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Choroid plexus cysts: Is biochemical testing a valuable adjunct to targeted ultrasonography?  

Microsoft Academic Search

Objective: We sought to determine whether biochemical testing is a valuable adjunct to ultrasonography in selecting patients with fetal choroid plexus cysts for amniocentesis. Study Design: The study population consists of 128 patients who had fetal choroid plexus cysts detected during ultrasonography performed between 18 and 22 weeks’ gestation. The patients had genetic counseling, and amniocentesis and biochemical testing were

Amy Sullivan; Thomas Giudice; Fotini Vavelidis; Siva Thiagarajah



Isolated fetal choroid plexus cysts and trisomy 18: A review and meta-analysis  

Microsoft Academic Search

OBJECTIVE: Risk of trisomy 18 in a fetus with ultrasonographic diagnosis of choroid plexus cysts and no other anomalies is controversial. Using our data and current literature, we performed a meta-analysis and estimated the positive predictive value of isolated choroid plexus cysts fot risomy 18.STUDY DESIGN: Between Jan. 1, 1989, and Dec. 31, 1992, all women undergoing ultrasonographic examination at

Susan J. Gross; Lee P. Shulman; Elizabeth A. Tolley; Donald S. Emerson; Richard E. Felker; Joe Leigh Simpson; Sherman Elias



Asymptomatic choroid plexus cysts in the lateral ventricles: an incidental finding on diffusion-weighted MRI  

Microsoft Academic Search

We assessed the role of diffusion-weighted imaging (DWI) in the detection of choroid plexus cysts. We reviewed more than 1000 patients who had undergone MRI in a 1-year period. We reviewed echo-planar DWI with b=1000 s\\/mm2, acquired at 1.0 tesla, for any difference in signal intensity which might indicate choroid plexus cysts. On conventional images, all cystic lesions were isointense

B. Cakir; H. Karakas; E. Unlu; N. Tuncbilek



Diagnosis and surgical resection of a choroid plexus cyst in a dog.  


A three-year-old neutered male toy fox terrier presented for a Chiari-like malformation. No neurological deficits were found on examination, although diffuse cervical, thoracolumbar and head pain were present. A mass within the fourth ventricle was apparent on magnetic resonance imaging (MRI) of the brain. The lesion was hyperintense to brain parenchyma on T2-weighted images, hypointense on T1-weighted images and there was strong, homogeneous contrast enhancement. The cystic mass was removed through a suboccipital craniectomy. Histopathology was consistent with a choroid plexus cyst. The dog recovered well from the procedure and was clinically normal three months after surgery. To the authors' knowledge this is the first description of the appearance of a choroid plexus cyst on MRI in a dog and of its surgical removal. Although they are an uncommon finding, choroid plexus cysts should be considered as a differential diagnosis for mass lesions within the fourth ventricle. PMID:20070492

Brewer, D M; Cerda-Gonzalez, S; Dewey, C W; Coates, J R



Acinar Choroid Plexus Adenoma.  

National Technical Information Service (NTIS)

Mucin-producing cystic tumors of the choroid plexus are rare and most are papillomas or carcinomas. An acinar choroid plexus adenoma of the right lateral ventricle is described. Symptoms and signs included headache, vomiting, papilledema, and a gait distu...

G. E. Fox R. L. Davis



The second-trimester fetus with isolated choroid plexus cysts: a meta-analysis of risk of trisomies 18 and 21  

Microsoft Academic Search

Objective: To assess the risk of trisomy 18 and trisomy 21 associated with isolated choroid plexus cysts diagnosed by ultrasound in the second trimester.Methods of Study Selection: We reviewed the unabridged PREMEDLINE and MEDLINE databases for articles written in the English language regarding second-trimester fetal isolated choroid plexus cysts and trisomies 18 and 21, published in the period 1987–1997. Selection

Pamela R Yoder; Rudy E Sabbagha; Susan J Gross; Carolyn M Zelop



Choroid plexus cyst of the left lateral ventricle with intermittent blockage of the foramen of Monro, and initial invagination into the III ventricle in a child  

Microsoft Academic Search

A cyst of the choroid plexus of the left lateral ventricle with intermittent blockage of the foramen of Monro and initially\\u000a with invagination of the III ventricle in a child is described. In a 6-week-old boy a ventriculoatrial shunt was implanted\\u000a for correction of an active asymmetrical hydrocephalus of unknown origin. When he was 3 months of age a water-soluble

J. Pa?ízek; Josef Jakubec; Vladimír Hobza; Jana N?me?ková; Zden?k ?ernoch; Miroslav Šercl; Jan Žižka; Josef Špa?ek; Stanislav N?me?ek; Petr Šuba



Thyroxine transport in choroid plexus  

SciTech Connect

The role of the choroid plexus in thyroid hormone transport between body and brain, suggested by strong synthesis and secretion of transthyretin in this tissue, was investigated in in vitro and in vivo systems. Rat choroid plexus pieces incubated in vitro were found to accumulate thyroid hormones from surrounding medium in a non-saturable process. At equilibrium, the ratio of thyroid hormone concentration in choroid plexus pieces to that in medium decreased upon increasing the concentration of transthyretin in the medium. Fluorescence quenching of fluorophores located at different depths in liposome membranes showed maximal hormone accumulation in the middle of the phospholipid bilayer. Partition coefficients of thyroxine and triiodothyronine between lipid and aqueous phase were about 20,000. After intravenous injection of /sup 125/I-labeled thyroid hormones, choroid plexus and parts of the brain steadily accumulated /sup 125/I-thyroxine, but not (/sup 125/I)triiodothyronine, for many hours. The accumulation of /sup 125/I-thyroxine in choroid plexus preceded that in brain. The amount of /sup 125/I-thyroxine in non-brain tissues and the (/sup 125/I)triiodothyronine content of all tissues decreased steadily beginning immediately after injection. A model is proposed for thyroxine transport from the bloodstream into cerebrospinal fluid based on partitioning of thyroxine between choroid plexus and surrounding fluids and binding of thyroxine to transthyretin newly synthesized and secreted by choroid plexus.

Dickson, P.W.; Aldred, A.R.; Menting, J.G.; Marley, P.D.; Sawyer, W.H.; Schreiber, G.



Xanthogranuloma of the choroid plexus  

SciTech Connect

Uncommon tumefactions known as xanthogranulomas can occur throughout the body. Some appear to develop as benign or malignant neoplasms. An even less familiar xanthogranuloma occurs within the choroid plexus. Most are tiny plaques only a few millimeters in diameter. However, they can present as masses of significant size within the glomus. When large and unilateral, they are included in the differential diagnosis of choroid plexus tumors. A computed tomographic (CT) study of such a tumor is presented.

Pear, B.L.



Focal ependymal differentiation in choroid plexus papillomas  

Microsoft Academic Search

Choroid plexus papillomas are usually easily distinguishable from papillary ependymomas by their delicate fibrovascular stroma and their cytologic similarity to normal choroid plexus epithelium. Exceptionally, however, examples are met which give rise to diagnostic difficulty. We therefore tested 22 choroid plexus papillomas for the presence of glial fibrillary acidic (GFA) protein using the immunoperoxidase technique. Positivity for the protein was

L. J. Rubinstein; J.-M. Brucher



Prenatal diagnosis of mosaic ring 22 duplication/deletion with terminal 22q13 deletion due to abnormal first trimester screening and choroid plexus cyst detected on ultrasound.  


We report a rare case of mosaic ring chromosome 22 duplication/deletion in a fetus for whom karyotype analysis was required because of an abnormal finding in the maternal serum screening test and a choroid plexus cyst detected on prenatal ultrasound. Additional prenatal study of the amniotic fluid by fluorescence in situ hybridization was performed and the terminal 22q13.3 deletion was detected on ring chromosome. The final karyotype was 45,XX,-22[3]/46,XX,r(22)(p11q13.2)[63]/46,XX,idicr(22)(p11q13.2;p11q13.2)[2]dn.ishder(22)(N25+, ARSA-, ter-). The pegnancy was terminated. Cytogenetic analysis of the intracardiac blood also revealed ring 22 mosaicism with only one metaphase spread with idicr(22) as the unstable isodicentric rings are subsequently lost from most cells. We discuss the prenatal diagnosis of this rare condition. PMID:20149051

Koç, Altu?; Arisoy, Ozgür; Pala, Elif; Erdem, Mehmet; Kaymak, Ay?egül Oztürk; Erkal, Ozgür; Karao?uz, Meral Yirmibe?



Epithelial Pathways in Choroid Plexus Electrolyte Transport  

NSDL National Science Digital Library

A stable intraventricular milieu is crucial for maintaining normal neuronal function. The choroid plexus epithelium produces the cerebrospinal fluid and in doing so influences the chemical composition of the interstitial fluid of the brain. Here, we review the molecular pathways involved in transport of the electrolytes Na+, K+, ClÃÂ, and HCO across the choroid plexus epithelium.

Helle Damkier (Aarhus University Anatomy); Peter Brown (University of Manchester); Jeppe Praetorius (Aarhus University)



Cystic choroid plexus papilloma in the cavum septum pellucidum.  


A choroid plexus papilloma is a rare CNS neoplasm arising from the neuroepithelial lining of the choroid plexus. A third ventricular location of a choroid plexus papilloma is rare compared with the more common sites in the lateral and fourth ventricles. Cystic choroid plexus papilloma represents an infrequent subtype that may present diagnostic ambiguity. The authors present a case of cystic choroid plexus papilloma within a cavum septum pellucidum that radiographically mimicked neurocysticercosis. PMID:19951048

Tuchman, Alexander; Kalhorn, Stephen P; Mikolaenko, Irina; Wisoff, Jeffrey H



Choroid plexus carcinoma of childhood.  


The presentation, growth patterns, and response to therapy of 11 consecutive children with choroid plexus carcinomas were analyzed, and the results were compared with the outcome reported in other series. Patients were a median of 26 months of age at diagnosis. Two patients had thalamic tumors, one had a posterior fossa primary, and the rest had ventricular lesions. Five of 11 (45%) children remain in continuous progression-free remission a median of 48 months from diagnosis. Four of the five in continuous remission had a "gross total" surgical resection, and only one received radiation therapy. Five of six patients with subtotal resections relapsed despite postoperative treatment with radiation therapy (three) and chemotherapy (one). The response to treatment with radiation therapy or chemotherapy at relapse was disappointing, with only one child (treated with etoposide) responding. In combination with other series, 11 of 14 children had prolonged progression-free survival after gross total resection (only two of whom received adjuvant therapy) compared with two of 20 after less than total resections, independent of the type of adjuvant therapy given. Adjuvant therapy for children with choroid plexus carcinomas is of unproven benefit, and this must be considered when analyzing innovative treatment trials for such children, especially for those with totally resected tumors. Patients with partially resected lesions fare poorly with present forms of treatment. PMID:1728390

Packer, R J; Perilongo, G; Johnson, D; Sutton, L N; Vezina, G; Zimmerman, R A; Ryan, J; Reaman, G; Schut, L



Cerebrospinal fluid secretion by the choroid plexus.  


The choroid plexus epithelium is a cuboidal cell monolayer, which produces the majority of the cerebrospinal fluid. The concerted action of a variety of integral membrane proteins mediates the transepithelial movement of solutes and water across the epithelium. Secretion by the choroid plexus is characterized by an extremely high rate and by the unusual cellular polarization of well-known epithelial transport proteins. This review focuses on the specific ion and water transport by the choroid plexus cells, and then attempts to integrate the action of specific transport proteins to formulate a model of cerebrospinal fluid secretion. Significant emphasis is placed on the concept of isotonic fluid transport across epithelia, as there is still surprisingly little consensus on the basic biophysics of this phenomenon. The role of the choroid plexus in the regulation of fluid and electrolyte balance in the central nervous system is discussed, and choroid plexus dysfunctions are described in a very diverse set of clinical conditions such as aging, Alzheimer's disease, brain edema, neoplasms, and hydrocephalus. Although the choroid plexus may only have an indirect influence on the pathogenesis of these conditions, the ability to modify epithelial function may be an important component of future therapies. PMID:24137023

Damkier, Helle H; Brown, Peter D; Praetorius, Jeppe



Choroid plexus papilloma with a hyperdiploid karyotype  

SciTech Connect

An 11-month-old male underwent surgery for a choroid plexus neoplasm, which on histologic examination was diagnosed as a benign papilloma. Chromosome analysis showed a karyotype of 55,XY,+7+7,+8,+9,+12,+12,+15,+20,+21 in all 20 metaphases analyzed. This is only the third benign choroid plexus papilloma that has been karyotyped, with the others being normal and hypodiploid (33 chromosomes). Three malignant choroid plexus carcinomas have also been analyzed, two with normal karyotypes and one hypodiploid (34 - 35 chromosomes). The two hypoidiploid neoplasms lack chromosomes 2, 3, 4, 5, 10, 13, 14, 17 and 18. Since the chromosomes that are lost in the hypodiploid neoplasms are different from the chromosomes gained in our tumor, it appears that the dosage of specific chromosomes is important in the origin of choroid plexus neoplasms. Benign choroid plexus papillomas can be difficult to differentiate from choroid plexus carcinomas. With the data available so far, it does not appear that cytogenetics can assist in making the diagnosis.

Roland, B.; Pinto, A. [Univ. of Calgary, Alberta (Canada)



[Choroid plexus carcinoma: report of 15 cases].  


Choroid plexus carcinoma (CPC) are rare central nervous system tumours derived from choroid plexus epithelium, affecting mainly children under 3 years of age. We present a clinical, epidemiological and histopathological study of 15 cases of CPC. Ten patients were male. Age ranged from 4 months to 21 years (mean=3,4). The lateral ventricles were affected in 73,3% of cases. Main symptom were: hydrocephalus (62.5%), intracranial hypertension (25%) and convulsion (12.5%). The patients were treated by surgery with partial resection in 75% of cases and total resection in 25%. There was one death due to surgical complication, 85.7% of patients had recurrence of tumours with mean survival rate of 13.6% months after diagnosis. Only one patient remain alive 5 years after initial treatment. These results support the poor prognosis and high mortality rate of CPC. PMID:10920414

Bleggi-Torres, L F; Urban, L A; Antoniuk, A; Carboni, P; Ramina, R; Gugelmin, E S



Choroid plexus protects cerebrospinal fluid against toxic metals  

SciTech Connect

Although heavy metal ions are known to be toxic to the central nervous system (CNS), the mechanisms by which the CNS may protect itself from initial challenges of such toxic ions is unknown. The choroid plexus is the principal site of formation of the cerebrospinal fluid (CSF) which bathes the brain. We have determined in rats and rabbits that after intraperitoneal administration of lead, cadmium, mercury, and arsenic compounds, these toxic metal ions accumulated in the lateral choroid plexus at concentrations of Pb, Hg, and As that were 70-, 95-, and 40-fold higher, respectively, than those found in CSF. Cd was not detected in the CSF. In addition, concentrations of these heavy metal ions were found to be many fold greater in the choroid plexus than in the brain or blood. The accumulation of Pb in the choroid plexus was dose-dependent and time-related. When the choroid plexus was preincubated, in vitro, with ouabain (1.5 mM), the uptake of Cd from the CSF side of the choroid plexus was inhibited 57%. Cadmium metallothionein was not found in the choroid plexus. Whereas the concentration of reduced glutathione in the choroid plexus was less than that in the brain cortex, the concentration of cysteine was fourfold greater. The lateral choroid plexus sequesters Pb, Cd, As, and Hg. It appears to be one of the important mechanisms that protects the CSF and the brain from the fluxes of toxic heavy metals in the blood.

Wei, Zheng; Perry, D.F.; Nelson, D.L.; Aposhian, H.V. (Univ. of Arizona, Tucson (United States))



Choroid Plexus Papillomas: A Single Institutional Experience  

Microsoft Academic Search

Objective: To determine the long-term outcome of resected choroid plexus papillomas (CPPs).\\u000aMethods: Medical records and histologic specimens were reviewed for 41 patients (19 male, 22 female; median age, 36 years; range, 6 months to 74 years) with CPP seen between 1974 and 2000. Tumor locations were as follows: 76%, fourth ventricle; 17%, lateral ventricle, and 7%, third ventricle. Fifty-six

Sunil Krishnan; Paul D. Brown; Bernd W. Scheithauer; Michael J. Ebersold; Julie E. Hammack; Jan C. Buckner



Effects of vasoactive stimuli on blood flow to choroid plexus  

SciTech Connect

The goal of this study was to examine effects of vasoactive stimuli on blood flow to choroid plexus. The authors used microspheres to measure blood flow to choroid plexus and cerebrum in anesthetized dogs and rabbits. A critical assumption of the microsphere method is that microspheres do not pass through arteriovenous shunts. Blood flow values obtained with simultaneous injection of 15- and 50-{mu}m microspheres were similar, which suggest that shunting of 15-{mu}m microspheres was minimal. Blood flow to choroid plexus under control conditions was 287 {plus minus} 26 (means {plus minus} SE) ml {center dot} min{sup {minus}1} {center dot} 100 g{sup {minus}1} in dogs and 385 {plus minus} 73 ml {center dot} min{sup {minus}1} 100 g{sup {minus}1} in rabbits. Consecutive measurements under control conditions indicated that values for blood flow are reproducible. Adenosine did not alter blood flow to cerebrum but increased blood flow to choroid plexus two- to threefold in dogs and rabbits. Norepinephrine and phenylephrine did not affect blood flow to choroid plexus and cerebrum but decreased blood flow to choroid plexus by {approx} 50%. The authors suggest that (1) the microsphere method provides reproducible valid measurements of blood flow to the choroid plexus in dogs and rabbits and (2) vasoactive stimuli may have profoundly different effects on blood flow to choroid plexus and cerebrum.

Faraci, F.M.; Mayhan, W.G.; Williams, J.K.; Heistad, D.D. (Univ. of Iowa College of Medicine, Iowa City (USA))



Fgf2 is expressed in human and murine embryonic choroid plexus and affects choroid plexus epithelial cell behaviour  

Microsoft Academic Search

BACKGROUND: Although fibroblast growth factor (Fgf) signalling plays crucial roles in several developing and mature tissues, little information is currently available on expression of Fgf2 during early choroid plexus development and whether Fgf2 directly affects the behaviour of the choroid plexus epithelium (CPe). The purpose of this study was to investigate expression of Fgf2 in rodent and human developing CPe

Sarah Greenwood; Adam Swetloff; Angela M Wade; Tetsuya Terasaki; Patrizia Ferretti



Identification of novel diagnostic markers for choroid plexus tumors: a microarray-based approach.  


To identify specific markers for the diagnosis of choroid plexus tumors, gene expression profiles of choroid plexus epithelial cells (n = 8) and ependymal cells (n = 6) microdissected from human autopsy brains as well as choroid plexus papilloma tissue were investigated using DNA microarrays. Protein expression of genes overexpressed in choroid plexus was evaluated in normal choroid plexus, choroid plexus papilloma, choroid plexus carcinoma, other primary brain tumors, and cerebral metastases. Forty-six genes found to be overexpressed in normal choroid plexus epithelial cells were also present in choroid plexus papilloma. Among those, 11 were further analyzed by immunohistochemistry. Expression of inward rectifier potassium channel Kir7.1 was confirmed in normal choroid plexus (34 of 35), choroid plexus papilloma (12 of 18), and choroid plexus carcinoma (5 of 5) but was not found in 100 other primary brain tumors and cerebral metastases. Similarly, stanniocalcin-1 stained normal choroid plexus (32 of 35), choroid plexus papilloma (16 of 18), and choroid plexus carcinoma (3 of 5), whereas staining was seen in only 2 of 100 other primary brain tumors and cerebral metastases. Transthyretin stained choroid plexus (33 of 35), choroid plexus papilloma (14 of 18), and plexus carcinoma (2 of 5), but its specificity was significantly lower. Antibodies directed against coagulation factor V, glutathione peroxidase 3, pigment epithelium derived factor, serotonin receptor 5-HTR2C, lumican, fibulin-1, plastin-1, and cytokeratin 18 revealed varying degrees of specificity and sensitivity. Our data suggest that antibodies directed against Kir7.1 and stanniocalcin-1 might serve as sensitive and specific diagnostic markers for choroid plexus tumors. PMID:16330944

Hasselblatt, Martin; Böhm, Christine; Tatenhorst, Lars; Dinh, Vinzenz; Newrzella, Dieter; Keyvani, Kathy; Jeibmann, Astrid; Buerger, Horst; Rickert, Christian H; Paulus, Werner



Extraventricular choroid plexus papilloma in the brainstem.  


Choroid plexus papilloma (CPP) is extremely rare in the brainstem. The authors report the case of a 10-year-old boy with a lesion in the pons that was misdiagnosed as a glioma preoperatively. The boy underwent partial resection of the lesion, which was diagnosed as a CPP based on histopathological findings. The authors review the MRI findings in this case and conclude that the presence of a well-defined boundary and no obvious cerebral edema are valuable features for distinguishing brainstem CPP from glioma. Although previous reports of parenchymal CPPs have described enhancement on contrast-enhanced T1-weighted MR images, the lesion in this case did not demonstrate significant enhancement. The authors note that the diagnosis of extraventricular CPP cannot be ruled out in a case of brainstem tumor without marked enhancement. PMID:23889355

Xiao, Anqi; Xu, Jianguo; He, Xin; You, Chao



The effects of cerebral ischemia on the rat choroid plexus  

Microsoft Academic Search

Although the blood–brain barrier effects of cerebral ischemia have been extensively examined, less attention has focused on ischemia-induced damage to the choroid plexuses that form the blood–cerebrospinal fluid (CSF) barrier (BSCFB). This study examined the rat lateral ventricle choroid plexuses (LVCP) in three ischemic models, bilateral common carotid artery occlusion (2VO)+hypotension with or without reperfusion and permanent middle cerebral artery

Steven R Ennis; Richard F Keep



The bright choroid plexus on MR: CT and pathologic correlation.  


Fourteen patients studied with MR imaging were found, incidentally, to have unusually bright, large choroid plexus glomera on T2-weighted sequences. A group of 167 patients was then examined retrospectively for size and intensity of the choroid plexus glomera on T2-weighted images. In the latter group of 167 patients, 66 (39.5%) had bright choroid plexus glomera. Of those who had bright choroid plexus glomera, eight of the 14 initial group and 11 of the 66 patients studied retrospectively had previous CT scans. The typical CT appearance of these bright glomera consisted of nonenhancing central regions of low (but not negative) attenuation with peripheral calcifications in the majority. The remainder showed noncalcified glomera. Fifty-two glomera were obtained at autopsy and examined retrospectively. Eight showed small, variably sized masses with lipid deposits, neuroepithelial microcysts, and peripheral psammoma body calcifications. One patient who died had a bright choroid plexus glomus on MR, and his glomera showed the same pathologic findings. The autopsy findings were believed to be typical pathologically for early xanthogranulomata formation. These early xanthogranulomatous changes appear to be of little clinical significance but must be differentiated from other lesions that can produce bright or enlarged choroid plexus glomera on MR. PMID:3132821

Hinshaw, D B; Fahmy, J L; Peckham, N; Thompson, J R; Hasso, A N; Holshouser, B; Paprocki, T


Evaluation of proliferative index and cell cycle protein expression in choroid plexus tumors in children  

Microsoft Academic Search

Choroid plexus tumors are papillary neoplasms originating from the epithelium of the choroid plexus within the cerebral ventricles. They may be highly proliferative tumors, but detailed studies confirming their proliferative potential are lacking. Accordingly, we performed a clinicopathological correlation study of neoplasms arising from the choroid plexus in children using immunohistochemistry to characterize both their proliferative potential and their degree

Carlos G. Carlotti Jr; Bodour Salhia; Sheila Weitzman; Mark Greenberg; Peter B. Dirks; Warren Mason; Lawrence E. Becker; James T. Rutka



The structure of the choroid plexus and the physiology of the choroid plexus epithelium.  


The choroid plexuses (CPs) are leaf-like highly vascular structures laying in the ventricles. The main function of choroid plexuses is the production of the cerebrospinal fluid (CSF). Although CPs have a unique distribution of ion transporters/channels, the mechanism of CSF production is similar to the production of fluids in other epithelia and is based on energy released from ATP hydrolysis, which drives unidirectional flux of ions accompanied by movement of water by osmosis. The CPs have an important role in the homeostasis of nutrients in the CSF since the kinetic parameters of glucose and amino acid (AA) transport across the CPs are the main reason for the low concentration of these molecules in the CSF. The CPs appear to be source of CSF-borne hormones and growth factors, including insulin-like growth factor II (IGF II), vasopressin (VP) and transforming growth factor beta1 (TGF-beta1). The CPs also synthesise the thyroid transporting protein transthyretin and transferrin and can chelate heavy metals. PMID:15381330

Redzic, Zoran B; Segal, Malcolm B



Choroid plexus failure in the Kearns-Sayre syndrome.  


The Kearns-Sayre syndrome is a mitochondrial disorder (generally due to mitochondrial DNA deletions) that causes ophthalmoplegia, retinopathy, ataxia and brain abnormalities such as leukoencephalopathy. In this syndrome, the choroid plexus epithelial cells, unlike brain cells, are greatly enlarged and granular, consistent with their inability to adequately transport folate from blood into cerebrospinal fluid (CSF), and homovanillic acid (a dopamine metabolite) from CSF into blood. This inability to transport folates from blood into CSF (and brain) adequately, causes cerebral folate deficiency that can be partially reversed by very high doses of reduced folates. The Kearns-Sayre syndrome is a disease that interferes with key choroid plexus functions and is a cause of generalized choroid plexus failure. PMID:20731822

Spector, Reynold; Johanson, Conrad E



Nodular lesions of choroid plexus in Hurler disease.  


Neuropathologic examination of six brains from children with Hurler disease revealed nodular lesions in the glomus of choroid plexus caused by proliferation of vacuolated pericytes, fibroblasts, and arachnoid cells on the background of collagenized and myxoid stroma. This localization of lesions can be explained by the presence of a rich vascular network, as well as cellular heterogeneity greater in the glomus than in other parts of the choroid plexus or in the brain parenchyma. The development of nodules did not correlate with the age, severity of hydrocephalus, or the degree of expansion of the perivascular spaces in the brain. PMID:21355678

Lach, Boleslaw; Haust, Maria D



Choroid plexus epithelium (normal and neoplastic) expresses synaptophysin. A potentially useful aid in differentiating carcinoma of the choroid plexus from metastatic papillary carcinomas.  


As an incidental finding in paraffin sections of brain tissue used as positive controls for synaptophysin immunostain, the cytoplasm of choroid plexus epithelium present was found to stain strongly positively for this substance. This was subsequently found to be the case in normal choroid plexuses in autopsy material from infancy to old age, as well as in epithelial cells of papillomas and carcinomas of the choroid plexus. The latter findings may prove useful in differentiating choroid plexus carcinomas from metastatic papillary carcinomas of extracerebral origin with the exception of neuroendocrine carcinomas of various sites that are usually positive for synaptophysin. PMID:10218635

Kepes, J J; Collins, J



Molecular Targeted Therapies of Childhood Choroid Plexus Carcinoma.  

National Technical Information Service (NTIS)

Choroid plexus carcinoma (CPC) is a rare malignant brain tumor originating from the epithelial cells lining the cerebral ventricles. CPC represents less than 0.6% of brain tumors in all age groups, yet is more frequent in children (2-4%), especially in in...

D. Malkin D. Merino



Extensive neuroprotection by choroid plexus transplants in excitotoxin lesioned monkeys  

Microsoft Academic Search

Huntington's disease (HD) results from degeneration of striatal neurons. Choroid plexus (CP) cells secrete neurotrophic factors, and CP transplants are neuroprotective in rat models of HD. To determine if similar neuroprotective effects could be obtained in primates, porcine CP was encapsulated in alginate capsules. PCR confirmed that the CP cells expressed transthyretin and immunocytochemistry demonstrated typical ZO-1 and tubulin staining.

Dwaine F. Emerich; Christopher G. Thanos; Moses Goddard; Stephen J. M. Skinner; Marilyn S. Geany; William J. Bell; Briannan Bintz; Patricia Schneider; Yaping Chu; Rangasamy Suresh Babu; Cesario V. Borlongan; Kim Boekelheide; Susan Hall; Bronwyn Bryant; Jeffrey H. Kordower



Choroid plexus papilloma in an infant: ultrasound diagnosis.  


A 6-month-old baby with enlarged head circumference was found on ultrasound to have a choroid plexus papilloma with striking sonographic appearance. This entity has received relatively little attention in the literature and may be encountered on ultrasound as the first imaging study. PMID:23015045

Lysyy, Oleg; Puzhevsky, Alexander; Strauss, Simon



Molecular Targeted Therapies of Childhood Choroid Plexus Carcinoma.  

National Technical Information Service (NTIS)

Choroid plexus carcinoma (CPC) is a rare malignant brain tumor originating from the epithelial cells lining the cerebral ventricles. CPC represents less than 0.6% of brain tumors in all age groups, yet is more frequent in children (2-4%), especially in in...

D. Malkin



Choroid plexus papilloma in a girl with hypomelanosis of Ito.  


The authors report a case of choroid plexus papilloma in a girl with hypomelanosis of Ito, and they review the literature in brief. Hypomelanosis of Ito is a rare neurocutaneous syndrome characterized by cutaneous hypopigmented whorls, streaks, and patches along lines of Blaschko. Most patients exhibit CNS manifestations, including psychomotor retardation, seizures, hypotonia, and ataxia. A 6-year-old girl with hypomelanosis of Ito was referred to the authors' hospital with bilateral tumors in the lateral ventricles. The right lateral ventricle tumor was surgically removed. Immunohistochemical investigations revealed the tumor to be a choroid plexus papilloma (WHO Grade I). A chromosomal investigation revealed that the tumor tissue demonstrated a large loss of heterozygosity at chromosome 10. The case reported here serves as a reminder that de novo brain tumors may arise in patients with chromosomal mosaicism. PMID:22793165

Morigaki, Ryoma; Pooh, Kyong-Hon; Shouno, Kenji; Taniguchi, Hidekazu; Endo, Shouichi; Nakagawa, Yoshinobu



Kearns–Sayre syndrome: oncocytic transformation of choroid plexus epithelium  

Microsoft Academic Search

Kearns–Sayre syndrome (KSS) is a sporadic multisystem disorder due to a defect of oxidative phosphorylation and associated with clonally-expanded rearrangements of mitochondrial DNA (mtDNA) deletions (?-mtDNAs) and\\/or duplications (dup-mtDNAs). To gain further insight into the pathogenesis of CNS dysfunction in KSS, we studied the choroid plexus from two autoptic cases using in situ hybridization (ISH) of mtDNA, and immunohistochemistry to

Kurenai Tanji; Eric A Schon; Salvatore DiMauro; Eduardo Bonilla



Choroid plexus papilloma in a Nigerian child: a case report.  


Choroid plexus papilloma is a rare but known cause of hydrocephalus among children. We report the case of an 8 month old girl who clinically was thought to have post-infective Hydrocephalus. Cranial CT however showed an associated intra-ventricular tumour which after surgical resection was reported as a Choroid plexus papilloma. This is the first time such a case is being diagnosed at our hospital and very few cases have been documented in literature from sub-Saharan Africa. This case highlights the available treatment and good prognosis that is possible with Choroid plexus papilloma. It also highlights the need for a high index of suspicion for less common causes of an enlarging head especially when the clinical picture is not typical as demonstrated in our patient. The seeming rarity of this disease in our environment may be partly due to the limited availability of CT scanners in many centres and the paucity of Neuroradiologist and Neurosurgeons in sub-Saharan Africa. PMID:20852665

Bankole, O B; Ojo, O A; Kanu, O O; Arigbabu, S O



IFN-?-dependent activation of the brain's choroid plexus for CNS immune surveillance and repair.  


Infiltrating T cells and monocyte-derived macrophages support central nervous system repair. Although infiltration of leucocytes to the injured central nervous system has recently been shown to be orchestrated by the brain's choroid plexus, the immunological mechanism that maintains this barrier and regulates its activity as a selective gate is poorly understood. Here, we hypothesized that CD4(+) effector memory T cells, recently shown to reside at the choroid plexus stroma, regulate leucocyte trafficking through this portal through their interactions with the choroid plexus epithelium. We found that the naïve choroid plexus is populated by T helper 1, T helper 2 and regulatory T cells, but not by encephalitogenic T cells. In vitro findings revealed that the expression of immune cell trafficking determinants by the choroid plexus epithelium is specifically induced by interferon-?. Tumour necrosis factor-? and interferon-? reciprocally controlled the expression of their receptors by the choroid plexus epithelium, and had a synergistic effect in inducing the epithelial expression of trafficking molecules. In vivo, interferon-?-dependent signalling controlled trafficking through the choroid plexus; interferon-? receptor knockout mice exhibited reduced levels of T cells and monocyte entry to the cerebrospinal fluid and impaired recovery following spinal cord injury. Moreover, reduced expression of trafficking molecules by the choroid plexus was correlated with reduced CD4(+) T cells in the choroid plexus and cerebrospinal fluid of interferon-? receptor knockout mice. Similar effect on the expression of trafficking molecules by the choroid plexus was found in bone-marrow chimeric mice lacking interferon-? receptor in the central nervous system, or reciprocally, lacking interferon-? in the circulation. Collectively, our findings attribute a novel immunological plasticity to the choroid plexus epithelium, allowing it to serve, through interferon-? signalling, as a tightly regulated entry gate into the central nervous system for circulating leucocytes immune surveillance under physiological conditions, and for repair following acute injury. PMID:24088808

Kunis, Gilad; Baruch, Kuti; Rosenzweig, Neta; Kertser, Alexander; Miller, Omer; Berkutzki, Tamara; Schwartz, Michal



The hyperdense choroid plexus: A CT finding associated with aortic arch obstruction in the newborn  

Microsoft Academic Search

We report the first observation of choroid plexus hyperdensity depicted by CT in two newborns with aortic arch obstruction. Neither infant had intracranial hemorrhage or infarction demonstrated by autopsy or cranial ultrasonography. Although not proven, we believe that such hyperdensity in these two cases represents abnormal vascularity within the choroid plexus related to upper extremity hypertension.

J. C. Rand; E. M. Burton; I. L. D. Tonkin; T. G. DiSessa



Neurogenic effects of ?-amyloid in the choroid plexus epithelial cells in Alzheimer's disease.  


?-amyloid (A?) can promote neurogenesis, both in vitro and in vivo, by inducing neural progenitor cells to differentiate into neurons. The choroid plexus in Alzheimer's disease (AD) is burdened with amyloid deposits and hosts neuronal progenitor cells. However, neurogenesis in this brain tissue is not firmly established. To investigate this issue further, we examined the effect of A? on the neuronal differentiation of choroid plexus epithelial cells in several experimental models of AD. Here we show that A? regulates neurogenesis in vitro in cultured choroid plexus epithelial cells as well as in vivo in the choroid plexus of APP/Ps1 mice. Treatment with oligomeric A? increased proliferation and differentiation of neuronal progenitor cells in cultured choroid plexus epithelial cells, but decreased survival of newly born neurons. These A?-induced neurogenic effects were also observed in choroid plexus of APP/PS1 mice, and detected also in autopsy tissue from AD patients. Analysis of signaling pathways revealed that pre-treating the choroid plexus epithelial cells with specific inhibitors of TyrK or MAPK diminished A?-induced neuronal proliferation. Taken together, our results support a role of A? in proliferation and differentiation in the choroid plexus epithelial cells in Alzheimer's disease. PMID:23455075

Bolos, Marta; Spuch, Carlos; Ordoñez-Gutierrez, Lara; Wandosell, Francisco; Ferrer, Isidro; Carro, Eva



Studies on the human choroid plexus in vitro.  


The role of human choroid plexus (CP) epithelium in the transport of solutes between the blood and the cerebrospinal fluid and/or in secretion processes may be studied by employing several experimental approaches. There are a number of in vitro techniques for human CP epithelium (CPE) and all have limitations that do not exclude them a priori, but that should be carefully taken into consideration. Developmental and morphological studies have been largely performed on human choroid plexus samples of either embryonic or post-mortem origin. Functional uptake studies may be performed on pathologically unaltered CP samples obtained during surgical removal of choroid plexus tumors. This approach can be used to explore transport processes mainly across the apical side of the CPE, but cannot be used to study vectorial transport across the CPE. Also, these samples have limited viability. A monolayer of CPE in culture, grown on permeable supports, provides the best available tool to study transport processes or polarized secretion by the CP, but thus far only limited attempts to culture these cells have been published and they mainly include data from neoplastic CPE. A study that used a human papilloma-derived cell line in culture showed that it forms a monolayer with barrier properties, although the cells express pleomorphic and neoplastic features and lack contact inhibition. Other cell cultures express some CPE markers but do not develop tight junctions/barrier properties. This article reviews the main characteristics and limitations of available in vitro methods to study human CPE, which could help researchers choose an appropriate experimental approach for a particular study. PMID:23391221

Redzic, Zoran B



Studies on the human choroid plexus in vitro  

PubMed Central

The role of human choroid plexus (CP) epithelium in the transport of solutes between the blood and the cerebrospinal fluid and/or in secretion processes may be studied by employing several experimental approaches. There are a number of in vitro techniques for human CP epithelium (CPE) and all have limitations that do not exclude them a priori, but that should be carefully taken into consideration. Developmental and morphological studies have been largely performed on human choroid plexus samples of either embryonic or post-mortem origin. Functional uptake studies may be performed on pathologically unaltered CP samples obtained during surgical removal of choroid plexus tumors. This approach can be used to explore transport processes mainly across the apical side of the CPE, but cannot be used to study vectorial transport across the CPE. Also, these samples have limited viability. A monolayer of CPE in culture, grown on permeable supports, provides the best available tool to study transport processes or polarized secretion by the CP, but thus far only limited attempts to culture these cells have been published and they mainly include data from neoplastic CPE. A study that used a human papilloma-derived cell line in culture showed that it forms a monolayer with barrier properties, although the cells express pleomorphic and neoplastic features and lack contact inhibition. Other cell cultures express some CPE markers but do not develop tight junctions/barrier properties. This article reviews the main characteristics and limitations of available in vitro methods to study human CPE, which could help researchers choose an appropriate experimental approach for a particular study.



The choroid plexus response to a repeated peripheral inflammatory stimulus  

PubMed Central

Background Chronic systemic inflammation triggers alterations in the central nervous system that may relate to the underlying inflammatory component reported in neurodegenerative disorders such as multiple sclerosis and Alzheimer's disease. However, it is far from being understood whether and how peripheral inflammation contributes to induce brain inflammatory response in such illnesses. As part of the barriers that separate the blood from the brain, the choroid plexus conveys inflammatory immune signals into the brain, largely through alterations in the composition of the cerebrospinal fluid. Results In the present study we investigated the mouse choroid plexus gene expression profile, using microarray analyses, in response to a repeated inflammatory stimulus induced by the intraperitoneal administration of lipopolysaccharide every two weeks for a period of three months; mice were sacrificed 3 and 15 days after the last lipopolysaccharide injection. The data show that the choroid plexus displays a sustained response to the repeated inflammatory stimuli by altering the expression profile of several genes. From a total of 24,000 probes, 369 are up-regulated and 167 are down-regulated 3 days after the last lipopolysaccharide injection, while at 15 days the number decreases to 98 and 128, respectively. The pathways displaying the most significant changes include those facilitating entry of cells into the cerebrospinal fluid, and those participating in the innate immune response to infection. Conclusion These observations contribute to a better understanding of the brain response to peripheral inflammation and pave the way to study their impact on the progression of several disorders of the central nervous system in which inflammation is known to be implicated.



Sonic hedgehog is required for vascular outgrowth in the hindbrain choroid plexus  

PubMed Central

SUMMARY Critical to the exchange and metabolic functions served by tissues like brain choroid plexi and lung is the coherent development of an epithelial sheet of large surface area in tight apposition to an extensive vascular bed. Here, we present functional experiments in the mouse demonstrating that Sonic hedgehog (Shh) produced by hindbrain choroid plexus epithelium induces the extensive vascular outgrowths and vascular surface area fundamental to choroid plexus functions, but does not induce the more specialized endothelial cell features of fenestrations and bore size. Our findings indicate that these Shh-dependent vascular elaborations occur even in the presence of Vegf and other established angiogenic factors, suggesting either that the levels of these factors are inadequate in the absence of Shh or that a different set of factors may be more essential to choroid plexus outgrowth. Transducing Shh signal is a perivascular cell – the pericyte – rather than the more integral vascular endothelial cell itself. Moreover, our findings suggest that hindbrain choroid plexus endothelial cells, as compared to other vascular endothelial cells, are more dependent upon pericytes for instruction. Thus, in addition to Shh acting on the progenitor pool for choroid plexus epithelial cells, as previously shown, it also acts on choroid plexus pericytes, and together serves the important role of coordinating the development of two disparate yet functionally dependent structures – the choroid plexus vasculature and its ensheathing epithelium.

Nielsen, Corinne M.; Dymecki, Susan M.



Active transport of riboflavin by the isolated choroid plexus in vitro.  


In vitro, the transport of [14C]riboflavin into and from the isolated choroid plexus, the anatomical locus of the blood-cerebrospinal fluid barrier, was studied. With concentrations of [14C]riboflavin of 0.7 microM (or greater) in the incubation medium, the choroid plexus accumulated [14C]riboflavin against a large concentration gradient by a process that did not depend on binding or intracellular metabolism of the [14C]riboflavin. The [14C]riboflavin accumulation process in isolated choroid plexus could be described by Michaelis-Menten transport kinetics (kt = 78 microM and Ymax = 1.65 mmol kg-1 (15 min)-1) and was inhibited by other flavins and probenecid but not by ribose, weak bases, or other B vitamins. The accumulation process was markedly depressed by iodoacetate and low temperatures. With a concentration of 0.08 microM [14C]riboflavin in the incubation medium, 28% of the [14C]riboflavin within the choroid plexus was converted to [14C]FAD or [14C]FMN intracellularly. Unlike the active transport of [14C]riboflavin into choroid plexus, accumulated [14C]riboflavin departed choroid plexus by a process independent of intracellular concentration or temperature. The efflux of [14C]riboflavin from choroid plexus could be described by first oder kinetics with a rate constant of -0.08 min-1. PMID:489597

Spector, R; Boose, B



Composition of fluid obtained from choroid plexus tissue isolated in a chamber in situ*  

PubMed Central

1. A method was developed for isolating a segment of the choroid plexus of the lateral ventricle of the cat brain in a chamber in situ. 2. A comparison of electrolyte and protein concentrations in serum, ultrafiltrate of serum, cisterna magna fluid, fluid accumulated in the chamber and fluid collected from the choroid plexus by another technique, demonstrates that the chamber fluid is a secretory product of the choroid plexus. 3. The rate of fluid formation in the chamber was 0·4 ?l. min-1 mg-1 of tissue, a value in good agreement with reports in the literature. 4. The observation that the concentration of K+ in choroid plexus fluid was lower than that in the serum ultrafiltrate suggests that K+ is regulated by an active transport process at the choroid plexus. 5. Significant correlation was found between electrolyte values and the protein content of the chamber fluid. This suggests that plasma is the probable source of the protein in the chamber fluid and that K+ and probably Ca2+ and Mg2+ in c.s.f. are subject to active homoeostatic regulation by the choroid plexus. 6. The technique described provides a new opportunity to study in detail the functional characteristics of the choroid plexus.

Miner, L. C.; Reed, D. J.



Biochemical study of prolactin binding sites in Xenopus laevis brain and choroid plexus  

SciTech Connect

The occurrence of prolactin binding sites in some brain structures (telencephalon, ventral hypothalamus, myelencephalon, hypophysis, and choroid plexus) from Xenopus laevis (anuran amphibian) was studied by the in vitro biochemical technique. The higher binding values were obtained at the level of the choroid plexus and above all of the hypothalamus. On the bases of hormonal specificity and high affinity, these binding sites are very similar to those of prolactin receptors of classical target tissues as well as of those described by us in other structures from Xenopus. To our knowledge, the present results provide the first demonstration of the occurrence of prolactin specific binding sites in Xenopus laevis choroid plexus cells.

Muccioli, G.; Guardabassi, A.; Pattono, P. (Univ. of Turin (Italy))



The Choroid Plexuses and the Barriers Between the Blood and the Cerebrospinal Fluid  

Microsoft Academic Search

1. The fluid homeostasis of the brain depends both on the endothelial blood–brain barrier and on the epithelial blood–cerebrospinal fluid (CSF) barrier located at the choroid plexuses and the outer arachnoid membrane.

Malcolm B. Segal



5HT1C receptor-mediated stimulation of inositol phosphate production in pig choroid plexus  

Microsoft Academic Search

1) 5-HT (5-hydroxytryptamine, serotonin) induces inositol phosphate production in a pig choroid plexus preparation. This effect has been pharmacologically characterized and the data compared to those obtained from radioligand binding studies performed with [3H]mesulergine to 5-HT1C sites in pig choroid plexus membranes. 2) The rank order of potency of agonists stimulating inositol phosphate production was: a-methyl-5-HT > 1-methyl-5-HT > DOI

Daniel Hoyer; Christian Waeber; Philippe Schoeffter; Jose Maria Palacios; Anant Dravid



Primary choroid plexus papilloma in the pituitary fossa: case report and literature review  

Microsoft Academic Search

Choroid plexus papillomas are rare tumors of the central nervous system and are usually confined to the ventricular system.\\u000a We illustrated a primary choroid plexus papilloma in the pituitary fossa. A 31-year-old female presented with amenorrhea and\\u000a intermittent galactorrhoea, with no visual complaints in the last 2 years. Endocrine testing showed no hormone excess or deficiency\\u000a of the pituitary and target

Liu-Guan Bian; Qing-Fang Sun; Hua-Cheng Wu; Hong Jiang; Yue-Hao Sun; Jian-Kang Shen



Protein synthesis and transport by the rat choroid plexus and ependyma  

Microsoft Academic Search

Light (LM-ARG) and electron microscope (EM-ARG) autoradiographs were prepared from immature rat choroid plexus and ependyma at 5, 10, 30, and 60 min and 16 h following intraperitoneal administration of [3H]- labeled amino acid mixtures. Intracellular protein synthesis and transport were ascertained in lateral and fourth ventricle choroid plexus epithelium by quantitative EM-ARG at the several post-injection intervals. ARG were

William F. Agnew; Renate B. Alvarez; Ted G. H. Yuen; Agnes K. Crews



Asymmetric localization of Notch2 on the microvillous surface in choroid plexus epithelial cells  

Microsoft Academic Search

Notch family molecules are transmembrane receptors that play various roles in contact-dependent cell–cell interactions in\\u000a a wide range of organs. In the brain, Notch2, but not the other members of Notch, is expressed in the choroid plexus at an\\u000a exceptionally high level. We immunohistochemically examined the cellular and subcellular localization of Notch2 protein in\\u000a the choroid plexus using confocal and

Masahiko Tanaka; Masahiro Kokubo; Tohru Marunouchi



Accumulation of pantothenic acid by the isolated choroid plexus and brain slices in vitro.  


In vitro, the transport of [14C]pantothenic acid into and from the isolated rabbit choroid plexus, an anatomical locus of the blood-CSF barrier, and brain slices was studied. The choroid plexus accumulated [14C]pantothenic acid from the medium against a concentration gradient, although at low concentrations (less than 1 microM) there was substantial intracellular phosphorylation and binding of the [14C]pantothenic acid. The saturable accumulation process in choroid plexus was inhibited by probenecid and caproic acid but not by nicotinic acid or by weak bases. The accumulation process was markedly inhibited by N-ethylmaleimide, poly-L-lysine (which blocks sodium transport), and low temperatures. [14C]Pantothenic acid was readily released from choroid plexus by a temperature-dependent process. Brain slices also accumulated and, at low concentrations, phosphorylated [14C]pantothenic acid from the medium by a temperature-, probenecid-, and N-ethylmaleimide-sensitive saturable process. However, unlike choroid plexus, brain slices did not concentrate free pantothenic acid and [14C]pantothenic acid accumulation was not sensitive to poly-L-lysine. [14C]Pantothenic acid was readily released from brain slices by a temperature-sensitive process. These results are consistent with the view that [14C]pantothenic acid enters the isolated choroid plexus and brain slices by active transport and facilitated diffusion, respectively. PMID:6736962

Spector, R; Boose, B



Active transport properties of porcine choroid plexus cells in culture.  


We have investigated the transport properties of cultured porcine choroid plexus cells grown on permeable membranes and in serum-free medium. Withdrawal of serum yielded cell cultures with permeabilities low enough to establish and maintain a pH-gradient between the two compartments of the filter system and to allow apical fluid secretion. This became possible because of ten-fold increased electrical resistance of 1700 Omega cm2 in the absence of serum. These plexus epithelial cells transported phenol red, fluorescein, riboflavin and penicillin G from the apical to the basolateral side. KM values and vmax were determined and come close to in vivo values. Competitive inhibition with probenicid showed that the organic anion transporter is involved. Riboflavin transport however was not completely inhibited and did not respond quantitatively to the stilben derivate SITS that blocks the Cl-/HCO3--exchanger. We assume that an additional transport system exists for riboflavin. Ascorbic acid and myo-inositol were transported from the basolateral to the apical side in vitro which strongly resembles the in vivo transport from the blood to the cerebrospinal fluid. Again the experimental in vitro KM values come close to the in vivo values. The established epithelial cell culture model thus closely mimics the blood-CSF-barrier and may be a useful tool to further elucidate transport to and from the brain. PMID:9622643

Hakvoort, A; Haselbach, M; Galla, H J



Choroid-plexus-derived Otx2 homeoprotein constrains adult cortical plasticity.  


Brain plasticity is often restricted to critical periods in early life. Here, we show that a key regulator of this process in the visual cortex, Otx2 homeoprotein, is synthesized and secreted globally from the choroid plexus. Consequently, Otx2 is maintained in selected GABA cells unexpectedly throughout the mature forebrain. Genetic disruption of choroid-expressed Otx2 impacts these distant circuits and in the primary visual cortex reopens binocular plasticity to restore vision in amblyopic mice. The potential to regulate adult cortical plasticity through the choroid plexus underscores the importance of this structure in brain physiology and offers therapeutic approaches to recovery from a broad range of neurodevelopmental disorders. PMID:23770240

Spatazza, Julien; Lee, Henry H C; Di Nardo, Ariel A; Tibaldi, Lorenzo; Joliot, Alain; Hensch, Takao K; Prochiantz, Alain



Unique serotonin receptor (5HT-1C) in choroid plexus is linked to phosphoinositide hydrolysis  

SciTech Connect

The binding of /sup 125/I-LSD to the 5HT-1C site and of /sup 3/H-ket-anserin to the 5HT-2 site was determined in choroid plexus and cerebral cortex of male Sprague-Dawley rats, respectively. As an index of phosphoinositide (PI) hydrolysis, whole choroid plexus and cerebral cortex slices were prelabelled with /sup 3/H-inositol and serotonin (5HT) stimulated release of /sup 3/H-inositol-1-phosphate was measured. 5HT stimulated PI hydrolysis in choroid plexus (6-fold) and in cerebral cortex (2.5-fold). 5HT was more potent in choroid plexus (EC/sub 50/ = 46 nM) consistent with the involvement of the 5HT-1C site. 5HT antagonists, ketanserin, mianserin and spiperone, inhibited the response to 5HT with different potencies in the two tissues. In cerebral cortex all 3 antagonists had nM affinities and a rank order (spiperone > ketanserin > mianserin) consistent with the 5HT-2 site. In choroid plexus, however, the rank order (mianserin > ketanserin > spiperone) and absolute potencies agreed with binding to the 5HT-1C site. These data suggest that the 5HT-1C site is a functional receptor which utilizes PI hydrolysis as its biochemical effector system.

Sanders-Bush, E.; Conn, P.J.; Hoffman, B.J.; Hartig, P.R.



In vivo Analysis of Choroid Plexus Morphogenesis in Zebrafish  

PubMed Central

Background The choroid plexus (ChP), a component of the blood-brain barrier (BBB), produces the cerebrospinal fluid (CSF) and as a result plays a role in (i) protecting and nurturing the brain as well as (ii) in coordinating neuronal migration during neurodevelopment. Until now ChP development was not analyzed in living vertebrates due to technical problems. Methodology/Principal Findings We have analyzed the formation of the fourth ventricle ChP of zebrafish in the GFP-tagged enhancer trap transgenic line SqET33-E20 (Gateways) by a combination of in vivo imaging, histology and mutant analysis. This process includes the formation of the tela choroidea (TC), the recruitment of cells from rhombic lips and, finally, the coalescence of TC resulting in formation of ChP. In Notch-deficient mib mutants the first phase of this process is affected with premature GFP expression, deficient cell recruitment into TC and abnormal patterning of ChP. In Hedgehog-deficient smu mutants the second phase of the ChP morphogenesis lacks cell recruitment and TC cells undergo apoptosis. Conclusions/Significance This study is the first to demonstrate the formation of ChP in vivo revealing a role of Notch and Hedgehog signalling pathways during different developmental phases of this process.

Fong, Steven H.; Ye, Zhang-Rui; Korzh, Vladimir



Clinicopathologic and immunohistochemical study of choroid plexus tumors: single-institution experience in Mexican population.  


In recent years, few studies have specifically focused on only histological features in choroid plexus tumors. We retrospectively reviewed the clinicopathologic and histological features in 37 patients with choroid plexus tumors and correlated these with glial fibrillary acidic protein (GFAP) expression and proliferation cell nuclear antigen (PCNA), p53, p21, and Rb labeling indexes, with special attention to tumor recurrence/regrowth. The study included 24 choroid plexus papillomas (CPPs), 4 atypical choroid plexus papillomas (ACPPs), and 9 choroid plexus carcinomas (CPCs). Patient age ranged from 15 to 70 years (mean 44 years). Most of the choroid plexus tumors were located in the IV ventricle. Recurrence was observed in 21 (52%) cases, 14 of which were CPP and 7 of which were CPC (P = 0.032). Histologic findings included major necrosis, fibrosis and psammoma bodies, amyloid deposits, inflammation, and thick vessels in recurrent tumors. The PCNA labeling index was 52.04 + or - 13.92 in CPPs, 76.50 + or - 17 in ACPPs, and 95.22 + or - 21.34 in CPCs (P = 0.009), and 67.43 + or - 28 in recurrent tumors. Similar values were found for p53, p21, and Rb. Furthermore, we observed that these presented more histological changes, adding, than nonrecurrent tumors, as well as a higher proliferation index of cell-cycle markers, and these were dependent predictor factors of survival. Recurrent tumors showed a different biological behavior than nonrecurrent tumors, but histological observations showed no mitotic features in order to consider them as grade II. PMID:20082118

Tena-Suck, Martha Lilia; Salinas-Lara, Citlaltepetl; Rembao-Bojórquez, Daniel; Castillejos, Manuel



Cryptococcal choroid plexitis: rare imaging findings of central nervous system cryptococcal infection in an immunocompetent individual  

PubMed Central

Central nervous system (CNS) cryptococcosis is a common opportunistic fungal infection in immunocompromised patients, and the imaging findings differ from those in immunocompetent patients. Here, we present the imaging findings in an immunocompetent woman of a rare case of central nervous system cryptococcal choroid plexitis with trapped temporal horns, enlarged enhancing bilateral choroid plexuses and multiple intraventricular choroid plexus cysts.

Kumari, R; Raval, M; Dhun, A



Biochemical parameters to assess choroid plexus dysfunction in Kearns-Sayre syndrome patients.  


Our aim was to assess biochemical parameters to detect choroid plexus dysfunction in Kearns-Sayre syndrome (KSS) patients. We studied CSF from 7 patients with KSS including total proteins, 5-methyltetrahydrofolate, homovanillic acid (HVA) and Selenium (Se) concentrations. High Se values, increased HVA and total protein concentrations and decreased 5-MTHF values were observed in all cases. This pattern seems very specific to KSS since it was only detected in 7 patients out of 1850 CSF samples analysed, and may represent a good biochemical model for evaluating choroid plexus dysfunction. The accumulated Se in CSF might have deleterious consequences such as toxicity effects. PMID:21745599

Tondo, Mireia; Málaga, Ignácio; O'Callaghan, Mar; Serrano, Mercedes; Emperador, Sonia; Ormazabal, Aida; Ruiz-Pesini, Eduardo; Montoya, Julio; Garcia-Silva, Maria T; Martin-Hernandez, Elena; Garcia-Cazorla, Angels; Pineda, Merce; Artuch, Rafael



Human choroid plexus papilloma cells efficiently transport glucose and vitamin C.  


In vitro and in vivo studies suggest that the basolateral membrane of choroid plexus cells, which is in contact with blood vessels, is involved in the uptake of the reduced form of vitamin C, ascorbic acid (AA), through the sodium-vitamin C cotransporter, (SVCT2). Moreover, very low levels of vitamin C were observed in the brains of SVCT2-null mice. The oxidized form of vitamin C, dehydroascorbic acid (DHA), is incorporated through the facilitative glucose transporters (GLUTs). In this study, the contribution of SVCT2 and GLUT1 to vitamin C uptake in human choroid plexus papilloma (HCPP) cells in culture was examined. Both the functional activity and the kinetic parameters of GLUT1 and SVCT2 in cells isolated from HCPP were observed. Finally, DHA uptake by GLUT1 in choroid plexus cells was assessed in the presence of phorbol-12-myristate-13-acetate (PMA)-activated human neutrophils. A marked increase in vitamin C uptake by choroid plexus cells was observed that was associated with superoxide generation and vitamin C oxidation (bystander effect). Thus, vitamin C can be incorporated by epithelial choroid plexus papilloma cells using the basolateral polarization of SVCT2 and GLUT1. This mechanism may be amplified with neutrophil infiltration (inflammation) of choroid plexus tumors. In choroid plexus papilloma cells, the vitamin C transporters SVCT2 and GLUT1 are polarized to the basolateral epithelial membrane, where SVCT2 is essential for AA flux from the blood vessels into the brain. However, neutrophils, attracted by inflammation or the tumor microenvironment, can oxidize extracellular AA to DHA, thereby enabling its uptake through GLUT1. For the first time, we show the in vivo and in vitro basolateral co-distribution of functional SVCT2 and GLUT1 in epithelial cells. We postulate that patients with choroid plexus papillomas may continue to transport vitamin C from the blood to CSF. However, increased transport of oxidized vitamin C could generate pro-oxidative conditions that may help control tumor growth. PMID:23647458

Ulloa, Viviana; García-Robles, María; Martínez, Fernando; Salazar, Katterine; Reinicke, Karin; Pérez, Fernando; Godoy, David F; Godoy, Alejandro S; Nualart, Francisco



Homeostatic capabilities of the choroid plexus epithelium in Alzheimer's disease  

PubMed Central

As the secretory source of vitamins, peptides and hormones for neurons, the choroid plexus (CP) epithelium critically provides substances for brain homeostasis. This distributive process of cerebrospinal fluid (CSF) volume transmission reaches many cellular targets in the CNS. In ageing and ageing-related dementias, the CP-CSF system is less able to regulate brain interstitial fluid. CP primarily generates CSF bulk flow, and so its malfunctioning exacerbates Alzheimers disease (AD). Considerable attention has been devoted to the blood-brain barrier in AD, but more insight is needed on regulatory systems at the human blood-CSF barrier in order to improve epithelial function in severe disease. Using autopsied CP specimens from AD patients, we immunocytochemically examined expression of heat shock proteins (HSP90 and GRP94), fibroblast growth factor receptors (FGFr) and a fluid-regulatory protein (NaK2Cl cotransporter isoform 1 or NKCC1). CP upregulated HSP90, FGFr and NKCC1, even in end-stage AD. These CP adjustments involve growth factors and neuropeptides that help to buffer perturbations in CNS water balance and metabolism. They shed light on CP-CSF system responses to ventriculomegaly and the altered intracranial pressure that occurs in AD and normal pressure hydrocephalus. The ability of injured CP to express key regulatory proteins even at Braak stage V/VI, points to plasticity and function that may be boosted by drug treatment to expedite CSF dynamics. The enhanced expression of human CP 'homeostatic proteins' in AD dementia is discussed in relation to brain deficits and pharmacology.

Johanson, Conrad; McMillan, Paul; Tavares, Rosemarie; Spangenberger, Anthony; Duncan, John; Silverberg, Gerald; Stopa, Edward



Effect of methylmercury administration on choroid plexus function in rats.  


Methylmercury (MeHg) is a well-known environmental neurotoxin. The choroid plexus (CP), the main component of the blood-cerebrospinal fluid (CSF) barrier (BCSFB), protects the brain from xenobiotics, similar to the blood-brain barrier. Because CP is considered a critical target site of MeHg-induced neurotoxic damage, functional alterations in CP may be caused in relation to the extent of MeHg-induced brain injury. To test this hypothesis, we examined time-dependent pathological alterations in rats administered subtoxic (asymptomatic group) or toxic (symptomatic group) MeHg doses for 3 weeks after the cessation of MeHg administration. We primarily assessed (1) mercury concentrations in the brain, CSF, and plasma; (2) histopathological changes in the brain; (3) albumin CSF/plasma concentration quotient (Q(alb)), an index of BCSFB dysfunction; and (4) concentration of CSF transthyretin (TTR), which is primarily produced in CP. Mercury concentrations in the brain, CSF, and plasma decreased, and Q(alb) and CSF TTR concentrations did not change significantly in the asymptomatic group. In the symptomatic group, brain and CSF mercury concentrations did not decrease for 2 weeks after the cessation of MeHg administration, but no pathological alteration occurred in the brain during this period. Pathological changes in the cerebellum became evident 3 weeks after the cessation of MeHg administration. Furthermore, Q(alb) continued to increase after the cessation of MeHg administration, whereas no decrease in CSF TTR concentration was observed, indicating selective impairment of CP function. These findings suggest that MeHg at toxic doses causes selective functional alteration of CP before leading to pathological alterations in the brain. PMID:21132277

Nakamura, Masaaki; Yasutake, Akira; Fujimura, Masatake; Hachiya, Noriyuki; Marumoto, Masumi



Choroid plexus carcinoma — responses to chemotherapy alone in newly diagnosed young children  

Microsoft Academic Search

Choroid plexus carcinoma (CPC) arising in the infant poses several treatment dilemmas. The tumor is often not totally resectable at presentation given its large size and tendency to invade adjacent brain. Because of its predisposition to regrow and metastasize, some form of postoperative cytotoxic therapy is required. Chemotherapy (CHT), as opposed to radiotherapy (RT), has 4 more desirable risk\\/benefit role

Jeffrey Allen; Jeffrey Wisoff; Larry Helson; Jennifer Pearce; Edward Arenson



Pathological and Immunohistochemical Studies of Choroid Plexus Carcinoma of the Dog  

Microsoft Academic Search

Choroid plexus carcinomas in four dogs (three male, one female) aged 2·5 to 10 years, were examined by light microscopy and immunohistochemistry. The dogs showed progressive neurological signs including ataxia, seizures, vestibular disease and cranial nerve deficits, lasting for several months in some cases. Primary tumours were localized in the lateral (one case), third (one case), and fourth (two cases)

C. Cantile; D. Campani; M. Menicagli; M. Arispici



Apocrine secretion by choroid plexus: isolated apical fragments synthesize protein in vitro  

SciTech Connect

Apocrine secretion was studied in the isolated rat choroid plexus. Choroid plexus explants were cultured for 1 and 16 hrs in minimal media containing S labeled methionine. Afterwards, the tissue was removed and the soluble and insoluble fractions of the incubation medium, as well as the tissue, were analyzed by transmission electron microscopy and SDS-PAGE followed by fluorography. When the explants were incubated for at least 1 hr, the nonsoluble fraction of the media contained cellular fragments morphologically similar to the apical region of the choroid plexus epithelium. An enriched fraction of these apical fragments (aposomes) was obtained and labeled with S methionine in minimal media for various periods of time. It was found that aposomes incorporated label linearly over a 22 hr period. In addition, the SDS-PAGE protein profile derived from this aposomal fraction was like the protein profile of CSF. The ratio of counts per DNA in the isolated aposomes indicated cells left in the aposomal fraction after removal of the choroid plexus contributed little to the incorporation of S methionine. The observation that aposomes are capable of protein synthesis suggests that aposomes may provide an additional route of entry for proteins into CSF.

Gudeman, D.; Nelson, S.R.; Merisko, E.M.



X-ray induced dysplasia in the developing telencephalic choroid plexus of mice exposed in utero  

SciTech Connect

Pregnant NMRI-mice were X-irradiated with single doses of 0.95 Gy (100 R) and 1.9 Gy (200 R) on day of gestation (dg) 12. For sampling, anesthetized animals were perfused with buffered glutaraldehyde solution or fixed by immersion in Karnovsky solution. LM, SEM, and TEM studies were carried out on brains prenatally and up to the age of 20 months to follow the radiation effects on the developing lateral choroid plexus. Radiation-induced changes were found using all three methods and at all stages studied. The normally sickle-shaped and stretched choroid plexus is shortened and irregular, and the dome-shaped plexus cells are flattened. Their superficial fine structures, i.e., the microvilli and cilia, are altered. Three stages of severity can be distinguished and the internal hydromicrocephalus increases from stage I to III. Intercellular spaces of the treated plexus epithelium are often dilated, but the tight junctions at the ventricular surface seem to be intact. The interstitium shows large dilations in comparison with the controls. Thus, gross changes and alterations in the fine structure can be induced in the choroid plexus by doses of 0.95 Gy and 1.9 Gy, which persist throughout postnatal life.

Heinzmann, U.



Iodine 125-lysergic acid diethylamide binds to a novel serotonergic site on rat choroid plexus epithelial cells  

SciTech Connect

/sup 125/I-Lysergic acid diethylamide (/sup 125/I-LSD) binds with high affinity to serotonergic sites on rat choroid plexus. These sites were localized to choroid plexus epithelial cells by use of a novel high resolution stripping film technique for light microscopic autoradiography. In membrane preparations from rat choroid plexus, the serotonergic site density was 3100 fmol/mg of protein, which is 10-fold higher than the density of any other serotonergic site in brain homogenates. The choroid plexus site exhibits a novel pharmacology that does not match the properties of 5-hydroxytryptamine-1a (5-HT1a), 5-HT1b, or 5-HT2 serotonergic sites. /sup 125/I-LSD binding to the choroid plexus site is potently inhibited by mianserin, serotonin, and (+)-LSD. Other serotonergic, dopaminergic, and adrenergic agonists and antagonists exhibit moderate to weak affinities for this site. The rat choroid plexus /sup 125/I-LSD binding site appears to represent a new type of serotonergic site which is located on non-neuronal cells in this tissue.

Yagaloff, K.A.; Hartig, P.R.



Fetal tumors of the choroid plexus: is differential diagnosis between papilloma and carcinoma possible?  


Fetal choroid plexus tumors are uncommon. The prognosis is widely variable and depends on the histological findings: papilloma or carcinoma. We report a case of prenatal diagnosis of choroid plexus mass detected by ultrasound at 33 weeks of gestation. Prenatal (T1, T2, T2* and diffusion weighted sequences) magnetic resonance imaging (MRI) was used to rule out a hematoma. Follow-up examination by ultrasound and MRI revealed a significant increase in the volume of the mass, suggesting a diagnosis of malignant tumor. A healthy neonate was delivered by Cesarean section at 38 weeks of gestation. Full surgical excision of the tumor was performed at 20 days after delivery and histological analysis revealed a papilloma. PMID:21800389

Anselem, O; Mezzetta, L; Grangé, G; Zerah, M; Benard, C; Marcou, V; Fallet-Bianco, C; Adamsbaum, C; Tsatsaris, V



A rare case of papillary carcinoma of choroids plexus: Its management and review of literature  

PubMed Central

Papillary carcinoma of choroids plexus is very rare. Only a few cases have been described in the literature, and it is most commonly found in the pediatric population. A further observation is added now. A 20-year-old lady presented with complaints of headache and vomiting from past one and half months, headache was increasing in severity and there was relief after vomiting. On examination, no abnormality was detected in any of her systems. The patient underwent computed tomography scan of brain, which showed space occupying lesion in the right frontal lobe. She underwent near total excision of the lesion. Postoperative period was uneventful. Histopathology was suggestive of papillary carcinoma of choroids plexus and was confirmed with immunohistochemistry. The patient received whole brain radiation and intrathecal chemotherapy. The patient tolerated the treatment well, except for grade two vomiting. She has completed one and half years of follow-up and is disease free.

Mukesh, S.; Janaki, M. G.; Ponni, Arul; Murali, S.



A sacro-caudal spinal cord choroid plexus papilloma in a shar-pei dog.  


A seven-year-old shar-pei dog was referred because of severe lumbosacral pain and faecal incontinence of 20 days' duration. Neurological examination was characterised by plegic tail, absence of perineal reflex, dilated anus, perineum and tail analgesia, and severe lumbosacral pain. The neurological clinical signs were suggestive of a selective lesion involving sacral and caudal spinal cord segments and/or related nerve roots. A magnetic resonance imaging of lumbosacral spine was performed and was suggestive of an intradural lesion. Primary or secondary neoplasia was considered as the most probable differential diagnosis. The dog was euthanased upon the owner's request. Histopathological examination confirmed the presence of an intradural-extramedullary neoplastic tissue enveloping intradural tract of spinal nerve roots. On the basis of histological and immunohistochemical findings, a diagnosis of well-differentiated choroid plexus papilloma was made. To the authors's knowledge, this is the first case of primary or metastatic spinal choroid plexus papilloma in dogs. PMID:23731182

Giannuzzi, A Pasquale; Gernone, F; Ricciardi, M; De Simone, A; Mandara, M Teresa



Inflammation of the Choroid Plexus and Ependymal Layer of the Ventricle Following Intraventricular Hemorrhage  

Microsoft Academic Search

Intraventricular hemorrhage (IVH), which afflicts thousands of people of all ages every year, frequently results in the development\\u000a of communicating hydrocephalus. Classically, IVH-induced hydrocephalus has been attributed to reduced resorption of cerebrospinal\\u000a fluid (CSF) due to dysfunction of arachnoid granulations, but this explanation may be incomplete. We hypothesized that IVH\\u000a would cause inflammation of the choroid plexus and of the

Philippe F. Simard; Cigdem Tosun; Ludmila Melnichenko; Svetlana Ivanova; Volodymyr Gerzanich; J. Marc Simard



Differential effects of chloroquine and of several other amphiphilic cationic drugs upon rat choroid plexus  

Microsoft Academic Search

Several cationic amphiphilic drugs, each of which is known to induce generalized lipidosis in rats, were compared with respect to their cytological effects on rat choroid plexus epithelium. Chloroquine induced large cytoplasmic vacuoles, whereas the other drugs (quinacrine, 4,4'-diethylaminoethoxyhexestrol, chlorphentermine, iprindole, 1-chloro-amitriptyline, clomipramine) caused formation of lamellated or crystalloid inclusions as usually seen in drug-induced lipidosis. The ultrastructure of the

W. Frisch; R. Lfillmann-Rauch



DNA methylation patterns of the CDH1, RARB, and SFN genes in choroid plexus tumors  

Microsoft Academic Search

Genetic and epigenetic alterations in choroid plexus tumors, a rare neuroepithelial neoplasm most frequently detected in children, are poorly characterized. Epigenetic silencing associated with aberrant CpG island methylation is one mechanism leading to the loss of tumor suppressor functions in cancer cells. Using methylation-specific polymerase chain reaction, the methylation patterns of the genes CDH1 (E-cadherin), RARB (retinoic acid receptor, beta),

Roberta Losi-Guembarovski; Hellen Kuasne; Alda L. Guembarovski; Cláudia A. Rainho; Ilce M. S. Cólus



Enhanced Prospects for Drug Delivery and Brain Targeting by the Choroid Plexus–CSF Route  

Microsoft Academic Search

The choroid plexus (CP), i.e., the blood–cerebrospinal fluid barrier (BCSFB) interface, is an epithelial boundary exploitable for drug delivery to brain. Agents transported from blood to lateral ventricles are convected by CSF volume transmission (bulk flow) to many periventricular targets. These include the caudate, hippocampus, specialized circumventricular organs, hypothalamus, and the downstream pia–glia and arachnoid membranes. The CSF circulatory system

Conrad E. Johanson; John A. Duncan; Edward G. Stopa; Andrew Baird



Natural Simian Virus 40 Strains Are Present in Human Choroid Plexus and Ependymoma Tumors  

Microsoft Academic Search

Simian virus 40 (SV40) sequences for large tumor antigen (T-ag) were recently detected in a significant fraction of certain human brain tumors of early childhood (Bergsagel et al., N. Engl. J. Med. 326, 988-993, 1992). In the current study, we sought to determine whether authentic SV40 was present in the choroid plexus and ependymoma tumors previously examined. Polymerase chain reaction

John A. Lednicky; Robert L. Garcea; Daniel J. Bergsagel; Janet S. Butel



Transport of cefodizime, a novel third generation cephalosporin antibiotic, in isolated rat choroid plexus  

SciTech Connect

To characterize the transport system by which cephalosporin antibiotics are accumulated by the choroid plexus, kinetic analysis of cefodizime transport was performed. Accumulation of cefodizime was against an electrochemical potential gradient via a saturable process (Km = 470 microM, Vmax = 174 nmol/ml of tissue per min) that was inhibited by metabolic inhibitors (KCN and 2,4-dinitrophenol), hypothermia, a sulfhydryl reagent (p-hydroxymer-curibenzoic acid) and anion transport inhibitors (probenecid and 4,4'-diisothiocyanostilbene -2,2'-disulfonic acid). Accumulation of cefodizime was inhibited competitively by benzylpenicillin with an inhibition constant of aproximately 100 microM. Cefodizime inhibited competitively the accumulation of benzylpenicillin with an inhibition constant of approximately 500 microM. Kinetic analysis using 16 kinds of beta-lactam antibiotics also supported the view (1) that the transport system of cefodizime is shared by benzylpenicillin and (2) that these beta-lactam antibiotics are transported via a common transport system. These findings indicate that the major transport system of cephalosporin antibiotics in the rat choroid plexus is via a carrier-mediated active anion transport process. The affinity of beta-lactam antibiotics for this transport system in the choroid plexus may be a major factor in determining their pharmacokinetics in the cerebrospinal fluid.

Nohjoh, T.; Suzuki, H.; Sawada, Y.; Sugiyama, Y.; Iga, T.; Hanano, M.



Defense of mammalian body against heavy metal-induced toxicities: Sequestration by the choroid plexus and elimination via the bile  

SciTech Connect

Tissue sequestration and biliary elimination are two of the important mechanisms by which mammalian body defends against heavy metal insults. In rats or rabbits that had received Pb, Cd, Hg, As and [sup 210]Po, these metal ions were sequestered in the choroid plexus at concentrations of Pb, Cd, Hg, As and Po that were 57, 33, 12, 13 and 5 times higher, respectively, than those found in the brain cortex. In addition, the concentrations of these heavy metal ions were many fold greater in the choroid plexus than in the CSF or blood. The accumulation of Pb in the choroid plexus was dose-dependent and time-related. When the choroid plexus was incubated, in vitro, with ouabain, the latter significantly inhibited the uptake of Cd from the CSF side of the choroid plexus. Cystine concentration was four times greater in the choroid plexus than in brain cortex. Results suggest that the choroid plexus sequesters toxic metal and metalloid ions. It appears to do this in order to protect the CSF and brain from toxic heavy metals in the blood. The effects of N-(2,3-dimercaptopropyl)phthalamidic acid (DMPA), meso-dimercaptosuccinic acid (DMSA) and 2,3-dimercapto-1-propane sulfonic acid (DMPS) on biliary excretion of Cd was studied in rat chronic intoxication mode. DMPA (0.10 mmol/kg, iv), when given to rats three days after exposure to Cd, elicited within 30 min a 20-fold increase in biliary Cd excretion. GSH in rat bile was also increased three fold as compared to control. Neither DMSA nor DMPS increased biliary Cd or GSH. Upon iv administration, DMPA, not DMSA, appeared in bile. An altered, presumably disulfide, form of DMPS was also found in bile. Incubation of DMPA or DMSA with Cd-saturated MT resulted in the removal of Cd from MT. DMPS, however, promoted the formation of MT polymers. DMPA protected biliary GSH from autoxidation.

Zheng Wei.



Transport of L-[125I]thyroxine by in situ perfused ovine choroid plexus: inhibition by lead exposure.  


Lead (Pb) exposure hinders brain development in children by mechanisms that remain unknown. Previous evidence shows that sequestration of Pb in the choroid plexus lowers the production and secretion of transthyretin (TTR), a thyroxine (T4) transport protein, from the choroid plexus into the cerebrospinal fluid (CSF). This study was undertaken to characterize the uptake kinetics of T4 by the choroid plexus and to determine if in vivo Pb exposure altered the T4 uptake in an in situ perfused ovine choroid plexus model. Sheep received i.p. injections of Pb acetate (20 mg Pb/kg) or Na acetate (as the controls) every 48 h for a period of 16 d. The [125I]T4 uptake was determined by a paired-tracer perfusion method using 0.5 microCi [125I]T4 and 2 microCi [14C]mannitol at various concentrations of unlabeled T4 (trace to 20 microM). The flux of [125I]T4 into the choroid plexus followed Michaelis-Menten kinetics with the maximum flux (Vmax) of 56.6 nmol/min/g and half-saturation constant (Km) of 10.7 mumol/L, suggesting an evident saturable influx of T4 into the choroid epithelium. In vivo Pb exposure in these sheep resulted in a significant accumulation of Pb in the choroid plexus and hippocampus. Pb treatment diminished the Vmax by 63.7% of control, but did not alter Km. The maximal cellular uptake (Umax) and net uptake (Unet) in Pb-treated animals were 2.1-fold and 1.9-fold, respectively, lower than those of control. Exposure to Pb, however, did not significantly change the flow rate through the choroid plexus. Data suggest that the choroid plexus may serve as a significant site for T4 transport into the CSF, and Pb exposure may hinder the influx of T4 from the blood into the choroid plexus. PMID:12712631

Zheng, Wei; Deane, Rashid; Redzic, Zoran; Preston, Jane E; Segal, Malcolm B



Choroid plexus epithelial monolayers - a cell culture model from porcine brain  

PubMed Central

Background The goal of the present study was to develop an in vitro choroid plexus (CP) epithelial cell culture model for studying transport of protein-mediated drug secretion from blood to cerebrospinal fluid (CSF) and vice versa. Methods Cells were isolated by mechanical and enzymatic treatment of freshly isolated porcine plexus tissue. Epithelial cell monolayers were grown and CSF secretion and transepithelial resistance were determined. The expression of f-actin as well as the choroid plexus marker protein transthyretin (TTR), were assessed. The expression of the export proteins p-glycoprotein (Pgp, Abcb1) and multidrug resistance protein 1 (Mrp1, Abcc1) was studied by RT-PCR, Western-blot and immunofluorescence techniques and their functional activity was assessed by transport and uptake experiments. Results Choroid plexus epithelial cells were isolated in high purity and grown to form confluent monolayers. Filter-grown monolayers displayed transendothelial resistance (TEER) values in the range of 100 to 150 ?cm2. Morphologically, the cells showed the typical net work of f-actin and expressed TTR at a high rate. The cultured cells were able to secrete CSF at a rate of 48.2 ± 4.6 ?l/cm2/h over 2–3 hours. The ABC-export protein Mrp1 was expressed in the basolateral (blood-facing) membranes of cell monolayers and intact tissue. P-glycoprotein showed only low expression within the apical (CSF directed) membrane but was located more in sub-apical cell compartments. This finding was paralleled by the lack of directed excretion of p-glycoprotein substrates, verapamil and rhodamine 123. Conclusion It was demonstrated that CP epithelium can be isolated and cultured, with cells growing into intact monolayers, fully differentiating and with properties resembling the tissue in vivo. Thus, the established primary porcine CP model, allowing investigation of complex transport processes, can be used as a reliable tool for analysis of xenobiotic transport across the blood-cerebrospinal fluid barrier (BCSFB).

Baehr, Carsten; Reichel, Valeska; Fricker, Gert



Transport of L-[ 125 I]Thyroxine bY iN Situ Perfused Ovine Choroid Plexus: Inhibition by Lead Exposure  

Microsoft Academic Search

Lead (Pb) exposure hinders brain development in children by mechanisms that remain unknown. Previous evidence shows that sequestration of Pb in the choroid plexus lowers the production and secretion of transthyretin (TTR), a thyroxine (T 4 ) transport protein, from the choroid plexus into the cerebrospinal fluid (CSF). This study was undertaken to characterize the uptake kinetics of T 4

Wei Zheng; Rashid Deane; Zoran Redzic; Jane Preston; Malcolm Segal



Regulatory volume increase in epithelial cells isolated from the mouse fourth ventricle choroid plexus involves Na +–H + exchange but not Na +–K +–2Cl ? cotransport  

Microsoft Academic Search

The aim of this study was to determine the ability of choroid plexus epithelial cells to volume regulate when exposed to hypertonic solutions, and furthermore to identify the ion transporters involved in any volume regulation. Experiments were performed on cells freshly isolated, using the enzyme dispase, from the mouse fourth ventricle choroid plexus. Cell volume was measured using a video-imaging

Alexandra L. H. Hughes; Antonina Pakhomova; Peter D. Brown



Dexamethasone prevents alteration of tight junction-associated proteins and barrier function in porcine choroid plexus epithelial cells after infection with Streptococcus suis in vitro  

Microsoft Academic Search

Apart from antibiotic treatment in bacterial meningitis supportive therapy including dexamethasone is widely used. In investigations on the pathogenesis of bacterial meningitis we previously demonstrated that Streptococcus suis (S. suis), a relevant cause of bacterial meningitis in pigs and humans, affects porcine choroid plexus epithelial cell (PCPEC) barrier function. The choroid plexus epithelium constitutes the structural basis of the blood-CSF

Tobias Tenenbaum; David Matalon; Rüdiger Adam; Annette Seibt; Corinna Wewer; Christian Schwerk; Hans-Joachim Galla; Horst Schroten



Na+-coupled bicarbonate transporters in duodenum, collecting ducts and choroid plexus.  


Epithelia cover the internal and external surfaces of the organism and form barriers between the various compartments. Some of these epithelia are specialized for effective transmembrane or even transepithelial movement of acid-base equivalents. Certain epithelia with a high rate of HCO3- transport express a few potent Na+-coupled acid-base transporters to gain a net HCO3- movement across the epithelium. Examples of such epithelia are renal proximal tubules and pancreatic ducts. In contrast, multiple Na+-coupled HCO3- transporters are expressed in other HCO3- secreting epithelia, such as the duodenal mucosa or the choroid plexus, which maintain suitable intracellular pH despite a variable demand for secreting HCO3-. In the duodenum, the epithelial cells must secrete HCO3- for neutralization of the gastric acid, and at the same time prevent cellular acidification. During the neutralization, large quantities of CO2 are formed in the duodenal lumen, which enter the epithelial cells. This would tend to lower intracellular pH and require effective counteracting mechanisms to avoid cell death and to maintain HCO3- secretion. The choroid plexus secretes the cerebrospinal fluid (CSF) and controls the pH of the otherwise poorly buffered CSF. The pCO2 of CSF fluctuates with plasma pCO2, and the choroid plexus must regulate the HCO3- secretion to minimize the effects of these fluctuations on CSF pH. This is done while maintaining pH neutrality in the epithelial cells. Thus, the Na+-HCO3- cotransporters appear to be involved in HCO3- import in more epithelia, where Na+/H+ exchangers were until recently thought to be sufficient for maintaining intracellular pH. PMID:21170886

Praetorius, Jeppe


Cimetidine transport in isolated brush border membrane vesicles from bovine choroid plexus  

SciTech Connect

The purpose of this study was to elucidate the mechanisms involved in the transport of cimetidine across the brush border membrane of choroid plexus epithelium. Brush border membrane vesicles were prepared from bovine choroid plexus and the uptake of (3H)cimetidine was studied using the methods of rapid vacuum filtration and scintillation counting. Cimetidine accumulated in the vesicles with time reaching equilibrium within 2 hr. The amount of cimetidine taken up by the vesicles at equilibrium decreased with increasing extravesicular media osmolarity suggesting that cimetidine accumulates in an osmotically reactive intravesicular space. Binding of cimetidine to the membrane was estimated to be less than 18%. Michaelis-Menten studies demonstrated that cimetidine transport involved both a saturable and a nonsaturable component. The Vmax and Km (mean +/- S.E.) were 16.7 +/- 5.9 pmol/sec/mg protein and 58.1 +/- 3.1 microM, respectively, suggesting that cimetidine is transported across the choroid plexus brush border membrane with a lower affinity and a higher capacity than across the renal brush border membrane. The organic cation, quinidine (0.1 mM), and the amino acid, histidine (20 mM), both significantly reduced the initial, but not the equilibrium, uptake of cimetidine. However, high concentrations (5 mM) of more polar organic cations including tetraethylammonium, as well as of several organic anions including salicylate did not inhibit cimetidine transport. Studies with unlabeled cimetidine revealed a countertransport phenomenon. Attempts to drive the concentrative uptake of cimetidine with various ion gradients were unsuccessful. Of note was the fact that an outwardly directed proton gradient could significantly accelerate the uptake of cimetidine.

Whittico, M.T.; Gang, Y.A.; Giacomini, K.M. (Univ. of California, San Francisco (USA))



The role of the choroid plexus in neutrophil invasion after traumatic brain injury  

PubMed Central

Traumatic brain injury (TBI) frequently results in neuroinflammation, which includes the invasion of neutrophils. After TBI, neutrophils infiltrate the choroid plexus (CP), a site of the blood-cerebrospinal fluid (CSF) barrier (BCSFB), and accumulate in the CSF space near the injury, from where these inflammatory cells may migrate to brain parenchyma. We have hypothesized that the CP functions as an entry point for neutrophils to invade the injured brain. Using the controlled cortical impact model of TBI in rats and an in vitro model of the BCSFB, we show that the CP produces CXC chemokines, such as cytokine-induced neutrophil chemoattractant (CINC)-1 or CXCL1, CINC-2? or CXCL3, and CINC-3 or CXCL2. These chemokines are secreted both apically and basolaterally from choroidal epithelium, a prerequisite for neutrophil migration across epithelial barriers. Consistent with these findings, we also provide electron microscopic evidence that neutrophils infiltrate the choroidal stroma and subsequently reach the intercellular space between choroidal epithelial cells. This is the first detailed analysis of the BCSFB function related to neutrophil trafficking. Our observations support the role of this barrier in post-traumatic neutrophil invasion.

Szmydynger-Chodobska, Joanna; Strazielle, Nathalie; Zink, Brian J.; Ghersi-Egea, Jean-Francois; Chodobski, Adam



Synchrotron radiation dichromographic imaging of the extra- and intracranial arterial circulations and choroid plexus  

NASA Astrophysics Data System (ADS)

This communication proposes the use of synchrotron radiation based k-edge dichromographic imaging for the simultaneous study of the extracranial and intracranial arterial circulations following a single peripheral intravenous injection of a contrast agent. This approach can provide images of the vertebral arteries, the common, external and internal carotid arteries, as well as the intracranial arteries, during a single scanning procedure, lasting only a few seconds, requiring an X-ray exposure on the order of about 30mGy/image. The method has specific advantages for the evaluation of the perfusion of the choroid plexus.

Rubenstein, E.



The kinetics of tiazofurin uptake by the isolated perfused choroid plexus of the sheep.  


Tiazofurin (TZF-beta-D-ribofuronosyl thiazole-4-carboxamide, NSC-286193) is a synthetic nucleoside analog with potent antitumor activity. Isolated choroid plexuses (CP) of sheep were perfused in situ and the uptake of [3H]-tiazofurin was determined in relation to the recovery of [14C]-mannitol by means of the paired indicator dilution technique. The maximal uptake of tiazofurin was 8.29 +/- 0.84% and was shown to be both carrier-mediated, sodium-dependent and inhibited by adenosine which suggests that it uses the carrier for endogenous nucleosides. However, the total tiazofurin uptake into the choroid plexus was negligible (0.93 +/- 1.97%) as a result of a high backflux, indicating that tiazofurin is not trapped within the cells of the CP to any significant degree. The kinetics for the uptake into the CP were more favorable than for its passage across the blood-brain barrier with a Km of 7.71 +/- 1.42 microM, a Vmax of 1.30 +/- 0.05 microM/min/g and a negligible constant of a free diffusion (Kd) which suggests that the CP/CSF route may act as an alternative pathway into the brain. PMID:10893696

Redzic, Z B; Segal, M B; Gasic, J M; Markovic, I D; Isakovic, A; Rakic, L M



The role of the cat choroid plexus in regulating cerebrospinal fluid magnesium.  

PubMed Central

1. The regulation of c.s.f. Mg concentration was studied using the cat choroid plexus isolated in a chamber in situ. 2. An increase in plasma Mg concentration was accompanied by the usual reciprocal decrease in plasma Ca concentration. Chamber fluid Ca concentration was unaffected. 3. Hypermagnesemia (plasma Mg concentration greater than 6 m-equiv/1.) caused relatively small increases in c.s.f. Mg concentration (delta plasma [Mg]/ delta c.s.f. [Mg] = 4). 4. Various chamber fluid Mg concentrations (0, 2.4 or 4.8 m-equiv/1.) were rapidly (within 30--60 min) returned to near the control value of 1.83 m-equiv/1. 5. When plasma and chamber fluid Mg concentrations were altered simultaneously, the final chamber fluid Mg concentration was returned towards normal with or against a concentration gradient. 6. The data indicate that the choroid plexus is involved in maintaining the constancy of the c.s.f. Mg concentration by sensing changes in the normal c.s.f. Mg concentration and altering approximately its rate of active secretion of Mg.

Reed, D J; Yen, M H



The fodrin-ankyrin cytoskeleton of choroid plexus preferentially colocalizes with apical Na+K(+)-ATPase rather than with basolateral anion exchanger AE2.  

PubMed Central

A unique feature of the choroid plexus as a single-layer epithelium is its localization of Na+K(+)-ATPase at its apical (lumenal) surface. In contrast, a band 3 (AE1)-related anion exchanger protein has been localized to the basolateral surface of the choroid plexus. Both Na+K(+)-ATPase and AE1 in other tissues have been shown to bind via ankyrin to the spectrin-actin-based membrane cytoskeleton. Since linkage of integral membrane proteins to the membrane cytoskeleton is important for their restriction to specialized domains of the cell surface, we investigated the polarity of the choroid plexus membrane cytoskeleton. We developed isoform-specific antibodies to confirm the identity of choroid plexus band 3-related polypeptide as AE2. We demonstrated that ankyrin, fodrin/spectrin, actin, myosin, and alpha-actinin are predominantly apical in choroid plexus and preferentially colocalize with apical Na+K(+)-ATPase rather than with basolateral anion exchanger AE2. Colchicine administration did not alter the polarity of apical cytoskeletal and transport proteins or basolateral AE2 in choroid plexus, suggesting that biosynthetic targeting of these proteins is not microtubule dependent. In choroid plexus papilloma, Na+K(+)-ATPase and AE2 were decreased in amount and failed to preserve their polarized distributions. Images

Alper, S L; Stuart-Tilley, A; Simmons, C F; Brown, D; Drenckhahn, D



The characteristics of nucleobase transport and metabolism by the perfused sheep choroid plexus.  


The uptake of nucleobases was investigated across the basolateral membrane of the sheep choroid plexus perfused in situ. The maximal uptake (U(max)) for hypoxanthine and adenine, was 35.51+/-1.50% and 30.71+/-0.49% and for guanine, thymine and uracil was 12.00+/-0.53%, 13.07+/-0.48% and 12.30+/-0.55%, respectively with a negligible backflux, except for that of thymine (35.11+/-5.37% of the U(max)). HPLC analysis revealed that the purine nucleobase hypoxanthine and the pyrimidine nucleobase thymine can pass intact through the choroid plexus and enter the cerebrospinal fluid CSF so the lack of backflux for hypoxanthine was not a result of metabolic trapping in the cell. Competition studies revealed that hypoxanthine, adenine and thymine shared the same transport system, while guanine and uracil were transported by a separate mechanism and that nucleosides can partially share the same transporter. HPLC analysis of sheep CSF collected in vivo revealed only two nucleobases were present adenine and hypoxanthine; with an R(CSF/Plasma) 0.19+/-0.02 and 3.43+/-0.20, respectively. Xanthine and urate, the final products of purine catabolism, could not be detected in the CSF even in trace amounts. These results suggest that the activity of xanthine oxidase in the brain of the sheep is very low so the metabolic degradation of purines is carried out only as far as hypoxanthine which then accumulates in the CSF. In conclusion, the presence of saturable transport systems for nucleobases at the basolateral membrane of the choroidal epithelium was demonstrated, which could be important for the distribution of the salvageable nucleobases, adenine and hypoxanthine in the central nervous system. PMID:11146053

Redzic, Z B; Segal, M B; Gasic, J M; Markovic, I D; Vojvodic, V P; Isakovic, A; Thomas, S A; Rakic, L M



Atypical transformation in sacral drop metastasis from posterior fossa choroid plexus papilloma.  


Choroid plexus papillomas (CPP) are rare tumours and spinal metastases of CPP are even less common. We report a 50-year-old woman with spinal drop metastases at Th9 and S1-2 6 years after total resection of a posterior fossa CPP. The metastasis at S1-2 was resected and histological examination showed transformation to an atypical CPP. Atypical transformation in a metastasis years after resection of a benign posterior fossa CPP has been described once. We would like to advocate craniospinal MRI at the time of initial diagnosis as well as periodic follow-up after total and subtotal resection of a posterior fossa CPP in adults at least once in 1 or 2 years, depending on the histological grading of the primary CPP. In our case report, this could have resulted in earlier diagnosis of the locoregional recurrence or of the spinal drop metastasis. PMID:22922909

Stuivenvolt, Mischa; Mandl, Ellen; Verheul, Jeroen; Fleischeuer, Ruth; Tijssen, Cees C



Altered pH(i) regulation and Na(+)/HCO3(-) transporter activity in choroid plexus of cilia-defective Tg737(orpk) mutant mouse.  


Tg737(orpk) mice have defects in cilia assembly and develop hydrocephalus in the perinatal period of life. Hydrocephalus is progressive and is thought to be initiated by abnormal ion and water transport across the choroid plexus epithelium. The pathology is further aggravated by the slow and disorganized beating of motile cilia on ependymal cells that contribute to decreased cerebrospinal fluid movement through the ventricles. Previously, we demonstrated that the hydrocephalus phenotype is associated with a marked increase in intracellular cAMP levels in choroid plexus epithelium, which is known to have regulatory effects on ion and fluid movement in many secretory epithelia. To evaluate whether the hydrocephalus in Tg737(orpk) mutants is associated with defects in ion transport, we compared the steady-state pH(i) and Na(+)-dependent transport activities of isolated choroid plexus epithelium tissue from Tg737(orpk) mutant and wild-type mice. The data indicate that Tg737(orpk) mutant choroid plexus epithelium have lower pH(i) and higher Na(+)-dependent HCO(3)(-) transport activity compared with wild-type choroid plexus epithelium. In addition, wild-type choroid plexus epithelium could be converted to a mutant phenotype with regard to the activity of Na(+)-dependent HCO(3)(-) transport by addition of dibutyryl-cAMP and mutant choroid plexus epithelium toward the wild-type phenotype by inhibiting PKA activity with H-89. Together, these data suggest that cilia have an important role in regulating normal physiology of choroid plexus epithelium and that ciliary dysfunction in Tg737(orpk) mutants disrupts a signaling pathway leading to elevated intracellular cAMP levels and aberrant regulation of pH(i) and ion transport activity. PMID:17182727

Banizs, Boglarka; Komlosi, Peter; Bevensee, Mark O; Schwiebert, Erik M; Bell, Phillip D; Yoder, Bradley K



Maturation of Rb+ and PAH accumulation by rabbit anterior uvea and choroid plexus  

SciTech Connect

In vitro accumulation of radioactive para-aminohippuric acid (/sup 3/H-PAH) and rubidium (/sup 86/Rb+) by the anterior uvea, ciliary processes, and the choroid plexus was evaluated in tissues from newborn and various aged rabbits. Accumulation of PAH was present in the anterior uvea at 1 day of age (tissue to media ratio, T/M, of 2.1 +/- 0.2) and remained at this level for the first 14 days of life. Accumulation did not rise to adult levels until 21 days of age (T/M 5.5 +/- 0.6). Rubidium accumulation in the anterior uvea, a measure of Na+, K+-pump activity, was higher than adult values 6 hr after birth (T/M25.2 +/- 0.9). Activity remained elevated through day 28 and did not fall to adult levels until day 60 (T/M 13.4 +/- 0.6). Accumulation studies on isolated ciliary processes were similar to those obtained from anterior uveal tissue. Daily subcutaneous injections of penicillin (300,000 units/kg/day) for 1 week had no effect on anterior uvea PAH accumulation (penicillin T/M was 1.7 +/- 0.1 and saline control T/M was 2.0 +/- 0.2). Accumulation of either /sup 3/H-PAH or /sup 86/Rb+ by the choroid plexus was present 1 day after birth in amounts that were similar to adult values and did not change during the 90 days of testing.

Krupin, T.; Fritz, C.; Becker, B.



Choroid Plexus  


... ventricle tumors tend to be found in very young children. Fourth ventricle and cerebellopontine angle tumors (the angle between the cerebrum and the pons of the brain stem) generally occur in patients ages 20-35. ...


Multi-sensor arrays for online monitoring of cell dynamics in in vitro studies with choroid plexus epithelial cells.  


Sensors and multi-sensor arrays are the basis of new technologies for the non-label monitoring of cell activity. In this paper we show that choroid plexus cells can be cultured on silicon chips and that sensors register in real time changes in their activity, constituting an interesting experimental paradigm for cell biology and medical research. To validate the signals recorded (metabolism = peri-cellular acidification, oxygen consumption = respiration; impedance = adhesion, cell shape and motility) we performed experiments with compounds that act in a well-known way on cells, influencing these parameters. Our in vitro model demonstrates the advantages of multi-sensor arrays in assessment and experimental characterization of dynamic cellular events--in this case in choroid plexus functions, however with applicability to other cell types as well. PMID:22438715

Mestres-Ventura, Pedro; Morguet, Andrea; de las Heras, Soledad García Gómez



Comparison of the global gene expression of choroid plexus and meninges and associated vasculature under control conditions and after pronounced hyperthermia or amphetamine toxicity  

PubMed Central

Background The meninges (arachnoid and pial membranes) and associated vasculature (MAV) and choroid plexus are important in maintaining cerebrospinal fluid (CSF) generation and flow. MAV vasculature was previously observed to be adversely affected by environmentally-induced hyperthermia (EIH) and more so by a neurotoxic amphetamine (AMPH) exposure. Herein, microarray and RT-PCR analysis was used to compare the gene expression profiles between choroid plexus and MAV under control conditions and at 3?hours and 1?day after EIH or AMPH exposure. Since AMPH and EIH are so disruptive to vasculature, genes related to vasculature integrity and function were of interest. Results Our data shows that, under control conditions, many of the genes with relatively high expression in both the MAV and choroid plexus are also abundant in many epithelial tissues. These genes function in transport of water, ions, and solutes, and likely play a role in CSF regulation. Most genes that help form the blood–brain barrier (BBB) and tight junctions were also highly expressed in MAV but not in choroid plexus. In MAV, exposure to EIH and more so to AMPH decreased the expression of BBB-related genes such as Sox18, Ocln, and Cldn5, but they were much less affected in the choroid plexus. There was a correlation between the genes related to reactive oxidative stress and damage that were significantly altered in the MAV and choroid plexus after either EIH or AMPH. However, AMPH (at 3?hr) significantly affected about 5 times as many genes as EIH in the MAV, while in the choroid plexus EIH affected more genes than AMPH. Several unique genes that are not specifically related to vascular damage increased to a much greater extent after AMPH compared to EIH in the MAV (Lbp, Reg3a, Reg3b, Slc15a1, Sct and Fst) and choroid plexus (Bmp4, Dio2 and Lbp). Conclusions Our study indicates that the disruption of choroid plexus function and damage produced by AMPH and EIH is significant, but the changes may not be as pronounced as they are in the MAV, particularly for AMPH. Expression profiles in the MAV and choroid plexus differed to some extent and differences were not restricted to vascular related genes.



Kinetics of nucleoside uptake by the basolateral side of the sheep choroid plexus epithelium perfused in situ.  


Sheep choroid plexus epithelium expresses equilibrative nucleoside transporters (ENT) 1 and 2 and concentrative nucleoside transporter 2 at the transcript level. This study aimed to explore the kinetics and functional role of these transporters at the basolateral side of the sheep choroid plexus epithelium perfused in situ. The cellular uptake of [(3)H]adenosine and [(3)H]uridine was insensitive to 1 microm nitrobenzylthioinosine (NBTI), and the uptake of [(3)H]adenosine was reduced significantly when 10 microm NBTI was present in low-Na(+) Ringer solution. This might suggest that ENT2, a transporter sensitive to micromolar NBTI, is functionally active at the basolateral side of the choroid plexus epithelium while ENT1, a transporter sensitive to nanomolar NBTI, is not active. When low-Na(+) Ringer solution was used for the in situ perfusion, the Na(+) concentration in the venous effluent decreased to 14 mm; under these conditions the maximal uptake (U(max)) of [(3)H]adenosine and [(3)H]uridine did not change significantly when compared with the U(max) obtained when Ringer solution that contained 145 mm Na(+) was used. Kinetic analysis revealed apparent Michaelis-Menten constants (K(m,app)) for cellular uptake of [(3)H]adenosine, [(3)H]inosine and [(3)H]thymidine of 1.2 +/- 0.2, 15.7 +/- 2.6 and 3.8 +/- 0.9 microm, respectively. The HPLC and HPLC-fluorometric analysis of the sheep plasma and cerebrospinal fluid revealed nanomolar concentrations of adenosine and thymidine and micromolar levels of inosine and nucleobases. Considering the estimated K(m,app) values, it appears that under normal conditions inosine is the more important nucleoside substrate for uptake by the basolateral membrane of the choroid plexus epithelium than other nucleosides. PMID:18039975

Markovic, Ivanka; Segal, Malcolm; Djuricic, Bogdan; Redzic, Zoran



Competitive antagonism by recognised 5HT 2 receptor antagonists at 5HT 1C receptors in pig choroid plexus  

Microsoft Academic Search

The effects of several antagonists, known to interact with 5-HT2 receptors (ritanserin, LY 53857, ICI 169,369, methysergide, mesulergine and ketanserin), were tested against 5-HT-stimulated production of inositol phosphate in pig choroid plexus, a 5-HT1C receptor model. These antagonists produced dextral shifts of the concentration response curve to 5-HT in a parallel manner, without depressing significantly the maximal response. The following

Inçi Sahin-Erdemli; Philippe Schoeffter; Daniel Hoyer



Characterization of immortalized choroid plexus epithelial cell lines for studies of transport processes across the blood-cerebrospinal fluid barrier  

Microsoft Academic Search

BACKGROUND: Two rodent choroid plexus (CP) epithelial cell lines, Z310 and TR-CSFB, were compared with primary rat CP epithelial cells and intact CP tissue with respect to transport protein expression, function and tight junction (TJ) formation. METHODS: For expression profiles of transporters and TJ proteins, qPCR and western blot analysis were used. Uptake assays were performed to study the functional

Juliane Kläs; Hartwig Wolburg; Tetsuya Terasaki; Gert Fricker; Valeska Reichel



The distribution of the anti-HIV drug, tenofovir (PMPA), into the brain, CSF and choroid plexuses  

Microsoft Academic Search

BACKGROUND: Tenofovir disoproxil fumarate, a prodrug of the nucleotide reverse transcriptase inhibitor, tenofovir (9-[9(R)-2-(phosphonomethoxy)propyl]adenine; PMPA), was recently approved for use in the combination therapy of human immunodeficiency virus (HIV)-1 infection. This study was undertaken to understand PMPA distribution to the virus sanctuary sites located in the brain, CSF and choroid plexuses and to clarify its possible role in reducing the

Christy Anthonypillai; Julie E Gibbs; Sarah A Thomas



Expression and functional activity of nucleoside transporters in human choroid plexus  

PubMed Central

Background Human equilibrative nucleoside transporters (hENTs) 1-3 and human concentrative nucleoside transporters (hCNTs) 1-3 in the human choroid plexus (hCP) play a role in the homeostasis of adenosine and other naturally occurring nucleosides in the brain; in addition, hENT1, hENT2 and hCNT3 mediate membrane transport of nucleoside reverse transcriptase inhibitors that could be used to treat HIV infection, 3'-azido-3'-deoxythymidine, 2'3'-dideoxycytidine and 2'3'-dideoxyinosine. This study aimed to explore the expression levels and functional activities of hENTs 1-3 and hCNTs 1-3 in human choroid plexus. Methods Freshly-isolated pieces of lateral ventricle hCP, removed for various clinical reasons during neurosurgery, were obtained under Local Ethics Committee approval. Quantification of mRNAs that encoded hENTs and hCNTs was performed by the hydrolysis probes-based reverse transcription real time-polymerase chain reaction (RT-qPCR); for each gene of interest and for 18 S ribosomal RNA, which was an endogenous control, the efficiency of PCR reaction (E) and the quantification cycle (Cq) were calculated. The uptake of [3H]inosine by the choroid plexus pieces was investigated to explore the functional activity of hENTs and hCNTs in the hCP. Results RT-qPCR revealed that the mRNA encoding the intracellularly located transporter hENT3 was the most abundant, with E-Cq value being only about 40 fold less that the E-Cq value for 18 S ribosomal RNA; mRNAs encoding hENT1, hENT2 and hCNT3 were much less abundant than mRNA for the hENT3, while mRNAs encoding hCNT1 and hCNT2 were of very low abundance and not detectable. Uptake of [3H]inosine by the CP samples was linear and consisted of an Na+-dependent component, which was probably mediated by hCNT3, and Na+-independent component, mediated by hENTs. The latter component was not sensitive to inhibition by S-(4-nitrobenzyl)-6-thioinosine (NBMPR), when used at a concentration of 0.5 ?M, a finding that excluded the involvement of hENT1, but it was very substantially inhibited by 10 ?M NBMPR, a finding that suggested the involvement of hENT2 in uptake. Conclusion Transcripts for hENT1-3 and hCNT3 were detected in human CP; mRNA for hENT3, an intracellularly located nucleoside transporter, was the most abundant. Human CP took up radiolabelled inosine by both concentrative and equilibrative processes. Concentrative uptake was probably mediated by hCNT3; the equilibrative uptake was mediated only by hENT2. The hENT1 transport activity was absent, which could suggest either that this protein was absent in the CP cells or that it was confined to the basolateral side of the CP epithelium.



Cotransport of sodium and chloride by the adult mammalian choroid plexus  

SciTech Connect

Cerebrospinal fluid formation stems primarily from the transport of Na and Cl in choroid plexus (CP). To characterize properties and modulation of choroidal transporters, we tested diuretics and other agents for ability to alter ion transport in vitro. Adult Sprague-Dawley rats were the source of CPs preincubated with drug for 20 min and then transferred to cerebrospinal fluid (CSF) medium containing 22Na or 36Cl with (3H)mannitol (extracellular correction). Complete base-line curves were established for cellular uptake of Na and Cl at 37 degrees C. The half-maximal uptake occurred at 12 s, so it was used to assess drug effects on rate of transport (nmol Na or Cl/mg CP). Bumetanide (10(-5) and 10(-4) M) decreased uptake of Na and Cl with maximal inhibition (up to 45%) at 10(-5) M. Another cotransport inhibitor, furosemide (10(-4) M), reduced transport of Na by 25% and Cl by 33%. However, acetazolamide (10(-4) M) and atriopeptin III (10(-7) M) significantly lowered uptake of Na (but not Cl), suggesting effect(s) other than on cotransport. The disulfonic stilbene 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS; 10(-4) M), known to inhibit Cl-HCO3 exchange, substantially reduced the transport of 36Cl. Bumetanide plus DIDS (both 10(-4) M) caused additive inhibition of 90% of Cl uptake, which provides strong evidence for the existence of both cotransport and antiport Cl carriers. Overall, this in vitro analysis, uncomplicated by variables of blood flow and neural tone, indicates the presence in rat CP of the cotransport of Na and Cl in addition to the established Na-H and Cl-HCO3 exchangers.

Johanson, C.E.; Sweeney, S.M.; Parmelee, J.T.; Epstein, M.H. (Brown Univ./Rhode Island Hospital, Providence (USA))



The choroid plexus-cerebrospinal fluid system: from development to aging.  


The function of the cerebrospinal fluid (CSF) and the tissue that secretes it, the choroid plexus (CP), has traditionally been thought of as both providing physical protection to the brain through buoyancy and facilitating the removal of brain metabolites through the bulk drainage of CSF. More recent studies suggest, however, that the CP-CSF system plays a much more active role in the development, homeostasis, and repair of the central nervous system (CNS). The highly specialized choroidal tissue synthesizes trophic and angiogenic factors, chemorepellents, and carrier proteins, and is strategically positioned within the ventricular cavities to supply the CNS with these biologically active substances. Through polarized transport systems and receptor-mediated transcytosis across the choroidal epithelium, the CP, a part of the blood-CSF barrier (BCSFB), controls the entry of nutrients, such as amino acids and nucleosides, and peptide hormones, such as leptin and prolactin, from the periphery into the brain. The CP also plays an important role in the clearance of toxins and drugs. During CNS development, CP-derived growth factors, such as members of the transforming growth factor-beta superfamily and retinoic acid, play an important role in controlling the patterning of neuronal differentiation in various brain regions. In the adult CNS, the CP appears to be critically involved in neuronal repair processes and the restoration of the brain microenvironment after traumatic and ischemic brain injury. Furthermore, recent studies suggest that the CP acts as a nursery for neuronal and astrocytic progenitor cells. The advancement of our knowledge of the neuroprotective capabilities of the CP may therefore facilitate the development of novel therapies for ischemic stroke and traumatic brain injury. In the later stages of life, the CP-CSF axis shows a decline in all aspects of its function, including CSF secretion and protein synthesis, which may in themselves increase the risk for development of late-life diseases, such as normal pressure hydrocephalus and Alzheimer's disease. The understanding of the mechanisms that underlie the dysfunction of the CP-CSF system in the elderly may help discover the treatments needed to reverse the negative effects of aging that lead to global CNS failure. PMID:16344101

Redzic, Zoran B; Preston, Jane E; Duncan, John A; Chodobski, Adam; Szmydynger-Chodobska, Joanna



Structural defects in cilia of the choroid plexus, subfornical organ and ventricular ependyma are associated with ventriculomegaly  

PubMed Central

Background Hydrocephalus is a heterogeneous disorder with multiple etiologies that are not yet fully understood. Animal models have implicated dysfunctional cilia of the ependyma and choroid plexus in the development of the disorder. In this report, we sought to determine the origin of the ventriculomegaly in four Bardet Biedl syndrome (BBS) mutant mouse strains as models of a ciliopathy. Methods Evans Blue dye was injected into the lateral ventricle of wild- type and BBS mutant mice to determine whether obstruction of intra- or extra-ventricular CSF flow contributed to ventriculomegaly. Transmission electron microscopy (TEM) was used to examine the ultrastructure of the choroid plexus, subfornical organ (SFO), subcommisural organ (SCO), and ventricular ependyma to evaluate their ultrastructure and the morphology of their primary and motile cilia. Results and discussion No obstruction of intra- or extra-ventricular CSF flow was observed, implying a communicating form of hydrocephalus in BBS mutant mice. TEM analyses of the mutants showed no evidence of choroidal papillomas or breakdown of the blood:CSF barrier. In contrast, structural defects were observed in a subpopulation of cilia lining the choroid plexus, SFO, and ventricular ependyma. These included disruptions of the microtubular structure of the axoneme and the presence of electron-dense vesicular-like material along the ciliary shaft and at the tips of cilia. Conclusions Abnormalities in cilia structure and function have the potential to influence ciliary intraflagellar transport (IFT), cilia maintenance, protein trafficking, and regulation of CSF production. Ciliary structural defects are the only consistent pathological features associated with CSF-related structures in BBS mutant mice. These defects are observed from an early age, and may contribute to the underlying pathophysiology of ventriculomegaly.



Polarized distribution of nucleoside transporters in rat brain endothelial and choroid plexus epithelial cells.  


This study investigated mRNA expression and protein localization of equilibrative and concentrative nucleoside transporters (ENTs, CNTs) in primary cultures of rat brain endothelial cells (RBEC) and rat choroid plexus epithelial cells (RCPEC). Reverse transcriptase PCR analysis revealed that RBEC and RCPEC contained mRNA for rENT1, rENT2 and rCNT2 and for rENT1, rENT2, rCNT2 and rCNT3, respectively. Immunoblotting of membrane fractions of RBEC, fresh RCPEC and primary cultures of RCPEC revealed the presence of rENT1, rENT2 and rCNT2 proteins in all samples. Measurement of [14C]adenosine uptake into cells grown as monolayers on permeable plastic supports revealed a polarized distribution of Na+-dependent adenosine uptake in that CNT activity was associated exclusively in membranes of RBEC facing the lower chamber (which corresponds to the surface facing the interstitial fluid in situ) and in membranes of RCPEC facing the upper chamber (which corresponds to the surface facing the cerebrospinal fluid in situ). In both RBEC and RCPEC, adenosine uptake from the opposite chambers was Na+-independent and partially inhibited by nitrobenzylthioinosine, indicating the presence of the equilibrative sensitive transporter rENT1. PMID:16111480

Redzic, Zoran B; Biringer, Jean; Barnes, Kay; Baldwin, Stephen A; Al-Sarraf, Hameed; Nicola, Pieris A; Young, James D; Cass, Carol E; Barrand, Margery A; Hladky, Stephen B



CNS-specific T cells shape brain function via the choroid plexus.  


Adaptive immunity was repeatedly shown to play a role in maintaining lifelong brain function. Under physiological conditions, this activity was associated with CD4(+) T cells specific for brain self-antigens. Nevertheless, direct interactions of T cells with the healthy neuronal parenchyma are hardly detectable. Recent studies have identified the brain's choroid plexus (CP) as an active neuro-immunological interface, enriched with CNS-specific CD4(+) T cells. Strategically positioned for receiving signals from both the central nervous system (CNS) through the cerebrospinal fluid (CSF), and from the circulation through epithelium-immune cell interactions, the CP has recently been recognized as an important immunological compartment in maintaining and restoring brain homeostasis/allostasis. Here, we propose that CNS-specific T cells shape brain function via the CP, and suggest this immunological control to be lost as part of aging, in general, and immune senescence, in particular. Accordingly, the CP may serve as a novel target for immunomodulation to restore brain equilibrium. PMID:23597431

Baruch, Kuti; Schwartz, Michal



Electron-microscopical study of the choroid plexus and epiplexus cells in cats following a cisternal injection of crotoxin complex.  


The choroid plexus and its associated epiplexus cells in the fourth ventricle in cats were studied with scanning and transmission electron microscopy (SEM, TEM) following a cisternal injection of crotoxin complex (phospholipase A2). In SEM, the epiplexus cells of the control animals were predominantly stellate with long radiating processes. At 2 h after the administration of crotoxin complex, these radiating processes flattened out forming sheet-like membranes covering the ventricular surface of the choroid epithelial cells. The membranous coverings remained extended in 5-hour-survival cats. Numerous blebs of different sizes were observed in areas that were not covered by the cytoplasmic membrane in 5-hour animals. Some of the blebs appeared to have ruptured. In TEM, the microvilli of the choroid epithelial cells in crotoxin complex-treated rats were dilated. The luminal surface of the epithelial cells showed eruption of blebs filled with amorphous materials. Pinocytotic vesicles increased in number in the apical cytoplasm. The lumen of the ventricle often contained portions of cytoplasm believed to be derived from the extrusion of the blebs. These appeared to be engulfed by the overlying epiplexus cells. It was concluded that the injected crotoxin complex stimulated both the secretory as well as pinocytotic activity of the choroid epithelial cells. The phagocytosis of the secretory products from the epithelial cells by epiplexus cells suggests a close functional relationship between the two cell types. PMID:3376729

Ling, E A; Gopalakrishnakone, P; Tan, C K



Pathomorphological changes in rat brain choroid plexus due to administration of the amine-curing agent, bis(4-amino-3-methylcyclohexyl)methane  

Microsoft Academic Search

Summary Repeated oral administration of an amine-curing agent for epoxy resin, bis(4-amino-3-methylcyclohexyl)methane, gave rise to severe damage in the choroid plexus of rat brain. The damaged epithelium presented varying degrees of swelling and hydropic vacuolation on light microscopy, and varying numbers of vacuoles and inclusion bodies, frequently with lamellar structure, on transmission electron microscopy. Scanning electron microscopy of the choroid

Toshikatsu Shibata; Susumu Ohshima; Yoshihiko Shimizu; Masako Suzuki; Masahiro Ishizuka; Norihiro Sasaki; Eiki Nakayama



The kinetics of hypoxanthine transport across the perfused choroid plexus of the sheep.  


The uptake of principal salvageable nucleobase hypoxanthine was investigated across the basolateral membrane of the sheep choroid plexus (CP) perfused in situ. The results suggest that hypoxanthine uptake was Na+-independent, which means that transport system on the basolateral membrane can mediate the transport in both directions. Although the unlabelled nucleosides adenosine and inosine markedly reduce the transport it seems that this inhibition was due to nucleoside degradation into nucleobases in the cells, since non-metabolised nucleoside analogue NBTI did not inhibit the transport. The presence of adenine also inhibits hypoxanthine uptake while the addition of the pyrimidines does not show any effect, so it seems that the transport of purine nucleobases through basolateral membrane is mediated via a common transporter which is different from the nucleoside transporters. The inclusion of allopurinol in the perfusion fluid did not change the value and general shape of the curve for the uptake which suggest that degradation of hypoxanthine into xanthine and uric acid does not occur in the CP. The capacity of the CP basolateral membrane to transport hypoxanthine is high (90.63+/-3.79 nM/min/g) and close to the values obtained for some essential amino acids by the CP and blood-brain barrier, while the free diffusion is negligible. The derived value of Km (20.72+/-2.42 microM) is higher than the concentration of hypoxanthine in the sheep plasma (15.61+/-2.28 microM) but less than a half of the concentration in the CSF, which indicates that the transport system at basolateral membrane mostly mediates the efflux of hypoxanthine from the cerebrospinal fluid in vivo. PMID:11792365

Redzic, Zoran B; Gasic, Jovana M; Segal, Malcolm B; Markovic, Ivanka D; Isakovic, Aleksandra J; Rakic, Miodrag Lj; Thomas, Sarah A; Rakic, Ljubisa M



A molecular characterization of the choroid plexus and stress-induced gene regulation  

PubMed Central

The role of the choroid plexus (CP) in brain homeostasis is being increasingly recognized and recent studies suggest that the CP has a more important role in physiological and pathological brain functions than currently appreciated. To obtain additional insight on the CP function, we performed a proteomics and transcriptomics characterization employing a combination of high resolution tandem mass spectrometry and gene expression analyses in normal rodent brain. Using multiple protein fractionation approaches, we identified 1400 CP proteins in adult CP. Microarray-based comparison of CP gene expression with the kidney, cortex and hippocampus showed significant overlap between the CP and the kidney. CP gene profiles were validated by in situ hybridization analysis of several target genes including klotho, CLIC 6, OATP 14 and Ezrin. Immunohistochemical analyses were performed for CP and enpendyma detection of several target proteins including cytokeratin, Rab7, klotho, tissue inhibitor of metalloprotease 1 (TIMP1), MMP9 and glial fibrillary acidic protein (GFAP). The molecular functions associated with various proteins of the CP proteome indicate that it is a blood–cerebrospinal fluid (CSF) barrier that exhibits high levels of metabolic activity. We also analyzed the gene expression changes induced by stress, an exacerbating factor for many illnesses, particularly mood disorders. Chronic stress altered the expression of several genes, downregulating 5HT2C, glucocorticoid receptor and the cilia genes IFT88 and smoothened while upregulating 5HT2A, BDNF, TNF? and IL-1b. The data presented here attach additional significance to the emerging importance of CP function in brain health and CNS disease states.

Sathyanesan, M; Girgenti, M J; Banasr, M; Stone, K; Bruce, C; Guilchicek, E; Wilczak-Havill, K; Nairn, A; Williams, K; Sass, S; Duman, J G; Newton, S S



Intracellular Localization and Subsequent Redistribution of Metal Transporters in a Rat Choroid Plexus Model Following Exposure to Manganese or Iron  

PubMed Central

Confocal microscopy was used to investigate the effects of manganese (Mn) and iron (Fe) exposure on the subcellular distribution of metal transporting proteins, i.e., divalent metal transporter 1 (DMT1), metal transporter protein 1 (MTP1), and transferrin receptor (TfR), in the rat intact choroid plexus which comprises the blood-cerebrospinal fluid barrier. In control tissue, DMT1 was concentrated below the apical epithelial membrane, MTP1 was diffuse within the cytosol, and TfR was distributed in vesicles around nuclei. Following Mn or Fe treatment (1 and 10 µM), the distribution of DMT1 was not affected. However, MTP1 and TfR moved markedly toward the apical pole of the cells. These shifts were abolished when microtubules were disrupted. Quantitative RT-PCR and Western blot analyses revealed a significant increase in mRNA and protein levels of TfR but not DMT1 and MTP1 after Mn exposure. These results suggest that early events in the tissue response to Mn or Fe exposure involve microtubule-dependent, intracellular trafficking of MTP1 and TfR. The intracellular trafficking of metal transporters in the choroid plexus following Mn exposure may partially contribute to Mn-induced disruption in Fe homeostasis in the cerebrospinal fluid (CSF) following Mn exposure.

Wang, Xueqian; Miller, David S.; Zheng, Wei



Insulin-like growth factor II messenger ribonucleic acids are synthesized in the choroid plexus of the rat brain  

SciTech Connect

Previous studies demonstrating the presence of immunoreactive insulin-like growth factors (IGFs) and their receptors in the brain suggest a role of the IGFs in the central nervous system. IGF-II has been implicated as the predominant IGF in brain of mature animals based on studies of immunoreactive peptide and of IGF-II mRNAs. To obtain information about the sites of synthesis of IGF-II in adult rat brain, a /sup 32/P-labeled 31 base long synthetic oligodeoxyribonucleotide complementary in sequence to trailer peptide coding sequences in rat IGF-II mRNA (IGF-II 31 mer) was hybridized with coronal sections of fixed rat brain. The IGF-II 31 mer showed specific hybridization with the choroid plexus throughout rat brain, whereas in other brain regions, structures or cells, hybridization was not discernibly above background. These findings suggest that the choroid plexus is a primary site of synthesis of IGF-II, a probable source of IGF-II in cerebrospinal fluid, and a potential source of IGF-II for actions on target cells within the adult rat brain.

Hynes, M.A.; Brooks, P.J.; Van Wyk, J.J.; Lund, P.K.



Intracellular localization and subsequent redistribution of metal transporters in a rat choroid plexus model following exposure to manganese or iron  

SciTech Connect

Confocal microscopy was used to investigate the effects of manganese (Mn) and iron (Fe) exposure on the subcellular distribution of metal transporting proteins, i.e., divalent metal transporter 1 (DMT1), metal transporter protein 1 (MTP1), and transferrin receptor (TfR), in the rat intact choroid plexus which comprises the blood-cerebrospinal fluid barrier. In control tissue, DMT1 was concentrated below the apical epithelial membrane, MTP1 was diffuse within the cytosol, and TfR was distributed in vesicles around nuclei. Following Mn or Fe treatment (1 and 10 {mu}M), the distribution of DMT1 was not affected. However, MTP1 and TfR moved markedly toward the apical pole of the cells. These shifts were abolished when microtubules were disrupted. Quantitative RT-PCR and Western blot analyses revealed a significant increase in mRNA and protein levels of TfR but not DMT1 and MTP1 after Mn exposure. These results suggest that early events in the tissue response to Mn or Fe exposure involve microtubule-dependent, intracellular trafficking of MTP1 and TfR. The intracellular trafficking of metal transporters in the choroid plexus following Mn exposure may partially contribute to Mn-induced disruption in Fe homeostasis in the cerebrospinal fluid (CSF) following Mn exposure.

Wang Xueqian [School of Health Sciences, Purdue University, West Lafayette, IN 47907 (United States); Miller, David S. [NIH/NIEHS, Research Triangle Park, NC 27709 (United States); Zheng Wei [School of Health Sciences, Purdue University, West Lafayette, IN 47907 (United States)], E-mail:



Ontogeny of specific prolactin binding sites in the rat choroid plexus and their temporal relation to the prolactin short-loop feedback system  

SciTech Connect

The development of prolactin receptors in the choroid plexus of the rat was examined using the in vivo autoradiographic approach employing the principle of competitive binding. Animals aged 0, 10, 14, and 18 days postnatal were perfusion fixed following hormone injection and prepared for light microscopic autoradiography. The choroid plexus first demonstrated specific binding of prolactin at 14 days postnatal. The lactogen specificity of these binding sites was further defined by the ability of I/sup 125/-prolactin to be displaced by unlabelled human growth hormone, which is lactogenic in rats, and not by unlabelled insulin, which is structurally dissimilar to prolactin. Morphometric analysis was performed on electron micrographs of choroid plexus from 10 and 14 day postnatal rats. The volume densities of constituents known to be involved in the synthesis and/or function of polypeptide hormone receptors were measured and differences tested for statistical significance. A semi-quantitative histo-fluorescence technique was used to evaluate the ability of prolactin to stimulate secretion of its inhibiting factor, dopamine, in 10 day postnatal rats. The present findings indicate that the ontogenesis of specific prolactin binding sites is not temporally connected with the establishment of the prolactin short-loop feedback system since activation of the system occurs prior to the establishment of specific prolactin binding at choroid plexus.

Silverman, .F.



A Visual Description of the Dissection of the Cerebral Surface Vasculature and Associated Meninges and the Choroid Plexus from Rat Brain  

PubMed Central

This video presentation was created to show a method of harvesting the two most important highly vascular structures, not residing within the brain proper, that support forebrain function. They are the cerebral surface (superficial) vasculature along with associated meninges (MAV) and the choroid plexus which are necessary for cerebral blood flow and cerebrospinal fluid (CSF) homeostasis. The tissue harvested is suitable for biochemical and physiological analysis, and the MAV has been shown to be sensitive to damage produced by amphetamine and hyperthermia 1,2. As well, the major and minor cerebral vasculatures harvested in MAV are of potentially high interest when investigating concussive types of head trauma. The MAV dissected in this presentation consists of the pial and some of the arachnoid membrane (less dura) of the meninges and the major and minor cerebral surface vasculature. The choroid plexus dissected is the structure that resides in the lateral ventricles as described by Oldfield and McKinley3,4,5,6. The methods used for harvesting these two tissues also facilitate the harvesting of regional cortical tissue devoid of meninges and larger cerebral surface vasculature, and is compatible with harvesting other brain tissues such as striatum, hypothalamus, hippocampus, etc. The dissection of the two tissues takes from 5 to 10 min total. The gene expression levels for the dissected MAV and choroid plexus, as shown and described in this presentation can be found at GSE23093 (MAV) and GSE29733 (choroid plexus) at the NCBI GEO repository. This data has been, and is being, used to help further understand the functioning of the MAV and choroid plexus and how neurotoxic events such as severe hyperthermia and AMPH adversely affect their function.

Bowyer, John F.; Thomas, Monzy; Patterson, Tucker A.; George, Nysia I.; Runnells, Jeffrey A.; Levi, Mark S.



Reference values for the right and left fetal choroid plexus at 11 to 13 weeks: an early sign of "developmental" laterality?  


Objectives- The purpose of this study was to establish reference values for the length, area, and circumference of the right and left fetal choroid plexus at 11 to 13 weeks with respect to the fetal biparietal diameter and to compare the right to the left side. Methods- We conducted a prospective study on 114 fetuses at 11 to 13 weeks undergoing first-trimester screening for aneuploidy and structural fetal abnormalities. After the establishment of the fetal situs, the plane of the "butterfly" was obtained on all fetuses, from which the length, area, and circumference of both the right and left choroid plexus were obtained and the right and left sides compared. Using a paired t test, analysis of variance, scatterplots, and linear and logarithmic fittings, reference ranges and charts for the length, area, and circumference of the choroid plexus were then formulated according to their relationship to the fetal biparietal diameter. P < .05 was considered statistically significant. Results- Reference values for the length, area, and circumference of the fetal choroid plexus, with respect to the fetal biparietal diameter, were established. There was a statistically significant difference between the right and left sides for all parameters, with all measurements statistically greater on the left side (P < .0001). Conclusions- Reference values for the length, area, and circumference of the fetal choroid plexus at 11 to 13 weeks are presented. These may prove to be of clinical importance in the early screening for central nervous system abnormalities. In addition, the statistically significant difference between the right and left sides may be an early sign of "developmental" laterality. PMID:23980224

Abu-Rustum, Reem S; Ziade, M Fouad; Abu-Rustum, Sameer E



Choroid plexus, ependyma and arachnoidea express receptors for vitamin D: differences between "seasonal" and "non-seasonal" breeders.  


Autoradiographic studies with [3H]1,25-dihydroxyvitamin D3 demonstrated nuclear high affinity binding sites (receptors) in epithelial cells of choroid plexus, ependyma and arachnoid in "seasonal" breeders of various vertebrate phyla, namely Xiphophorus helleri, Hyla crucifer, Xenopus laevis, Bufo woodhousei, Chrysemys scripta, Anolis carolinensis, Nerodia sipedon and Phodopus sungorus, but vitamin D receptors were undetectable in these tissues in non-seasonal breeders, such as zebra finch, laboratory mice and rats. Both "seasonal" and "non-seasonal" species, however, exhibited nuclear binding in distinct nuclei of CNS. The data suggest that vitamin D is involved in the regulation of certain functions at the level of the blood-brain barrier in species strongly affected by seasonal changes. PMID:1329147

Bidmon, H J; Stumpf, W E



Expression of junctional proteins in choroid plexus epithelial cell lines: a comparative study  

PubMed Central

Background There is an increasing interest in using choroid plexus (CP) epithelial cell lines to study the properties of the blood-cerebrospinal fluid barrier (BCSFB). Currently, there are three major CP-derived cell lines available. Z310 and TR-CSFB3, two immortalized cell lines carrying the simian virus 40 large T-antigen gene, were derived from rat CP epithelium, whereas the CPC-2 cell line was derived from human CP carcinoma. Although these cell lines have previously been used in various functional studies, the expression of adherens junction (AJ) and tight junction (TJ) proteins in these epithelial cells has not been systematically studied. Accordingly, in the present study, we sought to characterize the expression of these junctional proteins in these three cell lines. Methods The cells were grown in six-well cell culture plates. Reverse-transcriptase polymerase chain reaction, Western blotting, and immunocytochemistry were used to characterize the expression of AJ and TJ proteins in the CP cell lines. Results Z310 and TR-CSFB3 cells expressed a TJ protein, occludin, and its cytosolic binding partner, zonula occludens 1, as well as an AJ protein, E-cadherin, and ?-catenin, a cytoplasmic protein that interacts with E-cadherin. However, the expression of occludin and E-cadherin in TR-CSFB3 cells at both the mRNA and protein level was weaker than that found in Z301 cells. The immunocytochemical analysis also demonstrated that the staining pattern for these junctional proteins in TR-CSFB3 cells was discontinuous and the staining intensity was weaker than that observed in Z310 cells. The message for claudin 1 and claudin 2 was expressed at low levels in TR-CSFB3 cells and these cells were weakly immunopositive for claudin 1. In comparison, the message for these TJ proteins could not be detected in Z310 cells. CPC-2 cells expressed occludin, which was localized to areas of cell-cell contact, but the staining pattern for this TJ protein was found to be variable and irregular. Although CPC-2 cells expressed mRNA for claudin 1, claudin 2, and claudin 11, only claudin 1 was expressed at the protein level and it was localized to the nuclei rather than to areas of cell-cell contact. An AJ protein, E-cadherin, was also found to be mislocalized in CPC-2 cells, even though its cytosolic binding partner, ?-catenin, was restricted to areas of cell-cell contact, as in normal CP. Conclusion The three CP cell lines analyzed in this study vary considerably with regard to the expression of AJ and TJ proteins, which is likely reflected by different barrier properties of these in vitro models of BCSFB.

Szmydynger-Chodobska, Joanna; Pascale, Crissey L; Pfeffer, Andrew N; Coulter, Cassaundra; Chodobski, Adam



Expression of the insulin-like growth factor II gene in the choroid plexus and the leptomeninges of the adult rat central nervous system.  

PubMed Central

The rat insulin-like growth factor II gene, encoding a fetal somatomedin, expresses a multitranscript family in embryonic/fetal tissues and in the adult brain and spinal cord. By performing in situ hybridization on tissue sections of adult brain and spinal cord, we have found that these transcripts are not expressed in neural or glial cells but are expressed in the epithelium of the choroid plexus of each cerebral ventricle and in the leptomeninges. We propose that the choroidal epithelial cells synthesize and secrete insulin-like growth factor II into the cerebrospinal fluid. Images

Stylianopoulou, F; Herbert, J; Soares, M B; Efstratiadis, A



Thyroxine (T 4) transfer from CSF to choroid plexus and ventricular brain regions in rabbit: Contributory role of P-glycoprotein and organic anion transporting polypeptides  

Microsoft Academic Search

This study investigated the transfer of T4 from cerebrospinal fluid (CSF) into the choroid plexuses (CP) and ventricular brain regions, and the role of P-glycoprotein (P-gp), multidrug resistance protein 1 (mrp1) and organic anion transporting polypeptides (oatps). During in vivo ventriculo-cisternal (V-C) perfusion in the anesthetized rabbit (meditomidine hydrochloride 0.5 mg kg?1, pentobarbitone 10 mg kg?1 i.v.), 125I-T4 was perfused continuously into

Nouhad A. Kassem; Rashid Deane; Malcolm B. Segal; RuoLi Chen; Jane E. Preston



Low levels of Na, K-ATPase and carbonic anhydrase II during choroid plexus development suggest limited involvement in early CSF secretion  

PubMed Central

In the adult, cerebrospinal fluid (CSF) is produced by the actions of numerous transporters and enzymes creating ion gradients that drive the entry of water into the ventricles via the aquaporin-1 water channels (AQP1). It is not known when in development CSF secretion starts but, in the rat, it has been postulated to occur around the time of birth. However, recent evidence suggests that the secretion may start much earlier, as soon as the lateral choroid plexuses first appear (around E14). Purpose To investigate the developmental profiles of two major enzymes responsible for CSF secretion in the adult, Na, K-ATPase (NKA) and carbonic anhydrase II (CAII). Methods The developmental profiles of both enzymes were investigated using immunohistochemistry and Western Blot analysis in tissue from embryonic day (E) 15, 18, postnatal day (P) 0, 9 and adult rats. Result Western Blot analysis showed low levels of NKA at E15 followed by a progressive increase with age. Immunohistochemistry confirmed the presence of NKA on the apical membrane of the lateral ventricular choroid plexus epithelium from E15 onwards. Western Blot analysis of CAII was complicated by its presence in blood, but the amount of protein increased with age. Immunohistochemically, CAII appeared in the lateral ventricular choroid plexus between P0 and P9. Conclusions The low levels of NKA and CAII during early choroid plexus development indicate that other mechanisms, such as the previously described specific protein transfer across epithelial cells, may be involved in early CSF secretion and movement of water into the cerebral ventricles.

Johansson, Pia; Dziegielewska, Katarzyna; Saunders, Norman



Choroid Plexus Epithelial Expression of MDR1 P Glycoprotein and Multidrug Resistance-Associated Protein Contribute to the Blood-Cerebrospinal-Fluid Drug-Permeability Barrier  

Microsoft Academic Search

The blood-brain barrier and a blood-cerebrospinal-fluid (CSF) barrier function together to isolate the brain from circulating drugs, toxins, and xenobiotics. The blood-CSF drug-permeability barrier is localized to the epithelium of the choroid plexus (CP). However, the molecular mechanisms regulating drug permeability across the CP epithelium are defined poorly. Herein, we describe a drug-permeability barrier in human and rodent CP mediated

Vallabhaneni V. Rao; Julie L. Dahlheimer; Mark E. Bardgett; Abraham Z. Snyder; Rick A. Finch; Alan C. Sartorelli; David Piwnica-Worms



Choroid plexus papilloma of the cerebellopontine angle: a twelve patient series  

Microsoft Academic Search

BACKGROUNDChoroid plexus papillomas (CPPs), of the cerebellopontine angle (CPA), are a rare entity and no surgical series have been reported so far. We reviewed all the pertinent literature of 12 patients operated on in the last 20 years at our institution.METHODSAll the patients were adults, ranging from 19 to 61 years. The group included 6 males and 6 females. Preoperatively,

Andrea Talacchi; Enrico De Micheli; Cristina Lombardo; Sergio Turazzi; Albino Bricolo



Immunoreactivity for GABA, GAD65, GAD67 and Bestrophin-1 in the Meninges and the Choroid Plexus: Implications for Non-Neuronal Sources for GABA in the Developing Mouse Brain  

PubMed Central

Neural progenitors in the developing neocortex, neuroepithelial cells and radial glial cells, have a bipolar shape with a basal process contacting the basal membrane of the meninge and an apical plasma membrane facing the lateral ventricle, which the cerebrospinal fluid is filled with. Recent studies revealed that the meninges and the cerebrospinal fluid have certain roles to regulate brain development. ?-aminobutyric acid (GABA) is a neurotransmitter which appears first during development and works as a diffusible factor to regulate the properties of neural progenitors. In this study, we examined whether GABA can be released from the meninges and the choroid plexus in the developing mouse brain. Immunohistochemical analyses showed that glutamic acid decarboxylase 65 and 67 (GAD65 and GAD67), both of which are GABA-synthesizing enzymes, are expressed in the meninges. The epithelial cells in the choroid plexus express GAD65. GABA immunoreactivity could be observed beneath the basal membrane of the meninge and in the epithelial cells of the choroid plexus. Expression analyses on Bestrophin-1, which is known as a GABA-permeable channel in differentiated glial cells, suggested that the cells in the meninges and the epithelial cells in the choroid plexus have the channels able to permeate non-synaptic GABA into the extracellular space. Further studies showed that GAD65/67-expressing meningeal cells appear in a manner with rostral to caudal and lateral to dorsal gradient to cover the entire neocortex by E14.5 during development, while the cells in the choroid plexus in the lateral ventricle start to express GAD65 on E11–E12, the time when the choroid plexus starts to develop in the developing brain. These results totally suggest that the meninges and the choroid plexus can work as non-neuronal sources for ambient GABA which can modulate the properties of neural progenitors during neocortical development.

Tochitani, Shiro; Kondo, Shigeaki



Immunoreactivity for GABA, GAD65, GAD67 and Bestrophin-1 in the meninges and the choroid plexus: implications for non-neuronal sources for GABA in the developing mouse brain.  


Neural progenitors in the developing neocortex, neuroepithelial cells and radial glial cells, have a bipolar shape with a basal process contacting the basal membrane of the meninge and an apical plasma membrane facing the lateral ventricle, which the cerebrospinal fluid is filled with. Recent studies revealed that the meninges and the cerebrospinal fluid have certain roles to regulate brain development. ?-aminobutyric acid (GABA) is a neurotransmitter which appears first during development and works as a diffusible factor to regulate the properties of neural progenitors. In this study, we examined whether GABA can be released from the meninges and the choroid plexus in the developing mouse brain. Immunohistochemical analyses showed that glutamic acid decarboxylase 65 and 67 (GAD65 and GAD67), both of which are GABA-synthesizing enzymes, are expressed in the meninges. The epithelial cells in the choroid plexus express GAD65. GABA immunoreactivity could be observed beneath the basal membrane of the meninge and in the epithelial cells of the choroid plexus. Expression analyses on Bestrophin-1, which is known as a GABA-permeable channel in differentiated glial cells, suggested that the cells in the meninges and the epithelial cells in the choroid plexus have the channels able to permeate non-synaptic GABA into the extracellular space. Further studies showed that GAD65/67-expressing meningeal cells appear in a manner with rostral to caudal and lateral to dorsal gradient to cover the entire neocortex by E14.5 during development, while the cells in the choroid plexus in the lateral ventricle start to express GAD65 on E11-E12, the time when the choroid plexus starts to develop in the developing brain. These results totally suggest that the meninges and the choroid plexus can work as non-neuronal sources for ambient GABA which can modulate the properties of neural progenitors during neocortical development. PMID:23437266

Tochitani, Shiro; Kondo, Shigeaki



Increased {beta}-amyloid levels in the choroid plexus following lead exposure and the involvement of low-density lipoprotein receptor protein-1  

SciTech Connect

The choroid plexus, a barrier between the blood and cerebrospinal fluid (CSF), is known to accumulate lead (Pb) and also possibly function to maintain brain's homeostasis of A{beta}, an important peptide in the etiology of Alzheimer's disease. This study was designed to investigate if Pb exposure altered A{beta} levels at the blood-CSF barrier in the choroid plexus. Rats received ip injection of 27 mg Pb/kg. Twenty-four hours later, a FAM-labeled A{beta} (200 pmol) was infused into the lateral ventricle and the plexus tissues were removed to quantify A{beta} accumulation. Results revealed a significant increase in intracellular A{beta} accumulation in the Pb-exposed animals compared to controls (p < 0.001). When choroidal epithelial Z310 cells were treated with 10 {mu}M Pb for 24 h and 48 h, A{beta} (2 {mu}M in culture medium) accumulation was significantly increased by 1.5 fold (p < 0.05) and 1.8 fold (p < 0.05), respectively. To explore the mechanism, we examined the effect of Pb on low-density lipoprotein receptor protein-1 (LRP1), an intracellular A{beta} transport protein. Following acute Pb exposure with the aforementioned dose regimen, levels of LRP1 mRNA and proteins in the choroid plexus were decreased by 35% (p < 0.05) and 31.8% (p < 0.05), respectively, in comparison to those of controls. In Z310 cells exposed to 10 {mu}M Pb for 24 h and 48 h, a 33.1% and 33.4% decrease in the protein expression of LRP1 was observed (p < 0.05), respectively. Knocking down LRP1 resulted in even more substantial increases of cellular accumulation of A{beta}, from 31% in cells without knockdown to 72% in cells with LRP1 knockdown (p < 0.05). Taken together, these results suggest that the acute exposure to Pb results in an increased accumulation of intracellular A{beta} in the choroid plexus; the effect appears to be mediated, at least in part, via suppression of LRP1 production following Pb exposure.

Behl, Mamta; Zhang Yanshu; Monnot, Andrew D.; Jiang, Wendy [School of Health Sciences, Purdue University, 550 Stadium Mall Drive, Room 1169, West Lafayette, IN 47907 (United States); Zheng Wei [School of Health Sciences, Purdue University, 550 Stadium Mall Drive, Room 1169, West Lafayette, IN 47907 (United States)], E-mail:



CNS-specific immunity at the choroid plexus shifts toward destructive Th2 inflammation in brain aging  

PubMed Central

The adaptive arm of the immune system has been suggested as an important factor in brain function. However, given the fact that interactions of neurons or glial cells with T lymphocytes rarely occur within the healthy CNS parenchyma, the underlying mechanism is still a mystery. Here we found that at the interface between the brain and blood circulation, the epithelial layers of the choroid plexus (CP) are constitutively populated with CD4+ effector memory cells with a T-cell receptor repertoire specific to CNS antigens. With age, whereas CNS specificity in this compartment was largely maintained, the cytokine balance shifted in favor of the T helper type 2 (Th2) response; the Th2-derived cytokine IL-4 was elevated in the CP of old mice, relative to IFN-?, which decreased. We found this local cytokine shift to critically affect the CP epithelium, triggering it to produce the chemokine CCL11 shown to be associated with cognitive dysfunction. Partial restoration of cognitive ability in aged mice, by lymphopenia-induced homeostasis-driven proliferation of memory T cells, was correlated with restoration of the IL-4:IFN-? ratio at the CP and modulated the expression of plasticity-related genes at the hippocampus. Our data indicate that the cytokine milieu at the CP epithelium is affected by peripheral immunosenescence, with detrimental consequences to the aged brain. Amenable to immunomodulation, this interface is a unique target for arresting age-related cognitive decline.

Baruch, Kuti; Ron-Harel, Noga; Gal, Hilah; Deczkowska, Aleksandra; Shifrut, Eric; Ndifon, Wilfred; Mirlas-Neisberg, Nataly; Cardon, Michal; Vaknin, Ilan; Cahalon, Liora; Berkutzki, Tamara; Mattson, Mark P.; Gomez-Pinilla, Fernando; Friedman, Nir; Schwartz, Michal



Analysis of the Effects of Sex Hormone Background on the Rat Choroid Plexus Transcriptome by cDNA Microarrays  

PubMed Central

The choroid plexus (CP) are highly vascularized branched structures that protrude into the ventricles of the brain, and form a unique interface between the blood and the cerebrospinal fluid (CSF), the blood-CSF barrier, that are the main site of production and secretion of CSF. Sex hormones are widely recognized as neuroprotective agents against several neurodegenerative diseases, and the presence of sex hormones cognate receptors suggest that it may be a target for these hormones. In an effort to provide further insight into the neuroprotective mechanisms triggered by sex hormones we analyzed gene expression differences in the CP of female and male rats subjected to gonadectomy, using microarray technology. In gonadectomized female and male animals, 3045 genes were differentially expressed by 1.5-fold change, compared to sham controls. Analysis of the CP transcriptome showed that the top-five pathways significantly regulated by the sex hormone background are olfactory transduction, taste transduction, metabolism, steroid hormone biosynthesis and circadian rhythm pathways. These results represent the first overview of global expression changes in CP of female and male rats induced by gonadectomy and suggest that sex hormones are implicated in pathways with central roles in CP functions and CSF homeostasis.

Quintela, Telma; Goncalves, Isabel; Carreto, Laura C.; Santos, Manuel A. S.; Marcelino, Helena; Patriarca, Filipa M.; Santos, Cecilia R. A.



Cl-HCO3 exchange in choroid plexus: analysis by the DMO method for cell pH  

SciTech Connect

( UC)DMO distribution was used to measure steady-state intracellular pH (pHi) and (HCO3)i in adult rat choroid plexus (CP) incubated in synthetic cerebrospinal fluid (CSF) for 30 min. In controls at 37 degrees C, mean pHi (6.95 at PCO2 = 30 mmHg) was close to corresponding in vivo values; and (HCO3)i/(HCO3)csf, i.e., rHCO3, was 0.37. At normal (HCO3)csf = 18 mM, cell HCO3 was accumulated threefold above electrochemical equilibrium. (HCO3)i decreased proportionally with (HCO3)csf, as the latter was altered from 47 to 9 mM; in severe extracellular acidosis (( HCO3)csf = 3.7 mM), (HCO3)i was not reduced further and so rHCO3 rose to 0.66. Except in low (HCO3)csf, acetazolamide and ouabain (10(-4) M) caused small depletion of cell HCO3. 4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic acid lowered (HCO3)i by 60%, thus decreasing rHCO3 (0.16) and rCl (0.25) to values close to estimated equilibrium distribution (0.15). Augmented PCO2 associated with temperature reduction to 15 degrees C elevated (HCO3)i, thereby increasing rHCO3 (to 0.66) as well as rCl. Anion distribution ratios indicate heteroanion exchange in mammalian CP.

Johanson, C.E.; Parandoosh, Z.; Smith, Q.R.



Regulatory volume increase in epithelial cells isolated from the mouse fourth ventricle choroid plexus involves Na(+)-H(+) exchange but not Na(+)-K(+)-2Cl(-) cotransport.  


The aim of this study was to determine the ability of choroid plexus epithelial cells to volume regulate when exposed to hypertonic solutions, and furthermore to identify the ion transporters involved in any volume regulation. Experiments were performed on cells freshly isolated, using the enzyme dispase, from the mouse fourth ventricle choroid plexus. Cell volume was measured using a video-imaging method. Cells used in this study were all of a similar morphology and had a mean volume of 0.71pl. Cells shrank when superfused with hypertonic solutions to a minimum relative cell volume of 0.84+/-0.01 (n=8) in 3min. They then exhibited a regulatory volume increase (RVI) to reach a relative volume of 0.92+/-0.02 over the following 12min. The RVI was HCO(3)(-)-dependent, that is it was not observed in hepes-buffered solutions. A post-regulatory volume decrease RVI (post-RVD RVI) was also observed in cells following exposure to hypotonic solutions. The RVI and post-RVD RVI were inhibited by 10microM 5-(N-ethyl-N-isopropyl) amiloride or 10microM 5-(N-methyl-N-isobutyl) amiloride, both selective inhibitors of Na(+)-H(+) exchange (NHE). They were also inhibited by the anion transport inhibitor 100microM 2,2'-(1,2-ethenediyl) bis (5-isothiocyanatobenzenesulfonic acid). The Na(+)-K(+)-2Cl(-) cotransporter inhibitor, 10microM bumetanide, was without effect on either the RVI or the post-RVD RVI. The data indicate that NHE, probably in combination with Cl(-)-HCO(3)(-) exchangers, contributes to RVI in choroid plexus epithelial cells. PMID:20144884

Hughes, Alexandra L H; Pakhomova, Antonina; Brown, Peter D



Syndecan-1, a Cell Surface Proteoglycan, Negatively Regulates Initial Leukocyte Recruitment to the Brain across the Choroid Plexus in Murine Experimental Autoimmune Encephalomyelitis.  


The cell surface heparan sulfate proteoglycan, syndecan-1, has been reported to be a negative regulator of various inflammatory processes, but its precise mode of action is poorly defined. In this study, we use the murine model of the 35-55 peptide of myelin oligodendrocyte glycoprotein-induced experimental autoimmune encephalomyelitis (EAE), a T lymphocyte-mediated inflammation where the steps in disease development and recovery are well characterized, to decipher how syndecan-1 impacts on the inflammatory reaction. Syndecan-1 knockout (Sdc-1(-/-)) mice show enhanced disease severity and impaired recovery. The use of bone marrow chimeric mice reveals that both an immune cell and a CNS-resident source of syndecan-1 contribute to this phenotype. Epithelial cells of the choroid plexus, where initial CCL20-induced leukocyte recruitment to the brain occurs, are identified as the predominant site of syndecan-1 expression. Syndecan-1 is lost from this site during the course of EAE by shedding into the cerebrospinal fluid, which correlates with loss of epithelial cell surface-bound CCL20 and is associated with the upregulation of IL-6 expression. In Sdc-1(-/-) mice, early leukocyte recruitment via the choroid plexus is enhanced, and IL-6 is elevated, which collectively results in higher numbers of the disease inducing Th17 cells in the CNS, thereby contributing to enhanced disease severity. Furthermore, Sdc-1(-/-) mice have intrinsically elevated plasma cell numbers and higher myelin oligodendrocyte glycoprotein-specific Ab levels during EAE, which we propose contributes to impaired recovery. Our data identify the choroid plexus epithelium as a novel source of IL-6 in EAE and demonstrate that its expression negatively correlates with syndecan-1 expression at this site. PMID:24078687

Zhang, Xueli; Wu, Chuan; Song, Jian; Götte, Martin; Sorokin, Lydia



Dominant Expression of mRNA for Prostaglandin D Synthase in Leptomeninges, Choroid Plexus, and Oligodrendrocytes of the Adult Rat Brain  

Microsoft Academic Search

Glutathione-independent prostaglandin D synthase [prostaglandin-H_2 D-isomerase; (5Z,13E)-(15S)-9alpha, 11alpha-epidioxy-15-hydroxyprosta-5,13-dienoate D-isomerase, EC] is an enzyme responsible for biosynthesis of prostaglandin D_2 in the central nervous system. In situ hybridization with antisense RNA for the enzyme indicated that mRNA for the enzyme was predominantly expressed in the leptomeninges, choroid plexus, and oligodendrocytes of the adult rat brain. The findings agree with those

Yoshihiro Urade; Kunio Kitahama; Hitoshi Ohishi; Takeshi Kaneko; Noboru Mizuno; Osamu Hayaishi



Molecularly and temporally separable lineages comprise the hindbrain roof plate and contribute differentially to the choroid plexus  

PubMed Central

Summary Both hindbrain roof plate epithelium (hRPe) and choroid plexus epithelium (hCPe) produce morphogens and growth factors essential for proper hindbrain development. Despite their importance, little is known about how these essential structures develop. Recent genetic fate maps indicate that hRPe and hCPe descend from the same pool of dorsal neuroectodermal progenitor cells of the rhombic lip. A linear developmental progression has been assumed, with the rhombic lip producing nonmitotic hRPe, and seemingly uniform hRPe transforming into hCPe. Here we show that hRPe is not uniform but rather is comprised of three spatiotemporal fields, differing in organization, proliferative state, order of emergence from the rhombic lip, and molecular profile of either the constituent hRPe cells themselves and/or their parental progenitors. Only two fields contribute to hCPe. We also show an hCPe contribution directly by the rhombic lip at late embryonic stages when hRPe is no longer present; indeed the production interval for hCPe by the rhombic lip is surprisingly extensive. Further, we show that the hCPe lineage appears unique among the varied rhombic lip-derived lineages in its proliferative response to constitutively active Notch1 signaling. Collectively, these findings provide a new platform for investigating hRPe and hCPe as neural organizing centers and provide support for the model that they are themselves patterned structures, likely capable of influencing neural development along multiple spatial and temporal axes.

Hunter, Nina L.; Dymecki, Susan M.



Age-related changes in choroid plexus and blood-cerebrospinal fluid barrier function in the sheep.  


Dysfunction of the choroid plexuses (CPs) and the blood-cerebrospinal fluid barrier (BCSFB) might contribute to age-related cognitive decline and neurodegenerative disease. We used the CPs from young (1-2 years), middle-aged (3-6 years) and old (7-10 years) sheep to explore effects of aging on various aspects of CP and BCSFB functions. Total protein in the cerebrospinal fluid (CSF) was significantly higher in old compared to young sheep and CSF secretion by the CP perfused in situ was significantly lower in both old and middle-aged when compared to young sheep, which correlated with reduced (22)Na(+) uptake and efflux by the CP. Steady-state extractions of a low and medium size molecular weight extracellular space marker, (14)C-mannitol and (3)H-polyethylene glycol, respectively, were significantly higher in CPs from old compared to young animals; however, there was no significant difference in steady-state extraction of a high molecular weight marker, (125)I-bovine serum albumin. This indicates increased passive BCSFB permeability for small and medium sized molecules in old sheep. CP redox activity was significantly lower in the old animals as assessed by the MTT assay, however, there was no significant difference in ATP content and energy charge of the CP with age suggesting adequate baseline energy reserve capacity. These data indicate that normal aging processes alter protein content in the CSF, CSF secretion, integrity of the BCSFB and Na(+) flux in the epithelial layer, which could impact on CSF homeostasis and turnover. PMID:19133323

Chen, R L; Kassem, N A; Redzic, Z B; Chen, C P C; Segal, M B; Preston, J E



Molecular heterogeneity in the choroid plexus epithelium: the 22-member ?-protocadherin family is differentially expressed, apically localized, and implicated in CSF regulation  

PubMed Central

The choroid plexus (CP) epithelium develops from the ependyma that lines the ventricular system, and plays a critical role in the development and function of the brain. In addition to being the primary site of CSF production, the CP maintains the blood-CSF barrier via apical tight junctions between epithelial cells. Here we show that the 22-member ?-Protocadherin (?-Pcdh) family of cell adhesion molecules, which we have implicated previously in synaptogenesis and neuronal survival, is highly expressed by both CP epithelial and ependymal cells, in which ?-Pcdh protein localization is, surprisingly, tightly restricted to the apical membrane. Multi-label immunostaining demonstrates that ?-Pcdhs are excluded from tight junctions, basolateral adherens junctions, and apical cilia tufts. RT-PCR analysis indicates that, as a whole, the CP expresses most members of the Pcdh-? gene family. Immunostaining using novel monoclonal antibodies specific for single ?-Pcdh proteins shows that individual epithelial cells differ in their apically-localized ?-Pcdh repertoire. Restricted mutation of the Pcdh-? locus in the choroid plexus and ependyma leads to significant reductions in ventricular volume, without obvious disruptions of epithelial apical-basal polarity. Together, these results suggest an unsuspected role for the ?-Pcdhs in CSF production and demonstrate a surprising molecular heterogeneity in the CP epithelium.

Lobas, Mark A.; Helsper, Lindsey; Vernon, Claire G.; Schreiner, Dietmar; Zhang, Yong; Holtzman, Michael J.; Thedens, Daniel R.; Weiner, Joshua A.



The distributional nexus of choroid plexus to cerebrospinal fluid, ependyma and brain: toxicologic/pathologic phenomena, periventricular destabilization, and lesion spread.  


Bordering the ventricular cerebrospinal fluid (CSF) are epithelial cells of choroid plexus (CP), ependyma and circumventricular organs (CVOs) that contain homeostatic transporters for mediating secretion/reabsorption. The distributional pathway ("nexus") of CP-CSF-ependyma-brain furnishes peptides, hormones, and micronutrients to periventricular regions. In disease/toxicity, this nexus becomes a conduit for infectious and xenobiotic agents. The sleeping sickness trypanosome (a protozoan) disrupts CP and downstream CSF-brain. Piperamide is anti-trypanosomic but distorts CP epithelial ultrastructure by engendering hydropic vacuoles; this reflects phospholipidosis and altered lysosomal metabolism. CP swelling by vacuolation may occlude CSF flow. Toxic drug tools delineate injuries to choroidal compartments: cyclophosphamide (vasculature), methylcellulose (interstitium), and piperazine (epithelium). Structurally perturbed CP allows solutes to penetrate the ventricles. There, CSF-borne pathogens and xenobiotics may permeate the ependyma to harm neurogenic stem cell niches. Amoscanate, an anti-helmintic, potently injures rodent ependyma. Ependymal/brain regions near CP are vulnerable to CSF-borne toxicants; this proximity factor links regional barrier breakdown to nearby periventricular pathology. Diverse diseases (e.g., African sleeping sickness, multiple sclerosis) take early root in choroidal, circumventricular, or perivascular loci. Toxicokinetics informs on pathogen, anti-parasitic agent, and auto-antibody distribution along the CSF nexus. CVOs are susceptible to plasma-borne toxicants/pathogens. Countering the physico-chemical and pathogenic insults to the homeostasis-mediating ventricle-bordering cells sustains brain health and fluid balance. PMID:21189316

Johanson, Conrad; Stopa, Edward; McMillan, Paul; Roth, Daniel; Funk, Juergen; Krinke, Georg



Na+ dependent acid-base transporters in the choroid plexus; insights from slc4 and slc9 gene deletion studies  

PubMed Central

The choroid plexus epithelium (CPE) is located in the ventricular system of the brain, where it secretes the majority of the cerebrospinal fluid (CSF) that fills the ventricular system and surrounds the central nervous system. The CPE is a highly vascularized single layer of cuboidal cells with an unsurpassed transepithelial water and solute transport rate. Several members of the slc4a family of bicarbonate transporters are expressed in the CPE. In the basolateral membrane the electroneutral Na+ dependent Cl?/HCO3? exchanger, NCBE (slc4a10) is expressed. In the luminal membrane, the electrogenic Na+:HCO3? cotransporter, NBCe2 (slc4a5) is expressed. The electroneutral Na+:HCO3? cotransporter, NBCn1 (slc4a7), has been located in both membranes. In addition to the bicarbonate transporters, the Na+/H+ exchanger, NHE1 (slc9a1), is located in the luminal membrane of the CPE. Genetically modified mice targeting slc4a2, slc4a5, slc4a7, slc4a10, and slc9a1 have been generated. Deletion of slc4a5, 7 or 10, or slc9a1 has numerous impacts on CP function and structure in these mice. Removal of the transporters affects brain ventricle size (slc4a5 and slc4a10) and intracellular pH regulation (slc4a7 and slc4a10). In some instances, removal of the proteins from the CPE (slc4a5, 7, and 10) causes changes in abundance and localization of non-target transporters known to be involved in pH regulation and CSF secretion. The focus of this review is to combine the insights gathered from these knockout mice to highlight the impact of slc4 gene deletion on the CSF production and intracellular pH regulation resulting from the deletion of slc4a5, 7 and 10, and slc9a1. Furthermore, the review contains a comparison of the described human mutations of these genes to the findings in the knockout studies. Finally, the future perspective of utilizing these proteins as potential targets for the treatment of CSF disorders will be discussed.

Christensen, Henriette L.; Nguyen, An T.; Pedersen, Fredrik D.; Damkier, Helle H.



Leukoencephalopathy around a tumor cyst following intracystic methotrexate injection.  


A 4-year-old female with choroid plexus carcinoma developed progressive disturbance of consciousness 2 years after postoperative treatment with radiotherapy, chemotherapy, and focal methotrexate injection into a residual tumor cyst. Magnetic resonance imaging revealed white matter lesions localized around the expanding large cyst. A malignant recurrence of choroid plexus carcinoma with a propensity of cerebrospinal fluid overproduction was suspected. However, daily drainage of cerebrospinal fluid from the cyst and treatment with glycerol and dexamethasone achieved improvement. Diffuse hypoperfusion over the lesions on single-photon emission computed tomography denied the possibility of residual tumor aggravation and together with subsequent atrophic changes confirmed that the lesions reflect localized leukoencephalopathy, possibly associated with methotrexate forced into the parenchyma as a result of the expanding intracystic high pressure. PMID:15607610

Yano, Tamami; Sawaishi, Yukio; Hirayama, Aya; Takaku, Iwao; Takada, Goro



The characteristics of basolateral nucleoside transport in the perfused sheep choroid plexus and the effect of nitric oxide inhibition on these processes.  


The single pass paired dilution technique was used to measure the uptake of nucleosides across the basolateral face of the isolated in situ perfused sheep choroid plexus (CP). The uptake of labelled adenosine and guanosine into the CP was large (approximately 35%) whereas that of thymidine was less (approximately 15%). The addition of 0.5 mM unlabelled adenosine to the perfusate inhibited the uptake of labelled adenosine by 66%, guanosine by 100% and that of thymidine by 50%, whereas the addition of 0.5 mM unlabelled thymidine caused complete self-inhibition. The backflux of adenosine was very small which may indicate a high rate of cellular metabolism or a flux into cerebrospinal fluid (CSF). The addition of 0.5 mM unlabelled adenosine did not alter the backflux of adenosine, but increased that of guanosine and thymidine. The entry of radioactivity derived from adenosine across the apical side of the CP cells into the newly formed CSF was determined as a 'CSF uptake index' relative to [14C]butanol and found to be about 25%; however, HPLC analysis revealed that the majority of this activity was hypoxanthine, and not adenosine. The complete inhibition of nitric oxide synthase caused a significant reduction in adenosine uptake into the CP and an increase in backflux for this molecule. It would appear that the uptake for adenosine by the CP is governed by the rate of cellular metabolism and not by the rate of transport into the cells of the choroid plexus whereas for guanosine and thymidine, transport is of greater importance. PMID:9365012

Redzi?, Z B; Segal, M B; Markovi?, I D; Gasi?, J M; Vidovi?, V; Raki?, L M



Evidence that tolerance to the anxiogenic-like effects of mCPP does not involve alteration in the function of 5-HT(2C) receptors in the rat choroid plexus.  


The mechanisms by which 1-(3-chlorophenyl) piperazine (mCPP) causes anxiety are unclear, but it has been suggested that the serotonin 5-HT(2C) receptor subtype may be involved in this effect. We have therefore studied the effect of chronic treatment (3 weeks) with mCPP in two animal models of anxiety (light/dark choice task in mice and elevated plus-maze test in rats) and subsequently assessed the function of 5-HT(2C) receptors (measured by maximal stimulation of 5-HT(2C) receptor-mediated phosphoinositide hydrolysis) in rat choroid plexus, where the receptor is present at very high levels. mCPP treatment regimens led to a tolerance to the anxiogenic-like action of the drug, but failed to alter the second messenger coupling of the 5-HT(2C) receptors in the choroid plexus, thereby suggesting the involvement of different mechanisms in this behavioral effect. PMID:11224245

Griebel, G.; Moreau, J.-L.; Jenck, F.; Mutel, V.; Martin, J.R.; Misslin, R.



Initial experience with combined endoscopic third ventriculostomy and choroid plexus cauterization for post-hemorrhagic hydrocephalus of prematurity: the importance of prepontine cistern status and the predictive value of FIESTA MRI imaging  

Microsoft Academic Search

Purpose  Post-hemorrhagic hydrocephalus of prematurity (PHHP) is among the most common causes of infant hydrocephalus in developed\\u000a nations. This population has a high incidence of shunt failure, infection, and slit ventricle syndrome. Although effective\\u000a for other etiologies of infant hydrocephalus, the efficacy of combined endoscopic third ventriculostomy and choroid plexus\\u000a cauterization (ETV\\/CPC) in PHHP has not been investigated. This pilot study

Benjamin C. Warf; Jeffrey W. Campbell; Eric Riddle



Uneven distribution of nucleoside transporters and intracellular enzymatic degradation prevent transport of intact [14C] adenosine across the sheep choroid plexus epithelium as a monolayer in primary culture  

PubMed Central

Background Efflux transport of adenosine across the choroid plexus (CP) epithelium might contribute to the homeostasis of this neuromodulator in the extracellular fluids of the brain. The aim of this study was to explore adenosine transport across sheep CP epithelial cell monolayers in primary culture. Methods To explore transport of adenosine across the CP epithelium, we have developed a method for primary culture of the sheep choroid plexus epithelial cells (CPEC) on plastic permeable supports and analysed [14C] adenosine transport across this cellular layer, [14C] adenosine metabolism inside the cells, and cellular uptake of [14C] adenosine from either of the chambers. The primary cell culture consisted of an enriched epithelial cell fraction from the sheep fourth ventricle CP and was grown on laminin-precoated filter inserts. Results and conclusion CPEC grew as monolayers forming typical polygonal islands, reaching optical confluence on the third day after the seeding. Transepithelial electrical resistance increased over the time after seeding up to 85 ± 9 ? cm2 at day 8, while permeability towards [14C] sucrose, a marker of paracellular diffusion, simultaneously decreased. These cells expressed some features typical of the CPEC in situ, including three nucleoside transporters at the transcript level that normally mediate adenosine transport across cellular membranes. The estimated permeability of these monolayers towards [14C] adenosine was low and the same order of magnitude as for the markers of paracellular diffusion. However, inhibition of the intracellular enzymes, adenosine kinase and adenosine deaminase, led to a significant increase in transcellular permeability, indicating that intracellular phosphorylation into nucleotides might be a reason for the low transcellular permeability. HPLC analysis with simultaneous detection of radioactivity revealed that [14C] radioactivity which appeared in the acceptor chamber after the incubation of CPEC monolayers with [14C] adenosine in the donor chamber was mostly present as [14C] hypoxanthine, a product of adenosine metabolic degradation. Therefore, it appears that CPEC in primary cultures act as an enzymatic barrier towards adenosine. Cellular uptake studies revealed that concentrative uptake of [14C] adenosine was confined only to the side of these cells facing the upper or apical chamber, indicating uneven distribution of nucleoside transporters.

Redzic, Zoran B; Isakovic, Aleksandra J; Misirlic Dencic, Sonja T; Popadic, Dusan; Segal, Malcolm B



ATP7A gene addition to the choroid plexus results in long-term rescue of the lethal copper transport defect in a Menkes disease mouse model.  


Menkes disease is a lethal infantile neurodegenerative disorder of copper metabolism caused by mutations in a P-type ATPase, ATP7A. Currently available treatment (daily subcutaneous copper injections) is not entirely effective in the majority of affected individuals. The mottled-brindled (mo-br) mouse recapitulates the Menkes phenotype, including abnormal copper transport to the brain owing to mutation in the murine homolog, Atp7a, and dies by 14 days of age. We documented that mo-br mice on C57BL/6 background were not rescued by peripheral copper administration, and used this model to evaluate brain-directed therapies. Neonatal mo-br mice received lateral ventricle injections of either adeno-associated virus serotype 5 (AAV5) harboring a reduced-size human ATP7A (rsATP7A) complementary DNA (cDNA), copper chloride, or both. AAV5-rsATP7A showed selective transduction of choroid plexus epithelia and AAV5-rsATP7A plus copper combination treatment rescued mo-br mice; 86% survived to weaning (21 days), median survival increased to 43 days, 37% lived beyond 100 days, and 22% survived to the study end point (300 days). This synergistic treatment effect correlated with increased brain copper levels, enhanced activity of dopamine-?-hydroxylase, a copper-dependent enzyme, and correction of brain pathology. Our findings provide the first definitive evidence that gene therapy may have clinical utility in the treatment of Menkes disease. PMID:21878905

Donsante, Anthony; Yi, Ling; Zerfas, Patricia M; Brinster, Lauren R; Sullivan, Patricia; Goldstein, David S; Prohaska, Joseph; Centeno, Jose A; Rushing, Elisabeth; Kaler, Stephen G



Esophageal Cancer Related Gene-4 Is a Choroid Plexus-Derived Injury Response Gene: Evidence for a Biphasic Response in Early and Late Brain Injury  

PubMed Central

By virtue of its ability to regulate the composition of cerebrospinal fluid (CSF), the choroid plexus (CP) is ideally suited to instigate a rapid response to traumatic brain injury (TBI) by producing growth regulatory proteins. For example, Esophageal Cancer Related Gene-4 (Ecrg4) is a tumor suppressor gene that encodes a hormone-like peptide called augurin that is present in large concentrations in CP epithelia (CPe). Because augurin is thought to regulate senescence, neuroprogenitor cell growth and differentiation in the CNS, we evaluated the kinetics of Ecrg4 expression and augurin immunoreactivity in CPe after CNS injury. Adult rats were injured with a penetrating cortical lesion and alterations in augurin immunoreactivity were examined by immunohistochemistry. Ecrg4 gene expression was characterized by in situ hybridization. Cell surface augurin was identified histologically by confocal microscopy and biochemically by sub-cellular fractionation. Both Ecrg4 gene expression and augurin protein levels were decreased 24–72 hrs post-injury but restored to uninjured levels by day 7 post-injury. Protein staining in the supraoptic nucleus of the hypothalamus, used as a control brain region, did not show a decrease of auguin immunoreactivity. Ecrg4 gene expression localized to CPe cells, and augurin protein to the CPe ventricular face. Extracellular cell surface tethering of 14 kDa augurin was confirmed by cell surface fractionation of primary human CPe cells in vitro while a 6–8 kDa fragment of augurin was detected in conditioned media, indicating release from the cell surface by proteolytic processing. In rat CSF however, 14 kDa augurin was detected. We hypothesize the initial release and proteolytic processing of augurin participates in the activation phase of injury while sustained Ecrg4 down-regulation is dysinhibitory during the proliferative phase. Accordingly, augurin would play a constitutive inhibitory function in normal CNS while down regulation of Ecrg4 gene expression in injury, like in cancer, dysinhibits proliferation.

Podvin, Sonia; Gonzalez, Ana-Maria; Miller, Miles C.; Dang, Xitong; Botfield, Hannah; Donahue, John E.; Kurabi, Arwa; Boissaud-Cooke, Matthew; Rossi, Ryan; Leadbeater, Wendy E.; Johanson, Conrad E.; Coimbra, Raul; Stopa, Edward G.; Eliceiri, Brian P.; Baird, Andrew



Stereotactic Radiosurgical Treatment of Brain Metastases to the Choroid Plexus;Renal cell cancer; Recursive partitioning analysis (RPA); Graded prognostic assessment (GPA); Survival and outcomes; Gamma knife  

SciTech Connect

Purpose: Choroid plexus metastases (CPM) are uncommon lesions. Consequently, optimal management of CPM is uncertain. We summarize our experience with stereotactic radiosurgery (SRS) of CPM. Methods and Materials: Sixteen consecutive patients with presumed CPM treated with SRS between 1997 and 2007 were examined. Twelve were men with a median age at diagnosis of CPM of 61.9 {+-} 9.9 years; 14 had metastases from renal cell carcinoma (RCC). All patients had controlled primary disease at the time of treatment for CPM. Four patients with RCC and 1 with non-small-cell lung cancer had undergone whole-brain radiotherapy (WBRT) previously and 2 had received SRS to other brain metastases. The disease-free interval from the primary diagnosis to CPM diagnosis averaged 39.3 {+-} 46.2 months (range, 1.0-156.3). Five patients were asymptomatic; of the remaining 11, none had symptoms related to CPM. All presented with a single CPM. Results: Average maximum diameter of the CPMs was 2.0 {+-} 1.0 cm (range, 0.9-4.1 cm); mean volume was 2.4 {+-} 2.6 cm{sup 3} (range, 0.2-9.3). Median SRS dose was 24 Gy to the 53% isodose line (range, 14-24 Gy). Survival after SRS to the CPM was 25.3 {+-} 23.4 months (range, 3.2-101.6). Patients in Recursive Partitioning Analysis (RPA) class I (n = 10) had improved survival compared to those in class II (n = 6), as did those with better GPA scores. There were no local failures. After SRS, 1 patient underwent WBRT, 3 patients had one, and another had two subsequent SRS treatments to other brain lesions. Of the 14 patients who have died, 11 succumbed to systemic disease progression, 2 to progressive, multifocal central nervous system disease, and 1 to systemic disease with concurrent, stable central nervous system disease. There were no complications related to SRS. Conclusions: Most CPMs are associated with RCC. SRS represents a safe and viable treatment option as primary modality for these metastases, with excellent outcomes.

Siomin, Vitaly [Department of Neurosurgery, Cleveland Clinic, Cleveland, OH (United States); Lin, Jennifer L. [Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH (United States); Marko, Nicholas F., E-mail: [Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH (United States); Department of Neurosurgery, Cleveland Clinic, Cleveland, OH (United States); Barnett, Gene H.; Toms, Steven A. [Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH (United States); Department of Neurosurgery, Cleveland Clinic, Cleveland, OH (United States); Chao, Samuel T. [Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH (United States); Department of Radiation Oncology, Neurological and Taussig Cancer Institutes, Cleveland Clinic, Cleveland, OH (United States); Angelov, Lilyana; Vogelbaum, Michael A. [Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH (United States); Department of Neurosurgery, Cleveland Clinic, Cleveland, OH (United States); Navaratne, Kapila [Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH (United States); Suh, John H. [Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH (United States); Department of Radiation Oncology, Neurological and Taussig Cancer Institutes, Cleveland Clinic, Cleveland, OH (United States); Weil, Robert J. [Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH (United States); Department of Neurosurgery, Cleveland Clinic, Cleveland, OH (United States)



Prenatal Tests  


... help see the baby more clearly. What are choroid plexus cysts? The choroid plexus is the area of the brain that ... one or more cysts can form in the choroid plexus. These cysts are made of blood vessels ...


Sickle Cell Disease and Your Baby  


... also: Cleft lip and cleft palate What are choroid plexus cysts? The choroid plexus is the area of the brain that ... one or more cysts can form in the choroid plexus. These cysts are made of blood vessels ...




... also: Cleft lip and cleft palate What are choroid plexus cysts? The choroid plexus is the area of the brain that ... one or more cysts can form in the choroid plexus. These cysts are made of blood vessels ...


24S-hydroxycholesterol induces cholesterol release from choroid plexus epithelial cells in an apical- and apoE isoform-dependent manner concomitantly with the induction of ABCA1 and ABCG1 expression.  


The release of cholesterol from choroid plexus epithelial cells (CPE) plays an important role in cholesterol homeostasis in the CSF. The purpose of this study was to clarify the molecules involved in cholesterol release in CPE and the regulation mechanisms of the cholesterol release by the liver X receptor (LXR) using a conditionally immortalized CPE line (TR-CSFB3). The mRNA expression of LXRalpha, LXRbeta and their target genes, ATP-binding cassette transporter (ABC)A1, ABCG1, ABCG4 and ABCG5, were detected in rat choroid plexus. ABCA1 and ABCG1 protein were detected in the plasma membrane of TR-CSFB3 cells. Following treatment with 24S-hydroxycholesterol, an endogenous LXR ligand, the expression of ABCA1 and ABCG1 were induced in TR-CSFB3 cells. Moreover, apolipoprotein (apo)AI- and high-density lipoprotein (HDL)-mediated cholesterol release to the apical side of TR-CSFB3 cells was facilitated by this treatment, whereas that to the basal side was not affected. Following 24S-hydroxycholesterol treatment, apoE3-dependent cholesterol release from TR-CSFB3 cells was enhanced more than the apoE4-dependent release. These results suggest that LXR activation facilitates cholesterol release into the CSF from CPE through the functional induction of ABCA1 and ABCG1. The difference between apoE3 and apoE4 suggests that the cholesterol release from CPE is related to the development of neurodegenerative diseases. PMID:17101031

Fujiyoshi, Masachika; Ohtsuki, Sumio; Hori, Satoko; Tachikawa, Masanori; Terasaki, Tetsuya



Vergleichende Ultrastrukturstudien an glykogenreichen Plexus chorioidei (Embryonalzustand, Winterschlaf)  

Microsoft Academic Search

Choroidal epithelium of 3–4-month human fetuses and hibernating hedgehogs contains abundant glycogen. The appearance of the glycogen in electron microscope differs between the two types of choroidal epithelia. (1) In epithelial cells of the human fetal choroid plexus, large masses of glycogen had displaced cytoplasmic organelles, such as numerous immature mitochondria and arrays of granular endoplasmic reticulum, to cell apex

A. Oksche; H. Kirschstein; M. Vaupel-von Harnack



Giant Ependymal Cyst of the Temporal Horn – An Unusual Presentation  

Microsoft Academic Search

Primary benign cystic lesions in the brain are uncommon. However, extracerebral cysts like arachnoid cyst, epidermoid cyst and craniopharyngiomas are fairly common lesions. Also, colloid cyst in the third ventricle, dermoid cyst and endodermal cyst in the extracerebral location are not uncommon. On the contrary, intraventricular ependymal and choroidal cysts in the intraventricular location are infrequent. Surgical intervention is warranted

Sanjay J. Pawar; Rewati Raman Sharma; Ashok K. Mahapatra; Ebenezer J. Dev



Transport of [14C]hypoxanthine by sheep choroid plexus epithelium as a monolayer in primary culture: Na+-dependent and Na+-independent uptake by the apical membrane and rapid intracellular metabolic conversion to nucleotides.  


Hypoxanthine is the main product of purine metabolic degradation and previous studies have revealed that it is present in the sheep CSF and plasma in micromolar concentrations. The aim of this study was to elucidate the transport of this molecule across the sheep choroid plexus epithelium (CPE) as a monolayer in primary culture, to explore the mechanism of uptake by the apical side of the CPE and investigate the metabolic changes inside the cell. The estimated permeability of the CPE monolayer for [14C]hypoxanthine, [14C]adenine and [14C]guanine was low and comparable to the permeability towards the extracellular space markers. The study of [14C]hypoxanthine uptake by the CPE revealed two components: Na+-dependent and Na+-independent, the latter being partially mediated by the equilibrative nucleoside transporter 2. HPLC with simultaneous detection of radioactivity revealed that the majority of [14C]hypoxanthine inside the CPE is metabolised into [14C]nucleotides and [14C]inosine. The remaining intact [14C]hypoxanthine was transported across the opposite, basolateral side of CPE and appeared in the lower chamber buffer together with [14C]inosine. These findings indicate two possible roles of hypoxanthine uptake from the CSF by the CP epithelium in vivo: to provide material for nucleotide synthesis through the salvage pathways in the CPE, as well as to transfer excess hypoxanthine from CSF to blood. PMID:18164814

Isakovic, Aleksandra J; Dencic, Sonja Misirlic; Segal, Malcolm B; Redzic, Zoran B



Histochemische, elektronenmikroskopische und quantitative Studien über den Glykogenvorrat der Plexus chorioidei von Rana temporaria L  

Microsoft Academic Search

The epithelial cells of the choroid plexuses (third and fourth ventricle) inRana temporaria L. are rich in glycogen. This material seems to represent a storage depot of carbohydrate within the brain. The glycogen particles (about 300 Å in diameter) of the plexus epithelium form rosettes or aggregates that are more irregular than the alpha particles described in the liver cell.

Eberhard Paul





... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ...


Atypical Teratoid Rhaboid Tumor (ATRT)  


... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ...




... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ...




... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ...


Bone and Connective Tissue Tumors  


... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ...




... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ...


Choroidal melanoma  

PubMed Central

Choroidal melanoma is the most common primary intra-ocular malignant tumor and second most common site of ten malignant melanoma sites in the body. Current diagnosis of choroidal melanoma is based on both the clinical experience of the specialist and modern diagnostic techniques such as indirect ophthalmoscopy, A- and B-ultrasonography scans, fundus fluorescein angiography, and transillumination. Invasive studies such as fine needle aspiration cytology can have significant morbidity and should only be considered if therapeutic intervention is indicated and diagnosis cannot be established by any other means. Several modes of treatment are available for choroidal melanoma. Multiple factors are taken into account when deciding one approach over other approaches, such as visual acuity of the affected eye, visual acuity of the contralateral eye, tumor size, location, ocular structures involved and presence of metastases. A comprehensive review of literature available in books and indexed journals was done. This article discusses in detail epidemiology, diagnosis, current available treatment options, and prognosis and survival of choroidal melanoma.

Singh, Parul; Singh, Abhishek



Avian enteric nerve plexuses  

Microsoft Academic Search

The enteric nerve plexuses of the domestic fowl (Gallus domesticus) were investigated in sections and stretch preparations by means of the cholinesterase and glyoxylic acid fluorescence histochemical techniques. Cholinesterase-positive and varicose and non-varicose fluorescent nerve fibres were distributed at all levels of the gut in myenteric, submucosal, muscle and mucosal plexuses, and in a perivascular plexus. The density of the

H. A. Ali; J. McLelland



Zinc transporter 7 is located in the cis-Golgi apparatus of mouse choroid epithelial cells  

Technology Transfer Automated Retrieval System (TEKTRAN)

The cellular localization of zinc transporter 7 protein in the mouse choroid plexus, an area on the ventricles of the brain where cerebrospinal fluid (CSF) is produced, was examined in this study. Zinc transporter 7 expressing cells were detected in the third, lateral, and fourth ventricles of the m...


Brachial plexus neuropathy  

PubMed Central

Branchial plexus neuropathy is characterized by acute onset of intense pain in the shoulder or arm followed shortly by focal muscle weakness. This presentation may mislead the clinician into diagnosing shoulder or cervical spine pathology. Although brachial plexus neuropathy is not common, it should be considered in the differential diagnosis of pain and weakness of the arm. We present a patient with brachial plexus neuropathy who was originally misdiagnosed as having a cervical disc herniation. ImagesFigure 1Figure 2Figure 3

Hubka, Michael J; King, Laurie; Cassidy, J David; Donat, JR



Lumbosacral plexus neuritis.  


We studied four patients with neurologic disorders of the lumbosacral plexus. Except for location of symptoms, the disorder confirmed to criteria established for the clinical diagnosis of brachial plexus neuritis. Acute onset of pain in one or both legs was followed by weakness, loss of stretch reflexes, and sometimes atrophy of affected muscles. The disorder affected in individual nerves or parts of the plexus. Gradual recovery occurred in all four patients. PMID:7194440

Sander, J E; Sharp, F R



The Brachial Plexus  

NSDL National Science Digital Library

This project is designed to instruct students on the basic anatomy and physiology of the brachial plexus. Through exercises such as matching, coloring and labeling, students are introduced to the brachial plexus and its role in controlling the cutaneous sensation and movement of the upper limbs.

Mr. Samuel J Schwarzlose (Amarillo College Biology)



Unusual choroidal mass.  


We present a unique case of disseminated tuberculosis presenting initially in the eye solely as a choroidal mass without any inflammation, mimicking choroidal metastasis. A 19-year-old girl presented with a large choroidal mass lesion in the right eye. Systemic examination revealed axillary lymphadenopathy. A fundus fluorescein angiography, positron emission tomography scan, abdominal ultrasonography and raised biochemical markers such as serum CA-125 pointed towards the diagnosis of choroidal metastases with primary in the ovaries. Fine needle aspiration cytology of the adnexal mass and ascitic fluid revealed granulomatous inflammation with a negative acid-fast bacilli stain. A multiplex PCR of ascitic fluid for the sequence MPB64 and IS6110 was positive for tuberculosis. The final diagnosis of disseminated tuberculosis was made and the patient subsequently showed a good response to antitubercular therapy. PMID:23907976

Parchand, Swapnil Madhukar; Sharma, Kusum; Sharma, Aman; Singh, Ramandeep



Hemorrhagic retinal macrocysts, simulating choroidal melanoma: a case report  

PubMed Central

Introduction Hemorrhagic retinal macrocysts are extremely rare retinal lesions that can be mistaken for malignancy with subsequent enucleation. Such a case was diagnosed, by a retina specialist based on ultrasonography, as a choroidal melanoma with exudative retinal detachment and the patient was advised to have brachytherapy. Case presentation A 15-year-old Caucasian boy suffered sudden visual loss in the left eye and exam revealed vitreous hemorrhage. Magnetic resonance imaging revealed the mass as hyperintense on T1-weighted images and isointense on T2-weighted images with no enhancement after gadolinium dye. Following scleral buckle, the hemorrhagic retinal macrocyst collapsed gradually over a period of 5 weeks. The patient recovered visual acuity of 6/7.5 at the 1-year follow up. Conclusion A hemorrhagic retinal macrocyst can be erroneously diagnosed as choroidal melanoma. Hints for the presence of retinal macrocysts include: egg shape; cyst wall configuration; no attachment to the choroid; and presence of retinal detachment.

Mansour, Ahmad M; Jaroudi, Mahmoud O



Brachial Plexus Injury  


... from that shoulder. Brachial plexus injuries are common in contact sports, but they frequently result from auto or motorcycle ... with no apparent shoulder injury. Risk factors Participating in contact sports, particularly football and wrestling, or being involved in ...


Kidney Cysts  


... fluid-filled sac. There are two types of kidney cysts. Polycystic kidney disease (PKD) runs in families. In PKD, the cysts ... kidney failure, dialysis or kidney transplants. Acquired cystic kidney disease (ACKD) usually happens in people who are on ...


Osteolytic lumbar discal cyst: case report.  


A 25-year-old man presented with left lumboischialgia refractory to medical treatment. Neurological examination revealed L5 and S1 radiculopathy which rapidly worsened over a short period. Magnetic resonance imaging demonstrated disk bulging with a discal cyst at the L4-5 intervertebral space and disk herniation at the L5-S1 intervertebral space. Computed tomography showed osteolytic change of the L5 vertebral body adjacent to the cyst. Resection of the cyst and removal of the herniated disk were performed following fenestration of the L4-5 and L5-S1 interlaminar spaces. Bloody serous fluid followed by clear serous fluid was recognized during the aspiration and partial resection of the cyst at the L4-5 level. Histological examination demonstrated a cyst wall consisting of fibrous connective tissue without a single-layer lining of cells, and fibrin deposits. The patient's symptoms disappeared immediately after the operation. This osteolytic lumbar discal cyst possibly occurred subsequent to hemorrhage from the epidural venous plexus following intervertebral disk injury, hematoma encapsulation by connective fibrous tissue, and cyst wall formation in reaction to the disk injury and hemorrhage. The cyst may have enlarged due to the inflow of the serous fluid from the water-containing degenerated disk. PMID:18719328

Marushima, Aiki; Uemura, Kazuya; Sato, Naoaki; Maruno, Toru; Matsumura, Akira



Obstetrical brachial plexus palsy.  


Obstetrical brachial plexus palsy is considered to be the result of a trauma during the delivery, even if there remains some controversy surrounding the causes. Although most babies recover spontaneously in the first 3 months of life, a small number remains with poor recovery which requires surgical brachial plexus exploration. Surgical indications depend on the type of lesion (producing total or partial palsy) and particularly the nonrecovery of biceps function by the age of 3 months. In a global palsy, microsurgery will be mandatory and the strategy for restoration will focus first on hand reinnervation and secondarily on providing elbow flexion and shoulder stability. Further procedures may be necessary during growth in order to avoid fixed contractured deformities or to give or increase strength of important muscle functions like elbow flexion or wrist extension. The author reviews the history of obstetrical brachial plexus injury, epidemiology, and the specifics of descriptive and functional anatomy in babies and children. Clinical manifestations at birth are directly correlated with the anatomical lesion. Finally, operative procedures are considered, including strategies of reconstruction with nerve grafting in infants and secondary surgery to increase functional capacity at later ages. However, normal function is usually not recovered, particularly in total brachial plexus palsy. PMID:23622302

Romaña, M C; Rogier, A



Brachial Plexus Injuries  


... United Brachial Plexus Network 1610 Kent Street Kent, OH 44240 Tel: 866-877-7004 Fax: 866-877-7004 National Institute on Disability and Rehabilitation Research (NIDRR) U.S. Department of Education Office of Special Education and Rehabilitative Services 400 ...


Nasolabial Cyst  

PubMed Central

Nasolabial cyst is a rare nonodontogenics, soft-tissue cyst occurring in the sublabial area and anterior maxillary region. The patient usually presents with a slowly enlarging asymptomatic swelling. They are usually diagnosed in early stages because of cosmetic problems. In our paper we report a nasolabial cyst of a 53-year-old man and discuss the diagnosis, differential diagnosis, and treatment in the light of the literature.

Sahin, Caner



[Inflammatory choroidal neovascularisations].  


Inflammation plays a key role in the induction of choroidal neovascular membranes (CNV). This explains why each form of posterior uveitis may lead to CNV formation. Diseases like presumed ocular histoplasmosis syndrome (POHS), multifocal choroiditis (MFC) or punctate inner choroidopathy (PIC) carry a high risk of CNV creation. Inflammatory processes mostly cause classical membranes. Because of the classical membrane form, smaller membrane size and the younger age of the patients' inflammatory membranes are often better treatable than membranes in AMD patients. In the times before VEGF inhibition inflammatory membranes were treated with argon laser coagulation and later with PDT. Nowadays better visual acuity results are achievable through VEGF inhibitor injections with or without PDT. This is proven by a few publications with greater numbers of patients because of the rarity of the diseases and several case reports in the literature. In addition to CNV treatment the control of intraocular inflammation should never be forgotten because it forms the leading CNV trigger. PMID:22972355

Winterhalter, S; Joussen, A M; Pleyer, U; Stübiger, N



Obstetric brachial plexus injury  

PubMed Central

Obstetric brachial plexus injury (OBPI), also known as birth brachial plexus injury (BBPI), is unfortunately a rather common injury in newborn children. Incidence varies between 0.15 and 3 per 1000 live births in various series and countries. Although spontaneous recovery is known, there is a large subset which does not recover and needs primary or secondary surgical intervention. An extensive review of peer-reviewed publications has been done in this study, including clinical papers, review articles and systematic review of the subject. In addition, the authors’ experience of several hundred cases over the last 15 years has been added and has influenced the ultimate text. Causes of OBPI, indications of primary nerve surgery and secondary reconstruction of shoulder, etc. are discussed in detail. Although all affected children do not require surgery in infancy, a substantial proportion of them, however, require it and are better off for it. Secondary surgery is needed for shoulder elbow and hand problems. Results of nerve surgery are very encouraging. Children with OBPI should be seen early by a hand surgeon dealing with brachial plexus injuries. Good results are possible with early and appropriate intervention even in severe cases.

Thatte, Mukund R.; Mehta, Rujuta



Obstetric brachial plexus injury.  


Obstetric brachial plexus injury (OBPI), also known as birth brachial plexus injury (BBPI), is unfortunately a rather common injury in newborn children. Incidence varies between 0.15 and 3 per 1000 live births in various series and countries. Although spontaneous recovery is known, there is a large subset which does not recover and needs primary or secondary surgical intervention. An extensive review of peer-reviewed publications has been done in this study, including clinical papers, review articles and systematic review of the subject. In addition, the authors' experience of several hundred cases over the last 15 years has been added and has influenced the ultimate text. Causes of OBPI, indications of primary nerve surgery and secondary reconstruction of shoulder, etc. are discussed in detail. Although all affected children do not require surgery in infancy, a substantial proportion of them, however, require it and are better off for it. Secondary surgery is needed for shoulder elbow and hand problems. Results of nerve surgery are very encouraging. Children with OBPI should be seen early by a hand surgeon dealing with brachial plexus injuries. Good results are possible with early and appropriate intervention even in severe cases. PMID:22279269

Thatte, Mukund R; Mehta, Rujuta



Multimodal imaging of sarcoid choroidal granulomas  

PubMed Central

Background Enhanced-depth imaging optical coherence tomography (EDI-OCT) provides high-resolution imaging of the choroid. Herein, we report multimodal imaging, including EDI-OCT, of a case of sarcoid choroidal granulomas. Findings A 63-year-old female with biopsy-supported sarcoidosis presented with unilateral multifocal choroidal granulomas. Enhanced-depth imaging optical coherence tomography (EDI-OCT) demonstrated a homogenous hyporeflective choroidal lesion with choriocapillaris thinning and sparing of the surrounding choroid. The patient was started on oral steroids with a weekly taper schedule. Within 5 weeks, the choroidal lesions had clinically resolved with return of normal-appearing choroidal architecture on EDI-OCT. Indocyanine green angiography, however, demonstrated hypofluoresence at the sites of choroidal granulomas 11 months after the clinical resolution, suggesting a longstanding choroidal perfusion deficit undetected by OCT. Conclusions Choroidal imaging via EDI-OCT provides detailed morphologic information of sarcoid granulomas and can accurately demonstrate structural resolution of the lesions.



Lumbosacral Plexus: A Histological Study  

Microsoft Academic Search

Two hundred and forty histological paraffin sections were obtained from the midportion of the spinal nerve roots of 20 lumbosacral plexus (from L·4 to S3) bilaterally. All microscopic images were digitized using the NIH image software with a Nikon microscope and Sony videocamera. The total, fascicular as well as epineurial cross-sectional areas of the nerve roots in the lumbosacral plexus

N. A. Ebraheim; J. Lu; H. Yang; M. Huntoon; R. A. Yeasting



Ovarian Cysts  

MedlinePLUS Videos and Cool Tools

... and progesterone. • Ovulation, which is the release of eggs that are needed for reproduction. The hormones produced ... uterus to proceed with a pregnancy. Before the egg is released a small cyst forms on the ...


Method of Inhibiting Choroidal Neovascularization.  

National Technical Information Service (NTIS)

The present invention relates to compositions and methods for inhibiting unwanted angiogenesis, particularly those of ocular tissues. The treatment, inhibition, and/or prevention of choroidal neovasculature (CNV) is provided, along with an animal model fo...

R. Wen Z. Luo A. M. Laties



Choroidal Leiomyoma of Vascular Origin.  

National Technical Information Service (NTIS)

A 57-year-old man had a clinically suspected malignant melanoma in his left eye. On microscopic study, the enucleated eye harbored an unusual choroidal tumor that had extended extraocularly. This tumor had been variously interpreted microscopically as an ...

F. A. Jakobiec H. Witschel L. E. Zimmerman



Radiation therapy for choroidal melanoma  

Microsoft Academic Search

Radiotherapy offers patients with malignant melanoma of the choroid an eye and a vision-sparing alternative to enucleation. The most commonly used forms of radiotherapy are ophthalmic plaque brachytherapy and charged-particle (external beam) radiotherapy. Unfortunately, after all forms of radiotherapy for choroidal melanoma many patients experience sight-limiting side effects, and an average of 16.3% of patients treated with radiotherapy subsequently require

Paul T. Finger



Brachial plexus injury in newborns  


... brachial plexus injury: Breech delivery Larger-than-average newborn (such as an infant of a diabetic mother ) ... immediately or soon after birth, and may include: Newborn is not moving the upper or lower arm ...


Posttraumatic childhood lumbosacral plexus neuropathy.  


A 13-month-old male received crush injury to the abdomen resulting in paraparesis due to lumbosacral plexus neuropathy. The child was monitored with serial clinical examinations and electromyography/nerve conduction studies. He had complete clinical recovery. Lumbosacral plexus neuropathy is unusual in childhood and has not been previously reported as a result of abdominal trauma. This patient is presented with details of the clinical course, electrodiagnostic studies, discussion, and literature review. PMID:7748364

Egel, R T; Cueva, J P; Adair, R L



Management of birth brachial plexus palsy  

Microsoft Academic Search

Introduction  The indications for surgical repair of congenital brachial plexus palsy are controversial. Our objective was to determine the results of early brachial plexus surgery following obstetric-induced brachial plexus palsy.Methods  We performed a retrospective analysis of the outcome of 58 cases of brachial plexus surgery. The indication for operation consisted of the presence of less than antigravity strength in the biceps, triceps,

Donncha F. O’Brien; T. S. Park; Michael J. Noetzel; Trisha Weatherly



Choroidal metastases from lung adenocarcinoma.  


A 32-year-old woman presented with an unknown visual deficit. Fundus examination revealed a lesion compatible with a metastatic focus. Diagnostic workup revealed a lung mass and the biopsy was compatible with lung adenocarcinoma. The intraocular lesion was the only metastatic site at the time of diagnosis. She received local choroidal treatment and further systemic therapy. A pneumonectomy was performed. Five months later she progressed systemically and has since then received several lines of chemotherapy. Choroidal metastases are an infrequent site of systemic dissemination and associated with a poor prognosis, with a median survival of around 2 months if it is the first manifestation of a lung neoplasm. Here we review the literature on choroidal metastases, their treatment options and epidemiology. PMID:19828413

Martín Martorell, Paloma; Marí Cotino, José F; Insa, Amelia



Adrenal Cyst Presenting as Hepatic Hydatid Cyst  

PubMed Central

Introduction. Although adrenal cysts are uncommon, the incidence rate is increasing with the advances in radiological technologies. The incidental detection of adrenal cysts nowadays has become more frequent as a result of the increase usage of high quality imaging modalities. Adrenal cysts originate from the adrenal gland and can be classified into either true or pseudocyst. Presentation of Case. In this report, we described an adrenal cyst of endothelial type, in a 30-year-old lady who was mistakenly diagnosed to have a hydatid cyst both clinically and by imaging. Discussion. Although adrenal cysts are uncommon, the incidence rate is increasing with the frequent use of various high quality radiological technologies. Adrenal cyst should be considered in the differential diagnosis when dealing with upper abdominal cysts. The size of the adrenal cyst can vary from a few millimeters up to 50?cm in diameter. Most of the adrenal cysts are unilateral, while 8%–15% of those cysts do present bilaterally. The majority of cases are diagnosed between the 3rd and 5th decades. Conclusion. Although most of the adrenal cysts are benign in nature, surgical excision is advisable especially when the cysts are greater than 5?cm in diameter and in the case of suspecting malignancy.

Darwish, Abdulla; Nagaraj, Veena; Mustafa, Mohmmed B.



Orbital dermoid cyst  

Microsoft Academic Search

Over a thirteen year period forty patients underwent surgery to remove an orbital dermoid cyst. Cysts which became manifest after the age of three years were deeper and larger than most that were noted before that age. Three out of four epidermoid cysts appeared after the age of 17 years and had an intracranial component. The majority of cysts showed

W W Ehrlich; J E Wright



[Anatomical studies of the plexus ophthalmicus and plexus orbitalis medialis in sheep].  


Studied were the structure and the blood supply of plexus ophthalmicus and plexus orbitalis medialis in twenty newborn lambs and in ewes and rams aged up to eight years, employing the methods of preparation and corosion. It was found that sheep had well developed intraorbital venous plexuses. Plexus ophthalmicus was found to be formed by branches of the supraorbital and the external dorsal eye vein as well as by veins coming from the eye orbit and the accessory organs of the eye. It was said to have a cone-shaped form, 3 to 4 cm long, and with a dia at the base of about 2 cm. The veins that formed the plexus were found to be located radially and in a circular way, having a varying length and forming loops of different shape. Rete mirabile venosum ophthalmicum initiated from the dorsal wall of the plexus, embracing the arterial network--rete mirabile ophthalmicum. There was in the medial eye angle a well developed plexus orbitalis medialis connected with plexus ophthalmicus. The latter was found to be connected with plexus venosus cavernosus, the winglike plexus, and the maxillary vein. In newborn lambs plexus ophthalmicus and plexus orbitalis medialis were completely developed. It is believed that the venous plexuses have a collecting, distributing, and hemodynamic function with regard to the blood in the eye region, and particularly with regard to both rete mirabile ophthalmicum and rete mirabile epidurale rostrale. PMID:7170770

Gadzhev, S; Gudev, Kh



Unusual Orange-Colored Choroidal Metastases  

PubMed Central

Purpose To report the clinical and paraclinical features of two patients with orange- colored choroidal metastases in whom the primary cancers have not previously been associated with such lesions. Case Report Orange-colored choroidal lesions were detected on the fundus examination of one patient with metastatic small cell neuroendocrine tumor of the larynx and oropharynx, and in another subject with metastatic alveolar soft part sarcoma of the leg. Although ultrasonographic characteristics of the choroidal masses were comparable to those of choroidal hemangiomas, fluorescein angiography revealed delayed initial fluorescence along with minimal fluorescence in subsequent phases of the angiogram which were in clear distinction from the earlier appearing and progressively intense fluorescence observed with circumscribed choroidal hemangiomas. Conclusion Small cell neuroendocrine tumors and alveolar soft part sarcomas should be considered among the differential diagnoses for orange-colored choroidal metastases. Identifying these choroidal lesions could facilitate localizing the occult primary tumor. Fluorescein angiography may differentiate a unifocal orange choroidal metastasis from a circumscribed choroidal hemangioma.

Krema, Hatem; McGowan, Hugh; Tanzer, Herbert; Simpson, Rand; Laperriere, Normand



Choroidal calcification in bartter syndrome  

Microsoft Academic Search

PURPOSE: Bartter syndrome is characterized by hyperplasia of the renal juxtaglomerular apparatus, hyperaldosteronism, and hypokalemic alkalosis. We report a case of Bartter syndrome associated with normal serum calcium levels and posterior choroidal calcification.METHODS: Case report. A 59-year-old man with bilateral cataract and Bartter syndrome underwent a complete ophthalmic examination, including standardized echography before and after cataract surgery.RESULTS: Before cataract surgery,

Giorgio Marchini; Roberto Tosi; Barbara Parolini; Giovanna Castagna; Marco Zarbin



Primary brachial plexus neoplasia in cats.  


Conditions affecting the brachial plexus and its branches can cause lameness and/or neurological deficits. There are few reports of schwannomas in cats. In reported cases, the tumours arose from the dermis or subcutis of the limbs, head and neck and thorax, but there are no reports of primary tumours that arose from the brachial plexus itself. The purpose of this study is to present the clinical, radiological, ultrasonographical and pathological findings of primary brachial plexus tumour in three cats. PMID:23197498

Hanna, Fikry Younan



Choroidal Blood Flow During Isometric Exercises  

Microsoft Academic Search

Conclusions. Previous studies have demonstrated that during isometric exercise, blood pres- sures in the ophthalmic and brachial arteries rise in parallel. These observations and the current results indicate that an increase in PPm up to 67% induces an increase in choroidal vascular resistance that limits the increase in choroidal blood flow to approximately 12%. This regulatory process fails when PPm

Charles E. Riva; Patrick Titze; Mark Hero; Armand Movaffaghy; Benno L. Petrig


Aetiology and management of choroidal folds.  


Choroidal folds are known to be associated with a wide variety of pathological conditions, such as central serous retinopathy, choroidal naevi, tumours and papilloedema. They may also occur with surgical procedures, especially when hypotony of the globe occurs, such as following cataract surgery, laser therapy and from post-operative choroidal oedema or inflammation. However, choroidal folds are idiopathic in the majority of cases and can be associated with benign conditions, such as hypermetropia and optic disc drusen. Numerous patterns and orientations of choroidal folds are possible, with some authors suggesting that typical presentations are associated with particular pathological conditions. They may be seen as dark and light streaks on ophthalmoscopy (often more defined with red-free viewing) but are more apparent and differentiated from retinal folds by fluorescein angiography. The aetiology of choroidal folds appears to be linked to a combination of an anatomical attachment of Bruch's membrane to the underlying choriocapillaris and congestion of the choriocapillaris. This paper reviews aspects of the differential diagnosis of choroidal folds with guidelines for optometric management. Several case reports are presented to demonstrate some of the clinical features of choroidal folds. PMID:12482275

Jaworski, Andrew; Wolffsohn, James S; Napper, Genevieve A


Segmental nature of the choroidal vasculature  

Microsoft Academic Search

The various in vivo studies on posterior ciliary arteries and choroidal vasculature reported piecemeal by the author over the past few years have now been collated. A coherent picture of the vasculature emerges which is of considerable clinical significance. The observations show that the posterior ciliary arteries and their branches right down to the terminal choroidal arterioles, the choriocapillaris, and

S. S. Hayreh



Do arachnoid cysts grow?  

Microsoft Academic Search

The volumes of intracranial arachnoit cysts were measured in 136 CT scans of 86 patients. Absolute and relative cyst size was calculated. Left hemisphere and middle cranial fossa location prevailed. A slight negative correlation of relative cyst size with age (r=-0.21, NS) disappeared when analysis was restricted to the adult age group (=20 years). After the sample was divided into

T. Becker; M. Wagner; E. Hofmann; M. Warmuth-Metz; M. Nadjmi



Giant hydatid lung cysts  

Microsoft Academic Search

Objective: In this clinical retrospective study, we aimed to evaluate giant hydatid lung cyst cases as a different clinical entity that recorded in last 10 years in our clinic. Methods: Between February 1990 and May 2000, a total of 305 hydatid lung cyst cases from patients that had been operated were reviewed, and 67 (21.9%) cysts with more than 10

Nurettin Karaoglanoglu; Ibrahim Can Kurkcuoglu; Metin Gorguner; Atilla Eroglu; Atila Turkyilmaz


Giant hydatid lung cysts  

Microsoft Academic Search

Objective: In this clinical retrospective study, we aimed to evaluate giant hydatid lung cyst cases as a different clinical entity that recorded in last 10 years in our clinic. Methods: Between February 1990 and May 2000, a total of 305 hydatid lung cyst cases from patients that had been operated were reviewed, and 67 (21.9%) cysts with more than 10

Nurettin Karaoglanoglu; Ibrahim Can Kurkcuoglu; Metin Gorguner; Atilla Eroglu; Atila Turkyilmaz



Beware the Tarlov Cyst  

Microsoft Academic Search

Tarlov cysts are sacral perineural cysts. This case report describes the clinical course after biopsy of a very large Tarlov cyst via laparoscopy, which was thought preoperatively to be an adnexal mass. It serves as a warning against attempting biopsy or resection of these lesions.

Jane E. Hirst; Hugh Torode; William Sears; Michael J. Cousins



Beware the Tarlov cyst.  


Tarlov cysts are sacral perineural cysts. This case report describes the clinical course after biopsy of a very large Tarlov cyst via laparoscopy, which was thought preoperatively to be an adnexal mass. It serves as a warning against attempting biopsy or resection of these lesions. PMID:19110185

Hirst, Jane E; Torode, Hugh; Sears, William; Cousins, Michael J


Brachial plexus neuritis following HPV vaccination  

Microsoft Academic Search

We present a 19-year-old girl who developed a left brachial plexus neuritis following vaccination with a quadrivalent human papillomavirus (HPV) vaccine. Post-vaccination brachial plexus neuritis is a rare event. Nevertheless, this first case warrants careful attention in view of the large vaccination campaigns in young adolescents being launched all over the world.

Ph. Debeer; P. De Munter; F. Bruyninckx; R. Devlieger



Choroidal perfusion measurements made with optical coherence tomography  

NASA Astrophysics Data System (ADS)

Choroidal perfusion measurements are complicated by the choroid's location posterior to the retina and its associated retinal blood vessels. Optical coherence tomography is a relatively new imaging technique with sufficient spatial resolution to isolate choroidal backscattering events from the posterior eye. We modified a speckle imaging algorithm to analyze sequential axial depth scans obtained from posterior rat eye to obtain an indicator of choroidal perfusion. This indicator is correlated with known changes in choroidal blood flow in response to increased intraocular pressure.

Wu, Frank I.; Glucksberg, Matthew R.



Atlantoaxial intraspinal juxtafacet cyst.  


A 69-year-old man presented with progressive paralysis of the right arm and leg with a past history of metastatic rectal cancer. Magnetic resonance imaging showed a cystic mass lesion posterior to the odontoid process. Under a preoperative diagnosis of intradural extramedullary tumor, partial transcondylectomy and C1 hemilaminectomy were performed, and the cyst was removed through a transdural approach, decompressing the medulla oblongata and the cervical spinal cord. The histological diagnosis was juxtafacet cyst (ganglion cyst). An atlantoaxial intraspinal juxtafacet cyst at the level of the odontoid process is extremely rare. In our case, the cyst was removed using a posterior approach, resulting in rapid improvement in symptoms. PMID:23438667

Sameshima, Tetsuro; Shibahashi, Keita; Nozaki, Toshiki; Akabane, Atsuya; Kihara, Atsushi; Horiuchi, Hajime; Morita, Akio



Brachial plexus trauma: the morbidity of hemidiaphragmatic paralysis  

Microsoft Academic Search

Phrenic nerve palsy has previously been associated with brachial plexus root avulsion; severe unilateral phrenic nerve injury is not uncommonly associated with brachial plexus injury. Brachial plexus injuries can be traumatic (gunshot wounds, lacerations, stretch\\/contusion and avulsion injuries) or non-traumatic in aetiology (supraclavicular brachial plexus nerve block, subclavian vein catheterisation, cardiac surgeries, or obstetric complications such as birth palsy). Despite

O I Franko; Z Khalpey; J Gates



Anterior Cervical Arachnoid Cyst  

PubMed Central

This report is composed of two patients with anteriorly located cervical intradural arachnoid cyst and review of 24 cases in Englishlanguage literature. Both of our patients were in the first two decades of life with neck pain and motor weakness. With suspicious diagnosis of anterior arachnoid cyst surgery was carried out in both cases, though laminectomy in one and laminoplasty in the other. The cyst wall was widely fenestrated with subsequent subtotal excision of the cyst. Both cases had good long-term outcome. The review disclosed male predominance. 73% of the patients were diagnosed within the first two decades of life. Neck pain and motor weakness were the dominant signs and symptoms of this pathology. Magnetic resonance imaging showing a cerebrospinal fluid (CSF) containing cyst was the best mode of diagnosis. Wide cyst fenestration with waying CSF into subarachnoid cyst was the most appropriate and applied surgery with optimal outcome.

Sharifi, Give



Anterior cervical arachnoid cyst.  


This report is composed of two patients with anteriorly located cervical intradural arachnoid cyst and review of 24 cases in Englishlanguage literature. Both of our patients were in the first two decades of life with neck pain and motor weakness. With suspicious diagnosis of anterior arachnoid cyst surgery was carried out in both cases, though laminectomy in one and laminoplasty in the other. The cyst wall was widely fenestrated with subsequent subtotal excision of the cyst. Both cases had good long-term outcome. The review disclosed male predominance. 73% of the patients were diagnosed within the first two decades of life. Neck pain and motor weakness were the dominant signs and symptoms of this pathology. Magnetic resonance imaging showing a cerebrospinal fluid (CSF) containing cyst was the best mode of diagnosis. Wide cyst fenestration with waying CSF into subarachnoid cyst was the most appropriate and applied surgery with optimal outcome. PMID:23741550

Rahimizadeh, Abolfazl; Sharifi, Give



Multifocal photodynamic therapy for diffuse choroidal hemangioma  

PubMed Central

Background A choroidal hemangioma is an uncommon benign vascular tumor of the choroid that can be either circumscribed or diffuse. In our experience, diffuse choroidal hemangiomas in Asian patients often require multiple photodynamic therapy (PDT) treatment sessions. Methods We here provide a case report of a 7-year-old boy with Sturge–Weber syndrome who presented with diffuse choroidal hemangioma in the left eye. Five sessions of PDT treatment were required over a period of 1 year and a final optical coherence tomogram 3 months later revealed resolution of subretinal fluid and the choroidal hemangioma. Results Final visual acuity was 20/100 in the left eye with resolution of subretinal fluid. This case report illustrates that a single application of PDT using standard published parameters was insufficient to achieve the destruction of the enlarged vessels. This experience is similar to previous Chinese reports on circumscribed choroidal hemangiomas. The decision for repeat treatment was based on subretinal fluid recurrence, rather than complete tumor regression. Conclusion Our case report supports previous suggestions that larger dilated vessels in the vascular network of a choroidal hemangioma might affect the efficacy and selectivity of PDT in treating the eyes of Asian patients – which may explain the need for multiple treatments.

Ang, Marcus; Lee, Shu-Yen



Choroidal calcifications in patients with Gitelman's syndrome.  


Gitelman's syndrome is a renal tubular disorder characterized by a sodium and chloride reabsorption defect in distal tubular cells that determines hypokalemia, metabolic alkalosis, hypomagnesemia, and low calcium excretion. The presence of choroidal calcifications was sought in five patients with Gitelman's syndrome by ophthalmic examination, fluorescein angiography, indocyanine green angiography, and ocular ultrasonography. Calcifications observed in the choroid of two patients were shown by ultrasonography in both patients. Ophthalmic and fluorangiographic examinations detected this alteration in one of the two subjects. Chondrocalcinosis was found in one patient with choroidal calcifications. These findings suggest that precipitation of calcium salts can occur in the choroidal tissue of patients with Gitelman's syndrome. Deposits appeared to be well seen by ultrasonography because of their depth in ocular tissues. Sclerochoroidal calcifications may be favored by the low calcium excretion, which is associated with normal intestinal calcium absorption in patients with Gitelman's syndrome. PMID:11007691

Vezzoli, G; Soldati, L; Jansen, A; Pierro, L



Enucleation versus plaque irradiation for choroidal melanoma.  


The Collaborative Ocular Melanoma Study (COMS) is an international, multicenter-controlled study. The organization includes an Executive Committee, Steering Committee, 6 Central Units, 32 Clinical Centers, and a Data and Safety Monitoring Committee. Scientifically, the COMS consists of (1) a randomized trial of patients with medium choroidal melanoma treated with enucleation versus iodine-125 plaque irradiation, (2) a randomized trial of patients with large choroidal melanoma treated with enucleation versus preenucleation external beam irradiation and enucleation, and (3) a prospective observational study of patients with small choroidal melanoma to determine whether a randomized trial of treatment is appropriate. In design and conduct of the COMS, special consideration is given to biostatistics and sample size considerations, iodine-125 plaque irradiation of choroidal melanoma, and coordinated ocular melanoma research. Recruitment is in progress. However, the pool of eligible patients is limited and the COMS needs the continued support and cooperation of ophthalmologists throughout the United States and Canada. PMID:3174030

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



Enucleation versus plaque irradiation for choroidal melanoma  

SciTech Connect

The Collaborative Ocular Melanoma Study (COMS) is an international, multicenter-controlled study. The organization includes an Executive Committee, Steering Committee, 6 Central Units, 32 Clinical Centers, and a Data and Safety Monitoring Committee. Scientifically, the COMS consists of (1) a randomized trial of patients with medium choroidal melanoma treated with enucleation versus iodine-125 plaque irradiation, (2) a randomized trial of patients with large choroidal melanoma treated with enucleation versus preenucleation external beam irradiation and enucleation, and (3) a prospective observational study of patients with small choroidal melanoma to determine whether a randomized trial of treatment is appropriate. In design and conduct of the COMS, special consideration is given to biostatistics and sample size considerations, iodine-125 plaque irradiation of choroidal melanoma, and coordinated ocular melanoma research. Recruitment is in progress. However, the pool of eligible patients is limited and the COMS needs the continued support and cooperation of ophthalmologists throughout the United States and Canada.

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



A Histologic Study of Regional Choroidal Dystrophy.  

National Technical Information Service (NTIS)

Light and electron microscopy studies of eyes removed from an 84-year-old man after death indicated a normal optic nerve despite severe peripapillary choroidal atrophy. In the area of atrophy, the choriocapillaris retinal pigment epithelium, and photorece...

J. Weiter B. S. Fine



Proton beam irradiation of choroidal hemangiomas  

Microsoft Academic Search

PURPOSE: To present a large series of choroidal hemangiomas treated with proton beam irradiation and to describe the treatment outcomes.METHODS: We treated 54 eyes of 53 patients with choroidal hemangioma. The lesions consisted of 48 circumscribed hemangiomas and six diffuse hemangiomas in patients with Sturge-Weber syndrome. The total applied dose was 27.3 Gy in four eyes, 22.7 Gy in three

Leonidas Zografos; Emmanuel Egger; Ludmila Bercher; Line Chamot; Gudrun Munkel



Nitric Oxide and Choroidal Blood Flow Regulation  

Microsoft Academic Search

Purpose. Nitric oxide (NO) has been found to be an endothelial-derived relaxing factor mediating the vasodilatation that results from the stimulation of muscarinic endothelial recep- tors. It also has been identified as a putative neurotransmitter of parasympathetic origin in choroidal perivascular autonomic fibers. The authors investigated a potential role of NO in choroidal blood flow (ChBF) regulation. Methods. Local ChBF

R. M. Mann; C. E. Riva; R. A. Stone; G. E. Barnes; S. D. Cranstoun


[Knee joint cyst].  


Ninety cases of knee joint cysts were treated surgically. This included 50 patients with rheumatoid arthritis, 22 patients with degenerative-deforming changes, ten children with true cysts, and eight ones with post-traumatic cysts. Double-contrast X-ray examination with Lipiodol Ultra-fluid and air is of the best diagnostic value. All cases of knee joint cysts were treated surgically with a careful plastic closure of cyst gate. For this purpose the authors used the arcus tendon of the semi-membranous muscle. In cases of rheumatoid arthritis and degenerative changes cyst removal was preceded by synovectomy of the knee joint. Early and remote were good, no recurrence was observed. PMID:1299044

Noczy?ski, L; Benarz, W; Wojczys, R



Presumed choroidal metastasis of Merkel cell carcinoma  

SciTech Connect

Merkel cell carcinoma is a rare skin tumor of neural crest origin and is part of the amine precursor uptake and decarboxylase system. It typically occurs on the face of elderly people. Distant metastasis is almost uniformly fatal. Choroidal metastasis, to our knowledge, has not been described. We report a patient with Merkel cell carcinoma who had a synchronous solid choroidal tumor and a biopsy-proven brain metastasis. Our 56-year-old patient presented with a rapidly growing, violaceous preauricular skin tumor. Computed tomography of the head disclosed incidental brain and choroidal tumors. Light and electron microscopy of biopsy specimens of both the skin and the brain lesions showed Merkel cell carcinoma. Ophthalmoscopy, fluorescein angiography, and A and B echography revealed a solid choroidal mass. The brain and skin tumors responded well to irradiation. A radioactive episcleral plaque was applied subsequently to the choroidal tumor. All tumors regressed, and the patient was doing well 28 months later. To our knowledge this is the first case of presumed choroidal metastasis of Merkel cell carcinoma.

Small, K.W.; Rosenwasser, G.O.; Alexander, E. III; Rossitch, G.; Dutton, J.J. (Duke Univ. Medical Center, Durham, NC (USA))



The choroid as a sclera growth regulator.  


Emmetropization is a vision dependent mechanism that attempts to minimize refractive error through coordinated growth of the cornea, lens and sclera such that the axial length matches the focal length of the eye. It is generally accepted that this visually guided eye growth is controlled via a cascade of locally generated chemical events that are initiated in the retina and ultimately cause changes in scleral extracellular matrix (ECM) remodeling which lead to changes in eye size and refraction. Of much interest, therefore, are the molecular mechanisms that underpin emmetropization and visually guided ocular growth. The choroid, a highly vascularized layer located between the retina and the sclera is uniquely situated to relay retina-derived signals to the sclera to effect changes in ECM synthesis and ocular size. Studies initiated by Josh Wallman clearly demonstrate that the choroid plays an active role in emmetropization, both by modulation of its thickness to adjust the retina to the focal plane of the eye (choroidal accommodation), and well as through the release of growth factors that have the potential to regulate scleral extracellular matrix remodeling. His discoveries prompted numerous investigations on the molecular composition of the choroid and changes in gene expression associated with visually guided ocular growth. This article will review molecular and functional studies of the choroid to provide support for the hypothesis that the choroid is a source of sclera growth regulators that effect changes in ocular growth in response to visual stimuli. PMID:23528534

Summers, Jody A



Infected mesenteric cyst.  


Mesenteric cyst is a rare condition. Presentation with non-typhoid spontaneous infection in an unusual area makes it even more a rare situation with mesenteric cyst. Its diagnosis is mainly based on the imaging modalities. However, there are difficulties in diagnosis when it is present in an uncommon area and rare known complications. Mesenteric cyst can present with few uncommon emergency conditions which pose difficulties in diagnosis as well as treatment options as mentioned in this case. PMID:23605820

Reddy, G Ramesh; Gunadal, Shankar; Banda, Vanaja Reddy; Banda, Naveen Reddy



Mild Ventriculomegaly, Mild Cerebellar Hypoplasia and Dysplastic Choroid Plexus as Early Prenatal Signs of CHARGE Association  

Microsoft Academic Search

CHARGE association has been diagnosed postnatally in increasing numbers since the first description in 1979. The acronym CHARGE includes the abnormalities ocular Colobomas (iris, retina or nervus opticus), Heart disease, Atresia of choanae, Retarded growth and development and\\/or central nervous system anomalies, Genital hypoplasia, Ear anomalies and deafness. So far, no prenatal diagnosis of the CHARGE association has been described;

Rolf Becker; Beate Stiemer; Luitgard Neumann; Michael Entezami



[Intraventricular schwannoma of the choroid plexus. Case report and review of the literature.  


INTRODUCTION: Intraventricular tumors account for approximately 10% of central nervous system tumors. The intraventricular schwannomas are rare because there are only 15 cases reported in the international literature. CASE REPORT: A forty-one years old female, with a history of migraines during 17 years, consulted for headaches and nausea. Brain computed tomography and magnetic resonance imaging evidenced solid nodular lesion at the right occipital horn with homogeneous contrast enhancement. Complete excision was performed through a right parietal craneotomy and a transcortical approach. The postoperative evolution was favorable. The pathology report: schwannoma. The magnetic resonance imaging 18 months after resection showed no recurrence of tumors. CONCLUSION: Intraventricular schwannomas are very rare tumors. Surgery is treatment of choice for total resection. This is a diagnosis to consider in intraventricular tumors. PMID:23517695

Alberione, Federico; Welter, Diego; Peralta, Belén; Schulz, Javier; Asmus, Humberto; Brennan, Walter



Lack of correlation between tight junction morphology and permeability properties in developing choroid plexus  

Microsoft Academic Search

ELECTRON microscopical investigations of tight junctions (zonulae occludentes) using marker substances, have indicated that in some tissues these junctions may represent an extracellular pathway for transepithelial movement of certain small solutes1 and also restrict the movement of larger solutes2. The electrical resistance across some epithelial tissues has been used as a measure of the degree of permeability of the tight




Infected hepatic cyst.  


We describe an unusual case involving an infected hepatic cyst. An 88-year-old woman presented with acute onset of right upper quadrant abdominal pain, mild left lower abdominal pain, diarrhea, and fever. On admission, computed tomography revealed multiple hepatic cysts including an 8-cm cyst located in the left medial segment of the liver, which demonstrated a thickened wall enhanced with contrast media. Ultrasonography showed an 8-cm hypoechoic lesion which differed in appearance from the other, anechoic hepatic cysts. The serum concentration of C-reactive protein was 29.8 mg/dL; white blood cell count, 12,800/microL; CA19-9, 96 U/mL; and CEA, 2.2 ng/mL. Diagnosis of infected hepatic cyst was made by percutaneous transhepatic drainage of the cyst. Milky fluid was obtained and the patient's right upper quadrant abdominal pain resolved after drainage. The cyst fluid CA19-9 concentration was 18,000 U/mL. Cytology of the cyst fluid was negative. Serum CA19-9 (41 U/mL) and CEA (1.8 ng/mL) concentrations were improved 1 week after drainage. Escherichia coli was cultured from the drainage fluid. The patient was discharged 27 days after admission. Percutaneous transhepatic drainage is effective in the treatment of infected hepatic cysts. PMID:12749258

Yoshida, Hiroshi; Onda, Masahiko; Tajiri, Takashi; Mamada, Yasuhiro; Taniai, Nobuhiko; Mineta, Sho; Hirakata, Atsushi; Futami, Ryohei; Arima, Yasuo; Inoue, Matsuoh; Hatta, Shigeo; Kishimoto, Akio


Intradural bronchogenic cysts.  

PubMed Central

The pathological findings of an intradural and extramedullary cyst in the mid cervical spinal canal are described in a 55 year old woman who presented with a short history of pain and paraesthesia of the right arm. Intradural well defined solitary cystic lesions in the spinal canal are uncommon, their pathogenesis is poorly understood, and their nomenclature is confusing. In this case the cyst was a bronchogenic cyst; these are a rare form of such cysts and they are thought to be a malformation arising from a split notochordal syndrome and not a teratoma. Images

Wilkinson, N.; Reid, H.; Hughes, D.



Intraspinal arachnoid cysts  

Microsoft Academic Search

Summary Eight cases of intraspinal arachnoid cysts are described. The clinical, radiological, intraoperative and histological findings are presented and compared with similar reports in the literature.

A. L. Agnoli; R. Schönmayr; A. Laun



Orbital blood cyst.  

PubMed Central

A blood cyst of the orbit is an unusual cause of proptosis and most likely arises in a pre-existing haemangioma. If the cyst occurs at the apex of the orbit the blood should be aspirated. This is followed by excision of the cyst wall, the dissection being done with the aid of an operating microscope. If there is evidence of intracranial connection of the blood cyst, namely, splayed superior orbital fissure or cerebrospinal fluid leak, then the patient should be treated with an antibiotic to prevent intracranial infection. Images

Sevel, D.; Rosales, A.



Dermoid cyst: unusual localization.  


Dermoid cysts are embryonic lesions usually observed in the lateral eyebrow region and the midline nose and neck areas. Communication of these lesions with the central nervous system is rare and occurs in the nasal region. There are few clinical reports of temporal dermoid cysts presenting with intracranial extension, and we present a 15-year-old girl with a fronto-orbital dermoid cyst with intracranial extension and bone erosion. Her presenting symptom was a lacrimation reduction of the left eye. Excision of the cyst was done using a coronal approach because of its extension and localization. PMID:22976680

Rinna, Claudio; Reale, Gabriele; Calafati, Vincenzo; Calvani, Francesco; Ungari, Claudio



Retinal choroidal anastomoses and occult choroidal neovascularization in age-related macular degeneration  

Microsoft Academic Search

ObjectiveThis study was designed to identify the incidence of retinal choroidal anastomoses in patients with occult choroidal neovascularization (CNV) and focal hot spots on indocyanine green (ICG) angiography, to identify the clinical and angiographic features that would assist in their identification, and to determine if the presence of these anastomotic lesions affect the outcome of laser therapy.

Jason S Slakter; Lawrence A Yannuzzi; Ulrike Schneider; John A Sorenson; Antonio Ciardella; David R Guyer; Richard F Spaide; K. Bailey Freund; Dennis A Orlock



Genetics Home Reference: Gyrate atrophy of the choroid and retina  


... Genetic disorder catalog Conditions > Gyrate atrophy of the choroid and retina (often shortened to gyrate atrophy ) On ... What is gyrate atrophy? Gyrate atrophy of the choroid and retina, which is often shortened to gyrate ...


Primary Mediastinal Cysts  

PubMed Central

The purpose of this retrospective study was to analyze our experience with mediastinal cysts, emphasizing the clinical presentations and results of surgery. Thirty-two patients with mediastinal cysts underwent surgery from January 2000 through June 2005. The records of these patients were reviewed for age at presentation, sex, signs and symptoms at presentation, results of the imaging techniques, types of mediastinal cysts, location and size of cysts, types of surgical procedure, length of hospital stay, early postoperative complications, death, and other follow-up information. The 32 mediastinal cysts comprised 12 bronchogenic, 9 pericardial, 7 thymic, and 2 enteric cysts, together with 2 cystic teratomas. Overall, 14 of the 32 patients with mediastinal cysts were asymptomatic. The surgical approach was thoracotomy in 30 patients and median sternotomy in 2 patients. The mean length of hospital stay was 7.7 ± 2.6 days. All patients were free from recurrence during the mean follow-up period of 4.4 ± 3.3 years. Surgery for mediastinal cysts is associated with low morbidity and mortality rates and a very low recurrence rate. It offers a definitive diagnosis and cure, avoiding the higher morbidity and mortality risks associated with conservative observation.

Esme, Hidir; Eren, Sevval; Sezer, Murat; Solak, Okan



Subcutaneous Dermoid Cysts.  

National Technical Information Service (NTIS)

The clinical and pathologic features of 50 subcutaneous dermoid cysts were analyzed. The lesions were usually noted at birth and occurred along lines of embryonic fusion. Forty-one cysts were located in the region of the head, mainly about the eyes; nine ...

M. H. Brownstein E. B. Helwig



Fluorescence Microscopic Study of the Architecture and Structure of an Adrenergic Network in the Plexus myentericus (Auerbach), Plexus submucosus externus (Schabadasch) and Plexus submucosus internus (Meissner) of the Porcine Small Intestine  

Microsoft Academic Search

The distribution of adrenergic fibres in the ganglionated plexuses of the porcine small intestine has been made on air-dried stretch preparations using the glyoxylic acid fluorescence method. Adrenergic fluorescent fibres occur in the ganglia and internodal strands of the three fundamental ganglionated plexuses: the myenteric plexus (Auerbach) and the two superimposed meshworks of the plexus submucosus, i.e. the plexus submucosus

Dietrich W. Scheuermann; Werner Stach



Laparoscopic adrenal cyst resection.  


Two patients with left adrenal cysts underwent laparoscopic resection. In one case an adrenal origin of the cyst was suspected. In the other case the cyst was thought to be renal in origin. Both patients were female, ages 16 and 40 years. Operative time was 150 and 160 minutes. Blood loss was 50 and 30 mL. One patient received 14 mg of morphine and 60 mg of ketorolac. The other patient did not require any parenteral analgesics. Hospital stay was 1 day for both patients. Return to normal activity occurred at 15 and 7 days postoperatively, respectively. Histology in both cases revealed benign adrenal cysts. Our experience supports the laparoscopic approach for resection of adrenal cysts. PMID:9892002

Williams, J F; Wolf, J S



Primary perisplenic hydatid cyst.  


Splenic parasitic cysts due to flat worm Echinococci resulting in hydatid disease are a rare presentation as primary site even in the endemic regions. Primary splenic parasitic cysts have an incidence of 0.5-4%. A 21-year-old male with pet dogs at home, presented with 3 months history of gradually increasing discomfort in the left hypochondrium and tender splenomegaly. He had marked eosinophilia with normal liver function tests and positive serum IgM Echinococcus antibodies. Ultrasonography showed a cyst in the hilar region of spleen having septations with internal echos. An upper midline laparotomy was performed and a perisplenic cyst was removed along with spleen from the sub-diaphragmatic location. Histopathological examination confirmed acellular fibrous wall of hydatid cyst with germinal layer and scolices in the centre. Postoperatively, patient was continued on oral Albendazole for one month. PMID:19486579

Sharif, Muhammad Ashraf; Mahmood, Asad; Murtaza, Badar; Malik, Imran Bashir; Khan, Abdullah; Asghar, Zunera; Arif, Adeel



Inner cyst approach, remove bronchial cervical cyst.  


Although most cystic lesions in young adults represent a branchial cleft cyst, the bronchial cervical cyst is not rare (Acta Oto-Laryngologica 2010;130:300). Surgical excision is both diagnostic and curative and also eliminates the risk of infection or recurrence. As we have all known, it is hard to protect some important structures in an inflamed tissue, especially in infants. However, a correct approach can avoid this kind of iatrogenic injury. An accurate diagnosis is always by pathologic examination. The diagnosis can be made before operation when finding cartilage in the nodule. We present the preoperative diagnosis by finding gas in the nodule and removed it by inner cyst approach without surrounding tissue injury. PMID:24036776

Chen, Jiangbing; Shen, Weimin; Cui, Jie



Dermoid cyst: A rare intramedullary inclusion cyst  

PubMed Central

Intramedullary dermoid cysts are rare tumors, especially those not associated with spinal dysraphism. Only six cases have been reported in the literature. Of these, only two cases have had magnetic resonance imaging studies. We report a case of an 18-year-old female patient, who presented with progressive weakness of both the lower limbs and wasting of both the upper limbs. Magnetic resonance imaging (MRI) showed an intramedullary lesion extending from C3 to D2 with peripheral enhancement on contrast. Decompression of the cystic contents with partial removal of cyst wall was done. Hair with oily cholesterol and keratin debris was encountered. Histopathology confirmed the diagnosis of dermoid cyst. This case adds to the previous reported cases of the rare and uncommon intramedullary space occupying lesions of the spinal cord.

Patankar, A. P.; Sheth, J. H.



Dermoid cyst: A rare intramedullary inclusion cyst.  


Intramedullary dermoid cysts are rare tumors, especially those not associated with spinal dysraphism. Only six cases have been reported in the literature. Of these, only two cases have had magnetic resonance imaging studies. We report a case of an 18-year-old female patient, who presented with progressive weakness of both the lower limbs and wasting of both the upper limbs. Magnetic resonance imaging (MRI) showed an intramedullary lesion extending from C3 to D2 with peripheral enhancement on contrast. Decompression of the cystic contents with partial removal of cyst wall was done. Hair with oily cholesterol and keratin debris was encountered. Histopathology confirmed the diagnosis of dermoid cyst. This case adds to the previous reported cases of the rare and uncommon intramedullary space occupying lesions of the spinal cord. PMID:22870157

Patankar, A P; Sheth, J H



Choroidal thickness changes during the menstrual cycle.  


Abstract Purpose: To evaluate the effects of the menstrual cycle on the choroidal thickness of healthy women of reproductive age using spectral-domain optical coherence tomography. Materials and methods: A total of 23 right eyes of 23 women with regular natural menstrual cycles of 28-30?d and ages 22-30 years were included in this prospective study. The choroidal thicknesses of the women were measured using high-resolution spectral-domain optical coherence tomography line scans with the activated enhanced depth imaging mode in the early follicular, ovulatory and mid-luteal phases of the menstrual cycle (3rd, 14th and 21st days) using a follow-up scanning protocol of the Spectralis optical coherence tomograph by setting the early follicular phase scan as the reference image. Choroidal thickness measurements were taken at the fovea and at two points that were 1500?µm nasal and temporal to the fovea. The mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses were also measured. All measurements were taken within the same menstrual cycle. Results: The mean?±?standard deviation (standard error of the mean) of subfoveal choroidal thicknesses in the early follicular, ovulatory and mid-luteal phases were 383.87?±?84.38 (17.59), 373.74?±?82.40 (17.18) and 359.09?±?79.65 (16.61) µm, respectively. The relative reductions in choroidal thickness between early follicular and ovulatory phases and early follicular and mid-luteal phases were 2.64% and 6.47%, respectively. The subfoveal choroidal thickness was decreased significantly in the mid-luteal phase when compared with both the early follicular (p?choroidal thickness in the early follicular phase were non-conclusively greater (p?=?0.071) than in the ovulatory phase. Additionally, the mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses did not significantly differ during the menstrual cycle (p?>?0.05 for all). Conclusions: The choroidal thickness decreased significantly in the mid-luteal phase of the menstrual cycle in young, healthy women. These findings emphasize the importance of the menstrual phase in the interpretation of choroidal thickness measurements in women of reproductive age. PMID:23841496

Ula?, Fatih; Do?an, Umit; Duran, Bülent; Kele?, Asena; A?ca, Sümeyra; Celebi, Serdal



Brachial plexus variations during the fetal period.  


The brachial plexus is an important nervous system structure. It can be injured during the perinatal period and by postnatal damage. The goal of this study was to assess human fetal brachial plexus variability. A total of 220 brachial plexuses were surgically prepared from 110 human fetuses aged 14-32 weeks of fetal life (50 females and 60 males) ranging in CRL from 80 to 233 mm. The study incorporated the following methods: dissectional and anthropological, digital image acquisition, digital image processing using Image J and GIMP software, and statistical methods (Statistica 9.0). Symmetry and sexual dimorphism were examined. Anomalies of the brachial plexuses were observed in 117 (53.18 %) cases. No sexual dimorphism was found. It was observed that cord variations occurred more often on the left side. Division variants (33.64 %) occurred most often, but also cords (18.18 %) as well as root nerves and terminal ramifications (15.90 %) were found. Trunk anomalies were rare and occurred in only 5.45 % of plexuses. Three height types of median nerve roots in combination with the nerve were distinguished. In one-third of cases, median nerve root connections were found below the axillary fossa and even half in the proximal part of the humerus. In conclusion, the brachial plexus was characterized for anatomical structural variability. Most often division and cord variations were observed. Anomalies occurred regardless of sex or body side except for cord variants. Brachial plexus variation recognition is significant from the neurosurgical and traumatological point of view. PMID:22945314

Wo?niak, Jowita; K?dzia, Alicja; Dudek, Krzysztof



Management of adult choledochal cysts.  

PubMed Central

A review of the English literature reveals a total of 1,337 patients with choledochal cysts. Improved diagnostic techniques to visualize the biliary system are demonstrating an increasing number of unsuspected choledochal cysts in adult patients. Either choledochal cysts remain clinically silent until adulthood or may develop in later life. Experience is reported with adult patients having type I, II, III, and IV choledochal cysts. Type I cysts are preferably managed by excision but cyst anatomy may necessitate choledochoenteric drainage. Type II cysts are treated by excision except for those located within the pancreatic portion of the common bile duct. These are best managed by transduodenal cystoduodenostomy. The type III cyst (choledochocele) should be excised carefully, identifying and preserving the common bile and pancreatic ducts. Type IV cysts include a combination of any one of the first three types of cyst plus the presence of intrahepatic cyst or cysts. Treatment of these cysts is dictated by the type and location of the extrahepatic cyst. Since choledochal cysts are being recognized with increased frequency in adults, surgeons need to be aware of the diagnostic and treatment modalities available for each type of biliary cyst. Images Fig. 3. Fig. 4. Fig. 6. Fig. 7. Fig. 9. Fig. 10.

Powell, C S; Sawyers, J L; Reynolds, V H



Tuberculosis of the urachal cyst  

PubMed Central

Urachal cysts are uncommon. Rarely, these cysts can become infected. Tuberculosis of the urachal cyst is exceedingly rare, with only one case reported previously in the English language literature. Here we report the case of a 23-year-old male who presented with an infra-umbilical mass that turned out to be tuberculosis of the urachal cyst.

Kamal, Mir Reza; Jha, Jayesh Kumar



Tuberculosis of the urachal cyst.  


Urachal cysts are uncommon. Rarely, these cysts can become infected. Tuberculosis of the urachal cyst is exceedingly rare, with only one case reported previously in the English language literature. Here we report the case of a 23-year-old male who presented with an infra-umbilical mass that turned out to be tuberculosis of the urachal cyst. PMID:23346004

Jindal, Tarun; Kamal, Mir Reza; Jha, Jayesh Kumar



[Intraventricular arachnoid cyst].  


INTRODUCTION. Intracranial arachnoids cysts are considered benign developmental anomalies that occur within the arachnoid membrane and generally contain clear and colourless fluid resembling cerebrospinal fluid. The prevalence of these cysts is higher in the first two decades of life, and the incidence is widely quoted as approximately 1% of all space-occupying intracranial lesions. Arachnoids cysts in the elderly person are a rare occurrence. We report the unusual presentation of a woman with an intraventricular arachnoid cyst treated with endoscopic technique. CASE REPORT. A 75-year-old woman presented with progressive hemiparesis of two years duration. Cranial MR imaging showed a right parieto-occipital intraventricular cyst with local mass effect and moderate dilatation of lateral ventricles. A right-sided burr hole was made and the arachnoids cyst was reached and cysto-ventricle shunting was realized. This was followed by a septum pellucidum fenestration. There were no complications during the surgery and the patient presented no symptoms at time of discharge. CONCLUSIONS. The neuroendoscopic approach to intraventricular arachnoid cysts was effective with few complications. PMID:23799598

Rico-Cotelo, María; Diaz-Cabanas, Lucía; Allut, Alfredo G; Gelabert-Gonzalez, Miguel



Tarlov Cyst and Infertility  

PubMed Central

Background/Objective: Tarlov cysts or spinal perineurial cysts are uncommon lesions. These are mostly incidental findings on magnetic resonance imaging or myelograms. The objectives of this study were to describe Tarlov cysts of the sacral region as a potential cause for retrograde ejaculations and review available management options. Methods: Case report and literature review. Results: A 28-year-old man presented with back pain and retrograde ejaculations resulting in infertility. After microsurgical excision of large perineurial cysts, back pain resolved, but semen quality showed only marginal improvement. Later, the couple successfully conceived by intrauterine insemination. To the best of our knowledge, this is the first reported case of Tarlov cyst associated with retrograde ejaculation and infertility. Conclusions: Despite being mostly asymptomatic and an incidental finding, Tarlov cyst is an important clinical entity because of its tendency to increase in size with time. Tarlov cysts of the sacral and cauda equina region may be a rare underlying cause in otherwise unexplained retrograde ejaculations and infertility. Microsurgical excision may be a good option in a select group of patients.

Singh, Pankaj Kumar; Singh, Vinay Kumar; Azam, Amir; Gupta, Sanjeev



A case of reversible paraparesis following celiac plexus block  

Microsoft Academic Search

Background and Objectives: Permanent and acute reversible paraplegia following celiac plexus block (CPB) have been reported. We report a case of prolonged reversible paraparesis after alcohol celiac plexus block. Case Report: A 72-year-old man with primary multicentric pancreatic tumor and multiple hepatic metastases underwent alcohol celiac plexus neurolysis for severe abdominal pain radiating to the back. The patient had complete

Ashok Kumar; Shiva S. Tripathi; Debashish Dhar; Abhijit Bhattacharya



Delayed brachial plexus paralysis due to subclavian after clavicular fracture  

Microsoft Academic Search

Injuries to the brachial plexus and subclavian artery are serious complications of shoulder girdle trauma. Due to the close anatomical relationship between the brachial plexus and the subclavian artery in the thoracic outlet, both structures are often simultaneously involved in shoulder girdle injuries. Isolated lesions of the subclavian artery or the brachial plexus can also occur, especially with clavicular fractures.

B. Hansky; E. Murray; K. Minami; R. Kiirfer


Bilateral Testicular Epidermoid Cysts  

PubMed Central

Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a correct pre-operative diagnosis on imaging to enable a testis-sparing surgery.

Loberant, Norman; Bhatt, Shweta; Messing, Edward; Dogra, Vikram S.



Classification of ovarian endometriotic cysts.  


Current literature describes 3 different pathogenetic types of ovarian endometriotic cysts. Cortical invagination cysts arise when surface ovarian endometriotic deposits adhere to another structure (such as the broad ligament), blocking the egress of menstrual fluid produced by cycling endometriosis, which then collects and causes the ovarian cortex to invaginate. Surface inclusion cyst-related endometriotic cysts develop when endometriotic tissue colonizes preexisting inclusion cysts. Physiological cyst-related endometriotic cysts occur when endometriosis gains access to a follicle, such as at the time of ovulation. To determine whether routine histological examination is of use in the classification of endometriotic cysts, and if so, whether such classification is of clinical relevance, we reviewed the histology of endometriotic cysts of 29 women under 35 years of age. Young women were chosen so that ovarian cortex surrounding the endometriotic lining in invagination cysts could be identified by the finding of oocytes. Ten women (34%) had cortical invagination endometriotic cysts, but no inclusion or physiological cyst-related endometriomas were found. The remaining 19 women (66%) had unclassified endometriotic cysts, of which 14 (48% of total) had a fibrous wall between the endometriotic lining and medulla and 5 had extensive destruction of ovarian tissue. We concluded that cortical invagination cysts were the only common diagnosable sort of the 3 types currently being investigated and that unclassified cysts required further study to determine their pathogenesis. Our study highlights the need for a prospective study using standardized pathological and clinical methods. PMID:11293160

Scurry, J; Whitehead, J; Healey, M



Combination therapy for choroidal neovascularisation.  


Choroidal neovascularisation (CNV) often leads to severe vision loss and is becoming increasingly prevalent as the aging population grows. Age-related macular degeneration (AMD) is the most common cause of CNV, but CNV also affects younger people with pathological myopia, ocular histoplasmosis syndrome, angioid streaks and idiopathic disorders. The monotherapies available worldwide to treat patients with CNV have primarily been studied in CNV due to AMD, and all have their drawbacks. Combination therapy takes advantage of the strengths of each therapy and their different mechanisms of action to achieve good treatment outcomes with few repeated treatments. For example, combination (triple) therapy with verteporfin photodynamic therapy, anti-vascular endothelial growth factor (VEGF) therapy and anti-inflammatory therapy addresses three main targets of CNV development: the CNV itself, VEGF expression (which promotes CNV growth) and inflammation (which exacerbates the disease process). Such triple therapy has been shown to result in sustained improved vision after only one treatment. Vision outcomes similar to those observed with ranibizumab, the most promising and rigorously proven anti-VEGF monotherapy, may be possible with combination therapy without the need for continued monthly intravitreal injections, which are required if sustained outcomes are to be achieved with ranibizumab. The goal of CNV therapy is improved vision outcomes after one course of treatment. Combination therapy may lead to this goal. Such treatment could also result in fewer safety issues (fewer treatments are required and the unknown effects of continued long-term treatment are avoided), lower cost to both the patient and the medical system and greater convenience for patients (fewer clinic visits). However, combination therapy is beset with several challenges: different therapies, doses, timing and treatment sequences are possible, and it is therefore difficult to conduct large, definitive clinical trials to determine which treatment regimen is safest and most effective. Large controlled studies are needed to more clearly define effective and safe combination regimens for CNV. PMID:18020531

Augustin, Albert J; Offermann, Indre



[Percutaneous renal cyst puncture].  


Ultrasound-guided renal cyst puncture was performed on 31 cysts which were then 95% ethanol instilled to prevent recurrence of cystic fluid. Ethanol was allowed to remain in place for 20 minutes and removed through the catheter. Morphological improvement was observed on IVP and Tc-99m-DMSA renal scintigram, and DMSA renal uptake rate increased slightly. The cystic wall became thicker, and cystic fluid did not remain any more. The renal tissue near the cyst was intact. One third of the patients had hotflush and/or somewhat drunken sense but these symptoms were only temporary. This method of therapy is a safe and effective way of treating renal cysts. PMID:2998166

Higashi, Y; Kawamura, J; Yoshida, O



Rotifers ingest Giardia cysts.  


Seven species of rotifers representing 6 genera, Epiphanes, Plationus, Asplanchna, Philodina species A, Philodina species B. Platyias, and Brachionus, were exposed to Giardia cysts isolated from the feces of experimentally infected holstein calves. Giardia cysts were prestained with a fluorescein isothiocyanate-conjugated monoclonal antibody and mixed with viable rotifers on 3-well Teflon-coated microscope slides. Organisms were observed with phase-contrast, differential interference contrast, and fluorescence microscopy. Five rotifer species, Epiphanes brachionus, Plationus patulus, Philodina (both A and B), and Platyias quadricornis, ingested varying numbers of cysts, which were retained within the rotifers' bodies throughout the observation period. Rotifer ingestion of Giardia cysts may represent a means of reducing water contamination. PMID:12435156

Trout, J M; Walsh, E J; Fayer, R




NSDL National Science Digital Library

In this activity, learners examine how brine shrimp populations can survive in some of the harshest environments. Learners subject brine shrimp cysts to extreme conditions to evaluate the hardiness of these creatures.

Utah, University O.



Electrodiagnostic assessment of the brachial plexus.  


The brachial plexus is one of the largest and most complex structures of the peripheral nervous system and, as such, cannot be studied by a single nerve conduction study (NCS) or muscle sampled by needle electrode examination (NEE). Typically, the screening sensory NCS is used and expanded to identify the region of involvement, the motor NCS is applied to determine the severity of the process, and the NEE is used to further characterize the lesion. Our approach to the electrodiagnostic assessment of the brachial plexus is the focus of this article; 3 electrodiagnostic cases with discussion follow this article. PMID:22361374

Ferrante, Mark A



Spinal extradural arachnoid cyst  

Microsoft Academic Search

Summary  Spinal extradural arachnoid cysts are rare expanding lesions in the spinal canal. They usually present with progressive signs\\u000a and symptoms caused by spinal cord compression if they enlarge. A comprehensive review about spinal extradural arachnoid cyst\\u000a is made including the author’s own case of a 59-year-old woman with a 6-month history of progressive back pain radiating to\\u000a both legs. Key

J. Y. Choi; S. H. Kim; W. S. Lee; K. H. Sung



Age-related macular degeneration: choroidal ischaemia?  

PubMed Central

Aim Our aim is to use ultrasound to non-invasively detect differences in choroidal microarchitecture possibly related to ischaemia among normal eyes and those with wet and dry age-related macular degeneration (AMD). Design Prospective case series of subjects with dry AMD, wet AMD and age-matched controls. Methods Digitised 20?MHz B-scan radiofrequency ultrasound data of the region of the macula were segmented to extract the signal from the retina and choroid. This signal was processed by a wavelet transform, and statistical modelling was applied to the wavelet coefficients to examine differences among dry, wet and non-AMD eyes. Receiver operating characteristic (ROC) analysis was used to evaluate a multivariate classifier. Results In the 69 eyes of 52 patients, 18 did not have AMD, 23 had dry AMD and 28 had wet AMD. Multivariate models showed statistically significant differences between groups. Multiclass ROC analysis of the best model showed an excellent volume-under-curve of 0.892±0.17. The classifier is consistent with ischaemia in dry AMD. Conclusions Wavelet augmented ultrasound is sensitive to the organisational elements of choroidal microarchitecture relating to scatter and fluid tissue boundaries such as seen in ischaemia and inflammation, allowing statistically significant differentiation of dry, wet and non-AMD eyes. This study further supports the association of ischaemia with dry AMD and provides a rationale for treating dry AMD with pharmacological agents to increase choroidal perfusion. registration NCT00277784.

Coleman, D Jackson; Silverman, Ronald H; Rondeau, Mark J; Lloyd, Harriet O; Khanifar, Aziz A; Chan, R V Paul



Polypoidal choroidal vasculopathy with large vascular network  

Microsoft Academic Search

Purpose. To report characteristics of polypoidal choroidal vasculopathy (PCV) of large vascular networks that expand across the retinal vascular arcade. Methods. Among 60 consecutive eyes diagnosed as having PCV by fluorescein and indocyanine green (ICG) angiography, 12 eyes (9 patients) showed large lesions. The clinical and angiographic features of these 12 eyes were studied retrospectively. Results. Cases of large PCV

Hisashi Tateiwa; Sachiko Kuroiwa; Satoko Gaun; Jun Arai; Nagahisa Yoshimura



Photodynamic Therapy of Symptomatic Choroidal Nevi  

PubMed Central

Purpose: To evaluate the role of photodynamic therapy (PDT) for patients with symptomatic choroidal nevi involving the fovea or located near the fovea with subretinal fluid extending to the fovea. Materials and Methods: Retrospective review of five patients who underwent PDT for choroidal nevi at two separate centers in Ankara and Barcelona. Results: The mean initial logMAR visual acuity was 0.5 (range: 0 to 1.5). The mean largest tumor base diameter was 3.2 mm (range: 2.1–4.5 mm) and the mean tumor thickness was 1.1 mm (range: 0.7–1.6 mm). The mean number of PDT sessions was 1.6 (range:1–3). The mean final tumor thickness was 1.0 mm (range: 0–1.6 mm) at a mean follow-up of 19 months (range: 12–32 months). The mean final logMAR visual acuity was 0.4 (range: 0–1.5). Subfoveal fluid disappeared or decreased significantly in 4 of 5 eyes (80%) after PDT. Conclusions: PDT led to resolution of subretinal fluid with preservation of visual acuity in many symptomatic choroidal nevi in this study. Careful case selection is important as PDT of indeterminate pigmented tumors may delay the diagnosis and treatment of an early choroidal melanoma and thereby increase the risk for metastasis.

Amselem, Luis; Gunduz, Kaan; Adan, Alfredo; Karsl?oglu, Melisa Zisan; Rey, Amanda; Sabater, Noelia; Valldeperas, Xavier



Paediatric choroidal osteoma treated with ranibizumab.  


An 11-year-old patient presented with blurred vision in both eyes resulting from bilateral choroidal osteoma. The patient was treated with a course of monthly intravitreal injections of ranibizumab for 3 months and this led to improvement of visual acuity. This effect was sustained without the need for further injections over a 2-year period of follow-up. PMID:23192581

Vayalambrone, Deepak; Misra, Aseema



Main posterior watershed zone of the choroid  

Microsoft Academic Search

The main posterior watershed zone of the choroid is located between the nasal edge of the optic disc and the fovea and represents the area situated between the territories supplied by the temporal and nasal posterior ciliary arteries. In the fluorescein angiographies of 800 normal subjects a watershed zone was not observed in 33.1% due to technical reasons and in




Mechanisms of Retinal and Choroidal Neovasculaiization  

Microsoft Academic Search

Angiogenesis, or the formation of new blood vessels, is a major component of a number of retinal and choroidal diseases, including proliferative diabetic ret- inopathy and age-related macular degeneration. For more than 50 years, researchers and clinicians have hypothesized about the pathogenesis of vessel prolifer- ation. The establishment of techniques for culturing cells of the vasculature and neural retina, the

Patricia A. D'Amore



Retinal and choroidal microangiopathies: Therapeutic opportunities  

Microsoft Academic Search

Pathological angiogenesis in the retina and underlying choroid is a major cause of visual impairment in all age groups. The last decade has seen an explosion in the clinical availability of antiangiogenic compounds. Emphasis has been placed on inhibitors of the VEGF signaling pathway and considerable success has been achieved with aptamers and antibodies that bind VEGF. However, regression of

A. Afzal; L. C. Shaw; A. V. Ljubimov; M. E. Boulton; M. S. Segal; M. B. Grant



Primary Transpupillary Thermotherapy of Choroidal Melanocytic Lesions  

PubMed Central

Purpose: To evaluate the role of primary transpupillary thermotherapy (TTT) in the treatment of choroidal melanocytic lesions. Materials and Methods: Retrospective chart review of 24 patients (24 eyes) with choroidal melanocytic lesions, including 20 choroidal melanoma and four choroidal nevus treated with primary TTT. Choroidal nevus cases treated with primary TTT either demonstrated risk factors for growth into an early melanoma or had overlying choroidal neovascularization. Results: The mean initial tumor basal diameter was 6.6 (3.0-10.0) mm and the mean initial tumor thickness was 3.0 (1.0-5.0) mm. The mean number of TTT sessions was 2.5 (1-6). The mean decrease in tumor thickness was 1.2 mm (from 3.0 to 1.8 mm) at a mean follow-up of 22.7 (range 3-90) months. On the LogMar scale, visual acuity was stable at 1.0. Complications occurred in 50% of eyes. The most frequent complications were vitreous hemorrhage [5 patients (20.8%)], focal cataract [5 patients (20.8%)], iris atrophy [4 patients (16.6%)] and posterior synechia [4 patients (16.6%)]. There was no significant difference in the complication rate with respect to tumor thickness >3 mm versus tumor thickness ?3 mm and juxtapapillary versus nonjuxtapapillary location (Fisher’s exact test, P>0.05). Kaplan-Meier curves showed that 9% of eyes develop recurrence by 1 year and 27% develop recurrence by 5 years after primary TTT. Two eyes (8.3%) were enucleated because of neovascular glaucoma and one eye (4.1%) was exenterated because of extraocular tumor recurrence. Globe salvage was achieved in 21 patients (87.5%). One patient (4.1%) with extraocular tumor recurrence developed liver metastasis and expired. Conclusions: Although TTT may be useful in the treatment of small choroidal melanocytic lesions, the high complication and recurrence rates warrant close monitoring of patients after primary TTT even when a flat chorioretinal scar has been achieved.

Gunduz, Kaan; Karslioglu, Melisa Zisan; Kose, Kenan



What has changed in brachial plexus surgery?  

PubMed Central

Brachial plexus injuries, in all their severity and complexity, have been extensively studied. Although brachial plexus injuries are associated with serious and often definitive sequelae, many concepts have changed since the 1950s, when this pathological condition began to be treated more aggressively. Looking back over the last 20 years, it can be seen that the entire approach, from diagnosis to treatment, has changed significantly. Some concepts have become better established, while others have been introduced; thus, it can be said that currently, something can always be offered in terms of functional recovery, regardless of the degree of injury. Advances in microsurgical techniques have enabled improved results after neurolysis and have made it possible to perform neurotization, which has undoubtedly become the greatest differential in treating brachial plexus injuries. Improvements in imaging devices and electrical studies have allowed quick decisions that are reflected in better surgical outcomes. In this review, we intend to show the many developments in brachial plexus surgery that have significantly changed the results and have provided hope to the victims of this serious injury.

de Rezende, Marcelo Rosa; Silva, Gustavo Bersani; de Paula, Emygdio Jose Leomil; Junior, Rames Mattar; de Camargo, Olavo Pires



Morphological study of neurons in the nerve plexus on heart base of rats and guinea pigs  

Microsoft Academic Search

The paper describes the morphological pattern of neurons in the nerve plexus on the heart base of rats and guinea pigs. The nerve plexus, containing the investigated neurons, lies beneath the pulmonary arteries on the myocardium of the left atrium. This plexus is not covered by the epicardium. Therefore, contrary to the subepicardiac nerve plexus the investigated plexus was termed

Dainius H Pauza; Gertruda Skripkiene; Valdas Skripka; Neringa Pauziene; Rimvydas Stropus



Monozoic cysts of Hepatozoon canis.  


Small monozoic cysts found in the spleen of dogs infected with Hepatozoon canis are described from naturally and experimentally infected dogs. These forms of H. canis resemble cysts formed by other Hepatozoon species that infect frogs, lizards, and grey squirrels as intermediate hosts. The H. canis cyst stage differs in size and morphology from the large cysts of H. americanum, the second Hepatozoon species known to infect dogs. PMID:12760658

Baneth, Gad; Shkap, Varda



Spinal perineurial and meningeal cysts  

Microsoft Academic Search

Perineurial cysts may be responsible for clinical symptoms and a cure effected by their removal. They do not fill on initial myelography but may fill with Pantopaque some time, days or weeks, after Pantopaque has been instilled into the subarachnoid space. Perineurial cysts arise at the site of the posterior root ganglion. The cyst wall is composed of neural tissue.

I. M. Tarlov



Intraspinal epidermoid and dermoid cysts  

Microsoft Academic Search

Seven cases of intraspinal inclusion cysts, surgically treated between 1970 and 1984, are reported in this paper. Four were epidermoid cysts and three dermoid. Two cysts were located in the thoracic spine (one dermoid and one epidermoid) and five in the lumbosacral region (three epidermoid and two dermoid). Associated spinal dysraphia was noted in five cases. Congenital dermal sinus was

J. Shikata; T. Yamamuro; Y. Mikawa; Y. Kotoura



Arthroscopic treatment of meniscal cysts.  


Historically meniscal cysts have been treated with either an open total menisectomy, isolated cyst excision, or a combination of the two procedures. The advent of arthroscopic techniques has led to innovative treatment options for meniscal cyst management. A review of meniscal cysts and the results of arthroscopic treatment form the basis of this study. From 1986 to 1991, 18 patients with meniscal cysts were treated by arthroscopic cyst decompression. Thirteen men and five women comprised the study group and had an average age of 28 years. The follow-up period ranged from 6 to 60 months (average 26). Eight of the cysts were medial and 10 were lateral. A horizontal cleavage tear was noted in all cases, and 15 partial and three subtotal menisectomies were performed in conjunction with an intraarticular cyst decompression. There have been no recurrences to date, and all patients returned to their previous level of activity. Parameniscal cysts may result from synovial fluid tracking through a horizontal cleavage tear. Successful treatment of the meniscal cyst must include appropriate management of the torn meniscus, which can be entirely arthroscopic, consisting of a partial or subtotal meniscectomy, identification of the cyst opening, and cyst decompression. PMID:8280334

Ryu, R K; Ting, A J



Subcutaneous phaeohyphomycosis (mycotic cyst).  


Phaeohyphomycosis designates fungal infections caused by pheoid or melanized fungi and characterized histopathologically by the presence of septate hyphae, pseudohyphae, and yeasts. Etiologic agents include Exophiala, Phoma, Bipolaris, Phialophora, Colletotrichum, Curvularia, Alternaria, Exserohilum, and Phialemonium sp. The most common are Exophiala jeanselmei and Wangiella dermatitidis. The clinical presentation depends on the immune status of the host: superficial (tinea nigra and black piedra); cutaneous (scytalidiosis) and corneal; subcutaneous (mycotic cyst); and systemic phaeohyphomycosis in the immunocompromised host. The mycotic cyst is a localized form, characterized by subcutaneous asymptomatic nodular lesions that develop after traumatic implantation of fungi, especially on the extremities. The average size of the cysts is 2.5 cm. KOH examination reveals pigmented yeasts, pseudohyphae, and hyphae. A cutaneous biopsy specimen usually shows an abscess or a suppurative granuloma with pigmented yeasts and pseudohyphae. The treatment of choice is surgical excision, but additional anti-fungal therapy is recommended for recurrent cases and immunocompromised patients. PMID:22682192

Isa-Isa, Rafael; García, Carlos; Isa, Mariel; Arenas, Roberto


Choroidal neovascularization with granulomatous inflammation in ocular histoplasmosis syndrome  

Microsoft Academic Search

PURPOSE: To report pathologic examination of an excised choroidal neovascular membrane in a patient with ocular histoplasmosis syndrome that demonstrated granulomatous inflammation.METHOD: Case report. A 50-year-old woman with sudden vision loss in her left eye demonstrated clinical and fluorescein angiographic findings characteristic of choroidal neovascularization secondary to ocular histoplasmosis syndrome.RESULTS: Histopathologic examination of the surgically excised choroidal neovascular membrane disclosed

Eric S Mann; Steven J Fogarty; Marilyn C Kincaid



Alteration in choroidal blood flow produced by local pressure  

Microsoft Academic Search

Background  To investigate how transient pressure applied to the retinal pigment epithelium (RPE) layer and choroid affects choroidal blood flow in rabbits.Methods  Twelve rabbits underwent vitrectomy and local retinectomy. In nine of the rabbits a glass rod was used to exert brief pressure on the RPE layer and choroid. Three of the rabbits had no pressure indentation and were considered to be

Lena Ivert; Jian Kong; Peter Gouras



[Multilocular thymic cyst].  


We describe a case of multilocular thymic cyst with severe acute inflammation. A 23-year-old man was admitted to our hospital with a sudden onset of chest pain and high fever. A computed tomography scan showed multilocular cystic lesion at anterior mediastinum. We resected the tumor with the thymus by median sternotomy. Macroscopically, the mediastinal mass showed thick-walled multiloculated cavities filled with turbid yellow fluid. Histological examination revealed that the tumor was a multilocular thymic cyst which is reported by Suster. PMID:19280956

Saito, Y; Uragami, T; Satake, A; Yamakawa, Y; Kasugai, T



Multiple intracranial enterogenous cysts.  

PubMed Central

The case of a 40-year-old woman with increasing ataxia is described. Although the clinical presentation and evoked response studies raised the possibility of multiple sclerosis, further investigation revealed multiple cystic intracranial lesions. Surgical excision of one of the lesions relieved the patient's symptoms. Histological examination revealed that this was an enterogenous cyst. Although single cysts of this type have rarely been reported occurring in the posterior cranial fossa, the occurrence of multiple lesions, some in the supratentorial compartment, appears to be unique. Images

Walls, T J; Purohit, D P; Aji, W S; Schofield, I S; Barwick, D D



Giant nodular posterior scleritis simulating choroidal melanoma.  


A 45-year-old woman, complaining of sudden visual loss in the right eye (best-corrected visual acuity: 17/200), was suspected of having a malignant melanoma of the choroid. Fundus examination revealed a massive pale-colored subretinal mass temporal to the fovea, with adjoining choroidal folds and exudative retinal detachment. Ultrasonography was suggestive of posterior scleritis. Systemic evaluation was unremarkable. The patient was treated with high-dose systemic corticosteroids. The mass lesion resolved completely, with visual recovery to 20/20. Posterior scleritis should be suspected when evaluating subretinal mass-lesions, even when large and without overt inflammation. Early treatment may improve the visual prognosis and avoid misdirected management, including enucleation. PMID:16770031

Shukla, Dhananjay; Kim, Ramasamy



Unilateral Idiopathic Macular Telangiectasia with Choroidal Neovascularization.  


A 40-year-old man with decreasing visual acuity in his left eye over 1 year, diagnosed elsewhere as vein occlusion and treated unsuccessfully by systemic steroids was reported. Retrospective analysis of available previous imaging studies was undertaken, and a retrospective diagnosis of idiopathic macular telangiectasia (IMT) was made. Examination revealed subfoveal neovascularization and retinochoroidal anastomosis (RCA) in his left eye with macular edema and exudates surrounding it. The right eye was normal. Current fluorescein angiography (FA) confirmed the presence of choroidal neovascularization and RCA, and optical coherence tomography (OCT) demonstrated cystoid macular edema and subfoveal neovascularization.The patient was diagnosed with unilateral idiopathic macular telangiectasia complicated by subretinal neovascularization. The presences of a choroidal neovascularization process and an RCA have not, to our knowledge, been reported in this type of IMT. PMID:20337307

Mezad-Koursh, Daphna; Zayit-Soudry, Shiri; Barak, Adiel; Loewenstein, Anat



Solitary choroidal metastasis from bronchial carcinoid.  

PubMed Central

This report describes the clinical, light microscopical, and electron microscopical features of a metastasis from a bronchial carcinoid tumour occurring in a 29-year-old white woman. The eye lesions was diagnosed 30months after resection of the primary pulmonary tumour. Ophthalmoscopically the patient was observed to have a solid choroidal mass. Enucleation was carried out because of the possibility that the tumour was a primary choroidal melanoma. Enucleation was also indicated because of the relatively good prognosis for long-term survival in patients following excision of metastases from a bronchial carcinoid tumour. By light microscopy the metastasis was seen to be composed of cords; and ribbons of cells which showed positive staining characteristics for argentophilia. On electron microscopical study, neurosecretory vesicles, numerous microvilli, mitochondria, and light and dark cells, characteristic of endocrine tissue in different states of activity were noted. Images

Bell, R. M.; Bullock, J. D.; Albert, D. M.



Current perspectives of herpesviral retinitis and choroiditis.  


Vision-threatening viral retinitis are primarily caused by members of the herpesvirus family. The biology and molecular characterization of herpesviruses, clinical presentations of retinopathies, pathology and pathogenesis including the host responses, epidemiology and the laboratory methods of aetiological diagnosis of these diseases are described. Clinical syndromes are acute retinal necrosis (ARN), progressive outer retinal necrosis (PORN), cytomegalovirus (CMV) retinitis, multifocal choroiditis and serpiginous choroiditis besides other viral retinopathies. Herpes simplex virus (HSV) retinitis is more common in immunocompetent persons while varicella zoster virus (VZV) affects both immunocompetent and immunosuppressed patients equally. CMV retinitis is most common among patients with AIDS. The currently employed laboratory methods of antigen detection, virus isolation and antibody detection by enzyme linked immuno-sorbent assay (ELISA) have low sensitivity. Polymerase chain reaction (PCR) has increased the value of diagnosis due to its high clinical sensitivity and absolute specificity in detection of herpesviruses in intraocular specimens. PMID:16295367

Madhavan, H N; Priya, K; Biswas, J



Doxycycline-mediated Inhibition of Choroidal Neovascularization  

PubMed Central

Purpose Doxycycline, a broad spectrum antibiotic, has certain anti-angiogenic properties and can inhibit matrix metalloproteinases (MMPs/gelatinases). We investigated the effects of doxycycline on choroidal neovascularization (CNV), and regulation of MMP-2/-9 and pigment epithelium-derived factor (PEDF). Methods Doxycycline was orally administered to rats at 500, 50, 5, and 0.5 mg/kg/day, using non-treated animals as controls. Experimental CNV was induced with laser 7 days after doxycycline treatment started. At seven days post-induction, animals were euthanized, and eyes collected. RPE/choroid flat-mounts were labeled with isolectin IB4 to determine CNV lesion volumes using confocal microscopy and Volocity® software. MMP-2, MMP-9 and PEDF protein levels were determined by ELISA. MMP catalytic activity was determined in solution using fluorogenic gelatin and peptide substrates, by gelatin zymography in SDS-PAGE and by in situ DQ-gelatin zymography in RPE/choroid sections. Results CNV complex lesion volumes decreased with doxycycline in a dose-response relationship. A dosage of 500 mg/kg/day caused a 70% inhibition of CNV complex volume compared to control animals. Doxycycline elevated PEDF levels in plasma, and did not affect the plasma pro- and active MMP-2 and MMP-9 levels. However, the in vitro enzymatic activities of purified MMP-2 and MMP-9 declined significantly with doxycycline. MMP-2, MMP-9 and gelatinolytic activities in situ increased early in CNV lesion development. Doxycycline treatments and exogenous additions inhibited gelatinolytic activities in CNV lesions. Conclusions Doxycycline effectively hampered the progression of experimental CNV. The results suggest that orally administrated doxycycline can reach the choroid to attenuate proteolytic enzymes that remodel Bruch's membrane and promote the anti-angiogenic PEDF to inhibit neovascularization.

Samtani, S.; Amaral, J.; Campos, M.; Fariss, R. N.; Becerra, S. P.



Intravitreal ranibizumab in choroidal neovascularisation due to multifocal choroiditis and panuveitis syndrome.  


We report the use of intravitreal ranibizumab as initial and only treatment in a case of peripapillary choroidal neovascularisation (CNV) in a patient with multifocal choroiditis and panuveitis (MCP) syndrome. A 54-year-old woman presented with sudden reduced vision in the right eye of 2 weeks duration. A full ophthalmological examination was performed including biomicroscopy, fluorescein angiography and optical coherence tomography. A peripapillary choroidal neovascular membrane with subretinal haemorrhage extending to the fovea was revealed due to MCP syndrome. Three intravitreal injections of ranibizumab were performed with monthly intervals. There was clearance of the subretinal haemorrhage and reduction of the leakage after the first injection. The visual acuity improved to 20/20 in 3 months and remained stable at 2-year follow-up without angiographical leakage. Intravitreal injections of ranibizumab could be tried in cases of CNV due to MCP syndrome with very good response. PMID:23867878

Dardabounis, Doukas; Alvanos, Efstratios; Gatzioufas, Zisis; Panos, Georgios D



Symptomatic sacral perineurial (Tarlov) cysts.  


Sacral perineurial (Tarlov) cysts are rare lesions. Over a seven year period 4000 patients underwent surgery for lumbar disk herniation. In three patients neurological symptoms were caused by large sacral perineurial cysts. Methods of choice for diagnosis of Tarlov cysts are lumbosacral magnetic resonance imaging and computerized tomography myelography. The majority of Tarlov cysts are asymptomatic. In case of large (> or = 1.5 cm) and symptomatic perineurial cyst, as in three patients reported in this article, microsurgical treatment was successful. Although rare, perineurial (Tarlov) cysts must be taken into consideration when approaching to patient with low back and radicular pain. Authors review the medical literature, pathological and pathophysiological features and treatment options of sacral perineurial cysts. PMID:20102100

Sajko, Tomislav; Kova?, Damir; Kudeli?, Nenad; Kovac, Lana



Desmoid Tumour of the Brachial Plexus  

PubMed Central

Desmoid tumours of the brachial plexus are rare and may occur in extra-abdominal sites. The tumours are of fibroblastic origin and, although benign, are locally aggressive. Their relationship to critical neurovascular structures in their anatomic locations presents a challenge to the operating surgeons trying to adhere to the principles of surgery. Surprisingly little neurosurgical literature exists which was devoted to this topic despite the challenge these lesions present in surgery both at surgery and in choosing adjuvant therapies. We report a case of a large brachial plexus tumour in a patient which was diagnosed radiologically and histopathologically and the patient underwent surgical excision with good outcome. Desmoid tumours histologically are benign and are usually composed of proliferating, benign fibroblasts in an abundant matrix of collagen. They do not transform into malignant tumours or metastasize. Surgery is the mainstay of treatment; however, adjuvant radiation and chemotherapy remain controversial.

Juliette, Orege; Florentius, Koech; Francis, Ndiangui; Macharia, Benson Ndegwa; Neema, Mbaruku



Management of infant brachial plexus injuries.  


Management of brachial plexus injuries is geared toward normalization of limb function, primarily through optimization of nerve regeneration and mechanical increase in elbow flexion and shoulder stabilization. Changes in the skeletal muscles and the osteous structures of the upper extremity are ongoing throughout the course of treatment, mandating continual assessment and aggressive rehabilitation. In patients who present too late for microsurgical intervention, irreversible changes take place in skeletal muscles, highlighting the importance of early referral. However, secondary procedures have been shown to be beneficial in older patients and in those whose primary procedures failed. Further advances in bionics and stem cell therapy may help replace the dynamic functional deficits of obstetric brachial plexus palsy. PMID:15636767

Shenaq, Saleh M; Bullocks, Jamal M; Dhillon, Gupreet; Lee, Rita T; Laurent, John P



Canine intracranial epidermoid cyst.  


A 7-year-old intact male pitbull presented with a 2-month history of progressive dysequilibrium. Cerebrospinal fluid analysis was indicative of a central inflammatory or neoplastic disorder. A cerebellar cystic structure was identified on magnetic resonance imaging which was found to be an epidermoid cyst on histopathology. PMID:10528837

Platt, S R; Graham, J; Chrisman, C L; Adjiri-Awere, A; Clemmons, R M


Why not choledochal cyst?  

Microsoft Academic Search

With excision as a standard procedure for treating choledochal cyst, early diagnosis becomes a central issue in reducing morbidity and mortality from that disorder. In a retrospective analysis of 35 patients treated over a 10-year period, we found the diagnosis was delayed for an average of 11.9 months from the beginning of presenting symptoms. Three factors were responsible: (1) a

Jiin-Haur Chuang; Jer-Nan Lin; Kuae-Liang Wang; Chao-Long Chen; Chi Au; Man-Shan Kong; So-Chu Huang



Odonto calcifying cyst  

PubMed Central

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

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




Microsoft Academic Search

Summary.—A case of aneurysmal bone cyst located at the lateral periosteal surface of the humeral diaphysis is presented. The patient was treated by in-bloc tumor re- section and grafting of liophylized bone. The outcome has been satisfactory without tumor recurrence. Three years after surgery the patients remains free from disease. A relationship between previous trauma and the development of tumor



Renal Cysts and Urinomas  

PubMed Central

Renal cysts are a common imaging finding. Although most cysts never have symptoms, some cause pain, collecting system compression, hematuria, hypertension, and secondary infection. The mere presence of a cyst is not an indication for intervention, but treatment may be indicated in symptomatic patients or those with secondary obstruction. Urinomas generally are a contained collection of urine outside of the normal pathways where urine travels. As such, urinomas can arise anywhere from the upper abdomen down into the low pelvis and have a variety of etiologies. Ureteral obstruction with forniceal rupture and trauma (blunt, penetrating, or iatrogenic) are the most common causes of urinomas. When urinomas arise spontaneously, the likely cause varies with the patient's age. Blunt or penetrating trauma can cause perinephric urinomas by two mechanisms—direct disruption of the pelvis or collecting system or by degeneration of nonviable tissue. These urinomas are often perinephric, but can also occur in a subcapsular location. This review will discuss diagnosis, classification, and treatment of renal cysts and urinomas.

Lee, Jessica; Darcy, Michael



Dense suprasellar epidermoid cyst  

Microsoft Academic Search

A case of a dense epidermoid cyst of the suprasellar cistern is presented. The clinical symptoms were headache radiating to the left eye and a quadrant anopsia on the left eye. The density of the epidermoid was 62 HU and no significant contrast enhancement occured after contrast application. The main feature which allows differentiation from other hyperdense suprasellar lesions seems

O. Schubiger; A. Valavanis; E. Gessaga



Scanning Laser Ophthalmoscope Fundus Perimetry After Surgery for Choroidal Neovascularization  

Microsoft Academic Search

Purpose: Submacular surgery is under investigation for the treatment of subfoveal choroidal neovascularization secondary to age-related macular degeneration, ocular histoplasmosis syndrome, and other causes. The aims of this study were to determine whether the macular area from which choroidal neovascularization was removed surgically remained functional and whether there was any qualitative difference between eyes with different disease conditions or between

Anat Loewenstein; Janet S Sunness; Neil M Bressler; Marta J Marsh; Eugene de Juan



Vascular endothelial growth factor expression in choroidal neovascularization in rats  

Microsoft Academic Search

Background: The pathogenesis of choroidal neovascularization is largely unknown. We investigated vascular endothelial growth factor (VEGF) expression in laser-induced choroidal neovascularization (CNV) in rats.Methods: Intense krypton laser photocoagulation was applied to the posterior poles of the eyes of pigmented rats to induce CNV, which was confirmed by fluorescein angiography and histopathology. The eyeballs were enucleated 1, 3, 7, 14 and

Xianjin Yi; Nahoko Ogata; Masayuki Komada; Chikako Yamamoto; Kanji Takahashi; Koichiro Omori; Masanobu Uyama



Moving the retina: Choroidal modulation of refractive state  

Microsoft Academic Search

The chick eye is able to change its refractive state by as much as 7 D by pushing the retina forward or pulling it back; this is effected by changes in the thickness of the choroid, the vascular tissue behind the retina and pigment epithelium. Chick eyes first made myopic by wearing diffusers and then permitted unrestricted vision developed choroids

Josh Wallman; Christine Wildsoet; Aiming Xu; Michael D. Gottlieb; Debora L. Nickla; Lynn Marran; Wolf Krebs; Anne Mette Christensen



Primary cysts of the iris.  

PubMed Central

This paper has presented the author's experience with the evaluation and follow-up of 62 patients with primary cysts of the iris. On the basis of these observations, a classification of iris cyst is proposed. Accordingly, primary iris cysts are divided into epithelial and stromal categories, each having different clinical characteristics. Epithelial cysts arise between the pigmented epithelial layers of the iris and occur at the pupillary margin (central cysts), in the mid-portion of the iris (midzonal cysts) or, more commonly, in the iridociliary sulcus (peripheral cysts). In some cases, the cysts apparently break free from their epithelial attachment and migrate into the anterior chamber of vitreous chamber (dislodged cysts). Primary stromal cysts occur within the iris stroma and are not directly continuous with the posterior epithelium. They apparently arise from ectopic surface epithelium which is trapped in the iris during embryologic development. A study of the natural course and complications of these lesions has shown that the great majority of primary iris cysts, particularly those which arise from the iris pigment epithelial layer, are stationary lesions which rarely progress or cause visual complications. This finding is contradictory to the contemporary belief of certain authorities who stress that many such lesions lead to severe complications with blindness and loss of the eye. The natural course of primary epithelial cysts differs from that of secondary iris cysts which follow surgical or non-surgical trauma. The latter lesions do frequently enlarge and lead to severe complications such as inflammation and glaucoma. Images FIGURE 1 FIGURE 2 A FIGURE 2 B FIGURE 3 FIGURE 4 A FIGURE 4 B FIGURE 5 FIGURE 6 A FIGURE 6 B FIGURE 7 FIGURE 8 FIGURE 9 A FIGURE 9 B FIGURE 10 A FIGURE 10 B FIGURE 10 C FIGURE 10 D FIGURE 11 FIGURE 12 FIGURE 13 FIGURE 14 A FIGURE 14 B FIGURE 15 FIGURE 16 FIGURE 17 FIGURE 18

Shields, J A



Hemodynamic Parameters in Blood Vessels in Choroidal Melanoma Xenografts and Rat Choroid  

Microsoft Academic Search

PURPOSE. Choroidal melanoma is the most common primary ocular cancer among the adult population. To avoid enucle- ation, there has been a concerted effort to develop therapies that spare the affected eye and the patient's vision. Blood flow helps shape the tumor's microenvironment, plays a key role in the tumor's response to many different types of therapy, and is necessary

Rod D. Braun; Asad Abbas; S. Omar Bukhari; Willie Wilson



Suprachoroidal collection of internal tamponading agents through a choroidal hole  

PubMed Central

We report two cases of significantly large choroidal holes following penetrating trauma that led to suprachoroidal migration of internal tamponading agents during repair of retinal detachments with proliferative vitreoretinopathy secondary to penetrating trauma. In the first case, choroidal hole was a direct result of the injury and was identified immediately after vitreoretinal surgery which was done for traumatic retinal detachment with hemorrhagic choroidal detachment. In the second case, the hole occurred over a period of several months after the repair of traumatic retinal detachment with silicone oil tamponade. This was attributed to progressive fibrosis exerting traction on the bare choroid/retinal pigment epithelium. Choroidal hole significant enough to cause suprachoroidal migration of internal tamponading agents is a very rare complication seen in eyes with posttraumatic retinal detachment with proliferative vitreoretinopathy.

Mittal, Nishank; Verma, Aditya



Reduced Choroidal Neovascular Membrane Formation in Cyclooxygenase-2 Null Mice  

PubMed Central

Purpose. To assess the degree of laser-induced choroidal neovascular membrane formation in wild-type (WT) and COX-2 null mice and to measure vascular endothelial growth factor (VEGF), interleukin (IL)-1?, and tumor necrosis factor (TNF)-? levels in the retina and choroid. Methods. Four laser burns were placed in each eye of WT and COX-2 null mice to induce choroidal neovascularization. Fluorescein angiography (FA) was performed at 14 days, and retinal pigment epithelium-choroid-sclera (choroidal) flat mounts were prepared. The retina and choroid were isolated from WT and COX-2 null mice at 24, 72, and 168 hours after laser photocoagulation and from unlasered eyes and were tested for VEGF, IL-1?, and TNF-?. Results. COX-2 null mice demonstrated 58% (P = 0.001) and 48% (P = 0.001) reductions in CNV formation on FA and choroidal flat mounts, respectively, compared with WT mice. For unlasered mice, mean VEGF concentrations in the retina and choroid were 1.2 ± 0.42 pg/mg protein for WT but only 0.42 ± 0.2 pg/mg protein for COX-2 null mice (P < 0.05). After laser photocoagulation, WT mice showed significantly greater VEGF and IL-? expression in the retina and choroid by 168 hours (P < 0.05) and 72 hours (P < 0.05), respectively, compared with COX-2 null mice. Conclusions. COX-2 null mice exhibited significantly less choroidal neovascular membrane formation associated with reduced expression of VEGF. The results of this study suggest that COX-2 modulates VEGF expression in CNV and implicates a potential therapeutic role for nonsteroidal anti-inflammatory drugs.

Rezaei, Kasra A.; Toma, Hassanain S.; Cai, Jiyang; Penn, John S.; Sternberg, Paul



Clinical Manifestations of Synovial Cysts  

PubMed Central

Although synovial cysts are most commonly associated with rheumatoid arthritis and osteoarthritis, they may occur in many other conditions. The clinical manifestations of these cysts are numerous and may result from pressure, dissection or acute rupture. Vascular phenomena occur when popliteal cysts compress vessels, and result in venous stasis with subsequent lower extremity edema or thrombophlebitis. Rarely, popliteal cysts may cause arterial compromise with intermittent claudication. Neurological sequelae include pain, paresthesia, sensory loss, and muscle weakness or atrophy. When synovial cysts occur as mass lesions they may mimic popliteal aneurysms or hematomas, adenopathy, tumors or even inguinal hernias. Cutaneous joint fistulas, septic arthritis or osteomyelitis, and spinal cord and bladder compression are examples of other infrequent complications. Awareness of the heterogeneous manifestations of synovial cysts may enable clinicians to avoid unnecessary diagnostic studies and delay in appropriate management. Arthrography remains the definitive diagnostic procedure of choice, although ultrasound testing may be useful. ImagesFig. 1.Fig. 2.Fig. 3.

Burt, Todd B.; Gelman, Martin I.; MacCarter, Daryl K.; Samuelson, Cecil O.



Effects from birth brachial plexus injury and postural control.  


Of 32 children with birth brachial plexus injury, 31 had postural control deficits, including asymmetrical posture and atypical movements. Management of children with birth brachial plexus injury should address motor development of the entire body, not merely the affected extremity. PMID:23394776

Ridgway, Elizabeth; Valicenti-McDermott, Maria; Kornhaber, Lillian; Kathirithamby, Dona Rani; Wieder, Harriet



Brachial plexus injury after anterior shoulder dislocation : A case report  

Microsoft Academic Search

Brachial plexus injury is a rare complication of ante- rior dislocation of the shoulder : nine cases have been reported in the literature. We report a unique case of anterior dislocation of the shoulder with associated brachial plexus palsy involving the posterior and medial cords. This is the first reported case of such an injury. Previous case reports of brachial




Maxillofacial hydatid cysts  

Microsoft Academic Search

We report 2 cases of hydatid cysts occurring in the submandibular gland and buccal submucosa, respectively. Our first case occurred in the submandibular salivary gland of a 20-year-old woman and the second involved the buccal submucosa of a 6-year-old boy. Both diagnoses were made after the excision of the lesions. Both patients were evaluated after surgery, and both were followed

M. M. R. Bouckaert; E. J. Raubenheimer; F. J. Jacobs



Rathke's cleft cysts.  


Rathke's cleft cysts (RCCs) are benign, sellar and/or suprasellar lesions originating from the remnants of Rathke's pouch. Although a common finding in routine autopsies (12-33% of normal pituitary glands), symptomatic cases are rare and comprise 5-15% of all surgically resected sellar lesions. Small, asymptomatic RCC do not require surgical intervention, and their natural history is not clear. In series of nonoperated presumed RCCs, 26-94% did not progress during follow-up periods up to 9 years. In symptomatic ones, surgery is indicated, aiming to drain the cyst content and safely remove as much of the capsule as possible. Following surgical intervention, headaches and visual field defects improve or resolve in a significant number of patients (40-100% and 33-100%, respectively) and partial hypopituitarism recovers in 14-50%. Data on relapse rates published in the last 15 years are based on variable follow-up periods and show wide variation (between 0% and 33%). The lowest relapse rates have been described in reports with relatively short mean observation periods (<3 years), whereas in those with longer follow-up the relapse rates increase. Most of the relapses occur within 5-6 years, suggesting that follow-up is required for at least 5 years after surgery. Risk factors for relapse include the presence of squamous metaplasia in the cyst wall, cyst size and the presence of inflammation. Long-term sufficiently powered studies aiming to clarify the natural history of asymptomatic RCCs and of those relapsing postoperatively are required. PMID:21951110

Trifanescu, Raluca; Ansorge, Olaf; Wass, John A H; Grossman, Ashley B; Karavitaki, Niki



Plexus Irritation Caused by Interscalene Brachial Plexus Catheter for Shoulder Surgery  

Microsoft Academic Search

ontinuous interscalene brachial plexus block with bupivacaine has been used successfully in our hospital for most patients undergoing open or closed shoulder procedures, and especially for post- operative analgesia during shoulder physical therapy. The catheter is usually removed when analgesia for physical therapy is no longer required. We report two cases of possible nerve irritation associated with inter- scalene brachial

Flavio C. Ribeiro; Harris Georgousis; Rainer Bertram; Gerd Scheiber



Extradural arachnoid cysts in children  

Microsoft Academic Search

Background  Extradural arachnoid cysts in the spine are uncommon causes of spinal cord compression in the pediatric population that are\\u000a thought to arise from congenital defects in the dura mater. Most reports describe such cysts as communicating with the intrathecal\\u000a subarachnoid space through a small defect in the dura. Excision of the cyst with obliteration of the communicating dural defect\\u000a is

Ricardo Santos de Oliveira; Marcelo Campos Moraes Amato; Marcelo Volpon Santos; Gustavo Novelino Simão; Helio Rubens Machado



Intrapericardial cysts in the dog.  


Intrapericardial cysts were identified as the cause of impaired cardiac filling in six young dogs. Pneumopericardiography and two-dimensional echocardiography showed the cysts in 2 of 2 dogs and in 4 of 4 dogs, respectively. One dog, which was also infected with heartworms, died before surgical excision of the cyst could be performed. In the remaining dogs, surgical excision of the cysts and subtotal pericardiectomy was successfully accomplished. Histologic examination of the excised tissue from one dog suggested that it was a pericardial coelomic cyst. The gross and histologic characteristics of the cysts removed from the other five dogs resembled those of acquired cystic hematomas. The etiopathogenesis of these cysts was uncertain, but all cysts were connected to a fatty pedicle of tissue. In one dog, a stalk of tissue was observed to enter the pericardium through a small peritoneopericardial diaphragmatic hernia. In four dogs, the stalk of tissue was adhered to the apex of the parietal pericardium. These observations suggested that intrapericardial cysts, in some dogs, develop in association with, and possibly as a result of, congenital herniation and entrapment of omentum or a portion of the falciform ligament into the pericardial sac. PMID:8114033

Sisson, D; Thomas, W P; Reed, J; Atkins, C E; Gelberg, H B


A prospective study of EUS-guided celiac plexus neurolysis for pancreatic cancer pain  

Microsoft Academic Search

Background: Celiac plexus neurolysis, a chemical splanchnicectomy of the celiac plexus, is used to treat pain caused by pancreatic cancer. Most commonly, celiac plexus neurolysis is performed percutaneously under CT or fluoroscopic guidance, but can also be performed with EUS. The aim of this study was to prospectively assess the efficacy of EUS celiac plexus neurolysis in the management of

Naresh T. Gunaratnam; Aruna V. Sarma; Ian D. Norton; Maurits J. Wiersema



Imaging of retinal and choroidal vascular tumours.  


The most common intraocular vascular tumours are choroidal haemangiomas, vasoproliferative tumours, and retinal haemangioblastomas. Rarer conditions include cavernous retinal angioma and arteriovenous malformations. Options for ablating the tumour include photodynamic therapy, argon laser photocoagulation, trans-scleral diathermy, cryotherapy, anti-angiogenic agents, plaque radiotherapy, and proton beam radiotherapy. Secondary effects are common and include retinal exudates, macular oedema, epiretinal membranes, retinal fibrosis, as well as serous and tractional retinal detachment, which are treated using standard methods (ie, intravitreal anti-angiogenic agents or steroids as well as vitreoretinal procedures, such as epiretinal membrane peeling and release of retinal traction). The detection, diagnosis, and monitoring of vascular tumours and their complications have improved considerably thanks to advances in imaging. These include spectral domain and enhanced depth imaging optical coherence tomography (SD-OCT and EDI-OCT, respectively), wide-angle photography and angiography as well as wide-angle fundus autofluorescence. Such novel imaging has provided new diagnostic clues and has profoundly influenced therapeutic strategies so that vascular tumours and secondary effects are now treated concurrently instead of sequentially, enhancing any opportunities for conserving vision and the eye. In this review, we describe how SD-OCT, EDI-OCT, autofluorescence, wide-angle photography and wide-angle angiography have facilitated the evaluation of eyes with the more common vascular tumours, that is, choroidal haemangioma, retinal vasoproliferative tumours, and retinal haemangioblastoma. PMID:23196648

Heimann, H; Jmor, F; Damato, B



Automated Segmentation of the Choroid from Clinical SD-OCT  

PubMed Central

Purpose. We developed and evaluated a fully automated 3-dimensional (3D) method for segmentation of the choroidal vessels, and quantification of choroidal vasculature thickness and choriocapillaris-equivalent thickness of the macula, and evaluated repeat variability in normal subjects using standard clinically available spectral domain optical coherence tomography (SD-OCT). Methods. A total of 24 normal subjects was imaged twice, using clinically available, 3D SD-OCT. A novel, fully-automated 3D method was used to segment and visualize the choroidal vasculature in macular scans. Local choroidal vasculature and choriocapillaris-equivalent thicknesses were determined. Reproducibility on repeat imaging was analyzed using overlapping rates, Dice coefficient, and root mean square coefficient of variation (CV) of choroidal vasculature and choriocapillaris-equivalent thicknesses. Results. For the 6 × 6 mm2 macula-centered region as depicted by the SD-OCT, average choroidal vasculature thickness in normal subjects was 172.1 ?m (95% confidence interval [CI] 163.7–180.5 ?m) and average choriocapillaris-equivalent thickness was 23.1 ?m (95% CI 20.0–26.2 ?m). Overlapping rates were 0.79 ± 0.07 and 0.75 ± 0.06, Dice coefficient was 0.78 ± 0.08, CV of choroidal vasculature thickness was 8.0% (95% CI 6.3%–9.4%), and of choriocapillaris-equivalent thickness was 27.9% (95% CI 21.0%–33.3%). Conclusions. Fully automated 3D segmentation and quantitative analysis of the choroidal vasculature and choriocapillaris-equivalent thickness demonstrated excellent reproducibility in repeat scans (CV 8.0%) and good reproducibility of choriocapillaris-equivalent thickness (CV 27.9%). Our method has the potential to improve the diagnosis and management of patients with eye diseases in which the choroid is affected.

Zhang, Li; Lee, Kyungmoo; Niemeijer, Meindert; Mullins, Robert F.; Sonka, Milan; Abramoff, Michael D.



Detection of BRAF gene mutation in primary choroidal melanoma tissue.  


Numerous BRAF mutations have been detected in melanoma biopsy specimens and cell lines. In contrast, several studies report lack of BRAF mutations in uveal melanoma including primary and metastatic choroidal and ciliary body melanomas. To our knowledge, for the first time, here we report a case of choroidal melanoma harboring the BRAF mutation (V600E). The activation of RAF/MEK/ERK pathway, although independent of BRAF mutation, was reported in uveal melanoma. The presence of V600E mutation indicates that the RAF/MEK/ERK pathway, in addition to cutaneous melanoma progression, may play a role in the choroidal melanoma development. PMID:16410717

Malaponte, Grazia; Libra, Massimo; Gangemi, Pietro; Bevelacqua, Valentina; Mangano, Katia; D'Amico, Fabio; Mazzarino, Maria C; Stivala, Franca; McCubrey, James A; Travali, Salvatore



Iatrogenic choroidal neovascularization after krypton red laser photocoagulation.  


A major cause for failure of krypton red laser photocoagulation in patients with exudative age-related macular degeneration has been the development of recurrent choroidal neovascularization adjacent to the previously treated areas. After reviewing the possible causes of recurrences, it is apparent that a certain number are iatrogenic, ie, induced by krypton red laser causing disruption and damage to the pigment epithelium-Bruch's membrane-choroidal complex. We describe three separate episodes in two patients of iatrogenic recurrent choroidal neovascularization after krypton red laser photocoagulation. PMID:2471948

Orth, D H; Flood, T P; Packo, K H



Arachnoid cyst slit valves: the mechanism for arachnoid cyst enlargement.  


Arachnoid cysts are common, accounting for approximately 1% of intracranial mass lesions. Most are congenital, clinically silent, and remain static in size. Occasionally, they increase in size and produce symptoms due to mass effect or obstruction. The mechanism of enlargement of arachnoid cysts is controversial. One-way slit valves are often hypothesized as the mechanism for enlargement. The authors present 4 cases of suprasellar prepontine arachnoid cysts in which a slit valve was identified. The patients presented with hydrocephalus due to enlargement of the cyst. The valve was located in the arachnoid wall of the cyst directly over the basilar artery. The authors believe this slit valve was responsible for the net influx of CSF into the cyst and for its enlargement. They also present 1 case of an arachnoid cyst in the middle cranial fossa that had a small circular opening but lacked a slit valve. This cyst did not enlarge but surgery was required because of rupture and the development of a subdural hygroma. One-way slit valves exist and are a possible mechanism of enlargement of suprasellar prepontine arachnoid cysts. The valve was located directly over the basilar artery in each of these cases. Caudad-to-cephalad CSF flow during the cardiac cycle increased the opening of the valve, whereas cephalad-to-caudad CSF flow during the remainder of the cardiac cycle pushed the slit opening against the basilar artery and decreased the size of the opening. Arachnoid cysts that communicate CSF via circular, nonslit valves are probably more likely to remain stable. PMID:23662935

Halani, Sameer H; Safain, Mina G; Heilman, Carl B



Cerebral hydatid cysts in children  

Microsoft Academic Search

Twelve children with intracranial cysts ofEchinococcus granulosus underwent surgery during a period of 5 years and constituted 19% of all children operated on for intracranial space-occupying lesions. The more common symptoms were raised intracranial pressure (8 cases) and hemiparesis (7 cases). The total number of procedures was 14, with a standard craniotomy approach in 13. In 6 the cysts were

Romuald Krajewski; Zbigniew Stelmasiak



Bronchogenic cyst with multiple complications  

PubMed Central

Bronchogenic cysts are a rare type of mediastinal mass thought to arise from abnormal budding of the embryologic foregut. This paper presents a rare case of a 32-year-old male who developed multiple serious complications from a bronchial cyst. This rare presentation is discussed and the role of CT and MR imaging in making the diagnosis is highlighted.

Marshall, G; Cheah, C; Lenzo, NP



Cerebral arachnoid cysts in children  

Microsoft Academic Search

The case histories of 14 children are described in which hydrocephalus was found on investigation to be associated with a cyst of the posterior fossa or subarachnoid cisterns. The neuroradiological and histological findings are described. The cysts are considered to be developmental in origin. Their recognition and management are discussed.

M. J. G. Harrison



Arthroscopic treatment of meniscal cysts  

Microsoft Academic Search

Meniscal cysts occur most commonly in the lateral compartment of the knee, rarely involving the medial meniscus.In patients who are symptomatic and require treatment, an associated tear of the meniscus can commonly be found. Although the etiology of meniscal cysts remains controversial, it seems likely that influx of synovial fluid through microscopic and macroscopic tears in the meniscus plays a

Jess H. Lonner; J. Serge Parisien



Branchial cyst in a dog.  


A French bulldog was presented with a facial swelling. Histology revealed a branchial cleft cyst. The first attempt to treat by incision, aspiration and drainage was unsuccessful. A complete surgical excision of the mass using a CO2 Laser lead to a full recovery. The location, size and type of tissues were compatible with a first branchial cleft cyst Type II. PMID:23985094

Roux, P; Kuehn, N



Renal cyst puncture studies.  


The edict to contain costs and meet goals imposed by DRG remuneration policies mandates the work-up of asymptomatic renal mass lesions on an outpatient basis. This proved feasible in 98 per cent of patients. The vast majority of such mass lesions (82 to 90 per cent) is diagnosed with acceptable confidence by computed tomography and sonography alone. For a shrinking group of such patients, yet still 16 to 18 per cent, guided percutaneous aspiration biopsy is necessary to affirm the diagnosis. However, this technique has been refined during recent years to incorporate the use of thin needle equipment and can now be performed on an outpatient basis without significant risk of morbidity. For diagnosing hyperdense inflammatory and infected renal cysts, guided percutaneous aspiration is recommended as the most effective method. This procedure should take precedence over surgical exploration because it can diagnose and provide pertinent bacteriologic information that may determine the course of therapy. In many instances inflammatory cysts or even silent renal abscesses are diagnosed by a percutaneous aspiration technique that is then expanded to serve therapeutic purposes such as percutaneous drainage. Even these procedures can be performed safely on an outpatient basis provided the patient is followed closely. Because complications of percutaneous aspiration procedures are extremely rare, the procedure can be used safely on an outpatient basis. The impact of magnetic resonance imaging on the diagnosis of asymptomatic space-occupying lesions of the kidney is as yet not fully determined; however, this method appears promising for diagnosing some of the refractory lesions such as hemorrhagic cysts, aneurysms, or arteriovenous malformations. PMID:3101262

Lang, E K



[Splints in birth-related brachial plexus injuries].  


Most cases of obstetrical brachial plexus palsies are mild traction injuries which resolve under physical therapy within several weeks or months. Severe ruptures or avulsion injuries of the plexus can lead to lifelong impairment of the upper extremities. Hence, in severe brachial plexus injuries the indications for brachial plexus reconstruction should be evaluated, early. At the age of about 3 months, the infant should be presented in a centre specialised in obstetrical brachial plexus palsies. In almost all cases intensive physical therapy is performed. In addition, many patients require splinting in order to gain function as part of the conservative therapy or for postoperative fixation. Depending on the type of splint, different demands are made on design, material and strategy of adjustment. Many different natural and synthetic materials are available for orthopaedic constructions. Because of its good adjustment options, the use of low temperature thermoplastic is steadily increasing. This contribution presents an overview of our currently used splints, new technical developments in our experience with more than 200 patients with obstetrical brachial plexus palsy. We present our experience with the most common splints for the use in fixation after birth-related brachial plexus surgery, subscapularis release, trapezius muscle transfer and functional improvement of hands with a lack of wrist extension. PMID:21509702

Schenck, T L; Bayer, T; Enders, A; Marton, M-A; Machens, H-G; Müller-Felber, W; Giunta, R E



Asymptomatic giant arachnoid cyst.  


A 51-year-old male bricklayer without cerebral symptoms underwent whole-body FDG PET for suspicion of mediastinal sarcoidosis. PET/CT incidentally demonstrated a voluminous right frontal arachnoid cyst with normal glucose metabolism in the adjacent cortex. MRI demonstrated compression of the ipsilateral cerebral parenchyma and precentral, angulate, callosal, and superior frontal sulci. Functional bilateral finger-thumb paradigm MRI revealed right hemispheric reorganization of cortical motor activation with prominent activation between the inferior frontal gyrus and the postcentral gyrus. PMID:22955072

Hubele, Fabrice; Imperiale, Alessio; Kremer, Stéphane; Namer, Izzie Jacques



Scintigraphic features of choledochal cyst  

SciTech Connect

The scintigraphic appearances of 12 surgically proven cases of choledochal cyst were retrospectively reviewed. In seven of 12 cases, radionuclide accumulated in the choledochal cyst (i.e., the dilated common bile duct) in less than 1 hr. In three additional cases, delayed accumulation (1-24 hr) within the cyst was seen. In two of the 12 cases, no ductal activity appeared and the diagnosis of choledochal cyst could not be made, although in one of these two cases delayed images were not obtained. Other frequent findings included delayed or nonvisualization of the gallbladder (11 of 12) and the appearance of prominent intrahepatic ducts (five of 12). We conclude that hepatobiliary scintigraphy is a noninvasive test useful in the diagnosis of choledochal cyst.

Camponovo, E.; Buck, J.L.; Drane, W.E.



Keratoconus associated with choroidal neovascularization: a case report  

PubMed Central

Introduction Keratoconus and choroidal neovascularization can occur as a result of dysfunction of the epithelium and its basement membrane. Case presentation A 17-year-old Asian man, who was diagnosed with myopic choroidal neovascularization in both eyes and who subsequently underwent intravitreal injection of ranibizumab (Lucentis®) five times over six months, presented with further vision decrease and pain in his right eye. Examination showed corneal steepening and stromal edema in the inferocentral cornea of his right eye, both of which were indicative of advanced keratoconus with acute hydrops. Corneal topography also showed features consistent with keratoconus in his left eye. Fluorescein angiography and optical coherence tomography revealed choroidal neovascularization-associated subretinal hemorrhages and lacquer cracks in both eyes. Conclusion Keratoconus and choroidal neovascularization, possibly resulting from dysfunction of the epithelium and its basement membrane, can occur together in the same individual. This would suggest a possible connection in pathogenesis between these two conditions.



Cystoventricular Shunting of Intracranial Arachnoid Cysts  

Microsoft Academic Search

Ten patients with intracranial arachnoid cysts were treated with direct shunting of the cyst to a lateral ventricle. The strategic goal of cystoventricular shunting is to establish physiologically normal intracranial pressure relationships, rather than cyst obliteration. Cystoventricular shunts were successful in treating single and multiple intracranial cysts in supratentorial and infratentorial locations and in patients with normal and enlarged lateral

Lori A. McBride; Ken R. Winston; Jane E. Freeman



Arthroscopic excision of dorsal carpal ganglion cysts  

Microsoft Academic Search

Ganglion cysts are the most common tumor in the wrist. Dorsal carpal ganglion cysts represent 60 to 70% of all ganglion cysts in the hand and wrist. Standard treatment has been limited to observation, rest, immobilization, aspiration with or without injection, and surgical excision. Arthroscopic resection of dorsal carpal ganglion cyst have been done since the late 1980s. It has

Thomas Wiedrich; A. Lee Osterman



Epicardial cysts: report of two rare cases.  


Epicardial cysts originating directly from the epicardium are seen very rarely. Complete surgical excision is recommended when these cysts are detected. If cysts compress surrounding vital structures, cardiopulmonary bypass (CPB) should also be considered. We report herein 2 cases of multiloculated epicardial cysts, both of which were successfully excised, 1 with CPB. PMID:22360907

Hatemi, Ali Can; Kumbasar, Ulas; Servet, Ercan; Coskun, Ugur; Bostan, Cem; Oz, Büge



Pathogenesis of Arachnoid Cyst: Congenital or Traumatic?  

Microsoft Academic Search

For clarifying the pathophysiology of arachnoid cysts and restablishing therapeutic criteria for such cases, we reviewed a series of 90 cases with arachnoid cysts focusing on the traumatic origin. Arachnoid cysts of congenital origin have been well known. But we suspected that 14 out of 90 patients (15.6%) with arachnoid cyst were closely related to head trauma. Seven of them

Joong-Uhn Choi; Dong-Seok Kim



Dysontogenetic liver cysts and their surgical management  

Microsoft Academic Search

Summary  BACKGROUND: Liver cysts occur with a prevalence of 4–7% in the population. We present our experience in the management of these cysts. METHODS: Between 1994 and 2003, 42 patients (33 women, 9 men) were referred for surgery of dysontogenetic liver cysts. There were 19 patients with polycystic liver disease (PLD), 18 with simple cysts, 4 with Caroli disease, and one

P. Kornprat; H. Bacher; H. Cerwenka; A. El-Shabrawi; H. Hauser; C. Langner; H. J. Mischinger



Orbital cysts of childhood—classification, clinical features, and management  

Microsoft Academic Search

There is little in the literature about the clinical spectrum of orbital cysts of childhood and no comprehensive classification has been proposed. The authors propose a classification of orbital cysts of childhood and review their clinical features, pathology, and management. The major categories in the classification include cysts of surface epithelium, teratomatous cysts, neural cysts, secondary cysts, inflammatory cysts, and

Jerry A Shields; Carol L Shields



Treated Choroidal Melanoma with Late Metastases to the Contralateral Orbit  

PubMed Central

Choroidal melanoma is the commonest adult primary intraocular tumour,1 and usual sites of secondary spread are to liver, bone and lung. Although delayed recurrence of ipsilateral orbital melanoma is well documented, metastasis to the contralateral orbit is a rarely encountered phenomenon. We describe a case of metastatic spread to the contralateral orbit in a patient 12 years after proton beam radiotherapy of choroidal melanoma.

George, Sonia; Cooke, Carole A.; Mc Ginnity, Gerald F.; White, Steve; Venkatraman, Laksmi



Computer modeling of transpupillary thermotherapy for choroidal neovascularization  

NASA Astrophysics Data System (ADS)

Thermal effects of visible and near-infrared laser pulses were modeled in order to guide future pre-clinical and clinical studies for transpupillary thermotherapy for choroidal neovascularization. A finite-difference, thermophysical model of the native fundus was developed, and contributions were added to consider the effects of incident visible and near-infrared laser irradiation, natural pigment heterogeneity, an absorptive CNV complex, as well as subretinal and sub-RPE blood. Calculations were performed with and without choroidal convective cooling.

Berger, Jeffrey W.



Two cases of choroidal metastasis from breast cancer  

Microsoft Academic Search

We report two cases of choroidal metastasis from breast cancer. The first case was a 41-year-old woman with loss of her right\\u000a upper visual area in whom right breast cancer accompanied by lung and choroidal metastases were detected simultaneously. She\\u000a died without having received radiation therapy for the affected eye 6 months after mastectomy and oophorectomy. The second\\u000a case was

Shingo Inoue; Kaoru Nagahori; Haruki Yamada; Jun Itakura; Yoshiro Matsumoto



Foveolar Choroidal Blood Flow in Age-Related Macular Degeneration  

Microsoft Academic Search

METHODS. Laser Doppler flowmetry was used to assess relative choroidal blood velocity (CfoBVcl~), volume (CM?Vo)), and flow (CbBFlow) in the center of the fovea. Measurements were obtained in 20 eyes of 20 subjects with 10 or more large drusen, visual acuity of 20\\/32 or better, and no evidence of choroidal neovascularization. Findings obtained in these subjects were compared with those

Juan E. Grunwald; Seenu M. Hariprasad; Joan DuPont; Maureen G. Maguire; Stuart L. Fine; Alexander J. Brucker; Albert M. Maguire; Allen C. Ho


Retinal pigment epithelial tear after photodynamic therapy for choroidal neovascularization  

Microsoft Academic Search

PURPOSE: To report a case of retinal pigment epithelial tear after photodynamic therapy for choroidal neovascularization.METHODS: Case report. A 74-year-old woman with exudative age-related macular degeneration and classic subfoveal choroidal neovascularization RE underwent photodynamic therapy with verteporfin.RESULTS: Ophthalmoscopy and fluorescein angiography RE disclosed a retinal pigment epithelial tear in the area of photodynamic therapy.CONCLUSION: This case presents the first report

Faik Gelisken; Werner Inhoffen; Michael Partsch; Ulrike Schneider; Ingrid Kreissig



Transscleral Delivery of Bioactive Protein to the Choroid and Retina  

Microsoft Academic Search

PURPOSE. To investigate the feasibility of transscleral drug delivery to the choroid and retina. METHODS. An osmotic pump was used to deliver IgG across the sclera of pigmented rabbits, and levels were measured in the choroid, retina, vitreous humor, aqueous humor, orbit, and plasma over 28 days. This method was then used to deliver an anti-intercellular adhesion molecule-1 (ICAM-1) monoclonal

Jayakrishna Ambati; Evangelos S. Gragoudas; Joan W. Miller; Timothy T. You; Kazuaki Miyamoto; Francois C. Delori; Anthony P. Adamis



Choroidal thickness measurements during central serous chorioretinopathy treatment.  


To determine changes in choroidal thickness in patients with central serous chorioretinopathy (CSCR) during the first 3 months after initial diagnosis and assess variable therapeutic interventions via enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). In this prospective study, choroidal thickness was measured via EDI-OCT both in the affected and fellow eyes of 10 patients with CSCR at the fovea, as well as at 500 and 1,000 ?m both temporal and nasal from the centre of the fovea and at the leakage point (if present), visualised via fluorescein angiography. Follow-up measurements were performed after 2-3 weeks, 6-8 weeks and 3 months. Seven of the 10 patients received additional systemic therapy with oral acetazolamide. A control group of eight healthy subjects was recruited to determine normal choroidal thickness in healthy eyes. The mean age of the 10 patients (9 male, 1 female) in the CSCR group was 42.1 (±9.3) years. The choroid in the affected eyes was significantly thickened at baseline compared to fellow eyes and the eyes of healthy subjects. The choroid in the fellow eyes also revealed a slight thickening at baseline compared to normal eyes. During the 3 month follow-up period, the choroidal thickness of the affected eyes showed a highly significant decrease, but did not reach normal levels. Minor changes could also be observed in the fellow eyes but did not reach statistical significance. In patients with CSCR, the average choroidal thickness not only demonstrated a significant thickening at baseline, but also showed a marked decrease after 3 months, yet not reaching normal levels. Our data indicate that after 3 months, normalisation of choroidal thickness is not yet completed. PMID:23572440

Brandl, Caroline; Helbig, H; Gamulescu, M A



[Ultrastructural findings of arachnoid cysts and epithelial cysts].  


There may be several kinds of pathological conditions in the cystic lesion which are clinically diagnosed as benign intracranial cysts on CT scan. Light and electron microscopic studies on cyst walls were important in the differential diagnosis of benign intracranial cysts. We have studied 5 cases of intracranial arachnoid cysts and two epithelial cysts using the light and electron microscopy. Five cases of intracranial arachnoid cysts included two children and three adults (three females and two males). Three cases of them were localized in the middle cranial fossa, one case in the anterior and middle cranial fossa and one case in the lateral ventricle, giving headache and convulsion as the initial complaints. As for the epithelial cysts, one was localized at the para-collicular area complaining enlarged head and swollen anterior fontanelle and the other of four years was located in the fourth ventricle with headache and ataxic gait. On CT all of them demonstrated diffuse low density areas in both the arachnoid and the epithelial cysts without communicating findings between the cystic cavities and subarachnoid space on metrizamide CT cisternography. The arachnoid cyst walls were basically similar in structure to the normal arachnoid membrane and composed of elongated epithelial cells like the arachnoid cell and the connective tissues with lamellar collagen fiber bundles. However, 3 of the 5 cases had only fibrous tissues without epithelial cells. The inner sheath of the arachnoid cyst walls was composed of one or several layers of the arachnoid cells with flattened and relatively electron-dense cytoplasm on electron micrograph. They had a lot of elongated process and were tangled with each other, making large extracellular spaces between them. Below the electron dense arachnoid cells, compact packed cells with interdigitation partly demonstrated intercellular contacts such as numerous desmosomes and tight junctions. In those intercellular spaces collagen fibers and microfibrils were observed. The cells contained abundant cytoplasmic microfibrils and numerous organelles. They were separated from numerous collagen fibers and fibroblasts by non continuous basal lamina under the epithelial cells. Epithelial cyst wall had a layer of cuboidal or columnal epithelium in the inner layer of cyst wall. Those epithelial cells demonstrated granules having positive in PAS and mucicarmine stain in their cytoplasm. On electron microscopical study epithelial cells revealed a lot of microvilli and coating materials on the surface of them without cilia. The basement membranes were well developed under the epithelial cells separated from the connective tissues. In the intercellular clefts of the epithelial cells tight junctions and interdigitations were recognized.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1910938

Miyagami, M; Kasahara, E; Miyazaki, S; Tsubokawa, T; Kagawa, Y



Tooth in a cyst - Is it always a dentigerous cyst?  


We present the case report of an 18-year-old female patient who presented with unilateral nasal obstruction. Computed tomography scanning revealed an unerupted molar in the posterior wall of the right maxillary sinus with a cystic swelling in the sinus. The preoperative diagnosis was a dentigerous cyst. The patient underwent endoscopic removal of the cyst and tooth. The operative findings and histopathology showed that it was an odontogenic keratocyst. This paper stresses the importance of diagnosing this condition and that a tooth in a cyst is not always dentigerous. PMID:23120487

Vaid, Neelam; Kothadiya, Ajay; Adwani, Sushama



Management of obstetrical brachial plexus palsy with early plexus microreconstruction and late muscle transfers.  


Birth brachial plexus injury usually affects the upper roots. In most cases, spontaneous reinnervation occurs in a variable degree. This aberrant reinnervation leaves characteristic deformities of the shoulder, elbow, forearm, wrist, and hand. Common sequelae are the internal rotation and adduction deformity of the shoulder, elbow flexion contractures, forearm supination deformity, and lack of wrist extension and finger flexion. Nowadays, the strategy in the management of obstetrical brachial plexus palsy focuses in close follow-up of the baby up to 3-6 months and if there are no signs of recovery, microsurgical repair is indicated. Nonetheless, palliative surgery consisting of an ensemble of secondary procedures is used to further improve the overall function of the upper extremity in patients who present late or fail to improve after primary management. These secondary procedures include transfers of free vascularized and neurotized muscles. We present and discuss our experience in treating early and/or late obstetrical palsies utilizing the above-mentioned microsurgical strategy and review the literature on the management of brachial plexus birth palsy. PMID:18381657

Vekris, Marios D; Lykissas, Marios G; Beris, Alexandros E; Manoudis, Grigorios; Vekris, Anastasios D; Soucacos, Panayiotis N



Spinal perineurial and meningeal cysts.  


Perineurial cysts may be responsible for clinical symptoms and a cure effected by their removal. They do not fill on initial myelography but may fill with Pantopaque some time, days or weeks, after Pantopaque has been instilled into the subarachnoid space. Perineurial cysts arise at the site of the posterior root ganglion. The cyst wall is composed of neural tissue. When initial myelography fails to reveal an adequate cause for the patient's symptoms and signs referable to the caudal nerve roots, then about a millilitre of Pantopaque should be left in the canal for delayed myelography which may later reveal a sacral perineurial cyst or, occasionally, a meningeal cyst. Meningeal diverticula occur proximal to the posterior root ganglia and usually fill on initial myelography. They are in free communication with the subarachnoid space and are rarely in my experience responsible for clinical symptoms. Meningeal diverticula and meningeal cysts appear to represent a continuum. Pantopaque left in the subarachnoid space may convert a meningeal diverticulum into an expanding symptomatic meningeal cyst, as in the case described. Many cases described as perineurial cysts represent abnormally long arachnoidal prolongations over nerve roots or meningeal diverticula. In general, neither of the latter is of pathological significance. Perineurial, like meningeal cysts and diverticula, may be asymptomatic. They should be operated upon only if they produce progressive or disabling symptoms or signs clearly attributable to them. When myelography must be done, and this should be done only as a preliminary to a probable necessary operation, then patient effort should be made to remove the Pantopaque. PMID:5531903

Tarlov, I M



Spinal perineurial and meningeal cysts  

PubMed Central

Perineurial cysts may be responsible for clinical symptoms and a cure effected by their removal. They do not fill on initial myelography but may fill with Pantopaque some time, days or weeks, after Pantopaque has been instilled into the subarachnoid space. Perineurial cysts arise at the site of the posterior root ganglion. The cyst wall is composed of neural tissue. When initial myelography fails to reveal an adequate cause for the patient's symptoms and signs referable to the caudal nerve roots, then about a millilitre of Pantopaque should be left in the canal for delayed myelography which may later reveal a sacral perineurial cyst or, occasionally, a meningeal cyst. Meningeal diverticula occur proximal to the posterior root ganglia and usually fill on initial myelography. They are in free communication with the subarachnoid space and are rarely in my experience responsible for clinical symptoms. Meningeal diverticula and meningeal cysts appear to represent a continuum. Pantopaque left in the subarachnoid space may convert a meningeal diverticulum into an expanding symptomatic meningeal cyst, as in the case described. Many cases described as perineurial cysts represent abnormally long arachnoidal prolongations over nerve roots or meningeal diverticula. In general, neither of the latter is of pathological significance. Perineurial, like meningeal cysts and diverticula, may be asymptomatic. They should be operated upon only if they produce progressive or disabling symptoms or signs clearly attributable to them. When myelography must be done, and this should be done only as a preliminary to a probable necessary operation, then patient effort should be made to remove the Pantopaque. Images

Tarlov, I. M.



[Tarlov cyst and symptomatic bladder disfuction].  


Tarlov cysts or perineural cyst are lesions of the nerve roots located at the sacral level and uncertain aetiology. Most of these cysts remain asymptomatic with no clinical relevance. The symptomatic cysts are uncommon and the usual symptoms are pain or radiculopathy. We report the case of a 53-year-old woman witha symptomatic cyst (with a history of frequency and urgency syndrom), that disappears after surgery. PMID:19143297

Ruibal Moldes, M; Sánchez Rodríguez-Losada, J; López García, D; Casas Agudo, V; Janeiro País, J M; González Martín, M


Eruption cysts: A series of two cases  

PubMed Central

Eruption cysts are benign cysts that appear on the mucosa of a tooth shortly before its eruption. They may disappear by themselves but if they hurt, bleed or are infected they may require surgical treatment to expose the tooth and drain the contents. Here we present 2 case reports of eruption cysts presenting with different chief complaint. The treatment included incising the eruption cyst and draining the contents of the cyst.

Dhawan, Preeti; Kochhar, Gulsheen Kaur; Chachra, Sanjay; Advani, Shweta



Brachial plexus compression by an iatrogenic arteriovenous fistula  

Microsoft Academic Search

Summary  A case of left brachial plexus compression by an iatrogenic arteriovenous fistula was treated by detachable balloon technique\\u000a with immediate relief of pain. Good results on paresia were obtained in a few weeks.

J. G. Tebib; J. Bascoulergue; Ch. Dumontet; A. Paupert-Ravault; B. Prallet; F. Colson; M. Bouvier



Anatomy of the posterior approach to the lumbar plexus block  

Microsoft Academic Search

The purpose of this study was to describe the relation of the lumbar plexus with the psoas major and with the superficial\\u000a and deep landmarks close to it. Four cadavers were dissected and 22 computed tomography files of the lumbosacral region studied.\\u000a Cadaver dissections demonstrated that the lumbar plexus, at the level of L5, is within the substance of the

Juliana Farny; Pierre Drolet; Michel Girard



Brachial Plexus Injuries in Neonates: An Osteopathic Approach  

Microsoft Academic Search

Neonates and infants with brachial plexus injuries are typ- ically treated using splinting, range-of-motion exercise, and, in more severe cases, nerve reconstruction. However, myofas- cial release—a common osteopathic manipulative treatment technique that has been used to manage thoracic outlet syn- drome in adults—may provide effective, noninvasive man- agement of brachial plexus injuries in neonates and infants. While emphasizing the importance

David C. Mason; Carman A. Ciervo



Thermoablation of Liver Metastases: Efficacy of Temporary Celiac Plexus Block  

Microsoft Academic Search

Purpose: To determine the efficacy of celiac plexus block during thermoablation of liver metastases. Methods: Fifty-five consecutive patients underwent thermoablation therapy of liver tumors by laser-induced thermotherapy. Twenty-nine patients received a temporary celiac plexus block, 26 patients acted as control group. In both groups fentanyl and midazolam were administered intravenously upon request of the patient. The duration of the intervention,

A. N. Beck; M. Schäfer; M. Werk; M. Pech; G. Wieners; C. Cho; J. Ricke



Thermoablation of Liver Metastases: Efficacy of Temporary Celiac Plexus Block  

Microsoft Academic Search

Purpose. To determine the efficacy of celiac plexus block during thermoablation of liver metastases. Methods. Fifty-five consecutive patients underwent thermoablation therapy of liver tumors by laser-induced thermotherapy. Twenty-nine patients received a temporary celiac plexus block, 26 patients acted as control group. In both groups fentanyl and midazolam were administered intravenously upon request of the patient. The duration of the intervention,

A. N. Beck; M. Schaefer; M. Werk; M. Pech; G. Wieners; C. Cho; J. Ricke



Hydatid cyst of head of pancreas mimicking choledochal cyst  

PubMed Central

A 5-year-old girl presented with abdominal pain, intermittent jaundice and a gall bladder lump. Clinical examination and preoperative imaging suggested the diagnosis of a type I choledochal cyst (CDC). During surgery, this was found to be a hydatid cyst (HC) occupying the head of pancreas causing obstruction to the common bile duct (CBD). A pancreatic HC mimicking a CDC and presenting with CBD obstruction is unusual.

Agrawal, Sanwar; Parag, Pulak



Lumbar intraspinal extradural ganglion cyst  

PubMed Central

A case is presented of an intraspinal extradural ganglion cyst at the L4–5 level. The clinical picture suggested a herniated nucleus pulposus at this level. A myelogram revealed a round lesion almost completely obstructing the flow of Pantopaque at the L4–5 level. A ganglion cyst with a haemorrhage into it and the surrounding tissue was removed, and surgery was followed by complete recovery. Images

Brish, Adam; Payan, Hushong M.



Endoscopic approach to arachnoid cyst  

Microsoft Academic Search

A prospective study of 36 consecutive patients with congenital arachnoid cysts treated endoscopically is reported. There were\\u000a 15 female and 21 male patients. The mean age at the time of diagnosis was 12.3 years (10 days to 38 years). Arachnoid cysts\\u000a were located in the suprasellar region in 16 patients, the sylvian fissure in 11, the quadrigeminal cistern in 4

Joong-Uhn Choi; Dong-Seok Kim; Ryoong Huh



Endoscopic Management of Colloid Cysts.  


Background Microsurgical resection, stereotactic aspiration, endoscopically assisted microsurgical resection, and ventriculoperitoneal shunt have been the treatment options for colloid cysts of the third ventricle. Recently, an endoscopic approach has been recognized as an effective alternative to open surgery. There is suspicion about the long-term recurrence rate and about obtaining complete removal of cyst.Patients and Methods This is a prospective study of 24 patients with colloid cyst who underwent endoscopic resection. Preoperative computed tomography (CT) scans revealed hydrocephalus in all the patients. Postoperative magnetic resonance imaging (MRI) was done in all cases.Results Age ranged from 16 to 57 years. There were 16 male and 8 female patients. The diameter of the cyst varied from 14 to 24 mm. Operating time ranged from 90 to 156 minutes. Total resection was achieved in 21 patients. All patients with subtotal excision underwent coagulation of residual cyst wall. The follow-up period ranged from 6 to 78 months (mean, 37 months). None of the patients developed any symptoms at 26, 31, and 39 months of follow-up. Preoperative symptoms disappeared in all the patients except for memory disorders and seizures in one patient each. No residual cyst was observed on the postoperative MRIs in 21 patients. Hospital stay was 4 to 10 days (median, 6 days). No endoscopic operation was converted into an open resection.Conclusion Endoscopic excision of a colloid cyst is an effective and safe alternate method. Although the follow-up time was short, residual cyst wall remained asymptomatic without any evidence of growth after subtotal excision and coagulation of wall. PMID:23700169

Yadav, Yad Ram; Parihar, Vijay; Pande, Sonjjay; Namdev, Hemant



Chocolate cysts from ovarian follicles  

Microsoft Academic Search

Objective: To study the development of chocolate cysts by serial transvaginal ultrasonographic tracking of ovarian follicles.Design: Retrospective study.Setting: Department of Obstetrics and Gynaecology, Sunderland Royal Hospital, Sunderland, United Kingdom.Patient(s): We reviewed case notes of all patients who underwent laparoscopy for diathermy to endometriosis\\/ovarian diathermy\\/aspiration of ovarian cysts from 1989 to 1998. Twelve women with histories of infertility and proven chocolate

Smita Jain; Maureen E Dalton



Epidermoid cyst of the spleen.  


We report the case of a patient with a palpable mass and abdominal pain in the left upper quadrant. A physical examination revealed tenderness in this region. An ultrasound performed initially showed a large cystic structure. A CT examination revealed a large cyst originating in the spleen with loculations in its upper part and focal calcification in the wall. On MRI, the cystic mass showed high signal on T1-weighted and T2-weighted images. The carbohydrate antigen 19-9 (CA 19-9) was measured at 88 U/ml (standard <37.1 mUI/l). According to the imaging examinations and laboratory tests performed, it was impossible to determine if the splenic cyst was parasitic or non-parasitic. Given the most important risks of complications encountered in parasitic cysts, it was decided to treat this splenic cyst as a parasitic cyst. For this reason, an elective laparoscopic splenectomy with preoperative embolisation of the splenic artery was performed. The histological diagnosis was a primary epidermoid splenic cyst with inner lining epithelial cells. PMID:23667225

Vo, Quoc Duy; Monnard, Etienne; Hoogewoud, Henri Marcel



A noninvasive eye fixation monitoring system for CyberKnife radiotherapy of choroidal and orbital tumors  

SciTech Connect

A new noninvasive monitoring system for fixing the eye has been developed to treat orbital and choroidal tumors with CyberKnife-based radiotherapy. This device monitors the eye during CT/MRI scanning and during treatment. The results of this study demonstrate the feasibility of the fixation light system for CyberKnife-based treatments of orbital and choroidal tumors and supports the idea that larger choroidal melanomas and choroidal metastases could be treated with CyberKnife without implanting fiducial markers.

Daftari, I. K.; Petti, P. L.; Larson, D. A.; O'Brien, J. M.; Phillips, T. L. [Department of Radiation Oncology, University of California-San Francisco, 1600 Divisadero Street, San Francisco, California 94143 (United States)



Keratinous inclusion cyst of oesophagus: unusual finding.  


Cysts of the oesophagus are unusual findings and they are classified according to the embryological site of origin. It may represent inclusion cysts, retention cysts and developmental cysts. We present a case of keratinous inclusion cyst of the lower oesophagus in a 71-year-old Malay woman who presented with dyspepsia and severe epigastric pain. An oesophago-gastro-duodenoscopy demonstrated a sliding hiatus hernia with whitish ulcer-like lesion at the lower oesophagus. Biopsy from the lesion revealed a keratinous inclusion cyst. The patient was given pantoprazole and put on regular follow-up for monitoring any other development. PMID:23878290

Wan Abdul Rahman, Wan Faiziah; Mutum, Samarendra Singh; Fauzi, Mohd Hashairi



Thermoablation of Liver Metastases: Efficacy of Temporary Celiac Plexus Block  

SciTech Connect

Purpose. To determine the efficacy of celiac plexus block during thermoablation of liver metastases. Methods. Fifty-five consecutive patients underwent thermoablation therapy of liver tumors by laser-induced thermotherapy. Twenty-nine patients received a temporary celiac plexus block, 26 patients acted as control group. In both groups fentanyl and midazolam were administered intravenously upon request of the patient. The duration of the intervention, consumption of opiates, and individual pain sensations were documented. Results. No complications resulting from the celiac plexus block were recorded. Celiac plexus block significantly reduced the amount of pain medication used during thermoablation therapy of liver tumors (with block, 2.45 {mu}g fentanyl per kg body weight; without block, 3.58 {mu}g fentanyl per kg body weight, p < 0.05; midazolam consumption was not reduced) in patients with metastases {<=}5 mm from the liver capsule. For metastases farther away from the capsule no significant differences in opiate consumption were seen. Celiac plexus block reduced the time for thermoablation significantly (178 min versus 147 min, p < 0.05) no matter how far the metastases were from the liver capsule. Average time needed to set the block was 12 min (range 9-15 min); additional costs for the block were marginal. As expected (as pain medications were given according to individual patients' needs) pain indices did not differ significantly between the two groups. Conclusion. In patients with liver metastases {<=}5 mm from the liver capsule, celiac plexus block reduces the amount of opiates necessary, simplifying patient monitoring. In addition celiac plexus block reduces intervention time, with positive effects on overall workflow for all patients.

Beck, A.N., E-mail:; Schaefer, M.; Werk, M.; Pech, M.; Wieners, G.; Cho, C.; Ricke, J. [Universitaets Medicin Berlin, Charite, Campus-Virchow-Klinikum, Department of Radiology (Germany)



PET/CT imaging: detection of choroidal melanoma  

PubMed Central

Aim: To determine the size of untreated choroidal melanomas resolved by whole body positron emission tomography fused with computed tomography (PET/CT). Methods: 50 consecutive patients with untreated choroidal melanomas underwent whole body PET/CT. A functionally fused helical CT scan and 18-fluoro-2-deoxyglucose (FDG) PET scans were employed. The tumours were identified (both quantitatively and qualitatively) and compared with clinical measurements derived from ophthalmoscopic, angiographic, and ultrasonographic imaging. Standardised uptake values (SUV) of more than 2.5 were considered positive. Results: Among the 50 patients with choroidal melanoma, PET/CT scan SUVs of more than 2.5 were noted in 14 (28%) tumours. No AJCC T1 class tumours, 33.3% of T2 melanomas, and 75% of T3 melanomas were physiologically identifiable on PET/CT. With respect to COMS group classifications, no small choroidal tumours, 33% of medium, and 75% of large melanomas were physiologically identifiable. The sole ring melanoma was identifiable on PET/CT imaging. The smallest tumour physiologically identifiable by PET/CT had basal dimensions of 3×5.9 and an apical height of 2.9 mm. Conclusion: Though PET/CT was found to be capable of physiologically identifying certain medium (T2) and most large sized (T3) choroidal melanomas, physiological imaging was not completely dependent upon tumour size. Functionally fused PET/CT localised the tumours within the eye and assessed their physiological activity.

Reddy, S; Kurli, M; Tena, L B; Finger, P T



SERPING1 polymorphisms in polypoidal choroidal vasculopathy  

PubMed Central

Purpose To investigate whether common genetic variants in the complement component 1 inhibitor gene (serpin peptidase inhibitor, clade G, member 1, SERPING1) are associated with polypoidal choroidal vasculopathy (PCV) in a Chinese Han population. Methods DNA samples were obtained from 118 PCV patients and 115 healthy subjects. Data derived from the HapMap project were used to select tag single nucleotide polymorphisms (SNPs) across the extended SERPING1 region. A previously reported age-related macular degeneration-related risk factor (rs2511989) was forcibly included. Genotyping of each tag SNP was performed by PCR restriction fragment length polymorphism and direct DNA sequencing techniques. Results Four SNPs for SERPING1, rs2509897, rs1005510, rs11603020, and rs2511989, were chosen as tag SNPs. None of these tag SNPs were associated with PCV, according to the single-SNP association test (p=0.41–0.83). Evaluation of common haplotypes across SERPING1 did not reveal any association with PCV (p=0.49–0.82). Conclusions We found no evidence to support the role of any common SERPING1 variants, including the rs2511989 variant, in the susceptibility to PCV in a Chinese Han population.

Li, Meng; Zuo, Chengguo; Zhang, Xiongze; Chen, Hui; Huang, Shizhou; Luo, Guangwei



Gamma Knife Radiosurgery for Choroidal Hemangioma  

SciTech Connect

Purpose: Patients with choroidal hemangioma (CH), a benign ocular hamartoma, frequently presents with visual disturbance as a result of exudative retinal detachment (RD), which originates in subretinal fluid accumulation. We report our experience using the Leksell Gamma Knife in the management of symptomatic CH. Methods and Materials: Seven patients with symptomatic CH (circumscribed form in 3 patients and diffuse form in 4) were treated with the Leksell Gamma Knife at our institution during a 7-year period. All patients presented with exudative RD involving the macula that resulted in severe visual deterioration. The prescription dose to the target margin was 10 Gy in all cases. The mean tumor volume receiving the prescription dose was 536 mm{sup 3} (range, 151-1,057). The clinical data were analyzed in a retrospective fashion after a mean follow-up of 34.4 months (range, 9-76). Results: The resolution of exudative RD was achieved within 6 months, and the visual acuity of the affected eye had improved at the latest follow-up examination (p = .018) in all patients. No recurrence of exudative RD occurred. Thinning of the CHs was observed in most patients; however, symptomatic radiation toxicity had not developed in any of the patients. Conclusion: Symptomatic CHs can be safely and effectively managed with Gamma Knife radiosurgery using a marginal dose of 10 Gy.

Kim, Yun Taek; Kang, Se Woong [Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jung-Il, E-mail: [Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)



[Photodynamic therapy in choroidal new vessels].  


Photodynamic therapy (PDT) is a new approach for subfoveal choroidal new vessels (CNV) in age-related macular degeneration (ARM) and myopia, currently being evaluated in clinical trials. PDT is a two-step procedure: the intravenous perfusion of a photosensitizer is followed by light irradiation at the adapted wavelength. Verteporfin, the photosensitizer under investigation, has a maximum absorption at 692nm. Phase I and II studies determined the settings necessary to obtain optimal effects in humans with Verteporfin in the phase III study. It has been shown that this treatment is efficient and preserves initial visual acuity in 67% of Verteporfin-treated ARM eyes vs 39% of placebo-treated ARM eyes at 1 year. Fluorescein angiographic follow-up found a photo-occlusion of the CNV 14 days after treatment application followed by a partial reperfusion or reproliferation of the CNV at 3 months, resulting in the need for repeated treatments. Two-year results of the Phase III randomized clinical trial are awaited. PMID:11351216

Soubrane, G



Choroidal Venous Pulsations at an Arterio-venous Crossing in Polypoidal Choroidal Vasculopathy  

PubMed Central

It has been reported that pulsations in abnormal vessels are observed on indocyanine green (ICG) angiography in half of patients with polypoidal choroidal vasculopathy (PCV), although the mechanism of the pulsation is unknown. In this study, we report a case of PCV showing venous pulsations at an arterio-venous (A-V) crossing, and discuss a possible mechanism of polypoidal vessel formation and pulsations in PCV. A 66-year-old female presented with a reddish-orange elevated lesion and serous retinal detachment in the macula of her left eye, and was diagnosed as PCV. She was treated with photodynamic therapy (PDT), and followed-up through routine examinations, including ICG angiography. ICG angiography at presentation showed a branching vascular network and choroidal venules with dye leakage (polypoidal vessels) in the left eye. Pulsations, supposedly of venous origin, were observed at an A-V crossing in the abnormal vessels. Within 3 months after PDT, the polypoidal vessel ceased to leak and the pulsations vanished. The reddish-orange lesion gradually decreased in size with complete disappearance of retinal detachment. This study suggests that an unusual compression at an A-V crossing may make a venule polypoidal, and fluctuations of blood flow and pressure in the venule may cause pulsatile movements of the vessel wall.

Sameshima, Munefumi; Sakamoto, Taiji



Choroidal Venous Pulsations at an Arterio-venous Crossing in Polypoidal Choroidal Vasculopathy.  


It has been reported that pulsations in abnormal vessels are observed on indocyanine green (ICG) angiography in half of patients with polypoidal choroidal vasculopathy (PCV), although the mechanism of the pulsation is unknown. In this study, we report a case of PCV showing venous pulsations at an arterio-venous (A-V) crossing, and discuss a possible mechanism of polypoidal vessel formation and pulsations in PCV. A 66-year-old female presented with a reddish-orange elevated lesion and serous retinal detachment in the macula of her left eye, and was diagnosed as PCV. She was treated with photodynamic therapy (PDT), and followed-up through routine examinations, including ICG angiography. ICG angiography at presentation showed a branching vascular network and choroidal venules with dye leakage (polypoidal vessels) in the left eye. Pulsations, supposedly of venous origin, were observed at an A-V crossing in the abnormal vessels. Within 3 months after PDT, the polypoidal vessel ceased to leak and the pulsations vanished. The reddish-orange lesion gradually decreased in size with complete disappearance of retinal detachment. This study suggests that an unusual compression at an A-V crossing may make a venule polypoidal, and fluctuations of blood flow and pressure in the venule may cause pulsatile movements of the vessel wall. PMID:24082779

Okubo, Akiko; Sameshima, Munefumi; Sakamoto, Taiji



Inhibitory effects of triamcinolone acetonide on bFGF-induced migration and tube formation in choroidal microvascular endothelial cells  

Microsoft Academic Search

Background: Angiostatic drugs might provide desirable modulation of choroidal angiogenesis-related diseases, including histoplasmosis and the exudative form of age-related macular degeneration. However, the precise effects of this class of compounds in the choroidal neovascularization are still unclear. In the present study, we investigated the effects of triamcinolone acetonide (TA), an angiostatic steroid, on choroidal angiogenesis in vitro. Methods: Bovine choroidal

Yu-sheng Wang; Ulrike Friedrichs; Wolfram Eichler; Stephan Hoffmann; Peter Wiedemann



Multifocal choroidal metastases from thyroid carcinoma: a case report.  


We present the case of a 62-year-old female patient, with follicular variant of papillary thyroid carcinoma, which presented to our department for a severe decrease in vision at right eye level. Despite a complex therapy, that included a near-total thyroidectomy, thyroid I-131 ablation, suppressive therapy with LT4, and external beam radiotherapy with cobalt- 60, the patient developed multiple lung, mediastinal, liver, and bone metastases, followed after 1 year, by multifocal choroidal metastases. The complex ocular investigations performed for the diagnosis and follow-up of the choroidal metastases are presented. A review of the literature was also performed. The rarity of choroidal metastases in patients with thyroid carcinoma imposes, for their detection, periodic ocular examinations. PMID:23618581

Munteanu, M; Giuri, S; Ro?ca, C; Boruga, O; Cre?u, O


Ultrasound localization of the sacral plexus using a parasacral approach.  


In this report, we describe the feasibility of locating the sacral plexus nerve using a parasacral approach and an ultrasound-guided technique. The parasacral region using a curved probe (2-5 MHz) was scanned in 17 patients in search of the medial border of the ischial bone and the lateral border of the sacrum, which represent the limit of the greater sciatic foramen. In addition, attempts were made to identify the piriformis muscles and the gluteal arteries. The sacral plexus was identified at the level of the sciatic foramen as a round hyperechoic structure. The gluteal arteries were identified in 10 of 17 patients, but we failed to positively identify the piriformis muscle in any patient. To confirm localization of the sacral plexus, an insulated needle attached to a nerve stimulator was advanced and, in each case, a sacral plexus motor response was elicited (plantar flexion-12, dorsal flexion-1, hamstring muscle stimulation-3, gastrocnemius muscle stimulation-1-not recorded) at a current between 0.2 and 0.5 mA. No complications were observed. This report confirms the feasibility of using ultrasound to locate the sacral plexus using a parasacral approach. PMID:19448235

Ben-Ari, Alon Y; Joshi, Rama; Uskova, Anna; Chelly, Jacques E



A huge presacral Tarlov cyst. Case report.  


Perineural cysts have become a common incidental finding during lumbosacral magnetic resonance (MR) imaging. Only some of the symptomatic cysts warrant treatment. The authors describe the successful operative treatment of a patient with, to the best of their knowledge, the largest perineural cyst reported to date. A 29-year-old woman had been suffering from long-standing constipation and low-back pain. During an obstetric investigation for infertility, the clinician discovered a huge presacral cystic mass. Computed tomography myelography showed the lesion to be a huge Tarlov cyst arising from the left S-3 nerve root and compressing the ipsilateral S-2 nerve. The cyst was successfully treated by ligation of the cyst neck together with sectioning of the S-3 nerve root. Postoperative improvement in her symptoms and MR imaging findings were noted. Identification of the nerve root involved by the cyst wall, operative indication, operative procedure, and treatment of multiple cysts are important preoperative considerations. PMID:17688070

Ishii, Kazuhiko; Yuzurihara, Masahito; Asamoto, Shunji; Doi, Hiroshi; Kubota, Motoo



Improved assessment of laser-induced choroidal neovascularization.  


The primary objective of this study was to develop and evaluate new methods of analyzing laser-induced choroidal neovascularization (CNV), in order to make recommendations for improving the reporting of experimental CNV in the literature. Six laser burns of sufficient power to rupture Bruch's membrane were concentrically placed in each eye of 18 adult Norway rats. Eyes received intravitreal injections of either triamcinolone acetonide, ketorolac, or balanced salt solution (BSS). Fluorescein angiography (FA) was performed 2 and 3 weeks after injection, followed by choroidal flat mount preparation. Vascular leakage on FAs and vascular budding on choroidal mounts were quantified by measuring either the cross-sectional area of each CNV lesion contained within the best-fitting polygon using Adobe Photoshop (Lasso Technique or Quick Selection Technique), or the area of bright pixels within a lesion using Image-Pro Plus. On choroidal mounts, the Lasso Technique and Image-Pro Plus detected a significant difference in lesion size between either ketorolac or triamcinolone when compared to BSS, while the Quick Selection Technique did not (Lasso Technique, 0.78 and 0.64; Image-Pro Plus, 0.77 and 0.65). On FA, the Lasso Technique and Quick Selection Technique detected a significant difference in lesion size between either ketorolac or triamcinolone when compared to BSS, while Image-Pro Plus did not (Lasso Tool, 0.81 and 0.54; Quick Selection Tool, 0.76 and 0.57). Choroidal mounts and FA are both valuable for imaging experimental CNV. Adobe Photoshop and Image-Pro Plus are both able to detect subtle differences in CNV lesion size, when images are not manipulated. The combination of choroidal mounts and FA provides a more comprehensive assessment of CNV anatomy and physiology. PMID:20553963

Toma, Hassanain S; Barnett, Joshua M; Penn, John S; Kim, Stephen J



Treating peripapillary choroidal neovascular membranes: a review of the evidence  

PubMed Central

Peripapillary choroidal neovascular membranes (PCNM) are defined as a collection of new choroidal blood vessels, any portion of which lies within one disc diameter of the nerve head. There are two types of PCNM, and correct pre-interventional identification of growth site has been shown to stratify the chance of visual improvement following therapy. Clinical manifestations occur only where the membrane extends over the macula, if the vessels haemorrhage into the subretinal space or fluid exudation occurs within the macula. This review provides an update and overview on the diverse range of current treatment studies and strategies being used in present clinical ophthalmic practice.

Jutley, G; Jutley, G; Tah, V; Lindfield, D; Menon, G



[Choroidal neovascularization in children--prevalence, diagnostics and treatment].  


Choroidal neovascularization (CNV) belongs to the rare retinal disorders in children. Authors present 3 cases of CNV, which were diagnosed in patients between 12-15 years of age (2 females and 1 male). Complete ophthalmological examination including fluorescein angiography, indocyanine angiography and optical coherence tomography were performed in all cases. Laboratory tests to exclude the systemic diseases were also done. CNV in young people maybe a result of high myopia, angioid streaks, ocular histoplasmosis, trauma or it could be idiopathic. In our series, we found idiopathic CNV in 2 eyes and 1 CNV after traumatic choroidal break. Stabilization of visual acuity was achieved after argon laser treatment in 2 cases. PMID:16052819

Bernardczyk-Meller, Jadwiga; K?osowska-Zawadka, Anna; Wasiewicz-Rager, Joanna



Optical coherence angiography for the retina and choroid  

NASA Astrophysics Data System (ADS)

Noninvasive ophthalmic angiography is demonstrated for the in vivo human. Three-dimensional structural and flow imaging have been performed with a high-speed spectral-domain optical coherence tomography. The two methods are presented; (1) Doppler optical coherence angiography: three-dimensional vasculature of retinal and choroidal vessels are visualized by flow imaging; and, (2) scattering optical coherence angiography: the choroidal vasculature is segmented from three-dimensional OCT volume set. By integrating three-dimensional vasculature images, two-dimensional images of blood vessels are obtained. These are corresponding to fluorescein angiogram and indocyanine green angiogram.

Makita, Shuichi; Hong, Youngjoo; Miura, Masahiro; Yamanari, Masahiro; Yatagai, Toyohiko; Yasuno, Yoshiaki



Iatrogenic choroidal neovascularization following idiopathic epiretinal membrane peel  

PubMed Central

Summary Choroidal neovascularization is an uncommon complication of macular surgery. The functional outcome is poor despite various treatment options, including laser photocoagulation, photodynamic therapy, and a variety of surgical procedures. We report a case of iatrogenic choroidal neovascularization in a 69-year-old woman at the site of inadvertent retinal trauma 5 weeks after an epiretinal membrane peel. Visual acuity was 6/15 at the time of diagnosis. Four intravitreal bevacizumab injections were administered over a period of 6 months; treatment was discontinued when a disciform scar was noted. At last follow-up, 21 months after surgery, the patient’s visual acuity was counting fingers.

Goh, Yi Wei; Ehrlich,, Rita; Welch, Sarah



Symptomatic Tarlov Cyst Following Spontaneous Subarachnoid Hemorrhage  

PubMed Central

Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient's life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage.

Kong, Woo Keun; Hong, Seung-Koan



Symptomatic tarlov cyst following spontaneous subarachnoid hemorrhage.  


Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient's life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage. PMID:22053232

Kong, Woo Keun; Cho, Keun-Tae; Hong, Seung-Koan



"Primary Omental Hydatid Cyst": A Rare Entity  

PubMed Central

Hydatid cyst is caused by the parasite Echinococcus granulosus commonly seen in temperate regions. Primary omental hydatid cyst is rare entity. Diagnosis can be achieved with contrast-enhanced computed tomography of abdomen and pelvis along with serology. Eosinophilia is a strong pointer to hydatid cyst as a differential diagnosis. Open or laparoscopic excision of the cyst along with medical therapy remains the treatment of choice.

Sable, Shailesh; Mehta, Jyoti; Yadav, Sudeep; Jategaokar, Priyadarshan; Haldar, Premashish J.



Choroidal thickness in both eyes of patients with unilaterally active central serous chorioretinopathy  

PubMed Central

Objective To assess the change in the choroidal thickness of the unaffected eyes in patients with unilateral central serous chorioretinopathy (CSC). Methods Thirty eyes with unilateral idiopathic CSC and 30 age-matched normal eyes were included in this study. Choroidal thickness was evaluated from images obtained by enhanced depth image optical coherence tomography. The choroidal thicknesses of the affected eyes, unaffected eyes, and normal eyes were analyzed. Choroidal vascular dilation and hyperpermeability on indocyanine green angiography (ICGA) were analyzed and correlated with the changes in choroidal thickness. Results The mean choroidal thicknesses of the affected eyes, unaffected fellow eyes, and normal individuals were 445.58±100.25, 378.35±117.44, and 266.80±55.45??m, respectively. Compared with normal eyes, subfoveal choroidal thickness was increased significantly in the eyes with active CSC and in the unaffected fellow eyes (P<0.001 in both groups). The choroidal thickness was significantly greater in the eyes with active CSC than in the unaffected fellow eyes (P=0.003). ICGA revealed choroidal vascular hyperpermeability in 28 (93.3%) eyes with CSC and in 23 (73.3%) unaffected fellow eyes. Choroidal vascular dilation was detected in 21 (70.0%) eyes with CSC and in 18 (60.0%) unaffected fellow eyes. Conclusion Increased choroidal thickness in patients with unilateral CSC was noted not only in the affected eyes, but also in the unaffected fellow eyes. The results of this study suggest that CSC might be an essentially bilateral disorder.

Kim, Y T; Kang, S W; Bai, K H



Spontaneous hemorrhage into a lumbar synovial cyst  

PubMed Central

Lumbar synovial cysts frequently present with back pain, chronic radiculopathy and/or progressive symptoms of spinal canal compromise. These cysts generally appear in the context of degenerative lumbar spinal disease. Few cases of spontaneous hemorrhage into synovial cysts have been reported in the literature.

Alen, Jose F.; Ramos, Ana; Lobato, Ramiro D.; Lagares, Alfonso



Ventricular Tachycardia Caused by Mesothelial Cyst  

PubMed Central

A 27 year-old- lady was evaluated due to recurrent ventricular tachycardia. After performing echocardiography and cardiac MRI, she was found to have large pericardial cyst. Pathologic examination confirmed it as mesothelial pericardial cyst. Up to our knowledge it is the first presentation of simple pericardial cyst as ventricular a tachycardia.

Amirahmadi, Ali; Emkanjoo, Zahra; Mollazadeh, Reza; Mozaffari, Kambiz



Ventricular tachycardia caused by mesothelial cyst.  


A 27 year-old- lady was evaluated due to recurrent ventricular tachycardia. After performing echocardiography and cardiac MRI, she was found to have large pericardial cyst. Pathologic examination confirmed it as mesothelial pericardial cyst. Up to our knowledge it is the first presentation of simple pericardial cyst as ventricular a tachycardia. PMID:23329874

Amirahmadi, Ali; Emkanjoo, Zahra; Mollazadeh, Reza; Mozaffari, Kambiz



Laparoscopic ablation of peripelvic renal cysts  

Microsoft Academic Search

Recently, laparoscopic surgery has been reported for symptomatic renal cysts. A 60-year-old female was referred to Toyama Medical and Pharmaceutical University Hospital with a chief complaint of general fatigue and left back pain. CT demonstrated bilateral peripelvic renal cysts, and DIP demonstrated left hydronephrosis and a medial shift of the left renal pelvis. Laparoscopic ablation of bilateral peripelvic renal cysts

Akiou Okumura; Hideki Fuse; Yasuhiro Muraishi; Remon Nishio; Tetsuo Nozaki



Suprasellar arachnoid cysts: Options in operative management  

Microsoft Academic Search

Summary Suprasellar arachnoid cysts are uncommon lesions the optimal management of which is still subject for debate. Various authors have presented differing treatment preferences which include: 1) Subfrontal fenestration of the cyst to the basal cisterns; 2) Transcallosal fenestration of the cyst into the lateral ventricles with optional shunting; 3) Cystoperitoneal shunt; 4) Percutaneous ventriculocystostomy. There is a significant incidence

Z. H. Rappaport



[Primary calcified mediastinal hydatid cyst producing compression].  


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

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



Lung Cysts Associated with Pneumocystis carinil Pneumonia  

Microsoft Academic Search

OBJECTIVE. The purpose of our study was to characterize the radiographic fea- tures of thin-walled air-filled structures (cysts) related to Pneumocystls carinil pneu- monia in a large series of patients, determine the natural history of the cysts, and test the hypothesis that the cysts are associated with an increased risk of pneumothorax. MATERIALS AND METHODS. Of 100 patients with proved

Radiographic Characteristics; Caroline Chow; Philip A. Templeton; Charles S. White


Dermoid cyst in a bull.  


A 3-year-old bull was examined because of a fluctuant mass on the ventral midline of the cranial portion of the cervical area. The mass originally developed after the bull was handled in a squeeze chute for routine health care. The mass was aspirated and incised repeatedly during the 18 months before referral. The mass was excised at the referral center, and the histologic diagnosis was dermoid cyst. The mass had not redeveloped by 18 months after surgery. Dermoid cysts are most often seen in Rhodesian Ridgeback dogs, although a similar condition has been reported in a 5-week-old calf. PMID:8428839

Baird, A N; Wolfe, D F; Groth, A H



Intermittent claudication due to ischaemia of the lumbosacral plexus  

PubMed Central

The distinct clinical syndrome of exercise induced ischaemia of the lumbosacral plexus is not a widely known cause for intermittent claudication. Eight patients with the mentioned syndrome were investigated clinically, neurophysiologically, and with imaging techniques. The clinical examination showed a typical exercise induced sequence of symptoms: pain, paraesthesia, and sensory and motor deficits. The underlying vascular conditions were high grade stenoses or occlusions of the arteries supplying the lumbosacral plexus. Spinal stenosis could be excluded in all cases. Five patients received successful interventional radiological therapy. The syndrome can be diagnosed clinically and successful therapy is possible by interventional radiology.??

Wohlgemuth, W.; Rottach, K.; Stoehr, M



[Changes in the intracardiac nerve plexuses in sudden death].  


Neurohistoligical and histochemical study of 57 cases of sudden cardiac death and control material in the age aspect revealed deep changes in the intracardiac nerve plexuses. In cases of sudden cardiac death conjoint mosaic changes were seen in the microcirculation channel in which regions with empty capillaries and areas of blood stasis were found. In some of the cholinergic neurons signs of edema were seen and cholinesterase activity was reduced, though it was still high in the preterminal and terminal plexuses stretching along the conduction system and blood vessels and in the myocardium. The regional microcirculatory disorders may be linked with the neuroregulative metabolic disorders. PMID:7406978

Shvalev, V N; Zhuchkova, N I; Vikhert, A M



Influence of brachial plexus blockade on oxygen balance during surgery.  


The combined effects of anesthesia, motor blockade, and chemically induced sympathectomy after brachial plexus blockade can have a beneficial impact, when applied in selected, isolated diseased states of the upper limb. With the aim of using the prolonged effects of brachial plexus blockade for a future therapeutic application, we demonstrated a dependable methodology of venous blood gas monitoring and confirmed an improved oxygen balance of the blocked versus nonblocked upper extremity in a controlled, prospective study in healthy patients undergoing elective hand surgery. PMID:21525181

Lumenta, David B; Haslik, Werner; Beck, Harald; Pollreisz, Andreas; Andel, Harald; Frey, Manfred



Epidermoid cyst of the temporal region.  


Epidermoid cysts are rare, slow-growing, benign, developmental cysts that are derived from abnormally situated ectodermal tissue. Epidermoid cysts may grow anywhere on the body and about 7% of them are located in the head and neck. In literature, very few epidermoid cysts have been reported in the temporal region. Histopathologically, they are lined with plain stratified keratin-producing squamous epithelium, although in some cases part of the lining is made up of mucous secreting and ciliated epithelium. This may suggest an endodermal rather than an ectodermal origin. We present and discuss the management of a patient presenting a posttraumatic epidermoid cyst of the temporal region. PMID:21889899

Boffano, Paolo; Roccia, Fabio; Campisi, Paola; Zavattero, Emanuele; Gallesio, Cesare; Bosco, Giovanni Francesco



Interventricular hydatid cyst imitating pulmonary stenosis.  


Cardiac hydatid cyst is known to be a rarely occurring disease. The appearance of large cysts in the interventricular septum in childhood is even more rare. Although such cysts are usually asymptomatic, they can behave like valvular disorders, depending on their location. In addition, cardiac hydatid cysts originating from the interventricular septum carry the risk of rupturing into both ventricular cavities, which may lead to fatal complications. Thus, early surgical treatment is of extreme importance. We describe the case of a 7-year-old girl with a cardiac hydatid cyst that originated in the interventricular septum. PMID:18270135

Omay, Oguz; Celebi, Serdar; Kumbasar, Ulas; Babaoglu, Kadir; Gunay, Ilhan



Imaging of an atypical pericardial cyst.  


Pericardial cysts are uncommon mediastinal lesions that are usually congenital in origin. Patients are usually asymptomatic and the cysts are generally discovered on routine radiography for unrelated purposes. This case illustrates a symptomatic presentation of a haemorrhagic pericardial cyst in which radiographic, echocardiographic and multislice (MRI and CT) imaging were performed. The imaging findings were not typical of pericardial cysts leading to a diagnostic quandary despite the varied imaging techniques. In conclusion, it is important to appreciate that the imaging findings of pericardial cysts can be varied. Radiologists and clinicians alike should be aware of this variability. PMID:22921797

Abu Bakar, Norzailin; Abdul Aziz, Yang Faridah; Singh Sandhu, Ravinderjit; Fadzli, Farhana; Yaakub, Nur Adura; Krishnasamy, Sivakumar; Raja Mokhtar, Raja Amin



Clinical experience of symptomatic sacral perineural cyst.  


Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion and are usually asymptomatic. Symptomatic sacral perineural cysts are uncommon but sometimes require surgical treatment. A 69-year-old male presented with pain in the buttock. He was diagnosed as having a sacral cyst with magnetic resonance imaging. For the nonoperative diagnosis and treatment, caudal peridurography and block were performed. After the treatment, the patient's symptom was relieved. We suggest a caudal peridural block is effective in relieving pain from a sacral cyst. PMID:22787551

Jung, Ki Tae; Lee, Hyun Young; Lim, Kyung Joon



Clinical Experience of Symptomatic Sacral Perineural Cyst  

PubMed Central

Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion and are usually asymptomatic. Symptomatic sacral perineural cysts are uncommon but sometimes require surgical treatment. A 69-year-old male presented with pain in the buttock. He was diagnosed as having a sacral cyst with magnetic resonance imaging. For the nonoperative diagnosis and treatment, caudal peridurography and block were performed. After the treatment, the patient's symptom was relieved. We suggest a caudal peridural block is effective in relieving pain from a sacral cyst.

Jung, Ki Tae; Lee, Hyun Young



Prenatal diagnosis of a paraurethral cyst.  


Paraurethral cysts arising from Skene's gland are a rare cause of urogenital masses in the neonate. We report the case of a pelvic mass noted at the vaginal introitus on prenatal ultrasound that following delivery was found to be a paraurethral cyst. On prenatal ultrasound, there was no evidence of involvement of the urinary, gastrointestinal, or upper genital tract. Serial ultrasounds demonstrated slight enlargement of the cyst without other changes. The patient delivered at 33 weeks and postnatal evaluation demonstrated a paraurethral cyst. The cyst was managed expectantly and drained spontaneously on the second day of life with complete resolution. PMID:23146295

Johnson, Clark T; Millard, Sarah E; Wang, Ming-Hsien; Ehsanipoor, Robert M



Primary hydatid cyst of the retroperitoneum.  


Retroperitoneal contamination may occur during the natural history of hydatid disease. Primary hydatid cyst of the retroperitoneum is extremely rare. The authors report a case of a giant retroperitoneal hydatid cyst. Clinicians and surgeons must be aware of this possibility and follow a policy of nonsystematic puncture of an abdominal cyst and avoid spillage during surgery. Symptoms are related to the size, location, or ensuing complications of a cyst. Its occurrence should be strongly suspected ahead of any abdominal cyst, especially in an endemic area, where it may act as a parasite. Total and careful surgical excision is the gold-standard therapy. PMID:19954768

Sall, Ibrahima; Ali, Abdelmounaim Ait; El Kaoui, Hakim; Bouchentouf, Sidi Mohammed; El Hjouji, Abderrahmane; El Fahssi, Mohammed; Bounaim, Ahmed; Zentar, Aziz; Sair, Khalid



Subretinal Surgery for Choroidal Neovascularization in Patients With High Myopia  

Microsoft Academic Search

Objective: To analyze the visual outcome in patients undergoing surgical removal of subfoveal choroidal neo- vascularization (CNV) in eyes with high myopia. Methods: We retrospectively reviewed the medical rec- ords of 48 consecutive patients with high myopia ($6 diopters (D)) who underwent vitrectomy with surgical removal of subfoveal CNV. The patient population con- sisted of 2 groups. Group 1 included

Akinori Uemura; Matthew A. Thomas



Palladium-103 Radiation Therapy for Small Choroidal Melanoma.  


PURPOSE: To evaluate outcomes after ophthalmic plaque radiation therapy for small choroidal melanomas. DESIGN: Retrospective study, case series. PARTICIPANTS: Seventy-two patients with choroidal melanomas ?1.5 and ?2.4 mm apical height and ?10 mm width treated between 2002 and 2012, with a minimum follow-up of 8 months. METHODS: All patients were treated with palladium-103 plaque brachytherapy. Mean radiation dose to the tumor apex was 82.4 Gy (range, 70.0-102 Gy). MAIN OUTCOME MEASURES: Local control, radiation complications, visual acuity, and metastatic rate. RESULTS: Plaque radiotherapy provided 100% local tumor control and eye retention at a mean 54 months of observation (95% confidence interval, 46-63 months). The most common long-term brachytherapy-related complications were radiation maculopathy (43.1%) and radiation optic neuropathy (20.8%) developing at a mean of 27 months (range, 9-72 months) after irradiation. In this series, 94.4% of patients maintained 20/200 or better vision. There has been no small choroidal melanoma-related metastasis. CONCLUSIONS: Palladium-103 plaque radiation therapy offered excellent local control and visual acuity outcomes for patients with small choroidal melanoma. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article. PMID:23774104

Semenova, Ekaterina; Finger, Paul T



Complete infarction of the eye complicating a choroidal malignant melanoma.  

PubMed Central

Infarction of malignant melanoma of the choroid has been previously reported, but infarction of the whole eye in association with infarction of melanoma is a rare event that has not been previously described. We present such a case and discuss the possible pathogenesis. Images

Jones, H; Manners, R; Elkington, A R; Weller, R O



Transpupillary thermotherapy (TTT) for the treatment of choroidal neovascularisation  

Microsoft Academic Search

AIMTo assess the effectiveness of transpupillary thermotherapy (TTT) for the treatment of classic and occult choroidal neovascularisation (CNV).METHODIn a retrospective, case selected, open label trial 44 eyes of 42 patients with CNV secondary to age related macular degeneration (ARMD) were studied. 44 eyes with angiographically defined CNV were treated with diode laser (810 nm) TTT. Laser beam sizes ranged between

R S B Newsom; J C McAlister; M Saeed; J D A McHugh



Expression of vascular endothelial growth factor in experimental choroidal neovascularization  

Microsoft Academic Search

• Background: Although the choroidal neovascularization (CNV) is a common pathologic feature of a number of different eye diseases, its pathological mechanisms have not been fully elucidated. We investigated the expression of vascular endothelial growth factor (VEGF) in CNV using an experimental primate model. • Method: CNV was induced by intense laser photocoagulation in four monkey eyes. Single eyes were

Tatsuro Ishibashi; Yasuaki Hata; Hiroshi Yoshikawa; Kazunori Nakagawa; Katsuo Sueishi; Hajime Inomata



High-Resolution Histologic Analysis of the Human Choroidal Vasculature  

Microsoft Academic Search

Results. APase staining provided excellent visualization of the entire choroidal vasculature en bloc. Reaction product was generally more prominent in the choriocapillaris and collecting venules than in veins or arterioles, whereas arteries had the least activity. Diminished activity within focal regions of the choriocapillaris was observed in the far periphery of most aged subjects and was related to loss of

D. Scott McLeod; Gerard A. Lutty



VEGF Is Major Stimulator in Model of Choroidal Neovascularization  

Microsoft Academic Search

PURPOSE. Vascular endothelial growth factor (VEGF) is upregulated by hypoxia and is a major stimulatory factor for retinal neovascularization in ischemic retinopathies such as diabetic retinop- athy. This study sought to determine if VEGF is a stimulatory factor in a murine model of choroidal neovascularization (CNV).

Nohoon Kwak; Naoyuki Okamoto; Jeanette M. Wood; Peter A. Campochiaro



Vascular adhesion protein-1 blockade suppresses choroidal neovascularization  

PubMed Central

Vascular adhesion protein-1 (VAP-1) is an endothelial cell adhesion molecule involved in leukocyte recruitment. Leukocytes and, in particular, macrophages play an important role in the development of choroidal neovascularization (CNV), an integral component of age-related macular degeneration (AMD). Previously, we showed a role for VAP-1 in ocular inflammation. Here, we investigate the expression of VAP-1 in the choroid and its role in CNV development. VAP-1 was expressed in the choroid, exclusively in the vessels, and colocalized in the vessels of the CNV lesions. VAP-1 blockade with a novel and specific inhibitor significantly decreased CNV size, fluorescent angiographic leakage, and the accumulation of macrophages in the CNV lesions. Furthermore, VAP-1 blockade significantly reduced the expression of inflammation-associated molecules such as tumor necrosis factor (TNF) -?, monocyte chemoattractant protein (MCP) -1, and intercellular adhesion molecule (ICAM) -1. This work provides evidence for an important role of VAP-1 in the recruitment of macrophages to CNV lesions, establishing a novel link between VAP-1 and angiogenesis. Inhibition of VAP-1 may become a new therapeutic strategy in the treatment of AMD.—Noda, K., She, H., Nakazawa, T., Hisatomi, T., Nakao, S., Almulki, L., Zandi, S., Miyahara, S., Ito, Y., Thomas, K. L., Garland, R. C., Miller, J. W., Gragoudas, E. S., Mashima, Y., Hafezi-Moghadam, A. Vascular adhesion protein-1 blockade suppresses choroidal neovascularization.

Noda, Kousuke; She, Haicheng; Nakazawa, Toru; Hisatomi, Toshio; Nakao, Shintaro; Almulki, Lama; Zandi, Souska; Miyahara, Shinsuke; Ito, Yasuhiro; Thomas, Kennard L.; Garland, Rebecca C.; Miller, Joan W.; Gragoudas, Evangelos S.; Mashima, Yukihiko; Hafezi-Moghadam, Ali



Suppression of Experimental Choroidal Neovascularization by Curcumin in Mice  

PubMed Central

Purpose To investigate the effects of curcumin on the development of experimental choroidal neovascularization (CNV) with underlying cellular and molecular mechanisms. Methods C57BL/6N mice were pretreated with intraperitoneal injections of curcumin daily for 3 days prior to laser-induced CNV, and the drug treatments were continued until the end of the study. The CNV area was analyzed by fluorescein-labeled dextran angiography of retinal pigment epithelium (RPE)-choroid flat mounts on day 7 and 14, and CNV leakage was evaluated by fluorescein angiography (FA) on day 14 after laser photocoagulation. The infiltration of F4/80 positive macrophages and GR-1 positive granulocytes were evaluated by immunohistochemistry on RPE-choroid flat mounts on day 3. Their expression in RPE-choroid complex was quantified by real-time PCR (F4/80) and Western blotting (GR-1) on day 3. RPE-choroid levels of vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF)-?, monocyte chemotactic protein (MCP)-1, and intercellular adhesion molecule (ICAM)-1 were examined by ELISA on day 3. Double immunostaining of F4/80 and VEGF was performed on cryo-sections of CNV lesions on day 3. The expression of nuclear factor (NF)-?B and hypoxia-inducible factor (HIF)?1? in the RPE-choroid was determined by Western blotting. Results Curcumin-treated mice had significantly less CNV area (P<0.05) and CNV leakage (P<0.001) than vehicle-treated mice. Curcumin treatment led to significant inhibition of F4/80 positive macrophages (P<0.05) and GR-1 positive granulocytes infiltration (P<0.05). VEGF mainly expressed in F4/80 positive macrophages in laser injury sites, which was suppressed by curcumin treatment (P<0.01). Curcumin inhibited the RPE-choroid levels of TNF-? (P<0.05), MCP-1 (P<0.05) and ICAM-1 (P<0.05), and suppressed the activation of NF-?B in nuclear extracts (P<0.05) and the activation of HIF?1? (P<0.05). Conclusion Curcumin treatment led to the suppression of CNV development together with inflammatory and angiogenic processes including NF-?B and HIF?1? activation, the up-regulation of inflammatory and angiogenic cytokines, and infiltrating macrophages and granulocytes. This provides molecular and cellular evidence of the validity of curcumin supplementation as a therapeutic strategy for the suppression of age-related macular degeneration (AMD)-associated CNV.

Xie, Ping; Zhang, WeiWei; Yuan, Songtao; Chen, Zhiqiang; Yang, Qin; Yuan, DongQing; Wang, Feng; Liu, QingHuai



Neurohistopathologic findings after a neurolytic celiac plexus block with alcohol in patients with pancreatic cancer pain.  


Pancreatic cancer has a very poor prognosis resulting in the death of 98% of patients. Pain may be severe and difficult to treat. Management of pain includes chemotherapy, radiotherapy, pharmacologic treatment, and neurolytic celiac plexus block. Recent reviews of the efficacy of neurolytic celiac plexus block however, have reached conflicting conclusions. In this paper, we present two patients with severe pancreatic cancer pain resistant to pharmacologic treatment. Analgesic effect following repeated neurolytic celiac plexus blocks with alcohol was limited in time. Post-mortem neurohistopathologic examination of the celiac plexus revealed an abnormal celiac architecture with a combination of abnormal neurons with vacuolization and normal looking neuronal structures (ganglionic structures and nerve fibers) embedded in fibrotic hyalinized tissue. Our results show that a neurolytic celiac plexus block with alcohol is capable of partially destroying the celiac plexus. These findings may explain the significant but short-lasting analgesic effect following neurolytic celiac plexus block with alcohol. PMID:12139538

Vranken, J H; Zuurmond, W W A; Van Kemenade, F J; Dzoljic, M



Symptomatic Tarlov cyst: report and review.  


Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion. The cysts are relatively rare and most of them are asymptomatic. Some Tarlov cysts can exert pressure on nerve elements resulting in pain, radiculopathy and even multiple radiculopathy of cauda equina. There is no consensus on the appropriate therapeutic options of Tarlov cysts. The authors present a case of two sacral cysts diagnosed with magnetic resonance imaging. The initial symptoms were low back pain and sciatica and progressed to cauda equina syndrome. Surgical treatment was performed by sacral laminectomy and wide cyst fenestration. The neurological deficits were recovered and had not recurred after a follow-up period of nine months. The literature was reviewed and discussed. This is the first reported case in Thailand. PMID:16881441

Chaiyabud, Pradit; Suwanpratheep, Kitti



A case of symptomatic Rathke's cyst.  


Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly, and ranges in size from 2 to 40 mm in diameter. Asymptomatic cysts are common, detected during autopsies of 2-26% of individuals who have died of unrelated causes. Symptomatic cysts are rare and only approximately 150 cases have been reported. Females are twice as likely as males to have a cyst. Symptomatic cysts can trigger visual disturbances, pituitary dysfunction and headaches. Here we present a case of a 40-year-old female patient who presented with complains of visual disturbances, headache and amenorrhoea. On investigations, MRI of brain revealed findings suggestive of Rathke's cleft cyst. PMID:23355555

Naik, Vismay Dinesh; Thakore, Nilay Rajendra



Syringomyelia Associated with a Spinal Arachnoid Cyst  

PubMed Central

While syringomyelia is not a rare spinal disorder, syringomyelia associated with a spinal arachnoid cyst is very unusual. Here, we report a 62-year-old man who suffered from gait disturbance and numbness of bilateral lower extremities. Spinal magnetic resonance imaging (MRI) showed the presence of a spinal arachnoid cyst between the 7th cervical and 3rd thoracic vertebral segment and syringomyelia extending between the 6th cervical and 1st thoracic vertebral segment. The cyst had compressed the spinal cord anteriorly. Syringomyelia usually results from lesions that partially obstruct cerebrospinal fluid flow. Therefore, we concluded that the spinal arachnoid cyst was causing the syringomyelia. After simple excision of the arachnoid cyst, the symptoms were relieved. A follow-up MRI demonstrated that the syringomyelia had significantly decreased in size after removal of the arachnoid cyst. This report presents an unusual case of gait disturbance caused by syringomyelia associated with a spinal arachnoid cyst.

Kim, Min-Su



Non-parasitic splenic cysts.  


This article gives an overview of the topic, with emphasis on current concepts and management of the clinical situations in question, in particular the concepts related to treatment. An extensive review of the etiology and monitoring of patients with non-parasitic splenic cysts is also made. These reports are derived from major clinical studies published in the current medical literature. PMID:21340260

Schlittler, Luis Alberto; Dallagasperina, Viviane Weiller



Infratentorial Arachnoid Cysts in Children  

Microsoft Academic Search

8 Children surgically treated for posterior fossa arachnoid cyst are described. In all the cases an enlarging head was the presenting sign; intracranial hypertension was evident in 6 patients; 2 children were clinically regarded as being affected by ‘arrested’ hydrocephalus. Preoperative subarachnoid lumbar infusion tests (8 cases) and prolonged intraventricular CSF pressure recordings (2 cases) demonstrated abnormal CSF dynamics in

Concezio di Rocco; Massimo Caldarelli; Girolamo di Trapani



Arachnoid cysts: diagnosis and treatment  

Microsoft Academic Search

Twenty supratentorial and 10 infratentorial arachnoid cysts are reported. The patients were from 0 to 15 years of age. The commonest presenting symptoms in children were cranial enlargement, epileptic seizures, and psychomotor retardation. Neuroradiological evaluation included CT, metrizamide CT, cisternography, and angiography. Echography was performed in 5 newborns. Therapeutic criteria according to the clinical and neuroradiological findings are reviewed. Cystoperitoneal

D. Locatelli; N. Bonfanti; R. Sfogliarini; T. M. Gajno; S. Pezzotta



Epidermal cyst of the breast.  

PubMed Central

Two cases of epidermal cyst of the breast are presented. Mammography and ultrasonography merely confirmed that the masses were solid. As is usual with these extremely rare lesions, the initial diagnoses (fibroadenoma and carcinoma) were incorrect. Images Fig. 1 Fig. 2 Fig. 3A Fig. 3B Fig. 4 Fig. 5

Kowand, L M; Verhulst, L A; Copeland, C M; Bose, B



Microsurgical repair and secondary surgery in obstetrical brachial plexus palsy  

Microsoft Academic Search

We present a personal experience with 750 children suffering from obstetrical brachial plexus palsy. The related surgery is described, including early microsurgical nerve reconstruction and secondary procedures including tendon and muscle transfers. The clinical examination, indications and timing for surgery, technical details of primary and secondary operations and the possible outcome are discussed. Both clinical and research work need an

Jörg Bahm; Hassan Noaman; Claudia Ocampo-Pavez



Microsurgical anatomy of the internal vertebral venous plexuses  

Microsoft Academic Search

Few studies have been done about the venous vascularization of the spine since neuroradiologic studies in the 1960s and 70s. The aim of this study was to clarify the topography of the internal vertebral venous plexuses in relation to the posterior longitudinal ligament and the dura. The relationships of the vv. were studied at different levels of the spine. The

P. Chaynes; J. C. Verdié; J. Moscovici; J. Zadeh; Ph. Vaysse; J. Becue



Microsurgical anatomy of the internal vertebral venous plexuses  

Microsoft Academic Search

Summary Few studies have been done about the venous vascularization of the spine since neuroradiologic studies in the 1960s and 70s. The aim of this study was to clarify the topography of the internal vertebral venous plexuses in relation to the posterior longitudinal ligament and the dura. The relationships of the vv. were studied at different levels of the spine.

P. Chaynes; J. C. Verdié; J. Moscovici; J. Zadeh; Ph. Vaysse; J. Becue



Controversies surrounding the causes of brachial plexus injury  

Microsoft Academic Search

In the past decades, obstetric personnel have attempted to reduce the frequency of brachial plexus injury (BPI) by attempting to use less traction during the delivery of the fetal anterior shoulder. Clearly, these attempts have been unsuccessful in preventing or reducing the frequency of BPI. We conducted a nonsystematic literature review of the reported controversies regarding the mechanisms of BPI

Herbert F. Sandmire; Robert K. DeMott



Cerebral arachnoid cyst: A lesion of the child's brain  

Microsoft Academic Search

39 patients with 42 arachnoid cysts have been reviewed in a retrospective study. All kinds of arachnoid cysts reported in the literature were also found in this study. These consist mainly of congenital primary and posttraumatic secondary cysts. Cysts which cause no major neurological deficits require conservative treatment of symptoms only. Cysts which cause major symptoms because of their space

Kwesi Dei-Anang; Dieter Voth



Alexandrium fundyense cyst dynamics in the Gulf of Maine  

Microsoft Academic Search

The flux of cells from germinated cysts is critical in the population dynamics of many dinoflagellates. Here, data from a large-scale cyst survey are combined with surveys in other years to yield an Alexandrium fundyense cyst distribution map for the Gulf of Maine that is massive in geographic extent and cyst abundance. The benthic cyst population extends nearly 500km alongshore.

Donald M. Anderson; Charles A. Stock; Bruce A. Keafer; Amy Bronzino Nelson; Brian Thompson; Dennis J. McGillicuddy; Maureen Keller; Patricia A. Matrai; Jennifer Martin



Spinal endodermal cyst resembling an arachnoid cyst in appearance: Pitfalls in intraoperative diagnosis of cystic lesions  

PubMed Central

Background: Surgical treatment of endodermal cysts requires total removal of the cyst wall during the first operation to prevent recurrence. Therefore, intraoperative pathological diagnosis plays an important role in determining the optimal surgical strategy. We present a rare case of a spinal endodermal cyst and discuss its diagnostic difficulty during the intraoperative pathological examination. Case Description: An 18-year-old male presented with progressive paraparesis and precordial oppression. Magnetic resonance (MR) imaging revealed an intradural extramedullary cystic mass having the same signal intensity as cerebrospinal fluid (CSF) without gadolinium enhancement at the T1-T2 level. The preoperative diagnosis was an endodermal or arachnoid cyst. The patient underwent surgery. An intraoperative frozen section showed a cyst wall consisting of loose, thin, fibrous tissue intermittently covered by flattened epithelium. The diagnosis was an arachnoid cyst. Accordingly, partial resection of the cyst wall was performed to create CSF communication between the cyst and subarachnoid space. However, the postoperative pathological diagnosis from permanent sections was an endodermal cyst, which was lined with ciliated columnar epithelium that was immunopositive for cytokeratin and epithelial membrane antigen. Subsequent paraffin embedding and immunostaining of the intraoperative frozen sample also confirmed patchy cytokeratin expression by all flattened epithelial cells. The patient's cyst had refilled 10 months after surgery, and he subsequently underwent fenestration of the cyst wall and placement of a cyst-subarachnoid shunt. Conclusion: Examination of multiple samples from multiple sites or intraoperative immunostaining of frozen sections is recommended for accurate intraoperative diagnosis of endodermal cysts.

Kikkawa, Yuichiro; Nakamizo, Akira; Suzuki, Satoshi O; Tanaka, Shunya; Tsuchimochi, Ryosuke; Amano, Toshiyuki; Yoshimoto, Koji; Mizoguchi, Masahiro; Iwaki, Toru; Sasaki, Tomio



Detection of antigenic cyst wall elements in Colpoda inflata: an immunoelectron microscopic study and immunoblotting identification of cyst wall polypeptides.  


By using an antiserum against isolated cyst walls from resting cysts of the ciliate Colpoda inflata, cyst wall polypeptides have been identified by immunoblotting test. Likewise, an immunoelectron microscopical study on both complete resting cysts and isolated cyst walls to localize the cyst wall proteins recognized by the antiserum, has been carried out. The immunoblotting test showed that three main polypeptide bands were recognized by the antiserum, with tentative molecular weights of 61, 66 and 70 kDa respectively. This methodology provides a better identification of cyst wall proteins after electrophoretic separation of cyst wall samples from ciliate resting cysts. PMID:1905585

Martin-Gonzalez, A; Benitez, L; Cortadellas, N; Gutierrez, J C



Investigation of occult choroidal neovascularization at low-light level: clinical results  

NASA Astrophysics Data System (ADS)

This paper describes the development of a double TV camera system incorporated in a standard fundus camera for imaging the choroidal vascular network with very low intensity infrared light. The equipment was employed to perform indocyanine green (ICG) choroidal angiography in several chorioretinal pathologies with particular interest in age related macular degeneration (AMD). An evaluation and comparison of fluorescein and ICG angiograms is carried out for the diagnosis, localization, and laser treatment evaluation of choroidal neovascularizations (CNV).

Longobardi, Giuseppe; Ciamberlini, Claudio; Guarnieri, V.; Poggi, Pasquale; Panzardi, G.; Donati, M. C.; Faraldi, F.



Development of early tissue cysts and associated pathology of Besnoitia besnoiti in a naturally infected bull (Bos taurus) from South Africa.  


Besnoitia besnoiti is an apicomplexan that causes serious economic loss in cattle in many countries and the disease is now spreading in Europe. At least 2 phases of bovine besnoitiosis are recognized clinically. An acute febrile phase characterized by anasarca and necrosis of skin is associated with multiplication of tachyzoites in vascular endothelium; this phase is short-lived and rarely diagnosed. Chronic besnoitiosis characterized by dermal lesions is associated with the presence of macroscopic tissue cysts and is easily diagnosed. Here we report the development of early B. besnoiti tissue cysts in a naturally infected Hugenoot bull from South Africa. Tissue cysts were 10-70 ?m in diameter, contained 1-12 bradyzoites, and were most numerous in the dermis, testicles, and pampiniform venous plexus. Amylopectin granules in bradyzoites stained red with periodic acid Schiff (PAS) reaction. Bradyzoites varied in size and in the intensity of PAS reaction (some were PAS-negative), some were plump, and others were slender. With immunohistochemical staining with Besnoitia oryctofelisi and bradyzoite-specific antibodies (BAG-1 made against Toxoplasma gondii bradyzoites), the staining was confined to parasites, and all intracystic organisms were BAG-1 positive. With Gomori's silver stain only bradyzoites were stained very faintly whereas the rest of the tissue cyst was unstained. Ultrastructurally many tissue cysts contained dead bradyzoites and some appeared empty. Unlike bradyzoites from mature cysts, bradyzoites in the present case contained few or no micronemes. These findings are of diagnostic significance. Ultrastructually host cyst cells had features of myofibroblasts, and immunohistochemistry using antibodies against MAC387, lysozyme, vimentin, Von Willebrand factor, and smooth muscle actin confirmed this. Polymerase chain reaction on DNA extracted from lymph node of the bull confirmed B. besnoiti diagnosis. Associated clinical findings, lesions, and histopathology are briefly presented. The bull died of nephrotic syndrome; anasarca in acute besnoitiosis due to protein-losing glomerulopathy is a finding not previously reported in cattle. PMID:23327488

Dubey, J P; van Wilpe, E; Blignaut, D J C; Schares, G; Williams, J H



Prevesical hydatid cyst: an exceptional occurrence.  


Echinococcal cysts usually involve the liver; extrahepatic localization is reported in 11% of all cases of abdominal hydatid disease. We report a case of a prevesical hydatid cyst. A 53-year-old man was admitted with a large suprapubic mass. Ultrasonography and computed tomography revealed a cystic mass situated in front of the urinary bladder. There were no cysts in any other location. Serological tests were positive for Echinococcus. The patient was operated on and the cyst was completely excised. The pathologic examination confirmed the diagnosis of Echinococcosis. Isolated hydatid cyst situated in front of the urinary bladder has never been described in the literature. Hydatid cyst should always be considered in the differential diagnosis of abdominopelvic masses in endemic regions, before any procedure like puncture, biopsy or cystectomy, in order to avoid dissemination of the cystic contents or an anaphylactic shock. PMID:18953152

Chokki, A; Zribi, R; Nouira, S; Dziri, Ch


Allantoic cyst - an unusual umbilical cord swelling  

PubMed Central

We report a baby with an unusual umbilical cord swelling. On the antenatal scans, a cystic area within the umbilical cord near its insertion onto the abdominal wall was detected. Postnatally an unusually thick umbilical cord with a yellow fluid filled cyst at the base was noted. The fluid from the cyst was confirmed as urine and ultrasound confirmed patent urachus. The baby underwent a cystoscopy and excision of patent urachus with associated allantoic cyst. Allantoic cyst is a rare swelling formed at the base of umbilicus associated with a patent urachus which results from an allantoic remnant. Paediatricians need to be aware about this condition as investigation is required to differentiate allantois cysts from umbilical pseudocysts. A patent urachus with allantoic cyst requires surgical excision.

Gupta, N; Corbett, H; Ismail, R; Sathanantharajah, R; Sivakumar, S; McCarthy, Liam



[Tarlov's cyst: definition, etiopathogenesis, propaedeutic and treatment].  


Tarlov's cyst or perineurial cyst is disease on portion of the posterior nerve root in lumbo-sacral region. The lack of knowledge of physicians around the world about Tarlov's cyst as to their nature, significance and treatment also with differential diagnostics to radiculopathy in legs. With review of literature discuss about definition, etiopathogenesis, diagnostic investigation and treatment clinic and/or surgery. The pathogenesis Tarlov's cyst remains unclear; several cases have history of the trauma, old hemorrhage, congenital and iatrogenic. Cysts provoke low back pain, sacral radiculopathy, dyspareunia, urinary incontence. The magnetic resonance imaging is now the gold standard to diagnose cysts. The treatment is clinic or surgery depending neurologics finding and neuroimage. PMID:18625096

De Sá, Márcia Cristina; D'Angelo, Carla Tereza; Da Ros Malacarne, Guilherme; Neto, Pedro; Pagura, Jorge



Slit ventricle syndrome after cyst-peritoneal shunting for the treatment of intracranial arachnoid cyst  

Microsoft Academic Search

Serious complications following installation of a cyst-peritoneal shunt in an 8-year-old boy with asymptomatic arachnoid cyst in the middle cranial fossa are reported. Highly elevated intracranial pressure without association of ventriculomegaly seen in this patient indicates slit ventricle syndrome caused by malfunction of the cyst-peritoneal shunt. This phenomenon is worth recognizing as a possible consequence of cyst-peritoneal shunting for the

Nobuhiko Aoki; Tatsuo Sakai; Yoshihiro Umezawa



Protein variation in cyst nematodes  

Microsoft Academic Search

The magnitude of the protein divergence strongly suggests that Globodera<\\/u>rostochiensis<\\/u> and G.<\\/u>pallida<\\/u> have experienced hardly any morphological evolution during a time period of millions of years (chapter II). These morphologically nearly indistinguishable potato cyst nematode species are discriminated from one another by 70 % of their proteins revealed by two dimensional gel electrophoresis (2-DGE), which definitively excludes a recent divergence

J. Bakker



A noninvasive eye fixation monitoring system for CyberKnife radiotherapy of choroidal and orbital tumors.  


A new noninvasive monitoring system for fixing the eye has been developed to treat orbital and choroidal tumors with CyberKnife-based radiotherapy. This device monitors the eye during CT/MRI scanning and during treatment. The results of this study demonstrate the feasibility of the fixation light system for CyberKnife-based treatments of orbital and choroidal tumors and supports the idea that larger choroidal melanomas and choroidal metastases could be treated with CyberKnife without implanting fiducial markers. PMID:19378732

Daftari, I K; Petti, P L; Larson, D A; O'Brien, J M; Phillips, T L



Visualization of human retinal and choroidal vascular networks with phase-variance optical coherence tomography  

NASA Astrophysics Data System (ADS)

We present in vivo noninvasive retinal and choroidal perfusion maps with phase-variance optical coherence tomography (pvOCT). We acquired a pvOCT volumetric data set of a normal subject and visualized blood circulation in the retina and the choroid. En face projection views of the retina as well as the choroid were generated from a manually segmented volumetric data set. In addition, the processed pvOCT images were compared to current standard imaging modalities used for retinal and choroidal vasculature visualization in clinical settings, including fluorescein angiography (FA) and indocyanine green angiography (ICGA).

Kim, Dae Yu; Fingler, Jeff; Zawadzki, Robert J.; Verma, Malvika; Schwartz, Daniel M.; Werner, John S.; Fraser, Scott E.



Combined photodynamic therapy with verteporfin and intravitreal triamcinolone acetonide for choroidal neovascularization  

Microsoft Academic Search

PurposeTo examine combined photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide for choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).

Richard F Spaide; John Sorenson; Leandro Maranan



Genetics Home Reference: Megalencephalic leukoencephalopathy with subcortical cysts  


... below an area of the brain called the cerebral cortex. These cysts can grow in size and number. ... subcortical cysts? ataxia ; atrophy ; autosomal ; autosomal recessive ; cell ; cerebral cortex ; coma ; cysts ; difficulty swallowing ; dysarthria ; dysphagia ; dystonia ; gene ; ...


Surgical treatment of sacral perineural cyst--case report.  


A 67-year-old man presented with persistent penis and scrotum pain due to S-2 and S-3 radiculopathy caused by a sacral perineural cyst. The cyst was treated with microsurgical partial cyst removal and cyst wall imbrication, together with closure of the point through which cerebrospinal fluid (CSF) flowed from the subarachnoid space into the cyst cavity. His pain resolved without recurrence of the cyst or complications. Symptomatic perineural cysts are quite rare. Surgical closure of the point through which CSF flows from the subarachnoid space into the cyst cavity is the most important intervention for symptomatic perineural cysts. If the source of CSF leakage cannot be detected, placement of a cyst-subarachnoid shunt should be considered in addition to partial cyst removal and cyst wall imbrication. PMID:22198114

Matsumoto, Hiroaki; Matsumoto, Shigeo; Miki, Takanori; Miyaji, Yuki; Minami, Hiroaki; Masuda, Atsushi; Tominaga, Shogo; Yoshida, Yasuhisa; Yamaura, Ikuya; Natsume, Shigeatsu; Yoshida, Kozo



9 CFR 311.24 - Hogs affected with tapeworm cysts.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Hogs affected with tapeworm cysts. 311.24 Section 311.24 ...PARTS § 311.24 Hogs affected with tapeworm cysts. Carcasses of hogs affected with tapeworm cysts (Cysticercus cellulosae) may be...



9 CFR 311.24 - Hogs affected with tapeworm cysts.  

Code of Federal Regulations, 2010 CFR

...2009-01-01 false Hogs affected with tapeworm cysts. 311.24 Section 311.24 ...PARTS § 311.24 Hogs affected with tapeworm cysts. Carcasses of hogs affected with tapeworm cysts (Cysticercus cellulosae) may be...



Ciliated epithelium–lined radicular cysts  

Microsoft Academic Search

Objective. This report describes 3 cases of ciliated epithelium-lined radicular cysts among 256 apical periodontitis lesions and also illustrates the occurrence of an Actinomyces-infected periapical cyst. Study Design. Serial and step serial sections of 256 plastic-embedded root apices with attached apical periodontitis lesions that were prepared for a previous investigation were reviewed for the presence of ciliated epithelium-lined radicular cysts.

P. N. Ramachandran Nair; Gion Pajarola; Hans-Ulrich Luder



Alcohol sclerotherapy of simple parenchymal liver cysts.  


Three symptomatic non-parasitic liver cysts in three patients were treated by the technique of percutaneous aspiration followed by sclerosis of the cyst lining by irrigation with absolute alcohol. In two patients the treatment was fully successful, with partial success in the third case. Two cysts underwent two separate treatments. The technique, which is reviewed, was shown to be a safe and effective alternative to conventional surgical management. PMID:8512508

McCullough, K M



Tarlov cysts: a report of two cases.  


Perineural cysts are common and usually detected incidentally during magnetic resonance imaging of the lumbosacral spine. Treatment is indicated only when the cyst is symptomatic. We report one such patients presented with cauda equina syndrome and another with low back pain with claudication. They underwent excision and duraplasty; both motor and sensory fibres were carefully separated from the cyst wall using a nerve root retractor and penfield. There was no nerve root damage or neural deficit. Symptoms were relieved postoperatively. PMID:22535818

Sen, Ramesh Kumar; Goyal, Tarun; Tripathy, Sujit Kumar; Chakraborty, Soumya



Vaginal cysts causing tenesmus in a bitch.  


An eight-year-old female border collie was referred with a two-month history of faecal tenesmus. Ultrasonography and radiology identified fluid-filled masses in the cranial vagina. The fluid was drained from the vaginal cysts via an episiotomy and the clinical signs resolved. Histological examination confirmed that the cysts were of urogenital origin. This is believed to be the first report of vaginal cysts causing faecal tenesmus in the dog. PMID:7474963

Cauvin, A; Sullivan, M; Harvey, M J; Thompson, H



[Late and recurrent serous choroidal detachment after trabeculectomy: case report].  


A case of an 85 year-old white man with bilateral senile cataract and advanced primary open-angle glaucoma uncontrolled with maximal medical therapy, asteroid hyalosis in OD and age-related macular degeneration in OS, submitted to a phacotrabeculectomy OU with mitomycin-C is reported. Because the surgery failed in both eyes, even after laser suture lysis, 5-FU injections and needling, it was necessary to reintroduce hypotensive agents. With the fixed combination of 0.5% timolol+2% dorzolamide, a serous choroidal detachment with marked hypotony developed in both eyes; with 1% brinzolamide it only occurred in the OS. The IOP raised and the choroidal detachment resolved completely after discontinuation of the medications. The dilemma was finally solved through repeat needling with subconjunctival 5-FU injections. PMID:19820801

Silva, Nikias Alves da; Silva, Felício Aristóteles da


Cataract extraction after brachytherapy for malignant melanoma of the choroid  

SciTech Connect

Thirteen eyes of 55 consecutive patients treated with brachytherapy for malignant melanoma of the choroid developed postirradiation cataracts. Cataract development was more common in older patients and in patients with larger and more anterior tumors. Eleven eyes had extracapsular cataract extraction and intraocular lens implantation. Initial visual improvement occurred in 91% of eyes, with an average improvement of 5.5 lines. Visual acuity was maintained at 20/60 or better in 55% of the eyes over an average period of follow-up of 24 months (range, 6 to 40 months). These data suggest that, visually, cataract extraction can be helpful in selected patients who develop a cataract after brachytherapy for malignant melanoma of the choroid.

Fish, G.E.; Jost, B.F.; Snyder, W.I.; Fuller, D.G.; Birch, D.G. (Texas Retina Associates, Dallas (USA))



An intra-thyroid thyroglossal duct cyst.  


Thyroglossal duct cysts can be found in several different locations, although intra-thyroid presentations are rare. We present the case of an 11-year-old patient with a visible neck mass on the right thyroid lobe. On sonogram, it was consistent with a unilocular cyst measuring 2 centimeters in diameter. The cyst did not take up the radioisotope during a gammagram. Fine needle aspiration cytology suggested a diagnosis of thyroglossal duct cyst. At surgery, we found that there were no lesion-dependent thyroglossal tracts; we therefore performed a simple enucleation of the cyst, sparing the rest of the gland. The pathologic examination confirmed that it was an intra-thyroid thyroglossal duct cyst. After 8 months of follow-up, the patient has remained without complications of any kind or recurrence. Only four prior cases of intra-thyroid thyroglossal cysts have been described in the pediatric population. Half of them presented with a typical thyroglossal tract crossing the hyoid and the other half presented an isolated cyst. It is highly unlikely that a cold, cystic, thyroid mass in a child is a thyroglossal duct cyst. Diagnosis is made on the basis of fine needle aspiration cytology and the lesion is treated surgically. A thyroglossal tract must be methodically sought out during intervention, although they frequently do not exist. PMID:16418962

Pérez-Martínez, A; Bento-Bravo, L; Martínez-Bermejo, M A; Conde-Cortes, J; de Miguel-Medina, C



Scrotal calcinosis. Dystrophic calcification of epidermoid cysts.  


Scrotal calcinosis, consisting of solitary or multiple circumscribed deposits of calcium within the dermis of the scrotum, has generally been assumed to be idiopathic. We have recently examined three patients in whom scrotal epidermoid cysts in varying stages of inflammation coexisted with scrotal calcinosis. Some cysts showed calcification of their keratin contents with little evidence of active inflammation. Other cysts showed rupture of their epithelial walls associated with the presence of keratin fibers, granulomatous inflammation, and calcium granules in the surrounding dermis. It seems that so-called idiopathic scrotal calcinosis may represent the end stage of dystrophic calcification associated with the inflammation of scrotal epidermoid cysts. PMID:7149755

Swinehart, J M; Golitz, L E



[Hydatid cyst of the posterior fossa].  


Hydatidosis is an endemic affection in Tunisia. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2% of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease. We report the case of a four-year-old child admitted for high intracranial pressure. Brain CT scan showed an extradural posterior fossa cyst without enhancement after contrast medium injection. Operative finding revealed a hydatid cyst. The histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole post operatively. She feels well six months later. PMID:17434701

Braham, E; Bellil, S; Bellil, K; Chelly, I; Mekni, A; Haouet, S; Kchir, N; Khaldi, M; Zitouna, M



[Posterior fossa extradural and extracranial hydatid cyst].  


Hydatidosis is an endemic disease in Morocco. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2% of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease: only four cases have been reported in the literature. We report the case of a 37-year-old admitted for high intracranial pressure. Brain MRI showed an extradural and extracranial posterior fossa cyst without enhancement after contrast medium injection. Multiple hydatid cysts were removed and the histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole postoperatively with good follow-up 6 months later. PMID:20138319

Lakhdar, F; Arkha, Y; Bougrine, M; Derraz, S; El Ouahabi, A; El Khamlichi, A



Late onset of subfoveal choroidal neovascularisation following cerebral radiotherapy  

Microsoft Academic Search

A report of choroidal neovascularisation (CNV) associated with radiation retinopathy. A 43-year-old Caucasian man presented with a 4-week history of sudden loss of central vision in the left eye, 8.5 years following radical radiotherapy for left tempero-parietal anaplastic astrocytoma. His visual acuity was 6\\/6 in the right eye and 6\\/60 in the left eye. Ophthalmoscopy of the left eye showed

Abdul-Jabbar Ghauri; Mohammed Musadiq; Ying Sha; Samer Elsherbiny



Diabetic choroidal and iris vasculature scanning electron microscopy findings  

Microsoft Academic Search

Scanning Electron Microscopy (SEM) was used to study vascular casts of twenty-four autopsy eyes taken from patients with long-standing insulin-dependent Diabetes Mellitus. These casts were compared to casts of ten ‘normal’ autopsy eyes from patients without a history of diabetes or other vascular disease. The SEM findings in the choroidal vessels of the diabetic eyes included: increased tortuosity, focal vascular

Andrzej W. Fryczkowski; Barton L. Hodes; Jonathan Walker I



Photodynamic therapy of subfoveal choroidal neovascularization: clinical and angiographic examples  

Microsoft Academic Search

Background: Conventional photocoagulation of subfoveal choroidal neovascularization (CNV) is often accompanied by visual\\u000a loss due to thermal damage to adjacent retinal structures. Photodynamic therapy (PDT) allows vascular occlusion by selective\\u000a photochemical destruction of vascular endothelial cells only. In a pilot study we evaluated the use of PDT in CNV. Methods:\\u000a In a clinical phase I\\/II trial, patients with subfoveal CNV

Ursula Schmidt-Erfurth; Joan Miller; Michel Sickenberg; Arnd Bunse; Horst Laqua; Evangelos Gragoudas; Leonidas Zografos; Reginald Birngruber; Hubert van den Bergh; Andrew Strong; Ulrike Manjuris; Mario Fsadni; Bertrand Piguet; Neil M. Bressler



Histopathological findings in human choroidal melanomas after transpupillary thermotherapy  

Microsoft Academic Search

AIMSThe effect of transpupillary thermotherapy (TTT) on human choroidal melanomas was investigated by means of histopathology.METHODSBefore enucleation TTT was performed in 11 eyes with a xenon arc photocoagulator with a red filter or a diode laser at 810 nm. The exposure time was 1 minute; the estimated temperature at the top of the tumour was