with degree of liver/tumor enhancement and necrosis; and to assess the diagnostic performance of diffusion parameters vs. enhancement ratios (ER) for prediction of complete tumor necrosis. In this IRB approved HIPAA compliant study, we included 46 patients with HCC who underwent IVIM diffusion-weighted (DW) MRI in addition to routine sequences at 3.0 T. True diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (PF) and apparent diffusion coefficient (ADC) were quantified in tumors and liver parenchyma. Tumor ER were calculated using contrast-enhanced imaging, and degree of tumor necrosis was assessed using post-contrast image subtraction. IVIM parameters and ER were compared between HCC and background liver and between necrotic and viable tumor components. ROC analysis for prediction of complete tumor necrosis was performed. 79 HCCs were assessed (mean size 2.5 cm). D, PF and ADC were significantly higher in HCC vs. liver (p < 0.0001). There were weak significant negative/positive correlations between D/PF and ER, and significant correlations between D/PF/ADC and tumor necrosis (for D, r 0.452, p < 0.001). Among diffusion parameters, D had the highest area under the curve (AUC 0.811) for predicting complete tumor necrosis. ER outperformed diffusion parameters for prediction of complete tumor necrosis (AUC > 0.95, p < 0.002). D has a reasonable diagnostic performance for predicting complete tumor necrosis, however lower than that of contrast-enhanced imaging

Regulated necrosis and its implications in toxicology.

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Aki, Toshihiko; Funakoshi, Takeshi; Uemura, Koichi

2015-07-03

Recent research developments have revealed that caspase-dependent apoptosis is not the sole form of regulated cell death. Caspase-independent, but genetically regulated, forms of cell death include pyroptosis, necroptosis, parthanatos, and the recently discovered ferroptosis and autosis. Importantly, regulated necrosis can be modulated by small molecule inhibitors/activators, confirming the cell autonomous mechanism of these forms of cell death. The success of small molecule-mediated manipulation of regulated necrosis has produced great changes in the field of cell death research, and has also brought about significant changes in the fields of pharmacology as well as toxicology. In this review, we intend to summarize the modes of regulated cell death other than apoptosis, and discuss their implications in toxicology. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

rCBF in radiation necrosis as measured by xenon-enhanced CT

International Nuclear Information System (INIS)

Nakamura, Osamu; Nomura, Kazuhiro; Segawa, Hiromu; Nakagomi, Tadayoshi; Tanaka, Hideki; Yoshimasu, Norio; Takakura, Kintomo.

1986-01-01

We experienced a case of radiation necrosis in which the necrosis occurred two and a half years after radiation therapy against craniopharyngioma. In this case, we evaluated the regional cerebral blood flow (rCBF) by means of the Xe-enhanced CT method and studied the change in rCBF in comparison with the rCBF pattern of brain tumors or cerebral infarctions. In general, rCBF decreased in accordance with the low-density area in a conventional CT scan. The decrease in rCBF was most significant in the white matter, but the rCBF in the thinned cortex was also lowered. On the contrary, that of the basal ganglia was almost completely preserved. The rCBF pattern was different from those of brain tumors or diffuse cerebral infarction caused by the occlusion of the main arteries and was thought to be characteristic of radiation necrosis. Differential diagnosis between radiation necrosis and the recurrence of brain tumor has been thought to be difficult, but with this rCBF analysis the possibility of differential diagnosis between the two lesions was clearly indicated. (author)

Enoxaparin-induced skin necrosis at injection site after total knee arthroplasty

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Max Haffner, BS

2018-03-01

Full Text Available Enoxaparin is a widely used low-molecular-weight heparin for perioperative thromboembolic prophylaxis. Enoxaparin-induced skin necrosis in the setting of arthroplasty has been rarely reported in the literature with varying outcomes and management decisions. Our patient developed skin necrosis at his injection site and thrombocytopenia 10 days following left total knee arthroplasty surgery and after receiving subcutaneous Lovenox injections postoperatively. The patient was started on an alternative anticoagulation based on a high suspicion for heparin-induced thrombocytopenia and the wound was monitored without surgical debridement. Our case highlights the key clinical management decisions when facing this potentially life-threatening adverse reaction. Keywords: Lovenox, Enoxaparin, Skin necrosis, Adverse reaction, Arthroplasty

TRAIL-induced programmed necrosis as a novel approach to eliminate tumor cells

International Nuclear Information System (INIS)

Voigt, Susann; Kalthoff, Holger; Adam, Dieter; Philipp, Stephan; Davarnia, Parvin; Winoto-Morbach, Supandi; Röder, Christian; Arenz, Christoph; Trauzold, Anna; Kabelitz, Dieter; Schütze, Stefan

2014-01-01

The cytokine TRAIL represents one of the most promising candidates for the apoptotic elimination of tumor cells, either alone or in combination therapies. However, its efficacy is often limited by intrinsic or acquired resistance of tumor cells to apoptosis. Programmed necrosis is an alternative, molecularly distinct mode of programmed cell death that is elicited by TRAIL under conditions when the classical apoptosis machinery fails or is actively inhibited. The potential of TRAIL-induced programmed necrosis in tumor therapy is, however, almost completely uncharacterized. We therefore investigated its impact on a panel of tumor cell lines of wide-ranging origin. Cell death/viability was measured by flow cytometry/determination of intracellular ATP levels/crystal violet staining. Cell surface expression of TRAIL receptors was detected by flow cytometry, expression of proteins by Western blot. Ceramide levels were quantified by high-performance thin layer chromatography and densitometric analysis, clonogenic survival of cells was determined by crystal violet staining or by soft agarose cloning. TRAIL-induced programmed necrosis killed eight out of 14 tumor cell lines. Clonogenic survival was reduced in all sensitive and even one resistant cell lines tested. TRAIL synergized with chemotherapeutics in killing tumor cell lines by programmed necrosis, enhancing their effect in eight out of 10 tested tumor cell lines and in 41 out of 80 chemotherapeutic/TRAIL combinations. Susceptibility/resistance of the investigated tumor cell lines to programmed necrosis seems to primarily depend on expression of the pro-necrotic kinase RIPK3 rather than the related kinase RIPK1 or cell surface expression of TRAIL receptors. Furthermore, interference with production of the lipid ceramide protected all tested tumor cell lines. Our study provides evidence that TRAIL-induced programmed necrosis represents a feasible approach for the elimination of tumor cells, and that this treatment may

Post Traumatic Avascular Necrosis of the Proximal Carpal Row--A Case Report.

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Manohara, Ruben; Sebastin, Sandeep Jacob; Puhaindran, Mark Edward

2015-10-01

We report a case of avascular necrosis of the scaphoid, lunate and triquetrum in a young 21-year-old patient, after a purely ligamentous peri-lunate dislocation of the wrist. He presented with a Mayfield III peri-lunate dislocation after a road traffic accident and underwent an open reduction and internal fixation. Post-operatively, the scapho-lunate gap widened after removal of the temporary K-wires, and he gradually developed avascular necrosis of the scaphoid, lunate and triquetrum, and osteoarthritis of his wrist. We present this unusual case of simultaneous avascular necrosis of multiple carpal bones and discuss the possible risk factors and subsequent management plans for this complex injury. Our patient has no identifiable contributing factors to developing avascular necrosis. We suspect that the violence of the injury and surgery may have compromised the circulation, and advise caution when treating and counseling these patients pre-operatively.

Pediatric Digital Necrosis Secondary to Dressing Application: A Case Series.

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Bjorklund, Kim A; Rice, Dahlia M; Amalfi, Ashley N

2018-04-01

Pediatric digital necrosis resulting in revision amputation is a devastating outcome following digital dressing application. We report a series of 4 pediatric patients (age: 21 months-11 years) who presented for surgical consultation related to digital ischemia and irreversible necrosis following the application of Coban digital dressings. A review of the literature demonstrated that such injuries had not previously been described. In our case series, Coban dressing was utilized as a deterrent for thumb sucking, fingertip tuft fractures with nail bed lacerations, and a phalanx fracture secondary to crush injury. All 4 children suffered digital necrosis secondary to Coban dressings and ultimately required revision amputation. We discuss risks factors, application practices, and strategies to minimize complications with digital dressings in the pediatric population with the intent of creating awareness among hand surgeons to help promote safe practices and improve patient outcomes.

Coupling of Rigor Mortis and Intestinal Necrosis during C. elegans Organismal Death.

Science.gov (United States)

Galimov, Evgeniy R; Pryor, Rosina E; Poole, Sarah E; Benedetto, Alexandre; Pincus, Zachary; Gems, David

2018-03-06

Organismal death is a process of systemic collapse whose mechanisms are less well understood than those of cell death. We previously reported that death in C. elegans is accompanied by a calcium-propagated wave of intestinal necrosis, marked by a wave of blue autofluorescence (death fluorescence). Here, we describe another feature of organismal death, a wave of body wall muscle contraction, or death contraction (DC). This phenomenon is accompanied by a wave of intramuscular Ca 2+ release and, subsequently, of intestinal necrosis. Correlation of directions of the DC and intestinal necrosis waves implies coupling of these death processes. Long-lived insulin/IGF-1-signaling mutants show reduced DC and delayed intestinal necrosis, suggesting possible resistance to organismal death. DC resembles mammalian rigor mortis, a postmortem necrosis-related process in which Ca 2+ influx promotes muscle hyper-contraction. In contrast to mammals, DC is an early rather than a late event in C. elegans organismal death. VIDEO ABSTRACT. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

[Avascular necrosis of the femoral head in a patient with severe aplastic anaemia].

Science.gov (United States)

Plichta, Piotr; Pawelec, Katarzyna

2011-01-01

Avascular necrosis (AVN) is a pathological condition associated with numerous processes. Most frequent causes of ischaemia of the femoral head include trauma, corticosteroid therapy, radiation therapy, alcoholism, Gaucher's disease, systemic lupus erythematosus, rheumatoid arthritis. Corticosteroid therapy is considered the most frequent risk factor for developing avascular necrosis. In this paper we report a case of a 19-year old female patient who developed avascular necrosis of the right femoral head following treatment of severe aplastic anaemia. Clinical symptoms included groin pain and fever, painful abduction and internal rotation, tenderness over the right hip joint. The plain X-ray was not specific. However magnetic resonance imaging of the hip revealed changes characteristic for avascular necrosis. Conservative treatment was administrated. Two years after the onset of first clinical symptoms the patient is able to walk without pain, although the range of motion of the right hip joint is partially diminished. We evaluated the possible risk factors of AVN, diagnostic methods and prognosis. The onset of avascular necrosis should be considered as one of the relevant complications in patients with severe aplastic anaemia following immunosuppressive treatment.

Homeobox gene Dlx-2 is implicated in metabolic stress-induced necrosis

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Lim Sung-Chul

2011-09-01

Full Text Available Abstract Background In contrast to tumor-suppressive apoptosis and autophagic cell death, necrosis promotes tumor progression by releasing the pro-inflammatory and tumor-promoting cytokine high mobility group box 1 (HMGB1, and its presence in tumor patients is associated with poor prognosis. Thus, necrosis has important clinical implications in tumor development; however, its molecular mechanism remains poorly understood. Results In the present study, we show that Distal-less 2 (Dlx-2, a homeobox gene of the Dlx family that is involved in embryonic development, is induced in cancer cell lines dependently of reactive oxygen species (ROS in response to glucose deprivation (GD, one of the metabolic stresses occurring in solid tumors. Increased Dlx-2 expression was also detected in the inner regions, which experience metabolic stress, of human tumors and of a multicellular tumor spheroid, an in vitro model of solid tumors. Dlx-2 short hairpin RNA (shRNA inhibited metabolic stress-induced increase in propidium iodide-positive cell population and HMGB1 and lactate dehydrogenase (LDH release, indicating the important role(s of Dlx-2 in metabolic stress-induced necrosis. Dlx-2 shRNA appeared to exert its anti-necrotic effects by preventing metabolic stress-induced increases in mitochondrial ROS, which are responsible for triggering necrosis. Conclusions These results suggest that Dlx-2 may be involved in tumor progression via the regulation of metabolic stress-induced necrosis.

Fat necrosis Secondary to Pancreatitis Mimicking Transverse Colon Cancer: A Case Report

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S. Mirmomen

2007-02-01

Full Text Available Fat necrosis secondary to pancreatitis can be either mild and self limited or create severe organ damage,but may rarely lead to abdominal opancreatic pseudotumor.We report a case of fat necrosis secondary to pancreatitis which clinically simulates transverse colon cancer.

Genetic and serological typing of European infectious haematopoietic necrosis virus (IHNV) isolates

DEFF Research Database (Denmark)

Johansson, Tove; Einer-Jensen, Katja; Batts, William

2009-01-01

Infectious haematopoietic necrosis virus (IHNV) causes the lethal disease infectious haematopoietic necrosis (IHN) in juvenile salmon and trout. The nucleocapsid (N) protein gene and partial glycoprotein (G) gene (nucleotides 457 to 1061) of the European isolates IT-217A, FR-32/87, DE-DF 13/98 11...

Necrosis avascular de cabeza y cuello de fémur en un paciente con sida Avascular osteonecrosis of femoral head and neck in an AIDS patient

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María F. Villafañe

2004-04-01

Full Text Available La osteonecrosis avascular (ONA es una complicación que se describe con frecuencia creciente en pacientes infectados por el virus de la inmunodeficiencia humana tipo-1 (HIV-1. En su localización más común compromete la cabeza y cuello del fémur con dolor e impotencia funcional, en una o ambas caderas. Su etiología es multifactorial y la terapia antirretroviral de alta eficacia (HAART con inhibidores de proteasa (IP puede estar relacionada con la patogenia. En su evolución puede requerir el reemplazo total de la cadera con la colocación de una prótesis. Se presenta un paciente hemofílico, HIV-1 seropositivo, que desarrolló una ONA bilateral de cabeza y cuello de fémur mientras se encontraba bajo HAART.Avascular osteonecrosis (AON has increased in the last few years in patients infected with the human immunodeficiency virus type-1 (HIV-1. The most commonly affected bone is the femoral head and neck. Frequently these bilateral and clinical findings include moderate to severe pain and functional impotence of the affected joints. The etiology is multifactorial and highly active antiretroviral therapy (HAART with protease inhibitors (PI is probably related to its development. In the evolution, a total hip replacement may be needed. We present an hemophilic patient with AIDS, who developed a bilateral AON of the femoral head and neck during HAART.

Jejunal Replacement of Stomach in Two Children with Total Gastric Necrosis

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Onder Ozden

2014-04-01

Full Text Available Total gastrectomy is an extremely rare procedure in children and experience with its replacement is very limited. We present two patients who had jejunal replacement due to total gastric necrosis. The first patient was a- 2-year-old boy who admitted with a history of caustic ingestion. He was taken operation because of gastric perforation and necrosis. Anastomosis was applied by using jejunal segments. The second patient was an 11-years-old girl who left diaphragmatic hernia and acute gastric volvulus. At laparotomy, Total gastrectomy and Hunt-Lawrence type gastroesophostomy were made. Reconstruction with jejunum is thought as a good option in total gastric necrosis according to our 2 patient experiences. [Cukurova Med J 2014; 39(2.000: 403-407

Mammary fat necrosis following radiotherapy in the conservative management of localized breast cancer: Does it matter?

International Nuclear Information System (INIS)

Trombetta, Mark; Valakh, Vladimir; Julian, Thomas B.; Werts, E. Day; Parda, David

2010-01-01

Purpose: Fat necrosis is a well-described and relatively common complication arising from post-lumpectomy irradiation of the breast, most commonly breast brachytherapy. We wish to assess the clinical significance of fat necrosis resulting from post-lumpectomy breast irradiation. Methods: We reviewed the literature to determine the overall incidence and significance of fat necrosis to determine whether or not fat necrosis poses a significant clinical problem. Results: Fat necrosis occurs in up to one-quarter of patients following post-lumpectomy breast irradiation. Only rarely is invasive intervention required however, it does significantly degrade the quality of all modalities of breast imaging. Conclusions: Fat necrosis is a common complication of radiotherapy which rarely requires therapeutic intervention. However, post-therapeutic clinical imaging such as mammography, ultrasound and magnetic resonance imaging are affected which may result in additional diagnostic procedures up to and including biopsy.

The diagnostic value of contrast-enhanced CT in Acute bilateral renal cortical necrosis: a case report

International Nuclear Information System (INIS)

Choi, Pil Youb; Lee, Su Han; Lee, Woo Dong

1996-01-01

Acute renal cortical necrosis in which there is destruction of the renal cortex and sparing of the renal medulla, is a relatively rare cause of acute renal failure. A definitive diagnosis of acute renal cortical necrosis is based on renal biopsy, but on CT(computed tomography) the rather specific contrast-enhanced appearance of acute renal cortical necrosis has been described. As renal biopsy is not available, contrast-enhanced CT is a useful, noninvasive investigate modality for the early diagnosis of acute renal cortical necrosis. We report the characteristic CT findings of acute renal cortical necrosis in a patient with acute renal failure following an operation for abdominal trauma

A GSK-3β Inhibitor Protects Against Radiation Necrosis in Mouse Brain

Energy Technology Data Exchange (ETDEWEB)

Jiang, Xiaoyu [Department of Chemistry, Washington University, St. Louis, Missouri (United States); Perez-Torres, Carlos J. [Department of Radiology, Washington University, St. Louis, Missouri (United States); Thotala, Dinesh [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Engelbach, John A. [Department of Radiology, Washington University, St. Louis, Missouri (United States); Yuan, Liya [Department of Neurosurgery, Washington University, St. Louis, Missouri (United States); Cates, Jeremy [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Gao, Feng [Division of Biostatistics, Washington University, St. Louis, Missouri (United States); Alvin J. Siteman Cancer Center, Washington University, St. Louis, Missouri (United States); Drzymala, Robert E.; Rich, Keith M. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Department of Neurosurgery, Washington University, St. Louis, Missouri (United States); Schmidt, Robert E. [Department of Neuropathology, Washington University, St. Louis, Missouri (United States); Ackerman, Joseph J.H. [Department of Chemistry, Washington University, St. Louis, Missouri (United States); Department of Radiology, Washington University, St. Louis, Missouri (United States); Department of Internal Medicine, Washington University, St. Louis, Missouri (United States); Alvin J. Siteman Cancer Center, Washington University, St. Louis, Missouri (United States); Hallahan, Dennis E. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); Alvin J. Siteman Cancer Center, Washington University, St. Louis, Missouri (United States); Garbow, Joel R., E-mail: garbow@wustl.edu [Department of Radiology, Washington University, St. Louis, Missouri (United States); Alvin J. Siteman Cancer Center, Washington University, St. Louis, Missouri (United States)

2014-07-15

Purpose: To quantify the effectiveness of SB415286, a specific inhibitor of GSK-3β, as a neuroprotectant against radiation-induced central nervous system (brain) necrosis in a mouse model. Methods and Materials: Cohorts of mice were treated with SB415286 or dimethyl sulfoxide (DMSO) prior to irradiation with a single 45-Gy fraction targeted to the left hemisphere (brain) using a gamma knife machine. The onset and progression of radiation necrosis (RN) were monitored longitudinally by noninvasive in vivo small-animal magnetic resonance imaging (MRI) beginning 13 weeks postirradiation. MRI-derived necrotic volumes for SB415286- and DMSO-treated mice were compared. MRI results were supported by correlative histology. Results: Mice treated with SB415286 showed significant protection from radiation-induced necrosis, as determined by in vivo MRI with histologic validation. MRI-derived necrotic volumes were significantly smaller at all postirradiation time points in SB415286-treated animals. Although the irradiated hemispheres of the DMSO-treated mice demonstrated many of the classic histologic features of RN, including fibrinoid vascular necrosis, vascular telangiectasia, hemorrhage, and tissue loss, the irradiated hemispheres of the SB415286-treated mice consistently showed only minimal tissue damage. These studies confirmed that treatment with a GSK-3β inhibitor dramatically reduced delayed time-to-onset necrosis in irradiated brain. Conclusions: The unilateral cerebral hemispheric stereotactic radiation surgery mouse model in concert with longitudinal MRI monitoring provided a powerful platform for studying the onset and progression of RN and for developing and testing new neuroprotectants. Effectiveness of SB415286 as a neuroprotectant against necrosis motivates potential clinical trials of it or other GSK-3β inhibitors.

A GSK-3β Inhibitor Protects Against Radiation Necrosis in Mouse Brain

International Nuclear Information System (INIS)

Jiang, Xiaoyu; Perez-Torres, Carlos J.; Thotala, Dinesh; Engelbach, John A.; Yuan, Liya; Cates, Jeremy; Gao, Feng; Drzymala, Robert E.; Rich, Keith M.; Schmidt, Robert E.; Ackerman, Joseph J.H.; Hallahan, Dennis E.; Garbow, Joel R.

2014-01-01

Purpose: To quantify the effectiveness of SB415286, a specific inhibitor of GSK-3β, as a neuroprotectant against radiation-induced central nervous system (brain) necrosis in a mouse model. Methods and Materials: Cohorts of mice were treated with SB415286 or dimethyl sulfoxide (DMSO) prior to irradiation with a single 45-Gy fraction targeted to the left hemisphere (brain) using a gamma knife machine. The onset and progression of radiation necrosis (RN) were monitored longitudinally by noninvasive in vivo small-animal magnetic resonance imaging (MRI) beginning 13 weeks postirradiation. MRI-derived necrotic volumes for SB415286- and DMSO-treated mice were compared. MRI results were supported by correlative histology. Results: Mice treated with SB415286 showed significant protection from radiation-induced necrosis, as determined by in vivo MRI with histologic validation. MRI-derived necrotic volumes were significantly smaller at all postirradiation time points in SB415286-treated animals. Although the irradiated hemispheres of the DMSO-treated mice demonstrated many of the classic histologic features of RN, including fibrinoid vascular necrosis, vascular telangiectasia, hemorrhage, and tissue loss, the irradiated hemispheres of the SB415286-treated mice consistently showed only minimal tissue damage. These studies confirmed that treatment with a GSK-3β inhibitor dramatically reduced delayed time-to-onset necrosis in irradiated brain. Conclusions: The unilateral cerebral hemispheric stereotactic radiation surgery mouse model in concert with longitudinal MRI monitoring provided a powerful platform for studying the onset and progression of RN and for developing and testing new neuroprotectants. Effectiveness of SB415286 as a neuroprotectant against necrosis motivates potential clinical trials of it or other GSK-3β inhibitors

Myoglobinaemia in relation to cardiac necrosis

Energy Technology Data Exchange (ETDEWEB)

McComb, J M

1981-01-01

An evaluation of the usefulness of estimation of the serum myoglobin in the detection of myocardial necrosis was made in patients with suspected acute ischemic heart disease and in patients in whom elective cardiac catheterization was performed. Measurement of serum myoglobin, by radioimmunoassay, in patients admitted with suspected acute myocardial infarction, suggested that a raised serum myoglobin level was a sensitive indicator of myocardial necrosis. It also showed that the serum myoglobin rose to abnormal levels before the serum creatine kinase. A study of 70 consecutive patients confirmed that the serum myoglobin level is a sensitive indicator of acute myocardial infarction and showed that its sensitivity was greater, and its specificity similar to that of serum creatine kinase. This study allowed calculation of a predictive index for the diagnosis of acute myocardial infarction from the serum myoglobin and serum creatine kinase six hours after the onset of symptoms. The use of a single myoglobin measurement in 114 patients admitted to a coronary care unit was then studied. The proposition that myocardial damage might results from cardiac catheterization was investigated in 115 patients.

Evaluation of 99mTc-nitroimidazole in animal of myocardial necrosis

International Nuclear Information System (INIS)

Shimpi, H.H.; Mahapatra, S.; Noronha, O.P.D.

1998-01-01

Full text: Extensive studies carried out using 99m Tc-nitroimidazole (BMS 181321) suggested that it is a useful agent to investigate the status of hypoxia in solid tumors and ischemic myocardium. In vitro studies also showed that 99m Tc nitroimidazole is preferentially trapped in and retained by hypoxic, but viable cardiac muscle. We have evaluated the compound in an animal (rat) model of myocardial necrosis. 99m Tc-nitromidazole was labelled with 99m Tc by using cyclan and Sn-glucaric acid. The radiochemical purity was >95%. It was found to be very stable. Experimental (rat) animal of myocardial necrosis or ischemic necrosis was obtained by injecting iso proternol HCl subcutaneously (S.C.) at a dose of 5.25 mg/kg body weight. After 48 h, gross and microscopic necrotic changes were seen in the heart which closely resembled the myocardial infarct of necrotic lesion akin to ischemic necrosis of the myocardium. Animal biodistribution study demonstrated that 99m Tc nitroimidazole cleared very fast from the blood stream of both normal system. Significantly higher uptake was seen in heart of experimental animals compared to normal animals at 60 min. The ratios of heart to blood, liver and kidneys in both normal and experimental animals showed significantly higher ratios in experimental animals. The heart to blood ratio of experimental animal remained same up to 60 min. compared to a sharp decline with time in normal animals. The above results show that 99m Tc-nitroimidazole could be used for detection of myocardial necrosis or myocardial infarct in clinical conditions

A Review on Fat Necrosis of the Breast: The Dilemma of Differential Diagnosis with Cancer

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Toktam Beheshtian

2015-05-01

Full Text Available Fat necrosis is a benign inflammatory process which can involve adipose tissue anywhere in the body. A previous history of trauma or surgery may or may not be present. Information about the clinical and radiological appearance of this lesion is very important because it can mimic breast cancer.In this article, we review the features of fat necrosis in different imaging modalities including mammography, ultrasound, and magnetic resonance imaging (MRI, and compare them with histopathologic findings; then, we try to provide a logical approach for fat necrosis management.The appearance of fat necrosis at imaging is variable from definitely benign type to highly suspicious for malignancy. The specificity of mammography is higher than that of ultrasonography; therefore, for a definite diagnosis of fat necrosis, emphasis should be mainly based on mammography rather than ultrasonography.Finally, fat necrosis is not a common disease; however, regarding unusual and atypical findings in different imaging modalities, differentiation from a cancer may be difficult, especially in patients with a previous history of malignancy. Therefore, a multimodality approach is required for a definite diagnosis.

[S3 Guideline. Part 3: Non-Traumatic Avascular Necrosis in Adults - Surgical Treatment of Atraumatic Avascular Femoral Head Necrosis in Adults].

Science.gov (United States)

Maus, U; Roth, A; Tingart, M; Rader, C; Jäger, M; Nöth, U; Reppenhagen, S; Heiss, C; Beckmann, J

2015-10-01

The present article describes the guidelines for the surgical treatment of atraumatic avascular necrosis (aFKN). These include joint preserving and joint replacement procedures. As part of the targeted literature, 43 publications were included and evaluated to assess the surgical treatment. According to the GRADE and SIGN criteria level of evidence (LoE), grade of recommendation (EC) and expert consensus (EK) were listed for each statement and question. The analysed studies have shown that up to ARCO stage III, joint-preserving surgery can be performed. A particular joint-preserving surgery currently cannot be recommended as preferred method. The selection of the method depends on the extent of necrosis. Core decompression performed in stage ARCO I (reversible early stage) or stage ARCO II (irreversible early stage) with medial or central necrosis with an area of less than 30 % of the femoral head shows better results than conservative therapy. In ARCO stage III with infraction of the femoral head, the core decompression can be used for a short-term pain relief. For ARCO stage IIIC or stage IV core decompression should not be performed. In these cases, the indication for implantation of a total hip replacement should be checked. Additional therapeutic procedures (e.g., osteotomies) and innovative treatment options (advanced core decompression, autologous bone marrow, bone grafting, etc.) can be discussed in the individual case. In elective hip replacement complications and revision rates have been clearly declining for decades. In the case of an underlying aFKN, however, previous joint-preserving surgery (osteotomies and grafts in particular) can complicate the implantation of a THA significantly. However, the implant life seems to be dependent on the aetiology. Higher revision rates for avascular necrosis are particularly expected in sickle cell disease, Gaucher disease, or kidney transplantation patients. Furthermore, the relatively young age of the patient

Spinal bone marrow necrosis with vertebral compression fracture: differentiation of BMN from AVN.

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Nix, J S; Fitzgerald, R T; Samant, R S; Harrison, M; Angtuaco, E J

2014-09-01

Bone marrow necrosis (BMN) is a rare malignancy-associated hematologic disorder characterized by necrosis of myeloid and stromal marrow elements with preservation of cortical bone. Overlap between the imaging appearances of BMN and avascular necrosis (AVN) raises the potential for diagnostic confusion. We report a case of BMN presenting with a traumatic multi-level vertebral body collapse, and finding that may potentially confound distinction between the two entities. We discuss important pathophysiologic, clinical, and radiologic differences between BMN and AVN with emphasis on features important in the differential diagnosis.

Reversal of cerebral radiation necrosis with bevacizumab treatment in 17 Chinese patients

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Wang Yang

2012-08-01

Full Text Available Abstract Background Bevacizumab has been suggested as a new treatment modality for cerebral radiation necrosis due to its ability to block the effects of vascular endothelial growth factor (VEGF in leakage-prone capillaries, though its use still remains controversial in clinical practice. Methods The use of bevacizumab in 17 patients with symptomatic cerebral radiation necrosis poorly controlled with dexamethasone steroid treatments was examined between March 2010 and January 2012. Bevacizumab therapy was administered for a minimum of two cycles (7.5 mg/kg, at two-week interval with a median of four bevacizumab injections. Changes in bi-dimensional measurements of the largest radiation necrosis lesions were observed by gadolinium-enhanced and T2-weighted magnetic resonance imaging (MRI. Additionally, dexamethasone dosage, Karnofsky performance status (KPS, adverse event occurrence and associated clinical outcomes were recorded for each patient. Results MRI analysis revealed that the average reduction was 54.9% and 48.4% in post-gadolinium and T2-weighted sequence analysis, respectively. Significant clinical neurological improvements were expressed in 10 patients according to KPS values. Dexamethasone reduction was achieved four weeks after initiation of bevacizumab in all patients, with four patients successfully discontinuing dexamethasone treatment. Mild to moderate bevacizumab-related adverse events, such as fatigue, proteinuria and hypertension were observed in three patients. Upon follow-up at 4 to 12 months, 10 patients showed clinical improvement, and 7 patient deaths occurred from tumor progression (5 patients, recurrent necrosis (1 patient, and uncontrolled necrosis-induced edema (1 patient. Conclusions These findings suggest bevacizumab as a promising treatment for cerebral radiation necrosis induced by common radiation therapies, including external beam radiotherapy (EBRT, stereotactic radiosurgery (SRS, and fractionated stereotactic

Trigger wrist caused by avascular necrosis of the capitate: a case report.

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Matsui, Yuichiro; Kawamura, Daisuke; Kida, Hiroaki; Hatanaka, Kanako C; Iwasaki, Norimasa

2018-03-27

Trigger wrist is a rare condition first described by Marti in 1960, and various causes have been reported. The condition mostly occurs with finger flexion and extension, and rarely with flexion and extension of the wrist itself. Avascular necrosis of the capitate is also a rare condition, first described by Jönsson in 1942. While some reports of this condition have been published, little is known about its etiology. Therefore, no established treatment exists. We report a case of trigger wrist caused by avascular necrosis of the capitate. A 16-year-old right-handed male who was a high school handball player was referred to our department from a nearby hospital 5 months after the onset of pain in the dorsal aspect of the right wrist, with an unknown cause. At the previous hospital, imaging findings led to a diagnosis of avascular necrosis of the capitate, and conservative treatment with a wrist brace did not improve the pain. At the initial visit to our department, the patient was noted to have a painful trigger wrist that was brought on by wrist flexion and extension. Preoperative imaging findings led to a diagnosis of trigger wrist caused by capitolunate instability secondary to avascular necrosis of the capitate. We performed a partial excision of the proximal capitate with tendon ball interposition. Two years after surgery, the patient's clinical outcome was favorable, with no recurrence of wrist pain or triggering. Both trigger wrist and avascular necrosis of the capitate are rare disorders. When a patient presents with painful triggering at the wrist, surgeons must bear in mind that avascular necrosis of the capitate may result in this phenomenon. We recommend partial excision of the proximal capitate with tendon ball interposition for the treatment of this lesion.

MRI and US findings of subcutaneous fat necrosis of the newborn

Energy Technology Data Exchange (ETDEWEB)

Vasireddy, Syam; Long, Scott D. [Southern Illinois University, Department of Radiology, Springfield, IL (United States); St. John' s Hospital, Department of Radiology, Springfield, IL (United States); Sacheti, Bhavna [Medical College of Wisconsin, Department of Pediatric Critical Care, Milwaukee, WI (United States); Children' s Hospital Wisconsin, Department of Critical Care, Milwaukee, WI (United States); Mayforth, Ruth D. [Southern Illinois University, Department of Surgery, Springfield, IL (United States); St. John' s Hospital, Department of Surgery, Springfield, IL (United States)

2009-01-15

Subcutaneous fat necrosis of the newborn (SCFN) is an uncommon, benign disorder found in full-term or post-mature neonates. It usually presents in neonates who have experienced perinatal difficulty such as asphyxia, peripheral hypoxemia, hypothermia, meconium aspiration or trauma. We present a newborn with abnormal findings on MRI and US within the axilla, neck, and abdominal walls that were pathologically proved via biopsy to be subcutaneous fat necrosis. (orig.)

Angiographic analysis of avascular necrosis of a femoral head -selective angiography of medial femoral circumflex artery-

Energy Technology Data Exchange (ETDEWEB)

Ryu, Kyung Nam; Yoon, Yup; Lee, Sun Wha; Lim, Jae Hoon [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1991-07-15

The degree of anatomical revascularization of a necrotic femoral head and traumatic hip would provide information about treatment and prognosis. The authors analyzed the vascular changes of femoral head among unilateral avascular necrosis, bilateral avascular necrosis, and traumatic hips. Forty - four patients with avascular necrosis and 19 patients with traumatic hips were examined by selective angiography of the medial femoral circumflex artery. In the traumatic hip cases, 12 (63%) showed occlusion, 2 (11%) hypertrophy of the capsular branches, and 5 ( 26 % ) were normal . In the avascular necrosis cases, 15 (25%) showed occlusion, 39 (67%) had hypertrophy of the capsular branches, and 4 (7%) had normal findings. Hypertrophy of the superior capsular branch of the medial femoral circumflex artery is more frequently observed in avascular necrosis than in traumatic hip. Bilateral avascular necrosis reveals more frequent incidences than unilateral cases. Selective angiography could help in the therapy plan and also provide information about the contralateral side.

Angiographic analysis of avascular necrosis of a femoral head -selective angiography of medial femoral circumflex artery-

International Nuclear Information System (INIS)

Ryu, Kyung Nam; Yoon, Yup; Lee, Sun Wha; Lim, Jae Hoon

1991-01-01

The degree of anatomical revascularization of a necrotic femoral head and traumatic hip would provide information about treatment and prognosis. The authors analyzed the vascular changes of femoral head among unilateral avascular necrosis, bilateral avascular necrosis, and traumatic hips. Forty - four patients with avascular necrosis and 19 patients with traumatic hips were examined by selective angiography of the medial femoral circumflex artery. In the traumatic hip cases, 12 (63%) showed occlusion, 2 (11%) hypertrophy of the capsular branches, and 5 ( 26 % ) were normal . In the avascular necrosis cases, 15 (25%) showed occlusion, 39 (67%) had hypertrophy of the capsular branches, and 4 (7%) had normal findings. Hypertrophy of the superior capsular branch of the medial femoral circumflex artery is more frequently observed in avascular necrosis than in traumatic hip. Bilateral avascular necrosis reveals more frequent incidences than unilateral cases. Selective angiography could help in the therapy plan and also provide information about the contralateral side

Dose–Volume Relationships Associated With Temporal Lobe Radiation Necrosis After Skull Base Proton Beam Therapy

Energy Technology Data Exchange (ETDEWEB)

McDonald, Mark W., E-mail: markmcdonaldmd@gmail.com [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Linton, Okechukwu R. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Calley, Cynthia S.J. [Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (United States)

2015-02-01

Purpose: We evaluated patient and treatment parameters correlated with development of temporal lobe radiation necrosis. Methods and Materials: This was a retrospective analysis of a cohort of 66 patients treated for skull base chordoma, chondrosarcoma, adenoid cystic carcinoma, or sinonasal malignancies between 2005 and 2012, who had at least 6 months of clinical and radiographic follow-up. The median radiation dose was 75.6 Gy (relative biological effectiveness [RBE]). Analyzed factors included gender, age, hypertension, diabetes, smoking status, use of chemotherapy, and the absolute dose:volume data for both the right and left temporal lobes, considered separately. A generalized estimating equation (GEE) regression analysis evaluated potential predictors of radiation necrosis, and the median effective concentration (EC50) model estimated dose–volume parameters associated with radiation necrosis. Results: Median follow-up time was 31 months (range 6-96 months) and was 34 months in patients who were alive. The Kaplan-Meier estimate of overall survival at 3 years was 84.9%. The 3-year estimate of any grade temporal lobe radiation necrosis was 12.4%, and for grade 2 or higher radiation necrosis was 5.7%. On multivariate GEE, only dose–volume relationships were associated with the risk of radiation necrosis. In the EC50 model, all dose levels from 10 to 70 Gy (RBE) were highly correlated with radiation necrosis, with a 15% 3-year risk of any-grade temporal lobe radiation necrosis when the absolute volume of a temporal lobe receiving 60 Gy (RBE) (aV60) exceeded 5.5 cm{sup 3}, or aV70 > 1.7 cm{sup 3}. Conclusions: Dose–volume parameters are highly correlated with the risk of developing temporal lobe radiation necrosis. In this study the risk of radiation necrosis increased sharply when the temporal lobe aV60 exceeded 5.5 cm{sup 3} or aV70 > 1.7 cm{sup 3}. Treatment planning goals should include constraints on the volume of temporal lobes receiving

Oxidative burst-dependent NETosis is implicated in the resolution of necrosis-associated sterile inflammation

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Mona Helena Biermann

2016-12-01

Full Text Available Necrosis is associated with a profound inflammatory response. The regulation of necrosis-associated inflammation, particularly the mechanisms responsible for resolution of inflammation are incompletely characterized. Nanoparticles are known to induce plasma membrane damage and necrosis followed by sterile inflammation. We observed that injection of metabolically inert nanodiamonds resulted in paw edema in WT and Ncf1** mice. However, while inflammation quickly resolved in WT mice, it persisted over several weeks in Ncf1** mice indicating failure of resolution of inflammation. Mechanistically, NOX2-dependent reactive oxygen species (ROS production and formation of neutrophil extracellular traps (NETs were essential for the resolution of necrosis-induced inflammation: Hence, by evaluating the fate of the particles at the site of inflammation, we observed that Ncf1** mice deficient in NADPH-dependent ROS failed to generate granulation tissue therefore being unable to trap the nanodiamonds. These data suggest that NOX2-dependent NETosis is crucial for preventing the chronification of the inflammatory response to tissue necrosis by forming NETosis-dependent barriers between the necrotic and healthy surrounding tissue.

Genetic inhibition of protein kinase Cε attenuates necrosis in experimental pancreatitis

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Liu, Yannan; Tan, Tanya; Jia, Wenzhuo; Lugea, Aurelia; Mareninova, Olga; Waldron, Richard T.; Pandol, Stephen J.

2014-01-01

Understanding the regulation of death pathways, necrosis and apoptosis, in pancreatitis is important for developing therapies directed to the molecular pathogenesis of the disease. Protein kinase Cε (PKCε) has been previously shown to regulate inflammatory responses and zymogen activation in pancreatitis. Furthermore, we demonstrated that ethanol specifically activated PKCε in pancreatic acinar cells and that PKCε mediated the sensitizing effects of ethanol on inflammatory response in pancreatitis. Here we investigated the role of PKCε in the regulation of death pathways in pancreatitis. We found that genetic deletion of PKCε resulted in decreased necrosis and severity in the in vivo cerulein-induced pancreatitis and that inhibition of PKCε protected the acinar cells from CCK-8 hyperstimulation-induced necrosis and ATP reduction. These findings were associated with upregulation of mitochondrial Bak and Bcl-2/Bcl-xL, proapoptotic and prosurvival members in the Bcl-2 family, respectively, as well as increased mitochondrial cytochrome c release, caspase activation, and apoptosis in pancreatitis in PKCε knockout mice. We further confirmed that cerulein pancreatitis induced a dramatic mitochondrial translocation of PKCε, suggesting that PKCε regulated necrosis in pancreatitis via mechanisms involving mitochondria. Finally, we showed that PKCε deletion downregulated inhibitors of apoptosis proteins, c-IAP2, survivin, and c-FLIPs while promoting cleavage/inactivation of receptor-interacting protein kinase (RIP). Taken together, our findings provide evidence that PKCε activation during pancreatitis promotes necrosis through mechanisms involving mitochondrial proapoptotic and prosurvival Bcl-2 family proteins and upregulation of nonmitochondrial pathways that inhibit caspase activation and RIP cleavage/inactivation. Thus PKCε is a potential target for prevention and/or treatment of acute pancreatitis. PMID:25035113

Prediction and measurement of thermally induced cambial tissue necrosis in tree stems

Science.gov (United States)

Joshua L. Jones; Brent W. Webb; Bret W. Butler; Matthew B. Dickinson; Daniel Jimenez; James Reardon; Anthony S. Bova

2006-01-01

A model for fire-induced heating in tree stems is linked to a recently reported model for tissue necrosis. The combined model produces cambial tissue necrosis predictions in a tree stem as a function of heating rate, heating time, tree species, and stem diameter. Model accuracy is evaluated by comparison with experimental measurements in two hardwood and two softwood...

Prevalence of bone marrow necrosis in Egyptian cancer patients referring to the National Cancer Institute

International Nuclear Information System (INIS)

Elgamal, B.M.; Rashed, R.A.; Raslan, H.N.

2011-01-01

Bone marrow necrosis; Egyptian cancer patients Abstract Background: Bone marrow necrosis is a relatively rare entity which has been associated with a poor prognosis. It is most commonly found in patients with neoplastic disorders and severe infections. Methods: study comprised examination of 5043 bone marrow biopsy specimens performed at the National Cancer Institute, Cairo University, over 7 years period (March 2004-March 2011). It included 5 years retrospective (2867 archived samples) and 2 years prospective (2176 samples). Results: Bone marrow necrosis was diagnosed in fifteen out of 5043 examined specimens with a percentage of 0.3% and ranged from mild to massive according to semiquantitative estimation. Prognosis of all patients was poor with survival not exceeding 6 months from the date of marrow necrosis diagnosis. Conclusion: In Egyptian patients, bone marrow necrosis in association with malignancy is a rare disorder which is accompanied by a poor outcome

Expression of tumor necrosis factor alpha after focal cerebral ischaemia in the rat

NARCIS (Netherlands)

Buttini, M; Appel, K; Sauter, A; GebickeHaerter, PJ; Boddeke, HWGM

Induction of tumor necrosis factor alpha was studied in the brain of rats after focal cerebral ischaemia by occlusion of the left middle cerebral artery. Using a specific antisense riboprobe for in situ hybridization histochemistry, cells positive for tumor necrosis factor alpha messenger RNA were

Risk factors for pedicled flap necrosis in hand soft tissue reconstruction: a multivariate logistic regression analysis.

Science.gov (United States)

Gong, Xu; Cui, Jianli; Jiang, Ziping; Lu, Laijin; Li, Xiucun

2018-03-01

Few clinical retrospective studies have reported the risk factors of pedicled flap necrosis in hand soft tissue reconstruction. The aim of this study was to identify non-technical risk factors associated with pedicled flap perioperative necrosis in hand soft tissue reconstruction via a multivariate logistic regression analysis. For patients with hand soft tissue reconstruction, we carefully reviewed hospital records and identified 163 patients who met the inclusion criteria. The characteristics of these patients, flap transfer procedures and postoperative complications were recorded. Eleven predictors were identified. The correlations between pedicled flap necrosis and risk factors were analysed using a logistic regression model. Of 163 skin flaps, 125 flaps survived completely without any complications. The pedicled flap necrosis rate in hands was 11.04%, which included partial flap necrosis (7.36%) and total flap necrosis (3.68%). Soft tissue defects in fingers were noted in 68.10% of all cases. The logistic regression analysis indicated that the soft tissue defect site (P = 0.046, odds ratio (OR) = 0.079, confidence interval (CI) (0.006, 0.959)), flap size (P = 0.020, OR = 1.024, CI (1.004, 1.045)) and postoperative wound infection (P < 0.001, OR = 17.407, CI (3.821, 79.303)) were statistically significant risk factors for pedicled flap necrosis of the hand. Soft tissue defect site, flap size and postoperative wound infection were risk factors associated with pedicled flap necrosis in hand soft tissue defect reconstruction. © 2017 Royal Australasian College of Surgeons.

Prevalence and associations of symptomatic renal papillary necrosis ...

African Journals Online (AJOL)

2015-11-12

Nov 12, 2015 ... Diagnosis was based on microscopic hematuria and positive ultrasound findings. Their steady ... until recently the most widely accepted first account was documented by ... papillary necrosis in sickle cell anemia patients in.

Two types of bone necrosis in the Middle Triassic Pistosaurus longaevus bones: the results of integrated studies

Science.gov (United States)

Surmik, Dawid; Rothschild, Bruce M.; Dulski, Mateusz; Janiszewska, Katarzyna

2017-07-01

Avascular necrosis, diagnosed on the basis of either a specific pathological modification of the articular surfaces of bone or its radiologic appearance in vertebral centra, has been recognized in many Mesozoic marine reptiles as well as in present-day marine mammals. Its presence in the zoological and paleontologic record is usually associated with decompression syndrome, a disease that affects secondarily aquatic vertebrates that could dive. Bone necrosis can also be caused by infectious processes, but it differs in appearance from decompression syndrome-associated aseptic necrosis. Herein, we report evidence of septic necrosis in the proximal articular surface of the femur of a marine reptile, Pistosaurus longaevus, from the Middle Triassic of Poland and Germany. This is the oldest recognition of septic necrosis associated with septic arthritis in the fossil record so far, and the mineralogical composition of pathologically altered bone is described herein in detail. The occurrence of septic necrosis is contrasted with decompression syndrome-associated avascular necrosis, also described in Pistosaurus longaevus bone from Middle Triassic of Germany.

Autologous Platelet Concentrates as Treatment for Avascular Necrosis of Femoral Head in a Dog.

Science.gov (United States)

Parra, Estefanía; Vergara, Andrea; Silva, Raúl F

2017-03-01

Avascular necrosis of the femoral head is a developmental disturbance that generally affects young dogs of small breeds and produces ischemic necrosis of the femoral head resulting in an incongruous and malformed joint. The most common treatment is the excisional arthroplasty of the head and femoral neck. The aim of this study is to describe the treatment of avascular necrosis in a Yorkshire dog using intra-articular injections of autologous platelet concentrate. Evaluations were made at 0, 15, 30, 60, and 120 days of treatment, describing the following parameters: clinical gait analysis, perimetry, goniometry, and radiographic evaluations. The results obtained in this case suggest that the autologous platelet concentrate may be an alternative for the treatment of avascular necrosis of the femoral head in dogs. Copyright © 2017 Elsevier Inc. All rights reserved.

Study in vitro of dental enamel irradiated with a high power diode laser operating at 960 nm: morphological analysis of post-irradiation dental surface and thermal effect analysis in pulp chamber due to laser application

International Nuclear Information System (INIS)

Quinto Junior, Jose

2001-01-01

Objectives: This study examines the structural and thermal modifications induced in dental enamel under dye assisted diode laser irradiation. The aim of this study is to verify if this laser-assisted treatment is capable to modify the enamel surface by causing fusion of the enamel surface layer. At the same time, the pulpal temperature rise must be kept low enough in order not to cause pulpar necrosis. To achieve this target, it is necessary to determine suitable laser parameters. As is known, fusion of the enamel surface followed by re-solidification produce a more acid resistant layer. This surface treatment is being researched as a new method for caries prevention. Method and Materials: A series of fourteen identically prepared enamel samples of human teeth were irradiated with a high power diode laser operating at 960 nm and using fiber delivery. Prior to irradiation, a fine layer of cromophorous ink was applied to the enamel surface. In the first part of the experiment the best parameter for pulse duration was determined. In the second part of the experimental phase the same energy density was used but with different repetition rates. During irradiation we monitored the temperature rise in the pulpal cavity. The morphology of the treated samples was analysed under SEM. Results: The morphology of the treated samples showed a homogeneously re-solidified enamel layer. The results of the temperature analysis showed a decrease of the pulpal temperature rise with decreasing repetition rate. Conclusion: With the diode laser it is possible to cause morphological alterations of the enamel surface, which is known to increase the enamel resistance against acid attack, and still maintain the temperature rise in the pulpar chamber below damage threshold. (author)

Late temporal lobe necrosis after conventional radiotherapy for carcinoma of maxillary sinus.

Science.gov (United States)

Kanakamedala, Madhava R; Mahta, Ali; Liu, Jianlin; Kesari, Santosh

2012-12-01

Cerebral radiation necrosis is a serious late complication after conventional radiotherapy that can present with focal neurologic deficits or with more generalized signs and symptoms of increased intracranial pressure, depending on the location. The incidence and severity of radionecrosis are dose-volume dependent. We report a case of cerebral radiation necrosis 5 years after radiotherapy for a maxillary sinus carcinoma.

An avascular necrosis in Gaucher's disease

International Nuclear Information System (INIS)

Mansberg, R.; Uren, R.; Howman-Giles, R.

1999-01-01

Full text: Avascular necrosis is frequently associated with sickle cell disease and other haemoglobinopathies. It is less commonly associated with Gaucher's disease. A case with multi-modality imaging is presented. A 33-year-old male patient presented with a 4-day history of severe right knee pain. He was a febrile with mild swelling of the right knee. A diagnosis of Gaucher's disease had been made by bone marrow biopsy on a clinical picture of hepatosplenomegaly and thrombocytopenia some years earlier. A radiograph of the knee demonstrated an Erlenmeyer flask deformity of the distal femur. A bone scan demonstrated reduced perfusion to the distal right femoral shaft and femoral condyles. Delayed images demonstrated decreased tracer uptake in the distal right femur extending to the right medial femoral condyle consistent with a vascular necrosis. An MRI of the thighs demonstrated lipid accumulation in the marrow space of both femora consistent with Gaucher's disease associated with changes of bone oedema in the metadiaphysis and epiphysis of the right femur. The patient was treated with supportive measures and made an uneventful recovery and is being commenced on enzyme replacement therapy (Algucerase)

Aseptic necrosis of femoral head complicating thalassemia

International Nuclear Information System (INIS)

Orzincolo, C.; Castaldi, G.; Scutellary, P.N.; Bariani, L.; Pinca, A.

1986-01-01

Aseptic necrosis of the femoral head is described in 4 patients, selected from 280 patients with homozygous β-thalassemia (Cooley anemia). The incidence of the complication appears to be very high (14.5per mille) in thalassemia, compared to the general population. The possible mechanism are discussed. (orig.)

Spontaneous and bilateral avascular necrosis of the navicula: Müller-Weiss disease.

Science.gov (United States)

Aktaş, Erdem; Ayanoğlu, Tacettin; Hatipoğlu, Yasin; Kanatlı, Ulunay

2016-12-01

Although, trauma, foot deformity (pesplanovalgus), systemic diseases such as diabetes mellitus and lupus, drugs (steroids, antineoplastic) and excessive alcohol consumption have all been accused in the etiology of avascular necrosis of the tarsal bones, spontaneous avascular necrosis of the navicular bone, especially in adults, is a rare entity. In this article, we report a 50-year-old female patient with bilateral, spontaneous avascular necrosis of the navicular bone and related severe talonavicular arthrosis. Clinical and radiological findings were concordant with Müller-Weiss disease, which is a rare disease with complex idiopathic foot condition of the adult tarsal navicular bone characterized by progressive navicular fragmentation and talonavicular joint destruction. The patient was successfully treated with two-staged bilateral talonavicular arthrodesis.

Delayed radiation necrosis in the optochiasmatic region

International Nuclear Information System (INIS)

Andoh, Takashi; Yokoyama, Kazutoshi; Kumagai, Morio

1984-01-01

Two cases with delayed radiation necrosis of the chiasmatic region following irradiation of the hypophysis for treatment of Cushing's disease were presented. Case 1 was a 36-year-old female who had reduction of visual acuity and bitemporal hemianopsia 2 years after 60 Co-irradiation therapy (total 8000 rads) for Cushing's disease. CT scans showed low density in the pituitary fossa and irregular contrast-enhanced suprasellar mass, and metrizamide CT cisternography revealed the pituitary fossa filled with contrast medium. From those findings, secondary empty sella syndrome was suspicious. Case 2 was a 35-year-old male who had progressive visual disturbance 3 years after 60 Co-irradiation therapy (total 9050 rads) for Cushing's disease. The right visual acuity was 0.05 and the left one was 0.1. Examination of visual field showed left homonymous hemianopsia. CT scans showed the contrast enhanced suprasellar mass extending to the right anterior thalamic region, and metrizamide CT cisternography detected secondary empty sella as same as that of Case 1. Authors reviewed and analyzed literatures of delayed radiation necrosis. The incidence of this condition was 4% to 9% and onset of the symptoms occured approximately 2 years after irradiation to hypophysis. Administration of steroid hormone and surgical treatment for the radiation necrosis involving the chiasmatic region were almost ineffective and also the prognosis of radionecrotic lesions involving the hypothalamus was very poor. Therefore, radiotherapy for hypophyseal region must be carried out by means of a rotation or arching technique in order to avoid this condition and further total dosage and its fractionation in radiation therapy should not exceed 6000 rads and 200 rads a day. (J.P.N.)

Fat necrosis after abdominal surgery: A pitfall in interpretation of FDG-PET/CT.

Science.gov (United States)

Davidson, Tima; Lotan, Eyal; Klang, Eyal; Nissan, Johnatan; Goldstein, Jeffrey; Goshen, Elinor; Ben-Haim, Simona; Apter, Sara; Chikman, Bar

2018-06-01

We describe FDG-PET/CT findings of postoperative fat necrosis in patients following abdominal surgery, and evaluate their changes in size and FDG uptake over time. FDG-PET/CT scans from January 2007-January 2016 containing the term 'fat necrosis' were reviewed. Lesions meeting radiological criteria of fat necrosis in patients with prior abdominal surgery were included. Forty-four patients, 30 males, mean age 68.4 ± 11.0 years. Surgeries: laparotomy (n=37; 84.1 %), laparoscopy (n=3; 6.8 %), unknown (n=4; 9.1 %). CTs of all lesions included hyperdense well-defined rims surrounding a heterogeneous fatty core. Sites: peritoneum (n=34; 77 %), omental fat (n=19; 43 %), subcutaneous fat (n=8; 18 %), retroperitoneum (n=2; 5 %). Mean lesion long axis: 33.6±24.9 mm (range: 13.0-140.0). Mean SUVmax: 2.6±1.1 (range: 0.6-5.1). On serial CTs (n=34), lesions decreased in size (p=0.022). Serial FDG-PET/CT (n=24) showed no significant change in FDG-avidity (p=0.110). Mean SUVmax did not correlate with time from surgery (p=0.558) or lesion size (p=0.259). Postsurgical fat necrosis demonstrated characteristic CT features and may demonstrate increased FDG uptake. However, follow-up of subsequent imaging scans showed no increases in size or FDG-avidity. Awareness of this entity is important to avoid misinterpretation of findings as recurrent cancer. • Postsurgical fat necrosis may mimic cancer in FDG-PET/CT. • Follow-up of fat necrosis showed no increase in FDG intensity. • CT follow-up showed a decrease in lesion size. • FDG uptake did not correlate with time lapsed from surgery.

Oxidative stress and cardiomyocyte necrosis with elevated serum troponins: pathophysiologic mechanisms.

Science.gov (United States)

Robinson, Antwon D; Ramanathan, Kodangudi B; McGee, Jesse E; Newman, Kevin P; Weber, Karl T

2011-08-01

The progressive nature of heart failure is linked to multiple factors, including an ongoing loss of cardiomyocytes and necrosis. Necrotic cardiomyocytes leave behind several footprints: the spillage of their contents leading to elevations in serum troponins; and morphologic evidence of tissue repair with scarring. The pathophysiologic origins of cardiomyocyte necrosis relates to neurohormonal activation, including the adrenergic nervous system. Catecholamine-initiated excessive intracellular Ca accumulation and mitochondria Ca overloading in particular initiate a mitochondriocentric signal-transducer-effector pathway to necrosis and which includes the induction of oxidative stress and opening of their inner membrane permeability transition pore. Hypokalemia, ionized hypocalcemia and hypomagnesemia, where consequent elevations in parathyroid hormone further account for excessive intracellular Ca accumulation, hypozincemia and hyposelenemia each compromise metalloenzyme-based antioxidant defenses. The necrotic loss of cardiomyocytes and adverse structural remodeling of myocardium is related to the central role played by a mitochondriocentric pathway initiated by neurohormonal activation.

A Comparison of Computed Tomographic, Radiographic, Gross and Histological, Dental, and Alveolar Findings in 30 Abnormal Cheek Teeth from Equine Cadavers.

Science.gov (United States)

Liuti, Tiziana; Smith, Sionagh; Dixon, Padraic M

2017-01-01

Equine cheek teeth disorders, especially pulpar/apical infections, can have very serious consequences due to the frequent extension of infection to the supporting bones and/or adjacent paranasal sinuses. Limited studies have assessed the accuracy of computed tomographic (CT) imaging in the diagnosis of these disorders, and no study has directly compared imaging and pathological findings of the alveoli of diseased equine cheek teeth. To validate the accuracy of CT and radiographic imaging of cheek teeth disorders by comparing CT and radiographic imaging, gross and histological findings in abnormal cheek teeth and their alveoli extracted from equine cadaver heads. Ex vivo original study. Fifty-four cadaver heads from horses with unknown histories that had died or been euthanized on humane grounds obtained from a rendering plant had radiography, CT imaging, and gross pathological examinations performed. Based on imaging and gross examination findings, 30 abnormal cheek teeth (26 maxillary and 4 mandibular) identified in 26 heads were extracted along with their dental alveoli where possible, and further CT imaging, gross, and histological examinations were performed. Eight maxillary cheek teeth (including four with attached alveolar bone) from these heads, that were normal on gross and CT examinations, were used as controls. Gross pathological and histological examinations indicated that 28/30 teeth, including two supernumerary teeth, had pulpar/apical infection, including pulpar and apical changes. A further supernumerary and a dysplastic tooth were also identified. Abnormal calcified tissue architecture was present in all three supernumerary and in the dysplastic tooth. CT imaging strongly indicated the presence of pulpar/apical infection in 27 of the 28 (96.4%) pulpar/apically infected teeth, including the presence of intrapulpar gas ( N  = 19/28), apical clubbing ( N  = 20), periapical halo ( N  = 4), root lysis or fragmentation ( N  = 7), and

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

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Khoshnaw Najmaddin SH

2012-10-01

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

Progressive outer retinal necrosis associated with occlusive vasculitis in acquired immunodeficiency syndrome

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Chien-Chi Tseng

2015-05-01

Full Text Available A 45-year-old man, a case of acquired immunodeficiency syndrome, received a highly active antiretroviral therapy at the outpatient service for 4 years without regular follow-up. He experienced progressively blurred vision for 6 months and a cutaneous zoster on his back 3 months ago. He was diagnosed with progressive outer retinal necrosis by polymerase chain reaction-restriction fragment length polymorphism using an aqueous humor sample, which revealed an existence of varicella zoster virus. He was given a combination of systemic, intravitreal antiviral and a highly active antiretroviral therapy. Occlusive vasculitis, an unusual finding for progressive outer retinal necrosis, developed in both eyes 1 week after the secondary intravitreal injection. Unfortunately, his vision deteriorated to no light perception in both eyes within 2 weeks. Progressive outer retinal necrosis is characterized clinically as showing minimal or no inflammation in the aqueous and vitreous humors, absence of retinal vasculitis, and patches of yellowish spots located deep in the retina. Physicians should pay attention to this rare case of progressive outer retinal necrosis associated occlusive vasculitis with very poor prognosis in spite of aggressive treatment.

Endoscopic treatment of multilocular walled-off pancreatic necrosis with the multiple transluminal gateway technique.

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Jagielski, Mateusz; Smoczyński, Marian; Adrych, Krystian

2017-06-01

The development of minimally invasive techniques allowed access to the necrotic cavity through transperitoneal, retroperitoneal, transmural and transpapillary routes. The choice of access to walled-off pancreatic necrosis (WOPN) should depend not only on the spread of necrosis, but also on the experience of the clinical center. Herein we describe treatment of a patient with multilocular symptomatic walled-off pancreatic necrosis using minimally invasive techniques. The single transmural access (single transluminal gateway technique - SGT) to the necrotic collection of the patient was ineffective. The second gastrocystostomy was performed using the same minimally invasive technique as an extra way of access to the necrosis (multiple transluminal gateway technique - MTGT). In the described case the performance of the new technique consisting in endoscopic multiplexing transmural access (MTGT) was effective enough and led to complete recovery of the patient.

con dietas suplementadas con Cromo-L-metionina

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Ram\\u00F3n Garc\\u00EDa-Castillo

2006-01-01

Full Text Available Un total de 48 cerdos (Sus scrofa domesticus; 24 machos castrados y 24 hembras cruzados (Yorkshire, Hampshire, Duroc y Landrace de 3,5 a 4,0 meses de edad y 60,0 ± 5,0 kg PV en finalización. Se alimentaron con dietas isoproteícas (14,5 % PC e isoenergéticas (3.400 kcal EM/kg de MS, adicionadas con Cr-L-metionina (MiCroPlex® (0, 200, 400 y 600 ppb. El experimento tuvo una duración de 45 días y se realizó de agosto a noviembre del 2002 en las instalaciones de la Universidad Autónoma Agraria Antonio Narro, localizada en Saltillo, Coahuila, México. Al tener los animales aproximadamente 95 kg PV, se tomó muestra de 15 ml de sangre por cada animal para determinar la concentración de glucosa, ácido úrico, creatinina, urea, proteinas totales y colesterol. Se aplicó un diseño completamente al azar con arreglo factorial 2 x 4; dos para el factor sexo y cuatro para nivel de cromo. Los metabolitos en suero no fueron afectados (P>0,05 por el factor sexo. La glucosa en suero disminuyó (P<0,05 y el colesterol incrementó (P<0,05 con cromo en la dieta. Se concluye que el Cr incrementa el metabolismo de glucosa y disminuye el de colesterol, con lo cual puede haber energía disponible para síntesis de proteína la cual es necesaria para el crecimiento de los animales

Aspectos epidemiológicos, clínicos y bioquímicos en pacientes con hepatitis crónica del Hospital Pablo Tobón Uribe (HPTU entre 1991-2001

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Gonzálo Correa Arango

2001-04-01

Full Text Available

La hepatitis crónica representa una serie de desórdenes hepáticos
de variada etiología y severidad, caracterizados por inflamación
hepática con o sin necrosis, de al menos seis meses de evolución (1-3.
Nuestro objetivo es caracterizar las hepatitis crónicas diagnosticadas histológicamente en el HPTU en los últimos 10 años utilizando las historias clínicas de estos pacientes, en su aspecto epidemiológico, clínico y bioquímico, con el fin de impactar en aspectos como el tratamiento, las medidas de prevención y el enfoque diagnóstico.

Predisposing Factors of Liver Necrosis after Transcatheter Arterial Chemoembolization in Liver Metastases from Neuroendocrine Tumor

Energy Technology Data Exchange (ETDEWEB)

Joskin, Julien, E-mail: j.joskin@gmail.com; Baere, Thierry de, E-mail: Thierry.DEBAERE@igr.fr [Institut Gustave Roussy, Department of Interventional Radiology (France); Auperin, Anne, E-mail: Anne.AUPERIN@igr.fr [Institut Gustave Roussy, Department of Epidemiology (France); Tselikas, Lambros, E-mail: lambros.tselikas@gmail.com; Guiu, Boris, E-mail: boris.guiu@chu-dijon.fr; Farouil, Geoffroy, E-mail: g.farouil@gmail.com [Institut Gustave Roussy, Department of Interventional Radiology (France); Boige, Valérie, E-mail: boige@igr.fr; Malka, David, E-mail: david.malka@igr.fr [Institut Gustave Roussy, Department of Digestive Oncology (France); Leboulleux, Sophie, E-mail: sophie.leboulleux@igr.fr [Institut Gustave Roussy, Department of Nuclear Medicine and Endocrine Oncology (France); Ducreux, Michel, E-mail: ducreux@igr.fr [Institut Gustave Roussy, Department of Digestive Oncology (France); Baudin, Eric, E-mail: baudin@igr.fr [Institut Gustave Roussy, Department of Nuclear Medicine and Endocrine Oncology (France); Deschamps, Frédéric, E-mail: frederic.deschamps@igr.fr [Institut Gustave Roussy, Department of Interventional Radiology (France)

2015-04-15

PurposeTo investigate predictive factors for liver necrosis after transcatheter arterial chemoembolization (TACE) of neuroendocrine liver metastases.MethodsA total of 164 patients receiving 374 TACE were reviewed retrospectively to analyze predictive factors of liver necrosis. We analyzed patient age and sex; metastasis number and location; percentage of liver involvement; baseline liver function test; and pretreatment imaging abnormalities such as bile duct dilatation (BDD), portal vein narrowing (PVN), and portal vein thrombosis (PVT). We analyzed TACE technique such as Lipiodol or drug-eluting beads (DEB) as the drug’s vector; dose of chemotherapy; diameter of DEB; and number, frequency, and selectivity of TACE.ResultsLiver necrosis developed after 23 (6.1 %) of 374 TACE. In multivariate analysis, DEB > 300 μm in size induced more liver necrosis compared to Lipiodol (odds ratio [OR] 35.20; p < 0.0001) or with DEB < 300 μm in size (OR 19.95; p < 0.010). Pretreatment BDD (OR 119.64; p < 0.0001) and PVT (OR 9.83; p = 0.030) were predictive of liver necrosis. BDD or PVT responsible for liver necrosis were present before TACE in 59 % (13 of 22) and were induced by a previous TACE in 41 % (9 of 22) of cases.ConclusionDEB > 300 μm in size, BDD, and PVT are responsible for increased rate of liver necrosis after TACE. Careful analysis of BDD or PVT on pretreatment images as well as images taken between two courses can help avoid TACE complications.

Increase of tumor necrosis factor receptor 1 expression in women with unexplained early spontaneous abortion

Institute of Scientific and Technical Information of China (English)

YAN Chun-fang; YU Xue-wen; JIN Hui; LI Xu

2004-01-01

To investigate membrane tumor necrosis factor receptor 1 protein expression level in decidua andconcentration of soluble tumor necrosis factor receptor 1 in serum in women with unexplained early spontaneous abortion,threatened abortion, and compare the levels with healthy pregnant women. Methods: Thirty-seven women with unexplainedearly spontaneous abortion, 27 women with threatened abortion, and 34 healthy pregnant women undergoing artificial abortionof pregnancy at 6 - 10 weeks of gestation were selected. Decidual samples were collected when women were undergoing arti-ficial abortion, and blood samples were collected at the same time. The level of membrane tumor necrosis factor receptor 1 indecidua was detected by flow cytometer, and the concentration of soluble tumor necrosis factor receptor 1 in sera was mea-sured with an enzyme-linked immunosorbent assay. Results: The ercentages of membrane tumor necrosis factor receptor 1positive decidual cells were 16.42 ± 7.10 Mean ± SD for women with unexplained early spontaneous abortion and 13.14 ±6.30 for healthy pregnant women ( P ＜ 0.05). Serum oncentration of soluble tumor necrosis factor receptor 1 was signifi-cantly higher in women with unexplained early spontaneous abortion than in healthy pregnant women and in women withthreatened abortion, and no difference was found between healthy pregnant women and women with threatened abortion.Conclusion: Women with unexplained early spontaneous abortion present significantly higher expression of tumor necrosisfactor receptor 1 than healthy pregnant women, suggesting that over-expression of tumor necrosis factor receptor 1 may cont-ribute to the development of early spontaneous abortion.

[Is the Hawkins sign able to predict necrosis in fractures of the neck of the astragalus?].

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Rodríguez-Paz, S; Muñoz-Vives, J M; Froufe-Siota, M Á

2013-01-01

To assess if the Hawkins sign can predict whether or not astragalus fractures of the neck will develop avascular necrosis. It is also assessed whether the occurrence of this complication is related to the displacement of the fracture, soft tissue injury, or delay in the reduction or surgery. The results were compared with those found in the literature. A retrospective study was conducted on 23 talar neck fractures recorded over a a period of thirteen years. The following variables were analysed: displacement of the fracture, soft tissue injury, delay and type of treatment, complications, observation of the Hawkins sign, and functional outcome. There were 7 type I Hawkins fractures, 11 type II, and 4 type III and 1 type IV. Four cases developed avascular necrosis (2 Hawkins type II and 2 type III). Hawkins sign was observed in 12 cases, of which none developed necrosis. Four cases with negative Hawkins sign developed necrosis. No statistically significant differences were found when comparing the development of avascular necrosis with the displacement of the fracture, soft tissue injury, or delay in treatment. Differences were found when comparing the development of avascular necrosis with the Hawkins sign (P=.03). A positive Hawkins sign rules out that the fractured talus has developed avascular necrosis, but its absence does not confirm it. © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

Diagnostic ultrasonography in cattle with abdominal fat necrosis.

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Tharwat, Mohamed; Buczinski, Sébastien

2012-01-01

This study describes the ultrasonographic findings in 14 cows with abdominal fat necrosis. Ultrasonography of the abdomen revealed the presence of heterogeneous hyperechoic masses and hyperechoic omentum with localized masses floating in a hypoechoic peritoneal fluid. A hyperechogenic rim was imaged around both kidneys. The intestines were coated with hyperechoic capsules and the intestinal lumens were constricted. Ultrasonographic examination of the pancreatic parenchyma showed an overall increased echogenicity which was homogenously distributed in 3 cases. A diagnosis of abdominal fat necrosis was made with ultrasound-guided biopsy of the echogenic masses, and thereafter at postmortem examination. Results from this study demonstrate the efficacy of ultrasonography as an imaging modality for antemortem diagnosis of abdominal lipomatosis in cattle. To the authors' knowledge, this study is the first that illustrates ultrasonographic findings in cattle affected with abdominal lipomatosis.

Avascular necrosis of the epiphysis of the first metatarsal bone

Energy Technology Data Exchange (ETDEWEB)

Souverijns, G.; Peene, P.; Cleeren, P. [Department of Radiology, Virga Jesse Hospital, Hasselt (Belgium); Raes, M. [Department of Pediatrics, Virga Jesse Hospital, Hasselt (Belgium); Steenwerckx, A. [Department of Orthopaedics, Virga Jesse Hospital, Hasselt (Belgium)

2002-06-01

We report a case of avascular necrosis of the epiphysis of the right first metatarsal in a 6-year-old boy. Radiographs showed sclerosis, collapse and a crescent sign in the epiphysis. The diagnosis was confirmed by magnetic resonance imaging and scintigraphy. Arch support was the therapy of choice. Six months after the onset of symptoms, a definite reossification was present. To our knowledge, this is the first radiological report of avascular necrosis of the epiphysis of the first metatarsal bone in the world literature, which prompted a review of the osteochondroses and their etiology. (orig.)

Bullous lesions, sweat gland necrosis and rhabdomyolysis in alcoholic coma

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Neelakandhan Asokan

2014-01-01

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

Avascular necrosis of the epiphysis of the first metatarsal bone

International Nuclear Information System (INIS)

Souverijns, G.; Peene, P.; Cleeren, P.; Raes, M.; Steenwerckx, A.

2002-01-01

We report a case of avascular necrosis of the epiphysis of the right first metatarsal in a 6-year-old boy. Radiographs showed sclerosis, collapse and a crescent sign in the epiphysis. The diagnosis was confirmed by magnetic resonance imaging and scintigraphy. Arch support was the therapy of choice. Six months after the onset of symptoms, a definite reossification was present. To our knowledge, this is the first radiological report of avascular necrosis of the epiphysis of the first metatarsal bone in the world literature, which prompted a review of the osteochondroses and their etiology. (orig.)

Simultaneous canine distemper encephalitis and canine parvovirus infection with distemper-associated cardiac necrosis in a pup

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Headley,Selwyn Arlington; Saito,Taís Berelli

2003-01-01

Simultaneous infection of canine distemper virus and canine parvovirus associated with distemper myocardial degeneration and necrosis is described in a pup. The dog demonstrated myoclonus, nystagmus, enamel hypoplasia, abdominal pustules, and bilateral corneal ulceration clinically. Demyelinating encephalitis, myocardial degeneration and necrosis with mineralization, and necrosis, hemorrhage and fusion of intestinal villi were observed. The lesions observed in this dog are characteristic of a...

Novel biomarker identification using metabolomic profiling to differentiate radiation necrosis and recurrent tumor following Gamma Knife radiosurgery.

Science.gov (United States)

Lu, Alex Y; Turban, Jack L; Damisah, Eyiyemisi C; Li, Jie; Alomari, Ahmed K; Eid, Tore; Vortmeyer, Alexander O; Chiang, Veronica L

2017-08-01

OBJECTIVE Following an initial response of brain metastases to Gamma Knife radiosurgery, regrowth of the enhancing lesion as detected on MRI may represent either radiation necrosis (a treatment-related inflammatory change) or recurrent tumor. Differentiation of radiation necrosis from tumor is vital for management decision making but remains difficult by imaging alone. In this study, gas chromatography with time-of-flight mass spectrometry (GC-TOF) was used to identify differential metabolite profiles of the 2 tissue types obtained by surgical biopsy to find potential targets for noninvasive imaging. METHODS Specimens of pure radiation necrosis and pure tumor obtained from patient brain biopsies were flash-frozen and validated histologically. These formalin-free tissue samples were then analyzed using GC-TOF. The metabolite profiles of radiation necrosis and tumor samples were compared using multivariate and univariate statistical analysis. Statistical significance was defined as p ≤ 0.05. RESULTS For the metabolic profiling, GC-TOF was performed on 7 samples of radiation necrosis and 7 samples of tumor. Of the 141 metabolites identified, 17 (12.1%) were found to be statistically significantly different between comparison groups. Of these metabolites, 6 were increased in tumor, and 11 were increased in radiation necrosis. An unsupervised hierarchical clustering analysis found that tumor had elevated levels of metabolites associated with energy metabolism, whereas radiation necrosis had elevated levels of metabolites that were fatty acids and antioxidants/cofactors. CONCLUSIONS To the authors' knowledge, this is the first tissue-based metabolomics study of radiation necrosis and tumor. Radiation necrosis and recurrent tumor following Gamma Knife radiosurgery for brain metastases have unique metabolite profiles that may be targeted in the future to develop noninvasive metabolic imaging techniques.

Revascularización pulpar mediante la utilización de plasma rico en plaquetas autólogo o en combinación con una matriz colágena, como posibilidades terapéuticas para dientes con ápice abierto, pulpa necrótica y/o patología periapical.

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Paula Alejandra Camargo Guevara

2014-07-01

Full Text Available Objetivo: describir el uso del plasma rico en plaquetas autólogo o en combinación con una matriz colágena como posibilidades terapéuticas de revascularización en dientes con ápices abiertos, pulpa necrótica y/o lesión periapical. Métodos: se realizó una búsqueda temática de la literatura entre los años 2007 y 2013, por medios electrónicos, bases de datos, revistas y journals con alto impacto en endodoncia. Resultados: la endodoncia regenerativa es un procedimiento biológico diseñado para reemplazar estructuras lesionadas, enfermas o ausentes del complejo pulpo-dentinal. Hay tres factores que guían y permiten la regeneración tisular: células madre mesenquimales (MSC, que pueden diferenciarse y apoyar la continuación en el desarrollo radicular, factores de crecimiento (GF, para la inducción de la proliferación celular y la diferenciación, y un andamio adecuado que brinde soporte y promueva la migración, crecimiento y la diferenciación celular. El colágeno y el plasma rico en plaquetas (PRP han sido reportados como andamios de elección en la regeneración endodóntica, se dice que estimulan la formación de tejido, la organización y la adherencia celular, mejorando el tiempo de tratamiento y de evolución. Conclusiones: en los procedimientos de revascularización, elegir un andamio o soporte tridimensional como el colágeno tipo I o PRP sumado a la inducción de los tejidos periapicales, aumenta las posibilidades de éxito en el tratamiento de regeneraciónendodóntica gracias a las propiedades que brindan y a la interacción molecular.

Hemorrhagic necrosis due to peliosis hepatis: imaging findings and pathological correlation

International Nuclear Information System (INIS)

Vignaux, O.; Legmann, P.; Bonnin, A.; Pinieux, G. de; Chaussade, S.; Couturier, D.; Spaulding, C.

1999-01-01

Peliosis hepatis is an uncommon liver condition characterized by blood-filled cavities. We report the CT, angiographic and MR features of a case of peliosis hepatis with no obvious etiology and spontaneously regressing hemorrhagic necrosis. Helical CT showed multiple peripheral low-density regions with foci of spontaneous high density suggesting the presence of blood component. On MR imaging, the multiple peripheral lesions were hypointense on T1-weighted and hyperdense on T2-weighted images, with bright foci on all sequences suggesting subacute blood. Angiography showed no evidence of tumor or vascular malformation; multiple nodular vascular lesions filling in the parenchymal phase and persisting in the venous phase suggested blood-filled cavities. Pathological examination showed blood-filled spaces with no endothelial lining, characteristic of the parenchymal type of peliosis. Knowledge of the imaging features of hemorrhagic necrosis due to peliosis hepatis is important since it can be responsive to antibiotic therapy. Furthermore, differentiating hemorrhagic necrosis from hepatic abscess avoids dangerous and sometimes fatal percutaneous drainage. (orig.)

A prospective study of the incidence of asymptomatic pulp necrosis following crown preparation.

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Kontakiotis, E G; Filippatos, C G; Stefopoulos, S; Tzanetakis, G N

2015-06-01

To determine the incidence of asymptomatic pulp necrosis following crown preparation as well as the positive predictive value of the electric pulp testing. A total of 120 teeth with healthy pulps scheduled to receive fixed crowns (experimental teeth) were included. Teeth were divided into two groups according to the preoperative crown condition (intact teeth and teeth with preoperative caries, restorations or crowns) and into four groups according to tooth type (maxillary anterior teeth, maxillary posterior teeth, mandibular anterior teeth and mandibular posterior teeth). Experimental and control teeth were submitted to electric pulp testing on three different occasions before treatment commencement (stage 0), at the impression making session (stage 1) and just before the final cementation of the crown (stage 2). Teeth that were considered to contain necrotic pulps were submitted to root canal treatment. Upon access, absence of bleeding was considered as a confirmation of pulp necrosis. Data were analysed using bivariate (chi-square) and multivariate analysis (logistic regression). All reported probability values (P-values) were based on two-sided tests and compared to a significance level of 5%. The overall incidence of pulp necrosis was 9%. Intact teeth had a significantly lower incidence of pulp necrosis (5%) compared with preoperatively structurally compromised teeth (13%) [(OR: 9.113, P = 0.035)]. No significant differences were found amongst the four groups with regard to tooth type (P = 0.923). The positive predictive value of the electric pulp testing was 1.00. The incidence of asymptomatic pulp necrosis of teeth following crown preparation is noteworthy. The presence of preoperative caries, restorations or crowns of experimental teeth correlated with a significantly higher incidence of pulp necrosis. Electric pulp testing remains a useful diagnostic instrument for determining the pulp condition. © 2014 International Endodontic Journal. Published by

Correlation between electrical conductivity and apparent diffusion coefficient in breast cancer: effect of necrosis on magnetic resonance imaging.

Science.gov (United States)

Kim, Soo-Yeon; Shin, Jaewook; Kim, Dong-Hyun; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; You, Jai Kyung; Kim, Min Jung

2018-03-06

To investigate the correlation between conductivity and ADC in invasive ductal carcinoma according to the presence of necrosis on MRI. Eighty-one women with invasive ductal carcinoma ≥1 cm on T2-weighted fast spin echo sequence of preoperative MRI were included. Phase-based MR electric properties tomography was used to reconstruct conductivity. Mean ADC was measured. Necrosis was defined as an area with very high T2 signal intensity. The relationship between conductivity and ADC was examined using Spearman's correlation coefficient (r). Multiple linear regression analysis was performed to identify factors associated with conductivity or ADC. In the total group, conductivity showed negative correlation with ADC (r = -0.357, p = 0.001). This correlation was maintained in the subgroup without necrosis (n = 53, r = -0.455, p = 0.001), but not in the subgroup with necrosis (n = 28, r = -0.080, p = 0.687). The correlation between the two parameters was different according to necrosis (r = -0.455 vs -0.080, p = 0.047). HER2 enriched subtype was independently associated with conductivity (p = 0.029). Necrosis on MRI was independently associated with ADC (p = 0.027). Conductivity shows negative correlation with ADC that is abolished by the presence of necrosis on MRI. • Electric conductivity showed negative correlation with ADC • However, the correlation was abolished by the presence of necrosis on MRI • HER2-enriched subtype was independently associated with conductivity • Necrosis on MRI was independently associated with ADC.

Análise proteômica da polpa dentária humana com diferentes condições clínicas endodônticas

OpenAIRE

Silva, Poliana Amanda Oliveira

2017-01-01

A Análise proteômica de diferentes condições clínicas da polpa dentária humana pode fornecer informações globais sobre mecanismos de patogenicidade e interações multifatoriais existentes entre microrganismos e o tecido pulpar humano. Assim, o objetivo do estudo foi analisar de forma qualitativa proteínas presentes no tecido pulpar em condições clínicas de polpa normal, pulpite irreversível e necrose com lesão periapical visível radiograficamente. Para isso, três réplicas biológicas, conten...

Tumor necrosis is an important hallmark of aggressive endometrial cancer and associates with hypoxia, angiogenesis and inflammation responses.

Science.gov (United States)

Bredholt, Geir; Mannelqvist, Monica; Stefansson, Ingunn M; Birkeland, Even; Bø, Trond Hellem; Øyan, Anne M; Trovik, Jone; Kalland, Karl-Henning; Jonassen, Inge; Salvesen, Helga B; Wik, Elisabeth; Akslen, Lars A

2015-11-24

Tumor necrosis is associated with aggressive features of endometrial cancer and poor prognosis. Here, we investigated gene expression patterns and potential treatment targets related to presence of tumor necrosis in primary endometrial cancer lesions. By DNA microarray analysis, expression of genes related to tumor necrosis reflected multiple tumor-microenvironment interactions like tissue hypoxia, angiogenesis and inflammation pathways. A tumor necrosis signature of 38 genes and a related patient cluster (Cluster I, 67% of the cases) were associated with features of aggressive tumors such as type II cancers, estrogen receptor negative tumors and vascular invasion. Further, the tumor necrosis signature was increased in tumor cells grown in hypoxic conditions in vitro. Multiple genes with increased expression are known to be activated by HIF1A and NF-kB. Our findings indicate that the presence of tumor necrosis within primary tumors is associated with hypoxia, angiogenesis and inflammation responses. HIF1A, NF-kB and PI3K/mTOR might be potential treatment targets in aggressive endometrial cancers with presence of tumor necrosis.

Nonanaplastic follicular cell-derived thyroid carcinoma: mitosis and necrosis in long-term follow-up.

Science.gov (United States)

Skansing, Daniel Bräuner; Londero, Stefano Christian; Asschenfeldt, Pia; Larsen, Stine Rosenkilde; Godballe, Christian

2017-06-01

Nonanaplastic follicular cell-derived thyroid carcinoma (NAFCTC) includes differentiated- (DTC) and poorly differentiated thyroid carcinoma (PDTC). DTC has an excellent prognosis, while PDTC is situated between DTC and anaplastic carcinomas. Short-term studies suggest that PDTC patients diagnosed only on tumor necrosis and/or mitosis have a prognosis similar to those diagnosed according to the TURIN proposal. The purpose of this study was to evaluate prognosis for NAFCTC based on long-term follow-up illuminating the significance of tumor necrosis and mitosis. A cohort of 225 patients with NAFCTC was followed more than 20 years. Age, sex, distant metastasis, histology, tumor size, extrathyroidal invasion, lymph node metastasis, tumor necrosis and mitosis were examined as possible prognostic factors. Median follow-up time for patients alive was 28 years (range 20-43 years). Age, distant metastasis, extrathyroidal invasion, tumor size, tumor necrosis and mitosis were independent prognostic factors in multivariate analysis for overall survival (OS). In disease specific survival (DSS) age was not significant. Using only necrosis and/or mitosis as criteria for PDTC the 5-, 10- and 20-year OS for DTC was 87, 79 and 69%, respectively. In DSS it was 95, 92 and 90%. For PDTC the 5-, 10- and 20-year OS was 57, 40 and 25%, respectively. In DSS it was 71, 55 and 48%. Tumor necrosis and mitosis are highly significant prognostic indicators in analysis of long time survival of nonanaplastic follicular cell-derived thyroid carcinoma indicating that a simplification of the actually used criteria for poorly differentiated carcinomas may be justified.

Systemic anti-tumor necrosis factor antibody treatment exacerbates endotoxin-induced uveitis in the rat

NARCIS (Netherlands)

de Vos, A. F.; van Haren, M. A.; Verhagen, C.; Hoekzema, R.; Kijlstra, A.

1995-01-01

Tumor necrosis factor is released in the circulation and aqueous humor during endotoxin-induced uveitis, and induces acute uveitis when injected intraocularly in rats. To elucidate the role of tumor necrosis factor in the development of endotoxin-induced uveitis we analysed the effect of

Bilateral acute retinal necrosis-A case report

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Prasad Palimar

1992-01-01

Full Text Available A 42 year old man presented with acute bilateral uveitis and necrotizing retinitis. Systemic investigations including test for AIDS and CMV retinitis were negative. Despite oral Acyclovir, both eyes progressed rapidly to retinal detachment with loss of vision. Early recognition is necessary to diagnose the bilateral acute retinal necrosis syndrome and initiate treatment. Bilateral acute retinal necrosis (BARN is a term first coined by Young and Bird in 1978 although the syndrome had been originally described by Urayama et al as an unilateral condition. This syndrome is characterized by the triad of acute confluent peripheral necrotizing retinitis, moderate to severe vasculitis and vitritis in an otherwise healthy individual. Rhegmatogenous retinal detachment occurs within two to three months of the onset of the disease and the second eye is involved in 36% of patients, usually within 6 weeks. We herein report a patient who presented with simultaneous BARN leading to retinal detachment in a matter of days. Also, to our knowledge this is the first report of this condition in India.

Successful Treatment of Anterior Tracheal Necrosis after Total Thyroidectomy Using Vacuum-Assisted Closure Therapy

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Grégory Philippe

2012-01-01

Full Text Available Total thyroidectomy involving the adjacent structures of the trachea can cause tracheal damage such as early tracheal necrosis. The authors describe the first case of anterior tracheal necrosis following total thyroidectomy treated using vacuum-assisted closure device. After two weeks of VAC  therapy, there was no evidence of ongoing infection and the trachea was partially closed around a tracheotomy cannula, removed after 3 months. The use of a VAC  therapy to reduce and close the tracheal rent and to create a rapid granulation tissue over tracheal structure appeared as a good opportunity after anterior tracheal necrosis.

Importance of bacterial endotoxin (LPS in endodontics A importância da endotoxina bacteriana (LPS na endodontia atual

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Mario Roberto Leonardo

2004-06-01

Full Text Available New knowledge of the structure and biological activity of endotoxins (LPS has revolutionized concepts concerning their mechanisms of action and forms of inactivation. Since the 1980's, technological advances in microbiological culture and identification have shown that anaerobic microorganisms, especially Gram-negative, predominate in root canals of teeth with pulp necrosis and radiographically visible chronic periapical lesions. Gram-negative bacteria not only have different factors of virulence and generate sub-products that are toxic to apical and periapical tissues, as also contain endotoxin (LPS on their cell wall. This is especially important because endotoxin is released during multiplication or bacterial death, causing a series of biological effects that lead to an inflammatory reaction and resorption of mineralized tissues. Thus, due to the role of endotoxin in the pathogenesis of periapical lesions, we reviewed the literature concerning the biological activity of endotoxin and the relevance of its inactivation during treatment of teeth with pulp necrosis and chronic periapical lesion.O conhecimento mais aprofundado sobre a estrutura e atividade biológica das endotoxinas (LPS revolucionou os conceitos sobre seu mecanismo de ação e formas de inativação. A partir da década de 80, os avanços tecnológicos na cultura e identificação microbiológica demonstraram que, em canais radiculares de dentes portadores de necrose pulpar e lesão periapical crônica, visível radiograficamente, predominam microrganismos anaeróbios, particularmente os gram-negativos. Como se sabe, os microrganismos gram-negativos, além de possuírem diferentes fatores de virulência e gerarem produtos e sub-produtos tóxicos aos tecidos apicais e periapicais, contêm endotoxina em sua parede celular. Esse conhecimento é particularmente importante, uma vez que a endotoxina é liberada durante a multiplicação ou morte bacteriana, exercendo uma série de

Cytokines and chemokines involved in acute retinal necrosis

NARCIS (Netherlands)

L. De Visser (Lenneke); J.H. de Boer (Joke); G.T. Rijkers; Wiertz, K. (Karin); H.J. van den Ham; de Boer, R. (Rob); van Loon, A.M. (Anton M.); A. Rothová (Aniki); J.D.F. de Groot-Mijnes (Jolanda )

2017-01-01

textabstractPURPOSE. To investigate which cytokines and chemokines are involved in the immunopatho-genesis of acute retinal necrosis (ARN), and whether cytokine profiles are associated with clinical manifestations, such as visual outcome. METHODS. Serum and aqueous humor (AH) samples of 19 patients

Cytokines and Chemokines Involved in Acute Retinal Necrosis

NARCIS (Netherlands)

de Visser, Lenneke; H de Boer, Joke; T Rijkers, Ger; Wiertz, Karin; van den Ham, Henk-Jan; de Boer, Rob; M van Loon, Anton; Rothova, Aniki; de Groot-Mijnes, Jolanda D F

2017-01-01

Purpose: To investigate which cytokines and chemokines are involved in the immunopathogenesis of acute retinal necrosis (ARN), and whether cytokine profiles are associated with clinical manifestations, such as visual outcome. Methods: Serum and aqueous humor (AH) samples of 19 patients with ARN were

Restriction spectrum imaging of bevacizumab-related necrosis in a patient with GBM

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Nikdokht eFarid

2013-09-01

Full Text Available Importance:With the increasing use of antiangiogenic agents in the treatment of high grade gliomas, we are becoming increasingly aware of distinctive imaging findings seen in a subset of patients treated with these agents. Of particular interest is the development of regions of marked and persistent restricted diffusion. We describe a case with histopathologic validation, confirming that this region of restricted diffusion represents necrosis and not viable tumor. Observations:We present a case report of a 52-year-old man with GBM treated with temozolomide, radiation, and concurrent bevacizumab following gross total resection. The patient underwent sequential MRI's which included restriction-spectrum imaging (RSI, an advanced diffusion-weighted imaging (DWI technique, and MR perfusion. Following surgery, the patient developed an area of restricted diffusion on RSI which became larger and more confluent over the next several months. Marked signal intensity on RSI and very low cerebral blood volume (CBV on MR perfusion led us to favor bevacizumab-related necrosis over recurrent tumor. Subsequent histopathologic evaluation confirmed coagulative necrosis.Conclusions and Relevance:Our report increases the number of pathologically-proven cases of bevacizumab-related necrosis in the literature from three to four. Furthermore, our case demonstrates this phenomenon on RSI, which has been shown to have good sensitivity to restricted diffusion.

Avascular Necrosis in the Contralateral Hip in Patients With Congenital Femoral Deficiency: A Report of 3 Cases.

Science.gov (United States)

Brown, Timothy S; Wimberly, Robert L; Birch, John G

2017-01-01

Congenital femoral deficiency is an uncommon clinical entity. We report 3 patients who developed avascular necrosis of the hip in the long (normal) leg during longitudinal observation and/or treatment of congenital femoral deficiency. Patients were identified in limb length discrepancy clinic and their charts were retrospectively reviewed for clinical and radiographic data collection. We describe the occurrence of idiopathic avascular necrosis in the normal limb in patients being followed for limb length discrepancy. Although no conclusion could be drawn about the etiology of the avascular necrosis, we describe a previously undocumented relationship between congenital femoral deficiency and avascular necrosis in the contralateral hip. This occurred in our congenital femoral deficiency population at a rate higher than expected compared with published incidences of avascular necrosis of the hip in children. Level IV-case series.

Perilesional edema in radiation necrosis reflects axonal degeneration

International Nuclear Information System (INIS)

Perez-Torres, Carlos J; Yuan, Liya; Schmidt, Robert E; Rich, Keith M; Ackerman, Joseph JH; Garbow, Joel R

2015-01-01

Recently, we characterized a Gamma Knife® radiation necrosis mouse model with various magnetic resonance imaging (MRI) protocols to identify biomarkers useful in differentiation from tumors. Though the irradiation was focal to one hemisphere, a contralateral injury was observed that appeared to be localized in the white matter only. Interestingly, this injury was identifiable in T2-weighted images, apparent diffusion coefficient (ADC), and magnetization transfer ratio (MTR) maps, but not on post-contrast T1-weighted images. This observation of edema independent of vascular changes is akin to the perilesional edema seen in clinical radiation necrosis. The pathology underlying the observed white-matter MRI changes was explored by performing immunohistochemistry for healthy axons and myelin. The presence of both healthy axons and myelin was reduced in the contralateral white-matter lesion. Based on our immunohistochemical findings, the contralateral white-matter injury is most likely due to axonal degeneration

[Necrosis in fingers and toes following local anaesthesia with adrenaline--an urban legend?].

Science.gov (United States)

Finsen, Vilhjalmur

2013-09-17

It is often maintained that a local anaesthetic (usually lidocaine) with adrenaline must not be used in fingers and toes because it may cause necrosis due to vascular spasm in end arteries. This review article is an attempt to find evidence to support this warning. Relevant literature was found by means of searches in PubMed limited downwards to 1946 and in EMBASE from 1980 to 2012, and in reference lists. Five review articles on finger necrosis following local anaesthesia concluded that lidocaine with adrenaline does not entail a risk of ischaemic injury. One article found 48 reported cases of finger necrosis in the period 1880 to 2000. Most were from the first half of the 1900s, and none involved lidocaine. Gangrene of part of the finger tip has subsequently been described in one patient with Raynaud's syndrome. No cases of necrosis have been described in a large number of reported accidents in which EpiPen injections contained the same quantity of adrenaline as is found in 60 ml lidocaine with adrenaline. Over a quarter of a million reports have been made of operations on feet, hands, fingers and toes anaesthetised with lidocaine with adrenaline without resulting necrosis. There are no grounds for the warning against using lidocaine with adrenaline in fingers and toes. This anaesthetic offers considerable practical advantages. Care should be taken with infected fingers or fingers with poor circulation.

Nontraumatic femoral head necrosis. Classification of bone scintigraphic findings and diagnostic value of SPECT following planar imaging

Energy Technology Data Exchange (ETDEWEB)

Minoshima, Satoshi; Uchida, Yoshitaka; Anzai, Yoshimi; Uno, Kimiichi; Arimizu, Noboru [Chiba Univ. (Japan). School of Medicine

1994-09-01

This study was conducted to determine bone scintigraphic findings in nontraumatic femoral head avascular necrosis and diagnostic value of SPECT imaging following a conventional planar imaging. Forty-three femoral heads in twenty-six cases with idiopathic femoral head necrosis (n=2), systemic lupus erythematosus (n=22), aplastic anemia (n=1), and renal transplantation (n=1) were studied. The diagnosis for femoral head necrosis was based on magnetic resonance imaging as well as other diagnostic studies in all cases. Scintigraphic findings of planar and SPECT images were classified into six categories: normal (N); cold or decrease (C); partial increase with cold or decrease (PH+C); ring-like increase with a cold center (RH+C); partial increase (PH); diffuse and/or irregular increase (DH). Avascular necrosis was confirmed in twenty-four femoral heads, in which planar and SPECT images showed scintigraphic findings of N (n=3, 2), C (n=1, 3), PH+C (n=2, 8), RH+C (n=2, 3), PH (n=9, 2), and DH (n=7, 6), respectively. Femoral heads without avascular necrosis demonstrated planar and SPECT findings of N (n=16, 12), C (n=0, 6), and DH (n=3, 1), respectively. When considering C, PH+C, and RH+C as diagnostic findings for avascular necrosis, sensitivities of planar and SPECT images were 21% and 58%, and specificities were 100% and 68%, respectively. In nineteen femoral heads with normal planar findings (N), SPECT correctly identified avascular necrosis in two femoral heads and misidentified six normal femoral heads as avascular necrosis. In nineteen femoral heads with nondiagnostic abnormalities (PH, DH), SPECT correctly identified avascular necrosis in seven femoral heads and showed no false positive. Diagnostic planar findings in five femoral heads were concordant with SPECT diagnosis. These results indicate that SPECT imaging is most valuable when planar images show nondiagnostic abnormalities based on the proposed classification of scintigraphic findings. (author).

Nontraumatic femoral head necrosis. Classification of bone scintigraphic findings and diagnostic value of SPECT following planar imaging

International Nuclear Information System (INIS)

Minoshima, Satoshi; Uchida, Yoshitaka; Anzai, Yoshimi; Uno, Kimiichi; Arimizu, Noboru

1994-01-01

This study was conducted to determine bone scintigraphic findings in nontraumatic femoral head avascular necrosis and diagnostic value of SPECT imaging following a conventional planar imaging. Forty-three femoral heads in twenty-six cases with idiopathic femoral head necrosis (n=2), systemic lupus erythematosus (n=22), aplastic anemia (n=1), and renal transplantation (n=1) were studied. The diagnosis for femoral head necrosis was based on magnetic resonance imaging as well as other diagnostic studies in all cases. Scintigraphic findings of planar and SPECT images were classified into six categories: normal (N); cold or decrease (C); partial increase with cold or decrease (PH+C); ring-like increase with a cold center (RH+C); partial increase (PH); diffuse and/or irregular increase (DH). Avascular necrosis was confirmed in twenty-four femoral heads, in which planar and SPECT images showed scintigraphic findings of N (n=3, 2), C (n=1, 3), PH+C (n=2, 8), RH+C (n=2, 3), PH (n=9, 2), and DH (n=7, 6), respectively. Femoral heads without avascular necrosis demonstrated planar and SPECT findings of N (n=16, 12), C (n=0, 6), and DH (n=3, 1), respectively. When considering C, PH+C, and RH+C as diagnostic findings for avascular necrosis, sensitivities of planar and SPECT images were 21% and 58%, and specificities were 100% and 68%, respectively. In nineteen femoral heads with normal planar findings (N), SPECT correctly identified avascular necrosis in two femoral heads and misidentified six normal femoral heads as avascular necrosis. In nineteen femoral heads with nondiagnostic abnormalities (PH, DH), SPECT correctly identified avascular necrosis in seven femoral heads and showed no false positive. Diagnostic planar findings in five femoral heads were concordant with SPECT diagnosis. These results indicate that SPECT imaging is most valuable when planar images show nondiagnostic abnormalities based on the proposed classification of scintigraphic findings. (author)

Uterus necrosis after radiochemotherapy in two patients with advanced cervical cancer

International Nuclear Information System (INIS)

Marnitz, S.; Hinkelbein, W.; Koehler, C.; Schneider, A.; Fueller, J.

2006-01-01

Background: Simultaneous platinum-based radiochemotherapy is the standard of care for patients with advanced or node-positive cancer of the uterine cervix. A large body of literature concerning therapy-related acute and late morbidity is available. Chemoradiation-associated necrosis of the uterus has not been described so far. Case Report: Two patients are reported who were treated by combine chemoradiation between 2004 and 2005 for histologically confirmed cervical cancer following laparoscopic staging. Both patients were diagnosed with squamous cell cancer of the cervix FIGO stage IIB (T2b pN1 pM1 LYM G2) and FIGO IIIA (T3a pN1 MO G2), respectively. External-beam radiotherapy was applied in a 3-D-planned four-field technique, covering pelvic lymph nodes and primary tumor. Simultaneously, cisplatin was given to both patients. Following chemoradiation, both patientsdeveloped pelvic pain and an elevation of C-reactive protein (CRP) in the presence of a normal leukocyte count. Both patients underwent relaparoscopy, and necrosis of the uterus combined with partial necrosis of the bladder was diagnosed in patient 1. Patient 1 underwent total supralevatoric exenteration and patient 2 laparoscopically assisted hysterectomy withbilateral salpingo-oophorectomy. Conclusion: In patients with persisting or incident pelvic pain, questionable findings in imaging techniques and/or elevated inflammation parameters following completion of chemoradiation for cervical cancer, differential diagnosis should include radiogenic necrosis of the uterus and other pelvic organs. Laparoscopy is an ideal technique to exclude or confirm this diagnosis. (orig.)

Ischemia leads to apoptosis--and necrosis-like neuron death in the ischemic rat hippocampus

DEFF Research Database (Denmark)

Müller, Georg Johannes; Stadelmann, Christine; Bastholm, Lone

2004-01-01

necrosis; its expression peaked on days 3 to 4. Silver staining for nucleoli, which are a substrate for caspase-3, revealed a profound loss of nucleoli in cells with apoptosis-like morphology, whereas cells with necrosis-like morphology showed intact nucleoli. Overall, cells with apoptosis-like morphology...

Bilateral streptococcal corneoscleritis complicating β irradiation induced scleral necrosis

International Nuclear Information System (INIS)

Moriarty, A.P.; Crawford, G.J.; McAllister, I.L.; Constable, I.J.

1993-01-01

Bacterial corneoscleritis may complicate scleral necrosis induced by β irradiation following pterygium removal. Previous cases have been unilateral. The authors report a case of severe bilateral corneoscleritis caused by Streptococcus pneumoniae. (author)

Possible cause underlying gastric necrosis and perforation: Celiac artery thrombosis

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Ahmet Peker

2017-12-01

Full Text Available In this article, we are sharing a case of a 76-year-old woman with known hypertension, atrial fibrillation,diabetes mellitus, coronary artery disease, who is presenting with stomach necrosis and perforation possibly due to celiac artery thrombosis after newly developed abdominal pain and bloody vomiting. In our case, emergency surgery was planned and the patient refused the operation and was lost at 48 hours of clinical follow-up. We aimed to discuss the etiology of celiac artery thrombosis, briefly. We believe that necrosis and perforation of the stomach due to celiac artery thrombosis deserves to be shared because it is a rare and difficult case to manage.

Femoral head avascular necrosis

International Nuclear Information System (INIS)

Chrysikopoulos, H.; Sartoris, D.J.; Resnick, D.L.; Ashburn, W.; Pretorius, T.

1988-01-01

MR imaging has been shown to be more sensitive and specific than planar scintigraphy for avascular necrosis (AVN) of the femoral head. However, experience with single photon emission CT (SPECT) is limited. The authors retrospectively compared 1.5-T MR imaging with SPECT in 14 patients with suspected femoral head AVN. Agreement between MR imaging and SPECT was present in 24 femurs, 14 normal and ten with AVN. MR imaging showed changes of AVN in the remaining four femoral heads. Of these, one was normal and the other three inconclusive for AVN by SPECT. The authors conclude that MR imaging is superior to SPECT for the evaluation of AVN of the hip

Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis.

Science.gov (United States)

Kim, Jihyeung; Park, Jin Woo; Chung, Jeehyeok; Jeong Bae, Kee; Gong, Hyun Sik; Baek, Goo Hyun

2018-01-01

We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion with avascular necrosis. Although revascularization of the proximal fragment after surgery was not evaluated, bony union was confirmed in nearly all patients. IV.

Biofilms associated with bowel necrosis: A newly recognised ...

African Journals Online (AJOL)

All specimens showed varying degrees of bowel necrosis and an organising acute peritoneal reaction. In addition, all showed colonies of Gram-negative bacteria within a mucopolysaccharide matrix. Conclusions. The identification of biofilms in necrotic bowel has raised questions regarding their clinical implications. Further ...

Prevalence and associations of symptomatic renal papillary necrosis ...

African Journals Online (AJOL)

Aim: To assess the prevalence and associations of symptomatic renal papillary necrosis (RPN) in sickle cell anemia patients. Patients and Methods: The case notes of homozygous hemoglobin (Hb) S patients diagnosed with RPN were retrospectively assessed. Diagnosis was based on microscopic hematuria and positive ...

Tratamiento con implantes Leader-Nano en paciente con oligodoncia

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Salvador Javier Santos Medina

2015-03-01

Full Text Available Los implantes dentales de titanio han revolucionado el mundo de la rehabilitación desde su surgimiento. De manera particular, el empleo de implantes de carga inmediata acorta el tiempo quirúrgico y protésico, con el consiguiente bienestar estético. Se presenta el caso de una paciente femenina de 32 años de edad, con antecedentes de oligodoncia de ambos incisivos laterales superiores y portadora de prótesis parcial acrílica. Fue atendida por el equipo multidisciplinario de implantes en la Clínica Estomatológica Docente “3 de Octubre” y se le realizó tratamiento de rehabilitación integral con implantes Leader-Nano y prótesis fija con corona acrílica sobre dichos implantes. La implantología fue satisfactoria en la paciente; la mejoría estética y funcional, así como la satisfacción de la paciente, fueron los principales logros obtenidos

Experiencias de haber crecido con un padre/madre con trastorno mental severo (TMS)

OpenAIRE

Vivanco B, Gabriela; Grandón F, Pamela

2016-01-01

Introducción. La experiencia de vivir con personas que presentan un Trastorno Mental Severo (TMS) es difícil para las familias, en especial para los hijos quienes han sido poco estudiados. El objetivo de la investigación fue conocer cómo la experiencia de haber vivido con un padre o madre con un trastorno mental severo influyó en la infancia, adolescencia y adultez joven de sus hijos e hijas. Método. Se analizan las experiencias de convivencia con un padre/madre con TMS en 10 hijos (6 hombres...

Efecto de mezclas de fibra semicomposteada con suelo en el crecimiento y la tolerancia de enfermedades en vivero de palma aceitera

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Gabriel Garbanzo

2017-01-01

Full Text Available Se evaluó el efecto de diferentes mezclas de compost de fibra de racimos vacíos con suelo para sustrato en plantas de palma aceitera en vivero y su efecto sobre la severidad del Complejo de Necrosis Foliar (CNF en el Pacífico Sur de Costa Rica. Se realizaron mezclas volumétricas de 12, 25 37 y 50% de compost de fibra (C con un Inceptisol eútrico. Se sembraron plantas de palma aceitera del material Compacta x Ghana, se llenaron bolsas de 20 L y se acomodaron en un diseño experimental de bloques completos al azar, que comprendieron 5 tratamientos y 4 repeticiones. A los 85, 127, 176, 219, 261 y 304 días después de siembra (dds, se evaluó el crecimiento morfológico de las plantas, el porcentaje de severidad de CNF en las hojas y el peso seco de plantas, y se calculó la absorción de nutrimentos. También se evaluó la densidad aparente del suelo (Dap y la conductividad hidráulica (CH en las mezclas a los 90 y 300 dds. Se encontró que el tratamiento de 12% de fibra con suelo mostró significativamente el menor porcentaje de severidad de CNF y presentó el mayor balance porcentual de eficiencia de fertilización de los nutrimentos en comparación con el resto de los tratamientos. La Dap fue significativamente inferior y la CH superior en todas las mezclas cuando se comparó con el testigo. Se puede concluir que la mezcla de 12% de compost con 88% de suelo mejoró la absorción de nutrimentos en las plantas y aumentó la tolerancia a CNF en las plantas de palma aceitera en vivero.

Prediction of post-operative necrosis after mastectomy: A pilot study utilizing optical diffusion imaging spectroscopy

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Xie Xian-Jin

2009-11-01

Full Text Available Abstract Introduction Flap necrosis and epidermolysis occurs in 18-30% of all mastectomies. Complications may be prevented by intra-operative detection of ischemia. Currently, no technique enables quantitative valuation of mastectomy skin perfusion. Optical Diffusion Imaging Spectroscopy (ViOptix T.Ox Tissue Oximeter measures the ratio of oxyhemoglobin to deoxyhemoglobin over a 1 × 1 cm area to obtain a non-invasive measurement of perfusion (StO2. Methods This study evaluates the ability of ViOptix T.Ox Tissue Oximeter to predict mastectomy flap necrosis. StO2 measurements were taken at five points before and at completion of dissection in 10 patients. Data collected included: demographics, tumor size, flap length/thickness, co-morbidities, procedure length, and wound complications. Results One patient experienced mastectomy skin flap necrosis. Five patients underwent immediate reconstruction, including the patient with necrosis. Statistically significant factors contributing to necrosis included reduction in medial flap StO2 (p = 0.0189, reduction in inferior flap StO2 (p = 0.003, and flap length (p = 0.009. Conclusion StO2 reductions may be utilized to identify impaired perfusion in mastectomy skin flaps.

Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

Science.gov (United States)

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

2016-08-10

We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids. 2016 BMJ Publishing Group Ltd.

Pituitary necrosis and vasospasm following removal of craniopharyngioma

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Linda Ratanaprasatporn

2015-03-01

Full Text Available We report a case of vasospasm complicating delayed pituitary necrosis after craniopharyngioma resection in an 18-year old female. This is the first reported case that utilizes aggressive blood pressure management, fluid optimization, and rheologic doses of mannitol to successfully treat severe symptomatic vasospasm.

Osteomedullography: for early diagnosis of the fracture healing, nonunion and avascular necrosis

International Nuclear Information System (INIS)

Kim, Y. C.; Lee, S. H.; Lee, Y. C.; Whang, I. S.; Kim, H. S.

1981-01-01

Complications of non-union and avascular necrosis during fracture healing process are the most important problem. Early detection of the evidence of non-union and avascular necrosis and follow-up study of fracture healing process will reduce complications and sequellae in fracture patients. Femoral neck and tibial shaft are the most important fracture sites where non-union and/or avascular necrosis are frequently developed. Osteomedullography was performed in 30 cases of fracture, 21 femoral neck, 8 tibial shafts and 1 talar neck, in the Department of Radiology of National Medical Center during the period from August 1977 to March 1981. The following results were obtained: 1. 16 patients of femoral neck fracture were performed osteomedullography once. Non-union showing no crossing vein through the fracture site was noted in 12 cases from 16 patients. 4 cases from the 12 patients of non-union showed decreased viability but 2 case revealed good viability of the femoral head. 1 case from 4 cases of good union of fracture showed no evidence of viability of the femoral head. 2. More than twice of osteomedullography were performed in 5 cases of femoral neck fracture, and crossing vein was not appeared in 4 cases at 3 weeks after fracture. 3 cases showed crossing veins at 6 weeks, and 1 case revealed evidence of avascular necrosis of the femoral head at 9 weeks. 3. In 8 cases of tibial shaft fracture, 4 cases were non-union. Another 4 cases revealed intraosseous veins crossing in fracture site or additional Kaski's osteomedullographic signs, indicating bony union. 4. One talar neck fracture showed bony union with decreased viability of the body on 12 month after fracture. 5. Osteomedullography is considered as very important study for the early diagnosis of the fracture healing, non-union and avascular necrosis

Osteomedullography: for early diagnosis of the fracture healing, nonunion and avascular necrosis

Energy Technology Data Exchange (ETDEWEB)

Kim, Y C; Lee, S H; Lee, Y C; Whang, I S; Kim, H S [National Medical Center, Seoul (Korea, Republic of)

1981-12-15

Complications of non-union and avascular necrosis during fracture healing process are the most important problem. Early detection of the evidence of non-union and avascular necrosis and follow-up study of fracture healing process will reduce complications and sequellae in fracture patients. Femoral neck and tibial shaft are the most important fracture sites where non-union and/or avascular necrosis are frequently developed. Osteomedullography was performed in 30 cases of fracture, 21 femoral neck, 8 tibial shafts and 1 talar neck, in the Department of Radiology of National Medical Center during the period from August 1977 to March 1981. The following results were obtained: 1. 16 patients of femoral neck fracture were performed osteomedullography once. Non-union showing no crossing vein through the fracture site was noted in 12 cases from 16 patients. 4 cases from the 12 patients of non-union showed decreased viability but 2 case revealed good viability of the femoral head. 1 case from 4 cases of good union of fracture showed no evidence of viability of the femoral head. 2. More than twice of osteomedullography were performed in 5 cases of femoral neck fracture, and crossing vein was not appeared in 4 cases at 3 weeks after fracture. 3 cases showed crossing veins at 6 weeks, and 1 case revealed evidence of avascular necrosis of the femoral head at 9 weeks. 3. In 8 cases of tibial shaft fracture, 4 cases were non-union. Another 4 cases revealed intraosseous veins crossing in fracture site or additional Kaski's osteomedullographic signs, indicating bony union. 4. One talar neck fracture showed bony union with decreased viability of the body on 12 month after fracture. 5. Osteomedullography is considered as very important study for the early diagnosis of the fracture healing, non-union and avascular necrosis.

Rib necrosis after postoperative irradiation with 6MeV x-ray to breast cancer

Energy Technology Data Exchange (ETDEWEB)

Asakawa, H; Watarai, J; Otawa, H [Miyagi Prefectural Adult Disease Center, Natori (Japan)

1975-04-01

In order to examine quality of rays in radiation injury in the rib by high energy x-ray, radiation injury in the rib was roentgenologically followed up in the subjects that received postoperative irradiation only with 6 MeV x-ray to breast cancer. The subjects consisted of 79 patients with the age of 30 to 78 and were irradiated with 200 rads of 6 MeV x-ray 5 times a week delivered in 5 to 6 weeks postoperatively. Two fields were irradiated in a day and the total dose reached more than 5,000 rads. Roentgenologic follow up for more than 12 months revealed that rib necrosis occurred in 9 (11%) of 79 patients and that there was no relation to the age of patient. The necrosis was most likely to develop in the right second rib 10 to 23 months after the irradiation and the mean was 16 months. To the rib region where necrosis occurred, 1,880 to 2,230 ret were irradiated and the mean was 2,014 ret. There found no relation between the irradiation dose and occurrence of rib necrosis in the extent of 4,000 to 6,000 rads for tumor doses. Radiation injury in the lung was complicated in 8 (89%) of 9 patients with rib necrosis, indicating high incidence.

Mechanisms of tumor necrosis in photodynamic therapy with a chlorine photosensitizer: experimental studies

Science.gov (United States)

Privalov, Valeriy A.; Lappa, Alexander V.; Bigbov, Elmir N.

2011-02-01

A photodynamic therapy experiment on 118 inbred white mice with transplanted Ehrlich's tumor (mouse mammary gland adenocarcinoma) is performed to reveal mechanisms of necrosis formation. In 7-10 days the tumor of 1-1.5 cm diameter is formed under skin at the injection point, and PDT procedure is applied. There were used a chlorine type photosensitizer RadachlorineTM and 662 nm wavelength diode laser. The drug is injected by intravenously at the dose of 40 mg/kg; the irradiation is executed in 2-2.5 hours at the surface dose of about 200 J/cm2. Each of the mice had a photochemical reaction in form of destructive changes at the irradiation region with subsequent development of dry coagulation necrosis. After rejection of the necrosis there occurred epithelization of defect tissues in a tumor place. Histological investigations were conducted in different follow-up periods, in 5 and 30 min, 1, 3, 6, and 12 hours, 1, 3, 7 and 28 days after irradiation. They included optical microscopy, immune marker analysis, morphometry with measurements of volume density of epithelium, tumor stroma and necroses, vascular bed. The investigations showed that an important role in damaging mechanisms of photodynamic action belongs to hypoxic injuries of tumor mediated by micro vascular disorders and blood circulatory disturbances. The injuries are formed in a few stages: microcirculation angiospasm causing vessel paresis, irreversible stases in capillaries, diapedetic hemorrhages, thromboses, and thrombovasculitis. It is marked mucoid swelling and fibrinoid necrosis of vascular tissue. Progressive vasculitises result in total vessel obliteration and tumor necrosis.

Integrated management of sunflower necrosis disease

OpenAIRE

Shirshikar S.P.

2008-01-01

Sunflower necrosis disease (SND) is a new threat for sunflower cultivation in India. The disease was observed during 1997 in Karnataka, a major sunflower growing state of India. Later, its occurrence was reported from almost all sunflower growing states of India, posing threat to sunflower cultivation. Presently no reliable resistant sources are available. The disease being viral in nature is very much difficult to combat by single approach. At Oilseeds Research Station, Latur (M.S.), India, ...

[Avascular necrosis of the femoral head].

Science.gov (United States)

Porubský, Peter; Trč, Tomáš; Havlas, Vojtěch; Smetana, Pavel

Avascular necrosis of the femoral head in adults is not common, but not too rare diseases. In orthopedic practice, it is one of the diseases that are causing implantation of hip replacement at a relatively early age. In the early detection and initiation of therapy can delay the implantation of prosthesis for several years, which is certainly more convenient for the patient and beneficial. This article is intended to acquaint the reader with the basic diagnostic procedures and therapy.

Transcutaneous cervical vagal nerve stimulation modulates cardiac vagal tone and tumor necrosis factor-alpha

DEFF Research Database (Denmark)

Brock, C; Brock, B; Aziz, Q

2017-01-01

-VNS, there was an increase in cardiac vagal tone and a reduction in tumor necrosis factor-α in comparison to baseline. No change was seen in blood pressure, cardiac sympathetic index or other cytokines. These preliminary data suggest that t-VNS exerts an autonomic and a subtle antitumor necrosis factor-α effect, which...

Avascular necrosis in sickle cell (homozygous S) patients: Predictive ...

African Journals Online (AJOL)

2013-04-24

Apr 24, 2013 ... Results: The prevalence of AVN in sickle cell patients was ... Key words: Avascular necrosis, homozygous S, platelet count, sickle cell anemia, white cell count .... frequency of vaso‑occlusive crisis, platelet, and white cell.

Effects of sucralfate on gastric irritant-induced necrosis and apoptosis in cultured guinea pig gastric mucosal cells.

Science.gov (United States)

Hoshino, Tatsuya; Takano, Tatsunori; Tomisato, Wataru; Tsutsumi, Shinji; Hwang, Hyun-Jung; Koura, Yuko; Nishimoto, Kiyo; Tsuchiya, Tomofusa; Mizushima, Tohru

2003-01-01

We previously reported that several gastric irritants, including ethanol, hydrogen peroxide, and hydrochloric acid, induced both necrosis and apoptosis in cultured gastric mucosal cells. In the present study, we examined the effects of sucralfate, a unique gastroprotective drug, on gastric irritant-induced necrosis and apoptosis produced in vitro. Sucralfate strongly inhibited ethanol-induced necrosis in primary cultures of guinea pig gastric mucosal cells. The preincubation of cells with sucralfate was not necessary for its cytoprotective effect to be observed, thus making its mechanism of action different from that of other gastroprotective drugs. Necrosis of gastric mucosal cells induced by hydrogen peroxide or indomethacin was also suppressed by sucralfate. On the other hand, sucralfate only weakly inhibited ethanol-induced apoptosis. These results suggest that the cytoprotective effect of sucralfate on gastric mucosa in vivo can be explained, at least in part, by its inhibitory effect on gastric irritant-induced necrosis.

Superimposition of maximal stress and necrosis areas at the top of the femoral head in hip aseptic osteonecrosis.

Science.gov (United States)

Escudier, J-C; Ollivier, M; Donnez, M; Parratte, S; Lafforgue, P; Argenson, J-N

2018-05-01

Recent reports described possible mechanical factors in the development and aggravation of osteonecrosis of the femoral head (OFH), but these have yet to be confirmed on dedicated mechanical study. We therefore developed a 3D finite element model based on in-vivo data from patients with incipient OFH, with a view to determining whether the necrosis area was superimposed on the maximal stress area on the femoral head. The location of the necrosis area is determined by stress on the femoral head. All patients from the rheumatology department with early stage OFH in our center were investigated. Analysis of CT scans showed stress distribution on the head by 3D finite elements models, enabling determination of necrosis volume within the maximal stress area and of the percentage intersection of necrosis within the stress area (%I n/s: necrosis volume in stress area divided by total stress area volume and multiplied by 100) and of stress within the necrosis area (%I s/n: stress volume in necrosis area divided by total necrosis area volume and multiplied by 100). Nineteen of the 161 patients assessed retrospectively for the period between 2006 and 2015 had incipient unilateral OFH, 10 of whom (4 right, 6 left) had CT scans of sufficient quality for inclusion. Mean age was 52 years (range, 37-81 years). Mean maximal stress was 1.63MPa, mean maximal exported stress volume was 2,236.9 mm 3 and mean necrosis volume 6,291.1 mm 3 . Mean %I n/s was 83% and mean %I s/n 35%, with no significant differences according to gender, age, side or stress volume. There was a strong inverse correlation between necrosis volume and %I s/n (R 2 =-0.92) and a strong direct correlation between exported stress volume and %I s/n (R 2 =0.55). %I s/n was greater in small necrosis (stress area on the femoral head. The present results need confirmation by larger-scale studies. We consider it essential to take account of these mechanical parameters to reduce failure rates in conservative treatment of

Evaluación del riesgo ambiental de carbofurano en bioensayos con organismos no blanco

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José Alberto Iannacone

2011-06-01

Full Text Available El carbofurano es uno de los plaguicidas más empleado en la agricultura peruana. El objetivo de este trabajo fue evaluar el riesgo ambiental del carbofurano en bioensayos de toxicidad, sobre once especies no destinatarias. La siguiente secuencia relativa de mayor a menor cocientes de riesgo (CR del carbofurano para los 19 puntos finales de efecto en once especies fue encontrada: Daphnia magna (mortalidad > Lemna minor (inhibición de formación de las hojas > Paracheirodon innesi (nado extraño = P. innesi (incremento del movimiento opercular > Chironomus calligraphus (mortalidad > L. minor (necrosis > P. innesi (mortalidad > L. minor (clorosis > Tetrapygus niger (inhibición de la fecundación > Coturnix japonica (mortalidad > Oncorhynchus mykiss (incremento de coloración > Ceraeochrysa cincta (no eclosión de huevos > O. mykiss (mortalidad con oxígeno > O. mykiss (mortalidad sin oxígeno > Trichogramma pretiosum (mortalidad > C. cincta (mortalidad > T. pretiosum (no emergencia de adultos > Trichogramma pintoi (mortalidad > Beauveria bassiana (inhibición del crecimiento. Los cocientes de riesgo (CR indicaron en todos los casos un alto riesgo del carbofurano principalmente en el ambiente acuático en comparación con el terrestre.Carbofuran is one of the most employed pesticides in Peruvian agriculture. This research aimed to evaluate the risk assessment in bioassays of carbofuran on eleven non-target species. The following relative sequence in decreasing ecotoxicity order in terms of RQ (Risk quotient to carbofuran to 19 end points on 11 species was found: Daphnia magna (mortality > Lemna minor (inhibition of new fronds > Paracheirodon innesi (strange swim = P. innesi (increase of opercula movement > Chironomus calligraphus (mortality > L. minor (necrosis > P. innesi (mortality > L. minor (chlorosis > Tetrapygus niger (inhibition of fertilization> Coturnix japonica (mortality > Oncorhynchus mykiss (increase of coloration > Ceraeochrysa

Biofilms associated with bowel necrosis: A newly recognised ...

African Journals Online (AJOL)

role of biofilms has been established for oral infections, chronic wounds, indwelling ... bowel in infants and may be of significance in the pathogenesis of bowel necrosis and the ... implications in the understanding of the disease process. .... showed areas of mucosal ulceration and ... venous and urinary catheters, and dental.

Common bile duct cancer with massive necrosis mimicking choledochal dilatation on CT

International Nuclear Information System (INIS)

Miyake, H.; Matsumoto, S.; Ueda, S.; Maeda, T.; Aikawa, H.; Mori, H.

1991-01-01

Carcinomas of the common bile duct are usually seen as dilatation of the bile duct proximal to a solid mass on CT. In the case reported here, the common bile duct cancer itself mimicked dilated common bile duct on CT because of massive necrosis. In a case of simulating dilated common bile duct on CT, and discrepancy between CT and ultrasonography or endoscopic retrograde cholangiopancreatography, a common bile duct cancer with massive necrosis should be included in the differential diagnosis. (orig.)

Avascular necrosis of bilateral femoral heads in a patient with Fabry's disease.

LENUS (Irish Health Repository)

O'Neill, Francis

2012-07-13

The underlying cause of avascular necrosis (AVN) of the femoral head is often not apparent. We report the case of a 26 year old builder with a four month history of bilateral hip pain, and a diagnosis of bilateral femoral head avascular necrosis. Fabry\\'s disease was identified as the probable cause. Since 2001, enzyme replacement therapy for Fabry\\'s disease has become available, with a potential to influence the disease process, and this is of potential importance to clinicians treating AVN.

Excretion and toxicity evaluation of 131I-Sennoside A as a necrosis-avid agent.

Science.gov (United States)

Yin, Zhiqi; Sun, Lidan; Jin, Qiaomei; Song, Shaoli; Feng, Yuanbo; Liao, Hong; Ni, Yicheng; Zhang, Jian; Liu, Wei

2017-11-01

1. Sennoside A (SA) is a newly identified necrosis-avid agent that shows capability for imaging diagnosis and tumor necrosis targeted radiotherapy. As a water-soluble compound, 131 I-Sennoside A ( 131 I-SA) might be excreted predominately through the kidneys with the possibility of nephrotoxicity. 2. To further verify excretion pathway and examine nephrotoxicity of 131 I-SA, excretion and nephrotoxicity were appraised. The pharmacokinetics, hepatotoxicity and hematotoxicity of 131 I-SA were also evaluated to accelerate its possible clinical translation. All these studies were conducted in mice with ethanol-induced muscular necrosis following a single intravenous administration of 131I-SA at 18.5 MBq/kg or 370 MBq/kg. 3. Excretion data revealed that 131 I-SA was predominately (73.5% of the injected dose (% ID)) excreted via the kidneys with 69.5% ID detected in urine within 72 h post injection. Biodistribution study indicated that 131 I-SA exhibited initial high distribution in the kidneys but subsequently a fast renal clearance, which was further confirmed by the results of autoradiography and single-photon emission computed tomography-computed tomography (SPECT-CT) imaging. The maximum necrotic to normal muscle ratio reached to 7.9-fold at 48 h post injection, which further verified the necrosis avidity of 131 I-SA. Pharmacokinetic parameters showed that 131 I-SA had fast blood clearance with an elimination half-life of 6.7 h. Various functional indexes were no significant difference (p > 0.05) between before administration and 1 d, 8 d, 16 d after administration. Histopathology showed no signs of tissue damage. 4. These data suggest 131 I-SA is a safe and promising necrosis-avid agent applicable in imaging diagnosis and tumor necrosis targeted radiotherapy.

Trans fatty acids increase nitric oxide levels and pancreatic beta-cell necrosis in rats

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Kusmiyati Tjahjono DK

2013-04-01

Full Text Available Background The prevalence of diabetes in Indonesia is increasing due to various factors, including life style changes such as trans fatty acid (TFA intake. High TFA intake is known to be related to blood lipid profile changes resulting in cardiovascular disorders. This study was to identify the effect of TFA on nitric oxide (NO production and on necrosis of pancreatic beta cells. Methods A study of randomized pre-test post–test design with control group. Thirty Sprague Dawley rats were divided into 3 groups, i.e. group K (control, group P1 receiving a diet with 5% TFA, and P2 receiving 10% TFA. The intervention was performed for 8 weeks. NO level and pancreatic beta-cell necrosis were analyzed using Pearson’s chi square test. Results After 4 weeks of treatment there was no change in NO levels in group K, but increased NO in P2 (2.6-3.8 ìM. At 8 weeks after treatment, NO levels in groups P1 and P2 increased to 2.6-3.4 ìM and 4.2-14.3 ìM, respectively, while in group K only 2 rats had increased NO levels of 2.8-2.9 ìM. With Pearson’s chi-square test, there was a signifant difference in the proportions of necrotic pancreatic beta cells after 4 weeks and 8 weeks (p=0.000. No necrosis of beta cells was found in group K, mild necrosis in group P1 (1-25% and moderate necrosis in group P2 (26-50%. Conclusion TFA consumption significantly increases NO levels in Sprague Dawley rats and also results in moderate grades of necrosis of pancreatic beta cells.

Trans fatty acids increase nitric oxide levels and pancreatic beta-cell necrosis in rats

Directory of Open Access Journals (Sweden)

Kusmiyati Tjahjono DK

2015-12-01

Full Text Available BACKGROUND The prevalence of diabetes in Indonesia is increasing due to various factors, including life style changes such as trans fatty acid (TFA intake. High TFA intake is known to be related to blood lipid profile changes resulting in cardiovascular disorders. This study was to identify the effect of TFA on nitric oxide (NO production and on necrosis of pancreatic beta cells. METHODS A study of randomized pre-test post–test design with control group. Thirty Sprague Dawley rats were divided into 3 groups, i.e. group K (control, group P1 receiving a diet with 5% TFA, and P2 receiving 10% TFA. The intervention was performed for 8 weeks. NO level and pancreatic beta-cell necrosis were analyzed using Pearson’s chi square test. RESULTS After 4 weeks of treatment there was no change in NO levels in group K, but increased NO in P2 (2.6-3.8 ìM. At 8 weeks after treatment, NO levels in groups P1 and P2 increased to 2.6-3.4 ìM and 4.2-14.3 ìM, respectively, while in group K only 2 rats had increased NO levels of 2.8-2.9 ìM. With Pearson’s chi-square test, there was a signifant difference in the proportions of necrotic pancreatic beta cells after 4 weeks and 8 weeks (p= 0.000. No necrosis of beta cells was found in group K, mild necrosis in group P1 (1-25% and moderate necrosis in group P2 (26-50%. CONCLUSION TFA consumption significantly increases NO levels in Sprague Dawley rats and also results in moderate grades of necrosis of pancreatic beta cells

Aseptic necrosis in caisson workers: a new set of decompression tables.

Science.gov (United States)

Downs, G J; Kindwall, E P

1986-06-01

There is a high incidence of aseptic necrosis and decompression sickness among caisson workers due to inadequate decompression using the current OSHA decompression tables (1-7). Because of this, a new set of tables--Autodec III-O2--was developed which more effectively eliminates nitrogen from the body and, therefore, should decrease the incidence of both bends and aseptic necrosis. The Autodec III-O2 schedule's superiority was statistically significant at a level of 0.08 compared to the OSHA table. It is our conclusion that OSHA should adopt the Autodec III-O2 schedule as a replacement for the current decompression tables.

Avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Kokubo, Takeshi; Takatori, Yoshio; Kamogawa, Morihide; Nakamura, Toshitaka; Ninomiya, Setsuo; Yoshikawa, Kohki; Itai, Yuji; Iio, Masahiro; Mitamura, Tadayuki

1990-01-01

T1-weighted MR images of thirty-six hips in 25 patients with avascular necrosis of the femoral head were obtained two to five times during the course of 2 to 26 months. We investigated these MR images in the light of the chronological change and compared them with plain radiographs. MR images changes in 16 femoral head; in general, the abnormal low intensity area in the femoral head reduced in extent and the internal high intensity area became smaller of disappeared. Thirteen femoral heads among them became more flattened on plain radiographs in the same period. It is noted that four different zones are defined in the femoral head after bone necrosis takes place: the dead bone marrow, the dead marrow which still contains fat, the reactive interface and the hyperemic bone marrow. In T1-weighted MR images, the dead bone marrow, the reactive interface and the hyperemic bone marrow are demonstrated as low intensity area, while the dead marrow containing fat may remain high in intensity. On the basis of this knowledge of histopathology and MR images of this disease, we suggest that reduction of the abnormal low intensity area and disappearance of the internal high intensity area on MR images can be regarded as diminution of hyperemia in the living bone marrow and loss of fat in the dead bone marrow, respectively. (author)

Diarachidonoylphosphoethanolamine induces necrosis/necroptosis of malignant pleural mesothelioma cells.

Science.gov (United States)

Kaku, Yoshiko; Tsuchiya, Ayako; Kanno, Takeshi; Nakano, Takashi; Nishizaki, Tomoyuki

2015-09-01

The present study investigated 1,2-diarachidonoyl-sn-glycero-3-phosphoethanolamine (DAPE)-induced cell death in malignant pleural mesothelioma (MPM) cells. DAPE reduced cell viability in NCI-H28, NCI-H2052, NCI-H2452, and MSTO-211H MPM cell lines in a concentration (1-100μM)-dependent manner. In the flow cytometry using propidium iodide (PI) and annexin V (AV), DAPE significantly increased the population of PI-positive and AV-negative cells, corresponding to primary necrosis, and that of PI-positive and AV-positive cells, corresponding to late apoptosis/secondary necrosis, in NCI-H28 cells. DAPE-induced reduction of NCI-H28 cell viability was partially inhibited by necrostatin-1, an inhibitor of RIP1 kinase to induce necroptosis, or knocking-down RIP1. DAPE generated reactive oxygen species (ROS) followed by disruption of mitochondrial membrane potentials in NCI-H28 cells. DAPE-induced mitochondrial damage was attenuated by cyclosporin A, an inhibitor of cyclophilin D (CypD). DAPE did not affect expression and mitochondrial localization of p53 protein in NCI-H28 cells. DAPE significantly decreased intracellular ATP concentrations in NCI-H28 cells. Overall, the results of the present study indicate that DAPE induces necroptosis and necrosis of MPM cells; the former is mediated by RIP1 kinase and the latter is caused by generating ROS and opening CypD-dependent mitochondrial permeability transition pore, to reduce intracellular ATP concentrations. Copyright © 2015 Elsevier Inc. All rights reserved.

Cation dyshomeostasis and cardiomyocyte necrosis: the Fleckenstein hypothesis revisited

Science.gov (United States)

Borkowski, Brian J.; Cheema, Yaser; Shahbaz, Atta U.; Bhattacharya, Syamal K.; Weber, Karl T.

2011-01-01

An ongoing loss of cardiomyocytes to apoptotic and necrotic cell death pathways contributes to the progressive nature of heart failure. The pathophysiological origins of necrotic cell loss relate to the neurohormonal activation that accompanies acute and chronic stressor states and which includes effector hormones of the adrenergic nervous system. Fifty years ago, Albrecht Fleckenstein and coworkers hypothesized the hyperadrenergic state, which accompanies such stressors, causes cardiomyocyte necrosis based on catecholamine-initiated excessive intracellular Ca2+ accumulation (EICA), and mitochondrial Ca2+ overloading in particular, in which the ensuing dysfunction and structural degeneration of these organelles leads to necrosis. In recent years, two downstream factors have been identified which, together with EICA, constitute a signal–transducer–effector pathway: (i) mitochondria-based induction of oxidative stress, in which the rate of reactive oxygen metabolite generation exceeds their rate of detoxification by endogenous antioxidant defences; and (ii) the opening of the mitochondrial inner membrane permeability transition pore (mPTP) followed by organellar swelling and degeneration. The pathogenesis of stress-related cardiomyopathy syndromes is likely related to this pathway. Other factors which can account for cytotoxicity in stressor states include: hypokalaemia; ionized hypocalcaemia and hypomagnesaemia with resultant elevations in parathyroid hormone serving as a potent mediator of EICA; and hypozincaemia with hyposelenaemia, which compromise antioxidant defences. Herein, we revisit the Fleckenstein hypothesis of EICA in leading to cardiomyocyte necrosis and the central role played by mitochondria. PMID:21398641

Hip resurfacing arthroplasty in treatment of avascular necrosis of the femoral head.

Science.gov (United States)

Pyda, Michał; Koczy, Bogdan; Widuchowski, Wojciech; Widuchowska, Małgorzata; Stołtny, Tomasz; Mielnik, Michał; Hermanson, Jacek

2015-01-25

Hip resurfacing is a conservative type of total hip arthroplasty but its use is controversial, especially in patients with osteonecrosis. The aim of this study was analysis of the clinical and radiographic outcomes of hip resurfacing in patients with osteonecrosis. Between 2007 and 2008, 30 hip resurfacing arthroplasties were performed due to osteoarthritis secondary to avascular necrosis of femoral head staged as Ficat III and IV. Patients were qualified to resurfacing arthroplasty when the extent of avascular necrosis using Kerboul's method was avascular necrosis and head-neck junction was >20°. All patients were evaluated clinically and radiologically before and 60 months after the operation. The mean Harris Hip Score (HHS) score increased from 47.8 to 94.25 (p<0.05). Physical activity level (University of California, Los Angeles activity score--UCLA activity score) improved from 3.7 to 7.55 (p<0.05). No implant migration was observed. Management of osteonecrosis of the hip with resurfacing arthroplasty seems to be effective in strictly-selected patients.

Risk factors leading to mucoperiosteal flap necrosis after primary palatoplasty in patents with cleft palate.

Science.gov (United States)

Rossell-Perry, Percy; Figallo-Hudtwalcker, Olga; Vargas-Chanduvi, Roberto; Calderon-Ayvar, Yvette; Romero-Narvaez, Carolina

2017-10-01

Few studies have been published reporting risk factors for flap necrosis after primary palatoplasty in patients with cleft palate. This complication is rare, and the event is a disaster for both the patient and the surgeon. This study was performed to explore the associations between different risk factors and the development of flap necrosis after primary palatoplasty in patients with cleft palate. This is a case-control study. A 20 years retrospective analysis (1994-2015) of patients with nonsyndromic cleft palate was identified from medical records and screening day registries). Demographical and risk factor data were collected using a patient´s report, including information about age at surgery, gender, cleft palate type, and degree of severity. Odds ratios and 95% confident intervals were derived from logistic regression analysis. All cases with diagnoses of flap necrosis after primary palatoplasty were included in the study (48 patients) and 156 controls were considered. In multivariate analysis, female sex, age (older than 15 years), cleft type (bilateral and incomplete), and severe cleft palate index were associated with significantly increased risk for flap necrosis. The findings suggest that female sex, older age, cleft type (bilateral and incomplete), and severe cleft palatal index may be associated with the development of flap necrosis after primary palatoplasty in patients with cleft palate.

Intestinal volvulus with coagulative hepatic necrosis in a chicken.

Science.gov (United States)

Haridy, Mohie; Goryo, Masanobu; Sasaki, Jun; Okada, Kosuke

2010-04-01

A 7-week-old SPF chicken inoculated at 4 weeks of age with chicken anemia virus was puffed up depressed and had ruffled feathers and a good body condition. Intestinal volvulus involving the jejunum and part of the duodenum forming two loops with one knob was observed. Microscopically, venous infarction of the obstructed loops, periportal and sublobular multifocal coagulative hepatic necrosis and granulomatous inflammation of the cecal tonsils were observed. Gram staining revealed no bacteria in hepatic tissue; however, gram-positive bacilli were detected in the necrotic debris in the intestinal lumen. Immunosuppression might have predisposed the chicken to intestinal and cecal tonsil infection that then progressed to volvulus. Loss of the mucosal barrier in infarction might allow bacterial toxins and vasoactive factors to escape into the systemic circulation (toxemia) and be responsible for the hepatic necrosis.

Increased Flap Weight and Decreased Perforator Number Predict Fat Necrosis in DIEP Breast Reconstruction

Directory of Open Access Journals (Sweden)

Carolyn L. Mulvey, BS

2013-05-01

Conclusions: Flaps with increasing weight have increased risk of fat necrosis. These data suggest that inclusion of more than 1 perforator may decrease odds of fat necrosis in large flaps. Perforator flap breast reconstruction can be performed safely; however, considerations concerning race, body mass index, staging with tissue expanders, perforator number, and flap weight may optimize outcomes.

Conferencia clínico-patológica (CPC: insuficiencia corticosuprarrenal debida a infiltración crónica granulomatosa con necrosis de caseificación = Clinico-pathological conference (CPC: adrenal insufficiency due to chronic granulomatous infiltration with caseous necrosis

Directory of Open Access Journals (Sweden)

Cataño Correa, Juan Carlos

2011-12-01

Full Text Available Se presenta y discute el caso de una paciente de 39 años de edad, en embarazo, quien consultó el 29/07/2010, hacia la semana 28 de la gestación, por dolor en el hemiabdomen superior de 20 días de evolución. Entre sus antecedentes de importancia tenía los de una comunicación interauricular tipo ostium secundum, corregida quirúrgicamente el 20/07/2009, y prolapso leve de la válvula mitral. A su ingreso al hospital se le encontró actividad uterina, por la que había estado hospitalizada durante 13 días en otra institución en la que le administraron medicamentos para útero-inhibición y maduración pulmonar fetal; se le diagnosticaron además diabetes gestacional e hidropesía fetal no inmune. Evolucionó tórpidamente con irritabilidad uterina, dolor abdominal, taquicardia y taquipnea, y al tercer día de estancia en la unidad de cuidado intensivo tuvo parto vaginal difícil, que requirió el uso de fórceps; posterior al alumbramiento presentó dolor lumbar y colapso hemodinámico que obligaron a la administración de tratamiento vasopresor con norepinefrina y vasopresina; sin embargo, siguió acidótica e hipotensa, con tendencia a la bradicardia, y finalmente falleció.

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

Directory of Open Access Journals (Sweden)

Honglei eWeng

2015-06-01

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

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

Science.gov (United States)

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

2015-01-01

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

Avascular necrosis of the femoral head post heart-transplantation and steroid dosage.

Science.gov (United States)

Foley-Nolan, D; Daly, C; Barry, C; Woods, A; Neligan, M; Coughlan, R J

1992-12-01

Avascular necrosis (avn) post heart-transplantation has been considered to be due to the high doses of steroids used to immunosuppress these patients in attempting to prevent transplant rejection. This study shows that avascular necrosis occurs even when low dose steroids regimes are used and demonstrates no significant correlation between steroid dosage and the development of avn. Patients with symptomatic avn benefit from early diagnosis and management of their condition in that the need for total joint arthroplasty can be prevented in many cases.

Aspectos Psicosociales Relacionados con el TEPT en Pacientes con Cáncer de Mama

OpenAIRE

Hernández Moreno, Fresia Paloma; Landero Hernández, René

2015-01-01

El objetivo del estudio fue analizar la relación del estrés, la depresión y las estrategias de afrontamiento con el Trastorno de Estrés Postraumático (TEPT) en una muestra de pacientes con cáncer de mama. Se realizó con una muestra no probabilística de 52 mujeres con cáncer de mama. Se encontró una relación entre TEPT y estrés (r= .344, p= .014), TEPT y depresión (rs=.346, p= .013). El TEPT correlacionó con evitación cognitiva (r= .437, p= .001), TEPT y desesperanza (rs= .437, p= .001) y TEPT...

Generation of truncated recombinant form of tumor necrosis factor ...

African Journals Online (AJOL)

7. Original Research Article. Generation of truncated recombinant form of tumor necrosis factor ... as 6×His tagged using E.coli BL21 (DE3) expression system. The protein was ... proapoptotic signaling cascade through TNFR1. [5] which is ...

Soluble tumor necrosis factor receptor-1 in preterm infants with chronic lung disease.

Science.gov (United States)

Sato, Miho; Mori, Masaaki; Nishimaki, Shigeru; An, Hiromi; Naruto, Takuya; Sugai, Toshiyuki; Shima, Yoshio; Seki, Kazuo; Yokota, Shumpei

2010-04-01

It is clear that inflammation plays an important role in developing chronic lung disease in preterm infants. The purpose of the present study is to investigate changes of serum soluble tumor necrosis factor receptor-1 levels over time in infants with chronic lung disease. The serum levels of soluble tumor necrosis factor receptor-1 were measured after delivery, and at 7, 14, 21 and 28 days of age in 10 infants with chronic lung disease and in 18 infants without chronic lung disease. The serum level of soluble tumor necrosis factor receptor-1 was significantly higher in infants with chronic lung disease than in infants without chronic lung disease after delivery. The differences between these two groups remained up to 28 days of age. Prenatal inflammation with persistence into postnatal inflammation may be involved in the onset of chronic lung disease.

Short article: Presence, extent and location of pancreatic necrosis are independent of aetiology in acute pancreatitis.

Science.gov (United States)

Verdonk, Robert C; Sternby, Hanna; Dimova, Alexandra; Ignatavicius, Povilas; Koiva, Peter; Penttila, Anne K; Ilzarbe, Lucas; Regner, Sara; Rosendahl, Jonas; Bollen, Thomas L

2018-03-01

The most common aetiologies of acute pancreatitis (AP) are gallstones, alcohol and idiopathic. The impact of the aetiology of AP on the extent and morphology of pancreatic and extrapancreatic necrosis (EXPN) has not been clearly established. The aim of the present study was to assess the influence of aetiology on the presence and location of pancreatic necrosis in patients with AP. We carried out a post-hoc analysis of a previously established multicentre cohort of patients with AP in whom a computed tomography was available for review. Clinical data were obtained from the medical records. All computed tomographies were revised by the same expert radiologist. The impact of aetiology on pancreatic and EXPN was calculated. In total, 159 patients with necrotizing pancreatitis were identified from a cohort of 285 patients. The most frequent aetiologies were biliary (105 patients, 37%), followed by alcohol (102 patients, 36%) and other aetiologies including idiopathic (78 patients, 27%). No relationship was found between the aetiology and the presence of pancreatic necrosis, EXPN, location of pancreatic necrosis or presence of collections. We found no association between the aetiology of AP and the presence, extent and anatomical location of pancreatic necrosis.

Avascular necrosis of femoral head: findings of contrast-enhanced MR imaging

International Nuclear Information System (INIS)

Shin, Yong Moon; Kang, Heung Sik; Kim, Chu Wan; Kim, Hee Joong; Kim, Young Min

1995-01-01

To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. Sixteen patients with avascular necorsis of femoral head were examined with MRI. T1-weighted and T2-weighted image and contrast-enhanced T1-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the potions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease

Avascular necrosis of femoral head: findings of contrast-enhanced MR imaging

Energy Technology Data Exchange (ETDEWEB)

Shin, Yong Moon; Kang, Heung Sik; Kim, Chu Wan; Kim, Hee Joong; Kim, Young Min [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1995-06-15

To evaluate the findings and the role of contrast enhanced magnetic resonance imaging in avascular necrosis of femoral head. Sixteen patients with avascular necorsis of femoral head were examined with MRI. T1-weighted and T2-weighted image and contrast-enhanced T1-weighted images were obtained. Enhancing characteristics of the necrotic area and synovium were determined. Also a change of the disease extent after enhancement was assessed. Twenty seven avascular necrosis of the femoral head including 11 cases of bilateral lesion were detected. Fifteen cases revealed collapse of the femoral head. The portions of the lesion with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images showed contrast enhancement in 15 cases. However, the potions with low signal intensities both on T1 and T2-weighted images showed enhancement in one case. There was no significant change of the disease extent after enhancement. Synovium showed enhancement in 18 cases, and joint effusion was detected in 23 cases. Contrast enhanced MR images may be helpful in predicting histopathologic findings of avascular necrosis of the femoral head, but not useful for evaluating the extent of disease.

Paciente con esquizofrenia tratado con ziprasidona + clozapina

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Pol Yanguas E.

2013-05-01

Full Text Available P es un paciente diagnosticado de esquizofrenia, sigue en un piso tutelado un programa de rehabilitación, está medicado con clozapina 500 mg/día y ziprasidona 280 mg/ día. Padece hipercolesterolemia, tabaquismo y sus hábitos alimenticios no son buenos. La medicación que utiliza desde 2007 hasta ahora se refleja en la tabla 1. El último tratamiento se le introdujo el 7 de agosto de 2012, habiendo presentado un electro cardiograma (ECG normal, pero con ligera taquicardia ventricular y prolactinemia de 44,8 ng/ml (valores normales: 2-18 ng/ml.

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

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Tiffany J. Patton

2016-01-01

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

Maxillary Necrosis: A Sequelae of Fungal Osteomyelitis

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K Anbarasi

2010-01-01

Full Text Available Osteomyelitis is designated to a variety of bone diseases having inflammation as a common denominator. Persistent infection progresses to inflammation of marrow space, haversian system and periostium of affected region. Thrombosis of endothelial vessels cause necrosis and sequestrum formation. Both pyogenic and nonpyogenic infections of jaw lead to this condition. Immunosuppressed patients are more prone to mycelial infections, whereas their occurrence in immunocompetent individuals are highly unusual.

The effect of anti-tumor necrosis factor alpha agents on postoperative anastomotic complications in Crohn's disease

DEFF Research Database (Denmark)

El-Hussuna, Alaa Abdul-Hussein H; Krag, Aleksander; Olaison, Gunnar

2013-01-01

Patients with Crohn's disease treated with anti-tumor necrosis factor alpha agents may have an increased risk of surgical complications.......Patients with Crohn's disease treated with anti-tumor necrosis factor alpha agents may have an increased risk of surgical complications....

Risk Factor Analysis for Mastectomy Skin Flap Necrosis: Implications for Intraoperative Vascular Analysis.

Science.gov (United States)

Reintgen, Christian; Leavitt, Adam; Pace, Elizabeth; Molas-Pierson, Justine; Mast, Bruce A

2016-06-01

Skin flap necrosis after mastectomy can be a devastating complication significantly affecting patient outcomes. Routine vascular analysis (fluorescein or laser angiography) of mastectomy skin flaps in all patients has been advocated but is of questionable cost-effectiveness. The purpose of this study was to identify the incidence and causative risk factors for mastectomy skin flap necrosis and thereby calculate the fiscal reality of intraoperative vascular screening. This is an institutional review board-approved retrospective study of all patients from 2007 to 2013 who underwent mastectomy related to breast cancer. Skin flap necrosis was defined as major if it necessitated return to the operating room. Data analysis was done for determination of causative factors of necrosis, including age, body mass index, smoking, previous irradiation, coronary artery disease, chronic obstructive pulmonary disorder, hypertension, gastroesophageal reflux disease, hyperlipidemia, obstructive sleep apnea, asthma, diabetes, thyroid disease, history of lumpectomy, and breast reduction or augmentation. During this time, intraoperative vascular screening was not done. Five hundred eighty-one patients underwent 616 mastectomies with a total of 34 necrotic events (5.5%)-16 major and 18 minor. Analyses via Student t tests, univariate analyses, χ testing, and logistic regression showed that history of smoking was the only patient factor associated with postoperative necrosis (P = 0.008). More frequently represented in the necrosis group, but without statistical significance, are previous lumpectomy (P = 0.069) and immediate reconstruction (P = 0.078).For the entire study period, the actual cost to the hospital for major necrotic events was $7,123.10 or $445.19 for each of the 16 major necrotic events and $209.50 for all 34 necrotic events. Per-patient cost-effective screening would need to be less than $11.54 for all patients, $100.33 for highest risk patients (smokers), and $21.65 for

Rin4 causes hybrid necrosis and race-specific resistance in an interspecific lettuce hybrid.

Science.gov (United States)

Jeuken, Marieke J W; Zhang, Ningwen W; McHale, Leah K; Pelgrom, Koen; den Boer, Erik; Lindhout, Pim; Michelmore, Richard W; Visser, Richard G F; Niks, Rients E

2009-10-01

Some inter- and intraspecific crosses may result in reduced viability or sterility in the offspring, often due to genetic incompatibilities resulting from interactions between two or more loci. Hybrid necrosis is a postzygotic genetic incompatibility that is phenotypically manifested as necrotic lesions on the plant. We observed hybrid necrosis in interspecific lettuce (Lactuca sativa and Lactuca saligna) hybrids that correlated with resistance to downy mildew. Segregation analysis revealed a specific allelic combination at two interacting loci to be responsible. The allelic interaction had two consequences: (1) a quantitative temperature-dependent autoimmunity reaction leading to necrotic lesions, lethality, and quantitative resistance to an otherwise virulent race of Bremia lactucae; and (2) a qualitative temperature-independent race-specific resistance to an avirulent race of B. lactucae. We demonstrated by transient expression and silencing experiments that one of the two interacting genes was Rin4. In Arabidopsis thaliana, RIN4 is known to interact with multiple R gene products, and their interactions result in hypersensitive resistance to Pseudomonas syringae. Site-directed mutation studies on the necrosis-eliciting allele of Rin4 in lettuce showed that three residues were critical for hybrid necrosis.

Correlation of MRI Biomarkers with Tumor Necrosis in Hras5 Tumor Xenograft in Athymic Rats

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Daniel P. Bradley

2007-05-01

Full Text Available Magnetic resonance imaging (MRI can measure the effects of therapies targeting the tumor vasculature and has demonstrated that vascular-damaging agents (VDA induce acute vascular shutdown in tumors in human and animal models. However, at subtherapeutic doses, blood flow may recover before the induction of significant levels of necrosis. We present the relationship between changes in MRI biomarkers and tumor necrosis. Multiple MRI measurements were taken at 4.7 T in athymic rats (n = 24 bearing 1.94 ± 0.2-cm3 subcutaneous Hras5 tumors (ATCC 41000 before and 24 hours after clinically relevant doses of the VDA, ZD6126 (0-10 mg/kg, i.v.. We measured effective transverse relaxation rate (R2*, initial area under the gadolinium concentration-time curve (IAUGC60/150, equivalent enhancing fractions (EHF60/150, time constant (Ktrans, proportion of hypoperfused voxels as estimated from fit failures in Ktrans analysis, and signal intensity (SI in T2-weighted MRI (T2W. ZD6126 treatment induced < 90% dose-dependent tumor necrosis at 10 mg/kg; correspondingly, SI changes were evident from T2W MRI. Although R2* did not correlate, other MRI biomarkers significantly correlated with necrosis at doses of ≥ 5 mg/kg ZD6126. These data on Hras5 tumors suggest that the quantification of hypoperfused voxels might provide a useful biomarker of tumor necrosis.

Avascular necrosis of the femoral head at 2 years after pertrochanteric fracture surgery: Case report.

Science.gov (United States)

Deleanu, Bogdan; Prejbeanu, Radu; Vermesan, Dinu; Honcea, Lucian; Mioc, Mihail Lazar; Tsiridis, Eleftherios; Predescu, Vlad

2016-02-01

The avascular necrosis of the femoral head represents the death of bone tissue due to the lack of blood supply. The disease has a progressive evolution and left untreated leads to femoral head collapse and severe arthritis. We present a case of a pertrochanteric fracture which has been successfully operated with a dynamic interlocking trochanteric gamma nail on the right hip. At 2 years after surgery the patient developed an incipient avascular necrosis of the femoral head. Despite the good positioning of the implant, we considered that the source of the pain was an intolerance of the implant, and thus we removed it. After implant removal, the patient was kept under observation and conservative treatment, to prevent further damage to the right hip and allow the healing to occur. At 6 months after the gamma nail was removed the X-rays revealed advanced avascular necrosis of the femoral head and secondary osteoarthritis on the right hip. The patient underwent surgery with an uncemented total hip arthroplasty. There are a few discussions regarding the avascular necrosis of the femoral head. These discussions may include the predisposing risk factors, the treatment of choice and the postoperative complications. The avascular necrosis of the femoral head is a complication of pertrochanteric fractures that can not be foreseen or avoided. The optimal treatment in these cases is uncemented total hip arthroplasty.

Riesgo familiar total en familias con mujeres diagnosticadas con neoplasia de mama

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Nancy Cecilia Charrys-Bravo

2017-07-01

Full Text Available Objetivo: Determinar el riesgo familiar total de las familias con mujeres diagnosticadas con cáncer de mama, que asisten a un centro de salud oncológico en la ciudad de Barranquilla. Materiales y Métodos: El estudio fue de tipo descriptivo, transversal con abordaje cuantitativo. Se utilizó el instrumento Riesgo Familiar Total RFT 5-33. El universo estuvo conformado por familias con mujeres diagnosticadas con cáncer en mama. La muestra fue de 41 familias que integraron a 154 miembros; se abordó el estudio de manera censal, y no por medio de una muestra, porque el acceso a la información de la totalidad de las familia fue viable. Resultados: Los resultados mostraron que las familias, en su mayoría, son de tipo 2. El 68 % de las pacientes categorizan sus familias como amenazadas, el 5 % como familias de alto riesgo y un 27 % de las familias con un bajo riesgo. Conclusiones: Los hallazgos encontrados en esta investigación son importantes para las familias, lo cual permitirá establecer acciones y actividades que logren orientar e implementar procesos de atención específicos con el propósito de cuidar a las familias para que se mantengan sanos en un nivel de bajo riesgo; además, desarrollar controles y seguimiento a aquellas familias que se encuentran en un riesgo alto de amenazas, mediante acciones de promoción y prevención de la enfermedad de una manera amplia. Por lo anterior, se deben emprender programas más agresivos de prevención y promoción, especialmente con las familias que asisten en busca de apoyo médico para este padecimiento; de esta forma, se podrán diagnosticar los casos de forma temprana y proceder al respectivo tratamiento.

REDUCCIÓN DE ÓXIDOSDE NITROGENO CON CATALIZADORES ZEOLÍTICOS INTERCAMBIADOS CON COBALTO

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Enrique Alexis García Moya

2012-10-01

Full Text Available Se presenta un estudio sobre la reducción catalítica selectiva (RCS de NOx con metano en presencia de oxígeno en exceso con varios catalizadores a base de las zeolitas mordenita, ferrierita y ZSM-5 intercambiadas con diferentes cargas de cobalto y con las correspondientes zeolitas en forma acida. Cuando la mezcla reactiva contenía mayormente NO2 en lugar de NO, los catalizadores ácidos mostraron las más altas velocidades de formación de N2 en condiciones secas. Las mayores actividades se obtuvieron con los catalizadores Co-mordenita, siguiendo en orden de actividad los catalizadores Co-Ferrierita y Co-ZSM-5. El catalizador Co-Mordenita más activo se ensayó con una mezcla reactiva donde predominó el NO en lugar del NO2 bajo condiciones secas e hidrotérmicas y en presencia de SO2. Con la adición de 8% de agua a la mezcla de reacción se observó desactivación reversible, especialmente a bajas temperaturas. La adición de 60 ppm de SO2 disminuyó la velocidad de reacción aproximadamente a la mitad debido posiblemente al envenenamiento de algunos sitios activos.

Plasma lactate concentration as a predictor of gastric necrosis and survival among dogs with gastric dilatation-volvulus: 102 cases (1995-1998).

Science.gov (United States)

de Papp, E; Drobatz, K J; Hughes, D

1999-07-01

To determine relationships between plasma lactate concentration and gastric necrosis and between plasma lactate concentration and outcome for dogs with gastric dilatation-volvulus. Retrospective study. 102 dogs. Information on signalment, history, plasma lactate concentration, medical and surgical treatment, cost of hospitalization, and outcome was retrieved from medical records. 69 of 70 (99%) dogs with plasma lactate concentration dogs with plasma lactate concentration > 6.0 mmol/L (1 dog euthanatized for economic reasons was not included). Gastric necrosis was identified in 38 (37%) dogs. Median plasma lactate concentration in dogs with gastric necrosis (6.6 mmol/L) was significantly higher than concentration in dogs without gastric necrosis (3.3 mmol/L). Specificity and sensitivity of using plasma lactate concentration (with a cutoff of 6.0 mmol/L) to predict which dogs had gastric necrosis were 88 and 61%, respectively. Sixty-two of 63 (98%) dogs without gastric necrosis survived, compared with 25 of 38 (66%) dogs with gastric necrosis. Preoperative plasma lactate concentration was a good predictor of gastric necrosis and outcome for dogs with GDV. Preoperative measurement of plasma lactate concentration may assist in determining prognosis of dogs with GDV.

ORIGINAL ARTICLES Warfarin-induced skin necrosis in HIV-1 ...

African Journals Online (AJOL)

F Bhaijee, H Wainwright, G Meintjes, R J Wilkinson, G Todd, E de Vries, D J Pepper. Warfarin-induced skin necrosis (WISN) is a rare complication of warfarin ..... first few days of warfarin therapy.2,11 Warfarin is a vitamin K antagonist and ...

Fibrinolytic response to tumor necrosis factor in healthy subjects

NARCIS (Netherlands)

van der Poll, T.; Levi, M. [=Marcel M.; Büller, H. R.; van Deventer, S. J.; de Boer, J. P.; Hack, C. E.; ten Cate, J. W.

1991-01-01

Tumor necrosis factor (TNF) may be involved in the disturbance of the procoagulant-fibrinolytic balance in septicemia, leading to microvascular thrombosis. To assess the dynamics of the fibrinolytic response to TNF in humans, we performed a crossover saline-controlled study in six healthy men,

Terapias alternativas con animales para niños con necesidades especiales

OpenAIRE

Cea-Chueca, Aihnoa

2014-01-01

El presente trabajo de fin de grado consiste en la realización de un análisis y descripción de la literatura acerca de las distintas terapias animales, destinadas a niños con necesidades especiales: cómo y por qué surgieron, en qué consisten las terapias, cómo podemos utilizarlas, etc. Las terapias alternativas con animales se conocen como una alternativa terapéutica, donde se utiliza a un animal como co-terapeuta para poder desarrollar diferentes capacidades de los niños con necesidades espe...

Enfermedad cardíaca grave en la esclerosis sistémica Severe cardiac disease in scleroderma

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Alejandro R. Grinberg

2004-10-01

Full Text Available Una mujer de 36 años de edad con diagnóstico de esclerosis sistémica (ES desarrolló un cuadro agudo de miositis esquelética e insuficiencia cardíaca grave. Evolucionó con shock cardiogénico y a pesar del tratamiento con drogas inotrópicas y altas dosis de corticoides falleció a los cinco días de haber ingresado. La autopsia reveló áreas de necrosis coagulativa miocárdicas con miocitolisis y necrosis en banda de contracción. Son muy pocos los casos comunicados de insuficiencia cardíaca grave asociada a la ES.A 36 year-old female with a diagnosis of systemic sclerosis suffered from an acute episode of skeletal myositis and refractory heart failure with cardiogenic shock. Despite immunosuppressive treatment with high doses of corticosteroids and hemodynamic support she died five days after admission. The autopsy showed cardiac myocytolysis, myocyte necrosis and contraction band necrosis. There are very few reported cases of severe heart failure associated to systemic sclerosis.

Tl-201 and Tc-99m-DTPA neuro-SPECT in cerebral radiation necrosis

International Nuclear Information System (INIS)

Cleto, E.M. Jr.; Holmes, R.A.; Gumerlock, M.K.; Cabeen, M.; Logan, K.W.; Hoffman, T.J.

1992-01-01

The results in 3 cases of radiation necrosis demonstrate that by using both radionuclides Tl-201 and Tc-99m-DTPA, one can provide a semi-quantitative method to differentiate recurrent tumor from radiation necrosis. Focally increased cerebral Tl-201 activity in irradiated brain tumor patients is not specific for tumor recurrence, but when used in combination with DTPA, one is able to estimate the amount of Tl-201 activity resulting from increased blood-brain barrier permeability. If the average Tl-201 index is less than the average Tc-99m-DTPA index it suggests that the increased Tl-201 activity results primarily from blood-brain barrier breakdown. Tc-99m-DTPA SPECT, in addition to Tl-201 SPECT, or serial Tl-201 SPECT imaging may increase the accuracy of brain scintigraphy in differentiating radiation necrosis from tumor recurrence. To verify these preliminary findings, we are in the process of analyzing additional SPECT data on 9 more patients with malignant brain tumors. Using a slightly different method of quantifying Tl- 201/Tc-99m-DTPA ratios (computing the ratio of intralesional Tl-201 or Tc-99m-DTPA activity compared to adjacent scalp activity), patients with tumor recurrence have higher Tl-201/Tc-99m-DTPA ratios compared to those with radiation necrosis (verbal communication with Dr. Mary K. Gumerlock). (orig.) [de

Strategies to reduce the apical necrosis in vitro multiplication and rooting of Pistachio

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Mariela Cid

2016-07-01

Full Text Available The pistachio (Pistacia sp. is one of the least exploited fruit among the main causes is the high cost of plant material by the difficulties of propagation of the species. The propagation in vitro offers great potential for the industry of this species by multiplication scale of selected clones. The aim of this study was to control the apical necrosis of outbreaks in the in vitro propagation Pistachio. From young shoots of plants of this species kept in growing houses, proceeded to disinfection with sodium hypochlorite 1% for different times. The apical and axillary buds were established in the culture medium Murashige and Skoog (1962 modified and supplemented with 1 mg/L Metatopolina. Different types of bottles, number and type of explants and culture media formulations for two subcultures multiplication and rooting were evaluated. Glass flask of 200 ml capacity, and line proliferates DKW medium achieved the lowest values apical necrosis. In the multiplication phase values were low in all treatments tested no statistical difference between them compared to rooting where apical necrosis reached higher values. The average DKW and prolific lines obtained lower values. MS medium modified crop, favored the number of segments rooted and DKW (Driver and Kuniyuki, 1984 the number of segments that sprouted, the latter having lower incidence of apical necrosis.

Thallium brain SPECT and MRI correlation in the evaluation of tumour recurrence versus radiation necrosis

International Nuclear Information System (INIS)

Robins, P.D.; Mahoney, D.S.; Mullan, B.P.

2000-01-01

Full text: This study compares different methods of determining thallium tumour uptake indices. Correlation with MR was performed to evaluate features that may affect the thallium index (TI) and to improve specificity for differentiation of recurrent tumor from radiation necrosis. 23 patients who had received radiotherapy for a brain neoplasm were included. The TI was determined using three different methods including large and small regions-of-interest (ROI). The concordance between the thallium SPECT and MRI was assessed. The effect of central necrosis on the different thallium indices derived was evaluated. 18 patients were determined to have recurrent tumor and five had inactive disease. The optimal TI cut-off values was statistically delivered and sensitivity and specificity was 78-94% and 80% respectively for cut-off values between 2.0 and 2.6 depending on the method used to calculate the TI. When compared with MRI, the majority of SPECT abnormalities correlated well with location and degree of uptake and enhancement. Seven cases showed central necrosis and the degree of necrosis had less effect on the TI when a small ROI was used in these cases. In conclusion thallium brain SPECT is a sensitive technique for detecting recurrent tumour. When performing semi-quantitative assessment of thallium uptake, a smaller ROI over the most intense area of uptake will reduce the underestimation of the TI in the presence of necrosis and a Tl cut-off value of 2.6 gave optimal accuracy using this method. Correlation with MRI aids in localization, particularly where there is anatomic distortion and enables more accurate analysis of these lesions by avoiding areas of necrosis. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

BONE GRAFTING ENHANCED BY PLATELET-RICH PLASMA IN TREATMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD

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A. A. Korytkin

2018-01-01

Full Text Available Treatment of avascular necrosis of the femoral head is an issue of current interest while it affects young and employable people. So far there is no well-defined strategy of management which would help to postpone hip arthroplasty and further revision procedure. Hip sparing surgical treatment of avascular necrosis of the femoral head by bone grafting prior to head collapse proved to be a viable option not only during early stages of disease but also at advanced stages. Platelet-rich plasma (PRP addition to treatment plan potentially helps improving bone regeneration in situ.In this article the authors present a case of a 37 years old patient with avascular necrosis of the femoral head at a fragmentation stage (type 4B by ARCO. The authors centrifuged 15 ml of autologous whole blood (1500 RPM obtained by a special double-contoured syringe. During the surgical stage of treatment PRP and morselized bone graft were mixed to introduce and impact into the debrided zone of avascular necrosis. The authors also introduced 0.3–0.4 ml of PRP into the debrided zone of avascular necrosis after bone grafting. At 6 months follow-up CT images of the studied patient demonstrated signs of bone reorganization and no loss of femoral head sphericity. Preoperative Visual Analogue Scale (VAS, Harris Hip Score (HHS and Hip disability and Osteoarthritis Outcome Score (HOOS prior to treatment were 60, 45 and 33 points respectively. Postoperative VAS, HHS and HOOS scores were 10, 78 and 78 respectively. In the authors’ opinion, impaction bone grafting enhanced by PRP helps obtaining good and excellent outcomes not only at early but also at advanced stages of avascular necrosis.

Irregular echogenic foci representing coagulation necrosis: a useful but perhaps under-recognized EUS echo feature of malignant lymph node invasion.

Science.gov (United States)

Bhutani, Manoop S; Saftoiu, Adrian; Chaya, Charles; Gupta, Parantap; Markowitz, Avi B; Willis, Maurice; Kessel, Ivan; Sharma, Gulshan; Zwischenberger, Joseph B

2009-06-01

Coagulation necrosis has been described in malignant lymph nodes. Our aim was to determine if coagulation necrosis in mediastinal lymph nodes imaged by EUS could be used as a useful echo feature for predicting malignant invasion. Patients with known or suspected lung cancer who had undergone mediastinal lymph node staging by EUS. Tertiary Care university hospital. An expert endosonographer blinded to the final diagnosis, reviewed the archived digital EUS images of lymph nodes prior to being sampled by FNA. LNs positive for malignancy by FNA were included. The benign group included lymph node images with either negative EUS-FNA or lymph nodes imaged by EUS but not subjected to EUS-FNA, with surgical correlation of their benign nature. 24 patients were included. 8 patients were found to have coagulation necrosis. 7/8 patients had positive result for malignancy by EUS-FNA. One patient determined to have coagulation necrosis had a non-malignant diagnosis indicating a false positive result. 16 patients had no coagulation necrosis. In 6 patients with no coagulation necrosis, the final diagnosis was malignant and in the remaining 10 cases, the final diagnosis was benign. For coagulation necrosis as an echo feature for malignant invasion, sensitivity was 54%, specificity was 91%, positive predictive value was 88%, negative predictive value was 63% and accuracy was 71%. Coagulation necrosis is a useful echo feature for mediastinal lymph node staging by EUS.

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-05-15

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

Eficacia del proceso de esterilización de los Mini-Endo-bloc

Directory of Open Access Journals (Sweden)

Maritza Eraso Rodríguez

2017-01-01

Full Text Available El Mini-Endo-Bloc® es un elemento usado para mediar las limas durante la endodoncia, presenta muchas concavidades y orificios que dificultan el proceso de esterilización y pueden promover la infección cruzada o comprometer el pronóstico del tratamiento endodóntico. Objetivo: Observar la eficacia de la esterilización de los Mini-Endo-Bloc® utilizados en la clínica de la Federación Odontológica Colombiana (FOC. Métodos: Se recolectaron 60 Mini-Endo-Bloc® utilizados en pacientes que presentaban diagnósticos de necrosis pulpar y periodontitis apical, lo cuales se dividieron en dos grupos: Grupo control: 12 Mini-Endo-Bloc® desinfectados y no esterilizados. Grupo experimental: 48 Mini-Endo-Bloc® desinfectados y esterilizados, se realizó, según lo recomendado por la Farmacopea USPXXXV, prueba de esterilidad en Caldo Thioglycollate a 37°C, medio de caldo Casoy a 37°C y medio de caldo Casoy a 25°C para determinar presencia de bacterias, levaduras y hongos. Resultados: Al someter los Mini-Endo-Bloc® al protocolo de esterilización establecido por la FOC y teniendo en cuenta los parámetros de las pruebas de esterilidad, en el grupo experimental el 50% (n=24, fueron reprobadas (crecimiento microorganismos y 50% (n = 24 fueron aprobadas (no crecimiento de microorganismos. Discusión: la mitad de las muestras fueron reprobadas, estos resultados pueden ser por fallas en el proceso de desinfección mecánica manual directa, el cual se dificulta en los Mini-Endo-Bloc®, debido a su estructura y diseño, permitiendo que residuos biológicos permanezcan en la superficie del instrumento, evitando que el vapor saturado entre en contacto con el material o los microorganismos durante la esterilización.

Paraneoplastic digital necrosis associated with rectum carcinoma

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Ali Alkan

2015-12-01

Full Text Available Paraneoplastic vascular pathologies are rare in daily practice. There is limited data about this phenomenon. Patient with a diagnosis of metastatic rectum carcinoma presented with digital necrosis. The work up for vascular and rheumatological pathology was inconclusive. Lesions progressively improved with steroid therapy. Paraneoplastic vascular lesions are rare in oncology practice. Our case points out important parts of a rare clinical entity. J Clin Exp Invest 2015; 6 (4: 391-392

A Novel Murine Model for Localized Radiation Necrosis and its Characterization Using Advanced Magnetic Resonance Imaging

International Nuclear Information System (INIS)

Jost, Sarah C.; Hope, Andrew; Kiehl, Erich; Perry, Arie; Travers, Sarah; Garbow, Joel R.

2009-01-01

Purpose: To develop a murine model of radiation necrosis using fractionated, subtotal cranial irradiation; and to investigate the imaging signature of radiation-induced tissue damage using advanced magnetic resonance imaging techniques. Methods and Materials: Twenty-four mice each received 60 Gy of hemispheric (left) irradiation in 10 equal fractions. Magnetic resonance images at 4.7 T were subsequently collected using T1-, T2-, and diffusion sequences at selected time points after irradiation. After imaging, animals were killed and their brains fixed for correlative histologic analysis. Results: Contrast-enhanced T1- and T2-weighted magnetic resonance images at months 2, 3, and 4 showed changes consistent with progressive radiation necrosis. Quantitatively, mean diffusivity was significantly higher (mean = 0.86, 1.13, and 1.24 μm 2 /ms at 2, 3, and 4 months, respectively) in radiated brain, compared with contralateral untreated brain tissue (mean = 0.78, 0.82, and 0.83 μm 2 /ms) (p < 0.0001). Histology reflected changes typically seen in radiation necrosis. Conclusions: This murine model of radiation necrosis will facilitate investigation of imaging biomarkers that distinguish between radiation necrosis and tumor recurrence. In addition, this preclinical study supports clinical data suggesting that diffusion-weighted imaging may be helpful in answering this diagnostic question in clinical settings.

Variables socionutricionales de hogares mazahuas integrados por preescolares desnutridos con madres con obesidad y sin obesidad

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Conzuelo González, Viridiana Vanessa

2009-01-01

Full Text Available El primer objetivo fue conocer cuántos menores de cinco años con diferentes grados de desnutrición tienen una madre con sobrepeso/obesidad/ en una comunidad indígena que vive en extrema pobreza y bajo condiciones de migración masculina internacional. El segundo fue comparar tres variables socionutricionales (ingreso familiar, educación de la madre y adecuación nutrimental de la dieta diaria entre estos hogares y los hogares con desnutrición infantil y madres sin obesidad. Se realizó un estudio transversal (2006-2007, en la comunidad mazahua de San Francisco Tepeolulco, Municipio de Temascalcingo; que incluyó a 85 hogares integrados por preescolares con desnutrición inscritos al programa Oportunidades. Se determinó el estado nutrición de los preescolares con indicadores antropométricos y se obtuvo el IMC de las madres de estos infantes. Se aplicó una encuesta socionutricional, incluida el recordatorio de 24 horas, y complementado con la observación participante (cualitativa. Se encontró que 83% de las madres mazahuas presentaron sobrepeso u obesidad. El estado de nutrición de los preescolares con madres con obesidad presentó un porcentaje mayor de desnutrición (76%. En la variable género, se encontró que 54% de los niños con madres con obesidad tenía baja talla. Al relacionar el nivel educativo de la madre, esta variable resultó ser estadísticamente significativa (p=0.015, donde el analfabetismo está más relacionado con la desnutrición infantil que tienen madres de bajo y/o peso normal. La elevada prevalencia de hogares conformados con preescolares con desnutrición y madres con obesidad, es un síntoma más de la pobreza en zonas indígenas en México, con bajo índice de desarrollo humano.

Detection of experimental pancreas necrosis by DNA-ase labelled with radioiodine

International Nuclear Information System (INIS)

Tihanyi, Tibor; Duffek, Laszlo; Balint, Istvan; Flautner, Lajos

1986-01-01

Detection of pancreas necrosis was attempted in dog experiments. Strong association between pancreatic DNA-ase and actin molecules in vitro provided the theoretical basis for the procedure. Pancreatic DNA-ase labelled with 125 I was administered intravenously to dogs in which experimental pancreas necrosis was elicited. Accumulation ratio of radioactivity was above 20 in the necrotic pancreas whereas it varied between 1.6 and 5.6 in other tissues. After administration of 37 MBq 131 I labelled DNA-ase, accumulation of radioactivity could be clearly visualized in the necrotic portions of the removed pancreas by a gamma camera. The investigations will be extended in order to develop a clinically utilizable test. (L.E.)

Ranking of computed tomography in diagnosis of avascular necrosis of femoral head in adults

Energy Technology Data Exchange (ETDEWEB)

Nebel, G

1982-01-01

On 12 patients (7 males, 5 females) with the diagnosis of avascular (aseptic) necrosis of the femoral head the value of computed tomography was investigated. Stages II-IV were observed (following the staging of Ficat and Arlet). Exept for 2 cases the findings of necrosis on axial CT-slices were always located in the anterior part of the femoral head. The problems of early diagnosis of the disease are discussed.

Necrosis-Driven Systemic Immune Response Alters SAM Metabolism through the FOXO-GNMT Axis

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Fumiaki Obata

2014-05-01

Full Text Available Sterile inflammation triggered by endogenous factors is thought to contribute to the pathogenesis of acute and chronic inflammatory diseases. Here, we demonstrate that apoptosis-deficient mutants spontaneously develop a necrosis-driven systemic immune response in Drosophila and provide an in vivo model for studying the organismal response to sterile inflammation. Metabolomic analysis of hemolymph from apoptosis-deficient mutants revealed increased sarcosine and reduced S-adenosyl-methionine (SAM levels due to glycine N-methyltransferase (Gnmt upregulation. We showed that Gnmt was elevated in response to Toll activation induced by the local necrosis of wing epidermal cells. Necrosis-driven inflammatory conditions induced dFoxO hyperactivation, leading to an energy-wasting phenotype. Gnmt was cell-autonomously upregulated by dFoxO in the fat body as a possible rheostat for controlling energy loss, which functioned during fasting as well as inflammatory conditions. We propose that the dFoxO-Gnmt axis is essential for the maintenance of organismal SAM metabolism and energy homeostasis.

Phytoceuticals in Acute Pancreatitis: Targeting the Balance between Apoptosis and Necrosis

Science.gov (United States)

Gaman, Laura; Robu, Georgiana Catalina; Radoi, Mugurel Petrinel; Stroica, Laura; Badea, Mihaela

2018-01-01

Despite recent advances in understanding the complex pathogenesis of pancreatitis, the management of the disease remains suboptimal. The use of phytoceuticals (plant-derived pleiotropic multitarget molecules) represents a new research trend in pancreatology. The purpose of this review is to discuss the phytoceuticals with pancreatoprotective potential in acute pancreatitis and whose efficacy is based, at least in part, on their capacity to modulate the acinar cell death. The phytochemicals selected, belonging to such diverse classes as polyphenols, flavonoids, lignans, anthraquinones, sesquiterpene lactones, nitriles, and alkaloids, target the balance between apoptosis and necrosis. Activation of apoptosis via various mechanisms (e.g., inhibition of X-linked inhibitor of apoptosis proteins by embelin, upregulation of FasL gene expression by resveratrol) and/or inhibition of necrosis seem to represent the essential key for decreasing the severity of the disease. Apart from targeting the apoptosis/necrosis balance, the phytochemicals displayed other specific protective activities: inhibition of inflammasome (e.g., rutin), suppression of neutrophil infiltration (e.g., ligustrazine, resveratrol), and antioxidant activity. Even though many of the selected phytoceuticals represent a promising therapeutic alternative, there is a shortage of human evidence, and further studies are required to provide solid basis to justify their use in the treatment of pancreatitis. PMID:29686719

Avascular Necrosis of the Metacarpal Head: A Review of 4 Cases.

Science.gov (United States)

Aldekhayel, Salah; Ghanad, Erfan; Mudgal, Chaitanya S

2018-04-03

To report on 4 cases of avascular necrosis of the metacarpal head. We retrospectively reviewed 4 patients who received a diagnosis of avascular necrosis of the metacarpal head and were treated from 2000 to 2016. All patients were males with involvement of the dominant hand. Three patients had a history of trauma and/or fractures in another finger and one had a history of fracture in the same finger. The diagnosis was confirmed on regular x-rays and magnetic resonance imaging. Nonsurgical management was offered to all patients (rest, placement of an orthosis, and nonsteroidal anti-inflammatory drugs) for 3 to 6 months. Two patients responded well to nonsurgical management and improved in their symptoms. One patient refused surgical intervention and continued to have persistent pain. The other patient was treated with curettage and bone graft and had total resolution of pain symptoms with full active range of motion. A high index of suspicion is required to diagnose and treat avascular necrosis of the metacarpal head correctly. Treatment options are numerous and require further studies to investigate their effectiveness in the treatment of this rare disease. Therapeutic V. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

[Morel-Lavallée syndrome and post-traumatic nodular fat necrosis: Two post-traumatic complications mimicking cellulitis].

Science.gov (United States)

Moulin, C; Barthélémy, I; Emering, C; D'Incan, M

Dermal and subcutaneous inflammation following direct trauma is initially evocative of soft-tissue infection. However, two differential diagnoses must be considered: Morel-Lavallée syndrome and post-traumatic nodular fat necrosis. Case 1: a 51-year-old woman fell off her motorbike and had dermabrasions on her right and left tibial ridges that rapidly developed into dermo-hypodermitis of the entire limb. There was no improvement after 3 weeks of antibiotics. The patient was apyretic. She had a soft, non-inflammatory tumefaction on the inner aspect of her left knee. Ultrasound revealed subcutaneous collection in both legs. The surgeons confirmed a diagnosis of Morel-Lavallée syndrome and drained the two collections. Progress was good and the patient healed without major consequences. Case 2: following a fall on her stairs, a 40-year-old woman presented dermabrasions and haematomas on her left leg. Antibiotic therapy failed to prevent the progression of dermo-hypodermitis. The patient remained apyretic and there was no inflammatory syndrome. A CT scan showed thickening of a subcutaneous fat and fluid collection, resulting in diagnosis of post-traumatic nodular fat necrosis. Management was surgical and the outcome was good. These two cases show two post-traumatic cutaneous complications: Morel-Lavallée syndrome and post-traumatic nodular fat necrosis. Morel-Lavallée syndrome occurs after tangential trauma next to richly vascularized tissue. Post-traumatic nodular fat necrosis is defined as necrosis of adipocytes. In both cases, diagnosis is confirmed by imagery (Ultrasonography, tomography). Our two case reports show that inflammatory presentation of both Morel-Lavallée syndrome and post-traumatic nodular fat necrosis can lead to diagnostic and therapeutic errors while a surgical procedure is necessary since tissue necrosis can occur. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Randomized Double-Blind Placebo-Controlled Trial of Bevacizumab Therapy for Radiation Necrosis of the Central Nervous System

International Nuclear Information System (INIS)

Levin, Victor A.; Bidaut, Luc; Hou, Ping; Kumar, Ashok J.; Wefel, Jeffrey S.; Bekele, B. Nebiyou; Prabhu, Sujit; Loghin, Monica; Gilbert, Mark R.; Jackson, Edward F.

2011-01-01

Purpose: To conduct a controlled trial of bevacizumab for the treatment of symptomatic radiation necrosis of the brain. Methods and Materials: A total of 14 patients were entered into a placebo-controlled randomized double-blind study of bevacizumab for the treatment of central nervous system radiation necrosis. All patients were required to have radiographic or biopsy proof of central nervous system radiation necrosis and progressive neurologic symptoms or signs. Eligible patients had undergone irradiation for head-and-neck carcinoma, meningioma, or low- to mid-grade glioma. Patients were randomized to receive intravenous saline or bevacizumab at 3-week intervals. The magnetic resonance imaging findings 3 weeks after the second treatment and clinical signs and symptoms defined the response or progression. Results: The volumes of necrosis estimated on T 2 -weighted fluid-attenuated inversion recovery and T 1 -weighted gadolinium-enhanced magnetic resonance imaging scans demonstrated that although no patient receiving placebo responded (0 of 7), all bevacizumab-treated patients did so (5 of 5 randomized and 7 of 7 crossover) with decreases in T 2 -weighted fluid-attenuated inversion recovery and T 1 -weighted gadolinium-enhanced volumes and a decrease in endothelial transfer constant. All bevacizumab-treated patients-and none of the placebo-treated patients-showed improvement in neurologic symptoms or signs. At a median of 10 months after the last dose of bevacizumab in patients receiving all four study doses, only 2 patients had experienced a recurrence of magnetic resonance imaging changes consistent with progressive radiation necrosis; one patient received a single additional dose of bevacizumab and the other patient received two doses. Conclusion: The Class I evidence of bevacizumab efficacy from the present study in the treatment of central nervous system radiation necrosis justifies consideration of this treatment option for people with radiation necrosis

Avascular necrosis of the hip in multiple epiphyseal dysplasia

International Nuclear Information System (INIS)

Mackenzie, W.G.; Bassett, G.S.; Mandell, G.A.; Scott, C.I. Jr.

1989-01-01

We observed radiographic changes of avascular necrosis (AVN) of the capital femoral epiphysis in 9 hips of 11 patients with multiple epiphyseal dysplasia (MED). Plain roentgenography, bone scintigraphy, and magnetic resonance imaging (MRI) studies all revealed characteristic asymmetric changes in the presence of AVN superimposed on dysplastic femoral heads

Avascular necrosis in sickle cell (homozygous S) patients: Predictive ...

African Journals Online (AJOL)

... with the development of AVN. Conclusion: In conclusion, patients with a raised steady state platelet count may have a higher tendency to develop AVN and may require closer orthopedic review and prophylactic intervention. Key words: Avascular necrosis, homozygous S, platelet count, sickle cell anemia, white cell count ...

Receptor interactive protein kinase 3 promotes Cisplatin-triggered necrosis in apoptosis-resistant esophageal squamous cell carcinoma cells.

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Yang Xu

Full Text Available Cisplatin-based chemotherapy is currently the standard treatment for locally advanced esophageal cancer. Cisplatin has been shown to induce both apoptosis and necrosis in cancer cells, but the mechanism by which programmed necrosis is induced remains unknown. In this study, we provide evidence that cisplatin induces necrotic cell death in apoptosis-resistant esophageal cancer cells. This cell death is dependent on RIPK3 and on necrosome formation via autocrine production of TNFα. More importantly, we demonstrate that RIPK3 is necessary for cisplatin-induced killing of esophageal cancer cells because inhibition of RIPK1 activity by necrostatin or knockdown of RIPK3 significantly attenuates necrosis and leads to cisplatin resistance. Moreover, microarray analysis confirmed an anti-apoptotic molecular expression pattern in esophageal cancer cells in response to cisplatin. Taken together, our data indicate that RIPK3 and autocrine production of TNFα contribute to cisplatin sensitivity by initiating necrosis when the apoptotic pathway is suppressed or absent in esophageal cancer cells. These data provide new insight into the molecular mechanisms underlying cisplatin-induced necrosis and suggest that RIPK3 is a potential marker for predicting cisplatin sensitivity in apoptosis-resistant and advanced esophageal cancer.

Plasma exchange in Immunoglobulin A nephropathy with thrombotic microangiopathy and acute cortical necrosis

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P Doddi

2016-01-01

Full Text Available A 25-year-old female presented with decreased urine output, deranged renal function, thrombocytopenia, and hemolytic anemia. Kidney biopsy was consistent with thrombotic microangiopathy with acute cortical necrosis and Immunoglobulin A nephropathy (IgAN. Hemolytic anemia, thrombocytopenia and urine output improved after five sessions of plasma exchange. Renal function showed a delayed recovery and serum creatinine normalized by 3 months. This is first case of successful use of plasma exchange in hemolytic uremic syndrome with cortical necrosis associated with IgAN.

Terapia regenerativa con plasma rico en plaquetas en pacientes con quemaduras

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María del Carmen Franco Mora

2015-10-01

Full Text Available Se realizó un estudio comparativo, longitudinal y prospectivo de 60 adultos con quemaduras profundas, atendidos en el Hospital General docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde febrero de 2013 hasta igual mes de 2014, para evaluar la efectividad de la terapia regenerativa con plasma rico en plaquetas para la cicatrización de estas lesiones. La muestra fue dividida en 2 grupos de 30 integrantes cada uno: a los del primero se les aplicó plasma rico en plaquetas y a los del segundo sulfadiazina de plata. Se utilizaron las frecuencias absolutas y el porcentaje como medidas de resumen para variables cualitativos, así como la media aritmética y la desviación estándar para las cuantitativas. Con el proceder aplicado la cicatrización se completó en un tiempo menor, de manera que se demostró la efectividad de esta alternativa terapéutica en relación con el tratamiento convencional

Delayed radiation necrosis of the brain simulating a brain tumor

International Nuclear Information System (INIS)

Ikeda, Hiroya; Kanai, Nobuhiro; Kamikawa, Kiyoo

1976-01-01

Two cases of delayed radiation necrosis of the brain are reported. Case 1 was a 50-year-old man who had right hemiparesis and disorientation 26 months after Linac irradiation (5,000 rad), preceded by an operation for right maxillar carcinoma. A left carotid angiogram demonstrated a left temporal mass lesion, extending to the frontal lobe. Case 2 was a 41-year-old man who had previously had an operation for right intraorbital plasmocytoma, followed by two Co irradiations (6,400 rad, and 5,000 rad). He had the signs and symptoms of intracranial hypertension 36 months after his last irradiation. A left carotid angiogram demonstrated a left temporal mass lesion. Both cases were treated by administration of steroid hormone (which alleviated the signs and symptoms) and by temporal lobectomy. Microscopic examinations showed necrosis of the brain tissues associated with hyaline degeneration of blood vessel walls and perivascular cell infiltration. The signs and symptoms of intracranial hypertension subsided postoperatively. Thirteen other cases the same as ours were collected from literature. They showed the signs and symptoms simulating a brain tumor (like a metastatic brain tumor) after irradiation to extracranial malignant tumors. Diagnosis of radiation necrosis was made by operation or autopsy. A follow-up for a long time is necessary, because the pathological changes in the brain may be progressive and extending in some cases, although decompressive operations for mass lesions give excellent results. (auth.)

Model-Based Radiation Dose Correction for Yttrium-90 Microsphere Treatment of Liver Tumors With Central Necrosis

International Nuclear Information System (INIS)

Liu, Ching-Sheng; Lin, Ko-Han; Lee, Rheun-Chuan; Tseng, Hsiou-Shan; Wang, Ling-Wei; Huang, Pin-I; Chao, Liung-Sheau; Chang, Cheng-Yen; Yen, Sang-Hue; Tung, Chuan-Jong; Wang, Syh-Jen; Oliver Wong, Ching-yee; Liu, Ren-Shyan

2011-01-01

Purpose: The objectives of this study were to model and calculate the absorbed fraction φ of energy emitted from yttrium-90 ( 90 Y) microsphere treatment of necrotic liver tumors. Methods and Materials: The tumor necrosis model was proposed for the calculation of φ over the spherical shell region. Two approaches, the semianalytic method and the probabilistic method, were adopted. In the former method, the range--energy relationship and the sampling of electron paths were applied to calculate the energy deposition within the target region, using the straight-ahead and continuous-slowing-down approximation (CSDA) method. In the latter method, the Monte Carlo PENELOPE code was used to verify results from the first method. Results: The fraction of energy, φ, absorbed from 90 Y by 1-cm thickness of tumor shell from microsphere distribution by CSDA with complete beta spectrum was 0.832 ± 0.001 and 0.833 ± 0.001 for smaller (r T = 5 cm) and larger (r T = 10 cm) tumors (where r is the radii of the tumor [T] and necrosis [N]). The fraction absorbed depended mainly on the thickness of the tumor necrosis configuration, rather than on tumor necrosis size. The maximal absorbed fraction φ that occurred in tumors without central necrosis for each size of tumor was different: 0.950 ± 0.000, and 0.975 ± 0.000 for smaller (r T = 5 cm) and larger (r T = 10 cm) tumors, respectively (p 90 Y microsphere treatment of hepatic tumors with central necrosis. With this model, important information is provided regarding the absorbed fraction applicable to clinical 90 Y microsphere treatment.

Ranking of computed tomography in diagnosis of avascular necrosis of femoral head in adults

International Nuclear Information System (INIS)

Nebel, G.

1982-01-01

On 12 patients (7 males, 5 females) with the diagnosis of avascular (aseptic) necrosis of the femoral head the value of computed tomography was investigated. Stages II-IV were observed (following the staging of Ficat and Arlet). Exept for 2 cases the findings of necrosis on axial CT-slices were always located in the anterior part of the femoral head. The problems of early diagnosis of the disease are discussed. (orig.) [de

Tumor necrosis factor-alpha increases myocardial microvascular transport in vivo

DEFF Research Database (Denmark)

Hansen, P R; Svendsen, Jesper Hastrup; Høyer, S

1994-01-01

Tumor necrosis factor-alpha (TNF-alpha) is a primary mediator in the pathogenesis of tissue injury, and high circulating levels of TNF-alpha are found in a variety of pathological conditions. In open-chest anesthetized dogs, the effects of intracoronary recombinant human TNF-alpha (rTNF-alpha; 100...... in cardiac output and was associated with the appearance of areas with myocardial necrosis in the regional left ventricular wall. The myocardial plasma flow rate and maximum plasma flow rate in response to a 30-s coronary occlusion were not influenced by rTNF-alpha, although a decrease in the myocardial...... ng/kg for 60 min) on myocardial microvascular transport of a small hydrophilic indicator was examined by the single-injection, residue-detection method. Intracoronary infusion of rTNF-alpha increased myocardial microvascular transport after 120 min. This increase was preceded by a sustained decline...

Avascular necrosis of the femoral head and M.R.I

International Nuclear Information System (INIS)

Gires, F.; Leroy-Willig, A; Chevrot, A.; Wolff, J.L.

1987-01-01

Normal and pathologic femoral heads have been studied by MRI at 1.5 Tesla. The study was centered upon avascular necrosis (53 lesions). Twenty normal subjects and three patients with algodystrophy were examined. The osteonecrosis patterns were established from known lesions. A low signal rim surrounds an upper polar zone of conserved (Type I) or decreased (Type II) signal. The lesions age correlates significatively with their type: amongst type I lesions, 6 are asymptomatic and the 21 others have a mean age of 5.5 months; Type II lesions have a mean age of 12.7 months. Fourteen lesions were not seen on plain radiographs and six were not detected by bone scan. The older lesions with femoral head deformation are better depicted by standard radiologic techniques. Conservely MRI is the most efficient examination for recent avascular necrosis lesions [fr

RadConEd: A Graphical Data Editor for the Radiological Consequences Model, RadCon

International Nuclear Information System (INIS)

Crawford, J.; Domel, R.U.

2000-05-01

This document describes the application, RadConEd, which has been designed and implemented to enable users of the RadCon system to update these parameter files. The RadCon system is written in the Java programming language, and as such provides portability across computer platforms. The software described in this report was developed in line with the portability requirements of RadCon, thus providing a uniform user interface across computer platforms and bypassing the need of using system editors. In addition a number of data integrity measures were implemented

Expression of human soluble tumor necrosis factor (TNF)-related ...

African Journals Online (AJOL)

DR NJ TONUKARI

2011-06-06

Jun 6, 2011 ... bio-technique in bacterial (Lin et al., 2007), yeast (Xu et al., 2003) ... biological activity, such as human somatotropin (hST) .... sion way with chloroplast transit peptide (Wang et al., .... chloroplast protein synthesis capacity by massive expression of a ... necrosis factor-related apoptosis-inducing ligand in vivo.

Diagnostic methods in ischemic necrosis of the femoral head. Metodos de diagnostico en la necrosis isquemica de la cabeza femoral

Energy Technology Data Exchange (ETDEWEB)

Parra Blanco, J.A.; Pagola Serrano, M.A.; Delgado Macias, M.T. (Hospital Universitario Marques de Valdecilla, Santander (Spain))

1994-01-01

Ischemic necrosis of the femoral head (INFH) must be diagnosed at an early stage of development, when therapeutic approaches such as forage biopsy or osteotomy can prevent or slow the normal progression of the disease to arthrosis. In this article, on the basis of the pathological changes that characterize process, we review the advantages and limitations of the principal diagnostic techniques (table I) currently employed in the study of INFH. (Author)

Role of MRI in osteosarcoma for evaluation and prediction of chemotherapy response: correlation with histological necrosis

Energy Technology Data Exchange (ETDEWEB)

Bajpai, Jyoti; Bakhshi, Sameer [Dr. B. R. A. Institute Rotary Cancer Hospital, Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi (India); Gamnagatti, Shivanand [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Kumar, Rakesh; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Sreenivas, Vishnubhatla [All India Institute of Medical Sciences, Department of Biostatistics, New Delhi (India); Sharma, Mehar Chand; Safaya, Rajni [All India Institute of Medical Sciences, Department of Pathology, New Delhi (India); Khan, Shah Alam; Rastogi, Shishir [All India Institute of Medical Sciences, Department of Orthopedics, New Delhi (India)

2011-04-15

Histological necrosis, the current standard for response evaluation in osteosarcoma, is attainable after neoadjuvant chemotherapy. To establish the role of surrogate markers of response prediction and evaluation using MRI in the early phases of the disease. Thirty-one treatment-naive osteosarcoma patients received three cycles of neoadjuvant chemotherapy followed by surgery during 2006-2008. All patients underwent baseline and post-chemotherapy conventional, diffusion-weighted and dynamic contrast-enhanced MRI. Taking histological response (good response {>=}90% necrosis) as the reference standard, various parameters of MRI were compared to it. A tumor was considered ellipsoidal; volume, average tumor plane and its relative value (average tumor plane relative/body surface area) was calculated using the standard formula for ellipse. Receiver operating characteristic curves were generated to assess best threshold and predictability. After deriving thresholds for each parameter in univariable analysis, multivariable analysis was carried out. Both pre-and post-chemotherapy absolute and relative-size parameters correlated well with necrosis. Apparent diffusion coefficient did not correlate with necrosis; however, on adjusting for volume, significant correlation was found. Thus, we could derive a new parameter: diffusion per unit volume. In osteosarcoma, chemotherapy response can be predicted and evaluated by conventional and diffusion-weighted MRI early in the disease course and it correlates well with necrosis. Further, newly derived parameter diffusion per unit volume appears to be a sensitive substitute for response evaluation in osteosarcoma. (orig.)

Role of MRI in osteosarcoma for evaluation and prediction of chemotherapy response: correlation with histological necrosis

International Nuclear Information System (INIS)

Bajpai, Jyoti; Bakhshi, Sameer; Gamnagatti, Shivanand; Kumar, Rakesh; Malhotra, Arun; Sreenivas, Vishnubhatla; Sharma, Mehar Chand; Safaya, Rajni; Khan, Shah Alam; Rastogi, Shishir

2011-01-01

Histological necrosis, the current standard for response evaluation in osteosarcoma, is attainable after neoadjuvant chemotherapy. To establish the role of surrogate markers of response prediction and evaluation using MRI in the early phases of the disease. Thirty-one treatment-naive osteosarcoma patients received three cycles of neoadjuvant chemotherapy followed by surgery during 2006-2008. All patients underwent baseline and post-chemotherapy conventional, diffusion-weighted and dynamic contrast-enhanced MRI. Taking histological response (good response ≥90% necrosis) as the reference standard, various parameters of MRI were compared to it. A tumor was considered ellipsoidal; volume, average tumor plane and its relative value (average tumor plane relative/body surface area) was calculated using the standard formula for ellipse. Receiver operating characteristic curves were generated to assess best threshold and predictability. After deriving thresholds for each parameter in univariable analysis, multivariable analysis was carried out. Both pre-and post-chemotherapy absolute and relative-size parameters correlated well with necrosis. Apparent diffusion coefficient did not correlate with necrosis; however, on adjusting for volume, significant correlation was found. Thus, we could derive a new parameter: diffusion per unit volume. In osteosarcoma, chemotherapy response can be predicted and evaluated by conventional and diffusion-weighted MRI early in the disease course and it correlates well with necrosis. Further, newly derived parameter diffusion per unit volume appears to be a sensitive substitute for response evaluation in osteosarcoma. (orig.)

Surgical techniques in radiation induced temporal lobe necrosis in nasopharyngeal carcinoma patients.

Science.gov (United States)

Alfotih, Gobran Taha Ahmed; Zheng, Mei Guang; Cai, Wang Qing; Xu, Xin Ke; Hu, Zhen; Li, Fang Cheng

2016-01-01

Radiation induced brain injury ranges from acute reversible edema to late, irreversible radiation necrosis. Radiation induced temporal lobe necrosis is associated with permanent neurological deficits and occasionally progresses to death. We present our experience with surgery on radiation induced temporal lobe necrosis (RTLN) in nasopharyngeal carcinoma (NPC) patients with special consideration of clinical presentation, surgical technique, and outcomes. This retrospective study includes 12 patients with RTLN treated by the senior author between January 2010 and December 2014. Patients initially sought medical treatment due to headache; other symptoms were hearing loss, visual deterioration, seizure, hemiparesis, vertigo, memory loss and agnosia. A temporal approach through a linear incision was performed for all cases. RTLN was found in one side in 7 patients, and bilaterally in 5. 4 patients underwent resection of necrotic tissue bilaterally and 8 patients on one side. No death occurred in this series of cases. There were no post-operative complications, except 1 patient who developed aseptic meningitis. All 12 patients were free from headache. No seizure occurred in patients with preoperative epilepsy. Other symptoms such as hemiparesis and vertigo improved in all patients. Memory loss, agnosia and hearing loss did not change post-operatively in all cases. The follow-up MR images demonstrated no recurrence of necrotic lesions in all 12 patients. Neurosurgical intervention through a temporal approach with linear incision is warranted in patients with radiation induced temporal lobe necrosis with significant symptoms and signs of increased intracranial pressure, minimum space occupying effect on imaging, or neurological deterioration despite conservative management. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

[Short-term curative effects of Tantalum rod treatment in early avascular necrosis].

Science.gov (United States)

Ye, Fu-Sheng; Ni, Zhe-Ji; Chu, Xiao-Bing; He, Bang-Jian; Li, Ju; Tong, Pei-Jian

2013-08-01

To explore the recent clinical curative effect of Tantalum rod in treating the early avascular necrosis. From January 2008 to November 2008, the 25 patients (39 hips) with early avascular necrosis accepted tantalum rod placement and included 9 males (11 hips) and 16 females (28 hips) with an average age of 37 years old ranging from 18 to 74 years old. Four patients (6 hips) caused by Alcoholic, 6 patients (8 hips) by hormone, 2 cases (2 hips) by traumatic, 13 cases (23 hips) by idiopathic. Steinberg preoperative stage involved 7 hips in period I, 24 hips in period II, 8 hips in period III. Curative effect analysis included preoperative and postoperative Harris score, radiographic changes and hip replacement for follow-up to accept the end of the femoral head survival rate. All patients were followed up for 6 to 47 months (averaged 37.4 months). All 12 hips imaging appeard progress,including tantalum rod exit in 1 hip, hip hemiarthroplasty collapse in 3 hips, the area increased to avascular necrosis in 8 hips. Six hips accepted total hip replacement, including imaging progress in 5 hips (41.7%, 5/12), no imaging progress in 1 hip (3.7%,1/27). All hips' Kaplan-Meier survival curves showed 6-month survival rate was (97.4 +/- 2.5)% after tantalum stick insertion, 1-year survival rate was (94.7 +/- 3.6), and 2-year survival rate was (88.6 +/- 5.4)%, 3-year survival rate was (72.5 +/- 11.2). It is effective for treatment of avascular necrosis of femoral head in Steinberg I and II by Tantalum rod, and it can effectively relieve femoral head replacement time.

Calidad de vida, satisfacción con el tratamiento y bienestar emocional en pacientes con diabetes LADA

OpenAIRE

Granado Casas, Minerva

2014-01-01

Introducción: La calidad de vida, satisfacción con el tratamiento y bienestar emocional en pacientes con diabetes mellitus están relacionados con el control metabólico, las complicaciones y algunas variables socioeconómicas. Actualmente, no existe ningún estudio científico que analice la calidad de vida, satisfacción con el tratamiento y bienestar emocional en pacientes con diabetes LADA. Objetivos: Los objetivos principales fueron conocer la calidad de vida, satisfacción con el tratamient...

Rin4 Causes Hybrid Necrosis and Race-Specific Resistance in an Interspecific Lettuce Hybrid[W

Science.gov (United States)

Jeuken, Marieke J.W.; Zhang, Ningwen W.; McHale, Leah K.; Pelgrom, Koen; den Boer, Erik; Lindhout, Pim; Michelmore, Richard W.; Visser, Richard G.F.; Niks, Rients E.

2009-01-01

Some inter- and intraspecific crosses may result in reduced viability or sterility in the offspring, often due to genetic incompatibilities resulting from interactions between two or more loci. Hybrid necrosis is a postzygotic genetic incompatibility that is phenotypically manifested as necrotic lesions on the plant. We observed hybrid necrosis in interspecific lettuce (Lactuca sativa and Lactuca saligna) hybrids that correlated with resistance to downy mildew. Segregation analysis revealed a specific allelic combination at two interacting loci to be responsible. The allelic interaction had two consequences: (1) a quantitative temperature-dependent autoimmunity reaction leading to necrotic lesions, lethality, and quantitative resistance to an otherwise virulent race of Bremia lactucae; and (2) a qualitative temperature-independent race-specific resistance to an avirulent race of B. lactucae. We demonstrated by transient expression and silencing experiments that one of the two interacting genes was Rin4. In Arabidopsis thaliana, RIN4 is known to interact with multiple R gene products, and their interactions result in hypersensitive resistance to Pseudomonas syringae. Site-directed mutation studies on the necrosis-eliciting allele of Rin4 in lettuce showed that three residues were critical for hybrid necrosis. PMID:19855048

Magnetic resonance imaging for differentiating of torsion of the ovarian tumor with or without necrosis

International Nuclear Information System (INIS)

Kim, Jong Wook; Lee, Young Rae; Park, Hae Won

2000-01-01

The purpose of this study is to determine whether MRI is helpful for differentiating torsion of ovarian tumor, with or without necrosis. We retrospectively evaluated the MRI findings of nine patients with surgically confirmed torsion of the ovarian tumor, comparing them with the surgical and pathologic findings. The MRI findings were analyzed for contrast enhancement of twisted tumor, and the presence, signal intensity and contrast enhancement of twisted vascular pedicle. In all nine patients, MRI revealed a twisted vascular pedicle. Six patients with necrotic ovaries showed either no enhancement (n=3D4) or linear peripheral enhancement of twisted tumors (n=3D2), and lack of enhancement (n=3D5) or peripheral enhancement (n=3D1) of twisted vascular pedicles. In four of six patients with necrosis, T1-weighted MR images demonstrated a hyperintense pedicle; in three without necrosis, postcontrast T1-weighted MR images revealed well-enhanced twisted tumors (n=3D2) and twisted vascular pedicles (n=3D3). By depicting a lack of contrast enhancement and high signal intensity within a twisted vascular pedicle, MRI can help differentiate torsion of ovarian tumor with or without necrosis. (author)

Nuevas consideraciones fisiopatológicas sobre el síndrome de respuesta inflamatoria sistémica relacionada con la sepsis

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Vivian R. Mena Miranda

1996-04-01

Full Text Available El shock séptico constituye una de las primeras causas de morbilidad y mortalidad en las unidades de cuidados intensivos y forma parte de los estadios evolutivos la respuesta inflamatoria sistémica (SRIS en relación con la infección, que fueron modificados por Jaffari para su aplicación en la edad pediátrica. Está relacionado con la exposición del organismo a agentes exógenos y/o mediadores endógenos, que producen una inadecuada perfusión hística con alteración en el consumo de oxígeno, en la permeabilidad vascular y la aparición de trastornos hemodinámicos que comprometen la vida del paciente. Se considera que el mediador central en el shock séptico es el factor de necrosis tumoral-a(FNT- a, aunque también responden de forma descontrolada otras citocinas, los polimorfonucleares, el sistema de contacto, el fibrinolítico, el de la coagulación, así como otras sustancias endógenas. El conocimiento de su fisiopatología hace posible el diagnóstico y tratamiento precoz, sobre todo en los grupos de riesgo, y la reducción de la mortalidad en las unidades de terapia intensiva por esta afección.The septic shock is one of the first causes of morbidity and mortality in intensive care units, and the systemic inflammatory response syndrome (SIRS is a part of the evolutive stages related to the infection, that were modified by Jaffari for its application in the pediatric age. Septic shock is related with the organism exposition to exogenous agents, and/or endogenous mediators that produce an inadequate histic perfusion with alteration in oxygen consumption, in vascular permeability, and the presentation of hemodynamic disorders that compromise the patient's life. It is considered that the main mediator in septic shock is the tumoral necrosis factor - (TBF- , although other cytosines also reply in an uncontrolled fashion, the polymorphonuclears, the contact system, the fibrinolytic, the coagulation one, as well as other endogenous

Tumor Necrosis Factor Inhibitors for Inflammatory Bowel Disease

DEFF Research Database (Denmark)

Nielsen, Ole Haagen; Ainsworth, Mark Andrew

2013-01-01

A 35-year-old man presents with an exacerbation of Crohn's ileocolitis. He received a diagnosis of Crohn's disease 8 years ago and has been treated on three previous occasions with prednisone. Because of a recurrent need for glucocorticoids, treatment with azathioprine (150 mg per day) was starte...... colonoscopy show acute and chronic granulomatous inflammation, and the gastroenterologist recommends treatment with a tumor necrosis factor (TNF) inhibitor....

Severe ischemic bowel necrosis caused by terlipressin during treatment of hepatorenal syndrome

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Hae Rim Kim

2013-12-01

Full Text Available Terlipressin is a vasopressin analogue that is widely used in the treatment of hepatorenal syndrome or variceal bleeding. Because it acts mainly on splanchnic vessels, terlipressin has a lower incidence of severe ischemic complications than does vasopressin. However, it can still lead to serious complications such as myocardial infarction, skin necrosis, or bowel ischemia. Herein we report a case of severe ischemic bowel necrosis in a 46-year-old cirrhotic patient treated with terlipressin. Although the patient received bowel resection, death occurred due to ongoing hypotension and metabolic acidosis. Attention should be paid to patients complaining of abdominal pain during treatment with terlipressin.

Mastectomy Skin Necrosis After Breast Reconstruction: A Comparative Analysis Between Autologous Reconstruction and Implant-Based Reconstruction.

Science.gov (United States)

Sue, Gloria R; Lee, Gordon K

2018-05-01

Mastectomy skin necrosis is a significant problem after breast reconstruction. We sought to perform a comparative analysis on this complication between patients undergoing autologous breast reconstruction and patients undergoing 2-stage expander implant breast reconstruction. A retrospective review was performed on consecutive patients undergoing autologous breast reconstruction or 2-stage expander implant breast reconstruction by the senior author from 2006 through 2015. Patient demographic factors including age, body mass index, history of diabetes, history of smoking, and history of radiation to the breast were collected. Our primary outcome measure was mastectomy skin necrosis. Fisher exact test was used for statistical analysis between the 2 patient cohorts. The treatment patterns of mastectomy skin necrosis were then analyzed. We identified 204 patients who underwent autologous breast reconstruction and 293 patients who underwent 2-stage expander implant breast reconstruction. Patients undergoing autologous breast reconstruction were older, heavier, more likely to have diabetes, and more likely to have had prior radiation to the breast compared with patients undergoing implant-based reconstruction. The incidence of mastectomy skin necrosis was 30.4% of patients in the autologous group compared with only 10.6% of patients in the tissue expander group (P care in the autologous group, only 3.2% were treated with local wound care in the tissue expander group (P skin necrosis is significantly more likely to occur after autologous breast reconstruction compared with 2-stage expander implant-based breast reconstruction. Patients with autologous reconstructions are more readily treated with local wound care compared with patients with tissue expanders, who tended to require operative treatment of this complication. Patients considering breast reconstruction should be counseled appropriately regarding the differences in incidence and management of mastectomy skin

Development of detection method of early stage nontraumatic osteo-necrosis of the femoral head by dynamic MRI

International Nuclear Information System (INIS)

Morita, Fuminori; Ikehira, Hiroo; Kitahara, Hiroshi; Terada, Tomoko; Nakano, Yoshitada; Ishii, Teruyuki; Iida, Tetsu; Ikenouchi, Sumio; Moriya, Hideshige

1999-01-01

The early detection methods of nontraumatic osteo-necrosis of the femoral head were demonstrated with the dynamic or static enhancement MR imaging method using gadolinium-DTPA (Gd-DTPA). Even if with these methods we could not detect stage 0 of nontraumatic osteo-necrosis, but these pathological change should be induced at 0 stage in the patients who were medicated high-dose corticosteroids. The authors designed the big ROI (region of interest) dynamic MR imaging method to brake this diagnostic difficulty for 0 stage of femoral, and evaluated the efficacy of this technology with normal and femoral nontraumatic osteo-necrosis patients volunteer. (author)

Mastopexia con prótesis: técnica triplanar con colgajo en cola de pez para mamas con pobre calidad de cobertura

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M. Berrocal-Revueltas

2013-12-01

Full Text Available La mastopexia con implantes de silicona, es uno de los procedimientos más frecuentes en la práctica diaria en Cirugía Plástica. Sin embargo, la pobre calidad de la cobertura de las mamas, relacionada con piel estriada, escaso tejido subcutáneo y pérdida del parénquima mamario secundarios a la lactancia prolongada y a la pérdida masiva de peso, son causa del incremento progresivo de resultados insatisfactorios a medio y largo plazo que han sido evaluados, analizados y discutidos por los especialistas. Los resultados insatisfactorios más frecuentes en mastopexia con implantes en posición retromuscular son: doble contorno mamario, asimetrías y desplazamiento de los implantes. Los objetivos del presente estudio son: describir el nuevo método triplanar como alternativa útil para lograr mejores resultados en pacientes con mala calidad de cobertura y analizar los resultados obtenidos con el mismo. Realizamos un estudio observacional, descriptivo, prospectivo, en un grupo de 268 pacientes con diagnóstico de ptosis mamaria con hipotrofia y mala calidad de cobertura por piel estriada, escaso tejido celular subcutáneo y pérdida del parénquima mamario, secundarios a lactancia prolongada y pérdida masiva de peso, entre otros, a las que se les practicó mamoplastia de aumento con implantes de silicona mediante la aplicación del método triplanar descrito por la autora, entre enero del 2004 y enero del 2013 en el Hospital de Bocagrande de Cartagena, Colombia. El diseño de la técnica se basa en los principios de cicatriz vertical descrita por Lassus o Lejour o mediante cicatriz en "J", descrita por la autora. El método triplanar se basa en tres planos de cobertura del implante. Plano I: submuscular, para cubrir los dos tercios superiores del implante. Plano II: colgajo dermoglandular con dos prolongaciones distales triangulares de tejido adiposo, en forma de pez, para cubrir el tercio inferior del implante y el borde libre del m

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

Science.gov (United States)

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

2015-05-06

We present the case of a 54-year-old man who developed progressive outer retinal necrosis (PORN) as an initial manifestation of HIV infection without any significant risk factors for infection with HIV. PORN is usually found as a manifestation of known AIDS late in the disease. Our patient presented with transient visual loss followed by decrease in visual acuity and facial rash. Subsequent investigation revealed anterior chamber tap positive for varicella zoster virus (VZV), as well as HIV positivity, with an initial CD4 count of 48 cells/µL. Systemic and intravitreal antivirals against VZV, and highly active antiretroviral therapy against HIV were started, which halted further progression of retinal necrosis. This case highlights the importance of suspecting PORN where there is a rapidly progressive retinitis, and also testing the patient for HIV, so appropriate treatment can be started. 2015 BMJ Publishing Group Ltd.

Molecular imaging of tumor photoimmunotherapy: Evidence of photosensitized tumor necrosis and hemodynamic changes

DEFF Research Database (Denmark)

Kishimoto, Shun; Oshima, Nobu; Yamamoto, Kazutoshi

2018-01-01

Near-infrared photoimmunotherapy (NIR PIT) employs the photoabsorbing dye IR700 conjugated to antibodies specific for cell surface epidermal growth factor receptor (EGFR). NIR PIT has shown highly selective cytotoxicity in vitro and in vivo. Cell necrosis is thought to be the main mode of cytotox......Near-infrared photoimmunotherapy (NIR PIT) employs the photoabsorbing dye IR700 conjugated to antibodies specific for cell surface epidermal growth factor receptor (EGFR). NIR PIT has shown highly selective cytotoxicity in vitro and in vivo. Cell necrosis is thought to be the main mode...... of cytotoxicity based mainly on in vitro studies. To better understand the acute effects of NIR PIT, molecular imaging studies were performed to assess its cellular and vascular effects.In addition to in vitro studies for cytotoxicity of NIR PIT, the in vivo tumoricidal effects and hemodynamic changes induced....... Following NIR PIT, metabolic MRI using hyperpolarized fumarate showed the production of malate in EGFR-expressing A431 tumor xenografts, providing direct evidence for photosensitized tumor necrosis induced by NIR PIT. R2* mapping studies showed temporal changes in oxygenation, with an accompanying increase...

Efecto antioxidante y hepatoprotector del Petroselinum sativum (perejil en ratas, con intoxicación hepática inducida por paracetamol

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Luzmila Troncoso

2007-12-01

Full Text Available Objetivo: Determinar el efecto antioxidante y hepatoprotector del perejil (Petroselinum sativum en ratas con intoxicación hepática inducida por paracetamol. Lugar: Centro de Investigación de Bioquímica y Nutrición - "Laboratorio de Bioquímica Clínica y Nutricional "Leonidas Delgado Butrón" "Emilio Guija Poma" - Universidad Nacional Mayor de San Marcos. Lima, Perú. Diseño: Estudio analítico, transversal, prospectivo y cuasi-experimental. Material: Ratas albinas Holtzman machos adultas. Métodos: Se utilizó 40 ratas de 2 meses de edad, con pesos entre 280 y 320 g, distribuidas aleatoriamente en cuatro grupos de 10 animales cada uno. Todos los grupos recibieron la misma dieta y agua ad libitum, además de los respectivos tratamientos, los cuales fueron administrados por vía oral diariamente, durante 5 días: paracetamol (administrado en una dosis de 200 mg/kg de peso corporal para inducir la intoxicación hepática y, al mismo tiempo, un hepatoprotector, ya fuera farmacológico (fármaco hepatoprotector (FHP: Purinor® o natural (perejil; además, un grupo de paracetamol solo y otro de control. Al término del período experimental, los animales fueron sacrificados. En suero sanguíneo se determinó aspartato aminotransferasa (AST, alanina aminotransferasa (ALT, gamma glutamil transferasa (GGT, grupos sulfhidrilo, proteínas totales y albúmina sérica; y en el homogenizado citosólico de hígado, fracción posmitocondrial, se determinó superóxido dismutasa, catalasa, glucosa-6-fosfato deshidrogenasa, grupos sulfidrilo, especies reactivas al ácido tiobarbitúrico (TBARS o radicales libres y proteínas. Además, se realizó el estudio histopatológico del hígado, para identificar signos de necrosis y signos de regeneración posnecrótica. Principales medidas de resultados: Efecto antioxidante y hepatoprotector del perejil. Resultados: El perejil mostró un mejor efecto hepatoprotector que el FHP, frente a la acción nociva del

Mandibular Bone and Soft Tissues Necrosis Caused by an Arsenical Endodontic Preparation Treated with Piezoelectric Device

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A. Giudice

2013-01-01

Full Text Available This paper describes a case of wide mandibular bone necrosis associated with significant soft tissues injury after using an arsenical endodontic preparation in the right lower second molar for endodontic purpose. Authors debate about the hazardous effects of the arsenic paste and the usefulness of piezosurgery for treatment of this drug related bone necrosis.

Association of myocardial cell necrosis with experimental cardiac hypertrophy

Energy Technology Data Exchange (ETDEWEB)

Revis, N W; Cameron, A J.V.

1979-01-01

Cardiac hypertrophy was induced in rabbits by injecting thyroxime or isoprenaline, or by surgically constricting the abdominal aorta. An increase in heart weight was associated with a change in the ratios of bound to free forms of five lysosomal enzymes, a change in serum creatine phosphokinase and lactate dehydrogenase, and a change in the morphology of the myocardial cells. Isoprenaline treatment for 5 days induced a maximal change in heart weight, in the ratio of lysosomal enzymes, and in the serum enzymes. Thyroxine treatment was required for 15 days before maximal changes in heart weight, ratio, and serum enzymes were observed. In contrast, coarctation of the aorta caused a progressive change in heart weight, in the ratio of lysosomal enzymes, and in serum enzymes. These results suggest that necrosis of the myocardial cells does indeed accompany cardiac hypertrophy. It was further observed that autophagosomes, degenerating mitochondria in the myocardial cells during the induction of cardiac hypertrophy, and myofibril lysis were found, all of which confirms the suggestion of myocardial cell necrosis in the experimentally enlarged heart.

Ultrasound and MRI findings in appendicular and truncal fat necrosis

Energy Technology Data Exchange (ETDEWEB)

Robinson, Philip [Leeds Teaching Hospitals, Department of Radiology, Leeds (United Kingdom); Leeds Teaching Hospitals, Musculoskeletal Centre, X-Ray Department, Chapel Allerton Hospital, Leeds (United Kingdom); Farrant, Joanna M.; McKie, Scott [Leeds Teaching Hospitals, Department of Radiology, Leeds (United Kingdom); Bourke, Grainne [Leeds Teaching Hospitals, Department of Plastic Surgery, Leeds (United Kingdom); Merchant, William [Leeds Teaching Hospitals, Department of Pathology, Leeds (United Kingdom); Horgan, Kieran J. [Leeds Teaching Hospitals, Department of Surgery, Leeds (United Kingdom)

2008-03-15

The objective was to evaluate ultrasound and MRI in clinical appendicular and truncal fat necrosis. Thirty-three patients (14 men, 19 women, median age 55, range 29-95) were retrospectively evaluated. Histologically, three groups were seen: Group 1 (n = 18) consisted of patients with subcutaneous masses with septal and extrinsic oedema; in Group 2 (n = 11) necrosis occurred within lipomatous tumours and little oedema; and in Group 3 (n = 4) there were large complex masses consistent with Morel-Lavallee lesions. Two experienced radiologists reviewed MR (n = 30) and ultrasound (n = 32) images with consensus agreement. MRI was performed on a 1.5T system with T1-weighted, T2-weighted fat-suppressed and T1-weighted fat-suppressed post-intravenous gadolinium sequences obtained in two orthogonal planes. Ultrasound (linear 5- to 13.5-MHz probe) was performed in the longitudinal and short axis. Anatomical position, size, shape (oval, linear, ill-defined), internal architecture (lobules, septi or stranding), intrinsic signal characteristics, presence of surrounding pseudocapsule, extrinsic linear stranding and vascularity (gadolinium enhancement or power Doppler) were recorded. Anatomical locations were buttock/thigh (n = 17), leg (n = 6), upper limb (n = 5) and thoracic/abdominal wall (n = 5) with the majority of lesions (30 out of 33) oval/linear in shape. On ultrasound and MRI most lesions showed internal fat lobules, intervening septi and a surrounding pseudocapsule. Fat necrosis can usually be identified as containing multiple fat lobules on ultrasound and MRI despite a varying degree of inflammatory change surrounding and within the mass. (orig.)

Multivoxel proton MRS for differentiation of radiation-induced necrosis and tumor recurrence after gamma knife radiosurgery for brain metastases

International Nuclear Information System (INIS)

Chernov, M.F.; Hayashi, Motohiro; Izawa, Masahiro

2006-01-01

Multivoxel proton magnetic resonance spectroscopy (MRS) was used for differentiation of radiation-induced necrosis and tumor recurrence after gamma knife radiosurgery for intracranial metastases in 33 consecutive cases. All patients presented with enlargement of the treated lesion, increase of perilesional brain edema, and aggravation or appearance of neurological signs and symptoms on average 9.3±4.9 months after primary treatment. Metabolic imaging defined four types of lesions: pure tumor recurrence (11 cases), partial tumor recurrence (11 cases), radiation-induced tumor necrosis (10 cases), and radiation-induced necrosis of the peritumoral brain (1 case). In 1 patient, radiation-induced tumor necrosis was diagnosed 9 months after radiosurgery; however, partial tumor recurrence was identified 6 months later. With the exception of midline shift, which was found to be more typical for radiation-induced necrosis (P<0.01), no one clinical, radiologic, or radiosurgical parameter either at the time of primary treatment or at the time of deterioration showed a statistically significant association with the type of the lesion. Proton MRS-based diagnosis was confirmed histologically in all surgically treated patients (7 cases) and corresponded well to the clinical course in others. In conclusion, multivoxel proton MRS is an effective diagnostic modality for identification of radiation-induced necrosis and tumor recurrence that can be used for monitoring of metabolic changes in intracranial neoplasms after radiosurgical treatment. It can be also helpful for differentiation of radiation-induced necrosis of the tumor and that of the peritumoral brain, which may have important clinical and medicolegal implications. (author)

Estudio comparativo del efecto del cepillado con una crema dental con propóleos rojos y de un gel con clorofila

OpenAIRE

Estela Gispert Abreu; Elena Cantillo Estrada; Aracelys Rivero López; Berta Oramas Rodríguez

1998-01-01

Se analiza comparativamente el efecto de un gel dental de clorofila y de una crema dental con propóleos rojos sobre varios parámetros relacionados con la caries dental, en escolares que se cepillaron durante 21 días con dichos productos. Se obtuvieron resultados favorables principalmente en la disminución del grado de infección por Streptococcus mutans y la elevación de la capacidad individual de remineralización; salvo en este último no hubo diferencias estadísticamente significativas.Author...

Idiopathic and diabetic skeletal muscle necrosis: evaluation by magnetic resonance imaging

International Nuclear Information System (INIS)

Kattapuram, Taj M.; Suri, Rajeev; Kattapuram, Susan V.; Rosol, Michael S.; Rosenberg, Andrew E.

2005-01-01

Idiopathic and diabetic-associated muscle necrosis are similar, uncommon clinical entities requiring conservative management and minimal intervention to avoid complications and prolonged hospitalization. An early noninvasive diagnosis is therefore essential. We evaluated the magnetic resonance imaging (MRI) characteristics of muscle necrosis in 14 patients, in eight of whom the diagnoses were confirmed histologically. Two experienced musculoskeletal radiologists performed retrospective evaluations of the MRI studies of 14 patients with the diagnoses of skeletal muscle infarction. In 10 cases gadolinium-enhanced (T1-weighted fat-suppressed) sequences were available along with T1-weighted, T2-weighted images and STIR sequences, while in four cases contrast-enhanced images were not available. Eight patients had underlying diabetes and in six patients the cause of the myonecrosis was considered idiopathic. T1-weighted images demonstrated isointense swelling of the involved muscle, with mildly displaced fascial planes. There was effacement of the fat signal intensity within the muscle. Fat-suppressed T2-weighted images showed diffuse heterogeneous high signal intensity in the muscles suggestive of edema. Perifascial fluid collection was seen in eight cases. Subcutaneous edema was present in seven patients. Following intravenous gadolinium administration, MRI demonstrated a focal area of heterogeneously enhancing mass with peripheral enhancement. Within this focal lesion, linear dark areas were seen with serpentine enhancing streaks separating them in eight cases. In two cases, a central relatively nonenhancing mass with irregular margins and peripheral enhancement was noted. The peripheral enhancement involved a significant part of the muscle. No focal fluid collection was noted. We believe that the constellation of imaging findings on T1- and T2-weighted images and post-gadolinium sequences is highly suggestive of muscle necrosis. We consider certain specific findings

MutY DNA Glycosylase Protects Cells From Tumor Necrosis Factor Alpha-Induced Necroptosis.

Science.gov (United States)

Tran, An Hue Vy; Han, Se Hee; Kim, Joon; Grasso, Francesca; Kim, In San; Han, Ye Sun

2017-07-01

Numerous studies have implied that mutY DNA glycosylase (MYH) is involved in the repair of post-replicative mispairs and plays a critical role in the base excision repair pathway. Recent in vitro studies have shown that MYH interacts with tumor necrosis factor receptor type 1-associated death domain (TRADD), a key effector protein of tumor necrosis factor receptor-1 (TNFR1) signaling. The association between MYH and TRADD is reversed during tumor necrosis factor alpha (TNF-α)- and camptothecin (CPT)-induced apoptosis, and enhanced during TNF-α-induced survival. After investigating the role of MYH interacts with various proteins following TNF-α stimulation, here, we focus on MYH and TRADD interaction functions in necroptosis and its effects to related proteins. We report that the level of the MYH and TRADD complex was also reduced during necroptosis induced by TNF-α and zVAD-fmk. In particular, we also found that MYH is a biologically important necrosis suppressor. Under combined TNF-α and zVAD-fmk treatment, MYH-deficient cells were induced to enter the necroptosis pathway but primary mouse embryonic fibroblasts (MEFs) were not. Necroptosis in the absence of MYH proceeds via the inactivation of caspase-8, followed by an increase in the formation of the kinase receptor- interacting protein 1 (RIP1)-RIP3 complex. Our results suggested that MYH, which interacts with TRADD, inhibits TNF-α necroptotic signaling. Therefore, MYH inactivation is essential for necroptosis via the downregulation of caspase-8. J. Cell. Biochem. 118: 1827-1838, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

The Comparison Of Results For The Bone Grafting In Treatment Of Scaphoid Nonunion With And Without Avascular Necrosis

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Iman Qomashi

2011-02-01

Full Text Available Background: The varieties of treatment methods for the scaphoid nonunion have always been a discussable issue for orthopaedic surgeons. The current study, considered to be review for treatment results of the patients who sustained the scaphoid nonunion with or without avascular necrosis and compared these two groups clinically and radiologically. Methods: The clinical and radiologic files of the patients who sustained the scaphoid nonunion and underwent surgical treatment between 2004 and 2009 in our hospital, were collected and in the final follow-up, 37 patients and 38 nonunions underwent physical exam, grip power test, DASH questionnaire and radiography. Results: Avascular necrosis was detected in 22 cases and 16 cases had no avascular necrosis changes. Following open reduction and bone grafing, union was seen in 36 cases, and nonunion in 2 cases which one was in the avascular necrosis group and another in without avascular necrosis group. The comparison of the residual pain, range of motion, DASH score and grip power in two groups, did not show a meaningful difference (p>0.05. Conclusion: Although multiple studies indicated that in the presence of the avascular necrosis in the proximal fragment of the scaphiod, possibility of union in the conventional graft methods was lower than vascular pedicle grafts, but this study demonstrated that the conventional treatment method yet was associated with a considerable successs and a reliable treatment method.

Vascularized bone grafting in a canine carpal avascular necrosis model

NARCIS (Netherlands)

Willems, Wouter F.; Alberton, Gregory M.; Bishop, Allen T.; Kremer, Thomas

2011-01-01

Limited experimental research has been performed on the treatment of avascular necrosis (AVN) by vascularized bone grafting. A new model simulating carpal AVN was created to investigate surgical revascularization of necrotic bone. In seven mongrel dogs, AVN was induced by removal of the radial

Magnetic Resonance Imaging of Therapy-Induced Necrosis Using Gadolinium-Chelated Polyglutamic Acids

International Nuclear Information System (INIS)

Jackson, Edward F.; Esparza-Coss, Emilio; Wen Xiaoxia; Ng, Chaan S.; Daniel, Sherita L.; Price, Roger E.; Rivera, Belinda; Charnsangavej, Chusilp; Gelovani, Juri G.; Li Chun

2007-01-01

Purpose: Necrosis is the most common morphologic alteration found in tumors and surrounding normal tissues after radiation therapy or chemotherapy. Accurate measurement of necrosis may provide an early indication of treatment efficacy or associated toxicity. The purpose of this report is to evaluate the selective accumulation of polymeric paramagnetic magnetic resonance (MR) contrast agents-gadolinium p-aminobenzyl-diethylenetriaminepentaacetic acid-poly(glutamic acid) (L-PG-DTPA-Gd and D-PG-DTPA-Gd)-in necrotic tissue. Methods and Materials: Two different solid tumor models, human Colo-205 xenograft and syngeneic murine OCA-1 ovarian tumors, were used in this study. Necrotic response was induced by treatment with poly(L-glutamic acid)-paclitaxel conjugate (PG-TXL). T 1 -weighted spin-echo images were obtained immediately and up to 4 days after contrast injection and compared with corresponding histologic specimens. Two low-molecular-weight contrast agents, DTPA-Gd and oligomeric(L-glutamic acid)-DTPA-Gd, were used as nonspecific controls. Results: Initially, there was minimal tumor enhancement after injection of either L-PG-DTPA-Gd or D-PG-DTPA-Gd, but rapid enhancement after injection of low-molecular-weight agents. However, polymeric contrast agents, but not low-molecular-weight contrast agents, caused sustained enhancement in regions of tumor necrosis in both tumors treated with PG-TXL and untreated tumors. These data indicate that high molecular weight, rather than in vivo biodegradation, is necessary for the specific localization of polymeric MR contrast agents to necrotic tissue. Moreover, biotinylated L-PG-DTPA-Gd colocalized with macrophages in the tumor necrotic areas, suggesting that selective accumulation of L- and D-PG-DTPA-Gd in necrotic tissue was mediated through residing macrophages. Conclusions: Our data suggest that MR imaging with PG-DTPA-Gd may be a useful technique for noninvasive characterization of treatment-induced necrosis

MRI Evaluation of Post Core Decompression Changes in Avascular Necrosis of Hip.

Science.gov (United States)

Nori, Madhavi; Marupaka, Sravan Kumar; Alluri, Swathi; Md, Naseeruddin; Irfan, Kazi Amir; Jampala, Venkateshwarlu; Apsingi, Sunil; Eachempati, Krishna Kiran

2015-12-01

Avascular necrosis of hip typically presents in young patients. Core decompression in precollapse stage provides pain relief and preservation of femoral head. The results of core decompression vary considerably despite early diagnosis. The role of MRI in monitoring patients post surgically has not been clearly defined. To study pre and post core decompression MRI changes in avascular necrosis of hip. This is a contiguous observational cohort of 40 hips treated by core decompression for precollapse avascular necrosis of femoral head, who had a baseline MRI performed before surgery. Core decompression of the femoral head was performed within 4 weeks. Follow up radiograph and MRI scans were done at six months. Harris hip score preoperatively, 1 month and 6 months after the surgery was noted. Success in this study was defined as postoperative increase in Harris hip score (HHS) by 20 points and no additional femoral collapse. End point of clinical adverse outcome as defined by fall in Harris hip score was conversion or intention to convert to total hip replacement (THR). MRI parameters in the follow up scan were compared to the preoperative MRI. Effect of core decompression on bone marrow oedema and femoral head collapse was noted. Results were analysed using SPSS software version. Harris hip score improved from 57 to 80 in all patients initially. Six hips had a fall in Harris hip score to mean value of 34.1 during follow up (9 to 12 months) and underwent total hip replacement. MRI predictors of positive outcome are lesions with grade A extent, Grade A & B location. Bone marrow oedema with lesions less than 50% involvement, medial and central location. Careful selection of patients by MR criteria for core decompression provides satisfactory outcome in precollapse stage of avascular necrosis of hip.

Idiopathic Avascular Necrosis of First Metatarsal Head in a Pediatric Patient.

Science.gov (United States)

Kwon, Young-Uk; Choi, Jang-Seok; Kong, Gyu-Min; Ha, Byung-Ho

Idiopathic avascular necrosis of the first metatarsal head rarely occurs in pediatrics. The present case of avascular necrosis of the first metatarsal head occurred in a 13-year-old male who came to the clinic with a 9-month history of pain in the first metatarsophalangeal joint. Conservative treatment had been applied for 9 months, but the pain had not been relieved. Therefore, surgical treatment, including decompression and debridement, was performed in the first metatarsal head of the patient. After 6 months of follow-up monitoring, full range of motion of the first metatarsophalangeal joint was observed, and the pain had disappeared. No any other complications had developed during 18 months of follow-up monitoring. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

A prognostic model for soft tissue sarcoma of the extremities and trunk wall based on size, vascular invasion, necrosis, and growth pattern

DEFF Research Database (Denmark)

Carneiro, Ana; Bendahl, Par-Ola; Engellau, Jacob

2011-01-01

type, necrosis, and grade. METHODS:: Whole-tumor sections from 239 soft tissue sarcomas of the extremities were reviewed for the following prognostic factors: size, vascular invasion, necrosis, and growth pattern. A new prognostic model, referred to as SING (Size, Invasion, Necrosis, Growth...

Dexamethasone enhances necrosis-like neuronal death in ischemic rat hippocampus involving μ-calpain activation

DEFF Research Database (Denmark)

Müller, Georg Johannes; Hasseldam, Henrik; Rasmussen, Rune Skovgaard

2014-01-01

- and necrosis-like cell death morphologies in CA1 of rats treated with dexamethasone prior to TFI (DPTI). In addition, apoptosis- (casp-9, casp-3, casp-3-cleaved PARP and cleaved α-spectrin 145/150 and 120kDa) and necrosis-related (calpain-specific casp-9 cleavage, μ-calpain upregulation and cleaved α......Transient forebrain ischemia (TFI) leads to hippocampal CA1 pyramidal cell death which is aggravated by glucocorticoids (GC). It is unknown how GC affect apoptosis and necrosis in cerebral ischemia. We therefore investigated the co-localization of activated caspase-3 (casp-3) with apoptosis......-spectrin 145/150kDa) cell death mechanisms were investigated by Western blot analysis. DPTI expedited CA1 neuronal death from day 4 to day 1 and increased the magnitude of CA1 neuronal death from 66.2% to 91.3% at day 7. Furthermore, DPTI decreased the overall (days 1-7) percentage of dying neurons displaying...

SU-E-T-549: Modeling Relative Biological Effectiveness of Protons for Radiation Induced Brain Necrosis

International Nuclear Information System (INIS)

Mirkovic, D; Peeler, C; Grosshans, D; Titt, U; Taleei, R; Mohan, R

2015-01-01

Purpose: To develop a model of the relative biological effectiveness (RBE) of protons as a function of dose and linear energy transfer (LET) for induction of brain necrosis using clinical data. Methods: In this study, treatment planning information was exported from a clinical treatment planning system (TPS) and used to construct a detailed Monte Carlo model of the patient and the beam delivery system. The physical proton dose and LET were computed in each voxel of the patient volume using Monte Carlo particle transport. A follow-up magnetic resonance imaging (MRI) study registered to the treatment planning CT was used to determine the region of the necrosis in the brain volume. Both, the whole brain and the necrosis volumes were segmented from the computed tomography (CT) dataset using the contours drawn by a physician and the corresponding voxels were binned with respect to dose and LET. The brain necrosis probability was computed as a function of dose and LET by dividing the total volume of all necrosis voxels with a given dose and LET with the corresponding total brain volume resulting in a set of NTCP-like curves (probability as a function of dose parameterized by LET). Results: The resulting model shows dependence on both dose and LET indicating the weakness of the constant RBE model for describing the brain toxicity. To the best of our knowledge the constant RBE model is currently used in all clinical applications which may Result in increased rate of brain toxicities in patients treated with protons. Conclusion: Further studies are needed to develop more accurate brain toxicity models for patients treated with protons and other heavy ions

Paradoxical Reaction to Golimumab: Tumor Necrosis Factor α Inhibitor Inducing Psoriasis Pustulosa

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Marien Siqueira Soto Lopes

2013-11-01

Full Text Available Importance: Golimumab is a human monoclonal antibody, used for rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. Adverse reactions are increasing with this class of medication (tumor necrosis factor α inhibitors. Observations: The authors present a case of a female patient who presented with psoriasis pustulosa after the use of golimumab for rheumatoid arthritis. Conclusions and Relevance: Paradoxically, in this case, golimumab, which is used for psoriasis, induced the pustular form of this disease. We are observing an increasing number of patients who develop collateral effects with tumor necrosis factor α inhibitors, and the understanding of the mechanism of action and how these adverse reactions occur may contribute to avoid these sometimes severe situations.

Avascular necrosis of the hamate: three cases and review of the literature.

Science.gov (United States)

Peters, Sebastian J; Verstappen, C; Degreef, Ilse; Smet, Luc De

2014-11-01

Background Avascular necrosis of the hamate (hamate-AVN) is a seldom reported disease of which little is known on etiology, best treatment modalities, and outcome. Hamate-AVN can occur in multiple locations within the hamate. Case Description Case one was an 8-year-old girl with painful AVN of the hamate hook. Surgical excision of the hook was performed, leading to excellent results (follow-up 8 years). Case two was a 44-year-old man with hamate-AVN of the proximal pole surgically treated with a vascularized bone graft from the radius based on the fifth extensor compartment artery, leading to excellent results (follow-up 7 years). Case three was a 36-year-old woman with hamate-AVN of the proximal pole surgically treated with débridement and cancellous bone grafting, leading to poor results (follow-up 1 year). Literature Review Nine other cases of avascular necrosis of the hamate were found in literature, all but one treated surgically. Etiology, treatment, and results of these cases, combined with our own cases, are reviewed. Clinical Relevance This article summarizes and synthesizes all presented cases of avascular necrosis of the hamate. We hope this will be helpful to physicians in decision making when confronted with this rare entity. Level of Evidence 4.

Magnetic resonance imaging of congenital dislocation of the hip with avascular necrosis of the femoral head

Energy Technology Data Exchange (ETDEWEB)

Hayashi, Nobuhiko; Ikeda, Takeshi; Wada, Ikuo [Nagoya City Univ. (Japan). Faculty of Medicine; and others

1991-04-01

Magnetic resonance imaging (MRI) was performed on 22 patients (24 joints) with congenital dislocation of the hip (CDH) with avascular necrosis. T1 and T2 weighted images were obtained using spin echo techniques. Since positive images of the articular cartilage were obtained, it was possible to clearly image flattening or thickening of the articular cartilage of the femoral head and acetabulum in the coronal and in the axial plane of the T1 weighted image. There was a high intensity region in the femoral head with avascular necrosis in the coronal T2 weighted image. The wideness of the region increased with severity. Much information can be obtained with MRI and it is a useful technique in evaluating the pathology of CDH with avascular necrosis. (author).

Magnetic resonance imaging of congenital dislocation of the hip with avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Hayashi, Nobuhiko; Ikeda, Takeshi; Wada, Ikuo

1991-01-01

Magnetic resonance imaging (MRI) was performed on 22 patients (24 joints) with congenital dislocation of the hip (CDH) with avascular necrosis. T1 and T2 weighted images were obtained using spin echo techniques. Since positive images of the articular cartilage were obtained, it was possible to clearly image flattening or thickening of the articular cartilage of the femoral head and acetabulum in the coronal and in the axial plane of the T1 weighted image. There was a high intensity region in the femoral head with avascular necrosis in the coronal T2 weighted image. The wideness of the region increased with severity. Much information can be obtained with MRI and it is a useful technique in evaluating the pathology of CDH with avascular necrosis. (author)

Metabolic epidermal necrosis in two dogs with different underlying diseases.

Science.gov (United States)

Bond, R; McNeil, P E; Evans, H; Srebernik, N

1995-05-06

Two dogs with metabolic epidermal necrosis had hyperkeratosis of the footpads accompanied by erythematous, erosive and crusting lesions affecting the muzzle, external genitalia, perineum and periocular regions. Histopathological examination of skin biopsies revealed a superficial hydropic dermatitis with marked parakeratosis. Both dogs had high plasma activities of alkaline phosphatase and alanine aminotransferase and high concentrations of glucose, and also a marked hypoaminoacidaemia. Despite these similarities, the cutaneous eruptions were associated with different underlying diseases. One dog had a pancreatic carcinoma which had metastasised widely; the primary tumour and the metastases showed glucagon immunoreactivity on immunocytochemical staining, and the dog's plasma glucagon concentration was markedly greater than that of control dogs. The other dog had diffuse hepatic disease; its plasma glucagon concentration was similar to that of control samples and cirrhosis was identified post mortem. Metabolic epidermal necrosis in dogs is a distinct cutaneous reaction pattern which may be associated with different underlying systemic diseases; however, the pathogenesis of the skin lesions remains unclear.

Analysis for apoptosis and necrosis on adipocytes, stromal vascular fraction, and adipose-derived stem cells in human lipoaspirates after liposuction.

Science.gov (United States)

Wang, Wei Z; Fang, Xin-Hua; Williams, Shelley J; Stephenson, Linda L; Baynosa, Richard C; Wong, Nancy; Khiabani, Kayvan T; Zamboni, William A

2013-01-01

Adipose-derived stem cells have become the most studied adult stem cells. The authors examined the apoptosis and necrosis rates for adipocyte, stromal vascular fraction, and adipose-derived stem cells in fresh human lipoaspirates. Human lipoaspirate (n = 8) was harvested using a standard liposuction technique. Stromal vascular fraction cells were separated from adipocytes and cultured to obtain purified adipose-derived stem cells. A panel of stem cell markers was used to identify the surface phenotypes of cultured adipose-derived stem cells. Three distinct stem cell subpopulations (CD90/CD45, CD105/CD45, and CD34/CD31) were selected from the stromal vascular fraction. Apoptosis and necrosis were determined by annexin V/propidium iodide assay and analyzed by flow cytometry. The cultured adipose-derived stem cells demonstrated long-term proliferation and differentiation evidenced by cell doubling time and positive staining with oil red O and alkaline phosphatase. Isolated from lipoaspirates, adipocytes exhibited 19.7 ± 3.7 percent apoptosis and 1.1 ± 0.3 percent necrosis; stromal vascular fraction cells revealed 22.0 ± 6.3 percent of apoptosis and 11.2 ± 1.9 percent of necrosis; stromal vascular fraction cells had a higher rate of necrosis than adipocytes (p vascular fraction cells, 51.1 ± 3.7 percent expressed CD90/CD45, 7.5 ± 1.0 percent expressed CD105/CD45, and 26.4 ± 3.8 percent expressed CD34/CD31. CD34/CD31 adipose-derived stem cells had lower rates of apoptosis and necrosis compared with CD105/CD45 adipose-derived stem cells (p necrosis than adipocytes. However, the extent of apoptosis and necrosis was significantly different among adipose-derived stem cell subpopulations.

Fat Necrosis After Partial-Breast Irradiation With Brachytherapy or Electron Irradiation Versus Standard Whole-Breast Radiotherapy-4-Year Results of a Randomized Trial

International Nuclear Information System (INIS)

Loevey, Katalin; Fodor, Janos; Major, Tibor; Szabo, Eva; Orosz, Zsolt; Sulyok, Zoltan; Janvary, Levente; Froehlich, Georgina; Kasler, Miklos; Polgar, Csaba

2007-01-01

Purpose: To examine the incidence and clinical relevance of fat necrosis after accelerated partial-breast irradiation (PBI) using interstitial high-dose-rate brachytherapy (HDR-BT) in comparison with partial-breast electron irradiation (ELE) and whole-breast irradiation (WBI). Methods and Materials: Between 1998 and 2004, 258 early-stage breast cancer patients were randomized to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 x 5.2 Gy HDR-BT (n = 88) or 50 Gy ELE (n = 40). The incidence of fat necrosis, its impact on cosmetic outcome, accompanying radiologic features, and clinical symptoms were evaluated. Results: The 4-year actuarial rate of fat necrosis was 31.1% for all patients, and 31.9%, 36.5%, and 17.7% after WBI, HDR-BT and ELE, respectively (p WBI/HDR-BT = 0.26; p WBI/ELE = 0.11; p ELE/HDR-BT = 0.025). The respective rate of asymptomatic fat necrosis was 20.2%, 25.3%, and 10% of patients. The incidence of symptomatic fat necrosis was not significantly different after WBI (8.5%), HDR-BT (11.4%), and ELE (7.5%). Symptomatic fat necrosis was significantly associated with a worse cosmetic outcome, whereas asymptomatic fat necrosis was not. Fat necrosis was detectable with mammography and/or ultrasound in each case. Additional imaging examinations were required in 21% of cases and aspiration cytology in 42%. Conclusions: Asymptomatic fat necrosis is a common adverse event of breast-conserving therapy, having no significant clinical relevance in the majority of the cases. The incidence of both symptomatic and asymptomatic fat necrosis is similar after conventional WBI and accelerated partial-breast HDR-BT

Reye's syndrome with cortical laminar necrosis: MRI

International Nuclear Information System (INIS)

Kinoshita, T.; Takahashi, S.; Ishii, K.; Higano, S.; Matsumoto, K.; Sakamoto, K.; Haginoya, K.; Iinuma, K.

1996-01-01

Serial MRI findings are described in two patients with Reye's syndrome, demonstrating diffuse cortical and white matter changes. In the acute stage, T2-weighted images showed subtle but definite laminar high signal and contrast-enhanced T1-weighted images laminar enhancement, along the entire cerebral cortex bilaterally. In the chronic stage, unenhanced T1-weighted images showed diffuse cortical laminar high signal. These characteristic MRI features seemed very similar to those of laminar cortical necrosis in hypoxic brain damage. MRI also displayed delayed white matter changes with cerebral atrophy. (orig.)

Necrosis related HIF-1α expression predicts prognosis in patients with endometrioid endometrial carcinoma

International Nuclear Information System (INIS)

Seeber, Laura MS; Horrée, Nicole; Groep, Petra van der; Wall, Elsken van der; Verheijen, René HM; Diest, Paul J van

2010-01-01

Hypoxia inducible factor 1α (HIF-1α) plays an essential role in the adaptive response of cells to hypoxia and is associated with aggressive tumour behaviour. We have shown p27 kip1 , which is generally reduced in endometrial cancer, to be re-expressed in hypoxic regions. This possibly contributes to survival of cancer cells. The aim of this study was to evaluate the prognostic value of HIF-1α and p27 kip expression in patients with endometrioid endometrial cancer. Expression levels of HIF-1α, CAIX, Glut-1, and p27 kip1 were analyzed by immunohistochemistry. Percentage of positive cells, staining pattern (perinecrotic, diffuse, or mixed) and presence of necrosis were noted. Necrosis was correlated with shortened disease free survival (DFS) (p = 0.008) and overall survival (OS) (p = 0.045). For DFS, perinecrotic HIF-1α expression was also prognostic (p = 0.044). Moreover, high p27 kip1 expression was an additional prognostic factor for these patients with perinecrotic HIF-1α expression. In multivariate Cox regression, perinecrotic HIF-expression emerged as an independent prognostic factor. Perinecrotic HIF-1α expression was significantly associated with CAIX and Glut-1 expression, pointing towards functional HIF-1. In patients with endometrioid endometrial cancer, necrosis and necrosis-related expression of HIF-1α are important prognostic factors. More aggressive adjuvant treatment might be necessary to improve the outcome of patients with these characteristics

Differential role of tumor necrosis factor receptors in mouse brain inflammatory responses in cryolesion brain injury

DEFF Research Database (Denmark)

Quintana, Albert; Giralt, Mercedes; Rojas, Santiago

2005-01-01

Tumor necrosis factor-alpha (TNF-alpha) is one of the mediators dramatically increased after traumatic brain injury that leads to the activation, proliferation, and hypertrophy of mononuclear, phagocytic cells and gliosis. Eventually, TNF-alpha can induce both apoptosis and necrosis via intracell......Tumor necrosis factor-alpha (TNF-alpha) is one of the mediators dramatically increased after traumatic brain injury that leads to the activation, proliferation, and hypertrophy of mononuclear, phagocytic cells and gliosis. Eventually, TNF-alpha can induce both apoptosis and necrosis via...... intracellular signaling. This cytokine exerts its functions via interaction with two receptors: type-1 receptor (TNFR1) and type-2 receptor (TNFR2). In this work, the inflammatory response after a freeze injury (cryolesion) in the cortex was studied in wild-type (WT) animals and in mice lacking TNFR1 (TNFR1 KO...... signaling also affected the expression of apoptosis/cell death-related genes (Fas, Rip, p53), matrix metalloproteinases (MMP3, MMP9, MMP12), and their inhibitors (TIMP1), suggesting a role of TNFR1 in extracellular matrix remodeling after injury. However, GDNF, NGF, and BDNF expression were not affected...

Investigando con personas con dificultades de aprendizaje

Directory of Open Access Journals (Sweden)

Borja González Luna

2013-12-01

Full Text Available El artículo muestra los orígenes de lo que Walmsley (2008 denomina «investigación inclusiva». Para comprender qué se entiende por investigación inclusiva tenemos que remontarnos a los debates epistemológicos sobre las metodologías cuantitativas y cualitativas, acontecidos en la década de los 90, en torno a la revista Disability & Society. A partir de una síntesis de dichos debates, focalizados en el ámbito de la «discapacidad intelectual y del desarrollo», se exponen dos estrategias de colaboración con dicha población: a una aproximación etnográfica (de trabajo grupal, y b una aproximación biográfica (de trabajo individual. A continuación se esboza un posible diseño de trabajo de campo que intenta superar el paradigma cualitativo «clásico» con el objetivo de incluir a dicho colectivo más allá del rol de «sujetos de la investigación». Para finalizar se recoge el debate sobre la accesibilidad de los resultados de la investigación a los participantes en dichas investigaciones, y con ello la necesaria innovación en el ámbito de las «devoluciones» de los resultados, cuando se trata de incluir a personas que presentan limitaciones para la comprensión del lenguaje abstracto oral y/o escrito.

MODELADO CON REDES DE PETRI E IMPLEMENTACIÓN CON GRAFCET DE UN SISTEMA DE MANUFACTURA FLEXIBLE CON PROCESOS CONCURRENTES Y RECURSOS COMPARTIDOS

OpenAIRE

Johanna Stella Castellanos Arias; Leonardo Enrique Solaque Guzmán

2010-01-01

En este trabajo, se presenta el modelado de un Sistema de Manufactura Flexible (SMF), con procesos concurrentes y recursos compartidos mediante Sistemas a Eventos Discretos (SED), específicamente Redes de Petri (RdP), y GRAFCET. El SMF se plantea como un modelo hipotético que se modela con una RdP con el objeto de identificar su dinámica y hallar la secuencia óptima de funcionamiento del sistema. Se desarrolló un modelo matemático que permite estimar el vector de tiempo acumulado de un proces...

Generation of truncated recombinant form of tumor necrosis factor ...

African Journals Online (AJOL)

Purpose: To produce truncated recombinant form of tumor necrosis factor receptor 1 (TNFR1), cysteine-rich domain 2 (CRD2) and CRD3 regions of the receptor were generated using pET28a and E. coli/BL21. Methods: DNA coding sequence of CRD2 and CRD3 was cloned into pET28a vector and the corresponding ...

Autopsy case of delayed radiation necrosis of the brain

Energy Technology Data Exchange (ETDEWEB)

Ihara, Katsuo; Otsutomo, Michinori; Takeshita, Gen (Aomori Rosai Hospital (Japan))

1984-06-01

A 48-year-old housewife underwent radiation therapy with 5,000 rad of cobalt following surgery for craniopharyngioma. One year later she developed symptoms of increased intracranial pressure, so that recurrence or occurrence of cerebral tumor was suspected. She died two years after the occurrence of the disease and was found to have had delayed radiation necrosis of the brain at autopsy.

MR imaging in avascular necrosis of the femoral head: Histologic correlation

International Nuclear Information System (INIS)

Lang, P.; Genant, H.K.; Jergesen, H.E.; Chafetz, N.I.; Block, J.; Moseley, M.E.

1987-01-01

MR imaging at 2.0 T was performed in six intraoperatively obtained femoral head specimens with avascular necrosis. Contact radiography and gross morphologic and histologic sectioning were performed. A low-signal intensity ring or band surrounding a high-signal-intensity area represented the reactive tissue interface of mesenchymal infiltrate, amorphous cellular debris, and thickened trabecular bone adjacent to the necrotic zone. Segmental areas of decreased signal intensity were observed once the repair process had invaded the entire necrotic zone. Viable and necrotic marrow both demonstrated high signal intensities on short and long repetition time/echo time sequences. MR signal intensities are not tissue specific. In combination with anatomic configuration and location, however, prediction of tissue composition and stage of disease on which the mode of therapy is determined appears possible. MR imaging at 2.0 T provides improved marrow contrast in avascular necrosis

Avascular Necrosis of Bone after Renal Transplantation - Prevalence and Usefulness of Bone SPECT -

Energy Technology Data Exchange (ETDEWEB)

Choi, Yun Young; Yang, Seoung Oh; Ryuu, Jin Sook; Moon, Dae Hyuk; Lee, Hee Kyung [Asan Medical Center, University of Ulsan, Seoul (Korea, Republic of)

1995-09-15

Avascular necrosis(AVN) of bone can be resulted from various causes that disturb vascular supply to bone tissue, including steroid therapy after renal transplantation. In this study, we determine the prevalence of the avascular necrosis of bone after renal transplantation and compare the role of the bone scan, SPECT and MRI. In 301 patients with transplanted kidney, the prevalence of avascular necrosis was determined clinically. Site of bone necrosis was evaluated by clinical symptom, bone scan, SPECT and MRI. Bone scan was done in all patients with AVN. Bone SPECT and MRI were done in six cases; and MRI was done in two cases. The prevalence of AVN was 3.3% (10/301), and the site of AVN was 16 femoral heads in 10 patients (bilateral: 60%) and bilateral calcaneal tuberosity in one patient. Bone scan showed typical AVN (cold area with surrounding hot uptake) in 13 lesions, only hot uptake in three lesions (including two calcaneal tuberosities), decreased uptake in one lesion, and normal in one lesion. Decreased uptake and normal lesion showed an equivocal cold area without surrounding hot uptake on SPECT. A symptomatic patient with positive bone SPECT showed normal finding on MRI. The prevalence of AVN of bone after renal transplantation was 3.3%, and whole body bone scan showed multiple bone involvement. Two symptomatic hip joints without definite lesion on whole body bone scan or MRI showed cold defect on SPECT. Therefore, we conclude that bone SPECT should be performed in a symptomatic patient with negative bone scan or MRI in case with high risk of AVN after renal transplantation.

Avascular Necrosis of Bone after Renal Transplantation - Prevalence and Usefulness of Bone SPECT -

International Nuclear Information System (INIS)

Choi, Yun Young; Yang, Seoung Oh; Ryuu, Jin Sook; Moon, Dae Hyuk; Lee, Hee Kyung

1995-01-01

Avascular necrosis(AVN) of bone can be resulted from various causes that disturb vascular supply to bone tissue, including steroid therapy after renal transplantation. In this study, we determine the prevalence of the avascular necrosis of bone after renal transplantation and compare the role of the bone scan, SPECT and MRI. In 301 patients with transplanted kidney, the prevalence of avascular necrosis was determined clinically. Site of bone necrosis was evaluated by clinical symptom, bone scan, SPECT and MRI. Bone scan was done in all patients with AVN. Bone SPECT and MRI were done in six cases; and MRI was done in two cases. The prevalence of AVN was 3.3% (10/301), and the site of AVN was 16 femoral heads in 10 patients (bilateral: 60%) and bilateral calcaneal tuberosity in one patient. Bone scan showed typical AVN (cold area with surrounding hot uptake) in 13 lesions, only hot uptake in three lesions (including two calcaneal tuberosities), decreased uptake in one lesion, and normal in one lesion. Decreased uptake and normal lesion showed an equivocal cold area without surrounding hot uptake on SPECT. A symptomatic patient with positive bone SPECT showed normal finding on MRI. The prevalence of AVN of bone after renal transplantation was 3.3%, and whole body bone scan showed multiple bone involvement. Two symptomatic hip joints without definite lesion on whole body bone scan or MRI showed cold defect on SPECT. Therefore, we conclude that bone SPECT should be performed in a symptomatic patient with negative bone scan or MRI in case with high risk of AVN after renal transplantation.

A Novel Composite PMMA-based Bone Cement with Reduced Potential for Thermal Necrosis.

Science.gov (United States)

Lv, Yang; Li, Ailing; Zhou, Fang; Pan, Xiaoyu; Liang, Fuxin; Qu, Xiaozhong; Qiu, Dong; Yang, Zhenzhong

2015-06-03

Percutaneous vertebroplasty (VP) and balloon kyphoplasty (BKP) are now widely used to treat patients who suffer painful vertebral compression fractures. In each of these treatments, a bone cement paste is injected into the fractured vertebral body/bodies, and the cement of choice is a poly(methyl methacrylate) (PMMA) bone cement. One drawback of this cement is the very high exothermic temperature, which, it has been suggested, causes thermal necrosis of surrounding tissue. In the present work, we prepared novel composite PMMA bone cement where microcapsules containing a phase change material (paraffin) (PCMc) were mixed with the powder of the cement. A PCM absorbs generated heat and, as such, its presence in the cement may lead to reduction in thermal necrosis. We determined a number of properties of the composite cement. Compared to the values for a control cement (a commercially available PMMA cement used in VP and BKP), each composite cement was found to have significantly lower maximum exothermic temperature, increased setting time, significantly lower compressive strength, significantly lower compressive modulus, comparable biocompatibility, and significantly smaller thermal necrosis zone. Composite cement containing 20% PCMc may be suitable for use in VP and BKP and thus deserves further evaluation.

Experimental and clinical stuties on microcirculation disturbance in the hormonal avascular necrosis of femoral head

International Nuclear Information System (INIS)

Shen Xiaowen

2007-01-01

Objective: To find the correlation factors with microcirculation disturbance by animal and clinic exprements; making clear of the pathogenetic mechanism; and providing theoritical evidence for prevention and treatment of the disease. Methods: The rabbits femoral head avascular necrosis models were induced and created by corticoid steroids. The microcirculation including capillary blood flow rate, blood viscosity, blood ingredients and histopathologic change were studied comparatively between the experimental and the control groups in order to explore the correlative factors of the incidence and proper clinical treatment. Results: The expremental group showed intracappillary blood cells aggregation, obviously slow down of blood flow, increase of serum cholesterol and protein, together with decrease of femoral head capillary vasculation. The effective rate for hormone induced femoral head avaseular necrosis through anticoagulation and promotion of microvascular circulation reached 93.75%. Conclusion: Hormone induced femoral head avascular necrosis is a kind of microcirculation disturbance disease. (authors)

Tissue Necrosis Monitoring for HIFU Ablation with T1 Contrast MRI Imaging

Science.gov (United States)

Hwang, San-Chao; Yao, Ching; Kuo, Ih-Yuan; Tsai, Wei-Cheng; Chang, Hsu

2011-09-01

In MR-guided HIFU ablation, MTC (Magnetization Transfer Contrast) or perfusion imaging is usually used after ablation to evaluate the ablated area based on the thermally induced necrosis contrast. In our MR-guided HIFU ablation study, a T1 contrast MRI scan sequence has been used to distinguish between necrotic and non-necrotic tissue. The ablation of porcine meat in-vitro and in-vivo pig leg muscle show that the necrotic area of T1 contrast MRI image coincides with the photographs of sliced specimen. The sequence is considerably easier to apply than MTC or perfusion imaging, while giving good necrosis contrast. In addition, no injection of contrast agent is needed, allowing multiple scans to be applied throughout the entire ablation procedure.

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

Directory of Open Access Journals (Sweden)

Neha Goel

2016-04-01

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

con mala calidad de vida

Directory of Open Access Journals (Sweden)

Agustín Martín-Rodríguez

2007-01-01

Full Text Available En este estudio ex post facto se ha analizado si los familiares de pacientes con mala calidad de vida presentan diferencias en las variables clínicas de personalidad y relaciones familiares en función de que el paciente haya estado o no ingresado en una Unidad de Cuidados Intensivos. Seleccionamos dos grupos: 29 familiares de pacientes traumatizados graves transcurridos cuatro años de su ingreso en una UCI de Traumatología y con mala calidad de vida (debido a secuelas físicas y/o psicológicas tras el ingreso, tales como traumatismos craneoencefálicos, politraumatismos y tetraplejias traumáticas y 32 familiares de pacientes con mala calidad de vida con cuatro años de evolución de su enfermedad física (hipertensión, diabetes, artritis reumatoide y síndrome de intestino irritable que no han estado ingresados en la UCI. Para alcanzar nuestro objetivo empleamos una Encuesta Psicosocial y los siguientes instrumentos: Cuestionario de Análisis Clínico, Escala de Clima Social en la Familia y Escala de Adaptación Psicosocial de la Enfermedad. Los resultados mostraron que los familiares de pacientes con mala calidad de vida que estuvieron ingresados en la UCI hace cuatro años, presentan diferencias significativas en las variables agitación y expresividad comparados con los familiares de pacientes con mala calidad de vida que no han estado ingresados en la UCI.

Total gastric necrosis: A case report and literature review | Huang ...

African Journals Online (AJOL)

During the surgery, we found a total of 3500ml unclotted blood in the abdomen, splenic infarction and gastric necrosis. Total gastrectomy with Roux-en-Y esophagojejunostromy and splenectomy was performed. However, the patient died on the second day after the surgery. This case suggests that surgical treatment should ...

Necrosis - the dominant form of cell death after phototoxicity impact of hypericin in colon adenocarcinoma cells HT29

International Nuclear Information System (INIS)

Mikes, J.; Kleban, J.; Sackova, V.; Solar, P.; Fedorocko, P.

2006-01-01

Photodynamic therapy (PDT) is a therapeutical approach for the treatment of malignant as well as non-malignant disorders based on administration of nontoxic/weakly toxic photosensitive compound and its activation with light. Hypericin, one of the promising photosensitizers, is known to induce apoptosis with high efficiency in various cell line models. However, here we report the prevalence of necrosis in colon adenocarcinoma HT-29 cells exposed to an extensive range of PDT doses evoked by variations in two variables - hypericin concentration and light dose. Necrosis was the principal mode of cell death despite different PDT doses and the absence of anti-apoptotic Bcl-2 expression. It is likely that the mutation in p53 plays a crucial role in cell death signaling in HT-29. Data indicating proliferation shifting in HT29 cells, incidence of cell death (apoptosis, necrosis and secondary necrosis) and comparison of cytotoxicity and caspase-3 activity of HT29 with HeLa cells are presented. (authors)

Adenosine triphosphate hydrolysis reduces neutrophil infiltration and necrosis in partial-thickness scald burns in mice.

Science.gov (United States)

Bayliss, Jill; Delarosa, Sara; Wu, Jianfeng; Peterson, Jonathan R; Eboda, Oluwatobi N; Su, Grace L; Hemmila, Mark; Krebsbach, Paul H; Cederna, Paul S; Wang, Stewart C; Xi, Chuanwu; Levi, Benjamin

2014-01-01

Extracellular adenosine triphosphate (ATP), present in thermally injured tissue, modulates the inflammatory response and causes significant tissue damage. The authors hypothesize that neutrophil infiltration and ensuing tissue necrosis would be mitigated by removing ATP-dependent signaling at the burn site. Mice were subjected to 30% TBSA partial-thickness scald burn by dorsal skin immersion in a water bath at 60 or 20°C (nonburn controls). In the treatment arm, an ATP hydrolyzing enzyme, apyrase, was applied directly to the site immediately after injury. Skin was harvested after 24 hours and 5 days for hematoxylin and eosin stain, elastase, and Ki-67 staining. Tumor necrosis factor (TNF)-α and interferon (IFN)-β expression were measured through quantitative real-time polymerase chain reaction. At 24 hours, the amount of neutrophil infiltration was different between the burn and burn + apyrase groups (P burn group at 24 hours and 5 days. TNF-α and IFN-β expression at 24 hours in the apyrase group was lower than in the burn group (P burn site allays the neutrophil response to thermal injury and reduces tissue necrosis. This decrease in inflammation and tissue necrosis is at least partially because of TNF-α and IFN-β signaling. Apyrase could be used as topical inflammatory regulators to quell the injury caused by inflammation.

Calidad de vida relacionada con la salud del niño y del adolescente con obesidad

OpenAIRE

Hurtado-Valenzuela, Jaime Gabriel; Álvarez-Hernández, Gerardo

2014-01-01

Objetivo Estimar la calidad de vida relacionada con la salud (CVRS) en un grupo de niños y adolescentes con obesidad de la ciudad de Hermosillo, Sonora, México. Métodos Se realizó un estudio transversal utilizando el cuestionario PedsQL® para comparar la CVRS de 200 niños y adolescentes con obesidad al igual que a sus padres, con dos grupos de control, uno de la comunidad (n=400) y otro grupo de usuarios (n=200) del Hospital Infantil del Estado de Sonora. Las diferencias en la CVRS fueron eva...

Diagnostic scope of computer tomography in hip disease - Paget's disease, femoral head necrosis, coxarthrosis, coxarthritis

Energy Technology Data Exchange (ETDEWEB)

Nebel, G; Lingg, G; Reid, W

1982-10-01

The value of computer tomography was investigated in Paget's disease of the hip, femoral head necrosis (adult avascular and osteoradionecrosis), coxarthrosis and coxarthritis (bacterial and rheumatoid). The greatest value of CT is in the diagnosis of adult avascular necrosis of the femoral head and is valuable for localising the necrotic area in the axial plane. This is of value in planning surgical treatment (displacement osteotomy or endoprosthesis). In Paget's disease, coxarthrosis and coxarthritis, CT provides only additional or more precise information.

Diagnostic scope of computer tomography in hip disease - Paget's disease, femoral head necrosis, coxarthrosis, coxarthritis

International Nuclear Information System (INIS)

Nebel, G.; Lingg, G.; Reid, W.

1982-01-01

The value of computer tomography was investigated in Paget's disease of the hip, femoral head necrosis (adult avascular and osteoradionecrosis), coxarthrosis and coxarthritis (bacterial and rheumatoid). The greatest value of CT is in the diagnosis of adult avascular necrosis of the femoral head and is valuable for localising the necrotic area in the axial plane. This is of value in planning surgical treatment (displacement osteotomy or endoprosthesis). In Paget's disease, coxarthrosis and coxarthritis, CT provides only additional or more precise information. (orig.) [de

Intervención con menores con adicciones desde Proyecto Hombre

OpenAIRE

Pardo-Esteban, Belén; Escalza-González, Amaia

2015-01-01

En el citado seminario informaremos del programa de atención y prevención de las toxicomanías y otras adicciones, llevado a cabo por la Asociación Proyecto hombre. A continuación, trataremos la formación en adicciones y toxicomanía con los estudiantes, mediante charla, cuestionarios sobre conocimientos básicos en prevención de toxicomanía en menores y los diferentes programas de intervención posibles aducados a los perfiles de los usuarios. Terminaremos con un debate sobre los temas tra...

NARRATIVAS CONVERSACIONALES CON FAMILIAS Y DOCENTES DE NIÑOS Y NIÑAS CON DISCAPACIDAD: UN APORTE METODOLÓGICO

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NORA ANETH PAVA-RIPOLL

2015-01-01

Full Text Available Se presentan algunas ventajas y limitaciones de las narrativas conversacionales como estrategia de investigación para el trabajo con familias y docentes de niños con discapacidad. La narración realizada por muchas voces, como sucede en una conversación, privilegia la relación y el discurso entre las personas como fuente de construcción consensuada de significados. La interacción triádica entre familia, inclusión educativa y salud orientó los encuentros conversacionales con padres, acudientes y profesores de estos niños en la ciudad de Manizales (Colombia. Los participantes conformaron equipos conversacionales y equipos reflexivos y conversaron sobre preguntas propuestas, previamente elaboradas. Con este ejercicio investigativo se resalta el valor interaccional de esta estrategia desde tres ámbitos: entre los par ticipantes, con el investigador y con el contexto situacional. Se argumenta que la reflexividad está más relacionada con el hacer que con el ser y el sentir de las personas, las cuales no necesariamente se transforman en la narrativa...

Neutrophil Extracellular Trap-Related Extracellular Histones Cause Vascular Necrosis in Severe GN.

Science.gov (United States)

Kumar, Santhosh V R; Kulkarni, Onkar P; Mulay, Shrikant R; Darisipudi, Murthy N; Romoli, Simone; Thomasova, Dana; Scherbaum, Christina R; Hohenstein, Bernd; Hugo, Christian; Müller, Susanna; Liapis, Helen; Anders, Hans-Joachim

2015-10-01

Severe GN involves local neutrophil extracellular trap (NET) formation. We hypothesized a local cytotoxic effect of NET-related histone release in necrotizing GN. In vitro, histones from calf thymus or histones released by neutrophils undergoing NETosis killed glomerular endothelial cells, podocytes, and parietal epithelial cells in a dose-dependent manner. Histone-neutralizing agents such as antihistone IgG, activated protein C, or heparin prevented this effect. Histone toxicity on glomeruli ex vivo was Toll-like receptor 2/4 dependent, and lack of TLR2/4 attenuated histone-induced renal thrombotic microangiopathy and glomerular necrosis in mice. Anti-glomerular basement membrane GN involved NET formation and vascular necrosis, whereas blocking NET formation by peptidylarginine inhibition or preemptive anti-histone IgG injection significantly reduced all aspects of GN (i.e., vascular necrosis, podocyte loss, albuminuria, cytokine induction, recruitment or activation of glomerular leukocytes, and glomerular crescent formation). To evaluate histones as a therapeutic target, mice with established GN were treated with three different histone-neutralizing agents. Anti-histone IgG, recombinant activated protein C, and heparin were equally effective in abrogating severe GN, whereas combination therapy had no additive effects. Together, these results indicate that NET-related histone release during GN elicits cytotoxic and immunostimulatory effects. Furthermore, neutralizing extracellular histones is still therapeutic when initiated in established GN. Copyright © 2015 by the American Society of Nephrology.

MODELADO CON REDES DE PETRI E IMPLEMENTACIÓN CON GRAFCET DE UN SISTEMA DE MANUFACTURA FLEXIBLE CON PROCESOS CONCURRENTES Y RECURSOS COMPARTIDOS

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Johanna Stella Castellanos Arias

2010-01-01

Full Text Available En este trabajo, se presenta el modelado de un Sistema de Manufactura Flexible (SMF, con procesos concurrentes y recursos compartidos mediante Sistemas a Eventos Discretos (SED, específicamente Redes de Petri (RdP, y GRAFCET. El SMF se plantea como un modelo hipotético que se modela con una RdP con el objeto de identificar su dinámica y hallar la secuencia óptima de funcionamiento del sistema. Se desarrolló un modelo matemático que permite estimar el vector de tiempo acumulado de un proceso modelado mediante una RdP, el cual constituye la base para hallar la mejor secuencia posible del sistema modelado. Por último, se realizó una implementación en el Laboratorio de Automatización de la Universidad Militar Nueva Granada, que simula el funcionamiento del SMF modelado por un montaje electrohidroneumático controlado con GRAFCET mediante PLC.

Targeting of the tumor necrosis factor receptor superfamily for cancer immunotherapy

NARCIS (Netherlands)

Bremer, Edwin

2013-01-01

The tumor necrosis factor (TNF) ligand and cognate TNF receptor superfamilies constitute an important regulatory axis that is pivotal for immune homeostasis and correct execution of immune responses. TNF ligands and receptors are involved in diverse biological processes ranging from the selective

Microglia protect neurons against ischemia by synthesis of tumor necrosis factor

DEFF Research Database (Denmark)

Lambertsen, Kate Lykke; Clausen, Bettina Hjelm; Babcock, Alicia

2009-01-01

Microglia and infiltrating leukocytes are considered major producers of tumor necrosis factor (TNF), which is a crucial player in cerebral ischemia and brain inflammation. We have identified a neuroprotective role for microglial-derived TNF in cerebral ischemia in mice. We show that cortical...

Relación del perfil salival con el grado de inmunosupresión en pacientes infectados con VIH con y sin tratamiento antirretroviral

OpenAIRE

Vera Cruz, Moisés; Cornejo Salaza, José; Chiyong, Teresa Evaristo; Arevalo Abanto, Jorge A.; Villanueva Vílchez, Hugo G.

2014-01-01

El objetivo del estudio fue evaluar el perfil salival de pacientes con infección por VIH con y sin Tratamiento Antirretroviral de Gran Actividad (TARGA), por medio de la evaluación de los síntomas de hipofunción salival (Xerostomía, Disgeusia, Disfagia y Susceptibilidad de desarrollar úlceras orales), la Tasa de Flujo salival no estimulado, el pH salival y la viscosidad salival; estableciendo su relación con el Grado de Inmunosupresión, evaluado por medio del Recuento de Linfocitos CD4/μl. Se...

Delayed radiation necrosis 7 years after gamma knife surgery for arteriovenous malformation. Two case reports

International Nuclear Information System (INIS)

Oyoshi, Tatsuki; Yatsushiro, Kazutaka; Arita, Kazunori; Hirahara, Kazuho; Uetsuhara, Koichi

2010-01-01

A 44-year-old woman and a 55-year-old woman were treated with gamma knife surgery (GKS) for occipital arteriovenous malformation (AVM). Angiography confirmed complete nidus obliterations 2 years after GKS. However, both patients complained of chronic headache and visual symptoms from around 7 years after GKS. Magnetic resonance imaging showed round masses with or without cystic change surrounded by large areas of brain edema. Angiography also showed complete obliteration of AVM at this time. Extended corticosteroid treatment failed to control the edema. Both patients underwent total surgical removal of the mass. Visual disturbance and chronic headache improved postoperatively and the brain edema rapidly subsided. The histological diagnosis was radiation necrosis in both cases, attributed to the low conformity index and large 12-Gy volume due to usage of a large collimator for GKS. These cases of delayed radiation necrosis after GKS suggest that surgical removal of necrotic lesions is necessary for radiation necrosis intractable to medical treatment. (author)

Muscle necrosis in the extremities: evaluation with Tc-99m pyrophosphate scanning--a retrospective review

International Nuclear Information System (INIS)

Timmons, J.H.; Hartshorne, M.F.; Peters, V.J.; Cawthon, M.A.; Bauman, J.M.

1988-01-01

A retrospective review was done of 34 extremities studied between 1981 and 1985 with technetium-99m pyrophosphate scanning; 22 were subsequently amputated. Results of detailed pathologic examination or immediate postoperative examination of the resected extremity were available in 16 cases. In these cases, scanning had allowed correct prediction of the level of amputation and of the specific areas of muscle infarction in 13 cases. In the one case in which amputation was performed for infection rather than muscle necrosis, the lack of necrosis was correctly predicted with the scan. The limited results of this study indicate that the Tc-99m pyrophosphate scan allows the location of necrotic muscle to be predicted accurately and may therefore be a useful adjunct in determining the best level for ultimate amputation. Special caution is required in those cases in which muscle necrosis is due to acute causes (e.g., traumatic thrombosis) rather than chronic vascular disease

Protein A from orange-spotted nervous necrosis virus triggers type I interferon production in fish cell.

Science.gov (United States)

Huang, Runqing; Zhou, Qiong; Shi, Yan; Zhang, Jing; He, Jianguo; Xie, Junfeng

2018-05-04

Family Nodaviridae consists of two genera: Alphanodavirus and Betanodavirus, and the latter is classified into four genotypes, including red-spotted grouper nervous necrosis virus, tiger puffer nervous necrosis virus, striped jack nervous necrosis virus, and barfin flounder nervous necrosis virus. Type I interferons (IFNs) play a central role in the innate immune system and antiviral responses, and the interactions between IFN and NNV have been investigated in this study. We have found that the RNA-dependent RNA polymerase (RdRp) from orange-spotted nervous necrosis virus (OGNNV), named protein A, was capable of activating IFN promoter in fathead minnow (FHM) cells. Transient expression of protein A was found to induce IFN expression and secretion, endowing FHM cells with anti-tiger frog virus ability. Protein A from SJNNV can also induce IFN expression in FHM cells but that from Flock House virus (FHV), a well-studied representative species of genus Alphanodavirus, cannot. RdRp activity and mitochondrial localization were shown to be required for protein A to induce IFN expression by means of activating IRF3 but not NFκB. Furthermore, DsRNA synthesized in vitro transcription and poly I:C activated IFN promoter activity when transfected into FHM cells, and dsRNA were also detected in NNV-infected cells. We postulated that dsRNA, a PAMP, was produced by protein A, leading to activation of innate immune response. These results suggest that protein As from NNV are the agonists of innate immune response. This is the first work to demonstrate the interaction between NNV protein A and innate immune system, and may help to understand pathogenesis of NNV. Copyright © 2018. Published by Elsevier Ltd.

MRI demonstration of cortical laminar necrosis and delayed white matter injury in anoxic encephalopathy

International Nuclear Information System (INIS)

Sawada, H.; Udaka, F.; Seriu, N.; Shindou, K.; Kameyama, M.; Tsujimura, M.

1990-01-01

We performed serial radiological examinations on a patient with anoxic encephalopathy. In the early term after the anoxic insult, T1-weighted MRI revealed high signal intensity area distributed laminarly in the cerebral cortex and diffusely in the putamen, which were thought to refect the cortical necrosis and necrosis in the putamen. Single photon emission computed tomography using I-123 isopropylamphetamine showed persistent hypoperfusion in the arterial watershed zones. T2-weighted MRI performed several months after the anoxic episode revealed diffuse high-intensity lesions in the arterial watershed zones. These delayed-onset white matter lesions continued to extend over several months. (orig.)

SATISFACCIÓN CON EL TRATAMIENTO EN PACIENTES DE ATENCIÓN PRIMARIA CON ARTROSIS

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Carmen Llanos Val Jiménez

2017-01-01

Full Text Available Fundamentos: Al igual que en otros problemas crónicos, en el abor - daje del paciente con artrosis se tiende a un modelo de toma de decisiones compartidas, en el que el punto de vista del paciente debe ser considerado en la elección del tratamiento. El objetivo de este trabajo fue evaluar la sa - tisfacción con el tratamiento en pacientes diagnosticados de osteoartrosis y comprobar si existen diferencias entre diferentes opciones farmacológicas, así como determinar si existe asociación con el estado funcional y las carac - terísticas clínicas y sociodemográficas. Métodos: Se realizó un estudio observacional transversal en una muestra de 487 pacientes seleccionados mediante muestreo consecutivo. La variable principal fue el nivel de satisfacción con el tratamiento (cuestionario ARTS. El estado funcional de los pacientes fue evaluado mediante la escala WO - MAC. Otras variables fueron: características del tratamiento, adherencia te - rapéutica, eventos adversos, y variables clínicas y sociodemográficas. Resultados: En el cuestionario ARTS los pacientes, en un rango entre 28 y 87, obtuvieron una puntuación media de 65,3 (DE: 9,9. La puntuación no fue significativamente diferente en consumidores de 1, 2 o más fármacos. Entre quienes consumían un solo fármaco, no hubo diferencias entre los di - ferentes tipos de fármacos. En el estado funcional se obtuvo una puntuación media de 30,2 puntos (DE: 20,8 y se observó una débil correlación negativa con el nivel de satisfacción (r= - 0,252; p<0,001. Mediante regresión lineal múltiple, se observó mayor puntuación en la escala ARTS (p<0,05 en pa - cientes con menor puntuación en la escala WOMAC, mayor edad y ausencia de eventos adversos. Conclusión : En pacientes con osteoartritis se observa un nivel mode - rado de satisfacción con el tratamiento farmacológico, condicionado por su situación funcional, sus características sociodemográficas y por la presencia de eventos

Delayed radiation-induced necrosis of the brain stem

International Nuclear Information System (INIS)

Yukawa, Osamu; Kodama, Yasunori; Kyoda, Jun; Yuki, Kiyoshi; Taniguchi, Eiji; Katayama, Shoichi; Hiroi, Tadashi; Uozumi, Toru.

1993-01-01

A 46-year-old man had surgery for a mixed glioma of the frontotemporal lobe. Postoperatively he received 50 Gy of irradiation. Sixteen months later he developed left hemiparesis and left facial palsy. MRI revealed lesion brain stem and basal ganglia. Despite chemotherapy and an additional 50 Gy dose, the patient deteriorated. Autopsy revealed a wide spread radiation-induced necrosis in the right cerebral hemisphere, midbrain and pons. In radiation therapy, great care must be taken to protect the normal brain tissue. (author)

Hidroxilación de fenol con catalizadores ZSM-5 modificado con cobre

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César Augusto Caro

2005-01-01

Full Text Available Se sintetizaron varios catalizadores Cu-ZSM-5 con diferentes relaciones Si/Al y Si/Cu. Usando metilamina o hidróxido de sodio como agente mineralizante. Los catalizadores se caracterizaron por DRX, IR, análisis BET, UV-VIS y análisis elemental. El desempeño catalítico de los catalizadores sintetizados se evaluó en la hidroxilación de fenol con H2O2. Se encontró que la relación catecol (CAT/(hidroquinona (HQ + p-benzoquinona (PBQ aumentó con el contenido de agua, presentó un máximo cuando la relación en peso de agua/fenol fue de 53/1 y se favoreció a altas temperaturas, con el aumento del contenido de aluminio o con la disminución en el contenido de catalizador. El contenido de cobre no fue un factor determinante para la conversión ni para la selectividad en la hidroxilación de fenol. La producción de la p-benzoquinona (PBQ, producto de oxidación de la hidroquinona, fue mínimo cuando se usaron las siguientes condiciones: 80 ºC, fenol: 1 mmol, relación molar fenol/H2O2 de 3/1, catalizador: 20 mg, agua: 5 g, tiempo de reacción: 4 h.

Foot Skin Ischemic Necrosis following Heel Prick in a Newborn

Directory of Open Access Journals (Sweden)

Esad Koklu

2013-01-01

Full Text Available There are only a few reports on side effects after heel prick in neonates although heel prick has been performed all over the world for many years. The medicine staff had obtained only a drop of blood by pricking the baby’s heel using a lancet without compressing the heel or foot to measure his blood glucose level 3 hours after birth. However he developed a severe and hemorrhagic skin reaction on his entire left foot, beginning 30 minutes after obtaining the drop of blood by pricking the baby’s heel using a lancet. The lesion, which was treated with topical mupirocin and povidone-iodine solution daily, slowly decreased in size and had almost fully resolved within 3 weeks. He was healthy and 9 months old at the time of writing this paper. We herein report a case of foot skin ischemic necrosis following heel prick in a newborn. To our knowledge this patient is the first case of foot skin ischemic necrosis due to heel prick in newborns.

Rhabdomyolysis with acute tubular necrosis following occupational inhalation of thinners.

Science.gov (United States)

Ngajilo, D; Ehrlich, R

2017-07-01

Thinners are mixtures of organic solvents commonly containing toluene, xylene, acetone, hexane, benzene and methyl isobutyl ketone. This report describes a case of rhabdomyolysis with acute tubular necrosis and renal failure, most likely attributable to toluene, following occupational exposure to thinners while cleaning a steel water tank. These adverse health effects have previously been reported following acute poisoning or intentional inhalation by drug abusers, but rarely in the occupational setting. Poor working conditions, lack of health and safety training and delayed treatment contributed to the onset and severity of the patient's complications. This case emphasizes the need for strict control measures, including adequate ventilation, training on working in confined spaces, appropriate personal protective equipment and emergency rescue procedures in such settings. In addition, rhabdomyolysis, acute tubular necrosis and renal failure should be added to safety data material as possible complications of excessive inhalation of thinners. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effects of clay on fat necrosis and carcass characteristics in Japanese Black steers.

Science.gov (United States)

Oka, Akio; Iwamoto, Eiji; Tatsuda, Ken

2015-10-01

Twenty 10-month-old Japanese Black steers were used to evaluate the effects of clay on fat necrosis and carcass characteristics. Ten steers (Clay group) were fed the clay (50 g/day) during 10-30 months of age. The other 10 steers (Control group) were not fed it. There was no significant difference in body weight or average daily gain between the two groups (P > 0.05). The occurrence of fat necrotic mass in the Clay group (30%) was lower (P Clay group was smaller (P clay prevented the occurrence of fat necrosis and did not affect the carcass characteristics in Japanese Black steers. © 2015 Japanese Society of Animal Science.

ESTUDIO DE LA DIGESTION HUMANA CON ALUMNOS CON DIFICULTADES DE APRENDIZAJE

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Mª Begoña Carretero Gómez

2009-01-01

Full Text Available En esta experiencia se han seleccionado una serie de actividades relacionadas con la digestión con el fin de lograr una reestructuración de ideas y cambios conceptuales, y así con la conseguir que el alumnado aprenda a construir sus propios conocimientos acerca de cómo y donde se dan los procesos de digestión necesarios para la nutrición del organismo. El trabajo se ha llevado a cabo con alumnos de 3º de Educación Secundaria Obligatoria, pertenecientesal programa de diversificación curricular. Hemos querido hacer la ciencia más cercana para que comprendan que algunos procesos tienen su explicación científica y que la ciencia forma parte de nuestro día a día, fomentando el interés del estudiante así como su implicación en el proceso de enseñanza-aprendizaje. Por ello hemos trabajado a base de pequeñas investigaciones, donde es el alumno el que marca su ritmo de trabajo, investiga y hace sus aportaciones. Han aprendido a trabajar de una forma meticulosa donde el rigor esfundamental, contagiándose del afán investigador de manera que al realizar las experiencias se han aproximado al trabajo científico a la vez que aclaran y reestructuran conocimientos.

Esporotricosis cutánea diseminada con compromiso articular en una mujer con diabetes tipo 2

Directory of Open Access Journals (Sweden)

Sendy Solorzano

Full Text Available La esporotricosis diseminada es una presentación infrecuente de esta micosis. Aunque ha sido descrita en sujetos inmunocompetentes, con frecuencia existe compromiso de la inmunidad mediada por células T. Reportamos el caso de una mujer con diabetes tipo 2 no controlada que desarrolló esporotricosis cutánea diseminada. El curso de la enfermedad presentó varias complicaciones que incluyeron hepatitis secundaria a itraconazol y artritis de la rodilla con cultivo positivo para Sporothrix schenckii durante el tratamiento con solución saturada de ioduro de potasio. La discusión del caso incluye aspectos de la patogénesis de la esporotricosis diseminada y el manejo de la infección y sus complicaciones.

Association of prescription of oral sodium polystyrene sulfonate with sorbitol in an inpatient setting with colonic necrosis: a retrospective cohort study.

Science.gov (United States)

Watson, Maura A; Baker, Thomas P; Nguyen, Annie; Sebastianelli, Mary E; Stewart, Heather L; Oliver, David K; Abbott, Kevin C; Yuan, Christina M

2012-09-01

Colonic necrosis has been reported after sodium polystyrene sulfonate (SPS)/sorbitol use, but the incidence and relative risk (RR) are not established. Retrospective cohort study. 123,391 adult inpatients at a tertiary medical center. Receipt of SPS prescriptions (exposed) or a prescription other than SPS (unexposed internal comparison group) between September 1, 2001, and October 31, 2010. The main outcome measure was tissue-confirmed diagnosis of colonic necrosis, considered SPS-associated if SPS was prescribed 30 or fewer days before tissue accession date. Demographics, serum chemistry test results, hospital location, and International Classification of Diseases, Ninth Revision diagnostic codes. SPS was prescribed to 2,194 inpatients. 82 inpatient colonic necrosis cases were identified. 3 received oral SPS (1 gram per 4 milliliters of 33% sorbitol) 30 or fewer days before the colonic necrosis accession date (3.7% of inpatient colonic necrosis cases). The data were linked with 123,391 individuals who received inpatient prescriptions between the same dates. Colonic necrosis incidence was 0.14% (95% CI, 0.03%-0.40%) in those prescribed SPS versus 0.07% (95% CI, 0.05-0.08%) in those not prescribed SPS (RR, 2.10; 95% CI, 0.68-6.48; P = 0.2). The number needed to harm was 1,395 (95% CI, 298-5,100). Subgroup analysis (age >65 years; estimated glomerular filtration rate, sorbitol prescription was not associated significantly with an increased RR of colonic necrosis in this retrospective cohort analysis. Multivariate analysis would require retrospective clinical cohorts from larger or more than one hospital system(s). Published by Elsevier Inc.

False-positive breast screening due to fat necrosis following mammography

International Nuclear Information System (INIS)

Cawson, Jennifer N.; Malara, Frank A.

2004-01-01

Traumatic fat necrosis can result in a spectrum of imaging appearances that range from characteristically benign to those indistinguishable from malignancy. In such cases, biopsy might be required for diagnosis. The present case demonstrates a suspicious mammographic mass lesion appearing following a haematoma caused by a previous screening mammogram Copyright (2004) Blackwell Publishing Asia Pty Ltd

MicroRNA-351 Regulates Two-Types of Cell Death, Necrosis and Apoptosis, Induced by 5-fluoro-2'-deoxyuridine.

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Akira Sato

Full Text Available Cell-death can be necrosis and apoptosis. We are investigating the mechanisms regulating the cell death that occurs on treatment of mouse cancer cell-line FM3A with antitumor 5-fluoro-2'-deoxyuridine (FUdR: necrosis occurs for the original clone F28-7, and apoptosis for its variant F28-7-A. Here we report that a microRNA (miR-351 regulates the cell death pattern. The miR-351 is expressed strongly in F28-7-A but only weakly in F28-7. Induction of a higher expression of miR-351 in F28-7 by transfecting an miRNA mimic into F28-7 resulted in a change of the death mode; necrosis to apoptosis. Furthermore, transfection of an miR-351 inhibitor into F28-7-A resulted in the morphology change, apoptosis to necrosis, in this death-by-FUdR. Possible mechanism involving lamin B1 in this miR-351's regulatory action is discussed.

Necrosis of nose skin after varicella zoster infection : A case report

NARCIS (Netherlands)

Snel, Bart Jorrit; Visconti, Giuseppe; Grabietz, Patrice D.; Werker, Paul M. N.

Varicella zoster virus (VZV) is the causal agent of varicella (chickenpox) and herpes zoster (shingles). Primary VZV infection is a common childhood disease, but elderly patients and those having a compromised immune system are also at risk. We present the case of progressive necrosis of the nose

Transient osteoporosis or femoral head necrosis Early diagnosis via MRI. Transitorische Osteoporose oder Femurkopfnekrose Fruehdiagnose mit der MRT

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Higer, H P; Grimm, J; Pedrosa, P; Apel, R; Bandilla, K [Stiftung Deutsche Klinik fuer Diagnostik, Wiesbaden (Germany, F.R.). Fachbereich Kernspintomographie; Stiftung Deutsche Klinik fuer Diagnostik, Wiesbaden (Germany, F.R.). Fachbereich Rheumatologie; Mainz Univ. (Germany, F.R.). Orthopaedische Klinik und Poliklinik)

1989-04-01

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

Steroid Induced Bilateral Avascular Necrosis of Head of Femur in an Adult Male Patient - A Case Report.

Science.gov (United States)

Jadeja, Dharamvirsinh; Solanki, Vipul; Chavada, Bhavesh; Tripathi, Chandrabhanu

2016-01-01

A 28 year old male patient, known case of pemphigus vulgaris was on dexamethasone pulse therapy. Total 7 pulses were given after that he developed avascular necrosis of head of femur on both sides, which was confirmed by digital X- ray and MRI. Avascular necrosis is a disabling and progressive condition in young patients gradually leads to femoral head collapse and eventual total hip arthroplasty. As per WHO-UMC causality assessment criteria, the association between reaction and drug was possible, Naranjo's score was 7. According to Modified Schumock and Thornton's criteria, this reaction was not preventable. The Modified Hartwig and Siegel's scale showed that the reaction was severe (level 6). Here we present a case where the use of steroid for pemphigus vulgaris resulting in the development of bilateral avascular necrosis of head of femur.

The effect of BW12C on radiosensitivity and necrosis of murine tissues and tumours

International Nuclear Information System (INIS)

Stevens, G.; Hill, S.A.; Joiner, M.C.; Joiner, B.; Johns, H.; Williams, K.; Denekamp, J.

1994-01-01

BW12C is a drug that has the potential to induce normal tissue and tumour hypoxia by binding to haemoglobin, increasing its affinity for oxygen and thereby reducing oxygen availability to tissues. Initial results suggested that BW12C administration caused significant radioprotection of normal tissues and induced tumour necrosis, but variable results have been reported subsequently. This work was carried to extend the range of observations concerning the ability of BW12C to radioprotect normal tissues and tumours and to induce necrosis of tumours of the mouse. BW12C was administered as 70 mg/kg intravenous 15 min before irradiation of jejunum in CBA mice and of foot skin in WHT mice with single doses of 240 kVp X-rays while mice breathed gases of varying oxygen tensions. The radiosensitivities of these tissues were assessed by the crypt survival assay and the acute skin reaction, respectively. The radiosensitivity of CaNT tumours to single fraction irradiation was assessed by the regrowth delay assay following administration of single or multiple does of BW12C at varying times to air-breathing CBA mice. The radiation response was compared to the radiosensitivity of clamped tumours. The effect of BW12C alone on tumours was assessed by regrowth delay and histological examination for necrosis. Single or multiple doses of BW12C did not influence the radiosensitivity of CaNT tumours, although marked radioprotection could be induced by clamping the tumours during irradiation. Multiple doses of BW12C alone led to a slight increase in necrosis of the CaNT tumour but did not alter its growth rate. BW12C alone did not induce necrosis of the murine JT lymphoma. The results shown that BW12C did not have a significant effect as a radioprotective or necrotizing agent in these experimental systems. The reported differences in the radiomodifying effects of BW12C are probably tissue-specific and relate to complex biochemical and physiological interactions. 18 refs., 4 figs

Cortical laminar necrosis in dengue encephalitis-a case report.

Science.gov (United States)

Garg, Ravindra Kumar; Rizvi, Imran; Ingole, Rajan; Jain, Amita; Malhotra, Hardeep Singh; Kumar, Neeraj; Batra, Dhruv

2017-04-20

Dengue encephalitis is a rare neurological manifestation of dengue fever. Its clinical presentation is similar to other viral encephalitides and encephalopathy. No single specific finding on magnetic resonance imaging of dengue encephalitis has yet been documented. They are highly variable and atypical. A 15-year boy presented with fever, the headache and altered sensorium of 12-day duration. On neurological examination, his Glasgow Coma Scale score was 10 (E3M4V3). There was no focal neurological deficit. Laboratory evaluation revealed leukopenia and marked thrombocytopenia. Dengue virus IgM antibody was positive both in serum and cerebrospinal fluid. Magnetic resonance imaging of the brain revealed signal changes in bilateral parietooccipital and left frontal regions (left hemisphere more involved than the right hemisphere). There was gyriform enhancement bilateral parietooccipital regions consistent with cortical laminar necrosis. Bilaterally diffuse subcortical white matter was also involved and subtle T2 hyperintensity involving both basal ganglia was noted. Gradient echo sequence revealed presence of hemorrhage in the subcortical white matter. Patient was treated conservatively and received platelet transfusion. Patient became fully conscious after 7 days. In a patient with highly suggestive dengue e\\ephalitis, we describe an unusual magnetic resonance imaging finding. This report is possibly the first instance of cortical laminar necrosis in such a setting.

Efectos del tratamiento con litio sobre las funciones neurosicológicas de pacientes con trastorno bipolar de tipo I

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Anabel Martínez Aran

2008-11-01

Full Text Available OBJETIVO: determinar si el tratamiento continuo con litio influye en el desempeño cognitivo de un grupo de pacientes eutímicos con trastorno afectivo bipolar I. MÉTODO: se evaluó el desempeño cognitivo usando pruebas neurosicológicas de atención, memoria y función ejecutiva en 20 pacientes eutímicos con trastorno afectivo bipolar I que no tomaban medicación, 20 pacientes eutímicos con trastorno afectivo bipolar I quienes continuaban regularmente el tratamiento con carbonato de litio, y un tercer grupo de 20 pacientes control. RESULTADOS: no se encontraron diferencias estadísticamente significativas entre los dos grupos de pacientes con trastorno afectivo bipolar. Sin embargo, al compararlos con el grupo control, su desempeño en términos de memoria verbal, viso-verbal y asociación semántica medida fue menor. DISCUSIÓN: los pacientes con trastorno afectivo bipolar I muestran deficiencias en términos de memoria verbal y viso-verbal que no pueden ser atribuidos al tratamiento regular con carbonato de litio. Por el contrario, estas deficiencias podrían ser consideradas como características de rasgo de este trastorno.

Twenty years' delay of fellow eye involvement in herpes simplex virus type 2-associated bilateral acute retinal necrosis syndrome

NARCIS (Netherlands)

Schlingemann, R. O.; Bruinenberg, M.; Wertheim-van Dillen, P.; Feron, E.

1996-01-01

PURPOSE: To describe a case of acute retinal necrosis with concurrent encephalitis and determine the causative virus. The patient had a history of presumed acute retinal necrosis in the left eye at the age of 8 years and recurrent genital herpes. METHODS: Diagnostic anterior chamber puncture of the

Acne polimorfo: tratamiento con Implacen

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Rubén Pérez Armas

1995-06-01

Full Text Available Se realiza el estudio de 40 pacientes con acné polimorfo, los que fueron atendidos en la Consulta de Dermatología del Hospital Provincial Clinicoquirúrgico Docente "Celia Sánchez Manduley", en el período comprendido de enero de 1988 a diciembre de 1989. Se revisa la literatura médica sobre los diversos métodos y medicamentos utilizados en la terapéutica de esta dermatosis. Se describe el esquema de tratamiento empleado con implacén en 30 pacientes; los 10 restantes se trataron con placebo; se compara dicho esquema con los tradicionales y se observan mejores resultados con nuestro estudio. Se destaca la ausencia de recaídas, así como el resultado del tratamiento de acuerdo con el sexo.A study was performed in 40 patients presenting with polymorphic acne who were attended in the Dermatology Department of "Celia Sánchez Manduley" Clinicosurgical and Teaching Hospital from January, 1988 to December, 1989. A review of the literature was made seeking for the different methods and drugs used for the treatment of this dermatosis. The treatment schedule with the use of implacen in 30 patients is described. Such therapeutic schedule was compared with traditional ones and better results were observed with the use of implacen. The fact that there were no relapses is highlighted, as well as the result of treatment according to sex.