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1

[Endemic pleural plaques and environmental factors (author's transl)].  

PubMed

In an agricultural town in Burgenland (Austria) we found an increased prevalence of pleural plaques. These calcifying thickenings of the pleura are related to minimal asbestos exposure such as is mesothelioma, but they cannot be regarded as a precancerosis. The increased occurrence of pleural plaques in this town of nearly 3500 inhabitants (in which during 1916 to 1945 asbestos was mined) we first found at the chest x-ray archives of a pulmologic hospital, then by mass radiography and blind comparison with control groups. A photofluoroscopy of 300 persons yielded 16 cases with definite pleural plaques (5.3%) among which were 4 cases with suspected asbestosis and another 14 cases with uncertain pleural plaques (4.7%). The 600 control persons showed no such radiological changes. Interviews wich persons detected for pleural plaques at mass radiography gave no indication that they had occupational asbestos exposure. But asbestos was detected in the soil of vineyards and in the dust of the houses. Asbestos was also detectable in the atmospheric dust by x-ray diffraction and scanning electron microscopic techniques. PMID:749422

Neuberger, M; Gründorfer, W; Haider, M; Königshofer, R; Müller, H W; Raber, A; Riedmüller, G; Schwaighofer, B

1978-12-01

2

The association of pericardial fat with calcified coronary plaque  

PubMed Central

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. Design Participants in the community-based Multi-Ethnic Study of Atherosclerosis underwent a computed tomography scan for the assessment of calcified coronary plaque in 2001/02. We measured the volume of pericardial fat using these scans in 159 whites and blacks without symptomatic coronary heart disease from Forsyth County, NC, aged 55–74 years. Results Calcified coronary plaque was observed in 91 participants (57%). After adjusting for height, a one standard deviation increment in pericardial fat was associated with an increased odds of calcified coronary plaque (odds ratio (95% confidence interval): 1.92 (1.27, 2.90)). With further adjustment of other cardiovascular factors, pericardial fat was still significantly associated with calcified coronary plaque. This relationship did not differ by gender and ethnicity. On the other hand, body mass index and height-adjusted waist circumference were not associated with calcified coronary plaque. Conclusions Pericardial fat is independently associated with calcified coronary plaque.

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

2014-01-01

3

Localized pleural plaques and lung cancer  

SciTech Connect

In a mass chest radiography survey conducted in 1971 for 7,986 residents of three Finnish communities, 604 subjects (7.6%) with pleural plaques but not other asbestos-related radiographic signs were identified. The same number of referents, each individually matched to each plaque carrier on sex, birth year, and community, was selected from among persons in the same source population with no pleural plaques. The two groups were followed for investigation of incidence of lung cancer during 1972-1989. Twenty-eight of those with plaques and 25 referents contracted lung cancer (crude conditional RR = 1.1; CL95 = 0.7, 1.9). The application of the proportional hazards model, with adjustment for sex, age, and residence, resulted in a hazard ratio of 1.1 (CL = 0.6, 1.8). The risk ratio estimate may be biased; hence, the result is inconclusive in regard to the predictive assessment of lung cancer risk among carriers of pleural plaques.

Partanen, T.; Nurminen, M.; Zitting, A.; Koskinen, H.; Wiikeri, M.; Ahlman, K. (Department of Epidemiology and Biostatistics, Institute of Occupational Health, Helsinki (Finland))

1992-01-01

4

Elevated micronucleus frequencies in patients with pleural plaque secondary to environmental exposure to asbestos.  

PubMed

We examined genotoxic damage and frequency of micronuclei in people living in the Bekilli and Suller districts of Denizli city who had been diagnosed with pleural plaques as a result of environmental exposure to asbestos. Peripheral blood samples were obtained from 30 volunteer patients 59-86 years old who did not smoke or consume alcohol and who were diagnosed with calcified pleural plaques. We also examined 30 healthy controls with similar features, who also lived in downtown Denizli. Micronucleus frequencies, nuclear division index, and mitotic index were determined. Micronucleus frequency, nuclear division index, and mitotic index were significantly higher in patients who had been exposed to asbestos than in the controls. We conclude that asbestos had a genotoxic effect, resulting in an increase in micronucleus frequency and other changes in patients diagnosed with pleural plaques secondary to asbestos exposure. PMID:24615025

Gövercin, M; Tomat?r, A G; Evyapan, F; Acikbas, ?; Co?kun, G; Akdag, B

2014-01-01

5

A rotational ablation tool for calcified atherosclerotic plaque removal.  

PubMed

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

2011-12-01

6

Optical and mechanical parameter detection of calcified plaque for laser angioplasty  

NASA Astrophysics Data System (ADS)

Three potential guidance mechanisms for pulsed laser angioplasty were tested for their ability to discriminate between different tissue types. Holmium:YAG laser energy (wavelength=2.1 um, 100 mJ/pulse, 12.7 J/mm2 fluence) was delivered through a 100 um fiber into normal artery, fibrous plaque, and calcified plaque, as well as saline and blood. Plasma emission, mechanical fiber recoil, and acoustic shock wave were all measured during laser irradiation of these different substances. Plasma emission was detected by a photodiode at the proximal end of the fiber. Mechanical fiber recoil was detected using a phono cartridge mechanically coupled to the fiber 60 cm from the distal end. Acoustic sound waves were detected with a hydrophone in close proximity to the target site. The probability of generating plasma emission and the relative magnitudes (1-4) of the mechanical recoil and acoustic signal are as follows: Signal Blood Normal Aorta White Plaque Calcified Plaque plasma 0% 0% 0% 99% acoustic 4 1 1 4 recoil 1 2 2.5 4 A Fourier transform of the acoustic signal showed differences between blood, normal artery or non-calcified plaque, and calcified plaque. Mechanical recoil does not provide additional information. These techniques do not differentiate normal tissue from fibrous plaque but will discriminate calcified plaque from blood, normal artery, and non-calcified plaque. These techniques are relatively easy to implement and provide potentially useful feedback to guide laser ablation. Conclusion: The presence of plasma is a good indicator of calcified plaque; when used in conjunction with the acoustic signal it could indicate whether the fiber catheter is on calcified plaque, non-calcified tissue, or in blood.

Stetz, Mark L.; O'Brien, Kenneth M.; Scott, John J.; Baker, Glenn S.; Deckelbaum, Lawrence I.

1991-05-01

7

Asbestos fibers and pleural plaques in a general autopsy population.  

PubMed

It has been claimed that symmetric lower zone pleural or diaphargmatic plaques are markers of asbestos exposure both in asbestos workers and the general population. In this study, total pulmonary asbestos burden was analyzed for 29 patients selected because pleural plaques were found at autopsy, and the results were compared with values obtained for 25 patients who had no occupational asbestos exposure. The average number of asbestos bodies in the plaque groups was 1732/g wet lung, and in the control group, 42/g wet lung. Uncoated asbestos fibers were extracted from lung and counted, measured, and identified by morphologic examination, electron diffraction, and energy-dispersive x-ray spectroscopy. The total number of fibers/per gram wet lung in the plaque group (114 x 10(3)) was similar to that in the control group (99 x 10(3), as was the number of chrysotile fibers (51 x 10(3) versus 29 x 10(3)). However, the plaque patients had a marked increase in the number of the commercially used high aspect ratio amphiboles, amosite and crocidolite (50 x 10(3) versus 1 x 10(3). A retrospective history of fairly certain asbestos exposure was obtained for 16 of the plaque patients, and such a history correlated strongly with increased numbers of commercial amphiboles in lung. It is concluded that 1) in this general autopsy population, two subgroups of patients are present. About one half of the patients appear to have developed pleural plaques as a result of asbestos exposure, while the etiology of the plaques in the other half is unclear; 2) the presence of pleural plaques correlates with a modest (50-fold) increase in numbers of long high-aspect ratio commercial amphiboles in lung tissue but does not correlate with numbers of chrysotile fibers, noncommercial amphiboles, or the total number of asbestos fibers; 3) asbestos-induced lesions are related to a complex set of mineralogic parameters and not to mere numbers of fibers in lung. PMID:7124910

Churg, A

1982-10-01

8

Pleural plaques and exposure to mineral fibres in a male urban necropsy population  

Microsoft Academic Search

OBJECTIVES--The study aimed to evaluate the risk of pleural plaques according to the degree of past exposure to asbestos, type of amphibole asbestos, and smoking, as well as to estimate the aetiologic fraction of asbestos as a cause of plaques among urban men. METHODS--The occurrence and extent of pleural plaques were recorded at necropsies of 288 urban men aged 33

A Karjalainen; P J Karhunen; K Lalu; A Penttilä; E Vanhala; P Kyyrönen; A Tossavainen

1994-01-01

9

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

2013-01-01

10

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

2010-03-01

11

Technique of percutaneous direct needle puncture of calcified plaque in the superficial femoral artery or tibial artery to facilitate balloon catheter passage and balloon dilation of calcified lesions.  

PubMed

Heavy calcified arterial lesions are challenging to endovascular treatment. Even if a guide wire passes the lesion, calcified plaque can inhibit passage or dilation of the balloon catheter. We developed a novel technique of percutaneous direct needle puncture of calcified plaque (PIERCE) to allow subsequent passage and dilation of the balloon. PIERCE was performed in three patients with superficial femoral artery (SFA) lesions and one patient with a tibial artery lesion. In all four cases, balloon passage and lesion dilatation were achieved. Minor hemorrhage from the punctured site occurred in two patients with SFA lesions, which resolved with stent placement. PMID:24745907

Ichihashi, Shigeo; Sato, Tomoyasu; Iwakoshi, Shinichi; Itoh, Hirofumi; Kichikawa, Kimihiko

2014-05-01

12

Reliability of digital panoramic radiographs in detecting calcified carotid artery atheromatous plaques: A clinical study.  

PubMed

Objectives: The objective of this study was to determine whether digital panoramic radiography is a reliable method to detect calcified carotid artery atheromatous plaques (CCAAP) as compared with ultrasonography. Study Design: Digital panoramic radiographs were obtained from 50 patients who also underwent carotid ultrasound examination. The images were interpreted by trained maxillofacial radiologist for the presence or absence of calcified atheromatous plaques. The extent of carotid calcification on carotid ultrasonography was determined by a trained Sonologist, which was considered as the gold standard assessment. Results: Digital panoramic radiographs had a sensitivity of 76% and specificity of 98.66% in determining CCAAP. There was a high level of agreement between diagnoses, with a kappa value of 0.8. Conclusion: To conclude, digital panoramic radiographs had good sensitivity and high specificity in detecting CCAAP. If properly trained, dentists can detect such plaques and can refer patients to physician for timely medical treatment. PMID:24748296

Khambete, Neha; Kumar, Rahul; Risbud, Mukund; Joshi, Anil

2014-01-01

13

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

PubMed

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

2011-01-01

14

Optical coherence tomography assessment of calcified plaque modification after rotational atherectomy.  

PubMed

Rotational atherectomy (RA) facilitates stent delivery in highly calcified coronary plaques (CCP). However, lesion ablation by RA in angulated segments may be affected by guidewire bias, leading to a non-uniform plaque modification. Intravascular optical coherence tomography (iOCT) is the highest resolution (?10 ?m axial) intravascular imaging modality available for clinical use; furthermore, near infrared light easily penetrates calcium, with significantly fewer artifacts, including no "blooming effect" as seen by intravascular ultrasound. Therefore, it may pose as a unique tool for serial calcium quantification, as related in this article with pre- and post-RA assessment, allowing accurate characterization of plaque modification, as well as quality of stent deployment. The effects of guidewire bias in the debulking process have not been well documented by iOCT. We present a case of lesion preparation by RA affected by guidewire bias in which iOCT revealed unique insights into CCP modification. PMID:22045685

Attizzani, Guilherme F; Patrício, Lino; Bezerra, Hiram G

2013-02-01

15

A descriptive epidemiological study on pleural plaque cases identified from the worker's periodical health examinations in Kitakyushu, Japan.  

PubMed

Thirty-six pleural plaque (PP) cases, were identified from the worker's periodical health examination and were described in terms of its association with occupational exposure to asbestos and radiographic findings. Based on thorough interviews about job histories, 23 (64%) of the cases were classified to have had "definite" and an additional 5 (14%) with "possible" asbestos-exposed job histories. Asbestos-exposed job histories were represented mostly by plumbing and pipe fitting, insulating, and boiler and pipe insulating. The latency period between initial age of asbestos exposure and age at time of initial plaque detection was 31.1 +/- 10.3 yr. Calcified plaques were most prevalent in the diaphragm and the most frequent combination of multi-site PPs was found in the diaphragm and lung fields. All cases were either current or ex-smokers. The findings suggest that subjects with a history of asbestos exposure can be identified through the detection of PPs in chest X-ray films obtained in the worker's periodical health examinations. PMID:8377269

Takahashi, K; Sera, Y; Okubo, T

1993-07-01

16

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

PubMed

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

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

1982-10-01

17

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.

1982-01-01

18

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

2008-04-01

19

Non-calcified coronary atherosclerotic plaque visualization on CT: effects of contrast-enhancement and lipid-content fractions.  

PubMed

Computed tomography (CT) may characterize lipid-rich and presumably rupture-prone non-calcified coronary atherosclerotic plaque based on its Hounsfield-Unit (HU), but still inconclusively. This study aimed to evaluate factors influencing the HU-value of non-calcified plaque using software simulation. Several realistic virtual plaqueburdened coronary phantoms were constructed at 5 ?m resolution. CT scanning was simulated with settings resembling a 64-row multi-detector CT (64-MDCT) and reconstructed at 64-MDCT (0.4 mm) and MicroCT (48 ?m) resolutions. Influences of lumen contrast-enhancement, stenosis-grades, and plaque compositions on plaque visualization were analyzed. Lumen contrast-enhancement and mean plaque HU-value were positively correlated (R(2) > 0.92), with approximately the same slopes for all plaque compositions. Percentage lipid-content and mean plaque HU-value were negatively correlated (R(2) > 0.98). Stenosis-grade and noise had minimal influence on the correlations. Influence of lumen contrast-enhancement on plaque HU-value was following a specific exponentially declining pattern (y = Ae(-?x) + c) from the lumen border until 2-pixel radius. Outside 2-pixel radius, plaque HU-values deviated maximally 5 HU from non-contrast-enhanced reference. Thus, to avoid lumen contrast-enhancement influence, plaques should be measured outside 2-pixel radius from the lumen border. Based on the patterns found, a lumen influence correction algorithm may be developed. HU-based plaque percentage lipid-content determination might serve as an alternative plaque characterization method. However, its applicability is still hindered by many inherent limitations. PMID:23324971

Kristanto, Wisnumurti; van Ooijen, Peter M A; Greuter, Marcel J W; Groen, Jaap M; Vliegenthart, Rozemarijn; Oudkerk, Matthijs

2013-06-01

20

Environmental pleural plaques in residents of a Quebec chrysotile mining town  

SciTech Connect

We report four cases of pleural plaques found at autopsy in individuals who resided in or near the chrysotile mining town of Thetford Mines, Quebec, and who had never been employed in the chrysotile mining and milling industry. Three of these patients were farmers, and one was a road construction worker. Lung asbestos content of these cases was compared with that of a group of nine persons living in the same vicinity who did not have pleural plaques. The plaque group was found to have an equal chrysotile content but about a fourfold elevation in median tremolite content, a statistically significant increase. Fiber sizes were the same in both groups. Also, one plaque case had an elevated level of relatively long titanium oxide fibers. These observations suggest that environmental pleural plaques in this region of Quebec are probably caused by exposure to tremolite derived from local soil and rock and that other types of mineral fibers such as titanium oxide may occasionally also be the cause of such lesions.

Churg, A.; DePaoli, L.

1988-07-01

21

Asbestos-related pleural thickenings in Japanese sake brewers  

Microsoft Academic Search

Summary Asbestos was long used as an additive material for the filtration of many kinds of alcoholic beverages. There has been, however, only one case report of a distiller in Italy showing pleural thickenings and lung parenchymal fibrosis due to exposure to asbestos. We report a retired Japanese sake brewer who showed bilateral calcified pleural plaques on chest X-ray films.

Hiroyuki Horiil; Yukio Nagasakal; Yuichi Yamada

1992-01-01

22

Procoagulant activity of circulating microparticles is associated with the presence of moderate calcified plaque burden detected by multislice computed tomography  

PubMed Central

Background Circulating microparticles (MPs) have been reported to be associated with coronary artery disease (CAD). In this study, we explored the relationship between MPs procoagulant activity and characteristics of atherosclerotic plaque detected by 64-slice computed tomography angiography (CTA). Methods In 127 consecutive patients with CAD but without acute coronary syndrome and who underwent 64-slice CTA, MPs procoagulant activity in plasma (by a thrombin generation test), soluble form of lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) and N(epsilon)-(carboxymethyl) lysine (CML) circulating levels (by ELISA) were measured. A quantitative volumetric analysis of the lumen and plaque burden of the vessel wall (soft and calcific components), for the three major coronary vessels, was performed. The patients were classified in three groups according to the presence of calcium volume: non-calcified plaque (NCP) group (calcium volume (%) = 0), moderate calcified plaque (MCP) group (0 < calcium volume (%) < 1), and calcified plaque (CP) group (calcium volume (%) ? 1). Results MPs procoagulant activity and CML levels were higher in MCP group than in CP or NCP group (P = 0.009 and P = 0.027, respectively). MPs procoagulant activity was positively associated with CML (r = 0.317, P < 0.0001) and sLOX-1 levels (r = 0.216, P = 0.0025). Conclusions MPs procoagulant activity was higher in the MCP patient group and correlated positively with sLOX-1 and CML levels, suggesting that it may characterize a state of blood vulnerability that may locally precipitate plaque instability and increase the risk of subsequent major cardiovascular events.

Del Turco, Serena; Basta, Giuseppina; Mazzarisi, Alessandro; Battaglia, Debora; Navarra, Teresa; Coceani, Michele; Bianchi, Massimiliano; Schlueter, Mathis; Marraccini, Paolo

2014-01-01

23

Semiautomatic segmentation and quantification of calcified plaques in intracoronary optical coherence tomography images  

NASA Astrophysics Data System (ADS)

Coronary calcified plaque (CP) is both an important marker of atherosclerosis and major determinant of the success of coronary stenting. Intracoronary optical coherence tomography (OCT) with high spatial resolution can provide detailed volumetric characterization of CP. We present a semiautomatic method for segmentation and quantification of CP in OCT images. Following segmentation of the lumen, guide wire, and arterial wall, the CP was localized by edge detection and traced using a combined intensity and gradient-based level-set model. From the segmentation regions, quantification of the depth, area, angle fill fraction, and thickness of the CP was demonstrated. Validation by comparing the automatic results to expert manual segmentation of 106 in vivo images from eight patients showed an accuracy of 78+/-9%. For a variety of CP measurements, the bias was insignificant (except for depth measurement) and the agreement was adequate when the CP has a clear outer border and no guide-wire overlap. These results suggest that the proposed method can be used for automated CP analysis in OCT, thereby facilitating our understanding of coronary artery calcification in the process of atherosclerosis and helping guide complex interventional strategies in coronary arteries with superficial calcification.

Wang, Zhao; Kyono, Hiroyuki; Bezerra, Hiram G.; Wang, Hui; Gargesha, Madhusudhana; Alraies, Chadi; Xu, Chenyang; Schmitt, Joseph M.; Wilson, David L.; Costa, Marco A.; Rollins, Andrew M.

2010-11-01

24

Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs  

PubMed Central

Purpose This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs. Materials and Methods One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively. Results There was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value <0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, "With CCAP" and "Without CCAP", there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking. Conclusion This study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health.

Soroushian, Sheila; Ganguly, Rumpa

2013-01-01

25

Accuracy of dual-source CT in the characterisation of non-calcified plaque: use of a colour-coded analysis compared with virtual histology intravascular ultrasound  

PubMed Central

Non-invasive assessment of plaque volume and composition is important for risk stratification and long-term studies of plaque stabilisation. Our aim was to evaluate dual-source computed tomography (DSCT) and colour-coded analysis in the quantification and classification of coronary atheroma. DSCT and virtual histology intravascular ultrasound (IVUS-VH) were prospectively performed in 14 patients. 22 lesions were compared in terms of plaque volume, maximal per cent vessel stenosis and percentages of fatty, fibrous or calcified components. Plaque characterisation was performed with software that automatically segments luminal or outer vessel boundaries and uses CT attenuation for a colour-coded plaque analysis. Good correlation was found for per cent vessel stenosis in DSCT (53 ± 13%) and IVUS (51 ± 14%; r2 = 0.70). Mean volumes for entire plaque and non-calcified atheroma were 68.5 ± 33 mm3 and 56.7 ± 30 mm3, respectively, in DSCT and 60.8 ± 29 mm3 and 55.8 ± 26 mm3, respectively, in IVUS. Mean percentages of fatty, fibrous or calcified components were 28.2 ± 6%, 53.2 ± 9% and 18.7 ± 13%, respectively, in DSCT and 29.9 ± 5%, 55.3 ± 12% and 14.4 ± 9%, respectively, in IVUS-VH. Significant overestimation was present for the entire plaque and the volume of calcified plaque (p = 0.03; p = 0.0004). Although good correlation with IVUS was obtained for the entire plaque (r2 = 0.76) and non-calcified plaque volume (r2 = 0.84), correlation proved very poor and insignificant for percentage plaque composition. Interclass correlation coefficients for non-calcified plaque volume and percentages of fatty, fibrous or calcified components were 0.99, 0.99, 0.95 and 0.98, respectively, and intraclass coefficients were 0.98, 0.93, 0.98 and 0.99, respectively. We found that using Hounsfield unit-based analysis, DSCT allows for accurate quantification of non-calcified plaque. Although percentage plaque composition proves highly reproducible, it is not correlated with IVUS-VH.

Brodoefel, H; Burgstahler, C; Heuschmid, M; Reimann, A; Khosa, F; Kopp, A; Schroeder, S; Claussen, CD; Clouse, ME

2012-01-01

26

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

NASA Astrophysics Data System (ADS)

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

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

2014-03-01

27

Functional Properties of CD8+ Lymphocytes in Patients with Pleural Plaque and Malignant Mesothelioma  

PubMed Central

It is known that asbestos exposure can cause malignant mesothelioma (MM) and that CD8+ T cells play a critical role in antitumor immunity. We examined the properties of peripheral blood CD8+ lymphocytes from asbestos-exposed patients with pleural plaque (PL) and MM. The percentage of CD3+CD8+ cells in PBMCs did not differ among the three groups, although the total numbers of PBMCs of the PL and MM groups were lower than those of the healthy volunteers (HV). The percentage of IFN-?+ and CD107a+ cells in PMA/ionomycin-stimulated CD8+ lymphocytes did not differ among the three groups. Percentages of perforin+ cells and CD45RA? cells in fresh CD8+ lymphocytes of PL and MM groups were higher than those of HV. Percentages of granzyme B+ and perforin+ cells in PMA/ionomycin-stimulated CD8+ lymphocytes were higher in PL group compared with HV. The MM group showed a decrease of perforin level in CD8+ lymphocytes after stimulation compared with patients with PL. These results indicate that MM patients have characteristics of impairment in stimulation-induced cytotoxicity of peripheral blood CD8+ lymphocytes and that PL and MM patients have a common character of functional alteration in those lymphocytes, namely, an increase in memory cells, possibly related to exposure to asbestos.

Kumagai-Takei, Naoko; Nishimura, Yasumitsu; Maeda, Megumi; Hayashi, Hiroaki; Matsuzaki, Hidenori; Lee, Suni; Kishimoto, Takumi; Fukuoka, Kazuya; Nakano, Takashi; Otsuki, Takemi

2014-01-01

28

Enhanced discrimination of calcified and soft arterial plaques using computed tomography with a multi-energy-window photon counting x-ray detector  

Microsoft Academic Search

This work aims at discriminating between soft and calcified coronary artery plaques using microCT with a multi-energywindow photon counting X-ray detector (PCXD). We have previously investigated a solid state X-ray detector which has the capability to count individual photons in different energy windows. The data from these energy windows may be treated as multiple simultaneous X-ray acquisitions within non-overlapping energy

Xiaolan Wang; Jingyan Xu; Katsuyuki Taguchi; Bradley E. Patt; Douglas J. Wagenaar; Eric C. Frey

2009-01-01

29

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

PubMed Central

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

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

2013-01-01

30

Plasma Dickkopf1 (DKK1) Concentrations Negatively Associate with Atherosclerotic Calcified Plaque in African-Americans with Type 2 Diabetes  

PubMed Central

Background: Bone mineral density (BMD) and atherosclerotic arterial calcified plaque (CP) demonstrate inverse relationships through unknown mechanisms. Dickkopf-1 (DKK1) is an endogenous inhibitor of bone formation, and serum DKK1 has been associated with impaired osteoblast activation and susceptibility to bone loss. Plasma DKK1, BMD in the spine, and CP in three arterial beds were assessed in African-Americans (AAs) to determine relationships of serum DKK1 with atherosclerotic vascular calcification. Methods: Plasma DKK1, computed tomography-derived trabecular volumetric BMD (vBMD) in thoracic and lumbar vertebrae, and coronary artery, carotid artery, and aortoiliac CP were measured in 450 unrelated AAs with type 2 diabetes. Generalized linear models were fitted to test for associations between DKK1, vBMD, and CP. Results: Participants were 56% female with mean/sd/median age of 55.4/9.5/55.0 yr, diabetes duration of 10.3/8.2/8.0 yr, plasma DKK1 of 481.6/271.8/417 pg/ml, coronary artery CP mass score of 284/648/13, carotid artery CP mass score of 46/132/0, and aortoiliac CP mass score of 1613/2910/282. Adjusting for age, sex, body mass index, mean arterial blood pressure, smoking, hemoglobin A1c, and low-density lipoprotein-cholesterol, DKK1 was inversely associated with coronary artery and aortoiliac CP [parameter estimates ?0.0011 (P = 0.0137) and ?0.0010 (P = 0.0214), respectively], with a trend for carotid artery CP (P = 0.1404). No associations were observed between DKK1 and vBMD in the thoracic or lumbar vertebrae. Conclusions: Plasma DKK1 levels were inversely associated with coronary artery and aortoiliac CP, but not vBMD, in this cross-sectional study of AAs with type 2 diabetes. DKK1 may play a role in vascular mineral metabolism in this clinical setting.

Register, Thomas C.; Hruska, Keith A.; Divers, Jasmin; Bowden, Donald W.; Palmer, Nicholette D.; Carr, J. Jeffrey; Wagenknecht, Lynne E.; Hightower, R. Caresse; Xu, Jianzhao; Smith, S. Carrie; Dietzen, Dennis J.; Langefeld, Carl D.

2013-01-01

31

Enhanced discrimination of calcified and soft arterial plaques using computed tomography with a multi-energy-window photon counting x-ray detector  

NASA Astrophysics Data System (ADS)

This work aims at discriminating between soft and calcified coronary artery plaques using microCT with a multi-energywindow photon counting X-ray detector (PCXD). We have previously investigated a solid state X-ray detector which has the capability to count individual photons in different energy windows. The data from these energy windows may be treated as multiple simultaneous X-ray acquisitions within non-overlapping energy windows that can provide additional information about tissue differences. In this work, we simulated a photon counting detector with five energy windows. We investigated two approaches for using the energy information provided by this detector. First, we applied energy weighting to the reconstruction from different energy windows to improve the signal-to-noise ratio between calcified and soft plaques. This resulted in a significant improvement in the signal-to-noise ratio. Second, we applied the basis material decomposition method to discriminate coronary artery plaques based on their calcium content. The results were compared with those obtained using dual-kVp material decomposition. We observed significantly improved contrast-tonoise ratios for the PCXD-based approaches.

Wang, Xiaolan; Xu, Jingyan; Taguchi, Katsuyuki; Patt, Bradley E.; Wagenaar, Douglas J.; Frey, Eric C.

2009-02-01

32

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

SciTech Connect

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

King, Martin; Rodgers, Zachary; Giger, Maryellen L.; Bardo, Dianna M. E.; Patel, Amit R. [Department of Radiology, Committee on Medical Physics, University of Chicago, 5841 South Maryland Avenue, MC 2026, Chicago, Illinois 60637 (United States); Department of Diagnostic Radiology, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, Portland, Oregon 97239 (United States); Department of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 5084, Chicago, Illinois 60637 (United States)

2010-11-15

33

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

PubMed

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

2012-06-01

34

Pleural plaques related to "take-home" exposure to asbestos: An international case series  

PubMed Central

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

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

2008-01-01

35

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

2008-01-01

36

Small calcified coronary atherosclerotic plaque simulation model: minimal size and attenuation detectable by 64-MDCT and MicroCT.  

PubMed

Zero calcium score may not reflect the absence of calcifications as small calcifications could be missed. This study aimed to evaluate minimal size and minimal attenuation of coronary calcifications detectable by computed tomography (CT) and to determine the minimal spatial resolution required for detecting calcification onset. Using open source CT simulation software, CTSim(©), several 50%-stenotic coronary artery phantoms were designed with 5 ?m resolution, realistic morphology and tissue-specific Hounsfield Unit (HU) values. The plaque had an attenuation resembling fibrous plaque and contained a single calcification. X-ray projections were simulated with settings resembling non-contrast-enhanced 64 multi detector-row CT (64-MDCT). Scanning and reconstruction were simulated with spatial resolution of a 64-MDCT (0.4mm) and of a MicroCT (48 ?m). Starting from a single calcium granule, the calcification was simulated to grow in size and attenuation until it could be detected using clinically accepted calcium determination scheme on MicroCT and 64-MDCT images. The smallest coronary calcifications detectable at MicroCT and 64-MDCT, which had a realistic attenuation (-1,024 to 3,072 HU), were of 25 ?m and 215 ?m diameter, respectively. The area was overestimated 7.7 and 8.8 times, respectively. Calcifications with smaller size need to have an unrealistically high attenuation to be detectable by 64-MDCT. In conclusion, 64-MDCT is only able to detect coronary calcifications with minimal diameter of 215 ?m. Consequently, early onset of calcification in coronary plaque will remain invisible when using CT and a zero calcium score can not exclude the presence of coronary calcification. PMID:21509430

Kristanto, Wisnumurti; van Ooijen, Peter M A; Groen, Jaap M; Vliegenthart, Rozemarijn; Oudkerk, Matthijs

2012-04-01

37

Asbestos-related pleural thickenings in Japanese sake brewers.  

PubMed

Asbestos was long used as an additive material for the filtration of many kinds of alcoholic beverages. There has been, however, only one case report of a distiller in Italy showing pleural thickenings and lung parenchymal fibrosis due to exposure to asbestos. We report a retired Japanese sake brewer who showed bilateral calcified pleural plaques on chest X-ray films. X-ray diffraction analysis and energy disperse X-ray microanalysis demonstrated the additive material used for sake filtration to be almost pure chrysotile. Furthermore, 17 cases showing probably asbestos-related pleural thickenings were found on examination of 235 chest X-ray films of male workers at different sake breweries. These findings indicate that Japanese sake brewers should be listed as workers at possible risk of asbestos-related health problems. PMID:1336766

Horii, H; Nagasaka, Y; Yamada, Y

1992-01-01

38

Calcifying tendinitis  

Microsoft Academic Search

We report a clinicopathological study of 90 patients who had calcifying tendinitis, and propose a rationale for its treatment based upon pathogenetic mechanisms. Pain, the cardinal symptom of calcifying tendinitis, is probably subclinical before and during calcification, when tissue hypoxia is primarily responsible for the structural alterations. The pain becomes extremely severe during the resorptive phase, when hyperaemia prevails. Corticosteroid

H. K. Uhthoff; Kiriti Sarkar

1978-01-01

39

Calcifying nanoparticles associated encrusted urinary bladder cystitis.  

PubMed

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

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

2008-01-01

40

Calcifying tendinitis  

Microsoft Academic Search

Calcifying tendinitis is a condition of calcium deposition within the rotator cuff characterized by formative and resorptive phases. The vast majority of patients can be treated conservatively with pain relief, physiotherapy and prudent use of subacromial steroid injections. Some patients appear to remain in a prolonged formative phase with chronic symptoms. For this reason, patients not responding to conservative treatments

P. J Hughes; B Bolton-Maggs

2002-01-01

41

Malignant pleural diseases.  

PubMed

The incidence of malignant pleural effusions has been increasing over the last few decades (mainly due to the absolute increase in several types of cancers, especially those of lung and breast origin) and they account for up to 50% of the exudates in many clinical series. Although pleural malignancies are thought to present most frequently with a pleural effusion, several autopsy series, including the current one, found a pleural effusion present in little more than half of the cases of malignant pleural involvement (55% in this series). Thus, many pleural malignancies without effusion might pass unnoticed in clinical practice, especially in metastatic disease. Primary malignancies of the pleura (mesotheliomas) are associated with asbestos exposure in about two-thirds of cases, and they frequently present with chest pain, sometimes associated with a pleural effusion. Benign pleural plaques can coexist with malignant mesothelioma, and this association should be suspected when long-standing plaques change in shape or size over the years, and especially if chest pain develops in a previously asymptomatic patient. Metastatic pleural involvement is much more frequent than mesotheliomas, and its most frequent mechanism is the vascular spreading of tumour cells from distant organs to the lungs, and on to the visceral and parietal pleura. The visceral pleura was involved in up to 87% of the current metastatic cases, whereas the parietal zone in only 47% of the autopsy series. The diagnostic work-up lies in cytology, whose average yield is approximately 50%, and a biopsy technique (either by blind needle biopsy or thoracoscopy) is recommended when the effusion persists, for > 2 weeks, and the first cytology has been negative. Thoracoscopy has the additional advantage of allowing pleurodesis with talc poudrage if clear tumour lesions are found in the pleura. In cases of malignant effusion which are not sensitive to chemotherapy, pleurodesis is the treatment of choice for palliation of symptoms, and talc is the most effective agent. It can be used either in suspension ("slurry") or in dry aerosolized form ("talc poudrage"), but it seems that this last technique achieves the best effects. However, it requires thoracoscopy for a proper application, and this is its main drawback when that technique is not readily available. PMID:10786419

Rodriguez-Panadero, F

2000-02-01

42

Laser-induced fluorescence of atherosclerotic plaques  

NASA Astrophysics Data System (ADS)

In vitro laser-induced fluorescence (LIF) spectra and lifetimes of normal and atherosclerotic tissues are reported. The experimental arrangement conceived to measure LIF contained a 700 ps nitrogen pulsed laser (337.1 nm) and two quartz optical fibers to induce and respectively collect the fluorescence of normal and diseased samples. With UV laser excitation we found proeminent differences both in spectral and temporal range between normal artery and atherosclerotic plaques which was standard pathological classified in five types such as: normal artery, fibrous plaque, atherosclerotic plaque, calcified plaque and ulcerated plaque. As for statistics, the total number of measurements performed on each of the five mentioned types of tissues was 25.

Moise, N.; Pascu, Mihai L.; Carp, C.; Volvoreanu, C.

1998-07-01

43

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

PubMed

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

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

2014-04-01

44

Pleural needle biopsy  

MedlinePLUS

... a collection of fluid around the lung (persistent pleural effusion) or other abnormality of the pleural membrane. Pleural ... Broaddus VC, Light RW. Pleural effusion. In: Mason RJ, Broaddus VC, ... Textbook of Respiratory Medicine . 5th ed. Philadelphia, Pa: WB ...

45

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

2011-01-01

46

A calcified cardiac mass.  

PubMed

Cardiac fibromas are benign tumours, often diagnosed in childhood, but rarely they may be diagnosed in adults or the elderly. We present an interesting case of a middle-aged lady presenting with exertional chest pain and breathlessness, who was found to have a heavily calcified mass within the myocardium. With a previous history of chest trauma, a calcified myocardial haematoma was initially suspected. Complete surgical excision led to a total resolution of symptoms. Histological examination confirmed the diagnosis of a cardiac fibroma. Complete excision of cardiac fibromas, where possible, is advised and is associated with excellent survival. PMID:17126934

Iqbal, M Bilal; Stavri, George; Mittal, Tarun; Khaghani, Asghar

2007-02-14

47

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

2012-01-01

48

Pleural fluid analysis  

MedlinePLUS

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

49

Pathophysiology of atherosclerosis plaque progression.  

PubMed

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

2013-06-01

50

Automated coronary CT angiography plaque-lumen segmentation  

NASA Astrophysics Data System (ADS)

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

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

2009-02-01

51

Mechanisms of plaque formation and rupture.  

PubMed

Atherosclerosis causes clinical disease through luminal narrowing or by precipitating thrombi that obstruct blood flow to the heart (coronary heart disease), brain (ischemic stroke), or lower extremities (peripheral vascular disease). The most common of these manifestations is coronary heart disease, including stable angina pectoris and the acute coronary syndromes. Atherosclerosis is a lipoprotein-driven disease that leads to plaque formation at specific sites of the arterial tree through intimal inflammation, necrosis, fibrosis, and calcification. After decades of indolent progression, such plaques may suddenly cause life-threatening coronary thrombosis presenting as an acute coronary syndrome. Most often, the culprit morphology is plaque rupture with exposure of highly thrombogenic, red cell-rich necrotic core material. The permissive structural requirement for this to occur is an extremely thin fibrous cap, and thus, ruptures occur mainly among lesions defined as thin-cap fibroatheromas. Also common are thrombi forming on lesions without rupture (plaque erosion), most often on pathological intimal thickening or fibroatheromas. However, the mechanisms involved in plaque erosion remain largely unknown, although coronary spasm is suspected. The calcified nodule has been suggested as a rare cause of coronary thrombosis in highly calcified and tortious arteries in older individuals. To characterize the severity and prognosis of plaques, several terms are used. Plaque burden denotes the extent of disease, whereas plaque activity is an ambiguous term, which may refer to one of several processes that characterize progression. Plaque vulnerability describes the short-term risk of precipitating symptomatic thrombosis. In this review, we discuss mechanisms of atherosclerotic plaque initiation and progression; how plaques suddenly precipitate life-threatening thrombi; and the concepts of plaque burden, activity, and vulnerability. PMID:24902970

Bentzon, Jacob Fog; Otsuka, Fumiyuki; Virmani, Renu; Falk, Erling

2014-06-01

52

Gene expression profiles in the Peyronie’s disease plaque  

Microsoft Academic Search

Objectives. To provide molecular insight into the pathophysiology of Peyronie’s disease (PD), a preliminary profile of differential gene expression between the PD plaque and control tunica albuginea was obtained with DNA microarrays.Methods. Seven PD plaques and five control tunica albugineas were studied. cDNA specimens were prepared from RNA isolated from one calcified PD plaque and one control tissue and hybridized

Thomas R Magee; Ansha Qian; Jacob Rajfer; Fred C Sander; Laurence A Levine; Nestor F Gonzalez-Cadavid

2002-01-01

53

Plaque Psoriasis  

MedlinePLUS

... Programs Calendar of Events Medical Professionals Donate Donate Psoriasis About Psoriasis Symptoms and Diagnosis Types of Psoriasis ... Kit Find Us Online YouTube Twitter Facebook Plaque Psoriasis Plaque psoriasis is the most common form of ...

54

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

NASA Astrophysics Data System (ADS)

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

Chaisaowong, Kraisorn; Kraus, Thomas

2014-03-01

55

Utility of a scoring balloon for a severely calcified lesion: bench test and finite element analysis.  

PubMed

We aimed to investigate the effectiveness of a scoring balloon catheter in expanding a circumferentially calcified lesion compared to a conventional balloon catheter using an in vitro experiment setting and elucidate the underlying mechanisms of this ability using a finite element analysis. True efficacy of the scoring device and the underlying mechanisms for heavily calcified coronary lesions are unclear. We employed a Scoreflex scoring balloon catheter (OrbusNeich, Hong Kong, China). The ability of Scoreflex to dilate a calcified lesion was compared with a conventional balloon catheter using 3 different sized calcium tubes. The thickness of the calcium tubes were 2.0, 2.25, and 2.5 mm. The primary endpoints were the successful induction of cracks in the calcium tubes and the inflation pressures required for inducing cracks. The inflation pressure required for cracking the calcium tubes were consistently lower with Scoreflex (p < 0.05, Student t test). The finite element analysis revealed that the first principal stress applied to the calcified plaque was higher by at least threefold when applying the balloon catheter with scoring elements. A scoring balloon catheter can expand a calcified lesion with lower pressure than that of a conventional balloon. The finite element analysis revealed that the concentration of the stress observed in the outside of the calcified plaque just opposite to the scoring element is the underlying mechanism of the increased ability of Scoreflex to dilate the calcified lesion. PMID:24318791

Kawase, Yoshiaki; Saito, Naritatsu; Watanabe, Shin; Bao, Bingyuan; Yamamoto, Erika; Watanabe, Hiroki; Higami, Hirooki; Matsuo, Hitoshi; Ueno, Katsumi; Kimura, Takeshi

2014-04-01

56

Pleural mesothelioma.  

PubMed

Diffuse pleural malignant mesothelioma (DMM) is an uncommon tumor in the general population, but its incidence can be very high in persons exposed to asbestos. There has been controversy about the role of the different fiber types and their responsibility for causing DMM, particularly with chrysotile. Distinguishing between DMM and peripheral adenocarcinoma with pleural involvement is a frequent diagnostic problem. Immunohistochemical markers (positive for vimentin and negative for carcinoembryonic antigen and Leu M1) and electronmicroscopy aid in the diagnosis. Therapeutic results remain poor, and cure of DMM is rare. Local treatments such as surgery or radiation therapy are technically difficult because of the extent of disease. DMM continues to be a chemoresistant tumor. Because DMM is rare, study of this tumor has been hampered by the limited number of available patients in any given institution. Therefore, animal models or representative human malignant mesothelioma cell lines are needed for a dual investigation: first of the basic biology of this disease and second for a preclinical evaluation of chemotherapeutic agents and recombinant anticancer cytokines alone or in combination. Ongoing trials confirm that DMM is resistant to standard forms of therapy, but mesothelial cells are susceptible to immune effector cells and cytokines in in vitro and in vivo models. Thus, recombinant interferon-alpha, -beta, and -gamma have been used for both local and systemic treatment, as has interleukin-2 with and without autologous lymphokine-activated killer cells. In addition, substantial experimental evidence suggests synergy between cytotoxic drugs and cytokines. PMID:1591306

Ruffie, P

1992-04-01

57

Chronic pleuritic pain in four patients with asbestos induced pleural fibrosis.  

PubMed Central

Four patients occupationally exposed to asbestos, each suffering at least eight years of disabling, persistent, and often bilateral pleuritic pain are described. Radiographic evidence of pleural disease ranged from plaques seen only on computed tomography to typical bilateral plaques or diffuse thickening to extensive diffuse and circumscribed pleural fibrosis and calcification. There was no history or evidence of acute pleuritis or pleural effusion in three patients. Intermittent pleural friction rubs have been present in all four; one patient showed pleural uptake of gallium-67. Extensive workups including repeated pulmonary ventilation-perfusion scans and cardiac catheterisation have not yielded other diagnoses to explain the pain. It is proposed that persistent pleuritic pain be added to the manifestations of benign asbestos induced pleural disease. Images

Miller, A

1990-01-01

58

Ability of high-intensity ultrasound to ablate human atherosclerotic plaques and minimize debris size.  

PubMed

To investigate whether high-intensity ultrasound can destroy atherosclerotic plaques while sparing the normal arterial wall, 279 normal human aortic sites and 119 fibrous and 193 calcified plaques, obtained from 24 necropsies, were insonified in a water tank, at 20 kHz and at 5 different power intensities, ranging from 68 W/cm2 (P1) to 150 W/cm2 (P5). These intensities were associated with a total excursion of the ultrasound irradiation apparatus tip from 90 to 268 microns, respectively. Time to perforate normal aortic sites and fibrous and calcified plaques was recorded at each intensity. There was no difference in perforation time between normal aortic sites and fibrous and calcified plaques when high-power levels (P2 to P5) were used. However, at the lowest power (P1), perforation time for the normal aortic wall was significantly longer than for fibrous and calcified plaques: 30 +/- 18 seconds (166 observations), 14 +/- 7 seconds (p less than 0.001) (78 observations) and 12 +/- 8 seconds (p less than 0.001) (115 observations), respectively. When perforation times for normal vessel wall versus fibrous plaque and normal vessel wall versus calcified plaque from the same necropsy specimen were compared in a pairwise manner, the results were: 29 +/- 13 vs 16 +/- 7 (p less than 0.001) (48 paired observations) and 26 +/- 9 vs 10 +/- 5 seconds (p less than 0.001) (55 paired observations), respectively. Regardless of whether paired or unpaired comparison was applied, no significant difference was found in perforation time between fibrous and calcified plaques. The debris did not differ in size as measured separately for normal sites and fibrous and calcified plaques by a computer-interfaced Channelizer and Coulter Counter system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2063787

Ernst, A; Schenk, E A; Gracewski, S M; Woodlock, T J; Murant, F G; Alliger, H; Meltzer, R S

1991-07-15

59

Calcified retroperitoneal fibroma.  

PubMed

A case of 31-year-old male with a retroperitoneal tumor is described. Abdominal ultrasound revealed a left para-aortic calcific mass, adjacent to the left lobe of the liver and to the upper pole of the left kidney. A CT-scan of the abdomen showed the mass to originate from the left adrenal gland. At operation, a large, retroperitoneal mass, adherent to the left kidney and the spleen, but not infiltrating, was excised. Histologically the tumor was diagnosed as a calcified osteo-producing fibroma. Benign retroperitoneal tumors represent about 25% of all retroperitoneal neoplasm. This reported case represents a retroperitoneal tumor of slow growth and benign clinical course whose characteristic consists of the heavy calcifications which are normally absent in a fibroma type mass. PMID:9558778

Illuminati, G; Bertagni, A; Montesano, G; Soda, G; Baiocchini, A; Melis, M; Vietri, F

1997-01-01

60

Atherosclerosis imaging and calcified plaque: coronary artery disease risk assessment  

Microsoft Academic Search

Over the last decade, there has been increased recognition that atherosclerosis imaging adds greatly to the ability to identify patients at high risk for cardiac events. Technologies such as electron beam computed tomography and carotid intimal media thickness have contributed significantly to our understanding of the prevalence of preclinical atherosclerosis and its consequences. Guidelines and policy toward these modalities have

Matthew J Budoff

2003-01-01

61

Vascular calcifying progenitor cells possess bidirectional differentiation potentials.  

PubMed

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. PMID:23585735

Cho, Hyun-Ju; Cho, Hyun-Jai; 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

2013-01-01

62

Calcifying epithelial odontogenic tumor.  

PubMed

The calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial odontogenic neoplasm of slow growth that is locally aggressive and tends to invade bone and adjacent soft tissue. Here is reported the case of a 21-year-old female patient with a CEOT in the left mandibular posterior region. The computerized tomography in coronal plane revealed a hypodense lesion in the posterior region of the left mandibular body with hyperdense areas inside and was associated with element 37. An incisional biopsy of the lesion was performed and the histopathological analysis revealed the presence of layers of epithelial odontogenic cells that formed prominent intercellular bridges. A large quantity of extracellular, eosinophilic, and amyloid-like material and an occasional formation of concentric calcifications (Liesegang rings) were also found. The histopathological diagnosis was a Pindborg tumor. Resection of the tumor with a safety margin was performed and after 6 months of follow-up there has been no sign of recurrence of the lesion. PMID:24379981

Pereira, Olavo Hoston Gonçalves; de Carvalho, Laura Priscila Barboza; Lacerda Brasileiro Junior, Vilson; de Figueiredo, Cláudia Roberta Leite Vieira

2013-01-01

63

Calcifying Epithelial Odontogenic Tumor  

PubMed Central

The calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial odontogenic neoplasm of slow growth that is locally aggressive and tends to invade bone and adjacent soft tissue. Here is reported the case of a 21-year-old female patient with a CEOT in the left mandibular posterior region. The computerized tomography in coronal plane revealed a hypodense lesion in the posterior region of the left mandibular body with hyperdense areas inside and was associated with element 37. An incisional biopsy of the lesion was performed and the histopathological analysis revealed the presence of layers of epithelial odontogenic cells that formed prominent intercellular bridges. A large quantity of extracellular, eosinophilic, and amyloid-like material and an occasional formation of concentric calcifications (Liesegang rings) were also found. The histopathological diagnosis was a Pindborg tumor. Resection of the tumor with a safety margin was performed and after 6 months of follow-up there has been no sign of recurrence of the lesion.

Pereira, Olavo Hoston Goncalves; de Carvalho, Laura Priscila Barboza; Lacerda Brasileiro Junior, Vilson; de Figueiredo, Claudia Roberta Leite Vieira

2013-01-01

64

Proton-induced X-ray emission analysis of atherosclerotic plaques of the carotid bifurcation.  

PubMed

The trace elements of both calcified atherosclerotic plaques and plaque-free vessel walls of the carotid bifurcation from 31 autopsies were investigated using the proton-induced X-ray emission (PIXE) method. The trace elements studied were phosphorus (P), calcium (Ca), chrome (Cr), iron (Fe), copper (Cu), zinc (Zn), lead (Pb), selenium (Se), bromine (Br), strontium (Sr), and rubidium (Rb). All samples contained Fe and Zn. Mercury (Hg) was not detected in any of the samples studied. All plaque-free samples contained Cu and almost all Br and Ca, none Sr. All calcified atherosclerotic plaques contained Ca and almost all Br and Sr. The relative levels of Ca were higher in the calcified plaques than in the plaque-free vessel walls. The relative value of Ca in calcified and uncalcified samples was greatest in the group who had died because of cardiovascular disorders and smallest in the group who had died from other causes. There was a strong positive correlation between the Ca and Sr of the plaque samples and between the P and Br of the plaque-free samples. PMID:1384615

Peltomaa, M; Mattila, K; Wolf, J; Hyvönen-Dabek, M

1992-09-01

65

Endothelin1 is increased overlying atherosclerotic plaques in human arteries  

Microsoft Academic Search

The distribution of Endothelin-1 (ET-1), a potent vasoactive peptide, within endothelium of human atherosclerotic arteries was examined using a novel en face immunohistochemical technique. The vast majority of endothelial cells were immunoreactive for ET-1. Staining intensity was increased in areas overlying atherosclerotic plaques, calcified media, fatty streaks and about flow dividers, compared with adjacent regions. Multinucleated ‘giant’ endothelial cells were

Gregory T. Jones; André M. van Rij; Clive Solomon; Ian A. Thomson; Stephen G. K. Packer

1996-01-01

66

A comparative study on plaque vulnerability using constitutive equations.  

PubMed

Atherosclerosis is the most serious and common form of cardiovascular disease in which plaque builds up inside the arteries. Peak plaque stress is considered as the main reason for plaque rupture, which results in heart attack and stroke. In the current research, the finite element method is used to anticipate plaque vulnerability, using human samples. A total of 23 healthy and atherosclerotic human coronary arteries (14 healthy and 9 atherosclerotic) were removed within 5 h postmortem. The samples were mounted on a uniaxial tensile test machine and the obtained mechanical properties were used in finite element models. The peak plaque stresses for the Ogden hyperelastic model were compared to the Mooney-Rivlin and Neo-Hookean outcomes. The results indicated that hypocellular plaque in all three models has the highest stress values compared to the cellular and calcified ones and, as a result, is quite prone to rupture. The calcified plaque type, in contrast, has the lowest stress values and remains stable. The results can be used in plaque vulnerability prediction and have clinical implications for interventions and surgeries such as balloon-angioplasty, cardiopulmonary bypass and stenting. PMID:23999817

Karimi, A; Navidbakhsh, M; Faghihi, S

2014-03-01

67

[Plaque indices].  

PubMed

The objective quantitative evaluation of the extent of plaques is necessary for epidemiologic studies and for the estimation of the effects of various cleaning methods and agents. Numerous indices have been elaborated for this purpose. Relation planimetry is used for the detection and exact evaluation of small differences. The surfaces are measured with a compensating planimeter, the slides to be evaluated being projected on a white sheet by means of a microfilm reader. In this way, the plaque covered surfaces are determined as percentages of the total surfaces. PMID:283608

Kötzschke, R

1978-11-01

68

Malignant pleural disease.  

PubMed

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

2000-05-01

69

Relation of the Metabolic Syndrome to Quantity of Coronary Atherosclerotic Plaque  

PubMed Central

Although metabolic syndrome (MS) is associated with adverse cardiovascular outcomes, its association with presence and extent of coronary atherosclerotic plaques is not well described. To assess this relationship, multi-detector computed tomography (MDCT) based pattern of coronary plaques were assessed in 77 patients enrolled in the ROMICAT study (age 54±12 years, 79% Caucasians and 36% females) and compared among those who did (n=35, 45%) and did not (n=42, 55%) have MS. The presence of any, calcified, and non-calcified plaque was significantly higher in patients with than without MS (91%, 74%, and 77% vs. 46%, 45%, and 40% segments with plaque respectively, all p<0.01). The overall number of segments with plaques was also higher in MS patients (5.8±3.7 vs. 2.1±3.3, p<0.001). Metabolic syndrome was independently associated with both presence and extent of overall plaques after adjusting for the Framingham risk score (OR 6.7, 95% CI 1.6–28.8, p<0.01 for presence, ? coefficient 3.59, SE 0.88, p=0.009 for extent) and for individual risk factors including age, gender, smoking, body mass index, hypertension, diabetes, hyperlipidemia, and clinical coronary disease (OR 8.4, 95% CI 1.7–42.5, p=0.008 for presence, ? coefficient 2.35, SE 0.86, p=0.007 for extent). Similarly, MS was independently associated with calcified and non-calcified plaques individually. In conclusion, MS is independently associated with the presence and extent of both calcified and non-calcified coronary atherosclerotic plaques as detected by MDCT. These data may explain the higher cardiovascular risk in these patients and may lay the foundation for studies to determine whether such information may improve risk stratification.

Butler, Javed; Mooyaart, Eline AQ; Dannemann, Nina; Moselewski, Fabian; Shapiro, Michael D.; Ferencik, Maros; Brady, Thomas J.; Hoffmann, Udo

2009-01-01

70

Extraction of Collagen from Calcified Tissues.  

National Technical Information Service (NTIS)

A method is disclosed for extracting collagen from calcified tissue without a prior decalcification step. The method may be used with calcified tissues such as fish skin with scales, alligator skeletons, and crustacean exoskeletons. It does not require th...

J. N. Losso, M. Ogawa, M. A. Schexnayder, R. J. Porter

2005-01-01

71

Pleural Infection and Empyema  

PubMed Central

Increasing incidence of pleural infection has been reported worldwide in recent decades. The pathogens responsible for pleural infection are changing and differ from those in community acquired pneumonia. The main treatments for pleural infection are antibiotics and drainage of infected pleural fluid. The efficacy of intrapleural fibrinolytics remains unclear, although a recent randomized control study showed that the novel combination of tissue plasminogen activator and deoxyribonuclease had improved clinical outcomes. Surgical drainage is a critical treatment in patient with progression of sepsis and failure in tube drainage.

2014-01-01

72

Pleural function and lymphatics.  

PubMed

The pleural space plays an important role in respiratory function as the negative intrapleural pressure regimen ensures lung expansion and in the mean time maintains the tight mechanical coupling between the lung and the chest wall. The efficiency of the lung-chest wall coupling depends upon pleural liquid volume, which in turn reflects the balance between the filtration of fluid into and its egress out of the cavity. While filtration occurs through a single mechanism passively driving fluid from the interstitium of the parietal pleura into the cavity, several mechanisms may co-operate to remove pleural fluid. Among these, the pleural lymphatic system emerges as the most important one in quantitative terms and the only one able to cope with variable pleural fluid volume and drainage requirements. In this review, we present a detailed account of the actual knowledge on: (a) the complex morphology of the pleural lymphatic system, (b) the mechanism supporting pleural lymph formation and propulsion, (c) the dependence of pleural lymphatic function upon local tissue mechanics and (d) the effect of lymphatic inefficiency in the development of clinically severe pleural and, more in general, respiratory pathologies. PMID:23009260

Negrini, D; Moriondo, A

2013-02-01

73

Toward Unsupervised Classification of Calcified Arterial Lesions  

Microsoft Academic Search

\\u000a There is growing evidence that calcified arterial deposits play a crucial role in the pathogenesis of cardiovascular disease.\\u000a This paper investigates the challenging problem of unsupervised calcified lesion classification. We propose an algorithm,\\u000a US-CALC (UnSupervised Calcified Arterial Lesion Classification), that discriminates arterial lesions from non-arterial lesions. The\\u000a proposed method first mines the characteristics of calcified lesions using a novel optimization

Gerd Brunner; Uday Kurkure; Deepak R. Chittajallu; Raja P. Yalamanchili; Ioannis A. Kakadiaris

2008-01-01

74

Association between calcifying nanoparticles and placental calcification  

PubMed Central

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

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

2012-01-01

75

CO2 vascular anastomosis of atherosclerotic and calcified arteries  

NASA Astrophysics Data System (ADS)

The technique for CO2 laser fusion vascular anastomosis in normal vessels has been well established. Normal arterial wall has a predictable thermal response to the incident laser energy, with rapid heating and cooling of collagen within the arterial wall. Since atherosclerosis involves subendothelial cellular proliferation, lipid and calcium deposition, it may modify the thermal responsiveness of the arterial wall. To this study, CO2 laser fusion anastomoses were attempted in rabbits with non-calcific atherosclerosis and humans with calcific atherosclerosis. All anastomoses were successfully completed without alteration in technique despite the presence of plaque at the site of laser fusion. Histology of rabbit vessels revealed the classic laser fusion cap within the adventitia and persistent atherosclerotic plaque at the flow surface. Duplex imaging of patients post-operatively demonstrated long term anastomotic patency in 2 of 3 fistulae. These results suggest that neither non-calcified or calcified atherosclerosis significantly alters the arterial wall thermal responsiveness to CO2 laser energy or inhibits creation of laser fusion anastomoses. Therefore, this technique may be applicable to the treatment of patients with atherosclerotic occlusive disease.

White, John V.; Leefmans, Eric; Stewart, Gwendolyn J.; Katz, Mira L.; Comerota, Anthony J.

1990-06-01

76

Nanobacteria--propagating calcifying nanoparticles.  

PubMed

Nanobacteria, also known as calcifying nanoparticles (CNP), are controversial infectious agents not matching the current criteria for 'living organism'. Despite the controversy of their classification, they propagate and cause cell death in vitro and are associated or found in many human diseases. Thus, more efforts should be focussed on research on pathogenicity of CNP. PMID:16706890

Kajander, E O

2006-06-01

77

Coronary Plaque Type and Burden By Computed Tomography Angiography Without Association to C-Reactive Protein  

PubMed Central

Background: Contrast-enhanced computed tomography angiography (CTA) of the coronaries allows identification of plaques. Limited data exists on the relationship between C-reactive protein (CRP) and the plaque type or plaque burden detected by CTA. Aims: We studied relationship between CRP and coronary atherosclerosis. Materials and Methods: 92 patients without history of coronary disease underwent coronary CTA for chest pain. Coronary arteries were evaluated with each detected plaque labeled as calcified, noncalcified or mixed. Logarithmic transformation was done on CRP values for statistical analysis. Results: 1380 coronary segments were evaluated. The average age was 57 years (SE 1.0) and basal metabolic index (BMI) 28.9 kg/m2 (SE 0.5). Median CRP level was 2.75 mg/L (range 0.17-16.98). No association was found between CRP quartiles and plaque type. In stepwise multivariate analysis, only diabetes was associated with noncalcified plaque (P < 0.001). When calcified and mixed plaques were added to the model, age (P < 0.001), diabetes (P < 0.02), and statin use (P < 0.05) were associated with an increased number of plaques per subject. No association was found between log-CRP for any type of plaque. Conclusion: There was no association between CRP and plaque type by CTA. Lack of association is likely due to limited spatial resolution and underestimation of noncalcified plaque burden by CTA.

Navaravong, Leenhapong; Steenson, Carol; Sigurdsson, Gardar

2014-01-01

78

Impact of glucose intolerance on coronary calcified lesions evaluated using multislice computed tomography.  

PubMed

Metabolic syndrome has the unique concept that the common occurrence of individual disease components increases the risk of coronary artery disease (CAD). However, some studies suggest that the burden of different CAD risk factors is not equal, and focusing on the whole set of risk factors might neglect the impact of individual factors that could be useful targets for prophylactic therapies. The purpose of this study was to investigate the effect of glucose intolerance on CAD using multislice computed tomography (MSCT). Ninety-eight consecutive patients with at least one traditional CAD risk factor who visited a municipal hospital were enrolled in this study. The risk factors were impaired glucose tolerance (fasting glucose > or = 110 mg/dl or patients with diabetes), low high-density lipoprotein cholesterol (HDL-C, < 40 mg/dl for men and < or = 50 mg/dl for women), hypertriglycemia (triglyceride > or = 150 mg/dl), hypertension (blood pressure > or = 130/85 mmHg), and obesity (body mass index, > 25 kg/m(2) for men and > 23 kg/m(2) for women). CAD was determined by the presence of either stenoses, non-calcified plaques or calcified lesions. The following risk factors were significantly related in univariate logistic models: glucose intolerance and coronary calcified lesions (p = 0.001), and hypertriglycemia and non-calcified plaque lesions (p = 0.048). Multivariate models showed that glucose intolerance was significantly associated with calcified lesions, even after adjustment for gender, age, low HDL-C, hypertriglycemia, hypertension, and obesity (p = 0.018). Our results suggest that glucose intolerance might be closely related to the presence of coronary calcified lesions among traditional CAD risk factors. PMID:17548955

Nomura, Kyoko; Yamanouchi, Toshikazu; Kim, Gwang U; Ohwaki, Kazuhiro; Yano, Eiji

2007-06-01

79

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

PubMed

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

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

2008-01-01

80

Diagnostic Tools of Pleural Effusion  

PubMed Central

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

2014-01-01

81

Atherosclerotic plaque burden in cocaine users with acute chest pain: analysis by coronary computed tomography angiography.  

PubMed

Chest pain associated with cocaine use represents an increasing problem in the emergency department (ED). Cocaine use has been linked to the acute coronary syndrome (ACS) and acute myocardial infarction (AMI). We used coronary computed tomography angiography (cCTA) to evaluate the prevalence, severity and composition of atherosclerotic lesions in cocaine users. We studied 78 patients with non-occasional cocaine use (52 men, 44 ± 7 years, 23 under the acute influence) and acute chest pain but without ACS, who had undergone cCTA in the ED. Patients were matched one-to-one by gender, race, symptoms, and risk-factors with a control cohort (n = 78; 52 men, 45 ± 6 years) not using cocaine. Each coronary segment was evaluated for the presence and composition (calcified, non-calcified, partially calcified) of atherosclerotic plaque and for stenosis. The prevalence of coronary stenosis was not significantly different between patients with and without cocaine use (13% versus 5%, P > 0.05). However, cocaine users on average had significantly more atherosclerotic plaques (0.44 ± 0.88 versus 0.29 ± 0.83, P < 0.05) and a tendency towards more calcified (0.64 ± 1.23 versus 0.55 ± 1.22, P > 0.05) and non-calcified plaques (0.26 ± 0.63 versus 0.17 ± 0.57, P > 0.05), yet not reaching statistical significance. Furthermore, cocaine users had significantly more partially calcified plaques (0.41 ± 0.61 versus 0.17 ± 0.41, P < 0.05) and higher partially calcified plaque volume (59.7 ± 33.3 mm(3) versus 25.6 ± 12.6 mm(3), P < 0.05). Thus, cocaine users tend to have more pronounced coronary atherosclerosis compared to patients without cocaine use at the time of presentation with acute chest pain. PMID:23880201

Ebersberger, Ullrich; Sudarski, Sonja; Schoepf, U Joseph; Bamberg, Fabian; Tricarico, Francesco; Apfaltrer, Paul; Blanke, Philipp; Schindler, Andreas; Makowski, Marcus R; Headden, Gary F; Leber, Alexander W; Hoffmann, Ellen; Vliegenthart, Rozemarijn

2013-08-01

82

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

NASA Astrophysics Data System (ADS)

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

2008-11-01

83

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.

2011-01-01

84

Open pleural biopsy  

MedlinePLUS

... small plastic tube in your chest to prevent air and fluid from building up Today, most centers use a technique called video-assisted thoracoscopy, which uses a camera and tiny instruments to biopsy the pleural area. With this method, ...

85

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

2013-01-01

86

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.

2011-01-01

87

The Relationship of Epicardial Fat Volume to Coronary Plaque, Severe Coronary Stenosis, and High-Risk Coronary Plaque Features Assessed by Coronary CT Angiography  

PubMed Central

Background Associations of epicardial fat volume (EFV) measured on non-contrast cardiac computed tomography (NCT) include coronary plaque, myocardial ischemia and adverse cardiac events. Objectives This study aimed to define the relationship of EFV to coronary plaque type, severe coronary stenosis, and to the presence of high-risk plaque features (HRPFs). Methods We retrospectively evaluated 402 consecutive patients, with no prior history of coronary artery disease, who underwent same day non-contrast cardiac computed tomography (NCT) and coronary CT angiography (CTA). EFV was measured on NCT using validated, semi-automated, software. The coronary arteries were evaluated for coronary plaque type [calcified (CP), non-calcified (NCP) or partially-calcified (MP)] and coronary stenosis severity ?70% using coronary CTA. For patients with NCP and PCP, 2 high risk plaque features were evaluated: Low-attenuation plaque and positive remodeling. Results There were 402 patients with a median age of 66 years (range 23–92) of whom 226 (56%) were male. The EFV was larger in patients with CP (112 ± 55 cm3 vs. 89 ± 39 cm3), PCP (110 ± 57 cm3 vs. 98 ± 45 cm3) and NCP (115 ± 44 cm3 vs. EFV 100 ± 52 cm3. In the 192 patients with PCP or NCP, on multivariable analysis, after adjusting for conventional cardiovascular risk factors, EFV was an independent predictor of ?70% coronary artery stenosis (OR 3.0, 95% CI 1.3–6.6, p=0.008), any high risk plaque features (OR 1.7, 95% CI 0.9–3.4, p=0.04) and low attention plaque (OR 2.4, 95% CI 1.1–5.1, p=0.02), but not of positive remodeling. Conclusions Epicardial fat volume is larger in patients with CP, PCP and NCP. In patients with NCP and PCP, EFV is significantly associated with severe coronary stenosis, high risk plaque features and low attenuation plaque.

Rajani, Ronak; Shmilovich, Haim; Nakazato, Ryo; Nakanishi, Rine; Otaki, Yuka; Cheng, Victor Y.; Hayes, Sean W.; Thomson, Louise E.J.; Friedman, John D.; Slomka, Piotr J.; Min, James K.; Berman, Daniel S.; Dey, Damini

2013-01-01

88

Calcified left ventricular endomyocardial fibrosis.  

PubMed

Endomyocardial fibrosis (EMF) is a rare condition, but in certain tropical countries it is a major cause of illness and death. Moreover, the etiology of the disease is unknown, it has no specific treatment, and it carries a poor prognosis. As both the heart and the peritoneum may be affected by the inflammation and deposition of fibrous tissue, even left ventricular EMF may present with gross ascites mimicking right-heart failure. Notwithstanding attempts to standardize the diagnostic criteria, the clinical presentation may still be challenging. The case is described of calcified left ventricular EMF presenting with right-heart failure in the absence of right ventricular fibrosis. PMID:22808844

Grimaldi, Antonio; Vermi, Anna Chiara; Alfieri, Ottavio; Olivotto, Iacopo; Sacco, Francesco M; Camici, Paolo G; Freers, Juergen

2012-05-01

89

[Calcified].  

PubMed

A 73-year-old woman was referred due to an acute and progressive worsening of a previously mildly impaired kidney function of unknown origin. The kidney biopsy showed a phosphate nephropathy. We identified Colophos®, a phosphate-containing purgative as the causing agent, which the patient had received for bowel cleansing for a colonoscopy one day before the detection of the acute kidney failure. During the following months the kidney function initially declined further and then improved. Most cases of phosphate nephropathy are associated with the ingestion of phosphate-containing purgatives. Persons at risk are women, elderly persons, patients with impaired kidney function, hypertension, and dehydration. The consequence is sometimes an irreversible tubulointerstitial injury that can lead to end-stage renal disease in a minority of the cases. PMID:22618699

Gerber, L; Gaspert, A; Bleisch, J A

2012-05-23

90

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.

2013-04-01

91

Magnetic resonance of calcified tissues.  

PubMed

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

2013-04-01

92

Tuberculous pleural effusions.  

PubMed

Tuberculosis is the most frequent cause of death due to infectious diseases. In Europe, it is one of the most frequent types of pleural effusions in young patients. Tuberculosis is caused by the rupture of a pulmonary subpleural caseous focus, which releases mycobacterium into the pleural cavity, thereby triggering an immune response involving mainly macrophages, CD4+ T lymphocytes, and the cytokines released by these cells (especially interleukin 1, interleukin 2, and ?-interferon). In recent years, classical microbiological and histological methods of diagnosis have been joined by biochemical analyses of pleural fluid, which are faster and can be more sensitive. In particular, tuberculous effusions have high adenosine deaminase (ADA) activity, apparently due to high levels of the ADA isoenzyme ADA2, which is only found in monocytes and macrophages (although certain data suggest the possible involvement of activated T cells, too). It has been recommended that treatment for tuberculosis be initiated if analysis of pleural fluid shows high ADA activity, a lymphocyte/neutrophil ratio greater than 0.75, and no malignant cells. Another highly efficient marker is ?-interferon, which is released by activated CD4+ T cells, but its high price is an obstacle to its routine determination in clinical practice. Identification of mycobacterial DNA by means of the polymerase chain reaction (PCR) is less efficient, apparently because its sensitivity depends heavily on mycobacterium concentration. No other biochemical parameters currently appear to be of marked relevance for the diagnosis of tuberculous pleural effusion (TPE). TPE responds well to the standard treatment for tuberculosis. However, 50% of TPE patients have a thickened pleura as a result of the accumulation of fluid, and in 16% the quantity of effusion increases during treatment, even if corticosteroids are administered. It therefore seems reasonable for treatment with antituberculous drugs to be preceded by therapeutic thoracocentesis to remove as much fluid as possible. PMID:12719023

Valdés, Luis; Pose, Antonio; San José, Esther; Martínez Vázquez, José Manuel

2003-03-01

93

Non-invasive measurement of coronary plaque from coronary CT angiography and its clinical implications.  

PubMed

Coronary CT angiography (CTA) is increasingly used worldwide for direct, non-invasive evaluation of the coronary arteries. Advances in computed tomography (CT) technology over the last decade have enabled such reliable imaging of the coronary arteries. Beyond arterial stenosis, coronary CTA also permits assessment of atherosclerotic plaque (including plaque burden) and coronary artery remodeling, previously only achievable through invasive means. It has been shown that coronary plaque volumes for non-calcified and mixed plaques and the arterial remodeling index, correlate closely with invasive intravascular ultrasound. Several studies have also shown a strong relationship of adverse plaque features imaged by coronary CTA with acute coronary syndrome, all-cause death, major adverse cardiovascular events and myocardial ischemia. The aim of this review is to summarize current methods for quantitative measurement of atherosclerotic plaque features from coronary CTA and to discuss their clinical implications. PMID:23984930

Dey, Damini; Schuhbaeck, Annika; Min, James K; Berman, Daniel S; Achenbach, Stephan

2013-08-01

94

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

NASA Astrophysics Data System (ADS)

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

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

2014-04-01

95

Directional atherectomy of a heavy calcified axillary artery stenosis inducing critical hand ischemia.  

PubMed

The presence of a severe calcified peripheral artery lesion is responsible for a poor response to balloon dilation, due to significant acute vessel recoil and frequent flow-limiting dissections requiring stent implantation. This possibility could be associated with very high compression and/or fracture rates particularly in cases of lesion located at the mobile joints. In this setting directional atherectomy offers the theoretical advantages of eliminating stretch injury on arterial walls and reducing the restenosis rate by direct plaque excision. In this report, we present a case of critical hand ischemia due to a heavily calcified axillary artery lesion managed by directional atherectomy and balloon angioplasty followed by immediate angiographic success and sustained clinical benefit up to 3 years of follow-up. PMID:23371036

Anzuini, Angelo; Palloshi, Altin; Aprigliano, Gianfranco; Ielasi, Alfonso

2013-07-01

96

Quantification of coronary artery plaque using 64-slice dual-source CT: comparison of semi-automatic and automatic computer-aided analysis based on intravascular ultrasonography as the gold standard.  

PubMed

We evaluated the feasibility of automatic computer-aided analysis (CAA) compared with semi-automatic CAA for differentiating lipid-rich from fibrous plaques based on coronary CT angiography (CCTA) imaging. Seventy-four coronary plaques in 57 patients were evaluated by CCTA using 64-slice dual-source CT. Quantitative analysis of coronary artery plaques was performed by measuring the relative volumes (low, medium, and calcified) of plaque components using automatic CAA and by measuring mean CT density using semi-automatic CAA. We compared the two plaque measurement methods for lipid-rich and fibrous plaques using Pearson's correlation. Intravascular ultrasonography was used as the goal standard for assessment of plaques. Mean CT density of plaques tended to increase in the order of lipid [36 ± 19 Hounsfield unit (HU)], fibrous (106 ± 34 HU), and then calcified plaques (882 ± 296 HU). The mean relative volumes of 'low' components measured by automatic CAA were 13.8 ± 4.6, 7.9 ± 6.7, and 3.5 ± 3.0 % for lipid, fibrous, and calcified plaques, respectively (r = -0.348, P = 0.022). The mean relative volumes of 'medium' components on automatic CAA were 12.9 ± 4.1, 15.7 ± 9.6, and 5.6 ± 4.8 % for lipid, fibrous, and calcified plaques, respectively (r = -0.385, P = 0.011). The mean relative volumes of low and medium components within plaques significantly correlated with the types of plaques. Plaque analysis using automatic CAA has the potential to differentiate lipid from fibrous plaques based on measurement of the relative volume percentages of the low and medium components. PMID:24293043

Kim, Young Jun; Jin, Gong Yong; Kim, Eun Young; Han, Young Min; Chae, Jei Keon; Lee, Sang Rok; Kwon, Keun Sang

2013-12-01

97

Malignant Pleural Mesothelioma  

Microsoft Academic Search

\\u000a Mesotheliomas are neoplasms originating from the thin layer of mesothelial cells lining the serosal surfaces of the pleural,\\u000a pericardial and peritoneal cavities. This fact accounts for the otherwise curious reports of mesotheliomas arising from the\\u000a tunica vaginalis testis (1), which represents a diverticular remnant of the peritoneum carried with the testes into the scrotum\\u000a during their embryonic descent from the

Linus Ho; Sugarbaker J. David; Arthur T. Skarin

98

Diagnosis and Treatment of Malignant Pleural Effusions.  

National Technical Information Service (NTIS)

Contents: Radiological diagnosis in evaluating malignant pleural effusions; Biopsy, cytology, cell culture and electron microscopy in the diagnosis of malignant pleural effusions; Biological and immunological markers of maligant pleural effusions; Drug th...

1982-01-01

99

Imaging manifestations of pleural tumors.  

PubMed

Although radiologic assessment of pleural tumors may be accomplished with several imaging modalities, the standard noninvasive techniques include chest radiography and computed tomography (CT). These examinations may be supplemented with magnetic resonance imaging and occasionally with ultrasound. Depending on the location, size, and underlying histologic features, pleural tumors may produce a spectrum of findings. CT is particularly useful in defining the location and extent of these masses. The authors present a review of basic pleural anatomy and imaging features of both benign and malignant pleural neoplasms. The pleural may be involved by one of several primary or metastatic tumors. Specific cell types are diffuse malignant mesothelioma (the most common plain radiographic findings are unilateral pleural effusion and pleural thickening), localized fibrous tumor (circumscribed, spherical or ovoid, noncalcified lesions arising in the pleural surface), metastatic disease (radiographic findings may mimic those of malignant mesothelioma), and uncommon neoplasms including thymoma and lymphoma. Among these various pleural tumors, metastatic disease represents the most common neoplasm. PMID:1439021

Dynes, M C; White, E M; Fry, W A; Ghahremani, G G

1992-11-01

100

In vitro human atherosclerotic plaque recognition by photosensitizer mono-L-aspartyl chlorin e6 assisted light induced fluorescence (PALIF)  

NASA Astrophysics Data System (ADS)

The main aim of the presented experiments was to assess in vitro capabilities of Photosensitizer Assisted Light Induced Fluorescence (PALIF) to recognise different stages of atherosclerosis. Mono-L-asparyl-chlorin e-6 was used as a photosensitising agent and ultraviolet light (440 nm) as an excitation source to obtain spectra map of artery wall. The luminescence spectra were collected and analised. The specimans were histologically examined and classified into three groups: normal artery wall, atherosclerotic noncalcified plaque and calcified plaque. The ratio of green fluorescence (coming from collagen) to red fluorescence (coming from chlorin e6 bonded with lipid reach, noncalcified tissue) gies a chance to distinguish between normal artery or calcified plaque and noncalcified, lipid reach plaque. Further trials must be performed to evaluate in vitro athermoa detection algorithm as a feedback system for photoangioplasty.

Bialy, Dariusz; Derkacz, Arkadiusz; Wawrzynska, M.; Bednarkiewicz, A.; Ziolkowski, Piotr P.; Nowosad, H.; Strek, Wieslaw; Protasiewicz, Marcin

2003-10-01

101

[Management of malignant pleural effusion].  

PubMed

Malignant pleural effusions are the major cause of pleural effusions in patients older than 40. Their treatment is essentially palliative but recently improved with new efficient chemotherapy. The most frequent causes of malignant pleural effusions are pleural metastatic adenocarcinomas arising from lung in both sex, or from breast in women, and malignant mesothelioma. In both cases, thoracoscopy is useful for histological biopsies and sclerotherapy by talc poudrage. Pleural malignant mesotheliomas are linked in 70% of cases to professional asbestosis exposure. The histological diagnosis is difficult, relying on a standardized immunohistochemical analysis. Prophylactic irradiation has been proved to be efficient in the prevention of parietal seeding along the thoracocentesis and drainage channels. PET imaging could be of major interest in the diagnosis of mesothelioma and prognosis evaluation. Mesothelioma prognosis has recently been modified by the association of cisplatin with pemetrexed, a new antimetabolite agent, but mesothelioma remains seldom curable. PMID:17583136

Zalcman, Gérard; Lechapt, Emmanučle; Bergot, Emmanuel

2007-03-15

102

Calcifying Tendonitis of the Shoulder Joint  

Microsoft Academic Search

\\u000a \\u000a Background and Purpose:\\u000a   Calcifying tendonitis is a degenerative inflammatory joint disorder. Pain relief can be successfully achieved with low-dose\\u000a radiotherapy. It is actually unknown which types of calcifying tendonitis respond to radiotherapy and which do not. The authors\\u000a tried to get predictive objectives for the response to radiotherapy on the basis of different morphological patterns of calcifications\\u000a evaluated by X-ray

Boris Adamietz; Rüdiger Schulz-Wendtland; Sedat Alibek; Michael Uder; Rolf Sauer; Oliver Ott; Ludwig Keilholz

2010-01-01

103

Noninvasive assessment of the carotid and cerebrovascular atherosclerotic plaques by multidetector CT in type-2 diabetes mellitus patients with transient ischemic attack or stroke  

PubMed Central

Background The cerebrovasuclar artery disease as a common complication of type-2 diabetes mellitus (T2DM) caused huge economic burden and lives threatening to patients. We evaluated the prevalence and morphology of carotid and cerebrovascular atherosclerotic plaques in T2DM patients with transient ischemic attack (TIA) or stroke using multidetector CT (MDCT). Methods 64-MDCT and dual-source CT (DSCT) angiographies were performed in 195 T2DM patients with TIA or stroke (mean age 65.7+/-12.8 years; 118 men) between January 2009 to August 2011. During the process, plaque type, its distribution, extensive and obstructive natures were determined for each segment derived from the patients. Results Atherosclerotic plaques were detected in 183 (93.8%) patients. A total of 1056 segments with plaque were identified, of which 450 (42.6%) were non-calcified, 192 (18.2%) were mixed and 414 (39.2%) calcified ones. Among them, 562 (53.2%) resulted in mild stenosis, 291 (27.6%) moderate stenosis, 170 (16.1%) severe stenosis and 33 (3.1%) occlusion. Non-calcified plaques contributed 91.8% to non-obstructive lumen narrowing, while mixed and calcified plaques contributed 89.0% and 65.0% respectively. Conclusions MDCT angiography detected a high prevalence of plaques in T2DM patients with TIA or stroke. A relatively high proportion of plaques were non-calcified, as well as with non-obstructive stenosis. MDCT angiography might further enhance the detection and management of carotid and cerebrovascular atherosclerosis in T2DM patients with TIA and stroke

2013-01-01

104

Characterization of ultraviolet laser-induced autofluorescence of ceroid deposits and other structures in atherosclerotic plaques as a potential diagnostic for laser angiosurgery.  

PubMed

Unstained frozen sections of normal and atherosclerotic human aorta and coronary artery were examined using histochemical and fluorescence microscopic techniques to identify the structures responsible for autofluorescence under 351 to 364 nm laser excitation. These structures included elastin and collagen in normal and atherosclerotic specimens, calcium deposits in calcified plaques, and granular or ring-shaped deposits histochemically identified as ceroid found in both calcified and non-calcified plaques. Qualitatively, both the color and intensity of ceroid autofluorescence differed greatly from that of elastin or collagen. The emission spectra of elastin, collagen, and ceroid were examined by microscopic spectrofluorimetry, and were found to differ significantly as well. When compared with spectra of elastin and collagen, spectra of ceroid were broader, shifted to the red, and were somewhat resistant to bleaching. We conclude that detection of laser-induced ceroid autofluorescence may aid in identifying plaques for laser ablation. PMID:1729827

Verbunt, R J; Fitzmaurice, M A; Kramer, J R; Ratliff, N B; Kittrell, C; Taroni, P; Cothren, R M; Baraga, J; Feld, M

1992-01-01

105

Presence of calcified tissue in the human temporomandibular joint disc  

Microsoft Academic Search

Large calcified areas were observed in the articular discs of the temporomandibular joint from five patients suffering from articular dysfunctions. The calcified regions were always located inside the fibrous tissue of the discs. They had a woven bone-like morphological pattern and consisted of a compact mineralized tissue containing cells in irregular lacunae. In all the samples the calcified tissue was

Carla Marchetti; Giorgio Bernasconi; Marcella Reguzzoni

1997-01-01

106

MODE OF ACTION OF CALCIFIED SEAWEED ON GRASSLAND  

Microsoft Academic Search

Calcified seaweed, the particulate remains of a calcareous red algae, is used as a soil conditioner; but little is known of its effects. Two glasshouse pot experiments examined the effects of calcified seaweed application on a Hapludalf (Salwick series sandy silt loam) and Lolium perenne. Experiment 1 examined the effects of different particle sizes of calcified seaweed on soil pH.

Andrew Tye; Michael Fullen; Trevor Hocking

2001-01-01

107

CT appearances of pleural tumours.  

PubMed

Computed tomography (CT) is the imaging technique of choice for characterizing pleural masses with respect to their location, composition, and extent. CT also provides important information regarding invasion of the chest wall and surrounding structures. A spectrum of tumours can affect the pleura of which metastatic adenocarcinoma is the commonest cause of malignant pleural disease, while malignant mesothelioma is the most common primary pleural tumour. Certain CT features help differentiate benign from malignant processes. This pictorial review highlights the salient CT appearances of a range of tumours that may affect the pleura. PMID:19664483

Salahudeen, H M; Hoey, E T D; Robertson, R J; Darby, M J

2009-09-01

108

Investigation of atherosclerotic plaque by high-frequency EPR  

NASA Astrophysics Data System (ADS)

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

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

2013-12-01

109

[Thoracoscopy in malignant pleural effusions].  

PubMed

To assess the value of thoracoscopy in malignant pleural effusions, the procedure and results of thoracoscopy by using a fiberoptic bronchoscope and a rigid cold-light thoracoscope in 130 cases with malignant pleural effusion are reported. The overall diagnostic rate was 91.5% (119/130). The malignant pleural mesothelioma in 24 cases and metastatic cancers in 95 cases were histopathologically confirmed. Talcum powder, tetracycline and Corynebacterium parvum were separately sprayed through thoracoscope into pleural cavity in 69, 10 and 10 patients, and the success rates of complete and lasting pleurodesis were 87.0%, 5/10 and 8/10 respectively. Postoperative complications included transient fever and chest pain, local subcutaneous emphysema in 6 cases and tumor seeding at thoracoscopy site in 4 cases. It is concluded that thoracoscopy is simple, safe, reliable and of high practical value in the diagnosis of malignant pleural effusions and in assessment before exploratory thoracotomy, and that transendoscopical administration of drugs for pleurodesis is a very effective method for controlling malignant pleural effusions. The efficacy of the talc poudrage is better than tetracycline and Corynebacterium parvum. PMID:9206045

Zhang, D; Chen, Y; Tu, C

1996-03-01

110

Association of Metsovo lung and pleural mesothelioma with exposure to tremolite-containing whitewash.  

PubMed

Pleural thickening, bilateral pleural hyalinised plaques, and restrictive lung function are found among inhabitants of four small villages in northwestern Greece. Transbronchial biopsy samples from patients with disease contained tremolite fibres. Malignant pleural mesothelioma has now been reported in these villages and accounts for approximately 1% of the total mortality from 1981 to 1985. The principal whitewash once used in this area is predominantly asbestiform tremolite. The fibre is identical in every respect to fibres found in the lung tissues of people with Metsovo lung. The membrane activity of this tremolite is greater than that of the commercially used asbestiform amphiboles amosite and crocidolite. This measure of cytotoxicity lends further support to the hypothesis that this fibre is the agent of Metsovo lung and mesothelioma. PMID:2882352

Langer, A M; Nolan, R P; Constantopoulos, S H; Moutsopoulos, H M

1987-04-25

111

Gender differences in coronary plaque composition and burden detected in symptomatic patients referred for coronary computed tomographic angiography.  

PubMed

We assessed gender differences in coronary plaque burden and composition amongst symptomatic patients referred for coronary computed tomographic angiography (CCTA). Over all, 916 symptomatic patients who were referred for a clinically indicated CCTA were included in the study. CCTAs were interpreted on a per-segment basis for plaque composition (non-calcified, calcified, or mixed) and stenosis severity. A stenosis of ?50 % was considered obstructive coronary artery disease. Among 916 patients, 498 (54.3 %) patients were women. Obstructive stenosis was found in 11 % of women compared to 21 % of men (p < 0.0001). Men had significantly higher plaque prevalence, 67.9 % versus 51.6 % in women (unadjusted OR 1.98; 95 % CI, 1.51-2.60). This remained significant after adjusting for age and potential confounders (adjusted OR 2.96; 95 % CI, 2.01-4.36). A similar relationship existed for all three plaque subtypes. Men were also more likely to have mixed plaque burden (adjusted OR 1.24; 95 % CI, 1.08-1.43) than women without any significant differences in regards to the other plaque sub-types. In conclusion, symptomatic women have a lower prevalence of obstructive coronary artery disease and are less likely to have mixed coronary plaque compared to symptomatic men. Future studies are needed to determine the prognostic implications of these findings. PMID:22821474

Qureshi, Waqas; Blaha, Michael J; Nasir, Khurram; Al-Mallah, Mouaz H

2013-02-01

112

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

NASA Astrophysics Data System (ADS)

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

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

2006-03-01

113

Material-specific imaging of atherosclerotic plaque using coherently scattered x rays  

NASA Astrophysics Data System (ADS)

The formation and development of plaques in the arterial wall is a direct consequence of atherosclerosis. The composition of a plaque is of particular interest as it is thought to be an important indicator of vulnerability, or risk of rupture and thrombosis. Current diagnostic methods do not yet have the ability to fully characterize plaque composition. Coherent-scatter imaging, a technique being developed in our laboratory, produces images based on the low-angle scattering properties of tissue. As these properties depend on molecular structure, material-specific maps of the different components in a tissue can be created. Material-specific images were produced for an atherosclerotic carotid artery. The image distributions of fatty and calcified deposits agreed with visual examination of the specimen. Preliminary results indicate that fat and calcifications, two typical plaque constituents, can be identified and distinguished from the undiseased vessel wall using coherently scattered x rays.

Davidson, Melanie T.; Batchelar, Deidre L.; Cunningham, Ian A.

2002-05-01

114

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)

2008-09-23

115

Pleural malignancies including mesothelioma.  

PubMed

Malignant mesothelioma is caused almost exclusively by occupational exposure to asbestos. During the past few years, however, increasing evidence has mounted that background exposure to asbestos could be sufficient to cause mesothelioma. Treatment of malignant mesothelioma remains a big problem. Some new approaches are on their way, and the most exciting ones are local immunotherapy in very early cases. Some success has been reported with local interferon treatment. As for treatment of metastatic pleural disease, the main purpose is symptomatic relief of dyspnea caused by fluid accumulation. The best way to achieve a lasting palliation is pleurodesis, and the most common way to do this, is by chemical means. The drug of choice in the United States has for many years been tetracycline, but since injectable tetracycline is no longer available, some substitute must be found. The substance that will "win" is not yet clear, but the two leading contestants are talc and doxycycline. Bleomycin also has its supporters, and a dark horse is quinacrine, which although not easily available in the United States, has been used in many European centers for decades. PMID:9363074

Hillerdal, G

1995-07-01

116

Plaque Inhibiting Oligosaccharide.  

National Technical Information Service (NTIS)

The present invention relates to a purified oligosaccharide which can be isolated from a natural source, e.g. from the cell wall polysaccharide of Streptococcus sanguis. S. sanguis is found in significant numbers in human dental plaque. This oligosacchari...

F. J. Cassels J. London

1989-01-01

117

Sintered plaque characteristics  

NASA Technical Reports Server (NTRS)

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

Vaidyanathan, H.

1982-01-01

118

[Pleural empyema caused by Legionella pneumophila].  

PubMed

Although pleural effusion is not uncommon in legionellosis, the development of empyema and the demonstration of the organism in pleural fluid are exceptional. We report four patients with pleural empyema with isolation of Legionella pneumophila in the pleural fluid culture. The patients were three males and one female, with ages ranging from 36 and 83 years. All had left pleuritic pain, fever and pleural effusion. The appearance of pleural effusion was purulent in two cases and serofibrinous in the other two. Initially, the diagnosis was only suspected in one patient. The other three received inadequate treatment, until the result of the culture of the pleural fluid in BCYE-alpha medium was known. After giving erythromycin therapy at high doses, the outcome was favorable in the four patients. It is concluded that, in the absence of another diagnosis, the presence of L. pneumophila should be systematically investigated in the pleural fluid although the disease is not clinically suspected. PMID:2747322

Ribera, E; Ferrer, A; Gelabert, R; Xercavins, M; Martínez-Vázquez, J M

1989-04-29

119

Pleural effusions and diseases of the pleura.  

PubMed

There are four factors that govern fluid movement to or from the pleural space: hydrostatic pressure, colloid osmotic pressure, filtration coefficient, and lymphatic function. When any of these factors are altered, fluid accumulates within the pleural space. Congestive heart failure, pancreatitis, neoplasia, hypoalbuminemia, and pulmonary thromboembolism can evoke pleural effusions by altering normal fluid transport mechanisms. This approach to pleural effusion helps to explain fluid accumulation. Chylothorax, hemothorax, and empyema are also covered in the article. PMID:3907107

Noone, K E

1985-09-01

120

Massive pleural effusions in cryptococcal meningitis  

PubMed Central

Cryptococcal infection uncommonly presents with pulmonary manifestations and even more rarely so as massive bilateral effusions. Pleural involvement is usually associated with underlying pulmonary parenchymal lesions and is unusual while on antifungal therapy. We report a patient with cryptococcal meningitis who, while on intravenous 5-flucytosine and amphotericin B, developed life-threatening bilateral massive pleural effusions with evidence of spontaneous resolution, consistent with prior hypothesis of antigenic stimulation as the cause of pleural involvement.???Keywords: cryptococcosis; pleural effusions

Wong, C; Lim, K; Liam, C

1999-01-01

121

Coronary artery bypass grafting to a calcified right coronary artery  

Microsoft Academic Search

A severely calcified coronary artery demands a special technique in coronary artery bypass surgery. We have successfully developed\\u000a a “punch-out” technique for a calcified right coronary artery in a dialysis patient. After an incision into the target coronary\\u000a artery, the calcified arterial wall was resected using a punch to make an oval hole for anastomosis. Limited endarterectomy,\\u000a which consisted of

Masaru Yoshikai; Keiji Kamohara; Junji Yunoki

2002-01-01

122

Comparison of Racial Differences in Plaque Composition and Stenosis Between HIV-Positive and HIV-Negative Men from the Multicenter AIDS Cohort Study.  

PubMed

Previous studies demonstrated that blacks have less coronary artery calcification (CAC) than whites. We evaluated racial differences in plaque composition and stenosis in the Multicenter AIDS Cohort Study. HIV-positive and HIV-negative men underwent noncontrast cardiac computed tomography (CT) if they were aged 40 to 70 years, weighed <136 kg, and had no history of cardiac surgery or revascularization and, if eligible, coronary CT angiography (CTA). There were 1,001 men who underwent CT scans and 759 men CTA. We measured CAC on noncontrast CT and identified total plaque, noncalcified plaque, calcified plaque, mixed plaque, and coronary stenosis >50% on CTA. The association of presence and extent of plaque with race was determined after adjustment for HIV serostatus, cardiovascular risk factors, and measures of socioeconomic status. The prevalences of any plaque on CTA and noncalcified plaque were not different between black and white men; however, black men had lower prevalences of CAC (prevalence ratio [PR] 0.79, p = 0.01), calcified plaque (PR 0.69, p = 0.002), and stenosis >50% (PR 0.59, p = 0.009). There were no associations between black race and extent of plaque in fully adjusted models. Using log-linear regression, black race was associated with a lower extent of any plaque on CTA in HIV-positive men (estimate = -0.24, p = 0.051) but not in HIV-negative men (0.12, p = 0.50, HIV interaction p = 0.005). In conclusion, a lower prevalence of CAC in black compared with white men appears to reflect less calcification of plaque and stenosis rather than a lower overall prevalence of plaque. PMID:24929623

Miller, P Elliott; Budoff, Matthew; Zikusoka, Michelle; Li, Xiuhong; Palella, Frank; Kingsley, Lawrence A; Witt, Mallory D; Sharrett, A Richey; Jacobson, Lisa P; Post, Wendy S

2014-08-01

123

[VATS in malignant pleural effusions].  

PubMed

Between November 1992 and October 1996, 20 patients with malignant pleural effusions were submitted to VATS under general anesthesia. The overall positive histological diagnoses were obtained through VATS (20/20). The malignant pleural mesothelioma in 8 cases and metastatic cancers in 12 cases were histopathologically confirmed. Talc pleurodesis was performed for all the cases, and 18 patients gained lasting pleurodesis and the other 2 patients did not. The failure of pleurodesis was due to that the lung could not reexpand to come into contact with the chest wall. Postoperative complications included transient fever and slight asthma in 2 cases, and the symptoms were relieved obviously after some simple therapy to symptom. In conclusion, VATS has provided a high positive diagnosis of patients with malignant pleural effusions not diagnosed by conventional methods and good results in pleurodesis, but some operating skills must be emphasized. PMID:10678010

Cui, Y; Wang, J; Liu, T

1997-11-01

124

Liposarcoma of the pleural cavity.  

PubMed

We report a case of pleural liposarcoma in a 58-year-old male patient with a twenty-year history of smoking, who was admitted for chest pain and chronic cough. Pleural liposarcoma is a rare, highly malignant intrathoracic tumor arising from the soft tissue of the pleural cavity. Chest radiograph and CT scan revealed a homogeneous mass with subtotal opacification of the left hemithorax. Tumor diagnosis was based on histopathological examination of a transparietal biopsy and revealed a mixed type liposarcoma. Surgical resection was performed followed by adjuvant irradiation. No recurrence was diagnosed during the follow-up period of ten months and the patient continues to do well at the time of writing this paper. PMID:18810708

Alloubi, I; Boubia, S; Ridai, M

2008-10-01

125

Correlation between Plaque Composition as assessed by Virtual Histology and C-reactive Protein  

PubMed Central

Background Previous studies have shown that coronary plaque composition plays a pivotal role in plaque instability, and imaging modalities and serum biomarkers have been investigated to identify vulnerable plaque. Virtual histology IVUS (VH-IVUS) characterizes plaque components as calcified, fibrotic, fibrofatty, or necrotic core. C-reactive protein (hsCRP) is an independent risk factor and a powerful predictor of future coronary events. However, a relationship between inflammatory response indicated by CRP and plaque characteristics in ACS patients remains not well established. Objective To determine, by using VH-IVUS, the relation between coronary plaque components and plasma high-sensitivity CRP levels in patients with acute coronary syndromes (ACS). Methods 52 patients with ACS were enrolled in this prospective study. Electrocardiographically-gated VH-IVUS were performed in the culprit lesion before PCI. Blood sample was drawn from all patients before the procedure and after 24 hours, and hs-CRP levels were determined. Results Mean age was 55.3±4.9 years, 76.9% were men and 30.9% had diabetes. Mean MLA was 3.9±1.3 mm2, and plaque burden was 69±11.3%, as assessed by IVUS. VH-IVUS analysis at the minimum luminal site identified plaque components: fibrotic (59.6±15.8%), fibrofatty (7.6±8.2%), dense calcium (12.1±9.2%) and necrotic core (20.7±12.7%). Plasma hs-CRP (mean 16.02±18.07 mg/L) did not correlate with necrotic core (r=-0.089, p = 0.53) and other plaque components. Conclusions In this prospective study with patients with ACS, the predominant components of the culprit plaque were fibrotic and necrotic core. Serum hs C-reactive protein levels did not correlate with plaque composition.

Siqueira, Dimytri Alexandre de Alvim; Sousa, Amanda Guerra Moraes R.; Costa Junior, Jose de Ribamar; da Costa, Ricardo Alves; Staico, Rodolfo; Tanajura, Luis Fernando Leite; Centemero, Marinella Patrizia; Feres, Fausto; Abizaid, Alexandre Antonio Cunha; Sousa, J. Eduardo Moraes R.

2013-01-01

126

[Renal cell carcinoma with malignant pleural mesothelioma after asbestos exposure: a case report].  

PubMed

A 66-year-old man visited complaining of cough and sore throat. He had been exposed to asbestos 43 years ago. Chest X-ray revealed left pleural effusion and abnormal shadow in the right lung field. Chest computed tomography (CT) showed multiple enhanced nodules in the right pleural cavity. Abdominal CT showed a 3-cm enhanced tumor in the lower pole of the left kidney. Left radical nephrectomy was performed. Pathological diagnosis was renal cell carcinoma. Postoperatively pleural biopsy was performed by using thoracoscopy. White plaque was seen at the costal pleura and surface of lung. Pathological diagnosis was malignant pleural mesothelioma based on using mesothelium-associated antibodies: calretinin (+), CK5/6 (+), D2-40 (+), HBME-1 (+), TTF-1 (-), MOC31 (-), CEA (-). Combination therapy (extrapleural pneumonectomy, chemotherapy, and radiotherapy) was initiated. Malignant mesothelioma is a devastating neoplasm with a strong etiological relationship with asbestos exposure. The incidence is rising in industrialized countries, with the peak expected in the year 2020. However, renal cell carcinoma with malignant pleural mesothelioma is very rare and this is the 2nd case in the Japanese literature. PMID:18051806

Sawazaki, Harutake; Yoshikawa, Takeshi; Takahashi, Takeshi; Taki, Yoji; Takeuchi, Hideo; Sakai, Yasuhiro

2007-11-01

127

Pleural infection-current diagnosis and management  

PubMed Central

Pleural infection is a common and increasing clinical problem in thoracic medicine, resulting in significant morbidity and mortality. In recent years there has been a marked increase in interests and publications relating to evolving interventions and management options for pleural infection and empyema. Recently published research data as well as guidelines have suggested better approaches of radiological assessment, updated management algorithms for pleural infection, intrapleural adjunct therapies and re-examined the roles of biomarkers, pleural drainage techniques, and the role of surgery. This review highlights some of the recent advances and recommendations relevant to clinical care of pleural infection.

2012-01-01

128

Medical Thoracoscopy vs Closed Pleural Biopsy in Pleural Effusions: A Randomized Controlled Study  

PubMed Central

Background: Pleural effusion is a common diagnostic dilemma for the pulmonologist. A histological diagnosis would many a time steer the way to an accurate diagnosis of the aetiologies of pleural effusions. This study has compared two methods for obtaining histological specimens in cases of undiagnosed pleural effusions. Aim: To compare the efficacy of closed pleural biopsy with Abrahm’s needle and medical thoracoscopic biopsy in the diagnosis of undiagnosed exudative pleural effusions at a tertiary care setting. Study Design: Randomized controlled study. Study Period: November 2008–October 2010. Methodology: All patients who were admitted with pleural effusions underwent a clinical workup for pleural effusions. Light’s criterion was used to differentiate between exudative and transudative pleural effusions. Those patients with exudative pleural effusions, who did not have a specific diagnosis, were included in the study. Fifty eight patients were included in the study and they were randomized into 2 Groups of 29 patients each. One group was subjected to medical thoracoscopic pleural biopsy and the other to closed pleural biopsy with Abrahm’s needle. Demographic, clinical and biochemical characteristics, diagnostic yields and the complications among the two groups were compared. Result: Medical thoracoscopy has a diagnostic yield of 86.2% with complication rate of 10.3% compared to 62.1% and 17.2% respectively in closed pleural biopsy group. Conclusion: Medical thoracoscopic pleural biopsy had a better diagnostic yield with a lower complication rate as compared to closed pleural biopsy with Abrahm’s needle.

K.P., Suraj; T.P., Rajagopal; P.T., James; Chetambath, Ravindran

2014-01-01

129

Progression from calcifying tendinitis to rotator cuff tear  

Microsoft Academic Search

This report documents the clinical, radiographic and histologic findings in a 46-year-old man with calcifying tendinitis in his left shoulder which progressed to rotator cuff tear. The patient had a 1-year history of repeated calcifying tendinitis before being referred to our hospital. On the initial visit, radiographs and magnetic resonance imaging (MRI) revealed calcium deposition localized in the supraspinatus tendon

Masafumi Gotoh; Fujio Higuchi; Ritsu Suzuki; Kensuke Yamanaka

2003-01-01

130

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: ken.rosenzweig@mountsinai.org [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)

2012-07-15

131

LIBS analysis of artificial calcified tissues matrices.  

PubMed

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

2013-04-15

132

Vitamin K-Antagonists Accelerate Atherosclerotic Calcification and Induce a Vulnerable Plaque Phenotype  

PubMed Central

Background Vitamin K-antagonists (VKA) are treatment of choice and standard care for patients with venous thrombosis and thromboembolic risk. In experimental animal models as well as humans, VKA have been shown to promote medial elastocalcinosis. As vascular calcification is considered an independent risk factor for plaque instability, we here investigated the effect of VKA on coronary calcification in patients and on calcification of atherosclerotic plaques in the ApoE?/? model of atherosclerosis. Methodology/Principal Findings A total of 266 patients (133 VKA users and 133 gender and Framingham Risk Score matched non-VKA users) underwent 64-slice MDCT to assess the degree of coronary artery disease (CAD). VKA-users developed significantly more calcified coronary plaques as compared to non-VKA users. ApoE?/? mice (10 weeks) received a Western type diet (WTD) for 12 weeks, after which mice were fed a WTD supplemented with vitamin K1 (VK1, 1.5 mg/g) or vitamin K1 and warfarin (VK1&W; 1.5 mg/g & 3.0 mg/g) for 1 or 4 weeks, after which mice were sacrificed. Warfarin significantly increased frequency and extent of vascular calcification. Also, plaque calcification comprised microcalcification of the intimal layer. Furthermore, warfarin treatment decreased plaque expression of calcification regulatory protein carboxylated matrix Gla-protein, increased apoptosis and, surprisingly outward plaque remodeling, without affecting overall plaque burden. Conclusions/Significance VKA use is associated with coronary artery plaque calcification in patients with suspected CAD and causes changes in plaque morphology with features of plaque vulnerability in ApoE?/? mice. Our findings underscore the need for alternative anticoagulants that do not interfere with the vitamin K cycle.

Schurgers, Leon J.; Chatrou, Martijn L. L.; Herfs, Marjolein; Winkens, Mark H. M.; Westenfeld, Ralf; Veulemans, Verena; Krueger, Thilo; Shanahan, Catherine M.; Jahnen-Dechent, Willi; Biessen, Erik; Narula, Jagat; Vermeer, Cees; Hofstra, Leonard; Reutelingsperger, Chris P.

2012-01-01

133

Regression of calcified coronary artery plaque assessed by electron beam computed tomography  

Microsoft Academic Search

Summary Lipid lowering therapies and aggressive life style modifications can induce regression of coronary artery disease as demonstrated by several angiographic studies. Such regression has also been associated with greatly reduced cardiovascular event rates. However, coronary angiography is invasive and expensive and other non-invasive diagnostic approaches would be preferable. Electron beam computed tomography imaging is used to detect coronary artery

P. Raggi

2000-01-01

134

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

PubMed Central

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 × 106 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.

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.

2010-01-01

135

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

PubMed

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

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

2014-08-01

136

Treatment of complicated parapneumonic pleural effusion and pleural parapneumonic empyema  

PubMed Central

Summary Background We performed this observational prospective study to evaluate the results of the application of a diagnostic and therapeutic algorithm for complicated parapneumonic pleural effusion (CPPE) and pleural parapneumonic empyema (PPE). Material/Methods From 2001 to 2007, 210 patients with CPPE and PPE were confirmed through thoracocentesis and treated with pleural drainage tubes (PD), fibrinolytic treatment or surgical intervention (videothoracoscopy and posterolateral thoracotomy). Patients were divided into 3 groups: I (PD); II (PD and fibrinolytic treatment); IIIa (surgery after PD and fibrinolysis), and IIIb (direct surgery). The statistical study was done by variance analysis (ANOVA), ? 2 and Fisher exact test. Results The presence of alcohol or drug consumption, smoking and chronic obstructive pulmonary disease (COPD) were strongly associated with a great necessity for surgical treatment. The IIIa group was associated with increased drainage time, length of stay and complications. No mortality was observed. The selective use of PD and intrapleural fibrinolysis makes surgery unnecessary in more than 75% of cases. Conclusions The selective use of PD and fibrinolysis avoids surgery in more than 75% of cases. However, patients who require surgery have more complications, longer hospital stay, and more days on PD and they are more likely to require admittance to the Intensive Care Unit.

Suarez, Pedro Rodriguez; Gilart, Jorge Freixinet; Perez, Jose Maria Hernandez; Serhal, Mohamed Hussein; Artalejo, Antonio Lopez

2012-01-01

137

[Management of malignant pleural effusions].  

PubMed

Malignant pleural effusions with dyspnoea as their most common presenting symptom are a frequent clinical problem in patients with neoplastic disease. Lung carcinoma is the leading cause, followed by breast carcinoma and malignant lymphoma. The frequency of malignant mesothelioma is increasing in industrialized countries. In this overview, which is based on the ERS/ATS Statement 2001, the diagnostic approach, the differential diagnosis including causes of paramalignant effusions, as well as the therapeutic possibilities are described. Pleurodesis is the most important therapeutic modality, today preferably via thoracoscopic talc poudrage. Alternative local and systemic treatment options are discussed in detail. A special emphasis is put on the epidemiology, diagnosis, treatment, and prognosis of malignant effusions in patients with lung and breast carcinomas, and with lymphomas. Finally, open questions are listed which need future research, which will hopefully improve the treatment and prognosis of malignant pleural effusions. PMID:15724226

Loddenkemper, R

2005-02-01

138

Pulverisation of calcified and non-calcified gall bladder stones: extracorporeal shock wave lithotripsy used alone.  

PubMed Central

Using a modified electromagnetic lithotripter (Siemens), extracorporeal shock wave lithotripsy (ESWL) was performed in 260 patients with gall bladder stones. Exclusion criteria for treatment were a non-functioning gall bladder, subcostal gall bladder location, and multiple stones occupying more than three quarters of the gall bladder volume. Stone pulverisation was the end point of ESWL. The number of shock wave discharges and sessions was not limited. Pulverisation was achieved in 250 patients (96.1%) after a median of three ESWL sessions (range 1-21). The number of sessions required depended upon stone composition and burden. More than three sessions were required in 60.2% of patients with calcified stones compared with 35.9% of patients with non-calcified stones (p < 0.001). 65.8% of patients with stones measuring more than 30 mm in total diameter required more than three sessions compared with 42.9% of patients with a stone burden less than 30 mm (p < 0.01). At 18-24 (8-12) months follow up, stone clearance was achieved in 94.3% (80.4%) of patients with non-calcified stones, compared with 89.5% (76.8%) in patients with calcified stones and in 75% (71.4%) of patients with a total stone diameter more than 30 mm compared with 95.7% (80.4%) for patients with a total stone diameter less than 30 mm (p < 0.05). ESWL related complications (gross haematuria) occurred in three patients. Thirty six (13.8%) patients experienced biliary colic; four had cholecystectomy, and five endoscopic papillotomy because of common bile duct obstruction. Stone recurrence was seen in 5.3% of patients over a follow up period of up to two years (median 16.6 months).

Soehendra, N; Nam, V C; Binmoeller, K F; Koch, H; Bohnacker, S; Schreiber, H W

1994-01-01

139

Calcified obstructive disease of the aortic arch.  

PubMed

Coral reef aorta is described as rock-hard calcifications usually localized in the visceral part of the aorta. Rare cases of acquired coarctation of the descending aorta due to coral reefs have been mentioned in the literature. A more uncommon entity is the coral reef of the aortic arch. We are presenting a rare case of a 55-year old woman referred to our vascular department for bilateral lower limb claudication associated with resistant hypertension and anisotension. A thoracoabdominal computed tomography scan was subsequently performed and showed a preocclusive calcified lesion located at the termination of the aortic arch, involving the ostia of the left subclavian artery. An open surgical approach was decided upon and an aortic endarterectomy by transversal aortotomy was successfully performed. Although uncommon, acquired coarctation should be considered in all hypertensive patients presenting with bilateral lower limb claudication and blood pressure differences between the upper and lower extremities. PMID:24497606

Palcau, Laura; Gouicem, Djelloul; Cameliere, Lucie; Berger, Ludovic

2014-05-01

140

Nuclear analytical methods in calcified tissue research.  

PubMed

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

1995-01-01

141

Isolated congenital pleural effusion in two neonates.  

PubMed

Congenital isolated pleural effusion, a non-specific accumulation of fluid in the pleural space, is an uncommon anomaly which can be associated with structural malformations, inflammatory or iatrogenic problems, genetic syndromes or fetal hydrops. Here, we present two neonates with isolated congenital pleural effusion, one of which was associated with Down syndrome and the other with empyema and bloodstream infection caused by Burkholderia gladioli septicemia. We wanted to discuss the diagnosis and management of this rare clinical entity. PMID:22554367

Karagöl, Belma Sayg?l?; Okumu?, Nurullah; Karada?, Nilgün; Zenciro?lu, Ay?egül

2012-01-01

142

Cutting-balloon angioplasty before drug-eluting stent implantation for the treatment of severely calcified coronary lesions  

PubMed Central

Background Severely calcified coronary lesions respond poorly to balloon angioplasty, resulting in incomplete and asymmetrical stent expansion. Therefore, adequate plaque modification prior to drug-eluting stent (DES) implantation is the key for calcified lesion treatment. This study was to evaluate the safety and efficacy of cutting balloon angioplasty for severely calcified coronary lesions. Methods Ninety-two consecutive patients with severely calcified lesions (defined as calcium arc ? 180° calcium length ratio ? 0.5) treated with balloon dilatation before DES implantation were randomly divided into two groups based on the balloon type: 45 patients in the conventional balloon angioplasty (BA) group and 47 patients in the cutting balloon angioplasty (CB) group. Seven cases in BA group did not satisfactorily achieve dilatation and were transferred into the CB group. Intravascular ultrasound (IVUS) was performed before balloon dilatation and after stent implantation to obtain qualitative and quantitative lesion characteristics and evaluate the stent, including minimum lumen cross-sectional area (CSA), calcified arc and length, minimum stent CSA, stent apposition, stent symmetry, stent expansion, vessel dissection, and branch vessel jail. In-hospital, 1-month, and 6-month major adverse cardiac events (MACE) were reported. Results There were no statistical differences in clinical characteristics between the two groups, including calcium arc (222.2° ± 22.2° vs. 235.0° ± 22.1°, P = 0.570), calcium length ratio (0.67 ± 0.06 vs. 0.77 ± 0.05, P = 0.130), and minimum lumen CSA before PCI (2.59 ± 0.08 mm2 vs. 2.52 ± 0.08 mm2, P = 0.550). After stent implantation, the final minimum stent CSA (6.26 ± 0.40 mm2 vs. 5.03 ± 0.33 mm2; P = 0.031) and acute lumen gain (3.74 ± 0.38 mm2 vs. 2.44 ± 0.29 mm2, P = 0.015) were significantly larger in the CB group than that of the BA group. There were not statistically differences in stent expansion, stent symmetry, incomplete stent apposition, vessel dissection and branch vessel jail between two groups. The 30-day and 6-month MACE rates were also not different. Conclusions Cutting balloon angioplasty before DES implantation in severely calcified lesions appears to be more efficacies including significantly larger final stent CSA and larger acute lumen gain, without increasing complications during operations and the MACE rate in 6-month.

Tang, Zhe; Bai, Jing; Su, Shao-Ping; Wang, Yu; Liu, Mo-Han; Bai, Qi-Cai; Tian, Jin-Wen; Xue, Qiao; Gao, Lei; An, Chun-Xiu; Liu, Xiao-Juan

2014-01-01

143

A finite element investigation on plaque vulnerability in realistic healthy and atherosclerotic human coronary arteries.  

PubMed

Atherosclerosis is the most common arterial disease. It has been shown that stresses that are induced during blood circulation can cause plaque rupture and, in turn, lead to thrombosis and stroke. In this study, finite element method is used to predict plaque vulnerability based on peak plaque stress using human samples. A total of 23 healthy and atherosclerotic human coronary arteries of 14 healthy and 9 atherosclerotic patients are excised within 5 h postmortem. The samples are mounted on an uniaxial tensile test machine, and the obtained mechanical properties are used in two-dimensional and three-dimensional finite element models. The results including the Neo-Hookean hyperelastic coefficients of the samples as well as peak plaque stresses are analyzed. The results indicate that the atherosclerotic human coronary arteries have significantly (p < 0.05) higher stiffness compared with the healthy ones. The hypocellular plaque also has the highest stress values and, as a result, is most likely (vulnerable) to rupture, while the calcified type has the lowest stress values and, consequently, is expected to remain stable. The results could be used in the plaque vulnerability anticipation and have clinical implications in interventions and surgeries, including balloon angioplasty, bypass, and stenting. PMID:23513986

Karimi, Alireza; Navidbakhsh, Mahdi; Faghihi, Shahab; Shojaei, Ahmad; Hassani, Kamran

2013-02-01

144

Pleural-fluid myeloperoxidase in complicated and noncomplicated parapneumonic pleural effusions  

Microsoft Academic Search

The diagnostic accuracy of myeloperoxidase (MPO) in pleural fluid, for differentiating between complicated and noncomplicated parapneumonic pleural effusions (PPE) evaluated prospectively. Seventy patients aged w18 yrs with PPE (36 complicated and 34 noncomplicated) were studied after admission to a tertiary referral teaching hospital. MPO concen- tration was measured in plasma and pleural fluid using a double-antibody competitive radioimmunoassay. The concentrations

J. Alegre; J. Jufresa; R. Segura; A. Ferrer; L. Armadansz; C. Aleman; R. Marti; E. Ruiz; T. Fernandez de Sevilla

2002-01-01

145

Thoracoscopic parietal pleural argon beam coagulation versus pleural abrasion in the treatment of primary spontaneous pneumothorax  

Microsoft Academic Search

Objective: The obliteration of pleural space is useful to prevent recurrences of spontaneous pneumothorax. We retrospectively compared the results of pleural argon beam coagulation versus pleural abrasion in the treatment of primary spontaneous pneumothorax. Methods: Between 1996 and 2004, 136 patients underwent surgery for primary spontaneous pneumothorax, with 143 surgical procedures, all performed by VATS. Indications were recurrent pneumothorax in

Antonio Bobbio; Luca Ampollini; Eveline Internullo; Domenico Caporale; Leonardo Cattelani; Stefano Bettati; Paolo Carbognani; Michele Rusca

2006-01-01

146

Thoracoscopic parietal pleural argon beam coagulation versus pleural abrasion in the treatment of primary spontaneous pneumothorax  

Microsoft Academic Search

Objective: The obliteration of pleural space is useful to prevent recurrences of spontaneous pneumothorax. We retrospectively compared the results of pleural argon beam coagulation versus pleural abrasion in the treatment of primary spontaneous pneumothorax. Methods: Between 1996 and 2004, 136 patients underwent surgery for primary spontaneous pneumothorax, with 143 surgical procedures, all performed by VATS. Indications were recurrent pneumothorax in

Antonio Bobbio; Luca Ampollini; Eveline Internullo; Domenico Caporale; Leonardo Cattelani; Stefano Bettati; Paolo Carbognani; Michele Rusca; Viale Gramsci

2010-01-01

147

Candidate gene study revealed sex specific association between the OLR1 gene and carotid plaque  

PubMed Central

Background and Purpose Sex differences have been recognized in stroke risk; however, the sex-dependent genetic contribution to stroke is unclear. We sought to examine the sex-dependent associations between genes involved in lipid metabolism and carotid atherosclerotic plaque, a subclinical precursor of stroke. Methods For the Genetic Determinant of Subclinical Carotid Disease study, 287 Dominicans ascertained through the Northern Manhattan Study (NOMAS) were examined for carotid plaque using high-resolution ultrasound. Sixty-four single nucleotide polymorphisms (SNPs) in eleven lipid-related genes were genotyped. Plaque presence and plaque sub-phenotypes, including multiple, thick, irregular and calcified plaque, were analyzed. First, the interaction between each SNP and sex was evaluated for association with each plaque phenotype using multiple logistic regression and controlling for age, smoking, and the main effects of sex and SNP. For SNPs with suggestive evidence for interaction with sex (p<0.1 for the interaction term), stratification analysis by sex was performed to evaluate the sex-specific association between the SNP and plaque phenotypes. Results The most compelling finding is with the missense SNP rs11053646 (K167N) in the OLR1 gene, which encodes lectin-like oxidized LDL receptor. Stratification analysis revealed a strong association between rs11053646 and all plaque phenotypes in women (OR=2.44~5.86, p=0.0003~0.0081) but not in men (OR=0.85~1.22 p=0.77~0.92). Conclusions Genetic variation in genes involved in lipid metabolism may have sex-dependent effects on carotid plaque burden. Our findings provide a plausible biological basis underlying the sex difference in cardiovascular risk.

Wang, Liyong; Yanuck, Danielle; Beecham, Ashley; Gardener, Hannah; Slifer, Susan; Blanton, Susan H.; Sacco, Ralph L.; Rundek, Tatjana

2011-01-01

148

Primary systemic amyloidosis and persistent pleural effusions.  

PubMed

Persistent pleural effusions are not common in patients with primary systemic amyloidosis (AL). A recent review of this complication of the disease hypothesized that the pathophysiology of these effusions is pleural amyloid deposition, disrupting lymphatic drainage. We report the case of a 73-year-old woman with primary systemic AL and persistent bilateral pleural effusions, refractory to diuresis and repeated thoracenteses. The patient's cardiac and renal dysfunction was not severe enough to explain these persistent effusions. Thus, despite a lack of biopsy-proven amyloid deposition, we suggest that these effusions may be secondary to pleural amyloid deposition. PMID:19922337

Schwarz, Dan; Jue, Christopher; Sikov, William

2009-12-01

149

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

2013-01-01

150

Calcifying Aponeurotic Fibroma: Case Report with Radiographic and MR Features  

PubMed Central

Calcifying aponeurotic fibroma is a rare, benign fibroblastic tumor. The lesion has a propensity for local invasion and a high recurrent rate. Therefore, accurate preoperative diagnosis and complete excision are important to prevent the recurrence of the tumor after surgical removal. However, radiographic and magnetic resonance imaging findings of calcifying aponeurotic fibroma have been extremely rarely described in the radiology literature. Thus, we report a rare case of calcifying aponeurotic fibroma affecting the dorsal wrist in a 67-year-old man, describe radiographic and MR findings, and discuss the differential diagnosis of the tumor.

Kim, Yeon Mee

2014-01-01

151

Impact of strut-vessel distance and underlying plaque type on the resolution of acute strut malapposition: serial optimal coherence tomography analysis after everolimus-eluting stent implantation.  

PubMed

The consequences of acute strut malapposition in everolimus-eluting stents (EES) are unknown. This study investigated the impact of strut-vessel (S-V) distance and plaque type underneath acute strut malapposition on the mid-term vessel response in EES. Twenty-nine patients (35 EES) underwent optical coherence tomography (OCT) immediately after percutaneous coronary intervention and at 8-month follow-up. S-V distance and plaque type (lipid, calcified, or fibrous) underneath acute strut malapposition were evaluated. Follow-up OCT classified acute strut malapposition as persistent or resolved. The S-V cutoff value for predicting resolved strut malapposition and the incidence of intra-stent thrombi were determined. Among 569 cases of acute strut malapposition, involving 29,168 struts, 139 (24.4 %) were persistent. Mean S-V distance was significantly longer in persistent than in resolved strut malapposition (600 ± 294 vs. 231 ± 95 ?m; P < 0.0001). S-V distance ?380 ?m was the best cutoff value for predicting resolved strut malapposition (sensitivity 93.5 %, specificity 69.8 %, area under curve 0.878). Acute strut malapposition with S-V distance ?380 ?m remained persistent more frequently over lipid/calcified than over fibrous plaques (lipid: 13.4 %, calcified: 18.2 %, fibrous: 4.2 %; lipid vs. fibrous, P = 0.001; calcified vs. fibrous, P = 0.02). Intra-stent thrombi were more frequent in stents with ?1 persistent strut malapposition than in those without [4/11 stents (36.3 %) vs. 0/24 (0 %); P = 0.006]. Lipid and calcified plaque, together with S-V distance, affect the resolution of acute strut malapposition in EES. Persistent strut malapposition is associated with the presence of thrombi at follow-up, which could be the substrate for late stent thrombosis. PMID:24748583

Inoue, Takumi; Shinke, Toshiro; Otake, Hiromasa; Nakagawa, Masayuki; Hariki, Hirotoshi; Osue, Tsuyoshi; Iwasaki, Masamichi; Taniguchi, Yu; Nishio, Ryo; Hiranuma, Noritoshi; Konishi, Akihide; Kinutani, Hiroto; Kuroda, Masaru; Hirata, Ken-ichi

2014-06-01

152

Intra-articular calcifying synovial sarcoma mimicking synovial chondromatosis  

Microsoft Academic Search

A case of intra-articular calcifying synovial sarcoma of the right knee joint in a 27-year-old man is reported. Prior to\\u000a admission the patient had been suffering pain in the right knee for 5 years. Plain radiographs showed multiple calcified densities\\u000a in the anterior aspect of the right knee closely mimicking synovial chondromatosis. Histological examination revealed that\\u000a the lesion was a

T. Ishida; Takuo Iijima; Shinichi Moriyama; Chiyuki Nakamura; Tomoyuki Kitagawa; Rikuo Machinami

1996-01-01

153

Exudative pleural diseases in small animals.  

PubMed

Exudative pleural diseases are a common cause of respiratory distress and systemic illness in dogs and cats. This article addresses the pathophysiology, development, and classification of exudative pleural effusions. The most current diagnostic strategies, causes, imaging findings, and medical or surgical treatment options for select diseases are reviewed in detail. PMID:24268340

Epstein, Steven E

2014-01-01

154

Serum PDGF-AB in Pleural Mesothelioma  

Microsoft Academic Search

Overexpression of platelet-derived growth factor (PDGF) has been observed in lung and pleural tumors. The aim of this study was to evaluate the diagnostic and prognostic role of serum PDGF in pleural mesothelioma (PM). Four groups of subjects were studied: 93 malignant PM patients, 33 primary non small cell lung cancer patients, 51 subjects exposed to asbestos, defined as high-risk

Rosa Filiberti; Paola Marroni; Monica Neri; Andrea Ardizzoni; Pier Giacomo Betta; Mara A. Cafferata; Pier Aldo Canessa; Riccardo Puntoni; Giovanni Paolo Ivaldi; Michela Paganuzzi

2005-01-01

155

Diagnosis exjuvantibus of a persistent pleural effusion  

PubMed Central

The diagnosis of uremia-associated effusion is one of exclusion. A patient with an unexplained chronic pleural exudate, which cleared with dialysis, is reported. The differential diagnosis of pleural effusions in patients with chronic kidney disease and the management of uremic pleuritis is briefly discussed.

Porcel, Jose M.

2013-01-01

156

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

2008-01-01

157

Pleural effusion - An unusual cause  

PubMed Central

Hepatitis A (HAV) infection is one of the most common forms of hepatitis in the paediatric age group in developing countries. It is usually self-limiting and rarely accompanied by extra hepatic complication. In this article, we report two children with hepatitis A who had associated issues of pleural effusion and ascites. Both issues improved with resolution of hepatitis after symptomatic treatment. Although uncommon, extra hepatic manifestations can occur with hepatitis A. However, they resolve completely. Paediatricians in developing countries should be aware of this rare association to avoid unnecessary investigations.

Ponnurangam Nagarajan, Vinoth; Palaniyadi, Anitha; Sathyamoorthi, Muthamilselvan; Sasitharan, Rajendraprasath; Shuba, Sankaranarayan; Padur Sivaraman, Rajakumar; Scott, Julius Xavier

2012-01-01

158

Shaggy and calcified aorta: surgical implications.  

PubMed

Atheroembolism is an emerging problem in cardiovascular surgery, especially in elderly patients. Severe atherosclerosis of the thoracic aorta usually reflects systemic atherosclerosis. Aggressive preoperative and intraoperative evaluation of the aorta using enhanced CT, transesophageal echocardiography and epiaortic ultrasound is important in elderly patients as well as those with systemic atherosclerosis. To prevent atheroembolism, it is important to select an adequate arterial perfusion site and to avoid touching the diseased aorta until circulatory arrest. In atherosclerotic aortic arch aneurysm, central cannulation under ultrasound guidance and directing the dispersive cannula toward the aortic root is a simple and effective perfusion strategy. Axillary perfusion is useful as an alternative to central cannulation in atherosclerotic aortic disease, but special care is necessary to avoid complications when the patient has a small axillary artery or flail atheroma around the arch vessels. In femoral artery perfusion, retrograde perfusion may induce paradoxical cerebral embolism, but the incidence of stroke is comparable with axillary perfusion when there is adequate preoperative screening using transesophageal echography. Circulatory arrest with/without cerebral perfusion is another important strategy when the aorta has severe atherosclerosis. Recent literature has shown that mild hypothermia may be safe for anterior cerebral perfusion during circulatory arrest, but optimal flow rates and time limitations are unknown. A simple calcified aorta called "porcelain aorta" may be managed by circulatory arrest, local debridement and the clamp method. Several surgical options are proposed for this clinical entity but their use will diminish in the future because of transcatheter valve replacement. PMID:23404308

Fukuda, Ikuo; Daitoku, Kazuyuki; Minakawa, Masahito; Fukuda, Wakako

2013-06-01

159

Plaque assay for murine norovirus.  

PubMed

Murine norovirus (MNV) is the only member of the Norovirus genus that efficiently grows in tissue culture. Cell lysis and cytopathic effect (CPE) are observed during MNV-1 infection of murine dendritic cells or macrophages. This property of MNV-1 can be used to quantify the number of infectious particles in a given sample by performing a plaque assay. 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. 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, 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. 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). This assay measures the amount of virus required to produce CPE in 50% of inoculated tissue culture cells by endpoint titration. However, its limit of detection is higher compared to a plaque assay. 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. 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. PMID:22951568

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

2012-01-01

160

CT coronary angiography: impact of adapted statistical iterative reconstruction (ASIR) on coronary stenosis and plaque composition analysis.  

PubMed

To assess the impact of adaptive statistical iterative reconstruction (ASIR) on coronary plaque volume and composition analysis as well as on stenosis quantification in high definition coronary computed tomography angiography (CCTA). We included 50 plaques in 29 consecutive patients who were referred for the assessment of known or suspected coronary artery disease (CAD) with contrast-enhanced CCTA on a 64-slice high definition CT scanner (Discovery HD 750, GE Healthcare). CCTA scans were reconstructed with standard filtered back projection (FBP) with no ASIR (0 %) or with increasing contributions of ASIR, i.e. 20, 40, 60, 80 and 100 % (no FBP). Plaque analysis (volume, components and stenosis degree) was performed using a previously validated automated software. Mean values for minimal diameter and minimal area as well as degree of stenosis did not change significantly using different ASIR reconstructions. There was virtually no impact of reconstruction algorithms on mean plaque volume or plaque composition (e.g. soft, intermediate and calcified component). However, with increasing ASIR contribution, the percentage of plaque volume component between 401 and 500 HU decreased significantly (p < 0.05). Modern image reconstruction algorithms such as ASIR, which has been developed for noise reduction in latest high resolution CCTA scans, can be used reliably without interfering with the plaque analysis and stenosis severity assessment. PMID:23053859

Fuchs, Tobias A; Fiechter, Michael; Gebhard, Cathérine; Stehli, Julia; Ghadri, Jelena R; Kazakauskaite, Egle; Herzog, Bernhard A; Husmann, Lars; Gaemperli, Oliver; Kaufmann, Philipp A

2013-03-01

161

Parapneumonic pleural effusion and empyema.  

PubMed

At least 40% of all patients with pneumonia will have an associated pleural effusion, although a minority will require an intervention for a complicated parapneumonic effusion or empyema. All patients require medical management with antibiotics. Empyema and large or loculated effusions need to be formally drained, as well as parapneumonic effusions with a pH <7.20, glucose <3.4 mmol/l (60 mg/dl) or positive microbial stain and/or culture. Drainage is most frequently achieved with tube thoracostomy. The use of fibrinolytics remains controversial, although evidence suggests a role for the early use in complicated, loculated parapneumonic effusions and empyema, particularly in poor surgical candidates and in centres with inadequate surgical facilities. Early thoracoscopy is an alternative to thrombolytics, although its role is even less well defined than fibrinolytics. Local expertise and availability are likely to dictate the initial choice between tube thoracostomy (with or without fibrinolytics) and thoracoscopy. Open surgical intervention is sometimes required to control pleural sepsis or to restore chest mechanics. This review gives an overview of parapneumonic effusion and empyema, focusing on recent developments and controversies. PMID:18367849

Koegelenberg, Coenraad F N; Diacon, Andreas H; Bolliger, Chris T

2008-01-01

162

Imaging of the unstable plaque  

Microsoft Academic Search

Atherosclerosis is now considered a systemic inflammatory disorder affecting the arterial tree. Inflammation plays a role in all stages of the disease, from the initiation of the fatty streak to the final stage of plaque rupture. Atherosclerotic plaques that demonstrate the features of active inflammation are more likely to become symptomatic. In addition to having a higher risk of developing

Kiat Tsong Tan; Gregory Y. H. Lip

2008-01-01

163

Routes to chemical plaque control  

Microsoft Academic Search

A logical approach to the prevention of periodontal disease is through excellent supragingival plaque control. Such control is not generally achieved by mechanical oral hygiene procedures alone. Thus, there is a clear rationale for the use of antiplaque agents to augment mechanical means. The principle routes to chemical plaque control are to prevent colonization of the tooth surface, to inhibit

D. Cummins

1991-01-01

164

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

2010-01-01

165

The effect of iterative reconstruction on quantitative computed tomography assessment of coronary plaque composition.  

PubMed

To compare coronary plaque size and composition as well as degree of coronary artery stenosis on coronary Computed Tomography angiography (CCTA) using three levels of iterative reconstruction (IR) with standard filtered back projection (FBP). In 63 consecutive patients with a clinical indication for CCTA 55 coronary plaques were analysed. Raw data were reconstructed using standard FBP and levels 2, 4 and 6 of a commercially available IR algorithm (iDose(4)). CT attenuation and noise were measured in the aorta and two coronary arteries. Both signal-to-noise-ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The amount of lipid, fibrous and calcified plaque components and mean cross-sectional luminal area were analysed using dedicated software. Image noise was reduced by 41.6% (p < 0.0001) and SNR and CNR in the aorta were improved by 73.4% (p < 0.0001) and 72.9% (p < 0.0001) at IR level 6, respectively. IR improved objective image quality measures more in the aorta than in the coronary arteries. Furthermore, IR had no significant effect on measurements of plaque volume and cross-sectional luminal area. The application of IR significantly improves objective image quality, and does not alter quantitative analysis of coronary plaque volume, composition and luminal area. PMID:24046026

Takx, Richard A P; Willemink, Martin J; Nathoe, Hendrik M; Schilham, Arnold M R; Budde, Ricardo P J; de Jong, Pim A; Leiner, Tim

2014-01-01

166

Plaque Assay for Rickettsia rickettsii  

PubMed Central

A plaque technique for the assay of Rickettsia rickettsii is described. The method employs primary chick or green monkey kidney monolayer cell cultures with either an agarose or special Noble agar overlay. Plaques were counted in 6 days and resultant titers correlated well with ld50 end points obtained by a standard assay in embryonated eggs. Identification of the plaque-forming organisms was accomplished by direct observation of rickettsiae-like bodies in the monolayer lesions, inhibition of plaques by antibiotics, sensitivity of plaques to specific immune serum, and failure to cultivate other microorganisms from the infected cells. Versatility of the test was demonstrated by assaying samples of rickettsiae from several different sources commonly used in our laboratory. These included infected yolk sacs, various cell cultures, and infected guinea pig tissue. Sufficient numbers of viable rickettsiae were present in the cells of a single lesion to permit direct recovery. Images

Weinberg, Edmund H.; Stakebake, Jack R.; Gerone, Peter J.

1969-01-01

167

Effect of age and plaque morphology on diagnostic accuracy of dual source multidetector computed tomography coronary angiography  

PubMed Central

Background Multidetector computed tomography (MDCT) coronary angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. The purpose of this study is to investigate the effect of age and coronary plaque calcification on diagnostic accuracy of MDCT. Methods The patients were examined by using dual-source MDCT and conventional coronary angiography. MDCT results were analyzed with regard to the severity (> 50% stenosis) and morphology (non-calcified, mixed, or calcified) of coronary atherosclerotic plaques evaluated in a 16-segment model. Results In total, 181 patients (94 men and 87 women) with 2,687 coronary artery segments were examined with MDCT. Ninety three patients were older than 65 years of age (group A, 42 men) and 88 were younger (group B, 52 men). Two-hundred nine coronary artery segments (7.2%) were excluded because of small distal coronary vessel segments and/or motion artifacts. The overall number of segments with non-diagnostic image quality was similar in both groups of patients. Of the 2,687 evaluated segments, 157 (5.8%) were significantly diseased, and 144 of them were correctly detected by MDCT. Diagnostic evaluation showed that the sensitivity, positive predictive value, specificity, and negative predictive value were 89.5%, 62.5%, 96.0%, and 99.2%, respectively in group A, and 95.2%, 64.8%, 97.5%, and 99.8% in group B, respectively. In addition, detailed segment-based analyses in coronary segments with non-calcified, mixed and calcified plaques in both groups were similar diagnostic accuracy. Conclusions Very high diagnostic accuracy observed in this study suggests that MDCT coronary angiography could be a suitable diagnostic tool for not only younger patients but also for older patients.

Sunman, Hamza; Aytemir, Kudret; Yorgun, Hikmet; Canpolat, Ugur; Taher, Ali; Demiri, Edis; Haz?rolan, Tuncay; Sahiner, Levent; Kaya, Ergun B.; Kabakc?, Giray; Tokgozoglu, Lale; Oto, Ali

2014-01-01

168

How Does Calcification Influence Plaque Vulnerability? Insights from Fatigue Analysis  

PubMed Central

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

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

2014-01-01

169

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

2013-01-01

170

Is There a Role for a Needle Thoracoscopic Pleural Biopsy under Local Anesthesia for Pleural Effusions?  

PubMed Central

Background A closed pleural biopsy is commonly performed for diagnosing patients exhibiting pleural effusion if prior thoracentesis is not diagnostic. However, the diagnostic yield of such biopsies is unsatisfactory. Instead, a thoracoscopic pleural biopsy is more useful and less painful. Methods We compared the diagnostic yield of needle thoracoscopic pleural biopsy performed under local anesthesia with that of closed pleural biopsy. Sixty-seven patients with pleural effusion were randomized into groups A and B. Group A patients were subjected to closed pleural biopsies, and group B patients were subjected to pleural biopsies performed using needle thoracoscopy under local anesthesia. Results The diagnostic yields and complication rates of the two groups were compared. The diagnostic yield was 55.6% in group A and 93.5% in group B (p<0.05). Procedure-related complications developed in seven group A patients but not in any group B patients. Of the seven complications, five were pneumothorax and two were vasovagal syncope. Conclusion Needle thoracoscopic pleural biopsy under local anesthesia is a simple and safe procedure that has a high diagnostic yield. This procedure is recommended as a useful diagnostic modality if prior thoracentesis is non-diagnostic.

Son, Ho Sung; Darlong, Laleng Mawia; Jung, Jae Seong; Sun, Kyung; Kim, Kwang Taik; Kim, Hee Jung; Lee, Kanghoon; Lee, Seung Hun; Lee, Jong Tae

2014-01-01

171

Highly Accurate Diagnosis of Pleural Tuberculosis by Immunological Analysis of the Pleural Effusion  

PubMed Central

Pleural TB is notoriously difficult to diagnose due to its paucibacillary nature yet it is the most common cause of pleural effusions in TB endemic countries such as The Gambia. We identified both cellular and soluble biomarkers in the pleural fluid that allowed highly accurate diagnosis of pleural TB compared to peripheral blood markers. Multi-plex cytokine analysis on unstimulated pleural fluid showed that IP-10 resulted in a positive likelihood ratio (LR) of 9.6 versus 2.8 for IFN-?; a combination of IP-10, IL-6 and IL-10 resulted in an AUC of 0.96 and positive LR of 10. A striking finding was the significantly higher proportion of PPD-specific IFN-?+TNF-?+ cell population (PPD-IGTA) in the pleural fluid compared to peripheral blood of TB subjects. Presence of this pleural PPD-IGTA population resulted in 95% correct classification of pleural TB disease with a sensitivity of 95% and specificity of 100%. These data suggest that analysis of the site of infection provides superior diagnostic accuracy compared to peripheral blood for pleural TB, likely due to the sequestration of effector cells at this acute stage of disease.

Sutherland, Jayne S.; Garba, Danlani; Fombah, Augustin E.; Mendy-Gomez, Awa; Mendy, Francis S.; Antonio, Martin; Townend, John; Ideh, Readon C.; Corrah, Tumani; Ota, Martin O. C.

2012-01-01

172

Recurrent pleural effusion due to duropleural fistula.  

PubMed

A 76-year-old woman with history of multiple spinal surgeries was found to have chronic recurrent pleural effusion. Thoracentesis was performed, which showed a clear, "water-like" transudative fluid with a total protein level of 0.2 g/dL, glucose level equivalent to serum (118 mg/dL), low LDH level (76 U/dL), and low nucleated cell count. Given the appearance of the fluid, ?-2-transferrin was checked, which confirmed the presence of cerebrospinal fluid in the pleural space. On the basis of the clinical presentation, pleural fluid analysis, clear appearance of the pleural fluid, and ?-2-transferrin positivity, the patient was diagnosed with duropleural fistula. PMID:24992136

Saini, Parmeet; Callejas, Leyda; Gudi, Madhav; Grosu, Horiana B

2014-07-01

173

Tight junction physiology of pleural mesothelium  

PubMed Central

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

Markov, Alexander G.; Amasheh, Salah

2014-01-01

174

Combining Immunotoxin and Chemotherapy for Pleural Mesothelioma  

Cancer.gov

In this trial, patients with inoperable epithelial pleural mesothelioma will be given SS1P immunotoxin in combination with pemetrexed and cisplatin to determine the maximum tolerated dose of SS1P and side effects profile in these patients.

175

Investigating a Case of Recurrent Pleural Effusion  

PubMed Central

We describe the case of a patient with long-standing Parkinson's disease and recurrent bilateral pleural effusions. The pleural fluid was an exudate, rich in normal lymphocytes, and the echocardiogram, chest computerized axial tomography, and immunological, microbiological and cytological studies were negative. The patient had been taking bromocriptine, which can be related to chronic pleural effusions. Using Pubmed, we found about 40 cases of pleuropulmonary changes or constrictive pericarditis that were related to bromocriptine. We decided to suspend this drug, with resolution of the pleural effusion and respiratory complaints for more than a year now. We discuss possible underlining mechanisms for this and emphasize the importance of collecting the past medical history and medication and of considering possible iatrogenic effects.

Rodrigues, Patricia; Neves, Maria; Ferreira, Joao Pedro; Abreu, Miguel Araujo; Almeida, Fernanda

2011-01-01

176

Gravity Dependence of Pleural Liquid Turnover.  

National Technical Information Service (NTIS)

The turnover rate of pleural fluid as an experimental model to investigate the interstitial space physiology, in particular its dependence on the gravitational field was studied. Data was gathered in anesthetized animals (rabbits and dogs) breathing spont...

G. Miserocchi D. Negrini

1990-01-01

177

A pleural mass with pulmonary infiltrates  

PubMed Central

This case study describes a 34-year-old woman presenting with a subacute history of dyspnoea associated with pleural based masses and pulmonary infiltrates. A computed tomography guided biopsy confirmed the presence of a pleural based thymoma, and a video assisted thoracoscopic lung biopsy revealed the pulmonary infiltrates to be a lymphocytic interstitial pneumonitis (LIP). The thymomas responded successfully to chemotherapy and the LIP improved following corticosteroid therapy.

Ryerson, Chris; Malhotra, Samir; English, John; Ionescu, Diana; Lam, Stephen

2009-01-01

178

Thoracoscopic management of malignant pleural effusions.  

PubMed

Thoracoscopy has been around for decades, advocated by some, but until recently, ignored by many. Not surprisingly, its diagnostic and therapeutic efficacy in patients with suspected or proven malignant pleural effusions has withstood the test of time. Today, the potential benefits of thoracoscopy must be weighed against its cost in patients with limited life expectancy. Although diagnostic thoracoscopy requires only overnight hospitalization, pleurodesis imposes a longer hospital stay. The discomfort of an indwelling chest tube, the need for hospitalization, and the financial burden of thoracoscopic procedures compared with less-invasive means of pleural investigation and pleurodesis must be taken into account on an individual basis. Thoracoscopy should not be performed for the sake of intervention. Its indications and all diagnostic or therapeutic alternatives should always be carefully examined. Its role, however, in the diagnosis and treatment of patients with malignant pleural effusions is undeniable. The diagnostic accuracy of thoracoscopic pleural biopsy is excellent. Several studies demonstrate that thoracoscopic talc pleurodesis is more frequently successful than other methods of pleurodesis. As a staging procedure, thoracoscopy helps determine extent of disease, and possibly, prognosis in patients with metastatic pleural carcinomatosis, lung cancer, and malignant mesothelioma. As this procedure is increasingly rediscovered by our medical and surgical communities, greater clinical and experimental investigation aimed at establishing successful management strategies in patients with malignant pleural effusions will hopefully occur. PMID:8521705

Colt, H G

1995-09-01

179

Dental plaque identification at home  

MedlinePLUS

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

180

Plaque removal with variable instrumentation.  

PubMed

The purpose of this study was to evaluate dental plaque removal in a normal healthy mouth, during routine oral hygiene appointments using different techniques and without the use of any disclosing agents. 12 dental hygienists, randomly selected from a continuing education course, were asked to perform oral hygiene on the same patient to remove all the supra-gingival plaque without any time restriction and without the use of a disclosing agents. The plaque index score (O'Leary) was assessed before and after each session with the use of fluorescine and UV light source by an independent examiner. 3 groups of instruments were utilized: group A: ultrasonic scalers + prophy cups; group B: ultrasonic scalers + prophy cups + dental floss; group C: Gracey curettes + prophy cups. While no group was able to remove all the plaque, groups B and C performed significantly better. PMID:9350554

Checchi, L; Forteleoni, G; Pelliccioni, G A; Loriga, G

1997-10-01

181

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.

2010-04-01

182

Carotid endarterectomy for high plaques.  

PubMed

Seventeen instances of high plaque (plaque extending up to the level of the second cervical vertebra) were encountered out of a total of 454 carotid endarterectomies (3.7 percent). With careful dissection and knowledge of anatomy superior to hypoglossal nerve, carotid endarterectomy was accomplished without resorting to mandibular subluxation or dislocation. There was no operative mortality or perioperative strokes. One patient had perioperative myocardial infarction and another sustained temporary glossopharyngeal nerve dysfunction. High carotid plaques were more common in male patients with bilateral stenoses or contralateral internal carotid occlusion and could be suspected by findings of preoperative carotid arteriography in some instances. In the majority of cases, extension of high plaque in a tongue-shaped manner on the posterior wall of the internal carotid artery was an unexpected finding at the time of carotid endarterectomy. PMID:2929868

Hans, S S; Shah, S; Hans, B

1989-04-01

183

Role of the OPG/RANK/RANKL triad in calcifications of the atheromatous plaques: comparison between carotid and femoral beds.  

PubMed

Recent works demonstrated the difference of calcification genesis between carotid and femoral plaques, femoral plaques being more calcified. It has been clearly demonstrated that the molecular triad osteoprotegerin (OPG)/Receptor Activator of NFkB (RANK)/RANK Ligand (RANKL) exerts its activities in the osteoimmunology and vascular system. The aim of this study was to determine their expression and their potential role in calcifications of the atheromatous plaques located in two different peripheral arterial beds, carotid and femoral. The expression of OPG, RANK and RANKL was analyzed by immunochemistry in 40 carotid and femoral samples. Blood OPG and RANKL were quantified using specific ELISA assays. OPG staining was more frequently observed in carotid than in femoral plaques, especially in lipid core. Its expression correlated with macrophage infiltration more abundantly observed in carotid specimens. Surprisingly, serum OPG concentration was significantly lower in carotid population compared to femoral population while RANK and RANKL were equally expressed in both arterial beds. Carotid plaques that are less rich in calcium than femoral specimens, express more frequently OPG, this expression being correlated with the abundance of macrophages in the lesions. These data strengthen the key role played by OPG in the differential calcification in carotid and femoral plaques. PMID:22402034

Heymann, Marie-Françoise; Herisson, Fanny; Davaine, Jean-Michel; Charrier, Céline; Battaglia, Séverine; Passuti, Norbert; Lambert, Gilles; Gouëffic, Yann; Heymann, Dominique

2012-05-01

184

Paradoxic technetium-99 methylene diphosphonate localization in malignant mesothelioma.  

PubMed

The literature is replete with cases of Tc-99m bone imaging agent uptake in pleural effusions. Far rarer is the report of photopenia in a pleural effusion. In this case of malignant mesothelioma, we describe a unique case of unilateral hemithoracic photopenia from a pleural effusion with concomitant uptake in the contralateral lung resulting from calcified pleural plaques. Although initially perplexing clinically, this case can be readily explained with an understanding of basic physiological principles. PMID:16424688

Reidman, Daniel; Balingit, Antonio

2006-02-01

185

Periodontal pathogens in atheromatous plaque.  

PubMed

Background: There has been increasing attention paid in recent years to the possibility that oral bacterial infection, particularly periodontal disease may influence the initiation and or progression of systemic diseases. These studies confirm the observation that heart disease is the most commonly found systemic condition in patients with periodontal disease. Moreover, the literature has also highlighted substantial evidence indicating the presence of Gram-negative periodontal pathogens in atheromatous plaques. Aim: This study intends to investigate the possible association between periodontal health and coronary artery disease by evaluating periodontal status, association between the periodontal plaque and coronary atheromatous plaques for presence of micro-organisms such as, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia. Materials and methods: A case-control study was designed with seven patients who had undergone coronary endarterectomy for cardiovascular disease and 28 controls. The periodontal examination for cases was performed 1 day before vascular surgery and the controls were clinically examined. The atheromatous plaque sample collected during endarterectomy and the intraoral plaque samples were subjected to polymerase chain reaction for identification of A. actinomycetemcomitans, P. gingivalis, P. intermedia and T. forsythia. Results: The presence of periodontal bacteria DNA in coronary atheromatous plaques and sub-gingival plaque samples of the same patients was confirmed by this study. CONCLUSION A correlation was established between putative bacteria contributing to atheromatous plaques and species associated with periodontal disease. One particularly important study to be carried out is the investigation of a possible clinically meaningful reduction in coronary heart disease resulting from the prevention or treatment of periodontal disease. PMID:24943760

Rath, Saroj K; Mukherjee, Manish; Kaushik, R; Sen, Sourav; Kumar, Mukesh

2014-01-01

186

Recent concepts in plaque formation.  

PubMed

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

2003-01-01

187

INCIDĘNCIA DE EMPIEMA PLEURAL NOS FERIMENTOS TÓRACO-ABDOMINAIS INCIDENCE OF PLEURAL EMPYEMA AFTER THORACOABDOMINAL INJURIES  

Microsoft Academic Search

RESUMO: Objetivo: Os ferimentos penetrantes com comprometimento simultâneo das cavidades torácica e abdominal (FTA), além da dificuldade diagnóstica, merecem especial atençăo em relaçăo ŕ conduta adotada para o tratamento do espaço pleural. O objetivo do presente estudo foi identificar os principais fatores relacionados ŕ incidęncia de empiema pleural em pacientes com ferimentos penetrantes localizados na transiçăo toracoabdominal. Método: Utilizando-se o

Mauro José Fontelles; Mario Mantovani; Juliana Rezek Ajub; Flávia Silva Pinto

188

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.

2012-01-01

189

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.

2011-01-01

190

[Could pleural aspergillosis happen to be a complication of pleural drainage?].  

PubMed

Four cases of nosocomial aspergillosis are described where the responsibility of pleural drainage is advocated. Infection was pulmonary once, pleural three times. Pleural suction had been long lasting with incomplete re-expansion of the lung and major air leaks. The hypothesis of the responsibility of pleural drainage in the advent of aspergillosis is reinforced by the revision of medical papers, which leads to the conviction that similar cases have been described yet, even though the mechanism of the contamination had not been understood. Prevention needs to limitate the lasting of the suction, especially if there are major air leaks. Cure needs total re-expansion of the lung and suppression of any pleural cavity, even if a thoracoplasty is needed. An anti-fungal therapy is not always needed. PMID:24051186

Bellamy, J; Onea, F; N'Guyen Huu, P

2013-12-01

191

CT imaging findings of a calcifying epithelial odontogenic tumour.  

PubMed

We report a case of calcifying epithelial odontogenic tumour (CEOT), also known as a Pindborg tumour, with local aggressive behaviour. CT imaging showed a large expansile bone-forming lesion in the mandible, which showed the exact extent and nature of the lesion. We briefly discuss the imaging features of CEOT and the relevant literature. PMID:22190756

Venkateswarlu, M; Geetha, P; Lakshmi Kavitha, N

2012-01-01

192

Cimetidine for chronic calcifying tendinitis of the shoulder  

Microsoft Academic Search

Background and Objectives: Calcium deposits of the shoulder may persist for many years with resulting pain and impairment of mechanical function. The effects of different treatments vary significantly and do not show consistent and reliable long-term results. Cimetidine decreases calcium levels and improves symptoms in patients with hyperparathyroidism. We evaluated cimetidine as a treatment for chronic calcifying tendinitis of the

Masataka Yokoyama; Hiroshi Aono; Akio Takeda; Kiyoshi Morita

2003-01-01

193

Calcifying Tendinitis of the Shoulder: Midterm Results After Arthroscopic Treatment  

Microsoft Academic Search

Background: Calcifying tendinitis is a common and painful disorder of the shoulder characterized by the presence of calcific deposits in the tendons of the rotator cuff. When nonoperative treatment over a prolonged period of time fails, surgical treatment should be considered. Midterm success rates are inconsistent, and the role of subacromial decompression is still unclear.Hypothesis: Our hypotheses were that the

Maurice Balke; Rebecca Bielefeld; Carolin Schmidt; Nicolas Dedy; Dennis Liem

2012-01-01

194

Calcifying supracoracoid bursitis as a cause of chronic shoulder pain  

Microsoft Academic Search

A case of chronic shoulder pain is reported with marked limitation of both active and passive elevations and a normal range of motion of the glenohumeral joint. X-ray examination demonstrated cloudy calcification in the coracoclavicular region, presumably indicating calcifying supracoracoid bursitis.

J Mens; J K van der Korst

1984-01-01

195

Hemobilia: Calcified hepatic artery aneurysm presenting with massive gastrointestinal bleeding  

Microsoft Academic Search

A case of a calcified and ruptured hepatic artery aneurysm presenting with hemobilia and massive gastrointestinal bleeding is reported and illustrated. The clinical diagnosis should be entertained whenever the trial of findings (abdominal colic, gastrointestinal bleeding, elevated bilirubin levels) is present. Angiography is the method of choice in confirming this diagnosis. A short review of the clinical and radiographic syndrome

Emil J. Balthazar

1977-01-01

196

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

PubMed Central

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

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

2013-01-01

197

Pleural lavage cytology: where do we stand?  

PubMed

Although a malignant pleural effusion is considered a manifestation of an advanced stage disease not amenable to curative resection in patients with non-small cell lung cancer, the same is not true in the case of the presence of malignant cells in the pleural cavity without an accompanying effusion, discovered incidentally during the operation with pleural lavage cytology (PLC). PLC is a diagnostic technique used to detect tumor cells and translate this finding to a prognostic index. Various reports have attempted to utilize the results of PLC and draw inferences regarding the origins of malignant cells in the pleural cavity, the association of these results with various disease characteristics and, most importantly, their impact on disease recurrence and survival. However, due to non-consistent techniques and protocols used to acquire the samples for cytological evaluation and assess their significance, results are inhomogeneous. Nevertheless, the entrance of malignant cells in the pleural cavity follows the rules posed by the natural disease process when discovered before pulmonary resection takes place, while surgical manipulations certainly play an important role in the case malignant cells are checked over after pulmonary resection. In addition, although the prognostic significance of a positive PLC result is indisputable and significantly decreases long-term survival in the majority of studies, this factor has not yet been incorporated into the TNM staging system. Lastly, some authors have advocated the use of some form of adjuvant treatment for those patients found with positive PLC results, based on the assumption that a curative resection followed by multiple pleural washings will not remove the entirety of the population of malignant cells present in the pleural space. PMID:24238496

Toufektzian, Levon; Sepsas, Evangelos; Drossos, Vasileios; Gkiozos, Ioannis; Syrigos, Konstantinos

2014-01-01

198

Pleural tuberculosis mimicking inflammatory pseudotumour.  

PubMed

A pseudotumour is a rare presentation of bronchopulmonary tuberculosis which occurs in immunocompetent patients, which can simulate malignancy, both clinically and radiologically, and may cause delay in its diagnosis and treatment. The incidence of bronchopulmonary pseudotumours was found to vary from 2-4%, as was seen in various studies. A mycobacterial pseudotumour of the pleura is a rare entity. We are reporting a case of a pleura based tubercular pseudotumour in a 59 years old patient who presented with a four month history of the nonspecific symptoms of cough and chest pain. The radiological investigations showed that a pleural based mass lesion was occupying the right lower hemithorax. The initial biopsy was suggestive of a hyalinizing variant of an inflammatory pseudotumour. The follow-up surgical resected mass was consistent with the features of a tubercular granuloma. The clinical presentation and the histopathological findings have been presented, with a brief review of the literature. Due to its varied and unusual presentation, bronchopulmonary tuberculosis should always be kept in mind when a patient with a similar clinical and a radiological picture is being evaluated. PMID:23730653

P, Arul; Varghese, Renu G'boy; Ramdas, Anita

2013-04-01

199

Pleural Tuberculosis Mimicking Inflammatory Pseudotumour  

PubMed Central

A pseudotumour is a rare presentation of bronchopulmonary tuberculosis which occurs in immunocompetent patients, which can simulate malignancy, both clinically and radiologically, and may cause delay in its diagnosis and treatment. The incidence of bronchopulmonary pseudotumours was found to vary from 2-4%, as was seen in various studies. A mycobacterial pseudotumour of the pleura is a rare entity. We are reporting a case of a pleura based tubercular pseudotumour in a 59 years old patient who presented with a four month history of the nonspecific symptoms of cough and chest pain. The radiological investigations showed that a pleural based mass lesion was occupying the right lower hemithorax. The initial biopsy was suggestive of a hyalinizing variant of an inflammatory pseudotumour. The follow-up surgical resected mass was consistent with the features of a tubercular granuloma. The clinical presentation and the histopathological findings have been presented, with a brief review of the literature. Due to its varied and unusual presentation, bronchopulmonary tuberculosis should always be kept in mind when a patient with a similar clinical and a radiological picture is being evaluated.

P., Arul; Varghese, Renu G'boy; Ramdas, Anita

2013-01-01

200

The development and potential of acoustic radiation force impulse (ARFI) imaging for carotid artery plaque characterization.  

PubMed

Stroke is the third leading cause of death and long-term disability in the USA. Currently, surgical intervention decisions in asymptomatic patients are based upon the degree of carotid artery stenosis. While there is a clear benefit of endarterectomy for patients with severe (> 70%) stenosis, in those with high/moderate (50-69%) stenosis the evidence is less clear. Evidence suggests ischemic stroke is associated less with calcified and fibrous plaques than with those containing softer tissue, especially when accompanied by a thin fibrous cap. A reliable mechanism for the identification of individuals with atherosclerotic plaques which confer the highest risk for stroke is fundamental to the selection of patients for vascular interventions. Acoustic radiation force impulse (ARFI) imaging is a new ultrasonic-based imaging method that characterizes the mechanical properties of tissue by measuring displacement resulting from the application of acoustic radiation force. These displacements provide information about the local stiffness of tissue and can differentiate between soft and hard areas. Because arterial walls, soft tissue, atheromas, and calcifications have a wide range in their stiffness properties, they represent excellent candidates for ARFI imaging. We present information from early phantom experiments and excised human limb studies to in vivo carotid artery scans and provide evidence for the ability of ARFI to provide high-quality images which highlight mechanical differences in tissue stiffness not readily apparent in matched B-mode images. This allows ARFI to identify soft from hard plaques and differentiate characteristics associated with plaque vulnerability or stability. PMID:21447606

Allen, Jason D; Ham, Katherine L; Dumont, Douglas M; Sileshi, Bantayehu; Trahey, Gregg E; Dahl, Jeremy J

2011-08-01

201

[Thoracoscopic pleurodesis in malignant pleural effusions].  

PubMed

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

2005-01-01

202

An incisor plaque model in rats.  

PubMed

An in vivo model for studying plaque accumulation in rats has been described. This model investigates plaque formation on the mandibular incisors in animals which have been found to be rapid plaque-formers during a pre-test period. The accessibility of these tooth surfaces permits the removal of plaque prior to initiation of tests, the use of test groups balanced on the basis of plaque-forming potential, and interim assessments of plaque formation throughout the test period. In addition, baseline plaque scores of near zero can be attained, thereby permitting investigations of the impact of experimental measures on plaque formation. Moreover, the model permits intermittent plaque assessments throughout the test period. This model was found to have adequate sensitivity to distinguish effects between antimicrobial agents known to differ in their clinical activity and to detect differences between varying concentrations of the same agent. PMID:6582077

Schemehorn, B R; McDonald, J L; Stookey, G K; Park, K K

1984-01-01

203

The role of interventional therapy for pleural diseases.  

PubMed

Pleural diseases encompass a vast and heterogeneous group of diseases that have traditionally received relatively little attention from researchers, resulting in empiric approaches to patient management based largely on expert opinions and anecdotal evidence. Yet, paradoxically, pleural diseases represent a considerable burden for patients, providers, and the healthcare system as a whole, with a rising incidence of malignant pleural effusions and pleural space infections, in increasingly complex patients. Fortunately, the last decade has witnessed unprecedented research efforts from the pleural community, which have resulted in substantial advances in risk-stratification, patient selection, treatment efficacy and the development of evidence-based recommendations ultimately leading to improved patient care. In this review, we will present a summary of the current evidence for the management of pleural diseases with an emphasis on interventional procedures, and highlight the need for future research efforts in the field of malignant pleural effusions, pleural space infections and pneumothorax. PMID:24976255

DePew, Zachary S; Maldonado, Fabien

2014-08-01

204

A case of pleural paragonimiasis confused with tuberculous pleurisy.  

PubMed

Here, we report a case of pleural paragonimiasis that was confused with tuberculous pleurisy. A 38-year-old man complained of a mild febrile sensation and pleuritic chest pain. Radiologic findings showed right pleural effusion with pleural thickening and subpleural consolidation. Adenosine deaminase (ADA) activity in the pleural effusion was elevated (85.3 IU/L), whereas other examinations for tuberculosis were negative. At this time, the patient started empirical anti-tuberculous treatment. Despite 2 months of treatment, the pleural effusion persisted, and video-assisted thoracoscopic surgery was performed. Finally, the patient was diagnosed with pleural paragonimiasis based on the pathologic findings of chronic granulomatous inflammation containing Paragonimus eggs. This case suggested that pleural paragonimiasis should be considered when pleural effusion and elevated ADA levels are observed. PMID:24851131

Song, Junwhi; Hong, Goohyeon; Song, Jae-Uk; Kim, Wooyoul; Han, Seo Goo; Ko, Yousang; Chang, Boksoon; Jeong, Byeong-Ho; Eom, Jung Seop; Lee, Ji Hyun; Jhun, Byung Woo; Jeon, Kyeongman; Kim, Hong Kwan; Koh, Won-Jung

2014-04-01

205

A Case of Pleural Paragonimiasis Confused with Tuberculous Pleurisy  

PubMed Central

Here, we report a case of pleural paragonimiasis that was confused with tuberculous pleurisy. A 38-year-old man complained of a mild febrile sensation and pleuritic chest pain. Radiologic findings showed right pleural effusion with pleural thickening and subpleural consolidation. Adenosine deaminase (ADA) activity in the pleural effusion was elevated (85.3 IU/L), whereas other examinations for tuberculosis were negative. At this time, the patient started empirical anti-tuberculous treatment. Despite 2 months of treatment, the pleural effusion persisted, and video-assisted thoracoscopic surgery was performed. Finally, the patient was diagnosed with pleural paragonimiasis based on the pathologic findings of chronic granulomatous inflammation containing Paragonimus eggs. This case suggested that pleural paragonimiasis should be considered when pleural effusion and elevated ADA levels are observed.

Song, Junwhi; Hong, Goohyeon; Song, Jae-Uk; Kim, Wooyoul; Han, Seo Goo; Ko, Yousang; Chang, Boksoon; Jeong, Byeong-Ho; Eom, Jung Seop; Lee, Ji Hyun; Jhun, Byung Woo; Jeon, Kyeongman; Kim, Hong Kwan

2014-01-01

206

Denitrification in human dental plaque  

PubMed Central

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 can reduce this NO3- to nitrite (NO2-). Results We show that dental plaque mediates denitrification of NO3- to nitric oxide (NO), nitrous oxide (N2O), and dinitrogen (N2) using microsensor measurements, 15N isotopic labelling and molecular detection of denitrification genes. In vivo N2O accumulation rates in the mouth depended on the presence of dental plaque and on salivary NO3- concentrations. NO and N2O production by denitrification occurred under aerobic conditions and was regulated by plaque pH. Conclusions Increases of NO concentrations were in the range of effective concentrations for NO signalling to human host cells and, thus, may locally affect blood flow, signalling between nerves and inflammatory processes in the gum. This is specifically significant for the understanding of periodontal diseases, where NO has been shown to play a key role, but where gingival cells are believed to be the only source of NO. More generally, this study establishes denitrification by human-associated microbial communities as a significant metabolic pathway which, due to concurrent NO formation, provides a basis for symbiotic interactions.

2010-01-01

207

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

2012-01-01

208

Prolonged pleural catheters in the management of pleural effusions due to breast cancer  

PubMed Central

Background Breast cancer is the second most common etiologic cause in malignant pleural effusions (MPE). The aim of this study was to investigate the efficacy of long term pleural catheters in inducing self sclerosis in pleural effusions of breast cancer patients. Methods In this study, 26 patients with breast cancer relapleural effusions that occurred between January 2011 and July 2013, who were considered not to undergo any other treatments and managed with prolonged pleural catheters (Jackson-Pratt silicone flat drain), were retrospectively analyzed. Thirty pleural catheters were inserted in 26 patients. All patients were female, mean age was 52 (range, 37-66) years old. Drainage over 1,500 mL per day was not allowed in order to avoid a lung edema. The catheters were removed in patients who had restoration of lung expansion and drainage under 50 mL/day. Results The histologic subtypes in pleural effusions were invasive ductal carcinoma in 18 patients, ductal carcinoma in situ in 4, invasive lobular carcinoma in 2, tubular carcinoma in 1, and medullary carcinoma in 1. Three of the 26 patients underwent bilateral catheter insertion, and one patient underwent a reinsertion of the catheter into the same hemithorax due to a recurrence. The catheters were retained for a mean period of 18 days (range, 11-38 days). In one patient with invasive ductal carcinoma and paramalignant pleural effusion (PMPE) (3.8%), a recurrent pleural effusion was seen 34 days after removal of the catheter. There were no complications. One patient died while the catheter was in place. Conclusions Prolonged catheters for the management of pleural effusions in selected patients have become more popular than other treatment alternatives due to a shorter length of stay and lower costs. We recommend the use of Jackson Pratt (JP) silicone flat drains which in our opinion provide effective pleurodesis in addition to easy application in recurrent effusions caused by breast cancer.

Ordu, Cetin; Toker, Alper

2014-01-01

209

Pleural exudate in a tropical hospital.  

PubMed

In one hundred consecutive patients with non-purulent pleural exudates without apparent cause, the final diagnosis was tuberculosis in 58, malignancy in 20, pyogenic infection in four, cardiomyopathy in two, pulmonary infarction in one. The aetiology remained unknown in 15. The technique of "semi-open" pleural biopsy was performed under local anaesthesia. It accurately detected 70% of cancer and 69% of tuberculosis cases with a 9% complication rate and no mortality. Tuberculosis was seen at all ages but mainly between 20 and 39 yrs, where it represented 75% of cases. In this age group, malignancy was relatively rare: 10% of cases. In our environment of limited facilities, early chemotherapy trial for tuberculosis is justified for unknown pleural exudates in patients below the age of 40 yrs. PMID:2649393

Sinzobahamvya, N; Bhakta, H P

1989-02-01

210

Pleural Aspergillosis in an otherwise healthy individual  

PubMed Central

Pleural Aspergillosis is a rare entity, with most of the cases occurring on a background of lung disease or surgery. We report a case of a 16-year-old boy who developed pleural Aspergillosis in the absence of any obvious pre-disposing factors. Patient presented with fever, dry cough and left sided chest discomfort of 6 weeks duration. A chest radiograph revealed features of the left pyopneumothorax. Despite being started on presumptive antituberculous treatment and intercostal drainage his symptoms failed to resolve. The sputum and pus were then subjected to fungal smears and culture, which indicated growth of Aspergillus fumigatus. We report this case in view of the extreme rarity of pleural Aspergillosis occurring in a young healthy individual with no evidence of prior lung pathology. Furthermore, the source of infection was traced back to a very unusual possible focus – a decayed tooth infected with A. fumigatus, thus making the case even more interesting.

Bhatnagar, Tarun; Bhatnagar, Anuj Kumar

2014-01-01

211

Pleural Aspergillosis in an otherwise healthy individual.  

PubMed

Pleural Aspergillosis is a rare entity, with most of the cases occurring on a background of lung disease or surgery. We report a case of a 16-year-old boy who developed pleural Aspergillosis in the absence of any obvious pre-disposing factors. Patient presented with fever, dry cough and left sided chest discomfort of 6 weeks duration. A chest radiograph revealed features of the left pyopneumothorax. Despite being started on presumptive antituberculous treatment and intercostal drainage his symptoms failed to resolve. The sputum and pus were then subjected to fungal smears and culture, which indicated growth of Aspergillus fumigatus. We report this case in view of the extreme rarity of pleural Aspergillosis occurring in a young healthy individual with no evidence of prior lung pathology. Furthermore, the source of infection was traced back to a very unusual possible focus - a decayed tooth infected with A. fumigatus, thus making the case even more interesting. PMID:24778481

Bhatnagar, Tarun; Bhatnagar, Anuj Kumar

2014-04-01

212

Imaging Atherosclerosis and Vulnerable Plaque  

PubMed Central

Identifying patients at high risk for an acute cardiovascular event such as myocardial infarction or stroke and assessing the total atherosclerotic burden are clinically important. Currently available imaging modalities can delineate vascular wall anatomy and, with novel probes, target biologic processes important in plaque evolution and plaque stability. Expansion of the vessel wall involving remodeling of the extracellular matrix can be imaged, as can angiogenesis of the vasa vasorum, plaque inflammation, and fibrin deposits on early nonocclusive vascular thrombosis. Several imaging platforms are available for targeted vascular imaging to acquire information on both anatomy and pathobiology in the same imaging session using either hybrid technology (nuclear combined with CT) or MRI combined with novel probes targeting processes identified by molecular biology to be of importance. This article will discuss the current state of the art of these modalities and challenges to clinical translation.

Sadeghi, Mehran M.; Glover, David K.; Lanza, Gregory M.; Fayad, Zahi A.; Johnson, Lynne L.

2010-01-01

213

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.

2009-01-01

214

Defying gravity: subdiaphragmatic causes of pleural effusions.  

PubMed

Intra-abdominal fluid may migrate readily into the pleural space through naturally occurring holes in the diaphragm or intradiaphragmatic lymphatics. Although any type of fluid in the abdomen may migrate, additional pathologic mechanisms are involved in the development of chylous ascites/chylothorax, yellow nail syndrome, urinothorax, pancreaticopleural fistulas, or other connections. In the differential diagnosis of the large list of potential pleural fluid causes, intra-abdominal sources should be entertained by the practicing physician in the right clinical context. PMID:23411055

Bramley, Kyle; Puchalski, Jonathan T

2013-03-01

215

Pleural Empyema due to Group D Salmonella.  

PubMed

Non-typhi Salmonella normally presents as a bacteremia, enterocolitis, and endovascular infection but rarely manifests as pleuropulmonary disease. We present a case of a 66-year-old female with underlying pulmonary pathology, secondary to an extensive smoking history, who presented with a left-sided pleural effusion. The causative agent was identified as being group D Salmonella. Decortication of the lung was performed and the patient was discharged on antibiotics with resolution of her symptoms. This case helps to support the inclusion of Salmonella group D as a possible etiological agent of infection in the differential causes of exudative pleural effusions. PMID:23056966

Kam, Jennifer C; Abdul-Jawad, Sami; Modi, Chintan; Abdeen, Yazan; Asslo, Fady; Doraiswamy, Vikram; Depasquale, Joseph R; Spira, Robert S; Baddoura, Walid; Miller, Richard A

2012-01-01

216

Diagnostic Accuracy of Pleural Fluid Polymorphonuclear Elastase in the Differentiation between Pyogenic Bacterial Infectious and NonInfectious Pleural Effusions  

Microsoft Academic Search

Background and Objectives: To establish the diagnostic accuracy of the markers of neutrophil activity (elastase and lysozyme) determined in pleural fluid, for differentiating between pyogenic bacterial infectious and non-infectious pleural effusions. Patients and Methods: At our tertiary referral teaching hospital, 160 patients over 14 years with pleural effusion (PE), classified as pyogenic bacterial infectious (41 parapneumonic complicated, 32 parapneumonic non-complicated)

José Alegre; José Maria Surińach; Encarna Varela; Lluis Armadans; Ramón Marti; Rosa Segura; Carmen Aleman; Vicente Falcó; Tomás Fernandez de Sevilla

2000-01-01

217

Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure  

PubMed Central

Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible.

Arvin, Armita; Darvish, Alireza; Aflaki, Sareh

2014-01-01

218

Treatment of necrotic calcified tooth using intentional replantation procedure.  

PubMed

Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible. PMID:24716000

Moradi Majd, Nima; Arvin, Armita; Darvish, Alireza; Aflaki, Sareh; Homayouni, Hamed

2014-01-01

219

A Case of Peritoneal Free Floating Calcified Fibromyoma  

PubMed Central

Giant peritoneal loose bodies are rare and few reported cases are found in literature. These are commonly found in the pelvis. Preoperatively these cases are diagnosed accidentally on abdominopelvic evaluation. We report one such case in a male patient who presented to us with acute gangrenous cholecystitis. We had diagnosed the lesion accidentally on a routine ultrasound of the abdomen and pelvis as a calcified leiomyoma of sigmoid colon. On laparoscopy, it was freely floating in the peritoneal cavity without any kind of peritoneal attachment or attachment to any intraperitoneal organ. The peritoneal loose body was removed by a small abdominal incision. Histopathologically the lesion was reported as benign calcified fibromyoma. Small peritoneal loose bodies are relatively common but a large peritoneal loose body is very rare.

Sahadev, Ramaiah

2014-01-01

220

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

PubMed

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

2013-09-01

221

Videothoracoscopy in the diagnosis and treatment of malignant pleural mesothelioma with associated pleural effusions.  

PubMed

Between 1985 and 1994 46 of 662 patients examined by thoracoscopy for secondary malignant pleural effusion were diagnosed to have diffuse malignant pleural mesothelioma. Mean patient age was 59 years, with a male: female ratio of 5:1. The right hemithorax was more frequently involved than the left (55% versus 45%). Pleural fluid cytology revealed malignancy in 61.5% of cases. All patients were treated thoracoscopically by talc pleurodesis. Mean patients survival was 9.4 months. Survival after one, two, and 5 years was 37.5%, 12.5%, and 5%, respectively. The characteristics of mesothelioma and pleural effusion evident in thoracoscopy and their diagnostic relevance are discussed. We suggest talc instillation as the sole therapeutic maneuver in evolutioned cases, since the literature and our own experience indicate that survival is not significantly prolonged by more aggressive surgical approaches. PMID:9089969

Cantó, A; Guijarro, R; Arnau, A; Galbis, J; Martorell, M; García Aguado, R

1997-02-01

222

Recommendations of diagnosis and treatment of pleural effusion. Update.  

PubMed

Although during the last few years there have been several important changes in the diagnostic or therapeutic methods, pleural effusion is still one of the diseases that the respiratory specialist have to evaluate frequently. The aim of this paper is to update the knowledge about pleural effusions, rather than to review the causes of pleural diseases exhaustively. These recommendations have a longer extension for the subjects with a direct clinical usefulness, but a slight update of other pleural diseases has been also included. Among the main scientific advantages are included the thoracic ultrasonography, the intrapleural fibrinolytics, the pleurodesis agents, or the new pleural drainages techniques. PMID:24698396

Villena Garrido, Victoria; Cases Viedma, Enrique; Fernández Villar, Alberto; de Pablo Gafas, Alicia; Pérez Rodríguez, Esteban; Porcel Pérez, José Manuel; Rodríguez Panadero, Francisco; Ruiz Martínez, Carlos; Salvatierra Velázquez, Angel; Valdés Cuadrado, Luis

2014-06-01

223

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

2013-01-01

224

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

2008-01-01

225

Calcitonin treatment for calcifying tendinitis of the shoulder  

Microsoft Academic Search

In an open, uncontrolled trial, the clinical and radiological responses to calcitonin therapy in the treatment of acute calcifying\\u000a tendinitis of the shoulder were investigated. A total of 35 patients (38 shoulders) were enrolled. Each patient was injected\\u000a with 10 U synthetic calcitonin intramuscularly twice a week. The mean number of injections was 6.0 (range, 1–16). At the end\\u000a of

M. Yoshida; K. Kida; H. Kodama; M. Itokazu; K. Shimizu

2006-01-01

226

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.

2007-03-01

227

Gastric calcifying fibrous tumor: a very rare case report.  

PubMed

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. PMID:23109921

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

2012-05-01

228

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.

2012-01-01

229

Jejunal and multiple mesenteric calcifying fibrous pseudotumor induced jejunojejunal intussusception.  

PubMed

We describe here a patient with an unusual presentation--mesenteric calcifying fibrous pseudotumor in association with jejunojejunal intussusception. This 25-year-old woman came to our emergency department with severe abdominal distension and intermittent epigastric cramping pain. She was found to have rebound tenderness and an ill-defined mass palpable in her lower abdomen. Abdominal computed tomography revealed an inhomogeneous soft tissue mass with target sign and intussusception of small intestine was suspected. Emergency laparotomy showed jejunojejunal intussusception involving ~30cm of jejunum with multiple tumors on the mesentery surface extending over the whole bowel mesenteric and peritoneal surfaces. One of the mesenteric tumors formed the leading point of the intussusception. Segmental resection of jejunum with primary anastomosis was done. Some larger tumors were resected but most of the other tumors were left in place because they were small and numerous and total resection was impossible. Pathology confirmed that the lesions were benign mesenteric calcifying fibrous pseudotumors. In such patients, surgery might be curative. If a large segment of the bowel is affected by calcifying fibrous pseudotumor, smaller pseudotumors might be left in place because these tend to be asymptomatic. But they might become the leading points of recurrent intussusception. PMID:17588842

Liang, Hung-Hua; Chai, Chiah-Yang; Lin, Yun-Ho; Lee, Chii-Hong; Wu, Chih-Hsiung; Chang, Chun-Chao

2007-06-01

230

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

1971-01-01

231

Contemporary Management of Malignant Pleural Mesothelioma  

Microsoft Academic Search

The rapidly increasing incidence of malignant pleural mesothelioma underlines the urgency to achieve a consensus in the management of this tumor, which is biologically distinct from most other tumors. For patients with stage I tumors of epithelial type and good performance status, pleuropneumonectomy combined with chemotherapy and radiotherapy provides the best chance of prolonged survival, but further investigation is required

ERIC G. BUTCHART

232

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

233

Anti-adhesive membrane for pleural cavity.  

PubMed

An anti-adhesive membrane containing a large amount of glycerin was developed for lung surgery and was tested in the pleural cavity of six dogs. The test membranes were put between the lung and the chest wound of the pleural cavity wall to separate them. In five of the animals, no adhesion was observed after 3 weeks in the area where the membrane had been inserted, but the area without the membrane showed firm adhesion between the lung and the pleural cavity wall. A sixth animal observed for 3 months also showed no adhesion. Seprafilm, which is the product of choice for peritoneal surgeries, was used as a control in six dogs. Seprafilm could not prevent adhesion in the pleural cavity of all six animals after 3 weeks observation. The new test membrane contained glycerin, which gathered and dispersed abundant water. Together with this, growth factors are also dispersed, resulting in dilution of excessive growth factors at the wound sites. In general, fibroblasts do not migrate in an extremely hydrous gel matrix. Migration of fibroblasts into the membrane is minimized, resulting in the prevention of formation of adhesion tissue composed of fibroblasts and collagen fibers. From the results, we assume that water can prevent adhesion after surgery. PMID:20447048

Noishiki, Yasuharu; Shintani, Noriyuki

2010-03-01

234

Advances in the diagnosis of pleural disease in lung cancer.  

PubMed

Pleural disease in lung cancer can be benign or malignant with the latter carrying a grave prognosis. In this review, we describe and discuss the advances in pleural imaging, procedures, and biomarkers for the diagnosis of pleural diseases in lung cancer. Ultrasound and computed tomography are increasingly applied in the planning of pleural procedures to enhance diagnostic accuracy and safety whilst pleuroscopy gives excellent yield in excess of 93% in the evaluation of cytology negative pleural effusions. Invasion beyond the elastic layer of the visceral pleura upstages lung cancer, and may indicate a need for adjuvant chemotherapy. Biomarkers isolated from pleural fluid or tissue may aid in diagnosis and guide treatment in the future. Magnetic resonance imaging, positron emission tomography, narrow band imaging of the pleura and autofluorescence thoracoscopy are technologies that require further evaluation to better define their respective roles in the diagnostic algorithms of pleural diseases in lung cancer. PMID:21697244

See, Kay Choong; Lee, Pyng

2011-12-01

235

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.

2012-03-01

236

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.

2012-04-01

237

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

2013-01-01

238

Calcifying fibrous tumour originating from the right cardiac ventricle in a child.  

PubMed

Calcifying fibrous tumour is a rare benign fibrous lesion. It is paucicellular, with fibroblasts, dense collagenisation, psammomatous and dystrophic calcification, and patchy lymphoplasmacytic infiltrates. Calcifying fibrous tumour was first described in subcutaneous and deep soft tissues, and has been reported all over the body. However, calcifying fibrous tumour originating from the heart is extremely rare. This article describes the case of a giant calcifying fibrous tumour arising from the right ventricle in a child, where the tumour was totally resected and no recurrence was observed during a 4-year follow-up period. PMID:23391107

Zhang, Ben; Zhang, Weida; Wang, Xiaowu

2014-02-01

239

Talc mediates angiostasis in malignant pleural effusions via endostatin induction.  

PubMed

Talc remains the most effective sclerosing agent for pleurodesis. However, its mechanism of action in resolving pleural malignant disease remains unclear. The present study evaluated the angiogenic balance in the pleural space in patients with malignant pleural effusions (MPE) following talc insufflation. Patient pleural fluid samples were collected both before and after talc insufflation. The ability of pleural mesothelial cells (PMC) and malignant mesothelioma cells (MMC) to produce endostatin in vitro was compared. The biological effects of pleural fluids and conditioned media from talc-activated PMC on endothelial cells were evaluated by performing proliferation, invasion, tube formation and apoptosis assays. Pleural fluids from patients with MPE who received thoracoscopic talc insufflation contained significantly higher levels of endostatin (median 16.75 ng.mL(-1)) compared with pre-talc instillation (1.06 ng.mL(-1)). Talc-activated PMC released significantly greater amounts of endostatin (mean+/-SEM 1052.39+/-38.66 pg.mL(-1)) when compared with a MMC line (134.73+/-8.72 pg.mL(-1)). In conclusion, talc alters the angiogenic balance in the pleural space from a biologically active and angiogenic environment to an angiostatic milieu. Functional improvement following talc poudrage in patients with malignant pleural effusions may, in part, reflect these alterations in the pleural space. PMID:17251235

Nasreen, N; Najmunnisa, N; Mohammed, K A; Brown, S; Su, Y; Sriram, P S; Moudgil, B; Loddenkemper, R; Antony, V B

2007-04-01

240

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

2011-01-01

241

[Non plaque-related gingivitis].  

PubMed

Gingivitis is a symptom revealing an underlying pathology, mostly due to a bacterial accumulation. This explains why for dentists gingivitis is often synonymous of a plaque-related gingivitis. This is a dangerous simplification since it can be due to very different etiologies, which evidently imply very different treatments. This paper illustrates the most frequent causes, not only encountered by the periodontologist, but also by the general practitioner, such as erosive lichen planus, herpes, Candida and radiotherapy. PMID:12494701

van Steenberghe, D; Quirynen, M

2002-11-01

242

The relevance of Randall's plaques  

PubMed Central

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

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

2014-01-01

243

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

PubMed Central

Background A composite, peripheral gene expression score based on quantitative RNA-measurements has been validated for detecting stenosis against invasive coronary X-ray angiography. IVUS/VH has been validated for quantitative measurements of coronary plaque volume and composition and has been shown to be predictive of outcomes and treatment effects. The correlation between peripheral gene expression and coronary plaque composition by intravascular ultrasound with radiofrequency backscatter (IVUS/VH) is unknown. Methods Peripheral blood gene expression score (GES) was prospectively measured in 18 patients undergoing IVUS/VH. Plaque volume and composition [fibrous tissue (FI), fibro-fatty tissue (FF), necrotic core (NC) and dense calcium (DC)] were quantified in 3 dimensions in all plaques within the entire pullback. The relationship to GES was assessed by Spearman rank correlation. Results Mean age was 61.1±8.6 years; 67% were male. 1,158 mm of coronary anatomy was imaged by IVUS/VH. Using a validated scale of 1-40, mean GES was 21.6±9.4. GES was associated with plaque volume (R2=0.55; P=0.018), NC volume (R2=0.56; P=0.015), DC volume (R2=0.60; P=0.007), and non-calcified plaque volume (R2=0.50; P=0.036) by Spearman rank correlation. Conclusions In this preliminary report, increased GES was associated with higher plaque volume and a more vulnerable plaque phenotype as evidenced by NC and DC. This composite GES is not only associated with obstructive coronary disease, but also with higher plaque volume and vulnerable phenotype.

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

2013-01-01

244

Bacterial sex in dental plaque.  

PubMed

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

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

2013-01-01

245

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.

2012-01-01

246

Municipal pleural cancer mortality in Spain  

PubMed Central

Background: Pleural cancer is a recognised indicator of exposure to asbestos and mesothelioma mortality. Aims: To investigate the distribution of municipal mortality due to this tumour, using the autoregressive spatial model proposed by Besag, York, and Mollič. Methods: It was possible to compile and ascertain the posterior distribution of relative risk on the basis of a single Bayesian spatial model covering all of Spain's 8077 municipal areas. Maps were plotted depicting standardised mortality ratios, smoothed relative risk (RR) estimates, and the distribution of the posterior probability that RR >1. Results: There was a higher risk of death due to pleural cancer in well defined towns and areas, many of which correspond to municipalities where asbestos using industries once existed for many years, the prime example being the municipal pattern registered for Barcelona Province. The quality of mortality data, the suitability of the model used, and the usefulness of municipal atlases for environmental surveillance are discussed.

Lopez-Abente, G; Hernandez-Barrera, V; Pollan, M; Aragones, N; Perez-Gomez, B

2005-01-01

247

Endovascular Sharp Recanalization for Calcified Femoropopliteal Artery Occlusion  

PubMed Central

Endovascular intervention of peripheral chronic total occlusion (CTO) is technically challenging and time consuming. Various techniques and devices are used to facilitate lesion crossing and improve the success rate of the procedure. However, these new devices are quite expensive and not readily available. We report 2 cases of peripheral CTO wherein the occlusions were successfully crossed by using stiff end of Terumo glidewire. This sharp recanalization may be a useful technique for the recanalization of calcified peripheral CTOs when conventional techniques fail and new devices are not readily available, but it is accompanied by the risk of distal atheroembolism.

Huang, Hsuan-Li; Chou, Hsin-Hua; Wu, Tien-Yu

2012-01-01

248

Calcified Vocal Cord Nodule - A Unique Case Report  

PubMed Central

Vocal cord nodules are benign neoplastic lesions which occur due to submucosal oedema and haemorrhage, leading to fibrosis and hyalinization. Calcification in vocal cord nodules has not been reported so far in literature. It is thought to be a laryngeal counterpart of idiopathic calcinosis cutis. Here, we are reporting a case of a 38-year-old male patient who presented with a change in voice, which had a duration of one month. Laryngoscopic examination revealed a globular, yellowish white, sessile mass which arose from anterior commissure region of right vocal cord. Micro laryngeal excision was done. Histopathological examination was suggestive of a calcified nodule in vocal cord.

Sundarapandian, S; Suresh, Revathy V

2014-01-01

249

Cerebral metastasis from malignant pleural mesothelioma.  

PubMed

Malignant mesothelioma is an uncommon, highly invasive tumor derived from the mesothelial cells of pleura or peritoneum characterized by poor outcome. Mesothelioma was thought to metastasize locally only via direct invasion and not have distant spread. Distant metastases were discovered mostly on post-mortem examination. The authors present a case of 62-year-old man with pleural mesothelioma and brain metastasis. PMID:24963909

El Molla, Mohamed; Gragnaniello, Cristian; Al-Khawaja, Darweesh; Chiribao-Negri, Concepcion; Eftekhar, Behzad

2013-01-01

250

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.

2011-01-01

251

Radiological features of asbestos-related visceral pleural changes.  

PubMed

The radiological manifestations of asbestos-related visceral pleural changes are described. Generally, visceral pleural reactions follow the mesothelial cells response to various injurious substances, including asbestos, and even saline. The changes are nonspecific. They may occur subsequent to pleural reactions associated with many conditions, which include tuberculosis, viral pleurisy, malignancy and lymphoma, lupus, or rheumatoid-induced effusions, cardiac failure, and pulmonary embolism, among other etiologies. The failure to absorb the fibrinous exudate on the visceral pleural surface can lead to the development of diffuse fibrosis of the serosal surface, interlobar pleural thickening, localized pleural filaments (strands), subpleural wedge, and lenticular-shaped masses, and could be the forerunner of lobular atelectasis (pseudotumor) formation. Some of the features are recognized on posteroanterior chest radiographs and the counterparts corroborated with the use of routine and high-resolution computed tomography studies. PMID:2008921

Solomon, A

1991-01-01

252

Vulnerable Plaque Features on Coronary CT Angiography as Markers of Inducible Regional Myocardial Hypoperfusion from Severe Coronary Artery Stenoses  

PubMed Central

Objective We explored whether the presence of 3 known features of plaque vulnerability on coronary CT angiography (CCTA) – low attenuation plaque content (LAP), positive remodeling (PR), and spotty calcification (SC) – identifies plaques associated with greater inducible myocardial hypoperfusion measured by myocardial perfusion imaging (MPI). Methods We analyzed 49 patients free of cardiac disease who underwent CCTA and MPI within a 6-month period and were found on CCTA to have focal 70–99% stenosis from predominantly non-calcified plaque in the proximal or mid segment of 1 major coronary artery. Presence of LAP (?30 Hounsfield Units), PR (outer wall diameter exceeds proximal reference by ?5%), and SC (?3mm long and occupies ?90° of cross-sectional artery circumference) were determined. On MPI, reversible hypoperfusion in the myocardial territory corresponding to the diseased artery was quantified both as percentage of total myocardium (RevTPDART) by an automatic algorithm and as summed difference score (SDSART) by two experienced readers. RevTPDART?3% and SDSART?3 defined significant inducible hypoperfusion in the territory of the diseased artery. Results Plaques in patients with RevTPDART?3% more frequently exhibited LAP (70% vs. 14%, p<0.001) and PR (70% vs. 24%, p=0.001) but not SC (55% vs. 34%, p=0.154). RevTPDART increased from 1.3±1.2% in arteries with LAP?/PR? plaques to 3.2±4.3% with LAP+/PR? or LAP?/PR+ plaques to 8.3±2.4% with LAP+/PR+ plaques (p<0.001); SDSART showed a similar increase: 0.3±0.7 to 2.3±2.8 to 6.0±3.8 (p<0.001). Using the same LAP/PR categorization, there was a marked increase in the frequency of significant hypoperfusion as determined by both RevTPDART?3% (1/19 to 10/21 to 9/9, p<0.001) and SDSART?3 (1/19 to 8/21 to 8/9, p<0.001). LAP and PR, but not SC, were strong predictors of RevTPDART and SDSART in regression models adjusting for potential confounders. Conclusions Presence of low attenuation plaque and positive remodeling in severely stenotic plaques on CCTA is strongly predictive of myocardial hypoperfusion and may be useful in assessing the hemodynamic significance of such lesions.

Shmilovich, Haim; Cheng, Victor Y; Tamarappoo, Balaji K; Dey, Damini; Nakazato, Ryo; Gransar, Heidi; Thomson, Louise EJ; Hayes, Sean W; Friedman, John D; Germano, Guido; Slomka, Piotr J; Berman, Daniel S

2011-01-01

253

[A case of desmoplastic malignant pleural mesothelioma].  

PubMed

A 71-year-old woman with no history of asbestos exposure was referred to our hospital for evaluation of mediastinal soft tissue density. Six months prior to the admission, she had developed back pain and had been diagnosed as having intercostal neuralgia. Since the symptoms progressed, she was referred to another hospital. While chest radiography revealed no abnormality, chest computed tomography showed the prominence of mediastinal soft tissue, extending to the left hilum and partially destroying the nearby vertebrae. However, no pleural effusion was noted. After admission, a thoracoscopic examination was performed, and a whitish mass was found on the pleural surface partially adhering to the chest wall. Histological examination of the biopsied material showed dense areas of collagenous tissue with small foci of slightly atypical spindle cells. These findings led to the diagnosis of desmoplastic malignant pleural mesothelioma. The patient was treated with combined chemo-radiotherapy, but the response to this treatment was unclear. To date, reports for this subgroup of malignant mesothelioma are still rare. PMID:11510098

Tominaga, M; Tanaka, M; Fukuoka, M; Kawashima, M; Yatsunami, J; Nakahara, Y; Aoki, Y; Hayashi, S

2001-05-01

254

Pleural effusion in patients infected with the human immunodeficiency virus  

Microsoft Academic Search

In order to analyze the etiology, cytological and biochemical characteristics, and outcome of pleural disease in patients infected with HIV, the medical records of 86 HIV-positive patients with pleural effusion were reviewed. Controls were 106 HIV-negative patients with parapneumonic or tuberculous effusion. Most HIV-positive patients were intravenous drug abusers (95.3%). Pleural effusions in HIV-positive patients were caused by infections in

O. Trejo; J. A. Girón; E. Pérez-Guzmán; E. Segura; C. Fernández-Gutiérrez; A. García-Tapia; A. J. Clavo; A. Bascuńana

1997-01-01

255

What Are the Signs and Symptoms of Pleurisy and Other Pleural Disorders?  

MedlinePLUS

... stress, and tension; and hypotension (low blood pressure). Pleural Effusion A pleural effusion often has no symptoms. However, the disorder may ... Anxiety Restlessness Rate This Content: Pleurisy and Other Pleural Disorders Clinical Trials Clinical trials are research studies that ...

256

Diagnostic value of ex vivo pleural fluid interferon-gamma versus adapted whole-blood quantiferon-TB gold in tube assays in tuberculous pleural effusion  

PubMed Central

BACKGROUND: Noninvasive diagnosis of pleural tuberculosis (TB) remains a challenge due to the paucibacillary nature of the disease. As Mycobacterium tuberculosis (MTB)-specific T cells are recruited into pleural space in TB effusion; their indirect detection may provide useful clinical information. OBJECTIVES: Evaluation of pleural fluid interferon (INF)-? levels vs Quantiferon–TB Gold In tube assay (QFT- IT) in blood and its adapted variants, using pleural fluid or isolated pleural fluid cells in the diagnosis of pleural TB. METHODS: Thirty-eight patients with pleural effusion of unknown etiology presented at Assiut University Hospital, Egypt, were recruited. Blood and pleural fluid were collected at presentation for INF-? assays. Ex vivo pleural fluid INF-? levels, QFT-IT in blood and its adapted variants were compared with final diagnosis as confirmed by other tools including blind and/or thoracoscopic pleural biopsy. RESULTS: The final clinical diagnosis was TB in 20 (53%), malignancy in 10 (26%), and effusion due to other causes in eight patients (21%). Ex vivo pleural fluid INF-? levels accurately identified TB in all patients and were superior to the QFT-IT assays using blood or pleural fluid (70 and 78% sensitivity, with 60 and 83% specificity, respectively). QFT-IT assay applied to isolated pleural fluid cells had 100% sensitivity and 72% specificity. The optimal cut-off obtained with ROC analysis was 0.73 for TB Gold assay in blood assay, 0.82 IU/ml for the cultured pleural fluid assay, and 0.94 for isolated pleural cells assay. CONCLUSION: The ex vivo pleural fluid INF-? level is an accurate marker for the diagnosis of pleural TB. QFT- IT assay in peripheral blood or its adapted versions of the assay using pleural fluid and/or washed pleural fluid cells had no diagnostic advantage over pleural fluid INF-? in the diagnosis of pleural TB.

Eldin, Eman N.; Omar, Asmaa; Khairy, Mahmoud; Mekawy, Adel H. M.; Ghanem, Maha K.

2012-01-01

257

Yellow nail syndrome presenting with postpartum massive pleural effusion.  

PubMed

Yellow nail syndrome (YNS) is an uncommon clinical syndrome characterized by yellow-green discoloration of nails and recurrent respiratory tract lesions, pleural effusions and lymphedema. A 38-year-old woman was referred to the emergency complaining of chronic cough and increasing dyspnea within last 2 weeks. She had given birth 1 month ago. On examination, the patient exhibited dystrophic yellowish nails and mild peripheral lymphedema. A chest roentgenogram revealed a large right pleural effusion and a small left pleural effusion. YNS is a rare clinical entity but should be taken into consideration in patients with massive pleural effusions and persistent lymphedemas on the postpartum period. PMID:24279775

Günbatar, Hülya; Sertogullarindan, Bunyamin; Ekin, Selami; Arisoy, Ahmet; Ozkol, Hatice Uce

2014-07-01

258

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

2013-01-01

259

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

2008-01-01

260

Localization and expression of osteopontin in the rotator cuff tendons in patients with calcifying tendinitis  

Microsoft Academic Search

Calcifying tendinitis of rotator cuff tendons is a common and painful condition caused by ectopic calcification in humans. To examine the involvement of osteopontin (OPN), a potent regulator of calcium deposition on connective tissues, localization and expression of OPN protein and messenger (m)RNA were investigated in human tissue samples of calcified rotator cuff tendons. Immunohistochemistry demonstrated that OPN was localized

Eiji Takeuchi; Kazuomi Sugamoto; Takanobu Nakase; Takashi Miyamoto; Motoharu Kaneko; Tetsuya Tomita; Akira Myoui; Takahiro Ochi; Hideki Yoshikawa

2001-01-01

261

Calcified Loose Bodies Trapped in the Lateral Synovial Recess of the Knee  

Microsoft Academic Search

Calcified loose bodies originate in the knee joint for a variety of reasons and are removed when symptomatic. We present the case of a 56-year-old man who had multiple calcified bodies located in a sac beneath the iliotibial band known as the lateral synovial recess of the knee. Despite the fact that these loose bodies likely arose from the joint,

Daniel P. Tomlinson; Robert B. Carrigan; Brian J. Sennett

2005-01-01

262

Calcified cartilage, subchondral and cancellous bone morphometry within the knee of normal subjects  

Microsoft Academic Search

This study examined calcified cartilage and bone structure in the development of age-related cartilage changes in the knee. Image analysis was used to examine the calcified cartilage and bone structure. There was a significant decrease in bone volume fraction with increasing age in the knee except for the patella. The study found the cancellous network of the patella to be

Barbara Koszyca; Nicola L. Fazzalari; Barrie Vernon-Roberts

1996-01-01

263

Calcified cartilage morphometry and its relation to subchondral bone remodeling in equine arthrosis  

Microsoft Academic Search

The calcified layer of articular cartilage is known to be affected by age and mechanical factors that may play a role in the development of arthrosis. Because these factors are also related to subchondral remodeling and sclerosis, a morphometric study was carried out in fluorochrome-labeled animals to determine whether the level of subchondral remodeling affected the thickness of the calcified

R. W Norrdin; C. E Kawcak; B. A Capwell; C. W McIlwraith

1999-01-01

264

Species-specific responses of calcifying algae to changing seawater carbonate chemistry  

Microsoft Academic Search

Uptake of half of the fossil fuel CO2 into the ocean causes gradual seawater acidification. This has been shown to slow down calcification of major calcifying groups, such as corals, foraminifera, and coccolithophores. Here we show that two of the most productive marine calcifying species, the coccolithophores Coccolithus pelagicus and Calcidiscus leptoporus, do not follow the CO2-related calcification response previously

Gerald Langer; Markus Geisen; Karl-Heinz Baumann; Jessica Kläs; Ulf Riebesell; Silke Thoms; Jeremy R. Young

2006-01-01

265

Proteomic evaluation of biological nanoparticles isolated from human kidney stones and calcified arteries  

Microsoft Academic Search

Calcifying biological nanoparticles (NPs) develop under cell culture conditions from homogenates of diverse tissue samples displaying extraosseous mineralization, including kidney stones and calcified aneurysms. Probes to definitively identify NPs in biological systems are lacking. Therefore, the aim of this study was to begin to establish a proteomic biosignature of NPs in order to facilitate more definitive investigation of their contribution

Farooq A. Shiekh; Jon E. Charlesworth; Sung-Hoon Kim; Larry W. Hunter; Muthuvel Jayachandran; Virginia M. Miller; John C. Lieske

2010-01-01

266

Do blood-borne calcifying nanoparticles self-propagate?  

PubMed

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

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

2008-01-01

267

Calcified microspheres as biological entities and their isolation from bone.  

PubMed

Calcified microspheres, about 1 microm 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 normal human bone. Their persistence as discrete objects is confirmed by the application of methods for their isolation from the collagenous matrix of immature mouse calvarium and mature bovine femur. Five methods have been used to extract them and include (i) biochemical, (ii) chemical, (iii) mechanical, (iv) pyrogenous and (v) biological separation. Under the optical microscope, all isolates consisted of similar discrete objects and bridged assemblies, whose birefringence varied with treatment. After decalcification, their organic 'ghosts' remained. Each isolated microsphere had a complex substructure of clusters of non-collagenous calcified filaments surrounding a less dense centre. The filaments were 5 nm in diameter with a 5 nm periodicity and regular fine interfilamentous connections. It is concluded that the microspheres are independent, complex, pervasive and central to the containment (i.e. packaging) of calcium phosphate in bone. Their extraction will enable further analysis. PMID:10475573

Aaron, J E; Oliver, B; Clarke, N; Carter, D H

1999-07-01

268

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

269

Kyrieleis plaques in cytomegalovirus retinitis  

Microsoft Academic Search

Purpose  The purpose of this study is to report a case of Kyrieleis plaques (segmental retinal periarteritis) associated with cytomegalovirus\\u000a (CMV) retinitis.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A 47-year-old female with recently diagnosed human immunodeficiency virus and a CD4 count of 55 cells\\/µl presented with decreased\\u000a vision and floaters in her left eye. Ophthalmic examination revealed an advancing border of white granular CMV retinitis extending\\u000a into

Amar Patel; Matthew Pomykala; Krishna Mukkamala; Ronald C. Gentile

270

ACTIVATION OF T LYMPHOCYTES IN ATHEROSCLEROTIC PLAQUES  

PubMed Central

Objective To decipher the immunological mechanisms of plaque maturation and rupture, it is necessary to analyze the phenotypes and distribution of individual lymphocytes which migrate to the plaques as well as their activation at different stages of plaque formation. Methods and Results We developed a protocol to isolate plaque-residing immune cells and analyze their status using polychromatic flow cytometry. We found that the composition and phenotype of T lymphocytes in the plaques differs from that in blood. CD4 and, in particular, CD8+ T cells in plaques are highly activated; the fraction of CD8 T cells co-expressing CD25 and HLA-DR in plaques was 10 times larger than in blood. Conclusions The first flow-cytoanalysis of individual T cells in atherosclerotic plaques indicates that plaques represent a separate immunological compartment from blood with lymphocytes characterized by a high level of T cells activation, which is compatible with the presence of antigen(s) that trigger infiltration activation of these cells. The ability to isolate and characterize these cells may lead to the identification of such antigens.

Grivel, Jean-Charles; Ivanova, Oxana; Pinegina, Natalia; Blank, Paul S.; Shpektor, Alexander; Margolis, Leonid B.; Vasilieva, Elena

2011-01-01

271

The Development and Potential of Acoustic Radiation Force Impulse (ARFI) Imaging for Carotid Artery Plaque Characterization  

PubMed Central

Stroke is the third leading cause of death and long-term disability in the U.S. Currently, surgical intervention decisions in asymptomatic patients are based upon the degree of carotid artery stenosis. While there is a clear benefit of endarterectomy for patients with severe (>70%) stenosis, in those with high/moderate (50–69%) stenosis the evidence is less clear. Evidence suggests ischemic stroke is associated less with calcified and fibrous plaques than with those containing softer tissue, especially when this it is accompanied by a thin fibrous cap. A reliable mechanism for the identification of individuals with atherosclerotic plaques which confer the highest risk for stroke is fundamental to the selection of patients for vascular interventions. Acoustic Radiation Force Impulse (ARFI) imaging is a new ultrasonic-based imaging method that characterizes the mechanical properties of tissue by measuring displacement resulting from applied short duration acoustic radiation force. These displacements provide information about the local mechanical properties of tissue and can differentiate between soft and hard areas. Because arterial walls, soft tissue, atheromas, and calcifications have a wide range in their stiffness properties, they represent excellent candidates for ARFI imaging. We present information from early phantom experiments and excised human limb studies to in vivo carotid artery scans and provide evidence for the ability of ARFI to provide high quality images which highlight mechanical differences in tissue stiffness not readily apparent in matched B-mode images. This allows ARFI to identify soft from hard plaques and differentiate characteristics associated with plaque vulnerability or stability.

Allen, Jason D.; Ham, Katherine L.; Dumont, Douglas M.; Sileshi, Bantayehu; Trahey, Gregg E.; Dahl, Jeremy J.

2012-01-01

272

Amyloid plaques in PSAPP mice bind less metal than plaques in human Alzheimer's disease  

Microsoft Academic Search

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

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

2009-01-01

273

Ischemia modified albumin in the differential diagnosis of pleural effusions.  

PubMed

The differential diagnosis of pleural effusion often requires invasive procedures. Up to 25 percent of pleural effusions can remain undiagnosed with an unclear pathogenesis. Therefore new biological markers may increase diagnostic yield and provide better understanding of pathogenesis of pleural effusion. We hypothesized that new ischemia biomarker, "ischemia modified albumin (IMA)" would help in both the differentiation of the underlying etiologies and provide a better understanding of pathogenesis of pleural effusions. This study was done between December 2009 and September 2010 in the Department of Pulmonary Diseases of Gaziantep University Hospital. One hundred and sixteen subjects with pleural effusion were included. Pleural and blood IMA levels were measured by ELISA. The underlying etiologies of pleural effusions were as follows: transudates (n = 50), malignancy (n = 32), tuberculosis (n = 12), pulmonary thromboembolism (n = 6), pneumonia (n = 16). The median pleural IMA levels were significantly different between the groups (p < 0.000). There were no such differences in the blood levels of IMA. The most striking difference in the median pleural IMA levels was between transudates and exudates (7986 (25-75%, 5145-56.505) ng/mL; 3376 (25-75%, 1935-4660) ng/mL; respectively, p = 0.000). The area under the ROC curve was 0.837 ± 0.038 for the cut-off level higher than 4711 ng l/mL for the differentiation of transudates from exudates (sensitivity, 82%; specificity, 78%; 95% CI, 0.76 to 0.91; p = 0.0000). In conclusion, the pleural IMA levels are higher in transudates compared to exudates. No such differences were observed in blood levels of IMA suggesting that there are reasons other than ischemia that cause an increase in pleural fluid IMA levels. PMID:21843931

Dikensoy, Oner; Celik, Nuket; Kul, Seval; Gogebakan, Bulent; Bayram, Hasan; Light, Richard W

2011-11-01

274

Diagnostic utility of adenosine deaminase in exudative pleural effusions  

PubMed Central

Objective: To determine the diagnostic utility of adenosine deaminase (ADA) in exudative pleural effusions of different etiologies. Setting and Design: It was an observational study conducted at a tertiary care teaching institute. Materials and Methods: Of a total of 171 pleural fluid samples, 122 were found to be exudates and were included in the study. Pleural fluid ADA was done for all included patients. Pleural fluid ADA ?40 U/l was taken as diagnostic cut off for TB effusion. Statistical Analysis: Sensitivity, specificity positive and negative predictive value of pleural fluid ADA for diagnosing TB was calculated by using clinical calculator – 1, Richard Lowry 2001-2013. Results: There were 171 patients with pleural effusion, out of which 122 (71.8%) were found to be exudative and were studied further. There were 49 (40.1%), 36 (29.5%) and 33 (27%) cases of TB, malignancy and para pneumonic effusion respectively, whereas 4 (3.3%) cases remained undiagnosed. Median ADA values for TB, malignancy and para pneumonic effusion were 55.8 U/l (range 9.7-756 U/l), 18 U/l (6.5-81 U/l) and 25 U/l (3.4-172 U/l) respectively. Pleural fluid ADA >40U/l yielded 85.7% sensitivity, 80.8% specificity, 75% positive predictive value and 89.5% negative predictive value. Conclusion: Pleural fluid ADA remains useful in diagnosing tuberculosis pleural effusion. The median ADA for TB effusion in present cohort was 51.8 IU/ml. Pleural fluid ADA of 40 U/L yielded 89.5% negative predictive value and 75% positive predictive value. Pleural fluid ADA is cost effective and good screening test for diagnosis of TB.

Mehta, Asmita A.; Gupta, Amit Satish; Ahmed, Subin; Rajesh, V.

2014-01-01

275

Association of inflammatory markers with the morphology and extent of coronary plaque as evaluated by 64-slice multidetector computed tomography in patients with stable coronary artery disease.  

PubMed

We evaluated the association between inflammatory markers and coronary artery plaque assessed by 64-slice multidetector computed tomography. Coronary computed tomography angiography was performed in patients with chest discomfort suggestive of coronary artery disease (CAD). Individuals with an acute coronary syndrome were excluded from the study. Coronary plaque morphology, the number of artery segments exhibiting plaque, and the number of vessels with >50% stenosis were evaluated. Plasma levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), plasminogen activator inhibitor-1, and vascular endothelial growth factor were measured. Among the 178 patients studied (age 65 ± 10 years; 70% men), 125 were diagnosed with CAD. Hs-CRP and IL-6 concentrations were significantly higher in patients with CAD than in patients without (2.73 ± 4.7 vs. 1.32 ± 2.6 mg/L, P = 0.018, and 3.06 ± 3.3 vs. 2.19 ± 2.4 pg/mL, P = 0.036). The IL-6 level was high in patients with predominantly calcified plaque, and was significantly higher in patients with 4-9 plaque segments than in those with no or 1-3 plaque segments (4.07 ± 5.3 vs. 2.19 ± 2.4 pg/mL and 2.43 ± 2.0 pg/mL, respectively, P = 0.025). The number of stenotic vessels was not significantly related to inflammatory markers. Multivariate logistic analysis revealed that plasma levels of hs-CRP but not IL-6 were associated with the presence of coronary plaque with calcification (OR 3.37, P = 0.026). This study supports the usefulness of inflammatory markers for the evaluation of coronary plaque in patients with stable CAD. PMID:23358918

Harada, Ken; Amano, Tetsuya; Uetani, Tadayuki; Yoshida, Tomohiro; Kato, Bunichi; Kato, Masataka; Marui, Nobuyuki; Kumagai, Soichiro; Ando, Hirohiko; Ishii, Hideki; Matsubara, Tatsuaki; Murohara, Toyoaki

2013-06-01

276

Association of serum total bilirubin levels with the severity, extent and subtypes of coronary atherosclerotic plaques detected by coronary CT angiography.  

PubMed

In this study, we aimed to evaluate whether serum total bilirubin was associated with the severity and morphology of coronary atherosclerotic plaques detected by computed tomography angiography (CTA). The study population consisted of 1,115 patients (55.2 % men) who underwent dual-source 64-slice CTA for the assessment of coronary artery disease (CAD). Coronary arteries were evaluated on 16 segment basis and critical coronary plaque was described as luminal narrowing >50 %, whereas plaque morphology was assessed on per segment basis. Serum bilirubin levels were determined using commercially available assay kits. The critical atherosclerotic lesions were detected in 431/1,115 (38.6 %) subjects by CTA. Serum total bilirubin levels were found to be lower in patients with any coronary plaque (0.62 ± 0.21 vs. 0.70 ± 0.25 mg/dL, p = 0.002). Also bilirubin level was lower in patients with critical stenosis compared to non-critical stenosis (0.57 ± 0.18 vs. 0.70 ± 0.24 mg/dL, p < 0.001). Subjects having primarily noncalcified plaque (NCP) and mixed plaque (MP) have lower bilirubin levels compared to calcified plaque (CP) and normal subjects (0.62 ± 0.20 for NCP and 0.60 ± 0.19 for MP, 0.65 ± 0.26 for CP and 0.71 ± 0.25 for normal subjects, p < 0.001). This independent association was remained for NCP after multinominal regression analysis (OR: 0.76; 95 % CI 0.58-0.88; p < 0.001). Our study demonstrated that serum bilirubin level was significantly associated with the presence, severity and the noncalcified morphology of atherosclerotic plaques detected by CTA. Further prospective clinical studies are needed to clarify the exact physiopathologic and prognostic role of bilirubin in CAD. PMID:23546648

Canpolat, U?ur; Aytemir, Kudret; Yorgun, Hikmet; Haz?rolan, Tuncay; Kaya, Ergün Bar??; ?ahiner, Levent; Sunman, Hamza; Tokgözo?lu, Lale; Kabakc?, Giray; Oto, Ali

2013-08-01

277

Plaquing procedure for infectious hematopoietic necrosis virus  

USGS Publications Warehouse

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

Burke, J. A.; Mulcahy, D.

1980-01-01

278

Current status of vulnerable plaque detection.  

PubMed

Critical coronary stenoses have been shown to contribute to only a minority of acute coronary syndromes (ACS) 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 noninvasive imaging techniques have shown the potential to identify these high-risk plaques. The anatomical characteristics of the vulnerable plaque such as thin cap fibroatheroma and lipid pool can be identified with angioscopy, high frequency intravascular ultrasound, intravascular MRI, and optical coherence tomography. Efforts have also been made to recognize active inflammation in high-risk plaques using intravascular thermography. Plaque chemical composition by measuring electromagnetic radiation using spectroscopy is also an emerging technology to detect vulnerable plaques. Noninvasive imaging with MRI, CT, and PET also holds the potential to differentiate between low and high-risk plaques. However, at present none of these imaging modalities are able to detect vulnerable plaque neither has been shown to definitively predict outcome. Nevertheless in contrast, there has been a parallel development in the physiological assessment of advanced atherosclerotic coronary artery disease. Thus recent trials using fractional flow reserve in patients with modest non flow-limiting stenoses have shown that deferral of PCI with optimal medical therapy in these patients is superior to coronary intervention. 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. PMID:19670307

Sharif, Faisal; Murphy, Ross T

2010-01-01

279

New strategies to manage complicated pleural effusions  

PubMed Central

Expanded abstract Citation Rahman NM, Maskell NA, West A, Teoh R, Arnold A, Mackinlay C, Peckham D, Davies CW, Ali N, Kinnear W, Bentley A, Kahan BC, Wrightson JM, Davies HE, Hooper CE, Lee YC, Hedley EL, Crosthwaite N, Choo L, Helm EJ, Gleeson FV, Nunn AJ, Davies RJ: N Engl J Med 2011, 365:518-26. PMID: 21830966, available on www.pubmed. gov Background More than 30% of patients with pleural infection either die or require surgery. Drainage of infected fluid is the key to successful treatment, but intrapleural fibrinolytic therapy did not improve outcomes in an earlier, large, randomized trial therapy (Multicenter Intrapleural Sepsis Trial [MIST1]). Methods Objective: To evaluate the efficacy and safety of intrapleural DNase alone, alteplase alone, or the combination of both, to improve pleural drainage. Design: Multicenter, double-blind, double-dummy, 2 × 2 factorial randomized trial. Setting: Eleven centers in the United Kingdom (UK). Subjects: Adult patients (mean age 59 years, 72% men), who had clinical evidence of infection, and pleural fluid that had macroscopic purulence, a positive culture or Gram stain for bacteria, or a pH < 7.2. Intervention: Patients were assigned to 1 of the 4 study interventions for 3 days: double placebo, intrapleural tissue plasminogen activator (t-PA) and DNase, t-PA and placebo, or DNase and placebo. Outcomes: The primary outcome was the change in pleural opacity, measured as the percentage of the hemithorax occupied by effusion, on chest radiography on day 7 as compared with day 1. Secondary outcomes included referral for surgery, duration of hospital stay, and adverse events. Results The mean (± SD) change in pleural opacity was greater in the t-PA-DNase group than in the placebo group (-29.5 ± 23.3% vs. -17.2 ± 19.6%; difference, -7.9%; 95% confidence interval [CI], -13.4 to -2.4; P = 0.005). The change observed with t-PA alone and with DNase alone (-17.2 ± 24.3 and -14.7 ± 16.4%, respectively) was not significantly different from that observed with placebo. The frequency of surgical referral at 3 months was lower in the t-PA-DNase group than in the placebo group (2 of 48 patients [4%] vs. 8 of 51 patients [16%]; odds ratio for surgical referral, 0.17; 95% CI, 0.03 to 0.87; P = 0.03) but was greater in the DNase group (18 of 46 patients [39%]) than in the placebo group (odds ratio, 3.56; 95% CI, 1.30 to 9.75; P = 0.01). Combined t-PA-DNase therapy was associated with a reduction in the hospital stay, as compared with placebo (difference, -6.7 days; 95% CI, -12.0 to -1.9; P = 0.006). Hospital stay with either agent alone was not significantly different from that with placebo. The frequency of adverse events did not differ significantly among the groups. Conclusions Intrapleural t-PA-DNase therapy improved fluid drainage in patients with pleural infection and reduced the frequency of surgical referral and the duration of hospital stay. Treatment with DNase alone or t-PA alone was ineffective.

2012-01-01

280

New strategies to manage complicated pleural effusions.  

PubMed

EXPANDED ABSTRACT: CITATION: Rahman NM, Maskell NA, West A, Teoh R, Arnold A, Mackinlay C, Peckham D, Davies CW, Ali N, Kinnear W, Bentley A, Kahan BC, Wrightson JM, Davies HE, Hooper CE, Lee YC, Hedley EL, Crosthwaite N, Choo L, Helm EJ, Gleeson FV, Nunn AJ, Davies RJ: N Engl J Med 2011, 365:518-26. PMID: 21830966, available on www.pubmed. gov BACKGROUND: More than 30% of patients with pleural infection either die or require surgery. Drainage of infected fluid is the key to successful treatment, but intrapleural fibrinolytic therapy did not improve outcomes in an earlier, large, randomized trial therapy (Multicenter Intrapleural Sepsis Trial [MIST1]). METHODS: Objective: To evaluate the efficacy and safety of intrapleural DNase alone, alteplase alone, or the combination of both, to improve pleural drainage.Design: Multicenter, double-blind, double-dummy, 2 × 2 factorial randomized trial.Setting: Eleven centers in the United Kingdom (UK).Subjects: Adult patients (mean age 59 years, 72% men), who had clinical evidence of infection, and pleural fluid that had macroscopic purulence, a positive culture or Gram stain for bacteria, or a pH < 7.2.Intervention: Patients were assigned to 1 of the 4 study interventions for 3 days: double placebo, intrapleural tissue plasminogen activator (t-PA) and DNase, t-PA and placebo, or DNase and placebo.Outcomes: The primary outcome was the change in pleural opacity, measured as the percentage of the hemithorax occupied by effusion, on chest radiography on day 7 as compared with day 1. Secondary outcomes included referral for surgery, duration of hospital stay, and adverse events. RESULTS: The mean (± SD) change in pleural opacity was greater in the t-PA-DNase group than in the placebo group (-29.5 ± 23.3% vs. -17.2 ± 19.6%; difference, -7.9%; 95% confidence interval [CI], -13.4 to -2.4; P = 0.005). The change observed with t-PA alone and with DNase alone (-17.2 ± 24.3 and -14.7 ± 16.4%, respectively) was not significantly different from that observed with placebo. The frequency of surgical referral at 3 months was lower in the t-PA-DNase group than in the placebo group (2 of 48 patients [4%] vs. 8 of 51 patients [16%]; odds ratio for surgical referral, 0.17; 95% CI, 0.03 to 0.87; P = 0.03) but was greater in the DNase group (18 of 46 patients [39%]) than in the placebo group (odds ratio, 3.56; 95% CI, 1.30 to 9.75; P = 0.01). Combined t-PA-DNase therapy was associated with a reduction in the hospital stay, as compared with placebo (difference, -6.7 days; 95% CI, -12.0 to -1.9; P = 0.006). Hospital stay with either agent alone was not significantly different from that with placebo. The frequency of adverse events did not differ significantly among the groups. CONCLUSIONS: Intrapleural t-PA-DNase therapy improved fluid drainage in patients with pleural infection and reduced the frequency of surgical referral and the duration of hospital stay. Treatment with DNase alone or t-PA alone was ineffective. PMID:22621656

Safiyeh, Majed; Huang, David

2012-05-22

281

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

PubMed Central

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

2013-01-01

282

Sirolimus-eluting stents and calcified coronary lesions: clinical outcomes of patients treated with and without rotational atherectomy.  

PubMed

This study examined the outcomes of patients who underwent sirolimus-eluting stent (SES) implantation for the treatment of heavily calcified coronary lesions (HCCL) with and without the use of rotational atherectomy (rotablator). We investigated 150 consecutive patients with angiographic evidence of HCCL who underwent SES implantation. Sixty-nine patients underwent SES implantation without the need of rotablator (SES), and 81 patients required rotational atherectomy to modify the plaque and facilitate the delivery of the stent (SES + rotational atherectomy). Clinical success was equivalent in both groups (>98%) and there were no in-hospital outcome differences. At 6 months, the target lesion revascularization rate was 4.9% in SES vs. 4.2% in SES + rotational atherectomy groups, respectively (P = NS). Mortality at 6 months was 7.9% in the SES group vs. 6.8% in the SES + rotational atherectomy group (P = NS). SES performs well in patients with complex HCCL, with a relative low event rate. Lesions requiring rotational atherectomy to facilitate dilation and stenting had similar outcomes after SES implantation to those that could be stented without the need for rotablator. PMID:17086529

Clavijo, Leonardo C; Steinberg, Daniel H; Torguson, Rebecca; Kuchulakanti, Pramod K; Chu, William W; Fournadjiev, Jana; Satler, Lowell F; Kent, Kenneth M; Suddath, William O; Waksman, Ron; Pichard, Augusto D

2006-12-01

283

Chylothorax: diagnosis by lipoprotein electrophoresis of serum and pleural fluid  

Microsoft Academic Search

This report describes a 31-year-old woman who underwent a technically difficult left pneumonectomy for tuberculosis and developed thereafter a large left pleural effusion which was milky in colour. A traumatic chylothorax was suspected, and the diagnosis was confirmed by simultaneous fasting pleural and serum lipid studies and lipoprotein electrophoresis. The latter study was especially helpful in confirming the chylous nature

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

1977-01-01

284

Hemorrhagic pleural effusion secondary to sarcoidosis: A brief review  

PubMed Central

Pleural effusion is considered to be a rare manifestation of pulmonary sarcoidosis, but hemorrhagic effusion secondary to it is a very uncommon clinical presentation. This case is reported due to the rare manifestation in pulmonary sarcoidosis presenting clinically as hemorrhagic pleural effusion.

Kumar, Santosh; Verma, Sanjay Kumar; Singh, Rajni; Prasad, Rajendra

2009-01-01

285

Malignant Pleural Effusions: Review of Treatment and Our Experience  

Microsoft Academic Search

More than half of patients with malignancy present with a pleural effusion at some time in their course. Recurrent malignant pleural effusions (MPE) impair functions and worsen the quality of life. Once a patient develops MPE, only mechanical drainage relieves pulmonary compression and dyspnea. Optimal treatment is however, still controversial. During January 2001 to January 2006, our group treated 48

L. Bertolaccini; C. Zamprogna; L. Barberis; M. Navarra; E. Manno; A. D’Urso; F. Massaglia

2007-01-01

286

Pleurodesis outcome in malignant pleural mesothelioma.  

PubMed

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

2013-06-01

287

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.

2012-01-01

288

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

2003-01-01

289

Pleural Fluid Analysis: Standstill or a Work in Progress?  

PubMed Central

Pleural fluid analysis yields important diagnostic information in pleural effusions in combination with clinical history, examination, and radiology. For more than 30 years, the initial and most pragmatic step in this process is to determine whether the fluid is a transudate or an exudate. Light's criteria remain the most robust in separating the transudate-exudate classification which dictates further investigations or management. Recent studies have led to the evaluation and implementation of a number of additional fluid analyses that may improve the diagnostic utility of this method. This paper discusses the current practice and future direction of pleural fluid analysis in determining the aetiology of a pleural effusion. While this has been performed for a few decades, a number of other pleural characteristics are becoming available suggesting that this diagnostic tool is indeed a work in progress.

Hassan, T.; Al-Alawi, M.; Chotirmall, S. H.; McElvaney, N. G.

2012-01-01

290

Can bioabsorbable scaffolds be used in calcified lesions?  

PubMed

The technology of bioabsorbable vascular scaffolds (BVSs) that disappears with minimal trace essentially eliminating the risk of very late stent thrombosis appears exciting. However, these scaffolds have only been tried in simple lesions in which the risk of late stent thrombosis is very low. We would like to report the use of everolimus-eluting BVS in calcified coronary lesions following debulking the lesions using scoring balloons and rotational atherectomy. With the use of intravascular ultrasound, we have confirmed the adequate expansion of these scaffolds. These cases demonstrate the feasibility of BVS in complex lesions, but appropriate lesion preparation remains the key to aid adequate expansion of these scaffolds.© 2013 Wiley Periodicals, Inc. PMID:23592566

Basavarajaiah, Sandeep; Naganuma, Toru; Latib, Azeem; Colombo, Antonio

2014-07-01

291

Calcifying fibrous tumor of the stomach: a case report  

PubMed Central

Calcifying fibrous tumor (CFT) is a rare, benign mesenchymal tumor usually affecting children and young adults, and it shows a predilection for the soft tissue and the abdominal cavity. Intrinsic visceral CFT is extremely rare and we present herein the case of a 59-year-old man with an asymptomatic gastric lesion, incidentally detected 1 month before this presentation. Thus, gastric endoscopy revealed a polypoid submucosal mass in the fundus, covered by an erythematous mucosa. The polypoid mass was a 3.9 × 2.7 cm-sized well-defined tumor located in the proper muscle, with extension to the subserosa. The tumor showed characteristic hypocellular sclerosis with coarse collagen, mononuclear inflammatory infiltrates, sparse fibroblastic spindle cells and occasional, psammomatous or dystrophic calcifications. Immunohistochemically, the spindle cells were negative for CD117, CD34, platelet-derived growth factor receptor-alpha, S100, smooth muscle actin, desmin and anaplastic lymphoma kinase.

Jang, Kyu Yun; Moon, Woo Sung; Lee, Ho; Kim, Chan Young

2012-01-01

292

Nuclear analytical methods for trace element studies in calcified tissues.  

PubMed

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

1990-01-01

293

Calcified neurocysticercosis lesions and hippocampal sclerosis: potential dual pathology?  

PubMed

In areas where cysticercosis is endemic, calcified neurocysticercosis lesion(s) (CNL) and hippocampal sclerosis (HS) commonly coexist in patients with localization-related epilepsies. To understand the pathogenesis of HS associated with CNL, we compared the characteristics of three groups of patients with antiepileptic drug-resistant epilepsies: CNL with HS, CNL without HS (CNL alone), and HS without CNL (HS alone). In comparison to patients with CNL alone, those with CNL with HS had CNL more frequently located in the ipsilateral temporal lobe. Those with CNL with HS had a lower incidence of febrile seizures, older age at initial precipitating injury and at onset of habitual complex partial seizures, and more frequent clustering of seizures and extratemporal/bitemporal interictal epileptiform discharges as compared to patients with HS alone. Our study illustrates that HS associated with CNL might have a different pathophysiologic basis as compared to classical HS. PMID:22242912

Rathore, Chaturbhuj; Thomas, Bejoy; Kesavadas, Chandrasekharan; Radhakrishnan, Kurupath

2012-04-01

294

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

2011-01-01

295

Osseous changes in meningioma en plaque.  

PubMed

Hyperostosis is the most common skull change associated with meningioma. Five hyperostosis cases of meningioma en plaque infiltrating the skull processed without previous decalcification of the bone tissue were investigated histologically and immunohistochemically with antibodies against somatostatin receptor 2A (SSR2A). Undecalcified bone biopsies embedded in methylmethacrylate and paraffin-embedded extraosseous tumor tissues were analyzed. All five cases were well-differentiated meningotheliomatous meningiomas en plaque according to the WHO classification of tumors and revealed areas of hyperosteoidosis. Furthermore, all five meningiomas en plaque presented strong positive reactions to antibodies against SSR2A in both the intraosseous and extraosseous tumor proliferates. In summary, similar morphological changes characterized by hyperosteoidosis were observed in a small cohort of meningioma en plaque associated with expression of SSR2A and reports in the literature of the histogenesis of hyperostosis in meningioma en plaque are discussed. PMID:21378343

Matschke, Jakob; Addo, Jasmine; Bernreuther, Christian; Zustin, Jozef

2011-02-01

296

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

PubMed

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

2013-09-01

297

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

2013-01-01

298

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.

2012-01-01

299

Neurotrophin system activation in pleural effusions.  

PubMed

Neurotrophins (NTs) expression was assessed in malignant and non-malignant pleural effusions (inflammatory exudates and transudates). Enzyme-linked immunosorbent assay, in malignant exudates from small and non-small cell lung cancer (SCLC and NSCLC), detected nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin-3 (NT-3), and their levels are higher as compared with inflammatory and transudative effusions. By immunoblots, in cultured cancer cells coming from malignant pleural effusions, NTs and low- and high-affinity NT receptors were detected in a percentage of SCLC and NSCLC. Proliferation assay demonstrated that BDNF significantly increased cancer cell proliferation in vitro, on the contrary, NT-3 reduced cancer cell growth rate and NGF did not modify cell growth. Moreover, NGF protects cells from death during starvation. These effects are reverted by the addition of NT receptor antagonists. Cultured cancer cells injected into the lung of immunodeficient mice generate lung tumors expressing NTs and NT receptors. These findings suggest that NTs may be able to modulate cancer cell behavior and their growth. PMID:20214505

Ricci, Alberto; Mariotta, Salvatore; Pompili, Elena; Mancini, Rita; Bronzetti, Elena; De Vitis, Claudia; Pisani, Lara; Cherubini, Emanuela; Bruno, Pierdonato; Gencarelli, Giorgetta; Giovagnoli, Maria R; Terzano, Claudio; Ciliberto, Gennaro; Giarnieri, Enrico; Fumagalli, Lorenzo

2010-08-01

300

Staging algorithm for diffuse malignant pleural mesothelioma.  

PubMed

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

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

2010-02-01

301

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

PubMed

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

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

2009-01-01

302

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

PubMed Central

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

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

2014-01-01

303

Vascular plaque characterization using intravascular ultrasound elastography and NIR Raman spectroscopy in vitro  

NASA Astrophysics Data System (ADS)

The composition and morphology of the atherosclerotic lesion are considered to be important determinants of acute coronary ischemic syndromes. We investigated the potentials of a combination of intravascular ultrasound (IVUS) elastography and intravascular Near Infrared Raman (NIR) spectroscopy, to assess the physical and chemical composition of the vessel wall and plaque. Intact human coronary arteries were mounted in an in vitro pressurized perfusion setup and investigated with a 20 MHz VisionsR IVUS catheter. At selected cross- sections, two echo-frames were acquired at intraluminal pressures of 80 and 100 mmHg to strain the tissue in order to obtain elastograms. Next, Raman spectra were obtained during 30 seconds at 4 angles (0, 90, 180 and 270 degrees) using a sideways viewing probe. Spectra were modeled to obtain quantitative chemical information, while leaving the specimens intact. Calcified areas were identifiable on the echograms, elastograms and Raman spectra. A combination of geometric information provided by the echogram, chemical information as obtained with Raman spectroscopy, and high stress regions determined by the elastogram, may prove to be a valuable tool to identify plaque vulnerability.

de Korte, Chris L.; Buschman, Hendrik P.; van de Poll, Sweder W.; van der Steen, Anton F.; Puppels, Gerwin J.; van der Laarse, Arnoud

2000-04-01

304

77 FR 34389 - Determination of Regulatory Review Period for Purposes of Patent Extension; Progel Pleural Air...  

Federal Register 2010, 2011, 2012, 2013

...of Patent Extension; Progel Pleural Air Leak Sealant AGENCY: Food and Drug Administration...regulatory review period for Progel Pleural Air Leak Sealant and is publishing this notice of...the medical device, Progel Pleural Air Leak Sealant. Progel Pleural Air Leak...

2012-06-11

305

A mechanistic analysis of the role of microcalcifications in atherosclerotic plaque stability: potential implications for plaque rupture  

PubMed Central

The role of microcalcifications (?Calcs) in the biomechanics of vulnerable plaque rupture is examined. Our laboratory previously proposed (Ref. 44), using a very limited tissue sample, that ?Calcs embedded in the fibrous cap proper could significantly increase cap instability. This study has been greatly expanded. Ninety-two human coronary arteries containing 62 fibroatheroma were examined using high-resolution microcomputed tomography at 6.7-?m resolution and undecalcified histology with special emphasis on calcified particles <50 ?m in diameter. Our results reveal the presence of thousands of ?Calcs, the vast majority in lipid pools where they are not dangerous. However, 81 ?Calcs were also observed in the fibrous caps of nine of the fibroatheroma. All 81 of these ?Calcs were analyzed using three-dimensional finite-element analysis, and the results were used to develop important new clinical criteria for cap stability. These criteria include variation of the Young's modulus of the ?Calc and surrounding tissue, ?Calc size, and clustering. We found that local tissue stress could be increased fivefold when ?Calcs were closely spaced, and the peak circumferential stress in the thinnest nonruptured cap (66 ?m) if no ?Calcs were present was only 107 kPa, far less than the proposed minimum rupture threshold of 300 kPa. These results and histology suggest that there are numerous ?Calcs < 15 ?m in the caps, not visible at 6.7-?m resolution, and that our failure to find any nonruptured caps between 30 and 66 ?m is a strong indication that many of these caps contained ?Calcs.

Maldonado, Natalia; Kelly-Arnold, Adreanne; Vengrenyuk, Yuliya; Laudier, Damien; Fallon, John T.; Virmani, Renu; Cardoso, Luis

2012-01-01

306

The Potential Role of Optical Coherence Tomography in the Evaluation of Vulnerable Carotid Atheromatous Plaques: A Pilot Study  

SciTech Connect

Purpose. The decision to intervene surgically in patients with carotid artery disease is based on the presence of symptoms, along with the severity of carotid artery stenosis as assessed by ultrasound or X-ray computed tomography (CT). Optical coherence tomography (OCT) is a relatively new imaging technique that offers potential in the identification of, as well as the distinction between, stable and unstable atherosclerotic plaques. The purpose of our study was to evaluate whether OCT can be used as a noninvasive diagnostic tool to reveal the morphology of carotid stenosis from the adventitial surface of the carotid artery. To achieve this aim, excised atheromatous plaques were scanned by OCT from the external surface. Methods. Plaques removed at carotid endarterectomy were scanned by OCT from the external surface within 72 hr of surgery and then examined histologically. The images of the histologic slides and the scans were then compared. Results. We examined 10 carotid endarterectomy specimens and were able to identify calcification, cholesterol crystal clefts, and lipid deposits in the OCT images with histologic correlation. The strong light scattering from the calcified tissue and cholesterol crystal clefts limited the depth of light penetration, making observation of the intimal surface and the detail of the fibrous cap difficult. However, we were able to confidently identify the absence of an atherosclerotic plaque by OCT scans even from the external surface. Conclusion. The results of this pilot study demonstrate that OCT can reveal the main features of carotid stenosis but that plaque vulnerability cannot be reliably and precisely assessed if scanned from the external surface with OCT in its present form.

Prabhudesai, Vikramaditya [St. Joseph's Hospital, Diagnostic Imaging (Canada); Phelan, Cordelia [University Hospital of North Staffordshire, NHS Trust, Department of Pathology (United Kingdom); Yang, Ying [Institute of Science and Technology in Medicine, Keele University (United Kingdom)], E-mail: bea00@keele.ac.uk; Wang, Ruikang K. [Oregon Health and Science University, Department of Biomedical Engineering (United States); Cowling, Mark G. [University Hospital of North Staffordshire, NHS Trust, Department of Radiology (United Kingdom)

2006-12-15

307

Growth of necrotic cores in atherosclerotic plaque.  

PubMed

Plaques are fatty deposits that grow mainly in arteries and develop as a result of a chronic inflammatory response. Plaques are characterized as 'vulnerable' when they have large internal regions of necrosis and are heavily infiltrated by macrophages. The particular composition of a vulnerable plaque renders it susceptible to rupture, which releases thrombogenic agents into the bloodstream and can result in myocardial infarction. In this paper, we propose a mathematical model to predict the development of a plaque's necrotic core. By solving coupled reaction-diffusion equations for macrophages and dead cells, we focus on the joint effects of hypoxic cell death and chemoattraction to oxidized low-density lipoprotein (Ox-LDL), a molecule that is strongly linked to atherosclerosis. We do not model the mechanical properties of the plaque, its growth or rupture. Our model predicts cores that have approximately the right size and shape when compared to ultrasound images. Because our model is linear and autonomous, normal mode analysis and subsequent calculation of the smallest eigenvalue allow us to compute the times taken for the necrotic core to form. We find that the spatial distribution of Ox-LDL within the plaque determines not only the placement and size of cores, but their time of formation. Although plaques are biochemically complex, our study shows that certain aspects of their composition can be predicted and are, in fact, governed by simple physical models. PMID:21908792

Fok, Pak-Wing

2012-12-01

308

[Chemical control of plaque: comparative review].  

PubMed

Plaque control can be achieved by mechanical means. Since plaque removal can be laborious and difficult, chemical agents became important adjuncts to traditional oral hygiene procedures. Chlorhexidine is one of the synthetic antiseptics that has a unique antiplaque effect and 0.2% chlorhexidine can achieve a practically complete plaque control. It has one negative effect namely an extrinsic brown-yellow staining. Listerine has proven its ability to reduce plaque and gingivitis in a moderate way. Hexetidine has a greater antiplaque effect in combination with zinc and can be compared with a 0.1% chlorhexidine. Povidone-iodine can not be used to keep plaque at low levels. Sanguinarine can reduce plaque accumulation when the toothpaste and mouthrinse are used together. H2O2 is an antiplaque agent but has some negative effects such as ulcerations... One can conclude that the use of a chemical agent cannot replace a good mechanical plaque control but is rather an adjunct to oral hygiene under certain conditions. PMID:1891629

Marechal, M

1991-01-01

309

Comprehensive plaque assessment by coronary CT angiography.  

PubMed

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

Maurovich-Horvat, Pál; Ferencik, Maros; Voros, Szilard; Merkely, Béla; Hoffmann, Udo

2014-07-01

310

Parvovirus (feline panleucopaenia virus) plaque formation.  

PubMed

A plaque assay was developed for feline parvovirus (FPV; feline panleucopaenia virus) in a feline embryo (FEmb) cell line. Higher numbers and larger diameter plaques were obtained with a) seeding rates of 0.7 X 10(5) and 1.5 X 10(5) cells cf. 3 X 10(5) and 6 X 10(5) cells/well of 35 mm diameter, b) synchronised cells infected at the G1-S interface cf. nonsynchronised cells and c) 5 to 6 days incubation post inoculation. The plaque assay was standardised by using serum deprivation for 24 hours to synchronize cells, a seeding rate of 1.5 X 10(5) cells/35 mm diameter well, inoculation of virus 16 hours post seeding followed by 5 days incubation. The standardised assay gave consistent, reproducible results. A dose-response curve using the assay showed a linear, 45 degrees slope, relationship between plaque forming units and virus dilution which further verified the sensitivity and reliability of the assay. Plaques produced by "wild" type and plaque purified virus were invariably non uniform in diameter; diameter of plaques in fact followed a normal frequency distribution under standard assay conditions. PMID:2986580

Tham, K M; Studdert, M J

1985-01-01

311

Pleural Cholesterol to the Diagnosis of Exudative Effusion  

PubMed Central

Introduction: Diagnostic approaches to patients with a pleural effusion must be precise because many procedures depend on the nature of the fluid in the effusion. To date, no biochemical test is considered an appropriate alternative to Light’s criteria. This study compared the absolute pleural cholesterol (PC) level and the pleural cholesterol/serum cholesterol (PC/SC) ratio with Light’s criteria to determine exudative pleural effusions. Materials and Methodology: This study was a case series of 100 consecutive patients with pleural effusions. The clinical parameters that were used to diagnosis an exudative effusion included the cholesterol level, a pleural cholesterol level ? 50 mg/dL, a pleural/serum ratio ? 0.4, and Light’s criteria. The sensitivity, specificity, and positive and negative predictive values of each test for the diagnosis of an exudative effusion were assessed. Results: A total of 79 patients were definitively diagnosed with an exudative effusion and were included in the trial and analyzed. The mean PC level in the exudates was 90.39 mg/dL. The PC levels demonstrated a sensitivity of 97.22%, a specificity of 85.71%, a positive predictive value of 98.59% and a negative predictive value of 75%. The PC/SC ratio demonstrated a sensitivity of 81.48%, a specificity of 57.14%, a positive predictive value of 93.61% and a negative predictive value of 28.57%. Conclusion: The pleural cholesterol dosage level and the pleural/serum cholesterol ratio can be utilized as unique biomarkers to identify an exudative effusion and replace Light’s criteria.

Rufino, Rogerio; Marques, Bruna L.; Azambuja, Renato de Lima; Mafort, Thiago; Pugliese, Jose G.; da Costa, Claudia Henrique

2014-01-01

312

A modified COMS plaque for iris melanoma  

PubMed Central

Melanoma of the iris is a rare condition compared to posterior ocular tumors and in this case report we present a 51-year-old female patient with diffuse iris melanoma. Traditional COMS (Collaborative Ocular Melanoma Study) plaques are used at our institution for radiation therapy, so a novel modification of the traditional plaque was required to allow better conformance with placement on the cornea. The usual silastic insert was machined to dimensions in compliance with the cornea, placed without incident, and treatment delivered with excellent patient tolerance of the modified plaque.

Vasudev, Deepta; Rice, Roger K.; Goldbaum, Michael; Mundt, Arno J.

2011-01-01

313

Giant, completely calcified lumbar juxtafacet cyst: report of an unusual case.  

PubMed

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

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

2014-08-01

314

A rare case of a calcified glomus tumour in the thigh of an adolescent.  

PubMed

Glomus tumours are clinically defined by a triad of symptoms, i.e. paroxysmal pain, pinpoint tenderness and hypersensitivity to cold. These tumours typically affect the upper limbs, are small in size, superficially located and mostly found in adults. During a radiologic assessment of an idiopathic scoliosis in a 13-year-old girl, we found a calcified mass lesion in the soft tissue of the proximal thigh. The child was asymptomatic. Complementary exams permitted the definition of an interfascial calcified tumour with a long axis of 50 mm, with an inferior polar soft-tissue component. After excision, the anatomical pathology analysis confirmed the diagnosis of calcified glomus tumour. This clinical and radiologic presentation is particularly uncommon for a glomus tumour, which enriches the range of differential diagnoses of calcified masses in soft tissue. PMID:23417232

Dabadie, Alexia; Fernandez, Carla; Gorincour, Guillaume; Panuel, Michel; Petit, Philippe

2013-08-01

315

Evaluation of calcified carotid artery atheromas detected by panoramic radiograph among 80-year-olds  

Microsoft Academic Search

ObjectiveTo evaluate the incidence among 80-year-olds of calcified carotid artery atheromas (CCAAs) as detected on panoramic radiographs. The relationship between CCAAs and general and oral health was also evaluated.

Takeshi Ohba; Yutaka Takata; Toshihiro Ansai; Yasuhiro Morimoto; Tatsurou Tanaka; Shinji Kito; Shuji Awano; Sumio Akifusa; Tadamichi Takehara

2003-01-01

316

Malignant pleural mesothelioma: outcome of limited surgical management.  

PubMed

This study presents data on limited surgical management of malignant pleural mesothelioma. We reviewed retrospectively 70 cases of the disease managed surgically over a 10 year period. Fifteen patients received only diagnostic direct pleural biopsy, 40 had video-assisted thoracoscopic, pleural biopsy and talc pleurodesis while 15 patients underwent thoracotomy and pleurectomy for disease confined to the pleura. There were two in-hospital deaths. Actuarial survival was significantly longer in the thoracotomy group (median 14 months vs. 6 months in the other two groups, P < 0.03). Survival after limited surgical management of malignant mesothelioma is comparable to a previously reported more radical surgical approach. PMID:17669981

Phillips, Peter G; Asimakopoulos, George; Maiwand, M Omar

2003-03-01

317

Diagnosis and management of patients with pleural effusions.  

PubMed

Pleural effusions occur when fluid accumulates between the visceral and parietal pleura in the chest cavity, preventing the lung from expanding fully during inspiration. The reduction in lung volume, depression of the diaphragm and reduced chest wall compliance cause dyspnoea, and occasionally pain or cough. Pleural effusion is a complex problem caused by a variety of conditions requiring different treatment depending on the underlying diagnosis. This article discusses the causes and treatment of pleural effusions, referencing guidelines produced by the British Thoracic Society. PMID:24916260

Myatt, Rebecca

2014-06-11

318

Infective endocarditis superimposed on a massively calcified severely stenotic congenitally bicuspid aortic valve  

PubMed Central

We describe a 55-year-old man who presented with a stroke resulting from active infective endocarditis (IE) involving a heavily calcified bicuspid aortic valve. The case highlights the infrequency of IE involving a heavily calcified valve, the inability of the infection to penetrate the calcific deposits, and the ability of the infection to spread to the adjacent soft tissues, leading to ring abscess and its multiple complications.

Schussler, Jeffrey M.; Ko, Jong M.; Roberts, William C.

2014-01-01

319

Medium-energy shock wave therapy in the treatment of rotator cuff calcifying tendinitis  

Microsoft Academic Search

To evaluate the results of the treatment with medium-energy extracorporeal shock wave therapy (ESWT) in rotator cuff calcifying tendinitis. Fifty-four non-consecutive patients, who were referred to our institute for rotator cuff calcifying tendinitis, were managed with a standardized protocol in four sessions of medium-energy (0.11 mJ\\/mm2) ESWT administered with an electromagnetic lithotriptor. Pain was evaluated at the end of each session,

Biagio Moretti; Raffaele Garofalo; Stefania Genco; Vittorio Patella; Elyazid Mouhsine

2005-01-01

320

Extracorporeal shock wave therapy for chronic calcifying tendinitis of the shoulder  

Microsoft Academic Search

Over the past few years, extracorporeal shock wave therapy (ESWT) has been introduced for the treatment of some orthopedic\\u000a diseases. The aim of this study was to assess the efficacy of ESWT on chronic calcifying tendinitis of the shoulder through\\u000a a prospective study. We studied 30 patients (mean age, 56.6 years) with chronic calcifying tendinitis of the shoulder. The\\u000a patients

R. Padua; R. Bondě; E. Ceccarelli; S. Ripanti; L. Bondě; A. Campi

2002-01-01

321

Compensatory response of the unicellular-calcifying alga Emiliania huxleyi (Coccolithophoridales, Haptophyta) to ocean acidification  

Microsoft Academic Search

Ocean acidification damages calcareous organisms, such as calcifying algae, foraminifera, corals, and shells. In this study,\\u000a we made a device equipped with a Clark-type oxygen electrode and a pH-stat to examine how the most abundant calcifying phytoplankton,\\u000a the coccolithophorid Emiliania huxleyi, responded to acidification and alkalization of the seawater medium. When E. huxleyi was incubated at pH 8.2, close to

Shin-ya Fukuda; Iwane Suzuki; Takeo Hama; Yoshihiro Shiraiwa

2011-01-01

322

Atherosclerotic Plaque Component Segmentation in Combined Carotid MRI and CTA Data Incorporating Class Label Uncertainty  

PubMed Central

Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with CT for calcification. This registration does, however, not provide accurate voxelwise correspondence. We therefore evaluate three approaches that incorporate uncertainty in the ground truth used for training: I) soft labels are created by Gaussian blurring of the original binary histology segmentations to reduce weights at the boundaries between components, and are weighted by the estimated registration accuracy of the histology and in vivo imaging data (measured by overlap), II) samples are weighted by the local contour distance of the lumen and outer wall between histology and in vivo data, and III) 10% of each class is rejected by Gaussian outlier rejection. Classification was evaluated on the relative volumes (% of tissue type in the vessel wall) for calcified, fibrous and lipid-rich necrotic tissue, using linear discriminant (LDC) and support vector machine (SVM) classification. In addition, the combination of MRI and CTA data was compared to using only one imaging modality. Best results were obtained by LDC and outlier rejection: the volume error per vessel was 0.91.0% for calcification, 12.77.6% for fibrous and 12.18.1% for necrotic tissue, with Spearman rank correlation coefficients of 0.91 (calcification), 0.80 (fibrous) and 0.81 (necrotic). While segmentation using only MRI features yielded low accuracy for calcification, and segmentation using only CTA features yielded low accuracy for necrotic tissue, the combination of features from MRI and CTA gave good results for all studied components.

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

2014-01-01

323

Atherosclerotic Plaque Component Segmentation in Combined Carotid MRI and CTA Data Incorporating Class Label Uncertainty.  

PubMed

Atherosclerotic plaque composition can indicate plaque vulnerability. We segment atherosclerotic plaque components from the carotid artery on a combination of in vivo MRI and CT-angiography (CTA) data using supervised voxelwise classification. In contrast to previous studies the ground truth for training is directly obtained from 3D registration with histology for fibrous and lipid-rich necrotic tissue, and with [Formula: see text]CT for calcification. This registration does, however, not provide accurate voxelwise correspondence. We therefore evaluate three approaches that incorporate uncertainty in the ground truth used for training: I) soft labels are created by Gaussian blurring of the original binary histology segmentations to reduce weights at the boundaries between components, and are weighted by the estimated registration accuracy of the histology and in vivo imaging data (measured by overlap), II) samples are weighted by the local contour distance of the lumen and outer wall between histology and in vivo data, and III) 10% of each class is rejected by Gaussian outlier rejection. Classification was evaluated on the relative volumes (% of tissue type in the vessel wall) for calcified, fibrous and lipid-rich necrotic tissue, using linear discriminant (LDC) and support vector machine (SVM) classification. In addition, the combination of MRI and CTA data was compared to using only one imaging modality. Best results were obtained by LDC and outlier rejection: the volume error per vessel was 0.9[Formula: see text]1.0% for calcification, 12.7[Formula: see text]7.6% for fibrous and 12.1[Formula: see text]8.1% for necrotic tissue, with Spearman rank correlation coefficients of 0.91 (calcification), 0.80 (fibrous) and 0.81 (necrotic). While segmentation using only MRI features yielded low accuracy for calcification, and segmentation using only CTA features yielded low accuracy for necrotic tissue, the combination of features from MRI and CTA gave good results for all studied components. PMID:24762678

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

2014-01-01

324

[Pleural lipoma: report of a case].  

PubMed

Although lipomas are the most common form of the benign neoplasm, occurrence within the thoracic cage is uncommon, and lipomas originating from the pleura are very rare. We report an unusual case of a 63-year-old male whose serial chest X-ray demonstrated an abnormal shadow of which size was increasing. A chest wall tumor was suspected based on the findings of computed tomography (CT) of the thorax. The tumor was resected by video-assisted thoracoscopic surgery and the patient remains well with no recurrence 4 years postoperatively. The resected tumor was a yellowish pleural mass and the pathological diagnosis was a benign lipoma. It is possible to make a diagnosis of lipoma preoperatively by CT and magnetic resonance imaging (MRI), however, the correct differential diagnosis of lipoma and liposarcoma is imperfect only by radiological findings necessitating surgical removal if possible. However, in view of the imperfect differentiation between lipoma and liposarcoma, surgical treatment should be considered. PMID:16359024

Hayakawa, Masanobu

2005-12-01

325

Retinal arterial wall plaques in Susac syndrome  

Microsoft Academic Search

PurposeTo demonstrate retinal arterial wall plaques (RAWPs) in patients with Susac syndrome, a disorder that consists of the triad of branch retinal artery occlusion, encephalopathy, and hearing loss. The clinician may misinterpret these RAWPs as emboli.

Robert A Egan; Thuy Ha Nguyen; J. Donald M Gass; Joseph F Rizzo III; John Tivnan; John O Susac

2003-01-01

326

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

2011-01-01

327

Historical Plaque at Marshall Space Flight Center  

NASA Technical Reports Server (NTRS)

This plaque, located on the grounds of Marshall Space Flight Center in Huntsville, Alabama,commemorates the designation of the Saturn V Rocket as a National Historic Mechanical Engineering Landmark by the American Society of Mechanical Engineers in 1980.

2000-01-01

328

Historical Plaque at Marshall Space Flight Center  

NASA Technical Reports Server (NTRS)

This plaque, displayed on the grounds of Marshall Space Flight Center in Huntsville, Alabama, commemorates the Redstone Test Stand as an Alabama Historic Civil Engineering Landmark. The site was desinated as such in 1979.

2002-01-01

329

Tissue characterisation of atherosclerotic carotid plaques by MRI  

Microsoft Academic Search

Carotid artery plaques with intraplaque haemorrhage or atheromatous debris have been found to be associated with an increased risk of embolic stroke. Other methods have failed to detect plaque morphology, and it is not clear whether MRI allows differentiation between prognostically and therapeutically relevant plaque types. We examined 17 carotid bifurcation plaques which had been removed in toto by MRI.

M. Giirtler; A. Goldmann; W. Mohr; B. Widder

1995-01-01

330

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

SciTech Connect

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

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

1989-04-01

331

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

2011-01-01

332

Collagenases and cracks in the plaque  

PubMed Central

The core of an atheromatous plaque contains lipids, macrophages, and cellular debris, typically covered by a fibrous cap that separates the thrombogenic core from the blood. Rupture of the fibrous cap causes most fatal myocardial infarctions. Interstitial collagen confers tensile strength on the cap, as it does in skin and tendons. In 1994, Peter Libby and colleagues demonstrated overexpression of collagenolytic enzymes in atheromatous plaques and implicated MMPs in the destabilization of these lesions.

Libby, Peter

2013-01-01

333

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

2013-01-01

334

Studies of the Rickettsial Plaque Assay Technique  

PubMed Central

A plaque assay system for pathogenic rickettsiae, which utilizes primary chick embryo tissue cultures, is described. It proved to be a highly reproducible measure of infectiousness for Rickettsia rickettsi and R. typhi, which were employed in most studies; as well as for R. canada, R. prowazeki, R. sibirica, R. akari, R. conori, and Coxiella burneti. Plaque-forming units (PFU) were compared to direct rickettsial counts and to 50% infectious dose (ID50) values for embryonated eggs, mice, and guinea pigs. Plaque size, appearance, and number were influenced by diluent, incubation temperature after nutrient overlay, centrifugation of inoculated tissue cultures, and number of host cells planted initially in each flask. The most critical factors in plaque formation were diluent used in making rickettsial suspensions and incubation temperature (32 C) after nutrient overlay. Brain Heart Infusion was the only diluent capable of preventing significant delay in plaque formation and decreases in PFU and mouse ID50. Plaque formation was unaffected by genetic background of host cells, volume of inoculum, temperature and length of incubation period before nutrient overlay, and rapid freezing and thawing of rickettsial seed. Centrifugation of inoculated cultures at 600 × g resulted in 100% irreversible absorption of rickettsiae to host cells within 5 min, whereas without centrifugation at least 4 hr was required to achieve the same effect. Images

Wike, David A.; Tallent, George; Peacock, Marius G.; Ormsbee, Richard A.

1972-01-01

335

Studies of the rickettsial plaque assay technique.  

PubMed

A plaque assay system for pathogenic rickettsiae, which utilizes primary chick embryo tissue cultures, is described. It proved to be a highly reproducible measure of infectiousness for Rickettsia rickettsi and R. typhi, which were employed in most studies; as well as for R. canada, R. prowazeki, R. sibirica, R. akari, R. conori, and Coxiella burneti. Plaque-forming units (PFU) were compared to direct rickettsial counts and to 50% infectious dose (ID(50)) values for embryonated eggs, mice, and guinea pigs. Plaque size, appearance, and number were influenced by diluent, incubation temperature after nutrient overlay, centrifugation of inoculated tissue cultures, and number of host cells planted initially in each flask. The most critical factors in plaque formation were diluent used in making rickettsial suspensions and incubation temperature (32 C) after nutrient overlay. Brain Heart Infusion was the only diluent capable of preventing significant delay in plaque formation and decreases in PFU and mouse ID(50). Plaque formation was unaffected by genetic background of host cells, volume of inoculum, temperature and length of incubation period before nutrient overlay, and rapid freezing and thawing of rickettsial seed. Centrifugation of inoculated cultures at 600 x g resulted in 100% irreversible absorption of rickettsiae to host cells within 5 min, whereas without centrifugation at least 4 hr was required to achieve the same effect. PMID:4629250

Wike, D A; Tallent, G; Peacock, M G; Ormsbee, R A

1972-05-01

336

The role of calcifying nanoparticles in biology and medicine.  

PubMed

Calcifying nanoparticles (CNPs) (nanobacteria, nanobacteria-like particles, nanobes) were discovered over 25 years ago; nevertheless, their nature is still obscure. To date, nobody has been successful in credibly determining whether they are the smallest self-replicating life form on Earth, or whether they represent mineralo-protein complexes without any relation to living organisms. Proponents of both theories have a number of arguments in favor of the validity of their hypotheses. However, after epistemological analysis carried out in this review, all arguments used by proponents of the theory about the physicochemical model of CNP formation may be refuted on the basis of the performed investigations, and therefore published data suggest a biological nature of CNPs. The only obstacle to establish CNPs as living organisms is the absence of a fairly accurately sequenced genome at the present time. Moreover, it is clear that CNPs play an important role in etiopathogenesis of many diseases, and this association is independent from their nature. Consequently, emergence of CNPs in an organism is a pathological, not a physiological, process. The classification and new directions of further investigations devoted to the role of CNPs in biology and medicine are proposed. PMID:22287843

Kutikhin, Anton G; Brusina, Elena B; Yuzhalin, Arseniy E

2012-01-01

337

Association between dental pulp stones and calcifying nanoparticles  

PubMed Central

The etiology of dental pulp stones, one type of extraskeletal calcification disease, remains elusive to date. Calcifying nanoparticles (CNPs), formerly referred to as nanobacteria, were reported to be one etiological factor in a number of extraskeletal calcification diseases. We hypothesized that CNPs are involved in the calcification of the dental pulp tissue, and therefore investigated the link between CNPs and dental pulp stones. Sixty-five freshly collected dental pulp stones, each from a different patient, were analyzed. Thirteen of the pulp stones were examined for the existence of CNPs in situ by immunohistochemical staining (IHS), indirect immunofluorescence staining (IIFS), and transmission electron microscope (TEM). The remaining 52 pulp stones were used for isolation and cultivation of CNPs; the cultured CNPs were identified and confirmed via their shape and growth characteristics. Among the dental pulp stones examined in situ, 84.6% of the tissue samples staines positive for CNPs antigen by IHS; the corresponding rate by IIFS was 92.3 %. In 88.2% of the cultured samples, CNPs were isolated and cultivated successfully. The CNPs were visible under TEM as 200–400 nm diameter spherical particles surrounded by a compact crust. CNPs could be detected and isolated from a high percentage of dental pulp stones, suggesting that CNPs might play an important role in the calcification of dental pulp.

Zeng, Jinfeng; Yang, Fang; Zhang, Wei; Gong, Qimei; Du, Yu; Ling, Junqi

2011-01-01

338

Association between dental pulp stones and calcifying nanoparticles.  

PubMed

The etiology of dental pulp stones, one type of extraskeletal calcification disease, remains elusive to date. Calcifying nanoparticles (CNPs), formerly referred to as nanobacteria, were reported to be one etiological factor in a number of extraskeletal calcification diseases. We hypothesized that CNPs are involved in the calcification of the dental pulp tissue, and therefore investigated the link between CNPs and dental pulp stones. Sixty-five freshly collected dental pulp stones, each from a different patient, were analyzed. Thirteen of the pulp stones were examined for the existence of CNPs in situ by immunohistochemical staining (IHS), indirect immunofluorescence staining (IIFS), and transmission electron microscope (TEM). The remaining 52 pulp stones were used for isolation and cultivation of CNPs; the cultured CNPs were identified and confirmed via their shape and growth characteristics. Among the dental pulp stones examined in situ, 84.6% of the tissue samples staines positive for CNPs antigen by IHS; the corresponding rate by IIFS was 92.3 %. In 88.2% of the cultured samples, CNPs were isolated and cultivated successfully. The CNPs were visible under TEM as 200-400 nm diameter spherical particles surrounded by a compact crust. CNPs could be detected and isolated from a high percentage of dental pulp stones, suggesting that CNPs might play an important role in the calcification of dental pulp. PMID:21289988

Zeng, Jinfeng; Yang, Fang; Zhang, Wei; Gong, Qimei; Du, Yu; Ling, Junqi

2011-01-01

339

Applications of ion beam analysis to calcified tissue research.  

PubMed

Various nondestructive ion beam analysis techniques have been developed and applied to study the concentrations of fluorine and other trace elements in calcified tissues.Fluorine has been determined by prompt gamma activation analysis through the F(?,??)O reaction. This method is quick, convenient, and sensitive, and can also be applied to measure fluorine depth distribution nondestructively in teeth and bone samples. By the application of this technique, fluorine concentrations have been determined in a number of teeth with known histories and bones of experimental animals. Moreover, F-depth-distributions to 10-?m depths have also been obtained in a number of selected human and animal teeth.Carbon was measured by activation analysis with He-3 ions, and the technique of Proton-Induced X-ray Emission (PIXE) has been developed to simultaneously determine Ca, P, and trace elements in well-documented teeth. Dental hard tissues, i.e., enamel, dentine, cementum, and their junctions, as well as different parts of the same tissue, have been examined separately. A number of elements, Na, Mg, Al, P, Cl, Ca, Cr, Mn, Fe, Ni, Cu, Zn, Sr, Br, Rb and Pb, have been determined in these dental tissues. The concentrations of some of these elements vary considerably in different teeth and in various parts of the same tooth.The special advantages of these nuclear techniques for studying metabolic bone diseases, renal diseases, and the effect of Pb on childrens' intelligence are discussed. PMID:24254597

Chaudhri, M A

1987-04-01

340

Bioconvection in Cultures of the Calcifying Unicellular Alga Pleurochrysis Carterae  

NASA Technical Reports Server (NTRS)

The unicellular, marine, calcifying alga P leurochiysis carterae--a model to study cell morphogenesis, cell polarity, calcification, gravitaxis, reproduction and development-- has extremely flexible culture requirements. Support studies for a flight experiment addressing cell motility suggested that cell density (cells/ml) affects cell movement in P. carterae cultures through the gradual establishment of bioconvection as the culture grows. To assess the effect of cell density on direction of the movement, without the effects of aging of the culture, swimming behavior was analyzed in aliquots from a series of dilutions obtained from a stock culture. Results showed that at low concentrations cells swim randomly. As the concentration increases, upswimming patterns overtake random swimming. Gradually, up and down movement patterns prevail, representative of bioconvection. This oriented swimming of P. carterae occurs in a wide range of concentrations, adding to the list of flexible requirements, in this case, cell concentration, to be used for spaceflight studies addressing cell motility and bioconvection in a unicellular model of biologically directed mineralization.

Montufar-Solis, Dina; Duke, P. Jackie; Marsh, Mary E.

2003-01-01

341

Molecular mechanisms and therapeutic strategies of vulnerable atherosclerotic plaques  

Microsoft Academic Search

Vulnerable atherosclerotic plaque rupture leading to thrombosis is the major cause of acute coronary syndrome (ACS). Studies\\u000a on the pathophysiologic mechanism of both ACS and plaque stabilizing treatment are driving the development of animal models\\u000a of vulnerable plaque. In our laboratory, we established animal models of plaque rupture and thrombosis in rabbits and mice\\u000a that are similar to human plaque

Wen-Qiang Chen; Yun Zhang

2010-01-01

342

Minimally Invasive Surgical Treatment of Malignant Pleural Effusions  

PubMed Central

ABSTRACT Introduction: Usually the pleural cavity contains a small amount of liquid (approximately 10 ml). Pleural effusions appear when the liquid production rate overpasses the absorption rate with a greater amount of liquid inside the pleural cavity. Material and method: Between January 1998 to December 2008 we conducted a study in order to establish the adequate surgical treatment for MPEs. Effective control of a recurrent malignant pleural effusion can greatly improve the quality of life of the cancer patient. The present review collects and examines the clinical results of minimally invasive techniques designed to treat this problem. Results and discussion: Patients with MPEs were studied according to several criteria. In our study we observed the superiority of intraoperative talc poudrage, probably due to a more uniform distribution of talc particles over the pleural surface. Minimal pleurotomy with thoracic drainage and instillation of a talc suspension is also a safe and effective technique and should be employed when there are contraindications for the thoracoscopic minimally invasive procedure. Conclusions: On the basis of comparisons involving effectiveness, morbidity, and convenience, we recommend the thoracoscopic insufflations of talc as a fine powder with pleural drainage as the procedure of choice.

CIUCHE, Adrian; NISTOR, Claudiu; PANTILE, Daniel; Prof. HORVAT, Teodor

2011-01-01

343

Disposition of phosphomycin in patients with pleural effusion.  

PubMed Central

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

Lastra, C F; Marino, E L; Barrueco, M; Gervos, M S; Gil, A D

1984-01-01

344

Relationship between occupations and asbestosfibre content of the lungs in patients with pleural mesothelioma, lung cancer, and other diseases  

PubMed Central

Whitwell, F., Scott, Jean, and Grimshaw, Myra (1977).Thorax, 32, 377-386. Relationship between occupations and asbestos-fibre content of the lungs in patients with pleural mesothelioma, lung cancer, and other diseases. The light-visible asbestos-fibre content of 300 lung specimens has been measured using a potash-digestion and phase-contrast microscopy technique, and the results have been correlated with the occupations of the patients. Among 100 pleural mesothelioma specimens were 88 where the patients had been exposed to asbestos, and in 73 of these (83%) the lung tissue contained over 100 000 asbestos fibres per gram of dried lung, and only one specimen showed less than 20 000 fibres per gram. When asbestosis was present, the lungs nearly always showed over 3 million fibres per gram. In 100 control lungs (those without industrial disease or lung cancer) there were less than 20 000 fibres per gram of dried lung in 71% of specimens. Lungs from 100 patients with lung cancer but no industrial disease contained less than 20 000 fibres per gram of dried lung in 80% of cases. Patients with parietal pleural plaques nearly all had over 20 000 fibres per gram in their lungs. The number of asbestos fibres found in the lungs was closely related to the occupations of the patients but not to their home environment. Patients who had lived near likely sources of atmospheric asbestos pollution did not have higher asbestos fibre counts than the rest of the patients. It is concluded that there is a definite dose relationship between asbestos exposure and mesothelioma formation but that' `sub-asbestosis' levels of asbestos exposure do not contribute to the formation of lung cancer in those not subjected to industrial asbestos exposure. Images

Whitwell, F.; Scott, Jean; Grimshaw, Myra

1977-01-01

345

Stone Morphology Suggestive of Randall's Plaque  

NASA Astrophysics Data System (ADS)

Randall's plaques are found in a number of calcium oxalate stone formers. Stones developed on a Randall's plaque typically present a small depressed zone (``umbilication'') corresponding to the tip of the papilla and containing material detached from the plaque. By examining the morphology and infrared composition of 45,774 calculi referred to our laboratory over the past three decades, we identified 8,916 umbilicated calculi (19.5%). We have selected three periods of time corresponding to the first years of each decade. Over these periods, we analyzed 26,182 consecutive calculi. Among them, we identified 5,401 umbilicated calculi, of which 91.5% had an identifiable plaque. We analyzed the relative prevalence of umbilicated stones over time and the respective composition of Randall's plaque and stones. The proportion of umbilicated stones rose significantly from 10% in period 1 (1978-1984) to 21% in period 2 (1990-1993) and 22.2% in period 3 (2000-2006), with a parallel rise in the prevalence of stones with identifiable Randall's plaque. The main component of plaques was carbapatite in 90.8% of cases, whereas other components such as amorphous carbonated calcium phosphate, sodium hydrogen urate or uric acid were found in other cases. The morphology of plaques made of carbapatite was diverse, as was their carbonate content, thus suggesting variable pathophysiological mechanisms. Stones were made of whewellite as the main component in 51.4% of cases, or admixed with weddellite in 26.8%, predominant weddellite in 12.5% and other components (mainly uric acid) in 7.5% of cases. Our findings confirm that Randall's plaques are made of carbapatite in the great majority of cases, but with the stones more frequently composed of calcium oxalate monohydrate (which is associated with hyperoxaluria) than of calcium oxalate dihydrate (associated with hypercalciuria). In conclusion, in our country, stones developed on a carbapatite Randall's plaque are as frequently made of monohydrate than dihydrate calcium oxalate, thus suggesting a role for a high urine concentration in both oxalate and calcium ions in the lithogenic process.

Daudon, Michel; Traxer, Olivier; Jungers, Paul; Bazin, Dominique

2007-04-01

346

Current Concepts and Occurrence of Epithelial Odontogenic Tumors: II. Calcifying Epithelial Odontogenic Tumor Versus Ghost Cell Odontogenic Tumors Derived from Calcifying Odontogenic Cyst  

PubMed Central

Calcifying epithelial odontogenic tumors (CEOTs) and ghost cell odontogenic tumors (GCOTs) are characteristic odontogenic origin epithelial tumors which produce calcifying materials from transformed epithelial tumor cells. CEOT is a benign odontogenic tumor composed of polygonal epithelial tumor cells that show retrogressive calcific changes, amyloid-like deposition, and clear cytoplasm. Differentially, GCOTs are a group of transient tumors characterized by ghost cell presence, which comprise calcifying cystic odontogenic tumor (CCOT), dentinogenic ghost cell tumor (DGCT), and ghost cell odontogenic carcinoma (GCOC), all derived from calcifying odontogenic cysts (COCs). There is considerable confusion about COCs and GCOTs terminology, but these lesions can be classified as COCs or GCOTs, based on their cystic or tumorous natures, respectively. GCOTs include ameloblastomatous tumors derived from dominant odontogenic cysts classified as CCOTs, ghost cell-rich tumors producing dentinoid materials as DGCTs, and the GCOT malignant counterpart, GCOCs. Many authors have reported CEOTs and GCOTs variably express keratins, ?-catenin, BCL-2, BSP, RANKL, OPG, Notch1, Jagged1, TGF-?, SMADs, and other proteins. However, these heterogeneous lesions should be differentially diagnosed to allow for accurate tumor progression and prognosis prediction.

Kim, Yeon Sook

2014-01-01

347

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

2008-01-01

348

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

PubMed Central

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

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

2013-01-01

349

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.

2009-01-01

350

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

1996-01-01

351

A plaque-specific antibody clears existing ?-amyloid plaques in Alzheimer's disease mice.  

PubMed

A? Immunotherapy is a promising therapeutic approach for Alzheimer's disease. Preclinical studies demonstrate that plaque prevention is possible; however, the more relevant therapeutic removal of existing plaque has proven elusive. Monoclonal antibodies in development target both soluble and insoluble A? peptide. We hypothesized that antibody specificity for deposited plaque was critical for plaque removal since soluble A? peptide would block recognition of deposited forms. We developed a plaque-specific antibody that targets a modified A? peptide (A?(p3-42)), which showed robust clearance of pre-existing plaque without causing microhemorrhage. Interestingly, a comparator N-terminal A? antibody 3D6, which binds both soluble and insoluble A?(1-42), lacked efficacy for lowering existing plaque but manifested a significant microhemorrhage liability. Mechanistic studies suggested that the lack of efficacy for 3D6 was attributed to poor target engagement in plaques. These studies have profound implications for the development of therapeutic A? antibodies for Alzheimer's disease. PMID:23217740

Demattos, Ronald B; Lu, Jirong; Tang, Ying; Racke, Margaret M; Delong, Cindy A; Tzaferis, John A; Hole, Justin T; Forster, Beth M; McDonnell, Peter C; Liu, Feng; Kinley, Robert D; Jordan, William H; Hutton, Michael L

2012-12-01

352

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.

2008-01-01

353

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.

2011-02-01

354

Assessment of vulnerable plaque composition by matching the deformation of a parametric plaque model to measured plaque deformation.  

PubMed

Intravascular ultrasound (IVUS) elastography visualizes local radial strain of arteries in so-called elastograms to detect rupture-prone plaques. However, due to the unknown arterial stress distribution these elastograms cannot be directly interpreted as a morphology and material composition image. To overcome this limitation we have developed a method that reconstructs a Young's modulus image from an elastogram. This method is especially suited for thin-cap fibroatheromas (TCFAs), i.e., plaques with a media region containing a lipid pool covered by a cap. Reconstruction is done by a minimization algorithm that matches the strain image output, calculated with a parametric finite element model (PFEM) representation of a TCFA, to an elastogram by iteratively updating the PFEM geometry and material parameters. These geometry parameters delineate the TCFA media, lipid pool and cap regions by circles. The material parameter for each region is a Young's modulus, EM, EL, and EC, respectively. The method was successfully tested on computer-simulated TCFAs (n = 2), one defined by circles, the other by tracing TCFA histology, and additionally on a physical phantom (n = 1) having a stiff wall (measured EM = 16.8 kPa) with an eccentric soft region (measured EL = 4.2 kPa). Finally, it was applied on human coronary plaques in vitro (n = 1) and in vivo (n = 1). The corresponding simulated and measured elastograms of these plaques showed radial strain values from 0% up to 2% at a pressure differential of 20, 20, 1, 20, and 1 mmHg respectively. The used/reconstructed Young's moduli [kPa] were for the circular plaque EL = 50/66, EM = 1500/1484, EC = 2000/2047, for the traced plaque EL = 25/1, EM = 1000/1148, EC = 1500/1491, for the phantom EL = 4.2/4 kPa, EM = 16.8/16, for the in vitro plaque EL = n.a./29, EM = n.a./647, EC = n.a./1784 kPa and for the in vivo plaque EL = n.a./2, EM = n.a./188, Ec = n.a./188 kPa. PMID:15822809

Baldewsing, Radj A; Schaar, Johannes A; Mastik, Frits; Oomens, Cees W J; van der Steen, Antonius F W

2005-04-01

355

Semirigid thoracoscopy: an effective method for diagnosing pleural malignancies  

PubMed Central

Background Thoracoscopy with a semirigid instrument is a recent technique for diagnosing pleural diseases. The purpose of this study was to report diagnostic yield and complications of the method. Patients and methods. Patients with pleural effusion of unknown origin and/or pleural irregularities suspicious for pleural malignancy were included after less invasive means of diagnosis had failed. All procedures were performed under local anaesthesia with intravenous sedation/analgesia with a single point of entry with a semirigid thoracoscope (Olympus LTF-160). Data were collected prospectively between 2008 and 2012. Results One hundred fifteen thoracoscopies were performed on 111 patients. The median age was 65 years (range 28–86 years), 14.4% were female and 85.6% male. Seventy-three (65.8%) patients had malignant pleural disease (malignant mesothelioma, metastatic cancer) and 38 (34.2%) had benign disease. The sensitivity, negative predictive value, and accuracy of the procedure for malignancy were 96.0%, 93.0%, and 97.4% respectively. Pleurodesis was carried out in 34 patients; in 32 (94.1%) it was assessed as successful after 1 month. There were 24 adverse events: three empyemas/pleural infections, three bronchopleural fistulae after chest tube placement and lung re-expansion, five patients had excessive pain after pleurodesis, six patients had sedation-associated hypotension, and seven patients had self-limited fever after plerodesis. One patient died 11 days after a procedure for advanced carcinoma. Conclusions Semirigid thoracoscopy is an accurate and safe method for evaluation of pleural diseases and useful for therapeutic talc pleurodesis.

Rozman, Ales; Camlek, Luka; Kern, Izidor; Malovrh, Mateja Marc

2014-01-01

356

[Treatment of malignant pleural effusion by pleurodesis with talc].  

PubMed

In some types of cancer (breast, lung) a malignant pleural effusion may be present during the evolution of the neoplastic disease in more than 50% of cases. The main therapeutic option for palliative purposes in these cases is chemical pleurodesis with talc. The aims of this study were to report on our experience with the use of pleurodesis with talc in the treatment of patients affected by malignant pleural effusions and to analyse the results in the short and mean term. Over the period from January 1998 to December 1999, 16 patients were included in the study. The causes of the pleural effusion were a pleural mesothelioma in 1 patient and pleural metastases in 15 patients (from lung and breast cancers in 62%). We treated 14 of these patients with talc poudrage and 2 patients with talc slurry. The talc was applied under video-assisted thorascopic management in 15 patients, while in 1 patient the talc was injected via the thoracic drainage tube. Two patients died within the first month as a result of progression of the neoplastic disease and one patient was withdrawn from the study owing to failure to collaborate. Of the other 13 patients, 11 (84%) had a total or partial response to the pleurodesis; in 9 of these patients (69.2%) the response remained stable until death, while in 2 patients the pleural effusion reappeared after 3 and 5 months, respectively. Failure of the pleurodesis occurred in 2/13 patients owing to reappearance of the pleural effusion within the first month. PMID:11190547

Filippetti, M; Crucitti, G; Vanni, B; Della Giulia, M; Foggi, P; Del Monte, G

2000-01-01

357

IL-33 levels differentiate tuberculous pleurisy from malignant pleural effusions  

PubMed Central

Tuberculous pleural effusions (TPEs) and malignant pleural effusions (MPEs) are difficult to differentiate between in certain clinical situations. Interleukin (IL)-33 is a cytokine that participates in inflammatory responses and may have a role in pleural effusions. The present study aimed to investigate the concentrations and potential differential significance of IL-33 in patients with TPE and MPE. IL-33 levels in pleural effusion and serum samples were detected using sandwich enzyme-linked immunosorbent assay in 23 patients with TPE and 21 patients with MPE. The concentration of IL-33 (mean ± standard deviation) in the TPE patients (22.962±0.976 ng/l) was significantly higher than that in the MPE patients (12.603±5.153 ng/l; P<0.001; z=?4.572); however, there was no significant difference in the serum level of IL-33 in the patients with TPE compared with those with MPE (P>0.05). The concentration of IL-33 in the pleural effusions was positively correlated with that in the serum samples in each group (TPE: r=0.563, P=0.05; MPE: r=0.535, P<0.05). The cut-off value of pleural IL-33 for TPE was 19.86 ng/l, which yielded a sensitivity of 0.869, a specificity of 0.905 and an area under the corresponding receiver operating characteristic curve of 0.903. The present study identified that the level of pleural IL-33 is significantly increased in TPEs and may serve as a novel biomarker to differentiate between patients with TPE and MPE.

XUAN, WEI-XIA; ZHANG, JIAN-CHU; ZHOU, QIONG; YANG, WEI-BING; MA, LI-JUN

2014-01-01

358

Histone Deacetylase Inhibitors in Malignant Pleural Mesothelioma  

PubMed Central

Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer of the mesothelium with only a limited range of treatment options that are largely ineffective in improving survival. Recent efforts have turned toward the analysis of specific, dysregulated biologic pathways for insight into new treatment targets. Epigenetic regulation of tumor suppressor genes through chromatin condensation and decondensation has emerged as an important mechanism that leads to tumorogenesis. A family of histone acetyltransferases and deacetylases regulates this balance, with the latter facilitating chromatin condensation, thus preventing gene transcription, resulting in the loss of heterozygosity of tumor suppressors. Inhibition of this process, coupled with a similar inhibition of nonhistone protein deacetylation, ultimately leads to the promotion of apoptosis, cell cycle arrest, and inhibition of angiogenesis. An increasing amount of preclinical data highlighting the effectiveness of histone deacetylase inhibition in MPM cell lines and mouse xenograft models has led to a number of early phase clinical trials in patients with MPM. The results of these efforts have led to a multicenter, randomized, placebo-controlled phase III study of the histone deacetylase inhibitor vorinostat in patients with advanced MPM, offering hope for a new and effective therapy in patients with this disease.

Paik, Paul K.; Krug, Lee M.

2014-01-01

359

Diffuse malignant pleural mesothelioma and asbestos exposure  

PubMed Central

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 metastases were much commoner than has usually been described. Histological findings agreed with previous accounts of the tumour, except that, in our hands, special acid mucopolysaccharide staining was less reliable than Southgate's mucicarmine, which was of value in differential diagnosis. Association with asbestos was confirmed from industrial histories in 80% of cases, the commonest industries involved being shipbuilding and repairing in men and sackware repairing in women. Lungs of industrial mesothelioma cases showed basal asbestosis in 17% and excessive asbestos bodies in almost all the rest. Quantitative comparison of asbestos bodies in lung smears from mesothelioma cases compared with lung smears from other Merseyside adults showed much higher counts in the mesothelioma cases. The interval from first exposure to asbestos until appearance of mesothelioma ranged between 13 and 63 years, with a mean of 42 years. We think the incidence of mesothelioma will continue to rise with the increased use of asbestos until about 40 years after adequate protective measures have been taken. Images

Whitwell, F.; Rawcliffe, Rachel M.

1971-01-01

360

Articular calcified cartilage canals in the third metacarpal bone of 2-year-old thoroughbred racehorses  

PubMed Central

We describe morphological aspects of the articular calcified cartilage mineralizing front ‘tidemark’ in the distal joint surface of the third metacarpal bone from 14 horses. Compositional backscattered electron scanning electron microscopy and confocal scanning light microscopy were conducted on polymethylmethacrylate (PMMA)-embedded medio-lateral slices. After maceration, scanning electron microscopy (SEM) was used to study the calcified cartilage surface in the ‘wedges’ intervening between the slices. An anatomically reproducible clustering of canals in the calcified cartilage was found at one site on the sagittal ridge in all the horses. The site is one that is relatively less loaded during joint function. These canals through calcified cartilage result from osteoclastic resorption (cutting cones) penetrating from bone through to the non-mineralized hyaline articular cartilage. Their presence may indicate a pathway for connection between bone and cartilage extracellular fluid. In one horse, repair of such canals by plugging with new calcified cartilage was demonstrated. Differences in the degree of mineralization of regions of cartilage were seen in the combined compositional-cum-topographical backscattered SEM images of the macerated ‘tidemark’ front. More-or-less circular patches of lower mineralization density were frequently centred on (and may possibly originate from) canals. These microanatomical features should be searched for in other joints, at other ages and in other species to discover their frequency and significance.

Boyde, A; Firth, E C

2004-01-01

361

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

NASA Technical Reports Server (NTRS)

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.

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

1993-01-01

362

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

PubMed

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

1993-01-01

363

Infliximab for the treatment of plaque psoriasis  

PubMed Central

Infliximab is a monoclonal antibody that targets tumor necrosis factor-? (TNF?). It is used in the treatment of a number of inflammatory disorders including severe plaque psoriasis. TNF? is thought to have a major role in psoriasis by promoting an inflammatory infiltrate into the skin and inducing keratinocyte proliferation and preventing keratinocyte apoptosis, which directly contributes to the characteristic plaque skin lesions. Based on four randomized, placebo-controlled, double-blind clinical trials and nine open-label uncontrolled trials of the use of infliximab in plaque psoriasis, it was found that infliximab is a highly efficacious, rapid, sustainable, and relatively safe therapy. Yet as with any biologic, caution is recommended in its use as infusion reactions, lupus-like syndromes, infections, malignancies including lymphomas, as well as other rare events have been reported.

Gall, Jennifer S; Kalb, Robert E

2008-01-01

364

Visualizing the atherosclerotic plaque: a chemical perspective.  

PubMed

Atherosclerosis is the major underlying pathologic cause of coronary artery disease. An early detection of the disease can prevent clinical sequellae such as angina, myocardial infarction, and stroke. The different imaging techniques employed to visualize the atherosclerotic plaque provide information of diagnostic and prognostic value. Furthermore, the use of contrast agents helps to improve signal-to-noise ratio providing better images. For nuclear imaging techniques and optical imaging these agents are absolutely necessary. We report on the different contrast agents that have been used, are used or may be used in future in animals, humans, or excised tissues for the distinct imaging modalities for atherosclerotic plaque imaging. PMID:24526041

Teresa Albelda, Ma; Garcia-Espańa, Enrique; Frias, Juan C

2014-04-21

365

Dobesilate in the treatment of plaque psoriasis.  

PubMed

Fibroblast growth factor (FGF)-mediated pathways participate in many of the cellular events implicated in the pathogenesis of psoriasis. Thus, targeting FGF signals may be potentially therapeutic in the treatment of psoriasis. We report for the first time on a 43-year-old man with chronic-type plaque psoriasis with a daily topical treatment of dobesilate, a new FGF inhibitor. As early as at day 14, the patient had cleared or achieved excellent improvement of psoriatic skin lesions. Topical dobesilate offers the potential for treatment of plaque psoriasis without atrophy or other local side effects associated with the use of topical corticosteroids. PMID:16183548

Cuevas, Pedro; Arrazola, Jose M

2005-09-12

366

Percutaneous treatment of subarachnoid-pleural fistula with Onyx.  

PubMed

Subarachnoid-pleural fistula is a well-described complication after anterior surgery for thoracic disc herniation, but is difficult to treat by means of traditional chest and lumbar drains due to interference by positive ventilation pressures that may keep the fistula open and prevent proper closure. Current treatment strategies include surgical repair, which is technically challenging, and noninvasive positive pressure ventilation, which can take several weeks to be effective. In this report, the authors describe a novel treatment for subarachnoid-pleural fistula using percutaneous obliteration with Onyx. Surgery for removal of a T7-8 disc herniation associated with ossification of the posterior longitudinal ligament was performed in a 56-year-old woman via an anterior transthoracic transpleural approach. Ten days after surgery, she presented with diplopia due to a subarachnoid-pleural fistula that was confirmed by CT myelography. Percutaneous injection of Onyx was performed under local anesthesia. Postprocedure CT showed complete obliteration of the fistula with no adverse events. A CT scan obtained 1 month later showed complete resolution of the pleural effusion. Neurological examination at 3 months postsurgery was normal. Clinical and radiological follow-up at 1 year showed complete recovery and no sign of fistula recurrence. Percutaneous treatment for subarachnoid-pleural fistula is an easy, safe, and effective strategy and can therefore be proposed as a first-line option for this challenging complication. PMID:23432323

Knafo, Steven; Parker, Fabrice; Herbrecht, Anne; Court, Charles; Saliou, Guillaume

2013-04-01

367

Pulmonary epithelioid hemangioendothelioma accompanied by bilateral multiple calcified nodules in lung  

PubMed Central

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor. It can present either as one solitary nodule or bilateral multiple nodules, usually without calcification. We describe here an unusual case of PEH in a 42-year-old female with a 6.0 cm dominant mass along with bilateral multiple calcified small nodules measuring 0.2-1.0 cm in diameter with a 25-year plus followup history. Overall histologic findings of the solitary tumor accorded with conventional PEH. While multiple calcified small nodules were composed predominantly of intra-alveolar homogeneously eosinophilic matrix, and only a few bland small cells were embedded in it. This lesion has never been reported in the literature. After comprehensive analysis of morphology, radiography, histochemistry, immunohistochemistry and differential diagnoses, PEH presenting multiple calcified small nodules was confirmed.

2011-01-01

368

Assessment of vulnerable plaque composition by matching the deformation of a parametric plaque model to measured plaque deformation  

Microsoft Academic Search

Intravascular ultrasound (IVUS) elastography visualizes local radial strain of arteries in so-called elastograms to detect rupture-prone plaques. However, due to the unknown arterial stress distribution these elastograms cannot be directly interpreted as a morphology and material composition image. To overcome this limitation we have developed a method that reconstructs a Young's modulus image from an elastogram. This method is especially

Radj A. Baldewsing; Johannes A. Schaar; Frits Mastik; Cees. W. J. Oomens; Antonius F. W. van der Steen

2005-01-01

369

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.

2008-01-01

370

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

PubMed Central

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.

Singh, Urvinderpal; Garg, Nishi; Chopra, Vishal

2013-01-01

371

Use of Circular Foldable Nitinol Blades for Resecting Calcified Aortic Heart Valves  

Microsoft Academic Search

The use of percutaneous aortic valve implantation is limited, as the native calcified valve is left in situ. A new device\\u000a has been developed for resecting calcified aortic valves, using collapsible nickel-titanium blades: laser-cut T-structures\\u000a of Nitinol sheet-material (Ni51Ti49 at.%) have been grinded on a high-speed milling cutter to produce cutting edges which\\u000a have been given the shape of half-circles

Florian Hauck; Daniel Wendt; Sebastian Stühle; Emilia Kawa; Hermann Wendt; Wiebke Müller; Matthias Thielmann; Brigitte Kipfmüller; Bernd Vogel; Heinz Jakob

2009-01-01

372

[Non-parasitic calcified hepatic cyst. Report of a clinical case and review of the literature].  

PubMed

A case is presented of a 40 years old female, with an illness of three weeks duration, characterized by right upper quadrant fullness, pain and tenderness to palpation. Subsequently, her X ray studies showed a radiolucenly in the liver, with calcified solitary-hepatic cyst. A review is made of the pertinent literature, and it is stressed the diagnostic clues between a congenital and a parasitic hepatic cyst, in order to proceed to its proper therapy. Brief considerations of the present knowledge of the congenital calcified hepatic cyst and management are done. PMID:748914

Colinabarranco González, M; Galván Jiménez, G; Goméz Mansilla, M; Moreno Turbay, F

1978-01-01

373

A Calcified Taenia solium Granuloma Associated with Recurrent Perilesional Edema Causing Refractory Seizures: Histopathological Features  

PubMed Central

We describe the first detailed histological description of an excised calcified Taenia solium granuloma from a patient who developed recurrent seizures associated with perilesional edema surrounding a calcified cysticercus (PEC). The capsule, around a degenerated cysticercus, contained marked mononuclear infiltrates that extended to adjacent brain, which showed marked astrocytosis, microgliosis, and inflammatory perivascular infiltrates. The presence of large numbers of mononuclear cells supports an inflammatory cause of PEC. Immunosuppression or anti-inflammatory measures may be able to treat and prevent PEC and recurrent seizures.

Ooi, Winnie W.; Wijemanne, Subhashie; Thomas, Christine B.; Quezado, Martha; Brown, Charles R.; Nash, Theodore E.

2011-01-01

374

Calcifying Fibrous Tumor of the Small Intestine Associated with Castleman-like Lymphadenopathy.  

PubMed

Calcifying fibrous tumor is a rare mesenchymal tumor that most commonly presents in younger individuals. We report the case of a 25-year-old woman that presented with severe abdominal pain and a small bowel mass at the site of an ileocolic intussusception with associated mesenteric lymphadenopathy. Surgical resection was performed, and pathologic analysis revealed that the mass was a calcifying fibrous tumor associated with Castleman-like adenopathy. This case intends to support a possible association between these two entities. PMID:24452381

Valladolid, Genaro; Weisenberg, Elliot; Sundaresan, Ramamoorthy; Maker, Ajay V

2014-06-01

375

Explicit planktic calcifiers in the University of Victoria Earth System Climate Model  

NASA Astrophysics Data System (ADS)

Marine calcifiers as a plankton functional type (PFT) are a crucial part of the global carbon cycle, being responsible for much of the carbon export to the deep ocean entering via biological pathways. Deep ocean carbon export through calcifiers is controlled by physiological, ecological and biogeochemical factors. This paper describes the implementation of a phytoplankton coccolithophore PFT in the University of Victoria Earth System Climate Model (UVic ESCM), and improvements to the representation of zooplankton calcification and carbon export therein. The described modifications improve model performance with respect to carbon and nutrient fluxes. Primary production, export production, particulate organic carbon and calcite fluxes all fall within independent estimates.

Kvale, K. F.; Meissner, K. J.; Keller, D. P.; Eby, M.; Schmittner, A.

2014-03-01

376

Cephalometric calcified carotid artery atheromas in patients with obstructive sleep apnea  

Microsoft Academic Search

Background  In the progress of atherosclerosis, the carotid artery calcifies and sometimes appears as a calcified mass on a cephalometric\\u000a radiograph.\\u000a \\u000a \\u000a \\u000a \\u000a Purpose  This study was designed to evaluate the prevalence of calcification in cephalometric radiographs of OSA patients and to identify\\u000a the differences between subjects with and without carotid artery calcification.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 1,520 X-rays were evaluated. Data for group A,

Hiroko Tsuda; Fernanda R. Almeida; Toru Tsuda; Yasutaka Moritsuchi; Alan A. Lowe

2010-01-01

377

The "Hoover" (vacuum cleaner) technique for calcifying tendonitis deposits excision and removal of the calcific debris.  

PubMed

A new technical tip for the improvement of the arthroscopic treatment of symptomatic calcifying tendinitis is described. Arthroscopic excision of calcifying tendonitis may result with multiple minute calcific debris in the subacromial bursa, causing severe post operative pain due to chemical irritation of the bursa. We suggest the use of a bladeless shaver barrel as a "Hoover" (vacuum cleaner) for arthroscopic clearance of these miniature calcific debris from the subacromial space after resection of the major deposits. The use of this technique resulted in good clinical outcome with improved post operative pain. PMID:23204765

Ehud, Atoun; Ehud, Rath; Alexander, Van Tongel; Ali, Narvani; Giusseppe, Sforza; Ofer, Levy

2012-07-01

378

Calcifying Pseudoneoplasm of the Neuraxis. Two Case Reports and Review of CT and MR Findings.  

PubMed

Calcifying pseudoneoplasm is rarely encountered along the neuraxis, and only few cases have been reported to involve the spine. Its exact pathogenesis is unknown, and has been regarded as an unusual reactive process which must be differentiated from infection or malignancy. This rare entity carries a good prognosis after surgical resection. We report on the computed tomography and magnetic resonance imaging and diffusion-weighted features of calcifying pseudoneoplasm of the spine by describing two patients with involvement of the craniocervical junction, and thoracic spine. PMID:24029037

Muccio, C F; Cerase, A; Leone, A; Dalena, A M; Di Blasi, A; De Simone, M; Esposito, G

2012-09-01

379

DIFFERENTIAL EFFECT OF TETRAZOLIUM UPON BACTERIOPHAGE PLAQUE ASSAY TITERS  

EPA Science Inventory

This study examined whether the practice of incorporating either tetrazolium red ortetrazolium violet dye into plaque assay medium deleteriously influences plaque assay titers. epresentative members of six different virus families were studied: ystoviridae (06), Leviviridae (MS2)...

380

Enumeration of bacteriophages by the direct plating plaque assay.  

PubMed

A method is described for determination of the concentration of infectious phage particles by the direct plating plaque assay, which is simpler and faster than the double agar overlay plaque procedure outlined in the previous chapter. PMID:19066812

Mazzocco, Amanda; Waddell, Thomas E; Lingohr, Erika; Johnson, Roger P

2009-01-01

381

Epstein-Barr virus in pyothorax-associated pleural lymphoma.  

PubMed Central

Pleural B-cell lymphoma was found in five patients with a history of pyothorax that was the sequelae of tuberculosis 35 to 47 years previously. Epstein-Barr virus (EBV) DNA was detected in all five pleural tumors by polymerase chain reaction and Southern blot hybridization. The lymphoma cells were shown to express the latent membrane protein-1 and the EBV-encoded nuclear antigen-2 by immunocytochemistry and EBV-encoded small RNA by in situ hybridization. Three cases were shown to be EBV subtype A, whereas the remaining two were subtype B, as determined by differences in the EBV-encoded nuclear antigen-2 nucleotide sequence. The patients also had high titers of antibodies against EBV. These findings suggest that EBV is causally associated with the pleural lymphomas that originate at the site of chronic inflammation and fibrosis with a latent period of more than 40 years. Images Figure 1 Figure 2 Figure 3

Fukayama, M.; Ibuka, T.; Hayashi, Y.; Ooba, T.; Koike, M.; Mizutani, S.

1993-01-01

382

Improved treatment planning for COMS eye plaques  

Microsoft Academic Search

Purpose: A recent reanalysis of the Collaborative Ocular Melanoma Study (COMS) medium tumor trial concluded that incorporating factors to account for anisotropy, line source approximation, the gold plaque, and attenuation in the Silastic seed carrier into the dose calculations resulted in a significant and consistent reduction of calculated doses to structures of interest within the eye. The authors concluded that

Melvin A. Astrahan

2005-01-01

383

Pleural mesothelioma in Sweden: an analysis of the incidence according to the use of asbestos  

Microsoft Academic Search

OBJECTIVE: To investigate if the preventive measures taken to reduce the occupational exposure to asbestos have resulted in a decreased incidence of pleural mesothelioma in Sweden. METHODS: The incidence of pleural mesothelioma between 1958 and 1995 for birth cohorts born between 1885 and 1964 was investigated. The cases of pleural mesothelioma were identified through the Swedish Cancer Register. RESULTS: In

B. Jarvholm; A. Englund; M. Albin

1999-01-01

384

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

1999-01-01

385

Pleural Dosimetry and Pathobiological Responses in Rats and Hamsters Exposed Subchronically to MMVF 10a Fiberglass  

Microsoft Academic Search

2 surface area) following 12 weeks of exposure. With time postexposure, pleural burdens decreased in hamsters but were essentially unchanged in rats. Pleural inflam- matory responses in both species were minimal. In rats, pleural inflammation was characterized by increased numbers of macro- phages and increases in mesothelial cell replication during the period of fiber exposure. In contrast, hamsters had increased

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

2003-01-01

386

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

PubMed

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

2013-01-01

387

Sleep in patients with large pleural effusion: impact of thoracentesis  

Microsoft Academic Search

Purpose  This study aimed to evaluate the sleep quality and impact of thoracentesis on sleep in patients with a large pleural effusion.\\u000a \\u000a \\u000a \\u000a Methods  Patients with large unilateral pleural effusion were evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire\\u000a and dyspnea Borg scale. Full polysomnography (PSG) was performed on the night before and 36 h after thoracentesis.\\u000a \\u000a \\u000a \\u000a \\u000a Results  We studied 19 patients, 11 males

Bianca Fernandes Marcondes; Francisco Vargas; Fabio Henrique Paschoal; Ana Maria Cartaxo; Lisete R. Teixeira; Eduardo Henrique Genofre; Roberto Onishi; Robert Skomro; Geraldo Lorenzi-Filho

388

Study of immunoglobulins in pleura and pleural effusions.  

PubMed Central

The protein concentration of 35 pleural effusions was compared with that in the serum. The ratio of the pleural and serum concentration of albumin, IgG, IgA, and IgM is always below unity and appears to have no diagnostic value. However, the ratio of the concentration of these proteins was inversely related to their molecular weight. The underlying mechanism in malignant and inflammatory effusions appear similar and is in keeping with a diffusion process. Immunofluorescent staining of the pleura suggests the intercellular passage of the proteins through the mesothelial barrier. Images

Telvi, L; Jaubert, F; Eyquem, A; Andreux, J P; Labrousse, F; Chretien, J

1979-01-01

389

Malignant Pleural Effusion: Medical Approaches for Diagnosis and Management  

PubMed Central

Malignant pleural effusions (MPEs) are the second leading cause of exudative pleural effusions after parapneumonic effusions. In the vast majority of cases, a MPE signifies incurable disease associated with high morbidity and mortality. Considerable advances have been made for the diagnosis of MPEs, through the development of improved methods in the specialized cytological and imaging studies. The cytological or histological confirmation of malignant cells is currently important in establishing a diagnosis. Furthermore, despite major advancements in cancer treatment for the past two decades, management of MPE remains palliative. This article presents a comprehensive review of the medical approaches for diagnosis and management of MPE.

2014-01-01

390

Accidental pleural puncture by a thoracic epidural catheter.  

PubMed

We report the occurrence of an accidental pleural puncture by an epidural catheter that happened during the attempted induction of thoracic epidural anaesthesia using a paramedian approach in an awake patient. The incorrect placement of the catheter was recognised while the patient was undergoing thoracoscopic surgery. The possibility of accidental pleural puncture during attempted thoracic epidural catheter placement by either the paramedian or the midline approach should be borne in mind. A misplaced catheter may injure lung tissue and result in a potentially dangerous intra-operative tension pneumothorax. PMID:9505745

Zaugg, M; Stoehr, S; Weder, W; Zollinger, A

1998-01-01

391

Nonaccidental trauma presenting with respiratory distress and pleural effusion.  

PubMed

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

2012-01-01

392

Visceral leishmaniasis with pleural effusion in an immunocompetent patient.  

PubMed

Visceral leishmaniasis (VL) is usually characterized by splenomegaly, pallor and fever. Pleural effusion is an uncommon feature of this disease, which is encountered in immunocompromised patients. Here, we report a case of VL with pleural effusion in an immunocompetent patient. Pulmonary symptoms in VL are usually related to bacterial lung infection, vagal nerve compression by splenomegaly, and hypoalbuminaemia with mild pulmonary edema. Our patient presented with cough and chest pain. The clinical features of this case were baffling since they mimicked that of pulmonary tuberculosis. This case report emphasizes the need to recognize the diverse nature of presentation of this curable yet fatal infectious disease. PMID:24669085

Dasgupta, Senjuti; Saha, Moutushi; Chakrabarti, Sudipta; Chakraborty, Jayati

2014-01-01

393

Is silica involved in neuritic (senile) plaque formation?  

Microsoft Academic Search

The agent responsible for inducing neuritic (senile) plaque formation in senile dementia of the Alzheimer's type and in the ageing non-demented brain is unknown. Other workers have detected a high concentration of silicon in the rims and cores of senile neuritic plaques. We have therefore looked at whether the reaction of brain tissue to silica particles resembles a neuritic plaque.

S. Reesl; B. Cragg

1983-01-01

394

Three-Dimensional Ultrasound Observation of Carotid Artery Plaque Ulceration  

Microsoft Academic Search

Background and Purpose—Carotid artery plaque ulceration is associated with an increased risk of cerebral embolism. However, because of the rather poor diagnostic quality of conventional 2-D ultrasound and angiography compared with the evaluation of pathological specimens, little information exists on the natural course of carotid plaque ulceration. Recently, the introduction of 3-D ultrasound has made reproducible investigation of plaque morphology

Ulf Schminke; Lillian Motsch; Lutz Hilker; Christof Kessler

395

In vivo imaging reveals sigmoidal growth kinetic of ?-amyloid plaques.  

PubMed

A major neuropathological hallmark of Alzheimer's disease is the deposition of amyloid plaques in the brains of affected individuals. Amyloid plaques mainly consist of fibrillar ?-amyloid, which is a cleavage product of the amyloid precursor protein. The amyloid-cascade-hypothesis postulates A? accumulation as the central event in initiating a toxic cascade leading to Alzheimer's disease pathology and, ultimately, loss of cognitive function. We studied the kinetics of ?-amyloid deposition in Tg2576 mice, which overexpress human amyloid precursor protein with the Swedish mutation. Utilizing long-term two-photon imaging we were able to observe the entire kinetics of plaque growth in vivo. Essentially, we observed that plaque growth follows a sigmoid-shaped curve comprising a cubic growth phase, followed by saturation. In contrast, plaque density kinetics exhibited an asymptotic progression. Taking into account the fact that a critical concentration of A? is required to seed new plaques, we can propose the following kinetic model of ?-amyloid deposition in vivo. In the early cubic phase, plaque growth is not limited by A? concentration and plaque density increases very fast. During the transition phase, plaque density stabilizes whereas plaque volume increases strongly reflecting a robust growth of the plaques. In the late asymptotic phase, A? peptide production becomes rate-limiting for plaque growth. In conclusion, the present study offers a direct link between in vitro and in vivo studies facilitating the translation of A?-lowering strategies from laboratory models to patients. PMID:24678659

Burgold, Steffen; Filser, Severin; Dorostkar, Mario M; Schmidt, Boris; Herms, Jochen

2014-01-01

396

Correlation of hemodynamic forces and atherosclerotic plaque components  

NASA Astrophysics Data System (ADS)

Local hemodynamic forces in atherosclerotic carotid arteries are thought to trigger cellular and molecular mechanisms that determine plaque vulnerability. Magnetic Resonance Imaging (MRI) has emerged as a powerful tool to characterize human carotid atherosclerotic plaque composition and morphology, and to identify plaque features shown to be key determinants of plaque vulnerability. Image-based computational fluid dynamics (CFD) has allowed researchers to obtain time-resolved wall shear stress (WSS) information for atherosclerotic carotid arteries. A deeper understanding of the mechanisms of initiation and progression of atherosclerosis can be obtained through the comparison of WSS and plaque composition. The aim of this study was to explore the hypothesis that intra-plaque hemorrhage, a feature associated with adverse outcomes and plaque progression, is more likely to occur in plaques with elevated WSS levels. We compared 2D representations of the WSS distribution and the amount of intra-plaque hemorrhage to determine relationships between WSS patterns and plaque vulnerability. We extracted WSS data to compare patterns between cases with and without hemorrhage. We found elevated values of WSS at regions where intra-plaque hemorrhage was detected, suggesting that WSS might be used as a marker for the risk of intra-plaque hemorrhage and subsequent complications.

Canton, Gádór; Chiu, Bernard; Yuan, Chun; Kerwin, William S.

2010-03-01

397

Fluorescence lifetime imaging microscopy for the characterization of atherosclerotic plaques  

Microsoft Academic Search

Atherosclerotic plaque composition has been associated with plaque instability and rupture. This study investigates the use of fluorescence lifetime imaging microscopy (FLIM) for mapping plaque composition and assessing features of vulnerability. Measurements were conducted in atherosclerotic human aortic samples using an endoscopic FLIM system (spatial resolution of 35 µm; temporal resolution 200 ps) developed in our lab which allows mapping

Jennifer Phipps; Yinghua Sun; Ramez Saroufeem; Nisa Hatami; Laura Marcu

2009-01-01

398

Intravascular Modalities for Detection of Vulnerable Plaque Current Status  

Microsoft Academic Search

Progress in the diagnosis, treatment, and prevention of atherosclerotic coronary artery disease is dependent on a greater understanding of the mechanisms of coronary plaque progression. Autopsy studies have characterized a subgroup of high-risk, or vulnerable, plaques that result in acute coronary syndromes or sudden cardiac death. These angiographically modest plaques share certain pathologic characteristics: a thin, fibrous cap, lipid-rich core,

Briain D. MacNeill; Harry C. Lowe; Masamichi Takano; Valentin Fuster; Ik-Kyung Jang

399

In vivo imaging reveals sigmoidal growth kinetic of ?-amyloid plaques  

PubMed Central

A major neuropathological hallmark of Alzheimer’s disease is the deposition of amyloid plaques in the brains of affected individuals. Amyloid plaques mainly consist of fibrillar ?-amyloid, which is a cleavage product of the amyloid precursor protein. The amyloid-cascade-hypothesis postulates A? accumulation as the central event in initiating a toxic cascade leading to Alzheimer’s disease pathology and, ultimately, loss of cognitive function. We studied the kinetics of ?-amyloid deposition in Tg2576 mice, which overexpress human amyloid precursor protein with the Swedish mutation. Utilizing long-term two-photon imaging we were able to observe the entire kinetics of plaque growth in vivo. Essentially, we observed that plaque growth follows a sigmoid-shaped curve comprising a cubic growth phase, followed by saturation. In contrast, plaque density kinetics exhibited an asymptotic progression. Taking into account the fact that a critical concentration of A? is required to seed new plaques, we can propose the following kinetic model of ?-amyloid deposition in vivo. In the early cubic phase, plaque growth is not limited by A? concentration and plaque density increases very fast. During the transition phase, plaque density stabilizes whereas plaque volume increases strongly reflecting a robust growth of the plaques. In the late asymptotic phase, A? peptide production becomes rate-limiting for plaque growth. In conclusion, the present study offers a direct link between in vitro and in vivo studies facilitating the translation of A?-lowering strategies from laboratory models to patients.

2014-01-01

400

Videocapillaroscopic Findings in the Microcirculation of the Psoriatic Plaque  

Microsoft Academic Search

Background: Videocapillaroscopy (VCP) is a method to study the morphology and dynamics of microcirculation, but information about capillaroscopic features of the psoriatic plaque is limited. Objective: To investigate the distribution, morphology and density of capillaries in lesional and perilesional skin of the psoriatic plaque. Methods: VCP of a well-delimited plaque of the trunk, arms or legs in 15 consecutive patients

Rossella De Angelis; Leonardo Bugatti; Patrizia Del Medico; Massimiliano Nicolini; Giorgio Filosa

2002-01-01

401

Influence of microcalcifications on vulnerable plaque mechanics using FSI modeling  

Microsoft Academic Search

Sudden heart attacks remain one of the primary causes of premature death in the developed world. Asymptomatic vulnerable plaques that rupture are believed to prompt such fatal heart attacks and strokes. The role of microcalcifications in the vulnerable plaque rupture mechanics is still debated. Recent studies suggest the microcalcifications increase the plaque vulnerability. In this manuscript we present a numerical

Danny Bluestein; Yared Alemu; Idit Avrahami; Morteza Gharib; Kris Dumont; John J. Ricotta; Shmuel Einav

402

A direct vulnerable atherosclerotic plaque elasticity reconstruction method based on an original material-finite element formulation: theoretical framework.  

PubMed

The peak cap stress (PCS) amplitude is recognized as a biomechanical predictor of vulnerable plaque (VP) rupture. However, quantifying PCS in vivo remains a challenge since the stress depends on the plaque mechanical properties. In response, an iterative material finite element (FE) elasticity reconstruction method using strain measurements has been implemented for the solution of these inverse problems. Although this approach could resolve the mechanical characterization of VPs, it suffers from major limitations since (i) it is not adapted to characterize VPs exhibiting high material discontinuities between inclusions, and (ii) does not permit real time elasticity reconstruction for clinical use. The present theoretical study was therefore designed to develop a direct material-FE algorithm for elasticity reconstruction problems which accounts for material heterogeneities. We originally modified and adapted the extended FE method (Xfem), used mainly in crack analysis, to model material heterogeneities. This new algorithm was successfully applied to six coronary lesions of patients imaged in vivo with intravascular ultrasound. The results demonstrated that the mean relative absolute errors of the reconstructed Young's moduli obtained for the arterial wall, fibrosis, necrotic core, and calcified regions of the VPs decreased from 95.3 ± 15.56%, 98.85 ± 72.42%, 103.29 ± 111.86% and 95.3 ± 10.49%, respectively, to values smaller than 2.6 × 10(-8) ± 5.7 × 10(-8)% (i.e. close to the exact solutions) when including modified-Xfem method into our direct elasticity reconstruction method. PMID:24240392

Bouvier, Adeline; Deleaval, Flavien; Doyley, Marvin M; Yazdani, Saami K; Finet, Gérard; Le Floc'h, Simon; Cloutier, Guy; Pettigrew, Roderic I; Ohayon, Jacques

2013-12-01

403

The Effect of pH, Temperature and Plaque Thickness on the Hydrolysis of Monofluorophosphate in Experimental Dental Plaque  

Microsoft Academic Search

Monofluorophosphate (MFP), an anti-caries agent commonly used in toothpaste, is known to be degraded to fluoride and orthophosphate by bacterial phosphatases in dental plaque. We have examined the effect of pH, temperature, plaque thickness and some ions on this process. Both natural plaque and artificial microcosm plaque incubated with purified MFP at pH 4–10 showed an optimum pH of ?8

E. I. F. Pearce; G. H. Dibdin

2003-01-01

404