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Sample records for calcified pleural plaques

  1. Aetiology of pleural plaques

    PubMed Central

    Rous, V.; Studeny, J.

    1970-01-01

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

  2. Association between Randall's Plaque and Calcifying Nanoparticles

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

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

  3. The pathology of parietal pleural plaques

    PubMed Central

    Roberts, G. Hefin

    1971-01-01

    The incidence, morbid anatomy, histology, and relationship of hyaline pleural plaques to exposure to asbestos has been studied. Plaques were found in 12·3% of 334 hospital necropsies (in an urban population in Glasgow, 41 cases). In 85·3% (35 cases) asbestos bodies were found in the lungs. There is evidence of a dose-response relationship between the number of asbestos bodies found in the lungs and the presence of pleural plaques. The selective distribution of plaques within the pleural cavities suggests that mechanical factors play a part in their localization. Histological examination contributed little to understanding the mechanism of plaque formation; that asbestos bodies have been detected in only a few cases suggest that their presence in the parietal pleura is not essential to plaque formation. The suggested mechanisms of plaque formation are discussed. Images PMID:5556121

  4. Association between Randall's Plaque and Calcifying Nanoparticles

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

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

  5. Pleural plaque related to asbestos mining in Taiwan.

    PubMed

    Yang, Hsiao-Yu; Wang, Jung-Der; Chen, Pau-Chung; Lee, Jen-Jyh

    2010-12-01

    A 78-year-old woman complained of twisting-like pain in her left lower chest. During physical examination, friction rubbing was noted in both lungs. Chest radiography showed extensive bilateral pleural calcification. High-resolution computed tomography confirmed the presence of bilateral calcified pleural plaques. The patient had worked at a Japanese asbestos factory in Taiwan for 1 year when she was 16 years old. Her job involved picking out asbestos fibers from crushed asbestos minerals, but no protective equipment was used at that time. This is believed to be the first reported case of asbestos-related disease in Taiwan that resulted from asbestos mining. We also summarize the history of domestic asbestos mining, importation of asbestos, and trends in asbestos use in Taiwan. PMID:21195893

  6. Motion compensated reconstructions of calcified coronary plaques in cardiac CT

    NASA Astrophysics Data System (ADS)

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

    2007-03-01

    In order to obtain motion-compensated reconstructions of calcified coronary plaques in cardiac CT, the dynamic trajectory of the plaque must be known rather accurately. The purpose of this study is to evaluate whether the dynamic trajectories of a plaque extracted from reconstructions provided by a previously developed tracking algorithm can be used for obtaining motion-compensated reconstructions of this plaque. A single projection dataset of the modified FORBILD phantom containing a calcified plaque undergoing continuous periodic motion was acquired with a gantry rotation time of 0.4 s and a heart rate of 90 bpm. Three sets of phase-correlated 4D ROI images centered on the calcified plaque (labeled G1, G2, and G3) were obtained from this dataset by varying the numbers of data segments used for cardiac gating (N = 1, 2, 3) during the reconstruction steps of the tracking algorithm. Dynamic trajectories from each of these datasets were calculated from edge-based segmentations of these datasets. When compared to the true trajectory (labeled T), root-mean-square (RMS) values of position for trajectories G1, G2, and G3 were 1.473 mm, 1.166 mm, and 0.736 mm, respectively. Trajectories G1, G2, G3, and T then were used to obtain motion-compensated reconstructions MC1, MC2, MC3, and MCT, respectively, at 6.25 ms time intervals over 2 cardiac cycles. The areas (number of pixels) of the plaque then were measured at all time intervals for each set of reconstructions. When compared against areas obtained for MCT, RMS values of areas for reconstructions MC1, MC2, and MC3 were 26.888, 12.384, and 4.837, respectively. On visual inspection, MC3 also exhibited the least motion artifacts at most time intervals.

  7. Systematic review of pleural plaques and lung function

    PubMed Central

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

    2015-01-01

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

  8. Virtual Intravascular Endoscopy Visualization of Calcified Coronary Plaques

    PubMed Central

    Xu, Lei; Sun, Zhonghua

    2015-01-01

    Abstract This study was conducted to investigate the feasibility of using 3D virtual intravascular endoscopy (VIE) as a novel approach for characterization of calcified coronary plaques with the aim of differentiating superficial from deep calcified plaques, thus improving assessment of coronary stenosis. A total of 61 patients with suspected coronary artery disease were included in the study. Minimal lumen diameter (MLD) was measured and compared between coronary CT angiography (CCTA) (≥64-slice) and invasive coronary angiography (ICA) with regard to the measurement bias, whereas VIE findings were correlated with CCTA with respect to the diagnostic performance of coronary stenosis and the area under the curve (AUC) by receiver-operating characteristic curve analysis (ROC). In all 3 coronary arteries, the CCTA consistently underestimated the MLD relative to the ICA (P < 0.001). On a per-vessel assessment, the sensitivity, specificity, positive predictive value, and negative predictive value and 95% confidence interval (CI) were 94% (95% CI: 61%, 100%), 27% (95% CI: 18%, 38%), 33% (95% CI: 23%, 43%), and 92% (95% CI: 74%, 99%) for CCTA, and 100% (95% CI: 89%, 100%), 85% (95% CI: 75%, 92%), 71% (95% CI: 56%, 84%), and 100% (95% CI: 95%, 100%) for VIE, respectively. The AUC by ROC analysis for VIE demonstrated significant improvement in analysis of left anterior descending calcified plaques compared with CCTA (0.99 vs 0.60, P < 0.001), with better performance in the left circumflex and right coronary arteries (0.98 vs 0.84 and 0.77 vs 0.77, respectively; P = 0.07 and P = 0.96, respectively). There are no significant differences between 64-, 128-, and 640-slice CCTA and VIE in terms of sensitivity, specificity, positive and negative predictive value in the diagnosis of coronary stenosis. This study shows the feasibility of using VIE for characterizing morphological features of calcified plaques, therefore, significantly improving assessment of

  9. Micro-FTIR imaging spectroscopy of calcified atheromatous carotid plaques. Part IV

    NASA Astrophysics Data System (ADS)

    Alò, Francesco; Conti, Carla; Ferraris, Paolo; Giorgini, Elisabetta; Rubini, Corrado; Sabbatini, Simona; Tosi, Giorgio

    2009-03-01

    Micro-imaging infrared spectroscopy has been performed on atheromatous plaques in order to localize and characterize substances responsible for the cytotoxic effects that prevent macrophages clearance of lipidic and calcified materials. In plaques with different graded atherosclerotic lesions, infrared determinations allowed to visualize gruel and ceroid toxic components and variously calcified zones. Compare correlations let to visualize the progression of the lesion on going from the lumen to the outer media of the plaque.

  10. Automated detection framework of the calcified plaque with acoustic shadowing in IVUS images.

    PubMed

    Gao, Zhifan; Guo, Wei; Liu, Xin; Huang, Wenhua; Zhang, Heye; Tan, Ning; Hau, William Kongto; Zhang, Yuan-Ting; Liu, Huafeng

    2014-01-01

    Intravascular Ultrasound (IVUS) is one ultrasonic imaging technology to acquire vascular cross-sectional images for the visualization of the inner vessel structure. This technique has been widely used for the diagnosis and treatment of coronary artery diseases. The detection of the calcified plaque with acoustic shadowing in IVUS images plays a vital role in the quantitative analysis of atheromatous plaques. The conventional method of the calcium detection is manual drawing by the doctors. However, it is very time-consuming, and with high inter-observer and intra-observer variability between different doctors. Therefore, the computer-aided detection of the calcified plaque is highly desired. In this paper, an automated method is proposed to detect the calcified plaque with acoustic shadowing in IVUS images by the Rayleigh mixture model, the Markov random field, the graph searching method and the prior knowledge about the calcified plaque. The performance of our method was evaluated over 996 in-vivo IVUS images acquired from eight patients, and the detected calcified plaques are compared with manually detected calcified plaques by one cardiology doctor. The experimental results are quantitatively analyzed separately by three evaluation methods, the test of the sensitivity and specificity, the linear regression and the Bland-Altman analysis. The first method is used to evaluate the ability to distinguish between IVUS images with and without the calcified plaque, and the latter two methods can respectively measure the correlation and the agreement between our results and manual drawing results for locating the calcified plaque in the IVUS image. High sensitivity (94.68%) and specificity (95.82%), good correlation and agreement (>96.82% results fall within the 95% confidence interval in the Student t-test) demonstrate the effectiveness of the proposed method in the detection of the calcified plaque with acoustic shadowing in IVUS images. PMID:25372784

  11. Serum Osteoprotegerin Is Associated With Calcified Carotid Plaque

    PubMed Central

    Kwon, Ami; Choi, Yun-Seok; Choi, Yong-Won; Chung, Woo-Baek; Park, Chul-Soo; Chung, Wook-Sung; Lee, Man-Young; Youn, Ho-Joong

    2016-01-01

    Abstract Osteoprotegerin (OPG) is a kind of tumor necrosis factor, which is related to bone metabolism and vascular calcification. The increase of Osteoprotegerin concentration in serum is related to cardiovascular diseases in humans. The purpose of this study was to figure out the relevance between osteoprotegerin in serum and carotid calcification. Serum OPG concentrations were compared in 145 patients who underwent carotid sonography (average age: 68 ± 9 years old, male: female = 81:64). A calcified plaque (CP) (37 people [27%]), a noncalcified plaque (NCP) (54 people [37%]), and a nonplaque (NP) (54 people [37%]) were classified for this study. No significant differences among 3 groups were demonstrated in the distribution of age, diabetes, high blood pressure, and hyperlipidemia. Serum osteoprotegerin concentrations were significantly increased in CP group rather than NCP group or NP group; (median [interquartile range], 4016 [1410] vs 3210 [1802] pg/mL, P < 0.05 and 4016 [1410] vs 3204 [1754] pg/mL, P < 0.05). Serum osteoprotegerin concentrations did not indicate a significant difference between NCP Group or NP Group. This study had proved that patient group accompanied with carotid calcification in carotid artery disease had an increased serum OPG concentration, so it could consider that OPG plays an important function on calcification related to arteriosclerosis. PMID:27082605

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

    PubMed

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

    2016-01-01

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

  13. Low Adiponectin Levels Are an Independent Predictor of Mixed and Non-Calcified Coronary Atherosclerotic Plaques

    PubMed Central

    Lehrke, Michael; Stark, Renee; Greif, Martin; Becker, Alexander; von Ziegler, Franz; Tittus, Janine; Reiser, Maximilian; Becker, Christoph; Göke, Burkhard; Parhofer, Klaus G.; Leber, Alexander W.

    2009-01-01

    Background Atherosclerosis is the primary cause of coronary artery disease (CAD). There is increasing recognition that lesion composition rather than size determines the acute complications of atherosclerotic disease. Low serum adiponectin levels were reported to be associated with coronary artery disease and future incidence of acute coronary syndrome (ACS). The impact of adiponectin on lesion composition still remains to be determined. Methodology/Principal Findings We measured serum adiponectin levels in 303 patients with stable typical or atypical chest pain, who underwent dual-source multi-slice CT-angiography to exclude coronary artery stenosis. Atherosclerotic plaques were classified as calcified, mixed or non-calcified. In bivariate analysis adiponectin levels were inversely correlated with total coronary plaque burden (r = −0.21, p = 0.0004), mixed (r = −0.20, p = 0.0007) and non-calcified plaques (r = −0.18, p = 0.003). No correlation was seen with calcified plaques (r = −0.05, p = 0.39). In a fully adjusted multivariate model adiponectin levels remained predictive of total plaque burden (estimate: −0.036, 95%CI: −0.052 to −0.020, p<0.0001), mixed (estimate: −0.087, 95%CI: −0.132 to −0.042, p = 0.0001) and non-calcified plaques (estimate: −0.076, 95%CI: −0.115 to −0.038, p = 0.0001). Adiponectin levels were not associated with calcified plaques (estimate: −0.021, 95% CI: −0.043 to −0.001, p = 0.06). Since the majority of coronary plaques was calcified, adiponectin levels account for only 3% of the variability in total plaque number. In contrast, adiponectin accounts for approximately 20% of the variability in mixed and non-calcified plaque burden. Conclusions/Significance Adiponectin levels predict mixed and non-calcified coronary atherosclerotic plaque burden. Low adiponectin levels may contribute to coronary plaque vulnerability and may thus play a role in the pathophysiology of

  14. Detection of calcified atherosclerotic plaque by laser-induced plasma emission.

    PubMed

    Deckelbaum, L I; Scott, J J; Stetz, M L; O'Brien, K M; Baker, G

    1992-01-01

    The use of fluorescence spectroscopy to discriminate atherosclerotic from normal tissue is limited by a lower sensitivity for calcified than noncalcified atherosclerotic plaque (65% vs. 93%, respectively). To evaluate plasma emission as a means to detect calcified plaque, 325 normal and atherosclerotic cadaveric aortic sites were irradiated through a 100-micron silica fiber in blood by a pulsed holmium laser (lambda = 2.1 microns, fluence = 4 J/mm2). A photodiode positioned near the proximal end of the fiber detected plasma emission during a laser pulse. Plasma emission was detected at 0% (0/110) of normal, 0% (0/107) of noncalcified atherosclerotic tissue, and 91% (98/108) of calcified atherosclerotic sites. Spectroscopic analysis confirmed the presence of calcium lines in the plasma emission from calcified atherosclerotic plaque. Although ablative fluences (greater than 3 J/mm2) were required for plasma generation, a single laser pulse ablated only to a depth of 67 +/- 16 microns in normal tissue. In an additional 10 calcified atherosclerotic sites, laser ablation was continued as long as plasma emission was detected. In all cases, plaque ablation was terminated before arterial perforation. Furthermore, the adjunctive use of plasma detection improved the accuracy of fluorescence spectroscopic classification of normal and atherosclerotic tissue. In conclusion, plasma detection has a high sensitivity (91%) and specificity (100%) for calcified atherosclerotic plaque and may be a useful adjunct for laser angioplasty guidance. Furthermore, plasma detection can be implemented both simply and inexpensively. PMID:1614261

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

    SciTech Connect

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

    1984-10-01

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

  16. The Diagnostic Performance of Coronary CT Angiography for the Assessment of Coronary Stenosis in Calcified Plaque

    PubMed Central

    Xu, Yi; Zhu, Xiao-Mei; Zhang, Yu-Dong; Shi, Hai-Bin; Yu, Rong-Bin

    2016-01-01

    Purpose To prospectively evaluate the diagnostic performance of coronary CT angiography (CCTA) for the assessment of coronary stenosis in a calcified plaque, by using conventional coronary angiography (CAG) as a standard reference. Materials and Methods Eight hundred and ninety-four patients were known to have or have been suspicious of having coronary artery disease, underwent CCTA and conventional coronary angiography (CAG). All the images acquired were assessed. The calcified plaque in CCTA was classified into four types (I-IV) according to the ratio of calcified plaque volume to vessel circumference (RVTC). Overall diagnostic accuracy was made under receiver operating characteristic curve (AUC) analysis. CAG was used as the standard reference. Results A total of 12845 segments were evaluated in 894 patients, among which 4955 calcified plaques were detected on 3645(28.4%) segments by CCTA. The overall AUC, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 0.939, 97.8%, 90.1%, 71.2% and 99.4%, respectively. In type I-II calcification, CCTA had high diagnostic performance in AUC (type I: 0.983; type II: 0.976), sensitivity (96.7%; 98.1%), specificity (99.8%; 97.0%), PPV (95.7%; 90.1%), NPV (99.8%; 99.5%) and accuracy (99.6%; 97.3%). In type III-IV calcification, CCTA has high performance in sensitivity (type III: 97.6%; type IV: 97.9%) and NPV (98.3%; 98.7%), moderate performance in AUC (0.877; 0.829), while remarkable decrease in specificity (78.7%; 67.9%), PPV (71.0%; 56.2%) and accuracy (84.9%; 76.8%). Conclusion CCTA has highest accuracy in diagnosing the coronary artery stenosis of type I-II calcified plaques, but has a significant decrease in specificity, PPV and accuracy in type III-IV calcified plaque. PMID:27149622

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

    NASA Astrophysics Data System (ADS)

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

    2010-03-01

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

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

    SciTech Connect

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

    2007-12-15

    In coronary calcium scoring, motion artifacts affecting calcified plaques are commonly characterized using descriptive terms, which incorporate an element of subjectivity in their interpretations. Quantitative indices may improve the objective characterization of these motion artifacts. In this paper, an automated method for generating 12 quantitative indices, i.e., features that characterize the motion artifacts affecting calcified plaques, is presented. This method consists of using the rapid phase-correlated region-of-interest (ROI) tracking algorithm for reconstructing ROI images of calcified plaques automatically from the projection data obtained during a cardiac scan, and applying methods for extracting features from these images. The 12 features include two dynamic, six morphological, and four intensity-based features. The two dynamic features are three-dimensional (3D) velocity and 3D acceleration. The six morphological features include edge-based volume, threshold-based volume, sphericity, irregularity, average margin gradient, and variance of margin gradient. The four intensity-based features are maximum intensity, mean intensity, minimum intensity, and standard deviation of intensity. The 12 features were extracted from 54 reconstructed sets of simulated four-dimensional images from the dynamic NCAT phantom involving six calcified plaques under nine heart rate/multi-sector gating combinations. In order to determine how well the 12 features correlated with a plaque motion index, which was derived from the trajectory of the plaque, partial correlation coefficients adjusted for heart rate, number of gated sectors, and mean feature values of the six plaques were calculated for all 12 features. Features exhibiting stronger correlations (|r| set-membership sign [0.60,1.00]) with the motion index were 3D velocity, maximum intensity, and standard deviation of intensity. Features demonstrating stronger correlations (|r| set-membership sign [0.60,1.00]) with other

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

    SciTech Connect

    King, Martin; Giger, Maryellen L.; Suzuki, Kenji; Bardo, Dianna M. E.; Greenberg, Brent; Lan Li; Pan Xiaochuan

    2007-12-15

    An automated method for evaluating the image quality of calcified plaques with respect to motion artifacts in noncontrast-enhanced cardiac computed tomography (CT) images is introduced. This method involves using linear regression (LR) and artificial neural network (ANN) regression models for predicting two patient-specific, region-of-interest-specific, reconstruction-specific and temporal phase-specific image quality indices. The first is a plaque motion index, which is derived from the actual trajectory of the calcified plaque and is represented on a continuous scale. The second is an assessability index, which reflects the degree to which a calcified plaque is affected by motion artifacts, and is represented on an ordinal five-point scale. Two sets of assessability indices were provided independently by two radiologists experienced in evaluating cardiac CT images. Inputs for the regression models were selected from 12 features characterizing the dynamic, morphological, and intensity-based properties of the calcified plaques. Whereas LR-velocity (LR-V) used only a single feature (three-dimensional velocity), the LR-multiple (LR-M) and ANN regression models used the same subset of these 12 features selected through stepwise regression. The regression models were parameterized and evaluated using a database of simulated calcified plaque images from the dynamic NCAT phantom involving nine heart rate/multi-sector gating combinations and 40 cardiac phases covering two cardiac cycles. Six calcified plaques were used for the plaque motion indices and three calcified plaques were used for both sets of assessability indices. In one configuration, images from the second cardiac cycle were used for feature selection and regression model parameterization, whereas images from the first cardiac cycle were used for testing. With this configuration, repeated measures concordance correlation coefficients (CCCs) and associated 95% confidence intervals for the LR-V, LR-M, and ANN

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    1982-01-01

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

  3. Neutrophil/Lymphocyte Ratio Is Associated with Non-Calcified Plaque Burden in Patients with Coronary Artery Disease

    PubMed Central

    Nilsson, Lennart; Wieringa, Wouter G.; Pundziute, Gabija; Gjerde, Marcus; Engvall, Jan; Swahn, Eva; Jonasson, Lena

    2014-01-01

    Background Elevations in soluble markers of inflammation and changes in leukocyte subset distribution are frequently reported in patients with coronary artery disease (CAD). Lately, the neutrophil/lymphocyte ratio has emerged as a potential marker of both CAD severity and cardiovascular prognosis. Objectives The aim of the study was to investigate whether neutrophil/lymphocyte ratio and other immune-inflammatory markers were related to plaque burden, as assessed by coronary computed tomography angiography (CCTA), in patients with CAD. Methods Twenty patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and 30 patients with stable angina (SA) underwent CCTA at two occasions, immediately prior to coronary angiography and after three months. Atherosclerotic plaques were classified as calcified, mixed and non-calcified. Blood samples were drawn at both occasions. Leukocyte subsets were analyzed by white blood cell differential counts and flow cytometry. Levels of C-reactive protein (CRP) and interleukin(IL)-6 were measured in plasma. Blood analyses were also performed in 37 healthy controls. Results Plaque variables did not change over 3 months, total plaque burden being similar in NSTE-ACS and SA. However, non-calcified/total plaque ratio was higher in NSTE-ACS, 0.25(0.09–0.44) vs 0.11(0.00–0.25), p<0.05. At admission, levels of monocytes, neutrophils, neutrophil/lymphocyte ratios, CD4+ T cells, CRP and IL-6 were significantly elevated, while levels of NK cells were reduced, in both patient groups as compared to controls. After 3 months, levels of monocytes, neutrophils, neutrophil/lymphocyte ratios and CD4+ T cells remained elevated in patients. Neutrophil/lymphocyte ratios and neutrophil counts correlated significantly with numbers of non-calcified plaques and also with non-calcified/total plaque ratio (r = 0.403, p = 0.010 and r = 0.382, p = 0.024, respectively), but not with total plaque burden. Conclusions Among immune

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

    NASA Astrophysics Data System (ADS)

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

    2008-03-01

    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.

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

    PubMed

    Rocas, Delphine; Thivolet-Béjui, Françoise; Tronc, François; Chalabreysse, Lara

    2015-12-01

    Calcifying fibrous tumor is a rare soft tissue benign tumor (OMS 2002). Some pleural localisations are described, which affect slightly older individuals than the other soft tissue forms. The calcifying fibrous tumor is included in the 2004 World Health Organization classification of pleural tumors. A pleural tumor located in the right inferior pulmonary lobe is diagnosed in a 59-year-old man. This pleural tumor is macroscopically well-circumscribed. Histologically, the rare spindle tumoral cells are located between bundles of a collagenous tissue, sometimes hyalinized, with psammomatous or dystrophic calcifications. The tumoral cells have a fibrohistiocytic origin. They stain positively for antibodies against vimentin, factor XIIIa, CD68, CD163, CD34. Antibodies against smooth muscle actin, desmin, PS100, ALK1 and EBV are negative. Main differencial diagnoses are other benign pleural tumors (solitary fibrous tumor, inflammatory myofibroblastique tumor), some malignant tumors (desmoplastic malignant pleural mesothelioma) and pleural pseudotumors (calcified pleural plaques, chronic fibrous pleuritis, amylose, hyalinizing granuloma). Our case is the 15th pleural calcifying fibrous tumor being reported. PMID:26608111

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

    PubMed Central

    Soroushian, Sheila; Ganguly, Rumpa

    2013-01-01

    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. PMID:24380062

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

    NASA Astrophysics Data System (ADS)

    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

    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.

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

    PubMed

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

    2016-06-01

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

  9. Correction of lumen contrast-enhancement influence on non-calcified coronary atherosclerotic plaque quantification on CT.

    PubMed

    Kristanto, Wisnumurti; Tuncay, Volkan; Vliegenthart, Rozemarijn; van Ooijen, Peter M A; Oudkerk, Matthijs

    2015-02-01

    Lumen contrast-enhancement influences non-calcified atherosclerotic plaque Hounsfield-unit (HU) values in computed tomography (CT). This study aimed to construct and validate an algorithm to correct for this influence. Three coronary vessel phantoms with 1, 2, and 4 mm circular hollow lumina; with normal and plaque-infested walls were scanned simultaneously in oil using a dual-source CT scanner. Scanning was repeated as the lumina were alternately filled with water and four contrast solutions (100-400 HU, at 100 HU intervals). Images were reconstructed at 0.4 mm x-y pixel size. Pixel-by-pixel comparisons of contrast-enhanced and non-contrast-enhanced images confirmed exponential declining patterns in lumen contrast-enhancement influence on wall HU-values from the lumen border (y = Ae(-λx) + c). The median difference of the inside and outside 2-pixel radius part of the contrast-enhanced coronary phantom wall to the reference (non-contrast-enhanced images) was 45 and 2 HU, respectively. Based on the lumen contrast-enhancement influence patterns, a generalized correction algorithm was formulated. Application of the generalized correction algorithm to the inside 2-pixel radius part of the wall reduced the median difference to the reference to 4 HU. In conclusion, lumen contrast-enhancement influence on the vessel wall can be defined by an exponential approximation, allowing correction of the CT density of the vessel wall closest to the lumen. With this correction, a more accurate determination of vessel wall composition can be made. PMID:25326412

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

    PubMed Central

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

    2014-01-01

    The importance of commensal microbes for human health is increasingly recognized1-5, yet the impacts of evolutionary changes in human diet and culture on commensal microbiota remain almost unknown. Two of the greatest dietary shifts in human evolution involved the adoption of carbohydrate-rich Neolithic (farming) diets6,7 (beginning ~10,000 years BP6,8), and the more recent advent of industrially processed flour and sugar (~1850)9. Here, we show that calcified dental plaque (dental calculus) on ancient teeth preserves a detailed genetic record throughout this period. Data from 34 early European skeletons indicate that the transition from hunter-gatherer to farming shifted the oral microbial community to a disease-associated configuration. The composition of oral microbiota remained surprisingly constant between Neolithic and Medieval times, after which (the now ubiquitous) cariogenic bacteria became dominant, apparently during the Industrial Revolution. Modern oral microbiota are markedly less diverse than historic populations, which might be contributing to chronic oral (and other) disease in post-industrial lifestyles. PMID:23416520

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

    PubMed

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

    2013-04-01

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

  12. Calcified coronary artery plaque measurement with cardiac CT in population-based studies: standardized protocol of Multi-Ethnic Study of Atherosclerosis (MESA) and Coronary Artery Risk Development in Young Adults (CARDIA) study.

    PubMed

    Carr, J Jeffrey; Nelson, Jennifer Clark; Wong, Nathan D; McNitt-Gray, Michael; Arad, Yadon; Jacobs, David R; Sidney, Stephan; Bild, Diane E; Williams, O Dale; Detrano, Robert C

    2005-01-01

    Calcified coronary artery plaque, measured at cardiac computed tomography (CT), is a predictor of cardiovascular disease and may play an increasing role in cardiovascular disease risk assessment. The Multi-Ethnic Study of Atherosclerosis (MESA) and the Coronary Artery Risk Development in Young Adults (CARDIA) study of the National Heart, Lung, and Blood Institute are population-based studies in which calcified coronary artery plaque was measured with electron-beam and multi-detector row CT and a standardized protocol in 6814 (MESA) and 3044 (CARDIA study) participants. The studies were approved by the appropriate institutional review board from the study site or agency, and written informed consent was obtained from each participant. Participation in the CT examination was high, image quality was good, and agreement for the presence of calcified plaque was high (kappa = 0.92, MESA; kappa = 0.77, CARDIA study). Extremely high agreement was observed between and within CT image analysts for the presence (kappa > 0.90, all) and amount (intraclass correlation coefficients, >0.99) of calcified plaque. Measurement of calcified coronary artery plaque with cardiac CT is well accepted by participants and can be implemented with consistently high-quality results with a standardized protocol and trained personnel. If predictive value of calcified coronary artery plaque for cardiovascular events proves sufficient to justify screening a segment of the population, then a standardized cardiac CT protocol is feasible and will provide reproducible results for health care providers and the public. PMID:15618373

  13. Natural carcinogenic fiber and pleural plaques assessment in a general population: A cross-sectional study.

    PubMed

    Ledda, Caterina; Pomara, Cristoforo; Bracci, Massimo; Mangano, Dario; Ricceri, Vincenzo; Musumeci, Andrea; Ferrante, Margherita; Musumeci, Giuseppe; Loreto, Carla; Fenga, Concettina; Santarelli, Lory; Rapisarda, Venerando

    2016-10-01

    Natural carcinogenic fibers are asbestos and asbestiform fibers present as a natural component of soils or rocks. These fibers are released into the environment resulting in exposure of the general population. Environmental contamination by fibers are those cases occurred in: rural regions of Turkey, in Mediterranean countries and in other sites of the world, including northern Europe, USA and China. Fluoro-edenite(FE) is a natural mineral species first isolated in Biancavilla, Sicily. The fibers are similar in size and morphology to some amphibolic asbestos fibers, whose inhalation can cause chronic inflammation and cancer. The aim of the current study is to assess the presence and features of pleural plaques (PPs) in Biancavilla's general population exposed to FE through a retrospective cross-sectional study. All High-Resolution Computed Tomography (HRCT) chest scans carried out between June 2009 and June 2015 in Biancavilla municipality hospital site (exposed subjects) were reviewed. The exposed groups were 1:1 subjects, matched according to age and sex distributions, with unexposed subjects (n.1.240) randomly selected among HRCT chest scans carried out in a Hospital 30km away from Biancavilla. Subjects from Biancavilla with PPs were significantly more numerous than the control group ones (218 vs 38). Average age of either group was >60 years; the age of exposed subjects was significantly (p=0.0312) lesser than the unexposed group. In exposed subjects, in most PPs thickness ranged between 2 and 4.9cm(38%, n=83); while in unexposed ones PPs thickness was less than 2cm (55%, n=21). As to the size of PPs in exposed subjects, in most cases it ranged between 1cm and 24% of chest wall (53%, n=116); while in unexposed ones the size of PPs was lesser than 1cm (23%, n=58). Among exposed subjects, 36 cases (17%) PPs were detected with calcification, whereas in unexposed ones only three (8%) presented calcification. 137 lung parenchymal abnormalities were observed in

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-03-01

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

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

    SciTech Connect

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

    2010-11-15

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

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

    PubMed

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

    2012-06-01

    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

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

    PubMed Central

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

    2008-01-01

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

  19. An outbreak of pleural mesothelioma and chronic fibrosing pleurisy in the village of Karain/Urgüp in Anatolia.

    PubMed Central

    Baris, Y I; Sahin, A A; Ozesmi, M; Kerse, I; Ozen, E; Kolacan, B; Altinörs, M; Göktepeli, A

    1978-01-01

    The 575 inhabitants of the remote Anatolian village of Karain suffered 11 deaths from pleural mesothelioma in 1975/76 and there were five cases of fibrosing pleurisy. In the previous five years there had been 25 cases of mesothelioma. Calcified pleural plaques were common on survey radiography. Asbestos does not occur in the local soil or rock, nor is it handled in the village, but a few fibres were found in the water. Fibres were also found in the pleural tissue of two of five cases examined. Inhabitants of the neighbouring villages are free of mesothelioma. Images PMID:663877

  20. Calcified lesion modeling for excimer laser ablation

    NASA Astrophysics Data System (ADS)

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

    2009-06-01

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

  1. Calcifying nanoparticles associated encrusted urinary bladder cystitis

    PubMed Central

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

    2008-01-01

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

  2. Calcifying nanoparticles associated encrusted urinary bladder cystitis.

    PubMed

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

    2008-01-01

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

  3. Pleural Disorders

    MedlinePlus

    ... Pleural effusion - excess fluid in the pleural space Pneumothorax - buildup of air or gas in the pleural ... like COPD, tuberculosis, and acute lung injury, cause pneumothorax. Injury to the chest is the most common ...

  4. CT features of pleural masses and nodules.

    PubMed

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

    2012-01-01

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

  5. Pleural Disorders

    MedlinePlus

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

  6. Pleural effusion

    MedlinePlus

    ... Fluid on the lung; Pleural fluid Images Lungs Respiratory system Pleural cavity References Broaddus C, Light RW. Pleural effusion. In: Mason RJ, Broaddus CV, Martin TR, et al, eds. Textbook of Respiratory Medicine . 5th ed. Philadelphia, PA: Saunders Elsevier; 2010: ...

  7. Treatment of calcified coronary artery lesions.

    PubMed

    Farag, Mohamed; Costopoulos, Charis; Gorog, Diana A; Prasad, Abhiram; Srinivasan, Manivannan

    2016-06-01

    Heavily calcified coronary plaques represent a complex lesion subset and a challenge to the interventional cardiologist, as they are often resistant to simple plaque modification with conventional balloon angioplasty. Inadequate plaque modification can lead to stent underdeployment, which itself predisposes to in-stent restenosis and stent thrombosis. Over the years, a number of mechanical devices ranging from modified angioplasty balloons to atherectomy devices have become available in order to tackle such lesions. Here we review these devices concentrating on the evidence behind their use. PMID:26924773

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

    PubMed

    Fleury Feith, J; Jaurand, M-C

    2013-12-01

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

  9. Recurrent hydropneumothorax: An unusual presentation for malignant pleural mesothelioma.

    PubMed

    DeLapp, David; Chan, Christopher; Nystrom, Perry

    2016-01-01

    Mesothelioma is a rare pulmonary malignancy commonly associated with asbestos exposure. Its presentation is insidious and non-specific, with complaints of chest pain, dyspnea and cough. Chest X-ray may demonstrate unilateral pleural effusion. CT and PET scans may highlight nodular pleural plaques. Diagnosis often times is difficult with negative imaging and negative pleural fluid studies. In rare cases, hydropneumothoraces may be seen. We report a case of malignant pleural mesothelioma presenting as recurrent hydropneumothorax with negative CT scan of the chest for pleural abnormalities and negative pleural fluid studies. PMID:27489758

  10. Pleural tuberculosis.

    PubMed

    Chakrabarti, B; Davies, P D O

    2006-03-01

    Pleural effusions in tuberculosis are commonly seen in young adults as an immunological phenomenon occurring soon after primary infection. However, the epidemiology and demographics of tuberculous pleurisy are changing due to the impact of HIV co-infection and the increasing number of pleural effusions seen as part of re-activation disease. Pleural biopsy for histology and culture is the mainstay of diagnosis with closed needle biopsy adequate in the majority of cases. Techniques such as PCR of biopsy specimens and the role of pleural fluid ADA are still being evaluated as a diagnostic aid. Tuberculous empyema is less commonly seen in the western world and the diagnostic yield from pleural fluid here is greater than in "primary" effusions. Treatment with appropriate antituberculous chemotherapy is generally successful though there is currently insufficient evidence to recommend the routine use of corticosteroids in this condition. PMID:16700190

  11. Association between Image Characteristics on Chest CT and Severe Pleural Adhesion during Lung Cancer Surgery

    PubMed Central

    Jin, Kwang Nam; Sung, Yong Won; Oh, Se Jin; Choi, Ye Ra; Cho, Hyoun; Choi, Jae-Sung; Moon, Hyeon-Jong

    2016-01-01

    The aim of this study was to investigate the association between image characteristics on preoperative chest CT and severe pleural adhesion during surgery in lung cancer patients. We included consecutive 124 patients who underwent lung cancer surgeries. Preoperative chest CT was retrospectively reviewed to assess pleural thickening or calcification, pulmonary calcified nodules, active pulmonary inflammation, extent of emphysema, interstitial pneumonitis, and bronchiectasis in the operated thorax. The extent of pleural thickening or calcification was visually estimated and categorized into two groups: localized and diffuse. We measured total size of pulmonary calcified nodules. The extent of emphysema, interstitial pneumonitis, and bronchiectasis was also evaluated with a visual scoring system. The occurrence of severe pleural adhesion during lung cancer surgery was retrospectively investigated from the electrical medical records. We performed logistic regression analysis to determine the association of image characteristic on chest CT with severe pleural adhesion. Localized pleural thickening was found in 8 patients (6.5%), localized pleural calcification in 8 (6.5%), pulmonary calcified nodules in 28 (22.6%), and active pulmonary inflammation in 22 (17.7%). There was no patient with diffuse pleural thickening or calcification in this study. Trivial, mild, and moderate emphysema was found in 31 (25.0%), 21 (16.9%), and 12 (9.7%) patients, respectively. Severe pleural adhesion was found in 31 (25.0%) patients. The association of localized pleural thickening or calcification on CT with severe pleural adhesion was not found (P = 0.405 and 0.107, respectively). Size of pulmonary calcified nodules and extent of emphysema were significant variables in a univariate analysis (P = 0.045 and 0.005, respectively). In a multivariate analysis, moderate emphysema was significantly associated with severe pleural adhesion (odds ratio of 11.202, P = 0.001). In conclusion, severe

  12. In-Stent Restenosis Caused by a Calcified Nodule: A Novel Pattern of Neoatherosclerosis.

    PubMed

    Alfonso, Fernando; Cuesta, Javier; Bastante, Teresa; Aguilera, María Cruz; Benedicto, Amparo; Rivero, Fernando

    2016-06-01

    Neoatherosclerosis has been described as a cause of in-stent restenosis (ISR), particularly in patients treated with drug-eluting stents (DESs). Although neoatherosclerosis may present as calcified plaques, the occurrence of a "calcified nodule" within the stent has not been previously reported. We describe optical coherence tomographic findings in a patient presenting with a calcified nodule causing "undilatable" ISR 2 years after implantation of a DES. The clinical and technical implications of this novel pattern of neoatherosclerosis are discussed. PMID:26774232

  13. Isolation of calcifiable vesicles from human atherosclerotic aortas.

    PubMed

    Hsu, H H; Camacho, N P

    1999-04-01

    Advanced mineralization can cause brittleness of aortic walls with decreased elasticity thereby causing the wall to rupture. Although the precise mechanisms of dystrophic calcification remain unknown, morphological evidence reveals the presence of mineral-associated vesicles in the lesions and defective bioprosthetic valves. In an attempt to demonstrate the calcifiability of the vesicles, small segments of human atherosclerotic aortas with calcified lesions were removed at autopsy and then digested in a crude collagenase solution to release vesicles. A differential centrifugation was then used to isolate calcifiable vesicles, which was precipitated at 300,000 x g for 20 min. An exposure of the vesicles to a calcifying medium containing physiologic levels of Ca2+, Pi, and 1 mM ATP caused Ca deposition in a vesicle protein-concentration dependent manner. The calcifiability of the vesicles was further demonstrated by electron microscopy. Fourier transform spectroscopic analysis of the deposited mineral revealed the presence of a hydroxyapatite phase, closely resembling the native form of mineral in atherosclerotic plaques. In addition, calcifiable vesicles were enriched in ATP-hydrolyzing enzymes including Mg2+ or Ca2+-ATPase and NTP pyrophosphohydrolase that may be involved in normal and pathological calcification. Triton X-100 at 0.01% abolished 80% of both ATPase activity and ATP-initiated calcification. A comparison of vesicles isolated from non-atherosclerotic and atherosclerotic aortas indicated that atherosclerotic vesicles tended to have higher calcifiability. These observations suggest that the calcifiable vesicles play a part in dystrophic calcification of aortas in atherosclerosis. PMID:10217364

  14. Idiopathic calcified myocardial mass

    PubMed Central

    Patterson, David; Gibson, Derek; Gomes, Ricardo; McDonald, Lawson; Olsen, Eckhardt; Parker, John; Ross, Donald

    1974-01-01

    Patterson, D., Gibson, D., Gomes, R., McDonald, L., Olsen, E., Parker, J., and Ross, D. (1974).Thorax,29, 589-594. Idiopathic calcified myocardial mass. Myocardial calcification can be subdivided into three groups—metastatic, dystrophic or an extension inwards from the pericardium. This case in which the calcified myocardial mass was initially delineated by radiography and by echocardiography and subsequently removed does not fit into any subdivision and has been termed idiopathic. Images PMID:4279467

  15. Pleural needle biopsy

    MedlinePlus

    ... of the pleural membrane. Pleural biopsy can diagnose tuberculosis , cancer, and other diseases. If this type of ... lung cancer , malignant mesothelioma , and metastatic pleural tumor ), tuberculosis, other infections, or collagen vascular disease. Risks There ...

  16. 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 .

  17. Pleural fluid smear

    MedlinePlus

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

  18. Metastatic pleural tumor

    MedlinePlus

    ... of the chest Open pleural biopsy Pleural fluid analysis Pleural needle biopsy Removal of fluid from around ... Broaddus VC, et al., eds. Murray and Nadel's Textbook of Respiratory Medicine . 5th ed. Philadelphia, PA: Elsevier ...

  19. Pleural fluid culture

    MedlinePlus

    Culture - pleural fluid ... is used to get a sample of pleural fluid. The sample is sent to a laboratory and ... the chest wall into the pleural space. As fluid drains into a collection bottle, you may cough ...

  20. Disseminated Pleural Siliconoma Mimicking Malignant Pleural Mesothelioma.

    PubMed

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

    2015-12-01

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

  1. Multidetector CT Findings and Differential Diagnoses of Malignant Pleural Mesothelioma and Metastatic Pleural Diseases in Korea

    PubMed Central

    Kim, Yoon Kyung; Lee, Kyung Won; Yi, Chin A; Koo, Jin Mo; Jung, Soon-Hee

    2016-01-01

    Objective To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD). Materials and Methods The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque. Results Pleural thickening was the most common CT finding in MPM (96.1%) and MPD (93.8%). Circumferential pleural thickening (31.1% vs. 10.9%, odds ratio [OR] 3.670), thickening of fissural pleura (83.5% vs. 67.2%, OR 2.471), thickening of diaphragmatic pleura (90.3% vs. 73.4%, OR 3.364), pleural mass (38.8% vs. 23.4%, OR 2.074), pericardial involvement (56.3% vs. 20.3%, OR 5.056), and pleural plaque (66.0% vs. 21.9%, OR 6.939) were more frequently seen in MPM than in MPD. On the other hand, nodular pleural thickening (59.2% vs. 76.6%, OR 0.445), hilar lymph node metastasis (5.8% vs. 20.3%, OR 0.243), mediastinal lymph node metastasis (10.7% vs. 37.5%, OR 0.199), and hematogenous lung metastasis (9.7% vs. 29.2%, OR 0.261) were less frequent in MPM than in MPD. When we analyzed MPD from extrathoracic malignancy (EMPD) separately and compared them to MPM, circumferential pleural thickening, thickening of interlobar fissure, pericardial involvement and presence of pleural plaque were significant findings indicating MPM than EMPD. MPM had significantly lower occurrence of hematogenous lung metastasis, as compared with EMPD. Conclusion Awareness of frequent and infrequent CT findings could aid in distinguishing MPM from MPD. PMID:27390546

  2. Why marine phytoplankton calcify.

    PubMed

    Monteiro, Fanny M; Bach, Lennart T; Brownlee, Colin; Bown, Paul; Rickaby, Rosalind E M; Poulton, Alex J; Tyrrell, Toby; Beaufort, Luc; Dutkiewicz, Stephanie; Gibbs, Samantha; Gutowska, Magdalena A; Lee, Renee; Riebesell, Ulf; Young, Jeremy; Ridgwell, Andy

    2016-07-01

    Calcifying marine phytoplankton-coccolithophores- are some of the most successful yet enigmatic organisms in the ocean and are at risk from global change. To better understand how they will be affected, we need to know "why" coccolithophores calcify. We review coccolithophorid evolutionary history and cell biology as well as insights from recent experiments to provide a critical assessment of the costs and benefits of calcification. We conclude that calcification has high energy demands and that coccolithophores might have calcified initially to reduce grazing pressure but that additional benefits such as protection from photodamage and viral/bacterial attack further explain their high diversity and broad spectrum ecology. The cost-benefit aspect of these traits is illustrated by novel ecosystem modeling, although conclusive observations remain limited. In the future ocean, the trade-off between changing ecological and physiological costs of calcification and their benefits will ultimately decide how this important group is affected by ocean acidification and global warming. PMID:27453937

  3. Detection of Hydroxyapatite in Calcified Cardiovascular Tissues

    PubMed Central

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

    2012-01-01

    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. PMID:22877867

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

    NASA Astrophysics Data System (ADS)

    Chaisaowong, Kraisorn; Kraus, Thomas

    2014-03-01

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

  5. Influence of Cigarette Smoking on Burden and Characteristics of Coronary Artery Plaques in Chinese Men

    PubMed Central

    Sun, Yujiao; Yu, Xin; Zhi, Ying; Geng, Song; Li, Hua; Liu, Ting; Xu, Ke; Qi, Guoxian

    2015-01-01

    Background It is generally well-known that smoking has a substantial impact on general health, and cardiovascular health in particular. The purpose of this study was to analyze the effects of different smoking status on the burden and characteristics of coronary artery plaques in Chinese men. Methods Our study enrolled 1920 individuals with suspected coronary artery disease undergoing 256-detector-row computed tomography scan after clinical assessment. These study participants were stratified into three groups: never smoker, current smoker, and former smoker, according to their smoking status. Thereafter, the associations of different smoking status with the coronary artery plaques were assessed using both univariable and multivariable logistic regression. Results The prevalences of any plaque, significant stenosis and coronary artery calcium score (CACS) ≥ 10 were highest in the current smokers (all p < 0.05). The proportion of calcified plaques was the lowest and the prevalence of non-calcified plaques was the highest in current smokers (p = 0.004). The higher pack-years group had significantly elevated percentages of any plaque, significant stenosis, ≥ 2/LM vessel disease and CACS ≥ 10 than the lower pack-years group (all p < 0.001). The percent of calcified plaques was lower and the percent of non-calcified plaques was higher in the higher (> 20) pack-years group than in the lower pack-years group (≤ 20) (p = 0.024). Current smoking with higher pack-years was the independent risk factor for any plaque, significant stenosis, CACS ≥ 10, non-calcified and mixed plaques (all p < 0.05) after multivariate adjustments. Conclusions The current smokers had the most serious burden of coronary artery plaques and the highest percentage of non-calcified plaques. Current smoking with higher pack-years was a significant risk factor for coronary artery plaque burden and non-calcified and mixed plaques. PMID:27122899

  6. The clinical relevance of asbestos-induced pleural fibrosis

    SciTech Connect

    Schwartz, D.A. )

    1991-12-31

    Asbestos-induced pleural fibrosis is the most common radiographic abnormality among asbestos-exposed persons. Circumscribed pleural plaques and diffuse pleural thickening account for more than 90% of the asbestos-induced chest wall abnormalities, and their prevalence is expected to increase for the next 15 to 20 years. Several investigators have recently found that pleural plaques and diffuse pleural thickening independently contribute to the development of restrictive lung function. The work presented in this paper indicates that asbestos-induced pleural fibrosis is also associated with evidence of interstitial lung abnormalities, even among those with normal parenchyma on chest X-ray film. These parenchymal abnormalities include an increased percentage of lymphocytes on bronchoalveolar lavage and an increase in the interstitial changes observed on high-resolution chest computerized tomography (HRCT) scan. However, neither a lymphocytic alveolitis nor an interstitial parenchymal fibrosis influenced the relationship between pleural fibrosis and restrictive lung function. We conclude that asbestos-induced pleural disease contributes to the development of restrictive lung function and identify a group of exposed individuals who are at excess risk of asbestosis.

  7. Why marine phytoplankton calcify

    PubMed Central

    Monteiro, Fanny M.; Bach, Lennart T.; Brownlee, Colin; Bown, Paul; Rickaby, Rosalind E. M.; Poulton, Alex J.; Tyrrell, Toby; Beaufort, Luc; Dutkiewicz, Stephanie; Gibbs, Samantha; Gutowska, Magdalena A.; Lee, Renee; Riebesell, Ulf; Young, Jeremy; Ridgwell, Andy

    2016-01-01

    Calcifying marine phytoplankton—coccolithophores— are some of the most successful yet enigmatic organisms in the ocean and are at risk from global change. To better understand how they will be affected, we need to know “why” coccolithophores calcify. We review coccolithophorid evolutionary history and cell biology as well as insights from recent experiments to provide a critical assessment of the costs and benefits of calcification. We conclude that calcification has high energy demands and that coccolithophores might have calcified initially to reduce grazing pressure but that additional benefits such as protection from photodamage and viral/bacterial attack further explain their high diversity and broad spectrum ecology. The cost-benefit aspect of these traits is illustrated by novel ecosystem modeling, although conclusive observations remain limited. In the future ocean, the trade-off between changing ecological and physiological costs of calcification and their benefits will ultimately decide how this important group is affected by ocean acidification and global warming. PMID:27453937

  8. Clinical Investigation of Benign Asbestos Pleural Effusion

    PubMed Central

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

    2015-01-01

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

  9. Automated coronary CT angiography plaque-lumen segmentation

    NASA Astrophysics Data System (ADS)

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

    2009-02-01

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

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

    PubMed Central

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

    1987-01-01

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

  11. Open pleural biopsy

    MedlinePlus

    ... due to a virus, fungus, or parasite Mesothelioma Tuberculosis Risks There is a slight chance of: Air ... More Metastatic pleural tumor Pleural needle biopsy Pulmonary tuberculosis Tumor Update Date 11/4/2014 Updated by: ...

  12. Pleural Fluid Analysis Test

    MedlinePlus

    ... limited. Home Visit Global Sites Search Help? Pleural Fluid Analysis Share this page: Was this page helpful? Formal name: Pleural Fluid Analysis Related tests: Pericardial Fluid Analysis , Peritoneal Fluid ...

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

    PubMed Central

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

    2014-01-01

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

  14. Calcifying Fibrous Tumor

    PubMed Central

    Chorti, Angeliki; Papavramidis, Theodossis S.; Michalopoulos, Antonios

    2016-01-01

    Abstract Calcifying fibrous tumor (CFT) is a benign lesion characterized by its specific histological findings and is found as solitary or multiple lesions in several locations of the human body. The aim of the present systematic review is to give a detailed account of all reported cases of CFT in the literature and to analyze the available data, to completely characterize the entity from epidemiological, medical, and surgical aspects. A bibliographic research was performed from 1988 until 2015. A database with the patients’ characteristics was made, including sex, age, location of the tumor, symptoms, symptoms duration, size of the tumor, diagnostic methods, treatment, metastasis, and follow-up. A total of 104 articles were identified, reporting 157 cases of CFT. Mean age of patients was 33.58 years and the ratio between men and women was 1:1.27. The most common locations of CFT were stomach (18%), small intestine (8.7%), pleura (9.9%), mesentery (5%), and peritoneum (6.8%). Mean diameter of the tumor was estimated 4.6 cm. The correlations proceeded showed that as age increases, size decreases (P = 0.001) and that the tumor is larger in females (P = 0.027). Kruskal-Wallis test showed that the larger tumors appear in the neck and adrenal gland (P = 0.001). The percentage of asymptomatic patients was 30.57%. Computed tomography and biopsy were the most common tests for the diagnosis of CFT. Open surgical procedure was performed in the majority of cases. The median hospitalization was 6.06 days and the mean follow-up period was 29.97 months. Recurrences were mentioned in 10 of 96 patients with available data. No deaths owing to CFT were mentioned in the literature. CFT should be included in the differential diagnosis of enlarging mass revealed by clinical or imaging examination either incidentally or after specific acute or chronic symptomatology. PMID:27196478

  15. Metastatic pleural tumor

    MedlinePlus

    ... persons. Alternative Names Tumor - metastatic pleural Images Pleural space References Arenberg D, Pickens A. Metastatic malignant tumors. In: Mason RJ, Murray JF, Broaddus VC, et al., eds. Murray and Nadel's Textbook of Respiratory Medicine . 5th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap ...

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

    PubMed Central

    2015-01-01

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

  17. Vulnerable Plaque

    MedlinePlus

    ... all vulnerable plaque ruptures, and researchers at the Texas Heart Institute are looking at ways to determine ... comments. Terms of Use and Privacy Policy © Copyright Texas Heart Institute All rights reserved.

  18. Tuberculous pleural effusion

    PubMed Central

    Zhai, Kan; Lu, Yong

    2016-01-01

    Although it is curable, tuberculosis remains one of the most frequent causes of pleural effusions on a global scale, especially in developing countries. Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. TPE usually presents as an acute illness with fever, cough and pleuritic chest pain. The pleural fluid is an exudate that usually has predominantly lymphocytes. The gold standard for the diagnosis of TPE remains the detection of Mycobacterium tuberculosis in pleural fluid, or pleural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli, Although adenosine deaminase and interferon-γ in pleural fluid have been documented to be useful tests for the diagnosis of TPE. It can be accepted that in areas with high tuberculosis prevalence, the easiest way to establish the diagnosis of TPE in a patient with a lymphocytic pleural effusion is to generally demonstrate a adenosine deaminase level above 40 U/L. The recommended treatment for TPE is a regimen with isoniazid, rifampin, and pyrazinamide for two months followed by four months of two drugs, isoniazid and rifampin. PMID:27499981

  19. Tuberculous pleural effusion.

    PubMed

    Zhai, Kan; Lu, Yong; Shi, Huan-Zhong

    2016-07-01

    Although it is curable, tuberculosis remains one of the most frequent causes of pleural effusions on a global scale, especially in developing countries. Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. TPE usually presents as an acute illness with fever, cough and pleuritic chest pain. The pleural fluid is an exudate that usually has predominantly lymphocytes. The gold standard for the diagnosis of TPE remains the detection of Mycobacterium tuberculosis in pleural fluid, or pleural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli, Although adenosine deaminase and interferon-γ in pleural fluid have been documented to be useful tests for the diagnosis of TPE. It can be accepted that in areas with high tuberculosis prevalence, the easiest way to establish the diagnosis of TPE in a patient with a lymphocytic pleural effusion is to generally demonstrate a adenosine deaminase level above 40 U/L. The recommended treatment for TPE is a regimen with isoniazid, rifampin, and pyrazinamide for two months followed by four months of two drugs, isoniazid and rifampin. PMID:27499981

  20. Diagnostic Tools of Pleural Effusion

    PubMed Central

    2014-01-01

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

  1. Pleural fluid smear

    MedlinePlus

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

  2. Pleural fluid analysis

    MedlinePlus

    ... cleans the skin around the insertion site. Numbing medicine (anesthetic) is injected into the skin. A needle is placed through the skin and muscles of the chest wall into the pleural space. As fluid drains into a collection bottle, you ...

  3. Pleural fluid Gram stain

    MedlinePlus

    Gram stain of pleural fluid ... lungs fill a person's chest with air. If fluid builds up in the space outside the lungs ... chest, it can cause many problems. Removing the fluid can relieve a person's breathing problems and help ...

  4. CO2 vascular anastomosis of atherosclerotic and calcified arteries

    NASA Astrophysics Data System (ADS)

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

    1990-06-01

    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.

  5. Fishbowl Plaques.

    ERIC Educational Resources Information Center

    Lambert, Phyllis Gilchrist

    1998-01-01

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

  6. Cap buckling as a potential mechanism of atherosclerotic plaque vulnerability.

    PubMed

    Abdelali, Maria; Reiter, Steven; Mongrain, Rosaire; Bertrand, Michel; L'Allier, Philippe L; Kritikou, Ekaterini A; Tardif, Jean-Claude

    2014-04-01

    Plaque rupture in atherosclerosis is the primary cause of potentially deadly coronary events, yet about 40% of ruptures occur away from the plaque cap shoulders and cannot be fully explained with the current biomechanical theories. Here, cap buckling is considered as a potential destabilizing factor which increases the propensity of the atherosclerotic plaque to rupture and which may also explain plaque failure away from the cap shoulders. To investigate this phenomenon, quasistatic 2D finite element simulations are performed, considering the salient geometrical and nonlinear material properties of diverse atherosclerotic plaques over the range of physiological loads. The numerical results indicate that buckling may displace the location of the peak von Mises stresses in the deflected caps. Plaque buckling, together with its deleterious effects is further observed experimentally in plaque caps using a physical model of deformable mock coronary arteries with fibroatheroma. Moreover, an analytical approach combining quasistatic equilibrium equations with the Navier-Bresse formulas is used to demonstrate the buckling potential of a simplified arched slender cap under intraluminal pressure and supported by foundations. This analysis shows that plaque caps - calcified, fibrotic or cellular - may buckle in specific undulated shapes once submitted to critical loads. Finally, a preliminary analysis of intravascular ultrasonography recordings of patients with atherosclerotic coronary arteries corroborates the numerical, experimental and theoretical findings and shows that various plaque caps buckle in vivo. By displacing the sites of high stresses in the plaque cap, buckling may explain the atherosclerotic plaque cap rupture at various locations, including cap shoulders. PMID:24491969

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

    PubMed

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

    2016-03-01

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

  8. [Sarcoid pleural effusion].

    PubMed

    Rodríguez-Núñez, Nuria; Rábade, Carlos; Valdés, Luis

    2014-12-01

    Pleural effusion (PE) is a very uncommon manifestation of sarcoidosis. It is equally observed in men and women, can appear at any age and in all radiologic stages, though it is more common in stages i and ii. Effusions have usually a mild or medium size and mainly involve the right side. Various mechanisms can be implicated. PE will be a serous exudate if there is an increase in the capillary permeability due to direct involvement of the pleural membrane, a chylothorax if mediastinum lymph nodes compress the thoracic duct and/or the lymphatic drainage from the pleural cavity, an hemothorax if granuloma compress or invade pleural small vessels or capillaries, and even a transudate if there is compression of the inferior vena cava, atelectasis due to complete bronchial obstruction or when the resolution of the PE is incomplete with chronic thickening of visceral pleura (trapped lung). It manifests biochemically as a pauci-cellular exudate with a predominance of lymphocytes, though there can be a preponderance of eosinophils or neutrophils. Protein concentrations are usually proportionately higher than lactate dehidrogenase, adenosine deaminase is normally low and it is possible to find increased levels of CA-125 in women. The tuberculin test is negative and pleural or lung biopsies yield the diagnosis by confirming the presence of non-caseating granulomata. These PE can have a favorable self-limited outcome, even though in most cases treatment with corticosteroids is needed, while surgery is required in a few cases. PMID:24486113

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

    SciTech Connect

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

    1990-05-01

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

  10. Pleural haemangioma: A rare cause of recurrent pleural effusion

    PubMed Central

    Sindhwani, G.; Khanduri, R.; Nadia, S.; Jethani, V.

    2015-01-01

    A middle aged female presented with recurrent unilateral pleural effusion. Thoracoscopy revealed a vascular tumor in the apical region of pleural cavity arising from the chest wall. Biopsy from the tumor showed features of pleural hemangioma. She was successfully managed by surgical excision of the tumor. The case is being presented because of its rarity. PMID:27222779

  11. Pleural effusion in ARDS.

    PubMed

    Formenti, P; Umbrello, M

    2014-02-01

    Pleural effusion is a fluid collection within the pleural space and is a common finding in mechanically ventilated patients. It is frequently related to fluid overload, hyponcotic states, heart failure, and altered pleural pressure due to atelectasis or pneumonia. Recent literature has shown that its incidence within ARDS is increasing, even if, in most of cases, at least in the early phases, it seems of limited clinical relevance. Most of the knowledge of Pleural Effusion and of its interaction with lung/chest wall mechanics derives from a small number of experimental studies and from some clinical studies, in most of the cases performed with normal lung parenchyma. In ARDS, however, Pleural Effusion seems to have a little effect "per se" on tidal mechanics and oxygenation (increasing elastance and reducing PO2), that are already profoundly affected by the lung injury itself. To sum up all the observations, we can assume that Pleural Effusion alters regional transmural pressure, restricting more the inspiration phase, and creating an opening/closure effect that can be reverted by PEEP application in recruitable lungs. This restores volume and compliance only if the abdomen is normally expansible. Drainage of Pleural Effusion is frequently performed in ICU but the benefits and risks are not well established. Lung ultrasound is an effective technique with high sensitivity and specificity for both bedside diagnosis and drainage guidance. It may help to quantify and qualify the effusion and at the same time the grade of aeration of underling parenchyma. Aim of this review is to summarize the current evidence and opinions about the interaction between Pleural Effusion and positive pressure ventilation in the presence of ARDS, its impact on gas exchange and tidal mechanics, trying to figure out the best bedside management that is not available yet. The estimation of both lung and chest wall elastance may help in the clinical decision making whether to drain or not in

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

    PubMed Central

    Navaravong, Leenhapong; Steenson, Carol; Sigurdsson, Gardar

    2014-01-01

    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. PMID:25006560

  13. Pleural Fluid Cholesterol in Differentiating Exudative and Transudative Pleural Effusion

    PubMed Central

    Hamal, A. B.; Yogi, K. N.; Bam, N.; Das, S. K.; Karn, R.

    2013-01-01

    Objectives. To study the diagnostic value of pleural fluid cholesterol in differentiating transudative and exudative pleural effusion. To compare pleural fluid cholesterol level for exudates with Light's criteria. Design. Cross sectional descriptive study. Settings. Medical wards of Tribhuvan University Teaching Hospital. Methods. Sixty two cases of pleural effusion with definite clinical diagnosis admitted in TUTH were taken and classified as transudates (19) and exudates (43). The parameters pleural fluid protein/serum protein ratio (pfP/sP), pleural fluid LDH/ serum LDH ratio, pleural fluid LDH (pfLDH) and pleural fluid cholesterol (pCHOL) were compared with clinical diagnosis with regard to their usefulness for distinguishing between pleural exudates and transudates. Results. The pCHOL values determined were 1.92 ± 0.75 for exudates, 0.53 ± 0.28 for transudates, the differences between the transudates and others are statistically significant (P < 0.0001). It is seen that pfP/sP ratio has a sensitivity of 81.4% and specificity of 82.6%; pfLDH/sLDH ratio has a sensitivity of 86% and specificity of 94.7% and pCHOL with sensitivity of 97.7% and specificity of 100% for differentiating exudative and transudative PE. Conclusion. The determination of pCHOL is of great value for distinguishing between pleural exudates and transudates and should be included in routine laboratory analysis of pleural effusion. PMID:23365740

  14. Association between calcifying nanoparticles and placental calcification

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2016-03-01

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

  16. Pleural fluid culture

    MedlinePlus

    A procedure called thoracentesis is used to get a sample of pleural fluid. The sample is sent to a laboratory and examined under ... For thoracentesis, you sit on the edge of a chair or bed with your head and arms resting on ...

  17. Surgical Management of Calcified Hydatid Cysts of the Liver

    PubMed Central

    Tzardinoglou, E.; Kosmidis, Ch.; Katsohis, K.; Aletras, O.

    1999-01-01

    Hydatid disease of the liver is still a major cause of morbidity in Greece. Beside the common complications of rupture and suppuration, calcification of the hepatic cysts represent a not well studied, less frequent and sometimes difficult surgical problem. In the present study 75 cases with calcified symptomatic liver echinococcosis were operated on in the 1st Propedeutic Surgical Clinic between 1964 to 1996. Twenty-eight patients were male and 47 female with ages from 23 to 78 years. The diagnosis was based mainly on the clinical picture and radiological studies. In 5 cases the operative method was cystopericystectomy. We performed evacuation of the cystic cavity and partial pericystectomy and primary closure of the residual cavity in 6 cases, omentoplasty or filling of the residual cavity with a piece of muscle of the diaphragm in 4 cases and external drainage by closed tube, in 60 cases. In 12 of those with drainage, after a period of time, a second operation with easy, removal of most of the calcareous wall plaques was performed. The mortality rate was 2%. Our results could be considered satisfactory. In the calcified parasitic cysts of the liver the proposed technique is cystopericystectomy. An alternative procedure is pericystectomy and drainage with a “planned” reoperation with a bloodless, due to intervening inflammation, chiseling of the calcification. PMID:10468117

  18. Tuberculous pleural effusion.

    PubMed

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

    2014-10-01

    Tuberculous pleural effusion (TBPE) is the most common form of extrapulmonary tuberculosis (TB) in Spain, and is one of the most frequent causes of pleural effusion. Although the incidence has steadily declined (4.8 cases/100,000population in 2009), the percentage of TBPE remains steady with respect to the total number of TB cases (14.3%-19.3%). Almost two thirds are men, more than 60% are aged between 15-44years, and it is more common in patients with human immunodeficiency virus. The pathogenesis is usually a delayed hypersensitivity reaction. Symptoms vary depending on the population (more acute in young people and more prolonged in the elderly). The effusion is almost invariably a unilateral exudate (according to Light's criteria), more often on the right side, and the tuberculin test is negative in one third of cases. There are limitations in making a definitive diagnosis, so various pleural fluid biomarkers have been used for this. The combination of adenosine deaminase and lymphocyte percentage may be useful in this respect. Treatment is the same as for any TB. The addition of corticosteroids is not advisable, and chest drainage could help to improve symptoms more rapidly in large effusions. PMID:24721286

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

    PubMed Central

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

    2015-01-01

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

  20. Magnetic resonance of calcified tissues

    NASA Astrophysics Data System (ADS)

    Wehrli, Felix W.

    2013-04-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

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

  3. Pleurisy and Other Pleural Disorders

    MedlinePlus

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

  4. Cytology exam of pleural fluid

    MedlinePlus

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

  5. Cholelithoptysis and pleural empyema.

    PubMed

    Chopra, P; Killorn, P; Mehran, R J

    1999-07-01

    We report a case of delayed cholelithoptysis and pleural empyema caused by gallstone spillage at the time of laparoscopic cholecystecomy. An occult subphrenic abscess developed, and the patient became symptomatic only after trans-diaphragmatic penetration occurred. This resulted in expectoration of bile, gallstones, and pus. Spontaneous decompression of the empyema occurred because of a peritoneo-pleuro-bronchial fistula. This is the first case of such managed nonoperatively and provides support for the importance of intraoperative retrieval of spilled gallstones at the time of laparoscopic cholecystectomy. PMID:10421159

  6. [Malignant Pleural Mesotheliomas].

    PubMed

    Biancosino, C; Redwan, B; Krüger, M; Eberlein, M; Bölükbas, S

    2016-09-01

    Malignant pleural mesotheliomas (MPM) are very aggressive tumors, which originate from the mesothelial cells of the pleural surface. The main risk factor associated with MPM is exposure to asbestos. The latency period between asbestos exposure and MPM can be 30-60 years. Clinical symptoms and signs are often nonspecifc. The diagnosis of MPM requires an adequate tissue specimen for pathological examination, and video assisted thoracoscopic surgey (VATS) is associated with the highest diagnostic yield. MPM are histologically classified into epitheloid, sacromatoid and biphasic (mixed) sub-types. Accurate staging with invasive tests, if needed, is an important step before an interdisciplinary team can decide on an optimal (multi-modal) treatment approach. A multi-modal treatment approach (surgery, radiation oncology and chemotherapy) is superior to all approaches relying only on a single modality, if the patient qualifies for it from an oncological and functional standpoint. The goal of the surgical therapy is to achieve macroscopic complete resection. There are two competing surgical approaches and philosophies: extrapleural pneumonectomy (EPP) and radical pleurectomy (RP). Over the last years a paradigm shift from EPP to RP occurred and RP is now often the preferred surgical option. PMID:27612329

  7. Update on pleural diseases - 2007

    PubMed Central

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

    2007-01-01

    BACKGROUND: New information is available on pleural diseases. The authors selected articles to make recommendations on diagnostic and treatment aspects of pleural diseases. MATERIALS AND METHODS: Eleven articles published in the English language between 2004 and 2007 were chosen. The basis of selection of the articles was the impact on daily practice, change in prior thinking of a disease process or specific treatment modality, as well as proper design and execution of the study. 5-amino-laevulinic acid with fluorescent light combined with white light may allow further diagnostic yield in undiagnosed pleural disease. FDG-PET may allow prognostication of patients with pleural tumors. Utilizing ultrasound by trained Emergency Department physicians is a rapid and effective technique to evaluate non-traumatic pleural effusions in symptomatic patients. Serum osteopontin levels may distinguish patients exposed to asbestos with benign disease from those with pleural mesothelioma. Administration of streptokinase in patients with empyema does not need for surgical drainage, length of hospital stay, or mortality as compared to conventional treatment with chest tube drainage and intravenous antibiotics. Silver nitrate may be an alternative agent to talc for producing pleurodesis. Routine use of graded talc (50% particles greater than 25 microns) is recommended to reduce the morbidity associated with talc pleurodesis. Study design does not permit us to conclude that aspiration of spontaneous pneumothorax is as effective as chest tube drainage. Pleural catheter may prove to be an important palliative modality in treating debilitated patients or patients with trapped lung who show symptomatic improvement with drainage; however, at the present time, these catheters cannot be considered a first line treatment option for patients with malignant pleural effusion. One of the studies reviewed showed no significant difference in tract metastasis in patients with malignant mesothelioma

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

    NASA Astrophysics Data System (ADS)

    Wakaki, Moriaki; Yazaki, Syungo; Sunada, Yoshikazu

    2009-02-01

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

  9. Malignant Pleural Mesothelioma

    PubMed Central

    Tsao, Anne S.; Wistuba, Ignacio; Roth, Jack A.; Kindler, Hedy Lee

    2009-01-01

    Malignant pleural mesothelioma (MPM) is a deadly disease that occurs in 2,000 to 3,000 people each year in the United States. Although MPM is an extremely difficult disease to treat, with the median overall survival ranging between 9 and 17 months regardless of stage, there has been significant progress over the last few years that has reshaped the clinical landscape. This article will provide a comprehensive discussion of the latest developments in the treatment of MPM. We will provide an update of the major clinical trials that impact mesothelioma treatment in the resectable and unresectable settings, discuss the impact of novel therapeutics, and provide perspective on where the clinical research in mesothelioma is moving. In addition, there are controversial issues, such as the role of extrapleural pneumonectomy, adjuvant radiotherapy, and use of intensity-modulated radiotherapy versus hemithoracic therapy that will also be addressed in this manuscript. PMID:19255316

  10. Pleural mesothelial cells in pleural and lung diseases

    PubMed Central

    Antony, Veena B.

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  12. 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

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

    2013-12-01

    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

  13. DECT evaluation of noncalcified coronary artery plaque

    SciTech Connect

    Ravanfar Haghighi, Rezvan; Chatterjee, S.; Tabin, Milo; Singh, Rishi P.; Sharma, Munish; Krishna, Karthik; Sharma, Sanjiv; Jagia, Priya; Ray, Ruma; Arava, Sudhir; Yadav, Rakesh; Vani, V. C.; Lakshmi, R.; Kumar, Pratik; Mandal, Susama R.

    2015-10-15

    Purpose: Composition of the coronary artery plaque is known to have critical role in heart attack. While calcified plaque can easily be diagnosed by conventional CT, it fails to distinguish between fibrous and lipid rich plaques. In the present paper, the authors discuss the experimental techniques and obtain a numerical algorithm by which the electron density (ρ{sub e}) and the effective atomic number (Z{sub eff}) can be obtained from the dual energy computed tomography (DECT) data. The idea is to use this inversion method to characterize and distinguish between the lipid and fibrous coronary artery plaques. Methods: For the purpose of calibration of the CT machine, the authors prepare aqueous samples whose calculated values of (ρ{sub e}, Z{sub eff}) lie in the range of (2.65 × 10{sup 23} ≤ ρ{sub e} ≤ 3.64 × 10{sup 23}/cm{sup 3}) and (6.80 ≤ Z{sub eff} ≤ 8.90). The authors fill the phantom with these known samples and experimentally determine HU(V{sub 1}) and HU(V{sub 2}), with V{sub 1},V{sub 2} = 100 and 140 kVp, for the same pixels and thus determine the coefficients of inversion that allow us to determine (ρ{sub e}, Z{sub eff}) from the DECT data. The HU(100) and HU(140) for the coronary artery plaque are obtained by filling the channel of the coronary artery with a viscous solution of methyl cellulose in water, containing 2% contrast. These (ρ{sub e}, Z{sub eff}) values of the coronary artery plaque are used for their characterization on the basis of theoretical models of atomic compositions of the plaque materials. These results are compared with histopathological report. Results: The authors find that the calibration gives ρ{sub e} with an accuracy of ±3.5% while Z{sub eff} is found within ±1% of the actual value, the confidence being 95%. The HU(100) and HU(140) are found to be considerably different for the same plaque at the same position and there is a linear trend between these two HU values. It is noted that pure lipid type plaques

  14. Pleural malignancies including mesothelioma.

    PubMed

    Hillerdal, G

    1995-07-01

    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

  15. From vulnerable plaque to atherothrombosis.

    PubMed

    Thim, T; Hagensen, M K; Bentzon, J F; Falk, E

    2008-05-01

    Plaque rupture precipitates approximately 75% of all fatal coronary thrombi. Therefore, the plaque prone to rupture is the primary focus of this review. The lipid-rich core and fibrous cap are pivotal in the understanding of plaque rupture. Plaque rupture is a localized process within the plaque caused by degradation of a tiny fibrous cap rather than by diffuse inflammation of the plaque. Atherosclerosis is a multifocal disease, but plaques prone to rupture seem to be oligofocal at most. PMID:18410594

  16. Differential associations between blood biomarkers of inflammation, oxidation, and lipid metabolism with varying forms of coronary atherosclerotic plaque as quantified by coronary CT angiography

    PubMed Central

    Truong, Quynh A.; Koenig, Wolfgang; Schlett, Christopher L.; Nasir, Khurram; Butler, Javed; Kurtz, Emily; Nikolaou, Konstantin; Hoffmann, Udo; Januzzi, James L.

    2011-01-01

    Although epidemiologic data link biomarkers of cardiovascular risk with incident and prevalent coronary artery disease, exact anatomic relationships between biomarkers and coronary atherosclerosis as measured by coronary CT angiography remain unclear. Patients with acute chest pain who ultimately had no evidence of acute coronary syndrome underwent contrast-enhanced 64-slice coronary CT angiography to determine presence, extent and composition of coronary atherosclerotic plaque. We determined the differences in levels of blood biomarkers measured at the time of the CT scan between different CT-based atherosclerotic plaque groups. Among 313 patients (mean age: 51.6 ± 11 years, 62% male) high-sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase-2 were associated with the extent of calcified plaque (P = 0.03 and P<0.001), while hs-CRP and apolipoprotein A1 were associated with the extent of non-calcified plaque (P = 0.03 and P = 0.004; respectively). Despite a generally lower risk profile, subjects with exclusively non-calcified plaque had significantly higher levels of hs-CRP and oxidized low-density lipoprotein (P = 0.01 and P = 0.03; respectively) and lower levels of adiponectin (P = 0.03) when compared to subjects with calcified plaque (n = 130, 42%). Biomarkers reflecting inflammation, vascular remodeling, oxidation, and lipoprotein metabolism maybe associated with different patterns of coronary atherosclerosis as quantified by coronary CT angiography. PMID:21222039

  17. Pleural effusion presenting as mediastinal widening

    PubMed Central

    Mohapatra, Prasanta R.; Garg, Kranti; Prashanth, Chikkahonnaiah; Lahoria, Rupali

    2013-01-01

    We report a case of middle-aged female presenting with mediastinal widening on chest radiograph owing to pleural effusion. The pleural effusion presenting as mediastinal widening on chest radiograph is rarely reported. PMID:24339499

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

    NASA Astrophysics Data System (ADS)

    Karimi, Alireza; Navidbakhsh, Mahdi; Razaghi, Reza

    2014-07-01

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

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

    PubMed Central

    Nakano, Tomoyuki; Tetsuka, Kenji; Fukushima, Noriyoshi

    2016-01-01

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

  20. Hemorrhagic sarcoid pleural effusion: A rare entity

    PubMed Central

    Jha, Onkar; Nair, Vidya; Talwar, Deepak

    2016-01-01

    Involvement of pleura by sarcoidosis remains a rare manifestation and varies from pleural effusion, pneumothorax, pleural thickening, hydropneumothorax, trapped lung, hemothorax, or chylothorax. Sarcoid pleural effusions presenting as hemorrhagic effusions are even more rare. We report a case of active pulmonary sarcoidosis presenting as hemorrhagic pleural effusion requiring tissue diagnosis to rule out malignancy. The rarity of the presentation prompted us to report this case.

  1. Hemorrhagic sarcoid pleural effusion: A rare entity.

    PubMed

    Jha, Onkar; Nair, Vidya; Talwar, Deepak

    2016-01-01

    Involvement of pleura by sarcoidosis remains a rare manifestation and varies from pleural effusion, pneumothorax, pleural thickening, hydropneumothorax, trapped lung, hemothorax, or chylothorax. Sarcoid pleural effusions presenting as hemorrhagic effusions are even more rare. We report a case of active pulmonary sarcoidosis presenting as hemorrhagic pleural effusion requiring tissue diagnosis to rule out malignancy. The rarity of the presentation prompted us to report this case. PMID:27625449

  2. Pleural effusion: what lies underneath?

    PubMed

    Rodrigues, L Vaz; Raposo, J; Mendonça, C; Figueiredo, A; Barata, F; Meruje, M; Pires, J

    2009-01-01

    Malignant mesothelioma is a tumour of serous surfaces mainly arising at the pleura or the peritoneum. The diagnosis encompasses multiple problems as there is no pathognomonic hallmark for the disease, there are multiple histological types and the differentiation from other tumours, such as adenocarcinoma or metastatic pleural disease, can represent quite a challenge. Usually a diagnosis of malignant mesothelioma carries a dismal prognosis with scarce therapeutical options.The present report concerns a patient with a diagnosis of malignant pleural mesothelioma with endobronchial extension. Biopsy specimens were obtained through fibreoptic bronchoscopy and blind needle pleural biopsy. The final diagnosis was only possible after careful histological evaluation with a combination of immunohistochemical markers. PMID:21686530

  3. Pleural controversies: indwelling pleural catheter vs. pleurodesis for malignant pleural effusions

    PubMed Central

    Fortin, Marc

    2015-01-01

    Malignant pleural effusions (MPE) are frequent consequences of malignant disease and significantly impair the quality of life (QoL) of patients. There are two main options for the palliation of MPE-related symptoms: obliterating the pleural space by pleurodesis to prevent further fluid reaccumulation, or chronically draining the pleural fluid with an indwelling pleural catheter (IPC). There is controversy as to which approach is superior each having advantages and drawbacks. Pleurodesis offers a higher chance of rapid resolution of the pleural effusion with an intervention that is time limited but at the expense of a more invasive procedure, the need for a hospital stay and a higher need for repeat procedures. IPC offers an outpatient solution which is less invasive but at the cost of prolonged catheter drainages and care in a significant portion of patients who will not achieve pleurodesis. Impact on QoL, symptom relief and costs do not appear to be significantly different between the two options. Treatment of MPE should be tailored to the patient’s functional status, comorbidities, prognosis and personal preferences as well as local expertise. Hybrid approaches using pleurodesis techniques and IPC concomitantly may come into play in the near future to further improve patient care. PMID:26150918

  4. A review of a pleural service.

    PubMed

    Aujayeb, A; Parker, S; Bourke, S; Miller, J; Cooper, D

    2016-12-01

    This paper reviews the organisation and outcomes of a pleural service, specifically geared towards the management of malignant pleural effusions, in a district general hospital in the north east of England. We summarise the evidence behind local anaesthetic thoracoscopy and indwelling pleural catheters. We then summarise the review of our service, including a discussion around complications. PMID:27092367

  5. Primary malignant myelomatous pleural effusion.

    PubMed

    Mangla, Ankit; Agarwal, Nikki; Kim, George J; Catchatourian, Rosalind

    2016-08-01

    Primary malignant myelomatous pleural effusion (PMMPE) occurs in less than 1% of patients with multiple myeloma and is diagnosed either by visualization of plasma cells on cytology or by positive flow cytometry. The presence of immature plasma cells characterized by high nucleus to cytoplasm ratio, visible nucleolus and presence of Mott cells and Russell bodies are independent poor prognostic factors. The clinician should differentiate PMMPE from secondary pleural effusion as it is associated with a significantly worse prognosis and poor overall survival. PMID:27525090

  6. Ex vivo identification of atherosclerotic plaque calcification by a 31P solid-state magnetic resonance imaging technique.

    PubMed

    Hallock, Kevin J; Hamilton, James A

    2006-12-01

    Calcified tissue is a common component of atherosclerotic plaques, and occurs most often in mature plaques. The process of calcification is a poorly understood risk factor that may contribute to a plaque's vulnerability to sudden rupture. In this study a solid-state imaging sequence, termed single-point imaging (SPI), was used to observe calcification directly in ex vivo atherosclerotic plaques. Standards were used to validate the ability of (31)P SPI to detect and differentiate calcification from crystalline cholesterol, phospholipids, and other plaque components. After suitable experimental parameters were found, human carotid specimens obtained by endarterectomy were imaged ex vivo by (31)P solid-state imaging and standard (1)H methods. In contrast to (1)H imaging methods, (31)P imaging detected only the calcification in the plaque. PMID:17089379

  7. Comparative LIBS Analysis Of Calcified Tissues

    SciTech Connect

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

    2008-09-23

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

  8. Calcifying aponeurotic fibroma in a dog.

    PubMed

    Zaki, F A; Liu, S K; Kay, W J

    1975-02-15

    A calcifying aponeurotic fibroma involving the soft tissue and bone of the occipital area compressed and attenuated the cerebellum and brainstem of a 9-year-old female dog of mixed breeding. Clinical signs included a head tilt to the left; gait ataxia; anisocoria, with a midly dilated left pupil; horizontal nystagmus, with the fast phase to the right; and a mild depression of the level of consciousness. The signs were sequential and progressive. PMID:1116957

  9. Cytology exam of pleural fluid

    MedlinePlus

    ... of skin on your back is cleaned. Numbing medicine (local anesthetic) is injected in this area. The doctor inserts a needle through the skin and muscles of the chest wall into the pleural space. Fluid is collected. The needle is removed. A ...

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

    PubMed

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

    2016-04-01

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

  11. Calcifying cystic odontogenic tumor radiographically mimicking a sinus mucocele.

    PubMed

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

    2013-03-01

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

  12. Treatment of complicated parapneumonic pleural effusion and pleural parapneumonic empyema

    PubMed Central

    Suárez, Pedro Rodríguez; Gilart, Jorge Freixinet; Pérez, José María Hernández; Serhal, Mohamed Hussein; Artalejo, Antonio López

    2012-01-01

    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), χ 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. PMID:22739734

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

    PubMed Central

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

    2015-01-01

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

  14. Numerical observer for atherosclerotic plaque classification in spectral computed tomography.

    PubMed

    Lorsakul, Auranuch; Fakhri, Georges El; Worstell, William; Ouyang, Jinsong; Rakvongthai, Yothin; Laine, Andrew F; Li, Quanzheng

    2016-07-01

    carotid-atherosclerosis patient were used to validate our methods. We used an extended cardiac-torso anthropomorphic digital phantom and three simulated plaque types (i.e., calcified plaque, fatty-mixed plaque, and iodine-mixed blood). The images were reconstructed using a standard filtered backprojection (FBP) algorithm for all the acquisition methods and were applied to perform two different discrimination tasks of: (1) calcified plaque versus fatty-mixed plaque and (2) calcified plaque versus iodine-mixed blood. MECT outperformed DECT and conventional CT systems for all cases of the SKE/BKE and SKS/BKE tasks (all [Formula: see text]). On average of signal variability, MECT yielded the SNR improvements over other acquisition methods in the range of 46.8% to 65.3% (all [Formula: see text]) for FBP-Ramp images and 53.2% to 67.7% (all [Formula: see text]) for FBP-Hanning images for both identification tasks. This proposed numerical observer combined with our signal variability framework is promising for assessing material characterization obtained through the additional energy-dependent attenuation information of SCT. These methods can be further extended to other clinical tasks such as kidney or urinary stone identification applications. PMID:27429999

  15. Imaging unstable plaque.

    PubMed

    Sriranjan, Rouchelle S; Tarkin, Jason M; Evans, Nicholas R; Chowdhury, Mohammed M; Rudd, James H

    2016-09-01

    Recent advances in imaging technology have enabled us to utilise a range of diagnostic approaches to better characterise high-risk atherosclerotic plaque. The aim of this article is to review current and emerging techniques used to detect and quantify unstable plaque in the context of large and small arterial systems and will focus on both invasive and non-invasive imaging techniques. While the diagnosis of clinically relevant atherosclerosis still relies heavily on anatomical assessment of arterial luminal stenosis, evolving multimodal cross-sectional imaging techniques that encompass novel molecular probes can provide added information with regard to plaque composition and overall disease burden. Novel molecular probes currently being developed to track precursors of plaque rupture such as inflammation, micro-calcification, hypoxia and neoangiogenesis are likely to have translational applications beyond diagnostics and have the potential to play a part in quantifying early responses to therapeutic interventions and more accurate cardiovascular risk stratification. PMID:27273430

  16. Calcifying species sensitivity distributions for ocean acidification.

    PubMed

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

    2015-02-01

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

  17. Pleural calcification in northwest Greece

    SciTech Connect

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

    1985-12-01

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

  18. How Are Pleurisy and Other Pleural Disorders Diagnosed?

    MedlinePlus

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

  19. Advanced medical interventions in pleural disease.

    PubMed

    Bhatnagar, Rahul; Corcoran, John P; Maldonado, Fabien; Feller-Kopman, David; Janssen, Julius; Astoul, Philippe; Rahman, Najib M

    2016-06-01

    The burden of a number of pleural diseases continues to increase internationally. Although many pleural procedures have historically been the domain of interventional radiologists or thoracic surgeons, in recent years, there has been a marked expansion in the techniques available to the pulmonologist. This has been due in part to both technological advancements and a greater recognition that pleural disease is an important subspecialty of respiratory medicine. This article summarises the important literature relating to a number of advanced pleural interventions, including medical thoracoscopy, the insertion and use of indwelling pleural catheters, pleural manometry, point-of-care thoracic ultrasound, and image-guided closed pleural biopsy. We also aim to inform the reader regarding the latest updates to more established procedures such as chemical pleurodesis, thoracentesis and the management of chest drains, drawing on contemporary data from recent randomised trials. Finally, we shall look to explore the challenges faced by those practicing pleural medicine, especially relating to training, as well as possible future directions for the use and expansion of advanced medical interventions in pleural disease. PMID:27246597

  20. Clinical Importance of Echogenic Swirling Pleural Effusions.

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    2016-01-01

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

  3. Coronary Plaque Characteristics Assessed by 256-Slice Coronary CT Angiography and Association with High-Sensitivity C-Reactive Protein in Symptomatic Patients with Type 2 Diabetes.

    PubMed

    Zhang, Jinling; Lv, Zhehao; Zhao, Deli; Liu, Lili; Wan, Yong; Fan, Tingting; Li, Huimin; Guan, Ying; Liu, Bailu; Yang, Qi

    2016-01-01

    Little is known regarding plaque distribution, composition, and the association with inflammation in type 2 diabetes mellitus (DM2). This study aimed to assess the relationship between coronary plaque subtypes and high-sensitivity C-reactive protein levels. Coronary CTA were performed in 98 symptomatic DM2 patients and 107 non-DM2 patients using a 256-slice CT. The extent and types of plaque as well as luminal narrowing were evaluated. Patients with DM2 were more likely to have significant stenosis (>50%) with calcified plaques in at least one coronary segment (p < 0.01); the prevalence rates of diffuse calcified plaques in the DM2 and non-DM2 groups were 31.6% and 4.7%, respectively (p < 0.01). Plasma hs-CRP levels in DM2 with calcified plaques were higher compared with values obtained for the non-DM2 group (p < 0.01). In conclusion, combination of coronary CTA and hs-CRP might improve risk stratification in symptomatic DM2 patients. PMID:27579325

  4. Coronary Plaque Characteristics Assessed by 256-Slice Coronary CT Angiography and Association with High-Sensitivity C-Reactive Protein in Symptomatic Patients with Type 2 Diabetes

    PubMed Central

    Zhang, Jinling; Lv, Zhehao; Zhao, Deli; Liu, Lili; Wan, Yong; Fan, Tingting; Li, Huimin; Guan, Ying; Liu, Bailu

    2016-01-01

    Little is known regarding plaque distribution, composition, and the association with inflammation in type 2 diabetes mellitus (DM2). This study aimed to assess the relationship between coronary plaque subtypes and high-sensitivity C-reactive protein levels. Coronary CTA were performed in 98 symptomatic DM2 patients and 107 non-DM2 patients using a 256-slice CT. The extent and types of plaque as well as luminal narrowing were evaluated. Patients with DM2 were more likely to have significant stenosis (>50%) with calcified plaques in at least one coronary segment (p < 0.01); the prevalence rates of diffuse calcified plaques in the DM2 and non-DM2 groups were 31.6% and 4.7%, respectively (p < 0.01). Plasma hs-CRP levels in DM2 with calcified plaques were higher compared with values obtained for the non-DM2 group (p < 0.01). In conclusion, combination of coronary CTA and hs-CRP might improve risk stratification in symptomatic DM2 patients. PMID:27579325

  5. Comparison by optical coherence tomography of the frequency of lipid coronary plaques in current smokers, former smokers, and nonsmokers.

    PubMed

    Abtahian, Farhad; Yonetsu, Taishi; Kato, Koji; Jia, Haibo; Vergallo, Rocco; Tian, Jinwei; Hu, Sining; McNulty, Iris; Lee, Hang; Yu, Bo; Jang, Ik-Kyung

    2014-09-01

    Smoking is associated with high incidence of cardiovascular events including acute coronary syndrome. We sought to characterize coronary plaques in patients with ongoing smoking using optical coherence tomography (OCT) compared with former smokers and nonsmokers. We identified 465 coronary plaques from 182 subjects who underwent OCT imaging for all 3 coronary arteries. Subjects were divided into 3 groups: current smokers (n = 41), former smokers (n = 67), and nonsmokers (n = 74). OCT analysis included the presence of lipid-rich plaque, thin-cap fibroatheroma (TCFA), calcification, maximum lipid arc, lipid core length, lipid index, and fibrous cap thickness. Lipid index was defined by mean lipid arc multiplied by lipid core length. Compared with former smokers and nonsmokers, the incidence of lipid plaques and TCFA was significantly higher in current smokers (lipid plaques: 68.0% vs 45.9% and 52.6%, p = 0.002; TCFA: 18.4% vs 7.6% and 9.9%, p = 0.018). There was a trend for higher plaque disruption in current smokers. Former smokers were more likely to have calcified plaques than current and nonsmokers (52.9% vs 32.0% and 38.0%, p = 0.001). In a multivariate analysis, current smoking, low-density lipoprotein, and presentation with acute coronary syndrome were independently associated with the presence of TCFAs. In conclusion, current smokers are more likely to have lipid plaques and OCT-defined vulnerable plaques (TCFAs). Former smokers have increased number of calcified plaques. These results may explain the increased risk of acute cardiac events among smokers. PMID:25048344

  6. [ANALYSIS OF MICROFLORA OF PLEURAL CAVITY IN PLEURAL EMPYEMA].

    PubMed

    Chubar, I V

    2016-04-01

    In the pleural empyema (PE) treatment, not depending on introduction of multiple operative procedures and the medicinal preparations application, some issues remain unsolved, including the infection agents verification, the most rapid bronchial fistula elimination and the lung volume restoration. The EP infection agents spectrum, their sensitivity to preparations were revealed, as well as the enhanced rate of the methicillin-resistant stamms (MRSA) and the microorganisms associations verification. A reduction of the infection agents sensitivity towards "simple" antibacterial preparations was established, so the physicians, treating PE, must prescribe "hard" antibiotics, what enhances its cost. PMID:27434955

  7. TGF-beta 1 and 25-hydroxycholesterol stimulate osteoblast-like vascular cells to calcify.

    PubMed Central

    Watson, K E; Boström, K; Ravindranath, R; Lam, T; Norton, B; Demer, L L

    1994-01-01

    Previous studies in our laboratory demonstrated messenger RNA for bone morphogenetic protein-2a in human calcified plaque, suggesting that arterial calcification is a regulated process, similar to osteogenesis. To further test this hypothesis, we have isolated and cloned a subpopulation of cells from bovine aortic media that show osteoblastic potential. These novel cells are primarily distinguished from smooth muscle cells by expression of a surface marker preliminarily identified as a modified form of the ganglioside sialyl-lactosylceramide (GM3). Osteoblastic potential was indicated by high levels of alkaline phosphatase and collagen I, expression of osteopontin and osteonectin (SPARC), and production of bone-specific osteocalcin and hydroxyapatite. Cultures of these cells were stimulated to form increased numbers of calcium-mineral-producing nodules by the oxysterol 25-hydroxycholesterol as well as by transforming growth factor-beta 1, both known to be present in atherosclerotic lesions. The stimulation of calcifying vascular cells in the artery wall by these two factors suggests a possible mechanism for the colocalization of calcification with atherosclerosis in vivo. Images PMID:8182141

  8. Plaque, plaque model systems and pH.

    PubMed

    Sissons, C

    1998-06-01

    Four interlocking lines of research carried out during the Directorship of Dr TW Cutress in the Dental Research Unit were: plaque urea metabolism, which led to the study of plaque pH responses and their control; development of plaque-like biofilm model systems; plaque mineralisation to calculus; and plaque demineralisation of tooth tissue in caries. New modes of regulation of oral bacterial urea metabolism and its role in the mouth were discovered, especially a role as a pH-rise factor and in mineralisation processes. The development of microcosm plaques, consortia of major plaque species, and of the multi-plaque artificial mouth with the ability to measure pH continuously, has substantiated the theory that plaque thickness and fluid flow are important in determining plaque pH. For the first time, formation of large pH gradients inside plaque have been demonstrated and plaque pH experimentally controlled. Plaque growth curves can be accurately measured and procedures established for measuring antiplaque and anticaries agents. These studies exemplify the value of the fundamental approach adopted by Dr Cutress--that integrated, basic, applied, and public-health lines of research reinforce each other. PMID:9676473

  9. Assessment of carotid plaque neovascularization by contrast-enhanced ultrasound and high sensitivity C-reactive protein test in patients with acute cerebral infarction: a comparative study.

    PubMed

    Xu, Rong; Yin, Xiaohua; Xu, Weixin; Jin, Lin; Lu, Min; Wang, Yingchun

    2016-07-01

    Vulnerable carotid plaque easily ruptures and causes cerebral infarction. Plaque inflammation and neovascularization have both been shown as important characteristics in vulnerable plaque. We assessed neovascularization within carotid plaque using contrast-enhanced ultrasound, and also assessed inflammation, using high sensitivity C-reactive protein (hs-CRP) testing, in acute cerebral infarction patients. A total of 106 patients with acute cerebral infarction and 40 controls were enrolled in the study. All subjects had been previously found to have carotid atherosclerotic plaques, and the plaques were classified as soft plaque, hard plaque, mixed plaque, and calcified plaque, using carotid artery ultrasound. Contrast-enhanced ultrasound was performed on the plaques for quantitative analysis and hs-CRP levels were measured. The results showed that plaque enhancement was present in 81.1 % of cerebral infarction patients and 40.0 % of controls. The contrast parameters for cerebral infarction patients were significantly different from controls. For cerebral infarction patients, soft plaque showed the highest enhanced percentage, 95.1 %, with contrast parameters significantly different to other types of plaque. The hs-CRP levels of enhanced cerebral infarction patients were higher than in non-enhanced patients. Correlation analysis in cerebral infarction patients showed that hs-CRP levels were closely related to the contrast parameters. Acute cerebral infarction patients showed intense contrast enhancement and inflammation in carotid plaque, and different types of plaque had various degrees of enhancement, suggesting that contrast-enhanced ultrasound and hs-CRP might be used for plaque risk stratification. PMID:27021564

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

    PubMed

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

    2016-04-01

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

  11. Activation of calpain by renin-angiotensin system in pleural mesothelial cells mediates tuberculous pleural fibrosis

    PubMed Central

    Yang, Jie; Xiang, Fei; Cai, Peng-Cheng; Lu, Yu-Zhi; Xu, Xiao-Xiao; Yu, Fan; Li, Feng-Zhi; Greer, Peter A.; Shi, Huan-Zhong; Zhou, Qiong; Xin, Jian-Bao; Ye, Hong; Su, Yunchao

    2016-01-01

    Pleural fibrosis is defined as an excessive deposition of extracellular matrix (ECM) components that results in destruction of the normal pleural tissue architecture. It can result from diverse inflammatory conditions, especially tuberculous pleurisy. Pleural mesothelial cells (PMCs) play a pivotal role in pleural fibrosis. Calpain is a family of calcium-dependent endopeptidases, which plays an important role in ECM remodeling. However, the role of calpain in pleural fibrosis remains unknown. In the present study, we found that tuberculous pleural effusion (TPE) induced calpain activation in PMCs and that inhibition of calpain prevented TPE-induced collagen-I synthesis and cell proliferation of PMCs. Moreover, our data revealed that the levels of angiotensin (ANG)-converting enzyme (ACE) were significantly higher in pleural fluid of patients with TPE than those with malignant pleural effusion, and ACE-ANG II in TPE resulted in activation of calpain and subsequent triggering of the phosphatidylinositol 3-kinase (PI3K)/Akt/NF-κB signaling pathway in PMCs. Finally, calpain activation in PMCs and collagen depositions were confirmed in pleural biopsy specimens from patients with tuberculous pleurisy. Together, these studies demonstrated that calpain is activated by renin-angiotensin system in pleural fibrosis and mediates TPE-induced collagen-I synthesis and proliferation of PMCs via the PI3K/Akt/NF-κB signaling pathway. Calpain in PMCs might be a novel target for intervention in tuberculous pleural fibrosis. PMID:27261452

  12. Pleural fluid procalcitonin to distinguish infectious from noninfectious etiologies of pleural effusions.

    PubMed

    Khosla, Rahul; Khosla, Shikha G; Becker, Kenneth L; Nylen, Eric S

    2016-05-01

    In this study we investigate the diagnostic value of pleural fluid procalcitonin (PCT) in distinguishing infectious and noninfectious etiologies of pleural effusion. We reviewed the medical records of 75 hospitalized patients who underwent thoracentesis between 2011 and 2012. Data on pleural fluid lactate dehydrogenase (LDH), protein, albumin, cell count and differential, pH, Gram stain and culture, cytology, triglyceride, cholesterol, amylase, and PCT were collected. Data on serum LDH, protein, albumin, prothrombin time, normalized, and blood culture were also collected. Pleural effusions were classified into 2 groups, infectious and noninfectious. There were 18 infectious pleural effusions (IPE) and 57 noninfectious pleural effusions (NIPE). Median pleural fluid PCT was 1.088 ng/mL (0.312-2.940 ng/mL) in IPE and 0.123 ng/mL (0.05-0.263 ng/mL) in NIPE, with a P value < 0.0001. Pleural fluid PCT > 0.25 ng/mL had a sensitivity of 77.78% and specificity of 74.14% for diagnosing an IPE. A subgroup analysis of PCT in exudative infectious effusions versus exudative noninfectious malignant/paramalignant effusions showed higher levels in the former. PCT is a novel biomarker for diagnosing infectious pleural effusion, and it would be worthwhile to investigate the role of pleural PCT in assessing severity of illness, risk stratification, and antibiotic stewardship in hospitalized patients with pleural effusions. Journal of Hospital Medicine 2016;11:363-365. 2016 Society of Hospital Medicine. PMID:26821368

  13. Activation of calpain by renin-angiotensin system in pleural mesothelial cells mediates tuberculous pleural fibrosis.

    PubMed

    Yang, Jie; Xiang, Fei; Cai, Peng-Cheng; Lu, Yu-Zhi; Xu, Xiao-Xiao; Yu, Fan; Li, Feng-Zhi; Greer, Peter A; Shi, Huan-Zhong; Zhou, Qiong; Xin, Jian-Bao; Ye, Hong; Su, Yunchao; Ma, Wan-Li

    2016-07-01

    Pleural fibrosis is defined as an excessive deposition of extracellular matrix (ECM) components that results in destruction of the normal pleural tissue architecture. It can result from diverse inflammatory conditions, especially tuberculous pleurisy. Pleural mesothelial cells (PMCs) play a pivotal role in pleural fibrosis. Calpain is a family of calcium-dependent endopeptidases, which plays an important role in ECM remodeling. However, the role of calpain in pleural fibrosis remains unknown. In the present study, we found that tuberculous pleural effusion (TPE) induced calpain activation in PMCs and that inhibition of calpain prevented TPE-induced collagen-I synthesis and cell proliferation of PMCs. Moreover, our data revealed that the levels of angiotensin (ANG)-converting enzyme (ACE) were significantly higher in pleural fluid of patients with TPE than those with malignant pleural effusion, and ACE-ANG II in TPE resulted in activation of calpain and subsequent triggering of the phosphatidylinositol 3-kinase (PI3K)/Akt/NF-κB signaling pathway in PMCs. Finally, calpain activation in PMCs and collagen depositions were confirmed in pleural biopsy specimens from patients with tuberculous pleurisy. Together, these studies demonstrated that calpain is activated by renin-angiotensin system in pleural fibrosis and mediates TPE-induced collagen-I synthesis and proliferation of PMCs via the PI3K/Akt/NF-κB signaling pathway. Calpain in PMCs might be a novel target for intervention in tuberculous pleural fibrosis. PMID:27261452

  14. [Drug induced eosinophilic pleural effusion].

    PubMed

    Vasilescu, Raluca

    2014-01-01

    The hypersensitivity reactions induced by drugs, some widely used, like central nervous system medication, can have various presentations. The lung is a frequent target for such events. We present the case of 40-year-old male patient, non-smoker, with infant encephalopaty, seizures since age of 6 with polimorphic crisis (mainly absences), with anticonvulsivant treatment since 2011 (carbamazepine, sodium valproate, levetiracetam), with no respiratory medical history. Current symptoms started two weeks before, with chest pain, dry cough. He received no antibiotics. Chest X-ray and thoracic CT scan (27 June 2013) showed a left pleral effusion. Left exploratory thoracocentesis extracted 20 ml reddish pleural fluid: eosinophilic exsudate (60%) with normal adenosin deaminase. He also presents moderate blood eosinophilia (13.7%-1780/mm3). Pulmonary infarction with secondary pleurisy, thoracic trauma, acute pancreatitis with secondary pleurisy were excluded. No Loeffler transient infiltrates were documented, serology for Toxocara is IgG positive (historical) and not significant for current episode, no symptoms suggestive for toxocarosis (characteristic to young children, patient had no liver enlargement etc.), no hidatidosis or trichinelosis were found. As an exclusion diagnosis, a hypersensitivity reaction to anticonvulsivant medication was considered (mentioned in literature) carbamazepine and sodium valproate (even if medication was taken for a longer time), with blood and pleural eosinophilia. Together with the neurologist, the mentioned drugs were stopped and he was started on lamotrigine 2 tb/day and levetiracetam 1 tb/day, well tolerated, no absences were noticed. Total remission of blood eosinophilia and partial remission of pleural effusion were noticed. Subsequent follow-ups confirm favourable evolution, with healing of pleurisy and normal blood cell count, which are stable at 7 months after changing anticonvulsivant treatment. PMID:25241560

  15. Malignant pleural effusions in lymphoproliferative disorders.

    PubMed

    Ahmed, Shahid; Shahid, Rabia K; Rimawi, Rola; Siddiqui, Anita K; Rossoff, Leonard; Sison, Cristina P; Steinberg, Harry; Rai, Kanti R

    2005-07-01

    In order to determine variables that correlate with malignant pleural effusion and mortality in patients with lymphoproliferative disorders and pleural effusion, a retrospective study was performed. Clinical data of hospitalized patients with a lymphoid malignancy and pleural effusion who underwent thoracentesis from January 1993 to December 2002 were collected. A logistic regression analysis was carried out to determine prognostic variables that predict malignant pleural effusion and hospital mortality. There were 86 patients who were admitted on 91 occasions. The median age was 70 years (range 4 - 92) and the male:female ratio was 44:42. Sixty-four patients (74%) had advanced disease, 43 (50%) had received prior chemotherapy and 9 (10%) were in remission. Of 91 cases of pleural effusions, 44 (48%) were bilateral, 80 (88%) were exudates and 48 (53%) were due to malignant involvement of pleura. In multivariate analysis, symptomatic pleural effusion (odds ratio 10.3, 95% confidence interval 1.7 - 98.3), pleural fluid mesothelial cell count < 5% (odds ratio 8.0, 95% confidence interval 1.4 - 58.2), pleural fluid:serum lactate dehydrogenase (LDH) > or =1 (odds ratio 6.4, 95% confidence interval 1.2 - 45.6) and pleural fluid lymphocyte percentage > or =50 (odds ratio 6.4, 95% confidence interval 1.2 - 50) were significantly correlated with malignant effusion. A secondary cancer (odds ratio 11.9, 95% confidence interval 2.3 - 88.8), pleural fluid:serum LDH > or =1 (odds ratio 10.9, 95% confidence interval 2.6 - 64.9), and pneumonia (odds ratio 6.4, 95% confidence interval 1.7 - 28.6) were significantly correlated with hospital mortality. In conclusion, malignant pleural effusion is the common etiology of pleural effusion in patients with lymphoid malignancy. Many clinical and cytochemical markers have discriminatory values in identifying malignant effusion. A high pleural fluid to serum LDH level correlates with malignant pleural involvement and hospital mortality. PMID

  16. Calcified Cystic Lesion of the Pancreas.

    PubMed

    Li, Tao; Chen, Zhi-Qiang; Meng, Zhi-Xin; Hong, Jian-Guo; Zhi, Xu-Ting

    2016-06-01

    Pancreatic cystic lesion is a relatively uncommon condition with an estimated prevalence of 2 % in the general population. In the past two decades, there has been a dramatic increase in the prevalence of pancreatic cystic lesions because of the widespread use of high-resolution imaging, as well as the aging of the population. Pancreatic cystic lesions cover a wide spectrum of pathology and can range from obviously benign to borderline malignant potential lesions to overt malignancy. Though the presence of mural nodules, septa-like structures, or calcification on imaging examination contributes to the differential diagnosis, preoperatively determining the biological nature of these cystic lesions is sometimes challenging. In this paper, we report a rare case of pancreatic cystic lesion with an egg-shell like calcification. Complete resection was performed and histological examination confirmed the diagnosis of calcified pancreatic pseudocyst. PMID:26992398

  17. Pleural effusion: diagnosis, treatment, and management

    PubMed Central

    Karkhanis, Vinaya S; Joshi, Jyotsna M

    2012-01-01

    A pleural effusion is an excessive accumulation of fluid in the pleural space. It can pose a diagnostic dilemma to the treating physician because it may be related to disorders of the lung or pleura, or to a systemic disorder. Patients most commonly present with dyspnea, initially on exertion, predominantly dry cough, and pleuritic chest pain. To treat pleural effusion appropriately, it is important to determine its etiology. However, the etiology of pleural effusion remains unclear in nearly 20% of cases. Thoracocentesis should be performed for new and unexplained pleural effusions. Laboratory testing helps to distinguish pleural fluid transudate from an exudate. The diagnostic evaluation of pleural effusion includes chemical and microbiological studies, as well as cytological analysis, which can provide further information about the etiology of the disease process. Immunohistochemistry provides increased diagnostic accuracy. Transudative effusions are usually managed by treating the underlying medical disorder. However, a large, refractory pleural effusion, whether a transudate or exudate, must be drained to provide symptomatic relief. Management of exudative effusion depends on the underlying etiology of the effusion. Malignant effusions are usually drained to palliate symptoms and may require pleurodesis to prevent recurrence. Pleural biopsy is recommended for evaluation and exclusion of various etiologies, such as tuberculosis or malignant disease. Percutaneous closed pleural biopsy is easiest to perform, the least expensive, with minimal complications, and should be used routinely. Empyemas need to be treated with appropriate antibiotics and intercostal drainage. Surgery may be needed in selected cases where drainage procedure fails to produce improvement or to restore lung function and for closure of bronchopleural fistula. PMID:27147861

  18. Dental plaque identification at home

    MedlinePlus

    ... your teeth. Plaque is the major cause of tooth decay and gum disease ( gingivitis ). It is hard to ... the plaque is not removed, it can cause tooth decay or cause the gums to bleed easily (gingivitis) ...

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

    PubMed

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

    2013-05-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-05-01

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

  1. Formation and diagenesis of modern marine calcified cyanobacteria.

    PubMed

    Planavsky, N; Reid, R P; Lyons, T W; Myshrall, K L; Visscher, P T

    2009-12-01

    Calcified cyanobacterial microfossils are common in carbonate environments through most of the Phanerozoic, but are absent from the marine rock record over the past 65 Myr. There has been long-standing debate on the factors controlling the formation and temporal distribution of these fossils, fostered by the lack of a suitable modern analog. We describe calcified cyanobacteria filaments in a modern marine reef setting at Highborne Cay, Bahamas. Our observations and stable isotope data suggest that initial calcification occurs in living cyanobacteria and is photosynthetically induced. A single variety of cyanobacteria, Dichothrix sp., produces calcified filaments. Adjacent cyanobacterial mats form well-laminated stromatolites, rather than calcified filaments, indicating there can be a strong taxonomic control over the mechanism of microbial calcification. Petrographic analyses indicate that the calcified filaments are degraded during early diagenesis and are not present in well-lithified microbialites. The early diagenetic destruction of calcified filaments at Highborne Cay indicates that the absence of calcified cyanobacteria from periods of the Phanerozoic is likely to be caused by low preservation potential as well as inhibited formation. PMID:19796131

  2. Primary extraskeletal pleural osteosarcoma: a rare pleural identity.

    PubMed

    Copeland, Hannah; Makdisi, Peter B; Duncan, Michael; Wozniak, Thomas C; Makdisi, George

    2016-06-01

    A 69-year-old female with a history of a heart transplant 16 years prior, presented with a large left chest mass identified on fluoroscopy in the cardiac catheterization lab. The patient noted a 40 pound weight loss in one year. A chest X-ray (CXR) and chest computed tomography (CT) demonstrated a large complex cystic mass in the left chest. A CT guided aspiration was performed, and the cytology for the cyst fluid was negative for malignancy. The patient continued to have worsening shortness of breath, a repeat chest CT scan and magnetic resonance imaging (MRI) three months later, demonstrated a recurrence of the left pleural mass. Further, work-up was negative for tumor. A left video assisted thoracotomy exploration was performed and left thoracotomy was needed for the mass resection. The final pathology demonstrated a high grade osteosarcoma. The post-operative course was unremarkable. PMID:27386494

  3. Primary extraskeletal pleural osteosarcoma: a rare pleural identity

    PubMed Central

    Copeland, Hannah; Makdisi, Peter B.; Duncan, Michael; Wozniak, Thomas C.

    2016-01-01

    A 69-year-old female with a history of a heart transplant 16 years prior, presented with a large left chest mass identified on fluoroscopy in the cardiac catheterization lab. The patient noted a 40 pound weight loss in one year. A chest X-ray (CXR) and chest computed tomography (CT) demonstrated a large complex cystic mass in the left chest. A CT guided aspiration was performed, and the cytology for the cyst fluid was negative for malignancy. The patient continued to have worsening shortness of breath, a repeat chest CT scan and magnetic resonance imaging (MRI) three months later, demonstrated a recurrence of the left pleural mass. Further, work-up was negative for tumor. A left video assisted thoracotomy exploration was performed and left thoracotomy was needed for the mass resection. The final pathology demonstrated a high grade osteosarcoma. The post-operative course was unremarkable. PMID:27386494

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

    PubMed Central

    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

    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

  5. Mast cells mediate malignant pleural effusion formation

    PubMed Central

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

    2015-01-01

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

  6. Food supply confers calcifiers resistance to ocean acidification

    PubMed Central

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

    2016-01-01

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

  7. Food supply confers calcifiers resistance to ocean acidification.

    PubMed

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

    2016-01-01

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

  8. Detection of nanobacteria-like particles in human atherosclerotic plaques.

    PubMed

    Puskás, L G; Tiszlavicz, L; Rázga, Zs; Torday, L L; Krenács, T; Papp, J Gy

    2005-01-01

    Recent and historical evidence is consistent with the view that atherosclerosis is an infectious disease or microbial toxicosis impacted by genetics and behavior. Because small bacterial-like particles, also known as nanobacteria have been detected in kidney stones, kidney and liver cyst fluids, and can form a calcium apatite coat we posited that this agent is present in calcified human atherosclerotic plaques. Carotid and aortic atherosclerotic plaques and blood samples collected at autopsy were examined for nanobacteria-like structures by light microscopy (hematoxylin-eosin and a calcium-specific von Kossa staining), immuno-gold labeling for transmission electron microscopy (TEM) for specific nanobacterial antigens, and propagation from homogenized, filtered specimens in culture medium. Nanobacterial antigens were identified in situ by immuno-TEM in 9 of 14 plaque specimens, but none of the normal carotid or aortic tissue (5 specimens). Nanobacteria-like particles were propagated from 26 of 42 sclerotic aorta and carotid samples and were confirmed by dot immunoblot, light microscopy and TEM. [3H]L-aspartic acid was incorporated into high molecular weight compounds of demineralized particles. PCR amplification of 16S rDNA sequences from the particles was unsuccessful by traditional protocols. Identification of nanobacteria-like particles at the lesion supports, but does not by itself prove the hypothesis that these agents contribute to the pathogenesis of atherosclerosis, especially vascular calcifications. PMID:16196199

  9. Multiple calcifying hyperplastic dental follicles: A case report

    PubMed Central

    Aydin, Ulkem; Baykul, Timucin; Yildirim, Benay; Yildirim, Derya; Karaduman, Ayse

    2013-01-01

    This report describes a 31-year-old female patient with six impacted teeth. The crowns of the impacted teeth were surrounded with cyst-like lesions with a mixed internal structure and well-defined cortical borders. Microscopic examination of the specimen obtained from the follicle of the left mandibular third molar tooth revealed loose to moderately dense collagenous connective tissue with abundant calcified material and sparse epithelial islands. A diagnosis of multiple calcifying hyperplastic dental follicles was made. PMID:24380071

  10. Ex vivo comparison of angioscopy and histopathology for the evaluation of coronary plaque characteristics.

    PubMed

    Shibuya, Masahiko; Fujii, Kenichi; Hao, Hiroyuki; Imanaka, Takahiro; Fukunaga, Masashi; Miki, Kojiro; Tamaru, Hiroto; Nakata, Tsuyoshi; Sawada, Hisashi; Naito, Yoshiro; Hirota, Seiichi; Masuyama, Tohru

    2016-06-01

    The yellow plaque has been considered to be a vulnerable and high risk for acute coronary syndrome events but not fully evaluated. The aim of this study was to evaluate the relationship between angioscopic color grade and histological features in coronary autopsy specimens. We longitudinally sectioned 110 coronary arteries from 40 autopsy hearts with non-cardiovascular death. Harvested arteries were imaged with intravascular ultrasound to identify the focal plaque (plaque burden >50 %). An angioscopic examination of each focal plaque evaluated its color intensity as follows: 0 (white), 1 (light yellow), 2 (yellow), or 3 (dark yellow). The corresponding histological assessment was classified according to a modified version of the American Heart Association classification of atherosclerosis. Two hundred six plaques were matched to the histological analysis. Of these, 82 (40 %) were categorized as yellow (≥grade 1). Although, yellow plaque often includes thin-cap fibroatheroma (TCFA), the sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy for histological TCFA were 83, 91, 22, 99 and 91 %, respectively. The false-positive coronary angioscopic diagnoses for TCFA that contributed to the low positive predictive value consisted of the following plaques: thick FA (>65 μm), accumulations of large quantities of foam cells on the luminal surface, or dense calcified plates at the surface of the intima. Vulnerable coronary plaques were detected with high sensitivity and low positive predictive value from their yellow color on angioscopy. Not only fibroatheroma but also various types of plaques and their components, such as immature lipidic components and superficial calcium plates, appeared yellow on coronary angioscopy. PMID:26873010

  11. Pleural effusions in children undergoing cardiac surgery

    PubMed Central

    Talwar, Sachin; Agarwala, Sandeep; Mittal, Chander Mohan; Choudhary, Shiv Kumar; Airan, Balram

    2010-01-01

    Persistent pleural effusions are a source of significant morbidity and mortality following surgery in congenital heart disease. In this review, we discuss the etiology, pathophysiology, and management of this common complication. PMID:20814477

  12. Pancreatic Pseudocyst Pleural Fistula in Gallstone Pancreatitis

    PubMed Central

    Abdalla, Sala; Nikolopoulos, Ioannis; Kerwat, Rajab

    2016-01-01

    Extra-abdominal complications of pancreatitis such as pancreaticopleural fistulae are rare. A pancreaticopleural fistula occurs when inflammation of the pancreas and pancreatic ductal disruption lead to leakage of secretions through a fistulous tract into the thorax. The underlying aetiology in the majority of cases is alcohol-induced chronic pancreatitis. The diagnosis is often delayed given that the majority of patients present with pulmonary symptoms and frequently have large, persistent pleural effusions. The diagnosis is confirmed through imaging and the detection of significantly elevated amylase levels in the pleural exudate. Treatment options include somatostatin analogues, thoracocentesis, endoscopic retrograde cholangiopancreatography (ERCP) with pancreatic duct stenting, and surgery. The authors present a case of pancreatic pseudocyst pleural fistula in a woman with gallstone pancreatitis presenting with recurrent pneumonias and bilateral pleural effusions. PMID:27274876

  13. Pleural effusion and sarcoidosis: an unusual combination.

    PubMed

    Ferreiro, Lucía; San José, Esther; González-Barcala, Francisco Javier; Suárez-Antelo, Juan; Toubes, M Elena; Valdés, Luis

    2014-12-01

    Pleural involvement in sarcoidosis is uncommon and appears in several forms. To document the incidence and characteristics of pleural effusion in sarcoidosis patients, a review of the cases diagnosed in our centre between January 2001 and December 2012 was carried out. One hundred and ninety-five patients with sarcoidosis were identified; three (two men and one woman) presented with unilateral pleural effusion (1.5%): one in the right side and two in the left. Two were in stageii and one was in stageiv. The pleural fluid of the two patients who underwent thoracocentesis was predominantly lymphocytic. One of these patients presented chylothorax and the other had high CA-125levels. In general, these effusions are lymphocyte-rich, paucicellular, serous exudates (sometimes chylothorax) and contain proportionally higher levels of protein than LDH. Most cases are treated with corticosteroids, although it may resolve spontaneously. PMID:24565689

  14. La pelade par plaques

    PubMed Central

    Spano, Frank; Donovan, Jeff C.

    2015-01-01

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

  15. La pelade par plaques

    PubMed Central

    Spano, Frank; Donovan, Jeff C.

    2015-01-01

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

  16. Thoracoscopy in the diagnosis of pleural effusion.

    PubMed Central

    Cantó, A; Blasco, E; Casillas, M; Zarza, A G; Padilla, J; Pastor, J; Tarazona, V; París, F

    1977-01-01

    The technique, indications, and complications of diagnostic thoracoscopy are described. Two hundred and eight explorations have been performed in our service in the last seven years. From 137 pleural malignancies we have obtained an unequivocal positive biopsy in 129 (94%) with a minimum number of complications and no mortality. From our experience we conclude that thoracoscopy, when porperly performed, is diagnostic in most pleural conditions. Images PMID:594934

  17. Thoracoscopy in the diagnosis of pleural effusion.

    PubMed

    Cantó, A; Blasco, E; Casillas, M; Zarza, A G; Padilla, J; Pastor, J; Tarazona, V; París, F

    1977-10-01

    The technique, indications, and complications of diagnostic thoracoscopy are described. Two hundred and eight explorations have been performed in our service in the last seven years. From 137 pleural malignancies we have obtained an unequivocal positive biopsy in 129 (94%) with a minimum number of complications and no mortality. From our experience we conclude that thoracoscopy, when porperly performed, is diagnostic in most pleural conditions. PMID:594934

  18. An IR Navigation System for Pleural PDT

    NASA Astrophysics Data System (ADS)

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

    2015-03-01

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

  19. Pleural procedural complications: prevention and management

    PubMed Central

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

    2015-01-01

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

  20. Pleural LDH as a prognostic marker in adenocarcinoma lung with malignant pleural effusion

    PubMed Central

    Verma, Akash; Phua, Chee Kiang; Sim, Wen Yuan; Algoso, Reyes Elmer; Tee, Kuan Sen; Lew, Sennen J. W.; Lim, Albert Y. H.; Goh, Soon Keng; Tai, Dessmon Y. H.; Kor, Ai Ching; Ho, Benjamin; Abisheganaden, John

    2016-01-01

    Abstract To study the performance of serum and pleural lactate dehydrogenase (LDH) level in predicting survival in patients with adenocarcinoma lung presenting with malignant pleural effusions (MPE) at initial diagnosis. Retrospective cohort study of the patient hospitalized for adenocarcinoma lung with MPE in year 2012. Univariate analyses showed lower pleural fluid LDH 667 (313–967) versus 971 (214–3800), P = 0.04, female gender 9 (100%) versus 27 (41.5%), P = 0.009, never smoking status 9 (100%) versus 36 (55.3%), P = 0.009, and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy 8 (89%) versus 26 (40%), P = 0.009 to correlate with survival of more than 1.7 year versus less than 1.7 year. In multivariate analysis, low pleural fluid LDH and female gender maintained significance. The pleural LDH level of ≤1500 and >1500 U/L discriminated significantly (P = 0.009) between survival. High pleural LDH (>1500 IU/L) predicts shorter survival (less than a year) in patients with adenocarcinoma lung presenting with MPE at the time of initial diagnosis. This marker may be clinically applied for selecting therapeutic modality directed at prevention of reaccumulation of MPE. Patients with low pleural LDH may be considered suitable for measures that provide more sustained effect on prevention of reaccumulation such as chemical pleurodesis or tunneled pleural catheter. PMID:27368006

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

    PubMed

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

    2015-06-01

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

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

    PubMed Central

    Dixon, Giles; de Fonseka, Duneesha

    2015-01-01

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

  3. Coronary plaque quantification and fractional flow reserve by coronary computed tomography angiography identify ischaemia-causing lesions

    PubMed Central

    Gaur, Sara; Øvrehus, Kristian Altern; Dey, Damini; Leipsic, Jonathon; Bøtker, Hans Erik; Jensen, Jesper Møller; Narula, Jagat; Ahmadi, Amir; Achenbach, Stephan; Ko, Brian S.; Christiansen, Evald Høj; Kaltoft, Anne Kjer; Berman, Daniel S.; Bezerra, Hiram; Lassen, Jens Flensted; Nørgaard, Bjarne Linde

    2016-01-01

    Aims Coronary plaque characteristics are associated with ischaemia. Differences in plaque volumes and composition may explain the discordance between coronary stenosis severity and ischaemia. We evaluated the association between coronary stenosis severity, plaque characteristics, coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFRCT), and lesion-specific ischaemia identified by FFR in a substudy of the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). Methods and results Coronary CTA stenosis, plaque volumes, FFRCT, and FFR were assessed in 484 vessels from 254 patients. Stenosis >50% was considered obstructive. Plaque volumes (non-calcified plaque [NCP], low-density NCP [LD-NCP], and calcified plaque [CP]) were quantified using semi-automated software. Optimal thresholds of quantitative plaque variables were defined by area under the receiver-operating characteristics curve (AUC) analysis. Ischaemia was defined by FFR or FFRCT ≤0.80. Plaque volumes were inversely related to FFR irrespective of stenosis severity. Relative risk (95% confidence interval) for prediction of ischaemia for stenosis >50%, NCP ≥185 mm3, LD-NCP ≥30 mm3, CP ≥9 mm3, and FFRCT ≤0.80 were 5.0 (3.0–8.3), 3.7 (2.4–5.6), 4.6 (2.9–7.4), 1.4 (1.0–2.0), and 13.6 (8.4–21.9), respectively. Low-density NCP predicted ischaemia independent of other plaque characteristics. Low-density NCP and FFRCT yielded diagnostic improvement over stenosis assessment with AUCs increasing from 0.71 by stenosis >50% to 0.79 and 0.90 when adding LD-NCP ≥30 mm3 and LD-NCP ≥30 mm3 + FFRCT ≤0.80, respectively. Conclusion Stenosis severity, plaque characteristics, and FFRCT predict lesion-specific ischaemia. Plaque assessment and FFRCT provide improved discrimination of ischaemia compared with stenosis assessment alone. PMID:26763790

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

    PubMed

    Thomsen, Camilla; Abdulla, Jawdat

    2016-02-01

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

  5. Pleural lipoma: a non-surgical lesion?

    PubMed Central

    Jayle, Christophe; Hajj-Chahine, Jamil; Allain, Geraldine; Milin, Serge; Soubiron, Laurent; Corbi, Pierre

    2012-01-01

    Pleural lipomas are benign tumours that develop at the expense of adipose tissues, and they never evolve towards liposarcoma. Located usually at the mediastinal, bronchial and pulmonary levels, a pleural situation is extremely rare. Chest X-rays usually detect them and computed tomography scans confirm the diagnosis. As complications occur, a wait-and-see policy is common. We report our pleural lipoma surgical exeresis experience since 1999. We have operated on five cases of pleural lipomas among nearly 1800 cases of thoracic exeresis: three male and two female patients, without obesity (in all cases, body mass index (BMI) < 28). The mean age was 54.6 years (range 35–72 years). Four patients were electively operated and one in emergency, three with video-assisted thoracic surgery (VATS) procedure and two with open chest surgery, without recurrent cases. Advancements in VATS have greatly reduced the morbidity rate of these benign tumours especially if exeresis is performed early on a small, uncomplicated adhesion-free tumour. On the other hand, the operation may be deleterious, complicated by the presence of a large lipoma or in a complicating situation. In our opinion, we should revise the wait-and-see policy when facing these lesions considering their evolutionary potential. We should advise VATS in pleural lipomas. PMID:22371386

  6. Atypical Pleural Fluid Profiles in Tuberculous Pleural Effusion: Sequential Changes Compared with Parapneumonic and Malignant Pleural Effusions.

    PubMed

    Kim, Chang Ho; Lee, So Yeon; Lee, Yong Dae; Yoo, Seung Soo; Lee, Shin Yup; Cha, Seung Ick; Park, Jae Yong; Lee, Jaehee

    2016-01-01

    Objective Although tuberculous pleural effusion (TPE) is commonly characterized by lymphocytic predominance and high adenosine deaminase (ADA) levels, it may present with neutrophilic predominance or low ADA levels, which are more commonly found in parapneumonic effusion (PPE) or malignant pleural effusion (MPE), respectively. A few studies have observed that the atypical pleural fluid profiles of these cases of TPE may resolve at follow-up thoracentesis. However, these observations were incompletely analyzed and lacked comparison with proper control groups. Thus, limited data are available comparing the sequential pleural fluid changes between TPE and PPE or MPE with similar pleural fluid profiles. Methods TPE, PPE, and MPE patients who underwent sequential thoracentesis were retrospectively reviewed. The sequential changes in the pleural fluid profiles were compared between neutrophilic TPE and PPE, and lymphocytic TPE and MPE with low ADA levels. Results Twenty-three TPE patients (16 with neutrophilic exudates, seven with lymphocytic exudates), 72 cases of PPE with neutrophilic exudates, and 18 cases of MPE with lymphocytic exudates were included in the analysis. A sequential shift to lymphocytic exudates occurred significantly more often in TPE than in PPE cases. The initial and follow-up ADA levels in TPE cases with a lymphocytic shift were significantly higher than those in PPE cases with a lymphocytic shift. The ADA levels in the TPE cases with initial lymphocytic exudates and low ADA levels significantly increased at follow-up thoracentesis. For the TPE and MPE cases with initial lymphocytic exudates and ADA levels <40 U/L, the frequency of effusion with ADA levels ≥40 U/L at the second thoracentesis was significantly higher in the TPE cases. Conclusion Follow-up thoracentesis may provide useful information for clinical decision-making in suspected atypical TPE cases with neutrophilic exudates or low ADA levels. PMID:27374670

  7. Plasma lactoferrin levels in patients with chronic calcifying pancreatitis.

    PubMed

    Figarella, C; Gaia, E; Piantino, P

    1983-01-01

    Lactoferrin is a nonenzymatic secretory protein of human pancreas specifically increased in the external pancreatic secretion of patients with chronic calcifying pancreatitis. The possibility of an elevated concentration of plasma lactoferrin level in these patients needed to be explored even if the low pancreatic concentration of the protein did not favor this hypothesis. As expected, no increase could be observed between the plasma lactoferrin level of 16 patients with chronic calcifying pancreatitis (131 +/- 15 micrograms/l), compared to 17 controls (166 +/- 11 micrograms/l) and 15 patients with different organic diseases (187 +/- 18 micrograms/l). PMID:6628844

  8. Ameloblastomatous Calcifying Cystic Odontogenic Tumour: A Rare Variant

    PubMed Central

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

    2015-01-01

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

  9. Cardiac calcified amorphous tumor in a hemodialysis patient.

    PubMed

    Seo, Hiroyuki; Fujii, Hiromichi; Aoyama, Takanobu; Sasako, Yoshikado

    2016-06-01

    We present a case of cardiac calcified amorphous tumor, a rare intracardiac non-neoplastic tumor, in a hemodialysis patient. A 72-year-old woman with no history of thromboembolic, malignant, or inflammatory disease presented with dyspnea. Echocardiography revealed a highly echoic, slightly mobile mass with an acoustic shadow originating from the mitral subvalvular apparatus, extending to the left ventricular outflow tract. She underwent surgical resection of the mass through the aortic valve, which was easily excised from the papillary muscle and chordae tendineae. Histopathologic examination revealed nodular calcium deposits on a background of amorphous degenerated fibrin material, consistent with calcified amorphous tumor. PMID:25742783

  10. Primary systemic amyloidosis: A rare cause for pleural effusion.

    PubMed

    George, Sunny; Ravindran, M; Anandan, P T; Kiran, V N

    2014-01-01

    Pleural effusion is a common problem dealt by most of the practicing clinicians. Some causes for pleural effusion are less often considered as a differential diagnosis owing to its rarity. Here we report a case of renal amyloidosis on alternate day haemodialysis for about two months time presenting with left sided pleural effusion. On evaluation this turned out to be a case of amyloidosis on thoracoscopic pleural biopsy suggesting the possibility of Primary systemic amyloidosis. PMID:26029558

  11. Chemothorax: a rare cause of a transudative pleural effusion.

    PubMed

    Kelly, Devin; Geottman, David; Sarodia, Bipin

    2015-01-01

    We discovered a rare cause of pleural effusion, chemothorax. In this case, a patient with invasive ductal breast carcinoma was admitted for a large and symptomatic pleural effusion. The radiology report obtained prior to admission did not describe the location of the Infuse-a-Port catheter. After a bedside thoracentesis demonstrated results consistent with chemotherapy infusate in the pleural space, further review of the medical imaging demonstrated that the catheter was in the pleural space. PMID:26655229

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

    PubMed Central

    Ordu, Cetin; Toker, Alper

    2014-01-01

    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. PMID:24605219

  13. Carbimazole-induced exudative pleural effusions.

    PubMed

    Cardona Attard, Carol D; Gruppetta, Mark; Vassallo, Josanne; Vella, Sandro

    2016-01-01

    Carbimazole, an antithyroid drug, is associated with a significant number of side effects, but pleuropulmonary complications are rare. We report the case of a 42-year-old Caucasian man who developed dyspnoea secondary to bilateral exudative pleural effusions while on carbimazole therapy. Extensive investigations, including a vasculitic screen, ruled out other potential causes for this patient's clinical presentation. This patient's pleural effusions gradually resolved within a few months of stopping carbimazole therapy, suggesting a role for the latter in the aetiopathogenesis of his presentation. Clinicians should consider discontinuing treatment with carbimazole and introducing alternative antithyroid therapy in this setting, once other potential causes of a pleural effusion have been systematically ruled out. PMID:27045053

  14. Pleural abnormalities: thoracic ultrasound to the rescue!

    PubMed Central

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

    2013-01-01

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

  15. Pleural abnormalities: thoracic ultrasound to the rescue!

    PubMed

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

    2013-07-01

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

  16. Pioneer F Plaque Location

    NASA Technical Reports Server (NTRS)

    1972-01-01

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

  17. Sonographic pleural fluid volume estimation in cats.

    PubMed

    Shimali, Jerry; Cripps, Peter J; Newitt, Anna L M

    2010-02-01

    The aims of this study were to evaluate whether a recently published study used to objectively monitor pleural fluid volumes in dogs could be successfully employed in cats and secondly to assess its accuracy. Eleven feline cadavers were selected. Using the trans-sternal view employed in dogs, linear measurements from the pleural surface of the midline of the sternebra at the centre of the heart to the furthest ventro-lateral point of both right and left lung edges were recorded. Isotonic saline was injected using ultrasound guidance into both right and left pleural spaces and the measurements were repeated using standard increments until 400 ml total volume was reached. The mean measurement increased in a linear relationship with the cube root of fluid volume for all cats individually. An equation was produced to predict the volume of fluid from the mean linear measurement for all cats combined: Volume=[-3.75+2.41(mean)](3)(P<0.001) but variability in the slope of the curve for individual cats limited the accuracy of the combined equation. Equations were derived to predict the constant and slope of the curve for individual cats using the thoracic measurements made, but the residual diagnostic graphs demonstrated considerable variability. As in dogs, good correlation was found between the ultrasonographic measurement and fluid volume within individual cats. An accurate equation to predict absolute pleural fluid volume was not identified. Further analysis with reference to thoracic measurements did not increase accuracy. In conclusion, this study does provide a method of estimating absolute pleural fluid volume in cats, which may be clinical useful for pleural fluid volume monitoring but this is yet to be validated in live cats. PMID:19744872

  18. Tuberculous pleural effusions: advances and controversies

    PubMed Central

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

    2015-01-01

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

  19. Tuberculous pleural effusions: advances and controversies.

    PubMed

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

    2015-06-01

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

  20. How Are Pleurisy and Other Pleural Disorders Treated?

    MedlinePlus

    ... doctor may use a chest tube to deliver medicines called fibrinolytics to the pleural space. If the fluid still won't drain, you ... build up again after it's drained. Sometimes antitumor medicines will ... the pleural space. Sealing the pleural space is called pleurodesis (plur- ...

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

    PubMed Central

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

    2015-01-01

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

  2. Hemorrhagic pleural effusion due to pseudo-pancreatic cyst

    PubMed Central

    Sachdeva, Ruchi; Sachdeva, Sandeep

    2016-01-01

    Hemorrhagic pleural effusion is a common clinical entity still diagnosis is often missed. An unusual and often over-looked cause of pleural effusion is an intra-abdominal process including complication arising due to pancreatitis. We report a rare case of massive left sided hemorrhagic pleural effusion in a patient due to pancreatic pathology. PMID:27099855

  3. Cerebral air embolism after pleural streptokinase instillation.

    PubMed

    Janisch, Thorsten; Siekmann, Ullrich; Kopp, Rüdger

    2013-12-01

    Iatrogenic pulmonary barotrauma and cerebral arterial gas embolism (CAGE) may complicate a variety of medical procedures, such as certain types of surgery, drug administration through thoracic drainage, pneumoperitoneum, cystoscopy, bronchoscopy, etc. Hyperbaric oxygen treatment following the guidelines for CAGE in diving is the treatment of choice. Pleural streptokinase instillation is a common treatment for parapneumonic pleural effusion and may lead to CAGE. We present such a complication in a 79-year-old woman with a left-sided empyema. Neurological recovery was reasonable, but a left hemiparesis persisted. Prompt treatment of CAGE is necessary to avoid permanent injury and severe disability. PMID:24510333

  4. [Sonography in pleural effusion of horses].

    PubMed

    Stadtbäumer, G

    1989-01-01

    Pleural effusion in the horse can be caused by diseases such as pneumonia, trauma, pulmonary abscesses and thoracic neoplasms. Besides clinical (auscultation, percussion) and radiographic diagnostic procedures, the ultrasonic examination represents a method that supplies detailed information on quantity and location of fluid in the pleural space. By means of ultrasonic examination the most favourable position for a thoracentesis can be determined. Control of thoracentesis' efficiency as well as exact supervision of the disease's course are made feasible by repeated sonographic examinations. PMID:2694447

  5. Pleural effusion in a peritoneal dialysis patient.

    PubMed

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

    2011-04-01

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

  6. An uncommon infectious cause of pleural effusion.

    PubMed

    Aggarwal, Amitesh; Rajashekaraiah, Lokesh Champally; Misra, Kiran; Dev, Munish; Sharma, Vishal

    2011-10-01

    Lymphatic filariasis is one of the major public health problems across the globe. Clinical manifestations usually depend on the site of lymphatic involvement. A 21-year-old female resident of a non-endemic filarial region presented with axillary lymphadenopathy, bilateral pleural effusion, ascites and pedal oedema. Fine-needle aspiration cytology (FNAC) of axillary lymph nodes revealed microfilariae. On the administration of diethyl carbamazine, lymph nodes gradually disappeared, the patient improved symptomatically and the filarial antigen test after treatment was negative. We report this case of bilateral axillary lymphadenopathy with pleural effusion and ascites as a rare manifestation of filariasis. PMID:21914673

  7. Eosinophilic pleural effusion complicating allergic bronchopulmonary aspergillosis.

    PubMed

    Kirschner, Austin N; Kuhlmann, Erica; Kuzniar, Tomasz J

    2011-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is primarily a disease of patients with cystic fibrosis or asthma, who typically present with bronchial obstruction, fever, malaise, and expectoration of mucus plugs. We report a case of a young man with a history of asthma who presented with cough, left-sided pleuritic chest pain and was found to have lobar atelectasis and an eosinophilic, empyematous pleural effusion. Bronchoscopy and sputum cultures grew Aspergillus fumigatus, and testing confirmed strong allergic response to this mold, all consistent with a diagnosis of ABPA. This novel and unique presentation of ABPA expands on the differential diagnosis of eosinophilic pleural effusions. PMID:21311176

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

    PubMed Central

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

    2014-01-01

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

  9. CALCIFYING TENDINOPATHY: A LOCAL OR A SYSTEMIC CONDITION?

    PubMed Central

    Ejnisman, Benno; Andreoli, Carlos Vicente; Monteiro, Gustavo Cará; Pocchini, Alberto de Castro; Cohen, Carina; Tortato, Simone; Franklin, Marcelo Marques Khede; Machado, Arthur Beber; Cohen, Moisés

    2015-01-01

    Objective: To evaluate the relationship between cases of calcifying tendinopathy of the shoulder and symptomatic metabolic diseases such as kidney stones, gallstones and gout. Methods: Calcifying tendinopathy of the shoulder was diagnosed in 63 patients between May 2007 and September 2011. All the patients were treated by the same orthopedic surgeon and were interviewed to gather the following data: age at diagnosis, sex, affected side, dominant side, body mass index (BMI), smoking status and previous histories of kidney stones, gallstones or gout. For statistical analysis, a control group of 63 patients with similar demographic characteristics was used. Results: Among the 63 patients with calcifying tendinopathy of the shoulder, 35 (56%) were male. The right side was affected in 38 patients (60%) and the average age was 48.2 years. Thirty-one patients (49%) had histories involving some of the metabolic diseases investigated: 20 patients (32%) reported kidney stones, six (9.5%) gallstones, four (6.3%) gout and one (2%) concurrent diagnoses of kidney stones and gout. In the control group, eleven patients (17%) had histories involving some of the metabolic diseases investigated: six patients (9.5%) reported kidney stones, four (6.3%) gallstones and one (1.6 %) gout. Conclusions: The high frequency of nephrolithiasis in patients with calcifying tendinopathy of the shoulder in our study suggests that there are common mechanisms in the pathophysiology of these disorders. Better understanding of these diseases may enable improvement of diagnostics and treatments. PMID:27047854

  10. CT imaging findings of a calcifying epithelial odontogenic tumour

    PubMed Central

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

    2012-01-01

    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

  11. Infectious Complication Following Midface Reconstruction With Calcified Triglyceride.

    PubMed

    Cooper, Sarah E; Durairaj, Vikram D; Ramakrishnan, Vijay R

    2015-01-01

    This case report describes an infectious complication related to the use of calcified triglyceride (Kryptonite Bone Cement) in post-traumatic midface reconstruction. Ultimately, the infected material required removal, and the facial deformity was repaired with subsequent procedures. The literature suggests that bone cement products should be used with caution when in contact with the paranasal sinuses. PMID:24901377

  12. Calcified Granulomatous Disease: Occupational Associations and Lack of Familial Aggregation

    PubMed Central

    Reed, Robert M.; Amoroso, Anthony; Hashmi, Salman; Kligerman, Seth; Shuldiner, Alan R.; Mitchell, Braxton D.; Netzer, Giora

    2014-01-01

    Purpose The acute host response to histoplasma capsulatum infection varies according to exposure and susceptibility. Late sequelae include calcifications in the lung, thoracic lymphatics, and spleen. Determinants of calcified granuloma formation are poorly studied and may differ from those affecting acute response. We examined the occupational associations and familial aggregation of radiographic calcified granulomatous disease to characterize the determinants of calcified granuloma formation. Methods We analyzed prospectively collected cross-sectional data including computed tomograms from 872 adult members of the Old Order Amish of Lancaster County. Results Granulomas were present in 71 % of participants. Granulomas were present in the lung of 57 % of participants, in the hilar or mediastinal lymph nodes of 55 % of participants, and in the spleen of 29 % of participants. No significant differences were observed in the presence of granulomas between men and women. Each year of age was associated with 4 % higher odds of splenic calcifications, and a primary occupation of farming was associated with an 84 % higher odds of splenic calcifications. A compelling pattern of familial aggregation was not observed. Conclusions Calcified granulomatous disease does not appear to aggregate in families. Determinants influencing patterns of granulomatous disease include occupation, age, and geographic location. PMID:25038755

  13. Making a Lightweight Battery Plaque

    NASA Technical Reports Server (NTRS)

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

    1986-01-01

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

  14. Pathophysiology of Atherosclerotic Plaque Development.

    PubMed

    Rognoni, Andrea; Cavallino, Chiara; Veia, Alessia; Bacchini, Sara; Rosso, Roberta; Facchini, Manuela; Secco, Gioel G; Lupi, Alessandro; Nardi, Federico; Rametta, Francesco; Bongo, Angelo S

    2015-01-01

    Cardiovascular diseases and in particular coronary atherosclerotic disease are the leading cause of mortality and morbidity in the industrialized countries. Coronary atherosclerosis has been recognized for over a century and it was the subject of various studies. Pathophysiological studies have unravelled the interactions of molecular and cellular elements involved in atherogenesis; during the last decades the basic research has focused on the study of the instability of atherosclerotic plaque. Plaque rupture and resulting intracoronary thrombosis are thought to account for most acute coronary syndromes including ST - segment elevation myocardial infarction and non ST - segment elevation myocardial infarction. This is a brief review of the pathophysiology of atherosclerotic plaque development. PMID:25544119

  15. Are the days of closed pleural biopsy over? No

    PubMed Central

    Thangakunam, Balamugesh

    2015-01-01

    Closed pleural biopsy used to be a popular method of evaluation of pleural effusion. With the advent of thoracoscopy, this valuable method is being neglected. Studies have shown that closed pleural biopsy especially done with image guidance has high yield and low complication rate as compared to thoracoscopy. Given the ease of the procedure and the less cost involved, imaged guided closed pleural biopsy should be considered as the initial diagnostic step in undiagnosed pleural biopsy especially in developing countries with high prevalence of tuberculosis. PMID:26664179

  16. Recommendations of diagnosis and treatment of pleural effusion. Update.

    PubMed

    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

    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

  17. Sarcoidosis as unusual cause of massive pleural effusion

    PubMed Central

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

    2015-01-01

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

  18. Different characteristics of tuberculous pleural effusion according to pleural fluid cellular predominance and loculation

    PubMed Central

    Lee, Jaehee; Lim, Jae Kwang; Yoo, Seung Soo; Lee, Shin Yup; Cha, Seung Ick; Park, Jae Yong

    2016-01-01

    Background Tuberculous pleural effusion (TPE) exhibits different characteristics according to pleural fluid cellular predominance or whether the pleural fluid is free-flowing or loculated. However, its categorization based on either of these factors alone may be insufficient to properly reflect the heterogeneous manifestation of TPE. We evaluated the characteristics of the four TPE groups classified according to cellular predominance and whether the fluid is free-flowing or loculated. Methods A cohort of 375 patients with TPE was retrospectively reviewed. Clinical, radiological, and laboratory findings were compared between neutrophilic and lymphocytic TPE, and between free-flowing and loculated effusion for both neutrophilic and lymphocytic TPE. Results Lymphocytic TPE and neutrophilic TPE were observed in 336 (90%) and 39 (10%) patients, respectively. Pleural fluid loculation was present in 36% and 31% of the patients in the lymphocytic and neutrophilic groups, respectively. A few parameters of the laboratory findings between neutrophilic and lymphocytic TPE patients showed significant differences. However, these significant differences were prominently observed when comparing free-flowing and loculated subgroups of the respective neutrophilic and lymphocytic groups. Pleural fluid pH, lactate dehydrogenase, and adenosine deaminase levels were significantly different among the four subgroups. The neutrophilic loculated subgroup exhibited the most intense pleural inflammation and the highest mycobacterial yields when compared to the other subgroups. However, the percentage of neutrophils in the pleural fluid was not positively associated with the probability of culture-positive effusion. Conclusions The heterogeneous manifestation of TPE would be better characterized by using a classification system based on combined pleural fluid cellular predominance and loculation, with the neutrophilic loculated subgroup contributing to most of the clinically significant

  19. Pleural fluid infection caused by Dietzia cinnamea.

    PubMed

    Cawcutt, Kelly A; Bhatti, Micah M; Nelson, Darlene R

    2016-08-01

    Dietzia cinnamea was recovered from pleural fluid in an immunocompromised patient by inoculating blood culture bottles and was identified with matrix-assisted laser desorption ionization-time-of-flight mass spectrometry. The case shows the expanding ability of microbiology laboratories to identify rare organisms through newer techniques and technology. PMID:27312689

  20. A treatment planning system for pleural PDT

    NASA Astrophysics Data System (ADS)

    Sandell, Julia; Chang, Chang; Finlay, Jarod C.; Zhu, Timothy C.

    2010-02-01

    Uniform light fluence distribution for patients undergoing photodynamic therapy (PDT) is critical to ensure predictable PDT outcome. However, common practice uses a point source to deliver light to the pleural cavity. To improve the uniformity of light fluence rate distribution, we have developed a treatment planning system using an infrared camera to track the movement of the point source. This study examines the light fluence (rate) delivered to chest phantom to simulate a patient undergoing pleural PDT. Fluence rate (mW/cm2) and cumulative fluence (J/cm2) was monitored at 7 different sites during the entire light treatment delivery. Isotropic detectors were used for in-vivo light dosimetry. Light fluence rate in the pleural cavity is also calculated using the diffusion approximation with a finite-element model. We have established a correlation between the light fluence rate distribution and the light fluence rate measured on the selected points based on a spherical cavity model. Integrating sphere theory is used to aid the calculation of light fluence rate on the surface of the sphere as well as inside tissue assuming uniform optical properties. The resulting treatment planning tool can be valuable as a clinical guideline for future pleural PDT treatment.

  1. Pleuroperitoneal shunt for recurrent malignant pleural effusions.

    PubMed Central

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

    1990-01-01

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

  2. Automatic spatiotemporal matching of detected pleural thickenings

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

  3. Massive Pleural Fluid Collection in Adult Nigerians

    PubMed Central

    Okoh, Peter D.

    2016-01-01

    Background. There are no available literatures on massive pleural effusions (MPE) in our country. Aim. To determine the aetiology of MPE and compare the mortality rate between malignant and nonmalignant MPE in adult Nigerians. Methods. A prospective study of all the patients diagnosed with nontraumatic pleural fluid collections for one year in two tertiary federal hospitals in Southern Nigeria. A total of 101 consecutive patients with pleural fluid collections were studied. Diagnoses were made by clinical features and laboratory and radiological investigations. Results. Forty-eight patients (47.5%) had MPE with a mean age of 43 years ± 14.04 and 35 were females. Thirty patients (62.5%) were diagnosed with nonmalignant conditions (21 from pulmonary tuberculosis (PTB) and 9 from other causes). Haemorrhagic pleural collections were from malignancy in 12 (30.8%) and from PTB in 6 (15.4%). Straw-coloured collections were from malignancy in 9 (23.1%), from PTB in 8 (20.1%), and from posttraumatic exudative effusion in 3 (7.7%). Compared with nonmalignant MPE, patients with malignant collections had higher mortality within 6 months (8/18 versus 0/30 with a P value of 0.000). Conclusion. The presentation of patients with nontraumatic haemorrhagic or straw-coloured MPE narrows the diagnosis to PTB and malignancy with MPE cases being a marker for short survival rate. PMID:27437443

  4. Role of blind closed pleural biopsy in the management of pleural exudates

    PubMed Central

    Pereyra, Marco F; San-José, Esther; Ferreiro, Lucía; Golpe, Antonio; Antúnez, José; González-Barcala, Francisco-Javier; Abdulkader, Ihab; Álvarez-Dobaño, José M; Rodríguez-Núñez, Nuria; Valdés, Luis

    2013-01-01

    INTRODUCTION: The performance of blind closed pleural biopsy (BCPB) in the study of pleural exudates is controversial. OBJECTIVE: To assess the diagnostic yield of BCPB in clinical practice and its role in the study of pleural exudates. METHODS: Data were retrospectively collected on all patients who underwent BCPB performed between January 1999 and December 2011. RESULTS: A total of 658 BCPBs were performed on 575 patients. Pleural tissue was obtained in 590 (89.7%) of the biopsies. A malignant pleural effusion was found in 35% of patients. The cytology and the BCPB were positive in 69.2% and 59.2% of the patients, respectively. Of the patients with negative cytology, 21 had a positive BCPB (diagnostic improvement, 15%), which would have avoided one pleuroscopy for every seven BCPBs that were performed. Of the 113 patients with a tuberculous effusion, granulomas were observed in 87 and the Lowenstein culture was positive in an additional 17 (sensitivity 92%). The overall sensitivity was 33.9%, with a specificity and positive predictive value of 100%, and a negative predictive value of 71%. Complications were recorded in 14.4% of patients (pneumothorax 9.4%; chest pain 5.6%; vasovagal reaction, 4.1%; biopsy of another organ 0.5%). CONCLUSIONS: BCPB still has a significant role in the study of a pleural exudate. If an image-guided technique is unavailable, it seems reasonable to perform BCPB before resorting to a pleuroscopy. These results support BCPB as a relatively safe technique. PMID:23951560

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  7. Expression of cartilage-specific markers in calcified and non-calcified atherosclerotic lesions.

    PubMed

    Aigner, Thomas; Neureiter, Daniel; Câmpean, Valentina; Soder, Stephan; Amann, Kerstin

    2008-01-01

    Recently, molecular mechanisms resembling endochondral ossification were suggested to be important for atherosclerotic vessel calcification. The aim of this study was to investigate in a series of human atherosclerotic (non-diabetic) lesions of the crural arteries the distribution and expression of classical marker genes of the endochondral ossification pathway. Immunostaining for marker proteins S-100 protein and collagen types II and X were performed on atherosclerotic lesions of different grades (according to Stary). Quantitative real-time PCR for human COL1A1, COL2A1, COL10A1, SOX9, and BMP-2 was applied on RNA isolated from atherosclerotic arteries. In most samples, no expression of collagen type II and S-100 protein was found. Exceptionally, S-100 protein and type II collagen expression was observed very focally within advanced atherosclerotic plaques. Type X collagen was not detected in any of the lesions investigated. Overall, in our study we found no evidence that chondrogenic differentiation pathways are generally active in atherosclerotic plaque formation. In particular type X collagen, one important molecule in cartilage calcification, was not expressed in any of the investigated specimens. Occasionally, however, chondrocytic differentiation markers occur within atherosclerotic lesions. This most likely represents a metaplastic event associated, but not causative for atherosclerotic vessel degeneration and calcification. PMID:17335825

  8. Disappearance of La Caille Plaque

    NASA Astrophysics Data System (ADS)

    2010-04-01

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

  9. Reflection spectroscopy of atherosclerotic plaque

    NASA Astrophysics Data System (ADS)

    Lilledahl, Magnus B.; Haugen, Olav A.; Barkost, Marianne; Svaasand, Lars O.

    2006-03-01

    Heart disease is the primary cause of death in the western world. Many of these deaths are caused by the rupture of vulnerable plaque. Vulnerable plaques are characterized by a large lipid core covered by a thin fibrous cap. One method for detecting these plaques is reflection spectroscopy. Several studies have investigated this method using statistical methods. A more analytic and quantitative study might yield more insight into the sensitivity of this detection modality. This is the approach taken in this work. Reflectance spectra in the spectral region from 400 to 1700 nm are collected from 77 measurement points from 23 human aortas. A measure of lipid content in a plaque based on reflection spectra is presented. The measure of lipid content is compared with the thickness of the lipid core, determined from histology. Defining vulnerable plaque as having a lipid core >500 µm and fibrous cap <500 µm, vulnerable plaques are detected with a sensitivity of 88% and a specificity of 94%. Although the method can detect lipid content, it is not very sensitive to the thickness of the fibrous cap. Another detection modality is necessary to detect this feature.

  10. PLEURAL EFFECTS OF INDIUM PHOSPHIDE IN B6C3F1 MICE: NONFIBROUS PARTICULATE INDUCED PLEURAL FIBROSIS

    PubMed Central

    Kirby, Patrick J.; Shines, Cassandra J.; Taylor, Genie J.; Bousquet, Ronald W.; Price, Herman C.; Everitt, Jeffrey I.; Morgan, Daniel L.

    2010-01-01

    The mechanism(s) by which chronic inhalation of indium phosphide (InP) particles causes pleural fibrosis is not known. Few studies of InP pleural toxicity have been conducted because of the challenges in conducting particulate inhalation exposures, and because the pleural lesions developed slowly over the 2-year inhalation study. The authors investigated whether InP (1 mg/kg) administered by a single oropharyngeal aspiration would cause pleural fibrosis in male B6C3F1 mice. By 28 days after treatment, protein and lactate dehydrogenase (LDH) were significantly increased in bronchoalveolar lavage fluid (BALF), but were unchanged in pleural lavage fluid (PLF). A pronounced pleural effusion characterized by significant increases in cytokines and a 3.7-fold increase in cell number was detected 28 days after InP treatment. Aspiration of soluble InCl3 caused a similar delayed pleural effusion; however, other soluble metals, insoluble particles, and fibers did not. The effusion caused by InP was accompanied by areas of pleural thickening and inflammation at day 28, and by pleural fibrosis at day 98. Aspiration of InP produced pleural fibrosis that was histologically similar to lesions caused by chronic inhalation exposure, and in a shorter time period. This oropharyngeal aspiration model was used to provide an initial characterization of the progression of pleural lesions caused by InP. PMID:19995279

  11. Pioneer F Plaque Symbology

    NASA Technical Reports Server (NTRS)

    1972-01-01

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

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

    PubMed

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

    2011-08-01

    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

  13. Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure

    PubMed Central

    Arvin, Armita; Darvish, Alireza; Aflaki, Sareh

    2014-01-01

    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

  14. The use of ultrasonic spectroscopy to characterize calcified lesions

    NASA Technical Reports Server (NTRS)

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

    1981-01-01

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

  15. Effects of Stent Design and Atherosclerotic Plaque Composition on Arterial Wall Biomechanics

    PubMed Central

    Timmins, Lucas H.; Meyer, Clark A.; Moreno, Michael R.; Moore, James E.

    2008-01-01

    Purpose: To examine the solid mechanical effects of varying stent design and atherosclerotic plaque stiffness on the biomechanical environment induced in a diseased artery wall model. Methods: Computational modeling techniques were employed to investigate the final radius of the lumen and artery wall stresses after stent implantation. Two stent designs were studied (one stiff and one less stiff). The stenotic artery was modeled as an axisymmetrical diseased vessel with a 20% stenosis by diameter. The material properties of the diseased tissue in the artery models varied. Atherosclerotic plaques half as stiff (0.5×), of equal stiffness (1.0×), or twice as stiff (2.0×) as the artery wall were investigated. Results: Final lumen radius was dependent on stent design, and the stiffer stent deformed the artery to an approximately 10% greater radius than the more compliant design. Alternatively, circumferential stress levels were dependent on both stent design and plaque material properties. Overall, the stiffer stent subjected the artery wall to much higher stress values than the more compliant design, with differences in peak values of 0.50, 0.31, and 0.09 MPa for the 2.0×, 1.0×, and 0.5× stiff plaques, respectively. Conclusion: Evidence suggests that a judicious choice of stent design can minimize stress while maintaining a patent lumen in stenotic arteries. If confronted with a rigid, calcified plaque, stent design is more important, as design differences can impose dramatically different stress fields, while still providing arterial patency. Alternatively, stent design is not as much of an issue when treating a soft, lipid-laden plaque, as stress fields do not vary significantly among stent designs. PMID:19090628

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

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

    1990-10-01

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

  19. Denitrification in human dental plaque

    PubMed Central

    2010-01-01

    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. PMID:20307293

  20. A study to compare the diagnostic efficacy of closed pleural biopsy with that of the thoracoscopic guided pleural biopsy in patients of pleural effusion

    PubMed Central

    Mishra, Ashwini Kumar; Verma, Sanjeev Kumar; Kant, Surya; Kushwaha, Ram Awadh; Garg, Rajiv; Kumar, Santosh; Prakash, Ved; Verma, Ajay; Sagar, Mala

    2016-01-01

    Background: The diagnostic approach to exudative pleural effusion remains an underappreciated aspect of modern thoracic medicine. 15-20% of the pleural effusions remain undiagnosed. The most efficient approach to pleural exudates remains uncertain and controversial particularly if acquisition of pleural tissue is required. The clinician needs to consider various factors when confronted with the choice between closed pleural biopsy (CPB) and thoracoscopy. Hence this study was planned to compare the diagnostic efficacy of CPB and Thoracoscopic pleural biopsy (TPB). Materials and Methods: This was a prospective interventional study in patients of exudative pleural effusion. CPB was performed by Cope's biopsy needle. Then inspection of the pleural cavity was performed by single port rigid thoracoscope (KARL, STORZ TELECAM DX II 20 2330 20) with viewing angle of zero (0) degrees and biopsy taken from the diseased or unhealthy parietal pleura. Accordingly we compared the results of CPB and TPB. Results: 46 Patients underwent this study. In all 46 patients both CPB and TPB were performed. TPB was diagnostic in 36 cases (78.2%) while CPB was diagnostic only in 10 cases i.e. 21.7%. 10 (21,7%) cases remained undiagnosed. On thoracoscopic examination 30 patients were having nodularity, 25 (54.3%) were having adhesions and 20 (43.5%) were having hyperemia. 79.3% of the patients with nodularity turned out to be malignant and 71.4% of patients with adhesions and hyperemia tubercular. Conclusions: TPB has much greater diagnostic efficacy than CPB. PMID:27169119

  1. ARTHROSCOPIC TREATMENT OF CALCIFYING TENDINITIS OF THE ROTATOR CUFF

    PubMed Central

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

    2015-01-01

    To evaluate the clinical and radiographic results from arthroscopic surgical treatment of the rotator cuff in patients with calcifying tendinitis. Method: A retrospective study was conducted on twenty patients who underwent arthroscopic treatment for calcifying tendinitis of the shoulder between March 1999 and November 2005. Six patients were excluded due to loss of follow-up. The average follow-up period was 41.4 months. Eight patients (57%) were female and six (43%) were male. The right side was affected in 10 cases (71%) and the left in four cases (29%). Nine cases (64%) had calcification in the supraspinatus tendon, two (14%) in the infraspinatus tendon, and three (21%) in both tendons. Results: In all cases, resection of the calcium deposits was performed by means of a needle (Jelco® No. 14) in combination with curettage (mini-curette). Two shoulders (14%) underwent subacromial decompression, and one (7%) underwent excision of the distal clavicle. A tendon-tendon suture was performed in three shoulders (21%). None of the patients underwent tendon-bone reinsertion. The mean score obtained on the UCLA scale was 33 points (26-35), thus indicating that a majority of patients had good results. In the final radiographic evaluation, none of the patients showed signs of calcification. Conclusion: Arthroscopic treatment of calcifying tendinitis of the shoulder safely allows excision of the calcification, leading to good results in relation to shoulder pain and function. PMID:27022591

  2. Ultrastructure and histogenesis of the acral calcified angioleiomyoma.

    PubMed

    Díaz-Flores, Lucio; Gutiérrez, Ricardo; Alvarez-Argüelles, Hugo; González-Gómez, Miriam; García, Maria Del Pino; Díaz-Flores, Lucio

    2016-01-01

    We studied the ultrastructure, immunohistochemistry, and histogenesis of the acral calcified angioleiomyoma, observing three concentric zones: (a) pseudocapsular, thin, with spindle-shaped stromal cells (SCs), presenting scarce organelles and expressing CD34, (b) muscular, forming a ring, with smooth muscle cells of heterogenous phenotype (mainly in quantity and thickness of filaments, and in expression of h-caldesmon, αSMA, and desmin), and (c) central, extensive, calcified (spicular and/or star-shaped calcium deposits around collagen fibers), with pericytic involutive vasculature. The intratumoral vessels were thick (several layers of perivascular cells, with a continuum of phenotypes, resembling myopericytoma vessels) and thin (slit-like channels), without adventitial SCs or elastic material. The extratumoral vessels showed adventitial SCs (which contribute to form the tumor pseudocapsule), hyperplasia of the media and intima layers, and/or occlusion of the lumen by a wide, homogenous fibrotic central zone. Histogenetically, the collagenous matrix may act as a mineralization substrate and the calcifying modified pericytes as inductors; intratumoral vessels may originate from the peritumoral vessels or from the vessel where the tumor develops; and extratumoral vessel modifications, mimicking tumor features, concur with a minor repetitive trauma pathogenesis. PMID:26691377

  3. Cerebral metastasis from malignant pleural mesothelioma

    PubMed Central

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

    2013-01-01

    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

  4. [A case report of pleural involvement in primary macroglobulinemia].

    PubMed

    Noguchi, M; Yamaguchi, A; Tsuboi, E; Watanabe, T; Narui, K; Yoshimura, K; Chonabayashi, N; Nakata, K; Kanbayashi, H; Endo, Y

    1990-01-01

    A case of primary macroglobulinemia with pleural and gastric involvement was presented. A 48-year-old female was admitted with productive cough. On physical examination neither lymphoadenopathy nor hepatosplenomegaly were found. In addition, no bleeding tendency nor disturbance of the visual acuity were detected. Her chest roentgenogram showed a moderate amount of pleural effusion in the left pleural cavity without infiltration in the lung fields and no evidence of swollen hilar or mediastinal lymphnodes. A monoclonal M-band of to IgM-kappa type was observed in her serum and the pleural effusion. The diffuse ulcerative lesion in the gastric mucosa was detected by gastrofiberscopy. The lymphoid cells taken from the pleural effusion and the gastric mucosa stained positively with fluorescein-conjugated antiserum to u or the kappa chain. Pleural effusion and gastric infiltration of lymphoid cells improved remarkably following ACOP therapy. PMID:2113145

  5. Extrapleural pneumonectomy for malignant pleural mesothelioma.

    PubMed

    Argote-Greene, Luis M; Chang, Michael Y; Sugarbaker, David J

    2005-01-01

    Extrapleural pneumonectomy was introduced in the 1940s for the treatment of extensive infections of the lung and pleural space. Over the past 20 years, the extrapleural pneumonectomy technique has been modified and applied to the treatment of locally advanced malignant pleural mesothelioma, achieving substantial reductions in mortality. The current mortality rate of 3.4% at the Brigham and Women's Hospital has permitted us to expand our use of this operation to treat locally advanced lung cancer and thymoma. The extrapleural pneumonectomy technique consists of five basic steps: (1) Incision and exposure of the parietal pleura: (2) Dissection of the tumor and parietal pleura from the chest wall, diaphragm, and mediastinum: (3) Division and control of the pulmonary vessels and bronchus followed by lymph node dissection: (4) En bloc resection of the lung, pleura, pericardium, and diaphragm; (5) Reconstruction of the diaphragm and pericardium. Extrapleural pneumonectomy is a complex and challenging operation. Accompanied by a 60% minor and major complication rate, it requires a unique management approach to achieve 3.4% mortality. Primary contributing factors to the reduction in mortality include a reduced operative time of 3 h, refinements in operative technique, and improved selection of patients. The technique discussed below is the culmination of 20 years' experience with malignant pleural mesothelioma at the Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, MA USA. PMID:24414726

  6. Management of Parapneumonic Pleural Effusion in Adults.

    PubMed

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

    2015-12-01

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

  7. Carbimazole induced pleural effusion: a case report.

    PubMed

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

    2012-01-01

    Objective. To describe a patient with unilateral exudative pleural effusion that developed after commencement of carbimazole. Methods. We describe the presentation and clinical journey of an elderly woman who presented to the chest physicians initially with pleural effusion but was followed up by the endocrinology team. Result. The patient was a 77-year-old Caucasian woman who presented with symptoms of breathlessness and a confirmed unilateral pleural effusion while being on treatment for thyrotoxicosis. Her symptoms needed recurrent hospital admission for investigations and drainage, but no potential cause was identified after extensive investigations. A drug-induced exudative effusion consequent to carbimazole intake was diagnosed as discontinuation of the drug lead to complete resolution of the effusion with no recurrence. Conclusion. Physicians and Endocrinologist must bear in mind that this potentially rare complication of carbimazole while treating patients of thyrotoxicosis as appearance of similar features in their patients while being on carbimazole should lead to the discontinuation of the drug, and alternative treatment strategy should be considered. PMID:22953074

  8. Diagnosis and treatment of malignant pleural mesothelioma.

    PubMed

    Rodríguez Panadero, Francisco

    2015-04-01

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

  9. Invasive evaluation of plaque morphology of symptomatic superficial femoral artery stenoses using combined near-infrared spectroscopy and intravascular ultrasound.

    PubMed

    Zacharias, Sibin K; Safian, Robert D; Madder, Ryan D; Hanson, Ivan D; Pica, Mark C; Smith, James L; Goldstein, James A; Abbas, Amr E

    2016-08-01

    The purpose of this study is to characterize the plaque morphology of severe stenoses in the superficial femoral artery (SFA) employing combined near-infrared spectroscopy and intravascular ultrasound (NIRS-IVUS). Atherosclerosis is the most common cause of symptomatic peripheral arterial disease. Plaque composition of SFA stenoses has been characterized as primarily fibrous or fibrocalcific by non-invasive and autopsy studies. NIRS has been validated to detect lipid-core plaque (LCP) in the coronary circulation. We imaged severe SFA stenoses with NIRS-IVUS prior to revascularization in 31 patients (46 stenoses) with Rutherford claudication ⩾ class 3. Angiographic parameters included lesion location and stenosis severity. IVUS parameters included plaque burden and presence of calcium. NIRS images were analyzed for LCP and maximum lipid-core burden index in a 4-mm length of artery (maxLCBI4mm). By angiography, 38 (82.6%) lesions were calcified and 9 (19.6%) were chronic total occlusions. Baseline stenosis severity and lesion length were 86.0 ± 11.0% and 36.5 ± 46.5 mm, respectively. NIRS-IVUS identified calcium in 45 (97.8%) lesions and LCP in 17 (37.0%) lesions. MaxLCBI4mm was 433 ± 244. All lesions with LCP also contained calcium; there were no non-calcified lesions with LCP. In conclusion, this is the first study of combined NIRS-IVUS in patients with PAD. NIRS-IVUS demonstrates that nearly all patients with symptomatic severe SFA disease have fibrocalcific plaque, and one-third of such lesions contain LCP. These findings contrast with those in patients with acute coronary syndromes, and may have implications regarding the pathophysiology of atherosclerosis in different vascular beds. PMID:26957574

  10. Imaging Atherosclerosis and Vulnerable Plaque

    PubMed Central

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

    2010-01-01

    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. PMID:20395341

  11. Neuroimaging of the Vulnerable Plaque

    PubMed Central

    Lovblad, Karl-Olof; Mendes-Pereira, Vitor; Garibotto, Valentina; Assal, Frédéric; Willi, Jean-Pierre; Stztajzel, Roman; Ratib, Osman; Vargas, Maria Isabel

    2015-01-01

    Plaque vulnerability due to inflammation has been shown to be a participating factor in the degenerative process in the arterial wall that contributes to stenosis and embolism. This is believed to have an important role to play also in the genesis of stroke or cerebrovascular diseases. In order to appropriately screen patients for treatment, there is an absolute need to directly or indirectly visualize both the normal carotid and the suspected plaque. This can be done with a variety of techniques ranging from ultrasound to computed tomography (CT) and magnetic resonance imaging (MRI). In addition to angiographic techniques, direct imaging of the plaque can be done either by ultrasound or by the so-called molecular imaging techniques, i.e. positron emission tomography (PET). These findings, together with other clinical and paraclinical parameters should finally guide the therapeutic choice. PMID:24188487

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

    PubMed

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

    2015-10-01

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

  13. Pleural effusion as a result of chronic renal ischemia

    PubMed Central

    Akopov, Andrey; Semenov, Dmitry; Karev, Andrey; Filippov, Denis; Lukina, Olga

    2011-01-01

    We would like to present a case of patient with a transudative pleural effusion as a result of atherosclerotic occlusion of renal arteries. About 50 liters of fluid were drained from the right pleural cavity during 10 months period of observation. Successful revascularization of kidneys improved left ventricular function, stabilized hemodynamic of the pulmonary circulation and thus led to elimination of pleural effusion. PMID:22263089

  14. Pleural effusion as a result of chronic renal ischemia.

    PubMed

    Akopov, Andrey; Semenov, Dmitry; Karev, Andrey; Filippov, Denis; Lukina, Olga

    2011-09-01

    We would like to present a case of patient with a transudative pleural effusion as a result of atherosclerotic occlusion of renal arteries. About 50 liters of fluid were drained from the right pleural cavity during 10 months period of observation. Successful revascularization of kidneys improved left ventricular function, stabilized hemodynamic of the pulmonary circulation and thus led to elimination of pleural effusion. PMID:22263089

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

    PubMed Central

    Mantur, Prakash

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Saderne, V.; Wahl, M.

    2012-04-01

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

  17. [Contribution of pleural fluid analysis to the diagnosis of pleural effusion].

    PubMed

    Ferreiro, Lucía; Toubes, María Elena; Valdés, Luis

    2015-08-21

    Analysis of pleural fluid can have, on its own, a high diagnostic value. In addition to thoracocentesis, a diagnostic hypothesis based on medical history, physical examination, blood analysis and imaging tests, the diagnostic effectiveness will significantly increase in order to establish a definite or high probable diagnosis in a substantial number of patients. Differentiating transudates from exudates by the classical Light's criteria helps knowing the pathogenic mechanism resulting in pleural effusion, and it is also useful for differential diagnosis purposes. An increased N-terminal pro-brain natriuretic peptide, both in the fluid and in blood, in a due clinical context, is highly suggestive of heart failure. The presence of an increased inflammatory marker, such as C-reactive protein, together with the presence of over 50% of neutrophils is highly suggestive of parapneumonic pleural effusion. If, in these cases, the pH is<7.20, then the likelihood of complicated pleural effusion is high. There remains to be demonstrated the usefulness of other markers to differentiate complicated from uncomplicated effusions. An adenosine deaminase > 45 U/L and>50% lymphocytes is suggestive of tuberculosis. If a malignant effusion is suspected but the cytological result is negative, increased concentrations of some markers in the pleural fluid can yield high specificity values. Increased levels of mesothelin and fibruline-3 are suggestive of mesothelioma. Immunohistochemical studies can be useful to differentiate reactive mesothelial cells, mesothelioma and metastatic adenocarcinoma. An inadequate use of the information provided by the analysis of pleural fluid would results in a high rate of undiagnosed effusions, which is unacceptable in current clinical practice. PMID:25433793

  18. Molecular Imaging of Plaque Vulnerability

    PubMed Central

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

    2014-01-01

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

  19. Identifying Thoracic Malignancies Through Pleural Fluid Biomarkers

    PubMed Central

    Porcel, José M.; Esquerda, Aureli; Martínez-Alonso, Montserrat; Bielsa, Silvia; Salud, Antonieta

    2016-01-01

    Abstract The diagnosis of malignant pleural effusions may be challenging when cytological examination of aspirated pleural fluid is equivocal or noncontributory. The purpose of this study was to identify protein candidate biomarkers differentially expressed in the pleural fluid of patients with mesothelioma, lung adenocarcinoma, lymphoma, and tuberculosis (TB). A multiplex protein biochip comprising 120 biomarkers was used to determine the pleural fluid protein profile of 29 mesotheliomas, 29 lung adenocarcinomas, 12 lymphomas, and 35 tuberculosis. The relative abundance of these predetermined biomarkers among groups served to establish the differential diagnosis of: malignant versus benign (TB) effusions, lung adenocarcinoma versus mesothelioma, and lymphoma versus TB. The selected putative markers were validated using widely available commercial techniques in an independent sample of 102 patients. Significant differences were found in the protein expressions of metalloproteinase-9 (MMP-9), cathepsin-B, C-reactive protein, and chondroitin sulfate between malignant and TB effusions. When integrated into a scoring model, these proteins yielded 85% sensitivity, 100% specificity, and an area under the curve (AUC) of 0.98 for labeling malignancy in the verification sample. For lung adenocarcinoma–mesothelioma discrimination, combining CA19-9, CA15-3, and kallikrein-12 had maximal discriminatory capacity (65% sensitivity, 100% specificity, AUC 0.94); figures which also refer to the validation set. Last, cathepsin-B in isolation was only moderately useful (sensitivity 89%, specificity 62%, AUC 0.75) in separating lymphomatous and TB effusions. However, this last differentiation improved significantly when cathepsin-B was used with respect to the patient's age (sensitivity 72%, specificity 100%, AUC 0.94). In conclusion, panels of 4 (i.e., MMP-9, cathepsin-B, C-reactive protein, chondroitin sulfate), or 3 (i.e., CA19-9, CA15-3, kallikrein-12) different protein

  20. Large unilateral pleural effusion secondary to Moraxella catarrhalis infection.

    PubMed

    Naha, Kushal; Prabhu, Ravindra

    2011-01-01

    A 43-year-old male with chronic kidney disease on maintenance hemodialysis presented with breathlessness, cough and right-sided abdominal pain. Examination revealed a large right-sided pleural effusion and subsequent thoracocentesis yielded an exudate. Although the fluid culture was sterile, sputum culture produced Moraxella catarrhalis. Tuberculosis was ruled out by pleural fluid analysis and pleural biopsy. Antibiotics were administered and subsequent radiograms indicated resolution of the effusion. This is a rare case of a large unilateral pleural effusion secondary to M. catarrhalis infection in a nonsmoker with no pre-existing pulmonary pathology. PMID:23393539

  1. Ultrasound in the diagnosis and management of pleural effusions.

    PubMed

    Soni, Nilam J; Franco, Ricardo; Velez, Maria I; Schnobrich, Daniel; Dancel, Ria; Restrepo, Marcos I; Mayo, Paul H

    2015-12-01

    We review the literature on the use of point-of-care ultrasound to evaluate and manage pleural effusions. Point-of-care ultrasound is more sensitive than physical exam and chest radiography to detect pleural effusions, and avoids many negative aspects of computerized tomography. Additionally, point-of-care ultrasound can assess pleural fluid volume and character, revealing possible underlying pathologies and guiding management. Thoracentesis performed with ultrasound guidance has lower risk of pneumothorax and bleeding complications. Future research should focus on the clinical effectiveness of point-of-care ultrasound in the routine management of pleural effusions and how new technologies may expand its clinical utility. PMID:26218493

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

    PubMed Central

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

    2015-01-01

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

  3. The Management of Delayed Post-Pneumonectomy Broncho-Pleural Fistula and Esophago-Pleural Fistula.

    PubMed

    Noh, Dongsub; Park, Chang-Kwon

    2016-04-01

    Broncho-pleural fistula (BPF) and esophago-pleural fistula (EPF) after pulmonary resection are challenging to manage. BPF is controlled by irrigation and sterilization, but such therapy is not sufficient to promote closure of EPF, which usually requires surgical management. However, it is generally difficult to select an appropriate surgical method for closure of BPF and EPF. Here, we report a case of concomitant BPF and EPF after left completion pneumonectomy, in which both fistulas were closed through a right thoracotomy. PMID:27066439

  4. The Management of Delayed Post-Pneumonectomy Broncho-Pleural Fistula and Esophago-Pleural Fistula

    PubMed Central

    Noh, Dongsub; Park, Chang-Kwon

    2016-01-01

    Broncho-pleural fistula (BPF) and esophago-pleural fistula (EPF) after pulmonary resection are challenging to manage. BPF is controlled by irrigation and sterilization, but such therapy is not sufficient to promote closure of EPF, which usually requires surgical management. However, it is generally difficult to select an appropriate surgical method for closure of BPF and EPF. Here, we report a case of concomitant BPF and EPF after left completion pneumonectomy, in which both fistulas were closed through a right thoracotomy. PMID:27066439

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

    PubMed

    Harvey-Taylor, Jessica; Zhang, Yanhong; Kuderer, Valerie; Cooke, David T

    2013-06-01

    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. PMID:23825783

  6. Primary pleural intermediate hemangioendothelioma with pleural effusion as the only manifestation

    PubMed Central

    Jiang, Juan; Hu, Chengping; Zhou, Jianhua; Yang, Huaping; Cao, Liming; Deng, Pengbo

    2016-01-01

    Intermediate hemangioendothelioma is a group of rare tumors of vascular origin that show a borderline biological behavior and commonly arise in extremities, trunk, head or neck. Intermediate hemangioendothelioma originating in pleura is extremely rare. Herein we describe a case of primary pleural intermediate hemangioendothelioma in a 48-year-old man presenting with pleural effusion only. The patient was diagnosed by pleura biopsy and immunohistochemistry in our hospital. Even though neither systemic chemotherapy nor surgery was applied, he got relieved gradually and sustained asymptomatic during follow-up for 10 months. PMID:27162702

  7. Inhibiting macrophage proliferation suppresses atherosclerotic plaque inflammation

    PubMed Central

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

    2015-01-01

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

  8. Understanding Motivation of Plaque Control.

    ERIC Educational Resources Information Center

    Beck, Kenneth H.

    1982-01-01

    A theoretical model for understanding motivation of plaque control is presented. The belief in this model is that, if people can be convinced of their ability to control a health threat, they would be encouraged to take responsibility for their health. (CJ)

  9. Dynamics of mussel plaque detachment.

    PubMed

    Desmond, Kenneth W; Zacchia, Nicholas A; Waite, J Herbert; Valentine, Megan T

    2015-09-14

    Mussels are well known for their ability to generate and maintain strong, long-lasting adhesive bonds under hostile conditions. Many prior studies attribute their adhesive strength to the strong chemical interactions between the holdfast and substrate. While chemical interactions are certainly important, adhesive performance is also determined by contact geometry, and understanding the coupling between chemical interactions and the plaque shape and mechanical properties is essential in deploying bioinspired strategies when engineering improved adhesives. To investigate how the shape and mechanical properties of the mussel's plaque contribute to its adhesive performance, we use a custom built load frame capable of fully characterizing the dynamics of the detachment. With this, we can pull on samples along any orientation, while at the same time measuring the resulting force and imaging the bulk deformations of the plaque as well as the holdfast-substrate interface where debonding occurs. We find that the force-induced yielding of the mussel plaque improves the bond strength by two orders of magnitude and that the holdfast shape improves bond strength by an additional order of magnitude as compared to other simple geometries. These results demonstrate that optimizing the contact geometry can play as important a role on adhesive performance as optimizing the chemical interactions as observed in other organisms and model systems. PMID:26223522

  10. Multiphoton microscopy of atheroslcerotic plaques

    NASA Astrophysics Data System (ADS)

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

    2007-02-01

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

  11. Pleural Tags on CT Scans to Predict Visceral Pleural Invasion of Non-Small Cell Lung Cancer That Does Not Abut the Pleura.

    PubMed

    Hsu, Jui-Sheng; Han, I-Ting; Tsai, Tzu-Hsueh; Lin, Shiou-Fu; Jaw, Twei-Shiun; Liu, Gin-Chung; Chou, Shah-Hwa; Chong, Inn-Wen; Chen, Chiao-Yun

    2016-05-01

    Purpose To evaluate the association of pleural tags with visceral pleural invasion of non-small cell lung cancer (NSCLC) that does not abut the pleural surface. Materials and Methods This retrospective study was approved by the institutional review board. Informed consent was waived. The study of NSCLC that does not abut the pleura in 141 patients (44 patients [31.2%] with visceral pleural invasion proved by pathologic analysis and 97 patients [68.8%] without pleural invasion) was conducted at a single tertiary center. The pleural tags were classified into three types (type 1, one or more linear pleural tag; type 2, one or more linear pleural tag with soft tissue component at the pleural end; and type 3, one or more soft tissue cord-like pleural tag) and prioritized into types 3, 2, and 1 when more than one type was present. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive likelihood ratio (LR) were calculated. Results In the absence of pleural tags, no pleural invasion was found. The presence of type 2 pleural tags was moderately associated with visceral pleural invasion with the following results: positive LR, 5.06; accuracy, 71%; sensitivity, 36.4%; specificity, 92.8%; PPV, 76.2%; and NPV, 69.6%. Type 1 pleural tags provided weak evidence to rule out visceral pleural invasion (positive LR, 0.38). Type 3 pleural tags indicated minimal increase in the likelihood of visceral pleural invasion (positive LR, 1.68). Conclusion Type 2 pleural tags on conventional CT images can increase the accuracy of early diagnosis of visceral pleural invasion by NSCLC that does not abut the pleura. (©) RSNA, 2015. PMID:26653684

  12. Calcifying cystic odontogenic tumor associated with ameloblastic fibro-odontoma of the anterior mandible.

    PubMed

    Lee, Jun; Song, Young-Gook; Moon, Seong-Yong; Choi, Boyoung; Kim, Bong Chul; Yoon, Jung-Hoon

    2014-05-01

    Calcifying cystic odontogenic tumor, which was formerly named calcifying odontogenic cyst, is a benign odontogenic tumor containing clusters of ghost cells within ameloblastic epithelium. Calcifying cystic odontogenic tumors have been associated with other odontogenic tumors, a finding that is a rare event in other types of odontogenic cysts or tumors. This report describes a case of hybrid odontogenic tumor composed of calcifying cystic odontogenic tumor and ameloblastic fibroma-odontoma of the anterior mandible that occurred in a 4-year-old Korean girl. PMID:24785751

  13. In vivo light dosimetry for pleural PDT

    NASA Astrophysics Data System (ADS)

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

    2009-02-01

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

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

    PubMed Central

    2013-01-01

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

  15. Calcified amorphous tumor of the left atrial appendage.

    PubMed

    Watanabe, Yusuke; Naganuma, Toru; Nakao, Tatsuya; Nakamura, Sunao

    2016-01-01

    A 57-year-old female with end-stage renal dysfunction was admitted to our hospital. The echocardiogram revealed a 9mm×22mm hyperechoic mass in the left atrial appendage (LAA). The mass was extremely mobile. Considering the high risk of embolic events, we decided on a surgical resection. Microscopic examination of the mass revealed a nodular focus of calcification and fibrosis with focal chronic inflammation of the atrial endocardium. The endocardium was uniformly thickened with no evidence of neoplastic proliferation. The mass was diagnosed with a calcified amorphous tumor (CAT). This is first report of CAT of the LAA. PMID:26964029

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  18. Can bioabsorbable scaffolds be used in calcified lesions?

    PubMed

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

    2014-07-01

    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. PMID:23592566

  19. The Differential Diagnostic Values of Cytokine Levels in Pleural Effusions

    PubMed Central

    Akarsu, Saadet; Kurt, A. Nese Citak; Dogan, Yasar; Yilmaz, Erdal; Godekmerdan, Ahmet; Aygun, A. Denizmen

    2005-01-01

    The aim is to examine whether the changes in pleural fluid interleukin (IL)-1β, IL-2, IL-6, and IL-8 levels were significant in differential diagnosis of childhood pleural effusions. IL-1β, IL-2, IL-6, and IL-8 levels in pleural fluids of all 36 patients were measured. The levels of IL-1β, IL-2, IL-6, and IL-8 in pleural fluids were statistically significantly higher in the transudate group compared with those of the exudate group. The levels of IL-1β, IL-6, and IL-8 were also found to be statistically significantly higher in the empyema group compared with both the parapneumonic and the tuberculous pleural effusion groups. The levels of IL-2 and IL-6 were detected to be statistically significantly higher in the tuberculous pleural effusion group in comparison with those of the parapneumonic effusion group. The results showed that pleural fluids IL-1β, IL-2, IL-6, and IL-8 could be used in pleural fluids exudate and transudate distinction. PMID:15770060

  20. Unilateral pleural effusion without ascites in liver cirrhosis

    SciTech Connect

    Faiyaz, U.; Goyal, P.C.

    1983-09-01

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

  1. IL-5 in post-traumatic eosinophilic pleural effusion.

    PubMed Central

    Schandené, L; Namias, B; Crusiaux, A; Lybin, M; Devos, R; Velu, T; Capel, P; Bellens, R; Goldman, M

    1993-01-01

    Thoracic trauma or pneumothorax can result in pleural fluid eosinophilia. In this study we investigated the role of the eosinophilopoietic cytokine IL-5 in three cases of post-traumatic eosinophilic pleural effusions (EPE). Using a specific immunoenzymatic assay, significant levels of IL-5 were found in EPE (range 100-3000 pg/ml), while IL-5 was undetectable (< 25 pg/ml) in corresponding serum samples and in non-eosinophilic pleural fluids. IL-5 present in pleural fluids was found bioactive in a proliferative assay using a mouse CTLL-2 cell line transfected with the cDNA corresponding to the alpha chain of the human IL-5 receptor. Using a reverse polymerase chain reaction (PCR) method, we found IL-5 mRNA expression within pleural mononuclear cells from patients with EPE, but not in corresponding peripheral blood mononuclear cells (PBMC), confirming that IL-5 is synthesized locally in the pleural cavity. In the two cases in which pleural CD4+ cells were purified, these cells were identified as the major source of IL-5. Taken together, these data indicate that the development of post-traumatic EPE is related to a local secretion of IL-5 by CD4+ cells present in the pleural cavity. Images Fig. 1 PMID:8100745

  2. A RARE CASE OF PLEURAL LYMPHOMA

    PubMed Central

    Basuthakur, Sumitra; Sarkar, Anirban; Burman, Sushanta; Dandale, Rajesh

    2008-01-01

    We present a case report of a 20 years old male who had low grade fever, weight loss of about 10 kg and left-sided chest pain increasing in intensity over a year. Clinically, it mimicked left sided pleural effusion with a tender, soft, parietal swelling in left in-fraaxillary area. Chest x-ray and Computerized Tomography-scan of thorax showed pleura based mass in left hemi thorax. Computerized Tomography guided Fine Needle Aspiration Cytology confirmed the diagnosis of non Hodgkin Lymphoma, diffuse large B cell type, high-grade. PMID:21264085

  3. A novel method for non-invasive plaque morphology analysis by coronary computed tomography angiography.

    PubMed

    Fujimoto, Shinichiro; Kondo, Takeshi; Kodama, Takahide; Fujisawa, Yasuko; Groarke, John; Kumamaru, Kanako K; Takamura, Kazuhisa; Matsunaga, Eriko; Miyauchi, Katsumi; Daida, Hiroyuki; Rybicki, Frank J

    2014-10-01

    Coronary computed tomography angiography (CCTA) plaque morphology based on conventional Hounsfield units relies on absolute CT numbers is influenced by imaging and anatomical variables. The project describes and tests a novel alternative method, termed the "labeling method", which uses relative CT numbers and 3-dimensional plaque structure. Using virtual histology intravascular ultrasound (VH-IVUS) as the reference standard, this study compares the labeling method to a conventional CT-number based method to determine coronary plaque morphology. Thirty-seven high-risk, non-calcified atherosclerotic coronary lesions were prospectively evaluated in 33 consecutive patients who underwent CCTA followed by VH-IVUS (mean interval 8.6 ± 13.3 days). CCTA-derived vessel and minimum lumen areas were compared to VH-IVUS measures. Fibrotic and necrotic core areas were calculated by both the labeling method to the CT-number based method; both were tested for agreement with reference standard VH-IVUS. Inter- and intra-observer correlations were assessed. CCTA significantly underestimated minimum lumen area when compared to VH-IVUS (mean difference -1.4 ± 0.9 mm(2), p < 0.0001). Necrotic core and fibrous areas quantified using the labeling method demonstrated superior correlation with VH-IVUS compared to those quantified using the CT-number based method, Pearson's r = 0.75 versus 0.42 and r = 0.80 and 0.59, respectively. Compared to VH-IVUS, limits of agreement for the labeling method-derived necrotic core (-2.0 to 2.5 mm(2)) and fibrous areas (0.6-8.0 mm(2)) were more narrow than those determined using the CT-number based method (-3.7 to 7.3 and -4.0 to 8.9 mm(2), respectively). Inter- and intraobserver correlations were excellent for all CCTA derived measures (r = 0.85-0.98). A novel CCTA-based labeling method offers an alternative to conventional CT-number based analyses for plaque morphology. The labeling method demonstrates superior correlation to VH-IVUS for measures of

  4. Pleural Fluid Analysis: Standstill or a Work in Progress?

    PubMed Central

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

    2012-01-01

    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. PMID:22448326

  5. Concurrent pericardial and pleural effusions: a double jeopardy.

    PubMed

    Furst, Branko; Liu, Chyong-Jy J; Hansen, Philip; Musuku, Sridhar R

    2016-09-01

    A 19-year-old man with large malignant pleural and pericardial effusions with tamponade physiology and signs of congestive heart failure presented for emergent subxiphoid pericardial window. Surgical drainage of the pericardium was complicated by a paradoxical cardiovascular collapse that failed to respond to pressors and intravenous fluids. Suspecting a pericardial perforation, a median sternotomy was performed and revealed an intact heart. The arterial pressure was promptly restored after drainage of the pleural effusion. It is proposed that, in patients presenting with tamponading pericardial and pleural effusions, drainage of the pleural effusion be given priority. The pathophysiology of low cardiac output states resulting from pericardial and large pleural effusion is discussed and the literature reviewed. PMID:27555190

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

    PubMed Central

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

    2015-01-01

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

  7. Alveolar-filling growth pattern of sarcomatoid malignant pleural mesothelioma.

    PubMed

    Hayakawa, Takamitsu; Tajima, Shogo; Takanashi, Yusuke; Takahashi, Tsuyoshi; Neyatani, Hiroshi; Funai, Kazuhito

    2016-09-01

    A case of sarcomatoid malignant pleural mesothelioma showing extremely rare growth pattern is described. A 63-year-old man presented to our hospital with left pleural effusion. A computed tomography (CT) scan of the chest showed diffusely thickened left visceral and parietal pleura associated with intermingled pulmonary infiltrative shadowing. Biopsy of the pleura under general anaesthesia confirmed the diagnosis of sarcomatoid malignant pleural mesothelioma. The patient underwent left extra-pleural pneumonectomy. Histopathologically, the sarcomatoid spindle tumour cells changed their morphology to polygonal cells in the pulmonary parenchyma and grew upwards, filling the alveolar space without the destruction of its septa, showing an alveolar-filling growth pattern. The current report indicates a case of sarcomatoid pleural mesothelioma that shows an alveolar-filling growth pattern, despite having not been thoroughly categorized in the World Health Organization (WHO) classification. PMID:27516891

  8. IVUS-based histology of atherosclerotic plaques: improving longitudinal resolution

    NASA Astrophysics Data System (ADS)

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

    2010-03-01

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

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

    PubMed Central

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

    2013-01-01

    Intravascular optical coherence tomography (IVOCT) is rapidly becoming the method of choice for the in vivo investigation of coronary artery disease. While IVOCT visualizes atherosclerotic plaques with a resolution <20µm, image analysis in terms of tissue composition is currently performed by a time-consuming manual procedure based on the qualitative interpretation of image features. We illustrate an algorithm for the automated and systematic characterization of IVOCT atherosclerotic tissue. The proposed method consists in a supervised classification of image pixels according to textural features combined with the estimated value of the optical attenuation coefficient. IVOCT images of 64 plaques, from 49 in vivo IVOCT data sets, constituted the algorithm’s training and testing data sets. Validation was obtained by comparing automated analysis results to the manual assessment of atherosclerotic plaques. An overall pixel-wise accuracy of 81.5% with a classification feasibility of 76.5% and per-class accuracy of 89.5%, 72.1% and 79.5% for fibrotic, calcified and lipid-rich tissue respectively, was found. Moreover, measured optical properties were in agreement with previous results reported in literature. As such, an algorithm for automated tissue characterization was developed and validated using in vivo human data, suggesting that it can be applied to clinical IVOCT data. This might be an important step towards the integration of IVOCT in cardiovascular research and routine clinical practice. PMID:23847728

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

    NASA Astrophysics Data System (ADS)

    Saderne, V.; Wahl, M.

    2012-03-01

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

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

    PubMed

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

    2008-01-01

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

  12. The calcified lung nodule: What does it mean?

    PubMed Central

    Khan, Ali Nawaz; Al-Jahdali, Hamdan H.; Allen, Carolyn M.; Irion, Klaus L.; Al Ghanem, Sarah; Koteyar, Shyam Sunder

    2010-01-01

    The aim of this review is to present a pictorial essay emphasizing the various patterns of calcification in pulmonary nodules (PN) to aid diagnosis and to discuss the differential diagnosis and the pathogenesis where it is known. The imaging evaluation of PN is based on clinical history, size, distribution and the gross appearance of the nodule as well as feasibility of obtaining a tissue diagnosis. Imaging is instrumental in the management of PN and one should strive not only to identify small malignant tumors with high survival rates but to spare patients with benign PN from undergoing unnecessary surgery. The review emphasizes how to achieve these goals. One of the most reliable imaging features of a benign lesion is a benign pattern of calcification and periodic follow-up with computed tomography showing no growth for 2 years. Calcification in PN is generally considered as a pointer toward a possible benign disease. However, as we show here, calcification in PN as a criterion to determine benign nature is fallacious and can be misleading. The differential considerations of a calcified lesion include calcified granuloma, hamartoma, carcinoid, osteosarcoma, chondrosarcoma and lung metastases or a primary bronchogenic carcinoma among others. We describe and illustrate different patterns of calcification as seen in PN on imaging. PMID:20582171

  13. Staging algorithm for diffuse malignant pleural mesothelioma.

    PubMed

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

    2010-02-01

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

  14. Light dose verification for pleural PDT

    NASA Astrophysics Data System (ADS)

    Sandell, Julia L.; Liang, Xing; Zhu, Timothy

    2012-02-01

    The ability to deliver uniform light dose in Photodynamic therapy (PDT) is critical to treatment efficacy. Current protocol in pleural photodynamic therapy uses 7 isotropic detectors placed at discrete locations within the pleural cavity to monitor light dose throughout treatment. While effort is made to place the detectors uniformly through the cavity, measurements do not provide an overall uniform measurement of delivered dose. A real-time infrared (IR) tracking camera is development to better deliver and monitor a more uniform light distribution during treatment. It has been shown previously that there is good agreement between fluence calculated using IR tracking data and isotropic detector measurements for direct light phantom experiments. This study presents the results of an extensive phantom study which uses variable, patient-like geometries and optical properties (both absorption and scattering). Position data of the treatment is collected from the IR navigation system while concurrently light distribution measurements are made using the aforementioned isotropic detectors. These measurements are compared to fluence calculations made using data from the IR navigation system to verify our light distribution theory is correct and applicable in patient-like settings. The verification of this treatment planning technique is an important step in bringing real-time fluence monitoring into the clinic for more effective treatment.

  15. Rare cause of pleural nodularity: Splenosis.

    PubMed Central

    Gezer, Suat; Gülhan, S. S. Erkmen; Altinok, Tamer; Agaçkiran, Yetkin; Tastepe, A. Irfan

    2006-01-01

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

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

    SciTech Connect

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

    2014-10-01

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

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

    NASA Astrophysics Data System (ADS)

    Karimi, Alireza; Navidbakhsh, Mahdi; Razaghi, Reza

    2014-08-01

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

  18. CT and US features of renal matrix stones with calcified center

    SciTech Connect

    Kim, Seung H.; Lee, Sang E.; Park, In A.

    1996-05-01

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

  19. Multimodality Intravascular Imaging Assessment of Plaque Erosion versus Plaque Rupture in Patients with Acute Coronary Syndrome

    PubMed Central

    Kwon, Jee Eun; Mintz, Gary S.; Hong, Young Joon; Lee, Sung Yun; Kim, Ki Seok; Hahn, Joo-Yong; Kumar, Kaup Sharath; Won, Hoyoun; Hyeon, Seong Hyeop; Shin, Seung Yong; Lee, Kwang Je; Kim, Tae Ho; Kim, Chee Jeong; Kim, Sang Wook

    2016-01-01

    Background and Objectives We assessed plaque erosion of culprit lesions in patients with acute coronary syndrome in real world practice. Subjects and Methods Culprit lesion plaque rupture or plaque erosion was diagnosed with optical coherence tomography (OCT). Intravascular ultrasound (IVUS) was used to determine arterial remodeling. Positive remodeling was defined as a remodeling index (lesion/reference EEM [external elastic membrane area) >1.05. Results A total of 90 patients who had plaque rupture showing fibrous-cap discontinuity and ruptured cavity were enrolled. 36 patients showed definite OCT-plaque erosion, while 7 patients had probable OCT-plaque erosion. Overall, 26% (11/43) of definite/probable plaque erosion had non-ST elevation myocardial infarction (NSTEMI) while 35% (15/43) had ST elevation myocardial infarction (STEMI). Conversely, 14.5% (13/90) of plaque rupture had NSTEMI while 71% (64/90) had STEMI (p<0.0001). Among plaque erosion, white thrombus was seen in 55.8% (24/43) of patients and red thrombus in 27.9% (12/43) of patients. Compared to plaque erosion, plaque rupture more often showed positive remodeling (p=0.003) with a larger necrotic core area examined by virtual histology (VH)-IVUS, while negative remodeling was prominent in plaque erosion. Overall, 65% 28/43 of plaque erosions were located in the proximal 30 mm of a culprit vessel-similar to plaque ruptures (72%, 65/90, p=0.29). Conclusion Although most of plaque erosions show nearly normal coronary angiogram, modest plaque burden with negative remodeling and an uncommon fibroatheroma might be the nature of plaque erosion. Multimodality intravascular imaging with OCT and VH-IVUS showed fundamentally different pathoanatomic substrates underlying plaque rupture and erosion. PMID:27482258

  20. Thoracoscopic evaluation of 129 cases having undiagnosed exudative pleural effusions

    PubMed Central

    Patil, Chetan Basavaraj; Dixit, Ramakant; Gupta, Rakesh; Gupta, Neeraj; Indushekar, Varna

    2016-01-01

    Background: Medical thoracoscopy is a minimally invasive procedure used in diagnostic and therapeutic applications for pleural diseases. In this study, we describe our experience in the outcome and analysis of thoracoscopy in undiagnosed pleural effusion presenting to our center. Materials and Methods: This is a prospective study conducted over last 2 years. We performed thoracoscopy in 129 cases of undiagnosed exudative pleural effusions using rigid thoracoscope. Clinical, radiological, cyto and histopathological data of the patients were collected prospectively and analyzed. Results: The overall diagnostic yield of thoracoscopic pleural biopsy was 110/129 (85.2%) in patients with undiagnosed pleural effusion, and 19/129 (14.8%) patients remained unexplained. Histopathological diagnosis confirmed malignancy in 66.4% patients (both primary and metastatic pleural carcinoma), tuberculosis in 28.2%, others including parapneumonic effusion in 4 cases followed by multiple myeloma, lupus pleuritis, and pulmonary langerhans cell histiocytosis in one case each. Procedure-related mortality was nil. Minor complications related to the procedure include hemorrhage, subcutaneous emphysema, etc. Conclusion: Thoracoscopy is relatively a safe and well-tolerated procedure with high diagnostic accuracy in undiagnosed pleural effusions, decreasing the need of formal diagnostic thoracotomy. Every chest physician must, therefore, consider this procedure to decrease the time lag in achieving the final diagnosis and to initiate the treatment as early as possible. PMID:27625443

  1. Novel biomarker analysis of pleural effusion enhances differentiation of tuberculous from malignant pleural effusion

    PubMed Central

    Chen, Kuan-Yuan; Feng, Po-Hao; Chang, Chih-Cheng; Chen, Tzu-Tao; Chuang, Hsiao-Chi; Lee, Chun-Nin; Su, Chien-Ling; Lin, Lian-Yu; Lee, Kang-Yun

    2016-01-01

    Lymphocytic pleurisy is commonly observed in tuberculosis and cancer. Noninvasive biomarkers are needed to distinguish tuberculous pleural effusion (TPE) from malignant pleural effusion (MPE) because current clinical diagnostic procedures are often invasive. We identified immune response biomarkers that can discriminate between TPE and MPE. Fourteen pleural effusion biomarkers were compared in 22 MPE patients and five TPE patients. Of the innate immunity biomarkers, the median levels of interleukin (IL)-1β and interferon-induced protein-10 (IP-10) were higher in TPE patients than in MPE patients (P<0.05 and P<0.01, respectively). Of the adaptive immunity biomarkers, the median levels of IL-13 and interferon-γ (IFN-γ) were higher in TPE patients than in MPE patients (P<0.05). In addition, the levels of basic fibroblast growth factor were higher in MPE patients than in TPE patients (P<0.05). Receiver operator characteristic analysis of these biomarkers was performed, resulting in the highest area under the curve (AUC) for IP-10 (AUC =0.95, 95% confidence interval, P<0.01), followed by IL-13 (AUC =0.86, 95% confidence interval, P<0.05). Our study shows that five biomarkers (IL-1β, IP-10, IFN-γ, IL-13, and basic fibroblast growth factor) have a potential diagnostic role in differentiating TPE from MPE, particularly in lung cancer-related MPE. PMID:27354819

  2. Yield of closed pleural biopsy and cytology in exudative pleural effusion

    PubMed Central

    Zuberi, Faisal Faiyaz; Zuberi, Bader Faiyaz; Ali, Syed Khalid; Hussain, Sagheer; Mumtaz, Farhana

    2016-01-01

    Objective: To determine diagnostic yield of Closed Pleural Biopsy (CPB) and Cytology in Exudative Pleural Effusion (PE). Methods: This prospective comparative study was conducted at Chest Unit-II & Medical Unit-IV of Dow University of Health Sciences, Karachi Pakistan from January 2011 till December 2014. Results: Ninety-four patients with exudative PE were finally included. The mean age (SD) was 44.0 (13.8) years. Overall Specific Diagnosis was reached in 76/94 patients; 46 Tuberculosis PE (TPE) & 30 Malignant PE (MPE). CPB diagnosed all TPE patients alone and 28/30 of MPE. Cytology diagnosed only 10/30 patients of MPE with 8 patients having both CPB & Cytology positive for malignancy whereas in the remaining two cases only Cytology positive. The sensitivity of CPB in detecting TPE and MPE was 93.9% and 82.4% respectively whereas specificity for both was 100%. The diagnostic yield of cytology in detecting MPE is only (33.3%). The diagnostic yield of CPB for TPE and MPE is 100% and 93.3% respectively. The overall specific diagnostic yield of CPB is 78.7%. Conclusion: CPB is better than pleural fluid cytology alone with the later adding little to diagnostic yield when both combined in distinguishing TPE from MPE, the two main differential of exudative PE in a TB-Endemic country. PMID:27182239

  3. [Benign pleural effusion in a carpenter exposed to asbestos].

    PubMed

    Petersen, Rolf; Pedersen, Carsten Franck; Munch, Erik Peter

    2010-10-25

    A 55-year-old carpenter developed pleurisy with pleural effusion on the right side in 2000 and on the left side in 2003. No known causes of pleurisy were found. He had been occupationally exposed to asbestos during a 6-month-period in 1971 while working with roof sheets made of asbestos cement. In the literature there is evidence of asbestos being a cause of benign pleural effusion. We found it likely that the pleurisy with pleural effusion found in this patient was an occupational condition and it should therefore be notified as industrial injury. PMID:21040677

  4. Pleural effusion segmentation in thin-slice CT

    NASA Astrophysics Data System (ADS)

    Donohue, Rory; Shearer, Andrew; Bruzzi, John; Khosa, Huma

    2009-02-01

    A pleural effusion is excess fluid that collects in the pleural cavity, the fluid-filled space that surrounds the lungs. Surplus amounts of such fluid can impair breathing by limiting the expansion of the lungs during inhalation. Measuring the fluid volume is indicative of the effectiveness of any treatment but, due to the similarity to surround regions, fragments of collapsed lung present and topological changes; accurate quantification of the effusion volume is a difficult imaging problem. A novel code is presented which performs conditional region growth to accurately segment the effusion shape across a dataset. We demonstrate the applicability of our technique in the segmentation of pleural effusion and pulmonary masses.

  5. Systemic Air Embolism Associated with Pleural Pigtail Chest Tube Insertion

    PubMed Central

    Alkhankan, Emad; Nusair, Ahmad; Mazagri, Rida

    2016-01-01

    Pleural pigtail catheter placement is associated with many complications including pneumothorax, hemorrhage, and chest pain. Air embolism is a known but rare complication of pleural pigtail catheter insertion and has a high risk of occurrence with positive pressure ventilation. In this case report, we present a 50-year-old male with bilateral pneumonia who developed a pneumothorax while on mechanical ventilation with continuous positive airway pressure mode. During the placement of the pleural pigtail catheter to correct the pneumothorax, the patient developed a sudden left sided body weakness and became unresponsive. An air embolism was identified in the right main cerebral artery, which was fatal.

  6. Scintigraphic diagnosis of peritoneo-pleural communication in the absence of ascites.

    PubMed

    Daly, J J; Potts, J M; Gordon, L; Buse, M G

    1994-10-01

    Pleural effusion in the presence of cirrhosis and ascites is well recognized. Peritoneal fluid is thought to enter the pleural cavity either because of overloaded lymphatics or a structural defect between the peritoneal and chest cavities. Pleural effusion rarely occurs in the absence of demonstrable ascites. This report describes the scintigraphic diagnosis of peritoneo-pleural communication in a patient with cryptogenic cirrhosis and pleural effusion without ascites. PMID:7805325

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

    PubMed Central

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

    2016-01-01

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

  8. Status of Exudative Pleural Effusion in Adults of South Khorasan Province, Northeast Iran: Pleural Tuberculosis Tending toward Elderly

    PubMed Central

    Mortazavi-Moghaddam, Sayyed Gholam Reza; Sharifzadeh, Gholam Reza; Rezvani, Mohammad Reza

    2016-01-01

    The causes and situation of exudative pleural effusion vary from one area to another. A cross-sectional study was conducted on 327 patients with exudative pleural effusion in South Khorasan province (Iran). The patients were older than 12 years and comprised 172 (52.6%) males and 155 (47.4%) females. The study commenced in 2007 with seven years duration. The Light’s criteria were used to define exudative effusion. Procedures including pleural fluid analysis, microbiological study, pleural biopsy, and systemic investigations were conducted to determine the special cause of pleural effusion. The mean age of the patients was 63.4±18.4 years. Malignancies, tuberculosis, and parapneumonia pleural exudation were diagnosed in 125 (38.2%), 48 (14.7%), and 45 (13.8%) cases, respectively. Among malignant effusions, metastasis from lung cancer made 48 (38.4%) of the cases. The origin of metastasis was not determined in 44 (35.2%) patients. The mean age of patients was not significantly different between malignant (66.9±14.3 years) and tuberculosis (63.9±19.7 years) cases (P=0.16). The older age of tuberculosis patients could be a new discussion point on the overall impression created on the subject of tuberculosis pleural exudation (TB-PLE) occurring in young people. PMID:27365554

  9. Current surgical strategies for malignant pleural mesothelioma.

    PubMed

    Takuwa, Teruhisa; Hasegawa, Seiki

    2016-08-01

    Malignant pleural mesothelioma (MPM) is associated with a poor prognosis. The main components of multimodality treatment include surgery, chemotherapy, and radiation therapy. Surgery remains controversial. Two procedures are currently offered: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). The recent scientific literature suggests that P/D is a well-tolerated procedure, with the potential of becoming a default procedure in multimodality regimens. However, the precise treatment schemes and surgical procedures are yet to be established. In our study, we review the advantages and disadvantages of EPP and P/D, summarize the post-EPP and post-P/D observations (including mortality, morbidity, and median survival time), and discuss the choice of surgical technique (EPP vs. P/D). Moreover, we highlight the aspects of the multimodality treatments that are offered to MPM patients, including chemotherapy, radiotherapy, intensity-modulated radiation therapy, and other types of therapy. PMID:26590581

  10. Hydrothorax: pleural effusion associated with peritoneal dialysis.

    PubMed

    Lew, Susie Q

    2010-01-01

    Hydrothorax in a patient treated with peritoneal dialysis (PD) poses a diagnostic dilemma. Hydrothorax due to migration of dialysis fluid across the diaphragm and into the pleural space creates a serious complication of PD but generally does not threaten life. Shortness of breath causes the patient to seek medical attention. A sudden diminution in dialysis adequacy or poor ultrafiltration rate constitutes a unique marker for patients treated with PD compared to the general population. This article reviews the etiology for hydrothorax specifically in the PD population. Thoracentesis with chemical analysis of the fluid, imaging studies with and without contrast or markers, and video-assisted thoracoscopic surgery play important roles in the evaluation of hydrothorax. A conservative PD regimen, surgical intervention, and pleurodesis provide treatment options to those receiving PD. PMID:20056973

  11. Malignant pleural effusion: from bench to bedside.

    PubMed

    Psallidas, Ioannis; Kalomenidis, Ioannis; Porcel, Jose M; Robinson, Bruce W; Stathopoulos, Georgios T

    2016-06-01

    Malignant pleural effusion (MPE) is a common but serious condition that is related with poor quality of life, morbidity and mortality. Its incidence and associated healthcare costs are rising and its management remains palliative, with median survival ranging from 3 to 12 months. During the last decade there has been significant progress in unravelling the pathophysiology of MPE, as well as its diagnostics, imaging, and management. Nowadays, formerly bed-ridden patients are genotyped, phenotyped, and treated on an ambulatory basis. This article attempts to provide a comprehensive overview of current advances in MPE from bench to bedside. In addition, it highlights unanswered questions in current clinical practice and suggests future directions for basic and clinical research in the field. PMID:27246596

  12. Shunt site chronic calcified extradural hematoma: An avoidable complication

    PubMed Central

    Mishra, Sudhansu Sekhar; Satapathy, Mani Charan; Senapati, Satya Bhusan

    2014-01-01

    Extradural hematoma (EDH) after ventriculoperitoneal (VP) shunt procedure is a rare, dangerous but easily avoidable and manageable complication. It is more common in children and young adults presumably due to relatively lax adhesion of dura to calvarium. We report a case of an 18-year-old male with acqueductal stenosis who underwent VP shunt procedure. Three months later, a computed tomography (CT) scan was done for the complaints of intractable headache and altered sensorium which showed chronic calcified EDH near shunt site. The ventricular catheter was in position and the ventricles were decompressed. After surgical decompression of EDH his symptoms improved. We discuss the factors leading to formation of EDH, with stress on proper technique to prevent or minimize such an avoidable complication. PMID:25250078

  13. Retroperitoneal calcifying fibrous tumor mimicking an adrenal tumor.

    PubMed

    Prochaska, Erica C; Sciallis, Andrew P; Miller, Barbra S

    2016-01-01

    Establishing the etiology of a retroperitoneal tumor may be difficult due to close proximity of multiple organs. Evaluation of retroperitoneal tumors often leads to surgery, many times to obtain a definitive diagnosis and rule out malignancy. Calcifying fibrous tumors (CFT) are very rare soft tissue tumors occurring most often in young patients. They are most often found arising in the thoracic cavity, mediastinum, abdominal cavity and extremities and usually have a benign clinical course. Macrocscopically, the tumors are well circumscribed and firm with a white-tan appearance. Histologically, CFT comprised a hypocellular proliferation of bland spindle cells, densely hyalinized collagen, chronic lymphoplasmacytic inflammation and dystrophic calcifications. Other considerations in the pathologic differential diagnosis include solitary fibrous tumor and inflammatory myofibroblastic tumor. PMID:27252518

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

    PubMed

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

    2015-05-12

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

  15. Intraosseous calcifying epithelial odontogenic (Pindborg) tumor: A rare entity

    PubMed Central

    More, Chandramani B; Vijayvargiya, Ritika

    2015-01-01

    Calcifying epithelial odontogenic tumor (CEOT) is a locally aggressive, rare benign odontogenic neoplasm that accounts for <1% of all odontogenic tumors. It was first described by a Dutch pathologist Jens Jorgen Pindborg in 1955. It is most often located in the posterior mandible. The tumor usually appears between the second and sixth decade of life and has no gender predilection. It is slow-growing neoplasm with a recurrence rate of 10–15% and with rare malignant transformation. Early diagnosis is essential to avoid oro-maxillofacial deformation and destruction. CEOT is rarely reported in India. We, herewith present a rare case of CEOT with unusual features associated with an impacted right third molar in the posterior mandible of 35 years male, with an emphasis on clinical, radiographic, histopathology and immunohistochemical features. PMID:26604515

  16. New perspectives on rare connective tissue calcifying diseases.

    PubMed

    Rashdan, Nabil A; Rutsch, Frank; Kempf, Hervé; Váradi, András; Lefthériotis, Georges; MacRae, Vicky E

    2016-06-01

    Connective tissue calcifying diseases (CTCs) are characterized by abnormal calcium deposition in connective tissues. CTCs are caused by multiple factors including chronic diseases (Type II diabetes mellitus, chronic kidney disease), the use of pharmaceuticals (e.g. warfarin, glucocorticoids) and inherited rare genetic diseases such as pseudoxanthoma elasticum (PXE), generalized arterial calcification in infancy (GACI) and Keutel syndrome (KTLS). This review explores our current knowledge of these rare inherited CTCs, and highlights the most promising avenues for pharmaceutical intervention. Advancing our understanding of rare inherited forms of CTC is not only essential for the development of therapeutic strategies for patients suffering from these diseases, but also fundamental to delineating the mechanisms underpinning acquired chronic forms of CTC. PMID:26930168

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

    PubMed Central

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

    2015-01-01

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

  18. Retroperitoneal calcifying fibrous tumor mimicking an adrenal tumor

    PubMed Central

    Prochaska, Erica C.; Sciallis, Andrew P.; Miller, Barbra S.

    2016-01-01

    Establishing the etiology of a retroperitoneal tumor may be difficult due to close proximity of multiple organs. Evaluation of retroperitoneal tumors often leads to surgery, many times to obtain a definitive diagnosis and rule out malignancy. Calcifying fibrous tumors (CFT) are very rare soft tissue tumors occurring most often in young patients. They are most often found arising in the thoracic cavity, mediastinum, abdominal cavity and extremities and usually have a benign clinical course. Macrocscopically, the tumors are well circumscribed and firm with a white-tan appearance. Histologically, CFT comprised a hypocellular proliferation of bland spindle cells, densely hyalinized collagen, chronic lymphoplasmacytic inflammation and dystrophic calcifications. Other considerations in the pathologic differential diagnosis include solitary fibrous tumor and inflammatory myofibroblastic tumor. PMID:27252518

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

    PubMed

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

    2011-09-01

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

  20. When size matters: changing opinion in the management of pleural space—the rise of small-bore pleural catheters

    PubMed Central

    Sandri, Alberto; Guerrera, Francesco; Ferraris, Andrea; Marchisio, Filippo; Bora, Giulia; Costardi, Lorena; Solidoro, Paolo; Ruffini, Enrico; Oliaro, Alberto

    2016-01-01

    Tube thoracostomy is usually the first step to treat several thoracic/pleural conditions such as pneumothorax, pleural effusions, haemothorax, haemo-pneumothorax and empyema. Today, a wide range of drains is available, ranging from small to large bore ones. Indications for an appropriate selection remains yet matter of debate, especially regarding the use of small bore catheters. Through this paper, we aimed to retrace the improvements of drains through the years and to review the current clinical indications for chest drain placement in pleural/thoracic diseases, comparing the effectiveness of small-bore drains vs. large-bore ones. PMID:27499983

  1. ACTIVATION OF T LYMPHOCYTES IN ATHEROSCLEROTIC PLAQUES

    PubMed Central

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

    2011-01-01

    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. PMID:21960562

  2. Recurrent Pleural Effusions Occurring in Association with Primary Pulmonary Amyloidosis

    PubMed Central

    Tada, Lauren; Anjum, Humayun; Linville, W. Kenneth; Surani, Salim

    2015-01-01

    Recurrent pleural effusions occurring in association with immunoglobulin light chain amyloidosis and not associated with amyloid cardiomyopathy are rare. These portend an overall poor prognosis with mean survival time of approximately 1.8 months. We hereby report a case of a 59-year-old Caucasian female with recurrent pleural effusions and an ultimate diagnosis of pulmonary amyloidosis in association with plasma cell myeloma. The optimal treatment for recurrent pleural effusions in amyloidosis has not been determined; however, our patient responded to therapy with Cyclophosphamide-Bortezomib- (Velcade-) Dexamethasone (CyBorD) and had no repeat hospitalizations or recurrence of pleural effusion at four-month follow-up after initiation of therapy. PMID:26448893

  3. Ectopic congenital thymic cyst in the right pleural cavity.

    PubMed

    Bruno, Vito D; Mariscalco, Giovanni; Franzi, Francesca; Miceli, Antonio; Piffaretti, Gabriele; Sala, Andrea

    2010-10-01

    A 37-year-old man with a huge pleural cyst, presented with symptoms of right heart compression. The mass on the right side of the chest seemed initially to be in connection with the mediastinum. Computed tomography failed to define its relationship with the pericardium, and echocardiography excluded any involvement of the mediastinal structures. The final diagnosis was a congenital thymic cyst exclusively located in the pleural cavity. PMID:20947607

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

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2009-01-01

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

  6. Switching off malignant pleural effusion formation—fantasy or future?

    PubMed Central

    Giannou, Anastasios D.; Stathopoulos, Georgios T.

    2015-01-01

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

  7. Unilateral recurrent pleural effusion in a renal transplant patient.

    PubMed

    Binnani, Pooja; Gupta, Ruchi; Kedia, Nikhil; Bahadur, M M

    2012-01-01

    Pleural effusion is a frequent complication in patients undergoing hemodialysis (HD). We report a patient on HD with a novel cause of recurrent unilateral pleural effusion. A 45-year-old female patient on long-term maintenance HD presented to us with recurrent unilateral pleural effusion. She had a history of poor quality dialysis, severe anemia and severe hypertension. Despite correcting these factors and even after undergoing successful renal transplantation, she continued to have recurrent effusion. Left upper extremity venography demonstrated severe stenosis of the subclavian vein and an increased venous flow in the ipsilateral arteriovenous (AV) fistula. Ligation of the AV fistula led to dramatic resolution of the pleural effusion. Hemodialysis patients who develop unexplained pleural effusions ipsilateral to a functioning AV fistula should be investigated for stenosis in the brachiocephalic vein, particularly those patients who have had previous catheterizations of the jugular or subclavian veins on the same side as the effusion. Correcting the stenosis by venous angioplasty and/or ligation of the ipsilateral fistula can dramatically resolve the pleural effusion. A high index of suspicion is required to diagnose this complication for meaningful intervention. PMID:22237229

  8. [Parapneumonic pleural effusions and empyema in adults:current practice].

    PubMed

    Porcel, J M; Light, R W

    2009-11-01

    About 20% of hospitalized patients with bacterial pneumonia have an accompanying pleural effusion. Parapneumonic effusions (PPE) are associated with a considerable morbidity and mortality. The main decision in managing a patient with a PPE is whether to insert a chest tube (complicated PPE). Imaging (i.e., chest radiograph, ultrasound and computed tomography) and pleural fluid analysis (i.e., pH, glucose, lactate dehydrogenase, bacterial cults) provide essential information for patient management. Therefore, all PPEs should be aspirated for diagnostic purposes. This may require image-guidance if the effusion is small or heavily loculated. According to the current guidelines, any PPE that fulfills at least one of the following criteria should be drained: size > or = 1/2 of the hemithorax, loculations, pleural fluid pH < 7.20 (or alternatively pleural fluid glucose < 60 mg/dl), positive pleural fluid Gram stain or culture, or purulent appearance. The key components of the treatment of complicated PPE and empyema are the use of appropriate antibiotics, provision of nutritional support, and drainage of the pleural space by one of the following methods: therapeutic thoracentesis, tube thoracostomy, intrapleural fibrinolytics, thoracoscopy with breakdown of adhesions or thoracotomy with decortication. The routine use of intrapleural fibrinolytic therapy remains controversial. (c) 2009 Elsevier España, S.L. All rights reserved. PMID:19889319

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

    PubMed

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

    2015-01-01

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

  10. Intra-Pleural Colistin Methanesulfonate Therapy for Pleural Infection caused by Carbapenem-Resistant Acinetobacter Baumannii: A Successful Case Report

    PubMed Central

    Rana, Muhammad Asim; Rahman, Basheer Abd El; Mady, Ahmed Fouad; Odat, Mohammed Al; AlHarthy, Abdurehman; Ramadan, Omar El Sayed; Mumtaz, Shahzad Ahmed; Omrani, Ali S.

    2014-01-01

    Infections caused by carbapenem-resistant, Gram-negative bacteria are an increasing clinical challenge, since the antimicrobial treatment options are often limited to colistin methanesulfonate. No data are available regarding the pharmacokinetics of colistin in pleural fluid. We report the case of a 92-year old man with ventilator-associated pneumonia and pleurisy caused by Acinetobacter baumannii and Escherichia coli, which were both multidrug-resistant. After an unsuccessful treatment with intravenous colistin methanesulfonate and imipen-em-cilastatin, the addition of intra-pleural colistin methanesulfonate to the intravenous treatment led to a prompt clinical, radiological and microbiological resolution. This is the first report of a successful use of intra-pleural colistin in the literature. The intra-pleural colistin therapy should be considered in selected cases of pleurisy caused by multi-resistant Gram-negative bacteria. PMID:25276329

  11. Fluoride bioavailability in saliva and plaque

    PubMed Central

    2012-01-01

    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. PMID:22230722

  12. 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; Grimshaw, Myra

    1977-01-01

    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 PMID:929482

  13. Stabilization of high-risk plaques

    PubMed Central

    Takata, Kohei; Zhang, Bo; Miura, Shin-ichiro; Saku, Keijiro

    2016-01-01

    The prevalence of atherosclerotic cardiovascular diseases (ASCVDs) is increasing globally and they have become the leading cause of death in most countries. Numerous experimental and clinical studies have been conducted to identify major risk factors and effective control strategies for ASCVDs. The development of imaging modalities with the ability to determine the plaque composition enables us to further identify high-risk plaque and evaluate the effectiveness of different treatment strategies. While intensive lipid-lowering by statins can stabilize or even regress plaque by various mechanisms, such as the reduction of lipid accumulation in a necrotic lipid core, the reduction of inflammation, and improvement of endothelial function, there are still considerable residual risks that need to be understood. We reviewed important findings regarding plaque vulnerability and some encouraging emerging approaches for plaque stabilization. PMID:27500090

  14. How Should We Perform Rotational Atherectomy to an Angulated Calcified Lesion?

    PubMed

    Sakakura, Kenichi; Taniguchi, Yousuke; Matsumoto, Mitsunari; Wada, Hiroshi; Momomura, Shin-Ichi; Fujita, Hideo

    2016-05-25

    Rotational atherectomy to an angulated calcified lesion is always challenging. The risk of catastrophic complications such as a burr becoming stuck or vessel perforation is greater when the calcified lesion is angulated. We describe the case of an 83-year-old female suffering from unstable angina. Diagnostic coronary angiography revealed an angulated calcified lesion in the proximal segment of the right coronary artery. We performed rotational atherectomy to the lesion, but intentionally did not advance the rotational atherectomy burr beyond the top of the angulation. We controlled the rotational atherectomy burr and stopped it just before the top of the angulation to avoid complications. Following rotational atherectomy, balloon dilatation with a non-compliant balloon was performed, and drug-eluting stents were successfully deployed. In this manuscript, we provide a review of the literature on this topic, and discuss how rotational atherectomy to an angulated calcified lesion should be performed. PMID:27170474

  15. PDT dose dosimeter for pleural photodynamic therapy

    NASA Astrophysics Data System (ADS)

    Kim, Michele M.; Darafsheh, Arash; Ahmad, Mahmoud; Finlay, Jarod C.; Zhu, Timothy C.

    2016-03-01

    PDT dose is the product of the photosensitizer concentration and the light fluence in the target tissue. For improved dosimetry during plural photodynamic therapy (PDT), a PDT dose dosimeter was developed to measure both the light fluence and the photosensitizer concentration simultaneously in the same treatment location. Light fluence and spectral data were rigorously compared to other methods of measurement (e.g. photodiode, multi-fiber spectroscopy contact probe) to assess the accuracy of the measurements as well as their uncertainty. Photosensitizer concentration was obtained by measuring the fluorescence of the sensitizer excited by the treatment light. Fluence rate based on the intensity of the laser spectrum was compared to the data obtained by direct measurement of fluence rate by a fiber-coupled photodiode. Phantom studies were done to obtain an optical property correction for the fluorescence signal. Measurements were performed in patients treated Photofrin for different locations in the pleural cavity. Multiple sites were measured to investigate the heterogeneity of the cavity and to provide cross-validation via relative dosimetry. This novel method will allow for accurate real-time determination of delivered PDT dose and improved PDT dosimetry.

  16. Friction and morphology of pleural mesothelia.

    PubMed

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

    2016-01-01

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

  17. [Drug carrier nanosystems in malignant pleural mesothelioma].

    PubMed

    Turgut Coşan, Didem; Ak, Güntülü; Dağ, İlknur; Soyocak, Ahu; Dikmen, Gökhan; Dal, Aylin; Güneş, Hasan V; Metintaş, Muzaffer

    2016-03-01

    Malignant pleural mesothelioma (MPM), the incidence increased with each passing day, is an important lethal disease due to the limited survive with available treatment methods and with the lack of a standard treatment. Response and survive rates of cytotoxic agents which is used in MPM treatment are not good enough. Therefore, treatment studies of MPM seem to quite important and urgent. In cancer therapy, convensional chemotherapeutic agent applications, due to the lack of selectivity, lead to systemic toxicity. Besides the limited solubility of the agent used, the distribution between the cells is weak. It is very difficult to the pass through cellular barriers, particularly, drug resistance may develop to the treatment. All of these reasons lead to failure in the treatment process. Because of the fact that cytotoxic drugs either kill the rapidly growing and dividing cells or make them disfunctional by showing toxic effect on them, to avoid the side effects and to make an inherent effect for cytotoxic drug of active ingredient given for treatment on tumor, different studies have been under investigation. At the present time, nanocarriers as one of these solutions seem to have an important place. Nanocarriers are promising for the development of therapeutic effectiveness and safety. It seems that use of the nanocarrier in the treatment of mesothelioma has a potential, as effective alternative a method, with improve of the drug efficacy and reduce of toxicity in normal tissues. PMID:27266287

  18. PDT Dose Dosimeter for Pleural Photodynamic Therapy

    PubMed Central

    Kim, Michele M.; Darafsheh, Arash; Ahmad, Mahmoud; Finlay, Jarod C.; Zhu, Timothy C.

    2016-01-01

    PDT dose is the product of the photosensitizer concentration and the light fluence in the target tissue. For improved dosimetry during plural photodynamic therapy (PDT), a PDT dose dosimeter was developed to measure both the light fluence and the photosensitizer concentration simultaneously in the same treatment location. Light fluence and spectral data were rigorously compared to other methods of measurement (e.g. photodiode, multi-fiber spectroscopy contact probe) to assess the accuracy of the measurements as well as their uncertainty. Photosensitizer concentration was obtained by measuring the fluorescence of the sensitizer excited by the treatment light. Fluence rate based on the intensity of the laser spectrum was compared to the data obtained by direct measurement of fluence rate by a fiber-coupled photodiode. Phantom studies were done to obtain an optical property correction for the fluorescence signal. Measurements were performed in patients treated Photofrin for different locations in the pleural cavity. Multiple sites were measured to investigate the heterogeneity of the cavity and to provide cross-validation via relative dosimetry. This novel method will allow for accurate real-time determination of delivered PDT dose and improved PDT dosimetry. PMID:27053825

  19. Diffuse malignant pleural mesothelioma and asbestos exposure

    PubMed Central

    Whitwell, F.; Rawcliffe, Rachel M.

    1971-01-01

    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 PMID:5101273

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

    PubMed

    Peña-Torres, Leandro Miguel; Monterrubio-Guerrero, Alejandro; Díaz de León-Sandoval, Laura Alejandra

    2010-01-01

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

  1. Semirigid thoracoscopy: an effective method for diagnosing pleural malignancies

    PubMed Central

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

    2014-01-01

    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. PMID:24587782

  2. Pharmacokinetics of Linezolid and Ertapenem in experimental parapneumonic pleural effusion

    PubMed Central

    2010-01-01

    Objective To determine the extent of linezolid and ertapenem penetration into the empyemic fluid using a rabbit model of empyema. Methods An empyema was created via the intrapleural injection of Escherichia coli bacteria (ATCC 35218) into the pleural space of New Zealand white rabbits. After an empyema was verified by thoracocentesis, 24 hours post inoculation, linezolid (10 mg/kg) and ertapenem (60 mg/kg) were administered intravenously into 10 and 8 infected empyemic rabbits, respectively. Antibiotic levels were determined in samples of pleural fluid and blood serum, collected serially at 1, 2, 4, 6 and 8 hours, after administration each of the two antibiotics. Results Linezolid as well as ertapenem penetrate well into the empyemic pleural fluid, exhibiting a slower onset and decline compared to the corresponding blood serum levels. Equilibration between blood serum and pleural fluid compartments seems to occur at 1.5 hours for both linezolid and ertapenem, with peak pleural fluid levels (Cmaxpf of 2.02 ± 0.73 «mu»g/ml and Cmaxpf of 3.74 ± 1.39 «mu»g/ml, correspondingly) occurring 2 hours post antibiotics administration and decreasing very slowly thereafter. The serum concentrations for both antibiotics were significantly lower from the corresponding pleural fluid ones during the 8 hours collecting data, with the exception of samples collected at the 1st hour (Cmaxserum of 2.1 ± 1.2 «mu»g/ml for linezolid and Cmaxserum of 6.26 ± 2.98 «mu»g/ml for ertapenem). Conclusion Pleural fluid levels of both antibiotics are inhibitory for common specified pathogens causing empyema. PMID:20482752

  3. Reexpansion pulmonary oedema as a complication of pleural drainage.

    PubMed

    Adegboye, V O; Falade, A; Osinusi, K; Obajimi, M O

    2002-12-01

    One hundred and one (6%) of 1,678 patient studied had bilateral reexpansion pulmonary oedema(RPO). On the whole, one thousand, seven hundred and seventy nine (1,779) pleural spaces were studied, fifteen pleural spaces (0.8%), with mean age of 23 +/- 4.5 years had RPO. Among these 15 patients with RPO, the mean period of lung collapse before pneumothorax (PThx) was evacuated was 31.8 +/- 21.8 days and for hydrothorax (HThx) was 31.3 +/- 30.1 days; for 15 patients without RPO (controls), matched for age and sex, the mean period of lung collapse before CTTD was 7.5 +/- 4.1 days and 5.4 +/- 1.3 days respectively for PThx and HThx. The differences in the period of lung collapse among patients with RPO and those without, for each pleural disease was statistically significant (P < 0.03). Volume of pleural fluid drained before RPO was noticed was 2196 +/- 1103 mls, for the 15 matched patients without RPO (controls), it was 1060 +/- 115 mls (p < 0.05). Volume of pleural fluid drained among the patients with SR (Severe response), MR (mild to moderate response) and RD (radiological diagnosis) did not correlate with severity of response. We conclude that prevention of RPO is the desired goal in the management of pleural effusion or Pneumothorax. RPO is commonest among young patients who have had lung collapse for 7 or more days. In these circumstances RPO is prevented, its incidence and severity reduced by methods of gradual evacuation of PThx or pleural fluid drainage. PMID:12690682

  4. CBCT-Aided Microscopic and Ultrasonic Treatment for Upper or Middle Thirds Calcified Root Canals

    PubMed Central

    Yang, Ying-Ming; Guo, Bin; Guo, Li-Yang; Yang, Yan; Hong, Xiao; Pan, Hong-Ying

    2016-01-01

    Root canal calcification is considered a great challenge during root canal treatment. Although the application of ultrasonic instruments and dental operating microscope (DOM) has advantages, dealing with calcified root canals still suffers a great risk of failure because of limited information about the location, length, and direction of obliteration on periapical radiographs. In this work, a cone-beam computed tomography- (CBCT-) aided method aimed at solving complicated calcified root canals in which conventional approaches could not work was proposed. Thirteen teeth with sixteen calcified canals (12 calcified in the upper third, 4 calcified in the middle third), which cannot be negotiated with conventional methods, were treated with the aid of CBCT. The location of calcification and depth of instrumentation and operating direction were calculated and assessed in three dimensions with ultrasonic instruments under DOM. In all thirteen teeth, canals with upper and middle thirds calcification were treated successfully. Finally, a guideline was proposed to help achieve consistent apical patency in calcified canals. PMID:27525269

  5. Lasers in the management of calcified urinary tract stents

    NASA Astrophysics Data System (ADS)

    Nseyo, Unyime O.; Tunuguntla, Hari S. G. R.; Crone, Michael

    2003-06-01

    Indwelling double J ureteral stents are used for internal urinary diversion for ureteral obstruction and post-surgical drainage of the upper urinary tract. Stent calcification is a serious complication especially in those with forgotten stents. In a retrospective review of 16 patients (10 male and 6 female) we found holmium laser to be highly effective in the management of calcified stents. Encrustations/calcifications were noted on the distal end of the sent in 6 patiens (37.5%), middle and distal portions in 2 patients (12.5%), along the entire length of the stent in 3 patients (18.75%), lower portion of the stent in 4 patients (25%) and at the upper and lower ends of the stent in one patient (6.25%). Cystolitholapaxy, retrograde ureteroscopy (URS) with holmium: YAG (yttrium-aluminum-garnet) laser intracorporeal lithotripsy, percutaneous nephrostolithotomy (PNL) and antegrade URS with holmium: YAG laser intracorporeal lithotripsy were effectively performed without intraoperative complications. Lithotripsy became necessary before stent removal in 11 patients (68.75%). Holmium laser lithotripsy was useful in managing 7 patients (43.75%), and shockwave lithotripsy (SWL) in 6 patients (37.5%). In two patients (12.5%) both holmium and SWL were used before the stent can be removed.

  6. Bioconvection in Cultures of the Calcifying Unicellular Alga Pleurochrysis Carterae

    NASA Technical Reports Server (NTRS)

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

    2003-01-01

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

  7. Post-polymerization of urease-induced calcified, polymer hydrogels.

    PubMed

    Rauner, Nicolas; Buenger, Lea; Schuller, Stefanie; Tiller, Joerg C

    2015-01-01

    Urease-induced calcification is an innovative method to artificially produce highly filled CaCO3-based composite materials by intrinsic mineralization of hydrogels. The mechanical properties of these hybrid materials based on poly(2-hydroxyethylacrylate) cross-linked by triethylene glycol dimethacrylate are poor. Increasing the degree of calcification to up to 94 wt% improves the Young's moduli (YM) of the materials from some 40 MPa to more than 300 MPa. The introduction of calcium carbonate affine groups to the hydrogel matrix by copolymerizing acrylic acid and [2-(methacryloyloxy) ethyl]trimethylammonium chloride, respectively, does not increase the stiffness of the composites. A Young's modulus of more than 1 GPa is achieved by post-polymerization (PP) of the calcified hydrogels, which proves that the size of the contact area between the matrix and calcium carbonate crystals is the most crucial parameter for controlling the stiffness of hybrid materials. Switching from low Tg to high Tg hydrogel matrices (based on poly(N,N-dimethyl acrylamide)) results in a YM of up to 3.5 GPa after PP. PMID:25284027

  8. The role of calcifying nanoparticles in biology and medicine.

    PubMed

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

    2012-01-01

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

  9. Association between dental pulp stones and calcifying nanoparticles.

    PubMed

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

    2011-01-01

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

  10. The role of calcifying nanoparticles in biology and medicine

    PubMed Central

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

    2012-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2000-04-01

    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.

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

    PubMed

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

    2012-09-01

    The role of microcalcifications (μCalcs) in the biomechanics of vulnerable plaque rupture is examined. Our laboratory previously proposed (Ref. 44), using a very limited tissue sample, that μCalcs 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-μm resolution and undecalcified histology with special emphasis on calcified particles <50 μm in diameter. Our results reveal the presence of thousands of μCalcs, the vast majority in lipid pools where they are not dangerous. However, 81 μCalcs were also observed in the fibrous caps of nine of the fibroatheroma. All 81 of these μCalcs 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 μCalc and surrounding tissue, μCalc size, and clustering. We found that local tissue stress could be increased fivefold when μCalcs were closely spaced, and the peak circumferential stress in the thinnest nonruptured cap (66 μm) if no μCalcs 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 μCalcs < 15 μm in the caps, not visible at 6.7-μm resolution, and that our failure to find any nonruptured caps between 30 and 66 μm is a strong indication that many of these caps contained μCalcs. PMID:22777419

  13. Comprehensive plaque assessment by coronary CT angiography.

    PubMed

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

    2014-07-01

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

  14. Fibrillar Amyloid Plaque Formation Precedes Microglial Activation

    PubMed Central

    Steinbach, Sonja; Blazquez-Llorca, Lidia; Herms, Jochen

    2015-01-01

    In Alzheimer’s disease (AD), hallmark β-amyloid deposits are characterized by the presence of activated microglia around them. Despite an extensive characterization of the relation of amyloid plaques with microglia, little is known about the initiation of this interaction. In this study, the detailed investigation of very small plaques in brain slices in AD transgenic mice of the line APP-PS1(dE9) revealed different levels of microglia recruitment. Analysing plaques with a diameter of up to 10 μm we find that only the half are associated with clear morphologically activated microglia. Utilizing in vivo imaging of new appearing amyloid plaques in double-transgenic APP-PS1(dE9)xCX3CR1+/- mice further characterized the dynamic of morphological microglia activation. We observed no correlation of morphological microglia activation and plaque volume or plaque lifetime. Taken together, our results demonstrate a very prominent variation in size as well as in lifetime of new plaques relative to the state of microglia reaction. These observations might question the existing view that amyloid deposits by themselves are sufficient to attract and activate microglia in vivo. PMID:25799372

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

    SciTech Connect

    Prabhudesai, Vikramaditya; Phelan, Cordelia; Yang, Ying Wang, Ruikang K.; Cowling, Mark G.

    2006-12-15

    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.

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

    PubMed Central

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

    2014-01-01

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

  17. Sonographic estimation of pleural fluid volume in dogs.

    PubMed

    Newitt, Anna L M; Cripps, Peter J; Shimali, Jerry

    2009-01-01

    The aim of this study was to find an ultrasonographic method to estimate pleural fluid volume in dogs. Nine canine cadavers of mixed breed were studied. Using a transsternal view, linear measurements from the pleural surface of the midline of the sternebra at the center of the heart to the furthest ventrolateral point of both right and left lung edges were recorded. Isotonic saline was injected using ultrasound guidance into both right and left pleural spaces and the measurements were repeated using standard increments until 1000 ml total volume was reached. No relationship was identified between mean distance and injected volume up to 100 ml. Thereafter, the mean distance increased in an approximately linear relationship with the cube root of fluid volume. There was a high correlation (r > or = 0.899) between the ultrasonographic measurement and fluid volume within individual dogs, but it was not possible to produce a useful equation to calculate absolute pleural fluid volume for new subjects. Nevertheless, ultrasonography may be used to semiquantitatively monitor pleural fluid volume, so that a decrease in the mean linear measurement obtained reflects a decrease in the total fluid volume. PMID:19241761

  18. Intrapleural administration of DNase alone for pleural empyema

    PubMed Central

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

    2015-01-01

    Introduction: Pleural empyema is a severe complication of various diseases. The essential is the inserting a drain into the pleural cavity and evacuation of the pus. Sometimes the pus is very thick and its evacuation and re-expansion of the lung is very difficult. Methods: We report a group of 10 patients with intrapleural administration of Pulmozyme (dornase alpha) in dosages of either 2.5 mg once or on two separate occasions. All of the patients had a chest tube inserted into the pleural cavity. Measurement of viscosity was done before and after the instillation of the dornase alpha. Results: In six patients dornase alfa was introduced into the pleural cavity once. Three of them received this on the 4th whilst the rest were treated with the agent on the 6th day. Four patients received the dornase alpha twice because of the small amount of drainage fluid after the previous instillation. Five patients were discharged from hospital with complete re-expansion of their lungs. Two patients were qualified for a surgical operation since the lung was trapped and did not re-expand. Three patients had to be discharged with a drain as a result of incomplete re-expansion of the lung. In all the patients the density of the pus after administering the dornase alpha decreased and the amount of the pus drainage increased. Conclusions: Dornase alpha may be used in some patients with pleural empyema with good results. PMID:26885174

  19. Diagnostic Yield of Medical Thoracoscopy in Undiagnosed Pleural Effusion

    PubMed Central

    Kiani, Arda; Karimi, Mahmoud; Samadi, Katayoun; Sheikhy, Kambiz; Farzanegan, Behrooz; Pour Abdollah, Mihan; Jamaati, Hamidreza; Jabardarjani, Hamid Reza; Masjedi, Mohammad Reza

    2015-01-01

    Background: One of the most common indications for pleuroscopy is undiagnosed pleural effusion, which comprises about 25% of all cases of pleural effusions, which remain undiagnosed despite primary tests. Pleuroscopy was performed for the first time in Iran in Masih Daneshvari hospital located in Tehran. The aim of this study was to assess the diagnostic yield of pleuroscopy performed in this center in Iran. Materials and Methods: Three-hundred patients with undiagnosed pleural effusions were enrolled in this study. For all patients, primary tests including pleural effusion analysis, cytology and closed pleural biopsy (if needed) were conducted and all of them were inconclusive. The semirigid thoracoscopy (pleuroscopy) was performed for all patients for diagnostic purposes. Results: Eighty-seven percent of the peluroscopies were diagnostic and 67% of them were diagnosed as malignancy while the rest were diagnosed as tuberculosis. Only 11 patients developed minor complications. Conclusion: In conclusion, pleuroscopy is a safe procedure when performed by a skilled and experienced practitioner; it has a high diagnostic yield and results in only minor complications. PMID:27114723

  20. Mortality among patients with pleural effusion undergoing thoracentesis.

    PubMed

    DeBiasi, Erin M; Pisani, Margaret A; Murphy, Terrence E; Araujo, Katy; Kookoolis, Anna; Argento, A Christine; Puchalski, Jonathan

    2015-08-01

    Of the 1.5 million people diagnosed with pleural effusion in the USA annually, ~178 000 undergo thoracentesis. While it is known that malignant pleural effusion portends a poor prognosis, mortality of patients with nonmalignant effusions has not been well studied.This prospective cohort study evaluated 308 patients undergoing thoracentesis. Chart review was performed to obtain baseline characteristics. The aetiology of the effusions was determined using standardised criteria. Mortality was determined at 30 days and 1 year.247 unilateral and 61 bilateral thoracenteses were performed. Malignant effusion had the highest 30-day (37%) and 1-year (77%) mortality. There was substantial patient 30-day and 1-year mortality with effusions due to multiple benign aetiologies (29% and 55%), congestive heart failure (22% and 53%), and renal failure (14% and 57%, respectively). Patients with bilateral, relative to unilateral, pleural effusion were associated with higher risk of death at 30 days and 1 year (17% versus 47% (hazard ratio (HR) 2.58, 95% CI 1.44-4.63) and 36% versus 69% (HR 2.32, 95% CI 1.55-3.48), respectively).Patients undergoing thoracentesis for pleural effusion have high short- and long-term mortality. Patients with malignant effusion had the highest mortality followed by multiple benign aetiologies, congestive heart failure and renal failure. Bilateral pleural effusion is distinctly associated with high mortality. PMID:25837039

  1. The posterior pleural junction line in pneumoconiosis. A report of 3 cases with thickening.

    PubMed

    Thomas, R G; Sluis-Cremer, G K; Solomon, A

    1987-06-20

    Disease may change the position or cause thickening or distortion of the posterior pleural junction line. Pleural changes associated with silica or asbestos exposure may also result in radiologically recognisable thickening of the line. Three examples are presented. PMID:3603276

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

    PubMed Central

    2015-01-01

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

  3. Atherosclerosis and atheroma plaque rupture: imaging modalities in the visualization of vasa vasorum and atherosclerotic plaques.

    PubMed

    Sun, Zhonghua

    2014-01-01

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

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

    PubMed Central

    2014-01-01

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

  5. [Surgical treatment of lung cancer complicated by pleural effusion].

    PubMed

    Iaitskiĭ, N A; Akopov, A L; Egorov, V I; Deĭneka, I V; Chistiakov, I V

    2012-01-01

    The authors made a retrospective analysis of 51 patients with non-small-cell lung cancer with pleural effusion, not associated with tumor lesion of pleural leaves. Out of 51 operated patients 45 (88%) proved to be resectable. Among 45 patients (20 pneumonectomies, 24 lobectomies and 1 bilobectomy) combined interventions were fulfilled in 15 patients. In 27 (60%) out of 45 patients there was an injury of mediastinal lymph nodes, in 13 (29%)--intrapulmonary and root nodes. Complicated course of the postoperative period was noted in 27% of patients, lethality was 2%. One year survival after resection was 86%, three and five year survival was 54% and 30% respectively. The indices of survival reliably depended on the degree of lymphogenic dissemination. The presence of pleural effusion can not be a reason for refusal to fulfill radical surgical intervention. PMID:23488256

  6. Radiographically guided percutaneous catheter drainage of pleural fluid collections.

    PubMed

    Merriam, M A; Cronan, J J; Dorfman, G S; Lambiase, R E; Haas, R A

    1988-12-01

    We reviewed the outcome of guided percutaneous catheter drainage of pleural fluid collections in 18 patients over a 5-year period. Catheter positioning was guided by fluoroscopy in 10 (56%) cases, CT in seven (39%), and sonography in one (6%). Included were 16 patients with empyemas and one each with a sterile hematoma and transudate. In nine of the patients, previous surgical chest tube drainage had been unsuccessful. The majority of collections were treated with a 12- or 14-French catheter and closed underwater seal drainage. Twelve (80%) of the 15 patients who had an adequate trial of guided drainage were cured. Propyliodone oil suspension contrast sinography after catheter placement showed two clinically unsuspected bronchopleural fistulas. Although an extensive multilocular pleural collection was a contraindication to percutaneous catheter drainage, the thick fibrous peel of a chronic empyema was not. Drainage of pleural fluid collections with radiographic guidance ensures proper catheter placement and is successful in a high percentage of cases. PMID:3055887

  7. Ocean acidification and calcifying reef organisms: A mesocosm investigation

    USGS Publications Warehouse

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

    2008-01-01

    A long-term (10 months) controlled experiment was conducted to test the impact of increased partial pressure of carbon dioxide (pCO2) on common calcifying coral reef organisms. The experiment was conducted in replicate continuous flow coral reef mesocosms flushed with unfiltered sea water from Kaneohe Bay, Oahu, Hawaii. Mesocosms were located in full sunlight and experienced diurnal and seasonal fluctuations in temperature and sea water chemistry characteristic of the adjacent reef flat. Treatment mesocosms were manipulated to simulate an increase in pCO2 to levels expected in this century [midday pCO2 levels exceeding control mesocosms by 365 ?? 130 ??atm (mean ?? sd)]. Acidification had a profound impact on the development and growth of crustose coralline algae (CCA) populations. During the experiment, CCA developed 25% cover in the control mesocosms and only 4% in the acidified mesocosms, representing an 86% relative reduction. Free-living associations of CCA known as rhodoliths living in the control mesocosms grew at a rate of 0.6 g buoyant weight year-1 while those in the acidified experimental treatment decreased in weight at a rate of 0.9 g buoyant weight year-1, representing a 250% difference. CCA play an important role in the growth and stabilization of carbonate reefs, so future changes of this magnitude could greatly impact coral reefs throughout the world. Coral calcification decreased between 15% and 20% under acidified conditions. Linear extension decreased by 14% under acidified conditions in one experiment. Larvae of the coral Pocillopora damicornis were able to recruit under the acidified conditions. In addition, there was no significant difference in production of gametes by the coral Montipora capitata after 6 months of exposure to the treatments. ?? 2008 Springer-Verlag.

  8. Microscopic Observation of Self-Propagation of Calcifying Nanoparticles (Nanobacteria)

    NASA Technical Reports Server (NTRS)

    Mathew, Grace; McKay, David S.; Ciftcioglu, Neva

    2007-01-01

    Biologists typically define living organisms as carbon and water-based cellular forms with :self-replication" as the fundamental trait of the life process. However, this standard dictionary definition of life does not help scientists to categorize self-replicators like viruses, prions, proteons and artificial life. CNP also named nanobacteria were discovered in early 1990s as about 100 nanometer-sized bacteria-like particles with unique apatite mineral-shells around them, and found to be associated with pathological-calcification related diseases. Although CNP have been isolated and cultured from mammalian blood and diseased calcified tissues, and their biomineralizing properties well established, their biological nature and self-replicating capability have always been severely challenged. The terms "self-replication", "self-assembly" or "self-propagation" have been widely used for all systems including nanomachines, crystals, computer viruses and memes. In a simple taxonomy, all biological and non-biological "self replicators", have been classified into "living" or "nonliving" based on the properties of the systems and the amount of support they require to self-replicate. To enhance our understanding about self-replicating nature of CNP, we have investigated their growth in specific culture conditions using conventional inverted light microscope and BioStation IM, Nikon s latest time-lapse imaging system. Their morphological structure was examined using scanning (SEM) and transmission (TEM) electron microscopy. This present study, in conjunction with previous findings of metabolic activity, antibiotic sensitivity, antibody specificity, morphological aspects and infectivity, all concomitantly validate CNP as living self-replicators.

  9. Ocean acidification and calcifying reef organisms: a mesocosm investigation

    NASA Astrophysics Data System (ADS)

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

    2008-09-01

    A long-term (10 months) controlled experiment was conducted to test the impact of increased partial pressure of carbon dioxide ( pCO2) on common calcifying coral reef organisms. The experiment was conducted in replicate continuous flow coral reef mesocosms flushed with unfiltered sea water from Kaneohe Bay, Oahu, Hawaii. Mesocosms were located in full sunlight and experienced diurnal and seasonal fluctuations in temperature and sea water chemistry characteristic of the adjacent reef flat. Treatment mesocosms were manipulated to simulate an increase in pCO2 to levels expected in this century [midday pCO2 levels exceeding control mesocosms by 365 ± 130 μatm (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.

  10. Persistent Seroconversion after Accidental Eye Exposure to Calcifying Nanoparticles

    NASA Technical Reports Server (NTRS)

    Ciftcioglu, Neva; Aho, Katja M.; McKay, David S.; Kajander, E. Olavi

    2007-01-01

    Biosafety of nanomaterials has attracted much attention recently. We report here a case where accidental human eye exposure to biogenic nanosized calcium phosphate in the form of calcifying nanoparticles (CNP) raised a strong IgG immune response against proteins carried by CNP. The antibody titer has persisted over ten years at the high level. The IgG was detected by ELISA using CNPs propagated in media containing bovine and human serum as antigen. The exposure incident occurred to a woman scientist (WS) at a research laboratory in Finland at 1993. CNP, also termed "nanobacteria", is a unique self-replicating agent that has not been fully characterized and no data on biohazards were available at that time. Before the accident, her serum samples were negative for both CNP antigen and anti-CNP antibody using specific ELISA tests (Nanobac Oy, Kuopio, Finland). The accident occurred while WS was harvesting CNP cultures. Due to a high pressure in pipetting, CNP pellet splashed into her right eye. Both eyes were immediately washed with water and saline. The following days there was irritation and redness in the right eye. These symptoms disappeared within two weeks without any treatment. Three months after the accident, blood and urine samples of WS were tested for CNP cultures (2), CNP-specific ELISA tests, and blood cell counts. Blood cell counts were normal, CNP antigen and culture tests were negative. A high IgG anti-CNP antibody titer was detected (see Figure). The antibodies of this person have been used thereafter as positive control and standard in ELISA manufacturing (Nano-Sero IgG ELISA, Nanobac Oy, Kuopio, Finland).

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

    PubMed Central

    Roca, Elisa; Lacroix, Romaric; Judicone, Coralie; Laroumagne, Sophie; Robert, Stéphane; Cointe, Sylvie; Muller, Alexandre; Kaspi, Elise; Roll, Patrice; Brisson, Alain R.; Tantucci, Claudio

    2016-01-01

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

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

    PubMed

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

    2016-01-19

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

  13. CONFIRMED VIRUSES VERSUS UNCONFIRMED PLAQUES IN SEWAGE

    EPA Science Inventory

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

  14. Evaluation of Carotid Plaque Using Ultrasound Imaging

    PubMed Central

    2016-01-01

    Traditional risk factors for predicting of cardiovascular disease are not always effective predictors for development of cardiovascular events. This review summarizes several newly developed noninvasive imaging techniques for evaluating carotid plaques and their role in cardiovascular disease risk. PMID:27358696

  15. Vascular MR segmentation: wall and plaque

    NASA Astrophysics Data System (ADS)

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

    2003-05-01

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

  16. Relation of Plasma Lipoprotein(a) to Subclinical Coronary Plaque Volumes, Three-Vessel and Left Main Coronary Disease, and Severe Coronary Stenoses in Apparently Healthy African-Americans With a Family History of Early-Onset Coronary Artery Disease.

    PubMed

    Kral, Brian G; Kalyani, Rita R; Yanek, Lisa R; Vaidya, Dhananjay; Fishman, Elliot K; Becker, Diane M; Becker, Lewis C

    2016-09-01

    Serum lipoprotein(a) [Lp(a)] is a coronary artery disease (CAD) risk factor in persons of European ancestry. Levels are twofold to threefold higher in African-Americans (AAs), but reported associations with CAD have been inconsistent. The relation of Lp(a) with the extent and severity of subclinical coronary plaque has not been described in AAs. We screened 269 apparently healthy AAs for risk factors and coronary plaque using advanced coronary computed tomographic angiography. Total coronary plaque (TCP), noncalcified coronary plaque, and calcified coronary plaque volumes (mm(3)) were quantified using a validated automated method. Lp(a) was measured by ELISA. Multivariable modeling was performed with adjustment for traditional CAD risk factors and intrafamilial correlations. Mean age was 51 ± 11 years and 64% were female. Plaque was present in 41%. Lp(a) was independently associated with TCP volume [log(TCP + 1)] (p = 0.04), 3-vessel and/or left main involvement (p = 0.04), and at least 1 stenosis >50% (p = 0.006). Best-fit regression analyses showed that subjects with Lp(a) >40 mg/dl were threefold more likely to have 3-vessel and/or left main disease (95% confidence interval 1.4 to 6.8, p = 0.005) and fourfold more likely to have stenosis >50% (95% confidence interval 1.3 to 15.0, p = 0.02). In subjects with plaque (n = 110), multivariable models showed the Lp(a) level was significantly and independently associated with TCP (p = 0.009), noncalcified coronary plaque (p = 0.01), and calcified coronary plaque (p = 0.003) and affected vessel length (p = 0.01). In conclusion, high Lp(a) is strongly associated with coronary plaque volumes, extent, and severity in apparently healthy AAs. High levels of Lp(a) may be particularly important in the pathogenesis of CAD in AAs. PMID:27530333

  17. Collagenases and cracks in the plaque

    PubMed Central

    Libby, Peter

    2013-01-01

    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. PMID:23908120

  18. Detection of High-Risk Atherosclerotic Plaque

    PubMed Central

    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

    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. PMID:22974808

  19. Dissecting thoracic aortic aneurysm associated with tuberculous pleural effusion

    PubMed Central

    Im, Kyong Shil; Choi, Min Kyung; Jeon, Yong Kyoung

    2016-01-01

    We present the case of thoracic aortic aneurysm associated with the tuberculous pleural effusion. An 82-year-old woman underwent emergency stent graft under a diagnosis of dissecting thoracic aortic aneurysm. Preoperative computed tomography revealed right pleural effusion supposed to the hemothorax caused by the dissecting aneurysm. But, the effusion was sanguineous color fluid and it was determined to result from pulmonary tuberculosis. The medical team was exposed to the pulmonary tuberculosis; fortunately no one became infected. Physicians should be aware of the possibility of an infected aortic aneurysm and prepare for pathogen transmission. PMID:27499987

  20. Pleural effusion as a manifestation of multiple myeloma.

    PubMed

    Iqbal, Nousheen; Tariq, Muhammad Usman; Shaikh, Mohammad Usman; Majid, Hashir

    2016-01-01

    Multiple myeloma is a clonal B-cell malignancy, characterised by proliferation of plasma cells and secretion of paraproteins. These plasma cells accumulate predominantly in the bone marrow; rarely, they invade other areas, especially the thorax. Myeloma presenting with a pleural effusion is rare and reported in only 6% of patients with myeloma. Such patients generally present late and have a poor prognosis. Here, we describe a patient presenting with a lung mass, renal failure and a massive unilateral pleural effusion due to multiple myeloma who was treated successfully. PMID:27520995

  1. Visceral leishmaniasis with pleural effusion in an immunocompetent patient

    PubMed Central

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

    2014-01-01

    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

  2. Plaque fluid as a bacterial milieu.

    PubMed

    Edgar, W M; Higham, S M

    1990-06-01

    Studies of the extracellular, free concentrations of substrates, growth factors, inhibitors, and end-products of metabolism to which the intact plaque microflora is exposed in situ can assist in the understanding of factors controlling plaque pathogenicity. Information is becoming increasingly available from analysis of fluid separated by centrifugation of plaques collected at various intervals after an intra-oral pulse of dietary or experimental substrate, or different procedures or treatments having cariostatic potential. Such analytical results give more information than those obtained by analysis of aqueous or other extracts, because they yield values of substrate concentration representing those occurring at the bacterial cell surface. The largest body of information concerns extracellular levels of acid end-products of sugar catabolism in relation to food quality or sequence, and of amino acids and other products of nitrogen metabolism, in relation to studies of the detailed metabolic events of the Stephan curve, and of the demineralizing effect of the plaque environment. Areas where little information is available and which merit further study include plaque clearance of salivary and other components with anti-caries activity (e.g., antibodies, enzymes, fluorides, cations, other antimicrobials, etc.), and substrate concentrations to determine gradients for diffusion into and out of plaque. PMID:2191982

  3. Helicobacter pylori in dental plaque of Pakistanis.

    PubMed

    Butt, A K; Khan, A A; Bedi, R

    1999-07-01

    Helicobacter pylori is now generally accepted to play a key role in acid related and neoplastic pathology of gastroduodenal diseases. Recent reports have concluded that dental plaque is not an important reservoir for Helicobacter pylori, however, these studies did not consider the ethnic background of their subjects nor the amounts of dental plaque present. The aim of this study was to explore the association of Helicobacter pylori dental plaque colonisation in 125 males and 53 females (group I) attending a dental clinic in Pakistan. A simultaneous sample of 30 healthy volunteers with good orodental hygiene consisting of 17 males and 13 females was included as a control group (group II). Six dental plaque specimens were obtained from each subject with a sickle scaler; two were inoculated into CLO test gel and the remaining four were used to prepare cytology slides stained with Giemsa's stain. CLO test was positive in all specimens from group I, while cytology for Helicobacter pylori was positive in 173 cases in this group. One hundred and forty two cases had heavy plaque deposits and all of them were positive on cytology. In group II CLO test was positive in 20 and dental plaque cytology was positive in 7 cases. In conclusion, it is important that future studies into the prevalence of Helicobacter pylori in the oral cavity should take into account the levels of oral cleanliness and the ethnic background of the subjects. PMID:10833287

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

    NASA Astrophysics Data System (ADS)

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

    2009-08-01

    The use of percutaneous aortic valve implantation is limited, as the native calcified valve is left in situ. A new device has been developed for resecting calcified aortic valves, using collapsible nickel-titanium blades: laser-cut T-structures of Nitinol sheet-material (Ni51Ti49 at.%) have been grinded on a high-speed milling cutter to produce cutting edges which have been given the shape of half-circles afterwards. These have been connected to each other and to struts by using rivets which also serve as articulating axes for the cutting ring. The blades are folded around these axes and retreated into a tube to be inserted in the heart through the calcified valve leaflets. Once released, the cutting edges regain their ring-shape. By combining rotation of the ring with a translating movement against a second ring of slightly greater diameter on the instrument, a punching process is created which cuts the calcified valve leaflets and leaves a circular annulus, where a prosthesis can be fixed. In vitro cutting of artificially calcified valves ( n = 6) resulted in a resection time of t = 22 ± 6.29 s with a maximum turning moment of M = 2.4 ± 1.27 Nm, proving the function and the feasibility of the concept.

  5. Prevalence of Calcified Carotid Artery on Panoramic Radiographs in Postmenopausal Women

    PubMed Central

    Taheri, Jamileh Beigom; Moshfeghi, Mahkameh

    2009-01-01

    Background and aims This study was designed to evaluate the prevalence of calcified carotid artery in 50 year-old and older postmenopausal dental outpatients for early diagnosis of individuals at risk of stroke. Materials and methods This is a descriptive study of 200 panoramic radiographs. These radiographs included post-menopausal women referring to the Department of Oral Medicine at Shahid Beheshti Faculty of Dentistry during 2006-2007. The x-ray machine, developer and film type were the same for all the radiographs. Statistical analysis included chi-square test and Fisher’s exact test. Results We found 22 calcified carotid arteries. The left and right carotid arteries were involved in 7 and 9 cases, respec-tively. In 6 cases both carotid arteries were calcified. Four individuals had no vascular risk factor excluding age and others had at least one risk factor. We found significant statistical correlation between hypertension, past history of myocardial infarction, and hypercholesterolemia with calcified carotid artery on panoramic radiographs. Conclusion Under the limitations of the present study, prevalence of calcified carotid arteries is 11.0 % in 50 year-old and older postmenopausal dental outpatients. PMID:23230481

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

    NASA Technical Reports Server (NTRS)

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

    1993-01-01

    Tidal flat and lagoonal dolostones of the Neoproterozoic Draken Formation, Spitsbergen, exhibit excellent preservation of carbonate fabrics, including heavily calcified microfossils. The crust-forming cyanobacterium Polybessurus is preserved locally by carbonate precipitated on and within sheaths in mildly evaporitic upper intertidal to supratidal environments. In contrast, calcified filaments in columnar stromatolites reflect subtidal precipitation. Filament molds in dolomicrites independently document extremely early lithification. The presence of heavily calcified cyanobacteria in Draken and other Proterozoic carbonates constrains potential explanations for the widespread appearance of calcified microorganisms near the Proterozoic-Cambrian boundary. We propose that the rarity of Proterozoic examples principally reflects the abundance and wide distribution of carbonate crystals precipitated on the sea floor or in the water column. Cyanobacterial sheaths would have competed effectively as sites for carbonate nucleation and growth only where calcitic and/or aragonitic nuclei were absent. In this view, the Proterozoic-Cambrian expansion of calcified microfossils primarily reflects the emergence of skeletons as principal agents of carbonate deposition.

  7. Improved treatment planning for COMS eye plaques

    SciTech Connect

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

    2005-03-15

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

  8. Stone Morphology Suggestive of Randall's Plaque

    NASA Astrophysics Data System (ADS)

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

    2007-04-01

    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

  9. Localized Pleural Metastases of Renal Cell Carcinoma After Nephrectomy: A Case Report and Literature Review.

    PubMed

    Yasuda, Yuichiro; Tobino, Kazunori; Ko, Yuki; Asaji, Mina; Yamaji, Yoshikazu; Tsuruno, Kosuke; Mukasa, Yosuke; Ebi, Noriyuki

    2016-01-01

    We herein report the case of a 61-year-old Japanese male with localized pleural metastases of renal cell carcinoma. The patient was admitted to our hospital because of dyspnea on exertion and left-sided pleural effusion. He had undergone right radical nephrectomy 10 years previously. Contrast-enhanced whole-body computed tomography revealed scattered nodular thickening of the left pleura with contrast enhancement and left-sided pleural effusion. Thoracoscopy performed under local anesthesia was applied to obtain a biopsy of the pleural nodules, and the specimen was consequently diagnosed as exhibiting pleural metastasis of renal cell carcinoma, clear cell type. PMID:26705014

  10. Amyloid Plaques in PSAPP Mice Bind Less Metal than Plaques in Human Alzheimer’s Disease

    PubMed Central

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

    2009-01-01

    Amyloid beta (Aβ) 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 Aβ 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. PMID:19481608

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

    PubMed

    Gaffar, A; Afflitto, J; Nabi, N

    1997-10-01

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

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

    SciTech Connect

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

    2009-01-01

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

  13. Collection and evaluation of equine peritoneal and pleural effusions.

    PubMed

    Cowell, R L; Tyler, R D; Clinkenbeard, K D; MacAllister, C G

    1987-12-01

    This article discusses collection, slide preparation, culture technique, fluid analysis and evaluation, and cytologic evaluation of peritoneal and pleural effusions. The morphologic characteristics of various effusions are described, and the physical characteristics (volume, color, turbidity) of effusions are discussed. An algorithm for classifying effusions as transudates, modified transudates, or exudates is included, and each category is discussed. PMID:3322526

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

    PubMed

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

    2013-06-01

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

  15. Effect of positive pleural pressure on left ventricular performance

    SciTech Connect

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

    1984-01-01

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

  16. Complications of indwelling pleural catheter use and their management

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2013-09-01

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

  18. Use of anabolic-androgenic steroids masking the diagnosis of pleural tuberculosis: a case report

    PubMed Central

    2009-01-01

    Introduction Tuberculous pleural effusions are not always easy to diagnose but the presence of a lymphocyte-rich exudate associated with an increased adenosine deaminase level and a positive skin test result are highly sensitive diagnostic signs. Case presentation We report a case of pleural tuberculosis in a 31-year-old white male patient from Caracas, Venezuela who was negative for human immunodeficiency virus and presented 2 weeks after injecting the anabolic-androgenic steroid nandrolone decanoate, in whom all the tests for tuberculosis were initially negative; an eosinophilic pleural effusion with a low adenosine deaminase level, a negative tuberculin skin test and negative for acid-fast bacilli staining and culture of the pleural fluid. After excluding other causes of eosinophilic pleural effusion malignant pleural effusion was suspected. The patient did not return until 4 months later. The second thoracentesis obtained a pleural fluid suggestive for tuberculosis, with a predominance of lymphocytes, an elevated adenosine deaminase level (51 U/l) and a positive tuberculin skin test. Culture of pleural fragments confirmed pleural tuberculosis. Conclusion This case suggests that the use of an anabolic-androgenic steroid masks the definitive diagnosis of pleural tuberculosis by changing the key diagnostic parameters of the pleural fluid, a finding not previously reported. Available evidence of the effects of anabolic steroids on the immune system also suggests that patients using anabolic-androgenic steroids might be susceptible to developing tuberculosis in either reactivating a latent infection or facilitating development of the disease after a recent infection. PMID:19175931

  19. Case report: Ovarian cavernous haemangioma presenting as a heavily calcified adnexal mass.

    PubMed

    Kim, M Y; Rha, S E; Oh, S N; Lee, Y J; Jung, E S; Byun, J Y

    2008-11-01

    Haemangioma is an extremely rare tumour of the ovary. We describe the CT and MRI findings of a heavily calcified ovarian haemangioma in a 69-year-old woman presenting with adnexal torsion. CT showed a well-circumscribed mass with extensive punctate calcifications, located posterior to the uterus. MR images showed dark signal intensities of the mass on both T(1) and T(2) weighted images, with poor enhancement of the mass on contrast-enhanced T(1) weighted images. MR images also demonstrated a beak-like protrusion from the adnexal mass, representing the adnexal torsion. This is the first case report of a heavily calcified ovarian haemangioma in the English literature. Although rare, ovarian haemangioma should be included in the differential diagnosis of a heavily calcified adnexal mass. PMID:18941040

  20. EACTS expert consensus statement for surgical management of pleural empyema.

    PubMed

    Scarci, Marco; Abah, Udo; Solli, Piergiorgio; Page, Aravinda; Waller, David; van Schil, Paul; Melfi, Franca; Schmid, Ralph A; Athanassiadi, Kalliopi; Sousa Uva, Miguel; Cardillo, Giuseppe

    2015-11-01

    Pleural infection is a frequent clinical condition. Prompt treatment has been shown to reduce hospital costs, morbidity and mortality. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research. The European Association for Cardio-Thoracic Surgery (EACTS) Thoracic Domain and the EACTS Pleural Diseases Working Group established a team of thoracic surgeons to produce a comprehensive review of available scientific evidence with the aim to cover all aspects of surgical practice related to its treatment, in particular focusing on: surgical treatment of empyema in adults; surgical treatment of empyema in children; and surgical treatment of post-pneumonectomy empyema (PPE). In the management of Stage 1 empyema, prompt pleural space chest tube drainage is required. In patients with Stage 2 or 3 empyema who are fit enough to undergo an operative procedure, there is a demonstrated benefit of surgical debridement or decortication [possibly by video-assisted thoracoscopic surgery (VATS)] over tube thoracostomy alone in terms of treatment success and reduction in hospital stay. In children, a primary operative approach is an effective management strategy, associated with a lower mortality rate and a reduction of tube thoracostomy duration, length of antibiotic therapy, reintervention rate and hospital stay. Intrapleural fibrinolytic therapy is a reasonable alternative to primary operative management. Uncomplicated PPE [without bronchopleural fistula (BPF)] can be effectively managed with minimally invasive techniques, including fenestration, pleural space irrigation and VATS debridement. PPE associated with BPF can be effectively managed with individualized open surgical techniques, including direct repair, myoplastic and thoracoplastic techniques. Intrathoracic vacuum-assisted closure may be considered as an adjunct to the standard

  1. Malignant and Tuberculous Pleural Effusions: Immunophenotypic Cellular Characterization

    PubMed Central

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

    2008-01-01

    INTRODUCTION AND OBJECTIVES Tuberculosis and cancer are the main causes of pleural effusion. Pleural involvement is associated with migration of immune cells to the pleural cavity. We sought to characterize the immunophenotype of leukocytes in the pleural effusion and peripheral blood of patients with tuberculosis or malignancy. METHODS Thirty patients with tuberculosis (14) or malignancy (16) were studied. A control group included 20 healthy blood donors. RESULTS Malignant phycoerythrin pleural effusions showed higher percentages of CD3, CD4, CD3CD45RO, and CD20CD25 lymphocytes and lower percentages of CD3CD25 and CD20HLA-DR when compared to PB lymphocytes. Compared to PB, tuberculous effusions had a higher percentage of lymphocytes that co-expressed CD3, CD4, CD3CD45RO, CD3TCRαβ, CD3CD28, and CD20 and a lower percentage of CD14, CD8 and CD3TCRγδ-positive lymphocytes. Malignant effusions presented higher expression of CD14 whereas tuberculous effusions had higher expression of CD3 and CD3CD95L. Peripheral blood cells from tuberculosis patients showed higher expression of CD14, CD20CD25 and CD3CD95L. Compared with the control cells, tuberculosis and cancer peripheral blood cells presented a lower percentage of CD3CD4 and CD3CD28-positive cells as well as a higher percentage of CD3CD8, CD3CD25 and CD3CD80-positive cells. CONCLUSIONS Tuberculous and malignant peripheral blood is enriched with lymphocytes with a helper/inducer T cell phenotype, which are mainly of memory cells. CD14-positive cells were more frequently found in malignant effusions, while CD3-positive cells expressing Fas ligand were more frequently found in tuberculous effusions. PMID:18925324

  2. Hyperspectral imaging of atherosclerotic plaques in vitro

    NASA Astrophysics Data System (ADS)

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

    2011-02-01

    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.

  3. Growth of Necrotic Cores in Vulnerable Plaque

    NASA Astrophysics Data System (ADS)

    Fok, Pak-Wing

    2011-03-01

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

  4. Functional expression of dental plaque microbiota.

    PubMed

    Peterson, Scott N; Meissner, Tobias; Su, Andrew I; Snesrud, Erik; Ong, Ana C; Schork, Nicholas J; Bretz, Walter A

    2014-01-01

    Dental caries remains a significant public health problem and is considered pandemic worldwide. The prediction of dental caries based on profiling of microbial species involved in disease and equally important, the identification of species conferring dental health has proven more difficult than anticipated due to high interpersonal and geographical variability of dental plaque microbiota. We have used RNA-Seq to perform global gene expression analysis of dental plaque microbiota derived from 19 twin pairs that were either concordant (caries-active or caries-free) or discordant for dental caries. The transcription profiling allowed us to define a functional core microbiota consisting of nearly 60 species. Similarities in gene expression patterns allowed a preliminary assessment of the relative contribution of human genetics, environmental factors and caries phenotype on the microbiota's transcriptome. Correlation analysis of transcription allowed the identification of numerous functional networks, suggesting that inter-personal environmental variables may co-select for groups of genera and species. Analysis of functional role categories allowed the identification of dominant functions expressed by dental plaque biofilm communities, that highlight the biochemical priorities of dental plaque microbes to metabolize diverse sugars and cope with the acid and oxidative stress resulting from sugar fermentation. The wealth of data generated by deep sequencing of expressed transcripts enables a greatly expanded perspective concerning the functional expression of dental plaque microbiota. PMID:25177549

  5. Fatigue crack propagation analysis of plaque rupture.

    PubMed

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

    2013-10-01

    Rupture of atheromatous plaque is the major cause of stroke or heart attack. Considering that the cardiovascular system is a classic fatigue environment, plaque rupture was treated as a chronic fatigue crack growth process in this study. Fracture mechanics theory was introduced to describe the stress status at the crack tip and Paris' law was used to calculate the crack growth rate. The effect of anatomical variation of an idealized plaque cross-section model was investigated. The crack initiation was considered to be either at the maximum circumferential stress location or at any other possible locations around the lumen. Although the crack automatically initialized at the maximum circumferential stress location usually propagated faster than others, it was not necessarily the most critical location where the fatigue life reached its minimum. We found that the fatigue life was minimum for cracks initialized in the following three regions: the midcap zone, the shoulder zone, and the backside zone. The anatomical variation has a significant influence on the fatigue life. Either a decrease in cap thickness or an increase in lipid pool size resulted in a significant decrease in fatigue life. Comparing to the previously used stress analysis, this fatigue model provides some possible explanations of plaque rupture at a low stress level in a pulsatile cardiovascular environment, and the method proposed here may be useful for further investigation of the mechanism of plaque rupture based on in vivo patient data. PMID:23897295

  6. Disappearing large calcified thoracic disc herniation in a patient with thalassaemia.

    PubMed

    Ahmad, Faiz U; Schallert, Erica; Bregy, Amade; Post, Judith D; Vanni, Steven

    2016-01-01

    Regression of herniated disc fragments with subsequent improvement in clinical symptoms has been reported in the lumbar and cervical spine. Such regressions in the thoracic spine are extremely rare. We report a case of a 38-year-old patient with thalassaemia who had regression of a large calcified herniated thoracic disc causing cord compression, with subsequent herniation of a second calcified disc at a different level and discuss the possible aetiopathogenesis. This is the first such case reported in the thalassaemia population. PMID:26823353

  7. Calcifying fibrous tumor of the small intestine associated with Castleman-like lymphadenopathy.

    PubMed

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

    2014-06-01

    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

  8. Evaluation of pleural CYFRA 21-1 and carcinoembryonic antigen in the diagnosis of malignant pleural effusions.

    PubMed Central

    Salama, G.; Miédougé, M.; Rouzaud, P.; Mauduyt, M. A.; Pujazon, M. C.; Vincent, C.; Carles, P.; Serre, G.

    1998-01-01

    CYFRA 21-1 assay, measuring cytokeratin 19 fragments, was compared with carcinoembryonic antigen (CEA) assay, as an addition to cytological analysis for the diagnosis of malignant effusions. Both markers were determined with commercial enzyme immunoassays in pleural fluid from 196 patients. Cytological analysis and/or pleural biopsy confirmed the malignant origin of the effusion in 99 patients (76 carcinomas, nine pleural mesotheliomas and 14 non-epithelial malignancies). Effusions were confirmed as benign in 97 patients (33 cardiac failures, 39 infectious diseases--including 12 tuberculosis-- and 25 miscellaneous effusions). Both markers were significantly higher in malignant than in benign effusions. All the patients with non-epithelial malignancies presented CYFRA and CEA values lower than the 95% diagnostic specificity thresholds (100 and 6 ng ml(-1) respectively). The diagnostic sensitivity in the group of carcinomas and mesotheliomas was similar for CYFRA (58.8%) and CEA (64.7%). However, CEA had a significantly higher sensitivity in carcinomas (72.4% vs 55.3%), while CYFRA had a clearly higher sensitivity in mesotheliomas (89.9% vs 0%). Interestingly, 12 out of the 16 malignant effusions with a negative cytology were CEA and/or CYFRA positive. Regarding their high diagnostic sensitivity and their complementarity, CEA and CYFRA appear to be very useful for the diagnosis of malignant pleural effusions when cytology is negative. Images Figure 1 PMID:9472646

  9. Effect of delmopinol hydrochloride mouthrinse on plaque formation and gingivitis in "rapid" and "slow" plaque formers.

    PubMed

    Zee, K; Rundegren, J; Attström, R

    1997-07-01

    The aim of the present study was to investigate differences in the plaque and gingivitis inhibiting effect of delmopinol rinsing between "rapid" and "slow" plaque formers. 23 subjects (12 "rapid" and 11 "slow" plaque formers) were selected from 71 healthy young adults. The selection was based on the plaque index on the buccal surfaces of all premolars and 1st molars after 3-days without plaque control. The 23 subjects were randomly assigned into 3 groups with different mouthrinses, i.e., 0.1% delmopinol, 0.2% delmopinol, and placebo. The study was double-blind with parallel design between the "rapid" and "slow" plaque formers and cross-over design between 2 active periods and a placebo period. Each rinsing period lasted for 5 days. During the 3 test periods, the subjects refrained from all oral hygiene and rinsed 2x daily with either one of the 3 solutions. Gingival crevicular fluid (GCF) was collected from buccal surfaces of upper canines and premolars and bleeding on probing (BOP) recorded at 6 sites around each tooth before and after each test period. Plaque assessment, including plaque index (PI) and standardized color slides for planimetric analyses obtained from the canines and premolars, were only recorded after each test period. Results showed that the mean PI and planimetry values for both the "rapid" and "slow" plaque formers were lower than the placebo, for either the 0.1% or the 0.2% delmopinol mouthrinse. The differences between the" rapid" and "slow" plaque formers were not statistically significant. There was a small reduction in BOP in both groups for the delmopinol periods, as against a slight increase in the placebo period; the difference between the placebo group and the 2 groups of plaque formers was not statistically significant (p>0.6 for both 0.1% and 0.2% delmopinol). Results suggested that both 0.1% and 0.2% delmopinol reduce plaque formation and gingivitis to a similar extent in subjects with extreme rates of plaque formation. PMID:9226389

  10. Protocol of the PLeural Effusion And Symptom Evaluation (PLEASE) study on the pathophysiology of breathlessness in patients with symptomatic pleural effusions

    PubMed Central

    Thomas, Rajesh; Azzopardi, Maree; Muruganandan, Sanjeevan; Read, Catherine; Murray, Kevin; Eastwood, Peter; Jenkins, Sue; Singh, Bhajan; Lee, Y C Gary

    2016-01-01

    Introduction Pleural effusion is a common clinical problem that can complicate many medical conditions. Breathlessness is the most common symptom of pleural effusion of any cause and the most common reason for pleural drainage. However, improvement in breathlessness following drainage of an effusion is variable; some patients experience either no benefit or a worsening of their breathlessness. The physiological mechanisms underlying breathlessness in patients with a pleural effusion are unclear and likely to be multifactorial with patient-related and effusion-related factors contributing. A comprehensive study of the physiological and symptom responses to drainage of pleural effusions may provide a clearer understanding of these mechanisms, and may identify predictors of benefit from drainage. The ability to identify those patients whose breathlessness will (or will not) improve after pleural fluid drainage can help avoid unnecessary pleural drainage procedures, their associated morbidities and costs. The PLeural Effusion And Symptom Evaluation (PLEASE) study is a prospective study to comprehensively evaluate factors contributing to pleural effusion-related breathlessness. Methods and analysis The PLEASE study is a single-centre prospective study of 150 patients with symptomatic pleural effusions that require therapeutic drainage. The study aims to identify key factors that underlie breathlessness in patients with pleural effusions and develop predictors of improvement in breathlessness following effusion drainage. Participants will undergo evaluation pre-effusion and post-effusion drainage to assess their level of breathlessness at rest and during exercise, respiratory and other physiological responses as well as respiratory muscle mechanics. Pre-drainage and post-drainage parameters will be collected and compared to identify the key factors and mechanisms that correlate with improvement in breathlessness. Ethics and dissemination Approved by the Sir Charles

  11. Pleural mesothelial cells promote expansion of IL-17-producing CD8+ T cells in tuberculous pleural effusion.

    PubMed

    Li, X; Zhou, Q; Yang, W B; Xiong, X Z; Du, R H; Zhang, J C

    2013-05-01

    IL-17-producing CD8(+) T lymphocytes (Tc17 cells) have recently been detected in many cancers and autoimmune diseases. However, the possible implication of Tc17 cells in tuberculous pleural effusion remains unclarified. In this study, distribution and phenotypic features of Tc17 cells in both tuberculous pleural effusion (TPE) and peripheral blood from patients with tuberculosis were determined. The effects of proinflammatory cytokines and local accessory cells (pleural mesothelial cells) on Tc17 cell expansion were also explored. We found that TPE contained more Tc17 cells than the blood. Compared with IFN-γ-producing CD8(+) T cells, Tc17 cells displayed higher expression of chemokine receptors (CCRs) and lower expression of cytotoxic molecules. In particularly, Tc17 cells in TPE exhibited high expression levels of CCR6, which could migrate in response to CCL20. Furthermore, IL-1β, IL-6, IL-23, or their various combinations could promote Tc17 cell expansion from CD8(+) T cells, whereas the proliferative response of Tc17 cells to above cytokines was lower than that of Th17 cells. Pleural mesothelial cells (PMCs) were able to stimulate Tc17 cell expansion via cell contact in an IL-1β/IL-6/IL-23 independent fashion. Thus this study demonstrates that Tc17 cells marks a subset of non-cytotoxic, CCR6(+) CD8(+) T lymphocytes with low proliferative capacity. The overrepresentation of Tc17 cells in TPE may be due to Tc17 cell expansion stimulated by pleural proinflammatory cytokines and to recruitment of Tc17 cells from peripheral blood. Additionally, PMCs may promote the production of IL-17 by CD8(+) T cells at sites of TPE via cell-cell interactions. PMID:23299924

  12. Statistical segmentation of carotid plaque neovascularization

    NASA Astrophysics Data System (ADS)

    Akkus, Zeynettin; Bosch, Johan G.; Sánchez-Ferrero, Gonzalo V.; Carvalho, Diego D. B.; Renaud, Guillaume; van den Oord, Stijn C. H.; ten Kate, Gerrit L.; Schinkel, Arend F. L.; de Jong, Nico; van der Steen, Antonius F. W.

    2013-03-01

    In several studies, intraplaque neovascularization (IPN) has been linked with plaque vulnerability. The recent development of contrast enhanced ultrasound enables IPN detection, but an accurate quantification of IPN is a big challenge due to noise, motion, subtle contrast response, blooming of contrast and artifacts. We present an algorithm that automatically estimates the location and amount of contrast within the plaque over time. Plaque pixels are initially labeled through an iterative expectation-maximization (EM) algorithm. The used algorithm avoids several drawbacks of standard EM. It is capable of selecting the best number of components in an unsupervised way, based on a minimum message length criterion. Next, neighborhood information using a 5×5 kernel and spatiotemporal behavior are combined with the known characteristics of contrast spots in order to group components, identify artifacts and finalize the classification. Image sequences are divided into 3-seconds subgroups. A pixel is relabeled as an artifact if it is labeled as contrast for more than 1.5 seconds in at least two subgroups. For 10 plaques, automated segmentation results were validated with manual segmentation of contrast in 10 frames per clip. Average Dice index and area ratio were 0.73+/-0.1 (mean+/-SD) and 98.5+/-29.6 (%) respectively. Next, 45 atherosclerotic plaques were analyzed. Time integrated IPN surface area was calculated. Average area of IPN was 3.73+/-3.51 mm2. Average area of 45 plaques was 11.6+/-8.6 mm2. This method based on EM contrast segmentation provides a new way of IPN quantification.

  13. Longitudinal plaque redistribution during stent expansion.

    PubMed

    Maehara, A; Takagi, A; Okura, H; Hassan, A H; Bonneau, H N; Honda, Y; Yock, P G; Fitzgerald, P J

    2000-11-15

    The purpose of this study was to clarify the 3-dimensional behavior of plaque during coronary stent expansion. Serial intravascular ultrasound (IVUS) studies, preintervention, and poststenting were evaluated in 32 patients treated with a single-balloon expandable tubular stent. External elastic membrane (EEM), lumen, stent, and plaque + media cross-sectional area were measured at 1-mm intervals through the entire stent as well as proximal and distal reference segments 5 mm from the stent edge. Volumetric calculations were based on Simpson's rule. Overall, the plaque + media volume through the entire lesion did not change during stent expansion (218 +/- 51 vs 217 +/- 47 mm3, p = 0.69). However, EEM and lumen volume increased significantly (EEM volume, 391 +/- 84 vs 448 +/- 87 mm3 [p < 0.0001]; lumen volume, 173 +/- 52 vs 231 +/- 54 mm3 [p < 0.0001]). The change in lumen volume correlated strongly with the change in EEM volume (r = 0.85, p < 0.0001), but poorly with the change in plaque + media volume (r = 0.37, p = 0.03). Plaque + media volume decreased in the midstent zone (59 +/- 14 vs 53 +/- 11 mm3, p = 0.0005), and increased in the distal stent zone (40 +/- 11 vs 44 +/- 9 mm3, p = 0.003), but did not change in either the proximal stent zone or reference segments. The mechanism of stent expansion is a combination of vessel stretch and plaque redistribution, translating disease accumulation from the midstent zone to the distal stent zone. PMID:11074201

  14. Aterofisiol® in carotid plaque evolution

    PubMed Central

    Amato, Bruno; Compagna, Rita; Amato, Maurizio; Gallelli, Luca; de Franciscis, Stefano; Serra, Raffaele

    2015-01-01

    Background In patients with carotid stenosis, the risk of plaque rupture is related to the composition of the atherosclerotic plaque rather than to its magnitude. In this regard, we evaluated the effects of a supplement, Aterofisiol,® containing omega-3 (EPA [eicosapen acid] DHA [docosahexaenoic acid]), vitamin K2, vitamin B6, vitamin B12, oligomeric proanthocyanidins (OPC) and resveratrol on the composition of atherosclerotic plaque and on neurological symptoms in patients with carotid stenosis undergoing carotid endarterectomy. Methods The study was randomized, prospective, and double-blinded. Eligible patients were of both sexes, with carotid stenosis >70% who underwent endarterectomy. Enrolled patients were randomly allocated to receive either one tablet of acetylsalicylic acid 100 mg (Cardioaspirin®) + one tablet of Aterofisiol every 24 hours or one tablet of Cardioaspirin + one tablet of placebo every 24 hours. Each treatment was started 30 days before the surgery and was stopped 5 days before the surgery. The plaques were removed “en bloc” using standard surgical technique. Results During the study period, 214 patients (135 men and 79 women) were enrolled for intent-to-treat and randomized in two groups: Group A: 107 patients (68 men and 39 women) were treated with Cardioaspirin + Aterofisiol. Group B: 107 patients (67 men and 40 women) were treated with Cardioaspirin + placebo. At the end of the study, 202 patients participated fully (103 patients in Group A and 99 patients in Group B), making up the protocol evaluation population (94.4%). The mean lipid content of removed plaques was significantly lower (P<0.05) in Group A. We recorded a significantly lower incidence of neurological symptoms in Group A in comparison with Group B (P<0.05). Conclusion In the study, Aterofisiol showed to be effective in reducing the amounts of cholesterol and lipids in the plaques and in reducing adverse neurological events in the study group with respect to controls

  15. Cobalt plaque therapy of posterior uveal melanomas

    SciTech Connect

    Shields, J.A.; Augsburger, J.J.; Brady, L.W.; Day, J.L.

    1982-10-01

    One hundred patients with choroidal melanomas who were treated by the authors with cobalt plaque radiotherapy were analyzed with regard to tumor regression, visual results, complications, and mortality rate. The follow-up period at the time of this writing ranged from one to five years. These preliminary observations indicate that cobalt plaque radiotherapy induces tumor regression in 96% of cases, preserves useful vision in many cases and has fewer complications during the one- to five-year follow-up period than previously believed.

  16. MR Imaging of Coronary Arteries and Plaques.

    PubMed

    Dweck, Marc R; Puntman, Valentina; Vesey, Alex T; Fayad, Zahi A; Nagel, Eike

    2016-03-01

    Cardiac magnetic resonance offers the promise of radiation-free imaging of the coronary arteries, providing information with respect to luminal stenosis, plaque burden, high-risk plaque characteristics, and disease activity. In combination, this would provide a comprehensive, individualized assessment of coronary atherosclerosis that could be used to improve patient risk stratification and to guide treatment. However, the technical challenges involved with delivering upon this promise are considerable, requiring sophisticated approaches to both data acquisition and post-processing. In this review, we describe the current status of this technology, its capabilities, its limitations, and what will be required in the future to translate this technology into routine clinical practice. PMID:26965732

  17. Diagnostic Ability of FDG-PET/CT in the Detection of Malignant Pleural Effusion

    PubMed Central

    Nakajima, Reiko; Abe, Koichiro; Sakai, Shuji

    2015-01-01

    Abstract We investigated the role of F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) for the differential diagnosis of malignant and benign pleural effusion. We studied 36 consecutive patients with histologically proven cancer (excluding malignant mesothelioma) who underwent FDG-PET/CT for suspected malignant pleural effusion. Fourteen patients had cytologically proven malignant pleural effusion and the other 22 patients had either negative cytology or clinical follow-up, which confirmed the benign etiology. We examined the maximum standardized uptake values (SUVmax) of pleural effusion and the target-to-normal tissue ratio (TNR), calculated as the ratio of the pleural effusion SUVmax to the SUVmean of the normal tissues (liver, spleen, 12th thoracic vertebrae [Th12], thoracic aorta, and spinalis muscle). We also examined the size and density (in Hounsfield units) of the pleural effusion and pleural abnormalities on CT images. TNR (Th12) and increased pleural FDG uptake compared to background blood pool were significantly more frequent in cases with malignant pleural effusion (P < 0.05 for both). The cutoff TNR (Th12) value of >0.95 was the most accurate; the sensitivity, specificity, and accuracy for this value were 93%, 68%, and 75%, respectively. FDG-PET/CT can be a useful method for the differential diagnosis of malignant and benign pleural effusion. PMID:26200610

  18. Calcified neurocysticercosis associates with hippocampal atrophy: a population-based study.

    PubMed

    Del Brutto, Oscar H; Salgado, Perla; Lama, Julio; Del Brutto, Victor J; Campos, Xavier; Zambrano, Mauricio; García, Héctor H

    2015-01-01

    Calcified neurocysticercosis has been associated with hippocampal atrophy in patients with refractory epilepsy, but the relevance of this association in the population at large is unknown. We assessed calcified cysticerci and its association with hippocampal atrophy in elderly persons living in Atahualpa, an Ecuadorian village endemic for neurocysticercosis. All Atahualpa residents ≥ 60 years of age were invited to undergo computed tomography/magnetic resonance imaging for neurocysticercosis detection. Twenty-eight (11%) out of 248 enrolled persons had calcified cysticerci (case-patients) and were matched 1:1 by age, sex, and years of education to individuals without neurocysticercosis on computed tomography/magnetic resonance imaging (controls). Four case-patients and none of the controls had epilepsy (P = 0.134). Cognitive performance was similar across both groups. The Scheltens' medial temporal atrophy scale was used for hippocampal rating in case-patients and matched controls without neurocysticercosis. Mean score in the Scheltens' scale was higher in case-patients than in controls (P < 0.001). Atrophic hippocampi were noticed in 19 case-patients and five controls (P = 0.003). Atrophy was bilateral in 11 case-patients and unilateral in eight. All case-patients with unilateral hippocampal atrophy had at least one ipsilateral calcification. This study shows an association between calcified cysticerci and hippocampal atrophy and raises the possibility of an inflammation-mediated hippocampal damage as the responsible mechanism for these findings. PMID:25349375

  19. Calcified Neurocysticercosis Associates with Hippocampal Atrophy: A Population-Based Study

    PubMed Central

    Del Brutto, Oscar H.; Salgado, Perla; Lama, Julio; Del Brutto, Victor J.; Campos, Xavier; Zambrano, Mauricio; García, Héctor H.

    2015-01-01

    Calcified neurocysticercosis has been associated with hippocampal atrophy in patients with refractory epilepsy, but the relevance of this association in the population at large is unknown. We assessed calcified cysticerci and its association with hippocampal atrophy in elderly persons living in Atahualpa, an Ecuadorian village endemic for neurocysticercosis. All Atahualpa residents ≥ 60 years of age were invited to undergo computed tomography/magnetic resonance imaging for neurocysticercosis detection. Twenty-eight (11%) out of 248 enrolled persons had calcified cysticerci (case-patients) and were matched 1:1 by age, sex, and years of education to individuals without neurocysticercosis on computed tomography/magnetic resonance imaging (controls). Four case-patients and none of the controls had epilepsy (P = 0.134). Cognitive performance was similar across both groups. The Scheltens' medial temporal atrophy scale was used for hippocampal rating in case-patients and matched controls without neurocysticercosis. Mean score in the Scheltens' scale was higher in case-patients than in controls (P < 0.001). Atrophic hippocampi were noticed in 19 case-patients and five controls (P = 0.003). Atrophy was bilateral in 11 case-patients and unilateral in eight. All case-patients with unilateral hippocampal atrophy had at least one ipsilateral calcification. This study shows an association between calcified cysticerci and hippocampal atrophy and raises the possibility of an inflammation-mediated hippocampal damage as the responsible mechanism for these findings. PMID:25349375

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

    PubMed

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

    2009-11-01

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

  1. Calcifying Fibrous Pseudotumor of the Posterior Mediastinum With Encapsulation of the Thoracic Duct.

    PubMed

    Dissanayake, Sumudu N; Hagen, Jeffrey; Fedenko, Alexander; Lee, Christopher

    2016-07-01

    We report the first case of calcifying fibrous pseudotumor (CFPT) to arise in the posterior mediastinum with encapsulation of the thoracic duct. This exceedingly rare lesion was incidentally discovered in an asymptomatic young woman and treated with surgical resection, requiring ligation and excision of the thoracic duct. There has been no evidence of tumor recurrence or postoperative complication. PMID:27343527

  2. BATON ROUGE NATIONAL CEMETERY PLAQUE MOUNTED ON BASE OF FLAGPOLE, ...

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

    BATON ROUGE NATIONAL CEMETERY PLAQUE MOUNTED ON BASE OF FLAGPOLE, WITH NATIONAL REGISTER OF HISTORIC PLACES PLAQUE AT RIGHT. VIEW TO NORTH. - Baton Rouge National Cemetery, 220 North 19th Street, Baton Rouge, East Baton Rouge Parish, LA

  3. Treating cardiovascular atherosclerotic plaques with Tongmaijiangzhi (TMJZ) capsule.

    PubMed

    Ren, Hong-Qiang; Zhao, Li; Zhang, Zhong Shuang; Wang, Zhong; Wang, Li; Duan, Jun Cang; Li, Li; Zhai, Zhi Hong; Qu, De Tao; Huang, Hui

    2013-01-01

    Atherosclerotic plaques can cause serious syndromes and mortality. Cholesterol accumulation in the plaques can disrupt the arterial flow, with lumen narrowing and stenosis, which contributes to heart attack and sudden cardiac death. The pharmacological treatment to atherosclerotic plaques can be anti-hypertensives, anti-cholesterol, and cleaning of the existed plaques. This work examined the effects of pharmacological Tongmaijiangzhi (TMJZ) capsule on atherosclerotic plaques. The radiological findings of the atherosclerotic plaques of 107 patients receiving TMJZ treatment were analyzed. We found that the TMJZ administration decreases plaque volume and alters the composition in a relatively short period, showing highly promising effects. TMJZ treatment is able to remove the existed atherosclerotic plaques with no side effects observed. PMID:24311866

  4. 18. Photocopy of drawing of bronze dedication plaque, circa 1903 ...

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

    18. Photocopy of drawing of bronze dedication plaque, circa 1903 (original drawing in possession of City Engineer's Office Grand Rapids, Michigan) DEDICATION PLAQUE. - Bridge Street Bridge, Spanning Grand River, Michigan & Bridge Streets, Grand Rapids, MI

  5. Magnetic resonance imaging of juxtapapillary plaques in cadaver eyes.

    PubMed Central

    Williams, D F; Mieler, W F; Jaffe, G J; Robertson, D M; Hendrix, L

    1990-01-01

    Adequate treatment of juxtapapillary melanomas with episcleral plaque brachytherapy using lower energy radiation sources may be difficult because of uncertainties regarding the relationship of the plaque to the optic nerve and tumour base. We obtained magnetic resonance images of a dummy plaque placed in a juxtapapillary location in cadaver specimens. Although it is possible to place a plaque in close association with the optic nerve sheath, a tissue barrier exists which may prevent actual contact between the plaque and nerve. Posterior tilting of the plaque may also occur. Because of these uncertainties regarding plaque placement, juxtapapillary melanomas should be considered a distinct subgroup when evaluating the efficacy of radioactive plaque brachytherapy in the treatment of choroidal melanoma. Images PMID:2306444

  6. Comparative studies of inorganic carbon utilization in Emiliania huxleyi and some non-calcifying marine microalgae

    NASA Astrophysics Data System (ADS)

    Liang-Feng, Dong; Merrett, M. J.; Chao-Yuan, Wu

    1999-09-01

    Inorganic carbon utilization in the non-calcifying marine microalgae, Nannochloropsis oculata, Phaeodactylum tricornutum and Porphyridium purpureum was compared with high- and low-calcifying strains of Emiliania huxleyi grown in artificial seawater medium aerated with either air (0.03% V/V CO2) or CO2-free air. For high-calcifying strain of E. oculata and P. tricornutem, similar growth patterns were observed in air-and CO2-free air-grown cultures. P. purpureum showed a less final cell density in CO2-free air than in air-grown culture. However, low-calcifying strain of E. huxleyi was able to grow only in air-grown culture, but not in CO2-free air-grown culture. Measurements of alkalinity, pH, concentration of dissolved inorganic carbon (DIC) and free CO2 showed different patterns of DIC utilization. With N. oculata, P. tricornutum and P. purpureum the pattern of DIC utilization was characterized by an increase of pH and a decrease of DIC but a constant alkalinity in the cultures aerated with air or CO2-free air, suggesting that bicarbonate utilization was concomitant with an efflux of OH-. Both alkalinity and pH were maintained rather constant in air-grown culture of low-calcifying strain of E. huxleyi, suggesting that diffusive entry of CO2 could meet the requirement of DIC for its photosynthesis and growth. High-calcifying strain of E. huxleyi, however, showed a pattern of decrease of alkalinity and DIC but an almost constant pH, indicating that bicarbonate was the major form of inorganic carbon utilised by this organism and bicarbonate uptake is unlikely to be accompanied by an efflux of OH-. The final pH values reached by N. oculata, P. tricornutum and P. purpureum in a closed system were 10.75, 10.60 and 9.85 respectively, showing that bicarbonate utilisation is concomitant with an efflux of OH-. While the final pH of 8.4 in high-calcifying E. huxleyi suggests that bicarbonate utilization was not accompanied by an efflux of OH-.

  7. Lipidome of Atherosclerotic Plaques from Hypercholesterolemic Rabbits

    PubMed Central

    Bojic, Lazar A.; McLaren, David G.; Shah, Vinit; Previs, Stephen F.; Johns, Douglas G.; Castro-Perez, Jose M.

    2014-01-01

    The cellular, macromolecular and neutral lipid composition of the atherosclerotic plaque has been extensively characterized. However, a comprehensive lipidomic analysis of the major lipid classes within atherosclerotic lesions has not been reported. The objective of this study was to produce a detailed framework of the lipids that comprise the atherosclerotic lesion of a widely used pre-clinical model of plaque progression. Male New Zealand White rabbits were administered regular chow supplemented with 0.5% cholesterol (HC) for 12 weeks to induce hypercholesterolemia and atherosclerosis. Our lipidomic analyses of plaques isolated from rabbits fed the HC diet, using ultra-performance liquid chromatography (UPLC) and high-resolution mass spectrometry, detected most of the major lipid classes including: Cholesteryl esters, triacylglycerols, phosphatidylcholines, sphingomyelins, diacylglycerols, fatty acids, phosphatidylserines, lysophosphatidylcholines, ceramides, phosphatidylglycerols, phosphatidylinositols and phosphatidylethanolamines. Given that cholesteryl esters, triacylglycerols and phosphatidylcholines comprise greater than 75% of total plasma lipids, we directed particular attention towards the qualitative and quantitative assessment of the fatty acid composition of these lipids. We additionally found that sphingomyelins were relatively abundant lipid class within lesions, and compared the abundance of sphingomyelins to their precursor phosphatidylcholines. The studies presented here are the first approach to a comprehensive characterization of the atherosclerotic plaque lipidome. PMID:25517033

  8. Microtissue Culture Plaque Assay for Herpesvirus saimiri

    PubMed Central

    Chan, Emerson W.; Dunkel, Virginia C.

    1973-01-01

    A microtissue culture method for the plaque assay of Herpesvirus saimiri has been developed. Virus titrations carried out in Microtest II tissue culture plates (Falcon) yielded reproducible results that agreed well with those obtained by employing macrocultures. The described method is quantitative, reproducible, economical, and suitable for routine assay of large numbers of virus samples. Images PMID:4201642

  9. Pleural effusion resulting from malignant hepatoblastoma in a horse.

    PubMed

    Prater, P E; Patton, C S; Held, J P

    1989-02-01

    Pleural effusion, secondary to a metastasis from a malignant hepatoblastoma, was diagnosed in a 3-year-old Appaloosa gelding. Severe hemorrhagic transudate in both pleural cavities resulted in acute onset of labored breathing, tachypnea, tachycardia, and jugular vein pulsation. Results of ultrasonography and radiography of the ventral lung field and cranial portion of the abdomen initially were nondiagnostic, as were results of cytologic examination of peritoneal fluid and tracheal wash specimens. Moderately high serum gamma-glutamyl transferase and alkaline phosphatase activities, despite normal hepatocyte-specific enzyme (sorbital dehydrogenase) activity, were indicative of biliary stasis without hepatocyte destruction. The horse was euthanatized. Necropsy revealed a 47-kg hepatoblastoma, with metastases in the lungs and intestines. PMID:2537279

  10. Pleural effusion Due to Streptococcus milleri: Case descriptions.

    PubMed

    Madrid-Carbajal, Claudia Janeth; Molinos, Luis; García-Clemente, Marta; Pando-Sandoval, Ana; Fleites, Ana; Casan-Clarà, Pere

    2014-09-01

    In this study we analyzed the characteristics of patients with pleural effusion secondary to Streptococcus milleri studied retrospectively between January and March 2013 and found seven patients with a mean age of 60 years, 43% of which were smokers and 57% with a drinking habit. The most common associated factors were alcoholism, previous pneumonia and diabetes. Other bacteria were identified as Enterobacter aerogenes, Bacteroides and Prevotella intermedia capillosus in two patients. The mean duration of antibiotic therapy was 28 days; six patients underwent pleural drainage by chest tube and one patient needed surgery due to poor clinical progress. The mean duration of hospitalization was 30 days with satisfactory outcome in all cases, despite some changes in residual function. PMID:24439468

  11. Topographic congruence of calcified parenchymal neurocysticercosis and other structural brain lesions with epileptiform activity

    PubMed Central

    Saito, Erin K; Nagpal, Meera; Leon, Amanda; Mehta, Bijal; McMurtray, Aaron Matthew

    2016-01-01

    Introduction: Calcified parenchymal neurocysticercosis (NCC) lesions are commonly detected in many individuals with refractory epilepsy. However, the relationship between these lesions and epilepsy is not fully determined. We sought to determine if calcified parenchymal NCC demonstrated topographic congruence with epileptiform activity in refractory epilepsy patients. Additional patients with other structural brain lesions were included for comparison. Subjects and Methods: Retrospective cross-sectional analysis of all patients treated at a community-based neurology clinic for refractory epilepsy during a 3-month period and with structural brain lesions detected by neuroimaging studies. Results: A total of 105 patients were included in the study, including 63 with calcified parenchymal NCC lesions and 42 with other structural brain lesions. No significant relationship was detected between hemispheric localization of calcified parenchymal NCC lesions and epileptiform activity. For those with other structural brain lesions, the hemispheric localization was significantly related to the side of epileptiform activity (Chi-square = 11.13, P = 0.025). In addition, logistic regression models showed that those with right-sided non-NCC lesions were more likely to have right-sided epileptiform activity (odds ratio = 4.36, 95% confidence interval [CI] =1.16–16.31, P = 0.029), and those with left-sided non-NCC lesions were more likely to have left-sided epileptiform activity (odds ratio = 7.60, 95% CI = 1.89–30.49, P = 0.004). Conclusion: The lack of correlation between the side of calcified parenchymal NCC lesions and the side of the epileptiform activity suggests that these lesions may be incidental findings in many patients. PMID:26998434

  12. Brain Metastasis of Pleural Mesothelioma after a Subarachnoid Hemorrhage.

    PubMed

    Hirooka, Aya; Tamiya, Akihiro; Kanazu, Masaki; Nonaka, Junichi; Yonezawa, Taiji; Asami, Kazuhiro; Atagi, Shinji

    2016-01-01

    Malignant pleural mesothelioma (MPM) is an uncommon, fatal neoplasm induced by asbestos exposure. Brain metastases from MPM are extremely rare, with most such cases diagnosed only at the time of autopsy. This report describes what we believe to be the first case of MPM metastasizing to the brain after a subarachnoid hemorrhage, as well as the subsequent surgical removal of the brain metastasis. PMID:27041164

  13. [Treatment methods in multiple hepatic, pulmonary and pleural hydatidosis].

    PubMed

    Galie, N; Stoica, R; Cadar, G; Posea, R; Brânzea, R

    2001-01-01

    The modern treatment of hepato-pleural-pulmonary hydatidosis is based on surgical excision and medical treatment with drugs like: Mebendazol, Albendazol or Praziquantel. There are presented 23 patients with multiple hepato-pleuro-pulmonary hydatidosis, operated in the last 4 years. Surgical excision in pleuro-pulmonary hydatidosis is adapted to cysts topography, aiming to eliminate the intact cysts and to close the remaining cavities. PMID:11374380

  14. Pleural tissue repair with cord blood platelet gel

    PubMed Central

    Rosso, Lorenzo; Parazzi, Valentina; Damarco, Francesco; Righi, Ilaria; Santambrogio, Luigi; Rebulla, Paolo; Gatti, Stefano; Ferrero, Stefano; Nosotti, Mario; Lazzari, Lorenza

    2014-01-01

    Background Prolonged air leak is the major cause of morbidity after pulmonary resection. In this study we used in vitro and in vivo experiments to investigate an innovative approach based on the use of human umbilical cord blood platelet gel. Materials and methods In vitro, a scratch assay was performed to test the tissue repair capability mediated by cord blood platelet gel compared to the standard culture conditions using human primary mesothelial cells. In vivo, an iatrogenic injury was made to the left lung of 54 Wistar rats. Cord blood platelet gel was placed on the injured area only in treated animals and at different times histological changes and the presence of pleural adhesions were evaluated. In addition, changes in the pattern of soluble inflammatory factors were investigated using a multiplex proteome array. Results In vitro, mesothelial cell damage was repaired in a shorter time by cord blood platelet gel than in the control condition (24 versus 35 hours, respectively). In vivo, formation of new mesothelial tissue and complete tissue recovery were observed at 45±1 and 75±1 hours in treated animals and at 130±2.5 and 160±6 hours in controls, respectively. Pleural adhesions were evident in 43% of treated animals compared to 17% of controls. No complications were observed. Interestingly, some crucial soluble factors involved in inflammation were significantly reduced in treated animals. Discussion Cord blood platelet gel accelerates the repair of pleural damage and stimulates the development of pleural adhesions. Both properties could be particularly useful in the management of prolonged air leak, and to reduce inflammation. PMID:23736928

  15. Pleuro-peritoneal shunting. Alternative therapy for pleural effusions.

    PubMed Central

    Little, A G; Kadowaki, M H; Ferguson, M K; Staszek, V M; Skinner, D B

    1988-01-01

    Pleural effusions are resistant to standard therapy, which causes discomfort and can require prolonged hospitalization. As an alternative, pleuroperitoneal shunting for pleural effusions of various etiologies was evaluated. We implanted 36 shunts in 29 patients. Two patients had bilateral shunts and five had shunt revisions. The effusion was related to a malignancy in 22 patients, postoperative chylothorax in two patients, and other causes in five patients. Therapeutic thoracentesis had been attempted in 28 patients, and eight had had chest tube placement previously with attempted sclerosis. Seven patients had a trapped lung syndrome. There was no operative mortality. All patients were deemed ready for discharge from the hospital if they had recovered from the operation within 48 hours. Five patients had poor results, either because of a moribund status or their refusal or inability to pump the shunt. Of the remaining 24 patients, four had good results with temporary improvement, and excellent results were achieved in 20 patients (83.3%), who experienced symptomatic relief and stabilization or regression of pleural effusion until the time of their death. Patients with chylothorax experienced complete resolution. The 14 patients with malignant effusions had a median survival of 4 months, and there were no instances of peritoneal tumor seeding. In conclusion, pleuroperitoneal shunting is an alternative therapy for pleural effusions that requires a limited hospitalization only, is associated with minimal and short-term discomfort, achieves excellent results in properly selected patients, and is the only viable therapy when lung expansion cannot be achieved. Images Fig. 1. Figs. 3A-C. Figs. 3A-C. Figs. 4A and B. Figs. 5A-C. Figs. 5A-C. Figs. 6A-C. Figs. 6A-C. PMID:3178332

  16. Infectious Viral Quantification of Chikungunya Virus-Virus Plaque Assay.

    PubMed

    Kaur, Parveen; Lee, Regina Ching Hua; Chu, Justin Jang Hann

    2016-01-01

    The plaque assay is an essential method for quantification of infectious virus titer. Cells infected with virus particles are overlaid with a viscous substrate. A suitable incubation period results in the formation of plaques, which can be fixed and stained for visualization. Here, we describe a method for measuring Chikungunya virus (CHIKV) titers via virus plaque assays. PMID:27233264

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

    PubMed Central

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

    2012-01-01

    Malignant pleural mesothelioma is a rare and aggressive malignancy of the pleura correlated with exposure to asbestos, with a medium survival of 11–12 months after diagnosis. A case of a 67-year-old male who had previously worked in the asbestos industry and is a current smoker is reported. The computed tomography evaluation revealed a right pleural mass with pleural thickening, and the pleural biopsy confirmed a diagnosis of malignant pleural mesothelioma. He was treated with chemotherapy consisting of etoposide, paclitaxel, and pegylated liposomal doxorubicin hydrochloride. After completion of chemotherapy, radiologic evaluation confirmed a reduction of pleural thickening and improvement in his symptoms. A complete presentation of each drug formulation and characteristics are also included in this paper. The patient’s follow-up is continuing, and computed tomography reveals stable disease 9 years after initial examination. PMID:23055748

  18. Symptomatic benign pleural effusions among asbestos insulation workers: residual radiographic abnormalities.

    PubMed Central

    Lilis, R; Lerman, Y; Selikoff, I J

    1988-01-01

    During a cross sectional medical survey of 2815 insulation workers with 30 years or more from onset of asbestos exposure conducted from 1981 to 1983, a positive history of benign pleural effusion was found in 20 (0.71%). Two or three such episodes had occurred in four of these 20 subjects. The chest x ray abnormalities in these cases were characterised by pleural fibrosis in 19 and diffuse pleural fibrosis with blunting of the corresponding costophrenic angle in 16. In the total group of 2815 insulation workers diffuse pleural fibrosis was found in 142 (5.0%). Thus diffuse pleural fibrosis with blunting of the corresponding costophrenic angle is a frequent residual abnormality after benign pleural effusion. Its impact on pulmonary function can be pronounced. Images PMID:3260799

  19. "Dry" pleural mesothelioma successfully diagnosed on endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA).

    PubMed

    Lococo, Filippo; Rossi, Giulio; Agostini, Lorenzo; Filice, Angelina; Paci, Massimiliano; Rapicetta, Cristian; Ricchetti, Tommaso; Tenconi, Sara; Piro, Roberto; Sgarbi, Giorgio

    2014-01-01

    The acquisition of histologic material is obligatory in order to establish the diagnosis of malignant pleural mesothelioma (MPM). In particular, tissue acquisition in cases of "dry" MPM (focal pleural thickening without pleural effusion or mediastinal lymph node involvement) is usually performed via a thoracoscopic pleural biopsy. In contrast, the techniques for performing echoendoscopic (transbronchial or transesophageal) needle aspiration of pleural lesions have only rarely been reported due to the theoretical limitations of tissue acquisition in such cases. We herein report the first case of "dry" MPM successfully diagnosed via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in a 73-year-old man presenting with a pleural mass in the right costovertebral recess, adjacent to the carina. The patient underwent radical resection, and a definitive pathological examination confirmed the diagnosis of epithelioid MPM. PMID:24583437

  20. Localized malignant pleural sarcomatoid mesothelioma misdiagnosed as benign localized fibrous tumor

    PubMed Central

    Vo, Hong-Phuc

    2016-01-01

    Localized malignant pleural mesothelioma (LMPM) is a rare tumor with good prognosis by surgical resection. We report an atypical case of malignant pleural sarcomatoid mesothelioma (SM) in an asymptomatic 65-year-old woman, who had no history of exposure to asbestos. She presented with a small pleural mass without pleural effusion and was misdiagnosed as a benign localized fibrous tumor (BLFT) on pathologic examination through a surgical tumor specimen. However, seven months later, the patient returned with serious cancerous symptoms. A large recurrent tumor mass was found within the chest wall invading at the old surgical resection site. SM, a subtype of LMPM, was confirmed with histopathogy and immunohistochemisty. In conclusion, malignant pleural mesothelioma (MPM) can present with typical radiologic finding similar to a BLFT, and has a wide histopathologic presentation in biopsy specimen. A thorough pathologic investigation should be attempted even when a pleural mass resembles benign, localized, and small on radiologic studies. PMID:27293862

  1. Modified TB rapid test by proteinase K for rapid diagnosis of pleural tuberculosis.

    PubMed

    Yari, Shamsi; Hadizadeh Tasbiti, Alireza; Ghanei, Mostafa; Shokrgozar, Mohammad Ali; Fateh, Abolfazl; Yari, Fatemeh; Bahrmand, Ahmadreza

    2016-03-01

    The diagnosis of pleural tuberculosis continues to be a challenge due to the low sensitivity of traditional diagnostic methods. Better and more rapid tests are needed for diagnosis of pleural TB. In this study, pleural fluids were tested with rapid test to determine Mycobacterium tuberculosis (MTB antigen). Affinity chromatography was used to purify specific polyclonal antibodies against MTB antigen. Pleural samples after decontamination were treated with proteinase K. Rapid test for pleural fluids was prepared by specific antibody. Rapid test was performed on 85 pleural fluid patients. The patients had a mean age of 46.55 ± 15.96 years and 38 were men. The performance of rapid test, using proteinase K, was found to be the most impressive: sensitivity 93%, specificity 94%, PPV 90%, and NPV 96% compared with adenosine deaminase test (ADA), PCR, smear, and culture. The present study did demonstrate that modified TB rapid test can substantially improve the diagnosis of extrapulmonary TB. PMID:26693840

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

    PubMed

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

    2008-05-01

    Tuberculous pleuritis is a common manifestation of extrapulmonary tuberculosis and is the most common cause of pleural effusion in many countries. Conventional diagnostic tests, such as microscopic examination of the pleural fluid, biochemical tests, culture of pleural fluid, sputum or pleural tissue, and histopathological examination of pleural tissue, have known limitations. Due to these limitations, newer and more rapid diagnostic tests have been evaluated. In this review, the authors provide an overview of the performance of new diagnostic tests, including markers of specific and nonspecific immune response, nucleic acid amplification and detection, and predictive models based on combinations of markers. Directions for future development and evaluation of novel assays and biomarkers for pleural tuberculosis are also suggested. PMID:18448504

  3. Localized malignant pleural sarcomatoid mesothelioma misdiagnosed as benign localized fibrous tumor.

    PubMed

    Kim, Kwan-Chang; Vo, Hong-Phuc

    2016-06-01

    Localized malignant pleural mesothelioma (LMPM) is a rare tumor with good prognosis by surgical resection. We report an atypical case of malignant pleural sarcomatoid mesothelioma (SM) in an asymptomatic 65-year-old woman, who had no history of exposure to asbestos. She presented with a small pleural mass without pleural effusion and was misdiagnosed as a benign localized fibrous tumor (BLFT) on pathologic examination through a surgical tumor specimen. However, seven months later, the patient returned with serious cancerous symptoms. A large recurrent tumor mass was found within the chest wall invading at the old surgical resection site. SM, a subtype of LMPM, was confirmed with histopathogy and immunohistochemisty. In conclusion, malignant pleural mesothelioma (MPM) can present with typical radiologic finding similar to a BLFT, and has a wide histopathologic presentation in biopsy specimen. A thorough pathologic investigation should be attempted even when a pleural mass resembles benign, localized, and small on radiologic studies. PMID:27293862

  4. [Clinical Pathological Diagnosis, and Treatment for Pleural Mesothelioma].

    PubMed

    Kishimoto, Takumi; Fujimoto, Nobukazu; Nishi, Hideyuki

    2016-05-01

    For the differential diagnosis between fibrous pleuritis and other malignancies such as lung cancer, multiple immunostaining is essential to diagnose pleural mesothelioma. For cytological diagnosis of pleural effusions, differentiation between mesothelioma cells and reactive mesothelial cells is very difficult. Therefore, histological diagnoses of tumor tissues obtained via biopsy are essential. To diagnose epthelioid mesothelioma, more than 2 positive and negative markers must be consistent with those known for mesothelioma. To diagnose sarcomatoid mesothelioma, keratin is usually positive, differentiating the diagnosis from that for real sarcoma. For surgical treatment for pleural mesothelioma, extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D) are usually performed. The proportion of P/D increases because of the low death rates with surgery and similar survivals. However, a trimodal approach, such as EPP with chemotherapy and radiotherapy, is best for longer survival and expected to be curative. For chemotherapy, only cisplatin (CDDP) combined with pemetrexed (PEM) is effective, and no other agents have been identified for this disease. Nowadays, clinical immunotherapy trials start with phase II study. PMID:27210080

  5. Regional differences in pleural lymphatic albumin concentration in sheep

    SciTech Connect

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

    1987-01-01

    We used quantitative reflectance autoradiography to compare the concentration of albumin in visceral pleural lymphatics at the cranial and caudal ends of the sheep's lung in the vertical (60 degrees head-up) and horizontal (supine) positions. Twelve to fourteen hours after injecting 125I-albumin intravenously we placed four anesthetized sheep in the vertical position to establish a microvascular hydrostatic pressure gradient along the vertical height of the lung. We placed two anesthetized sheep in the horizontal position. Four hours later, we fixed the left lung and removed visceral pleural tissue blocks from the cranial and caudal ends, separated by a 15-cm distance, along the costovertebral margin. We measured the silver grain density in the pleural lymphatic autoradiograms by dark-field reflectance microspectrophotometry. In the vertical position, the lymph albumin concentration at the cranial end (top) of the lung averaged 2.5 +/- 0.4 g/dl compared with the caudal end (bottom), which averaged 1.8 +/- 0.3 g/dl. The difference (42% greater at the top than the bottom) is significant (P less than 0.05). The computed gradient in perimicrovascular interstitial albumin osmotic pressure was 0.26 +/- 0.13 cmH2O/cm lung height. There were no differences between the cranial and caudal lymphatic groups in the two horizontal sheep. We conclude that in the sheep lung there is a gradient in perimicrovascular albumin concentration due to the vertical gradient in microvascular hydrostatic pressure.

  6. In vivo light dosimetry for HPPH-mediated pleural PDT

    NASA Astrophysics Data System (ADS)

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

    2010-02-01

    This study examines the light fluence (rate) delivered to patients undergoing pleural PDT as a function of treatment time, treatment volume and surface area. The accuracy of treatment delivery is analyzed as a function of the calibration accuracies of each isotropic detector and the calibration integrating sphere. The patients studied here are enrolled in a Phase I clinical trial of HPPH-mediated PDT for the treatment of non-small cell lung cancer with pleural effusion. Patients are administered 4mg per kg body weight HPPH 24-48 hours before the surgery. Patients undergoing photodynamic therapy (PDT) are treated with light therapy with a fluence of 15-60 J/cm2 at 661nm. Fluence rate (mW/cm2) and cumulative fluence (J/cm2) is monitored at 7 different sites during the entire light treatment delivery. Isotropic detectors are used for in-vivo light dosimetry. The anisotropy of each isotropic detector was found to be within 15%. The mean fluence rate delivery and treatment time are recorded. A correlation between the treatment time and the treatment volume is established. The result can be used as a clinical guideline for future pleural PDT treatment.

  7. Current controversies in the management of malignant pleural effusions.

    PubMed

    Azzopardi, Maree; Porcel, José M; Koegelenberg, Coenraad F N; Lee, Y C Gary; Fysh, Edward T H

    2014-12-01

    Malignant pleural effusion (MPE) can complicate most malignancies and is a common clinical problem presenting to respiratory and cancer care physicians. Despite its frequent occurrence, current knowledge of MPE remains limited and controversy surrounds almost every aspect in its diagnosis and management. A lack of robust data has led to significant practice variations worldwide, inefficiencies in healthcare provision, and threats to patient safety. Recent studies have highlighted evolving concepts in MPE care that challenge traditional beliefs. Advancing laboratory techniques have improved the diagnostic yield from pleural fluid cytology, minimizing the need for invasive tissue biopsies, even in many cases of mesothelioma. Imaging-guided biopsy is comparable to thoracoscopy in suitable patients, if cytological examination was noncontributory. Cumulating evidence for the benefits of indwelling pleural catheters (IPCs) has led some centers to adopt this approach as first-line definitive management for MPE over conventional talc pleurodesis. The optimal technique of talc pleurodesis is still debated despite its use for many decades. Strategies combining pleurodesis and IPC are being studied. MPE consists of a heterogenous group of diseases and careful phenotyping of malignant effusion patients can provide important clinical information that will advance the field and allow better stratification of patients and planning of therapy accordingly. This review addresses the controversies in MPE diagnosis and management and exposes the deficits in knowledge of MPE that should be the focus of future research. PMID:25463163

  8. Cardiac tamponade and bilateral pleural effusion in a very low birth weight infant.

    PubMed

    Haass, Cristina; Sorrentino, Elena; Tempera, Alessia; Consigli, Chiara; De Paola, Domenico; Calcagni, Giulio; Piastra, Marco; Finocchi, Maurizio

    2009-02-01

    A very low birth weight premature newborn developed a sudden cardiac tamponade due to parenteral fluid extravasation 1 month after central line insertion. Besides tensive pericardial effusion a bilateral pleural effusion also developed. An emergency pericardiocentesis was really life-saving and after pleural fluid removal a complete cardiorespiratory recovery was obtained. Pericardial and bilateral pleural effusions very rarely coexist as a complication of central line extravasation. PMID:19253161

  9. Pleural effusion with parenteral nutrition solution: an unusual complication of an "appropriately" placed umbilical venous catheter.

    PubMed

    Pabalan, Maria Janina U; Wynn, Ralph J; Reynolds, Anne Marie; Ryan, Rita M; Youssfi, Mostafa; Manja, Veena; Lakshminrusimha, Satyan

    2007-11-01

    Pleural effusion is not an uncommon complication of percutaneous intravenous catheters in neonates. Umbilical venous catheters (UVCs) are associated with pleural effusion following abnormal placement in the left atrium or pulmonary veins due to venous obstruction. We report for the first time a case of right-sided pleural effusion with parenteral nutrition solution following a UVC that appeared to be positioned appropriately in the inferior vena cava. PMID:17972230

  10. A Modified Dummy Plaque for the Accurate Placement of Ruthenium-106 Plaques in Brachytherapy of Intraocular Tumours

    PubMed Central

    Krohn, Jørgen

    2015-01-01

    Purpose To present a new technique to ensure the correct positioning of ruthenium plaques in episcleral brachytherapy. Materials and Methods An acrylic dummy plaque is made opaque by sanding both sides with sandpaper, and its edge is covered by a black marking tape. This modified plaque is temporarily sutured to the sclera overlying the choroidal tumour site. The tip of an endoillumination probe is placed at the anterior edge of the plaque, yielding a strong light scattering within the opaque acrylic material. Due to the light-absorbing tape around the plaque border, the scattered light is confined within the plaque, and its perimeter can be observed by indirect ophthalmoscopy as a circle of transilluminated light surrounding the tumour. When the correct position has been found, the dummy plaque is replaced by a ruthenium-106 plaque. Results The technique was successfully applied in 5 patients with posterior choroidal melanoma. Compared to standard focal transillumination, its main advantage is that the position of the entire plaque and tumour can be observed simultaneously in one field without any movement or manipulation of the light probe or plaque. Conclusion The described transillumination technique and modified dummy plaque facilitate the correct positioning of ruthenium plaques in brachytherapy of choroidal melanoma. PMID:27172165

  11. A 22-year-old man with pleural tuberculosis associated hydropneumothorax: Case report and literature review.

    PubMed

    Sharan, Lauren A; Price, Thea P; Hehn, Boyd; Manoff, David; Cowan, Scott W

    2016-01-01

    A 22-year-old Asian male presented with fever, non-productive cough, right-sided pleuritic chest pain and was found to have a large right hydropneumothorax. A chest tube was placed. Pleural fluid analysis revealed a lymphocytic predominant exudate and he was subsequently started on four-drug daily anti-tuberculosis therapy (isoniazid, ethambutol, rifampin, pyrazinamide). Pleural biopsy revealed acid-fast bacilli. Given his persistent pleural effusion, he was given four doses of intrapleural tissue plasminogen activator (tPA) and dornase alpha (DNase) via his chest tube over a period of 6 days resulting in clinical and radiologic improvement. Pleural biopsy and pleural fluid culture specimens later revealed Mycobacterium tuberculosis. Intrapleural tPA-DNase therapy has demonstrated improved resolution of infections and shortened hospitalizations for parapneumonic infectious effusions. However, there is little literature on the use of intrapleural fibrinolytics specifically for pleural tuberculosis associated effusions. Furthermore, the American Thoracic Society does not comment on therapeutic thoracentesis or intrapleural fibrinolytic therapy in their recommendations for treatment of pleural tuberculosis. In our case of pleural TB-associated hydropneumothorax, the use of intrapleural tPA-DNase therapy facilitated pleural fluid drainage and resulted in near-complete resolution of the effusion. PMID:27144114

  12. Analysis of Lymphocyte Immunological Reactivity in Patients with Pleural Effusions of Different Aetiology

    PubMed Central

    Goseva, Zlatica; Kaeva, Biserka Jovkovska; Gjorcev, Angelko; Janeva, Elena Jovanovska; Arsovski, Zoran; Pejkovska, Sava; Tatabitovska, Aleksandra

    2016-01-01

    BACKGROUND: The proportion of T and B lymphocytes in pleural fluids and blood may point to the presence of local immunological phenomena in pleural disorders. AIM: Aim of study was to evaluate the lymphocyte phenotype and the ratio between helper (CD4+) and cytotoxic/suppressor (CD8+) lymphocytes in malignant and non-malignant effusions. MATERIAL AND METHODS: We studied 48 patients with pleural effusions. First group had 18 patients with tuberculosis pleural effusions; second group had 20 patients with malignant pleural fluids, third group had 10 patients with transudates and 30 healthy controls. We investigated the distribution of T and B lymphocytes, T cells with helper/inducer CD4 or suppresser/cytotoxic CD8 phenotypes and the CD16 subset. RESULTS: Results showed decreases levels of CD3, CD4, and CD16 T cells in blood of patients versus healthy controls. There were increases in the percentage of the CD3 and CD4 T cells in the pleural fluid compared with values in the blood with statistical significance in tuberculous pleurisy. The values of CD8 were similar in the pleural fluid and in blood. Levels of CD16 were non-significantly higher in pleural fluid in all groups. CONCLUSION: This study confirms the hypothesis that pleural cavity is compartment with immunological reactivity and results could be used in differential diagnosis together with other examinations. PMID:27275329

  13. Incidence, etiology, and outcome of pleural effusions in allogeneic hematopoietic stem cell transplantation.

    PubMed

    Modi, Dipenkumar; Jang, Hyejeong; Kim, Seongho; Deol, Abhinav; Ayash, Lois; Bhutani, Divaya; Lum, Lawrence G; Ratanatharathorn, Voravit; Manasa, Richard; Mellert, Kendra; Uberti, Joseph P

    2016-09-01

    Pleural effusion is a known entity in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT); however, the incidence, risk factors, and morbidity-mortality outcomes associated with pleural effusions remain unknown. We retrospectively evaluated pleural effusions in 618 consecutive adult patients who underwent allogeneic HSCT from January 2008 to December 2013 at our institution. Seventy one patients developed pleural effusion at a median of 40 days (range, 1 - 869) post-HSCT with the cumulative incidence of 9.9% (95% CI, 7.7 - 12.5%) at 1 year. Infectious etiology was commonly associated with pleural effusions followed by volume overload and serositis type chronic GVHD. In multivariate analysis, higher comorbidity index (P = 0.03) and active GVHD (P = 0.018) were found to be significant independent predictors for pleural effusion development. Higher comorbidity index, very high disease risk index, ≤7/8 HLA matching, and unrelated donor were associated with inferior overall survival (OS) (P < 0.03). More importantly, patients with pleural effusion were noted to have poor OS in comparison to patients without pleural effusion (P < 0.001). Overall, pleural effusion is a frequently occurring complication after allogeneic HSCT, adding to morbidity and mortality and hence, early identification is required. Am. J. Hematol. 91:E341-E347, 2016. © 2016 Wiley Periodicals, Inc. PMID:27238902

  14. A 22-year-old man with pleural tuberculosis associated hydropneumothorax: Case report and literature review

    PubMed Central

    Sharan, Lauren A.; Price, Thea P.; Hehn, Boyd; Manoff, David; Cowan, Scott W.

    2016-01-01

    A 22-year-old Asian male presented with fever, non-productive cough, right-sided pleuritic chest pain and was found to have a large right hydropneumothorax. A chest tube was placed. Pleural fluid analysis revealed a lymphocytic predominant exudate and he was subsequently started on four-drug daily anti-tuberculosis therapy (isoniazid, ethambutol, rifampin, pyrazinamide). Pleural biopsy revealed acid-fast bacilli. Given his persistent pleural effusion, he was given four doses of intrapleural tissue plasminogen activator (tPA) and dornase alpha (DNase) via his chest tube over a period of 6 days resulting in clinical and radiologic improvement. Pleural biopsy and pleural fluid culture specimens later revealed Mycobacterium tuberculosis. Intrapleural tPA-DNase therapy has demonstrated improved resolution of infections and shortened hospitalizations for parapneumonic infectious effusions. However, there is little literature on the use of intrapleural fibrinolytics specifically for pleural tuberculosis associated effusions. Furthermore, the American Thoracic Society does not comment on therapeutic thoracentesis or intrapleural fibrinolytic therapy in their recommendations for treatment of pleural tuberculosis. In our case of pleural TB-associated hydropneumothorax, the use of intrapleural tPA-DNase therapy facilitated pleural fluid drainage and resulted in near-complete resolution of the effusion. PMID:27144114

  15. Intrapleural Corticosteroid Injection in Eosinophilic Pleural Effusion Associated with Undifferentiated Connective Tissue Disease

    PubMed Central

    Kim, Eunjung; Yang, Bokyung; Kim, Mihee; Kang, Jingu; Lee, Jiun

    2013-01-01

    Eosinophilic pleural effusion (EPE) is defined as a pleural effusion that contains at least 10% eosinophils. EPE occurs due to a variety of causes such as blood or air in the pleural space, infection, malignancy, or an autoimmune disease. Undifferentiated connective tissue disease (UCTD) associated with eosinophilic pleural effusion is a rare condition generally characterized by the presence of the signs and symptoms but not fulfilling the existing classification criteria. We report a case involving a 67-year-old man with UCTD and EPE, who has been successfully treated with a single intrapleural corticosteroid injection. PMID:24265645

  16. A potential role for VEGF in the diagnostic approach of pleural effusions

    PubMed Central

    Psatha, Aggeliki; Makris, Demosthenes; Daniil, Zoe; Kiropoulos, Theodoros; Gourgoulianis, Konstantinos

    2016-01-01

    Background Vascular endothelial growth factor (VEGF) may play a role in pleural fluid formation, as it represents a potent inducer of capillary permeability. We aimed to investigate the diagnostic utility of VEGF levels in pleural fluid and serum in patients with pleural effusions with initially negative diagnostic work up. Methods Seventy-one patients with exudative lymphocytic pleural effusions undiagnosed after initial diagnostic work up were enrolled in this prospective study and their clinical course was followed up to 24 months. VEGF levels were measured in serum and pleural fluid by using immunoenzymometric assay. Results During the follow up period, in 43 patients the pleural effusion was eventually attributed to malignancy while in the rest 28 patients it was due to non-malignant causes (benign and unknown origin). Patients with malignancy had significantly higher VEGF levels in pleural fluid compared to patients with non-malignant effusions (1,506 vs. 588 pg/dL, P=0.0001), while no statistically significant difference was found in the VEGF serum levels between the two groups. Conclusions Pleural VEGF levels may be helpful in identifying malignant pleural effusion (MPE) in patients with negative diagnostic work up at the initial assessment and help in selecting patients for more invasive procedures. PMID:27499957

  17. Recanalization of a Heavily Calcified Chronic Total Occlusion in a Femoropopliteal Artery Using a Wingman Crossing Catheter

    PubMed Central

    Inoue, Naoto; Tanaka, Akiko

    2016-01-01

    We present a 77-year-old female with heavily calcified chronic total occlusions (CTO) in a superficial femoral artery treated by endovascular therapy using a Wingman crossing catheter, which is an over-the-wire catheter with a metallic blade, controlled manually. The blade could probe and track the calcified cap of CTO, wherein any hydrophilic guidewires or looped wires could not penetrate. Moreover, the Wingman could proceed through the occlusion and introduce a guidewire into distal intramedial lumen as a support catheter. Finally, wire crossing was achieved using a bi-directional approach. The Wingman can be a simple solution for crossing calcified peripheral CTO. PMID:27375810

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

    PubMed

    Saderne, Vincent; Wahl, Martin

    2013-01-01

    Seaweeds are key species of the Baltic Sea benthic ecosystems. They are the substratum of numerous fouling epibionts like bryozoans and tubeworms. Several of these epibionts bear calcified structures and could be impacted by the high pCO2 events of the late summer upwellings in the Baltic nearshores. Those events are expected to increase in strength and duration with global change and ocean acidification. If calcifying epibionts are impacted by transient acidification as driven by upwelling events, their increasing prevalence could cause a shift of the fouling communities toward fleshy species. The aim of the present study was to test the sensitivity of selected seaweed macrofoulers to transient elevation of pCO2 in their natural microenvironment, i.e. the boundary layer covering the thallus surface of brown seaweeds. Fragments of the macroalga Fucus serratus bearing an epibiotic community composed of the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium hirsutum (Bryozoa) were maintained for 30 days under three pCO2 conditions: natural 460 ± 59 µatm, present-day upwelling1193 ± 166 µatm and future upwelling 3150 ± 446 µatm. Only the highest pCO2 caused a significant reduction of growth rates and settlement of S. spirorbis individuals. Additionally, S. spirorbis settled juveniles exhibited enhanced calcification of 40% during daylight hours compared to dark hours, possibly reflecting a day-night alternation of an acidification-modulating effect by algal photosynthesis as opposed to an acidification-enhancing effect of algal respiration. E. pilosa colonies showed significantly increased growth rates at intermediate pCO2 (1193 µatm) but no response to higher pCO2. No effect of acidification on A. hirsutum colonies growth rates was observed. The results suggest a remarkable resistance of the algal macro-epibionts to levels of acidification occurring at present day upwellings in the Baltic. Only extreme

  19. Differential Responses of Calcifying and Non-Calcifying Epibionts of a Brown Macroalga to Present-Day and Future Upwelling pCO2

    PubMed Central

    Saderne, Vincent; Wahl, Martin

    2013-01-01

    Seaweeds are key species of the Baltic Sea benthic ecosystems. They are the substratum of numerous fouling epibionts like bryozoans and tubeworms. Several of these epibionts bear calcified structures and could be impacted by the high pCO2 events of the late summer upwellings in the Baltic nearshores. Those events are expected to increase in strength and duration with global change and ocean acidification. If calcifying epibionts are impacted by transient acidification as driven by upwelling events, their increasing prevalence could cause a shift of the fouling communities toward fleshy species. The aim of the present study was to test the sensitivity of selected seaweed macrofoulers to transient elevation of pCO2 in their natural microenvironment, i.e. the boundary layer covering the thallus surface of brown seaweeds. Fragments of the macroalga Fucus serratus bearing an epibiotic community composed of the calcifiers Spirorbis spirorbis (Annelida) and Electra pilosa (Bryozoa) and the non-calcifier Alcyonidium hirsutum (Bryozoa) were maintained for 30 days under three pCO2 conditions: natural 460±59 µatm, present-day upwelling1193±166 µatm and future upwelling 3150±446 µatm. Only the highest pCO2 caused a significant reduction of growth rates and settlement of S. spirorbis individuals. Additionally, S. spirorbis settled juveniles exhibited enhanced calcification of 40% during daylight hours compared to dark hours, possibly reflecting a day-night alternation of an acidification-modulating effect by algal photosynthesis as opposed to an acidification-enhancing effect of algal respiration. E. pilosa colonies showed significantly increased growth rates at intermediate pCO2 (1193 µatm) but no response to higher pCO2. No effect of acidification on A. hirsutum colonies growth rates was observed. The results suggest a remarkable resistance of the algal macro-epibionts to levels of acidification occurring at present day upwellings in the Baltic. Only extreme future

  20. Differential expression of bone matrix regulatory proteins in human atherosclerotic plaques.

    PubMed

    Dhore, C R; Cleutjens, J P; Lutgens, E; Cleutjens, K B; Geusens, P P; Kitslaar, P J; Tordoir, J H; Spronk, H M; Vermeer, C; Daemen, M J

    2001-12-01

    In the present study, we examined the expression of regulators of bone formation and osteoclastogenesis in human atherosclerosis because accumulating evidence suggests that atherosclerotic calcification shares features with bone calcification. The most striking finding of this study was the constitutive immunoreactivity of matrix Gla protein, osteocalcin, and bone sialoprotein in nondiseased aortas and the absence of bone morphogenetic protein (BMP)-2, BMP-4, osteopontin, and osteonectin in nondiseased aortas and early atherosclerotic lesions. When atherosclerotic plaques demonstrated calcification or bone formation, BMP-2, BMP-4, osteopontin, and osteonectin were upregulated. Interestingly, this upregulation was associated with a sustained immunoreactivity of matrix Gla protein, osteocalcin, and bone sialoprotein. The 2 modulators of osteoclastogenesis (osteoprotegerin [OPG] and its ligand, OPGL) were present in the nondiseased vessel wall and in early atherosclerotic lesions. In advanced calcified lesions, OPG was present in bone structures, whereas OPGL was only present in the extracellular matrix surrounding calcium deposits. The observed expression patterns suggest a tight regulation of the expression of bone matrix regulatory proteins during human atherogenesis. The expression pattern of both OPG and OPGL during atherogenesis might suggest a regulatory role of these proteins not only in osteoclastogenesis but also in atherosclerotic calcification. PMID:11742876

  1. Plaque Production by Arboviruses in Singh's Aedes albopictus Cells

    PubMed Central

    Yunker, C. E.; Cory, J.

    1975-01-01

    We report plaquing tests of 124 virus strains, mostly arboviruses of 21 serological groups, in Singh's line of Aedes albopictus cells. Thirty of these plaqued; all were arboviruses of six groups and were known or presumed to be mosquito borne. Failing to plaque were 86 strains of arboviruses, mostly tick borne, two strains of insect pathogens, and six animal viruses not classified as arboviruses. Among mosquito-borne agents, plaquing ability appeared related to serological classification. California group and most A-group viruses failed to plaque, but nearly all members of B and Bunyamwera groups readily plaqued. Within serological group B, 14 of 16 mosquito-borne agents plaqued, but none of 13 tick-borne or vector-unassociated viruses did so. Some implications of these results for recognition and classification of arboviruses are discussed. Images PMID:234160

  2. Imaging of coronary atherosclerosis and identification of the vulnerable plaque

    PubMed Central

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

    2003-01-01

    Identification of the vulnerable plaque responsible for the occurrence of acute coronary syndromes and acute coronary death is a prerequisite for the stabilisation of this vulnerable plaque. Comprehensive coronary atherosclerosis imaging in clinical practice should involve visualisation of the entire coronary artery tree and characterisation of the plaque, including the three-dimensional morphology of the plaque, encroachment of the plaque on the vessel lumen, the major tissue components of the plaque, remodelling of the vessel and presence of inflammation. Obviously, no single diagnostic modality is available that provides such comprehensive imaging and unfortunately no diagnostic tool is available that unequivocally identifies the vulnerable plaque. The objective of this article is to discuss experience with currently available diagnostic modalities for coronary atherosclerosis imaging. In addition, a number of evolving techniques will be briefly discussed. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7 PMID:25696244

  3. Noninvasive imaging modalities to visualize atherosclerotic plaques

    PubMed Central

    2016-01-01

    Atherosclerotic cardiovascular disease is becoming a major cause of death in the world due to global epidemic of diabetes and obesity. For the prevention of atherosclerotic cardiovascular disease, it is necessary to detect high-risk atherosclerotic plaques prior to events. Recent technological advances enable to visualize atherosclerotic plaques noninvasively. This ability of noninvasive imaging helps to refine cardiovascular risk assessment in various individuals, select optimal therapeutic strategy and evaluate the efficacy of medical therapies. In this review, we discuss the role of the currently available imaging modalities including computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography. Advantages and disadvantages of each noninvasive imaging modality will be also summarized. PMID:27500092

  4. Enucleation versus plaque irradiation for choroidal melanoma

    SciTech Connect

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

    1988-07-01

    The Collaborative Ocular Melanoma Study (COMS) is an international, multicenter-controlled study. The organization includes an Executive Committee, Steering Committee, 6 Central Units, 32 Clinical Centers, and a Data and Safety Monitoring Committee. Scientifically, the COMS consists of (1) a randomized trial of patients with medium choroidal melanoma treated with enucleation versus iodine-125 plaque irradiation, (2) a randomized trial of patients with large choroidal melanoma treated with enucleation versus preenucleation external beam irradiation and enucleation, and (3) a prospective observational study of patients with small choroidal melanoma to determine whether a randomized trial of treatment is appropriate. In design and conduct of the COMS, special consideration is given to biostatistics and sample size considerations, iodine-125 plaque irradiation of choroidal melanoma, and coordinated ocular melanoma research. Recruitment is in progress. However, the pool of eligible patients is limited and the COMS needs the continued support and cooperation of ophthalmologists throughout the United States and Canada.

  5. Noninvasive imaging modalities to visualize atherosclerotic plaques.

    PubMed

    Shishikura, Daisuke

    2016-08-01

    Atherosclerotic cardiovascular disease is becoming a major cause of death in the world due to global epidemic of diabetes and obesity. For the prevention of atherosclerotic cardiovascular disease, it is necessary to detect high-risk atherosclerotic plaques prior to events. Recent technological advances enable to visualize atherosclerotic plaques noninvasively. This ability of noninvasive imaging helps to refine cardiovascular risk assessment in various individuals, select optimal therapeutic strategy and evaluate the efficacy of medical therapies. In this review, we discuss the role of the currently available imaging modalities including computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography. Advantages and disadvantages of each noninvasive imaging modality will be also summarized. PMID:27500092

  6. An Additional Potential Factor for Kidney Stone Formation during Space Flights: Calcifying Nanoparticles (Nanobacteria): A Case Report

    NASA Technical Reports Server (NTRS)

    Jones, Jeffrey A.; Ciftcioglu, Neva; Schmid, Joseph; Griffith, Donald

    2007-01-01

    Spaceflight-induced microgravity appears to be a risk factor for the development of urinary calculi due to skeletal calcium liberation and other undefined factors, resulting in stone disease in crewmembers during and after spaceflight. Calcifying nanoparticles, or nanobacteria, reproduce at a more rapid rate in simulated microgravity conditions and create external shells of calcium phosphate in the form of apatite. The questions arises whether calcifying nanoparticles are niduses for calculi and contribute to the development of clinical stone disease in humans, who possess environmental factors predisposing to the development of urinary calculi and potentially impaired immunological defenses during spaceflight. A case of a urinary calculus passed from an astronaut post-flight with morphological characteristics of calcifying nanoparticles and staining positive for a calcifying nanoparticle unique antigen, is presented.

  7. Microwave plaque thermoradiotherapy for choroidal melanoma.

    PubMed Central

    Finger, P. T.

    1992-01-01

    Microwave thermoradiotherapy was used as a primary treatment for 44 patients with choroidal melanoma. An episcleral dish-shaped microwave antenna was placed beneath the tumour at the time of plaque brachytherapy. While temperatures were measured at the sclera, the tumour's apex was targeted to receive a minimum of 42 degrees C for 45 minutes. In addition, the patients received full or reduced doses of plaque radiotherapy. No patients have been lost to follow-up. Two eyes have been enucleated: one for rubeotic glaucoma, and one for uveitic glaucoma. Though six patients have died, only one death was due to metastatic choroidal melanoma (39 months after treatment). Clinical observations suggest that the addition of microwave heating to plaque radiation therapy of choroidal melanoma has been well tolerated. There has been a 97.7% local control rate (with a mean follow-up of 22.2 months). We have reduced the minimum tumour radiation dose (apex dose) to levels used for thermoradiotherapy of cutaneous melanomas (50 Gy/5000 rad). Within the range of this follow-up period no adverse effects which might preclude the use of this microwave heat delivery system for treatment of choroidal melanoma have been noted. Images PMID:1622949

  8. Cataractogenesis after Cobalt-60 eye plaque radiotherapy

    SciTech Connect

    Kleineidam, M.; Augsburger, J.J. ); Hernandez, C.; Glennon, P.; Brady, L.W. )

    1993-07-15

    This study was designed to estimate the actuarial incidence of typical postirradiation cataracts and to identify prognostic factors related to their development in melanoma-containing eyes treated by Cobalt-60 plaque radiotherapy. A special interest was the impact of calculated radiation dose and dose-rate to the lens. The authors evaluated the actuarial occurrence of post-irradiation cataract in 365 patients with primary posterior uveal melanoma treated by Cobalt-60 plaque radiotherapy between 1976 and 1986. Only 22% (S.E. = 4.6%) of the patients who received a total dose of 6 to 20 Gy at the center of the lens developed a visually significant cataract attributable to the radiation within 5 years after treatment. Using multivariate Cox proportional hazards modeling, the authors identified thickness of the tumor, location of the tumor's anterior margin relative to the equatorward and the ora serrata, and diameter of the eye plaque used as the best combination of covariables for predicting length of time until development of cataract. Surprisingly, the dose of radiation delivered to the lens, which was strongly correlated to all of these covariables, was not a significant predictive factor in multivariate analysis. The results suggest that success of efforts to decrease the occurrence rate of post-irradiation cataracts by better treatment planning might be limited in patients with posterior uveal melanoma. 21 refs., 2 figs., 5 tabs.

  9. Integrally calcified solitary fibrous tumor in the retroperitoneum: a case report and review of the literature.

    PubMed

    Maki, Takehiro; Fujino, Syotaro; Misu, Kenjiro; Kaneko, Hiroyuki; Inomata, Hitoshi; Omi, Makoto; Tateno, Masatoshi; Nihei, Kazuyoshi

    2016-12-01

    Solitary fibrous tumor (SFT) is a rare stromal neoplasm and usually occurs in the thoracic cavity. We here report a case of retroperitoneal SFT with prominent calcification. A 64-year-old man presented with an incidentally detected retroperitoneal mass in the right upper abdomen. Imaging tests indicated an integrally calcified mass. The lesion was observed for 2 years and laparoscopically resected according to the patient's wish. Microscopically, the mass was mostly occupied by calcification and proliferous spindle cells were scattered with positive CD34 expression. We diagnosed morphologically benign SFT and the patient remained disease-free 1 year after the excision. There has been no report of such integrally calcified SFT. Retroperitoneal SFT is difficult to make a preoperative diagnosis, and careful follow-up after the excision is recommended because morphological malignancy does not always correspond to clinical malignancy. PMID:26943690

  10. A role for diatom-like silicon transporters in calcifying coccolithophores

    PubMed Central

    Durak, Grażyna M.; Taylor, Alison R.; Walker, Charlotte E.; Probert, Ian; de Vargas, Colomban; Audic, Stephane; Schroeder, Declan; Brownlee, Colin; Wheeler, Glen L.

    2016-01-01

    Biomineralization by marine phytoplankton, such as the silicifying diatoms and calcifying coccolithophores, plays an important role in carbon and nutrient cycling in the oceans. Silicification and calcification are distinct cellular processes with no known common mechanisms. It is thought that coccolithophores are able to outcompete diatoms in Si-depleted waters, which can contribute to the formation of coccolithophore blooms. Here we show that an expanded family of diatom-like silicon transporters (SITs) are present in both silicifying and calcifying haptophyte phytoplankton, including some globally important coccolithophores. Si is required for calcification in these coccolithophores, indicating that Si uptake contributes to the very different forms of biomineralization in diatoms and coccolithophores. Significantly, SITs and the requirement for Si are absent from highly abundant bloom-forming coccolithophores, such as Emiliania huxleyi. These very different requirements for Si in coccolithophores are likely to have major influence on their competitive interactions with diatoms and other siliceous phytoplankton. PMID:26842659

  11. Bilateral Calcifying Cystic Odontogenic Tumour of Mandible: A Rare Case Report and Review of Literature.

    PubMed

    Khandelwal, Pragun; Aditya, Amita; Mhapuskar, Amit

    2015-11-01

    Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination. PMID:26673837

  12. Bilateral Calcifying Cystic Odontogenic Tumour of Mandible: A Rare Case Report and Review of Literature

    PubMed Central

    Khandelwal, Pragun; Mhapuskar, Amit

    2015-01-01

    Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination. PMID:26673837

  13. Calcifying cystic odontogenic tumor associated with an odontome – a diverse lesion encountered

    PubMed Central

    Radheshyam, Chourasia; Alokenath, Bandyopadhyay; Kumar, Harish; Abikshyeet, Panda

    2015-01-01

    The human jaw is an exclusive habitat for odontogenic lesions. Ghost cells associated odontogenic lesions are a diverse group with a variety of presentations in the jaws. Calcifying cystic odontogenic tumor is a benign cystic neoplasm of odontogenic origin which demonstrates ghost cells in the epithelial component. This tumor sometimes mimics the features of a cyst clinically and radiographically, but histopathologically as well as behavior-wise shows the features of a tumor. Many classification systems have been proposed and revised from time to time. Presently a dualistic concept is highlighted to classify this group of lesions. The present case highlights a case of calcifying cystic odontogenic tumor associated with a complex composite odontome, which appeared like a cyst clinically and radiographically. PMID:26345145

  14. Portal cavernoma caused by a calcified hydatid cyst of the liver (case report).

    PubMed

    Colovic, Radoje B; Grubor, Nikica M; Colic, Momcilo U; Colovic, Natasa R; Atkinson, Henry Dushan E

    2008-03-01

    A portal cavernoma is a network of porto-porto collateral dilated tortuous veins lying within the hepatoduodenal ligament, which develops as a sequel to portal vein obstruction. This can be the result of extra-hepatic portal vein obstruction from local extrinsic occlusion, or by a prothrombotic disorder, or both. A 56-year-old woman presented with right upper quadrant abdominal pain. Examination and investigations revealed the presence of gallstones, a cavernous portal vein, several calcified hydatid cysts within the liver, grade III haemorrhoids, but no oesophageal varicosities. She had no previous abdominal surgery, and had normal full laboratory workup, including inflammatory markers, clotting analyses, and thrombophilia screen. At open surgery it became apparent that the portal cavernoma had been caused by local pressure from a calcified hydatid cyst of the caudate lobe of the liver. To the best of our knowledge, this is the first report of portal cavernoma caused by a hydatid cyst of the liver. PMID:18301307

  15. Inhibition of plaque formation and plaque acidogenicity by zinc and chlorhexidine combinations.

    PubMed

    Giertsen, E; Scheie, A A; Rölla, G

    1988-12-01

    Zinc ions and chlorhexidine (CH) were found to exhibit a synergistic inhibitory effect on in vitro growth of S. sobrinus OMZ 176 and of S. sanguis 10556. A clinical mouthrinsing experiment was performed in a group of 10 volunteers to assess the plaque-inhibiting capacity of this combination. Sucrose enhanced plaque accumulations were assessed (Plaque Index, Silness & Löe) after 4 days of twice daily mouthrinses with 10 ml aqueous solutions of either 10.0 mM zinc or 0.55 mM CH, or with a combination of zinc ions and CH, during which period no mechanical toothcleaning was performed. The Zn-CH combination showed improved inhibition properties compared to the individual agents. The effects on plaque acidogenicity of 8.0 mM zinc, 0.44 mM CH, and of zinc and CH in combination were also assessed in a test panel of five volunteers. The Zn-CH combination inhibited acid production by dental plaque significantly (P less than or equal to 0.05) more than the individual agents 1 h 30 min after a single rinse. PMID:3206200

  16. Can calcified pulmonary metastases detected by (18)F-FDG PET/CT suggest the primary tumor?

    PubMed

    Hong, Chae Moon; Ahn, Byeong Cheol

    2016-01-01

    Many calcified nodules are encountered on the (18)F-FDG PET/CT scan and even though most of them are benign, the possibility of calcified pulmonary metastases (CPM) should be considered. The CT portion can often differentiate benign diseases due to their morphology. Measuring SUVmax is very important. Understanding the mechanism of calcification in malignant metastatic pulmonary lesions may be useful to suggest their origin. PMID:27035906

  17. Diverse Findings in Calcified Thrombus Between Histopathology and In Vivo Imaging Including Intravascular Ultrasound, Optical Coherence Tomography, and Angioscopy.

    PubMed

    Koga, Seiji; Ikeda, Satoshi; Nakata, Tomoo; Kawano, Hiroaki; Abe, Kuniko; Maemura, Koji

    2015-01-01

    A 46-year-old woman on hemodialysis due to end-stage renal disease was admitted for repeated thrombus formation in previously implanted drug-eluting stents in the right coronary artery. We could successfully aspirate this thrombus, and histopathology revealed a calcified thrombus comprising multiple microcalcifications and fibrinous materials. This is the first report showing how a calcified thrombus is visualized in vivo by intracoronary imaging modalities including intravascular ultrasound, optical coherence tomography, and angioscopy. PMID:26549397

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

    PubMed Central

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

    2013-01-01

    A hybrid odontogenic tumor comprising two distinct lesions is extremely rare. We presented a hybrid odontogenic tumor composed of a calcifying cystic odontogenic tumor (CCOT) and a plexiform ameloblastoma. This tumor was observed in the anterior area of the mandible of a 17-year-old Indian male. Masses of ghost epithelial cells with the characteristics of CCOT were seen in the lining of the cyst. The odontogenic epithelia with the features of plexiform ameloblastoma were also observed. PMID:24124318

  19. Intravascular probe for detection of vulnerable plaque

    NASA Astrophysics Data System (ADS)

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

    2001-12-01

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

  20. Grossly calcified choroid plexus concealing foramen of Monro meningiomas as an unusual cause of obstructive hydrocephalus

    PubMed Central

    Kawaguchi, Tomohiro; Fujimura, Miki; Tominaga, Teiji

    2016-01-01

    Various intraventricular tumors can present with calcifications; however, the choroid plexus can also have physiological calcifications. This is the first case report of meningiomas located at the bilateral foramen of Monro (FOM), concealed by a grossly calcified choroid plexus, presenting with obstructive hydrocephalus. A 60-year-old woman with disturbed consciousness was admitted by ambulance. Head computed tomography revealed significantly high-density lesions that smoothly extended from the choroid plexus of the lateral ventricles to the third ventricle. They occupied both sides of the FOM, resulting in obstructive hydrocephalus. The diagnostic endoscopic biopsy was performed using a flexible neuroendoscopic system, and an egg shell-like grossly calcified choroid plexus was found to smoothly extend toward the FOM. Resection was not selected because the calcified lesions had tightly adhered to the veins and fornix; therefore, the patient underwent ventriculo-peritoneal shunting. The lesions were histologically identified as psammomatous meningiomas with low proliferation potential (the Ki-67 labeling index was lower than 1%). She was discharged 10 days after surgery without neurological deficits. As calcifications can have tumoral and nontumoral origins, we considered neuroendoscopic exploration to be essential in order to achieve an accurate diagnosis and select optimal management. PMID:26889294

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

    PubMed Central

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

    2013-01-01

    Odontogenic tumors are derived from epithelial, ectomesenchymal and/or mesenchymal elements that are or have been a part of the tooth-forming apparatus. Of all the odontogenic tumors, calcifying epithelial odontogenic tumor accounts for 1% of the cases. Approximately 200 cases have been reported to date. There is no sex predilection, with a 2:1 predilection for the mandible, mostly in the premolar/molar region. It is often locally invasive. Most often, it is associated with an impacted tooth, is asymptomatic and requires biopsy for diagnosis. Presented here is a rare case of an intraosseous calcifying epithelial odontogenic tumor surrounding a supernumerary tooth. Furthermore, the occurrence of this tumor in the anterior maxilla (an uncommon site) in a pediatric patient makes it rarer. Although the present case was asymptomatic, root resorption and displacement of adjacent teeth necessitated its surgical removal. The lesion was surgically enucleated and histopathological examination confirmed calcifying epithelial odontogenic tumor, showing abundant calcifications in the form of Liesegang rings. PMID:23487408

  2. Crystal alignment of carbonated apatite in bone and calcified tendon: results from quantitative texture analysis.

    PubMed

    Wenk, H R; Heidelbach, F

    1999-04-01

    Calcified tissue contains collagen associated with minute crystallites of carbonated apatite. In this study, methods of quantitative X-ray texture analysis were used to determine the orientation distribution and texture strength of apatite in a calcified turkey tendon and in trabecular and cortical regions of osteonal bovine ankle bone (metacarpus). To resolve local heterogeneity, a 2 or 10 microm synchrotron microfocus X-ray beam (lambda = 0.78 A) was employed. Both samples revealed a strong texture. In the case of turkey tendon, 12 times more c axes of hexagonal apatite were parallel to the fibril axis than perpendicular, and a axes had rotational freedom about the c axis. In bovine bone, the orientation density of the c axes was three times higher parallel to the surface of collagen fibrils than perpendicular to it, and there was no preferential alignment with respect to the long axis of the bone (fiber texture). Whereas half of the apatite crystallites were strongly oriented, the remaining half had a random orientation distribution. The synchrotron X-ray texture results were consistent with previous analyses of mineral orientation in calcified tissues by conventional X-ray and neutron diffraction and electron microscopy, but gave, for the first time, a quantitative description. PMID:10221548

  3. Grossly calcified choroid plexus concealing foramen of Monro meningiomas as an unusual cause of obstructive hydrocephalus.

    PubMed

    Kawaguchi, Tomohiro; Fujimura, Miki; Tominaga, Teiji

    2016-01-01

    Various intraventricular tumors can present with calcifications; however, the choroid plexus can also have physiological calcifications. This is the first case report of meningiomas located at the bilateral foramen of Monro (FOM), concealed by a grossly calcified choroid plexus, presenting with obstructive hydrocephalus. A 60-year-old woman with disturbed consciousness was admitted by ambulance. Head computed tomography revealed significantly high-density lesions that smoothly extended from the choroid plexus of the lateral ventricles to the third ventricle. They occupied both sides of the FOM, resulting in obstructive hydrocephalus. The diagnostic endoscopic biopsy was performed using a flexible neuroendoscopic system, and an egg shell-like grossly calcified choroid plexus was found to smoothly extend toward the FOM. Resection was not selected because the calcified lesions had tightly adhered to the veins and fornix; therefore, the patient underwent ventriculo-peritoneal shunting. The lesions were histologically identified as psammomatous meningiomas with low proliferation potential (the Ki-67 labeling index was lower than 1%). She was discharged 10 days after surgery without neurological deficits. As calcifications can have tumoral and nontumoral origins, we considered neuroendoscopic exploration to be essential in order to achieve an accurate diagnosis and select optimal management. PMID:26889294

  4. Pacific-wide contrast highlights resistance of reef calcifiers to ocean acidification.

    PubMed

    Comeau, S; Carpenter, R C; Nojiri, Y; Putnam, H M; Sakai, K; Edmunds, P J

    2014-09-01

    Ocean acidification (OA) and its associated decline in calcium carbonate saturation states is one of the major threats that tropical coral reefs face this century. Previous studies of the effect of OA on coral reef calcifiers have described a wide variety of outcomes for studies using comparable partial pressure of CO2 (pCO2) ranges, suggesting that key questions remain unresolved. One unresolved hypothesis posits that heterogeneity in the response of reef calcifiers to high pCO2 is a result of regional-scale variation in the responses to OA. To test this hypothesis, we incubated two coral taxa (Pocillopora damicornis and massive Porites) and two calcified algae (Porolithon onkodes and Halimeda macroloba) under 400, 700 and 1000 μatm pCO2 levels in experiments in Moorea (French Polynesia), Hawaii (USA) and Okinawa (Japan), where environmental conditions differ. Both corals and H. macroloba were insensitive to OA at all three locations, while the effects of OA on P. onkodes were location-specific. In Moorea and Hawaii, calcification of P. onkodes was depressed by high pCO2, but for specimens in Okinawa, there was no effect of OA. Using a study of large geographical scale, we show that resistance to OA of some reef species is a constitutive character expressed across the Pacific. PMID:25056628

  5. Pacific-wide contrast highlights resistance of reef calcifiers to ocean acidification

    PubMed Central

    Comeau, S.; Carpenter, R. C.; Nojiri, Y; Putnam, H. M.; Sakai, K.; Edmunds, P. J.

    2014-01-01

    Ocean acidification (OA) and its associated decline in calcium carbonate saturation states is one of the major threats that tropical coral reefs face this century. Previous studies of the effect of OA on coral reef calcifiers have described a wide variety of outcomes for studies using comparable partial pressure of CO2 (pCO2) ranges, suggesting that key questions remain unresolved. One unresolved hypothesis posits that heterogeneity in the response of reef calcifiers to high pCO2 is a result of regional-scale variation in the responses to OA. To test this hypothesis, we incubated two coral taxa (Pocillopora damicornis and massive Porites) and two calcified algae (Porolithon onkodes and Halimeda macroloba) under 400, 700 and 1000 μatm pCO2 levels in experiments in Moorea (French Polynesia), Hawaii (USA) and Okinawa (Japan), where environmental conditions differ. Both corals and H. macroloba were insensitive to OA at all three locations, while the effects of OA on P. onkodes were location-specific. In Moorea and Hawaii, calcification of P. onkodes was depressed by high pCO2, but for specimens in Okinawa, there was no effect of OA. Using a study of large geographical scale, we show that resistance to OA of some reef species is a constitutive character expressed across the Pacific. PMID:25056628

  6. Characterising the microbiome of Corallina officinalis, a dominant calcified intertidal red alga.

    PubMed

    Brodie, Juliet; Williamson, Christopher; Barker, Gary L; Walker, Rachel H; Briscoe, Andrew; Yallop, Marian

    2016-08-01

    The living prokaryotic microbiome of the calcified geniculate (articulated) red alga, Corallina officinalis from the intertidal seashore is characterised for the first time based on the V6 hypervariable region of 16S rRNA. Results revealed an extraordinary diversity of bacteria associated with the microbiome. Thirty-five prokaryotic phyla were recovered, of which Proteobacteria, Cyanobacteria, Bacteroidetes, Actinobacteria, Planctomycetes, Acidobacteria, Verrucomicrobia, Firmicutes and Chloroflexi made up the core microbiome. Unclassified sequences made up 25% of sequences, suggesting insufficient sampling of the world's oceans/macroalgae. The greatest diversity in the microbiome was on the upper shore, followed by the lower shore then the middle shore, although the microbiome community composition did not vary between shore levels. The C. officinalis core microbiome was broadly similar in composition to those reported in the literature for crustose coralline algae (CCAs) and free-living rhodoliths. Differences in relative abundance of the phyla between the different types of calcified macroalgal species may relate to the intertidal versus subtidal habit of the taxa and functionality of the microbiome components. The results indicate that much work is needed to identify prokaryotic taxa, and to determine the nature of the relationship of the bacteria with the calcified host spatially, temporally and functionally. PMID:27222222

  7. Transdural approach for calcified central disc herniations of the upper lumbar spine. Technical note.

    PubMed

    Choi, Jeong-Wook; Lee, Jung-Kil; Moon, Kyung-Sub; Hur, Hyuk; Kim, Yeon-Seong; Kim, Soo-Han

    2007-09-01

    Disc herniations of the upper lumbar spine (L1-2 and L2-3) have a frequency of 1 to 2% of all disc herniations. During posterior discectomy after laminectomy, significant manipulation of the exiting nerve root is unavoidable because of the narrow lamina and the difficulty in mobilizing the nerve root. The authors adopted a transdural approach in patients with calcified central disc herniation at the L1-2 level to reduce the risk of nerve root injury. Four patients suffering from radiating pain together with back pain were treated using the transdural approach. Preoperative neuroimaging studies revealed severe central disc herniation with calcification at the L1-2 level. After laminectomy or laminotomy, the incised dura mater was tacked, and the cauda equina rootlets were gently retracted. An intentional durotomy was performed over its maximal bulging of the ventral dura. After meticulous dissection of dense adhesions between the disc herniation and the dural sac, adequate decompression with removal of calcified disc fragments and osteophytes was accomplished. Clinical symptoms improved in all patients. Postoperative permanent cerebrospinal fluid leakage and pseudomeningocele were not observed, and no patient had a progressive lumbar deformity at an average follow-up of 53 months. Transient mild motor weakness and sensory change were observed in two patients postoperatively; however, these symptoms resolved completely within 1 week. The posterior transdural approach offers an alternative in central calcified upper lumbar disc herniation when root retraction is dangerous. PMID:17877277

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

    PubMed

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

    2010-10-01

    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 to disease. Biological NPs derived from human kidney stones and calcified aneurysms were completely decalcified by overnight treatment with ethylenediaminetetraacetic acid or brief incubation in HCl, as evidenced by lack of a calcium shell and of Alizarin Red S staining, by transmission electron microscopy and confocal microscopy, respectively. Decalcified NPs contained numerous proteins, including some from bovine serum and others of prokaryotic origin. Most prominent of the latter group was EF-Tu, which appeared to be identical to EF-Tu from Staphylococcus epidermidis. A monoclonal antibody against human EF-Tu recognized a protein in Western blots of total NP lysate, as well as in intact NPs by immunofluorescence and immunogold EM. Approximately 8% of NPs were quantitatively recognized by the antibody using flow cytometry. Therefore, we have defined methods to reproducibly decalcify biological NPs, and identified key components of their proteome. These elements, including EF-Tu, can be used as biomarkers to further define the processes that mediate propagation of biological NPs and their contribution to disease. PMID:20466084

  9. Treatment of Calcified Insertional Achilles Tendinopathy by the Posterior Midline Approach.

    PubMed

    Miao, Xu-Dong; Jiang, Hongfei; Wu, Yong-Ping; Tao, Hui-Min; Yang, Di-Sheng; Hu, Hang

    2016-01-01

    The present study investigated the clinical outcomes of the posterior midline approach in the treatment of 34 patients with significantly calcified insertional Achilles tendinopathy. The posterior midline approach was applied for the surgical treatment of 34 patients with chronic significantly calcified insertional Achilles tendinopathy after failed conservative treatment. Gastrocnemius recession was performed simultaneously for patients with gastrocnemius contracture. The Fowler-Philip angle and parallel pitch lines were measured before surgery, and the visual analog scale, Tegner score, and Victorian Institute of Sport tendon study group score were recorded before and after surgery. The mean follow-up period was 45.2 ± 17.7 (range 24 to 84) months. After surgery, the visual analog scale score had decreased notably, and the Tegner score and Victorian Institute of Sport tendon study group score had increased significantly. The posterior midline approach can achieve satisfactory outcomes in the treatment of significantly calcified insertional Achilles tendinopathy, and gastrocnemius recession (Strayer procedure) should be performed for patients with gastrocnemius contracture to improve the surgical outcome. PMID:26874831

  10. The established and future biomarkers of malignant pleural mesothelioma.

    PubMed

    Panou, V; Vyberg, M; Weinreich, U M; Meristoudis, C; Falkmer, U G; Røe, O D

    2015-06-01

    Malignant pleural mesothelioma (MPM) is an asbestos-related cancer with a median survival of 12months. The MPM incidence is 1-6/100,000 and is increasing as a result of historic asbestos exposure in industrialized countries and continued use of asbestos in developing countries. Lack of accurate biomarkers makes diagnosis, prognostication and treatment prediction of MPM challenging. The aim of this review is to identify the front line of MPM biomarkers with current or potential clinical impact. Literature search using the PubMed and PLoS One databases, the related-articles function of PubMed and the reference lists of associated publications until April 26th 2015 revealed a plethora of candidate biomarkers. The current gold standard of MPM diagnosis is a combination of two positive and two negative immunohistochemical markers in the epithelioid and biphasic type, but sarcomatous type do not have specific markers, making diagnosis more difficult. Mesothelin in serum and pleural fluid may serve as adjuvant diagnostic with high specificity but low sensitivity. Circulating proteomic and microRNA signatures, fibulin-3, tumor cell gene-ratio test, transcriptomic, lncRNA, glycopeptides, pleural fluid FISH assay, hyaluronate/N-ERC mesothelin and deformability cytometry may be important future markers. Putative predictive markers for pemetrexed-platinum are tumor TS and TYMS, for vinorelbine the ERCC1, beta-tubuline class III and BRCA1. Mutations of the BAP1 gene are potential markers of MPM susceptibility. In conclusion, the current status of MPM biomarkers is not satisfactory but encouraging as more sensitive and specific non-invasive markers are emerging. However, prospective validation is needed before clinical application. PMID:25979846

  11. Light dosimetry and dose verification for pleural PDT

    NASA Astrophysics Data System (ADS)

    Dimofte, Andreea; Sharikova, Anna V.; Meo, Julia L.; Simone, Charles B.; Friedberg, Joseph S.; Zhu, Timothy C.

    2013-03-01

    In-vivo light dosimetry for patients undergoing photodynamic therapy (PDT) is critical for predicting PDT outcome. Patients in this study are enrolled in a Phase I clinical trial of HPPH-mediated PDT for the treatment of non-small cell lung cancer with pleural effusion. They are administered 4mg per kg body weight HPPH 48 hours before the surgery and receive light therapy with a fluence of 15-45 J/cm2 at 661 and 665nm. Fluence rate (mW/cm2) and cumulative fluence (J/cm2) are monitored at 7 sites during the light treatment delivery using isotropic detectors. Light fluence (rate) delivered to patients is examined as a function of treatment time, volume and surface area. In a previous study, a correlation between the treatment time and the treatment volume and surface area was established. However, we did not include the direct light and the effect of the shape of the pleural surface on the scattered light. A real-time infrared (IR) navigation system was used to separate the contribution from the direct light. An improved expression that accurately calculates the total fluence at the cavity wall as a function of light source location, cavity geometry and optical properties is determined based on theoretical and phantom studies. The theoretical study includes an expression for light fluence rate in an elliptical geometry instead of the spheroid geometry used previously. The calculated light fluence is compared to the measured fluence in patients of different cavity geometries and optical properties. The result can be used as a clinical guideline for future pleural PDT treatment.

  12. Dose backscatter factors for selected beta sources as a function of source, calcified plaque and contrast agent using Monte Carlo calculations

    NASA Astrophysics Data System (ADS)

    Lee, Sung-Woo; Reece, Warren Daniel

    2004-02-01

    Electron backscattering is a prominent secondary effect in beta dosimetry, and is closely correlated with factors such as the geometries of the source and the scattering material, as well as the composition of the scattering material. Previous results were varied depending on the experimental setup and detector resolution, and were generally performed for monoenergetic electron beams, which makes direct application of these factors to beta sources difficult. In this work, backscattering factors were calculated with MCNP 4C for selected beta sources currently in use (32P and 90Sr/90Y) as well as for sources of potential therapeutic use (45Ca, 142Pr and 185W). Specifically, the calculations used beta spectra generated by the SADDE MOD2 code. The factors were calculated as a function of the distance from the interface between water and scatterers. The scatterers include source surroundings, source supporting materials and contrast agents commonly used for imaging purposes in brachytherapy. The results were fit by a simple function for future incorporation into a dose point kernel code. Due to the high-Z material content (iodine, Z = 53) in the contrast agent, a significant dose backscatter was observed near the water interface. Different cross-section algorithms in the MCNP code (inherent and ITS 3.0) affect the factor calculations. The results generated by the ITS 3.0 algorithm closely matched the EGS4 calculations for 32P. The dependence of backscatter factors on log(Z + 1) (Baily 1980 Med. Phys. 7 514-9) was observed for all the beta sources with a high correlation coefficient, R (>0.95). The overall results indicate that the backscattering effect is significant at short distances from the surface of the interface between water and the scattering material. This model can also aid in choosing a source support or mixing materials for beta brachytherapy sources.

  13. Expression of fibroblast specific protein-1 in pleural tuberculosis and its clinical biological significance

    PubMed Central

    2014-01-01

    Background Fibroblast specific protein-1 (S100A4) is related with many fibrotic diseases, but its role in the pathogenesis of pleural fibrosis has not been fully elucidated. Then we aim to investigate the expression and effect of fibroblast specific protein-1 (S100A4) in pleural tuberculosis and, subsequently, pleural fibrosis. Methods The expression of S100A4 in pleura was examined in 30 patients with pleural tuberculosis and 5 control (disease-free) patients by immunohistochemistry using the streptavidin-peroxidase (S-P) conjugated method. Results The expression of S100A4 in pleura was mainly distributed in the nucleus and cytoplasm of fibroblasts and vascular endothelial cells, and the positive rate was 90.0% (27 out of 30 patients with pleural tuberculosis). There were no expressions of S100A4 in the control group. In the pleura of all 30 patients with pleural tuberculosis, S100A4 had a higher expression in the two- to eight-week duration of the disease. Conclusions S100A4 plays an important role in the phenotypic transformation of pleural mesothelial cells and the development of pleural fibrosis. PMID:24885536

  14. Abomasal ulceration and abomaso-pleural fistula in an 11-month-old beefmaster bull

    PubMed Central

    Costa, Lais R. R.; Gill, Marjorie S.; Williams, Jamie; Johnson, Anthony J.; Angel, Kenneth L.; Mirza, Mustajab H.

    2002-01-01

    An 11-month-old, beefmaster bull presented with anorexia and signs of respiratory disease. Physical examination, thoracic ultrasonography and radiography, and pleural fluid analysis indicated pericarditis and septic neutrophilic pleuropneumonia. Postmortem findings were abomasal adherence to the diaphragm, a fibrotic fistulous tract connecting the abomasum and pleural cavity, granulomatous abomasitis, granulomatous pericarditis, and fibrinonecrotic pleuritis. PMID:11901596

  15. Air transport and the fate of pneumothorax in pleural adhesions.

    PubMed Central

    Haid, M M; Paladini, P; Maccherini, M; Di Bisceglie, M; Biagi, G; Gotti, G

    1992-01-01

    Air travel is contraindicated in patients with a pneumothorax but was necessary because of the exigencies of war in three patients. Three patients with high velocity missile injuries to the chest and pleural adhesions are reported. All had to be evacuated by air, without an intercostal drain or oxygen supplement, from the war stricken area of Northern Somalia (Horn of Africa) to Mogadishu. Two patients with a partial pneumothorax flew on military transport aeroplanes at an altitude of 3000 m in a non-pressurised cabin and recovered rapidly after a few days in hospital. One patient, transported on a small Cessna aeroplane, died after developing bilateral tension pneumothoraces. Images PMID:1481187

  16. Renal Lymphangiectasia: A Curious Cause of Pleural Effusion.

    PubMed

    Nassiri, Amir Ahmad; Lotfollahi, Legha; Bakhshayeshkaram, Mehrdad; Kiani, Arda; Haghighi, Shirin; Alavi Darazam, Ilad; Rashidfarokhi, Farin

    2015-01-01

    Renal lymphangiectasia is a disorder of the lymphatic system of the kidneys, which can be congenital or acquired. Although the exact etiology remains unknown, an obstructive process resulting from several causes, including infection, inflammation or malignant infiltration, has been suggested to be responsible for the acquired form. This disorder may be associated with several pathologies. We report a case of a 24-year-old man with renal lymphangiectasia presenting with polycythemia, ascites and pleural effusion associated with hepatitis C virus (HCV) infection in an intravenous (IV) drug user. Our case is the first in the literature that shows an association between HCV infection and IV drug use. PMID:26858768

  17. A Giant Mature Cystic Teratoma Mimicking a Pleural Effusion

    PubMed Central

    Dorterler, Mustafa Erman; Boleken, Mehmet Emin; Koçarslan, Sezen

    2016-01-01

    The vast majority of teratomas originating from more than a single germ layer are benign. Often, such teratomas are initially asymptomatic. Later symptoms are caused by the weight per se of the teratoma and include chest pain, cough, dyspnea, and/or recurrent attacks of pneumonia. A mediastinal teratoma is treated by total surgical resection of the mass. Here, we report a case of giant mature cystic teratoma mimicking a pleural effusion in the thorax at the 7-month-old female patient with a symptom of persistent pulmonary infection and tachypnea. PMID:26942032

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

    PubMed

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

    2013-10-01

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

  19. Real-time treatment feedback guidance of Pleural PDT

    NASA Astrophysics Data System (ADS)

    Zhu, Timothy C.; Kim, Michele M.; Liang, Xing; Liu, Baochang; Meo, Julia L.; Finlay, Jarod C.; Dimofte, Andreea; Rodriguez, Carmen; Simone, Charles; Cengel, Keith; Friedberg, Joseph

    2013-03-01

    Pleural photodynamic therapy (PDT) has been used as an adjuvant treatment with lung-sparing surgical treatment for mesothelioma with remarkable results. In the current intrapleural PDT protocol, a moving fiber-based point source is used to deliver the light and the light dose are monitored by 7 detectors placed in the pleural cavity. To improve the delivery of light dose uniformity, an infrared (IR) camera system is used to track the motion of the light sources. A treatment planning system uses feedback from the detectors as well as the IR camera to update light fluence distribution in real-time, which is used to guide the light source motion for uniform light dose distribution. We have improved the GUI of the light dose calculation engine to provide real-time light fluence distribution suitable for guiding the surgery to delivery light more uniformly. A dual-correction method is used in the feedback system, so that fluence calculation can match detector readings using both direct and scatter light models. An improved measurement device is developed to automatically acquire laser position for the point source. Comparison of the effects of the guidance is presented in phantom study.

  20. A large pleural effusion in a patient receiving peritoneal dialysis.

    PubMed

    Tapawan, Karen; Chen, Elaine; Selk, Natalie; Hong, Edward; Virmani, Sumeet; Balk, Robert

    2011-01-01

    Hydrothorax as a complication of peritoneal dialysis (PD) is a rare but recognized event. Proposed mechanisms for the development of a pleuro-peritoneal communication include congenital diaphragmatic defects, acquired weakening of diaphragmatic fibers caused by high intra-abdominal pressures during peritoneal dialysis, and impairments in lymphatic drainage. Pleural fluid analysis and diagnostic imaging assist in differentiation from other causes of pleural effusion. Nearly 50% of patients with this diagnosis have resolution of hydrothorax after temporary cessation of PD with interim hemodialysis for 2-6 weeks. Historically, other treatment options have included conventional pleurodesis and open thoracotomy with direct repair, producing variable results. With the advent of video-assisted thoracoscopy (VATS), surgical repairs and pleurodesis are now frequently performed under direct visualization with minimal invasiveness. We report a case of hydrothorax in a patient after recent introduction to peritoneal dialysis. Pleuro-peritoneal communication was documented with thoracentesis and radionuclide scanning. VATS pleurodesis with talc was performed. Repeat scintigraphy performed 1 week after the procedure revealed no residual communication, and patient was able to resume PD without further complications. PMID:21480997