Science.gov

Sample records for calcified pleural plaques

  1. Aetiology of pleural plaques

    PubMed Central

    Rous, V.; Studeny, J.

    1970-01-01

    Pleural plaques were found in 644 (6·6%) of 9,760 photofluorograms taken in 1965 in a region of Pelhřimov district; the incidence was highest in the age group 66-70 years. The advanced age of those affected may be explained by the greater frequency of the causative agent in the past. The disorder was known in Pelhřimov district as early as 1930; it was then thought to be posttuberculous. The past history of the cases was uninformative; as a rule, the only common previous disease was pleurisy with effusion, occurring in 9·7%. The general condition of those affected was excellent; only 8% were aware of the fact that pleural lesions were present. The disorder was found mainly in farmers, familial incidence was common, and if two generations of one family suffered from the condition, the older generation was affected in 100%. Pleural plaques consist morphologically of limited areas of hyalinized collagenous connective tissue with calcium salt deposits. Tubercle bacilli could not be cultivated from the lesions. Mineralological analysis showed no evidence of silicates in the pleural plaques and a normal content in the lungs. The aetiological factor responsible for the development of pleural plaques in Pelhřimov district is not known, but asbestos cannot be implicated. The unknown noxious agent is carried to the pleura by the lymph and blood stream. Pleural plaques are an endemic disorder. The traditional view that lesions are post-tuberculous appears, in the region submitted to this study, to be a possible explanation. Images PMID:5465601

  2. Association between Randall's Plaque and Calcifying Nanoparticles

    NASA Technical Reports Server (NTRS)

    Citfcioglu, Neva; Vejdani, Kaveh; Lee, Olivia; Mathew, Grace; Aho, Katja M.; Kajander, Olavi; McKay, David S.; Jones, Jeffrey A.; Feiveson, Alan H.; Stoller, Marshall L.

    2007-01-01

    Randall initially described calcified subepithelial papillary plaques, which he hypothesized as nidi for kidney stone formation. The discovery of calcifying nanoparticles (CNP) in many calcifying processes of human tissues has raised another hypothesis about their possible involvement in urinary stone formation. This research is the first attempt to investigate the potential association of these two hypotheses. We collected renal papilla and blood samples from 17 human patients who had undergone laparoscopic nephrectomy due to neoplasia. Immunohistochemical staining (IHS) was applied on the tissue samples using monoclonal antibody 8D10 (mAb) against CNP. Homogenized papillary tissues and serum samples were cultured for CNP. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) analysis were performed on fixed papillary samples. Randall's plaques were visible on gross inspection in 11 out of 17 collected samples. IHS was positive for CNP antigen in 8 of these 11 visually positive samples, but in only 1 of the remaining 6 samples. SEM revealed spherical apatite formations in 14 samples, all of which had calcium and phosphate peaks detected by EDS analysis. From this study, there was some evidence of a link between the presence of Randall's plaques and the detection of CNP, also referred to as nanobacteria. Although causality was not demonstrated, these results suggest that further studies with negative control samples should be made to explore the etiology of Randall's plaque formation, thus leading to a better understanding of the pathogenesis of stone formation.

  3. Association between Randall's Plaque and Calcifying Nanoparticles

    NASA Technical Reports Server (NTRS)

    Ciftcioglu, Neva; Vejdani, Kaveh; Lee, Olivia; Mathew, Grace; Aho, Katja M.; Kajander, Olavi; McKay, David S.; Jones, Jeff A.; Hayat, Matthew; Stoller, Marshall L.

    2007-01-01

    Randall's plaques, first described by Alexander Randall in the 1930s, are small subepithelial calcifications in the renal papillae (RP) that also extend deeply into the renal medulla. Despite the strong correlation between the presence of these plaques and the formation of renal stones, the precise origin and pathogenesis of Randall s plaque formation remain elusive. The discovery of calcifying nanoparticles (CNP) and their detection in many calcifying processes of human tissues has raised hypotheses about their possible involvement in renal stone formation. We collected RP and blood samples from 17 human patients who had undergone laparoscopic nephrectomy due to neoplasia. Homogenized RP tissues and serum samples were cultured for CNP. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) analysis were performed on fixed RP samples. Immunohistochemical staining (IHS) was applied on the tissue samples using CNP-specific monoclonal antibody (mAb). Randall s plaques were visible on gross inspection in 11 out of 17 collected samples. Cultures of all serum samples and 13 tissue homogenates had CNP growth within 4 weeks. SEM revealed spherical apatite formations in 14 samples, with calcium and phosphate peaks detected by EDS analysis. IHS was positive in 9 out of 17 samples. A strong link was found between the presence of Randall s plaques and the detection of CNP, also referred to as nanobacteria. These results suggest new insights into the etiology of Randall's plaque formation, and will help us understand the pathogenesis of stone formation. Further studies on this topic may lead us to new approaches on early diagnosis and novel medical therapies of kidney stone formation.

  4. Are pleural plaques an appropriate endpoint for risk analyses?

    PubMed

    Maxim, L Daniel; Niebo, Ronald; Utell, Mark J

    2015-01-01

    This review summarizes the literature on the relation between the development of pleural plaques and non-malignant and malignant disease in cohorts exposed to asbestos and other fibers. The available evidence indicates that, absent any other pleural disease, the presence of pleural plaques does not result in respiratory symptoms or clinically significant impacts on lung function. For certain types of asbestos, the development of pleural plaques is statistically correlated with malignant disease, but the evidence is consistent with the hypothesis that pleural plaques without other pleural disease are a marker of exposure, rather than an independent risk factor. Pleural plaques have also developed in cohorts exposed to other fibers that have not proven to be carcinogenic. Risk analyses should be based on the avoidance of known adverse conditions, rather than pleural plaques per se. PMID:26075933

  5. Asbestos related pleural plaques in retired boiler room workers.

    PubMed

    Hsiao, T M; Ho, C K; Su, W P; Hwang, J J; Tsai, M S; Chau, T T; Lu, S N; Chang, W Y

    1993-02-01

    Occupational disease is often underestimated and only a few formal reports have been published in Taiwan. This study reports of a group of workers with asbestos-induced-disease, pleural plaque in Taiwan. Pleural plaque is a marker of exposure to asbestos. The disease was found in chest radiographs of five boiler room workers in a sugar refining factory. The chest radiographs of 248 current workers in that plant were reviewed, and none of them was found to have pleural plaques. The storage of asbestos and the long-time use of mixed asbestos cement for insulation of the inner wall of the stove and pipes were found in the factory. The authors believe that the pleural plaques might be resulted from occupational exposure to asbestos. It is suggested that the use of asbestos should be prohibited, step by step, and regular follow-up of the workers with an asbestos exposure history is required. PMID:8492355

  6. Systematic review of pleural plaques and lung function

    PubMed Central

    Kerper, Laura E.; Lynch, Heather N.; Zu, Ke; Tao, Ge; Utell, Mark J.

    2015-01-01

    Abstract Context US EPA proposed a Reference Concentration for Libby amphibole asbestos based on the premise that pleural plaques are adverse and cause lung function deficits. Objective We conducted a systematic review to evaluate whether there is an association between pleural plaques and lung function and ascertain whether results were dependent on the method used to identify plaques. Methods Using the PubMed database, we identified studies that evaluated pleural plaques and lung function. We assessed each study for quality, then integrated evidence and assessed associations based on the Bradford Hill guidelines. We also compared the results of HRCT studies to those of X-ray studies. Results We identified 16 HRCT and 36 X-ray studies. We rated six HRCT and 16 X-ray studies as higher quality based on a risk-of-bias analysis. Half of the higher quality studies reported small but statistically significant mean lung function decrements associated with plaques. None of the differences were clinically significant. Many studies had limitations, such as inappropriate controls and/or insufficient adjustment for confounders. There was little consistency in the direction of effect for the most commonly reported measurements. X-ray results were more variable than HRCT results. Pleural plaques were not associated with changes in lung function over time in longitudinal studies. Conclusion The weight of evidence indicates that pleural plaques do not impact lung function. Observed associations are most likely due to unidentified abnormalities or other factors. PMID:25518994

  7. Virtual Intravascular Endoscopy Visualization of Calcified Coronary Plaques

    PubMed Central

    Xu, Lei; Sun, Zhonghua

    2015-01-01

    Abstract This study was conducted to investigate the feasibility of using 3D virtual intravascular endoscopy (VIE) as a novel approach for characterization of calcified coronary plaques with the aim of differentiating superficial from deep calcified plaques, thus improving assessment of coronary stenosis. A total of 61 patients with suspected coronary artery disease were included in the study. Minimal lumen diameter (MLD) was measured and compared between coronary CT angiography (CCTA) (?64-slice) and invasive coronary angiography (ICA) with regard to the measurement bias, whereas VIE findings were correlated with CCTA with respect to the diagnostic performance of coronary stenosis and the area under the curve (AUC) by receiver-operating characteristic curve analysis (ROC). In all 3 coronary arteries, the CCTA consistently underestimated the MLD relative to the ICA (P?calcified plaques compared with CCTA (0.99 vs 0.60, P?calcified plaques, therefore, significantly improving assessment of coronary stenosis. PMID:25929936

  8. Association between Randalls plaque and calcifying nanoparticles

    PubMed Central

    iftio?lu, Neva; Vejdani, Kaveh; Lee, Olivia; Mathew, Grace; Aho, Katja M; Kajander, E Olavi; McKay, David S; Jones, Jeffrey A; Stoller, Marshall L

    2008-01-01

    Objectives Randall initially described calcified subepithelial papillary plaques, which he hypothesized as nidi for urinary calculi. The discovery of calcifying nanoparticles (CNP), also referred to as nanobacteria, in calcified soft tissues has raised another hypothesis about their possible involvement in urinary stone formation. This research is the first attempt to investigate the potential association of these two hypotheses. Methods We collected renal papilla and blood samples from 17 human patients who had undergone laparoscopic nephrectomy. Immunohistochemical staining (IHS) was applied using monoclonal antibody (mAb) against CNP. Homogenized papillary tissues and serum samples were cultured for CNP. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) were performed on papillary samples. Serum samples were tested for CNP antigen and antibody with enzyme-linked immunosorbent assay (ELISA). Results Randalls plaques (RP) were visible on gross inspection in 11 out of 17 samples. IHS was positive for CNP antigen in 8 of the visually positive samples, but in only 1 of the remaining samples. SEM revealed spherical apatite-formations in 14 samples confirmed by EDS analysis. In cultures, all serum samples and 13 tissue homogenates grew CNP. In ELISA, 14 samples were positive for CNP-antigen and 11 samples were positive for CNP-antibody. Conclusion There was evidence of a link between detection of CNP and presence of RP. Although causality was not demonstrated, these results suggest that further studies with negative control samples should be made to explore the etiology of RP formation, thus leading to a better understanding of the pathogenesis of stone formation. PMID:18488421

  9. Focal pleural thickening mimicking pleural plaques on chest computed tomography: tips and tricks.

    PubMed

    Alfudhili, Khalid M; Lynch, David A; Laurent, Francois; Ferretti, Gilbert R; Dunet, Vincent; Beigelman-Aubry, Catherine

    2016-01-01

    Diagnosis of pleural plaques (PPs) is commonly straightforward, especially when a typical appearance is observed in a context of previous asbestos exposure. Nevertheless, numerous causes of focal pleural thickening may be seen in routine practice. They may be related to normal structures, functional pleural thickening, previous tuberculosis, pleural metastasis, silicosis or other rarer conditions. An application of a rigorous technical approach as well as a familiarity with loco-regional anatomy and the knowledge of typical aspects of PP are required. Indeed, false-positive or false-negative results may engender psychological and medico-legal consequences or can delay diagnosis of malignant pleural involvement. Correct recognition of PPs is crucial, as they may also be an independent risk factor for mortality from lung cancer in asbestos-exposed workers particularly in either smokers or former/ex-smokers. Finally, the presence of PP(s) may help in considering asbestosis as a cause of interstitial lung disease predominating in the subpleural area of the lower lobes. The aim of this pictorial essay is to provide a brief reminder of the normal anatomy of the pleura and its surroundings as well as the various aspects of PPs. Afterwards, the common pitfalls encountered in PP diagnosis will be emphasized and practical clues to differentiate actual plaque and pseudoplaque will be concisely described. PMID:26539633

  10. Pleural plaques and risk of cancer in Turin, northwestern Italy. An autopsy study

    SciTech Connect

    Mollo, F.; Andrion, A.; Colombo, A.; Segnan, N.; Pira, E.

    1984-10-01

    The relationship between the occurrence of neoplastic diseases and the presence of pleural plaques was studied in a series of 1097 autopsies performed in Turin from the adult general population. In men, pleural plaques showed an association with the presence of laryngeal, pulmonary, esophageal, and colorectal cancer. Only cancer of the larynx was strongly related to the occurrence of such pleural changes. This autopsy investigation confirms previous observations by others based on x-ray findings, and suggests that pleural plaques may be regarded as risk indicators of possibly asbestos-related tumors in the general population.

  11. Hemodynamic Instability during Carotid Angioplasty and Stenting-Relationship of Calcified Plaque and Its Characteristics

    PubMed Central

    Jeon, Jin Sue; Hwang, Gyojun

    2013-01-01

    Purpose During carotid angioplasty and stenting (CAS), hemodynamic instability (HDI) can occur, possibly causing post-procedural ischemic complications. The goal of this study was to investigate the risk factors of HDI focusing on characteristics of plaque. Materials and Methods Thirty nine CAS patients were retrospectively evaluated for HDI. Prolonged HDI that lasted over 30 minutes was analyzed in relation to characteristics of calcified plaque. Results Nineteen (48.7%) patients had HDI. Ten of the 19 had both bradycardia and hypotension, and nine had only bradycardia. All bradycardia was treated well with a transcutaneous temporary cardiac pacemaker. But eight patients presented with prolonged hypotension in spite of recovery of bradycardia. Calcified plaque was a related factor associated with HDI (odds ratio, 8.571; 95% confidence interval, 1.321-55.62; p=0.024). Extensive and eccentric type calcified plaques were associated with prolonged hypotension (p=0.04, and p=0.028, respectively). Conclusion The calcification of plaque is a predictable factor of HDI during CAS, and its extensive and eccentric calcified plaques may be related to prolonged HDI. PMID:23364959

  12. Improving visualization of intracranial arteries at the skull base for CT angiography with calcified plaques

    NASA Astrophysics Data System (ADS)

    Huang, Adam; Lee, Chung-Wei; Yang, Chung-Yi; Liu, Hon-Man

    2010-03-01

    Bony structures at the skull base were the main obstacle to detection and estimation of arterial stenoses and aneurysms for CT angiography in the brain. Direct subtraction and the matched mask bone elimination (MMBE) have become two standard methods for removing bony structures. However, clinicians regularly find that calcified plaques at or near the carotid canal cannot be removed satisfactorily by existing methods. The blood-plaque boundary tends to be blurred by subtraction operation while plaque size is constantly overestimated by the bone mask dilation operation in the MMBE approach. In this study, we propose using the level of enhancement to adjust the MMBE bone mask more intelligently on the artery- and tissue-bone/plaque boundaries. The original MMBE method is only applied to the tissue-bone boundary voxels; while the artery-bone/blood-plaque boundary voxels, identified by a higher enhancement level, are processed by direct subtraction instead. A dataset of 6 patients (3 scanned with a regular dose and 3 scanned with a reduced dose) with calcified plaques at or near the skull base is used to examine our new method. Preliminary results indicate that the visualization of intracranial arteries with calcified plaques at the skull base can be improved effectively and efficiently.

  13. Pleural plaque profiles on the chest radiographs and CT scans of asbestos-exposed Japanese construction workers.

    PubMed

    Elshazley, Momen; Shibata, Eiji; Hisanaga, Naomi; Ichihara, Gaku; Ewis, Ashraf A; Kamijima, Michihiro; Ichihara, Sahoko; Sakai, Kiyoshi; Sato, Mitsuo; Kondo, Masashi; Hasegawa, Yoshinori

    2011-01-01

    Pleural plaques are asymptomatic focal thickenings of the pleura and considered the hallmark of asbestos exposure. However, it is often difficult to detect pleural plaques on chest x-rays (CXR). In a retrospective study, using chest CT scans of 140 Japanese asbestos-exposed construction workers who have probable or definite findings of pleural plaque on CXR; firstly, we proposed plaque morphology-based classification for CXR findings, and then we examined if those classified findings could be confirmed as pleural plaques on CT scans. Our morphology-based classification of pleural plaque findings included nine types. The percentages of confirmed pleural plaques on CT scans by type (number of confirmed pleural plaque on CT/number of observed on CXR) were 93% (40/43) for straight, 89% (56/63) for diamond, 88% (7/8) for double, 83% (19/23) for tapered medially, 80% (20/25) for parallel, 77% (23/30) for crescent, 79% (11/14) for tenting, 72% (18/25) for tapered-laterally (long type), and 0% (0/9) for tapered-laterally (short type). When added to the ILO classification, morphology-based classification of CXR pleural plaque findings makes its detection easier and hence chest radiograph continues to be a suitable tool for screening asbestos-related pleural plaques based on its simplicity, low radiation exposure, wide availability and cost-effectiveness. PMID:21828957

  14. [Erionite-induced pleural plaques. Exposition to urban pollution in a female Turkish migrant in Germany].

    PubMed

    Grsel, B; Kaya, A; Stahl, U; Rauber, K; Kuntz, C

    2008-06-01

    Erionite is a zeolite mineral of volcanic origin which contains no asbestos. It is found in different regions of the world, including southeast Turkey in ash and dust, from which it can cause inflammatory pleural plaques or malignant pleural mesothelioma (MPM). We report a female Turkish migrant exposed to urban pollution in her home country who decades later suffered from pleural plaques with a nonspecific chronic inflammatory disease. The differential diagnosis of inflammatory pleural plaques was assumed radiologically and confirmed by video-assisted thoracoscopic biopsy. Short-term clinical and radiologic control of the patient will be necessary because of the risk of MPM. For epidemiologic considerations discussed referring to current literature, a growing incidence of this type of disease in migrants from high-risk areas must be reckoned with in Germany, even without exposition to asbestos. PMID:18506411

  15. Feature-based characterization of motion-contaminated calcified plaques in cardiac multidetector CT

    SciTech Connect

    King, Martin; Giger, Maryellen L.; Suzuki, Kenji; Pan, Xiaochuan

    2007-12-15

    In coronary calcium scoring, motion artifacts affecting calcified plaques are commonly characterized using descriptive terms, which incorporate an element of subjectivity in their interpretations. Quantitative indices may improve the objective characterization of these motion artifacts. In this paper, an automated method for generating 12 quantitative indices, i.e., features that characterize the motion artifacts affecting calcified plaques, is presented. This method consists of using the rapid phase-correlated region-of-interest (ROI) tracking algorithm for reconstructing ROI images of calcified plaques automatically from the projection data obtained during a cardiac scan, and applying methods for extracting features from these images. The 12 features include two dynamic, six morphological, and four intensity-based features. The two dynamic features are three-dimensional (3D) velocity and 3D acceleration. The six morphological features include edge-based volume, threshold-based volume, sphericity, irregularity, average margin gradient, and variance of margin gradient. The four intensity-based features are maximum intensity, mean intensity, minimum intensity, and standard deviation of intensity. The 12 features were extracted from 54 reconstructed sets of simulated four-dimensional images from the dynamic NCAT phantom involving six calcified plaques under nine heart rate/multi-sector gating combinations. In order to determine how well the 12 features correlated with a plaque motion index, which was derived from the trajectory of the plaque, partial correlation coefficients adjusted for heart rate, number of gated sectors, and mean feature values of the six plaques were calculated for all 12 features. Features exhibiting stronger correlations (|r| set-membership sign [0.60,1.00]) with the motion index were 3D velocity, maximum intensity, and standard deviation of intensity. Features demonstrating stronger correlations (|r| set-membership sign [0.60,1.00]) with other features mostly involved intensity-based features. Edge-based volume/irregularity and average margin gradient/variance of margin gradient were the only two feature pairs out of 12 with stronger correlations that did not involve intensity-based features. Automatically extracted features of the motion artifacts affecting calcified plaques in cardiac computed tomography images potentially can be used to develop models for predicting image assessability with respect to motion artifacts.

  16. A systematic review of the association between pleural plaques and changes in lung function

    PubMed Central

    Kopylev, Leonid; Christensen, Krista Yorita; Brown, James S; Cooper, Glinda S

    2015-01-01

    Objectives To conduct a systematic review of changes in lung function in relation to presence of pleural plaques in asbestos-exposed populations. Methods Database searches of PubMed and Web of Science were supplemented by review of papers reference lists and journals tables of contents. Methodological features (eg, consideration of potential confounding by smoking) of identified articles were reviewed by ?two reviewers. Meta-analyses of 20 studies estimated a summary effect of the decrements in per cent predicted (%pred) forced vital capacity (FVC) and forced expiratory volume in 1?s (FEV1) associated with presence of pleural plaques. Results Among asbestos-exposed workers, the presence of pleural plaques was associated with statistically significant decrements in FVC (4.09%pred, 95% CI 2.31to 5.86) and FEV1 (1.99%pred, 95% CI 0.22 to 3.77). Effects of similar magnitude were seen when stratifying by imaging type (X-ray or high-resolution CT) and when excluding studies with potential methodological limitations. Undetected asbestosis was considered as an unlikely explanation of the observed decrements. Several studies provided evidence of an association between size of pleural plaques and degree of pulmonary decrease, and presence of pleural plaques and increased rate or degree of pulmonary impairment. Conclusions The presence of pleural plaques is associated with a small, but statistically significant mean difference in FVC and FEV1 in comparison to asbestos-exposed individuals without plaques or other abnormalities. From a public health perspective, small group mean decrements in lung function coupled with an increased rate of decline in lung function of the exposed population may be consequential. PMID:25504898

  17. Detection of pleural plaques in workers exposed to inhalation of natural fluoro-edenite fibres

    PubMed Central

    RAPISARDA, VENERANDO; LEDDA, CATERINA; RICCERI, VINCENZO; ARENA, FRANCESCO; MUSUMECI, ANDREA; MARCONI, ANDREA; FAGO, LUCREZIA; BRACCI, MASSIMO; SANTARELLI, LORY; FERRANTE, MARGHERITA

    2015-01-01

    Fluoro-edenite is a natural mineral species initially isolated in Biancavilla, Sicily. The fibres are similar in size and morphology to certain amphibolic asbestos fibres, the inhalation of which may cause chronic inflammation and cancer. Occupational asbestos exposure is known to be associated with pleural and lung diseases, including pleural plaques. The aim of this study was to report the pleural and lung parenchymal lesions detected by high-resolution computed tomography (HRCT) in a group of construction workers exposed to fluoro-edenite. Information regarding life habits and occupational history was collected from 43 workers enrolled into the study. The participants underwent physical examination, blood analysis, search for uncoated fibres and ferruginous bodies in the sputum, pulmonary function tests, including diffusion capacity for carbon monoxide (TLCO), and HRCT chest imaging. A general descriptive outcome analysis was also conducted; a prevalence ratio (PR) with 95% confidence interval and a two-tailed test P-value were calculated for pleural plaques using log-binomial regression, measuring plaque size and thickness, and cumulative exposure index (CEI). The mean values of the functional respiratory tests were within the normal range for all participants. A restrictive ventilatory defect was identified in two (5%) subjects and an obstructive ventilatory defect in three (7%) subjects. TLCO was reduced in two additional participants. Fibres were detected in 19 (44%) of subjects. Pleural involvement was documented in 39 (91%) workers, of whom 31 (72%) had bilateral plaques. Calcifications were detected in 25 (58%) of these participants. PR indicated a progressive increase in the risk of developing pleural lesions with rising CEI, i.e. length of exposure. The present findings demonstrate for the first time the presence of pleural plaques in the lungs of subjects exposed to fluoro-edenite fibres, and not to asbestos, through residing in Biancavilla and through their occupation. PMID:26137010

  18. Numbers and types of asbestos fibers in subjects with pleural plaques.

    PubMed Central

    Warnock, M. L.; Prescott, B. T.; Kuwahara, T. J.

    1982-01-01

    The authors analyzed asbestos fibers in lung samples from 20 subjects with pleural plaques discovered on autopsy and compared the findings to their previous analyses of lungs from subjects with little or no asbestos exposure and no plaques. Sixteen of the subjects with plaques had a history of exposure to asbestos. The authors used electron-optical methods and energy-dispersive x-ray spectroscopy to investigate the structure, diffraction patterns, and chemical composition of the asbestos fibers. The subjects with plaques had significantly higher median concentrations than the control subjects for amosite and crocidolite fibers (P less than 0.01) but not for the other fiber types. Minimal microscopic asbestosis was present in the 3 subjects who had the highest amosite concentrations. In the subjects with typical plaques, a history of asbestos exposure, and more fibers than in the control population, the relation of the plaques to asbestos was confirmed; for others, it was uncertain. PMID:7124907

  19. Congenital plaque-type glomuvenous malformations associated with fetal pleural effusion and ascites.

    PubMed

    Goujon, Elisa; Cordoro, Kelly M; Barat, Muriel; Rousseau, Thierry; Brouillard, Pascal; Vikkula, Miikka; Frieden, Ilona J; Vabres, Pierre

    2011-01-01

    Glomuvenous malformations are hereditary vascular anomalies, usually without extracutaneous involvement. We report two cases of extensive thoracic plaque-type glomuvenous malformation in newborns who had previously been diagnosed in utero with pleural effusion and ascites, suggesting a pathogenic link between the two conditions. PMID:21133993

  20. Computerized detection of non-calcified plaques in coronary CT angiography: topological soft-gradient detection method for plaque prescreening

    NASA Astrophysics Data System (ADS)

    Wei, Jun; Zhou, Chuan; Chan, Heang-Ping; Chughtai, Aamer; Patel, Smita; Agarwal, Prachi; Kuriakose, Jean; Hadjiiski, Lubomir; Kazerooni, Ella

    2013-03-01

    Non-calcified plaque (NCP) detection in coronary CT angiography (cCTA) is challenging due to the low CT number of NCP, the large number of coronary arteries and multiple phase CT acquisition. We are developing computervision methods for automated detection of NCPs in cCTA. A data set of 62 cCTA scans with 87 NCPs was collected retrospectively from patient files. Multiscale coronary vessel enhancement and rolling balloon tracking were first applied to each cCTA volume to extract the coronary artery trees. Each extracted vessel was reformatted to a straightened volume composed of cCTA slices perpendicular to the vessel centerline. A new topological soft-gradient (TSG) detection method was developed to prescreen for both positive and negative remodeling candidates by analyzing the 2D topological features of the radial gradient field surface along the vessel wall. Nineteen features were designed to describe the relative location along the coronary artery, shape, distribution of CT values, and radial gradients of each NCP candidate. With a machine learning algorithm and a two-loop leave-one-case-out training and testing resampling method, useful features were selected and combined into an NCP likelihood measure to differentiate TPs from FPs. The detection performance was evaluated by FROC analysis. Our TSG method achieved a sensitivity of 96.6% with 35.4 FPs/scan at prescreening. Classification with the NCP likelihood measure reduced the FP rates to 13.1, 10.0 and 6.7 FPs/scan at sensitivities of 90%, 80%, and 70%, respectively. These results demonstrated that the new TSG method is useful for computerized detection of NCPs in cCTA.

  1. [About a case of calcifying fibrous tumor of the pleura].

    PubMed

    Rocas, Delphine; Thivolet-Bjui, Franoise; Tronc, Franois; Chalabreysse, Lara

    2015-12-01

    Calcifying fibrous tumor is a rare soft tissue benign tumor (OMS2002). Some pleural localisations are described, which affect slightly older individuals than the other soft tissue forms. The calcifying fibrous tumor is included in the 2004World Health Organization classification of pleural tumors. A pleural tumor located in the right inferior pulmonary lobe is diagnosed in a 59-year-old man. This pleural tumor is macroscopically well-circumscribed. Histologically, the rare spindle tumoral cells are located between bundles of a collagenous tissue, sometimes hyalinized, with psammomatous or dystrophic calcifications. The tumoral cells have a fibrohistiocytic origin. They stain positively for antibodies against vimentin, factor XIIIa, CD68, CD163, CD34. Antibodies against smooth muscle actin, desmin, PS100, ALK1and EBV are negative. Main differencial diagnoses are other benign pleural tumors (solitary fibrous tumor, inflammatory myofibroblastique tumor), some malignant tumors (desmoplastic malignant pleural mesothelioma) and pleural pseudotumors (calcified pleural plaques, chronic fibrous pleuritis, amylose, hyalinizing granuloma). Our case is the 15thpleural calcifying fibrous tumor being reported. PMID:26608111

  2. CT Characteristics of Pleural Plaques Related to Occupational or Environmental Asbestos Exposure from South Korean Asbestos Mines

    PubMed Central

    Myong, Jun-Pyo; Lee, Jeong Kyong; Kim, Jeung Sook; Kim, Yoon Kyung; Jung, Soon-Hee

    2015-01-01

    Objective This study evaluated the CT characteristics of pleural plaques in asbestos-exposed individuals and compared occupational versus environmental exposure groups. Materials and Methods This study enrolled 181 subjects with occupational exposure and 98 with environmental exposure from chrysotile asbestos mines, who had pleural plaques confirmed by a chest CT. The CT scans were analyzed for morphological characteristics, the number and distribution of pleural plaques and combined pulmonary fibrosis. Furthermore, the CT findings were compared between the occupational and environmental exposure groups. Results Concerning the 279 subjects, the pleural plaques were single in 2.2% and unilateral in 3.6%, and showed variable widths (range, 1-20 mm; mean, 5.4 ± 2.7 mm) and lengths (5-310 mm; 72.6 ± 54.8 mm). The chest wall was the most commonly involved (98.6%), with an upper predominance on the ventral side (upper, 77.8% vs. lower, 55.9%, p < 0.001) and a lower predominance on the dorsal side (upper, 74.9% vs. lower, 91.8%, p = 0.02). Diaphragmatic involvement (78.1%) showed a right-side predominance (right, 73.8% vs. left, 55.6%, p < 0.001), whereas mediastinal plaques (42.7%) were more frequent on the left (right, 17.6% vs. left, 39.4%, p < 0.001). The extent and maximum length of plaques, and presence and severity of combined asbestosis, were significantly higher in the occupational exposure group (p < 0.05). Conclusion Pleural plaques in asbestos-exposed individuals are variable in number and size; and show a predominant distribution in the upper ventral and lower dorsal chest walls, right diaphragm, and left mediastinum. Asbestos mine workers have a higher extent of plaques and pulmonary fibrosis versus environmentally exposed individuals. PMID:26357506

  3. FBLN-3 as a biomarker of pleural plaques in workers occupationally exposed to carcinogenic fibers: a pilot study.

    PubMed

    Rapisarda, Venerando; Ledda, Caterina; Migliore, Marcello; Salemi, Rossella; Musumeci, Andrea; Bracci, Massimo; Marconi, Andrea; Loreto, Carla; Libra, Massimo

    2015-11-01

    FBLN-3 has recently been proposed as a biomarker for malignant mesothelioma. A significantly increased standardized mortality rate from malignant mesothelioma has been reported in Biancavilla, Italy. Its cause has been identified in environmental exposure to fluoro-edenite. The aim of this study was to seek a correlation between plasma FBLN-3 concentration and pleural plaques in subjects exposed to fluoro-edenite and in a nonexposed control group. Pleural plaques was never detected in the control group, whereas it was found in 52% of exposed subjects. Median FBLN-3 concentrations were 12.96 and 5.29 ng/ml in the exposed and the control group, respectively (p < 0.001). FBLN-3 plasma levels exhibited a high predictive value for the presence of pleural plaques. PMID:26638921

  4. Calcified Atherosclerotic Plaque and Bone Mineral Density in Type 2 Diabetes

    PubMed Central

    Carr, J. Jeffrey; Register, Thomas C.; Hsu, Fang-Chi; Lohman, Kurt; Lenchik, Leon; Bowden, Donald W.; Langefeld, Carl D.; Xu, Jianzhou; Rich, Stephen S.; Wagenknecht, Lynne E.; Freedman, Barry I.

    2008-01-01

    The purpose of the present study was to determine the relationships between atherosclerotic calcified plaque (CP) and bone mineral density (BMD) in subjects with type 2 diabetes mellitus (DM2). CP in the coronary arteries, carotid bifurcation, and abdominal aorta was measured using computed tomography (CT) in 1,023 diabetic subjects from 453 families. Trabecular volumetric BMD in thoracic (T-vBMD) and lumbar (L-vBMD) spine was measured with quantitative CT (QCT), while areal BMD (aBMD) in the lumbar spine and hip was measured by dual X-ray absorptiometry (DXA). Correlation coefficients were computed to assess the magnitude of associations and generalized estimating equations (GEE1) were used to make statistical inferences while accounting for familial correlation. Subjects were 53.8% female, 85% European American (EA) and 15% African American (AA). After adjustment for age, significant inverse associations between CP and vBMD persisted in EA men (correlations between -0.11 and -0.16, all p < 0.05 with the exception of carotid CP vs. T-vBMD, p=0.076) and in AA women, excluding aortic CP, (correlations between -0.16 and -0.25, all p < 0.05). Estrogen use in AA but not EA women was consistently associated with an inverse relation between CP and vBMD. Significant inverse relationships between CP and vBMD were observed in EA men and AA women with DM2 after adjusting for age and other covariates. QCT determined vBMD was more strongly related to CP than aBMD by DXA. The relation between CP and BMD in diabetes is influenced by age, sex, and ethnicity, with further effect modification by hormone replacement therapy. PMID:17964237

  5. Computerized luminal analysis for detection of non-calcified plaques in coronary CT angiography

    NASA Astrophysics Data System (ADS)

    Wei, Jun; Zhou, Chuan; Chan, Heang-Ping; Chughtai, Aamer; Patel, Smita; Agarwal, Prachi; Kuriakose, Jean; Hadjiiski, Lubomir; Kazerooni, Ella

    2014-03-01

    Non-calcified plaque (NCP) detection in coronary CT angiography (cCTA) is challenging due to the low CT number of NCP, the large number of coronary arteries and multiple phase CT acquisition. We are developing computer-vision methods for automated detection of NCPs in cCTA. A data set of 62 cCTA scans with 87 NCPs was collected retrospectively from patient files. Multiscale coronary vessel enhancement and rolling balloon tracking were first applied to each cCTA volume to extract the coronary artery trees. Each extracted vessel was reformatted to a straightened volume composed of cCTA slices perpendicular to the vessel centerline. A topological soft-gradient (TSG) detection method was developed to prescreen for both positive and negative remodeling candidates by analyzing the 2D topological features of the radial gradient field surface along the vessel wall. A quantitative luminal analysis was newly designed for feature extraction and false positive (FP) reduction. We extracted 9 geometric features and 6 gray-level features, to quantify the differences between NCPs and FPs. The gray-level features included 4 features to measure local statistical characteristics and 2 asymmetry features to measure the asymmetric spatial location of gray-level density along the vessel centerline. The geometric features included a radius differential feature and 8 features extracted from two transformed volumes: the volumetric shape indexing and the gradient direction mapping volumes. With a machine learning algorithm and feature selection method, useful features were selected and combined into an NCP likelihood measure to differentiate TPs from FPs. With the NCP likelihood measure as a decision variable in the receiver operating characteristic (ROC) analysis, the area under the curve achieved a value of 0.85+/-0.01, indicating that the luminal analysis is effective in reducing FPs for NCP detection.

  6. The fate of people with pleural hyalinosis (plaques): relationship to direct and indirect asbestos exposure.

    PubMed

    Navrátil, M; Morávková, K; Gafronová, M; Hruska, F

    1988-01-01

    A follow-up study of persons with pleural plaques was concluded in 1984. The first cohort was made up of employees and retired workers with direct absestos exposure in an asbestos factory (AZ factory) producing heat-resistant textiles, friction engine parts and heat-resistant boards. The raw material was imported chrysotile and small amounts of crocidolite. The follow-up was started in the 1950s. Our second cohort comprised residents selected by radiographic screening in a vast area surrounding the AZ factory who had had indirect asbestos exposure by airborn asbestos fibres. The follow-up period began in the 1970s. A control group consisted of employees and retired workers of a railway repair shop, without exposure to asbestos dust and within a corresponding age bracket. At the time of assessing our results, most of the subjects assigned to all the three groups were no longer alive so we were able to analyse data regarding their life and death. Hyalinosis complicata and pleural mesothelioma (peritoneal mesothelioma in one case) were present and resulted in death only in those with direct asbestos exposure. While lung cancer was among the causes of death in both cohorts with exposure as well as in the control group, its prevalence in the group with direct exposure was significantly higher than in the control group. By contrast, "other neoplasia" was found both in the control group and in exposed persons without any specific prevalence. PMID:3147172

  7. In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients with Acute Coronary Syndrome by Intravascular Optical Coherence Tomography

    PubMed Central

    Jia, Haibo; Abtahian, Farhad; Aguirre, Aaron D; Lee, Stephen; Chia, Stanley; Lowe, Harry; Kato, Koji; Yonetsu, Taishi; Vergallo, Rocco; Hu, Sining; Tian, Jinwei; Lee, Hang; Park, Seung-Jung; Jang, Yang-Soo; Raffel, Owen C.; Mizuno, Kyoichi; Uemura, Shiro; Itoh, Tomonori; Kakuta, Tsunekazu; Choi, So-Yeon; Dauerman, Harold L.; Prasad, Abhiram; Toma, Catalin; McNulty, Iris; Zhang, Shaosong; Yu, Bo; Fuster, Valentine; Narula, Jagat; Virmani, Renu; Jang, Ik-Kyung

    2013-01-01

    Objectives To characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo. Methods One hundred and twenty-six patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or others using a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7%, 31.0%, and 7.9%, respectively. Patients with OCT-erosion were the youngest compared with those with PR and OCT-CN (53.813.1 years vs. 60.611.5 years, 65.15.0 years, p=0.005). Compared with patients with PR, presentation with non-ST-segment elevation ACS (NSTE-ACS) was more common in patients with OCT-erosion (61.5% vs. 29.1%, p=0.008) and OCT-CN (100% vs. 29.1%, p<0.001). OCT-erosion had a lower frequency of lipid plaque (43.6% vs. 100%, p<0.001), thicker fibrous cap (169.399.1 ?m vs. 60.416.6 ?m, p<0.001), and smaller lipid arc (202.873.6 vs. 275.860.4, p<0.001) than PR. The diameter stenosis was least severe in OCT-erosion followed by OCT-CN and PR (55.414.7% vs. 66.113.5% vs. 68.812.9%, p<0.001). Conclusions OCT is a promising modality for identifying OCT-erosion and OCT-CN in vivo. OCT-erosion is a frequent finding in patients with ACS, especially in those with NSTE-ACS and younger patients. OCT-CN is the least common etiology for ACS and is more common in older patients. PMID:23810884

  8. Genetic Mapping of Vascular Calcified Plaque Loci on Chromosome 16p in European Americans from the Diabetes Heart Study

    PubMed Central

    LEHTINEN, ALLISON B; COX, AMANDA J; ZIEGLER, JULIE T; VORUGANTI, V. SAROJA; XU, JIANZHAO; FREEDMAN, BARRY I; CARR, J. JEFFREY; COMUZZIE, ANTHONY G; LANGEFELD, CARL D; BOWDEN, DONALD W

    2010-01-01

    SUMMARY A carotid artery calcified plaque (CarCP) linkage peak on chromosome 16p (LOD 4.39 at 8.4cM) in European American (EA) families with type 2 diabetes mellitus (T2DM) from the Diabetes Heart Study (DHS) has been refined by fine-mapping and candidate genes and SNPs evaluated for association with subclinical CVD. Fine-mapping was based on 104 SNPs in 937 subjects from 315 families, including 45 SNPs in six candidate genes (CACNA1H, SEPX1, ABCA3, IL32, SOCS1, and KIAA0350). Linkage and association analyses using variance components analysis (SOLAR; adjusting for age, gender, BMI, and T2DM status) refined the original CarCP linkage into two distinct linkage regions (LOD scores: 3.89 at 6.9cM and 4.86 at 16.0cM). Evidence of linkage for coronary calcified plaque (LOD: 2.27 at 19cM) and a vascular calcification principle component (LOD: 3.71 at 16.0cM) was also observed. The strongest evidence for association with CarCP was observed with SNPs in the A2BP1 gene region (rs4337300 p=0.005) with modest evidence of association with SNPs in CACNA1H (p=0.0100.033). Bayesian Quantitative Trait Nucleotide analysis identified a SNP, rs1358489, with either a functional effect on CarCP or in linkage disequilibrium with a functional SNP. This study refined the 16p region contributing to vascular calcification. Although the causal variants remain to be identified the results are consistent with a linkage peak which is due to multiple common variants, though rare variants cannot be excluded. PMID:21309755

  9. Improved non-calcified plaque delineation on coronary CT angiography by sonogram-affirmed iterative reconstruction with different filter strength and relationship with BMI

    PubMed Central

    Zhao, Lei; Plank, Fabian; Kummann, Moritz; Burghard, Philipp; Klauser, Andrea; Dichtl, Wolfgang

    2015-01-01

    Purpose To prospectively compare non-calcified plaque delineation and image quality of coronary computed tomography angiography (CCTA) obtained with sinogram-affirmed iterative reconstruction (IR) with different filter strengths and filtered back projection (FBP). Methods A total of 57 patients [28.1% females; body mass index (BMI) 29.2±6.5 kg/m2] were investigated. CCTA was performed using 128-slice dual-source CT. Images were reconstructed with standard FBP and sinogram-affirmed IR using different filter strength (IR-2, IR-3, IR-4) (SAFIRE, Siemens, Germany). Image quality of CCTA and a non-calcified plaque outer border delineation score were evaluated by using a 5-scale score: from 1= poor to 5= excellent. Image noise, contrast-to-noise ratio (CNR) of aortic root, left main (LM) and right coronary artery, and the non-calcified plaque delineation were quantified and compared among the 4 image reconstructions, and were compared between different BMI groups (BMI <28 and ≥28). Statistical analyses included one-way analysis of variance (ANOVA), least significant difference (LSD) and Kruskal-Wallis test. Results There were 71.9% patients in FBP, 96.5% in IR-2, 96.5% in IR-3 and 98.2% in IR-4 who had overall CCTA image quality ≥3, and there were statistical differences in CCTA exam image quality score among those groups, respectively (P<0.001). Sixty-one non-calcified plaques were detected by IR-2 to IR-4, out of those 11 (18%) were missed by FBP. Plaque delineation score increased constantly from FBP (2.7±0.4) to IR-2 (3.2±0.3), to IR-3 (3.5±0.3) up to IR-4 (4.0±0.4), while CNRs of the non-calcifying plaque increased and image noise decreased, respectively. Similarly, CNR of aortic root, LM and right coronary artery improved and image noise declined from FBP to IR-2, IR-3 and IR-4. There were no significant differences of image quality and plaque delineation score between low and high BMI groups within same reconstruction (all P>0.05). Significant differences in image quality and plaque delineation scores among different image reconstructions both in low and high BMI groups (all P<0.001) were found. I4f revealed the highest image quality and plaque delineation score. Conclusions IR offers improved image quality and non-calcified plaque delineation as compared with FBP, especially if BMI is increasing. Importantly, 18% of non-calcified plaques were missed with FBP. IR-4 shows the best image quality score and plaque delineation score among the different IR-filter strength. PMID:25984450

  10. Dataset of calcified plaque condition in the stenotic coronary artery lesion obtained using multidetector computed tomography to indicate the addition of rotational atherectomy during percutaneous coronary intervention

    PubMed Central

    Akutsu, Yasushi; Hamazaki, Yuji; Sekimoto, Teruo; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Suyama, Jumpei; Gokan, Takehiko; Sakai, Koshiro; Kosaki, Ryota; Yokota, Hiroyuki; Tsujita, Hiroaki; Tsukamoto, Shigeto; Sakurai, Masayuki; Sambe, Takehiko; Oguchi, Katsuji; Uchida, Naoki; Kobayashi, Shinichi; Aoki, Atsushi; Kobayashi, Youichi

    2016-01-01

    Our data shows the regional coronary artery calcium scores (lesion CAC) on multidetector computed tomography (MDCT) and the cross-section imaging on MDCT angiography (CTA) in the target lesion of the patients with stable angina pectoris who were scheduled for percutaneous coronary intervention (PCI). CAC and CTA data were measured using a 128-slice scanner (Somatom Definition AS+; Siemens Medical Solutions, Forchheim, Germany) before PCI. CAC was measured in a non-contrast-enhanced scan and was quantified using the Calcium Score module of SYNAPSE VINCENT software (Fujifilm Co. Tokyo, Japan) and expressed in Agatston units. CTA were then continued with a contrast-enhanced ECG gating to measure the severity of the calcified plaque condition. We present that both CAC and CTA data are used as a benchmark to consider the addition of rotational atherectomy during PCI to severely calcified plaque lesions. PMID:26977441

  11. Dataset of calcified plaque condition in the stenotic coronary artery lesion obtained using multidetector computed tomography to indicate the addition of rotational atherectomy during percutaneous coronary intervention.

    PubMed

    Akutsu, Yasushi; Hamazaki, Yuji; Sekimoto, Teruo; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Suyama, Jumpei; Gokan, Takehiko; Sakai, Koshiro; Kosaki, Ryota; Yokota, Hiroyuki; Tsujita, Hiroaki; Tsukamoto, Shigeto; Sakurai, Masayuki; Sambe, Takehiko; Oguchi, Katsuji; Uchida, Naoki; Kobayashi, Shinichi; Aoki, Atsushi; Kobayashi, Youichi

    2016-06-01

    Our data shows the regional coronary artery calcium scores (lesion CAC) on multidetector computed tomography (MDCT) and the cross-section imaging on MDCT angiography (CTA) in the target lesion of the patients with stable angina pectoris who were scheduled for percutaneous coronary intervention (PCI). CAC and CTA data were measured using a 128-slice scanner (Somatom Definition AS+; Siemens Medical Solutions, Forchheim, Germany) before PCI. CAC was measured in a non-contrast-enhanced scan and was quantified using the Calcium Score module of SYNAPSE VINCENT software (Fujifilm Co. Tokyo, Japan) and expressed in Agatston units. CTA were then continued with a contrast-enhanced ECG gating to measure the severity of the calcified plaque condition. We present that both CAC and CTA data are used as a benchmark to consider the addition of rotational atherectomy during PCI to severely calcified plaque lesions. PMID:26977441

  12. Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions.

    PubMed

    Adler, Christina J; Dobney, Keith; Weyrich, Laura S; Kaidonis, John; Walker, Alan W; Haak, Wolfgang; Bradshaw, Corey J A; Townsend, Grant; So?tysiak, Arkadiusz; Alt, Kurt W; Parkhill, Julian; Cooper, Alan

    2013-04-01

    The importance of commensal microbes for human health is increasingly recognized, yet the impacts of evolutionary changes in human diet and culture on commensal microbiota remain almost unknown. Two of the greatest dietary shifts in human evolution involved the adoption of carbohydrate-rich Neolithic (farming) diets (beginning ?10,000 years before the present) and the more recent advent of industrially processed flour and sugar (in ?1850). Here, we show that calcified dental plaque (dental calculus) on ancient teeth preserves a detailed genetic record throughout this period. Data from 34 early European skeletons indicate that the transition from hunter-gatherer to farming shifted the oral microbial community to a disease-associated configuration. The composition of oral microbiota remained unexpectedly constant between Neolithic and medieval times, after which (the now ubiquitous) cariogenic bacteria became dominant, apparently during the Industrial Revolution. Modern oral microbiotic ecosystems are markedly less diverse than historic populations, which might be contributing to chronic oral (and other) disease in postindustrial lifestyles. PMID:23416520

  13. Contrast-enhanced MR imaging of atherosclerosis using citrate-coated superparamagnetic iron oxide nanoparticles: calcifying microvesicles as imaging target for plaque characterization

    PubMed Central

    Wagner, Susanne; Schnorr, Jrg; Ludwig, Antje; Stangl, Verena; Ebert, Monika; Hamm, Bernd; Taupitz, Matthias

    2013-01-01

    Objective To evaluate the suitability of citrate-coated very small superparamagnetic iron oxide particles (VSOP) as a contrast agent for identifying inflammation in atherosclerotic lesions using magnetic resonance imaging (MRI). Methods and results VSOP, which have already been evaluated as a blood pool contrast agent for MR angiography in human clinical trials, were investigated in Watanabe heritable hyper-lipidemic rabbits to determine to what extent their accumulation in atherosclerotic lesions is a function of macrophage density and other characteristics of progressive atherosclerotic plaques. In advanced atherosclerotic lesions, a significant MRI signal loss was found within 1 hour after intravenous administration of VSOP at the intended clinical dose of 0.05 mmol Fe/kg. Histological examinations confirmed correlations between the loss of MRI signal in the vessel wall and the presence of Prussian blue-stained iron colocalized with macrophages in the plaque cap, but surprisingly also with calcifying microvesicles at the intimomedial interface. Critical electrolyte magnesium chloride concentration in combination with Alcian blue stain indicates that highly sulfated glycosaminoglycans are a major constituent of these calcifying microvesicles, which may serve as the key molecules for binding VSOP due to their highly complexing properties. Conclusion Calcifying microvesicles and macrophages are the targets for intravenously injected VSOP in atherosclerotic plaques, suggesting that VSOP-enhanced MRI may render clinically relevant information on the composition and inflammatory activity of progressive atherosclerotic lesions at risk of destabilization. PMID:23450179

  14. Pleural plaques related to “take-home” exposure to asbestos: An international case series

    PubMed Central

    Peretz, Alon; Van Hee, Victor C; Kramer, Mordechai R; Pitlik, Silvio; Keifer, Matthew C

    2008-01-01

    Context: While a large number of studies indicate the risks of high-level exposures to asbestos in the workplace setting, a relatively small number of studies describe the risk of pleural disease related to “take-home” asbestos brought into the household by workers exposed to asbestos. Consequently, the risk of pleural disease in family members of asbestos-exposed workers is likely underappreciated. Case presentations: Two families of siblings, one in Israel and one in the US, were evaluated because of their significant exposures to asbestos brought into the home by family members with heavy occupational exposures. Two of the four children of an asbestos cement debagger in Petach Tikvah, Israel and two children of a pipe lagger in a naval shipyard near Seattle, Washington, manifested benign pleural disease without parenchymal disease, despite having no occupational exposure to asbestos. Discussion: These cases illustrate that “take-home” asbestos exposure may lead to pleural disease at higher rates than commonly realized. Relevance to clinical practice: Providers should recognize that due to the potential for “take-home” exposures, asbestos-related disease in a patient may be a marker for disease in household contacts. Patients with family members heavily exposed to asbestos should be strongly encouraged to quit smoking in an effort to reduce any further carcinogenic exposures. Additionally, workplace control and regulation of asbestos use should be emphasized to protect both workers and their families. PMID:20428401

  15. Association of egg consumption and calcified atherosclerotic plaque in the coronary arteries: the NHLBI Family Heart Study

    PubMed Central

    Robbins, Jeremy M.; Petrone, Andrew B.; Ellison, R. Curtis; Hunt, Steven C.; Carr, J. Jeffrey; Heiss, Gerardo; Arnett, Donna K.; Gaziano, J. Michael; Djoussé, Luc

    2015-01-01

    Background and Aims Eggs are a ubiquitous and important source of dietary cholesterol and nutrients, yet their relationship to coronary heart disease (CHD) remains unclear. While some data have suggested a positive association between egg consumption and CHD, especially among diabetic subjects, limited data exist on the influence of egg consumption on subclinical disease. Thus, we sought to examine whether egg consumption is associated with calcified atherosclerotic plaques in the coronary arteries. Methods In a cross-sectional design, we studied 1848 participants of the NHLBI Family Heart Study without known CHD. Egg consumption was assessed by a semi-quantitative food frequency questionnaire and coronary-artery calcium (CAC) was measured by cardiac CT. We defined prevalent CAC using an Agatston score of at least 100 and fitted generalized estimating equations to calculate prevalence odds ratios of CAC. Results Mean age was 56.5 years and 41% were male. Median consumption of eggs was 1/week. There was no association between frequency of egg consumption and prevalent CAC. Odds ratios (95% CI) for CAC were 1.0 (reference), 0.95 (0.66-1.38), 0.94 (0.63-1.40), and 0.90 (0.57-1.42) for egg consumption of almost never, 1-3 times per month, once per week, and 2+ times per week, respectively (p for trend 0.66), adjusting for age, sex, BMI, smoking, alcohol, physical activity, income, field center, total calories, and bacon. Additional control for hypertension and diabetes mellitus, or restricting the analysis to subjects with diabetes mellitus or fasting glucose >126 mg/dL did not alter the findings. Conclusions These data do not provide evidence for an association between egg consumption and prevalent CAC in adult men and women. PMID:25642410

  16. Quantitative analysis of arterial flow properties for detection of non-calcified plaques in ECG-gated coronary CT angiography

    NASA Astrophysics Data System (ADS)

    Wei, Jun; Zhou, Chuan; Chan, Heang-Ping; Chughtai, Aamer; Agarwal, Prachi; Kuriakose, Jean; Hadjiiski, Lubomir; Patel, Smita; Kazerooni, Ella

    2015-03-01

    We are developing a computer-aided detection system to assist radiologists in detection of non-calcified plaques (NCPs) in coronary CT angiograms (cCTA). In this study, we performed quantitative analysis of arterial flow properties in each vessel branch and extracted flow information to differentiate the presence and absence of stenosis in a vessel segment. Under rest conditions, blood flow in a single vessel branch was assumed to follow Poiseuille's law. For a uniform pressure distribution, two quantitative flow features, the normalized arterial compliance per unit length (Cu) and the normalized volumetric flow (Q) along the vessel centerline, were calculated based on the parabolic Poiseuille solution. The flow features were evaluated for a two-class classification task to differentiate NCP candidates obtained by prescreening as true NCPs and false positives (FPs) in cCTA. For evaluation, a data set of 83 cCTA scans was retrospectively collected from 83 patient files with IRB approval. A total of 118 NCPs were identified by experienced cardiothoracic radiologists. The correlation between the two flow features was 0.32. The discriminatory ability of the flow features evaluated as the area under the ROC curve (AUC) was 0.65 for Cu and 0.63 for Q in comparison with AUCs of 0.56-0.69 from our previous luminal features. With stepwise LDA feature selection, volumetric flow (Q) was selected in addition to three other luminal features. With FROC analysis, the test results indicated a reduction of the FP rates to 3.14, 1.98, and 1.32 FPs/scan at sensitivities of 90%, 80%, and 70%, respectively. The study indicated that quantitative blood flow analysis has the potential to provide useful features for the detection of NCPs in cCTA.

  17. Computerized method for evaluating diagnostic image quality of calcified plaque images in cardiac CT: Validation on a physical dynamic cardiac phantom

    SciTech Connect

    King, Martin; Rodgers, Zachary; Giger, Maryellen L.; Bardo, Dianna M. E.; Patel, Amit R.

    2010-11-15

    Purpose: In cardiac computed tomography (CT), important clinical indices, such as the coronary calcium score and the percentage of coronary artery stenosis, are often adversely affected by motion artifacts. As a result, the expert observer must decide whether or not to use these indices during image interpretation. Computerized methods potentially can be used to assist in these decisions. In a previous study, an artificial neural network (ANN) regression model provided assessability (image quality) indices of calcified plaque images from the software NCAT phantom that were highly agreeable with those provided by expert observers. The method predicted assessability indices based on computer-extracted features of the plaque. In the current study, the ANN-predicted assessability indices were used to identify calcified plaque images with diagnostic calcium scores (based on mass) from a physical dynamic cardiac phantom. The basic assumption was that better quality images were associated with more accurate calcium scores. Methods: A 64-channel CT scanner was used to obtain 500 calcified plaque images from a physical dynamic cardiac phantom at different heart rates, cardiac phases, and plaque locations. Two expert observers independently provided separate sets of assessability indices for each of these images. Separate sets of ANN-predicted assessability indices tailored to each observer were then generated within the framework of a bootstrap resampling scheme. For each resampling iteration, the absolute calcium score error between the calcium scores of the motion-contaminated plaque image and its corresponding stationary image served as the ground truth in terms of indicating images with diagnostic calcium scores. The performances of the ANN-predicted and observer-assigned indices in identifying images with diagnostic calcium scores were then evaluated using ROC analysis. Results: Assessability indices provided by the first observer and the corresponding ANN performed similarly (AUC{sub OBS1}=0.80 [0.73,0.86] vs AUC{sub ANN1}=0.88 [0.82,0.92]) as that of the second observer and the corresponding ANN (AUC{sub OBS2}=0.87 [0.83,0.91] vs AUC{sub ANN2}=0.90 [0.85,0.94]). Moreover, the ANN-predicted indices were generated in a fraction of the time required to obtain the observer-assigned indices. Conclusions: ANN-predicted assessability indices performed similar to observer-assigned assessability indices in identifying images with diagnostic calcium scores from the physical dynamic cardiac phantom. The results of this study demonstrate the potential of using computerized methods for identifying images with diagnostic clinical indices in cardiac CT images.

  18. Impact of cardiovascular risk factors on vessel wall inflammation and calcified plaque burden differs across vascular beds: a PET-CT study.

    PubMed

    Strobl, Frederik F; Rominger, Axel; Wolpers, Sarah; Rist, Carsten; Bamberg, Fabian; Thierfelder, Kolja M; Nikolaou, Konstantin; Uebleis, Christopher; Hacker, Marcus; Reiser, Maximilian F; Saam, Tobias

    2013-12-01

    To evaluate the effect of age, gender and cardiovascular risk factors on vessel wall inflammation and the calcified plaque burden in different vascular beds as assessed by PET/CT. 315 patients (mean age: 57.8years, 123 male and 192 female) who underwent whole body 18F-FDG PET/CT examinations were included in the study. Blood pool-corrected standardised uptake value (TBR) and the calcified plaque score (CPS, grade 0-4) were determined in the thoracic and abdominal aorta, both common carotid and both iliac arteries. The following cardiovascular risk factors were documented: Age ?65years (n=114), male gender (n=123), diabetes (n=15), hyperlipidemia (n=62), hypertension (n=76), body mass index (BMI)?30 (n=38), current smoker (n=32). Effects of risk factors on TBR and CPS in different arterial beds were assessed using multivariate regression analysis. In the thoracic aorta TBR was independently associated with age ?65years and male gender, CPS was independently associated with age ?65years, male gender, hypertension and diabetes. In the abdominal aorta, TBR was independently associated with age ?65years and male gender, CPS with age ?65years, diabetes and smoking. Independent associations in the carotid arteries were found for age ?65years, male gender and BMI?30 in TBR and for age ?65 and diabetes in CPS. In the iliac arteries, TBR was independently associated with age ?65 and CPS with age ?65, male gender, hypertension, diabetes and smoking. Findings of this PET/CT study demonstrate that the impact of cardiovascular risk factors on vessel wall inflammation and calcified plaque burden differs across vascular territories. Overall, CPS was more closely associated with cardiovascular risk factors compared to TBR. PMID:23979062

  19. CT findings in malignant pleural mesothelioma related to nonoccupational exposure to asbestos and fibrous zeolite (erionite)

    SciTech Connect

    Erzen, C.; Eryilmaz, M.; Kalyoncu, F.; Bilir, N.; Sahin, A.; Baris, Y.I. )

    1991-03-01

    Endemic malignant pleural mesothelioma (MPM) in Turkey is related to two mineral fibers, tremolite asbestos and fibrous zeolite (erionite). Thirteen cases of MPM from the Cappadocian area, where the soil is rich in erionite, and 29 cases of MPM, from villages whose occupants have high asbestos exposure, were examined by CT. The CT findings of the two groups of MPM were compared with respect to the configuration of the pleural lesions, stage of disease, fissural involvement, pleural effusion, presence of calcified pleural plaques, and chronic fibrosing pleuritis. In erionite-related MPM the pleural lesions were flat and smooth in 69.1%; in asbestos-related MPM the lesions were nodular in 55.1%. Stage IV disease, calcified pleural plaques, and chronic fibrosing pleuritis were more common in the erionite-related MPM. The rest of the findings were similar in both groups. The early radiological diagnosis of erionite-related MPM may be even more difficult because of the similarity of the pleural lesions to chronic fibrosing pleuritis.

  20. Influence of trigger type, tube voltage and heart rate on calcified plaque imaging in dual source cardiac computed tomography: phantom study

    PubMed Central

    2014-01-01

    Background To investigate the impact of high pitch cardiac CT vs. retrospective ECG gated CT on the quantification of calcified vessel stenoses, with assessment of the influence of tube voltage, reconstruction kernel and heart rate. Methods A 4D cardiac movement phantom equipped with three different plaque phantoms (12.5%, 25% and 50% stenosis at different calcification levels), was scanned with a 128-row dual source CT scanner, applying different trigger types (gated vs. prospectively triggered high pitch), tube voltages (100-120kV) and heart rates (5090 beats per minute, bpm). Images were reconstructed using different standard (B26f, B46f, B70f) and iterative (I26f, I70f) convolution kernels. Absolute and relative plaque sizes were measured and statistically compared. Radiation dose associated with the different methods (gated vs. high pitch, 100kV vs. 120kV) were compared. Results Compared to the known diameters of the phantom plaques and vessels both CT-examination techniques overestimated the degrees of stenoses. Using the high pitch CT-protocol plaques appeared larger (0.09??0.31mm, 2??8 percent points, PP) in comparison to the ECG-gated CT-scans. Reducing tube voltage had a similar effect, resulting in higher grading of the same stenoses by 3??8 PP. In turn, sharper convolution kernels lead to a lower grading of stenoses (differences of up to 5%). Pairwise comparison of B26f and I26f, B46f and B70f, and B70f and I70f showed differences of 01??68 PP of the plaque depiction. Motion artifacts were present only at 90bpm high pitch experiments. High-pitch protocols were associated with significantly lower radiation doses compared with the ECG-gated protocols (258.0mGy vs. 2829.8mGy CTDIvol, p???0.0001). Conclusion Prospectively triggered high-pitch cardiac CT led to an overestimation of plaque diameter and degree of stenoses in a coronary phantom. This overestimation is only slight and probably negligible in a clinical situation. Even at higher heart rates high pitch CT-scanning allowed reliable measurements of plaque and vessel diameters with only slight differences compared ECG-gated protocols, although motion artifacts were present at 90bpm using the high pitch protocols. PMID:25178653

  1. Successful rotational atherectomy for a repetitive restenosis lesion with underexpansion of double layer drug-eluting stents due to heavily calcified plaque.

    PubMed

    Kawata, Masahito; Kato, Yukinori; Takada, Hiroki; Kamemura, Kohei; Matsuura, Akira; Sakamoto, Susumu

    2016-01-01

    A 72-year-old male was treated. First percutaneous coronary intervention (PCI) for chronic total occlusion of proximal left anterior descending artery was performed after rotational atherectomy with 1.5-mm burr. Focal underexpansion of Promus stent occurred due to the heavily calcified plaque. After first restenosis, OCT-guided PCI was performed with 26atm balloon dilatation. After second restenosis, Resolute Integrity was implanted. After third restenosis, rotational atherectomy with 1.5-, 1.75- and 2.15-mm burrs was performed. All stent struts disappeared at the lesion and Promus Element was implanted. No restenosis occurred after 6months. Cautious rotational atherectomy could ablate double layer drug-eluting stents effectively. PMID:25666528

  2. [Calcifying panniculitis].

    PubMed

    Buchet, S; Blanc, D; Humbert, P; Derancourt, C; Arbey-Gindre, F; Atallah, L; Agache, P

    1992-01-01

    We report a case of calcifying panniculitis which occurred in a 67-year old woman suffering from chronic renal failure and primarily involved anticoagulant injection sites. Calcifying panniculitis is a rare condition belonging to the spectrum of calciphylaxis first described by Selye in 1962. This disease seems to imply necessarily a specific morbid background including renal failure together with calcium-phosphate metabolism impairment. Following the action of a so-called "challenger" (in the present case calcium heparinate [Calciparine], a subcutaneously administered anticoagulant drug), the lesions start as painful subcutaneous nodules soon turning into plaques of necrosis. The area involved mainly includes the abdomen and thighs, due to the preferential distribution of fat and the classical use of such regions for subcutaneous injections. In our patients, histological examination disclosed an initial involvement of subcutaneous fat vessels mimicking mediacalcosis, soon followed by calcium-phosphate deposits within interadipocyte spaces. An electron microscopy study confirmed the presence of calcium crystals within the cytoplasms of some connective tissue cells and the extracellular matrix. From a review of the literature, it seems reasonable to normalize the calcium-phosphate product by reducing hyperparathyroidism as a first therapeutic step. Then, wide surgical excision of the necrotic areas should be performed to rule out any possibility of self worsening of the lesions and provide the best chance of healing without superinfection. The use of diphosphonates on pathophysiological grounds is discussed. PMID:1285593

  3. Calcified lesion modeling for excimer laser ablation

    NASA Astrophysics Data System (ADS)

    Scott, Holly A.; Archuleta, Andrew; Splinter, Robert

    2009-06-01

    Objective: Develop a representative calcium target model to evaluate penetration of calcified plaque lesions during atherectomy procedures using 308 nm Excimer laser ablation. Materials and Methods: An in-vitro model representing human calcified plaque was analyzed using Plaster-of-Paris and cement based composite materials as well as a fibrinogen model. The materials were tested for mechanical consistency. The most likely candidate(s) resulting from initial mechanical and chemical screening was submitted for ablation testing. The penetration rate of specific multi-fiber catheter designs and a single fiber probe was obtained and compared to that in human cadaver calcified plaque. The effects of lasing parameters and catheter tip design on penetration speed in a representative calcified model were verified against the results in human cadaver specimens. Results: In Plaster of Paris, the best penetration was obtained using the single fiber tip configuration operating at 100 Fluence, 120 Hz. Calcified human lesions are twice as hard, twice as elastic as and much more complex than Plaster of Paris. Penetration of human calcified specimens was highly inconsistent and varied significantly from specimen to specimen and within individual specimens. Conclusions: Although Plaster of Paris demonstrated predictable increases in penetration with higher energy density and repetition rate, it can not be considered a totally representative laser ablation model for calcified lesions. This is in part due to the more heterogeneous nature and higher density composition of cadaver intravascular human calcified occlusions. Further testing will require a more representative model of human calcified lesions.

  4. Calcifying nanoparticles associated encrusted urinary bladder cystitis.

    PubMed

    Jelic, Tomislav M; Roque, Rod; Yasar, Uzay; Tomchin, Shayna B; Serrato, Jose M; Deem, Samuel G; Tierney, James P; Chang, Ho-Huang

    2008-01-01

    Encrusted cystitis is a subtype of chronic cystitis characterized by multiple calcifications in the form of plaques located in the interstitium of the urinary bladder mucosa and frequently associated with mucosal ulcers. It is a very rare disease of controversial etiology. Our transmission electron microscopy of the calcified plaques of encrusted cystitis has revealed that the smallest formed particles (elementary units) of these calcifications are electron-dense shells surrounding an electron lucent core, diagnostic of calcifying nanoparticles (previously called nanobacteria). We pioneer the notion that calcifying nanoparticles are the causative agents of encrusted urinary bladder cystitis. PMID:18990947

  5. [Calcified parotiditis].

    PubMed

    Laudenbach, P

    1975-06-01

    Six cases of parotiditis with multiple concretions clearly seen on X-rays in front view and without contrast, and associated with parenchymatous cavitation, have led us to suggest the concept of calcified parotiditis. The process was seen to be bilateral each time such an eventuality was sought. Histological examination confirmed that the calcifications were situated in the small efferent canals and provides evidence in favour of the similarity between such forms of parotiditis and calcified pancreatitis. As with pancreatitis, it is difficult to say whether such calcifications are responsible for ascending infection or if they result from it. PMID:1057233

  6. [Pleural lymphatics and pleural diseases related to fibres].

    PubMed

    Fleury Feith, J; Jaurand, M-C

    2013-12-01

    It is now well established that some pleural diseases, pleural plaques and malignant mesothelioma are related to asbestos fibre exposure although the mechanism of action of asbestos fibres is not fully understood. The development of artificial mineral fibres and carbon nanotubes, which share some morphological characteristics similar to asbestos fibres, is a present concern in the context of pleural diseases. Pleural plaques develop only in the parietal pleura, and in the 1990s, clinical observations have shown that the early development of mesothelioma also occurred on the parietal pleura. The peculiarity of the parietal pleura in contrast to the visceral pleura is the presence of "stomas" which are communication holes between the pleural cavity and the parietal pleura lymphatics. Morphological observations by thoracoscopy and experimental studies have shown that inhaled fibres translocate to the pleural space and, in human, are present in the parietal pleura at specific anthracotic areas (blackspots). Fibres accumulate on the stomas, up to block and locally induce an inflammatory reaction with cytokines release, that can be the bed of mesothelioma. However, despite the experimental data and observations in human pathology, the mechanisms of fibre translocation into the pleura is not yet clearly established. PMID:24210155

  7. Pleural effusion

    MedlinePLUS

    ... to congestive heart failure, you may receive diuretics (water pills) and other medications to treat heart failure. Pleural effusion caused by infection is treated with antibiotics. In people with cancer or infection, ...

  8. Pleural Disorders

    MedlinePLUS

    ... in and out. Disorders of the pleura include Pleurisy - inflammation of the pleura that causes sharp pain ... Viral infection is the most common cause of pleurisy. The most common cause of pleural effusion is ...

  9. Calcification as a sign of sarcomatous degeneration of malignant pleural mesotheliomas: A new CT finding

    SciTech Connect

    Raizon, A.; Schwartz, A.; Hix, W.; Rockoff, S.D.

    1996-01-01

    We present two cases demonstrating, on CT examination, heavily calcified mass lesions associated with malignant pleural mesothelioma in workers occupationally exposed to asbestos. These masses proved to be osteogenic sarcomatous degeneration within mesotheliomas. The observation of dense calcification within a pleural mass should raise a suspicion of osteosarcomatous degeneration if it is seen in conjunction with other classic signs of malignant pleural mesothelioma. 8 refs., 5 figs.

  10. Pleural fluid smear

    MedlinePLUS

    ... the fluid that has collected in the pleural space. This is the space between the lining of the outside of the ... the chest. When fluid collects in the pleural space, the condition is called pleural effusion .

  11. Pleural fluid analysis

    MedlinePLUS

    ... of fluid that has collected in the pleural space. This is the space between the lining of the outside of the ... the chest. When fluid collects in the pleural space, the condition is called pleural effusion .

  12. Disseminated Pleural Siliconoma Mimicking Malignant Pleural Mesothelioma.

    PubMed

    Tanaka, Toshiki; Tao, Hiroyuki; Hayashi, Tatsuro; Yoshiyama, Koichi; Furukawa, Masashi; Yoshida, Kumiko; Okabe, Kazunori

    2015-12-01

    A 48-year-old woman with a 3-month history of back pain was admitted for further examination of multiple left pleural nodules. She had undergone bilateral breast augmentation with silicone implants 10 years previously. Nine years after the operation, both ruptured implants were removed, and autologous fat was injected. Computed tomography revealed multiple pleural nodules suggestive of malignant pleural mesothelioma. Thoracoscopic exploration revealed multiple pleural nodules with massive pleural adhesions. The nodules were filled with viscous liquid and were histologically determined to be siliconomas. Disseminated pleural siliconoma should be recognized as a late adverse event of silicone breast implantation. PMID:26652527

  13. Successful penetration and bougie dilatation with Brockenbrough needle for severely calcified occlusion in superficial femoral artery.

    PubMed

    Makita, Toshio; Suzuki, Kenji; Takizawa, Kaname; Ootomo, Tatsushi; Inoue, Naoto; Meguro, Taiichirou

    2014-04-01

    A 75-year-old hemodialysis patient with right critical limb ischemia received endovascular therapy for a chronic total occlusion (CTO) in a diffusely calcified superficial femoral artery (SFA). During a retrograde approach, a Brockenbrough needle (BN) was able to penetrate the calcified hard plaque formed in the middle segment of the CTO. Moreover, bougie dilatation with the BN allowed balloon crossing and stent deployment, even after failure to pass a 2.0-mm monorail balloon across the plaque. These results suggest that the BN offers a new therapeutic option in the penetration and modification of severely calcified CTO in SFA. PMID:23979907

  14. Detection, modeling and matching of pleural thickenings from CT data towards an early diagnosis of malignant pleural mesothelioma

    NASA Astrophysics Data System (ADS)

    Chaisaowong, Kraisorn; Kraus, Thomas

    2014-03-01

    Pleural thickenings can be caused by asbestos exposure and may evolve into malignant pleural mesothelioma. While an early diagnosis plays the key role to an early treatment, and therefore helping to reduce morbidity, the growth rate of a pleural thickening can be in turn essential evidence to an early diagnosis of the pleural mesothelioma. The detection of pleural thickenings is today done by a visual inspection of CT data, which is time-consuming and underlies the physician's subjective judgment. Computer-assisted diagnosis systems to automatically assess pleural mesothelioma have been reported worldwide. But in this paper, an image analysis pipeline to automatically detect pleural thickenings and measure their volume is described. We first delineate automatically the pleural contour in the CT images. An adaptive surface-base smoothing technique is then applied to the pleural contours to identify all potential thickenings. A following tissue-specific topology-oriented detection based on a probabilistic Hounsfield Unit model of pleural plaques specify then the genuine pleural thickenings among them. The assessment of the detected pleural thickenings is based on the volumetry of the 3D model, created by mesh construction algorithm followed by Laplace-Beltrami eigenfunction expansion surface smoothing technique. Finally, the spatiotemporal matching of pleural thickenings from consecutive CT data is carried out based on the semi-automatic lung registration towards the assessment of its growth rate. With these methods, a new computer-assisted diagnosis system is presented in order to assure a precise and reproducible assessment of pleural thickenings towards the diagnosis of the pleural mesothelioma in its early stage.

  15. Clinical Investigation of Benign Asbestos Pleural Effusion

    PubMed Central

    Fujimoto, Nobukazu; Gemba, Kenichi; Aoe, Keisuke; Kato, Katsuya; Yokoyama, Takako; Usami, Ikuji; Onishi, Kazuo; Mizuhashi, Keiichi; Yusa, Toshikazu; Kishimoto, Takumi

    2015-01-01

    There is no detailed information about benign asbestos pleural effusion (BAPE). The aim of the study was to clarify the clinical features of BAPE. The criteria of enrolled patients were as follows: (1) history of asbestos exposure; (2) presence of pleural effusion determined by chest X-ray, CT, and thoracentesis; and (3) the absence of other causes of effusion. Clinical information was retrospectively analysed and the radiological images were reviewed. There were 110 BAPE patients between 1991 and 2012. All were males and the median age at diagnosis was 74 years. The median duration of asbestos exposure and period of latency for disease onset of BAPE were 31 and 48 years, respectively. Mean values of hyaluronic acid, adenosine deaminase, and carcinoembryonic antigen in the pleural fluid were 39,840?ng/mL, 23.9?IU/L, and 1.8?ng/mL, respectively. Pleural plaques were detected in 98 cases (89.1%). Asbestosis was present in 6 (5.5%) cases, rounded atelectasis was detected in 41 (37.3%) cases, and diffuse pleural thickening (DPT) was detected in 30 (27.3%) cases. One case developed lung cancer (LC) before and after BAPE. None of the cases developed malignant pleural mesothelioma (MPM) during the follow-up. PMID:26689234

  16. Metastatic pleural tumor

    MedlinePLUS

    ... Pleural fluid analysis Pleural needle biopsy Removal of fluid from around the lungs ( thoracentesis ) ... tumors usually cannot be removed with surgery. The original ... lot of fluid collecting around your lungs and you have shortness ...

  17. Asbestos induced diffuse pleural fibrosis: pathology and mineralogy.

    PubMed Central

    Stephens, M; Gibbs, A R; Pooley, F D; Wagner, J C

    1987-01-01

    Lungs from seven cases of diffuse pleural fibrosis with known asbestos exposure were studied to determine the gross and microscopic pathological features and relate these to the analysed mineral fibre content of the lung. All seven individuals had had substantial exposure, ranging from two to 25 years, and chronic chest problems and at necropsy all cases met the criteria for compensatable disease. Macroscopically, all had extensive visceral pleural fibrosis and extensive areas of adhesions, and four also had discrete parietal pleural plaques. The histological features were similar in all the cases--most strikingly the basket weave pattern of the thickened pleura and a dense subpleural parenchymal interstitial fibrosis with fine honeycombing, extending up to 1 cm into the underlying lung. The similar histological appearances raise the possibility that diffuse pleural fibrosis and pleural plaques have a similar pathogenesis. Amphibole asbestos (crocidolite and amosite) counts were high in six of the seven cases and chrysotile counts in four; four cases had high mullite counts, but the importance of this is not known. It is concluded that diffuse pleural fibrosis is a specific asbestos associated entity, of uncertain pathogenesis, with mineral fibre counts falling between those found with plaques and those in minimal asbestosis. Images PMID:3660310

  18. Automated coronary CT angiography plaque-lumen segmentation

    NASA Astrophysics Data System (ADS)

    Cline, Harvey E.; Krishnan, Karthik; Napel, Sandy; Rubin, Geoffrey D.; Turner, Wesley D.; Avila, Ricardo S.

    2009-02-01

    We are investigating the feasibility of a computer-aided detection (CAD) system to assist radiologists in diagnosing coronary artery disease in ECG gated cardiac multi-detector CT scans having calcified plaque. Coronary artery stenosis analysis is challenging if calcified plaque or the iodinated blood pool hides viable lumen. The research described herein provides an improved presentation to the radiologist by removing obscuring calcified plaque and blood pool. The algorithm derives a Gaussian estimate of the point spread function (PSF) of the scanner responsible for plaque blooming by fitting measured CTA image profiles. An initial estimate of the extent of calcified plaque is obtained from the image evidence using a simple threshold. The Gaussian PSF estimate is then convolved with the initial plaque estimate to obtain an estimate of the extent of the blooming artifact and this plaque blooming image is subtracted from the CT image to obtain an image largely free of obscuring plaque. In a separate step, the obscuring blood pool is suppressed using morphological operations and adaptive region growing. After processing by our algorithm, we are able to project the segmented plaque-free lumen to form synthetic angiograms free from obstruction. We can also analyze the coronary arteries with vessel tracking and centerline extraction to produce cross sectional images for measuring lumen stenosis. As an additional aid to radiologists, we also produce plots of calcified plaque and lumen cross-sectional area along selected blood vessels. The method was validated using digital phantoms and actual patient data, including in one case, a validation against the results of a catheter angiogram.

  19. Ultrasound Tissue Characterization of Vulnerable Atherosclerotic Plaque

    PubMed Central

    Picano, Eugenio; Paterni, Marco

    2015-01-01

    A thrombotic occlusion of the vessel fed by ruptured coronary atherosclerotic plaque may result in unstable angina, myocardial infarction or death, whereas embolization from a plaque in carotid arteries may result in transient ischemic attack or stroke. The atherosclerotic plaque prone to such clinical events is termed high-risk or vulnerable plaque, and its identification in humans before it becomes symptomatic has been elusive to date. Ultrasonic tissue characterization of the atherosclerotic plaque is possible with different techniquessuch as vascular, transesophageal, and intravascular ultrasoundon a variety of arterial segments, including carotid, aorta, and coronary districts. The image analysis can be based on visual, video-densitometric or radiofrequency methods and identifies three distinct textural patterns: hypo-echoic (corresponding to lipid- and hemorrhage-rich plaque), iso- or moderately hyper-echoic (fibrotic or fibro-fatty plaque), and markedly hyperechoic with shadowing (calcific plaque). Hypoechoic or dishomogeneous plaques, with spotty microcalcification and large plaque burden, with plaque neovascularization and surface irregularities by contrast-enhanced ultrasound, are more prone to clinical complications than hyperechoic, extensively calcified, homogeneous plaques with limited plaque burden, smooth luminal plaque surface and absence of neovascularization. Plaque ultrasound morphology is important, along with plaque geometry, in determining the atherosclerotic prognostic burden in the individual patient. New quantitative methods beyond backscatter (to include speed of sound, attenuation, strain, temperature, and high order statistics) are under development to evaluate vascular tissues. Although not yet ready for widespread clinical use, tissue characterization is listed by the American Society of Echocardiography roadmap to 2020 as one of the most promising fields of application in cardiovascular ultrasound imaging, offering unique opportunities for the early detection and treatment of atherosclerotic disease. PMID:25950760

  20. Ultrasound tissue characterization of vulnerable atherosclerotic plaque.

    PubMed

    Picano, Eugenio; Paterni, Marco

    2015-01-01

    A thrombotic occlusion of the vessel fed by ruptured coronary atherosclerotic plaque may result in unstable angina, myocardial infarction or death, whereas embolization from a plaque in carotid arteries may result in transient ischemic attack or stroke. The atherosclerotic plaque prone to such clinical events is termed high-risk or vulnerable plaque, and its identification in humans before it becomes symptomatic has been elusive to date. Ultrasonic tissue characterization of the atherosclerotic plaque is possible with different techniques--such as vascular, transesophageal, and intravascular ultrasound--on a variety of arterial segments, including carotid, aorta, and coronary districts. The image analysis can be based on visual, video-densitometric or radiofrequency methods and identifies three distinct textural patterns: hypo-echoic (corresponding to lipid- and hemorrhage-rich plaque), iso- or moderately hyper-echoic (fibrotic or fibro-fatty plaque), and markedly hyperechoic with shadowing (calcific plaque). Hypoechoic or dishomogeneous plaques, with spotty microcalcification and large plaque burden, with plaque neovascularization and surface irregularities by contrast-enhanced ultrasound, are more prone to clinical complications than hyperechoic, extensively calcified, homogeneous plaques with limited plaque burden, smooth luminal plaque surface and absence of neovascularization. Plaque ultrasound morphology is important, along with plaque geometry, in determining the atherosclerotic prognostic burden in the individual patient. New quantitative methods beyond backscatter (to include speed of sound, attenuation, strain, temperature, and high order statistics) are under development to evaluate vascular tissues. Although not yet ready for widespread clinical use, tissue characterization is listed by the American Society of Echocardiography roadmap to 2020 as one of the most promising fields of application in cardiovascular ultrasound imaging, offering unique opportunities for the early detection and treatment of atherosclerotic disease. PMID:25950760

  1. Indwelling pleural catheters for malignant pleural effusion.

    PubMed

    McPhillips, Dympna; Breen, David

    2015-06-01

    Pleural effusions are a common cause of symptoms in patients with malignancy and can adversely affect quality of life. However, not all effusions in the setting of malignancy are due to the cancer itself and therefore it is essential to perform an extensive assessment to diagnose the underlying aetiology. There are a number of treatment options available to manage a malignant effusion and reduce the associated symptomatology. The choice of intervention depends on a number of factors and, in particular, patient preference. In this paper, we will discuss the role of an indwelling pleural catheter in the outpatient management of individuals with malignant effusions. PMID:26126674

  2. A case of multiple pleural cryptococcosis without pleural effusion

    PubMed Central

    Takahagi, Akihiro; Tao, Hiroyuki; Hayashi, Tatsuro; Yoshiyama, Koichi; Furukawa, Masashi; Yoshida, Kumiko; Murakami, Tomoyuki; Okabe, Kazunori

    2015-01-01

    Pulmonary cryptococcosis is most likely to occur in immunocompromised patients. The radiological manifestations generally include pulmonary parenchymal lesions, namely, pulmonary nodules, cavitary lesions, and consolidation; thus, multiple pleural nodules are unusual presentation. Here, we report a woman who presented with multiple pleural cryptococcosis without pleural effusion. The patient had previously undergone surgery for stage II rectal cancer. In addition, she received 6 cycles of chemotherapy for follicular lymphoma. Computed tomography (CT) revealed multiple small nodules involving the pleura without pleural effusion, which suggested possible recurrence of rectal cancer or malignant lymphoma as pleural dissemination. Thoracoscopic examination was performed, and pleural cryptococcosis was diagnosed. Although pleural cryptococcosis without pleural effusion is extremely rare presentation, clinicians should consider it when an immunocompromised patient presents with multiple pleural nodules. Thoracoscopic exploration should be the best procedure for the definitive diagnosis of multiple pleural nodules. PMID:26623138

  3. Focal pleural tumorlike conditions: nodules and masses beyond mesotheliomas and metastasis.

    PubMed

    de Paula, Maria Clara Fernandes; Escuissato, Dante Luiz; Belm, Luciana Camara; Zanetti, Glucia; Souza, Arthur Soares; Hochhegger, Bruno; Nobre, Luiz Felipe; Marchiori, Edson

    2015-10-01

    A tumorlike condition of the pleura is any nonmalignant lesion of the pleura or within the pleural space that could be confused with a pleural tumor on initial imaging. Tumorlike conditions of the pleura are relatively rare compared with neoplastic lesions such as mesotheliomas and metastases. Imaging-based diagnosis of these conditions can be difficult due to the similarity of appearance. Thus, recognition of certain imaging patterns and interpretation of these patterns in the clinical context are important. Pleural endometriosis, thoracic splenosis, thoracolithiasis, foreign bodies, pleural pseudotumors and pleural plaques are significant examples of focal tumorlike conditions discussed in this article. Computed tomography is the mainstay imaging technique for the primary assessment of pleural disease, but other imaging methods, such as magnetic resonance imaging and positron-emission tomography, can be of great support in the diagnosis. PMID:26094051

  4. Simulation of human atherosclerotic femoral plaque tissue: the influence of plaque material model on numerical results

    PubMed Central

    2015-01-01

    Background Due to the limited number of experimental studies that mechanically characterise human atherosclerotic plaque tissue from the femoral arteries, a recent trend has emerged in current literature whereby one set of material data based on aortic plaque tissue is employed to numerically represent diseased femoral artery tissue. This study aims to generate novel vessel-appropriate material models for femoral plaque tissue and assess the influence of using material models based on experimental data generated from aortic plaque testing to represent diseased femoral arterial tissue. Methods Novel material models based on experimental data generated from testing of atherosclerotic femoral artery tissue are developed and a computational analysis of the revascularisation of a quarter model idealised diseased femoral artery from a 90% diameter stenosis to a 10% diameter stenosis is performed using these novel material models. The simulation is also performed using material models based on experimental data obtained from aortic plaque testing in order to examine the effect of employing vessel appropriate material models versus those currently employed in literature to represent femoral plaque tissue. Results Simulations that employ material models based on atherosclerotic aortic tissue exhibit much higher maximum principal stresses within the plaque than simulations that employ material models based on atherosclerotic femoral tissue. Specifically, employing a material model based on calcified aortic tissue, instead of one based on heavily calcified femoral tissue, to represent diseased femoral arterial vessels results in a 487 fold increase in maximum principal stress within the plaque at a depth of 0.8 mm from the lumen. Conclusions Large differences are induced on numerical results as a consequence of employing material models based on aortic plaque, in place of material models based on femoral plaque, to represent a diseased femoral vessel. Due to these large discrepancies, future studies should seek to employ vessel-appropriate material models to simulate the response of diseased femoral tissue in order to obtain the most accurate numerical results. PMID:25602515

  5. Diagnostic Tools of Pleural Effusion

    PubMed Central

    2014-01-01

    Pleural effusion is not a rare disease in Korea. The diagnosis of pleural effusion is very difficult, even though the patients often complain of typical symptoms indicating of pleural diseases. Pleural effusion is characterized by the pleural cavity filled with transudative or exudative pleural fluids, and it is developed by various etiologies. The presence of pleural effusion can be confirmed by radiological studies including simple chest radiography, ultrasonography, or computed tomography. Identifying the causes of pleural effusions by pleural fluid analysis is essential for proper treatments. This review article provides information on the diagnostic approaches of pleural effusions and further suggested ways to confirm their various etiologies, by using the most recent journals for references. PMID:24920946

  6. Pleural fluid Gram stain

    MedlinePLUS

    Gram stain of pleural fluid ... mixing it with a violet stain (called a Gram stain). A laboratory specialist uses a microscope to ... diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. ...

  7. Pleural fluid culture

    MedlinePLUS

    ... cleans the skin around the insertion site. Numbing medicine (anesthetic) is injected into the skin. A needle is placed through the skin and muscles of the chest wall into the space around the lungs, called the pleural space. As ...

  8. Enrichment of calcifying extracellular vesicles using density-based ultracentrifugation protocol

    PubMed Central

    Hutcheson, Joshua D.; Goettsch, Claudia; Pham, Tan; Iwashita, Masaya; Aikawa, Masanori; Singh, Sasha A.; Aikawa, Elena

    2014-01-01

    Calcifying extracellular vesicles (EVs) released from cells within atherosclerotic plaques have received increased attention for their role in mediating vascular calcification, a major predictor of cardiovascular morbidity and mortality. However, little is known about the difference between this pathologic vesicle population and other EVs that contribute to physiological cellular processes. One major challenge that hinders research into these differences is the inability to selectively isolate calcifying EVs from other vesicle populations. In this study, we hypothesized that the formation of mineral within calcifying EVs would increase the density of the vesicles such that they would pellet at a faster rate during ultracentrifugation. We show that after 10 min of ultracentrifugation at 100,000g, calcifying EVs are depleted from the conditioned media of calcifying coronary artery smooth muscle cells and are enriched in the pelleted portion. We utilized mass spectrometry to establish functional proteomic differences between the calcifying EVs enriched in the 10 min ultracentrifugation compared to other vesicle populations preferentially pelleted by longer ultracentrifugation times. The procedures established in this study will allow us to enrich the vesicle population of interest and perform advanced proteomic analyses to find subtle differences between calcifying EVs and other vesicle populations that may be translated into therapeutic targets for vascular calcification. Finally, we will show that the differences in ultracentrifugation times required to pellet the vesicle populations can also be used to estimate physical differences between the vesicles. PMID:25491249

  9. Clinical consequences of asbestos-related diffuse pleural thickening: A review

    PubMed Central

    Miles, Susan E; Sandrini, Alessandra; Johnson, Anthony R; Yates, Deborah H

    2008-01-01

    Asbestos-related diffuse pleural thickening (DPT), or extensive fibrosis of the visceral pleura secondary to asbestos exposure, is increasingly common due to the large number of workers previously exposed to asbestos. It may coexist with asbestos related pleural plaques but has a distinctly different pathology. The pathogenesis of this condition as distinct from pleural plaques is gradually becoming understood. Generation of reactive oxygen and nitrogen species, profibrotic cytokines and growth factors in response to asbestos is likely to play a role in the formation of a fibrinous intrapleural matrix. Benign asbestos related pleural effusions commonly antedate the development of diffuse pleural thickening. Environmental as well as occupational exposure to asbestos may also result in pleural fibrosis, particularly in geographic areas with naturally occurring asbestiform soil minerals. Pleural disorders may also occur after household exposure. High resolution computed tomography (CT) is more sensitive and specific than chest radiography for the diagnosis of diffuse pleural thickening, and several classification systems for asbestos-related disorders have been devised. Magnetic resonance imaging and fluorodeoxyglucose positron emission tomography (PET) scanning may be useful in distinguishing between DPT and malignant mesothelioma. DPT may be associated with symptoms such as dyspnoea and chest pain. It causes a restrictive defect on lung function and may rarely result in respiratory failure and death. Treatment is primarily supportive. PMID:18775081

  10. [Pleural lymphatics and effusions].

    PubMed

    Mordant, P; Arame, A; Legras, A; Le Pimpec Barthes, F; Riquet, M

    2013-06-01

    The pleural lymphatic system has a great absorption capacity. Its most known function is fluid resorption. The pleura which cover the lungs (visceral pleura), the mediastinum, diaphragm and thoracic wall (parietal pleura) are formed by a mesothelial cell layer (mesothelium). This permeable layer is in direct contact with the vascular endothelium. The mesothelium is based over a connective tissue (interstitium) containing the blood and lymphatic vessels. The primary lymphatic vessels drain interstitium but are also in direct contact with pleural space by the stoma or openings, situated in the lower parts of parietal pleura, i.e: diaphragm, over lower ribs and mediastinum but not existing in the adjacent visceral pleura. In addition, a part of interstitial pulmonary fluid entered in the pleural cavity by passing the visceral pleura would be absorbed by these openings. The resorption process is active and directly related to the function of smooth muscles of lymphatic vessels. Besides resorption, we must emphasize that this "pumping" activity is permanent and the origin of negative pressure (the pleural void) in pleural cavity, a unique property. The other resorbed elements are molecules, bacterial and cellular debris, cells, red blood and cancer cells. PMID:23523230

  11. Matrix vesicles in the fibrous cap of atherosclerotic plaque: possible contribution to plaque rupture

    PubMed Central

    Bobryshev, Y V; Killingsworth, M C; Lord, R S A; Grabs, A J

    2008-01-01

    Plaque rupture is the most common type of plaque complication and leads to acute ischaemic events such as myocardial infarction and stroke. Calcification has been suggested as a possible indicator of plaque instability. Although the role of matrix vesicles in the initial stages of arterial calcification has been recognized, no studies have yet been carried out to examine a possible role of matrix vesicles in plaque destabilization. Tissue specimens selected for the present study represented carotid specimens obtained from patients undergoing carotid endarterectomy. Serial frozen cross-sections of the tissue specimens were cut and mounted on glass slides. The thickness of the fibrous cap (FCT) in each advanced atherosclerotic lesion, containing a well developed lipid/necrotic core, was measured at its narrowest sites in sets of serial sections. According to established criteria, atherosclerotic plaque specimens were histologically subdivided into two groups: vulnerable plaques with thin fibrous caps (FCT <100 ?m) and presumably stable plaques, in which fibrous caps were thicker than 100 ?m. Twenty-four carotid plaques (12 vulnerable and 12 presumably stable plaques) were collected for the present analysis of matrix vesicles in fibrous caps. In order to provide a sufficient number of representative areas from each plaque, laser capture microdissection (LCM) was carried out. The quantification of matrix vesicles in ultrathin sections of vulnerable and stable plaques revealed that the numbers of matrix vesicles were significantly higher in fibrous caps of vulnerable plaques than those in stable plaques (8.9080.544 versus 6.2080.467 matrix vesicles per 1.92 ?m2 standard area; P= 0.0002). Electron microscopy combined with X-ray elemental microanalysis showed that some matrix vesicles in atherosclerotic plaques were undergoing calcification and were characterized by a high content of calcium and phosphorus. The percentage of calcified matrix vesicles/microcalcifications was significantly higher in fibrous caps in vulnerable plaques compared with that in stable plaques (6.7050.436 versus 5.3220A94; P= 0.0474). The findings reinforce a view that the texture of the extracellular matrix in the thinning fibrous cap of atherosclerotic plaque is altered and this might contribute to plaque destabilization. PMID:18194456

  12. Pleurisy and Other Pleural Disorders

    MedlinePLUS

    ... page from the NHLBI on Twitter. What Are Pleurisy and Other Pleural Disorders? Pleurisy (PLUR-ih-se) is a condition in ... conditions can cause pleurisy, including viral infections. Other Pleural Disorders Pneumothorax Air or gas can build up in ...

  13. Severe calcified saccular pulmonary artery aneurysm.

    PubMed

    Hao, Xing-Hai; Liu, Jian-Hua; Bao, Chuan-Ming; Yang, Jun; Lai, Yong-Qiang

    2009-05-01

    Pulmonary artery aneurysm is a very rare entity. Severe calcified saccular pulmonary artery aneurysm is not reported in the literature. A 19-year-old man with a severe calcified saccular pulmonary artery aneurysm is described. PMID:19379914

  14. Determinants of restrictive lung function in asbestos-induced pleural fibrosis

    SciTech Connect

    Schwartz, D.A.; Galvin, J.R.; Dayton, C.S.; Stanford, W.; Merchant, J.A.; Hunninghake, G.W. )

    1990-05-01

    We evaluated whether restrictive lung function among asbestos-exposed individuals with pleural fibrosis was caused by radiographically inapparent parenchymal inflammation and/or parenchymal fibrosis. All 24 study participants were sheet metal workers who were nonsmokers with normal parenchyma on posteroanterior chest radiograph. These subjects had either normal pleura (n = 7), circumscribed plaques (n = 9), or diffuse pleural thickening (n = 8). After controlling for age, years in the trade, and pack-years of smoking, we found that sheet metal workers with diffuse pleural thickening had a lower forced vital capacity (P less than 0.001), total lung capacity (P less than 0.01), and CO-diffusing capacity of the lung (P less than 0.05) than those with normal pleura. Similarly, sheet metal workers with circumscribed plaques were found to have a reduced forced vital capacity; however, because of the small number of study subjects, this difference (regression coefficient = -11.0) was only marginally significant (P = 0.06). Although circumscribed plaque and diffuse pleural thickening were both associated with a lymphocytic alveolitis and a higher prevalence of parenchymal fibrosis on high-resolution computerized tomography (HRCT) scan, neither a lymphocytic alveolitis nor the finding of parenchymal fibrosis on HRCT scan influenced the relationship between pleural fibrosis and restrictive lung function. We conclude that pleural fibrosis is associated with restrictive lung function and abnormally low diffusion that appears to be independent of our measures of parenchymal injury (chest X-ray, bronchoalveolar lavage, and HRCT scan).

  15. On the effect of calcification volume and configuration on the mechanical behaviour of carotid plaque tissue.

    PubMed

    Barrett, H E; Cunnane, E M; Kavanagh, E G; Walsh, M T

    2016-03-01

    Vascular calcification is a complex molecular process that exhibits a number of relatively characteristic morphology patterns in atherosclerotic plaques. Treatment of arterial stenosis by endovascular intervention, involving forceful circumferential expansion of the plaque, can be unpredictable in calcified lesions. The aim of this study was to determine the mechanical stretching mechanisms and define the mechanical limits for circumferentially expanding carotid plaque lesions under the influence of distinct calcification patterns. Mechanical and structural characterisation was performed on 17 human carotid plaques acquired from patients undergoing endarterectomy procedures. The mechanical properties were determined using uniaxial extension tests that stretch the lesions to complete failure along their circumferential axis. Calcification morphology of mechanically ruptured plaque lesions was characterised using high resolution micro computed tomography imaging. Scanning electron microscopy was used to examine the mechanically induced failure sites and to identify the interface boundary conditions between calcified and non-calcified tissue. The mechanical tests produced four distinct trends in mechanical behaviour which corresponded to the calcification patterns that structurally defined each mechanical group. Each calcification pattern produced unique mechanical restraining effects on the plaque tissue stretching properties evidenced by the variation in degree of stretch to failure. Resistance to failure appears to rely on interactions between calcification and non-calcified tissue. Scanning electron microscopy examination revealed structural gradations at interface boundary conditions to facilitate the transfer of stress. This study emphasises the mechanical influence of distinct calcification configurations on plaque expansion properties and highlights the importance of pre-operative lesion characterisation to optimise treatment outcomes. PMID:26655460

  16. Association between calcifying nanoparticles and placental calcification

    PubMed Central

    Guo, Yanan; Zhang, Dechun; Lu, He; Luo, Shuang; Shen, Xuecheng

    2012-01-01

    Background The purpose of this study was to examine the possible contribution of calcifying nanoparticles to the pathogenesis of placental calcification. Methods Calcified placental tissues and distal tissue samples were collected from 36 confirmed placental calcification cases. In addition, 20 normal placental tissue samples were obtained as a control group. All the tissue samples were cultured using special nanobacterial culture methods. The cultured calcifying nanoparticles were examined by transmission electron microscopy (TEM), and their growth was monitored by optical density (OD) at a wavelength of 650 nm. 16S rRNA gene expression of the cultured calcifying nanoparticles was also isolated and sequenced. Results Novel calcifying nanoparticles wrapped with electron-dense shells between 50 nm to 500 nm in diameter were observed in the extracellular matrix of calcified placental tissues. They were detected in placental villi and hydroxyapatite crystals, and contained nucleic acid-like materials. After isolation and four weeks of culture, 28 of 36 calcified placental tissue samples showed white granular precipitates attached to the bottom of the culture tubes. OD650 measurements indicated that the precipitates from the calcified placental tissues were able to grow in culture, whereas no such precipitates from the control tissues were observed. The 16S rRNA genes were isolated from the cultured calcifying nanoparticles and calcified placental tissues, and their gene sequencing results implied that calcifying nanoparticles were novel nanobacteria (GenBank JF823648). Conclusion Our results suggest that these novel calcifying nanoparticles may play a role in placental calcification. PMID:22615531

  17. The influence of plaque composition on underlying arterial wall stress during stent expansion: the case for lesion-specific stents.

    PubMed

    Pericevic, Ian; Lally, Caitrona; Toner, Deborah; Kelly, Daniel John

    2009-05-01

    Intracoronary stent implantation is a mechanical procedure, the success of which depends to a large degree on the mechanical properties of each vessel component involved and the pressure applied to the balloon. Little is known about the influence of plaque composition on arterial overstretching and the subsequent injury to the vessel wall following stenting. An idealised finite element model was developed to investigate the influence of both plaque types (hypercellular, hypocellular and calcified) and stent inflation pressures (9, 12 and 15 atm) on vessel and plaque stresses during the implantation of a balloon expandable coronary stent into an idealised stenosed artery. The plaque type was found to have a significant influence on the stresses induced within the artery during stenting. Higher stresses were predicted in the artery wall for cellular plaques, while the stiffer calcified plaque appeared to play a protective role by reducing the levels of stress within the arterial tissue for a given inflation pressure. Higher pressures can be applied to calcified plaques with a lower risk of arterial vascular injury which may reduce the stimulus for in-stent restenosis. Results also suggest that the risk of plaque rupture, and any subsequent thrombosis due to platelet deposition at the fissure, is greater for calcified plaques with low fracture stresses. PMID:19129001

  18. Pleural needle biopsy

    MedlinePLUS

    ... the skin and into the lining of the lungs and chest wall (pleural membrane). A larger, hollow needle is then placed gently through the skin into the chest cavity. Sometimes, the provider uses ultrasound or CT imaging to guide the needle. A ...

  19. An ultrastructural study of calcifying odontogenic cyst, especially calcified material.

    PubMed

    Mimura, Masafumi; Tanaka, Nobuyuki; Kimijima, Yutaka; Ichinose, Shizuko; Sasaki, Kodo; Amagasa, Teruo

    2002-06-01

    The ultrastructural features of calcification in a case of calcifying odontogenic cyst (COC) were studied. Scanning electron microscopic examination of the inner parts of the cyst wall revealed many short microvilli, and X-ray microanalysis of the high-density masses in the intercellular parts showed prominent calcium peaks, which meant that these masses were calcified materials. On transmission electron microscopic observations, many calcifications exhibited a distinctive ring formation around the periphery of a central core that consisted of an amorphous structure. These calcifications were observed with necrotic remnants of nuclear material and many identifiable mitochondria, thin fibers, and epithelial cells. The cytoplasm of ghost cells consisted of numerous short electron-dense tonofilament bundles. Needle-like structures were shown in the tonofilament bundles. X-ray diffraction analysis showed that the needle-like crystals were hydroxyapatite. It is suggested that calcification in a COC may be related to degenerative mitochondria and tonofilament bundles of ghost cells. PMID:12181653

  20. Genesis and growth of extracellular-vesicle-derived microcalcification in atherosclerotic plaques.

    PubMed

    Hutcheson, Joshua D; Goettsch, Claudia; Bertazzo, Sergio; Maldonado, Natalia; Ruiz, Jessica L; Goh, Wilson; Yabusaki, Katsumi; Faits, Tyler; Bouten, Carlijn; Franck, Gregory; Quillard, Thibaut; Libby, Peter; Aikawa, Masanori; Weinbaum, Sheldon; Aikawa, Elena

    2016-03-01

    Clinical evidence links arterial calcification and cardiovascular risk. Finite-element modelling of the stress distribution within atherosclerotic plaques has suggested that subcellular microcalcifications in the fibrous cap may promote material failure of the plaque, but that large calcifications can stabilize it. Yet the physicochemical mechanisms underlying such mineral formation and growth in atheromata remain unknown. Here, by using three-dimensional collagen hydrogels that mimic structural features of the atherosclerotic fibrous cap, and high-resolution microscopic and spectroscopic analyses of both the hydrogels and of calcified human plaques, we demonstrate that calcific mineral formation and maturation results from a series of events involving the aggregation of calcifying extracellular vesicles, and the formation of microcalcifications and ultimately large calcification areas. We also show that calcification morphology and the plaque's collagen content-two determinants of atherosclerotic plaque stability-are interlinked. PMID:26752654

  1. Pneumocystis carinii pleural effusion. Pathogenesis and pleural fluid analysis.

    PubMed

    Horowitz, M L; Schiff, M; Samuels, J; Russo, R; Schnader, J

    1993-07-01

    We present three new cases of Pneumocystis carinii in pleural effusions of patients with AIDS, bringing the total number of reported cases to six. In our patients, diagnosis was made by visualization of Pneumocystis in pleural fluid stained with Gomori methenamine silver. LDH was greater than 400, and pleural fluid to serum LDH ratio was greater than 1.0 in all cases at time of presentation. All six reported patients have been associated with aerosolized pentamidine, and five of the six had documented underlying Pneumocystis pneumonia. The sixth patient, which we report, presented with primary pleural infection with Pneumocystis. Although we could not document underlying pneumonia, we suspect it was present. Pneumocystis pleural disease appears to be an anatomic extension of smoldering subpleural Pneumocystis pneumonia, and prognosis is not worse than with pneumonia alone. PMID:8317805

  2. Male Gender and Arterial Hypertension are Plaque Predictors at Coronary Computed Tomography Angiography

    PubMed Central

    Oliveira, Joselina Luzia Menezes; Hirata, Mario Hiroyuki; Sousa, Amanda Guerra de Moraes Rego; Gabriel, Fabola Santos; Hirata, Thiago Dominguez Crespo; Tavares, Irlaneide da Silva; Melo, Luiza Dantas; Dria, Fabiana de Santana; Sousa, Antnio Carlos Sobral; Pinto, Ibraim Masciarelli Francisco

    2015-01-01

    Background Systemic Arterial Hypertension (SAH) is one of the main risk factors for Coronary Artery Disease (CAD), in addition to male gender. Differences in coronary artery lesions between hypertensive and normotensive individuals of both genders at the Coronary Computed Tomography Angiography (CCTA) have not been clearly determined. Objective To Investigate the calcium score (CS), CAD extent and characteristics of coronary plaques at CCTA in men and women with and without SAH. Methods Prospective cross-sectional study of 509 patients undergoing CCTA for CAD diagnosis and risk stratification, from November 2011 to December 2012, at Instituto de Cardiologia Dante Pazzanese. Individuals were stratified according to gender and subdivided according to the presence (HT +) or absence (HT-) of SAH. Results HT+ women were older (62.3 10.2 vs 57.8 12.8, p = 0.01). As for the assessment of CAD extent, the HT+ individuals of both genders had significant CAD, although multivessel disease is more frequent in HT + men. The regression analysis for significant CAD showed that age and male gender were the determinant factors of multivessel disease and CS ? 100. Plaque type analysis showed that SAH was a predictive risk factor for partially calcified plaques (OR = 3.9). Conclusion Hypertensive men had multivessel disease more often than women. Male gender was a determinant factor of significant CAD, multivessel disease, CS ? 100 and calcified and partially calcified plaques, whereas SAH was predictive of partially calcified plaques. PMID:25861034

  3. Cytology exam of pleural fluid

    MedlinePLUS

    ... the lungs. This area is called the pleural space. Cytology means the study of cells. ... A sample of fluid from the pleural space is needed. The sample is taken using a procedure called thoracentesis . The procedure is done in the following way: You sit on a ...

  4. Feasibility of diagnosing unstable plaque in patients with acute coronary syndrome using iMap-IVUS*

    PubMed Central

    LIU, Jian; WANG, Zhao; WANG, Wei-min; LI, Qi; MA, Yu-liang; LIU, Chuan-fen; LU, Ming-yu; ZHAO, Hong

    2015-01-01

    Objective: To compare the plaque composition between stable and unstable plaques, characterize unstable plaque by using iMap-intravascular ultrasound (IVUS), and quantify the diagnostic criteria for unstable plaque. Methods: Thirty-three acute coronary syndrome (ACS) patients who had undergone coronary angiography and IVUS from February 19, 2014 to December 19, 2014 at Peking University People’s Hospital were enrolled in the study. Baseline data were collected. The patients were divided into two groups according to their gray-scale IVUS imaging, stable plaque and unstable plaque. A difference-in-difference evaluation was performed using the baseline data and off-line iMap imaging results between the two groups. A receiver operating characteristic (ROC) curve was constructed to obtain the optimal cut-off value to diagnose unstable plaque. Results: Percentages of fibrotic and necrotic tissues, absolute values of lipidic, necrotic, and calcified tissues, and plaque burden were independent predictors for unstable plaque. Absolute necrotic area was the best predictor and exhibited the highest diagnostic value for plaque vulnerability (area under the curve (AUC)=0.806, P=0.000, 95% CI (0.718, 0.894)). The cut-off score for predicting unstable plaque was 4.0 mm2. Conclusions: This study attempted to propose a cut-off value based on absolute necrotic area using iMap-IVUS to predict plaque vulnerability in patients with ACS. This score might provide a valuable reference for diagnosing unstable plaque. PMID:26537210

  5. Calcified ovarian fibromas in prepubertal girls.

    PubMed

    Bosch-Banyeras, J M; Lucaya, X; Bernet, M; Iriondo, F; Capdevila, A; Bau, A; Zuasnabar, A; Bosch, J

    1989-08-01

    Ovarian fibromas in prepubertal girls are rare. We describe two girls aged 8 and 11 years with extensively calcified ovarian fibromas. One patient had a single unilateral fibroma with metaplastic bone formation in the calcified area. The other patient had bilateral nodular fibromas suggesting the possibility of naevoid basal-cell carcinoma syndrome although broader manifestations are lacking at present. PMID:2792126

  6. Genesis and growth of extracellular-vesicle-derived microcalcification in atherosclerotic plaques

    NASA Astrophysics Data System (ADS)

    Hutcheson, Joshua D.; Goettsch, Claudia; Bertazzo, Sergio; Maldonado, Natalia; Ruiz, Jessica L.; Goh, Wilson; Yabusaki, Katsumi; Faits, Tyler; Bouten, Carlijn; Franck, Gregory; Quillard, Thibaut; Libby, Peter; Aikawa, Masanori; Weinbaum, Sheldon; Aikawa, Elena

    2016-03-01

    Clinical evidence links arterial calcification and cardiovascular risk. Finite-element modelling of the stress distribution within atherosclerotic plaques has suggested that subcellular microcalcifications in the fibrous cap may promote material failure of the plaque, but that large calcifications can stabilize it. Yet the physicochemical mechanisms underlying such mineral formation and growth in atheromata remain unknown. Here, by using three-dimensional collagen hydrogels that mimic structural features of the atherosclerotic fibrous cap, and high-resolution microscopic and spectroscopic analyses of both the hydrogels and of calcified human plaques, we demonstrate that calcific mineral formation and maturation results from a series of events involving the aggregation of calcifying extracellular vesicles, and the formation of microcalcifications and ultimately large calcification areas. We also show that calcification morphology and the plaque’s collagen content--two determinants of atherosclerotic plaque stability--are interlinked.

  7. Pleural involvement in lung cancer

    PubMed Central

    Giannou, Anastasios D.; Stathopoulos, Georgios T.

    2015-01-01

    The pleural space, a sterile secluded environment in the thoracic cavity, represents an attractive metastatic site for various cancers of lung, breast and gastrointestinal origins. Whereas lung and breast adenocarcinomas could invade the pleural space because of their anatomic proximity, distant cancers like ovarian or gastrointestinal tract adenocarcinomas may employ more active mechanisms to the same end. A pleural metastasis is often accompanied by a malignant pleural effusion (MPE), an unfavorable complication that severely restricts the quality of life and expectancy of the cancer patient. MPE is the net product of three different processes, namely inflammation, enhanced angiogenesis and vascular leakage. Current efforts are focusing on the identification of cancer cell autocrine (specific mutation spectra and biochemical pathways) and paracrine (cytokine and chemokine signals) characteristics as well as host features (immunological or other) that underlie the MPE phenotype. Herein we examine the pleural histology, cytology and molecular characteristics that make the pleural cavity an attractive metastasis destination for lung adenocarcinoma. Mesothelial and tumor features that may account for the tumors ability to invade the pleural space are highlighted. Finally, possible therapeutic interventions specifically targeting MPE are discussed. PMID:26150915

  8. Update on pleural diseases - 2007

    PubMed Central

    Bishay, Ayman; Raoof, Suhail; Esan, Adebayo; Sung, Arthur; Wali, Siraj; Lee, Leonard Y.; George, Liziamma; Saleh, Anthony; Baumann, Michael

    2007-01-01

    BACKGROUND: New information is available on pleural diseases. The authors selected articles to make recommendations on diagnostic and treatment aspects of pleural diseases. MATERIALS AND METHODS: Eleven articles published in the English language between 2004 and 2007 were chosen. The basis of selection of the articles was the impact on daily practice, change in prior thinking of a disease process or specific treatment modality, as well as proper design and execution of the study. 5-amino-laevulinic acid with fluorescent light combined with white light may allow further diagnostic yield in undiagnosed pleural disease. FDG-PET may allow prognostication of patients with pleural tumors. Utilizing ultrasound by trained Emergency Department physicians is a rapid and effective technique to evaluate non-traumatic pleural effusions in symptomatic patients. Serum osteopontin levels may distinguish patients exposed to asbestos with benign disease from those with pleural mesothelioma. Administration of streptokinase in patients with empyema does not need for surgical drainage, length of hospital stay, or mortality as compared to conventional treatment with chest tube drainage and intravenous antibiotics. Silver nitrate may be an alternative agent to talc for producing pleurodesis. Routine use of graded talc (50% particles greater than 25 microns) is recommended to reduce the morbidity associated with talc pleurodesis. Study design does not permit us to conclude that aspiration of spontaneous pneumothorax is as effective as chest tube drainage. Pleural catheter may prove to be an important palliative modality in treating debilitated patients or patients with trapped lung who show symptomatic improvement with drainage; however, at the present time, these catheters cannot be considered a first line treatment option for patients with malignant pleural effusion. One of the studies reviewed showed no significant difference in tract metastasis in patients with malignant mesothelioma undergoing an invasive pleural procedure with or without irradiation to the procedure site. However, the design of the trial does not allow us to make this conclusion at the present time. PMID:19727362

  9. Magnetic resonance of calcified tissues

    PubMed Central

    Wehrli, Felix W.

    2016-01-01

    MRI of the human body is largely made possible by the favorable relaxation properties of protons of water and triacyl glycerides prevalent in soft tissues. Hard tissues key among them bone are generally less amenable to measurement with in vivo MR imaging techniques, not so much as a result of the lower proton density but rather due to the extremely short life-times of the proton signal in water bound to solid-like entities, typically collagen, or being trapped in micro-pores. Either mechanism can enhance T2 relaxation by up to three orders of magnitude relative to their soft-tissue counterparts. Detection of these protons requires solid-state techniques that have emerged in recent years and that promise to add a new dimension to the study of hard tissues. Alternative approaches to probe calcified tissues exploit their characteristic magnetic properties. Bone, teeth and extra-osseous calcium-containing biomaterials are unique in that they are more diamagnetic than all other tissues and thus yield information indirectly by virtue of the induced magnetic fields present in their vicinity. Progress has also been made in methods allowing very high-resolution structural imaging of trabecular and cortical bone relying on detection of the surrounding soft-tissues. This brief review, much of it drawn from work conducted in the authors laboratory, seeks to highlight opportunities with focus on early-stage developments for image-based assessment of structure, function, physiology and mechanics of calcified tissues in humans via liquid and solid-state approaches, including proton, deuteron and phosphorus NMR and MRI. PMID:23414678

  10. CT of malignant pleural mesothelioma

    SciTech Connect

    Mirvis, S.; Dutcher, J.P.; Haney, P.J.; Whitley, N.O.; Aisner, J.

    1983-04-01

    The CT scans, plain films, and clinical courses of nine patients with malignant pleural mesothelioma were reviewed to assess the value of computed tomography (CT) in the initial evalation and follow-up of this malignancy. The initial pretreatment scans showed a typical lobulated rind of pleural tumor encasing the lung associated with variable amounts of pleural fluid. Local invasion of the mediastinum, pericardium, diaphragm, and contralateral thorax were well depicted on CT; unsuspected abdominal extension of tumor was demonstrated on CT scans of five patients. Serial scans during treatment provided objective evidence of either regression or growth of tumor mass, even when the patients' clinical status and plain films appeared stable.

  11. Chondrosarcoma of the Rib Mimicking Malignant Pleural Mesothelioma

    PubMed Central

    Furukawa, Masashi; Tao, Hiroyuki; Tanaka, Toshiki; Onoda, Hideko; Murakami, Tomoyuki; Okabe, Kazunori

    2016-01-01

    A 62-year-old man with a history of long-term asbestos exposure was found to have a chest wall tumor invading the sixth rib on chest computed tomography. The computed tomography also revealed multiple plaques in the pleura. Malignant pleural mesothelioma was suspected, and thoracoscopic surgery was performed. Thoracoscopy revealed that the tumor location was extrapleural. Thus, excisional biopsy was performed. The tumor was histologically diagnosed as chondrosarcoma. Additional wide resection of the chest wall, including the fifth, sixth, and seventh ribs, was performed. Chest wall reconstruction was performed with a polypropylene mesh. PMID:26933413

  12. Pleural mesothelial cells in pleural and lung diseases

    PubMed Central

    Antony, Veena B.

    2015-01-01

    During development, the mesoderm maintains a complex relationship with the developing endoderm giving rise to the mature lung. Pleural mesothelial cells (PMCs) derived from the mesoderm play a key role during the development of the lung. The pleural mesothelium differentiates to give rise to the endothelium and smooth muscle cells via epithelial-to-mesenchymal transition (EMT). An aberrant recapitulation of such developmental pathways can play an important role in the pathogenesis of disease processes such as idiopathic pulmonary fibrosis (IPF). The PMC is the central component of the immune responses of the pleura. When exposed to noxious stimuli, it demonstrates innate immune responses such as Toll-like receptor (TLR) recognition of pathogen associated molecular patterns as well as causes the release of several cytokines to activate adaptive immune responses. Development of pleural effusions occurs due to an imbalance in the dynamic interaction between junctional proteins, n-cadherin and β-catenin, and phosphorylation of adherens junctions between PMCs, which is caused in part by vascular endothelial growth factor (VEGF) released by PMCs. PMCs play an important role in defense mechanisms against bacterial and mycobacterial pleural infections, and in pathogenesis of malignant pleural effusion, asbestos related pleural disease and malignant pleural mesothelioma. PMCs also play a key role in the resolution of inflammation, which can occur with or without fibrosis. Fibrosis occurs as a result of disordered fibrin turnover and due to the effects of cytokines such as transforming growth factor-β, platelet-derived growth factor (PDGF), and basic fibroblast growth factor; which are released by PMCs. Recent studies have demonstrated a role for PMCs in the pathogenesis of IPF suggesting their potential as a cellular biomarker of disease activity and as a possible therapeutic target. Pleural-based therapies targeting PMCs for treatment of IPF and other lung diseases need further exploration. PMID:26150910

  13. Pleural effusion in liver disease.

    PubMed

    Alonso, Jos Castellote

    2010-12-01

    Hepatic hydrothorax is the paradigmatic pleural effusion in liver cirrhosis. It is defined as a pleural effusion in a patient with portal hypertension and no cardiopulmonary disease. The estimated prevalence of this complication in patients with liver cirrhosis is 5 to 6%. Its pathophysiology involves movement of ascitic fluid from the peritoneal cavity into the pleural space through diaphragmatic defects. Thoracentesis and pleural fluid analysis are necessary for diagnosis. Initial management consists of sodium restriction, diuretics, and therapeutic thoracentesis. A transjugular intrahepatic portosystemic shunt may provide a bridge prior to liver transplantation. Spontaneous bacterial empyema is the infection of a preexisting hydrothorax. The more frequent bacteria involved are ENTEROBACTERIACEAE and gram-positive cocci. Antibiotic therapy is the cornerstone of therapy. This article reviews etiology, clinical manifestations, and therapy of these two complications of liver cirrhosis and portal hypertension. PMID:21213201

  14. A computational fluid-structure interaction model for plaque vulnerability assessment in atherosclerotic human coronary arteries

    NASA Astrophysics Data System (ADS)

    Karimi, Alireza; Navidbakhsh, Mahdi; Razaghi, Reza; Haghpanahi, Mohammad

    2014-04-01

    Coronary artery disease is responsible for a third of global deaths worldwide. Computational simulations of blood flow can be used to understand the interactions of artery/plaque and blood in coronary artery disease and to better predict the rupture of atherosclerotic plaques. So far, the mechanical properties of animals' coronary artery have been mostly used for hemodynamic simulation of atherosclerotic arteries. The mechanical properties of animals' coronary arteries are often not accurate enough and can be only used for an approximate estimation and comparative assessment of the cognate parameters in human. In this study, a three-dimensional (3D) computational fluid-structure interactions model with three different plaque types is presented to perform a more accurate plaque vulnerability assessment for human atherosclerotic plaques. The coronary arteries of twenty-two male individuals were removed during autopsy and subjected to uniaxial tensile loading. The hyperelastic material coefficients of coronary arteries were calculated and implemented to the computational model. The fully coupled fluid and structure models were solved using the explicit dynamics finite element code LS-DYNA. The normal and shear stresses induced within the plaques were significantly affected by different plaque types. The highest von Mises (153 KPa) and shear (57 KPa) stresses were observed for hypocellular plaques, while the lowest von Mises (70 KPa) and shear (39 KPa) stresses were observed on the stiffer calcified plaques. The results suggest that the risk of plaque rupture due to blood flow is lower for cellular and hypocellular plaques, while higher for calcified plaques with low fracture stresses.

  15. Associations between Tobacco, Alcohol, and Drug Use with Coronary Artery Plaque among HIV-Infected and Uninfected Men in the Multicenter AIDS Cohort Study

    PubMed Central

    Kelly, Sean G.; Plankey, Michael; Post, Wendy S.; Li, Xiuhong; Stall, Ronald; Jacobson, Lisa P.; Witt, Mallory D.; Kingsley, Lawrence; Cox, Christopher; Budoff, Matthew; Palella, Frank J.

    2016-01-01

    Background We characterized associations between smoking, alcohol, and recreational drug use and coronary plaque by HIV serostatus within the Multicenter AIDS Cohort Study (MACS). Methods MACS participants (N = 1005, 621 HIV+ and 384 HIV-) underwent non-contrast CT scanning to measure coronary artery calcium; 764 underwent coronary CT angiograms to evaluate plaque type and extent. Self-reported use of alcohol, tobacco, smoked/inhaled cocaine, methamphetamine, ecstasy, marijuana, inhaled nitrites, and erectile dysfunction drugs was obtained at semi-annual visits beginning 10 years prior to CT scanning. Multivariable logistic and linear regression models were performed, stratified by HIV serostatus. Results Among HIV+ men, current smoking, former smoking, and cumulative pack years of smoking were positively associated with multiple coronary plaque measures (coronary artery calcium presence and extent, total plaque presence and extent, calcified plaque presence, and stenosis >50%). Smoking was significantly associated with fewer plaque measures of comparable effect size among HIV- men; current smoking and calcified plaque extent was the only such association. Heavy alcohol use (>14 drinks/week) was associated with stenosis >50% among HIV+ men. Among HIV- men, low/moderate (1–14 drinks/week) and heavy alcohol use were inversely associated with coronary artery calcium and calcified plaque extent. Few significant associations between other recreational drug use and plaque measures were observed. Conclusion Smoking is strongly associated with coronary plaque among HIV+ men, underscoring the value of smoking cessation for HIV+ persons. Alcohol use may protect against coronary artery calcium and calcified plaque progression in HIV- (but not HIV+) men. Few positive associations were observed between recreational drug use and coronary plaque measures. PMID:26811937

  16. Analysis of the movement of calcified lymph nodes during breathing

    SciTech Connect

    Jenkins, Peter . E-mail: peter.jenkins@glos.nhs.uk; Salmon, Clare; Mannion, Cathy

    2005-02-01

    Purpose: To identify and measure the respiratory-induced movement of calcified mediastinal lymph nodes. Methods and materials: Twenty-one patients receiving radiation therapy for primary lung or pleural tumors were noted to have calcification within one or more mediastinal lymph nodes. The breathing motion of 27 such nodes was measured with orthogonal fluoroscopic imaging during quiet respiration. Results: All 27 nodes showed some motion synchronous with breathing. The mean respiratory movement was 6.6 mm, 2.6 mm, and 1.4 mm in the craniocaudal, dorsoventral, and mediolateral planes, respectively. There was a significant difference in the amplitude of motion in the craniocaudal plane compared with movement in the other two directions (p < 0.001). No differences were seen in the movement of lymph nodes dependent on position within the mediastinum (supracarinal vs. infracarinal or hilar vs. mediastinal). Neither size of the primary tumor nor spirometric parameters were correlated with the amplitude of lymph node movement. Conclusions: Mediastinal lymph nodes move during breathing, and this needs to be accounted for when the internal margin component of the PTV is defined. The amplitude of this movement is anisotropic and seems to be less than that reported for primary lung tumors. This should permit a modest reduction in the margin allowed for breathing movement around involved mediastinal nodes, particularly in the mediolateral and dorsoventral planes.

  17. Successful thrombectomy for coronary embolism likely due to floating aortic plaque in ascending aorta.

    PubMed

    Nakamura, Daisuke; Makino, Nobuhiko; Egami, Yasuyuki; Shutta, Ryu; Tanouchi, Jun; Nishino, Masami

    2015-07-01

    A 70-year-old man with chest pain underwent coronary intervention for acute myocardial infarction. We immediately performed coronary thrombectomy with aspiration catheter and collected solid material as a result. After aspiration, we achieved thrombolysis in myocardial infarction trial (TIMI)-flow grade 3 without stenosis. Transesophageal echocardiography showed no intracardiac thrombus but pronounced mobile aortic plaque in ascending aorta. Transthoracic echocardiography showed moderate aortic regurgitation. A histological examination of retrieved material revealed severe calcified atherosclerotic plaque without thrombotic components. Thereby, coronary embolism in this case may have been caused by embolism of flaked aortic plaque, which was possibly carried by aortic regurgitation flow. PMID:25179773

  18. CT of malignant pleural mesothelioma

    SciTech Connect

    Alexander, E.; Clark, R.A.; Colley, D.P.; Mitchell, S.E.

    1981-08-01

    Malignant pleural mesothelioma is a rare tumor. Although the chest film findings of pleural mesothelioma are well described, there are few descriptions of the findings of computed tomography (CT). This report describes the CT findings in five cases of pleural mesothelioma. In each case the CT showed an extensive, irregular, pleural-based mass surrounding the lung, spreading into the fissures, and extending into the mediastinum. In two cases there was also extension into the contralateral chest, and in one case each there was extension into the abdomen and chest wall. In each case the chest radiographs underestimated the extent of disease, when compared to CT. When an irregular, pleural-based mass involving most of the hemithorax is identified on CT, the diagnosis of mesothelioma can be suggested and at the same time the extent of the tumor may be evaluated. This is important because the diagnosis of mesothelioma is difficult and because treatment and prognosis may depend on the extent of the disease.

  19. Study on calcifying treatments of hydroxyapatite (HAp) using calcifying promotion solution

    NASA Astrophysics Data System (ADS)

    Wakaki, Moriaki; Yazaki, Syungo; Sunada, Yoshikazu

    2009-02-01

    Apatite is expected to be a useful material for artificial bones in surgery and artificial dental roots in dentistry. In particular, studies have recently been conducted into the reconstruction of teeth using Hydroxyapatite (HAp), and several supplements such as gum have become popular for keeping teeth in good condition. However, the decalcifying and calcifying processes are still not well understood. The aim of this research is to study the decalcifying and calcifying mechanisms of HAp. Specifically, the calcifying treatments were carried out on sintered pellets of HAp without pores using Phosphate Acid Maltodextrin (PMD) and Xylitol calcifying promotion agents. A natural calcifying liquid which simulates the situation within a human mouth was used as a reference. SEM, EDX, X-ray, IR and Raman measurements were used for the characterization of structures, morphologies, formed elements and physical properties. It was confirmed that a precursor material OCP was grown on the HAp pellet by the calcification treatment using each promotion agent.

  20. Modern supragingival plaque control.

    PubMed

    Iacono, V J; Aldredge, W A; Lucks, H; Schwartzstein, S

    1998-06-01

    Supragingival plaque control is essential for the maintenance of oral health. Despite the many chemotherapeutic agents available as mouthrinses and toothpastes, mechanical plaque removal is still the best method to achieve effective plaque control. This is due, in part, to the lack of development of oral antimicrobials with the effectiveness and substantivity of chlorhexidine gluconate but without its adverse effects of dental staining and calculus formation. The use of the numerous mechanical (manual and electric) oral hygiene devices extant and their effectiveness, however, are dependent upon patient dexterity and compliance and concomitant active professional treatment for the monitoring of home care, oral hygiene instruction and patient motivation. This paper evaluates the current methods available to reduce plaque and gingivitis with emphasis on their effectiveness at both supragingival plaque control and disease prevention. In addition, recent studies on the newer oscillating/rotating electric plaque removers and interdental cleaning devices will be discussed as related to their efficacy and compliance. PMID:9779111

  1. Orbital Atherectomy for Treating De Novo Severely Calcified Coronary Narrowing (1-Year Results from the Pivotal ORBIT II Trial).

    PubMed

    Gnreux, Philippe; Lee, Arthur C; Kim, Christopher Y; Lee, Michael; Shlofmitz, Richard; Moses, Jeffrey W; Stone, Gregg W; Chambers, Jeff W

    2015-06-15

    Percutaneous coronary intervention of severely calcified lesions has historically been associated with major adverse cardiac event (MACE) rates as high as 30%. In the ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial, treatment of de novo severely calcified lesions with the Diamondback 360 Coronary Orbital Atherectomy System (OAS) resulted in low rates of procedural and 30-day adverse ischemic events. The long-term results from this trial have not been reported. We sought to determine the 1-year outcomes after orbital atherectomy of severely calcified coronary lesions. ORBIT II was a single-arm trial enrolling 443 subjects at 49 US sites with severely calcified lesions usually excluded from randomized trials. OAS utilizes a centrifugal differential sanding mechanism of action for plaque modification prior to stent implantation. After OAS drug-eluting stents were implanted in 88.2% of the patients. The primary safety end point was 30-day MACE, the composite of cardiac death, myocardial infarction, or target vessel revascularization [TVR]. The present analysis reports the 1-year follow-up results from ORBIT II. One-year data were available in 433 of 443 patients (97.7%), with median follow-up time of 16.7months. The 1-year MACE rate was 16.4%, including cardiac death (3.0%), myocardial infarction (9.7%), and target vessel revascularization (5.9%). The 1-year target lesion revascularization rate was 4.7%, and stent thrombosis occurred in 1 patient (0.2%). Independent predictors of 1-year MACE and target vessel revascularization were diameter stenosis at baseline and the use of bare-metal stents. In patients with severely calcified lesions who underwent percutaneous coronary intervention, the use of OAS was associated with low rates of 1-year adverse ischemic events compared with historical controls. This finding has important clinical implications for the selection of optimum treatment strategies for patients with severely calcified lesions. PMID:25910525

  2. Asymptomatic localized pleural amyloidosis mimicking malignant pleural mesothelioma: report of a case

    PubMed Central

    Nakano, Tomoyuki; Tetsuka, Kenji; Fukushima, Noriyoshi

    2016-01-01

    We herein report an asymptomatic 65-year-old male with localized pleural amyloidosis mimicking malignant pleural mesothelioma. He had a history of exposure to asbestos and was admitted for investigation of an abnormal pleural thickness detected by chest radiography. Positron emission tomography showed elevation of standardized uptake value corresponding to the pleural thickness. Partial pleurectomy including the tumor was performed for the purpose of diagnosis and local disease control. The pathological examination showed that the tumor was pleural amyloidosis. The tumor was diagnosed as localized primary amyloidosis, because serum monoclonal protein concentration did not increase. Pleural amyloidosis should be considered as a differential diagnosis from pleural mesothelioma. PMID:26904248

  3. Minoxidil-associated exudative pleural effusion.

    PubMed

    Siddiqui, Atif; Ansari, Mohammed; Shakil, Jawairia; Chemitiganti, Rama

    2010-05-01

    Recurrent pleural effusions are associated with significant morbidity and mortality. Drug-related reactions causing pleural effusions are not common, but their identification can potentially improve patient outcome. Minoxidil has been implicated in pleuropericardial effusions in patients with chronic kidney disease. The exact mechanism by which pleural effusion occurs is still unclear. We report a case of isolated exudative pleural effusion associated with minoxidil in a patient without underlying kidney disease that almost completely resolved after the drug was discontinued. PMID:20375958

  4. Exudative pleural effusions secondary to gastrointestinal diseases.

    PubMed

    Light, R W

    1985-03-01

    Several different diseases of the gastrointestinal tract may have an associated exudative pleural effusion. In the acutely ill patient with a pleural effusion, the possibility of esophageal perforation should always be considered. It is important to establish this diagnosis as soon as possible since the mortality rate increases markedly if drainage of the mediastinum is delayed for even 12 or 24 hours. The best screening test for esophageal rupture is the level of amylase in the pleural fluid. All patients with undiagnosed exudative pleural effusions should have the amylase level in their pleural fluid measured to rule out a pancreatic etiology for their pleural effusion. In patients with acute pancreatitis, the clinical presentation may be dominated by chest symptoms. Such patients have small to moderately sized pleural effusions that resolve rapidly once appropriate therapy is instituted. If symptoms persist, the possibility of a pancreatic abscess or a pancreatic pseudocyst should be considered. Patients with pancreatic pseudocysts may develop a sinus tract between the pseudocyst and the pleural space. In this situation a large pleural effusion develops. Frequently there are no abdominal symptoms and the diagnosis will not be made unless a pleural fluid amylase is obtained. Patients with exudative pleural effusions that contain predominantly polymorphonuclear leukocytes should be suspected of having an intra-abdominal abscess, particularly when there is no associated parenchymal infiltrate. Subphrenic, intrahepatic, and splenic abscesses all have a high incidence of accompanying pleural effusion. Abdominal CT scanning is the method of choice to establish each of these diagnoses. PMID:3847297

  5. Comparison of coronary plaque subtypes in male and female patients using 320-row MDCTA

    PubMed Central

    Khosa, Faisal; Khan, Atif N.; Nasir, Khurram; Bedayat, Arash; Malik, Zehra; Jon, Ali F.; Cheema, Ahmad R.; Clouse, Melvin E.; Welty, Francine K.

    2015-01-01

    Objective Determine plaque subtype and volume difference in male and female patients with obstructive and non-obstructive CAD using 320-row MDCTA. Materials and methods 128 patients with suspected CAD underwent MDCTA. All studies were divided into two groups based on disease severity. 070% stenosis (non-obstructive CAD) & >70% (obstructive). All were compared for plaque quantity and subtypes by gender. Main arteries, RCA, LM, LAD and LCX were analyzed using Vitrea 5.2 software to quantify fatty, fibrous and calcified plaque. Thresholds for coronary plaque quantification (volume in mm3) were preset at 35 12 HU for fatty, 90 24 HU for fibrous and >130 HU for calcified/mixed plaque and analyzed using STATA software. Results Total plaque burden in 118 patients [65M: 53F] was significantly higher in all arteries in males compared to females with non-obstructive disease. Total plaque volume for males vs. females was: RCA: 10.10 5.02 mm3 vs. 6.89 2.75 mm3, respectively, p = 0.001; LAD: 7.21 3.38 mm3 vs. 5.89 1.93 mm3, respectively, p = 0.04; LCX: 9.13 3.27 mm3 vs. 7.16 1.73 mm3, respectively, p = 0.002; LM 15.13 4.51 mm3 vs. 11.85 4.03 mm3, respectively, p = 0.001. In sub-analyses, males had significantly more fibrous and fatty plaque in LM, LAD & LCX than females. However in the RCA, only fibrous plaque was significantly greater in males. Calcified plaque volume was not significantly different in both genders. Only 8% of patients had obstructive CAD (>70% stenosis); there was no significant difference in plaque volume or subtypes. Conclusion In patients with non-obstructive CAD, males were found to have significantly higher total coronary plaque volume with predominance of fibrous and fatty subtypes compared to females of the same age and BMI. There was no significant difference in plaque subtype or volume in patients with obstructive disease. PMID:23287639

  6. A finite element study of balloon expandable stent for plaque and arterial wall vulnerability assessment

    NASA Astrophysics Data System (ADS)

    Karimi, Alireza; Navidbakhsh, Mahdi; Razaghi, Reza

    2014-07-01

    The stresses induced within plaque tissues and arterial layers during stent expansion inside an atherosclerotic artery can be exceeded from the yield stresses of those tissues and, consequently, lead to plaque or arterial layer rupture. The distribution and magnitude of the stresses in each component involved in stenting might be clearly different for different plaque types and different arterial layers. In this study, a nonlinear finite element simulation was employed to investigate the effect of plaque composition (calcified, cellular, and hypocellular) on the stresses induced in the arterial layers (intima, media, and adventitia) during implantation of a balloon expandable coronary stent into a stenosed artery. The atherosclerotic artery was assumed to consist of a plaque and normal/healthy arterial tissues on its outer side. The results indicated a significant influence of plaque types on the maximum stresses induced within the plaque wall and arterial layers during stenting but not when computing maximum stress on the stent. The stress on the stiffest calcified plaque wall was in the fracture level (2.38 MPa), whereas cellular and hypocellular plaques remain stable owing to less stress on their walls. Regardless of plaque types, the highest von Mises stresses were observed on the stiffest intima layer, whereas the lowest stresses were seen to be located in less stiff media layer. The computed stresses on the intima layer were found to be high enough to initiate a rupture in this stiff layer. These findings suggest a higher risk of arterial vascular injury for the intima layer, while a lower risk of arterial injury for the media and adventitia layers.

  7. Transverse Colon Diverticulitis with Calcified Fecalith

    PubMed Central

    Solak, Aynur; Solak, Ilhami; Genç, Berhan; Sahin, Neslin; Yalaz, Seyhan

    2013-01-01

    Left colonic diverticula are common in Western populations, whereas right colonic diverticulosis primarily occurs in Oriental populations. Diverticulitis of the transverse colon is very rare, with very few cases reported in the literature. Herein, we report a case of transverse colon diverticulitis caused by a calcified stone in a 69-year-old female. This was a solitary diverticulum. The signs and symptoms of the disease are similar to acute pancreatitis. To the best of our knowledge, this is the first report describing the MRI findings of a patient with trans-verse colon diverticulitis caused by a calcified stone. PMID:25610254

  8. Calcified bodies in New World cutaneous leishmaniasis.

    PubMed

    Alvarez, Patricia; Salinas, Cesar; Bravo, Francisco

    2011-12-01

    We report a case of a 9-year-old boy who presented with 2 lesions that were compatible clinically with cutaneous leishmaniasis of the New World. A skin biopsy showed tuberculoid granulomas with rounded calcified bodies. The diagnosis was supported by a positive leishmanin test and a positive polymerase chain reaction. The patient responded to specific treatment for leishmaniasis. These calcified bodies, described under different names in the literature (Michaelis-Gutmann bodies, Schaumann bodies, psammoma bodies, or conchoidal bodies), have been reported in an experimental leishmaniasis and, only once before, in a case of human leishmaniasis of the Old World. PMID:22042260

  9. Inflammation and plaque vulnerability.

    PubMed

    Hansson, G K; Libby, P; Tabas, I

    2015-11-01

    Atherosclerosis is a maladaptive, nonresolving chronic inflammatory disease that occurs at sites of blood flow disturbance. The disease usually remains silent until a breakdown of integrity at the arterial surface triggers the formation of a thrombus. By occluding the lumen, the thrombus or emboli detaching from it elicits ischaemic symptoms that may be life-threatening. Two types of surface damage can cause atherothrombosis: plaque rupture and endothelial erosion. Plaque rupture is thought to be caused by loss of mechanical stability, often due to reduced tensile strength of the collagen cap surrounding the plaque. Therefore, plaques with reduced collagen content are thought to be more vulnerable than those with a thick collagen cap. Endothelial erosion, on the other hand, may occur after injurious insults to the endothelium instigated by metabolic disturbance or immune insults. This review discusses the molecular mechanisms involved in plaque vulnerability and the development of atherothrombosis. PMID:26260307

  10. Imaging the vulnerable plaque.

    PubMed

    Vancraeynest, David; Pasquet, Agnes; Roelants, Vronique; Gerber, Bernhard L; Vanoverschelde, Jean-Louis J

    2011-05-17

    Cardiovascular diseases are still the primary causes of mortality in the United States and in Western Europe. Arterial thrombosis is triggered by a ruptured atherosclerotic plaque and precipitates an acute vascular event, which is responsible for the high mortality rate. These rupture-prone plaques are called "vulnerable plaques." During the past decades, much effort has been put toward accurately detecting the presence of vulnerable plaques with different imaging techniques. In this review, we provide an overview of the currently available invasive and noninvasive imaging modalities used to detect vulnerable plaques. We will discuss the upcoming challenges in translating these techniques into clinical practice and in assigning them their exact place in the decision-making process. PMID:21565634

  11. Relationship between thyroid function and carotid artery plaque ulceration.

    PubMed

    Sevuk, Utkan; Bahadir, Mehmet Veysi; Altindag, Rojhat; Baysal, Erkan; Altintas, Bernas; Yaylak, Baris; Adiyaman, Mehmet Sahin; Ay, Nurettin

    2015-12-01

    Carotid artery plaque ulceration (PU) is known to be associated with cerebrovascular events (CVE). Even within euthyroid ranges, thyroid function has been reported to be associated with carotid atherosclerosis. However, the relationship between thyroid function and carotid PU remains unclear. Our aim was to determine the relationship between thyroid function and PU in patients with internal carotid artery stenosis (ICS). Records of patients with CVE were retrospectively reviewed. A total of 250 consecutive patients with ICS who had computed tomography angiography (CTA) of the carotid arteries following hospitalization were included in the study. CTA was used for the evaluation of carotid artery plaque morphology and ulceration. Plaque morphology was classified as fatty, mixed or calcified. Patients were divided into two groups according to the presence or absence of PU. Subclinical hypothyroidism (SCH) and hypothyroidism were significantly more common in patients with PU (p<0.001 and p=0.003, respectively). Patients with PU had higher incidence of low-normal FT4 levels (p=0.02). Compared with patients who had no PU, patients with PU had decreased FT4 levels and elevated TSH levels (p=0.001 and p=0.001, respectively). TSH level (OR 1.33, p=0.001), SCH (OR 4.2, p=0.001), hypothyroidism (OR 3.15, p=0.037), fatty plaque (OR 2.16, p=0.01) and calcified plaque (OR 0.19, p<0.001) were independently associated with PU. Our results suggest that SCH and hypothyroidism could be a risk factor for PU and subsequent CVE. Thyroid functions may be useful for risk stratification of patients with ICS. PMID:25672265

  12. [Unilateral to bilateral pleurisy: Pleural tuberculosis?].

    PubMed

    Ben Ameur, S; Smaoui, S; Kamoun, F; Chabchoub, I; Kamoun, T; Messaadi, F; Aloulou, H; Hachicha, M

    2016-04-01

    Pleural tuberculosis is the first or second most common form of extrapulmonary tuberculosis as well as the main cause of pleural effusion in many countries. It is rare in young infants and is more common in children over 10 years of age. We report the case of a 19-month-old girl admitted for prolonged fever with unilateral pleural effusion. The mother reported a history of lymph node tuberculosis 6 years previously. Intravenous antibiotics with cefotaxime and vancomycin were started. Thoracocentesis yielded a serosanguinous exudate fluid with a lymphocyte predominance. The tuberculin skin test and PCR GeneXpert(©) on pleural fluid were negative. The initial outcome was favorable, but the chest X-rays 10 days after discharge showed bilateral pleural effusion. Pleural biopsy was proposed but the culture of pleural fluid was positive for Mycobacterium tuberculosis. The child was put under standard treatment for tuberculosis. The outcome was favorable. PMID:26922570

  13. Pleural Intensity-Modulated Radiotherapy for Malignant Pleural Mesothelioma

    SciTech Connect

    Rosenzweig, Kenneth E.; Zauderer, Marjorie G.; Laser, Benjamin; Krug, Lee M.; Yorke, Ellen; Sima, Camelia S.; Flores, Raja; Rusch, Valerie

    2012-07-15

    Purpose: In patients with malignant pleural mesothelioma who are unable to undergo pneumonectomy, it is difficult to deliver tumoricidal radiation doses to the pleura without significant toxicity. We have implemented a technique of using intensity-modulated radiotherapy (IMRT) to treat these patients, and we report the feasibility and toxicity of this approach. Methods and Materials: Between 2005 and 2010, 36 patients with malignant pleural mesothelioma and two intact lungs (i.e., no previous pneumonectomy) were treated with pleural IMRT to the hemithorax (median dose, 46.8 Gy; range, 41.4-50.4) at Memorial Sloan-Kettering Cancer Center. Results: Of the 36 patients, 56% had right-sided tumors. The histologic type was epithelial in 78%, sarcomatoid in 6%, and mixed in 17%, and 6% had Stage I, 28% had Stage II, 33% had Stage III, and 33% had Stage IV. Thirty-two patients (89%) received induction chemotherapy (mostly cisplatin and pemetrexed); 56% underwent pleurectomy/decortication before IMRT and 44% did not undergo resection. Of the 36 patients evaluable for acute toxicity, 7 (20%) had Grade 3 or worse pneumonitis (including 1 death) and 2 had Grade 3 fatigue. In 30 patients assessable for late toxicity, 5 had continuing Grade 3 pneumonitis. For patients treated with surgery, the 1- and 2-year survival rate was 75% and 53%, and the median survival was 26 months. For patients who did not undergo surgical resection, the 1- and 2-year survival rate was 69% and 28%, and the median survival was 17 months. Conclusions: Treating the intact lung with pleural IMRT in patients with malignant pleural mesothelioma is a safe and feasible treatment option with an acceptable rate of pneumonitis. Additionally, the survival rates were encouraging in our retrospective series, particularly for the patients who underwent pleurectomy/decortication. We have initiated a Phase II trial of induction chemotherapy with pemetrexed and cisplatin with or without pleurectomy/decortication, followed by pleural IMRT to prospectively evaluate the toxicity and survival.

  14. Investigation of atherosclerotic plaque by high-frequency EPR

    NASA Astrophysics Data System (ADS)

    Biktagirov, T. B.; Chelyshev, Yu A.; Gafurov, M. R.; Mamin, G. V.; Orlinskii, S. B.; Osin, Yu N.; Salakhov, M. Kh

    2013-12-01

    We present a comparative study of samples of aorta walls from male patients with atherosclerosis and hydroxyapatite powders with the average size of crystallites of 30 nm synthesized by the wet precipitation technique by using 94 GHz pulsed EPR. Origin of the observed paramagnetic centers is discussed. Supported by the electron microscopy and microanalysis, it is shown that EPR spectra from the calcified biological tissues correlates with those obtained in inorganic hydroxyapatites. The hypothesis about the important role of (nano)hydroxyapatite in formation of the mineral deposits and atherosclerotic plaque instability is further sustained.

  15. Sintered plaque characteristics

    NASA Technical Reports Server (NTRS)

    Vaidyanathan, H.

    1982-01-01

    The structural transformations occurring during sintering, the fabrication of a slurry produced sintered plaque, are detailed. Degradation of the positive electrode in performance in cycling in a nickel hydrogen battery were traced to the quality of the sintered plaque. Electrode degradation was found to be a limiting factor in the battery cycle life. Details of microstructural characterization and distribution of pores, examination of plastic flow during shrinkage, and observations of the rounding of nickel powder particles during the slurry process are presented.

  16. Pleural calcification in northwest Greece

    SciTech Connect

    Bazas, T.; Oakes, D.; Gilson, J.C.; Bazas, B.; McDonald, J.C.

    1985-12-01

    Mass miniature radiography in 1969 detected a high prevalence of pleural calcification in three villages in northwest Greece. In 1980 a survey of a 15% sample of the population over the age of 10 was carried out with a 80% response rate. Full-size radiographs, ventilatory capacity measurements, and a detailed questionnaire on respiratory symptoms, type of work, and residence were used. Independent classification of the 408 films by two readers using the ILO/UC scheme showed very few small opacities but a very high prevalence of pleural calcification first evident in young adults and rising to 70% in the elderly. The overall prevalence was 34.7% in men and 21.5% in women. A comparison with the 1969 survey showed a progression rate of 5% per annum. In neither sex was there a significant relation of pleural calcification to smoking, ventilatory capacity, nor type of work, though those classified as field croppers had a slightly higher prevalence. There was no obvious evidence of increased lung cancer or mesothelioma in the village. The agent responsible for this apparently benign condition was not identified.

  17. Shape-based segmentation and visualization techniques for evaluation of atherosclerotic plaques in coronary artery disease

    NASA Astrophysics Data System (ADS)

    Rinck, Daniel; Krger, Sebastian; Reimann, Anja; Scheuering, Michael

    2006-03-01

    Multi-slice computed tomography (MSCT) has developed strongly in the emerging field of cardiovascular imaging. The manual analysis of atherosclerotic plaques in coronary arteries is a very time consuming and labor intensive process and today only qualitative analysis is possible. In this paper we present a new shape-based segmentation and visualization technique for quantitative analysis of atherosclerotic plaques in coronary artery disease. The new technique takes into account several aspects of the vascular anatomy. It uses two surface representations, one for the contrast filled vessel lumen and also one for the vascular wall. The deviation between these two surfaces is defined as plaque volume. These surface representations can be edited by the user manually. With this kind of representation it is possible to calculate sub plaque volumes (such as: lipid rich core, fibrous tissue, calcified tissue) inside this suspicious area. Also a high quality 3D visualization, using Open Inventor is possible.

  18. Clinical Importance of Echogenic Swirling Pleural Effusions.

    PubMed

    Lane, Alison B; Petteys, Sarah; Ginn, Meghan; Nations, Joel A

    2016-04-01

    Thoracic sonography is an important tool in diagnosis and assessment of pleural effusions and can provide valuable information about the characteristics of accumulated pleural fluid, in addition to improving the safety of thoracentesis. In addition to the 4 classic sonographic pleural effusion patterns (anechoic, complex nonseptate, complex septate, and homogeneously echogenic), an echogenic swirling pattern has been previously described, which was originally thought to be associated with malignant effusion. Two cases of pleural effusion with an echogenic swirling pattern are described below, illustrating that this sonographic finding can be seen in both exudative and transudative effusions. PMID:26931787

  19. Comparative LIBS Analysis Of Calcified Tissues

    SciTech Connect

    Abdel-Salam, Z. A.; Harith, M. A.

    2008-09-23

    Signal enhancement, limits of detection, and relevance to environmental concentration for element in calcified tissues using LIBS with single and double laser pulses will be presented. These measurements were performed on three calcified tissues representing different matrices, namely enamel of human teeth, shells and eggshells. This method depends on the role of the laser induced shock wave on the ionization rate of the ablated target material atoms. The effect of the laser single and double pulse on the ionic to atomic ratio of calcium and magnesium spectral emission lines, CaII/CaI and MgII/MgI, will be presented and compared with the previous results and its relevance to the target material hardness. The results show that in case of single pulse the intensity ratios in calcium are higher than the double pulse while there is no appreciable difference between both in case of magnesium.

  20. How Are Pleurisy and Other Pleural Disorders Diagnosed?

    MedlinePLUS

    ... a pleural effusion, fluid buildup in the pleural space will prevent a friction rub. But if you ... buildup of air or gas in the pleural space). Diagnostic Tests Depending on the results of your ...

  1. Calcifying fibrous pseudotumor of the breast.

    PubMed

    Mangat, Amrit; Schiller, Carol; Mengoni, Patricia; Reynolds, Carol; Jeruss, Jacqueline S

    2009-01-01

    Calcifying fibrous pseudotumor (CFP) is classified as a benign fibrous lesion, and is a rare pathologic entity. Previous reports have described CFPs in the extremities, chest wall, pleura, scrotum, mediastinum, neck, and visceral peritoneum. We present the first reported case of a CFP in the breast. CFP should be considered in the differential diagnosis for patients presenting with coarse indeterminate calcifications of the breast. PMID:19645787

  2. Ion-translocating properties of calcifiable proteolipids

    SciTech Connect

    Swain, L.D.; Boyan, B.D.

    1988-03-01

    De novo formation of calcium hydroxyapatite in biological systems occurs on membrane surfaces through specific interactions of Ca, Pi, phospholipids, calcifiable proteolipids, and ion flux to and from the nucleating site. This paper reports an in vitro model demonstrating an ion transport function for calcifiable proteolipid. Bacterionema matruchotii proteolipid was incubated with a radiolabeled H+-channel inhibitor, 14C-dicyclohexyl-carbodiimide, and binding characterized by displacement studies with DCCD or ethyldimethylaminopropylcarbodiimide. A carboxyl binding site was suggested by displacement of DCCD by the nucleophile, glycine ethyl ester. The displacement studies indicated that proteolipid bound DCCD via carboxyl group interaction in a hydrophobic region of the protein. SDS-polyacrylamide gel electrophoresis showed that all label was associated with a single band of 8500 Mr. No non-specific binding of 14C-DCCD to phospholipids occurred, since all bound label was associated with protein following Sephadex LH-20 chromatography of crude proteolipid. Phospholipid liposomes were prepared containing bacteriorhodopsin and proteolipid or proteolipid-14C-DCCD, via cholate dialysis. Transmembrane pH changes established by the bacteriorhodopsin H+ pump were measured in the presence and absence of added proteolipid. Proteolipid had an effect similar to those of uncouplers such as tetraphenylboron. Both the rate and extent of proton translocation increased following addition of proteolipid to BR-liposomes. 14C-DCCD abolished the proteolipid-augmented ion transport. When tetraphenylboron was used to abolish the transmembrane electrical potential, calcifiable proteolipid did not augment proton transport.

  3. FDG-PET evaluation of pleural abnormalities

    SciTech Connect

    Lowe, V.J.; Patz, E.; Harris, P.L.

    1994-05-01

    Pleural abnormalities identified on anatomical studies are often nonspecific and may represent benign or malignant disease. We prospectively evaluated the ability of FDG-PET to identify malignancy in patients with pleural abnormalities detected on chest radiographs or chest CT. Thirty-two patients with pleural abnormalities (pleural masses, thickening or effusions) found on chest radiographs or CT were evaluated by FDG-PET. Regions of interest (ROI) were identified on the PET images correlating to anatomic abnormalities and standard uptake ratios (SUR`s) of these ROI`s were calculated. A SUR value of 2.5 or greater was considered positive for malignancy. Physicians blinded to biopsy results graded their confidence of malignancy (1-5 scale) and graded lesion FDG uptake with respect to mediastinal radioactivity. Twenty-three of the patients had definitive diagnoses by tissue biopsy. Seventeen of these patients had malignant (SUR=7.9{plus_minus}3.8) and 6 had benign (SUR=2.8{plus_minus}2.4) causes of their pleural abnormalities (p=0.001). All but two malignant cases had SURs higher than 2.5 and one of these two was correctly interpreted by the observers. SURs lower than 2.5 were seen in four of the six (67%) benign pleural abnormalities. Using a combination of both visual and semiquantitative analysis, the sensitivity of FDG-PET for detecting malignant pleural abnormalities was 94%. Active infections in the pleural space had increased FDG uptake on PET studies while other benign pleural abnormalities did not. FDG-PET has very high sensitivity for detecting malignant pleural abnormalities and can differentiate benign from malignant pleural abnormalities.

  4. Mechanical, biological and structural characterization of human atherosclerotic femoral plaque tissue.

    PubMed

    Cunnane, E M; Mulvihill, J J E; Barrett, H E; Healy, D A; Kavanagh, E G; Walsh, S R; Walsh, M T

    2015-01-01

    The failure of endovascular treatments of peripheral arterial disease represents a critical clinical issue. Specialized data are required to tailor such procedures to account for the mechanical response of the diseased femoral arterial tissue to medical device deployment. The purpose of this study is to characterize the mechanical response of atherosclerotic femoral arterial tissue to large deformation, the conditions typical of angioplasty and stenting, and also to determine the mechanically induced failure properties and to relate this behaviour to biological content and structural composition using uniaxial testing, Fourier transform infrared spectroscopy and scanning electron microscopy. Mechanical and biological characterization of 20 plaque samples obtained from femoral endarterectomy identified three distinct classifications. "Lightly calcified" samples display linear mechanical responses and fail at relatively high stretch. "Moderately calcified" samples undergo an increase in stiffness and ultimate strength coupled with a decrease in ductility. Structural characterization reveals calcified nodules within this group that may be acting to reinforce the tissue matrix, thus increasing the stiffness and ultimate strength. "Heavily calcified" samples account for the majority of samples tested and exhibit significantly reduced ultimate strength and ductility compared to the preceding groups. Structural characterization of this group reveals large areas of calcified tissue dominating the failure cross-sections of the samples. The frequency and structural dominance of these features solely within this group offers an explanation as to the reduced ultimate strength and ductility and highlights the need for modern peripheral endovascular devices to account for this behaviour during novel medical device design. PMID:25242646

  5. 9. VIEW OF BRIDGE PLAQUE. PLAQUE IS LOCATED ON EASTERN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. VIEW OF BRIDGE PLAQUE. PLAQUE IS LOCATED ON EASTERN PARAPET ABOVE PIER. - Core Creek County Bridge, Spanning Core Creek, approximately 1 mile South of State Route 332 (Newtown Bypass), Newtown, Bucks County, PA

  6. Pulmonary Silicosis Presents with Pleural Effusion

    PubMed Central

    Salih, Mohsin; Aljarod, Tarake; Ayan, Mohamed; Jeffrey, Melnick; Shah, Bobby H.

    2015-01-01

    Silica and silicate mineral dust inhalation can cause a variety of histopathological changes in the lungs and pleura. These include pulmonary silicotic nodules, interstitial infiltrate, fibrosis, and pleural thickening. Pleural effusion is an extremely rare presentation of silicosis. To our best knowledge, there have been only 2 cases of silicosis with pleural effusion reported in medical literature. Herein, we describe a case of a 77-year-old male with almost 50 years' history of occupational silica exposure. He presented with a 4-week history of exertional shortness of breath. He is a lifetime nonsmoker, with no known other significant pulmonary disease. He had chest X-ray which showed a right lung infiltrate and bilateral pleural thickening and effusion. Chest CT showed moderate-sized bilateral pleural effusion and thickening with multiple bilateral intrapulmonary nodules seen. He had undergone extensive workup and was diagnosed with silicosis. PMID:26435716

  7. Supraspinatus Intramuscular Calcified Hematoma or Necrosis Associated with Tendon Tear

    PubMed Central

    Lädermann, Alexandre; Genevay, Muriel; Abrassart, Sophie; Schwitzguébel, Adrien Jean-Pierre

    2015-01-01

    Introduction. Rotator cuff intramuscular calcification is a rare condition usually caused by heterotopic ossification and myositis ossificans. Case Presentation. We describe a patient with voluminous calcified mass entrapped in supraspinatus muscle associated with corresponding tendon tear. Histological examination corresponded to a calcified hematoma or necrosis. Patient was surgically managed with open excision of the calcified hematoma and rotator cuff arthroscopic repair. At 6 months, supraspinatus muscle was healed, and functional outcome was good. Discussion and Conclusion. We hypothesized that supraspinatus intramuscular calcified hematoma was responsible for mechanical stress on the tendon. This association has never been described. PMID:26380138

  8. [Pleural effusion induced by bromocriptine].

    PubMed

    Diot, E; Diot, P; Le Rolland, A; Jonville, A P; Lasfargues, G; Lemarie, E; Lavandier, M; Guilmot, J L

    1990-01-01

    Bromocriptine, a derivative of ergot of rye, is used in high doses for the treatment of Parkinson's disease and may be responsible for pleuro-pulmonary complications. We report a case of a 72 year old patient treated for 2 years for Parkinson's disease with a daily dose of 30 mgms. of bromocriptine and in whom a pleural effusion, initially unilateral then bilateral, was discovered with a deterioration in the general physical state. The effusion was a transudate and examination did not give any clues as to aetiology, there was a rapidly favourable outcome following the cessation of treatment. Amongst the respiratory complications of bromocriptine it is the pleuro-pulmonary fibrosis which is most frequently reported. The cases of isolated pleural effusions are rare and are generally exudates. Several hypotheses have been put forward to explain the pathogenesis of these disorders: there is a theory that the molecule induces a toxic fibrogenesis, there is a vascular theory analogous with the secondary effects of methysergide and finally immunological theory. The frequency of the disorder is probably underestimated and these drug reactions justify a close follow up for any respiratory problems in patients who are subjected to treatment with bromocriptine. PMID:2320790

  9. [Pleurodesis in malignant pleural effusion].

    PubMed

    Bronner, G M; Baas, P; Beijnen, J H

    1997-09-20

    About 50% of the pleural effusions diagnosed are caused by a malignancy, especially by thoracic, pulmonary and ovarian cancer and lymphomas. The accumulation of fluid is caused by metastasization to the pleura and obstruction of lymph vessels and nodes. The effusion generally decreases if the tumour responds to systemic treatment. However, frequently this does not occur and the fluid has to be removed, to alleviate symptoms such as dyspnoea, coughing and a heavy sensation in the chest. Possible surgical therapies are draining through a needle or a drain, (partial) pleural resection and the creation of a pleuro-peritoneal shunt. Disadvantages of these are early recurrences, the severity of the intervention and (or) the high morbidity and mortality. The current standard treatment is pleurodesis brought about by a sclerosing agent, usually via a drain. The substances preferably used for this purpose are, in the order of decreasing importance, tetracycline, bleomycin or talc, doxycycline or minocycline. The most frequent adverse effects are chest pain and fever during and after the pleurodesis. PMID:9545735

  10. Calcifying species sensitivity distributions for ocean acidification.

    PubMed

    Azevedo, Ligia B; De Schryver, An M; Hendriks, A Jan; Huijbregts, Mark A J

    2015-02-01

    Increasing CO2 atmospheric levels lead to increasing ocean acidification, thereby enhancing calcium carbonate dissolution of calcifying species. We gathered peer-reviewed experimental data on the effects of acidified seawater on calcifying species growth, reproduction, and survival. The data were used to derive species-specific median effective concentrations, i.e., pH50, and pH10, via logistic regression. Subsequently, we developed species sensitivity distributions (SSDs) to assess the potentially affected fraction (PAF) of species exposed to pH declines. Effects on species growth were observed at higher pH than those on species reproduction (mean pH10 was 7.73 vs 7.63 and mean pH50 was 7.28 vs 7.11 for the two life processes, respectively) and the variability in the sensitivity of species increased with increasing number of species available for the PAF (pH10 standard deviation was 0.20, 0.21, and 0.33 for survival, reproduction, and growth, respectively). The SSDs were then applied to two climate change scenarios to estimate the increase in PAF (?PAF) by future ocean acidification. In a high CO2 emission scenario, ?PAF was 3 to 10% (for pH50) and 21 to 32% (for pH10). In a low emission scenario, ?PAF was 1 to 4% (for pH50) and 7 to 12% (for pH10). Our SSDs developed for the effect of decreasing ocean pH on calcifying marine species assemblages can also be used for comparison with other environmental stressors. PMID:25551400

  11. Peripheral calcifying epithelial odontogenic tumor- Case report.

    PubMed

    Shetty, Deepthi; Jayade, Bhushan V; Jayade, Gautam; Gopalkrishnan, K

    2014-01-01

    The calcifying epithelial odontogenic tumor (CEOT), Pindborg tumor is a benign, slow growing, but locally invasive neoplasm. It is known to have a common intraosseous variant and a very rare extraosseous variant. We report an unusual case of an extraosseous variant of CEOT of unusual large size and maxillary anterior location, the treatment was planned considering the clinical, radiological and histological features. Though peripheral types are less aggressive and had no recurrence, in our case regular follow up is required considering the aggressiveness of the lesion and its proximity to important adjacent structures. PMID:25737934

  12. Calcified Pulmonary Nodules Identified in a 350-Year-Old-Joseon Mummy: the First Report on Ancient Pulmonary Tuberculosis from Archaeologically Obtained Pre-modern Korean Samples.

    PubMed

    Kim, Yi-Suk; Lee, In Sun; Oh, Chang Seok; Kim, Myeung Ju; Cha, Soon Chul; Shin, Dong Hoon

    2016-01-01

    We found calcified pulmonary nodules in a middle-aged female mummy discovered from 350-yr-old Joseon tomb of Korea. In the CT scan, we found six radiopaque nodules in right lung, through the levels of thoracic vertebrae 1 to 6. We also found presumptive pleural adhesions in right thoracic cavity of CT images. We re-confirmed radiological findings by our post-factum dissection on the same mummy. By the differential diagnosis, we speculate that the radiopaque calcification nodules and associated pleural adhesion could have been caused by tuberculosis. This is the first-ever report on the pulmonary tuberculosis identified in archaeologically obtained, pre-modern Korean samples. PMID:26770051

  13. Calcified Pulmonary Nodules Identified in a 350-Year-Old-Joseon Mummy: the First Report on Ancient Pulmonary Tuberculosis from Archaeologically Obtained Pre-modern Korean Samples

    PubMed Central

    2016-01-01

    We found calcified pulmonary nodules in a middle-aged female mummy discovered from 350-yr-old Joseon tomb of Korea. In the CT scan, we found six radiopaque nodules in right lung, through the levels of thoracic vertebrae 1 to 6. We also found presumptive pleural adhesions in right thoracic cavity of CT images. We re-confirmed radiological findings by our post-factum dissection on the same mummy. By the differential diagnosis, we speculate that the radiopaque calcification nodules and associated pleural adhesion could have been caused by tuberculosis. This is the first-ever report on the pulmonary tuberculosis identified in archaeologically obtained, pre-modern Korean samples. PMID:26770051

  14. Talcoma: A Diagnostic Challenge in Differential Diagnosis of Pleural Masses.

    PubMed

    Ocak, Iclal; Dewan, Rohit

    2015-01-01

    Talcoma is a pleural mass which may develop as a rare complication following talc pleurodesis. Talc pleurodesis is performed to obliterate the pleural space to prevent recurrent pleural effusions or persistent pneumothoraces. The present report describes a case of a patient who developed enlarging pleural mass (talcoma) following talc pleurodesis. PMID:26273487

  15. Talcoma: A Diagnostic Challenge in Differential Diagnosis of Pleural Masses

    PubMed Central

    Ocak, Iclal; Dewan, Rohit

    2015-01-01

    Talcoma is a pleural mass which may develop as a rare complication following talc pleurodesis. Talc pleurodesis is performed to obliterate the pleural space to prevent recurrent pleural effusions or persistent pneumothoraces. The present report describes a case of a patient who developed enlarging pleural mass (talcoma) following talc pleurodesis. PMID:26273487

  16. Mast cells mediate malignant pleural effusion formation.

    PubMed

    Giannou, Anastasios D; Marazioti, Antonia; Spella, Magda; Kanellakis, Nikolaos I; Apostolopoulou, Hara; Psallidas, Ioannis; Prijovich, Zeljko M; Vreka, Malamati; Zazara, Dimitra E; Lilis, Ioannis; Papaleonidopoulos, Vassilios; Kairi, Chrysoula A; Patmanidi, Alexandra L; Giopanou, Ioanna; Spiropoulou, Nikolitsa; Harokopos, Vaggelis; Aidinis, Vassilis; Spyratos, Dionisios; Teliousi, Stamatia; Papadaki, Helen; Taraviras, Stavros; Snyder, Linda A; Eickelberg, Oliver; Kardamakis, Dimitrios; Iwakura, Yoichiro; Feyerabend, Thorsten B; Rodewald, Hans-Reimer; Kalomenidis, Ioannis; Blackwell, Timothy S; Agalioti, Theodora; Stathopoulos, Georgios T

    2015-06-01

    Mast cells (MCs) have been identified in various tumors; however, the role of these cells in tumorigenesis remains controversial. Here, we quantified MCs in human and murine malignant pleural effusions (MPEs) and evaluated the fate and function of these cells in MPE development. Evaluation of murine MPE-competent lung and colon adenocarcinomas revealed that these tumors actively attract and subsequently degranulate MCs in the pleural space by elaborating CCL2 and osteopontin. MCs were required for effusion development, as MPEs did not form in mice lacking MCs, and pleural infusion of MCs with MPE-incompetent cells promoted MPE formation. Once homed to the pleural space, MCs released tryptase AB1 and IL-1?, which in turn induced pleural vasculature leakiness and triggered NF-?B activation in pleural tumor cells, thereby fostering pleural fluid accumulation and tumor growth. Evaluation of human effusions revealed that MCs are elevated in MPEs compared with benign effusions. Moreover, MC abundance correlated with MPE formation in a human cancer cell-induced effusion model. Treatment of mice with the c-KIT inhibitor imatinib mesylate limited effusion precipitation by mouse and human adenocarcinoma cells. Together, the results of this study indicate that MCs are required for MPE formation and suggest that MC-dependent effusion formation is therapeutically addressable. PMID:25915587

  17. Mast cells mediate malignant pleural effusion formation

    PubMed Central

    Giannou, Anastasios D.; Marazioti, Antonia; Spella, Magda; Kanellakis, Nikolaos I.; Apostolopoulou, Hara; Psallidas, Ioannis; Prijovich, Zeljko M.; Vreka, Malamati; Zazara, Dimitra E.; Lilis, Ioannis; Papaleonidopoulos, Vassilios; Kairi, Chrysoula A.; Patmanidi, Alexandra L.; Giopanou, Ioanna; Spiropoulou, Nikolitsa; Harokopos, Vaggelis; Aidinis, Vassilis; Spyratos, Dionisios; Teliousi, Stamatia; Papadaki, Helen; Taraviras, Stavros; Snyder, Linda A.; Eickelberg, Oliver; Kardamakis, Dimitrios; Iwakura, Yoichiro; Feyerabend, Thorsten B.; Rodewald, Hans-Reimer; Kalomenidis, Ioannis; Blackwell, Timothy S.; Agalioti, Theodora; Stathopoulos, Georgios T.

    2015-01-01

    Mast cells (MCs) have been identified in various tumors; however, the role of these cells in tumorigenesis remains controversial. Here, we quantified MCs in human and murine malignant pleural effusions (MPEs) and evaluated the fate and function of these cells in MPE development. Evaluation of murine MPE-competent lung and colon adenocarcinomas revealed that these tumors actively attract and subsequently degranulate MCs in the pleural space by elaborating CCL2 and osteopontin. MCs were required for effusion development, as MPEs did not form in mice lacking MCs, and pleural infusion of MCs with MPE-incompetent cells promoted MPE formation. Once homed to the pleural space, MCs released tryptase AB1 and IL-1β, which in turn induced pleural vasculature leakiness and triggered NF-κB activation in pleural tumor cells, thereby fostering pleural fluid accumulation and tumor growth. Evaluation of human effusions revealed that MCs are elevated in MPEs compared with benign effusions. Moreover, MC abundance correlated with MPE formation in a human cancer cell–induced effusion model. Treatment of mice with the c-KIT inhibitor imatinib mesylate limited effusion precipitation by mouse and human adenocarcinoma cells. Together, the results of this study indicate that MCs are required for MPE formation and suggest that MC-dependent effusion formation is therapeutically addressable. PMID:25915587

  18. Computed tomography of localized pleural mesothelioma

    SciTech Connect

    Dedrick, C.G.; McLoud, T.C.; Shepard, J.O.; Shipley, R.T.

    1985-02-01

    The computed tomographic (CT) features of six pathologically proven cases of fibrous mesothelioma were reviewed. There were no pathognomonic CT characteristics, but in all cases CT suggested or supported the preoperative diagnosis. CT findings included well delineated, often lobulated, noncalcified soft-tissue masses in close relation to a pleural surface, associated crural thickening, and absence of chest wall invasion. An obtuse angle of the mass with respect to the pleural surface was not particularly useful. Rather, a smoothly tapering margin was more characteristic of a pleural lesion.

  19. Rare case of acral calcified angioleiomyoma with macroscopic calcium extrusion.

    PubMed

    Blalock, Travis W; Kerr, Christy; DeRienzo, Damian P; Greenway, Hubert T

    2015-06-01

    Acral calcified angioleiomyoma is an uncommon tumor that presents as a non-descript papule or subcutaneous nodule, classically on the foot. Biopsy or excision is typically the diagnostic method of choice as well as the treatment for these sometimes painful tumors. We report an uncommon clinical presentation of acral calcified angioleiomyoma with considerable extrusion of calcium perforating through the skin. PMID:25937420

  20. Enhanced characterization of calcified areas in intravascular ultrasound virtual histology images by quantification of the acoustic shadow: validation against computed tomography coronary angiography.

    PubMed

    Broersen, Alexander; de Graaf, Michiel A; Eggermont, Jeroen; Wolterbeek, Ron; Kitslaar, Pieter H; Dijkstra, Jouke; Bax, Jeroen J; Reiber, Johan H C; Scholte, Arthur J

    2016-04-01

    We enhance intravascular ultrasound virtual histology (VH) tissue characterization by fully automatic quantification of the acoustic shadow behind calcified plaque. VH is unable to characterize atherosclerosis located behind calcifications. In this study, the quantified acoustic shadows are considered calcified to approximate the real dense calcium (DC) plaque volume. In total, 57 patients with 108 coronary lesions were included. A novel post-processing step is applied on the VH images to quantify the acoustic shadow and enhance the VH results. The VH and enhanced VH results are compared to quantitative computed tomography angiography (QTA) plaque characterization as reference standard. The correlation of the plaque types between enhanced VH and QTA differs significantly from the correlation with unenhanced VH. For DC, the correlation improved from 0.733 to 0.818. Instead of an underestimation of DC in VH with a bias of 8.5 mm(3), there was a smaller overestimation of 1.1 mm(3) in the enhanced VH. Although tissue characterization within the acoustic shadow in VH is difficult, the novel algorithm improved the DC tissue characterization. This algorithm contributes to accurate assessment of calcium on VH and could be applied in clinical studies. PMID:26667446

  1. Photon counting spectral CT component analysis of coronary artery atherosclerotic plaque samples

    PubMed Central

    Coulon, P; Thran, A; Roessl, E; Martens, G; Sigovan, M; Douek, P

    2014-01-01

    Objective: To evaluate the capabilities of photon counting spectral CT to differentiate components of coronary atherosclerotic plaque based on differences in spectral attenuation and iodine-based contrast agent concentration. Methods: 10 calcified and 13 lipid-rich non-calcified histologically demonstrated atheromatous plaques from post-mortem human coronary arteries were scanned with a photon counting spectral CT scanner. Individual photons were counted and classified in one of six energy bins from 25 to 70?keV. Based on a maximum likelihood approach, maps of photoelectric absorption (PA), Compton scattering (CS) and iodine concentration (IC) were reconstructed. Intensity measurements were performed on each map in the vessel wall, the surrounding perivascular fat and the lipid-rich and the calcified plaques. PA and CS values are expressed relative to pure water values. A comparison between these different elements was performed using KruskalWallis tests with pairwise post hoc MannWhitney U-tests and Sidak p-value adjustments. Results: Results for vessel wall, surrounding perivascular fat and lipid-rich and calcified plaques were, respectively, 1.19??0.09, 0.73??0.05, 1.08??0.14 and 17.79??6.70 for PA; 0.96??0.02, 0.83??0.02, 0.91??0.03 and 2.53??0.63 for CS; and 83.3??10.1, 37.6??8.1, 55.2??14.0 and 4.9??20.0?mmol?l?1 for IC, with a significant difference between all tissues for PA, CS and IC (p?plaque samples by analysing differences in spectral attenuation and iodine-based contrast agent concentration. Advances in knowledge: Photon counting spectral CT is a promising technique to identify plaque components by analysing differences in iodine-based contrast agent concentration, photoelectric attenuation and Compton scattering. PMID:24874766

  2. La pelade par plaques

    PubMed Central

    Spano, Frank; Donovan, Jeff C.

    2015-01-01

    Résumé Objectif Présenter aux médecins de famille des renseignements de base pour faire comprendre les schémas thérapeutiques et les résultats des traitements pour la pelade par plaques, de même que les aider à identifier les patients pour qui une demande de consultation en dermatologie pourrait s’imposer. Sources des données Une recension a été effectuée dans PubMed pour trouver des articles pertinents concernant le traitement de la pelade par plaques. Message principal La pelade par plaques est une forme auto-immune de perte pileuse qui touche à la fois les enfants et les adultes. Même s’il n’y a pas de mortalité associée à la maladie, la morbidité découlant des effets psychologiques de la perte des cheveux peut être dévastatrice. Lorsque la pelade par plaques et le sous-type de la maladie sont identifiés, un schéma thérapeutique approprié peut être amorcé pour aider à arrêter la chute des cheveux et possiblement faire commencer la repousse. Les traitements de première intention sont la triamcinolone intralésionnelle avec des corticostéroïdes topiques ou du minoxidil ou les 2. Les médecins de famille peuvent prescrire ces traitements en toute sécurité et amorcer ces thérapies. Les cas plus avancés ou réfractaires pourraient avoir besoin de diphénylcyclopropénone topique ou d’anthraline topique. On peut traiter la perte de cils avec des analogues de la prostaglandine. Les personnes ayant subi une perte de cheveux abondante peuvent recourir à des options de camouflage ou à des prothèses capillaires. Il est important de surveiller les troubles psychiatriques en raison des effets psychologiques profonds de la perte de cheveux. Conclusion Les médecins de famille verront de nombreux patients qui perdent leurs cheveux. La reconnaissance de la pelade par plaques et la compréhension du processus pathologique sous-jacent permettent d’amorcer un schéma thérapeutique approprié. Les cas plus graves ou réfractaires doivent être identifiés pour qu’une demande de consultation en dermatologie soit demandée au besoin.

  3. La pelade par plaques

    PubMed Central

    Spano, Frank; Donovan, Jeff C.

    2015-01-01

    Résumé Objectif Présenter aux médecins de famille des renseignements de base pour faire comprendre l’épidémiologie, la pathogenèse, l’histologie et l’approche clinique au diagnostic de la pelade par plaques. Sources des données Une recension a été effectuée dans PubMed pour trouver des articles pertinents concernant la pathogenèse, le diagnostic et le pronostic de la pelade par plaques. Message principal La pelade par plaques est une forme de perte pileuse auto-immune dont la prévalence durant une vie est d’environ 2 %. Des antécédents personnels ou familiaux de troubles auto-immuns concomitants, comme le vitiligo ou une maladie de la thyroïde, peuvent être observés dans un petit sous-groupe de patients. Le diagnostic peut souvent être posé de manière clinique en se fondant sur la perte de cheveux non cicatricielle et circulaire caractéristique, accompagnée de cheveux en « point d’exclamation » en périphérie chez ceux dont le problème en est aux premiers stades. Le diagnostic des cas plus complexes ou des présentations inhabituelles peut être facilité par une biopsie et un examen histologique. Le pronostic varie largement et de mauvais résultats sont associés à une apparition à un âge précoce, une perte importante, la variante ophiasis, des changements aux ongles, des antécédents familiaux ou des troubles auto-immuns concomitants. Conclusion La pelade par plaques est une forme auto-immune de perte de cheveux périodiquement observée en soins primaires. Les médecins de famille sont bien placés pour identifier la pelade par plaques, déterminer la gravité de la maladie et poser le diagnostic différentiel approprié. De plus, ils sont en mesure de renseigner leurs patients à propos de l’évolution clinique de la maladie ainsi que du pronostic général selon le sous-type de patients.

  4. Interventions to treat malignant pleural effusions.

    PubMed

    Lenker, April; Mayer, Deborah K; Bernard, Stephen A

    2015-10-01

    Malignant pleural effusions (MPEs) are common complications that occur with advanced stages of cancer. In general, they indicate a poor prognosis and greatly affect quality of life (QOL). The treatment goal of MPEs is to provide relief of symptoms. The standard treatment for MPEs is talc pleurodesis; however, indwelling pleural catheters have become more frequently used. This article focuses on current management strategies for MPEs and assesses their influence on QOL.At a GlanceSymptoms of malignant pleural effusions (MPEs), which involve the accumulation of fluid in the pleural space, include dyspnea, shortness of breath, chest pain, and other issues that decrease functional status.Treatment for MPEs should be palliative, achieving immediate symptom relief and improved quality of life.The optimal treatment strategy for MPEs should have minimal side effects, require minimal or no hospitalization, and have low rates of recurrence. PMID:26414568

  5. Tight junction physiology of pleural mesothelium.

    PubMed

    Markov, Alexander G; Amasheh, Salah

    2014-01-01

    Pleura consists of visceral and parietal cell layers, producing a fluid, which is necessary for lubrication of the pleural space. Function of both mesothelial cell layers is necessary for the regulation of a constant pleural fluid volume and composition to facilitate lung movement during breathing. Recent studies have demonstrated that pleural mesothelial cells show a distinct expression pattern of tight junction proteins which are known to ubiquitously determine paracellular permeability. Most tight junction proteins provide a sealing function to epithelia, but some have been shown to have a paracellular channel function or ambiguous properties. Here we provide an in-depth review of the current knowledge concerning specific functional contribution of these proteins determining transport and barrier function of pleural mesothelium. PMID:25009499

  6. Tight junction physiology of pleural mesothelium

    PubMed Central

    Markov, Alexander G.; Amasheh, Salah

    2014-01-01

    Pleura consists of visceral and parietal cell layers, producing a fluid, which is necessary for lubrication of the pleural space. Function of both mesothelial cell layers is necessary for the regulation of a constant pleural fluid volume and composition to facilitate lung movement during breathing. Recent studies have demonstrated that pleural mesothelial cells show a distinct expression pattern of tight junction proteins which are known to ubiquitously determine paracellular permeability. Most tight junction proteins provide a sealing function to epithelia, but some have been shown to have a paracellular channel function or ambiguous properties. Here we provide an in-depth review of the current knowledge concerning specific functional contribution of these proteins determining transport and barrier function of pleural mesothelium. PMID:25009499

  7. Pleural space complications associated with lung transplantation.

    PubMed

    Arndt, Andrew; Boffa, Daniel J

    2015-01-01

    Lung transplantation represents a life-saving option for some end-stage lung diseases. Despite the magnitude of anatomic manipulation and the fragility of the patient population, the procedures have become progressively safer. Perioperative morbidity, however, remains high. Pleural space complications are particularly common. This article discusses hemothorax, chylothorax, air leak or pneumothorax, recurrent effusion, empyema, trapped lung, and chronic pleural complications. PMID:25430432

  8. Detection of Symptomatic Carotid Plaque Using Source Data from MR and CT Angiography: A Correlative Study

    PubMed Central

    Gupta, Ajay; Baradaran, Hediyeh; Mtui, Edward E.; Kamel, Hooman; Pandya, Ankur; Giambrone, Ashley; Iadecola, Costantino; Sanelli, Pina C.

    2016-01-01

    Background Carotid plaque MRI has been a useful method to characterize vulnerable atherosclerotic plaque elements. Recent investigations have suggested that source images from CT angiography (CTA) and MR angiography (MRA) can identify the simple high-risk features of symptom-producing carotid artery plaque. We studied the correlation and relative diagnostic accuracies of CTA and MRA source images in detecting symptomatic carotid artery plaque. Methods Subjects were eligible if they had carotid stenosis between 50 and 99% and had MRA and CTA exams performed within 10 days of one another. We measured the soft (non-calcified) plaque and hard (calcified) plaque thickness on CTA axial source images and intraplaque high-intensity signal (IHIS) on 3D-time-of-flight MRA source images in subjects. We assessed whether a correlation existed between increasing CTA soft plaque thicknesses and the presence of MRA IHIS using the Student's t-test. We calculated the differences in sensitivity and specificity measures of CTA and MRA source-imaging data with the occurrence of recent ipsilateral stroke or transient ischemic attack (TIA) as the reference standard. We also performed logistic regression analyses to evaluate the predictive strength of plaque showing both IHIS and increased CTA soft plaque thickness in predicting symptomatic disease status. Results Of 1994 screened patients, 48 arteries met the final inclusion criteria with MRA and CTA performed within 10 days of one another. The mean and median time between CTA and MRA exams were 2.0 days and 1 day, respectively. A total of 34 of 48 stenotic vessels (70.8%) were responsible for giving rise to ipsilateral stroke or TIA. CTA mean soft plaque thickness was significantly greater (4.47 vs. 2.30 mm, p < 0.0001) in patients with MRA-defined IHIS, while CTA hard plaque thickness was significantly greater (2.09 vs. 1.16 mm, p = 0.0134) in patients without MRA evidence of IHIS. CTA soft plaque thickness measurements were more sensitive than MRA IHIS (91.2 vs. 67.6%, p=0.011) in detecting symptomatic plaque, while differences in specificity were not significantly different (p = 0.1573). In the subset of patients with both IHIS on MRA and plaque thickness >2.4 mm on CTA, the odds ratio of detecting symptomatic plaque, corrected for stenosis severity, was 45.3 (p < 0.0005). Conclusions Unprocessed source images from CTA and MRA, which are routinely evaluated for clinical studies demonstrate the highly correlated presence of IHIS and increasing soft plaque thickness. In particular, plaque that shows high-risk features on both MRA and CTA are very strongly associated with symptom-producing carotid plaque. With further validation, such techniques are promising practical methods of extracting risk information from routine neck angiographic imaging. PMID:25721945

  9. An IR Navigation System for Pleural PDT

    PubMed Central

    Zhu, Timothy C.; Liang, Xing; Kim, Michele M.; Finlay, Jarod C.; Dimofte, Andreea; Rodriguez, Carmen; Simone, Charles B.; Friedberg, Joseph S.; Cengel, Keith A.

    2015-01-01

    Pleural photodynamic therapy (PDT) has been used as an adjuvant treatment with lung-sparing surgical treatment for malignant pleural mesothelioma (MPM). In the current pleural PDT protocol, a moving fiber-based point source is used to deliver the light. The light fluences at multiple locations are monitored by several isotropic detectors placed in the pleural cavity. To improve the delivery of light fluence uniformity, an infrared (IR) navigation system is used to track the motion of the light source in real-time at a rate of 20 60 Hz. A treatment planning system uses the laser source positions obtained from the IR camera to calculate light fluence distribution to monitor the light fluence uniformity on the surface of the pleural cavity. A novel reconstruction algorithm is used to determine the pleural cavity surface contour. A dual-correction method is used to match the calculated fluences at detector locations to the detector readings. Preliminary data from a phantom shows superior light uniformity using this method. Light fluence uniformity from patient treatments is also shown with and without the correction method. PMID:25995987

  10. Pleural procedural complications: prevention and management

    PubMed Central

    Psallidas, Ioannis; Wrightson, John M.; Hallifax, Robert J.; Rahman, Najib M.

    2015-01-01

    Pleural disease is common with a rising case frequency. Many of these patients will be symptomatic and require diagnostic and/or therapeutic procedures. Patients with pleural disease present to a number of different medical specialties, and an equally broad range of clinicians are therefore required to have practical knowledge of these procedures. There is often underestimation of the morbidity and mortality associated with pleural interventions, even those regarded as being relatively straightforward, with potentially significant implications for processes relating to patient safety and informed consent. The advent of thoracic ultrasound (TUS) has had a major influence on patient safety and the number of physicians with the necessary skill set to perform pleural procedures. As the variety and complexity of pleural interventions increases, there is increasing recognition that early specialist input can reduce the risk of complications and number of procedures a patient requires. This review looks at the means by which complications of pleural procedures arise, along with how they can be managed or ideally prevented. PMID:26150919

  11. Pleural infection: past, present, and future directions.

    PubMed

    Corcoran, John P; Wrightson, John M; Belcher, Elizabeth; DeCamp, Malcolm M; Feller-Kopman, David; Rahman, Najib M

    2015-07-01

    Pleural space infections are increasing in incidence and continue to have high associated morbidity, mortality, and need for invasive treatments such as thoracic surgery. The mechanisms of progression from a non-infected, pneumonia-related effusion to a confirmed pleural infection have been well described in the scientific literature, but the route by which pathogenic organisms access the pleural space is poorly understood. Data suggests that not all pleural infections can be related to lung parenchymal infection. Studies examining the microbiological profile of pleural infection inform antibiotic choice and can help to delineate the source and pathogenesis of infection. The development of radiological methods and use of clinical indices to predict which patients with pleural infection will have a poor outcome, as well as inform patient selection for more invasive treatments, is particularly important. Randomised clinical trial and case series data have shown that the combination of an intrapleural tissue plasminogen activator and deoxyribonuclease therapy can potentially improve outcomes, but the use of this treatment as compared with surgical options has not been precisely defined, particularly in terms of when and in which patients it should be used. PMID:26170076

  12. The Differential Diagnosis of Pleural Effusions

    PubMed Central

    Sahn, Steven A.

    1982-01-01

    The presence of pleural effusion enables a physician to obtain a specimen of a body cavity fluid easily. With a systematic analysis of the pleural fluid, in conjunction with the clinical features and ancillary laboratory data, a clinician should be able to arrive at either a presumptive or definitive diagnosis in approximately 90 percent of cases. Selectivity should be exercised in ordering analyses on pleural fluid. The first important deductive step is to decide whether the effusion is a transudate (due to imbalances in hydrostatic or oncotic pressures) or an exudate (inflammatory); serum protein and lactate dehydrogenase measurements will be decisive. The differential diagnosis of a transudate is relatively limited and usually easily discernible from the clinical presentation. The differential diagnosis of exudate poses a more difficult challenge for clinicians. The use of certain pleural fluid tests such as leukocyte count and differential, glucose, pH and, when indicated, pleural fluid amylase determinations, helps to narrow the differential diagnosis of an exudative pleural effusion. PMID:6182697

  13. An IR Navigation System for Pleural PDT

    NASA Astrophysics Data System (ADS)

    Zhu, Timothy; Liang, Xing; Kim, Michele; Finlay, Jarod; Dimofte, Andreea; Rodriguez, Carmen; Simone, Charles; Friedberg, Joseph; Cengel, Keith

    2015-03-01

    Pleural photodynamic therapy (PDT) has been used as an adjuvant treatment with lung-sparing surgical treatment for malignant pleural mesothelioma (MPM). In the current pleural PDT protocol, a moving fiber-based point source is used to deliver the light. The light fluences at multiple locations are monitored by several isotropic detectors placed in the pleural cavity. To improve the delivery of light fluence uniformity, an infrared (IR) navigation system is used to track the motion of the light source in real-time at a rate of 20 - 60 Hz. A treatment planning system uses the laser source positions obtained from the IR camera to calculate light fluence distribution to monitor the light dose uniformity on the surface of the pleural cavity. A novel reconstruction algorithm is used to determine the pleural cavity surface contour. A dual-correction method is used to match the calculated fluences at detector locations to the detector readings. Preliminary data from a phantom shows superior light uniformity using this method. Light fluence uniformity from patient treatments is also shown with and without the correction method.

  14. Effect of calcification on the mechanical stability of plaque based on a three-dimensional carotid bifurcation model

    PubMed Central

    2012-01-01

    Background This study characterizes the distribution and components of plaque structure by presenting a three-dimensional blood-vessel modelling with the aim of determining mechanical properties due to the effect of lipid core and calcification within a plaque. Numerical simulation has been used to answer how cap thickness and calcium distribution in lipids influence the biomechanical stress on the plaque. Method Modelling atherosclerotic plaque based on structural analysis confirms the rationale for plaque mechanical examination and the feasibility of our simulation model. Meaningful validation of predictions from modelled atherosclerotic plaque model typically requires examination of bona fide atherosclerotic lesions. To analyze a more accurate plaque rupture, fluid-structure interaction is applied to three-dimensional blood-vessel carotid bifurcation modelling. A patient-specific pressure variation is applied onto the plaque to influence its vulnerability. Results Modelling of the human atherosclerotic artery with varying degrees of lipid core elasticity, fibrous cap thickness and calcification gap, which is defined as the distance between the fibrous cap and calcification agglomerate, form the basis of our rupture analysis. Finite element analysis shows that the calcification gap should be conservatively smaller than its threshold to maintain plaque stability. The results add new mechanistic insights and methodologically sound data to investigate plaque rupture mechanics. Conclusion Structural analysis using a three-dimensional calcified model represents a more realistic simulation of late-stage atherosclerotic plaque. We also demonstrate that increases of calcium content that is coupled with a decrease in lipid core volume can stabilize plaque structurally. PMID:22336469

  15. Association of coronary plaque burden with fractional flow reserve: should we keep attempting to derive physiology from anatomy?

    PubMed Central

    Abd, Thura T.

    2015-01-01

    Coronary computed tomography angiography (CTA) has been used increasingly for the diagnosis of coronary artery disease over the past decade. Compared to invasive coronary angiography (ICA), coronary CTA has the ability to visualize and quantify atherosclerotic plaque both calcified and non-calcified. Traditional measures of evaluating a coronary stenosis such as diameter stenosis, area stenosis, minimal lumen diameter and minimal luminal area are limited in their ability to predict its functional significance especially when diameter stenosis ranges between 30-69% (intermediate range). Measurement of invasive fractional flow reserve (FFR) is considered the gold standard for assessment of the hemodynamic significance of a stenosis. The current study by Nakazato et al. evaluates the performance of an emerging coronary CTA-derived anatomical measure percent aggregate plaque volume to improve the detection of hemodynamic significant stenosis as compared with invasive FFR. PMID:25774351

  16. Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women.

    PubMed

    Rodriguez, Karen; Kwan, Alan C; Lai, Shenghan; Lima, Joo A C; Vigneault, Davis; Sandfort, Veit; Pattanayak, Puskar; Ahlman, Mark A; Mallek, Marissa; Sibley, Christopher T; Bluemke, David A

    2015-10-01

    Purpose To assess the relationship between total, calcified, and noncalcified coronary plaque burdens throughout the entire coronary vasculature at coronary computed tomographic (CT) angiography in relationship to cardiovascular risk factors in asymptomatic individuals with low-to-moderate risk. Materials and Methods This HIPAA-compliant study had institutional review board approval, and written informed consent was obtained. Two hundred two subjects were recruited to an ongoing prospective study designed to evaluate the effect of HMG-CoA reductase inhibitors on atherosclerosis. Eligible subjects were asymptomatic individuals older than 55 years who were eligible for statin therapy. Coronary CT angiography was performed by using a 320-detector row scanner. Coronary wall thickness and plaque were evaluated in all epicardial coronary arteries greater than 2 mm in diameter. Images were analyzed by using dedicated software involving an adaptive lumen attenuation algorithm. Total plaque index (calcified plus noncalcified plaque) was defined as plaque volume divided by vessel length. Multivariable regression analysis was performed to determine the relationship between risk factors and plaque indexes. Results The mean age of the subjects was 65.5 years 6.9 (standard deviation) (36% women), and the median coronary artery calcium (CAC) score was 73 (interquartile range, 1-434). The total coronary plaque index was higher in men than in women (42.06 mm(2) 9.22 vs 34.33 mm(2) 8.35; P < .001). In multivariable analysis controlling for all risk factors, total plaque index remained higher in men than in women (by 5.01 mm(2); P = .03) and in those with higher simvastatin doses (by 0.44 mm(2)/10 mg simvastatin dose equivalent; P = .02). Noncalcified plaque index was positively correlated with systolic blood pressure (? = 0.80 mm(2)/10 mm Hg; P = .03), diabetes (? = 4.47 mm(2); P = .03), and low-density lipoprotein (LDL) cholesterol level (? = 0.04 mm(2)/mg/dL; P = .02); the association with LDL cholesterol level remained significant (P = .02) after additional adjustment for the CAC score. Conclusion LDL cholesterol level, systolic blood pressure, and diabetes were associated with noncalcified plaque burden at coronary CT angiography in asymptomatic individuals with low-to-moderate risk. () RSNA, 2015 Online supplemental material is available for this article. PMID:26035436

  17. Irregularly calcified eggs and eggshells of Caiman latirostris (Alligatoridae: Crocodylia)

    NASA Astrophysics Data System (ADS)

    Fernndez, Mariela Soledad; Simoncini, Melina Soledad; Dyke, Gareth

    2013-05-01

    We describe irregularly calcified egg and eggshell morphologies for the first time in nests of the broad-snouted caiman, Caiman latirostris. Research is based on detailed descriptions of 270 eggs from a total sample of 46,800 collected between 2005 and 2011 in Santa Fe Province, Argentina, and encompasses animals from both natural habitats and held in captivity. We discuss possible reasons for the occurrence of eggs with different mineralisation patterns in our extensive C. latirostris field sample and its conservation significance; the chemistry of egg laying in amniotes is sensitive to environmental contamination which, in turn, has biological implications. Based on our egg sample, we identify two caiman eggshell abnormalities: (1) regularly calcified eggs with either calcitic nodules or superficial wrinkles at one egg end and (2) irregularly calcified eggs with structural gaps that weaken the shell. Some recently laid clutches we examined included eggs with most of the shell broken and detached from the flexible membrane. Most type 1 regularly calcified eggs lost their initial calcified nodules during incubation, suggesting that these deposits do not affect embryo survival rates. In contrast, irregularly calcified caiman eggs have a mean hatching success rate of 8.9 % (range 0-38 %) across our sample compared to a mean normal success of 75 %. Most irregularly calcified caiman eggs probably die because of infections caused by fungi and bacteria in the organic nest material, although another possible explanation that merits further investigation could be an increase in permeability, leading to embryo dehydration.

  18. Irregularly calcified eggs and eggshells of Caiman latirostris (Alligatoridae: Crocodylia).

    PubMed

    Fernndez, Mariela Soledad; Simoncini, Melina Soledad; Dyke, Gareth

    2013-05-01

    We describe irregularly calcified egg and eggshell morphologies for the first time in nests of the broad-snouted caiman, Caiman latirostris. Research is based on detailed descriptions of 270 eggs from a total sample of 46,800 collected between 2005 and 2011 in Santa Fe Province, Argentina, and encompasses animals from both natural habitats and held in captivity. We discuss possible reasons for the occurrence of eggs with different mineralisation patterns in our extensive C. latirostris field sample and its conservation significance; the chemistry of egg laying in amniotes is sensitive to environmental contamination which, in turn, has biological implications. Based on our egg sample, we identify two caiman eggshell abnormalities: (1) regularly calcified eggs with either calcitic nodules or superficial wrinkles at one egg end and (2) irregularly calcified eggs with structural gaps that weaken the shell. Some recently laid clutches we examined included eggs with most of the shell broken and detached from the flexible membrane. Most type 1 regularly calcified eggs lost their initial calcified nodules during incubation, suggesting that these deposits do not affect embryo survival rates. In contrast, irregularly calcified caiman eggs have a mean hatching success rate of 8.9% (range 0-38%) across our sample compared to a mean normal success of 75%. Most irregularly calcified caiman eggs probably die because of infections caused by fungi and bacteria in the organic nest material, although another possible explanation that merits further investigation could be an increase in permeability, leading to embryo dehydration. PMID:23604383

  19. Pleural controversies: image guided biopsy vs. thoracoscopy for undiagnosed pleural effusions?

    PubMed Central

    Dixon, Giles; de Fonseka, Duneesha

    2015-01-01

    Undiagnosed pleural effusions present an increasing diagnostic burden upon healthcare providers internationally. The investigation of pleural effusions often requires the acquisition of tissue for histological analysis and diagnosis. Historically there were two options for tissue biopsy: a gold standard surgical biopsy or a blind closed pleural biopsy. Over the last decade however, image-guided Tru-cut biopsies and local anaesthetic thoracoscopic (local anaesthetic thoracoscopy) biopsies have become more widespread. Image-guided techniques acquire samples under ultrasound (US) or computed tomography (CT) guidance whereas LAT involves the direct visualisation and biopsy of the pleura with pleuroscopy. Both techniques have been shown to be superior to blind closed pleural biopsy for the diagnosis of pleural or metastatic malignancy. However, closed biopsy remains a viable method of investigation in areas of high incidence of tuberculosis (TB). Beyond this, each investigative technique has its own advantages and disadvantages. Image-guided biopsy is less invasive, usually carried out as an outpatient procedure, and enables tissue biopsy in frail patients and those with pleural thickening but no pleural fluid. Local anaesthetic thoracoscopy (LAT) provides diagnostic and therapeutic capabilities in one procedure. Large volume thoracentesis, multiple pleural biopsies and talc poudrage can be carried out in a single procedure. The overall diagnostic yield is similar for both techniques, although there are no large-scale direct comparisons. Both techniques share low complication rates. PMID:26150917

  20. Pleural controversies: image guided biopsy vs. thoracoscopy for undiagnosed pleural effusions?

    PubMed

    Dixon, Giles; de Fonseka, Duneesha; Maskell, Nick

    2015-06-01

    Undiagnosed pleural effusions present an increasing diagnostic burden upon healthcare providers internationally. The investigation of pleural effusions often requires the acquisition of tissue for histological analysis and diagnosis. Historically there were two options for tissue biopsy: a 'gold standard' surgical biopsy or a "blind" closed pleural biopsy. Over the last decade however, image-guided Tru-cut biopsies and local anaesthetic thoracoscopic (local anaesthetic thoracoscopy) biopsies have become more widespread. Image-guided techniques acquire samples under ultrasound (US) or computed tomography (CT) guidance whereas LAT involves the direct visualisation and biopsy of the pleura with pleuroscopy. Both techniques have been shown to be superior to 'blind' closed pleural biopsy for the diagnosis of pleural or metastatic malignancy. However, closed biopsy remains a viable method of investigation in areas of high incidence of tuberculosis (TB). Beyond this, each investigative technique has its own advantages and disadvantages. Image-guided biopsy is less invasive, usually carried out as an outpatient procedure, and enables tissue biopsy in frail patients and those with pleural thickening but no pleural fluid. Local anaesthetic thoracoscopy (LAT) provides diagnostic and therapeutic capabilities in one procedure. Large volume thoracentesis, multiple pleural biopsies and talc poudrage can be carried out in a single procedure. The overall diagnostic yield is similar for both techniques, although there are no large-scale direct comparisons. Both techniques share low complication rates. PMID:26150917

  1. Gingival calcifying epithelial tumor - a rare case report.

    PubMed

    Tejasvi, M L A; Balaji, B B; Pramkusam, K; Donempudi, G; Bhayya, H

    2014-01-01

    Calcifying epithelial odontogenic tumors are rare odontogenic neoplasms that account for approximately one percent of all odontogenic tumors. Extra osseous variant is very rare with very few cases being reported in literature Peripheral Calcifying epithelial odontogenic tumor (CEOT) commonly resemble oral hyperplastic or reactive lesions and are histologically similar to their intraosseous counterparts. Here we report a rare case of gingival calcifying epithelial odontogenic tumor in the mandibular posterior region in a 31 year old female patient. Interestingly on literature review in on PubMed search only 22 case reports were available in, English literature, added to that this report will be the 23rd case. PMID:25855116

  2. C-Reactive Protein, Sialic Acid and Adenosine Deaminase Levels in Serum and Pleural Fluid from Patients with Pleural Effusion

    PubMed Central

    Kim, Ji Woon; Yang, In Ae; Oh, Eun A; Rhyoo, Young Gun; Jang, Young Ho; Ryang, Dong Wook; Yoo, JooYong

    1988-01-01

    Laboratory analysis of pleural fluids is essential to determine underlying diseases. The authors evaluated the clinical significance of C-reactive protein (C-RP), sialic acid (SA), and adenosine deaminase (ADA) determinations in sera and pleural fluids from 37 patients with pleural effusion. (FP12)C-RP and sialic acid levels and ADA activities were higher in exudates than in transudates of pleural fluids. Serum and pleural fluid C-RP levels were high in patients with pyothorax. Determinations of serum sialic acid and the pleural fluid to serum ratio were useful for the differential diagnosis of pulmonary tuberculosis and malignancy. ADA activities of pleural fluid and serum are useful for the differentiation of malignancy from tuberculosis and nonspecific pyothorax. C-RP concentrations of pleural fluid correlated to serum levels. However, concentrations of sialic acid and ADA activities were not correlated to serum levels and only correlated to protein concentrations of pleural fluids. PMID:3154188

  3. The pleural mesothelium in development and disease

    PubMed Central

    Batra, Hitesh; Antony, Veena B.

    2014-01-01

    The pleural mesothelium, derived from the embryonic mesoderm, is formed by a metabolically active monolayer of cells that blanket the chest wall and lungs on the parietal and visceral surfaces, respectively. The pleura and lungs are formed as a result of an intricate relationship between the mesoderm and the endoderm during development. Mesenchymal signaling pathways such as Wnt/B-catenin, Bmp4, and sonic hedgehog appear to be quintessential for lung development. Pleural Mesothelial Cells (PMCs) are known to express Wilms tumor-1 (Wt1) gene and in lineage labeling studies of the developing embryo, PMCs were found to track into the lung parenchyma and undergo mesothelial-mesenchymal transition (MMT) to form α-smooth muscle actin (α-SMA)-positive cells of the mesenchyme and vasculature. There is definite evidence that mesothelial cells can differentiate and this seems to play an important role in pleural and parenchymal pathologies. Mesothelial cells can differentiate into adipocytes, chondrocytes, and osteoblasts; and have been shown to clonally generate fibroblasts and smooth muscle cells in murine models. This supports the possibility that they may also modulate lung injury-repair by re-activation of developmental programs in the adult reflecting an altered recapitulation of development, with implications for regenerative biology of the lung. In a mouse model of lung fibrosis using lineage-tracing studies, PMCs lost their polarity and cell-cell junctional complexes, migrated into lung parenchyma, and underwent phenotypic transition into myofibroblasts in response to the pro-fibrotic mediator, transforming growth factor-β1 (TGF-β1). However, intra-pleural heme-oxygenase-1 (HO-1) induction inhibited PMC migration after intra-tracheal fibrogenic injury. Intra-pleural fluorescein isothiocyanate labeled nanoparticles decorated with a surface antibody to mesothelin, a surface marker of mesothelial cells, migrate into the lung parenchyma with PMCs supporting a potential role for pleural based therapies to modulate pleural mesothelial activation and parenchymal disease progression. PMID:25136318

  4. [Thoracoscopic pleurodesis in malignant pleural effusions].

    PubMed

    Mitrofan, C; Aldea, A; Grigorescu, Cristina; Jitaru, Iulia; Iosep, G; Aram?, A; Danciu, Cristina-Elena; Bolog, S; Mih?escu, Tr

    2005-01-01

    We performed retrospectively study on 136 thoracoscopies done in our clinic in the period January 2000 and December 2004. We reviewed 136 thoracoscopies, 71 patients were male and 65 were female (mean age 58.4 years). Straw colored effusions were present in 78 cases (57%) and hemorrhagic in 58 cases (43%). The surgical procedure consist in diagnostic of thoracoscopy with drainage of pleural effusion, multiply pleural biopsy, pleurodesis and continuous pleural drainage. In our study, the talc powder (5g) was successfully as sclerosing agent. The primary tumor was: lung-63 (46%), breast-26 (19%), mesothelioma-21 (15.5%), stomach-3, ovarian-3, prostate-3, colon-2, lymphoma-1, leukemia-2, plasmocytoma-1 and unknown primary tumor in 11 cases (8%). Adverse effects included-chest pain-35 cases (25%), fever-20 cases (15%), empyema-6 cases (4.5%), prolonged air leak-5 cases (4%), pulmonary infection-2 cases, acute respiratory failure-1 case, malignant invasion of scar-1 patient. For statistical analysis, the success of talc pleurodesis was defined as the absence of pleural fluid on the follow-up chest radiographs. Pleurodesis was successful in 125 cases (92%) of the patients after 1 month-follow-up. Thoracoscopic talc pleurodesis is a safe, economical and effective treatment for malignant pleural effusion. PMID:16612848

  5. Food supply confers calcifiers resistance to ocean acidification.

    PubMed

    Ramajo, Laura; Pérez-León, Elia; Hendriks, Iris E; Marbà, Núria; Krause-Jensen, Dorte; Sejr, Mikael K; Blicher, Martin E; Lagos, Nelson A; Olsen, Ylva S; Duarte, Carlos M

    2016-01-01

    Invasion of ocean surface waters by anthropogenic CO2 emitted to the atmosphere is expected to reduce surface seawater pH to 7.8 by the end of this century compromising marine calcifiers. A broad range of biological and mineralogical mechanisms allow marine calcifiers to cope with ocean acidification, however these mechanisms are energetically demanding which affect other biological processes (trade-offs) with important implications for the resilience of the organisms against stressful conditions. Hence, food availability may play a critical role in determining the resistance of calcifiers to OA. Here we show, based on a meta-analysis of existing experimental results assessing the role of food supply in the response of organisms to OA, that food supply consistently confers calcifiers resistance to ocean acidification. PMID:26778520

  6. Food supply confers calcifiers resistance to ocean acidification

    PubMed Central

    Ramajo, Laura; Pérez-León, Elia; Hendriks, Iris E.; Marbà, Núria; Krause-Jensen, Dorte; Sejr, Mikael K.; Blicher, Martin E.; Lagos, Nelson A.; Olsen, Ylva S.; Duarte, Carlos M.

    2016-01-01

    Invasion of ocean surface waters by anthropogenic CO2 emitted to the atmosphere is expected to reduce surface seawater pH to 7.8 by the end of this century compromising marine calcifiers. A broad range of biological and mineralogical mechanisms allow marine calcifiers to cope with ocean acidification, however these mechanisms are energetically demanding which affect other biological processes (trade-offs) with important implications for the resilience of the organisms against stressful conditions. Hence, food availability may play a critical role in determining the resistance of calcifiers to OA. Here we show, based on a meta-analysis of existing experimental results assessing the role of food supply in the response of organisms to OA, that food supply consistently confers calcifiers resistance to ocean acidification. PMID:26778520

  7. Malignant pleural mesothelioma in Italy

    PubMed Central

    Bianchi, Claudio; Bianchi, Tommaso

    2009-01-01

    This study reviews a series of 811 malignant pleural mesothelioma cases, diagnosed at hospitals in Trieste and Monfalcone districts of north eastern Italy, a narrow coastal strip with a population of about three lakh, in the period 1968-2008. The diagnosis was based on histological examination in 801 cases, and cytological findings in 10. Necropsy was performed in 610 cases. Occupational histories were obtained directly from the patients or their relatives through personal or telephone interviews. Routine lung sections were examined for asbestos bodies in 500 cases. In 143 cases asbestos bodies were isolated and counted by chemical digestion of the lung tissue using the Smith-Naylor method. The series included 717 men and 94 women aged between 32 and 93 years (mean 69.2 years). Detailed occupational data was obtained for 732 cases. The majority of patients had marine jobs - shipbuilding (449 cases), maritime trades (56 cases), and port activities (39 cases). The nature of work of other patients included a variety of occupations, with non-shipbuilding industries being the most common. Thirty-four women cleaned the work clothes of family members occupationally exposed and hence had a history of asbestos exposure at home. Most of the patients had their first exposure to asbestos before 1960. The latency period ranged between 13 and 73 years (mean 48.2). Latency period among insulators and dock workers were shorter than other categories. Asbestos bodies were detected on routine lung sections in 343 cases (68.6%). Lung asbestos body burdens after isolation ranged between two to 10 millions bodies per gram of dried tissue. Despite some limitations in the use of asbestos in this area since the 1970s, the incidence of tumor remained high during the last years. PMID:20386624

  8. Malignant pleural mesothelioma in Italy.

    PubMed

    Bianchi, Claudio; Bianchi, Tommaso

    2009-08-01

    This study reviews a series of 811 malignant pleural mesothelioma cases, diagnosed at hospitals in Trieste and Monfalcone districts of north eastern Italy, a narrow coastal strip with a population of about three lakh, in the period 1968-2008. The diagnosis was based on histological examination in 801 cases, and cytological findings in 10. Necropsy was performed in 610 cases. Occupational histories were obtained directly from the patients or their relatives through personal or telephone interviews. Routine lung sections were examined for asbestos bodies in 500 cases. In 143 cases asbestos bodies were isolated and counted by chemical digestion of the lung tissue using the Smith-Naylor method. The series included 717 men and 94 women aged between 32 and 93 years (mean 69.2 years). Detailed occupational data was obtained for 732 cases.The majority of patients had marine jobs - shipbuilding (449 cases), maritime trades (56 cases), and port activities (39 cases). The nature of work of other patients included a variety of occupations, with non-shipbuilding industries being the most common. Thirty-four women cleaned the work clothes of family members occupationally exposed and hence had a history of asbestos exposure at home. Most of the patients had their first exposure to asbestos before 1960. The latency period ranged between 13 and 73 years (mean 48.2). Latency period among insulators and dock workers were shorter than other categories. Asbestos bodies were detected on routine lung sections in 343 cases (68.6%). Lung asbestos body burdens after isolation ranged between two to 10 millions bodies per gram of dried tissue. Despite some limitations in the use of asbestos in this area since the 1970s, the incidence of tumor remained high during the last years. PMID:20386624

  9. Intracoronary ultrasound-defined plaque composition: computer-aided plaque characterization and correlation with histologic samples obtained during directional coronary atherectomy.

    PubMed

    Rasheed, Q; Dhawale, P J; Anderson, J; Hodgson, J M

    1995-04-01

    The ability to classify lesion composition accurately may be important for selecting or guiding interventional therapy and for understanding the pathophysiologic basis of individual lesions. To assess the usefulness of ultrasound in classifying lesions, intracoronary ultrasound images were obtained from 44 atherosclerotic lesions in patients before directional atherectomy. Lesions were classified by visual analysis and by computer-assisted gray-level statistics. Atherectomy samples were evaluated histologically for elastosis and calcium and quantitatively by morphometric analysis for various tissue components. The computer-assisted quantitative classification agreed well with the findings on visual analysis. Visual and computer-assisted quantitative ultrasound images were found to have distinctive histologic features. Lesions with predominantly echogenic plaque had a larger fraction of dense fibrous, elastic, or calcified tissue. Lesions with predominantly echolucent soft plaque had a greater fraction of loose fibrous, smooth-muscle, thrombotic, or necrotic elements. Thus intracoronary ultrasound allows accurate classification of lesion composition in patients. PMID:7900609

  10. Rapidly calcified epidural hematoma in a neonate.

    PubMed

    Yu, Dong Kun; Heo, Dong Hwa; Cho, Sung Min; Cho, Yong Jun

    2008-08-01

    We report a very rare case of a rapidly calcified chronic epidural hematoma (EDH) in a neonate. A 26-day-old female infant was referred to us from a regional hospital because of drowsy mentality and a seizure attack. She was delivered through caesarian section because normal spontaneous vaginal delivery was prolonged and failed. At birth, mild scalp swelling was found on the right frontal area. Scalp swelling was spontaneously resolved and she was discharged without any problems. On the 25th day after her birth, the baby presented with drowsiness and hypotonia following a generalized tonic-clonic seizure. Magnetic resonance imaging (MRI) and a computed tomography (CT) scan revealed a chronic EDH that had a thick layer of calcification. A small burr-hole trephination was performed and a single silastic drainage catheter was inserted. After the operation, a total of 12 ml of liquefied hematoma was drained, and the patient's mentality improved from drowsiness to alertness. The patient was asymptomatic when discharged. PMID:19096702

  11. Pioneer F Plaque Location

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The Pioneer F spacecraft, destined to be the first man made object to escape from the solar system into interstellar space, carries this pictorial plaque. It is designed to show scientifically educated inhabitants of some other star system, who might intercept it millions of years from now, when Pioneer was launched, from where, and by what kind of beings. (Hopefully, any aliens reading the plaque will not use this knowledge to immediately invade Earth.) The design is etched into a 6 inch by 9 inch gold-anodized aluminum plate, attached to the spacecraft's attenna support struts in a position to help shield it from erosion by interstellar dust. The radiating lines at left represents the positions of 14 pulsars, a cosmic source of radio energy, arranged to indicate our sun as the home star of our civilization. The '1-' symbols at the ends of the lines are binary numbers that represent the frequencies of these pulsars at the time of launch of Pioneer F relative of that to the hydrogen atom shown at the upper left with a '1' unity symbol. The hydrogen atom is thus used as a 'universal clock,' and the regular decrease in the frequencies of the pulsars will enable another civilization to determine the time that has elapsed since Pioneer F was launched. The hydrogen is also used as a 'universal yardstick' for sizing the human figures and outline of the spacecraft shown on the right. The hydrogen wavelength, about 8 inches, multiplied by the binary number representing '8' shown next to the woman gives her height, 64 inches. The figures represent the type of creature that created Pioneer. The man's hand is raised in a gesture of good will. Across the bottom are the planets, ranging outward from the Sun, with the spacecraft trajectory arching away from Earth, passing Mars, and swinging by Jupiter.

  12. [Pleural trichomoniasis due to trichomonas tenax].

    PubMed

    Porcheret, H; Maisonneuve, L; Estve, V; Jagot, J L; Le Pennec, M P

    2002-02-01

    Thoracic infections due to Trichomonas species often go unrecognised as they are seldom described in the literature. We describe a case that, to our knowledge, is the first reported case of empyema caused by this organism. A 59 year old man with metastatic adenocarcinoma of the lung developed a right pyopneumothorax following treatment with corticosteroids and radiotherapy. The pleural fluid was purulent and fetid, and contained large numbers of Trichomonas tenax amongst a mixed bacterial flora. Pleural drainage and antibiotic therapy with metronidazole, ciprofloxacin and gentalline were instituted immediately, but the patient died 4 days later. Trichomonas tenax is part of the normal oral floral and may on occasions colonize the airways. It can thus become involved during aspiration pneumonia or cause pleural infection following the rupture of a pulmonary abscess. Such infection tends to be associated with concurrent respiratory pathology or with immunodepression. The significance Trichomonas tenax when found in the airways is unclear and their pathogenic role is discussed. PMID:17546821

  13. Pleural abnormalities: thoracic ultrasound to the rescue!

    PubMed Central

    Pathmanathan, Sega; Lakshminarayana, Umesh B.; Avery, Gerard R.; Kastelik, Jack A.; Morjaria, Jaymin B.

    2013-01-01

    Diaphragmatic hernias that are diagnosed in adulthood may be traumatic or congenital in nature. Therefore, respiratory specialists need to be aware of the presentation of patients with these conditions. In this report, we describe a case series of patients with congenital and traumatic diaphragmatic hernias and highlight a varied range of their presentations. Abnormalities were noted in the thorax on the chest radiographs, but it was unclear as to the nature of the anomaly. The findings on thoracic ultrasound conducted by a pulmonologist helped to direct appropriate investigations avoiding unnecessary interventions. Instead of pleural effusions, consolidation or collapse, thoracic computed tomography demonstrated diaphragmatic hernias which were managed either conservatively or by surgery. There is increasing evidence that pulmonary specialists should be trained in thoracic ultrasonography to identify pleural pathology as well as safely conducting pleural-based interventions. PMID:23819018

  14. Diagnostic performance of different pleural fluid biomarkers in tuberculous pleurisy.

    PubMed

    Klimiuk, J; Krenke, R; Safianowska, A; Korczynski, P; Chazan, R

    2015-01-01

    Due to the paucibacillary nature of tuberculous pleural effusion the diagnosis of pleural tuberculosis is challenging. This prospective study was undertaken to evaluate the diagnostic performance of ten different pleural fluid biomarkers in the differentiation between tuberculous and non-tuberculous pleural effusions. Two hundred and three patients with pleural effusion (117 men and 86 women, median age 65 years) were enrolled. Routine diagnostic work-up, including thoracentesis and pleural fluid analysis, was performed to determine the cause of pleural effusion. The following biomarkers were measured in pleural fluid: adenosine deaminase (ADA), interferon gamma (IFN-?), interleukin 2 soluble receptor (IL-2sR?), sub-unit p40 of interleukin 12b (IL-12p40), interleukin 18 (IL-18), interleukin 23 (IL-23), IFN-? induced protein 10 kDa (IP-10), Fas-ligand, human macrophage-derived chemokine (MDC) and tumor necrosis factor alfa (TNF-?). There were 44 (21.7%) patients with tuberculous pleural effusion, 88 (43.3%) patients with malignant pleural effusion, 35 (17.2%) with parapneumonic effusion/pleural empyema, 30 (14.8%) with pleural transudates, and 6 (3%) with miscellaneous underlying diseases. Pleural fluid IFN-? was found the most accurate marker differentiating tuberculous from non-tuberculous pleural effusion, with sensitivity, specificity, PPV, NPV, and AUC 97%, 98%, 95.5%, 99.4%, and 0.99, respectively. Two other biomarkers (IP-10 and Fas ligand) also showed very high diagnostic accuracy with AUC?0.95. AUC for ADA was 0.92. We conclude that IFN-?, IP-10, and Fas-ligand in pleural fluid are highly accurate biomarkers differentiating tuberculous from non-tuberculous pleural effusion. PMID:25523627

  15. Tuberculous pleural effusions: advances and controversies.

    PubMed

    Vorster, Morné J; Allwood, Brian W; Diacon, Andreas H; Koegelenberg, Coenraad F N

    2015-06-01

    On a global scale, tuberculosis (TB) remains one of the most frequent causes of pleural effusions. Our understanding of the pathogenesis of the disease has evolved and what was once thought to be an effusion as a result of a pure delayed hypersensitivity reaction is now believed to be the consequence of direct infection of the pleural space with a cascade of events including an immunological response. Pulmonary involvement is more common than previously believed and induced sputum, which is grossly underutilised, can be diagnostic in approximately 50%. The gold standard for the diagnosis of tuberculous pleuritis remains the detection of Mycobacterium tuberculosis in pleural fluid, or pleural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli (AFB). In high burden settings, however, the diagnosis is frequently inferred in patients who present with a lymphocytic predominant exudate and a high adenosine deaminase (ADA) level, which is a valuable adjunct in the diagnostic evaluation. ADA is generally readily accessible, and together with lymphocyte predominance justifies treatment initiation in patients with a high pre-test probability. Still, false-negative and false-positive results remain an issue. When adding closed pleural biopsy to ADA and lymphocyte count, diagnostic accuracy approaches that of thoracoscopy. The role of other biomarkers is less well described. Early pleural drainage may have a role in selected cases, but more research is required to validate its use and to define the subpopulation that may benefit from such interventions. PMID:26150911

  16. Tuberculous pleural effusions: advances and controversies

    PubMed Central

    Allwood, Brian W.; Diacon, Andreas H.; Koegelenberg, Coenraad F. N.

    2015-01-01

    On a global scale, tuberculosis (TB) remains one of the most frequent causes of pleural effusions. Our understanding of the pathogenesis of the disease has evolved and what was once thought to be an effusion as a result of a pure delayed hypersensitivity reaction is now believed to be the consequence of direct infection of the pleural space with a cascade of events including an immunological response. Pulmonary involvement is more common than previously believed and induced sputum, which is grossly underutilised, can be diagnostic in approximately 50%. The gold standard for the diagnosis of tuberculous pleuritis remains the detection of Mycobacterium tuberculosis in pleural fluid, or pleural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli (AFB). In high burden settings, however, the diagnosis is frequently inferred in patients who present with a lymphocytic predominant exudate and a high adenosine deaminase (ADA) level, which is a valuable adjunct in the diagnostic evaluation. ADA is generally readily accessible, and together with lymphocyte predominance justifies treatment initiation in patients with a high pre-test probability. Still, false-negative and false-positive results remain an issue. When adding closed pleural biopsy to ADA and lymphocyte count, diagnostic accuracy approaches that of thoracoscopy. The role of other biomarkers is less well described. Early pleural drainage may have a role in selected cases, but more research is required to validate its use and to define the subpopulation that may benefit from such interventions. PMID:26150911

  17. A Pleural Loose Body Mimicking a Pleural Tumor: A Case Report

    PubMed Central

    Shim, Sung Shine; Chun, Eun Mi; Won, Tae Hee; Park, Sanghui

    2015-01-01

    We present a rare case of a pleural loose body, thought to be a pedunculated pleural tumor, found incidentally in a 58-year-old female. Computed tomography showed a non-enhancing mass, which migrated along the mediastinum and paravertebral area. Thoracoscopic surgery revealed a 4 cm, soap-like mass that was found to be a fibrin body consisting of hyalinized collagen histopathologically. Mobility and the lack of contrast enhancement of a pleural mass are important clues to diagnosing this benign condition. PMID:26355378

  18. A case of young woman with recurrent right pleural effusion

    PubMed Central

    Mehta, Asmita A; Gupta, Amit; Venkitakrishnan, Rajesh

    2015-01-01

    Endomterisois is usually found in women of child-bearing age. A case is presented of massive right-sided pleural effusion caused by endometriosis. The final diagnosis was made by thoracoscopic pleural biopsy. Physicians should be aware of this potentially treatable cause of pleural effusion having excluded other possibilities such as malignancy and tuberculosis. PMID:26664182

  19. Computed tomography demonstration of subarachnoid-pleural fistula.

    PubMed

    Hicken, P; Martin, J; Hakanson, S

    1990-08-01

    A persistent left pleural effusion caused diagnostic difficulty in a young girl, 2 years after a road accident had rendered her paraplegic. Eventually, after instillation of a contrast medium into the pleural fluid, computed tomography showed a fistulous communication between the subarachnoid and pleural spaces at the level in the dorsal spine where trauma had occurred. PMID:2207780

  20. Characteristics of high-risk coronary plaques identified by computed tomographic angiography and associated prognosis: a systematic review and meta-analysis.

    PubMed

    Thomsen, Camilla; Abdulla, Jawdat

    2016-02-01

    To clarify the potential role of coronary computed tomographic angiography (CCTA) in characterizing and prognosticating high-risk coronary plaques. A systematic review and meta-analysis were conducted to compare high-risk vs. low-risk plaques and culprit vs. non-culprit lesions in patients with acute coronary syndrome (ACS) vs. stable angina (SA). High-risk plaques were defined by at least one of the following features: non-calcified plaque (NCP), the presence of spotty calcified plaque (SCP), or increased remodelling index (RI). Results of included studies were pooled as odds ratios (OR) or weighted mean differences (WMD) with 95% confidence interval (CI). Eighteen eligible studies provided data to compare plaque types, plaque volume, and RI. Six studies provided data on ACS events in vulnerable high-risk vs. low-risk calcified plaques after 35 2 months of follow-up. ACS patients had significantly higher number of NCP and SCP compared with SA patients with OR = 1.96 (1.47-2.60; 95% CI) P = 0.0001 and OR = 4.5 (2.98-6.83; 95% CI) P = 0.0001, respectively. Total plaque volume in ACS was not larger than SA: WMD = 22.9 (-22.1 to 67; 95% CI) mm(3), P = 0.32, but NCP volume was significantly larger: WMD = 28.8 (10.9-46.7; 95% CI) mm(3), P = 0.002. RI was higher in culprit lesions in ACS compared with SA and compared with non-culprit lesions in ACS patients: WMD = 0.48 (0.25-0.70; 95% CI) P = 0.0001 and 0.19 (0.07-0.30) P = 0.0001, respectively. The associated risk of future ACS was significantly higher in high-risk than in low-risk plaques: OR = 12.1 (5.24-28.1; 95% CI) P = 0.0001. CCTA can non-invasively characterize high-risk vulnerable coronary plaques and can predict future ACS events in patients with high-risk plaques. PMID:26690951

  1. Making a Lightweight Battery Plaque

    NASA Technical Reports Server (NTRS)

    Reid, M. A.; Post, R. E.; Soltis, D.

    1986-01-01

    Plaque formed in porous plastic by electroless plating. Lightweight plaque prepared by electroless plating of porous plastic contains embedded wire or expanded metal grid. Plastic may or may not be filled with soluble pore former. If it contains soluble pore former, treated to remove soluble pore former and increase porosity. Porous plastic then clamped into rig that allows plating solutions to flow through plastic. Lightweight nickel plaque used as electrode substrate for alkaline batteries, chiefly Ni and Cd electrodes, and for use as electrolyte-reservoir plates for fuel cells.

  2. Different Plaque Composition and Progression in Patients with Stable and Unstable Coronary Syndromes Evaluated by Cardiac CT

    PubMed Central

    Dalager, Maiken Glud; Bøttcher, Morten; Thygesen, Jesper; Andersen, Gratien; Bøtker, Hans Erik

    2015-01-01

    Objective. To compare the quantity, subtype, and progression of atherosclerosis by cardiac computed tomography (CT) and intravascular ultrasound (IVUS) in patients with stable (SAP) and unstable angina pectoris or non-ST-elevation myocardial infarction (UAP/n-STEMI). Methods. Forty patients with SAP and 20 with UAP/n-STEMI underwent cardiac CT and angiography with IVUS at baseline and after one year. Atherosclerotic segments were divided into calcified, mixed, or noncalcified subtypes, and significant stenoses were registered. Results. Thirty-two SAP and 15 UAP/n-STEMI patients completed the CT follow-up. At baseline, the number of atherosclerotic segments was higher in UAP/n-STEMI than in SAP (P = 0.039). UAP/n-STEMI patients had more segments with noncalcified plaques (P = 0.0005) whereas SAP patients had more segments with calcified plaques (P = 0.013). The number of segments with significant stenosis did not differ between the groups, but noncalcified plaques more frequently caused significant stenoses in UAP/n-STEMI than in SAP patients (P = 0.0002). After one year the number of segments with atherosclerosis increased in SAP patients (P = 0.0001). The number of atherosclerotic segments remained unchanged in UAP/n-STEMI patients. However, composition was altered as the number of segments with noncalcified plaques decreased (P = 0.018). IVUS data confirmed the CT findings. Conclusion. Quantity, subtype, and progression of atherosclerosis differ between SAP and UAP/n-STEMI patients. PMID:26339610

  3. The Immune Response Is Involved in Atherosclerotic Plaque Calcification: Could the RANKL/RANK/OPG System Be a Marker of Plaque Instability?

    PubMed Central

    Montecucco, Fabrizio; Steffens, Sabine; Mach, Franois

    2007-01-01

    Atherogenesis is characterized by an intense inflammatory process, involving immune and vascular cells. These cells play a crucial role in all phases of atherosclerotic plaque formation and complication through cytokine, protease, and prothrombotic factor secretion. The accumulation of inflammatory cells and thus high amounts of soluble mediators are responsible for the evolution of some plaques to instable phenotype which may lead to rupture. One condition strongly associated with plaque rupture is calcification, a physiopathological process orchestrated by several soluble factors, including the receptor activator of nuclear factor (NF)?B ligand (RANKL)/receptor activator of nuclear factor (NF)?B (RANK)/osteoprotegerin (OPG) system. Although some studies showed some interesting correlations with acute ischemic events, at present, more evidences are needed to evaluate the predictive and diagnostic value of serum sRANKL and OPG levels for clinical use. The major limitation is probably the poor specificity of these factors for cardiovascular disease. The identification of tissue-specific isoforms could increase the importance of sRANKL and OPG in predicting calcified plaque rupture and the dramatic ischemic consequences in the brain and the heart. PMID:18320012

  4. Sarcoidosis as unusual cause of massive pleural effusion

    PubMed Central

    Joshi, Sharad; Periwal, Pallavi; Dogra, Vikas; Talwar, Deepak

    2015-01-01

    Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Pleural involvement is relatively rare. Development of pleural effusion in sarcoidosis needs to be evaluated for other causes, especially tuberculosis in endemic countries. Sarcoid pleural effusion responds to systemic corticosteroids. We are presenting case of 42 year old male patient of sarcoidosis who developed massive pleural effusion while on treatment with steroids, which was attributed to disease per se. Sarcoidosis as a cause of massive pleural effusion has not been mentioned before in published literature. PMID:26744683

  5. How Does Calcification Influence Plaque Vulnerability? Insights from Fatigue Analysis

    PubMed Central

    Wu, Baijian; Pei, Xuan; Li, Zhi-Yong

    2014-01-01

    Background. Calcification is commonly believed to be associated with cardiovascular disease burden. But whether or not the calcifications have a negative effect on plaque vulnerability is still under debate. Methods and Results. Fatigue rupture analysis and the fatigue life were used to evaluate the rupture risk. An idealized baseline model containing no calcification was first built. Based on the baseline model, we investigated the influence of calcification on rupture path and fatigue life by adding a circular calcification and changing its location within the fibrous cap area. Results show that 84.0% of calcified cases increase the fatigue life up to 11.4%. For rupture paths 10D far from the calcification, the life change is negligible. Calcifications close to lumen increase more fatigue life than those close to the lipid pool. Also, calcifications in the middle area of fibrous cap increase more fatigue life than those in the shoulder area. Conclusion. Calcifications may play a positive role in the plaque stability. The influence of the calcification only exists in a local area. Calcifications close to lumen may be influenced more than those close to lipid pool. And calcifications in the middle area of fibrous cap are seemly influenced more than those in the shoulder area. PMID:24955401

  6. Spontaneous pleural empyema due to Yersinia enterocolitica.

    PubMed

    Mofredj, Ali; Gurin, Jean-Michel; Leibinger, Frank; Masmoudi, Rafik

    2003-05-01

    Yersinia enterocolitica is a well-known cause of enterocolitis. Although focal extraintestinal manifestations and disseminated disease have been described, usually in immunosuppressed patients, infection in the chest seems to be rare. We report the case of an alcoholic man who had spontaneous pleural empyema due to Y. enterocolitica. PMID:12911198

  7. Automatic spatiotemporal matching of detected pleural thickenings

    NASA Astrophysics Data System (ADS)

    Chaisaowong, Kraisorn; Keller, Simon Kai; Kraus, Thomas

    2014-01-01

    Pleural thickenings can be found in asbestos exposed patient's lung. Non-invasive diagnosis including CT imaging can detect aggressive malignant pleural mesothelioma in its early stage. In order to create a quantitative documentation of automatic detected pleural thickenings over time, the differences in volume and thickness of the detected thickenings have to be calculated. Physicians usually estimate the change of each thickening via visual comparison which provides neither quantitative nor qualitative measures. In this work, automatic spatiotemporal matching techniques of the detected pleural thickenings at two points of time based on the semi-automatic registration have been developed, implemented, and tested so that the same thickening can be compared fully automatically. As result, the application of the mapping technique using the principal components analysis turns out to be advantageous than the feature-based mapping using centroid and mean Hounsfield Units of each thickening, since the resulting sensitivity was improved to 98.46% from 42.19%, while the accuracy of feature-based mapping is only slightly higher (84.38% to 76.19%).

  8. Pleuroperitoneal shunt for recurrent malignant pleural effusions.

    PubMed Central

    Tsang, V; Fernando, H C; Goldstraw, P

    1990-01-01

    The therapeutic options available for the management of malignant pleural effusions associated with a restricting malignant cortex remain unsatisfactory. The efficacy of pleuroperitoneal shunts was evaluated in 16 patients with recurrent malignant effusions. There were no operative deaths; one patient died on the third postoperative day as a result of lymphangitis carcinomatosa. The median hospital stay was five (range 3-21) days. Palliation was obtained in all but one of the other 15 patients. There was no appreciable reaccumulation of pleural fluid as judged by radiography. Two patients developed occlusion of the shunt. In one case this was due to blood clots in the pleural catheter and necessitated insertion of a new shunt. The other shunt was removed because of obstructing infected fibrin debris, and a rib resection was performed. There were eight deaths related to the underlying malignancy after a mean interval of 7.3 (range 1.5-23) months. The other six patients are still alive, with a mean survival of 11.0 (range 5-20) months, and have achieved good symptomatic relief. The insertion of a pleuroperitoneal shunt can offer effective palliation for patients with recurrent malignant pleural effusions. Images PMID:1696401

  9. Potential diagnostic value of serum/pleural fluid IL-31 levels for tuberculous pleural effusion.

    PubMed

    Gao, Yan; Ou, Qinfang; Wu, Jing; Zhang, Bingyan; Shen, Lei; Chen, Shaolong; Weng, Xinhua; Zhang, Ying; Zhang, Wenhong; Shao, Lingyun

    2016-01-01

    The aim of this study was to explore the diagnostic value of IL-31 levels in the pleural fluid and plasma to differentially diagnose tuberculous and malignant pleural effusion. We enrolled 91 cases, including tuberculous pleural effusion (TPE, n?=?50), malignant pleural effusion (MPE, n?=?41), other cases including pneumonia with pleural fluid, pulmonary tuberculosis and healthy people as controls. Whole blood was stimulated with the M. tuberculosis-specific antigens and plasma was collected. The multiplex bead-based cytokine immunoassay was employed to measure the levels of various cytokines. IL-31 was found to be the most prominent cytokine (P?pleural fluid with the plasma tuberculosis-specific IL-31 levels improved the sensitivity and specificity to 94.0% and 95.1%, respectively. Thus, we identified a novel biomarker for the diagnosis of TPE for clinical application. PMID:26864868

  10. Pleural Small Cell Lung Carcinoma: An Unusual Culprit in Pleural Effusion

    PubMed Central

    Adejorin, Oluwaseyi D.; Sodhi, Amik; Hare, Felicia A.; Headley, Arthur S.; Murillo, Luis C.; Kadaria, Dipen

    2015-01-01

    Patient: Male, 77 Final Diagnosis: Pleural small cell carcinoma Symptoms: Chest pain • shortness of breath Medication: — Clinical Procedure: Thoracocentesis Specialty: Pulmonology Objective: Rare disease Background: Small cell lung carcinoma (SCLC) usually presents as lung or mediastinal lesions. It is very rare for SCLC to present primarily as an isolated pleural effusion with no lung or mediastinal lesions. Case Report: We report the case of a 77-year-old white male with a 60-pack year history of smoking, chronic obstructive pulmonary disease (stage IV), and asbestos exposure who presented with shortness of breath and left lateral chest pain for 7 days. On physical examination, he was very short of breath, with a prolonged expiratory phase on chest auscultation. Laboratory results were normal except for leukocytosis and chest radiograph revealing left-sided pleural effusion. Computerized tomography (CT) scanning of the chest with IV contrast showed left-sided pleural effusion without any lung or mediastinal lesions. Thoracentesis was performed and fluid was sent for analysis. Repeat CT chest/abdomen/pelvis, done immediately following thoracocentesis, did not show any masses or lymphadenopathy. Fluid analysis, including cytology and immunostain pattern, was consistent with small cell carcinoma. Conclusions: Small cell lung cancer presenting as an isolated pleural effusion is extremely rare. It requires close attention to cytology and immunohistochemistry of pleural fluid samples. It also has implications for management and should be managed as limited-stage SCLC. PMID:26714576

  11. Potential diagnostic value of serum/pleural fluid IL-31 levels for tuberculous pleural effusion

    PubMed Central

    Gao, Yan; Ou, Qinfang; Wu, Jing; Zhang, Bingyan; Shen, Lei; Chen, Shaolong; Weng, Xinhua; Zhang, Ying; Zhang, Wenhong; Shao, Lingyun

    2016-01-01

    The aim of this study was to explore the diagnostic value of IL-31 levels in the pleural fluid and plasma to differentially diagnose tuberculous and malignant pleural effusion. We enrolled 91 cases, including tuberculous pleural effusion (TPE, n = 50), malignant pleural effusion (MPE, n = 41), other cases including pneumonia with pleural fluid, pulmonary tuberculosis and healthy people as controls. Whole blood was stimulated with the M. tuberculosis–specific antigens and plasma was collected. The multiplex bead-based cytokine immunoassay was employed to measure the levels of various cytokines. IL-31 was found to be the most prominent cytokine (P < 0.0001), and with an optimal cut-off value of 67.5 pg/mL, the sensitivity and specificity for the diagnosis of TPE were 86% and 100%, respectively. Furthermore, the tuberculosis-specific IL-31 levels in the plasma of TPE patients were higher than that of MPE patients (P = 0.0002). At an optimal cut-off value of 23.9 pg/mL, the sensitivity and specificity for the diagnosis of TPE were 92.9% and 85.7%, respectively. Ultimately, the combination of pleural fluid with the plasma tuberculosis-specific IL-31 levels improved the sensitivity and specificity to 94.0% and 95.1%, respectively. Thus, we identified a novel biomarker for the diagnosis of TPE for clinical application. PMID:26864868

  12. Dental plaque identification at home

    MedlinePLUS

    ... special tablets that contain a red dye that stains the plaque. One tablet is chewed thoroughly, moving ... this method is that it leaves no pink stains in the mouth. In the office, dentists are ...

  13. Disappearance of La Caille Plaque

    NASA Astrophysics Data System (ADS)

    2010-04-01

    A bronze plaque erected to the memory of N.-L. de La Caille near the site of his observatory in Central Cape Town, has been stolen by metal thieves. It was designed by the famous architect Sir Herbert Baker.

  14. Pioneer F Plaque Symbology

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The Pioneer F spacecraft, destined to be the first man made object to escape from the solar system into interstellar space, carries this pictorial plaque. It is designed to show scientifically educated inhabitants of some other star system, who might intercept it millions of years from now, when Pioneer was launched, from where, and by what kind of beings. (With the hope that they would not invade Earth.) The design is etched into a 6 inch by 9 inch gold-anodized aluminum plate, attached to the spacecraft's attenna support struts in a position to help shield it from erosion by interstellar dust. The radiating lines at left represents the positions of 14 pulsars, a cosmic source of radio energy, arranged to indicate our sun as the home star of our civilization. The '1-' symbols at the ends of the lines are binary numbers that represent the frequencies of these pulsars at the time of launch of Pioneer F relative of that to the hydrogen atom shown at the upper left with a '1' unity symbol. The hydrogen atom is thus used as a 'universal clock,' and the regular decrease in the frequencies of the pulsars will enable another civilization to determine the time that has elapsed since Pioneer F was launched. The hydrogen is also used as a 'universal yardstick' for sizing the human figures and outline of the spacecraft shown on the right. The hydrogen wavelength, about 8 inches, multiplied by the binary number representing '8' shown next to the woman gives her height, 64 inches. The figures represent the type of creature that created Pioneer. The man's hand is raised in a gesture of good will. Across the bottom are the planets, ranging outward from the Sun, with the spacecraft trajectory arching away from Earth, passing Mars, and swinging by Jupiter.

  15. Giant, calcified colloid cyst of the lateral ventricle.

    PubMed

    Two, Aimee; Christian, Eisha; Mathew, Anna; Giannotta, Steven; Zada, Gabriel

    2016-02-01

    We report a patient with a giant, calcified colloid cyst in the left lateral ventricle. Colloid cysts are slow growing, benign lesions, commonly originating in the roof of the anterior third ventricle near the foramen of Monro. Many colloid cysts are small lesions which are either discovered incidentally or cause headache, visual changes, memory deficits, and/or syncope. Giant colloid cysts are rare. A 40-year-old man presented with a month long history of worsening headaches and was found to have a multiloculated 5cm intraventricular mass with an anterior hyperdensity, suggestive of calcification, arising within the lateral ventricles. He underwent an interhemispheric transcallosal approach for resection of the mass. The pathology was consistent with a giant colloid cyst with calcification in the anterior cyst wall. Giant, calcified mass is a rare presentation of colloid cyst. Although rare, this diagnosis remains an important consideration in the differential diagnosis of any calcified, cystic intraventricular mass. PMID:26358201

  16. Progression from calcifying tendinitis to rotator cuff tear.

    PubMed

    Gotoh, Masafumi; Higuchi, Fujio; Suzuki, Ritsu; Yamanaka, Kensuke

    2003-02-01

    This report documents the clinical, radiographic and histologic findings in a 46-year-old man with calcifying tendinitis in his left shoulder which progressed to rotator cuff tear. The patient had a 1-year history of repeated calcifying tendinitis before being referred to our hospital. On the initial visit, radiographs and magnetic resonance imaging (MRI) revealed calcium deposition localized in the supraspinatus tendon without apparent tear. Three months after the first visit, MRI revealed a partial-thickness rotator cuff tear at the site of calcium deposition. Surgical and histologic findings demonstrated that calcium deposition was the cause of cuff rupture. To our knowledge, based on a review of the English literature, this is the first case report in which the progression from calcifying tendinitis to rotator cuff tear has been serially observed. PMID:12589487

  17. Effects of bacteriophage traits on plaque formation

    PubMed Central

    2011-01-01

    Background The appearance of plaques on a bacterial lawn is one of the enduring imageries in modern day biology. The seeming simplicity of a plaque has invited many hypotheses and models in trying to describe and explain the details of its formation. However, until now, there has been no systematic experimental exploration on how different bacteriophage (phage) traits may influence the formation of a plaque. In this study, we constructed a series of isogenic ? phages that differ in their adsorption rate, lysis timing, or morphology so that we can determine the effects if these changes on three plaque properties: size, progeny productivity, and phage concentration within plaques. Results We found that the adsorption rate has a diminishing, but negative impact on all three plaque measurements. Interestingly, there exists a concave relationship between the lysis time and plaque size, resulting in an apparent optimal lysis time that maximizes the plaque size. Although suggestive in appearance, we did not detect a significant effect of lysis time on plaque productivity. Nonetheless, the combined effects of plaque size and productivity resulted in an apparent convex relationship between the lysis time and phage concentration within plaques. Lastly, we found that virion morphology also affected plaque size. We compared our results to the available models on plaque size and productivity. For the models in their current forms, a few of them can capture the qualitative aspects of our results, but not consistently in both plaque properties. Conclusions By using a collection of isogenic phage strains, we were able to investigate the effects of individual phage traits on plaque size, plaque productivity, and average phage concentration in a plaque while holding all other traits constant. The controlled nature of our study allowed us to test several model predictions on plaque size and plaque productivity. It seems that a more realistic theoretical approach to plaque formation is needed in order to capture the complex interaction between phage and its bacterium host in a spatially restricted environment. PMID:21827665

  18. Ameloblastomatous calcifying cystic odontogenic tumour: a rare variant.

    PubMed

    Devaraju, Rama Raju; Duggi, Lakshmi Srujana; Gantala, Ramlal; Sanjeevareddygari, Shylaja; Potturi, Abhinand

    2015-03-01

    Calcifying Cystic Odontogenic Tumor (CCOT) was previously described by Gorlin et al., in 1962 as Calcifying odontogenic cyst. CCOT is a rare lesion which accounts for 2% of all odontogenic pathological changes in the jaws. One of the variants, Ameloblastomatous proliferating type of CCOT is even more rare and very few cases have been reported in the light of literature review. This case report is an effort to bring forth a case of ameloblastomatous proliferating type of CCOT in a 65 year male, who presented with a painful swelling in the right jaw crossing midline causing facial asymmetry and confirmed by histopathological evaluation. PMID:25954714

  19. Ameloblastomatous Calcifying Cystic Odontogenic Tumour: A Rare Variant

    PubMed Central

    Devaraju, Rama Raju; Duggi, Lakshmi Srujana; Sanjeevareddygari, Shylaja; Potturi, Abhinand

    2015-01-01

    Calcifying Cystic Odontogenic Tumor (CCOT) was previously described by Gorlin et al., in 1962 as Calcifying odontogenic cyst. CCOT is a rare lesion which accounts for 2% of all odontogenic pathological changes in the jaws. One of the variants, Ameloblastomatous proliferating type of CCOT is even more rare and very few cases have been reported in the light of literature review. This case report is an effort to bring forth a case of ameloblastomatous proliferating type of CCOT in a 65 year male, who presented with a painful swelling in the right jaw crossing midline causing facial asymmetry and confirmed by histopathological evaluation. PMID:25954714

  20. Primary mediastinal adenocarcinoma originating from a calcified nodule

    PubMed Central

    Chen, Gang; Qiu, Xiaoming; Liu, Yi; Qiao, Yanjie; Shi, Tao; Chen, Jun; Zhou, Qinghua

    2014-01-01

    Primary mediastinal adenocarcinoma is rare, but its originating from a calcified nodule is even more unusual. We present herein a 55-year-old female with a superior mediastinal mass, first discovered 2 years prior that changed dramatically from its original appearance as a calcified nodule. The mass was completely resected, and histopathological examination revealed a primary adenocarcinoma. The patient has been disease-free for over 13 months since surgery. To the best of our knowledge, this is the first reported case of mediastinal adenocarcinoma to demonstrate such a surprising course of development. PMID:25126198

  1. Comparison of the effects of pitavastatin versus pravastatin on coronary artery plaque phenotype assessed by tissue characterization using serial virtual histology intravascular ultrasound.

    PubMed

    Nozue, Tsuyoshi; Yamamoto, Shingo; Tohyama, Shinichi; Fukui, Kazuki; Umezawa, Shigeo; Onishi, Yuko; Kunishima, Tomoyuki; Sato, Akira; Nozato, Toshihiro; Miyake, Shogo; Takeyama, Youichi; Morino, Yoshihiro; Yamauchi, Takao; Muramatsu, Toshiya; Hibi, Kiyoshi; Terashima, Mitsuyasu; Michishita, Ichiro

    2015-01-01

    Thin-cap fibroatheroma (TCFA) is the most common type of vulnerable plaque and is the precursor of plaque rupture. However, rupture of a TCFA is not the only mechanism underlying thrombus formation or acute coronary syndrome. Although statin therapy changes the composition of coronary artery plaques, the effects of statins, particularly different types of statins, on plaque phenotype have not been fully examined. This study compared the effects of pitavastatin versus pravastatin on coronary artery plaque phenotype assessed by virtual histology (VH) intravascular ultrasound (IVUS) in patients with angina pectoris (AP). Coronary atherosclerosis in nonculprit lesions was evaluated using VH-IVUS at baseline and 8 months after statin therapy; analyzable IVUS data were obtained from 83 patients with stable AP (39 patients treated with pitavastatin and 44 with pravastatin) and 36 patients with unstable AP (19 patients treated with pitavastatin and 17 with pravastatin). Pitavastatin had a strong effect on reducing pathologic intimal thickening (PIT), especially in patients with unstable AP, but had no impact on VH-TCFA or fibroatheroma (FA). By contrast, pravastatin had weak effects on reducing PIT, VH-TCFA, or FA. Increases in the number of calcified plaques were observed for both statins. In conclusion, pitavastatin and pravastatin changed coronary artery plaque phenotype as assessed by VH-IVUS in patients with AP. However, the effects of these statins on coronary artery plaque phenotype were different. PMID:24337500

  2. Pleural Photodynamic Therapy and Surgery in Lung Cancer and Thymoma Patients with Pleural Spread.

    PubMed

    Chen, Ke-Cheng; Hsieh, Yi-Shan; Tseng, Ying-Fan; Shieh, Ming-Jium; Chen, Jin-Shing; Lai, Hong-Shiee; Lee, Jang-Ming

    2015-01-01

    Pleural spread is difficult to treat in malignancies, especially in lung cancer and thymoma. Monotherapy with surgery fails to have a better survival benefit than palliative chemotherapy, the currently accepted treatment. Photodynamic therapy utilizes a photosensitizer to target the tumor site, and the tumor is exposed to light after performing a pleurectomy and tumor resection. However, the benefits of this procedure to lung cancer or thymoma patients are unknown. We retrospectively reviewed the clinical characteristics and treatment outcomes of patients with lung cancer or thymoma with pleural seeding who underwent pleural photodynamic therapy and surgery between 2005 and 2013. Eighteen patients enrolled in this study. The mean patient age was 52.9 12.2 years. Lung cancer was the inciting cancer of pleural dissemination in 10 patients (55.6%), and thymoma in 8 (44.4%). There was no procedure-related mortality. Using Kaplan-Meier survival analysis, the 3-year survival rate and the 5-year survival rate were 68.9% and 57.4%, respectively. We compared the PDT lung cancer patients with those receiving chemotherapy or target therapy (n = 51) and found that the PDT group had better survival than non-PDT patients (mean survival time: 39.0 versus 17.6 months; P = .047). With proper patient selection, radical surgical resection combined with intrapleural photodynamic therapy for pleural spread in patients with non-small cell lung cancer or thymoma is feasible and may provide a survival benefit. PMID:26193470

  3. Pleural Photodynamic Therapy and Surgery in Lung Cancer and Thymoma Patients with Pleural Spread

    PubMed Central

    Tseng, Ying-Fan; Shieh, Ming-Jium; Chen, Jin-Shing; Lai, Hong-Shiee; Lee, Jang-Ming

    2015-01-01

    Pleural spread is difficult to treat in malignancies, especially in lung cancer and thymoma. Monotherapy with surgery fails to have a better survival benefit than palliative chemotherapy, the currently accepted treatment. Photodynamic therapy utilizes a photosensitizer to target the tumor site, and the tumor is exposed to light after performing a pleurectomy and tumor resection. However, the benefits of this procedure to lung cancer or thymoma patients are unknown. We retrospectively reviewed the clinical characteristics and treatment outcomes of patients with lung cancer or thymoma with pleural seeding who underwent pleural photodynamic therapy and surgery between 2005 and 2013. Eighteen patients enrolled in this study. The mean patient age was 52.9 12.2 years. Lung cancer was the inciting cancer of pleural dissemination in 10 patients (55.6%), and thymoma in 8 (44.4%). There was no procedure-related mortality. Using Kaplan-Meier survival analysis, the 3-year survival rate and the 5-year survival rate were 68.9% and 57.4%, respectively. We compared the PDT lung cancer patients with those receiving chemotherapy or target therapy (n = 51) and found that the PDT group had better survival than non-PDT patients (mean survival time: 39.0 versus 17.6 months; P = .047). With proper patient selection, radical surgical resection combined with intrapleural photodynamic therapy for pleural spread in patients with non-small cell lung cancer or thymoma is feasible and may provide a survival benefit. PMID:26193470

  4. Pleural Small Cell Lung Carcinoma: An Unusual Culprit in Pleural Effusion.

    PubMed

    Adejorin, Oluwaseyi D; Sodhi, Amik; Hare, Felicia A; Headley, Arthur S; Murillo, Luis C; Kadaria, Dipen

    2015-01-01

    BACKGROUND Small cell lung carcinoma (SCLC) usually presents as lung or mediastinal lesions. It is very rare for SCLC to present primarily as an isolated pleural effusion with no lung or mediastinal lesions. CASE REPORT We report the case of a 77-year-old white male with a 60-pack year history of smoking, chronic obstructive pulmonary disease (stage IV), and asbestos exposure who presented with shortness of breath and left lateral chest pain for 7 days. On physical examination, he was very short of breath, with a prolonged expiratory phase on chest auscultation. Laboratory results were normal except for leukocytosis and chest radiograph revealing left-sided pleural effusion. Computerized tomography (CT) scanning of the chest with IV contrast showed left-sided pleural effusion without any lung or mediastinal lesions. Thoracentesis was performed and fluid was sent for analysis. Repeat CT chest/abdomen/pelvis, done immediately following thoracocentesis, did not show any masses or lymphadenopathy. Fluid analysis, including cytology and immunostain pattern, was consistent with small cell carcinoma. CONCLUSIONS Small cell lung cancer presenting as an isolated pleural effusion is extremely rare. It requires close attention to cytology and immunohistochemistry of pleural fluid samples. It also has implications for management and should be managed as limited-stage SCLC. PMID:26714576

  5. Localized benign pleural mesothelioma: a case report.

    PubMed

    Altin, R; Erol, Y; Ozdemir, H; Kart, L; Ozen, O; Mahmutyazyeyoglu, K

    2003-01-01

    Primary neoplasms of the pleura are rare tumors and the majority are generally mesotheliomas. Mesotheliomas are either localized and mostly benign, or diffuse and uniformly malignant neoplasms. Localised benign pulmonary mesothelioma (solitary fibrous tumor of the pleura) are originally thought to be a variant of diffuse pleural mesothelioma because they consists of a spindle cell stroma associated with branching tubular structures lined by cuboidal cells. Our case which is reported below shows the clinical spectrum of the more common benign variant. Clinical differential diagnosis of benign and malign mesotheliomas is not clear. Complete surgical resection is the preferred treatment for both types and usually curative with the benign mesothelioma. The localised pleural variant is benign in most cases, and it is even less common, constituting only 10% of all mesotheliomas [1]. The importance of localised benign mesothelioma is that it is almost impossible to differentiate from a malignant neoplasm preoperatively and it may occasionally recur, sometimes with a malignant change. PMID:14635508

  6. Hedgehog Signaling in Malignant Pleural Mesothelioma.

    PubMed

    Felley-Bosco, Emanuela; Opitz, Isabelle; Meerang, Mayura

    2015-01-01

    Malignant pleural mesothelioma (MPM) is a cancer associated with exposure to asbestos fibers, which accumulate in the pleural space, damage tissue and stimulate regeneration. Hedgehog signaling is a pathway important during embryonic mesothelium development and is inactivated in adult mesothelium. The pathway is reactivated in some MPM patients with poor clinical outcome, mainly mediated by the expression of the ligands. Nevertheless, mutations in components of the pathway have been observed in a few cases. Data from different MPM animal models and primary culture suggest that both autocrine and paracrine Hedgehog signaling are important to maintain tumor growth. Drugs inhibiting the pathway at the level of the smoothened receptor (Smo) or glioma-associated protein transcription factors (Gli) have been used mostly in experimental models. For clinical development, biomarkers are necessary for the selection of patients who can benefit from Hedgehog signaling inhibition. PMID:26184317

  7. Hedgehog Signaling in Malignant Pleural Mesothelioma

    PubMed Central

    Felley-Bosco, Emanuela; Opitz, Isabelle; Meerang, Mayura

    2015-01-01

    Malignant pleural mesothelioma (MPM) is a cancer associated with exposure to asbestos fibers, which accumulate in the pleural space, damage tissue and stimulate regeneration. Hedgehog signaling is a pathway important during embryonic mesothelium development and is inactivated in adult mesothelium. The pathway is reactivated in some MPM patients with poor clinical outcome, mainly mediated by the expression of the ligands. Nevertheless, mutations in components of the pathway have been observed in a few cases. Data from different MPM animal models and primary culture suggest that both autocrine and paracrine Hedgehog signaling are important to maintain tumor growth. Drugs inhibiting the pathway at the level of the smoothened receptor (Smo) or glioma-associated protein transcription factors (Gli) have been used mostly in experimental models. For clinical development, biomarkers are necessary for the selection of patients who can benefit from Hedgehog signaling inhibition. PMID:26184317

  8. Pleural effusion cytology of embryonal rhabdomyosarcoma.

    PubMed

    Thompson, K S; Jensen, J D; Bhoopalam, N; Reyes, C V

    1997-03-01

    This case report concerns an embryonal rhabdomyosarcoma of the testis in a 31-yr-old white male patient who underwent radical left orchiectomy, followed by combined irradiation and chemotherapy, and who 2 yr later presented with dyspnea at rest, nonproductive cough, and lower back pain for 1 wk. Chest radiographs demonstrated a bilateral pleural effusion and diffuse infiltrating lesion of the pleurae, mimicking a mesothelioma. The pleural fluid displayed noncohesive, malignant, small, round cells about 2-5 times larger than mature lymphocytes. They had large, darkly stained, pleomorphic nuclei and bubbly cytoplasm with poorly defined borders. The diagnosis of embryonal rhabdomyosarcoma was supported by a positive myosin immunostaining and ultrastructural findings of intracytoplasmic actin and myosin-type microfilaments. Our case is also notable in that the tumor was a pure rhabdomyosarcoma involving a testicular origin, and the patient is the oldest reported in the literature. PMID:9099552

  9. Regulation of atherosclerotic plaque inflammation.

    PubMed

    Bck, M; Weber, C; Lutgens, E

    2015-11-01

    The immune reactions that regulate atherosclerotic plaque inflammation involve chemokines, lipid mediators and costimulatory molecules. Chemokines are a family of chemotactic cytokines that mediate immune cell recruitment and control cell homeostasis and activation of different immune cell types and subsets. Chemokine production and activation of chemokine receptors form a positive feedback mechanism to recruit monocytes, neutrophils and lymphocytes into the atherosclerotic plaque. In addition, chemokine signalling affects immune cell mobilization from the bone marrow. Targeting several of the chemokines and/or chemokine receptors reduces experimental atherosclerosis, whereas specific chemokine pathways appear to be involved in plaque regression. Leukotrienes are lipid mediators that are formed locally in atherosclerotic lesions from arachidonic acid. Leukotrienes mediate immune cell recruitment and activation within the plaque as well as smooth muscle cell proliferation and endothelial dysfunction. Antileukotrienes decrease experimental atherosclerosis, and recent observational data suggest beneficial clinical effects of leukotriene receptor antagonism in cardiovascular disease prevention. By contrast, other lipid mediators, such as lipoxins and metabolites of omega-3 fatty acids, have been associated with the resolution of inflammation. Costimulatory molecules play a central role in fine-tuning immunological reactions and mediate crosstalk between innate and adaptive immunity in atherosclerosis. Targeting these interactions is a promising approach for the treatment of atherosclerosis, but immunological side effects are still a concern. In summary, targeting chemokines, leukotriene receptors and costimulatory molecules could represent potential therapeutic strategies to control atherosclerotic plaque inflammation. PMID:25823439

  10. Diagnosis and treatment of malignant pleural mesothelioma.

    PubMed

    Rodrguez Panadero, Francisco

    2015-04-01

    There are three major challenges in the diagnosis of malignant pleural mesothelioma: mesothelioma must be distinguished from benign mesothelial hyperplasia; malignant mesothelioma (and its subtypes) must be distinguished from metastatic carcinoma; and invasion of structures adjacent to the pleura must be demonstrated. The basis for clarifying the first two aspects is determination of a panel of monoclonal antibodies with appropriate immunohistochemical evaluation performed by highly qualified experts. Clarification of the third aspect requires sufficiently abundant, deep biopsy material, for which thoracoscopy is the technique of choice. Video-assisted needle biopsy with real-time imaging can be of great assistance when there is diffuse nodal thickening and scant or absent effusion. Given the difficulties of reaching an early diagnosis, cure is not generally achieved with radical surgery (pleuropneumonectomy), so liberation of the tumor mass with pleurectomy/decortication combined with chemo- or radiation therapy (multimodal treatment) has been gaining followers in recent years. In cases in which surgery is not feasible, chemotherapy (a combination of pemetrexed and platinum-derived compounds, in most cases) with pleurodesis or a tunneled pleural drainage catheter, if control of pleural effusion is required, can be considered. Radiation therapy is reserved for treatment of pain associated with infiltration of the chest wall or any other neighboring structure. In any case, comprehensive support treatment for pain control in specialist units is essential: this acquires particular significance in this type of malignancy. PMID:25059587

  11. Management of Parapneumonic Pleural Effusion in Adults.

    PubMed

    Ferreiro, Lucía; San José, María Esther; Valdés, Luis

    2015-12-01

    Pleural infections have high morbidity and mortality, and their incidence in all age groups is growing worldwide. Not all infectious effusions are parapneumonic and, in such cases, the organisms found in the pleural space are not the same as those observed in lung parenchyma infections. The diagnostic difficulty lies in knowing whether an infectious effusion will evolve into a complicated effusion/empyema, as the diagnostic methods used for this purpose provide poor results. The mainstays of treatment are to establish an early diagnosis and to commence an antibiotic regimen and chest drain as soon as possible. This should preferably be carried out with fine tubes, due to certain morphological, bacteriological and biochemical characteristics of the pleural fluid. Fluid analysis, particularly pH, is the most reliable method for assessing evolution. In a subgroup of patients, fibrinolytics may help to improve recovery, and their combination with DNase has been found to obtain better results. If medical treatment fails and surgery is required, video-assisted thoracoscopic surgery (VATS) is, at least, comparable to decortication by thoracotomy, so should only undertaken if previous techniques have failed. Further clinical trials are needed to analyze factors that could affect the results obtained, in order to define new evidence-based diagnostic and therapeutic strategies that provide more effective, standardized management of this disease. PMID:25820035

  12. Macrophage-Derived Matrix Vesicles: An Alternative Novel Mechanism for Microcalcification in Atherosclerotic Plaques

    PubMed Central

    New, Sophie E.; Goettsch, Claudia; Aikawa, Masanori; Marchini, Julio F.; Shibasaki, Manabu; Yabusaki, Katsumi; Libby, Peter; Shanahan, Catherine M.; Croce, Kevin; Aikawa, Elena

    2013-01-01

    Rationale We previously showed that early calcification of atherosclerotic plaques associates with macrophage accumulation. Chronic renal disease (CRD) and mineral imbalance accelerates calcification and the subsequent release of matrix vesicles (MVs) precursors of microcalcification. Objective We tested the hypothesis that macrophage-derived MVs contribute directly to microcalcification. Methods and Results Macrophages associated with regions of calcified vesicular structures in human carotid plaques (n=136 patients). In vitro, macrophages released MVs with high calcification and aggregation potential. MVs expressed exosomal markers (CD9 and TSG101), and contained S100A9 and annexin V (Anx5). Silencing S100A9 in vitro and genetic deficiency in S100A9?/? mice reduced MV calcification, while stimulation with S100A9 increased calcification potential. Externalization of phosphatidylserine (PS) after Ca/P stimulation and interaction of S100A9 and Anx5, indicated that a PS-Anx5-S100A9 membrane complex facilitates hydroxyapatite nucleation within the macrophage-derived MV membrane. Conclusions Our results support the novel concept that macrophages release calcifying MVs enriched in S100A9 and Anx5, which contribute to accelerated microcalcification in CRD. PMID:23616621

  13. Delayed internal pancreatic fistula with pancreatic pleural effusion postsplenectomy

    PubMed Central

    Jin, Shu-Guang; Chen, Zhe-Yu; Yan, Lu-Nan; Zeng, Yong

    2010-01-01

    The occurrence of pancreatic pleural effusion, secondary to an internal pancreatic fistula, is a rare clinical syndrome and diagnosis is often missed. The key to the diagnosis is a dramatically elevated pleural fluid amylase. This pancreatic pleural effusion is also called a pancreatic pleural fistula. It is characterized by profuse pleural fluid and has a tendency to recur. Here we report a case of delayed internal pancreatic fistula with pancreatic pleural effusion emerging after splenectomy. From the treatment of this case, we conclude that the symptoms and signs of a subphrenic effusion are often obscure; abdominal computed tomography may be required to look for occult, intra-abdominal infection; and active conservative treatment should be carried out in the early period of this complication to reduce the need for endoscopy or surgery. PMID:20845520

  14. Sarcoid pleural effusion: three cases and review of the literature.

    PubMed Central

    Nicholls, A J; Friend, J A; Legge, J S

    1980-01-01

    Pleural sarcoidosis is rare--it is little recognised in Birtian although several cases have been reported in the international literature. Three white men with pleural effusions caused by sacroidosis have been seen in a two-year period when approximately 60 new cases of thoracic sarcoidosis have been presented. In one patient a recurrent massive effusion was only diagnosed as being caused by sarcoidosis after thoractomy, and in two further patients small symptomatic pleural effusions were present at the onset of typical sarcoidosis. Two patients were successfully treated with steroids and the third improved spontaneously. Percutaneous biopsy is not always helpful in diagnosing pleural sarcoidosis, but a lymphocytic, often blood-stained, pleural aspirate is highly characteristic. While other diseases may coexist, a pleural effusion in a patient with histologically proven sarcoidosis is more likely to be caused by the primary disease than by any other condition. Images PMID:7434269

  15. Cutaneous and pleural involvement in a patient with multiple myeloma.

    PubMed

    Saidane, Olfa; Slouma, Maroua; Haouet, Slim; Abdelmoula, Leila

    2015-01-01

    Multiple myeloma (MM) is a malignant proliferation of a single clone of plasma cells and an excess of monoclonal immunoglobulin production. It is rarely associated with cutaneous and pleural involvement. We report a new case of a 62-year-old woman with a history of a symptomatic MM. Three months after chemotherapy initiation, she presented with subcutaneous nodules. Ultrasound-guided needle biopsy confirmed the diagnosis of cutaneous plasmacytomas. She underwent local radiation therapy leading to complete regression of subcutaneous nodules. One month later, she developed dyspnoea. Thoracic CT scan showed pleural thickening associated with pleural effusion. Pleural biopsy confirmed the diagnosis of pleural plasmacytoma. Chemotherapy including vincristine, doxorubicin and dexamethasone was administered. Cutaneous involvement and pleural effusion accompanying MM are uncommon. They are associated with poor prognosis. PMID:26438677

  16. Acquired Large Calcified Unruptured Sinus of Valsalva Aneurysm.

    PubMed

    Park, Sang-Hyun; Seol, Sang-Hoon; Seo, Guang-Won; Song, Pil-Sang; Kim, Dong-Kie; Kim, Ki-Hun; Kim, Doo-Il

    2015-11-01

    Acquired aneurysms of the sinus of Valsalva are rare. They are caused by infections such as tuberculosis, syphilis and endocarditis, as well as atherosclerosis and traumatic injury. They may be asymptomatic and incidentally discovered. We present a rare case of a large acquired calcified unruptured aneurysm of the right coronary sinus of Valsalva that was compressing the right ventricular outflow tract. PMID:26105986

  17. The utility of ultrasound-guided thoracentesis and pleural biopsy in undiagnosed pleural exudates.

    PubMed

    Koegelenberg, Coenraad Frederik N; Irusen, Elvis Malcom; von Groote-Bidlingmaier, Florian; Bruwer, Johannes Willem; Batubara, Enas Mansour A; Diacon, Andreas Henri

    2015-10-01

    We assessed the utility of ultrasound to guide the selection of closed pleural biopsy technique and site and to assess the respective contributions of repeat thoracentesis and closed pleural biopsy in 100 consecutive patients with undiagnosed pleural exudates. Thoracentesis was more likely to be diagnostic in TB than malignancy (77.8% vs 31.0%, p<0.001). The addition of ultrasound-guided biopsy increased the combined yield for all diagnoses from 48.0% to 90.0% (p<0.001), for malignancy from 31.0% to 89.7% (p<0.001) and for TB from 77.8% to 88.9% (p=0.688). Our findings suggest that this minimally invasive approach has a high diagnostic yield. PMID:25997433

  18. Pleural Nocardiosis in an Immunocompetent Patient: A Case Report.

    PubMed

    Bagali, Smitha; Mantur, Prakash

    2016-01-01

    Nocardiosis is a rare infection that has attracted attention with its increased rate of occurrence in the recent years. In India there is a rare documentation of the pleural involvement in nocardiosis. We report here a case of pleural nocardiosis caused by Nocardia brasiliensis in an immunocompetent patient. This case highlights the importance of considering nocardiosis as a differential diagnosis in patients with pleural lesions. PMID:26894067

  19. An unusual case of pleural empyema in a tsunami survivor.

    PubMed

    Ota, Hideki; Kawai, Hideki

    2012-06-01

    A 74-year-old man who survived the tsunami after the Great East Japan Earthquake, was admitted to our department because of respiratory distress. He developed aspiration pneumonia and pleural empyema of the right thorax. Decortication was performed by video-assisted thoracoscopic surgery. An unsuspected aspirated pine tree branch and pulmonary pleural fistula were discovered. The branch was removed, the pleural fistula was opened for drainage of the intrapulmonary abscess, and the patient made a good recovery. PMID:22718730

  20. Pleural Nocardiosis in an Immunocompetent Patient: A Case Report

    PubMed Central

    Mantur, Prakash

    2016-01-01

    Nocardiosis is a rare infection that has attracted attention with its increased rate of occurrence in the recent years. In India there is a rare documentation of the pleural involvement in nocardiosis. We report here a case of pleural nocardiosis caused by Nocardia brasiliensis in an immunocompetent patient. This case highlights the importance of considering nocardiosis as a differential diagnosis in patients with pleural lesions. PMID:26894067

  1. Histopathologic Characteristics of Atherosclerotic Coronary Disease and Implications of the Findings for the Invasive and Noninvasive Detection of Vulnerable Plaques

    PubMed Central

    Narula, Jagat; Nakano, Masataka; Virmani, Renu; Kolodgie, Frank D.; Petersen, Rita; Newcomb, Robert; Malik, Shaista; Fuster, Valentin; Finn, Aloke V.

    2014-01-01

    Objectives The goal of this study was to identify histomorphologic characteristics of atherosclerotic plaques and to determine the amenability of some of these components to be used as markers for invasive and noninvasive imaging. Background Rupture of the atherosclerotic plaques is responsible for the majority of acute coronary events, and the culprit lesions demonstrate distinct histopathologic features. It has been tacitly believed that plaque rupture (PR) is associated with angiographically minimally occlusive lesions. Methods We obtained 295 coronary atherosclerotic plaques, including stable (fibroatheroma [FA]; n = 105), vulnerable (thin-cap fibroatheroma [TCFA]; n = 88), and disrupted plaques (plaque rupture [PR]; n = 102) from the hearts of 181 men and 32 women who had died suddenly. The hierarchical importance of fibrous cap thickness, percent luminal stenosis, macrophage area, necrotic core area, and calcified plaque area was evaluated by using recursive partitioning analysis. Because clinical assessment of fibrous cap thickness is not possible by noninvasive imaging, it was excluded from the second set of partitioning analysis. Results Thickness of the fibrous cap emerged as the best discriminator of plaque type; the cap thickness measured <55 ?m in ruptured plaques, and all FA were associated with >84-?m cap thickness. Although the majority of TCFA were found in the 54- to 84-?m thickness group, those with <54-?m thickness were more likely to show <74% luminal stenosis (area under the curve: FA, 1.0; TCFA, 0.89; PR, 0.90). After exclusion of cap thickness, analysis of the plaque characteristics revealed macrophage infiltration and necrotic core to be the 2 best discriminators of plaque types (area under the curve: FA, 0.82; TCFA, 0.58; PR, 0.72). More than 75% cross-section area stenosis was seen in 70% of PR and 40% of TCFA; only 5% PR and 10% TCFA were <50% narrowed. Conclusions This postmortem study defines histomorphologic characteristics of vulnerable plaques, which may help develop imaging strategies for identification of such plaques in patients at a high risk of sustaining acute coronary events. PMID:23473409

  2. Molecular Imaging of Plaque Vulnerability

    PubMed Central

    Tavakoli, Sina; Vashist, Aseem; Sadeghi, Mehran M.

    2014-01-01

    Over the past decade significant progress has been made in the development of novel imaging strategies focusing on the biology of the vessel wall for identification of vulnerable plaques. While the majority of these studies are still in the preclinical stage, few techniques (e.g., 18F-FDG and 18F-NaF PET imaging) have already been evaluated in clinical studies with promising results. Here, we will briefly review the pathobiology of atherosclerosis and discuss molecular imaging strategies that have been developed to target these events, with an emphasis on mechanisms that are associated with atherosclerotic plaque vulnerability. PMID:25124827

  3. Pleural fluid tumour markers in malignant pleural effusion with inconclusive cytologic results

    PubMed Central

    Antonangelo, L.; Sales, R.K.; Cor, A.P.; Acencio, M.M.P.; Teixeira, L.R.; Vargas, F.S.

    2015-01-01

    Background The presence of tumour cells in pleural fluid or tissue defines an effusion as malignant. Cytology analysis of the pleural fluid has about 60% diagnostic sensitivity. Several tests have been proposed to improve diagnosisamong them, the concentrations of tumour markers in pleural fluid. We evaluated whether the concentrations of tumour markers in pleural fluid could improve the diagnosis of malignant pleural effusion (mpe) when cytology is doubtful. Methods Lymphocytic pleural fluids secondary to tuberculosis or malignancy from 156 outpatients were submitted for cytology and tumour marker quantification [carcinoembryonic antigen (cea), cancer antigen 15-3 (ca15-3), carbohydrate antigen 19-9 (ca19-9), cancer antigen 72-4 (ca72-4), cancer antigen 125 (ca125), and cyfra 21-1). Oneway analysis of variance, the Student t-test or MannWhitney test, and receiver operating characteristic curves were used in the statistical analysis. Results Concentrations of the tumour markers cea, ca15-3, ca125, and cyfra 21-1 were higher in mpes than they were in the benign effusions (p < 0.001), regardless of cytology results. The markers ca19-9 and ca72-4 did not discriminate malignant from benign effusions. When comparing the concentrations of tumour markers in mpes having positive, suspicious, or negative cytology with concentrations in benign effusions, we observed higher levels of cea, ca15-3, cyfra 21-1, and ca125 in malignant effusions with positive cytology (p = 0.003, p = 0.001, p = 0.002, and p = 0.001 respectively). In pleural fluid, only ca125 was higher in mpes with suspicious or negative cytology (p = 0.001) than in benign effusions. Conclusions Given high specificity and a sensitivity of about 60%, the concentrations of tumour markers in pleural effusions could be evaluated in cases of inconclusive cytology in patients with a high pre-test chance of malignancy or a history of cancer. PMID:26628873

  4. Disseminated plasma cell myeloma presenting as massive pleural effusion

    PubMed Central

    Babu, Kanahasubramanian Anand; Sundararajan, Lakshmikanthan; Prabu, Pandurangan; Parameswaran, Ashok

    2015-01-01

    Plasma cell myeloma (PCM) is a hematologic malignancy of plasma cell origin and usually associated with the presence of lytic bone lesions. Pleural effusions are rarely associated with PCM and most often signify a concurrent disease process. Malignant myelomatous pleural effusions are even more unusual and carry a poor prognosis. We report a unique case of unsuspected PCM with thoracic involvement in the form of massive left side pleural effusion. Pleural fluid cytology revealed numerous atypical plasma cells. Subsequently on further workup, urine Bence Jones protein was positive. Bone marrow aspiration and biopsy and computed tomography of the chest and abdomen revealed features consistent with multiple myeloma. PMID:26664659

  5. Coronary Atherosclerotic Plaque Detected by Computed Tomographic Angiography in Subjects with Diabetes Compared to Those without Diabetes

    PubMed Central

    Khazai, Bahram; Luo, Yanting; Rosenberg, Steven; Wingrove, James; Budoff, Matthew J

    2015-01-01

    Objectives Little data are available regarding coronary plaque composition and semi-quantitative scores in individuals with diabetes; the extent to which diabetes may affect the presence and extent of Coronary Artery Calcium (CAC) needs more evaluation. Considering that this information may be of great value in formulating preventive interventions in this population, we compared these findings in individuals with diabetes to those without. Methods Multi-Detector Computed Tomographic (MDCT) images of 861 consecutive patients with diabetes who were referred to Los Angeles Biomedical Research Institute from January 2000 to September 2012, were evaluated using a 15coronary segment model. All 861 patients underwent calcium scoring and from these; 389 had coronary CT angiography (CTA). CAC score was compared to 861 age, sex and ethnicity matched controls without diabetes after adjustment for Body Mass Index (BMI), family history of coronary artery disease, hyperlipidemia, hypertension and smoking. Segment Involvement Score (SIS; the total number of segments with any plaque), Segment Stenosis Score (SSS; the sum of maximal stenosis score per segment), Total Plaque Score (TPS; the sum of the plaque amount per segment) and plaque compositionwere compared to 389 age, sex and ethnicity matched controls without diabetes after adjustment for BMI, family history of coronary artery disease, hyperlipidemia, hypertension and smoking. Results Diabetes was positively correlated to the presence and extent of CAC (P<0.0001 for both). SIS, SSS and TPS were significantly higher in those with diabetes (P<0.0001). Number of mixed and calcified plaques were significantly higher in those with diabetes (P = 0.018 and P<0.001 respectively) but there was no significant difference in the number of non-calcified plaques between the two groups (P = 0.398). Conclusions Patients with diabetes have higher CAC and semi-quantitative coronary plaque scores compared to the age, gender and ethnicity matched controls without diabetes after adjustment for cardiovascular risk factors. Since mixed plaque is associated with worse long-term clinical outcomes, these findings support more aggressive preventive measures in this population. PMID:26600086

  6. Comparison of plaque characteristics in narrowings with ST-elevation myocardial infarction (STEMI), non-STEMI/unstable angina pectoris and stable coronary artery disease (from the ADAPT-DES IVUS Substudy).

    PubMed

    Dong, Liang; Mintz, Gary S; Witzenbichler, Bernhard; Metzger, D Christopher; Rinaldi, Michael J; Duffy, Peter L; Weisz, Giora; Stuckey, Thomas D; Brodie, Bruce R; Yun, Kyeong Ho; Xu, Ke; Kirtane, Ajay J; Stone, Gregg W; Maehara, Akiko

    2015-04-01

    Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents (ADAPT-DES) was a prospective, multicenter registry of 8,582 consecutive stable and unstable patients who underwent percutaneous coronary intervention using a drug-eluting stent. We sought to identify key morphologic features leading to ST-segment elevation myocardial infarction (STEMI) versus non-STEMI (NSTEMI) or unstable angina pectoris (UA) versus stable coronary artery disease (CAD) presentation. In the prespecified grayscale and virtual histology (VH) substudy of ADAPT-DES, preintervention imaging identified 676 patients with a single culprit lesion. The relation between lesion morphology and clinical presentation was compared among patients with (1) STEMI, (2) NSTEMI or UA, and (3) stable CAD. Intravascular ultrasound identified more plaque rupture and VH thin-cap fibroatheroma (TCFA) in STEMI lesions compared with NSTEMI/UA or stable CAD lesions; conversely, fibroatheromas appeared more often calcified with a thick fibrous cap in stable CAD. Minimum lumen cross-sectional area (MLA) was smaller with larger plaque burden and positive remodeling in STEMI lesions. Lesions with plaque rupture versus those without plaque rupture showed higher prevalence of VH-TCFA and larger plaque burden with positive remodeling, especially in patients with STEMI. Multivariate analysis showed that in the lesions with plaque rupture, plaque burden at the MLA site was the only independent predictor for STEMI (cutoff of plaque burden = 85%) and in lesions without plaque rupture, MLA was the only independent predictor for STEMI (cutoff of MLA = 2.3 mm(2)). In conclusion, culprit lesions causing STEMI have smaller lumen areas, greater plaque burden, and more plaque rupture or VH-TCFA compared with NSTEMI/UA or stable CAD; in lesions with plaque rupture, only plaque burden predicted STEMI, and in lesions without plaque rupture, only MLA area predicted STEMI. PMID:25661569

  7. Etoricoxib- induced pleural effusion: A case for rational use of analgesics

    PubMed Central

    Balasingam, Nisahan; Thirunavukarasu, Kumanan; Selvaratnam, Gowry

    2015-01-01

    Pleural effusion caused by drug is an uncommon event in clinical practice. Etoricoxib induced pleural effusion is an extremely rare. We describe a patient with pleural effusion as an adverse drug reaction of etoricoxib. PMID:26816478

  8. Increasing the Spatial Resolution of 3T Carotid MRI Has No Beneficial Effect for Plaque Component Measurement Reproducibility

    PubMed Central

    van Wijk, Diederik F.; Strang, Aart C.; Duivenvoorden, Raphael; Enklaar, Dirk-Jan F.; Zwinderman, Aeilko H.; van der Geest, Rob J.; Kastelein, John J. P.; de Groot, Eric; Stroes, Erik S. G.; Nederveen, Aart J.

    2015-01-01

    Purpose Different in-plane resolutions have been used for carotid 3T MRI. We compared the reproducibility, as well as the within- and between reader variability of high and routinely used spatial resolution in scans of patients with atherosclerotic carotid artery disease. Since no consensus exists about the optimal segmentation method, we analysed all imaging data using two different segmentation methods. Materials and Methods In 31 patient with carotid atherosclerosis a high (0.25 0.25 mm2; HR) and routinely used (0.50 0.50 mm2; LR) spatial resolution carotid MRI scan were performed within one month. A fully blinded closed and a simultaneously open segmentation were used to quantify the lipid rich necrotic core (LRNC), calcified and loose matrix (LM) plaque area and the fibrous cap (FC) thickness. Results No significant differences were observed between scan-rescan reproducibility for HR versus LR measurements, nor did we find any significant difference between the within-reader and between-reader reproducibility. The same applies for differences between the open and closed reads. All intraclass correlation coefficients between scans and rescans for the LRNC, calcified and LM plaque area, as well as the FC thickness measurements with the open segmentation method were excellent (all above 0.75). Conclusions Increasing the spatial resolution at the expense of the contrast-to-noise ratio does not improve carotid plaque component scan-rescan reproducibility in patients with atherosclerotic carotid disease, nor does using a different segmentation method. PMID:26161783

  9. Metsovo lung: pleural calcification and restrictive lung function in northwestern Greece. Environmental exposure to mineral fiber as etiology

    SciTech Connect

    Constantopoulos, S.H.; Goudevenos, J.A.; Saratzis, N.; Langer, A.M.; Selikoff, I.J.; Moutsopoulos, H.M.

    1985-12-01

    Pleural calcifications are described in 122 of 268 (45.5%) inhabitants of four villages (Metsovo, Anilio, Milea, and Votonosi) in a small area of northwestern Greece (total population about 5000). All affected individuals are of one ethnic group, Vlachi. Calcifications were not noted in any of the 103 persons in the control group made up of 73 non-Vlachi inhabitants from the same and neighboring villages and 30 Vlachi from distant villages. The calcifications were seen in both sexes, equally, and their frequency increased with age, from 28.6% between 30 and 39 years to 81.0% in individuals over 70 years of age. When plaque development was extensive, a small restrictive pulmonary function defect was noted. Because of its prevalence in the Metsovo area we call this clinical pattern Metsovo lung. The identification of tremolite, related amphibole fibers, and traces of chrysotile fiber in settled dusts and soil specimens and of identical fibers in tissue specimens obtained at lung biopsy from 8 people with plaques supports the hypothesis that abestiform minerals are the agents responsible for these disease processes. Further, reports of the occurrence of mesothelioma and benign pleural effusions in inhabitants in the Metsovo area, along with the striking similarities to disease patterns observed in the Karain area of Turkey, add further weight to the hypothesis that mineral fiber(s) in the environment of the four villages are agent(s) in the etiology of Metsovo lung.

  10. Noncalcified Coronary Plaque Volumes in Healthy People with a Family History of Early-Onset Coronary Artery Disease

    PubMed Central

    Kral, Brian G.; Becker, Lewis C.; Vaidya, Dhananjay; Yanek, Lisa R.; Qayyum, Rehan; Zimmerman, Stefan L.; Dey, Damini; Berman, Daniel S.; Moy, Taryn F.; Fishman, Elliot K.; Becker, Diane M.

    2015-01-01

    Background Although age and sex distributions of calcified plaque (CCP) have been well described in the general population, noncalcified plaque (NCP) distributions remain unknown. This is important because NCP is a putative precursor for clinical CAD and could serve as a sentinel for aggressive primary prevention, especially in higher risk populations. We examined the distributions of NCP and CCP in healthy 30-74 year old individuals from families with early-onset coronary artery disease (CAD). Methods and Results Participants in the GeneSTAR family study (N=805), mean age 51.1 10.8 years, 56% female, were screened for CAD risk factors and for coronary plaque using dual-source CT angiography. Plaque volumes (mm3) were quantified using a validated automated method. The prevalence of coronary plaque was 57.8% in males and 35.8% in females (p<0.0001). NCP volume increased with age (p<0.001) and was higher in males than females (p<0.001). Although NCP, as a percent of total plaque, was inversely related to age (p<0.01), NCP accounted for most of the total plaque volume at all ages, especially in males and females <55 years (>70% and >80%, respectively). Higher Framingham risk was associated with the number of affected vessels (p<0.01) but 44% of males and 20.8% of females considered intermediate risk had left main and/or 3-vessel disease involvement. Conclusions The majority of coronary plaque was noncalcified, particularly in younger individuals. These findings support the importance of assessing family history and suggest that early primary prevention interventions may be warranted at younger ages in families with early onset CAD. PMID:24577355

  11. Multiphoton microscopy of atheroslcerotic plaques

    NASA Astrophysics Data System (ADS)

    Lilledahl, Magnus B.; de Lange Davies, Catharina; Haugen, Olav A.; Svaasand, Lars O.

    2007-02-01

    Multiphoton microscopy is a techniques that fascilitates three dimensional imaging of intact, unstained tissue. Especially connective tissue has a relatively strong nonlinear optical response and can easily be imaged. Atherosclerosis is a disease where lipids accumulate in the vessel wall and there is a thickening of the intima by growth of a cap of connective tissue. The mechanical strength of this fibrous cap is of clinically importance. If the cap ruptures a thrombosis forms which can block a coronary vessel and therby causing myocardial infarction. Multiphoton microscopy can be used to image the fibrous cap and thereby determine the thickness of the cap and the structure of the connective fibres. This could possibly be developed into a diagnostic and clincal tool to monitor the vulnerability of a plaque and also to better understand the development of a plaque and effects of treatment. We have collected multiphoton microscopy images from atherosclerotic plaque in human aorta, both two photon excited fluorescens and second harmonic generated signal. The feasability of using this technique to determine the state of the plaque is explored.

  12. Inhibiting macrophage proliferation suppresses atherosclerotic plaque inflammation

    PubMed Central

    Tang, Jun; Lobatto, Mark E.; Hassing, Laurien; van der Staay, Susanne; van Rijs, Sarian M.; Calcagno, Claudia; Braza, Mounia S.; Baxter, Samantha; Fay, Francois; Sanchez-Gaytan, Brenda L.; Duivenvoorden, Raphaël; Sager, Hendrik B.; Astudillo, Yaritzy M.; Leong, Wei; Ramachandran, Sarayu; Storm, Gert; Pérez-Medina, Carlos; Reiner, Thomas; Cormode, David P.; Strijkers, Gustav J.; Stroes, Erik S. G.; Swirski, Filip K.; Nahrendorf, Matthias; Fisher, Edward A.; Fayad, Zahi A.; Mulder, Willem J. M.

    2015-01-01

    Inflammation drives atherosclerotic plaque progression and rupture, and is a compelling therapeutic target. Consequently, attenuating inflammation by reducing local macrophage accumulation is an appealing approach. This can potentially be accomplished by either blocking blood monocyte recruitment to the plaque or increasing macrophage apoptosis and emigration. Because macrophage proliferation was recently shown to dominate macrophage accumulation in advanced plaques, locally inhibiting macrophage proliferation may reduce plaque inflammation and produce long-term therapeutic benefits. To test this hypothesis, we used nanoparticle-based delivery of simvastatin to inhibit plaque macrophage proliferation in apolipoprotein E–deficient mice (Apoe−/−) with advanced atherosclerotic plaques. This resulted in the rapid reduction of plaque inflammation and favorable phenotype remodeling. We then combined this short-term nanoparticle intervention with an 8-week oral statin treatment, and this regimen rapidly reduced and continuously suppressed plaque inflammation. Our results demonstrate that pharmacologically inhibiting local macrophage proliferation can effectively treat inflammation in atherosclerosis. PMID:26295063

  13. In vivo light dosimetry for pleural PDT

    NASA Astrophysics Data System (ADS)

    Dimofte, Andreea; Zhu, Timothy C.; Finlay, Jarod C.; Culligan, Melissa; Edmonds, Christine E.; Friedberg, Joseph S.; Cengel, Keith; Hahn, Stephen M.

    2009-02-01

    In-vivo light Dosimetry for patients undergoing photodynamic therapy (PDT) is one of the important dosimetry quantities critical for predicting PDT outcome. This study examines the light fluence (rate) delivered to patients undergoing pleural PDT as a function of treatment time, treatment volume and surface area, and its accuracy as a function of the calibration accuracies of each isotropic detector and the calibration integrating sphere. The patients studied here were enrolled in Phase II clinical trial of Photofrin-mediated PDT for the treatment of non-small cell lung cancer with pleural effusion. The ages of the patients studied varied from 34 to 69 year old. All patients were administered 2mg per kg body weight Photoprin 24 hours before the surgery. Patients undergoing photodynamic therapy (PDT) are treated with laser light with a light fluence of 60 J/cm^2 at 630nm. Fluence rate (mW/cm^2) and cumulative fluence (J/cm^2) was monitored at 7 different sites during the entire light treatment delivery. Isotropic detectors were used for in-vivo light dosimetry. The anisotropy of each isotropic detector was found to be within 30%. The mean fluence rate delivery varied from 37.84 to 94.05 mW/cm^2 and treatment time varied from 1762 to 5232s. We have established a correlation between the treatment time and the treatment volume. The results are discussed using an integrating sphere theory and the measured tissue optical properties. The result can be used as a clinical guideline for future pleural PDT treatment.

  14. Tissue inhibitor of metalloproteinase-1 is responsible for residual pleural thickening in pleural tuberculosis.

    PubMed

    Hwang, Ki-Eun; Shon, Young-Jun; Cha, Byong-Ki; Park, Mi-Jeong; Chu, Min-Su; Kim, Young-Jun; Jeong, Eun-Taik; Kim, Hak-Ryul

    2015-01-01

    Residual pleural thickening (RPT) is the most frequent complication associated with pleural tuberculosis, and may occur even after successful anti-tuberculosis medications. Matrix metalloproteinases (MMPs) are zinc-dependent proteinases capable of degrading all components of the extracellular matrix. The proteolytic action of MMPs may be involved in the pathogenesis of tuberculosis. MMP-9, secreted by monocytes and lymphocyte, may lead to long-term fibrosis. The aim of the present study was to determine whether MMP-2 and/or MMP-9 and their specific inhibitors, tissue inhibitors of metalloproteinase 1 (TIMP-1) and TIMP-2, could be used to predict RPT. This retrospective study enrolled 52 patients diagnosed with pleural tuberculosis. Levels of MMP-2, MMP-9, TIMP-1, and TIM-2 were determined in the pleural fluid by ELISA. The RPT was measured on chest X-ray at the completion of treatment and the final follow-up. The average periods of anti-tuberculosis medication and the follow-up after completion of treatment were 6.7 and 7.6 months, respectively. MMP-2 or MMP-9 levels had no significant correlation to RPT. The patients with RPT > 2 mm at the completion of anti-tuberculosis medication and the final follow-up had higher TIMP-1 levels (p = 0.00 and p = 0.001, respectively). However, patients with RPT > 2 mm at the completion of anti-tuberculosis medication had lower TIMP-2 levels (p = 0.005). In a logistic regression model, elevated TIMP-1 levels at the completion of anti-tuberculosis medications were associated with RPT. In conclusion, higher TIMP-1 levels are responsible for the development of RPT and may be helpful for predicting RPT in pleural tuberculosis. PMID:25854270

  15. Defect in recruiting effector memory CD8+ T-cells in malignant pleural effusions compared to normal pleural fluid

    PubMed Central

    2013-01-01

    Background Malignant pleural effusions (MPE) are a common and fatal complication in cancers including lung or breast cancers, or malignant pleural mesothelioma (MPM). MPE animal models and immunotherapy trials in MPM patients previously suggested defects of the cellular immunity in MPE. However only few observational studies of the immune response were done in MPM patients, using questionable control groups (transudate). Methods We compared T cell populations evaluated by flow cytometry from blood and pleural effusion of untreated patients with MPM (n?=?58), pleural metastasis of adenocarcinoma (n?=?30) or with benign pleural lesions associated with asbestos exposure (n?=?23). Blood and pleural fluid were also obtained from healthy subjects, providing normal values for T cell populations. Results Blood CD4+ or CD8+ T cells percentages were similar in all groups of patients or healthy subjects. Whereas pleural fluid from healthy controls contained mainly CD8+ T cells, benign or malignant pleural effusions included mainly CD4+ T cells. Effector memory T cells were the main T cell subpopulation in pleural fluid from healthy subjects. In contrast, there was a striking and selective recruitment of central memory CD4+ T cells in MPE, but not of effector cells CD8+ T cells or NK cells in the pleural fluid as one would expect in order to obtain an efficient immune response. Conclusions Comparing for the first time MPE to pleural fluid from healthy subjects, we found a local defect in recruiting effector CD8+ T cells, which may be involved in the escape of tumor cells from immune response. Further studies are needed to characterize which subtypes of effector CD8+ T cells are involved, opening prospects for cell therapy in MPE and MPM. PMID:23816056

  16. [Endobronchial ultrasound in the diagnosis of malignant pleural mesothelioma].

    PubMed

    Guinde, J; Laroumagne, S; Kaspi, E; Martinez, S; Tazi-Mezalek, R; Astoul, P; Dutau, H

    2015-09-01

    The diagnosis of malignant pleural mesothelioma relies mostly on the pathological examination of pleural samples, validated by a panel of experts and generally obtained during medical or surgical thoracoscopy performed for the management of an exudative pleural effusion. In the absence of pleural effusion (dry-type mesothelioma), the diagnostic approach depends on the features of the lesions (pleural thickness, nodules and/or masses) and their pleural location. Ultrasound and CT-guided needle aspiration represent recognized alternative diagnostic techniques in these situations. We present the case of a patient, presenting a dry-type mesothelioma, whose diagnosis was obtained by endobronchial ultrasound (EBUS)-guided needle aspiration of a pleural mediastinal mass and confirmed by a CT-guided needle aspiration of another pleural mass in close contact with the chest wall. The samples have been compared and show quantitative and qualitative similarities. EBUS represents a minimally invasive alternative diagnostic technique for dry-type mesothelioma, showing thickness of the mediastinal pleura in contact with a central airway or when thoracoscopy, which remains the "gold standard" diagnostic approach, is not feasible. PMID:26071130

  17. Diagnostic value of neurotrophin expression in malignant pleural effusions

    PubMed Central

    DUYSINX, BERNARD C.; PAULUS, ASTRID; HEINEN, VINCENT; NGUYEN, DELPHINE; HENKET, MONIQUE; CORHAY, JEAN-LOUIS; LOUIS, RENAUD

    2011-01-01

    Neurotrophins (NTs) modulate the growth of human malignancies, including lung cancers. Our prospective study evaluated the accuracy of pleural NTs [nerve growth factor, brain-derived neurotrophic factor (BDNF), neurotrophin 3 (nT3) and 4 (nT4)] levels for differentiating benign from malignant pleural exudates. Levels of NTs were measured by ELISA in 170 patients with non-neutrophilic (<50%) exudative benign or malignant pleurisies diagnosed by pleuroscopy. Fifty-nine benign (9 infections and 50 inflammatory diseases) and 111 malignant (50 extrathoracic tumors, 51 lung cancers and 10 mesotheliomas) pleural exudates were diagnosed by thoracoscopy. Levels of BDNF were significantly higher in malignant than in benign effusions [17 pg/ml (0367) vs. 8 pg/ml (051), p<0.05]. ROC analysis showed an area under the curve of 0.609 (p=0.012; best threshold 44 pg/ml). Pleural BDNF levels were significantly higher in pleural metastasis of pulmonary tumors and in mesothelioma than in pleural benign effusions. Finally, a higher proportion of pleural nT3 was detected in squamous cell lung carcinoma in comparison to that in non-squamous cell lung carcinoma (72.7 vs. 10%, p<0.0001). NTs and particularly BDNF may play a role in the pathogenesis of malignant pleural effusions. PMID:22977602

  18. Unilateral pleural effusion without ascites in liver cirrhosis

    SciTech Connect

    Faiyaz, U.; Goyal, P.C.

    1983-09-01

    The source of massive pleural effusion was not apparent in a 58-year-old man who had cirrhosis but no demonstrable ascites. Intraperitoneal injection of technetium Tc 99m sulfur colloid established the presence of peritoneopleural communication. This diagnostic technique can be helpful in evaluating patients with cirrhosis of the liver and pleural effusion with or without ascites.

  19. Extraosseous calcifying cystic odontogenic tumor: An uncommon variant.

    PubMed

    Mittal, Navin; Sah, Kunal; Chandra, Sunira; Gupta, Suchitra; Mittal, Shaksham; Agarwal, Mansi

    2013-07-01

    Odontogenic cysts comprise a diverse group of exceptional lesions derived from epithelial elements of the tooth-forming apparatus. Calcifying cystic odontogenic tumor is a rare odontogenic lesion, which represents about 2% of all odontogenic tumors and cysts. It may occur in a central (intraosseous) or peripheral (extraosseous calcifying cystic odontogenic tumor [ECCOT]) location. ECCOT in contrast to central, tends to affect the older patients, commonly located in the anterior lower jaw, is less aggressive and the recurrence is rare. Here, we report clinico-pathological and radiographic features of ECCOT located in relation to 48 (posterior lower jaw) measuring about 1 cm in the greatest diameter in a 17-year-old male. PMID:24665187

  20. The use of ultrasonic spectroscopy to characterize calcified lesions

    NASA Technical Reports Server (NTRS)

    Rooney, J. A.; Gammell, P. M.; Hestenes, J. D.; Chin, H. P.; Blankenhorn, D. H.

    1981-01-01

    A quantitative basis is developed for the medical application of ultrasonic spectroscopy, particularly in the characterization of calcified lesions associated with atherosclerotic conditions. A theory of the field radiation patterns of disk and ring sources is presented which can be used to predict minima in the reflection spectra of a target as a function of frequency and angle relative to the acoustic axis. The theory is then tested experimentally for objects of known geometry by the use of a time delay spectroscopy system using a swept frequency technique, and results are obtained which demonstrate the usefulness of the technique. Finally, the theory is verified in the determination of lesion diameter and orientation from spectra received from calcified lesions on in vitro arterial specimens as a function of angle.

  1. Management of Pleural Effusion, Empyema, and Lung Abscess

    PubMed Central

    Yu, Hyeon

    2011-01-01

    Pleural effusion is an accumulation of fluid in the pleural space that is classified as transudate or exudate according to its composition and underlying pathophysiology. Empyema is defined by purulent fluid collection in the pleural space, which is most commonly caused by pneumonia. A lung abscess, on the other hand, is a parenchymal necrosis with confined cavitation that results from a pulmonary infection. Pleural effusion, empyema, and lung abscess are commonly encountered clinical problems that increase mortality. These conditions have traditionally been managed by antibiotics or surgical placement of a large drainage tube. However, as the efficacy of minimally invasive interventional procedures has been well established, image-guided small percutaneous drainage tubes have been considered as the mainstay of treatment for patients with pleural fluid collections or a lung abscess. In this article, the technical aspects of image-guided interventions, indications, expected benefits, and complications are discussed and the published literature is reviewed. PMID:22379278

  2. Silicone Breast Implants: A Rare Cause of Pleural Effusion

    PubMed Central

    Shaik, Imam H.; Gandrapu, Bindu; Flores, David; Matta, Jyoti; Syed, Amer K.

    2015-01-01

    Pleural effusions are one of the rarest complications reported in patients with silicone gel filled breast implants. The silicone implants have potential to provoke chronic inflammation of pleura and subsequent pulmonary complications such as pleural effusion. Herein, we report a 44-year-old female who presented with left sided pleural effusion, six weeks after a silicone breast implantation surgery. The most common infectious, inflammatory, and malignant causes of pleural effusion were excluded with pleural fluid cytology and cultures. With recurrent effusion in the setting of recent surgery, the chemical reaction to silicone breast implants was sought and exploration was performed which revealed foreign body reaction (FBR) to silicone material. The symptoms dramatically improved after the explantation. PMID:26693375

  3. Pleural effusion in sarcoidosis: a report of six cases.

    PubMed Central

    Sharma, O P; Gordonson, J

    1975-01-01

    Six (4 percent) of 150 patients with sarcoidosis had a pleural effusion. A review of the literature revealed seven more patients with pleural sarcoidosis. Analysis of the 13 patients reported so far did not reveal any clinical, radiological, or laboratory feature which may be of diagnostic significance. The diagnosis of pleural sarcoidosis was based on clinical or radiographic grounds and histological evidence of noncaseating granulomata. In three of the patients pleural fluid resolved spontaneously; the other three were treated with corticosteroids. It is suggested that pleural involvement in sarcoidosis, especially in Negroes, may be more frequent than is generally realized and the effusion may occur either at the time of initial presentation or later in the course of the disease. Images PMID:1124534

  4. Three-Dimensional Ultrasound of Carotid Plaque.

    PubMed

    Spence, J David; Parraga, Grace

    2016-02-01

    Measurement of plaque burden is different from measurement of carotid intima-media thickness (IMT). Carotid total plaque area is a stronger predictor of cardiovascular risk than IMT, and in contrast to progression of IMT, which does not predict cardiovascular events, progression of total plaque area and total plaque volume strongly predict cardiovascular events. Measurement of plaque burden is useful in genetic research, and in evaluation of new therapies for atherosclerosis. Perhaps more importantly, it can be used for management of patients. A strategy called "treating arteries instead of treating risk factors" markedly reduces risk among patients with asymptomatic carotid stenosis. PMID:26610661

  5. Calcified-tissue investigations using synchrotron x-ray microscopy

    SciTech Connect

    Jones, K.W.; Spanne, P.; Schidlovsky, G.; Dejun, X. ); Bockman, R.S. . Medical Coll.); Rabinowitz, M.B. ); Hammond, P.B.; Bornschein, R.L. ); Hoeltzel, D.A. )

    1990-10-01

    Synchrotron x-ray microscopy (SXRM) in both emission and absorption modes has been used to examine elemental distributions in specimens of rat tibia, human deciduous teeth, and an orthopedic implant phantom. The work was performed with a spatial resolution of 8 {mu}m for the emission work and 25 {mu}m for the absorption work. The results illustrate the usefulness of SXRM for measurements of different types of calcified tissue. 3 figs.

  6. ARTHROSCOPIC TREATMENT OF CALCIFYING TENDINITIS OF THE ROTATOR CUFF

    PubMed Central

    Neto, Arnaldo Amado Ferreira; Trevizani, Cassio Silva; Benegas, Eduardo; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emílio Conforto; Bitar, Alexandre Carneiro; Neto, Francisco José dos Santos

    2015-01-01

    To evaluate the clinical and radiographic results from arthroscopic surgical treatment of the rotator cuff in patients with calcifying tendinitis. Method: A retrospective study was conducted on twenty patients who underwent arthroscopic treatment for calcifying tendinitis of the shoulder between March 1999 and November 2005. Six patients were excluded due to loss of follow-up. The average follow-up period was 41.4 months. Eight patients (57%) were female and six (43%) were male. The right side was affected in 10 cases (71%) and the left in four cases (29%). Nine cases (64%) had calcification in the supraspinatus tendon, two (14%) in the infraspinatus tendon, and three (21%) in both tendons. Results: In all cases, resection of the calcium deposits was performed by means of a needle (Jelco® No. 14) in combination with curettage (mini-curette). Two shoulders (14%) underwent subacromial decompression, and one (7%) underwent excision of the distal clavicle. A tendon-tendon suture was performed in three shoulders (21%). None of the patients underwent tendon-bone reinsertion. The mean score obtained on the UCLA scale was 33 points (26-35), thus indicating that a majority of patients had good results. In the final radiographic evaluation, none of the patients showed signs of calcification. Conclusion: Arthroscopic treatment of calcifying tendinitis of the shoulder safely allows excision of the calcification, leading to good results in relation to shoulder pain and function.

  7. Pleural effusion in patients infected with the human immunodeficiency virus.

    PubMed

    Trejo, O; Girn, J A; Prez-Guzmn, E; Segura, E; Fernndez-Gutirrez, C; Garca-Tapia, A; Clavo, A J; Bascuana, A

    1997-11-01

    In order to analyze the etiology, cytological and biochemical characteristics, and outcome of pleural disease in patients infected with HIV, the medical records of 86 HIV-positive patients with pleural effusion were reviewed. Controls were 106 HIV-negative patients with parapneumonic or tuberculous effusion. Most HIV-positive patients were intravenous drug abusers (95.3%). Pleural effusions in HIV-positive patients were caused by infections in 76 (89.4%) cases. Parapneumonic effusion was diagnosed in 59 patients and tuberculous pleuritis in 15 patients. Staphylococcus aureus was the most frequently isolated bacteria. Parameters for differentiating complicated cases of parapneumonic exudate from uncomplicated cases, such as pleural fluid pH < 7.20 (sensitivity 80% vs. 84.3%), pleural fluid glucose < 35 mg/dl (sensitivity 45% vs. 56.25%) pleural fluid LDH > 1600 UI/l (sensitivity 85% vs. 62.50%), showed similar sensitivity in HIV-positive and HIV-negative patients. Monocytes in pleural fluid were significantly decreased in tuberculous pleuritis in HIV-positive patients (506 +/- 425 vs. 1014 +/- 1196 monocytes/ml, p < 0.05). No significant differences were detected in the outcome of HIV-positive and HIV-negative patients with pleural disease. It can be concluded that the pleural effusion was of predominantly infectious etiology in HIV-positive patients from populations with a high prevalence of intravenous drug abuse. Neither the biochemical parameters in pleural fluid nor the outcome differed significantly between HIV-positive and HIV-negative patients. PMID:9447902

  8. Rare cause of pleural nodularity: Splenosis.

    PubMed Central

    Gezer, Suat; Glhan, S. S. Erkmen; Altinok, Tamer; Agakiran, Yetkin; Tastepe, A. Irfan

    2006-01-01

    Splenosis is a rare condition described as ectopic splenic tissue implantation generally after a splenic rupture. A 35-year-old male patient who had a history of splenectomy operation due to gunshot wound seven years ago was referred to our hospital with complaints, including exhaustion, sweating and shortness of breath. Thoracic computed tomography of the patient showed nodular pleural thickenings at the level of the left lower lobe, which proved to be unrelated with the presenting symptoms. The patient underwent a minithoracotomy for diagnosis and treatment. During the intraoperative observation, dark-colored, soft, multiple nodular lesions with a biggest size of 2 cm inside the visceral pleura over an area of 5 x 10 cm in dimension were observed. Also, a few tiny nodules in the lung parenchyma approximately 1-cm deep to the pleural nodules were palpated. The lesions were excised. The histopathological examination of the specimen showed splenic tissue in the lung parenchyma and pleura, so the lesions were accepted as splenosis. Pleuropulmonary splenosis, which develops generally after simultaneous rupture of the diaphragma and spleen, is a very rare condition. Most of the patients are asymptomatic and the lesions are detected accidentally. If the diagnosis can be made preoperatively, surgical excision is not needed. Images Figure 1 Figure 2 PMID:16916134

  9. Staging algorithm for diffuse malignant pleural mesothelioma.

    PubMed

    Zielinski, Marcin; Hauer, Jolanta; Hauer, Lukasz; Pankowski, Juliusz; Nabialek, Tomasz; Szlubowski, Artur

    2010-02-01

    An algorithm of preoperative mediastinal nodal staging with endobronchial/endoesophageal ultrasonography (EBUS/EUS) and transcervical extended mediastinal lymphadenectomy (TEMLA) combined with laparoscopy/peritoneal lavage and cytology was analyzed to establish the realistic criteria for radical multimodality treatment of malignant pleural mesothelioma (MPM). The algorithm included computed tomography (CT), thoracoscopy with multiple pleural biopsies and talc pleurodesis, EBUS/EUS and one-stage TEMLA and laparoscopy/peritoneal lavage and cytology of the fluid. Forty-two patients were diagnosed from 1 January 2004 to 31 December 2008. There were 16 women and 26 men in ages ranging from 43 to 77 years (mean 57.8); 31 epithelioid, 2 sarcomatoid and 9 biphasic type MPM. 21/42 patients were considered possible candidates for multimodality treatment. Three patients who received neoadjuvant chemotherapy were excluded from this study. EBUS/EUS was performed to stage the mediastinal nodes. In 3/18 patients metastatic nodes were discovered. In the rest of the 15 patients simultaneous TEMLA and laparoscopy/peritoneal lavage and cytology of the fluid were performed. In three patients TEMLA was positive, in six patients laparoscopy was positive and in two patients both TEMLA and laparoscopy were positive. Finally, 4/42 (9.5%) patients underwent thoracotomy with one exploration (chest wall infiltration) and three pleuropneumonectomies with the subsequent chemo- and radiotherapy. The proposed algorithm of preoperative staging spared the majority of MPM patients from futile surgery. PMID:19843550

  10. Bacterial sex in dental plaque

    PubMed Central

    Olsen, Ingar; Tribble, Gena D.; Fiehn, Nils-Erik; Wang, Bing-Yan

    2013-01-01

    Genes are transferred between bacteria in dental plaque by transduction, conjugation, and transformation. Membrane vesicles can also provide a mechanism for horizontal gene transfer. DNA transfer is considered bacterial sex, but the transfer is not parallel to processes that we associate with sex in higher organisms. Several examples of bacterial gene transfer in the oral cavity are given in this review. How frequently this occurs in dental plaque is not clear, but evidence suggests that it affects a number of the major genera present. It has been estimated that new sequences in genomes established through horizontal gene transfer can constitute up to 30% of bacterial genomes. Gene transfer can be both inter- and intrageneric, and it can also affect transient organisms. The transferred DNA can be integrated or recombined in the recipient's chromosome or remain as an extrachromosomal inheritable element. This can make dental plaque a reservoir for antimicrobial resistance genes. The ability to transfer DNA is important for bacteria, making them better adapted to the harsh environment of the human mouth, and promoting their survival, virulence, and pathogenicity. PMID:23741559

  11. The riddle of Randall's plaques.

    PubMed

    Prien, E L

    1975-10-01

    Randall described a pre-calculus lesion of the renal papilla in the 1930s and this was substantiated by others during the next decade and then largely ignored. This insignificant subepithelial calcification of the renal papilla. Randall's plaque type I, becomes the nucleus of at least 15% of calcium oxalate calculi, as demonstrated by apatite nuclei existing in papillary depression on the external stone surface. Cross section study of the stone demonstrates the peripheral nucleus with eccentric lamination postulating a mural origin. Contrariwise, study of the stone developing upon a nucleus originating in the papillary ducts (without producing obstruction) or out in the calix demonstrates a central nucleus surrounded by concentric laminations or lack of a mural origin, the more common type of calcium oxalate stone structure. Obstruction of the papillary ducts by hyperexcretion of stone salt may result in anemic infarction and sloughing of the apex of the papilla. Data concerning the prevalence of Randall's plaques in the population have been reviewed. Evidence of the incidence of calcium oxalate calculi that have developed upon Randall's plaques has been presented. A plea for further study of the pathology of the renal papilla has been voiced. PMID:1235369

  12. Failure Patterns After Hemithoracic Pleural Intensity Modulated Radiation Therapy for Malignant Pleural Mesothelioma

    SciTech Connect

    Rimner, Andreas; Spratt, Daniel E.; Zauderer, Marjorie G.; Rosenzweig, Kenneth E.; Wu, Abraham J.; Foster, Amanda; Yorke, Ellen D.; Adusumilli, Prasad; Rusch, Valerie W.; Krug, Lee M.

    2014-10-01

    Purpose: We previously reported our technique for delivering intensity modulated radiation therapy (IMRT) to the entire pleura while attempting to spare the lung in patients with malignant pleural mesothelioma (MPM). Herein, we report a detailed pattern-of-failure analysis in patients with MPM who were unresectable or underwent pleurectomy/decortication (P/D), uniformly treated with hemithoracic pleural IMRT. Methods and Materials: Sixty-seven patients with MPM were treated with definitive or adjuvant hemithoracic pleural IMRT between November 2004 and May 2013. Pretreatment imaging, treatment plans, and posttreatment imaging were retrospectively reviewed to determine failure location(s). Failures were categorized as in-field (within the 90% isodose line), marginal (<90% and ≥50% isodose lines), out-of-field (outside the 50% isodose line), or distant. Results: The median follow-up was 24 months from diagnosis and the median time to in-field local failure from the end of RT was 10 months. Forty-three in-field local failures (64%) were found with a 1- and 2-year actuarial failure rate of 56% and 74%, respectively. For patients who underwent P/D versus those who received a partial pleurectomy or were deemed unresectable, the median time to in-field local failure was 14 months versus 6 months, respectively, with 1- and 2-year actuarial in-field local failure rates of 43% and 60% versus 66% and 83%, respectively (P=.03). There were 13 marginal failures (19%). Five of the marginal failures (38%) were located within the costomediastinal recess. Marginal failures decreased with increasing institutional experience (P=.04). Twenty-five patients (37%) had out-of-field failures. Distant failures occurred in 32 patients (48%). Conclusions: After hemithoracic pleural IMRT, local failure remains the dominant form of failure pattern. Patients treated with adjuvant hemithoracic pleural IMRT after P/D experience a significantly longer time to local and distant failure than patients treated with definitive pleural IMRT. Increasing experience and improvement in target delineation minimize the incidence of avoidable marginal failures.

  13. Effect of Ocean acidification on growth, calcification and reproduction of calcifying and non-calcifying epibionts of brown algae

    NASA Astrophysics Data System (ADS)

    Saderne, V.; Wahl, M.

    2012-04-01

    Anthropogenic emissions of CO2 are leading to an acidification of the oceans of 0.4 pH units in the course of this century according to the more severe model scenarios. The excess of CO2 could notably affect the benthic communities of calcifiers and macrophytes in different aspects (photosynthesis, respiration and calcification). Seaweeds are one of the key species of nearshore benthic ecosystems of the Baltic Sea. They are the substratum of several fouling epibionts like bryozoans and tubeworms. Most of those species are bearing calcified structures and could therefore be potentially impacted by the seawater pCO2. On the other hand, the biological activity of the host may substantially modulate the pH and pCO2 conditions in the boundary layer where the epibionts live. The aim of the present study was to test the sensitivity of seaweed macrofouling communities to higher pCO2 concentration. Fragments of macroalgae Fucus serratus bearing the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium gelatinosum (Bryozoa) were maintained for 30 days under three pCO2: natural 460 ± 59 µatm and enriched 1193 ± 166 µatm and 3150 ± 446 µatm. Our study showed a significant reduction of growth rates and reproduction of Spirorbis individuals at the highest pCO2. Tubeworms Juveniles exhibited enhanced calcification of 40 % when in the light compare to dark, presumably due to effect of photosynthetic and respiratory activities of the host alga. Electra colonies showed significantly improved growth rates at 1193 µatm. The overall net dissolution of the communities was significantly higher at 3150 µatm. No effect on Alcyonidium colonies growth rates was observed. Those results suggest a remarkable resistance of the algal macro-epibiontic communities to the most elevated pCO2 predicted for 2100 for open ocean (~1000 µatm) conditions. Concerns remains with regards to higher pCO2 possibly found in the future Baltic Sea.

  14. Evaluation of Cepheid's Xpert MTB/RIF Test on Pleural Fluid in the Diagnosis of Pleural Tuberculosis in a High Prevalence HIV/TB Setting

    PubMed Central

    Kirenga, Bruce J.; Kiragga, Agnes; Lukande, Robert; Nsereko, Maria; Ssengooba, Willy; Katamba, Achilles; Worodria, William; Joloba, Moses L.; Mayanja-Kizza, Harriet

    2014-01-01

    Background Diagnosis of pleural tuberculosis (TB) using routinely available diagnostic methods is challenging due to the paucibacillary nature of the disease. Histopathology and pleural tissue TB culture involves an invasive procedure which requires expertise and appropriate equipment, both often unavailable in many health units. Xpert MTB/Rif test has been widely evaluated in sputum specimens but data on its performance in pleural TB is scarce. We evaluated the accuracy of Cepheid's Xpert MTB/Rif test on pleural fluid in the diagnosis of pleural TB in Uganda. Methods Consenting adult patients with exudative pleural effusions underwent pleural biopsy and the tissue obtained subjected to Lowenstein-Jensen and mycobacterial growth indicator tube MTB cultures and histopathology. Pleural fluid for Xpert MTB/Rif testing was also collected. Data on socio-demographic characteristics, clinical symptoms, HIV status and CD4 count were also collected. Sensitivity, specificity, positive and negative predictive values of Xpert MTB/Rif test on pleural fluid in pleural TB diagnosis were calculated using pleural tissue MTB culture and/or histopathology as the reference standard. Results Of the 116 participants [female 50%, mean age 34 (SD 13], 87/116 (75%) had pleural TB confirmed on pleural tissue culture and/or histopathology. The Xpert MTB/Rif test identified 25 (28.7%) of the 87 confirmed pleural TB cases. The sensitivity and specificity of Xpert MTB/Rif test were 28.7% and 96.6% respectively while the positive and negative predictive values were 96.1% and 31.1% respectively. Conclusion Xpert MTB/Rif test on pleural fluid does not accurately diagnose pleural TB and therefore cannot be used as an initial evaluation test in patients with suspected pleural TB. New, rapid and accurate tests for the diagnosis of pleural TB are still warranted. PMID:25051491

  15. Endobronchial valves in the management of broncho-pleural and alveolo-pleural fistulae.

    PubMed

    El-Sameed, Y; Waness, A; Al Shamsi, I; Mehta, A C

    2012-06-01

    Pneumothorax from bronchopleural or alveolo-pleural fistulae can be complicated by prolonged air leak (AL). This can occur in a variety of clinical settings. Examples include structural lung disease, such as bronchiectasis, and cavitary lung disorders. Prolonged AL is associated with prolonged hospital stay, atelectasis, pneumonia, and thromboembolic disease. Endobronchial valves (EBVs) have been recently introduced to manage such situations. The global experience in this novel therapeutic modality is still evolving. We report our preliminary experience with managing persistent AL treated successfully with EBVs and review the current literature on this subject. Our experience shows that EBVs are an effective tool for the management of prolonged AL from persistent bronchopleural or alveolo-pleural fistulae. It is a minimally invasive procedure recommended as an option, particularly in patients not fit for surgical repair. PMID:22246554

  16. [Hyperthermic chemoperfusion of the pleural cavity in the combined treatment for malignant pleural mesothelioma].

    PubMed

    Levchenko, E V; Mamontov, O Iu; Senchik, K Iu; Barchuk, A S; Gel'fond, M L

    2014-01-01

    The literature and our own experience were analyzed in multimodal approach to the treatment of patients with malignant pleural mesothelioma (MPM). Survival and quality of life of patients with MPM who underwent multimodal treatment, according to modern standards, are often limited by the occurrence of local recurrences. The value of a number of local therapy methods is still being explored in order to determine the possible side effects as well as the duration of disease-free survival. Photodynamic therapy and intraoperative hyperthermic chemoperfusion of the pleural cavity are the methods of the local treatment of this disease, applied after surgery. These approaches have been investigated separately in several studies, but their efficacy and tolerability is still not clear. The authors wanted to find the best indications for the use of these methods and to assess the immediate and long-term results. PMID:25552068

  17. Prevention of Pleural Adhesions by Bioactive Polypeptides - A Pilot Study

    PubMed Central

    kerberg, D.; Posaric-Bauden, M.; Isaksson, K.; Andersson, R.; Tingstedt, B.

    2013-01-01

    Objective: Postoperative pleural adhesions lead to major problems in repeated thoracic surgery. To date, no antiadhesive product has been proven clinically effective. Previous studies of differently charged polypeptides, poly-L-lysine (PL) and poly-L-glutamate (PG) have shown promising results reducing postoperative abdominal adhesions in experimental settings. This pilot study examined the possible pleural adhesion prevention by using the PL+PG concept after pleural surgery and its possible effect on key parameters; plasmin activator inhibitor-1 (PAI-1) and tissue growth factor beta 1 (TGFb) in the fibrinolytic process. Methods: A total of 22 male rats were used in the study, one control group (n=10) and one experimental group (n=12). All animals underwent primary pleural surgery, the controls receiving saline in the pleural cavity and the experimental group the PL+PG solution administered by spray. The animals were evaluated on day 7. Macroscopic appearance of adhesions was evaluated by a scoring system. Histology slides of the adhesions and pleural biopsies for evaluation of PAI-1 and TGFb1 were taken on day 7. Results: A significant reduction of adhesions in the PL+PG group (p<0.05) was noted at day 7 both regarding the length and severity of adhesions. There were no significant differences in the concentration of PAI-1 and TGFb1 when comparing the two groups. Conclusions: PL+PG may be used to prevent pleural adhesions. The process of fibrinolysis, and fibrosis was though not affected after PLPG administration. PMID:24151443

  18. Foreign body granuloma mimicking recurrence of malignant pleural mesothelioma

    PubMed Central

    Nakasuka, Takamasa; Fujimoto, Nobukazu; Hara, Naofumi; Miyamoto, Yosuke; Yamagishi, Tomoko; Asano, Michiko; Nishi, Hideyuki; Kishimoto, Takumi

    2015-01-01

    A 72-year-old man visited our hospital due to right pleural effusion. He had worked as a welder at a shipbuilding company and had been exposed to asbestos. Cytological examination and thoracoscopic pleural biopsy yielded a diagnosis of epithelial malignant pleural mesothelioma (MPM); extrapleural pneumonectomy (EPP) was performed. Two years later, he became aware of right-back swelling that became a fist-sized mass over 2 months. Microscopy of a tissue specimen revealed no malignant cells, but did indicate foreign body granuloma. Subcutaneous lesions that develop after EPP do not necessarily result from the recurrence of MPM, but could have benign etiologies. PMID:26744667

  19. Reduction of rat pleural microvilli caused by noise pollution.

    PubMed

    Oliveira, Maria Joo; Pereira, Antnio S; Ferreira, Paula G; Grande, Nuno R; Aguas, Artur P; Guimares, Laura; Freitas, Diamantino; Carvalho, Antnio P

    2003-01-01

    Scanning electron microscopy (SEM) was used to investigate whether chronic exposure to noise modifies pleural morphology. Rats were submitted to 8-h/day schedule of noise that is similar to the working hours at cotton-mill rooms. Morphometry of the area occupied by microvilli on the pleural surface showed a decrease in microvilli after 3 months of rat exposure to noise. The reduction of microvilli was 10% after 3 months of noise exposure (reaching 20% after 7 months of noise treatment) and is consistent with pleural effusions found in some of the patients working in noise-polluted environments. PMID:14710437

  20. Primary diffuse pleural rhabdomyosarcoma in an adult patient.

    PubMed

    Koksal, Deniz; Ibrahimov, Ferhad; Bugdayci, Meral; Gedikoglu, Gokhan; Emri, Salih

    2016-01-01

    Rhabdomyosarcoma is an aggressive malignant tumor of childhood, originating from immature cells that are destinated to form striated skeletal muscle. It usually arises in the head and neck or the extremities. Primary diffuse pleural rhabdomyosarcoma is exceptionally rare. Herein we report a case of primary diffuse pleural rhabdomyosarcoma in a 48-year-old man. The diagnosis was confimed by percutaneous pleural biopsy. Chemotherapy (cisplatin, ifosfamide, adriamycin, vincristine) was initiated due to the large volume of the tumor. After 3 months, computed tomography of the thorax showed stable radiological findings. PMID:26207004

  1. Foreign body granuloma mimicking recurrence of malignant pleural mesothelioma.

    PubMed

    Nakasuka, Takamasa; Fujimoto, Nobukazu; Hara, Naofumi; Miyamoto, Yosuke; Yamagishi, Tomoko; Asano, Michiko; Nishi, Hideyuki; Kishimoto, Takumi

    2015-01-01

    A 72-year-old man visited our hospital due to right pleural effusion. He had worked as a welder at a shipbuilding company and had been exposed to asbestos. Cytological examination and thoracoscopic pleural biopsy yielded a diagnosis of epithelial malignant pleural mesothelioma (MPM); extrapleural pneumonectomy (EPP) was performed. Two years later, he became aware of right-back swelling that became a fist-sized mass over 2 months. Microscopy of a tissue specimen revealed no malignant cells, but did indicate foreign body granuloma. Subcutaneous lesions that develop after EPP do not necessarily result from the recurrence of MPM, but could have benign etiologies. PMID:26744667

  2. Chylothorax: diagnosis by lipoprotein electrophoresis of serum and pleural fluid.

    PubMed Central

    Seriff, N S; Cohen, M L; Samuel, P; Schulster, P L

    1977-01-01

    This report describes a 31-year-old woman who underwent a technically difficult left pneumonectomy for tuberculosis and developed thereafter a large left pleural effusion which was milky in colour. A traumatic chylothorax was suspected, and the diagnosis was confirmed by simultaneous fasting pleural and serum lipid studies and lipoprotein electrophoresis. The latter study was especially helpful in confirming the chylous nature of the fluid in that it revealed a marked chylomicron band at the origin; this was not present in the patient's serum nor in the pleural fluid of five patients with other disease states studied as controls. Images PMID:841541

  3. Friction and morphology of pleural mesothelia.

    PubMed

    Pecchiari, Matteo; Sartori, Patrizia; Conte, Vincenzo; D'Angelo, Edgardo; Moscheni, Claudia

    2016-01-01

    To verify the hypothesis that by enmeshing lubricants, microvilli reduce the coefficient of kinetic friction (?) of pleural mesothelium, ? was measured during reciprocating sliding of rabbit's visceral against parietal pleura before and after addition of hyaluronan, and related to the morphological features of the microvillar network. Because no relation was found between ? or ? changes after hyaluronan and microvillar characteristics, the latter are not determinants of the frictional forces which oppose sliding of normal mesothelial surfaces under physiological conditions, nor of the effects of hyaluronan. Addition of hyaluronan increased ? slightly but significantly in normal specimens, probably by altering the physiological mix of lubricants, but decreased ? of damaged mesothelia, suggesting protective, anti-abrasion properties. Indeed, while sliding of an injured against a normal pleura heavily damaged the latter and increased ? when Ringer was interposed between the surfaces, both effects were limited or prevented when hyaluronan was interposed between the injured and normal pleura before onset of sliding. PMID:26376001

  4. Review: Cell Dynamics in Malignant Pleural Effusions.

    PubMed

    Giarnieri, Enrico; Bellipanni, Gianfranco; Macaluso, Marcella; Mancini, Rita; Holstein, Adam Carl; Milanese, Carla; Giovagnoli, Maria Rosaria; Giordano, Antonio; Russo, Giuseppe

    2015-02-01

    Malignant pleural effusions (MPEs) are a common manifestation found in patients with lung cancer. After cytological and histological confirmation of malignancy, talc pleurodesis still remains the treatment of choice in patients with MPEs resistant to chemotherapy. Despite this, primary challenges include reduced quality of life and life expectancy in general. Therefore, a better understanding of the cell biology of MPEs, along with improvements in treatment is greatly needed. It has recently been demonstrated that MPEs may represent an excellent source for identification of molecular mechanisms within the tumor and its environment. The present review summarizes the current understanding of MPEs cells and tumor microenvironment, and particularly focuses on dissecting the cross-talk between MPEs and epithelial to mesenchymal transition (EMT), inflammation and cancer stem cells. PMID:25205557

  5. Malignant pleural effusion and algorithm management

    PubMed Central

    Zarogoulidis, Konstantinos; Darwiche, Kaid; Tsakiridis, Kosmas; Machairiotis, Nikolaos; Kougioumtzi, Ioanna; Courcoutsakis, Nikolaos; Terzi, Eirini; Zaric, Bojan; Huang, Haidong; Freitag, Lutz; Spyratos, Dionysios

    2013-01-01

    Involvement of the pleura in lung cancer is a common manifestation accompanying with reduced life expectancy. Symptoms relief and improvement of the quality of life are the primary goals of the management of malignant pleural effusion (MPE). Histological confirmation is essential for optimal patient management. Lung cancer patients, with life expectancy more than 3 months, resistant to chemotherapy should be treated with thoracentesis, intercoastal tube drainage and installation of a sclerosant agent or pleurodesis through thoracospopic procedures or placement of an indwelling pleura catheter. Talc pleurodesis (sterile asbestos-free graded, particle size >15 ?m), as poudrage or slurry still remains the treatment of choice in patients with MPE resistant to chemotherapy. PMID:24102015

  6. Systemic treatment of malignant pleural mesothelioma.

    PubMed

    Grosso, Federica; Scagliotti, Giorgio Vittorio

    2012-03-01

    Malignant pleural mesothelioma is a rare malignancy with a dismal prognosis. The clinical management of most of the patients with this disease is quite challenging, and, overall, the therapeutic strategy has not yet benefited from the recent advances in molecular biology. Randomized evidence supports the use of cisplatin in combination with pemetrexed or raltitrexed as first-line treatments. In elderly patients with comorbidities cisplatin may be replaced by carboplatin because of a lesser burden of toxicities. The role of second-line chemotherapy is unproven, although pemetrexed can be regarded as the standard option in pemetrexed-naive patients and therapeutic rechallenge with pemetrexed may be considered in selected patients with prolonged disease control after first-line therapy. Targeted therapies failed to demonstrate any substantial activity; however, immunotherapies may complement other treatment strategies. In summary, there is an unmet clinical need and innovative approaches to select new potentially active drugs are highly warranted. PMID:22409465

  7. Plaque and arterial vulnerability investigation in a three-layer atherosclerotic human coronary artery using computational fluid-structure interaction method

    NASA Astrophysics Data System (ADS)

    Karimi, Alireza; Navidbakhsh, Mahdi; Razaghi, Reza

    2014-08-01

    Coronary artery disease is the common form of cardiovascular diseases and known to be the main reason of deaths in the world. Fluid-Structure Interaction (FSI) simulations can be employed to assess the interactions of artery/plaque and blood to provide a more precise anticipation for rupture of arterial tissue layers and plaque tissues inside an atherosclerotic artery. To date, the arterial tissue in computational FSI simulations has been considered as a one-layer structure. However, a single layer assumption might have deeply bounded the results and, consequently, more computational simulation is needed by considering the arterial tissue as a three-layer structure. In this study, a three-dimensional computational FSI model of an atherosclerotic artery with a three-layer structure and different plaque types was established to perform a more accurate arterial wall/plaque tissue vulnerability assessment. The hyperelastic material coefficients of arterial layers were calculated and implemented in the computational model. The fully coupled fluid and structure models were solved using the explicit dynamics finite element code LS-DYNA. The results revealed the significant role of plaque types in the normal and shear stresses induced within the arterial tissue layers. The highest von Mises and shear stresses were observed on the stiffest calcified plaque with 3.59 and 3.27 MPa, while the lowest von Mises and shear stresses were seen on the hypocellular plaque with 1.15 and 0.63 MPa, respectively. Regardless of plaque types, the media and adventitia layers were played protective roles by displaying less stress on their wall, whilst the intima layer was at a high risk of rupture. The findings of this study have implications not only for determining the most vulnerable arterial layer/plaque tissue inside an atherosclerotic coronary artery but also for balloon-angioplasty, stenting, and bypass surgeries.

  8. A peripheral blood gene expression score is associated with plaque volume and phenotype by intravascular ultrasound with radiofrequency backscatter analysis: results from the ATLANTA study

    PubMed Central

    Joshi, Parag H.; Vazquez, Gustavo; Qian, Zhen; Sharma, Abhinav; Anderson, Hunt; Murrieta, Laura; Flockhart, Nancy; Karmpaliotis, Dimitri; Kalynych, Anna; Asztalos, Bela; Elashoff, Michael R.; Blanchard, John; Rosenberg, Steven; Brown, Charles; Voros, Szilard

    2013-01-01

    Background A composite, peripheral gene expression score based on quantitative RNA-measurements has been validated for detecting stenosis against invasive coronary X-ray angiography. IVUS/VH has been validated for quantitative measurements of coronary plaque volume and composition and has been shown to be predictive of outcomes and treatment effects. The correlation between peripheral gene expression and coronary plaque composition by intravascular ultrasound with radiofrequency backscatter (IVUS/VH) is unknown. Methods Peripheral blood gene expression score (GES) was prospectively measured in 18 patients undergoing IVUS/VH. Plaque volume and composition [fibrous tissue (FI), fibro-fatty tissue (FF), necrotic core (NC) and dense calcium (DC)] were quantified in 3 dimensions in all plaques within the entire pullback. The relationship to GES was assessed by Spearman rank correlation. Results Mean age was 61.18.6 years; 67% were male. 1,158 mm of coronary anatomy was imaged by IVUS/VH. Using a validated scale of 1-40, mean GES was 21.69.4. GES was associated with plaque volume (R2=0.55; P=0.018), NC volume (R2=0.56; P=0.015), DC volume (R2=0.60; P=0.007), and non-calcified plaque volume (R2=0.50; P=0.036) by Spearman rank correlation. Conclusions In this preliminary report, increased GES was associated with higher plaque volume and a more vulnerable plaque phenotype as evidenced by NC and DC. This composite GES is not only associated with obstructive coronary disease, but also with higher plaque volume and vulnerable phenotype. PMID:24282740

  9. Broncho-Pleural Fistula with Hydropneumothorax at CT: Diagnostic Implications in Mycobacterium avium Complex Lung Disease with Pleural Involvement

    PubMed Central

    Yoon, Hyun Jung; Chung, Myung Jin; Lee, Kyung Soo; Kim, Jung Soo; Park, Hye Yun

    2016-01-01

    Objective To determine the patho-mechanism of pleural effusion or hydropneumothorax in Mycobacterium avium complex (MAC) lung disease through the computed tomographic (CT) findings. Materials and Methods We retrospectively collected data from 5 patients who had pleural fluid samples that were culture-positive for MAC between January 2001 and December 2013. The clinical findings were investigated and the radiological findings on chest CT were reviewed by 2 radiologists. Results The 5 patients were all male with a median age of 77 and all had underlying comorbid conditions. Pleural fluid analysis revealed a wide range of white blood cell counts (410–100690/µL). The causative microorganisms were determined as Mycobacterium avium and Mycobacterium intracellulare in 1 and 4 patients, respectively. Radiologically, the peripheral portion of the involved lung demonstrated fibro-bullous changes or cavitary lesions causing lung destruction, reflecting the chronic, insidious nature of MAC lung disease. All patients had broncho-pleural fistulas (BPFs) and pneumothorax was accompanied with pleural effusion. Conclusion In patients with underlying MAC lung disease who present with pleural effusion, the presence of BPFs and pleural air on CT imaging are indicative that spread of MAC infection is the cause of the effusion. PMID:26957917

  10. The relevance of Randall's plaques

    PubMed Central

    Strakosha, Ruth; Monga, Manoj; Wong, Michael Y. C.

    2014-01-01

    The pathophysiology of nephrolithiasis is not fully understood. The pioneering work of Alexander Randall in the 1940s sought to clarify our understanding of stone formation. This review traces the inception of the theory of Randall's plaques and the refinement of the hypothesis in the early days of kidney stone research. It then reviews the contemporary findings utilizing sophisticated investigative techniques that shed additional light on the pathophysiology and redefine the seminal findings of Dr. Randall that were made 70 years ago. PMID:24497683

  11. Three-Dimensional Carotid Plaque MR Imaging.

    PubMed

    Yuan, Chun; Parker, Dennis L

    2016-02-01

    There has been significant progress made in 3-dimensional (3D) carotid plaque MR imaging techniques in recent years. Three-dimensional plaque imaging clearly represents the future in clinical use. With effective flow-suppression techniques, choices of different contrast weighting acquisitions, and time-efficient imaging approaches, 3D plaque imaging offers flexible imaging plane and view angle analysis, large coverage, multivascular beds capability, and even can be used in fast screening. PMID:26610656

  12. Analysis of Multicontrast Carotid Plaque MR Imaging.

    PubMed

    Chen, Huijun; Zhang, Qiang; Kerwin, William

    2016-02-01

    Plaque imaging by MR imaging provides a wealth of information on the characteristics of individual plaque that may reveal vulnerability to rupture, likelihood of progression, or optimal treatment strategy. T1-weighted and T2-weighted images among other options reveal plaque morphology and composition. Dynamic contrast-enhanced-MR imaging reveals plaque activity. To extract this information, image processing tools are needed. Numerous approaches for analyzing such images have been developed, validated against histologic gold standards, and used in clinical studies. These efforts are summarized in this article. PMID:26610657

  13. Right Atrial Calcified Ball Thrombus Mimicking a Myxoma.

    PubMed

    Yamane, Yoshitaka; Morimoto, Hironobu; Okubo, Shuhei; Koshiyama, Hiroshi; Mukai, Shogo

    2016-02-01

    An 80-year-old woman was admitted to our hospital because of congestive heart failure. Transthoracic echocardiography revealed severe aortic valve stenosis, and a mobile calcified mass was attached to the interatrial septum in the right atrium. We suspected that the mass was cardiac myxoma. We urgently performed aortic valve replacement and resection of the mass. The histological diagnosis of the mass was thrombus, and her post-operative course was uneventful. Although the mechanism of right atrial thrombus formation in our case was unclear, it is important to continue anticoagulation therapy after surgery to avoid recurrence. Furthermore, strict follow-up in this patient is needed. PMID:26602227

  14. Targeting Angiogenesis-Dependent Calcified Neoplasms Using Combined Polymer Therapeutics

    PubMed Central

    Segal, Ehud; Pan, Huaizhong; Ofek, Paula; Udagawa, Taturo; Kope?kov, Pavla; Kope?ek, Jind?ich; Satchi-Fainaro, Ronit

    2009-01-01

    Background There is an immense clinical need for novel therapeutics for the treatment of angiogenesis-dependent calcified neoplasms such as osteosarcomas and bone metastases. We developed a new therapeutic strategy to target bone metastases and calcified neoplasms using combined polymer-bound angiogenesis inhibitors. Using an advanced living polymerization technique, the reversible addition-fragmentation chain transfer (RAFT), we conjugated the aminobisphosphonate alendronate (ALN), and the potent anti-angiogenic agent TNP-470 with N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer through a Glycine-Glycine-Proline-Norleucine linker, cleaved by cathepsin K, a cysteine protease overexpressed at resorption sites in bone tissues. In this approach, dual targeting is achieved. Passive accumulation is possible due to the increase in molecular weight following polymer conjugation of the drugs, thus extravasating from the tumor leaky vessels and not from normal healthy vessels. Active targeting to the calcified tissues is achieved by ALN's affinity to bone mineral. Methods and Finding The anti-angiogenic and antitumor potency of HPMA copolymer-ALN-TNP-470 conjugate was evaluated both in vitro and in vivo. We show that free and conjugated ALN-TNP-470 have synergistic anti-angiogenic and antitumor activity by inhibiting proliferation, migration and capillary-like tube formation of endothelial and human osteosarcoma cells in vitro. Evaluation of anti-angiogenic, antitumor activity and body distribution of HPMA copolymer-ALN-TNP-470 conjugate was performed on severe combined immunodeficiency (SCID) male mice inoculated with mCherry-labeled MG-63-Ras human osteosarcoma and by modified Miles permeability assay. Our targeted bi-specific conjugate reduced VEGF-induced vascular hyperpermeability by 92% and remarkably inhibited osteosarcoma growth in mice by 96%. Conclusions This is the first report to describe a new concept of a narrowly-dispersed combined polymer therapeutic designed to target both tumor and endothelial compartments of bone metastases and calcified neoplasms at a single administration. This new approach of co-delivery of two synergistic drugs may have clinical utility as a potential therapy for angiogenesis-dependent cancers such as osteosarcoma and bone metastases. PMID:19381291

  15. Calcified myocardial necrosis in pediatric patients after cardiopulmonary resuscitation.

    PubMed

    Buschmann, Claas T; Stenzel, Werner; Martin, Hubert; Heppner, Frank L; Guddat, Saskia S; Tsokos, Michael

    2013-12-01

    We report three autopsy cases of wide-spread myocardial necrosis with calcification in pediatric patients after temporary generalized hypoxia and initially successful cardiopulmonary resuscitation, but subsequent in-hospital death. Autopsy and histological workup in all three cases showed multiple circumscribed calcified and necrotic areas in progressive stages of organization within the myocardium. We conclude that these macro- and microscopic autopsy features appear to be related to reperfusion injuries in children as a consequence of hypoxic-ischemic changes occurring in the peri- and postresuscitation period. PMID:23264200

  16. Ameloblastomatous calcifying odontogenic cyst: a rare histological variant.

    PubMed

    Samuel, Soumi; Sreelatha, S V; Venkatesh, S; Nair, Preeti P

    2013-01-01

    The calcifying odontogenic cyst (COC) occurs mainly as an intraosseous lesion in mandible or maxilla, but the peripheral variation of COC has also been reported. The confusion regarding its nature as cyst or tumour has not been resolved and a vast diversity has been noted in clinicopathological aspects of COC. We report a case of COCs with minimal mural ameloblastomatous proliferation in a 13-year-old girl, who presented with a painless swelling in the left jaw causing mild facial asymmetry. PMID:23696143

  17. Multifocal peritoneal calcifying fibrous tumour: incidental finding at cholecystectomy

    PubMed Central

    Gatt, Noel; Falzon, Sharon; Ratynska, Marzena

    2011-01-01

    Calcifying fibrous tumour (CFT) is a benign tumour of elusive aetiology and a potential for local recurrence. Despite its peculiar histological characteristics it can still be confused with interrelated differential diagnosis like inflammatory myofibroblastic tumour (IMT) or solitary fibrous tumours. The clinical differential diagnosis is however much wider. To date seven cases of multiple peritoneal CFTs are on record. The authors present a case discovered incidentally during laparoscopic cholecystectomy, with no previous history and no radiological diagnosis achieved despite having undergone magnetic resonance cholangiopancreatography (MRCP) and normal routine perioperative investigation. The patient is disease-free 12 months after diagnosis. The case report is followed by a detailed literature review. PMID:22689663

  18. [CALCIFYING NANOPARTICLES IN PATHOMORPHOGENESIS OF STRUCTURAL LESIONS OF HEART VALVES].

    PubMed

    Gulyaev, N I; Korovin, A E; Kusay, A S; Nevorotin, A I

    2015-01-01

    Over the last 10 years, calcifying nanoparticles (CNP) have attracted attention as structures detected. together with many other nanostructures in biopsies from patients operated for the correction of aortic valve malformations. The results of the present work performed with the use of high-resolution transmission and scanning electron microscopes agree on the whole with the data of other authors. Some new findings include CNP adhesion to collagen fibers and specifically-shaped, shallow invaginations or craters at their surface. The possible pathophysiological mechanisms that promote involvement of CNP in the development of the disease are considered. PMID:26669035

  19. Peripheral Calcifying Cystic Odontogenic Tumour - A Rare Case Report

    PubMed Central

    Shenoi, Ramakrishna; Gadve, Vandana; Rajderkar, Anand; Dive, Alka

    2015-01-01

    Odontogenic lesions are derived from remnants of the components of the developing tooth germ. The calcifying cystic odontogenic tumour (CCOT) is a benign cystic neoplasm of odontogenic origin that is characterized by ameloblastoma-like epithelial cells and ghost cells. Most peripheral CCOTs are located in the anterior gingiva of the mandible or maxilla. This is a rare case report of CCOT. The rare feature in our case was its peripheral nature of existence and its location in the left buccal vestibule and retromolar region. Based on the radiological, cytological and histopathological findings the lesion was surgically excised. PMID:26393218

  20. Peripheral Calcifying Cystic Odontogenic Tumour - A Rare Case Report.

    PubMed

    Kolte, Vrinda Sunil; Shenoi, Ramakrishna; Gadve, Vandana; Rajderkar, Anand; Dive, Alka

    2015-07-01

    Odontogenic lesions are derived from remnants of the components of the developing tooth germ. The calcifying cystic odontogenic tumour (CCOT) is a benign cystic neoplasm of odontogenic origin that is characterized by ameloblastoma-like epithelial cells and ghost cells. Most peripheral CCOTs are located in the anterior gingiva of the mandible or maxilla. This is a rare case report of CCOT. The rare feature in our case was its peripheral nature of existence and its location in the left buccal vestibule and retromolar region. Based on the radiological, cytological and histopathological findings the lesion was surgically excised. PMID:26393218

  1. How Are Pleurisy and Other Pleural Disorders Treated?

    MedlinePLUS

    ... Entire Site Health Topics News & Resources Intramural Research Public Health Topics Education & Awareness Resources Contact The Health Information ... Contact Us FAQs Home Health Information for the Public Health Topics Pleurisy and Other Pleural Disorders How Are ...

  2. Impact of HIV infection on tuberculous pleural effusion.

    PubMed

    Marjani, Majid; Yousefzadeh, Amir; Baghaei, Parvaneh; Tabarsi, Payam; Moniri, Afshin; Masjedi, Mohammad Reza; Velayati, Ali Akbar

    2016-04-01

    The nature of tuberculosis (TB), being one of the most common opportunistic infections, is different among HIV-infected patients than HIV-negative patients. A retrospective study was conducted on HIV-positive and HIV-negative patients with new TB pleural effusion who were admitted to the National Research Institute of Tuberculosis and Lung Diseases in Tehran, Iran from 2005 to 2012. The two groups were compared with respect to clinical, imaging, mycobacteriologic and histopathologic characteristics of TB pleural effusion. In all, 42 HIV-positive and 132 HIV-negative cases of TB pleural effusion were included. Bilateral pleural effusion was statistically more common in the HIV-positive group (p = 0.004, OR = 3.81, 95% CI: 1.46-9.94) without any correlation with CD4 cell count. Pulmonary infiltration was found in 81% of HIV-positive and 49.2% of HIV-negative patients (p = 0.001, OR = 4.38, 95% CI: 1.88-10.1). Mycobacteriologic studies led to the diagnosis of TB in 66.6% of HIV-infected and 49.2% of HIV-negative patients. In 23.8% of HIV-positive and 50.7% of HIV-negative patients TB was ultimately diagnosed by pleural biopsy. HIV remained significantly associated with positive culture of pleural fluid in multivariate analysis. The diagnostic approach to TB pleural effusion in HIV-infected patients may be different. The diagnostic yield of mycobacteriologic studies was higher among HIV-positive patients, which may help in reducing the need for invasive procedures like pleural biopsy. PMID:25957323

  3. A catalogue of treatment and technologies for malignant pleural mesothelioma.

    PubMed

    Schunselaar, Laurel M; Quispel-Janssen, Josine M M F; Neefjes, Jacques J C; Baas, Paul

    2016-04-01

    Malignant pleural mesothelioma is an aggressive fatal malignancy with a prognosis that has not significantly improved in the last decades. This review summarizes the current state of treatment and the various attempts that are made to improve overall survival for patients with malignant pleural mesothelioma. It also discusses technologies and protocols to test new and hopefully more effective compounds in a more individualized manner. These developments are expected to improve the prognosis for this group of patients. PMID:26943000

  4. Peritoneal-Pleural Leaks Demonstrated by CT Peritoneography

    PubMed Central

    Xu, Tian; Xie, Jingyuan; Wang, Weiming; Ren, Hong; Chen, Nan

    2015-01-01

    Introduction Acute hydrothorax is an uncommon complication of peritoneal dialysis (PD). Currently, there is no specific diagnostic method. Although it is not a life-threatening complication, hydrothorax often requires interrupting or quitting PD. Misdiagnosis often leads to more serious consequences. Case Presentation A 49-year-old woman (height 163 cm, weight 58 kg, BMI 21.82), who started PD 3 months previously, suddenly presented with acute dyspnea and a right pleural effusion. Blood routine examination, serum albumin and a series of laboratory tests were immediately performed. Except for the serum creatinine, all of the other tests were within normal range. Thoracentesis was performed to obtain pleural fluid specimens; there was also no evidence of a tumor or inflammation. Congestive heart failure, infection and hypoalbuminemia were excluded as well. Because PD-associated pleural leakage was suspected, computerized tomography (CT) peritoneography was performed next. The first CT scan showed that the CT value of pleural effusion was 6 Hounsfield units (HU). On the evening of the same day, 100 ml ionic contrast medium was mixed with 2 l dialysate and infused into the peritoneal cavity. The next morning, a CT scan was performed again. The CT value of pleural effusion at the same site increased to 40 HU. At the end, pleural leakage was clearly diagnosed. Subsequently, she received temporary hemodialysis and a small dose of automated PD. After 3 months, she successfully returned to PD without any recurrence of hydrothorax. Conclusion Although similar case reports are not rare, this report provided a simple and effective method for diagnosing pleural leakage. Furthermore, noninvasive treatment of pleural effusion will also get a satisfactory outcome. PMID:26266244

  5. Black Pleural Effusion: A Unique Presentation of Metastatic Melanoma

    PubMed Central

    Chhabra, Akansha; Mukherjee, Vikramjit; Chowdhary, Mudit; Danckers, Mauricio; Fridman, David

    2015-01-01

    Metastatic melanoma is a rare form of skin cancer, but one that comes with a high mortality rate. Pulmonary involvement is frequently seen in metastatic melanoma with only 2% of malignant melanoma patients with thorax metastasis presenting with pleural effusions. Herein, we report an extremely rare case of black pleural effusion from thoracic metastasis of cutaneous malignant melanoma. A 74-year-old man with known metastatic melanoma presented with a 1-month history of worsening lower back and hip pain and was found to have extensive osseous metastatic disease and multiple compression fractures. The patient underwent an uneventful kyphoplasty; however, the following day, he became acutely hypoxic and tachypneic with increased oxygen requirements. Radiographic evaluation revealed new bilateral pleural effusions. Bedside thoracentesis revealed a densely exudative, lymphocyte-predominant black effusion. Cytological examination showed numerous neoplastic cells with melanin deposition. A diagnosis of thoracic metastasis of malignant melanoma was established based on the gross and microscopic appearance of the pleural fluid. To the best of our knowledge, this is the first reported case of black pleural effusions secondary to metastatic melanoma in the United States. Despite the rarity of this presentation, it is important to determine the etiology of the black pleural effusion and to keep metastatic melanoma as a differential diagnosis. PMID:26078741

  6. Disposition of phosphomycin in patients with pleural effusion.

    PubMed Central

    Lastra, C F; Mario, E L; Barrueco, M; Gervs, M S; Gil, A D

    1984-01-01

    The pharmacokinetics of phosphomycin were studied in seven patients with pleural effusion of varied etiologies. All patients received a single intravenous bolus of 30 mg of antibiotic per kg. Phosphomycin levels in plasma and pleural fluid were determined simultaneously. Antibiotic levels in plasma followed a two-compartment open kinetic model. In the pleural fluid, maximum concentrations of phosphomycin, 42.63 +/- 16.03 micrograms/ml (mean +/- standard deviation), were reached at 3.69 +/- 1.08 h after administration of the antibiotic. The disappearance constant of the antibiotic from the pleural fluid was significantly smaller (0.16 +/- 0.06 h-1) than the elimination constant determined from the levels of drug in plasma (0.73 +/- 0.26 h-1). Phosphomycin persisted in antibacterial concentrations in the pleural fluid for a considerable period of time. The low accessibility of phosphomycin observed in one of the patients in the study, with a maximum concentration value of 2.16 micrograms of phosphomycin per ml of pleural fluid, could be due to the existence of pachypleuritis in that patient; this was later confirmed in clinical and histological studies done after the research described here. PMID:6732214

  7. Reabsorption kinetics of albumin from pleural space of dogs

    SciTech Connect

    Miniati, M.; Parker, J.C.; Pistolesi, M.; Cartledge, J.T.; Martin, D.J.; Giuntini, C.; Taylor, A.E.

    1988-08-01

    The reabsorption of albumin from the pleural space was measured in eight dogs receiving 0.5 ml intrapleural injection of /sup 131/I-labeled albumin and a simultaneous intravenous injection of /sup 125/I-labeled albumin. Plasma curves for both tracers were obtained over 24 h. The /sup 125/I-albumin curve served as input function of albumin for interstitial spaces, including pleura, whereas the /sup 131/I-albumin curve represented the output function from pleural space. The frequency function of albumin transit times from pleural space to plasma was obtained by deconvolution of input-output plasma curves. Plasma recovery of /sup 131/I-albumin was complete by 24 h, and the mean transit time from pleura to plasma averaged 7.95 +/- 1.57 (SD) h. Albumin reabsorption occurred mainly via lymphatics as indicated by experiments in 16 additional dogs in which their right lymph ducts or thoracic ducts were ligated before intrapleural injection. A pleural lymph flow of 0.020 +/- 0.003 (SD) ml.kg-1.h-1 was estimated, which is balanced by a comparable filtration of fluid into the pleural space. This suggests that, under physiological conditions, the subpleural lymphatics represent an important control mechanism of pleural liquid pressure.

  8. Switching off malignant pleural effusion formationfantasy or future?

    PubMed Central

    Giannou, Anastasios D.; Stathopoulos, Georgios T.

    2015-01-01

    Malignant pleural effusion (MPE) is common and difficult to treat. In the vast majority of patients the presence of MPE heralds incurable disease, associated with poor quality of life, morbidity and mortality. Current therapeutic approaches are inefficient and merely offer palliation of associated symptoms. Recent scientific progress has shed light in the biologic processes governing the mechanisms behind the pathobiology of MPE. Pleural based tumors interfere with pleural fluid drainage, as well as the host vasculature and immune system, resulting in decreased fluid absorption and increased pleural fluid production via enhanced plasma extravasation into the pleural space. In order to achieve this feat, pleural based tumors must elicit critical vasoactive events in the pleura, thus forming a favorable microenvironment for tumor dissemination and MPE development. Such properties involve specific transcriptional signaling cascades in addition to secretion of important mediators which attract and activate host cell populations which, in turn, impact tumor cell functions. The dissection of the biologic steps leading to MPE formation provides novel therapeutic targets and recent research findings provide encouraging results towards future therapeutic innovations in MPE management. PMID:26150914

  9. Pleural Fluid Analysis in Chronic Hemothorax: A Mimicker of Infection

    PubMed Central

    DiVietro, Matthew L; Huggins, John Terrill; Angotti, Lauren Brown; Kummerfeldt, Carlos E; Nestor, Jennings E; Doelken, Peter; Sahn, Steven A

    2015-01-01

    OBJECTIVES Timing to video-assisted thoracoscopic surgery (VATS) in hemothorax is based on preventing acute and long-term complications of retained blood products in the pleural space, including pleural space infection. We propose that the persistence of blood in the pleural space induces a proinflammatory state, independent of active infection. METHODS We identified six patients with a hemothorax by clinical history, radiographic imaging, and pleural fluid analysis from a database of 1133 patients undergoing thoracentesis from 2002 to 2010 at the Medical University of South Carolina. RESULTS In four of the six patients identified, the time from injury to thoracentesis was one, four, four, and five days, respectively. The fluid pH range was 7.327.41. The lactate dehydrogenase (LDH) range was 210884 IU/L (mean 547 IU/L), and the absolute neutrophil count (ANC) range was 11963631 cells/L. In two patients, the time from injury to thoracentesis was 7 and 60 days. In these two patients, the pH was 7.18 and 6.91, LDH was 1679 and 961 IU/L, and the ANC was 8134 and 5943 cells/L. Microbiology and pathology were negative in all patients. CONCLUSIONS The persistence of blood outside the vascular compartment, and within the pleural space, biochemically mirrors infection. We will explore the multiple mechanisms that account for development of pleural fluid acidosis, inflammation, and neutrophil recruitment. PMID:26309422

  10. Plaquing procedure for infectious hematopoietic necrosis virus

    USGS Publications Warehouse

    Burke, J.A.; Mulcahy, D.

    1980-01-01

    A single overlay plaque assay was designed and evaluated for infectious hematopoietic necrosis virus. Epithelioma papillosum carpio cells were grown in normal atmosphere with tris(hydroxymethyl)aminomethane- or HEPES (N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid)-buffered media. Plaques were larger and formed more quickly on 1- to 3-day-old cell monolayers than on older monolayers. Cell culture medium with a 10% addition of fetal calf serum (MEM 10) or without serum (MEM 0) were the most efficient virus diluents. Dilution with phosphate-buffered saline, saline, normal broth, or deionized water reduced plaque numbers. Variations in the pH (7.0 to 8.0) of a MEM 0 diluent did not affect plaque numbers. Increasing the volume of viral inoculum above 0.15 ml (15- by 60-mm plate) decreased plaquing efficiency. Significantly more plaques occurred under gum tragacanth and methylcellulose than under agar or agarose overlays. Varying the pH (6.8 to 7.4) of methylcellulose overlays did not significantly change plaque numbers. More plaques formed under the thicker overlays of both methylcellulose and gum tragacanth. Tris(hydroxymethyl)aminomethane and HEPES performed equally well, buffering either medium or overlay. Plaque numbers were reduced when cells were rinsed after virus adsorption or less than 1 h was allowed for adsorption. Variation in adsorption time between 60 and 180 min did not change plaque numbers. The mean plaque formation time was 7 days at 16 degrees C. The viral dose response was linear when the standardized assay was used.

  11. Effect of Ocean acidification on growth, calcification and recruitment of calcifying and non-calcifying epibionts of brown algae

    NASA Astrophysics Data System (ADS)

    Saderne, V.; Wahl, M.

    2012-03-01

    Anthropogenic emissions of CO2 are leading to an acidification of the oceans by 0.4 pH units in the course of this century according to the more severe model scenarios. The excess of CO2 could notably affect the benthic communities of calcifiers and macrophytes in different aspects (photosynthesis, respiration and calcification). Seaweeds are key species of nearshore benthic ecosystems of the Baltic Sea. They frequently are the substratum of fouling epibionts like bryozoans and tubeworms. Most of those species secrete calcified structures and could therefore be impacted by the seawater pCO2. On the other hand, the biological activity of the host may substantially modulate the pH and pCO2 conditions in the thallus boundary layer where the epibionts live. The aim of the present study was to test the sensitivity of seaweed macrofouling communities to higher pCO2 concentrations. Fragments of the macroalga Fucus serratus bearing the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium gelatinosum (Bryozoa) were maintained for 30 days under three pCO2 conditions: natural 460 ± 59 μatm and enriched 1193 ± 166 μatm and 3150 ± 446 μatm. Our study showed a significant reduction of growth rates and recruitment of Spirorbis individuals only at the highest pCO2. At a finer temporal resolution, the tubeworm recruits exhibited enhanced calcification of 40% during irradiation hours compared to dark hours, presumably due to the effect of photosynthetic and respiratory activities of the host alga on the carbonate system. Electra colonies showed significantly increased growth rates at 1193 μatm. No effect on Alcyonidium colonies growth rates was observed. Those results suggest a remarkable resistance of the algal macro-epibiontic communities to the most elevated pCO2 foreseen in year 2100 for open ocean (~1000 μatm) conditions possibly due to the modulation of environmental conditions by the biological activities of the host alga.

  12. Do blood-borne calcifying nanoparticles self-propagate?

    PubMed

    Mathew, Grace; Mckay, David S; Ciftioglu, Neva

    2008-01-01

    The nanotechnology industry is currently in the process of producing new nanoparticles. The biological activity of nanoparticles including adverse as well as beneficial effects tends to increase as their size decreases. The smaller the particles are, the greater their bioactivity and toxicity. Thus, one can easily conjecture the impact ofa nanoparticle if it could also self-replicate. This in vitro study reveals the self-propagating ability of unique calcifying nanoparticles (CNP) that can be as small as 50 nm in size and found in blood, blood products, and calcified soft tissues. Although specific detection techniques, morphological characteristics and biomineralizing properties of CNP are well established, their genomic information and self-propagating capability have always been challenged. The objective of this study is to document the propagation of CNP under physiological conditions, using inverted light microscopy (LM) and the Biostation IM time-lapse imaging system. Their detailed morphological structure was examined using scanning (SEM) and transmission (TEM) electron microscopy. This present study, in conjunction with previous findings of metabolic activity, antibiotic sensitivity, antibody specificity, morphological aspects and infectivity, validates CNP as self-replicators. Therefore these sterile-filterable, blood-borne nanoparticles should be of concern to the nanomedicine industry. PMID:18686786

  13. Occurrence, extent, and implications of pressure waves during excimer laser ablation of normal arterial wall and atherosclerotic plaque.

    PubMed

    Haase, K K; Hanke, H; Baumbach, A; Hassenstein, S; Wehrmann, M; Duda, S; Rose, C; von Münch, W; Karsch, K R

    1993-01-01

    Ablation of atherosclerotic plaque and normal arterial wall was performed using a Xenon-Chloride Excimer laser with a wave-length of 308 nm and a pulse duration of 115 ns. The light was transmitted via a 600 microns bare fibre and adjusted to an energy density of 3.5J/cm2. The acoustic signals generated by the laser pulse were measured with two types of hydrophones consisting of polyvinylidenefluoride with active diameters of 0.3 mm and 0.5 mm and recorded on a dual channel digital storage oscilloscope using either a 0.5 m coaxial cable or a broadband fibre-optic transmission system. Tissue was retrieved from nine cadaver human aortas and macroscopically classified as either normal or calcified atherosclerotic plaque. Histological analysis (Haematoxylin eosin, elastica van Gieson, and immunohistochemical staining) was carried out after the experiments to verify the macroscopic diagnosis and to correlate the acoustic responses with the tissue characteristics. For normal arterial wall, maximum peak pressure was 1.28 MPa +/- 0.85 MPa, rise time 163 ns +/- 43 ns, and pressure increase 8.2k Pa +/- 5.4k Pa/ns. For calcified, atheromatous segments, a maximum peak pressure of 2.02 MPa +/- 1.16 MPa, a rise time of 69.9 ns +/- 25.8 ns, and a pressure increase of 32.3 kPa +/- 21.3 kPa/ns was found. Statistical analysis showed a significant shorter rise time (P < 0.0001) and a higher pressure increase (P < 0.0001) for calcified tissue in comparison to normal arterial wall, whereas maximum pressures alone did not allow a differentiation of tissue characteristics. Several hundred kPa are generated during Excimer laser ablation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8515665

  14. Biomechanics and Inflammation in Atherosclerotic Plaque Erosion and Plaque Rupture: Implications for Cardiovascular Events in Women

    PubMed Central

    Campbell, Ian C.; Suever, Jonathan D.; Timmins, Lucas H.; Veneziani, Alessandro; Vito, Raymond P.; Virmani, Renu; Oshinski, John N.; Taylor, W. Robert

    2014-01-01

    Objective Although plaque erosion causes approximately 40% of all coronary thrombi and disproportionally affects women more than men, its mechanism is not well understood. The role of tissue mechanics in plaque rupture and regulation of mechanosensitive inflammatory proteins is well established, but their role in plaque erosion is unknown. Given obvious differences in morphology between plaque erosion and rupture, we hypothesized that inflammation in general as well as the association between local mechanical strain and inflammation known to exist in plaque rupture may not occur in plaque erosion. Therefore, our objective was to determine if similar mechanisms underlie plaque rupture and plaque erosion. Methods and Results We studied a total of 74 human coronary plaque specimens obtained at autopsy. Using lesion-specific computer modeling of solid mechanics, we calculated the stress and strain distribution for each plaque and determined if there were any relationships with markers of inflammation. Consistent with previous studies, inflammatory markers were positively associated with increasing strain in specimens with rupture and thin-cap fibroatheromas. Conversely, overall staining for inflammatory markers and apoptosis were significantly lower in erosion, and there was no relationship with mechanical strain. Samples with plaque erosion most closely resembled those with the stable phenotype of thick-cap fibroatheromas. Conclusions In contrast to classic plaque rupture, plaque erosion was not associated with markers of inflammation and mechanical strain. These data suggest that plaque erosion is a distinct pathophysiological process with a different etiology and therefore raises the possibility that a different therapeutic approach may be required to prevent plaque erosion. PMID:25365517

  15. Effects of Coexisting Pneumonia and End-stage Renal Disease on Pleural Fluid Analysis in Patients With Hydrostatic Pleural Effusion

    PubMed Central

    Huggins, John T.; Goldblatt, Mark; Nietert, Paul; Sahn, Steven A.

    2013-01-01

    Background: In individual patients, especially those who are hospitalized, several conditions often coexist that may be responsible for the development of a pleural effusion and may affect the pleural fluid analysis (PFA). The objective of this study was to investigate the effects of end-stage renal disease and pneumonia on PFA in patients with hydrostatic pleural effusion. Methods: In a retrospective analysis of 1,064 consecutive patients who underwent thoracentesis at a university hospital, cell counts and pleural fluid protein, lactate dehydrogenase, pH, and glucose levels were examined in those (n = 300) with clinical evidence of hydrostatic pleural effusion. Results: The 300 patients (28.1%) with pleural effusions had congestive heart failure (CHF), circulatory overload (CO), or both. Expert consensus was achieved in 66 (22%) for CHF as the sole diagnosis (SCHF), 30 (10%) for CHF and coexisting pneumonia (PCHF), and 26 (8.7%) for end-stage renal disease (ESRD) with coexisting CO or CHF. The remaining 178 patients were excluded because of complicating conditions. There were minor, but statistically significant differences in pleural fluid/serum protein ratios in patients with ESRD with coexisting CO or CHF compared with SCHF. Compared with SCHF, there were statistically significant tendencies for higher protein and lactate dehydrogenase concentrations and lower pH levels in those with PCHF. The total nucleated cell count and the absolute neutrophil count were significantly higher in PCHF. Conclusions: ESRD in patients with hydrostatic pleural effusions has a minimal effect on the PFA. Coexisting pneumonia most often results in an exudative effusion in patients with CHF. PMID:23288037

  16. Vandetanib and indwelling pleural catheter for non-small cell lung cancer with recurrent malignant pleural effusion

    PubMed Central

    Massarelli, Erminia; Onn, Amir; Marom, Edith M.; Alden, Christine M.; Liu, Diane D.; Tran, Hai T.; Mino, Barbara; Wistuba, Ignacio I.; Faiz, Saadia A.; Bashoura, Lara; Eapen, George A.; Morice, Rodolfo C.; Jack Lee, J.; Hong, Waun K.; Herbst, Roy S.; Jimenez, Carlos A.

    2014-01-01

    Background Non-small-cell lung cancer patients with malignant pleural effusion have a poor overall median survival (4.3 months). Vascular endothelial growth factor (VEGF) is a key regulator of pleural effusion production. It is unknown if pharmacological inhibition of VEGF signaling modifies the disease course of non-small-cell lung cancer patients with recurrent malignant pleural effusion. We report the final results of a single-arm phase II clinical trial of the VEGF receptor inhibitor vandetanib combined with intrapleural catheter placement in patients with non-small-cell lung cancer and recurrent malignant pleural effusion, to determine whether vandetanib reduces time to pleurodesis. Material and Methods Non-small-cell lung cancer patients with proven metastatic disease to the pleural space by pleural fluid cytology or pleural biopsy who required intrapleural catheter placement were eligible for enrollment. On the same day of the intrapleural catheter insertion, the patients were started on a daily oral dose of 300 mg vandetanib, for a maximum of 10 weeks. The primary endpoint was time to pleurodesis, with response rate as the secondary endpoint. Exploratory analyses included measurement of pleural fluid cytokines and angiogenic factors before and during therapy. Results Twenty eligible patients were included in the trial. Eleven patients completed 10 weeks of treatment. Median time to pleurodesis was 35 days (95% confidence interval 15, NA). Median time to pleurodesis in the historical cohort was 63 days (95% confidence interval 45, 86) when adjusted for ECOG performance status ? 2. Conclusions Vandetanib therapy was well tolerated; however it did not significantly reduce time to pleurodesis. PMID:24913066

  17. Advanced MRI for carotid plaque imaging.

    PubMed

    Singh, Navneet; Moody, Alan R; Roifman, Idan; Bluemke, David A; Zavodni, Anna E H

    2016-01-01

    Atherosclerosis is the ubiquitous underling pathological process that manifests in heart attack and stroke, cumulating in the death of one in three North American adults. High-resolution magnetic resonance imaging (MRI) is able to delineate atherosclerotic plaque components and total plaque burden within the carotid arteries. Using dedicated hardware, high resolution images can be obtained. Combining pre- and post-contrast T1, T2, proton-density, and magnetization-prepared rapid acquisition gradient echo weighted fat-saturation imaging, plaque components can be defined. Post-processing software allows for semi- and fully automated quantitative analysis. Imaging correlation with surgical specimens suggests that this technique accurately differentiates plaque features. Total plaque burden and specific plaque components such as a thin fibrous cap, large fatty or necrotic core and intraplaque hemorrhage are accepted markers of neuroischemic events. Given the systemic nature of atherosclerosis, emerging science suggests that the presence of carotid plaque is also an indicator of coronary artery plaque burden, although the preliminary data primarily involves patients with stable coronary disease. While the availability and cost-effectiveness of MRI will ultimately be important determinants of whether carotid MRI is adopted clinically in cardiovascular risk assessment, the high accuracy and reliability of this technique suggests that it has potential as an imaging biomarker of future risk. PMID:26293362

  18. Detecting the vulnerable plaque in patients.

    PubMed

    Gonalves, I; den Ruijter, H; Nahrendorf, M; Pasterkamp, G

    2015-11-01

    Atherosclerosis is a systemic condition that eventually evolves into vulnerable plaques and cardiovascular events. Pathology studies reveal that rupture-prone atherosclerotic plaques have a distinct morphology, namely a thin, inflamed fibrous cap covering a large lipidic and necrotic core. With the fast development of imaging techniques in the last decades, detecting vulnerable plaques thereby identifying individuals at high risk for cardiovascular events has become of major interest. Yet, in current clinical practice, there is no routine use of any vascular imaging modality to assess plaque characteristics as each unique technique has its pros and cons. This review describes the techniques that may evolve into screening tool for the detection of the vulnerable plaque. Finally, it seems that plaque morphology has been changing in the last decades leading to a higher prevalence of 'stable' atherosclerotic plaques, possibly due to the implementation of primary prevention strategies or other approaches. Therefore, the nomenclature of vulnerable plaque lesions should be very carefully defined in all studies. PMID:26306911

  19. Haemodynamical stress in mouse aortic arch with atherosclerotic plaques: Preliminary study of plaque progression

    PubMed Central

    Assemat, P.; Siu, K.K.; Armitage, J.A.; Hokke, S.N.; Dart, A.; Chin-Dusting, J.; Hourigan, K.

    2014-01-01

    Atherosclerotic plaques develop at particular sites in the arterial tree, and this regional localisation depends largely on haemodynamic parameters (such as wall shear stress; WSS) as described in the literature. Plaque rupture can result in heart attack or stroke and hence understanding the development and vulnerability of atherosclerotic plaques is critically important. The purpose of this study is to characterise the haemodynamics of blood flow in the mouse aortic arch using numerical modelling. The geometries are digitalised from synchrotron imaging and realistic pulsatile blood flow is considered under rigid wall assumptions. Two cases are considered; arteries with and without plaque. Mice that are fed under fat diet present plaques in the aortic arch whose size is dependent on the number of weeks under the diet. The plaque distribution in the region is however relatively constant through the different samples. This result underlines the influence of the geometry and consequently of the wall shear stresses for plaque formation with plaques growing in region of relative low shear stresses. A discussion of the flow field in real geometry in the presence and absence of plaques is conducted. The presence of plaques was shown to alter the blood flow and hence WSS distribution, with regions of localised high WSS, mainly on the wall of the brachiocephalic artery where luminal narrowing is most pronounced. In addition, arch plaques are shown to induce recirculation in the blood flow, a phenomenon with potential influence on the progression of the plaques. The oscillatory shear index and the relative residence time have been calculated on the geometry with plaques to show the presence of this recirculation in the arch, an approach that may be useful for future studies on plaque progression. PMID:25349678

  20. Correlation of coronary plaque characteristics and obstructive stenosis with chronic kidney disease by coronary CT angiography

    PubMed Central

    Wang, Chengming; Duanmu, Yibo; Zhu, Yi; Xu, Lu

    2015-01-01

    Background Chronic kidney disease (CKD) is an independent risk factor for cardiovascular events. We evaluated the correlation of coronary plaque characteristics and obstructive stenosis with CKD by coronary computed tomographic angiography (CCTA). Methods We enrolled 491 subjects who were suspected coronary artery disease (CAD) undergoing CCTA. Estimated glomerular filtration rate (eGFR) was calculated by the modification of diet in renal disease (MDRD) equation. Patients were subdivided into four groups based on their eGFR: normal GFR (n=213, eGFR ?90 mL/min/1.73 m2), mild renal insufficiency (n=191, eGFR 60-89 mL/min/1.73 m2), moderate renal insufficiency(n=78, eGFR <60 mL/min/1.73 m2, ?30 mL/min/1.73 m2), and severe renal insufficiency (n=9, eGFR <30 mL/min/1.73 m2, ?15 mL/min/1.73 m2). Results Spearman correlation regression analysis showed that the prevalence of any plaque, calcified plaque (CP), mixed plaque (MP) were positively correlate with CKD (r=0.173, P<0.001; r=0.127, P=0.005; r=0.171, P<0.001), after adjustment for traditional risk factors the prevalence of any plaque and MP were still positively correlate with CKD (r=0.106, P=002; r=0.178, P<0.001). And the prevalence of any stenosis and severe stenosis were positively correlate with CKD (r=0.13, P<0.001; r=0.149, P<0.001), after adjustment for traditional risk factors were still positively correlate with CKD (r=0.134, P=0.003; r=0.174, P<0.001). Conclusions CKD is closely related with occurrence of CAD. CKD patients from mild renal insufficiency to severe renal insufficiency are the risk factors for CAD. More serious renal function impairment will indicates higher risk of coronary plaque, MP and obstructive stenosis. PMID:26676159

  1. Transnasal endoscopic resection of a calcifying cystic odontogenic tumor.

    PubMed

    Schuster, Daniel; Cure, Joel; Woodworth, Bradford A

    2014-08-01

    Calcifying cystic odontogenic tumor (CCOT) is a rare histologic subtype of odontogenic tumor. Treatment requires complete enucleation. We report what we believe is the first case of CCOT to be removed via a transnasal endoscopic approach. A 16-year-old boy was referred to our department by his dentist for evaluation of an expansile mass of the left maxillary sinus. The dentist had noted an area of hyperlucency of the left palate during a routine examination. Computed tomography confirmed the presence of a large tumor. Complete resection of the tumor was achieved via a transnasal endoscopic surgical approach. Resection of odontogenic tumors is necessary because of their tendency to expand and produce a mass effect on surrounding structures. We believe resection via an entirely transnasal endoscopic approach is a valuable and important technique in the treatment of odontogenic tumors that leaves the patient with a more cosmetically acceptable postoperative appearance. PMID:25181672

  2. Coral symbiotic algae calcify ex hospite in partnership with bacteria

    PubMed Central

    Frommlet, Jörg C.; Sousa, Maria L.; Alves, Artur; Vieira, Sandra I.; Suggett, David J.; Serôdio, João

    2015-01-01

    Dinoflagellates of the genus Symbiodinium are commonly recognized as invertebrate endosymbionts that are of central importance for the functioning of coral reef ecosystems. However, the endosymbiotic phase within Symbiodinium life history is inherently tied to a more cryptic free-living (ex hospite) phase that remains largely unexplored. Here we show that free-living Symbiodinium spp. in culture commonly form calcifying bacterial–algal communities that produce aragonitic spherulites and encase the dinoflagellates as endolithic cells. This process is driven by Symbiodinium photosynthesis but occurs only in partnership with bacteria. Our findings not only place dinoflagellates on the map of microbial–algal organomineralization processes but also point toward an endolithic phase in the Symbiodinium life history, a phenomenon that may provide new perspectives on the biology and ecology of Symbiodinium spp. and the evolutionary history of the coral–dinoflagellate symbiosis. PMID:25918367

  3. Coral symbiotic algae calcify ex hospite in partnership with bacteria.

    PubMed

    Frommlet, Jrg C; Sousa, Maria L; Alves, Artur; Vieira, Sandra I; Suggett, David J; Serdio, Joo

    2015-05-12

    Dinoflagellates of the genus Symbiodinium are commonly recognized as invertebrate endosymbionts that are of central importance for the functioning of coral reef ecosystems. However, the endosymbiotic phase within Symbiodinium life history is inherently tied to a more cryptic free-living (ex hospite) phase that remains largely unexplored. Here we show that free-living Symbiodinium spp. in culture commonly form calcifying bacterial-algal communities that produce aragonitic spherulites and encase the dinoflagellates as endolithic cells. This process is driven by Symbiodinium photosynthesis but occurs only in partnership with bacteria. Our findings not only place dinoflagellates on the map of microbial-algal organomineralization processes but also point toward an endolithic phase in the Symbiodinium life history, a phenomenon that may provide new perspectives on the biology and ecology of Symbiodinium spp. and the evolutionary history of the coral-dinoflagellate symbiosis. PMID:25918367

  4. Effect of calcifying bacteria on permeation properties of concrete structures.

    PubMed

    Achal, V; Mukherjee, A; Reddy, M S

    2011-09-01

    Microbially enhanced calcite precipitation on concrete or mortar has become an important area of research regarding construction materials. This study examined the effect of calcite precipitation induced by Sporosarcina pasteurii (Bp M-3) on parameters affecting the durability of concrete or mortar. An inexpensive industrial waste, corn steep liquor (CSL), from starch industry was used as nutrient source for the growth of bacteria and calcite production, and the results obtained with CSL were compared with those of the standard commercial medium. Bacterial deposition of a layer of calcite on the surface of the specimens resulted in substantial decrease of water uptake, permeability, and chloride penetration compared with control specimens without bacteria. The results obtained with CSL medium were comparable to those obtained with standard medium, indicating the economization of the biocalcification process. The results suggest that calcifying bacteria play an important role in enhancing the durability of concrete structures. PMID:21104104

  5. Comprehensive plaque assessment by coronary CT angiography.

    PubMed

    Maurovich-Horvat, Pl; Ferencik, Maros; Voros, Szilard; Merkely, Bla; Hoffmann, Udo

    2014-07-01

    Most acute coronary syndromes are caused by sudden luminal thrombosis due to atherosclerotic plaque rupture or erosion. Preventing such an event seems to be the only effective strategy to reduce mortality and morbidity of coronary heart disease. Coronary lesions prone to rupture have a distinct morphology compared with stable plaques, and provide a unique opportunity for noninvasive imaging to identify vulnerable plaques before they lead to clinical events. The submillimeter spatial resolution and excellent image quality of modern computed tomography (CT) scanners allow coronary atherosclerotic lesions to be detected, characterized, and quantified. Large plaque volume, low CT attenuation, napkin-ring sign, positive remodelling, and spotty calcification are all associated with a high risk of acute cardiovascular events in patients. Computation fluid dynamics allow the calculation of lesion-specific endothelial shear stress and fractional flow reserve, which add functional information to plaque assessment using CT. The combination of morphologic and functional characteristics of coronary plaques might enable noninvasive detection of vulnerable plaques in the future. PMID:24755916

  6. Protocol of the Australasian Malignant Pleural Effusion (AMPLE) trial: a multicentre randomised study comparing indwelling pleural catheter versus talc pleurodesis

    PubMed Central

    Fysh, Edward T H; Thomas, Rajesh; Read, Catherine A; Lam, Ben C H; Yap, Elaine; Horwood, Fiona C; Lee, Pyng; Piccolo, Francesco; Shrestha, Ranjan; Garske, Luke A; Lam, David C L; Rosenstengel, Andrew; Bint, Michael; Murray, Kevin; Smith, Nicola A; Lee, Y C Gary

    2014-01-01

    Introduction Malignant pleural effusion can complicate most cancers. It causes breathlessness and requires hospitalisation for invasive pleural drainages. Malignant effusions often herald advanced cancers and limited prognosis. Minimising time spent in hospital is of high priority to patients and their families. Various treatment strategies exist for the management of malignant effusions, though there is no consensus governing the best choice. Talc pleurodesis is the conventional management but requires hospitalisation (and substantial healthcare resources), can cause significant side effects, and has a suboptimal success rate. Indwelling pleural catheters (IPCs) allow ambulatory fluid drainage without hospitalisation, and are increasingly employed for management of malignant effusions. Previous studies have only investigated the length of hospital care immediately related to IPC insertion. Whether IPC management reduces time spent in hospital in the patients remaining lifespan is unknown. A strategy of malignant effusion management that reduces hospital admission days will allow patients to spend more time outside hospital, reduce costs and save healthcare resources. Methods and analysis The Australasian Malignant Pleural Effusion (AMPLE) trial is a multicentred, randomised trial designed to compare IPC with talc pleurodesis for the management of malignant pleural effusion. This study will randomise 146 adults with malignant pleural effusions (1:1) to IPC management or talc slurry pleurodesis. The primary end point is the total number of days spent in hospital (for any admissions) from treatment procedure to death or end of study follow-up. Secondary end points include hospital days specific to pleural effusion management, adverse events, self-reported symptom and quality-of-life scores. Ethics and dissemination The Sir Charles Gairdner Group Human Research Ethics Committee has approved the study as have the ethics boards of all the participating hospitals. The trial results will be published in peer-reviewed journals and presented at scientific conferences. Trial registration numbers Australia New Zealand Clinical Trials RegistryACTRN12611000567921; National Institutes of HealthNCT02045121. PMID:25377015

  7. Intrapleural administration of DNase alone for pleural empyema

    PubMed Central

    Bobek, Vladimir; Majewski, Andrzej; Kolostova, Katarina; Rzechonek, Adam; Lischke, Robert; Schutzner, Jan; Kacprzak, Grzegorz

    2015-01-01

    Introduction: Pleural empyema is a severe complication of various diseases. The essential is the inserting a drain into the pleural cavity and evacuation of the pus. Sometimes the pus is very thick and its evacuation and re-expansion of the lung is very difficult. Methods: We report a group of 10 patients with intrapleural administration of Pulmozyme (dornase alpha) in dosages of either 2.5 mg once or on two separate occasions. All of the patients had a chest tube inserted into the pleural cavity. Measurement of viscosity was done before and after the instillation of the dornase alpha. Results: In six patients dornase alfa was introduced into the pleural cavity once. Three of them received this on the 4th whilst the rest were treated with the agent on the 6th day. Four patients received the dornase alpha twice because of the small amount of drainage fluid after the previous instillation. Five patients were discharged from hospital with complete re-expansion of their lungs. Two patients were qualified for a surgical operation since the lung was trapped and did not re-expand. Three patients had to be discharged with a drain as a result of incomplete re-expansion of the lung. In all the patients the density of the pus after administering the dornase alpha decreased and the amount of the pus drainage increased. Conclusions: Dornase alpha may be used in some patients with pleural empyema with good results.

  8. Mechanics of the canine diaphragm in pleural effusion.

    PubMed

    De Troyer, Andr; Leduc, Dimitri; Cappello, Matteo; Gevenois, Pierre Alain

    2012-09-01

    Pleural effusion is a complicating feature of many diseases of the lung and pleura, but its effects on the mechanics of the diaphragm have not been assessed. In the present study, radiopaque markers were attached along muscle bundles in the midcostal region of the diaphragm in anesthetized dogs, and the three-dimensional location of the markers during relaxation before and after the stepwise introduction of liquid into the left or right pleural space and during phrenic nerve stimulation in the same conditions was determined using computed tomography. From these data, accurate measurements of diaphragm muscle length and displacement were obtained, and the changes in pleural and abdominal pressure were analyzed as functions of these parameters. The effect of liquid instillation on the axial position of rib 5 was also measured. The data showed that 1) liquid leaked through the dorsal mediastinal sheet behind the pericardium so that effusion was bilateral; 2) effusion caused a caudal displacement of the relaxed diaphragm; 3) this displacement was, compared with passive lung inflation, much larger than the cranial displacement of the ribs; and 4) the capacity of the diaphragm to generate pressure, in particular pleural pressure, decreased markedly as effusion increased, and this decrease was well explained by the decrease in active muscle length. It is concluded that pleural effusion has a major adverse effect on the pressure-generating capacity of the diaphragm and that this is the result of the action of hydrostatic forces on the muscle. PMID:22797306

  9. Brain metastases in malignant pleural mesothelioma.

    PubMed

    Yamagishi, Tomoko; Fujimoto, Nobukazu; Miyamoto, Yosuke; Asano, Michiko; Fuchimoto, Yasuko; Wada, Sae; Kitamura, Kenichi; Ozaki, Shinji; Nishi, Hideyuki; Kishimoto, Takumi

    2016-03-01

    The brain is a rare site of metastasis in malignant pleural mesothelioma (MPM), and its clinical features and prognosis remain unclear. The aim of this study was to investigate the incidence, prognosis, and risk factors for brain metastases (BM) in MPM patients. Between July 1993 and October 2014, 150 patients with histologically proven MPM were included in this retrospective study. The cumulative incidence of BM was estimated with the Kaplan-Meier method, and differences between groups were analyzed by the log-rank test. Multivariate logistic regression analysis was applied to assess risk factors for BM. The median follow-up time was 11 months (range 0-154.0 months). A total of eight patients (5.3 %) developed BM during the course of their illness. Multivariate analysis identified age <65 years (odds ratio [OR] = 5.83, p = 0.038) and International Mesothelioma Interest Group stage IV (OR = 1.69, p = 0.040) as independent factors related to increased risk of developing BM. The 1-and 2-year cumulative rates of BM were 4.0 % (95 % confidence intervals [CI] 1.4-8.5 %) and 5.3 % (95 % CI 2.3-10.2 %), respectively. Our study showed that the overall survival (OS) of patients with BM was worse than that of patients without BM (median OS 6.5 vs. 11.0 months, p = 0.037). The prognosis for BM in MPM patients is poor. Clinicians should perform careful screening for BM, especially in patients with risk factors. PMID:26620209

  10. Immunologic characterization of normal human pleural macrophages.

    PubMed

    Frankenberger, M; Passlick, B; Hofer, T; Siebeck, M; Maier, K L; Ziegler-Heitbrock, L H

    2000-09-01

    Human pleural macrophages (PLM) have been studied in effusions, but little is known about normal human PLM. We therefore analyzed resting human PLM recovered by lavage before lobe resection from patients with a central bronchial tumor, not involving the pleura, and from patients with pulmonary chondroma, intrapulmonary hemorrhage, and pneumothorax. Analysis of surface antigens, phagocytosis capacity, and cytokine production was done in comparison to the regular CD14(++) blood monocytes and the recently described blood monocyte subset CD14(+)CD16(+) monocytes. When defining fluorescence intensity for the various markers on CD14(++) monocytes as 100%, the PLM gave the following pattern: CD14, 45%; CD32, 200%; CD64, 72%; CD11b, 128%; CD33, 74%; CD54, 299%; and HLA-DR, 1,906%. When CD16 on the CD14(+)CD16(+) monocytes was set as 100%, the level of CD16 expression on PLM was 7.7%. Taken together, when compared to blood monocytes, PLM appear to represent a cell-type intermediate of regular CD14(++) monocytes and the CD14(+)CD16(+) subset. In functional studies, we demonstrate that PLM can perform efficient Fc-receptor-mediated phagocytosis of antibody-coated sheep red blood cells. Compared with blood monocytes, the capacity of PLM to produce tumor necrosis factor is similar, but a striking finding in PLM was the constitutive interleukin-10 messenger RNA expression that could not be substantially increased by lipopolysaccharide stimulation. This first characterization of normal, noneffusion human PLM can form the basis for a better interpretation of findings in malignant and inflammatory exudates. PMID:10970835

  11. Clinical Perspective of Carotid Plaque Imaging.

    PubMed

    Bonati, Leo H; Nederkoorn, Paul J

    2016-02-01

    At present, patients with carotid disease are selected for invasive recanalization therapies mainly based on the degree of luminal narrowing and the presence or absence of recent ischemic symptoms. A more sophisticated risk model takes into account other clinical variables, such as age, sex, and the type of recent symptoms, as well as presence of ulcerated plaque. A growing body of evidence shows that noninvasive imaging of the carotid plaque by various methods reliably identifies structural correlates of plaque vulnerability, which are associated with an increased risk of cerebrovascular events. PMID:26610668

  12. Emergency operation of a patient with spontaneous rupture and massive hemorrhage of pleural solitary fibrous tumor.

    PubMed

    Shao, Feng; Yang, Rusong; Pan, Yanqing

    2014-10-01

    Solitary fibrous tumor (SFT) is a rare pleural disease with asymptomatic clinical course. We report a case of a patient with spontaneous rupture and massive hemorrhage of pleural SFT, which was treated by emergency operation. PMID:25364532

  13. The past, current and future of diagnosis and management of pleural disease

    PubMed Central

    2015-01-01

    Pleural disease is frequently encountered by the chest physician. Pleural effusions arise as the sequelae of underlying disease processes including pressure/volume imbalances, infection and malignancy. In addition to pleural effusions, persistent air leaks after surgery and bronchopleural fistulae remain a challenge. Our understanding of pleural disease including its diagnosis and management, have made tremendous strides. The introduction of the molecular detection of organism specific infection, risk stratification and improvements in the non-surgical treatment of patients with pleural infection are all within reach and may be the standard of care in the very near future. Malignant pleural effusion management continues to evolve with the introduction of tunneled pleural catheters and procedures combining that and chemical pleurodesis. These advances in the diagnostic and therapeutic evaluation of pleural disease as well as what seems to be an increasing multidisciplinary interest in the space foretell a bright future. PMID:26807281

  14. The past, current and future of diagnosis and management of pleural disease.

    PubMed

    Akulian, Jason; Feller-Kopman, David

    2015-12-01

    Pleural disease is frequently encountered by the chest physician. Pleural effusions arise as the sequelae of underlying disease processes including pressure/volume imbalances, infection and malignancy. In addition to pleural effusions, persistent air leaks after surgery and bronchopleural fistulae remain a challenge. Our understanding of pleural disease including its diagnosis and management, have made tremendous strides. The introduction of the molecular detection of organism specific infection, risk stratification and improvements in the non-surgical treatment of patients with pleural infection are all within reach and may be the standard of care in the very near future. Malignant pleural effusion management continues to evolve with the introduction of tunneled pleural catheters and procedures combining that and chemical pleurodesis. These advances in the diagnostic and therapeutic evaluation of pleural disease as well as what seems to be an increasing multidisciplinary interest in the space foretell a bright future. PMID:26807281

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

    PubMed Central

    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. Patients were followed through 12 months post-procedure. Results: Twenty-nine lesions were treated with OAS-BA in 25 patients. The mean maximum balloon inflation pressure was 5.2 ± 1.2 atm. Virtual histology IVUS (VH-IVUS) analysis revealed at the maximum calcium ablation site that calcium reduction was responsible for 86% of the lumen area increase. The minimum lumen area increased from 4.0 mm2 to 9.1 mm2 (<.0001), and the percentage of area stenosis decreased from 76.9% to 43.0% (<.0001) after OAS-BA. At 12 months, the target lesion revascularization rate was 8.2%, and ankle–brachial index and Rutherford classification improved significantly from baseline through follow-up. Conclusion: The VH-IVUS analysis reveals that OAS modifies the calcified component of the plaque burden. It is hypothesized that calcium modification by OAS changes the lesion compliance, allowing for low pressure adjunctive BA. The clinical outcomes were favorable through 12-month follow-up. PMID:26490645

  16. Atherosclerosis and Atheroma Plaque Rupture: Imaging Modalities in the Visualization of Vasa Vasorum and Atherosclerotic Plaques

    PubMed Central

    2014-01-01

    Invasive angiography has been widely accepted as the gold standard to diagnose cardiovascular pathologies. Despite its superior resolution of demonstrating atherosclerotic plaque in terms of degree of lumen stenosis, the morphological assessment for the plaque is insufficient for the analysis of plaque components, and therefore, unable to predict the risk status or vulnerability of atherosclerotic plaque. There is an increased body of evidence to show that the vasa vasorum play an important role in the initiation, progression, and complications of atherosclerotic plaque leading to major adverse cardiac events. This paper provides an overview of the evidence-based reviews of various imaging modalities with regard to their potential value for comprehensive characterization of the composition, burden, and neovascularization of atherosclerotic plaque. PMID:24688380

  17. Calcifying nanoparticles (nanobacteria): an additional potential factor for urolithiasis in space flight crews.

    PubMed

    Jones, Jeffrey A; Ciftcioglu, Neva; Schmid, Josef F; Barr, Yael R; Griffith, Donald

    2009-01-01

    Spaceflight-induced microgravity appears to be a risk factor for the development of urinary calculi, resulting in urolithiasis during and after spaceflight. Calcifying nanoparticles, or nanobacteria, multiply more rapidly in simulated microgravity and create external shells of calcium phosphate. The question arises whether calcifying nanoparticles are nidi for calculi and contribute to the development of clinically significant urolithiasis in those who are predisposed to the development of urinary calculi because of intrinsic or extrinsic factors. This case report describes a calculus recovered after flight from an astronaut that, on morphologic and immunochemical analysis (including specific monoclonal antibody staining), demonstrated characteristics of calcifying nanoparticles. PMID:18718644

  18. Symptomatic and asymptomatic carotid artery plaque

    PubMed Central

    Mughal, Majid M; Khan, Mohsin K; DeMarco, J Kevin; Majid, Arshad; Shamoun, Fadi; Abela, George S

    2011-01-01

    Carotid atherosclerotic plaques represent both stable and unstable atheromatous lesions. Atherosclerotic plaques that are prone to rupture owing to their intrinsic composition such as a large lipid core, thin fibrous cap and intraplaque hemorrhage are associated with subsequent thromboembolic ischemic events. At least 1520% of all ischemic strokes are attributable to carotid artery atherosclerosis. Characterization of plaques may enhance the understanding of natural history and ultimately the treatment of atherosclerotic disease. MRI of carotid plaque and embolic signals during transcranial Doppler have identified features beyond luminal stenosis that are predictive of future transient ischemic attacks and stroke. The value of specific therapies to prevent stroke in symptomatic and asymptomatic patients with severe carotid artery stenosis are the subject of current research and analysis of recently published clinical trials that are discussed in this article. PMID:21985544

  19. Nuclear Molecular Imaging for Vulnerable Atherosclerotic Plaques

    PubMed Central

    Lee, Soo Jin

    2015-01-01

    Atherosclerosis is an inflammatory disease as well as a lipid disorder. Atherosclerotic plaque formed in vessel walls may cause ischemia, and the rupture of vulnerable plaque may result in fatal events, like myocardial infarction or stroke. Because morphological imaging has limitations in diagnosing vulnerable plaque, molecular imaging has been developed, in particular, the use of nuclear imaging probes. Molecular imaging targets various aspects of vulnerable plaque, such as inflammatory cell accumulation, endothelial activation, proteolysis, neoangiogenesis, hypoxia, apoptosis, and calcification. Many preclinical and clinical studies have been conducted with various imaging probes and some of them have exhibited promising results. Despite some limitations in imaging technology, molecular imaging is expected to be used both in the research and clinical fields as imaging instruments become more advanced. PMID:26357491

  20. Vascular MR segmentation: wall and plaque

    NASA Astrophysics Data System (ADS)

    Yang, Fuxing; Holzapfel, Gerhard; Schulze-Bauer, Christian; Stollberger, Rudolf; Thedens, Daniel; Bolinger, Lizann; Stolpen, Alan; Sonka, Milan

    2003-05-01

    Cardiovascular events frequently result from local rupture of vulnerable atherosclerotic plaque. Non-invasive assessment of plaque vulnerability is needed to allow institution of preventive measures before heart attack or stroke occur. A computerized method for segmentation of arterial wall layers and plaque from high-resolution volumetric MR images is reported. The method uses dynamic programming to detect optimal borders in each MRI frame. The accuracy of the results was tested in 62 T1-weighted MR images from 6 vessel specimens in comparison to borders manually determined by an expert observer. The mean signed border positioning errors for the lumen, internal elastic lamina, and external elastic lamina borders were -0.12+/-0.14 mm, 0.04+/-0.12mm, and -0.15+/-0.13 mm, respectively. The presented wall layer segmentation approach is one of the first steps towards non-invasive assessment of plaque vulnerability in atherosclerotic subjects.

  1. Detection of EpCAM-positive microparticles in pleural fluid: A new approach to mini-invasively identify patients with malignant pleural effusions.

    PubMed

    Roca, Elisa; Lacroix, Romaric; Judicone, Coralie; Laroumagne, Sophie; Robert, Stphane; Cointe, Sylvie; Muller, Alexandre; Kaspi, Elise; Roll, Patrice; Brisson, Alain R; Tantucci, Claudio; Astoul, Philippe; Dignat-George, Franoise

    2016-01-19

    Pleural biomarkers allowing to mini-invasively discriminate benign from malignant pleural effusions are needed. Among potential candidates, microparticles (MPs) are extracellular vesicles that vectorize antigen derived from the parent cell. We hypothesized that tumor-derived MPs could be present in the pleural liquid and help to identify patients with malignant pleural effusions. Using highly sensitive flow cytometry and cryo-electron microscopy, we showed that large amounts of MPs from hematopoetic and vascular origin could be detectable in pleural fluids. Their level did not differ between benign (n = 14) and malignant (n = 71) pleural effusions. Analysis of selected tumoral associated antigens (podoplanin, mucin 1 and EpCAM, epithelial-cell-adhesion-molecule) evidenced for the first time the presence of tumor-derived MPs expressing EpCAM in malignant pleural fluids only (Specificity = 93%, Sensitivity = 49% and 45% for flow cytometry and ELISA, respectively). The detection of EpCAM-positive-MPs (EpCAM + MPs) by flow cytometry showed a better specificity and sensitivity than ELISA to distinguish between pleural carcinoma and the others malignant pleural effusions (MPE; Sp: 96% vs 89%; Se: 79% vs 66%). Combining EpCAM+ MPs and cytology improved the diagnosis of MPE compared to cytology alone. This study establishes the basis for using EpCAM+ MPs as a promising new biomarker that could be added to the armamentarium to mini-invasively identify patients with malignant pleural effusions. PMID:26689993

  2. Pleural effusion lipoproteins measured by NMR spectroscopy for diagnosis of exudative pleural effusions: a novel tool for pore-size estimation.

    PubMed

    Lam, Ching-Wan; Law, Chun-Yiu

    2014-09-01

    High-resolution proton nuclear magnetic resonance (NMR) spectrometry of biofluids has been increasingly used in laboratory diagnosis of various diseases. In this study, we extended the use of (1)H NMR spectroscopy for laboratory diagnosis of exudative pleural effusions using pleural fluids. We compared this new NMR-based test with Light's criteria, the current gold standard for laboratory diagnosis of exudative pleural effusions. We analyzed 67 samples of pleural effusions from patients with pulmonary malignancy (N = 32), pulmonary tuberculosis (N = 18), and congestive heart failure (N = 17). The metabolomes of pleural effusions were analyzed using (1)H NMR spectroscopy on a Bruker 600 MHz spectrometer. Through a metabolome-wide association approach with filtering of insignificant markers (p value <4 × 10(-6)) and multivariate analysis (principal component analysis and orthogonal partial least squares-discriminant analysis), lipoprotein was found to be the best biomarker that distinguished exudates from transudates. Using NMR-based lipoprotein profiling to classify exudative pleural effusions from transudates, the area-under-receiver operating characteristic (ROC) curve was 0.96 with sensitivity of 98%, specificity of 88%, and accuracy of 98%. In contrast, the current gold standard, Light's criteria, give a specificity of only 65% at the same sensitivity level of 98%. Using the principle of size exclusion, NMR-based lipoprotein profiling of pleural fluids has an unprecedented diagnostic performance superiority over the Light's criteria. The capillary leaks secondary to inflammation result in a larger pleural pore-size, which allows the large-sized lipoproteins to accumulate in exudative pleural effusions. In contrast, the pleural permeability is intact in transudates, which allow only small-sized lipoproteins to pass into the pleural effusions. The average capillary pore-size of the pleura can therefore be determined by using NMR-based lipoprotein profiling of pleural fluids. We believe this new test will change the current clinical practice for management of pleural effusions and will become a new standard for clinical practice. PMID:25072840

  3. Carotenoids Co-Localize with Hydroxyapatite, Cholesterol, and Other Lipids in Calcified Stenotic Aortic Valves. Ex Vivo Raman Maps Compared to Histological Patterns

    PubMed Central

    Bonetti, A.; Bonifacio, A.; Mora, A. Della; Livi, U.; Marchini, M.; Ortolani, F.

    2015-01-01

    Unlike its application for atherosclerotic plaque analysis, Raman microspectroscopy was sporadically used to check the sole nature of bioapatite deposits in stenotic aortic valves, neglecting the involvement of accumulated lipids/lipoproteins in the calcific process. Here, Raman microspectroscopy was employed for examination of stenotic aortic valve leaflets to add information on nature and distribution of accumulated lipids and their correlation with mineralization in the light of its potential precocious diagnostic use. Cryosections from surgically explanted stenotic aortic valves (n=4) were studied matching Raman maps against specific histological patterns. Raman maps revealed the presence of phospholipids/triglycerides and cholesterol, which showed spatial overlapping with one another and Raman-identified hydroxyapatite. Moreover, the Raman patterns correlated with those displayed by both von-Kossa-calcium- and Nile-blue-stained serial cryosections. Raman analysis also provided the first identification of carotenoids, which co-localized with the identified lipid moieties. Additional fit concerned the distribution of collagen and elastin. The good correlation of Raman maps with high-affinity staining patterns proved that Raman microspectroscopy is a reliable tool in evaluating calcification degree, alteration/displacement of extracellular matrix components, and accumulation rate of different lipid forms in calcified heart valves. In addition, the novel identification of carotenoids supports the concept that valve stenosis is an atherosclerosis-like valve lesion, consistently with their previous Raman microspectroscopical identification inside atherosclerotic plaques. PMID:26150160

  4. A new inexpensive customized plaque for choroidal melanoma iodine-125 plaque therapy.

    PubMed

    Vine, A K; Tenhaken, R K; Diaz, R F; Maxson, B B; Lichter, A S

    1989-04-01

    The authors have developed a new inexpensive precious metal alloy plaque for use in customized iodine-125 plaque therapy. Each plaque is formed from two flat circular gold/palladium foils which are used in dental crown work. Using a simple manual mechanism, the two forms are stamped over a customized acrylic die shaped to the dimensions of the tumor base plus a 2-mm margin. Completed plaques consist of a back wall, a 2-mm side wall, and a 1.5-mm wide lip with holes for suture placement. Advantages include: simple construction from inexpensive components, customized shape, and iodine seeds that are readily visible on plane radiographs. PMID:2726186

  5. Quality-Adjusted Survival Following Treatment of Malignant Pleural Effusions With Indwelling Pleural Catheters

    PubMed Central

    Jimenez, Carlos A.; Lei, Xiudong; Cantor, Scott B.; Grosu, Horiana B.; Lazarus, Donald R.; Faiz, Saadia A.; Bashoura, Lara; Shannon, Vickie R.; Balachandran, Dave; Noor, Lailla; Hashmi, Yousra B.; Casal, Roberto F.; Morice, Rodolfo C.; Eapen, George A.

    2014-01-01

    Background: Malignant pleural effusions (MPEs) are a frequent cause of dyspnea in patients with cancer. Although indwelling pleural catheters (IPCs) have been used since 1997, there are no studies of quality-adjusted survival following IPC placement. Methods: With a standardized algorithm, this prospective observational cohort study of patients with MPE treated with IPCs assessed global health-related quality of life using the SF-6D to calculate utilities. Quality-adjusted life days (QALDs) were calculated by integrating utilities over time. Results: A total of 266 patients were enrolled. Median quality-adjusted survival was 95.1 QALDs. Dyspnea improved significantly following IPC placement (P < .001), but utility increased only modestly. Patients who had chemotherapy or radiation after IPC placement (P < .001) and those who were more short of breath at baseline (P = .005) had greater improvements in utility. In a competing risk model, the 1-year cumulative incidence of events was death with IPC in place, 35.7%; IPC removal due to decreased drainage, 51.9%; and IPC removal due to complications, 7.3%. Recurrent MPE requiring repeat intervention occurred in 14% of patients whose IPC was removed. Recurrence was more common when IPC removal was due to complications (P = .04) or malfunction (P < .001) rather than to decreased drainage. Conclusions: IPC placement has significant beneficial effects in selected patient populations. The determinants of quality-adjusted survival in patients with MPE are complex. Although dyspnea is one of them, receiving treatment after IPC placement is also important. Future research should use patient-centered outcomes in addition to time-to-event analysis. Trial registry: ClinicalTrials.gov; No.: NCT01117740; URL: www.clinicaltrials.gov PMID:24480929

  6. Management of malignant pleural effusion by an indwelling pleural catheter: A cost-efficiency analysis

    PubMed Central

    Rial, Maribel Botana; Lamela, Isaura Parente; Fernndez, Virginia Leiro; Arca, Jos Abal; Delgado, Manuel Nez; Pombo, Carlos Vilario; Hernndez, Cristina Ramos; Fernndez-Villar, Alberto

    2015-01-01

    BACKGROUND: For patients that are expected to survive for longer, the risk of complications combined with the need for more vacuum drainage bottles have become barriers to the placement of indwelling pleural catheter (IPC), since these could increase costs. OBJETIVES: The objective of the current article is to determine the cost and efficiency of treating malignant pleural effusion (MPE) with IPC in Spanish hospitals. METHODS: We compared the cost associated with the use of IPC per outpatient and per inpatient. We analyzed the number of consultations, length of hospital stay, and outcome of the procedure. RESULTS: Fifty-five patients were recruited. Spontaneous pleurodesis was achieved in 34.4% of the cases. Post-catheterization complications were observed in 7.2%. Supplementary procedures were unnecessary and 87.7% of the patients reported improved dyspnea. In 64.9% of the cases, the IPCs were inserted during hospitalization with a median hospitalization time of 4 days (1-7.5). There were differences in the number of visits with more consultations being observed in the outpatient group. There was no difference in the number of vacuum drainage bottles used. The complications supposed a cost increase of 1045.6 per outpatient and 432.54 per inpatient. The overall average cost of treatment per outpatient was 3310.2 and 5450.3 per inpatient. CONCLUSIONS: The treatment with IPC was effective, safe, without need of any more procedures and led to improved dyspnea in more than 85% of the patients. The cost is lower in the outpatient group, although complications represent an increased cost in both groups. PMID:26229560

  7. A rare pleural effusion in a young male

    PubMed Central

    Begum, Shabana; Mukherjee, Subhasis; Biswas, Debabani; Misra, Amartya Kumar; Ghosh, Priyanka; Bhanja, Pulakesh

    2015-01-01

    A 28-year-old male presented with fever with right-sided chest pain for 2 weeks. Clinicoradiological picture was suggestive of right-sided pleural effusion. He had history of polytrauma following a road traffic accident and had to undergo emergency laparotomy a month ago. Microscopic and culture examination of the pleural fluid showed neutrophilia, high bilirubin content and presence of gram-negative bacilli. Ultrasound of the abdomen showed the presence of biloma in the liver and right subdiaphragmatic space with fistulous communication into the right thoracic cavity. The patient was managed successfully with complete recovery. PMID:26180393

  8. Secondary Syphilis with Pleural Effusion: Case Report and Literature Review

    PubMed Central

    Elzouki, Abdel-Naser; Al-Kawaaz, Mustafa; Tafesh, Zaid

    2012-01-01

    Here we present a case of a 38-year-old Indian man with a history of extramarital relationships who presented with pleurisy, skin rash, and radiological findings of pleural effusion. After thorough investigation of the etiology of his acute illness, he was found to be positive for syphilis. Review of literature revealed a small number of case reports of pleural effusion as a manifestation of secondary syphilis. The review of criteria proposed in the literature was utilized to diagnose this patient as a case of pulmonary syphilis. PMID:23304580

  9. CT differentiation of subphrenic abscess and pleural effusion

    SciTech Connect

    Alexander, E.S.; Proto, A.V.; Clark, R.A.

    1983-01-01

    The computed tomographic scans of 38 patients with proven subphrenic abscesses and 28 patients with proven pleural effusions were reviewed without knowledge of the final diagnosis. In 26% of cases the hemidiaphragm could be identified directly as a stripe, while in 71% of cases only the hemidiaphragmatic contour could be seen. In 3% of cases the hemidiaphragm position was indeterminate because insufficient scans of the chest or abdomen were obtained. In the cases where the hemidiaphragm position could be established, the computed tomographic diagnosis was correct in 100% of subphrenic abscesses and in 96% of pleural effusions. Methods of identifying the hemidiaphragm on computed tomography and the possible pitfalls are discussed.

  10. Low pleural fluid amylase associated with spontaneous rupture of the esophagus.

    PubMed

    Rudin, J S; Ellrodt, A G; Phillips, E H

    1983-05-01

    All previously reported determinations of pleural fluid amylase in Boerhaave's syndrome have demonstrated elevated values. We treated a patient with Sjögen's syndrome who had a low pleural fluid amylase level and the concomitant unusual finding of leakage of esophageal contents into the right pleural space. PMID:6206811

  11. Eosinophilic pleural effusion due to Spirometra mansoni spargana: a case report and review of the literature.

    PubMed

    Lin, Quan; Ouyang, Jin-Sheng; Li, Jian-Min; Yang, Li; Li, Yu-Ping; Chen, Cheng-Shui

    2015-05-01

    A 36-year-old female presented with an eosinophilic pleural effusion. The eosinophilic pleural effusion was considered to have been caused by a parasitic infection. Spirometra mansoni spargana was confirmed by semi-rigid thoracoscopy. About 2 months after treatment with praziquantel for 3 days, the pleural effusion had disappeared on the chest roentgenogram. PMID:25820094

  12. Talc pleurodesis through indwelling pleural catheters for malignant pleural effusions: retrospective case series of a novel clinical pathway.

    PubMed

    Ahmed, Liju; Ip, Hugh; Rao, Deepak; Patel, Nishil; Noorzad, Farinaz

    2014-12-01

    Malignant pleural effusions cause significant morbidity, but there is no gold standard minimally invasive treatment. A new therapeutic approach combines talc pleurodesis and indwelling pleural catheters (IPCs) to enable outpatient management. This case series summarizes the safety and efficacy data of all patients (24) with a symptomatic malignant pleural effusion who underwent talc pleurodeses via IPCs between December 2010 and July 2013. Successful pleurodesis was achieved in 22 procedures (92%). There was one empyema, one hydropneumothorax, one recurrent effusion, and two minor complications: one drain site wound infection and one complaint of chest pain. Twenty-two procedures (92%) were performed in the outpatient setting. This report confirms the safety and efficacy of administering talc slurry through IPCs in an outpatient setting. Studies in a larger cohort are necessary to define the role of this novel approach in the treatment algorithm of patients with this condition. PMID:25451360

  13. Multi-feature-based plaque characterization in ex vivo MRI trained by registration to 3D histology

    NASA Astrophysics Data System (ADS)

    van Engelen, Arna; Niessen, Wiro J.; Klein, Stefan; Groen, Harald C.; Verhagen, Hence JM; Wentzel, Jolanda J.; van der Lugt, Aad; de Bruijne, Marleen

    2012-01-01

    We present a new method for automated characterization of atherosclerotic plaque composition in ex vivo MRI. It uses MRI intensities as well as four other types of features: smoothed, gradient magnitude and Laplacian images at several scales, and the distances to the lumen and outer vessel wall. The ground truth for fibrous, necrotic and calcified tissue was provided by histology and ?CT in 12 carotid plaque specimens. Semi-automatic registration of a 3D stack of histological slices and ?CT images to MRI allowed for 3D rotations and in-plane deformations of histology. By basing voxelwise classification on different combinations of features, we evaluated their relative importance. To establish whether training by 3D registration yields different results than training by 2D registration, we determined plaque composition using (1) a 2D slice-based registration approach for three manually selected MRI and histology slices per specimen, and (2) an approach that uses only the three corresponding MRI slices from the 3D-registered volumes. Voxelwise classification accuracy was best when all features were used (73.3 6.3%) and was significantly better than when only original intensities and distance features were used (Friedman, p < 0.05). Although 2D registration or selection of three slices from the 3D set slightly decreased accuracy, these differences were non-significant.

  14. Giant, Completely Calcified Lumbar Juxtafacet Cyst: Report of an Unusual Case

    PubMed Central

    Huang, Kevin T.; Owens, Timothy R.; Wang, Teresa S.; Moreno, Jessica R.; Bagley, Jacob H.; Bagley, Carlos A.

    2013-01-01

    Study Design?Case report. Objective?To report the case of one patient who developed a giant, completely calcified, juxtafacet cyst. Methods?A 57-year-old woman presented with a 2-year history of progressively worsening lower back pain, left leg pain, weakness, and paresthesias. Imaging showed a giant, completely calcified mass arising from the left L5S1 facet joint, with coexisting grade I L5 on S1 anterolisthesis. The patient was treated with laminectomy, excision of the mass, and L5S1 fixation and fusion. Results?The patient had an uncomplicated postoperative course and had complete resolution of her symptoms as of 1-year follow-up. Conclusions?When presented with a solid-appearing, calcified mass arising from the facet joint, a completely calcified juxtafacet cyst should be considered as part of the differential diagnosis. PMID:25083359

  15. An exceptional collision tumor: gastric calcified stromal tumor and pancreatic adenocarcinoma

    PubMed Central

    Baba, Hicham; Elfahssi, Mohamed; Belhamidi, Mohamed Said; Elhjouji, Abderrahman; Bounaim, Ahmed; Ali, Abdelmounaim Ait; Sair, Khalid; Zentar, Aziz

    2015-01-01

    The authors report an exceptional case of collision tumor comprised of a gastric calcified stromal tumor and a pancreatic adenocarcinoma. The pancreatic tumor was detected fortuitously on the histological exam of resection specimen.

  16. Improved treatment planning for COMS eye plaques

    SciTech Connect

    Astrahan, Melvin A. . E-mail: astrahan@usc.edu

    2005-03-15

    Purpose: A recent reanalysis of the Collaborative Ocular Melanoma Study (COMS) medium tumor trial concluded that incorporating factors to account for anisotropy, line source approximation, the gold plaque, and attenuation in the Silastic seed carrier into the dose calculations resulted in a significant and consistent reduction of calculated doses to structures of interest within the eye. The authors concluded that future eye plaque dosimetry should be 'performed using the most up-to-date parameters available.' The reason these factors are important is attributable to the low energy {sup 125}I radiation (approximately 28 keV) that is primarily absorbed by the photoelectric process. Photoelectric absorption is quite dependent on the atomic composition of the absorbing material. Being 40% silicon by weight, the effective atomic number of Silastic is significantly greater than that of water. Although the AAPM TG43 brachytherapy formalism inherently addresses the issues of source anisotropy and geometry, its parameter that accounts for scatter and attenuation, the radial dose function g(r), assumes that the source is immersed in infinite homogeneous water. In this work, factors are proposed for {sup 125}I that correct for attenuation in the Silastic carrier and scatter deficits resulting from the gold plaque and nearby air. The implications of using {sup 103}Pd seeds in COMS plaques are also discussed. Methods and materials: An existing TG43-based ophthalmic plaque planning system was modified to incorporate additional scatter and attenuation correction factors that better account for the path length of primary radiation in the Silastic seed carrier and the distance between the dose calculation point and the eye-air interface. Results: Compared with homogeneous water, the dose-modifying effects of the Silastic and gold are greatest near the plaque surface and immediately adjacent to the plaque, while being least near the center of the eye. The calculated dose distribution surrounding a single {sup 125}I seed centered in a COMS 20 mm plaque was found to be consistent with previously published examples that used thermoluminescent dosimetry measurements and Monte Carlo methods. For fully loaded 12 and 20 mm plaques, calculated dose to critical ocular structures ranged from 16%-50% less than would have been reported using the standard COMS dose calculation protocol. Conclusions: Treatment planning for COMS eye plaques that accurately accounts for the presence of the gold, Silastic and extraocular air is both possible and practical.

  17. [A case of the calcifying epithelial odontogenic tumor (Pindborg's tumor). Reported and literature review].

    PubMed

    Pea-Torres, Leandro Miguel; Monterrubio-Guerrero, Alejandro; Daz de Len-Sandoval, Laura Alejandra

    2010-01-01

    The calcifying epithelial odontogenic tumor known as Pindborg's tumor, is a rare odontogenic neoplasm of the jaws. One of their characteristics is the cortical expansion and the relationship with a non erupted tooth. Since the original description in 1955, only 200 cases approximately have been described in the world literature. This article reviews the literature and describes a case of patient who presented calcifying epithelial odontogenic tumor in the jaw undergoing surgical excision treatment with an evolution without complications. PMID:20929626

  18. New tetratrichomonas species in two patients with pleural empyema.

    PubMed

    Lopez-Escamilla, Eduardo; Sanchez-Aguillon, Fabiola; Alatorre-Fernandez, Cynthia Pamela; Aguilar-Zapata, Daniel; Arroyo-Escalante, Sara; Arellano, Teresa; Moncada-Barron, David; Romero-Valdovinos, Mirza; Martinez-Hernandez, Fernando; Rodriguez-Zulueta, Patricia; Maravilla, Pablo

    2013-09-01

    Two unusual occurrences of pleural trichomonosis due to a new Tetratrichomonas species previously reported but not named were confirmed. In one patient, Trichomonas tenax and a Tetratrichomonas species were also detected in the oral cavity by molecular methods. We suggest that this new Tetratrichomonas species be named Tetratrichomonas empyemagena. PMID:23784131

  19. Complications of indwelling pleural catheter use and their management

    PubMed Central

    Lui, Macy M S; Thomas, Rajesh; Lee, Y C Gary

    2016-01-01

    The growing utilisation of indwelling pleural catheters (IPCs) has put forward a new era in the management of recurrent symptomatic pleural effusions. IPC use is safe compared to talc pleurodesis, though complications can occur. Pleural infection affects <5% of patients, and is usually responsive to antibiotic treatment without requiring catheter removal or surgery. Pleural loculations develop over time, limiting drainage in 10% of patients, which can be improved with intrapleural fibrinolytic therapy. Catheter tract metastasis can occur with most tumours but is more common in mesothelioma. The metastases usually respond to analgaesics and/or external radiotherapy. Long-term intermittent drainage of exudative effusions or chylothorax can potentially lead to loss of nutrients, though no data exist on any clinical impact. Fibrin clots within the catheter lumen can result in blockage. Chest pain following IPC insertion is often mild, and adjustments in analgaesics and drainage practice are usually all that are required. As clinical experience with the use of IPC accumulates, the profile and natural course of complications are increasingly described. We aim to summarise the available literature on IPC-related complications and the evidence to support specific strategies. PMID:26870384

  20. New Tetratrichomonas Species in Two Patients with Pleural Empyema

    PubMed Central

    Lopez-Escamilla, Eduardo; Sanchez-Aguillon, Fabiola; Alatorre-Fernandez, Cynthia Pamela; Aguilar-Zapata, Daniel; Arroyo-Escalante, Sara; Arellano, Teresa; Moncada-Barron, David; Romero-Valdovinos, Mirza; Martinez-Hernandez, Fernando; Rodriguez-Zulueta, Patricia

    2013-01-01

    Two unusual occurrences of pleural trichomonosis due to a new Tetratrichomonas species previously reported but not named were confirmed. In one patient, Trichomonas tenax and a Tetratrichomonas species were also detected in the oral cavity by molecular methods. We suggest that this new Tetratrichomonas species be named Tetratrichomonas empyemagena. PMID:23784131

  1. Mediastinectomy for management of chronic pyogranulomatous pleural disease in dogs.

    PubMed

    Trinterud, T; Nelissen, P; Caine, A R; White, R A S

    2014-06-14

    The medical records of 12 dogs with chronic pyogranulomatous pleural disease unresponsive to medical management were reviewed retrospectively. Resection of the mediastinal pleura (mediastinectomy) was performed through a median sternotomy to remove all diseased and surgically accessible mediastinal pleural tissue. Dogs were re-examined two weeks postoperatively, and long-term outcome was evaluated by contacting owners by phone. Twelve dogs underwent mediastinectomy; additional surgeries included subtotal pericardiectomy (8), lung lobectomy (4) and partial diaphragmatic resection (2). Histology of resected tissue consistently revealed neutrophilic, pyogranulomatous cellulitis/serositis. Foreign material was evident in the mediastinal tissue of five dogs and microorganisms were recovered from three dogs. Two dogs developed pneumothorax immediately postoperatively; one dog developed haemothorax one month postoperatively and was euthanased. Median follow-up time was eight months (range: 6-43?months); eleven dogs were alive and considered to be symptom-free by their owners. Mediastinectomy resulted in complete resolution of symptoms in most dogs (92 per cent) and was associated with a low incidence of major complications. The results of this study indicated that mediastinectomy results in favourable outcome for dogs with chronic pleural pyogranulomatous pleural disease unresponsive to medical management. PMID:24686857

  2. Complications of indwelling pleural catheter use and their management.

    PubMed

    Lui, Macy M S; Thomas, Rajesh; Lee, Y C Gary

    2016-01-01

    The growing utilisation of indwelling pleural catheters (IPCs) has put forward a new era in the management of recurrent symptomatic pleural effusions. IPC use is safe compared to talc pleurodesis, though complications can occur. Pleural infection affects <5% of patients, and is usually responsive to antibiotic treatment without requiring catheter removal or surgery. Pleural loculations develop over time, limiting drainage in 10% of patients, which can be improved with intrapleural fibrinolytic therapy. Catheter tract metastasis can occur with most tumours but is more common in mesothelioma. The metastases usually respond to analgaesics and/or external radiotherapy. Long-term intermittent drainage of exudative effusions or chylothorax can potentially lead to loss of nutrients, though no data exist on any clinical impact. Fibrin clots within the catheter lumen can result in blockage. Chest pain following IPC insertion is often mild, and adjustments in analgaesics and drainage practice are usually all that are required. As clinical experience with the use of IPC accumulates, the profile and natural course of complications are increasingly described. We aim to summarise the available literature on IPC-related complications and the evidence to support specific strategies. PMID:26870384

  3. [Pleural empyema and lung abscess: current treatment options].

    PubMed

    Hecker, E; Hamouri, S; Mller, E; Ewig, S

    2012-06-01

    Parapneumonic pleural empyema has been classified into different stages and classes. While the American Thoracic Society (ATS) classification is based on the natural course of the disease, Light has classified pleural empyema according to the radiological, physical and biochemical characteristics, and the American College of Chest Physician (ACCP) has categorised the patients with pleural empyema according to the risk of a poor outcome. According to this classification the management of the pleural empyema is based on the stage of the disease. Therapeutic strategies include chest tube, chest tube with fibrinolysis, thoracoscopic debridement and decortication in open or minimally invasive techniques. Primary lung abscesses develop in previously healthy lung parenchyma and are caused by aspiration. In addition, abscess formation can occur without aspiration, and important differences relate to community-acquired, nosocomial abscesses and those in the immunosuppressed host. 90 % of all lung abscesses can be cured with antibiotic treatment alone, 10 % have to be treated with an interventional catheter or chest tubes and only 1 % require thoracic surgery because of complications independent of the former conservative or interventional treatment strategies. PMID:22711325

  4. Pleural Mesothelioma Presenting as Periumbilical Metastasis: The First Clinical Documentation

    PubMed Central

    Falkenstern-Ge, R. F.; Kimmich, M.; Bode-Erdmann, S.; Friedel, G.; Ott, G.; Kohlhufl, M.

    2013-01-01

    Introduction. Pleural mesothelioma with metastasis to the subcutaneous tissue of the abdominal wall at first diagnosis and without penetration into the peritoneum is an extremely rare clinical presentation. Methods. Patients with pleural mesothelioma have low survival rate. Usually, the disease at presentation is confined to its site of origin (most often the pleural cavity). A 55-year-old man was referred to our center due to increasing dyspnea and a painful periumbilical mass in the anterior abdominal wall. CT scan revealed both advanced mesothelioma of the pleura and a tumor mass confined to the subcutaneous fatty tissue without penetration through the peritoneum. Results. Video-assisted thoracoscopy confirmed the diagnosis of epithelioid pleural mesothelioma, which was also confirmed by a biopsy of the periumbilical mass. Systemic chemotherapy with cisplatin and pemetrexed was initiated. Under the ongoing systemic chemotherapy, the evaluation revealed partial remission of pleura mesothelioma and its subcutaneous manifestation of the abdominal wall. Conclusion. Mesothelioma of the pleura with a simultaneous metastasis to the subcutaneous fatty tissue of the abdominal wall at presentation without penetration of peritoneum is a rare clinical presentation of mesothelioma disease. The knowledge of its natural history is very limited. This is the first ever clinical documentation of a patient with pleura mesothelioma and simultaneous subcutaneous manifestation of abdominal wall. PMID:23691382

  5. Effect of positive pleural pressure on left ventricular performance

    SciTech Connect

    Natarajan, T.K.; Karam, M.; Wise, R.; Wagner, H.N.

    1984-01-01

    A sudden increase in pleural pressure such as coughing or a valsalva maneuver causes a transient increase in left ventricular stroke volume but the mechanism is not known. To help understand this phenomenon we studied 7 normal volunteers during spontaneous breathing and when breathing under positive pleural pressure. The positive pressure was developed by expiring against a 24cm H/sub 2/O threshold load. Radionuclide ventriculopgraphy using a double gating technique as performed. Image data were acquired during the cardiac cycles occurring during positive pleural pressure by means of a pressure transducer coupled to an EKG gate. They were compared to data acquired by EKG gating alone under quiet respiration as control. Results are shown for end diastolic (EDC), end systolic (ESC) and stroke counts (SC) and are expressed as % change from control for each parameter. The authors conclude that a transient increase in positive pleural pressure comparable to that reached during forceful coughing increases stroke volume and cardiac output through a combination of increased end diastolic volume with a lesser increase in end systolic volume. This effect was seen in the absence of any change in cardiac rhythm or rate.

  6. [Pleural empyema - treatment strategies in light of etiology].

    PubMed

    Hecker, E; Hecker, H C; Hecker, K A

    2013-06-01

    The variety of strategies in the treatment of parapneumonic pleural empyema demonstrates the ambiguity for the method of choice. Parapneumonic pleural empyema has been classified into different stages and classes. While the American Thoracic Society (ATS) classification is based on the natural course of the disease, or according to the radiological, physical and biochemical characteristics respectively, the American College of Chest Physicians (ACCP) has categorized the patients with pleural empyema according to the risk of a poor outcome. The British Thoracic Society (BTS) developed a treatment algorithm based on a systematic review of peer-reviewed literature. With regard to this classification the management of parapneumonic and postoperative pleural empyema is based on the stage of the disease. Therapeutic strategies include chest tube alone, chest tube with fibrinolysis, thoracoscopic debridement and decortication in open or minimally invasive techniques, closed empyemectomy, or treatment with thoracomyoplasty, open window treatment or vacuum clothing with negative pressure. The different conservative and operative therapeutic possibilities determinate the central treatment function of thoracic surgery. PMID:23807591

  7. Chemical agents for the control of plaque and plaque microflora: an overview.

    PubMed

    Gaffar, A; Afflitto, J; Nabi, N

    1997-10-01

    This presentation provides an overview of the technologies available for the chemical control of plaque. It is generally accepted that the formation of dental plaque at the interfaces of tooth/gingiva is one of the major causes of gingival inflammation and dental caries. Several therapeutic approaches have been used to control dental plaque and supragingival infections. These include fluoride preparations such as stannous fluoride, oxygenating agents, anti-attachment agents, and cationic and non-cationic antibacterial agents. Among the fluoride preparations, stable stannous fluoride pastes and gels have been shown to reduce supragingival plaque, gingivitis, hypersensitivity and caries. The effect of the oxygenating agents on the supragingival plaque has been equivocal, but recent data indicate that a stable agent which provides sustained active oxygen release is effective in controlling plaque. A polymer, PVPA, which reduced attachment of bacteria to teeth was shown to significantly reduce plaque formation in humans. A new generation of antibacterials includes non-ionics such as triclosan, which in combination with a special polymer delivery system, has been shown to reduce plaque, gingivitis, supragingival calculus and dental caries in long-term studies conducted around the world. Unlike the first generation of agents, the triclosan/copolymer/sodium fluoride system is effective in long-term clinicals and does not cause staining of teeth, increase in calculus, or disturbance in the oral microbial ecology. PMID:9395116

  8. Amyloid Plaques in PSAPP Mice Bind Less Metal than Plaques in Human Alzheimer's Disease

    SciTech Connect

    Leskovjan, A.; Lanzirotti, A; Miller, L

    2009-01-01

    Amyloid beta (A{Beta}) is the primary component of Alzheimer's disease (AD) plaques, a key pathological feature of the disease. Metal ions of zinc (Zn), copper (Cu), iron (Fe), and calcium (Ca) are elevated in human amyloid plaques and are thought to be involved in neurodegeneration. Transgenic mouse models of AD also exhibit amyloid plaques, but fail to exhibit the high degree of neurodegeneration observed in humans. In this study, we imaged the Zn, Cu, Fe, and Ca ion distribution in the PSAPP transgenic mouse model representing end-stage AD (N = 6) using synchrotron X-ray fluorescence (XRF) microprobe. In order to account for differences in density in the plaques, the relative protein content was imaged with synchrotron Fourier transform infrared microspectroscopy (FTIRM) on the same samples. FTIRM results revealed a 61% increase in protein content in the plaques compared to the surrounding tissue. After normalizing to protein density, we found that the PSAPP plaques contained only a 29% increase in Zn and there was actually less Cu, Fe, and Ca in the plaque compared to the surrounding tissue. Since metal binding to A{beta} is thought to induce redox chemistry that is toxic to neurons, the reduced metal binding in PSAPP mice is consistent with the lack of neurodegeneration in these animals. These findings were in stark contrast to the high metal ion content observed in human AD plaques, further implicating the role of metal ions in human AD pathology.

  9. Lasers in the management of calcified urinary tract stents

    NASA Astrophysics Data System (ADS)

    Nseyo, Unyime O.; Tunuguntla, Hari S. G. R.; Crone, Michael

    2003-06-01

    Indwelling double J ureteral stents are used for internal urinary diversion for ureteral obstruction and post-surgical drainage of the upper urinary tract. Stent calcification is a serious complication especially in those with forgotten stents. In a retrospective review of 16 patients (10 male and 6 female) we found holmium laser to be highly effective in the management of calcified stents. Encrustations/calcifications were noted on the distal end of the sent in 6 patiens (37.5%), middle and distal portions in 2 patients (12.5%), along the entire length of the stent in 3 patients (18.75%), lower portion of the stent in 4 patients (25%) and at the upper and lower ends of the stent in one patient (6.25%). Cystolitholapaxy, retrograde ureteroscopy (URS) with holmium: YAG (yttrium-aluminum-garnet) laser intracorporeal lithotripsy, percutaneous nephrostolithotomy (PNL) and antegrade URS with holmium: YAG laser intracorporeal lithotripsy were effectively performed without intraoperative complications. Lithotripsy became necessary before stent removal in 11 patients (68.75%). Holmium laser lithotripsy was useful in managing 7 patients (43.75%), and shockwave lithotripsy (SWL) in 6 patients (37.5%). In two patients (12.5%) both holmium and SWL were used before the stent can be removed.

  10. Bioconvection in Cultures of the Calcifying Unicellular Alga Pleurochrysis Carterae

    NASA Technical Reports Server (NTRS)

    Montufar-Solis, Dina; Duke, P. Jackie; Marsh, Mary E.

    2003-01-01

    The unicellular, marine, calcifying alga P leurochiysis carterae--a model to study cell morphogenesis, cell polarity, calcification, gravitaxis, reproduction and development-- has extremely flexible culture requirements. Support studies for a flight experiment addressing cell motility suggested that cell density (cells/ml) affects cell movement in P. carterae cultures through the gradual establishment of bioconvection as the culture grows. To assess the effect of cell density on direction of the movement, without the effects of aging of the culture, swimming behavior was analyzed in aliquots from a series of dilutions obtained from a stock culture. Results showed that at low concentrations cells swim randomly. As the concentration increases, upswimming patterns overtake random swimming. Gradually, up and down movement patterns prevail, representative of bioconvection. This oriented swimming of P. carterae occurs in a wide range of concentrations, adding to the list of flexible requirements, in this case, cell concentration, to be used for spaceflight studies addressing cell motility and bioconvection in a unicellular model of biologically directed mineralization.

  11. Association between dental pulp stones and calcifying nanoparticles.

    PubMed

    Zeng, Jinfeng; Yang, Fang; Zhang, Wei; Gong, Qimei; Du, Yu; Ling, Junqi

    2011-01-01

    The etiology of dental pulp stones, one type of extraskeletal calcification disease, remains elusive to date. Calcifying nanoparticles (CNPs), formerly referred to as nanobacteria, were reported to be one etiological factor in a number of extraskeletal calcification diseases. We hypothesized that CNPs are involved in the calcification of the dental pulp tissue, and therefore investigated the link between CNPs and dental pulp stones. Sixty-five freshly collected dental pulp stones, each from a different patient, were analyzed. Thirteen of the pulp stones were examined for the existence of CNPs in situ by immunohistochemical staining (IHS), indirect immunofluorescence staining (IIFS), and transmission electron microscope (TEM). The remaining 52 pulp stones were used for isolation and cultivation of CNPs; the cultured CNPs were identified and confirmed via their shape and growth characteristics. Among the dental pulp stones examined in situ, 84.6% of the tissue samples staines positive for CNPs antigen by IHS; the corresponding rate by IIFS was 92.3 %. In 88.2% of the cultured samples, CNPs were isolated and cultivated successfully. The CNPs were visible under TEM as 200-400 nm diameter spherical particles surrounded by a compact crust. CNPs could be detected and isolated from a high percentage of dental pulp stones, suggesting that CNPs might play an important role in the calcification of dental pulp. PMID:21289988

  12. The role of calcifying nanoparticles in biology and medicine.

    PubMed

    Kutikhin, Anton G; Brusina, Elena B; Yuzhalin, Arseniy E

    2012-01-01

    Calcifying nanoparticles (CNPs) (nanobacteria, nanobacteria-like particles, nanobes) were discovered over 25 years ago; nevertheless, their nature is still obscure. To date, nobody has been successful in credibly determining whether they are the smallest self-replicating life form on Earth, or whether they represent mineralo-protein complexes without any relation to living organisms. Proponents of both theories have a number of arguments in favor of the validity of their hypotheses. However, after epistemological analysis carried out in this review, all arguments used by proponents of the theory about the physicochemical model of CNP formation may be refuted on the basis of the performed investigations, and therefore published data suggest a biological nature of CNPs. The only obstacle to establish CNPs as living organisms is the absence of a fairly accurately sequenced genome at the present time. Moreover, it is clear that CNPs play an important role in etiopathogenesis of many diseases, and this association is independent from their nature. Consequently, emergence of CNPs in an organism is a pathological, not a physiological, process. The classification and new directions of further investigations devoted to the role of CNPs in biology and medicine are proposed. PMID:22287843

  13. Association between dental pulp stones and calcifying nanoparticles

    PubMed Central

    Zeng, Jinfeng; Yang, Fang; Zhang, Wei; Gong, Qimei; Du, Yu; Ling, Junqi

    2011-01-01

    The etiology of dental pulp stones, one type of extraskeletal calcification disease, remains elusive to date. Calcifying nanoparticles (CNPs), formerly referred to as nanobacteria, were reported to be one etiological factor in a number of extraskeletal calcification diseases. We hypothesized that CNPs are involved in the calcification of the dental pulp tissue, and therefore investigated the link between CNPs and dental pulp stones. Sixty-five freshly collected dental pulp stones, each from a different patient, were analyzed. Thirteen of the pulp stones were examined for the existence of CNPs in situ by immunohistochemical staining (IHS), indirect immunofluorescence staining (IIFS), and transmission electron microscope (TEM). The remaining 52 pulp stones were used for isolation and cultivation of CNPs; the cultured CNPs were identified and confirmed via their shape and growth characteristics. Among the dental pulp stones examined in situ, 84.6% of the tissue samples staines positive for CNPs antigen by IHS; the corresponding rate by IIFS was 92.3 %. In 88.2% of the cultured samples, CNPs were isolated and cultivated successfully. The CNPs were visible under TEM as 200400 nm diameter spherical particles surrounded by a compact crust. CNPs could be detected and isolated from a high percentage of dental pulp stones, suggesting that CNPs might play an important role in the calcification of dental pulp. PMID:21289988

  14. EACTS expert consensus statement for surgical management of pleural empyema.

    PubMed

    Scarci, Marco; Abah, Udo; Solli, Piergiorgio; Page, Aravinda; Waller, David; van Schil, Paul; Melfi, Franca; Schmid, Ralph A; Athanassiadi, Kalliopi; Sousa Uva, Miguel; Cardillo, Giuseppe

    2015-11-01

    Pleural infection is a frequent clinical condition. Prompt treatment has been shown to reduce hospital costs, morbidity and mortality. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research. The European Association for Cardio-Thoracic Surgery (EACTS) Thoracic Domain and the EACTS Pleural Diseases Working Group established a team of thoracic surgeons to produce a comprehensive review of available scientific evidence with the aim to cover all aspects of surgical practice related to its treatment, in particular focusing on: surgical treatment of empyema in adults; surgical treatment of empyema in children; and surgical treatment of post-pneumonectomy empyema (PPE). In the management of Stage 1 empyema, prompt pleural space chest tube drainage is required. In patients with Stage 2 or 3 empyema who are fit enough to undergo an operative procedure, there is a demonstrated benefit of surgical debridement or decortication [possibly by video-assisted thoracoscopic surgery (VATS)] over tube thoracostomy alone in terms of treatment success and reduction in hospital stay. In children, a primary operative approach is an effective management strategy, associated with a lower mortality rate and a reduction of tube thoracostomy duration, length of antibiotic therapy, reintervention rate and hospital stay. Intrapleural fibrinolytic therapy is a reasonable alternative to primary operative management. Uncomplicated PPE [without bronchopleural fistula (BPF)] can be effectively managed with minimally invasive techniques, including fenestration, pleural space irrigation and VATS debridement. PPE associated with BPF can be effectively managed with individualized open surgical techniques, including direct repair, myoplastic and thoracoplastic techniques. Intrathoracic vacuum-assisted closure may be considered as an adjunct to the standard treatment. The current literature cements the role of VATS in the management of pleural empyema, even if the choice of surgical approach relies on the individual surgeon's preference. PMID:26254467

  15. Functional expression of dental plaque microbiota

    PubMed Central

    Peterson, Scott N.; Meissner, Tobias; Su, Andrew I.; Snesrud, Erik; Ong, Ana C.; Schork, Nicholas J.; Bretz, Walter A.

    2014-01-01

    Dental caries remains a significant public health problem and is considered pandemic worldwide. The prediction of dental caries based on profiling of microbial species involved in disease and equally important, the identification of species conferring dental health has proven more difficult than anticipated due to high interpersonal and geographical variability of dental plaque microbiota. We have used RNA-Seq to perform global gene expression analysis of dental plaque microbiota derived from 19 twin pairs that were either concordant (caries-active or caries-free) or discordant for dental caries. The transcription profiling allowed us to define a functional core microbiota consisting of nearly 60 species. Similarities in gene expression patterns allowed a preliminary assessment of the relative contribution of human genetics, environmental factors and caries phenotype on the microbiota's transcriptome. Correlation analysis of transcription allowed the identification of numerous functional networks, suggesting that inter-personal environmental variables may co-select for groups of genera and species. Analysis of functional role categories allowed the identification of dominant functions expressed by dental plaque biofilm communities, that highlight the biochemical priorities of dental plaque microbes to metabolize diverse sugars and cope with the acid and oxidative stress resulting from sugar fermentation. The wealth of data generated by deep sequencing of expressed transcripts enables a greatly expanded perspective concerning the functional expression of dental plaque microbiota. PMID:25177549

  16. Assessment of vulnerable plaque composition by matching the deformation of a parametric plaque model to measured plaque deformation.

    PubMed

    Baldewsing, Radj A; Schaar, Johannes A; Mastik, Frits; Oomens, Cees W J; van der Steen, Antonius F W

    2005-04-01

    Intravascular ultrasound (IVUS) elastography visualizes local radial strain of arteries in so-called elastograms to detect rupture-prone plaques. However, due to the unknown arterial stress distribution these elastograms cannot be directly interpreted as a morphology and material composition image. To overcome this limitation we have developed a method that reconstructs a Young's modulus image from an elastogram. This method is especially suited for thin-cap fibroatheromas (TCFAs), i.e., plaques with a media region containing a lipid pool covered by a cap. Reconstruction is done by a minimization algorithm that matches the strain image output, calculated with a parametric finite element model (PFEM) representation of a TCFA, to an elastogram by iteratively updating the PFEM geometry and material parameters. These geometry parameters delineate the TCFA media, lipid pool and cap regions by circles. The material parameter for each region is a Young's modulus, EM, EL, and EC, respectively. The method was successfully tested on computer-simulated TCFAs (n = 2), one defined by circles, the other by tracing TCFA histology, and additionally on a physical phantom (n = 1) having a stiff wall (measured EM = 16.8 kPa) with an eccentric soft region (measured EL = 4.2 kPa). Finally, it was applied on human coronary plaques in vitro (n = 1) and in vivo (n = 1). The corresponding simulated and measured elastograms of these plaques showed radial strain values from 0% up to 2% at a pressure differential of 20, 20, 1, 20, and 1 mmHg respectively. The used/reconstructed Young's moduli [kPa] were for the circular plaque EL = 50/66, EM = 1500/1484, EC = 2000/2047, for the traced plaque EL = 25/1, EM = 1000/1148, EC = 1500/1491, for the phantom EL = 4.2/4 kPa, EM = 16.8/16, for the in vitro plaque EL = n.a./29, EM = n.a./647, EC = n.a./1784 kPa and for the in vivo plaque EL = n.a./2, EM = n.a./188, Ec = n.a./188 kPa. PMID:15822809

  17. Current Concepts and Occurrence of Epithelial Odontogenic Tumors: II. Calcifying Epithelial Odontogenic Tumor Versus Ghost Cell Odontogenic Tumors Derived from Calcifying Odontogenic Cyst

    PubMed Central

    Kim, Yeon Sook

    2014-01-01

    Calcifying epithelial odontogenic tumors (CEOTs) and ghost cell odontogenic tumors (GCOTs) are characteristic odontogenic origin epithelial tumors which produce calcifying materials from transformed epithelial tumor cells. CEOT is a benign odontogenic tumor composed of polygonal epithelial tumor cells that show retrogressive calcific changes, amyloid-like deposition, and clear cytoplasm. Differentially, GCOTs are a group of transient tumors characterized by ghost cell presence, which comprise calcifying cystic odontogenic tumor (CCOT), dentinogenic ghost cell tumor (DGCT), and ghost cell odontogenic carcinoma (GCOC), all derived from calcifying odontogenic cysts (COCs). There is considerable confusion about COCs and GCOTs terminology, but these lesions can be classified as COCs or GCOTs, based on their cystic or tumorous natures, respectively. GCOTs include ameloblastomatous tumors derived from dominant odontogenic cysts classified as CCOTs, ghost cell-rich tumors producing dentinoid materials as DGCTs, and the GCOT malignant counterpart, GCOCs. Many authors have reported CEOTs and GCOTs variably express keratins, ?-catenin, BCL-2, BSP, RANKL, OPG, Notch1, Jagged1, TGF-?, SMADs, and other proteins. However, these heterogeneous lesions should be differentially diagnosed to allow for accurate tumor progression and prognosis prediction. PMID:25013415

  18. Aterofisiol® in carotid plaque evolution

    PubMed Central

    Amato, Bruno; Compagna, Rita; Amato, Maurizio; Gallelli, Luca; de Franciscis, Stefano; Serra, Raffaele

    2015-01-01

    Background In patients with carotid stenosis, the risk of plaque rupture is related to the composition of the atherosclerotic plaque rather than to its magnitude. In this regard, we evaluated the effects of a supplement, Aterofisiol,® containing omega-3 (EPA [eicosapen acid] DHA [docosahexaenoic acid]), vitamin K2, vitamin B6, vitamin B12, oligomeric proanthocyanidins (OPC) and resveratrol on the composition of atherosclerotic plaque and on neurological symptoms in patients with carotid stenosis undergoing carotid endarterectomy. Methods The study was randomized, prospective, and double-blinded. Eligible patients were of both sexes, with carotid stenosis >70% who underwent endarterectomy. Enrolled patients were randomly allocated to receive either one tablet of acetylsalicylic acid 100 mg (Cardioaspirin®) + one tablet of Aterofisiol every 24 hours or one tablet of Cardioaspirin + one tablet of placebo every 24 hours. Each treatment was started 30 days before the surgery and was stopped 5 days before the surgery. The plaques were removed “en bloc” using standard surgical technique. Results During the study period, 214 patients (135 men and 79 women) were enrolled for intent-to-treat and randomized in two groups: Group A: 107 patients (68 men and 39 women) were treated with Cardioaspirin + Aterofisiol. Group B: 107 patients (67 men and 40 women) were treated with Cardioaspirin + placebo. At the end of the study, 202 patients participated fully (103 patients in Group A and 99 patients in Group B), making up the protocol evaluation population (94.4%). The mean lipid content of removed plaques was significantly lower (P<0.05) in Group A. We recorded a significantly lower incidence of neurological symptoms in Group A in comparison with Group B (P<0.05). Conclusion In the study, Aterofisiol showed to be effective in reducing the amounts of cholesterol and lipids in the plaques and in reducing adverse neurological events in the study group with respect to controls. PMID:26229448

  19. Statistical segmentation of carotid plaque neovascularization

    NASA Astrophysics Data System (ADS)

    Akkus, Zeynettin; Bosch, Johan G.; Snchez-Ferrero, Gonzalo V.; Carvalho, Diego D. B.; Renaud, Guillaume; van den Oord, Stijn C. H.; ten Kate, Gerrit L.; Schinkel, Arend F. L.; de Jong, Nico; van der Steen, Antonius F. W.

    2013-03-01

    In several studies, intraplaque neovascularization (IPN) has been linked with plaque vulnerability. The recent development of contrast enhanced ultrasound enables IPN detection, but an accurate quantification of IPN is a big challenge due to noise, motion, subtle contrast response, blooming of contrast and artifacts. We present an algorithm that automatically estimates the location and amount of contrast within the plaque over time. Plaque pixels are initially labeled through an iterative expectation-maximization (EM) algorithm. The used algorithm avoids several drawbacks of standard EM. It is capable of selecting the best number of components in an unsupervised way, based on a minimum message length criterion. Next, neighborhood information using a 55 kernel and spatiotemporal behavior are combined with the known characteristics of contrast spots in order to group components, identify artifacts and finalize the classification. Image sequences are divided into 3-seconds subgroups. A pixel is relabeled as an artifact if it is labeled as contrast for more than 1.5 seconds in at least two subgroups. For 10 plaques, automated segmentation results were validated with manual segmentation of contrast in 10 frames per clip. Average Dice index and area ratio were 0.73+/-0.1 (mean+/-SD) and 98.5+/-29.6 (%) respectively. Next, 45 atherosclerotic plaques were analyzed. Time integrated IPN surface area was calculated. Average area of IPN was 3.73+/-3.51 mm2. Average area of 45 plaques was 11.6+/-8.6 mm2. This method based on EM contrast segmentation provides a new way of IPN quantification.

  20. Cobalt60 plaques in recurrent retinoblastoma

    SciTech Connect

    Fass, D.; McCormick, B.; Abramson, D.; Ellsworth, R. )

    1991-08-01

    Cobalt60 plaque irradiation is one treatment option for patients with recurrent retinoblastoma following conventional external beam irradiation (ERT). Tumorocidal doses can be delivered without excessive risk of normal tissue injury. In patients not considered candidates for xenon arc or cryotherapy, 60Co is an alternative to enucleation. Between 1968 and 1987, 85 patients were treated with 60Co plaques, 72 of whom had failed prior ERT. Age at diagnosis ranged from 1 week to 4 years. There are 37 males and 35 females. Seventy-one patients had bilateral disease and one had unilateral. Three patients had both eyes plaqued. Prior ERT ranged from 30 to 70 Gy (mean 4200 Gy). Time from initial therapy to failure ranged from 13 to 60 months. Cobalt plaques of 10 mm, 15 mm, or 10 {times} 15 mm were used depending on tumor size and location. Dose prescribed to the apex of the tumor ranged from 30 to 50 Gy (median 40 Gy) given over 3 to 8 days. Twelve patients had two plaque applications; three patients had three plaque applications. All patients were followed with routine ophthalmoscopic examinations. Follow-up ranged from 2 to 22 years (mean 8.7). Seven patients died of metastatic disease; 10 patients developed non-ocular second tumors. Thirty patients required enucleation. Twenty-two patients had clear tumor progression, two patients had radiation complications, and six patients had a combination of tumor growth and complications. Cobalt60 can salvage eyes in retinoblastoma patients failing ERT. Currently, the authors are using I125 in an attempt to spare normal ocular tissue and reduce subsequent complications.

  1. Microscopic Observation of Self-Propagation of Calcifying Nanoparticles (Nanobacteria)

    NASA Technical Reports Server (NTRS)

    Mathew, Grace; McKay, David S.; Ciftcioglu, Neva

    2007-01-01

    Biologists typically define living organisms as carbon and water-based cellular forms with :self-replication" as the fundamental trait of the life process. However, this standard dictionary definition of life does not help scientists to categorize self-replicators like viruses, prions, proteons and artificial life. CNP also named nanobacteria were discovered in early 1990s as about 100 nanometer-sized bacteria-like particles with unique apatite mineral-shells around them, and found to be associated with pathological-calcification related diseases. Although CNP have been isolated and cultured from mammalian blood and diseased calcified tissues, and their biomineralizing properties well established, their biological nature and self-replicating capability have always been severely challenged. The terms "self-replication", "self-assembly" or "self-propagation" have been widely used for all systems including nanomachines, crystals, computer viruses and memes. In a simple taxonomy, all biological and non-biological "self replicators", have been classified into "living" or "nonliving" based on the properties of the systems and the amount of support they require to self-replicate. To enhance our understanding about self-replicating nature of CNP, we have investigated their growth in specific culture conditions using conventional inverted light microscope and BioStation IM, Nikon s latest time-lapse imaging system. Their morphological structure was examined using scanning (SEM) and transmission (TEM) electron microscopy. This present study, in conjunction with previous findings of metabolic activity, antibiotic sensitivity, antibody specificity, morphological aspects and infectivity, all concomitantly validate CNP as living self-replicators.

  2. Ocean acidification and calcifying reef organisms: A mesocosm investigation

    USGS Publications Warehouse

    Jokiel, P.L.; Rodgers, K.S.; Kuffner, I.B.; Andersson, A.J.; Cox, E.F.; MacKenzie, F.T.

    2008-01-01

    A long-term (10 months) controlled experiment was conducted to test the impact of increased partial pressure of carbon dioxide (pCO2) on common calcifying coral reef organisms. The experiment was conducted in replicate continuous flow coral reef mesocosms flushed with unfiltered sea water from Kaneohe Bay, Oahu, Hawaii. Mesocosms were located in full sunlight and experienced diurnal and seasonal fluctuations in temperature and sea water chemistry characteristic of the adjacent reef flat. Treatment mesocosms were manipulated to simulate an increase in pCO2 to levels expected in this century [midday pCO2 levels exceeding control mesocosms by 365 ?? 130 ??atm (mean ?? sd)]. Acidification had a profound impact on the development and growth of crustose coralline algae (CCA) populations. During the experiment, CCA developed 25% cover in the control mesocosms and only 4% in the acidified mesocosms, representing an 86% relative reduction. Free-living associations of CCA known as rhodoliths living in the control mesocosms grew at a rate of 0.6 g buoyant weight year-1 while those in the acidified experimental treatment decreased in weight at a rate of 0.9 g buoyant weight year-1, representing a 250% difference. CCA play an important role in the growth and stabilization of carbonate reefs, so future changes of this magnitude could greatly impact coral reefs throughout the world. Coral calcification decreased between 15% and 20% under acidified conditions. Linear extension decreased by 14% under acidified conditions in one experiment. Larvae of the coral Pocillopora damicornis were able to recruit under the acidified conditions. In addition, there was no significant difference in production of gametes by the coral Montipora capitata after 6 months of exposure to the treatments. ?? 2008 Springer-Verlag.

  3. Persistent Seroconversion after Accidental Eye Exposure to Calcifying Nanoparticles

    NASA Technical Reports Server (NTRS)

    Ciftcioglu, Neva; Aho, Katja M.; McKay, David S.; Kajander, E. Olavi

    2007-01-01

    Biosafety of nanomaterials has attracted much attention recently. We report here a case where accidental human eye exposure to biogenic nanosized calcium phosphate in the form of calcifying nanoparticles (CNP) raised a strong IgG immune response against proteins carried by CNP. The antibody titer has persisted over ten years at the high level. The IgG was detected by ELISA using CNPs propagated in media containing bovine and human serum as antigen. The exposure incident occurred to a woman scientist (WS) at a research laboratory in Finland at 1993. CNP, also termed "nanobacteria", is a unique self-replicating agent that has not been fully characterized and no data on biohazards were available at that time. Before the accident, her serum samples were negative for both CNP antigen and anti-CNP antibody using specific ELISA tests (Nanobac Oy, Kuopio, Finland). The accident occurred while WS was harvesting CNP cultures. Due to a high pressure in pipetting, CNP pellet splashed into her right eye. Both eyes were immediately washed with water and saline. The following days there was irritation and redness in the right eye. These symptoms disappeared within two weeks without any treatment. Three months after the accident, blood and urine samples of WS were tested for CNP cultures (2), CNP-specific ELISA tests, and blood cell counts. Blood cell counts were normal, CNP antigen and culture tests were negative. A high IgG anti-CNP antibody titer was detected (see Figure). The antibodies of this person have been used thereafter as positive control and standard in ELISA manufacturing (Nano-Sero IgG ELISA, Nanobac Oy, Kuopio, Finland).

  4. Ocean acidification and calcifying reef organisms: a mesocosm investigation

    NASA Astrophysics Data System (ADS)

    Jokiel, P. L.; Rodgers, K. S.; Kuffner, I. B.; Andersson, A. J.; Cox, E. F.; MacKenzie, F. T.

    2008-09-01

    A long-term (10 months) controlled experiment was conducted to test the impact of increased partial pressure of carbon dioxide ( pCO2) on common calcifying coral reef organisms. The experiment was conducted in replicate continuous flow coral reef mesocosms flushed with unfiltered sea water from Kaneohe Bay, Oahu, Hawaii. Mesocosms were located in full sunlight and experienced diurnal and seasonal fluctuations in temperature and sea water chemistry characteristic of the adjacent reef flat. Treatment mesocosms were manipulated to simulate an increase in pCO2 to levels expected in this century [midday pCO2 levels exceeding control mesocosms by 365 130 ?atm (mean sd)]. Acidification had a profound impact on the development and growth of crustose coralline algae (CCA) populations. During the experiment, CCA developed 25% cover in the control mesocosms and only 4% in the acidified mesocosms, representing an 86% relative reduction. Free-living associations of CCA known as rhodoliths living in the control mesocosms grew at a rate of 0.6 g buoyant weight year-1 while those in the acidified experimental treatment decreased in weight at a rate of 0.9 g buoyant weight year-1, representing a 250% difference. CCA play an important role in the growth and stabilization of carbonate reefs, so future changes of this magnitude could greatly impact coral reefs throughout the world. Coral calcification decreased between 15% and 20% under acidified conditions. Linear extension decreased by 14% under acidified conditions in one experiment. Larvae of the coral Pocillopora damicornis were able to recruit under the acidified conditions. In addition, there was no significant difference in production of gametes by the coral Montipora capitata after 6 months of exposure to the treatments.

  5. Dobesilate in the treatment of plaque psoriasis.

    PubMed

    Cuevas, Pedro; Arrazola, Jose M

    2005-09-12

    Fibroblast growth factor (FGF)-mediated pathways participate in many of the cellular events implicated in the pathogenesis of psoriasis. Thus, targeting FGF signals may be potentially therapeutic in the treatment of psoriasis. We report for the first time on a 43-year-old man with chronic-type plaque psoriasis with a daily topical treatment of dobesilate, a new FGF inhibitor. As early as at day 14, the patient had cleared or achieved excellent improvement of psoriatic skin lesions. Topical dobesilate offers the potential for treatment of plaque psoriasis without atrophy or other local side effects associated with the use of topical corticosteroids. PMID:16183548

  6. Evidence of a hypermineralised calcified fibrocartilage on the human femoral neck and lesser trochanter

    PubMed Central

    SHEA, J. E.; VAJDA, E. G.; BLOEBAUM, R. D.

    2001-01-01

    Femoral neck fractures are a major cause of morbidity and mortality in elderly humans. In addition to the age-related loss of cancellous bone, changes to the microstructure and morphology of the metaphyseal cortex may be a contributing factor in osteoporotic hip fractures. Recent investigations have identified a hypermineralised tissue on the neck of the femur and trochanteric region that increases in fractional area with advancing age in both males (Boyce & Bloebaum, 1993) and females (Vajda & Bloebaum, 1999). The aim of this study was to determine if the hypermineralised tissue previously observed on the proximal femur is calcified fibrocartilage. Regional variations in the fractional area of hypermineralised tissue, cortical bone, and porosity of the cortical bone along the neck of the femur and lesser trochanter were also quantified. Comparison of back scattered electron and light microscope images of the same area show that regions of hypermineralised tissue correlate with the regions of calcified fibrocartilage from tendon and capsular insertions. The hypermineralised tissue and calcified fibrocartilage had similar morphological features such as the interdigitations of the calcified fibrocartilage into the bone, lacunar spaces, and distinctly shaped pores adjacent to the 2 tissues. Regions of the neck that did not contain insertions were covered with periosteum. There were no regional differences (P > 0.05) on the superior and inferior femoral neck in terms of the percentage area of hypermineralised calcified fibrocartilage, cortical bone, or cortical bone porosity. The lesser trochanter exhibited regional differences in the fractional area of hypermineralised calcified fibrocartilage (P = 0.007) and cortical bone (P = 0.007) but not porosity of the cortical bone (P > 0.05). The effects of calcified fibrocartilage on femoral neck periosteal expansion, repair, and mechanics are unknown, but may play a role in osteoporotic fractures and intracapsular fracture healing. PMID:11273040

  7. Systemic and local ACTH produced during inflammatory states promotes osteochondrogenic mesenchymal cell differentiation contributing to the pathologic progression of calcified atherosclerosis

    PubMed Central

    Evans, Jodi F.; Ragolia, Louis

    2012-01-01

    There are many well-known roles for the proopiomelanocortin (POMC) derived peptides and their receptors, the melanocortin receptors (MC-R). The focus here is on the evolving role of the melanocortin system in inflammation. Chronic inflammatory states such as those occurring in diabetes and obesity are associated with both a hyperactive hypothalamic-pituitary-adrenal (HPA) axis as well as increased incidence of atherosclerosis. An inflammation-induced hyperactive HPA axis along with increased leukocyte infiltration can lead to significant exposure to melanocortin peptides, particularly ACTH, in an inflamed vasculature. Mesenchymal progenitor cells are present throughout the vasculature, express receptors for the melanocortin peptides, and respond to ACTH with increased osteochondrogenic differentiation. Coupled to the increased exposure to ACTH during HPA hyperactivity is increased glucocorticoid (GC) exposure. GCs also promote chondrogenic differentiation of mesenchymal progenitors and increase their expression of MC-R as well as their expression of POMC and its cleavage products. It is hypothesized that during inflammatory states systemically produced ACTH and glucocorticoid as well as ACTH produced locally by macrophage and other immune cells, can influence and potentiate mesenchymal progenitor cell differentiation along the osteochondrogenic lineages. In turn the increase in osteochondrogenic matrix contributes to the pathophysiological progression of the calcified atherosclerotic plaque. The roles of the melanocortin system in inflammation and its resolution have just begun to be explored. Investigations into the ACTH-induced matrix changes among mesenchymal cell populations are warranted. ACTH signaling through the MC-R represents a new therapeutic target for the prevention and treatment of calcified atherosclerosis. PMID:23026706

  8. Diagnostic Ability of FDG-PET/CT in the Detection of Malignant Pleural Effusion

    PubMed Central

    Nakajima, Reiko; Abe, Koichiro; Sakai, Shuji

    2015-01-01

    Abstract We investigated the role of F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) for the differential diagnosis of malignant and benign pleural effusion. We studied 36 consecutive patients with histologically proven cancer (excluding malignant mesothelioma) who underwent FDG-PET/CT for suspected malignant pleural effusion. Fourteen patients had cytologically proven malignant pleural effusion and the other 22 patients had either negative cytology or clinical follow-up, which confirmed the benign etiology. We examined the maximum standardized uptake values (SUVmax) of pleural effusion and the target-to-normal tissue ratio (TNR), calculated as the ratio of the pleural effusion SUVmax to the SUVmean of the normal tissues (liver, spleen, 12th thoracic vertebrae [Th12], thoracic aorta, and spinalis muscle). We also examined the size and density (in Hounsfield units) of the pleural effusion and pleural abnormalities on CT images. TNR (Th12) and increased pleural FDG uptake compared to background blood pool were significantly more frequent in cases with malignant pleural effusion (P?0.95 was the most accurate; the sensitivity, specificity, and accuracy for this value were 93%, 68%, and 75%, respectively. FDG-PET/CT can be a useful method for the differential diagnosis of malignant and benign pleural effusion. PMID:26200610

  9. Use of Circular Foldable Nitinol Blades for Resecting Calcified Aortic Heart Valves

    NASA Astrophysics Data System (ADS)

    Hauck, Florian; Wendt, Daniel; Stühle, Sebastian; Kawa, Emilia; Wendt, Hermann; Müller, Wiebke; Thielmann, Matthias; Kipfmüller, Brigitte; Vogel, Bernd; Jakob, Heinz

    2009-08-01

    The use of percutaneous aortic valve implantation is limited, as the native calcified valve is left in situ. A new device has been developed for resecting calcified aortic valves, using collapsible nickel-titanium blades: laser-cut T-structures of Nitinol sheet-material (Ni51Ti49 at.%) have been grinded on a high-speed milling cutter to produce cutting edges which have been given the shape of half-circles afterwards. These have been connected to each other and to struts by using rivets which also serve as articulating axes for the cutting ring. The blades are folded around these axes and retreated into a tube to be inserted in the heart through the calcified valve leaflets. Once released, the cutting edges regain their ring-shape. By combining rotation of the ring with a translating movement against a second ring of slightly greater diameter on the instrument, a punching process is created which cuts the calcified valve leaflets and leaves a circular annulus, where a prosthesis can be fixed. In vitro cutting of artificially calcified valves ( n = 6) resulted in a resection time of t = 22 ± 6.29 s with a maximum turning moment of M = 2.4 ± 1.27 Nm, proving the function and the feasibility of the concept.

  10. Calcified microbes in Neoproterozoic carbonates: implications for our understanding of the Proterozoic/Cambrian transition

    NASA Technical Reports Server (NTRS)

    Knoll, A. H.; Fairchild, I. J.; Swett, K.

    1993-01-01

    Tidal flat and lagoonal dolostones of the Neoproterozoic Draken Formation, Spitsbergen, exhibit excellent preservation of carbonate fabrics, including heavily calcified microfossils. The crust-forming cyanobacterium Polybessurus is preserved locally by carbonate precipitated on and within sheaths in mildly evaporitic upper intertidal to supratidal environments. In contrast, calcified filaments in columnar stromatolites reflect subtidal precipitation. Filament molds in dolomicrites independently document extremely early lithification. The presence of heavily calcified cyanobacteria in Draken and other Proterozoic carbonates constrains potential explanations for the widespread appearance of calcified microorganisms near the Proterozoic-Cambrian boundary. We propose that the rarity of Proterozoic examples principally reflects the abundance and wide distribution of carbonate crystals precipitated on the sea floor or in the water column. Cyanobacterial sheaths would have competed effectively as sites for carbonate nucleation and growth only where calcitic and/or aragonitic nuclei were absent. In this view, the Proterozoic-Cambrian expansion of calcified microfossils primarily reflects the emergence of skeletons as principal agents of carbonate deposition.

  11. Automatic segmentation and measurement of pleural effusions on CT.

    PubMed

    Yao, Jianhua; Bliton, John; Summers, Ronald M

    2013-07-01

    Pleural effusion is an important biomarker for the diagnosis of many diseases. We develop an automated method to evaluate pleural effusion on CT scans, the measurement of which is prohibitively time consuming when performed manually. The method is based on parietal and visceral pleura extraction, active contour models, region growing, Bezier surface fitting, and deformable surface modeling. Twelve CT scans with three manual segmentations were used to validate the automatic segmentation method. The method was then applied on 91 additional scans for visual assessment. The segmentation method yielded a correlation coefficient of 0.97 and a Dice coefficient of 0.720.13 when compared to a professional manual segmentation. The visual assessment estimated 83% cases with negligible or small segmentation errors, 14% with medium errors, and 3% with large errors. PMID:23372069

  12. Pleural, peritoneal and pericardial effusions – a biochemical approach

    PubMed Central

    Kopcinovic, Lara Milevoj; Culej, Jelena

    2014-01-01

    The pathological accumulation of serous fluids in the pleural, peritoneal and pericardial space occurs in a variety of conditions. Since patient management depends on right and timely diagnosis, biochemical analysis of extravascular body fluids is considered a valuable tool in the patient management process. The biochemical evaluation of serous fluids includes the determination of gross appearance, differentiation of transudative from exudative effusions and additional specific biochemical testing to assess the effusion etiology. This article summarized data from the most relevant literature concerning practice with special emphasis on usefulness of biochemical tests used for the investigation of pleural, peritoneal and pericardial effusions. Additionally, preanalytical issues concerning serous fluid analysis were addressed and recommendations concerning acceptable analytical practice in serous fluid analysis were presented. PMID:24627721

  13. Pleural effusion Due to Streptococcus milleri: Case descriptions.

    PubMed

    Madrid-Carbajal, Claudia Janeth; Molinos, Luis; Garca-Clemente, Marta; Pando-Sandoval, Ana; Fleites, Ana; Casan-Clar, Pere

    2014-09-01

    In this study we analyzed the characteristics of patients with pleural effusion secondary to Streptococcus milleri studied retrospectively between January and March 2013 and found seven patients with a mean age of 60 years, 43% of which were smokers and 57% with a drinking habit. The most common associated factors were alcoholism, previous pneumonia and diabetes. Other bacteria were identified as Enterobacter aerogenes, Bacteroides and Prevotella intermedia capillosus in two patients. The mean duration of antibiotic therapy was 28 days; six patients underwent pleural drainage by chest tube and one patient needed surgery due to poor clinical progress. The mean duration of hospitalization was 30 days with satisfactory outcome in all cases, despite some changes in residual function. PMID:24439468

  14. Liomyosarcome pleural primitif: propos d'un cas

    PubMed Central

    Ouafki, Imane; Sghiri, Tanae; El Yacoubi, Hind; Boutayeb, Saber; Mrabti, Hind; Errihani, Hassan

    2013-01-01

    Nous rapportons le cas d'un liomyosarcome pleural primitif, localement avanc, chez un homme de 64 ans, trait par chimiothrapie. La circonstance de dcouverte est une masse intra-thoracique, augmentant progressivement de volume, dans un contexte de fivre et d'altration de ltat gnral. La tomodensitomtrie abdominale a objectiv la tumeur. L'exploration chirurgicale a rvl une tumeur pleurale, trs localement avance, envahissant le mdiastin. Une simple biopsie a t ralise. L'examen anatomopathologique avec complment immunohistochimique tait en faveur d'un liomyosarcome de haut grade. Notre patient a reu une chimiothrapie base de Doxorubicine la dose de 60 mg / m2, administre tous les 21 jours. Lvaluation aprs 6 cycles de chimiothrapie a retrouv un bnfice clinique et une rponse partielle radiologique estime 30%. Actuellement, il est en bon contrle. PMID:23847701

  15. Adalimumab: A Review in Chronic Plaque Psoriasis.

    PubMed

    Burness, Celeste B; McKeage, Kate

    2015-12-01

    Adalimumab (Humira()) is a fully human monoclonal antibody against tumour necrosis factor (TNF), formulated for subcutaneous administration. It is well established in the treatment of adults with moderate-to-severe chronic plaque psoriasis and has recently received approval in the EU for the treatment of severe chronic plaque psoriasis in children and adolescents from 4years of age. In a phase III trial in paediatric patients, a significantly greater proportion of patients receiving adalimumab 0.8mg/kg (to a maximum of 40mg) every other week (eow) achieved a ?75% improvement from baseline in Psoriasis Area and Severity Index than those receiving methotrexate after 16weeks of treatment. In adults, well-designed randomized clinical trials demonstrated that adalimumab 40mg eow effectively reduced the signs and symptoms of psoriasis and improved dermatology-specific and general measures of health-related quality of life, with these benefits sustained during long-term treatment. Adalimumab was generally well tolerated, compared with placebo or methotrexate, during clinical trials in paediatric and adult patients with chronic plaque psoriasis. Thus, adalimumab remains an important treatment strategy in adults with moderate-to-severe chronic plaque psoriasis and provides a promising new systemic treatment option for children and adolescents from 4years of age with severe psoriasis. PMID:26586242

  16. Magnetic resonance imaging of juxtapapillary plaques in cadaver eyes.

    PubMed Central

    Williams, D F; Mieler, W F; Jaffe, G J; Robertson, D M; Hendrix, L

    1990-01-01

    Adequate treatment of juxtapapillary melanomas with episcleral plaque brachytherapy using lower energy radiation sources may be difficult because of uncertainties regarding the relationship of the plaque to the optic nerve and tumour base. We obtained magnetic resonance images of a dummy plaque placed in a juxtapapillary location in cadaver specimens. Although it is possible to place a plaque in close association with the optic nerve sheath, a tissue barrier exists which may prevent actual contact between the plaque and nerve. Posterior tilting of the plaque may also occur. Because of these uncertainties regarding plaque placement, juxtapapillary melanomas should be considered a distinct subgroup when evaluating the efficacy of radioactive plaque brachytherapy in the treatment of choroidal melanoma. Images PMID:2306444

  17. Treating cardiovascular atherosclerotic plaques with Tongmaijiangzhi (TMJZ) capsule.

    PubMed

    Ren, Hong-Qiang; Zhao, Li; Zhang, Zhong Shuang; Wang, Zhong; Wang, Li; Duan, Jun Cang; Li, Li; Zhai, Zhi Hong; Qu, De Tao; Huang, Hui

    2013-01-01

    Atherosclerotic plaques can cause serious syndromes and mortality. Cholesterol accumulation in the plaques can disrupt the arterial flow, with lumen narrowing and stenosis, which contributes to heart attack and sudden cardiac death. The pharmacological treatment to atherosclerotic plaques can be anti-hypertensives, anti-cholesterol, and cleaning of the existed plaques. This work examined the effects of pharmacological Tongmaijiangzhi (TMJZ) capsule on atherosclerotic plaques. The radiological findings of the atherosclerotic plaques of 107 patients receiving TMJZ treatment were analyzed. We found that the TMJZ administration decreases plaque volume and alters the composition in a relatively short period, showing highly promising effects. TMJZ treatment is able to remove the existed atherosclerotic plaques with no side effects observed. PMID:24311866

  18. 18. Photocopy of drawing of bronze dedication plaque, circa 1903 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. Photocopy of drawing of bronze dedication plaque, circa 1903 (original drawing in possession of City Engineer's Office Grand Rapids, Michigan) DEDICATION PLAQUE. - Bridge Street Bridge, Spanning Grand River, Michigan & Bridge Streets, Grand Rapids, Kent County, MI

  19. DIFFERENTIAL EFFECT OF TETRAZOLIUM UPON BACTERIOPHAGE PLAQUE ASSAY TITERS

    EPA Science Inventory

    This study examined whether the practice of incorporating either tetrazolium red ortetrazolium violet dye into plaque assay medium deleteriously influences plaque assay titers. epresentative members of six different virus families were studied: ystoviridae (06), Leviviridae (MS2)...

  20. Improvement of malignant pleural mesothelioma immunotherapy by epigenetic modulators.

    PubMed

    Hamaidia, Malik; Staumont, Bernard; Duysinx, Bernard; Louis, Renaud; Willems, Luc

    2016-01-01

    In the absence of a satisfactory treatment of malignant pleural mesothelioma (MPM), novel therapeutic strategies are urgently needed. Among these, immunotherapy offers a series of advantages such as tumor specificity and good tolerability. Unfortunately, MPM immunotherapy is frequently limited by incomplete cell differentiation or feedback loop regulatory mechanisms. In this review, we describe different components of the innate immune system and discuss strategies to improve MPM immunotherapy by using epigenetic modulators. PMID:26303419

  1. [Treatment methods in multiple hepatic, pulmonary and pleural hydatidosis].

    PubMed

    Galie, N; Stoica, R; Cadar, G; Posea, R; Brnzea, R

    2001-01-01

    The modern treatment of hepato-pleural-pulmonary hydatidosis is based on surgical excision and medical treatment with drugs like: Mebendazol, Albendazol or Praziquantel. There are presented 23 patients with multiple hepato-pleuro-pulmonary hydatidosis, operated in the last 4 years. Surgical excision in pleuro-pulmonary hydatidosis is adapted to cysts topography, aiming to eliminate the intact cysts and to close the remaining cavities. PMID:11374380

  2. Morphologic and functional imaging of malignant pleural mesothelioma.

    PubMed

    Yamamuro, Masaki; Gerbaudo, Victor H; Gill, Ritu R; Jacobson, Francine L; Sugarbaker, David J; Hatabu, Hiroto

    2007-12-01

    Malignant pleural mesothelioma (MPM) is an aggressive tumor that arises from the pleura and frequently extends to adjacent structures. MPM cells produce and respond to many angiogenic factors, such as vascular endothelial growth factor (VEGF). VEGF expression in MPM is correlated with microvascular density, which is associated with poor survival. CT has been widely used as the primary imaging modality for the clinical evaluation of MPM. Major findings include nodular pleural thickening, unilateral pleural effusion, and tumor invasion of adjacent structures. CT tends to underestimate early chest wall invasion and peritoneal involvement and has well-known limitations in the evaluation of lymph node metastases. Perfusion CT can evaluate the microvasculature of tumors, while its disadvantages, such as high radiation exposure or side effects from iodinated contrast, limit its use in both research and clinical settings. MRI can provide additional information to CT. Because of its excellent contrast resolution, MRI is superior to CT, both in the differentiation of malignant from benign pleural disease, and in the assessment of chest wall and diaphragmatic involvement. Perfusion MRI is the most promising technique for the assessment of the tumor microvasculature. In MPM, therapeutic effects of chemotherapy can be monitored with perfusion MRI. It has been shown that FDG-PET is useful for the differentiation of benign from malignant lesions, for staging and monitoring metabolic response to therapy against MPM, and that it has prognostic value. An initial report on PET/CT imaging of MPM has shown increased accuracy of overall staging, improving the assessment of tumor resectability. PET/CT seems to be superior to other imaging modalities in detecting more extensive disease involvement, and identifying unsuspected occult distant metastases. PMID:17954021

  3. Pleural tissue repair with cord blood platelet gel

    PubMed Central

    Rosso, Lorenzo; Parazzi, Valentina; Damarco, Francesco; Righi, Ilaria; Santambrogio, Luigi; Rebulla, Paolo; Gatti, Stefano; Ferrero, Stefano; Nosotti, Mario; Lazzari, Lorenza

    2014-01-01

    Background Prolonged air leak is the major cause of morbidity after pulmonary resection. In this study we used in vitro and in vivo experiments to investigate an innovative approach based on the use of human umbilical cord blood platelet gel. Materials and methods In vitro, a scratch assay was performed to test the tissue repair capability mediated by cord blood platelet gel compared to the standard culture conditions using human primary mesothelial cells. In vivo, an iatrogenic injury was made to the left lung of 54 Wistar rats. Cord blood platelet gel was placed on the injured area only in treated animals and at different times histological changes and the presence of pleural adhesions were evaluated. In addition, changes in the pattern of soluble inflammatory factors were investigated using a multiplex proteome array. Results In vitro, mesothelial cell damage was repaired in a shorter time by cord blood platelet gel than in the control condition (24 versus 35 hours, respectively). In vivo, formation of new mesothelial tissue and complete tissue recovery were observed at 451 and 751 hours in treated animals and at 1302.5 and 1606 hours in controls, respectively. Pleural adhesions were evident in 43% of treated animals compared to 17% of controls. No complications were observed. Interestingly, some crucial soluble factors involved in inflammation were significantly reduced in treated animals. Discussion Cord blood platelet gel accelerates the repair of pleural damage and stimulates the development of pleural adhesions. Both properties could be particularly useful in the management of prolonged air leak, and to reduce inflammation. PMID:23736928

  4. Inflamed psoriatic plaques: Drug toxicity or disease exacerbation?

    PubMed Central

    Jindal, Nidhi; Arora, Kshama; Jindal, Pooja; Jain, Vijay Kumar; Ghosh, Sangita

    2013-01-01

    We are presenting a case of Methotrexate treated stable plaque psoriasis, in whom inflamed psoriatic plaques of drug toxicity were misdiagnosed as disease exacerbation. Erosive psoriatic plaques were present in the absence of biochemical or hematological derangements. Ulceration of psoriatic plaques in the presence of disturbed hematological profile is well described as a harbinger of methotrexate toxicity, but this kind of erosions in the absence of any systemic involvement is the first report of its kind. PMID:24014924

  5. Regional differences in pleural lymphatic albumin concentration in sheep

    SciTech Connect

    Albertine, K.H.; Schultz, E.L.; Wiener-Kronish, J.P.; Staub, N.C.

    1987-01-01

    We used quantitative reflectance autoradiography to compare the concentration of albumin in visceral pleural lymphatics at the cranial and caudal ends of the sheep's lung in the vertical (60 degrees head-up) and horizontal (supine) positions. Twelve to fourteen hours after injecting 125I-albumin intravenously we placed four anesthetized sheep in the vertical position to establish a microvascular hydrostatic pressure gradient along the vertical height of the lung. We placed two anesthetized sheep in the horizontal position. Four hours later, we fixed the left lung and removed visceral pleural tissue blocks from the cranial and caudal ends, separated by a 15-cm distance, along the costovertebral margin. We measured the silver grain density in the pleural lymphatic autoradiograms by dark-field reflectance microspectrophotometry. In the vertical position, the lymph albumin concentration at the cranial end (top) of the lung averaged 2.5 +/- 0.4 g/dl compared with the caudal end (bottom), which averaged 1.8 +/- 0.3 g/dl. The difference (42% greater at the top than the bottom) is significant (P less than 0.05). The computed gradient in perimicrovascular interstitial albumin osmotic pressure was 0.26 +/- 0.13 cmH2O/cm lung height. There were no differences between the cranial and caudal lymphatic groups in the two horizontal sheep. We conclude that in the sheep lung there is a gradient in perimicrovascular albumin concentration due to the vertical gradient in microvascular hydrostatic pressure.

  6. Current controversies in the management of malignant pleural effusions.

    PubMed

    Azzopardi, Maree; Porcel, Jos M; Koegelenberg, Coenraad F N; Lee, Y C Gary; Fysh, Edward T H

    2014-12-01

    Malignant pleural effusion (MPE) can complicate most malignancies and is a common clinical problem presenting to respiratory and cancer care physicians. Despite its frequent occurrence, current knowledge of MPE remains limited and controversy surrounds almost every aspect in its diagnosis and management. A lack of robust data has led to significant practice variations worldwide, inefficiencies in healthcare provision, and threats to patient safety. Recent studies have highlighted evolving concepts in MPE care that challenge traditional beliefs. Advancing laboratory techniques have improved the diagnostic yield from pleural fluid cytology, minimizing the need for invasive tissue biopsies, even in many cases of mesothelioma. Imaging-guided biopsy is comparable to thoracoscopy in suitable patients, if cytological examination was noncontributory. Cumulating evidence for the benefits of indwelling pleural catheters (IPCs) has led some centers to adopt this approach as first-line definitive management for MPE over conventional talc pleurodesis. The optimal technique of talc pleurodesis is still debated despite its use for many decades. Strategies combining pleurodesis and IPC are being studied. MPE consists of a heterogenous group of diseases and careful phenotyping of malignant effusion patients can provide important clinical information that will advance the field and allow better stratification of patients and planning of therapy accordingly. This review addresses the controversies in MPE diagnosis and management and exposes the deficits in knowledge of MPE that should be the focus of future research. PMID:25463163

  7. Current trends in radiologic management of malignant pleural mesothelioma.

    PubMed

    Gill, Ritu R; Gerbaudo, Victor H; Sugarbaker, David J; Hatabu, Hiroto

    2009-01-01

    Malignant pleural mesothelioma (MPM) is an aggressive pleural tumor with a complex growth pattern. Imaging plays a crucial role in diagnosis and management. Computed tomography (CT) has been the mainstay in the clinical evaluation of MPM; however it underestimates early chest wall invasion, peritoneal involvement, and has well-known limitations in nodal metastatic evaluation. Perfusion CT can evaluate the microvasculature of tumors; however its disadvantages, such as high radiation exposure and side effects from iodinated contrast, have limited its use to research settings. Magnetic resonance imaging (MRI) is superior to CT, both in the differentiation of malignant from benign pleural disease and in the assessment of chest wall and diaphragmatic involvement. Perfusion and diffusion MRI are promising new techniques for the assessment of tumor cellularity and microvasculature and can be used for quantitative and qualitative assessment of treatment response. Fluorodeoxyglucose positron emission tomography (FDG-PET) is useful for the differentiation of benign from malignant lesions, for staging, and for monitoring response to therapy. PET-CT is superior to other imaging modalities in detecting more extensive disease involvement and identifying unsuspected occult distant metastases. This review focuses on the practical aspects of the radiological assessment of MPM, highlighting the role of the radiologist in preoperative and postoperative evaluation with a multimodality approach. PMID:19822282

  8. In vivo light dosimetry for HPPH-mediated pleural PDT

    NASA Astrophysics Data System (ADS)

    Dimofte, Andreea; Zhu, Timothy C.; Finlay, Jarod C.; Cullighan, Melissa; Edmonds, Christine E.; Friedberg, Joseph S.; Cengel, Keith; Hahn, Stephen M.

    2010-02-01

    This study examines the light fluence (rate) delivered to patients undergoing pleural PDT as a function of treatment time, treatment volume and surface area. The accuracy of treatment delivery is analyzed as a function of the calibration accuracies of each isotropic detector and the calibration integrating sphere. The patients studied here are enrolled in a Phase I clinical trial of HPPH-mediated PDT for the treatment of non-small cell lung cancer with pleural effusion. Patients are administered 4mg per kg body weight HPPH 24-48 hours before the surgery. Patients undergoing photodynamic therapy (PDT) are treated with light therapy with a fluence of 15-60 J/cm2 at 661nm. Fluence rate (mW/cm2) and cumulative fluence (J/cm2) is monitored at 7 different sites during the entire light treatment delivery. Isotropic detectors are used for in-vivo light dosimetry. The anisotropy of each isotropic detector was found to be within 15%. The mean fluence rate delivery and treatment time are recorded. A correlation between the treatment time and the treatment volume is established. The result can be used as a clinical guideline for future pleural PDT treatment.

  9. Coronary CT Angiography in Heavily Calcified Coronary Arteries: Improvement of Coronary Lumen Visualization and Coronary Stenosis Assessment With Image Postprocessing Methods

    PubMed Central

    Sun, Zhonghua; Ng, Curtise K.C.; Xu, Lei; Fan, Zhanming; Lei, Jing

    2015-01-01

    Abstract To compare the diagnostic value of coronary CT angiography (CCTA) with use of 2 image postprocessing methods (CCTA_S) and (CCTA_OS) and original data (CCTA_O) for the assessment of heavily calcified plaques. Fifty patients (41 men, 9 women; mean age 61.9 years ± 9.1) with suspected coronary artery disease who underwent CCTA and invasive coronary angiography (ICA) examinations were included in the study. Image data were postprocessed with “sharpen” and smooth reconstruction algorithms in comparison with the original data without undergoing any image postprocessing to determine the effects on suppressing blooming artifacts due to heavy calcification in the coronary arteries. Minimal lumen diameter and degree of stenosis were measured and compared between CCTA_S, CCTA_OS, and CCTA_O with ICA as the reference method. The area under the curve (AUC) by receiver-operating characteristic curve analysis (ROC) was also compared among these 3 CCTA techniques. On a per-vessel assessment, the sensitivity, specificity, positive predictive value and negative predictive value, and 95% confidence interval (CI) were 100% (95% CI: 89%, 100%), 33% (95% CI: 22%, 45%), 41% (95% CI: 30%, 53%), 100% (95% CI: 85%, 100%) for CCTA_O, 94% (95% CI: 79%, 99%), 66% (95% CI: 54%, 77%), 57% (95% CI: 43%, 70%), and 95% (95% CI: 85%, 99%) for CCTA_S, 94% (95% CI: 79%, 99%), 44% (95% CI: 32%, 57%), 44% (95% CI: 32%, 57%), and 97% (95% CI: 79%, 99%) for CCTA_OS, respectively. The AUC by ROC curve analysis for CCTA_S showed significant improvement for detection of >50% coronary stenosis in left anterior descending coronary artery compared to that of CCTA_OS and CCTA_O methods (P < 0.05), with no significance differences for detection of coronary stenosis in the left circumflex and right coronary arteries (P > 0.05). CCTA with “sharpen” reconstruction reduces blooming artifacts from heavy calcification, thus, leading to significant improvement of specificity and positive predictive value of CCTA in patients with heavily calcified plaques. However, specificity is still moderate and additional functional imaging may be needed. PMID:26632895

  10. Hot tips on hot tips: technical problems with percutaneous insertion of a microwave antenna through rigid tissue.

    PubMed

    Danaher, Luke A; Steinke, Karin

    2013-02-01

    We report an instance of microwave antenna breakage upon insertion through rigid costal cartilage and tip dislodgement during withdrawal of the antenna. Furthermore, we highlight antenna incompatibility with certain coaxial needles. Given the complexity and fragility of microwave antennas, it is not recommended to insert them through rigid tissue such as cartilage or calcified pleural plaques. PMID:23374555

  11. Variation in the pharmacokinetics of gentamicin and tobramycin in patients with pleural effusions and hypoalbuminemia.

    PubMed Central

    Etzel, J V; Nafziger, A N; Bertino, J S

    1992-01-01

    The pharmacokinetic parameters of gentamicin and tobramycin were evaluated and compared for 260 patients with pleural effusions and 1,049 patients without pleural effusions by chest radiograph. Pharmacokinetic data were collected prospectively and analyzed by using our aminoglycoside data base. Univariate analysis revealed that the patients with pleural effusions demonstrated significantly lower serum albumin concentrations, greater aminoglycoside volumes of distribution, longer elimination half-lives, and lower peak and higher trough concentrations in serum than the patients without pleural effusions. Patients with pleural effusions were significantly older and had lower total body weight. Stepwise multiple linear regression analysis revealed that lower total body weight and serum albumin concentration, presence of pleural effusion, and greater age were associated with significantly greater volumes of distribution. Calculated creatinine clearance, age, total body weight, and shock were associated with reduced aminoglycoside clearance in these patients. PMID:1622185

  12. Modified TB rapid test by proteinase K for rapid diagnosis of pleural tuberculosis.

    PubMed

    Yari, Shamsi; Hadizadeh Tasbiti, Alireza; Ghanei, Mostafa; Shokrgozar, Mohammad Ali; Fateh, Abolfazl; Yari, Fatemeh; Bahrmand, Ahmadreza

    2016-03-01

    The diagnosis of pleural tuberculosis continues to be a challenge due to the low sensitivity of traditional diagnostic methods. Better and more rapid tests are needed for diagnosis of pleural TB. In this study, pleural fluids were tested with rapid test to determine Mycobacterium tuberculosis (MTB antigen). Affinity chromatography was used to purify specific polyclonal antibodies against MTB antigen. Pleural samples after decontamination were treated with proteinase K. Rapid test for pleural fluids was prepared by specific antibody. Rapid test was performed on 85 pleural fluid patients. The patients had a mean age of 46.55 15.96 years and 38 were men. The performance of rapid test, using proteinase K, was found to be the most impressive: sensitivity 93%, specificity 94%, PPV 90%, and NPV 96% compared with adenosine deaminase test (ADA), PCR, smear, and culture. The present study did demonstrate that modified TB rapid test can substantially improve the diagnosis of extrapulmonary TB. PMID:26693840

  13. Correlation of hemodynamic forces and atherosclerotic plaque components

    NASA Astrophysics Data System (ADS)

    Canton, Gdr; Chiu, Bernard; Yuan, Chun; Kerwin, William S.

    2010-02-01

    Local hemodynamic forces in atherosclerotic carotid arteries are thought to trigger cellular and molecular mechanisms that determine plaque vulnerability. Magnetic Resonance Imaging (MRI) has emerged as a powerful tool to characterize human carotid atherosclerotic plaque composition and morphology, and to identify plaque features shown to be key determinants of plaque vulnerability. Image-based computational fluid dynamics (CFD) has allowed researchers to obtain time-resolved wall shear stress (WSS) information for atherosclerotic carotid arteries. A deeper understanding of the mechanisms of initiation and progression of atherosclerosis can be obtained through the comparison of WSS and plaque composition. The aim of this study was to explore the hypothesis that intra-plaque hemorrhage, a feature associated with adverse outcomes and plaque progression, is more likely to occur in plaques with elevated WSS levels. We compared 2D representations of the WSS distribution and the amount of intra-plaque hemorrhage to determine relationships between WSS patterns and plaque vulnerability. We extracted WSS data to compare patterns between cases with and without hemorrhage. We found elevated values of WSS at regions where intra-plaque hemorrhage was detected, suggesting that WSS might be used as a marker for the risk of intra-plaque hemorrhage and subsequent complications.

  14. In vivo imaging reveals sigmoidal growth kinetic of ?-amyloid plaques

    PubMed Central

    2014-01-01

    A major neuropathological hallmark of Alzheimers disease is the deposition of amyloid plaques in the brains of affected individuals. Amyloid plaques mainly consist of fibrillar ?-amyloid, which is a cleavage product of the amyloid precursor protein. The amyloid-cascade-hypothesis postulates A? accumulation as the central event in initiating a toxic cascade leading to Alzheimers disease pathology and, ultimately, loss of cognitive function. We studied the kinetics of ?-amyloid deposition in Tg2576 mice, which overexpress human amyloid precursor protein with the Swedish mutation. Utilizing long-term two-photon imaging we were able to observe the entire kinetics of plaque growth in vivo. Essentially, we observed that plaque growth follows a sigmoid-shaped curve comprising a cubic growth phase, followed by saturation. In contrast, plaque density kinetics exhibited an asymptotic progression. Taking into account the fact that a critical concentration of A? is required to seed new plaques, we can propose the following kinetic model of ?-amyloid deposition in vivo. In the early cubic phase, plaque growth is not limited by A? concentration and plaque density increases very fast. During the transition phase, plaque density stabilizes whereas plaque volume increases strongly reflecting a robust growth of the plaques. In the late asymptotic phase, A? peptide production becomes rate-limiting for plaque growth. In conclusion, the present study offers a direct link between in vitro and in vivo studies facilitating the translation of A?-lowering strategies from laboratory models to patients. PMID:24678659

  15. In situ detection of bacteria in calcified biofilms using FISH and CARD-FISH.

    PubMed

    Shiraishi, Fumito; Zippel, Barbara; Neu, Thomas R; Arp, Gernot

    2008-09-01

    Modified protocols of fluorescence in situ hybridization (FISH) and catalyze reporter deposition fluorescence in situ hybridization (CARD-FISH) were developed in order to detect bacteria in situ in calcified stromatolite biofilms. Smooth, well-preserved thin sections of calcified biofilms (approximately 5 microm thin, vertical sectioning of approximately 1 cm deep) were obtained by cryo-sectioning using the adhesive tape-stabilization technique. A modified hybridization buffer was applied during hybridization to prevent calcite dissolution as well as false binding of oligonucleotide probes to the charged mineral surfaces. Particularly, bright and specific CARD-FISH signals allowed the detection of bacteria in intensively calcified biofilms even at low magnification, which is suitable for investigating millimeter- to centimeter-scale vertical distribution patterns of bacteria. PMID:18571259

  16. Elevated glucose in pleural effusion: an early clue to esophageal perforation.

    PubMed

    Almoosa, Khalid F; Wardell, Noel; Javaheri, Shahrokh

    2007-05-01

    Esophageal perforation is a rare cause of pleural effusions that carries with it a high mortality rate if diagnosis is delayed. The chemical characteristics of the pleural effusion include high amylase and low pH levels. However, these variables are nonspecific. We present a case of pleural effusion in a patient with markedly elevated glucose levels from recent cola ingestion as a specific clue to the diagnosis of esophageal perforation. PMID:17494806

  17. Minimal Pleural Effusion in Small Cell Lung Cancer: Proportion, Mechanisms, and Prognostic Effect.

    PubMed

    Ryu, Jeong-Seon; Lim, Jun Hyeok; Lee, Jeong Min; Kim, Woo Chul; Lee, Kyung-Hee; Memon, Azra; Lee, Seul-Ki; Yi, Bo-Rim; Kim, Hyun-Jung; Hwang, Seung-Sik

    2016-02-01

    Purpose To determine the frequency and investigate possible mechanisms and prognostic relevance of minimal (<10-mm thickness) pleural effusion in patients with small cell lung cancer (SCLC). Materials and Methods The single-center retrospective study was approved by the institutional review board of the hospital, and informed consent was waived by the patients. A cohort of 360 consecutive patients diagnosed with SCLC by using histologic analysis was enrolled in this study. Based on the status of pleural effusion on chest computed tomographic (CT) scans at diagnosis, patients were classified into three groups: no pleural effusion, minimal pleural effusion, and malignant pleural effusion. Eighteen variables related to patient, environment, stage, and treatment were included in the final model as potential confounders. Results Minimal pleural effusion was present in 74 patients (20.6%) and malignant pleural effusion in 83 patients (23.0%). Median survival was significantly different in patients with no, minimal, or malignant pleural effusion (median survival, 11.2, 5.93, and 4.83 months, respectively; P < .001, log-rank test). In the fully adjusted final model, patients with minimal pleural effusion had a significantly increased risk of death compared with those with no pleural effusion (adjusted hazard ratio, 1.454 [95% confidence interval: 1.012, 2.090]; P = .001). The prognostic effect was significant in patients with stage I-III disease (adjusted hazard ratio, 2.751 [95% confidence interval: 1.586, 4.773]; P < .001), but it disappeared in stage IV disease. An indirect mechanism representing mediastinal lymphadenopathy was responsible for the accumulation in all but one patient with minimal pleural effusion. Conclusions Minimal pleural effusion is a common clinical finding in staging SCLC. Its presence is associated with worse survival in patients and should be considered when CT scans are interpreted. () RSNA, 2015 Online supplemental material is available for this article. PMID:26323029

  18. Utility of semi-rigid thoracoscopy in undiagnosed exudative pleural effusion

    PubMed Central

    Nattusamy, Loganathan; Madan, Karan; Mohan, Anant; Hadda, Vijay; Jain, Deepali; Madan, Neha Kawatra; Arava, Sudheer; Khilnani, Gopi C; Guleria, Randeep

    2015-01-01

    Background: Semi-rigid thoracoscopy is a safe and efficacious procedure in patients with undiagnosed pleural effusion. Literature on its utility from developing countries is limited. We herein describe our initial experience on the utility of semi-rigid thoracoscopy from a tertiary care teaching and referral center in north India. We also perform a systematic review of studies reporting the utility of semi-rigid thoracoscopy from India. Patients and Methods: The primary objective was to evaluate the diagnostic utility of semi-rigid thoracoscopy in patients with undiagnosed exudative pleural effusion. Semi-rigid thoracoscopy was performed under local anesthesia and conscious sedation in the bronchoscopy suite. Results: A total of 48 patients underwent semi-rigid thoracoscopy between August 2012 and December 2013 for undiagnosed pleural effusion. Mean age was 50.9 14.1 years (range: 1778 years). Pre-procedure clinico-radiological diagnoses were malignant pleural effusion [36 patients (75%)], tuberculosis (TB) [10 (20.83%) patients], and empyema [2 patients (4.17%)]. Patients with empyema underwent the procedure for pleural biopsy, optimal placement of intercostal tube and adhesiolysis. Thoracoscopic pleural biopsy diagnosed pleural malignancy in 30 (62.5%) patients and TB in 2 (4.17%) patients. Fourteen (29.17%) patients were diagnosed with non-specific pleuritis and normal pleura was diagnosed on a pleural biopsy in 2 (4.17%) patients. Overall, a definitive diagnosis of either pleural malignancy or TB was obtained in 32 (66.7%) patients. Combined overall sensitivity, specificity, positive predictive value and negative predictive value of thoracoscopic pleural biopsy for malignant pleural effusion were 96.77%, 100%, 100% and 66.67%, respectively. There was no procedure-related mortality. On performing a systematic review of literature, four studies on semi-rigid thoracoscopy from India were identified. Conclusion: Semi-rigid thoracoscopy is a safe and efficacious procedure in patients with undiagnosed exudative pleural effusions. PMID:25814795

  19. A multi-modal multiphoton investigation of microstructure in the deep zone and calcified cartilage

    PubMed Central

    Mansfield, Jessica C; Peter Winlove, C

    2012-01-01

    Multi-modal multiphoton microscopy was used to investigate tissue microstructure in the zone of calcified cartilage, focussing on the collagen fibre organisation at the tidemark and cement line. Thick, unstained and unfixed sagittal sections were prepared from the equine metacarpophalangeal joint. Second harmonic generation (SHG) provided contrast for collagen, two-photon fluorescence (TPF) for endogenous fluorophores, and coherent anti-Stokes Raman scattering (CARS) allowed the cells to be visualised. The structure of radial and calcified cartilage was found to vary with location across the joint, with the palma regions showing a more ordered parallel arrangement of collagen fibres than the cortical ridge and dorsal regions. These patterns may be associated with regional variations in joint loading. In addition, the cell lacunae had a greater diameter in the dorsal region than in the palmar region. At the cement line some collagen fibres were observed crossing between the calcified cartilage and the subchondral bone. At the tidemark the fibres were parallel and continuous between the radial and calcified cartilage. Beneath early superficial lesions the structure of the tidemark and calcified cartilage was disrupted with discontinuities and gaps in the fibrillar organisation. Cartilage microstructure varies in the deep zones between regions of different loading. The variations in collagen structure observed may be significant to the local mechanical properties of the cartilage and therefore may be important to its mechanical interactions with the subchondral bone. The calcified cartilage is altered even below early superficial lesions and therefore is important in the understanding of the aetiology of osteoarthritis. PMID:22332832

  20. Medical thoracoscopic removal of a metal needle from the pleural space.

    PubMed

    Gupta, Richa; James, Prince; Thangakunam, Balamugesh; Christopher, Devasahayam Jesudas

    2014-01-01

    Medical thoracoscopy is an excellent diagnostic and therapeutic tool for management of pleural diseases. There have been case reports of removal of foreign bodies from pleural spaces with video-assisted thoracoscopic surgery under general anaesthesia by thoracic surgeons. We present a case of successful removal of an 8?cm long metal needle from the pleural space with single port medical semirigid thoracoscopy under local anaesthesia by a chest physician. Removal of a foreign body from the pleural space is one more indication for medical thoracoscopy, however, an experienced chest physician and proper case selection are very important for safety and a successful outcome of this procedure. PMID:25301430

  1. Massive malignant pleural effusion due to lung adenocarcinoma in 13-year-old boy.

    PubMed

    Afghani, Reza; Hajimohammadi, Amir; Azarhoush, Ramin; Kazemi-Nejad, Vahideh; Yari, Behrouz; Rezapour Esfahani, Mona

    2016-05-01

    A 13-year-old boy with no risk factors for lung cancer presented with a massive left-sided pleural effusion and a mediastinal shift on chest radiography and computed tomography. A chest tube drained bloody pleural fluid with an exudative pattern. A pleural biopsy and wedge biopsy of the left lower lobe revealed mucinous adenocarcinoma in the left lower lobe wedge biopsy and metastatic adenocarcinoma in the pleural biopsy. The patient is currently undergoing chemotherapy. Radiotherapy is planned after shrinkage of the tumor. Adenocarcinoma of the lung is very rarely seen in teenagers or children, especially in the absence of risk factors. PMID:26857800

  2. Resolution of pancreatico-pleural fistula with endoscopic ultrasound-guided therapy

    PubMed Central

    Houlihan, M.D.; Bowyer, B.A.; Barclay, R.L.

    2013-01-01

    Pancreatico-pleural fistula is an uncommon cause of recurrent pleural effusion. Delayed diagnosis may occur if fluid amylase level is not obtained early in the clinical course. As most cases of pancreatico-pleural effusion are due to chronic pancreatitis, endoscopic therapy may be effective if pancreatic fluid secretion can be diverted to a more physiologic pathway. However, when severe pancreatitis leads to disconnection of the pancreatic duct, it precludes conventional endoscopic treatment via transpapillary stenting of the pancreatic duct. We describe a patient with a chronic, refractory pancreatico-pleural fistula arising from chronic pancreatitis with a disconnected pancreatic duct syndrome, which resolved following endoscopic ultrasound-guided therapy. PMID:26029626

  3. Rhodotorula mucilaginosa Fungemia and Pleural Tuberculosis in an Immunocompetent Patient: An Uncommon Association.

    PubMed

    Pereira, Cludia; Ribeiro, Sofia; Lopes, Virgnia; Mendona, Teresa

    2016-02-01

    We report an atypical case of Rhodotorula mucilaginosa fungemia coexisting with pleural tuberculosis, in an immunocompetent host. The patient was an inhaled drug abuser and worked in a fruit market. The diagnosis of Rhodotorula mucilaginosa infection was established by the isolation of the yeast in two blood cultures followed by a good response to amphotericin B treatment. Persistent evening fever and pleural effusion led to the second diagnosis-pleural tuberculosis. In the last 5years, this was the only case of Rhodotorula mucilaginosa fungemia in our hospital and the first case in the literature that documents Rhodotorula mucilaginosa fungemia associated with pleural tuberculosis. PMID:26369644

  4. The Hoover (vacuum cleaner) technique for calcifying tendonitis deposits excision and removal of the calcific debris

    PubMed Central

    Ehud, Atoun; Ehud, Rath; Alexander, Van Tongel; Ali, Narvani; Giusseppe, Sforza; Ofer, Levy

    2012-01-01

    A new technical tip for the improvement of the arthroscopic treatment of symptomatic calcifying tendinitis is described. Arthroscopic excision of calcifying tendonitis may result with multiple minute calcific debris in the subacromial bursa, causing severe post operative pain due to chemical irritation of the bursa. We suggest the use of a bladeless shaver barrel as a Hoover (vacuum cleaner) for arthroscopic clearance of these miniature calcific debris from the subacromial space after resection of the major deposits. The use of this technique resulted in good clinical outcome with improved post operative pain. PMID:23204765

  5. Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treating de novo, severely calcified lesions.

    PubMed

    Chambers, Jeffrey W; Diage, Tiffini

    2014-09-01

    Coronary lesions with severe (or heavy) calcification are classified as complex lesions and are known to carry lower success rates and higher complication rates following percutaneous coronary intervention. The Diamondback 360() Coronary Orbital Atherectomy System is the first and only device approved for use in the USA as a treatment for severely calcified coronary lesions to facilitate stent delivery and optimal deployment. Availability of this device provides a safe and effective option for physicians to improve treatment outcomes in this patient population with severely calcified coronary lesions. PMID:24961517

  6. Disappearing large calcified thoracic disc herniation in a patient with thalassaemia.

    PubMed

    Ahmad, Faiz U; Schallert, Erica; Bregy, Amade; Post, Judith D; Vanni, Steven

    2016-01-01

    Regression of herniated disc fragments with subsequent improvement in clinical symptoms has been reported in the lumbar and cervical spine. Such regressions in the thoracic spine are extremely rare. We report a case of a 38-year-old patient with thalassaemia who had regression of a large calcified herniated thoracic disc causing cord compression, with subsequent herniation of a second calcified disc at a different level and discuss the possible aetiopathogenesis. This is the first such case reported in the thalassaemia population. PMID:26823353

  7. The "Hoover" (vacuum cleaner) technique for calcifying tendonitis deposits excision and removal of the calcific debris.

    PubMed

    Ehud, Atoun; Ehud, Rath; Alexander, Van Tongel; Ali, Narvani; Giusseppe, Sforza; Ofer, Levy

    2012-07-01

    A new technical tip for the improvement of the arthroscopic treatment of symptomatic calcifying tendinitis is described. Arthroscopic excision of calcifying tendonitis may result with multiple minute calcific debris in the subacromial bursa, causing severe post operative pain due to chemical irritation of the bursa. We suggest the use of a bladeless shaver barrel as a "Hoover" (vacuum cleaner) for arthroscopic clearance of these miniature calcific debris from the subacromial space after resection of the major deposits. The use of this technique resulted in good clinical outcome with improved post operative pain. PMID:23204765

  8. Atherosclerotic plaque characterization by spatial and temporal speckle pattern analysis

    NASA Astrophysics Data System (ADS)

    Tearney, Guillermo J.; Bouma, Brett E.

    2002-04-01

    Improved methods are needed to identify the vulnerable coronary plaques responsible for acute myocardial infraction or sudden cardiac death. We describe a method for characterizing the structure and biomechanical properties of atherosclerotic plaques based on speckle pattern fluctuations. Near-field speckle images were acquired from five human aortic specimens ex vivo. The speckle decorrelation time constant varied significantly for vulnerable aortic plaques (? = 40 ms) versus stable plaques (? = 400 ms) and normal aorta (? = 500 ms). These initial results indicate that different atherosclerotic plaque types may be distinguished by analysis of temporal and spatial speckle pattern fluctuations.

  9. Computed tomography imaging of coronary artery plaque: characterization and prognosis.

    PubMed

    Baumann, Stefan; Renker, Matthias; Meinel, Felix G; Wichmann, Julian L; Fuller, Stephen R; Bayer, Richard R; Schoepf, U Joseph; Steinberg, Daniel H

    2015-03-01

    The exact definition and prognostication of vulnerable plaque remain elusive, and multiple imaging modalities aim to identify these plaques. As a noninvasive technique for the diagnosis of coronary artery disease, coronary computed tomography angiography has become increasingly utilized, primarily in patients with an elevated cardiovascular risk profile. Recent advances in technical methods have allowed for improved visualization of the vessel wall and surrounding tissue, allowing for improved characterization of vulnerable plaques by identifying features such as low-density plaques, positive remodeling, and spotty calcification. Quantification and qualification of these plaques may enhance the ability to predict future cardiovascular events. PMID:25726996

  10. A direct vulnerable atherosclerotic plaque elasticity reconstruction method based on an original material-finite element formulation: theoretical framework

    PubMed Central

    Bouvier, Adeline; Deleaval, Flavien; Doyley, Marvin M; Yazdani, Saami K; Finet, Grard; Le Floc'h, Simon; Cloutier, Guy; Pettigrew, Roderic I; Ohayon, Jacques

    2016-01-01

    The peak cap stress (PCS) amplitude is recognized as a biomechanical predictor of vulnerable plaque (VP) rupture. However, quantifying PCS in vivo remains a challenge since the stress depends on the plaque mechanical properties. In response, an iterative material finite element (FE) elasticity reconstruction method using strain measurements has been implemented for the solution of these inverse problems. Although this approach could resolve the mechanical characterization of VPs, it suffers from major limitations since (i) it is not adapted to characterize VPs exhibiting high material discontinuities between inclusions, and (ii) does not permit real time elasticity reconstruction for clinical use. The present theoretical study was therefore designed to develop a direct material-FE algorithm for elasticity reconstruction problems which accounts for material heterogeneities. We originally modified and adapted the extended FE method (Xfem), used mainly in crack analysis, to model material heterogeneities. This new algorithm was successfully applied to six coronary lesions of patients imaged in vivo with intravascular ultrasound. The results demonstrated that the mean relative absolute errors of the reconstructed Young's moduli obtained for the arterial wall, fibrosis, necrotic core, and calcified regions of the VPs decreased from 95.315.56%, 98.8572.42%, 103.29111.86% and 95.310.49%, respectively, to values smaller than 2.6 10?85.7 10?8% (i.e. close to the exact solutions) when including modified-Xfem method into our direct elasticity reconstruction method. PMID:24240392

  11. A direct vulnerable atherosclerotic plaque elasticity reconstruction method based on an original material-finite element formulation: theoretical framework

    NASA Astrophysics Data System (ADS)

    Bouvier, Adeline; Deleaval, Flavien; Doyley, Marvin M.; Yazdani, Saami K.; Finet, Grard; Le Floc'h, Simon; Cloutier, Guy; Pettigrew, Roderic I.; Ohayon, Jacques

    2013-12-01

    The peak cap stress (PCS) amplitude is recognized as a biomechanical predictor of vulnerable plaque (VP) rupture. However, quantifying PCS in vivo remains a challenge since the stress depends on the plaque mechanical properties. In response, an iterative material finite element (FE) elasticity reconstruction method using strain measurements has been implemented for the solution of these inverse problems. Although this approach could resolve the mechanical characterization of VPs, it suffers from major limitations since (i) it is not adapted to characterize VPs exhibiting high material discontinuities between inclusions, and (ii) does not permit real time elasticity reconstruction for clinical use. The present theoretical study was therefore designed to develop a direct material-FE algorithm for elasticity reconstruction problems which accounts for material heterogeneities. We originally modified and adapted the extended FE method (Xfem), used mainly in crack analysis, to model material heterogeneities. This new algorithm was successfully applied to six coronary lesions of patients imaged in vivo with intravascular ultrasound. The results demonstrated that the mean relative absolute errors of the reconstructed Young's moduli obtained for the arterial wall, fibrosis, necrotic core, and calcified regions of the VPs decreased from 95.315.56%, 98.8572.42%, 103.29111.86% and 95.310.49%, respectively, to values smaller than 2.6 10-85.7 10-8% (i.e. close to the exact solutions) when including modified-Xfem method into our direct elasticity reconstruction method.

  12. Animal models for plaque rupture: a biomechanical assessment.

    PubMed

    van der Heiden, Kim; Hoogendoorn, Ayla; Daemen, Mat J; Gijsen, Frank J H

    2016-02-29

    Rupture of atherosclerotic plaques is the main cause of acute cardiovascular events. Animal models of plaque rupture are rare but essential for testing new imaging modalities to enable diagnosis of the patient at risk. Moreover, they enable the design of new treatment strategies to prevent plaque rupture. Several animal models for the study of atherosclerosis are available. Plaque rupture in these models only occurs following severe surgical or pharmaceutical intervention. In the process of plaque rupture, composition, biology and mechanics each play a role, but the latter has been disregarded in many animal studies. The biomechanical environment for atherosclerotic plaques is comprised of two parts, the pressure-induced stress distribution, mainly - but not exclusively - influenced by plaque composition, and the strength distribution throughout the plaque, largely determined by the inflammatory state. This environment differs considerably between humans and most animals, resulting in suboptimal conditions for plaque rupture. In this review we describe the role of the biomechanical environment in plaque rupture and assess this environment in animal models that present with plaque rupture. PMID:26607378

  13. Calcium transport in strongly calcifying laying birds: mechanisms and regulation.

    PubMed

    Bar, Arie

    2009-04-01

    Birds that lay long clutches (series of eggs laid sequentially before a "pause day"), among them the high-producing, strongly-calcifying Gallus gallus domesticus (domestic hen) and Coturnix coturnix japonica (Japanese quail), transfer about 10% of their total body calcium daily. They appear, therefore, to be the most efficient calcium-transporters among vertebrates. Such intensive transport imposes severe demands on ionic calcium (Ca2+) homeostasis, and activates at least two extremely effective mechanisms for Ca2+ transfer from food and bone to the eggshell. This review focuses on the development, action and regulation of the mechanisms associated with paracellular and transcellular Ca2+ transport in the intestine and the eggshell gland (ESG); it also considers some of the proteins (calbindin, Ca2+ATPase, Na+/Ca2+ exchange, epithelial calcium channels (TRPVs), osteopontin and carbonic anhydrase (CA) associated with this phenomenon. Calbindins are discussed in some detail, as they appear to be a major component of the transcellular transport system, and as only they have been studied extensively in birds. The review aims to gather old and new knowledge, which could form a conceptual basis, albeit not a completely accepted one, for our understanding of the mechanisms associated with this phenomenon. In the intestine, the transcellular pathway appears to compensate for low Ca2+ intake, but in birds fed adequate calcium the major drive for calcium absorption remains the electrochemical potential difference (ECPD) that facilitates paracellular transport. However, the mechanisms involved in Ca2+ transport into the ESG lumen are not yet established. In the ESG, the presence of Ca2+-ATPase and calbindin--two components of the transcellular transport pathway--and the apparently uphill transport of Ca2+ support the idea that Ca2+ is transported via the transcellular pathway. However, the positive (plasma with respect to mucosa) electrical potential difference (EPD) in the ESG, among other findings, indicates that there may be major alternative or complementary paracellular passive transport pathways. The available evidence hints that the flow from the gut to the ESG, which occurs during a relatively short period (11 to 14 h out the 24- to 25.5-h egg cycle), is primarily driven by carbonic anhydrase (CA) activity in the ESG, which results in high HCO3(-) content that, in turn, "sucks out" Ca2+ from the intestinal lumen via the blood and ESG cells, and deposits it in the shell crystals. The increased CA activity appears to be dependent on energy input, whereas it seems most likely that the Ca2+ movement is secondary, that it utilizes passive paracellular routes that fluctuate in accordance with the appearance of the energy-dependent CA activity, and that the level of Ca2+ movement mimics that of the CA activity. The on-off signals for the overall phenomenon have not yet been identified. They appear to be associated with the circadian cycle of gonadal hormones, coupled with the egg cycle: it is most likely that progesterone acts as the "off" signal, and that the "on" signal is provided by the combined effect of an as-yet undefined endocrine factor associated with ovulation and with the mechanical strain that results from "egg white" formation and "plumping". This strain may initially trigger the formation of the mammillae and the seeding of shell calcium crystals in the isthmus, and thereafter initiate the formation of the shell in the ESG. PMID:19118637

  14. Plaque Production by Arboviruses in Singh's Aedes albopictus Cells

    PubMed Central

    Yunker, C. E.; Cory, J.

    1975-01-01

    We report plaquing tests of 124 virus strains, mostly arboviruses of 21 serological groups, in Singh's line of Aedes albopictus cells. Thirty of these plaqued; all were arboviruses of six groups and were known or presumed to be mosquito borne. Failing to plaque were 86 strains of arboviruses, mostly tick borne, two strains of insect pathogens, and six animal viruses not classified as arboviruses. Among mosquito-borne agents, plaquing ability appeared related to serological classification. California group and most A-group viruses failed to plaque, but nearly all members of B and Bunyamwera groups readily plaqued. Within serological group B, 14 of 16 mosquito-borne agents plaqued, but none of 13 tick-borne or vector-unassociated viruses did so. Some implications of these results for recognition and classification of arboviruses are discussed. Images PMID:234160

  15. Enucleation versus plaque irradiation for choroidal melanoma

    SciTech Connect

    Straatsma, B.R.; Fine, S.L.; Earle, J.D.; Hawkins, B.S.; Diener-West, M.; McLaughlin, J.A.

    1988-07-01

    The Collaborative Ocular Melanoma Study (COMS) is an international, multicenter-controlled study. The organization includes an Executive Committee, Steering Committee, 6 Central Units, 32 Clinical Centers, and a Data and Safety Monitoring Committee. Scientifically, the COMS consists of (1) a randomized trial of patients with medium choroidal melanoma treated with enucleation versus iodine-125 plaque irradiation, (2) a randomized trial of patients with large choroidal melanoma treated with enucleation versus preenucleation external beam irradiation and enucleation, and (3) a prospective observational study of patients with small choroidal melanoma to determine whether a randomized trial of treatment is appropriate. In design and conduct of the COMS, special consideration is given to biostatistics and sample size considerations, iodine-125 plaque irradiation of choroidal melanoma, and coordinated ocular melanoma research. Recruitment is in progress. However, the pool of eligible patients is limited and the COMS needs the continued support and cooperation of ophthalmologists throughout the United States and Canada.

  16. Choroidal melanoma: I-125 plaque therapy

    SciTech Connect

    Bosworth, J.L.; Packer, S.; Rotman, M.; Ho, T.; Finger, P.T.

    1988-10-01

    An iodine-125 eye plaque was used to treat 58 patients with choroidal melanoma. Patients were followed up for a mean of 48.7 months. Fifty patients had medium-sized lesions (height between 3.1 and 8.0 mm and base diameter less than 16.0 mm), and six patients had large lesions. There were 24 lesions less than 3.0 mm from the optic nerve. The average radiation dose to the apex of the tumor was 8,468 cGy (dose rate, 71 cGy per hour). Initial local disease control was achieved in 50 patients (86.2%). One patient with local treatment failure received another plaque treatment, which controlled disease, so the total disease control rate was 87.9%. Only eight patients died of their disease. Complications were similar to those with other treatment methods, but none of the patients in this study developed optic nerve atrophy.

  17. Macrophage iron, hepcidin, and atherosclerotic plaque stability.

    PubMed

    Sullivan, Jerome L

    2007-09-01

    Hepcidin has emerged as the key hormone in the regulation of iron balance and recycling. Elevated levels increase iron in macrophages and inhibit gastrointestinal iron uptake. The physiology of hepcidin suggests an additional mechanism by which iron depletion could protect against atherosclerotic lesion progression. Without hepcidin, macrophages retain less iron. Very low hepcidin levels occur in iron deficiency anemia and also in homozygous hemochromatosis. There is defective retention of iron in macrophages in hemochromatosis and also evidently no increase in atherosclerosis in this disorder. In normal subjects with intact hepcidin responses, atherosclerotic plaque has been reported to have roughly an order of magnitude higher iron concentration than that in healthy arterial wall. Hepcidin may promote plaque destabilization by preventing iron mobilization from macrophages within atherosclerotic lesions; the absence of this mobilization may result in increased cellular iron loads, lipid peroxidation, and progression to foam cells. Marked downregulation of hepcidin (e.g., by induction of iron deficiency anemia) could accelerate iron loss from intralesional macrophages. It is proposed that the minimally proatherogenic level of hepcidin is near the low levels associated with iron deficiency anemia or homozygous hemochromatosis. Induced iron deficiency anemia intensely mobilizes macrophage iron throughout the body to support erythropoiesis. Macrophage iron in the interior of atherosclerotic plaques is not exempt from this process. Decreases in both intralesional iron and lesion size by systemic iron reduction have been shown in animal studies. It remains to be confirmed in humans that a period of systemic iron depletion can decrease lesion size and increase lesion stability as demonstrated in animal studies. The proposed effects of hepcidin and iron in plaque progression offer an explanation of the paradox of no increase in atherosclerosis in patients with hemochromatosis despite a key role of iron in atherogenesis in normal subjects. PMID:17720947

  18. Retroperitoneal liposarcoma associated with small plaque parapsoriasis

    PubMed Central

    Tartaglia, Francesco; Blasi, Sara; Sgueglia, Monica; Polichetti, Paolo; Tromba, Luciana; Berni, Alberto

    2007-01-01

    Background Extremely rare cases of paraneoplastic syndromes or ectopic production of proteins associated with liposarcoma are reported in literature. Production of Granulocyte-Colony Stimulating Factor, alpha-fetoprotein, paraneoplastic pemphigus and leucocytosis, Acrokeratosis paraneoplastica (Bazex's syndrome) are reported. The present report describes a case of retroperitoneal liposarcoma associated with small plaque parapsoriasis. Our search in the English literature of such a kind of association did not reveal any case reported. Case presentation A 74 year male patient was admitted to our hospital because of the presence of an abdominal mass in right iliac fossa. He also complained of a two-year history of psoriasiform eruptions. The CT scan showed a retroperitoneal pelvic mass. Therefore surgical resection of the tumor was performed. After surgery, the skin eruptions disappeared completely in seven days and so a diagnosis of parapsoriasis syndrome was done. Conclusion Parallel disappearing of skin eruptions after surgery, typical clinical picture and not specific histology of the cutaneous lesions suggest the diagnosis of small plaque parapsoriasis. Therefore we propose to add Small Plaque Parapsoriasis to the list of paraneoplastic syndromes associated to liposarcoma. PMID:17620118

  19. Angiogenesis in human coronary atherosclerotic plaques.

    PubMed Central

    O'Brien, E. R.; Garvin, M. R.; Dev, R.; Stewart, D. K.; Hinohara, T.; Simpson, J. B.; Schwartz, S. M.

    1994-01-01

    Neovascularization in the walls of coronary arteries is associated with the presence of atherosclerotic plaque. The mechanisms responsible for the formation of these intraplaque microvessels are not understood. The purpose of this study is to examine the prevalence of endothelial cell replication in plaque microvessels. Two hundred and one primary and restenotic coronary atherectomy specimens were analyzed for the presence of microvessels and proliferation as reflected by positive immunolabeling for Ulex agglutinin and the proliferating cell nuclear antigen, respectively. In primary but not restenotic specimens, proliferation of any cell type was associated with the detection of microvessels on the same slide. However, intraplaque microvessels were more commonly found in restenotic compared to primary specimens (P = 0.004). Twelve highly vascularized specimens with evidence of replication were subjected to detailed histomorphological and quantitative image analyses. At 200 x, the most vascular optical field of each slide was identified and consistently included plaque macrophages. Total slide endothelial cell replication indices for these specimens varied, but in some instances were remarkably elevated (eg, 43.5%). The role of intraplaque angiogenesis may be analogous to that of tumor or wound angiogenesis and be important in development and progression of coronary artery lesions and restenosis. Images Figure 4 Figure 5 PMID:7524331

  20. Cataractogenesis after Cobalt-60 eye plaque radiotherapy

    SciTech Connect

    Kleineidam, M.; Augsburger, J.J. ); Hernandez, C.; Glennon, P.; Brady, L.W. )

    1993-07-15

    This study was designed to estimate the actuarial incidence of typical postirradiation cataracts and to identify prognostic factors related to their development in melanoma-containing eyes treated by Cobalt-60 plaque radiotherapy. A special interest was the impact of calculated radiation dose and dose-rate to the lens. The authors evaluated the actuarial occurrence of post-irradiation cataract in 365 patients with primary posterior uveal melanoma treated by Cobalt-60 plaque radiotherapy between 1976 and 1986. Only 22% (S.E. = 4.6%) of the patients who received a total dose of 6 to 20 Gy at the center of the lens developed a visually significant cataract attributable to the radiation within 5 years after treatment. Using multivariate Cox proportional hazards modeling, the authors identified thickness of the tumor, location of the tumor's anterior margin relative to the equatorward and the ora serrata, and diameter of the eye plaque used as the best combination of covariables for predicting length of time until development of cataract. Surprisingly, the dose of radiation delivered to the lens, which was strongly correlated to all of these covariables, was not a significant predictive factor in multivariate analysis. The results suggest that success of efforts to decrease the occurrence rate of post-irradiation cataracts by better treatment planning might be limited in patients with posterior uveal melanoma. 21 refs., 2 figs., 5 tabs.

  1. True ablation of atheromatous plaques with laser energy. A phase I safety study.

    PubMed Central

    Reilly, M K; Perry, M O; Nanney, L B

    1991-01-01

    A laser system coupling pulsed dye laser to a 2-mm fiberoptic catheter with incorporated angioscope has been developed for recanalization of occluded arteries. Nine patients with superficial femoral artery occlusions of 4.5 to 49 cm in length were operated on and the recanalized artery harvested for pathologic examination. There were two arterial perforations. The ease of recanalization was determined by plaque composition. Heavily calcified and yellow fibro-fatty lesions were rapidly removed. Smooth white fibrous lesions resisted laser ablation. Direct angioscopy often disclosed discontinuous areas of occlusion that were more susceptible to recanalization. These were not seen on preoperative arteriograms. Microscopic examination of the specimens showed a central core of ablation. There was no evidence of acute damage to the vessel wall, with intact internal elastic lamina demonstrated in the recanalized segments. It appears that fibrous lesions will require a different laser for ablation; however, the delivery/angioscope systems function satisfactorily. Images Fig. 1. Fig. 2. Fig. 3. PMID:2025064

  2. Positive Vascular Remodeling in Culprit Coronary Lesion is Associated With Plaque Composition: An Intravascular Ultrasound-Virtual Histology Study

    PubMed Central

    Lee, Chung Seop; Seo, Young Hoon; Yang, Dong Ju; Kim, Ki Hong; Park, Hyun Woong; Yuk, Hyung Bin; Lee, Moo-Sik; Kim, Wan-Ho; Kwon, Taek-Geun

    2012-01-01

    Background and Objectives The relationship between the positive remodeling (PR) of a coronary artery and plaque composition has been studied only in a relatively small number of study population or non-culprit lesion. We evaluated the association between coronary plaque composition and coronary artery remodeling in a relatively large number of culprit lesions. Subjects and Methods The study population consisted of 325 consecutive patients with coronary artery disease that underwent intravascular ultrasound-virtual histology examination in a culprit lesion. The remodeling index (RI) was calculated as the lesion external elastic membrane (EEM) area divided by the average reference EEM area. Results The lesions with PR (RI>1.05, n=97, mean RI=1.190.12) had a higher fibrous volume/lesion length (3.852.12 mm3/mm vs. 3.041.79 mm3/mm, p=0.003) and necrotic core volume/lesion length (1.260.89 mm3/mm vs. 0.900.66 mm3/mm, p=0.001) than those with negative remodeling (NR) (RI<0.95, n=132, mean RI=0.820.09). At the minimal luminal area site, the lesions with PR had a higher fibrous area (5.813.17 mm2 vs. 3.612.30 mm2, p<0.001), dense calcified area (0.730.69 mm2 vs. 0.460.43 mm2, p=0.001), and necrotic core area (1.931.33 mm2 vs. 1.060.91 mm2, p<0.001) than those with NR. RI showed significant positive correlation with fibrous volume/lesion length (r=0.173, p=0.002), necrotic core volume/lesion length (r=0.188, p=0.001), fibrous area (r=0.347, p<0.001), fibrofatty area (r=0.111, p=0.036), dense calcified area (r=0.239, p<0.001), and necrotic core area (r=0.334, p<0.001). Multivariate analysis showed that the independent factor for PR was the necrotic core volume/lesion length (beta=0.130, 95% confidence interval; 0.002-0.056, p=0.037) over the entire lesion. Conclusion This study suggests that PR in a culprit lesion is associated with the necrotic core volume in the entire lesion, which is a characteristic of vulnerable plaque. PMID:23236326

  3. Comparison of pleural responses of rats and hamsters to subchronic inhalation of refractory ceramic fibers.

    PubMed

    Everitt, J I; Gelzleichter, T R; Bermudez, E; Mangum, J B; Wong, B A; Janszen, D B; Moss, O R

    1997-09-01

    In the present subchronic study, we compared pleural inflammation, visceral pleural collagen deposition, and visceral and parietal pleural mesothelial cell proliferation in rats and hamsters identically exposed to a kaolin-based refractory ceramic fiber, (RCF)-1 by nose-only inhalation exposure, and correlated the results to translocation of fibers to the pleural cavity. Fischer 344 rats and Syrian golden hamsters were exposed to 650 fibers/cc of RCF-1, for 4 hr/day, 5 days/week for 12 weeks. Following 4 and 12 weeks of exposure, and after a 12-week recovery period, pleural lavage fluid was analyzed for cytologic and biochemical evidence of inflammation. Visceral and parietal pleural mesothelial cell proliferation was assessed by immunocytochemical detection of bromodeoxyuridine incorporation. Pleural collagen was quantitated using morphometric analysis of lung sections stained with Sirius Red. Fiber-exposed rats and hamsters had qualitatively similar pleural inflammation at each time point. Mesothelial cell proliferation was more pronounced in hamsters than in rats at each time point and at each site. In both species, the mesothelial cell labeling index was highest in the parietal pleural mesothelial cells lining the surface of the diaphragm at each time point. Hamsters but not rats had significantly elevated collagen in the visceral pleura at the 12-week postexposure time point. Fibers were found in the pleural cavities of both species at each time point. These fibers were generally short and thin. These results suggest that mesothelial cell proliferation and fibroproliferative changes in the pleura of rodents following short-term inhalation exposure are associated with fiber translocation to the pleura and may be predictive of chronic pleural disease outcomes following long-term exposure. PMID:9400725

  4. Intravascular probe for detection of vulnerable plaque

    NASA Astrophysics Data System (ADS)

    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, acute myocardial infarction, and sudden cardiac death.

  5. Effects of seawater pCO2 changes on the calcifying fluid of scleractinian corals

    NASA Astrophysics Data System (ADS)

    Hohn, S.; Merico, A.

    2012-03-01

    Rising atmospheric CO2 concentrations due to anthropogenic emissions induce changes in the ocean carbonate chemistry and a drop in ocean pH. This acidification process is expected to harm calcifying organisms like coccolithophores, molluscs, echinoderms, and corals. A severe decline in coral abundance is, for example, expected by the end of this century with associated disastrous effects on reef ecosystems. Despite the growing importance of the topic, little progress has been made with respect to modelling the impact of acidification on coral calcification. Here we present a model for a coral polyp that simulates the carbonate system in four different compartments: the seawater, the polyp tissue, the coelenteron, and the calicoblastic layer. Precipitation of calcium carbonate takes place in the metabolically controlled calicoblastic layer beneath the polyp tissue. The model is adjusted to a state of activity as observed by direct microsensor measurements in the calcifying fluid. Simulated CO2 perturbation experiments reveal decreasing calcification rates under elevated pCO2 despite strong metabolic control of the calcifying fluid. Diffusion of CO2 through the tissue into the calicoblastic layer increases with increasing seawater pCO2 leading to decreased aragonite saturation in the calcifying fluid of the coral polyp. Our modelling study provides important insights into the complexity of the calcification process at the organism level and helps to quantify the effect of ocean acidification on corals.

  6. Perilesional brain edema and seizure activity in patients with calcified neurocysticercosis

    PubMed Central

    Nash, Theodore E.; Pretell, E. Javier; Lescano, Andres. G.; Bustos, Javier A.; Gilman, Robert H.; Gonzalez, Armando E.; Garcia, Hctor H.

    2013-01-01

    Background Cysticercosis due to Taenia solium is a leading cause of adult acquired seizures and epilepsy that frequently occurs in patients with only calcified larval cysts. Transient episodes of perilesional brain edema occur around calcified foci but its importance, association with seizures, incidence, and pathophysiology are unknown. Methods One hundred and ten persons with only calcified lesions and a history of seizures or severe headaches were followed prospectively in a cohort design to assess the incidence of seizure relapses. In a nested case-control sub study, perilesional edema was assessed by MRI at the time a seizure occurred in the symptomatic patient and in a matched asymptomatic control, amongst the 110 followed. Results Median follow up was 32.33 months (SD 19.99). Twenty-nine people had an incident seizure with an estimated 5 year seizure incidence of 36%. Twenty-four patients of the 29 with seizure relapse had an MRI evaluation within five days of the event. Perilesional edema was found in 12 (50.0%) compared to 2 of 23 asymptomatic matched controls (8.7%). Conclusions Perilesional edema occurs frequently and is associated with episodic seizure activity in calcified neurocysticercosis. Our findings are likely representative of symptomatic patients in endemic regions and suggest a unique and possibly preventable cause of seizures in this population. PMID:18986841

  7. Ultrastructural characteristics of ostrich eggshell: outer shell membrane and the calcified layers.

    PubMed

    Richards, P D; Richards, P A; Lee, M E

    2000-06-01

    The ultrastructure of the eggshell of the domestic hen has been well researched and structural studies of other avian species, such as the ostrich, often base their interpretation of egg shell structure on that of the chicken. In the ostrich, lowered hatchability and hatching trauma may be due to shell ultrastructural abnormalities. In the present study the ultrastructure of the calcified portion, and the outer shell membrane (OSM), of domesticated ostrich eggshells was investigated using standard electron microscopic techniques. Transmission and scanning electron microscopy studies demonstrated intimate contact between cup-shaped structures present on the OSM and the mammillary layer of the calcified portion of the shell. The initial calcium carbonate growth of the calcified shell was of a dendritic nature with nucleation sites on the surface of the cup's contents. The dendritic growth gave way to a more randomly-orientated, smaller crystallite growth structure, which changed in form as it neared the vertical crystal layer (VCL). The VCL is described as being both amorphous and 'crumbly' depending on the plane of fracture. These observations suggest that firstly, initial calcification is contained within the cups and is then directed outwards to form the shell and that secondly, the VCL may contain an evolutionary, calcified cuticular layer. These observations serve as a baseline for studies investigating the effect of shell structure and strength on hatchling trauma and the influence of maternal diet. PMID:11030359

  8. Calcified neurocysticercosis associates with hippocampal atrophy: a population-based study.

    PubMed

    Del Brutto, Oscar H; Salgado, Perla; Lama, Julio; Del Brutto, Victor J; Campos, Xavier; Zambrano, Mauricio; Garca, Hctor H

    2015-01-01

    Calcified neurocysticercosis has been associated with hippocampal atrophy in patients with refractory epilepsy, but the relevance of this association in the population at large is unknown. We assessed calcified cysticerci and its association with hippocampal atrophy in elderly persons living in Atahualpa, an Ecuadorian village endemic for neurocysticercosis. All Atahualpa residents ? 60 years of age were invited to undergo computed tomography/magnetic resonance imaging for neurocysticercosis detection. Twenty-eight (11%) out of 248 enrolled persons had calcified cysticerci (case-patients) and were matched 1:1 by age, sex, and years of education to individuals without neurocysticercosis on computed tomography/magnetic resonance imaging (controls). Four case-patients and none of the controls had epilepsy (P = 0.134). Cognitive performance was similar across both groups. The Scheltens' medial temporal atrophy scale was used for hippocampal rating in case-patients and matched controls without neurocysticercosis. Mean score in the Scheltens' scale was higher in case-patients than in controls (P < 0.001). Atrophic hippocampi were noticed in 19 case-patients and five controls (P = 0.003). Atrophy was bilateral in 11 case-patients and unilateral in eight. All case-patients with unilateral hippocampal atrophy had at least one ipsilateral calcification. This study shows an association between calcified cysticerci and hippocampal atrophy and raises the possibility of an inflammation-mediated hippocampal damage as the responsible mechanism for these findings. PMID:25349375

  9. MULTIPLE CALCIFIED RIGHT ATRIAL MYXOMAS ASSOCIATED WITH TRICUSPID INSUFFICIENCY IN A CHILD

    PubMed Central

    Martinez, Manuel Jimenez; Franco, Eliud Hernandez; Avalos, Luis Lasso; Perez, Alejandro Martinez

    1979-01-01

    Multiple calcified myxomas of the right atrium were discovered in a 12-year-old girl and were associated with a dysplastic tricuspid valve that was grossly insufficient. Surgical resection of three pedunculated masses was performed, and the tricuspid valve was replaced with a biologic prosthesis. Images PMID:15216310

  10. Long-Term Trends in Calcifying Plankton and pH in the North Sea

    PubMed Central

    Beare, Doug; McQuatters-Gollop, Abigail; van der Hammen, Tessa; Machiels, Marcel; Teoh, Shwu Jiau; Hall-Spencer, Jason M.

    2013-01-01

    Relationships between six calcifying plankton groups and pH are explored in a highly biologically productive and data-rich area of the central North Sea using time-series datasets. The long-term trends show that abundances of foraminiferans, coccolithophores, and echinoderm larvae have risen over the last few decades while the abundances of bivalves and pteropods have declined. Despite good coverage of pH data for the study area there is uncertainty over the quality of this historical dataset; pH appears to have been declining since the mid 1990s but there was no statistical connection between the abundance of the calcifying plankton and the pH trends. If there are any effects of pH on calcifying plankton in the North Sea they appear to be masked by the combined effects of other climatic (e.g. temperature), chemical (nutrient concentrations) and biotic (predation) drivers. Certain calcified plankton have proliferated in the central North Sea, and are tolerant of changes in pH that have occurred since the 1950s but bivalve larvae and pteropods have declined. An improved monitoring programme is required as ocean acidification may be occurring at a rate that will exceed the environmental niches of numerous planktonic taxa, testing their capacities for acclimation and genetic adaptation. PMID:23658686

  11. Calcified Neurocysticercosis Associates with Hippocampal Atrophy: A Population-Based Study

    PubMed Central

    Del Brutto, Oscar H.; Salgado, Perla; Lama, Julio; Del Brutto, Victor J.; Campos, Xavier; Zambrano, Mauricio; García, Héctor H.

    2015-01-01

    Calcified neurocysticercosis has been associated with hippocampal atrophy in patients with refractory epilepsy, but the relevance of this association in the population at large is unknown. We assessed calcified cysticerci and its association with hippocampal atrophy in elderly persons living in Atahualpa, an Ecuadorian village endemic for neurocysticercosis. All Atahualpa residents ≥ 60 years of age were invited to undergo computed tomography/magnetic resonance imaging for neurocysticercosis detection. Twenty-eight (11%) out of 248 enrolled persons had calcified cysticerci (case-patients) and were matched 1:1 by age, sex, and years of education to individuals without neurocysticercosis on computed tomography/magnetic resonance imaging (controls). Four case-patients and none of the controls had epilepsy (P = 0.134). Cognitive performance was similar across both groups. The Scheltens' medial temporal atrophy scale was used for hippocampal rating in case-patients and matched controls without neurocysticercosis. Mean score in the Scheltens' scale was higher in case-patients than in controls (P < 0.001). Atrophic hippocampi were noticed in 19 case-patients and five controls (P = 0.003). Atrophy was bilateral in 11 case-patients and unilateral in eight. All case-patients with unilateral hippocampal atrophy had at least one ipsilateral calcification. This study shows an association between calcified cysticerci and hippocampal atrophy and raises the possibility of an inflammation-mediated hippocampal damage as the responsible mechanism for these findings. PMID:25349375

  12. The established and future biomarkers of malignant pleural mesothelioma.

    PubMed

    Panou, V; Vyberg, M; Weinreich, U M; Meristoudis, C; Falkmer, U G; Re, O D

    2015-06-01

    Malignant pleural mesothelioma (MPM) is an asbestos-related cancer with a median survival of 12months. The MPM incidence is 1-6/100,000 and is increasing as a result of historic asbestos exposure in industrialized countries and continued use of asbestos in developing countries. Lack of accurate biomarkers makes diagnosis, prognostication and treatment prediction of MPM challenging. The aim of this review is to identify the front line of MPM biomarkers with current or potential clinical impact. Literature search using the PubMed and PLoS One databases, the related-articles function of PubMed and the reference lists of associated publications until April 26th 2015 revealed a plethora of candidate biomarkers. The current gold standard of MPM diagnosis is a combination of two positive and two negative immunohistochemical markers in the epithelioid and biphasic type, but sarcomatous type do not have specific markers, making diagnosis more difficult. Mesothelin in serum and pleural fluid may serve as adjuvant diagnostic with high specificity but low sensitivity. Circulating proteomic and microRNA signatures, fibulin-3, tumor cell gene-ratio test, transcriptomic, lncRNA, glycopeptides, pleural fluid FISH assay, hyaluronate/N-ERC mesothelin and deformability cytometry may be important future markers. Putative predictive markers for pemetrexed-platinum are tumor TS and TYMS, for vinorelbine the ERCC1, beta-tubuline class III and BRCA1. Mutations of the BAP1 gene are potential markers of MPM susceptibility. In conclusion, the current status of MPM biomarkers is not satisfactory but encouraging as more sensitive and specific non-invasive markers are emerging. However, prospective validation is needed before clinical application. PMID:25979846

  13. Light dosimetry and dose verification for pleural PDT

    NASA Astrophysics Data System (ADS)

    Dimofte, Andreea; Sharikova, Anna V.; Meo, Julia L.; Simone, Charles B.; Friedberg, Joseph S.; Zhu, Timothy C.

    2013-03-01

    In-vivo light dosimetry for patients undergoing photodynamic therapy (PDT) is critical for predicting PDT outcome. Patients in this study are enrolled in a Phase I clinical trial of HPPH-mediated PDT for the treatment of non-small cell lung cancer with pleural effusion. They are administered 4mg per kg body weight HPPH 48 hours before the surgery and receive light therapy with a fluence of 15-45 J/cm2 at 661 and 665nm. Fluence rate (mW/cm2) and cumulative fluence (J/cm2) are monitored at 7 sites during the light treatment delivery using isotropic detectors. Light fluence (rate) delivered to patients is examined as a function of treatment time, volume and surface area. In a previous study, a correlation between the treatment time and the treatment volume and surface area was established. However, we did not include the direct light and the effect of the shape of the pleural surface on the scattered light. A real-time infrared (IR) navigation system was used to separate the contribution from the direct light. An improved expression that accurately calculates the total fluence at the cavity wall as a function of light source location, cavity geometry and optical properties is determined based on theoretical and phantom studies. The theoretical study includes an expression for light fluence rate in an elliptical geometry instead of the spheroid geometry used previously. The calculated light fluence is compared to the measured fluence in patients of different cavity geometries and optical properties. The result can be used as a clinical guideline for future pleural PDT treatment.

  14. Comparative studies of inorganic carbon utilization in Emiliania huxleyi and some non-calcifying marine microalgae

    NASA Astrophysics Data System (ADS)

    Dong, Liang-Feng; Merrett, M. J.; Wu, Chao-Yuan

    1999-09-01

    Inorganic carbon utilization in the non-calcifying marine microalgae, Nannochloropsis oculata, Phaeodactylum tricornutum and Porphyridium purpureum was compared with high- and low-calcifying strains of Emiliania huxleyi grown in artificial seawater medium aerated with either air (0.03% V/V CO2) or CO2-free air. For high-calcifying strain of E. oculata and P. tricornutem, similar growth patterns were observed in air-and CO2-free air-grown cultures. P. purpureum showed a less final cell density in CO2-free air than in air-grown culture. However, low-calcifying strain of E. huxleyi was able to grow only in air-grown culture, but not in CO2-free air-grown culture. Measurements of alkalinity, pH, concentration of dissolved inorganic carbon (DIC) and free CO2 showed different patterns of DIC utilization. With N. oculata, P. tricornutum and P. purpureum the pattern of DIC utilization was characterized by an increase of pH and a decrease of DIC but a constant alkalinity in the cultures aerated with air or CO2-free air, suggesting that bicarbonate utilization was concomitant with an efflux of OH-. Both alkalinity and pH were maintained rather constant in air-grown culture of low-calcifying strain of E. huxleyi, suggesting that diffusive entry of CO2 could meet the requirement of DIC for its photosynthesis and growth. High-calcifying strain of E. huxleyi, however, showed a pattern of decrease of alkalinity and DIC but an almost constant pH, indicating that bicarbonate was the major form of inorganic carbon utilised by this organism and bicarbonate uptake is unlikely to be accompanied by an efflux of OH-. The final pH values reached by N. oculata, P. tricornutum and P. purpureum in a closed system were 10.75, 10.60 and 9.85 respectively, showing that bicarbonate utilisation is concomitant with an efflux of OH-. While the final pH of 8.4 in high-calcifying E. huxleyi suggests that bicarbonate utilization was not accompanied by an efflux of OH-.

  15. Rapidly progressive paraplegia and pleural empyema: how does that correlate?

    PubMed

    Lescan, Mario; Lepski, Guilherme; Steger, Volker; Schlensak, Christian; Walker, Tobias

    2013-11-01

    A 74-year-old man presented with progressive dyspnea after a 10-days latency following a thoracic trauma. CT imaging showed multiple rib fracture and an empyema that was primarily treated by a chest tube. In the course of the hospital stay, a rapidly progressive paraplegia developed and the MR imaging revealed a peridural abscess caused by a pleural empyema. Due to trauma-related barrier damage and the initial delay of the operative therapy a usually less invasive pathogen (streptococcus intermedius) could affect the peridural space. The successful therapy consisted of urgent laminectomy and a subsequent video-assisted thoracoscopy supported by systemic antibiotic therapy. PMID:23275088

  16. Endoscopic stenting for double bronco-pleural fistula after lobectomy.

    PubMed

    Cusumano, Giacomo; Terminella, Alberto; Vasta, Ignazio; Riscica Lizzio, Carmelo; Bellofiore, Salvatore; Saita, Salvatore

    2015-10-01

    Bronchial fistula is one of the most serious complications after pulmonary resection. It presents a challenge in terms of treatment, with a high risk of perioperative mortality. We describe a patient who underwent a right upper lobectomy and systematic hilar-mediastinal lymphadenectomy for lung adenocarcinoma complicated by 2 bronchopleural fistulas. The lesions were sited at the upper lobar stump and the pars membranacea of the intermediate bronchus. The patient was successfully treated by placement of an endobronchial prosthesis (initially a self-expanding prosthesis and subsequently, a Dumon prosthesis) and a pleural chest drain, to avoid a potential right pneumonectomy. PMID:25931566

  17. Differential diagnosis of pleural mesothelioma using Logic Learning Machine

    PubMed Central

    2015-01-01

    Background Tumour markers are standard tools for the differential diagnosis of cancer. However, the occurrence of nonspecific symptoms and different malignancies involving the same cancer site may lead to a high proportion of misclassifications. Classification accuracy can be improved by combining information from different markers using standard data mining techniques, like Decision Tree (DT), Artificial Neural Network (ANN), and k-Nearest Neighbour (KNN) classifier. Unfortunately, each method suffers from some unavoidable limitations. DT, in general, tends to show a low classification performance, whereas ANN and KNN produce a "black-box" classification that does not provide biological information useful for clinical purposes. Methods Logic Learning Machine (LLM) is an innovative method of supervised data analysis capable of building classifiers described by a set of intelligible rules including simple conditions in their antecedent part. It is essentially an efficient implementation of the Switching Neural Network model and reaches excellent classification accuracy while keeping low the computational demand. LLM was applied to data from a consecutive cohort of 169 patients admitted for diagnosis to two pulmonary departments in Northern Italy from 2009 to 2011. Patients included 52 malignant pleural mesotheliomas (MPM), 62 pleural metastases (MTX) from other tumours and 55 benign diseases (BD) associated with pleurisies. Concentration of three tumour markers (CEA, CYFRA 21-1 and SMRP) was measured in the pleural fluid of each patient and a cytological examination was also carried out. The performance of LLM and that of three competing methods (DT, KNN and ANN) was assessed by leave-one-out cross-validation. Results LLM outperformed all other considered methods. Global accuracy was 77.5% for LLM, 72.8% for DT, 54.4% for KNN, and 63.9% for ANN, respectively. In more details, LLM correctly classified 79% of MPM, 66% of MTX and 89% of BD. The corresponding figures for DT were: MPM = 83%, MTX = 55% and BD = 84%; for KNN: MPM = 58%, MTX = 45%, BD = 62%; for ANN: MPM = 71%, MTX = 47%, BD = 76%. Finally, LLM provided classification rules in a very good agreement with a priori knowledge about the biological role of the considered tumour markers. Conclusions LLM is a new flexible tool potentially useful for the differential diagnosis of pleural mesothelioma. PMID:26051106

  18. Renal Lymphangiectasia: A Curious Cause of Pleural Effusion

    PubMed Central

    Nassiri, Amir Ahmad; Lotfollahi, Legha; Bakhshayeshkaram, Mehrdad; Kiani, Arda; Haghighi, Shirin; Alavi Darazam, Ilad

    2015-01-01

    Renal lymphangiectasia is a disorder of the lymphatic system of the kidneys, which can be congenital or acquired. Although the exact etiology remains unknown, an obstructive process resulting from several causes, including infection, inflammation or malignant infiltration, has been suggested to be responsible for the acquired form. This disorder may be associated with several pathologies. We report a case of a 24-year-old man with renal lymphangiectasia presenting with polycythemia, ascites and pleural effusion associated with hepatitis C virus (HCV) infection in an intravenous (IV) drug user. Our case is the first in the literature that shows an association between HCV infection and IV drug use. PMID:26858768

  19. An Update in the Management of Malignant Pleural Effusion

    PubMed Central

    Muduly, DK; Deo, SVS; Subi, TS; Kallianpur, AA; Shukla, NK

    2011-01-01

    Malignant pleural effusion (MPE) usually presents in the disseminated and advanced stage of malignancy. Dyspnea is the debilitating symptom which needs palliation in these patients. Various modalities are available in the management of MPE. Careful consideration of the patient's expected survival and quality of life is needed when deciding the optimum treatment modality in such patients. In this article, different modalities of the palliative management of MPE are discussed with an attempt to derive a treatment algorithm for the management of MPE. PMID:21976848

  20. A Giant Mature Cystic Teratoma Mimicking a Pleural Effusion

    PubMed Central

    Dorterler, Mustafa Erman; Boleken, Mehmet Emin; Koarslan, Sezen

    2016-01-01

    The vast majority of teratomas originating from more than a single germ layer are benign. Often, such teratomas are initially asymptomatic. Later symptoms are caused by the weight per se of the teratoma and include chest pain, cough, dyspnea, and/or recurrent attacks of pneumonia. A mediastinal teratoma is treated by total surgical resection of the mass. Here, we report a case of giant mature cystic teratoma mimicking a pleural effusion in the thorax at the 7-month-old female patient with a symptom of persistent pulmonary infection and tachypnea.

  1. Impact of Plaque Composition on Long-Term Clinical Outcomes in Patients with Coronary Artery Occlusive Disease

    PubMed Central

    Kim, Ki Hong; Kim, Wan Ho; Park, Hyun Woong; Song, In Girl; Yang, Dong Ju; Seo, Young Hoon; Yuk, Hyung Bin; Park, Yo Han; Kwon, Taek Geun; Rihal, Charanjit S; Lerman, Amir; Lee, Moo-Sik

    2013-01-01

    Background and Objectives It is unclear which plaque component is related with long-term clinical outcomes in patients with coronary artery occlusive disease (CAOD). We assessed the relationship between plaque compositions and long-term clinical outcomes in those patients. Subjects and Methods The study subjects consisted of 339 consecutive patients (mean 61.712.2 years old, 239 males) who underwent coronary angiogram and a virtual histology-intravascular ultrasound examination. Major adverse cardiac and cerebrovascular events (MACCE), including all-cause death, non-fatal myocardial infarction, cerebrovascular events, and target vessel revascularization were evaluated during a mean 28-month follow-up period. Results Patients with high fibrofatty volume (FFV, >8.90 mm3, n=169) had a higher incidence of MACCE (25.4% vs. 14.7%, p=0.015), male sex (75.7% vs. 65.3%, p=0.043), acute coronary syndrome (53.3% vs. 35.9%, p=0.002), multivessel disease (62.7% vs. 41.8%, p<0.001) and post-stent slow flow (10.7% vs. 2.4%, p=0.002) than those with low FFV (FFV?8.90 mm3, n=170). Other plaque composition factors such as fibrous area/volume, dense calcified area/volume, and necrotic core area/volume did not show any impact on MACCE. Cardiogenic shock {hazard ratio (HR)=8.44; 95% confidence interval (CI)=3.00-23.79; p<0.001} and FFV (HR=1.85; 95% CI=1.12-3.07; p=0.016) were the independent predictors of MACCE by Cox regression analysis. Thin-cap fibroatheroma, necrotic core area, and necrotic core volume were not associated with MACCE. Conclusion FFV of a culprit lesion was associated with unfavorable long-term clinical outcomes in patients with CAOD. PMID:23882286

  2. Etanercept-induced lupus erythematosus presenting as a unilateral pleural effusion.

    PubMed

    Abunasser, Jafar; Forouhar, Faripour A; Metersky, Mark L

    2008-10-01

    A 72-year-old man receiving etanercept for the treatment of psoriatic arthritis had an exudative pleural effusion with nonspecific fluid analysis and pleural biopsy findings. He was ultimately found to have drug-induced lupus erythematosus due to the etanercept. The spectrum of autoimmune disease due to the use of tumor necrosis factor inhibitors is reviewed. PMID:18842918

  3. Abomasal ulceration and abomaso-pleural fistula in an 11-month-old beefmaster bull

    PubMed Central

    Costa, Lais R. R.; Gill, Marjorie S.; Williams, Jamie; Johnson, Anthony J.; Angel, Kenneth L.; Mirza, Mustajab H.

    2002-01-01

    An 11-month-old, beefmaster bull presented with anorexia and signs of respiratory disease. Physical examination, thoracic ultrasonography and radiography, and pleural fluid analysis indicated pericarditis and septic neutrophilic pleuropneumonia. Postmortem findings were abomasal adherence to the diaphragm, a fibrotic fistulous tract connecting the abomasum and pleural cavity, granulomatous abomasitis, granulomatous pericarditis, and fibrinonecrotic pleuritis. PMID:11901596

  4. [Chronic pneumonia caused by paraffin oil and pleural modifications: mesothelial hyperplasia and mesothelioma].

    PubMed

    Meyniard, O; Boissonnas, A; Laisne, M J; Laroche, C; Abelanet, R

    1980-01-01

    A 82 years old woman with no past history of cardiac or pulmonary disease or asbestos exposure, but with chronic administration of paraffin oil as laxative, had lipid pneumonia and a primary neoplasic pleural effusion. From the reported case, the authors discuss the possible part of mineral oil as pleural carcinogenic factor (mesothelioma). PMID:7187068

  5. Development of a Rabbit Pleural Cancer Model by Using VX2 Tumors

    PubMed Central

    Kreuter, Kelly A.; El-Abbadi, Naglaa; Shbeeb, Alia; Tseng, Lillian; Mahon, Sari Brenner; Narula, Navneet; Burney, Tanya; Colt, Henri; Brenner, Matthew

    2008-01-01

    Primary and secondary pleural cancer remains an important clinical problem, with research progress limited by the lack of a suitable moderate- to large-sized (3 to 4 kg) animal model of pleural cancer. Many potential pleura-based imaging and treatment modalities cannot be investigated sufficiently by using currently available small murine animal models because their pleural space is not comparable to that of humans and therefore does not allow for the use of standard thoracoscopic techniques. Here we describe the development of a reproducible model of pleural malignancy in moderate-sized immunocompetent rabbits. Under thoracoscopic guidance, 915 106 VX2 carcinoma cells were inoculated into the plural space of 3 to 4 kg New Zealand white rabbits that had undergone gentle pleural abrasion. Malignant tumor involvement developed on the visceral and parietal pleural surfaces in an average of 2 to 4 wk. This novel pleural tumor model induction method likely will facilitate a broad range of investigations of pleural cancer diagnostics and therapeutics. PMID:18589872

  6. Exclusive intrapulmonary lepidic growth of a malignant pleural mesothelioma presenting with pneumothorax and involving the peritoneum.

    PubMed

    Rossi, Giulio; Cavazza, Alberto; Turrini, Ercole; Costantini, Matteo; Casali, Christian; Morandi, Uliano; Dallari, Rossano

    2006-07-01

    We report a rare case of malignant pleural mesothelioma presenting clinically with pneumothorax and histologically with an exclusive intrapulmonary lepidic growth. Neither intrathoracic nodules nor pleural thickening were found. The patient subsequently experienced acute abdominal pain with peritonitis and intestinal occlusion by peritoneal mesothelioma. The morphologic clues leading to the correct diagnosis of mesothelioma with prominent intrapulmonary growth are briefly discussed. PMID:16959711

  7. The microscopic network structure of mussel (Mytilus) adhesive plaques.

    PubMed

    Filippidi, Emmanouela; DeMartini, Daniel G; Malo de Molina, Paula; Danner, Eric W; Kim, Juntae; Helgeson, Matthew E; Waite, J Herbert; Valentine, Megan T

    2015-12-01

    Marine mussels of the genus Mytilus live in the hostile intertidal zone, attached to rocks, bio-fouled surfaces and each other via collagen-rich threads ending in adhesive pads, the plaques. Plaques adhere in salty, alkaline seawater, withstanding waves and tidal currents. Each plaque requires a force of several newtons to detach. Although the molecular composition of the plaques has been well studied, a complete understanding of supra-molecular plaque architecture and its role in maintaining adhesive strength remains elusive. Here, electron microscopy and neutron scattering studies of plaques harvested from Mytilus californianus and Mytilus galloprovincialis reveal a complex network structure reminiscent of structural foams. Two characteristic length scales are observed characterizing a dense meshwork (approx. 100 nm) with large interpenetrating pores (approx. 1 µm). The network withstands chemical denaturation, indicating significant cross-linking. Plaques formed at lower temperatures have finer network struts, from which we hypothesize a kinetically controlled formation mechanism. When mussels are induced to create plaques, the resulting structure lacks a well-defined network architecture, showcasing the importance of processing over self-assembly. Together, these new data provide essential insight into plaque structure and formation and set the foundation to understand the role of plaque structure in stress distribution and toughening in natural and biomimetic materials. PMID:26631333

  8. New concepts in the composition, crystallization and growth of the mineral component of calcified tissues

    NASA Astrophysics Data System (ADS)

    Montel, G.; Bonel, G.; Heughebaert, J. C.; Trombe, J. C.; Rey, C.

    1981-05-01

    Several difficulties arise when studying the mineral component of calcified tissues: this material is complex, due to the large number of atomic components; it is poorly crystallized, heterogeneous, and varies with different factors (animal species, kind of bone, age, sampling zone, etc.); it is strongly linked to the organic component (collagen, etc.), and today no available technique allows a complete separation of these two components without alteration of one of the other. Research on synthetic materials allows the elaboration of some models to account, at least partially, for the nature and properties of the calcified-tissue mineral component. So, glycine fixation by apatite constitutes the first model of the collagen-apatite bond. The introduction of carbonate ions into the apatitic lattice can take place in two kinds of site, and under different forms. The replacement of PO 3-4 ions by HPO 2-4 can also be observed. The properties of phosphates depend on the presence of these various substituents, and therefore such substitutions can play an important role in phosphate behaviour in biological media. The study of the hydrolysis and crystallization of amorphous phosphate into apatite leads to new conceptions relative to the possible existence of an amorphous "phase" in calcified tissues. The conversion of amorphous phosphates to crystalline apatite is dependent on numerous ions (Mg 2+, P 2O 4-7, CO 32-, etc.). Studies on synthetic materials can be regarded as a basis for the further study of calcified tissues, partic ularly to determine their constitution and properties. Besides, such studies enable the synthesis of materials, for implants, very similar to calcified tissues.

  9. Micro-analysis of plaque fluid from single-site fasted plaque

    SciTech Connect

    Vogel, G.L.; Carey, C.M.; Chow, L.C.; Tatevossian, A. )

    1990-06-01

    Despite the site-specific nature of caries, nearly all data on the concentration of ions relevant to the level of saturation of plaque fluid with respect to calcium phosphate minerals or enamel are from studies that used pooled samples. A procedure is described for the collection and analysis of inorganic ions relevant to these saturation levels in plaque fluid samples collected from a single surface on a single tooth. Various methods for examining data obtained by this procedure are described, and a mathematical procedure employing potential plots is recommended.

  10. [Pleural puncture biopsy--a diagnostic method in serofibrinous tuberculous pleurisy in children].

    PubMed

    Murgoci, G; Galbenu, P

    1989-01-01

    The biopsy of the parietal biopsy with the help of a needle has become an essential method of diagnosis in the adult patients with a pleural malady of an unknown etiology and may become a complementary paraclinical method in children. A sure diagnosis in the tubercular serofibrinous pleurisy with children is made by rendering evident the Koch bacillus on the direct test or in culture and by rendering evident the tubercular lesions on fragments of pleural biopsy puncture. The study is supported on the results obtained at the pleural biopsy puncture performed on a number of 6 children. In four cases out of six the histological test of the pleural fragment has rendered evident the presence of tubercular lymphoepithelioid nodulus with central necrosis, thus carrying the argument of certitude. The pleural biopsy puncture allows an early and sure diagnosis in over two-thirds of the pleurisies of a tubercular etiology. PMID:2554468

  11. [Pleural puncture biopsy--a diagnostic method in tuberculous serofibrinous pleurisy in children].

    PubMed

    Murgoci, G; Galbenu, P

    1991-01-01

    The biopsy of the parietal pleura with a special needle has become an essential diagnosis method in the adult patients with pleural disease of unknown etiology, and might become a complementary paraclinical method for children also. The certitude diagnosis in tuberculous serous fibrinous pleurisy of the child is laid on evidencing Koch's bacillus at the direct examination or in culture, and on fragments of pleural biopsy puncture, in evidencing the lesions. The study is based on the results obtained in the pleural biopsy puncture made on 6 children. The histologic examination of the pleural fragment showed, in 4 cases of 6, the presence of tuberculous lymphoepithelioid nodules, with central caseous necrosis thus granting certitude to the diagnosis. The pleural biopsy puncture permits an early and certain diagnosis in more than 2/3 of the pleurisies of tuberculous etiology. PMID:1667594

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

    SciTech Connect

    Teirstein, A.S.; Chahinian, P.; Goldsmith, S.J.; Sorek, M.

    1986-01-01

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

  13. Lung scan perfusion defects limited to matching pleural effusions: low probability of pulmonary embolism

    SciTech Connect

    Bedont, R.A.; Datz, F.L.

    1985-12-01

    Patients with a new pleural effusion are often sent for a ventilation-perfusion scan to exclude a pulmonary embolism. This retrospective study assessed the probability of pulmonary embolism when a pleural effusion and a perfusion defect of similar size are the only significant imaging abnormalities. In 451 reports of patients who were scanned for suspected pulmonary embolism, 53 had perfusion defects secondary to pleural effusion without other significant perfusion defects. Using pulmonary angiography, venography, analysis of pleural fluid, clinical course, and other radiographic and laboratory studies to establish the final diagnosis, only two patients had documented venous thrombotic disease: one had pulmonary emboli, the other thrombophlebitis. Lung scans having significant perfusion defects limited to pleural effusions and matching them in size have a low probability for pulmonary embolism.

  14. [Pleural involvement and functional effect of asbestosis in 380 exposed patients].

    PubMed

    Lemenager, J; Raffaelli, C; Letourneux, M; Sesboue, B; Boulier, A

    1985-07-01

    A large number of pleural abnormalities was detected by radiological and functional monitoring of 380 persons (mean age: 47 years) working in an asbestos processing factory. There were 127 cases of parietal pleura thickening (after 22 1/2 years' exposure), 11 cases of pleural calcifications (after 26 years' exposure) and 29 cases of obliteration of the costophrenic angle. Fourteen images of pulmonary asbestosis were encountered, 7 of which were associated with pleural effusion; they occurred at a mean age of 50 years, after 22 years' exposure. Pleural lesions had a restrictive influence on respiratory function in 24% of the cases and were sometimes painful. Small airway obstruction was detected by flow-volume loops in 9% non-smokers with pleural thickening, which suggests that intra-radiological lung lesions exist in asbestosis. PMID:3161061

  15. EUS-guided fine needle tissue acquisition for the diagnosis of pleural metastases from endometrial cancer.

    PubMed

    Larghi, A; Lococo, F; Mainenti, S; Petrone, G; Cesario, A; Granone, P; Scambia, G; Costamagna, G

    2014-01-01

    Transesophageal EUS-FNA have become a useful tool in the evaluation of the mediastinum, especially during the staging work-up examination of patients with non-small-cell lung cancer (NSCLC) or other malignancies. We report a challenging case of a 53 years-old woman with an endometrial adenocarcinoma who subsequently presented with right pleural effusion, diffuse pleural thickening with few pleural lesions. The patient referred a long history of exposure to amiantum, this posing a differential diagnosis between primary pleural tumour (mesothelioma) and neoplastic pleural localization of the endometrial cancer. The cytological examination of the pleural effusion (sampled via thoracenthesis) was not adequate to reach a diagnosis. Although a right-video-assisted thoracoscopy was considered the gold standard in this clinical setting to achieve a tissue acquisition of the pleura, an EUS (as the least invasive procedure) was attempted to reach a definitive diagnosis. EUS-FNTA of the pleura was done using a 19-Gauge needle and the pathological and immunophenotypic features were diagnostic for a pleural metastasis of high-grade endometrial serous carcinoma. The patient received adjuvant chemotherapy with a complete regression of the pleural lesions. We take the opportunity of this challenging case to discuss the efficacy and safety of EUS-FNAT to sample the pleural lesions with the use of a large calibre needle if the lesion lies just under the EUS cursor. We may assume that, in selected patients, this technique could be presented as a viable option to the more invasive surgical procedure, which has been previously the gold standard for the pleural tissue acquisition. PMID:24867517

  16. [Parapneumonic pleural effusions: Epidemiology, diagnosis, classification and management].

    PubMed

    Letheulle, J; Kerjouan, M; Bnzit, F; De Latour, B; Tattevin, P; Piau, C; Lna, H; Desrues, B; Le Tulzo, Y; Jouneau, S

    2015-04-01

    Parapneumonic pleural effusions represent the main cause of pleural infections. Their incidence is constantly increasing. Although by definition they are considered to be a "parapneumonic" phenomenon, the microbial epidemiology of these effusions differs from pneumonia with a higher prevalence of anaerobic bacteria. The first thoracentesis is the most important diagnostic stage because it allows for a distinction between complicated and non-complicated parapneumonic effusions. Only complicated parapneumonic effusions need to be drained. Therapeutic evacuation modalities include repeated therapeutic thoracentesis, chest tube drainage or thoracic surgery. The choice of the first-line evacuation treatment is still controversial and there are few prospective controlled studies. The effectiveness of fibrinolytic agents is not established except when they are combined with DNase. Antibiotics are mandatory; they should be initiated as quickly as possible and should be active against anaerobic bacteria except for in the context of pneumococcal infections. There are few data on the use of chest physiotherapy, which remains widely used. Mortality is still high and is influenced by underlying comorbidities. PMID:25595878

  17. Photodynamic Therapy for Lung Cancer and Malignant Pleural Mesothelioma

    PubMed Central

    Simone, Charles B.; Cengel, Keith A.

    2014-01-01

    Photodynamic therapy (PDT) is a form of non-ionizing radiation therapy that uses a drug, called a photosensitizer, combined with light to produce singlet oxygen (1O2) that can exert anti-cancer activity through apoptotic, necrotic, or autophagic tumor cell death. PDT is increasingly being used to treat thoracic malignancies. For early-stage non-small cell lung cancer (NSCLC), PDT is primarily employed as an endobronchial therapy to definitively treat endobronchial or roentgenographically occult tumors. Similarly, patients with multiple primary lung cancers may be definitively treated with PDT. For advanced or metastatic NSCLC and small cell lung cancer (SCLC), PDT is primarily employed to palliate symptoms from obstructing endobronchial lesions causing airway compromise or hemoptysis. PDT can be used in advanced NSCLC to attempt to increase operability or to reduce the extent of operation required, and selectively to treat pleural dissemination intraoperatively following macroscopically complete surgical resection. Intraoperative PDT can be safely combined with macroscopically complete surgical resection and other treatment modalities for malignant pleural mesothelioma (MPM) to improve local control and prolong survival. This report reviews the mechanism of and rationale for using PDT to treat thoracic malignancies, details prospective and major retrospectives studies of PDT to treat NSCLC, SCLC, and MPM, and describes improvements in and future roles and directions of PDT. PMID:25499640

  18. Real-time treatment feedback guidance of Pleural PDT

    NASA Astrophysics Data System (ADS)

    Zhu, Timothy C.; Kim, Michele M.; Liang, Xing; Liu, Baochang; Meo, Julia L.; Finlay, Jarod C.; Dimofte, Andreea; Rodriguez, Carmen; Simone, Charles; Cengel, Keith; Friedberg, Joseph

    2013-03-01

    Pleural photodynamic therapy (PDT) has been used as an adjuvant treatment with lung-sparing surgical treatment for mesothelioma with remarkable results. In the current intrapleural PDT protocol, a moving fiber-based point source is used to deliver the light and the light dose are monitored by 7 detectors placed in the pleural cavity. To improve the delivery of light dose uniformity, an infrared (IR) camera system is used to track the motion of the light sources. A treatment planning system uses feedback from the detectors as well as the IR camera to update light fluence distribution in real-time, which is used to guide the light source motion for uniform light dose distribution. We have improved the GUI of the light dose calculation engine to provide real-time light fluence distribution suitable for guiding the surgery to delivery light more uniformly. A dual-correction method is used in the feedback system, so that fluence calculation can match detector readings using both direct and scatter light models. An improved measurement device is developed to automatically acquire laser position for the point source. Comparison of the effects of the guidance is presented in phantom study.

  19. SEOM guidelines for the treatment of malignant pleural mesothelioma.

    PubMed

    Lianes, Pilar; Remon, Jordi; Bover, Isabel; Isla, Dolores

    2011-08-01

    Mesothelioma is a rare malignant tumour. Asbestos is the principal aetiological agent of malignant pleural mesothelioma (MPM) (?80% of cases). The incidence of MPM is still increasing and will peak within the next 10 years. There are three main histological types of MPM: epithelial (?60%), sarcomatous and mixed. There is no standard approach for patients with MPM. Surgery (radical extra-pleural pneumonectomy or pleurectomy/decortication) may be part of the initial treatment for carefully selected patients, generally combined with neoadjuvant or adjuvant chemotherapy and/or adjuvant radiotherapy, and should only be performed by experienced thoracic surgeons as part of a multidisciplinary team. Radiotherapy could be used as prophylaxis to reduce the incidence of recurrence at sites of diagnoses or therapeutic instrument insertion, in a multimodal treatment to improve locoregional control and to palliate symptoms. Based on the better compliance of neoadjuvant chemotherapy, lower rate of surgical morbidity and the possibility to select the optimal patients to be submitted to surgery, a neoadjuvant strategy is a better option than adjuvant chemotherapy, although there is no standard optimal sequence and types of treatment for multimodal therapy. In patients with no resectable disease, chemotherapy is the best option with platinum and pemetrexed or raltitrexed. At this time there is no widely approved salvage therapy. PMID:21821492

  20. Computer Simulations of Atherosclerotic Plaque Growth in Coronary Arteries

    PubMed Central

    Liu, Biyue; Tang, Dalin

    2011-01-01

    A three dimensional mathematical model with a linear plaque growth function was developed to investigate the geometrical adaptation of atherosclerotic plaques in coronary arteries and study the influences of flow wall shear stress (WSS), blood viscosity and the inlet flow rate on the growth of atherosclerotic plaques using computational plaque growth simulations. The simulation results indicated that the plaque wall thickness at the neck of the stenosis increased at a decreasing rate in the atherosclerosis progression. The simulation results also showed a strong dependence of the plaque wall thickness increase on the blood viscosity and the inlet flow rate. The progression rate in a coronary artery was lower with a higher inlet velocity flow rate and higher with a smaller value of the blood viscosity. PMID:21141673

  1. Congenital Milia En Plaque on Scalp

    PubMed Central

    Ghosh, Sangita; Sangal, Shikha

    2015-01-01

    Milia en plaque is a rare disease entity characterized by confluence of multiple keratin-filled cysts resulting from the obstruction of hair follicle without any preceding primary dermatosis. Fewer than 40 cases have been reported so far in dermatological literature, and most cases are described to occur in adults and in the peri-auricular area. We describe a case of congenital MEP on scalp of a five-year-old boy with a blaschkoid extension into posterior nuchal area. This case report claims its uniqueness because of the unusual site and congenital presentation. PMID:25657433

  2. Stability Analysis of a Model of Atherosclerotic Plaque Growth

    PubMed Central

    Reddy, Sushruth; Seshaiyer, Padmanabhan

    2015-01-01

    Atherosclerosis, the formation of life-threatening plaques in blood vessels, is a form of cardiovascular disease. In this paper, we analyze a simplified model of plaque growth to derive physically meaningful results about the growth of plaques. In particular, the main results of this paper are two conditions, which express that the immune response increases as LDL cholesterol levels increase and that diffusion prevails over inflammation in a healthy artery. PMID:25883675

  3. Dosimetric Benefit of a New Ophthalmic Radiation Plaque

    SciTech Connect

    Marwaha, Gaurav; Cleveland Clinic Foundation, Cleveland, Ohio ; Wilkinson, Allan; Cleveland Clinic Foundation, Cleveland, Ohio ; Bena, James; Cleveland Clinic Foundation, Cleveland, Ohio ; Macklis, Roger; Cleveland Clinic Foundation, Cleveland, Ohio ; Singh, Arun D.; Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio; Cleveland Clinic Foundation, Cleveland, Ohio

    2012-12-01

    Purpose: To determine whether the computed dosimetry of a new ophthalmic plaque, EP917, when compared with the standard Collaborative Ocular Melanoma Study (COMS) plaques, could reduce radiation exposure to vision critical structures of the eye. Methods and Materials: One hundred consecutive patients with uveal melanoma treated with COMS radiation plaques between 2007 and 2010 were included in this study. These treatment plans were generated with the use of Bebig Plaque Simulator treatment-planning software, both for COMS plaques and for EP917 plaques using I-125. Dose distributions were calculated for a prescription of 85 Gy to the tumor apex. Doses to the optic disc, opposite retina, lens, and macula were obtained, and differences between the 2 groups were analyzed by standard parametric methods. Results: When compared with the COMS plaques, the EP917 plaques used fewer radiation seeds by an average difference of 1.94 (P<.001; 95% confidence interval [CI], -2.8 to -1.06) and required less total strength of radiation sources by an average of 17.74 U (air kerma units) (P<.001; 95% CI, -20.16 to -15.32). The total radiation doses delivered to the optic disc, opposite retina, and macula were significantly less by 4.57 Gy, 0.50 Gy, and 11.18 Gy, respectively, with the EP917 plaques vs the COMS plaques. Conclusion: EP917 plaques deliver less overall radiation exposure to critical vision structures than COMS treatment plaques while still delivering the same total therapeutic dose to the tumor.

  4. Multimodality imaging of carotid atherosclerotic plaque: Going beyond stenosis

    PubMed Central

    Hingwala, Divyata; Kesavadas, Chandrasekharan; Sylaja, Padmavathy N; Thomas, Bejoy; Kapilamoorthy, Tirur Raman

    2013-01-01

    Apart from the degree of stenosis, the morphology of carotid atherosclerotic plaques and presence of neovascularization are important factors that may help to evaluate the risk and vulnerability of plaques and may also influence the choice of treatment. In this article, we aim to describe the techniques and imaging findings on CTA, high resolution MRI and contrast enhanced ultrasound in the evaluation of carotid atherosclerotic plaques. We also discuss a few representative cases from our institute with the related clinical implications. PMID:23986615

  5. Differential responses of calcifying and non-calcifying epibionts of a brown macroalga to present-day and future upwelling pCO2.

    PubMed

    Saderne, Vincent; Wahl, Martin

    2013-01-01

    Seaweeds are key species of the Baltic Sea benthic ecosystems. They are the substratum of numerous fouling epibionts like bryozoans and tubeworms. Several of these epibionts bear calcified structures and could be impacted by the high pCO2 events of the late summer upwellings in the Baltic nearshores. Those events are expected to increase in strength and duration with global change and ocean acidification. If calcifying epibionts are impacted by transient acidification as driven by upwelling events, their increasing prevalence could cause a shift of the fouling communities toward fleshy species. The aim of the present study was to test the sensitivity of selected seaweed macrofoulers to transient elevation of pCO2 in their natural microenvironment, i.e. the boundary layer covering the thallus surface of brown seaweeds. Fragments of the macroalga Fucus serratus bearing an epibiotic community composed of the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium hirsutum (Bryozoa) were maintained for 30 days under three pCO2 conditions: natural 460 ± 59 µatm, present-day upwelling1193 ± 166 µatm and future upwelling 3150 ± 446 µatm. Only the highest pCO2 caused a significant reduction of growth rates and settlement of S. spirorbis individuals. Additionally, S. spirorbis settled juveniles exhibited enhanced calcification of 40% during daylight hours compared to dark hours, possibly reflecting a day-night alternation of an acidification-modulating effect by algal photosynthesis as opposed to an acidification-enhancing effect of algal respiration. E. pilosa colonies showed significantly increased growth rates at intermediate pCO2 (1193 µatm) but no response to higher pCO2. No effect of acidification on A. hirsutum colonies growth rates was observed. The results suggest a remarkable resistance of the algal macro-epibionts to levels of acidification occurring at present day upwellings in the Baltic. Only extreme future upwelling conditions impacted the tubeworm S. spirorbis, but not the bryozoans. PMID:23894659

  6. Differential Responses of Calcifying and Non-Calcifying Epibionts of a Brown Macroalga to Present-Day and Future Upwelling pCO2

    PubMed Central

    Saderne, Vincent; Wahl, Martin

    2013-01-01

    Seaweeds are key species of the Baltic Sea benthic ecosystems. They are the substratum of numerous fouling epibionts like bryozoans and tubeworms. Several of these epibionts bear calcified structures and could be impacted by the high pCO2 events of the late summer upwellings in the Baltic nearshores. Those events are expected to increase in strength and duration with global change and ocean acidification. If calcifying epibionts are impacted by transient acidification as driven by upwelling events, their increasing prevalence could cause a shift of the fouling communities toward fleshy species. The aim of the present study was to test the sensitivity of selected seaweed macrofoulers to transient elevation of pCO2 in their natural microenvironment, i.e. the boundary layer covering the thallus surface of brown seaweeds. Fragments of the macroalga Fucus serratus bearing an epibiotic community composed of the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium hirsutum (Bryozoa) were maintained for 30 days under three pCO2 conditions: natural 460±59 µatm, present-day upwelling1193±166 µatm and future upwelling 3150±446 µatm. Only the highest pCO2 caused a significant reduction of growth rates and settlement of S. spirorbis individuals. Additionally, S. spirorbis settled juveniles exhibited enhanced calcification of 40% during daylight hours compared to dark hours, possibly reflecting a day-night alternation of an acidification-modulating effect by algal photosynthesis as opposed to an acidification-enhancing effect of algal respiration. E. pilosa colonies showed significantly increased growth rates at intermediate pCO2 (1193 µatm) but no response to higher pCO2. No effect of acidification on A. hirsutum colonies growth rates was observed. The results suggest a remarkable resistance of the algal macro-epibionts to levels of acidification occurring at present day upwellings in the Baltic. Only extreme future upwelling conditions impacted the tubeworm S. spirorbis, but not the bryozoans. PMID:23894659

  7. The role of Randall plaques on kidney stone formation

    PubMed Central

    2014-01-01

    Randalls plaque is microscopically a plaque of calcium deposited in the interstitial tissue of the renal papilla. These plaques are thought to serve as a nidus for urinary stone formation. Large amounts of Randalls plaque are unique to idiopathic calcium oxalate stone formers. Although Randalls plaques can be found in other stone formers, only in idiopathic calcium oxalate stone formers, the detailed mechanism of stone overgrow on plaque was thoroughly studied. Calcification is invariably located in the basement membrane of the loops of Henle and from there plaques spread through the interstitium toward urothelium. Within the basement membrane, mineral deposits are individual laminated particles in which zones of crystal and organic matrix overlay each other. In the interstitium, the particles appear to fuse on the collagen bundles to form a syncytium of crystal islands in an organic sea. By loss of integrity of urothelium, regions of plaque are exposed to urine. The exposed surface will touch and be covered by molecules of urine origin, including osteopontin, Tamm Horsfall protein, and crystals formed under urine supersaturations, resulting in a ribbon of alternating matrix and crystal. Eventually crystallization escapes from matrix modulation and crystals extend outward into the space of urine and begin to form a calcium oxalate stone proper. Randalls plaque plays an important role and is prerequisite of kidney stone formation in idiopathic calcium oxalate stone formers. PMID:26816774

  8. Subsurface ablation of atherosclerotic plaque using ultrafast laser pulses

    PubMed Central

    Lanvin, Thomas; Conkey, Donald B.; Frobert, Aurelien; Valentin, Jeremy; Goy, Jean-Jacques; Cook, Stéphane; Giraud, Marie-Noelle; Psaltis, Demetri

    2015-01-01

    We perform subsurface ablation of atherosclerotic plaque using ultrafast pulses. Excised mouse aortas containing atherosclerotic plaque were ablated with ultrafast near-infrared (NIR) laser pulses. Optical coherence tomography (OCT) was used to observe the ablation result, while the physical damage was inspected in histological sections. We characterize the effects of incident pulse energy on surface damage, ablation hole size, and filament propagation. We find that it is possible to ablate plaque just below the surface without causing surface damage, which motivates further investigation of ultrafast ablation for subsurface atherosclerotic plaque removal. PMID:26203381

  9. Nature or The Natural Evolution of Plaque: What Matters?

    PubMed Central

    AURSULESEI, Viviana

    2013-01-01

    ABSTRACT Progression to major acute cardiovascular events often is triggered by an atherosclerotic plaque complicated by rupture or erosion, namely the vulnerable plaque. Early and secure identification of these plaques would allow the development of individualized therapeutic and pharmacological strategies, applied in a timely manner. Imaging methods have a huge potential in detecting and monitoring the evolution of vulnerable plaque. Even though there are multiple invasive and noninvasive techniques, clinical application is for now a matter of choosing the relevant imaging feature for the prognosis, the methodology of study and the target population. PMID:24790659

  10. 14. DETAIL VIEW OF COMMEMORATIVE PLAQUE AND FINIAL, NORTH END ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. DETAIL VIEW OF COMMEMORATIVE PLAQUE AND FINIAL, NORTH END SPAN - East Bloomsburg Bridge, Spanning Susquehanna River at Pennsylvania Route 487 (Legislative Route 283), Bloomsburg, Columbia County, PA

  11. DETAIL OF PLAQUE WITH ADDITIONAL DESIGN AND CONSTRUCTION INFORMATION, SOUTHEAST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL OF PLAQUE WITH ADDITIONAL DESIGN AND CONSTRUCTION INFORMATION, SOUTHEAST ABUTMENT - Connecticut Avenue Bridge, Spans Rock Creek & Potomac Parkway at Connecticut Avenue, Washington, District of Columbia, DC

  12. Photolichenoid plaques with associated vitiliginous pigmentary changes.

    PubMed

    Tran, Kathleen; Hartman, Rachael; Tzu, Julia; Meehan, Shane; Sanders, Scott E; Pomeranz, Miriam Keltz; Sanchez, Miguel

    2011-01-01

    A 49-year-old man with advanced HIV/AIDS on anti-retroviral therapy (HAART) and trimethoprim-sulfamethoxazole (TMP-SMX) presented with a several-month history of pruritic, erythematous, lichenified papules that coalesced into hyperkeratotic plaques on the trunk and extremities in a sun-exposed distribution. He shortly thereafter developed a progressive depigmentation over more than 80 percent of his body surface area. A biopsy specimen of an erythematous plaque on the trunk showed a superficial and mid-dermal infiltrate of lymphocytes with eosinophils, most consistent with either chronic lichenoid drug eruption or atypical lymphoproliferative disorder (ACLD) of HIV. The patient's lichenoid skin disease has persisted despite discontinuation of TMP-SMX, although it has improved partially with administration of topical glucocorticoids and acitretin. His depigmentation has continued to progress. We discuss the overlapping diagnostic entities which may be comprised by this patient's clinical disease, and highlight a unique presentation of the complex interaction between HIV infection and the skin. PMID:22031639

  13. Assessment of plaque assay methods for alphaviruses.

    PubMed

    Juarez, Diana; Long, Kanya C; Aguilar, Patricia; Kochel, Tadeusz J; Halsey, Eric S

    2013-01-01

    Viruses from the Alphavirus genus are responsible for numerous arboviral diseases impacting human health throughout the world. Confirmation of acute alphavirus infection is based on viral isolation, identification of viral RNA, or a fourfold or greater increase in antibody titers between acute and convalescent samples. In convalescence, the specificity of antibodies to an alphavirus may be confirmed by plaque reduction neutralization test. To identify the best method for alphavirus and neutralizing antibody recognition, the standard solid method using a cell monolayer overlay with 0.4% agarose and the semisolid method using a cell suspension overlay with 0.6% carboxymethyl cellulose (CMC) overlay were evaluated. Mayaro virus, Una virus, Venezuelan equine encephalitis virus (VEEV), and Western equine encephalitis virus (WEEV) were selected to be tested by both methods. The results indicate that the solid method showed consistently greater sensitivity than the semisolid method. Also, a "semisolid-variant method" using a 0.6% CMC overlay on a cell monolayer was assayed for virus titration. This method provided the same sensitivity as the solid method for VEEV and also had greater sensitivity for WEEV titration. Modifications in plaque assay conditions affect significantly results and therefore evaluation of the performance of each new assay is needed. PMID:23085307

  14. Plaque-type morphea in children.

    PubMed

    St?nescu, Ligia; Vlcea, Alina; Popescu, Carmen Florina; Niculescu, Carmen Elena; Ciobanu, O; C?lin, G

    2010-01-01

    We present the case of a girl, aged 8-year-old, with a history of acrocyanosis and repeated respiratory infections with beta-hemolytic streptococcus, which was consulted for the presence of skin lesions in the right buttock area. Clinical examination showed, in the right buttock region, an oval plaque with a diameter about 12 cm, hard, well defined, with irregular outline. The biopsy was performed and it revealed typical aspects of plaque-type morphea. The epidermis was mostly atrophic, with areas of ridge reduction; an important proliferation of collagen fibers within superficial and deep dermis and an abundant lymphocytic inflammatory infiltrate throughout the dermal thickness reaching hypodermic level and infiltrating it. General treatment consisted of antibiotics; vitamin E; local treatment with topical cortisone; analogues of vitamin D3 to which we associated topical adjuvants with repairing and healing role applied to the biopsied area. Evolution was favorable after three months of treatment, with obvious improvement of skin lesions; skin became more elastic and the purple red contour ring disappeared. PMID:20809038

  15. Malignant pleural mesothelioma: A single-center experience in Turkey

    PubMed Central

    Sezer, Ahmet; Smbl, Ahmet Taner; Abal?, Hseyin; Mertsoylu, Hseyin; zy?lkan, zgr

    2014-01-01

    Background Malignant pleural mesothelioma is a rare lethal malignancy caused by asbestos exposure. It is more frequently seen in certain regions in Turkey. In this retrospective study, we aimed to analyse demographic, clinical, and pathological data and treatment-related features in 54 patients. Material/Methods The study included 54 patients diagnosed with malignant mesothelioma that were followed and treated. Results Of the 54 patients, 34 (55.6%) were male. The median age in men and women were 60.3 (38.277.2) and 65.8 (37.777.5) years, respectively. In 35 (64.8%), exposure to asbestosis was present. Epithelial type was found in 27 (50.0%), followed by mixed type in 7 (13.0%) patients, and in 20 (37.0%) patients the subtype could not be determined. The disease was staged as IV in 37 (68.5%) patients. In 28 patients (51.9%), it was right-sided and in 1 (1.9%) it was bilateral. The most frequent metastatic sites (in decreasing order) were lungs, mediastinum, diaphragm, liver, and thoracal wall. Of the 54 patients, 36 (66.6%) received 1st-line chemotherapy and 20 (37%) 2nd-line chemotherapy. Eighteen patients (33.3%) received radiotherapy; 11 (20.3%) with palliative intention and 7 (12.9%) with curative intention. Median overall survival (OS) was 12.03 months (95% CI 7.216.8). OS was not affected by sex (p=0.32), smoking history (p=0.51), alcohol consumption (p=0.36), family history (p=0.67), pleural effusion presence (p=0.80), operation (p=0.14), clinical stage (p=0.072), symptom at presentation (p=0.66), having mixed type histology (p=0.079), asbestos exposure (p=0.06), and type of 1st-line chemotherapy (p=0.161). On the contrary, it may be positively affected by good ECOG PS (01) (p<0.01), age below 65 (p=0.03), left-sided disease (p=0.01), receiving chemotherapy (p<0.01), having unilateral pleural effusion (p=0.018), and type of 2nd-line chemotherapy (p=0.025). Conclusions OS of our patients was better than that found in the literature, seeming to be positively affected by early stages, better ECOG PS, age below 65 years, left side involvement, and having second-line chemotherapy with cisplatin-gemcitabine or 3M. Overall treatment success seems to be comparable to what is currently expected. PMID:24842043

  16. Pemetrexed: new drug. Pleural mesothelioma: a first encouraging trial.

    PubMed

    2005-12-01

    (1) Chemotherapy does not appear to prolong the survival of patients with inoperable pleural mesothelioma, and the tumour response rate barely exceeds 20%. A combination of cisplatin + doxorubicin seems to provide the best response rates. (2) In a trial of second-line docetaxel therapy in patients with non small cell lung cancer, survival was extended by about 3 months compared with palliative care (7.5 versus 4.6 months). (3) Pemetrexed, an antifolate closely related to methotrexate and raltitrexed, has been authorized for use for both conditions. (4) In a randomised single-blind trial involving 456 patients with previously untreated pleural mesothelioma, survival was prolonged by about 3 months by a cisplatin + pemetrexed combination in comparison with cisplatin + placebo (12.1 versus 9.3 months). The respective tumour response rates were 41.3% and 16.7%. This is the only available comparative trial of pemetrexed in patients with mesothelioma. A more appropriate comparator would have been a cisplatin-based regimen such as cisplatin + doxorubicin. (5) A "non inferiority" trial of second-line treatment in 571 patients with locally advanced or metastatic non small cell lung cancer showed no significant difference in median survival time with pemetrexed versus docetaxel (about 8 months with both treatments). However, this trial does not rule out the possibility that pemetrexed is less effective than docetaxel. (6) Supplementation with folic acid and vitamin B12 reduces haematological and gastrointestinal complications associated with the antifolate activity of pemetrexed. (7) Despite this supplementation, more than 15% of patients in the mesothelioma trial developed severe neutropenia, leukopenia or fatigue during cisplatin + pemetrexed therapy. Pemetrexed aggravates the nausea and vomiting provoked by cisplatin, a drug that is highly emetic. (8) The adverse effects of pemetrexed were similar to those of docetaxel in the trial comparing the two drugs. However, neutropenia (5% versus 40%) and febrile neutropenia (2% versus 13%) occurred less frequently with pemetrexed. (9) Patients receiving pemetrexed must be monitored closely for some rare but potentially severe adverse effects; they include angina, myocardial infarction and stroke, liver damage, and bullous skin rash. (10) According to the summary of product characteristics (SPC), pemetrexed therapy must be administered in combination with folic acid and vitamin B12 supplementation in order to reduce haematological toxicity, and also with corticosteroid therapy to reduce the risk of serious skin reactions. (11) In practice, given the absence of a better alternative, and pending the results of a second trial, the cisplatin + pemetrexed combination can be used as a first-line regimen for patients with pleural mesothelioma. However, pemetrexed cannot replace docetaxel in second-line treatment of non small cell lung cancer. PMID:16400741

  17. Effect of using pump on postoperative pleural effusion in the patients that underwent CABG

    PubMed Central

    Özülkü, Mehmet; Aygün, Fatih

    2015-01-01

    Objective The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. Methods A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden) heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11. Results The incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump) as compared to Group 2 (off-pump). But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893), P>0.05 for bilateral pleural effusion (P=0.780)]. Left pleural effusion was encountered to be lower in Group 2 (off-pump). The difference was found to be statistically significant (P<0.05, P=0.006). Conclusion Under the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.

  18. A novel method for chronic measurement of pleural pressure in conscious rats.

    PubMed

    Murphy, D J; Renninger, J P; Gossett, K A

    1998-04-01

    Pleural pressures are used to evaluate lung function and are generally measured acutely in anesthetized animals. Previous attempts to measure pleural pressure chronically in conscious animals have involved surgical implantation of pressure-sensitive catheters directly into the pleural cavity. The success of these techniques has been limited by lung damage and/or tissue growth and encapsulation of the pressure-sensitive catheter with damping or loss of the signal. These problems have been eliminated by developing a novel surgical procedure for placement of a pressure-sensitive catheter beneath the pleural surface. The catheter (attached to a radiotelemetry transmitter) is surgically implanted beneath the serosal layer of the esophagus within the thoracic cavity. This is accomplished by making a small incision in the serosal layer of the esophagus caudal to the diaphragm and advancing the catheter cranially into the thoracic cavity until pressure changes are maximal. The accuracy of these measurements was verified by comparison with direct pleural pressure measurements over the range of -3 to -34 cm H2O. The pleural pressure changes remained constant for at least 14 weeks following surgery, and there was no evidence of tissue damage or growth around the catheter. This novel method for measuring pleural pressure chronically in conscious rats will facilitate evaluation of the effects of drugs, environmental agents, or disease on respiratory function by allowing repeated and simultaneous measurements of both ventilatory (breathing) patterns and lung function in conscious animals. PMID:9741387

  19. Adenosine deaminase is a useful biomarker to diagnose pleural tuberculosis in low to medium prevalence settings.

    PubMed

    Michot, Jean-Marie; Madec, Yoann; Bulifon, Sophie; Thorette-Tcherniak, Ccile; Fortineau, Nicolas; Nol, Nicolas; Lambotte, Olivier; El Jahiri, Younes; Delacour, Herv; Delfraissy, Jean-Franois; Blanc, Franois-Xavier

    2016-03-01

    Adenosine deaminase (ADA) activity measurement in pleural fluid is a relevant test to diagnose pleural tuberculosis (pTB) in high tuberculosis prevalence settings. We investigated the diagnostic utility of pleural ADA using a retrospective analysis of patients admitted with newly diagnosed pleural effusion without identified etiology between 2001 and 2008 in Paris suburb, a low to medium tuberculosis prevalence area. 104 adults (mean age 55 years; 34 with pTB, 70 with other diagnoses) were analyzed. Median follow-up was 15.6 months. Mean [interquartile range] pleural ADA was 119 U/L [IQR: 83-143] in pTB and 24 U/L [IQR: 15-31] in non-tuberculous effusions (P<0.001). With an optimal pleural ADA cut-off value of 41.5 U/L for pTB diagnosis, sensitivity and specificity were 97.1% and 92.9%, while positive and negative predictive values were 86.8% and 98.5%, respectively. We conclude that pleural ADA activity could be integrated in the diagnostic procedures of pTB in low to medium tuberculosis prevalence settings. PMID:26707067

  20. A review of uncommon cytopathologic diagnoses of pleural effusions from a chest diseases center in Turkey

    PubMed Central

    Cakir, Ebru; Demirag, Funda; Aydin, Mehtap; Erdogan, Yurdanur

    2011-01-01

    Background: After pneumonia, cancer involving the pleura is the leading cause of exudative pleural effusion. Cytologic examination of pleural effusions is an important initial step in management of malignant effusions. The aim of this study is to evaluate the spectrum of uncommon malignant pleural effusions in a chest disease center in Turkey. Materials and Methods: A retrospective study of samples of pleural effusions submitted to Ataturk Chest Diseases and Chest Surgery Education and Research Hospital Department of Pathology between March 2005 and November 2008 was performed. Results: Out of a total of 4684 samples reviewed 364 (7.8%) were positive for cancer cells. Of the malignant pleural effusions 295 (81%) were classified as adenocarcinoma or carcinoma not otherwise specified (NOS). Pleural effusion specimens revealing a diagnosis other than adenocarcinoma/carcinoma NOS were: 32 (8.8%) malignant mesotheliomas, 14 (3.8%) small cell carcinomas, 13 (3.5%) hematolymphoid malignancies and 10 (2.7%) squamous cell carcinoma. Hematolymphoid malignancies included non- Hodgkin lymphoma (diffuse B large cell lymphoma, mantle cell lymphoma), multiple myeloma, chronic myeloid leukemia, and acute myeloid leukemia. Conclusions: Despite that adenocarcinoma is the most common cause of malignant pleural effusions, there is a significant number of hematological and non-hematological uncommon causes of such effusions. Cytopathologists and clinicians must keep in mind these uncommon entities in routine practice for an accurate diagnosis. PMID:21799700

  1. An Additional Potential Factor for Kidney Stone Formation during Space Flights: Calcifying Nanoparticles (Nanobacteria): A Case Report

    NASA Technical Reports Server (NTRS)

    Jones, Jeffrey A.; Ciftcioglu, Neva; Schmid, Joseph; Griffith, Donald

    2007-01-01

    Spaceflight-induced microgravity appears to be a risk factor for the development of urinary calculi due to skeletal calcium liberation and other undefined factors, resulting in stone disease in crewmembers during and after spaceflight. Calcifying nanoparticles, or nanobacteria, reproduce at a more rapid rate in simulated microgravity conditions and create external shells of calcium phosphate in the form of apatite. The questions arises whether calcifying nanoparticles are niduses for calculi and contribute to the development of clinical stone disease in humans, who possess environmental factors predisposing to the development of urinary calculi and potentially impaired immunological defenses during spaceflight. A case of a urinary calculus passed from an astronaut post-flight with morphological characteristics of calcifying nanoparticles and staining positive for a calcifying nanoparticle unique antigen, is presented.

  2. Organized chronic subdural haematoma with a thick calcified inner membrane successfully treated by surgery: a case report.

    PubMed

    Oda, Shinri; Shimoda, Masami; Hoshikawa, Kaori; Shiramizu, Hideki; Matsumae, Mitsunori

    2010-09-01

    The optimal surgical procedure for patients with calcified and organized chronic subdural haematoma (CSDH), or "armoured brain", has not been established because it is difficult to obtain good re-expansion of the brain after surgery. We present herein the case of a 32-year-old woman with huge calcified CSDH manifesting as refractory headache, periods of unconsciousness, and unsteady gait who obtained favourable results after craniotomy. Thinning of the thick calcified inner membrane using high-speed air drilling was performed after removal of the organized CSDH. The patient obtained good re-expansion after surgery. This observation illustrates that it is possible to perform such a surgery even on a huge calcified CSDH. PMID:21319032

  3. Automated extraction of pleural effusion in three-dimensional thoracic CT images

    NASA Astrophysics Data System (ADS)

    Kido, Shoji; Tsunomori, Akinori

    2009-02-01

    It is important for diagnosis of pulmonary diseases to measure volume of accumulating pleural effusion in threedimensional thoracic CT images quantitatively. However, automated extraction of pulmonary effusion correctly is difficult. Conventional extraction algorithm using a gray-level based threshold can not extract pleural effusion from thoracic wall or mediastinum correctly, because density of pleural effusion in CT images is similar to those of thoracic wall or mediastinum. So, we have developed an automated extraction method of pulmonary effusion by use of extracting lung area with pleural effusion. Our method used a template of lung obtained from a normal lung for segmentation of lungs with pleural effusions. Registration process consisted of two steps. First step was a global matching processing between normal and abnormal lungs of organs such as bronchi, bones (ribs, sternum and vertebrae) and upper surfaces of livers which were extracted using a region-growing algorithm. Second step was a local matching processing between normal and abnormal lungs which were deformed by the parameter obtained from the global matching processing. Finally, we segmented a lung with pleural effusion by use of the template which was deformed by two parameters obtained from the global matching processing and the local matching processing. We compared our method with a conventional extraction method using a gray-level based threshold and two published methods. The extraction rates of pleural effusions obtained from our method were much higher than those obtained from other methods. Automated extraction method of pulmonary effusion by use of extracting lung area with pleural effusion is promising for diagnosis of pulmonary diseases by providing quantitative volume of accumulating pleural effusion.

  4. Clear cell variant of calcifying epithelial odontogenic tumor: Case report with immunohistochemical findings

    PubMed Central

    Turatti, Eveline; Brasil, Juviano; Romaach, Mrio-Jos; de Almeida, Oslei-Paes

    2015-01-01

    Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm, locally aggressive, characterized by sheets and nests of polyhedral epithelial cells exhibiting eosinophilic cytoplasm or less often clear cytoplasm. Additional features include nuclear pleomorphism without mitotic activity, concentric calcifications, and deposits of amyloid. Herein, we present an additional example of clear cell variant of CEOT occurring in a 25-year-old female. Microscopically, the tumor consisted on proliferation of epithelial cells with eosinophilic, clear vacuolated cytoplasm interspersed with focal areas of amyloid deposition. Tumor cells were immunopositive for AE1/AE3, CK14, CK19, ?-catenin, CD138, and p63. Key words:Calcifying epithelial odontogenic tumor, clear cell, histopathology, immunohistochemistry. PMID:25810830

  5. Integrally calcified solitary fibrous tumor in the retroperitoneum: a case report and review of the literature.

    PubMed

    Maki, Takehiro; Fujino, Syotaro; Misu, Kenjiro; Kaneko, Hiroyuki; Inomata, Hitoshi; Omi, Makoto; Tateno, Masatoshi; Nihei, Kazuyoshi

    2016-12-01

    Solitary fibrous tumor (SFT) is a rare stromal neoplasm and usually occurs in the thoracic cavity. We here report a case of retroperitoneal SFT with prominent calcification. A 64-year-old man presented with an incidentally detected retroperitoneal mass in the right upper abdomen. Imaging tests indicated an integrally calcified mass. The lesion was observed for 2 years and laparoscopically resected according to the patient's wish. Microscopically, the mass was mostly occupied by calcification and proliferous spindle cells were scattered with positive CD34 expression. We diagnosed morphologically benign SFT and the patient remained disease-free 1 year after the excision. There has been no report of such integrally calcified SFT. Retroperitoneal SFT is difficult to make a preoperative diagnosis, and careful follow-up after the excision is recommended because morphological malignancy does not always correspond to clinical malignancy. PMID:26943690

  6. A role for diatom-like silicon transporters in calcifying coccolithophores

    PubMed Central

    Durak, Grażyna M.; Taylor, Alison R.; Walker, Charlotte E.; Probert, Ian; de Vargas, Colomban; Audic, Stephane; Schroeder, Declan; Brownlee, Colin; Wheeler, Glen L.

    2016-01-01

    Biomineralization by marine phytoplankton, such as the silicifying diatoms and calcifying coccolithophores, plays an important role in carbon and nutrient cycling in the oceans. Silicification and calcification are distinct cellular processes with no known common mechanisms. It is thought that coccolithophores are able to outcompete diatoms in Si-depleted waters, which can contribute to the formation of coccolithophore blooms. Here we show that an expanded family of diatom-like silicon transporters (SITs) are present in both silicifying and calcifying haptophyte phytoplankton, including some globally important coccolithophores. Si is required for calcification in these coccolithophores, indicating that Si uptake contributes to the very different forms of biomineralization in diatoms and coccolithophores. Significantly, SITs and the requirement for Si are absent from highly abundant bloom-forming coccolithophores, such as Emiliania huxleyi. These very different requirements for Si in coccolithophores are likely to have major influence on their competitive interactions with diatoms and other siliceous phytoplankton. PMID:26842659

  7. A role for diatom-like silicon transporters in calcifying coccolithophores.

    PubMed

    Durak, Grażyna M; Taylor, Alison R; Walker, Charlotte E; Probert, Ian; de Vargas, Colomban; Audic, Stephane; Schroeder, Declan; Brownlee, Colin; Wheeler, Glen L

    2016-01-01

    Biomineralization by marine phytoplankton, such as the silicifying diatoms and calcifying coccolithophores, plays an important role in carbon and nutrient cycling in the oceans. Silicification and calcification are distinct cellular processes with no known common mechanisms. It is thought that coccolithophores are able to outcompete diatoms in Si-depleted waters, which can contribute to the formation of coccolithophore blooms. Here we show that an expanded family of diatom-like silicon transporters (SITs) are present in both silicifying and calcifying haptophyte phytoplankton, including some globally important coccolithophores. Si is required for calcification in these coccolithophores, indicating that Si uptake contributes to the very different forms of biomineralization in diatoms and coccolithophores. Significantly, SITs and the requirement for Si are absent from highly abundant bloom-forming coccolithophores, such as Emiliania huxleyi. These very different requirements for Si in coccolithophores are likely to have major influence on their competitive interactions with diatoms and other siliceous phytoplankton. PMID:26842659

  8. Gastric Calcifying Fibrous Tumor: A Case of Suspected Immunoglobulin G4-related Gastric Disease

    PubMed Central

    Zhang, Hejun; Jin, Zhu; Ding, Shigang

    2015-01-01

    Gastrointestinal lesions resulting from immunoglobulin G4-related disease are classified into two types: One is a gastrointestinal lesion showing marked thickening of the wall, and the other is an IgG4-related pseudotumor. We report the case of a woman with gastric calcifying fibrous tumor undergoing endoscopic resection that contained 62 IgG4+ plasma cells per high-power field and an IgG4-to-IgG ratio of 41% in lesional plasma cells, which shared clinical and histopathological features associated with gastric IgG4-related pseudotumor. So, we postulate that calcifying fibrous tumor as part of the spectrum of IgG4-related disease might be the unifying concept with IgG4-related pseudotumor. Meanwhile, the patient had coexistent autoimmune diseases, including autoimmune atrophic gastritis, Hashimoto's thyroiditis, and possible primary biliary cirrhosis. The clinical follow-up evaluation was uneventful. PMID:26655140

  9. Calcifying cystic odontogenic tumor associated with an odontome a diverse lesion encountered

    PubMed Central

    Radheshyam, Chourasia; Alokenath, Bandyopadhyay; Kumar, Harish; Abikshyeet, Panda

    2015-01-01

    The human jaw is an exclusive habitat for odontogenic lesions. Ghost cells associated odontogenic lesions are a diverse group with a variety of presentations in the jaws. Calcifying cystic odontogenic tumor is a benign cystic neoplasm of odontogenic origin which demonstrates ghost cells in the epithelial component. This tumor sometimes mimics the features of a cyst clinically and radiographically, but histopathologically as well as behavior-wise shows the features of a tumor. Many classification systems have been proposed and revised from time to time. Presently a dualistic concept is highlighted to classify this group of lesions. The present case highlights a case of calcifying cystic odontogenic tumor associated with a complex composite odontome, which appeared like a cyst clinically and radiographically. PMID:26345145

  10. Bilateral Calcifying Cystic Odontogenic Tumour of Mandible: A Rare Case Report and Review of Literature.

    PubMed

    Khandelwal, Pragun; Aditya, Amita; Mhapuskar, Amit

    2015-11-01

    Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination. PMID:26673837

  11. Bilateral Calcifying Cystic Odontogenic Tumour of Mandible: A Rare Case Report and Review of Literature

    PubMed Central

    Khandelwal, Pragun; Mhapuskar, Amit

    2015-01-01

    Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination. PMID:26673837

  12. Diverse Findings in Calcified Thrombus Between Histopathology and In Vivo Imaging Including Intravascular Ultrasound, Optical Coherence Tomography, and Angioscopy.

    PubMed

    Koga, Seiji; Ikeda, Satoshi; Nakata, Tomoo; Kawano, Hiroaki; Abe, Kuniko; Maemura, Koji

    2015-12-01

    A 46-year-old woman on hemodialysis due to end-stage renal disease was admitted for repeated thrombus formation in previously implanted drug-eluting stents in the right coronary artery. We could successfully aspirate this thrombus, and histopathology revealed a calcified thrombus comprising multiple microcalcifications and fibrinous materials. This is the first report showing how a calcified thrombus is visualized in vivo by intracoronary imaging modalities including intravascular ultrasound, optical coherence tomography, and angioscopy. PMID:26549397

  13. A rare case of hybrid odontogenic tumor: Calcifying epithelial odontogenic tumor combined with ameloblastoma

    PubMed Central

    Wadhwan, Vijay; Sharma, Preeti; Bansal, Vishal

    2015-01-01

    A hybrid odontogenic tumor comprising two distinct lesions is extremely rare. Nevertheless, such tumors have been reported in the literature for academic and research interest. However, it is still obscure whether they behave as a new entity or they solely present separate histopathologic patterns. Here, we present a true hybrid neoplasm of combined ameloblastoma and calcifying epithelial odontogenic tumor showing intermixed histopathologic patterns of both the tumors. PMID:26604514

  14. Pleural procedures and patient safety: a national BTS audit of practice.

    PubMed

    Hooper, Clare E; Welham, Sally A; Maskell, Nick A

    2015-02-01

    The BTS pleural procedures audit collected data over a 2-month period in June and July 2011. In contrast with the 2010 audit, which focussed simply on chest drain insertions, data on all pleural aspirations and local anaesthetic thoracoscopy (LAT) was also collected. Ninety hospitals submitted data, covering a patient population of 33 million. Twenty-one per cent of centres ran a specialist pleural disease clinic, 71% had a nominated chest drain safety lead, and 20% had thoracic surgery on site. Additionally, one-third of centres had a physician-led LAT service. PMID:24658342

  15. Improved Diagnosis of Pleural Tuberculosis Using the Microscopic-Observation Drug-Susceptibility Technique

    PubMed Central

    Tovar, Marco; Siedner, Mark J.; Gilman, Robert H.; Santillan, Carlos; Caviedes, Luz; Valencia, Teresa; Jave, Oswaldo; Rod Escombe, A.; Moore, David A. J.; Evans, Carlton A.

    2010-01-01

    Tests for pleural tuberculosis are insensitive and expensive. We compared nonproprietary microscopic-observation drug-susceptibility (MODS) culture with Lwenstein-Jensen culture for evaluation of pleural specimens. MODS culture was associated with greatly increased diagnostic sensitivity and shorter time to diagnosis, compared with Lwenstein-Jensen culture (sensitivity of culture of biopsy specimens, 81% vs. 51%; time to diagnosis, 11 days vs. 24 days; P < .001). The MODS technique is inexpensive, allows drug-susceptibility testing, and is a considerably improved diagnostic method for pleural tuberculosis. PMID:18300380

  16. Primary pleural angiosarcoma associated with pneumoconiosis: An autopsy case.

    PubMed

    Matsuda, Katsuya; Yamaryo, Takeshi; Akazawa, Yuko; Kawakami, Kenji; Nakashima, Masahiro

    2015-11-01

    We report a case of pleural angiosarcoma in an adult male patient confirmed by autopsy and possibly associated with pneumoconiosis. The lesion was characterized by thickened pleura of both lungs with nodular tumors. Histologically, the tumor was composed of spindle-to-polygonal epithelioid cells that were positive for CD31, CD34, vimentin, and cytokeratin on immunohistochemical staining but were negative for calretinin. Further examination revealed mix-dust pathological findings consistent with the existence of pneumoconiosis; dystrophic ossification, anthracosis, and fractal small dust particles were observed in the lung parenchyma and a hilar lymph node. The current case suggests that pneumoconiosis-associated pathologies may be risk factors for the development of angiosarcoma in the pleura. PMID:26314557

  17. Management of malignant pleural mesothelioma—The European experience

    PubMed Central

    2014-01-01

    Management of malignant pleural mesothelioma (MPM) remains a clinical challenge and the incidence of the disease will continue to increase worldwide. Several aspects of mesothelioma treatment are discussed controversially, in particular, regarding extent and best type of surgery, radiotherapy, and the role of neoadjuvant or adjuvant treatment. However, best survival data is reported from groups using multimodality treatment including macroscopic complete resection (MCR) achieved by either extrapleural pneumonectomy (EPP) or (extended) pleurectomy/decortication for patients qualifying from the tumor biology, stage, and patient’s performance status and comorbidities. Several aspects have to be considered during surgery but morbidity and mortality have been reduced at experienced centres. The final analysis of extended selection algorithms is pending. PMID:24868442

  18. Environmental household exposures to asbestos and occurrence of pleural mesothelioma

    SciTech Connect

    Dodoli, D.; Del Nevo, M.; Fiumalbi, C.; Iaia, T.E.; Cristaudo, A.; Comba, P.; Viti, C.; Battista, G. )

    1992-01-01

    The authors reviewed the certificates of 39,650 deaths which occurred in the period 1975-1988 in Leghorn and of 45,900 in La Spezia (Italy) in the period 1958-1988. In total 262 cases have been recorded as pleural mesothelioma. The main occupational exposures occurred in the shipbuilding industry. Regarding non-occupational exposures to asbestos, 13 cases of mesothelioma were found in women who had washed the work clothes of their relatives at home; we also found other domestic uses of asbestos which were rarely or never discussed previously in the literature: six cases might be explained by the installation of fireproof or non-conductive materials in the domestic environment. These exposures probably are more frequent than realized until now.

  19. A Large Pleural Effusion following Abdominal Aortic Surgery

    PubMed Central

    Ramsaran, Vinoo K.; Seeram, Vandana K.; Cury, James; Shujaat, Adil

    2015-01-01

    Chylous ascites and coexistent chylothorax is a rare but important complication following retroperitoneal abdominal surgery. We report a 70-year-old male who developed gradual abdominal distension, chest tightness, and dyspnea five months after having an uncomplicated aortobifemoral bypass performed. Physical examination was consistent with a large right sided effusion and ascites which were confirmed by computed tomography. Thoracentesis yielded an opaque milky fluid with analysis consistent with a chylothorax with a paracentesis revealing fluid that was similar in both appearance and biochemistry. The patient failed initial conservative management so a chest tube was placed followed by chemical pleurodesis. We review the literature of the pathophysiology and treatment approach to such a pleural effusion. PMID:26635989

  20. Future developments in the management of malignant pleural mesothelioma.

    PubMed

    Zucali, Paolo Andrea; De Vincenzo, Fabio; Simonelli, Matteo; Santoro, Armando

    2009-04-01

    Malignant pleural mesothelioma (MPM) is an aggressive tumor with a poor prognosis and an increasing incidence as a result of widespread exposure to asbestos. In the past few years, there have been several developments in the management of patients with MPM, including more accurate staging and patient selection, improvements in surgical techniques and postoperative care, novel chemotherapy regimens and new radiotherapy techniques. However, chemotherapy remains the mainstay of treatment, considering that surgery and radiotherapy have a limited role in highly selected patients, and its results are still modest, with a median survival of approximately 1 year. The principal goals of this review are to summarize the improvements in the management of MPM that have been achieved recently and to outline the therapeutic approaches in development. PMID:19374599