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Sample records for linfoma intravascular tratado

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

    OpenAIRE

    Gallego Martínez, Juan

    2016-01-01

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

  2. Recaída neurológica en perros con linfoma tratados con quimioterapia: revisión de 13 casos

    OpenAIRE

    2011-01-01

    Se realiza un estudio retrospectivo de 13 casos de perros tratados con quimioterapia por linfoma que sufren recaída con afectación del sistema nervioso central o periférico, con el fin de describir los hallazgos encontrados y respuesta al tratamiento de los mismos. No se ha encontrado correlación estadística entre sexo, edad, estadio clínico o forma de presentación de la enfermedad neoplásica con la aparición de signos neurológicos. Sin embargo, se ha demostrado una predisposición racial a de...

  3. High grade primary adrenal intravascular large B-cell lymphoma manifesting as Addison disease Linfoma intravascular de alto grado de células B grandes y origen suprarrenal que se manifiesta en forma de enfermedad de Addison

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    J. Venizelos

    2007-08-01

    Full Text Available We report a rare case of a 68 aged male who presented with adrenal failure and was diagnosed of high grade large B-cell lymphoma primarily arising in the adrenal glands. The patient was administrated with additional chemotherapy but he passed away 7 months later due to infection in the lungs. Intravascular lymphoma should be suspected in patients with bilateral adrenal masses who present with rapidly progressive adrenal insufficiency.Publicamos el caso poco frecuente de un varón de 68 años de edad que debutó con insuficiencia adrenal y fue diagnosticado de linfoma de alto grado de células B grandes ubicado principalmente en las glándulas suprarrenales. Al paciente le administraron quimioterapia adicional, pero falleció 7 meses después de infección pulmonar. El linfoma intravascular debe sospecharse en los pacientes con masas suprarrenales bilaterales que presenten insuficiencia adrenal rápidamente progresiva.

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

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    Eleazar Chaib

    2002-09-01

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

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

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    Luciana Britto

    2010-01-01

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

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

    OpenAIRE

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

    2008-01-01

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

  7. Linfoma óseo primario

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    Onilda Labrada Silva

    2014-08-01

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

  8. Intravascular ultrasound

    Science.gov (United States)

    IVUS; Ultrasound - coronary artery; Endovascular ultrasound; Intravascular echocardiography ... A tiny ultrasound wand is attached to the top of a thin tube. This tube is called a catheter. The catheter ...

  9. Recidiva tardia de linfoma da zona marginal

    OpenAIRE

    Rocha,Talita M. B.S.; Bortolheiro,Tereza C.; Costa, Eduardo; Haardt,Daniela; Roberto P. Paes; Chiattone, Carlos S.

    2009-01-01

    O linfoma de zona marginal é um linfoma de baixo grau com curso clínico indolente e potencial de recidiva.1,2 Apresentamos um caso de recidiva tardia após 25 anos de aparente remissão completa, levantando a possibilidade de recidiva de doença preexistente ou desenvolvimento de novo clone neoplásico.

  10. Linfoma no Hodgkin primario de vagina

    OpenAIRE

    Guldrís N,Eva María; Vázquez C,María Pía; Carballo N,Elba; Porto Q,Magdalena; Heliodoro Alba O,Luis; Iglesias R,Begoña

    2013-01-01

    La afectación primaria del tracto genital femenino de los linfomas no Hodgkin es poco frecuente (2% de los linfomas primarios extraganglionares). Los órganos más afectados son los ovarios seguidos del cérvix, siendo la localización endometrial y vaginal extremadamente rara. Presentamos el caso de una paciente de 44 años diagnosticada de linfoma primario de vagina, estadio IE A, con remisión completa tras tratamiento combinado quimioterápico y quirúrgico. Es importante tener presente estas rar...

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

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    Roseana de Almeida Freitas

    2008-06-01

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

  12. Amiloidosis sistémica y linfoma no Hodgkin

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    Daniel V. Drake Sosa

    2014-08-01

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

  13. Linfoma do sistema nervoso central: ensaio iconográfico

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    Fabiano Reis

    2013-04-01

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

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

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    I. Serrano-Navarro

    2008-11-01

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

  15. Intravascular malignant lymphomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Martin-Duverneuil, N.; Lafitte, F.; Chiras, J. [Service de Neuroradiologie Charcot, Batiment Babinski, Hopital de la Salpetriere, 75013 Paris (France); Mokhtari, K. [Service de Neuropathologie, Hopital de la Salpetriere, 75013 Paris (France); Behin, A.; Hoang-Xuan, K. [Departement de Neurologie, Hopital de la Salpetriere, 75013 Paris (France)

    2002-09-01

    Intravascular malignant lymphomatosis is a rare and probably often overlooked disease characterised by massive intravascular proliferation of lymphoid cells, usually with a poor prognosis. CT and MRI appearances are nonspecific; the most suggestive finding being both asymmetrical, bilateral, contrast enhancing high-signal areas on T2 weighting and infarct-like lesions of the cortex and basal ganglia. We report two patients with previously unreported dural and spinal cord involvement. (orig.)

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

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    B. Madrigal

    2008-08-01

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

  17. Linfoma tiroideo en paciente con tiroiditis de Hashimoto

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    Carmen Aravena G.; Daniela Aguayo Y.; Francisca Marín A.; Felipe Cayumil F.

    2014-01-01

    INTRODUCCIÓN: El linfoma tiroideo (LT) es una neoplasia infrecuente (menos del 1% de linfomas y menos del 2% de neoplasias tiroideas). Su incidencia es mayoritaria en mujeres, entre 60 y 75 años. La tiroiditis de Hashimoto es un importante factor de riesgo. El objetivo es destacar la importancia del estudio precoz del bocio rápidamente progresivo. PRESENTACIÓN DEL CASO: Hombre de 63 años, con antecedentes de hipertensión arterial, tabaquismo crónico activo e hipotiroidismo por tiroiditis de H...

  18. Harmonic Intravascular Ultrasound

    NARCIS (Netherlands)

    M.E. Frijlink (Martijn)

    2006-01-01

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

  19. Linfoma no-Hodgkin del sistema nervioso central

    OpenAIRE

    Iglesias Rozas, José Rafael, 1942-

    2000-01-01

    Diecisiete imágenes de un linfoma no-Hodgkin del sistema nervioso central en una paciente de 66 años. Seventeen pictures of a non-Hodgkin lymphoma of the central nervous system in a 66-year-old female patient.

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

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    Ana Carolina Ituarte

    2005-01-01

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

  1. Intravascular "mulberry-like" bodies

    DEFF Research Database (Denmark)

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

    1988-01-01

    Intravascular "mulberry-like" bodies in a stillborn female infant with moderate maceration are reported. The histogenesis of these structures is discussed based on light-microscopic, immunohistochemical and ultrastructural findings. No demonstrable causal relation between the intravascular lesions...... and fetal death was found, the cause of death being attributed to intrauterine asphyxia. It is concluded, that intravascular "mulberry-bodies" most likely represent artifacts due to red blood cell autolysis....

  2. How Is Disseminated Intravascular Coagulation Treated?

    Science.gov (United States)

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

  3. Disseminated intravascular coagulation in cancer patients

    NARCIS (Netherlands)

    M. Levi

    2009-01-01

    Disseminated intravascular coagulation (DIC) is a syndrome that may complicate a variety of diseases, including malignant disease. DIC is characterized by widespread, intravascular activation of coagulation (leading to intravascular fibrin deposition) and simultaneous consumption of coagulation fact

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

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    Cristiane do Prado Silva

    2008-04-01

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

  5. Taquicardia ventricular associada com linfoma não-Hodgkin

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    Diego Chemello

    2011-12-01

    Full Text Available Linfoma não-Hodgkin sistêmico pode afetar o miocárdio, particularmente em pacientes imunocomprometidos. Quando presentes, sinais e sintomas são geralmente inespecíficos, tornando o diagnóstico de envolvimento cardíaco muito difícil antes da autópsia. Arritmias ventriculares também são pouco usuais nesse cenário. Descrevemos um caso de linfoma não-Hodgkin miocárdico secundário, que se apresentou com taquicardia ventricular monomórfica sustentada e espessamento do septo interventricular basal. Completa remissão das lesões miocárdicas foi observada após o término da quimioterapia de segunda linha, sem recorrências posteriores de arritmias em oito meses.

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

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    Kryssia Rodríguez-Castro

    2005-10-01

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

  7. ENFERMEDAD RENAL POLIQUISTICA ASOCIADA A LINFOMA EXTRANODAL EN UN CANINO

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    Diego Echeverry B

    2006-12-01

    Full Text Available Objetivo: Presentar el caso de un paciente canino, con enfermedad renal poliquística, asociada alinfoma extranodal. Materiales y métodos: Se estudió el caso de un paciente canino de raza SiberianHusky de 7 años de edad, al que se le encontraron múltiples nódulos renales bilaterales, condiagnóstico histopatológico de linfoma extranodal. Resultados: Se expone el caso clínico de unpaciente canino de raza Siberian Husky, que es presentado a consulta dermatológica por exhibirlesiones alopécicas multifocales. Una vez realizado el examen físico sistemático se evidenció demanera incidental nefromegalia. Los exámenes paraclínicos e histopatológicos aplicadosdemostraron la presencia de enfermedad renal poliquística asociada a linfoma extranodal, comoconsecuencia se presento falla renal crónica. Conclusiones: El linfoma extranodal renal es unaentidad patológica de rara presentación, clínicamente cursa con signos muy similares a otrasalteraciones tumorales, su diagnóstico suele ser histopatológico.

  8. An intravascular protein osmometer.

    Science.gov (United States)

    Henson, J W; Brace, R A

    1983-05-01

    Our purpose was to develop an intravascular osmometer for measuring the colloid (i.e., protein) osmotic pressure (COP) of circulating blood. A semipermeable hollow fiber from a Cordis Dow artificial kidney (C-DAK 4000) was attached to polyethylene tubing on one end, filled with saline, and sealed at the other end. This was small enough to be inserted into the vasculature of research animals. Protein osmotic pressure plus hydrostatic pressure was measured by a Statham pressure transducer attached to the hollow fiber. Simultaneously, a second catheter and transducer was used to measure hydrostatic pressure, which was subtracted from the pressure measured from the fiber with an on-line computer. The system was documented by a variety of tests. The colloid osmotic pressure vs. albumin concentration curve determined with the fiber is identical to the curve determined by standard membrane osmometry. The time constant for 2- and 8-cm fibers was 2.6 +/- 0.6 and 1.5 +/- 0.5 (+/- SD) min, respectively. The reflection coefficient (+/- SD) of the fiber for NaCl is 0.042 +/- 0.019 (n = 38); COP measured at varying temperatures (absolute scale) changed linearly as expected from COP = nCRT (i.e., van't Hoff's law). Finally, hollow-fiber osmometers were inserted into femoral veins of dogs and sheep, and blood COP was continuously recorded during osmotic manipulations. In conclusion, we attempted to develop and document a simple method for continuous measurement of intravascular colloid osmotic pressure.

  9. Primary lymphoma of the colon Linfoma primario de colon

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    Marta Pascual

    2013-02-01

    Full Text Available Background: primary colorectal lymphoma is a very rare disease, representing less than 0.5 % of all primary colorectal neoplasms. The gastrointestinal tract is the most frequently involved site of all extranodal lymphomas, the most common type of that is non-Hodgkin's lymphoma. Early diagnosis is often difficult because of unspecific symptoms. Therapeutic approaches have classically included radical resection, chemotherapy and radiotherapy. Materials and methods: we present our experience in the management of primary colorectal lymphomas over a 17-year period (1994-20011. Results: in this period 7 cases of primary colorectal lymphoma were diagnosed in our institution. Abdominal pain and change in bowel habit were the most frequent symptoms. Five patients underwent emergency surgery because of bleeding or bowel obstruction. All primary intestinal lymphomas studied were of the B-cell phenotype. Patients were followed up for a median of 59 months (range 1-180. Three of them are alive with no evidence of recurrence. Conclusion: combination treatment with chemotherapy and surgery can obtain good remission rate. Surgery can resolve complications such bleeding or intestinal perforation that are implicated in lymphoma mortality.Introducción: el linfoma primario de colon y recto es una patología poco prevalente, representa tan solo el 0,5 % de todas las neoplasias primarias de colon y recto. El tracto gastrointestinal es el lugar donde asientan la gran mayoría de los linfomas extranodales, siendo el más frecuente el tipo linfoma no-Hodking. El diagnóstico precoz es siempre difícil debido a que la sintomatología es muy poco específica. Los algoritmos terapéuticos han incluido clásicamente la resección radical, el tratamiento con quimioterapia y con radioterapia. Materiales y métodos: presentamos nuestra experiencia en el manejo de los linfomas primarios de colon en un periodo de 17 años (1994-2011. Resultados: en dicho periodo en nuestro

  10. Transplante de células-tronco hematopoéticas em linfoma Hodgkin

    Directory of Open Access Journals (Sweden)

    Rosane I. Bittencourt

    Full Text Available O linfoma Hodgkin(LH é uma malignidade hematológica que conta com um armamentário terapêutico selecionado de acordo com o estadiamento e a classificação prognóstica de cada doente. A sobrevida dos pacientes tratados para o LH clássico vem aumentando significativamente, com taxas de cura entre 80%-85%. Entretanto, 20%-25% são refratários aos tratamentos iniciais e cerca de 30% recaem após ter alcançado resposta completa. Os pacientes considerados com falha à terapia de primeira linha ainda têm uma segunda chance de cura se apresentarem quimiossensibilidade aos esquemas de salvamento, seguido por uma das modalidades de transplante de células-tronco hematopoéticas (TCTH. O TCTH autólogo representa uma estratégia atrativa para os pacientes com LH que falham ao tratamento convencional de primeira linha. Os resultados em termos de sobrevidas livre de doença e global são superiores aos esquemas de salvamento com quimioterapia convencional. Este procedimento tem finalidade curativa para 50% dos pacientes em segunda remissão quimiossensíveis e pode levar a remissões duráveis naqueles com mais de duas linhas de terapia. Atualmente, o TCTH alogênico, basicamente com condicionamento de intensidade reduzida (RIC, está indicado em pacientes com recaída precoce após o TCTH autólogo ou em pacientes bastante jovens com refratariedade a mais de duas linhas de tratamento convencional.

  11. Intravascular large B cell lymphoma

    Directory of Open Access Journals (Sweden)

    Ricardo García-Muñoz

    2014-01-01

    Full Text Available Intravascular large B cell lymphoma (IVBCL is a rare type of extranodal large B cell lymphoma characterized by selective growth of lymphoma cells within the microvasculature. We present an illustrative case of intravascular B cell lymphoma suspected by the presence of a very small monoclonal B cell population identified by immunophenotype and polymerase chain reaction in bone marrow. The diagnosis was confirmed by skin biopsy.

  12. Linfoma no Hodgkin primario de ciego : A propósito de un caso

    OpenAIRE

    Corvalán, Magdalena; Colque Peca, María Lourdes; Ruiz Hardoy, Ignacio; Berra, Julio; Morganti, Abel

    2016-01-01

    El tracto gastrointestinal es el sitio donde más habitualmente se localizan los linfomas extranodales, siendo colon y recto el tercer lugar en frecuencia (10-20%, luego de estómago e intestino delgado) 1, 2, 3, 4 y, dentro de éstos, el ciego ocupa el primer lugar, probablemente debido a que posee mayor cantidad de tejido linfoide 1, 3. Los linfomas primarios de colon son tumores raros, que comprenden 3% de todos los linfomas y 0,1- 0,5% de todas las neoplasias colorrectales 2, 4. Dentro de...

  13. Manifestação bucal de linfoma difuso de grandes células B

    OpenAIRE

    Paulo Sérgio S Santos; Ferreira,Eduardo S.; Rafael M. Vidote; Roberto Antonio P. Paes; Freitas,Ronaldo R.

    2009-01-01

    O linfoma de células B acomete cerca de 90% de todos os casos de linfoma. O aparecimento da lesão bucal deste tipo de linfoma é pouco comum e raras vezes se manifesta em região anterior de mandíbula. Neste relato de caso, o paciente de 22 anos, sexo masculino, com diagnóstico de linfoma de grandes células B em mediastino e pleura, após um ano de tratamento apresentou lesão nodular em região anterior de mandíbula, comprometendo os dentes incisivos inferiores. O diagnóstico histológico e imuno-...

  14. con transformación a Linfoma del manto

    Directory of Open Access Journals (Sweden)

    M. Martínez Gabarrón

    2013-06-01

    Full Text Available La Macroglobulinemia de Waldenström (MW es una enfermedad infrecuente con una incidencia de tres casos por millón de habitantes al año aproximadamente1 y cuyo diagnóstico siempre plantea importantes dudas. La edad media de diagnóstico es de 64 años siendo más frecuente en varones (60% y en la raza caucasiana2. Se considera una patología progresiva, crónica y en general de curso lento. La causa más frecuente de muerte son las segundas neoplasias y de todas ellas la trasformación a linfoma inmunoblástico causa un pequeño porcentaje de ellas. Exponemos el caso de una mujer diagnosticada de Macroglobulinemia de Waldenström que presentó precozmente una trasformación a linfoma del manto con rápida y nefasta progresión. Waldenström's Macroglobulinemia (MW is an uncommon disease with an incidence of three cases per million population per year approximately and whose diagnosis presents important questions always. The average age of diagnosis is 64 years being more frequent in males (60% and Caucasian race. It is considered a progressive, chronic disease and slow course generally. The second malignancies are the most frequent cause of death and a small percentage of them transformation to Immunoblastic Lymphoma. We present the case of a diagnosed woman of Waldenström's Macroglobulinemia who presented a transformation to mantle cell lymphoma precociously with quick and grim progression.

  15. Linfoma não Hodgkin gástrico Gastric non-Hodgkin Lymphoma

    Directory of Open Access Journals (Sweden)

    Renata O. Costa

    2010-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Carlos Vergara-Uzcategui

    2014-09-01

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

  17. Pain in an osseous lymphoma. A case presentation. Dolor en el linfoma oseo. Presentación de un caso.

    Directory of Open Access Journals (Sweden)

    Alexis Guillén Sánchez

    Full Text Available This is a 79 year-old, white, male patient suffering from osseous lymphoma, a less frequent illness, came to the university Hospital Dr. Gustavo Aldereguía Lima¨ in Cienfuegos city, Cuba complaining of intercostal pain in the left hemithorax. This pain was not relieved with the regular medical treatment, that´s why the anesthesia service doctors gave assistance. Costal osteolysis at level D7, D8 and D9 were shown in a thorax X ray. He was treated with analgesic through peridural via such as morphine, local anesthetic. Betametasone was used as anti-inflammatory having positive results. The use of ethylic alcohol as agents contributed to the patient´s improvement and to get back to his normal life. 

    Se presenta el caso de un paciente del hospital provincial clínico quirúrgico universitario ¨Dr. Gustavo Aldereguía Lima¨ de Cienfuegos, portador de una enfermedad muy poco frecuente (linfoma óseo, de 79 años de edad, masculino, de raza blanca, que refería dolor intercostal en hemitórax izquierdo, el cual no cedía ante el tratamiento médico habitual, por lo que es atendido por anestesiología. En el rayos X de tórax se apreció osteolisis costal a nivel de D7, D8 y D9. En forma frecuente fue tratado con analgésicos por vía peridural: morfina, anestésicos locales y como antiinflamatorio la betametasona con resultados satisfactorios. El uso de agentes como el alcohol etílico, contribuyó a mejorar su cuadro y a que se incorporara a sus labores habituales.

  18. Linfoma primário renal em cão: relato de caso

    OpenAIRE

    Costa Neto, João Moreira da; Lima, Alessandra da Silva Estrela; Ribeiro,Lorena; Teixeira, Diana; Damasceno, Karine; Melo, Stella Maria Barrouin; Trindade, Eduardo

    2012-01-01

    Os tumores renais primários são incomuns em cães, sendo mais frequentes as metástases de melanoma, hemangiossarcoma, carcinoma e linfoma. Este último é uma neoplasia linfóide, de origem multifatorial, decorrente da transformação maligna de linfócitos. A forma anatômica extranodal do linfoma é considerada rara, podendo acometer diversos órgãos, inclusive os rins. O objetivo deste relato é descrever o caso de um canino, fêmea, da raça Pit Bull, com seis anos de idade, com processo expansivo no ...

  19. Recidiva tardia de linfoma da zona marginal Late relapse of marginal zone lymphoma

    OpenAIRE

    Rocha,Talita M. B.S.; Bortolheiro,Tereza C.; Eduardo Costa; Daniela Haardt; Roberto P. Paes; Chiattone, Carlos S.

    2009-01-01

    O linfoma de zona marginal é um linfoma de baixo grau com curso clínico indolente e potencial de recidiva.1,2 Apresentamos um caso de recidiva tardia após 25 anos de aparente remissão completa, levantando a possibilidade de recidiva de doença preexistente ou desenvolvimento de novo clone neoplásico.Marginal zone lymphoma is a low grade lymphoma with an indolent course and chance to relapse. We present a case of a patient who suffered relapse after 25 years of apparently complete remission of ...

  20. UM TRATADO PARA O AMOR

    Directory of Open Access Journals (Sweden)

    Maria José Caldeira do Amaral

    2015-07-01

    Full Text Available No Tratado do Amor Cortês - Tractatus de Amore - André Capelão deseja oferecer ao leitor a arte cortês de amar, a beleza do desejo erótico e a disciplina da paixão constitutiva dessa arte que é amar. O maior argumento dessa obra é efetivar o suspiro fundo que a dimensão amorosa infunde na alma do homem e da mulher aos quais foi concedida a virtude. Para esse autor, escriba da chancelaria real e talvez, não se sabe com certeza, um Ordo Sacratus, o amor é a raiz de toda cortesia, a fonte de todo bem. Nosso objetivo, então, é encontrar nessa suma amorosa construída nos enlaces da Literatura de Cavalaria Medieval, os desdobramentos essenciais dessa vida afetiva bela e virtuosa no enredo profundo do qual emerge o afeto, a fé e a contradição da experiência humana do sofrimento amoroso. Palavras Chave: Literatura Medieval. Amor Cortês, André Capelão, virtude, desejo. Abstract: With the treaty toward the love - Tractatus de Amore – André Capelão offers to the reader the courteous’ art for love, the erotic desire’s beauty and the  suffering discipline belong this love’s art  is. The best reason of this literary composition is to achieve the depth sigh that the loving dimension infuses into the lovers’s soul, the man and the woman wich this virtue was conceded. For this author, the royal chancery scribe and perhaps, no one knows for sure, a Sacratus Ordo, love is the root of all free, the source of all good. Our goal, then, is to find this sum loving built in interlacing of Medieval Knights literature, the essential developments of this beautiful and virtuous love life in the deep storyline which emerges affection, faith and the contradiction of the human experience of love suffering. Key words: Medieval Literature. Courteous Love. André Capelão. Virtue.

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

    Directory of Open Access Journals (Sweden)

    Leila Antonangelo

    2005-12-01

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

  2. Estudio histológico e inmunofenotípico de linfoma canino en el centro de México

    OpenAIRE

    Francisco J. Álvarez Berger; Enrique Aburto Fernández; Gerardo Aristi Urista; Gilberto Chávez Gris

    2009-01-01

    El inmunofenotipo constituye un factor importante en el pronóstico del linfoma canino. Se ha demostrado que perros con linfoma de células B presentan tiempos de sobrevivencia más largos que los perros con linfoma de células T. Los antígenos CD3 y CD79a son los marcadores más utilizados en inmunohistoquímica para la determinación del fenotipo celular T y B, respectivamente, en muestras fijadas en formalina y conservadas en bloques de parafi na. En este estudio se describen las características ...

  3. Linfoma primario de hueso con afectación multicéntrica

    Directory of Open Access Journals (Sweden)

    Marcelo Graziadio

    2012-10-01

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

  4. Linfoma angioinmunoblástico de células T

    Directory of Open Access Journals (Sweden)

    Gargantilla P

    2016-09-01

    Full Text Available Se trata de un linfoma muy agresivo, con una mediana de supervivencia en torno a los 3 años. En cuanto al tratamiento, se han ensayado varias modalidades terapéuticas entre las cuales se encuentran los corticoides, los fármacos citotóxicos (vorinostat, romidepsin, panbinostat y belinostat y los inmunomoduladores (rituximab, lenalidomide.

  5. Linfomas extranodales en el Área Metropolitana de Bucaramanga: 2000-2004

    Directory of Open Access Journals (Sweden)

    Claudia Janeth Uribe Pérez, MD* Carlos Alberto García Ramírez, MD* Erika Eliana Meza Durán, Enf * Rafael Miguel Camacho López** Diana Josefina Acevedo Jurado**

    2009-01-01

    Full Text Available Antecedentes: Los linfomas extranodales (LEN se localizan en cualquier sitio diferente a los ganglios linfáticos, como el tracto gastrointestinal (TGI y la piel; la mayoría son de tipo linfoma no Hodgkin (LNH. Representan entre el 25-45% de todos los LNH, y el subtipo histopatológico más frecuente corresponde a linfoma difuso de células B grandes (LDCBG. El objetivo de este estudio es identificar algunas características socio-demográficas de los pacientes con linfomas extranodales residentes en el Área Metropolitana de Bucaramanga (AMB, así como otras características propias de los LEN. Metodología: Usando los datos recolectados en el RPC – AMB se calcularon frecuencias de algunas variables (sexo, edad, localización anatómica, tipo histopatológico de los LEN. Resultados: entre los años 2000-2004 se detectaron 247 casos de linfomas; 72 (29% correspondieron a LEN. El 58 % de los casos ocurrieron en hombres y el 42% en mujeres. Se encontró predominio de la enfermedad en la 6a y 7a década de la vida. Los sitios de mayor presentación fueron TGI (29%, piel (14%, y tejidos blandos (14%. Las clasificaciones más frecuentes para los LEN fueron LNH – NOS (No especificado (27,7% y linfoma difuso de células B grandes (19,4%. Conclusiones: Se encontraron semejanzas en las características de los LEN-NH comparado con los datos registrados a nivel mundial. Es necesario promover la implementación de métodos diagnósticos avanzados para este tipo de neoplasias. [Uribe CJ, García CA, Meza EE, Camacho RM, Acevedo DJ. Linfomas extranodales en el Área Metropolitana de Bucaramanga: 2000-2004. MedUNAB 2009; 12:19-21].

  6. Iatrogenic intravascular pneumocephalus secondary to intravenous catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Yildiz, Altan; Oezer, Caner; Egilmez, Hulusi; Duce, Meltem Nass; Apaydin, Demir F.; Yalcinoglu, Orhan [Department of Radiology, Faculty of Medicine, Mersin University (Turkey)

    2002-03-01

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

  7. Linfoma B difuso de células grandes en ovario: presentación de un caso

    OpenAIRE

    Abulhaj Martínez,Mariam; Alayón Hernández,Nicolás; Sotelo Avilés,Rafael; Arévalo Reyes,Encarnación; Caba Molina,Mercedes; Gómez Morales,Mercedes

    2013-01-01

    El linfoma B difuso de células grandes es un linfoma no Hodgkin de fenotipo B y gran agresividad, con una diseminación a ovario del 7%. Su presentación de forma primaria en ovario es muy poco común, representando el 0,5% de todos los linfomas no Hodgkin y el 1,5% de todos los tumores de ovario. En este caso se presenta una paciente con clínica de dolor y distensión abdominal con una masa pélvica palpable, estableciéndose posteriormente el diagnóstico de linfoma B difuso de células grandes bil...

  8. Intravascular Stenting in Microvascular Anastomoses

    DEFF Research Database (Denmark)

    Assersen, Kristine; Sørensen, Jens

    2015-01-01

    Background The effect of intravascular stenting (IVaS) on microvascular anastomoses has given adverse results. For experienced microsurgeons the benefit of IVaS is doubtful. We have investigated the potential benefit of the IVaS technique for two groups of inexperienced microsurgeons with different...... surgical levels of experience (medical students and young residents). Experienced microsurgeons acted as a control group. Materials and Methods In an experimental crossover study, 139 microsurgical anastomoses were performed on the femoral artery in 70 rats by 10 surgeons. On one side of the rat, the IVaS...... spent on the anastomosis. Results No significant difference in patency rates was seen between the stenting and conventional technique in all three groups. The experienced microsurgeons had 100% patency rate with both techniques. The medical students had 20/28 in the IVaS and 19/28 conventional group...

  9. Obstetrical disseminated intravascular coagulation score.

    Science.gov (United States)

    Kobayashi, Takao

    2014-06-01

    Obstetrical disseminated intravascular coagulation (DIC) is usually a very acute, serious complication of pregnancy. The obstetrical DIC score helps with making a prompt diagnosis and starting treatment early. This DIC score, in which higher scores are given for clinical parameters rather than for laboratory parameters, has three components: (i) the underlying diseases; (ii) the clinical symptoms; and (iii) the laboratory findings (coagulation tests). It is justifiably appropriate to initiate therapy for DIC when the obstetrical DIC score reaches 8 points or more before obtaining the results of coagulation tests. Improvement of blood coagulation tests and clinical symptoms are essential to the efficacy evaluation for treatment after a diagnosis of obstetrical DIC. Therefore, the efficacy evaluation criteria for obstetrical DIC are also defined to enable follow-up of the clinical efficacy of DIC therapy.

  10. Treatment of Disseminated Intravascular Coagulation.

    Science.gov (United States)

    Makruasi, Nisa

    2015-11-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic activation of blood coagulation, generation of thrombin, and leading to disturbance of the microvasculature. In this article, definition and diagnostic criteria of DIC depend on the International Society of Thrombosis and Haemostasis (ISTH). There is no gold standard for diagnosis of DIC, only low quality evidence is used in general practice. Many diagnostic tests and repeated measurement are required. For the treatment of DIC, there is no good quality evidence. The most important treatment for DIC is the specific treatment of the conditions associated DIC. Platelets and/or plasma transfusion may be also necessary if indicated. Nevertheless, there is no gold standard for diagnosis and treatment of DIC, we use only low quality evidence in general practice.

  11. Experience with intravascular lead extraction

    Institute of Scientific and Technical Information of China (English)

    MA Jian; TANG Kai; WANG Fang-zheng; ZHANG Shu; HUANG Cong-xin

    2005-01-01

    @@ With the increase of clinical use of cardiac pacemaker, a certain kinds of severe leads-related complications (especially infection) have presented in a few patients who underwent pacemaker implantation. The best way to manage this problem is to remove the transvenous leads.1,2 The technique for percutaneous removal of transvenous leads have undergone considerable development in western countries over the past 2 decades. However, there was scarce data on the application of this technique in China. This article reports the results of transvenous extraction of 171 permanent pacemaker leads with the standard lead extraction devices and intravascular countertraction technique during the period from January 1996 to May 2005 in the Center of Arrhythmia Diagnosis and Treatment, Fu Wai Hospital, Beijing, China.

  12. Improcedencia del control represivo de constitucionalidad de tratados internacionales

    OpenAIRE

    Miriam Lorena Henríquez Viñas

    2007-01-01

    La autora analiza la situación de los tratados internacionales cuando ya han ingresado al ordenamiento jurídico. Considerando los argumentos que le permiten concluir la inconveniencia de un control reparador de tratados internacionales.

  13. Epidemiología del linfoma con compromiso de cabeza y cuello en el Centro Asistencial Sótero del Río

    OpenAIRE

    García M,Raimundo; Fernández G,Roberto; González E,Rubén

    2011-01-01

    Introducción: Los linfomas son la neoplasia hematológica más frecuente del adulto, ocupando el tercer lugar de las neoplasias de cabeza y cuello (CyC). Se distinguen dos tipos, el linfoma de Hodgkin (LH) y el linfoma no Hodgkin (LNH), constituyendo dos entidades clínicas separadas. Objetivo: Evaluar las manifestaciones de los linfomas en la región de CyC, analizando las diferencias de presentación y comportamiento entre en LH y el LNH. Material y método: Estudio retrospectivo de todos los cas...

  14. Linfomas de la órbita y anexos oculares: Correlación clínico patológica de 25 casos

    Directory of Open Access Journals (Sweden)

    Erica A. Rojas Bilbao

    2010-08-01

    Full Text Available Se evaluaron las características clínicas, histológicas y la evolución de una cohorte de pacientes con linfomas de la órbita y anexos oculares. Entre 1995 y 2008 se estudiaron 25 casos de linfomas de la órbita y anexos oculares en un centro oncológico de referencia. En cada caso se analizó el inmunofenotipo usando un panel de anticuerpos monoclonales (CD45, CD20, CD3, CD5, CD23, BCL2, BCL6, BCL10, Ki67, CD30, CD15, BCL1, Kappa, Lambda, CD138. Las lesiones fueron evaluadas utilizando el sistema de clasificación de linfomas (OMS, 2008. Se analizaron 23 linfomas primarios y dos secundarios. Los subtipos histológicos fueron: 16 linfomas B de la zona marginal asociados a las mucosas (MALT, cuatro linfomas difusos de células grandes B, dos linfomas foliculares y un paciente con linfoma Hodgkin. De los 25 casos estudiados, 22 presentaron estadios localizados. El linfoma MALT fue el subtipo más frecuente. En este estudio se observó enfermedad localizada en la mayoría de los casos y con baja progresión a distancia.

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

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Laelia Pumilla Botelho

    2000-03-01

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

  16. Coagulación intravascular diseminada = Disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Arango Barrientos, Marcos

    2010-12-01

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

  17. Linfoma não Hodgkin simulando hanseníase virchowiana

    OpenAIRE

    Rocha Vanessa Barreto; Carvalho Saôny Victor de; Araújo Marcelo Grossi; Guedes Antônio Carlos Martins

    2003-01-01

    Os autores relatam caso de linfoma não Hodgkin em paciente do sexo feminino, de 28 anos, ressaltando o diagnóstico diferencial com formas multibacilares de hanseníase. Além de achados clínicos passíveis de confusão, a histologia mostrava, de modo não usual, infiltrado inflamatório mononuclear perineural e perianexial.

  18. Granuloma anular asociado a linfoma no Hodgkim difuso de células B grandes

    Directory of Open Access Journals (Sweden)

    Rafael Alejandro Gómez Baute

    2011-08-01

    Full Text Available Se presenta el caso de un paciente de 55 años con antecedentes de ser hipertenso controlado, atendido en servicio de hematología por adenopatías de características linfomatosas distribuidas en cadenas ganglionares, axilares, inguinales y epitrocleares distribuidas de forma bilateral. Los exámenes permitieron arribar al diagnóstico de un linfoma no Hogdkin difuso de células B grandes y de un granuloma anular.

  19. [A method for studying intravascular platelet aggregation in vitro].

    Science.gov (United States)

    Ikonnikova, E I; Chernousova, L A; Moshkina, I R

    1999-06-01

    A simple available method for evaluating intravascular platelet aggregation is proposed. It consists in graphic recording of disaggregation of platelet-rich citrate plasma, which indicates the degree of intravascular aggregation. Intravascular aggregation is notably increased in coronary patients and negligible in normal subjects. The method may be used for the diagnosis of diseases with a high thrombogenic risk.

  20. Abscesso cerebelar tratado clinicamente: relato de caso

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    Vialogo Josué Guimarães Granha

    2001-01-01

    Full Text Available Apresentamos um caso de abscesso cerebelar secundário a otite média crônica, localizado no hemisfério cerebelar direito, em uma paciente pediátrica, que foi tratado clinicamente. Obtendo resolução sem necessidade de cirurgia. A antibioticoterapia foi escolhida segundo critérios da literatura para os agentes etiológicos mais prováveis. Discutimos a patogênese, histopatogênese, o quadro clínico, o diagnóstico e as formas de tratamento dos abscessos do sistema nervoso central.

  1. Image and Signal Processing in Intravascular Ultrasound

    NARCIS (Netherlands)

    W. Li (Wenguang)

    1997-01-01

    textabstractIntravascular ultrasound (rvUS) is a new imaging mOdality providing real-time, crosssectional, high-resolution images of the arterial lumen and vessel wall. In contrast to conventional x-ray angiography that only displays silhouette views of the vessel lumen, IVUS imaging permits visuali

  2. Las Historias de un Tratado Comercial

    Directory of Open Access Journals (Sweden)

    Sofía JASO GARCÍA

    2009-11-01

    Full Text Available RESUMEN: ¿Cuáles son las razones que han favorecido un tratado de libre comercio en América del Norte? El artículo sugiere algunos de los intereses políticos y económicos inmersos en la negociacián. Como Canadá ya tiene su propio acuerdo con los Estados Unidos, su objetivo fundamental será evitar que México logre beneficios que pudieran perjudicarle. Para México, por su parte, el tratado puede ser la alternativa para recuperar el crecimiento económico, mientras que para Estados Unidos es una opción para mantener su competitividad frente a Europa y el Sudeste Asiático, y para reorientar sus relaciones con América Latina.ABSTRACT: Which are the reasons that are leading to a free-trade treaty in North America? The article suggests some economical and political interests involved in the negociation. As Canada has it's own agreement with the US, it would try to be ahead of Mexican benefits in the dkaL From Mexico's viewpoint, the treaty may be the alternative to restore economical growth, and for the US, it could be an option to mantain it's competitiveness against Europe and Southern Asia, and to reorientate it's relations with Latin America.

  3. Linfoma no Hodgkin primario de sistema nervioso central en un paciente pediátrico sin inmunodeficiencia relacionada

    OpenAIRE

    Rocío Cárdenas-Cardos; Marco Rodrigo Aguilar-Ortiz; Liliana Velasco-Hidalgo; Pedro Mario Pasquel García-Vázquez; Roberto Rivera-Luna; Alfonso Marhx-Bracho

    2015-01-01

    El linfoma no Hodgkin primario de sistema nervioso central es una afección poco frecuente en la población pediátrica. No existen (o son pocas) las recomendaciones o estudios clínicos que sean útiles para definir la mejor opción terapéutica. El objetivo de este trabajo es describir el caso de una niña con linfoma primario de sistema nervioso central, sin ninguna inmunodeficiencia asociada, y realizar de una revisión cualitativa de la literatura especializada sobre esta enfermedad en niños. ...

  4. Utilidad de la gammagrafía con Ga 67 en el seguimiento de pacientes con linfoma: Reporte preliminar

    OpenAIRE

    Saavedra, Patricia; Cano, Roque; Morales, Rosanna; Sánchez, Rolando; Muñoz, Luis; Gómez, Henry; Carracedo, Carlos; León, Luis; Vallejos, Carlos; Casanova, Luis; Guerrero,Jorge; Cisneros, Félix

    2005-01-01

    El objetivo del estudio fue determinar la utilidad de la gammagrafía con galio 67 en la valoración de respuesta al tratamiento en pacientes con Enfermedad de Hodgkin o con Linfoma No Hodgkin. Entre marzo del 2003 y junio del 2004, se evaluaron a 21 pacientes entre 15 y 72 años con Linfoma non Hodgkin (08 pacientes) y Enfermedad de Hodgkin (13 pacientes). De los 21 rastreos corporales con galio 67 realizados, 14 fueron considerados negativos y 07 positivos, teniéndose un caso falso negativo ...

  5. Mapping intravascular ultrasound controversies in interventional cardiology practice.

    Directory of Open Access Journals (Sweden)

    David Maresca

    Full Text Available Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with

  6. Aportación al conocimiento clínico y prosnóstico de los Linfomas de Cabeza y Cuello

    OpenAIRE

    Gómez Gómez, Mª José

    2015-01-01

    Los linfomas son neoplasias del sistema linforreticular que asientan preferentemente en los ganglios linfáticos. Representan aproximadamente el 5% de todas las neoplasias malignas que se pueden desarrollar en la región anatómica de la cabeza y cuello. En general los Linfomas no Hodgkin son más frecuentes que los Hodgkin y suponen el 88% de todos los linfomas. En términos generales el modo de presentación más frecuente y común de estos tumores en esta región anatómica es la aparición de ad...

  7. Insuficiência renal aguda como manifestação inicial de linfoma de Burkitt renal

    OpenAIRE

    Carvalho,José Gastão Rocha de; Tafarel,Jean Rodrigo; Carvalho,Wilson Beleski de; Azambuja,Ana Paula; Zenaro,Elicéia Soraia; Bendlin, Rodrigo

    2006-01-01

    Relatamos o caso de um jovem de 14 anos que procurou atendimento médico por edema e hipertensão, sendo insuficiência renal aguda secundária a linfoma de Burkitt renal diagnosticada após avaliação laboratorial, de imagem e biópsia de massa tumoral renal.

  8. Linfoma no Hodgkin primario de sistema nervioso central en un paciente pediátrico sin inmunodeficiencia relacionada

    Directory of Open Access Journals (Sweden)

    Rocío Cárdenas-Cardos

    2015-10-01

    Full Text Available El linfoma no Hodgkin primario de sistema nervioso central es una afección poco frecuente en la población pediátrica. No existen (o son pocas las recomendaciones o estudios clínicos que sean útiles para definir la mejor opción terapéutica. El objetivo de este trabajo es describir el caso de una niña con linfoma primario de sistema nervioso central, sin ninguna inmunodeficiencia asociada, y realizar de una revisión cualitativa de la literatura especializada sobre esta enfermedad en niños. Se ha postulado la posibilidad de cambios citogenéticos que pudieran explicar la heterogeneidad en el comportamiento de esta enfermedad pues se ha visto que es distinto al de otros linfomas en presentaciones habituales. La experiencia de tratamiento en niños con linfoma se basa en resultados de tratamientos obtenidos en pacientes adultos, con regímenes basados principalmente en antimetabolitos como metotrexato y citarabina. Aún es controvertida la utilidad de la radioterapia craneal, la cual sólo se recomienda en casos específicos.

  9. Temporary intravascular shunts for peripheral vascular trauma.

    Directory of Open Access Journals (Sweden)

    Husain A

    1992-04-01

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

  10. [Disseminated intravascular coagulation in solid tumours].

    Science.gov (United States)

    Ferrand, François Régis; Garcia-Hejl, Carine; Moussaid, Yassine; Schernberg, Antoine; Bidard, François-Clément; Pavic, Michel; Khenifer, Safia; Stoclin, Annabelle

    2014-06-01

    Disseminated intravascular coagulation (DIC) is a complex abnormality of hemostasis with dramatic consequences and long described as associated with tumors. Yet the diagnosis and management of paraneoplastic DIC are poorly defined. The purpose of this paper is to review DIC associated with solid tumors, at the pathophysiological and therapeutic levels in particular. We also report data from a recent retrospective series of patients with DIC in the context of a solid tumor, to illustrate the epidemiological, clinical and prognostic.

  11. Diagnosis and treatment of disseminated intravascular coagulation.

    Science.gov (United States)

    Levi, M

    2014-06-01

    Disseminated intravascular coagulation (DIC) is a condition in which systemic activation of coagulation without a specific localization occurs, resulting in extensive formation of intravascular fibrin, particularly in small and midsize vessels. Disseminated intravascular coagulation may lead to several altered coagulation parameters, including a low platelet count, abnormal global clotting assays, low levels of physiological anticoagulant proteases, or increased fibrin degradation products. Also, more complex assays for activation of coagulation factors or pathways may indicate involvement of these molecules in DIC. None of these tests alone, however, can accurately ascertain or rebuff a diagnosis of DIC. Nonetheless, a combination of readily available routine assays may be instrumental in establishing a diagnosis of DIC and can also be useful to point to a subset of patients with DIC that may need definite, often costly, interventions in the hemostatic system. Current insights on relevant etiological pathways that may contribute to the occurrence of DIC have led to innovative therapeutic and adjunctive approaches to patient with DIC. Management options directed at the amelioration of hemostatic activation may tentatively be indicated and were found to be advantageous in experimental and clinical investigations. These treatments encompass elimination of tissue factor-mediated thrombin generation or restitution of normal anticoagulant function.

  12. Síndrome de enmascaramiento en un paciente con un linfoma primario del sistema nervioso central

    Directory of Open Access Journals (Sweden)

    J. A. Mazzei

    2003-12-01

    Full Text Available Se describe el caso de un varón de 37 años con un linfoma primario del sistema nervioso central y con múltiples localizaciones supra e infratentoriales. El paciente presentaba manifestaciones de inflamación intraocular como expresión de su neoplasia intracraneana (síndrome de enmascaramiento y linfocitopenia con un recuento disminuido de CD4- como representación de una inmunodeficiencia cuya etiología no logramos identificar. El diagnóstico de linfoma se confirmó a través del estudio citológico del humor vítreo. El paciente falleció 10 meses después del comienzo de los síntomas.We report the case of a 37-year-old, white male with a primary central nervous system lymphoma with multiple supra and infratentorial locations. The patient developed manifestations of intraocular inflammation secondary to the intracranial neoplasm (masquerade syndrome and lymphocytopenia -with a low CD4 cell count- representing an immunodeficiency state which etiology was undiagnosed. The diagnosis of lymphoma was established by vitreous cytology. The patient died 10 months after the beginning of the symptoms.

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

    Directory of Open Access Journals (Sweden)

    C. N. Pisoni

    2003-06-01

    Full Text Available Se presenta una paciente de 36 años con diagnóstico de lupus eritematoso sistémico tratada con prednisona y ciclofosfamida que se internó por cefalea, hemiparesia y hemianestesia braquiocrural derecha de dos semanas de evolución. Se realizó una tomografía computada y una resonancia magnética nuclear de cerebro que mostraron una lesión nodular frontal izquierda. Se efectuó una biopsia a cielo abierto de la lesión cerebral cuyo diagnóstico histopatológico fue linfoma B de celulas grandes, difuso. Se inició radioterapia, no completó el tratamiento por complicaciones y falleció. Son muy pocos los casos publicados de linfoma primario del sistema nervioso central asociado a lupus eritematoso sistémico.A 36 year-old woman with systemic lupus erythematosus was admitted to our hospital with headache, brachiocrural hemiparesis and hemianesthesia. She had been treated with prednisone and cyclophosphamide. CT scan and MRI revealed a 15 mm nodular mass enhanced with gadolinium in left frontal convexity. CNS biopsy was performed and a diffuse large B-cell lymphoma was diagnosed. She was treated with radiation therapy without response and died. There are few reports of erythematosus systemic lupus associated with primary central nervous system lymphoma.

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

    Directory of Open Access Journals (Sweden)

    M. Romero-Gómez

    2008-03-01

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

  15. Transplante de células-tronco hematopoéticas em linfoma Hodgkin Stem cell transplantation in Hodgkin lymphoma

    Directory of Open Access Journals (Sweden)

    Rosane I. Bittencourt

    2010-05-01

    Full Text Available O linfoma Hodgkin(LH é uma malignidade hematológica que conta com um armamentário terapêutico selecionado de acordo com o estadiamento e a classificação prognóstica de cada doente. A sobrevida dos pacientes tratados para o LH clássico vem aumentando significativamente, com taxas de cura entre 80%-85%. Entretanto, 20%-25% são refratários aos tratamentos iniciais e cerca de 30% recaem após ter alcançado resposta completa. Os pacientes considerados com falha à terapia de primeira linha ainda têm uma segunda chance de cura se apresentarem quimiossensibilidade aos esquemas de salvamento, seguido por uma das modalidades de transplante de células-tronco hematopoéticas (TCTH. O TCTH autólogo representa uma estratégia atrativa para os pacientes com LH que falham ao tratamento convencional de primeira linha. Os resultados em termos de sobrevidas livre de doença e global são superiores aos esquemas de salvamento com quimioterapia convencional. Este procedimento tem finalidade curativa para 50% dos pacientes em segunda remissão quimiossensíveis e pode levar a remissões duráveis naqueles com mais de duas linhas de terapia. Atualmente, o TCTH alogênico, basicamente com condicionamento de intensidade reduzida (RIC, está indicado em pacientes com recaída precoce após o TCTH autólogo ou em pacientes bastante jovens com refratariedade a mais de duas linhas de tratamento convencional.Hodgkin's Lymphoma is a hematologic malignancy with a wide range of therapeutic options that must be chosen according to the stage and the prognostic classification of each patient. The overall survival of patients treated for classic Hodgkin's Lymphoma is increasing significantly, with current cure rates being between 80% and 85%. Nevertheless, 20% to 25% are refractory to the initial treatment and about 30% relapse after having reached a complete response. Patients that have failed standard therapy still have a second chance of cure if they present

  16. Burkitt-like lymphoma in an infant: a case report Linfoma burkitt-like em um lactente: relato de caso

    Directory of Open Access Journals (Sweden)

    Claudete Esteves Klumb

    2003-01-01

    Full Text Available Childhood non-Hodgkin's lymphomas, including Burkitt and Burkitt-like, are rarely diagnosed in infants. A case of B-cell lymphoma in a 13-month-old girl with extensive abdominal disease, ascites, pleural effusion, and tumor lysis syndrome is reported. Phenotypic analysis showed a germinal center B-cell phenotype, and a B-cell clonality was confirmed by polymerase chain reaction. There was no evidence of Epstein-Barr and HIV infection. The case herein reported emphasizes the need for considering the diagnosis of lymphoma even in very young children.Os linfomas não Hodgkin da infância, incluindo os linfomas de Burkitt e Burkitt-like são raros em lactentes. Um caso de linfoma não Hodgkin B em uma lactente de 13 meses de idade é descrito. Ao diagnóstico a paciente apresentava extenso comprometimento abdominal associado à ascite, derrame pleural e síndrome de lise tumoral. A análise imunofenotípica mostrou um fenótipo compatível com células linfóides oriundas do centro germinativo e a origem clonal dessas células foi demonstrada por reação em cadeia da polimerase. Não foi demonstrada associação do linfoma com infecção pelo vírus Epstein-Barr e/ou virus da imunodeficiência adquirida. O caso apresentado enfatiza a necessidade de considerar o diagnóstico de linfoma mesmo em lactentes.

  17. Linfoma T intestinal monomórfico CD56+. Primer caso informado en Colombia y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Diana Lucía Martínez-Baquero

    2015-01-01

    Full Text Available Se informa el caso de una mujer de 80 años con hallazgo incidental de masa abdominal en mesogastrio. Se le realiza resección de intestino delgado por sospecha de absceso con síndrome adherencial. El estudio patológico de la pieza quirúrgica demostró compromiso por linfoma no Hodgkin T monomórfico CD56+. Los linfomas T del tubo digestivo son inusuales; corresponden al 5% de las neoplasias linfoides de esta localización. El linfoma intestinal T monomórfico CD56+ corresponde a 10-20% de los linfomas T intestinales. Se presenta en regiones donde la enfermedad celiaca es infrecuente y no se asocia a enteropatía. Su curso es agresivo y habitualmente se manifiesta como una emergencia quirúrgica por obstrucción o perforación intestinal.

  18. Análise de achados de imagem e alterações clínicas em pacientes com linfoma

    Directory of Open Access Journals (Sweden)

    Caldas Flávio Augusto Ataliba

    2002-01-01

    Full Text Available A tomografia computadorizada é atualmente o estudo de imagem de escolha para a detecção e estadiamento de linfomas. A tomografia computadorizada é capaz de mensurar com acurácia significativa a extensão e o volume do tumor e prover informações que possam ser usadas para planejar uma estratégia terapêutica apropriada. O presente trabalho teve como objetivo descrever e analisar os achados de imagem obtidos por meio de tomografia computadorizada de tórax e abdome, acompanhada de ultra-sonografia de abdome total de pacientes com diagnóstico de linfoma e com sorologia negativa para o vírus HIV, alterações clínicas, como a queixa que levou o paciente a procurar o serviço de saúde, já revelando sinais de acometimento da doença linfocitária, neste momento ainda não diagnosticada, e alterações ao exame físico nesta primeira consulta. A amostra estudada foi composta por 30 pacientes, sendo que, destes, 40% teriam o diagnóstico de linfoma não-Hodgkin, 46,6% de linfoma Hodgkin, 10% de linfoma de Burkitt e 3,3% com o diagnóstico de linfoma linfoblástico.

  19. Hypothesis: Disseminated Intravascular Inflammation as the Inflammatory Counterpart to Disseminated Intravascular Coagulation

    Science.gov (United States)

    Bull, Brian S.; Bull, Maureen H.

    1994-08-01

    We have identified a leukocyte activation syndrome that is occasionally associated with the transfusion of intraoperatively recovered erythrocytes. This syndrome appears to result from intravascular damage caused by leukocytes activated during the erythrocyte salvage process. We hypothesize that this syndrome is part of a larger disease grouping: disseminated intravascular inflammation (DII). DII is the analog of the coagulation disorder disseminated intravascular coagulation. In disseminated intravascular coagulation, the organ damage results from uncontrolled activation of the clotting pathway; in DII the damage is caused by leukocytes that have become activated by direct contact with bacteria or in rare instances-such as erythrocyte salvage-in the absence of bacteria and bacterial products. Recent studies of the hazards associated with intraoperative blood salvage indicate that activation of leukocytes can be achieved by exposure to activated platelets alone. If such activated leukocytes are reinfused along with the washed erythrocytes, widespread organ damage may result. The lung is the organ most severely affected by activated leukocytes. Adult respiratory distress syndrome is one outcome. It is likely that DII is a presently unrecognized pathophysiological process that complicates a variety of primary disease states and increases their lethality.

  20. The Diagnosis and Man Disseminated Intravascular Coagulation

    Institute of Scientific and Technical Information of China (English)

    Flelcher B.; Taylor.Jr

    2003-01-01

    @@ This review describes disseminated intravascular coagulation(DIC) as a syndrome in which hemostatic factors are activated and products are generated. This syndrome ranges in severity from an obvious decompensated coagulopathy (overt-DIC) to the subclinical compensated activation of hemostatic factors(non-overt DIC). Ths first part of this review emphasizes two points: First, activation of the hemostatic system is controlled by a vast network of capillaries and venules through anticoagulant and antiinflammatory regulatory factors that operate from the endothelium( e. G. , protein C and thrombomodulin, tissue factor pathway inhibitor).

  1. Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice

    NARCIS (Netherlands)

    Maresca, D.; Adams, S.; Maresca, B.; Van der Steen, A.F.W.

    2014-01-01

    Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innova

  2. Hallazgo casual de un linfoma no Hodgkin en la base de la lengua

    OpenAIRE

    Tavárez Rodríguez, Juan José; Benito Orejas, José Ignacio; Morais Pérez, Darío; Trueba Arguiñarena, Javier

    2013-01-01

    [ES] Presentamos el caso clínico de un varón de 65 años, al que descubrimos de forma casual una tumoración submucosa en la amígdala lingual, cuyo diagnóstico pudo realizarse mediante una punción/biopsia con aguja gruesa guiada por ecografía. La evaluación anatomo-patológica demostraba la existencia de un linfoma no Hodgkin de fenotipo B. El estudio de extensión clasificaba al proceso de Estadio I-A y el tratamiento inicial fue con radioterapia local.Justifican esta publicación, el escaso núme...

  3. Granuloma anular asociado a linfoma no Hodgkim difuso de células B grandes

    Directory of Open Access Journals (Sweden)

    Liermis M. Dita Salabert

    2011-12-01

    Full Text Available Se presenta el caso de un paciente de 55 años con antecedentes de ser hipertenso controlado, atendido en servicio de hematología por adenopatías de características linfomatosas distribuidas en cadenas ganglionares, axilares, inguinales y epitrocleares distribuidas de forma bilateral. Los exámenes permitieron arribar al diagnóstico de un linfoma no Hogdkin difuso de células B grandes y de un granuloma anular.Granuloma Annulare Associated with non Hodgkin Diffuse Large B-cell LymphomaThe case of a male, 55 years old patient, with a history of controlled hypertension is presented. The patient was treated in the hematology service for adenopathies of lymphomatous type distributed in nodal chains: axillary, inguinal and epitrochlear and bilaterally distributed. Tests allowed to conclude a final diagnose of non Hodgkin diffuse large B-cell lymphoma and a granuloma annulare.  

  4. Linfoma no Hodgkin de presentación ósea. Reporte de un caso.

    OpenAIRE

    2012-01-01

    Se describe el caso de un varón de 15 años con cuadro clínico caracterizado por dolor y aumento de volumen de la rodilla derecha, fiebre, diaforesis, cefalea, ganglios palpables y pérdida de peso. En la radiografía y RMN de rodilla se encontró acentuada alteración de la epífisis y metáfisis proximal de la tibia y de la metáfisis distal del fémur. La biopsia e inmunohistoquímica fueron compatibles con linfoma no-Hodgkin difuso de células grandes B.

  5. Pulsed liquid microjet for intravascular injection

    Science.gov (United States)

    Palanker, Daniel V.; Fletcher, Daniel A.; Miller, Jason; Huie, Philip; Marmor, Michael; Blumenkranz, Mark S.

    2002-06-01

    Occlusions of the retinal veins and arteries are associated with common diseases such as hypertension and arteriosclerosis and usually cause severe and irreversible loss of vision. Treatments for these vascular diseases have been unsatisfactory to date in part because of the difficulty of delivering thrombolytic drugs locally within the eye. In this article we describe a pulsed liquid microjet for minimally invasive intra-vascular drug delivery. The microjet is driven by a vapor bubble following an explosive evaporation of saline, produced by a microsecond-long electric discharge in front of the 25 micrometers electrode inside the micronozzle. Expansion of the transient vapor bubble produces a water jet with a diameter equal to the diameter of the nozzle, and with a velocity and duration that are controlled by the pulse energy. We found that fluid could be injected through the wall of a 60-micrometers -diameter artery in choriallantoic membrane using a 15-micrometers diameter liquid jet traveling at more than 60 m/s. Histological analysis of these arteries showed that the width of the perforation is limited to the diameter of the micronozzle, and the penetration depth of the jet is controlled by the discharge energy. The pulsed liquid microjet offers a promising technique for precise and needle-free intravascular delivery of thrombolytic drugs for localized treatment of retinal vascular occlusions.

  6. Fast integrated intravascular photoacoustic/ultrasound catheter

    Science.gov (United States)

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

    2016-03-01

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

  7. Esquistossomose: 1.000 pacientes tratados

    Directory of Open Access Journals (Sweden)

    Pedro Aquino Noleto

    1974-12-01

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

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

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    Marcelo Corti

    2007-06-01

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

  9. Linfoma T tipo paniculitis en paciente con lupus cutáneo discoide crónico

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    Lucía Alvela-Suárez

    2012-03-01

    Full Text Available Presentamos el caso de un paciente diagnosticado de lupus discoide crónico que, tras un episodio de paniculitis lúpica, presentó lesiones desimilares características que, una vez biopsiadas, fueron compatibles conun linfoma T cutáneo tipo paniculitis. El diagnóstico diferencial entre estasdos entidades es, en ocasiones, complejo y algunos autores defienden que se trata de diferentes formas de la misma entidad.

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

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    Marcelo Corti

    2005-08-01

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

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

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    Marcelo Graziadio

    2012-10-01

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

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

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    Maria Christina Lopes Araujo de Oliveira

    2011-08-01

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

  13. Intravascular ultrasound for angiographically indeterminant left main coronary artery disease.

    Science.gov (United States)

    Parashara, D K; Jacobs, L E; Ledley, G S; Yazdanfar, S; Oline, J; Kotler, M N

    1994-01-01

    The precise diagnosis of the presence of significant left main coronary artery disease has profound prognostic and therapeutic implications. Coronary cineangiography has shown to be imprecise and inaccurate to determine the percent stenosis of the left main coronary artery. We report a case with significant left main coronary artery disease in whom coronary cineangiography was in discordance with the clinical data and intravascular ultrasonography. Based on the intravascular ultrasound findings, the patient underwent coronary artery bypass graft surgery. Therefore, the intravascular ultrasonography may be the procedure of choice for assessing indeterminant left main coronary artery lesions by coronary angiography.

  14. Quinine-Induced Disseminated Intravascular Coagulation

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    Firas Abed

    2016-01-01

    Full Text Available Every drug comes with some side effect. It is the benefit/risk ratio that determines the medical use of the drug. Quinine, a known antimalarial drug, has been used for nocturnal leg cramps since the 1930s; it is associated with severe life-threatening hematological and cardiovascular side effects. Disseminated intravascular coagulation (DIC, albeit rare, is a known coagulopathy associated with Quinine. It is imperative to inquire about the Quinine intake in medication history in patients with coagulopathy, as most patients still consider it a harmless home remedy for nocturnal leg cramps. In this report, we present a case of coagulopathy in a middle-aged woman, who gave a history of taking Quinine for nocturnal leg cramps, as her home remedy. Early identification of the offending agent led to the diagnosis, prompt discontinuation of the medication, and complete recovery and prevented the future possibility of recurrence.

  15. Intravascular Ultrasound Image Segmentation Using Morphological Snakes

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    Hamdi Mohamed Ali

    2012-06-01

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

  16. Ventricular metastasis resulting in disseminated intravascular coagulation

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    Davis Ian D

    2005-05-01

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

  17. [Disseminated intravascular coagulation: clinical and biological diagnosis].

    Science.gov (United States)

    Touaoussa, Aziz; El Youssi, Hind; El Hassani, Imane; Hanouf, Daham; El Bergui, Imane; Zoulati, Ghizlane; Amrani Hassani, Moncef

    2015-01-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by the systemic activation of blood coagulation. Its pathophysiological mechanisms are complex and dependent on the underlying pathology, making the clinical and biological expression of quite variable DIC. Among the various biological parameters disrupted, most are not specific, and none of them allows in itself to make the diagnosis. All this does not facilitate the task of the practitioner for diagnosis of overt DIC, much less that of the non-overt DIC, early stage whose treatment would improve the prognosis. These considerations have led to develop scores, combining several parameters depending on their availability in daily practice, as well as their diagnostic relevance. Of all the scores, the ISTH (International society of thrombosis and hemostasis) remains the most used.

  18. Disseminated intravascular coagulation in burn injury.

    Science.gov (United States)

    Lippi, Giuseppe; Ippolito, Luigi; Cervellin, Gianfranco

    2010-06-01

    Disseminated intravascular coagulation (DIC) is a complex and multifaceted disorder characterized by the activation of coagulation and fibrinolytic pathways, consumption of coagulation factors, and depletion of coagulation regulatory proteins. The introduction into the circulation of cellular debris characterized by strong thromboplastic activity due to tissue factor exposition or release (in or from burned tissues), which can thereby activate extrinsic pathway of coagulation system and trigger massive thrombin generation when present in sufficient concentration, represents the most plausible biological explanation to support the development of intravascular coagulation in patients with burn injury. Severe burns left untreated might also lead to an immunological and inflammatory response (activation of the complement cascade), which can amplify fibrinolysis and blood clotting. Overall, the real prevalence of DIC in patients with burns is as yet unclear. Postmortem, retrospective, and even longitudinal investigations are in fact biased by several factors, such as the objective difficulty to establish whether DIC might have occurred as a primary complication of burns or rather as a consequence of other superimposed pathologies (e.g., sepsis, multiple organ failure), the different diagnostic criteria for assessing DIC, and the heterogeneity of the patient samples studied. Nevertheless, the current scientific evidence is consistent with the hypothesis that biochemical changes suggestive for DIC (hypercoagulability, hypo- and hyperfibrinolysis) are commonplace in patients with burn trauma, and their severity increases exponentially with the severity of injury. Overt DIC seems to occur especially in critically ill burn patients or in those with severe burns (up to third degree) and large involvement of body surface area, in whom an appropriate therapy might be effective to prevent the otherwise fulminant course. Although early prophylaxis with antithrombin concentrates

  19. Control de constitucionalidad de los tratados internacionales en Colombia

    OpenAIRE

    Hernán Alejandro Olano García

    2006-01-01

    El autor presenta un trabajo con los aspectos más destacados de la jurisprudencia de la Corte Constitucional colombiana en torno al control jurisdiccional de constitucionalidad de los tratados públicos internacionales, la cual es previa al canje de instrumentos de ratificación, automática, puesto que en caso de no enviarse a la Corte ésta conoce directamente, ya que el control comprende la revisión constitucional del tratado y de su ley aprobatoria.

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

    Directory of Open Access Journals (Sweden)

    R. Molina Villaverde

    2008-03-01

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

  1. Subharmonic Contrast Intravascular Ultrasound for Vasa Vasorum Imaging

    NARCIS (Netherlands)

    Goertz, David E.; Frijlink, Martijn E.; Tempel, Dennie; Bhagwandas, Vijay; Gisolf, Andries; Krams, Robert; Jong, de Nico; Steen, van der Antonius F.W.

    2007-01-01

    The feasibility of subharmonic contrast intravascular ultrasound (IVUS) imaging was investigated using a prototype nonlinear IVUS system and the commercial contrast agent Definity™. The system employed a mechanically scanned commercial catheter with a custom transducer element fabricated to have sen

  2. Linfomas plasmoblásticos del tracto gastrointestinal en pacientes con sida

    Directory of Open Access Journals (Sweden)

    Alejandro Avilés-Salas

    2011-12-01

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

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

    Directory of Open Access Journals (Sweden)

    A. Torre Iturraspe

    2005-04-01

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

  4. Esquistossomose: 1.000 pacientes tratados

    Directory of Open Access Journals (Sweden)

    Pedro Aquino Noleto

    1974-12-01

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

  5. La Salud y el Tratado de Libre Comercio (TLC.

    Directory of Open Access Journals (Sweden)

    Gustavo Malagón Londoño

    2004-09-01

    Se pregunta uno si con el espectro proyectado las pretensiones de obligar a normas rígidas de patentes, propiedad intelectual y otras inherentes se lograría un tratado justo o mas bien se agravaría la situación de los países en serios problemas actualmente...

  6. Intravascular Large B-Cell Lymphoma

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    Maria S. Khan MD, FACP

    2014-03-01

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

  7. Intravascular probe for detection of vulnerable plaque

    Science.gov (United States)

    Patt, Bradley E.; Iwanczyk, Jan S.; MacDonald, Lawrence R.; Yamaguchi, Yuko; Tull, Carolyn R.; Janecek, Martin; Hoffman, Edward J.; Strauss, H. William; Tsugita, Ross; Ghazarossian, Vartan

    2001-12-01

    Coronary angiography is unable to define the status of the atheroma, and only measures the luminal dimensions of the blood vessel, without providing information about plaque content. Up to 70% of heart attacks are caused by minimally obstructive vulnerable plaques, which are too small to be detected adequately by angiography. We have developed an intravascular imaging detector to identify vulnerable coronary artery plaques. The detector works by sensing beta or conversion electron radiotracer emissions from plaque-binding radiotracers. The device overcomes the technical constraints of size, sensitivity and conformance to the intravascular environment. The detector at the distal end of the catheter uses six 7mm long by 0.5mm diameter scintillation fibers coupled to 1.5m long plastic fibers. The fibers are offset from each other longitudinally by 6mm and arranged spirally around a guide wire in the catheter. At the proximal end of the catheter the optical fibers are coupled to an interface box with a snap on connector. The interface box contains a position sensitive photomultiplier tube (PSPMT) to decode the individual fibers. The whole detector assembly fits into an 8-French (2.7 mm in diameter) catheter. The PSPMT image is further decoded with software to give a linear image, the total instantaneous count rate and an audio output whose tone corresponds to the count rate. The device was tested with F-18 and Tl-204 sources. Spectrometric response, spatial resolution, sensitivity and beta to background ratio were measured. System resolution is 6 mm and the sensitivity is >500 cps / micrometers Ci when the source is 1 mm from the detector. The beta to background ratio was 11.2 for F-18 measured on a single fiber. The current device will lead to a system allowing imaging of labeled vulnerable plaque in coronary arteries. This type of signature is expected to enable targeted and cost effective therapies to prevent acute coronary artery diseases such as: unstable angina

  8. Laboratory testing in disseminated intravascular coagulation.

    Science.gov (United States)

    Favaloro, Emmanuel J

    2010-06-01

    The diagnosis of disseminated intravascular coagulation (DIC) relies on clinical signs and symptoms, identification of the underlying disease, the results of laboratory testing, and differentiation from other pathologies. The clinical features mainly depend on the underlying cause of the DIC. The laboratory diagnosis of DIC uses a combination of tests because no single test result alone can firmly establish or rule out the diagnosis. Global tests of hemostasis may initially provide evidence of coagulation activation and later in the process provide evidence of consumption of coagulation factors, but their individual diagnostic efficiency is limited. Fibrinolytic markers, in particular D-dimer, are reflective of activation of both coagulation and fibrinolysis, so that a normal finding can be useful for ruling-out DIC. Decreased levels of the natural anticoagulants (in particular, antithrombin and protein C) are frequently observed in patients with DIC, but their measurement is not normally incorporated into standard diagnostic algorithms. New tests are being explored for utility in DIC, and some additional tests may be useful on a case-by-case basis, depending on the proposed cause of the DIC or their local availability. For example, clot waveform analysis is useful but currently limited to a single instrument. Also, procalcitonin is an inflammatory biomarker that may be useful within the context of septic DIC, and activated factor X clotting time is an emerging test of procoagulant phospholipids that also seems to hold promise in DIC.

  9. Primary intravascular synovial sarcoma: case report.

    Science.gov (United States)

    Tuncer, Osman Nuri; Erbasan, Ozan; Golbasi, Ilhan

    2012-10-01

    Synovial sarcoma (SS), a mesenchymal spindle cell tumor, displays variable epithelial differentiation, including glandular formation, and features a specific chromosomal translocation, t(X;18)(p11;q11). SS accounts for 5% to 10% of soft-tissue sarcomas. These tumors occur mostly in the joints, especially near the knee, but they also occur in other locations. Primary intravascular SS (IVSS) are extremely rare; only 6 well-documented cases have been reported in the English literature. We describe a new case of primary IVSS of the superior vena cava (SVC) in a 16-year-old boy. A transthoracic echocardiogram confirmed a large (4.8 × 4.6 cm) circumscribed mass filling the right atrium, as well as a moderate pericardial effusion. The mass extended from the SVC to the tricuspid valve but did not prevent valve coaptation. Surgery via a transatrial approach revealed a huge mass (8 to 12 cm) attached to the SVC via a 5-mm pedicle. The tumor was excised, and the patient experienced an uneventful postoperative course. Fluorescence in situ hybridization analysis revealed the presence of the SS-specific translocation.

  10. Carcinoma hepatocelular y linfoma folicular en paciente cirrótico por virus de la hepatitis C

    OpenAIRE

    García, L.; Boschero, F.; Río, V. del; Balbín, E.; Espeche, W.

    2016-01-01

    El virus de la hepatitis C (VHC) tiene demostrado poder oncogénico. Su asociación con Carcinoma Hepatocelular (CHC) en pacientes con cirrosis hepática es bien conocida como también con el Linfoma no Hodgkin indolente. Es poco frecuente que estas tres entidades se presenten simultáneamente. El objetivo de este reporte es describir la presentación clínica, la metodología diagnóstica y la evolución de un paciente que presentó concomitantemente infección crónica por virus C, cirrosis, hepatocarci...

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

    OpenAIRE

    Max Schindler; Nicolás Kreplak; Lucía Acevedo; Héctor Damis; Guillermo Márquez; María del Carmen Ardaiz

    2014-01-01

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

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

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    Max Schindler

    2014-02-01

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

  13. Diagnóstico inicial de Linfoma de Hodgkin en biopsias de médula ósea

    OpenAIRE

    Kitagawa, R. B.; Martín, C. A.

    2016-01-01

    El Linfoma de Hodgkin (LH) es una neoplasia maligna de células linfoides B, habitualmente originada a nivel de los ganglios linfáticos. Durante la evolución de la enfermedad puede producirse el compromiso medular, que varía del 1 al 10% según el subtipo histopatológico, siendo éste muy raro como sitio inicial de presentación. Presentamos seis casos de LH diagnosticados inicialmente en biopsias de médula ósea.

  14. Intravascular brachytherapy for peripheral vascular disease

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    Hagen, Anja

    2008-09-01

    Full Text Available Scientific background: Percutaneous transluminal angioplasties (PTA through balloon dilatation with or without stenting, i.e. vessel expansion through balloons with or without of implantation of small tubes, called stents, are used in the treatment of peripheral artery occlusive disease (PAOD. The intravascular vessel irradiation, called intravascular brachytherapy, promises a reduction in the rate of repeated stenosis (rate of restenosis after PTA. Research questions: The evaluation addresses questions on medical efficacy, cost-effectiveness as well as ethic, social and legal implications in the use of brachytherapy in PAOD patients. Methods: A systematic literature search was conducted in August 2007 in the most important medical electronic databases for publications beginning from 2002. The medical evaluation included randomized controlled trials (RCT. The information synthesis was performed using meta-analysis. Health economic modeling was performed with clinical assumptions derived from the meta-analysis and economical assumptions derived from the German Diagnosis Related Groups (G-DRG-2007. Results: Medical evaluation: Twelve publications about seven RCT on brachytherapy vs. no brachytherapy were included in the medical evaluation. Two RCT showed a significant reduction in the rate of restenosis at six and/or twelve months for brachytherapy vs. no brachytherapy after successful balloon dilatation, the relative risk in the meta-analysis was 0.62 (95% CI: 0.46 to 0.84. At five years, time to recurrence of restenosis was significantly delayed after brachytherapy. One RCT showed a significant reduction in the rate of restenosis at six months for brachytherapy vs. no brachytherapy after PTA with optional stenting, the relative risk in the meta-analysis was 0.76 (95% CI: 0.61 to 0.95. One RCT observed a significantly higher rate of late thrombotic occlusions after brachytherapy in the subgroup of stented patients. A single RCT for brachytherapy

  15. Los tratados internacionales como base de la diplomacia mundial.

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    Larys Leiba Hernández Villalobos

    2004-01-01

    Full Text Available Se presenta un análisis sobre las generalidades de los tratados internacionales: regulación jurídica, clasificación, estructura e innovaciones contempladas en la Constitución de la República Bolivariana de Venezuela (CRBV. Las fuentes documentales utilizadas se en marcan dentro del ámbito constitucional, legal y doctrinal. Se concluye que los tratados internacionales constituyen en la era actual, sin lugar a dudas, la «base de la diplomacia mundial», puesto que ayudan a que una sociedad globalizada marcada por intereses contrapuestos en el ámbito económico, político, religioso, militar, cultural, entre otros, pueda convivir conforme a un orden internacional establecido. Además, estos acuerdos contribuyen a lograr el mantenimiento de la paz, el orden público y la re;olución de conflictos internacionales.

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

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    Alexandre Caixeta Guimarães

    2012-06-01

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

  17. Las reglas de origen en los tratados de libre comercio

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    Marlon Iván Maldonado Narváez

    2014-01-01

    Full Text Available La presente revisión de los aspectos del libre comercio y las reglas de origen tiene como propósito hacer una evaluación general de los tratados de libre comercio en el ámbito colombiano, algunas de sus consecuencias y los ele- mentos que los componen, especialmente el referente al tema de las Reglas de Origen. El estudio de las Reglas de Origen, como uno de los aspectos fundamentales de las negociaciones de cualquier tratado de libre comercio, es determinante para entender si con ellas se busca proteger algún sector de la industria, o si por el contrario se establecen de manera abierta para facilitar el libre intercambio. Mediante una breve evaluación del Tratado de Libre Comercio entre Colombia y Estados Unidos, la postura asumida durante las negociaciones y los intereses de ambos países previamente a la firma del acuerdo se hace una valoración de lo riguroso que pueden ser las Reglas de Origen en dicho acuerdo.

  18. REUSO DO EFLUENTE TRATADO NA INDÚSTRIA CURTIDORA

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    Karl Heinz Luersen

    2012-05-01

    Full Text Available Com o objetivo de avaliar a possibilidade de reúso do efluente líquido tratado de uma indústria curtidora, foi realizada esta pesquisa. O procedimento experimental comparou a produção de couros confeccionados com água potável, extraída de poços artesianos, com couros produzidos a partir do efluente líquido final tratado. Para alcançar este objetivo, foram realizados testes físicos e químicos através de análises em laboratório (análises químicas e de resistências físicas e avaliações organolépticas executadas por profissionais do setor de couro (quanto a cor, firmeza de flor, enchimento e toque. A avaliação analítica e a das características organolépticas não indicam diferenças representativas quando comparadas aos padrões de referência da ABNT de couros produzidos, permitindo, assim, concluir que o reúso de efluente tratado não altera a aparência dos artigos de couro.

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

    Directory of Open Access Journals (Sweden)

    I. Venizelos

    2007-05-01

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

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

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    Arnaldo Tabares Olives

    1982-06-01

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

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

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    Bruno Correia Jham

    2007-10-01

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

  2. Linfoma primário do sistema nervoso central Primary central nervous system lymphoma

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    Marcelo Bellesso

    2008-02-01

    Full Text Available O linfoma primário do sistema nervoso central (LPSNC é um linfoma extralinfonodal que, ao diagnóstico, encontra-se restrito ao parênquima cerebral, às meninges e/ou cordão espinhal e/ou olhos. Sua incidência triplicou nas últimas três décadas para 0,4 casos por 100.000 habitantes, representando 4% dos tumores do sistema nervoso central (SNC. Embora pacientes infectados pelo HIV tenham 3.600 vezes maior risco para o desenvolvimento do LPSNC, a incidência não aumentou apenas neste grupo de pessoas. Dados sugerem reduções da incidência de LPSNC em pacientes infectados após a introdução de drogas anti-retrovirais. Cerca de 90% dos casos de LPSNC são classificados como linfoma difuso de grandes células B, 10% têm envolvimento ocular e 10% são HIV positivos. A apresentação clínica depende da localização tumoral, prevalecendo os sintomas neurológicos em detrimento aos sistêmicos. Os exames de tomografia computadorizada (TC e ressonância nuclear magnética (RNM são essenciais para o diagnóstico, porém o exame confirmatório deve ser o anatomopatológico. O estadiamento deve ser feito com exames de imagem e biópsia de medula óssea (BMO bilateral. Os principais fatores de mau prognóstico são: performance status do paciente acima de 1, idade superior a 60 anos, DHL elevada, hiperproteinorraquia e acometimento de área cerebral não hemisférica. Alguns fatores de prognóstico biológicos também podem influenciar na sobrevida, a exemplo da expressão de Bcl-6, que confere melhor prognóstico. O tratamento de escolha é a combinação de quimioterapia contendo altas doses de metotrexate e radioterapia (RDT. Devido às altas taxas de neurotoxicidade associada à RDT, seu uso tem ficado mais restrito aos pacientes idosos, e os recidivados ou refratários.Primary Central Nervous System lymphoma (PCNSL is an extranodal non-Hodgkin lymphoma in the brain, leptomeninges, spinal cord or eyes. The incidence of PCNSL increased

  3. Epidemiología y patología de la leucemia/linfoma de células T del adulto en Cali y el suroccidente colombiano.

    Directory of Open Access Journals (Sweden)

    Edwin Carrascal

    2009-11-01

    Full Text Available Introducción: Este estudio se realizó con el fin de obtener un acercamiento con la epidemiología geográfica de las neoplasias linfoide en Cali y el suroccidente colombiano, con atención especial en la leucemia linfoma de células T del adulto. Materiales y métodos: Se utilizó información del Registro Poblacional de Cáncer de Cali, de las personas con linfoma no Hodgkin y leucemia linfoides entre 1987 y 1996 procedentes de la costa pacífica. Se obtuvo material incluido en parafina de los pacientes con linfoma no Hodgkin del departamento de Patología, del Hospital Universitario del Valle, con el próposito de investigar secuencias provirales para HTLV-I usando técnicas biomoleculares. Además, se obtuvieron muestras de sangre de voluntarios nativos de Tumaco que representan niveles socioecónomicos bajo, medio y alto, y se analizaron para anticuerpos contra HTLV-I/II con una prueba de imunoabsorción ligada con enzimas (ELISA, Abbott® y confirmados por Western blot. Resultados: La tasa de incidencia global para linfoma no Hodgkin es al menos dos veces mayor para leucemias en ambos sexos y no ha mostrado cambios notables, mientras la leucemia linfoide ha aumentado en ambos sexos, de manera más notoria en mujeres. La tasa de incidencia para linfoma no Hodgkin aumenta con la edad en ambos sexos. Cinco de 75 casos de linfoma fueron positivos para secuencia de HTLV-I por PCR, en los especímenes tisulares y ninguno de los pacientes tenía prueba serológica para HTLV; 18 (5.1% de las 356 personas fueron positivas serológicamente para anticuerpos contra el HTLV-I muestreadas en Tumaco. Conclusiones: Varios casos de ATL pueden pasar desapercibidos en pacientes con linfoma no Hodgkin en quienes la asociación no había sido sospechada. La seroprevalencia de HTLV-I en Tumaco es más alta en mujeres. Merece la pena continuar investigando la intercurrencia con infecciones u otros factores medioambientales que facilitarían una progresión r

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

    OpenAIRE

    B. Madrigal; J. J. Arenal; Torres, A.; M. J. Peñarrubia; A. Vara; Ruiz, M.; Hernández, A.; P. Enríquez

    2008-01-01

    Comunicamos un caso de mucormicosis intestinal en un hombre de 46 años de edad, diagnosticado de enfermedad de Hodgkin clásica, estadio IV-B. Durante la primera fase de la quimioterapia, sufrió una hemorragia digestiva masiva secundaria a una úlcera yeyunal por zigomicosis tipo mucor, diagnosticada por biopsia endoscópica. El paciente fue tratado con antifúngicos y resección quirúrgica del intestino afectado. En la cirugía, se apreció una doble perforación yeyunal cubierta. El estudio anatomo...

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

    Directory of Open Access Journals (Sweden)

    Marchiori Edson

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    MIELLI SYLVIA REGINA

    1998-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mauro Zamboni

    2004-02-01

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

  8. 21 CFR 880.5970 - Percutaneous, implanted, long-term intravascular catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Percutaneous, implanted, long-term intravascular... and Personal Use Therapeutic Devices § 880.5970 Percutaneous, implanted, long-term intravascular catheter. (a) Identification. A percutaneous, implanted, long-term intravascular catheter is a device...

  9. 21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Subcutaneous, implanted, intravascular infusion... Hospital and Personal Use Therapeutic Devices § 880.5965 Subcutaneous, implanted, intravascular infusion port and catheter. (a) Identification. A subcutaneous, implanted, intravascular infusion port...

  10. The Present Situation on Disseminated Intravascular. Coagulation Studies

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2001-01-01

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

  11. Current concepts in the management of disseminated intravascular coagulation.

    Science.gov (United States)

    Thachil, Jecko; Toh, Cheng Hock

    2012-04-01

    Disseminated Intravascular Coagulation is a clinicopathological syndrome where widespread intravascular coagulation occurs in response to an inciting process. The pathophysiology for this disorder is complex with an important role for thrombin, the central regulator of the coagulation process. Since the clinical spectrum of DIC is variable due to its dynamic nature, the laboratory diagnosis should ideally be not based on a single marker or an isolated set of results. The treatment should primary focus on the management of the underlying triggering condition with blood products used as resuscitative measures. Newer therapeutic modalities have been recently tried with success although the management of DIC still remains a major challenge.

  12. Extremely refractory Kawasaki disease with disseminated intravascular coagulation.

    Science.gov (United States)

    Koh, Young Kwon; Lee, Jae Hee; Park, Yeong Bong

    2017-03-07

    Disseminated intravascular coagulation is a rare complication of Kawasaki disease and appears in Kawasaki disease patients. We report a case of refractory Kawasaki disease complicated with disseminated intravascular coagulation and giant coronary aneurysm. A 5-month-old boy presented with Kawasaki disease with coagulopathy. Although the coagulopathy improved after fresh-frozen plasma and antithrombin-III administration, the fever persisted despite two rounds of intravenous immunoglobulin, along with intravenous methylprednisolone pulse therapy and infliximab administration. Despite all efforts to treatment, the patient had giant coronary aneurysms and died suddenly.

  13. Tratamento do linfoma de Hodgkin após falha do transplante autólogo Treatment of Hodgkin's lymphoma after failure of autologous stem cell transplant

    Directory of Open Access Journals (Sweden)

    Fernanda M. Santos

    2008-08-01

    Full Text Available O linfoma de Hodgkin (LH é uma neoplasia do tecido linfóide de excelente prognóstico, porém, aproximadamente 15% dos pacientes em estádios precoces e 35% dos em estádios avançados progridem após o tratamento inicial. O transplante autólogo de medula óssea ou de células-tronco periféricas (ATMO é o tratamento de escolha nesses casos. Nosso estudo tem como objetivo avaliar o tipo de tratamento utilizado, a taxa de resposta e a sobrevida de pacientes recidivados ou refratários ao ATMO. De 38 pacientes com LH submetidos a ATMO entre abril de 1996 e novembro de 2005, foram avaliados 17 que apresentaram recidiva/refratariedade ao ATMO. Nesses casos, o tratamento de resgate foi individualizado, a depender das condições clínicas de cada um, sendo constituído usualmente de drogas citotóxicas não utilizadas previamente. Após o ATMO, dez (59% dos 17 pacientes obtiveram remissão completa, um (6% remissão parcial e seis (35% foram refratários. Em 14 dos 17 pacientes foi instituída quimioterapia de resgate com diversos esquemas no momento da recidiva/refratariedade após ATMO; um paciente foi tratado com radioterapia exclusiva e dois foram a óbito antes de qualquer terapia. Observamos uma taxa de resposta global de 57,4% (IC95%: 23,2 - 90,7%. A mediana da sobrevida livre de progressão foi de 19 meses e a mediana de sobrevida global foi de 32 meses. Apesar do LH recidivado/refratário ao ATMO não ser curável com os quimioterápicos atualmente disponíveis, os pacientes apresentaram longa sobrevida, com freqüentes exacerbações da doença.Hodgkin's lymphoma (HL is a lymphoid malignancy with excellent prognosis, however nearly 15% of the patients in early stages and 35% in advanced stages have progressive disease after initial treatment. Autologous bone marrow or hematopoietic stem cell transplantation (ABMT are the treatments of choice in these cases. This report presents the therapeutic approach and the outcome of HL patients who

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

    Directory of Open Access Journals (Sweden)

    J. C. Rodríguez-Sanjuán

    2006-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Abrahão E. Hallack Neto

    2006-12-01

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

  16. A Prognostic Dilemma of Basal Cell Carcinoma with Intravascular Invasion

    Science.gov (United States)

    Niumsawatt, Vachara; Castley, Andrew

    2016-01-01

    Summary: Basal cell carcinoma is the most common malignancy; however, it very rarely metastasizes. Despite the low mortality caused by this cancer, once it spreads, it has dim prognosis. We report a case of basal cell carcinoma with rare intravascular invasion and review the literature for risk factors and management of metastasis.

  17. Disseminated intravascular coagulopathy in dengue:a brief review

    Institute of Scientific and Technical Information of China (English)

    Viroj Wiwanitkit

    2009-01-01

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

  18. Detection of vascular morphology by high frequency intravascular ultrasonic imaging

    NARCIS (Netherlands)

    W.J. Gussenhoven (Wilhelmina Johanna); G.S. Madretsma (Guno); H. Pieterman; S.H.K. The (Salem); L. Wenguang; F.C. van Egmond (F.); N. Bom (Klaas)

    1991-01-01

    textabstractThis study was designed to validate the potential clinical utility of intravascular ultrasonic imaging in vitro and in vivo. In vitro studies were performed to assess the accuracy of dimensional and morphological information. In vitro images of human vessels (n = 75) demonstrated that le

  19. Disseminated intravascular coagulation in malaria: A case report

    Directory of Open Access Journals (Sweden)

    Laltanpuii Sailo

    2014-01-01

    Full Text Available Disseminated intravascular coagulation (DIC is seen in <5% of patients with severe Plasmodium falciparum malaria and is more common in cerebral malaria. Here, we report the diagnosis and management of a case of severe P. falciparum malaria with DIC.

  20. Retinal and choroidal intravascular spectral-domain optical coherence tomography

    DEFF Research Database (Denmark)

    Willerslev, Anne; Li, Xiao Qiang; Cordtz, Peter;

    2014-01-01

    flow in the retinal vessels in patients with ocular ischaemic syndrome and central retinal artery occlusion were both associated with lower reflectivity of the blood and an unstructured intravascular SD-OCT profile. Discussion:  This qualitative in vivo study found a characteristically structured SD...

  1. Brachytherapy optimal planning with application to intravascular radiation therapy

    DEFF Research Database (Denmark)

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

    1999-01-01

    . Dose rate calculations are based on the sosimetry formulation of the American Association of Physicists in Medicine, Task Group 43. We apply the technique to optimal planning for intravascular brachytherapy of intimal hyperplasia using ultrasound data and 192Ir seeds. The planning includes...

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

    Directory of Open Access Journals (Sweden)

    Juan Manuel de Faramiñán Gilbert

    2009-01-01

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

  3. Endocrown de composite en molar endodónticamente tratado

    OpenAIRE

    Pagola, M. B.; Chrestia, E.

    2015-01-01

    Tradicionalmente, la devolución de función y estética a dientes tratados endodónticamente con extensa perdida coronaria, se ha logrado fabricando coronas totales con pernos intrarradiculares. Con el advenimiento de la odontología adhesiva, es posible restaurarlas con onlays y overlays, usando la extensión de la cámara pulpar como recurso de retención. Las restauraciones endocrown están formadas por un monobloque que contiene la porción coronaria integrada a una proyección apical que llena la ...

  4. PARLAMENTO E TRATADOS INTERNACIONAIS: O MODELO CONSTITUCIONAL DO BRASIL

    OpenAIRE

    Rezek, José Francisco; Corte Internacional de Justiça da Haia, Professor do Instituto Rio Branco

    2013-01-01

    É da responsabilidade do poder Executivo, mesmo nas grandes democracias parlamentares, a dinâmica das relações internacionais.   Notadamente o comprometimento externo formal, a expressão do consentimento do Estado em relação aos tratados, é algo que se materializa sempre num ato de governo — a assinatura, a ratificação, a adesão.  Mas é próprio das democracias, ainda que sob o sistema de governo presidencialista, que os pressupostos do consentimento, ditados pelo direito interno, tenham norma...

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

    OpenAIRE

    2014-01-01

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

  6. El Tratado de Asunción y el Mercosur

    Directory of Open Access Journals (Sweden)

    Miguel Berthet

    2015-10-01

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

  7. tratados internacionales en América Latina

    Directory of Open Access Journals (Sweden)

    Víctor Bazán

    2006-01-01

    Full Text Available En este artículo el autor analiza las soluciones que, desde el plano de las respectivas normativas constitucionales, ofrece el derecho comparado de algunos países latinoamericanos en relación con la problemática del control de constitucionalidad de los tratados y convenios internacionales. En el trabajo se postula fundamentalmente que dicho contralor de constitucionalidad debe ser previo y obligatorio, en orden a prevenir contradicciones o disturbios normativos ad intra e intensificar, así, la búsqueda de la preservación de la supremacía constitucional; coadyuvar al mantenimiento de la coherencia y lógica del sistema de fuentes, y evitar la vinculación jurídica del Estado correspondiente en el ámbito internacional sin proceder, previamente, a las adecuaciones normativas pertinentes o, en su caso, a desistir de la aprobación del tratado o a concretarla con reservas, pues –entre diversos aspectos de la cuestión– la responsabilidad internacional del Estado está en juego.

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

    Directory of Open Access Journals (Sweden)

    Andrea Fargier Paoli

    2013-01-01

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

  9. Contribuição da medicina nuclear para a avaliação dos linfomas

    Directory of Open Access Journals (Sweden)

    Sapienza Marcelo T.

    2001-01-01

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

  10. Linfoma de Burkitt primario de la cavidad oral en una paciente con sida. Reporte de un caso y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    2015-01-01

    Full Text Available Los linfomas no Hodgkin (LNH son un grupo heterogéneo de enfermedades linfoproliferativas con elevada prevalencia en pacientes infectados por el virus de la inmunodeficiencia humana (VIH. La inmunodeficiencia asociada al sida predispone al desarrollo de LNH, incluyendo el linfoma de Burkitt (LB. El LB es un subtipo infrecuente y agresivo de LNH con elevada frecuencia en pacientes con sida. Se asocia a una alta tasa de replicación celular (determinada por el índice Ki67 y con alta frecuencia de compromiso extranodal como forma de presentación clínica de la neoplasia. Se presenta una paciente con sida que desarrolló un LB primario de la cavidad oral y se realiza una revisión de la literatura sobre el tema.

  11. Reuso do efluente tratado na indústria curtidora

    Directory of Open Access Journals (Sweden)

    Karl Heinz Luersen

    2012-01-01

    Full Text Available Com o objetivo de avaliar a possibilidade de reúso do efluente líquido tratado de uma indústria curtidora, foi realizada esta pesquisa. O procedimento experimental comparou a produção de couros confeccionados com água potável, extraída de poçosartesianos, com couros produzidos a partir do efluente líquido final tratado. Para alcançar este objetivo, foram realizados testes físicose químicos através de análises em laboratório (análises químicas e de resistências físicas e avaliações organolépticas executadas porprofissionais do setor de couro (quanto a cor, firmeza de flor, enchimento e toque. A avaliação analítica e a das característicasorganolépticas não indicam diferenças representativas quando comparadas aos padrões de referência da ABNT de couros produzidos,permitindo, assim, concluir que o reúso de efluente tratado não altera a aparência dos artigos de couro.Abstract This research was carried out to evaluate the possibility of reuse of a tannery treated effluent. The experimental procedure compared the production of leather made by the use of drinking water, extracted from artesian wells, to leather produced by the use of the final treated liquid effluent. In order to achieve this goal, physic-chemical tests were carried out in laboratory (chemical and physical resistance analysis and leather industry professionals performed organoleptic evaluations (for color, grain firmness, filling and touch. The analytical evaluation and the organoleptic properties evaluation do not indicate a statistically significant difference when compared to ABNT reference standards of produced leathers, what allows the researchers to conclude that the reuse of treated effluent does not change the appearance of leather goods.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    that the relaxivity of intravascular contrast agents depends significantly on the host tissue. This agrees with experimental data by Johnson et al. (Magn Reson Med 2000;44:909). In particular, the present results suggest a several-fold increase in the relaxivity of Gd-based contrast agents in brain tissue compared...... with bulk blood. The enhancement of relaxation in tissue is due to the contrast in magnetic susceptibility between blood vessels and parenchyma induced by the presence of paramagnetic tracer. Beyond the perfusion measurements, the results can be applied to quantitation of functional MRI and to vessel size......The concentration of MRI tracers cannot be measured directly by MRI and is commonly evaluated indirectly using their relaxation effect. This study develops a comprehensive theoretical model to describe the transverse relaxation in perfused tissue caused by intravascular tracers. The model takes...

  13. Disseminated intravascular coagulation in term and preterm neonates.

    Science.gov (United States)

    Veldman, Alex; Fischer, Doris; Nold, Marcel F; Wong, Flora Y

    2010-06-01

    Among critically ill patients, the risk of developing disseminated intravascular coagulation (DIC) is probably highest in neonates. Low plasma reserves in pro- and anticoagulant coagulation factors, intravascular volume contraction after birth, and a high incidence of hypoxia and sepsis in critically ill newborns rapidly lead to a decompensation of the coagulation system in this population. Global coagulation tests and single-factor plasma levels have to be interpreted in the context of age-corrected normal ranges. Platelet consumption and reduced protein C plasma levels have diagnostic value; the latter also has prognostic potential in neonates with DIC and sepsis. Therapeutic success relies heavily on reversal of the underlying condition. Some coagulation-specific therapies have been explored in small studies and case series with varying success and sometimes conflicting results. Therefore, larger controlled trials in this common and serious condition are urgently needed.

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

    Directory of Open Access Journals (Sweden)

    María Florencia Villafañe

    2006-08-01

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

  15. Design of low noise transimpedance amplifier for intravascular ultrasound

    KAUST Repository

    Reda, Dina

    2009-11-01

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

  16. Intravascular papillary endothelial hyperplasia of the mandibular lingual mucosa

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  17. Asian-variant intravascular lymphoma in the African race

    OpenAIRE

    Holly Geyer; Nina Karlin; Brian Palen; Ruben Mesa

    2012-01-01

    Intravascular large B-cell lymphoma (IVLBCL) is an exceptionally rare form of non- Hodgkin lymphoma (NHL) distinguished by the preferential growth of neoplastic cells within blood vessel lumen. Challenging to detect and deemed disseminated at diagnosis, this condition is characterized by a highly aggressive, inconspicuous course with a high mortality rate. We describe the case of a 48 year-old African-American female presenting with a two month history of low-grade fevers and malaise. Laborat...

  18. Silent intravascular lymphoma initially manifesting as a unilateral adrenal incidentaloma.

    Science.gov (United States)

    Takahashi, Yoshiko; Iida, Keiji; Hino, Yasuhisa; Ohara, Takeshi; Kurahashi, Toshifumi; Tashiro, Takashi; Chihara, Kazuo

    2012-01-01

    Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of malignant lymphoma. Although the involvement of adrenal glands in IVLBCL is often observed, primary adrenal IVLBCL is rare. Most reported cases of adrenal IVLBCL showed bilateral lesions resulting in rapidly progressive adrenal failure and poor prognosis. Here, we report a case of slowly progressive primary adrenal IVLBCL manifesting initially with unilateral adrenal incidentaloma. This case is a silent IVLBCL and shows that the enlargement of both adrenal glands can be followed.

  19. Intravascular papillary endothelial hyperplasia: An unusual histopathological entity.

    Science.gov (United States)

    Mahapatra, Qury S; Sahai, Kavita; Malik, Ajay; Mani, N S

    2015-01-01

    Intravascular papillary endothelial hyperplasia (Masson's tumor) is a benign lesion of the skin and subcutaneous tissue consisting of a reactive proliferation of endothelial cells with papillary formations related to a thrombus. It poses a diagnostic challenge as the clinical signs and symptoms are nonspecific and may mimic a soft tissue sarcoma. The diagnosis is based on histopathology. Here we report two cases of Masson's hemangioma occurring on the upper lip and on the left hand.

  20. Intravascular papillary endothelial hyperplasia: An unusual histopathological entity

    Directory of Open Access Journals (Sweden)

    Qury S Mahapatra

    2015-01-01

    Full Text Available Intravascular papillary endothelial hyperplasia (Masson′s tumor is a benign lesion of the skin and subcutaneous tissue consisting of a reactive proliferation of endothelial cells with papillary formations related to a thrombus. It poses a diagnostic challenge as the clinical signs and symptoms are nonspecific and may mimic a soft tissue sarcoma. The diagnosis is based on histopathology. Here we report two cases of Masson′s hemangioma occurring on the upper lip and on the left hand.

  1. Central Venous Catheter Intravascular Malpositioning: Causes, Prevention, Diagnosis, and Correction.

    Science.gov (United States)

    Roldan, Carlos J; Paniagua, Linda

    2015-09-01

    Despite the level of skill of the operator and the use of ultrasound guidance, central venous catheter (CVC) placement can result in CVC malpositioning, an unintended placement of the catheter tip in an inadequate vessel. CVC malpositioning is not a complication of central line insertion; however, undiagnosed CVC malpositioning can be associated with significant morbidity and mortality. The objectives of this review were to describe factors associated with intravascular malpositioning of CVCs inserted via the neck and chest and to offer ways of preventing, identifying, and correcting such malpositioning. A literature search of PubMed, Cochrane Library, and MD Consult was performed in June 2014. By searching for "Central line malposition" and then for "Central venous catheters intravascular malposition," we found 178 articles written in English. Of those, we found that 39 were relevant to our objectives and included them in our review. According to those articles, intravascular CVC malpositioning is associated with the presence of congenital and acquired anatomical variants, catheter insertion in left thoracic venous system, inappropriate bevel orientation upon needle insertion, and patient's body habitus variants. Although plain chest radiography is the standard imaging modality for confirming catheter tip location, signs and symptoms of CVC malpositioning even in presence of normal or inconclusive conventional radiography findings should prompt the use of additional diagnostic methods to confirm or rule out CVC malpositioning. With very few exceptions, the recommendation in cases of intravascular CVC malpositioning is to remove and relocate the catheter. Knowing the mechanisms of CVC malpositioning and how to prevent, identify, and correct CVC malpositioning could decrease harm to patients with this condition.

  2. Central Venous Catheter Intravascular Malpositioning: Causes, Prevention, Diagnosis, and Correction

    Directory of Open Access Journals (Sweden)

    Carlos J. Roldan

    2015-10-01

    Full Text Available Despite the level of skill of the operator and the use of ultrasound guidance, central venous catheter (CVC placement can result in CVC malpositioning, an unintended placement of the catheter tip in an inadequate vessel. CVC malpositioning is not a complication of central line insertion; however, undiagnosed CVC malpositioning can be associated with significant morbidity and mortality. The objectives of this review were to describe factors associated with intravascular malpositioning of CVCs inserted via the neck and chest and to offer ways of preventing, identifying, and correcting such malpositioning. A literature search of PubMed, Cochrane Library, and MD Consult was performed in June 2014. By searching for “Central line malposition” and then for “Central venous catheters intravascular malposition,” we found 178 articles written in English. Of those, we found that 39 were relevant to our objectives and included them in our review. According to those articles, intravascular CVC malpositioning is associated with the presence of congenital and acquired anatomical variants, catheter insertion in left thoracic venous system, inappropriate bevel orientation upon needle insertion, and patient’s body habitus variants. Although plain chest radiography is the standard imaging modality for confirming catheter tip location, signs and symptoms of CVC malpositioning even in presence of normal or inconclusive conventional radiography findings should prompt the use of additional diagnostic methods to confirm or rule out CVC malpositioning. With very few exceptions, the recommendation in cases of intravascular CVC malpositioning is to remove and relocate the catheter. Knowing the mechanisms of CVC malpositioning and how to prevent, identify, and correct CVC malpositioning could decrease harm to patients with this condition.

  3. Intravascular foreign bodies: danger of unretrieved fragmented medical devices.

    Science.gov (United States)

    Tateishi, Minori; Tomizawa, Yasuko

    2009-01-01

    A warning on the danger of unretrieved device fragments and recommendations to mitigate the danger were issued by the Food and Drug Administration in January 2008. The causes of intravascular foreign bodies are classified into three main categories: improper manipulation and usage, device defects, and others, such as patient and anatomical factors. Device failure after long-term use is rarely predicted at the time of approval, since device abnormality is rarely experienced in animal studies and clinical trials conducted during development of the device. Stent fracture due to metal fatigue is one example. Complex complications could occur from simultaneous use of two or more devices with diverse characteristics. The success rate of percutaneous retrieval of intravascular foreign bodies has improved with the advances in commercially available devices. However, the procedure is not always successful and sometimes surgical removal becomes necessary. Appropriate device selection and acquisition of experience in using the device are important. When an intravascular foreign body cannot be retrieved, the risk of complication could be high. Magnetic resonance imaging examination sometimes causes adverse events, including burns due to the heat generated by metal movement. Such information should be correctly recorded. Furthermore, it is necessary to provide patients with adequate information about the characteristics of implanted devices and unretrieved fragments. We reviewed the literature on unretrieved medical device fragments and include articles that describe the Japanese experience.

  4. Asian-variant intravascular lymphoma in the African race

    Directory of Open Access Journals (Sweden)

    Holly Geyer

    2012-03-01

    Full Text Available Intravascular large B-cell lymphoma (IVLBCL is an exceptionally rare form of non- Hodgkin lymphoma (NHL distinguished by the preferential growth of neoplastic cells within blood vessel lumen. Challenging to detect and deemed disseminated at diagnosis, this condition is characterized by a highly aggressive, inconspicuous course with a high mortality rate. We describe the case of a 48 year-old African-American female presenting with a two month history of low-grade fevers and malaise. Laboratory data was notable for anemia, thrombocytopenia, elevated liver function tests, and hematuria. An extensive workup for infectious, rheumatologic and malignant causes was negative. Her symptoms progressed and within two weeks, she was admitted for disseminated intravascular coagulation (DIC. Her course was complicated by diffuse pulmonary hemorrhage and ultimately, care was withdrawn. Autopsy identified widespread CD-20 positive intravascular large B-cell lymphoma with significant hepatosplenic involvement, characteristic of the Asian variant IVLBCL. This case uniquely highlights development of the Asian variant IVLBVL in a previously undescribed race. Identified by its intraluminal vascular growth pattern, IVLBCL generally spares lymphatic channels. Diagnosis and differentiation of this condition from other hematological malignancies via skin, visceral and bone marrow biopsy is imperative as anthracycline-containing chemotherapies may significantly improve clinical outcomes. This article outlines the common presentation, natural course, and treatment options of IVLBCL, along with the histopathology, immunohistochemistry, and chromosomal aberrations common to this condition.

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

    Directory of Open Access Journals (Sweden)

    Daniel Hugo Martins

    2014-06-01

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

  6. El Tratado de Versalles y el huevo de la serpiente

    OpenAIRE

    Cruset, María Eugenia

    2009-01-01

    Si algo enseña la historia es que no hay verdadero y pacífico desarrollo sin verdad, justicia y reparación. O, dicho en sentido negativo, nada hay más explosivo y destructivo para cualquier país que las arbitrariedades e inequidades. Este año se cumplen 90 años de uno de los episodios más gráficos de lo que estamos diciendo: el Tratado de Versalles, que firmado el 28 de junio de 1919 significó el fin de la Primer Guerra Mundial con la humillante derrota de Alemania. Flagrante situación de arb...

  7. Disseminated intravascular large-cell lymphoma with initial presentation mimicking Guillain-Barré syndrome.

    Science.gov (United States)

    Jiang, Qin Li; Pytel, Peter; Rowin, Julie

    2010-07-01

    We report a patient with intravascular large B-cell lymphoma who initially presented with acute ascending weakness and sensory changes. Electrodiagnostic testing and cerebral spinal fluid (CSF) studies were initially suggestive of a demyelinating polyneuropathy. Further clinical evaluation and testing were consistent with mononeuropathy multiplex. Autopsy revealed disseminated intravascular large-cell lymphoma. Intravascular large-cell lymphoma should be considered in the differential diagnosis of a rapidly evolving neuropathy associated with other organ involvement.

  8. Intravascular large B-cell lymphoma presenting with fulminant pseudomembranous colitis.

    Science.gov (United States)

    Wang, Tao; Ghaffar, Hasan; Grin, Andrea

    2013-05-01

    Intravascular large B-cell lymphoma is a rare entity that usually presents in late stages with non-specific symptoms. We present a case of an incidentally discovered intravascular large B-cell lymphoma in a 78-year-old man who underwent colectomy for medically refractory pseudomembranous colitis. The malignant lymphocytes were preferentially localized to small colonic submucosal vasculature, without any evidence of an extravascular tumor mass. The gastrointestinal system is an exceeding rare initial diagnostic site for intravascular lymphoma, and presentation with pseudomembranous colitis has not been previously reported. We discuss the current definition of intravascular lymphoma, clinicopathological variants, differential diagnoses, as well as current therapy.

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

    Directory of Open Access Journals (Sweden)

    Luís Fernando Pracchia

    2005-10-01

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

  10. Linfomas de la órbita y anexos oculares: Correlación clínico patológica de 25 casos Orbital and ocular adnexal lymphomas: Clinico-pathological correlation in 25 cases

    Directory of Open Access Journals (Sweden)

    Erica A. Rojas Bilbao

    2010-08-01

    Full Text Available Se evaluaron las características clínicas, histológicas y la evolución de una cohorte de pacientes con linfomas de la órbita y anexos oculares. Entre 1995 y 2008 se estudiaron 25 casos de linfomas de la órbita y anexos oculares en un centro oncológico de referencia. En cada caso se analizó el inmunofenotipo usando un panel de anticuerpos monoclonales (CD45, CD20, CD3, CD5, CD23, BCL2, BCL6, BCL10, Ki67, CD30, CD15, BCL1, Kappa, Lambda, CD138. Las lesiones fueron evaluadas utilizando el sistema de clasificación de linfomas (OMS, 2008. Se analizaron 23 linfomas primarios y dos secundarios. Los subtipos histológicos fueron: 16 linfomas B de la zona marginal asociados a las mucosas (MALT, cuatro linfomas difusos de células grandes B, dos linfomas foliculares y un paciente con linfoma Hodgkin. De los 25 casos estudiados, 22 presentaron estadios localizados. El linfoma MALT fue el subtipo más frecuente. En este estudio se observó enfermedad localizada en la mayoría de los casos y con baja progresión a distancia.Clinical, histological features and outcome of a cohort of patients with orbital and adnexal lymphoproliferative tumors were evaluated. Twenty-five cases in an oncologic referral center from 1995 to 2008, were included in the study. Each case had detailed immunophenotypic analysis using a panel of monoclonal antibodies (CD45, CD20, CD3, CD5, CD23, BCL2, BCL6, BCL10, Ki67, CD30, CD15, BCL1, Kappa, Lambda, CD138. Lesions were classified by using WHO (2008 lymphomas classification. Twenty-three patients were found to have primary and two secondary lymphomas. Histological subtypes were: 16 patients with marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma, four diffuse large B cell lymphomas, two mantle cell lymphomas, two follicular lymphomas, and one Hodgkin lymphoma. Among the 25 patients studied, 22 had localized stage. Extranodal marginal zone lymphoma was the most frequent type of primary orbital

  11. Laparoscopic colectomy for primary colonic lymphoma Tratamiento del linfoma primario de colon mediante colectomía laparoscópica

    Directory of Open Access Journals (Sweden)

    D. Martínez-Ramos

    2005-10-01

    Full Text Available Primary colorectal lymphoma is an infrequent disease of unknown origin and with a growing incidence. Differentiation be-tween primary lymphoma and secondary colorectal involvement is of great therapeutic and prognostic importance. The diagnosis must always be based on histological findings. Different forms of presentation have been described, though all are nonspecific. While full agreement on the best management approach for colorectal lymphoma is lacking, surgical resection is usually the treatment of choice. The role of chemotherapy has not been defined. This study reports on a case of primary lymphoma in the cecum, with clinical manifestations in the form of meteorism and early satiety. The diagnosis was established by colonoscopy and biopsy. The absence of lymph-node involvement, tumor size, existing cardiopulmonary risk factors, and the fact that a full resection of the malignancy proved possible, with tumor-free resection margins, led us to exclude adjuvant chemotherapy. After one year of follow-up the patient remains disease-free.El linfoma primario colorrectal es una enfermedad muy infrecuente, de causa desconocida y con una incidencia en aumento. Diferenciar entre el linfoma primario y la afectación colorrectal secundaria en el linfoma sistémico es de elevada importancia terapéutica y pronóstica. El diagnóstico ha de ser siempre histológico. Se han descrito diferentes formas de presentación, pero todas ellas inespecíficas. No existe un total acuerdo sobre cuál es el mejor tratamiento del linfoma colorrectal. La resección quirúrgica suele ser el procedimiento de elección, sin haberse definido el papel de la quimioterapia. Presentamos un caso de linfoma primario localizado en el ciego, cuyas manifestaciones clínicas fueron meteorismo y saciedad precoz, siendo diagnosticado mediante colonoscopia y biopsia. La resección asistida por laparoscopia fue el tratamiento de elección. La no afectación ganglionar, tamaño tumoral

  12. Removal of Chronic Intravascular Blood Clots using Liquid Plasma

    Science.gov (United States)

    Jung, Jae-Chul; Choi, Myeong; Koo, Il; Yu, Zengqi; Collins, George

    2011-10-01

    An electrical embolectomy device for removing chronic intravascular blood clots using liquid plasma under saline environment was demonstrated. We employed a proxy experimental blood clot model of deep vein thrombosis (DVT) and actual equine blood clot. Thermal damage to contiguous tissue and the collagen denaturing via the plasma irradiation were investigated by histological analysis using birefringence of the tissue and verified by FT-IR spectroscopic study, respectively, which showed the high removal rate up to 2 mm per minute at room temperature and small thermal damage less than 200 μm.

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

    Energy Technology Data Exchange (ETDEWEB)

    Raininko, R.

    1981-04-01

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

  14. Protection against high intravascular pressure in giraffe legs

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  15. Silent Intravascular Lymphoma Initially Manifesting as a Unilateral Adrenal Incidentaloma

    Directory of Open Access Journals (Sweden)

    Yoshiko Takahashi

    2012-01-01

    Full Text Available Intravascular large B-cell lymphoma (IVLBCL is a rare subtype of malignant lymphoma. Although the involvement of adrenal glands in IVLBCL is often observed, primary adrenal IVLBCL is rare. Most reported cases of adrenal IVLBCL showed bilateral lesions resulting in rapidly progressive adrenal failure and poor prognosis. Here, we report a case of slowly progressive primary adrenal IVLBCL manifesting initially with unilateral adrenal incidentaloma. This case is a silent IVLBCL and shows that the enlargement of both adrenal glands can be followed.

  16. Method for Observing Intravascular BongHan Duct

    CERN Document Server

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

    2002-01-01

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

  17. Application of tissue characterization in intravascular ultrasound imaging

    Science.gov (United States)

    Mullen, William L.; Fitzgerald, Peter J.; Yock, Paul G.

    1994-05-01

    Current intravascular ultrasound imaging technology is able to determine the extent and distribution of pathologic processes within the vessel wall, but is not highly sensitive in discriminating between certain types of tissue. `Tissue characterization' refers to a set of computer-based techniques that utilize features of the ultrasound signal beyond basic amplitude to help define the composition of the tissue of interest. This technique involves quantitative analysis of the ultrasound signals reflected from tissue before these signals pass through the processing steps in the ultrasound instrument.

  18. El Tratado De Dilectione Dei de Balduino de Ford

    Directory of Open Access Journals (Sweden)

    Carlos Hallet

    2004-01-01

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

  19. Tratamiento de rescate en linfomas agresivos: eficacia del trasplante autólogo de progenitores hematopoyéticos y evaluación de nuevos fármacos

    OpenAIRE

    Redondo Guijo, Alba María

    2014-01-01

    [ES]Los linfomas no Hodgkin presentan una incidencia comprendida entre 3 y 6 casos por cada 100.000 habitantes y año y son la causa del 3% de mortalidad por procesos neoplásicos. Constituyen un grupo heterogéneo de neoplasias linfoides y esta diversidad determina que su tratamiento sea uno de los aspectos más complejos y controvertidos de la hematología. La presente tesis doctoral se centra, principalmente, en los linfomas difusos de células grandes B (LDCGB) que constituyen el grupo más frec...

  20. Aplicação do índice prognóstico internacional em pacientes com linfoma difuso de grandes células B em uma instituição brasileira

    OpenAIRE

    Abrahão E. Hallack Neto; Pereira, Juliana; Dorlhiac-Llacer, Pedro; Beitler,Beatriz; Dalton A. F. Chamone

    2005-01-01

    O linfoma difuso de grandes células B (LDGCB) corresponde a 50% dos casos de linfoma não-Hodgkin (LNH). A partir de 1993, o tratamento destes pacientes passou a ser direcionado pelo Índice Internacional de Prognóstico (IPI) validado em vários estudos. Entretanto a aplicação do IPI ainda não foi avaliada em nossa população e em nossas condições socioeconômicas. Neste estudo avaliamos o impacto do IPI ajustado para a idade (IPIa) na remissão completa (RC), sobrevida global (SG) e sobrevida livr...

  1. Constitución, Tratado de Libre Comercio Andino – Estados Unidos, Comunidad Andina

    Directory of Open Access Journals (Sweden)

    Marcel Tangarife Torres

    2007-12-01

    Full Text Available El presente escrito pretende hacer algunas reflexiones acerca de las relaciones jurídicas existentes entre la Constitución Política, el Tratado de Libre Comercio con Estados Unidos (TLC

  2. Focused intravascular ultrasonic probe using dimpled transducer elements.

    Science.gov (United States)

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

    2015-02-01

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

  3. Thyroid Storm Complicated by Bicytopenia and Disseminated Intravascular Coagulation

    Science.gov (United States)

    Tokushima, Yoshinori; Sakanishi, Yuta; Nagae, Kou; Tokushima, Midori; Tago, Masaki; Tomonaga, Motosuke; Yoshioka, Tsuneaki; Hyakutake, Masaki; Sugioka, Takashi; Yamashita, Shu-ichi

    2014-01-01

    Patient: Male, 23 Final Diagnosis: Thyroid storm Symptoms: Delirium • diarrhea • fever • hypertension • hyperventilation • tachycardia • weight loss Medication: — Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Unusual clinical course Background: The clinical presentation of thyroid storm includes fever, tachycardia, hypertension, and neurological abnormalities. It is a serious condition with a high mortality rate. Furthermore, some other complications affect the clinical course of thyroid storm. Although it is reported that prognosis is poor when thyroid storm is complicated by disseminated intravascular coagulation syndrome (DIC) and leukopenia, reports of such cases are rare. Case Report: A 23-year-old man presented with delirium, high pyrexia, diarrhea, and weight loss of 18 kg over 2 months. According to the criteria of Burch and Wartofsky, he was diagnosed with thyroid storm on the basis of his symptom-complex and laboratory data that confirmed the presence of hyperthyroidism. Investigations also found leukopenia, thrombocytopenia, and disseminated intravascular coagulation, all of which are very rare complications of thyroid storm. We successfully treated him with combined therapy including anti-thyroid medication, despite leukopenia. Conclusions: Early diagnosis and treatment are essential in ensuring a good outcome for patients with this rare combination of medical problems. PMID:25072662

  4. Development of catheters for combined intravascular ultrasound and photoacoustic imaging

    Science.gov (United States)

    Karpiouk, Andrei B.; Wang, Bo; Emelianov, Stanislav Y.

    2009-02-01

    Coronary atherosclerosis is a complex disease accompanied by the development of plaques in the arterial wall. Since the vulnerability of the plaques depends on their composition, the appropriate treatment of the arteriosclerosis requires a reliable characterization of the plaques' geometry and content. The intravascular ultrasound (IVUS) imaging is capable of providing structural details of the plaques as well as some functional information. In turn, more functional information about the same plaques can be obtained from intravascular photoacoustic (IVPA) images since the optical properties of the plaque's components differ from that of their environment. The combined IVUS/IVPA imaging is capable of simultaneously detecting and differentiating the plaques, thus determining their vulnerability. The potential of combined IVUS/IVPA imaging has already been demonstrated in phantoms and ex-vivo experiments. However, for in-vivo or clinical imaging, an integrated IVUS/IVPA catheter is required. In this paper, we introduce two prototypes of integrated IVUS/IVPA catheters for in-vivo imaging based on a commercially available single-element IVUS imaging catheter. The light delivery systems are developed using multimode optical fibers with custom-designed distal tips. Both prototypes were tested and compared using an arterial mimicking phantom. The advantages and limitations of both designs are discussed. Overall, the results of our studies suggest that both designs of integrated IVUS/IVPA catheter have a potential for in-vivo IVPA/IVUS imaging of atherosclerotic plaques.

  5. [Disseminated intravascular coagulation. Case series and literature review].

    Science.gov (United States)

    Del Carpio-Orantes, Luis; García-Ortiz, Jorge José

    2014-01-01

    INTRODUCCIÓN: la coagulación intravascular diseminada es una entidad caracteriza por activación de la cascada de la coagulación y fibrinólisis endógena, que puede provocar la muerte. Nuestros objetivos fueron identificar la incidencia de coagulación intravascular diseminada, sus agentes etiológicos y la correlación entre la puntuación de la escala Apache II y la propuesta por la Sociedad Internacional de Trombosis y Hemostasia para el diagnóstico de esta entidad. MÉTODOS: estudio retrospectivo, observacional y descriptivo de pacientes atendidos en una unidad de cuidados intensivos en un periodo de 17 meses. Se analizó etiología, edad, sexo, conteo de plaquetas, coagulograma, niveles de fibrinógeno sérico y cuantificación del dímero D. Se calculó la puntuación de la escala propuesta por la Sociedad Internacional de Trombosis y Hemostasia y de la escala APACHE II.

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

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    Luigi Brancato

    2016-08-01

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

  7. High speed intravascular photoacoustic imaging of atherosclerotic arteries (Conference Presentation)

    Science.gov (United States)

    Piao, Zhonglie; Ma, Teng; Qu, Yueqiao; Li, Jiawen; Yu, Mingyue; He, Youmin; Shung, K. Kirk; Zhou, Qifa; Kim, Chang-Seok; Chen, Zhongping

    2016-02-01

    Cardiovascular disease is the leading cause of death in the industrialized nations. Accurate quantification of both the morphology and composition of lipid-rich vulnerable atherosclerotic plaque are essential for early detection and optimal treatment in clinics. In previous works, intravascular photoacoustic (IVPA) imaging for detection of lipid-rich plaque within coronary artery walls has been demonstrated in ex vivo, but the imaging speed is still limited. In order to increase the imaging speed, a high repetition rate laser is needed. In this work, we present a high speed integrated IVPA/US imaging system with a 500 Hz optical parametric oscillator laser at 1725 nm. A miniature catheter with 1.0 mm outer diameter was designed with a 200 μm multimode fiber and an ultrasound transducer with 45 MHz center frequency. The fiber was polished at 38 degree and enclosed in a glass capillary for total internal reflection. An optical/electrical rotary junction and pull-back mechanism was applied for rotating and linearly scanning the catheter to obtain three-dimensional imaging. Atherosclerotic rabbit abdominal aorta was imaged as two frame/second at 1725 nm. Furthermore, by wide tuning range of the laser wavelength from 1680 nm to 1770 nm, spectroscopic photoacoustic analysis of lipid-mimicking phantom and an human atherosclerotic artery was performed ex vivo. The results demonstrated that the developed IVPA/US imaging system is capable for high speed intravascular imaging for plaque detection.

  8. A short contemporary history of disseminated intravascular coagulation.

    Science.gov (United States)

    Levi, Marcel; van der Poll, Tom

    2014-11-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to a widespread deposition of fibrin in the circulation. There is ample experimental and pathological evidence that the fibrin deposition contributes to multiple organ failure. The massive and ongoing activation of coagulation may result in depletion of platelets and coagulation factors, which may cause bleeding (consumption coagulopathy). The syndrome of DIC is well known in the medical literature for centuries, although a more precise description of the underlying mechanisms had to await the 20th century. Initial ideas on a role of the contact activation system as the primary trigger for the systemic activation of coagulation as well as a presumed hyperfibrinolytic response in DIC have been found to be misconceptions. Experimental and clinical evidence now indicate that the initiation of coagulation in DIC is caused by tissue factor expression, which in combination with downregulated physiological anticoagulant pathways and impaired fibrinolysis leads to widespread fibrin deposition. In addition, an extensive bidirectional interaction between coagulation and inflammation may further contribute to the pathogenesis of DIC.

  9. Linfomas em pacientes com a forma hepatoesplênica da esquistossomose mansônica Lymphoma in patients harboring hepatosplenic mansonic schistosomiasis

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    Álvaro Antônio Bandeira Ferraz

    2006-06-01

    Full Text Available RACIONAL: Cada vez mais se estabelece a correlação entre agentes infecciosos e doenças linfoproliferativas, sobretudo vírus e bactérias, através da ativação de linfócitos. OBJETIVO: Descrever 6 novos casos, de uma série de 254 pacientes (2,36% com esquistossomose mansônica na forma hepatoesplênica. CASUÍSTICA E MÉTODOS: São descritos 6 pacientes, dentre os 254 portadores de esquistossomose mansônica na forma hepatoesplênica, acompanhados nos últimos 13 anos no Serviço de Cirurgia Geral do Hospital das Clínicas da Universidade Federal de Pernambuco, Recife, PE. RESULTADOS: Todos os seis casos ocorreram em mulheres. Os exames histopatológicos evidenciaram dois casos de linfomas de zona marginal esplênica, um de linfoma de grandes células com imunoblastos, um de linfoma difuso de grandes células, um de linfoma maligno de grandes células não clivadas, e um outro caso de doença de Hodgkin. Metade das seis pacientes evoluiu para o óbito entre 4 a 15 meses após o diagnóstico. As outras três persistem em acompanhamento no Serviço de Oncologia da mesma instituição. CONCLUSÃO: A incidência de linfoma nos 254 pacientes acompanhados foi de 2,36%. Pretende-se chamar a atenção para a ocorrência de linfomas nos baços de pacientes com esquistossomose mansônica, na forma hepatoesplênica.BACKGROUND: Correlation between infectious agents and linfoproliferative diseases are more stablished, over all virus and bacteria, through the activation of linfocytes. AIM: To describe six new cases, of a series of 254 patients (2,36% with mansonic schistosomiasis, in the hepatosplenic form. METHODS: Six patients will be described, amongst the 254 carriers of mansonic schistosomiasis, in the hepatosplenic form, followed in the last 13 years. RESULTS: All the six cases had occurred in women. The histopathologic examinations had evidenced two cases of marginal splenic zone lymphomas, one of great cells with immunoblasts lymphomas, one

  10. La Política Criminal de los Tratados Internacionales

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    Jean Pierre Matus A

    2007-01-01

    Full Text Available El artículo expone las principales características comunes de los "delitos de trascendencia internacional" (international crimes contemplados en tratados y convenciones, que no constituyen "crímenes de derecho internacional" (crimes under international law, presentando un rudimiento de sistematización de su parte general, en el sentido de la dogmática continental. Se sostiene que los hechos comprendidos en tales categorías, que en general afectan la libertad, la vida y la seguridad personal, se reconocen como delictivos por un amplio número de Estados, lo que podría ser indicador de la existencia de un incipiente "Estado mundial", con reglas comunes de penalización al mismo tiempo necesitadas de implementación por parte de los Estados e independientes de la existencia de un órgano supranacional para hacerlas efectivasThis article exposes the principal characteristics that are common to the international crimes contemplated in treaties and conventions which do not constitute "crimes under international law", presenting a rudiment of systematization of its general part in the sense of the continental dogmatic. It is sustained that the facts understood in these categories, which in general affects the liberty, the life, and the personal security considered as crimes by a wide number of States which could be an indicator of the existence of an incipient "world state", with common rules of penalization at the same time needed to implement by the states and independents of the existence of an supranational organ to make these effective

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

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    Alejandro Roisman

    2014-04-01

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

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

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    Marcos R. G. de Freitas

    1981-12-01

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

  13. Bronquiolite obliterante com pneumonia em organização e aspergiloma em paciente com linfoma-leucemia de células T

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    JHAYYA TERESA S.

    2000-01-01

    Full Text Available Há poucos relatos na literatura médica referentes à associação de bronquiolite obliterante com pneumonia em organização (BOPO e aspergiloma. Apresenta-se uma associação de BOPO e aspergiloma pulmonar em uma paciente com linfoma-leucemia de células T do adulto. Sugere-se que os achados deste caso representam uma associação fortuita e não a expressão de unidade nosológica.

  14. Adaptive Estimation of Intravascular Shear Rate Based on Parameter Optimization

    Science.gov (United States)

    Nitta, Naotaka; Takeda, Naoto

    2008-05-01

    The relationships between the intravascular wall shear stress, controlled by flow dynamics, and the progress of arteriosclerosis plaque have been clarified by various studies. Since the shear stress is determined by the viscosity coefficient and shear rate, both factors must be estimated accurately. In this paper, an adaptive method for improving the accuracy of quantitative shear rate estimation was investigated. First, the parameter dependence of the estimated shear rate was investigated in terms of the differential window width and the number of averaged velocity profiles based on simulation and experimental data, and then the shear rate calculation was optimized. The optimized result revealed that the proposed adaptive method of shear rate estimation was effective for improving the accuracy of shear rate calculation.

  15. [Traumatic abruption of the placenta with disseminated intravascular coagulation].

    Science.gov (United States)

    Benz, R; Malär, A-U; Benz-Wörner, J; Scherer, M; Hodel, M; Gähler, A; Haberthür, C; Konrad, C

    2012-10-01

    Trauma in pregnancy is infrequent and a systematic primary strategy constitutes a real challenge for the interdisciplinary team. With a high fetal mortality rate and a substantial maternal mortality rate traumatic placental abruption is a severe emergency which every anesthetist should be aware of. After hemodynamic stabilization of the mother and control of the viability of the fetus the therapy of traumatic placental abruption consists mostly of an immediate caesarean section. Coagulopathy by depletion of coagulation factors as well as disseminated intravascular coagulation (DIC) have to be expected and consequently a massive blood loss must be anticipated. Thrombelastography provides assistance for fast differential diagnosis and goal-directed treatment of the disturbed sections of the coagulation cascade.

  16. Disseminated intravascular coagulation in obstetric and gynecologic disorders.

    Science.gov (United States)

    Montagnana, Martina; Franchi, Massimo; Danese, Elisa; Gotsch, Francesca; Guidi, Gian Cesare

    2010-06-01

    Disseminated intravascular coagulation (DIC) is a syndrome characterized by a massive, widespread, and ongoing activation of the coagulation system, secondary to a variety of clinical conditions. Many obstetric complications, such as abruptio placentae, amniotic fluid embolism, endotoxin sepsis, retained dead fetus, post-hemorrhagic shock, hydatidiform mole, and gynecologic malignancies, might trigger DIC. In these gynecologic and obstetric settings, DIC is usually associated with high mortality and morbidity rates. No single laboratory test is sensitive or specific enough to diagnose DIC definitively, but it can be diagnosed by using a combination of multiple clinical and laboratory tests that reflect the pathophysiology of the syndrome. At present, the therapeutical approach to pregnancy- and gynecologic-related DIC comprises the specific and aggressive treatment of the underlying disease, eventually followed by a supportive blood product replacement therapy and restoration of physiological anticoagulant pathways. This article reviews the etiopathogenesis, clinical manifestations, laboratory diagnosis, and therapy of pregnancy- and gynecologic-related DIC.

  17. Potential diagnostic markers for disseminated intravascular coagulation of sepsis.

    Science.gov (United States)

    Iba, Toshiaki; Ito, Takashi; Maruyama, Ikuro; Jilma, Bernd; Brenner, Thorsten; Müller, Marcella C A; Juffermans, Nicole P; Thachil, Jecko

    2016-03-01

    Disseminated intravascular coagulation (DIC) is an acquired thrombo-haemorrhagic disorder which arises in clinical scenarios like sepsis, trauma and malignancies. The clinic-laboratory diagnosis of DIC is made in a patient who develops the combination of laboratory abnormalities in the appropriate clinical scenario. The most common laboratory parameters in this setting have been the clotting profile, platelet count, serum fibrinogen and fibrin degradation markers. These tests had the advantage that they could be performed easily and in most laboratories. However, with the better understanding of the pathophysiology of DIC, in recent years, more specific tests have been suggested to be useful in this setting. The newer tests can also prove to be useful in prognostication in DIC. In addition, they may provide assistance in the selection and monitoring of patients diagnosed with DIC.

  18. Thrombocytopenia and thrombosis in disseminated intravascular coagulation (DIC).

    Science.gov (United States)

    Kitchens, Craig S

    2009-01-01

    Disseminated intravascular coagulation (DIC) is the physiologic result of pathologic overstimulation of the coagulation system. Despite multiple triggers, a myriad of laboratory abnormalities, and a clinical presentation ranging from gross hemostatic failure to life-threatening thrombosis, or even both simultaneously, a simplified clinical approach augmented by a few readily available tests allows prompt identification of the process and elucidation of treatment opportunities. Platelet counts in DIC may be low, especially in acute sepsis-associated DIC, yet increased in malignancy-associated chronic DIC. Thrombotic risk is not a function of the platelet count, and thrombocytopenia does not protect the patient from thrombosis. The stratification of both thrombotic risk and hemorrhagic risk will be addressed.

  19. Advanced Congestive Heart Failure Associated With Disseminated Intravascular Coagulopathy.

    Science.gov (United States)

    Sarcon, Annahita; Liu, Xiaoli; Ton, David; Haywood, James; Hitchcock, Todd

    2015-01-01

    Background. Disseminated intravascular coagulopathy (DIC) is a complication of an underlying disease and not a primary illness. It is most commonly associated with sepsis, trauma, obstetrical complications, and malignancies. There are very few cases in the literature illustrating the association between DIC and congestive heart failure. Findings. In this report, we present a case of severe congestive heart failure, leading to biventricular thrombi and subsequently DIC. Conclusion. We suggest that the association between congestive heart failure and DIC is an underrecognized one. Congestive heart failure continues to remain a major cause of morbidity and mortality despite advances in medical therapies. Thus far, the precise role of coagulation factors in congestive heart failure is unknown. Further investigations are needed to elucidate the pathophysiology of congestive heart failure and coagulation factors.

  20. Basic studies on intravascular low-intensity laser therapy

    Science.gov (United States)

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

    2006-09-01

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

  1. Acute renal failure and intravascular hemolysis following henna ingestion

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    Hala E. A. Qurashi

    2013-01-01

    Full Text Available The powder of henna plant (Lawsonia inermis Linn. is extensively used as a decorative skin paint for nail coloring and as a hair dye. Most reports of henna toxicity have been attributed to adding a synthetic dye para-phenylenediamine (PPD. PPD is marketed as black henna added to natural henna to accentuate the dark color and shorten the application time. PPD toxicity is well known and extensively reported in medical literature. We report a case of a young Saudi male who presented with characteristic features of acute renal failure and intravascular hemolysis following ingestion of henna mixture. Management of PPD poisoning is only suppor-tive and helpful only if instituted early. Diagnosis requires a high degree of clinical suspicion, as the clinical features are quite distinctive.

  2. Evaluation of Disseminated Intravascular Coagulation in the Craniocerebral Traumas

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    Faruk Altinel

    2014-06-01

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

  3. Search of intravascular hemolysis in patients with the cutaneous form of loxoscelism Pesquisa de hemólise intravascular na forma cutânea de loxoscelismo

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    Pasquale Morena

    1994-04-01

    Full Text Available Haptoglobin assay, a highly sensitive method to detect intravascular hemolysis was carried out in the sera of 19 patients referred to Hospital Vital Brazil with the cutaneous form of loxoscelism in order to investigate the occurrence of mild intravascular hemolysis. Data from this series did not show decreased levels haptoglobin, ruling out intravascular hemolysis in these patients with cutaneous form of loxoscelism.Dezenove pacientes que apresentaram a forma clínica cutânea do loxoscelismo foram investigados com o propósito de pesquisar hemólise intravascular sub-clínica, lançando mão da dosagem de haptoglobina, um método altamente sensível que permite detectar discreta presença de hemólise intravascular. Não foi encontrada diminuição de haptoglobina, o que descarta uma ação hemolítica do veneno da Loxosceles nestes pacientes.

  4. Inusual presentación de un Linfoma B cutáneo en un paciente joven Unusual presentation of a cutaneous B Lymphoma in a young male

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    M V Calzinari

    2008-06-01

    Full Text Available Se reporta el caso de un paciente masculino de 23 años de edad, que se presenta con una úlcera de región latero cervical, única, sin compromiso del estado general. Se solicita estudio histopatológico de la lesión e inmunomarcación, con diagnóstico de Linfoma no Hodgkin B de células grandes cutáneos primarios. Se realiza una revisión sobre los Linfomas no Hodgkin B de células grandes cutáneos primarios, siendo anecdótica la presentación en pacientes jóvenes.We report a case of a 23 year old male with a lateral cervical ulcer, without general involvement. Histophatological study and immunomarcation were positive to non Hodgkin Difuse Primary Cutaneous Large B-Cell Lymphoma. A revision was made about Primary Cutaneous B-Cell Lymphomas, being unusual this presentation in young people.

  5. Linfoma não Hodgkin primário da coluna vertebral Primary non-Hodgkin's lymphoma of the vertebral column

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    Ronald F. Pinheiro

    2009-01-01

    Full Text Available O linfoma primário do osso (LPO é uma condição extremamente rara, habitualmente confundida com outras lesões ósseas primárias. É responsável por cerca de 3%-5% de todos os tumores malignos no osso e 4%-7% de todos os linfomas nãoHodgkin extranodais. Caracteriza-se pelo envolvimento de um ou vários locais ósseos, com ou sem comprometimento de linfonodos regionais e vísceras. Histopatologicamente, o linfoma non Hodgkin de grandes células B representa a maioria dos casos de LPO. Ossos longos são mais frequentemente comprometidos, e o fêmur é o sítio mais acometido. Osso ilíaco e da coluna vertebral também podem ser atingidos. Relatamos um caso raro de linfoma não Hodgkin da vértebra em mulher de 41 anos. A imuno-histoquímica revelou CD20 e CD45 positivos. Ela foi diagnosticada com linfoma primário difuso de grandes células B da coluna vertebral. O estudo histopatológico da medula óssea não detectou infiltração por hemopatia linfoide. A paciente foi tratada com quimioterapia CHOP juntamente com etoposide, seguida de radioterapia (dose total = 3600cGy na região tóraco-lombar. Não houve evidência de recidiva em um período de vinte meses de acompanhamento.Primary bone lymphoma (PBL is an extremely rare condition, commonly confused with other primary bone injuries. It accounts for approximately 3-5% of all malignant bone tumors and 4-7% of all extranodal non-Hodgkin's lymphomas. It is characterized by the involvement of one or multiple bone locations, with or without the involvement of regional lymph nodes and viscera. Histopathologically, diffuse large-B-cell lymphomas account for the majority of cases of PBL. Long bones are usually involved, with the femur being the most commonly affected site. Pelvic bones and the vertebral column can also be involved. We report on a rare case of PLB of the vertebra in a 41-year-old woman. Immunohistochemistry examinations revealed CD20 and CD45 positive cells. She was diagnosed

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

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    Roland Bank

    2003-01-01

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

  7. EVOLUCIÓN DE LA PROPIEDAD INTELECTUAL EN LOS TRATADOS DE LIBRE COMERCIO SUSCRITOS POR CANADÁ.

    OpenAIRE

    Vaccaro, Christian Schmitz

    2012-01-01

    O esforço para integrar-se economicamente se enquadra em uma ampla tendência de globalização, especialmente econômica e comercial, que impera em nosso mundo há algum tempo. Isso leva ao cumprimento de altas exigências para poder competir nos mercados mundiais. O Canadá tem assinado múltiplos tratados de livre comércio com várias nações. Para os fins do presente trabalho, centrar-nos-emos particularmente na relação entre propriedade intelectual e tratados de livre comércio, examinando as dispo...

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

    OpenAIRE

    Roland Bank

    2003-01-01

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

  9. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-15

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

  10. Application of Near Infrared Spectroscopy, Intravascular Ultrasound and the Coronary Calcium Score to Predict Adverse Coronary Events

    Science.gov (United States)

    2015-10-01

    Award Number: W81XWH-11-1-0831 TITLE: Application of Near Infrared Spectroscopy, Intravascular Ultrasound and the Coronary Calcium Score to...3. DATES COVERED 26-SEP-2014 to 25-SEP-2015 4. TITLE AND SUBTITLE Application of Near Infrared Spectroscopy, Intravascular Ultrasound and the...planned. 15. SUBJECT TERMS coronary artery disease, near infrared spectroscopy, calcium scoring, intravascular ultrasound 16. SECURIY CLASSIFICATION OF

  11. Adult T-cell leukemia/lymphoma: report of two cases Leucemia/linfoma de células T do adulto: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Ricardo Aparecido Olivo

    2008-06-01

    Full Text Available Adult T-cell leukemia/lymphoma is a lymphoproliferative disorder of mature T lymphocytes associated with infection with human T-cell lymphotrophic virus type I (HTLV-I. Adult T-cell leukemia/lymphoma is characterized by clinical and laboratory polymorphism that allows it to be classified into four distinct subgroups: smoldering, chronic, acute and lymphomatous types. We present here two cases of adult T-cell leukemia/lymphoma, respectively in the acute and lymphomatous forms of the disease. Case 1 was a 35-year-old woman who presented abdominal distension accompanied by hepatosplenomegaly, adenomegaly, skin lesions, positivity for anti-HTLV-I antibodies and leukocytosis with the presence of flower cells. Case 2 was a 38-year-old man who was admitted with generalized lymphadenomegaly, positivity for anti-HTLV-I antibodies, hypercalcemia and osteolytic lesions. In this paper, we correlate the clinical-laboratory findings of these two cases with data in the literature.A leucemia/linfoma de células T do adulto é um distúrbio linfoproliferativo de linfócitos T maduros associado à infecção pelo vírus linfotrópico de células T humanas tipo I (HTLV-I. A leucemia/linfoma de células T do adulto tem polimorfismo clínico e laboratorial, que a classifica em quatro subgrupos distintos entre si: smoldering, crônica, aguda e linfomatosa. Apresentamos neste artigo, dois casos de leucemia/linfoma de células T do adulto, respectivamente, nas formas aguda e linfomatosa da doença. O caso 1: uma paciente de 35 anos apresentava distensão abdominal com hepato-esplenomegalia, adenomegalia, lesões cutâneas, anticorpos anti-HTLV-I positivo e leucocitose com presença de flower cell. O caso 2: homem de 38 anos, internado com linfadenomegalia generalizada, anticorpos anti-HTLV-I positivo, hipercalcemia e lesões osteolíticas. Neste artigo correlacionamos os achados clínicos e laboratoriais destes dois casos com dados da literatura.

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

    Directory of Open Access Journals (Sweden)

    Silvana I. Romero Vidomlansky

    2011-06-01

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

  13. Subharmonic contrast intravascular ultrasound for vasa vasorum imaging.

    Science.gov (United States)

    Goertz, David E; Frijlink, Martijn E; Tempel, Dennie; Bhagwandas, Vijay; Gisolf, Andries; Krams, Robert; de Jong, Nico; van der Steen, Antonius F W

    2007-12-01

    The feasibility of subharmonic contrast intravascular ultrasound (IVUS) imaging was investigated using a prototype nonlinear IVUS system and the commercial contrast agent Definity . The system employed a mechanically scanned commercial catheter with a custom transducer element fabricated to have sensitivity at both 15 and 30 MHz. Experiments were conducted at a fundamental frequency of 30 MHz (F30; 25% bandwidth), with on-axis pressures ranging from 0.12 to 0.79 MPa, as measured with a needle hydrophone. In vitro characterization experiments demonstrated the detection of 15 MHz subharmonic signals (SH15) when pressure levels reached 360 kPa. The formation of SH15 images was shown, with tissue signals suppressed to near the noise floor and contrast to tissue ratios were improved by up to 30 dB relative to F30. In vivo experiments were performed using the atherosclerotic rabbit aorta model. Following the bolus injection of contrast agent upstream of the imaging catheter, agent was detected within the aorta, vena cava and within the perivascular space. These results provide a first in vivo demonstration of subharmonic contrast IVUS and suggest its potential as a new technique for imaging vasa vasorum.

  14. [Progress in diagnosis and treatment for disseminated intravascular coagulation].

    Science.gov (United States)

    Wada, Hideo; Matsumoto, Takeshi; Aota, Takumi; Yamashita, Yoshiki

    2015-02-01

    As the development of a hypercoagulable state in the setting of disseminated intravascular coagulation (DIC) induces localized infection, therapy for DIC should be evaluated according to the findings of examinations for both severe sepsis and DIC. DIC is classified into the following types: "bleeding type," "organ failure type," "asymptomatic type," and "complication type." The "bleeding type" and "organ failure type" are considered to reflect the "plasmin inhibitor (PI) deficiency type" and "antithrombin (AT) deficiency type," respectively. In order to improve the diagnosis of DIC, in particular limitations in global coagulation tests, the Japanese Society of Thrombosis and Hemostasis recently proposed tentative diagnostic criteria for DIC using hemostatic molecular markers and AT. The recommendations for treatment of DIC, especially the use of AT concentrates, recombinant activated protein C and thrombomodulin, vary among several guidelines for the management of DIC. These agents inhibit the effects of key proteases in activating coagulation and consequently exert an anti-inflammatory effect on DIC. Hence, it is necessary to extensively evaluate these agents in well-conducted clinical trials.

  15. Diagnostic criteria and laboratory tests for disseminated intravascular coagulation.

    Science.gov (United States)

    Wada, Hideo; Matsumoto, Takeshi; Hatada, Tuyoshi

    2012-12-01

    Three diagnostic criteria for disseminated intravascular coagulation (DIC) have been established by the Japanese Ministry of Health, Labor and Welfare, the International Society on Thrombosis and Hemostasis (ISTH) and the Japanese Association for Acute Medicine. The diagnostic criteria involving global coagulation tests, such as the Japanese Ministry of Health, Labor and Welfare criteria and the ISTH overt diagnostic criteria, are first-generation DIC diagnostic criteria, those involving global coagulation tests and changes in these tests such as the Japanese Association for Acute Medicine criteria, are second-generation DIC diagnostic criteria, and those including non-overt DIC diagnostic criteria involving global coagulation tests, changes in these tests and hemostatic molecular markers will be the future (third-generation) DIC diagnostic criteria. There are no significant differences in the three diagnostic criteria with respect to predicting poor outcomes. Therefore, the third generation of diagnostic criteria including hemostatic molecular markers is expected to be established. Standardization and the determination of adequate cutoff values should be required for each laboratory test.

  16. Back to the future: testing in disseminated intravascular coagulation.

    Science.gov (United States)

    Toh, Cheng-Hock; Downey, Colin

    2005-11-01

    Following on from the first clinical observations on disseminated intravascular coagulation (DIC) in the nineteenth century, the dawn of laboratory testing for DIC began with the availability of assays that characterized the extrinsic and intrinsic pathways of coagulation. Markedly increased clotting times were the hallmark of DIC. As the understanding of the biochemistry of haemostasis and thrombosis improved, new tests were developed based on the molecular players that participate in the process. However, many are non-specific for DIC and/or are unwieldy in performance to keep apace with the demands of the acute clinical setting. The renewed emphasis in DIC for the modern laboratory of the twenty-first century has seen a return to the simple, rapid and practical global tests of coagulation within scoring systems that also capture the pathophysiological continuum by trend analysis. Additionally, new technologies based on these simple tests of coagulation hold promise in also indicating the in vivo interplay between coagulation and inflammation during DIC.

  17. Thromboelastometry in patients with severe sepsis and disseminated intravascular coagulation.

    Science.gov (United States)

    Sivula, Mirka; Pettilä, Ville; Niemi, Tomi T; Varpula, Marjut; Kuitunen, Anne H

    2009-09-01

    Severe sepsis induces coagulopathy, which may lead to disseminated intravascular coagulation (DIC). Thromboelastometry is a point-of-care whole blood coagulation monitor, which has been validated in human endotoxemia model. We assessed thromboelastometry in severe sepsis and overt DIC and investigated its applicability in differentiating sepsis-related coagulation disturbances. Thromboelastometry (EXTEM and FIBTEM tests) and traditional coagulation assays were analyzed in 28 patients with severe sepsis, 12 of who fulfilled the criteria of overt DIC on admission. Ten healthy persons served as controls. Coagulation parameters, clotting time, clot formation time (CFT), alpha angle, maximal clot firmness (MCF) and lysis index at 60 min, were registered. In patients with overt DIC, EXTEM MCF, CFT and alpha angle differed from that in both healthy controls and patients without DIC, indicating hypocoagulation (MCF 52, 63 and 68 mm; CFT 184, 88 and 73 s; and alpha angle 58, 72 and 76 degrees , respectively, P coagulation assays showed progressively worsening coagulopathy from controls to septic patients without DIC and further to those with overt DIC. We conclude that thromboelastometry may be a valuable tool in assessing whole blood coagulation capacity in patients with severe sepsis with and without overt DIC.

  18. Primary intravascular large B-cell lymphoma of pituitary

    Directory of Open Access Journals (Sweden)

    K R Anila

    2012-01-01

    Full Text Available A 68-year-old retired nurse, who was a known hypertensive on medication, presented with prolonged fever of 2-month duration without any clinical evidence of infection. On examination she had altered mental status. She also had other nonspecific complaints such as sleep disturbances, loss of weight, etc. On investigation, she was found to have anemia, thrombocytopenia, raised erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, and lactate dehydrogenase (LDH values. She also had electrolyte imbalance. Radiological evaluation of brain showed mass lesion in the sella turcica, suggestive of pituitary adenoma. Biochemical evaluation showed hypopituitarism. Trans-sphenoidal biopsy was done. Based on histopathological and immunohistochemical findings a diagnosis of intravascular large B-cell lymphoma (IVLBCL of pituitary was made. Our patient′s condition deteriorated rapidly and she succumbed to her illness before therapy could be initiated. We are reporting this case because of the rare subtype of large B-cell lymphoma presenting at an extremely unusual primary site.

  19. Huge Intravascular Tumor Extending to the Heart: Leiomyomatosis

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    Suat Doganci

    2015-01-01

    Full Text Available Intravenous leiomyomatosis (IVL is a rare neoplasm characterized by histologically benign-looking smooth muscle cell tumor mass, which is growing within the intrauterine and extrauterine venous system. In this report we aimed to present an unusual case of IVL, which is originating from iliac vein and extended throughout to right cardiac chambers. A 49-year-old female patient, who was treated with warfarin sodium due to right iliac vein thrombosis, was admitted to our department with intermittent dyspnea, palpitation, and dizziness. Physical examination was almost normal except bilateral pretibial edema. On magnetic resonance venography, there was an intravenous mass, which is originated from right internal iliac vein and extended into the inferior vena cava. Transthoracic echocardiography and transesophageal echocardiography revealed a huge mass extending from the inferior vena cava through the right atrium, with obvious venous occlusion. Thoracic, abdominal, and pelvic MR showed an intravascular mass, which is concordant with leiomyomatosis. Surgery was performed through median sternotomy. A huge mass with 25-cm length and 186-gr weight was excised through right atrial oblique incision, on beating heart with cardiopulmonary bypass. Histopathologic assessment was compatible with IVL. Exact strategy for the surgical treatment of IVL is still controversial. We used one-stage approach, with complete resection of a huge IVL extending from right atrium to right iliac vein. In such cases, high recurrence rate is a significant problem; therefore it should be kept in mind.

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

    DEFF Research Database (Denmark)

    Kosonen, Petteri; Vikman, Saila; Jensen, Lisette Okkels;

    2013-01-01

    This prospective multicenter registry used intravascular ultrasound (IVUS) in patients with definite stent thrombosis (ST) to compare rates of incomplete stent apposition (ISA), stent fracture and stent expansion in patients treated with drug-eluting (DES) versus bare metal (BMS) stents. ST...... is a rare, but potential life threatening event after coronary stent implantation. The etiology seems to be multifactorial....

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

    OpenAIRE

    2010-01-01

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

  2. A imagem e a cor no Tratado de Hume: elementos de ontologia política

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    Cesar Kiraly

    2011-12-01

    Full Text Available Neste ensaio investigo a imagem e a cor no Tratado de Hume, de modo a relacionar com a instituição, em oposição à constituição.In this essay I inquiry the image and the color in Hume's Treatise, in the way to relate with the institution, in opposition to the constitution.

  3. El sistema del Tratado Antártico en sus bodas de oro

    Directory of Open Access Journals (Sweden)

    Roberto Puceiro Ripol

    2010-07-01

    Full Text Available Del pasado al presente ... y hacia el futuro. Una inédita maquinaria provocadora y desafiante. Las partes como protagonistas. Las reuniones consultivas del Tratado Antártico como eje del sistema. Propósitos y principios. Las forzosas nueva convenciones. Los órganos complementarios. Conclusiones

  4. Un Tratado no tan simple: el realismo mágico del funcionalismo.

    OpenAIRE

    2008-01-01

    El Tratado de Lisboa de 13 de diciembre de 2007, fruto de una esforzada, discreta y, por ello, excelete presidencia alemana en el primer semestre de ese año, encara en los meses que quedan de 2008 la recta final del proceso de prestaciones de consentimiento en los Parlamentos nacionales. Proceso no del todo exento de algunos temores.

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

    Directory of Open Access Journals (Sweden)

    M. J. Varas

    2006-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Mila Correia Góis Peixoto

    2009-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Silvia M. Luporini

    2006-12-01

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

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

    Directory of Open Access Journals (Sweden)

    L.F. Moraes

    2012-12-01

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

  9. Linfoma de células en anillo de sello que simula carcinoma mucosecretante Signet ing cell lymphoma mimicking mucin-producing carcinoma

    Directory of Open Access Journals (Sweden)

    Ana María Saenz de Chirife

    2004-12-01

    Full Text Available El linfoma de células en anillo de sello es una neoplasia poco frecuente, caracterizada por la presensencia de grandes células de citoplasma vacuolado, claro, similar a los encontrados en adeno-carcinomas mucosecretantes. Se ha descripto en ganglios linfáticos y tejidos extralinfáticos. Se presenta el caso de un paciente varón de 59 años con linfoma de células en anillo de sello localizado en pared lateral de orofaringe. Esta localización creemos que no ha sido descripta anteriormente. La histología mostró células en anillo de sello y el inmunofenotipo tumoral fue: vimentina, CD45, CD20, Ig M y cadenas kappa positivos, siendo la fracción de crecimiento tumoral alta (Ki 67:70%. El paciente evolucionó desfavorablemente y falleció a los dos meses del diagnóstico sin recibir tratamiento.Signet ring cell lymphoma is a rare neoplasm caracterized by large, vacuolated and clear cells mimicking mucin-producing adenocarcinoma. It is localized in nodal and extranodal sites. A case of a 59 years old male, with a diffuse lymphoma signet ring cell type localized on oropharingeal mucosa is reported. The histopathology study showed signet ring cells and the immunophenotype was: vimentine(+, CD45(+, CD20(+, Ig M(+, Kappa chain(+ and high index proliferative activity of neoplastic cells (Ki 67:70%. After a review of the literature and previous reports, we could not find a similar case in this anatomic site. The patient had a unfavourable clinical course and died two months after the diagnosis without receiving any treatment.

  10. Assessment of culprit lesions by intravascular ultrasound in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    LIU Jian; LIU Chuan-fen; LU Ming-yu; MA Yu-liang; WANG Long; CHEN Hong; WANG Wei-min

    2009-01-01

    Background Intravascular ultrasound has become the standard invasive method for diagnosing coronary artery disease. The aim of the present study was to evaluate the ability of intravascular ultrasound for assessment of culprit lesion morphology during primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).Methods We performed 18 intravascular ultrasound assessments preintervention during the primary PCI for AMI. intravascular ultrasound analysis included qualitative and quantitative measurements of reference and lesion extemal elastic membrane (EEM), lumen, and plaque plus media (P&M) area. Positive remodeling was defined as lesion/mean reference EEM >1.0. Culprit lesions were identified by a combination of electrocardiogram (ECG) and coronary angiography.Results There was an average of 1.44 infarct-related artery (IRA) plaques per patient. The incidences of thrombus and plaque ruptures were 28% (5) and 33% (6), respectively. Hypoechoic plaque was observed in 72% (13) of AMI patients. Calcified lesions could be found in 33% (6) of culprit lesions. Sixty percent of the culprit lesion sites presented with positive remodeling.Conclusions Intravascular ultrasound is a safe and feasible imaging modality in patients with AMI and can help identify plaque rupture, intracoronary thrombus or calcification. The culprit lesion site in AMI cases often presents with positive remodeling.

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

    Directory of Open Access Journals (Sweden)

    Cristina Besada

    2010-06-01

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

  12. Imminent Cardiac Risk Assessment via Optical Intravascular Biochemical Analysis

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-01-01

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

  13. Meta-analysis on intravascular low energy laser therapy

    Science.gov (United States)

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

    2008-12-01

    Intravascular low energy laser therapy (ILELT) was put forward for cardiocirculatory diseases in USA in 1982, was popular in Russia in 1980s, and then in China in 1990s. The therapeutic effects of ILELT and drugs in comparison with drugs only on Chinese patients and their blood parameters were analyzed with meta-analyses and reported as (OR, 95%CI) for patient improvement and (WMD, 95% CI) for blood parameter improvement, where 95%CI, OR and WMD denoted 95% confidence intervals, odds ratio and weighted mean difference, respectively. It was found that the patients of cerebral infarction (2.39, 2.09~2.74) and cerebrovascular diseases (2.97, 1.69~2.53) were cured, respectively, (P low density lipoprotein cholesterol (-0.6, -1.01~-0.19), triacylglycerol (0.63, -0.83~-0.42), high density lipoprotein (0.34, 0.10~0.59), erythrocyte aggregation index (-0.24, -0.27~-0.21), erythrocyte Sedimentation Rate (-4.57, -7.26~-1.89), fibrinogen (-0.76, -1.31~-0.21), whole blood contrast viscosity (-0.40, -0.69~-0.12), low cut blood viscosity (-1.2, -1.93~-0.48), high cut blood viscosity (-0.62, -0.92~-0.32), whole blood viscosity(-1.2, -1.85~-0.54) and plasma blood contrast viscosity(-0.07, -0.12~-0.03) were found improved (P < 0.05). It is concluded that the patients of cerebral infarction, cerebrovascular diseases and diabetes might be improved with ILELT, which might be mediated by blood parameter improvement.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-15

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

  15. Monolithic CMUT-on-CMOS integration for intravascular ultrasound applications.

    Science.gov (United States)

    Zahorian, Jaime; Hochman, Michael; Xu, Toby; Satir, Sarp; Gurun, Gokce; Karaman, Mustafa; Degertekin, F Levent

    2011-12-01

    One of the most important promises of capacitive micromachined ultrasonic transducer (CMUT) technology is integration with electronics. This approach is required to minimize the parasitic capacitances in the receive mode, especially in catheter-based volumetric imaging arrays, for which the elements must be small. Furthermore, optimization of the available silicon area and minimized number of connections occurs when the CMUTs are fabricated directly above the associated electronics. Here, we describe successful fabrication and performance evaluation of CMUT arrays for intravascular imaging on custom-designed CMOS receiver electronics from a commercial IC foundry. The CMUT-on-CMOS process starts with surface isolation and mechanical planarization of the CMOS electronics to reduce topography. The rest of the CMUT fabrication is achieved by modifying a low-temperature micromachining process through the addition of a single mask and developing a dry etching step to produce sloped sidewalls for simple and reliable CMUT-to-CMOS interconnection. This CMUT-to-CMOS interconnect method reduced the parasitic capacitance by a factor of 200 when compared with a standard wire-bonding method. Characterization experiments indicate that the CMUT-on-CMOS elements are uniform in frequency response and are similar to CMUTs simultaneously fabricated on standard silicon wafers without electronics integration. Ex- periments on a 1.6-mm-diameter dual-ring CMUT array with a center frequency of 15 MHz show that both the CMUTs and the integrated CMOS electronics are fully functional. The SNR measurements indicate that the performance is adequate for imaging chronic total occlusions located 1 cm from the CMUT array.

  16. Supportive management strategies for disseminated intravascular coagulation. An international consensus.

    Science.gov (United States)

    Squizzato, Alessandro; Hunt, Beverley J; Kinasewitz, Gary T; Wada, Hideo; Ten Cate, Hugo; Thachil, Jecko; Levi, Marcel; Vicente, Vicente; D'Angelo, Armando; Di Nisio, Marcello

    2016-05-01

    The cornerstone of the management of disseminated intravascular coagulation (DIC) is the treatment of the underlying condition triggering the coagulopathy. However, a number of uncertainties remain over the optimal supportive treatment. The aim of this study was to provide evidence and expert-based recommendations on the optimal supportive haemostatic and antithrombotic treatment strategies for patients with DIC. A working group defined five relevant clinical scenarios. Published studies were systematically searched in the MEDLINE and EMBASE databases (up to May 2014). Seven internationally recognised experts were asked to independently provide clinical advice. A two-phase blinded data collection technique was used to reach consensus. Only three randomised controlled trials (RCTs) on the supportive management of DIC were identified. The RCTs (overall less than 100 patients) investigated the use of fresh frozen plasma and platelet transfusion and found no differences in survival between the intervention and control groups. The experts' approach was heterogeneous, although there was consensus that supportive management should vary according to the underlying cause, clinical manifestations and severity of blood test abnormalities. Platelet transfusion should be given to maintain platelet count > 50×10⁹/l in case of bleeding while a lower threshold of 20 to 30×10⁹/l may be used in DIC without bleeding. Thromboprophylaxis with low-molecular-weight heparin is advised until bleeding ensues or platelet count drops below 30×10⁹/l. In conclusion, in the absence of solid evidence from RCTs, an individualised supportive management of DIC is advisable based on the type of underlying disease, presence of bleeding or thrombotic complications and laboratory tests results.

  17. SEPSIS-ASSOCIATED DISSEMINATED INTRAVASCULAR COAGULATION AND THROMBOEMBOLIC DISEASE

    Directory of Open Access Journals (Sweden)

    Nicola Semeraro

    2010-08-01

    Full Text Available Sepsis is almost invariably associated with haemostatic abnormalities ranging from subclinical activation of blood coagulation (hypercoagulability, which may contribute to localized venous thromboembolism, to acute disseminated intravascular coagulation (DIC, characterized by massive thrombin formation and widespread microvascular thrombosis, partly responsible of the multiple organ dysfunction syndrome (MODS, and subsequent consumption of platelets and coagulation proteins causing, in most severe cases, bleeding manifestations. There is general agreement that the key event underlying this life-threatening sepsis complication is the overwhelming inflammatory host response to the infectious agent leading to the overexpression of inflammatory mediators. Mechanistically, the latter, together with the micro-organism and its derivatives, causes DIC by 1 up-regulation of procoagulant molecules, primarily tissue factor (TF, which is produced mainly by stimulated monocytes-macrophages and by specific cells in target tissues; 2 impairment of physiological anticoagulant pathways (antithrombin, protein C pathway, tissue factor pathway inhibitor, which is orchestrated mainly by dysfunctional endothelial cells (ECs; and 3 suppression of fibrinolysis due to increased plasminogen activator inhibitor-1 (PAI-1 by ECs and likely also to thrombin-mediated  activation of thrombin-activatable fibrinolysis inhibitor (TAFI. Notably, clotting enzymes non only lead to microvascular thrombosis but can also elicit cellular responses that amplify the inflammatory reactions. Inflammatory mediators can also cause, directly or indirectly, cell apoptosis or necrosis and recent evidence indicates that products released from dead cells, such as nuclear proteins (particularly extracellular histones, are able to propagate further inflammation, coagulation, cell death and MODS. These insights into the pathogenetic mechanisms of DIC and MODS may have important implications for the

  18. Biopsia por aspiración con aguja fina (BAAF) para el diagnóstico de linfoma no hodking cutáneo asociado a HTLV I-II. Presentación de caso.

    OpenAIRE

    Núñez Carrión., Ericka Cecilia

    2010-01-01

    INTRODUCCIÓN: El HTLV-1 es el primer retrovirus oncógeno humano que fue aislado por vez primera. Más tarde se demostró que el virus del linfoma leucemia de células T humanas (HTLV-1) era el agente causal de la Leucemia/linfoma de células T del adulto (ATL). EL HTLV-1 es más común en Japón y en el Caribe que en los Estados Unidos. También se ha descrito posteriormente en varios países latinoamericanos incluyendo Perú. El HTLV-1 pertenece a la familia de los retrovirus humanos, con tropismo pos...

  19. Nonlinear dynamic characteristics of SMA intravascular stent under radial stochastic loads.

    Science.gov (United States)

    Zhu, Zhiwen; Zhang, Qingxin; Xu, Jia

    2014-01-01

    Nonlinear dynamic characteristics of shape memory alloy (SMA) intravascular stent under radial stochastic loads were studied in this paper. Von de Pol item was improved to interpret the hysteretic phenomena of SMA, and the nonlinear dynamic model of SMA intravascular stent under radial stochastic loads was developed. The conditions of stochastic stability of the system were obtained in singular boundary theory. The steady-state probability density function of the dynamic response of the system was given, and the stochastic Hopf bifurcation characteristics of the system were analyzed. Theoretical analysis and numerical simulation show that the stability of the trivial solution varies with bifurcation parameters, and stochastic Hopf bifurcation appears in the process, which can cause stent fracture or loss. The results of this paper are helpful to application of SMA intravascular stent in biomedical engineering fields.

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

    Directory of Open Access Journals (Sweden)

    Watanabe,Makoto

    1978-04-01

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

  1. Intravascular lymphoma presenting as a specific pulmonary embolism and acute respiratory failure: a case report

    Directory of Open Access Journals (Sweden)

    Georgin-Lavialle Sophie

    2009-05-01

    Full Text Available Abstract Introduction The occurrence of an intravascular lymphoma with severe pulmonary involvement mimicking pulmonary embolism is described. Case presentation A 38-year-old man was referred to our intensive care unit with acute respiratory failure and long lasting fever. Appropriate investigations failed to demonstrate any bacterial, viral, parasitic or mycobacterial infection. A chest computed tomography scan ruled out any proximal or sub-segmental pulmonary embolism but the ventilation/perfusion lung scan concluded that there was a high probability of pulmonary embolism. The cutaneous biopsy pathology diagnosed intravascular lymphoma. Conclusion Intravascular lymphoma is a rare disease characterized by exclusive or predominant growth of neoplastic cells within the lumina of small blood vessels. Lung involvement seems to be common, but predominant lung presentation of this disease is rare. In our patient, urgent chemotherapy, along with adequate supportive care allowed complete recovery.

  2. Accumulation of /sup 99m/Tc-sulfur colloid by the lung and kidney following disseminated intravascular coagulation

    Energy Technology Data Exchange (ETDEWEB)

    Smith, F.W.; Brown, R.G.; Ash, J.M.; Gilday, D.L.

    1980-06-01

    A patient is described who demonstrated accumulation of /sup 99m/Tc-sulfur colloid in both the lung and kidney following treatment for disseminated intravascular coagulation. This phenomenon has been demonstrated experimentally in animals following the induction of disseminated intravascular coagulation, but to our knowledge has not been previously described in humans.

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

    Directory of Open Access Journals (Sweden)

    Alan Kardec Barreira Junior

    2011-04-01

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

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

    Directory of Open Access Journals (Sweden)

    José Antonio Sanches Jr

    2006-02-01

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

  5. Introduction of a programme for intravascular transfusions at severe rhesus isoimmunization.

    Science.gov (United States)

    Westgren, M; Jabbar, F; Larsen, J F; Rahman, F; Selbing, A; Stangenberg, M

    1988-01-01

    Thirty-seven fetuses with severe rhesus isoimmunization with a gestational age of less than 30 week underwent 92 intravascular transfusions. Of these, 77 were intracardiac, 13 umbilical vein and two umbilical artery transfusions. Procedure related complications occurred at eight (10%) intracardiac and at two (14%) umbilical cord transfusions. Reversal of hydrops was observed in 10 of 16 fetuses. The perinatal mortality among transfusion treated fetuses was 8/37 (21%). It is concluded that intravascular, intrauterine transfusion leads to improved results among fetuses with early onset of hydrops. Problems concerning indications and technique are discussed.

  6. Recent acquisitions in the pathophysiology, diagnosis and treatment of disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Lippi Giuseppe

    2006-02-01

    Full Text Available Abstract Disseminated intravascular coagulation (DIC is a disorder characterized by both acute generalized, widespread activation of coagulation, which results in thrombotic complications due to the intravascular formation of fibrin, and diffuse hemorrhages, due to the consumption of platelets and coagulation factors. Systemic activation of coagulation may occur in a variety of disorders, including sepsis, severe infections, malignancies, obstetric or vascular disorders, and severe toxic or immunological reactions. In this review, we briefly report the present knowledge about the pathophysiology and diagnosis of DIC. Particular attention is also given to the current standard and experimental therapies of overt DIC.

  7. Avances y perspectivas del aprovechamiento del tratado de libre comercio con Estados Unidos

    Directory of Open Access Journals (Sweden)

    Hernando José Gómez

    2013-08-01

    Full Text Available En este artículo se hace una revisión de las oportunidades y los retos de exportación frente al Tratado de Libre Comercio (TLC con Estados Unidos. Asimismo, se traza un análisis de las necesidades transversales de los sectores de la economía incluyendo temas sanitarios, fitosanitarios y de calidad. De igual manera, se destaca la importancia de robustecer la industria nacional en términos de competitividad del sector agrícola y ganadero, confecciones, servicios en salud, metalmecánica, agroindustria, entre otros, de la mano de acciones logísticas y estrategias de innovación para lograr la eficiencia y aprovechamiento del tratado bilateral.

  8. Tratado de Clínica Pediátrica, 3 volumes

    OpenAIRE

    2014-01-01

    Aceitei opinar sobre o TRATADO DE CLÍNICA PEDIÁTRICA, honrado com o convite da Acta Pediátrica Portuguesa, para poder dar testemunho da muita admiração que tenho pelo autor: pela pessoa, pelo pedagogo eminente e empenhado, e pelo técnico e cientista.Há cerca de seis meses começou a distribuição do terceiro e último volume da obra - TRATADO DE CLÍNICA PEDIÁTRICA, cujo editor/coordenador é o médico - pediatra, Professor João M. Videira Amaral(JMVA), Catedrático Jubilado da Faculdade de Ciências...

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

    Directory of Open Access Journals (Sweden)

    M Mohandes

    2010-09-01

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

  10. IMPACT OF OBESITY ON ENDOTOXIN-INDUCED DISSEMINATED INTRAVASCULAR COAGULATION.

    Science.gov (United States)

    Duburcq, Thibault; Tournoys, Antoine; Gnemmi, Viviane; Hubert, Thomas; Gmyr, Valery; Pattou, François; Jourdain, Mercé

    2015-10-01

    An early activation of coagulation and fibrinolysis occurs during sepsis, leading to the syndrome of disseminated intravascular coagulation (DIC). Obesity has been demonstrated to be a hypercoagulable and hypofibrinolytic state, but its impact on DIC has never been studied. In this study, we aimed to determine if obesity impairs DIC in an acute endotoxic shock model using minipigs. This was a prospective, comparative, and experimental ancillary study approved by the Animal Ethics Committee. Pigs were chosen as a clinically relevant species, resembling humans in coagulation reactions. Four groups of five "Yucatan" minipigs were studied: lean and obese control groups, a lean lipopolysaccharide (LPS) group receiving Escherichia coli endotoxin (LPS), and an obese LPS group receiving the same endotoxin dose. We measured standard coagulation parameters (prothrombin time [PT], platelet count, and fibrinogen levels), thrombin-antithrombin complexes, tissue-type plasminogen activator, and plasminogen activator inhibitor-1. All measurements were performed at baseline and 30, 60, 90, 150, and 300 min. Results were given as median with interquartile ranges. At baseline, platelet count (477 [428 - 532] G/L vs. 381 [307 - 442] G/L; P = 0.005) and fibrinogen levels (4.6 [3.8 - 5.2] g/L vs. 2 [1.8 - 2.9] g/L; P coagulation parameters (PT, platelet count, and fibrinogen levels) and the increase in thrombin-antithrombin complexes (581 [382 - 1,057] μg/mL vs. 247 [125 - 369] μg/mL at 150 min; P = 0.03) were significantly more important in the obese LPS group compared with those in the lean LPS group. Concerning the fibrinolytic reaction, we found a slightly more elevated increase of plasminogen activator inhibitor-1 in the obese LPS group at 300 min (481 [365 - 617] ng/mL vs. 355 [209 - 660] ng/mL; P = 0.66). In our model of endotoxic shock, obese pigs developed a more severe DIC with a more severe procoagulant response.

  11. Rifampicin-induced disseminated intravascular coagulation in pulmonary tuberculosis treatment

    Science.gov (United States)

    Chen, Guo; He, Jian-Qing

    2017-01-01

    Abstract Rationale: Disseminated intravascular coagulation (DIC) induced by daily rifampicin therapy is rare, especially the patient is absent of malignancy, severe infection, and prior exposure to rifampicin. Patient concerns: We report a case of DIC induced by daily rifampicin treatment for pulmonary tuberculosis. A 22-year-old, previously healthy man received an anti-tuberculosis therapy consisting of isoniazid, rifampicin, ethambutol, and pyrazinamide on the daily dose recommended by the World Health Organization tuberculosis guidelines after a diagnosis of pulmonary tuberculosis. Two weeks later, he was transferred to the West China Hospital with nasal hemorrhage for 1 week, hematochezia, hematuria, and petechiae for 5 days. Diagnoses: Laboratory data and symptoms on admission indicated DIC. Interventions: The anti-tuberculosis drugs were discontinued after admission and he was initiated with targeted treatment for DIC, omeprazole and polyene hosphatidylcholine infusion, as well as nutrition supportive treatment. Five days after admission, ethambutol, moxifloxacin, and amikacin were added to the patient without further active hemorrhage. Eight days after admission, the platelet count had risen gradually. Isoniazid was administered on 24 days after admission, while his liver function tests and platelet counts returned to normal. No recurrence of DIC occurred. The diagnosis of rifampicin-induced DIC was confirmed. Outcomes: The patient recovered and left hospital with isoniazid, ethambutol, levofloxacin, and streptomycin after 4 weeks of hospitalization. There was no recurrence of DIC or hemorrhage during the 8 months of follow-up. The literature review revealed that there were 10 other cases of rifampicin-induced DIC. Only 4 cases received rifampicin on a daily basis for pulmonary tuberculosis treatment and the others were on intermittent dosing schedule for pulmonary tuberculosis or leprosy treatment. Lessons: As a rare adverse effect, DIC induced by

  12. A influência dos tratados de cálculo infinitesimal de Euler no séc. XVIII

    OpenAIRE

    João Caramalho Domingues, João

    2012-01-01

    Leonhard Euler (1701–1783) foi provavelmente o mais influente matemático do séc. XVIII. Entre as suas obras clássicas contam-se três tratados que, no seu conjunto (perfazendo seis volumes), fornecem uma apresentação «completa» do cálculo infinitesimal: uma introdução à análise infinitesimal [Euler 1748 ]; um tratado de cálculo diferencial [Euler 1755 ]; e um tratado de cálculo integral [Euler 1768–1770 ]. Estes tratados são muito mais avançados do que quaisquer outros publicados anteriormente...

  13. Los tratados internacionales (art. 93 a 96 de la CE). Especial referencia a la ciudadanía europea

    OpenAIRE

    Mangas, Araceli

    2016-01-01

    El artículo analiza la posición de la Constitución española en materia de tratados internacionales, en especial la atribución del ejercicio de derechos soberanía, y los efectos de la ciudadanía de la UE en el sistema constitucional español ante el Tratado de Maastricht de 1992.

  14. Utilização de efluente tratado em complexo industrial automotivo

    Directory of Open Access Journals (Sweden)

    Sandro Carlos Pohl

    Full Text Available RESUMO Neste trabalho, realizaram-se modificações nos sistemas produtivo e de tratamento de efluentes em um complexo industrial automotivo a fim de possibilitar a utilização do efluente tratado no sistema de torres de resfriamento. Inicialmente, realizou-se um balanço hídrico nos processos industriais para determinar o consumo de água e analisou-se a qualidade do efluente tratado quanto aos parâmetros físico-químicos em dois pontos do sistema de tratamento de efluentes: no decantador secundário (P1 do tratamento físico-químico e na saída da lagoa de polimento (P2. Essas análises mostraram que o efluente tratado no decantador secundário não tem capacidade de atender às especificações da água de circulação das torres de resfriamento sem a realização de muitas alterações em seu tratamento, optando-se pela utilização do efluente tratado na saída da lagoa de polimento após modificações, como: alteração na concentração de ácido fosfórico e de ácido nítrico da solução de limpeza dos tanques de fosfatização, elevação em 50% da capacidade de aeração da lagoa aerada e troca do coagulante sulfato de alumínio pelo cloreto férrico no tratamento físico-químico. Assim, os parâmetros do efluente tratado na lagoa de polimento aproximaram-se aos parâmetros especificados para água de torres de resfriamento. A introdução desse efluente na proporção de 40% do volume da água de circulação na torre de resfriamento resultou em elevação do ciclo de dureza e redução no ciclo de sílica. A utilização de um filtro abrandador na saída da lagoa de polimento proporcionou a redução dos parâmetros de qualidade da água para valores similares aos da água de recirculação nas torres de resfriamento.

  15. Disseminated intravascular coagulation as an unusual presentation of an Epstein-Barr virus infection

    NARCIS (Netherlands)

    van Steijn, JHM; van Tol, KM; van Essen, LH; Gans, ROB

    2000-01-01

    Epstein-Barr viral (EBV)-infection usually presents as fever, sore throat, fatigue, lymphadenopathy and atypical lymphocytosis. We describe a patient with disseminated intravascular coagulation as the presenting symptom caused by a primary EBV infection. (C) 2000 Elsevier Science B.V. All rights res

  16. Coronary plaque composition as assessed by greyscale intravascular ultrasound and radiofrequency spectral data analysis

    NARCIS (Netherlands)

    N. Gonzalo (Nieves); H.M. Garcia-Garcia (Hector); J.M.R. Ligthart (Jürgen); G.A. Rodriguez-Granillo (Gaston); E. Meliga (Emanuele); Y. Onuma (Yoshinobu); J.C.H. Schuurbiers (Johan); N. Bruining (Nico); P.W.J.C. Serruys (Patrick)

    2008-01-01

    textabstractObjectives: (i) To explore the relation between greyscale intravascular ultrasound (IVUS) plaque qualitative classification and IVUS radiofrequency data (RFD) analysis tissue types; (ii) to evaluate if plaque composition as assessed by RFD analysis can be predicted by visual assessment o

  17. Serial intravascular ultrasound assessment of changes in coronary atherosclerotic plaque dimensions and composition: an update

    DEFF Research Database (Denmark)

    Hartmann, Marc; Huisman, Jennifer; Böse, Dirk;

    2011-01-01

    This manuscript reviews the use of serial intravascular ultrasound (IVUS) examination of coronary atherosclerosis in recent observational studies and randomized trials that revealed the effects of cholesterol-lowering and lipid-modifying therapies and offered novel insight into plaque progression...

  18. Lung and renal uptake of techneticum Tc 99m sulphur colloid related to disseminated intravascular coagulation

    Energy Technology Data Exchange (ETDEWEB)

    Jelle Teertstra, H.; Verdegaal, W.P.; Ras, G.J.

    1985-01-01

    In addition to a recently published case study, we present another three cases in which we observed both lung and renal uptake of technetium Tc 99m sulphur colloid which was related to a period of disseminated intravascular coagulation. Being familiar with this relationship may influence the diagnosis and course of the illness in certain patients.

  19. [Rhabdomyolysis, disseminated intravascular coagulation and multiple organ failure in a patient with cocaine and heroine poisoning].

    Science.gov (United States)

    Vreugdenhil, G; Ligthart, J; de Leeuw, P W

    1992-06-20

    A 19-year-old female patient with cocaine and heroin intoxication is described in whom several life threatening complications such as hypovolemic shock, cardiopulmonary insufficiency, rhabdomyolysis, diffuse intravascular coagulation and multiple organ failure occurred. The patient survived the intoxication after quick intensive treatment.

  20. Three-dimensional quantitative coronary angiography and the registration with intravascular ultrasound and optical coherence tomography

    NARCIS (Netherlands)

    Tu, Shengxian

    2012-01-01

    This thesis proposes several new algorithms including X-ray angiographic image enhancement, three-dimensional (3D) angiographic reconstruction, angiographic overlap prediction, and the co-registration of X-ray angiography with intracoronary imaging devices, such as intravascular ultrasound (IVUS) an

  1. Radiological imaging of florid intravascular papillary endothelial hyperplasia in the mandibule: case report and literature review.

    Science.gov (United States)

    Xu, Sheng-Sheng; Li, Dan

    2014-01-01

    Intravascular papillary endothelial hyperplasia was a rare benign vascular proliferative process as a result of papillary proliferation of the endothelial cells within the vessels. To our knowledge, we reported the second case occurring in the madibule, and the first reported in 1984 in the literature. We discussed manifestations of multislice computed tomography and panoramic radiography about the lesion and relevant literature was reviewed.

  2. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies

    DEFF Research Database (Denmark)

    Tearney, Guillermo J; Regar, Evelyn; Akasaka, Takashi

    2012-01-01

    The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the di...... the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease....

  3. Introducing intravascular microdialysis for continuous lactate monitoring in patients undergoing cardiac surgery : a prospective observational study

    NARCIS (Netherlands)

    Schierenbeck, Fanny; Nijsten, Maarten W. N.; Franco-Cereceda, Anders; Liska, Jan

    2014-01-01

    Introduction: Lactate is a marker of hypoperfusion and may be used for risk assessment in critically ill patients. Although evidence suggests that repeated lactate measurements are of clinical interest, how and when lactate should be analyzed is controversial. Intravascular microdialysis provides a

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

    NARCIS (Netherlands)

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

    2002-01-01

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

  5. High-resolution intravascular magnetic resonance quantification of atherosclerotic plaque at 3T

    Directory of Open Access Journals (Sweden)

    Qian Di

    2012-03-01

    Full Text Available Abstract Background The thickness of fibrous caps (FCT of atherosclerotic lesions is a critical factor affecting plaque vulnerability to rupture. This study tests whether 3 Tesla high-resolution intravascular cardiovascular magnetic resonance (CMR employing tiny loopless detectors can identify lesions and accurately measure FCT in human arterial specimens, and whether such an approach is feasible in vivo using animal models. Methods Receive-only 2.2 mm and 0.8 mm diameter intravascular loopless CMR detectors were fabricated for a clinical 3 Tesla MR scanner, and the absolute signal-to-noise ratio determined. The detectors were applied in a two-step protocol comprised of CMR angiography to identify atherosclerotic lesions, followed by high-resolution CMR to characterize FCT, lesion size, and/or vessel wall thickness. The protocol was applied in fresh human iliac and carotid artery specimens in a human-equivalent saline bath. Mean FCT measured by 80 μm intravascular CMR was compared with histology of the same sections. In vivo studies compared aortic wall thickness and plaque size in healthy and hyperlipidemic rabbit models, with post-mortem histology. Results Histology confirmed plaques in human specimens, with calcifications appearing as signal voids. Mean FCT agreed with histological measurements within 13% on average (correlation coefficient, R = 0.98; Bland-Altman analysis, -1.3 ± 68.9 μm. In vivo aortic wall and plaque size measured by 80 μm intravascular CMR agreed with histology. Conclusion Intravascular 3T CMR with loopless detectors can both locate atherosclerotic lesions, and accurately measure FCT at high-resolution in a strategy that appears feasible in vivo. The approach shows promise for quantifying vulnerable plaque for evaluating experimental therapies.

  6. Comparação entre as técnicas de imunofenotipagem por citometria de fluxo e reação em cadeia da polimerase no diagnóstico dos linfomas folicular e difuso de grande célula B

    OpenAIRE

    Silva, Renata da

    2009-01-01

    Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências Biológicas. Programa de Pós-Graduação em Biotecnologia. Os linfomas constituem um grupo heterogêneo de desordens malignas com diferentes comportamentos clínicos, distintos fatores patológicos e características epidemiológicas. O Linfoma Folicular (LF) e o Linfoma Difuso de Grande Célula B (LDGC) são os mais freqüentes tipos de neoplasia linfóide de células B maduras. Na atual classificação OMS para os linfo...

  7. Micose fungoide: relato de caso tratado com radioterapia Mycosis fungoides: case report treated with radiotherapy

    Directory of Open Access Journals (Sweden)

    Gustavo Nader Marta

    2011-06-01

    Full Text Available Micose fungoide é um tipo de linfoma não Hodgkin de células T raro que acomete primariamente a pele. Caracteriza-se pela presença de placas eritematosas que evoluem para lesões ulceradas, tumores em toda a pele ou ainda infiltração de medula óssea em estágios avançados. Como opção de tratamento para os casos iniciais, tem-se quimioterapia e corticoterapia tópica, fototerapia e radioterapia. Este estudo relata o caso de um doente com múltiplas lesões tumorais na pele já biopsiadas com diagnóstico de micose fungoide. O paciente foi refratário ao tratamento com quimioterapia tópica e fototerapia, sendo então indicada irradiação total da pele com elétronsMycosis fungoides is a rare type of non-Hodgkin's lymphoma of T cells that primarily affects the skin. It is characterized by the presence of erythematous plaques that evolve into ulcerated lesions, tumors throughout the skin or even bone marrow infiltration in advanced stages. Chemotherapy and topical steroids, phototherapy and radiotherapy are treatment options for early cases. This study reports the case of patient with multiple tumor lesions in the skin already biopsied with diagnosis of mycosis fungoides. The patient was refractory to both treatments with topical chemotherapy and phototherapy. It was then indicated total skin irradiation with electrons

  8. Dermatomiosite juvenil e linfoma de Hodgkin: uma rara associação Juvenile dermatomyositis and Hodgkin disease: a rare association

    Directory of Open Access Journals (Sweden)

    André Cavalcanti

    2007-12-01

    Full Text Available A dermatomiosite (DM em adultos está freqüentemente associada com câncer. Já na faixa etária pediátrica, a dermatomiosite juvenil (DMJ é predominantemente idiopática, e sua associação com neoplasia é rara e com base apenas em relatos de casos. Embora rara, a presença de neoplasia em pacientes com DMJ deve ser sempre suspeitada quando houver manifestações clínicas atípicas e alterações laboratoriais incomuns. A seguir, descrevemos e discutimos um caso de DMJ e linfoma de Hodgkin em uma adolescente.Dermatomyositis (DM in adults is frequently associated with cancer. In contrast, during childhood juvenile dermatomyositis (JDM is predominantly idiopathic and its association with neoplasia is rare and based only in case reports. Although rare, the presence of neoplasia in JDM patients must always be suspected in face of atypical clinical manifestations and uncommon laboratorial findings. We describe and discuss a case of JDM and Hodgkin disease in an adolescent.

  9. Derechos fundamentales y estatuto jurídico de las iglesias tras el Tratado de Lisboa

    OpenAIRE

    Rordrigues-Arújo, A.M. (Alexandra Maria)

    2011-01-01

    Este trabajo versa sobre la relación entre el estatuto de las iglesias y los derechos fundamentales en la Unión Europea. Se estructura en dos partes. La primera se refiere a la protección de los derechos fundamentales en la UE; la segunda aborda las tres cuestiones más importantes que sur- gieron sobre el tema en las discusiones de la Con- vención Europea celebrada para la elaboración de la llamada Constitución Europea, que, tras su fracaso, dio lugar al Tratado de Lisboa: 1a. La relación ent...

  10. Avaliação do crescimento e desenvolvimento de ratos tratados com Pereskia aculeata, Miller

    OpenAIRE

    Silva,Débora Oliveira da; Dias, Álvaro Guerra; Silva, Adriana Lourenço da

    2012-01-01

    A planta Perskia aculeata, Miller, conhecida no Brasil como ora-pro-nobis, possui elevados teores de proteína, fibras dietéticas totais, minerais e vitaminas. O presente estudo buscou avaliar o crescimento e o desenvolvimento de ratos tratados com dietas contendo a planta Pereskia aculeata, Miller e restrição de proteína. Foram utilizados 24 ratos machos, recém desmamados da linhagem Wistar. Os animais foram divididos em 4 grupos de dieta: padrão de caseína; restrição total de proteína; su...

  11. Láminas y tratados franceses en la academia de bellas artes de puebla

    OpenAIRE

    Boadella, Montserrat Galí

    2015-01-01

    En este ensayo se analiza la influencia que tuvieron, para la vicia artística de Puebla, los libros, láminas y tratados franceses de la Academia de Bellas Artes de esta ciudad. Fundada en 1813, dicha institución poseía un importante acervo de impresos franceses, algunos de ellos donados por los protectores de la Academia: otros comprados en Francia por José Manzo y Jaramillo, profesor de dibujo de la misma. La presencia de estos materiales apunta hacia un problema más amplio: el de la influen...

  12. DESEQUILIBRIO EN LA APLICACION DEL TRATADO DE EXTRADICION SUSCRITO ENTRE COLOMBIA Y ESTADOS UNIDOS

    OpenAIRE

    Franco Viggiani, Leidy Mariana; Ruiz Barajas, Yulieth Paola

    2015-01-01

    El tema de la extradición ha cobrado mucha vigencia en los últimos años producto de la entrega a Estados Unidos, de varios capos del narcotráfico, así como de jefes de los grupos de autodefensa, y algunos miembros de las Farc; así como otra serie de ciudadanos colombianos, que han sido pedidos en extradición por diferentes delitos. Estas extradiciones, a pesar de haberse suscrito un tratado de extradición entre los dos países, no se han celebrado en el marco del mismo, pues este a pesar de...

  13. Accurate monitoring of intravascular fluid volume: A novel application of intrathoracic impedance measures for the guidance of volume reduction therapy

    Directory of Open Access Journals (Sweden)

    Barbara A. Lara

    2015-09-01

    Conclusion: Impedance vectors derived from a multivector monitoring system reflect changes in intravascular plasma volume. Two of these vectors most closely track changes in plasma volume and may be used to more accurately guide and optimize volume reduction therapy.

  14. COAGULACIÓN INTRAVASCULAR DISEMINADA SECUNDARIA A ANEURISMA AÓRTICO DIAGNOSTICADA TRAS EXTRACCIÓN DENTAL

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    Cuevas-Ruiz MV

    2006-04-01

    Full Text Available RESUMEN:Las manifestaciones de la coagulación intravascular diseminada (CID están determinadas por la causa subyacente; sin embargo, en los casos de CID compensada el diagnóstico se basa en las pruebas de laboratorio.Presentamos el caso de un varón de 81 años al que se diagnostico de una coagulación intravascular diseminada secundaria a un aneurisma gigante de ambas ilíacas tras una extracción dentaria. SUMMARYThe clinical presentation of disseminated intravascular coagulopathy (DIC is determined by the underlying disease. However, in patients with chronic DIC the diagnostic is based in laboratory tests.We report a case of an 81-year-old male who was diagnosed disseminated intravascular coagulopathy secondary to gigant iliac aneurysm after a dental extraction

  15. La reforma de la Constitución Argentina de 1994 y los tratados sobre Derechos Humanos a 20 años de su vigencia

    OpenAIRE

    Hitters, Juan Carlos

    2014-01-01

    Sumario: - I. La reforma de 1994. Generalidades. A. Introducción. B. Los Tratados Internacionales sobre Derechos Humanos. 1) Generalidades. 2) Particularidades. C. El Derecho Internacional de los Derechos Humanos. D. Internacionalización de los Derechos Humanos. - II. Particularidades de la Reforma de 1994. Jerarquía Constitucional de los Tratados sobre Derechos Humanos. A. Generalidades. La constitución internacionalizada. B. Tratados Internacionales sobre Derechos Human...

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

    Directory of Open Access Journals (Sweden)

    Flávia P. S. Costa

    2005-03-01

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

  17. Consideraciones jurídicas sobre la jurisprudencia del Tribunal Constitucional sobre tratados internacionales y derechos esenciales contenidos en tratados internacionales, después de la reforma constitucional de 2005

    Directory of Open Access Journals (Sweden)

    Humberto Nogueira Alcalá

    2013-01-01

    Full Text Available El artículo tiene por finalidad analizar la jurisprudencia del Tribunal Constitucional chileno acerca de la consideración de los tratados internacionales después de la reforma constitucional de 2005 al artículo 54 No 1 de la Constitución, como asimismo, el tratamiento jurisprudencial acerca de los derechos esenciales asegurados por tratados internacionales y la determinación de si el Tribunal Constitucional realiza una distinción adecuada entre los derechos esenciales que como tales limitan el ejercicio de la soberanía y el tratado internacional en que dichos derechos se encuentran asegurados y garantizados.

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

    Directory of Open Access Journals (Sweden)

    Hugo Fontan Köhler

    2008-12-01

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

  19. Un tratado sobre la extranjería de lo propio (El uruguayo de Copi

    Directory of Open Access Journals (Sweden)

    María Negroni

    2006-09-01

    Full Text Available El uruguayo de Copi es un tratado sobre la lengua, una descripción desopilante de un país, un ácido comentario político, una burla impiadosa de los valores culturales, una pesadilla personal, un golpe de teatro donde cualquier versión de la realidad se vuelve precaria y se trastoca al compás de una imaginación afiebrada que no hace más que dar rienda suelta a los materiales del inconsciente. Pero sobre todo, es la visión desnuda de la relación imposible de un escritor con el país que ha dejado atrás. Un tratado sobre el horror de confrontarse con la realidad carcelaria del pasado. Un intento de "calmar" los fantasmas, es decir, de hacerlos hablar y moverse y morir y resucitar en una trama que transita en medio de cadáveres y mares desaparecidos y un territorio que se achica constantemente. Un texto fundamental para indagar cuestiones relacionadas con la "identidad" nacional y con las maneras en que los desplazamientos culturales (con su concomitante tránsito entre lenguas y visiones del mundo, tan comunes en el mundo actual, afectan la escritura.

  20. Proteccionismo, filibusterismo, libre comercio: José Martí y los tratados comerciales

    Directory of Open Access Journals (Sweden)

    José Luis Díaz Naranjo

    2014-07-01

    Full Text Available Aun cuando los tratados de libre comercio se han constituido en los principales instrumentos de regulación en lo comercial, entre países, en los últimos 25 años, estos han sido un referente constante en los procesos bilaterales y multilaterales de negociación en esta materia. Como práctica se remonta al siglo XIX. En este sentido José Martí, héroe cubano, desarrolla un análisis del acuerdo comercial entre México y los Estados Unidos, propuesto en 1883, que mantiene vigencia, sobre la base de los preceptos en los que se fundamenta, el tráficode mercancías y uso de recursos de todo tipo. Los acuerdos de esta naturaleza responden a estrategias propias del proceso de acumulación de capital, dentro del marco de la realización de la ganancia. Este artículo hace referencia al análisis martiano y su expresión en el proceso de globalización del signo actual, el referido a los tratados de libre comercio como medios de expansión y dominio político y económico.

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

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    de la Peña Barroso, Efrén

    2012-12-01

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

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

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    Lorenzo Martín-Retortillo Baquer

    2011-07-01

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

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

    DEFF Research Database (Denmark)

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

    1989-01-01

    1. The effect of intravenous catecholamine infusions and of intravenous insulin on plasma volume and intravascular mass of albumin was investigated in healthy males. 2. Physiological doses of adrenaline (0.5 microgram/min and 3 microgram/min) increased peripheral venous packed cell volume...... significantly; intravenous noradrenaline at 0.5 microgram/min had no effect on packed cell volume, whereas packed cell volume increased significantly at 3 micrograms of noradrenaline/min. No significant change in packed cell volume was found during saline infusion. 3. During adrenaline infusion at 6 micrograms...... in packed cell volume, plasma volume, intravascular mass of albumin and transcapillary escape rate of albumin during hypoglycaemia may be explained by the combined actions of adrenaline and insulin....

  4. Regression of coronary atherosclerosis by simvastatin: a serial intravascular ultrasound study

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Pedersen, Knud Erik;

    2004-01-01

    BACKGROUND: Angiography of the coronary arteries reflects only changes in luminal dimensions. With intravascular ultrasound, cross-sectional images can be obtained and area measurements can be added to calculate volumes of the external elastic membrane (EEM), plaque plus media (P+M), and lumen...... in a not previously revascularized coronary artery, serial intravascular ultrasound studies with an ECG-triggered pullback were performed at baseline, after 3 months on a lipid-lowering diet, and after another 12 months on simvastatin 40 mg/d. Mean length of the analyzed atherosclerotic segments was 5.9+/-3.3 mm.......2+/-0.7 mmol/L, Ptherapy with simvastatin for 12 months is associated with a significant P+M regression in coronary arteries measured as reduction in P+M and EEM volumes without any...

  5. An Arthrobacter spp. bacteremia leading to fetal death and maternal disseminated intravascular coagulation.

    Science.gov (United States)

    Shigeta, Naoya; Ozaki, Kimiaki; Hori, Kensuke; Ito, Kimihiko; Nakayama, Masahiro; Nakahira, Kumiko; Yanagihara, Itaru

    2013-02-01

    A 34-year-old parous woman developed high fever and threatened preterm labor after a 1-day trip, for which she was receiving prenatal care at a hospital. Three days after onset, at 24 4/7 weeks of gestation, she was transferred to our hospital in an emergency. Soon after the woman's arrival at our hospital, the infant was spontaneously stillborn via a transvaginal delivery. Laboratory tests revealed severe maternal disseminated intravascular coagulation with renal and liver insufficiency. Histopathologic examination of the placenta revealed vast fibrin deposition and remarkable neutrophilic infiltration in the intervillous space, suggesting a rare bacterial infection caused by Arthrobacter spp. The bacteria were predominantly detected in the placenta and maternal blood serum by common bacterial 16S rRNA sequencing after polymerase chain reaction amplification. We report the first case, to our knowledge, of bacteremia with Arthrobacter spp., which may lead to maternal disseminated intravascular coagulation and intrauterine fetal death.

  6. Distal polyneuropathy after canine heartworm disease therapy complicated by disseminated intravascular coagulation.

    Science.gov (United States)

    Dillon, A R; Braund, K G

    1982-08-01

    A 3-year-old male Setter-type dog had a progressive distal sensorimotor polyneuropathy characterized by weakness, bilateral atrophy of distal appendicular musculature, and reduced response to tactile stimuli. The diagnosis of a distal axonopathy was supported by electromyographic findings of fibrillation potentials, positive sharp waves in distal limb muscles, and absence of evoked action potentials, myopathic changes of atrophic angular fibers, and myelinated nerve fiber depletion in distal parts of peripheral nerves. The neuropathy appeared 5 weeks after 38 days of heparin therapy for disseminated intravascular coagulation. The disseminated intravascular coagulation, a complication of thiacetarsamide therapy for heartworm disease, had resolved 40 days after the end of heparin therapy. The cause of the neuropathy was not determined.

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

    OpenAIRE

    Sancho Cía, Juan-Manuel

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Paula Maio

    2013-04-01

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

  9. Linfoma no Hodgkin centrofacial relacionado a VIH: Reporte de un caso y revisión de la literatura HIV-related centrofacial non-hodgkin lymphoma: Case report and literature review

    OpenAIRE

    Karla Gabriela Ocampo-García; Rigoberto Dolores-Velázquez; José Luis Barrera-Franco; Janai Aciel Requena; Mayra Gabriela Heredia

    2012-01-01

    El linfoma no Hodgkin (LNH) ocupa el segundo lugar en frecuencia entre las neoplasias vinculadas con el sida, los senos maxilares, la cavidad nasal y el seno etmoidal son los sitios más comunes (33%). Aproximadamente el 3% de los casos definidos como sida presentan LNH en el inicio del curso de infección por VIH. Los LNH parecen el resultado de una proliferación incontrolada de precursores linfoides inmaduros que han perdido la capacidad de diferenciarse y que se acumulan progresivamente en e...

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

    Directory of Open Access Journals (Sweden)

    José Gastão Rocha de Carvalho

    2006-06-01

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

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

    OpenAIRE

    José Gastão Rocha de Carvalho; Jean Rodrigo Tafarel; Wilson Beleski de Carvalho; Ana Paula de Azambuja; Elicéia Soraia Zenaro; Rodrigo Bendlin

    2006-01-01

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

  12. Identification of chronic myocardial infarction with extracellular or intravascular contrast agents in magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Jian WANG; Hong-yu LIU; Hang L(U); Bo XIANG; Marco GRUWEL; Boguslaw TOMANEK; Roxanne DESLAURIERS; Gang-hong TIAN

    2008-01-01

    Aim: To determine whether extracellular or intravascular contrast agents could detect chronic scarred myocardium in magnetic resonance imaging (MRI). Methods: Eighteen pigs underwent a 4 week ligation of 1 or 2 diagonal coronary arteries to induce chronic myocardial infarction. The hearts were then removed and perfused in a Langendorff apparatus. Eighteen hearts were divided into 2 groups. The hearts in groups Ⅰ (n=9) and Ⅱ (n=9) 收稿日期the bolus injection of Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA, 0.05 mmol/kg) and ga-dolinium-based macromolecular agent (P792, 15 μmol/kg), respectively. First pass T2* MRI was acquired using a FLASH sequence. Delayed enhancement T1 MRI was acquired with an inversion recovery prepared TurboFLASH sequence.Results: Wash-in of both agents resulted in a sharp and dramatic T2* signal loss of scarred myocardium similar to that of normal myocardium. The magnitude and velocity of T2* signal recovery caused by wash-out of extracellular agents in normal myocardium was significantly less than that in scarred myocardium. Conversely, the T2* signal of scarred and normal myocardium recovered to plateau rapidly and simultaneously due to wash-out of intravascular agents. At the fol-lowing equilibrium, extracellular agent-enhanced T1 signal intensity was signifi-cantly greater in scarred myocardium than in normal myocardium, whereas there was no significantly statistical difference in intravascular agent-enhanced T1 sig-nal intensity between scarred and normal myocardium. Conclusion: After admin-istration of extracellular agents, wash-out T2* first-pass and delayed enhanced T1 MRI could identify scarred myocardium as a hyperenhanced region. Conversely, scarred myocardium was indistinguishable from normal myocardium during first-pass and the steady state of intravascular agents.

  13. Laparoscopic manipulation of a probe-based confocal laser endomicroscope using a steerable intravascular catheter.

    Science.gov (United States)

    Schneider, Crispin; Desjardins, Adrien E; Gurusamy, Kurinchi; Hawkes, David J; Davidson, Brian R

    2015-04-01

    Probe-based confocal laser endomicroscopy is an emerging imaging modality that enables visualization of histologic details during endoscopy and surgery. A method of guiding the probe with millimeter accuracy is required to enable imaging in all regions of the abdomen accessed during laparoscopy. On the basis of a porcine model of laparoscopic liver resection, we report our experience of using a steerable intravascular catheter to guide a probe-based confocal laser endomicroscope.

  14. MRI evaluation and follow-up of bone necrosis after meningococcal infection and disseminated intravascular coagulation

    Energy Technology Data Exchange (ETDEWEB)

    Damry, N. (Dept. of Radiology, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium)); Schurmans, T. (Dept. of Peadiatrics, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium)); Perlmutter, N. (Dept. of Radiology, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium))

    1993-10-01

    Disseminated intravascular coagulation (DIC) is a serious complication of meningococcal septicaemia. It often results in infarction of various tissues namely the skin, adrenal glands, kidneys, brain and, much less commonly, bones. We describe a patient who presented bone lesions after meningococcal septicaemia. In addition to plain radiography and scintigraphy the lesions were evaluated with MRI and have proved to be extensive and still progressive, approxximately 18 months after the onset of the disease. (orig.)

  15. [Evaluation of the severity course and prognosis of disseminated intravascular blood coagulation syndrome].

    Science.gov (United States)

    Kinakh, M V; Chaplyk, V V; Fedchyshyn, N R

    2009-01-01

    Activation of the peroxidal oxidation of lipids (POL) processes with its primary and secondary products levels raising constitutes a favourable sign, according to data of examination of 66 patients, suffering different phases of disseminated intravascular blood coagulation syndrome (DIBCS). The POL products contents reduction (areactive course) characterizes the process severity and constitutes an unfavourable prognostical sign. The areactive course rate is the highest in the patients, suffering DIBCS, phase III.

  16. Orbital Atherectomy Plaque Modification Assessment of the Femoropopliteal Artery Via Intravascular Ultrasound (TRUTH Study)

    OpenAIRE

    Babaev, Anvar; Zavlunova, Susanna; Attubato, Michael J.; Martinsen, Brad J.; Mintz,Gary S.; Maehara, Akiko

    2015-01-01

    Objective: The Tissue Removal Assessment with Ultrasound of the SFA and Popliteal (TRUTH) study assessed the performance of the orbital atherectomy system (OAS) to treat femoropopliteal arteries, including determining its effect on plaque removal. Methods: Patients with symptomatic femoropopliteal peripheral arterial disease were treated with the OAS followed by adjunctive balloon angioplasty (BA). Intravascular ultrasound (IVUS) images were collected pre- and post-OAS and post-OAS BA. Patien...

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

    DEFF Research Database (Denmark)

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

    1995-01-01

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

  18. THROMBOPHILIA AND INTENSITY OF THE INTRAVASCULAR MICROCOAGULATION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ATHEROTHROMBOSIS

    Directory of Open Access Journals (Sweden)

    E. A. Shelest

    2015-09-01

    Full Text Available Aim. To study the intensity of the intravascular microcoagulation in patients with atherothrombosis (AT, chronic obstructive pulmonary disease (COPD and thrombophilia.Material and methods. 115 patients were enrolled into the study: 37 patients with COPD (22 with thrombophilia and 15 without thrombophilia; 37 patients with AT (23 with thrombophilia and 14 without thrombophilia; 41 patients with COPD+AT (24 with thrombophilia and 17 without thrombophilia. In the control group 53 healthy people (39 with thrombophilia and 14 without thrombophilia were included. Median age was 62 (56.5, 69 years. The intensity of intravascular microcoagulation was measured: platelet factor 4 (PF4 by ELISA, D-dimer by ELISA, XIIa-dependent fibrinolysis (time. Polymerase chain reaction was used for detection of such trombophilia parameters as Leiden mutation, prothrombin gene mutation 20210A, mutation in the gene of methylenetetrahydrofolate reductase (MTHFR and plasminogen activator inhibitor-1 (PAI-1.Results. The level of PF4 and D-dimer was significantly higher while fibrinolytic activity was lower in COPD (103.5 ME/ml, 70 ng/ml, 650 s, respectively, AT (127.1 ME/ml, 96,9 ng/ml, 850 s, respectively and COPD+AT (136.5 ME/ml, 106.5 ng/ml, 1148 s, respectively groups as compared with the control group (p<0.05. When analyzing the level of intravascular coagulation parameters in patients with thrombophilia and without it, levels of PF4, D-dimer and XIIa-dependent fibrinolysis (time were significantly higher in thrombophilia subgroups among all patients (p<0.05. In patients with thrombophilia levels of these parameters were significantly higher in those with two or more thrombophilia gene polymorphisms than with one (p<0.01.Conclusion. The intensity of intravascular microcoagulation increases in patients with thrombophilia, atherothrombosis and COPD.

  19. Study of restenosis in drug eluting stents: new insights from greyscale intravascular ultrasound and virtual histology.

    Science.gov (United States)

    Garcia-Garcia, Hector M; Shen, Zhujun; Piazza, Nicolo

    2009-05-01

    In current cardiology practice, many patients undergo secondary revascularisation due to reduced long-term vein graft patency or in-stent restenosis. In this report, we describe causes of drug-eluting stent restenosis identifiable by intravascular ultrasound imaging (IVUS) and variables related to restenosis used for reporting greyscale IVUS. In addition, IVUS findings in bypass grafts and the long-term results after stent implantation are provided. Finally, the usefulness of IVUS virtual histology for the study of restenosis is described.

  20. Tubercular lymphadenitis and abdominal tuberculosis with autoimmune hemolytic anemia and severe intravascular hemolysis

    Directory of Open Access Journals (Sweden)

    Ashutosh M Somalwar

    2013-01-01

    Full Text Available Tuberculosis, a common disease in the developing world and a resurging problem in the developed world, is associated with numerous hematological manifestations. The most common manifestation is normochromic normocytic anemia of chronic disease. Hemolytic anemia is rare, and there are only a few previously reported cases. We report a case of autoimmune hemolytic anemia with severe intravascular hemolysis in a case of abdominal tuberculosis. To our knowledge, this is one of the few cases reported in the literature.

  1. Surgical management of Wilms tumor with intravascular extension: a single-institution experience.

    Science.gov (United States)

    Aspiazu, Diego; Fernandez-Pineda, Israel; Cabello, Rosa; Ramirez, Gema; Alvarez-Madrid, Antonio; De Agustin, Juan Carlos

    2012-02-01

    The purpose of this study was to retrospectively analyze the clinical presentation, treatment, and outcomes of children with Wilms tumor (WT) and intravascular extension who were treated at a single institution. A retrospective review was conducted of medical records of all children with Wilms tumor and intravascular extension treated at Virgen del Rocio Children's Hospital between 1992 and 2010. Seven patients (median age 3.4 years, range 2-8.1 years) were identified. At diagnosis, 6 of the 7 patients (85.7%) presented with tumor thrombus that reached the right atrium (RA) and 1 patient with infrahepatic inferior vena cava (IVC) thrombus. All patients received neoadjuvant chemotherapy (SIOP 2001 protocol) with vincristine, doxorubicin, and actinomycin D. Regression of the intravascular extension of the tumor was documented in all patients. Postchemotherapy level of extension was suprahepatic IVC in 1 patient, infrahepatic IVC in 2 patients, renal vein (RV) in 1 patient, and RA in 3 patients. Nephrectomy and thrombectomy were performed in all cases, requiring cardiopulmonary bypass for the 4 patients who presented with suprahepatic IVC and RA thrombus. The other 3 patients with infrahepatic IVC and RV involvement underwent cavotomy and thrombus extraction. Computed tomography, ultrasonography, and echocardiography were used for diagnosis and follow-up. All patients remain disease-free with a median follow-up of 6.3 years (range, 2-19 years). Neoadjuvant chemotherapy for WT with intravascular extension may facilitate the resection by decreasing the extent of the tumor thrombus. Cardiopulmonary bypass is indicated for suprahepatic IVC and RA involvement. Accurate diagnostic imaging is necessary.

  2. Los tratados silogísticos de Boecio: sus fuentes, historia e influencia en la cristiandad latina

    OpenAIRE

    2007-01-01

    En este artículo se describen los contenidos de un tratado sobre lógica aristotélica escrito por Boecio en el VI d. C, llamado por nuestras ediciones modernas De syllogismo categórico (=DSC). A través de sus contenidos, es posible mostrar: (i) la importancia de este tratado en el proceso de transmisión de la lógica de Aristóteles al medioevo latino; (ii) su relación con otro tratado monográfico similar, titulado por la crítica moderna Introductio ad syllogismos categóricos (ISC) y su relación...

  3. Cardiovascular disease in haemodialysis: role of the intravascular innate immune system.

    Science.gov (United States)

    Ekdahl, Kristina N; Soveri, Inga; Hilborn, Jöns; Fellström, Bengt; Nilsson, Bo

    2017-02-27

    Haemodialysis is a life-saving renal replacement modality for end-stage renal disease, but this therapy also represents a major challenge to the intravascular innate immune system, which is comprised of the complement, contact and coagulation systems. Chronic inflammation is strongly associated with cardiovascular disease (CVD) in patients on haemodialysis. Biomaterial-induced contact activation of proteins within the plasma cascade systems occurs during haemodialysis and initially leads to local generation of inflammatory mediators on the biomaterial surface. The inflammation is spread by soluble activation products and mediators that are generated during haemodialysis and transported in the extracorporeal circuit back into the patient together with activated leukocytes and platelets. The combined effect is activation of the endothelium of the cardiovascular system, which loses its anti-thrombotic and anti-inflammatory properties, leading to atherogenesis and arteriosclerosis. This concept suggests that maximum suppression of the intravascular innate immune system is needed to minimize the risk of CVD in patients on haemodialysis. A potential approach to achieve this goal is to treat patients with broad-specificity systemic drugs that target more than one of the intravascular cascade systems. Alternatively, 'stealth' biomaterials that cause minimal cascade system activation could be used in haemodialysis circuits.

  4. Primary Intravascular large B-cell lymphoma of lung: a report of one case and review

    Directory of Open Access Journals (Sweden)

    Yu Hui

    2012-06-01

    Full Text Available Abstract Objective To investigate the clinicopathological features of primary intravascular large B-cell lymphoma of lung. Methods A case of primary pulmonary intravascular large B-cell lymphoma was analysed in histopathology and immunophenotype. Results The patient is a 42-year-old female who had cough for one year. Computed tomography showed ground-glass opacities and small nodules in bilateral lung fields. Histopathology demonstrated accumulation of similar sized neoplastic cells within alveolar capillaries, widening the alveolar septae. The alveolar structure sustained in part of districtions. Immunohistologically, the tumor cells were positive for CD20 and negative for CD3,CK, which were similar to the diffuse large B-cell lymphoma. Conclusions Intravascular large B-cell lymphoma is an uncommon type of non-Hodgkin’s lymphoma. Primary pulmonary presentation is even more rare. The diagnosis is based on the histopathology and immunohistochemistry. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2076991810705433.

  5. Stochastic bifurcation characteristics of SMA intravascular stent subjected to radial and axial excitations.

    Science.gov (United States)

    Zhu, Zhiwen; Zhang, Wendi; Xu, Jia

    2014-01-01

    A kind of shape memory alloy (SMA) hysteretic nonlinear model is developed, and the stochastic bifurcation characteristics of SMA intravascular stents subjected to radial and axial excitations are studied in this paper. A new nonlinear differential item is introduced to interpret the hysteretic phenomena of SMA strain-stress curves, and the dynamic model of SMA intravascular stent subjected to radial and axial stochastic excitations is established. The conditions of the system's stochastic stability are determined, and the probability density function of the system response is obtained. Finally, the stochastic Hopf bifurcation characteristics of the system are analyzed. Theoretical analysis and numerical simulation show that the system stability varies with bifurcation parameters, and stochastic Hopf bifurcation occurs in the process; there are two limit cycles in the stationary probability density of the system response in some cases, which means that there are two vibration amplitudes whose probability are both very high; jumping phenomena between the two vibration amplitudes appears with the change of conditions, which may cause stent fracture or loss. The results of this paper are helpful for application of SMA intravascular stent in biomedical engineering fields.

  6. Intravascular Large B-Cell Lymphoma Diagnosed on Prostate Biopsy: A Case Report

    Directory of Open Access Journals (Sweden)

    Nazan Özsan

    2014-12-01

    Full Text Available Intravascular large B-cell lymphoma (IVLBCL is a very rare type of non-Hodgkin lymphoma, usually affecting elderly patients and characterized by selective infiltration of neoplastic cells within blood vessels’ lumina. IVLBCL diagnosed with prostatic involvement is extremely rare. We report a patient of 65 years old, having mostly neurological complaints but diagnosed with IVLBCL upon histopathological examination of transurethral prostate resection material, which revealed large neoplastic cell infiltration totally limited within the lumens of small vessels. By immunohistochemistry, neoplastic cell infiltration was positive with MUM1, bcl-6, and bcl-2 and negative with ALK1, CD10, and CD30, with a high Ki-67 proliferation index. CD34 and CD31 staining showed expression in endothelial cells, highlighting the intravascular nature of neoplastic infiltrate. The patient unfortunately refused to receive treatment and died of the disease 8 months after the diagnosis. IVLBCL, though very rare, should be considered in differential diagnosis of all organ biopsies with intravascular infiltration. Further improvements in the understanding of the pathogenesis and biology of this rare type of lymphoma are mandatory.

  7. Evaluation of CT virtual intravascular endoscopy in fenestrated stent grafts: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Z. [Dept. of Imaging and Applied Physics, Curtin Univ. of Tech., Perth, WA (Australia); Allen, Y.; Fitzsimmons, B.; Hartely, D. [Cook R and D, WA (Australia); Lawrence-Brown, M. [Dept. of Public Health, Curtin Univ. of Tech., Perth, WA (Australia)

    2007-06-15

    We aim in this study to investigate the potential value of CT virtual intravascular endoscopy in patients diagnosed with abdominal aortic aneurysms undergoing fenestrated stent grafts. Both pre-and post-fenestration (within 3 months of implantation) multislice CT data were collected in eight patients and used for generation of virtual endoscopy images in our preliminary study. Variable fenestrations were deployed in 25 aortic branches with scallop fenestration implanted in six aortic ostia, large fenestration in four aortic ostia and small fenestration in 15 renal ostia, respectively. Measurements of the aortic ostia diameters both pre- and post-fenestration were successfully performed with virtual intravascular endoscopy visualization, and endovascular stents as well as their relationship to the aortic ostia were clearly demonstrated. Our results showed that there was no significant change of diameter of the aortic ostia following fenestrated stem grafts. Endovascular stents were clearly visualized on virtual endoscopy images, and no apparent deformity or malrotation was observed in this small group. Our preliminary study provides new insights into anatomic configuration/dimension of aortic ostia and endovascular stents, and virtual intravascular endoscopy could be a valuable technique to follow-up patients treated with fenestrated stent grafts. (orig.)

  8. Disseminated intravascular coagulation scores as predictors for progressive hemorrhage and neurological prognosis following traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    Yirui Sun; Jin Hu; Caihua Xi; Ersong Wang; Jianqing Wang; Yong Liu; Hua Liu; Qiang Yuan; Haijun Yao; Liangfu Zhou

    2011-01-01

    Coagulation abnormalities, such as disseminated intravascular coagulation (DIC), are associated with progressive hemcrrhagic injury (PHI) following head trauma.However, the exact relationship between coagulopathy and PHI remains unclear.The present study utilized a scoring system defined by the International Society of Thrombosis and Haemostasis to investigate whether a high DIC score is predictive for PHI.This study was a multicenter prospective design involving four hospitals, a 6-month observation, and follow-up.Of 352 traumatic brain injury (TBI) patients, serial CT scan indicated approximately one third of patients developed progressive hemorrhage, which was most frequently observed in the frontal, temporal, and orbitof rontal lobes of patients with brain contusion.PHI-positive patients exhibited poor prognosis, as indicated by prolonged length of hospital/intensive care unit stay and high mortality.More importantly, a DIC score after TBI, as well as patient age and sex, could serve as predictors for PHI.In addition, DIC scores were closely associated with injury severity.Therefore, the DIC scoring system facilitated early PHI diagnosis in TBI patients, and DIC scores might serve as a valuable predictor for TBI patients with PHI.Key Words: coagulopathy; disseminated intravascular coagulation; disseminated intravascular coagulation scoring; intracranial hemorrhage; progressive hemorrhagic injury; traumatic brain injury

  9. Impacto del tratado de libre comercio entre colombia y eeuu, sobre el acceso a los medicamentos en colombia

    OpenAIRE

    José David Millán Cano; Wilson Giovanny Jiménez Barbosa

    2012-01-01

    Este artículo, más que pretender continuar con la franca crítica al Tratado de Libre Comercio (TLC) entre Colombia y EE.UU, busca dar una aproximación a las posibles repercusiones que este acuerdo tendrá sobre el acceso a los medicamentos de los afiliados al Sistema General de Seguridad Social en Salud (SGSSS) colombiano en  mediano y largo plazo.Para lograr esto, se definirá qué se entiende por Tratado de Libre Comercio, para luego realizar una breve reseña histórica de su evolución. Luego, ...

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

    Directory of Open Access Journals (Sweden)

    Alejandro Avilés-Salas

    2011-12-01

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

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

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    Adriana Moreira Viana Borba

    2007-04-01

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

  12. Linfoma ileal primário como uma causa de intussuscepção ileocecal recorrente Primary ileal lymphoma as a cause of recurrent ileocecal

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    Fábio César Miranda Torricelli

    2008-06-01

    Full Text Available INTRODUÇÃO: A intussuscepção ocorre quando um segmento proximal do intestino invagina para dentro do lúmen do segmento distal adjacente. Esta patologia é relativamente comum em crianças, sendo geralmente idiopática, diferentemente do que é evidenciado em adolescentes e adultos, os quais apresentam uma causa orgânica comprovada na maioria dos casos. O linfoma intestinal como etiologia desta patologia é extremamente raro. RELATO DE CASO: Um paciente de 16 anos, masculino, referindo dor abdominal em quadrante inferior direito há 36 horas associada a vômitos e fezes com sangue vivo compareceu em nosso serviço. O exame físico se apresentava dentro da normalidade exceto por uma massa palpável no quadrante inferior direito. A ultra-sonografia abdominal revelou intussuscepção ileocecal. A colonoscopia demonstrou uma massa protuberante proveniente do orifício da válvula ileocecal que foi reduzida, tendo o paciente um alívio completo dos sintomas. Três semanas após, o paciente retornou ao nosso hospital com recorrência dos sintomas. Uma laparotomia exploradora foi realizada evidenciando uma massa polipóide no íleo terminal com intussuscepção para dentro do ceco. Uma colectomia direita ampliada foi realizada. Após exame patológico da peça e estadiamento tumoral, um linfoma de Burkitt primário foi diagnosticado. A recuperação pós-operatória não apresentou intercorrências e o paciente foi encaminhado para quimioterapia adjuvante.INTRODUCTION: Intussusception occurs when a proximal segment of bowel telescopes into the lumen of the adjacent distal segment. It is common in children being usually idiophatic, in contrast to adolescents and adults, who have a demonstrable etiology in most cases. Intestinal lymphoma is an unusual cause of intussusception in adolescents and adults. CASE REPORT: A 16 year-old male presented with right lower quadrant abdominal pain lasting for 36 hours, with vomiting and bloody stool. Physical

  13. Los tratados silogísticos de Boecio y su interdependencia temática

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    Manuel Correia

    2009-01-01

    Full Text Available En este artículo se discuten las más importantes hipótesis modernas que han intentado explicar la interrelation doctrinal que los tratados silogísticos escritos por Boecio tienen entre sí, el De sylhgismo categórico y la Introductio ad syllogismos categóricos. Se revisan las hipótesis que señalan una dependencia fuerte entre ambos tratados y también las que apuntan hacia una dependencia más débil y, luego de criticar estas posiciones, la discusión abre la posibilidad cierta de que los tratados tengan objetos temáticos diferentes y estén relacionados de una manera más extrínseca que lo que se había creído hasta aquí, ya que el segundo de ellos estaría pensado como un complemento al primero. El argumento se basa tanto en la manifiesta falta de utilidad que los términos indefinidos tendrían en las premisas silogísticas como en la casi nula noticia de que, alguna vez en la antigüedad, se desarrolló una silogística con términos indefinidos en las premisas.In this article, the most important hypotheses concerning the doctrinal relation between Boethius' two syllogistic treatises are discussed: De syllogismo categórico and the Introductio ad syllogismos categóricos. By means of a review of both, I discard the hypothesis pointing out a strong dependence and the other hypotheses resting on a weaker dependence. I conclude that the relation between both treatises is more extrinsic than what has been believed up to here, because the second treatise is thought to be an appendage of the first one. The argument is supported on both the apparent lack of utility in using indefinite terms in the premises of a syllogism and the almost entirely absence of textual evidences that a syllogistic with indefinite terms in the premises was developed some time in ancient times.

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

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    Renato Soriani Paschoal

    2009-08-01

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

  15. Leucemia linfóide crônica e linfoma linfocítico de pequenas células Chronic lymphocytic leukemia and small lymphocytic lymphoma

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    Lucia M. R. Silla

    2005-12-01

    Full Text Available O linfoma linfocítico de pequenas células (LLPC é considerado uma variante tumoral da leucemia linfocítica crônica e, por conseguinte, a mesma doença. Existem similaridades clínicas, morfológicas, imunofenotípicas e genéticas que parecem resistir até mesmo a uma análise mais aprofundada com o instrumental técnico atualmente disponível para o estudo da biologia molecular. Talvez o refinamento das técnicas de análise da expressão de multiplos genes, incluindo genes para microRNAs, tanto das células malignas quanto das remanescentes benignas do microambiente, e os avanços no conhecimento de determinantes da diferenciação celular possam, em um futuro próximo, esclarecer afinal se LLPC e LLC são doenças diferentes.Small lymphocytic lymphoma (SLL and chronic lymphocytic leukemia (CLL are thought to be different expressions of the same disease. There are clinical, morphological, immuno-phenotypical and genotypical similarities that seem to resist even to advanced molecular biology techniques. It still needs to be defined, through a more refined understanding of the gene profile expression and microRNA biology of the malignant and surrounding micro-environment benign cells and a better understanding of the new paradigms of cell differentiation relativity, if SLL and CLL are different diseases.

  16. Delivery efficiency of periadventitial approach in comparison of intravascular delivery: an assessment of pharmacokinetics in porcine arteries

    Institute of Scientific and Technical Information of China (English)

    Yong-hua Xu; Gordon McLennan

    2005-01-01

    Objective To investigate the delivery efficacy of periadventitial delivery of 125I-iododeoxyuridine (125I-IUdR) in comparison of intravascular delivery to determine the optimal delivery method for inhibiting post-angioplasty restenosis. Methods In 8 pigs, one side carotid, subclavian and iliac arteries of each pig were injured by balloon angioplasty with a 20% overstretches. Then, 4 mCi of 125I-IUdR was delivered at each targeted vessel with periadventitial method in 4 pigs (periadventitial group) and with intravascular method via a porous balloon catheter in other 4 pigs (intravascular group). The animals survived for 5 hours and the blood radioactivity was investigated prior to and hourly after procedure until sacrifice. The targeted vessels and renal arteries (for control) were harvested for gamma-counting and histological observation. Meanwhile, the radioactivity in thyroid, liver, bladder, small bowel and each kidney also were measured to determine the biodistribution of 125I. The activities of 125I presented in arterial and tissue specimens were compared between the two delivery groups. The targeted arteries were histologically observed and the ratio of intima to media (I∶M ratio) was calculated. Results The target arterial walls in the periadventitial group had 3.4 times as much of 125I radioactivity as in the intravascular group, respectively (P=0.038); the blood activity in intravascular group was significantly higher than periadventitial group immediate after procedure (P0.05). The mean I: M ratios in both groups were 0.05 without additional injury at the vessel wall. Conclusion The periadventitial delivery offered substantial advantage over intravascular approach with high local delivery efficacy. The apparent redistribution rate is more rapid following intravascular delivery.

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

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    I. Zazpe

    2005-12-01

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

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

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    Jorge Alberto Thomé

    2005-04-01

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

  19. Clonación y Transcripción del Gen EBER-1 del Virus Epatein-Barr: estudio de su expresión genética en linfomas por hibridación in situ

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    I Guerrero

    1999-01-01

    Full Text Available La capacidad del virus de Epstein Barr (VEB de inducir transformación e inmortalización de linfocitos y su alta prevalencia en algunas neoplasias linfoides ha motivado intensa investigación de su biología y comportamiento. Describimos la hibridación in situ (HIS, para la identificación de transcriptos del virus de Epstein-Barr, desarrollado en la Unidad de Biología Molecular del Centro de Investigación en Cáncer Maes - Heller, en biopsias de linfoma incluidas en parafina. El gen EBER-1(Epstein Barr-encoded RNA fue clonado y transcrito, el ARN transcrito fue evaluado con óptimos resultados en las líneas celulares Raji y Daudi que expresan EBER. Este transcrito marcado fue usado como sonda para determinar la expresión genética del virus en 159 especímenes biológicos en estudio y en controles positivos y negativos conocidos empleando la HIS. La actividad transcripcional del virus fue observada en 44% de los casos estudiados. Concluimos que la HIS en tejido incluido en parafina es una buena alternativa para detectar actividad del VEB y la presencia o ausencia de EBER puede ser considerada como marcador biológico en la etiopatología de estos linfomas.

  20. Do conceito de propriedade no Segundo tratado sobre o governo de John Locke

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    Amaro de Oliveira Fleck

    2012-12-01

    Full Text Available Embora o Segundo tratado sobre o governo não tenha por intuito fundamentar o conceito de propriedade, mas sim o de mostrar o que torna um governo legítimo e em que circunstâncias o recurso à resistência não pode ser considerado ilegal, a teoria da propriedade como algo que se adquire mediante o trabalho, contida nesta obra, foi a concepção predominante acerca da propriedade ao longo da época moderna. O presente artigo busca expor os argumentos contidos nesta teoria, tanto contextualizando-os dentro da argumentação geral da obra quanto mostrando no que diferem das fundamentações da propriedade precedentes

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

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    John Saxe-Fernández

    1999-12-01

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

  2. Constitución, Tratado de Libre Comercio Andino – Estados Unidos, Comunidad Andina

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    Marcel Tangarife Torres

    2007-12-01

    Full Text Available El presente escrito pretende hacer algunas reflexiones acerca de las relaciones jurídicas existentes entre la Constitución Política, el Tratado de Libre Comercio con Estados Unidos (TLC, y el ordenamiento jurídico de la comunidad andina. En esta oportunidad se recogerán algunos planteamientos hechos por el autor en publicaciones anteriores, con las actualizaciones, ampliaciones y precisiones que surgen de un proceso tan dinámico como el de la internacionalización de las relaciones económicas y comerciales. el autor pide excusas por citar algunos trabajos suyos, pues existe un gran vacío de doctrina especializada sobre la materia, vacío que ojalá sea llenado con prontitud.

  3. ¿Qué pasa si Ecuador no firma el Tratado de Libre Comercio?

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    Falconí , Fander

    2006-01-01

    Full Text Available Este artículo examina la pertinencia o no de firmar el Tratado de Libre Comercio (TLC con los Estados Unidos, dado el estado actual de las negociaciones, el contexto político y los escenarios posibles en caso de no concretarse este acuerdo. Se concluye con la necesidad de darle un mayor contenido a la posibilidad de no firmar el TLC, en tanto que se requieren propuestas concretas para una inserción dinámica del país en el mercado mundial, para consolidar incluso sus relaciones con los Estados Unidos y, sobre todo, para construir una integración verdadera, que no sea simplemente la reedición de caducas prácticas integracionistas.

  4. Melanoma "in situ" tratado con Imiquimod Melanoma in situ treated with Imiquimod

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    RE Achenbach

    Full Text Available Comunicamos un caso con dos melanomas "in situ", en un varón de 86 años, localizados en ambos lados de la cara con alto riesgo quirúrgico, quien fuera tratado con imiquimod al 5% una vez al día durante dos meses; los resultados hasta el momento, clínicos e histológicos han sido satisfactorios.A 86 years-old man with two melanomas "in situ" at both sides of his face, treated with imiquimod 5% are presented. The patient has a cardiovascular high risk due to isquemic heart disease, for that reason we start the treatment with imiquimod once a day for two months. The clinical and histological response was good and a follow up will be as long as we can.

  5. El tratado de estadística de Fernández-Baños

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    Arenzana, Víctor

    1997-01-01

    El Tratado de Estadística de Olegario Fernández Baños fue el primer libro de Estadística Matemática en sentido moderno que se publicó en España. Anteriormente, se habían publicado libros de estadística para la asignatura de geógrafa y estadística industrial y Mercantil de las Escuelas de Comercio y para la de Economía Política de las Facultades de Derecho. tos libros de texto para esas asignaturas trataban, generalmente, temas de carácter administrativa, descripción de los métodos estadístic...

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

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    Emilio Pfeffer Urquiaga

    2003-01-01

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

  7. APLICACIÓN DE LOS TRATADOS INTERNACIONALES SOBRE DERECHOS HUMANOS EN LA JURISPRUDENCIA CONSTITUCIONAL PERUANA

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    Francisco José Eguiguren Praeli

    2003-01-01

    Full Text Available El artículo analiza las diferencias normativas en materia de derechos fundamentales o humanos en las Constitucionales de 1979 y 1993, realizando un análisis de la jurisprudencia del Tribunal Constitucional en la materia durante el imperio de la Carta Fundamental de 1993 y el impacto en el derecho interno de los tratados de derechos humanos y las resoluciones de la Comisión y la Corte Interamericana de Derechos Humanos.This article compares the norms on human rights of the Peruvian constitutions of 1979 and 1993, analyzing the opinions of the Constitutional Court since 1993 and the impact on internal law of human rights treaties and the decisions of the Inter-American Commission and Court on Human Rights.

  8. O tratado sobre a luz de Huygens: comentários

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    Krapas, Sonia; Departamento de Física – UFF Niterói – RJ; Queiroz, Glória Regina Pessôa Campello; Instituto de Física - UERJ Rio de Janeiro – RJ; Uzêda, Diego; Instituto de Ciências e Tecnologia Maria Thereza – FAMATh Niterói – RJ

    2011-01-01

    http://dx.doi.org/10.5007/2175-7941.2011v28n1p123Huygens é conhecido no ensino introdutório de Física por dar conta da refração segundo um modelo ondulatório. Livros didáticos lhe rendem homenagens atribuindo seu nome a um princípio, mas em sua obra máxima, Tratado sobre a luz, é possível se ver muito mais: sua inventividade na defesa de um modelo ondulatório para a luz como alternativo ao modelo corpuscular. Neste trabalho, tenta-se evidenciar o raciocínio de Huygens, mostrando que, apesar d...

  9. Las fuentes citadas en el tratado agrícola de al-Tignari

    OpenAIRE

    García Sánchez, Expiración

    2001-01-01

    Al-Tignari (s. XI-XII) es uno de los representantes más destacados de la escuela agronómica andalusí. Su tratado, titulado Kitab Zuhrat al-bustan wa-nuzhat al-adhan, sigue un método dualista en el que la teoría racional va acompañada de la práctica vivida y experimentada. Por ello, no se limita a ofrecer una larga lista de fuentes, en un alarde de erudición, sino que la mayoría de las que cita son casi siempre identificables. En el estudio llevado a cabo en este trabajo se aprecia que la trad...

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

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    Marco A. Morales Tobar

    2003-01-01

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

  11. Vinos, carnes, ferrocarriles y el Tratado de Libre Comercio entre Argentina y Chile (1905-1910

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    Pablo Lacoste

    2004-06-01

    Full Text Available Entre 1905 y 1910 Chile y Argentina negociaron la firma de un Tratado de Comercio con vistas a suprimir los aranceles aduaneros y consagrar el principio de "Cordillera Libre". El centro de atracción eran las exportaciones de ganado argentino a Chile y de vino chileno a Argentina. Pero en ambos países se produjo una fuerte reacción de los intereses creados con vistas a frustrar las tratativas diplomáticas. Tanto la Sociedad Nacional de Agricultura (Chile como el Centro Vitivinícola Nacional (Argentina realizaron intensas gestiones para alcanzar sus objetivos; esta última corporación llegó a movilizar miles de personas para oponerse al tratado; y hasta solicitó ayuda a los ferrocarriles británicos para que obstaculizaran el ingreso de los vinos chilenos al mercado argentino. La intensa resistencia de estas corporaciones terminaron por frustrar el proyecto, el cual fue definitivamente archivado en 1911.Between 1905 and 1910, Chile and Argentina negotiated the signature of a Trade Agreement in order to abolish the customs duties and consecrate the principle of "Free Mountain Range". The centre of attraction was the exports of Argentinean cattle to Chile and of Chilean wine to Argentina. But in both countries there aroused a strong reaction of the vested interests, purposely to thwart the diplomatic negotiations. Both, the Sociedad Nacional de Agricultura (Chile as well as the Centro Vitivinícola Nacional (Argentina carried out intense negotiations to reach their objectives; the latter even movilized thousands of people to oppose the treaty and went as far as requesting the help of the British railroads to block the entrance of Chilean wines to the Argentinean market. The stiff opposition of these corporations finally frustrated the project, which was definitively filed away in 1911.

  12. LA RELACIÓN ENTRE TRATADOS DE INVERSIÓN Y CONVENIOS DE DOBLE TRIBUTACIÓN: el caso chileno

    Directory of Open Access Journals (Sweden)

    Rodrigo Polanco Lazo

    Full Text Available El presente artículo examina las relaciones entre los tratados de inversión y los tratados de doble tributación, considerando que, en la actual evolución de ambos tipos de acuerdos, sus disposiciones pueden presentar superposiciones en aspectos tales como estándares de protección, transparencia, trato nacional, cláusula de la nación más favorecida, expropiación y transferencias de capital. Tomando el ejemplo de los tratados suscritos por Chile, en este trabajo se examinan las consecuencias de las trasposiciones de ambos acuerdos, desde el punto de vista de sus mecanismos de solución de controversias, como en lo referido a los conflictos de jerarquía normativa entre esos dos tipos de tratados. Asimismo, se efectúa un análisis sobre iniciativas de tipo multilateral que afectan a ambas categorías de acuerdos como el Base Erosion and Profit Shifting (BEPS.

  13. A feasibility study of an intravascular imaging antenna to image atherosclerotic plaques in Swine using 3.0 T MRI.

    Directory of Open Access Journals (Sweden)

    Chen Zhang

    Full Text Available To investigate the feasibility of an intravascular imaging antenna to image abdominal aorta atherosclerotic plaque in swine using 3.0T magnetic resonance imaging (MRI.Atherosclerotic model was established in 6 swine. After 8 months, swine underwent an MR examination, which was performed using an intravascular imaging guide-wire, and images of the common iliac artery and the abdominal aorta were acquired. Intravascular ultrasound (IVUS was performed in the right femoral artery; images at the same position as for the MR examination were obtained. The luminal border and external elastic membrane of the targeted arteries were individually drawn in the MR and IVUS images. After co-registering these images, the vessel, lumen, and vessel wall areas and the plaque burden in the same lesions imaged using different modalities were calculated and compared. The diagnostic accuracy of intravascular MR examination in delineating the vessel wall and detecting plaques were analyzed and compared using IVUS.Compared with IVUS, good agreement was found between MRI and IVUS for delineating vessel, lumen, and vessel wall areas and plaque burden (r value: 0.98, 0.95, 0.96 and 0.91, respectively; P<0.001.Compared with IVUS, using an intravascular imaging guide-wire to image deep seated arteries allowed determination of the vessel, lumen and vessel wall areas and plaque size and burden. This may provide an alternative method for detecting atherosclerotic plaques in the future.

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

    Directory of Open Access Journals (Sweden)

    Zerkowski Hans-Reinhard

    2006-05-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  16. An electro-responsive hydrogel for intravascular applications: an in vitro and in vivo evaluation.

    Science.gov (United States)

    Verbrugghe, Peter; Verhoeven, Jelle; Coudyzer, Walter; Verbeken, Eric; Dubruel, Peter; Mendes, Eduardo; Stam, Frank; Meuris, Bart; Herijgers, Paul

    2015-11-01

    There is a growing interest in using hydrogels for biomedical applications, because of more favourable characteristics. Some of these hydrogels can be activated by using particular stimuli, for example electrical fields. These stimuli can change the hydrogel shape in a predefined way. It could make them capable of adaptation to patient-specific anatomy even post-implantation. This is the first paper aiming to describe in vivo studies of an electro-responsive, Pluronic F127 based hydrogel, for intravascular applications. Pluronic methacrylic acid hydrogel (PF127/MANa) was in vitro tested for its haemolytic and cytotoxic effects. Minimal invasive implantation in the carotid artery of sheep was used to evaluate its medium-term biological effects, through biochemical, macroscopic, radiographic, and microscopic evaluation. Indirect and direct testing of the material gave no indication of the haemolytic effects of the material. Determination of fibroblast viability after 24 h of incubation in an extract of the hydrogel showed no cytotoxic effects. Occlusion was obtained within 1 h following in vivo implantation. Evaluation at time of autopsy showed a persistent occlusion with no systemic effects, no signs of embolization and mild effects on the arterial wall. An important proof-of-concept was obtained showing biocompatibility and effectiveness of a pluronic based electro-responsive hydrogel for obtaining an arterial occlusion with limited biological impact. So the selected pluronic-methacrylic acid based hydrogel can be used as an endovascular occlusion device. More importantly it is the first step in further development of electro-active hydrogels for a broad range of intra-vascular applications (e.g. system to prevent endoleakage in aortic aneurysm treatment, intra-vascular drug delivery).

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

    OpenAIRE

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

    2014-01-01

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

  18. Intravascular Papillary Endothelial Hyperplasia: Diagnostic Sequence and Literature Review of an Orofacial Lesion

    Directory of Open Access Journals (Sweden)

    Mahima V. Guledgud

    2014-01-01

    Full Text Available Intravascular papillary endothelial hyperplasia or Masson’s tumor is a rare reactive disease of vascular origin characterized by exuberant proliferation of endothelial cells notably occurring within blood vessels of head, neck, and extremities. The importance of this entity is its ability to mimic a variety of diseases both benign and malignant in the orofacial region. Here, we present a case of Masson’s tumor within the masseter muscle in a 40-year-old female with emphasis on the sequential investigative procedures performed to diagnose this entity.

  19. Intravascular Papillary Endothelial Hyperplasia (Masson’s Tumor): Diagnosis the Plastic Surgeon Should Be Aware of

    Science.gov (United States)

    Boukovalas, Stefanos; Dillard, Rachel; Qiu, Suimin

    2017-01-01

    Summary: Intravascular papillary endothelial hyperplasia (IPEH) or Masson’s tumor is a rare benign entity commonly found on the head, neck, and upper extremities. It usually arises within a blood vessel but is considered to be a nonneoplastic reactive process often associated with vascular injury. Typically, IPEHs cause no symptoms and present as slowly growing soft-tissue masses. Given their prevalent location and indolent clinical presentation, the plastic surgeon should be familiar with this rare entity. We are presenting a case of IPEH of the forehead with unusual clinical and pathologic characteristics. Differential diagnosis, special considerations regarding preoperative work-up, and treatment options are discussed.

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

    Science.gov (United States)

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

    2016-01-01

    Mercury is a toxic heavy metal and occurs in organic and inorganic forms. Inorganic mercury includes elemental mercury and mercury salts. Mercury salts are usually white powder or crystals, and widely used in indigenous medicines and folk remedies in Asia. Inorganic mercury poisoning causes acute kidney injury (AKI) and gastrointestinal manifestations and can be life-threatening. We describe a case with unknown substance poisoning who developed AKI and disseminated intravascular coagulation (DIC). Renal biopsy showed acute tubular necrosis. Later, the consumed substance was proven to be mercuric chloride. His renal failure improved over time, and his creatinine normalized after 2 months. PMID:27194836

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

    Directory of Open Access Journals (Sweden)

    Prashanth M. Thalanayar

    2015-01-01

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

  2. Automated Contour Detection for Intravascular Ultrasound Image Sequences Based on Fast Active Contour Algorithm

    Institute of Scientific and Technical Information of China (English)

    DONG Hai-yan; WANG Hui-nan

    2006-01-01

    Intravascular ultrasound can provide high-resolution real-time crosssectional images about lumen, plaque and tissue. Traditionally, the luminal border and medial-adventitial border are traced manually. This process is extremely timeconsuming and the subjective difference would be large. In this paper, a new automated contour detection method is introduced based on fast active contour model.Experimental results found that lumen and vessel area measurements after automated detection showed good agreement with manual tracings with high correlation coefficients (0.94 and 0.95, respectively) and small system difference ( -0.32 and 0.56, respectively). So it can be a reliable and accurate diagnostic tool.

  3. Disseminated intravascular coagulation in a patient with metastatic prostate cancer: Fatal outcome following strontium-89 therapy

    Energy Technology Data Exchange (ETDEWEB)

    Leong, C.; McKenzie, R.; Coupland, D.B. [Univ. of British Columbia, (Canada)] [and others

    1994-10-01

    A patient with metastatic prostate cancer was found to have low-grade disseminated intravascular coagulation (DIC). He had significant bone pain despite external-beam radiotherapy and was given {sup 89}Sr with subsequent thrombocytopenia and epistaxis. The patient died from generalized hemorrhage 36 days postinjection. Although it is not possible to establish a causal relationship between {sup 89}Sr and DIC, practitioners should be alert to complications associated with the primary disorder which might occur at a time to raise concern about the intervention. 8 refs., 1 tab.

  4. Primary bilateral adrenal intravascular large B-cell lymphoma associated with adrenal failure.

    Science.gov (United States)

    Fukushima, Ayumi; Okada, Yosuke; Tanikawa, Takahisa; Onaka, Takashi; Tanaka, Aya; Higashi, Takehiro; Tsukada, Junichi; Tanaka, Yoshiya

    2003-07-01

    We report a rare case of bilateral primary adrenal non-Hodgkin's lymphoma with adrenal failure. A 66-year-old woman developed symptoms of adrenal failure. The cause of adrenal failure was suspected to be malignant lymphoma based on the high levels of serum soluble interleukin-2 receptor and LDH. Bilateral adrenalectomy was performed and pathological examination showed intravascular large B-cell lymphoma (IVL). Although complete remission was achieved, recurrence occurred three months later with brain metastases. IVL should be suspected in patients with bilateral adrenal tumors who present with rapidly progressive adrenal failure.

  5. Potential for tissue characterization of plaque and arterial wall using intravascular ultrasound

    Science.gov (United States)

    Sudhir, Krishnakutty; Fitzgerald, Peter J.; Yock, Paul G.

    1993-09-01

    Current intravascular ultrasound imaging technology is able to determine the extent and distribution of pathologic processes within the vessel wall, but is not highly sensitive in discriminating between different types of pathologic tissue. `Tissue characterization' refers to a set of computer-based techniques that utilize features of the ultrasound signal beyond basic amplitude to help define the structure of the tissue of interest. Although preliminary results with this approach are encouraging, additional work is needed to define its clinical application in vascular disease.

  6. Eptifibatide-induced thrombocytopenia: with thrombosis and disseminated intravascular coagulation immediately after left main coronary artery percutaneous coronary angioplasty.

    Science.gov (United States)

    Tempelhof, Michael W; Benzuly, Keith H; Fintel, Dan; Krichavsky, Marc Z

    2012-01-01

    Early clinical trials of eptifibatide did not show a significant association between eptifibatide and the development of thrombocytopenia, thrombosis, or disseminated intravascular coagulation. However, more recent literature has suggested a significant association between eptifibatide and the development of thrombocytopenia and thrombosis. Although the true incidence and the pathophysiology of these associations are unknown, the development of these events can be life-threatening. Herein, we describe the case of a patient who experienced acute onset of profound thrombocytopenia, developing thrombosis, pulmonary emboli, and disseminated intravascular coagulation. This paper adds to the few previous reports of cases that suggested an association between thrombocytopenia, thrombosis, and the administration of eptifibatide. To the best of our knowledge, this is the first case report in the medical literature that associates the new onset of thrombocytopenia, thrombosis, and disseminated intravascular coagulation with the administration of eptifibatide. We also provide a subject review.

  7. Offline fusion of co-registered intravascular ultrasound and frequency domain optical coherence tomography images for the analysis of human atherosclerotic plaques

    DEFF Research Database (Denmark)

    Räber, Lorenz; Heo, Jung Ho; Radu, Maria D

    2012-01-01

    To demonstrate the feasibility and potential usefulness of an offline fusion of matched optical coherence tomography (OCT) and intravascular ultrasound (IVUS)/virtual histology (IVUS-VH) images.......To demonstrate the feasibility and potential usefulness of an offline fusion of matched optical coherence tomography (OCT) and intravascular ultrasound (IVUS)/virtual histology (IVUS-VH) images....

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

    Directory of Open Access Journals (Sweden)

    Carlos Raúl Villegas

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Carlos Raúl Villegas

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Matheus Henrique Magalhães Silva

    2013-06-01

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

  11. Can intravascular lymphomatosis mimic sinus thrombosis? A case report with 8 months' follow-up and fatal outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kenez, J.; Barsi, P.; Kocher, I.; Stangl, E. [Nat. Inst. of Psychiatry and Neurology, Department of Neuroradiology, Huvoesvoelgyi st 116, 1021 Budapest (Hungary); Majtenyi, K. [Department of Neuropathology, National Institute of Psychiatry and Neurology, Budapest (Hungary); Molnar, B.; Komoly, S. [Department of Neurology, Jahn Ferenc Hospital, Budapest (Hungary)

    2000-06-01

    We report a case of intravascular lymphomatosis of the brain with 8 months' follow-up and fatal outcome. Several MRI investigations revealed variegated, rapidly changing infarct-like lesions and invasion of the walls of the superior sagittal sinus and deep veins. When disturbances of the venous outflow are detected with multifocal infarct-like lesions, intravascular lymphomatosis should be considered in the differential diagnosis. Brain biopsy may ensure the proper diagnosis ante mortem, but failure of biopsy is frequent, as in our case. (orig.)

  12. Tendência das taxas de mortalidade por linfoma não-Hodgkin na Região Sudeste do Brasil, 1980-2007 Trends in mortality rates from non-Hodgkin lymphoma in Southeast Brazil, 1980-2007

    Directory of Open Access Journals (Sweden)

    Laércio Lima Luz

    2011-07-01

    Full Text Available A mortalidade por linfoma não-Hodgkin vem diminuindo em vários países, porém, para o Brasil, as estimativas apontam crescimento em ambos os sexos. O objetivo deste estudo foi analisar a tendência da mortalidade por linfoma não-Hodgkin em indivíduos com 20 ou mais anos, nas capitais da Região Sudeste, entre 1980 e 2007. Utilizou-se como fonte de dados o Sistema de Informações sobre Mortalidade (SIM e o Departamento de Informática do SUS (DATASUS. A tendência das taxas de mortalidade por linfoma não Hodgkin por faixas etárias foi analisada por meio de modelos de regressão polinomial. Foi observada tendência linear de incremento estatisticamente significativa em Belo Horizonte (Minas Gerais e São Paulo para faixa etária de 60 ou mais anos. Ao analisar de forma separada os períodos 1980-1995 e 1996-2007, só se observou tendência de incremento estatisticamente significativa no período inicial. Os resultados sugerem que o incremento observado entre 1980-2007 poderia ser resultante do crescimento das taxas de mortalidade entre 1980-1995, já que, no último período, não foram observadas tendências estatisticamente significativas nessas cidades.Mortality rates from non-Hodgkin lymphoma (NHL have declined in many countries in recent decades. However, mortality estimates for Brazil indicate an increase in these rates. This study aimed to analyze NHL mortality trends for 1980-2007 in individuals 20 years and older in State capitals in Southeast Brazil. Population data were obtained from the Mortality Information System and the Health Statistics Division of the Unified National Health System (DATASUS. Age-related mortality trends were analyzed using polynomial regression models. In the 60 and older age group, a statistically significant upward linear trend was observed for Belo Horizonte and São Paulo in 1980-2007. When analyzed in two different periods, 1980-1995 and 1996-2007, statistically significant increases in NHL mortality

  13. Principales retos de la negociación de un tratado de libre comercio con Estados Unidos: Disciplinas en materia de inversión

    OpenAIRE

    Sergio Gómez Lora; Jaime Zabludovsky

    2005-01-01

    El Tratado de Libre Comercio de América del Norte (TLCAN) incluyó, por primera ocasión en un tratado de libre comercio (TLC), disciplinas de amplio alcance en materia de inversión, además de un mecanismo a través del cual un inversionista puede demandar a un Estado por violación del nivel de protección previsto en el acuerdo. El tema es una alta prioridad en la agenda estadounidense de negociaciones comerciales internacionales y ha sido incorporado en los tratados de libre comercio que este p...

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

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

    2011-09-01

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

  17. Multiorgan dysfunction in a gravid woman with placental abruption and disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Kezić Aleksandra

    2007-01-01

    Full Text Available The most frequent obstetrical cause of coagulation disorders as disseminated intravascular coagulation is placental abruption, which can be found in women without any apparent clinical disturbances or in the state of established preeclampsia. Hypertension occurs in 5-8% of all pregnancies and may be complicated by preeclampsia. Preeclampsia is a complex clinical syndrome with insufficiently clear pathophysiology based on the damage of the vascular endothelium. As a result of this, generalized endothelial disruption in preeclampsia, a multiorgan dysfunction, can develop, most frequently reflected in the clinical presentation with hematological and renal disturbances and with a disordered function of the liver and central nervous system. We are presenting a case of a gravid woman with poorly regulated hypertension that resulted from development of preeclampsia, later complicated by placental abruption and disseminated intravascular coagulation (DIC with multi-organ dysfunction. The importance of rapid recognition of coagulation disorder and the attempt at surgical treatment aiming at removal of the triggering mechanisms of DIC was shown, suggesting all the symptomatic therapeutic measures would be ineffective. Although our patient was surgically treated in the phase of generalized disorder characterized by development of coma, acute respiratory distress syndrome and renal insufficiency when mortality was 70%, the recovery of functions of all involved organs was achieved, except for the renal function that required chronic haemodialysis treatment.

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

    Science.gov (United States)

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

    2016-05-01

    Intravascular photoacoustic (IVPA) imaging can visualize the coronary atherosclerotic plaque composition on the basis of the optical absorption contrast. Most of the photoacoustic (PA) energy of human coronary plaque lipids was found to lie in the frequency band between 2 and 15 MHz requiring a very broadband transducer, especially if a combination with intravascular ultrasound is desired. We have developed a broadband polyvinylidene difluoride (PVDF) transducer (0.6 × 0.6 mm, 52 μm thick) with integrated electronics to match the low capacitance of such a small polyvinylidene difluoride element (<5 pF/mm(2)) with the high capacitive load of the long cable (∼100 pF/m). The new readout circuit provides an output voltage with a sensitivity of about 3.8 μV/Pa at 2.25 MHz. Its response is flat within 10 dB in the range 2 to 15 MHz. The root mean square (rms) output noise level is 259 μV over the entire bandwidth (1-20 MHz), resulting in a minimum detectable pressure of 30 Pa at 2.25 MHz.

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

    CERN Document Server

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

    2003-01-01

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

  20. Atomic layer deposition enhanced grafting of phosphorylcholine on stainless steel for intravascular stents.

    Science.gov (United States)

    Zhong, Qi; Yan, Jin; Qian, Xu; Zhang, Tao; Zhang, Zhuo; Li, Aidong

    2014-09-01

    In-stent restenosis (ISR) and re-endothelialization delay are two major issues of intravascular stent in terms of clinical safety and effects. Construction of mimetic cell membrane surface on stents using phosphorylcholine have been regarded as one of the most powerful strategies to resolve these two issues and improve the performance of stents. In this study, atomic layer deposition (ALD) technology, which is widely used in semiconductor industry, was utilized to fabricate ultra-thin layer (10nm) of alumina (Al2O3) on 316L stainless steel (SS), then the alumina covered surface was modified with 3-aminopropyltriethoxysilane (APS) and 2-methacryloyloxyethyl phosphorylcholine (MPC) sequentially in order to produce phosphorylcholine mimetic cell membrane surface. The pristine and modified surfaces were characterized using X-ray photoelectron spectroscopy, atomic force microscope and water contact angle measurement. Furthermore, the abilities of protein adsorption, platelet adhesion and cell proliferation on the surfaces were investigated. It was found that alumina layer can significantly enhance the surface grafting of APS and MPC on SS; and in turn efficiently inhibit protein adsorption and platelet adhesion, and promote the attachment and proliferation of human umbilical vein endothelial cells (HUVEC) on the surfaces. In association with the fact that the deposition of alumina layer is also beneficial to the improvement of adhesion and integrity of drug-carrying polymer coating on drug eluting stents, we expect that ALD technology can largely assist in the modifications on inert metallic surfaces and benefit implantable medical devices, especially intravascular stents.

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

    Directory of Open Access Journals (Sweden)

    Martha Isabel G\\u00F3mez Lee

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Martha Isabel Gómez Lee

    2009-11-01

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

  3. Estudo do raspado de conjuntiva de pacientes tratados de retinoblastoma: Etapa II ¾ citologia

    Directory of Open Access Journals (Sweden)

    Santos Maria Carmen Menezes

    2002-01-01

    Full Text Available Objetivo: A citologia da conjuntiva humana tem sido amplamente estu-dada. A falta de dados sobre as características do raspado ocular em pacientes tratados de retinoblastoma submetidos à enucleação e radioterapia foi o que motivou este estudo. Métodos: Foram examinadas 114 órbitas de 58 pacientes. Este trabalho apresenta os resultados da citologia conjuntival, em 4 condições, com e sem enucleação, com e sem radioterapia. Resultados: No infiltrado leucocitário das órbitas com bulbo ocular predominaram os linfócitos e nas demais, os polimorfonucleares neutrófilos. De maneira geral, as alterações das células epiteliais mais encontradas nas lâminas dos esfregaços conjuntivais de órbitas irradiadas foram: células com núcleo aumentado e nucléolo proeminente e com hialinização do citoplasma. Conclusão: Os achados citológicos do raspado conjuntival não indicaram perfil característico e distinto para cada grupo.

  4. Pre-treatment with bone marrow-derived mesenchymal stem cells inhibits systemic intravascular coagulation and attenuates organ dysfunction in lipopolysaccharide-induced disseminated intravascular coagulation rat model

    Institute of Scientific and Technical Information of China (English)

    WANG Biao; WU Shu-ming; WANG Tao; LIU Kai; ZHANG Gong; ZHANG Xi-quan; YU Jian-hua; LIU Chuan-zhen; FANG Chang-cun

    2012-01-01

    Background Bacterial lipopolysaccharide (LPS) can activate immunological cells to secrete various proinflammatory cytokines involved in the pathophysiological process of disseminated intravascular coagulation (DIC) during infection.In recent years,it has been found that bone marrow-derived mesenchymal stem cells (BMSCs) can affect the activity of these immune cells and regulate the secretion of proinflammatory cytokines.Here,we report the possible protective effect of BMSCs pre-treatment in LPS-induced DIC rat model and the mechanism.Methods Forty-eight adult male rats were divided into five experimental groups and one control group with eight animals in each group.In the treatment groups,0,1×106,2×106,3×106,and 5×106 of BMSCs were injected intravenously for 3 days before LPS injection,while the control group was treated with pure cell culture medium injection.Then,the LPS (3 mg/kg) was injected via the tail vein in the treatment groups,while the control group received 0.9% NaCl.Blood was withdrawn before and 4 and 8 hours after LPS administration.The following parameters were monitored:platelets (PLT),fibrinogen (Fib),D-dimer (D-D),activated partial thromboplastin time (APTT),prothrombin time (PT),tumor necrosis factor-o (TNF-α),interferon-γ (IFN-γ),interleukin-1β (IL-1β),creatinine (Cr),alanine aminotransferase (ALT),creatinine kinase-MB (CK-MB),and endothelin (ET).Results Compared with the control group,a significant change of coagulation parameters were found in the experimental groups.The plasma level of the inflammatory mediator (TNF-α,IFN-γ,IL-1β),organ indicator (Cr,ALT,and CK-MB),and ET in the experimental groups were much lower (P <0.05) than that in the control group.Furthermore,some of these effects were dose-dependent; the statistical comparison of the plasma levels between the groups (from group 2 to group 5) showed a significant difference (P<0.05),except the ALT and CK-MB levels (P>0.05).Conclusion Pre-treatment with BMSCs can

  5. Las enfermedades yudam y baras (lepra) en los tratados de derecho islámico (doctrina Malikí)

    OpenAIRE

    2001-01-01

    En los tratados jurídicos figuran dos tipos de enfermedades con los nombres de yudam y baras, términos árabes ambos cuya ambigüedad semántica hace difícil el establecimiento de su significado y, por lo tanto, también de su traducción. No obstante, las fuentes lexicográficas y médicas, contrastadas con los modernos diccionarios árabes y diccionarios bilingües, permiten una aproximación al significado que tales términos poseían en el contexto espacial y temporal de los tratados jurídicos malikí...

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

    Directory of Open Access Journals (Sweden)

    Francisco Endara Flores

    2011-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Juan Lanero Fernández

    2009-06-01

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

  8. Tratado del burro y otras bestias. Una historia del simbolismo animal en Occidente, de Alberto del Campo Tejedor

    Directory of Open Access Journals (Sweden)

    Santiago Montero-Cruzada

    2015-01-01

    Full Text Available Con la máxima de Persio como jáquima, Auriculas asini quis non habet?, se apuntan los aspectos principales que han llevado a realizar una revisión analítica y crítica del contenido de la obra Tratado del burro y otras bestias. Una historia del simbolismo animal en Occidente, del antropólogo Alberto del Campo Tejedor.

  9. Tratado del burro y otras bestias. Una historia del simbolismo animal en Occidente, de Alberto del Campo Tejedor

    OpenAIRE

    Santiago Montero-Cruzada

    2015-01-01

    Con la máxima de Persio como jáquima, Auriculas asini quis non habet?, se apuntan los aspectos principales que han llevado a realizar una revisión analítica y crítica del contenido de la obra Tratado del burro y otras bestias. Una historia del simbolismo animal en Occidente, del antropólogo Alberto del Campo Tejedor.

  10. Manifestações de linfoma na síndrome de Sjögren: existe relação? Lymphoma's manifestations in Sjögren's syndrome: is there a relation?

    Directory of Open Access Journals (Sweden)

    Fabrícia Dias Colombano Limares

    2005-06-01

    Full Text Available A Síndrome de Sjögren (SS é considerada uma afecção multissistêmica, crônica, que se caracteriza pela infiltração linfocítica nas glândulas exócrinas e a produção de auto-anticorpos. OBJETIVO: Vários estudos têm notado um aumento na incidência de linfomas malignos em pacientes com SS. Em nosso estudo tentamos descrever esta relação. FORMA DE ESTUDO: Coorte transversal. MATERIAL E MÉTODO: Pacientes com Síndrome Sicca acompanhados no ambulatório de Estomatologia do Departamento de Otorrinolaringologia da Santa Casa de Misericórdia de São Paulo, no período de julho de 1999 a abril de 2002. RESULTADOS: Dos 39 pacientes, 24 foram classificados com SS. A idade variou de 19 a 83 anos, com predominância do sexo feminino (69,7%. O intervalo de tempo entre o início dos sintomas e o diagnóstico de SS variou de 3,77 anos. Não foi observado desenvolvimento de linfoma em nenhum dos pacientes avaliados. CONCLUSÃO: O diagnóstico de SS e o aumento do risco de desenvolvimento de Linfoma ao longo dos anos são importantes, então um longo período de seguimento destes pacientes é fundamental. Observamos que nossos achados foram diferentes quando comparados com a literatura. Nós não encontramos nenhum linfoma em nossos pacientes.Sjögren's Syndrome (SS is considered a multisystemic chronic disorder, which is characterized by a lymphocytic infiltration of exocrine glands and autoantibodies production. AIM: Several studies have demonstrated increased incidence of Lymphoma in SS patients. Our study tries to determine this relation. STUDY DESIGN: Transversal cohort. MATERIAL AND METHOD: Patients with Sicca's Syndrome from the Stomathology service, Santa Casa de Misericórdia Hospital, in Sao Paulo, ENT Department, from July 1999 to April 2002. RESULTS: Out of 39 patients, 24 were diagnose as SS. Ages ranged from 19 to 83 years old, with predominance of women (69.7%. Time between the first symptoms and SS diagnosis were variable

  11. Movilización de progenitores hematopoyéticos de sangre periférica para transplante autólogo en pacientes con linfomas e infección por el virus de la inmunodeficiencia humana

    OpenAIRE

    Sagüés Serrano, Miguel; Feliu Frasnedo, Evarist; Ribera Santasusana, Josep María

    2012-01-01

    La infección por el virus de la inmunodeficiencia humana (VIH) es un factor limitante para la movilización de progenitores hematopoyéticos de sangre periférica (PHSP). En este estudio se compararon los resultados de dos estrategias de movilización de PHSP en 42 pacientes con linfoma e infección por el VIH remitidos para trasplante autogénico y los factores asociados con una movilización adecuada. La tasa de movilización satisfactoria (recolección &1,6x106 células CD34/Kg) con G-CSF (16/22 [72...

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

    Directory of Open Access Journals (Sweden)

    Susy Frankel

    2011-11-01

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

  13. El tratado secreto del Barón de Río Branco: la alianza entre Brasil y Ecuador, 1904

    Directory of Open Access Journals (Sweden)

    Luís Cláudio Villafañe G. Santos

    2016-06-01

    Full Text Available Es casi desconocida en las historiografías de Brasil y Ecuador la existencia de un tratado militar secreto entre ambos países, rmado el 5 de mayo de 1904, dirigido contra las pretensiones territoriales de Perú. El artículo estudia una creciente tensión entre Brasil y Perú, que disputaban un área de 442 mil kilómetros cuadrados en la Amazonía. Por iniciativa del Barón de Río Branco, se rmó un tratado secreto de alianza militar entre Brasil y Ecuador. Si bien este acuerdo no fue raticado por los países rmantes, fue de suma importancia para forzar al gobierno peruano a iniciar negociaciones con Brasil, que años más tarde resultaron en el tratado de límites entre los dos países.

  14. The removal of intravascular bullets by interventional radiology: the prevention of central migration by balloon occlusion--case report.

    Science.gov (United States)

    Sclafani, S J; Shatzkes, D; Scalea, T

    1991-10-01

    A migratory intravascular bullet fragment located within the hypogastric vein was removed successfully with the aid of interventional radiologic techniques. The authors describe the use of the technique of balloon trapping as part of this procedure. A balloon should be inflated between the foreign body and the heart before retrieval is attempted in order to prevent migration back to the heart during the manipulation.

  15. Subacute fat-embolism-like syndrome following high-volume intramuscular and accidental intravascular injection of mineral oil

    DEFF Research Database (Denmark)

    Hjort, Mathias; Hoegberg, Lotte Christine Groth; Jansen, Tejs

    2015-01-01

    Objective. We present a rare case of subacute fat-embolism-like syndrome (FES-like) following intravascular injection of mineral oil-steroid solution with delayed diagnosis, acute onset of pulmonary distress, and transient clinical deterioration. Case report. A 40-year-old man was admitted...... frequent causes to respiratory failure....

  16. Quality control for intravascular intrauterine transfusion using cumulative sum (CUSUM) analysis for the monitoring of individual performance

    NARCIS (Netherlands)

    Lindenburg, I.T.; Wolterbeek, R..; Oepkes, D.; Klumper, F.J.; Vandenbussche, F.P.H.A.; Kamp, I.L. van

    2011-01-01

    INTRODUCTION: Intravascular intrauterine transfusion (IUT) is an effective and relatively safe method for the treatment of fetal anemia. Although implemented in centers all over the world in the 1980s, the length and strength of the learning curve for this procedure has never been studied. Cumulativ

  17. SELECTIVE DECONTAMINATION OF THE DIGESTIVE-TRACT CONTRIBUTES TO THE CONTROL OF DISSEMINATED INTRAVASCULAR COAGULATION IN SEVERE LIVER IMPAIRMENT

    NARCIS (Netherlands)

    VANSAENE, HKF; STOUTENBEEK, CP; FABERNIJHOLT, R; VANSAENE, JJM

    1992-01-01

    A premature neonate with severe Coxsackie B1 hepatitis acquired in utero developed disseminated intravascular coagulation a few days after birth. The neonate did not respond to conventional treatment. Eradication of aerobic gram-negative bacilli (Enterobacteriaceae) from the gut with oral nonabsorba

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  19. Successful percutaneous transluminal angioplasty and stenting for symptomatic intracranial vertebral artery stenosis using intravascular ultrasound virtual histology.

    Science.gov (United States)

    Takayama, Katsutoshi; Taoka, Toshiaki; Nakagawa, Hiroyuki; Myouchin, Kaoru; Wada, Takeshi; Sakamoto, Masahiko; Fukusumi, Akio; Iwasaki, Satoru; Kurokawa, Shinichiro; Kichikawa, Kimihiko

    2007-06-01

    This is the first report of percutaneous transluminal angioplasty (PTA) of an intracranial artery applying intravascular ultrasound virtual histology (IVUS-VH), which has been recently developed for tissue characterization of coronary artery plaque. We report a case of successful PTA and stenting for symptomatic intracranial vertebral artery stenosis using IVUS-VH.

  20. Classificação dos linfomas não-Hodgkin: estudo morfológico e imunoistoquímico de 145 casos Classification of non-Hodgkin's lymphoma: morphological and immunological study of 145 cases

    Directory of Open Access Journals (Sweden)

    Cristiane Bedran Milito

    2002-01-01

    Full Text Available A classificação dos linfomas não-Hodgkin tem sido, ao longo dos últimos trinta anos, motivo de controvérsia. Várias classificações têm sido propostas em busca de um consenso entre patologistas e clínicos. Este trabalho teve como objetivo analisar criticamente três destas classificações através do estudo retrospectivo de 145 casos de linfomas primários de gânglio linfático selecionados do Serviço de Anatomia Patológica do Hospital Universitário Clementino Fraga Filho, entre 1979 e 1995. Os casos revistos foram classificados pelas propostas da Working Formulation, de Kiel e da Real. Testes imunoistoquímicos com os anticorpos anti-CD45, anti-CD20, anti-CD45RO e anti-CD30 foram realizados. Cento e sete casos (73,7% apresentaram fenótipo B; 33 casos (22,7%, fenótipo T; e quatro casos foram nulos (linfoma anaplásico de grandes células. Foi possível prever o fenótipo pela morfologia em 89,4% dos casos. Os linfomas de alto grau predominaram (59,2%, sendo o linfoma centroblástico o de maior freqüência (31,7% . Os linfomas foliculares representaram 29 casos (20%, com maior incidência dos de grandes células (31% do que dos de pequenas células (27,5%. Quando comparadas as três classificações, observamos que determinados grupos da Working Formulation abrigam múltiplas entidades. Isto se deve ao fato de a classificação da Working Formulation ser baseada somente em achados morfológicos e, por isso, deve ter seu uso desaconselhado. Já a classificação de Kiel e a da Real devem ter o seu emprego estimulado, pois apresentam, além de uma boa análise histopatológica, um estudo imunológico que define entidades biológicas correlacionando-se, quando possível, com a célula de origem.The non-Hodgkin's lymphomas classifications have been a controversial reason for the last thirty years. Many classifications have been proposed trying to achieve a consensus among pathologists and clinicians. The objective of this study was

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

    Directory of Open Access Journals (Sweden)

    Renata Baldissera

    2010-05-01

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

  2. Manifestaciones cardiovasculares en pacientes tratados con hemodiálisis periódica por fístula arteriovenosa funcional

    OpenAIRE

    2016-01-01

    Introducción: Las manifestaciones cardiovasculares producidas por la fístula arteriovenosa en pacientes tratados con hemodiálisis constituyen un aspecto de importancia, al ser las enfermedades cardiovasculares la principal causa de morbilidad y mortalidad. Objetivo: Determinar las manifestaciones cardiovasculares de los pacientes tratados con hemodiálisis periódica por fístula arteriovenosa funcional. Método: Estudio descriptivo, transversal, con 81 pacientes en tratamiento dialítico qu...

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

    OpenAIRE

    Borrego Dorado, Isabel

    2016-01-01

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

  4. Linfomas não-Hodgkin extranodais em Salvador-Bahia: aspectos clínicos e classificação histopatológica segundo a OMS-2001 Extranodal non-Hodgkins lymphomas in Salvador, Brazil: clinical aspects and histopathological classification according to the WHO-2001 guidelines

    Directory of Open Access Journals (Sweden)

    Marinho M. Silva Neto

    2008-02-01

    Full Text Available Linfomas não-Hodgkin (LNH extranodais representam cerca de um terço de todos os linfomas e atualmente apresentam taxa de incidência maior que a de linfomas nodais. Diferenças entre LNH nodais e extranodais incluem etiologia, formas de apresentação e resposta terapêutica, entretanto não dispomos de dados na nossa população. Este estudo teve como objetivo caracterizar os LNH extranodais diagnosticados no Hospital Aristides Maltez, em Salvador-Bahia. Foram avaliados, retrospectivamente, 145 diagnósticos de linfoma não-Hodgkin, segundo a OMS-2001, no período de janeiro de 1999 a julho de 2001. A freqüência de linfomas extranodais foi de 30,3%. A idade média dos pacientes foi de 55,6 anos e a relação homem/mulher foi de 1:1. A maioria dos pacientes apresentava estadios avançados (III ou IV de Ann Arbor, presença de sintomas B, LDH normal, bom desempenho pela escala do ECOG e IPI entre zero e dois. Nove pacientes estão vivos e em remissão completa (22,5% após um seguimento médio de 23 meses. O sítio extranodal mais comumente acometido foram as tonsilas, seguidas pela cavidade oral, pele e trato gastrointestinal, dentre outros. O linfoma difuso de grandes células B foi o mais comum subtipo histológico, seguido pelo linfoma anaplásico de grandes células. Concluímos que o mais freqüente sítio extranodal de apresentação em nosso estudo difere da maioria da literatura, porém nossa freqüência de linfoma extranodal é semelhante à mesma.Extranodal non-Hodgkins lymphomas represent approximately one third of all lymphomas and currently have an incidence higher than nodal lymphomas. Differences in etiology, presentation and outcome of these lymphomas have been reported. However, there are no data in our population. This study was carried out in the Pathological Anatomy Service of Aristides Maltez Hospital in Salvador, Bahia. One hundred and forty-five non-Hodgkins lymphomas cases according to the WHO-2001 classification

  5. Enfermedad de Chagas aguda, en un adulto tratado con benznidazol (Rochagan® en Costa Rica

    Directory of Open Access Journals (Sweden)

    Víctor M. Montenegro

    2004-06-01

    Full Text Available Se da a conocer un caso agudo de la enfermedad de Chagas en un adulto de 48 años con signo de Romaña, infectado al recibir un chorro de orina de una chinche (T. dimidiata, cuando trataba de destripada con un palo de café. Es el primer adulto con enfermedad de Chagas aguda tratado en Costa Rica con benznidazol. Se citan los síntomas encontrados, así como los aspectos epidemiológicos relacionados con su presentación. Se enfatizan el tratamiento y la evolución del caso. Se hace un llamado de atención a los clínicos, ya que este caso no fue diagnosticado apropiadamente desde un inicio, lo que evidencia el desconocimiento que existe de la enfermedad de Chagas como motivo de consulta.An acute case of Chagas "disease with Romañas" sign, in a 48 years old man, is described. Treatment with Benznidazol was succesfull. This is the first acute case in an adult treated with this drug in Costa Rica. Reference is made to the epidemiological aspects involved in this case and to the mechanism of infection. This person became infected when he was trying to kiU a nymph of T. dimidiata with a coffe stick and received a jet of urine directly in the right eye. The case was not diagnosed by the clinicians while the patient was at the hospital indicating the poor knowledge of practitioners about the characteristics of the disease in our country.

  6. Los tratados silogísticos de Boecio: sus fuentes, historia e influencia en la cristiandad latina

    Directory of Open Access Journals (Sweden)

    Manuel Correia

    2007-01-01

    Full Text Available En este artículo se describen los contenidos de un tratado sobre lógica aristotélica escrito por Boecio en el VI d. C, llamado por nuestras ediciones modernas De syllogismo categórico (=DSC. A través de sus contenidos, es posible mostrar: (i la importancia de este tratado en el proceso de transmisión de la lógica de Aristóteles al medioevo latino; (ii su relación con otro tratado monográfico similar, titulado por la crítica moderna Introductio ad syllogismos categóricos (ISC y su relación temática con DSC; (iii las fuentes más probables de ambos tratados; y, finalmente, (iv su influencia en el medioevo latino. La hipótesis que se defiende en este artículo es que los contenidos lógicos de este tratado, en particular la clasificación de las proposiciones categóricas, contenida en el corazón del DSC, entregan no solo el objeto temático al tratado, sino también coherencia argumentativa y unidad. En especial, el estudio de esta clasificación permite demostrar la unidad de DSC y en particular que el segundo libro de DSC es genuino y no espurio como sostuvieron, no hace mucho, los estudiosos Murari y McKinlay; además, esta misma clasificación permite apreciar su diferencia con ISC, por el hecho de que este último tratado posee una clasificación diferente a la de DSC. La base de la hipótesis propuesta se halla en que la clasificación mencionada es un intento por generar, a partir de los elementos preposicionales, las principales operaciones lógicas definidas por Aristóteles en sus escritos lógicos, asunto que en la revisión de De Rijk (1964 no quedó totalmente establecidoIn this article, the author describes the contents of a treatise on Aristotelian logic, written by Boethius in the sixth century A.D., titled in our modern editions as De syllogismo categórico (DSC. It is possible to show, through the contents: (i the importance of this treatise for the transmission process of Aristotle's logic to the Latin medieval

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated...... the prevalence of overt DIC and ACoTS in trauma patients and characterized these conditions based on their biomarker profiles. METHODS: Observational study at a single Level I Trauma Centre. Inclusion of 80 adult trauma patients ([greater than or equal to]18 years) who met criteria for full trauma team...... activation and had an arterial cannula inserted. Blood was sampled a median of 68 min (IQR 48-88) post-injury. Data on demography, biochemistry, injury severity score (ISS) and mortality were recorded. Plasma/serum was analyzed for biomarkers reflecting tissue/endothelial cell/glycocalyx damage (histone...

  8. Development of a Mechanical Scanning-type Intravascular Ultrasound System Using a Miniature Ultrasound Motor

    Science.gov (United States)

    Tanabe, Masayuki; Xie, Shangping; Tagawa, Norio; Moriya, Tadashi; Furukawa, Yuji

    2007-07-01

    Intravascular ultrasound (IVUS) plays an important role for the detection of arteriosclerosis, which causes the ischemic heart disease. In mechanical scanning-type IVUS, it is necessary to rotate a transducer or a reflecting mirror. A method that involves rotating the transducer using a torque wire causes image distortion (NURD: non uniform rotation distortion). For a method that involves placing an electromagnetic motor on the tip of an IVUS probe is difficult to miniaturize the probe. Our objectives are to miniaturize the probe (1 mm in diameter, 5 mm in length) and to remove NURD. Therefore, we conducted a study to assess the feasibility of attaining these objectives by constructing a prototype IVUS system, in which an ultrasound motor using a stator in the form of a helical coil (abbreviated as CS-USM: coiled stator-ultrasonic motor) is incorporated, and to clarify problems that need to be solved in constructing the probe.

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

    DEFF Research Database (Denmark)

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

    2001-01-01

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

  10. Optical coherence tomography – near infrared spectroscopy system and catheter for intravascular imaging

    Science.gov (United States)

    Fard, Ali M.; Vacas-Jacques, Paulino; Hamidi, Ehsan; Wang, Hao; Carruth, Robert W.; Gardecki, Joseph A.; Tearney, Guillermo J.

    2013-01-01

    Owing to its superior resolution, intravascular optical coherence tomography (IVOCT) is a promising tool for imaging the microstructure of coronary artery walls. However, IVOCT does not identify chemicals and molecules in the tissue, which is required for a more complete understanding and accurate diagnosis of coronary disease. Here we present a dual-modality imaging system and catheter that uniquely combines IVOCT with diffuse near-infrared spectroscopy (NIRS) in a single dual-modality imaging device for simultaneous acquisition of microstructural and compositional information. As a proof-of-concept demonstration, the device has been used to visualize co-incident microstructural and spectroscopic information obtained from a diseased cadaver human coronary artery. PMID:24514658

  11. Intravascular ultrasound assessment of very late bare-metal stent thrombosis: a case report

    Institute of Scientific and Technical Information of China (English)

    Ji Hyun Lee; Kyung Min Kim; Jun Won Lee; Sung Gyun Ahn; Young Jin Youn

    2012-01-01

    Very late stent thrombosis (VLST) is increasingly being regarded as a complication of drug-eluting stents (DES),and delayed endothelization,local hypersensitivity reactions,and late stent malapposition due to excessive positive remodeling have been postulated as mechanisms.Considering that stent endothelialization seems to be completed within 4 weeks following bare-metal stent (BMS) placement and that BMS do not possess antiproliferative coating,the mechanism of VLST may differ between patients with DES and those with BMS.We report a case of VLST 9 years after BMS implantation,in which thrombus from the ruptured neointima was confirmed by intravascular ultrasound.This finding suggests that de novo plaque rupture at the neointimal layer within the stent may be one of the explanations for VLST.

  12. Distribution of intravascularly injected lanthanum ions in ganglia of the autonomic nervous system of the rat.

    Science.gov (United States)

    DePace, D M

    1984-12-01

    Intravascular injection of lanthanum revealed that tight junctions of capillaries in sympathetic ganglia are impermeable to small ions and thus behave like capillaries of the blood-brain barrier. The failure of lanthanum to accumulate in the extracellular space suggests that fenestrated capillaries are not as ion-permeable as use of horseradish peroxidase (HRP) by some authors has indicated. A possible toxic action associated with high concentrations of HRP may be responsible for the high permeability of this substance. Testing with lanthanum demonstrated that sympathetic ganglia possess anatomic features that provide a hematic barrier. The blood-ganglion barrier resembles, but has not yet been demonstrated to be as absolute as the blood-brain barrier.

  13. A state-of-the-art review on segmentation algorithms in intravascular ultrasound (IVUS) images.

    Science.gov (United States)

    Katouzian, Amin; Angelini, Elsa D; Carlier, Stéphane G; Suri, Jasjit S; Navab, Nassir; Laine, Andrew F

    2012-09-01

    Over the past two decades, intravascular ultrasound (IVUS) image segmentation has remained a challenge for researchers while the use of this imaging modality is rapidly growing in catheterization procedures and in research studies. IVUS provides cross-sectional grayscale images of the arterial wall and the extent of atherosclerotic plaques with high spatial resolution in real time. In this paper, we review recently developed image processing methods for the detection of media-adventitia and luminal borders in IVUS images acquired with different transducers operating at frequencies ranging from 20 to 45 MHz. We discuss methodological challenges, lack of diversity in reported datasets, and weaknesses of quantification metrics that make IVUS segmentation still an open problem despite all efforts. In conclusion, we call for a common reference database, validation metrics, and ground-truth definition with which new and existing algorithms could be benchmarked.

  14. Intravascular ultrasound assessment of remodelling and reference segment plaque burden in type-2 diabetic patients

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Mintz, Gary S;

    2007-01-01

    with type-2 diabetes mellitus. METHODS AND RESULTS: We used pre-intervention IVUS to study 62 de novo lesions in 43 patients with type-2 diabetes mellitus. The lesion site was the image slice with the smallest lumen cross-sectional area (CSA). The proximal and distal reference segments were the most normal...... size [slope = -0.12 (95% CI -0.17 to -0.07); P type-2 diabetes mellitus. CONCLUSION: Lesions in type-2 diabetic patients are different from previous reports in non-diabetics. Lesions in type-2 diabetics are characterized by a large reference segment plaque burden......AIMS: Intravascular ultrasound (IVUS) assesses arterial remodelling by comparing the lesion external elastic membrane (EEM) with the reference segments; however, reference segments are rarely disease-free. The aim was to assess lesion and reference segment remodelling and plaque burden in patients...

  15. Pathogenesis and management of peripartum coagulopathic calamities (disseminated intravascular coagulation and amniotic fluid embolism).

    Science.gov (United States)

    Levi, Marcel

    2013-01-01

    Acute coagulopathic peripartum calamities are relatively rare but contribute importantly to maternal morbidity and mortality in the Western world. Abruptio placenta, amniotic fluid embolism, and retained fetal or placental material may lead to fulminant intravascular activation of coagulation which results in thromboembolic complications and consumption coagulopathy causing severe hemorrhage. The central underlying pathophysiological pathway in the coagulopathy associated with these syndromes is the occurrence of tissue factor, released from the placenta and amniotic fluid, in the circulation, in combination with low levels of physiological anticoagulant factors during pregnancy. The diagnosis of DIC may be made trough conventional composite scoring systems employing routine coagulation tests, whereas for the diagnosis of amniotic fluid embolism measurement of insulin like growth factor binding protein-1 seems promising. Therapy is aimed at removing the precipitating factor combined with supportive adjunctive treatment options.

  16. Diagnosis of overt disseminated intravascular coagulation in critically Ill adults by Sonoclot coagulation analysis.

    Science.gov (United States)

    Wan, Peng; Tong, Hua-Sheng; Zhang, Xing-Qin; Duan, Peng-Kai; Tang, You-Qing; Su, Lei

    2014-08-01

    Disseminated intravascular coagulation (DIC) diagnosis is hampered by the limited availability of reliable clinical or laboratory tests. Currently available tests are time consuming and expensive. We investigated whether coagulation and platelet function analyses using the Sonoclot system were suitable for overt DIC diagnosis in critically ill adults. This was an observational diagnostic study performed in 498 patients presenting with an underlying disorder associated with DIC. Overt DIC patients were identified according to an International Society on Thrombosis and Hemostasis (ISTH) score of >5. Coagulation and platelet parameters were analyzed using the Sonoclot system, and compared with ISTH as the gold standard. Receiver operating characteristic curves and area under the curves were used to evaluate the value of the Sonoclot parameters. There were no differences for age or gender between the groups. Significant correlations were observed between activated clotting time (ACT) and ISTH score (r = 0.7; P coagulation dysfunction in patients with overt DIC.

  17. Disseminated intravascular coagulation does not play a major role in the pathogenesis of classical swine fever.

    Science.gov (United States)

    Blome, Sandra; Meindl-Böhmer, Alexandra; Nowak, Götz; Moennig, Volker

    2013-03-23

    Classical swine fever (CSF) is a multi-systemic disease that can be accompanied by severe haemorrhagic lesions. The underlying pathogenetic mechanisms are still far from being understood, though disseminated intravascular coagulation (DIC) was discussed as a major factor. In the presented study, the direct thrombin inhibitor hirudin was used in an attempt to elucidate the role of the coagulation system in the pathogenesis of CSF-induced haemorrhagic lesions. Two groups of piglets (n=5) were infected with highly virulent CSF virus (CSFV) strain CSF0634. One group underwent daily treatment with hirudin, the other served as untreated challenge infection control. Assessment of clinical signs using a clinical score system, coagulation tests, and blood counts were performed daily. Both groups developed acute-lethal CSF with haemorrhagic lesions. Although changes in the coagulation system were seen in the late stages of CSFV infection, our results strongly suggest that DIC does not present the crucial event in the pathogenesis of haemorrhagic lesions.

  18. Intravascular photoacoustic detection of vulnerable plaque based on constituent selected imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Jian; Xing Da, E-mail: xingda@scnu.edu.cn [MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631 (China)

    2011-01-01

    Atherosclerosis, a disease of the large arteries, is the primary cause of heart disease and stroke. Over decades, atherosclerosis is characterized by thickening of the walls of the arteries, only advanced atherosclerotic disease could be observed. Photoacoustic imaging is a hybrid imaging technique that combines the advantages of high spatial resolution of ultrasound with contrast of optical absorption. In this paper, we present an intravascular photoacoustic (IVPA) imaging system to characterize vulnerable plaques by using the optical absorption contrast between different constituents. Epidemiological studies have revealed several important plaque constituents associated with early atherosclerosis, such as macrophage, cholesterol, lipid, calcification, and so on. We chose a section of lipid rich atherosclerosis artery and a section of normal artery as the phantom. Two IVPA images of them are given to show the difference between sick and normal. As a new method of detecting vulnerable plaque, IVPA constituents imaging will provide more details for diagnosis that offer an enticing prospect in early detecting of atherosclerosis.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated...... activation and had an arterial cannula inserted. Blood was sampled a median of 68 min (IQR 48-88) post-injury. Data on demography, biochemistry, injury severity score (ISS) and mortality were recorded. Plasma/serum was analyzed for biomarkers reflecting tissue/endothelial cell/glycocalyx damage (histone......-complexed DNA fragments, Annexin V, thrombomodulin, syndecan-1), coagulation activation/inhibition (prothrombinfragment 1+2, thrombin/antithrombin-complexes, antithrombin, protein C, activated protein C, endothelial protein C receptor, protein S, tissue factor pathway inhibitor, vWF), factor consumption...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Elham Vali Khojeini

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Choi, C.K.

    2002-06-25

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

  3. Real-time volumetric lipid imaging in vivo by intravascular photoacoustics at 20 frames per second

    Science.gov (United States)

    Wu, Min; Springeling, Geert; Lovrak, Matija; Mastik, Frits; Iskander-Rizk, Sophinese; Wang, Tianshi; van Beusekom, Heleen M. M.; van der Steen, A. F. W.; Van Soest, Gijs

    2017-01-01

    Lipid deposition can be assessed with combined intravascular photoacoustic/ultrasound (IVPA/US) imaging. To date, the clinical translation of IVPA/US imaging has been stalled by a low imaging speed and catheter complexity. In this paper, we demonstrate imaging of lipid targets in swine coronary arteries in vivo, at a clinically useful frame rate of 20 s−1. We confirmed image contrast for atherosclerotic plaque in human samples ex vivo. The system is on a mobile platform and provides real-time data visualization during acquisition. We achieved an IVPA signal-to-noise ratio of 20 dB. These data show that clinical translation of IVPA is possible in principle. PMID:28270995

  4. Recanalization of an accidentally crushed coronary stent by intravascular ultrasonography catheter entrapment.

    Science.gov (United States)

    Kim, Jae Yun; Lee, Nae-Hee; Cho, Yoon Haeng; Suh, Jon; Seo, Hye-Sun; Kim, Do Hoi; Jeon, Young Woo

    2011-06-01

    Intravascular ultrasonography (IVUS) imaging is a user-friendly technique widely used during coronary interventions. An 80-year-old man was admitted with chest pain, and successful percutaneous coronary intervention was performed with stent implantation. One week later, the patient complained of further chest pain. Urgent coronary angiography showed total occlusion of the middle left anterior descending artery and the aspiration of thrombi was high. IVUS imaging showed inadequate stent strut apposition and distal dissection. We attempted another stent implantation but the IVUS catheter was stuck on the 0.014 inch wire. Therefore, we tried to pass the wire across the lateral side. After the wire was successfully passaged, the sprinter balloon was passed through the crushed stent to expand it. After 4 days later, the patient was discharged with no symptoms or electrocardiographic change.

  5. The expanding indications for virtual histology intravascular ultrasound for plaque analysis prior to carotid stenting.

    Science.gov (United States)

    Schiro, B J; Wholey, M H

    2008-12-01

    Complications of carotid artery stenting (CAS), including stroke, remain relatively high when compared with carotid endarterectomy (CEA). Current selection criteria for patients undergoing CAS are based predominately on surgical risk related to other comorbidities. Little attention is given to the morphology of the atherosclerotic plaque, although studies have shown that extensive variability exists which confers certain risks for plaque vulnerability. Virtual Histology intravascular ultrasound (VH IVUS) offers a unique method of assessing plaque morphology prior to CAS. Herein, the authors review the concepts of atherosclerotic plaque morphology and discuss the background of VH IVUS and illustrate its use in the carotid system. With selection of the appropriate patient and the appropriate plaque, more favorable outcomes of CAS may be achieved which will solidify its place as a frontline treatment of carotid vascular disease.

  6. [Disseminated intravascular coagulation and acute kidney injury requiring renal replacement therapy after diagnostic amniocentesis].

    Science.gov (United States)

    Ratković, Marina; Bašić-Jukić, Nikolina; Gledović, Branka; Radunović, Danilo

    2014-04-01

    Disseminated intravascular coagulation (DIC) is a very rare complication of amniocentesis. We present a case of a 33-year-old patient who developed DIC with acute respiratory distress syndrome and acute kidney injury after diagnostic amniocentesis. The patient required replacement of renal function for 59 days with continuous venovenous hemodiafiltration and later with hemodialysis. She was treated with heparin, fresh frozen plasma, platelets and cryoprecipitate. Her condition was further complicated with the development of intracranial hematoma. After 67 days of hospitalization, she was discharged from the hospital with serum creatinine 337 μmol/L. Three years later, her serum creatinine was 102 μmol/L, and she is currently in the 7th month of pregnancy.

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

    Directory of Open Access Journals (Sweden)

    Jia Nan

    2011-09-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  9. Histopatologia das lâminas do casco de equinos com laminite aguda induzida e tratados com ketoprofeno, fenilbutazona e flunixin meglumine Histopathology of the digital laminae from horses with acute induced laminitis treated with ketoprophen, phenylbutazone, and flunixin meglumin

    Directory of Open Access Journals (Sweden)

    F.O. Paes Leme

    2010-04-01

    Full Text Available Avaliaram-se as alterações histológicas do tecido laminar, obtido por biopsia, em 20 equinos portadores de laminite induzida por sobrecarga de carboidratos e tratados com ketoprofeno, fenilbutazona ou flunixin meglumine. A biopsia foi colhida dos dígitos torácicos 72 horas após a indução. Os achados histológicos foram comparados com os achados de amostras de equinos isentos de laminite. Infiltrado inflamatório neutrofílico foi observado em 80%, congestão em 50%, hemorragia em 35% e hiperplasia na túnica íntima das arteríolas das lâminas dérmicas primárias em 15% das amostras. As taxas de microtrombos e coágulos foram 15% e 20%, respectivamente. Estes achados parecem decorrer dos distúrbios circulatórios que ocasionaram edema, congestão e hiperemia, seguidos de degeneração. Em 70% das análises realizadas nos animais tratados, as lesões histológicas foram inferiores aos graus de claudicação observados. Conclui-se que a biopsia de tecido laminar digital de equinos é viável, os artefatos decorrentes da técnica de biopsia não prejudicam a análise histológica das amostras e os anti-inflamatórios não esteroidais não são capazes de evitar as lesões laminares quando administrados após o início da sintomatologia clínica de laminite.Experimental laminitis caused by carbohydrate overload was induced in 20 healthy horses. Seventy two hours after induction, samples of the laminar tissue were obtained by biopsy from the thoracic limbs digits for histopathology. The histological findings were compared to samples from horses without laminitis. Neutrophilic infiltrate was observed in 80% of the samples, congestion in 50%, hemorrhage in 35%, and hyperplasia of the arteriolar intima layer of the primary dermal lamina in 15%. Thrombi and intravascular blood clots were observed in 15% and 20% of the samples, respectively. Apparently, these findings were due to circulatory changes that resulted in edema, congestion, and

  10. Combined optical coherence tomography and intravascular ultrasound radio frequency data analysis for plaque characterization. Classification accuracy of human coronary plaques in vitro

    NARCIS (Netherlands)

    T.P.M. Goderie; G. van Soest (Gijs); H.M. Garcia-Garcia (Hector); N. Gonzalo (Nieves); S. Koljenovic (Senada); G.J.H.L. Leenders (Geert); F. Mastik (Frits); E.S. Regar (Eveline); J.W. Oosterhuis (Wolter); P.W.J.C. Serruys (Patrick); A.F.W. van der Steen (Ton)

    2010-01-01

    textabstractThis study was performed to characterize coronary plaque types by optical coherence tomography (OCT) and intravascular ultrasound (IVUS) radiofrequency (RF) data analysis, and to investigate the possibility of error reduction by combining these techniques. Intracoronary imaging methods h

  11. Produtividade da mamona irrigada com esgoto doméstico tratado Productivity of castor bean irrigated with treated domestic sewage

    Directory of Open Access Journals (Sweden)

    Neyliane C. de Souza

    2010-05-01

    Full Text Available A mamoneira (Ricinus communis L., oleaginosa de relevante importância econômica e social no Nordeste, apresenta-se como alternativa para a produção do biodiesel. O experimento objetivou avaliar, em escala real, os aspectos produtivos da cultura da mamona irrigada com esgoto doméstico tratado. Empregou-se o sistema de microaspersão; a delimitação experimental foi de quatro repetições e quatro tratamentos: T1: água do poço e adubação recomendada; T2: esgoto doméstico tratado e adubação recomendada; T3: somente esgoto doméstico tratado e T4: esgoto doméstico tratado e metade da adubação recomendada. Verificou-se que as unidades irrigadas com esgoto tratado superaram as irrigadas com água, em quase todas as variáveis analisadas. A produtividade foi maior nos tratamentos irrigados com esgoto e adubação (T2 e (T4, alcançando produtividade de 1.986 e 1.412 kg ha-1, respectivamente. O teor de óleo contido nas sementes foi analisado e não apresentou nenhuma diferença significativa entre os tratamentos com adubação (T1, T2 e T4, sendo que o tratamento com esgoto tratado (T3 forneceu baixíssimos teores de óleo na semente.The castor bean (Ricinus communis L., an oil crop of economic and social importance for the Northeast region of Brazil, can be used for biodiesel production. The experiment aimed to evaluate, at a realistic scale, the productive aspects of the castor bean irrigated with treated sewage. Microsprinkler irrigation method was selected, and the experimental set-up consisted of four repetitions and four different treatments: well water and recommended fertilization (T1; treated wastewater and recommended fertilization (T2; treated wastewater without external recommended fertilization (T3; and treated wastewater and half of recommended fertilization (T4. It was found that units irrigated with treated sewage exceeded the ones irrigated with well water in almost all variables. The highest productivities were in the

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

    Directory of Open Access Journals (Sweden)

    E. I. Bertoncini

    1999-09-01

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

  13. La igualdad de genero en el Tratado Constitucional de la Unión Europea

    Directory of Open Access Journals (Sweden)

    Emanuela Lombardo

    2012-02-01

    Full Text Available El artículo analiza el tratamiento de la igualdad de género en el Tratado Constitucional Europeo de 2004, con especial referencia a la incorporación de una perspectiva de género en el proceso. Evalúa tanto los resultados positivos, relacionados con el mantenimiento del acervo comunitario en materia de igualdad, la inclusión de la Carta de los Derechos Fundamentales de la UE, y las movilizaciones a favor de la igualdad dentro y fuera de la Convención, como los resultados negativos, concernientes a la limitada capacidad de incorporar una perspectiva  de género en el proceso y en el texto constitucional. Ésta se atribuye al concepto estrecho de igualdad de género adoptado en el documento, a las resistencias en incorporar una perspectiva de género en todas las áreas políticas, a la baja representación de las mujeres en la Convención, y a la ausencia de una perspectiva de género en el proceso institucional y administrativo. En la conclusión se avanzan algunas hipótesis explicativas de dichas limitaciones. The article analyses the treatment of gender equality in the 2004 European Constitutional Treaty, with particular reference to the incorporation of a gender perspective in the process. The assessment includes positive results, that are related to the maintenance of the acquis cornrnmunautaire on equality, the inclusion of the Charter of Fundamental Rights, and the mobilisation in favour of equality within and outside the body of the Convention. It also considers the negative results that have to do with the limited capacity to incorporate a gender perspective into the process and the text of the Constitution. This limits are attributed to the narrow concept of gender equality adopted in the document, the resistance to incorporate a gender perspective into all policy areas, the low representation of women in the Convention, and the absence of a gender perspective in the institutional and administrative process. The

  14. Pulmonary intravascular large B-cell lymphoma successfully treated with rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone immunochemotherapy: Report of a patient surviving for over 1 year

    OpenAIRE

    NISHII-ITO, SHIZUKA; Izumi, Hiroki; Touge, Hirokazu; TAKEDA, KENICHI; Hosoda, Yuzuru; Yamasaki, Akira; Kuwamoto, Satoshi; Shimizu, Eiji; Motokura, Toru

    2016-01-01

    A 73-year-old man with a history of lethargy, fever and dyspnea was admitted to Tottori University Hospital. A computed tomography (CT) scan revealed splenomegaly and diffusely spreading ground-glass opacities (GGOs) in both lungs. A video-assisted thoracoscopic surgery (VATS)-guided lung biopsy revealed intravascular proliferation of large atypical lymphoid cells in the arteries, veins and alveolar walls. The patient was diagnosed with intravascular large B-cell lymphoma (IVLBCL); he receive...

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

    Directory of Open Access Journals (Sweden)

    Raphael Carvalho de Vasconcelos

    2015-08-01

    Full Text Available La personalidad jurídica es elemento fundamental para la actuación de un sujeto en el orden internacional. La efectiva participación en el espacio global no depende, sin embargo, sólo del cumplimiento de este requisito. Doctrina y jurisprudencia reconocen la personificación de las organizaciones internacionales actualmente sin grandes reservas, pero, ¿correspondería entender que cualquier tratado dotado de personería jurídica debe ser considerado investido de poderes para actuar en el orden internacional muchas veces de forma pareja a los estados? Se propone, en este breve estudio, identificar la existencia de un sistema de solución de diferencias institucionalizado como un requisito necesario para la actuación de las referidas estructuras como sujetos de derecho internacional estableciendo criterios capaces de distinguir las organizaciones internacionales de meros tratados asociativos. En la primera parte, son establecidos los contenidos de conceptos como personalidad y capacidad y, en seguida, el pronunciamiento de la Corte Internacional de Justicia que reconoció la personería jurídica internacional de las Naciones Unidas contribuye al avance de la construcción teórica sugerida. En la tercera parte, las perspectivas interna e internacional son contrapuestas e introducen el siguiente debate, que fija las bases de la separación entre los conceptos de organización internacional y de tratados asociativos. Para fundamentar la diferenciación señalada, se propone, entonces, el reconocimiento de la importancia de los sistemas institucionalizados de solución de controversias como requisito que avale la propuesta de una nueva clasificación de los sujetos de derecho internacional.

  16. El encuentro entre René Descartes e Isaac Beeckman (1618-1619: El tratado hidrostático

    Directory of Open Access Journals (Sweden)

    Jorge Moreno

    2014-02-01

    Full Text Available El tratado hidrostático fue uno de los primeros textos de Descartes, fruto de su decisivo encuentro con Isaac Beeckman. En este artículo, analizaremos cómo fue concebido y los motivos que llevaron a Descartes a cuestionar alguno de los aspectos fundamentales de la física matemática de Beeckman. Este episodio está íntimamente relacionado con la independencia de las disciplinas matemáticas y su aplicación a cuestiones propias de la filosofía natural.

  17. CRECIMIENTO DE PLANTAS DE TOMATE (Lycopersicon esculentum Mill) EN UN SUELO ROJO COMPACTADO TRATADO CON LODO DE DEPURADORA

    OpenAIRE

    E. Utria; Inés Reynaldo; Cabrera, A; Ada Morúa

    2004-01-01

    Con el objetivo de evaluar y comparar la respuesta de algunos componentes del crecimiento en plantas de tomate, en un suelo Ferralítico Rojo compactado tratado con varias dosis de lodo de depuradora, se realizó el presente trabajo en el Instituto Nacional de Ciencias Agrícolas. Se hizo un experimento que se repitió por dos años, en los cuales los resultados mostraron un incremento de la altura de la planta, diámetro del tallo, superficie foliar, masa seca de la parte aérea y radical de las pl...

  18. FEOCROMOCITOMA MALIGNO: COMUNICACIÓN DE 2 CASOS TRATADOS CON CIRUGÍA DE MÍNIMA INVASIÓN

    OpenAIRE

    Castillo C,Octavio A; Riera A,Pablo; Rodríguez J,Yáder; Alemán F,Enrique; Aranguren G,Gabriel; López-Vallejo C,Jorge

    2014-01-01

    Introducción: El Feocromocitoma es un tumor de células cromafines productor de catecolaminas. Su variedad maligna es muy poco frecuente. Objetivo: Describir 2 casos de Feocromocitoma maligno tratados con cirugía mínimamente invasiva. Casos clínicos: Presentamos 2 pacientes de sexo femenino, de 31 y 51 años respectivamente. La primera con historia de hipertensión arterial de larga data y uso de múltiples fármacos. La segunda paciente debuta con dolor abdominal. En ambos casos los estudios radi...

  19. Determinantes del aumento de peso en pacientes tratados con antipsicóticos: estudio de casos y controles

    OpenAIRE

    Martín Novoa, Silvia

    2015-01-01

    Cuando se pauta un tratamiento con fármacos antipsicóticos, sobre todo los de segunda generación, hay que tener en cuenta su efecto sobre el metabolismo, ya que una de las consecuencias más destacadas es la ganancia de peso. El presente estudio busca conocer los determinantes del aumento de peso en pacientes tratados con antipsicóticos. Se ha utilizado un diseño de casos y controles, disponiendo de una muestra de 158 sujetos, donde 53 componían los casos y 105 los controles. Se consideraron v...

  20. Selguimiento del peso corporal en pacientes tratados con antipsicóticos: revisión bibliográfica

    OpenAIRE

    2015-01-01

    El tratamiento con antipsicóticos es uno de los principales factores de riesgo que más contribuye a la ganancia de peso en personas con enfermedades mentales graves. Los efectos negativos derivados del sobrepeso y la obesidad, sumados a los propios de la enfermedad, tienen como consecuencia una menor calidad y esperanza de vida en estos pacientes. El objetivo principal de este estudio es realizar una revisión bibliográfica del seguimiento de peso en pacientes tratados con antipsicóticos. ...

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

    Directory of Open Access Journals (Sweden)

    Guillermo Bruna Contreras

    2003-01-01

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

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

    OpenAIRE

    Raphael Carvalho de Vasconcelos

    2015-01-01

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

  3. Inserción de Colombia en el mercado de China, hacia un tratado de libre comercio Colombia – China.

    OpenAIRE

    Mateus Reina, Luisa Fernanda; Rojas Rubiano, Jeimy Vanesa

    2015-01-01

    El presente trabajo busca evaluar las oportunidades y amenazas que se pueden generar a causa de la creación de un Tratado de Libre Comercio con China, identificando así el impacto que tendrían dichas alianzas sobre el desarrollo económico del país y sobre la competitividad en la región. A partir del análisis de las relaciones comerciales y particularidades de las dos economías, se tendrá en cuenta variables como la reducción del crecimiento económico de China que ha venido experimenta...

  4. Tránsito del Derecho Penal Internacional desde el Tratado de Versalles y de Nuremberg hasta Roma

    OpenAIRE

    Castaño, Deissy Motta

    2012-01-01

    El marco del presente artículo se sustenta en la trascendencia del análisis de las instituciones internacionales en relación con los delitos contemplados como crímenes de guerra en conflagraciones entre Estados y su intervención en la problemática de la violencia interna. El tránsito del derecho penal internacional desde el Tratado de Versalles y de Nuremberg hasta Roma, constituye una aproximación a una genealogía histórica del derecho internacional, relativo a los crímenes de guerra durante...

  5. SOBRE LA DECLARACIÓN DE INAPLICABILIDAD DE LOS TRATADOS INTERNACIONALES. UN ESTUDIO EN DEFENSA DE SU FUNDAMENTO Y LEGITIMIDAD

    Directory of Open Access Journals (Sweden)

    Manuel Antonio Núñez Poblete

    2010-01-01

    Full Text Available Esta investigación tiene por objeto revisar los fundamentos que explican la legitimidad de la inaplicabilidad de los tratados internacionales bajo la Constitución chilena. La defensa de esta forma de revisión judicial es argumentada desde fundamentos constitucionales, tales como el amplio sentido del concepto de "precepto legal", la necesidad del control y el nuevo significado de la declaración de inaplicabilidad. Finalmente, se examina críticamente la tesis que sostiene la responsabilidad internacional del Estado.

  6. Efectos del Tratado de la Unión Europea en el gasto militar: eficiencia o descapitalización

    OpenAIRE

    Vázquez Ramos, José Alfredo

    1996-01-01

    Este trabajo tiene por objeto determinar el efecto que el Tratado de la Unión Europea (TUE), tanto a través de la Política Exterior y de Seguridad Común (PESC), como de los criterios de convergencia nominal, ha producido sobre el gasto militar español y su eficiencia. El primer paso en este análisis pasa por construir un indicador que permita medir la "calidad" del bien público Defensa y evaluar esta variable en el seno de los compromisos de la Unión. Los resultados obtenidos muestran finalme...

  7. Capacitação de enfermeiros para uso da ultrassonografia na punção intravascular periférica Capacitación de enfermeros en el uso de la ultrasonografía en la punción intravascular periférica Training of nurses in the use of intravascular ultrasound in peripheral puncture

    Directory of Open Access Journals (Sweden)

    Ariane Ferreira Machado Avelar

    2010-06-01

    Full Text Available Este artigo relata a estratégia de capacitação de enfermeiros para uso da ultrassonografia vascular na obtenção do acesso vascular periférico. O programa foi composto por intervenções educacionais teóricas e práticas desenvolvidas em um período de seis meses. As estratégias foram elaboradas e implementadas por dois enfermeiros especialistas em terapia intravascular, um médico especialista em ultrassonografia vascular e um engenheiro biomédico. Oito enfermeiros participaram da capacitação e, ao final, os conhecimentos, as competências e habilidades adquiridas na identificação de artérias, veias, fluxo sanguíneo e posicionamento de cateteres foram avaliados. A estratégia possibilitou que enfermeiros pediatras adquirissem competências capazes de promover intervenções inovadoras na punção intravascular periférica.Este artículo relata la estrategia de capacitación de enfermeros en el uso de la ultrasonografía vascular en la obtención del acceso vascular periférico. El programa estuvo compuesto por intervenciones educacionales teóricas y prácticas desarrolladas en un período de seis meses. Las estrategias fueron elaboradas e implementadas por dos enfermeros especialistas en terapia intravascular, un médico especialista en ultrasonografía vascular y, un ingeniero biomédico. Ocho enfermeros participaron de la capacitación. Al final, los conocimientos, las competencias y habilidades adquiridas en la identificación de arterias, venas, flujo sanguíneo y posición de catéteres, fueron evaluados. La estrategia posibilitó que los enfermeros pediatras adquiriesen competencias capaces de promover intervenciones innovadoras en la punción intravascular periférica.The objective was to explain, to the nurses training, procedures using vascular ultrasound for obtaining peripheral vascular access. The program consisted of theoretical and practical educational interventions developed over a period of six months. The

  8. Determination of regional flow by use of intravascular PET tracers: microvascular theory and experimental validation for pig livers

    DEFF Research Database (Denmark)

    Munk, O L; Bass, L; Feng, H;

    2003-01-01

    Today, the standard approach for the kinetic analysis of dynamic PET studies is compartment models, in which the tracer and its metabolites are confined to a few well-mixed compartments. We examine whether the standard model is suitable for modern PET data or whether theories including more...... physiologic realism can advance the interpretation of dynamic PET data. A more detailed microvascular theory is developed for intravascular tracers in single-capillary and multiple-capillary systems. The microvascular models, which account for concentration gradients in capillaries, are validated and compared......-inlet concentration was calculated as the flow-weighted inlet concentration. Dynamic PET data were analyzed with a traditional single-compartment model and 2 microvascular models. RESULTS: Microvascular models provided a better fit of the tissue activity of an intravascular tracer than did the compartment model...

  9. Deep venous thrombosis and pulmonary embolism caused by an intravascular synovial sarcoma of the common femoral vein.

    Science.gov (United States)

    Schoneveld, J M; Debing, E; Verfaillie, G; Geers, C; Van den Brande, P

    2012-11-01

    Malignant tumors arising in deep veins of the lower extremities are very uncommon. To our best knowledge, this is the seventh case of a primary venous intravascular synovial sarcoma (SS) reported in literature. A 32-year-old woman was admitted with a second episode of deep venous thrombosis of the right lower limb and pulmonary embolism. Physical and radiological examinations showed besides the thrombosis a tumor arising from the right common femoral vein involving the bifurcation of the common femoral artery. At surgery, en block resection of the tumor including the deep femoral vein and arterial bifurcation was done with an arterial reconstruction using a synthetic graft. Histopathological examination revealed an intravascular SS of the common femoral vein. The mainstay of curative therapy is complete surgical resection of all tumor manifestations with negative histological margins.

  10. [2 cases of acute disseminated intravascular coagulation in normal pregnancy and as the first symptom of acute promyelocytic leukemia].

    Science.gov (United States)

    Kardaszewicz, E; Bujak, M; Spychałowicz, W; Siudyka, A; Harbut-Gryłka, A

    Two cases of the acute disseminated intravascular coagulation (DIC) are presented. DIC in the first case was diagnosed in healthy pregnant woman without any obstetric pathology. This patient recovered completely. The acute DIC in another patient preceded the acute promyelocytic leukemia. The patient died despite a control of DIC. DIC therapy included antifibrinolytic agents and additionally corticoids in pregnant patient. Heparin was not administered because of post partum period and foreseen cytostatic therapy in the leukemic patient.

  11. The qualitative assessment of biodegradable coronary stents with the use of intravascular ultrasound, optical coherence tomography and histology

    OpenAIRE

    Burcu GÜL

    2014-01-01

    Percutaneous coronary intervention (PCI) is the most common treatment for coronary artery disease (CAD). The first form of PCI introduced was balloon angioplasty. After that, the advent of coronary stents (tubular wire mesh for intravascular mechanical support) led to a new era in interventional cardiology. Through the implantation of bare metal stents (BMS), all three limitations of balloon angioplasty – coronary artery dissection, elastic recoil and negative remodelling – are prevented. Unf...

  12. 弥散性血管内凝血诊断指南%Guideline for diagnosis of disseminated intravascular coagulation

    Institute of Scientific and Technical Information of China (English)

    英国血液学标准化委员会

    2010-01-01

    @@ 弥散性血管内凝血(disseminated intravascular coagulation,DIC)的诊断应包括临床和实验室资料(C级,水平Ⅳ).国际血栓与止血委员会(ISTH)的DIC评分系统提供了客观的DIC诊断与治疗标准,该评分系统与临床和预后有关(C级,水平Ⅳ).

  13. Viral infection and disseminated intravascular coagulation%病毒感染与弥散性血管内凝血

    Institute of Scientific and Technical Information of China (English)

    张素芬; 赵昕

    2002-01-01

    @@ 弥散性血管内凝血(disseminated intravascular coagulation,DIC)是一种发生在许多严重疾病基础上或某些特殊条件下由致病因素激活人体凝血系统,导致微循环弥散性微血栓形成及继发性纤溶亢进的血栓-出血综合征.

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

    Directory of Open Access Journals (Sweden)

    N. Zabalegui

    2009-04-01

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

  15. Intravascular clearance of disseminating Cryptococcus neoformans in the brain can be improved by enhancing neutrophil recruitment in mice.

    Science.gov (United States)

    Sun, Donglei; Zhang, Mingshun; Liu, Gongguan; Wu, Hui; Li, Chang; Zhou, Hong; Zhang, Xiquan; Shi, Meiqing

    2016-07-01

    Extrapulmonary dissemination of Cryptococcus neoformans (C. neoformans) is one of the most critical steps in the development of meningoencephalitis. Here, we report that clearance of the disseminating C. neoformans occurs within the brain microvasculature. Interestingly, the efficiency of the intravascular clearance in the brain is reduced compared to that in the lung. Intravascular clearance is mainly mediated by neutrophils, and complement C5a receptor signaling is crucial for mediating neutrophil recruitment in the vasculature. C. neoformans stimulated actin polymerization of neutrophils is critically involved in their recruitment to the lung, which is associated with the unique vascular structure detected in the lung. The relatively lower efficiency of fungal clearance in the brain vasculature correlates with less efficient recruitment of neutrophils. Accordingly, intravascular clearance of C. neoformans in the brain could be remarkably improved by increasing the recruitment of neutrophils. We conclude that neutrophils have the ability to eliminate C. neoformans arrested in the vasculature. However, insufficient recruitment of neutrophils limited the optimal clearance of this microorganism in the brain. These results imply that a therapeutic strategy aimed at enhancing the accumulation of neutrophils could help prevent cryptococcal meningoencephalitis.

  16. Efficacy of alfaxalone for intravascular anesthesia and euthanasia in blue crabs (Callinectes sapidus).

    Science.gov (United States)

    Minter, Larry J; Harms, Craig A; Archibald, Kate E; Broadhurst, Heather; Bailey, Kate M; Christiansen, Emily F; Lewbart, Gregory A; Posner, Lysa P

    2013-09-01

    The objective of this study was to characterize the behavioral effects and changes in heart rate of four doses of alfaxalone delivered by intravascular injection to blue crabs (Callinectes sapidus). Thirty (male, n = 27; female, n = 3) blue crabs were randomly assigned to one of four treatment groups of alfaxalone: eight animals were assigned to each of the 5-, 10-, and 15-mg/kg treatment groups, and the remaining six animals were assigned to the 100-mg/kg group. Times for anesthetic induction and recovery periods were recorded. Righting reflex, defensive posturing, and heart rate were evaluated before, during, and after the anesthetic trial. Anesthesia was induced in all 14 animals consolidated into the high-dosage group (15 mg/kg [n = 8] and 100 mg/kg [n = 6]), which was significantly greater than 8 of 16 animals in the low-dosage group (5 mg/kg [n = 2] and 10 mg/kg [n = 6]). Median anesthesia induction time for all crabs was 0.4 min, with no significant difference in induction time between groups observed. Median recovery time was 9.4 min (n = 2), 6.1 min (n = 5), 11.3 min (n = 8), and 66.1 min (n = 5) for the 5-, 10-, 15-, and 100-mg/kg groups, respectively. Recovery times were significantly longer for crabs exposed to an induction dose of 100 mg/kg compared with the 10- and 15-mg/kg induction doses. A significant decrease in the median heart rate was observed between the baseline value and that observed at both induction and 5 min postinjection in the 100-mg/kg dose trial. Two mortalities were observed during the anesthesia trials (n = 1, 10 mg/kg; n = 1, 100 mg/kg), both associated with the autotomization of limbs. In summary, the intravascular administration of alfaxalone at 15 mg/kg provided rapid and reliable sedation, whereas alfaxalone administered at 100 mg/kg produced rapid and long lasting anesthesia.

  17. Análise quantitativa dos tecidos gengivais de ratos tratados com fenitoína e ciclosporina

    Directory of Open Access Journals (Sweden)

    SPOLIDORIO Luís Carlos

    2000-01-01

    Full Text Available Os aumentos gengivais podem ser decorrentes de reações teciduais a estímulos idiopáticos, patológicos e farmacológicos. O objetivo desse trabalho foi avaliar morfometricamente e estereologicamente a ação da fenitoína (Fen e ciclosporina (CsA sobre os tecidos gengivais de ratos. Dez ratos receberam, por via intraperitonial, Fen na dose inicial de 2 mg/kg de peso corporal/dia, aumentando 2 mg a cada duas semanas, durante 60 dias. Em outros 10 ratos, administraram-se, por via subcutânea, 10mg/kg de peso corporal/dia de CsA, durante o mesmo período do grupo anterior. Os valores morfométricos e estereométricos dos tecidos gengivais dos ratos tratados com CsA foram significativamente maiores quando comparado com os valores dos tecidos gengivais do grupo tratado com Fen. Esses resultados sugerem que a CsA na dose utilizada é mais eficaz no desenvolvimento do aumento gengival em ratos, podendo estar atuando na proliferação de fibroblastos e no desequilíbrio fisiológico da síntese de fibras colágenas.

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

    Directory of Open Access Journals (Sweden)

    L. M. Asenjo

    2007-07-01

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

  19. Análisis comparativo de morbilidad en grandes quemados tratados con sesiones de autoinjertos frente a cultivo de queratinocitos

    Directory of Open Access Journals (Sweden)

    M. Rubio-Yanchuck

    2015-09-01

    Full Text Available La cobertura rápida y eficaz de las lesiones es un factor limitante en el tratamiento de grandes quemados. Los autoinjertos siguen siendo el tratamiento de elección pero no están exentos de riesgos. El uso de sustitutos de piel cultivada (SPC puede llegar a reducir la morbilidad implícita en el uso de autoinjertos. El objetivo de este estudio es realizar un análisis comparativo de la morbilidad asociada al uso de queratinocitos y autoinjertos en pacientes tratados inicialmente con aloinjertos como cobertura temporal. Realizamos un análisis retrospectivo de morbilidad en 21 pacientes con una superficie corporal quemada (SCQ mayor o igual al 40% en el Hospital Universitario La Paz, Madrid (España entre 2011y 2015. Fueron divididos en 2 grupos según la cobertura definitiva utilizada: un primer grupo con sesiones de autoinjerto, y un segundo grupo con cultivos de queratinocitos y áreas menores de autoinjertos. Fueron 5 mujeres y 16 varones con media de edad de 40,38 años, SCQ del 60,43% y SCQ dérmico profunda-subdérmica del 59,05%. La media de cirugías necesarias en pacientes tratados con autoinjertos y SPC fue 5,36 y 6,7 respectivamente. La incidencia de sepsis fue 80 frente a 50%; el fracaso renal agudo del 63,6 frente al 50%; y de neumonía del 27.3 frente al 40%. Entre los pacientes que sobrevivieron la estancia media en Unidad de Cuidados Intensivos fue de 66,16 frente a 50,6 días, la estancia media hospitalaria fue de 75,6 frente a 63,3 días y la media del número de trasfusiones fue de 75,6 frente a 63.3. La complicación del lecho quirúrgico en el grupo de autoinjertos fue del 63% frente al 0% en los tratados con queratinocitos, y las necesidades medias de noradrenalina fueron de 0,1 frente a 0,03 µg/kg/min. Los pacientes con lecho quirúrgico complicado tuvieron unos requerimientos medios de noradrenalina de 0,117 frente a 0,044 en pacientes con lecho quirúrgico no complicado. Como conclusión, los pacientes tratados con

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

    Directory of Open Access Journals (Sweden)

    Michelle M. Barcelos

    2009-01-01

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

  1. La elaboración, interpretación y aplicación de los tratados internacionales en el Derecho Español

    OpenAIRE

    Olivares Lerma, José María

    2014-01-01

    Treball Final de Grau en Dret. Codi: DR1052. Curs: 2013/2014 En este trabajo se tratará el tema de la elaboración, interpretación y aplicación de los tratados internacionales en el Derecho Español, tanto en la actualidad, como en el futuro, con la reforma que se va a producir. Se tratarán aspectos relacionados con la formación de los tratados internacionales, como se aplican estos tratados y su interpretación. Además, se hará un análisis crítico del nuevo Proyecto de Ley de ...

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

    Science.gov (United States)

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

    2016-02-01

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

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

    Science.gov (United States)

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

    2014-07-01

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

  4. 80-MHz intravascular ultrasound transducer using PMN-PT free-standing film.

    Science.gov (United States)

    Li, Xiang; Wu, Wei; Chung, Youngsoo; Shih, Wan Y; Shih, Wei-Heng; Zhou, Qifa; Shung, K Kirk

    2011-11-01

    [Pb(Mg(1/3)Nb(2/3))O(3)](0.63)[PbTiO(3)](0.37) (PMN-PT) free-standing film of comparable piezoelectric properties to bulk material with thickness of 30 μm has been fabricated using a modified precursor coating approach. At 1 kHz, the dielectric permittivity and loss were 4364 and 0.033, respectively. The remnant polarization and coercive field were 28 μC/cm(2) and 18.43 kV/cm. The electromechanical coupling coefficient k(t) was measured to be 0.55, which was close to that of bulk PMN-PT single-crystal material. Based on this film, high-frequency (82 MHz) miniature ultrasonic transducers were fabricated with 65% bandwidth and 23 dB insertion loss. Axial and lateral resolutions were determined to be as high as 35 and 176 μm. In vitro intravascular imaging on healthy rabbit aorta was performed using the thin film transducers. In comparison with a 35-MHz IVUS transducer, the 80-MHz transducer showed superior resolution and contrast with satisfactory penetration depth. The imaging results suggest that PMN-PT free-standing thin film technology is a feasible and efficient way to fabricate very-high-frequency ultrasonic transducers.

  5. Angled-focused 45 MHz PMN-PT single element transducer for intravascular ultrasound imaging.

    Science.gov (United States)

    Yoon, Sangpil; Williams, Jay; Kang, Bong Jin; Yoon, Changhan; Cabrera-Munoz, Nestor; Jeong, Jong Seob; Lee, Sang Goo; Shung, K Kirk; Kim, Hyung Ham

    2015-06-01

    A transducer with an angled and focused aperture for intravascular ultrasound imaging has been developed. The acoustic stack for the angled-focused transducer was made of PMN-PT single crystal with one matching layer, one protective coating layer, and a highly damped backing layer. It was then press-focused to a desired focal length and inserted into a thin needle housing with an angled tip. A transducer with an angled and unfocused aperture was also made, following the same fabrication procedure, to compare the performance of the two transducers. The focused and unfocused transducers were tested to measure their center frequencies, bandwidths, and spatial resolutions. Lateral resolution of the angled-focused transducer (AFT) improved more than two times compared to that of the angled-unfocused transducer (AUT). A tissue-mimicking phantom in water and a rabbit aorta tissue sample in rabbit blood were scanned using AFT and AUT. Imaging with AFT offered improved contrast, over imaging with AUT, of the tissue-mimicking phantom and the rabbit aorta tissue sample by 23 dB and 8 dB, respectively. The results show that AFT has strong potential to provide morphological and pathological information of coronary arteries with high resolution and high contrast.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-01-15

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

  7. Intravascular optical coherence tomography to characterize tissue deformation during angioplasty: preliminary experiments with artery phantoms

    Science.gov (United States)

    Azarnoush, Hamed; Vergnole, Sébastien; Pazos, Valérie; Bisaillon, Charles-Étienne; Boulet, Benoit; Lamouche, Guy

    2012-09-01

    We explored the potential of intravascular optical coherence tomography (IVOCT) to assess deformation during angioplasty balloon inflation. Using a semi-compliant balloon and artery phantoms, we considered two experimental scenarios. The goal for the first scenario was to investigate if variation in the elasticity of the structure surrounding the balloon could be sensed by IVOCT monitoring. In this scenario, we used three single-layer phantoms with various mechanical properties. Image analysis was performed to extract the inner and outer diameters of the phantoms at various pressures. The goal for the second scenario was twofold. First, we investigated the IVOCT capability to monitor a more complex balloon inflation process. The balloon was in a folded state prior to inflation. This allowed studying two stages of deformation: during balloon unfolding and during balloon expansion. Second, we investigated IVOCT capability to monitor the deformation in a three-layer phantom used to better mimic a true artery. So, not only were the IVOCT images processed to provide the inner and outer diameters of the phantom, but the layer thicknesses were also determined. In both scenarios, IVOCT monitoring revealed to be very efficient in providing relevant information about the phantom deformation during balloon inflation.

  8. [A Case of Intravascular Lymphoma Mimicking Acute Sinusitis in Which the Outcome was Unfortunate].

    Science.gov (United States)

    Kambara, Rumi; Horii, Arata; Osak, Yasuhiro; Inohara, Hidenori

    2015-06-01

    Intravascular large B-cell lymphomas (IVLBCL) are a rare and aggressive non-Hodgkin Lymphoma characterized by proliferation of malignant lymphoid cells into the small blood vessels of the whole body. Making a diagnosis is very difficult due to the lack of mass formation and lymph node enlargement, resulting in a poor prognosis. We report herein on a case of IVLBCL which was proved by a biopsy of the nasal mucosa during endoscopic sinus surgery. A 77-year-old woman was admitted with complaints of headache, rhinorrhea, and fever. Computed tomography showed a shadow in the ethmoid sinus on both sides but without polyps. We suspected acute sinusitis and started therapy, however, high fever persisted with worsening of the patient's general condition. Pathological analysis of biopsy specimens from the nasal cavity and sinuses revealed proliferation of malignant lymphoid cells into the small blood vessels and the final diagnosis was IVLBCL. Chemotherapy was initially effective for her general condition but she died 13 months after the first visit. It is important to suspect IVLBCL, if there is any deterioration of the patient's general condition and persistence of the disease against treatment. The nasal cavity is recommended as a site of random biopsy because of its rich population of small blood vessels.

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Baityakov V.V.

    2012-03-01

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

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

    Science.gov (United States)

    Zheng, Sun; Bing-Ru, Liu

    2016-08-12

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

  12. Emergent Uterine Arterial Embolization Using N-Butyl Cyanoacrylate in Postpartum Hemorrhage with Disseminated Intravascular Coagulation

    Science.gov (United States)

    Kasai, Michi; Kasai, Junko; Seki, Kazuo; Sekikawa, Zenjiro; Torimoto, Izumi; Takebayashi, Shigeo; Hirahara, Fumiki

    2017-01-01

    Although it is widely accepted that uterine artery embolization (UAE) is an effective therapeutic strategy for postpartum hemorrhage (PPH), no consensus has been reached regarding the efficacy of UAE in patients with PPH with disseminated intravascular coagulation (DIC). This single-center retrospective cohort study included patients treated with UAE using NBCA for PPH between 2010 and 2015. The patients were divided into DIC and non-DIC groups, according to the obstetrical DIC score and the overt DIC diagnostic criteria issued by the International Society of Thrombosis and Haemostasis (ISTH), and their clinical outcomes were compared. There were 28 patients treated with UAE using NBCA. Complete hemostasis was achieved by UAE in 19 of 28 patients. In eight of nine patients with unsuccessful hemostasis, surgical hemostatic interventions were performed after UAE, and hemostasis was achieved in seven patients. UAE using NBCA showed no significant intergroup differences in complete hemostasis according to the presence or absence of DIC based on obstetrical DIC score (70% versus 62.5%, P = 1.000) or ISTH DIC score (54.5% versus 76.5%, P = 0.409). UAE using NBCA may be a useful first-choice treatment for PPH with DIC.

  13. Blood-borne phagocytes internalize urate microaggregates and prevent intravascular NETosis by urate crystals

    Science.gov (United States)

    Pieterse, Elmar; Jeremic, Ivica; Czegley, Christine; Weidner, Daniela; Biermann, Mona H.C.; Veissi, Susan; Maueröder, Christian; Schauer, Christine; Bilyy, Rostyslav; Dumych, Tetiana; Hoffmann, Markus; Munoz, Luis E.; Bengtsson, Anders A.; Schett, Georg; van der Vlag, Johan; Herrmann, Martin

    2016-01-01

    Hyperuricemia is strongly linked to cardiovascular complications including atherosclerosis and thrombosis. In individuals with hyperuricemia, needle-shaped monosodium urate crystals (nsMSU) frequently form within joints or urine, giving rise to gouty arthritis or renal calculi, respectively. These nsMSU are potent instigators of neutrophil extracellular trap (NET) formation. Little is known on the mechanism(s) that prevent nsMSU formation within hyperuricemic blood, which would potentially cause detrimental consequences for the host. Here, we report that complement proteins and fetuins facilitate the continuous clearance by blood-borne phagocytes and resident macrophages of small urate microaggregates (UMA; <1 μm in size) that initially form in hyperuricemic blood. If this clearance fails, UMA exhibit bipolar growth to form typical full-sized nsMSU with a size up to 100 μm. In contrast to UMA, nsMSU stimulated neutrophils to release NETs. Under conditions of flow, nsMSU and NETs formed densely packed DNase I-resistant tophus-like structures with a high obstructive potential, highlighting the importance of an adequate and rapid removal of UMA from the circulation. Under pathological conditions, intravascularly formed nsMSU may hold the key to the incompletely understood association between NET-driven cardiovascular disease and hyperuricemia. PMID:27917897

  14. Sonoclot coagulation analysis: a useful tool to predict mortality in overt disseminated intravascular coagulation.

    Science.gov (United States)

    Wan, Peng; Yu, Min; Qian, Min; Tong, Huasheng; Su, Lei

    2016-01-01

    Disseminated intravascular coagulation (DIC) contributes to high mortality. The study was performed to investigate Sonoclot as a potential predictor of 30-day survival in overt DIC. This cohort included 237 consecutive critically ill patients with overt DIC, admitted to a 15-bed multidisciplinary ICU between July 2010 and July 2013. Hemostasis was analyzed with Sonoclot, including activated clotting time (ACT), clot rate, and platelet function, as well as routine clotting test at admission to the critical care center. Sonoclot variables differed in survivors and nonsurvivors. Mean ACT was prolonged (289.9 ± 200.5 vs. 194.8 ± 126.6 s; P < 0.001) and platelet function (1.2 ± 0.9 vs. 1.6 ± 1.2; P = 0.010) was reduced in nonsurvivors. The clot rate was not different. Cox proportional-hazard model showed that ACT and platelet function correlated independently with survival (P < 0.05). Kaplan-Meier survival curve analysis suggested that patients with one pathological Sonoclot findings have better outcome (P < 0.05). After ACT and platelet function were introduced, the receiver-operating characteristic area under the curve of model achieved 0.876 (P < 0.05), with a specificity of 82.6% and a sensitivity of 80.5% in prediction of 30-day survival by multivariate analyses. Our data suggest that the Sonoclot can predict mortality in critically ill patients with overt DIC.

  15. A novel thromboelastographic score to identify overt disseminated intravascular coagulation resulting in a hypocoagulable state.

    Science.gov (United States)

    Sharma, Prashant; Saxena, Renu

    2010-07-01

    Thromboelastography (TEM) yields a multitude of data that are complicated to analyze. We evaluated its value in identification of global coagulopathy in overt disseminated intravascular coagulation (DIC). We studied 21 patients, each with International Society for Haemostasis and Thrombosis scores of 5 or more (compatible with overt DIC) and less than 5 (suggestive of nonovert DIC), who underwent whole blood nonadditive TEM. A TEM score based on the reaction and kappa times, alpha angle, and maximum amplitude was defined as the total number of TEM parameters deranged in the direction of hypocoagulability. The TEM score at a cutoff of 2 or more achieved sensitivity of 95.2%, specificity of 81.0%, and the highest receiver operating characteristic area under the curve of all parameters of 0.957 for identifying overt DIC. Individual TEM parameters correlated variably with conventional tests. Their combination into a cohesive TEM score possibly better captured the multiple hemostatic derangements occurring in DIC. The TEM score may bring objectivity to the analysis of TEM data.

  16. Poor prognosis of hypocoagulability assessed by thrombin generation assay in disseminated intravascular coagulation.

    Science.gov (United States)

    Lee, Kyunghoon; Kim, Ji-Eun; Kwon, Jihyun; Kim, Inho; Yoon, Sung-Soo; Park, Seonyang; Han, Kyou-Sup; Kim, Hyun Kyung

    2014-04-01

    Overall assessment of the hemostatic system including procoagulant and anticoagulant changes may help assess the clinical status and prognosis of disseminated intravascular coagulation (DIC). The thrombin generation assay provides useful information about the global hemostatic status. Therefore, we measured several parameters of global hemostatic potential by the thrombin generation assay in patients suspected of having DIC. A total of 114 patients with suspected DIC were included. The thrombin generation assay was performed on the calibrated automated thrombogram using tissue factor with or without the addition of thrombomodulin, showing three parameters: lag time, endogenous thrombin potential (ETP), and peak thrombin. Both 1 and 5 pmol/l tissue factor-stimulated ETP and peak thrombin were well correlated with DIC severity. Interestingly, antithrombin level greatly affected ETP, whereas protein C influenced lag time. Prognostic analysis revealed that the area under the curve of peak thrombin stimulated by 1 pmol/l tissue factor was superior to that of D-dimer. Moreover, multivariate Cox analysis showed that the lag time and time to peak with both 1 and 5 pmol/l tissue factor were independent prognostic markers. ETP and peak thrombin well reflect DIC severity. Hypocoagulability manifesting as prolonged lag time and time to peak is expected to be an independent prognostic marker in DIC.

  17. Anticoagulant therapy for sepsis-associated disseminated intravascular coagulation: the view from Japan.

    Science.gov (United States)

    Iba, T; Gando, S; Thachil, J

    2014-07-01

    The current management of disseminated intravascular coagulation (DIC) is based on aggressive treatment of the underlying condition and resuscitation with appropriate blood products. Anticoagulant therapy has appeared and disappeared in the different guidelines and important documents detailing the treatment of DIC. For example, Surviving Sepsis Campaign (SSC) guidelines, the 'global standard' for the management of severe sepsis, had recombinant activated protein C highly recommended in the original version, but this was withdrawn in the latest version due to the lack of evidence. In contrast, recent international guidance released from the International Society on Thrombosis and Haemostasis has introduced the potential efficacy of other agents. In sepsis-related DIC, the basis for anticoagulant therapy comes from the mounting evidence for the anti-inflammatory effects which these agents possess and can prove beneficial in septic situations. Several studies have clearly shown the important cross-talk between coagulation and inflammation in patients with sepsis. More recently, neutrophil extracellular traps and damage-associated molecular patterns (DAMPs), especially histones, have been demonstrated to play a crucial role in the coagulopathy of sepsis. Once again, the natural anticoagulants have an important function in neutralizing the effects of DAMPs and histones. In this review, in addition to examining the important role of anticoagulants in the septic milieu, the clinical studies examining antithrombin, recombinant thrombomodulin and plasma-derived activated protein C are detailed. However, large-scale randomized controlled trials are yet to be performed, with important consideration of the timing, dosage and duration of treatment.

  18. Global fibrinolytic capacity in pediatric patients with sepsis and disseminated intravascular coagulation.

    Science.gov (United States)

    Bay, Ali; Oner, Ahmet Faik; Kose, Dogan; Dogan, Murat

    2006-10-01

    There are many complex pathophysiologic changes of the coagulation system in sepsis. The fibrinolytic system was evaluated in septic children using the global fibrinolytic capacity (GFC), a new technique reflecting the overall fibrinolytic activity. The study consisted of 24 children with sepsis, 36 children with sepsis plus disseminated intravascular coagulation (DIC), and 20 healthy age-matched control individuals. Compared with controls, 86% of sepsis patients and 87% of sepsis plus DIC patients had decreased GFC levels. Between the sepsis plus DIC and sepsis groups there was no significant difference in terms of GFC levels. While 19 patients (52.7%) died in the sepsis plus DIC group, only three patients (12.5%) died in the sepsis group. When survivors and nonsurvivors were compared in terms of coagulation tests, there were significant differences for protein C, antithrombin, platelet, fibrinogen, aspartate aminotransferase, alanine aminotransferase, prothrombin time, and white blood cell values. In conclusion, the level of GFC reduced in most of the pediatric sepsis patients but no difference was observed between patients with sepsis and patients with sepsis plus DIC. While inhibition of fibrinolysis is an important finding in sepsis, the mortality is mainly associated with the presence of end-organ damage and the status of coagulation parameters.

  19. Low ADAMTS-13 activity during hemorrhagic events with disseminated intravascular coagulation.

    Science.gov (United States)

    Chinen, Yoshiaki; Kuroda, Junya; Ohshiro, Muneo; Shimura, Yuji; Mizutani, Shinsuke; Nagoshi, Hisao; Sasaki, Nana; Nakayama, Ryuko; Kiyota, Miki; Yamamoto-Sugitani, Mio; Kobayashi, Tsutomu; Matsumoto, Yosuke; Horiike, Shigeo; Taniwaki, Masafumi

    2013-04-01

    Disseminated intravascular coagulation (DIC) is a life-threatening complication, and its control is essential for therapeutic success. Recombinant human soluble thrombomodulin alfa (rTM) is a novel therapeutic agent for DIC. The efficacy of rTM in the treatment of DIC is reportedly superior to that of conventional anti-DIC treatments, such as unfractionated heparin or low molecular weight heparin, but hemorrhagic events occasionally interfere with the therapeutic benefits of rTM. We assessed the clinical features of 20 consecutive patients who were given rTM for DIC associated with various hematologic disorders. Eight patients achieved remission of both primary disease and DIC, eight died due to progression of the primary disease, and four died of various hemorrhagic complications. Assessment of 16 biomarkers for coagulation showed that the four patients who died of hemorrhagic complications despite remission of their primary disease showed lower ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin Type 1 motif, member 13) plasma activity than other patients (P = 0.016). The optimal cut-off level of ADAMTS-13 for predicting risk of hemorrhagic complications was 42 % (P = 0.007). Plasma ADAMTS-13 activity determined at diagnosis of DIC may help predict the risk of hemorrhagic events during and/or following DIC treatment with hematologic disorders.

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

    Science.gov (United States)

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

    2016-11-01

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

  1. High Frequency of Bone Marrow Involvement in Intravascular Large B-Cell Lymphoma.

    Science.gov (United States)

    Wang, Jianchao; Ding, Wenshuang; Gao, Limin; Yao, Wenqing; Chen, Min; Zhao, Sha; Liu, Weiping; Zhang, Wenyan

    2017-04-01

    Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of diffuse large B-cell lymphoma. Thirteen cases of IVLBCL with a median age of 56 years were analyzed retrospectively. Nonspecific symptoms such as fever and hepatosplenomegaly were the most common manifestations, and the bone marrow was usually involved in 8/13 (61.5%) cases. All tumors expressed CD20, and 12/13 (92.3%) of the tumors exhibited a nongerminal center phenotype by Hans algorithm. CD5 was expressed in 3/12 (25%) of the tumors. MYC was negative in all cases, and BCL2 was positive in 10/12 (83.3%) cases. Cytogenetic analysis revealed 5 cases that did not have rearrangements in either the MYC or the BCL2 gene. No association with Epstein-Barr virus was found. Seven of 11 patients received chemotherapy. The median survival time was 6 months. Patients with hemophagocytic syndrome had poor prognoses. Our study demonstrates that IVLBCL has a poor clinical outcome with a high frequency of bone marrow involvement and that the MYC gene may not play an important role in the poor prognosis of IVLBCL.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

    Objective To evaluate the potential value of intravascular ultrasound (IVUS) imaging in the diagnosis of aortic intramural hematoma (AIH). Methods From September 2002 to May 2005, a consecutive series of 15 patients with suspected aortic dissection (AD) underwent both IVUS imaging and spiral computed tomography (CT). Six patients diagnosed as acute type B AIH by CT or IVUS composed the present study group. Results The study group consisted of five males and one female with mean age of 66 years old. All of them had chest or back pain. In one patient, CT omitted a localized AIH and an associated penetrating atherosclerotic ulcer (PAU), which were detected by IVUS. In another patient, CT mistaken a partly thrombosed false lumen as an AIH, whereas IVUS detected a subtle intimal tear and slow moving blood in the false lumen. In the four rest patients, both CT and IVUS made the diagnosis of AIH, however, IVUS detected three PAUs in three of them, only one of them was also detected by CT, and two of them escaped initial CT and were confirmed by follow up CT or magnetic resonance imaging. Conclusions IVUS imaging is a safe examination and has high accuracy in the diagnosis of AIH, particularly for diagnosing localized AIH, distinguishing AIH with thrombosed classic AD and detecting accompanied small PAUs. PMID:22783309

  4. Treatment Effects of Xuebijing Injection in Severe Septic Patients with Disseminated Intravascular Coagulation

    Directory of Open Access Journals (Sweden)

    Qin Yin

    2014-01-01

    Full Text Available The treatment effects of Xuebijing (XBJ injection in severe septic patients with disseminated intravascular coagulation (DIC were investigated in this study. 171 severe septic patients with DIC were divided into the control group (n=83 or intervention group (n=88. Routine therapies were administered in both groups, and XBJ injection was administered additionally in the intervention group. Incidence of DIC, clinical severity scores, and coagulation parameters at 7 days after administration of XBJ injection were compared between the two groups, and short-term prognosis was evaluated by 28-day mortality. Compared with the control group, incidence of DIC in the intervention group was significantly lower at 7 days after administration of XBJ injection (P<0.001. In addition, differences of platelet count and prothrombin time were significantly greater in the intervention group than in the control group (P all <0.05, and similar results were also found for differences of the Mortality in Emergency Department Sepsis score and Acute Physiology and Chronic Health Evaluation II score (P all <0.05. Furthermore, 28-day mortality was significantly lower in the intervention group (P=0.034. These results demonstrate that XBJ injection can effectively treat DIC caused by severe sepsis and improve short-term prognosis of severe septic patients with DIC.

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

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    An, Eun Jung; Kim, Young Hwan; Kwon, Bo Ra; Kim, See Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-12-15

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

  6. Alveolar rhabdomyosarcoma with massive disseminated intravascular coagulopathy treated with systemic chemotherapy.

    Science.gov (United States)

    Yoon, Byung Gyu; Baek, Hee Jo; Oh, Burm Seok; Han, Dong Kyun; Choi, Yoo Duk; Kook, Hoon

    2015-12-01

    It is uncommon for pediatric patients with rhabdomyosarcoma to present with clinical and/or laboratory features of disseminated intravascular coagulation (DIC). We report a case of metastatic alveolar rhabdomyosarcoma with severe bleeding because of DIC in a 13-year-old boy. He experienced persistent oozing at the site of a previous operation, gross hematuria, and massive epistaxis. Two weeks after initiating combination chemotherapy consisting of vincristine, doxorubicin, and cyclophosphamide, the patients' laboratory indications of DIC began to resolve. During this period, the patient received massive blood transfusion of a total of 311 units (26 units of red blood cells, 26 units of fresh frozen plasma, 74 units of platelet concentrates, 17 units of single donor platelets, and 168 units of cryoprecipitate), antithrombin-III and a synthetic protease inhibitor. Despite chemotherapy and radiation therapy, he died 1 year later because of disease progression. In children with metastatic rhabdomyosarcoma and massive DIC, prompt chemotherapy and aggressive supportive care is important to decrease malignancy-triggered procoagulant activities.

  7. Oral Intravascular Papillary Endothelial Hyperplasia Associated with an Organizing Thrombus: Case Report and Immunohistochemical Analysis

    Science.gov (United States)

    Fernandes, Darcy; Travassos, Daphine Caxias; Ferrisse, Túlio Morandin; Massucato, Elaine Maria Sgavioli; Navarro, Cláudia Maria; Onofre, Mirian Aparecida; León, Jorge Esquiche

    2016-01-01

    Intravascular papillary endothelial hyperplasia (IPEH) is a benign lesion of the skin and mucosa of vascular origin characterized by reactive proliferation of endothelial cells. A 76-year-old woman was referred presenting a painless nodule on the lip. Intraoral examination revealed bluish submucosal nodular proliferation, measuring 10 × 5 × 5 mm, affecting the lower labial mucosa. The lesion had a firm consistency and it was not fixed to the adjacent tissues. The main differential diagnoses were mucocele/mucus retention cyst, sialolith, or salivary gland neoplasia. An incisional biopsy was performed and during the intraoperative procedure an encapsulated red-bluish nodular mass was observed. Microscopic analysis revealed papillary endothelial proliferation in the center of the lesion and fibrin admixed with inflammatory cells in organization peripherally. There was no nuclear atypia, mitotic figures, or necrosis. The endothelial cells were CD34 positive, with low Ki-67 proliferation index (4%). α-SMA highlighted the vessel walls, whereas negativity for D2-40 excluded lymphatic origin. Final diagnosis was IPEH associated with an organizing thrombus. Dentists should be aware about this rare benign vascular lesion, whose final diagnosis is achieved only after histopathology analysis. Surgical removal is the treatment of choice and no recurrence is expected. PMID:28053797

  8. 6,7-Dihydroxy-3-phenylcoumarin inhibits thromboplastin induced disseminated intravascular coagulation.

    Science.gov (United States)

    Tunali, Tugba; Yarat, Aysen; Bulut, Mustafa; Emekli, Nesrin

    2004-07-01

    6,7-Dihydroxy-3-phenylcoumarin (DHPC) was tested to determine whether it had any effect on vitamin K inhibition, by investigating the prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen level and platelet count. The anticoagulant and antithrombotic effects of DHPC were compared with those of warfarin by conducting a 4 h acute trial on thromboplastin-induced disseminated intravascular coagulation (DIC), investigating various haemostatic and antioxidant system parameters and performing a haemogram. Of most significance was that in the 5-d DHPC trial on healthy controls, PT, APTT, fibrinogen, platelet count remained within normal levels. In the 4-h DIC trial, both DHPC (0.025 mg/kg, i.v.) and warfarin (0.25 mg/kg, i.v.) significantly inhibited DIC, by reducing the PT, APTT, and fibrin degradation products and increasing fibrinogen levels and platelet count. In the DIC drug groups, lipid peroxidation significantly increased only in the warfarin group and glutathione significantly increased only in the DHPC group. However leucocyte count was significantly higher in the DHPC than the warfarin group. Further investigation is required for why DHPC is effective on the parameters investigated, at doses one-tenth of those of warfarin.

  9. On-line monitoring of the intravascular volume during haemodialysis by continuous refractometry.

    Science.gov (United States)

    Kuhlmann, U; van Buuren, F; Aziz, O; Lange, H

    1999-01-01

    The control of intravascular volume (IVV) by continuous on-line measurement of protein concentration would optimise the patients' specific rate of ultrafiltration. To prove the accuracy of a refractometric device, plasma was continuously drawn by haemofiltration during 10 haemodialysis treatments of male patients. Refractometry reflects highly significant changes in the concentrations of filtrate proteins (r = 0.862, p < 0.001) and blood proteins (rtotal = 0.593, ptotal < 0.001). In vitro, the refractometric device detected a change of protein concentration of 0.041 g/L through a refraction increase of 0.1 mV. The power of discrimination was 0.067% of IVV However, in vivo, the accuracy of IVV refractometric monitoring is reduced by interference factors such as sodium (0. 141 mV/mmol/L), glucose (0.034 mV/mg/dl) and triglycerides (-0.040 mV/mg/dl). Adjustment of the refraction data using sodium and glucose electrodes and plasma filters with a cut-off below the size of chylomicrons is recommended.

  10. Intravascular Immune Surveillance by CXCR6+ NKT Cells Patrolling Liver Sinusoids

    Directory of Open Access Journals (Sweden)

    Geissmann Frederic

    2005-01-01

    Full Text Available We examined the in vivo behavior of liver natural killer T cells (NKT cells by intravital fluorescence microscopic imaging of mice in which a green fluorescent protein cDNA was used to replace the gene encoding the chemokine receptor CXCR6. NKT cells, which account for most CXCR6+ cells in liver, were found to crawl within hepatic sinusoids at 10-20 µm/min and to stop upon T cell antigen receptor activation. CXCR6-deficient mice exhibited a selective and severe reduction of CD1d-reactive NKT cells in the liver and decreased susceptibility to T-cell-dependent hepatitis. CXCL16, the cell surface ligand for CXCR6, is expressed on sinusoidal endothelial cells, and CXCR6 deficiency resulted in reduced survival, but not in altered speed or pattern of patrolling of NKT cells. Thus, NKT cells patrol liver sinusoids to provide intravascular immune surveillance, and CXCR6 contributes to liver-based immune responses by regulating their abundance.

  11. Intravascular immune surveillance by CXCR6+ NKT cells patrolling liver sinusoids.

    Directory of Open Access Journals (Sweden)

    Frederic Geissmann

    2005-04-01

    Full Text Available We examined the in vivo behavior of liver natural killer T cells (NKT cells by intravital fluorescence microscopic imaging of mice in which a green fluorescent protein cDNA was used to replace the gene encoding the chemokine receptor CXCR6. NKT cells, which account for most CXCR6(+ cells in liver, were found to crawl within hepatic sinusoids at 10-20 microm/min and to stop upon T cell antigen receptor activation. CXCR6-deficient mice exhibited a selective and severe reduction of CD1d-reactive NKT cells in the liver and decreased susceptibility to T-cell-dependent hepatitis. CXCL16, the cell surface ligand for CXCR6, is expressed on sinusoidal endothelial cells, and CXCR6 deficiency resulted in reduced survival, but not in altered speed or pattern of patrolling of NKT cells. Thus, NKT cells patrol liver sinusoids to provide intravascular immune surveillance, and CXCR6 contributes to liver-based immune responses by regulating their abundance.

  12. Coronary atherosclerosis is already ongoing in pre-diabeticstatus: Insight from intravascular imaging modalities

    Institute of Scientific and Technical Information of China (English)

    Osamu Kurihara; Masamichi Takano; Yoshihiko Seino; Wataru Shimizu; Kyoichi Mizuno

    2015-01-01

    Diabetes mellitus is a powerful risk factor of coronaryartery disease (CAD), leading to death and disability.In recent years, given the accumulating evidence thatprediabetes is also related to increasing risk of CADincluding cardiovascular events, a new guideline hasbeen proposed for the treatment of blood cholesterolfor primary prevention of cardiovascular events. Thisguideline recommends aggressive lipid-lowering statintherapy for primary prevention in diabetes and otherpatients. The ultimate goal of patient managementis to inhibit progression of systemic atherosclerosisand prevent fatal cardiovascular events such as acutecoronary syndrome (ACS). Because disruption ofatherosclerotic coronary plaques is a trigger of ACS,the high-risk atheroma is called a vulnerable plaque.Several types of novel diagnostic imaging technologieshave been developed for identifying the characteristicsof coronary atherosclerosis before the onset of ACS,especially vulnerable plaques. According to coronaryangioscopic evaluation, atherosclerosis severity andplaque vulnerability were more advanced in prediabeticthan in nondiabetic patients and comparable to thatin diabetic patients. In addition, pharmacologicalintervention by statin therapy changed plaque color andcomplexity, and the dynamic changes in plaque featuresare considered plaque stabilization. In this article, wereview the findings of atherosclerosis in prediabetes,detected by intravascular imaging modalities, and thetherapeutic implications.

  13. A random walk-based method for segmentation of intravascular ultrasound images

    Science.gov (United States)

    Yan, Jiayong; Liu, Hong; Cui, Yaoyao

    2014-04-01

    Intravascular ultrasound (IVUS) is an important imaging technique that is used to study vascular wall architecture for diagnosis and assessment of the vascular diseases. Segmentation of lumen and media-adventitia boundaries from IVUS images is a basic and necessary step for quantitative assessment of the vascular walls. Due to ultrasound speckles, artifacts and individual differences, automated segmentation of IVUS images represents a challenging task. In this paper, a random walk based method is proposed for fully automated segmentation of IVUS images. Robust and accurate determination of the seed points for different regions is the key to successful use of the random walk algorithm in segmentation of IVUS images and is the focus of our work. The presented method mainly comprises five steps: firstly, the seed points inside the lumen and outside the adventitia are roughly estimated with intensity information, respectively; secondly, the seed points outside the adventitia are refined, and those of the media are determined through the results of applying random walk to the IVUS image with the roughly estimated seed points; thirdly, the media-adventitia boundary is detected by using random walk with the seed points obtained in the second step and the image gradient; fourthly, the seed points for media and lumen are refined; finally, the lumen boundary is extracted by using random walk again with the seed points obtained in the fourth step and the image gradient. The tests of the proposed algorithm on the in vivo dataset demonstrate the effectiveness of the presented IVUS image segmentation approach.

  14. The virtual histology intravascular ultrasound appearance of newly placed drug-eluting stents.

    Science.gov (United States)

    Kim, Sang-Wook; Mintz, Gary S; Hong, Young-Joon; Pakala, Rajbabu; Park, Kyung-Sook; Pichard, Augusto D; Satler, Lowell F; Kent, Kenneth M; Suddath, William O; Waksman, Ron; Weissman, Neil J

    2008-11-01

    Intravascular ultrasound (IVUS) is used before and after intervention and at follow-up to assess the quality of the acute result as well as the long-term effects of stent implantation. Virtual histology (VH) IVUS classifies tissue into fibrous and fibrofatty plaque, dense calcium, and necrotic core. Although most interventional procedures include stent implantation, VH IVUS classification of stent metal has not been validated. In this study, the VH IVUS appearance of acutely implanted stents was assessed in 27 patients (30 lesions). Most stent struts (80%) appeared white (misclassified as "calcium") surrounded by red (misclassified as "necrotic core"); 2% appeared just white, and 17% were not detectable (compared with grayscale IVUS because of the software-imposed gray medial stripe). The rate of "white surrounded by red" was similar over the lengths of the stents; however, undetectable struts were mostly at the distal edges (31%). Quantitatively, including the struts within the regions of interest increased the amount of "calcium" from 0.23 +/- 0.35 to 1.07 +/- 0.66 mm(2) (p stents have an appearance that can be misclassified by VH IVUS as "calcium with or without necrotic core." It is important not to overinterpret VH IVUS studies of chronically implanted stents when this appearance is observed at follow-up. A separate classification for stent struts is necessary to avoid these misconceptions and misclassifications.

  15. Hyperkalemia after irradiation of packed red blood cells: Possible effects with intravascular fetal transfusion

    Energy Technology Data Exchange (ETDEWEB)

    Thorp, J.A.; Plapp, F.V.; Cohen, G.R.; Yeast, J.D.; O' Kell, R.T.; Stephenson, S. (St. Luke' s Perinatal Center, Kansas City, MO (USA))

    1990-08-01

    Plasma potassium, calcium, and albumin concentrations in irradiated blood, and in fetal blood before and after transfusion, were measured. Dangerously high plasma potassium levels were observed in some units of irradiated packed red blood cells (range, 13.9 to 66.5 mEq/L; mean, 44.7 mEq/L) and could be one possible explanation for the high incidence of fetal arrhythmia associated with fetal intravascular transfusion. There are many factors operative in the preparation of irradiated packed red blood cells that may predispose to high potassium levels: the age of the red blood cells, the number of procedures used to concentrate the blood, the duration of time elapsed from concentration, the duration of time elapsed from irradiation, and the hematocrit. Use of fresh blood, avoidance of multiple packing procedures, limiting the hematocrit in the donor unit to less than or equal to 80%, and minimizing the time between concentration, irradiation and transfusion may minimize the potassium levels, and therefore making an additional washing procedure unnecessary.

  16. Ex vivo detection of macrophages in atherosclerotic plaques using intravascular ultrasonic-photoacoustic imaging

    Science.gov (United States)

    Quang Bui, Nhat; Hlaing, Kyu Kyu; Lee, Yong Wook; Kang, Hyun Wook; Oh, Junghwan

    2017-01-01

    Macrophages are excellent imaging targets for detecting atherosclerotic plaques as they are involved in all the developmental stages of atherosclerosis. However, no imaging technique is currently capable of visualizing macrophages inside blood vessel walls. The current study develops an intravascular ultrasonic-photoacoustic (IVUP) imaging system combined with indocyanine green (ICG) as a contrast agent to provide morphological and compositional information about the targeted samples. Both tissue-mimicking vessel phantoms and atherosclerotic plaque-mimicking porcine arterial tissues are used to demonstrate the feasibility of mapping macrophages labeled with ICG by endoscopically applying the proposed hybrid technique. A delay pulse triggering technique is able to sequentially acquire photoacoustic (PA) and ultrasound (US) signals from a single scan without using any external devices. The acquired PA and US signals are used to reconstruct 2D cross-sectional and 3D volumetric images of the entire tissue with the ICG-loaded macrophages injected. Due to high imaging contrast and sensitivity, the IVUP imaging vividly reveals structural information and detects the spatial distribution of the ICG-labeled macrophages inside the samples. ICG-assisted IVUP imaging can be a feasible imaging modality for the endoscopic detection of atherosclerotic plaques.

  17. Effectiveness Evaluation of Skin Covers against Intravascular Brachytherapy Sources Using VARSKIN3 Code

    Directory of Open Access Journals (Sweden)

    Baghani HR

    2013-12-01

    Full Text Available Background and Objective: The most common intravascular brachytherapy sources include 32P, 188Re, 106Rh and 90Sr/90Y. In this research, skin absorbed dose for different covering materials in dealing with these sources were evaluated and the best covering material for skin protection and reduction of absorbed dose by radiation staff was recognized and recommended. Method: Four materials including polyethylene, cotton and two different kinds of plastic were proposed as skin covers and skin absorbed dose at different depths for each kind of the materials was calculated separately using the VARSKIN3 code. Results: The results suggested that for all sources, skin absorbed dose was minimized when using polyethylene. Considering this material as skin cover, maximum and minimum doses at skin surface were related to 90Sr/90Y and 106Rh, respectively. Conclusion: polyethylene was found the most effective cover in reducing skin dose and protecting the skin. Furthermore, proper agreement between the results of VARSKIN3 and other experimental measurements indicated that VRASKIN3 is a powerful tool for skin dose calculations when working with beta emitter sources. Therefore, it can be utilized in dealing with the issue of radiation protection.

  18. The Imaging Modulography Technique Revisited for High-Definition Intravascular Ultrasound: Theoretical Framework.

    Science.gov (United States)

    Tacheau, Antoine; Le Floc'h, Simon; Finet, Gérard; Doyley, Marvin M; Pettigrew, Roderic I; Cloutier, Guy; Ohayon, Jacques

    2016-03-01

    Mechanical characterization of atherosclerotic lesions remains an essential step for the detection of vulnerable plaques (VPs). Recently, an intravascular ultrasound (IVUS) elasticity reconstruction method (iMOD) has been tested in vivo by our group. The major limitation of iMOD is the need to estimate the strain field in the entire VP despite attenuated depth penetration signals when using high-definition (HD) IVUS systems. Therefore, an extended iMOD approach (E-iMOD) was designed and applied to coronary lesions of patients imaged in vivo with IVUS. The E-iMOD method (i) quantified necrotic core areas with a mean absolute relative error of 3.5 ± 3.5% and (ii) identified Young's moduli of the necrotic cores and fibrous regions with mean values of 5.7 ± 0.8 kPa and 794.5 ± 22.0 kPa instead of 5 kPa and 800 kPa, respectively. This study demonstrates the potential of the improved HD-IVUS modulography technique E-iMOD to characterize coronary VPs.

  19. CNS intravascular large cell lymphoma in a patient with autoimmune hemolytic anemia.

    Science.gov (United States)

    Alexandrescu, Sanda; Orengo, James P; Toossi, Shahed; Perry, Arie; Treseler, Patrick; Hess, Christopher; Margeta, Marta

    2015-04-01

    Intravascular large cell lymphoma (IVLCL) is a rare disease characterized by proliferation of malignant lymphocytes within the small blood vessel lumens. The association of IVLCL with autoimmune hemolytic anemia (AIHA) has been described in a single case report, but the true prevalence of this co-occurrence is not known because of declining autopsy rates. Here, we report a case of a 41-year-old woman who carried a diagnosis of AIHA for 2 years, with repeated hemolytic episodes that were initially well controlled with immunomodulatory treatment. At her last presentation, the patient developed rapidly progressive neurologic symptoms and leukoencephalopathy on MRI; she died 4 weeks later with a clinical impression of thrombotic microangiopathy, a known complication of AIHA. At autopsy, the brain showed widespread platelet thrombi and intraparenchymal hemorrhages characteristic of this disorder. In addition, there was evidence of a clinically unsuspected IVLCL, most likely of B-cell lineage. This case illustrates a potential association between IVLCL and AIHA, highlights the need for broad differential diagnosis in cases with atypical disease presentation or progression, and underlines the importance of autopsy in establishing the full cause of morbidity and mortality.

  20. Intravascular optical coherence tomography light scattering artifacts: merry-go-rounding, blooming, and ghost struts

    Science.gov (United States)

    Mancuso, J. Jacob; Halaney, David L.; Elahi, Sahar; Ho, Derek; Wang, Tianyi; Ouyang, Yongjian; Dijkstra, Jouke; Milner, Thomas E.; Feldman, Marc D.

    2014-12-01

    We sought to elucidate the mechanisms underlying two common intravascular optical coherence tomography (IV-OCT) artifacts that occur when imaging metallic stents: "merry-go-rounding" (MGR), which is an increase in strut arc length (SAL), and "blooming," which is an increase in the strut reflection thickness (blooming thickness). Due to uncontrollable variables that occur in vivo, we performed an in vitro assessment of MGR and blooming in stented vessel phantoms. Using Xience V and Driver stents, we examined the effects of catheter offset, intimal strut coverage, and residual blood on SAL and blooming thickness in IV-OCT images. Catheter offset and strut coverage both caused minor MGR, while the greatest MGR effect resulted from light scattering by residual blood in the vessel lumen, with 1% hematocrit (Hct) causing a more than fourfold increase in SAL compared with saline (pResidual blood also resulted in blooming, with blooming thickness more than doubling when imaged in 0.5% Hct compared with saline (presidual blood in the imaging field, is the predominant cause of MGR. Light scattering also results in blooming, and a newly described artifact, three-dimensional-MGR, which results in "ghost struts" in B-scans.

  1. Tratado de Libre Comercio y educación superior. El caso de México, un antecedente para América Latina

    OpenAIRE

    Hugo Aboites Aguilar

    2007-01-01

    En una primera parte, este artículo presenta tres razones por las que para los actores económicos resulta importante y estratégica la inclusión de la educación y el conocimiento en acuerdos como el Tratado de Libre Comercio de América del Norte. Este tipo de tratados 1) elimina obstáculos a las inversiones y el comercio de mercancías en un campo hasta ahora reservado a los estados nacionales en América Latina; 2) redefine la educación de tal manera que pueda ser comercializa...

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

    OpenAIRE

    2013-01-01

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

  3. Adult T-cell leukemia-lymphoma in a patient with HTLV-I/II associated myelopathy Leucemia - linfoma de células T do adulto em um paciente com mielopatia associada a HTLV-I/II

    Directory of Open Access Journals (Sweden)

    Virgínia Freitas

    1997-06-01

    Full Text Available Chronic myelopathy associated with T-lymphotropic virus type I (HAM has been described as an endemic disease in several areas of the world, meanwhile there are few papers describing the association between HAM and adult T cell leukemia-lymphoma. We report the case of a man that, after four years of progressive spastic paraparesis and neurogenic bladder, developed a clinical picture of a lymphoproliferative disorder characterized by dermal and systemic envolvement, mimicking mycosis fungoides/Sézary syndrome.Apesar da infecção pelo HTLV-I ser endêmica em várias regiões do mundo, poucos são os relatos da associação entre leucemia-linfoma de células T do adulto (ATLL e encefalomieloneuropatia pelo HTLV-I. No presente artigo é descrito um paciente que no curso do comprometimento neurológico pelo HTLV-I desenvolveu quadro de leucemia com infiltração de tecido dérmico semelhante ao encontrado na micose fungóide/síndrome de Sézary.

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

    Directory of Open Access Journals (Sweden)

    Z. Casariego

    2006-12-01

    Full Text Available Introducción: Los linfomas No-Hodgkin presentan características propias cuando se asocian a la infección por el Virus de la Inmunodeficiencia Humana. La cavidad bucal es una de las localizaciones a tener en cuenta en pacientes con Sida (LNHORS Si bien se registran casos en los primeros estadios de la infección, el diagnóstico previo diferencial estomatológico y su seguimiento no se realizan en nuestro medio con la frecuencia que esta enfermedad requiere. En los pacientes VIH positivos, las características generales están relacionadas con la edad de los pacientes, el estado de base inmunológico de la infección, la adherencia a los tratamientos, una historia de más de 35 años de drogadicción intravenosa y el tipo de linfoma. El presente trabajo tiene dos objetivos: 1 Presentar una actualización del tema ya que en los últimos años se han investigado los diferentes tipos y subtipos histológicos, su estratificación y tratamientos en forma intensa y 2 presentar un caso clínico de Linfoma no Hodgkin con localización en la cavidad bucal de evolución no frecuente. Desarrollo: Una paciente de 34 años de edad con una masa tumoral en el hueso maxilar mucosa gingival y paladar duro y blando. La lesión estaba ulcerada en la primera consulta y hacía protrusión a través de la cavidad bucal. Resultados: se realizaron estudios sistémicos, biopsias de las lesiones orales,. estudio histológico y marcación inmunohistoquímica,, búsqueda por diagnóstico por imágenes de otras manifestaciones y localizaciones de linfomas. Fueron establecidos tratamientos, seguimiento y evolución. Conclusiones: Un diagnóstico eficiente y temprano de los pacientes con LNHORS por un equipo de salud, puede incrementar las sobrevidas, en un marco, donde pueda ser posible la reconstitución de la función inmunológica y puedan ser aplicados los nuevos regímenes de infusión contínua con quimioterápicos.Introduction: Non-Hodgkin Lymphoma presents their

  5. Primer caso en México y América Latina de linfoma anaplásico de células gigantes en paciente con implantes mamarios

    Directory of Open Access Journals (Sweden)

    Cesar Torres-Rivero

    Full Text Available El Linfoma Anaplásico de Células Gigantes (LACG asociado a implantes mamarios es una patología poco frecuente. Desde el primer caso publicado en la década de los noventa, en los últimos años hemos observado un mayor número de casos recogidos en la literatura. Si bien se tiene información de aproximadamente 90 casos publicados en el mundo, algunos autores mencionan la posibilidad de que existan más de 100 o 200 casos, por lo que su presencia ha suscitado mucha controversia, si bien en general se sigue considerando una patología infrecuente. Hasta donde hemos podido conocer, presentamos el primer caso de LACG documentado por un cirujano plástico en México y América Latina, en una mujer de 43 años de edad portadora de implantes mamarios, con historia de asimetría mamaria unilateral por seroma tardío, y en la que tras 2 punciones sin mejoría de la sintomatología se realizó retirada del implante y capsulectomía, confirmando en líquido periprotésico la presencia del LACG.

  6. Un tratado sobre la extranjería de lo propio (El uruguayo de Copi)

    OpenAIRE

    2006-01-01

    El uruguayo de Copi es un tratado sobre la lengua, una descripción desopilante de un país, un ácido comentario político, una burla impiadosa de los valores culturales, una pesadilla personal, un golpe de teatro donde cualquier versión de la realidad se vuelve precaria y se trastoca al compás de una imaginación afiebrada que no hace más que dar rienda suelta a los materiales del inconsciente. Pero sobre todo, es la visión desnuda de la relación imposible de un escritor con el país que ha dejad...

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

    Directory of Open Access Journals (Sweden)

    Bopaya Bidanda

    2006-11-01

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

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

    OpenAIRE

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

    2001-01-01

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

  9. Un tratado de nobleza de un regidor coruñés de principios del siglo XVII

    Directory of Open Access Journals (Sweden)

    García Hurtado, Manuel Reyes

    2006-12-01

    Full Text Available We present the publication and annotated study of a treatise on nobility written about 1621 by Juan Melio de Sande, an councillor from A Coruña. We emphasise the characteristics common to these kinds of texts and we try to clarify the author’s motives. In his format, argument, and authorities referred to, he could only follow the most reputable specialists on the subject of genealogy at that time.

    Presentamos la publicación y el estudio anotado de un tratado de nobleza redactado hacia 1621 por el regidor de A Coruña Juan Melio de Sande. Hacemos hincapié en las características comunes a este tipo de textos e intentamos dilucidar las motivaciones de su autor. En su formato, argumentación y autoridades empleadas no hace sino seguir a los más reputados especialistas en materia nobiliaria de su tiempo.

  10. Los tratados y la diplomacia en la antigüedad: el derecho internacional como sustento de la conquista romana

    Directory of Open Access Journals (Sweden)

    Galindo Roldán, Juan, M.

    2013-12-01

    Full Text Available El Derecho Internacional, a diferencia de lo que sostuvo la doctrina clásica, no es una invención de la modernidad sino más bien una consecuencia de la civilización. En este sentido, el presente trabajo sostiene que los romanos, desde sus orígenes tempranos, han hecho del Derecho Internacional el modo normal conforme el cual se vinculaban con otros pueblos. Este breve ensayo aborda el estudio de diferentes eventos históricos de los primeros siglos de Roma, para identificar de qué manera los tratados y la diplomacia operaron como herramientas de legitimación de las conquistas romanas.

  11. Protocatechuic aldehyde inhibits migration and proliferation of vascular smooth muscle cells and intravascular thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Chang Yoon [The Hotchkiss School, Lakeville, CT (United States); Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Ku, Cheol Ryong [Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Cho, Yoon Hee, E-mail: wooriminji@gmail.com [Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Eun Jig, E-mail: ejlee423@yuhs.ac [Endocrinology, Brain Korea 21 Project for Medical Science, Institute of Endocrine Research, and Severance Integrative Research Institute for Cerebral and Cardiovascular Disease, Yonsei University College of Medicine, Seoul (Korea, Republic of); Endocrinology, Northwestern University Feinberg School of Medicine, Chicago, IL (United States)

    2012-06-22

    Highlights: Black-Right-Pointing-Pointer Protocatechuic aldehyde (PCA) inhibits ROS production in VSMCs. Black-Right-Pointing-Pointer PCA inhibits proliferation and migration in PDGF-induced VSMCs. Black-Right-Pointing-Pointer PCA has anti-platelet effects in ex vivo rat whole blood. Black-Right-Pointing-Pointer We report the potential therapeutic role of PCA in atherosclerosis. -- Abstract: The migration and proliferation of vascular smooth muscle cells (VSMCs) and formation of intravascular thrombosis play crucial roles in the development of atherosclerotic lesions. This study examined the effects of protocatechuic aldehyde (PCA), a compound isolated from the aqueous extract of the root of Salvia miltiorrhiza, an herb used in traditional Chinese medicine to treat a variety of vascular diseases, on the migration and proliferation of VSMCs and platelets due to platelet-derived growth factor (PDGF). DNA 5-bromo-2 Prime -deoxy-uridine (BrdU) incorporation and wound-healing assays indicated that PCA significantly attenuated PDGF-induced proliferation and migration of VSMCs at a pharmacologically relevant concentration (100 {mu}M). On a molecular level, we observed down-regulation of the phosphatidylinositol 3-kinase (PI3K)/Akt and the mitogen-activated protein kinase (MAPK) pathways, both of which regulate key enzymes associated with migration and proliferation. We also found that PCA induced S-phase arrest of the VSMC cell cycle and suppressed cyclin D2 expression. In addition, PCA inhibited PDGF-BB-stimulated reactive oxygen species production in VSMCs, indicating that PCA's antioxidant properties may contribute to its suppression of PDGF-induced migration and proliferation in VSMCs. Finally, PCA exhibited an anti-thrombotic effect related to its inhibition of platelet aggregation, confirmed with an aggregometer. Together, these findings suggest a potential therapeutic role of PCA in the treatment of atherosclerosis and angioplasty-induced vascular restenosis.

  12. Delineation of atherosclerotic plaque using subharmonic imaging filtering techniques and a commercial intravascular ultrasound system.

    Science.gov (United States)

    Sridharan, Anush; Eisenbrey, John R; Machado, Priscilla; deMuinck, Ebo D; Doyley, Marvin M; Forsberg, Flemming

    2013-01-01

    The ability to delineate atherosclerotic plaque from the surrounding tissue using custom-developed subharmonic imaging (SHI) digital filtering techniques was investigated in vivo using a commercially available system. Atherosclerosis was induced in the aorta of two Watanabe Heritable Hyperlipidemic rabbits following which injections of an ultrasound contrast agent (UCA) Definity (Lantheus Medical Imaging, N Billerica, Massachusetts) were administered. Imaging was performed using a Galaxy intravascular ultrasound (IVUS) scanner (Boston Scientific, Natick, Massachusetts) equipped with an Atlantis® SR Pro Imaging Catheter (Boston Scientific). Four preliminary band-pass filters were designed to isolate the subharmonic signal (from surrounding tissue) and applied to the radio-frequency (RF) data. Preliminary filter performances were compared in terms of vessel-tissue contrast-to-tissue ratio (CTR) and visual examination. Based on preliminary results, a subharmonic adaptive filter and a stopband (SB) filter were designed and applied to the RF data. Images were classified as fundamental, SHI, and SB. Four readers performed qualitative analysis of 168 randomly selected images (across all three imaging modes). The images were scored for overall image quality, image noise, plaque visualization, and vessel lumen visualization. A Wilcoxon signed-rank test was used to compare the scores followed by intraclass correlation (ICC) evaluation. Quantitative analysis was performed by calculating the CTRs for the vessel-to-plaque and vessel-to-tissue (compared using a paired student's t test). Qualitative analysis showed SHI and SB to have significantly less image noise relative to the fundamental mode (p < 0.001). Fundamental mode scored significantly higher than SHI and SB for the remaining three categories. ICC showed mixed results among reader evaluation for delineation of plaque. However, quantitatively, SHI produced the best vessel-plaque CTR.

  13. Angioplasty Guided by Intravascular Ultrasound: Meta-Analysis of Randomized Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Figueiredo, José Albuquerque Neto de, E-mail: jafneto@cardiol.br; Nogueira, Iara Antonia Lustosa [Universidade Federal do Maranhão, São Luiz, MA (Brazil); Figueiro, Mabel Fernandes; Buehler, Anna Maria; Berwanger, Otavio [Instituto de Ensino e Pesquisa do Hospital do Coração, São Paulo, SP (Brazil)

    2013-08-15

    The impact of intravascular ultrasound (IVUS) use on stenting has shown inconclusive results. Systematic review and meta-analysis of the impact of IVUS on stenting regarding the clinical and angiographic evolution. A search was performed in Medline/Pubmed, CENTRAL, Embase, Lilacs, Scopus and Web of Science databases. It included randomized clinical trials (RCTs) that evaluated the implantation of stents guided by IVUS, compared with those using angiography alone (ANGIO). The minimum follow-up duration was six months and the following outcomes were assessed: thrombosis, mortality, myocardial infarction, percutaneous and surgical revascularization, major adverse cardiovascular events (MACE) and restenosis. The binary outcomes were presented considering the number of events in each group; the estimates were generated by a random effects model, considering Mantel-Haenszel statistics as weighting agent and magnitude of effect for the relative risk (RR) with its respective 95% confidence interval (95%CI). Higgins I{sup 2} test was used to quantify the consistency between the results of each study. A total of 2,689 articles were evaluated, including 8 RCTs. There was a 27% reduction in angiographic restenosis (RR: 0.73, 95% CI: 0.54-0.97, I{sup 2} = 51%) and statistically significant reduction in the rates of percutaneous revascularization and overall (RR: 0.88; 95% CI: 0.51 to 1.53, I{sup 2} = 61%, RR: 0.73, 95% CI: 0.54 to 0.99, I{sup 2} = 55%), with no statistical difference in surgical revascularization (RR: 0.95, 95% CI: 0.52-1.74, I{sup 2} = 0%) in favor of IVUS vs. ANGIO. There were no differences regarding the other outcomes in the comparison between the two strategies. Angioplasty with stenting guided by IVUS decreases the rates of restenosis and revascularization, with no impact on MACE, acute myocardial infarction, mortality or thrombosis outcomes.

  14. Myocardial bridging detection by non-invasive multislice spiral computed tomography: comparison with intravascular ultrasound

    Institute of Scientific and Technical Information of China (English)

    WANG Ming-hui; ZHANG Feng; Raimund Erbel; GE Jun-bo; SUN Ai-jun; QIAN Ju-ying; LING Qing-zhi; ZENG Meng-su; GE Lei; WANG Ke-qiang; FAN Bing; YAN Wei

    2008-01-01

    Background Invasive intravascular ultrasound (IVUS) is current dlagnostic Standard for myocardial bridging (MB).Non-invasive multislice computerized tomography coronary angiography (MSCT) technique has provided a good anatomical view of the tunnel arten/ now.Methods A total of 51 consecutive patients with atypical or typical angina scheduled for IVUS were enrolled in this study and MSCT was performed 7 days before IVUS. Coronary imaging was quantified using IVUS and MSCT. Four main vessels (left main artery (LMA), left anterior descending (LAD), left circumflex (LCX), right coronary artery (RCA)) were examined.Results Forty-one out of 51 (80%) patients received metaprolol (25 mg) before the MSCT scan and 25 of them were current beta-blocker users. The mean heart rate was (64±3) beats per minute. A total of 51 patients underwent IVUS examination (30 with MB and 21 without MB) were chosen for this study. Twenty-eight out of 30 MB cases were correctly diagnosed by MSCT and 2 patients with MB were not detected. Comparison with IVUS, the sensitivity of detection by MSCT was 93%, specificity was 100%. The lumen diameter of the tunnel artery derived from MSCT and IVUS significantly decreased from (2.9±0.3) mm to (2.4±0.4) mm (P<0.001) and from (3.3±0.3) mm to (2.6±0.5) mm (P<0.001),respectively. Minimal and maximal diameters of MB derived from MSCT were significantly smaller than those from IVUS ((2.4±0.4) mm vs (2.6±0.5) mm, P<0.05 and (2.9±0.3) mm vs (3.3±0.3) mm, P<0.05), respectively.Conclusions MSCT offers a reliable non-invasive method for MB in LAD and atherosclerosis diagnosis with diagnostic accuracy comparable with invasive IVUS.

  15. Compensatory enlargement in transplant coronary artery disease: an intravascular ultrasound study

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background It is unclear to what extent the "Glagov phenomenon" occurs in transplant coronary artery disease (TCAD). The objective of this study was to evaluate the relationship between intimal hyperplasia and compensatory enlargement in TCAD. Methods Intravascular ultrasound imaging was performed on 190 cardiac transplant recipients at (1.4±0.6) months and again (12.1±0.7) months after cardiac transplantation. Studies 1 year apart were matched at 625 sites. There were 345 coronary artery sites that had an increase in intimal area >10% from baseline to one year, and this comprised the data set of the present study. Results At the first year, 91% of coronary artery sites with intimal growth had a total cross-sectional area stenosis ≤40%, but 38% of the sites showed a decrease of >10% in lumen area. Receiver operating characteristic curve demonstrated that the change in cross-sectional area stenosis cut-off level at year 1 was 8% with a sensitivity of 75% and a specificity of 82% in predicting lumen loss. At a total cross-sectional area stenosis of 20%, sensitivity was 65% with a specificity of 81% in predicting lumen loss. Conclusions In TCAD, vessel enlargement as a compensatory mechanism for plaque growth is generally inadequate. Instead of continued vessel expansion, luminal narrowing develops when there is more than 8% cross-sectional area filled with intimal hyperplasia. In distinction to native coronary artery atherosclerotic disease, the transition point in transplant vasculopathy where the lumen is diminished by increasing intimal growth, occurs at a lower threshold, 20% vs 40% of vessel cross-sectional area.

  16. Supplemental dose of antithrombin use in disseminated intravascular coagulation patients after abdominal sepsis.

    Science.gov (United States)

    Tagami, Takashi; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

    2015-08-31

    The effectiveness of supplemental dose antithrombin administration (1,500 to 3,000 IU/ day) for patients with sepsis-associated disseminated intravascular coagulation (DIC), especially sepsis due to abdominal origin, remains uncertain. This was a retrospective cohort study of patients with mechanically ventilated septic shock and DIC after emergency surgery for perforation of the lower intestinal tract using a nationwide administrative database, Japanese Diagnosis Procedure Combination inpatient database. A total of 2,164 patients treated at 612 hospitals during the 33-month study period between 2010 and 2013 were divided into an antithrombin group (n=1,021) and a control group (n=1,143), from which 518 propensity score-matched pairs were generated. Although there was no significant 28-day mortality difference between the two groups in the unmatched groups (control vs antithrombin: 25.7 vs 22.9 %; difference, 2.8 %; 95 % confidence interval [CI], -0.8-6.4), a significant difference existed between the two groups in propensity-score weighted groups (26.3 vs 21.7 %; difference, 4.6 %; 95 % CI, 2.0-7.1) and propensity-score matched groups (27.6 vs 19.9 %; difference, 7.7 %; 95 % CI, 2.5-12.9). Logistic regression analyses showed a significant association between antithrombin use and lower 28-day mortality in propensity-matched groups (odds ratio, 0.65; 95 % CI, 0.49-0.87). Analysis using the hospital antithrombin-prescribing rate as an instrumental variable showed that receipt of antithrombin was associated with a 6.5 % (95 % CI, 0.05-13.0) reduction in 28-day mortality. Supplemental dose of antithrombin administration may be associated with reduced 28-day mortality in sepsis-associated DIC patients after emergency laparotomy for intestinal perforation.

  17. Tanshinone ⅡA protects rabbits against LPS-induced disseminated intravascular coagulation (DIC)

    Institute of Scientific and Technical Information of China (English)

    Liang-cai WU; Xi LIN; Hao SUN

    2012-01-01

    Aim:To evaluate the effects of tanshinone ⅡA (Tan ⅡA),a lipophilic diterpene from the Chinese herb Salvia miltiorrhiza,on lipopolysaccharide (LPS)-induced disseminated intravascular coagulation (DIC) in rabbits.Methods:LPS-induced DIC model was made in adult male New Zealand rabbits by continuous intravenous infusion of LPS (0.5 mg/kg)via marginal ear vein for 6 h.The animals were simultaneously administered with Tan ⅡA (1,3 and 10 mg/kg) or heparin (500 000IU/kg) through continuous infusion via the contralateral marginal ear vein for 6 h.Before and 2 and 6 h after the start of LPS infusion,blood samples were taken for biochemical analyses.Results:Continuous infusion of LPS into the rabbits gradually impaired the hemostatic parameters,damaged renal and liver functions,increased the plasma TNF-α level,and led to a high mortality rate (80%).Treatment of the rabbits with Tan ⅡA dose-dependently attenuated the increase in activated partial thromboplastin time (APTT),prothrombin time (PT) and fibrin-fibrinogen degradation products (FDP); ameliorated the decrease in plasma levels of fibrinogen and platelets; and reversed the decline in activity of protein C and antithrombin Ⅲ.Meanwhile,the treatment significantly suppressed the increase in the plasma levels of aminotransferase,creatinine and TNF-α,and led to much lower mortality (46.7% and 26.7% for the medium- and high-dose groups).Treatment of the rabbits with the high dose of heparin also effectively improved the hemostatic parameters,ameliorated liver and renal injuries,and reduced the plasma level of TNF-α,and significantly reduced the mortality (33.3%).Conclusion:Tan ⅡA exerts a protective effect against DIC in rabbits.

  18. Thromboelastometry (TEM) findings in disseminated intravascular coagulation in a pig model of endotoxinemia.

    Science.gov (United States)

    Schöchl, Herbert; Solomon, Cristina; Schulz, Arthur; Voelckel, Wolfgang; Hanke, Alexander; Van Griensven, Martijn; Redl, Heinz; Bahrami, Soheyl

    2011-01-01

    Standard coagulation tests have a low specificity and sensitivity for diagnosing disseminated intravascular coagulation. The aim of this study was to determine whether whole blood thromboelastometry (TEM) detects lipopolysaccharide (LPS)-induced changes in coagulation. Blood samples from 10 pigs were drawn at baseline, before and at the end of LPS infusion and 2, 3, 4 and 5 h after the start of endotoxinemia. Simultaneous to TEM, standard coagulation tests and extended coagulation analysis including tissue plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI-1) were performed. Endotoxinemia resulted in a significant acceleration of the nonactivated TEM (NATEM) clotting time 2 h after the end of LPS infusion; in contrast, the changes in international normalized ratio and activated partial thromboplastin time suggested delayed initiation of coagulation. NATEM maximum clot firmness (MCF) and fibrin-based thromboelastometry test (FIBTEM)-MCF decreased significantly from baseline until the last time point (from 64.6 ± 7.8 and 35.1 ± 12.8 mm to 52.8 ± 4.6 and 21.4 ± 11.8 mm, respectively; P = 0.01 for both parameters). A sharp, transient increase of t-PA had no effect on maximum lysis in the NATEM test. PAI-1 increased significantly 3 h after the start of LPS infusion, paralleled by a decrease in maximum lysis. In conclusion, TEM was superior to standard coagulation tests in reflecting initial activation of coagulation during endotoxinemia. TEM further suggested consumption of coagulation substrate; at the same time, inhibition of plasminogen activation was accompanied by improved clot stability. Further investigations are necessary to establish the clinical relevance of these findings.

  19. High mobility group B1 levels in sepsis and Disseminated Intravascular Coagulation.

    Science.gov (United States)

    Eskici, Zeynep M; Açıkgöz, Şerefden; Pişkin, Nihal; Mungan, Görkem; Can, Murat; Güven, Berrak; Köktürk, Fürüzan

    2012-01-01

    Cytokines trigger coagulant and fibrinolytic systems in sepsis to result in Disseminated Intravascular Coagulation (DIC) that is an important complication and leads to disseminated hemorrhages and multi-organ failure. High Mobility Group B1 DNA Binding (HMGB1) protein is a cytokine taking part in systemic inflammatory response. The objective of this study was to investigate HMGB1 levels in groups of septic patients with and without DIC.Twenty-one septic patients without DIC and 12 septic patients with DIC from the Intensive Care Unit (ICU) were included in the study. In addition, 20 patients admitted to the ICU without sepsis or DIC and 20 healthy volunteers served as controls. Levels of HMGB1, prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, protein C, protein S, anti-thrombin III (ATIII), platelet (thrombocyte) and leukocyte count were determined. Levels of fibrinogen, protein C, ATIII and platelet count were significantly lower and D-dimer was significantly higher in the group with sepsis plus DIC compared to the group with sepsis without DIC. Levels of HMGB1 were higher in the group with sepsis and DIC compared to the group with sepsis; however, the difference was not statistically significant and the levels of HGMB1 of both groups were significantly higher compared to ICU and healthy control groups. HMGB1 levels were not significantly different in survivor and non survivor patients. HMGB1 levels did not differ in lower respiratory tract infection (LRTI) and urinary tract infection (UTI) in regard to the etiology of sepsis.

  20. [Effect of xuebijing oral effervescent tablet on endotoxin induced fever and disseminated intravascular coagulation rabbit model].

    Science.gov (United States)

    Guo, Shan-Shan; Gao, Ying-Jie; Tian, Xue-Chuan; Jin, Ya-Hong; Liu, Fang-Zhou; Cui, Xiao-Lan

    2013-08-01

    In order to discover the mechanism of Xuebijing oral effervescent tablet (XBJOET) to treat infectious diseases, the effect of XBJOET on endotoxin induced rabbit fever and disseminated intravascular coagulation (DIC) was investigated. Auricle microcirculation in rabbit was detected by laser speckle blood perfusion imager system; coagulation function was measured by coagulation analyzer, fibrinolytic system was quantified by Elisa assay and micro thrombosis in tissues was observed with HE staining under light microscope. The results demonstrated that the body temperature of rabbit decreased significantly at 1-3 h after administration with 4.8, 2.4 and 1.2 g x kg(-1) XBJOET to endotoxin induced DIC rabbit model, the auricle microcirculation blood flow in model group (54.45 +/- 14.53) PU was lower than that in control group (77.18 +/- 12.32) PU. The auricle microcirculation blood flow increased markedly and there was significant difference between model group and 1.2 g x kg(-1) XBJOET group. There was significant difference between model group and control group in the content of PAI1 and FIB. The PAI1 levels in model and control groups were (30.48 +/- 2.46) ng x mL(-1) and (20.93 +/- 3.25) ng x mL(-1), respectively. The FIB levels in model and control group were (3.34 +/- 1.09) g x L(-1) and (4.84 +/- 1.10) g x L(-1), respectively. The content of PAI1 in rabbit plasma decreased notably, there were significant differences between model group and 4.8, 2.4 g x kg(-1) XBJOET groups. On the contrary the content of FIB increased. XBJOET possessed pharmacological activities of curing infectious fever and DIC, the mechanism of which is related to amelioration of microcirculation disturbance, inhibition of fibrinolytic system activation and coagulation and micro thrombosis elimination.