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Motion compensated reconstructions of calcified coronary plaques in cardiac CT  

Microsoft Academic Search

In order to obtain motion-compensated reconstructions of calcified coronary plaques in cardiac CT, the dynamic trajectory of the plaque must be known rather accurately. The purpose of this study is to evaluate whether the dynamic trajectories of a plaque extracted from reconstructions provided by a previously developed tracking algorithm can be used for obtaining motion-compensated reconstructions of this plaque. A

Martin King; Xiaochuan Pan; Maryellen Giger; Kenji Suzuki



The Association of Pericardial Fat With Calcified Coronary Plaque  

Microsoft Academic Search

Background:Pericardial fat has a higher secretion of inflammatory cytokines than subcutaneous fat. Cytokines released from pericardial fat around coronary arteries may act locally on the adjacent cells.Objective:We examined the relationship between pericardial fat and calcified coronary plaque.Methods and Procedures:Participants in the community-based Multi-Ethnic Study of Atherosclerosis (MESA) underwent a computed tomography (CT) scan for the assessment of calcified coronary plaque

Jingzhong Ding; Stephen B. Kritchevsky; Tamara B. Harris; Gregory L. Burke; Robert C. Detrano; Moyses Szklo; J. Jeffrey Carr



A rotational ablation tool for calcified atherosclerotic plaque removal.  


Atherosclerosis is a major cardiovascular disease involving accumulations of lipids, white blood cells, and other materials on the inside of artery walls. Since the calcification found in the advanced stage of atherosclerosis dramatically enhances the mechanical properties of the plaque, restoring the original lumen of the artery remains a challenge. High-speed rotational atherectomy, when performed with an ablating grinder to remove the plaque, produces much better results in the treatment of calcified plaque compared to other methods. However, the high-speed rotation of the Rotablator commercial rotational atherectomy device produces microcavitation, which should be avoided because of the serious complications it can cause. This research involves the development of a high-speed rotational ablation tool that does not generate microcavitation. It relies on surface modification to achieve the required surface roughness. The surface roughness of the tool for differential cutting was designed based on lubrication theory, and the surface of the tool was modified using Nd:YAG laser beam engraving. Electron microscope images and profiles indicated that the engraved surface of the tool had approximately 1 ?m of root mean square surface roughness. The ablation experiment was performed on hydroxyapatite/polylactide composite with an elastic modulus similar to that of calcified plaque. In addition, differential cutting was verified on silicone rubber with an elastic modulus similar to that of a normal artery. The tool performance and reliability were evaluated by measuring the ablation force exerted, the size of the debris generated during ablation, and through visual inspection of the silicone rubber surface. PMID:21792606

Kim, Min-Hyeng; Kim, Hyung-Jung; Kim, Nicholas N; Yoon, Hae-Sung; Ahn, Sung-Hoon



Stationary and high-frequency pulsed electron paramagnetic resonance of a calcified atherosclerotic plaque  

NASA Astrophysics Data System (ADS)

New possibilities of applying high-frequency electron paramagnetic resonance in medicine are demonstrated on an example of the investigation of a calcified atherosclerotic plaque. After the irradiation of the atherosclerotic plaque by x rays, a new type of paramagnetic centers—organomineral radicals—is detected. The spectral and relaxation characteristics of these radicals depend on the calcification degree of the atherosclerotic plaque and can be used for diagnostics.

Abdul'Yanov, V. A.; Galiullina, L. F.; Galyavich, A. S.; Izotov, V. G.; Mamin, G. V.; Orlinskii, S. B.; Rodionov, A. A.; Salakhov, M. Kh.; Silkin, N. I.; Sitdikova, L. M.; Khairullin, R. N.; Chelyshev, Yu. A.



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

PubMed Central

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.

Jeon, Jin Sue; Hwang, Gyojun



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

NASA Astrophysics Data System (ADS)

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.

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



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

SciTech Connect

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.

King, Martin; Giger, Maryellen L.; Suzuki, Kenji; Pan, Xiaochuan [Department of Radiology, Committee on Medical Physics, University of Chicago, Chicago, Illinois 60637 (United States)



Computerized assessment of motion-contaminated calcified plaques in cardiac multidetector CT  

SciTech Connect

An automated method for evaluating the image quality of calcified plaques with respect to motion artifacts in noncontrast-enhanced cardiac computed tomography (CT) images is introduced. This method involves using linear regression (LR) and artificial neural network (ANN) regression models for predicting two patient-specific, region-of-interest-specific, reconstruction-specific and temporal phase-specific image quality indices. The first is a plaque motion index, which is derived from the actual trajectory of the calcified plaque and is represented on a continuous scale. The second is an assessability index, which reflects the degree to which a calcified plaque is affected by motion artifacts, and is represented on an ordinal five-point scale. Two sets of assessability indices were provided independently by two radiologists experienced in evaluating cardiac CT images. Inputs for the regression models were selected from 12 features characterizing the dynamic, morphological, and intensity-based properties of the calcified plaques. Whereas LR-velocity (LR-V) used only a single feature (three-dimensional velocity), the LR-multiple (LR-M) and ANN regression models used the same subset of these 12 features selected through stepwise regression. The regression models were parameterized and evaluated using a database of simulated calcified plaque images from the dynamic NCAT phantom involving nine heart rate/multi-sector gating combinations and 40 cardiac phases covering two cardiac cycles. Six calcified plaques were used for the plaque motion indices and three calcified plaques were used for both sets of assessability indices. In one configuration, images from the second cardiac cycle were used for feature selection and regression model parameterization, whereas images from the first cardiac cycle were used for testing. With this configuration, repeated measures concordance correlation coefficients (CCCs) and associated 95% confidence intervals for the LR-V, LR-M, and ANN were 0.817 [0.785, 0.848], 0.894 [0.869, 0.916], and 0.917 [0.892, 0.936] for the plaque motion indices. For the two sets of assessability indices, CCC values for the ANN model were 0.843 [0.791, 0.877] and 0.793 [0.747, 0.828]. These two CCC values were statistically greater than the CCC value of 0.689 [0.648, 0.727], which was obtained by comparing the two sets of assessability indices with each other. These preliminary results suggest that the variabilities of assessability indices provided by regression models can lie within the variabilities of the indices assigned by independent observers. Thus, the potential exists for using regression models and assessability indices for determining optimal phases for cardiac CT image interpretation.

King, Martin; Giger, Maryellen L.; Suzuki, Kenji; Bardo, Dianna M. E.; Greenberg, Brent; Lan Li; Pan Xiaochuan [Department of Radiology, Committee on Medical Physics, University of Chicago, Chicago, Illinois 60637 (United States)



Is There a Relation between Non-Calcifying Coronary Plaques and Acute Coronary Syndromes? A Retrospective Study Using Multislice Computed Tomography  

Microsoft Academic Search

Objectives: The purpose of this study was to assess whether different coronary plaque types as classified by multislice computed tomography (CT) are retrospectively correlated with acute coronary syndromes (ACS) in an unselected study population. Methods: Sixty-three consecutive patients were examined with 16-slice CT coronary angiography. Coronary plaque types were classified as calcifying type 1, mixed (calcifying > non-calcifying) type 2,

Gudrun Feuchtner; Thomas Postel; Franz Weidinger; Matthias Frick; Hannes Alber; Wolfgang Dichtl; Daniel Jodocy; Ammar Mallouhi; Otmar Pachinger; Dieter zur Nedden; Guy J. Friedrich



Detection and Quantification of Calcified Coronary Plaque With Multidetector-Row CT  

Microsoft Academic Search

Multidetector-row computed tomography (MDCT) has rapidly developed into a powerful tool for noninvasive measurement of calcified\\u000a plaque in the coronary arteries over the past decade. Identification and quantification of coronary artery calcifications\\u000a (CAC) with X-ray devices is well established in the literature with chest radiographs, fluoroscopy, computed tomography (CT\\u000a without electrocardiogram [ECG] gating) and cardiac CT (electron beam CT [EBCT],

J. Jeffrey Carr


Pleural plaques: a review of diagnostic issues and possible nonasbestos factors.  


The authors reviewed nonasbestos etiologies and diagnostic issues related to pleural plaques. Through searches of PUBMED and DIALOG using the term pleural plaques, they identified 125 articles. The authors found additional references by reviewing citations of these 125 articles. Exposure to nonasbestos agents (eg, erionite, silicates, manmade fibers) was cited as a possible factor in plaque development, although this association was based on limited data; empyema, tuberculosis, rib fractures, and hemothorax also were cited as potential etiologies. Rib companion shadows, fat, intercostal vessels, and muscles can appear as plaques; thus, radiographic diagnosis requires careful evaluation. Chest x-rays show large false negative and varying false positive rates. The terms calcification and thickening often were used as synonymous with plaques; however, these terms have different meanings. The authors concluded that plaques may be associated with nonasbestos exposures and certain medical conditions. Without a thorough exposure/medical history, plaque reports can be misleading. PMID:17867573

Clarke, Chester C; Mowat, Fionna S; Kelsh, Michael A; Roberts, Mark A


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


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

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



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


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

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



Computerized assessment of coronary calcified plaques in CT images of a dynamic cardiac phantom  

NASA Astrophysics Data System (ADS)

Motion artifacts in cardiac CT are an obstacle to obtaining diagnostically usable images. Although phase-specific reconstruction can produce images with improved assessability (image quality), this requires that the radiologist spend time and effort evaluating multiple image sets from reconstructions at different phases. In this study, ordinal logistic regression (OLR) and artificial neural network (ANN) models were used to automatically assign assessability to images of coronary calcified plaques obtained using a physical, dynamic cardiac phantom. 350 plaque images of 7 plaques from five data sets (heart rates 60, 60, 70, 80, 90) and ten phases of reconstruction were obtained using standard cardiac CT scanning parameters on a Phillips Brilliance 64-channel clinical CT scanner. Six features of the plaques (velocity, acceleration, edge-based volume, threshold-based volume, sphericity, and standard deviation of intensity) as well as mean feature values and heart rate were used for training the OLR and ANN in a round-robin re-sampling scheme based on training and testing groups with independent plaques. For each image, an ordinal assessability index rating on a 1-5 scale was assigned by a cardiac radiologist (D.B.) for use as a "truth" in training the OLR and ANN. The mean difference between the assessability index truth and model-predicted assessability index values was +0.111 with SD=0.942 for the OLR and +0.143 with SD=0.916 for the ANN. Comparing images from the repeat 60 bpm scans gave concordance correlation coefficients (CCCs) of 0.794 [0.743, 0.837] (value, 95% CI) for the radiologist assigned values, 0.894 [0.856, 0.922] for the OLR, and 0.861 [0.818, 0.895] for the ANN. Thus, the variability of the OLR and ANN assessability index values appear to lie within the variability of the radiologist assigned values.

Rodgers, Zachary B.; King, Martin; Giger, Maryellen L.; Vannier, Michael; Bardo, Dianna M. E.; Suzuki, Kenji; Lan, Li



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

PubMed Central

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.

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



Medico-Legal Aspects of Asbestos-Induced Pleural Plaques: The Issue of Worker's Compensation  

Microsoft Academic Search

As pleural plaques are the most frequent sequela found in individuals formerly exposed to asbestos, and as asbestos is a known carcinogen, there is debate as to whether they are an occupationally related condition which should be com pensated. In order to get an idea on how the issue of compensation is dealt with in a series of European countries,

M. Rüegger; R. Schütz



Non-calcified coronary plaque volume inversely related to CD4 count in HIV infection  

PubMed Central

Background Non-calcified coronary artery plaque (NCAP) may be an important predictor of cardiovascular events, however, few studies have directly measured NCAP in HIV-infected individuals. Methods We completed a prospective cross-sectional evaluation of NCAP and coronary calcium scores using CT angiography in HIV-infected subjects (n=26) without known coronary artery disease (CAD), but who had one or more CAD risk factor and compared them to controls matched on age, race, sex, body mass index and Framingham risk score (n=26). Results There was no difference in coronary calcium scores (114 ± 218 vs. 124 ± 298 p=0.89) or NCAP volume (65 ± 86 mm3 vs. 63 ± 82 mm3, p=0.38) between HIV-infected subjects and controls, respectively. Among HIV-infected subjects, lower CD4 count was associated with increased NCAP volume (r=-0.52, p=0.006). CD4 count remained a significant predictor of NCAP in a multivariate analysis that adjusted for age and duration of antiretroviral therapy. Conclusion Plaque burden is similar between HIV-infected and uninfected individuals when matched on traditional CAD risk factors, however immune function may mediate the development of atherosclerosis in HIV infection.

Duarte, Horacio; Matta, Jatin R.; Muldoon, Nancy; Masur, Henry; Hadigan, Colleen; Gharib, Ahmed M.



Abnormal pulmonary function associated with diaphragmatic pleural plaques due to exposure to asbestos.  


Pulmonary function was measured in 79 men with diaphragmatic pleural plaques (DPP) as the only abnormality characteristic of asbestos disease on chest radiographs. They were selected from 4572 construction and shipyard workers exposed to asbestos. Abnormalities of pulmonary function in 21 non-smokers and 43 current smokers were compared with referent values adjusted for height, age, and duration of cigarette smoking. In the non-smokers, flows (FEV1) FEF75-85 and FEV1/FVC) were reduced and TGV and RV/TGV were raised. Current smokers had similar significant reductions. Thus by contrast with some current opinion that plaques are "an index only of past asbestos exposure," workers with plaques, even limited to the diaphragm, have functional impairment typical of pulmonary asbestosis. This suggests that they have pulmonary asbestosis, which is below the threshold of radiographic recognition. PMID:2207032

Kilburn, K H; Warshaw, R H



Vitamin d, adiposity, and calcified atherosclerotic plaque in african-americans.  


Context: Inverse associations are reported between circulating 25-hydroxyvitamin D and visceral adiposity. The effects of vitamin D levels on atherosclerosis are unknown. Objective: The objective of this study was to test for relationships between vitamin D, adiposity, bone density, and atherosclerosis in African-Americans. Design: Circulating 25-hydroxyvitamin D, 1,25 dihydroxyvitamin D, intact PTH, C-reactive protein and computed tomography-derived calcified atherosclerotic plaque (CP), bone density, and fat volumes were measured. Setting: Examinations were performed at a single outpatient general clinical research center visit. Subjects: Three hundred forty African-Americans with type 2 diabetes were evaluated. Mean +/- SD age was 55.6 +/- 9.6 yr, diabetes duration 10.6 +/- 8.3 yr, glomerular filtration rate 1.6 +/- 0.5 ml/sec, body mass index 35.6 +/- 8.7 kg/m(2), and 25-hydroxyvitamin D concentration 50.4 +/- 30.5 nmol/liter. Main Outcome Measure: Biomarkers were tested for association with pericardial, visceral, im, and sc adipose tissues; thoracic and lumbar vertebral bone density; and aorta, coronary, and carotid artery CP. Results: Adjusting for age, gender, body mass index, glycosylated hemoglobin, and glomerular filtration rate, 25-hydroxyvitamin D was negatively associated with visceral adiposity (P = 0.009) and positively associated with carotid artery CP and aorta CP (P = 0.013 and 0.014, respectively) but not with coronary artery CP or bone density. Conclusions: We confirmed an inverse association between vitamin D and visceral adiposity in African-Americans with diabetes. In addition, positive associations exist between 25-hydroxyvitamin D and aorta and carotid artery CP in African-Americans. The effects of supplementing vitamin D to raise the serum 25-hydroxyvitamin D level on atherosclerosis in African-Americans are unknown. Prospective trials are needed to determine the cardiovascular effects of supplemental vitamin D in this ethnic group. PMID:20061416

Freedman, Barry I; Wagenknecht, Lynne E; Hairston, Kristen G; Bowden, Donald W; Carr, J Jeffrey; Hightower, R Caresse; Gordon, Ethel J; Xu, Jianzhao; Langefeld, Carl D; Divers, Jasmin



Railroad workers with pleural plaques: II. Small airway dysfunction among asbestos-exposed workers.  


Increased volume of trapped gas (VTG) was found in 87 asbestos-exposed railroad repair shop workers, divided into three subgroups according to smoking habits. All the examined subjects had pleural plaques. Determination of VTG was used to study function of small airways. Increased VTG was found among asbestos-exposed smokers as well as nonsmokers. In both groups the VTG:TLC ratio was elevated compared with controls. Increased VTG is a sign of small airways dysfunction. In asbestos-exposed subjects, it might be caused by an early peribronchial reaction to inhaled asbestos fibers. PMID:3232684

Hjortsberg, U; Orbaek, P; Aborelius, M; Ranstam, J; Welinder, H



Mechanical behavior of calcified plaques: a summary of compression and stress-relaxation experiments  

Microsoft Academic Search

Summary This paper summarizes the results from mechanical testing of atherosclerotic plaques performed in the Cardiovascular Mechanics Laboratory and the Laboratory for Implantable Materials at UMBC. The motivation for our work is that balloon angioplasty, stenting, and roto-ablation are mechanical processes that are designed to permanently alter the shape of an occluded arterial lumen. The mechanisms of permanent plaque deformation

L. D. T. Topoleski; N. V. Salunke



Genetic mapping of vascular calcified plaque loci on chromosome 16p in European Americans from the diabetes heart study.  


A linkage peak for carotid artery calcified plaque (CarCP) on chromosome 16p (LOD 4.39 at 8.4 cM) in families with type 2 diabetes mellitus (T2DM) from the Diabetes Heart Study (DHS) has been refined. Fine mapping encompassed 104 single-nucleotide polymorphisms (SNPs) in 937 subjects from 315 families; including 45 SNPs in six candidate genes (CACNA1H, SEPX1, ABCA3, IL32, SOCS1, CLEC16A). Linkage and association analyses using variance components analysis adjusting for age, gender, body mass index (BMI), and diabetes status refined the CarCP linkage into two distinct peaks (LODs: 3.89 at 6.9 cM and 4.86 at 16.0 cM). Evidence of linkage for coronary calcified plaque (LOD: 2.27 at 19 cM) and a vascular calcification principle component (LOD: 3.71 at 16.0 cM) 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= 0.010-0.033). Bayesian quantitative trait nucleotide (BQTN) analysis identified a SNP, rs1358489, with either a functional effect on CarCP or in linkage disequilibrium (LD) with a functional SNP. This study refined the 16p region contributing to vascular calcification. The causal variants remain to be identified, but results are consistent with a linkage peak that is due to multiple common variants, though rare variants cannot be excluded. PMID:21309755

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



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


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

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



Chocolate Consumption is Inversely Associated with Calcified Atherosclerotic Plaque in the Coronary Arteries: The NHLBI Family Heart Study  

PubMed Central

Background and Aims While a diet rich in anti-oxidant has been favorably associated with coronary disease and hypertension, limited data have evaluated the influence of such diet on subclinical disease. Thus, we sought to examine whether chocolate consumption is associated with calcified atherosclerotic plaque in the coronary arteries (CAC). Methods In a cross-sectional design, we studied 2,217 participants of the NHLBI Family Heart Study. Chocolate consumption was assessed by a semi-quantitative food-frequency questionnaire and 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 There was an inverse association between frequency of chocolate consumption and prevalent CAC. Odds ratios (95% CI) for CAC were 1.0 (reference), 0.94 (0.66-1.35), 0.78 (0.53-1.13), and 0.68 (0.48-0.97) for chocolate consumption of 0, 1-3 times per month, once per week, and 2+ times per week, respectively (p for trend 0.022), adjusting for age, sex, energy intake, waist-hip ratio, education, smoking, alcohol consumption, ratio of total-to-HDL-cholesterol, non-chocolate candy, and diabetes mellitus. Controlling for additional confounders did not alter the findings. Exclusion of subjects with coronary heart disease or diabetes mellitus did not materially change the odds ratio estimates but did modestly decrease the overall significance (p = 0.07). Conclusions These data suggest that chocolate consumption might be inversely associated with prevalent CAC.

Djousse, Luc; Hopkins, Paul N.; Arnett, Donna K.; Pankow, James S.; Borecki, Ingrid; North, Kari E.; Ellison, R. Curtis



Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type arising in the pleura with pleural fibrous plaques in a lathe worker.  


Our patient was an 86-year-old man who had worked as a lathe operator for 40 years. He had no history of tuberculosis, pyothorax, or autoimmune disease. He had not been exposed to asbestos. He was asymptomatic, but an imaging study showed gradually increasing pleural plaques. A biopsy specimen of a pleural lesion showed sclerosis of the pleura and diffuse infiltration of small- to medium-sized B lymphocytes. Polymerase chain reaction-based analysis detected monoclonal rearrangement of immunoglobulin heavy-chain genes. Histologic diagnosis was extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma). The lymphoma was negative for Epstein-Barr virus. We report a rare case of a metal worker with MALT lymphoma arising in the pleura with pleural fibrous plaques. It is speculated that MALT lymphoma might develop in the background of pneumoconiosis. Inflammatory and/or immunologic reactions to metal particles might contribute to the oncogenesis of this tumor. PMID:21546297

Nakatsuka, Shin-ichi; Nagano, Teruaki; Kimura, Hayato; Hanada, Shoji; Inoue, Hidetoshi; Iwata, Takashi



Prospective Validation that Vulnerable Plaque Associated with Major Adverse Outcomes Have Larger Plaque Volume, Less Dense Calcium, and More Non-Calcified Plaque by Quantitative, Three-Dimensional Measurements Using Intravascular Ultrasound with Radiofrequency Backscatter Analysis : Results from the ATLANTA I Study.  


Whether quantitative, two-dimensional, and three-dimensional plaque measurements by intravascular ultrasound with radiofrequency backscatter (IVUS/VH) are different between intermediate lesions with or without major adverse cardiovascular events (MACE) is unknown. IVUS/VH-derived parameters were compared in 60 patients with an intermediate coronary lesion (40-70 %) between lesions that did or did not result in MACE over 12 months. IVUS/VH measurements were done at the site of the minimal lumen area (MLA) and on a per-plaque basis, defined by 40 % plaque burden. Pre-specified, adjudicated MACE events occurred in 5 of 60 patients (8.3 %). MACE lesions had larger plaque burden (65 % vs. 53 %, p?=?0.004), less dense calcium (6.6 % vs. 14.7 %, p?=?0.05), and more non-calcified plaque, mostly fibrofatty kind (17.6 % vs. 10 %, p?=?0.02). Intermediate coronary lesions associated with MACE at 12 months have more plaque, less dense calcium, and more non-calcified plaque, particularly fibrofatty tissue by IVUS/VH. PMID:23695823

Vazquez-Figueroa, Jesus G; Rinehart, Sarah; Qian, Zhen; Joshi, Parag H; Sharma, Abhinav; Lee, James; Anderson, Hunt; Murrieta, Laura; Wilmer, Charles; Carlson, Harold; Taylor, Kenneth; Ballard, William; Karmpaliotis, Dimitri; Kalynych, Anna; Brown, Charles; Voros, Szilard



Intra- and interobserver variability in detection and assessment of calcified and noncalcified coronary artery plaques using 64-slice computed tomography  

Microsoft Academic Search

Objective Multislice computed tomography (MSCT) is an emerging noninvasive technique for detecting coronary plaques. The present study\\u000a investigated agreement in the detection and characterization of coronary plaques and reproducibility of volumetric analysis.\\u000a Methods A total of 20 patients underwent MSCT coronary angiography using 64 * 0.5 mm detector collimation. Two readers independently\\u000a visually evaluated all MSCT datasets for the presence of coronary plaques

Hans Hoffmann; Katja Frieler; Bernd Hamm; Marc Dewey



North American Erionite-Associated Mesothelioma with Pleural Plaques and Pulmonary Fibrosis: A Case Report  

PubMed Central

Erionite, a fibrous zeolite mineral, has been categorized as a class I carcinogenic agent for its causative role in mesothelioma. In select villages in Turkey, erionite is the cause of more than 50% of mesotheliomas. In contrast, in the United States mesotheliomas are frequently associated with asbestos exposure. We describe the first reported case of a patient with erionite-associated pleural mesothelioma with classic pathologic changes typical of asbestos-related pulmonary and pleural pathology. This case report indicates that in addition to Turkey, erionite-associated disease can occur in North America and that subjects with erionite exposure are not only at risk of developing mesothelioma, but may develop interstitial fibrosis and additional pulmonary pathology impacting lung function and patient survival.

Kliment, Corrine R.; Clemens, Kristen; Oury, Tim D.



North american erionite-associated mesothelioma with pleural plaques and pulmonary fibrosis: a case report.  


Erionite, a fibrous zeolite mineral, has been categorized as a class I carcinogenic agent for its causative role in mesothelioma. In select villages in Turkey, erionite is the cause of more than 50% of mesotheliomas. In contrast, in the United States mesotheliomas are frequently associated with asbestos exposure. We describe the first reported case of a patient with erionite-associated pleural mesothelioma with classic pathologic changes typical of asbestos-related pulmonary and pleural pathology. This case report indicates that in addition to Turkey, erionite-associated disease can occur in North America and that subjects with erionite exposure are not only at risk of developing mesothelioma, but may develop interstitial fibrosis and additional pulmonary pathology impacting lung function and patient survival. PMID:19158938

Kliment, Corrine R; Clemens, Kristen; Oury, Tim D



An outbreak of pleural mesothelioma and chronic fibrosing pleurisy in the village of Karain/Urg?p in Anatolia.  

PubMed Central

The 575 inhabitants of the remote Anatolian village of Karain suffered 11 deaths from pleural mesothelioma in 1975/76 and there were five cases of fibrosing pleurisy. In the previous five years there had been 25 cases of mesothelioma. Calcified pleural plaques were common on survey radiography. Asbestos does not occur in the local soil or rock, nor is it handled in the village, but a few fibres were found in the water. Fibres were also found in the pleural tissue of two of five cases examined. Inhabitants of the neighbouring villages are free of mesothelioma. Images

Baris, Y I; Sahin, A A; Ozesmi, M; Kerse, I; Ozen, E; Kolacan, B; Altinors, M; Goktepeli, A



Mineralization in calcified plaque is like that of cortical bone-Further evidence from ultrashort echo time (UTE) magnetic resonance imaging of carotid plaque calcification and cortical bone.  


Purpose: This study aims to investigate carotid plaque calcification (CPC) using two-dimensional (2D) and 3D ultrashort echo time (UTE) magnetic resonance imaging (MRI) sequences and compare T1, T2?, water concentration, and bone mineral density (BMD) of CPC with those of cortical bone.Methods: Twelve carotid plaque specimens and eight tibial cortical bone samples were imaged with UTE sequences. Adiabatic inversion recovery prepared UTE (IR-UTE) acquisitions were used for T2? measurement. Saturation recovery prepared UTE acquisitions were used for T1 measurement. Water concentration was measured by comparing signal from CPC and bone with that from a phantom. BMD was measured with ?CT. Conventional gradient echo and fast spin echo images were also acquired for comparison.Results: Our studies show that CPC and cortical bone have similar T1 and BMD values but different T2? and water concentration. For CPC T2?s ranged from 0.31 to 3.87 ms, T1s ranged from 114 to 332 ms, water concentrations ranged from 6.4% to 17.6%, and BMD ranged from 977 to 1319 mg?ml. For cortical bone T2?s ranged from 0.33 to 0.45 ms, T1s ranged from 198 to 254?ms, water concentrations ranged from 24.7% to 33.8%, and mineral densities ranged from 970 to 1287 mg?ml. On average CPC shows about 5% longer T1, 5% lower BMD, 440% longer T2?, and 130% lower water concentration when compared to human cortical bone.Conclusions: CPC bears remarkable similarities with cortical bone in terms of BMD and T1. CPC shows a higher mean T2? and a lower mean water concentration. PMID:24089920

Du, Jiang; Peterson, Michael; Kansal, Nikhil; Bydder, Graeme M; Kahn, Andrew



Impact of HDL genetic risk scores on coronary artery calcified plaque and mortality in individuals with type 2 diabetes from the Diabetes Heart Study  

PubMed Central

Background Patients with type 2 diabetes (T2D) are at elevated risk for cardiovascular disease (CVD) events and mortality. Recent studies have assessed the impact of genetic variants affecting high-density lipoprotein cholesterol (HDL) concentrations on CVD risk in the general population. This study examined the utility of HDL-associated single nucleotide polymorphisms (SNPs) for CVD risk prediction in European Americans with T2D enrolled in the Diabetes Heart Study (DHS). Methods Genetic risk scores (GRS) of HDL-associated SNPs were constructed and evaluated for potential associations with mortality and with coronary artery calcified atherosclerotic plaque (CAC), a measure of subclinical CVD strongly associated with CVD events and mortality. Two sets of SNPs were used to construct GRS; while all SNPs were selected primarily for their impacts on HDL, one set of SNPs had pleiotropic effects on other lipid parameters, while the other set lacked effects on low-density lipoprotein cholesterol (LDL) or triglyceride concentrations. Results The GRS were specifically associated with HDL concentrations (4.90?×?10-7?



Calcifying tendinopathy  

Microsoft Academic Search

Summary The authors examined 119 tendons with light-, and 34 tendons with electron microscope, excised within 48 h after spontaneous rupture of tendon. By light microscopic study 9, and by electron microscopic examination 18 cases of calcifying tendopathy could be detected. The calcification occured without necrosis or inflammation. The authors concluded, that calcifying tendinopathy is a hypoxic alteration of the

L. Józsa; B. J. Bálint; A. Réffy



Calcified lesion modeling for excimer laser ablation  

NASA Astrophysics Data System (ADS)

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.

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



CT features of pleural masses and nodules.  


Pleural space masses and nodules are rarely described on computed tomography (CT) in veterinary medicine and have only been described in patients with neoplasia. Our purpose was to describe the CT findings and diagnoses in seven patients with pleural masses and nodules. Two patients had broad-based, plaque-like pleural masses, both of which were due to neoplasia (primary pleural carcinoma, metastatic thymoma). Two patients had well-defined pleural nodules and nodular pleural thickening, one of which had mesothelial hypertrophy, and another of which had metastatic hemangiosarcoma. Three patients had ill-defined pleural nodules to nodular pleural thickening, one of which had metastatic pulmonary carcinoma, while the other two had bacterial infection with mesothelial proliferation (n = 2), fibrinous pleuritis (n = 1), and severe mediastinal pleuritis/mediastinitis (n = 2). Five of the seven patients had focal, multifocal or diffuse smooth, and/or irregular pleural thickening. Five of seven patients had pleural effusion, and postcontrast CT was useful in several patients for delineating the pleural lesions from the effusion. All patients except one had additional lesions identified on CT besides those in the pleural space. CT is useful in identifying and characterizing pleural space lesions and could be used to guide further diagnostic procedures such as thoracoscopy or exploratory thoracotomy. Both neoplastic and nonneoplastic diseases should be considered in the differential diagnoses for pleural space masses and nodules found on CT. PMID:22092656

Reetz, Jennifer A; Buza, Elizabeth L; Krick, Erika L


Pleural Disorders  


... layers of the pleura is a very thin space. Normally it's filled with a small amount of ... breathing Pleural effusion - excess fluid in the pleural space Pneumothorax - buildup of air or gas in the ...


Pleural effusion  

PubMed Central

Pleural disease remains a commonly encountered clinical problem for both general physicians and chest specialists. This review focuses on the investigation of undiagnosed pleural effusions and the management of malignant and parapneumonic effusions. New developments in this area are also discussed at the end of the review. It aims to be evidence based together with some practical suggestions for practising clinicians.

Medford, A; Maskell, N



Pleural mesothelioma.  


Pleural mesotheliomas are uncommon tumors. Correct diagnosis of the benign variant is rarely made preoperatively, and resection is the treatment of choice and is curative. Malignant pleural mesotheliomas are locally aggressive and difficult to treat. They may be seen clinically as localized pleural tumors or as diffuse pleural disease with effusion and encasement of the lung and obliteration of the pleural space. The localized forms of malignant mesotheliomas are fibrosarcomatous. Their diagnosis and treatment do not differ from those for soft-part sarcomas seen elsewhere. Wide en-bloc excision is the treatment of choice and can be curative. The diffuse forms of malignant mesotheliomas are mainly epithelial. Treatment is generally unsatisfactory, and long-term survival is rare. Two surgical approaches are currently available: an extrapleural pneumonectomy and a pleurectomy with irradiation. The authors favor the latter approach because of its wider applicability, lower morbidity rate, and better survival advantage. Steps in selecting the best surgical mode of treatment are presented. PMID:3541812

Martini, N; McCormack, P M; Bains, M S; Kaiser, L R; Burt, M E; Hilaris, B S



Comparison of Electron-Beam Computed Tomography and Intracoronary Ultrasound in Detecting Calcified and Noncalcified Plaques in Patients With Acute Coronary Syndromes and No or Minimal to Moderate Angiographic Coronary Artery Disease  

Microsoft Academic Search

We compared intracoronary ultrasound (ICUS) and electron-beam computed tomography (EBCT) on a coronary segmental basis in 40 consecutive patients with acute coronary syndromes and no or minimal to moderate angiographic disease (53 ± 10 years; 34 men, 6 women). ICUS was used to define plaques, and EBCT was used to quantify coronary calcium (using a threshold of a CT density

Axel Schmermund; Dietrich Baumgart; Michael Adamzik; Junbo Ge; Dietrich Grönemeyer; Rainer Seibel; Cornelia Sehnert; Günter Görge; Michael Haude; Raimund Erbel



Non-Neoplastic and Neoplastic Pleural Endpoints Following Fiber Exposure  

Microsoft Academic Search

Exposure to asbestos fibers is associated with non-neoplastic pleural diseases including plaques, fibrosis, and benign effusions, as well as with diffuse malignant pleural mesothelioma. Translocation and retention of fibers are fundamental processes in understanding the interactions between the dose and dimensions of fibers retained at this anatomic site and the subsequent pathological reactions. The initial interaction of fibers with target

V. Courtney Broaddus; Jeffrey I. Everitt; Brad Black; Agnes B. Kane



Calcified right atrial mass  

PubMed Central

This is the report of a case of a grossly calcified right atrial mass in a woman of 40 who also suffered from systemic hypertension, pyelonephritis, and hepatic cirrhosis. The differential diagnosis, surgical treatment, and necropsy findings are described along with a review of the literature. Images

Fleming, H. A.; Stovin, P. G. I.



Detection of Hydroxyapatite in Calcified Cardiovascular Tissues  

PubMed Central

Objective The objective of this study is to develop a method for selective detection of the calcific (hydroxyapatite) component in human aortic smooth muscle cells in vitro and in calcified cardiovascular tissues ex vivo. This method uses a novel optical molecular imaging contrast dye, Cy-HABP-19, to target calcified cells and tissues. Methods A peptide that mimics the binding affinity of osteocalcin was used to label hydroxyapatite in vitro and ex vivo. Morphological changes in vascular smooth muscle cells were evaluated at an early stage of the mineralization process induced by extrinsic stimuli, osteogenic factors and a magnetic suspension cell culture. Hydroxyapatite components were detected in monolayers of these cells in the presence of osteogenic factors and a magnetic suspension environment. Results Atherosclerotic plaque contains multiple components including lipidic, fibrotic, thrombotic, and calcific materials. Using optical imaging and the Cy-HABP-19 molecular imaging probe, we demonstrated that hydroxyapatite components could be selectively distinguished from various calcium salts in human aortic smooth muscle cells in vitro and in calcified cardiovascular tissues, carotid endarterectomy samples and aortic valves, ex vivo. Conclusion Hydroxyapatite deposits in cardiovascular tissues were selectively detected in the early stage of the calcification process using our Cy-HABP-19 probe. This new probe makes it possible to study the earliest events associated with vascular hydroxyapatite deposition at the cellular and molecular levels. This target-selective molecular imaging probe approach holds high potential for revealing early pathophysiological changes, leading to progression, regression, or stabilization of cardiovascular diseases.

Lee, Jae Sam; Morrisett, Joel D.; Tung, Ching-Hsuan



A Rheolytic System for Percutaneous Coronary and Peripheral Plaque Removal  

Microsoft Academic Search

A method for plaque dissolution has been identified that percutaneously delivers a pulsatile high-velocity stream of saline to the site of an atheromatous lesion within a coronary or peripheral artery. In vitro evaluation and in vivo canine and porcine testing were performed using this 'rheolytic' system to deter mine its feasibility in ablating calcified plaque and soft thrombotic tissue.A prototype

William J. Drasler; Mark L. Jenson; Gregory J. Wilson; Joseph M. Thielen; Emmanuil I. Protonotarios; Robert G. Dutcher; Zinon C. Possis



Odonto calcifying cyst  

PubMed Central

The calcifying odontogenic cyst (COC) is reported to be associated with odontoma in 24% of cases. Separation of the cases of calcifying odontogenic cyst associated with odontoma (COCaO) may lead to a better understanding of the pathogenesis of this lesion. The literature revealed 52 cases of COCaO. The male to female ratio was 1:1.9, with a mean age of 16 years. Most common location was the maxilla (61.5%). The radiographic appearance of most cases (80.5%) was a well-defined, mixed radiolucent-radiopaque lesion. Histologically, the lesions consisted of a single large cyst with tooth-like structures as an integral part, giving the impression of a single lesion. In addition to the unique histologic features, differences in gender and distribution were found between the cases of COCaO and those of simple COC. COCaO may be regarded as a separate entity and classified as a benign, mixed odontogenic tumor. The term odontocalcifying odontogenic cyst is suggested.

Aswath, Nalini; Mastan, Kader; Manikandan, Tirupathi; Samuel, Gigi



Pathophysiology of atherosclerosis plaque progression.  


Atherosclerotic plaque rupture with luminal thrombosis is the most common mechanism responsible for the majority of acute coronary syndromes and sudden coronary death. The precursor lesion of plaque rupture is thought to be a thin cap fibroatheroma (TCFA) or "vulnerable plaque". TCFA is characterised by a necrotic core with an overlying thin fibrous cap (?65 ?m) that is infiltrated by macrophages and T-lymphocytes. Intraplaque haemorrhage is a major contributor to the enlargement of the necrotic core. Haemorrhage is thought to occur from leaky vasa vasorum that invades the intima from the adventitia as the intima enlarges. The early atherosclerotic plaque progression from pathologic intimal thickening (PIT) to a fibroatheroma is thought to be the result of macrophage infiltration. PIT is characterised by the presence of lipid pools which consist of proteoglycan with lipid insudation. The conversion of the lipid pool to a necrotic core is poorly understood but is thought to occur as a result of macrophage infiltration which releases matrix metalloproteinase (MMPs) along with macrophage apoptosis that leads to the formation of a acellular necrotic core. The fibroatheroma has a thick fibrous cap that begins to thin over time through macrophage MMP release and apoptotic death of smooth muscle cells converting the fibroatheroma into a TCFA. Other causes of thrombosis include plaque erosion which is less frequent than plaque rupture but is a common cause of thrombosis in young individuals especially women <50 years of age. The underlying lesion morphology in plaque erosion consists of PIT or a thick cap fibroatheroma. Calcified nodule is the least frequent cause of thrombosis, which occurs in older individuals with heavily calcified and tortious arteries. PMID:23541627

Sakakura, Kenichi; Nakano, Masataka; Otsuka, Fumiyuki; Ladich, Elena; Kolodgie, Frank D; Virmani, Renu



Pleural procedures and pleuroscopy.  


Pleural procedures are commonly performed by physicians from a range of specialities. These procedures vary in complexity, from relatively straightforward pleural aspiration to more challenging procedures such as pleuroscopy. After appropriate training, even complex pleural procedures have a low risk of complications. Nevertheless, an appreciation of procedural risks is essential for physician training and forms the crux of a valid patient consent process. This review presents a systematic evaluation of the potential complications of common pleural procedures. PMID:19703062

Wrightson, John M; Helm, Emma J; Rahman, Najib M; Gleeson, Fergus V; Davies, Robert J O



Vascular Calcifying Progenitor Cells Possess Bidirectional Differentiation Potentials  

PubMed Central

Vascular calcification is an advanced feature of atherosclerosis for which no effective therapy is available. To investigate the modulation or reversal of calcification, we identified calcifying progenitor cells and investigated their calcifying/decalcifying potentials. Cells from the aortas of mice were sorted into four groups using Sca-1 and PDGFR? markers. Sca-1+ (Sca-1+/PDGFR?+ and Sca-1+/PDGFR??) progenitor cells exhibited greater osteoblastic differentiation potentials than Sca-1? (Sca-1?/PDGFR?+ and Sca-1?/PDGFR??) progenitor cells. Among Sca-1+ progenitor populations, Sca-1+/PDGFR?? cells possessed bidirectional differentiation potentials towards both osteoblastic and osteoclastic lineages, whereas Sca-1+/PDGFR?+ cells differentiated into an osteoblastic lineage unidirectionally. When treated with a peroxisome proliferator activated receptor ? (PPAR?) agonist, Sca-1+/PDGFR?? cells preferentially differentiated into osteoclast-like cells. Sca-1+ progenitor cells in the artery originated from the bone marrow (BM) and could be clonally expanded. Vessel-resident BM-derived Sca-1+ calcifying progenitor cells displayed nonhematopoietic, mesenchymal characteristics. To evaluate the modulation of in vivo calcification, we established models of ectopic and atherosclerotic calcification. Computed tomography indicated that Sca-1+ progenitor cells increased the volume and calcium scores of ectopic calcification. However, Sca-1+/PDGFR?? cells treated with a PPAR? agonist decreased bone formation 2-fold compared with untreated cells. Systemic infusion of Sca-1+/PDGFR?? cells into Apoe?/? mice increased the severity of calcified atherosclerotic plaques. However, Sca-1+/PDGFR?? cells in which PPAR? was activated displayed markedly decreased plaque severity. Immunofluorescent staining indicated that Sca-1+/PDGFR?? cells mainly expressed osteocalcin; however, activation of PPAR? triggered receptor activator for nuclear factor-?B (RANK) expression, indicating their bidirectional fate in vivo. These findings suggest that a subtype of BM-derived and vessel-resident progenitor cells offer a therapeutic target for the prevention of vascular calcification and that PPAR? activation may be an option to reverse calcification.

Lee, Ho-Jae; Song, Myung-Kang; Seo, Ji-Yun; Bae, Yeon-Hee; Kim, Ju-Young; Lee, Hae-Young; Lee, Whal; Koo, Bon-Kwon; Oh, Byung-Hee; Park, Young-Bae; Kim, Hyo-Soo



Duropleural fistula manifested as a large pleural transudate: an unusual complication of transthoracic diskectomy.  


A 52-year-old patient presented with large symptomatic transudative pleural effusion 4 months following T8 to T9 transthoracic diskectomy. Anterior approach diskectomy has replaced the traditional laminectomy for treating symptomatic centrally herniated and calcified thoracic disks. We describe in this report the first case of a large cerebrospinal fluid collection in the pleural cavity caused by persistent postoperative duropleural fistula. The possibility of a duropleural fistula should be entertained in patients who present with a pleural effusion following transthoracic diskectomy. PMID:9872224

Monla-Hassan, J; Eichenhorn, M; Spickler, E; Talati, S; Nockels, R; Hyzy, R



Malignant pleural disease.  


The vast majority of pleural neoplasms invade the pleura secondarily and can be seen in patients with bronchogenic carcinoma, breast cancer, lymphoma, and ovarian or gastric carcinoma. Primary pleural neoplasms are less common, although they have developed notoriety since the up-surge of malignant mesothelioma and the knowledge of its connection to asbestos exposure. Other malignant primary tumors include localized fibrous tumor and pleural liposarcoma. In most patients with diffuse malignant pleural disease the chest radiograph shows pleural effusion with or without pleural thickening. Computed tomography (CT) usually provides precise localization and extent of the disease and may be of value in assessing chest wall and mediastinal involvement. In specific situations, magnetic resonance (MR) may be useful as a problem-solving tool when CT findings of chest wall or diaphragmatic invasion are equivocal or in patients with contraindication to intravenous administration of ionic contrast material. PMID:10874176

Bonomo, L; Feragalli, B; Sacco, R; Merlino, B; Storto, M L



Atherosclerotic plaque composition and classification identified by coronary computed tomography: assessment of computed tomography-generated plaque maps compared with virtual histology intravascular ultrasound and histology.  


Background- Computed tomography (CT) is used routinely for coronary angiography, and higher-risk features of plaques can also be identified. However, the ability of CT to discriminate individual plaque components and classify plaques according to accepted histological definitions is unknown. Methods and Results- We first determined CT attenuation ranges for individual plaque components using combined in vivo CT coregistered with virtual histology intravascular ultrasound (VH-IVUS) in 108 plaques from 57 patients. Comparison with contrast attenuation created plaque/contrast attenuation ratios that were significantly different for each component. In a separate validation cohort of 47 patients, these Plaque Maps correlated significantly with VH-IVUS-determined plaque component volumes (necrotic core: r=0.41, P=0.002; fibrous plaque: r=0.54, P<0.001; calcified plaque: r=0.59, P<0.001; total plaque: r=0.62, P<0.001). We also assessed VH-IVUS and CT Plaque Maps against coregistered histology in 72 (VH-IVUS) and 87 (CT) segments from 8 postmortem coronary arteries. The diagnostic accuracy of CT to detect calcified plaque (83% versus 92%), necrotic core (80% versus 65%), and fibroatheroma (80% versus 79%) was comparable with VH-IVUS. However, although VH-IVUS could identify thin-cap fibroatheromas (TCFA) with a diagnostic accuracy of between 74% and 82% (depending on the TCFA definition used), the spatial resolution of CT prevented direct identification of TCFA. Conclusions- CT-derived Plaque Maps based on contrast-adjusted attenuation ranges can define individual plaque components with a similar accuracy to VH-IVUS ex vivo. However, coronary CT Plaque Maps could not reliably classify plaques and identify TCFA, such that high-risk plaques may be misclassified or overlooked. PMID:23960215

Obaid, Daniel R; Calvert, Patrick A; Gopalan, Deepa; Parker, Richard A; Hoole, Stephen P; West, Nick E J; Goddard, Martin; Rudd, James H F; Bennett, Martin R



Bancroftian filarial pleural effusion.  

PubMed Central

This paper describes a case of filarial pleural effusion, the fifth such to be reported. Microfilariae of Wuchereria bancrofti were detected in the pleural fluid on cytological examination. There was a prompt and complete response to treatment with diethylcarbamazine. There were, however, no symptoms and signs of tropical pulmonary eosinophilia nor any peripheral eosinophilia. Images Figure 1

Aggarwal, J.; Kapila, K.; Gaur, A.; Wali, J. P.



[Pleural mesothelioma: imaging contribution].  


Imaging plays an essential role in management of patients of with pleural mesothelioma. In this article, we discuss the respective roles for ultrasonography, computed tomography, magnetic resonance imaging, and positon emission tomography for the diagnosis, staging, and postherapeutic evaluation of pleural mesothelioma. PMID:16670665

Laurent, F; Corneloup, O; Montaudon, M; Latrabe, V; Laffon, E



Malignant pleural disease  

Microsoft Academic Search

The vast majority of pleural neoplasms invade the pleura secondarily and can be seen in patients with bronchogenic carcinoma, breast cancer, lymphoma, and ovarian or gastric carcinoma. Primary pleural neoplasms are less common, although they have developed notoriety since the up-surge of malignant mesothelioma and the knowledge of its connection to asbestos exposure. Other malignant primary tumors include localized fibrous

Lorenzo Bonomo; Beatrice Feragalli; Rocco Sacco; Biagio Merlino; Maria Luigia Storto



Pleural mesothelioma - case report  

PubMed Central

Summary Background: Pleural mesothelioma is a very rare neoplasm; especially the local form. The diagnostics is difficult and the prognosis unfavourable. Case Report: We presented a case of a man with dyspnoea and cough. His chest radiogram showed hydrothorax on the left side. Neither the examinations of the pleural liquid, nor the CT-guided fine needle biopsy established the diagnosis. CT showed features suggestive of pleural mesothelioma. The diagnosis was confirmed by thoracoscopy. Although no neoplastic cells were found in the thoracoscopic specimen from the supradiaphragmatic tumor, we assumed that to be a case of a diffuse, primarily local form of mesothelioma. Conclusions: Diagnostics of pleural mesothelioma is very difficult. CT and thoracoscopy seem to be very valuable diagnostic methods. It is worth remembering that pleural mesothelioma can have a local form which may transform into a diffuse one.

Klawiter, Anna; Damaszke, Tomasz



Fishbowl Plaques.  

ERIC Educational Resources Information Center

|Presents an elementary art activity that successfully teaches the process of slabbing by having students create fishbowl plaques. Explains the process step-by-step beginning with a demonstration to the students along with showing previous examples. Endorses a type of clay that fires white because the glaze colors are much more vibrant. (CMK)|

Lambert, Phyllis Gilchrist



Pleural culture (image)  


... and sent to the labarotory for testing. The sample pleural fluid is placed on culture plates containing growth media. When colonies of microorganisms have reached sufficient size, a series of biochemical tests can be performed ...


Pleural tuberculosis presented as multiple pleural masses: An atypical presentation  

PubMed Central

Tuberculous involvement of the pleura usually presents as pleural effusion, empyema or pleural thickening. Pleural tuberculosis presenting with multiple masses without parenchymal involvement or lymphadenopathy has been reported rarely in the English literature. We report a case of a 68-year-old male with unilateral pleural tuberculosis presenting as multiple different sized nodular masses evident on computed tomography (CT) of the chest with a large hemorrhagic pleural effusion, which initially raised a possibility of mesothelioma. Pleuroscopy also revealed multiple pleural masses. Pathological examination of the biopsy specimen showed multiple epitheloid cell granulomas confirming the diagnosis.

Patel, Anand; Choudhury, Sushmita



Comparative LIBS Analysis Of Calcified Tissues  

Microsoft Academic Search

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

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



Non-Neoplastic and Neoplastic Pleural Endpoints Following Fiber Exposure  

PubMed Central

Exposure to asbestos fibers is associated with non-neoplastic pleural diseases including plaques, fibrosis, and benign effusions, as well as with diffuse malignant pleural mesothelioma. Translocation and retention of fibers are fundamental processes in understanding the interactions between the dose and dimensions of fibers retained at this anatomic site and the subsequent pathological reactions. The initial interaction of fibers with target cells in the pleura has been studied in cellular models in vitro and in experimental studies in vivo. The proposed biological mechanisms responsible for non-neoplastic and neoplastic pleural diseases and the physical and chemical properties of asbestos fibers relevant to these mechanisms are critically reviewed. Understanding mechanisms of asbestos fiber toxicity may help us anticipate the problems from future exposures both to asbestos and to novel fibrous materials such as nanotubes. Gaps in our understanding have been outlined as guides for future research.

Broaddus, V. Courtney; Everitt, Jeffrey I.; Black, Brad; Kane, Agnes B.



Determinants of restrictive lung function in asbestos-induced pleural fibrosis  

SciTech Connect

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).

Schwartz, D.A.; Galvin, J.R.; Dayton, C.S.; Stanford, W.; Merchant, J.A.; Hunninghake, G.W. (Univ. of Iowa, Iowa City (USA))



Preliminary in vivo atherosclerotic carotid plaque characterization using the accumulated axial strain and relative lateral shift strain indices  

PubMed Central

In this paper, we explore two parameters or strain indices related to plaque deformation during the cardiac cycle, namely, the maximum accumulated axial strain in plaque and the relative lateral shifts between plaque and vessel wall under in vivo clinical ultrasound imaging conditions for possible identification of vulnerable plaque. These strain indices enable differentiation between calcified and lipidic plaque tissue utilizing a new perspective based on the stiffness and mobility of the plaque. In addition, they also provide the ability to distinguish between softer plaques that undergo large deformations during the cardiac cycle when compared to stiffer plaque tissue. Soft plaques that undergo large deformations over the cardiac cycle are more prone to rupture and to release micro-emboli into the cerebral bloodstream. The ability to identify vulnerable plaque, prone to rupture, would significantly enhance the clinical utility of this method for screening patients. We present preliminary in vivo results obtained from ultrasound radio frequency data collected over 16 atherosclerotic plaque patients before these patients undergo a carotid endarterectomy procedure. Our preliminary in vivo results indicate that the maximum accumulated axial strain over a cardiac cycle and the maximum relative lateral shift or displacement of the plaque are useful strain indices that provide differentiation between soft and calcified plaques.

Shi, Hairong; Mitchell, Carol C; McCormick, Matthew; Kliewer, Mark A; Dempsey, Robert J; Varghese, Tomy



Reproducibility of IVUS Border Detection for Carotid Atherosclerotic Plaque Assessment  

PubMed Central

Plaque composition is a potentially important diagnostic feature for carotid artery stenting (CAS). The purpose of this investigation is to evaluate the reproducibility of manual border correction in intravascular ultrasound with virtual histology (VH IVUS) images. Three images each were obtained from 51 CAS datasets on which automatic border detection was corrected manually by two trained observers. Plaque was classified using the definitions from the CAPITAL (Carotid Artery Plaque Virtual Histology Evaluation) study, listed in order from least to most pathological: no plaque, pathological intimal thickening, fibroatheroma, fibrocalcific, calcified fibroatheroma, thin-cap fibroatheroma, and calcified thin-cap fibroatheroma. Inter-observer variability was quantified using both weighted and unweighted Kappa statistics. Bland-Altman analysis was used to compare the cross-sectional areas of the vessel and lumen. Agreement using necrotic core percentage as the criterion was evaluated using the unweighted Kappa statistic. Agreement between classifications of plaque type was evaluated using the weighted Kappa statistic. There was substantial agreement between the observers based on necrotic core percentage (? = 0.63), while the agreement was moderate (?quadratic = 0.60) based on plaque classification. Due to the time-consuming nature of manual border detection, an improved automatic border detection algorithm is necessary for using VH IVUS as a diagnostic tool for assessing the suitability of patients with carotid artery occlusive disease for CAS.

Siewiorek, Gail M.; Loghmanpour, Natasha A.; Winston, Brion M.; Wholey, Mark H.; Finol, Ender A.



Magnetic resonance of calcified tissues.  


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 author's 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

Wehrli, Felix W



Magnetic resonance of calcified tissues  

NASA Astrophysics Data System (ADS)

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 author's 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.

Wehrli, Felix W.



Lower ratio of high-molecular-weight adiponectin level to total may be associated with coronary high-risk plaque  

PubMed Central

Background Although high-molecular-weight (HMW) adiponectin is believed to protect against atherosclerosis, the association between HMW adiponectin and the composition of coronary plaques is unknown. We evaluated whether the HMW to total adiponectin ratio was associated with the presence of coronary plaque and its composition using multi-slice computed tomography coronary angiography (MSCTCA). Methods Serum total and HMW adiponectin levels were measured in 53 consecutive patients (age, 71) with >50% coronary artery stenosis detected by MSCTCA. A low-attenuation coronary plaque was defined as a plaque with a mean CT density <50 Hounsfield units. Multivariate logistic regression analyses were performed to evaluate the predictors of the presence of low-attenuation coronary plaques, which is thought to be high risk, on CT. Results Decreased serum levels of total as well as HMW adiponectin were significantly associated with the presence of at least one calcified or non-calcified coronary artery plaque (total adiponectin level: odds ratio 0.76, 95% CI 0.58–0.99, P?=?0.048; HMW adiponectin level: odds ratio 0.65, 95% CI 0.42–0.99, P?=?0.047). A low ratio of HMW to total adiponectin was significantly associated with the presence of low-attenuation coronary plaques (4.55, 1.94–21.90, P?=?0.049). However, neither the total adiponectin nor the HMW adiponectin level was associated with the presence of low-attenuation coronary plaques. Conclusion Lower total or HMW adiponectin levels are associated with the presence of calcified and non-calcified coronary plaques, whereas a lower ratio of HMW to total adiponectin associated with the presence of low-attenuation coronary plaques (thought to be high risk). Measurement of total and HMW adiponectin levels and the HMW to total adiponectin ratio may be useful for risk stratification of coronary artery plaques.



Diagnosis of Vulnerable Atherosclerotic Plaques by Time-Resolved Fluorescence Spectroscopy and Ultrasound Imaging  

Microsoft Academic Search

In this study, time-resolved laser-induced fluorescence spectroscopy (TR-LIFS) and ultrasonography were applied to detect vulnerable (high-risk) atherosclerotic plaque. A total of 813 TR-LIFS measurements were taken from carotid plaques of 65 patients, and subsequently analyzed using the Laguerre deconvolution technique. The investigated spots were classified by histopathology as thin, fibrotic, calcified, low-inflamed, inflamed and necrotic lesions. Spectral and time-resolved parameters

J. A. Jo; Q. Fang; T. Papaioannou; J. H. Qiao; M. C. Fishbein; B. Beseth; A. H. Dorafshar; T. Reil; D. Baker; J. Freischlag; K. K. Shung; L. Sun; L. Marcu



Variation in atherosclerotic plaque composition according to increasing coronary artery calcium scores on computed tomography angiography  

Microsoft Academic Search

Increasing coronary artery calcium scores (CACS) are independently associated with cardiac events. Recent advents in coronary\\u000a computed tomography angiography (CCTA) have allowed us to better characterize individual plaque. Currently, it is unknown\\u000a if higher CACS are likely to be associated with more calcified or mixed and heterogeneous plaque burden on CCTA. The study\\u000a population consisted of 1,043 South Korean asymptomatic

Khurram Nasir; Juan J. Rivera; Yeonyee E. Yoon; Sung-A Chang; Sang-iI Choi; Eun-Ju Chun; Dong-Joo Choi; Matthew J. Budoff; Roger S. Blumenthal; Hyuk-Jae Chang



Analysis of the movement of calcified lymph nodes during breathing  

SciTech Connect

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.

Jenkins, Peter [Gloucestershire Oncology Centre, Cheltenham General Hospital, Cheltenham (United Kingdom)]. E-mail:; Salmon, Clare [Gloucestershire Oncology Centre, Cheltenham General Hospital, Cheltenham (United Kingdom); Mannion, Cathy [Gloucestershire Oncology Centre, Cheltenham General Hospital, Cheltenham (United Kingdom)



Association between the volume of carotid artery plaque and its subcomponents and the volume of white matter lesions in patients selected for endarterectomy.  


OBJECTIVE. The amount of cerebral white matter lesions (WMLs) and the severity of carotid artery disease are correlated in this study. The association between the severity of WMLs and the volume of the different components of carotid artery plaque is also evaluated. MATERIALS AND METHODS. Fifty consecutive patients (39 men, 11 women; mean [SD] age, 71 ± 9 years) with carotid artery stenosis who underwent carotid endarterectomy were included in this study. On admission, patients underwent head and neck CT angiography (CTA) and brain MRI. The CTA-based plaque volume and the percentages of the three main plaque components (fatty, mixed, and calcified) were calculated according to the attenuation values. Leukoaraiosis lesion volume on FLAIR images was determined using a semiautomated segmentation technique. Pearson correlation was conducted between the leukoaraiosis lesion volume on FLAIR images and the volumes of the different plaque components. RESULTS. Pearson correlation analysis was performed to determine WML volume versus total carotid plaque volume (? = 0.2531; p = 0.0262), fatty plaque volume (? = 0.387; p = 0.0005), mixed plaque volume (? = 0.1709; p = 0.15), and calcified plaque volume (? = 0.0146; p = 0.899). The WML volume was also compared against fatty plaque percentage (? = 0.343; p = 0.0018), mixed plaque percentage (? = 0.181; p = 0.124), and calcified plaque percentage (? = -0.209; p = 0.068). CONCLUSION. The cerebral WML volume and the total volume of the plaque are correlated. The amount of fat within the plaque is an additional risk factor, whereas the calcified component seems to be protective. PMID:24147504

Saba, Luca; Raz, Eytan; Grassi, Roberto; Di Paolo, Pier Luigi; Iacomino, Aniello; Montisci, Roberto; Piga, Mario



Cholelithoptysis and pleural empyema  

Microsoft Academic Search

We report a case of delayed cholelithoptysis and pleural empyema caused by gallstone spillage at the time of laparoscopic cholecystecomy. An occult subphrenic abscess developed, and the patient became symptomatic only after trans-diaphragmatic penetration occurred. This resulted in expectoration of bile, gallstones, and pus. Spontaneous decompression of the empyema occurred because of a peritoneo-pleuro-bronchial fistula. This is the first case

Priya Chopra; Patrick Killorn; Reza John Mehran



Calcified vestibular schwannoma in the cerebellopontine angle.  


Although vestibular schwannoma is a common tumor in the cerebellopontine angle, calcified vestibular schwannoma is rare. A 59-year-old woman with sudden onset epileptic seizures, was referred to Hokkaido Neurosurgical Memorial Hospital. Neurological examination revealed left Bruns nystagmus, left deafness and left cerebellar ataxia. Brain MRI revealed a mass, about 3cm in diameter, in the left cerebellopontine angle. The mass showed heterogeneous intensity on T1- and T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. Hydrocephalus was seen. On CT scan, the tumor was calcified. Preoperatively, vestibular schwannoma, meningioma, cavernous hemangioma, or thrombosed giant aneurysm were considered as differential diagnoses. The pathological diagnosis was schwannoma. For a calcified mass in the cerebellopontine angle, vestibular schwannoma should be considered in the differential diagnosis to plan appropriate treatment strategies. PMID:17884507

Katoh, Masahito; Aida, Toshimitsu; Imamura, Hiroyuki; Aoki, Takeshi; Yoshino, Masami; Kashiwazaki, Daina; Takei, Hidetoshi



Pleurisy and Other Pleural Disorders  


... the layers of tissue is a very thin space called the pleural space. Normally this space is filled with a small amount of fluid— ... or gas can build up in the pleural space. When this happens, it's called a pneumothorax (noo- ...


Calcifying tendinitis of the rotator cuff with cortical bone erosion  

Microsoft Academic Search

Calcifying tendinitis occurs most commonly in the rotator cuff tendons, particularly involving the supraspinatus tendon insertion, and is often asymptomatic. Cortical erosion secondary to calcifying tendinitis has been reported in multiple locations, including in the rotator cuff tendons. We present a pathologically proven case of symptomatic calcifying tendinitis involving the infraspinatus tendon with cortical erosion with correlative radiographic, CT, and

Roxanne Chan; David H. Kim; Peter J. Millett; Barbara N. Weissman



Pleural effusion in temporal arteritis.  


A 73-year-old woman was admitted to hospital with a one-month history of temporal headache, low-grade fever, fatigue, nocturnal sweats and pleural pain. On the fifth day after admission she developed chest pain at the left site of the thorax, productive cough and progressive dyspnea. A pleural effusion was revealed on physical examination, as well as a bilateral temporal artery thickening. An erythrocyte sedimentation rate of 135 mm in the 1st hour was found. Chest X-ray showed left pleural effusion. Thoracocentesis revealed serous fluid exudate. A percutaneous pleural biopsy showed only minimal inflammatory changes. Temporal artery biopsy showed giant cell arteritis. The patient received prednisone 60 mg/daily with a dramatic clinical response. Pleural effusion is a rare manifestation of temporal arteritis; only seven cases have been reported worldwide. We present a new case of temporal arteritis with pleurisy. PMID:12792976

Karachalios, George; Charalabopoulos, Alexander; Charalabopoulos, Konstantin


[Primary calcified mediastinal hydatid cyst producing compression].  


A mediastinal hydatid cyst is rare (< 0.1% of hydatidosis). It most frequently progresses to calcification rather than a pulmonary hydatid cyst because there is no relationship to ventilation. We report a case of calcified mediastinal hydatid cyst which was confirmed on histological examinations from the operative specimen, in an agricultural worker of 58 who presented with a homolateral paralysed diaphragm. PMID:9082506

Benzarti, M; Jerray, M; Khirouni, S; Souissi, J; Ommezzine, N; Mezghenni, S; Hayouni, A; Garrouche, A; Klabi, N



[Management of pleural drainage].  


In the neonatal population, pleural effusion and particularly tension pneumothorax can be a deadly situation. Pneumothorax occurs more often in the neonatal period that any other time of life. Tension pneumothorax can result in very high pressures within the pleural space, collapsing the lung on the involved side and resulting in immediate hypoxia, hypercapnia and subsequent circulatory collapse. For these reasons, the ability to recognize, understand and treat these pathologies is essential for neonatal health and a good outcome. Neonates have many factors that can contribute to. these problems. These include respiratory distress syndrome, mechanical ventilation, sepsis, pneumonia, aspiration of meconium, congentital malformation, hydrothorax, congenital or acquired chylothorax. The diagnosis can be made by clinical examination, transillumination (pneumothorax) and chest x-ray. Besides, lung ultrasound constitutes a visual medicine and provides a transparent approach to the acutely ill patient, newborn included, guiding diagnosis, management and care. Newborns with moderate to severe symptoms and those receiving positive pressure ventilation require tube thoracostomy. If a tension pneumothorax is suspected, emergency needle decompression in the second intercostal space in the midclavicular line is required. In this article, we describe the management of tube thoracostomy using trocar tubes or pigtail catheters. Besides, we pay attention to the use of pain control for neonates undergoing painful procedures such as chest tube insertion. PMID:21090089

Soffiati, M; Bonaldi, A; Biban, P



[Malignant pleural mesothelioma].  


Malignant pleural mesothelioma continues to be a clinical challenge and its incidence will continue to increase worldwide. Once diagnosed with pleural mesothelioma, patients nearly invariably die of the disease. While the benefit of chemotherapy for advanced disease has been established, many other aspects of treatment continue to be controversial, in particular in regard to surgery and radiotherapy. However, the best survival data is reported from groups using multimodality treatment including surgery for patients qualifying from a tumor stage - and functional perspective. Therefore, efforts should focus on improving staging systems. Translational studies should be included with the final aim of finding reliable markers for response to therapy. Despite both, the increase in basic biologic knowledge and the fact that many new agents have reached various stages of development, the number of new treatments that have been approved for patients has not increased. As mesothelioma is a rare disease, the number of patients is limiting and more innovative trial designs (such as multi-arm multi-stage trials [1]) using cooperative platforms to eliminate less effective treatments may be the best way forward. PMID:22753288

Opitz, I; Weder, W



Environmental pulmonary health problems related to mineral dusts: Examples from central Anatolia, Turkey  

Microsoft Academic Search

There are a number of benign disorders including pleural thickening (PT), calcified pleural plaques (CPP), and malignant diseases such as malignant pleural mesothelioma (MPM) in central Anatolia. Earlier studies suggested tremolite was the main cause, and there was no explanation why some of the population did not have malignant cases, and plaques were by far the most frequent manifestation of

M. Do?an



Calcifying (juvenile) aponeurotic fibroma of the scalp.  


Calcifying aponeurotic fibroma is a benign tumor with a predilection for distal parts of the extremities; it is very rare in the head and neck region. It commonly affects young patients-hence the term juvenile in the name. It is fibroblastic in origin and considered a cartilage analogue of fibromatosis, but its exact etiology remains unknown. Clinically, this tumor needs to be differentiated from fibromatosis, nodular fasciitis, chondroma, schwannoma, and rheumatoid nodule. A 24-year-old woman presented with swelling in the forehead for the previous 6 months. Wide surgical excision of the lesion was performed, and histopathologic examination revealed a calcifying aponeurotic fibroma. We reviewed the literature on this rare clinical entity and present our hypothesis on its etiology. PMID:22033965

Thakur, Jagdeep S; Diwana, Vijay K; Sharma, Sudarshan; Thakur, Anamika



Comparative LIBS Analysis Of Calcified Tissues  

SciTech Connect

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.

Abdel-Salam, Z. A.; Harith, M. A. [National Institute of Laser Enhanced Science (NILES), Cairo University (Egypt)



Comparative LIBS Analysis Of Calcified Tissues  

NASA Astrophysics Data System (ADS)

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.

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



[Pleural effusions of neoplastic etiology].  


A prospective analysis was made of 50 patients with neoplastic pleural exudation for the period 1977-1979. Twenty five of the patients (50%) are with advanced age (60-75). Bronchogenic carcinoma is the most often primary localization of the neoplastic exudates --26 patients (52%), followed by mammary carcinoma--10 cases (20%). In 76 per cent of the patients the pleural exudation is the first clinical manifestation of the neoplastic disease. In the rest of the cases, the metastatic exudation was manifested by the third year after the diagnosis of primary tumor. Dyspnea is outlined as a leading clinical symptom. The data from the biochemical and cytological studies of the pleural punctate were analyzed. The cytological finding is with the highest diagnostic value for the neoplastic pleural exudates. PMID:7101882

Zlatanov, Z; Peneva, M; Kokoshian, M



Ion-translocating properties of calcifiable proteolipids  

SciTech Connect

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.

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



Multidetector-row CT cardiac imaging with 4 and 16 slices for coronary CTA and imaging of atherosclerotic plaques  

Microsoft Academic Search

suring coronary arterial calcification by acquiring a stack of contiguous 3-mm sections [14]. The calcium score, as originally proposed by Agatston [15], is determined on the basis of the product of the total area of a calcified plaque and an arbitrary scoring system for those pixels with an attenuation greater than 130 HU. Theoretically, this multisection data set should give

Andreas F. Kopp; Axel Küttner; Martin Heuschmid; Stephen Schröder; B. Ohnesorge; C. D. Claussen



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

PubMed Central

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.



Calcifying cystic odontogenic tumor radiographically mimicking a sinus mucocele.  


The calcifying cystic odontogenic tumor or Gorlin cyst is an uncommon lesion with a variable clinical behavior and considerable histopathologic diversity. The authors report a case of calcifying cystic odontogenic tumor that was being treated as a maxillary sinus mucocele. The possibility of mimicking numerous odontogenic and nonodontogenic lesions makes the calcifying cystic odontogenic tumor difficult for a clinical diagnosis. The present case demonstrates that a specific knowledge in oral pathology is required to differentiate odontogenic lesions. PMID:23524811

de Santana Santos, Thiago; Frota, Riedel; de Souza Andrade, Emanuel Sávio; de Oliveira E Silva, Emanuel Dias



Echogenic carotid artery plaques are associated with vertebral fractures in postmenopausal women with low bone mass.  


Although low bone mass has been associated with atherosclerosis even after adjustment for age, little is known about the association between vertebral fractures and calcified atherosclerotic plaques. Our objective was to investigate whether osteoporotic vertebral fractures are independently related to the prevalence of atherosclerotic carotid plaques in postmenopausal women with low bone mass. We enrolled 195 postmenopausal women with osteopenia or osteoporosis. Bone mineral density and the presence of vertebral fractures were assessed. Intima media thickness and atherosclerotic plaques of the carotid artery were assessed using ultrasonography. Of the 195 subjects in the study, 84 had no plaques and 111 had at least one. The percentage of women with vertebral fractures was significantly higher in subjects with echogenic carotid plaques than in those without (27% vs. 11%, respectively; P < 0.05). However, there was no difference in the prevalence of vertebral fractures between women with echolucent plaques and those without (10.9% vs. 10.7%, respectively; P = nonsignificant). By logistic regression analysis with multivariate adjustment, age (P < 0.01), dyslipidemia (P < 0.05), and the presence of vertebral fracture (P < 0.05) were independent risk factors for echogenic carotid plaques. Osteoporotic vertebral fractures are associated with an increased risk of echogenic atherosclerotic plaques in postmenopausal women with low bone mass. It appears that the high association of echogenic atherosclerotic plaques and vertebral fractures could partially explain why osteoporotic vertebral fractures are linked to increased mortality. PMID:18496724

Kim, Se Hwa; Kim, Yoo Mee; Cho, Mi Ae; Rhee, Yumie; Hur, Kyu Yeon; Kang, Eun Seok; Cha, Bong Soo; Lee, Eun Jig; Lee, Hyun Chul; Lim, Sung Kil



Diffuse neoplasms of the pleural serosa.  


This study describes the diffuse neoplastic conditions that may affect pleural membranes. These include mesothelioma, the most important and common malignancy of pleural origin, and metastatic involvement by carcinomas, lymphomas and thymomas. On the basis of diagnostic imaging, we identify the distinctive features of pleural involvement by each of these conditions and provide elements enabling accurate differential diagnosis. Finally, we discuss the best diagnostic approach in the case of suspected primary or secondary neoplastic involvement of pleural membranes. PMID:22986697

Cardinale, L; Ardissone, F; Asteggiano, F; Laugelli, E M; Penna, D; Fava, C



Pleural diseases related to metastatic malignancies  

Microsoft Academic Search

Pleural effusions associated with malignancy (either malignant or paramalignant) pose diagnostic and therapeutic dilemmas for the clinician. This article reviews the common causes of malignant and paramalignant pleural effu- sions, pathogenesis, clinical presentation, chest radiography, pleural fluid charac- teristics, diagnosis, prognosis, and treatment. Talc, used either by poudrage or slurry, is the most effective agent used for pleu- rodesis. Talc,

S. A. Sahn



LIBS analysis of artificial calcified tissues matrices.  


In most laser-based analytical methods, the reproducibility of quantitative measurements strongly depends on maintaining uniform and stable experimental conditions. For LIBS analysis this means that for accurate estimation of elemental concentration, using the calibration curves obtained from reference samples, the plasma parameters have to be kept as constant as possible. In addition, calcified tissues such as bone are normally less "tough" in their texture than many samples, especially metals. Thus, the ablation process could change the sample morphological features rapidly, and result in poor reproducibility statistics. In the present work, three artificial reference sample sets have been fabricated. These samples represent three different calcium based matrices, CaCO3 matrix, bone ash matrix and Ca hydroxyapatite matrix. A comparative study of UV (266 nm) and IR (1064 nm) LIBS for these three sets of samples has been performed under similar experimental conditions for the two systems (laser energy, spot size, repetition rate, irradiance, etc.) to examine the wavelength effect. The analytical results demonstrated that UV-LIBS has improved reproducibility, precision, stable plasma conditions, better linear fitting, and the reduction of matrix effects. Bone ash could be used as a suitable standard reference material for calcified tissue calibration using LIBS with a 266 nm excitation wavelength. PMID:23601869

Kasem, M A; Gonzalez, J J; Russo, R E; Harith, M A



Recurrent calcifying odontogenic cyst involving the maxillary sinus  

Microsoft Academic Search

The calcifying odontogenic cyst is an uncommon lesion that occurs in both jaws, however involvement of the maxillary sinus is rare. The accepted mode of treatment is enucleation with curettage since it is generally believed that recurrence following such treatment is extremely rare. Of the reported cases of recurrent calcifying odontogenic cysts, none have involved the maxillary sinus.This report is

John Spencer Mbia Daniels



Calcified right atrial thrombus in HIV infected patient.  


Calcified right atrial thrombi are rare cardiac masses that may be complicated by pulmonary embolism. Although they can be discovered by a transthoracic echocardiography, they may need histological examination to differentiate them from other cardiac masses. We report a case of a 44-year-old woman who presented with a calcified right atrial thrombus and progressive dyspnoea. PMID:23819008

Mwita, Julius Chacha; Goepamang, Monkgogi; Mkubwa, Jack Joseph; Gunness, Teeluck Kumar; Reebye, Deshmukh; Motumise, Kelebogile



Effects of carbon dioxide, Nd-YAG, and argon laser radiation on coronary atheromatous plaques.  


Laser radiation has been successfully applied in several areas of medical practice. However, its use in cardiology and specifically its effects on obstructive atherosclerosis have largely been unexplored. To evaluate effects of laser radiation on atherosclerotic plaques 25 fresh necropsy atherosclerotic coronary artery segments were exposed to laser radiation with either a carbon dioxide, Nd-YAG, or argon laser. Split or intact segments were prepared under dry conditions or while immersed in saline solution or blood and exposed to laser radiation as power and duration of exposure varied. All 3 lasers were capable of creating controlled injury to atherosclerotic plaques. In general, the magnitude of injury varied according to the total energy delivered (that is, power times duration of exposure. Calcified and noncalcified plaques were penetrated with similar levels of injury. Histologic examination demonstrated that laser radiation produced a wedge incision in the atherosclerotic plaque which was surrounded by zones of thermal and acoustic injury. PMID:6816057

Abela, G S; Normann, S; Cohen, D; Feldman, R L; Geiser, E A; Conti, C R



Regulation of vulnerable plaque development by the heme oxygenase/carbon monoxide system.  


Plaque rupture and luminal thrombosis is the most common cause of coronary occlusion that leads to acute coronary syndromes. High-risk plaques, or vulnerable plaques, are defined as lesions that are prone to rupture, also known as thin cap fibroatheroma (TCFA), or lesions prone to erosion or with calcified cores. This review will focus mainly on the vulnerable plaque, which is thought to be the precursor of the thrombogenic or ruptured plaque. Heme oxygenase 1 (HO-1) protein expression is specifically increased in lesions with a vulnerable plaque phenotype resembling TCFAs and correlates with a rise in expression levels of intimal proinflammatory markers. Data from several human and animal studies imply an important function for HO-1 in the genetic regulation of early, as well as late atherogenesis, and plaque destabilization toward a vulnerable phenotype. Although a direct association between HO-1, vulnerable plaque development, and clinical outcome is for now missing, the correlations that have been reported for HO-1 and coronary artery disease point to a possible link. PMID:20656217

Larsen, Katarína; Cheng, Caroline; Duckers, Henricus J



Pleural Intensity-Modulated Radiotherapy for Malignant Pleural Mesothelioma  

SciTech Connect

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.

Rosenzweig, Kenneth E., E-mail: [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States); Zauderer, Marjorie G. [Department of Medicine, Thoracic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Laser, Benjamin [Department of Radiation Oncology, Henry Ford Hospital, Detroit, MI (United States); Krug, Lee M. [Department of Medicine, Thoracic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Yorke, Ellen [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Sima, Camelia S. [Department of Epidemiology/Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Rimner, Andreas [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Flores, Raja [Department of Surgery, Mount Sinai Medical Center, New York, NY (United States); Rusch, Valerie [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)



Calcifying cystic odontogenic tumour: CT imaging  

PubMed Central

Objectives Calcifying cystic odontogenic tumour (CCOT) is a rare disorder of the jaw. A comparison between conventional radiographs and CT images in CCOTs has not been reported. The purposes of this study were to analyse conventional radiographs and CT images of CCOTs, establish CT images of CCOTs and assess the utility of CT in the diagnosis of CCOTs. Methods Nine patients with a histopathologically confirmed CCOT who had both conventional radiographs and CT images were enrolled. Results CT was superior to conventional radiographs in detecting buccolingual expansion, odontomas and radio-opaque bodies. Conclusion The characteristic CT appearances of CCOT were that radio-opaque bodies were typically located in the periphery of the lesion and the shape of radio-opaque bodies was linear and/or spotted. CT was useful in diagnosing a CCOT.

Uchiyama, Y; Akiyama, H; Murakami, S; Koseki, T; Kishino, M; Fukuda, Y; Shimizutani, K; Furukawa, S



Nuclear analytical methods in calcified tissue research.  


Various nuclear analytical methods have been developed and applied to determine the elemental composition of calcified tissues (teeth and bones). Fluorine was determined by prompt gamma-activation analysis through the 19F(rho, alpha, gamma)16O reaction. Carbon was measured by activation analysis with 3He ions, and the technique of proton-induced x-ray emission (PIXE) was applied to simultaneously determine calcium, phosphorus, and trace elements in well-documented teeth. Dental hard tissues (enamel, dentine, cementum, and their junctions) and different parts of the same tissue were examined separately. With the use of a proton microprobe, we measured the surface distribution of fluorine and other elements on and around carious lesions on the enamel. The depth profiles of fluorine, and other elements were also measured right up to the amelodentin junction. We discuss the development of various nuclear techniques and their applications, mainly in the field of dental health and to some extent in the study of the role of lead in mental retardation. We do not mention other important areas of calcified tissue research where these techniques could play an important role (e.g., in accurate and nondestructive measurements of calcium, phosphorus, and other elements in small bone biopsies taken from patients with metabolic bone disorders). No suitable chemical method appears to be available that can provide accurate assessment of calcium, phosphorus, and other trace elements in small bone biopsies. Moreover, the nondestructive nature of the nuclear methods has an extra advantage in that the bone samples, which are normally rather small in quantity, subsequently can be used for histologic examination. PMID:8748217

Chaudhri, M A


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

NASA Astrophysics Data System (ADS)

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.

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



Peripheral calcifying cystic odontogenic tumour of the maxillary gingiva  

PubMed Central

Background Odontogenic tumors are lesions that are derived from remnants of the components of the developing tooth germ. The calcifying cystic odontogenic tumor or calcifying odontogenic cyst is a benign cystic neoplasm of odontogenic origin that is characterized by an ameloblastoma-like epithelium and ghost cells. Calcifying cystic odontogenic tumor may be centrally or peripherally located, and its ghost cells may exhibit calcification, as first described by Gorlin in 1962. Most peripheral calcifying cystic odontogenic tumors are located in the anterior gingiva of the mandible or maxilla. Case presentation Authors report a rare case of a peripheral calcifying cystic odontogenic tumor of the maxillary gingiva. A 39-year-old male patient presented with a fibrous mass on the attached buccal gingiva of the upper left cuspid teeth. It was 0.7-cm-diameter, painless and it was clinically diagnosed as a peripheral ossifying fibroma. After an excisional biopsy, the diagnosis was peripheric calcifying cystic odontogenic tumor. The patient was monitored for five years following the excision, and no recurrence was detected. Conclusions All biopsy material must be sent for histological examination. If the histological examination of gingival lesions with innocuous appearance is not performed, the frequency of peripheral calcifying cystic odontogenic tumor and other peripheral odontogenic tumors may be underestimated.



Multiple Calcifying Hyperplastic Dental Follicle (MCHDF): A Case Report  

PubMed Central

Evaluation of enlarged follicles with unerupted teeth is always important because some changes may occur. One of the ex-tremely rare conditions seen in dental follicles is multiple calcifying hyperplastic dental follicle. We report a case of multi-ple calcifying hyperplastic dental follicle. Radiographs showed that mandibular third molars had a pericoronal radiolucent zone delineated by a well-defined and sclerotic border. Microscopic examination revealed a combination of fibrous connec-tive and small calcifications. Multiple calcifying hyperplastic dental follicle is a rare condition and its correct diagnosis is necessary to apply appropriate treatment.

Jamshidi, Shokoofeh; Zargaran, Massoumeh; Mohtasham, Nooshin



Demonstration of anti-tumor activity of oncolytic measles virus strains in a malignant pleural effusion breast cancer model.  


Breast cancer is the second leading cause of malignant effusions in cancer patients. Pleural effusion indicates incurable disease with limited palliative treatment options and poor outcome. Here, we demonstrate the therapeutic efficacy of measles virus (MV) vaccine strain derivative against malignant pleural effusion in an MDA-MB-231 xenograft model of advanced breast cancer. Both systemic intravenous (i.v.) and intrapleural (t.t.) administered virus caused massive infection and syncytia formation in the pleural tumor deposits. Intrapleural administration of 1.5 x 10(6) plaque-forming units (PFU) total dose of MV significantly improved median survival by approximately 80% compared to the control animal group. Furthermore, we tested human dendritic cells as carriers for delivery of oncolytic MV infection to breast cancer pleural metastases. Carrier-delivered MV infection prevented accumulation of the pleural exudate and also significantly improved the survival of the treated mice. This is the first demonstration of the therapeutic potential of oncolytic virotherapy against malignant pleural effusions in a pre-clinical model of advanced breast cancer. PMID:19894113

Iankov, Ianko D; Msaouel, Pavlos; Allen, Cory; Federspiel, Mark J; Bulur, Peggy A; Dietz, Allan B; Gastineau, Dennis; Ikeda, Yasuhiro; Ingle, James N; Russell, Stephen J; Galanis, Evanthia



[Calcified cerebral hydatid cyst. Report of a case].  


The cerebral localization of the hydatid cyst is still rare (1 to 4% of the cases). The calcified cerebral hydatid cyst is exceptional. We report one case collected in our department. It is about a patient of 28 years old, that the case histories consist in convulsive attacks since the age of 8 years old, hospitalized because of a left hemiparesis with progressive installation. The cerebral computerized tomography showed a right parieto-occipital that is largely calcified. During the operation, a calcified hydatid cyst discovered with various daughter vesicles and a cerebral gliosis, the latter has been extracted entirely. The evolution has been favourable with improvement of the left hemiparesis. The calcified hydatid cyst of brain is still exceptional, its symptomatology is the same as the safe CHC, but it poses some diagnostic and therapeutic problems. PMID:11924143

Choukri, M; Bertal, A; Lakhdar, A; Achouri, M; Ouboukhlik, A; el Kamar, A; el Azhari, A



How Are Pleurisy and Other Pleural Disorders Diagnosed?  


... 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 ...


Divalproex sodium-induced eosinophilic pleural effusion.  


Eosinophilic pleural effusion is defined as an effusion in which eosinophils constitute more than 10% of white blood cells. These effusions can be due to multiple causes with drugs being implicated as one of the etiological agents. We report a case of 48-year-old woman with seizure disorder on divalproex sodium (Depakote) who presented with dyspnea. A chest radiograph demonstrated right pleural effusion. Investigations showed peripheral blood eosinophilia with thoracocentesis revealing eosinophilic exudative pleural effusion. An extensive workup for other causes of eosinophilic pleural effusion was unrevealing. Withdrawal of Depakote resulted in resolution of the effusion. PMID:19512997

Joshi, Prachi; Kasmani, Rahil; Hollingsworth, Jocelyn; Fernandes, Karl; Mahajan, Kewal


Diagnosis and Management of Pleural Effusions: A Practical Approach  

Microsoft Academic Search

Pleural effusion is defined as an abnormal amount of pleural fluid accumulation in the pleural space and is the result of\\u000a an imbalance between excessive pleural fluid formation and pleural fluid absorption. Although the list of causes of pleural\\u000a effusions is extensive, the great majority of the cases are caused by pneumonia, congestive heart failure, and malignancy.\\u000a In this article,

Enrique Diaz-Guzman; Raed A. Dweik



Calcified cartilage islands in rat cortical bone.  


Rats display little to no haversian remodeling of cortical bone. This fact, combined with the endochondral formation of cortical bone, means that rat femoral cortical bone contains highly mineralized cartilage islands in a central band of mid-femoral cross sections. We demonstrate that these islands have a significantly higher degree of mineralization than the surrounding bone, using quantitative backscattered electron imaging. The cartilaginous nature of the islands was verified by immunostaining for collagen type II. Toluidine blue staining of longitudinal sections and three-dimensional synchrotron radiation X-ray tomographic microscopy confirmed that the islands are elongated along the femoral long axis. Nanoindentation revealed significantly higher values of both reduced modulus and hardness in the islands compared to the surrounding bone, reflecting a higher degree of mineralization. The calcified cartilage islands were distributed in a central zone of the bone, from the growth plates through the mid-femoral bone. The presence of these cartilage islands and their possible effect on mechanical properties could be an additional reason why haversian remodeling is observed in higher-order species. PMID:23274728

Bach-Gansmo, Fiona Linnea; Irvine, Sarah Catherine; Brüel, Annemarie; Thomsen, Jesper Skovhus; Birkedal, Henrik



Simultaneous bilateral spontaneous pneumothorax with pleural window communicating with bilateral pleural spaces.  


A pleural window communicating between bilateral pleural cavities is a serious condition in patients with pneumothorax, allowing air to leak from the affected lung into the contralateral pleural cavity and resulting in bilateral spontaneous pneumothorax. We treated a patient with a history of right-sided bullectomy for simultaneous bilateral spontaneous pneumothorax that subsequently recurred. A pleural window (1 cm long) was detected in the mid-mediastinum, and direct suture closure with localized pleural abrasion using argon beam coagulation on the circumference of the lesion was performed at video-assisted thoracoscopic surgery. PMID:18355546

Yamada, Shunsuke; Yoshino, Kazuho; Inoue, Hiroshi



Establishment of epithelial cell line MDA-MB-157 from metastatic pleural effusion of human breast carcinoma  

Microsoft Academic Search

Summary  An epithelial cell line, MDA-MB-157, has been established from the pleural fluid of a metastatic human breast carcinoma. The\\u000a cell line is characterized by rapid growth of cells in dense plaques and in suspension. The cells were originally isolated\\u000a in a complex medium containing Leibovitz's L-15, Waymouth's MB752\\/1 and Ham's F-10 media with 16% fetal calf serum, glutathione,\\u000a cortisol, insulin,

R. K. Young; R. M. Cailleau; B. Mackay; W. J. Reeves



Diagnosis and treatment of malignant pleural effusion  

Microsoft Academic Search

Pleural effusion is a common and important complication of malignancy which may at times be difficult to diagnose or treat. Its well recognized association with numerous diseases plus the limitations of our usual diagnostic tests may occasionally cause difficulty. In the oncology patient there are a number of common medical problems associated with the development of pleural effusion which frequently

Frederick H. Hausheer; John W. Yarbro



Mesothelioma and Asbestos-Related Pleural Diseases  

Microsoft Academic Search

At present, the use of asbestos is not regulated at a worldwide scale. Moreover, there is a latency period between asbestos exposure and the manifestations of asbestos-related diseases. Consequently, pulmonologists are still dealing with consequences of asbestos exposure, which mainly occur at the pleural surface. The aim of this review is to provide an overview of asbestos-related pleural diseases. We

Laurent Greillier; Philippe Astoul



Pleural effusion in aluminum phosphide poisoning  

PubMed Central

Aluminium phosphide (ALP) is a common agrochemical pesticide poisoning with high mortality rate. Primary manifestations are due to myocardial and gastrointestinal involvement. Pleural effusion in ALP poisoning is occasionally reported. We report a case of pleural effusion that developed after ALP ingestion and resolved along with recovery from poisoning.

Garg, Kranti; Mohapatra, Prasanta R.; Sodhi, Mandeep K.; Janmeja, Ashok K.



High Zn content of Randall's plaque: a ?-X-ray fluorescence investigation.  


Kidney stone disease, or nephrolithiasis, is a common ailment. Among the different risk factors usually associated with nephrolithiasis are dehydration, metabolic defects (especially with regard to calcium and oxalate). The presence of a mineral deposit at the surface of the renal papilla (termed Randall's plaque) has all been recently underlined. Of note, Randall's plaque is made of the calcium phosphate, carbapatite, and serves as a nucleus for kidney stone formation. The process by which apatite nanocrystals nucleate and form Randall's plaque remains unclear. This paper deals with the possible relationship between trace elements and the formation of this mineral. The investigation has been performed on a set of Randall's plaques, extracted from human kidney stones, through ?-X-ray diffraction and ?-X-ray fluorescence analyses in order to determine the chemical composition of the plaque as well as the nature and the amount of trace elements. Our data provide evidence that Zn levels are dramatically increased in carbapatite of RP by comparison to carbapatite in kidney stones, suggesting that calcified deposits within the medullar interstitium are a pathological process involving a tissue reaction. Further studies, perhaps including the investigation of biomarkers for inflammation, are necessary for clarifying the role of Zn in Randall's plaque formation. PMID:21763116

Carpentier, Xavier; Bazin, Dominique; Combes, Christelle; Mazouyes, Aurélie; Rouzičre, Stephan; Albouy, Pierre Antoine; Foy, Eddy; Daudon, Michel



[Therapeutic and microbiologic aspects of pleural empyema].  


The pleural empyema is a severe disease which passes with respiratory insufficiency and general toxic symptoms. The early staged surgical treatment combined with total evacuation of the puss from pleural cavity is important for the successful outcome of the disease. We made retrospective study including 82 patients with pleural (61 with acute and 21 with chronic) empyema. We performed the following operative interventions: thoracocentesis with active aspiration--at 43, VATS--20, decortication and pleurectomy--in 16, thoracoplastic with muscle flap--3. Three patients died. The most common causes for the empyema were Gr (+) coccy. At most of the patients combined operative treatment and antibiotic therapy were the most effective. PMID:16042054

Uchikov, A; Murdzhev, K; Paskalev, G; Grigirov, D; Murdzheva, M; Kamenov, T



Pleural effusion: An unusual cause and association  

PubMed Central

Filaria has a wide spectrum of presentation. We hereby present a case of Filarial pleural effusion that is a rarity in itself. Filarial lung involvement is usually in the form of tropical pulmonary eosinophilia with pulmonary infiltrates and peripheral eosinophilia, unlike our case where isolated pleural effusion of Filarial etiology was detected. Microfilaria has been isolated from Pleural fluid in very few cases, and ours was one such. Of late, there have been many incidental detections of Filarial parasites from varied anatomical sites in association with malignancy. Even in our case, we had one such unusual association.

Navaz, Alam K.; Raikar, Madhusudan P.; Acharya, Vishak; Shetty, Sanmath K.



Rotablation in the treatment of high-risk patients with heavily calcified left-main coronary lesions  

PubMed Central

Objective Heavily calcified left-main coronary diseases (LMCA) remain a formidable challenge for percutaneous interventions (PCI). This study was to investigate the safety and efficacy of using rotational atherectomy (RA) in treating such lesions in actual practice. Methods From February 2004 to March 2012, all consecutive patients who received RA for heavily-calcified LMCA lesions in our cath lab were enrolled. The relevant clinical and angiographic characteristics at the time of index PCI, as well as the clinical follow-up outcomes, were retrieved and analyzed. Results A total of 34 consecutive patients were recruited with a mean age 77.2 ± 10.2 years. There were 82.4% presented with acute coronary syndrome and 11.8% with cardiogenic shock. Chronic renal disease and diabetes were seen in 64.7% and 52.9%, respectively. Triple-vessel coronary disease was found in 76.5% of them. The mean SYNTAX score was 50 ± 15 and EuroSCORE II scale 5.6 ± 4.8. The angiographic success rate was 100% with a procedural success rate of 91.2%. The mean number of burrs per patient was 1.7 ± 0.5. Crossing-over stenting was used in 64.7%. Most stents were drug-eluting (67.6%). Intra-aortic ballon pump was used in 20.6% of the procedures. Three patients died during hospitalization, all due to presenting cardiogenic shock. No major complication occurred. Among 31 hospital survivors, the major adverse cardiac events (MACE) rate was 16.1%, all due to target lesion revascularization or target vessel revascularization. Conclusions In high-surgical-risk elderly patients, plaque modification with RA in PCI of heavily-calcified LMCA could be safely accomplished with a minimal complication rate and low out-of-hospital MACE.

Chiang, Meng-Hsiu; Yi, Hung-Tao; Tsao, Cheng-Rong; Chang, Wei-Chun; Su, Chieh-Shou; Liu, Tsun-Jui; Liang, Kae-Woei; Ting, Chih-Tai; Lee, Wen-Lieng



Histopathological classification of tympanosclerotic plaques  

Microsoft Academic Search

Tympanosclerotic plaques seen in the middle ear and tympanic membrane as a sequelae of otitis media have different characteristics.\\u000a Tympanosclerotic plaque consistency shows a wide range from soft to hard during surgical excision and can be classified histologically.\\u000a The aim of this study is to classify surgically excised tympanosclerotic plaques macroscopically and histologically. Seventeen\\u000a surgically excised tympanosclerotic tissues were examined

Adin Selcuk; Serdar Ensar?; Ayse Kose Sarg?n; Belgin Can; Huseyin Dere



Characterization of coronary plaques with combined use of intravascular ultrasound, virtual histology and optical coherence tomography.  


According to post-mortem studies, luminal thrombosis occurs from plaque rupture, erosion and calcified nodules. In vivo studies have found thin cap fibroatheroma (TCFA) as the main vulnerable lesion, prone to rupture. Few data about other post-mortem lesions have been reported in vivo. Our main objective is to characterize in vivo the coronary plaques with intravascular ultrasound-virtual histology (IVUS-VH) and optical coherence tomography (OCT), in order to detect not only thin cap fibroatheroma (TCFA), but also other possible vulnerable lesions. The secondary objective is to correlate these findings with clinical and analytical data. Twenty-five patients (18 stable) submitted to coronary angiography were included in this pilot study. After angiography, the three vessels were studied (when possible) with IVUS-VH and OCT. Plaque characteristics were correlated with clinical and analytical data. Forty-six lesions were analyzed. IVUS-VH detected significant necrotic core in 15 (3 were definite TCFA). OCT detected TCFA in 10 lesions, erosion in 6, thrombus in 5 and calcified nodule in 8. Possible vulnerable lesion was found in 61% of stable and 57% of unstable patients. Erosions and calcified nodules were only found in stable patients. Those with significant necrotic core had higher body mass index (P=0.016), higher levels of hs-CRP (P=0.019) and triglycerides (P=0.040). The higher the levels of hs-CRP, the larger the size of the necrotic core (r=0.69, P=0.003). Lesions with characteristics of vulnerability were detected by IVUS-VH and OCT in more than 50% of stable and unstable coronary patients. A significant necrotic core was mainly correlated with higher hs-CRP. PMID:21977297

Sánchez-Elvira, Guillermo; Coma-Canella, Isabel; Artaiz, Miguel; Páramo, José Antonio; Barba, Joaquín; Calabuig, José



Characterization of coronary plaques with combined use of intravascular ultrasound, virtual histology and optical coherence tomography  

PubMed Central

According to post-mortem studies, luminal thrombosis occurs from plaque rupture, erosion and calcified nodules. In vivo studies have found thin cap fibroatheroma (TCFA) as the main vulnerable lesion, prone to rupture. Few data about other post-mortem lesions have been reported in vivo. Our main objective is to characterize in vivo the coronary plaques with intravascular ultrasound-virtual histology (IVUS-VH) and optical coherence tomography (OCT), in order to detect not only thin cap fibroatheroma (TCFA), but also other possible vulnerable lesions. The secondary objective is to correlate these findings with clinical and analytical data. Twenty-five patients (18 stable) submitted to coronary angiography were included in this pilot study. After angiography, the three vessels were studied (when possible) with IVUS-VH and OCT. Plaque characteristics were correlated with clinical and analytical data. Forty-six lesions were analyzed. IVUS-VH detected significant necrotic core in 15 (3 were definite TCFA). OCT detected TCFA in 10 lesions, erosion in 6, thrombus in 5 and calcified nodule in 8. Possible vulnerable lesion was found in 61% of stable and 57% of unstable patients. Erosions and calcified nodules were only found in stable patients. Those with significant necrotic core had higher body mass index (P=0.016), higher levels of hs-CRP (P=0.019) and triglycerides (P=0.040). The higher the levels of hs-CRP, the larger the size of the necrotic core (r=0.69, P=0.003). Lesions with characteristics of vulnerability were detected by IVUS-VH and OCT in more than 50% of stable and unstable coronary patients. A significant necrotic core was mainly correlated with higher hs-CRP.

Sanchez-Elvira, Guillermo; Coma-Canella, Isabel; Artaiz, Miguel; Paramo, Jose Antonio; Barba, Joaquin; Calabuig, Jose



Talc pleurodesis in recurrent pleural effusions  

Microsoft Academic Search

Background and aims: The treatment of recurrent malignant pleural effusions is known to be difficult and varies from observation in asymptomatic\\u000a patients to pleurectomy with varying results. This prospective study presents the efficacy and the limits of iodized talc\\u000a pleurodesis in patients with malignant and non-malignant recurrent pleural effusions. Methods: In a prospective trial talc pleurodesis was performed in 50

C. A. Jacobi; Frank A. Wenger; Thomas Schmitz-Rixen; Joachim M. Müller



Pancreatic-pleural fistula in chronic pancreatitis.  


Pancreatic-pleural fistula is a rare condition and few data related to its diagnosis and treatment are available. A fistulous connection linking the pancreas with the pleura via the diaphragm or mediastinum through the retroperitoneal area is formed. We report on a case with pancreatic-pleural fistula at its early stages in an alcoholic male patient aged 45 years with known chronic pancreatitis. The operation by Roux-en-Y jejuno-pseudocystostomy was followed by chest tube drainage. PMID:22560825

Elkaoui, Hakim; Atoini, Fouad; Bouchentouf, Sidi Mohamed; El Omari, Fatima; Mahi, Mohamed; Ait Ali, Abdelmounaim; Bounaim, Ahmed; Sair, Khalid; Zentar, Aziz



An unusual cause of massive pleural effusion.  


Pleural effusions in ovarian hyperstimulation syndrome, whether transudative or exudative, can occur in up to 30% of cases. This disorder is always reversible but may have various clinical presentations and degrees of severity. Although assessing for risk factors to predict clinical severity is helpful, it is rare for ovarian hyperstimulation syndrome to present as a massive pleural effusion requiring emergent intervention. In this study, such a case is reported. PMID:23187121

Bass, Leon C; Dillard, Thomas A; Forseen, Caralee J; Davis, William B



Aortic dissection presenting as pleural effusion  

PubMed Central

Aortic dissection is a life threatening emergency. This case illustrates the unusual way an aortic dissection can present. This patient presented with sharp, left interscapular pain, which subsided after a while and left-sided pleural effusion. Further investigations revealed that this was a case of thoracic aortic dissection with a leak into pleural space. She underwent thoracic endovascular aortic repair with stent graft insertion.

Somasamudra, Pramod; Smith, Ed; Tandan, Ronja



Recurrent calcifying aponeurotic fibroma of the thumb: case report.  


We present an unusual case report of an aggressive, recurrent calcifying aponeurotic fibroma of the thumb in an adult man with invasion into the distal and proximal phalanges, the skin, the radial and ulnar neurovascular bundles, and the tendons, treated with amputation and an immediate toe-to-thumb transfer. PMID:21093179

Giuffre, Jennifer L; Kovachevich, Rudy; Bishop, Allen T; Shin, Alexander Y



Clinical features of 46 eyes with calcified hydrogel intraocular lenses  

Microsoft Academic Search

Purpose: To clarify the clinical features of delayed calcification of hydrogel intraocular lenses (IOLs) based on observation of a large case series.Setting: Ophthalmology department of 2 university teaching hospitals, Hong Kong, China.Methods: The first 44 patients with a known diagnosis of calcified IOL were recruited. Medical and ophthalmic histories were obtained. Surgical details, surgical complications, and visual acuity before and

Alexis Ka Fai Yu; Kenneth Yan Wing Kwan; David Ho Yin Chan; Daniel Yee Tak Fong



Calcified Microspheres as Biological Entities and Their Isolation from Bone  

Microsoft Academic Search

Calcified microspheres, about 1µm in diameter, appear at sites of bone formation where they invest the collagenous matrix, become confluent and disappear. Evidence that the particle boundaries are not lost with compaction but merely deformed is supported in section by the granular histochemical staining of the inorganic phase for bone salt, lipid, fibronectin and acid phosphatase in osteomalacic, acid-etched and

Jean E. Aaron; Brian Oliver; Nicholas Clarke; D. Howard Carter



The Differential Diagnosis of Pleural Effusions  

PubMed Central

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.

Sahn, Steven A.



Denitrification in human dental plaque  

Microsoft Academic Search

BACKGROUND: Microbial denitrification is not considered important in human-associated microbial communities. Accordingly, metabolic investigations of the microbial biofilm communities of human dental plaque have focused on aerobic respiration and acid fermentation of carbohydrates, even though it is known that the oral habitat is constantly exposed to nitrate (NO3-) concentrations in the millimolar range and that dental plaque houses bacteria that

Frank Schreiber; Peter Stief; Armin Gieseke; Ines M Heisterkamp; Willy Verstraete; Dirk de Beer; Paul Stoodley



Control of Specific Plaque Bacteria  

Microsoft Academic Search

The Specific Plaque Hypothesis posits that particular bacteria are of unique importance in the etiology of dental caries and periodontal diseases, and a logical conclusion is that these bacteria should be the targets for our 'magic bullets' in devising plaque-control methods. This paper considers the development of preventive measures based on understanding of the significance of particular bacterial species and

R. R. B. Russell



Dental plaque as a biofilm  

Microsoft Academic Search

Dental plaque is the diverse microbial community found on the tooth surface embedded in a matrix of polymers of bacterial and salivary origin. Once a tooth surface is cleaned, a conditioning film of proteins and glycoproteins is adsorbed rapidly to the tooth surface. Plaque formation involves the interaction between early bacterial colonisers and this film (the acquired enamel pellicle). To

P D Marsh; D J Bradshaw



Association of Randall's Plaques with Collagen Fibers and Membrane Vesicles  

PubMed Central

Background Idiopathic calcium oxalate (CaOx) kidney stones develop by deposition of CaOx crystals on Randall's plaques (RP). Mechanisms involved in RP formation are still unclear. Objective It is our hypotheses that RP formation is similar to vascular calcification involving components of extracellular matrix including membrane bound vesicles (MV) and collagen fibers. In order to verify our hypothesis we critically examined renal papillary tissue from stone patients. Methods 4 mm cold-cup biopies of renal papillae were performed on fifteen idiopathic stone patients undergoing PCNL. Tissue was immediately fixed and processed for analyses by various light and electron microscopic techniques. Results and Limitations Spherulitic CaP crystals, the hallmark of RP's, were seen in all samples examined. They were seen in interstitium as well as laminated basement membrane of tubular epithelia. Large crystalline deposits comprised of dark elongated strands mixed with spherulites. Strands showed banded patterns similar to collagen. Crystal deposits were surrounded by collagen fibers and membrane bound vesicles. Energy dispersive x-ray microanalyses (EDX) and electron diffraction identified the crystals as hydroxyapatite. The number of kidneys examined is small and urinary data was not available for all the patients. Conclusions Results presented here show that crystals in the Randall's plaques are associated with both the collagen as well as MV. Collagen fibers appeared calcified and vesicles contained crystals. We conclude that crystal deposition in renal papillae may have started with membrane vesicle induced nucleation and grew by addition of crystals on the periphery within a collagen framework.

Khan, Saeed R.; Rodriguez, Douglas E.; Gower, Laurie B.; Monga, Manoj



Mechanism of lumen enlargement with direct stenting versus predilatation stenting: influence of remodelling and plaque characteristics assessed by volumetric intracoronary ultrasound  

Microsoft Academic Search

Objective: To compare the effects of arterial remodelling and plaque characteristics on the mechanisms of direct stenting and predilatation stenting. Direct stenting has become routine in some laboratories and differs technically from predilatation stenting.Methods: Pre- and post-interventional volumetric intravascular ultrasound (IVUS) was undertaken in 30 patients with direct stenting and in 30 with predilatation stenting of non-calcified native coronary lesions,

G Finet; N J Weissman; G S Mintz; L F Satler; K M Kent; J R Laird; G A Adelmann; A E Ajani; M T Castagna; G Rioufol; A D Pichard



Pleural posttransplantation lymphoproliferative disorder following liver transplantation.  


A case of posttransplantation lymphoproliferative disorder (PTLD) involving the pleura is reported. The patient was a 57-year-old man who underwent liver transplantation 2 years prior to the development of PTLD. The PTLD was pleural-based and was first detected by radiologic studies as a pleural effusion. Transbronchial biopsy and cytologic examination of 2 pleural fluid specimens were nondiagnostic. Subsequent open-wedge biopsy revealed a monomorphic PTLD, composed of large immunoblasts with plasmacytoid differentiation. Immunohistochemical studies demonstrated B-cell lineage with expression of monotypic cytoplasmic immunoglobulin kappa light chain and CD79a, and absence of T-cell antigens. Immunohistochemical and in situ hybridization studies demonstrated Epstein-Barr virus protein and RNA, respectively. No evidence of human herpesvirus 8 DNA was detected by polymerase chain reaction. We report this case because pleural-based PTLD is rare. The diagnosis of this entity is made more difficult by the fact that PTLD is often underrepresented in pleural fluid cytology samples. PMID:11231496

Hoffmann, H; Schlette, E; Actor, J; Medeiros, L J



[Thoracoscopic pleurodesis in malignant pleural effusions].  


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

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


Distribution, Size, and Shape of Abdominal Aortic Calcified Deposits and Their Relationship to Mortality in Postmenopausal Women  

PubMed Central

Abdominal aortic calcifications (AACs) correlate strongly with coronary artery calcifications and can be predictors of cardiovascular mortality. We investigated whether size, shape, and distribution of AACs are related to mortality and how such prognostic markers perform compared to the state-of-the-art AC24 marker introduced by Kauppila. Methods. For 308 postmenopausal women, we quantified the number of AAC and the percentage of the abdominal aorta that the lesions occupied in terms of their area, simulated plaque area, thickness, wall coverage, and length. We analysed inter-/intraobserver reproducibility and predictive ability of mortality after 8-9 years via Cox regression leading to hazard ratios (HRs). Results. The coefficient of variation was below 25% for all markers. The strongest individual predictors were the number of calcifications (HR = 2.4) and the simulated area percentage (HR = 2.96) of a calcified plaque, and, unlike AC24 (HR = 1.66), they allowed mortality prediction also after adjusting for traditional risk factors. In a combined Cox regression model, the strongest complementary predictors were the number of calcifications (HR = 2.76) and the area percentage (HR = ?3.84). Conclusion. Morphometric markers of AAC quantified from radiographs may be a useful tool for screening and monitoring risk of CVD mortality.

Ganz, Melanie; de Bruijne, Marleen; Dam, Erik B.; Pettersen, Paola; Karsdal, Morten A.; Christiansen, Claus; Nielsen, Mads



Plaque quantitation through protein measurement.  


This study was undertaken to establish whether the quantitation of dental plaque protein by a dye-binding method (Coomassie G-250) may be used as an index of the amount of dental plaque sampled. Ten sites were sampled in 34 children on 5 occasions at 4 month intervals. The mean protein concentration in 1391 plaque samples was 6.9 +/- 4.1 micrograms (micrograms) (mean +/- standard deviation). A three-way analysis of variance showed that the plaque protein concentration was similar at the different sampling sites in the same child (p = 0.14), but statistically significant differences were observed with respect to time of sampling (F = 36.24; p = 0.0001) and individual sampled (F = 5.69; p = 0.0001). These observations indicate that plaque bacterial counts may be expressed as units of protein concentration and this method may be useful to relate the number of viable bacteria to an estimate of the amount of plaque collected. This ratio allows standardisation for any variation in the amount of plaque collected. PMID:1401432

Smit, A; Cleaton-Jones, P E; Boardman, M E



[Mitral valve replacement for a severely calcified mitral annulus].  


An 80-year-old woman was referred to our institution because of acute heart failure due to moderate mitral stenosis and severe regurgitation. After medical treatment of heart failure, she underwent mitral valve surgery. Intraoperatively severe calcification of the posterior mitral annulus was revealed. We excised only the anterior mitral leaflet and preserved the posterior mitral leaflet to prevent a fatal complication such as left ventricular rupture, injury of the coronary artery or embolism. Partial resection of the calcified annulus was performed using Ultrasonic Surgical System (SonoSurg), after 2-0 polyester mattress sutures were placed through the anterior and posterior annuli from the left ventricle to the left atrium. Then, mitral valve replacement was performed using a St. Jude Medical mechanical heart valve at the supra-annular position. The postoperative course was uneventful. We concluded that partial resection of a severely calcified posterior mitral annulus by the ultrasonic device was a safe and simple procedure. PMID:24008639

Kuriyama, Mitsuhito; Kioka, Yukio; Tanabe, Atsushi



Calcifying epithelial odontogenic tumor: an immunohistochemical case study  

Microsoft Academic Search

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic tumor. A case of CEOT in a 25-year-old female\\u000a is presented here. Histologically, the case showed sheets of polyhedral epithelial cells with deep eosinophilic cytoplasm\\u000a and prominent nuclei. Nuclear pleomorphism and hyperchromatism were evident. Globules of amyloid-like material among the tumor\\u000a cells were prominent. Also found was a small area

Sopee Poomsawat; Jirapa Punyasingh



Ocean acidification and calcifying reef organisms: a mesocosm investigation  

Microsoft Academic Search

A long-term (10 months) controlled experiment was conducted to test the impact of increased partial pressure of carbon dioxide\\u000a (pCO2) on common calcifying coral reef organisms. The experiment was conducted in replicate continuous flow coral reef mesocosms\\u000a flushed with unfiltered sea water from Kaneohe Bay, Oahu, Hawaii. Mesocosms were located in full sunlight and experienced\\u000a diurnal and seasonal fluctuations in temperature

P. L. Jokiel; K. S. Rodgers; I. B. Kuffner; A. J. Andersson; E. F. Cox; F. T. Mackenzie



Malherbe's Calcifying Epithelioma (Pilomatrixoma): An Uncommon Periocular Tumor  

PubMed Central

Benign calcifying epithelioma of Malherbe or pilomatrixoma or pilomatricoma is an uncommon lesion of the periocular tissues, arising from the matrix cells at the base of the hair. In the periocular area, it usually arises from the lids and eyebrows. Pilomatrixoma has certain characteristic clinical and histopathologic features, but since it is not commonly suspected preoperatively, certain distinctive clinical features of tumor should suggest clinical diagnosis followed by histopathologic confirmation.

Ali, Mohammad Javed; Honavar, Santosh G; Naik, Milind N; Vemuganti, Geeta K



Frequency and characteristics of pleural effusions in pulmonary embolism.  


(Full text is available at Pulmonary embolism (PE) is the fourth cause of pleural effusions, after pneumonia, neoinfiltrates and tuberculosis. Several questions are yet unanswered: are the pleural effusions in PE exudates or transudates, what is their size, are they unilateral or bilateral, are they only haemorrhagic, etc. The aim of this study is to determine the frequency, side, size, biochemical and cytological characteristics of pleural effusions in PE. In this study, 100 patients with suspicion of PE were examined and treated and in all the diagnosis of PE was establish. 31 of them had pleural effusions. Of 31 patients with PE and pleural effusions, six (9.84%), had bilateral pleural effusions, 14 (22.95%) patients had right-sided pleural effusion, and 11 (18.03%) had pleural effusion on the left side. 22 (36.07%) had small pleural effusions, 8 (13.11%) had medium and 1 (1.64%) had a large pleural effusion.18 (29.51%) had yellowish colored pleural effusions, 12 (19.67%) had haemorrhagic pleural effusions and 1 (1.64%) had transparent pleural effusion. Values of the total protein in pleural effusions varied in the interval 45.70 ± 7.25 gr/l., 30 patients had LDH an effusion/sera ratio bigger than 0.6, and 1 patient had an LDH p/s ratio < 0.6. 15 patients (24.59) had neutrophil cells, 10 (16.39%) had lymphocytes, and eosinophil cells dominated in 5 (8.20%). One patient (1.64%) had a negative cytological finding. We can conclude that pleural effusions secondary to PE can be found in around one third of all cases with PE. They are small, mostly unilateral, often but not always haemorrhagic. They are always exudates with a predomination of neutrofil cells. Key words: pulmonary embolism, pleural effusion, unilateral, exudates, neutrofil. PMID:23425873

Sandevski, A; Jovkovska Kaeva, B; Gligorovski, Lj; Simonovska, Lj; Sandevska, E



Calcified multilocular thymic cyst associated with thymoma: a case report  

PubMed Central

Introduction There are few case reports of thymoma with a thymic cyst. Such an association renders it difficult for any pathologist to differentiate from other neoplasms, such as a cystic thymoma. Case presentation A 50-year-old Berber woman from Morocco was admitted with a chronic cough of more than 10 years duration. Her medical history and physical examination were normal. Anterior chest radiography demonstrated a calcified opacity in her right anterior mediastinum. A chest-computed tomogram revealed a round cystic tumor, with significant calcification in her right anterior mediastinum. A surgical exploration was performed. The tumor seemed to be a well-encapsulated and totally calcified lesion, arising from the right lobe of her thymus. It was removed by partial resection of her thymus. Through histology, the calcified tumor exhibited some areas of multilocular fibrous-wall cysts. These cysts were partially lined by small cuboidal cells with severe chronic inflammation and an AB thymoma that arose from the wall of the cyst. Conclusion Greater attention should be given to multilocular thymic cysts, to exclude the possibility of neoplasm, especially when the cyst wall is thickened.



Gastric Calcifying Fibrous Tumor: A Very Rare Case Report  

PubMed Central

Calcifying fibrous tumor is a very rare benign mesenchymal tumor which shows a predilection for soft tissue, mesentery and peritoneum. Up to date only 7 cases have been reported in the literature confined to the gastric wall. We report a rare case of a calcifying fibrous tumor of the stomach in a 60-year-old man who presented with dyspepsia, flatulence and feeling weight. A clinical and laboratory investigation was performed with normal results. Gastroscopy revealed a bulge in the gastric body measuring 1 cm with normal overlying mucosa, and mucosal biopsies showed chronic gastritis. Endoscopic ultrasound of the gastric bulge showed a 1 × 0.8 cm hypoechoic lesion involving the gastric wall. After the above finding a wedge resection of the stomach was performed. Microscopically the lesion consisted of well-circumscribed hypocellular hyalinized fibrosclerotic tissue with lympoplasmatic infiltrates, lymphoid aggregates and psammomatous calcifications. Lesional cells were positive for vimentin and factor XIII and negative for actin, desmin, S100p, CD117, CD34, CD31 and ALK-1. The lesion involved the muscularis propria with variable submucosal extension. Calcifying fibrous tumor has shown an excellent prognosis with recurrences being rare and showing the same morphology as the primary lesion.

Vasilakaki, T.; Skafida, E.; Tsavari, A.; Arkoumani, E.; Koulia, K.; Myoteri, D.; Grammatoglou, X.; Moustou, E.; Firfiris, N.; Zisis, D.



Gastric calcifying fibrous tumor removed by endoscopic submucosal dissection.  


The World Health Organization describes calcifying fibrous tumors (CFTs) as rare, benign lesions characterized by hypocellular, densely hyalinized collagenization with lymphoplasmacytic infiltration. These tumors rarely involve the gastrointestinal (GI) tract. A routine endoscopic upper gastrointestinal screen detected a 10-mm submucosal tumor (SMT) in the lesser curvature of the lower corpus of the stomach of an apparently healthy, 37-year-old woman with no history of Helicobacter pylori infection. Endoscopic ultrasonography (EUS) localized the internally isoechoic, homogeneous SMT mainly within the submucosa. Malignancy was ruled out using endoscopic submucosal dissection (ESD). A pathological examination confirmed complete resection of the SMT, and defined a hypocellular, spindle-cell tumor with a densely hyalinized, collagenous matrix, scattered lymphoplasmacytic aggregates as well as a few psammomatous, dystrophic calcified foci. The mass was immunohistochemically positive for vimentin and negative for CD117 (c-kit protein), CD34, desmin, smooth muscle actin (SMA) and S100. Therefore, the histological findings were characteristic of a CFT. To date, CFT resection by ESD has not been described. This is the first case report of a gastric calcifying fibrous tumor being completely resected by ESD after endoscopic ultrasonography. PMID:24044047

Ogasawara, Naotaka; Izawa, Shinya; Mizuno, Mari; Tanabe, Atsushi; Ozeki, Tomonori; Noda, Hisatsugu; Takahashi, Emiko; Sasaki, Makoto; Yokoi, Toyoharu; Kasugai, Kunio




Microsoft Academic Search

Objective: To evaluate the common causes of pleural effusion in children. Design: Retrospective study. Setting: Liaquat University Hospitals Jamshoro, Hyderabad. Method: The data of all paediatric patients of major pleural effusion from January 2005 was collected and analyzed retrospectively to determine the cause of pleural effusion. Result: This study was conducted on 50 patients. The boys were 30 (60%) and

Saleh AB Memon; Shajeel J Shaikh


Diagnostic approaches in patients with tuberculous pleural effusion  

Microsoft Academic Search

The conventional bacteriologic methods used for diagnosing pleural tuberculosis are less sensitive and time consuming. The objective of this study was to develop nonbacteriologic methods and to assess their potential utilities for the rapid diagnosis, especially in smear\\/culture-negative patients. One hundred forty patients with pleural effusion were investigated for tuberculous etiology by bacteriologic methods. Mycobacterium tuberculosis in the pleural fluid

Y. Anie; S. Sumi; Philip Varghese; Latha G. K. Madhavi; Mundayoor Sathish; V. V. Radhakrishnan



Diagnostic utility of pleural fluid and serum markers in differentiation between malignant and non-malignant pleural effusions  

PubMed Central

Study objective To evaluate the diagnostic value of four different tumor markers: cancer antigen 125 (CA-125), carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA 21-1) and neuron specific enolase (NSE) in patients with malignant and non-malignant pleural effusion. Material and methods One hundred and two patients with pleural effusion treated in the University Hospital in Warsaw between 2001 and 2003 were studied. They underwent an extensive, diagnostic work-up in order to determine the pleural effusion etiology. Patients with known pleural fluid etiology were labeled as the study group and submitted for further analysis. Pleural fluid and serum samples for CA-125, CEA, CYFRA 21-1 and NSE measurements were collected during the first thoracentesis, centrifuged, and frozen until further use. Pleural fluid and serum concentration of tumor markers were assessed by electrochemiluminescence methods using commercial kits. Results 74 patients (32 M, 42 F; mean age 65 ± 14 years) composed the final study group. Exudative pleural effusion was found in 62 patients; of these 36 were malignant (48.6% of all effusions), 20 parapneumonic (or pleural empyema), and 6 tuberculous. In 12 patients, pleural transudate was diagnosed. The highest diagnostic sensitivity for malignant pleural effusion was found for NSE (94.4% and 80.6% in the pleural fluid and serum, respectively). However, the specificity of NSE measurement was relatively low (36.1% and 47.4% in pleural fluid and serum, respectively). The most specific markers of malignant pleural fluid etiology were pleural fluid CYFRA 21-1 and CEA levels (92.1% and 92.1%, respectively). CA-125 was found to be the most specific serum marker of pleural malignancies (78.9%). The AUC for combined pleural markers was 0.89, combined serum markers 0.82, combined ratio pleural/serum markers 0.88. Conclusions There are significant differences between the diagnostic value of various pleural fluid and serum markers. Overall, pleural fluid markers are superior to serum markers in determining the pleural fluid etiology. A combination of two or more tumor markers may help improve their diagnostic accuracy. Pleural fluid and serum measurements of different tumor markers play a limited role in the differentiation between malignant and non-malignant pleural effusions.



Pleural effusion in a peritoneal dialysis patient.  


A 34-year-old female presented with end-stage renal disease (ESRD) treated by peritoneal dialysis (CAPD) complained of a dry cough. Chest X-ray and chest computed tomography (CT) scan revealed massive right hydrothorax. Because the glucose concentration of pleural fluid was markedly high compared with that of serum, we performed isotope and contrast peritoneography. We used CT for localizing it. MRI was also trying to show transdiaphragmatic leakage in peritoneoflural fistula. Temporary discontinuation of CAPD, tetracycline instillation into the pleural space and surgical patch grafting of the diaphragmatic leak have all been described. A novel method may be video-assisted talc pleurodesis. PMID:22111056

Bae, Eun Hui; Kim, Chang Seong; Choi, Joon Seok; Kim, Soo Wan



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

NASA Astrophysics Data System (ADS)

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 ?atm and enriched 1193 ± 166 ?atm and 3150 ± 446 ?atm. 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 ?atm. 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 ?atm) conditions possibly due to the modulation of environmental conditions by the biological activities of the host alga.

Saderne, V.; Wahl, M.



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

NASA Astrophysics Data System (ADS)

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.

Saderne, V.; Wahl, M.



Disappearance of La Caille Plaque  

NASA Astrophysics Data System (ADS)

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.



Dental plaque identification at home  


... 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 ...


A Plaque Assay for Feline Panleukopenia Virus  

Microsoft Academic Search

SUMMARY Plaque formation with representative strains of feline panleukopenia virus (FPV) has been obtained using a permanent line of feline kidney cells under agarose over- lay. FPV-infected cells appear as white plaques after neutral red staining. Plaque size is determined by the extent of cell division in the infected monolayer. FPV assay by the plaque procedure is rapid and gives




Carbohydrates in Pooled Dental Plaque  

Microsoft Academic Search

Dental plaque was collected from approximately 3,500 schoolchildren, and immediately pooled and frozen. The lyophilized plaque was processed in several batches as follows:After an aqueous extraction the water-insoluble portion was further extracted with 1 N KOH. Both aqueous and alkaline extracts were further subfractionated by precipitation at different ethanol concentrations. Nature and composition of carbohydrates in sub-fractions were investigated using

P. Hotz; B. Guggenheim; R. Schmid



Recent concepts in plaque formation.  


Dental plaque is an adherent, bacterial film, and is the main pathological agent for periodontal diseases. The formation of dental plaque can occur both supragingivally and subgingivally. The development of plaque is a three-step process. Following the formation of a pellicle, pioneer micro-organisms will adhere to it, proliferate and form colonies. The final stage involves the aggregation of filamentous organisms and spirochetes into a cohesive biofilm. Many products of the plaque bacteria reach the subepithelial tissue, causing inflammatory responses such as increased vascularity and leukocyte diapedesis. Both supragingival and subgingival plaque may form a hard, mineralized mass called calculus. The surface of calculus harbours bacteria, which may exacerbate the inflammatory responses. An effective oral antiseptic must be active against a wide range of Gram-positive and Gram-negative bacterial species, including streptococci and fusobacteria. Ideally, an effective agent would also penetrate the plaque biofilm. Data show that essential oil and chlorhexidine mouthwashes have the broadest antimicrobial effects. PMID:12787195

Bernimoulin, J-P



Simultaneous bilateral spontaneous pneumothorax with congenital pleuro-pleural communication  

PubMed Central

A single pleural space can lead to serious simultaneous bilateral pneumothorax in cases of congenital or acquired pleuro-pleural communication. Here we report a 35-year-old man with bilateral pneumothorax. Chest computed tomography scans revealed a small air space between the esophagus and aorta, suggesting pleuro-pleural communication. Bilateral thoracoscopic bullectomy was performed. Repeated inspection revealed a 2-cm-long pleural window between the aorta and esophagus, which was closed with a collagen patch. Although congenital pleuro-pleural communication has been regarded as rare, as many as nine patients have been reported (if suspected cases are included). The lower middle mediastinum should be carefully inspected.

Suzuki, Takashi; Yokoi, Masahide; Yoshida, Shuji; Takeyama, Teruaki; Nakazaki, Haruhiro; Goto, Hidenori; Sato, Fumitomo; Takagi, Keigo; Otsuka, Hajime



Simultaneous bilateral spontaneous pneumothorax with congenital pleuro-pleural communication.  


A single pleural space can lead to serious simultaneous bilateral pneumothorax in cases of congenital or acquired pleuro-pleural communication. Here we report a 35-year-old man with bilateral pneumothorax. Chest computed tomography scans revealed a small air space between the esophagus and aorta, suggesting pleuro-pleural communication. Bilateral thoracoscopic bullectomy was performed. Repeated inspection revealed a 2-cm-long pleural window between the aorta and esophagus, which was closed with a collagen patch. Although congenital pleuro-pleural communication has been regarded as rare, as many as nine patients have been reported (if suspected cases are included). The lower middle mediastinum should be carefully inspected. PMID:23372954

Hata, Yoshinobu; Suzuki, Takashi; Yokoi, Masahide; Yoshida, Shuji; Takeyama, Teruaki; Nakazaki, Haruhiro; Goto, Hidenori; Sato, Fumitomo; Takagi, Keigo; Otsuka, Hajime



Plaque Assay for Murine Norovirus  

PubMed Central

Murine norovirus (MNV) is the only member of the Norovirus genus that efficiently grows in tissue culture 1, 2. Cell lysis and cytopathic effect (CPE) are observed during MNV-1 infection of murine dendritic cells or macrophages 1. This property of MNV-1 can be used to quantify the number of infectious particles in a given sample by performing a plaque assay 1. The plaque assay relies on the ability of MNV-1 to lyse cells and to form holes in a confluent cell monolayer, which are called plaques 3. Multiple techniques can be used to detect viral infections in tissue culture, harvested tissue, clinical, and environmental samples, but not all measure the number of infectious particles (e.g. qRT-PCR). One way to quantify infectious viral particles is to perform a plaque assay 3, which will be described in detail below. A variation on the MNV plaque assay is the fluorescent focus assay, where MNV antigen is immunostained in cell monolayers 4. This assay can be faster, since viral antigen expression precedes plaque formation. It is also useful for titrating viruses unable to form plaques. However, the fluorescent focus assay requires additional resources beyond those of the plaque assay, such as antibodies and a microscope to count focus-forming units. Infectious MNV can also be quantified by determining the 50% Tissue Culture Infective Dose (TCID50) 3. This assay measures the amount of virus required to produce CPE in 50% of inoculated tissue culture cells by endpoint titration 5. However, its limit of detection is higher compared to a plaque assay 4. In this article, we describe a plaque assay protocol that can be used to effectively determine the number of infectious MNV particles present in biological or environmental samples 1, 4, 6. This method is based on the preparation of 10-fold serial dilutions of MNV-containing samples, which are used to inoculate a monolayer of permissive cells (RAW 264.7 murine macrophage cells). Virus is allowed to attach to the cell monolayer for a given period of time and then aspirated before covering cells with a mixture of agarose and cell culture media. The agar enables the spread of viral progeny to neighboring cells while limiting spread to distantly located cells. Consequently, infected cells are lysed and form holes in the monolayer known as plaques. Upon sufficient spread of virus, plaques become visible following staining of cells with dyes, like neutral red, methylene blue, or crystal violet. At low dilutions, each plaque originates from one infectious viral particle and its progeny, which spread to neighboring cells. Thus, counting the number of plaques allows one to calculate plaque-forming units (PFU) present in the undiluted sample 3.

Gonzalez-Hernandez, Mariam B.; Bragazzi Cunha, Juliana; Wobus, Christiane E.



Effects of bacteriophage traits on plaque formation  

PubMed Central

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.



Immunologic Characterization of Normal Human Pleural Macrophages  

Microsoft Academic Search

Human pleural macrophages (PLM) have been studied in effu- sions, but little is known about normal human PLM. We there- fore 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 pneumotho- rax. Analysis of surface antigens, phagocytosis capacity, and

Marion Frankenberger; Bernward Passlick; Thomas Hofer; Matthias Siebeck; Konrad L. Maier


Diffuse malignant pleural mesothelioma and asbestos exposure  

Microsoft Academic Search

Pleural mesothelioma has been diagnosed in 52 patients in three hospitals on Merseyside between 1955 and 1970, 60% being diagnosed from operation specimens and the rest from postmortem tissues. Necropsies eventually held on nearly half the operation cases confirmed the diagnosis, giving a necropsy rate of 70% for the series. The morbid anatomy conformed to earlier descriptions except that widespread

F. Whitwell; Rachel M. Rawcliffe



Pleural Effusions in Critically Ill Patients  

Microsoft Academic Search

Pleural effusions (PEs) are common in critically ill patients mainly as a consequence of severe cardiopulmonary disorders frequently encountered in these patients. Their impact on the pathophysiology of acute respiratory failure remains unknown. They are usually small and uncomplicated transudates that are easily overlooked on a supine portable chest X-ray and do not require drainage or infectious exudates that always

Ioannis Pneumatikos; Demosthenes Bouros



Clustering of plaques contributes to plaque growth in a mouse model of Alzheimer's disease.  


Amyloid-? (A?) plaque deposition plays a central role in the pathogenesis of Alzheimer's disease (AD). Post-mortem analysis of plaque development in mouse models of AD revealed that plaques are initially small, but then increase in size and become more numerous with age. There is evidence that plaques can grow uniformly over time; however, a complementary hypothesis of plaque development is that small plaques cluster and grow together thereby forming larger plaques. To investigate the latter hypothesis, we studied plaque formation in APPPS1 mice using in vivo two-photon microscopy and immunohistochemical analysis. We used sequential pre- and post-mortem staining techniques to label plaques at different stages of development and to detect newly emerged plaques. Post-mortem analysis revealed that a subset (22 %) of newly formed plaques appeared very close (<40 ?m) to pre-existing plaques and that many close plaques (25 %) that were initially separate merged over time to form one single large plaque. Our results suggest that small plaques can cluster together, thus forming larger plaques as a complementary mechanism to simple uniform plaque growth from a single initial plaque. This study deepens our understanding of A? deposition and demonstrates that there are multiple mechanisms at play in plaque development. PMID:23775142

McCarter, Joanna F; Liebscher, Sabine; Bachhuber, Teresa; Abou-Ajram, Claudia; Hübener, Mark; Hyman, Bradley T; Haass, Christian; Meyer-Luehmann, Melanie



Ameloblastomatous calcifying odontogenic cyst: a rare histological variant.  


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

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



Calcified myocardial necrosis in pediatric patients after cardiopulmonary resuscitation.  


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

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



The use of Jackson-Pratt silicone flat drains as prolonged pleural catheters for the management of pleural effusions  

PubMed Central

Introduction Imbalance between secretion and absorbtion of pleural fluid results in pleural effusion. Emergence of pleural effusion ipsilateral or contralateral to the side drained previously is named recurrent effusion. There is currently no standart approach for the management of recurrent pleural effusions. Materials and methods Eighteen patients, treated between 2011 and 2012 for recurrent pleural effusions due to various etiologies, not considered for surgical or other treatments, and underwent placement of prolonged pleural catheters (Jackson-Pratt drain) were included in this study. Twenty two prolonged pleural catheters were inserted in 18 patients. There were 10 females and 8 males, with mean age 59 (35-77). In 20 patients the catheters were inserted by an anterior approach, and by a posterior approach in one patient. Daily drainage above 1,500 mL was not permitted in order to avoid pulmonary edema. Catheters were removed in patients who had lung expansion and drainage under 50 mL/day. Results The most common etiology for pleural effusions was extrathoracic malignancy in 9 patients, primary bronchial carcinoma in 5 patients, and benign pleural effusion in 4 patients. Four patients underwent bilateral prolonged pleural catheter insertion. The catheters were retained for a mean period of 19 (10-40) days. Pleural effusion recurred two months after removal of the catheter in one patient with primary bronchial cancer (5%). Only one patient developed a complication (empyema) while under drainage (5%). Two patients died while the catheter was in place. Conclusions Decreased length of stay and lower costs have enabled prolonged are the major advantages of pleural catheter applications in appropriate patients compared to other treatment methods. We believe that the Jackson Pratt silicone flat drains provide effective pleurodesis along with easy application, and suggest their use as an alternative to pleurodesis in especially malignant pleural effusions and not benign pleural effusions.

Kasapoglu, Tugce; Ece, Ferah; Toker, Alper



Penetration of azithromycin in experimental pleural empyema fluid.  


There were no data about the extent of azithromycin penetration into the empyemic pleural fluid in humans and in experimental animals. An empyema was created via the intrapleural injection of an Escherichia coli solution into the pleural space of New Zealand white rabbits. After an empyema was verified by thoracocentesis, 24h post inoculation, azithromycin (15 mg/kg) was administered intravenously. Antibiotic levels were determined in samples of pleural fluid and blood serum, collected serially at 2, 8, 24, 48 and 72 h, after administration. Azithromycin levels were estimated using an HPLC analytical method with fluorimetric detection. Azithromycin penetrated well into the empyemic pleural fluid, exhibiting a slower onset and decline compared to the corresponding blood serum levels. Equilibration between pleural fluid and blood serum compartments seemed to occur at 2h, with peak pleural fluid levels (C(maxpf) of 0.48 microg/ml) occurring 24h post administration and decreasing thereafter. Azithromycin peak serum concentration (C(maxserum) of 0.24 microg/ml) was observed 2h after administration and, thereafter, serum antibiotic levels remained lower than the corresponding pleural fluid ones. The area under the concentration versus time curve (AUC) and terminal half-life (T(1/2)) of azithromycin was three- to six fold and twofold higher, respectively, in the pleural fluid compared to the blood serum compartment. After intravenous administration, azithromycin penetrated well into the empyemic pleural fluid, exhibiting pleural fluid levels that are inhibitory for most erythromycin-sensitive pathogens causing empyema. PMID:19854169

Saroglou, Maria; Ismailos, George; Tryfon, Stavros; Liapakis, Ioannis; Papalois, Apostolos; Bouros, Demosthenes



Interleukin-18 is up-regulated in infectious pleural effusions.  


The aim of this study was to investigate the pleural and systemic expression of interleukin-18 (IL-18) in patients with pleural effusions (PEs), and the effects of the cytokine in mouse pleural space. One hundred and sixty patients, 23 with pleural effusions (PEs) due to heart failure, 60 malignant, 25 parapneumonic/empyemas, 15 tuberculous and 37 with exudates of miscellaneous etiologies were included in the study. Pleural fluid (PF) and serum IL-18 content was determined using ELISA. IL-18 was injected intrapleurally in mice and pleural inflammation was assessed using pleural lavage. The highest PF IL-18 levels were observed in parapneumonic PEs and the lowest PF IL-18 levels in patients with exudates of miscellaneous aetiologies and transudates. PF IL-18 levels were significantly higher in patients with empyemas compared to those with uncomplicated (p=0.009) or complicated (p=0.028) parapneumonic effusions, while serum levels did not differ significantly among the three groups. Pleural IL-18 content was higher than that of blood only in patients with empyemas. In patients with pleural exudates of all etiologies and in those with parapneumonic PEs/empyema, PF IL-18 levels were correlated with markers of acute pleural inflammation such as the percentage of PF neutrophils, PF LDH and PF/serum LDH ratio, low PF glucose and PF/serum glucose ratio and low PF pH. In mice, intrapleural IL-18 caused neutrophil-predominant pleural inflammation. In conclusion, IL-18 is linked to the intensity of neutrophilic pleural inflammation in patients with PEs, it is up-regulated in the pleural space of patients with empyema and it stimulates the accumulation of neutrophils in mouse pleura. PMID:23660216

Rovina, Nikoletta; Dima, Efrossini; Psallidas, Ioannis; Moschos, Charalampos; Kollintza, Androniki; Kalomenidis, Ioannis



Novel tests for diagnosing tuberculous pleural effusion: what works and what does not?  

Microsoft Academic Search

Tuberculous pleuritis is a common manifestation of extrapulmonary tuberculosis and is the most common cause of pleural effusion in many countries. Conventional diagnostic tests, such as microscopic examination of the pleural fluid, biochemical tests, culture of pleural fluid, sputum or pleural tissue, and histopathological examination of pleural tissue, have known limitations. Due to these limitations, newer and more rapid diagnostic

A. Trajman; M. Pai; K. Dheda; R. van Zyl Smit; A. A. Zwerling; R. Joshi; S. Kalantri; P. Daleye; D. Menzies



Rare Cases of Primary Pleural Hodgkin and Non-Hodgkin Lymphomas  

Microsoft Academic Search

Primary pleural lymphoma is rare. It occurs in only 7% of lymphoma cases. We report herein two cases of primary pleural Hodgkin and non-Hodgkin follicular lymphomas diagnosed by thoracoscopy under local anesthesia. Both patients presented initially with dyspnea revealing pleural effusions. The pleural findings during thoracoscopy differed in the two cases and selective pleural biopsies under optical forceps led to

Paschalis Steiropoulos; George Kouliatsis; Georgia Karpathiou; Maria Popidou; Marios E. Froudarakis



Assessment of coronary artery disease and calcified coronary plaque burden by computed tomography in patients with and without diabetes mellitus  

Microsoft Academic Search

Purpose  To compare the coronary atherosclerotic burden in patients with and without type-2 diabetes using CT Coronary Angiography\\u000a (CTCA).\\u000a \\u000a \\u000a \\u000a \\u000a Methods and Materials  147 diabetic (mean age: 65?±?10 years; male: 89) and 979 nondiabetic patients (mean age: 61?±?13 years; male: 567) without\\u000a a history of coronary artery disease (CAD) underwent CTCA. The per-patient number of diseased coronary segments was determined\\u000a and each diseased segment was

Erica Maffei; Sara Seitun; Koen Nieman; Chiara Martini; Andrea Igoren Guaricci; Carlo Tedeschi; Annick C. Weustink; Nico R. Mollet; Elena Berti; Roberto Grilli; Giancarlo Messalli; Filippo Cademartiri



CT and US features of renal matrix stones with calcified center  

SciTech Connect

We report imaging findings of renal matrix stones in a patient with congenital ureteropelvic junction obstruction associated with urinary tract infection. The stones were composed of a calcified center and a non-calcified peripheral matrix that was slightly high attenuated on CT and nonshadowing on US. 8 refs., 1 fig.

Kim, Seung H.; Lee, Sang E.; Park, In A. [Seoul National Univ. Hospital (Korea, Republic of)



Ocean acidification: documenting its impact on calcifying phytoplankton at basin scales  

Microsoft Academic Search

In this paper, we evaluate several approaches to discern the impact of ocean acidifica- tion on calcifying plankton, over basin scales. We focus on estimates of the standing stock of particu- late inorganic carbon (PIC) associated with calcifying plankton since it is thought that these organ- isms will be the most sensitive to ocean acidification. Chemical techniques provide the greatest

William M. Balch; Victoria J. Fabry



Pleural fluid cell-free DNA integrity index to identify cytologically negative malignant pleural effusions including mesotheliomas  

PubMed Central

Background The diagnosis of malignant pleural effusions (MPE) is often clinically challenging, especially if the cytology is negative for malignancy. DNA integrity index has been reported to be a marker of malignancy. The aim of this study was to evaluate the utility of pleural fluid DNA integrity index in the diagnosis of MPE. Methods We studied 75 pleural fluid and matched serum samples from consecutive subjects. Pleural fluid and serum ALU DNA repeats [115bp, 247bp and 247bp/115bp ratio (DNA integrity index)] were assessed by real-time quantitative PCR. Pleural fluid and serum mesothelin levels were quantified using ELISA. Results Based on clinico-pathological evaluation, 52 subjects had MPE (including 16 mesotheliomas) and 23 had benign effusions. Pleural fluid DNA integrity index was higher in MPE compared with benign effusions (1.2 vs. 0.8; p<0.001). Cytology had a sensitivity of 55% in diagnosing MPE. If cytology and pleural fluid DNA integrity index were considered together, they exhibited 81% sensitivity and 87% specificity in distinguishing benign and malignant effusions. In cytology-negative pleural effusions (35 MPE and 28 benign effusions), elevated pleural fluid DNA integrity index had an 81% positive predictive value in detecting MPEs. In the detection of mesothelioma, at a specificity of 90%, pleural fluid DNA integrity index had similar sensitivity to pleural fluid and serum mesothelin (75% each respectively). Conclusion Pleural fluid DNA integrity index is a promising diagnostic biomarker for identification of MPEs, including mesothelioma. This biomarker may be particularly useful in cases of MPE where pleural aspirate cytology is negative, and could guide the decision to undertake more invasive definitive testing. A prospective validation study is being undertaken to validate our findings and test the clinical utility of this biomarker for altering clinical practice.



Pleural Enterococcus faecalis empyema: an unusual case.  


A 63-year-old female patient was admitted to the department of neurology following an acute ischemic infarction of the right medial cerebral artery. She developed fever, respiratory failure, and hypotension and had to be transferred to the intensive care unit (ICU) for intubation and mechanical ventilation. Chest X-ray showed increased density of the complete right hemi-thorax, indicative of massive pleural effusion. Chest tube drainage produced 1.5 l of pus in 1 h. Cultures revealed growth of Enterococcus faecalis. The patient was treated with amoxicillin and clavulanic acid with good clinical response. Enterococci very rarely cause spontaneous pleural empyema. The natural resistance of enterococci to several types of antibiotics can lead to selection of enterococci as seen in other clinical studies and may lead to this unusual clinical consequence. PMID:17973078

Bergman, R; Tjan, D H T; Schouten, M A; Haas, L E M; van Zanten, A R H



Electrochemical Impedance Spectroscopy to Characterize Inflammatory Atherosclerotic Plaques  

PubMed Central

Despite advances in diagnosis and therapy, atherosclerotic cardiovascular disease remains the leading cause of morbidity and mortality in the Western world. Predicting metabolically active atherosclerotic lesions has remained an unmet clinical need. We hereby developed an electrochemical strategy to characterize the inflammatory states of high-risk atherosclerotic plaques. Using the concentric bipolar microelectrodes, we sought to demonstrate distinct Electrochemical Impedance Spectroscopic (EIS) measurements for unstable atherosclerotic plaques that harbored active lipids and inflammatory cells. Using equivalent circuits to simulate vessel impedance at the electrode-endoluminal tissue interface, we demonstrated specific electric elements to model working and counter electrode interfaces as well as the tissue impedance. Using explants of human coronary, carotid, and femoral arteries at various Stary stages of atherosclerotic lesions (n = 15), we performed endoluminal EIS measurements (n = 147) and validated with histology and immunohistochemistry. We computed the vascular tissue resistance using the equivalent circuit model and normalized the resistance to the lesion-free regions. Tissue resistance was significantly elevated in the oxLDL-rich thin-cap atheromas (1.57±0.40, n = 14, p < 0.001) and fatty streaks (1.36±0.28, n = 33, p < 0.001) as compared with lesion-free region (1.00±0.18, n = 82) or oxLDL-absent fibrous atheromas (0.86±0.30, n = 12). Tissue resistance was also elevated in the calcified core of fibrous atheroma (2.37±0.60, n = 6, p < 0.001). Despite presence of fibrous structures, tissue resistance between ox-LDL-absent fibroatheroma and the lesion-free regions was statistically insignificant (0.86±0.30, n = 12, p > 0.05). Hence, we demonstrate that the application of EIS strategy was sensitive to detect fibrous cap oxLDL-rich lesions and specific to distinguish oxLDL-absent fibroatheroma.

Yu, Fei; Dai, Xiaohu; Beebe, Tyler; Hsiai, Tzung



Telomerase activity in pleural malignant mesotheliomas  

PubMed Central

New treatments are needed for malignant pleural mesothelioma (MPM), which currently has a poor prognosis. Cellular immortalisation, one of the hallmarks of cancer, depends on the activity of a telomere length maintenance mechanism (TMM) – either telomerase or alternative lengthening of telomeres (ALT). The TMMs are widely regarded as potential targets for cancer therapies and telomerase inhibitors have entered clinical trials. The aim of this study was to determine what proportion of MPMs use ALT and/or telomerase. Forty-three MPMs from 42 patients were examined for telomerase and ALT activity. Telomerase activity was detected by immunoaffinity purification followed by the telomere repeat amplification protocol (TRAP), and ALT activity was determined by the C-circle assay and by assessing telomere lengths using terminal restriction fragment analyses. We found that 43 of 43 MPMs were telomerase-positive[+] and ALT-negative[?]. Therefore, to investigate whether pleural mesothelial cells are unusually susceptible to activation of telomerase, we examined activation of the TMMs in an in vitro model of cellular immortalisation, in which normal pleural mesothelial cells were transduced with simian virus 40 (SV40) oncogenes. We found that normal mesothelial cells were TMM-negative, and that expression of the SV40 oncogenes did not directly activate telomerase or ALT. Immortalisation, which in this experimental system results from additional genetic changes that have not yet been identified, was accompanied by activation of either TMM. Therefore, pleural mesothelial cells are capable of activating either TMM in vitro, and the observation that 100% of MPMs were telomerase[+] suggests that there are factors in vivo that select for telomerase activity during oncogenesis of this tumour type. We conclude that MPM is a tumour that could be considered for anti-telomerase therapy.

Au, Amy Y.M.; Hackl, Torben; Yeager, Thomas R.; Cohen, Scott B.; Pass, Harvey I.; Harris, Curtis C.; Reddel, Roger R.



Mechanisms of Pleural Involvement in Orphan Diseases  

Microsoft Academic Search

Over the past 10 years, the widespread clinical applicability of semi-invasive and noninvasive diagnostic tools including medical thoracoscopy and ultrasonography has expanded the occurrence of pleural effusions to include several rare diseases such as granulomatous, connective tissue and autoimmune disorders including sarcoidosis, granulomatosis with polyangiitis (Wegener’s), systemic sclerosis, lupus erythematosus, rheumatoid arthritis, Sjögren’s syndrome, amyloidosis, Langerhans cell histiocytosis, and others.

Stavros Anevlavis; Argyris Tzouvelekis; Demosthenes Bouros



Minimally-Invasive Localization of Oncolytic Herpes Simplex Viral Therapy of Metastatic Pleural Cancer  

PubMed Central

Purpose Herpes simplex virus-one (HSV-1) oncolytic therapy and gene therapy are promising treatment modalities against cancer. NV1066, one such HSV-1 virus carries a marker gene for enhanced green fluorescent protein (EGFP). The purpose of this study was to determine whether NV1066 is cytotoxic to lung cancer and whether EGFP is a detectable marker of viral infection in vitro and in vivo. We further investigated whether EGFP expression in infected cells can be used to localize the virus and to identify small metastatic tumor foci (< 1 mm.) in vivo by means of minimally invasive endoscopic systems equipped with fluorescent filters. Experimental Design In A549 human lung cancer cells, in vitro viral replication was determined by plaque assay, cell kill by LDH release assay, and EGFP expression by flow cytometry. In vivo, A549 cells were injected into the pleural cavity of athymic mice. Mice were treated with intrapleural injection of NV1066 or saline and examined for EGFP expression in tumor deposits using a stereomicroscope or a fluorescent thoracoscopic system. Results NV1066 replicated in, expressed EGFP in infected cells and killed tumor cells in vitro. In vivo, treatment with intrapleural NV1066 decreased pleural disease burden, as measured by chest wall nodule counts and organ weights. EGFP was easily visualized in tumor deposits, including microscopic foci, by fluorescent thoracoscopy. Conclusions NV1066 has significant oncolytic activity against a human NSCLC cell line and is effective in limiting the progression of metastatic disease in an in vivo orthotopic model. By incorporating fluorescent filters into endoscopic systems, a minimally-invasive means for diagnosing small metastatic pleural deposits and localization of viral therapy for thoracic malignancies may be developed using the EGFP marker gene inserted in oncolytic herpes simplex viruses.

Stiles, Brendon M.; Adusumilli, Prasad S.; Bhargava, Amit; Stanziale, Stephen F.; Kim, Teresa H.; Chan, Mei-Ki; Huq, Rumana; Wong, Richard; Rusch, Valerie W.; Fong, Yuman



Plaque Formation by Virulent Shigella flexneri.  

National Technical Information Service (NTIS)

An in vitro tissue culture plaque assay was developed to investigate the intracellular replication and intercellular spread of virulent shigellae. Shigella plaques were formed in HeLa cell monolayers in the presence of an agarose overlay containing tissue...

E. V. Oaks M. E. Wingfield S. B. Formal



Acute myeloid leukemia with leukemic pleural effusion.  


Acute myeloid leukemia (AML) may be associated with extramedullary tumor growth, which is commonly known as myeloid sarcoma. Although AML with leukemic pleural effusion is considered rare, the true incidence is not clear. We report three cases of AML involving pleural effusion in this study. The cases were encountered in a single institute within two years, suggesting that leukemic effusion is more common than previously reported. Leukemic cells showed evidence of monocytic differentiation in all cases. Two patients presented with advanced AML. Both had concurrent myeloid sarcoma. Both were ineligible for intensive treatment and died soon after diagnosis of myeloid sarcoma. The third patient had pleural effusion upon diagnosis of AML. Remission was achieved and the effusion disappeared after treatment. We conclude leukemic effusion may become more common in an era of improved care and prolonged survival for AML patients. The prognostic impact is unclear and patients should be given standard AML treatment whenever possible. Diagn. Cytopathol. 2013;41:909-913. © 2012 Wiley Periodicals, Inc. PMID:22550016

Chang, Hung



Carbimazole Induced Pleural Effusion: A Case Report  

PubMed Central

Objective. To describe a patient with unilateral exudative pleural effusion that developed after commencement of carbimazole. Methods. We describe the presentation and clinical journey of an elderly woman who presented to the chest physicians initially with pleural effusion but was followed up by the endocrinology team. Result. The patient was a 77-year-old Caucasian woman who presented with symptoms of breathlessness and a confirmed unilateral pleural effusion while being on treatment for thyrotoxicosis. Her symptoms needed recurrent hospital admission for investigations and drainage, but no potential cause was identified after extensive investigations. A drug-induced exudative effusion consequent to carbimazole intake was diagnosed as discontinuation of the drug lead to complete resolution of the effusion with no recurrence. Conclusion. Physicians and Endocrinologist must bear in mind that this potentially rare complication of carbimazole while treating patients of thyrotoxicosis as appearance of similar features in their patients while being on carbimazole should lead to the discontinuation of the drug, and alternative treatment strategy should be considered.

Das, Gautam; Stanaway, Stephen E. R. S.; Brohan, Liz



Fibre distribution in the lungs and pleura of subjects with asbestos related diffuse pleural fibrosis.  

PubMed Central

The lungs from 13 cases of diffuse pleural fibrosis associated with a history of exposure to asbestos were examined. Samples were taken from the visceral pleura and central and subpleural zones of the lungs for histopathological and mineralogical studies. The fibre type, size, and number were estimated for each of these regions by transmission electron microscopy and energy dispersive x ray analysis. Amphibole fibre counts were raised when compared with a non-occupationally exposed group and matched those seen in cases of pleural plaques, mild asbestosis, and mesothelioma. A wide case to case variation of distribution was seen. No significant difference was apparent between central and subpleural zones, whereas low asbestos counts were found in the pleura; these were mainly short chrysotile fibres. Within the lungs more (45%) of the longer (greater than 4 microns) and thinner (less than 0.25 micron) amphibole fibres were retained in keeping with other studies implicating such fibre profiles in the pathogenesis of asbestos related disease.

Gibbs, A R; Stephens, M; Griffiths, D M; Blight, B J; Pooley, F D



The diagnosis and management of pleural effusions in the ICU.  


Pleural effusions are common in critically ill patients. Most effusions in intensive care unit (ICU) patients are of limited clinical significance; however, some are important and require aggressive management. Transudative effusions in the ICU are commonly caused by volume overload, decreased plasma oncotic pressure, and regions of altered pleural pressure attributable to atelectasis and mechanical ventilation. Exudates are sequelae of pulmonary or pleural infection, pulmonary embolism, postsurgical complications, and malignancy. Increases in pleural fluid volume are accommodated principally by chest wall expansion and, to a lesser degree, by lung collapse. Studies in mechanically ventilated patients suggest that pleural fluid drainage can result in improved oxygenation for up to 48 hours, but data on clinical outcomes are limited. Mechanically ventilated patients with pleural effusions should be semirecumbant and treated with higher levels of positive-end expiratory pressure. Rarely, large effusions can cause cardiac tamponade or tension physiology, requiring urgent drainage. Bedside ultrasound is both sensitive and specific for diagnosing pleural effusions in mechanically ventilated patients. Sonographic findings of septation and homogenous echogenicity may suggest an exudative effusion, but definitive diagnosis requires pleural fluid sampling. Thoracentesis should be carried out under ultrasound guidance. Antibiotic regimens for parapneumonic effusions should be based on current pneumonia guidelines, and anaerobic coverage should be included in the case of empyema. Decompression of the pleural space may be necessary to improve respiratory mechanics, as well as to treat complicated effusions. While small-bore catheters inserted under ultrasound guidance may be used for nonseptated effusions, surgical consultation should be sought in cases where this approach fails, or where the effusion appears complex and septated at the outset. Further research is needed to determine the effects of pleural fluid drainage on clinical outcomes in mechanically ventilated patients, to evaluate weaning strategies that include pleural fluid drainage, and to better identify patients in whom pleural effusions are more likely to be infected. PMID:22080544

Maslove, David M; Chen, Benson Tze-Ming; Wang, Helena; Kuschner, Ware G



Interleukin8 and Markers of Neutrophil Degranulation in Pleural Effusions  

Microsoft Academic Search

In order to know the degree of interleukin-8 (IL-8) production in the pleural space and its relation- ship to neutrophil activation, IL-8, neutrophil elastase (NE), and myeloperoxidase (MPO) were as- sessed in blood and pleural fluid (PF) of 219 patients with pleural effusions. Correlations between blood and PF IL-8, NE, and MPO were either absent or weak, except for IL-8




Multiphoton microscopy of atheroslcerotic plaques  

NASA Astrophysics Data System (ADS)

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.

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



Antiangiogenic therapy for normalization of atherosclerotic plaque vasculature: a potential strategy for plaque stabilization  

Microsoft Academic Search

Angiogenesis within human atherosclerotic plaques has an important role in plaque progression as immature blood vessels leak red blood cells and inflammatory mediators into the plaque center. Accumulation of free cholesterol from red blood cell membranes potentially increases the size of the necrotic core and triggers a chain of events that promote plaque destabilization. Antiangiogenic agents have been shown to

Aloke V Finn; Frank D Kolodgie; Renu Virmani; Rakesh K Jain; Herman K Gold



Relationship Between Dental Plaque Indices and Bacteria in Dental Plaque and Those in Saliva  

Microsoft Academic Search

A variety of indices has been developed for the quantitation of dental plaque. The aim of this study was to determine the correlation between the Löe plaque index and the number of bacteria on the same tooth. Furthermore, the effect of plaque accumulation on the salivary counts of some dental plaque organisms was estimated. Twenty volunteers were asked to abstain

M. J. M. Schaeken; T. J. Creugers; J. S. Van Der Hoeven



Soluble mesothelin-related protein in pleural effusion from patients with malignant pleural mesothelioma  

PubMed Central

Malignant pleural mesothelioma (MPM) is a highly aggressive neoplasm primarily arising from surface serosal cells of the pleura and is strongly associated with asbestos exposure. Patients with MPM often develop pleural fluid as initial presentation. However, cytological diagnosis using pleural fluid is usually difficult and has limited utility. A useful molecular marker for differential diagnosis particularly with lung cancer (LC) is urgently needed. The aim of the present study was to investigate the diagnostic value of soluble mesothelin-related protein (SMRP) in pleural fluid. Pleural fluids were collected from 23 patients with MPM, 38 with LC, 26 with benign asbestos pleurisy (BAP), 5 with tuberculosis pleurisy (TP) and 4 with chronic heart failure (CHF), and the SMRP concentration was determined. All data were analyzed by using non-parametric two-sided statistical tests. The median concentration of SMRP in MPM, LC, BAP, TP and CHF were 11.5 (range 0.90–82.80), 5.20 (0.05–36.40), 6.65 (1.45–11.25), 3.20 (1.65–6.50) and 2.03 (1.35–2.80) nmol/l, respectively. The SMRP concentration was significantly higher in MPM than in the other diseases (P=0.001). The area under the ROC curve (AUC) values of the MPM diagnosis was 0.75 for the differential diagnosis from the other groups. Based on the cut-off value of 8 nmol/l, the sensitivity and specificity for diagnosis of MPM were 70.0 and 68.4%, respectively. These results indicate that the SMRP concentration in pleural fluid is a useful marker for the diagnosis of MPM.




IVUS-based histology of atherosclerotic plaques: improving longitudinal resolution  

NASA Astrophysics Data System (ADS)

Although Virtual Histology (VH) is the in-vivo gold standard for atherosclerosis plaque characterization in IVUS images, it suffers from a poor longitudinal resolution due to ECG-gating. In this paper, we propose an image-based approach to overcome this limitation. Since each tissue have different echogenic characteristics, they show in IVUS images different local frequency components. By using Redundant Wavelet Packet Transform (RWPT), IVUS images are decomposed in multiple sub-band images. To encode the textural statistics of each resulting image, run-length features are extracted from the neighborhood centered on each pixel. To provide the best discrimination power according to these features, relevant sub-bands are selected by using Local Discriminant Bases (LDB) algorithm in combination with Fisher's criterion. A structure of weighted multi-class SVM permits the classification of the extracted feature vectors into three tissue classes, namely fibro-fatty, necrotic core and dense calcified tissues. Results shows the superiority of our approach with an overall accuracy of 72% in comparison to methods based on Local Binary Pattern and Co-occurrence, which respectively give accuracy rates of 70% and 71%.

Taki, Arash; Pauly, Olivier; Setarehdan, S. Kamaledin; Unal, Gozde; Navab, Nassir



Multimodality imaging of atherosclerotic plaque activity and composition using FDG-PET/CT and MRI in carotid and femoral arteries  

PubMed Central

Purpose To evaluate the relationship between atherosclerotic plaque inflammation, as assessed by FDG-Positron Emission Tomography/Computed Tomography (FDG-PET/CT), and plaque morphology and composition, as assessed by magnetic resonance imaging (MRI), in the carotid and femoral arteries. Materials and methods Sixteen patients underwent FDG-PET/CT and MRI (T2 weighted (T2W) and Proton density weighted (PDW)) of the carotid and femoral arteries. For every image slice, two observers determined the corresponding regions of the FDG-PET/CT and MRI image sets by matching CT and T2W axial images. Each plaque was then classified into one of three groups according to the CT appearance and T2W/PDW signal: 1) collagen, 2) lipid-necrotic core and 3) calcium. Arterial FDG uptake was measured for each plaque and normalized to vein FDG activity to produce a blood-normalized artery activity called the target to background ratio (TBR). The vessel wall thickness (VWT), the vessel wall area and the total vessel wall area were measured from the T2W MR images. Results The TBR value was higher in the lipid-necrotic core group compared to the collagen and calcium groups, (p < 0.001). The lipid-necrotic core group demonstrated a significant TBR variation according to the median of the VWT (TBR = 1.26 ± 0.25 vs. TBR = 1.50 ± 0.12). There was no correlation with other morphological MR parameters. Conclusions This study demonstrates the complementary value of non-invasive FDG-PET/CT and MR imaging for the evaluation of atherosclerotic plaque composition and activity. Lipid-rich plaques are more inflamed than either calcified or collagen-rich plaques.

Silvera, Stephane S.; el Aidi, Hamza; Rudd, James H. F.; Mani, Venkatesh; Yang, Lingde; Farkouh, Michael; Fuster, Valentin; Fayad, Zahi A.



Diagnosis of systemic amyloidosis and amyloidosis mediated cardiomyopathy by VATS pleural biopsy for chronic pleural effusion  

PubMed Central

Amyloidosis is a family of diseases characterized by the extracellular accumulation of amyloid protein, causing altered physiology based on its abnormal deposition in an organ. The etiology of persistent pleural effusions in patients with systemic amyloidosis is unknown. Endomyocardial biopsy is the gold standard of diagnosis for patients with cardiac involvement in systemic amyloidosis. We present the case of a patient with systemic amyloidosis whose diagnosis was made by pleural pathology collected via video-assisted thoracic surgery after a false negative endomyocardial biopsy.

Harvey-Taylor, Jessica; Zhang, Yanhong; Kuderer, Valerie



Automated tissue characterization of in vivo atherosclerotic plaques by intravascular optical coherence tomography images  

PubMed Central

Intravascular optical coherence tomography (IVOCT) is rapidly becoming the method of choice for the in vivo investigation of coronary artery disease. While IVOCT visualizes atherosclerotic plaques with a resolution <20µm, image analysis in terms of tissue composition is currently performed by a time-consuming manual procedure based on the qualitative interpretation of image features. We illustrate an algorithm for the automated and systematic characterization of IVOCT atherosclerotic tissue. The proposed method consists in a supervised classification of image pixels according to textural features combined with the estimated value of the optical attenuation coefficient. IVOCT images of 64 plaques, from 49 in vivo IVOCT data sets, constituted the algorithm’s training and testing data sets. Validation was obtained by comparing automated analysis results to the manual assessment of atherosclerotic plaques. An overall pixel-wise accuracy of 81.5% with a classification feasibility of 76.5% and per-class accuracy of 89.5%, 72.1% and 79.5% for fibrotic, calcified and lipid-rich tissue respectively, was found. Moreover, measured optical properties were in agreement with previous results reported in literature. As such, an algorithm for automated tissue characterization was developed and validated using in vivo human data, suggesting that it can be applied to clinical IVOCT data. This might be an important step towards the integration of IVOCT in cardiovascular research and routine clinical practice.

Ughi, Giovanni Jacopo; Adriaenssens, Tom; Sinnaeve, Peter; Desmet, Walter; D'hooge, Jan



Ultra-short echo time cardiovascular magnetic resonance of atherosclerotic carotid plaque  

PubMed Central

Background Multi-contrast weighted cardiovascular magnetic resonance (CMR) allows detailed plaque characterisation and assessment of plaque vulnerability. The aim of this preliminary study was to show the potential of Ultra-short Echo Time (UTE) subtraction MR in detecting calcification. Methods 14 ex-vivo human carotid arteries were scanned using CMR and CT, prior to histological slide preparation. Two images were acquired using a double-echo 3D UTE pulse, one with a long TE and the second with an ultra-short TE, with the same TR. An UTE subtraction (?UTE) image containing only ultra-short T2 (and T2*) signals was obtained by post-processing subtraction of the 2 UTE images. The ?UTE image was compared to the conventional 3D T1-weighted sequence and CT scan of the carotid arteries. Results In atheromatous carotid arteries, there was a 71% agreement between the high signal intensity areas on ?UTE images and CT scan. The same areas were represented as low signal intensity on T1W and areas of void on histology, indicating focal calcification. However, in 15% of all the scans there were some incongruent regions of high intensity on ?UTE that did not correspond with a high intensity signal on CT, and histology confirmed the absence of calcification. Conclusions We have demonstrated that the UTE sequence has potential to identify calcified plaque. Further work is needed to fully understand the UTE findings.



Tension Pneumothorax After Placement of a Tunneled Pleural Drainage Catheter in a Patient with Recurrent Malignant Pleural Effusions  

SciTech Connect

A case of tension pneumothorax developed after placement of a tunneled pleural catheter for treatment of malignant pleural effusion in a patient with advanced lung cancer. The catheter placement was carried out by an experienced operator under direct ultrasound guidance, and the patient showed immediate symptomatic improvement with acute decompensation occurring several hours later. Possible mechanisms for this serious complication of tunneled pleural catheter placement are described, and potential strategies to avoid or prevent it in future are discussed.

Wachsman, A.M., E-mail:; Hoffer, E.K.; Forauer, A.R.; Silas, A.M.; Gemery, J.M. [Dartmouth-Hitchcock Medical Center, Division of Interventional Radiology, Department of Radiology (United States)



An unusual cause of recurrent throat pain - calcified stylohyoid ligament.  


Calcified stylohyoid ligament is also called an elongated styloid process and the symptom complex that it produces is called Eagle's syndrome. The symptoms of neck pain, sore throat, foreign body sensation in the throat, dysphagia and otalgia may be confused with other head and neck pain and are often worsened by yawning, opening the mouth wide or turning the head laterally. This is the result of involvement of cranial nerves, carotid plexus and cervical plexus. Carotid artery involvement causes wider symptomatology. Sometimes, it presents as a complication of tonsillectomy procedure. Elongated styloid process is conveniently identified on firm digital examination of tonsillar fossa. Diagnosis is made with appropriate radiological examination. Non-surgical treatment options include re-assurance, analgesia, anti-inflammatory medications and surgical option is shortening of the elongated styloid process by transoral or external approach. The condition is hereby described in a 59 years old male. PMID:22482387

Baig, Salman; Patil, Nash; Considine, Niall



Nuclear analytical methods for trace element studies in calcified tissues.  


Various nuclear analytical methods have been developed and applied to determine the elemental composition of calcified tissues (teeth and bones). Fluorine was determined by prompt gamma activation analysis through the 19F(p, alpha gamma) 16O reaction. Carbon was measured by activation analysis with He-3 ions, and the technique of Proton-Induced X-ray Emission (PIXE) was applied to simultaneously determine Ca, P, and trace elements in well-documented teeth. Dental hard tissues: enamel, dentine, cementum, and their junctions, as well as different parts of the same tissue, were examined separately. Furthermore, using a Proton Microprobe, we measured the surface distribution of F and other elements on and around carious lesions on the enamel. The depth profiles of F, and other elements, were also measured right up to the amelodentin junction. PMID:1704714

Chaudhri, M A


Calcifying epithelial odontogenic tumor of the maxilla (Pindborg tumor).  


Calcifying epithelial odontogenic tumor (CEOT), or the Pindborg tumor, is very rare neoplasm, which accounts up to 1% of all odontogenic tumors. These tumors involve mandible almost twice as common as the maxillary bone, mostly in the premolar and molar region and present at first with local swelling. There is no gender predilection and the tumor usually appears between 2nd and 6th decade of life. We report the case of a 36-year-old male patient with a Pindborg tumor in the maxillary region on the right side, also involving the adjacent maxillary sinus, with destroying of the local anatomical structures. Complete surgical excision of the tumor has been performed and four years after surgical treatment, there is no sign of recurrence. PMID:23397788

Müller, Danko; Manojlovi?, Spomenka; Luksi?, Ivica; Grgurevi?, Jaksa



Characterization of Porcine Aortic Valvular Interstitial Cell 'Calcified' Nodules  

PubMed Central

Valve interstitial cells populate aortic valve cusps and have been implicated in aortic valve calcification. Here we investigate a common in vitro model for aortic valve calcification by characterizing nodule formation in porcine aortic valve interstitial cells (PAVICs) cultured in osteogenic (OST) medium supplemented with transforming growth factor beta 1 (TGF-?1). Using a combination of materials science and biological techniques, we investigate the relevance of PAVICs nodules in modeling the mineralised material produced in calcified aortic valve disease. PAVICs were grown in OST medium supplemented with TGF-?1 (OST+TGF-?1) or basal (CTL) medium for up to 21 days. Murine calvarial osteoblasts (MOBs) were grown in OST medium for 28 days as a known mineralizing model for comparison. PAVICs grown in OST+TGF-?1 produced nodular structures staining positive for calcium content; however, micro-Raman spectroscopy allowed live, noninvasive imaging that showed an absence of mineralized material, which was readily identified in nodules formed by MOBs and has been identified in human valves. Gene expression analysis, immunostaining, and transmission electron microscopy imaging revealed that PAVICs grown in OST+TGF-?1 medium produced abundant extracellular matrix via the upregulation of the gene for Type I Collagen. PAVICs, nevertheless, did not appear to further transdifferentiate to osteoblasts. Our results demonstrate that ‘calcified’ nodules formed from PAVICs grown in OST+TGF-?1 medium do not mineralize after 21 days in culture, but rather they express a myofibroblast-like phenotype and produce a collagen-rich extracellular matrix. This study clarifies further the role of PAVICs as a model of calcification of the human aortic valve.

Cloyd, Kristy L.; El-Hamamsy, Ismail; Boonrungsiman, Suwimon; Hedegaard, Martin; Gentleman, Eileen; Sarathchandra, Padmini; Colazzo, Francesca; Gentleman, Molly M.; Yacoub, Magdi H.; Chester, Adrian H.; Stevens, Molly M.



Categorisation of pleural fluids in routine clinical practice: analysis of pleural fluid protein and lactate dehydrogenase alone compared with modified Light’s criteria  

Microsoft Academic Search

Modified Light’s criteria are widely used to categorise pleural fluids as either exudates or transudates. These criteria include fluid\\/serum ratios and therefore require a blood sample. It is not clear whether analysis of pleural fluid alone would alter pleural fluid categorisation in routine clinical practice. In this study, pleural fluids were categorised using cut-off values for pleural fluid protein (?30

M J Murphy; F Jenkinson



Lumbar spinal stenosis due to a large calcified mass in the ligamentum flavum.  


We describe a rare case of lumbar spinal stenosis due to a large calcified mass in the ligamentum flavum. This patient presented with a 12-month history of severe right leg pain and intermittent claudication. A computed tomography scan was performed, revealing a large calcified mass on the ligamentum flavum at the right-hand side of the lumbar spinal canal. We performed a laminotomy at the L4/5 level with resection of the calcified mass from the ligamentum flavum. The findings of various analyses suggested that the calcified mass consisted mostly of Ca3(PO4)2 and calcium phosphate intermixed with protein and water. The calcified mass in the ligamentum flavum was causing lumbar spinal stenosis. Surgical decompression by resection of the mass was effective in this patient. The calcified material was composed mainly of elements derived from calcium phosphate. Degenerative changes in the ligamentum flavum of the lumbar spine may have been involved in the production of this calcified mass. PMID:24066222

Seki, Shoji; Kawaguchi, Yoshiharu; Ishihara, Hirokazu; Oya, Takeshi; Kimura, Tomoatsu



Lumbar Spinal Stenosis Due to a Large Calcified Mass in the Ligamentum Flavum  

PubMed Central

We describe a rare case of lumbar spinal stenosis due to a large calcified mass in the ligamentum flavum. This patient presented with a 12-month history of severe right leg pain and intermittent claudication. A computed tomography scan was performed, revealing a large calcified mass on the ligamentum flavum at the right-hand side of the lumbar spinal canal. We performed a laminotomy at the L4/5 level with resection of the calcified mass from the ligamentum flavum. The findings of various analyses suggested that the calcified mass consisted mostly of Ca3(PO4)2 and calcium phosphate intermixed with protein and water. The calcified mass in the ligamentum flavum was causing lumbar spinal stenosis. Surgical decompression by resection of the mass was effective in this patient. The calcified material was composed mainly of elements derived from calcium phosphate. Degenerative changes in the ligamentum flavum of the lumbar spine may have been involved in the production of this calcified mass.

Kawaguchi, Yoshiharu; Ishihara, Hirokazu; Oya, Takeshi; Kimura, Tomoatsu



The composition and extent of coronary artery plaque detected by multislice computed tomographic angiography provides incremental prognostic value in patients with suspected coronary artery disease.  


Multislice computed tomographic coronary angiography (CTCA) provides accurate noninvasive assessment of coronary artery disease (CAD). However, data on the prognostic value of CTCA in patients with suspected CAD are only beginning to emerge. The aim of the study was to assess the prognostic value of CTCA in patients with suspected CAD. Patients (males = 259, females = 235; mean age 58.2 ± 9.8 years) with suspected CAD who underwent 16- or 64-slice CTCA were followed for 1,308 ± 318 days for cardiac death, nonfatal myocaridal infarction (MI) and late (>90 days after CTCA) revascularization. Patient outcomes were related to clinical and CTCA data. Cox proportional-hazards model was applied in stepwise forward fashion to identify outcome predictors. Coronary artery plaque was found in 340 patients. Cardiac events occurred in 40 patients including cardiac death (n = 9), nonfatal MI (n = 8) and late revascularization (n = 23). A multivariable analysis identified the following independent predictors for adverse cardiac events: obstructive plaque in a proximal coronary artery segment (hazard ratio (HR) 2.73; 95% confidence interval (CI): 1.35-5.54; P = 0.005), the number of segments with noncalcified plaque(s) (HR 1.53 per segment; 95%CI: 1.21-1.92; P < 0.001), the number of segments with mixed plaque(s) (HR 1.56 per segment; 95%CI: 1.27-1.92; P < 0.001) and the number of segments with calcified plaque(s) (HR 1.21 per segment; 95%CI: 1.07-1.37; P = 0.002). In patients with suspected CAD, both the extent and composition of atherosclerotic plaque as determined by CTCA are prognostic of subsequent cardiac events. PMID:21369735

Miszalski-Jamka, Tomasz; Klimeczek, Piotr; Bany?, Robert; Krupi?ski, Maciej; Nycz, Krzysztof; Bury, Krzysztof; Lada, Micha?; Pelberg, Robert; Kereiakes, Dean; Mazur, Wojciech



Shear stress and plaque development.  


Although traditional cardiovascular risk factors 'prime the soil' for atherogenesis systemically, atherosclerosis primarily occurs in a site-specific manner with a predilection towards the inner wall of curvatures and outer wall of bifurcations with sparing of flow-dividers. Wall shear stress is a frictional force exerted parallel to the vessel wall that leads to alteration of the endothelial phenotype, endothelial cell signaling, gene and protein expression leading to a proinflammatory phenotype, reduced nitric oxide availability and disruption of the extracellular matrix, which in turn leads to plaque development. Clinical and experimental data are emerging that suggest the pathobiology associated with abnormal wall shear stress results in atherosclerotic plaque development and progression. PMID:20397828

Dhawan, Saurabh S; Avati Nanjundappa, Ravi P; Branch, Jonathan R; Taylor, W Robert; Quyyumi, Arshed A; Jo, Hanjoong; McDaniel, Michael C; Suo, Jin; Giddens, Don; Samady, Habib



Sudden Unilateral Vision Loss Arising from Calcified Amorphous Tumor of the Left Ventricle  

PubMed Central

Calcified amorphous tumor of the heart is a very rare non-neoplastic intracavitary mass. The clinical presentation is similar to that of other cardiac masses. The precise cause and best approach to treatment remain unclear. We describe a case of cardiac calcified amorphous tumor presenting with refractory unilateral vision loss that was successfully treated by surgical excision. To our knowledge, this is only the 2nd reported case of retinal arterial embolism due to cardiac calcified amorphous tumor in the English-language literature.

Nazli, Yunus; Colak, Necmettin; Atar, Inci Asli; Alpay, Mehmet Fatih; Haltas, Hacer; Eryonucu, Beyhan; Cakir, Omer



Visualization of the Vulnerable Plaque  

Microsoft Academic Search

Thrombosis is the main cause of acute coronary syndrome and myocardial infarction (Naghavi et al., 2003). The mechanism underlying thrombus formation is presently under debate, but several pathological conditions have\\u000a been identified from human postmortem studies that correspond with the presence of thrombus. Of these conditions plaque rupture\\u000a is the most common, but erosion of the endothelial layer and existence

Rob Krams; Johannes Schaar; Frank Helderman; Caroline Cheng; Babak Mousavi Gourabi; L. C. A. Damme; D. Segers; Evelyn Regar; Cornelis J. Slager; Pim J. Feyter; Anton F. W. Steen; Patrick W. Serruys


[Talc pleurodesis in malignant pleural effusions].  


Pleural effusions associated with malignancy--either malignant or paramalignant diseases--were found in ca. 20% of these patients. Large pleural effusions cause mainly dyspnoea but also cough and chest pain. The presence and degree of dyspnoea depend on the size of the effusion and the patient's underlying pulmonary function. In acute cases and large effusions immediate chest drainage is indicated in symptomatic patients, followed by the treatment of the underlying disease, e. g. chemotherapy. The most effective therapy for controlling reiterated malignant pleural effusions is the thoracoscopic talc poudrage (2.5-10 g) which has been shown to have a success rate of > 90%. Talc induces a broad inflammatory reaction involving mesothelial cells of the pleura, coagulation parameters, fibroblast proliferation eventually leading to symphysis of the pleura. This procedure is reserved for patients who are in good general conditions, who are expected to have a reasonably long survival, and who failed chemical pleurodesis. A good predictor for longer survival time is a Karnofsky Performance Scale > or = 40 indicating a survival time > 30 days, which therefore should be considered prior to the procedure. The adult respiratory distress syndrome (ARDS) is the most important complication initially observed in the US in up to 9% of all cases. ARDS incidence was strongly related to high number (50%) of small talc particles < 15 microm. In summary, talc poudrage or slurry (talc particle size > 10 microm) in malignant pleura effusions is a safe and effective method to induce pleura symphysis. Complaints and complications such as chest pain, transient fever, and empyema are rare or very are which are almost exclusively related to the therapeutic procedure itself. PMID:16463249

Kolschmann, S; Ballin, A; Juergens, U-R; Rohde, G; Gessner, C; Hammerschmidt, S; Wirtz, H; Gillissen, A



Pleural Transport Physiology: Insights from Biological Marker Measurements in Transudates  

PubMed Central

Aims: The aim of this study was to evaluate the physicochemical properties of the pleural mesothelial barrier and of the biological markers that facilitate or eliminate the passage of molecules through the pleura. Methods and Material: Pleural fluid samples from sixty-five patients with heart failure were analyzed. The biological markers studied were lactate dehydrogenase (LDH), adenosine deaminase (ADA), interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-? (TNF-?), carcinoembryonic antigen (CEA), copper/zinc superoxide dismutase (CuZnSOD), matrix metalloproteinase-2 (MMP-2), -3 (MMP-3), -7(MMP-7), -8 (MMP-8) and -9 (MMP-9). Based on the pleural fluid/serum ratio, these molecules were divided into three groups: a) the LDH-like group with a pleural fluid/serum ratio between 0,4 and 0,8 (LDH, CEA, CuZnSOD, ADA, CRP, MMP-8), b) molecules with a pleural fluid/serum ratio less than 0,4 (MMP-7 and MMP-9) and c) molecules with a pleural fluid/serum ratio equal or above 1 (TNF-?, IL-6, MMP-2 and MMP-3). Results: No correlation between the molecular radius and the pleural fluid to serum ratio of the above biological markers was found. Conclusions: The molecular size is not a major determinant for the passage of molecules through the mesothelial barrier. Several other factors may influence the transport of the above molecules to pleural cavity, such as their charge and shape.

Apostolidou, Eleni; Tsilioni, Irini; Hatzoglou, Chrissi; Molyvdas, Paschalis-Adam; Gourgoulianis I, Konstantinos



Penetration of Clarithromycin in Experimental Pleural Empyema Model Fluid  

Microsoft Academic Search

Background: The degree of penetration of clarithromycin into the pleural fluid has not been studied. Objective: To determine the degree to which clarithromycin penetrates into empyemic pleural fluid using a new rabbit model of empyema. Methods: An empyema was created via the intrapleural injection of 1 ml turpentine followed 24 h later by instillation of 5 ml (1010) Escherichia coli

I. E. Liapakis; R. W. Light; M. S. Pitiakoudis; A. J. Karayiannakis; E. J. Giamarellos-Bourboulis; G. Ismailos; S. Anagnostoulis; C. E. Simopoulos; D. E. Bouros



Current concepts in chemotherapy for malignant pleural mesothelioma  

Microsoft Academic Search

Objectives: The aim of this study was to provide an overview of the most active single agents and combination regimens in malignant pleural mesothelioma (MPM). Data Source: Literature on English-language trials in humans was searched on Medline until October 2007. Indexing terms were malignant pleural mesothelioma and chemotherapy. Study Selections: Trials with 15 patients and with data on activity were

Jens Benn Sřrensen



Detection of Pleural Effusions on Supine Chest Radiographs  

Microsoft Academic Search

A prospective analysis of anteroposterior supine radiographs in 34 patients was undertaken to determine the detectability of pleural effusions on supine radlographs. The presence of pleural effusions and quantity of fluid (small, moderate, or large) were evaluated by using the following radiographic signs: increased homogeneous densfty superimposed over the lung, loss of the hemidiaphragm silhouette, blunted costophrenic angle, apical capping,

James A. Ruskin; Jud W. Gurney; M. Kristin Thorsen; Lawrence R. Goodman


Cytoreductive surgery and post-operative heated pleural chemotherapy for the management of pleural surface malignancy.  


Abstract Purpose: We retrospectively analysed the long-term outcomes of cytoreductive surgery and post-operative heated pleural chemotherapy (HPC) for thoracic malignancies with pleural spread. Materials and methods: Between 1987 and 2010, 160 patients were enrolled. There were 101 patients with non-small cell lung cancer (NSCLC), 25 with malignant pleural mesothelioma (MPM), 12 with thymoma, and 22 with tumours metastatic to the lung and pleura. Immediately after intra-thoracic administration of cisplatin or carboplatin, hyperthermia was performed by using an 8.00?MHz radiofrequency capacitive heating device for 1 to 4 courses in each patient. Results: There was no systemic toxicity or treatment-related mortality. Five-year overall survival rates were 37.4% in NSCLC, 15.9% in MPM, 91.7% in thymoma, and 25.8% in metastatic lung tumour. Five-year local relapse-free survival (RFS) rates were 55.2% in NSCLC, 24.4% in MPM, 64.8% in thymoma, and 27.2% in tumours metastatic to the lung and pleura. When 101 NSCLCs were categorised into pleural lavage cytology positive (grade 1: n?=?37), limited extent of carcinomatous pleuritis (grade 2: n?=?21), and extensive carcinomatous pleuritis (grade 3: n?=?43), 5-year overall survival rates were 62.5%, 49.2%, and 13.6%, respectively. The local RFS was significantly better in group 1/2 than in group 3. Conclusions: Although our study has some of the usual weaknesses of a single institution retrospective study, cytoreductive surgery and HPC are feasible and safe. It is suggested that HPC may have a potential role for local control as adjuvant treatment for cytoreductive surgery in patients with minor pleural spread. PMID:24028146

Kodama, Ken; Higashiyama, Masahiko; Okami, Jiro; Tokunaga, Toshiteru; Fujiwara, Ayako; Imamura, Fumio; Nakayama, Tomio



Malignant pleural effusion and algorithm management  

PubMed Central

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.

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



Pleurodesis outcome in malignant pleural mesothelioma.  


Few data exist on the pleurodesis outcome in patients with malignant pleural mesothelioma (MPM). A retrospective review of the Western Australian Mesothelioma Registry over 5 years revealed 390 evaluable patients. Only a subset of patients (42.3%) underwent pleurodesis, surgically (n=78) or by bedside instillation of sclerosants (n=87). Surgical pleurodesis showed no advantages over bedside pleurodesis in efficacy (32% vs 31% failures requiring further drainage, p=0.98), patient survival (p=0.52) or total time spent in hospital from procedure till death (p=0.36). No clinical, biochemical or radiographic parameters tested adequately predict pleurodesis outcome. PMID:23299964

Fysh, Edward Thomas Hamilton; Tan, Sze Khen; Read, Catherine Ann; Lee, Felicity; McKenzie, Kate; Olsen, Nola; Weerasena, Indunil; Threlfall, Timothy; de Klerk, Nicholas; Musk, A William; Lee, Y C Gary



True ablation of atheromatous plaques with laser energy. A phase I safety study.  

PubMed Central

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.

Reilly, M K; Perry, M O; Nanney, L B



Differences in plaque morphology and correlation of stenosis at the carotid artery bifurcation and the carotid siphon.  


OBJECTIVE. The purpose of this study was to compare the type of plaque and the degree of stenosis in the carotid artery bifurcation and the carotid siphon to explore potential correlations between these parameters. MATERIALS AND METHODS. A total of 119 patients (87 men, 32 women; mean age, 69 years) were retrospectively studied using MDCT angiography. Component types of the carotid artery bifurcation and the carotid siphon plaque were defined according to attenuation values, and the volumes of each plaque component were calculated. The degree of stenosis was calculated according to the North American Symptomatic Endarterectomy Trial method. Data were compared using the Wilcoxon signed-rank test, Spearman correlation analysis, and receiver operating characteristic (ROC) analysis. RESULTS. The results of the Wilcoxon test showed a statistically significant difference (p = 0.0001) between the degree of stenosis at the carotid artery bifurcation and that at the carotid siphon. We observed a statistically significant difference (p = 0.0001) between the total volumes of the carotid artery bifurcation (mean value, 748 mm(3)) and the carotid siphon (mean value, 54 mm(3)) plaque. Moreover, the respective mean percentages of calcified, mixed, and lipid components of plaque were 17%, 56%, and 27% in the carotid artery bifurcation and 73%, 19%, and 8% in the carotid siphon, showing a statistically significant difference (p = 0.001). ROC analysis did not show association between carotid siphon plaque volume and previous cerebrovascular events (Az = 0.562; p = 0.149), whereas the total volume of the carotid artery bifurcation plaque-and, in particular, the volume of the lipid components-showed a statistically significant association (Az = 0.691, and Az = 0.758; p < 0.001). CONCLUSION. No significant association was found between presence of mixed and fatty components of plaque in the carotid artery bifurcation and presence of similar components in the carotid siphon. The carotid artery bifurcation total plaque volume (and, in particular, carotid artery bifurcation lipid volume) was associated with previous cerebrovascular events, whereas no association with the volume of carotid siphon plaque (and its subcomponents) was found. PMID:24147484

Saba, Luca; Raz, Eytan; Anzidei, Michele; Francone, Marco; Piga, Mario



[Eosinophilic pleural effusion possibly induced by fibrin sealant].  


A 74-year-old man underwent right upper lobectomy for the lung cancer and bullectomy of right lower lobe. Fibrin sealant was used for sealing the excision line. The increase of the pleural effusion with increasing C-reactive protein( CRP) and eosinophilia was noted at the 17th day after the operation. The pleural effusion was transparent and yellowish colored suggesting transudatory liquid. The eosinophil in the pleural effusion was as high as 14%. The drainage of the pleural effusion was performed for 2 days resulting in disappearing the abnormal accumulation without any additional treatment. The cause of pleural effusion was supposed to be fibrin sealant by a positive result of the drug lymphocyte stimulation test. PMID:22314171

Kambayashi, Takatoyo; Suzuki, Takashi



The diagnostic value of pleural fluid pH.  


One hundred eighty-three patients had simultaneous blood and pleural fluid pH determinations. Thirty-six effusions were transudates, and 147 were exudates. In 46 effusions, the pleural fluid pH was less than 7.30; all 46 were exudates. A pleural fluid pH less than 7.30 was associated with the following six diagnoses: (1) empyema; (2) malignancy; (3) collagen vascular disease; (4) tuberculosis; (5) esophageal rupture; and (6) hemothorax. The results of pleural fluid pH determination are immediately available, narrow the differential diagnosis of the exudate, and may expedite patient management. The pH of pleural fluid should be measured whenever a diagnostic thoracocentesis is performed. PMID:7471845

Good, J T; Taryle, D A; Maulitz, R M; Kaplan, R L; Sahn, S A




PubMed Central

A pleural effusion is a condition where there is a buildup of abnormal fluid within the pleural space. This paper presents an automated method to evaluate the severity of pleural effusion using regular chest CT images. First the lungs are segmented using region growing, mathematical morphology and anatomical knowledge. Then the visceral and parietal layers of the pleura are extracted based on anatomical landmarks, curve fitting and active contour models. Finally, the pleural space is segmented and the pleural effusion is quantified. Our method was tested on 15 chest CT studies. The automated segmentation is validated against manual tracing and radiologist’s qualitative grading. The Pearson correlation between computer evaluation and radiologist’s grading is 0.956 (P=10?7). The Dice coefficient between the automated and manual segmentation is 0.74±0.07, which is comparable to the variation between two different manual tracings.

Yao, Jianhua; Han, Wei; Summers, Ronald M.



Management of Pleural Effusion, Empyema, and Lung Abscess  

PubMed Central

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.

Yu, Hyeon



Calcifying epithelial odontogenic tumour presenting at a surgical site: case report.  


We describe the management of a calcifying epithelial odontogenic tumour with an atypical clinical presentation at the site of a previously surgically exposed impacted maxillary canine in a 51-year-old woman. PMID:23291091

Rahman, Naomi; Cole, Emma; Webb, Roger



[Diagnostic image. A woman with a calcified structure in the bladder].  


A 79-year-old woman suffered from microscopic haematuria following a symptomatic cystitis. Abdominal ultrasound investigation suggested a bladder stone. Cystoscopy revealed a calcified bladder tumour. After resection pathologic examination showed a superficial invasive urothelial carcinoma. PMID:19900329

Wondergem, Niels; van Haarst, Ernst P



Rare cause of pleural nodularity: Splenosis.  

PubMed Central

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

Gezer, Suat; Gulhan, S. S. Erkmen; Altinok, Tamer; Agackiran, Yetkin; Tastepe, A. Irfan



Mechanisms controlling the volume of pleural fluid and extravascular lung water  

Microsoft Academic Search

Pleural and interstitial lung fluid volumes are strictly controlled and maintained at the minimum thanks to the ability of lymphatics to match the increase in filtration rate. In the pleural cavity, fluid accumulation is easily accommodated by retraction of lung and chest wall (high compliance of the pleural space); the increase of lymph flow per unit increase in pleural fluid

G. Miserocchi; Universitadi Milano-Bicocca



Gene therapy for the vulnerable plaque  

Microsoft Academic Search

Rupture of coronary atherosclerotic plaque and subsequent formation of an occlusive intracoronary thrombus (Figure 410-1)\\u000a are the major events precipitating acute coronary syndromes [1–6]. The vulnerable plaque is smaller in size [7], richer in lipids [1],[2], and more infiltrated with macrophages [2,3,8–10] than the stable, fibromuscular lesion. Therefore, lowering the lipid and\\/or macrophage pools stored in the plaque may “stabilize”

Douglas W. Losordo; Jeffrey M. Isner


Prevention of Pleural Adhesions by Bioactive Polypeptides - A Pilot Study  

PubMed Central

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.

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



The pleural curtain of the camel (Camelus dromedarius).  


The visceral pleura of the camel (Camelus dromedarius) possesses a fibrous curtain of pleural threads or extensions along its basal margins, which extends into the pleural cavity of the costophrenic recesses. These threads are lined by mesothelium and have a core or stroma, which is largely collagenous. Small threads are avascular and nearly acellular. In larger proximal threads, blood vessels in the stroma are often arranged in a branching network, with irregular endothelia surrounded by several incomplete basal laminae. Lymphocytes and other inflammatory cell types aggregate in the stroma near blood vessels. The threads are lined by typical mesothelium except in patches close to the main pleural surface. These patches consist of layers of loosely applied cells with numerous cellular processes and features suggestive of phagocytosis. The position of the pleural curtain in the costophrenic recess and the presence of possibly phagocytotic cells suggest that the pleural curtain stirs, samples, and cleans the pleural fluid. The pleural curtain appears to be a feature of camelids and has also been seen in giraffes. PMID:20652936

Buzzell, Gerald R; Kinne, Joerg; Tariq, Saeed; Wernery, Ulrich



Biomechanical structural stresses of atherosclerotic plaques.  


Atherosclerotic plaques may rupture without warning, causing fatal clinical events such as myocardial infarction and stroke. Degree of stenosis, which is the current criterion for assessment of atherosclerotic disease severity, has been observed to have poor correlation with plaque vulnerability. Under physiological conditions, plaque undertakes mechanical loadings due to blood pressure and flow. From the material view point, rupture possibly occurs when the extra loading exceeds the material strength of the plaque. Therefore, morphological and mechanical features should be considered in an integrated way for a more accurate assessment of plaque vulnerability and for identification of the at-risk patient. Biomechanical stress analysis is a technique that allows such comprehensive assessment. This article focuses on the mechanical stresses in the plaque structure, which are believed to be of greater magnitude than the associated wall shear stress and are thought to be more closely associated with plaque rupture. We discuss the basic mechanics that govern plaque behavior, the material properties of atherosclerotic tissues and the studies investigating the association between high biomechanical stresses and plaque rupture. Parameter studies investigating the effect of morphologic factors on the critical biomechanical stresses and limitations of current simulation models are also reviewed. PMID:20936933

Sadat, Umar; Teng, Zhongzhao; Gillard, Jonathan H



Neurone-specific enolase levels in pleural effusions in patients with rheumatoid arthritis.  

PubMed Central

BACKGROUND: High pleural fluid levels of neurone-specific enolase (NSE) have been reported, not only in patients with small cell lung cancer but also in those with chronic inflammatory diseases. METHODS: NSE concentrations were determined in pleural fluid and serum from 342 patients with pleural effusions including 17 with rheumatoid arthritis. RESULTS: The median NSE concentration in pleural fluid was higher in rheumatoid effusions than in any other condition studied. The median pleural fluid:serum NSE ratio was highest in patients with rheumatoid arthritis (11.6) and about unity in all other diseases including small cell lung cancer (0.9). In patients with rheumatoid arthritis pleural fluid concentrations of NSE correlated inversely with pleural fluid glucose concentrations and the pH of the pleural fluid. CONCLUSIONS: A high pleural fluid:serum NSE ratio was found consistently in pleural effusions from patients with rheumatoid disease.

Nyberg, P.; Soderblom, T.; Pettersson, T.; Riska, H.; Klockars, M.; Linko, L.



[Bilateral pleural effusion and rheumatoid arthritis. Diagnostic value of pleural fluid cytology].  


We present a 69 years old male patient diagnosed of rheumatoid arthritis (RA) with signs of pleuropulmonar disease. The diagnose of RA was done of 49 years and since then treated with non steroid antiinflammatory drugs and during the acute phases of RA with steroid drugs. The pleural effusions showed an exudate with pseudochilothorax criteria with acid pH acid low glucose concentrations. The cytological study of the effusion demonstrated the presence of characteristic mononuclear cells. PMID:8634794

Jareńo Esteban, J; Chillón Martín, M J; Villegas Fernández, F; Callol Sánchez, L; Girón Moreno, R M; Gómez de Terreros, F J



Local Maximal Stress Hypothesis and Computational Plaque Vulnerability Index for Atherosclerotic Plaque Assessment  

PubMed Central

It is believed that atherosclerotic plaque rupture may be related to maximal stress conditions in the plaque. More careful examination of stress distributions in plaques reveals that it may be the local stress/strain behaviors at critical sites such as very thin plaque cap and locations with plaque cap weakness that are more closely related to plaque rupture risk. A “local maximal stress hypothesis” and a stress-based computational plaque vulnerability index (CPVI) are proposed to assess plaque vulnerability. A critical site selection (CSS) method is proposed to identify critical sites in the plaque and critical stress conditions which are be used to determine CPVI values. Our initial results based on 34 2D MRI slices from 14 human coronary plaque samples indicate that CPVI plaque assessment has an 85% agreement rate (91% if the square root of stress values is used) with assessment given by histopathological analysis. Large-scale and long-term patient studies are needed to further validate our findings for more accurate quantitative plaque vulnerability assessment.

Tang, Dalin; Yang, Chun; Zheng, Jie; Woodard, Pamela K.; Saffitz, Jeffrey E.; Petruccelli, Joseph D.; Sicard, Gregorio A.; Yuan, Chun



Cholesterol in human atherosclerotic plaque is a marker for underlying disease state and plaque vulnerability  

PubMed Central

Background Cholesterol deposition in arterial wall drives atherosclerosis. The key goal of this study was to examine the relationship between plaque cholesterol content and patient characteristics that typically associate with disease state and lesion vulnerability. Quantitative assays for free cholesterol, cholesteryl ester, triglyceride, and protein markers in atherosclerotic plaque were established and applied to plaque samples from multiple patients and arterial beds (Carotid and peripheral arteries; 98 lesions in total). Results We observed a lower cholesterol level in restenotic than primary peripheral plaque. We observed a trend toward a higher level in symptomatic than asymptomatic carotid plaque. Peripheral plaque from a group of well-managed diabetic patients displayed a weak trend of more free cholesterol deposition than plaque from non-diabetic patients. Plaque triglyceride content exhibited less difference in the same comparisons. We also measured cholesterol in multiple segments within one carotid plaque sample, and found that cholesterol content positively correlated with markers of plaque vulnerability, and negatively correlated with stability markers. Conclusions Our results offer important biological validation of cholesterol as a key lipid marker for plaque severity. Results also suggest cholesterol is a more sensitive plaque marker than routine histological staining for neutral lipids.



Permanent indwelling catheters in the management of pleural effusions.  


The treatment of chronic recurrent pleural effusions continues to evolve with the recent emergence of tunneled indwelling pleural catheters (IPCs). Talc pleurodesis has been the standard of care for treatment of recurrent pleural effusions, but IPCs have gained more favor in recent years. IPCs offer several advantages, including a less invasive procedure, short postprocedure hospital stay, and greater patient control in the management of symptoms. Further randomized controlled studies are needed to more clearly differentiate which patients are better served by an IPC rather than traditional pleurodesis as their initial intervention. PMID:23206718

Gillen, Jacob; Lau, Christine



Differentiation Between Malignant and Benign Pleural Effusions: Methylation Specific Polymerase Chain Reaction Analysis  

Microsoft Academic Search

Normally, very small amounts of pleural fluid are present in the pleural spaces, and this fluid is not detectable by routine\\u000a methods. When certain disorders occur, excessive pleural fluid may accumulate and cause pulmonary signs and symptoms. Pleural\\u000a effusions occur when the rate of fluid formation exceeds that of fluid absorption. Once a symptomatic, unexplained pleural\\u000a effusion arises, a diagnosis

Susana Benlloch; Josč Marcelo Galbis-Caravajal; Bartomeu Massutí


Definition of postresectional residual pleural space  

PubMed Central

Background Complications of the residual postoperative pleural space (RPPS) after partial pulmonary resections increase hospital stay, cost and morbidity. The objectives of this study were to define and identify the long-term outcome of RPPS. Methods A total of 140 partial pulmonary resections were performed in a 3-year period. Fifty-eight (41.4%) patients who had RPPS on the first postoperative day were followed up. We examined the chest x-rays of these patients on postoperative day 1 and 7 and week 4 and 12, and we documented any complications and reoperations. Results RPPS persisted in 6 patients (10.4%) and was reabsorbed in 44 patients (75.8%) in the 12th week. Residual spaces were complicated in 8 patients (13.7%), of whom 4 (6.8%) had reoperation and 4 (6.8%) were redrained. Reoperated patients had a mean of 13 (standard deviation [SD] 2.4, range 11–16) days of postoperative hospitalization, whereas redrained patients had a mean of 58.5 (SD 21.7, range 36–88) days of additional hospitalization. Conclusions We determined air leakage and space infection to be the major complications of the RPPS. Infectious complications were noticed in the postoperative third and fourth weeks (14–30 d), and reoperated patients had a shorter duration of postoperative hospitalization. Early operation is recommended in complicated pleural space patients. The space that is not complicated until the end of the first month can be defined as benign. This study demonstrated that follow-up of a benign space after the first postoperative month is not necessary.

Solak, Okan; Sayar, Adnan; Metin, Muzaffer; Turna, Akif; Erdogu, Volkan; Pekcolaklar, Atilla; Gurses, Atilla



Life on the margin: implications of ocean acidification on Mg-calcite, high latitude and cold-water marine calcifiers  

Microsoft Academic Search

Future anthropogenic emissions of CO2 and the resulting ocean acidification may have severe consequences for marine calcifying organisms and ecosystems. Marine calcifiers depositing calcitic hard parts that contain significant concentrations of magnesium, i.e. Mg-calcite, and calcify- ing organisms living in high latitude and\\/or cold-water environments are at immediate risk to ocean acidification and decreasing seawater carbonate saturation because they are

Andreas J. Andersson; Fred T. Mackenzie; Nicholas R. Bates



Imaging of High-Risk Plaque  

Microsoft Academic Search

‘High-risk’ or ‘vulnerable’ plaques in the coronary arteries have characteristics that make them more prone to disruption and subsequent thrombosis – the mechanisms of most acute coronary syndromes (ACS). There are a number of imaging modalities that are capable of visualizing these features. This article discusses invasive modalities for identifying ‘high-risk’ plaque such as intravascular ultrasound, coronary angioscopy, optical coherence

Dmitry Nemirovsky



Fluoride bioavailability in saliva and plaque  

PubMed Central

Background Different fluoride formulations may have different effects on caries prevention. It was the aim of this clinical study to assess the fluoride content, provided by NaF compared to amine fluoride, in saliva and plaque. Methods Eight trained volunteers brushed their teeth in the morning for 3 minutes with either NaF or amine fluoride, and saliva and 3-day-plaque-regrowth was collected at 5 time intervals during 6 hours after tooth brushing. The amount of collected saliva and plaque was measured, and the fluoride content was analysed using a fluoride sensitive electrode. All subjects repeated all study cycles 5 times, and 3 cycles per subject underwent statistical analysis using the Wilcoxon-Mann-Whitney test. Results Immediately after brushing the fluoride concentration in saliva increased rapidly and dropped to the baseline level after 360 minutes. No difference was found between NaF and amine fluoride. All plaque fluoride levels were elevated after 30 minutes until 120 minutes after tooth brushing, and decreasing after 360 minutes to baseline. According to the highly individual profile of fluoride in saliva and plaque, both levels of bioavailability correlated for the first 30 minutes, and the fluoride content of saliva and plaque was back to baseline after 6 hours. Conclusions Fluoride levels in saliva and plaque are interindividually highly variable. However, no significant difference in bioavailability between NaF and amine fluoride, in saliva, or in plaque was found.



New insights into atherosclerotic plaque rupture  

Microsoft Academic Search

Coronary artery atherosclerosis is the major cause of mortality and morbidity in the indus- trialised world. Progressive narrowing of cor- onary arteries causes angina. However, it is rupture of the plaque that causes the cata- strophic consequences of atherosclerosis, such as myocardial infarction. Recent work has identified that the stability of the plaque rather than its absolute size determines the

D M Braganza; M R Bennett



Ocean acidification and calcifying reef organisms: A mesocosm investigation  

USGS Publications Warehouse

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.

Jokiel, P. L.; Rodgers, K. S.; Kuffner, I. B.; Andersson, A. J.; Cox, E. F.; Mackenzie, F. T.



Oesophago-pleural fistula complicating a case of tuberculous pyopneumothorax.  


The case of a 3-year-old girl who developed an oesophago-pleural fistula following tuberculous pyopneumothorax is described. She was successful managed followed by surgical closure of the fistula. PMID:6730011

Adeyemo, A O; Omole, C O



Pleural infection: a case where clinical improvement was misleading.  


A 28-year-old Gurkha soldier presented with signs of severe chest sepsis and respiratory distress. High-flow oxygen, broad-spectrum intravenous antibiotics and intravenous fluids were started immediately. Bedside thoracic ultrasound demonstrated a moderate right pleural effusion suggestive of an empyema. A pleural aspirate was borderline for pleural infection, therefore, a chest drain was inserted and the patient was transferred to high dependency. Within 48 h the patient clinically improved. Three weeks later, a persistently raised C reactive protein and indeterminate right lower lobe radiographic changes was observed. Video-assisted thorascopic surgery was subsequently performed. Although technically difficult, a large amount of pus was drained from the pleural cavity. The patient was discharged, returning to normal army duties 8 weeks later. Follow-up chest radiographs showed complete resolution of the empyema and no evidence of scarring. The CRP normalised to <1. PMID:23605824

Gould, Justin



Pulmonary functional impairment associated with pleural asbestos disease. Circumscribed and diffuse thickening.  


To define the pulmonary functional impairment associated with pleural asbestos signs (PAS), we compared 738 men with only circumscribed (plaques) or diffuse pleural thickening on chest roentgenograms but no irregular opacities by ILO pneumoconiosis criteria (1980) with 738 age-matched asbestos-exposed men without any roentgenographic signs and with 228 men unexposed to asbestos. All men were white. Spirometry and total thoracic gas volumes (TGV) were measured and expressed as percentage of predicted of white Michigan men who have been modeled for spirometric values thereby adjusting for height, age, and in current and ex-smokers for duration of smoking. Asbestos-exposed men who never smoked had reduced FEF75-85 (p less than 0.01) and increased TGV (p less than .0001) as compared with unexposed men. The 155 men with PAS who had never smoked had reduced flows (p less than .0001), FVC (p less than 0.0056), and TGV (p less than .0001) when compared with 155 age-matched asbestos-exposed men. The 325 asbestos-exposed current smokers with normal chest roentgenograms compared with unexposed smokers had reduced expiratory airflows (p less than 0.0001), reduced FEV1 (p less than 0.004), and increased TGV (p less than 0.0001). The 325 current smokers with PAS had additional air trapping that further reduced vital capacity. Thus, PAS were associated with significant pulmonary dysfunction in men who never smoked, and current and ex-smokers had additional dysfunction even after adjustment for duration of smoking. PMID:2209158

Kilburn, K H; Warshaw, R



Advanced Techniques for MRI of Atherosclerotic Plaque  

PubMed Central

This review examines the state of the art in vessel wall imaging by MRI with an emphasis on the biomechanical assessment of atherosclerotic plaque. Three areas of advanced techniques are discussed. First, alternative contrast mechanisms, including susceptibility, magnetization transfer, diffusion and perfusion, are presented in regards to how they facilitate accurate determination of plaque constituents underlying biomechanics. Second, imaging technologies, including hardware and sequences, are reviewed in regards to how they provide the resolution and SNR necessary for determining plaque structure. Finally, techniques for combining MRI data into an overall assessment of plaque biomechanical properties, including wall shear stress and internal plaque strain, are presented. The paper closes with a discussion of the extent to which these techniques have been applied to different arteries commonly targeted by vessel wall MRI.

Kerwin, William S.; Canton, Gador



Subarachnoid-pleural fistula: unusual complication of thoracotomy.  


A case of subarachnoid-pleural fistula caused by a traction injury of the intercostal neurovascular bundle during thoracotomy is presented. Headaches, air within the ventricles of the brain, and clear drainage from the chest catheter should alert the surgeon to the presence of a subarachnoid-pleural fistula. If spontaneous closure of the fistula does not occur after a brief trial of chest catheter drainage, early operative intervention is advised. PMID:6246314

Frantz, P T; Battaglini, J W



Massive pleural effusion due to IgG multiple myeloma  

PubMed Central

Pleural effusion directly attributable to multiple myeloma is exceedingly uncommon and is said to occur in only 1–2% of cases. Of these around 80% occur in IgA disease. We report a case of myelomatous pleural effusion (proven on cytological and immunohistochemical analysis) in a patient with the IgG-? subtype. We describe the diagnosis, pathogenesis and management of this condition and show the radiological and cytological evidence of the case.

Lang, Kathryn J.; Lidder, Surjit; Aitchison, Robin



Unilateral Massive Pleural Effusion: A Presentation of Unsuspected Multiple Myeloma  

Microsoft Academic Search

Pleural effusion in case of multiple myeloma is usually multifactorial but effusion due to myelomatous deposition of pleura\\u000a is extremely uncommon. We are reporting a unique case of unsuspected multiple myeloma presenting as left sided massive pleural\\u000a effusion due to myelomatous deposit in pleura and a rare M-band in the alpha-2 region in serum protein electrophoresis. A\\u000a 61 year lady presented

Alok G. Ghoshal; Supriya Sarkar; Anup Majumder; Sudipta Chakrabarti



Reabsorption kinetics of albumin from pleural space of dogs  

SciTech Connect

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) 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.

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



Calcified microbes in Neoproterozoic carbonates: implications for our understanding of the Proterozoic/Cambrian transition.  


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. PMID:11539428

Knoll, A H; Fairchild, I J; Swett, K



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

NASA Astrophysics Data System (ADS)

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.

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



A Case of Old Calcifying Epithelioma Processed Symptomless over 40 Years  

PubMed Central

Calcifying epithelioma, a benign tumor derived from the hair apparatus and consisted of hair matrix cells, is relatively prevalent in females. We report a case of right preauricular calcifying epithelioma that was incidentally detected at the examination of multiple facial fractures and became an old lesion without symptoms for 40 years. The patient who was a 42-year-old male visited our department for the first time in October 2011 with a chief complaint of multiple facial fractures. Radiographic imaging demonstrated fracture lines at the anterior and posterior walls of the left maxillary sinus and zygomatic arch and revealed a mass at a right preauricular area. The extraction was performed under general anaesthesia. No recurrence has been observed 15 months after surgery. We also reviewed the literature of calcifying epithelioma.

Takeoka, Takashi; Okumura, Kenya; Tagawa, Toshiro



Pharmacokinetics of Linezolid and Ertapenem in experimental parapneumonic pleural effusion  

PubMed Central

Objective To determine the extent of linezolid and ertapenem penetration into the empyemic fluid using a rabbit model of empyema. Methods An empyema was created via the intrapleural injection of Escherichia coli bacteria (ATCC 35218) into the pleural space of New Zealand white rabbits. After an empyema was verified by thoracocentesis, 24 hours post inoculation, linezolid (10 mg/kg) and ertapenem (60 mg/kg) were administered intravenously into 10 and 8 infected empyemic rabbits, respectively. Antibiotic levels were determined in samples of pleural fluid and blood serum, collected serially at 1, 2, 4, 6 and 8 hours, after administration each of the two antibiotics. Results Linezolid as well as ertapenem penetrate well into the empyemic pleural fluid, exhibiting a slower onset and decline compared to the corresponding blood serum levels. Equilibration between blood serum and pleural fluid compartments seems to occur at 1.5 hours for both linezolid and ertapenem, with peak pleural fluid levels (Cmaxpf of 2.02 ± 0.73 «mu»g/ml and Cmaxpf of 3.74 ± 1.39 «mu»g/ml, correspondingly) occurring 2 hours post antibiotics administration and decreasing very slowly thereafter. The serum concentrations for both antibiotics were significantly lower from the corresponding pleural fluid ones during the 8 hours collecting data, with the exception of samples collected at the 1st hour (Cmaxserum of 2.1 ± 1.2 «mu»g/ml for linezolid and Cmaxserum of 6.26 ± 2.98 «mu»g/ml for ertapenem). Conclusion Pleural fluid levels of both antibiotics are inhibitory for common specified pathogens causing empyema.



A Case of a Subepidermal Calcified Nodule on the Sole without Trauma  

PubMed Central

Subepidermal calcified nodule is an uncommon form of calcinosis cutis, which most commonly occurs in children. It usually presents as an asymptomatic, solitary verrucous nodule on the head and neck region, but occasionally as multiple lesions. Serum calcium and phosphorus levels are usually normal. Histopathology shows well-formed homogeneous eosinophilic material and granules in the upper dermis. Material in the dermis stained with von Kossa was positive. We report on an unusual case of a subepidermal calcified nodule occurring on the sole. A 21-month-old male presented with an oval-shaped, whitish, hard nodule measuring 5×5 mm on the left sole, without any previous history of trauma.

Ahn, In Su; Chung, Bo Young; Lee, Hee Bong; Kim, Hye One; Ahn, Hye Kyoung; Lee, Cheol Heon



Differential responses of calcifying and non-calcifying epibionts of a brown macroalga to present-day and future upwelling pCO2.  


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

Saderne, Vincent; Wahl, Martin



Effect of N -chlorotaurine mouth rinses on plaque regrowth and plaque vitality  

Microsoft Academic Search

The purpose of this 4-day plaque regrowth study was to assess the effect of N-chlorotaurine (NCT) mouth rinses on plaque inhibition and plaque vitality. Eighty volunteers participated in this investigator-blind,\\u000a randomized, clinical controlled study in parallel groups. No oral hygiene was permitted except rinsing with a 2% or 3% NCT\\u000a mouth rinse, a positive or a negative control. Primary parameters

K. Lorenz; D. Mayer; G. Bruhn; B. Noack; M. Brecx; C. Heumann; H. Toutenburg; L. Netuschil; M. Nagl; W. Gottardi; T. Hoffmann




EPA Science Inventory

Ninety-two treated and untreated sewage samples from seven wastewater treatment plants in Chicago, Illinois, Memphis, Tennessee, and Cincinnati, Ohio were examined for their virus content. Concentrated and unconcentrated samples were plaque assayed in five different cell culture ...


Symptomatic and asymptomatic carotid artery plaque  

PubMed Central

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 15–20% 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.

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



Carotid Plaque Age Is a Feature of Plaque Stability Inversely Related to Levels of Plasma Insulin  

PubMed Central

Background The stability of atherosclerotic plaques determines the risk for rupture, which may lead to thrombus formation and potentially severe clinical complications such as myocardial infarction and stroke. Although the rate of plaque formation may be important for plaque stability, this process is not well understood. We took advantage of the atmospheric 14C-declination curve (a result of the atomic bomb tests in the 1950s and 1960s) to determine the average biological age of carotid plaques. Methodology/Principal Finding The cores of carotid plaques were dissected from 29 well-characterized, symptomatic patients with carotid stenosis and analyzed for 14C content by accelerator mass spectrometry. The average plaque age (i.e. formation time) was 9.6±3.3 years. All but two plaques had formed within 5–15 years before surgery. Plaque age was not associated with the chronological ages of the patients but was inversely related to plasma insulin levels (p?=?0.0014). Most plaques were echo-lucent rather than echo-rich (2.24±0.97, range 1–5). However, plaques in the lowest tercile of plaque age (most recently formed) were characterized by further instability with a higher content of lipids and macrophages (67.8±12.4 vs. 50.4±6.2, p?=?0.00005; 57.6±26.1 vs. 39.8±25.7, p<0.0005, respectively), less collagen (45.3±6.1 vs. 51.1±9.8, p<0.05), and fewer smooth muscle cells (130±31 vs. 141±21, p<0.05) than plaques in the highest tercile. Microarray analysis of plaques in the lowest tercile also showed increased activity of genes involved in immune responses and oxidative phosphorylation. Conclusions/Significance Our results show, for the first time, that plaque age, as judge by relative incorporation of 14C, can improve our understanding of carotid plaque stability and therefore risk for clinical complications. Our results also suggest that levels of plasma insulin might be involved in determining carotid plaque age.

Hagg, Sara; Salehpour, Mehran; Noori, Peri; Lundstrom, Jesper; Possnert, Goran; Takolander, Rabbe; Konrad, Peter; Rosfors, Stefan; Ruusalepp, Arno; Skogsberg, Josefin; Tegner, Jesper; Bjorkegren, Johan



Oral biofilm models for mechanical plaque removal  

Microsoft Academic Search

In vitro plaque removal studies require biofilm models that resemble in vivo dental plaque. Here, we compare contact and non-contact\\u000a removal of single and dual-species biofilms as well as of biofilms grown from human whole saliva in vitro using different\\u000a biofilm models. Bacteria were adhered to a salivary pellicle for 2 h or grown after adhesion for 16 h, after which, their

Martinus J. Verkaik; Henk J. Busscher; Minie Rustema-Abbing; Anje M. Slomp; Frank Abbas; Henny C. van der Mei



Visualising noncalcified coronary plaques by CT  

Microsoft Academic Search

Due to a rapid improvement of the new generation submillimetre multislice CT-technology noninvasive tomographic imaging of the coronary vessel wall has become reality. First clinical studies have shown the ability in particular of 16-slice CT to determine plaque burden, plaque composition and compensatory vessel-wall remodelling. These novel findings already constitute an important step forward to assess coronary atherosclerosis noninvasively in

Alexander W. Leber; Andreas Knez; Alexander Becker; Christoph Becker; Maximilian Reiser; Gerhard Steinbeck; Peter Boekstegers



Drug-eluting stents and vulnerable plaque  

Microsoft Academic Search

Coronary artery disease with acute coronary syndromes (ACS) is the leading cause of death worldwide in both men and women.\\u000a ACS mostly occur as a result of rupture of “vulnerable plaque” with a superimposed thrombus formation, which ultimately leads\\u000a to distal cessation of blood flow. Vulnerable plaque mostly occurs in mildly obstructive coronary lesions rather than severely\\u000a stenosed (< 50%)

Mehmet Cilingiroglu; Faisal Khan



Radiolabelled probes for imaging of atherosclerotic plaques  

PubMed Central

Cardiovascular disease is the leading cause of death worldwide. Unstable atherosclerotic plaques are prone to rupture followed by thrombus formation, vessel stenosis, and occlusion and frequently lead to acute myocardial infarction and brain infarction. As such, unstable plaques represent an important diagnostic target in clinical settings and the specific diagnosis of unstable plaques would enable preventive treatments for cardiovascular disease. To date, various imaging methods such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), and intravascular ultrasound (IVUS) have been widely used clinically. Although these methods have advantages in terms of spatial resolution and the ability to make detailed identification of morphological alterations such as calcifications and vessel stenosis, these techniques require skill or expertise to discriminate plaque instability, which is essential for early diagnosis and treatment and can present difficulties for quantitative estimation. On the other hand, nuclear imaging techniques such as positron emission tomography (PET) and single photon emission computed tomography (SPECT) can noninvasively collect quantitative information on the expression levels of functional molecules and metabolic activities in vivo and thus provide functional diagnoses of unstable plaques with high sensitivity. Specifically, unstable plaques are characterized by an abundance of invasive inflammatory cells (macrophages), increased oxidative stress that increases oxidized LDL and its receptor expressed on cells in the lesions, increased occurrence of apoptosis of macrophages and other cells involved in disease progression, increased protease expression and activity, and finally thrombus formation triggered by plaque rupture, which is the most important mechanism leading to the onset of infarctions and ischemic sudden death. Therefore, these characteristics can all be targets for molecular imaging by PET and SPECT. In this paper, we review the present state and future of radiolabelled probes that have been developed for detecting atherosclerotic unstable plaques with nuclear imaging techniques.

Temma, Takashi; Saji, Hideo



Detection of High-Risk Atherosclerotic Plaque  

PubMed Central

The leading cause of major morbidity and mortality in most countries around the world is atherosclerotic cardiovascular disease, most commonly caused by thrombotic occlusion of a high-risk coronary plaque resulting in myocardial infarction or cardiac death, or embolization from a high-risk carotid plaque resulting in stroke. The lesions prone to result in such clinical events are termed vulnerable or high-risk plaques, and their identification may lead to the development of pharmacological and mechanical intervention strategies to prevent such events. Autopsy studies from patients dying of acute myocardial infarction or sudden death have shown that such events typically arise from specific types of atherosclerotic plaques, most commonly the thin-cap fibroatheroma. However, the search in human beings for vulnerable plaques before their becoming symptomatic has been elusive. Recently, the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study demonstrated that coronary plaques that are likely to cause future cardiac events, regardless of angiographic severity, are characterized by large plaque burden and small lumen area and/or are thin-cap fibroatheromas verified by radiofrequency intravascular ultrasound imaging. This study opened the door to identifying additional invasive and noninvasive imaging modalities that may improve detection of high-risk atherosclerotic lesions and patients. Beyond classic risk factors, novel biomarkers and genetic profiling may identify those patients in whom noninvasive imaging for vulnerable plaque screening, followed by invasive imaging for risk confirmation is warranted, and in whom future pharmacological and/or device-based focal or regional therapies may be applied to improve long-term prognosis.

Fleg, Jerome L.; Stone, Gregg W.; Fayad, Zahi A.; Granada, Juan F.; Hatsukami, Thomas S.; Kolodgie, Frank D.; Ohayon, Jacques; Pettigrew, Roderic; Sabatine, Marc S.; Tearney, Guillermo; Waxman, Sergio; Domanski, Michael J.; Srinivas, Pothur R.; Narula, Jagat



Evaluation of serum cyfra21 in patients with pleural effusion  

PubMed Central

Background The aim of this study is to determine the level of serum cytokeratin19 fragment (cyfra21-1) in patients with benign or malignant pleural effusion and evaluation the sensitivity and specificity of this tumor marker. Method & Material We prospectively evaluated 98 patients (39 malignant, 54 benign and the results were inconclusive in 5) with pleural effusion. The diagnosis of malignant pleural effusion was defined by cytological or histological results. We used serum cyfra21-1 criteria from literature of Roch company. Level of the marker was determined using electrochemiluminescence. Results There was statistically significant difference between mean of serum cyfra21-1 levels of benign (3.9±7.6) and malignant(19.5± 30) pleural effusion (p=0.01). In addition the sensitivity, specificity, positive predictive value and negative predictive value of serum cyfra21-1 at the cut off point of 3.3 ng/ml , was 84% , 61%, 61% and 84 % respectively. Conclusion Serum cyfra21-1 is useful as a measure in differentiating malignant from benign pleural effusion.

Azimi, Q; Rezadoost, B; Jalali Nadoushan, M; Davati, A



Intrapleural immunotherapy with Corynebacterium parvum in recurrent malignant pleural effusions.  

PubMed Central

Twenty-one patients with proven recurrent malignant pleural effusions were randomly allocated to treatment groups receiving either intrapleural Corynebacterium parvum in a dose of 7 mg or intrapleural mustine (20 mg). The designated intrapleural therapy was repeated on one occasion if further pleural aspiration was required. Corynebacterium parvum (nine patients) proved superior to mustine (12 patients) in suppressing the reaccumulation of pleural fluid, and was associated with only minimal side-effects of fever and nausea in two patients. Mustine caused marked nausea and vomiting in almost all patients. Three of the four patients who were deemed "failures" after mustine therapy had complete suppression of pleural fluid reaccumulation after a single dose of C parvum, the survival of the fourth being too short to assess a response adequately. There were no failures in the C parvum treated group. Corynebacterium parvum appears to be an effective, well-tolerated agent in the management of recurrent pleural effusions. The relative contribution of its potent immunological stimulant effect to its mode of action remains uncertain.

Millar, J W; Hunter, A M; Horne, N W



Calcium transport in strongly calcifying laying birds: mechanisms and regulation.  


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

Bar, Arie



Asbestos Burden Predicts Survival in Pleural Mesothelioma  

PubMed Central

Background Malignant pleural mesothelioma (MPM) is a rapidly fatal asbestos-associated malignancy with a median survival time of < 1 year following diagnosis. Treatment strategy is determined in part using known prognostic factors. Objective The aim of this study was to examine the relationship between asbestos exposure and survival outcome in MPM in an effort to advance the understanding of the contribution of asbestos exposure to MPM prognosis. Methods We studied incident cases of MPM patients enrolled through the International Mesothelioma Program at Brigham and Women’s Hospital in Boston, Massachusetts, using survival follow-up, self-reported asbestos exposure (n = 128), and a subset of cases (n = 80) with quantitative asbestos fiber burden measures. Results Consistent with the established literature, we found independent, significant associations between male sex and reduced survival (p < 0.04), as well as between nonepithelioid tumor histology and reduced survival (p < 0.02). Although self-reported exposure to asbestos was not predictive of survival among our cases, stratifying quantitative asbestos fiber burden [number of asbestos bodies per gram of lung (wet weight)] into groups of low (0–99 asbestos bodies), moderate (100–1,099), and high fiber burden (> 1,099), suggested a survival duration association among these groups (p = 0.06). After adjusting for covariates in a Cox model, we found that patients with a low asbestos burden had a 3-fold elevated risk of death compared to patients with a moderate fiber burden [95% confidence interval (CI), 0.95–9.5; p = 0.06], and patients with a high asbestos burden had a 4.8-fold elevated risk of death (95% CI, 1.5–15.0; p < 0.01) versus those with moderate exposure. Conclusion Our data suggest that patient survival is associated with asbestos fiber burden in MPM and is perhaps modified by susceptibility.

Christensen, Brock C.; Godleski, John J.; Roelofs, Cora R.; Longacker, Jennifer L.; Bueno, Raphael; Sugarbaker, David J.; Marsit, Carmen J.; Nelson, Heather H.; Kelsey, Karl T.



Nuclear Factor-B Affects Tumor Progression in a Mouse Model of Malignant Pleural Effusion  

Microsoft Academic Search

We developed a novel mouse model of malignant pleural effusion (MPE) by injecting Lewis lung cancer (LLC) cells directly into the pleural space of syngeneic C57B\\/6 mice. The pleural effusions in this model share common cellular and biochemical features with human MPEs. Implantation and growth of pleural tumors triggers a host inflammatoryresponsecharacterized bya mixedinflammatory cellinfluxintothepleuralfluid.LLCcellsexhibitedhighbasalnuclear factor (NF)-B activity in vitro

Georgios T. Stathopoulos; Zhiwen Zhu; M. Brett Everhart; Ioannis Kalomenidis; William E. Lawson; Semra Bilaceroglu; Todd E. Peterson; Daphne Mitchell; Fiona E. Yull; Richard W. Light; Timothy S. Blackwell



Eosinophilic pleural effusion and giardiasis: A causal or a casual relationship?  


A case of bilateral eosinophilic pleural effusion with coincidental intestinal infestation of giardia lamblia is being reported. After reviewing the possible causes of this type of pleural effusion, no clinical or laboratory data were obtained which could explain this condition except giardiasis. Moreover the clearance of pleural effusion with the treatment of giardia with metronidazole suggests giardia as the probable cause of bilateral eosinophilic pleural effusion. PMID:23661922

Singh, Urvinderpal; Garg, Nishi; Chopra, Vishal



Successful endografting with simultaneous visceral artery bypass grafting for severely calcified thoracoabdominal aortic aneurysm  

Microsoft Academic Search

We present two cases of severely calcified thoracoabdominal aortic aneurysm treated by means of endografting with a retrograde aortomesenteric bifurcated bypass graft reconstructing the celiac axis and superior mesenteric artery. To avoid spinal ischemia, we monitored evoked spinal cord potential and performed an occlusion test of the intercostal arteries using a retrievable stentgraft. No change in evoked spinal cord potential

Yoshiko Watanabe; Shin Ishimaru; Satoshi Kawaguchi; Taro Shimazaki; Yoshihiko Yokoi; Mikihiko Ito; Yukio Obitsu; Mikio Ishikawa



Calcifying Epithelial Odontogenic Tumor: A Survey of 23 Cases and Discussion of Histomorphologic Variations.  

National Technical Information Service (NTIS)

There are 23 acceptable cases of calcifying epithelial odontogenic tumor on file at the Armed Forces Institutes of Pathology. With the addition of these cases, a total of reported cases in the English literature reaches 69 and the previous age range of 16...

S. O. Krolls J. J. Pindborg



Pleomorphic undifferentiated sarcoma of urinary bladder with calcified pulmonary metastasis: A rare entity  

PubMed Central

We report the case of a 29-year-old male who presented to us with hematuria, dysuria and bilateral flank pain. On evaluation, the patient was found to have primary pleomorphic undifferentiated sarcoma of bladder with calcified pulmonary metastasis, confirmed with computerized tomography scan and immunohistochemistry.

Mylarappa, Prasad; Prathvi; Javali, Tarun; Ramesh, D; Prabhu, Vinay; Rau, Aarathi R




PubMed Central

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

Martinez, Manuel Jimenez; Franco, Eliud Hernandez; Avalos, Luis Lasso; Perez, Alejandro Martinez



Effects of seawater pCO2 changes on the calcifying fluid of scleractinian corals  

NASA Astrophysics Data System (ADS)

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.

Hohn, S.; Merico, A.



Calcified epibionts as palaeoecological tools: examples from the Recent and Pleistocene reefs of Barbados  

Microsoft Academic Search

Calcified epibionts (crustose coralline algae, bryozoans, foraminiferans and serpulid worms) which colinize primary framebuilders of Recent Barbados reefs exhibit a well-defined zonation of species and morphological growth forms in response to environmental factors such as water turbulence and light. Exposed environments are characterized by thick crusts of coralline algae whereas cryptic environments are dominated by thin crusts of algae, bryozoans,

W. Martindale



Gorlin syndrome: two unusual cases of recurrent, bilateral, multinodular, calcified ovarian fibromas with conservative surgical treatment.  


Gynecologically, NBCCS is variously associated (14%-75% cases) to typically bilateral, multinodular, calcified, ovarian fibromas. We report 2 rare cases of unusually recurrent bilateral ovarian fibromas treated with conservative surgery. Preservation of the normal ovarian tissue is always recommended, even though there is the risk of recurrences, given the benign nature of the lesions and the young age of patients. PMID:22381971

Fedele, Luigi; Motta, Francesca; Frontino, Giada; Pallotti, Francesco


Clear-cell variant of calcifying epithelial odontogenic tumor (Pindborg tumor) in the mandible.  


We present an uncommon case (female patient aged 59 years) of the clear-cell variant of calcifying epithelial odontogenic tumor (CEOT) (also known as Pindborg tumor) in the mandible. The clinical characteristics and probable origins of the clear tumor cells of previously reported cases of clear-cell variant of intraosseous CEOT are also summarized and discussed. PMID:23703711

Chen, Ching-Yi; Wu, Chung-Wei; Wang, Wen-Chen; Lin, Li-Min; Chen, Yuk-Kwan



A clinical and electron microscopic study of a calcifying epithelial odontogenic tumour  

PubMed Central

The clinical features and the histological and ultrastructural appearances of a case of calcifying epithelial odontogenic tumour are described. The ultrastructural features of the cells of this tumour are comparable to cells of the stratum intermedium of the enamel organ. It is suggested that the amyloid-staining material found in this tumour is a cellular secretion rather than a cytoplasmic degeneration. Images

Mainwaring, A. R.; Ahmed, Ali; Hopkinson, J. M.; Anderson, P.



Long-Term Trends in Calcifying Plankton and pH in the North Sea  

PubMed Central

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.

Beare, Doug; McQuatters-Gollop, Abigail; van der Hammen, Tessa; Machiels, Marcel; Teoh, Shwu Jiau; Hall-Spencer, Jason M.



Bilateral tonsilloliths and calcified carotid atheromas: case report and literature review.  


Tonsilloliths and calcified carotid atheromas are dystrophic calcifications that can be identified in routine oral radiographs. This case report is the first description in the English literature of the simultaneous occurrence of bilateral tonsilloliths and calcified carotid atheromas. Panoramic oral radiographs from a 62-year-old woman presented bilateral radiopaque images of the left and right ramus of the mandible; multiple and well-defined radiopacities below the left angle of the mandible, next to the C3-C4 cervical vertebrae; and a single radiopacity on the right side between the hyoid bone and the mandible base. Computed tomography confirmed the exact location of the calcifications in the oropharyngeal and carotid spaces. A diagnosis of bilateral tonsilloliths and calcified carotid atheromas was reached. Doppler ultrasound indicated a degree of stenosis of ± 20% within the right and left carotids. The patient was referred to a vascular surgeon to evaluate the calcified carotid atheromas. Follow-up of the tonsilloliths was also performed. PMID:22867758

de Oliveira, Camila de Nazaré Alves; Amaral, Tania Mara Pimenta; Abdo, Evandro Neves; Mesquita, Ricardo Alves



Clear-cell variant of calcifying epithelial odontogenic tumor (Pindborg tumor) in the mandible  

PubMed Central

We present an uncommon case (female patient aged 59 years) of the clear-cell variant of calcifying epithelial odontogenic tumor (CEOT) (also known as Pindborg tumor) in the mandible. The clinical characteristics and probable origins of the clear tumor cells of previously reported cases of clear-cell variant of intraosseous CEOT are also summarized and discussed.

Chen, Ching-Yi; Wu, Chung-Wei; Wang, Wen-Chen; Lin, Li-Min; Chen, Yuk-Kwan



Effectiveness of the hugging balloon technique in coronary angioplasty for a heavy, encircling, calcified coronary lesion.  


We report our experience in coronary angioplasty and intravascular ultrasonography (IVUS) on a heavy, encircling, calcified lesion that was not dilated with the use of a cutting balloon and a non-compliant balloon. The angioplasty was successfully performed with a simple and inexpensive hugging balloon technique. PMID:19997547

Ahn, Min Soo; Yoon, Junghan; Lee, Jun Won; Lee, Kyoung Hoon; Kim, Jang Young; Yoo, Byung Su; Lee, Seung Hwan; Choe, Kyung Hoon



The role of pleuroscopy in undiagnosed exudative pleural effusion  

PubMed Central

Aims: To find the diagnostic yield of a pleuroscopic pleural biopsy and to find the complication rates. Settings and Design: Institutional based prospective study. Materials and Methods: Sixty-eight consecutive patients who had undiagnosed exudative pleural effusion were recruited for pleuroscopy from September 2007 to August 2010. Results: A total of 68 patients (55 males and 13 females; mean age 49 years) underwent pleuroscopy. Malignancy was diagnosed in 24 patients, 22 patients had non-specific inflammation, tuberculosis was found in 16 patients, empyema was found in 2 patients, 1 patient had sarcoidosis, 1 patient had normal pleura and it was non-diagnostic in 2 patients. The diagnostic yield was 97%. There were no major complications, only four patients had minor complication like subcutaneous emphysema (three patients) and prolonged air leak (one patient). Conclusions: Pleuroscopy is a safe, simple, and valuable tool in the diagnosis of undiagnosed exudative pleural effusion with minimal complication rates.

Prabhu, V. G.; Narasimhan, R.



[Malignant pleural mesothelioma in general practice; complex pain problems].  


In three patients, men aged 67, 57 and 69 years, malignant pleural mesothelioma was diagnosed. All three had worked as coal miners and were presented with thoracic pain. They were among seven cases of malignant pleural mesothelioma diagnosed in a period of five years in one suburban general practice (adherence: 5600 patients) in the former mining area in the province of Limburg. The terminal phase of the disease was characterized by intractable pain. High doses of opioids and adjuvants were necessary to achieve acceptable pain relief. It is suggested that step one of the 'analgesic ladder for cancer pain management' of the WHO (non-opioids) should be followed soon by step three (strong opioids). Because the incidence of pleural mesothelioma is not yet decreasing, it is important to know that pain management remains a serious problem. PMID:9380133

Leclercq, R M; Jongmans-Liedekerken, A W



Cytologic Diagnosis of Malignant Pleural Effusion in Multiple Myeloma - Two Case Reports -  

Microsoft Academic Search

Malignant pleural effusion in multiple myeloma (MM) is extremely rare and is associated with poor prognosis. We experienced two cases of MM IgA type with malignant pleural effusion. The diagnoses were based on characteristic cytology and CD138 immunocytochemistry. The patients received several cycles of combination chemotherapy, since symptoms were more aggressive with an uncontrolled pleural effusion. We review the clinical

Yoo Duk Choi; Sung Sun Kim; Chang Woo Han; Ji Shin Lee; Jong Hee Nam; Sang Woo Juhng; Chan Choi



Comparison of pulmonary and pleural responses of rats and hamsters to inhaled refractory ceramic fibers  

Microsoft Academic Search

The present study was designed to determine whether pleural fiber burdens or subchronic pleural fibroproliferative and inflam- matory changes can help explain the marked interspecies differ- ences in pleural fibrosis and mesothelioma that are observed fol- lowing long-term inhalation of RCF-1 ceramic fibers by rats and hamsters. Fischer 344 rats and Syrian golden hamsters were ex- posed to RCF-1 for

Thomas R. Gelzleichter; Edilberto Bermudez; James B. Mangum; Brian A. Wong; Derek B. Janszen; Owen R. Moss; Jeffrey I. Everitt



Pleural amyloidosis as the first sign of IgD multiple myeloma  

Microsoft Academic Search

We describe a case of IgD myeloma with amyloid and plasmocytic pleural localisations. At the onset of the disease it mimicked rheumatoid arthritis, which can be the first presentation of both AL amyloidosis and multiple myeloma. Pleural effusion can happen first in IgD myeloma, but our observation is of interest in that it confirms the very rare possibility of pleural

Christian Hubert Roux; V. Breuil; O. Brocq; L. Euller-Ziegler



[Adenosine deaminase activity in tuberculous and malignant pleural effusions].  


Measurement of pleural adenosine deaminase activity (ADA) is a useful diagnostic tool for tuberculous pleurisy, but false-positive findings from non-tuberculous effusions have been reported. In order to improve diagnostic value of ADA it is recommended to estimate activity of both ADA1 and ADA2 izoenzymes or 2'-deoxyadenosine/adenosine activity ratio. In order to evaluate ADA as a diagnostic parameter total ADA, with adenosine as a substrate, and 2'-deoxyadenosine/adenosine activity ratio were measured in tuberculous and malignant pleural effusions. Altogether, 26 pleural exudates (11 tuberculous and 15 malignant) were selected. ADA either with adenosine or 2'-deoxyadenosine was determined by colorimetric method of Giusti. Each pleural fluid sample was diluted prior to the assay (1:8) to avoid enzyme inhibition which was observed in nondiluted pleural effusions. The ADA level reached the diagnostic cut-off set for tuberculous effusions (40 U/L) in every 11 tuberculous exudates with the mean value of 85,3+/-47,1 U/L; in 9 of these the 2'-deoxyadenosine/adenosine ratio was less than 0,45. In the malignant group of patients, no one ADA level exceed 40 U/L, being estimated at 10,6+/-7,7 U/L (p<0,001). In 10 of these 15 exudates the 2'-deoxyadenosine/adenosine ratio was undetectable, in four it was less than 0,45 and only in one it was over 0,45. We concluded that ADA measured by the Giusti method proceeded by the dilution 1:8 of the pleural effusion samples very good differentiates tuberculous from malignant pleurisy, without the necessity to determine the 2'-deoxyadenosine/adenosine ratio. The investigation needs to be continued on the more numerous groups of patients. PMID:17175968

Safianowska, Aleksandra; Krenke, Rafa?; Dmowska-Sobstyl, Barbara; Bogacka-Zatorska, Elzbieta; Domaga?a-Kulawik, Joanna; Chazan, Ryszarda



Immune responses and immunotherapeutic interventions in malignant pleural mesothelioma  

PubMed Central

Malignant pleural mesothelioma (MPM) is an aggressive, primary pleural malignancy with poor prognosis, hypothesized to originate from a chronic inflammatory state within the pleura. Similar to what has been observed in other solid tumors (melanoma, ovarian and colorectal cancer), clinical and pre-clinical MPM investigations have correlated anti-tumor immune responses with improved survival. As such, a better understanding of the complex MPM tumor microenvironment is imperative in strategizing successful immunotherapies. Herein, we review the immune responses vital to the development and progression of MPM, as well as assess the role of immunomodulatory therapies, highlighting recent pre-clinical and clinical immunotherapy investigations.

Bograd, Adam J.; Suzuki, Kei; Vertes, Eva; Colovos, Christos; Morales, Eduardo A.; Sadelain, Michel; Adusumilli, Prasad S.



Nonaccidental trauma presenting with respiratory distress and pleural effusion.  


Nonaccidental trauma (NAT) is common and presents with varied symptoms. Pleural effusion as a complication of physical abuse has not been described in the past. We report the case of a 10-week-old infant who presented with multiple nonspecific complaints that included respiratory distress, refusal to feed, constipation, and lethargy. Sepsis was the working diagnosis on admission, but a massive pleural effusion and rib fractures seen on chest imaging ultimately led to the diagnosis of nonaccidental trauma. This interesting case highlights the importance of maintaining a high index of suspicion for abuse irrespective of atypical presenting signs. PMID:22217891

Sagar, Malvika; Shukla, Samarth; Bradley-Dodds, Kelly



Pharmacokinetics of linezolid in the mediastinum and pleural space.  


The purpose of this study was to investigate the penetration of linezolid into the mediastinum and pleural space by comparing its concentration in the serum, mediastinum, and pleural space. The linezolid area under the concentration-versus-time curve from zero to 12h (AUC)mediastinumfluid/serum and AUCpleuralfluid/serum ratio were 1.32 and 1.64, respectively. The results suggest that the linezolid concentration in the mediastinum varies as in the serum, and that the concentration in the mediastinum is the same as or greater than that in the serum. PMID:23684451

Tsuji, Yasuhiro; Hashimoto, Wataru; Taniguchi, Shinichiro; Hiraki, Yoichi; Mizoguchi, Akiko; Yukawa, Eiji; To, Hideto



Anaerobes in nosocomial and community acquired pleural infections.  


Anaerobes are important causes of pleural space infections. The aim of the study is to evaluate the role of the anaerobic bacteria in pleural infections. The study involved 278 consecutive clinical samples sent to the Clinical Microbiology Laboratory of Tertiary Chest Hospital. Anaerobes were isolated in 39 community acquired and five nosocomial cases out of 278 anaerobic cultivations (15.8%). Total of 56 anaerobe strains were identified and 21 aerobes were accompanied to anaerobic isolates. Aerobe isolates were associated with anaerobic microorganisms in 19 cases (43.2%). Bacteroides species (21.4%) and Pseudomonas aeruginosa (33.3%) were the most common anaerobic and aerobic isolates. PMID:24064649

Senol, G; Coskun, M; Gunduz, A; Bicmen, C; Tibet, G


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


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

Gaffar, A; Afflitto, J; Nabi, N



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

PubMed Central

Amyloid beta (A?) 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? 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.

Leskovjan, Andreana C.; Lanzirotti, Antonio; Miller, Lisa M.



Thermal detection of cellular infiltrates in living atherosclerotic plaques: possible implications for plaque rupture and thrombosis  

Microsoft Academic Search

SummaryBackground Atherosclerotic lesions are heterogeneous and prognosis cannot easily be predicted, even with intracoronary ultrasound and angioscopy. Serial angiographic and necropsy studies suggest that the risk of plaque rupture correlates only weakly with the degree of stenosis. Most ruptured plaques are characterised by a large pool of cholesterol or necrotic debris and a thin fibrous cap with a dense infiltration

W. Casscells; W. K. Vaughn; H. McAllister; J. T. Willerson; B. Hathorn; M. David; T. Krabach; G. Bearman



Diagnostic Value and Prognostic Significance of Pleural C-Reactive Protein in Lung Cancer Patients with Malignant Pleural Effusions  

PubMed Central

Purpose C-reactive protein (CRP) has been implicated in various inflammatory and advanced malignant states. Increased serum CRP (s-CRP) levels have been shown to be associated with independent prognostic factors for survival in patients with advanced lung cancer. However, only few studies have focused on the role of CRP in pleural effusions. This study aimed to evaluate the diagnostic and prognostic value of pleural CRP (p-CRP) in lung cancer patients with malignant pleural effusion (MPE). Materials and Methods Pleural effusion (PE) samples were collected from patients with MPE (68 lung cancers; 12 extrathoracic tumors), and from 68 patients with various benign conditions (31 with pneumonia; 37 with tuberculosis). Concentrations of p- and s-CRP were measured by enzyme-linked immunosorbent assay. CRP level in pleural fluid and its association with survival were examined. Results p-CRP levels correlated with s-CRP levels (r=0.82, p<0.0001). For the differential diagnosis of MPE and benign PE, the area under the receiver operating characteristic curve was greater for p-CRP (0.86) than for s-CRP (0.77). High p-CRP expression significantly correlated with shorter overall survival (p=0.006). P-CRP was independent prognostic factor significantly associated with overall survival on multivariated analysis (p=0.0001). The relative risk of death for lung cancer patients with high p-CRP levels was 3.909 (95% confidence interval, 2.000-7.639). Conclusion P-CRP is superior to s-CRP in determining pleural fluid etiology. Quantitative measurement of p-CRP might be a useful complementary diagnostic and prognostic test for lung cancer patients with MPE.

Park, Do-Sim; Kim, Dong; Hwang, Ki-Eun; Hwang, Yu-Ri; Park, Chul; Seol, Chang-Hwan; Cho, Kyung-Hwa; Kim, Byoung-Ryun; Park, Seong-Hoon; Jeong, Eun-Taik



Effect of ventilation frequency and tidal volume on pleural space thickness in rabbits.  


The thickness of the pleural space was measured by fluorescence video-microscopy during mechanical ventilation in anesthetized paralyzed rabbits. A transparent parietal pleural window was made in the fourth or sixth intercostal space near midchest by dissection of intercostal muscle and endothoracic fascia. Fluorescence-labeled (fluorescein isothiocyanate) dextran solution (1 ml) was injected into the pleural space via a rib capsule and allowed to mix with the pleural liquid. With the rabbit in the left lateral decubitus position and the pleural window superior, the light emitted from the pleural liquid through the pleural window was measured through the videomicroscope. Both ventilation frequency and tidal volume were varied. Pleural space thickness was determined by in vitro calibration of the pleural liquid at the end of the experiment. At a frequency of 40 breaths/min and a tidal volume of 20 ml, pleural space thickness averaged 35 +/- 15 (SD) microns (n = 7). When frequency was reduced to 8 breaths/min, this value was reduced by 40% to 22 +/- 11 microns. A reduction in tidal volume from 20 to 6 ml at a frequency of 40 breaths/min produced a similar reduction in pleural space thickness. During apnea, pleural space thickness averaged 11 +/- 3 microns. Cardiogenic motion had no measurable effect on pleural space thickness. The increased pleural space thickness with ventilation might serve to reduce the power dissipated due to sliding of the lung relative to the chest wall. Results support the concept of lubrication as the primary function of the pleural space. PMID:8282639

Wang, P M; Lai-Fook, S J



Hyperspectral imaging of atherosclerotic plaques in vitro  

NASA Astrophysics Data System (ADS)

Vulnerable plaques constitute a risk for serious heart problems, and are difficult to identify using existing methods. Hyperspectral imaging combines spectral- and spatial information, providing new possibilities for precise optical characterization of atherosclerotic lesions. Hyperspectral data were collected from excised aorta samples (n = 11) using both white-light and ultraviolet illumination. Single lesions (n = 42) were chosen for further investigation, and classified according to histological findings. The corresponding hyperspectral images were characterized using statistical image analysis tools (minimum noise fraction, K-means clustering, principal component analysis) and evaluation of reflectance/fluorescence spectra. Image analysis combined with histology revealed the complexity and heterogeneity of aortic plaques. Plaque features such as lipids and calcifications could be identified from the hyperspectral images. Most of the advanced lesions had a central region surrounded by an outer rim or shoulder-region of the plaque, which is considered a weak spot in vulnerable lesions. These features could be identified in both the white-light and fluorescence data. Hyperspectral imaging was shown to be a promising tool for detection and characterization of advanced atherosclerotic plaques in vitro. Hyperspectral imaging provides more diagnostic information about the heterogeneity of the lesions than conventional single point spectroscopic measurements.

Larsen, Eivind L. P.; Randeberg, Lise L.; Olstad, Elisabeth; Haugen, Olav A.; Aksnes, Astrid; Svaasand, Lars O.



Growth of Necrotic Cores in Vulnerable Plaque  

NASA Astrophysics Data System (ADS)

Plaques are fatty deposits that grow mainly in arteries and develop as a result of a chronic inflammatory response. Plaques are called vulnerable when they are prone to mechanical rupture. Vulnerable Plaques (VPs) are characterized by lipid-rich, necrotic cores that are heavily infiltrated with macrophages. The rupture of VPs releases thrombogenic agents into the bloodstream, usually resulting in myocardial infarctions. We propose a quantitative model to predict the development of a plaque's necrotic core. By solving coupled reaction-diffusion equations for macrophages and dead cells, we explore the joint effects of hypoxic cell death and chemo-attraction to Ox-LDL, a molecule that is strongly linked to atherosclerosis. Our model predicts cores that have approximately the right size and shape. Normal mode analysis and subsequent calculation of the smallest eigenvalues allow us to compute the times required for the system to reach its steady state. This study allows us to make quantitative predictions for how quickly vulnerable plaques develop and how their growth depends on system parameters such as chemotactic coefficients and cell death rates.

Fok, Pak-Wing



Hyperspectral imaging of atherosclerotic plaques in vitro.  


Vulnerable plaques constitute a risk for serious heart problems, and are difficult to identify using existing methods. Hyperspectral imaging combines spectral- and spatial information, providing new possibilities for precise optical characterization of atherosclerotic lesions. Hyperspectral data were collected from excised aorta samples (n = 11) using both white-light and ultraviolet illumination. Single lesions (n = 42) were chosen for further investigation, and classified according to histological findings. The corresponding hyperspectral images were characterized using statistical image analysis tools (minimum noise fraction, K-means clustering, principal component analysis) and evaluation of reflectance/fluorescence spectra. Image analysis combined with histology revealed the complexity and heterogeneity of aortic plaques. Plaque features such as lipids and calcifications could be identified from the hyperspectral images. Most of the advanced lesions had a central region surrounded by an outer rim or shoulder-region of the plaque, which is considered a weak spot in vulnerable lesions. These features could be identified in both the white-light and fluorescence data. Hyperspectral imaging was shown to be a promising tool for detection and characterization of advanced atherosclerotic plaques in vitro. Hyperspectral imaging provides more diagnostic information about the heterogeneity of the lesions than conventional single point spectroscopic measurements. PMID:21361695

Larsen, Eivind L P; Randeberg, Lise L; Olstad, Elisabeth; Haugen, Olav A; Aksnes, Astrid; Svaasand, Lars O



Measurement of Pleural Temperature During Radiofrequency Ablation of Lung Tumors to Investigate Its Relationship to Occurrence of Pneumothorax or Pleural Effusion  

SciTech Connect

The purpose of this study was to investigate the relationship between pleural temperature and pneumothorax or pleural effusion after radiofrequency (RF) ablation of lung tumors. The pleural temperature was measured immediately outside the lung surface nearest to the tumor with a fiber-type thermocouple during 25 ablation procedures for 34 tumors in 22 patients. The procedures were divided into two groups depending on the highest pleural temperature: P-group I and P-group II, with highest pleural temperatures of <40 deg. C and {>=}40 deg. C, respectively. The incidence of pneumothorax or pleural effusion was compared between the groups. Multiple variables were compared between the groups to determine the factors that affect the pleural temperature. The overall incidence of pneumothorax and pleural effusion was 56% (14/25) and 20% (5/25), respectively. Temperature data in five ablation procedures were excluded from the analyses because these were affected by the pneumothorax. P-group I and P-group II comprised 10 procedures and 10 procedures, respectively. The incidence of pleural effusion was significantly higher in P-group II (4/10) than in P-group I (0/10) (p = 0.043). However, the incidence of pneumothorax did not differ significantly (p = 0.50) between P-group I (4/10) and P-group II (5/10). Factors significantly affecting the pleural temperature were distance between the electrode and the pleura (p < 0.001) and length of the lung parenchyma between the electrode and the pleura (p < 0.001). We conclude that higher pleural temperature appeared to be associated with the occurrence of pleural effusion and not with that of pneumothorax.

Tajiri, Nobuhisa, E-mail:; Hiraki, Takao; Mimura, Hidefumi; Gobara, Hideo; Mukai, Takashi; Hase, Soichiro; Fujiwara, Hiroyasu; Iguchi, Toshihiro; Sakurai, Jun [Okayama University Medical School, Department of Radiology (Japan); Aoe, Motoi; Sano, Yoshifumi; Date, Hiroshi [Okayama University Medical School, Department of Cancer and Thoracic Surgery (Japan); Kanazawa, Susumu [Okayama University Medical School, Department of Radiology (Japan)



False-positive reactions with enzyme-linked immunosorbent assay of Mycobacterium tuberculosis antigens in pleural fluid  

Microsoft Academic Search

Summary. The value of enzyme-linked immunosorbent assay (ELISA) for the diagnosis of tuberculous pleural effusion has not been defined. We performed ELISA by a double antibody sandwich technique with anti-BCG antibody in the solid phase to detect Mycobacterium tuberculosis antigen in pleural fluid from 36 patients with pleural effusion (tuberculosis 15, lung cancer 12, miscellaneous 9). Pleural fluids from 12

R. Dhand; N. K. Ganguly; CHETNA VAISHNAVI; R. Gilhotra; S. K. Malik



Analysis of mycoplasmal pleural effusion by the polymerase chain reaction  

Microsoft Academic Search

Ten pediatric patients with mycoplasmal pleuritis were tested for the presence of Mycoplasma pneumoniae in pleural fluid by the polymerase chain reaction (PCR). Three of the four PCR positive cases left a persistent consolidation. The remaining one was an infant who required mechanical ventilation. PCR may be useful in predicting delayed resolution of roent- genographic abnormality.

Mitsuo Narita; Yoshihiro Matsuzono; Osamu Itakura; Satoshi Yamada; Takehiro Togashi



Chemotherapy for malignant pleural mesothelioma: past results and recent developments  

Microsoft Academic Search

This review summarises the results of previously conducted clinical trials, and subsequently presents data arising from all phase II–III studies on chemotherapy of malignant pleural mesothelioma (MPM) published since the last relevant overview. While response rates exceeding 30% have barely been achieved with established cytotoxic drugs in MPM therapy, novel chemotherapeutic agents and their combinations appear more promising. This applies

S Tomek; S Emri; K Krejcy; C Manegold



BTS guidelines for the management of pleural infection in children  

Microsoft Academic Search

of the abstracted bullet points from,each section. Following that is an algorithm,summarising,the management,of pleural infection,in children (fig 1). Each section starts with,bulleted points of key recommendations,using the revised SIGN grading,system,(table 1) available,on,http:\\/\\/\\/guidelines\\/fulltext\\/50\\/section6.

I M Balfour-Lynn; E Abrahamson; G Cohen; J Hartley; S King; D Parikh; D Spencer; A H Thomson; D Urquhart



Pleural mesothelioma after neighborhood exposure to asbestos during childhood.  


A 38-year-old woman with pleural mesothelioma who had a history of neighborhood asbestos exposure during her childhood was demonstrated. She had no known history of occupational asbestos exposure. This is the first case of mesothelioma with neighborhood asbestos exposure reported in Japan. Previously-reported cases of mesothelioma with neighborhood asbestos exposure in the English language literature were reviewed. PMID:1942646

Inase, N; Takayama, S; Nakayama, M; Miura, H; Kimula, Y


Three-Dimensional Stereoscopic Volume Rendering of Malignant Pleural Mesothelioma  

PubMed Central

Our objective was to investigate the application of three-dimensional (3D) stereoscopic volume rendering with perceptual colorization on preoperative imaging for malignant pleural mesothelioma. At present, we have prospectively enrolled 6 patients being considered for resection of malignant pleural mesothelioma that have undergone a multidetector-row computed tomography (CT) scan of the chest. The CT data sets were volume rendered without preprocessing. The resultant 3D rendering was displayed stereoscopically and used to provide information regarding tumor extent, morphology, and anatomic involvement. To demonstrate this technique, this information was compared with the corresponding two-dimensional CT grayscale axial images from two of these patients. Three-dimensional stereoscopic reconstructions of the CT data sets provided detailed information regarding the local extent of tumor that could be used for preoperative surgical planning. Three-dimensional stereoscopic volume rendering for malignant pleural mesothelioma is a novel approach. Combined with our innovative perceptual colorization algorithm, stereoscopic volumetric analysis potentially allows for the accurate determination of the extent of pleural mesothelioma with results difficult to duplicate using grayscale, multiplanar CT images.

Mollberg, Nathan M.; Parsad, Nigel M.; Armato, Samuel G.; Vigneswaran, Janani; Kindler, Hedy L.; Sensakovic, William F.; Salgia, Ravi; Silverstein, Jonathan C.; Vigneswaran, Wickii T.



Three-dimensional stereoscopic volume rendering of malignant pleural mesothelioma.  


Our objective was to investigate the application of three-dimensional (3D) stereoscopic volume rendering with perceptual colorization on preoperative imaging for malignant pleural mesothelioma. At present, we have prospectively enrolled 6 patients being considered for resection of malignant pleural mesothelioma that have undergone a multidetector-row computed tomography (CT) scan of the chest. The CT data sets were volume rendered without preprocessing. The resultant 3D rendering was displayed stereoscopically and used to provide information regarding tumor extent, morphology, and anatomic involvement. To demonstrate this technique, this information was compared with the corresponding two-dimensional CT grayscale axial images from two of these patients. Three-dimensional stereoscopic reconstructions of the CT data sets provided detailed information regarding the local extent of tumor that could be used for preoperative surgical planning. Three-dimensional stereoscopic volume rendering for malignant pleural mesothelioma is a novel approach. Combined with our innovative perceptual colorization algorithm, stereoscopic volumetric analysis potentially allows for the accurate determination of the extent of pleural mesothelioma with results difficult to duplicate using grayscale, multiplanar CT images. PMID:23102002

Mollberg, Nathan M; Parsad, Nigel M; Armato, Samuel G; Vigneswaran, Janani; Kindler, Hedy L; Sensakovic, William F; Salgia, Ravi; Silverstein, Jonathan C; Vigneswaran, Wickii T


Pleural effusions in lymphoblastic lymphoma: A diagnostic alternative  

Microsoft Academic Search

Background: Children with large anterior mediastinal masses frequently present with severe respiratory compromise and often pose a difficult diagnostic dilemma. A biopsy is preferred for diagnosis before treatment can begin; however, many of these children are at risk of acute clinical deterioration and cardiovascular arrest with the induction of anesthesia. The authors noted a correlation between pleural effusions and lymphoblastic

Beverly E. Chaignaud; Timothy A. Bonsack; Harry P. Kozakewich; Robert C. Shamberger



Bilateral hemorrhagic pleural effusion due to kerosene aspiration  

PubMed Central

Kerosene ingested, intentionally or accidentally, is toxic. Data is scarce on complications and outcomes of hydrocarbon poisoning following kerosene aspiration in adults and there has been no known case of bilateral hemorrhagic effusion occurring due to it in literature. We, hereby, report a case of a bilateral hemorrhagic pleural effusion secondary to hydrocarbon aspiration in a 40-year old adult.

Prasad, Rajendra; Karmakar, Saurabh; Sodhi, Rakhee; Karmakar, Shilpi



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


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

Hecker, E; Hamouri, S; Müller, E; Ewig, S



Effect of positive pleural pressure on left ventricular performance  

SciTech Connect

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.

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



Rare case of benign pleural fibrous mesothelioma: A surgical experience  

Microsoft Academic Search

Conclusion  Case study demonstrates importance of keeping pleural pathology in mind while dealing with all peripheral space occupying\\u000a lesions of the thorax. ACT guided biopsy can serve as the best diagnostic tool and surgical excision should be employed as\\u000a the definitive procedure in all cases at the earliest.

Anand Yadav; Sanjay Kumar; Sanjeev Khulbe; Sameer Sharma; Vikas Ahlwat; Raj Kumar Yadav; Rajendra Mohan Mathur; Chandra Prakash Shrivastva



Pericardial, retroperitoneal, and pleural fibrosis induced by pergolide  

Microsoft Academic Search

Three patients with Parkinson’s disease are described who developed pericardial, retroperitoneal, and pleural fibrosis associated with pergolide treatment. Surgical intervention was required in all three cases, either to reach a tissue diagnosis or for potentially life threatening complications. Symptoms emerged on average 2 years after the institution of treatment, and were sufficiently non-specific to cause significant delays in diagnosis in

S Shaunak; A Wilkins; J B Pilling; D J Dick



Pleural Mesothelioma Presenting as Periumbilical Metastasis: The First Clinical Documentation  

PubMed Central

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.

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



Rapidly Progressive Lung Cysts and Pleural Effusion: A Case Report  

PubMed Central

Angiosarcoma is a rare but highly malignant tumor arising from vascular endothelial cells. Angiosarcoma commonly arises from the heart, liver, breast, and skin including the scalp. Angiosarcoma metastasizing to the lungs can present as either pneumothorax, hemothorax, or pleural effusions. They can rarely present as rapidly enlarging thin-walled pulmonary cysts. A review of the literature is included.

Olsen, Diana; Molloy, Charlene; Sriram, P. S.



New tetratrichomonas species in two patients with pleural empyema.  


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

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



A possible role for Epstein-Barr virus in the pathogenesis of pleural effusion.  


A high percentage of pleural effusions remain unexplained despite an intensive diagnostic workup. Epstein-Barr virus (EBV) infections occur worldwide and affect the majority of the population. The present study investigated the prevalence and clinical relevance of EBV in pleural effusions. A prospective study was performed in which 60 consecutive patients with pleural effusion were enrolled. Real-time quantitative EBV-PCR was performed on pleural fluid and serum. Pleural fluid was further evaluated using standard biochemical, cytological and microbiological procedures. Demographic data, medical history and medication were recorded. A total of 24 (40%), from 60 pleural fluids tested, were positive in the EBV-PCR. Median EBV-DNA levels for positive samples was 454 genome equivalents (geq).mL-1 (range 36-163,446 geq.mL-1). A total of 20 (59%) out of 34 unexplained pleural effusions were EBV-PCR positive. Serological analysis of all patients with a positive PCR revealed a previous infection. Patients with a positive EBV-PCR on pleural fluid were more likely to have a positive EBV-PCR on serum than patients with a negative PCR on pleural fluid. Epstein-Barr virus reactivation in pleural fluid is a frequent event and the absence of an alternative diagnosis to explain the nature of the effusion in the majority of cases suggests an aetiological role for Epstein-Barr virus in the development of pleural effusion. PMID:16204598

Thijsen, S F T; Luderer, R; van Gorp, J M H; Oudejans, S J G; Bossink, A W J



Malignant and Tuberculous Pleural Effusions: Immunophenotypic Cellular Characterization  

PubMed Central

INTRODUCTION AND OBJECTIVES Tuberculosis and cancer are the main causes of pleural effusion. Pleural involvement is associated with migration of immune cells to the pleural cavity. We sought to characterize the immunophenotype of leukocytes in the pleural effusion and peripheral blood of patients with tuberculosis or malignancy. METHODS Thirty patients with tuberculosis (14) or malignancy (16) were studied. A control group included 20 healthy blood donors. RESULTS Malignant phycoerythrin pleural effusions showed higher percentages of CD3, CD4, CD3CD45RO, and CD20CD25 lymphocytes and lower percentages of CD3CD25 and CD20HLA-DR when compared to PB lymphocytes. Compared to PB, tuberculous effusions had a higher percentage of lymphocytes that co-expressed CD3, CD4, CD3CD45RO, CD3TCR??, CD3CD28, and CD20 and a lower percentage of CD14, CD8 and CD3TCR??-positive lymphocytes. Malignant effusions presented higher expression of CD14 whereas tuberculous effusions had higher expression of CD3 and CD3CD95L. Peripheral blood cells from tuberculosis patients showed higher expression of CD14, CD20CD25 and CD3CD95L. Compared with the control cells, tuberculosis and cancer peripheral blood cells presented a lower percentage of CD3CD4 and CD3CD28-positive cells as well as a higher percentage of CD3CD8, CD3CD25 and CD3CD80-positive cells. CONCLUSIONS Tuberculous and malignant peripheral blood is enriched with lymphocytes with a helper/inducer T cell phenotype, which are mainly of memory cells. CD14-positive cells were more frequently found in malignant effusions, while CD3-positive cells expressing Fas ligand were more frequently found in tuberculous effusions.

de Aguiar, Lucia Maria Zanatta; Antonangelo, Leila; Vargas, Francisco S.; Zerbini, Maria Claudia Nogueira; Sales, Maria Mirtes; Uip, David E.; Saldiva, Paulo Hilario Nascimento



A pigmented calcifying cystic odontogenic tumor associated with compound odontoma: a case report and review of literature  

PubMed Central

Background Pigmented intraosseous odontogenic lesions are rare with only 47 reported cases in the English literature. Among them, pigmented calcifying cystic odontogenic tumor, formerly known as calcifying odontogenic cyst, is the most common lesion with 20 reported cases. Methods A case of pigmented calcifying cystic odontogenic tumor associated with odontoma occurring at the mandibular canine-premolar region of a young Japanese boy is presented with radiographic, and histological findings. Special staining, electron microscopic study and immunohistochemical staining were also done to characterize the pigmentation. Results The pigments in the lesion were confirmed to be melanin by Masson-Fontana staining and by transmission electron microscopy. The presence of dendritic melanocytes within the lesion was also demonstrated by S-100 immunostaining. Conclusion The present case report of pigmented calcifying cystic odontogenic tumor associated with odontoma features a comprehensive study on melanin and melanocytes, including histochemical, immunohistochemical and transmission electron microscopic findings.

Han, Phuu P; Nagatsuka, Hitoshi; Siar, Chong H; Tsujigiwa, Hidetsugu; Gunduz, Mehmet; Tamamura, Ryo; Borkosky, Silvia S; Katase, Naoki; Nagai, Noriyuki



Acetic acid lontophoresis and ultrasound for the treatment of calcifying tendinitis of the shoulder: A randomized control trial  

Microsoft Academic Search

Objective: To assess the effects of acetic acid iontophoresis (AAI) and ultrasound on calcifying tendinitis of the shoulder, and to determine the relation between changes in the radiological measures of calcium deposit (CD) and shoulder function.Design: Randomized control trial.Setting: General community, private practice.Patients: Twenty-two adults (7 men, 15 women) with a calcifying tendinitis of the shoulder, without associated conditions, stratified

Marc Perron; Francine Malouin



An Unusual Type II Dens Invaginatus with Calcified Canals in a Maxillary Lateral Incisor - A Case Report  

PubMed Central

Dens invaginatus is a developmental malformation resulting from the invagination of enamel organ into the dental papilla. Management of dens invaginatus is an endodontic challenge. Presence of calcified canals in dens invaginatus makes it even more complicated. Modification of the treatment plan is required to treat such cases. This case report deals with the management of a Type II Dens Invaginatus in a lateral incisor with calcified canals.

Subbiya, Arunajatesan; Geethapriya, Nagarajan; Pradeepkumar, Angambakam Rajasekaran; Vivekanandhan, Paramasivam



A Plaque Assay System for Several Species of Rickettsia.  

National Technical Information Service (NTIS)

The plaque assay procedure developed in this laboratory for the Bitter Root strain of Rickettsia rickettsii has recently been shown to be appropriate for other rickettsiae. Large (2 mm) distinct plaques were formed when chick primary monolayers were infec...

J. E. McDade J. E. Stakebake P. J. Gerone



A rare presentation of hybrid odontogenic tumor involving calcifying cystic odontogenic tumor and plexiform ameloblastoma  

PubMed Central

A hybrid odontogenic tumor comprising two distinct lesions is extremely rare. We presented a hybrid odontogenic tumor composed of a calcifying cystic odontogenic tumor (CCOT) and a plexiform ameloblastoma. This tumor was observed in the anterior area of the mandible of a 17-year-old Indian male. Masses of ghost epithelial cells with the characteristics of CCOT were seen in the lining of the cyst. The odontogenic epithelia with the features of plexiform ameloblastoma were also observed.

Chaubey, Snehal S.; Mishra, Sunil S.; Degwekar, Shirish S.; Chaubey, Saujanya



Calcifying ghost cell odontogenic cyst: A review on terminologies and classifications.  


Calcifying ghost cell odontogenic cyst (CGCOC) is a relatively uncommon odontogenic lesion characterized by varied clinical, radiographical features and biological behavior. CGCOC can exhibit either as a cystic or a solid lesion. Since its first description by Gorlin et al, in 1962, it has been known by different names and classified and sub-classified into various types. In this article we present a case of CGCOC and discuss the related literature regarding the terminology, classification and biological behavior of CGCOC. PMID:23248487

Thinakaran, Meera; Sivakumar, Palanivelu; Ramalingam, Sudhakar; Jeddy, Nadeem; Balaguhan, S



Calcifying aponeurotic fibroma of the big toe with an unusual presentation  

Microsoft Academic Search

We report a case of a rare condition, calcifying aponeurotic fibroma, with an unusual presentation in a 13-year-old girl affecting the big toe. It is a relatively benign condition with a good prognosis following complete surgical excision. Clinically and radiologically it is similar to, and maybe confused with, more sinister lesions, i.e. fibrous hamartoma of infancy, diffuse infantile fibromatosis, nodular

Syed S. Ali; F. A. Butt; A Addison; Phauda R Thebe



Dissolution of Calcified Cholesterol Stones and of Brown and Black Pigment Stones of the Gallbladder  

Microsoft Academic Search

The influence of different solvents on cholesterol and pigment stones was investigated in vitro. Stone analysis was performed chemically, with infrared spectroscopy (IRS), scanning electron microscopy, energy-dispersive X-microanalysis (EDXA) and wave-length-dispersive X-microanalysis (WDXA). Each set of stones came from one source: eight human calcified cholesterol stones (CHS), eight fragments of bovine radiopaque Ca-bilirubinate stones (BBIL), and two complete BBIL. CHS

U. Leuschner; U. Wosiewitz; H. Baumgärtel; M. Leuschner; K. Iwamura; X. Klicic; H. Frenk



Fluoride increases lead concentrations in whole blood and in calcified tissues from lead-exposed rats.  


Higher blood lead (BPb) levels have been reported in children living in communities that receive fluoride-treated water. Here, we examined whether fluoride co-administered with lead increases BPb and lead concentrations in calcified tissues in Wistar rats exposed to this metal from the beginning of gestation. We exposed female rats and their offspring to control water (Control Group), 100mg/L of fluoride (F Group), 30mg/L of lead (Pb Group), or 100mg/L of fluoride and 30mg/L of lead (F+Pb Group) from 1 week prior to mating until offspring was 81 days old. Blood and calcified tissues (enamel, dentine, and bone) were harvested at day 81 for lead and fluoride analyses. Higher BPb concentrations were found in the F+Pb Group compared with the Pb Group (76.7+/-11.0microg/dL vs. 22.6+/-8.5microg/dL, respectively; p<0.001). Two- to threefold higher lead concentrations were found in the calcified tissues in the F+Pb Group compared with the Pb Group (all p<0.001). Fluoride concentrations were similar in the F and in the F+Pb Groups. These findings show that fluoride consistently increases BPb and calcified tissues Pb concentrations in animals exposed to low levels of lead and suggest that a biological effect not yet recognized may underlie the epidemiological association between increased BPb lead levels in children living in water-fluoridated communities. PMID:20188782

Sawan, Rosangela M M; Leite, Giselle A S; Saraiva, Maria C P; Barbosa, Fernando; Tanus-Santos, Jose E; Gerlach, Raquel F



A case of intramuscular cysticercosis diagnosed definitively by mitochondrial DNA analysis of extremely calcified cysts.  


A case of obsolete intramuscular cysticercosis diagnosed definitively by mitochondrial DNA analysis of extremely calcified cysts was reported. X-ray and computed tomography findings highly suggested cysticercosis due to Taenia solium; however, no direct evidence of cysticercosis was obtained through serological or histopathological examinations. Mitochondrial DNA analysis of a histopathological specimen confirmed the causative agent to be the Asian genotype of T. solium. PMID:16406683

Yamasaki, Hiroshi; Nagase, Teruaki; Kiyoshige, Yoshiro; Suzuki, Mamoru; Nakaya, Kazuhiro; Itoh, Yukio; Sako, Yasuhito; Nakao, Minoru; Ito, Akira



Intracoronary imaging for detecting vulnerable plaque.  


It is now generally recognized that acute coronary syndromes most commonly result from disruption of thin-cap fibroatheroma (TCFA), which is characterized by a large necrotic core with an overlying thin-fibrous cap measuring <65 ?m. Recent advances in intracoronary imaging modalities have significantly improved the ability to detect TCFA in vivo. Intravascular ultrasound (IVUS) is perhaps the most promising modality that has been used more than 15 years to evaluate atherosclerotic plaque. IVUS has revealed a lot of the clinical evidence regarding vulnerable plaque detection in live humans. Recently, by analyzing the IVUS acoustic signal before demodulation and scan conversion, IVUS radiofrequency analysis can be used to differentiate adjacent smaller areas of atherosclerotic plaque with heterogeneous composition. Coronary angioscopy allows direct visualization of the coronary artery wall and provides detailed information of the luminal surface of plaque, such as color, thrombus or disruption. Optical coherence tomography imaging, recently been introduced for in vivo human imaging, offers a higher resolution than any other available imaging modality, and can visualize a thin fibrous cap measuring <65 ?m. In this review, we will discuss the features and limitations of each imaging modalities for detecting TCFA. PMID:23370454

Fujii, Kenichi; Hao, Hiroyuki; Ohyanagi, Mitsumasa; Masuyama, Tohru



Positive Vascular Remodeling in Culprit Coronary Lesion is Associated With Plaque Composition: An Intravascular Ultrasound-Virtual Histology Study  

PubMed Central

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=1.19±0.12) had a higher fibrous volume/lesion length (3.85±2.12 mm3/mm vs. 3.04±1.79 mm3/mm, p=0.003) and necrotic core volume/lesion length (1.26±0.89 mm3/mm vs. 0.90±0.66 mm3/mm, p=0.001) than those with negative remodeling (NR) (RI<0.95, n=132, mean RI=0.82±0.09). At the minimal luminal area site, the lesions with PR had a higher fibrous area (5.81±3.17 mm2 vs. 3.61±2.30 mm2, p<0.001), dense calcified area (0.73±0.69 mm2 vs. 0.46±0.43 mm2, p=0.001), and necrotic core area (1.93±1.33 mm2 vs. 1.06±0.91 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.

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



Calcifying Epithelial Odontogenic Tumor in Anterior Maxilla Associated with a Supernumerary Tooth: A Case Report  

PubMed Central

Odontogenic tumors are derived from epithelial, ectomesenchymal and/or mesenchymal elements that are or have been a part of the tooth-forming apparatus. Of all the odontogenic tumors, calcifying epithelial odontogenic tumor accounts for 1% of the cases. Approximately 200 cases have been reported to date. There is no sex predilection, with a 2:1 predilection for the mandible, mostly in the premolar/molar region. It is often locally invasive. Most often, it is associated with an impacted tooth, is asymptomatic and requires biopsy for diagnosis. Presented here is a rare case of an intraosseous calcifying epithelial odontogenic tumor surrounding a supernumerary tooth. Furthermore, the occurrence of this tumor in the anterior maxilla (an uncommon site) in a pediatric patient makes it rarer. Although the present case was asymptomatic, root resorption and displacement of adjacent teeth necessitated its surgical removal. The lesion was surgically enucleated and histopathological examination confirmed calcifying epithelial odontogenic tumor, showing abundant calcifications in the form of Liesegang rings.

Sharma, Urvashi; Gulati, Anubha; Batra, Hemant; Singh, Devinderpreet



Past constraints on the vulnerability of marine calcifiers to massive carbon dioxide release  

NASA Astrophysics Data System (ADS)

Increasing concentrations of carbon dioxide in sea water are driving a progressive acidification of the ocean. Although the associated changes in the carbonate chemistry of surface and deep waters may adversely affect marine calcifying organisms, current experiments do not always produce consistent results for a given species. Ocean sediments record past biological responses to transient greenhouse warming and ocean acidification. During the Palaeocene-Eocene thermal maximum, for example, the biodiversity of benthic calcifying organisms decreased markedly, whereas extinctions of surface dwellers were very limited. Here we use the Earth system model GENIE-1 to simulate and compare directly past and present environmental changes in the marine realm. In our simulation of future ocean conditions, we find an undersaturation with respect to carbonate in the deep ocean that exceeds that experienced during the Palaeocene-Eocene thermal maximum and could endanger calcifying organisms. Furthermore, our simulations show higher rates of environmental change at the surface for the future than the Palaeocene-Eocene thermal maximum, which could potentially challenge the ability of plankton to adapt.

Ridgwell, Andy; Schmidt, Daniela N.



Structure of Dental Plaque and the Plaque-Enamel Interface in Human Experimental Caries  

Microsoft Academic Search

This study describes the ultrastructrure of dental plaque and the plaque-enamel interface after 2 and 3 weeks’ exposure to a cariogenic challenge. Five dental students carried a total of 25 specimens of smooth surface enamel in intraoral acrylic appliances. During the initial 3 days the volunteers refrained from oral hygiene and performed nine daily mouthrinses with 10% (w\\/v) solutions of

B. Nyvad; O. Fejerskov



Fluorescent Green Plaques: Light at the End of the Catheter?  

PubMed Central

The field of vascular molecular imaging is searching for the `holy grail' of an imaging technique that will quantitatively and reliably assess vulnerable coronary plaques. Fluorescence imaging with indocyanine green specifically identifies lipid-rich plaques in rabbits and in human plaques and represents a promising, though invasive, approach.

Mehta, Nehal N.; Rader, Daniel J.



Rayleigh Mixture Model for Plaque Characterization in Intravascular Ultrasound  

Microsoft Academic Search

Vulnerable plaques are the major cause of carotid and coronary vascular problems, such as heart attack or stroke. A correct modeling of plaque echomorphology and composition can help the identification of such lesions. The Rayleigh distribution is widely used to describe (nearly) homogeneous areas in ultrasound images. Since plaques may contain tissues with heterogeneous re- gions, more complex distributions depending

José C. Seabra; Francesco Ciompi; Oriol Pujol; Josepa Mauri; Petia Radeva; Joăo Sanches



Plaque reduction over time of an integrated oral hygiene system.  


This article compares the efficacy of a prototype integrated system (the IntelliClean System from Sonicare and Crest) in the reduction of supragingival plaque to that of a manual toothbrush and conventional toothpaste. The integrated system was compared to a manual toothbrush with conventional toothpaste in a randomized, single-blinded, parallel, 4-week, controlled clinical trial with 100 subjects randomized to each treatment group. There was a low dropout rate, with 89 subjects in the manual toothbrush group (11% loss to follow-up) and 93 subjects in the integrated system group (7% loss to follow-up) completing the study. The Turesky modification of the Quigley and Hein Plaque Index was used to assess full-mouth plaque scores for each subject. Prebrushing plaque scores were obtained at baseline and at 4 weeks after 14 to 20 hours of plaque accumulation. A survey also was conducted at the conclusion of the study to determine the attitude toward the two oral hygiene systems. The integrated system was found to significantly reduce overall and interproximal prebrushing plaque scores over 4 weeks, both by 8.6%, demonstrating statistically significant superiority in overall plaque reduction (P = .002) and interproximal plaque reduction (P < .001) compared to the manual toothbrush with conventional toothpaste, which showed no significant reduction in either overall plaque or interproximal plaque. This study demonstrates that the IntelliClean System from Sonicare and Crest is superior to a manual toothbrush with conventional toothpaste in reducing overall plaque and interproximal plaque over time. PMID:15637975

Nunn, Martha E; Ruhlman, C Douglas; Mallatt, Philip R; Rodriguez, Sally M; Ortblad, Katherine M



Biomechanics of Plaque Rupture: Progress, Problems, and New Frontiers  

Microsoft Academic Search

Plaque rupture has become identified as a critical step in the evolution of arterial plaques, especially as clinically significant events occur in critical arteries. It has become common in the past dozen years or so to consider which plaques are vulnerable, even though not yet ruptured. Thrombotic events have remained significant, but in a context where they are seen as

Peter D. Richardson



Clinical Studies of Plaque Control Agents: An Overview  

Microsoft Academic Search

Dental plaque is massed packed bacterial cells which accumulate on the supra- and subgingival surfaces of the teeth as well as on the oral mucosa. The microorganisms of plaque have been shown to be associated with both dental caries and periodontal disease. This overview of clinical studies of plaque control agents reviews the properties and effects of chemical compounds which

Ralph R. Lobene



Comparison of the Effectiveness of Some Pleural Sclerosing Agents Used for Control of Effusions in Malignant Pleural Mesothelioma: A Review of 117 Cases  

Microsoft Academic Search

Background and Objectives: Management of malignant pleural mesothelioma (MPM) has been an important clinical issue regardless of the treatment modality employed. We aimed to investigate the efficacy of oxytetracycline (OT), Corynebacterium parvum (CP), and nitrogen mustard (NM) in the management of pleural effusion associated with MPM. Methods: One hundred and seventeen patients who had stage-2 MPM or over according to

Hasan Bayram; Füsun Topçu; Ömer Satici



Antiangiogenic therapy for normalization of atherosclerotic plaque vasculature: a potential strategy for plaque stabilization.  


Angiogenesis within human atherosclerotic plaques has an important role in plaque progression as immature blood vessels leak red blood cells and inflammatory mediators into the plaque center. Accumulation of free cholesterol from red blood cell membranes potentially increases the size of the necrotic core and triggers a chain of events that promote plaque destabilization. Antiangiogenic agents have been shown to prune some tumor vessels and 'normalize' the structure and function of the remaining vasculature, thereby improving the access of chemotherapeutic agents to tumors. We propose that antiangiogenic therapy can similarly stabilize vulnerable 'rupture-prone' plaques by pruning and normalizing immature intraplaque vessels, preventing further intraplaque hemorrhage. This normalization would limit necrotic core enlargement, further luminal narrowing and the degree of inflammation. Such normalization has been realized using vascular endothelial growth factor antagonists for the treatment of cancer and age-related macular degeneration. The development of this novel approach to prevent plaque progression might add to the armamentarium of preventive measures for acute myocardial infarction, stroke and sudden cardiac death. PMID:17712362

Jain, Rakesh K; Finn, Aloke V; Kolodgie, Frank D; Gold, Herman K; Virmani, Renu



MRI plaque imaging reveals high-risk carotid plaques especially in diabetic patients irrespective of the degree of stenosis  

Microsoft Academic Search

BACKGROUND: Plaque imaging based on magnetic resonance imaging (MRI) represents a new modality for risk assessment in atherosclerosis. It allows classification of carotid plaques in high-risk and low-risk lesion types (I-VIII). Type 2 diabetes mellitus (DM 2) represents a known risk factor for atherosclerosis, but its specific influence on plaque vulnerability is not fully understood. This study investigates whether MRI-plaque

L Esposito; T Saam; P Heider; Angelina Bockelbrink; Jaroslav Pelisek; D Sepp; R Feurer; C Winkler; T Liebig; K Holzer; O Pauly; S Sadikovic; B Hemmer; H Poppert



Magnetic resonance imaging of carotid plaque inflammation in acute coronary syndromes: A sign of multisite plaque activation  

Microsoft Academic Search

Widespread plaque inflammation has been demonstrated in acute coronary syndromes (ACS). We evaluated signs of plaque inflammation in carotid arteries of patients with ACS by contrast-enhanced magnetic resonance imaging (MRI).Carotid MRI was performed in 13 patients with ACS and in 9 controls having at least 1 carotid plaque with a stenosis ?40%. MRI criteria of plaque inflammation were: increased T2

Antonella Lombardo; Vittoria Rizzello; Luigi Natale; Mariaelena Lombardi; Stefano Coli; Francesco Snider; Lorenzo Bonomo; Filippo Crea



Simple Method for Plating Escherichia coli Bacteriophages Forming Very Small Plaques or No Plaques under Standard Conditions  

Microsoft Academic Search

The use of low concentrations (optimally 2.5 to 3.5 g\\/ml, depending on top agar thickness) of ampicillin in the bottom agar of the plate allows for formation of highly visible plaques of bacteriophages which otherwise form extremely small plaques or no plaques on Escherichia coli lawns. Using this method, we were able to obtain plaques of newly isolated bacteriophages, propagated

J. M. Los; Piotr Golec; G. Wegrzyn; A. Wegrzyn; M. Los



Study of non-destructive methods to evaluate plaque properties and non-Newtonian blood flow inside arteries with plaque  

Microsoft Academic Search

Knowledge about the flow profile characteristics of blood inside vascular arteries in the presence of plaque is of greater interest to cardio vascular research community. Along with the flow pattern, the study of mechanical properties of the artery vessel wall and plaque is an important phenomenon that supports the detection and diagnosis of the vulnerability of plaque inside the arteries.

Rajagopa Balakrishnan



Impact of Plaque Composition on Long-Term Clinical Outcomes in Patients with Coronary Artery Occlusive Disease  

PubMed Central

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 61.7±12.2 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.

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



Malignant pleural mesothelioma in Turkey, 2000-2002.  


Both asbestos and erionite related malignant pleural mesothelioma (MPM) is a serious health problem in Turkey. Erionite has a higher potency in the lung than asbestos and familial clustering of malignant mesothelioma suggests a genetic predisposition to this cancer among affected individuals. Neither Simian virus 40 (SV40) nor human herpes virus 8 (HHV-8) are co-factors in the pathenogenesis of environmentally induced mesothelioma. A survival advantage has been demonstrated in patients with asbestos-induced mesothelioma compared with erionite-induced mesothelioma. This together with the proliferation index (PI) can be used as an independent prognostic factor for patients with malignant pleural mesothelioma. It is envisaged that the application of these prognostic approaches together with the new TNM staging system will allow investigations to be more precisely carried out and evaluated. PMID:15261427

Emri, Salih; Demir, Ahmet U



The gelatinous plaque: its relation to coronary atherosclerosis.  


The relations between the gelatinous plaque and the atherosclerotic plaque were investigated on more than 500 subjects aged 1--40 years. The appearance of the light microscopic aspect of the gelatinous plaque was related to a particular: a) evolution of the process of histolysis involving branch pads and thickened intimas; b) insudation, occurring in nodular proliferations of intimal smooth muscle cells; c) stage of atheroma formation. The results showed that the term gelatinous plaque did not refer to an independent, early atherosclerotic lesion, or a true precursor of advanced lesions,but to an intermediate, transitional stage in the complex histogenesis of the atherosclerotic plaque. PMID:7394458

Velican, C; Velican, D


Pegylated liposomal doxorubicin in malignant pleural mesothelioma: a possible guardian for long-term survival  

PubMed Central

Malignant pleural mesothelioma is a rare and aggressive malignancy of the pleura correlated with exposure to asbestos, with a medium survival of 11–12 months after diagnosis. A case of a 67-year-old male who had previously worked in the asbestos industry and is a current smoker is reported. The computed tomography evaluation revealed a right pleural mass with pleural thickening, and the pleural biopsy confirmed a diagnosis of malignant pleural mesothelioma. He was treated with chemotherapy consisting of etoposide, paclitaxel, and pegylated liposomal doxorubicin hydrochloride. After completion of chemotherapy, radiologic evaluation confirmed a reduction of pleural thickening and improvement in his symptoms. A complete presentation of each drug formulation and characteristics are also included in this paper. The patient’s follow-up is continuing, and computed tomography reveals stable disease 9 years after initial examination.

Zarogoulidis, Paul; Mavroudi, Maria; Porpodis, Konstantinos; Domvri, Kalliopi; Sakkas, Antonios; Machairiotis, Nikolaos; Stylianaki, Aikaterini; Tsiotsios, Anastasios; Courcoutsakis, Nikolaos; Zarogoulidis, Konstantinos



Regional differences in pleural lymphatic albumin concentration in sheep  

SciTech Connect

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.

Albertine, K.H.; Schultz, E.L.; Wiener-Kronish, J.P.; Staub, N.C.



Junior doctor training in pleural procedures: a quality survey.  


Pleural effusion is a common medical condition encountered by doctors. This study was conducted to ascertain the level of junior doctor (physician-in-training) training, knowledge and supervision in the management of pleural effusion. The information was collected with the help of a proforma, from 49 junior medical doctors working in a metropolitan health service. All the doctors who participated in the survey had come across pleural effusion in their practice, but only 67% of doctors had any experience with the procedure of diagnostic thoracentesis. Sixty-seven percent of doctors conveyed that they will refer the majority of cases (75-100%) for radiological-guided thoracentesis. The main reasons for referral for radiologically guided procedure were lack of experience (65%), fear of complications (61%), lack of supervision and guidance (49%), and lack of time (38%). A significant proportion of doctors interviewed (47%) was unaware of the major indications for intercostal tube drainage of parapneumonic effusions. This survey highlights deficiencies in junior doctor knowledge and procedural skills. Junior doctor training should be tailored to increase the 'hands-on' training time and increased patient contact. Senior clinicians should be given sufficient 'protected time' for teaching and training. PMID:23324092

Aiyappan, V; Munawar, A; Thien, F



Lung resection for lung cancer after pleural empyema.  


Background The association of pleural empyema and lung cancer has traditionally been considered as a contraindication for lung resection. However, several aspects of this problem still remain controversial.Materials and Methods A retrospective study was conducted including 15 patients (12 pneumonectomies and 3 lobectomies) who underwent a lung resection for primary lung cancer after previous pleural empyema.Results In all but one patient, empyema was treated by chest tube for 15 to 40 days. In only two patients, the diagnosis of empyema preceded the diagnosis of lung cancer. Among patients with pneumonectomy, a good intrapleural cleavage plane existed in only one patient with no signs of infection. In each patient with a lobectomy, preoperative chest tube aspiration took 20 to 30 days and in none of them intraoperative signs of infection existed. In patients with pneumonectomy, empyema without bronchopleural fistula occurred in two patients, while in one patient, empyema was associated with fistula. The operative morbidity after pneumonectomy was 33.3%.Conclusion Association of pleural empyema and lung cancer is not an absolute contraindication for surgery. Potentially curative operation is possible, provided a full control of infection is achieved. PMID:23754321

Subotic, Dragan; Petrov, Danail; Gajic, Milan



Significance of ABCA1 in human carotid atherosclerotic plaques  

PubMed Central

The ATP-binding cassette transporter A1 (ABCA1) is an important effector in the regulation of cholesterol efflux from cells. In this study, we assessed the role of ABCA1 in human carotid atherosclerotic plaques (CAPs). We found that ABCA1 and retinoid X receptor ? (RXR?) mRNAs were significantly increased in the atherosclerotic plaques compared to control arteries. The increased ABCA1 mRNA correlated with that of RXR? in plaques. According to the modified American Heart Association plaque classification, atherosclerotic specimens were assigned to three grades, and ABCA1 and RXR? mRNA levels were compared across plaques of different grades. Resultantly, plaques of grade II and III exhibited higher mRNA levels than grade I, but there was no difference in mRNA levels between plaques of grade II and III. By contrast, ABCA1 and RXR? protein levels were notably reduced in plaques relative to control tissues. Similarly, plaques of grade II and III exhibited lower ABCA1 and RXR? protein levels than grade I, and there was no difference in protein levels between plaques of grade II and III. Our findings suggest that decreased ABCA1 protein plays a key role in the pathogenesis of CAP; the regulation of ABCA1 may be mediated by RXR? and ABCA1 mRNA levels may serve as an indicator for plaque stability.




Imaging of coronary atherosclerosis and identification of the vulnerable plaque  

PubMed Central

Identification of the vulnerable plaque responsible for the occurrence of acute coronary syndromes and acute coronary death is a prerequisite for the stabilisation of this vulnerable plaque. Comprehensive coronary atherosclerosis imaging in clinical practice should involve visualisation of the entire coronary artery tree and characterisation of the plaque, including the three-dimensional morphology of the plaque, encroachment of the plaque on the vessel lumen, the major tissue components of the plaque, remodelling of the vessel and presence of inflammation. Obviously, no single diagnostic modality is available that provides such comprehensive imaging and unfortunately no diagnostic tool is available that unequivocally identifies the vulnerable plaque. The objective of this article is to discuss experience with currently available diagnostic modalities for coronary atherosclerosis imaging. In addition, a number of evolving techniques will be briefly discussed. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7

de Feyter, P.J.; Serruys, P. W.; Nieman, K.; Mollet, N.; Cademartiri, F.; van Geuns, R. J.; Slager, C.; van der Steen, A.F.W.; Krams, R.; Schaar, J.A.; Wielopolski, P.; Pattynama, P.M.T.; Arampatzis, A.; van der Lugt, A.; Regar, E.; Ligthart, J.; Smits, P.



Diagnostic value of tumor markers for differentiating malignant and benign pleural effusions of Iranian patients  

Microsoft Academic Search

In order to evaluate the diagnostic yield of tumor markers in differentiating malignant and benign pleural effusions, we carried\\u000a out a prospective study in a group of Iranian people. Pleural and serum levels of carcinoembryonic antigen (CEA), carbohydrate\\u000a antigen 15-3 (CA15-3), neuron-specific enolase (NSE) and cancer antigen 125 (CA 125) were assayed prospectively in patients\\u000a with pleural effusion (40 malignant

Sied Mohammad Ali Ghayumi; Samrad Mehrabi; Mehrnossh Doroudchi; Abbas Ghaderi



Thoracoscopic, histological, and clinical findings in nine case of rheumatoid pleural effusion.  

PubMed Central

A characteristic thoracoscopic picture of a granular parietal pleural surface was found in nine patients with rheumatoid pleurisy. Characteristic changes could be identified histopathologically in material obtained by biopsy. The rheumatoid pleural effusion resolved within an average of 14 months and no serious complications developed after the pleurisy. It is concluded that in rheumatoid pleural effusion a positive diagnosis can be made by thoracoscopy, preferably supported by the identification of microscopic structural changes in the parietal pleura. Images

Faurschou, P; Francis, D; Faarup, P



Effect of mechanical ventilation on regional variation of pleural liquid thickness in rabbits.  


We studied the effect of ventilation on the regional distribution of pleural liquid thickness in anesthetized rabbits. Three transparent pleural windows were made between the second and eight intercostal space along the midaxillary line of the right chest. Fluorescein isothiocyanate-labeled dextran (1 ml) was injected into the pleural space through a rib capsule and allowed to mix with the pleural liquid. The light emitted from the pleural space beneath the windows was measured by fluorescence videomicroscopy at a constant tidal volume (20 ml) and two ventilation frequencies (20 and 40 breaths/min). Pleural liquid thickness was determined from the light measurements after in vitro calibration of pleural liquid collected postmortem. At 20 breaths/min, pleural liquid thickness increased with a cranial-caudal distance from 5 microns at the second to third intercostal space to 30 microns at the sixth through eighth intercostal space. At 40 breaths/min, pleural space thickness was unchanged at the second to third intercostal space but increased to 46 microns at the sixth through eighth intercostal space. To determine this effect on pleural liquid shear stress, we measured relative lung velocity from videomicroscopic images of the lung surface through the windows. Lung velocity amplitude increased with cranial-caudal distance and with ventilation frequency. Calculated shear stress amplitude was constant with cranial-caudal distance but increased with ventilation frequency. Thus, pleural liquid thickness is matched to the relative lung motion so as to maintain a spatially uniform shear stress amplitude in pleural liquid during mechanical ventilation. PMID:9087944

Wang, P M; Lai-Fook, S J



Enucleation versus plaque irradiation for choroidal melanoma.  


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. PMID:3174030

Straatsma, B R; Fine, S L; Earle, J D; Hawkins, B S; Diener-West, M; McLaughlin, J A



Enucleation versus plaque irradiation for choroidal melanoma  

SciTech Connect

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.

Straatsma, B.R.; Fine, S.L.; Earle, J.D.; Hawkins, B.S.; Diener-West, M.; McLaughlin, J.A.



The pathogenesis of the low pleural fluid pH in esophageal rupture.  


To determine the possible mechanisms responsible for the low pH pleural effusion associated with esophageal rupture we evaluated the following possibilities: (1) gastric acid reflux, (2) bacterial metabolism, and (3) leukocyte metabolism. Neither elimination of gastric hydrogen ion contribution by distal esophageal ligation nor elimination of bacteria with antibiotics prevented the progressive fall in pleural fluid pH after esophageal rupture. Only elimination of polymorphonuclear leukocytes from the pleural space by rendering animals leukopenic with nitrogen mustard, prevented a low pH effusion after esophageal rupture. It appears that pleural fluid leukocyte metabolism is primarily responsible for the low pH effusion associated with esophageal rupture. PMID:6859653

Good, J T; Antony, V B; Reller, L B; Maulitz, R M; Sahn, S A



Subarachnoid-Pleural Fistula: Applied Anatomy of the Thoracic Spinal Nerve Root  

PubMed Central

Subarachnoid-pleural fistula (SPF) is a rare complication of chest or spine operations for neoplastic disease. Concomitant dural and parietal pleural defects permit flow of cerebrospinal fluid into the pleural cavity or intrapleural air into the subarachnoid space. Dural injury recognized intraoperatively permits immediate repair, but unnoticed damage may cause postoperative pleural effusion, intracranial hypotension, meningitis, or pneumocephalus. We review two cases of SPF following surgical intervention for chest wall metastatic disease to motivate a detailed review of the anatomy of neural, osseous, and ligamentous structures at the intervertebral foramen. We further provide recommendations for avoidance and detection of such complication.

Shamji, Mohammed F.; Sundaresan, Sudhir; Da Silva, Vasco; Seely, Jean; Shamji, Farid M.



Nuclear Factor-?B Affects Tumor Progression in a Mouse Model of Malignant Pleural Effusion  

PubMed Central

We developed a novel mouse model of malignant pleural effusion (MPE) by injecting Lewis lung cancer (LLC) cells directly into the pleural space of syngeneic C57B/6 mice. The pleural effusions in this model share common cellular and biochemical features with human MPEs. Implantation and growth of pleural tumors triggers a host inflammatory response characterized by a mixed inflammatory cell influx into the pleural fluid. LLC cells exhibited high basal nuclear factor (NF)-?B activity in vitro and in vivo, which we used to drive expression of a NF-?B–dependent green fluorescent protein-firefly luciferase fusion reporter construct. NF-?B–dependent reporter expression allowed intravital tracing of pleural tumors. Inhibition of NF-?B in LLC cells did not affect cell viability in culture; however, injection of LLC cells expressing a dominant NF-?B inhibitor resulted in decreased tumor burden, decreased pleural effusion volume, and decreased pleural effusion TNF-? levels. These studies indicate that tumor NF-?B activity regulates pleural tumor progression. This reproducible model of MPE can be used to further study the influence of specific host and tumor factors on the pathogenesis of MPE and evaluate new therapeutic strategies.

Stathopoulos, Georgios T.; Zhu, Zhiwen; Everhart, M. Brett; Kalomenidis, Ioannis; Lawson, William E.; Bilaceroglu, Semra; Peterson, Todd E.; Mitchell, Daphne; Yull, Fiona E.; Light, Richard W.; Blackwell, Timothy S.



Cellular immune response in multiple sclerosis plaques.  

PubMed Central

Multiple sclerosis plaques were immunohistochemically stained to exhibit cells expressing immune-system antigens. Human leukocyte antigen (HLA)-DR-positive cells formed dense rings around all plaque regions. The majority were reactive microglia/macrophages. Counterstaining with oil red O revealed heavy myelin debris within these cells. They were distinct from astrocytes, which were identified with an antibody to glial fibrillary acidic protein (GFAP) and which did not contain oil red O myelin debris. Numerous leukocytes and microglia were stained with antibody to leukocyte common antigen (LCA). Lymphocytes in cuffs around vessels, along the margins of capillary walls, and, sparingly, in the tissue matrix of affected areas, were stained with antibodies to CD4 (T-helper/inducer) and CD8 (T-cytotoxic/suppressor). In experimental allergic encephalomyelitis (EAE) induced in Lewis rats, a similar proliferation of Ia-positive (OX6, OX17) cells displaying reactive microglia/macrophage morphology was observed. These Ia-positive cells also were easily distinguished from GFAP-positive astrocytes. The results suggest that macrophages/reactive microglia, and not astrocytes, express class II MHC antigens in multiple sclerosis and EAE plaques. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9

Boyle, E. A.; McGeer, P. L.



Cataractogenesis after Cobalt-60 eye plaque radiotherapy  

SciTech Connect

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.

Kleineidam, M.; Augsburger, J.J. (Wills Eye Hospital, Philadelphia, PA (United States)); Hernandez, C.; Glennon, P.; Brady, L.W. (Hahnemann Univ., Philadelphia, PA (United States))



Angiogenesis in human coronary atherosclerotic plaques.  

PubMed Central

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

O'Brien, E. R.; Garvin, M. R.; Dev, R.; Stewart, D. K.; Hinohara, T.; Simpson, J. B.; Schwartz, S. M.



Predominance of heavily calcified coccolithophores at low CaCO3 saturation during winter in the Bay of Biscay.  


Coccolithophores are an important component of the Earth system, and, as calcifiers, their possible susceptibility to ocean acidification is of major concern. Laboratory studies at enhanced pCO(2) levels have produced divergent results without overall consensus. However, it has been predicted from these studies that, although calcification may not be depressed in all species, acidification will produce "a transition in dominance from more to less heavily calcified coccolithophores" [Ridgwell A, et al., (2009) Biogeosciences 6:2611-2623]. A recent observational study [Beaufort L, et al., (2011) Nature 476:80-83] also suggested that coccolithophores are less calcified in more acidic conditions. We present the results of a large observational study of coccolithophore morphology in the Bay of Biscay. Samples were collected once a month for over a year, along a 1,000-km-long transect. Our data clearly show that there is a pronounced seasonality in the morphotypes of Emiliania huxleyi, the most abundant coccolithophore species. Whereas pH and CaCO(3) saturation are lowest in winter, the E. huxleyi population shifts from <10% (summer) to >90% (winter) of the heavily calcified form. However, it is unlikely that the shifts in carbonate chemistry alone caused the morphotype shift. Our finding that the most heavily calcified morphotype dominates when conditions are most acidic is contrary to the earlier predictions and raises further questions about the fate of coccolithophores in a high-CO(2) world. PMID:22615387

Smith, Helen E K; Tyrrell, Toby; Charalampopoulou, Anastasia; Dumousseaud, Cynthia; Legge, Oliver J; Birchenough, Sarah; Pettit, Laura R; Garley, Rebecca; Hartman, Sue E; Hartman, Mark C; Sagoo, Navjit; Daniels, Chris J; Achterberg, Eric P; Hydes, David J



Intravascular probe for detection of vulnerable plaque  

NASA Astrophysics Data System (ADS)

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.

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



The ultrastructure of the organic phase associated with the inorganic substance in calcified tissues.  


An organic phase is closely associated with the mineral substance is all calcified matrices, where it can be demonstrated as crystal-bound proteins by biochemical methods and as crystal ghosts by electron microscopy. Interest in crystal ghosts derives chiefly from the observation that they have the same shape, arrangement, and orientation as inorganic crystallites, which suggests they may have a role in their formation. Histochemically, crystal ghosts of epiphyseal cartilage react with colloidal iron (pH 2.0), acidic phosphotungstic acid, ruthenium red, and a number of cations including calcium, barium, magnesium, lanthanum, strontium, and terbium chloride. Their reactivity is removed by methylation and only incompletely restored by saponification. Moreover, the crystal ghosts located at the periphery of the calcified areas contain vic-glycol groups, as shown by their reactivity with periodic acid-silver nitrate and periodic acid-thiosemicarbazide-osmium. All these reactions show that the crystal ghosts of epiphyseal cartilage contain acidic, probably sulfate groups and, at least initially, vic-glycol groups. Their reactivity decreases as the calcification process is completed. Although the available data are not sufficient to allow a full understanding of the nature and function of these structures, they seem to play an important role in calcification. The hypothesis is presented that crystal ghosts are preformed in calcifying matrices and are activated by the unmasking of the reactive groups in their polymeric molecule; the unmasked groups then link up with inorganic ions in such a way to form organic-inorganic structures the inorganic ions of which are arranged in an apatitelike configuration and the filamentlike shape of which is the same as that of the polymeric molecule. PMID:3042232

Bonucci, E; Silvestrini, G; Di Grezia, R



Extended replacement of a calcified ascending aorta in adulthood sporadic, diffuse type, supravalvular aortic stenosis.  


The diffuse variant of supravalvular aortic stenosis (SVAS) is one of the most rare congenital vascular pathological conditions of adulthood. Due to its rarity, surgical treatment of this clinical entity is still a matter of debate because of the variable degree of aortic narrowing, presence of multilevel obstruction, and age at presentation, all factors that strongly influence the disease prognosis. We report a case of an adult patient with an extremely calcified diffuse SVAS who underwent successful replacement of the ascending aorta through the interposition of a tubular prosthesis. Six months' follow-up showed complete relief of the aortic gradient and an improvement in clinical performance. PMID:21546371

Borghetti, Valentino; D'Addario, Giancarlo; Bravi, Ilaria; Pardinia, Alessandro



Resistance to extinction of low fitness virus subjected to plaque-to-plaque transfers: diversification by mutation clustering 1 1 Edited by J. Karn  

Microsoft Academic Search

Plaque-to-plaque transfers of RNA viruses lead to accumulation of mutations and fitness decrease. To test whether continuing plaque-to-plaque transfers would lead to viral extinction, we have subjected several low fitness foot-and-mouth disease virus (FMDV) clones to up to 130 successive plaque transfers, and have analyzed the evolution of plaque titers and genomic nucleotide sequences. No case of viral extinction could

Cristina Escarm??s; Gema Gómez-Mariano; Mercedes Dávila; Ester Lázaro; Esteban Domingo



Role of Adenosine Deaminase Estimation in Differentiation of Tuberculous and Non-tuberculous Exudative Pleural Effusions  

PubMed Central

Background Tuberculosis kills five lakh patients every year in India, commonest being pulmonary tuberculosis and is often associated with effusion. Delay in diagnosis and treatment results in poor prognosis. Several studies have suggested the role of adenosine deaminase (ADA) in the diagnosis of tuberculous pleural effusions, but false-positive results from lymphocytic effusions have also been reported. The purpose of this study is to find out the role of ADA levels in differentiation of tuberculous and non-tuberculous exudative pleural effusions of different etiologies. Methods Ninety-six lymphocytic pleural fluid samples were consecutively selected and divided into two groups: tuberculous (n = 56) and non-tuberculous (n = 40), depending upon the etiology [Malignancy (n = 16), Infectious diseases (n = 18), Pulmonary embolism (n = 1), Collagen vascular diseases (n = 3) and Sarcoidosis (n = 2)]. ADA was estimated in pleural fluid in all the cases. Results In all 56 samples, ADA level of tuberculous group was above diagnostic cut-off (40 U/L), while only one sample was above cut-off in non-tuberculous group (2.5%). The negative predictive value of ADA for the diagnosis of non-tuberculous etiology was 97.5% (39 of 40) lymphocytic pleural effusion patients. Conclusions In this study, ADA levels in nontuberculous exudative pleural effusions rarely exceeded the cut-off; set for tuberculous disease. The pleural fluid ADA levels were significantly higher in tuberculous exudative pleural effusions when compared with non-tuberculous exudative pleural effusions. Keywords Adenosine deaminase; Tuberculous effusion; Pleural fluid; Exudative pleural effusions

Gupta, Bharat Kumar; Bharat, Vinay; Bandyopadhyay, Debapriya



Computer Simulations of Atherosclerotic Plaque Growth in Coronary Arteries  

PubMed Central

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.

Liu, Biyue; Tang, Dalin



Primary pleural squamous cell carcinoma misdiagnosed as localized mesothelioma: a case report and review of the literature  

PubMed Central

Primary pleural squamous cell carcinoma is very rare, and there is a lack of experience in the diagnosis and treatment of this condition. An asymptomatic 75-year-old man was referred to us after a right pleural nodule was found on computed tomography during a routine health examination. He underwent surgery for his pleural tumor twice over the following 2 years. Histopathological examination eventually led to a diagnosis of primary pleural squamous cell carcinoma.



The interface sign: a computed tomographic sign for distinguishig pleural and intra-abdominal fluid  

SciTech Connect

On computed tomographic scans of the upper abdomen the interface sign can help distinguish pleural and intra-abdominal fluid readily and accurately.A hazy interface between the fluid and liver or spleen is characteristic of pleural fluid. A sharp interface is characteristic of ascites. The interface sign has proved to be accurate in 30 consecutive cases.

Teplick, J.G.; Teplick, S.K.; Goodman, L.; Haskin, M.E.



Resection and perfusion thermochemotherapy: a new approach for the treatment of thymic malignancies with pleural spread  

Microsoft Academic Search

Background. Thymoma and thymic carcinoma with pleural spread have a high rate of locoregional recurrence and poor prognosis. Maximal debulking coupled with aggressive local treatment could offer a chance for cure. This study evaluates the early and midterm results of operation and hyperthermic pleural perfusion with cisplatinum for thymic malignancies.Methods. Fifteen patients (11 men), 20 to 67 years old (10

Yael Refaely; David A Simansky; Michael Paley; Maya Gottfried; Alon Yellin



Randomised controlled trial of intrapleural streptokinase in community acquired pleural infection  

Microsoft Academic Search

BACKGROUND: Standard treatment for pleural infection includes catheter drainage and antibiotics. Tube drainage often fails if the fluid is loculated by fibrinous adhesions when surgical drainage is needed. Streptokinase may aid the process of pleural drainage, but there have been no controlled trials to assess its efficacy. METHODS: Twenty four patients with infected community acquired parapneumonic effusions were studied. All

R. J. Davies; Z. C. Traill; F. V. Gleeson



U.K. Controlled Trial of Intrapleural Streptokinase for Pleural Infection  

Microsoft Academic Search

background Intrapleural fibrinolytic agents are used in the drainage of infected pleural-fluid collec- tions. This use is based on small trials that did not have the statistical power to evaluate accurately important clinical outcomes, including safety. We conducted a trial to clarify the therapeutic role of intrapleural streptokinase. methods In this double-blind trial, 454 patients with pleural infection (defined by

Nicholas A. Maskell; Christopher W. H. Davies; Andrew J. Nunn; Emma L. Hedley; Fergus V. Gleeson; Robert Miller; Rhian Gabe; Glyn L. Rees; Timothy E. A. Peto; Mark A. Woodhead; Janet H. Darbyshire; Robert J. O. Davies



Preoperative Tumor Volume Is Associated With Outcome In Malignant Pleural Mesothelioma  

Microsoft Academic Search

Objectives: Our objective was to analyze the impact of preoperative and postresection solid tumor volumes on outcomes in 47 of 48 consecutive patients undergoing resection for malignant pleural mesothelioma who were treated prospectively and randomized to photodynamic therapy or no photodynamic therapy. Methods: From July 1993 to June 1996, 48 patients with malignant pleural mesothelioma had cytoreductive debulking to 5

Harvey I. Pass; Barbara K. Temeck; Karen Kranda; Seth M. Steinberg; Irwin R. Feuerstein



Pleural space irrigation and modified clagett procedure for the treatment of early postpneumonectomy empyema  

Microsoft Academic Search

Objective: The incidence of postpneumonectomy empyema is 5% to 10%. Approximately half of postpneumonectomy empyemas occur within 4 weeks of pneumonectomy. A bronchopleural fistula is found in more than 80% of the patients. The classic treatment of postpneumonectomy empyema includes parenteral antibiotics, drainage of the pleural space, removal of necrotic tissue, and open pleural packing for many weeks followed by

Farid Gharagozloo; Gregory Trachiotis; Andrew Wolfe; Kevin J. DuBree; James L. Cox



Breath Sound Distribution Images of Patients With Pneumonia and Pleural Effusion  

Microsoft Academic Search

OBJECTIVE: To determine whether breath sound distribution maps can differentiate between patients with pneumonia or pleural effusion versus healthy controls. METHODS: We recorded breath sounds from 20 patients conventionally diagnosed as having pleural effusion, 20 patients conventionally diagnosed as having pneumonia, and 60 healthy controls, of whom 20 served as a learning sample. All subjects were examined with a computer-based

Ram Mor; Igal Kushnir; Jean-Jacques Meyer; Joseph Ekstein; Issahar Ben-Dov



Chemical and immunological features of pleural effusions: comparison between rheumatoid arthritis and other diseases.  

PubMed Central

The value of determination of pleural fluid glucose, pH, lactic dehydrogenase, IgG, IgA, IgM, C3, C4, anti-IgG antibody, and hydroxyproline in distinguishing between pleural effusions caused by rheumatoid arthritis (RA) and those resulting from other diseases was studied. The series comprised seven patients with RA and 115 patients with other diseases including systemic lupus erythematosus, tuberculosis, malignant disease, empyema, pneumonia, congestive heart failure, and nonspecific pleural effusion. The low glucose concentration, the low pH and the low C4 level in rheumatoid pleural effusion were the most valuable diagnostic findings. The presence of anti-IgG antibody in pleural fluid was not specific for RA. The concentration of hydroxyproline in pleural fluid and the pleural fluid-to-plasma hydroxyproline ratio were significantly higher in RA than in tuberculosis and malignant disease. The results support the view that local metabolic and immunological phenomena as well as a high turnover of collagen occur in the pleural cavity in RA.

Pettersson, T; Klockars, M; Hellstrom, P E



Pleurectomy\\/decortication for palliation in malignant pleural mesothelioma: results of surgery  

Microsoft Academic Search

Objective: Surgery can only offer palliation in an attempt to slow the progression of malignant pleural mesothelioma (MPM). We want to assess the effectiveness and safety of pleurectomy\\/decortication in establishing a tissue diagnosis, and controlling pleural fluid accumulation and symptoms in patients with MPM. Methods: We reviewed our pleurectomy results in 100 patients with MPM over a 19 year period.

Ö Soysal; N Karao?lano?lu; S Demircan; S Topçu; ? Ta?tepe; S Kaya; M Ünlü; G Çetin



Role of mesothelial and submesothelial stromal cells in matrix remodeling following pleural injury.  

PubMed Central

The pleural response to injury is a complex and poorly understood multifactorial process that can result in the development of fibrosis or obliteration of the pleural space. Pleural fibroblasts are considered the main source of extracellular matrix but cell culture studies have demonstrated synthesis of matrix components by mesothelial cells. We assessed the mesothelial cell contribution to extracellular matrix during pleural healing using immunohistochemical technique. Paraffin-embedded tissue of 3 normal adult lungs and 7 adults with active pleuritis were studied using monoclonal antibodies to cytokeratin, type IV collagen, vimentin, and type I procollagen (PCI). Normal pleural had a single layer of cytokeratin-positive and PCI-negative mesothelium over a thin, continuous type IV collagen-positive basement membrane and PCI-negative submesothelial stroma. Areas of active pleuritis showed loss of the continuous linear staining with anti-type IV collagen antibody. Coexpression of cytokeratin, vimentin and PCI was identified in spindle and/or cuboidal cells located in the fibrin layer, submesothelial connective tissue layer, or on the pleural surface. These findings suggest that reactive mesothelial cells play an active role in the production of extracellular matrix during pleural injury, and that disruption of the submesothelial basement membrane is a key event in determining subsequent fibrous organization of pleural exudate. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5

Davila, R. M.; Crouch, E. C.



Development of a Rabbit Pleural Cancer Model by Using VX2 Tumors  

PubMed Central

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, 9–15 × 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.

Kreuter, Kelly A.; El-Abbadi, Naglaa; Shbeeb, Alia; Tseng, Lillian; Mahon, Sari Brenner; Narula, Navneet; Burney, Tanya; Colt, Henri; Brenner, Matthew



Factors Influencing Length of Hospital Stay in Patients with Bacterial Pleural Effusion  

Microsoft Academic Search

Background: Factors influencing length of hospital stay have been poorly analyzed in parapneumonic pleural effusions (PPE). Objectives: The aim of this work is to identify the variables that determine increased hospital stay in patients with infectious pleural effusion (PE). Patients and Methods: We analyzed 112 patients with PE: empyema, complicated parapneumonic and non-complicated parapneumonic. Epidemiologic, biochemical, therapeutic and radiological variables

T. Soriano; J. Alegre; C. Alemán; E. Ruiz; A. Vázquez; J. L. Carrasco; R. Segura; A. Ferrer; T. Fernández de Sevilla



Open-Window Thoracostomy and Thoracomyoplasty to Manage Chronic Pleural Empyema  

Microsoft Academic Search

Background. The purpose of this study is to report our 15-year experience treating chronic empyemas after pulmonary resection and tuberculosis.Methods. Open-window thoracostomy and thoracomyoplasty were used to treat 40 patients with chronic pleural empyema characterized by residual empyematic cavity, bronchopleural fistula, and persistent pleural infections that were secondary to tuberculosis (n = 22) or pulmonary resection (n = 18). Between

Mariano Garc??a-Yuste; Guillermo Ramos; José L Duque; Felix Heras; Manuel Castanedo; Luis J Cerezal; José M Matilla



A Plaque Assay for the Simian Rotavirus SA11  

Microsoft Academic Search

SUMMARY A sensitive, quantitative and reproducible plaque assay for the measurement of the simian rotavirus SAII is described. Plaque formation required the presence of the facilitators pancreatin or trypsin and diethylaminoethyl-dextran in the agar overlay. SAII produced plaques in three continuous primate cell lines: MA-Io4, CV-I and LLC-MK2. MA-Io 4 cells were the most sensitive.




The Mutability of Small-Plaque-Forming Encephalomyocarditis Virus  

Microsoft Academic Search

SUMMARY Sixty-four single plaque subclones of a small-plaque-forming mutant of encephalomyocarditis virus, EMC\\/r +, were isolated and titrated. In addition to EMC\\/r + virus, some contained large-plaque-forming virus, EMC\\/r. The selective conditions which prevailed during the growth and iso- lation of the subclones were analysed in detail. All the evidence suggests that only negligible differential selection favouring either the parental

D. C. Breeze; H. Subak-Sharpe



Oral biofilm models for mechanical plaque removal  

PubMed Central

In vitro plaque removal studies require biofilm models that resemble in vivo dental plaque. Here, we compare contact and non-contact removal of single and dual-species biofilms as well as of biofilms grown from human whole saliva in vitro using different biofilm models. Bacteria were adhered to a salivary pellicle for 2 h or grown after adhesion for 16 h, after which, their removal was evaluated. In a contact mode, no differences were observed between the manual, rotating, or sonic brushing; and removal was on average 39%, 84%, and 95% for Streptococcus mutans, Streptococcus oralis, and Actinomyces naeslundii, respectively, and 90% and 54% for the dual- and multi-species biofilms, respectively. However, in a non-contact mode, rotating and sonic brushes still removed considerable numbers of bacteria (24–40%), while the manual brush as a control (5–11%) did not. Single A. naeslundii and dual-species (A. naeslundii and S. oralis) biofilms were more difficult to remove after 16 h growth than after 2 h adhesion (on average, 62% and 93% for 16- and 2-h-old biofilms, respectively), while in contrast, biofilms grown from whole saliva were easier to remove (97% after 16 h and 54% after 2 h of growth). Considering the strong adhesion of dual-species biofilms and their easier more reproducible growth compared with biofilms grown from whole saliva, dual-species biofilms of A. naeslundii and S. oralis are suggested to be preferred for use in mechanical plaque removal studies in vitro.

Verkaik, Martinus J.; Busscher, Henk J.; Rustema-Abbing, Minie; Slomp, Anje M.; Abbas, Frank



Oral biofilm models for mechanical plaque removal.  


In vitro plaque removal studies require biofilm models that resemble in vivo dental plaque. Here, we compare contact and non-contact removal of single and dual-species biofilms as well as of biofilms grown from human whole saliva in vitro using different biofilm models. Bacteria were adhered to a salivary pellicle for 2 h or grown after adhesion for 16 h, after which, their removal was evaluated. In a contact mode, no differences were observed between the manual, rotating, or sonic brushing; and removal was on average 39%, 84%, and 95% for Streptococcus mutans, Streptococcus oralis, and Actinomyces naeslundii, respectively, and 90% and 54% for the dual- and multi-species biofilms, respectively. However, in a non-contact mode, rotating and sonic brushes still removed considerable numbers of bacteria (24-40%), while the manual brush as a control (5-11%) did not. Single A. naeslundii and dual-species (A. naeslundii and S. oralis) biofilms were more difficult to remove after 16 h growth than after 2 h adhesion (on average, 62% and 93% for 16- and 2-h-old biofilms, respectively), while in contrast, biofilms grown from whole saliva were easier to remove (97% after 16 h and 54% after 2 h of growth). Considering the strong adhesion of dual-species biofilms and their easier more reproducible growth compared with biofilms grown from whole saliva, dual-species biofilms of A. naeslundii and S. oralis are suggested to be preferred for use in mechanical plaque removal studies in vitro. PMID:19565279

Verkaik, Martinus J; Busscher, Henk J; Rustema-Abbing, Minie; Slomp, Anje M; Abbas, Frank; van der Mei, Henny C



Hepatitis A with Pleural Effusion, Ascites and Acalculous Cholecystitis  

PubMed Central

Background Hepatitis A virus (HAV) infection constitutes an important health problem in developing countries. It is usually a benign self-limiting disease, but may present with atypical clinical findings. Case Presentation A twelve-year-old male with ascites, pleural effusion, and acalculous cholecystitis during the course of HAV infection is reported. He was managed conservatively and clinical improvement was observed with resolution of HAV infection. Conclusion To our knowledge, this is the first case in which all these three rare complications were observed in a single patient in the early period of disease.

Erdem, Ela; Urganc?, Nafiye; Ceylan, Yasemin; Kara, Nursu; Ozcelik, Gul; Gulec, Seda Geylani



[Pulmonary and pleural reaction patterns to artificial mineral fibers --rockwool].  


Epidemiological and animal studies about the fibrogenic and carcinogenic properties of natural mineral fibers required the development of man made vitreous fibers as substitutes for asbestos containing material. The question about the possible fibrogenic and carcinogenic properties of man-made vitreous fibers is not yet answered. By means of different experimental animal studies we tried to investigate the man made vitreous fibers-related pulmonary and pleural diseases. The experimental administration of rockwool induce lesions in the lung of the rats. The lung showed an extensive granulomatous inflammation. In the observation time of 10 months we did not find any malignant tumor of the lung and the pleura. PMID:7511301

Respondek, M; Voss, B; Wiethege, T; Kerenyi, T; Müller, K M



[Malignant pleural mesothelioma after radiation treatment for Hodgkin lymphoma].  


Malignant mesothelioma is a relatively uncommon malignancy. Although the pathogenesis is primarily related to asbestos, the role of ionizing radiation is more controversial. We report the case of a 41-year-old male who developed pleural mesothelioma. He had both, a prior short asbestos exposure and a thoracic radiotherapy for Hodgkin's disease 26years before. The evidence for radiotherapy as cause for mesothelioma is expanding and the diagnosis of mesothelioma in patients who had previous irradiation should be kept in mind. PMID:23796498

Vandenbos, F; Figueredo, M; Dumon-Gubeno, M-C; Nicolle, I; Tarhini, A; Butori, C; Mouroux, J



Unshelled abalone and corrupted urchins: development of marine calcifiers in a changing ocean.  


The most fragile skeletons produced by benthic marine calcifiers are those that larvae and juveniles make to support their bodies. Ocean warming, acidification, decreased carbonate saturation and their interactive effects are likely to impair skeletogenesis. Failure to produce skeleton in a changing ocean has negative implications for a diversity of marine species. We examined the interactive effects of warming and acidification on an abalone (Haliotis coccoradiata) and a sea urchin (Heliocidaris erythrogramma) reared from fertilization in temperature and pH/pCO(2) treatments in a climatically and regionally relevant setting. Exposure of ectodermal (abalone) and mesodermal (echinoid) calcifying systems to warming (+2°C to 4°C) and acidification (pH 7.6-7.8) resulted in unshelled larvae and abnormal juveniles. Haliotis development was most sensitive with no interaction between stressors. For Heliocidaris, the percentage of normal juveniles decreased in response to both stressors, although a +2°C warming diminished the negative effect of low pH. The number of spines produced decreased with increasing acidification/pCO(2), and the interactive effect between stressors indicated that a +2°C warming reduced the negative effects of low pH. At +4°C, the developmental thermal tolerance was breached. Our results show that projected near-future climate change will have deleterious effects on development with differences in vulnerability in the two species. PMID:21177689

Byrne, Maria; Ho, Melanie; Wong, Eunice; Soars, Natalie A; Selvakumaraswamy, Paulina; Shepard-Brennand, Hannah; Dworjanyn, Symon A; Davis, Andrew R



Unshelled abalone and corrupted urchins: development of marine calcifiers in a changing ocean  

PubMed Central

The most fragile skeletons produced by benthic marine calcifiers are those that larvae and juveniles make to support their bodies. Ocean warming, acidification, decreased carbonate saturation and their interactive effects are likely to impair skeletogenesis. Failure to produce skeleton in a changing ocean has negative implications for a diversity of marine species. We examined the interactive effects of warming and acidification on an abalone (Haliotis coccoradiata) and a sea urchin (Heliocidaris erythrogramma) reared from fertilization in temperature and pH/pCO2 treatments in a climatically and regionally relevant setting. Exposure of ectodermal (abalone) and mesodermal (echinoid) calcifying systems to warming (+2°C to 4°C) and acidification (pH 7.6–7.8) resulted in unshelled larvae and abnormal juveniles. Haliotis development was most sensitive with no interaction between stressors. For Heliocidaris, the percentage of normal juveniles decreased in response to both stressors, although a +2°C warming diminished the negative effect of low pH. The number of spines produced decreased with increasing acidification/pCO2, and the interactive effect between stressors indicated that a +2°C warming reduced the negative effects of low pH. At +4°C, the developmental thermal tolerance was breached. Our results show that projected near-future climate change will have deleterious effects on development with differences in vulnerability in the two species.

Byrne, Maria; Ho, Melanie; Wong, Eunice; Soars, Natalie A.; Selvakumaraswamy, Paulina; Shepard-Brennand, Hannah; Dworjanyn, Symon A.; Davis, Andrew R.



Quantitative laser-induced breakdown spectroscopy analysis of calcified tissue samples  

NASA Astrophysics Data System (ADS)

We report on the application of laser-induced breakdown spectroscopy (LIBS) to the analysis of important minerals and the accumulation of potentially toxic elements in calcified tissue, to trace e.g. the influence of environmental exposure, and other medical or biological factors. This theme was exemplified for quantitative detection and mapping of Al, Pb and Sr in representative samples, including teeth (first teeth of infants, second teeth of children and teeth of adults) and bones (tibia and femur). In addition to identifying and quantifying major and trace elements in the tissues, one- and two-dimensional profiles and maps were generated. Such maps (a) provide time/concentration relations, (b) allow to follow mineralisation of the hydroxyapatite matrix and the migration of the elements within it and (c) enable to identify disease states, such as caries in teeth. In order to obtain quantitative calibration, reference samples in the form of pressed pellets with calcified tissue-equivalent material (majority compound of pellets is CaCO 3) were used whose physical properties closely resembled hydroxyapatite. Compounds of Al, Sr and Pb were added to the pellets, containing atomic concentrations in the range 100-10 000 ppm relative to the Ca content of the matrix. Analytical results based on this calibration against artificial samples for the trace elements under investigation agree with literature values, and with our atomic absorption spectroscopy (AAS) cross-validation measurements.

Samek, O.; Beddows, D. C. S.; Telle, H. H.; Kaiser, J.; Liška, M.; Cáceres, J. O.; Gonzáles Ureńa, A.



Spontaneous intracranial hypotension from calcified thoracic disc protrusions causing CSF leak successfully treated with targeted epidural blood patch.  


Spontaneous spinal cerebrospinal fluid (CSF) leaks are increasingly recognized in patients presenting with orthostatic headache and ultimately diagnosed with intracranial hypotension. While the precise cause of these spontaneous leaks is unknown, it is thought to result from underlying weakness in the spinal meninges and may be associated with meningeal diverticula or Tarlov cysts. Rarely, calcified intervertebral discs or bony osteophytes can result in CSF leakage, which has been described in the surgery literature but not well recognized in the radiology literature. The authors present three cases of patients presenting with CSF leaks from calcified thoracic disc protrusions that were successfully treated with epidural blood patches. PMID:23395554

Allmendinger, Andrew M; Lee, Thomas C



Plaque stability and the southern European paradox.  


Differences between European countries in coronary heart disease mortality were initially described in the 20th century, and albeit less dramatic than first reported, these differences remain substantial. Three main hypotheses have been proposed to explain the so-called "Mediterranean paradox": a) underestimation of coronary heart disease mortality due to methodological flaws; b) the "lag time" hypothesis, and c) the traditional Mediterranean diet and lifestyle. In this manuscript we present and discuss another possible explanation for the Mediterranean paradox related to the higher prevalence and and incidence of stable atheromatous plaques in this area. Full English text available PMID:23485186

Dégano, Irene R; Elosua, Roberto; Kaski, Juan C; Fernández-Bergés, Daniel J; Grau, María; Marrugat, Jaume



Plaque stability and the southern European paradox.  


Differences between European countries in coronary heart disease mortality were initially described in the 20th century, and albeit less dramatic than first reported, these differences remain substantial. Three main hypotheses have been proposed to explain the so-called "Mediterranean paradox": a) underestimation of coronary heart disease mortality due to methodological flaws; b) the "lag time" hypothesis, and c) the traditional Mediterranean diet and lifestyle. In this manuscript we present and discuss another possible explanation for the Mediterranean paradox related to the higher prevalence and and incidence of stable atheromatous plaques in this area. PMID:23078876

Dégano, Irene R; Elosua, Roberto; Kaski, Juan C; Fernández-Bergés, Daniel J; Grau, María; Marrugat, Jaume



[Plaque surgery for Peyronie's disease: heterologous grafts].  


Surgical treatment of Induratio Penis Plastica includes conservative procedures (phalloplasty), substitutive procedures (prosthesis) and combined procedures (phalloplasty plus prosthesis). Our policy for conservative treatment is based on radical removal of the plaque and replacement with biological patches. During a 15 year experience we employed lyophilized dura mater, autologous dermal graft, preputial skin, cadaveric dermal graft (AlloDerm), venous graft and porcine SIS (Small Intestine Submucosa) graft. Our experience confirms the superiority of venous grafts, but preliminary results with SIS grafts are encouraging. PMID:12868152

Paradiso, Matteo; Sedigh, Omid; Milan, Gian Luca



Urothelial Plaque Formation in Post-Golgi Compartments  

PubMed Central

Urothelial plaques are specialized membrane domains in urothelial superficial (umbrella) cells, composed of highly ordered uroplakin particles. We investigated membrane compartments involved in the formation of urothelial plaques in mouse umbrella cells. The Golgi apparatus did not contain uroplakins organized into plaques. In the post-Golgi region, three distinct membrane compartments containing uroplakins were characterized: i) Small rounded vesicles, located close to the Golgi apparatus, were labelled weakly with anti-uroplakin antibodies and they possessed no plaques; we termed them “uroplakin-positive transporting vesicles” (UPTVs). ii) Spherical-to-flattened vesicles, termed “immature fusiform vesicles” (iFVs), were uroplakin-positive in their central regions and contained small urothelial plaques. iii) Flattened “mature fusiform vesicles” (mFVs) contained large plaques, which were densely labelled with anti-uroplakin antibodies. Endoytotic marker horseradish peroxidase was not found in these post-Golgi compartments. We propose a detailed model of de novo urothelial plaque formation in post-Golgi compartments: UPTVs carrying individual 16-nm particles detach from the Golgi apparatus and subsequently fuse into iFV. Concentration of 16-nm particles into plaques and removal of uroplakin-negative membranes takes place in iFVs. With additional fusions and buddings, iFVs mature into mFVs, each carrying two urothelial plaques toward the apical surface of the umbrella cell.

Hudoklin, Samo; Jezernik, Kristijan; Neumuller, Josef; Pavelka, Margit; Romih, Rok



Non-invasive detection of vulnerable coronary plaque  

PubMed Central

Critical coronary stenoses have been shown to contribute to only a minority of acute coronary syndromes and sudden cardiac death. Autopsy studies have identified a subgroup of high-risk patients with disrupted vulnerable plaque and modest stenosis. Consequently, a clinical need exists to develop methods to identify these plaques prospectively before disruption and clinical expression of disease. Recent advances in invasive and non-invasive imaging techniques have shown the potential to identify these high-risk plaques. Non-invasive imaging with magnetic resonance imaging, computed tomography and positron emission tomography holds the potential to differentiate between low- and high-risk plaques. There have been significant technological advances in non-invasive imaging modalities, and the aim is to achieve a diagnostic sensitivity for these technologies similar to that of the invasive modalities. Molecular imaging with the use of novel targeted nanoparticles may help in detecting high-risk plaques that will ultimately cause acute myocardial infarction. Moreover, nanoparticle-based imaging may even provide non-invasive treatments for these plaques. However, at present none of these imaging modalities are able to detect vulnerable plaque nor have they been shown to definitively predict outcome. Further trials are needed to provide more information regarding the natural history of high-risk but non-flow-limiting plaque to establish patient specific targeted therapy and to refine plaque stabilizing strategies in the future.

Sharif, Faisal; Lohan, Derek G; Wijns, William




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


Plaque Formation by Mumps Virus and Inhibition by Antiserum  

PubMed Central

Boston and ABC strains of mumps virus produced plaques approximately 1.0 mm in diameter in monolayers of BGM cells. The plaques were circular and either clear or target-like in form. Ricki strain virus produced plaques of similar size and form but, in addition, a red plaque was observed with this agent. The vaccine strain of mumps virus, Jeryl Lynn, produced minute clear plaques approximately 0.3 mm in diameter. Incorporation of diethylaminoethyl (DEAE)-dextran into the overlay medium did not affect the size difference between Jeryl Lynn plaques and those of the other strains. However plaques of the Jeryl Lynn and Ricki strains were more easily visualized when the overlay medium contained 400 ?g/ml of DEAE-dextran. Simultaneous titration by plaque formation and roller tube infectivity showed that these two methods were of equal sensitivity. Virus neutralization by antibody was demonstrated by plaque reduction. Rise in antibody titer was observed in sera from human and animal infection, human vaccination, and rabbit immunization. Images

Flanagan, Thomas D.; Barron, Almen L.



An unusual cause of unilateral pleural effusion in the setting of aortic stenosis: acute myeloid leukemia.  


Pleural effusion has various causes. In the setting of aortic stenosis, new onset pleural effusion is generally considered as a consequence of heart failure. Here, we describe a 50-year-old male patient who had been followed with aortic stenosis for 30 years. During his admission he presented with exertional dyspnea and pleuritic chest pain. He had no other symptoms or findings of cardiac failure. Complete blood count revealed neutrophilic leukocytosis, a normal hemoglobin level and normal platelet count. Left sided pleural effusion was noted on the posteroanterior chest X-ray. Examination of the pleural fluid revealed myeloid blasts. Bone marrow aspiration smear and flow cytometric analysis of the bone marrow and pleural fluid were consistent with acute myeloid leukemia. PMID:17380003

Fatih, Tufan; Selim, Yavuz; Mesut, Ayer; Demirel, Yildirim Naciye; Yuksel, Pekcelen



Lung scan perfusion defects limited to matching pleural effusions: low probability of pulmonary embolism  

SciTech Connect

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.

Bedont, R.A.; Datz, F.L.



Hypoechoic areas on ultrasound images of atheroma are not always diagnostic of fatty plaque  

Microsoft Academic Search

Atherosclerotic plaques in ultrasound (US) images may have bright areas suggestive of fibrous plaque and hypoechoic areas that are often interpreted as fatty plaque. The current study was designed to test the hypothesis that fibrous tissue in atherosclerotic plaques will be hyperechoic or hypoechoic, depending on collagen fiber morphology. Twelve segments of aortic arch containing atherosclerotic plaques obtained from cadavers

Ghasan M. Tabel; Jaroslaw Hepel; Peter Whittaker; Betsy Palal; P. Anthony Chandraratna



Stress analysis of carotid plaque rupture based on in vivo high resolution MRI  

Microsoft Academic Search

Atheromatous carotid plaque rupture is responsible for the majority of ischaemic strokes in the developed world. Plaque rupture has been associated with plaque morphology, plaque components’ properties, inflammation and local stress concentration. High resolution multi-spectral magnetic resonance imaging (MRI) has allowed the plaque components to be visualized in vivo. This study combined the recent advances in finite element analysis (FEA)

Zhi-Yong Li; Simon Howarth; Rikin A. Trivedi; Jean M. U-King-Im; Martin J. Graves; Andrew Brown; Liqun Wang; Jonathan H. Gillard



Plaque rupture with severe pre-existing stenosis precipitating coronary thrombosis. Characteristics of coronary atherosclerotic plaques underlying fatal occlusive thrombi  

Microsoft Academic Search

Ruptured atheromatous plaques were identified by step-sectioning technique as responsible for 40 of 51 recent coronary artery thrombi and 63 larger intimal haemorrhages. The degree of pre-existing luminal narrowing at the site of rupture was decisive for whether plaque rupture caused occlusive thrombosis or just intimal haemorrhage. If the pre-existing stenosis was greater than 90% (histologically determined) then plaque rupture

E Falk



Elevated levels of anti inflammatory IL-10 and pro inflammatory IL-17 in malignant pleural effusions  

PubMed Central

Background Pleural effusions can be caused by highly different underlying diseases and are characterized by complex interactions of various local and circulating cells as well as numerous soluble parameters like interleukins (IL). Knowledge of this complex network can be helpful in order to make the differential diagnosis in known malignant pleural effusions and understand the underlying immunochemistry of each disease or condition. Methods We investigated immunoreactive concentrations of Interleukin 10 (IL-10) and Interleukin 17 (IL-17) in malignant pleural effusions and peripheral blood from patients with bronchial carcinomas and other carcinomas, excluding other conditions such as congestive heart failure (CHF) and pneumonias in twenty four (24) patients (9 men/15 women), 37-74 years (mean:61) with already diagnosed malignant pleural effusions applying the ELISA method. Results The SPSS 15 program for Windows was used. Quantitative analysis showed high concentrations of IL-10 and IL-17 in pleural fluid and blood. Even though IL-17 levels -both blood and pleural- were lower than IL-10’s, statistical correlation between blood and pleural concentations was proven, confirming once more the systematic action of these cytokines. At the same time high IL-17 levels in malignant effusions shows maybe a new perspective in understanding the pathophysiology of malignant pleural effusions. Conclusions Our results confirm the pathogenetic role of these cytokines in malignant pleural effusions combining for the first time a pro- and an anti- inflammatory cytokine. The observation that IL-17 is elevated in malignant pleural effusions may give a new meaning in Virchow’s remarks 100 years ago. Larger number of patients is needed to confirm our hypothesis.



Assessment of plaque assay methods for alphaviruses.  


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

Juarez, Diana; Long, Kanya C; Aguilar, Patricia; Kochel, Tadeusz J; Halsey, Eric S



[Palliative therapy of tumor-induced pleural effusions with radioisotopes].  


Radioactive substances are widely used in the treatment of malignant pleural and peritoneal effusions. Since the instillation of radioactive 198Au rarely yielded long-term therapeutic successes, we examined the effect of 90yttrium silicate in intrapleural instillation. In 74 patients suffering from pleural effusion characterised by a rapid an high relapse tendency, the malignant genesis of the effusion having been confirmed histologically by thoracoscopy or cytologically, 50 mCi of 90yttrium silicate were instilled intrapleurally after maximally complete drainage of the exudate via puncture. In all patients the production of the effusion was clearly reduced under this therapy or was at least temporarily completely discontinued. 63 patients died since initiation of therapy. Their average survival time was about 288 days. 11 patients are still under outpatient follow-up control and did not show any repeated formation of an effusion. No significant side effects have been recorded so far, neither subjectively nor haematologically or via chemical examination in the laboratory. PMID:2470082

Austgen, M



A distinctive colour associated with high iodine content in malignant pleural effusion from metastatic papillary thyroid cancer: a case report  

PubMed Central

Introduction Pleural effusions are a common clinical problem and affect about one million people in the United States and United Kingdom each year. Over 60 causes of pleural effusion have been identified; establishing the definitive aetiology can be difficult, and often requires invasive procedures. Guidelines state that macroscopic examination of the fluid should be the first step in determining the aetiology of a pleural effusion. Papillary thyroid carcinoma is an uncommon cause of malignant pleural effusion, with only 10 cases reported in the literature, their physical characteristics and composition having been rarely described. We describe for the first time a distinctive brown colour of the malignant effusion (despite centrifugation) from a rare case of metastatic papillary thyroid cancer to the pleura, associated with a high pleural fluid iodine content. Such a characteristic may be useful in expediting diagnosis of a malignant pleural effusion in the appropriate clinical context. Case presentation We present the case of a 71-year-old Caucasian man with metastatic papillary thyroid cancer; a large, long-standing, right-sided pleural effusion and a 83-fold higher pleural thyroglobulin level compared to corresponding serum, supporting this malignancy as the cause of the patient’s effusion. The pleural fluid had a distinctive pigmentation similar to iodine-containing antiseptic preparations. Biopsy during medical thoracoscopy confirmed metastatic papillary thyroid carcinoma. Analysis of pleural fluid showed a pleural thyroglobulin level over 80 times that of serum levels (29,000?g/L versus 350ug/L). Pleural fluid iodine content was 23,000ug/L and may account for the fluid’s distinctive pigment, as iodine is an essential component in thyroglobulin and thyroid hormone synthesis. Conclusions Pleural fluid pigmentation may aid diagnosis in the appropriate clinical setting. A distinctive iodine-like brown colour of pleural fluid may represent elevated iodine content and should raise consideration of metastatic thyroid cancer as a cause for a pleural effusion.



Carotid plaque, a subclinical precursor of vascular events  

PubMed Central

Background Carotid atherosclerosis is a known biomarker associated with future vascular disease. The risk associated with small, nonstenotic carotid plaques is less clear. The objective of this study was to examine the association between maximum carotid plaque thickness and risk of vascular events in an urban multiethnic cohort. Methods As part of the population-based Northern Manhattan Study, carotid plaque was analyzed among 2,189 subjects. Maximum carotid plaque thickness was evaluated at the cutoff level of 1.9 mm, a prespecified value of the 75th percentile of the plaque thickness distribution. The primary outcome measure was combined vascular events (ischemic stroke, myocardial infarction, or vascular death). Results Carotid plaque was present in 1,263 (58%) subjects. After a mean follow-up of 6.9 years, vascular events occurred among 319 subjects; 121 had fatal or nonfatal ischemic stroke, 118 had fatal or nonfatal myocardial infarction, and 166 died of vascular causes. Subjects with maximum carotid plaque thickness greater than 1.9 mm had a 2.8-fold increased risk of combined vascular events in comparison to the subjects without carotid plaque (hazard ratio, 2.80; 95% CI, 2.04–3.84). In fully adjusted models, this association was significant only among Hispanics. Approximately 44% of the low-risk individuals by Framingham risk score had a 10-year vascular risk of 18.3% if having carotid plaque. Conclusions Maximum carotid plaque thickness is a simple and noninvasive marker of subclinical atherosclerosis associated with increased risk of vascular outcomes in a multiethnic cohort. Maximum carotid plaque thickness may be a simple and nonexpensive tool to assist with vascular risk stratification in preventive strategies and a surrogate endpoint in clinical trials.

Rundek, T.; Arif, H.; Boden-Albala, B.; Elkind, M.S.; Paik, M.C.; Sacco, R.L.



Plaque distribution and vascular remodeling of ruptured and nonruptured coronary plaques in the same vessel: an intravascular ultrasound study in vivo  

Microsoft Academic Search

OBJECTIVESThis study was designed to identify potential differences between the intravascular ultrasound (IVUS) characteristics of spontaneously ruptured and nonruptured coronary plaques.BACKGROUNDThe identification of vulnerable plaques in vivo may allow targeted prevention of acute coronary events and more effective evaluation of novel therapeutic approaches.METHODSIntravascular ultrasound was used to identify 29 ruptured plaques in arteries containing another nonruptured plaque in an adjacent

Clemens von Birgelen; Wolfgang Klinkhart; Gary S Mintz; Alexandra Papatheodorou; Jörg Herrmann; Dietrich Baumgart; Michael Haude; Heinrich Wieneke; Junbo Ge; Raimund Erbel



Arthroscopic treatment of calcifying tendinitis of the shoulder: Clinical and ultrasonographic follow-up findings at two to five years  

Microsoft Academic Search

From 1996 to 1999, 95 shoulders with calcifying tendinitis of the rotator cuff were treated arthroscopically by the same surgeon and assigned to the same rehabilitation program. The 63 patients matching the inclusion criteria were reviewed after a mean follow-up of 36 months. Preoperative and postoperative clinical functional assessment was performed separately by the same three surgeons using the Constant

Giuseppe Porcellini; Paolo Paladini; Fabrizio Campi; Massimo Paganelli



Generic analysis of the response of calcifying microalgae to an elevation of pCO2 : qualitative vs quantitative analysis  

Microsoft Academic Search

Calcifying microalgae can play a key role in atmospheric CO2 trapping through large scale precipitation of calcium carbonate in the oceans. However, recent experiments revealed that the associated fluxes may be slow down by an increase in atmospheric CO2 concentration. In this paper we design models to account for the decrease in calcification and photosynthesis rates observed after an increase

Olivier Bernard; Antoine Sciandrab; Villefranche-sur-mer FRANCE


Atherosclerotic inflammation triggers osteogenic bone transformation in calcified and stenotic human aortic valves: Still a matter of debate  

Microsoft Academic Search

Sclerotic calcification of the aortic valve is a common disease in advanced age. However, pathophysiologic processes leading to valve calcifications are poorly understood. Transformation of atherosclerotic triggers to osteogenic differentiation is controversially discussed and is thought as a trigger of bone transformation in end stage disease.This study focuses on the transcriptional gene-profiling of severe calcified stenotic human aortic valves to

Thomas Anger; Walter Carson; Michael Weyand; Werner G. Daniel; Martin Hoeher; Christoph D. Garlichs



Increasing Costs Due to Ocean Acidification Drives Phytoplankton to Be More Heavily Calcified: Optimal Growth Strategy of Coccolithophores  

Microsoft Academic Search

Ocean acidification is potentially one of the greatest threats to marine ecosystems and global carbon cycling. Amongst calcifying organisms, coccolithophores have received special attention because their calcite precipitation plays a significant role in alkalinity flux to the deep ocean (i.e., inorganic carbon pump). Currently, empirical effort is devoted to evaluating the plastic responses to acidification, but evolutionary considerations are missing

Takahiro Irie; Kazuhiro Bessho; Helen S. Findlay; Piero Calosi



Artificial plaque removal with Carisolv system: a clinical approach.  


In the present study, removal of artifcial plaque in pits and fissures with the Carisolv system was compared with that of conventional bristle brush methoda in vitro. The results indicate that in the dental clinic, complete plaque removal with the Carisolv is possible, and in addition to acid etching, treated cavity was almost free of debris which might increase sealant retention. PMID:17550047

Yamada, Yoshishige; Hossain, Mozammal; Kimura, Yuichi; Nakamura, Yukio; Masuda, Yoshiko; Shimizu, Yuko; Matsumoto, Koukichi



Scanning Electron Microscope Study of the Formation of Dental Plaque  

Microsoft Academic Search

Few investigations on the development of dental have considered the first changes which can occur on a cleaned tooth surface during the first 4 h of exposure to the Plaque oral environment. The present study has investigated, using the scanning electron microscope, the colonization of enamel surfaces in vivo, and some of the factors influencing plaque formation during the initial

C. A. Saxton



Demonstration of MHC-specific haemolytic plaque-forming cells  

Microsoft Academic Search

IT would be convenient to be able to measure the antibody response to alloantigens of the major histocompatibility complex (MHC) at a cellular level. As MHC alloantigens are expressed on erythrocyte membranes in mice one might suppose that a conventional Jerne plaque assay with enumeration of haemolytic plaque-forming cells (allo-PFC) against a lawn of suitable allogeneic erythrocytes would be straightforward.

Jonathan C. Howard; Jose R. F. Corvalan



No cultural detection of Helicobacter pylori in dental plaque.  


Helicobacter pylori causes human type B gastritis and is involved in the etiology of peptic ulcer disease. The routes of transmission of H. pylori are still unclear. The microorganism may be transmitted orally, since H. pylori has been detected in dental plaques. To confirm the hypothesis that dental plaques are a reservoir of H. pylori, 100 dental plaque specimens from 55 dental surgery patients were incubated on one nonselective and up to four selective agar media for the detection of H. pylori. In addition, urease activity of the plaque material was tested, and the gingival status of the patients was assessed. H. pylori was not cultivated from any of the specimens investigated. Plaque material from 12 patients with moderate and severe gingivitis showed urease activity. The results do not confirm the hypothesis that dental plaques are a relevant reservoir of viable H. pylori cells. However, non-cultivatable forms of H. pylori may survive in dental plaques. Urea cleaving activity of dental plaque may be a marker of gingival inflammation. PMID:7803925

Von Recklinghausen, G; Weischer, T; Ansorg, R; Mohr, C



Aggregative Behavior of Bacteria Isolated from Canine Dental Plaque  

Microsoft Academic Search

Interbacterial adhesion of bacteria isolated from canine dental plaque was assessed by performing a visual coaggregation assay. Using conditions mimicking those likely to be encountered in vivo, the entire cultivable plaque microbiota from a single dog was assessed, and eight (6.7%) unique coaggregation interactions were detected for 120 crosses. Transmission electron microscopy was used to visualize several of the bacteria

David R. Elliott; Michael Wilson; Catherine M. F. Buckley; David A. Spratt



24. View of one of the plaques from Clark Fork ...  

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

24. View of one of the plaques from Clark Fork Vehicle Bridge. Presently located at the Bonner County Historical Museum in Sandpoint, Idaho. A plaque was attached at each end of the bridge. Only one remains. - Clark Fork Vehicle Bridge, Spanning Clark Fork River, serves Highway 200, Clark Fork, Bonner County, ID


Effect of Oil Pulling on Plaque and Gingivitis  

Microsoft Academic Search

Oil pulling is an age-old process mentioned in Charaka Samhita and Sushratha's Arthashastra. This study was conducted to assess the effect of oil pulling on Plaque and Gingivitis. Objectives: (1) To assess the effect of oil pulling on plaque and gingivitis. (2) To monitor its safety on oral soft and hard tissues. Methodology: 10 subjects performed Oil Pulling along with

HV Amith; Anil V Ankola; L Nagesh


The use of indwelling pleural catheters for the management of malignant pleural effusion - direct costs in a dutch hospital.  


Background: Indwelling pleural catheters (IPCs) are increasingly used in the treatment of malignant pleural effusion (MPE). In general, these catheters have been reported to manage MPE efficiently. Unfortunately, insurance companies in the Netherlands do not reimburse these catheters in either first-line treatment or following failed talc pleurodesis. Objectives: Investigation of direct costs of IPC placement. Methods: Retrospective analysis of a prospectively collected database. Direct costs for both catheters and vacuum bottles were calculated. Indicators for indirect costs such as adverse events and complications and the need for additional home care for drainage were registered. Results: Mean costs for IPC amounted to EUR 2,173 and were different between tumor types - mesothelioma: EUR 4,028, breast: EUR 2,204, lung: EUR 1,146 and other: EUR 1,841; p = 0.017. Four patients were admitted to hospital for treatment of complications. Mean costs for IPC placement was similar when inserted as frontline treatment and after failed pleurodesis. Approximately 75% of patients did not need any help from specialized home care. Conclusion: Direct costs for IPC placement turn out to be acceptable when compared with estimated hospitalization costs for pleurodesis treatment. Randomized controlled trials have to be performed to compare the cost-effectiveness of IPCs compared to pleurodesis. PMID:23887083

Boshuizen, Rogier C; Onderwater, Suzanne; Burgers, Sjaak J A; van den Heuvel, Michel M



Flow Cytometry Method as a Diagnostic Tool for Pleural Fluid Involvement in a Patient with Multiple Myeloma  

PubMed Central

Multiple myeloma is a malignant proliferation of plasma cells that mainly affects bone marrow. Pleural effusions secondary to pleural myelomatous involvement have rarely been reported in the literature. As it is rarely detected, we aimed to report a case in which pleural effusion of a multiple myeloma was confirmed as true myelomatous involvement by flow cytometry method. A 52-years old man presented to our clinic with chest and back pain lasting for 3 months. On the chest radiography, pleural fluid was detected in left hemithorax. Pleural fluid flow cytometry was performed. In the flow cytometry, CD56, CD38 and CD138 found to be positive, while CD19 was negative. True myelomatous pleural effusions are very uncommon, with fewer than 100 cases reported worldwide. Flow cytometry is a potentially useful and simple method for detection of pleural fluid involvement in multiple myeloma.

Keklik, Muzaffer; Sivgin, Serdar; Pala, Cigdem; Eroglu, Celalettin; Akyol, Gulsah; Kaynar, Leylagul; Koker, M. Yavuz; Camlica, Demet; Unal, Ali; Cetin, Mustafa; Eser, Bulent



Fluoride in plaque following use of dentifrices containing sodium monofluorophosphate.  


Previous work showed that plaque fluoride increased with increasing NaF content of mouthwashes following daily use. The main aim of this study was to test whether a similar relationship was detectable after regular use of dentifrices containing amounts of sodium monofluorophosphate equivalent to 1000, 1500, and 2500 micrograms F/g. Plaque was collected from three groups, each consisting of approximately 80 children, who had each used one of the dentrifrices for one year. Plaque fluoride increased significantly with increasing Na2FPO3 content of the dentifrices. For the 1000-micrograms-F/g group, plaque fluoride also increased