These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

Edema  

MedlinePLUS

... you have edema of the legs, wear support stockings. You can buy these at most drugstores. Support stockings put pressure on your legs to keep fluid ... for me to exercise? Should I wear support stockings? What lifestyle changes should I make? Can you ...

2

[Vulvar varices].  

PubMed

The authors treated in 1983-1993 72 patients with vulvar varicosities who suffered particularly during pregnancy. Typical symptoms are pruritus, pain caused by pressure in the vulvar area and the sensation of prolapse. According to the authors surgical treatment is unnecessary and involves risk. They recommend compressive sclerotherapy as described by Fegan, using sodium tetradecyl sulphate S.T.D. Hegefort England not only in case of a marked clinical symptomatology but also as prevention of dangerous haemorrhage during delivery. PMID:7551501

Labas, P; Michalko, L; Svec, R

1995-08-01

3

Vulvar carcinoma.  

PubMed

Carcinoma of the vulva is an uncommon gynecologic malignancy primarily affecting postmenopausal women. The lesion is most commonly associated with HPV DNA, although, for many, a defined preinvasive to invasive connection is not readily apparent. Most patients experience symptoms of pruritus, irritation, and even pain for weeks or months before the diagnostic biopsy is performed. Patient embarrassment and unfamiliarity and reluctance on the part of the physician to fully evaluate these symptoms add to the delay. Vulvar carcinoma is staged surgically following resection. A concerted effort to conserve as much normal tissue as possible has been the focus of recent investigation. Separate incision resection of the vulvar mass and groin has improved wound healing and quality of life for many patients. The effect these conservative procedures have on long-term survival is currently being evaluated. Increased use of radiation therapy or chemoradiation has allowed organ preservation in many otherwise exenterative cases. In some instances, this neoadjuvant therapy has provided an opportunity to surgically clear otherwise unresectable lesions. Current radiotherapy techniques might also be as effective as groin dissection in certain low-risk patients. Adjuvant radiation and chemoradiation improve local control and reduce groin recurrence risk. In addition, patients with histologically positive groins enjoy longer survival when the pelvis is also treated. Selected use of multimodality therapy will likely extend the lives of women with vulvar cancer. PMID:12057056

Coleman, R L; Santoso, J T

2000-06-01

4

Vaginal and Vulvar Cancer  

MedlinePLUS

... vaginal and vulvar cancers are caused by the human papillomavirus (HPV), a common virus that is passed from one ... a vaccine that protects against the types of HPV that most often cause cervical, vaginal, and vulvar ...

5

Vulvar basal cell carcinoma.  

PubMed

Although the basal cell carcinoma (BCC) is the most common malignancy of skin, it is rarely seen in vulva and constitutes 2% to 4% of all vulvar cancers. The cause is unknown but, chronic vulvar irritation is the most important underlying factor. The patients over 60 years are affected more frequently than younger ones. PMID:23455815

Kara, Mustafa; Colgecen, E; Yildirim, Erdogan Nilsen

2012-01-01

6

What Is Vulvar Cancer?  

MedlinePLUS

... Bartholin glands less often. Types of vulvar cancer Squamous cell carcinomas Most cancers of the vulva are squamous cell ... of skin cells. There are several subtypes of squamous cell carcinoma: The keratinizing type is most common, and usually ...

7

Pediatric Vulvar Lichen Sclerosus  

MedlinePLUS

... likely to develop a particular skin cancer called squamous cell carcinoma. Because it is not known whether or not ... sclerosus have an increased risk of developing vulvar squamous cell carcinoma later in life, it makes sense that all ...

8

Vulvar and vaginal HPV disease.  

PubMed

Human papilloma virus is associated with a multitude of lower genital tract diseases in women in addition to cervical cancer, including genital warts, vulvar intraepithelial neoplasia, vaginal intraepithelial neoplasia, and some vulvar, vaginal, and anal cancers that are associated with oncogenic subtypes. The degree to which HPV manifests pathology depends on viral type, host immune response, and local environmental factors. This article reviews the evaluation and management of the following vulvar and vaginal human papilloma virus diseases: condyloma, vulvar intraepithelial neoplasia, and vaginal intraepithelial neoplasia. Included is a brief discussion of the association with vulvar and vaginal cancer. PMID:23732036

Nelson, Erin L; Stockdale, Colleen K

2013-06-01

9

Angiogenesis in Vulvar Intraepithelial Neoplasia  

Microsoft Academic Search

Vulvar intraepithelial neoplasia (VIN) has been reported to be a precursor of invasive vulvar cancer. Switching to the angiogenic phenotype is considered a key step in tumor growth. Microvessel density (MVD) and vascular endothelial growth factor (VEGF), a highly angiogenic peptide, are important parameters of tumor angiogenesis. Forty-three histologic slides with 38 VIN I–III lesions were immunohistochemically stained for factor

Dagmar Bancher-Todesca; Andreas Obermair; Selcuk Bilgi; Petra Kohlberger; Christian Kainz; Gerhard Breitenecker; Sepp Leodolter; Gerald Gitsch

1997-01-01

10

Drugs Approved for Vulvar Cancer  

Cancer.gov

This page lists cancer drugs approved by the Food and Drug Administration (FDA) for vulvar cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

11

Can Vulvar Cancer Be Prevented?  

MedlinePLUS

... reduce your chances of developing vulvar cancer. Avoid HPV infection Infection with human papilloma virus (HPV) is ... HPV and pass the virus to somebody else. HPV in men The 2 main factors influencing the ...

12

Vulvar Skin Atrophy Induced by Topical Glucocorticoids  

PubMed Central

Steroid induced skin atrophy is the most frequent and perhaps most important cutaneous side effect of topical glucocorticoid therapy. To date, it has not been described in vulvar skin. We describe a patient with significant vulvar skin atrophy following prolonged steroid application to treat vulvar dermatitis. The extensive atrophy in the perineum resulted in secondary ‘webbing’ and partial obstruction of genital hiatus and superimposed dyspareunia. Prolonged topical steroids may result in atrophic changes in vulvar skin. Therefore, further research in clinical correlates of steroid-induced atrophy in the vulvar region is warranted. PMID:22594868

Johnson, Elisabeth; Groben, Pamela; Eanes, Alisa; Iyer, Priya; Ugoeke, Joseph; Zolnoun, Denniz

2011-01-01

13

How Is Vulvar Cancer Diagnosed?  

MedlinePLUS

... procedure is discussed in more detail in the " Surgery for vulvar cancer " section). Magnetic resonance imaging (MRI) Magnetic resonance imaging (MRI) scans use radio waves and strong magnets instead of x-rays to make images of the body. The energy from the radio waves is absorbed ...

14

Serum Concentrations of Tissue Polypeptide Antigen in Patients with Vulvar Intraepithelial Neoplasia and Vulvar Cancer  

Microsoft Academic Search

The aim of the present study was to evaluate the clinical usefulness of the cytokeratin tumor marker tissue polypeptide antigen (TPA) in patients with vulvar cancer. This retrospective study comprises 41 patients with vulvar cancer FIGO stages I–III, 17 patients with vulvar intraepithelial neoplasia (VIN) III, and 40 healthy female controls. Serum concentrations of TPA were measured using a microparticle

Lukas Hefler; Clemens Tempfer; Katrin Frischmuth; Georg Maenner; Nicole Concin; Gerhard Sliutz; Alexander Reinthaller; Sepp Leodolter; Christian Kainz

2000-01-01

15

Lymphedema After Surgery in Patients With Endometrial Cancer, Cervical Cancer, or Vulvar Cancer  

ClinicalTrials.gov

Lymphedema; Stage IA Cervical Cancer; Stage IA Endometrial Carcinoma; Stage IA Vulvar Cancer; Stage IB Cervical Cancer; Stage IB Endometrial Carcinoma; Stage IB Vulvar Cancer; Stage II Endometrial Carcinoma; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVB Vulvar Cancer

2014-03-07

16

Vulvar lipoleiomyoma in a dog.  

PubMed

A vulvar neoplasm from a 5-year-old female Siberian Husky dog was removed surgically and examined histologically. Macroscopically, the neoplasm was firm, white, and measured 6 x 4 x 3 cm. Microscopically, the neoplasm was expansile, nonencapsulated, and composed of lobules of mature adipocytes ad-mixed with streams and bundles of well-differentiated smooth muscle cells. Immunohistochemically, the neoplastic cells had strong diffuse cytoplasmic immunoreactivity for alpha-smooth muscle actin and desmin, and no immunoreactivity for cytokeratin or vimentin. On the basis of gross, histopathologic, and immunohistochemical findings, a diagnosis of lipoleiomyoma was made. This is, to the author's knowledge, the first report of canine vulvar lipoleiomyoma. PMID:15690962

Radi, Zaher A

2005-01-01

17

The role of angiogenesis in vulvar cancer, vulvar intraepithelial neoplasia, and vulvar lichen sclerosus as determined by microvessel density analysis  

Microsoft Academic Search

ObjectivesWe compared microvessel density (MVD) in normal, benign, preneoplastic, and neoplastic (squamous cell carcinoma (SCC)) vulvar disease to ascertain if this parameter could identify cases with lichen sclerosus (LS) and high-grade vulvar intraepithelial neoplasia (VIN3) at risk of developing malignancy.

Jamna Saravanamuthu; Wendy M. N Reid; David S. t George; Julie C Crow; Kerstin J Rolfe; Allan B MacLean; Christopher W Perrett

2003-01-01

18

Therapy for Primary Vulvar Carcinoma  

PubMed Central

The rather rare vulvar cancer is almost always a squamous cell carcinoma that mostly develops from an underlying VIN or HPV infection. In addition, lichen sclerosus et atrophicans, immune deficiency, nicotine abuse or anogenital intraepithelial neoplasias may play a role in the pathogenesis. Surgical therapy aims at an R0 resection in the sense of a complete vulvectomy or a radical local excision with, if necessary, plastic reconstruction. Also, the vulvar field resection with consideration of the compartment model has been discussed. Besides the classic inguinofemoral lymphadenectomy, in selected cases of vulvar cancer sentinel biopsies are performed by experienced surgeons in the larger centres. In contrast, systemic therapy plays only a subordinate role; in isolated cases down-staging by means of neoadjuvant chemotherapy may be useful. However, there is at present no indication for adjuvant chemotherapy. Neoadjuvant radiochemotherapy is also not to be recommended on account of its unfavourable ratio of efficacy to side effects. On the other hand adjuvant radiotherapy is indicated in cases of positive inguinal lymph nodes. According to the current data the indication should be made generously in such cases. PMID:24882877

Herr, D.; Juhasz-Boess, I.; Solomayer, E. F.

2014-01-01

19

Quality of life and female sexual function after skinning vulvectomy with split-thickness skin graft in women with vulvar intraepithelial neoplasia or vulvar Paget disease.  

E-print Network

graft in women with vulvar intraepithelial neoplasia or vulvar Paget disease. V. Lavoué1, 2+* , A.1016/j.ejso.2013.09.014 #12;2 Abstract Objective: Vulvar intraepithelial neoplasia (VIN) and vulvar,version1-9Oct2013 #12;3 Keywords: Vulvectomy; Skin graft; Vulvar intraepithelial neoplasia; Vulvar

Paris-Sud XI, Université de

20

Differentiated vulvar intraepithelial neoplasia contains Tp53 mutations and is genetically linked to vulvar squamous cell carcinoma  

Microsoft Academic Search

Differentiated vulvar intraepithelial neoplasia is a unique precursor to vulvar squamous cell carcinoma that is typically HPV-negative and frequently associated with nuclear p53 staining. These features imply a mode of pathogenesis involving somatic mutations. However, the genetic relationship of differentiated vulvar intraepithelial neoplasm and vulvar squamous cell carcinoma and the role of Tp53 mutations in this process have not been

Alvaro P Pinto; Alexander Miron; Yosuf Yassin; Nicolas Monte; Terri Y C Woo; Karishma K Mehra; Fabiola Medeiros; Christopher P Crum

2010-01-01

21

[Urinary retention caused by vulvar carcinoma].  

PubMed

Epidermoid carcinoma is the most frequent neoplasia of the vulva. It usually appears in aged post-menopausal women (51-70 years). The signs and symptoms are unremarkable: vulvar bulk or protuberance, pruritus, painful ulcer, flow, vulvar irritation, dysuria or haemorrhage, all of which motivate that this condition may be ignored, overlooked, or be the cause of self-treatment. At other times a dangerous shyness causes considerable delays by postponing the visit to the specialist. Many patients refuse to go to see a physician. The existence of urinary signs and symptoms in a patient with vulvar neoplasia are indicative of urethral invasion and the advanced stage of the condition. A case is presented here of an advanced vulva carcinoma in an 82 year-old woman who come with urinary retention by urethral infiltration and perineal destruction. We review the most relevant aspects of vulvar carcinomas associated with obstructive uropathy. PMID:7717162

Romero Pérez, P

1995-01-01

22

Vulvar Syringoma: A Rare Case Report  

PubMed Central

Syringoma is a benign eccrine sweat gland tumour affecting mostly females at puberty as multiple soft papules usually 1-2 mm in diameter. The sites of predilection are lower eyelids, cheeks. Syringoma of the vulva is a rare disorder. Only few cases have been reported in the literature. We report here a case of 46-year-old female who presented to gynecology department with vulvar papules associated with vulvar itching and burning since two years. Microscopic examination of the punch biopsy revealed numerous small ducts lined by two layers of epithelial cells embedded in a fibrous stroma. Some of the ducts showed small comma like tails of epithelial cells imparting them a tadpole shape. Despite being a rare diagnosis, vulvar syringoma should be kept in differential diagnosis with vulvar pruritus

Nibhoria, Sarita; Yadav, Ashish

2014-01-01

23

Vulvar Intraepithelial Neoplasia: New concepts and strategy  

Microsoft Academic Search

Vulvar intraepithelial neoplasia (VIN) is a rare condition which can develop into an invasive\\u000acarcinoma. This skin-disease affects mainly young women, and causes many severe and\\u000along-lasting symptoms such as pruritus, vulvodynia and psychosexual dysfunction. Over\\u000a80% of VIN-affected women present with multifocal vulvar disease, and often neoplastic\\u000achanges can be found in the entire lower genital tract. Clinically, it

Seters van M

2008-01-01

24

Optical coherence tomography in vulvar intraepithelial neoplasia  

NASA Astrophysics Data System (ADS)

Vulvar squamous cell carcinoma (VSCC) is a gynecological cancer with an incidence of two to three per 100,000 women. VSCC arises from vulvar intraepithelial neoplasia (VIN), which is diagnosed through painful punch biopsy. In this study, optical coherence tomography (OCT) is used to differentiate between normal and VIN tissue. We hypothesize that (a) epidermal layer thickness measured in OCT images is different in normal tissue and VIN, and (b) quantitative analysis of the attenuation coefficient (?oct) extracted from OCT data differentiates VIN from normal vulvar tissue. Twenty lesions from 16 patients are imaged with OCT. Directly after data acquisition, a biopsy is performed. Epidermal thickness is measured and values of ?oct are extracted from 200 OCT scans of normal and VIN tissue. For both methods, statistical analysis is performed using Paired Mann-Whitney-test. Correlation between the two methods is tested using a Spearman-correlation test. Both epidermal layer thickness as well as the ?oct are different between normal vulvar tissue and VIN lesions (p<0.0001). Moreover, no correlation is found between the epidermal layer thickness and ?oct. This study demonstrates that both the epidermal thickness and the attenuation coefficient of vulvar epithelial tissue containing VIN are different from that of normal vulvar tissue.

Wessels, Ronni; de Bruin, Daniel M.; Faber, Dirk J.; van Boven, Hester H.; Vincent, Andrew D.; van Leeuwen, Ton G.; van Beurden, Marc; Ruers, Theo J. M.

2012-11-01

25

Vulvar susceptibility to contact irritants and allergens: a review  

Microsoft Academic Search

Vulvar tissue differs from cutaneous epithelia in structure, morphology and biophysical characteristics. For example, the skin of the labia majora exhibits elevated hydration, occlusion and frictional properties, which may increase susceptibility to irritants and contact sensitizers. Furthermore, the nonkeratinized vulvar vestibule is likely to be more permeable than keratinized regions. These differences heighten vulvar susceptibility to topical agents. This reviews

Miranda A. Farage

2005-01-01

26

Patients with usual vulvar intraepithelial neoplasia-related vulvar cancer have an increased risk of cervical abnormalities  

Microsoft Academic Search

Background:Vulvar squamous cell carcinoma (SCC) originates the following two pathways, related to differentiated (d) vulvar intraepithelial neoplasia (VIN) or to human papillomavirus (HPV)-related usual (u) VIN. Multicentric HPV infections (cervix, vagina and vulva) are common. We hypothesise that patients with a uVIN-related vulvar SCC more often have cervical high-grade squamous intraepithelial lesions (HSILs) compared with women with dVIN-related vulvar SCC.Methods:All

R. P. de Bie; H. P. van de Nieuwenhof; R. L. M. Bekkers; W. J. G. Melchers; A. G. Siebers; J. Bulten; L. F. A. G. Massuger; J. A. de Hullu; RP de Bie

2009-01-01

27

Expression of Ki67 in Vulvar Carcinoma and Vulvar Intraepithelial Neoplasia III: Correlation with Clinical Prognostic Factors  

Microsoft Academic Search

Objectives. In vulvar carcinoma, the expression of Ki-67 has been previously found to correlate with patient outcome. The objective of the study was to determine whether a specific pattern of expression was associated with occult vulvar cancer in patients with vulvar intraepithelial neoplasia (VIN) III and whether patterns of Ki-67 expression correlated with other clinical prognostic factors.Methods. 19 women with

Susan C. Modesitt; Pamela A. Groben; Leslie A. Walton; Wesley C. Fowler; Linda Van Le

2000-01-01

28

Sentinel node biopsy in early vulvar cancer  

PubMed Central

Lymph node pathologic status is the most important prognostic factor in vulvar cancer; however, complete inguinofemoral node dissection is associated with significant morbidity. Lymphoscintigraphy associated with gamma-probe guided surgery reliably detects sentinel nodes in melanoma and breast cancer patients. This study evaluates the feasibility of the surgical identification of sentinel groin nodes using lymphoscintigraphy and a gamma-detecting probe in patients with early vulvar cancer. Technetium-99m-labelled colloid human albumin was administered perilesionally in 37 patients with invasive epidermoid vulvar cancer (T1–T2) and lymphoscintigraphy performed the day before surgery. An intraoperative gamma-detecting probe was used to identify sentinel nodes during surgery. A complete inguinofemoral node dissection was then performed. Sentinel nodes were submitted separately to pathologic evaluation. A total of 55 groins were dissected in 37 patients. Localization of the SN was successful in all cases. Eight cases had positive nodes: in all the sentinel node as positive; the sentinel node was the only positive node in five cases. Twenty-nine patients showed negative sentinel nodes: all of them were negative for lymph node metastases. Lymphoscintigraphy and sentinel-node biopsy under gamma-detecting probe guidance proved to be an easy and reliable method for the detection of sentinel node in early vulvar cancer. This technique may represent a true advance in the direction of less aggressive treatments in patients with vulvar cancer. © 2000 Cancer Research Campaign PMID:10646880

Cicco, C De; Sideri, M; Bartolomei, M; Grana, C; Cremonesi, M; Fiorenza, M; Maggioni, A; Bocciolone, L; Mangioni, C; Colombo, N; Paganelli, G

2000-01-01

29

A cluster of vulvar cancer and vulvar intraepithelial neoplasia in young Australian Indigenous women  

Microsoft Academic Search

Objective  To describe the epidemiological features of a possible disease cluster of vulvar cancer and pre-cancers in Australian Indigenous\\u000a women living in the Northern Territory (NT) of Australia.\\u000a \\u000a \\u000a \\u000a Methods  We identified NT-resident women with a confirmed histological diagnosis of vulvar cancer or high-grade vulvar intraepithelial\\u000a neoplasia (VIN) between 1 January 1996 and 31 December 2005.\\u000a \\u000a \\u000a \\u000a Results  Seventy-one women were identified; 32 diagnosed with

John R. Condon; Alice R. Rumbold; Jane C. Thorn; Margaret M. O’Brien; Margaret J. Davy; Ibrahim Zardawi

2009-01-01

30

Vulvar Nonclear Cell Syringoma Associated with Pruritus and Diabetes Mellitus  

PubMed Central

Background. Syringoma is a benign eccrine sweat gland tumor, characterized by multiple skin colored or slightly yellowish papules. Vulvar syringoma without extragenital involvement is an extremely rare variant of syringoma. Mail Observations. Herein, we report a 40-year-old diabetic female patient who presented with only lichenified plaques on the vulvar region without any extragenital lesions. Diagnosis of vulvar syringoma was made depending on the characteristic double lined cystic enlargements and comma-like tails found in histopathological examination. Immunohistochemical stains for estrogen and progesterone receptors were negative. Conclusion. Vulvar syringoma may present with no obvious papules on lichenified plaques. PMID:24069540

Ibiloglu, Ibrahim; Durmazlar, Nezih

2013-01-01

31

Cilnidipine induced ankle edema.  

PubMed

Cilnidipine is a 4(th) generation dihydropyridine calcium channel blocker approved recently for the treatment of essential hypertension. It is not known to present with ankle edema like amlodipine. Moreover, it has been proposed as an alternative anti-hypertensive for patients with amlodipine-induced edema. We report a case of cilnidipine induced ankle edema. PMID:24987189

Annil, Vishal R; Mahajan, Annil; Mahajan, Vivek; Khajuria, Vijay; Gillani, Zahid

2014-01-01

32

Cilnidipine induced ankle edema  

PubMed Central

Cilnidipine is a 4th generation dihydropyridine calcium channel blocker approved recently for the treatment of essential hypertension. It is not known to present with ankle edema like amlodipine. Moreover, it has been proposed as an alternative anti-hypertensive for patients with amlodipine-induced edema. We report a case of cilnidipine induced ankle edema. PMID:24987189

Annil, Vishal R.; Mahajan, Annil; Mahajan, Vivek; Khajuria, Vijay; Gillani, Zahid

2014-01-01

33

Pre-neoplastic lesions of vulvar cancer.  

PubMed

The monitoring of potentially neoplastic lesions is based on the determination of the histopathologic characteristics of the lesion, which is done either by large surgical resection of the lesions "in toto" or by biopsy of the lesion. Chronic vulvar dystrophy may develop into carcinoma, the supposed likelihood varying according to the various Authors. The lesion which is histologically defined as atypical keratoacanthoma is the most frequent precursor of carcinoma. Most Authors agree in believing that lichen scleroatrophic does not often develop into carcinoma. It is, nevertheless, the most frequent precursor of leukoplakia which is, on the other hand, a risk lesion. However, any chronic vulvar irritation may increase the risk of cancer and must therefore be carefully monitored by multiple biopsies to be examined at regular intervals. PMID:6873087

Locatelli, F; Scarselli, G; Branconi, F; Citernesi, A; Tantini, C; Vallecchi, C; Savino, L

1983-01-01

34

Treatment of vulvar intraepithelial neoplasia with topical imiquimod  

Microsoft Academic Search

Background: Alternatives to surgery are needed for the treatment of vulvar intraepithelial neoplasia. We investigated the effectiveness of imiquimod 5% cream, a topical immuneresponse modulator, for the treatment of this condition. Methods: Fifty-two patients with grade 2 or 3 vulvar intraepithelial neoplasia were randomly assigned to receive either imiquimod or placebo, applied twice weekly for 16 weeks. The primary outcome

Manon van Seters; Marc van Beurden; Kate ten F. J. W; Ilse Beckmann; M. J. C. Eijkemans; C. J. M. Meijer; N. K. Aaronson; K. Aaronson; C. Heijmans-Antonissen; Freek J. Zijlstra; T. J. M. Helmerhorst

2008-01-01

35

Vulvar intraepithelial neoplasia and microinvasive carcinoma of the vulva  

Microsoft Academic Search

The pathological, cytological, and clinical features of vulvar intraepithelial neoplasia (VIN) are described. The rate of progression of VIN III to an invasive carcinoma is very low and spontaneous regression can occur. These features prevent the drawing of a direct analogy between vulvar and cervical intraepithelial neoplasia. The concept of microinvasive carcinoma of the vulva is discussed, and it is

C H Buckley; E B Butler; H Fox

1984-01-01

36

Perceived Stereotyping and Seeking Care for Chronic Vulvar Pain  

PubMed Central

Objectives We examined stereotyping of chronic pain sufferers among women aged 18 – 40 years and determined whether perceived stereotyping affects seeking care for women with chronic vulvar pain. Design Cross-sectional study using a community-based survey of vulvodynia asking if “Doctors think that people with chronic pain exaggerate their pain”, and if “People believe that vulvar pain is used as an excuse to avoid having sex”. Setting and Participants 12,834 women aged 18 – 40 years in metropolitan Minneapolis/St. Paul, Minnesota. Paul, Minnesota. Outcome Measures Women were considered to have a history of chronic vulvar pain if they reported vulvar burning lasting more than 3 months or vulvar pain on contact. Results 4,987 (38.9%) women reported a chronic pain condition; 1,651 had chronic vulvar pain. Women experiencing chronic pain were more likely than those without to perceive stereotyping from both doctors and others; a dose-response with the number of pain conditions existed. Women with chronic vulvar pain were more likely to believe that people think vulvar pain is an excuse to avoid intercourse. Half of the women with chronic vulvar pain did not seek medical care for it; of these, 40.4% perceived stereotyping from doctors. However, it was women who actually sought care (45.1%) who were more likely to feel stigmatized by doctors (adj. relative risk=1.11, 95% CI: 1.01-1.23). Conclusions Perceived negative stereotyping among chronic pain sufferers is common, particularly negative perceptions about physicians. In fact, chronic vulvar pain sufferers who felt stigmatized were more likely to have sought care than those who didn't feel stigmatized. PMID:23742116

Nguyen, Ruby H.N.; Turner, Rachael M.; Rydell, Sarah A.; MacLehose, Richard F.; Harlow, Bernard L.

2014-01-01

37

Vulvar Langerhans cell histiocytosis: a case report  

PubMed Central

Langerhans cell histiocytoses (LCH) are a rare group of disorders that comprise a large spectrum of diseases initially known as histiocytosis X. In this case report, we relate a case of LCH affecting the vulva of a 47-year-old female. The patient presented since 3 years with a vulvar lesion characterized by non-healing ulcers and a perineal granuloma on which she underwent surgery. Professionals should keep in mind not to treat straightforwardly lesions of the genital tract as simple sexually transmitted diseases. Chronic, atypical genital lesions seen in women need to be worked up and dealt with accordingly.

Khoummane, Nadia; Guimeya, Cyriane; Lipombi, Dominique; Gielen, Francois

2014-01-01

38

Innervated island flaps in morphofunctional vulvar reconstruction.  

PubMed

In this article, the authors present their own experience in vulvar reconstruction following vulvectomy using two different innervated island flaps according to the size and site of the defect. Island-flap mobilization is possible thanks to the rich blood supply of the perineal region. The methods described are a "V-Y amplified sliding flap from the pubis" and a "fasciocutaneous island flap" raised from one or both gluteal folds. The V-Y amplified sliding flap from the pubis is indicated when the defect is symmetric and located anteriorly. This flap is harvested from the pubis and vascularized by the deep arterial network of the pubis. Sensory innervation is provided by branches of the ileo-inguinal nerve. The fasciocutaneous island flap, raised from one or both gluteal folds, can be used following hemivulvectomy or radical vulvectomy, respectively, to cover posteriorly located defects. Vascularization is provided by the musculocutaneous perforating branches of the pudendal artery, whereas sensory innervation is maintained through the perineal branches of the pudendal nerve. Twenty-two patients have undergone reconstructive surgery of the vulvar region from 1989 to date. On 14 patients, a V-Y amplified sliding flap was used; on 7 patients, reconstruction was carried out by island flaps raised from the gluteal fold. Both techniques are compatible with inguino-femoral lymphadenectomy, and they allow for a correct morphofunctional reconstruction and provide good local sensibility. The final result is aesthetically satisfactory, as all final scars are hidden in natural folds. PMID:10809093

Moschella, F; Cordova, A

2000-04-01

39

What's New in Vulvar Cancer Research and Treatment?  

MedlinePLUS

... to stop the abnormal behavior of these cells. HPV vaccines Vaccines for preventing and treating vulvar and ... meant to prevent infection with certain types of HPV by boosting the body’s immunity to them. Two ...

40

The vulvar epithelium differs from the skin: implications for cutaneous testing to address topical vulvar exposures.  

PubMed

Vulvar tissue is more permeable than exposed skin due to differences in structure, occlusion, hydration and susceptibility to friction. The safety assessment of products that contact the vulva should account for this potentially heightened permeability. Standard clinical patch tests may not sufficiently mimic vulvar exposures. Because testing on the vulva is not routinely feasible, we are investigating new and modified cutaneous test methods to increase the degree of conservatism of the safety assessment. To this end, we have 1) developed a method to assess chemical and frictional effects by means of repeated application to the popliteal fossa (the behind-the-knee test); 2) modified the quantitative risk assessment for the induction of allergic contact dermatitis; and 3) proposed a modified human repeat insult patch test for assessing materials intended for vulvar contact. Modification of the traditional 4-day, irritation patch test by using wet samples or compromized skin sites failed to enhance test sensitivity. Future studies will evaluate testing in subjects with heightened susceptibility to chemical and sensory irritation, in order to increase test sensitivity to chemical irritants. These approaches can be employed to augment the margin of safety when cutaneous test methods are applied to agents that contact the vulva. PMID:15500670

Farage, Miranda; Maibach, Howard I

2004-10-01

41

STUDIES ON PULMONARY EDEMA  

PubMed Central

1. Bilateral cervical vagotomy in rabbits soon leads to death, usually within 8 to 24 hours. 2. Gradually increasing dyspnea, crises with expulsion of frothy, serous or sanguineous fluid from the mouth and nose, and terminal asphyxia are the important clinical features. 3. Postmortem examination reveals severe acute pulmonary edema and congestion, variable amounts of bronchopneumonia, and evidences of aspiration of food and secretions. This picture is similar to that found in the lungs in the bulbar form of poliomyelitis. 4. These changes are brought about by a combination of factors secondary to bilateral vagotomy: laryngeal paralysis (aspiration of food, slow asphyxia); loss of the vagal innervation of the lungs. 5. Laryngeal paralysis is not an essential factor in the production of severe pulmonary edema and death following bilateral cervical vagotomy. 6. To denote the pathogenesis of this type of edema, the term neuropathic pulmonary edema is employed. PMID:19870671

Farber, Sidney

1937-01-01

42

Ischemic Edema and Necrosis  

Microsoft Academic Search

Animal studies have substantially added to our understanding of the creation and development of vasogenic edema and necrosis\\u000a after stroke onset. T2 has emerged as the most commonly applied MR parameter to study this aspect of infarct evolution in\\u000a animal as well as in human stroke (Warach 2001). Although MRI monitoring of vasogenic edema is possible, there are still open

Susanne Wegener; Mathias Hoehn; Tobias Back

43

Vitamin D receptor expression in patients with vulvar cancer.  

PubMed

The anticarcinogenic potential of vitamin D is attributed to antiproliferative and prodifferentiative effects on cells for a wide variety of carcinomas. The biological effects of 1,25(OH)(2)D (calcitriol) are mediated through a soluble receptor protein termed vitamin D receptor (VDR). However, thus far there have been no studies evaluating the association between VDR expression and vulvar cancer. Using immunohistochemical analysis, VDR expression was evaluated separately in the nucleus, cytoplasm and membrane, in vulvar cancer samples and adjacent non-pathological vulvar tissue from 48 squamous cell carcinoma patients with no prior therapy, and the association between VDR and overall survival was investigated. Overall, among the 48 vulvar cancer cases, nuclear and cytoplasmic VDR expression was present in 47 (97.9%) and 23 (47.9%) cases respectively. The median nuclear VDR expression was significantly higher as compared to the cytoplasmic VDR in the vulvar cancer tissue. No significant correlation between VDR values and the age of the patients was detected. Nuclear and cytoplasmatic VDR in the vulvar cancer tissue were also compared according to the tumor size, and no significant association between mean tumor VDR and tumor size was detected. There was no association between cytoplasmatic VDR expression and OS, but better OS was observed in patients with reduced nuclear VDR expression as compared to those with high VDR expression. VDR may be considered as a useful pathological marker. PMID:22213317

Salehin, Darius; Haugk, Christina; Thill, Marc; Cordes, Tim; William, Marina; Hemmerlein, Bernhard; Friedrich, Michael

2012-01-01

44

[Edema and the tropics].  

PubMed

People visiting or living in tropical or subtropical regions are exposed to various factors, which can lead to edema. Tourists staying for only a short time in the tropics are exposed to different risks, with other disease patterns, than people living in the tropics or immigrants from tropical regions. The differential diagnosis of edema and swelling is extensive and it can sometimes be difficult to distinguish classical edema with fluid retention in the extravascular interstitial space, from lymphedema or swelling due to other aetiologies. The patients often connect the edema to their stay in the tropics although it may have been pre-existing with no obvious relation to their travels. Already the long trip in the plane can lead to an "economy class syndrome" due to deep venous thrombosis. Contacts with animal or plant toxins, parasites or parasitic larvae can produce peripheral edema. The diagnosis can often only be made by taking a meticulous history, checking for eosinophilia and with the help of serological investigations. Chronic lymphedema or elephantiasis of the limbs is often due to blocked lymph vessels by filarial worms. It has to be distinguished from other forms as e.g. podoconiosis due to blockage by mineral particles in barefoot walking people. The trend to book adventure and trekking holidays at high altitude leads to high altitude peripheral edema or non-freezing cold injuries such as frostbites and trench foot. Edema can be an unwanted side effect of a range of drugs e.g. nifedipine, which is used to prevent and treat high altitude pulmonary edema. Protein malnutrition, (Kwashiorkor), and vitamin B6 deficiency, (Beri-Beri) are very rarely observed in immigrants and almost never in tourists. A very painful swelling of fingers and hands in children and young adults of African origin can be observed during a sickle cell crisis. Many protein loosing nephropathies connected with plant and animal toxins but also bacterial, viral or parasitic agents, can lead to edema. But very often edema in tourists or immigrants from the tropics is not related to their stay abroad. To take an accurate history of the itinerary, eating habits and exposure to water etc. is very important. Knowledge of the precise epidemiology and geographic distribution of diseases are essential. PMID:15605460

Holzer, B R

2004-11-01

45

Cystoid macular edema  

PubMed Central

We review the epidemiology, pathophysiology, and etiology of cystoid macular edema (CME). Inflammatory, diabetic, post-cataract, and macular edema due to age-related macular degeneration is described. The role of chronic inflammation and hypoxia and direct macular traction is evaluated in each case according to different views from the literature. The different diagnostic methods for evaluating the edema are described. Special attention is given to fluoroangiography and the most modern methods of macula examination, such as ocular coherence tomography and multifocal electroretinography. Finally, we discuss the treatment of cystoid macular edema in relation to its etiology. In this chapter we briefly refer to the therapeutic value of laser treatment especially in diabetic maculopathy or vitrectomy in some selected cases. Our paper is focused mainly on recent therapeutic treatment with intravitreal injection of triamcinolone acetonide and anti-VEGF factors like bevacizumab (Avastin), ranibizumab (Lucentis), pegaptamid (Macugen), and others. The goal of this paper is to review the current status of this treatment for macular edema due to diabetic maculopathy, central retinal vein occlusion and post-cataract surgery. For this reason the results of recent multicenter clinical trials are quoted, as also our experience on the use of intravitreal injections of anti-VEGF factors and we discuss its value in clinical practice. PMID:19668445

Rotsos, Tryfon G; Moschos, Marilita M

2008-01-01

46

Surgery for brain edema.  

PubMed

Brain edema is a common pathophysiological process seen in many neurosurgical conditions. It can be localized in relation to focal lesions or generalized in diffuse types of brain injury. In addition to local adverse effects occurring at a cellular level, brain edema is associated with raised intracranial pressure (ICP), and both phenomena contribute to poor outcome in patients. One of the goals in treating patients with acute neurosurgical conditions in intensive care is to control brain edema and maintain ICP below target levels. The mainstay of treatment is medical therapy to reduce edema, but in certain patients--for example, those with diffuse severe traumatic brain injury (TBI) and malignant middle cerebral artery infarction--such treatment is not effective. In these patients, opening the skull (decompressive craniectomy) to reduce ICP is a potential option. In this review the authors discuss the role of decompressive craniectomy as a surgical option in patients with brain edema in the context of a variety of pathological entities. They also address the current evidence for the technique (predominantly observational series) and the ongoing randomized studies of decompressive craniectomy in TBI and ischemic stroke. PMID:17613232

Hutchinson, Peter; Timofeev, Ivan; Kirkpatrick, Peter

2007-01-01

47

Use of the Female Sexual Function Index in Women with Vulvar Intraepithelial Neoplasia  

Microsoft Academic Search

The present investigation extends the validation of the Female Sexual Function Index (FSFI; Rosen et al., 2000) to include women with vulvar excisions for vulvar intraepithelial neoplasia (VIN). No instrument previously has been validated in this population. We administered the instrument to 43 women (n = 43) with VIN treated with vulvar excision and age-matched healthy controls (n = 43).

Wendy M. Likes; Cheryl Stegbauer; Donna Hathaway; Candice Brown; Todd Tillmanns

2006-01-01

48

Latest advances in edema  

NASA Technical Reports Server (NTRS)

Basic concepts in the physiopathology of edema are reviewed. The mechanisms of fluid exchange across the capillary endothelium are explained. Interstitial flow and lymph formation are examined. Clinical disorders of tissue and lymphatic transport, microcirculatory derangements in venous disorders, protein disorders, and lymphatic system disorders are explored. Techniques for investigational imaging of the lymphatic system are explained.

Villavicencio, J. L.; Hargens, A. R.; Pikoulicz, E.

1996-01-01

49

Vulvar lichen sclerosus and squamous cell carcinoma: A cohort, case control, and investigational study with historical perspective; implications for chronic inflammation and sclerosis in the development of neoplasia  

Microsoft Academic Search

The histological changes of lichen sclerosus (LS) are frequently found in association with vulvar squamous cell carcinoma (SCC). The importance of chronic inflammation and scarring in oncogenesis is well recognized. Thirty-two patients with symptomatic vulvar LS and 60 with vulvar SCC were studied. Paraffin sections of vulvar LS, and three controls groups (acute scars, normal vulva, and vulvar lichen simplex

J. Andrew Carlson; Robert Ambros; John Malfetano; Jeffery Ross; Richard Grabowski; Philina Lamb; Helen Figge; Martin C Mihm

1998-01-01

50

Specific intraepithelial localization of mast cells in differentiated vulvar intraepithelial neoplasia and its possible contribution to vulvar squamous cell carcinoma development  

Microsoft Academic Search

AIMS: The aetiology of vulvar squamous cell carcinomas (SCC) that are not causally associated with high-risk human papillomavirus remains largely elusive. The aim of this study was to analyse the inflammatory response in its presumed precursor lesions, lichen sclerosus (LS) and differentiated vulvar intraepithelial neoplasia (dVIN), and provide evidence that dVIN is a likely precursor of vulvar SCC. METHODS AND

H. P. van de Nieuwenhof; K. M. Hebeda; J. Bulten; I. Otte-Holler; L. F. A. G. Massuger; J. A. de Hullu; L. C. L. T. van Kempen

2010-01-01

51

Treatment of vulvar intraepithelial neoplasia with the CO 2 laser  

Microsoft Academic Search

From 1982 to 1987, 18 consecutive patients with vulvar intraepithelial neoplasia were treated with CO2 laser vaporization. Prior genital tract malignancy or premalignancy was seen in 72% of the patients. The area around the commisura posterior was involved in 94% of the cases, and the disease showed multifocal localization in 56%.

Nina Palmgren Colov; Ingrid Thranov; Arne Berget

1990-01-01

52

Vulvar epithelioid hemangiosarcoma with solar elastosis in a mare.  

PubMed

A 15-year-old female gray Appaloosa horse was presented with history of a mass over the right dorsal commissure of vulva for the past 7 months. Based on histopathological examination, and positive staining with factor VIII-related antigen, vimentin, and Verhoeff-van Gieson stain, the vulvar mass was diagnosed as hemangiosarcoma with marked solar elastosis. PMID:21908370

Gumber, Sanjeev; Baia, Petrisor; Wakamatsu, Nobuko

2011-09-01

53

Large vulvar lipoma in an adolescent: a case report.  

PubMed

Lipomas are the most common benign tumors of soft tissues. However, conventional lipomas have been reported only rarely as presenting in the vulva. We present a case of vulvar lipoma in a 17-yr-old woman, possibly caused by chronic intermittent irritation. PMID:18756071

Lee, Jung Hoon; Chung, Seung Moon

2008-08-01

54

Vulvar Dermatoses – Irritant and Allergic Contact Dermatitis of the Vulva  

Microsoft Academic Search

Irritant and allergic contact dermatitis are commonly seen in patients complaining about itching, burning and irritation in the vulvar area. Irritation often precedes allergic sensitization. Clinically, irritant and allergic contact dermatitis can be difficult to distinguish. Diagnosis is made by history, clinical investigation and patch testing. Recommended patch test series are the standard series, a medicament series, the patient’s own

A. Bauer; C. Rödiger; C. Greif; M. Kaatz; P. Elsner

2005-01-01

55

Coiling of a vulvar arterio-venous malformation  

PubMed Central

The authors report the case of a 13-year-old girl with a painful vulvar swelling and abnormal vaginal bleeding, increasing in size after trauma. With MRI (GE Signa HDx 1.5 Tesla), it is diagnosed as an arterio-venous malformation arising from the left superior femoral artery. It is treated by embolisation using a coil. PMID:22674935

Van der Woude, Daisy Adriana Annejan; Stegeman, Marjan; Seelen, Jan L

2011-01-01

56

Management options for vulvar carcinoma in a low resource setting  

PubMed Central

Background Vulvar carcinoma is a rare tumor of the female genital tract. In Nigeria, very few studies have looked at the management options for vulvar carcinoma. The objective of this study was therefore, to describe the management options available and the challenges in treating this malignancy in Nigeria. Methods A descriptive study of all vulvar cancer cases managed at the Nnamdi Azikiwe University Teaching Hospital, Nnewi over a 12 year period (1998-2009). The theatre, ward register, histo-pathologic records and case notes of all women who had surgery for vulvar carcinomas were retrieved and socio-demographic characteristics, clinical presentation, type of surgery, histologic type and complications of treatment were retrieved and analyzed. Results There were 867 gynecological malignancies and vulval carcinoma accounted for 11 cases, giving a prevalence of 1.27%. The ages ranged from 54 to 79 years with a mean of 61.2 years. Parity was 2-14, with a mean of 6.7± 2.33. Most of the patients were of low socio-economic class. All the 11 patients had surgery as 1st line treatment. Radical vulvectomy was done for 6 cases since they presented in the advanced stage. The complications of surgery included hemorrhage (18.2%), chronic lymphedema, wound infection and anesthetic complications. There were no hospital mortalities. Late presentation, with stage III (45.4%) was the commonest stage at presentation while the majority of the vulvar carcinomas (72.7%) were of epithelial origin. Squamous cell carcinoma predominated (63.6%). Conclusion Carcinoma of the vulva is a rare gynecological malignancy in Nigeria. Surgery and radiotherapy remains the mainstay of this disease in Nigeria and can be highly successful if patients present early. PMID:21040577

2010-01-01

57

Contact hypersensitivity to oxazolone provokes vulvar mechanical hyperalgesia in mice.  

PubMed

The interplay among pain, allergy and dysregulated inflammation promises to yield significant conceptual advances in immunology and chronic pain. Hapten-mediated contact hypersensitivity reactions are used to model skin allergies in rodents but have not been utilized to study associated changes in pain perception in the affected skin. Here we characterized changes in mechanical hyperalgesia in oxazolone-sensitized female mice challenged with single and repeated labiar skin exposure to oxazolone. Female mice were sensitized with topical oxazolone on their flanks and challenged 1-3 times on the labia. We then measured mechanical sensitivity of the vulvar region with an electronic pressure meter and evaluated expression of inflammatory genes, leukocyte influx and levels of innervation in the labiar tissue. Oxazolone-sensitized mice developed vulvar mechanical hyperalgesia after a single labiar oxazolone challenge. Hyperalgesia lasted up to 24 hours along with local influx of neutrophils, upregulation of inflammatory cytokine gene expression, and increased density of cutaneous labiar nerve fibers. Three daily oxazolone challenges produced vulvar mechanical hyperalgesic responses and increases in nerve density that were detectable up to 5 days post-challenge even after overt inflammation resolved. This persistent vulvar hyperalgesia is resonant with vulvodynia, an understudied chronic pain condition that is remarkably prevalent in 18-60 year-old women. An elevated risk for vulvodynia has been associated with a history of environmental allergies. Our pre-clinical model can be readily adapted to regimens of chronic exposures and long-term assessment of vulvar pain with and without concurrent inflammation to improve our understanding of mechanisms underlying subsets of vulvodynia and to develop new therapeutics for this condition. PMID:24205293

Martinov, Tijana; Glenn-Finer, Rose; Burley, Sarah; Tonc, Elena; Balsells, Evelyn; Ashbaugh, Alyssa; Swanson, Linnea; Daughters, Randy S; Chatterjea, Devavani

2013-01-01

58

Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma  

Microsoft Academic Search

Lichen sclerosus is considered to be the precursor lesion of vulvar squamous cell carcinoma, of which only 2–5% progress to squamous cell carcinoma. Differentiated vulvar intraepithelial neoplasia (VIN) has been proposed to be the direct precursor lesion, but this is a recently recognized, and a difficult to diagnose, entity, which may easily be mistaken for a benign dermatosis. The aim

Hedwig P van de Nieuwenhof; Johan Bulten; Harrie Hollema; Rianne G Dommerholt; Leon F A G Massuger; Ate G J van der Zee; Joanne A de Hullu; Leon C L T van Kempen

2011-01-01

59

Colposcopy and High Resolution Anoscopy in Screening For Anal Dysplasia in Patients With Cervical, Vaginal, or Vulvar Dysplasia or Cancer  

ClinicalTrials.gov

Cervical Intraepithelial Neoplasia Grade 1; Cervical Intraepithelial Neoplasia Grade 2; Cervical Intraepithelial Neoplasia Grade 3; Recurrent Cervical Cancer; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Stage 0 Cervical Cancer; Stage 0 Vaginal Cancer; Stage 0 Vulvar Cancer; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IV Vulvar Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Cervical Cancer; Stage IVB Vaginal Cancer

2012-06-08

60

Detection and identification of human papiliomavirus in vulvar intraepithelial neoplasia  

Microsoft Academic Search

Objective  To evaluate the rate and types of human papillomavirus infection in vulvar intraepithelial neoplasia.\\u000a \\u000a \\u000a \\u000a Methods  We detected and identified HPV in 40 VIN cases with 67 lesions using PCR based reverse line blot hybridization and DNA sequencing.\\u000a Among the 40 patients, 13 were diagnosed as VIN III, 11 as VIN II, and 16 as VIN I. 31 patients had multifocal disease.

Yi Guo; Juan-hua Wu; Wei Li; Qian Wang; Hui Li

2007-01-01

61

Spontaneous regression of vulvar intraepithelial neoplasia 2-3  

Microsoft Academic Search

Objective: To determine the background and clinical features of a group of women who experienced spontaneous regression of vulvar intraepithelial neoplasia (VIN) 2-3 before treatment was undertaken.Methods: A retrospective review was made of the records of 14 women who experienced spontaneous regression of VIN 2-3.Results: The women were 15–27 years of age (median 19.5 years). Ninety-three percent were non-white. All

Ronald W Jones; Darion M Rowan

2000-01-01

62

[Vulvar lichen sclerosus in a girl with Turner syndrome].  

PubMed

Dermatological complications in Turner syndrome are infrequent but occasionally cause significant morbidity. Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous affection characterized by pruritus in the anogenital area. It is yet not clear its pathophysiology but it's linked with genetic factors and autoimmunity. This is a case report of a girl with Turner syndrome with growth hormone treatment that started with vulvar pruritus and was diagnosed as lichen sclerosus. PMID:24955917

Ocampo, Dolores; González, Verónica

2014-08-01

63

Immunohistochemical expression of SOX2 in vulvar intraepithelial neoplasia and squamous cell carcinoma.  

PubMed

SOX2 is a transcription factor controlling pluripotency in both embryonic stem cells and adult tissue-specific stem cells. SOX2 has been reported as an important factor in squamous cell carcinomas (SCC) of different locations and is involved in tumorigenesis. We evaluated the expression of SOX2 in vulvar non-neoplastic and neoplastic epithelia to test whether it is related to neoplastic progression. SOX2 immunoexpression was evaluated in 101 formalin-fixed, paraffin-embedded archival vulvar epithelia consisting of normal squamous vulvar epithelia (n=25), lichen sclerosus (n=9), high-grade classic vulvar intraepithelial neoplasia (HG-VIN, n=16), differentiated vulvar intraepithelial neoplasia (d-VIN, n=18), and vulvar invasive keratinizing SCC (n=33). Immunoexpression of SOX2 was nuclear and increased stepwise from normal vulvar epithelia/lichen sclerosus to HG-VIN and d-VIN (P<0.0001), from HG-VIN and d-VIN to invasive SCC (P=0.0029), and followed the morphologic distribution of atypical squamous epithelial cells. Scores for normal vulvar epithelia versus lichen sclerosus and HG-VIN versus d-VIN, respectively, did not differ significantly. SOX2 expression increased from tumor Grade 1 to 3 (P=0.0124); there was no relation to recurrence and survival. This is the first study presenting SOX2 as overexpressed in vulvar intraepithelial and invasive squamous lesions. This overexpression apparently reflects an early event in the neoplastic transformation of vulvar squamous epithelia. However, SOX2 seems to play a role in histologic dedifferentiation to Grade 3 invasive SCC too, and may be relevant to vulvar carcinogenesis. PMID:23518916

Brustmann, Hermann; Brunner, Andreas

2013-05-01

64

Feasibility of Collecting Vulvar Pain Variability and Its Correlates Using Prospective Collection with Smartphones  

PubMed Central

Context. Vulvar pain level may fluctuate in women with vulvodynia even in the absence of therapy; however, there is little evidence suggesting which factors may be associated with variability. Objective. Determine the feasibility of using smartphones to collect prospective data on vulvar pain and factors that may influence vulvar pain level. Methods. 24 clinically confirmed women were enrolled from a population-based study and asked to answer five questions using their smartphones each week for one month. Questions assessed vulvar pain level (0–10), presence of pain upon wakening, pain elsewhere in their body, treatment use, and intercourse. Results. Women completed 100% of their scheduled surveys, with acceptability measures highly endorsed. Vulvar pain ratings had a standard deviation within women of 1.6, with greater variation on average among those with higher average pain levels (P < 0.001). On the weeks when a woman reported waking with pain, her vulvar pain level was higher by 1.82 on average (P < 0.001). Overall, average vulvar pain level was not significantly associated with the frequency of reporting other body pains (P = 0.64). Conclusion. Our smartphone tracking system promoted excellent compliance with weekly tracking of factors that are otherwise difficult to recall, some of which were highly associated with vulvar pain level. PMID:25006458

Nguyen, Ruby H. N.; Turner, Rachael M.; Sieling, Jared; Williams, David A.; Hodges, James S.; Harlow, Bernard L.

2014-01-01

65

Trends in Squamous Cell Carcinoma of the Vulva: The Influence of Vulvar Intraepithelial Neoplasia  

Microsoft Academic Search

Objective: To determine trends in the clinicopathology of vulvar squamous cell carcinoma over the past 2 decades, with particular reference to the possible effects of the increasing incidence of vulvar intraepithelial neoplasia (VIN) during this time.Methods: Two cohorts of 56 and 57 women with squamous cell carcinoma of the vulva and separated by at least 2 decades were reviewed retrospectively.

R. W Jones; Judith Baranyai; S Stables

1997-01-01

66

Vulvar intraepithelial neoplasia III: occult cancer and the impact of margin status on recurrence  

Microsoft Academic Search

Objective: To determine the impact of margin status on disease recurrence and the incidence of occult cancer in women diagnosed with vulvar intraepithelial neoplasia (VIN) III and treated with surgical excision.Methods: Between 1989 and 1995, 73 women were diagnosed preoperatively with VIN III by vulvar biopsy and were treated with surgical resection. Patients were examined postoperatively, and recurrence was diagnosed

Susan C Modesitt; Anne B Waters; Leslie Walton; Wesley C Fowler; Linda Van Le

1998-01-01

67

The etiologic role of HPV in vulvar squamous cell carcinoma fine tuned  

Microsoft Academic Search

PURPOSE: High-risk human papilloma virus (HPV) plays a role in the development of a subset of vulvar squamous cell carcinomas. Uncertainty exists about the true impact of HPV in this tumor type because conflicting reports have been published with diverging prevalence rates. This study was done to fine tune the role of high-risk HPV infection in vulvar squamous cell carcinoma

H. P. van de Nieuwenhof; L. C. L. T. van Kempen; J. A. de Hullu; R. L. M. Bekkers; J. Bulten; W. J. G. Melchers; L. F. A. G. Massuger

2009-01-01

68

Vulvar Intraepithelial Neoplasia III: A Viral Disease of Undetermined Progressive Potential  

Microsoft Academic Search

Seventy-three patients with vulvar intraepithelial neoplasia (VIN) grade III were followed for a median of 5 years after primary treatment. Thirty women also had a diagnosis of cervical neoplasia. During the follow-up 26 patients (36%) had one or more vulvar recurrences. Recurrences were seen significantly more often in the patients who also had cervical neoplasia, indicating a common etiology. Microinvasive

Ulla Hørding; Jette Junge; Hemming Poulsen; Finn Lundvall

1995-01-01

69

Vulvar squamous papillomatosis and human papillomavirus infection. A polymerase chain reaction study  

Microsoft Academic Search

Squamous papillae of the vulvar vestibule and introitus are quite a common clinical finding, however their origin is uncertain. They were formerly described as a normal variant of the mucosal epithelium, but recently they have been attributed to human papillomavirus (HPV) infection. Eight women with clinical findings compatible with a diagnosis of vulvar squamous papillomatosis were studied. All were free

Michele Fimiani; Carlo Mazzatenta; Maurizio Biagioli; Lucio Andreassi

1993-01-01

70

Postextubation pulmonary edema: an unusual cause of transient pulmonary edema.  

PubMed

We report a case of sudden onset of respiratory distress caused by pulmonary edema due to laryngospasm. The diagnosis was established by the clinical context and chest X-ray. A CT-scan was performed to narrow down the differential diagnosis and to confirm the diagnosis. Postextubation pulmonary edema due to laryngospasm is a rare entity with a typical clinical and radiographic presentation. PMID:23610874

Carels, K; Herpels, V; Cardoen, L; Lecluyse, C; Traen, S; Verschakelen, J

2013-01-01

71

Physiological skin surface water loss dynamics of human vulvar and forearm skin.  

PubMed

In order to estimate the influence of occlusion and sweating on forearm and vulvar skin surface water loss (SSWL), both were measured simultaneously and continuously for 30 min in 8 healthy women. Vulvar SSWL decreased significantly during the measuring period from 24.9 +/- 5.2 gm-2 h-1 (mean +/- standard error of the mean) in the first 5 min, to 13.4 +/- 1.7 gm-2 h-1 in the last 5 min (p less than 0.05), whereas no significant changes were observed in forearm SSWL. The vulvar SSWL decay curve followed a logarithmic equation of the form y = a*tb. Irregular SSWL increases ('bursts') were observed in vulvar (but not in forearm) skin of 7 out of 8 women. These SSWL bursts were considered to be caused by sweating. The study shows possible causes of systematic errors in vulvar irritation studies. Methods for error reduction are discussed. PMID:1969199

Elsner, P; Wilhelm, D; Maibach, H I

1990-01-01

72

Recognition and management of vulvar dermatologic conditions: lichen sclerosus, lichen planus, and lichen simplex chronicus.  

PubMed

Lichen sclerosus, lichen planus, and lichen simplex chronicus are dermatologic conditions that can affect the vulva. Symptoms include vulvar itching, irritation, burning, and pain, which may be chronic or recurrent and can lead to significant physical discomfort and emotional distress that can affect mood and sexual relationships. With symptoms similar to common vaginal infections, women often seek care from gynecological providers and may be treated for vaginal infections without relief. Recognition and treatment of these vulvar conditions is important for symptom relief, sexual function, prevention of progressive vulvar scarring, and to provide surveillance for associated vulvar cancer. This article reviews these conditions including signs and symptoms, the process of evaluation, treatment, and follow-up, with attention to education and guidelines for vulvar care and hygiene. PMID:22594865

Thorstensen, Katrina Alef; Birenbaum, Debra L

2012-01-01

73

The most common chromosome aberration detected by high-resolution comparative genomic hybridization in vulvar intraepithelial neoplasia is not seen in vulvar squamous cell carcinoma  

Microsoft Academic Search

We analyzed genetic changes in condylomas (four cases), vulvar intraepithelial neoplasia I–III (VIN I–III, eleven cases), and primary vulvar squamous cell carcinomas (VSCC, ten cases) by high-resolution comparative genomic hybridization (HR-CGH) and flowcytometry. All samples were also human papilloma virus (HPV)-genotyped. Gain of chromosome 1, the aberration most often seen in VIN III (67%), was not seen in HPV-positive or

T. Bryndorf; M. Kirchhoff; J. Larsen; B. Andreasson; B. Bjerregaard; H. Westh; H. Rose; C. Lundsteen

2004-01-01

74

Genetic and epigenetic variation in vulvar cancer: Current research and future clinical practice.  

PubMed

Vulvar cancer is a relatively rare gynaecological malignancy, the treatment of which is associated with significant patient morbidity. With reports that the incidence of vulvar cancer is increasing, there is a rising need for improved preventive, diagnostic and therapeutic tools. Recent advances within genetics and epigenetics present possible approaches for addressing this need, by contributing to the clarification of the aetiology of this disease, identifying screening and drug targets and introducing the potential for personalised treatments. This paper reviews the genetic and epigenetic research undertaken to date within vulvar cancer, evaluates its potential for clinical application and identifies directions for future research. PMID:25159988

McWhirter, Rebekah E; Marthick, James R; Boyle, Jacqueline A; Dickinson, Joanne L

2014-10-01

75

Pathways of vulvar intraepithelial neoplasia and squamous cell carcinoma.  

PubMed

Vulvar squamous cell carcinoma (VSCC) accounts for >90% of the malignant tumours of the vulva. Most VSCCs originate in intraepithelial lesions, named vulvar intraepithelial neoplasia (VIN), that precede the development of VSCC by a variable period of time. Strong evidence has accumulated showing that there are two different aetiopathogenic pathways for the development of VSCC and VIN, one associated with infection by human papillomavirus (HPV), and a second independent of HPV infection. These two different types of VSCC have different epidemiological, pathological and clinical characteristics, and should therefore be considered as two separate entities. Histologically, HPV-associated VSCCs are of the basaloid or warty type, and arise from VIN of the usual type. Inactivation of p53 and the retinoblastoma tumour suppressor gene product by the viral gene products E6 and E7 is involved in the process of malignant transformation. HPV-independent VSCCs are histologically keratinizing, are associated with differentiated VIN and lichen sclerosus, and frequently show mutations of p53. p16(INK4a) and p53 immunostaining can be useful for classifying VSCC into HPV-associated or HPV-independent. Although large, multicentre studies are needed to definitively assess the involvement of HPV in the prognosis of VSCC, most studies have not found clear differences in survival between HPV-associated and HPV-independent tumours. PMID:23190170

Del Pino, Marta; Rodriguez-Carunchio, Leonardo; Ordi, Jaume

2013-01-01

76

Aberrant staining patterns of E-cadherin and ?-catenin: a potential diagnostic value for distinguishing vulvar intraepithelial neoplasia from non-neoplastic vulvar lesions.  

PubMed

Histologically, vulvar intraepithelial neoplasm (VIN) is a proliferative disorder of the female vulva. No single clinical characteristic or pathognomonic feature facilitates the diagnosis of VIN, and the agreement between different pathologists on the diagnoses varies significantly. In this study, we evaluate the immunohistochemical expression patterns of E-cadherin and ?-catenin in 22 patients with VIN and 10 patients with non-neoplastic vulvar lesions. our results showed that membranous staining for E-cadherin and ?-catenin was observed in squamous epithelial cells of all control non-neoplastic vulvar samples. Abnormal E-cadherin (17/19, 89.5%) and ?-catenin (15/19, 78.9%) staining occurred more frequently in usual-type VIN than in non-neoplastic vulvar lesions (P=0.000 and P=0.000, respectively). However, in differentiated VIN, only 1 patient showed abnormal E-cadherin and ?-catenin immunohistochemical expressions, which did not differ significantly. The abnormal expression of E-cadherin and ?-catenin proteins might be useful in distinguishing VIN from non-neoplastic vulvar squamous epithelium lesions in problematic cases. PMID:23826417

Li, Bo; Zhang, Qingfu; Ouyang, Ling; Jia, Lin; Han, Xue; Zhou, Yang; Tong, Xin; Song, Zixuan; Zhang, Shulang; Qiu, Xueshan

2013-01-01

77

Sentinel Node Dissection Safe in the Treatment of Early Vulvar Cancer  

Cancer.gov

Sentinel node dissection is an effective way to detect whether cancer has spread in early-stage vulvar cancer, though significant experience with the technique is essential, according to the Feb. 20, 2008, Journal of Clinical Oncology.

78

Recurrent Negative Pressure Pulmonary Edema  

PubMed Central

An African-American man, aged 34 years, underwent an elective uncomplicated right wrist laceration repair while under general anesthesia. Following extubation, the patient developed hypoxemia, tachypnea, shortness of breath, pulmonary rales, frothy sputum, decreased oxygen saturation, and evidence of upper airway obstruction. Chest radiograph showed pulmonary edema. The patient was diagnosed with post-extubation pulmonary edema (aka. negative pressure pulmonary edema [NPPE]) and was treated with intravenous furosemide and oxygen therapy; he improved remarkably within a few hours. Once stabilized, the patient described a similar episode 10 years earlier following surgery for multiple gunshot wounds. Negative pressure pulmonary edema following tracheal extubation is an uncommon (0.1%) and life-threatening complication of patients undergoing endotracheal intubation and general anesthesia for surgical procedures. The common pattern in these cases is the occurrence of an episode of airway obstruction upon emergence from general anesthesia, usually caused by laryngospasm. Patients who are predisposed to airway obstruction may have an increased risk of airway complications upon extubation after general anesthesia. Prevention and early relief of upper airway obstruction should decrease incidence. Recurrent NPPE has not been previously described in the literature. Herein, we describe the first case of recurrent NPPE in the same patient following extubation. PMID:20852091

Pathak, Vikas; Rendon, Iliana S. Hurtado; Ciubotaru, Ronald L.

2011-01-01

79

The contribution of MIB 1 in the accurate grading of vulvar intraepithelial neoplasia  

Microsoft Academic Search

AIM: To determine the interobserver variation in scoring presence and grade of vulvar intraepithelial neoplasia (VIN) in haematoxylin\\/eosin (H\\/E) slides, MIB 1 slides, and the combined use of H\\/E and MIB 1 slides. METHODS: 10 slides were stained with H\\/E and MIB 1 with each of the following diagnoses: normal vulvar skin, VIN 1, VIN 2, and VIN 3. Six

M. van Beurden; A. J. de Craen; H. C. de Vet; J. L. G. Blaauwgeers; P. Drillenberg; M. P. W. Gallee; N. W. de Kraker; F. B. Lammes; F. J. ten Kate

1999-01-01

80

Disturbed Patterns of Immunocompetent Cells in Usual-Type Vulvar Intraepithelial Neoplasia  

Microsoft Academic Search

Genital infection with human papillomavirus (HPV) is usually transient, as the immune system is capable of eliminating the virus. When immunity ''fails'' andthe infection persists, vulvar intraepithelial neoplasia (VIN) may develop. In this study, we examinedthe distribution of inflammatory cells in 51 patients with HPV-associatedusual-type VIN andin 19 healthy controls. Frozen vulvar tissue samples were testedfor the presence of HPV-DNA,

Manon van Seters; Ilse Beckmann; Claudia Heijmans-Antonissen; Marc van Beurden; Patricia C. Ewing; Freek J. Zijlstra; Theo J. M. Helmerhorst; Alex KleinJan

81

Vulvar problems in elderly women. Don't assume that menopause is the culprit.  

PubMed

Like many other parts of the body, the vulva is affected by cessation of estrogen after menopause. Vulvar pruritus and irritation are common findings with normal aging, but they may also be signs of infection, inflammation, or other skin conditions. Misdiagnosis results in incorrect treatment, a dissatisfied patient and, often, referral to a gynecology clinic. In this article, two instructors in the field describe acute and chronic vulvar disorders and summarize how to identify and treat them. PMID:9300022

Barhan, S; Ezenagu, L

1997-09-01

82

A case of usual (basaloid)-type vulvar intraepithelial neoplasia that failed to respond to imiquimod cream: clinical implications  

Microsoft Academic Search

The authors report a case of usual-type (basaloid-type) vulvar intraepithelial neoplasia (VIN) 3 that failed to respond to\\u000a imiquimod cream. A 51-year-old Japanese woman visited her local gynecologist complaining of vulvar itching. Atypical cells\\u000a were noted in cytology smears, but nine vulvar biopsy specimens showed benign proliferation of epithelial tissue. The patient\\u000a was placed under careful observation for 8 months, when

Takaya Shiozaki; Tsutomu Tabata; Kuniaki Toriyabe; Takashi Motohashi; Eiji Kondo; Kouji Tanida; Toshiharu Okugawa; Norimasa Sagawa

83

The first leg video endoscopic groin lymphadenectomy in vulvar cancer: A case report  

PubMed Central

INTRODUCTION The current management of vulvar cancer depends on the extension of disease, and includes primary tumor resection with safety margin as well as inguinofemoral lymph node staging. We report the case of the first leg videoendoscopic inguinal lymphadenectomy performed in a woman with a squamous cell vulvar carcinoma. PRESENTATION OF CASE A 74 years old female referred to our institution complaining of vulvar mass associated with bleeding and swelling from external genitals, vaginal burning sensation and dysuria for 5 months. A vulvar–vaginal examination under narcosis reported a right major labium lesion of 5 cm with an irregular and ulcerated surface, easily bleeding on palpation, involving anteriorly the clitoral region and with a histological finding of a poorly differentiated squamous cell invasive carcinoma of the vulva ulcerating the surface epithelium. We performed, after adequate informed consent, a radical vulvectomy with a standard right inguinofemoral lymphadenectomy and a contralateral simultaneous video endoscopic inguinal lymphadenectomy-Leg procedure. DISCUSSION Our minimally invasive VEIL-Leg approach, performed for the first time in literature in a woman with vulvar cancer, could reduce the presence of high risk factors represented by surgical incision and by procedure-related complications, including wound infection and breakdown, hematoma, cellulitis and hernia formation. CONCLUSION A multicenter prospective randomized study will be helpful to clarify how this procedure could replace the standard laparotomic approach to inguinal lymphadenectomy in the vulvar cancer treatment and staging. PMID:24973526

Naldini, Angelica; Rossitto, Cristiano; Morciano, Andrea; Panico, Giovanni; Campagna, Giuseppe; Paparella, Pierluigi; Scambia, Giovanni

2014-01-01

84

Alterations of the p16 INK4a\\/Rb\\/cyclin-D1 pathway in vulvar carcinoma, vulvar intraepithelial neoplasia, and lichen sclerosus  

Microsoft Academic Search

Three different alterations in the p16\\/pRb\\/cyclin-D1 pathway (p16INK4a-promoter hypermethylation and expression of pRb and cyclin-D1) were investigated in a series of 38 cases of vulvar carcinoma (VC), 13 cases of vulvar intraepithelial neoplasia (VIN), and 21 cases of lichen sclerosus (LS). Paraffin blocks from 72 patients were selected for investigation of DNA methylation patterns in the CpG island of p16INK4a

Enrique Lerma; Manel Esteller; James G. Herman; Jaime Prat

2002-01-01

85

Phosphorylated S6 as an immunohistochemical biomarker of vulvar intraepithelial neoplasia.  

PubMed

As life expectancy lengthens, cases of non-viral-associated vulvar squamous cell carcinoma and its precursor lesion, so-called differentiated vulvar intraepithelial neoplasia (VIN), continue to increase in frequency. Differentiated VIN often is difficult to recognize and failure to detect it before invasion results in morbidity and mortality. Thus, identification of a reliable biomarker for this type of lesion would be of great clinical benefit. Our recent studies have identified activation (ser235/236 phosphorylation) of ribosomal protein S6 (p-S6) in basal epithelial cells as an event that precedes and accompanies laminin ?(2) overexpression in most preinvasive oral dysplasias. To test this as a potential biomarker of vulvar dysplasia, we immunostained seven differentiated VINs and nine papillomavirus-related 'classic' VINs, most of which were associated with carcinoma, for p-S6. All carcinomas, all differentiated VINs, and most classic VINs contained regions of p-S6 staining in the basal layer, whereas basal and parabasal cells of normal vulvar epithelium and hyperplastic and inflamed lesions lacking cellular atypia were p-S6 negative. Laminin ?(2) was expressed in a subset of VINs, always occurring within basal p-S6 positive regions, as we had found previously for oral dysplasias. Lichen sclerosus is considered a potential precursor of vulvar carcinoma. Two lichen sclerosus lesions of patients with a concurrent carcinoma and one of six lichen sclerosus lesions without atypia or known concurrent carcinoma were basal p-S6 positive. In summary, there is a distinct difference in p-S6 basal cell layer staining between benign and neoplastic vulvar squamous epithelium, with consistent staining of differentiated VIN and of some lichen sclerosus lesions. These results support further studies to assess the potential of p-S6 as a biomarker to identify vulvar lesions at risk of progressing to invasive cancer. PMID:23765247

Pinto, Alvaro P; Degen, Martin; Barron, Patricia; Crum, Christopher P; Rheinwald, James G

2013-11-01

86

Localized amyloidosis of the vulva with and without vulvar intraepithelial neoplasia: report of a series.  

PubMed

Localized primary cutaneous amyloidosis is uncommon in Europe and North America and is infrequently reported in the English literature. The constituents of such deposits have not been previously examined; this series characterizes amyloid deposits in localized vulvar amyloidosis and their association with vulvar intraepithelial neoplasia. All biopsies and excisions of vulva over 18 months were reviewed. Cases with suspected amyloidosis were retrieved after institutional review board approval. Twenty cases mimicking amyloidosis were selected as controls. All study and control cases were stained with Congo red. Four Congo red-positive study cases were studied by liquid chromatography-tandem mass spectrometry. Of 27 Congo red-positive study cases, 25 were then examined by immunohistochemical stains with antibodies to cytokeratin 5 (CK5) and cytokeratin 14 (CK14). Of 149 cases reviewed, 26 localized and 1 systemic vulvar amyloidosis were identified. Liquid chromatography-tandem mass spectrometry analysis of the deposits revealed unique peptide profile consistent with CK5 and CK14. Immunohistochemical staining with antibodies to CK5 and CK14 also detected these components in the deposits. The vulvar deposit of systemic amyloidosis consisted of amyloid light chain (?)-type amyloid deposit. All control cases were negative for Congo red. Keratin-associated amyloid materials (CK5 and CK14) were found to be unique in localized vulvar amyloidosis. Leakage of keratins from the basal layer of the epithelium into the superficial dermis may have been the possible source of the deposits. It appears to be associated with both high-grade and low-grade vulvar intraepithelial neoplasias and, rarely, lichen sclerosus, seborrheic keratosis, and benign vulvar skin. PMID:25149547

Quddus, M Ruhul; Sung, C James; Simon, Rochelle A; Lawrence, W Dwayne

2014-10-01

87

Vulvitis granulomatosa: a cryptogenic chronic inflammatory hypertrophy of vulvar labia related to cheilitis granulomatosa and Crohn's disease.  

PubMed

We report the cases of two patients with vulvitis granulomatosa, a chronic inflammatory hypertrophy of the vulvar labia thought to represent the vulvar variant of cheilitis granulomatosa. One of the women later experienced recurring cheilitis granulomatosa, while the other developed intestinal Crohn's disease 6 years later. The interrelationships of vulvitis granulomatosa, cheilitis granulomatosa, and Crohn's disease are discussed. PMID:8598339

Guerrieri, C; Ohlsson, E; Rydén, G; Westermark, P

1995-10-01

88

Ranibizumab in diabetic macular edema  

PubMed Central

By 2050 the prevalence of diabetes will more than triple globally, dramatically increasing the societal and financial burden of this disease worldwide. As a consequence of this growth, it is anticipated that there will be a concurrent rise in the numbers of patients with diabetic macular edema (DME), already among the most common causes of severe vision loss worldwide. Recent available therapies for DME target the secreted cytokine, vascular endothelial growth factor (VEGF). This review focuses on the treatment of DME using the first humanized monoclonal antibody targeting VEGF that has been Food and Drug Administration-approved for the use in the eye, ranibizumab (Lucentis®). PMID:24379922

Krispel, Claudia; Rodrigues, Murilo; Xin, Xiaoban; Sodhi, Akrit

2013-01-01

89

Reexpansion pulmonary edema in children  

PubMed Central

OBJECTIVE To present a case of a patient with clinical and radiological features of reexpansion pulmonary edema, a rare and potentially fatal disease. CASE DESCRIPTION An 11-year-old boy presenting fever, clinical signs and radiological features of large pleural effusion initially treated as a parapneumonic process. Due to clinical deterioration he underwent tube thoracostomy, with evacuation of 3,000 mL of fluid; he shortly presented acute respiratory insufficiency and needed mechanical ventilation. He had an atypical evolution (extubated twice with no satisfactory response). Computerized tomography findings matched those of reexpansion edema. He recovered satisfactorily after intensive care, and pleural tuberculosis was diagnosed afterwards. COMMENTS Despite its rareness in the pediatric population (only five case reports gathered), the knowledge of this pathology and its prevention is very important, due to high mortality rates. It is recommended, among other measures, slow evacuation of the pleural effusion, not removing more than 1,500 mL of fluid at once. PMID:24142327

Rodrigues, Antonio Lucas L.; Lopes, Carlos Eduardo; Romaneli, Mariana Tresoldi das N.; Fraga, Andrea de Melo A.; Pereira, Ricardo Mendes; Tresoldi, Antonia Teresinha

2013-01-01

90

Diabetic Macular Edema: Current and Emerging Therapies  

PubMed Central

Diabetic macular edema is a leading cause of vision impairment among people within the working- age population. This review discusses the pathogenesis of diabetic macular edema and the treatment options currently available for the treatment of diabetic macular edema, including for focal/grid photocoagulation, intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factor agents. The biologic rationale for novel therapeutic agents, many of which are currently being evaluated in clinical trials, also is reviewed. PMID:22346109

Wenick, Adam S.; Bressler, Neil M.

2012-01-01

91

Pathology Slide Review in Vulvar Cancer Does Not Change Patient Management  

PubMed Central

Hypothesis. Pathology slide review in vulvar cancer is only necessary in a restricted number of cases. Methods. A retrospective chart review of all cases of vulvar cancer treated in a tertiary centre between January 1, 2000, and April 1, 2006. Histopathology reports from the referring and tertiary centre were compared. Results. 121 pathology reports from 112 patients were reviewed. Of the original reports, 56% were deemed adequate, commenting on tumor type and depth of infiltration; of the reviews, 83% were adequate. Conclusion. There were no discrepancies that influenced patient management. We suggest that vulvar cancer biopsies need to be reviewed only when the tumor is less than 10?mm in linear extension, when the infiltration is 1?mm or less, when there is no residual tumor on inspection, and in any nonsquamous cancer. PMID:25006513

Ewing-Graham, Patricia C.; van Doorn, Helena C.

2014-01-01

92

Vulvar Carcinoma in Pregnant Women Aged Less than 40 Years: Case Report  

PubMed Central

Background Invasive squamous cell carcinoma of the vulva is primarily a disease of postmenopausal women and thus is rarely associated with pregnancy. Case We have reported on a young woman under 40 years old with vulvar carcinoma, which occurred during the pregnancy but optimal treatment was delayed to the postpartum period. This 37-year-old woman was diagnosed with 3x3 cm vulvar lesion, 2 weeks after cesarean section, subsequent biopsy revealed squamous cell carcinoma. She had a history of an ulcer on her left labia minor at the third month of the pregnancy. She was treated by a modified radical vulvectomy and bilateral groin lymphadenectomy. She did not receive any additional treatments. Now after two years, she has had no recurrence of the disease. Conclusion This case emphasizes on the need to consider malignancy as a differential diagnosis in vulvar lesions of pregnant young women. PMID:25250170

Hasanzadeh, Malihe; Zamiri-Akhlaghi, Amir; Hassanpoor-Moghaddam, Maryam; Shahidsales, Soodabeh

2014-01-01

93

Comparison of molecular abnormalities in vulvar and vaginal melanomas.  

PubMed

Malignant melanoma of the vulva and vagina is relatively uncommon and accounts for <5% of all melanomas in women. The aim of our study was to establish the biological properties and evaluate potential therapeutic targets in these tumors. We collected a series of 65 cases from three centers and re-evaluated the tumor tissue for predominant growth pattern (superficial spreading, nodular, and mucosal lentiginous) and tumor thickness. KIT (CD117) expression was detected immunohistochemically. In addition, tumors were screened for BRAF, NRAS, and KIT mutations by PCR and DNA sequencing as well as for KIT amplifications by fluorescence in situ hybridization. None of the cases contained BRAF mutations. NRAS mutations and KIT amplifications were detected in similar frequency (?12%) in tumors of the vulva and vagina. In contrast, KIT mutations were present in 18% of primary melanomas of the vulva, but in none of the tumors arising in the vagina. Moderate or strong KIT protein expression was detected in 30 cases, including all tumors with KIT mutations and 6 of the 7 with KIT amplifications. In conclusion, BRAF mutations are virtually absent in melanomas originating from the vulva or vagina, whereas NRAS mutations and KIT amplifications occur in both locations. KIT mutations appear to be specific for melanomas of the vulva, suggesting that in spite of the anatomic proximity, the development of vulvar and vaginal melanomas involves different molecular alterations which may be targeted by novel treatment approaches. PMID:24603591

Aulmann, Sebastian; Sinn, Hans P; Penzel, Roland; Gilks, C Blake; Schott, Sarah; Hassel, Jessica C; Schmidt, Dietmar; Kommoss, Friedrich; Schirmacher, Peter; Kommoss, Stefan

2014-10-01

94

A clinical and pathological overview of vulvar condyloma acuminatum, intraepithelial neoplasia, and squamous cell carcinoma.  

PubMed

Condyloma acuminatum, intraepithelial neoplasia, and squamous cell carcinoma are three relatively frequent vulvar lesions. Condyloma acuminatum is induced by low risk genotypes of human papillomavirus (HPV). Vulvar intraepithelial neoplasia (VIN) and squamous cell carcinoma have different etiopathogenic pathways and are related or not with high risk HPV types. The goal of this paper is to review the main pathological and clinical features of these lesions. A special attention has been paid also to epidemiological data, pathological classification, and clinical implications of these diseases. PMID:24719870

Léonard, Boris; Kridelka, Frederic; Delbecque, Katty; Goffin, Frederic; Demoulin, Stéphanie; Doyen, Jean; Delvenne, Philippe

2014-01-01

95

A Clinical and Pathological Overview of Vulvar Condyloma Acuminatum, Intraepithelial Neoplasia, and Squamous Cell Carcinoma  

PubMed Central

Condyloma acuminatum, intraepithelial neoplasia, and squamous cell carcinoma are three relatively frequent vulvar lesions. Condyloma acuminatum is induced by low risk genotypes of human papillomavirus (HPV). Vulvar intraepithelial neoplasia (VIN) and squamous cell carcinoma have different etiopathogenic pathways and are related or not with high risk HPV types. The goal of this paper is to review the main pathological and clinical features of these lesions. A special attention has been paid also to epidemiological data, pathological classification, and clinical implications of these diseases. PMID:24719870

Léonard, Boris; Kridelka, Frederic; Delbecque, Katty; Goffin, Frederic; Demoulin, Stéphanie; Doyen, Jean; Delvenne, Philippe

2014-01-01

96

Feto-maternal outcome of pregnancy complicated by vulvar cancer: a systematic review of literature.  

PubMed

Vulvar cancer is an extremely rare complication during pregnancy, and its effect on pregnancy and survival is not well understood. A systematic literature review was conducted in order to examine the fetal and maternal outcomes and optimal management of pregnancy complicated by vulvar cancer. PubMed/MEDLINE were used to identify case reports with searching keywords "pregnancy" and "vulvar cancer" between January 1955 and February 2014 that identified 36 cases for analysis. Mean age was 30.7. The most common presenting symptom and gestational age were vulvar mass/swelling (75.0%) and the second trimester of pregnancy (54.8%), respectively. Vulvar biopsy at the time of initial presentation to care during pregnancy was performed in only 46.7% of cases. Among delayed cases for biopsy, mean duration of delay was 12.8 weeks and the majority had a delay for more than 8 weeks (62.5%). The majority of vulvar cancer was squamous histology (47.2%) and stage I disease (60.0%). Vulvectomy and inguinal-femoral lymphadenectomy were performed in 97.1% and 63.9%, respectively. Abdominal delivery was recorded in 46.2% of cases. Live birth and full term delivery rates were 96.3% and 74.0%, respectively. For survival analysis, delay in diagnosis and advanced stage disease were commonly associated with decreased disease-free survival (5-year rate, delay in diagnosis >8 versus ?8 weeks, 0% versus 69.1%, hazard ratio (HR) 7.86, 95% confidence interval (CI) 2.03-30.6, p=0.001; and stage III-IV versus stage I-II, 0% versus 59.8%, HR 3.35, 95% CI 1.16-9.68, p=0.011) and overall survival (5-year rate, delay in diagnosis >8 versus ?8 weeks, 0% versus 67.1%, hazard ratio (HR) 14.8, 95% CI 1.77-124, p=0.001; and stage III-IV versus stage I-II, 0% versus 86.4%, HR 8.22, 95% CI 2.06-33.2, p<0.001). In conclusion, while the majority of cases resulted in good pregnancy outcomes, diagnosis of vulvar cancer during pregnancy is frequently delayed. Since delayed diagnosis is a significant prognosticator of decreased survival outcomes, early recognition is integral in the management of pregnancy complicated by vulvar cancer. PMID:24768232

Matsuo, Koji; Whitman, Stephanie A; Blake, Erin A; Conturie, Charlotte L; Ciccone, Marcia A; Jung, Carrie E; Takiuchi, Tsuyoshi; Nishimura, Masato

2014-08-01

97

Early invasive vulvar squamous cell carcinoma arising in a woman with vulvar pemphigus vulgaris and systemic lupus erythematosus  

PubMed Central

Background Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and mucous membranes. Genital involvement occurs when most other common sites are concurrently affected or are in remission. Systemic lupus erythematosus (SLE) is an autoimmune disease that may affect many parts of the body and the skin with occasional bullous lesions. Pemphigus vulgaris and SLE may be associated, albeit rarely. Here, we report the first case of a woman affected with SLE presenting with early invasive squamous cell carcinoma (SCC) arising from Pemphigus Vulgaris of the vulva. Case presentation A 27-year-old Caucasian woman was admitted to our Gynaecology Unit for bleeding vegetant lesions of the vulva. Her history was characterized by systemic lupus erythematosus and PV. Biopsy showed concomitant PV and vulvar intraepithelial neoplasia (VIN) grade 3. One month later a new biopsy revealed progression from VIN 3 to early SCC. Despite chemotherapy, no remission of disease was observed. She died six months after diagnosis Conclusion Our case underlines PV as another chronic inflammatory disease of the lower genital tract predisposing to VIN-SCC. It suggests the need for careful follow-up of patients with chronic inflammatory disease, especially when concomitant autoimmune disorders are present. Moreover, a biopsy should be always performed if there are PV lesions because of the possibility of neoplastic disease. PMID:20573220

2010-01-01

98

Integration of HPV16 and HPV18 DNA in vulvar intraepithelial neoplasia  

Microsoft Academic Search

Objective.Vulvar intraepithelial neoplasia (VIN) is a premalignant disease of the lower genital tract. The increased occurrence of high-risk human papillomavirus (HPV) infection seems to be associated with the increasing frequency of VIN. Integration of HPV DNA into host chromosome has been hypothesized to be a critical step in the carcinogenesis of cervical neoplasia resulting in altered expression of two viral

Peter Hillemanns; Xiuli Wang

2006-01-01

99

Vulvar Intraepithelial Neoplasia in Women Infected with Human Immunodeficiency Virus1  

Microsoft Academic Search

The purpose of this study was to determine the response of vulvar intraepithelial neoplasia (VIN) lesions to standard treatment methods in women infected with human immunodeficiency virus (HIV). We reviewed all cases of VIN over a 4-year period at an inner-city hospital. We reviewed the clinical records of these women to abstract demographic information as well as information about tobacco

Abner P. Korn; Priscilla D. Abercrombie; Anne Foster

1996-01-01

100

Vulvar intraepithelial neoplasia: Age, morphological phenotype, papillomavirus DNA, and coexisting invasive carcinoma  

Microsoft Academic Search

Recent studies suggest that subsets of vulvar intraepithelial neoplasia (VIN) may be distinguished based on morphological presentation, the presence or absence of human papillomavirus (HPV) nucleic acids, and patient age. We analyzed 65 VIN lesions, including 15 with associated squamous cell carcinoma, to determine the relationship between pathological parameters associated with common types of VIN (multinucleation, koilocytosis, verruco-papillary morphology, diffuse

Hope K Haefner; James E Tate; Catherine M McLachlin; Christopher P Crum

1995-01-01

101

Photodynamic Therapy of Vulvar Intraepithelial Neoplasia III Using Topically Applied 5-Aminolevulinic Acid  

Microsoft Academic Search

Objectives. The aim of this study was twofold: first, to determine the feasibility of photodynamic therapy (PDT) of vulvar intraepithelial neoplasia III (VIN III) using topically applied 5-aminolevulinic acid (ALA) for photosensitization, and second, to compare PDT results with those of laser evaporation and local excision.Methods. Fifteen patients with VIN III had 10 g of 10% ALA gel applied to

Mathias K. Fehr; René Hornung; Viola A. Schwarz; René Simeon; Urs Haller; Pius Wyss

2001-01-01

102

Vulvar intraepithelial neoplasia—The need for auditable measures of management  

Microsoft Academic Search

ObjectivesSurgical excision is currently the standard treatment for vulvar intraepithelial neoplasia (VIN). To date it has proved difficult to evaluate the management of VIN in reported series due to heterogeneity in datasets. The objective of this study was to justify standardised data presentation to permit comparison between series and facilitate determination of an optimal strategy for management of VIN. We

Ram Athavale; R. Naik; K. A. Godfrey; P. Cross; M. H. Hatem; A. de Barros Lopes

2008-01-01

103

Medical Management of Vulvar Vestibulitis: Results of a Sequential Treatment Plan  

PubMed Central

Objective: The objectives of this study were to assess the efficacy of medical management for vulvar vestibulitis and to examine several historical variables and determine their predictive values as to which treatments will be most successful. Methods: Seventy-four patients diagnosed with vulvar vestibulitis were evaluated. Each patient was treated using a sequence of consecutive medical therapies for vulvar vestibulitis. These therapies were topical aqueous 4% lidocaine with intercourse, topical corticosteroid therapy, oral amitriptyline, topical low-dose 5-fluorouracil (5-FU) cream, intralesional alpha-interferon, and a low-oxalate diet in combination with oral calcium citrate. The patients were followed over 3–30 months and their responses to therapy were assessed. In addition, a statistical analysis was performed to determine the positive predictive values of certain historical variables and specific treatment successes. Results: Forty-nine patients reported positive responses to one of the initiated therapies. More specifically, 18.1% of the patients who used lidocaine, 33.8% who used topical corticosteroids, 57.1% who used amitriptyline, 16.7% who used 5-FU, none who received interferon, and 50% who tried a low-oxalate diet had positive responses to therapy. No historical variables were predictive of which therapies would have the most successful outcome. Conclusions: Medical management is effective in alleviating the symptoms of vulvar vestibulitis. Various aspects of a patient's history are not helpful in selecting the therapy that will be most effective. PMID:18472890

Halpern, Meredith

1995-01-01

104

A new model of spinal cord edema.  

PubMed

Edema of the spinal cord has not been well understood. Brain edema produced by Marmarou's infusion method is essentially similar to vasogenic edema. This infusion method for producing edema was applied to a cat spinal cord. After laminectomy, a 30-gauge needle was inserted into the intumescentia cervicalis. A total amount of 10 microliters of 2% Evans' blue or autoserum were infused using an infusion pump at a rate of 5 microliters/hr. Macroscopally, Evans' blue was observed in the vicinity of infused site at the same level of the needle insertion and was seen spreading mainly longitudinally in the lateral column for a certain distance. The extracellular space was markedly distended in the in fused white mater and filled with electron-dense materials which were thought to be proteins in the electron microscopic study. The fine structural features were similar to the findings which were seen in Marmarou's infusion type of brain edema. Using this model, it seems to be feasible to produce reproducible spinal cord edema at any location in order to investigate not only the morphological aspect but also physiological aspect of the edema. PMID:9416351

Naruse, H; Tanaka, K; Kim, A; Hakuba, A

1997-01-01

105

Cromolyn cream for recalcitrant idiopathic vulvar vestibulitis: results of a placebo controlled study  

PubMed Central

Objective: Patients with chronic idiopathic vulvar vestibulitis have increased mast cells when biopsied, and cromolyn has been suggested as a treatment. The purpose of this study was to assess the efficacy of 4% cromolyn cream in women with vulvar vestibulitis. Methods: A prospective, double blind, randomised, placebo controlled study was initiated at two centres. Patients with vulvar vestibulitis were assigned to apply cromolyn or placebo cream to the vestibule. Symptoms (burning, irritation) and signs (erythema, extent of erythema, tenderness) were recorded on a 0–3 scale. In the sexually active patient subgroup, dyspareunia was also evaluated. Results: 13 of the 26 evaluable patients received cromolyn. Patients in the cromolyn arm were more likely to have failed therapy with amitriptyline (p = 0.05), but the two groups were otherwise similar upon study entry. Overall, scores decreased from a median of 9 to 5 (p = 0.001) during the study, but the level of improvement was similar between both groups. Improvement was unrelated to duration of symptoms, fluconazole use, or sexual activity. Five patients (38%) taking cromolyn and six (46%) taking placebo felt they had a 50% or greater reduction in symptoms. In the 21 sexually active patients, the total score decreased from a mean of 12 to 8 (p = 0.005), but there was no statistically significant difference between study arms. Conclusions: Cromolyn cream did not confer a significant benefit in patients with vulvar vestibulitis. The large placebo response suggests the need for large well controlled studies of other treatment modalities. Key Words: cromolyn cream; vulvar vestibulitis PMID:11158692

Nyirjesy, P.; Sobel, J.; Weitz, M; Leaman, D.; Small, M.; Gelone, S.

2001-01-01

106

Pimecrolimus Cream 1% for Treatment of Vulvar Lichen Simplex Chronicus: An Open-Label, Preliminary Trial  

Microsoft Academic Search

Background: To evaluate efficacy and safety of pimecrolimus cream 1% twice daily for treatment of vulvar lichen simplex chronicus (LSC). Methods: Patients in this 12-week, open-label study had biopsy-proven vulvar LSC. Inclusion criteria were patient-reported Visual Analog Scale for Pruritus Relief ?3 (VAS-PR, 0 cm = no itching to 10 cm = severe itching) and Investigator’s Global Assessment ?2 (IGA,

Andrew T. Goldstein; Anne Parneix-Spake; Calogera L. McCormick; Lara J. Burrows

2007-01-01

107

Immunohistochemical expression of p16 and p53 in vulvar intraepithelial neoplasia and squamous cell carcinoma of the vulva  

Microsoft Academic Search

This study was undertaken to examine the expression of p16 and p53 in vulvar intraepithelial neoplasia (VIN) and squamous\\u000a cell carcinoma (SCC) of the vulva. We also analyzed the relationship between p16 and p53 immunoexpression in women younger\\u000a vs. older than 55 years of age. Seventyseven histologic samples of vulvar tissue, treated surgically between June 2000 and\\u000a November 2004 at

Mauricio Cordoni Nogueira; Ernesto de Paula Guedes Neto; Marcos Wengrover Rosa; Eduardo Zettler; Cláudio Galleano Zettler

2006-01-01

108

Acute vulvar pain in a lady with post circumcision inclusion cyst of the vulva containing stones: a case report  

PubMed Central

Background Despite global eradication efforts, female genital cutting is still deep routed practice in some parts of Asia and East Africa. The crude and unscientific natures of the practice lead to many complications. Epidermoid inclusion cysts of the vulva are one of the late complications of female genital cutting and typically present as painless cystic swellings. But clinical presentation as ‘stone’ containing, hard vulvar mass is reported only once in the literature and presentation with acute vulvar pain has never been documented. Case presentation A 21 yrs old, Ethiopian, unmarried, lady presented with sever acute vulvar pain, discharge, and a stony hard vulvar swelling 13 years after type-III female genital cutting (infibulation). Surgical excision of the cyst, which contained two ‘stones’ inside it, and defibulation were done. Histopathology confirmed calcified, keratinizing epidermoid inclusion cyst of the vulva. Conclusions Clinicians, in areas where female genital cutting is prevalent, should be aware of such unusual late vulvar complication of the practice which might be misdiagnosed for other solid vulvar swellings and be familiar with the appropriate management. PMID:24387298

2014-01-01

109

The historical discovery of macular edema.  

PubMed

The occurrence of macular edema, or of intraretinal fluid in general, was largely unknown prior to the invention of the ophthalmoscope. One of the first reports on 'Retinitis in Glycosuria', a disease complex, which today would partly be described as diabetic maculopathy, was published in 1856 by Jaeger. His observations were confirmed less than twenty years later by Nettleship in London, and in 1875 Appolinaire Bouchardat from Paris described fluid and lipid accumulation in the macula which led--in his words--to a glucose induced amblyopia. The first pathophysiological hypotheses of fluid accumulation in the posterior pole were then put forward in 1882 by Tartuferi, who thought the edema represented swelling of photoreceptor sheaths. In 1896, the Frenchman Nuel coined the term 'oedème maculaire' which he had observed in a retinitis pigmentosa patient. However, it was not until the end of the first World War, that the Swiss ophthalmologist Alfred Vogt observed macular edema in a variety of other ocular conditions such as iridocyclitiOFF macular edema to a macular hole. A quarter of a century later Bangerter coined the German term 'Zystoides Makulaödem', and in 1950, Hruby was the first to draw attention to the development of macular edema after cataract extraction. Three years later this was followed by Irvine's classical paper on cystoid macular edema after intra- and extracapsular cataract extraction which had been complicated by incarceration of the vitreous in the anterior segment with consecutive tugging on the macula. A decade later, the phenomenon of cystic fluid accumulation in the macula after cataract extraction was further characterised by Gass and Norton using fluorescein angiography. The ensuing years saw the emergence of new concepts regarding the blood-retinal barrier and the paramount role of its dysfunction in the development of macular edema. PMID:10896334

Wolfensberger, T J

1999-01-01

110

Magnetic resonance imaging of vulvar dermatofibrosarcoma protuberans - report of a case  

PubMed Central

Background Dermatofibrosarcoma protuberans (DFSP) of the vulva is a rare low-grade soft tissue sarcoma. Magnetic resonance imaging (MRI) findings of vulvar DFSP were essentially unreported in the literature. Case report We report a DFSP of vulva with its clinical, histological and MRI features. As far we know this is the first case of histologically confirmed vulvar DFSP presenting with MR images. The diagnosis of DFSP is usually made by histopathologic and clinical findings. Conclusions MRI is useful both for the diagnosis of DFSP and following up the patients since it has high soft tissue resolution and no risk of radiation exposure. With MRI the relation to the adjacent anatomical structures, extension and depth of the tumour and possible lymph node involvement can also be demonstrated. PMID:24133389

Ozmen, Evrim; Guney, Guven; Algin, Oktay

2013-01-01

111

The burn edema process: current concepts.  

PubMed

Massive tissue edema after thermal injury is a well-recognized entity. Although this process is responsible for the patient's large fluid needs during resuscitation and also for local problems, such as a compartment syndrome, there have been no effective treatment modalities introduced into clinical care to control the degree of edema. A review of what is now known about the edema process is presented here, including attempted prevention and treatment modalities. The pathogenesis involves changes in most of the physical forces controlling fluid flux across the capillary and also how fluid accumulates in the interstitium. Increased capillary permeability to protein is but one of these changes. The presence of an initial profound negative interstitial pressure "sucking" fluid into the tissues and a marked increase in interstitial space compliance are equally important components. A host of mediators, especially oxidants, have been reported to cause these physical changes, and some mediator inhibitors appear to be of benefit, especially antioxidants. However, few clinical trials, aimed at decreasing edema, have been performed. With these new insights into the edema process, future prevention and treatment modalities can be developed. PMID:15879742

Demling, Robert H

2005-01-01

112

Use of neutral plasma coagulation in groin node dissection for vulvar malignancy: a novel technique.  

PubMed

Vulvar cancer is an uncommon disease with approximately 1000 cases reported annually in the UK. Lymph node involvement is an important prognostic indicator. Vulvectomy and bilateral groin node dissection are the preferred surgical treatments for early disease and increase survival. However, significant morbidity with lymphocyst formation and wound breakdown has been reported in more than 50% of cases. We report the first case following use of the PlasmaJet(®) neutral argon coagulation system to reduce postoperative lymphocyst formation. PMID:21792333

Madhuri, Thumuluru Kavitha; Tailor, Anil; Butler-Manuel, Simon

2011-01-01

113

HPV-related vulvar intraepithelial neoplasia: Outcome of different management modalities  

Microsoft Academic Search

Objective: To evaluate the outcome of various management schemes for HPV-related vulvar intraepithelial neoplasia (VIN, usual type). Methods: Retrospective chart review of patients with histologically diagnosed grade 2\\/3-VIN who had at least one year of follow-up. The variables that were collected included patient characteristics, management modalities, and clinical outcome. Results: Fifty patients with a median age of 45 years old

I. Bruchim; S. Mahmud; E. Tunitsky; K. Grzywacz; A. Ferenczy

2007-01-01

114

Evaluation of CO 2 Laser Excision or Vaporization for the Treatment of Vulvar Intraepithelial Neoplasia  

Microsoft Academic Search

Objective. Ourobjective was to evaluate the results of laser surgery in patients with vulvar intraepithelial neoplasia (VIN).Methods. From January 1990 to December 1996, 52 patients with histologically proven VIN were treated with CO2 laser vaporization or laser excision. The analysis included anamnestic characteristics, clinical aspects, types of treatment, correlation of the preoperative biopsy with the excised pathologic specimen, and follow-up

M. Sideri; L. Spinaci; N. Spolti; F. Schettino

1999-01-01

115

Cryotherapy for massive vulvar lymphatic leakage complicated with lymphangiomas following gynecological cancer treatment.  

PubMed

Vulvar lymphatic leakage is a severe complication associated with gynecological cancer treatments. However, standard treatment strategies have not yet been determined. We encountered a rare case of a 76-year-old multiparous woman suffering from massive lymphatic fluid leakage from the entire vulva, and papules developed and were identified as lymphangiomas. A large amount of straw-colored discharge continued from all vulvar papules, which extended over the mons pubis. Nine years ago, the patient had undergone a radical hysterectomy with concurrent chemoradiation for uterine cervical cancer treatment. Her serum albumin level was 1.9 mg/dl, which was attributed to the loss of a large amount of lymph fluid due to leakage from the vulva. Her quality of life gradually decreased because of general fatigue and the need for frequent diaper exchanges every 2 h. The patient received a less-invasive treatment with cryotherapy using liquid nitrogen. She also received a multimodality treatment consisting of the intravenous administration of albumin, massage of the lower limbs and intensive rehabilitation. Cryotherapy was administered once a week for 3 months. Her discharge almost stopped and vulvar lymphangiomas decreased without any major complications. To the best of our knowledge, this is the first case report of massive lymphatic leakage complicated with vulvar lymphangiomas. Additionally, this case may represent the first successful treatment of vulva lymph leakage by cryotherapy without recurrence. Cryotherapy may have the potential to improve the quality of life as a less-invasive treatment for gynecological cancer survivors without serious complications. PMID:25190008

Yanazume, Shintaro; Douzono, Haruhiko; Kubo, Hidemichi; Nagata, Tomomi; Douchi, Tsutomu; Kobayashi, Hiroaki

2014-11-01

116

Use of neutral plasma coagulation in groin node dissection for vulvar malignancy: a novel technique  

PubMed Central

Vulvar cancer is an uncommon disease with approximately 1000 cases reported annually in the UK. Lymph node involvement is an important prognostic indicator. Vulvectomy and bilateral groin node dissection are the preferred surgical treatments for early disease and increase survival. However, significant morbidity with lymphocyst formation and wound breakdown has been reported in more than 50% of cases. We report the first case following use of the PlasmaJet® neutral argon coagulation system to reduce postoperative lymphocyst formation. PMID:21792333

Madhuri, Thumuluru Kavitha; Tailor, Anil; Butler-Manuel, Simon

2011-01-01

117

A clinicopathological review of 33 patients with vulvar melanoma identifies c-KIT as a prognostic marker  

PubMed Central

Vulvar melanoma is the second most common vulvar cancer. Patients with vulvar melanoma usually present with the disease at a late stage and have a poor prognosis. The prognostic predictors reported in the literature are not unequivocal and the role of lichen sclerosus and c-KIT mutations in the aetiology of vulvar melanoma is unclear. Breslow staging currently seems to be the most adequate predictor of prognosis. We thus performed a clinicopathological and literature review to identify suitable predictors of prognosis and survival and investigated the expression of c-KIT (by immunohistochemistry) in patients with vulvar melanoma (n=33) from the Gynaecological Cancer Centres of the Royal Hospital for Women (Sydney, Australia) and John Hunter Hospital (Newcastle, Australia). Our series of 33 patients fitted the expected clinical profile of older women: delayed presentation, high stage, limited response to treatment and poor prognosis. We identified 3 patients (9.1%) with lichen sclerosus associated with melanoma in situ, although no lichen sclerosus was found in the areas of invasive melanoma. No patient had vulvar nevi. We identified a) Breslow’s depth, b) an absence of any of the pathological risk factors, such as satellitosis, in-transit metastasis, lymphovascular space invasion (LVSI) and dermal mitosis, c) removal of inguino-femoral lymph nodes, d) lateral margin of >1 cm, and e) c-KIT expression as valuable prognostic predictors for disease-free survival. We conclude that c-KIT expression is, apart from Breslow’s depth, another valuable predictor of prognosis and survival. Lichen sclerosus may be associated with vulvar melanoma. PMID:24535703

HEINZELMANN-SCHWARZ, VIOLA A.; NIXDORF, SHERI; VALADAN, MEHRNAZ; DICZBALIS, MONICA; OLIVIER, JAKE; OTTON, GEOFF; FEDIER, ANDRE; HACKER, NEVILLE F.; SCURRY, JAMES P.

2014-01-01

118

Management of patients with vulvar cancer: a perspective review according to tumour stage  

PubMed Central

Treatment of patients with vulvar cancer is challenging for gynaecologic oncologists. Owing to the localization in a sensitive area, surgical radicality and the indication for adjuvant treatment have to be balanced with psychosocial aspects to treat patients adequately. Clinical management is therefore highly dependent on the tumour stage. For patients with early-stage disease (FIGO I–II) therapy mainly concentrates on surgery with resection of the primary tumour and staging of the groin lymph nodes. In intermediate-stage vulvar cancer (FIGO III), advanced disease is expressed by affected inguinofemoral lymph nodes bringing radical lymphadenectomy and adjuvant therapy as well as radiation or chemoradiation into the focus of treatment. For locally advanced or metastatic vulvar cancer (FIGO IV) neoadjuvant or definitive chemoradiation has to be considered besides surgery. Owing to the low incidence of the disease, the level of evidence for different treatment modalities is poor. This review therefore puts different recommendations of clinical management in context and highlights the need for future trials. PMID:23634196

Woelber, Linn; Trillsch, Fabian; Kock, Lilli; Grimm, Donata; Petersen, Cordula; Choschzick, Matthias; Jaenicke, Fritz

2013-01-01

119

Diabetic macular edema: New promising therapies  

PubMed Central

The treatment of diabetic macular edema is rapidly evolving. The era of laser therapy is being quickly replaced by an era of pharmacotherapy. Several pharmacotherapies have been recently developed for the treatment of retinal vascular diseases such as diabetic macular edema. Several intravitreal injections or sustained delivery devices have undergone phase 3 testing while others are currently being evaluated. The results of clinical trials have shown the superiority of some of these agents to laser therapy. However, with the availability of several of these newer agents, it may be difficult to individualize treatment options especially those patients respond differently to various therapies. As such, more effort is still needed in order to determine the best treatment regimen for a given patient. In this article, we briefly summarize the major new therapeutic additions for the treatment of diabetic macular edema and allude to some future promising therapies. PMID:24379924

Shamsi, Hanan N Al; Masaud, Jluwi S; Ghazi, Nicola G

2013-01-01

120

Current status in diabetic macular edema treatments  

PubMed Central

Diabetes is a serious chronic condition, which increase the risk of cardiovascular diseases, kidney failure and nerve damage leading to amputation. Furthermore the ocular complications include diabetic macular edema, is the leading cause of blindness among adults in the industrialized countries. Today, blindness from diabetic macular edema is largely preventable with timely detection and appropriate interventional therapy. The treatment should include an optimized control of glycemia, arterial tension, lipids and renal status. The photocoagulation laser is currently restricted to focal macular edema in some countries, but due the high cost of intravitreal drugs, the use of laser treatment for focal and diffuse diabetic macular edema (DME), can be valid as gold standard in many countries. The intravitreal anti vascular endothelial growth factor drugs (ranibizumab and bevacizumab), are indicated in the treatment of all types of DME, but the correct protocol for administration should be defined for the different Retina Scientific Societies. The corticosteroids for diffuse DME, has a place in pseudophakic patients, but its complications restricted the use of these drugs for some patients. Finally the intravitreal interface plays an important role and its exploration is mandatory in all DME patients. PMID:24147200

Romero-Aroca, Pedro

2013-01-01

121

Interstitial lung edema triggered by marathon running.  

PubMed

The purpose of this study was to determine whether marathon running causes lung edema, and if so, to determine its effects on runners. Posterior/anterior (PA) radiographs were taken one day before the marathon and at 19, 55, and 98min post-marathon in 26 runners. The pre and post exercise radiographs of each runner were collated, and then read simultaneously. Two physicians interpreted the images independently in a blinded fashion. The PA radiographs were viewed together at each time-point and findings suggestive for interstitial lung edema were rated as 'mild,' 'moderate,' or 'severe' based on four different radiological criteria. Forty-six percent of the runners presented radiographic findings suggestive of mild to severe interstitial lung edema. Radiographic findings persisted until 98-min post-marathon, with at least moderate degree increases found more frequently in women (55%) than men (6%) (p<0.01). In conclusion, about half of the runners developed interstitial lung edema of varying degrees post-exercise with the incidence being higher in women compared to men. PMID:24369923

Zavorsky, Gerald S; Milne, Eric N C; Lavorini, Federico; Rienzi, Joseph P; Lavin, Kaleen M; Straub, Allison M; Pistolesi, Massimo

2014-01-01

122

Prevention, identification and treatment of vulvar squamous (pre)malignancies: a review focusing on quality of care.  

PubMed

Vulvar squamous cell carcinoma, its precursor lesions (usual and differentiated vulvar intraepithelial neoplasia) and lichen sclerosus are rare diseases that may have a large impact on the lives of affected women and their partners. Proper identification is vital, but the lesions are sometimes difficult to diagnose because of their rarity and variety of symptoms. High quality of care and proper treatment is important in order to minimize the morbidity and mortality caused by these lesions. This review gives an outline of the latest insights regarding the current evidence in this area and unresolved issues. Additionally, it highlights the improvements that should be made in order to optimize prevention and identification of (pre-)malignant vulvar lesions and to increase the quality of care for these patients. PMID:23875663

van den Einden, Loes Cg; van der Avoort, Irene Am; de Hullu, Joanne A

2013-07-01

123

Cervical and Vulvar Cancer Risk in Relation to Joint Effects of Cigarette Smoking and Genetic Variation in Interleukin 2  

PubMed Central

Cigarette smoking is an established co-factor to human papillomavirus (HPV) in the development of cervical and vulvar squamous cell carcinoma (SCC), and may influence risk through an immunosuppressive pathway. Genetic variation in interleukin 2 (IL2), associated in some studies with inhibition of HPV-targeted immunity, may modify the effect of smoking on the risk of HPV-related anogenital cancers. We conducted a population-based case-only study to measure the departure from a multiplicative joint effect of cigarette smoking and IL2 variation on cervical and vulvar SCC. Genotyping of four IL2 tagSNPs (rs2069762, rs2069763, rs2069777, and rs2069778) was performed in 399 cervical and 486 vulvar SCC cases who had been interviewed regarding their smoking history. Compared to cases carrying the rs2069762 TT genotype, we observed significant departures from multiplicativity for smoking and carriership of the TG or GG genotypes in vulvar SCC risk (interaction odds ratio (IOR)=1.67, 95% confidence interval (CI): 1.16, 2.41). Carriership of one of three diplotypes together with cigarette smoking was associated with either a supra-multiplicative (TGCT/GGCC, IOR=2.09, 95% CI: 0.98, 4.46) or sub-multiplicative (TTCC/TGTC, IOR=0.37, 95% CI: 0.16, 0.85 or TGCT/TGCC, IOR=0.37, 95% CI: 0.15, 0.87) joint effect in vulvar cancer risk. For cervical SCC, departure from multiplicativity was observed for smokers homozygous for the rs2069763 variant allele (TT versus GG or GT genotypes) (IOR=1.87, 95% CI: 1.00, 3.48), and for carriership of the TTCC/TTCC diplotype, (IOR=2.08, 95% CI: 1.01, 4.30). These results suggest that cervical and vulvar SCC risk among cigarette smokers is modified by genetic variation in IL2. PMID:18628433

Hussain, Shehnaz K.; Madeleine, Margaret M.; Johnson, Lisa G.; Du, Qin; Malkki, Mari; Wilkerson, Hui-Wen; Farin, Federico M.; Carter, Joseph J.; Galloway, Denise A.; Daling, Janet R.; Petersdorf, Effie W.; Schwartz, Stephen M.

2008-01-01

124

Postobstructive pulmonary edema induced by endotracheal tube occlusion  

Microsoft Academic Search

Pulmonary edema is a well-described complication of upper airway obstruction, most commonly caused in adults by postanesthetic laryngospasm. The mechanism initiating the formation of postobstructive pulmonary edema is believed to be the markedly negative intrapleural pressure generated by a forceful inspiratory effort against an obstructed extrathoracic airway. We herein describe a young, male patient who developed pulmonary edema postoperatively, upon

P. V. Dicpinigaitis; D. C. Mehta

1995-01-01

125

Vulvar vitiligo-like depigmentation and multiple halos of hypomelanosis at the trunk following treatment with imiquimod 5% cream for vulvar condylomata: casual or related events?  

PubMed

A 25-year-old Caucasian female with multiple genital warts involving the vulvar area was treated with imiquimod 5% cream. During follow-up the patient developed areas of hypopigmentation at the site of application of imiquimod cream and areas of hypomelanosis around multiple preexisting nevi of the trunk. At 18 months follow-up genital depigmentation persisted and halo nevi of the trunk were still present. Different mechanisms of imiquimod-induced depigmentation have been reported. Halo nevi are considered expression of an autoimmune response. In the case presented here, it might be conceivable that both vitiligo-like depigmentation at the site of application and halo of hypomelanosis around melanocytic nevi have been induced by the same immunologic mechanism elicited by topical application of imiquimod. PMID:25184923

Serra, Maíra Chiarelli; Menicanti, Claudia; Pennacchioli, Elisabetta; Tosti, Giulio

2014-01-01

126

[Pharmacological correction of traumatic brain edema].  

PubMed

Experiments on rats were made to study the action of the derivatives of benzodiazepine (diazepam, 0.5 mg/kg and phenazepam, 0.1 mg/kg), and GABA (phenibut, 50 mg/kg, pantogam, 160 mg/kg, nicotinoyl-GABA, 500 mg/kg, piracetam, 1000 mg/kg) on the development of a traumatic brain edema. Diazepam, phenazepam and phenibut were demonstrated to produce a marked antiedematous action. The drugs made water content in the brain return to normal and reduced marked biochemical alterations in the brain. It is suggested that the protective action of the drug under study on the development of brain edema is linked with the action on the mediator structures and brain tissue metabolism. PMID:6142833

Novikov, V E; Iasnetsov, V S

1984-01-01

127

Vulvar dermatoses--irritant and allergic contact dermatitis of the vulva.  

PubMed

Irritant and allergic contact dermatitis are commonly seen in patients complaining about itching, burning and irritation in the vulvar area. Irritation often precedes allergic sensitization. Clinically, irritant and allergic contact dermatitis can be difficult to distinguish. Diagnosis is made by history, clinical investigation and patch testing. Recommended patch test series are the standard series, a medicament series, the patient's own topical medicaments, popular remedies and other suspected products. A skin biopsy may be useful to establish the diagnosis of contact dermatitis, but it is usually not helpful for the differential diagnosis between irritant and allergic dermatitis. PMID:15724097

Bauer, A; Rodiger, C; Greif, C; Kaatz, M; Elsner, P

2005-01-01

128

Treatment of vulvar intraepithelial neoplasia using topical imiquimod 5% cream in a genitourinary medicine clinic setting.  

PubMed

In the last five years, options for the treatment of vulvar intraepithelial neoplasia (VIN) have come to include the use of the immune response modifier imiquimod, following case reports of its efficacy in the USA and Europe. Despite topical imiquimod 5% cream being frequently prescribed for the treatment of ano-genital warts, there are no reports of it being used for the treatment of VIN in a genitourinary medicine setting. In this case report self-administered topical imiquimod 5% cream proved an effective treatment for undifferentiated VIN2/3 and should be considered as an alternative therapy in a genitourinary medicine setting. PMID:17326867

McQuillan, O; Morgan, E

2007-01-01

129

Acute pulmonary edema after intramyometrial prostodin.  

PubMed

A 25 year old, 68 kg, primigravida, was taken up for emergency caesarean section for meconium stained liquor and fetal distress. She was a known case of pre eclampsia and her blood pressure was controlled on tab methyl dopa. she was administered general anaesthesia. after delivery of baby she went into postpartum hemorrhage which was controlled with intramyometrial prostodin. but immediately after its administration she went into acute pulmonary edema. PMID:21772700

Baduni, Neha; Sanwal, Manoj K; Jain, Aruna

2011-04-01

130

Acute pulmonary edema after intramyometrial prostodin  

PubMed Central

A 25 year old, 68 kg, primigravida, was taken up for emergency caesarean section for meconium stained liquor and fetal distress. She was a known case of pre eclampsia and her blood pressure was controlled on tab methyl dopa. she was administered general anaesthesia. after delivery of baby she went into postpartum hemorrhage which was controlled with intramyometrial prostodin. but immediately after its administration she went into acute pulmonary edema. PMID:21772700

Baduni, Neha; Sanwal, Manoj K; Jain, Aruna

2011-01-01

131

Combination Therapy for Diabetic Macular Edema  

PubMed Central

Diabetic macular edema is a main reason for visual loss in diabetic patients. Until recent years, macular laser photocoagulation was the only available therapy. The awareness that inflammation is an important factor in the pathogenetic process of DME gave reason for intravitreal treatment with corticosteroids. The introduction of anti-VEGF drugs brought a revolutionary change in the treatment of DME. This paper will review the important clinical trials with an emphasis on combination therapies. PMID:22523648

Zur, Dinah; Loewenstein, Anat

2012-01-01

132

Oxygen-deficient metabolism and corneal edema  

Microsoft Academic Search

Wear of low-oxygen-transmissible soft contact lenses swells the cornea significantly, even during open eye. Although oxygen-deficient corneal edema is well-documented, a self-consistent quantitative prediction based on the underlying metabolic reactions is not available. We present a biochemical description of the human cornea that quantifies hypoxic swelling through the coupled transport of water, salt, and respiratory metabolites. Aerobic and anaerobic consumption

B. K. Leung; J. A. Bonanno; C. J. Radke

2011-01-01

133

A microstructural study of spinal cord edema.  

PubMed

The experimental spinal cord edema was produced in a cat by the infusion method of Marmarou. Horseradish peroxidase (HRP) dissolved in autoserum of a cat was used as a tracer. After laminectomy, a 30-gauge needle was inserted into the intumescentia cervicalis. A total amount of 20 microliters of a tracer was infused at a rate of 10 microliters/hr. The structural features were studied immediately and 3 days after infusion. Immediately after infusion, HRP was noted in the infused white and gray matters. Though the perivascular space in the white matter at the infused site was widely distended and filled with HRP, the space in the gray matter was not distended but filled with HRP. HRP which was observed along vessels led to the surface of the spinal cord. Swelling of astrocyte was not observed. Three days after infusion, the extracellular space and the perivascular space in the infused white matter were still expanded but were not filled with HRP. The fine structural features were similar to the findings as seen in Marmarou's infusion type of brain edema. Using this model, it seems to be feasible to study the resolution process of spinal cord edema. PMID:11449985

Naruse, H; Tanaka, K; Kim, A

2000-01-01

134

New Compton densitometer for measuring pulmonary edema  

SciTech Connect

Pulmonary edema is the pathological increase of extravascular lung water found most often in patients with congestive heart failure and other critically ill patients who suffer from intravenous fluid overload. A non-invasive lung density monitor that is accurate, easily portable, safe and inexpensive is needed for clinical evaluation of pulmonary edema. Other researchers who have employed Compton scattering techniques generally used systems of extended size and detectors with poor energy resolution. This has resulted in significant systematic biases from multiply-scattered photons and larger errors in counting statistics at a given radiation dose to the patient. We are proposing a patented approach in which only backscattered photons are measured with a high-resolution HPGe detector in a compact system geometry. By proper design and a unique data extraction scheme, effects of the variable chest wall on lung density measurements are minimized. Preliminary test results indicate that with a radioactive source of under 30 GBq, it should be possible to make an accurate lung density measurement in one minute, with a risk of radiation exposure to the patient a thousand times smaller than that from a typical chest x-ray. The ability to make safe, frequent lung density measurements could be very helpful for monitoring the course of P.E. at the hospital bedside or outpatient clinics, and for evaluating the efficacy of therapy in clinical research. 6 refs., 5 figs.

Loo, B.W.; Goulding, F.S.; Simon, D.S.

1985-10-01

135

Intravitreal bevacizumab for macular edema from idiopathic juxtafoveal retinal telangiectasis.  

PubMed

To assess the potential visual benefit of intravitreal bevacizumab in a patient with idiopathic juxtafoveal retinal telangiectasis refractory to focal laser treatment, an intravitreal injection of bevacizumab (1.25 mg) was given. Within 1 week, visual acuity improved from 20/50 to 20/25 and optical coherence tomography demonstrated complete resolution of macular edema. There was no adverse effect. The macular edema recurred after 3 months, requiring a repeat injection of bevacizumab with subsequent resolution of macular edema. An intravitreal injection of bevacizumab may provide potential short-term visual benefit in patients with macular edema from idiopathic juxtafoveal retinal telangiectasis. PMID:17396701

Moon, Suk J; Berger, Adam S; Tolentino, Michael J; Misch, David M

2007-01-01

136

The Curious Question of Exercise-Induced Pulmonary Edema  

PubMed Central

The question of whether pulmonary edema develops during exercise on land is controversial. Yet, the development of pulmonary edema during swimming and diving is well established. This paper addresses the current controversies that exist in the field of exercise-induced pulmonary edema on land and with water immersion. It also discusses the mechanisms by which pulmonary edema can develop during land exercise, swimming, and diving and the current gaps in knowledge that exist. Finally, this paper discusses how these fields can continue to advance and the areas where clinical knowledge is lacking. PMID:21660232

Bates, Melissa L.; Farrell, Emily T.; Eldridge, Marlowe W.

2011-01-01

137

Corticosteroid withdrawal precipitates perilesional edema around calcified Taenia solium cysts.  

PubMed

Calcified Taenia solium granulomas are the focus of repeated episodes of perilesional edema and seizures in 50% of persons with calcifications, history of seizures, and a positive serology for cysticercosis. The pathophysiology is unclear but recent studies suggest the edema is caused by inflammation. We report two new cases and four other published cases where cessation of corticosteroids appeared to result in recurrence or new appearance of perilesional edema around calcifications. This suggests that perilesional edema is an immune-mediated phenomenon. PMID:24002482

Mejia, Rojelio; Nash, Theodore E

2013-11-01

138

Malignant Melanoma of the Urethra: A Rare Histologic Subdivision of Vulvar Cancer with a Poor Prognosis  

PubMed Central

Malignant melanoma of the urethra is a rare tumour that is difficult to diagnose and treat, resulting in a poor prognosis. In this paper, we present the case of a 65-year-old woman who was referred to a gynaecologist because of a urethral mass that mimicked a caruncle. The tumour was removed by local excision, and a pathological analysis revealed a malignant melanoma. Distal urethrectomy was performed after three months with no evidence of residual tumour. There was no evidence of disease at a six-year followup. In this paper, we compare the epidemiology, treatment, staging, and prognosis of vulvar cancer in general to malignant melanoma of the vulva in particular. PMID:23320214

Gunther, Veronika; Alkatout, I.; Lez, C.; Altarac, S.; Fures, R.; Cupic, H.; Persec, Z.; Hrgovic, Z.; Mundhenke, C.

2012-01-01

139

Role of early edema in the development of regional seizure-related brain damage  

Microsoft Academic Search

Kainic acid-induced seizures produced early (2 hr) generalized edema and later (24 and 48 hr) necrotic edema in temporal cortex and hippocampus as measured by specific gravity changes. Mannitol given during the seizure partially protected against the early edema and prevented the necrotic edema indicating early edema may play a role in later brain damage. However, H2O intoxication, causing much

Stanley R. Nelson; John P. Olson

1987-01-01

140

Excellent Tolerance to Cilnidipine in Hypertensives with Amlodipine - Induced Edema  

PubMed Central

Background: Ankle edema is a common adverse effect of amlodipine, an L-type calcium channel blocker (CCB). Cilnidipine is a newer L/N-type CCB, approved for treatment of essential hypertension. Aim: This study was designed to determine whether cilnidipine can produce resolution of amlodipine-induced edema while maintaining adequate control of hypertension. Materials and Methods: A prospective study was performed on 27 patients with essential hypertension with amlodipine-induced edema. Concomitant nephropathy, cardiac failure, hepatic cirrhosis, or other causes of edema, and secondary hypertension were excluded by appropriate tests. Amlodipine therapy was substituted in all the cases with an efficacy-equivalent dose of cilnidipine. Clinical assessment of ankle edema and measurement of bilateral ankle circumference, body weight, blood pressure, and pulse rate were performed at onset of the study and after 4 weeks of cilnidipine therapy. Results: At completion of the study, edema had resolved in all the patients. There was a significant decrease in bilateral ankle circumference and body weight (P < 0.001). There was no significant change in mean arterial blood pressure and pulse rate. Conclusions: Therapy with cilnidipine resulted in complete resolution of amlodipine-induced edema in all the cases without significant worsening of hypertension or tachycardia. Cilnidipine is an acceptable alternative antihypertensive for patients with amlodipine-induced edema. PMID:23378956

Shetty, Ranjan; Vivek, G; Naha, Kushal; Tumkur, Anil; Raj, Abhinav; Bairy, K L

2013-01-01

141

Parietal Occipital Edema in Hypertensive Encephalopathy: A Pathogenic Mechanism  

Microsoft Academic Search

Eight patients with hypertensive encephalopathy from diverse etiologies developed cerebral edema in the vertebrobasilar distribution which resolved after blood pressure was lowered. Parietal occipital edema is a recognized feature of hypertensive encephalopathy. The explanation for this regional pathological variation in hypertensive encephalopathy remains undefined. Some evidence suggests that sympathetic innervation of the anterior cerebral vasculature may be protective, and conversely,

Raj D. Sheth; Jack E. Riggs; John B. Bodenstenier; Alvoro R. Gutierrez; Leena M. Ketonen; Orlando A. Ortiz

1996-01-01

142

Automatic classification of diabetic macular edema in digital fundus images  

Microsoft Academic Search

Diabetic macular edema is a common complication of diabetic retinopathy due to the presence of exudates in proximity with the fovea. In this paper, an automated method to classify diabetic macular edema is presented. The fovea is localized and the regions of macula are marked based on the Early Treatment Diabetic Retinopathy Studies (ETDRS) grading scale. Extraction method using marker-controlled

S. T. Lim; W. M. D. W. Zaki; A. Hussain; S. L. Lim; S. Kusalavan

2011-01-01

143

Treatment of vulvar intraepithelial neoplasia with topical imiquimod: Seven years median follow-up of a randomized clinical trial  

Microsoft Academic Search

ObjectiveRecently we reported on the efficacy of imiquimod for treating vulvar intraepithelial neoplasia (VIN) in a placebo-controlled, double-blinded randomized clinical trial (RCT). Four weeks after treatment, a complete response was observed in 35% of patients and a partial response in 46%. All complete responders remained disease-free at 12months follow-up. In the current investigations, we assessed long-term follow-up at least 5years

Annelinde Terlou; Manon van Seters; Patricia C. Ewing; Neil K. Aaronson; Chad M. Gundy; Claudia Heijmans-Antonissen; Wim G. V. Quint; Leen J. Blok; Marc van Beurden; Theo J. M. Helmerhorst

2011-01-01

144

Vulvar carcinoma  

Microsoft Academic Search

Opinion statement  Carcinoma of the vulva is an uncommon gynecologic malignancy primarily affecting postmenopausal women. The lesion is most\\u000a commonly associated with HPV DNA, although, for many, a defined preinvasive to invasive connection is not readily apparent.\\u000a Most patients experience symptoms of pruritus, irritation, and even pain for weeks or months before the diagnostic biopsy\\u000a is performed. Patient embarrassment and unfamiliarity

Robert L. Coleman; Joseph T. Santoso

2000-01-01

145

Vulvar Cancer  

MedlinePLUS

... how advanced the cancer is. It might include surgery, radiation therapy, chemotherapy, or biologic therapy. Biologic therapy boosts your body's own ability to fight cancer. NIH: National Cancer Institute

146

Ospemifene for the treatment of dyspareunia associated with vulvar and vaginal atrophy: potential benefits in bone and breast.  

PubMed

Ospemifene is a selective estrogen receptor modulator (SERM), or estrogen receptor agonist/antagonist, that was recently approved by the US Food and Drug Administration for the treatment of dyspareunia associated with vulvar and vaginal atrophy, a chronic condition that affects up to 60% of postmenopausal women. Ospemifene is the first and only nonestrogen compound approved for this indication. Compared with other approved SERMs, such as tamoxifen, toremifene, bazedoxifene, and raloxifene, the estrogen-like effects of ospemifene in the vaginal epithelium are unique. This review first discusses the rationale for developing ospemifene, including its mechanism of action, and then focuses on the clinical development of ospemifene for the treatment of dyspareunia associated with vulvar and vaginal atrophy. Included are discussions of the effects of ospemifene on the endometrium, serum lipids, coagulation markers, bone, and breast cancer. In conclusion, ospemifene is a SERM with a unique estrogen agonist/antagonist tissue profile that was recently approved in the US for the treatment of dyspareunia associated with vulvar and vaginal atrophy in postmenopausal women. Ospemifene warrants further clinical investigation for the treatment and prevention of osteoporosis and breast cancer. PMID:24109197

Soe, Lin H; Wurz, Gregory T; Kao, Chiao-Jung; Degregorio, Michael W

2013-01-01

147

Painless transient bone marrow edema syndrome in a pediatric patient.  

PubMed

Transient regional migratory osteoporosis, considered to be part of the spectrum of bone marrow edema syndrome, is a rare condition with an unknown etiology. Patients usually present with lower extremity pain, most commonly in the 4th-5th decades of life. We describe a 15-year-old male patient with type 1 Gaucher disease who presented with transient bone marrow edema syndrome with features most closely resembling regional migratory osteoporosis. The patient presented with bone marrow edema of the lateral tibial epiphysis of his right knee that was incidentally seen on routine surveillance MRI that was performed as protocol for patients with type 1 Gaucher disease on enzyme replacement therapy. At this time, the patient had no pain and physical examination was normal. Follow-up MRI of the right knee 4 months afterward showed complete resolution of the signal abnormality in the right tibial epiphysis, and repeat study 8 months later displayed a new focus of painless migratory edema of the medial tibial epiphysis of the same knee. These changes completely resolved as well. Marrow signal abnormalities in children with Gaucher disease can have a broad differential, including infection, marrow infiltration, trauma, osteonecrosis, and bone marrow edema syndrome, amongst others. Correct diagnosis of bone marrow edema syndrome is critical, as this disease process most often resolves on conservative measures. The unusual presentation of transient bone marrow edema syndrome with regional migratory osteoporosis features in a young patient with Gaucher disease is described. PMID:24893724

Joshi, Vivek; Hermann, George; Balwani, Manisha; Simpson, William L

2014-11-01

148

Comparison of human papillomavirus detections in urine, vulvar, and cervical samples from women attending a colposcopy clinic.  

PubMed

While urine-based sampling for human papillomavirus (HPV) is being explored as a simple and noninvasive approach for cervical cancer screening, data comparing HPV genotyping in urine and those in cellular sampling of the cervix and vulva, and their correlation with rigorously confirmed cervical disease status, are sparse. We performed HPV genotyping on voided-urine and clinician-collected vulvar and cervical samples from 72 women undergoing colposcopy. Although urine-based HPV carcinogenic HPV detection was lower (58.3%) than cervical (73.6%) and vulvar (72.1%) detection (P = 0.05 and 0.07, respectively), the agreement of urine HPV with cervical and vulvar HPV was moderate (kappa = 0.55) and substantial (kappa = 0.62), respectively. Urine-based carcinogenic HPV detection had a clinical sensitivity of 80.8% (95% confidence interval [CI] = 60.7 to 93.5) and a specificity of 53.3% (95% CI = 37.9 to 68.3) for diagnosing cervical intraepithelial neoplasia grades 2/3 (CIN2/3) on histology; 90.0% of CIN3 was positive for urine HPV. The corresponding sensitivity and specificity values for vulvar sampling were 92% (95% CI = 74 to 99) and 40.5% (95% CI = 25.6 to 56.7), and those for cervical sampling were 96.2% (95% CI = 80.4 to 99.9) and 40% (95% CI = 25.7 to 55.7), respectively. HPV16 was the most common carcinogenic genotype detectable in 25% of urine, 33.8% of vulvar, and 31.9% of cervical samples overall, with prevalence increasing with cervical disease grade, regardless of the sampling method. Stronger cervical HPV PCR signal strengths were associated with increased frequency of urine HPV detection. In summary, the relatively lower detection rates but comparable clinical performance of urine-based HPV sampling underscore the need for larger studies to evaluate urine-based sampling for cervical cancer screening, epidemiologic studies, and postvaccination HPV disease surveillance. PMID:24197879

Sahasrabuddhe, Vikrant V; Gravitt, Patti E; Dunn, S Terence; Brown, David; Allen, Richard A; Eby, Yolanda J; Smith, Katie; Zuna, Rosemary E; Zhang, Roy R; Gold, Michael A; Schiffman, Mark; Walker, Joan L; Castle, Philip E; Wentzensen, Nicolas

2014-01-01

149

Novel inhibitors of Anthrax edema factor  

PubMed Central

Several pathogenic bacteria produce adenylyl cyclase toxins, such as the edema factor (EF) of Bacillus anthracis. These disturb cellular metabolism by catalyzing production of excessive amounts of the regulatory molecule cAMP. Here, a structure-based method, where a 3D- pharmacophore that fit the active site of EF was constructed from fragments, was used to identify non-nucleotide inhibitors of EF. A library of small molecule fragments was docked to the EF- active site in existing crystal structures and those with the highest HINT scores were assembled into a 3D-pharmacophore. About 10,000 compounds, from over 2.7 million compounds in the ZINC database, had a similar molecular framework. These were ranked according to their docking scores, using methodology that was shown to achieve maximum accuracy (i.e., how well the docked position matched the experimentally determined site for ATP analogues in crystal structures of the complex). Finally, 19 diverse compounds with the best AutoDock binding/docking scores were assayed in a cell based assay for their ability to reduce cAMP secretion induced by EF. Four of the test compounds, from different structural groups, inhibited in the low micromolar range. One of these has a core structure common to phosphatase inhibitors previously identified by high-throughput assays of a diversity library. Thus, the fragment based pharmacophore identified a small number of diverse compounds for assay, and greatly enhanced the selection process of advanced lead compounds for combinatorial design. PMID:18620864

Chen, Deliang; Misra, Milind; Sower, Laurie; Peterson, Johnny W.; Kellogg, Glen E.; Schein, Catherine H.

2008-01-01

150

A clinical overview of bone marrow edema.  

PubMed

Bone marrow edema (BME) is a descriptive term which identifies a specific magnetic resonance imaging (MRI) pattern that can be observed in a number of clinical entities, which are often characterized by pain as their main symptom, but show significant differences in terms of histopathological findings, causal mechanisms and prognosis. Bone marrow lesions in the subchondral bone of subjects with knee osteoarthritis (OA) seem to be associated with pain and progression of cartilage damage over time. Some histopathological studies of advanced OA have shown a prevalent fibrosis and bone marrow necrosis. BME of the subchondral bone in rheumatoid arthritis is associated with an infiltrate of inflammatory cells and osteoclasts and has a predictive value of further development of erosions. In spondyloarthritis, BME of the sacroiliac joints identifies an active sacroiliitis and is associated with histological inflammation and radiographic progression, whereas the relationship between BME lesions of the spine and syndesmophyte development is still controversial. BME syndromes (BMES), such as transient osteoporosis of the hip, regional migratory osteoporosis, and transient post-traumatic BMES, are characterized by a BME pattern on MRI and a self-limiting course. The potential evolution of BMES toward osteonecrosis is still controversial. PMID:25069499

Manara, M; Varenna, M

2014-01-01

151

Patterns of diabetic macular edema with optical coherence tomography  

Microsoft Academic Search

PURPOSE: We report cross-sectional images of diabetic macular edema and correlation between tomographic features and visual acuity with best correction by means of optical coherence tomography.METHOD: In a prospective study, optical coherence tomography was performed in 59 eyes of 42 patients with diabetic macular edema and in 10 eyes of 10 normal control subjects.RESULTS: Optical coherence tomography showed three patterns

Tomohiro Otani; Shoji Kishi; Yasuhiro Maruyama

1999-01-01

152

Appraising Pulmonary Edema Using Supine Chest Roentgenograms in Ventilated Patients  

Microsoft Academic Search

The role of portable, anteroposterior, supine chest X-rays (CXRs) in distinguishing hydrostatic pulmo- nary edema (HPE) from permeability pulmonary edema (PPE) in mechanically ventilated patients is controversial. We prospectively obtained and evaluated such CXRs in 33 supine, mechanically venti- lated intensive-care-unit patients with pulmonary artery catheters. Three chest radiologists indepen- dently reviewed CXRs without clinical information and recorded the cardiothoracic

JASON W. W. THOMASON; E. WESLEY ELY; CAROLINE CHILES; GILBERT FERRETTI; RITA I. FREIMANIS; EDWARD F. HAPONIK

1998-01-01

153

Treatment of Brain Edema in Acute Liver Failure  

Microsoft Academic Search

Opinion statement  Cerebral edema is very common in patients with acute liver failure and encephalopathy. In severe cases, it produces brain\\u000a tissue shift and potentially fatal herniation. Brain swelling in acute liver failure is produced by a combination of cytotoxic\\u000a (cellular) and vasogenic edema. Accumulation of ammonia and glutamine leads to disturbances in the regulation of cerebral\\u000a osmolytes, increased free radical

Alejandro A. Rabinstein

2010-01-01

154

Negative pressure pulmonary edema after acute upper airway obstruction  

Microsoft Academic Search

Study Objectives: To review the clinical characteristics and the pathogenesis of negative pressure pulmonary edema, and to determine its incidence in surgical patients.Design: Retrospective case-report study.Setting: Operating room, postanesthesia care unit and surgical intensive care of a teaching hospital.Patients: 30 surgical adult ASA physical status I, II, III, IV, and V patients who suffered from negative pressure pulmonary edema during

Krishnaprasad Deepika; Charbel A. Kenaan; Alex M. Barrocas; Janett J. Fonseca; George B. Bikazi

1997-01-01

155

Disk Edema and Cranial MRI Optic Nerve Enhancement  

Microsoft Academic Search

A 43-year-old woman presented with painful visual loss and optic disk edema in the right eye (OD) diagnosed as optic neuritis. Initial non–gadolinium-enhanced fat suppressed cranial magnetic resonance imaging (MRI) was normal. Three months later, the disk edema persisted and a gadolinium-enhanced MRI scan of the brain and orbits with fat suppression showed enhancement of the optic nerve OD, most

Michael S Vaphiades

2001-01-01

156

Raised Leg Exercises for Leg Edema in the Elderly  

Microsoft Academic Search

Leg edema is a common problem in the elderly and requires further evaluation and management. Method: From October 1990 to July 1992, 245 patients presented to the Cleveland Clinic Florida with leg edema. All patients were counseled about the benefits of twenty-minute, three-times-a-day raised-leg exercises. Fifty seven (57) of the 245 patients were not compliant with this regimen (nonexercise group).

Jerry O. Ciocon; Daisy Galindo-Ciocon; Diana J. Galindo

1995-01-01

157

Evaluation of brain edema using magnetic resonance proton relaxation times.  

PubMed

Experimental and clinical studies on the evaluation of water content in cases of brain edema were performed in vivo, using MR proton relaxation times (longitudinal relaxation time, T1; transverse relaxation time, T2). Brain edema was produced in the white matter of cats by the direct infusion method. The correlations between proton relaxation times obtained from MR images and the water content of white matter were studied both in autoserum-infused cats and in saline-infused cats. The correlations between T1 as well as T2 and the water content in human vasogenic brain edema were also examined and compared with the data obtained from the serum group. T1 and T2 showed good correlations with the water content of white matter not only in the experimental animals but also in the clinical cases. The quality of the edema fluid did not influence relaxation time and T1 seemed to represent almost solely the water content of the tissue. T2, however, was affected by the nature of existence of water and was more sensitive than T1 in detecting extravasated edema fluid. It seems feasible therefore to evaluate the water content of brain edema on the basis of T1 values. PMID:2396512

Fu, Y; Tanaka, K; Nishimura, S

1990-01-01

158

An update on vulvar intraepithelial neoplasia: terminology and a practical approach to diagnosis.  

PubMed

There are two distinct types of vulvar intraepithelial neoplasia (VIN), which differ in their clinical presentation, aetiology, pathogenesis and histological/immunophenotypical features. One form driven by high-risk human papilloma virus infection usually occurs in young women and has been termed classic or usual VIN (uVIN). The other, not related to viral infection, occurs in postmenopausal women with chronic skin conditions such as lichen sclerosus and lichen simplex chronicus and is termed differentiated or simplex-type VIN. The latter is the precursor lesion of the most common type of squamous cell carcinoma (SCC) in the vulva, namely keratinizing SCC (representing 60% of cases). In contrast, uVIN usually gives rise to basaloid or warty SCC (40% of cases). The histological features of uVIN are similar to those of high grade lesions encountered in other lower anogenital tract sites (hyperchomatic nuclei with high nuclear to cytoplasmic ratios and increased mitotic activity). However, differentiated VIN has very subtle histopathological changes and often escapes diagnosis. Since uVIN is driven by high-risk human papilloma virus infections, p16 immunohistochemistry is diffusely positive in these lesions and is characterized with a high Ki-67 proliferation index. In contrast, differentiated or simplex-type VIN is consistently negative for p16 and the majority of the cases harbour TP53 mutations, correlating with p53 positivity by immunohistochemistry. PMID:24399036

Reyes, M Carolina; Cooper, Kumarasen

2014-04-01

159

The significance of the histologic alterations adjacent to invasive vulvar carcinoma.  

PubMed

It has been superficially recognized, but not appreciated, that carcinoma of the vulva differs in many respects from carcinoma of the uterine cervix. Past studies have suggested that "leukoplakia and leukoplakia-like lesions" are probably premalignant conditions since they are commonly associated with invasive cancer. Conversely, studies of the dystrophies during the past 15 years have indicated that the latter uncommonly progress to invasive cancer if treated adequately. In an attempt to review the histopathologic changes associated with invasive cancer, the last 98 cases of invasive disease were studied and the histopathologic characteristics of the adjacent tissue were divided into categories. It was noted that less than 20% of the invasive cancers demonstrated classic in situ neoplasia in the adjacent area, whereas more than 50% showed patterns suggestive of the dystrophies. Thus, although the dystrophies were not necessarily the precursory lesions, they did demonstrate probable long-term irritation, which is of major importance in the genesis of vulvar cancer. Furthermore, in situ cancer, as seen in the young patient, rarely seems to progress to invasive disease. PMID:7405987

Buscema, J; Stern, J; Woodruff, J D

1980-08-15

160

Sentinel lymph node detection and accuracy in vulvar cancer: Experience of a tertiary center in Turkey  

PubMed Central

Objective To explore the accuracy of sentinel lymph node (SLN) dissection in predicting regional lymph node status by using either only Technetium-99m-labelled (Tc-99m) or in combination with a blue dye in patients with squamous cell cancer of vulva. Material and Methods Twenty-one patients who had T1 (?2 cm) or T2 (>2cm) tumors that did not encroach into the urethra, vagina or anus were included in the study. For the first twelve patients, Tc-99m was used for SLN identification, and the combined technique was used in subsequent patients. Preoperatively, Tc-99m and a blue dye was injected intradermally around the tumor. Following SLN dissection, complete inguinofemoral lymphadenectomy was performed. Results We could detect SLN in all 21 patients (100%) by either Tc-99m or the combined method. SLN was found to be histopathologically negative in 13 groins via Tc-99m and 10 groins via the combined method. Twenty-one of these 23 (91.3%) groin non-SLN were also negative, but in two groins, we detected metastatic non-SLN. Conclusion Although SLN dissection appears promising in vulvar cancer, false negative cases are reported in the literature. Sentinel lymph node dissection without complete lymphadenectomy does not seem appropriate for routine clinical use, since it is known that groin metastasis is fatal. PMID:24592094

Boran, Nurettin; C?r?k, Derya Akdag; Is?kdogan, Zuhal; K?r, Metin; Turan, Taner; Tulunay, Gokhan; Kose, Mehmet Faruk

2013-01-01

161

Treatment of vulvar/vaginal condyloma by HPV: developed instrumentation and clinical report  

NASA Astrophysics Data System (ADS)

Human papillomavirus (HPVs) are a family of sexually viruses with over 100 different genotypes identified till date. They are associated in 99% of cervical cancers, with HPV16 found in about 50% of cases. They are a cause of the second most common female cancer worldwide. PDT may constitute an alternative treatment for condyloma by HPV. In this work we present the development of a PDT device specifically designed for the treatment of vulvar and vaginal lesions induced by HPV. This equipment has been used in a clinical protocol and it is optically based on 640 nm LED (light emitting diodes) arrays. There are three illumination probes available that were anatomically designed for specific site applications: a 30 mm x 115 mm diffuser cylinder for intravaginal illumination and uniform irradiance of 42 mW/cm2; a 36 mm circular probe with 118 mW/cm2 and a 74 mm circular probe with 57 mW/cm2, both for external illumination. The 10% aminolevulinic acid cream is topically placed over the lesions and 4-6 hours after the application the illumination is performed. The illumination time is set depending on the chosen probe and treatment area to achieve a fluence of 200 J/cm2. In this presentation, the preliminary results of this clinical trial will be presented.

Inada, N. M.; Kurachi, C.; Ferreira, J.; Ribeiro, E. S.; Guimarães, O. C. C.; Quintana, S. M.; Lombardi, W.; Bagnato, V. S.

2009-06-01

162

[Negative pressure pulmonary edema. Post-obstructive lung edema after use of a laryngeal mask].  

PubMed

A 31-year-old male patient was scheduled for surgical treatment of a distal radius fracture under general anaesthesia using a laryngeal mask airway and spontaneous ventilation. The intraoperative course was uneventful. During recovery, the patient strongly bit the laryngeal mask, producing a complete obstruction of the artificial airway in combination with very forceful inspiratory efforts until the mask was removed. In the recovery room the patient developed dyspnea and desaturation. A portable chest radiograph demonstrated bilateral alveolar infiltration suggesting pulmonary edema. The patient was transferred to the intensive care unit where drug therapy (furosemide and hydrocortisone) and treatment with the continuous flow continuous positive airway pressure (CF-CPAP) system led to complete recovery within 24 h. PMID:16132936

Sickmann, K; Seider, R; Dahm, M; Nold, H

2005-12-01

163

Glyburide in Treating Malignant Cerebral Edema. Blocking Sulfonyl Urea One (SUR1) Receptors  

PubMed Central

Cerebral edema is a serious side effect of malignant stroke. On average 70,000 patients are diagnosed with malignant cerebral edema every year, of those patients, approximately 60-80% results in fatalities. The treatment of cerebral edema includes multimodality approaches. In this article, we discuss our experience with glibenclamide in the treatment for malignant cerebral edema. Our study indicates that glibenclamide may decrease cerebral edema by blocking SUR1 receptors in ischemic stroke and non-ischemic etiologies.

Ahmed, Iftekhar

2014-01-01

164

Laparoscopy to Evaluate Scrotal Edema During Peritoneal Dialysis  

PubMed Central

Background: Acute scrotal edema is an infrequent complication in patients who undergo continuous ambulatory peritoneal dialysis (CAPD), occurring in 2% to 4% of patients. Inguinal hernia is usually the cause, but the diagnosis is sometimes confusing. Imaging modalities such as computed tomographic peritoneography are helpful but can be equivocal. We have used diagnostic laparoscopy in conjunction with open unilateral or bilateral hernia repair for diagnosis and treatment of peritoneal dialysis (PD) patients with acute scrotal edema. Technique and Cases: Three patients with acute scrotal edema while receiving CAPD over the span of 7 years had inconclusive results at clinical examination and on diagnostic imaging. All patients underwent diagnostic laparoscopy that revealed indirect inguinal hernia, which was concomitantly repaired using an open-mesh technique. Results: Diagnostic laparoscopy revealed the etiology of the scrotal edema 100% of the time, with no complications, and allowed concomitant repair of the hernia. One patient had postoperative catheter outflow obstruction, which was deemed to be unrelated to the hernia repair. Conclusion: Diagnostic laparoscopy is helpful in confirming the source of acute scrotal edema in CAPD patients and can be performed in conjunction with an open-mesh repair with minimal added time or risk. PMID:24018081

Jorge, Juaquito M.

2013-01-01

165

Edema can be a handicap in treatment of anorexia nervosa.  

PubMed

Anorexia and bulimia nervosa are common in western civilized countries. They are among the psychiatric disorders in that they are often accompanied by a variety of life-threatening physical abnormalities. These patients need a close follow-up of the pediatrician in collaboration with the psychiatrist since the changes in bodily functions affect the psychiatric therapy. The challenge to the physician is to use the traditional tools of medicine to diagnose and treat these physical abnormalities using careful medical history, a complete physical examination and appropriate laboratory testing. Peripheral edema is seen as a physical finding in anorexia nervosa (AN) and it is not rare. The estimated frequency is up to 20% among adolescent patients. Peripheral edema in this setting can be easily confused as weight gain. There are five possible mechanisms for its occurrence: hypoproteinemia, electrolyte imbalance, hormonal changes, rapid refeedings, and abuse of laxative, diuretics and diet pills. Patients with eating disorders may ingest a large number of drugs in an attempt to control their weight. We present a case of a female adolescent with AN and peripheral edema who terminated her psychiatric treatment during the refeeding phase because of the unbearable anxiety caused by this edema that affected her body image dramatically. With this case study, we point out the importance of assessing peripheral edema and discriminating it from true weight gain. PMID:20196395

Derman, Orhan; Kiliç, Emine Zinnur

2009-01-01

166

Management of venous edema: insights from an international task force.  

PubMed

An International Task Force made up of a panel of 16 experts has reviewed and objectively evaluated all aspects of chronic venous disease of the leg (CVDL). All available publications on CVDL from 1983 to 1997 were identified through computerized search in Medline and by a manual search. Next, three different screenings were performed in order to select only relevant papers providing a level of scientific evidence that was considered moderate to strong. Final conclusions and further therapeutic recommendations were made based on these publications. Medication, compression, local therapy, sclerotherapy, and surgery are the accepted available therapeutic options for CVDL. For edema, the following recommendations can be made: edema is an early sign of CVDL, but before starting any treatment, nonvenous causes of edema should be excluded. Medication and compression are the therapeutic options for edema that are accepted by the Task Force. Evaluation of their efficacy is based on objective measures of edema. Several well-conducted, placebo-controlled trials have shown efficacy of drugs such as micronized purified flavonoid fraction, rutosides, calcium dobesilate, and coumarin rutin. Graduated compression stockings have been shown to be effective; compression needs to be exerted at least at 35 mm Hg. Bandages, if properly applied, both fixed and stretched, can produce favorable results. Sclerotherapy or surgery is not indicated unless there is saphenofemoral or saphenopopliteal reflux. In the absence of such reflux or following deep venous thrombosis, there is no evidence to support sclerotherapy or surgery. PMID:10667638

Clement, D L

2000-01-01

167

Regression of diabetic macular edema after subcutaneous exenatide.  

PubMed

The aim of this study is to report a case of complete regression of diabetic macular edema after subcutaneous injection of exenatide in a patient with type 2 diabetes mellitus. This study is an interventional case report. Blood investigations, complete ophthalmic examinations and optical coherence tomography were performed. A 55-year-old female affected by poorly controlled type 2 diabetes mellitus presented with visual impairment due to macular edema in the right eye. The left eye showed mild edema without visual loss. Best-corrected visual acuity (BCVA) was 20/80 and 20/20, respectively. The patient was encouraged to improve metabolic control, and the antidiabetic therapy was modified combining exenatide 10 ?g subcutaneously twice daily to her regimen of oral metformin. The patient did not receive any ocular treatment. A complete tomographic resolution of macular edema was observed after 1 month and BCVA improved to 20/63. These findings were confirmed for the entire 6-month follow-up duration. No ocular or non-ocular adverse events were recorded. This is the first reported case of complete regression of macular edema in a diabetic patient after subcutaneous injection of exenatide. PMID:23925692

Sarao, Valentina; Veritti, Daniele; Lanzetta, Paolo

2014-06-01

168

Interobserver variability and the effect of education in the histopathological diagnosis of differentiated vulvar intraepithelial neoplasia.  

PubMed

No published data concerning intraobserver and interobserver variability in the histopathological diagnosis of differentiated vulvar intraepithelial neoplasia (DVIN) are available, although it is widely accepted to be a subtle and difficult histopathological diagnosis. In this study, the reproducibility of the histopathological diagnosis of DVIN is evaluated. Furthermore, we investigated the possible improvement of the reproducibility after providing guidelines with histological characteristics and tried to identify histological characteristics that are most important in the recognition of DVIN. A total number of 34 hematoxylin and eosin-stained slides were included in this study and were analyzed by six pathologists each with a different level of education. Slides were reviewed before and after studying a guideline with histological characteristics of DVIN. Kappa statistics were used to compare the interobserver variability. Pathologists with a substantial agreement were asked to rank items by usefulness in the recognition of DVIN. The interobserver agreement during the first session varied between 0.08 and 0.54, which slightly increased during the second session toward an agreement between -0.01 and 0.75. Pathologists specialized in gynecopathology reached a substantial agreement (kappa 0.75). The top five of criteria indicated to be the most useful in the diagnosis of DVIN included: atypical mitosis in the basal layer, basal cellular atypia, dyskeratosis, prominent nucleoli and elongation and anastomosis of rete ridges. In conclusion, the histopathological diagnosis of DVIN is difficult, which is expressed by low interobserver agreement. Only in experienced pathologists with training in gynecopathology, kappa values reached a substantial agreement after providing strict guidelines. Therefore, it should be considered that specimens with an unclear diagnosis and/or clinical suspicion for DVIN should be revised by a pathologist specialized in gynecopathology. When adhering to suggested criteria the diagnosis of DVIN can be made easier. PMID:23370772

van den Einden, Loes C G; de Hullu, Joanne A; Massuger, Leon F A G; Grefte, Johanna M M; Bult, Peter; Wiersma, Anne; van Engen-van Grunsven, Adriana C H; Sturm, Bart; Bosch, Steven L; Hollema, Harry; Bulten, Johan

2013-06-01

169

Tumor proteomics by multivariate analysis on individual pathway data for characterization of vulvar cancer phenotypes.  

PubMed

Vulvar squamous cell carcinoma (VSCC) is the fourth most common gynecological cancer. Based on etiology VSCC is divided into two subtypes; one related to high-risk human papilloma virus (HPV) and one HPV negative. The two subtypes are proposed to develop via separate intracellular signaling pathways. We investigated a suggested link between HPV infection and relapse risk in VSCC through in-depth protein profiling of 14 VSCC tumor specimens. The tumor proteomes were analyzed by liquid-chromatography tandem mass spectrometry. Relative protein quantification was performed by 8-plex isobaric tags for relative and absolute quantification. Labeled peptides were fractionated by high-resolution isoelectric focusing prior to liquid-chromatography tandem mass spectrometry to reduce sample complexity. In total, 1579 proteins were regarded as accurately quantified and analyzed further. For classification of clinical groups, data analysis was performed by comparing protein level differences between tumors defined by HPV and/or relapse status. Further, we performed a biological analysis on individual tumor proteomes by matching data to known biological pathways. We here present a novel analysis approach that combines pathway alteration data on individual tumor level with multivariate statistics for HPV and relapse status comparisons. Four proteins (signal transducer and activator of transcription-1, myxovirus resistance protein 1, proteasome subunit alpha type-5 and legumain) identified as main classifiers of relapse status were validated by immunohistochemistry (IHC). Two of the proteins are interferon-regulated and on mRNA level known to be repressed by HPV. By both liquid-chromatography tandem mass spectrometry and immunohistochemistry data we could single out a subgroup of HPV negative/relapse-associated tumors. The pathway level data analysis confirmed three of the proteins, and further identified the ubiquitin-proteasome pathway as altered in the high risk subgroup. We show that pathway fingerprinting with resolution on individual tumor level adds biological information that strengthens a generalized protein analysis. PMID:22499770

Sandberg, Annsofi; Lindell, Gunnel; Källström, Brita Nordström; Branca, Rui Mamede; Danielsson, Kristina Gemzell; Dahlberg, Mats; Larson, Barbro; Forshed, Jenny; Lehtiö, Janne

2012-07-01

170

Kawasaki Disease with Retropharyngeal Edema following a Blackfly Bite  

PubMed Central

We describe a patient with Kawasaki disease (KD) and retropharyngeal edema following a blackfly bite. An 8-year-old boy was referred to our hospital because of a 3-day-history of fever and left neck swelling and redness after a blackfly bite. Computed tomography of the neck revealed left cervical lymph nodes swelling with edema, increased density of the adjacent subcutaneous tissue layer, and low density of the retropharyngeum. The patient was initially presumed to have cervical cellulitis, lymphadenitis, and retropharyngeal abscess. He was administered antibiotics intravenously, which did not improve his condition. The patient subsequently exhibited other signs of KD and was diagnosed with KD and retropharyngeal edema. Intravenous immunoglobulin therapy and oral flurbiprofen completely resolved the symptoms and signs. A blackfly bite sometimes incites a systemic reaction in humans due to a hypersensitive reaction to salivary secretions, which may have contributed to the development of KD in our patient.

Watanabe, Toru

2014-01-01

171

Primary Tumor Vascularity, HIF-1? and VEGF expression in vulvar squamous cell carcinomas: their relationships with clinicopathological characteristics and prognostic impact  

PubMed Central

Background Increased vascularity is a crucial event in the tumor progression and has prognostic significance in various cancers. However, the ultimate role of angiogenesis in the pathogenesis and clinical outcome of vulvar carcinoma patients is still not settled. Methods Tumor vascularity using CD34 stained slides measured by Chalkley counting method as well as hypoxia-inducible factor (HIF)-1? and vascular endothelial growth factor (VEGF) immunoexpression was examined in 158 vulvar squamous cell carcinomas. Associations between vascular Chalkley count, HIF-1? and VEGF expression and clinicopathological factors and clinical outcome were evaluated. Results High CD34 Chalkley count was found to correlate with larger tumor diameter (P = 0.002), deep invasion (P < 0.001) and HIF-1? (P = 0.04), whereas high VEGF expression correlate significantly with poor tumor differentiation (P = 0.007). No significant association between CD34 Chalkley counts and VEGF expression and disease-specific survival was observed. High HIF-1? expression showed better disease specific survival in both univariate and multivariate analyses (P = 0.001). Conclusions A significant association between high tumor vascularity and larger tumor size as well as deeper tumor invasion suggests an important role of angiogenesis in the growth and progression of vulvar carcinomas. HIF-1? expression in vulvar carcinomas was a statistically independent prognostic factor. PMID:24165149

2013-01-01

172

Resolution of macular edema in idiopathic juxtafoveal telangiectasis using PDT.  

PubMed

A 57-year-old woman was treated by photodynamic therapy for macular edema due to idiopathic juxtafoveal telangiectasis (presumed type 1A) without subretinal neovascularization. Initial visual acuity of the treated eye was 20/200 and it improved to 20/40 by 3 months after the photodynamic therapy session. Visual acuity remained stable 32 months after the treatment. Color photographs and fundus fluorescein angiography before and after photodynamic therapy revealed regression of hemorrhages, exudates, and fluorescein leakage. Photodynamic therapy has long-term benefits for the patient with idiopathic juxtafoveal telangiectasis, presumed type 1A, because it can improve visual acuity and macular edema. PMID:19205501

Kotoula, Maria G; Chatzoulis, Dimitrios Z; Karabatsas, Constantinos H; Tsiloulis, Aristoteles; Tsironi, Evangelia E

2009-01-01

173

Flash pulmonary edema in an orthotopic heart transplant recipient.  

PubMed

Flash pulmonary edema (FPE) is a severe renovascular disease that leads to acute recurring pulmonary edema and acute systemic hypertension. Though rarely reported in the literature, its incidence is probably underestimated secondary to misdiagnosis, especially in patients with normal left ventricular function. We report the case of an orthotopic heart transplant recipient who presented with FPE despite having normal left ventricular function and no signs or symptoms of transplant rejection. Discovery of severe bilateral atherosclerotic renal artery stenosis in this patient led to emergency hepatorenal bypass surgery and a favorable postoperative course. PMID:21118836

Kindo, Michel; Gerelli, Sébastien; Billaud, Philippe; Mazzucotelli, Jean-Philippe

2011-02-01

174

Viral Load, Integration and Methylation of E2BS3 and 4 in Human Papilloma Virus (HPV) 16-Positive Vaginal and Vulvar Carcinomas  

PubMed Central

Objective To investigate if viral load, integration and methylation of E2BS3 and 4 represent different ways of tumor transformation in vaginal and vulvar carcinoma and to elucidate its clinical impact. Methods Fifty-seven samples, positive for HPV16, were selected for the study. Detection of viral load was made with realtime-PCR using copy numbers of E6 and integration was calculated from comparing E2 to E6-copies. Methylation of E2BS3 and 4 was analysed using bisulphite treatment of tumor DNA, followed by PCR and pyrosequencing. Results Vaginal tumors were found to have a higher viral load (p?=?0.024) compared to vulvar tumors but a high copy number (> median value, 15 000) as well as high methylation (>50%) was significantly (p?=?0.010 and p?=?0.045) associated with a worse cancer-specific survival rate in vulvar carcinoma, but not in vaginal carcinoma. Four groups could be defined for the complete series using a Cluster Two step analysis; (1) tumors holding episomal viral DNA, viral load below 150 000 copies not highly methylated (n?=?25, 46.3%); (2) tumors harboring episomal viral DNA and being highly methylated (>50%; n?=?6, 11.1%); (3) tumors with viral DNA fully integrated (n?=?11, 20.4%), and (4) tumors harboring episomal viral DNA and being medium- or unmethylated (<50%) and having a high viral load (> total mean value 150 000; n?=?12, 22.2%). The completely integrated tumors were found to be distinct group, whilst some overlap between the groups with high methylation and high viral load was observed. Conclusion HPV16- related integration, methylation in E2BS3 and 4 and viral load may represent different viral characteristics driving vaginal and vulvar carcinogenesis. HPV16- related parameters were found to be of clinical importance in the vulvar series only. PMID:25393237

Lillsunde Larsson, Gabriella; Helenius, Gisela; Sorbe, Bengt; Karlsson, Mats G.

2014-01-01

175

Variations in the vulvar temperature of sows during proestrus and estrus as determined by infrared thermography and its relation to ovulation.  

PubMed

The prediction of ovulation time is one of the most important and yet difficult processes in pig production, and it has a considerable impact on the fertility of the herd and litter size. The objective of this study was to assess the vulvar skin temperature of sows during proestrus and estrus using infrared thermography and to establish a possible relationship between the variations in vulvar temperature and ovulation. The experimental group comprised 36 crossbred Large White × Landrace females, of which 6 were gilts and 30 were multiparous sows. Estrus was detected twice daily and the temperature was obtained every 6 hours from the vulvar area and from two control points in the gluteal area (Gluteal skin temperature [GST]). A third variable, vulvar-gluteal temperature (VGT) was obtained from the difference between the vulvar skin temperature and the GST values. The animals were divided into two subgroups: group A consisting of 11 animals with estrus detected at 6:00 AM, Day 4 postweaning, and group B comprising seven animals with estrus detected at 6:00 AM, Day 5 post-weaning. Both groups showed a similar trend in the VGT. The VGT increased during the proestrus, reaching a peak 24 hours before estrus in group A and 48 hours before estrus in group B. The VGT then decreased markedly reaching the lowest value in groups A and B, respectively, 12 and 6 hours after estrus. Although the time of ovulation was only estimated on the basis of a literature review, the matching between the temporal variations of the VGT values and the predicted time of the peak of estradiol secretion that ultimately leads to the ovulation processes suggests that the VGT values represent a potential predictive marker of the ovulatory events. PMID:25159660

Simões, Vasco G; Lyazrhi, Faouzi; Picard-Hagen, Nicole; Gayrard, Véronique; Martineau, Guy-Pierre; Waret-Szkuta, Agnès

2014-11-01

176

The use of Hypertonic Saline in the Treatment of Post-Traumatic Cerebral Edema: A Review  

Microsoft Academic Search

Effective methods for treating cerebral edema have recently become a matter of both extensive research and significant debate within the neurosurgery and trauma surgery communities. The pathophysiologic progression and outcome of different forms of cerebral edema associated with traumatic brain injury have yet to be fully elucidated. There are heterogeneous factors influencing the onset and progress of post-traumatic cerebral edema,

Jeffrey E. Catrambone; Wenzhuan He; Charles J. Prestigiacomo; Tracy K. McIntosh; Peter W. Carmel; Allen Maniker

2008-01-01

177

[Edema as a measure for severity of chronic venous insufficiency and efficacy of its treatment].  

PubMed

The author characterizes the edema as an important quantitative objective measure of severity for chronic venous diseases in both early and advanced stages. The problems of edema assessment methods and the importance of its management in clinical practice are discussed. The results of studies on the use of micronized purified flavonoid fraction (MPFF, Detralex) for edema syndrome coping are presented. PMID:19791434

Sapelkin, S V

2008-01-01

178

Ranibizumab for Macular Edema Due to Retinal Vein Occlusions: Implication of VEGF as a Critical Stimulator  

Microsoft Academic Search

Macular edema is a major cause of vision loss in patients with central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). It is not clear how much of the edema is due to hydrodynamic changes from the obstruction and how much is due to chemical mediators. Patients with macular edema due to CRVO (n = 20) or BRVO

Peter A Campochiaro; Gulnar Hafiz; Syed Mahmood Shah; Quan Dong Nguyen; Howard Ying; Diana V Do; Edward Quinlan; Ingrid Zimmer-Galler; Julia A Haller; Sharon D Solomon; Jennifer U Sung; Yasmin Hadi; Kashif A Janjua; Nida Jawed; David F Choy; Joseph R Arron

2008-01-01

179

Bilateral and simultaneous cystoid macular edema associated with latanoprost use: report of two cases.  

PubMed

Cystoid macular edema is an uncommon, but well known, side effect of latanoprost. Two cases of bilateral and simultaneous cystoid macular edema associated with latanoprost use are described, which complete resolution of the edema is observed upon drug discontinuation. PMID:20549052

Brasil, Oswaldo Ferreira Moura; Brasil, Maria Vitoria Moura; Ventura, Marcelo Palis; Maia, Hugo Soares

2010-01-01

180

A rare complication of generalized edema in juvenile dermatomyositis: a report of one case  

Microsoft Academic Search

Juvenile dermatomyositis (JDM) is a rare autoimmune disease characterized by inflammation of the muscle, connective tissue, skin, gastrointestinal tract and small nerves. Periorbital and facial edema may also be associated. Although localized edema is a common feature of juvenile dermatomyositis, generalized edema has been reported rarely. In this article, we report a 14-year-old boy with juvenile dermatomyositis presenting with generalized

Hamza Karabiber; Mehmet Aslan; Alpay Alkan; Cengiz Yakinci

2004-01-01

181

From symptoms to leg edema: efficacy of Daflon 500 mg.  

PubMed

This article reviews the mechanisms by which micronized purified flavonoid fraction (MPFF; Daflon 500 mg) acts on symptoms as well as on edema in patients with chronic venous disease, in the light of new advances in the understanding of the pathophysiology of this chronic condition. Deterioration of venous wall tone followed by valve dysfunction leading eventually to varicose veins are the key pathophysiologic features that produce venous hypertension. Both mechanical and biological factors are responsible for the deterioration of the venous wall in large veins. These are decreased shear stress and hypoxia of the media and of the endothelium, which act as triggering factors for biochemical reactions leading to inflammation. There is a body of evidence that inflammation in chronic venous insufficiency (CVI) plays a role right from the early stages of venous dysfunction and venous valve restructuring. The whole process of venous wall stretching and dilation is painful and may present as leg heaviness, a sensation of swelling, and paresthesia. Daflon 500 mg relieves symptoms, edema, and red blood cell aggregation, which cause paresthesia and restless legs. At the level of the microcirculation, dysfunction of microvessels is observed, characterized by an increase in capillary permeability followed by skin changes. The earliest manifestation of microcirculatory disorder is edema. At this level, Daflon 500 mg acts favorably on microcirculatory complications by normalizing the synthesis of prostaglandins and free radicals. It decreases bradykinin-induced microvascular leakage and inhibits leukocyte activation, trapping, and migration. Its efficacy in decreasing CVI edema and ankle swelling has been proven in rigorous studies that are reviewed in this paper. Daflon 500 mg, a well-established oral flavonoid that consists of 90% micronized diosmin and 10% flavonoids expressed as hesperidin, may be prescribed from the very beginning of the disease for the relief of pain and edema, and in any CVI patient presenting with symptoms as well. Daflon 500 mg is thus the first-line treatment for edema and symptoms of CVI at any stage of the disease. At advanced disease stages, Daflon 500 mg may be used in conjunction with sclerotherapy, surgery, and/or compression therapy or as an alternative treatment when other treatments are not indicated or not feasible. PMID:12934755

Nicolaides, Andrew N

2003-01-01

182

Intravitreal bevacizumab for macular edema due to occlusive vasculitis.  

PubMed

Systemic vasculitides can cause retinal vascular pathology, including cotton-wool spots, retinal hemorrhages, vascular occlusion, and capillary nonperfusion. Two main causes of visual decline include macular edema and retinal neovascularization. Presumably, both of these complications are caused by increased intraocular levels of vascular growth and permeability factors. We report a patient with occlusive retinal vasculitis associated with mixed connective tissue disease who was treated with intravitreal bevacizumab for chronic macular edema. One month after treatment, visual acuity improved from 20/80 to 20/60, and foveal thickness decreased from 543 microns to 306 microns. This effect persisted for at least 3 months after treatment. No complications, including increased retinal ischemia, were observed. PMID:17564933

Margolis, Ron; Lowder, Careen Y; Sears, Jonathan E; Kaiser, Peter K

2007-01-01

183

Fatal cerebral edema and intracranial hemorrhage associated with hypernatremic dehydration  

Microsoft Academic Search

We report neuroimaging findings of intracranial hemorrhage and cerebral edema in an infant with obtundation and seizures,\\u000a initially suspected to be secondary to non-accidental trauma but finally attributed to hypernatremic dehydration. Neuroimaging\\u000a findings due to hypernatremic dehydration have not been previously described in the radiologic literature. Hypernatremia should\\u000a be included in the differential diagnosis of intracranial hemorrhage in the infant

Raman Mocharla; Steven M. Schexnayder; Charles M. Glasier

1997-01-01

184

Fatal cerebral edema and intracranial hemorrhage associated with hypernatremic dehydration.  

PubMed

We report neuroimaging findings of intracranial hemorrhage and cerebral edema in an infant with obtundation and seizures, initially suspected to be secondary to non-accidental trauma but finally attributed to hypernatremic dehydration. Neuroimaging findings due to hypernatremic dehydration have not been previously described in the radiologic literature. Hypernatremia should be included in the differential diagnosis of intracranial hemorrhage in the infant without evidence of nonaccidental trauma. PMID:9323240

Mocharla, R; Schexnayder, S M; Glasier, C M

1997-10-01

185

Asymmetric Angioneurotic Edema Associated With Thrombolysis for Acute Stroke  

Microsoft Academic Search

We present a case of acute asymmetric angioneurotic edema associated with the use of recombinant tissue plasminogen activator (rtPA) for acute ischemic stroke. rtPA was administered for an acute ischemic stroke in accordance with the recently reported National Institute of Neurological Disorders and Stroke protocol, after which marked asymmetric angioedema requiring upper-airway control developed. Although atypical and anaphylactoid reactions have

Arthur Pancioli; Thomas Brott; Virginia Robertson; Rosie Miller

1997-01-01

186

Significance of bone marrow edema in pathogenesis of rheumatoid arthritis  

PubMed Central

Summary Assessing the pathology of the synovium, its thickening and increased vascularity through ultrasound and magnetic resonance examinations (more often an ultrasound study alone) is still considered a sensitive parameter in the diagnosis of rheumatoid arthritis and in monitoring of treatment efficacy. Magnetic resonance studies showed that, aside from the joint pannus, the subchondral bone tissue constitutes an essential element in the development of rheumatoid arthritis. Bone marrow edema correlates with inflammation severity, joint destruction, clinical signs and symptoms of rheumatoid arthritis, and thus is considered a predictor of rapid radiological progression of the disease. The newest studies reveal that bone marrow edema may be a more sensitive indicator of the response to therapy than appearance of the synovium. Bone marrow edema presents with increased signal in T2-weighted images, being most visible in fat saturation or IR sequences (STIR, TIRM). On the other hand, it is hypointense and less evident in T1-weighted images. It becomes enhanced (hyperintense) after contrast administration. Histopathological studies confirmed that it is a result of bone inflammation (osteitis/osteomyelitis), i.e. replacememt of bone marrow fat by inflammatory infiltrates containing macrophages, T lymphocytes, B lymphocytes, plasma cells and osteoclasts. Bone marrow edema appears after a few weeks from occurrence of symptoms and therefore is considered an early marker of inflammation. It correlates with clinical assessment of disease activity and elevated markers of acute inflammatory phase, i.e. ESR and CRP. It is a reversible phenomenon and may become attenuated due to biological treatment. It is considered a “herald” of erosions, as the risk of their formation is 6-fold higher in sites where BME was previously noted PMID:23493495

Sudol-Szopinska, Iwona; Kontny, Ewa; Maslinski, Wlodzimierz; Prochorec-Sobieszek, Monika; Warczynska, Agnieszka; Kwiatkowska, Brygida

2013-01-01

187

Olanzapine as a cause of peripheric edema in an elderly man.  

PubMed

Edema can be observed as side-effect of many medications, of which calcium channel blockers are the best known. Elderly people use many more medications than their younger counterparts and are usually more prone to developing medication-induced side-effects. Atypical antipsychotics have occasionally been shown to induce peripheric edema. Age is put forward as a risk factor for olanzapine-induced edema. We present here the case of an elderly man who developed upper- and lower-limb edema during use of olanzapine to emphasize its relatively frequent association with edema in the elderly. PMID:23740642

Ak?n, Sibel; Bahat, Gülistan; Tufan, Fatih; Saka, Bülent; Oztop, Nida; Erten, Nilgün; Karan, Mehmet Akif

2013-04-01

188

Radiation-induced edema after Gamma Knife treatment for meningiomas.  

PubMed

A retrospective study was performed to analyze some parameters in a consecutive series of 35 Gamma Knife treatments in 34 patients with benign meningiomas. The minimum dose to the tumors was never less than 12 Gy. The follow-up period was from 1 to 3 years. A semiquantitative method of tumor volume assessment was used to measure the tumor response to treatment. The presence and clinical significance of postradiation edema were noted. Even in this short follow-up period, 11 of the 35 tumors were reduced in volume. No tumors increased in size. Edema developed preferentially in nonbasal tumors, especially those around the midline and sagittal sinus. In all but one case where radiation-induced edema was observed was the margin tumor dose 18 Gy or more. It is suggested that doses of 18 Gy or more should probably be avoided in the Gamma Knife treatment of meningiomas and that the greatest care should be taken in selecting non-skull base tumors for this form of treatment. PMID:9032853

Ganz, J C; Schröttner, O; Pendl, G

1996-01-01

189

Resuscitation-induced intestinal edema and related dysfunction: State of the science  

PubMed Central

High volume resuscitation and damage control surgical methods, while responsible for significantly decreasing morbidity and mortality from traumatic injuries, are associated with pathophysiological derangements that lead to subsequent end organ edema and dysfunction. Alterations in hydrostatic and oncotic pressures frequently result in intestinal edema and subsequent dysfunction. The purpose of this review is to examine the principles involved in the development of intestinal edema, current and historical models for the study of edema, effects of edema on intestinal function (particularly ileus), molecular mediators governing edema-induced dysfunction, potential role of mechanotransduction, and therapeutic effects of hypertonic saline. We review the current state of the science as it relates to resuscitation induced intestinal edema and resultant dysfunction. PMID:19959186

Shah, Shinil K.; Uray, Karen S.; Stewart, Randolph H.; Laine, Glen A.; Cox, Charles S.

2013-01-01

190

Daflon 500 mg: symptoms and edema clinical update.  

PubMed

Patients suffering from any class of the Clinical, Etiological, Anatomical, Pathophysiological (CEAP) classification of chronic venous disease (CVD) may be symptomatic (C0s-C6s). Leg heaviness, discomfort, itching, cramps, pain, paresthesia, and edema (C3) are the most frequent manifestations of CVD and a major reason for medical consultation. Daflon 500 mg (micronized purified flavonoid fraction [MPFF]) is an effective treatment for symptoms and edema in CVD as demonstrated in several randomized controlled studies. A 2-month, double-blind study in 40 patients established the superiority of Daflon 500 mg over placebo with regard to symptoms and objective signs. This was confirmed in another double-blind, placebo-controlled trial (2 months' treatment, 160 patients), and in the Reflux assEssment and quaLity of lIfe improvEment with micronized Flavonoids (RELIEF) study. The latter included 5,052 patients in 23 countries, using a visual analog scale for evaluating pain, leg heaviness, cramps, and a sensation of swelling. All symptoms showed significant and progressive improvement. The quality-of-life results (scores on the ChronIc Venous Insufficiency quality of life Questionnaire [CIVIQ]) paralleled those of symptoms. The decrease in the ankle and calf circumferences was significantly greater (p < 0.001) in the group of patients treated with Daflon 500 mg in two studies, and correlated well with the improvement in the sensation of swelling (p < 0.001). This was confirmed with more sophisticated measurement techniques as in the RELIEF study or in a trial assessing edema with an optoelectronic volumeter in 20 patients. A further double-blind, randomized, controlled study established a statistically significant difference in favor of Daflon 500 mg in comparison with diosmin, both on symptoms and edema. The therapeutic efficacy of Daflon 500 mg on CVD symptoms and edema has been demonstrated in double-blind, randomized, controlled studies. Further studies using a new approach may define the most precise and validated methodology for application in future research in phlebology. PMID:16193223

Ramelet, Albert-Adrien

2005-01-01

191

Expression of the human papillomavirus type 16 genome in SK-v cells, a line derived from a vulvar intraepithelial neoplasia  

Microsoft Academic Search

The SK-v cells, established from a premalignant vulvar lesion, contain human papillomavirus type 16 (HPV- 16) sequences integrated at a single cellular site and derive from a cell clone present in vivo. Transcription of the HPV-16 genome in SK-v cells was analysed by cDNA heteroduplex mapping and sequencing, and by RNase mapping. Viral sequences were shown to be transcribed into

S. Schneider-Maunoury; G. Pehau-Arnaudet; F. Breitburd; G. Orth

1990-01-01

192

Anti-HPV16 E2 protein T-cell responses and viral control in women with usual vulvar intraepithelial neoplasia and their healthy partners  

Microsoft Academic Search

T-cell responses (proliferation, intracellular cytokine synthesis and IFN? ELISPOT) against human papillomavirus 16 (HPV16) E2 peptides were tested during 18 months in a longitudinal study in eight women presenting with HPV16-related usual vulvar intraepithelial neoplasia (VIN) and their healthy male partners. In six women, anti-E2 proliferative responses and cytokine production (single IFN? and\\/or dual IFN?\\/IL2 and\\/or single IL2) by CD4+

Remi Cheynier

2012-01-01

193

An autoimmune phenotype in vulvar lichen sclerosus and lichen planus: a Th1 response and high levels of microRNA-155.  

PubMed

Vulvar lichen sclerosus and lichen planus are T-cell-mediated chronic skin disorders. Although autoimmunity has been suggested, the exact pathogenesis of these disorders is still unknown. Therefore, the aim of the current study was to investigate the molecular and immunological mechanisms critical to the pathogenesis of vulvar lichen sclerosus and lichen planus. By using gene expression profiling and real-time RT-PCR experiments, we demonstrated a significantly increased expression of the pro-inflammatory cytokines (IFN?, CXCR3, CXCL9, CXCL10, CXCL11, CCR5, CCL4, and CCL5) specific for a Th1 IFN?-induced immune response. In addition, BIC/microRNA-155 (miR-155)--a microRNA involved in regulation of the immune response--was significantly upregulated in lichen sclerosus and lichen planus (9.5- and 17.7-fold change, respectively). Immunohistochemistry showed a significant T-cell response, with pronounced dermal infiltrates of CD4(+), CD8(+), and FOXP3(+) cells. In conclusion, these data demonstrate an autoimmune phenotype in vulvar lichen sclerosus and lichen planus, characterized by increased levels of Th1-specific cytokines, a dense T-cell infiltrate, and enhanced BIC/miR-155 expression. PMID:22113482

Terlou, Annelinde; Santegoets, Lindy A M; van der Meijden, Willem I; Heijmans-Antonissen, Claudia; Swagemakers, Sigrid M A; van der Spek, Peter J; Ewing, Patricia C; van Beurden, Marc; Helmerhorst, Theo J M; Blok, Leen J

2012-03-01

194

Breast edema in breast cancer patients following breast-conserving surgery and radiotherapy: a systematic review.  

PubMed

Breast-conserving surgery (BCS) is commonly used in breast cancer treatment. Despite its benefits, some women will be troubled by breast edema. Breast edema may cause an unsatisfactory cosmetic result, influencing the quality of life. The purpose of this systematic review is to investigate the incidence of breast edema and to identify risk factors of breast edema in breast cancer patients following BCS and radiotherapy. A systematic literature search was performed using different electronic databases (PubMed, Web of Science, Cochrane, Embase) until June 2014. Inclusion criteria were as follows: (1) research studies that included female breast cancer patients who were treated with BCS and radiotherapy and (2) studies that investigated the incidence of breast edema and/or risk factors of breast edema. Exclusion criteria were (1) reviews or case studies and (2) studies published before 1995. We identified in total 28 papers which represented 4,011 patients. There was a great variation in the incidence of breast edema (0-90.4 %). We identified several possible risk factors for breast edema namely increasing irradiated breast volume, increasing boost volume, the use of a photon boost, increasing breast separation, a higher density of the breast tissue, a large tumor, a higher specimen weight, postoperative infection, acute postoperative toxicity, and diabetes mellitus. However, their prognostic value remains uncertain. Breast edema is a common complaint after BCS and radiotherapy. A number of possible risk factors associated with breast edema were identified, but further research is warranted. PMID:25164973

Verbelen, Hanne; Gebruers, Nick; Beyers, Tinne; De Monie, Anne-Caroline; Tjalma, Wiebren

2014-10-01

195

Preventive treatment of alveolar pulmonary edema of cardiogenic origin  

PubMed Central

Objective To evaluate the efficacy of preventive treatment (PT) on alveolar pulmonary edema (APE) of cardiogenic origin using a monitor based on principles of internal thoracic impedance (ITI) measurements. Methods We conducted blinded clinical trials on patients with ST-elevation myocardial infarction (STEMI) and monitored whether the condition would progress to APE. ITI was measured non-invasively by the Edema Guard Monitor (EGM, model RS-207) every 30 min. The measurement threshold for the diagnosis of APE was fixed at > 12% decrease in ITI from baseline as described in our methodology. The patients were divided into one group that received standard treatment after the appearance of clinical signs of APE without considering the prediction of APE by EGM devise (Group 1), and another group of asymptomatic patients in whom development of APE was predicted by using only EGM measurements (Group 2). The latter participants' PT consisted of furosemide, intravenous nitroglycerine and supplemental oxygen. Results One-hundred and fifty patients with acute STEMI were enrolled into this study. Group 1 included 100 patients (53% males, age 64.1 ± 12.6 years). Treatment was started after the clinical appearance of overt signs of APE. Group 2 included 50 patients (54% males, age 65.2 ± 11.9 years) who received PT based on EGM measurements. Group 2 had significantly fewer cases of APE (n = 4, 8%) than Group 1 (n = 100, 100%) (P > 0.001). While APE was lethal in six (6%) Group 1 patients, PT resulted in prompt resolution of APE in all four (8%) Group 2 patients. Conclusion ITI is a useful modality for early diagnosis and PT of pulmonary edema of cardiogenic origin. PMID:23341835

Charach, Gideon; Shochat, Michael; Rabinovich, Alexander; Ayzenberg, Oded; George, Jacob; Charach, Lior; Rabinovich, Pavel

2012-01-01

196

Alcohol Abuse Enhances Pulmonary Edema in Acute Respiratory Distress Syndrome  

PubMed Central

Background Pulmonary edema is a cardinal feature of the life-threatening condition known as Acute Respiratory Distress Syndrome (ARDS). Patients with chronic alcohol abuse are known to be at increased risk of developing and dying from ARDS. Based upon preclinical data, we hypothesized that a history of chronic alcohol abuse in ARDS patients is associated with greater quantities and slower resolution of pulmonary edema compared to ARDS patients without a history of alcohol abuse. Methods A PiCCO™ transpulmonary thermodilution catheter was inserted into 35 patients within 72 hours of meeting American European Consensus Criteria definition of ARDS. Pulmonary edema was quantified as extravascular lung water (EVLW) and measured for up to 7 days in 13 patients with a history of chronic alcohol abuse and 22 patients without a history of chronic alcohol abuse. Results Mean EVLW was higher in patients with a history of chronic alcohol abuse (16.6mL/kg vs. 10.5mL/kg, p<0.0001). Patients with alcohol abuse had significantly greater EVLW over the duration of the study (RM-ANOVA p=0.003). There was a trend towards slower resolution of EVLW in patients with a history of alcohol abuse (a decrease of 0.5mL/kg vs. 2.4mL/kg, p=0.17) over the study period. A history of alcohol abuse conferred a greater than three-fold increased risk of elevated EVLW [OR 3.16, (1.26-7.93)] using multivariate logistic regression analysis. Conclusions In patients who develop ARDS, alcohol abuse is associated with greater levels EVLW and a trend towards slower resolution of EVLW. Combined with mechanistic and preclinical evidence linking chronic alcohol consumption and ARDS, targeted therapies should be developed for these patients. PMID:19572988

Berkowitz, David M.; Danai, Pajman A.; Eaton, Stephanie; Moss, Marc; Martin, Greg S.

2014-01-01

197

Pulmonary edema after aneurysm surgery is modified by mannitol.  

PubMed Central

Abdominal aortic aneurysmectomy (AAA) results in thromboxane (Tx)A2 generation, a rise in mean pulmonary artery pressure (MPAP), leukopenia, and noncardiogenic pulmonary edema. This study tests whether mannitol, a hydroxyl radical scavenger, modifies these events. Patients received mannitol 0.2 g/kg (n = 14) or saline (n = 12) intravenously before infrarenal aortic clamping. With saline, 30 minutes after clamping, plasma TxB2 levels rose from 124 to 290 pg/mL (p less than 0.01), and MPAP rose from 19 to 27 mmHg (p less than 0.01). Aortic clamp release led to further increases in plasma TxB2 to 378 pg/mL (p less than 0.01) and MPAP to 34 mmHg (p less than 0.01). The white blood count (WBC) fell from 9800 to 4400/mm3 (p less than 0.01). Four to eight hours after surgery, physiologic shunting (Q[sc]S[xsc]/Q[sc]T[xsc]) rose from 9% to 20% (p less than 0.01) and peak inspiratory pressure (PIP) increased from 22 to 32 cmH2O (p less than 0.01). Chest radiography demonstrated pulmonary edema while the pulmonary wedge pressure was 12 mmHg, excluding left ventricular failure. By 24 hours pulmonary edema resolved and the PIP and PaO2 returned to baseline. Mannitol treatment relative to saline, during and after aortic clamping reduced plasma TxB2 levels to 155 and 198 pg/mL, respectively (p less than 0.01); MPAP to 21 and 26 mmHg (p less than 0.01); minimized the decline in WBC to 5850/mm3 (p less than 0.01), and the postoperative rise in Q[sc]S[xsc]/Q[sc]T[xsc] to 12%, and PIP to 28 cmH2O (both p less than 0.01). Chest radiography showed no pulmonary edema. Finally in vitro studies documented that mannitol 1 to 10(-4)M, but not dextrose, in a dose-dependent manner inhibited Tx synthesis by ADP-activated platelets. These data indicate that mannitol maintains pulmonary function after AAA by limiting ischemia-induced thromboxane synthesis. PMID:2511812

Paterson, I S; Klausner, J M; Goldman, G; Pugatch, R; Feingold, H; Allen, P; Mannick, J A; Valeri, C R; Shepro, D; Hechtman, H B

1989-01-01

198

Pathology Case Study: History of Fatigue and Edema  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a man presented with fatigue and two weeks of increasing edema. Visitors are given both the microscopic and gross descriptions, laboratory findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hepatopathology.

Adamson, Ann T.

2007-10-30

199

Intravitreal Corticosteroids in the Management of Diabetic Macular Edema  

PubMed Central

Diabetic macular edema (DME) remains an important worldwide cause of visual loss. Corticosteroids have a role in the treatment of some patients with advanced or recurrent DME. The best studied steroids for this indication are triamcinolone acetonide, dexamethasone, and fluocinolone acetonide. All steroids are associated with risks of cataract and intraocular pressure elevation. In addition, intravitreal injection of any medication is associated with risks of infectious endophthalmitis, which has led to the investigation of various extended-release steroid implants. At this time, no steroid is approved by the United States Food and Drug Administration (FDA) for the treatment of DME. PMID:24224143

Flynn, Harry W.; Scott, Ingrid U.

2013-01-01

200

Single-case design evaluation of compression therapy for edema of the stroke-affected hand.  

PubMed

OBJECTIVE. To explore the efficacy of low- and high-stretch compression bandaging for edema management in the stroke-affected upper limb. METHOD. A single-case, ABA-design study was conducted with 8 participants alternately allocated to receive low- or high-stretch bandaging. Edema was measured with circumferential tape at four specified points from the hand to the mid-forearm. All measurements were represented graphically for visual analysis, and celeration lines were calculated to indicate the degree of slope in each phase. RESULTS. Visual analysis indicated fluctuating edema volume in the first baseline phase, decreasing edema volume in the intervention phase, and increasing edema volume in the second baseline phase. The results did not clearly distinguish between the two bandaging groups. CONCLUSION. Compression bandaging may have benefits in the management of edema after stroke. Further research is required to identify factors contributing to the long-term maintenance of reductions gained after compression bandaging. PMID:24581407

Gustafsson, Louise; Walter, Alexandra; Bower, Kylie; Slaughter, Adrienne; Hoyle, Melanie

2014-01-01

201

Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome  

PubMed Central

Obstructive sleep apnea (OSA) may occur in association with obesity-hypoventilation (Pickwickian) syndrome, a disorder of ventilatory control affecting individuals with morbid obesity. Through the pressor effects of chronic hypercapnia and hypoxemia, this syndrome may result in pulmonary hypertension, right heart failure, and massive peripheral edema. We present a case of severe scrotal edema in a 36-year-old male with OSA and obesity-hypoventilation syndrome. A tracheostomy was performed to relieve hypoxemia and led to dramatic improvement of scrotal edema. No scrotal surgery was necessary. Followup at two months showed complete resolution of scrotal edema, improvement in mental status, and normalization of arterial blood gas measurements. This case demonstrates that OSA and obesity-hypoventilation syndrome may present with massive scrotal edema. Furthermore, if OSA is recognized as the cause of right heart failure, and if the apnea is corrected, the resultant improvement in cardiac function may allow reversal of massive peripheral, including scrotal, edema. PMID:23533435

Dreifuss, Stephanie E.; Manders, Ernest K.

2013-01-01

202

Diabetic papillopathy with macular edema treated with intravitreal ranibizumab  

PubMed Central

We report a case of diabetic papillopathy that demonstrated a resolution of optic disk swelling and rapid visual recovery when intravitreal ranibizumab was administered. A 51-year-old male presented with acute painless visual loss in his right eye. His vision was 20/320 in the right eye and 20/50 in the left eye. Fundus examination of the right eye showed nonproliferative diabetic retinopathy with macular edema and a swollen optic disk. Fluorescein angiography showed dye leakage from the right optic disk. Optical coherent tomography revealed a significant increase in retinal nerve fiber-layer thickness. Magnetic resonance imaging of the brain was normal. The patient received a single intravitreal ranibizumab (0.5 mg) injection. Two weeks following injection, there was marked regression of the disk swelling and improvement of macular edema, with vision improving to 20/100. Three months following injection, there was complete resolution of the optic disk swelling. No further treatment was required. PMID:24348012

Kim, Moosang; Lee, Jang-Hun; Lee, Seung-Jun

2013-01-01

203

Enzymatic vitrectomy for diabetic retinopathy and diabetic macular edema  

PubMed Central

The aim of this paper is to determine the role of enzymatic vitrectomy performed by intravitreal injection of autologous plasmin enzyme (APE) in the management of diabetic retinopathy and diabetic macular edema (DME). Diabetic patients with proliferative diabetic retinopathy or DME and evident posterior hyaloid adherence to the retinal surface were included. All cases were treated with an initial intravitreal injection of APE and reevaluated one month later, measuring changes in best-corrected visual acuity (BCVA), macular thickness and the status of the posterior hyaloid. A second APE injection was performed in cases with no evident posterior vitreous detachment (PVD) after the initial treatment. Sixty-three eyes were included in the present review. A complete PVD appeared in 38% of cases (24 eyes) after one injection of plasmin and the total increased to 51% (32 eyes) after the second injection, separated at least by one month. The central macular thickness improved in all cases (100%) and BCVA in 89%. Finally, in 50% of eyes with proliferative diabetic retinopathy, a high reduction of new vessels regression was observed. Enzymatic vitrectomy could be considered a good therapeutic alternative in diabetic retinopathy and macular edema. PMID:24379923

Diaz-Llopis, Manuel; Udaondo, Patricia; Millan, Jose Maria; Arevalo, J Fernando

2013-01-01

204

Structure-based redesign of an edema toxin inhibitor  

PubMed Central

Edema Factor toxin (EF) of Bacillus anthracis (NIAID category A), and several other toxins from NIAID category B Biodefense target bacteria are adenylyl cyclases or adenylyl cyclase agonists that catalyze the conversion of ATP to 3?,5?-cyclic adenosine monophosphate (cAMP). We previously identified compound 1 (3-[(9-Oxo-9H-fluorene-1-carbonyl)-amino]-benzoic acid), that inhibits EF activity in cultured mammalian cells, and reduces diarrhea caused by enterotoxigenic Escherichia coli (ETEC) at an oral dosage of 15 ?g/mouse. Here, molecular docking was used to predict improvements in potency and solubility of new derivatives of compound 1 in inhibiting edema toxin-(ET) catalyzed stimulation of cyclic AMP production in murine monocyte-macrophage cells (RAW 264.7). Structure-activity relationship (SAR) analysis of the bioassay results for 22 compounds indicated positions important for activity. Several derivatives demonstrated superior pharmacological properties compared to our initial lead compound, and are promising candidates to treat anthrax infections and diarrheal diseases induced by toxin-producing bacteria. PMID:22154558

Chen, Deliang; Ma, Lili; Kanalas, John J.; Gao, Jian; Pawlik, Jennifer; Jimenez, Maria Estrella; Walter, Mary A.; Peterson, Johnny W.; Gilbertson, Scott R.; Schein, Catherine H.

2011-01-01

205

Ibuprofen prevents synthetic smoke-induced pulmonary edema  

SciTech Connect

Multiple potentially injurious agents are present in smoke but the importance of each of these agents in producing lung injury as well as the mechanisms by which the lung injury is produced are unknown. In order to study smoke inhalation injury, we developed a synthetic smoke composed of a carrier of hot carbon particles of known size to which a single known common toxic agent in smoke, in this case HCI, could be added. We then exposed rats to the smoke, assayed their blood for the metabolites of thromboxane and prostacyclin, and intervened shortly after smoke with the cyclooxygenase inhibitors indomethacin or ibuprofen to see if the resulting lung injury could be prevented. Smoke exposure produced mild pulmonary edema after 6 h with a wet-to-dry weight ratio of 5.6 +/- 0.2 SEM (n = 11) compared with the non-smoke-exposed control animals with a wet-to-dry weight ratio of 4.3 +/- 0.2 (n = 12), p less than 0.001. Thromboxane B, and 6-keto-prostaglandin F1 alpha rose to 1660 +/- 250 pg/ml (p less than 0.01) and to 600 +/- 100 pg/ml (p greater than 0.1), respectively, in the smoke-injured animals compared with 770 +/- 150 pg/ml and 400 +/- 100 pg/ml in the non-smoke-exposed control animals. Indomethacin (n = 11) blocked the increase in both thromboxane and prostacyclin metabolites but failed to prevent lung edema.

Shinozawa, Y.; Hales, C.; Jung, W.; Burke, J.

1986-12-01

206

Evidence for increased intracranial pressure in high altitude pulmonary edema.  

PubMed

We sought to determine if optic nerve sheath diameter (ONSD), a surrogate measure of ICP, is increased in high altitude pulmonary edema (HAPE). Five HAPE patients (one with a codiagnosis of high altitude cerebral edema [HACE]) treated at the Himalayan Rescue Association clinic in Pheriche, Nepal (4240 m), underwent optic nerve sheath ultrasonography (ONSU) at admission to determine ONSD. Results were compared to ONSD in 32 control subjects at the same altitude without evidence of altitude illness. Four of the five HAPE patients underwent repeat ONSU at discharge. All exams were read by two blinded observers. The mean ONSD for HAPE patients on presentation was 5.7 +/- 0.44 mm and for controls was 4.7 +/- 0.56 mm (p = 0.003). Excluding the patient with a coexistent clinical diagnosis of HACE, mean ONSD at presentation for the other four HAPE patients was 5.7 +/- 0.50 mm and was significantly different from controls (p = 0.007). In the four HAPE patients with repeat exams, ONSD decreased by 17% +/- 15% (95% CI 4-30%) between admission and discharge. We conclude that HAPE is associated with increased ONSD, a surrogate measure of increased ICP. PMID:18081509

Fagenholz, Peter J; Gutman, Jonathan A; Murray, Alice F; Noble, Vicki E; Camargo, Carlos A; Harris, N Stuart

2007-01-01

207

Rhodiola crenulata Extract Alleviates Hypoxic Pulmonary Edema in Rats  

PubMed Central

Sudden exposure of nonacclimatized individuals to high altitude can easily lead to high altitude illnesses. High altitude pulmonary edema (HAPE) is the most lethal form of high altitude illness. The present study was designed to investigate the ability of Rhodiola crenulata extract (RCE), an herbal medicine traditionally used as an antiacute mountain sickness remedy, to attenuate hypoxia-induced pulmonary injury. Exposure of animals to hypobaric hypoxia led to a significant increase in pathological indicators for pulmonary edema, including the lung water content, disruption of the alveolar-capillary barrier, and protein-rich fluid in the lungs. In addition, hypobaric hypoxia also increased oxidative stress markers, including (ROS) production, (MDA) level, and (MPO) activity. Furthermore, overexpression of plasma (ET-1), (VEGF) in (BALF), and (HIF-1?) in lung tissue was also found. However, pretreatment with RCE relieved the HAPE findings by curtailing all of the hypoxia-induced lung injury parameters. These findings suggest that RCE confers effective protection for maintaining the integrity of the alveolar-capillary barrier by alleviating the elevated ET-1 and VEGF levels; it does so by reducing hypoxia-induced oxidative stress. Our results offer substantial evidence to support arguments in favor of traditional applications of Rhodiola crenulata for antihigh altitude illness. PMID:23710233

Li, Min-Hui; Shi, Li-Shian; Ho, Cheng-Wen

2013-01-01

208

Pneumothorax after reexpansion pulmonary edema: experience with 2 patients.  

PubMed

Thoracentesis is one of the most commonly performed medical procedures with an excellent safety profile. We describe 2 patients, both of whom developed 2 very rare complications after image-guided thoracentesis. Both patients developed clinically relevant reexpansion pulmonary edema (RPE). Within 2 weeks of their first thoracentesis, both patients underwent a second thoracentesis, which was complicated by a large pneumothorax requiring drainage by tube thoracostomy. Pneumothorax and RPE are independent rare complications (<1%) that occur after thoracentesis. The development of these unusual complications in the same sequence in these 2 patients suggests that there may be a causal relationship between pneumothorax and RPE after sequential thoracenteses. Further investigations are necessary to better describe the underlying pathophysiology and mechanism that may explain this association. PMID:23208630

Berkowitz, David; Alazemi, Saleh; Majid, Adnan; Michaud, Gaetane; Ernst, Armin

2011-10-01

209

Negative Pressure Pulmonary Edema After Oral and Maxillofacial Surgery  

PubMed Central

Negative pressure pulmonary edema (NPPE) following upper airway obstruction (UAO) has been reported in several clinical situations. The main cause of NPPE is reported to be increased negative intrathoracic pressure. We present a case of NPPE that occurred after general anesthesia for plate removal after jaw deformity surgery. After completion of the surgery, administration of inhaled anesthetics was stopped and the patient opened his eyes on verbal command. Immediately after extubation, the patient stopped breathing and became cyanotic. Acute UAO following laryngospasm was suspected. Soon after reintubation, pink, frothy fluid came out of the endotracheal tube, and a tentative diagnosis of NPPE was made. Continuous positive airway pressure was applied. In addition, furosemide and dexamethasone were administered. By the next day, the symptoms had almost disappeared. PMID:19642719

Mamiya, Hideki; Ichinohe, Tatsuya; Kaneko, Yuzuru

2009-01-01

210

Managing diabetic macular edema: The leading cause of diabetes blindness  

PubMed Central

Diabetic macular edema (DME) is the leading cause of blindness in young adults in developed countries, affecting 12% of type 1 and 28% of type 2 diabetic patients. The gold standard DME treatment should be based on a good control of glycemia along with control of lipids and renal function. However, despite the systemic metabolic control values being essential for patients with diabetic retinopathy (DR), it has proven to be insufficient for DME if it appears. With these patients, additional measures are needed in order to avoid the subsequent loss of vision. While laser treatment of DME has been the only valid treatment so far, it has been inadequate in chronic cases. The introduction of new treatments, such as intravitreal corticosteroids or anti-VEGF drugs, have recently shown their safety and efficacy and together with laser photocoagulation are becoming the treatments of choice in the management of DME. PMID:21860693

Romero-Aroca, Pedro

2011-01-01

211

Treatment of macular edema due to retinal vein occlusions  

PubMed Central

Retinal vein occlusion (RVO) is a prevalent retinal vascular disease, second only to diabetic retinopathy. Previously there was no treatment for central retinal vein occlusion (CRVO) and patients were simply observed for the development of severe complications, generally resulting in poor visual outcomes. The only treatment for branch vein occlusion (BRVO) was grid laser photocoagulation, which reduces edema very slowly and provides benefit in some, but not all patients. Within the past year, clinical trials have demonstrated the effects of three new pharmacologic treatments, ranibizumab, triamcinolone acetonide, and dexamethasone implants. The benefit/risk ratio is best for intraocular injections of ranibizumab, making this first-line therapy for most patients with CRVO or BRVO, while intraocular steroids are likely to play adjunctive roles. Standard care for patients with RVO has changed and will continue to evolve as results with other new agents are revealed. PMID:21629578

Channa, Roomasa; Smith, Michael; Campochiaro, Peter A

2011-01-01

212

Pulmonary edema of environmental origin--newer concepts  

SciTech Connect

Pulmonary edema of non-cardiac origin is usually an urgent clinical problem, which has recently increased in frequency throughout the world in the past few years. This is partly due to sociological factors and to pre-eminent advances in industrial technology. Recent severe massive toxic gas explosions have had national and worldwide implications. Therefore, urgent and appropriate therapy is of utmost importance in most of these patients. The use of high flow oxygen with Constant Positive Pressure Breathing are the main inhalational therapeutic approaches. Newer modalities of treatment include: (1) earlier Fiberoptic bronchoscopy in those individuals afflicted with aspiration problems and (2) certain specific chemical blocking agents for the management of phosgene intoxication and hydrogen sulfide toxicity. Preventive environmental measures are also important.

Cordasco, E.M.; Demeter, S.R.; Kester, L.; Cordasco, M.A.; Lammert, G.; Beerel, F.

1986-06-01

213

Cost-Effectiveness of Treatment of Diabetic Macular Edema  

PubMed Central

Background Macular edema is the most common cause of visual loss among patients with diabetes. Objective To determine the cost-effectiveness of different treatments of diabetic macular edema (DME). Design Markov model. Data Sources Published literature and expert opinion. Target Population Patients with clinically significant DME. Time Horizon Lifetime. Perspective Societal. Intervention Laser treatment, intraocular injections of triamcinolone or a vascular endothelial growth factor (VEGF) inhibitor, or a combination of both. Outcome Measures Discounted costs, gains in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). Results of Base-Case Analysis All treatments except laser monotherapy substantially reduced costs, and all treatments except triamcinolone monotherapy increased QALYs. Laser treatment plus a VEGF inhibitor achieved the greatest benefit, gaining 0.56 QALYs at a cost of $6975 for an ICER of $12 410 per QALY compared with laser treatment plus triamcinolone. Monotherapy with a VEGF inhibitor achieved similar outcomes to combination therapy with laser treatment plus a VEGF inhibitor. Laser monotherapy and triamcinolone monotherapy were less effective and more costly than combination therapy. Results of Sensitivity Analysis VEGF inhibitor monotherapy was sometimes preferred over laser treatment plus a VEGF inhibitor, depending on the reduction in quality of life with loss of visual acuity. When the VEGF inhibitor bevacizumab was as effective as ranibizumab, it was preferable to because of its lower cost. Limitation Long-term outcome data for treated and untreated diseases are limited. Conclusion The most effective treatment of DME is VEGF inhibitor injections with or without laser treatment. This therapy compares favorably with cost-effective interventions for other conditions. Primary Funding Source Agency for Healthcare Research and Quality. PMID:24573663

Pershing, Suzann; Enns, Eva A.; Matesic, Brian; Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.

2014-01-01

214

Unilateral High-Altitude Pulmonary Edema in a Subject with Right Pulmonary Artery Hypoplasia  

Microsoft Academic Search

High-altitude pulmonary edema (HAPE) is an uncommon type of non-cardio-genic, high-permeability pulmonary edema. The authors describe a case of unilateral, left-sided HAPE that occurred in a man with right pulmonary artery hypoplasia.

G. Fiorenzano; V. Rastelli; V. Greco; A. Di Stefano; M. Dottorini

1994-01-01

215

Bone marrow edema of the mandibular condyle related to internal derangement, osteoarthrosis, and joint effusion  

Microsoft Academic Search

Purpose: The purpose of this prospective study was to evaluate whether common magnetic resonance imaging (MRI) variables such as temporomandibular joint (TMJ) internal derangement, osteoarthrosis, and effusion may predict the diagnostic group of bone marrow edema of the mandibular condyle. Materials and Methods: The relationship between bone marrow edema and TMJ disc displacement, osteoarthrosis, and effusion was analyzed in MRIs

Iris Brandlmaier; Christoph Schmid; Stefan Bertram; Ansgar Rudisch

2003-01-01

216

A comparative study of treatment for brain edema: Magnesium sulphate versus dexamethasone sodium phosphate  

Microsoft Academic Search

Treatments for brain edema are important and one of the major options is corticosteroids. Cell membrane stabilization and prevention of formation of free radicals are the main mechanisms of action of steroids in edema treatment. As an alternative therapeutic agent, magnesium sulphate has been used for its neuroprotective effect in various injury models. In our animal model of brain injury,

Omer Faruk Turkoglu; Hakan Eroglu; Ozerk Okutan; M. Kagan Tun; Ebru Bodur; Mustafa F. Sargon; Levent Öner; Etem Beskonakl?

2008-01-01

217

Amantadine Induced Corneal Edema in a Patient with Primary Progressive Freezing of Gait  

PubMed Central

Amantadine is commonly used for Parkinsonism. However amantadine can induce adverse corneal reaction. Here we report a patient with primary progressive freezing of gait who had severe corneal edema associated with amantadine, which was reversible after discontinuation of the amantadine. This report alerts neurologists for this reversible but potentially critical corneal edema in patients with Parkinsonism who are receiving amantadine. PMID:24868424

Kim, Young Eun; Yun, Ji Young; Yang, Hui-Jun; Kim, Han-Joon; Kim, Mee Kum; Wee, Won Ryang; Jeon, Beom S.

2013-01-01

218

Pulmonary edema due to partial upper airway obstruction in a child  

Microsoft Academic Search

The case of an 8-year-old boy is reported, who developed acute pulmonary edema associated with acute subglottic swelling and subsequent partial upper airway obstruction after extubation and recovery from anaesthesia. The main factors responsible for the formation of pulmonary edema presumbly are a large subatmospheric transpulmonary pressure gradient and hypoxia leading to translocation of circulating blood volume into the pulmonary

R. Scherer; P. Dreyer; G. Jorch

1988-01-01

219

Modulation of carrageenan-induced hind paw edema by substance P  

Microsoft Academic Search

Substance P has been implicated as a mediator of inflammation. The involvement of this neuropeptide in carrageenan-induced hind paw edema in the rat was assessed. Subcutaneous injection of carrageenan into the rat paw caused a significant increase in substance P levels, which preceded the onset of inflammation. While injection of substance P alone caused mild edema, coadministration of submaximal doses

James P. Gilligan; Susan J. Lovato; Mark D. Erion; Arco Y. Jeng

1994-01-01

220

Acute pulmonary edema from unrecognized high irrigation pressure in hysteroscopy: a report of two cases.  

PubMed

After two consecutive patients underwent hysteroscopy that was complicated by pulmonary edema, the pneumatically inflated pressure cuff machine was checked and found that the pressure gauge was in error, with actual pressure being twice that of the recorded number. High irrigation pressures with a seemingly normal amount of irrigation fluid may induce acute pulmonary edema. PMID:19100936

Hsieh, Ming-Hui; Chen, Ta-Liang; Lin, Yu-Hua; Chang, Chuen-Chau; Lin, Chao-Shun; Lee, Yuan-Wen

2008-12-01

221

Acute pulmonary edema from unrecognized high irrigation pressure in hysteroscopy: a report of two cases  

Microsoft Academic Search

After two consecutive patients underwent hysteroscopy that was complicated by pulmonary edema, the pneumatically inflated pressure cuff machine was checked and found that the pressure gauge was in error, with actual pressure being twice that of the recorded number. High irrigation pressures with a seemingly normal amount of irrigation fluid may induce acute pulmonary edema.

Ming-Hui Hsieh; Ta-Liang Chen; Yu-Hua Lin; Chuen-Chau Chang; Chao-Shun Lin; Yuan-Wen Lee

2008-01-01

222

J Neurotrauma . Author manuscript Perfusional deficit and the dynamics of cerebral edemas in experimental  

E-print Network

was to characterize edema dynamics, cerebral blood volume and flow alterations in an experimental model of brainJ Neurotrauma . Author manuscript Page /1 9 Perfusional deficit and the dynamics of cerebral edemas, a 70 80 reduction in cerebral blood flow is% ­ % measured within the lesioned region. Transient

Paris-Sud XI, Université de

223

Coexisting high-grade vulvar intraepithelial neoplasia (VIN) and condyloma acuminatum: independent lesions due to different HPV types occurring in immunocompromised patients.  

PubMed

The majority of vulvar intraepithelial neoplasia (VIN) is high-grade and is related to high-risk human papillomavirus (HRHPV) (most commonly HPV 16). It is considered to be the precursor of HRHPV-related vulvar squamous cell carcinoma. Vulvar condyloma acuminatum is low-risk HPV (LRHPV)-related (most commonly types 6 and 11) and has virtually no risk of neoplastic progression. While infection with multiple LRHPV and HRHPV types has been reported for cervical squamous intraepithelial lesions, coexisting vulvar condyloma and adjacent high-grade VIN have not been well characterized. Eleven cases of concurrent condyloma acuminatum and adjacent flat high-grade VIN and 3 cases of high-grade VIN with prominent condylomatous architecture were analyzed using immunohistochemical analysis of p16 expression, in situ hybridization (ISH) for HPV detection [HPV 6/11, HPV 16, HPV 18, and HPV wide spectrum (types 6, 11, 16, 18, 31, 33, 35, 45, 51, 52) probes], and HPV typing by a polymerase chain reaction (PCR)-based method (in select cases). All patients had underlying immunosuppressive conditions (human immunodeficiency virus infection or posttransplant therapy). Among the 11 cases of concurrent high-grade VIN and condyloma, the lesions were directly adjacent to one another in 5 cases (with 2 of these demonstrating an intimate admixture of lesions), and in 6 cases the lesions were found in separate tissue sections from the same specimen. Diffuse/strong p16 expression was seen in all high-grade VIN lesions, whereas patchy/weak staining was found in all condylomata. All condylomata contained HPV 6 or 11 as detected by ISH. HRHPV was detected in all of the accompanying high-grade VIN lesions. Ten contained HPV 16 (9 by ISH, 1 by PCR), with the remaining case containing multiple HPV types by PCR. All condylomatous high-grade VIN lesions demonstrated diffuse/strong p16 expression and had evidence of HRHPV (1 with HPV 16 by ISH, 1 with HPV 18 by ISH, and 1 with multiple HPV types by PCR), with no detection of HPV 6 or 11 by ISH. The restriction of LRHPV to condylomatous components and HRHPV to high-grade VIN components of adjacent lesions suggests these are independent lesions caused by different HPV types. Diffuse p16 expression can highlight small foci of high-grade VIN, which may be overlooked in more abundant condylomatous tissue from immunosuppressed patients. The presence of only HRHPV in those VIN lesions with high-grade cytologic features but prominent condylomatous architecture supports their classification as forms of pure high-grade VIN and distinguishes them from condyloma acuminatum. PMID:23026935

Maniar, Kruti P; Ronnett, Brigitte M; Vang, Russell; Yemelyanova, Anna

2013-01-01

224

T2-Weighted Cardiac Magnetic Resonance Imaging of Edema in Myocardial Diseases  

PubMed Central

The purpose of this paper is to describe imaging techniques and findings of T2-weighted magnetic resonance imaging (MRI) of edema in myocardial diseases. T2-weighted cardiac MRI is acquired by combining acceleration techniques with motion and signal suppression techniques. The MRI findings should be interpreted based on coronary artery supply, intramural distribution, and comparison with delayed-enhancement MRI. In acute myocardial diseases, such as acute myocardial infarction and myocarditis, the edema is larger than myocardial scarring, whereas the edema can be smaller than the scarring in some types of nonischemic cardiomyopathy, including hypertrophic cardiomyopathy. T2-weighted MRI of edema identifies myocardial edema associated with ischemia, inflammation, vasculitis, or intervention in the myocardium and provides information complementary to delayed-enhancement MRI. PMID:22973170

Amano, Yasuo; Tachi, Masaki; Tani, Hitomi; Mizuno, Kyoichi; Kobayashi, Yasuhiro; Kumita, Shinichiro

2012-01-01

225

Macular Edema After Cataract Surgery In Eyes Without Pre-operative Central-involved Diabetic Macular Edema  

PubMed Central

Objective To estimate the incidence of central-involved macular edema (ME)16 weeks following cataract surgery in eyes with diabetic retinopathy (DR) without definite central-involved diabetic macular edema (DME) preoperatively. Methods In a multicenter, prospective, observational study, participants (N = 293) with DR without definite OCT central subfield (CSF) thickening underwent cataract surgery. The primary outcome was development of central-involved ME defined as; (1) OCT CSF thickness ? 250?m (time domain) or ? 310?m (spectral domain) with ?1 step increase in logOCT CSF thickness pre-operative to the 16-week visit; (2) ?2-step increase in logOCT CSF pre-operative to 16-week visit; or (3) non-topical treatment for ME received before the 16-week visit with either of the OCT criteria met at the time of treatment. Results Median participant age was 64 years with median visual acuity letter score of 69 (Snellen equivalent 20/40). Forty-four percent of eyes had history of prior treatment for DME. Sixteen weeks postoperatively, central-involved ME was noted in 0% (95%CI: 0-20%) of 17 eyes with no pre-operative DME. Of eyes with non-central involved DME, 10% (95%CI: 5-18%) of 97 eyes without central involved DME and 12% (95%CI: 7-19%) of 147 eyes with possible central involved DME at baseline progressed to central-involved ME. History of DME treatment was significantly associated with central-involved ME development (P<0.001). Conclusion In eyes with DR without concurrent central-involved DME, presence of non-central DME immediately prior to cataract surgery, or history of DME treatment, may increase risk of developing central-involved ME 16 weeks after cataract extraction. PMID:23599174

Baker, Carl W.; Almukhtar, Talat; Bressler, Neil M.; Glassman, Adam R.; Grover, Sandeep; Kim, Stephen J.; Murtha, Timothy J.; Rauser, Michael E.; Stockdale, Cynthia

2014-01-01

226

Hyaluronidase injection for the treatment of eyelid edema: a retrospective analysis of 20 patients  

PubMed Central

Background Hyaluronidase (Hylase Dessau®) is a hyaluronic acid-metabolizing enzyme, which has been shown to loosen the extracellular matrix, thereby improving the diffusion of local anesthetics. Lower eyelid edema is a common post-interventional complication of cosmetic procedures performed in the lid region, such as the injection of hyaluronic acid fillers for tear-trough augmentation. The purpose of this study was to validate the efficacy of hyaluronidase in the management of lower eyelid edema. Methods We performed a retrospective analysis with 20 patients with lower eyelid edema. Most patients (n?=?14) presented with edema following hyaluronic acid injection (tear-trough augmentation), whereas the minority (n?=?6) were treated due to idiopathic edema (malar edema or malar mounds). Patients were treated by local infiltration of approximately 0.2 ml to 0.5 ml of hyaluronidase (Hylase Dessau® 20 IU to 75 IU) per eyelid. Photographs were taken prior to and seven days after infiltration. Results Hyaluronidase was found to reduce effectively and rapidly or resolve eyelid edema after a single injection. No relevant adverse effects were observed. However, it must be noted that a hyaluronidase injection may also dissolve injected hyaluronic acid fillers and may therefore negatively affect tear-trough augmentations. While the effects of a treatment for edema due to tear-trough augmentation were permanent, malar edema and malar mounds reoccurred within two to three weeks. Conclusion The infiltration of hyaluronidase is rapid, safe and currently the only effective option for the management of eyelid edema. No relevant adverse effects were observed. PMID:24886711

2014-01-01

227

Small changes in lung function in runners with marathon?induced interstitial lung edema  

PubMed Central

Abstract The purpose of this study was to assess lung function in runners with marathon?induced lung edema. Thirty?six (24 males) healthy subjects, 34 (SD 9) years old, body mass index 23.7 (2.6) kg/m2 had posterior/anterior (PA) radiographs taken 1 day before and 21 (6) minutes post marathon finish. Pulmonary function was performed 1–3 weeks before and 73 (27) minutes post finish. The PA radiographs were viewed together, as a set, and evaluated by two experienced readers separately who were blinded as to time the images were obtained. Radiographs were scored for edema based on four different radiological characteristics such that the summed scores for any runner could range from 0 (no edema) to a maximum of 8 (severe interstitial edema). Overall, the mean edema score increased significantly from 0.2 to 1.0 units (P <0.01), and from 0.0 to 2.9 units post exercise in the six subjects that were edema positive (P = 0.03). Despite a 2% decrease in forced vital capacity (FVC, P =0.024) and a 12% decrease in alveolar?membrane diffusing capacity for carbon monoxide (DmCO, P =0.01), there was no relation between the change in the edema score and the change in DmCO or FVC. In conclusion, (1) mild pulmonary edema occurs in at least 17% of subjects and that changes in pulmonary function cannot predict the occurrence or severity of edema, (2) lung edema is of minimal physiological significance as marathon performance is unaffected, exercise?induced arterial hypoxemia is unlikely, and postexercise pulmonary function changes are mild. PMID:24973330

Zavorsky, Gerald S.; Milne, Eric N.C.; Lavorini, Federico; Rienzi, Joseph P.; Cutrufello, Paul T.; Kumar, Sridhar S.; Pistolesi, Massimo

2014-01-01

228

Safety and efficacy of ospemifene for the treatment of dyspareunia associated with vulvar and vaginal atrophy due to menopause  

PubMed Central

During the menopausal transition, women experience a number of symptoms due to declining estrogen levels, including vasomotor symptoms and vulvar and vaginal atrophy (VVA). Unlike vasomotor symptoms, vaginal dryness and dyspareunia, the main symptoms of VVA, typically worsen without treatment and can significantly impact the quality of life. Up to 60% of postmenopausal women may be affected by VVA, but many women unfortunately do not seek treatment due to embarrassment or other factors. After 20+ years in development, ospemifene (Osphena™) was approved by the US Food and Drug Administration in 2013 for treatment of moderate-to-severe dyspareunia associated with VVA due to menopause. As the first non-hormonal alternative to estrogen-based products for this indication, the approval of ospemifene represents a significant milestone in postmenopausal women’s health. Ospemifene is a non-steroidal estrogen receptor agonist/antagonist, also known as a selective estrogen receptor modulator (SERM), from the same chemical class as the breast cancer drugs tamoxifen and toremifene. Unlike other selective estrogen receptor modulators, ospemifene exerts a strong, nearly full estrogen agonist effect in the vaginal epithelium, making it well suited for the treatment of dyspareunia in postmenopausal women. Results of Phase III clinical trials showed that ospemifene significantly improved the vaginal maturation index (decreased parabasal cells and increased superficial cells), decreased vaginal pH, and decreased severity of the self-identified most bothersome symptom (dyspareunia or vaginal dryness) compared to placebo. Long-term safety studies revealed that 60 mg ospemifene given daily for 52 weeks was well tolerated and was not associated with any endometrium or breast-related safety concerns. This review discusses the preclinical and clinical data supporting the use of ospemifene for the treatment of dyspareunia associated with VVA due to menopause and provides an overview of its clinical safety.

Wurz, Gregory T; Kao, Chiao-Jung; DeGregorio, Michael W

2014-01-01

229

Hypertrophic lichen sclerosus with dyskeratosis and parakeratosis--a common presentation of vulvar lichen sclerosus not associated with a significant risk of malignancy.  

PubMed

Epithelial hyperplasia, individual necrotic keratocytes, and parakeratosis are common findings in lichen sclerosus. When those changes are prominent, they may pose diagnostic problems, especially because such lesions often show no or only minimal sclerosis. Necrotic keratocytes are often numerous and are found in all reaches of the epidermis, presenting themselves as eosinophilic globules with or without remnants of pyknotic nuclei. Because those changes tend to be accentuated focally above dermal papillae, they often give rise to narrow columns of parakeratosis in the overlying cornified layer. Within those columns, individual necrotic keratocytes with pyknotic nuclei are preserved as distinct dyskeratotic parakeratotic cells. That constellation of findings is fairly characteristic of hypertrophic lichen sclerosus. It was found, at least subtle and focally, in 14 of 70 consecutive biopsy specimens of lichen sclerosus, most of which came from the vulva of elderly women. Although similar cases have been described as differentiated vulvar intraepithelial neoplasia (VIN) in the literature, there was no significant nuclear atypia, no crowding of nuclei, and no significant mitotic activity in any of those lesions. Follow-up of at least 5 years in 8 patients revealed no development of squamous cell carcinoma. Hypertrophic lichen sclerosus with dyskeratosis and parakeratosis seems to be a relatively common presentation of vulvar lichen sclerosus not associated with a significant risk of malignancy. PMID:23328790

Weyers, Wolfgang

2013-10-01

230

The Effect of TIP on Pneumovirus-Induced Pulmonary Edema in Mice  

PubMed Central

Background Pulmonary edema plays a pivotal role in the pathophysiology of respiratory syncytial virus (RSV)-induced respiratory failure. In this study we determined whether treatment with TIP (AP301), a synthetic cyclic peptide that mimics the lectin-like domain of human TNF, decreases pulmonary edema in a mouse model of severe human RSV infection. TIP is currently undergoing clinical trials as a therapy for pulmonary permeability edema and has been shown to decrease pulmonary edema in different lung injury models. Methods C57BL/6 mice were infected with pneumonia virus of mice (PVM) and received TIP or saline (control group) by intratracheal instillation on day five (early administration) or day seven (late administration) after infection. In a separate set of experiments the effect of multiple dose administration of TIP versus saline was tested. Pulmonary edema was determined by the lung wet-to-dry (W/D) weight ratio and was assessed at different time-points after the administration of TIP. Secondary outcomes included clinical scores and lung cellular response. Results TIP did not have an effect on pulmonary edema in different dose regimens at different time points during PVM infection. In addition, TIP administration did not affect clinical severity scores or lung cellular response. Conclusion In this murine model of severe RSV infection TIP did not affect pulmonary edema nor course of disease. PMID:25047452

van den Berg, Elske; Bem, Reinout A.; Bos, Albert P.; Lutter, Rene; van Woensel, Job B. M.

2014-01-01

231

Evaluation of Peritumoral Edema in the Delineation of Radiotherapy Clinical Target Volumes for Glioblastoma  

SciTech Connect

Purpose: To evaluate the spatial relationship between peritumoral edema and recurrence pattern in patients with glioblastoma (GBM). Methods and Materials: Forty-eight primary GBM patients received three-dimensional conformal radiotherapy that did not intentionally include peritumoral edema within the clinical target volume between July 2000 and June 2001. All 48 patients have subsequently recurred, and their original treatment planning parameters were used for this study. New theoretical radiation treatment plans were created for the same 48 patients, based on Radiation Therapy Oncology Group (RTOG) target delineation guidelines that specify inclusion of peritumoral edema. Target volume and recurrent tumor coverage, as well as percent volume of normal brain irradiated, were assessed for both methods of target delineation using dose-volume histograms. Results: A comparison between the location of recurrent tumor and peritumoral edema volumes from all 48 cases failed to show correlation by linear regression modeling (r {sup 2} 0.0007; p = 0.3). For patients with edema >75 cm{sup 3}, the percent volume of brain irradiated to 46 Gy was significantly greater in treatment plans that intentionally included peritumoral edema compared with those that did not (38% vs. 31%; p = 0.003). The pattern of failure was identical between the two sets of plans (40 central, 3 in-field, 3 marginal, and 2 distant recurrence). Conclusion: Clinical target volume delineation based on a 2-cm margin rather than on peritumoral edema did not seem to alter the central pattern of failure for patients with GBM. For patients with peritumoral edema >75 cm{sup 3}, using a constant 2-cm margin resulted in a smaller median percent volume of brain being irradiated to 30 Gy, 46 Gy, and 50 Gy compared with corresponding theoretical RTOG plans that deliberately included peritumoral edema.

Chang, Eric L. [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States)]. E-mail: echang@mdanderson.org; Akyurek, Serap [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Avalos, Tedde C [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Rebueno, Neal C [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Spicer, Chris C [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Garcia, John C [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Famiglietti, Robin [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Allen, Pamela K. [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Chao, K.S. Clifford [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Mahajan, Anita [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Woo, Shiao Y. [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Maor, Moshe H. [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States)

2007-05-01

232

Local and systemic treatments for acute edema after burn injury: a systematic review of the literature.  

PubMed

Burn injury is a complex trauma that results in local and generalized edema. Edema fluid limits the exchange of vital nutrients in healing the burn wound and will compromise vulnerable tissues. Although the importance of edema control in tissue salvage is recognized, treatments targeted at edema control have not been critically reviewed. Thus, the objective was to assess the evidence for the effectiveness of local and systemic treatments for edema management immediately after burn injury. Searches for randomized controlled trials were conducted of online databases, research and thesis registers, and grey literature repositories. Handsearches included journals, bibliographies, and proceedings. Authors were contacted to clarify and submit extra study details. Eight studies were included. Management of acute major burn resuscitation including colloid increases lung edema (mean difference [MD], 0.04 ml/ml alv vol; 95% confidence interval [CI], 0.03-0.04; P < .00001) and mortality (risk ratio, 3.67; 95% CI, 1.16-11.58; P = .03). Continuous administration of vitamin C in acute burn resuscitation reduces local wound edema (MD, -3.50 ml/g; 95% CI, -4.63 to -2.37; P < .00001) and systemic fluid retention (MD, -8.60 kg; 95% CI, -13.47 to -3.73; P = .0005). Local acute hand burn edema is reduced (MD, -29.00 ml; 95% CI, -53.14 to -4.86; P = .02), and active hand motion increased (MD, 10.00°; 95% CI, 4.58-15.42; P = .0003), using electrical stimulation with usual physiotherapy. Each review outcome was based on a small single-facility study. Thus, future research in intervention for acute burn edema must focus on multicentre trials and validation of outcome measures in the burn population. PMID:21252688

Edgar, Dale Wesley; Fish, Joel S; Gomez, Manuel; Wood, Fiona Melanie

2011-01-01

233

Treatment of systemic hypertension is important for improvement of macular edema associated with retinal vein occlusion  

PubMed Central

Background We report our findings in three cases of unilateral macular edema associated with retinal vein occlusion (RVO) that improved after successful treatment of systemic hypertension alone. Methods All three cases had systemic hypertension but no diabetes mellitus or other ocular diseases associated with macular edema. All patients were treated only with medication for systemic hypertension. Optical coherence tomography was performed to determine the foveal thickness before and after treatment. Results Case one was a 72-year-old woman with a central RVO who had macular edema in her left eye and a visual acuity (VA) of 20/50. Her blood pressure (BP) was 169/96 mmHg. One month after the initiation of a calcium blocker to treat her systemic hypertension, her BP was decreased, macular edema was reduced, and her VA improved to 20/20. Case two was a 62-year-old woman with branch RVO. Her VA was 20/40 and her BP was 165/97 mmHg. Six weeks after initiation of medication to treat her systemic hypertension, her RVO-related macular edema had decreased and her VA improved to 20/20. Case three was a 71-year-old man with branch RVO. His VA was 20/50 and his BP was 165/87 mmHg. One month after initiation of treatment for systemic hypertension, his RVO-related macular edema had disappeared and his VA improved to 20/20. All three cases had nonischemic RVO by fluorescein angiography, and they did not develop ischemic changes for at least 1 year. Conclusion The reduction of macular edema following a decrease in the systemic hypertension suggests that the edema was most likely caused by leakage of fluids from the blood vessels. We recommend that the blood pressure should be measured in all patients with macular edema before initiating intravitreal anti-VEGF therapy. PMID:24876761

Kida, Teruyo; Morishita, Seita; Kakurai, Keigo; Suzuki, Hiroyuki; Oku, Hidehiro; Ikeda, Tsunehiko

2014-01-01

234

Structural changes in individual retinal layers in diabetic macular edema.  

PubMed

Optical coherence tomography (OCT) has enabled objective measurement of the total retinal thickness in diabetic macular edema (DME). The central retinal thickness is correlated modestly with visual impairment and changes paradoxically after treatments compared to the visual acuity. This suggests the clinical relevance of the central retinal thickness in DME and the presence of other factors that affect visual disturbance. Recent advances in spectral-domain (SD) OCT have provided better delineation of the structural changes and fine lesions in the individual retinal layers. Cystoid spaces in the inner nuclear layer and outer plexiform layer are related to quantitative and qualitative parameters in fluorescein angiography. OCT often shows vitreoretinal interface abnormalities in eyes with sponge-like retinal swelling. Serous retinal detachment is sometimes accompanied by hyperreflective foci in the subretinal fluid, which exacerbates the pathogenesis at the interface of the photoreceptors and retinal pigment epithelium. Photoreceptor damage at the fovea is thought to be represented by disruption of the external limiting membrane or the junction between the inner and outer segment lines and is correlated with visual impairment. Hyperreflective foci in the outer retinal layers on SD-OCT images, another marker of visual disturbance, are associated with foveal photoreceptor damage. PMID:24073417

Murakami, Tomoaki; Yoshimura, Nagahisa

2013-01-01

235

Bevacizumab for the management of diabetic macular edema  

PubMed Central

Diabetic retinopathy (DR) is a leading cause of vision loss in the working-age population and is relatedto 1%-5% of cases of blindness worldwide. Diabetic macular edema (DME) is the most frequent cause of DR vision loss and is an important public health problem. Recent studies have implicated vascular endothelial growth factor (VEGF) in DR and DME pathogenesis, as well as provided evidence of the benefits of anti-VEGF agents for the management of such conditions. Despite the benefits of intravitreal ranibizumab injection for the management of DME, the cost-effectiveness of intravitreal bevacizumab therapy has gained increasing interest in the scientific community. This review summarizes the studies examining bevacizumab for the management of DME, focusing on the efficacy and duration of the clinical benefits of decreasing DME and the improvement of best-corrected visual acuity (BCVA). There is strong evidence that intravitreal bevacizumab injection therapy has a good cost-effective profile in the management of DME and may be associated with laser photocoagulation; however, its clinical superiority in terms of the duration of DME regression and the improvement of BCVA compared with intravitreal ranibizumab and other intravitreal anti-VEGF therapies remains unclear and deserves further investigation. PMID:23593532

Stefanini, Francisco Rosa; Arevalo, J Fernando; Maia, Mauricio

2013-01-01

236

Optical coherence tomography classification of diabetic cystoid macular edema  

PubMed Central

Purpose To propose a new classification of diabetic cystoid macular edema (CME) based on optical coherence tomography (OCT) findings and cover all new important findings. Patients and methods A retrospective study was carried out in the El-Minia Investigation Eye Center between January 2012 and November 2012. It included 104 eyes of 86 patients, aged between 50 and 71 years, all with type II diabetes mellitus of duration from 5 to 20 years. All patients were diagnosed to have CME, as assessed by OCT, with measurement of the vertical size of the largest macular cyst and maximum macular thickness, and the relation between them. Results Patients were divided into four groups. Eyes with cysts less than 30% of macular thickness were considered to have CME I (n = 4, 3.84%), while those between 30% and 60% were considered to have CME II (n = 62, 59.62%). Eyes with cysts between 60% and 90% of macular thickness were considered to have CME III (n = 36, 34.62%). CME IV was diagnosed when the size of the cyst became more than 90% of the macular thickness, and this was encountered in two eyes (1.92%). Conclusions OCT is a useful technique for quantitative measurement and helps in better anatomical characterization of CME, and this classification of diabetic CME may be of value in classification of CME due to causes other than diabetes. PMID:24039393

Helmy, Yasser M; Allah, Heba R Atta

2013-01-01

237

Structural Changes in Individual Retinal Layers in Diabetic Macular Edema  

PubMed Central

Optical coherence tomography (OCT) has enabled objective measurement of the total retinal thickness in diabetic macular edema (DME). The central retinal thickness is correlated modestly with visual impairment and changes paradoxically after treatments compared to the visual acuity. This suggests the clinical relevance of the central retinal thickness in DME and the presence of other factors that affect visual disturbance. Recent advances in spectral-domain (SD) OCT have provided better delineation of the structural changes and fine lesions in the individual retinal layers. Cystoid spaces in the inner nuclear layer and outer plexiform layer are related to quantitative and qualitative parameters in fluorescein angiography. OCT often shows vitreoretinal interface abnormalities in eyes with sponge-like retinal swelling. Serous retinal detachment is sometimes accompanied by hyperreflective foci in the subretinal fluid, which exacerbates the pathogenesis at the interface of the photoreceptors and retinal pigment epithelium. Photoreceptor damage at the fovea is thought to be represented by disruption of the external limiting membrane or the junction between the inner and outer segment lines and is correlated with visual impairment. Hyperreflective foci in the outer retinal layers on SD-OCT images, another marker of visual disturbance, are associated with foveal photoreceptor damage. PMID:24073417

Yoshimura, Nagahisa

2013-01-01

238

Proanthocyanidin to prevent formation of the reexpansion pulmonary edema  

PubMed Central

Background We aimed to investigate the preventive effect of Proanthocyanidine (PC) in the prevention of RPE formation. Methods Subjects were divided into four groups each containing 10 rats. In the Control Group (CG): RPE wasn't performed. Then subjects were followed up for three days and they were sacrificed after the follow up period. Samplings were made from tissues for measurement of biochemical and histopathologic parameters. In the Second Group (PCG): The same protocol as CG was applied, except the administration of PC to the subjects. In the third RPE Group (RPEG): Again the same protocol as CG was applied, but as a difference, RPE was performed. In the Treatment Group (TG): The same protocol as RPEG was applied except the administration of PC to the subjects. Results In RPEG group, the most important histopathological finding was severe pulmonary edema with alveolar damage and acute inflammatory cells. These findings were less in the TG group. RPE caused increased MDA levels, and decreased GPx, SOD and CAT activity significantly in lung tissue. Conclusion PC decreased MDA levels. Oxidative stress plays an important role in pathophysiology of RPE and PC treatment was shown to be useful to prevent formation of RPE. PMID:19638221

Yucel, Orhan; Ucar, Ergun; Tozkoparan, Ergun; Gunal, Armagan; Akay, Cemal; Sahin, Mehmet Ali; Genc, Onur

2009-01-01

239

Anti-VEGF for the Management of Diabetic Macular Edema  

PubMed Central

Diabetic retinopathy (DR) is an important cause of vision loss around the world, being the leading cause in the population between 20 and 60 years old. Among patients with DR, diabetic macular edema (DME) is the most frequent cause of vision impairment and represents a significant public health issue. Macular photocoagulation has been the standard treatment for this condition reducing the risk of moderate visual loss by approximately 50%. The role of vascular endothelial growth factor (VEGF) in DR and DME pathogenesis has been demonstrated in recent studies. This review addresses and summarizes data from the clinical trials that investigated anti-VEGF for the management of DME and evaluates their impact on clinical practice. The literature searches were conducted between August and October 2013 in PubMed and Cochrane Library with no date restrictions and went through the most relevant studies on pegaptanib, ranibizumab, bevacizumab, and aflibercept for the management of DME. The efficacy and safety of intravitreal anti-VEGF as therapy for DME have recently been proved by various clinical trials providing significantly positive visual and anatomical results. Regarding clinical practice, those outcomes have placed intravitreal injection of anti-VEGF as an option that must be considered for the treatment of DME. PMID:24741610

Stefanini, Francisco Rosa; Badaró, Emmerson; Falabella, Paulo; Koss, Michael; Farah, Michel Eid; Maia, Maurício

2014-01-01

240

The mechanism of neurogenic pulmonary edema in epilepsy.  

PubMed

Neurogenic pulmonary edema (NPE) is found in many epilepsy patients at autopsy. It is a life-threatening complication, known for almost 100 years, but its etiopathogenesis is still not completely understood. In this study, we used the tremor rat (TRM: tm/tm) as an animal model of epilepsy to investigate the potential mechanisms of NPE under epileptic conditions. We performed reverse-phase high-pressure liquid chromatography assay, H&E and Masson staining, TUNEL assay, and Western blot experiments to determine the role of seizures in NPE. We found the level of catecholamine was higher in TRM rats. Also the occurrence of alveolar cell apoptosis was increased. Moreover, pulmonary vascular remodeling including the deposition of collagen and medial thickening was also found in TRM rats. Further study showed that cell apoptosis was mediated by increasing Bax, decreasing Bcl-2, and activating caspase-3. In addition, the protein level of phosphorylated ERK (p-ERK) was found to be decreased while phosphorylated JNK and phosphorylated p38 were upregulated in TRM rats. Thus, these findings suggest that pulmonary vascular remodeling and alveolar cell apoptosis might be involved in epilepsy-induced NPE and that the mitogen-activated protein kinase signal pathway was involved. PMID:24142459

Zhao, Hong; Lin, Guijun; Shi, Mumu; Gao, Jingquan; Wang, Yanming; Wang, Hongzhi; Sun, Hongli; Cao, Yonggang

2014-01-01

241

Fluoroquinolones reduce carrageenan-induced edema in rats and the involvement of the glucocorticoid receptor system.  

PubMed

We studied the effect of fluoroquinolones (FQs) on carrageenan-induced edema in the rat footpad. Ciprofloxacin, gatifloxacin, sparfloxacin, norfloxacin, and enoxacin (s.c., 100 mg/kg), which have piperazinyl and/or cyclopropyl groups, inhibited carrageenan-induced edema, whereas levofloxacin, tosufloxacin, and pazufloxacin did not. The reduction of edema by ciprofloxacin, sparfloxacin, and enoxacin was abolished by pretreatment with mifepristone, an antagonist of the glucocorticoid receptor. These results suggest that FQs with piperazinyl and/or cyclopropyl groups can modify biological responses through enhancing the glucocorticoid-glucocorticoid receptor system. PMID:19396522

Ogino, Hiromi; Yamada, Kaori; Yuhara, Mizuki; Tsuchida, Saori; Maezawa, Kayoko; Kizu, Junko; Hori, Seiji

2009-04-01

242

Reexpansion pulmonary edema following a posttraumatic pneumothorax: a case report and review of the literature  

PubMed Central

The reexpansion pulmonary edema is a rare, but life threatening complication of a pneumothorax. Early recognition and a fast symptom orientated therapy are necessary for a good outcome. Several cases after non traumatic pneumothoraces are reported. We describe a patient who presented with a post-traumatic right pneumothorax. After the insertion of a chest tube he developed a reexpansion pulmonary edema, which had to be treated by an intubation. Additionally, a review of the literature regarding case reports of reexpansion pulmonary edema is presented. PMID:21888638

2011-01-01

243

Characterization of corneal edema by forward and backward second harmonic generation microscopy  

NASA Astrophysics Data System (ADS)

We used second harmonic generation (SHG) microscopy to image and quantify the structural changes of bovine corneal edema. Forward SHG (FWSHG) and backward SHG (BWSHG) signals were simultaneously collected from normal and edematous bovine corneas to reveal their morphological differences. In SHG imaging, edematous corneas can be characterized by uneven expansion in the lamellar interspacing and increased lamellar thickness in posterior stroma (depth > 200 ?m), while the anterior stroma composed of interwoven collagen architecture remained unaffected. Our work demonstrate the capability of SHG imaging in providing morphological information for the investigation of corneal edema biophysics and its potential application in the in vivo evaluation of advancing corneal edema.

Hsueh, Chiu-Mei; Lo, Wen; Chen, Wei-Liang; Hovhannisyan, Vladimir A.; Tan, Hsin-Yuan; Dong, Chen-Yuan

2010-02-01

244

Evaluation & design of a novel drug delivery device for treating tumor-related cerebral edema  

E-print Network

Tumor-related cerebral edema is a debilitating medical condition that afflicts tens of thousands of newly diagnosed brain cancer patients in the U.S. each year, where the standard care of treatment indicates the systemic ...

Shair, Kamal A. (Kamal Abdo)

2010-01-01

245

MYELIN BASIC PROTEIN-MESSENGER RNA (MBP-MRNA) EXPRESSION DURING TRIETHYLTIN-INDUCED MYELIN EDEMA  

EPA Science Inventory

Triethyltin (TET) is a neurotoxicant that produces severe but transient cerebral edema, characterized ultrastructurally by vacuolation of the intraperiod line of central nervous system (CNS) myelin. ET has been reported to depress levels of myelin basic protein (MBP), a glycoprot...

246

Cell-mediated allergy to cerebral aneurysm clip causing extensive cerebral edema.  

PubMed

The authors report the first case of vasogenic cerebral edema due to a cell-mediated hypersensitivity reaction to a nickel-containing aneurysm clip. The patient initially presented for elective clipping of a right middle cerebral artery aneurysm, and on long-term follow-up she demonstrated relapsing-remitting cerebral edema. Four years post-aneurysm clipping, she underwent an exploratory craniotomy given unsuccessful conservative management of her headaches and imaging evidence of cerebral edema with mass effect. During surgery, gross parenchymal edema and inflammatory nodules were observed. Histopathology was consistent with a cell-mediated (Type IV) hypersensitivity reaction. Concerns regarding nickel allergy are often reported in the cardiac literature. This case highlights the possibility of nickel hypersensitivity when using nickel-containing aneurysm clips, especially in patients with known nickel allergies. PMID:24995790

Tan, Terence; Tee, Jin W; Han, Tiew F

2014-10-01

247

Quick and accurate measures in negative pressure pulmonary edema: a guideline for orthognathic surgeons.  

PubMed

Perioperative pulmonary edema is a rare complication of maxillofacial surgery. However, this potentially fatal complication may arise during any maxillofacial surgery. Negative pressure pulmonary edema can be caused by upper airway obstruction after operation. When this phenomenon arises, if not treated properly, it progresses rapidly causing fatal outcomes. Because orthognathic surgery is performed mostly on healthy and young patients, surgeons and anesthesiologists might neglect the possibility of such complications. Therefore, we must always take into consideration the possibility of negative pressure pulmonary edema. Careful observation of the patient; accurate knowledge; and active, quick, and noninvasive safe measures are required to treat this malady when it does occur. We report a case of negative pressure pulmonary edema after orthognathic surgery and its successful treatment. PMID:25153065

Hong, Sung Ok; Chung, Jun-Young; Lee, Deok-Won

2014-09-01

248

Various irrigation fluids affect postoperative brain edema and cellular damage during experimental neurosurgery in rats  

Microsoft Academic Search

BackgroundThis study was conducted to investigate how various irrigation fluids used during neurosurgical procedures affect the degree of postoperative brain edema and cellular damage during experimental neurosurgery in rats.

Kazuhisa Doi; Takeshi Kawano; Yujiro Morioka; Yasutaka Fujita; Masuhiro Nishimura

2006-01-01

249

Efficacy and retention times of intravitreal triamcinolone acetonide for macular edema  

Microsoft Academic Search

Purpose  To evaluate the retention of intravitreal triamcinolone acetonide (TA) particles and the efficacy of TA therapy for patients\\u000a with cystoid macular edema in branch retinal vein occlusion (BRVO) or diabetic macular edema (DME). We monitored the TA particles\\u000a until absorption from the vitreous cavity was complete. The correlation between the intravitreal retention time of TA and\\u000a its efficacy was evaluated

Akiko Kogure; Kishiko Ohkoshi; Shunsuke Kogure; Tatsuo Yamaguchi; Shoji Kishi

2008-01-01

250

B-type natriuretic peptide measurement for early diagnosis of acute pulmonary edema during pregnancy.  

PubMed

Calcium-channel blockers administered to pregnant women as tocolytic agents can cause acute pulmonary edema. The first signs of this severe complication can be atypical and so delay introduction of appropriate therapy. We describe three cases in whom B-type natriuretic peptide measurements proved to be relevant in early diagnosis and monitoring of pregnant women with acute pulmonary edema. B-type natriuretic peptide measurement in this setting could contribute to timely diagnosis and improve follow-up. PMID:25231570

Seror, Jeremy; Lefevre, Guillaume; Berkane, Nathalie; Richard, Frederic; Bornes, Marie; Uzan, Serge; Berkane, Nadia

2014-12-01

251

Are sildenafil and theophylline effective in the prevention of high-altitude pulmonary edema?  

Microsoft Academic Search

High-altitude pulmonary edema reflects a potentially life-threatening condition affecting susceptible persons in the second night after ascent to altitudes above 2500m. Currently, nifedipine is the only pharmacological intervention approved for both, prevention and treatment of high-altitude pulmonary edema. We evaluated the application of the phosphodiesterase-V inhibitor sildenafil combined with the non-selective phosphodiesterase-inhibitor theophylline as preventive agents. In theory, the proposed

A Kleinsasser; A Loeckinger

2002-01-01

252

Connectivity of Default-Mode Network Is Associated with Cerebral Edema in Hepatic Encephalopathy  

Microsoft Academic Search

Cerebral edema, a well-known feature of acute liver disease, can occur in cirrhotic patients regardless of hepatic encephalopathy (HE) and adversely affect prognosis. This study characterized and correlated functional HE abnormalities in the brain to cerebral edema using resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI). Forty-one cirrhotic patients (16 without HE, 14 minimal HE, 11 overt

Wei-Che Lin; Tun-Wei Hsu; Chao-Long Chen; Changwei W. Wu; Cheng-Hsien Lu; Hsiu-Ling Chen; Shau-Hsuan Li; Pin-Yang Yeh; Yu-Fan Cheng; Ching-Po Lin

2012-01-01

253

Acute hemorrhagic edema of infancy: report of 4 cases and review of the current literature.  

PubMed

Acute hemorrhagic edema of infancy (AHEI) is a cutaneous leukocytoclastic vasculitis that usually occurs in children younger than 2 years of age. It is a rare disease characterized by mild fever, a violent onset of hemorrhagic skin lesions, and edema usually followed by a spontaneous and complete recovery. Although the etiology is unknown, AHEI often follows infections, drug treatment, or vaccination. In the present report, the authors describe 4 cases of AHEI and review the relevant literature. PMID:18772356

Karremann, Michael; Jordan, Alexander J; Bell, Nellie; Witsch, Michael; Dürken, Matthias

2009-04-01

254

Acute bone marrow edema of the hip: role of MR imaging  

Microsoft Academic Search

Acute bone marrow edema of the hip is a diagnostic challenge for both radiologists and clinicians. Marrow edema is often seen\\u000a in patients with hip pain and restriction of motion. In patients with acute non-traumatic hip pain, whose radiographs are\\u000a negative or inconclusive, MR imaging is the imaging study of choice. MR imaging is the most sensitive and specific imaging

Apostolos H. Karantanas

2007-01-01

255

Predictors of Life-Threatening Brain Edema in Middle Cerebral Artery Infarction  

Microsoft Academic Search

Background: We performed a systematic review to identify predictors of the development of life-threatening brain edema in patients with middle cerebral artery infarction. Methods: We searched Medline from January 1966 and Embase from January 1974 to April 2007 for cohort and case-control studies on predictors of life-threatening edema in patients with middle cerebral artery infarction. Crude data were used to

Jeannette Hofmeijer; Ale Algra; L. Jaap Kappelle; H. Bart van der Worp

2008-01-01

256

Nitric oxide modulates pancreatic edema formation in rat caerulein-induced pancreatitis  

Microsoft Academic Search

This study was designed to investigate the role of nitric oxide (NO) in the formation of pancreatic edema in caerulein-induced\\u000a pancreatitis in rats. Pancreatitis was produced by two intraperitoneal injections of caerulein, and plasma amylase concentration,\\u000a pancreatic edema index (pancreatic wet weight\\/body weight), and Evans blue extravasation (as a measure of vascular permeability)\\u000a were evaluated 5h after the first injection.

Takashi Abe; Tooru Shimosegawa; Akihiko Satoh; Reishi Abe; Yoshifumi Kikuchi; Masaru Koizumi; Takayoshi Toyota

1995-01-01

257

Intraocular bevacizumab for macular edema due to CRVO. A multifocal-ERG and OCT study  

Microsoft Academic Search

Purpose To evaluate by multifocal electroretinography (MFERG) and optical coherence tomography (OCT) the effectiveness of intravitreal\\u000a use of bevacizumab (Avastin) in the treatment of macular edema due to central retinal vein occlusion (CRVO). Methods A total of 10 eyes of 10 patients (six males and four females) with macular edema due to CRVO were studied before and after\\u000a intravitreal use

Marilita M. Moschos; Michael Moschos

2008-01-01

258

Treatment of leg edema and wounds in a patient with severe musculoskeletal injuries.  

PubMed

This case report describes the application of a technique for the treatment of leg edema and wounds resulting from a severe distal tibiofibular fracture. Following injury and numerous fracture- and wound-related surgeries in the first year postinjury, this patient developed leg edema, required daily treatment of 2 leg wounds, and was unable to wear a shoe due to foot swelling. He was referred to the physical therapy clinic 1 year postinjury for ankle rehabilitation and to diminish the leg edema. Therapy consisting of manual lymph drainage, compressive bandaging, exercise, and skin care was provided for 7 weeks. A compression stocking was issued near the end of treatment, which the patient continued to wear daily thereafter. At the time of discharge from therapy, the leg edema had decreased 74% and the wound area of both wounds had decreased 89%. Improvements continued following discharge. By 10 weeks after the start of treatment, edema had decreased 80.9%, one wound had healed, and the second wound was 93% improved. The patient was able to wear a shoe and resume recreational activities. This case report provides insight into a treatment that may shorten rehabilitation and control the cost of caring for injuries complicated by prolonged edema. PMID:9781704

Weiss, J M

1998-10-01

259

Infliximab for Diabetic Macular Edema Refractory to Laser Photocoagulation  

PubMed Central

OBJECTIVE Because many patients with diabetic macular edema (DME) do not respond to focal/grid laser photocoagulation, the only currently approved treatment, alternatives are needed. Based on encouraging preliminary findings, we aimed to assess efficacy and safety of the anti–tumor necrosis factor (TNF) monoclonal antibody infliximab in this condition. RESEARCH DESIGN AND METHODS This was a single-center, double-blind, randomized, placebo-controlled, crossover study. Eleven patients with sight-threatening DME persisting after two sessions of laser photocoagulation received infliximab (5 mg/kg) intravenously at weeks 0, 2, 6, and 14, followed by placebo at weeks 16, 18, 22, and 30, or vice versa. Blinding was maintained to week 32, when the final assessments were performed. Best corrected visual acuity evaluated by a mixed-models approach for imbalanced crossover design using the percentage difference as the outcome variable was the primary study end point. Data were analyzed on an intention-to-treat basis. RESULTS Early Treatment of Diabetic Retinopathy Study (ETDRS) scores dropped from 31.6 ± 5.1 (mean ± SD) letters read at baseline to 28.8 ± 11.6 letters read at week 16 in six placebo-treated eyes and improved to 35.4 ± 11.2 letters read after infliximab. In contrast, visual acuity improved from 23.5 ± 10.3 at baseline to 30.4 ± 13.4 letters read at week 16 in eight infliximab-treated eyes and was sustained at completion of placebo treatment (31.4 ± 12.1 letters read). The excess visual acuity in infliximab-treated eyes was greater by 24.3% compared with that in placebo-treated eyes (95% CI 4.8–43.7; P = 0.017). Infliximab treatment was well tolerated. CONCLUSIONS The positive results of this small phase III study suggest that larger and longer term trials should be conducted to assess the efficacy of systemic or intravitreal anti-TNF agent administration for primary treatment of DME. PMID:20413522

Sfikakis, Petros P.; Grigoropoulos, Vlassis; Emfietzoglou, Ioannis; Theodossiadis, George; Tentolouris, Nicholas; Delicha, Evi; Katsiari, Christina; Alexiadou, Kleopatra; Hatziagelaki, Erifili; Theodossiadis, Panayiotis G.

2010-01-01

260

Management of a Klippel-Trenaunay syndrome in pregnant women with mega-cisterna magna and splenic and vulvar varices at birth: a case report.  

PubMed

Klippel-Trenaunay syndrome (KTS) is a rare, sporadic and complex malformation characterized by the clinical triad of: (i) capillary malformation (port-wine stain); (ii) soft tissue and bone hypertrophy or occasionally, hypertrophy of one lower limb; and (iii) atypical lateral varicosity. The maternal and fetal risks associated with pregnancy in women with KTS are proportional to disease severity, which can be exacerbated by pregnancy. Complications include bleeding, disseminated intravascular coagulation, thromboembolic events and pain. Here, we report the case of a pregnant woman with KTS who had an uneventful pregnancy, labor and postpartum course, but had splenic and large vulvar vein varices. The obstetrical course of women with KTS varies. Management is largely conservative and multidisciplinary approaches form the mainstay for managing these patients based on their symptoms. PMID:22612590

Atis, Alev; Ozdemir, Gunseli; Tuncer, Gulden; Cetincelik, Umran; Goker, Nimet; Ozsoy, Sibel

2012-11-01

261

Delayed increase of astrocytic aquaporin 4 after juvenile traumatic brain injury: possible role in edema resolution?  

PubMed Central

Traumatic brain injury (TBI) is one of the leading causes of death and disability in children and adolescents. The neuropathological sequelae that result from TBI are a complex cascade of events including edema formation, which occurs more frequently in the pediatric than the adult population. This developmental difference in the response to injury may be related to higher water content in the young brain and also to molecular mechanisms regulating water homeostasis. Aquaporins (AQPs) provide a unique opportunity to examine the mechanisms underlying water mobility, which remain poorly understood in the juvenile post-traumatic edema process. We examined the spatiotemporal expression pattern of principal brain AQPs (AQP1, 4, and 9) after juvenile TBI (jTBI) related to edema formation and resolution observed using magnetic resonance imaging (MRI). Using a controlled cortical impact in post-natal 17 day-old rats as a model of jTBI, neuroimaging analysis showed a global decrease in water mobility (apparent diffusion coefficient, ADC) and an increase in edema (T2-values) at 1 day post-injury, which normalized by 3 days. Immunohistochemical analysis of AQP4 in perivascular astrocyte endfeet was increased in the lesion at 3 and 7 days post-injury as edema resolved. In contrast, AQP1 levels distant from the injury site were increased at 7, 30, and 60 days within septal neurons but did not correlate with changes in edema formation. Group differences were not observed for AQP9. Overall, our observations confirm that astrocytic AQP4 plays a more central role than AQP1 or AQP9 during the edema process in the young brain. PMID:22728101

Fukuda, Andrew M; Pop, Viorela; Spagnoli, David; Ashwal, Stephen; Obenaus, Andre; Badaut, Jerome

2012-01-01

262

Delayed increase of astrocytic aquaporin 4 after juvenile traumatic brain injury: possible role in edema resolution?  

PubMed

Traumatic brain injury (TBI) is one of the leading causes of death and disability in children and adolescents. The neuropathological sequelae that result from TBI are a complex cascade of events including edema formation, which occurs more frequently in the pediatric than the adult population. This developmental difference in the response to injury may be related to higher water content in the young brain and also to molecular mechanisms regulating water homeostasis. Aquaporins (AQPs) provide a unique opportunity to examine the mechanisms underlying water mobility, which remain poorly understood in the juvenile post-traumatic edema process. We examined the spatiotemporal expression pattern of principal brain AQPs (AQP1, AQP4, and AQP9) after juvenile TBI (jTBI) related to edema formation and resolution observed using magnetic resonance imaging (MRI). Using a controlled cortical impact in post-natal 17 day-old rats as a model of jTBI, neuroimaging analysis showed a global decrease in water mobility (apparent diffusion coefficient, ADC) and an increase in edema (T2-values) at 1 day post-injury, which normalized by 3 days. Immunohistochemical analysis of AQP4 in perivascular astrocyte endfeet was increased in the lesion at 3 and 7days post-injury as edema resolved. In contrast, AQP1 levels distant from the injury site were increased at 7, 30, and 60 days within septal neurons but did not correlate with changes in edema formation. Group differences were not observed for AQP9. Overall, our observations confirm that astrocyticAQP4 plays a more central role than AQP1 or AQP9 during the edema process in the young brain. PMID:22728101

Fukuda, A M; Pop, V; Spagnoli, D; Ashwal, S; Obenaus, A; Badaut, J

2012-10-11

263

Fluorescein angiography vs. optical coherence tomography for diagnosis of uveitic macular edema  

PubMed Central

Objective To evaluate agreement between fluorescein angiography (FA) and optical coherence tomography (OCT) for diagnosis of macular edema in patients with uveitis. Design Multicenter cross-sectional study Participants Four hundred seventy-nine eyes with uveitis of 255 patients Methods The macular status of dilated eyes with intermediate, posterior or panuveitis was assessed via Stratus-3 OCT and FA. Kappa statistics evaluated agreement between the diagnostic approaches. Main Outcome Measures Macular thickening (center point thickness ?240 ?m per reading center grading of OCT images-“MT”) and macular leakage (central subfield fluorescein leakage ?0.44 disk areas per reading center grading of FA images-“ML”); agreement amongst these outcomes in diagnosing “macular edema.” Results OCT (90.4%) more frequently returned usable information regarding macular edema than FA (77%) and biomicroscopy (76%). Agreement in diagnosis of MT and ML (?=0.44) was moderate. ML was present in 40% of cases free of MT, whereas MT was present in 34% of cases without ML. Biomicroscopic evaluation for macular edema failed to detect 40% and 45% of cases of MT and ML respectively and diagnosed 17% and 17% of cases with macular edema which did not have MT or ML respectively; these results may underestimate biomicroscopic errors (ophthalmologists were not explicitly masked to OCT and FA results). Among eyes free of ML, phakic eyes without cataract rarely (4%) had MT. No factors were found that effectively ruled out ML when MT was absent. Conclusion OCT and FA offered only moderate agreement regarding macular edema status in uveitis cases, probably because what they measure (MT and ML) are related but non-identical macular pathologies. Given its lower cost, greater safety, and greater likelihood of obtaining usable information, OCT may be the best initial test for evaluation of suspected macular edema. However, given that ML cannot be ruled out if MT is absent and vice versa, obtaining the second test after a negative result on the first seems justified when detection of ML or MT would alter management. Given that biomicroscopic evaluation for macular edema frequently erred, ancillary testing for macular edema seems indicated when knowledge of ML or MT status would affect management. PMID:23706700

Kempen, John H.; Sugar, Elizabeth A.; Jaffe, Glenn J.; Acharya, Nisha R.; Dunn, James P.; Elner, Susan G.; Lightman, Susan L.; Thorne, Jennifer E.; Vitale, Albert T.; Altaweel, Michael M.

2013-01-01

264

Cardiac MRI of Edema in Acute Myocardial Infarction using Cine Balanced SSFP: A Translational Study  

PubMed Central

Objective To investigate the capabilities of balanced steady-state-free-precession (bSSFP) MRI as a novel cine imaging approach for characterizing myocardial edema in animals and patients following reperfused myocardial infarction. Background Current MRI methods require two separate scans for assessment of myocardial edema and cardiac function. Methods Mini-pigs (n=13) with experimentally induced reperfused myocardial infarction and patients with reperfused STEMI (n=26) underwent MR scans on days 2–4 post reperfusion. Cine bSSFP, T2-STIR, and late-gadolinium enhancement (LGE) were performed at 1.5T. Cine bSSFP and T2-STIR images were acquired with body coil to mitigate surface coil bias. Signal, contrast and the area of edema were compared. Additional patients (n=10) were analyzed for the effect of microvascular obstruction on bSSFP. A receiver-operator-characteristic analysis was performed to assess the accuracy of edema detection. Results An area of hyperintense bSSFP signal consistent with edema was observed in the infarction zone (contrast-to-noise ratio (CNR) 37±13) in all animals and correlated well with the area of LGE (R=0.83, p<0.01). In all patients, T2-STIR and bSSFP images showed regional hyperintensity in the infarction zone. Normalized CNR were not different between T2-STIR and bSSFP. On a slice-basis, the volumes of hyperintensity on T2-STIR and bSSFP images correlated well (R=0.86, p<0.001), and their means were not different. When compared with T2-STIR, bSSFP was positive for edema in 25/26 patients (sensitivity of 96%) and was negative in all controls (specificity 100%). All patients with MVO showed a significant reduction of signal in the subendocardial infarction zone, compared to infarcted epicardial tissue without MVO (p<0.05). Conclusion Myocardial edema from STEMI can be detected using cine bSSFP imaging with image contrast similar to T2-STIR. This new imaging approach allows for evaluating cardiac function and edema simultaneously, thereby reducing patient scan time and increasing efficiency. Further work is necessary to optimize edema contrast in bSSFP images. PMID:22172783

Kumar, Andreas; Beohar, Nirat; Arumana, Jain Mangalathu; Larose, Eric; Li, Debiao; Friedrich, Matthias G; Dharmakumar, Rohan

2012-01-01

265

Elevated VEGF Levels in Pulmonary Edema Fluid and PBMCs from Patients with Acute Hantavirus Pulmonary Syndrome  

PubMed Central

Hantavirus pulmonary syndrome is characterized by vascular permeability, hypoxia, and acute pulmonary edema. Vascular endothelial growth factor (VEGF) is induced by hypoxia, potently induces vascular permeability, and is associated with high-altitude-induced pulmonary edema. Hantaviruses alter the normal regulation of ?3 integrins that restrict VEGF-directed permeability and hantavirus infected endothelial cells are hyperresponsive to the permeabilizing effects of VEGF. However, the role of VEGF in acute pulmonary edema observed in HPS patients remains unclear. Here we retrospectively evaluate VEGF levels in pulmonary edema fluid (PEF), plasma, sera, and PBMCs from 31 HPS patients. VEGF was elevated in HPS patients PEF compared to controls with the highest levels observed in PEF samples from a fatal HPS case. VEGF levels were highest in PBMC samples during the first five days of hospitalization and diminished during recovery. Significantly increased PEF and PBMC VEGF levels are consistent with acute pulmonary edema observed in HPS patients and HPS disease severity. We observed substantially lower VEGF levels in a severe HPS disease survivor after extracorporeal membrane oxygenation. These findings suggest the importance of patients' VEGF levels during HPS, support the involvement of VEGF responses in HPS pathogenesis, and suggest targeting VEGF responses as a potential therapeutic approach. PMID:22956954

Gavrilovskaya, Irina; Gorbunova, Elena; Koster, Frederick; Mackow, Erich

2012-01-01

266

Posttraumatic reduction of edema with aquaporin-4 RNA interference improves acute and chronic functional recovery  

PubMed Central

Traumatic brain injury (TBI) is common in young children and adolescents and is associated with long-term disability and mortality. The neuropathologic sequelae that result from juvenile TBI are a complex cascade of events that include edema formation and brain swelling. Brain aquaporin-4 (AQP4) has a key role in edema formation. Thus, development of novel treatments targeting AQP4 to reduce edema could lessen the neuropathologic sequelae. We hypothesized that inhibiting AQP4 expression by injection of small-interfering RNA (siRNA) targeting AQP4 (siAQP4) after juvenile TBI would decrease edema formation, neuroinflammation, neuronal cell death, and improve neurologic outcomes. The siAQP4 or a RNA-induced silencing complex (RISC)-free control siRNA (siGLO) was injected lateral to the trauma site after controlled cortical impact in postnatal day 17 rats. Magnetic resonance imaging, neurologic testing, and immunohistochemistry were performed to assess outcomes. Pups treated with siAQP4 showed acute (3 days after injury) improvements in motor function and in spatial memory at long term (60 days after injury) compared with siGLO-treated animals. These improvements were associated with decreased edema formation, increased microglial activation, decreased blood–brain barrier disruption, reduced astrogliosis and neuronal cell death. The effectiveness of our treatment paradigm was associated with a 30% decrease in AQP4 expression at the injection site. PMID:23899928

Fukuda, Andrew M; Adami, Arash; Pop, Viorela; Bellone, John A; Coats, Jacqueline S; Hartman, Richard E; Ashwal, Stephen; Obenaus, Andre; Badaut, Jerome

2013-01-01

267

The malar septum: the anatomic basis of malar mounds and malar edema.  

PubMed

The anatomy of malar mounds and malar edema is evaluated in a series of 18 fresh cadaver dissections. Dye injection, histologic evaluation, and gross anatomic dissection are used to identify a previously unrecognized fascial structure of the lower eyelid and cheek. The malar septum originates from orbital rim periosteum superiorly and inserts into cheek skin 2.5 to 3 cm inferior to the lateral canthus. This fascial structure acts as a relatively impermeable barrier that allows tissue edema and hemoglobin pigment to accumulate above its cutaneous insertion. The malar septum, which acts as both a functional and a structural barrier, defines the lower boundary of several clinical entities: malar mounds, malar edema, malar festoons, and periorbital ecchymosis. The permeability characteristics of the malar septum suggest that, at least in some persons, malar mounds may be accentuated by chronic lower eyelid edema, and these characteristics may imply a time course in the progressive development from malar edema to malar mounds and, ultimately, to malar festoons. The anatomy of the malar septum is clinically relevant because it defines the four anatomic compartments of the malar mound that should be considered during surgery: the superior compartment of suborbicularis oculi fat, orbicularis oculi muscle, and superficial cheek fat and cheek skin superior to the cutaneous insertion of the malar septum. PMID:19327681

Pessa, J E; Garza, J R

1997-01-01

268

Predominant vasogenic edema in a patient with fatal cerebral air embolism.  

PubMed

Cerebral air embolism (CAE) is a rare neurologic complication that can occur in patients undergoing various medical procedures or trauma. CAE can sometimes result in death caused by severe brain edema. In spite of these implications, the pathophysiologic mechanisms and radiologic features of fatal CAE remain to be elucidated. In this case report, a patient with carcinomatous pleuritis lost consciousness and developed quadriplegia and had generalized seizures during intrathoracic lavage. Serial computed tomography (CT) revealed the presence of air in intracranial blood vessels following severe brain edema; these are typically observed on the CT scans of patients with fatal CAE. Diffusion-weighted imaging (DWI) of the brain obtained at 24 hours after the onset of CAE revealed scattered cortical gyriform high signal intensity often observed in CAE cases, whereas the apparent diffusion coefficient and T2-weighted imaging revealed diffuse hyperintensity in the subcortical deep white matter, indicating vasogenic edema. Our case showed predominant vasogenic edema rather than cortical ischemic changes in the subcortical deep white matter area. These findings indicate that diffuse subcortical vasogenic edema could be the main cause of mortality in fatal CAE. PMID:21185741

Tanaka, Ryota; Shimada, Yoshiaki; Shimura, Hideki; Oizumi, Hideki; Hattori, Nobutaka; Tanaka, Shigeki

2012-08-01

269

Lung edema due to hydrogen peroxide is independent of cyclooxygenase products  

SciTech Connect

Active oxygen species can cause lung injury. Although a direct action on endothelial cells is proposed, the possibility exists that they might cause injury via mediators. We considered that active oxygen species would stimulate the generation of cyclooxygenase metabolites, which then alter pulmonary vasoreactivity and cause edema. We chemically produced hydrogen peroxide by adding glucose oxidase to a plasma- and cell-free, but ..beta..-D-glucose-containing, solution, which perfused isolated rat lungs. Addition of glucose oxidase to the perfusate caused a marked decrease in pulmonary vasoreactivity, accompanied by an increase in the concentrations of prostacyclin, thromboxane A/sub 2/, and prostaglandin F/sub 2..cap alpha../. Pretreatment with catalase, a specific scavenger of hydrogen peroxide, preserved pulomonary vasoreactivity, inhibited the increase of the concentration of the measured prostaglandins, and prevented edema formation. Indomethacin effectively blocked lung prostaglandin production but neither prevented the decrease in vasoreactivity nor inhibited edema formation. From these data we conclude the hydrogen peroxide impaired pulmonary vasoreactivity and subsequently caused edema. Depsite the fact that hydrogen peroxide stimulated lung prostaglandin production, cyclooxygenase-derived products neither caused the decrease in vasoreactivity nor the development of edema.

Burghuber, O.; Mathias, M.M.; McMurtry, I.F.; Reeves, J.T.; Voelkel, N.F.

1984-01-01

270

Posttraumatic reduction of edema with aquaporin-4 RNA interference improves acute and chronic functional recovery.  

PubMed

Traumatic brain injury (TBI) is common in young children and adolescents and is associated with long-term disability and mortality. The neuropathologic sequelae that result from juvenile TBI are a complex cascade of events that include edema formation and brain swelling. Brain aquaporin-4 (AQP4) has a key role in edema formation. Thus, development of novel treatments targeting AQP4 to reduce edema could lessen the neuropathologic sequelae. We hypothesized that inhibiting AQP4 expression by injection of small-interfering RNA (siRNA) targeting AQP4 (siAQP4) after juvenile TBI would decrease edema formation, neuroinflammation, neuronal cell death, and improve neurologic outcomes. The siAQP4 or a RNA-induced silencing complex (RISC)-free control siRNA (siGLO) was injected lateral to the trauma site after controlled cortical impact in postnatal day 17 rats. Magnetic resonance imaging, neurologic testing, and immunohistochemistry were performed to assess outcomes. Pups treated with siAQP4 showed acute (3 days after injury) improvements in motor function and in spatial memory at long term (60 days after injury) compared with siGLO-treated animals. These improvements were associated with decreased edema formation, increased microglial activation, decreased blood-brain barrier disruption, reduced astrogliosis and neuronal cell death. The effectiveness of our treatment paradigm was associated with a 30% decrease in AQP4 expression at the injection site. PMID:23899928

Fukuda, Andrew M; Adami, Arash; Pop, Viorela; Bellone, John A; Coats, Jacqueline S; Hartman, Richard E; Ashwal, Stephen; Obenaus, Andre; Badaut, Jerome

2013-10-01

271

Observation of post-MCAO cortical inflammatory edema in rats by 7.0 Tesla MRI.  

PubMed

This study aimed to investigate inflammatory edema after cerebral ischemia through 7.0T MRI and proton magnetic resonance spectroscopy (MRS). All SD rats were randomly divided into sham operated group and middle cerebral artery occlusion (MCAO)-1 day, -3 day and -7 day groups. MRI scan of the brain was performed on a 7.0 Tesla MRI scanner. The volume of positive signals in the ischemic side was detected by using a T2 weighted spinecho multislice sequence; the changes in the height of water-peak were measured with point resolved spectroscopy (PRESS) sequences; cortical edema was detected by using wet-dry weight method; the degrees of nerve injury were evaluated by Bederson neurological score system; double-labeling immunofluorescence technique was used to explore the molecular mechanisms of post-ischemia cerebral edema. The results showed that high T2WI signals were observed in MCAO-1 day, -3 day and -7 day groups, and the water-peak height and water-peak area of MCAO groups were higher than those of sham operated group (P<0.05). Neurological score results were consistent with the degree of brain edema, and a large number of microglia accumulated in the ischemic cortex. Our results suggested that non-invasive MRI technology with the advantage of high spatial resolution and tissue resolution can comprehensively and dynamically observe inflammatory edema after cerebral ischemia from a three-dimensional space, and contribute to evaluation and treatments in clinic. PMID:24496690

Xiong, Ying; Zhu, Wen-zhen; Zhang, Qiang; Wang, Wei

2014-02-01

272

Correlation between subacute sensorimotor deficits and brain edema in two mouse models of intracerebral hemorrhage.  

PubMed

Formation of brain edema after intracerebral hemorrhage (ICH) is highly associated with its poor outcome. However, the relationship between cerebral edema and behavioral deficits has not been thoroughly examined in the preclinical setting. Hence, this study aimed to evaluate the ability of common sensorimotor tests to predict the extent of brain edema in two mouse models of ICH. One hundred male CD-1 mice were subjected to sham surgery or ICH induction via intrastriatal injection of either autologous blood (30 ?L) or bacterial collagenase (0.0375U or 0.075U). At 24 and 72 h after surgery, animals underwent a battery of behavioral tests, including the modified Garcia neuroscore (Neuroscore), corner turn test (CTT), forelimb placing test (FPT), wire hang task (WHT) and beam walking (BW). Brain edema was evaluated via the wet weight/dry weight method. Intrastriatal injection of autologous blood or bacterial collagenase resulted in a significant increase in brain water content and associated sensorimotor deficits (p<0.05). A significant correlation between brain edema and sensorimotor deficits was observed for all behavioral tests except for WHT and BW. Based on these findings, we recommend implementing the Neuroscore, CTT and/or FPT in preclinical studies of unilateral ICH in mice. PMID:24518201

Krafft, Paul R; McBride, Devin W; Lekic, Tim; Rolland, William B; Mansell, Charles E; Ma, Qingyi; Tang, Jiping; Zhang, John H

2014-05-01

273

Aqueous flare and inflammatory factors in macular edema with central retinal vein occlusion: a case series  

PubMed Central

Background The association of inflammatory factors and the aqueous flare value with macular edema in central retinal vein occlusion (CRVO) patients remains unclear. We investigated the relations between the aqueous flare value and vitreous levels of vascular endothelial growth factor (VEGF), soluble intercellular adhesion molecule-1 (sICAM-1), and interleukin-6 (IL-6) in patients with CRVO and macular edema or patients with idiopathic macular hole (MH). Methods In 38 patients who underwent unilateral vitrectomy (21 CRVO patients and 17 MH patients), vitreous samples were obtained during vitrectomy to measure VEGF, sICAM-1, and IL-6. Retinal ischemia was evaluated from capillary non-perfusion on fluorescein angiography, and the CRVO patients were classified into nonischemic or ischemic groups. Aqueous flare values were measured with a laser flare meter and macular edema was examined by optical coherence tomography. Results The median aqueous flare value increased significantly across the three groups (MH group?edema in the CRVO group. Conclusions Inflammation and/or ischemia may increase vascular permeability and disrupt the blood-aqueous barrier by increasing levels of inflammatory factors in patients with CRVO and macular edema. PMID:24325604

2013-01-01

274

Selective inhibition of inducible nitric oxide synthase reduces neurological deficit but not cerebral edema following traumatic brain injury  

Microsoft Academic Search

The role of inducible nitric oxide synthase (iNOS) in cerebral edema and neurological deficit following traumatic brain injury (TBI) is not yet clear-cut. Therefore, the aim of this study was to investigate the effect of three different iNOS inhibitors on cerebral edema and functional outcome after TBI. First, the time courses of blood–brain barrier (BBB) breakdown, cerebral edema, and neurological

G. Louin; C. Marchand-Verrecchia; B. Palmier; M. Plotkine; M. Jafarian-Tehrani

2006-01-01

275

Edema-inducing activity of phospholipase A 2 purified from human synovial fluid and inhibition by aristolochic acid  

Microsoft Academic Search

A neutral-active, Ca2+-dependent phospholipase A2 (PLA2) purified 11,000-fold from human synovial fluid (HSF) induced edema when injected into the mouse foot pad. The edema produced by HSF-PLA2 was dose-dependent and was positively correlated with the dose-dependent in vitro expression of PLA2 activity. Maximum edema was achieved within 45 min after the injection and persisted for atleast 6 h. Aristolochic acid

B. S. Vishwanath; A. A. Fawzy; R. C. Franson

1988-01-01

276

[Selected vulvar dermatoses].  

PubMed

Numerous cutaneous lesions are located in the region of the female genital organs, occasionally presenting a diagnostic and therapeutic challenge. The most common cases include: eczema vulvae, lichen simplex chronius, lichen sclerosus et atrophicus or lichen planus. Clinical presentation of these lesions is not always characteristic for certain dermatoses. Thus, it is important to conduct proper tests, including histopathological or contact allergy examination. Only thorough diagnostics allows to implement correct therapy. This paper shows a detailed description of dermal lesions located in the region of the female genital organs of the allergic and lichenoid origin, together with the literature review on diagnosis and treatment. PMID:24455854

Olek-Hrab, Karolina; Jenerowicz, Dorota; Osmola-Ma?kowska, Agnieszka; Pola?ska, Adriana; Teresiak-Miko?ajczak, Ewa; Silny, Wojciech; Adamski, Zygmunt

2013-11-01

277

Pediatric Vulvar Lichen Sclerosus  

MedlinePLUS

Lichen sclerosus—pronounced "LIKE-in skler-O-sus"—is a skin disease that mainly involves the genital ... occurs in children, it is often called "Pediatric Lichen Sclerosus". Lichen sclerosus in young girls mainly involves ...

278

The effect of experimental spinal cord edema on the spinal evoked potential.  

PubMed

Experimental spinal cord edema was successfully produced in the cat intumescentia cervicalis by the infusion method of Marmarou. The water content around the infusion site significantly increased to 75.9% from the normal value of 69.8% of white matter in the lateral column, with the infusion of 20 microliters of autoserum. The edema was observed for a length of ca.20 mm, spreading mainly longitudinally in the lateral column. The spinal evoked potential was measured four times on the course of infusion and the N1 peak latency at the end of infusion did not show any significant difference compared to the value before infusion. This model may contribute to basic understanding of pathophysiology of spinal cord edema by changing the nature and the volume of infusate, and the location of infusion, according to the experimental purpose. PMID:9779156

Tanaka, K; Kim, A; Naruse, H; Hakuba, A

1998-01-01

279

Volcano like pattern in optical coherence tomography in chronic diabetic macular edema.  

PubMed

In this article we herein report an interesting vitreo-macular interface abnormality associated with chronic diabetic cystoid macular edema. It is an observational case study of three diabetic patients examined in the diabetic clinic. All the patients had proliferative diabetic retinopathy with chronic macular edema. A serial cross sectional OCT examination and tracking of both the longitudinal progression of macular thickening and vitreo-macular interface revealed cystoid macular edema with a characteristic hyperreflective vitreous shadow emerging from the vitreofoveal interface. All the patients had dehiscence of inner retinal layers. This particular morphological feature at the vitreo-foveolar interface, which we name as "volcano sign", has not been described earlier. The probable mechanism of such a finding probably could be due to slow progressive leakage of chronic cytoid fluid into the vitreous with condensation of the overlying vitreous. Vitreo-macular traction followed by posterior vitreous detachment probably would have contributed to such a morphological event. PMID:24843311

Pai, Sivakami A; Hussain, Nazimul; Hebri, Sudhira P; Lootah, Afra M; Dekhain, Moza A

2014-04-01

280

Intravitreal Injection of Bevacizumab to Treat a Macular Edema Caused by Leber's Miliary Aneurysm  

PubMed Central

Purpose Leber's miliary aneurysm is a variant of Coats’ disease and similar to type 1 idiopathic macular telangiectasia. A recent report showed that an intravitreal injection of bevacizumab (IVB) was effective in an adult patient with type 1 idiopathic macular telangiectasia. We describe our experience with an adult patient with a macular edema caused by Leber's miliary aneurysm, which had not been resolved by prior retinal laser photocoagulation, who underwent IVB. Methods We investigated the ocular characteristics of the patient before and after a single administration of IVB. Results The macular edema had partially improved 1 month after IVB, but then it worsened. We performed laser photocoagulation to treat the aneurysms near the fovea. The macular edema improved, but there was no improvement in visual acuity. Conclusion In this patient, the effect of IVB was limited. PMID:23275795

Takeyama, Masayuki; Iwaki, Masayoshi; Zako, Masahiro

2012-01-01

281

Surgical Management of Massive Labial Edema in a Gravid Preeclamptic Diabetic  

PubMed Central

Background. Massive labial edema is a rare complication during pregnancy that can jeopardize vaginal delivery, as well as leading to maternal and fetal morbidity. It can be related to systemic pathologies, but has been commonly associated with preeclampsia and diabetes. This increased and sometimes longstanding pressure may result in a “labial compartment syndrome” leading to microvascular damage and tissue necrosis if not resolved in a timely fashion. Case. Massive labial edema was treated first conservatively and then surgically in a gravid diabetic patient with severe preeclampsia. Immediately after Cesarean section, the labial compartment syndrome was relieved surgically and resolved rapidly. Conclusion. When conservative attempts at management of labial edema fail, or rapid resolution is critical to maternal and fetal outcome, surgical alternatives should be considered. PMID:25371838

Lindsey, Jennifer S.; DeVente, James E.

2014-01-01

282

Pulmonary edema following postoperative laryngospasm: case reports and review of the literature.  

PubMed Central

Pulmonary edema that follows upper airway obstruction may occur in a variety of clinical situations. The predominant mechanism is forced inspiration against a closed or occluded glottis, inducing large intrapleural and transpulmonary pressure gradients favoring the transudation of fluid from the pulmonary capillaries into the interstitium. Postanesthetic laryngospasm has been implicated as the most frequent cause of this syndrome in adults. Risk factors for development of postlaryngospasm pulmonary edema include difficult intubation; nasal, oral, or pharyngeal surgical site; and obesity with obstructive apnea. The syndrome is recognized by development of hypoxia shortly (1-90 min) after a laryngospasm. A chest radiograph will reveal a symmetric bilateral infiltrate with normal heart size. Cardiogenic pulmonary edema and aspiration must be ruled out. Treatment is directed at correction of hypoxia with supplemental oxygen and use of diuretics (furosemide). Occasionally patients may require intubation. Images Figure 1 Figure 2 Figure 3 PMID:9481972

Scarbrough, F. E.; Wittenberg, J. M.; Smith, B. R.; Adcock, D. K.

1997-01-01

283

Ipsilateral reexpansion pulmonary edema after drainage of a spontaneous pneumothorax: a case report  

PubMed Central

We report a case of ipsilateral reexpansion pulmonary edema occurring after the insertion of a chest tube in a patient with spontaneous pneumothorax. The patient received supplemental oxygen via a non-rebreather face mask to compensate for hypoxemia. 24 hours after the acute event, the patient recovered completely without residual hypoxemia. Reexpansion pulmonary edema after the insertion of a thoracic drainage for pneumothorax or pleural effusion is a rare complication with a high mortality rate up to 20%. It should be considered in case of hypoxemia following the insertion of a chest tube. The exact pathophysiology leading to this complication is not known. Risk factors for reexpansion pulmonary edema should be evaluated and considered prior to the insertion of chest tubes. Treatment is supportive. PMID:17903268

Conen, Anna; Joos, Ladina; Bingisser, Roland

2007-01-01

284

Induced and sustained hypernatremia for the prevention and treatment of cerebral edema following brain injury.  

PubMed

Cerebral edema develops in response to and as a result of a variety of neurologic insults such as ischemic stroke, traumatic brain injury, and tumor. It deforms brain tissue, resulting in localized mass effect and increase in intracranial pressure (ICP) that are associated with a high rate of morbidity and mortality. When administered in bolus form, hyperosmolar agents such as mannitol and hypertonic saline have been shown to reduce total brain water content and decrease ICP, and are currently the mainstays of pharmacological treatment. However, surprisingly, little is known about the increasingly common clinical practice of inducing a state of sustained hypernatremia. Herein, we review the available studies employing sustained hyperosmolar therapy to induce hypernatremia for the prevention and/or treatment of cerebral edema. Insufficient evidence exists to recommend pharmacologic induction of hypernatremia as a treatment for cerebral edema. The strategy of vigilant avoidance of hyponatremia is currently a safer, potentially more efficacious paradigm. PMID:23468135

Ryu, Justine H; Walcott, Brian P; Kahle, Kristopher T; Sheth, Sameer A; Peterson, Randall T; Nahed, Brian V; Coumans, Jean-Valery C E; Simard, J Marc

2013-10-01

285

A Case of Eosinophilic Fasciitis Presenting as Pitting Edema of the Lower Extremities  

PubMed Central

Eosinophilic fasciitis is a rare disease characterized by diffuse fasciitis with peripheral eosinophilia and progressive induration and thickening of the skin and soft tissues. We report a 19-year-old female who presented with pitting edema in both lower extremities. She had a history of excessive physical activity before her symptoms developed. Physical examination revealed 2+ pitting edema in both lower legs. She complained of mild pain in both knee joints and feet, with no tenderness or heating sensations. Laboratory results were unremarkable except for severe eosinophilia. Parasite infection, venous thrombosis, and cardiac and renal problems were excluded. A magnetic resonance imaging study of both lower extremities revealed increased signal intensity in the subcutaneous lesions, consistent with superficial inflammation of the fascia. Mixed perivenular lymphoplasmacytic and eosinophilic infiltration in the subcutaneous lesion were observed on biopsy. The patient was treated with corticosteroids, resulting in remarkable improvement in both edema and eosinophilia. PMID:24587957

Lee, Hee Seon; Chang, Soo Jin; Kang, Myung Suk; Yoon, Choon Sik; Kim, Kyung Won; Sohn, Myung Hyun

2014-01-01

286

Cerebral edema following iodine-131 therapy for thyroid carcinoma metastatic to the brain  

SciTech Connect

Brain metastases are rare in well-differentiated thyroid carcinoma but when present they can lead to the patient's death. Iodine-131 therapy for intracerebral thyroid carcinoma metastases causes radiation-induced acute cerebral edema that can lead to CNS complications and even death. We present a case in which a patient with intracerebral /sup 131/I uptake developed seizures, slurred speech, and muscle weakness 12 hr following /sup 131/I therapy. The patient's CT scan, post-therapy, confirmed an intracranial metastasis with a significant amount of surrounding edema. Radiotherapists, when using external beam radiation to treat intracerebral metastases, commonly place these patients on steroids, glycerol, or mannitol prior to instituting therapy, to prevent complications from radiation-induced cerebral edema. This technique could be applied to /sup 131/I therapy of intracranial thyroid carcinoma metastases as well.

Datz, F.L.

1986-05-01

287

Regional Differences in Cerebral Edema after Traumatic Brain Injury Identified by Impedance Analysis  

PubMed Central

Objective Cerebral edema is a common and potentially devastating sequel of traumatic brain injury. We developed and validated a system capable of tissue impedance analysis, which was found to correlate with cerebral edema. Design and Methods Constant sinusoidal current (50 ?A), at frequencies from 500 to 5000 Hz, was applied across a bipolar electrode unit superficially placed in a rat brain after traumatic brain injury. Rats were randomized to three groups: severe controlled cortical injury (CCI), mild CCI, or sham injury. At 60 hours post CCI, cerebral voltage and phase angle were measured at each frequency at the site of injury, at the penumbral region, at the ipsilateral frontal region, and in the contralateral hemisphere. Impedance measurements were also obtained in vivo. The electrical properties of varied injuries and specified locations were compared using a repeated measures analysis of variance (RMANOVA), were correlated with regional tissue water percentage using regression analyses, and were combined to generate polar coordinates. Results The measured voltage was significantly different at the site of injury (p<0.0001), in the penumbra (p=0.002), and in the contralateral hemisphere (p=0.005) when severe, mild, and sham CCI rats were compared. Severely injured rats had statistically different voltage measurements when the various sites were compared (p=0.002). The ex vivo measurements correlated with in vivo measurements. Further, the impedance measurements correlated with measured tissue water percentage at the site of injury (R2=0.69; p<0.0001). The creation of a polar coordinate graph, incorporating voltage and phase angle measurements, enabled the identification of impedance areas unique to normal, mild edema, and severe edema measurements in the rat brain. Conclusions Electrical measurements and tissue water percentages quantified regional and severity differences in rat brain edema after CCI. Impedance was inversely proportional to the tissue water percentage. Thus, impedance measurement can be used to quantify severity of cerebral edema in real time at specific sites. PMID:19181334

Harting, Matthew T.; Smith, Carter T.; Radhakrishnan, Ravi S.; Aroom, Kevin R.; Dash, Pramod K.; Gill, Brijesh; Cox, Charles S.

2013-01-01

288

Salicylate-induced pulmonary edema--a near-miss diagnosis.  

PubMed

A 43-year-old white woman presented to the emergency department with confusion, agitation, and progressive dyspnea. Chest x-ray revealed pulmonary edema. Initial diagnostic considerations were pneumonia, pulmonary embolism, sepsis, central nervous system infection, substance toxicity, and heart failure. Her salicylate level was 92.6 mg/dL, and an arterial blood gas revealed a respiratory alkalosis and nonanion gap metabolic acidosis, consistent with salicylate poisoning. Noncardiogenic pulmonary edema is an atypical presentation of salicylate toxicity, and this case highlights the importance of an early toxicology screen to make a time-critical diagnosis and provide specific treatment. PMID:24361138

Yuklyaeva, Nataliya; Chaudhary, Ahmad; Gorantla, Ramakrishna; Bischof, Edward

2014-05-01

289

Conservative management of bilateral massive edema of the ovary. A case report.  

PubMed

A case of bilateral massive ovarian edema with unilateral ovarian torsion is reported. Following surgical removal of the adnexa with the torsion, the edema of the opposite ovary resolved with oral contraceptive therapy. This has not been previously reported. This case is instructive because the nodular appearance and yellow color of the ovaries and the presence of yellow ascitic fluid could lead to an erroneous diagnosis of malignancy, resulting in performance of a more radical surgical procedure than is necessary. A review of the literature and the unusual nature of this lesion indicates the need for caution in diagnosis and management. PMID:8441135

Hubbell, G P; Punch, M R; Elkins, T E; Abrams, G D

1993-01-01

290

Pulmonary edema at recovery after colic operation with in-situ nasogastric tube in a horse.  

PubMed

After an uneventful general anesthesia, in a horse negative pressure pulmonary edema developed due to acute upper airway obstruction during the anesthetic recovery phase after colic surgery. No pathologic alteration of respiration was observed until the horse stood up and began suffocating. The horse had recovered with the nasogastric tube in situ. This, together with the postmortem diagnosis of laryngeal hemiplegia resulted in impairment of airflow through the larynx and development of pulmonary edema. Our objective is to alert clinicians about the possible hazard of recovery with an in-situ nasogastric tube. PMID:21866513

Veres-Nyéki, K O; Graubner, C; Aloisio, F; Spadavecchia, C

2011-09-01

291

Negative pressure pulmonary edema with laryngeal mask airway use: Recognition, pathophysiology and treatment modalities  

PubMed Central

Negative pressure pulmonary edema (NPPE) following the use of the laryngeal mask airway (LMA) is an uncommon and under-reported event. We present a case of a 58-year-old male, who developed NPPE following LMA use. After biting vigorously on his LMA, the patient developed stridor upon emergence, with concurrent appearance of blood-tinged, frothy sputum and pulmonary edema. He subsequently required three days of mechanical ventilation. After discontinuation of mechanical ventilation the patient continued to require additional pulmonary support using continuous positive airway pressure, with a full facemask, to correct the persistent hypoxemia. His roentgenographic findings demonstrated an accelerated improvement with judicious administration of intravenous furosemide. PMID:22837897

Vandse, Rashmi; Kothari, Deven S; Tripathi, Ravi S; Lopez, Luis; Stawicki, Stanislaw P A; Papadimos, Thomas J

2012-01-01

292

Enhanced expression of aquaporin-9 in rat brain edema induced by bacterial lipopolysaccharides  

Microsoft Academic Search

Summary  To investigate the role of AQP9 in brain edema, the expression of AQP9 in an infectious rat brain edema model induced by the\\u000a injection of lipopolysaccharide (LPS) was examined. Immunohistochemistry and reverse transcription-polymerase chain reaction\\u000a (RT-PCR) analysis demonstrated that the expressions of AQP9 mRNA and protein at all observed intervals were significantly\\u000a increased in LPS-treated animals in comparison with the

Huaili Wang; Runming Jin; Peichao Tian; Zhihong Zhuo

2009-01-01

293

Continuous positive airway pressure vs. proportional assist ventilation for noninvasive ventilation in acute cardiogenic pulmonary edema  

Microsoft Academic Search

Objective  To compare continuous positive airway pressure (CPAP) and proportional assist ventilation (PAV) as modes of noninvasive ventilatory\\u000a support in patients with severe cardiogenic pulmonary edema.\\u000a \\u000a \\u000a \\u000a Design and setting  A prospective multicenter randomized study in the medical ICUs of three teaching hospitals.\\u000a \\u000a \\u000a \\u000a Patients  Thirty-six adult patients with cardiogenic pulmonary edema (CPA) with unresolving dyspnea, respiratory rate above 30\\/min and\\/or\\u000a SpO2 above 90% with

Thierry Rusterholtz; Pierre-Edouard Bollaert; Marc Feissel; Florence Romano-Girard; Marie-Line Harlay; Michel Zaehringer; Benjamin Dusang; Philippe Sauder

2008-01-01

294

Vitreous inflammatory factors in macular edema with central retinal vein occlusion  

Microsoft Academic Search

Purpose  To investigate the correlation of soluble intercellular adhesion molecule 1 (sICAM-1) and vascular endothelial growth factor\\u000a (VEGF) with macular edema in patients with central retinal vein occlusion (CRVO).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Twenty-nine patients who had CRVO with macular edema and 16 patients with non-ischemic ocular diseases (control group) participated.\\u000a Retinal ischemia was evaluated by measuring the area of capillary non-perfusion with fluorescein angiography

Hidetaka Noma; Hideharu Funatsu; Seiyo Harino; Tatsuya Mimura; Shuichiro Eguchi; Sadao Hori

2011-01-01

295

Intraocular triamcinolone acetonide for macular edema due to CRVO. A multifocal-ERG and OCT study  

Microsoft Academic Search

Purpose  To investigate the effectiveness of intravitreal triamcinolone acetonide in the treatment of cystoid macular edema due to\\u000a central retinal vein occlusion (CRVO). A noncomparative, prospective, interventional case series.\\u000a \\u000a \\u000a \\u000a Methods  In this study 15 eyes of 15 patients (9 males and 6 females) with macular edema due to non-ischemic CRVO were treated with\\u000a intravitreal injection of 4 mg triamcinolone acetonide and followed-up for

Marilita M. Moschos; Dimitrios Brouzas; Eleni Loukianou; Michael Apostolopoulos; Michael Moschos

2007-01-01

296

A case of negative pressure pulmonary edema in an asthmatic patient after laparoscopic cholecystectomy  

PubMed Central

Negative pressure pulmonary edema is often misdiagnosed or can go clinically unrecognized by anesthesiologists. It is characterized by a markedly low intrapleural pressure which leads to exudation of fluid and red blood cells in the interstitium. Recognition of patients with predisposing factors for upper airway obstruction is important in the diagnosis which is often confused with pulmonary aspiration of gastric contents. Signs and symptoms are subtle and edema is usually self-limited. Our patient was management conservatively with maintenance of a patent airway and administration of supplemental oxygen and had a successful outcome.

Rasheed, Asim; Palaria, Urmila; Rani, Dolly; Sharma, Shatrunjay

2014-01-01

297

Obstructive Sleep Apnea Is Frequent in Patients with Hypertensive Intracerebral Hemorrhage and Is Related to Perihematoma Edema  

Microsoft Academic Search

Background: Obstructive sleep apnea (OSA) is related to increased systemic inflammation and arterial hypertension. We hypothesize that OSA is frequent in patients with acute hypertensive intracerebral hemorrhage (ICH) and is related to the perihematoma edema. Methods: Thirty-two non-comatose patients with a hypertensive ICH underwent polysomnography in the acute phase. Perihematoma edema volume was measured on CT scans at admission, after

Octavio M. Pontes-Neto; Regina M. F. Fernandes; Heidi H. Sander; Larissa A. T. da Silva; Débora C. Mariano; Fernando Nobre; Gustavo Simão; Draulio B. de Araujo; Antonio C. dos Santos; João P. Leite

2010-01-01

298

Hipertensión endocraneana secundaria a edema cerebral y la utilización de soluciones salinas hipertónicas y manitol en su tratamiento  

Microsoft Academic Search

SUMMARY: During the last years, the intracranial hypertension and brain edema has been studied in detail. Research drives us to find new and better treatments. We have made a short review about the classic definitions that are necessary to understand the physiology, physiopathology and treatment of the brain edema. We also compare the advantage and disadvantage between the traditional and

Susan Soto Pernudi; Jorge Fernández Alpízar

299

Prospective Randomized Controlled Trial to Analyze the Effects of Intermittent Pneumatic Compression on Edema Following Autologous Femoropopliteal Bypass Surgery  

Microsoft Academic Search

Background: Patients who undergo autologous femoropopliteal bypass surgery develop postoperative edema in the revascularized leg. The effects of intermittent pneumatic compression (IPC) to treat and to prevent postreconstructive edema were examined in this study. Methods: In a prospective randomized trial, patients were assigned to one of two groups. All patients suffered from peripheral arterial disease, and all were subjected to

Slaa te A; D. E. J. G. J. Dolmans; G. H. Ho; P. G. H. Mulder; Waal van der J. C. H; Laan van der L

2010-01-01

300

An evaluation of standing-induced lower leg edema as a function of floor surace  

E-print Network

>F=0.140) had no significant effect on the edema of any of the segments. No significant interactions were noted. In the subjective discomfort analysis, significance was found due to gender (Prob=0.033). For the body regions of the legs and back, females...

DiSalvi, Lawrence Roberts

2012-06-07

301

Hypoxia and the Edema Syndrome: Elucidation of a Mechanism of Teratogenesis  

EPA Science Inventory

The elucidation of mechanisms and pathogenesis of birth defects is exceedingly complex. Consequently, there are few examples where the etiology of birth defects caused by a specific agent has been well described. One such example is the "Edema Syndrome" first described by Casimer...

302

Electron microscopic study of perivascular structure associated with experimentally induced brain edema in cats.  

PubMed

The fine structural features and water content of white matter associated with the resolution process of brain edema were sequentially investigated in the model produced by infusion of autoserum, mock CSF, or ferritin into the centrum semiovale of cats. The correlation between water content and morphological features was good. Mock CSF-infused edema disappeared within 3 days, serum infused edema within 6 days. In a fine structural study of serum-infused white matter, the distended extracellular spaces were found to be occupied with electron-dense materials, active phagocytosis of the dense materials being observed in the macrophages. Around the postcapillary venules, edematous changes were characterized by wide expansion of the perivascular spaces between endothelial cells and astrocytic endfeet. In some instances, the dense materials in the cytoplasm or in the membrane-bound vacuoles of the astrocytic endfeet were continuous with those in the perivascular space, through the hiatuses of the perivascular astrocytic endfeet being separated at their margins. At 3 days after infusion, wide distension of the extracellular space persisted, but the dense materials had markedly diminished. These results strongly suggest that water clearance of vasogenic brain edema does not commence until proteinaceous macromolecules are degraded and removed from the extracellular space. Perivascular channels around the postcapillary venules might also have some role on the movement of edematous fluid. PMID:2396518

Ohata, K; Tanaka, K; Katsuyama, J; Nishimura, S

1990-01-01

303

Effect of High Voltage Stimulation on Edema Reduction in the Rat Hind Limb  

Microsoft Academic Search

The purpose of this study was to test the effect of high voltage stimulation (HVS) on edema reduction in the rat hindpaw. The animals were divided into a control group (n = 20) and a treated group (n = 20). The right hindpaw volume was measured, and then the animal's paw was traumatized. The animals in the treated group were

THOMAS M. MOHR; THOMAS K. AKERS; RICHARD G. LANDRY

304

Impact of clipping versus coiling on postoperative hemodynamics and pulmonary edema after subarachnoid hemorrhage.  

PubMed

Volume management is critical for assessment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). This multicenter prospective cohort study compared the impact of surgical clipping versus endovascular coiling on postoperative hemodynamics and pulmonary edema in patients with SAH. Hemodynamic parameters were measured for 14 days using a transpulmonary thermodilution system. The study included 202 patients, including 160 who underwent clipping and 42 who underwent coiling. There were no differences in global ejection fraction (GEF), cardiac index, systemic vascular resistance index, or global end-diastolic volume index between the clipping and coiling groups in the early period. However, extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) were significantly higher in the clipping group in the vasospasm period. Postoperative C-reactive protein (CRP) level was higher in the clipping group and was significantly correlated with postoperative brain natriuretic peptide level. Multivariate analysis found that PVPI and GEF were independently associated with high EVLWI in the early period, suggesting cardiogenic edema, and that CRP and PVPI, but not GEF, were independently associated with high EVLWI in the vasospasm period, suggesting noncardiogenic edema. In conclusion, clipping affects postoperative CRP level and may thereby increase noncardiogenic pulmonary edema in the vasospasm period. His trial is registered with University Hospital Medical Information Network UMIN000003794. PMID:24818154

Horie, Nobutaka; Iwaasa, Mitsutoshi; Isotani, Eiji; Ishizaka, Shunsuke; Inoue, Tooru; Nagata, Izumi

2014-01-01

305

Reexpansion pulmonary edema after treatment of simultaneous bilateral spontaneous tension pneumothorax  

PubMed Central

We report a case of 46-year-old male with simultaneous bilateral spontaneous tension pneumothorax. Severe reexpansion pulmonary edema developed after bilateral tube thoracoscomy, but he was recovered after 2 days ventilator care. After bilateral wedge resection and talc pleurodesis, he was discharged without complications and had remained well and without recurrence during the 8-year follow-up. PMID:23557179

2013-01-01

306

Disruption of ion homeostasis in the neurogliovascular unit underlies the pathogenesis of ischemic cerebral edema.  

PubMed

Cerebral edema is a major cause of morbidity and mortality following ischemic stroke, but its underlying molecular pathophysiology is incompletely understood. Recent data have revealed the importance of ion flux via channels and transporters expressed in the neurogliovascular unit in the development of ischemia-triggered cytotoxic edema, vasogenic edema, and hemorrhagic conversion. Disruption of homeostatic mechanisms governing cell volume regulation and epithelial/endothelial ion transport due to ischemia-associated energy failure results in the thermodynamically driven re-equilibration of solutes and water across the CSF-blood and blood-brain barriers that ultimately increases the brain's extravascular volume. Additionally, hypoxia, inflammation, and other stress-triggered increases in the functional expression of ion channels and transporters normally expressed at low levels in the neurogliovascular unit cause disruptions in ion homeostasis that contribute to ischemic cerebral edema. Here, we review the pathophysiological significance of several molecular mediators of ion transport expressed in the neurogliovascular unit, including targets of existing FDA-approved drugs, which might be potential nodes for therapeutic intervention. PMID:24323726

Khanna, Arjun; Kahle, Kristopher T; Walcott, Brian P; Gerzanich, Volodymyr; Simard, J Marc

2014-02-01

307

Late Cytotoxic Edema in 2 Children With Hemiplegia: Hemiplegic Migraine or Stroke?  

PubMed Central

Hemiplegic migraine (HM) is a rare variant of migraine with aura, characterized by migrainous headache and fully reversible motor deficit within 24 hours. Both sporadic and familial forms of HMs are genetically heterogenous with little information on neuroimaging during and after acute attacks. We report 2 cases of children with presumed HM and late cytotoxic edema. PMID:22404149

Kedia, Sita; Stence, Nicholas; Manco-Johnson, Marilyn; Armstrong-Wells, Jennifer; Bernard, Timothy J.

2013-01-01

308

The Influence of Cellular Hypoxia and Reactive Oxygen Species on the Development of Endothelial Cell Edema  

Microsoft Academic Search

We investigated in vitro whether endothelial cell edema is induced by cellular hypoxia or oxygen radical formation. Measurements of relative cell volume (RCV) were made using microweight analysis, liquid scintillation spectrometry and analysis of cellular protein content. To validate this method of determining cell volume, endothelial cells were incubated in media of different osmolarities. Vascular endothelial cells reacted to osmotic

M. Hensel; T. Volk; W. J. Kox

1997-01-01

309

Premature parturition, edema, and ascites in an alpaca infected with Anaplasma phagocytophilum  

PubMed Central

An 8-year-old alpaca was presented for fever, anorexia, edema, ascites, and premature parturition. She was determined to have Anaplasma phagocytophilum infection based on positive blood polymerase chain reaction (PCR) and positive acute and convalescent serum titers. Antibiotics and supportive therapies were administered and the alpaca made a complete recovery. PMID:23633715

Tinkler, Stacy H.; Firshman, Anna M.; Sharkey, Leslie C.

2012-01-01

310

Molecular analysis of mammalian adenylyl cyclases and edema factor, a bacterial adenylyly cyclase toxin  

E-print Network

and regulatory mechanisms by activators and inhibitors. In addition to mACs, bacterial AC toxins such as edema factor (EF) from Bacillus anthracis and CyaA from Bordetella pertussis have also been identified. Following infection, the AC toxins cause a dramatic...

Suryanarayana, Srividya

2008-12-16

311

Pharmacologic aspects of a phlebotropic drug in CVI-associated edema.  

PubMed

Several phlebotropic drugs, or edema-protecting drugs, are available, the most important of which are found in the gamma-benzopyrone family (flavonoids). gamma-Benzopyrones can be plant extracts, semisynthetic preparations, or synthetic preparations. This family is divided into two different groups: flavones and flavonols, and flavanes (flavanones). The flavone group contains various types of molecule and includes diosmin. Here we discuss the pharmacologic aspects in edema associated with chronic venous insufficiency (CVI) of one of the reference phlebotropic drugs, micronized purified flavonoid fraction (MPFF), a semisynthetic preparation from the diosmin group, which represents the latest improvement in flavonoid formulation. Before we detail the pharmacologic aspects, a brief summary of the pathophysiology of edema in CVI is necessary. Several factors are implicated: the veins, which create the conditions favorable to edema; the microcirculation, which is the site of fluid transfer into the interstitial tissue; and the lymphatics, which have a limited possibility to reduce edema. Major discoveries are currently being made in CVI and the microcirculation. Results of studies show that MPFF decreases capillary permeability and increases capillary resistance, which could partly be explained by inhibition of leukocyte activation, migration, and adhesion. This inhibition is linked to a significant decrease in plasma levels of endothelial adhesion molecules (VCAM-1 and ICAM-1) after MPFF treatment. Thus, the CVI-induced damage to the microcirculation is counteracted by MPFF. The lymphatic system is also improved by MPFF treatment. The lymphagogue activity of MPFF has been demonstrated in experimental animal models and confirmed by microlymphographic measurement in patients suffering from severe CVI. The pharmacologic activity of MPFF in lymphedema was observed in a study using an animal model of acute lymphedema and in a study in patients with upper limb lymphedema secondary to breast cancer treatment. All these findings point to the importance of acting on each factor involved in the formation and maintenance of edema. This pharmacologic activity is indeed reflected by the clinical efficacy on edema observed during treatment with MPFF. PMID:10667639

Ramelet, A A

2000-01-01

312

Cerebral edema in children with diabetic ketoacidosis: vasogenic rather than cellular?  

PubMed

Cerebral edema (CE) is accumulation of water in the intracellular or extracellular spaces of the brain. Vasogenic edema occurs when there is breakdown of the tight endothelial junctions of the blood-brain barrier (BBB), leading to extravasation of intravascular protein and fluid into the interstitial space of the brain. In cellular edema the BBB remains intact and there is swelling of astrocytes with corresponding reduction in extracellular space. In this review we bring together clinical evidence from neuropathology and cerebral magnetic resonance (MR) studies in pediatric patients presenting in diabetic ketoacidosis (DKA), and use applied physiology to understand whether CE complicating DKA is vasogenic, rather than cellular in origin. Because the first-line of defense against CE is the interface between the intravascular compartment and the extracellular space in the brain much of the focus in this review is the BBB. The principal pathologic finding in fatal cases is perivascular with BBB disruption and albumin extravasation, suggesting increased vascular permeability. DKA induces an inflammatory response and the mechanism of BBB transcellular permeability may be an immunologic cascade that disrupts tight junctions. The principal MR finding in subclinical cases of CE is vasogenic rather than cellular edema. We propose that the following physiology be considered when treating cases: bolus dose of intravenous mannitol may result in fall in serum sodium concentration, and therefore clinical worsening. Failure to respond to mannitol should prompt the use of 3% hypertonic saline (HS). Bolus dose of intravenous 3% HS is expected to effect vasogenic edema provided that the reflection coefficient is close to 1. Failure to respond to 3% HS should prompt the use of mannitol. PMID:24866062

Tasker, Robert C; Acerini, Carlo L

2014-06-01

313

Corticosterone mediates electroacupuncture-produced anti-edema in a rat model of inflammation  

PubMed Central

Background Electroacupuncture (EA) has been reported to produce anti-edema and anti-hyperalgesia effects on inflammatory disease. However, the mechanisms are not clear. The present study investigated the biochemical mechanisms of EA anti-inflammation in a rat model. Methods Three experiments were conducted on male Sprague-Dawley rats (n = 7–8/per group). Inflammation was induced by injecting complete Freund's adjuvant (CFA) subcutaneously into the plantar surface of one hind paw. Experiment 1 measured plasma corticosterone (CORT) levels to see if EA regulates CORT secretion. Experiment 2 studied the effects of the adrenal gland on the therapeutic actions of EA using adrenalectomy (ADX) rats. Experiment 3 determined whether a prototypical glucocorticoid receptor antagonist, RU486, affects EA anti-edema. EA treatment, 10 Hz at 3 mA and 0.1 ms pulse width, was given twice, for 20 min each, once immediately after CFA administration and again 2 h post-CFA. Plasma CORT levels, paw thickness, indicative of the intensity of inflammation, and paw withdrawal latency (PWL) were measured 2 h and 5 h after the CFA injection. Results EA significantly increased plasma corticosterone levels 2 h (5 folds) and 5 h (10 folds) after CFA administration compared to sham EA control, but EA alone in naive rats and CFA alone did not induce significant increases in corticosterone. Adrenalectomy blocked EA-produced anti-edema, but not EA anti-hyperalgesia. RU486 (15 ?l, 15 ?g/?l), a prototypical glucocorticoid receptor antagonist, also prevented EA anti-edema. Conclusion The data demonstrate that EA activates the adrenals to increase plasma corticosterone levels and suppress edema and suggest that EA effects differ in healthy subjects and in those with pathologies. PMID:17697336

Li, Aihui; Zhang, Rui-Xin; Wang, Yi; Zhang, Haiqing; Ren, Ke; Berman, Brian M; Tan, Ming; Lao, Lixing

2007-01-01

314

Neutrophil depletion reduces edema formation and tissue loss following traumatic brain injury in mice  

PubMed Central

Background Brain edema as a result of secondary injury following traumatic brain injury (TBI) is a major clinical concern. Neutrophils are known to cause increased vascular permeability leading to edema formation in peripheral tissue, but their role in the pathology following TBI remains unclear. Methods In this study we used controlled cortical impact (CCI) as a model for TBI and investigated the role of neutrophils in the response to injury. The outcome of mice that were depleted of neutrophils using an anti-Gr-1 antibody was compared to that in mice with intact neutrophil count. The effect of neutrophil depletion on blood-brain barrier function was assessed by Evan's blue dye extravasation, and analysis of brain water content was used as a measurement of brain edema formation (24 and 48 hours after CCI). Lesion volume was measured 7 and 14 days after CCI. Immunohistochemistry was used to assess cell death, using a marker for cleaved caspase-3 at 24 hours after injury, and microglial/macrophage activation 7 days after CCI. Data were analyzed using Mann-Whitney test for non-parametric data. Results Neutrophil depletion did not significantly affect Evan's blue extravasation at any time-point after CCI. However, neutrophil-depleted mice exhibited a decreased water content both at 24 and 48 hours after CCI indicating reduced edema formation. Furthermore, brain tissue loss was attenuated in neutropenic mice at 7 and 14 days after injury. Additionally, these mice had a significantly reduced number of activated microglia/macrophages 7 days after CCI, and of cleaved caspase-3 positive cells 24 h after injury. Conclusion Our results suggest that neutrophils are involved in the edema formation, but not the extravasation of large proteins, as well as contributing to cell death and tissue loss following TBI in mice. PMID:22269349

2012-01-01

315

Comparative Assessment of Lymph Node Micrometastasis in Cervical, Endometrial and Vulvar Cancer: Insights on the Real Time qRT-PCR Approach versus Immunohistochemistry, Employing Dual Molecular Markers  

PubMed Central

To address the value of qRT-PCR and IHC in accurately detecting lymph node micrometastasis in gynecological cancer, we performed a systematic approach, using a set of dual molecular tumor-specific markers such as cytokeratin 19 (CK19) and carbonic anhydrase 9 (CA9), in a series of 46 patients (19 with cervical cancer, 18 with endometrial cancer, and 9 with vulvar cancer). A total of 1281 lymph nodes were analyzed and 28 were found positive by histopathology. Following this documentation, 82 lymph nodes, 11 positive and 71 negative, were randomly selected and further analyzed both by IHC and qRT-PCR for CK19 and CA9 expression. All 11 (100%) expressed CK19 by IHC, while only 6 (54.5%) expressed CA9. On the contrary, all the histologically negative for micrometastases lymph nodes were also negative by IHC analysis for both markers. The comparative diagnostic efficacy of the two markers using qRT-PCR, however, disclosed that the analysis of the same aliquots of the 82 lymph nodes led to 100% specificity for the CK19 biomarker, while, in contrast, CA9 failed to recapitulate a similar pattern. These data suggest that qRT-PCR exhibits a better diagnostic accuracy compared to IHC, while CK19 displays a consistent pattern of detection compared to CA9. PMID:24527437

Pappa, Kalliopi I.; Rodolakis, Alexandros; Christodoulou, Ioanna; Gazouli, Maria; Markaki, Sofia; Antsaklis, Aris; Anagnou, Nicholas P.

2014-01-01

316

Cytotoxic Edema Is Responsible for Raised Intracranial Pressure in Fulminant Hepatic Failure: In Vivo Demonstration Using Diffusion-Weighted MRI in Human Subjects  

Microsoft Academic Search

It is not clear whether cerebral edema in fulminant hepatic failure is predominantly vasogenic or cytotoxic, though cytotoxic edema due to astrocyte swelling is more likely. Diffusion-weighted magnetic resonance imaging can differentiate vasogenic from cytotoxic edema. We performed diffusion-weighted imaging in patients with fulminant hepatic failure to clarify the issue by measuring apparent diffusion coefficient, which quantifies movement of water

Piyush Ranjan; Asht Mangal Mishra; Ravindra Kale; Vivek Anand Saraswat; Rakesh Kumar Gupta

2005-01-01

317

Increased brain edema following 5-aminolevulinic acid mediated photodynamic in normal and tumor bearing rats  

NASA Astrophysics Data System (ADS)

Introduction: Failure of treatment for high grade gliomas is usually due to local recurrence at the site of surgical resection indicating that a more aggressive form of local therapy, such as PDT, could be of benefit. PDT causes damage to both tumor cells as well as cerebral blood vessels leading to degradation of the blood brain barrier with subsequent increase of brain edema. The increase in brain edema following ALA-PDT was evaluated in terms of animal survival, histopatological changes in normal brain and tumor tissue and MRI scanning. The effect of steroid treatment, to reduce post-treatment PDT induced edema, was also examined. Methods:Tumors were established in the brains of inbred BD-IX and Fisher rats. At various times following tumor induction the animals were injected with ALA ip. and four hours later light treatment at escalating fluences and fluence rates were given. Nontumor bearing control animals were also exposed to ALA-PDT in a similar manner to evaluate damage to normal brain and degree of blood brain barrier (BBB) disruption. Results: Despite a very low level of PpIX production in normal brain, with a 200:1 tumor to normal tissue selectivity ratio measured at a distance of 2 mm from the tumor border, many animals succumbed shortly after treatment. A total radiant energy of 54 J to non-tumor bearing animals resulted in 50% mortality within 5 days of treatment. Treatment of tumor bearing animals with moderate fluence levels produced similar brain edema compared to higher fluence levels. ALA PDT in nontumor bearing animals produced edema that was light dose dependent. PDT appeared to open the BBB for a period of 24-48 hrs after which it was restored. The addition of post operative steroid treatment reduced the incident of post treatment morbidity and mortality. Conclusions: T2 and contrast enhanced T1 MRI scanning proved to be a highly effective and non-evasive modality in following the development of the edema reaction and the degree and time course of BBB dysfunction thus allowing the use of fewer animals.

Hirschberg, Henry; Angell-Petersen, Even; Spetalen, Signe; Mathews, Marlon; Madsen, Steen J.

2007-02-01

318

Anti-inflammatory activity of Achillea and Ruscus topical gel on carrageenan-induced paw edema in rats.  

PubMed

The anti-inflammatory activity of Achillea and Ruscus extracts was studied in comparison with diclofenac sodium topical gel (diclosal Emulgel), using the carrageenan induced paw edema model in Albino rats. Gel formulation was prepared containing 6% of each extract in gel base, namely sodium carboxymethylcellulose (NaCMC). The kinetics of drug release from the prepared formulation was studied separately in each case. Results showed that the release follows the Higuchi square root equation. The pharmacological screening revealed that the percent reduction of edema for Achillea extract and Ruscus extract were 48.1% and 18.8%, respectively, while diclosal Emulgel produced 47% reduction of edema. PMID:17203864

Maswadeh, Hamzah M; Semreen, Mohammad H; Naddaf, Ahmad R

2006-01-01

319

Laser-Based Strategies to Treat Diabetic Macular Edema: History and New Promising Therapies  

PubMed Central

Diabetic macular edema (DME) is the main cause of visual impairment in diabetic patients. The management of DME is complex and often various treatment approaches are needed. At the present time, despite the enthusiasm for evaluating several new treatments for DME, including the intravitreal pharmacologic therapies (e.g., corticosteroids and anti-VEGF drugs), laser photocoagulation still remains the current standard in DME. The purpose of this review is to update our knowledge on laser photocoagulation for DME and describe the developments in laser systems. And we will also discuss the new laser techniques and review the latest results including benefits of combined therapy. In this paper, we briefly summarize the major laser therapeutics for the treatment of diabetic macular edema and allude to some future promising laser therapies. PMID:25332833

Park, Young Gun; Kim, Eun Yeong; Roh, Young Jung

2014-01-01

320

Subthreshold Diode Micropulse Laser Photocoagulation (SDM) as Invisible Retinal Phototherapy for Diabetic Macular Edema: A Review  

PubMed Central

Purpose: To present the state-of-the-art of subthreshold diode laser micropulse photocoagulation (SDM) as invisible retinal phototherapy for diabetic macular edema (DME). Method: To review the role and evolution of retinal laser treatment for DME. Results: Thermal laser retinal photocoagulation has been the cornerstone of treatment for diabetic macular edema for over four decades. Throughout, laser induced retinal damage produced by conventional photocoagulation has been universally accepted as necessary to produce a therapeutic benefit, despite the inherent risks, adverse effects and limitations of thermally destructive treatment. Recently, SDM, performed as invisible retinal phototherapy for DME, has been found to be effective in the absence of any retinal damage or adverse effect, fundamentally altering our understanding of laser treatment for retinal disease. Summary: The discovery of clinically effective and harmless SDM treatment for DME offers exciting new information that will improve our understanding of laser treatment for retinal disease, expand treatment indications, and improve patient outcomes. PMID:22587512

Luttrull, Jeffrey K; Dorin, Giorgio

2012-01-01

321

Radiographically Severe but Clinically Mild Reexpansion Pulmonary Edema following Decompression of a Spontaneous Pneumothorax  

PubMed Central

The case is a 48-year-old female who presented with mild dyspnea on exertion and cough with unremarkable vital signs and was found to have a large right sided pneumothorax. She underwent small bore chest tube decompression with immediate reexpansion of the collapsed lung. However, she rapidly developed moderate hypoxemia and radiographic evidence of reexpansion pulmonary edema (REPE) on both the treated and contralateral sides. Within a week, she had a normal chest X-ray and was asymptomatic. This case describes a rare complication of spontaneous pneumothorax and highlights the lack of correlation between symptoms, sequelae, and radiographic severity of pneumothorax and reexpansion pulmonary edema. Proposed pathophysiologic mechanisms include increased production of reactive oxygen species with subsequent loss of surfactant and increased vascular permeability, and loss of vasoregulatory tone. PMID:25165607

Harner, William E.; Crawley, Eric A.

2014-01-01

322

Water Permeability and TCDD-Induced Edema in Zebrafish Early-Life Stages  

Microsoft Academic Search

A common response to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposure in teleost embryos is blue-sac disease, charac- terized by pericardial and yolk-sac edema. The cellular and extra- cellular fluids of freshwater fish are hyperosmotic compared to the surrounding water. In order to be in osmotic balance, freshwater fish must maintain a barrier to minimize water entry and excrete excess water that passes the

Adrian J. Hill; Amy L. Prasch; Richard E. Peterson; Warren Heideman

2004-01-01

323

Aldosterone Regulates Na,K-ATPase and Increases Lung Edema Clearance in Rats  

Microsoft Academic Search

Aldosterone increases the Na,K-ATPase function in renal cells involved in active Na 1 transport. Be- cause the alveolar type 2 (AT2) cells participate in active Na 1 transport, we studied whether aldoster- one regulates the Na,K-ATPase in rat AT2 cells and whether aldosterone delivered by aerosols to spontaneously breathing rats affects edema clearance in a model of isolated-perfused lungs. The

WALTER G. OLIVERA; DAVID E. CICCOLELLA; NORA BARQUIN; KAREN M. RIDGE; DAVID H. RUTSCHMAN; DONOVAN B. YEATES; JACOB I. SZNAJDER

2000-01-01

324

Commercial double-indicator-dilution densitometer using heavy water: Evaluation in oleic-acid pulmonary edema  

Microsoft Academic Search

We evaluated a commercially available, double-indicator-dilution densitometric system for the estimation of pulmonary extravascular\\u000a water volume in oleic acid-induced pulmonary edema. Indocyanine green and heavy water were used as the nondiffusible and diffusible\\u000a tracers, respectively. Pulmonary extravascular water volume, measured with this system, was 67% of the gravimetric value (r = 0.91), which was consistent with values obtained from the

Lars G. Leksell; Mark S. Schreiner; Angelina Sylvestro; Gordon R. Neufeld

1990-01-01

325

Cellular and Systemic Effects of Anthrax Lethal Toxin and Edema Toxin  

PubMed Central

Anthrax lethal toxin (LT) and edema toxin (ET) are the major virulence factors of anthrax and can replicate the lethality and symptoms associated with the disease. This review provides an overview of our current understanding of anthrax toxin effects in animal models and the cytotoxicity (necrosis and apoptosis) induced by LT in different cells. A brief reexamination of early historic findings on toxin in vivo effects in the context of our current knowledge is also presented. PMID:19638283

Moayeri, Mahtab; Leppla, Stephen H.

2009-01-01

326

Pulmonary edema associated with methylene blue dye administration during sentinel lymph node biopsy.  

PubMed

Sentinel lymph node biopsy (SLNB) is an established procedure for staging early breast cancer. Recently, methylene blue dye has been advocated as a safe, efficacious and cost-effective substitute for isosulfan blue in sentinel lymph node mapping. In this case report, we describe a 44-year-old woman who developed pulmonary edema associated with the use of methylene blue dye for SLNB. PMID:19110921

Teknos, Daniel; Ramcharan, Alexius; Oluwole, Soji F

2008-12-01

327

Evidence of peroxynitrite involvement in the carrageenan-induced rat paw edema  

Microsoft Academic Search

The role of peroxynitrite generated from nitric oxide and superoxide anion was investigated in a model of acute inflammation induced by the injection of carrageenan into the rat hind paw. Paw edema was inhibited 8 h following the administration of carrageenan by N-iminoethyl-l-lysine (3–30 mg\\/kg, n = 6) or aminoguanidine (30–300 mg\\/kg, n = 6), two selective inhibitors of inducible

Daniela Salvemini; Zhi-Qiang Wang; David M. Bourdon; Michael K. Stern; Mark G. Currie; Pamela T. Manning

1996-01-01

328

Regulators of vascular permeability: potential sites for intervention in the treatment of macular edema  

Microsoft Academic Search

Rather than being a non-specific reaction to a noxious stimulus, breakdown of the capillary blood-retinal barrier causing\\u000a macular edema appears to be dependent on a number of active processes which may be open to pharmacological manipulation. Extracellular\\u000a influences which may affect barrier function include serum and neighboring cell types, which act though cytokines, such as\\u000a vascular endothelial growth factor and

Mark C. Gillies

1999-01-01

329

Unusual ventilation perfusion scintigram in a case of immunologic pulmonary edema clinically simulating pulmonary embolism  

SciTech Connect

A case of immunologic pulmonary edema secondary to hydrochlorothiazide allergy developed in a 55-year-old woman that clinically simulated pulmonary embolism. The patient had abnormal washin images with normal washout images on an Xe-133 ventilation study. On the perfusion study, large bilateral central and posterior perfusion defects were present that showed an unusual mirror image pattern on the lateral and posterior oblique views. Resolution of radiographic and scintigraphic abnormalities occurred over a 3-day period in conjunction with corticosteroid therapy.

Campeau, R.J.; Faust, J.M.; Ahmad, S.

1987-11-01

330

Validating Imaging Biomarkers of Cerebral Edema in Patients with Severe Ischemic Stroke  

PubMed Central

Background and Purpose There is no validated neuroimaging marker for quantifying brain edema. We sought to test whether MRI-based metrics would reliably change during the early subacute period in a manner consistent with edema and whether they would correlate with relevant clinical endpoints. Methods Serial MRI studies from patients in the EPITHET trial with initial diffusion weighted imaging (DWI) lesion volume >82 cm3 were analyzed. Two independent readers outlined the hemisphere and lateral ventricle on the involved side and calculated respective volumes at baseline and day 3 to 5. We assessed inter-rater agreement, volume change between scans and the association of volume change with early neurological deterioration (END: NIHSS score worsening ?4 points), 90-day modified Rankin Scale (mRS) score 0–4 and mortality. Results Of 12 patients who met study criteria, average baseline and follow-up DWI lesion size was 138 cm3 and 234 cm3, respectively. Mean time to follow-up MRI was 62 hours. Concordance correlation coefficients between readers were >0.90 for both hemisphere and ventricle volume assessment. Mean percent hemisphere volume increase was 16.2±8.3% (p<.0001), and mean percent ventricle volume decrease was 45.6±16.9% (p<0.001). Percent hemisphere growth predicted END (area under the curve [AUC]=0.92, p=0.0005) and 90-day mRS 0–4 (AUC 0.80, p=0.02). Conclusions In this exploratory analysis of severe ischemic stroke patients, statistically significant changes in hemisphere and ventricular volumes within the first week are consistent with expected changes of cerebral edema. MRI-based analysis of hemisphere growth appears to be a suitable biomarker for edema formation. PMID:22325573

Yoo, Albert J.; Sheth, Kevin N.; Kimberly, W. Taylor; Chaudhry, Zeshan A.; Elm, Jordan J.; Jacobson, Sven; Davis, Stephen M.; Donnan, Geoffrey A.; Albers, Gregory W.; Stern, Barney J.; Gonzalez, R. Gilberto

2012-01-01

331

Natural history of perihematomal edema following intracerebral hemorrhage measured by serial magnetic resonance imaging  

PubMed Central

Background Knowledge on natural history and clinical impact of perihematomal edema (PHE) associated with intracerebral hemorrhage (ICH) is limited. We aimed to define the time course, predictors and clinical significance of PHE measured by serial MR imaging. Methods Patients with primary supratentorial ICH of ? 5cc underwent serial MRIs at pre-specified intervals during the first month. Hematoma (Hv) and PHE (Ev) volumes were measured on FLAIR. Relative PHE (rPHE) was defined as Ev/Hv. Neurological assessments were performed at admission and with each MRI. Barthel Index, modified Rankin and extended Glasgow outcome scales were done at 3 months. Results Twenty-seven patients with 88 MRIs were prospectively included. Median Hv and Ev on the first MRI were 39 and 46cc. Median peak absolute Ev was 88cc. Larger hematomas produced larger absolute Ev (r2=0.6) and smaller rPHE (r2 =0.7). Edema volume growth was fastest in the first two days, but continued until 12±3 days. In multivariate analysis, a higher admission hematocrit was associated with a greater delay in peak PHE (p=0.06). Higher admission PTT was associated with higher peak rPHE (p=0.02). Edema volume growth correlated with a decline in neurologic status at 48 hours (81 Vs 43cc, p=0.03), but not with 3-month functional outcome. Conclusions Perihematomal edema volume measured by MRI increases most rapidly in the first two days after symptom onset and peaks towards the end of the 2nd week. The timing and magnitude of PHE volume is associated with hematological factors. Its clinical significance deserves further study. PMID:21164136

Venkatasubramanian, Chitra; Mlynash, Michael; Finley-Caulfield, Anna; Eyngorn, Irina; Kalimuthu, Rajalakshmi; Snider, Ryan W.; Wijman, Christine Anne

2011-01-01

332

Treatment of tyramine-induced brain edema with anion transport inhibitor L-644,711  

Microsoft Academic Search

Tyramine induces coma in phenelzine-treated dogs. Development of coma in these animals is associated with brain edema, abnormal brain scans of Tc-99m-diethylene-triamine-penta-acetic acid (Tc-99m-DTPA), and elevated levels of CSF catecholamines. We found that the intravenous administration of 6-7 mg\\/kg of a single dose of L-644,711 given fifteen minutes after the oral administration of tyramine to phenelzine-pretreated animals followed by an

B. A. Faraj; E. J. Jr. Cragoe; R. Sarper; M. Camp; E. Malveaux

1988-01-01

333

Bone marrow edema syndromes of the hip: MRI features in different hip disorders  

Microsoft Academic Search

The objectives of this study were to describe the essential magnetic resonance imaging (MRI) features of bone marrow edema\\u000a syndromes affecting the hip joint. In addition, to evaluate the role of MRI in the assessment of hip joint involvement in\\u000a different clinical settings that may share similar clinical findings. Thirty-four patients who complained of hip pain were\\u000a studied consecutively. Of

Yasser Ragab; Yasser Emad; Alaa Abou-Zeid

2008-01-01

334

Pulmonary edema secondary to chronic upper airway obstruction. Hemodynamic study in a child  

Microsoft Academic Search

A 22-month-old girl with the syndrome of hypoventilation, pulmonary hypertension, cor pulmonale and pulmonary edema due to adenoidal hypertrophy is described. Adenoidectomy resulted in relief of all symptoms and signs within 24 h. Hemodynamic study using pulmonary artery catheter showed that the pulmonary artery pressure returned to normal 48 h after relief of the obstruction. The normal left ventricular end-diastolic

S. Sofer; R. Baer; Y. Gussarsky; A. Lieberman; J. Bar-Ziv

1984-01-01

335

Inhibition of hind-paw edema and cutaneous vascular plasma extravasation in mice by acetylshikonin  

Microsoft Academic Search

Acetylshikonin, a naphthoquinone isolated from the Chinese herb medicine, tzu ts'ao, was demonstrated to inhibit the polymyxin B-induced hind-paw edema in normal as well as in adrenalectomized mice. Liver glycogen content was increased in adrenalectomized mice pretreated with dexamethasone, but not with acetylshikonin. Like diphenhydramine, methysergide and isoproterenol, acetylshikonin reduced the plasma exudation evoked in dorsal hind-paw skin by antidromic

Jih-Pyang Wang; Shue-Ling Raung; Ling-Chu Chang; Sheng-Chu Kuo

1995-01-01

336

Synergism between subthreshold doses of phenylbutazone and prednisolone in rat hind-paw carrageenan edema  

Microsoft Academic Search

When phenylbutazone (PhB) and prednisolone (PD) or cortisol acetate (HC) were administered together by oral route a synergic inhibitory effect on rat hind-paw carrageenan edema occurred, marked antiphlogistic effect being obtained by associating subthreshold doses of drugs. By administering a fixed subthreshold dose of PD with increasing subthreshold doses of PhB, statistically significant phlogosis inhibition was obtained, the degree of

M. Sandrini

1979-01-01

337

Dual Effects of Hyperprolactinemia on Carrageenan-Induced Inflammatory Paw Edema in Rats  

Microsoft Academic Search

Objectives: The effects of short-term 5-day and long-term 30-day hyperprolactinemia induced by domperidone (1.7 mg\\/kg\\/day, s.c.) or ectopic pituitary graft on the acute inflammatory response induced by carrageenan were evaluated in male rats. Both models of hyperprolactinemia effectively increased serum prolactin (PRL) levels. Methods: The volume in milliliters of inflammatory edema was measured by plethysmography 1, 2, 3, 4, 6,

Julieta E. Ochoa-Amaya; Benjamin E. Malucelli; Pablo E. Cruz-Casallas; Antonia G. Nasello; Luciano F. Felicio; Maria I. R. Carvalho-Freitas

2011-01-01

338

Malignant irreversible global cerebral edema as a complication of fourth ventricular arachnoid cyst.  

PubMed

Abstract Arachnoid cysts are benign congenital lesions of the central nervous system accounting for 1% of all intracranial masses. Intraventricular location of arachnoid cyst especially in the fourth ventricle is rare. Fenestration or marsupialization of these "innocent-looking" benign cysts can lead to dreadful life-threatening complications. We report a rare case of development of malignant irreversible global cerebral edema in a 21-year-old lady following surgical decompression of fourth ventricular arachnoid cyst. PMID:24779389

Baldawa, Sachin; Anvekar, Balaji; Valsangkar, Ashwin; Valsangkar, Shirish

2014-12-01

339

Optical coherence tomography in diabetic macular edema: patterns and related risk factors.  

PubMed

Introduction: Diabetic Macular Edema (DME) is an important cause of vision loss in diabetic retinopathy. Optical Coherence Tomography (OCT) is a non-invasive modality that produces high-resolution images of retinal layers. Objective: To evaluate the prevalence of DME patterns and their association with risk factors and visual acuity. Materials and Methods: In this cross-sectional study, type 2 diabetics with macular edema referred to our center during a ten-month period underwent OCT. Patients with macular edema due to causes other than diabetes and with OCT images of improper quality were excluded from the study. Four distinct patterns were found in the OCT images. A questionnaire including age, sex, duration of diabetes, serum TG and cholesterol, HbA1c, BMI and visual acuity, as well as the findings of OCT images were filled for the subjects. Results: Eighty-six eyes from 46 patients were evaluated. The most and the least common patterns were sponge-like retinal swelling (SLRS) and posterior hyaloidal traction (PHT) found in 64.0% and 5.8% of the subjects, respectively. A sub-retinal fluid pattern was more common in males (p=0.011) and in patients with serum TG > 200mg/dl (p=0.037). There were significant associations between central foveal (r=0.45, p less than 0.001), nasal (r=0.35, p=0.001) and temporal (r=0.32, p=0.003) thicknesses with visual acuity. Moreover, the highest thickness (462.4±119.2?m) and also the worst visual acuity (1.0±0.5logMAR) pertained to the cystoid macular edema (CME) pattern. Conclusion: Our study showed that the most common OCT pattern of DME is the sponge-like retinal swelling, while posterior hyaloidal traction has the lowest prevalence. A higher foveal thickness and a lower visual acuity are seen in the CME pattern. PMID:24172553

Ahmadpour-Baghdadabad, M; Manaviat, M; Shojaoddiny-Ardekani, A

2013-07-01

340

Unilateral dependant pulmonary edema during laparoscopic donor nephrectomy: report of three cases  

PubMed Central

Summary Unilateral pulmonary edema of the dependant lung was observed in three patients during laparoscopic donor nephrectomy. Patients were treated with O2 supplementation by face mask, fluid restriction and diuretic. All the patients were relieved of symptoms with radiological improvement. The possible causes of this unusual complication following laparoscopic surgery appear to be prolonged lateral decubitus position and high intraoperative fluid infusion. PMID:20640211

Modi, Manisha; Shah, Veena; Modi, Pranjal

2009-01-01

341

Lung Function and Breathing Pattern in Subjects Developing High Altitude Pulmonary Edema  

Microsoft Academic Search

IntroductionThe purpose of the study was to comprehensively evaluate physiologic changes associated with development of high altitude pulmonary edema (HAPE). We tested whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage.MethodsIn 18 mountaineers, spirometry, diffusing capacity, nitrogen washout, nocturnal ventilation and pulse oximetry were recorded at 490 m and during 3 days

Christian F. Clarenbach; Oliver Senn; Andreas L. Christ; Manuel Fischler; Marco Maggiorini; Konrad E. Bloch

2012-01-01

342

Intravitreal triamcinolone acetonide as treatment of macular edema in central retinal vein occlusion  

Microsoft Academic Search

Purpose. To report the clinical outcome of a patient receiving an intravitreal injection of triamcinolone acetonide as treatment of bilateral, long-standing, cystoid macular edema due to central retinal vein occlusion. Methods. A 70-years-old patient suffering from bilateral central retinal vein occlusion for 2 years and 1.5 years, respectively, received transconjunctivally an intravitreal injection of 25 mg of crystalline triamcinolone acetonide

Jost B. Jonas; Ingrid Kreissig; Robert F. Degenring

2002-01-01

343

690. Angiopoietin-1 Reduces Lung Edema and Mortality Induced by Bacterial Endotoxin  

Microsoft Academic Search

Acute lung injury (ALI) is a frequent cause of morbidity and mortality in patients with bacterial sepsis. Capillary leakage together with interstitial and alveolar edema are the hallmarks of this condition. The loss of integrity in the endothelial barrier is a prerequisite for development of ALI. Angiopoietin-1 (Ang-1) binds to the Tie2 receptor. This interaction activates the phosphatidylinositol 3?-kinase\\/Akt survival

Yao Qi Huang; Harald Sauthoff; Teona Pipiya; Shu Chen; William N. Rom; John G. Hay

2004-01-01

344

Coronary artery air embolism causing pulmonary edema secondary to acute coronary syndrome in a diver.  

PubMed

Air embolism in the coronary arteries is a known complication of coronary angiography. Diving is a non-iatrogenic cause of arterial air embolism, commonly presenting with neurological and musculoskeletal symptoms. This is the first known case of coronary air embolism confirmed on coronary angiography in a diver presenting with pulmonary edema secondary to acute coronary syndrome. The possible mechanisms of coronary air embolism during a dive are reviewed in this article. PMID:19057040

Sammut, Mark Adrian; Cassar, Andrew; Felice, Herbert

2008-12-01

345

Chronic edema of the lips--a rare but real problem: a report of 3 cases and their response to therapy.  

PubMed

Chronic edema of the lips is rare but disabling. We present 3 illustrative cases of chronic edema involving the lips. The causes were (1) idiopathic, (2) lymphedema occurring after radiation therapy, and (3) cheilitis granulomatosa. The edema subsided with compression therapy in the first 2 patients. Surgical decompression was helpful in the second patient, and dapsone therapy was initiated in the third. Chronic edema of the lips can be a clinically significant problem. These 3 cases illustrate the various causes and an approach to the management of chronic edema of the lips. PMID:16243146

van der Kooi, Kaisa; Davis, Mark D P; McCloskey, Gayle

2005-11-01

346

Acute Ethanol-Induced Changes in Edema and Metabolite Concentrations in Rat Brain  

PubMed Central

The aim of this study is to describe the acute effects of EtOH on brain edema and cerebral metabolites, using diffusion weight imaging (DWI) and proton magnetic resonance spectroscopy (1H-MRS) at a 7.0T MR and to define changes in apparent diffusion coefficient (ADC) values and the concentration of metabolites in the rat brain after acute EtOH intoxication. ADC values in each ROI decreased significantly at 1 h and 3 h after ethanol administration. ADC values in frontal lobe were decreased significantly compared with other regions at 3 h. For EtOH/Cr+PCr and cerebral metabolites (Cho, Tau, and Glu) differing over time, no significant differences for Ins, NAA, and Cr were observed in frontal lobes. Regression analysis revealed a significant association between TSEtOH/Cr+PCr and TSCho, TSTau, TSGlu, and TSADC. The changes of ADC values in different brain regions reflect the process of the cytotoxic edema in vivo. The characterization of frontal lobes metabolites changes and the correlations between TSEtOH/Cr+PCr and TSCho, TSTau, and TSGlu provide a better understanding for the biological mechanisms in neurotoxic effects of EtOH on the brain. In addition, the correlations between TSEtOH/Cr+PCr and TSADC will help us to understand development of the ethanol-induced brain cytotoxic edema. PMID:24783201

Liu, Huimin; Yan, Gen; Liu, Baoguo; Kong, Lingmei; Ding, Yan; Tan, Hui; Zhang, Guishan

2014-01-01

347

Crocin alleviates the local paw edema induced by histamine in rats  

PubMed Central

Objective: Crocin, as an active constituent of saffron, has many biological functions including antioxidant and anti-inflammatory activities. The present study was aimed to investigate the effects of crocin and chlorpheniramine on local edema induced by histamine. Materials and Methods: Local edema was induced by subcutaneous injection of histamine (100 ?l, 0.1%) in ventral surface of right hind paw. The thickness of paw was measured at 1 h before and 1, 2, 3 h after injection of histamine, using a fine caliper. The number of neutrophils in paw tissue sections was counted 3 h after intraplantar injection of histamine. Results: Intraperitoneal injection of crocin at doses of 100 and 200 mg/kg and chlorpheniramine at a dose of 10 mg/kg significantly (p<0.05) decreased both paw thickness and infiltration of neutrophils in paw tissues. In a combined treatment, intraperitoneal injection of an effective dose of crocin (100 mg/kg) with an ineffective dose of chlorpheniramine (2.5 mg/kg) produced a more documented response in comparison with crocin (100 mg/kg) and chlorpheniramine (2.5 mg/kg) used alone. Conclusion: The results suggested that both crocin and chlorpheniramine suppressed histamine-induced local paw edema. Moreover, histamine H1 receptors function may be affected by crocin. PMID:25050237

Tamaddonfard, Esmaeal; Farshid, Amir Abbas; Hosseini, Leila

2012-01-01

348

Establishment and evaluation of an experimental animal model of high altitude cerebral edema.  

PubMed

The aim of our study was to develop a model of high altitude cerebral edema (HACE) using an acute, hypobaric hypoxia environment combined with exhaustive exercise. Forty healthy male Sprague-Dawley rats were randomly divided into a plains control group (PC group) and a plateau altitude hypoxia group (AH group). After 2 days of treadmill adaptation under normoxic conditions, the AH group was housed in hypobaric conditions (simulating 4000 m above sea level) for 2 days while performing exhaustive exercise. The simulated altitude was then increased to 8000 m for 3 days of simple hypobaric hypoxia exposure. Compared with the PC group, the AH group showed significantly greater (P<0.01) water content and Evans blue staining in their brain tissue. Furthermore, the hippocampal formation was seriously damaged, and the number of pyramidal cells decreased. In addition, the brain structure was altered into a loose state with notable edema, which was demonstrated by the leakage of lanthanum nitrate particles from brain microvessels into the surrounding tissue through widened tight junctions. Some neurons and glial cell organelles were swollen and some nerve fibers were demyelinated as well. We have shown that acute hypobaric hypoxia exposure with exhaustive exercise increases the permeability of the blood-brain barrier and leads to cerebral edema, making this a valid animal model of HACE. PMID:23680461

Guo, Ping; Luo, Han; Fan, Yong; Luo, Yongjun; Zhou, Qiquan

2013-06-28

349

Inhibition of chlorine-induced pulmonary inflammation and edema by mometasone and budesonide  

PubMed Central

Chlorine gas is a widely used industrial compound that is highly toxic by inhalation and is considered a chemical threat agent. Inhalation of high levels of chlorine results in acute lung injury characterized by pneumonitis, pulmonary edema, and decrements in lung function. Because inflammatory processes can promote damage in the injured lung, anti-inflammatory therapy may be of potential benefit for treating chemical-induced acute lung injury. We previously developed a chlorine inhalation model in which mice develop epithelial injury, neutrophilic inflammation, pulmonary edema, and impaired pulmonary function. This model was used to evaluate nine corticosteroids for the ability to inhibit chlorine-induced neutrophilic inflammation. Two of the most potent corticosteroids in this assay, mometasone and budesonide, were investigated further. Mometasone or budesonide administered intraperitoneally 1 h after chlorine inhalation caused a dose-dependent inhibition of neutrophil influx in lung tissue sections and in the number of neutrophils in lung lavage fluid. Budesonide, but not mometasone, reduced the levels of the neutrophil attractant CXCL1 in lavage fluid 6 h after exposure. Mometasone or budesonide also significantly inhibited pulmonary edema assessed 1 day after chlorine exposure. Chlorine inhalation resulted in airway hyperreactivity to inhaled methacholine, but neither mometasone nor budesonide significantly affected this parameter. The results suggest that mometasone and budesonide may represent potential treatments for chemical-induced lung injury. PMID:23800689

Chen, Jing; Mo, Yiqun; Schlueter, Connie F.; Hoyle, Gary W.

2013-01-01

350

A pre-injury high ethanol intake in rats promotes brain edema following traumatic brain injury.  

PubMed

Abstract Drinking is a risk factor for traumatic brain injury (TBI), and ethanol can aggravate the outcome by promoting brain edema. The mechanism involved is not fully understood. It has been confirmed that aquaporin-4 (AQP4) and vascular endothelial growth factor (VEGF) play pivotal roles in cytotoxic/vasogenic brain edema individually, and both of these proteins are downstream regulatory factors of hypoxia-inducible factor-1? (HIF-1?). In this study, we used a fluid percussion injury (FPI) model in rats to determine the effects of acute ethanol intake on the expression levels of HIF-1?, AQP4, and VEGF prior to FPI. The animals were sacrificed 1, 2, 3, and 4 days post-injury. We found that the expression levels of HIF-1? and AQP4 were significantly upregulated in the ethanol-pretreated groups, whereas the VEGF expression level was not. In addition, there was a positive correlation between HIF-1? and AQP4. The results of this study indicate that cytotoxic brain edema may play an important role in the early stage of FPI in ethanol-pre-treated animals and that HIF-1? and AQP4 might be involved. PMID:24814385

Wu, Weichuan; Tian, Runfa; Hao, Shuyu; Xu, Feifan; Mao, Xiang; Liu, Baiyun

2014-12-01

351

Effect of a Dynamic Air Cushion on the Development of Leg Edema during Wheelchair Sitting.  

PubMed

[Purpose] To clarify how a novel dynamic cushion affects the leg edema evoked by wheelchair sitting, we measured the changes in leg volume induced during wheelchair sitting with the dynamic air cushion or a static cushion. [Subjects and Methods] Nine healthy male subjects participated in this study. Leg edema during wheelchair sitting was evaluated with strain gauge plethysmography (the gauge was placed around the middle portion of the lower thigh). Following a period of rest, each subject was asked to sit on a wheelchair containing the dynamic cushion for 15?min. Then, the protocol was repeated with a static cushion. The angles of the knee and ankle joints were set to 90 degrees, and no footrests were used. [Results] The change in leg volume observed during sitting on the dynamic cushion (0.00 ± 0.03?mL/100?mL) was smaller than that observed during sitting on the static cushion (0.02 ± 0.02?mL/100?mL). [Conclusion] These results suggested that the dynamic cushion relieved leg edema during wheelchair sitting. PMID:25013295

Murata, Jun; Murata, Shin; Ohyama, Michie; Kogo, Haruki; Matsubara, Shohzo

2014-06-01

352

Inhibition of chlorine-induced pulmonary inflammation and edema by mometasone and budesonide.  

PubMed

Chlorine gas is a widely used industrial compound that is highly toxic by inhalation and is considered a chemical threat agent. Inhalation of high levels of chlorine results in acute lung injury characterized by pneumonitis, pulmonary edema, and decrements in lung function. Because inflammatory processes can promote damage in the injured lung, anti-inflammatory therapy may be of potential benefit for treating chemical-induced acute lung injury. We previously developed a chlorine inhalation model in which mice develop epithelial injury, neutrophilic inflammation, pulmonary edema, and impaired pulmonary function. This model was used to evaluate nine corticosteroids for the ability to inhibit chlorine-induced neutrophilic inflammation. Two of the most potent corticosteroids in this assay, mometasone and budesonide, were investigated further. Mometasone or budesonide administered intraperitoneally 1h after chlorine inhalation caused a dose-dependent inhibition of neutrophil influx in lung tissue sections and in the number of neutrophils in lung lavage fluid. Budesonide, but not mometasone, reduced the levels of the neutrophil attractant CXCL1 in lavage fluid 6h after exposure. Mometasone or budesonide also significantly inhibited pulmonary edema assessed 1 day after chlorine exposure. Chlorine inhalation resulted in airway hyperreactivity to inhaled methacholine, but neither mometasone nor budesonide significantly affected this parameter. The results suggest that mometasone and budesonide may represent potential treatments for chemical-induced lung injury. PMID:23800689

Chen, Jing; Mo, Yiqun; Schlueter, Connie F; Hoyle, Gary W

2013-10-15

353

Bilateral acute anterior uveitis and optic disc edema following a snake bite.  

PubMed

The authors wish to report a case of bilateral acute anterior uveitis and optic disc edema following a hemotoxic snake bite, in order to highlight the concomitant occurrence of these conditions and the potential adverse effects of anti-snake venom (ASV). A 35-year-old male was bitten by a viper at seventeen thirty hours, and was started on ASV. Two days following treatment he experienced sudden onset redness and painful diminution of vision in both eyes (OU). On examination, the patient's visual acuity (VA) in OU was 20/200. Examination revealed fresh keratic precipitates, cells, and flare in the anterior chamber (AC), posterior synechiae, sluggish and ill-sustained pupillary reaction, and hyperemic, edematous disc with blurred margins in OU. He was started on topical steroids, cycloplegics and intravenous methylprednisolone. Following treatment, the patient showed improvement and was continued on topical medications and oral prednisolone tapered over 3 weeks, after which VA OU improved, the AC showed no cells and flare and disc edema resolved. Uveitis and optic disc edema in snake bite can either be due to the direct toxic effects of the venom or the effect of ASV. Steroids have a beneficial role in the management of these symptoms. PMID:24688264

Kumar, Praveen K; Ahuja, Shashi; Kumar, Praveen S

2014-04-01

354

Hypertonic saline alters hydraulic conductivity and up-regulates mucosal/submucosal aquaporin 4 in resuscitation-induced intestinal edema  

PubMed Central

Objective To characterize membrane conductivity by applying mathematical modeling techniques and immunohistochemistry to localize and predict areas of the bowel where aquaporins may be associated with edema resolution/prevention associated with hypertonic saline. Intestinal edema induced by resuscitation and mesenteric venous hypertension impairs intestinal transit/contractility. Hypertonic saline decreases intestinal edema and improves transit. Aquaporins are water transport membrane proteins that may be up-regulated with edema and/or hypertonic saline. Design Laboratory study. Setting University research laboratory. Subjects Male Sprague Dawley rats, weighing 270 to 330 g. Interventions Rats were randomized to control (with and without hypertonic saline) and mesenteric venous hypertension with either 80 mL/kg normal saline (RESUS + VH + VEH) or 80 mL/kg with hypertonic saline (RESUS + VH + HTS). After 6 hrs, intestinal wet/dry ratios, urine output, peritoneal fluid, and intraluminal fluid were measured. Hydraulic conductivity was calculated from our previously known and published pressure-flow data. The cDNA microarray, Western blot, polymerase chain reaction, and immunohistochemistry studies were conducted for and candidate aquaporins and distribution in intestinal edema resolution. Measurements and Main Results Hypertonic saline decreased edema and increased urine, intraluminal, and peritoneal volume. RESUS + VH favors fluid flux into the interstitium. Hypertonic saline causes increased hydraulic conductivity at the seromuscular and mucosal surfaces at the same time limiting flow into the interstitium. This is associated with increased aquaporin 4 expression in the intestinal mucosa and submucosa. Conclusions Hypertonic saline mitigates intestinal edema development and promotes fluid redistribution secondary to increased membrane conductivity at the mucosal and seromuscular surfaces. This is associated with up-regulation of aquaporin 4 either gene expression and protein. Aquaporin 4 may be a useful therapeutic target for strategies to enhance edema resolution. PMID:19770732

Radhakrishnan, Ravi S.; Shah, Shinil K.; Lance, Samuel H.; Radhakrishnan, Hari R.; Xue, Hasen; Radhakrishnan, Geetha L.; Ramaswamy, Uma S.; Walker, Peter A.; Uray, Karen S.; Laine, Glen A.; Stewart, Randolph H.; Cox, Charles S.

2014-01-01

355

T2-prepared SSFP improves diagnostic confidence in edema imaging in acute myocardial infarction compared to turbo spin echo  

Microsoft Academic Search

T2-weighted MRI of edema in acute myocardial infarction (MI) provides a means of differentiating acute and chronic MI, and assessing the area at risk of infarction. Conventional T2- weighted imaging of edema uses a turbo spin-echo (TSE) read- out with dark-blood preparation. Clinical applications of dark- blood TSE methods can be limited by artifacts such as posterior wall signal loss

Peter Kellman; Anthony H. Aletras; Christine Mancini; Elliot R. McVeigh; Andrew E. Arai

2007-01-01

356

Histamine-induced edema in the rat paw — effect of capsaicin denervation and a CGRP receptor antagonist  

Microsoft Academic Search

Histamine is known to cause edema and excitation of small-diameter primary afferent neurons. In the present study we wanted to investigate to which extent afferent neurons participate in histamine-induced edema and, subsequently, determine possible inhibitory effects of a tachykinin NK1 receptor and CGRP receptor antagonist on the histamine response. Intraplantar injection of histamine (0.5 ?mol) into the rat hind paw

Rainer Amann; Rufina Schuligoi; Ilse Lanz; Josef Donnerer

1995-01-01

357

Safety and efficacy of topical Cidofovir to treat high-grade perianal and vulvar intraepithelial neoplasia in HIV-positive men and women  

PubMed Central

Objective To evaluate the safety and efficacy of topical cidofovir for treatment of high-grade squamous perianal and vulvar intraepithelial neoplasia (PAIN and VIN) lesions in HIV-positive individuals. Design Phase IIa prospective multicenter trial conducted at eight clinical sites through the AIDS Malignancy Consortium (AMC) Methods HIV-positive patients with biopsy-proven high-grade PAIN that was ? 3 cm2 were enrolled. PAIN biopsy specimens were assessed for HPV using PCR and type-specific HPV probing. Subjects applied 1% topical cidofovir to PAIN and VIN (if present) for 6 two-week cycles. Results were designated as complete response (CR), partial response (PR) (> 50% reduction in size), stable disease (SD), or progressive disease (PD). Results Twenty-four men and 9 women (8 with high-grade VIN as well) were enrolled. Mean age was 44 years, mean CD4+ count was 412 cells/?l. HPV DNA (most commonly HPV16) was detected in all pre-treatment study specimens. Twenty six (79%) subjects completed treatment per protocol—CR: 5 (15%); PR: 12 (36%), SD: 7 (21%); PD: 2 (6%) (1 with a superficially invasive cancer and 1 with new area of high-grade PAIN). Treatment was well tolerated with most common adverse events being mild to moderate affecting lesional skin: pain/burning/irritation (25 subjects) and ulceration (13 subjects). Conclusions Topical cidofovir had 51% efficacy in the short-term treatment of high-grade PAIN and VIN with acceptable toxicity in HIV-positive individuals. Randomized control studies with more prolonged treatment courses and longer follow-up to assess the durability of the response are needed. PMID:23032420

STIER, Elizabeth A; GOLDSTONE, Stephen E.; EINSTEIN, Mark H.; JAY, Naomi; BERRY, J. Michael; WILKIN, Timothy; LEE, Jeannette Y.; DARRAGH, Teresa M.; DA COSTA, Maria; PANTHER, Lori; ABOULAFIA, David; PALEFSKY, Joel M.

2013-01-01

358

Ospemifene: A first-in-class, non-hormonal selective estrogen receptor modulator approved for the treatment of dyspareunia associated with vulvar and vaginal atrophy.  

PubMed

Ospemifene is a selective estrogen receptor modulator (SERM) approved for the treatment of dyspareunia associated with vulvar and vaginal atrophy (VVA) due to menopause. As the first non-hormonal treatment for this indication, the approval of ospemifene represents a significant milestone in postmenopausal women's health. Ospemifene is a triphenylethylene similar in chemical structure to tamoxifen and toremifene. Consistent with other SERMs such as tamoxifen, toremifene, and raloxifene, ospemifene possesses a distinctive mix of estrogenic and antiestrogenic tissue-specific effects in bone, breast tissue, serum lipids, and the vagina. Among the approved SERMs, ospemifene is the only agent with a nearly full estrogen agonist effect on the vaginal epithelium while having neutral to slight estrogenic effects in the endometrium, making ospemifene uniquely suited for the treatment of dyspareunia associated with VVA, also known as atrophic vaginitis, which affects up to 50% of postmenopausal women. This review begins with a brief history of the discovery of ospemifene, its mechanism of action, and its preclinical development, with an emphasis on its tissue-specific effects on bone, breast, uterus and endometrium, serum lipids and vagina. A brief discussion on the genotoxicity of ospemifene compared to tamoxifen and toremifene is included. The focus then shifts to the clinical development of ospemifene from Phase I through Phase III. We will close with the FDA approval of ospemifene and a justification of the future clinical evaluation of ospemifene as a potential breast cancer chemopreventive agent, where several preclinical studies in different rodent breast cancer models strongly suggest ospemifene is as effective as tamoxifen. PMID:25087944

DeGregorio, Michael W; Zerbe, Robert L; Wurz, Gregory T

2014-11-01

359

Comparison between the fluorescence spectroscopy and the 125I albumin-labeling technique for the study of skin edema dynamics  

NASA Astrophysics Data System (ADS)

Skin injury caused by chemicals substances as the carrageenan produces a local inflammatory reaction involving the liberation of mediators that leads to an increase in vascular permeability and, consequently, edema formation. The vascular permeability can be evaluated by measuring the amount of some extravasating specific dyes. The Evans blue dye is recommended due to its systemic effect and non-toxicity to the organism. That dye binds to the plasma albumin and emits radiation when excited, allowing for spectroscopic monitoring of the edema. In this study, the amount of extravasating plasma albumin in the site of the carrageenan-induced edema in Wistar rats is evaluated by fluorescence spectroscopy. The intensity of the Evans blue dye fluorescence signal for different edema evolution times is compared to the 125I labeled albumin data obtained with a g-counter. A dye laser (458 nm) was used as the fluorescence excitation source. The fluorescence intensity was taken at the 680 nm peak of the dye spectral emission. The spectroscopic data shows the dye emission intensity growing with the settling up of the edema and decreasing as the tissue recovers from the inflammatory stimulus. A good correlation between the spectroscopic and the g-counter data was obtained, which suggests that the Evans blue dye fluorescence is a promising technique for the qualitative and quantitative analysis of edema dynamics.

da Silva Melo, Milene; Zangaro, Renato A.; Villaverde, Antonio G. J. B.; Antunes, Edson; Camargo, Enilton A.; Martins, Rodrigo A. B. L.; Ferreira, Denise M.; Pacheco, Marcos T. T.; Munin, Egberto

2004-07-01

360

Expression of Aquaporin 4 and Breakdown of the Blood-Brain Barrier after Hypoglycemia-Induced Brain Edema in Rats  

PubMed Central

Background Hypoglycemia-induced brain edema is a severe clinical event that often results in death. The mechanisms by which hypoglycemia induces brain edema are unclear. Methods In a hypoglycemic injury model established in adult rats, brain edema was verified by measuring brain water content and visualizing water accumulation using hematoxylin and eosin staining. Temporal expression of aquaporin 4 (AQP4) and the integrity of the blood-brain barrier (BBB) were evaluated. We assessed the distribution and expression of AQP4 following glucose deprivation in astrocyte cultures. Results Brain edema was induced immediately after severe hypoglycemia but continued to progress even after recovery from hypoglycemia. Upregulation of AQP4 expression and moderate breakdown of the BBB were observed 24 h after recovery. In vitro, significant redistribution of AQP4 to the plasma membrane was induced following 6 h glucose deprivation. Conclusion Hypoglycemia-induced brain edema is caused by cytotoxic and vasogenic factors. Changes in AQP4 location and expression may play a protective role in edema resolution. PMID:25264602

Deng, Jiangshan; Zhao, Fei; Yu, Xiaoyan; Zhao, Yuwu; Li, Dawei; Shi, Hong; Sun, Yongning

2014-01-01

361

Contributions of Edema Factor and Protective Antigen to the Induction of Protective Immunity by Bacillus anthracis Edema Toxin as an Intranasal Adjuvant  

PubMed Central

We have shown that intranasal coapplication of Bacillus anthracis protective Ag (PA) together with a B. anthracis edema factor (EF) mutant having reduced adenylate cyclase activity (i.e., EF-S414N) enhances anti-PAAb responses, but also acts as a mucosal adjuvant for coadministered unrelated Ags. To elucidate the role of edema toxin (EdTx) components in its adjuvanticity, we examined how a PA mutant lacking the ability to bind EF (PA-U7) or another mutant that allows the cellular uptake of EF, but fails to efficiently mediate its translocation into the cytosol (PA-dFF), would affect EdTx-induced adaptive immunity. Native EdTx promotes costimulatory molecule expression by macrophages and B lymphocytes, and a broad spectrum of cytokine responses by cervical lymph node cells in vitro. These effects were reduced or abrogated when cells were treated with EF plus PA-dFF, or PA-U7 instead of PA. We also intranasally immunized groups of mice with a recombinant fusion protein of Yersinia pestis F1 and LcrVAgs (F1-V) together with EdTx variants consisting of wild-type or mutants PA and EF. Analysis of serum and mucosal Ab responses against F1-V or EdTx components (i.e., PA and EF) revealed no adjuvant activity in mice that received PA-U7 instead of PA. In contrast, coimmunization with PA-dFF enhanced serum Ab responses. Finally, immunization with native PA and an EF mutant lacking adenylate cyclase activity (EF-K346R) failed to enhance Ab responses. In summary, a fully functional PA and a minimum of adenylate cyclase activity are needed for EdTx to act as a mucosal adjuvant. PMID:20952678

Duverger, Alexandra; Carre, Jeanne-Marie; Jee, Junbae; Leppla, Stephen H.; Cormet-Boyaka, Estelle; Tang, Wei-Jen; Tome, Daniel; Boyaka, Prosper N.

2013-01-01

362

Pulmonary edema  

MedlinePLUS

... failure: pathophysiology and diagnosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: ... failure: management and prognosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: ...

363

Comparison of diffusion-weighted with T2-weighted imaging for detection of edema in acute myocardial infarction  

PubMed Central

Background Recent studies, performed with the use of a commercially available diffusion weighted imaging (DWI) sequence, showed that they are sensitive to the increase of water content in the myocardium and may be used as an alternative to the standard T2-weighted sequences. The aim of this study was to compare two methods of myocardial edema imaging: DWI and T2-TIRM. Methods The study included 91 acute and post STEMI patients. We applied a qualitative and quantitative image analysis. The qualitative analysis consisted of evaluation of the quality of blood suppression, presence of artifacts and occurrence of high signal (edema) areas. On the basis of edema detection in AMI and control (post STEMI) group, the sensitivity and specificity of TIRM and DWI were determined. Two contrast to noise ratios (CNR) were calculated: CNR1 - the contrast between edema and healthy myocardium and CNR2 - the contrast between edema and intraventricular blood pool. The area of edema was measured for both TIRM and DWI sequences and compared with the infarct size in LGE images. Results Edema occurred more frequently in the DWI sequence. A major difference was observed in the inferior wall, where an edema-high signal was observed in 46% in T2-TIRM, whereas in the DWI sequence in 85%. An analysis of the image quality parameters showed that the use of DWI sequence allows complete blood signal suppression in the left ventricular cavity and reduces the occurrence of motion artifacts. However, it is connected with a higher incidence of magnetic susceptibility artifacts and image distortion. An analysis of the CNRs showed that CNR1 in T2-TIRM sequence depends on the infarct location and has the lowest value for the inferior wall. The area of edema measured on DWI images was significantly larger than in T2-TIRM. Conclusions DWI is a new technique for edema detection in patients with acute myocardial infarction which may be recommended for the diagnosis of acute injuries, especially in patients with slow-flow artifacts in TIRM images. PMID:24098944

2013-01-01

364

Risk of heart failure and edema associated with the use of pregabalin: a systematic review  

PubMed Central

Background Pregabalin is used in the treatment of postherpetic neuralgia, diabetic neuropathic pain, partial seizures, anxiety disorders and fibromyalgia. Recognized adverse effects associated with its use include cognitive impairment, somnolence and dizziness. Heart failure associated with pregabalin has been described, however the strength of this association has not been well characterized. To examine this further, we will conduct a systematic review of the risk of heart failure and edema associated with use of pregabalin. Methods/design We will include all studies (experimental, quasi-experimental, observational, case series/reports, drug regulatory reports) that examine the use of pregabalin compared to placebo, gabapentin or conventional care. Our primary outcome is heart failure and the secondary outcomes include edema and weight gain. We will search electronic databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials), and grey literature sources (trial registries, conference abstracts) to identify relevant studies. To ensure literature saturation, we will contact drug manufacturers, conduct forward citation searching, and scan the reference lists of key articles and included studies. We will not restrict inclusion by language or publication status. Two reviewers will screen citations (titles and abstracts) and full-text articles, conduct data abstraction, and appraise risk of bias. Random-effects meta-analysis will be conducted if the studies are deemed heterogeneous in terms of clinical, statistical and methodological factors but still suitable for meta-analysis. Conclusions The results of this review will assist physicians to better appreciate pregabalin’s risk for edema or congestive heart failure and will be pertinent to the thousands of patients worldwide who are administered this medication. Our protocol was registered in the PROSPERO database (CRD42012002948). PMID:23641821

2013-01-01

365

Hyperbaric oxygen reduces edema and necrosis of skeletal muscle in compartment syndromes associated with hemorrhagic hypotension  

SciTech Connect

This study examined the effect of exposures to hyperbaric oxygen on the development of the edema and necrosis of muscle that are associated with compartment syndromes that are complicated by hemorrhagic hypotension. A compartment syndrome (twenty millimeters of mercury for six hours) was induced by infusion of autologous plasma in the anterolateral compartment of the left hind limb of seven anesthetized dogs while the mean arterial blood pressure was maintained at sixty-five millimeters of mercury after 30 per cent loss of blood volume. These dogs were treated with hyperbaric oxygen (two atmospheres of pure oxygen) and were compared with six dogs that had an identical compartment syndrome and hypotensive condition but were not exposed to hyperbaric oxygen. Forty-eight hours later, edema was quantified by measuring the weights of the muscles (the pressurized muscle compared with the contralateral muscle), and necrosis of muscle was evaluated by measuring the uptake of technetium-99m stannous pyrophosphate. The ratio for edema was significantly (p = 0.01) greater in dogs that had not been exposed to hyperbaric oxygen (1.15 +/- 0.01) than in the dogs that had been treated with hyperbaric oxygen (1.01 +/- 0.03), and the ratio for necrosis of muscle was also significantly (p = 0.04) greater in dogs that had not had hyperbaric oxygen (1.96 +/- 0.41) than in those that had been treated with hyperbaric oxygen (1.05 +/- 0.11). Comparisons were also made with the muscles of four normal control dogs and separately with the muscles of six normotensive dogs that had an identical compartment syndrome and normal blood pressure and were not treated with hyperbaric oxygen.

Skyhar, M.J.; Hargens, A.R.; Strauss, M.B.; Gershuni, D.H.; Hart, G.B.; Akeson, W.H.

1986-10-01

366

Subtenon Vs Intravitreal Triamcinolone injection in Diabetic Macular Edema, A prospective study in Chinese population  

PubMed Central

Objective: Purpose of this study was to validate that Subtenon (SB) Triamcinolone (TA) injection is an alternative to Intravitreal (IV) Triamcinolone (TA) injection for the treatment of diabetic macular edema (DME). Methods: Forty eyes were selected having DME due to type 1 or type 2 diabetes. All the patients were treated with photocoagulation. IVTA was administered in one eye and SBTA in following eye of same patient. Improvement in visual acuity, macular edema and intraocular pressure was assessed before treatment and on 2nd, 4th, 8th and 12th week after treatment. Results: After administration of IVTA, MVA was reduced from baseline value (0.805 ± 0.069Log/MAR) to (0.577 ± 0.091 Log/MAR, p<.001) at the end of treatment. Similar results were observed after SBTA administration. MVA was reduced from (0.814 ± 0.082Log/MAR) to (0.49 ± 0.080 Log/MAR, p<.001) at 12th week. After IVTA injection Central macular thickness was significantly reduced to (246.8 ± 25 µm, p<0.001) from (390.5 ± 17 µm). There were no significant (p=0.51) difference in both eyes receiving different routes of same treatment. After SBTA injection CMT was significantly reduced to lower values (241.5 ± 27 µm, p<0.001) from (394.4 ± 21 µm). Intraocular pressure after IVTA administration was high (2.32 ± 0.72 mm/Hg, p=0.04) as compared to baseline (1.82 ± 0.94 mm/Hg). Similar pattern was also seen after SBTA administration but to significant extent. Elevation of IoP was observed in both eyes. Conclusion: Subtenon Triamcinolone injection is an alternative to Intravitreal Triamcinolone Injection for Diabetic Macular Edema. PMID:25097510

Luo, Dawei; Zhu, Bijun; Zheng, Zhi; Zhou, Haidong; Sun, Xiaodong; Xu, Xun

2014-01-01

367

Baicalin attenuates brain edema in a rat model of intracerebral hemorrhage.  

PubMed

Baicalin is a flavonoid compound purified from the roots of Scutellaria baicalensis, which possesses multiple biological activities. Previous studies have shown that baicalin is protective in ischemic cerebral diseases. The aim of the present study was to examine the effects of baicalin on brain injury in a rat model of intracerebral hemorrhage (ICH) and to explore the possible mechanisms. Intracerebral hemorrhage was induced in male Wistar rats by injection of 0.5 U collagenaseVII to the caudate nucleus. Sham operation rats were injected with equal volume of saline. After the induction of ICH, the rats were randomly divided into four groups and administered with different dose of baicalin (0, 25, 50, or 100 mg/kg in saline) through peritoneal injection. The brain tissues around the hemorrhage areas were collected on days 1, 3, and 5 after treatment. Brain edema was analyzed by desiccation method; the metalloproteinase-9 (MMP-9) protein and mRNA expression were determined by western blotting and real time RT-PCR, respectively. Nuclear factor-?B (NF-?B) protein expression was analyzed by western blotting. IL-1? and IL-6 levels were determined by enzyme-linked immunosorbent assay. Blood-brain barrier permeability was determined by Evans blue leakage method. The results showed that baicalin reduced brain edema following ICH in a dose-dependent manner, with concomitant inhibition of NF-?B activation and suppression of MMP-9 expression. In addition, baicalin also reduced IL-1? and IL-6 production, as well as blood-brain barrier permeability. The above results indicated that baicalin prevents against perihematomal edema development after intracerebral hemorrhage possibly through an anti-inflammatory mechanism. PMID:23974988

Zhou, Qing-Bo; Jin, Yun-Ling; Jia, Qing; Zhang, Yuan; Li, Lu-Yang; Liu, Ping; Liu, Yuan-Tao

2014-02-01

368

Bone marrow edema and osteitis in rheumatoid arthritis: the imaging perspective  

PubMed Central

Magnetic resonance imaging bone marrow edema is an imaging feature that has been described in many conditions, including osteomyelitis, overuse syndromes, avascular necrosis, trauma, and inflammatory arthritides. In rheumatoid arthritis (RA), bone edema has special significance as it has been shown to be a common and widespread lesion that is often apparent at the hands and wrists but has also been described elsewhere, including the feet. It may occur in early or late disease and has been shown in several large cohort studies to have major negative implications for prognosis. It is the strongest predictor of erosive progression yet to be identified and characteristically occurs in those patients with the most aggressive and potentially disabling disease. In patients with undifferentiated arthritis, bone edema also predicts progression to criteria-positive RA, both independently and to a greater extent when combined with anti-cyclic citrullinated peptide status or rheumatoid factor positivity. Its histological correlate in the late stages of RA has been shown to be osteitis, in which the bone marrow beneath the joint is invaded by an inflammatory and vascular lymphoplasmacytic infiltrate. This lies adjacent to trabecular bone, where increased numbers of osteoclasts have been observed within resorption lacunae, suggesting a mechanistic link between inflammation and erosive bone damage. This could lead to erosion both of the overlying cortex, leading to classic radiographic rheumatoid erosions, and of local trabecular bone, possibly contributing to periarticular osteopenia and cyst formation. In addition to synovitis, osteitis is now regarded as a major rheumatoid lesion that is responsive to therapeutic intervention. PMID:23043770

2012-01-01

369

Connectivity of Default-Mode Network Is Associated with Cerebral Edema in Hepatic Encephalopathy  

PubMed Central

Cerebral edema, a well-known feature of acute liver disease, can occur in cirrhotic patients regardless of hepatic encephalopathy (HE) and adversely affect prognosis. This study characterized and correlated functional HE abnormalities in the brain to cerebral edema using resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI). Forty-one cirrhotic patients (16 without HE, 14 minimal HE, 11 overt HE) and 32 healthy controls were assessed. The HE grade in cirrhotic patients was evaluated by the West Haven criteria and neuro-psychological examinations. Functional connectivity correlation coefficient (fc-CC) of the default mode network (DMN) was determined by rs-fMRI, while the corresponding mean diffusivity (MD) was obtained from DTI. Correlations among inter-cortical fc-CC, DTI indices, Cognitive Ability Screening Instrument scores, and laboratory tests were also analyzed. Results showed that gradual reductions of HE-related consciousness levels, from “without HE” or “minimal HE” to “overt HE”, correlated with decreased anterior-posterior fc-CC in DMN [F(4.415), p?=?0.000)]. The MD values from regions with anterior-posterior fc-CC differences in DMN revealed significant differences between the overt HE group and other groups. Increased MD in this network was inversely associated with decreased fc-CC in DMN and linearly correlated with poor cognitive performance. In conclusion, cerebral edema can be linked to altered cerebral temporal architecture that modifies both within- and between-network connectivity in HE. Reduced fc-CC in DMN is associated with behavior and consciousness deterioration. Through appropriate targets, rs-fMRI technology may provide relevant supplemental information for monitoring HE and serve as a new biomarker for clinical diagnosis. PMID:22623966

Lin, Wei-Che; Hsu, Tun-Wei; Chen, Chao-Long; Wu, Changwei W.; Lu, Cheng-Hsien; Chen, Hsiu-Ling; Li, Shau-Hsuan; Yeh, Pin-Yang

2012-01-01

370

Association Between a Quantitative CT Scan Measure of Brain Edema and Outcome After Cardiac Arrest  

PubMed Central

Background Cerebral edema is one physical change associated with brain injury and decreased survival after cardiac arrest. Edema appears on computed tomography (CT) scan of the brain as decreased x-ray attenuation by gray matter. This study tested whether the gray matter attenuation to white matter attenuation ratio (GWR) was associated with survival and functional recovery. Methods Subjects were patients hospitalized after cardiac arrest at a single institution between 1/1/2005 and 7/30/2010. Subjects were included if they had non-traumatic cardiac arrest and a non-contrast CT scan within 24 hours after cardiac arrest. Attenuation (Hounsfield Units) was measured in gray matter (caudate nucleus, putamen, thalamus, and cortex) and in white matter (internal capsule, corpus callosum and centrum semiovale). The GWR was calculated for basal ganglia and cerebrum. Outcomes included survival and functional status at hospital discharge. Results For 680 patients, 258 CT scans were available, but 18 were excluded because of hemorrhage (10), intravenous contrast (3) or technical artifact (5), leaving 240 CT scans for analysis. Lower GWR values were associated with lower initial Glasgow Coma Scale motor score. Overall survival was 36%, but decreased with decreasing GWR. The average of basal ganglia and cerebrum GWR provided the best discrimination. Only 2/58 subjects with average GWR<1.20 survived and both were treated with hypothermia. The association of GWR with functional outcome was completely explained by mortality when GWR<1.20. Conclusions Subjects with severe cerebral edema, defined by GWR<1.20, have very low survival with conventional care, including hypothermia. GWR estimates pre-treatment likelihood of survival after cardiac arrest. PMID:21592642

Metter, Robert B.; Rittenberger, Jon C.; Guyette, Francis X.; Callaway, Clifton W.

2011-01-01

371

Factors Affecting Reading Speed in Patients with Diabetic Macular Edema Treated with Laser Photocoagulation  

PubMed Central

Purpose To study the factors that may affect reading speed in patients with diabetic macular edema previously treated with laser photocoagulation. Methods Consecutive patients with type II diabetes treated with laser photocoagulation for diabetic macular edema (DME) at least twelve months previously, with best corrected visual acuity of better than 65 letters (approximately 20/40) measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts were included in this study. Patients previously treated with pan-retinal photocoagulation, vitrectomy, intravitreal steroid or anti-VEGF therapy were excluded. Any other ocular co-morbidities that may influence reading ability such as cataract, glaucoma or macular degeneration were also excluded. All patients were refracted by a certified examiner, the following measurements were collected: best corrected visual acuity (BCVA), contrast sensitivity with Pelli-Robson chart, reading speed with MNREAD chart, microperimetry with Nidek MP1, and central subfield thickness with Zeiss spectral domain optical coherent topography. Results The slow reading group had poorer contrast sensitivity (p?=?0.001), reduced retinal sensitivity (p?=?0.027) and less stable fixation (p?=?0.013). Most interestingly the reduced retinal sensitivity findings were driven by the microperimetry value on the right subfield (p?=?0.033), (nasal to the fovea in the right eye and temporal to the fovea in the left eye). Multiple linear regression analysis showed that contrast sensitivity is probably the most important factor that affects reading speed (p?=?0.001). Conclusion Reduced retinal sensitivity after laser treatment is associated with reduced reading speed in patients with diabetic macular edema. PMID:25265280

Pearce, Elizabeth; Sivaprasad, Sobha; Chong, Ngaihang V.

2014-01-01

372

Aqueous levels of erythropoietin in acute retinal vein occlusion with macular edema  

PubMed Central

AIM To investigate the aqueous erythropoietin (EPO) levels and associated factors in patients with acute retinal vein occlusion (RVO). METHODS The aqueous EPO level was measured in patients with macular edema (ME) secondary to acute branched retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). Aqueous fluid from cataract patients served as the control. We also evaluated whether aqueous level of EPO was associated with factors such as serum EPO level, non-perfusion area, central macular thickness (CMT), and arterio-venous (AV) transit time RESULTS Twenty-seven RVO patients (16 BRVO, 11 CRVO) and 9 control subjects were enrolled in the study. The aqueous EPO level (mU/mL) was higher in RVO (68.2±54.3) than that in the control subjects (12.9±5.9). More specifically, the aqueous EPO level was higher in CRVO (118.9±52.1) than that in BRVO (33.3±10.8). However, no differences were found in serum EPO levels among three groups. CMT in RVO patients had a positive correlation with the aqueous EPO level (r=0.66). Also, in terms of non-perfusion area, the aqueous EPO levels were more elevated in the ischemic subgroup than in the non-ischemic subgroup in both BRVO and CRVO. CONCLUSION Aqueous EPO levels are elevated in patients with macular edema secondary to recent onset RVO. Patients with CRVO have higher EPO levels than those with BRVO. The aqueous EPO level in RVO has a positive correlation with CMT and is associated with non-perfusion area. These results suggest that the aqueous EPO level could be associated with retinal ischemia and may be involved in the pathogenesis of macular edema secondary to RVO. PMID:24967199

Shin, Hyun Jin; Kim, Hyung Chan; Moon, Jun Woong

2014-01-01

373

Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report  

PubMed Central

Central retinal vein occlusion (CRVO) is frequent in patients with systemic lupus erythematosus (SLE), but the treatment of the macular edema with this disease is extremely difficult. We report a case of cystoid macular edema (CME) secondary to unilateral CRVO in a patient with SLE that responded to intravitreous injection of an anti-vascular endothelial growth factor (VEGF) agent. A 33-year-old Japanese woman was referred to our department with unilateral impairment of vision. Microperimetry (MP-1) showed a cessation of foveal sensitivity. Fluorescein angiography showed CME without ischaemia of the macular region or peripheral retina (nonischemic CRVO). A diagnosis of CME and unilateral nonischemic CRVO combined with SLE was made and intravitreous anti-VEGF therapy was given. A sample of aqueous humor was harvested at the start of intravitreous injection after obtaining informed consent. Then the levels of VEGF and monocyte chemotactic protein (MCP)-1 were measured in the aqueous humor by enzyme-linked immunosorbent assay, revealing that VEGF was 234 pg/mL and MCP-1 was 501 pg/mL. Two weeks later, left eye vision improved to 20/20. Optical coherence tomography (OCT) showed considerable amelioration of retinal swelling and CME. MP-1 showed a marked increase of foveal sensitivity. However, she had recurrence of edema 3 months later. After harvesting aqueous humor again, intravitreous injection of an anti-VEGF agent was repeated for CME. The aqueous VEGF and MCP-1 levels were 156 pg/mL and 360 pg/mL, respectively. These findings suggest that inflammation was improved by intravitreous injection of bevacizumab. Intravitreous injection of anti-VEGF agents may be effective for CME due to nonischemic CRVO in SLE patients if their inflammatory factor levels are low. PMID:23690676

Noma, Hidetaka; Shimizu, Hiroshi; Mimura, Tatsuya

2013-01-01

374

Dynamics of Rabbit Brain Edema in Focal Lesion and Perilesion Area after Traumatic Brain Injury: A MRI Study  

PubMed Central

Abstract To understand the dynamics of brain edema in different areas after traumatic brain injury (TBI) in rabbit, we used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) to monitor blood–brain barrier (BBB) permeability and cytotoxic brain edema after weight drop-induced TBI in rabbit. The dynamics of BBB permeability and brain edema were quantified using Ktrans and apparent diffusion coefficient (ADC) in the focal and perifocal lesion areas, as well as the area contralateral to the lesion. In the focal lesion area, Ktrans began to increase at 3?h post-TBI, peaked at 3 days, and decreased gradually while remaining higher than sham injury animals at 7 and 30 days. ADC was more variable, increased slightly at 3?h, decreased to its lowest value at 7 days, then increased to a peak at 30 days. In the perifocal lesion area, Ktrans began to increase at 1 day, peaked at 3–7 days, and returned to control level by 30 days. ADC showed a trend to increase at 1 day, followed by a continuous increase thereafter. In the contralateral area, no changes in Ktrans and ADC were observed at any time-point. These data demonstrate that different types of brain edema predominate in the focal and perifocal lesion areas. Specifically cytotoxic edema was predominant in the focal lesion area while vasogenic edema predominated in the perifocal area in acute phase. Furthermore, secondary opening of the BBB after TBI may appear if secondary injury is not controlled. BBB damage may be a driving force for cytotoxic brain edema and could be a new target for TBI intervention. PMID:21675826

Wei, Xiao-Er; Zhang, Yu-Zhen; Li, Yue-Hua; Li, Ming-Hua

2012-01-01

375

Spontaneous Resolution of Vitreomacular Traction in Two Patients with Diabetic Macular Edema  

PubMed Central

The nature of the vitreoretinal interface in conditions like diabetic macular edema (DME) remains incompletely understood. Furthermore, it is not clear what the role of pharmacological enzymatic vitreolysis will play in cases of vitreomacular traction (VMT) associated with macular disease like DME. We describe the spontaneous resolution of VMT in 2 patients with DME. As both surgical and pharmacologic interventions have been suggested to treat DME in the setting of VMT, we feel that a clarification of the nomenclature and reporting of these cases of natural history may be useful in more fully understanding the complex decision-making involved when determining whether to treat this subset of patients. PMID:24707275

Almeida, David R.P.; Chin, Eric K.

2014-01-01

376

Spontaneous resolution of vitreomacular traction in two patients with diabetic macular edema.  

PubMed

The nature of the vitreoretinal interface in conditions like diabetic macular edema (DME) remains incompletely understood. Furthermore, it is not clear what the role of pharmacological enzymatic vitreolysis will play in cases of vitreomacular traction (VMT) associated with macular disease like DME. We describe the spontaneous resolution of VMT in 2 patients with DME. As both surgical and pharmacologic interventions have been suggested to treat DME in the setting of VMT, we feel that a clarification of the nomenclature and reporting of these cases of natural history may be useful in more fully understanding the complex decision-making involved when determining whether to treat this subset of patients. PMID:24707275

Almeida, David R P; Chin, Eric K

2014-01-01

377

IL-2 induces pulmonary edema and vasoconstriction independent of circulating lymphocytes  

SciTech Connect

We investigated the effect of IL-2 in the isolated guinea pig lung perfused with phosphate-buffered Ringer's solution (containing 0.5 g/100 ml albumin and 5.5 mM dextrose) to determine the mechanism of IL-2-induced pulmonary edema. IL-2 (0 to 10,000 U/ml) was added to the perfusate following a 10 min baseline steady-state period. Pulmonary arterial pressure (Ppa), pulmonary capillary pressure (Ppc), and change in lung weight (as a measure of developing pulmonary edema) were recorded at 0, 10, 30, 40, and 60 min. The capillary filtration coefficient (Kf.c), an index of vascular permeability to water, was measured at 30 and 60 min. Infusion of IL-2 increased Ppc (from 3.9 +/- 0.1 cm H2O at baseline to 8.8 +/- 1.1 cm H2O at 60 min for IL-2 at 2000 U/ml, p less than 0.01; and from 3.8 +/- 0.1 cm H2O at baseline to 8.9 +/- 0.6 cm H2O at 60 min for IL-2 at 10,000 U/ml, p less than 0.01. The lung weight also increased (32% at IL-2 concentration of 2000 U/ml, and 26% at IL-2 concentration of 10,000 U/ml) The capillary filtration coefficient did not change with IL-2 infusion. The IL-2 response was prevented using the pulmonary vasodilator, papaverine. The infusion of IL-2 was associated with the generation of thromboxane A2(TxA2) in the effluent perfusate. Inhibition of TxA2 synthetase using Dazoxiben prevented the pulmonary vasoconstriction and edema response to IL-2. In addition, IL-2 had no effect on the transendothelial clearance of 125I-albumin. The results indicate that IL-2 causes pulmonary edema secondary to an increase in Ppc. The response is mediated by IL-2 stimulation of TxA2 generation from the lung.

Ferro, T.J.; Johnson, A.; Everitt, J.; Malik, A.B.

1989-03-15

378

Laryngeal edema associated with the ProSeal™ laryngeal mask airway in upper respiratory tract infection  

Microsoft Academic Search

\\u000a Abstract\\u000a Purpose  We report an unusual case of vocal cord edema associated with the use of a ProSeal™ laryngeal mask airway (PLMA) in an adult\\u000a patient with an undiagnosed upper respiratory tract infection (URTI).\\u000a \\u000a \\u000a \\u000a Clinical features  A 55-yr-old woman had fixation of a radial fracture under general anesthesia with muscle relaxation. She developed audible\\u000a wheezing 30 min after PLMA insertion. Bronchoscopic examination

Ki Jinn Chin; Victor W. T. Chee

2006-01-01

379

Is helmet CPAP first line pre-hospital treatment of presumed severe acute pulmonary edema?  

Microsoft Academic Search

Purpose  Non-invasive continuous positive airway pressure (CPAP) is effective in reducing intubation rate and mortality of patient\\u000a with acute cardiogenic pulmonary edema (ACPE). We report our experience on pre-hospital application of CPAP by helmet as an\\u000a adjunct to medical therapy or as a stand alone procedure in patient with presumed ACPE.\\u000a \\u000a \\u000a \\u000a Methods  In pre-hospital treatment of 62 patients with presumed ACPE, CPAP

Giuseppe Foti; Fabio Sangalli; Lorenzo Berra; Stefano Sironi; Marco Cazzaniga; Gian Piera Rossi; Giacomo Bellani; Antonio Pesenti

2009-01-01

380

Pediatric cerebral stroke: susceptibility-weighted imaging may predict post-ischemic malignant edema.  

PubMed

Susceptibility-weighted imaging (SWI) is an advanced MRI technique providing information on the blood oxygenation level. Deoxyhemoglobin is increased in hypoperfused tissue characterized by SWI-hypointensity, while high oxyhemoglobin concentration within hyperperfused tissue results in a SWI iso- or hyperintensity compared to healthy brain tissue. We describe a child with a stroke, where SWI in addition to excluding hemorrhage and delineating the thrombus proved invaluable in determining regions of hyperperfusion or luxury perfusion, which contributed further to the prognosis including an increased risk of developing post-ischemic malignant edema. PMID:24199819

Bosemani, Thangamadhan; Poretti, Andrea; Orman, Gunes; Meoded, Avner; Huisman, Thierry A G M

2013-10-01

381

Stress-induced cardiomyopathy after negative pressure pulmonary edema during emergence from anesthesia -A case report-  

PubMed Central

Stress-induced cardiomyopathy (SICM) presenting as an acute myocardial dysfunction is characterized by transient left ventricular wall motion abnormality, which has been known to be associated with excessive catecholamine production caused due to various types of stress. Sympathetic hyperactivity is common during the perioperative period, and reports of SICM occurring during this period have actually increased. We present a case of SICM following negative pressure pulmonary edema due to upper airway obstruction during emergence from anesthesia. Excessive catecholamine release in response to respiratory difficulty could have been the underlying inciting factor. PMID:22323959

Lee, Su Hyun; Chang, Chul Ho; Park, Jeong Soo

2012-01-01

382

Update of intravitreal steroids for the treatment of diabetic macular edema.  

PubMed

Diabetic macular edema is considered the most important factor related to visual impairment in patients with diabetic retinopathy. Together with the use of grid and focal laser photocoagulation, today the intravitreal administration of pharmacotherapies represents the standard of care for the treatment of this complication: anti-vascular endothelium growth factor agents and steroids are the drugs currently used for this aim. Differently from laser therapy, which prevents visual deterioration, the intravitreal approach allows the promotion of visual recovery. However, the intravitreal injections require to be repeated with high frequency, and this carries the risk of drug- and procedure-related adverse effects. PMID:25195600

Bandello, Francesco; Preziosa, Chiara; Querques, Giuseppe; Lattanzio, Rosangela

2014-01-01

383

Predictive factors for changes in macular edema in intravitreal bevacizumab therapy of retinal vein occlusion  

Microsoft Academic Search

Background  To evaluate prognostic factors of response to intravitreal bevacizumab therapy of macular edema (ME) due to central retinal\\u000a vein occlusion (CRVO) or branch retinal vein occlusion (BRVO).\\u000a \\u000a \\u000a \\u000a Methods  Patients with ME due to CRVO (32 patients) or BRVO (38 patients) received intravitreal bevacizumab (2.5 mg\\/0.1 ml) at baseline,\\u000a and every 6 to 8 weeks if OCT showed persistent or recurrent ME. Visual acuity (EDTRS),

Thomas Ach; Alexandra E. Hoeh; Karen B. Schaal; Alexander F. Scheuerle; Stefan Dithmar

2010-01-01

384

Hepatic multiple myelolipoma with severe coelomic edema in a red-bellied tamarin (Saguinus labiatus).  

PubMed

This report describes hepatic multiple myelolipoma with severe coelomic edema in a 14-year-old, male red-bellied tamarin (Saguinus labiatus). Multiple small and large nodules were formed in all lobes of the liver. Histopathologically, the nodules comprised mature and normal adipocytes and hematopoietic elements at various ratios that were composed of granulocytic, erythrocytic, and megakaryocytic series in various phases of maturation. All nodules were encapsulated and demarcated hepatocytes around masses. Myelolipoma in the liver is rare, and there are no reports of any cases to date. To our knowledge, this is the first report of hepatic multiple myelolipoma in a red-bellied tamarin. PMID:22526461

Yamaguchi, Ryo; Nakamura, Shin-ichi; Ito, Shu; Une, Yumi

2012-07-01

385

Pulmonary edema and pleural effusion in norepinephrine-stimulated rats--hemodynamic or inflammatory effect?  

PubMed

Stimulation with norepinephrine (NE) leads to pulmonary edema and pleural effusion in rats. These pulmonary fluid shifts may result from pulmonary congestion due to the hemodynamic effects of NE and/or inflammation with an increase in vascular permeability. The contribution of these two factors were investigated in the present study. Female Sprague-Dawley rats received continuous i.v. NE infusion (0.1 mg/kg/h) over time intervals between 90 min and 72 h. After heart catheterization, pleural fluid (PF) and lung tissue were obtained. In some of the animals, a bronchoalveolar lavage (BAL) was performed. Pulmonary edema and inflammation were shown histologically. We determined the expression of interleukin (IL)-6 as one of the most potent acute-phase protein mediators in serum, PF and BAL supernatant fluid (BALF) using ELISA as well as in the lung tissue using Western blotting. Total protein concentration in BALF and PF served as indicators of increased capillary permeability. Pulmonary edema and pleural effusion appeared coincidentally with an increase in total peripheral resistance (TPR) after 6 h of NE infusion. PF reached a maximum between 8 and 16 h (2.2 +/- 0.3 ml, controls < 0.5 ml) and disappeared within 48 h. Activation of IL-6 in the fluids was observed after 8 h of NE stimulation. In the lung tissue it started after 12 h and reached 330% of the control value after 48 h. Pulmonary inflammation was documented histologically. It was accompanied by increased protein concentration in BALF after 24 h of NE treatment. Hemodynamic effects of NE are the main causative factors in the initial phase of the pulmonary fluid shifts. Additionally, NE leads to an activation of cytokines such as IL-6 and to inflammation and to an increase in capillary permeability. However, inflammation and increased capillary permeability occurred later than pulmonary edema and pleural effusion. Hence, we conclude that they are secondary factors which may contribute to maintain the fluid shifts over a longer period of time. PMID:12962143

Rassler, Beate; Reissig, Christian; Briest, Wilfried; Tannapfel, Andrea; Zimmer, Heinz-Gerd

2003-08-01

386

Unilateral Thrombosis of a Deep Cerebral Vein Associated with Transient Unilateral Thalamic Edema  

PubMed Central

Symptoms of deep cerebral vein thrombosis (DCVT) are variable and nonspecific. Radiologic findings are essential for the diagnoses. In the majority of cases of deep internal cerebral venous thrombosis, the thalamus is affected bilaterally, and venous hypertension by thrombosis causes parenchymal edema or venous infarction and may sometimes cause venous hemorrhage. Intravenous injections of mannitol can be administered or decompressive craniectomy can be performed for reduction of intracranial pressure. The objectives of antithrombotic treatment in DCVT include recanalization of the sinus or vein, and prevention of propagation of the thrombus. Herein, the authors report DCVT which was successfully treated by low molecular weight heparin. PMID:23210053

Chung, Sang Won; Min, Byoung Kook; Kwon, Jeong Taik; Nam, Taek Kyun; Lee, Byoung Hoon

2012-01-01

387

Candesartan Attenuates Ischemic Brain Edema and Protects the Blood-Brain Barrier Integrity from Ischemia/Reperfusion Injury in Rats  

PubMed Central

Background: Angiotensin II (Ang II) has an important role on cerebral microcirculation; however, its direct roles in terms of ischemic brain edema need to be clarified. This study evaluated the role of central Ang II by using candesartan, as an AT1 receptor blocker, in the brain edema formation and blood-brain barrier (BBB) disruption caused by ischemia/reperfusion (I/R) injuries in rat. Methods: Rats were exposed to 60-min middle cerebral artery (MCA) occlusion. Vehicle and non-hypotensive doses of candesartan (0.1 mg/kg) were administered one hour before ischemia. Neurological dysfunction scoring was evaluated following 24 h of reperfusion. Animals were then decapitated under deep anesthesia for the assessments of cerebral infarct size, edema formation, and BBB permeability. Results: The outcomes of 24 h reperfusion after 60-min MCA occlusion were severe neurological disability, massive BBB disruption (Evans blue extravasation = 12.5 ± 1.94 µg/g tissue), 4.02% edema, and cerebral infarction (317 ± 21 mm3). Candesartan at a dose of 0.1 mg/kg, without changing arterial blood pressure, improved neurological dysfunction scoring together with significant reductions in BBB disruption (54.9%), edema (59.2%), and cerebral infarction (54.9%). Conclusions: Inactivation of central AT1 receptors, if not accompanied with arterial hypotension, protected cerebral micro-vasculatures from damaging effects of acute stroke. PMID:25326022

Panahpour, Hamdollah; Nekooeian, Ali Akbar; Dehghani, Gholam Abbas

2014-01-01

388

Alveolar epithelial damage. A critical difference between high pressure and oleic acid-induced low pressure pulmonary edema.  

PubMed Central

The present study was designed to compare high pressure pulmonary edema (HPPE) and oleic acid-induced low pressure pulmonary edema (OAPE) in dogs when similar amounts of extra vascular water were present in the lung. The high pressure edema was produced by intravenous fluid overload and by inflating an aortic balloon catheter (n = 6). The low pressure edema was produced by the injecting 0.08 mg/kg oleic acid suspended in 5 ml saline (n = 6). Comparison of the difference between initial control measurements and final measurements in the edematous states showed that the animals with OAPE had a greater fall in percent oxygen saturation and a greater increase in shunt fractions. The light microscopic studies showed that OAPE was associated with greater amounts of alveolar flooding than HPPE where the edema fluid was located to a greater extent in the peribronchial interstitial space. The electron microscopy studies showed that the alveolar flooding in OAPE was associated with epithelial disruption, and tracer studies carried out in rabbits showed that dextran (150,000 mol wt) could pass from blood to airspace and that dextran (40,000 mol wt) could pass from air-space to blood in OAPE. We conclude that epithelial disruption is responsible for the excessive alveolar flooding in OAPE and that this results in a greater impairment in gas exchange. Images PMID:2423558

Montaner, J S; Tsang, J; Evans, K G; Mullen, J B; Burns, A R; Walker, D C; Wiggs, B; Hogg, J C

1986-01-01

389

A Novel Zebrafish Model to Provide Mechanistic Insights into the Inflammatory Events in Carrageenan-Induced Abdominal Edema  

PubMed Central

A suitable small animal model may help in the screening and evaluation of new drugs, especially those from natural products, which can be administered at lower dosages, fulfilling an urgent worldwide need. In this study, we explore whether zebrafish could be a model organism for carrageenan-induced abdominal edema. The research results showed that intraperitoneal (i.p.) administration of 1.5% ?-carrageenan in a volume of 20 µL significantly increased abdominal edema in adult zebrafish. Levels of the proinflammatory proteins tumor necrosis factor-? (TNF-?) and inducible nitric oxide synthase (iNOS) were increased in carrageenan-injected adult zebrafish during the development of abdominal edema. An associated enhancement was also observed in the leukocyte marker, myeloperoxidase (MPO). To support these results, we further observed that i.p. methylprednisolone (MP; 1 µg), a positive control, significantly inhibited carrageenan-induced inflammation 24 h after carrageenan administration. Furthermore, i.p. pretreatment with either an anti-TNF-? antibody (1?5 dilution in a volume of 20 µL) or the iNOS-selective inhibitor aminoguanidine (AG; 1 µg) inhibited carrageenan-induced abdominal edema in adult zebrafish. This new animal model is uncomplicated, easy to develop, and involves a straightforward inducement of inflammatory edema for the evaluation of small volumes of drugs or test compounds. PMID:25141004

Huang, Shi-Ying; Feng, Chien-Wei; Hung, Han-Chun; Chakraborty, Chiranjib; Chen, Chun-Hong; Chen, Wu-Fu; Jean, Yen-Hsuan; Wang, Hui-Min David; Sung, Chun-Sung; Sun, Yu-Min; Wu, Chang-Yi; Liu, Wangta; Hsiao, Chung-Der; Wen, Zhi-Hong

2014-01-01

390

Temporal correlation of optical coherence tomography in-vivo images of rabbit airway for the diagnosis of edema  

NASA Astrophysics Data System (ADS)

Recently, full-range optical coherence tomography (OCT) systems have been developed to image the human airway. These novel systems utilize a fiber-based OCT probe which acquires three-dimensional (3-D) images with micrometer resolution. Following an airway injury, mucosal edema is the first step in the body's inflammatory response, which occasionally leads to airway stenosis, a life-threatening condition for critically ill newborns. Therefore, early detection of edema is vital for airway management and prevention of stenosis. In order to examine the potential of the full-range OCT to diagnose edema, we investigated temporal correlation of OCT images obtained from the subglottic airway of live rabbits. Temporally correlated OCT images were acquired at fixed locations in the rabbit subglottis of either artificially induced edema or normal tissues. Edematous tissue was experimentally modeled by injecting saline beneath the epithelial layer of the subglottic mucosa. The calculated cross temporal correlations between OCT images of normal airway regions show periodicity that correlates with the respiratory motion of the airway. However, the temporal correlation functions calculated from OCT images of the edematous regions show randomness without the periodic characteristic. These in-vivo experimental results of temporal correlations between OCT images show the potential of a computer-based or -aided diagnosis of edema in the human respiratory mucosa with a full-range OCT system.

Kang, DongYel; Wang, Alex; Tjoa, Tjoson; Volgger, Veronika; Hamamoto, Ashley; Su, Erica; Jing, Joseph; Chen, Zhongping; Wong, Brian J. F.

2014-03-01

391

Catecholamine-induced pulmonary edema and pleural effusion in rats--alpha- and beta-adrenergic effects.  

PubMed

We investigated the contribution of alpha- and beta-adrenergic pathways to catecholamine-induced pulmonary edema and the role of pleural effusion in preventing alveolar edema. Female Sprague-Dawley rats received continuous intravenous infusion of norepinephrine and of separate alpha- or beta-adrenergic stimulation over 6-24 h. We performed heart catheterization in vivo and excised post mortem lung tissue for histological analysis. Interleukin (IL)-6 and total protein concentrations were determined in serum, pleural fluid (PF) and bronchoalveolar lavage fluid. alpha-Adrenergic treatment increased right ventricular systolic pressure (RVSP) and total peripheral resistance (TPR) and caused severe alveolar edema associated with IL-6 activation in serum and diffuse pulmonary inflammation. PF amounts were moderate (0.9+/-0.2 ml). beta-Adrenergic stimulation also increased RVSP but decreased TPR. Interstitial but not alveolar edema and focal inflammation without IL-6 activation developed. Large PF amounts (6.2+/-1.5 ml) occurred which were considered to prevent alveolar edema. We conclude that both alpha- and beta-adrenergic stimulation contribute to pulmonary fluid shifts in rats, but alpha-adrenergic pathways cause more acute and more severe lung injury than beta-adrenergic mechanisms. PMID:12706063

Rassler, Beate; Reissig, Christian; Briest, Wilfried; Tannapfel, Andrea; Zimmer, Heinz Gerd

2003-04-15

392

Protective effect of ginkgolide B on high altitude cerebral edema of rats.  

PubMed

Ginkgolide B (GB) is one of the ginkgolides isolated from leaves of the Ginkgo biloba tree. The aim of this study was to investigate whether GB has a protective effect on high altitude cerebral edema (HACE) of rats. HACE was induced by hypobaric hypoxia exposure for 24 hours in an animal decompression chamber with the chamber pressure of 267 mmHg to simulate an altitude of 8000 m. Before the exposure, three doses (3, 6, and 12 mg·kg(-1)) of GB were given intraperitoneally (ip) daily for 3 days. Effects of GB on brain water content (BWC), activity of superoxide dismutase (SOD), concentration of glutathione (GSH) and malondialdehyde (MDA), expression of active caspase-3 and poly(ADP-ribose) polymerase (PARP) were measured. In GB pretreatment groups (6 and 12 mg·kg(-1), but not 3 mg·kg(-1)), BWC, the concentration of MDA, the expression of active caspase-3 and PARP were reduced significantly, while the activity of SOD and concentration of GSH were significantly increased. In conclusion, these results indicate that GB has a protective effect on cerebral edema caused by high altitude in rats. The protective effect of GB might be attributed to its antioxidant properties and suppression of the caspase-dependent apoptosis pathway. PMID:23537262

Botao, Yu; Ma, Jie; Xiao, Wenjing; Xiang, Qingyu; Fan, Kaihua; Hou, Jun; Wu, Juan; Jing, Weihua

2013-03-01

393

Feasibility of using diffuse reflectance spectroscopy for the quantification of brain edema  

NASA Astrophysics Data System (ADS)

Many diseased states of the brain can result in the displacement of brain tissues and restrict cerebral blood flow, disrupting function in a life-threatening manner. Clinical examples where displacements are observed include venous thromboses, hematomas, strokes, tumors, abscesses, and, particularly, brain edema. For the latter, the brain tissue swells, displacing the cerebral spinal fluid (CSF) layer that surrounds it, eventually pressing itself against the skull. Under such conditions, catheters are often inserted into the brain's ventricles or the subarachnoid space to monitor increased pressure. These are invasive procedures that incur increased risk of infection and consequently are used reluctantly by clinicians. Recent studies in the field of biomedical optics have suggested that the presence or absence of the CSF layer can lead to dramatic changes in NIR signals obtained from diffuse reflectance measurements around the head. In this study, we consider how this sensitivity of NIR signals to CSF might be exploited to non-invasively monitor the onset and resolution of brain edema.

Rodriguez, Juan G.; Sisson, Cynthia; Hendricks, Chad; Pattillo, Chris; McWaters, Megan; Hardjasudarma, Mardjohan; Quarles, Chad; Yaroslavsky, Anna N.; Yaroslavsky, Ilya V.; Battarbee, Harold

2001-05-01

394

Acute Methamphetamine Intoxication: Brain Hyperthermia, Blood-Brain Barrier and Brain Edema  

PubMed Central

Methamphetamine (METH) is a powerful and often abused stimulant with potent addictive and neurotoxic properties. While it is generally assumed that multiple chemical substances released in the brain following METH-induced metabolic activation (or oxidative stress) are primary factors underlying damage of neural cells, in this work we will present data suggesting a role of brain hyperthermia and associated leakage of the brain-blood barrier (BBB) in acute METH-induced toxicity. First, we show that METH induces a dose-dependent brain and body hyperthermia, which is strongly potentiated by associated physiological activation and in warm environments that prevent proper heat dissipation to the external environment. Second, we demonstrate that acute METH intoxication induces robust, widespread but structure-specific leakage of the BBB, acute glial activation, and increased water content (edema), which are related to drug-induced brain hyperthermia. Third, we document widespread morphological abnormalities of brain cells, including neurons, glia, epithelial and endothelial cells developing rapidly during acute METH intoxication. These structural abnormalities are tightly related to the extent of brain hyperthermia, leakage of the BBB, and brain edema. While it is unclear whether these rapidly developed morphological abnormalities are reversible, this study demonstrates that METH induces multiple functional and structural perturbations in the brain, determining its acute toxicity and possibly contributing to neurotoxicity. PMID:19897075

Kiyatkin, Eugene A.; Sharma, Hari S.

2011-01-01

395

Treatment of tyramine-induced brain edema with anion transport inhibitor L-644,711  

SciTech Connect

Tyramine induces coma in phenelzine-treated dogs. Development of coma in these animals is associated with brain edema, abnormal brain scans of Tc-99m-diethylene-triamine-penta-acetic acid (Tc-99m-DTPA), and elevated levels of CSF catecholamines. We found that the intravenous administration of 6-7 mg/kg of a single dose of L-644,711 given fifteen minutes after the oral administration of tyramine to phenelzine-pretreated animals followed by an infusion of normal saline containing 6-7 mg/kg of the drug given over a period of 2 hr caused reversal of brain injury. This was accompanied by full recovery within a period of 24 hr of all the animals tested. A follow-up study revealed that 24 hr after treatment with L-644,711 CSF levels of catecholamines and brain images of Tc-99m-DTPA were indistinguishable from normal controls. Animals that received no drug died from unresolved coma within 4 to 24 hr. Animals that had recovered due to therapy with L-644,711 were given 10-14 days rest followed by a repetition of the phenelzine and tyramine treatment but denied L-644,711 therapy. These animals also died of unresolved coma within 24 hr. This preliminary study suggest that the use of L-644,711 may constitute an important advance in treatment of brain edema of a wide range of neurological disorders.

Faraj, B.A.; Cragoe, E.J. Jr.; Sarper, R.; Camp, M.; Malveaux, E.

1988-01-01

396

Cellular basis of inflammation, edema and the activity of Daflon 500 mg.  

PubMed

Inflammation activates leukocytes causing the release of agents that disrupt the endothelial barrier to such an extent that retention of plasma protein is impaired. This phenomenon can be observed using microvascular methods in which ischemia-reperfusion-induced inflammation-like condition are analyzed in terms of the increased adherence of leukocytes to the venular endothelium. Pretreatment with Daflon 500 mg, a purified, micronized, flavonoid fraction consisting of 90% diosmin and 10% hesperidin, prior to the induction of 4 h of tourniquet ischemia significantly lowers the number of adherent leukocytes. This observation is linked to the protective effect of flavonoids in the treatment of edema, as decreased activation is also associated with a decreased platelet and complement system activation, leading to a lowered release of histamine and decreased leukocyte-dependent endothelial damage. It is proposed that attenuation of leukocyte adherence during ischemia-reperfusion is evidence of the protective endothelial effect of Daflon 500 mg and its ability to control edema in clinical situation. PMID:8748884

Friesenecker, B; Tsai, A G; Intaglietta, M

1995-01-01

397

Nlrp3 Prevents Early Renal Interstitial Edema and Vascular Permeability in Unilateral Ureteral Obstruction  

PubMed Central

Progressive renal disease is characterized by tubulo-interstitial injury with ongoing inflammation and fibrosis. The Nlrp3 inflammasome contributes to these pathophysiological processes through its canonical effects in cytokine maturation. Nlrp3 may additionally exert inflammasome-independent effects following tissue injury. Hence, in this study we investigated potential non-canonical effects of Nlrp3 following progressive renal injury by subjecting WT and Nlrp3-deficient (?/?) mice to unilateral ureter obstruction (UUO). Our results revealed a progressive increase of renal Nlrp3 mRNA in WT mice following UUO. The absence of Nlrp3 resulted in enhanced tubular injury and dilatation and an elevated expression of injury biomarker NGAL after UUO. Moreover, interstitial edema was significantly elevated in Nlrp3?/? mice. This could be explained by increased intratubular pressure and an enhanced tubular and vascular permeability. In accordance, renal vascular leakage was elevated in Nlrp3?/? mice that associated with reduced mRNA expression of intercellular junction components. The decreased epithelial barrier function in Nlrp3?/? mice was not associated with increased apoptosis and/or proliferation of renal epithelial cells. Nlrp3 deficiency did not affect renal fibrosis or inflammation. Together, our data reveal a novel non-canonical effect of Nlrp3 in preserving renal integrity and protection against early tubular injury and interstitial edema following progressive renal injury. PMID:24454932

Pulskens, Wilco P.; Butter, Loes M.; Teske, Gwendoline J.; Claessen, Nike; Dessing, Mark C.; Flavell, Richard A.; Sutterwala, Fayyaz S.; Florquin, Sandrine; Leemans, Jaklien C.

2014-01-01

398

MRI Evidence: Acute Mountain Sickness Is Not Associated with Cerebral Edema Formation during Simulated High Altitude  

PubMed Central

Acute mountain sickness (AMS) is a common condition among non-acclimatized individuals ascending to high altitude. However, the underlying mechanisms causing the symptoms of AMS are still unknown. It has been suggested that AMS is a mild form of high-altitude cerebral edema both sharing a common pathophysiological mechanism. We hypothesized that brain swelling and consequently AMS development is more pronounced when subjects exercise in hypoxia compared to resting conditions. Twenty males were studied before and after an eight hour passive (PHE) and active (plus exercise) hypoxic exposure (AHE) (FiO2?=?11.0%, PiO2?80 mmHg). Cerebral edema formation was investigated with a 1.5 Tesla magnetic resonance scanner and analyzed by voxel based morphometry (VBM), AMS was assessed using the Lake Louise Score. During PHE and AHE AMS was diagnosed in 50% and 70% of participants, respectively (p>0.05). While PHE slightly increased gray and white matter volume and the apparent diffusion coefficient, these changes were clearly more pronounced during AHE but were unrelated to AMS. In conclusion, our findings indicate that rest and especially exercise in normobaric hypoxia are associated with accumulation of water in the extracellular space, however independent of AMS development. Thus, it is suggested that AMS and HACE do not share a common pathophysiological mechanism. PMID:23226263

Mairer, Klemens; Gobel, Markus; Defrancesco, Michaela; Wille, Maria; Messner, Hubert; Loizides, Alexander; Schocke, Michael; Burtscher, Martin

2012-01-01

399

Critical appraisal of ranibizumab in the treatment of diabetic macular edema  

PubMed Central

Diabetic retinopathy is the leading cause of blindness among individuals of working age in industrialized nations, with most of the vision loss resulting from diabetic macular edema (DME). The formation of DME depends on the action of several growth factors and inflammatory mediators, but vascular endothelial growth factor (VEGF) appears to be critical for breaking down the blood-retinal barrier and promoting the accumulation of macular edema. Laser photocoagulation has been the standard-of-care for three decades, and although it stabilizes vision, significant gains in visual acuity after treatment are unusual. Several VEGF inhibitors (pegaptanib, aflibercept, and ranibizumab) have been initially developed and tested for the treatment of age-related macular degeneration and subsequently for DME. In Phase I, II, and III trials for DME, ranibizumab has been shown to be superior to macular laser photocoagulation and intraocular triamcinolone acetonide injections for improving visual acuity and drying the macula. As a result, ranibizumab is the only anti-VEGF drug that has been approved by the United States Food and Drug Administration for the treatment of DME. Most experts now consider intravitreal anti-VEGF therapy to be standard-of-care for DME involving the fovea. PMID:23836955

Stewart, Michael W

2013-01-01

400

Mechanistic studies of pericardial edema in early life stages (ELS) of medaka (Oryzias latipes)  

SciTech Connect

Pericardial edema (PE), a manifestation of developmental toxicity in fish ELS, may compromise stock recruitment and survival. However, the mechanism underlying this common lesion is unknown. Possible mechanisms for PE in ELS of medaka were studied by metabolic and morphologic methods. In the laboratory, medaka embryos readily develop PE after brief exposure to dioxin, trichloroethylene (TCE) soot extract, or thiobencarb. Histopathological analyses, regardless of agent, indicated widespread edema without cellular infiltrates in pericardial and peritoneal cavities and in subepithelial spaces of skin. Additionally, endothelia of sinus venosus and adjacent atrium were enlarged. Walls of dilated sinoatrial compartments showed subendothelial fluid accumulation. Ethoxyresorufin O-deethylase activity (indicator of CYPL A induction), considerably higher in embryos exposed to dioxin and TCE soot, was suppressed by thiobencarb. In vivo {sup 31}P nuclear magnetic resonance (NMR) spectroscopy of living embryos (pregastrula through hatching) previously treated with thiobencarb, showed a temporary depression of ATP and phosphocreatine levels, with an apparent transient alkalinization in intracellular (possibly yolk sac) pH. Results indicate that induction of CYP1A is not a requirement for development of PE, and that ionic imbalances and/or metabolic disorders following exposure may be causative factor(s).

Villalobos, S.A.; Fan, T.W.M.; Higashi, R.M.; Hinton, D.E. [Univ. of California, Davis, CA (United States)

1995-12-31

401

Nlrp3 prevents early renal interstitial edema and vascular permeability in unilateral ureteral obstruction.  

PubMed

Progressive renal disease is characterized by tubulo-interstitial injury with ongoing inflammation and fibrosis. The Nlrp3 inflammasome contributes to these pathophysiological processes through its canonical effects in cytokine maturation. Nlrp3 may additionally exert inflammasome-independent effects following tissue injury. Hence, in this study we investigated potential non-canonical effects of Nlrp3 following progressive renal injury by subjecting WT and Nlrp3-deficient (-/-) mice to unilateral ureter obstruction (UUO). Our results revealed a progressive increase of renal Nlrp3 mRNA in WT mice following UUO. The absence of Nlrp3 resulted in enhanced tubular injury and dilatation and an elevated expression of injury biomarker NGAL after UUO. Moreover, interstitial edema was significantly elevated in Nlrp3-/- mice. This could be explained by increased intratubular pressure and an enhanced tubular and vascular permeability. In accordance, renal vascular leakage was elevated in Nlrp3-/- mice that associated with reduced mRNA expression of intercellular junction components. The decreased epithelial barrier function in Nlrp3-/- mice was not associated with increased apoptosis and/or proliferation of renal epithelial cells. Nlrp3 deficiency did not affect renal fibrosis or inflammation. Together, our data reveal a novel non-canonical effect of Nlrp3 in preserving renal integrity and protection against early tubular injury and interstitial edema following progressive renal injury. PMID:24454932

Pulskens, Wilco P; Butter, Loes M; Teske, Gwendoline J; Claessen, Nike; Dessing, Mark C; Flavell, Richard A; Sutterwala, Fayyaz S; Florquin, Sandrine; Leemans, Jaklien C

2014-01-01

402

Rifaximin, but not growth factor 1, reduces brain edema in cirrhotic rats  

PubMed Central

AIM: To compare rifaximin and insulin-like growth factor (IGF)-1 treatment of hyperammonemia and brain edema in cirrhotic rats with portal occlusion. METHODS: Rats with CCl4-induced cirrhosis with ascites plus portal vein occlusion and controls were randomized into six groups: Cirrhosis; Cirrhosis + IGF-1; Cirrhosis + rifaximin; Controls; Controls + IGF-1; and Controls + rifaximin. An oral glutamine-challenge test was performed, and plasma and cerebral ammonia, glucose, bilirubin, transaminases, endotoxemia, brain water content and ileocecal cultures were measured and liver histology was assessed. RESULTS: Rifaximin treatment significantly reduced bacterial overgrowth and endotoxemia compared with cirrhosis groups, and improved some liver function parameters (bilirubin, alanine aminotransferase and aspartate aminotransferase). These effects were associated with a significant reduction in cerebral water content. Blood and cerebral ammonia levels, and area-under-the-curve values for oral glutamine-challenge tests were similar in rifaximin-treated cirrhotic rats and control group animals. By contrast, IGF-1 administration failed to improve most alterations observed in cirrhosis. CONCLUSION: By reducing gut bacterial overgrowth, only rifaximin was capable of normalizing plasma and brain ammonia and thereby abolishing low-grade brain edema, alterations associated with hepatic encephalopathy. PMID:22563196

Òdena, Gemma; Miquel, Mireia; Serafín, Anna; Galan, Amparo; Morillas, Rosa; Planas, Ramon; Bartolí, Ramon

2012-01-01

403

An unusual cause of bilateral massive peripheral edema in a young male with type 1 diabetes mellitus.  

PubMed

The present article demonstrates an unusual case of bilateral massive peripheral edema caused by neurogenic areflexic bladder in diabetes mellitus type 1. A 28-year-old patient with diabetes type 1 treated for a number of years was referred to the department of internal medicine because of massive edema of his lower limbs. Blood samples revealed increased concentrations of glucose (21.2 mmol/L) and glycated hemoglobin (8.5%). The computed tomography examination of abdomen and pelvis confirmed enlargement of the bladder, with smooth external contour and normal wall thickness. In addition, computed tomography demonstrated bilateral compression of the iliac veins caused by the enlarged bladder. This case highlights the importance of keeping a broad differential diagnosis in mind for patients with diabetes and massive peripheral edema. Neurogenic bladder should be considered in the differential diagnosis, especially for patients with poor glycemia control and long-standing diabetes complicated by diabetic neuropathy. PMID:25028196

Ga?, Pawe?; Stoinska, Anna; Balawejder, Kamila; Ja?wiec, Przemys?aw; Miszalski-Jamka, Tomasz; Szuba, Andrzej

2014-10-01

404

Lipophilic amino alcohols reduces carrageenan-induced paw edema and anti-OVA DTH in BALB/c mice.  

PubMed

The inflammation process is a coordinated response of the organism related to immune response with release of pro-inflammatory substances, as nitric oxide, TNF-? and IL-1?. In this work, a series of lipophilic amino alcohols were evaluated on RAW264.7 and primary macrophages for the modulation of nitric oxide and TNF-?. The most potent compounds were submitted to the treatment of BALB/c mice and evaluation of the carrageenan-induced paw edema and TNF-? and IL1-? release in the paws and anti-OVA delayed type hypersensitivity reaction. RAW264.7 and primary macrophages were incubated in the presence of amino alcohols at different concentrations (1, 0.5, 0.05 and 0.005 ?g mL(-1)). All tested compounds were not cytotoxic, however the inhibition of NO and TNF-? were observed only in RAW264.7 cultures. The NO production were reduced in 100% for all compounds, but only the compounds 4a and 4b expressively reduced the TNF-? release (67% and 92% respectively). On the carrageenan-induced paw edema, the compound 4b treatment showed reduction of edema, TNF-? and IL-1? as efficient as dexamethasone treatment. Meanwhile, the compound 4a treatment showed only slight reduction of paw edema. In the anti-OVA DTH reaction, both compounds showed reduction in the paw edema as effective as dexamethasone. In function of the observed results in vitro and in the acute and anti-OVA inflammation of mice paw edema compound 4b showed promissory anti-inflammatory properties. PMID:24035232

Reis, Elaine F C; Castro, Sandra B R; Alves, Caio Cesar S; Oliveira, Erick E; Corrêa, Tais A; Almeida, Mauro V; Ferreira, Ana Paula

2013-11-01

405

Safety and Efficacy of Mild Compression (18-25 mm Hg) Therapy in Patients with Diabetes and Lower Extremity Edema  

PubMed Central

Background Patients with diabetes often present with lower extremity (LE) edema; however, because of concomitant peripheral arterial disease, compression therapy is generally avoided by providers in fear of compromising arterial circulation. This pilot study sought to assess whether diabetic socks with mild compression (18–25 mm Hg) can reduce LE edema in patients with diabetes without negatively impacting vascularity. Methods Eighteen subjects (9 males, 9 females) aged 61 ± 11 years with diabetes, LE edema, and a mean ankle–brachial index (ABI) of 1.10 ± 0.21 successfully completed this uncontrolled study. At baseline, subjects were fitted and instructed to wear the socks during all waking hours. Follow-up visits occurred weekly for four consecutive weeks. Edema was quantified through midfoot, ankle, and calf circumferences and cutaneous fluid measurements. Vascular status was tracked via ABI. Results Repeated measures analysis of variance and least significant difference post hoc analyses were used for data analyses. Calf circumferences showed a statistically significant (p < .05) decrease of 1.3 ± 0.28 cm after just one week and remained significantly smaller than baseline throughout the study. Foot circumferences were significantly reduced at week 2 (?0.98 ± 0.35 cm) and remained significantly below baseline for the remainder of the study. The ankle also demonstrated a trend of circumference reduction but was not statistically significant. Cutaneous edema significantly reduced by week 3 (?3.1 ± 1.3 U) and remained so at week 4. Ankle–brachial index significantly increased (0.14 ± 0.049) at week 2 but was not significantly higher at weeks 3 or 4. No adverse events occurred during the study. Conclusions Mild compression therapy (18–25 mm Hg) decreased swelling in diabetes patients with LE edema without compromising vascularity. PMID:22768895

Wu, Stephanie C; Crews, Ryan T; Najafi, Bijan; Slone-Rivera, Nancy; Minder, Jessica L; Andersen, Charles A

2012-01-01

406

Photobiostimulation reduces edema formation induced in mice by Lys-49 phospholipases A2 isolated from Bothrops moojeni venom.  

PubMed

The prominent local myotoxic effects induced by Bothrops snake venom are due, in part, to myotoxins. This effect is not neutralized by antivenom, which is the main therapy for victims of snakebite. Two basic myotoxins named MjTX-I and MjTX-II were isolated from Bothrops moojeni venom. Both myotoxins have a Lys-49 phospholipase A2 structure devoid of enzymatic activity, but are highly myonecrotic and edema-inducing. In this study, we analyzed the effect of a low-level laser (LLL) at 685 nm, an energy density of 2.2 J cm(-2), and the irradiation time of 15 s, and a light emitting diode (LED) at 635 or 945 nm at energy densities of 4 and 3.8 J cm(-2), and irradiation times of 41 and 38 s, respectively, applied 30 min and 3 h after edema formation in mice caused by MjTX-I or MjTX-II. MjTX-I or MjTX-II caused a significant edema formation in envenomed paws. LLL and LED irradiation significantly reduced the edema formation by both myotoxins from 1 up to 6 hours after the injection. Both LLL and LEDs were similar in reducing the edema formation induced by myotoxins. The combined photobiostimulation with antivenom had the same effect in reducing edema as treatment with the LLL or LEDs alone. In conclusion, the results of this study indicate that photobiostimulation could be used in association with antivenom therapy for treatment of local effects of Bothrops species venom. PMID:25232894

Nadur-Andrade, Nikele; Dale, Camila Squarzone; Santos, Adriano Silvio Dos; Soares, Andreimar M; de Lima, Carlos J; Zamuner, Stella Regina

2014-10-15

407

Transient Osteoporosis of the Hip/Bone Marrow Edema Syndrome with Soft Tissue Involvement: A Case Report  

PubMed Central

Transient osteoporosis of the hip (TOH) is a rare condition mainly affecting pregnant women in their third trimester and middle aged men. We report a case of TOH/Bone marrow edema syndrome in pregnancy with involvement of the surrounding soft tissues on magnetic resonance image, which has not been previously reported. The presence of such edema in the soft tissues may help to differentiate this condition from early avascular necrosis of the hip, and may also provide an insight into the pathogenesis of the condition. The reported patient was treated conservatively and fully recovered. PMID:22125731

Abdulhak, Aref A. Bin; Ba-Mougadam, Fawziah A.; Al-Nakshabandi, Nizar A.; Al-Tannir, Mohamad A.

2011-01-01

408

Dual-energy computed tomographic virtual noncalcium algorithm for detection of bone marrow edema in acute fractures: early experiences.  

PubMed

Computed tomography (CT) is often used to assess the presence of occult fractures when plain radiographs are equivocal in the acute traumatic setting. While providing increased spatial resolution, conventional computed tomography is limited in the assessment of bone marrow edema, a finding that is readily detectable on magnetic resonance imaging (MRI).Dual-energy CT has recently been shown to demonstrate patterns of bone marrow edema similar to corresponding MRI studies. Dual-energy CT may therefore provide a convenient modality for further characterizing acute bony injury when MRI is not readily available. We report our initial experiences of 4 cases with imaging and clinical correlation. PMID:24834889

Reagan, Adrian C; Mallinson, Paul I; O'Connell, Timothy; McLaughlin, Patrick D; Krauss, Bernhard; Munk, Peter L; Nicolaou, Savvas; Ouellette, Hugue A

2014-01-01

409

Prospective Randomized Controlled Trial to Analyze the Effects of Intermittent Pneumatic Compression on Edema Following Autologous Femoropopliteal Bypass Surgery  

Microsoft Academic Search

Background  Patients who undergo autologous femoropopliteal bypass surgery develop postoperative edema in the revascularized leg. The\\u000a effects of intermittent pneumatic compression (IPC) to treat and to prevent postreconstructive edema were examined in this\\u000a study.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  In a prospective randomized trial, patients were assigned to one of two groups. All patients suffered from peripheral arterial\\u000a disease, and all were subjected to autologous femoropopliteal

Alexander te Slaa; Dennis E. J. G. J. Dolmans; Gwan H. Ho; Paul G. H. Mulder; Jan C. H. van der Waal; Hans G. W. de Groot; Lijckle van der Laan

2011-01-01

410

VA/Q distribution during heavy exercise and recovery in humans: implications for pulmonary edema  

NASA Technical Reports Server (NTRS)

Ventilation-perfusion (VA/Q) inequality has been shown to increase with exercise. Potential mechanisms for this increase include nonuniform pulmonary vasoconstriction, ventilatory time constant inequality, reduced large airway gas mixing, and development of interstitial pulmonary edema. We hypothesized that persistence of VA/Q mismatch after ventilation and cardiac output subside during recovery would be consistent with edema; however, rapid resolution would suggest mechanisms related to changes in ventilation and blood flow per se. Thirteen healthy males performed near-maximal cycle ergometry at an inspiratory PO2 of 91 Torr (because hypoxia accentuates VA/Q mismatch on exercise). Cardiorespiratory variables and inert gas elimination patterns were measured at rest, during exercise, and between 2 and 30 min of recovery. Two profiles of VA/Q distribution behavior emerged during heavy exercise: in group 1 an increase in VA/Q mismatch (log SDQ of 0.35 +/- 0.02 at rest and 0.44 +/- 0.02 at exercise; P less than 0.05, n = 7) and in group 2 no change in VA/Q mismatch (n = 6). There were no differences in anthropometric data, work rate, O2 uptake, or ventilation during heavy exercise between groups. Group 1 demonstrated significantly greater VA/Q inequality, lower vital capacity, and higher forced expiratory flow at 25-75% of forced vital capacity for the first 20 min during recovery than group 2. Cardiac index was higher in group 1 both during heavy exercise and 4 and 6 min postexercise. However, both ventilation and cardiac output returned toward baseline values more rapidly than did VA/Q relationships. Arterial pH was lower in group 1 during exercise and recovery. We conclude that greater VA/Q inequality in group 1 and its persistence during recovery are consistent with the hypothesis that edema occurs and contributes to the increase in VA/Q inequality during exercise. This is supported by observation of greater blood flows and acidosis and, presumably therefore, higher pulmonary vascular pressures in such subjects.

Schaffartzik, W.; Poole, D. C.; Derion, T.; Tsukimoto, K.; Hogan, M. C.; Arcos, J. P.; Bebout, D. E.; Wagner, P. D.

1992-01-01

411

Minimally Invasive Surgery plus rt-PA for Intracerebral Hemorrhage Evacuation (MISTIE) Decreases Perihematomal Edema  

PubMed Central

Background and Purpose Perihematomal edema (PHE) can worsen outcomes following ICH. Reports suggest that blood degradation products lead to PHE. We hypothesized that hematoma evacuation will reduce PHE volume and that treatment with rt-PA will not exacerbate it. Methods MISTIE II tested safety and efficacy of hematoma evacuation after ICH. We conducted a semi-automated, computerized volumetric analysis on CT to assess impact of hematoma removal on PHE and 2) effects of rt-PA on PHE. Volumetric analyses were performed on Baseline Stability (BLS) and End of Treatment (EOT) scans. Results Seventy-nine surgical and 39 medical patients from MISTIE II were analyzed. Mean hematoma volume at EOT was 19.6±14.5 cc for the surgical cohort and 40.7±13.9 cc for the medical cohort (p<0.001). Edema volume at EOT was lower for the surgical cohort: 27.7±13.3 cc than medical cohort: 41.7±14.6 cc (p<0.001). Graded effect of clot removal on PHE was observed when patients with >65%, 20-65%, and <20% ICH removed were analyzed (p<0.001). Positive correlation between PHE reduction and percent of ICH removed was identified (?=0.658; p<0.001). In the surgical cohort, 69 patients underwent surgical aspiration and rt-PA (S+rt-PA) while 10 underwent surgical aspiration only (SO). Both cohorts achieved similar clot reduction: S+rt-PA, 18.9±14.5 cc; and SO, 24.5±14.0 cc (p=0.26). Edema at EOT in S+rt-PA was 28.1±13.8 cc and 24.4±8.6 cc in SO (p=0.41). Conclusions Hematoma evacuation is associated with significant reduction in PHE. Furthermore, PHE does not appear to be exacerbated by rt-PA, making such neurotoxic effects unlikely when the drug is delivered to intracranial clot. Clinical Trial Registration Information URL: http://clinicaltrials.gov/ct2/show/NCT00224770?term=MISTIE&rank=1 Clinicaltrials.gov ID: NCT00224770 PMID:23391763

Mould, W. Andrew; Carhuapoma, J. Ricardo; Muschelli, John; Lane, Karen; Morgan, Timothy C; McBee, Nichol A; Bistran-Hall, Amanda J; Ullman, Natalie L; Vespa, Paul; Martin, Neil A; Awad, Issam; Zuccarello, Mario; Hanley, Daniel F.

2014-01-01

412

The Effect of Dexmedetomidine on Brain Edema and Neurological Outcomes in Surgical Brain Injury in Rats  

PubMed Central

Background Surgical brain injury (SBI) is damage to functional brain tissue resulting from neurosurgical manipulations such as sharp dissection, electrocautery, retraction, and direct applied pressure. Brain edema is the major contributor to morbidity with inflammation, necrosis, oxidative stress and apoptosis likely playing smaller roles. Effective therapies for SBI may improve neurological outcomes and postoperative morbidities associated with brain surgery. Previous studies show an adrenergic correlation to blood-brain barrier control. The alpha-2 receptor agonist dexmedetomidine (DEX) has been shown to improve neurological outcomes in stroke models. We hypothesized that DEX may reduce brain edema and improve neurological outcomes in a rat model of SBI. Methods Male Sprague-Dawley rats (n=63) weighing 280–350g were randomly assigned to one of four intraperitoneal (IP) treatment groups: sham IP, vehicle IP, DEX 10 mg/kg, and DEX 30 mg/kg. Treatments were given 30 minutes before SBI. These treatment groups were repeated to observe the physiologic impact of DEX on mean arterial blood pressure (MAP), heart rate (HR), and blood glucose on SBI naïve animals. Rats were also assigned to four postinjury IV treatment groups: sham IV, vehicle IV, DEX 10/5, and DEX 30/15 (DEX group doses were 10 and 30 mg/kg/hr, with 5 and 15 mg/kg initial loading doses respectively). Initial loading doses began 20 minutes after SBI, followed by 2 hours of infusion. SBI animals were subjected to neurological testing 24 hours after brain injury by a blinded observer, promptly killed, and brain water content measured via the dry/wet weight method. Results All treatment groups showed a significant difference in ipsilateral frontal brain water content and neurological scores when compared with sham animals. However, there was no difference between DEX-treated and vehicle animals. Physiologic monitoring showed treatment with low or high doses of DEX significantly decreased MAP and HR, and briefly increased blood glucose compared with naïve or vehicle-treated animals. Conclusions DEX administration did not reduce brain edema or improve neurological function after SBI in this study. The statistical difference in brain water content and neurological scores when comparing sham treatment to vehicle and DEX treatments shows consistent reproduction of this model. Significant changes in MAP, HR, and blood glucose after DEX as compared to vehicle and sham treatments suggest appropriate delivery of drug. PMID:22584551

Benggon, Michael; Chen, Han; Applegate, Richard; Martin, Robert; Zhang, John H.

2012-01-01

413

Comparison of Modified-ETDRS and Mild Macular Grid Laser Photocoagulation Strategies for Diabetic Macular Edema  

PubMed Central

Purpose To compare two laser photocoagulation techniques for treatment of diabetic macular edema (DME): modified-ETDRS direct/grid photocoagulation (mETDRS) and a, potentially milder, but potentially more extensive, mild macular grid (MMG) laser technique in which small mild burns are placed throughout the macula, whether or not edema is present, and microaneurysms are not treated directly. Methods 263 subjects (mean age 59 years) with previously untreated DME were randomly assigned to receive laser photocoagulation by mETDRS (N=162 eyes) or MMG (N=161 eyes) technique. Visual acuity, fundus photographs and OCT measurements were obtained at baseline and after 3.5, 8, and 12 months. Treatment was repeated if DME persisted. Main Outcome Measure Change in OCT measures at 12-months follow up. Results From baseline to 12 months, among eyes with baseline central subfield thickness ? 250 microns, central subfield thickening decreased by an average of 88 microns in the mETDRS group and decreased by 49 microns in the MMG group (adjusted mean difference: 33 microns, 95% confidence interval 5 to 61 microns, P=0.02). Weighted inner zone thickening by OCT decreased by 42 and 28 microns, respectively (adjusted mean difference: 14 microns, 95% confidence interval 1 to 27 microns, P=0.04), maximum retinal thickening (maximum of the central and four inner subfields) decreased by 66 and 39 microns, respectively (adjusted mean difference: 27 microns, 95% confidence interval 6 to 47 microns, P=0.01), and retinal volume decreased by 0.8 and 0.4 mm3, respectively (adjusted mean difference: 0.3 mm3, 95% confidence interval 0.02 to 0.53 mm3, P=0.03). At 12 months, the mean change in visual acuity was 0 letters in the mETDRS group and 2 letters worse in the MMG group (adjusted mean difference: 2 letters, 95% confidence interval ?0.5 to 5 letters, P=0.10). Conclusions At 12 months after treatment, the MMG technique is less effective at reducing OCT measured retinal thickening than the more extensively evaluated current mETDRS laser photocoagulation approach. However, the visual acuity outcome with both approaches is not substantially different. Given these findings a larger long-term trial of the MMG technique is not justified. Application to Clinical Practice Modified ETDRS focal photocoagulation should continue as a standard approach for treating diabetic macular edema. PMID:17420366

2008-01-01

414

Investigando cúmulos estelares masivos con el VVV  

NASA Astrophysics Data System (ADS)

Preliminary results are presented for the study of infrared data of three mas- sive stellar clusters. Have been combined photometric observations (JHK; VVV project = Vista Variables in the Vía Láctea) and spectroscopic (follow- up) observations of the brightest stars in these clusters. In this way we have been able to refine the values of distance, reddening, age and masses of the involved objects. FULL TEXT IN SPANISH

Chené, A.-N.; Clarke, J. R. A.; Borissova, J.; Moni Bidin, C.; Mauro, F.; Bonatto, C.; Kurtev, R.; Baume, G.; Feinstein, C.; Minniti, D.; Catelan, M.; Lucas, P. W.; Geisler, D.

415

Nicardipine-Induced Acute Pulmonary Edema: A Rare but Severe Complication of Tocolysis  

PubMed Central

We report four cases of acute pulmonary edema that occurred during treatment by intravenous tocolysis using nicardipine in pregnancy patients with no previous heart problems. Clinical severity justified hospitalization in intensive care unit (ICU) each time. Acute dyspnea has begun at an average of 63 hours after initiation of treatment. For all patients, the first diagnosis suspected was pulmonary embolism. The patients' condition improved rapidly with appropriate diuretic treatment and by modifying the tocolysis. The use of intravenous nicardipine is widely used for tocolysis in France even if its prescription does not have a marketing authorization. The pathophysiological mechanisms of this complication remain unclear. The main reported risk factors are spontaneous preterm labor, multiple pregnancy, concomitant obstetrical disease, association with beta-agonists, and fetal lung maturation corticotherapy. A better knowledge of this rare but serious adverse event should improve the management of patients. Nifedipine or atosiban, the efficiency of which tocolysis was also studied, could be an alternative. PMID:25215245

Serena, Claire; Begot, Emmanuelle; Cros, Jérôme; Hodler, Charles; Fedou, Anne Laure; Nathan-Denizot, Nathalie; Clavel, Marc

2014-01-01

416

Variable manifestations of familial hemiplegic migraine associated with reversible cerebral edema in children.  

PubMed

Three children with familial hemiplegic migraine presented with right-sided weakness, speech difficulty, altered mental status, and gait abnormalities. These persistent aura signs were accompanied by left-sided slowing and cerebral dysfunction, documented by electroencephalograms. Cranial magnetic resonance imaging revealed cortical edema restricted to the left cerebral hemisphere. Follow-up electroencephalogram and imaging studies produced normal results 1-4 months afterward. However, cognitive changes persisted. Genetic testing demonstrated variable results: one child manifested a CACNA1A mutation compatible with familial hemiplegic migraine type 1, whereas another demonstrated an ATP1A2 sequence alteration. No known mutations were evident in the third child, with minor head trauma thought to precipitate the familial hemiplegic migraine. These findings demonstrate the variable clinical and genetic heterogeneity of childhood familial hemiplegic migraine. PMID:22883286

Asghar, Sheila J; Milesi-Hallé, Alessandra; Kaushik, Chavvi; Glasier, Charles; Sharp, Gregory B

2012-09-01

417

Cornea pseudoguttata: a clinical and histopathologic description of endothelial cell edema.  

PubMed

Cornea guttata is a well-recognized corneal condition that is characterized by localized thickenings of Descemet's membrane. When these lesions disrupt, the regular endothelial mosaic, dark spots are seen in specular reflection. This same clinical appearance can be present during short-term episodes of iritis and corneal inflammation. Since it disappears with resolution of the inflammation, true cornea guttata (thickening of Descemet's membrane) obviously does not occur. Three cases of this transient clinical entity occurred. Production of iritis and corneal inflammation in rabbits with the use of bovine serum albumin and cautery resulted in the same transient appearance of dark spots, which interrupted the normal endothelial mosaic seen in specular reflection. Scanning and transmission electron microscopy of the cornea "pseudoguttata" disclosed transient endothelial cel edema. PMID:7259610

Krachmer, J H; Schnitzer, J I; Fratkin, J

1981-08-01

418

[Maternal complications from tocolytic treatment with beta-mimetics. Three cases of pulmonary edema].  

PubMed

We report three cases of pulmonary edema associated with prolonged intravenous tocolytic therapy with beta 2-adrenergic agonists among patients with multiple pregnancies. Although beta 2-adrenergic agonists may have direct myocardial side-effects, the underlying pathophysiologic mechanisms are mainly noncardiogenic. The most important one appears to be the fluid overload, related to amounts of fluids given intravenously and to direct result of beta-sympathomimetic therapy on renal excretion of sodium and water. Neonatal benefit of prolonged tocolytic therapy remains hypothetical. If this strategy is used, the prevention of cardiovascular adverse effects requires an intensive maternal supervision, especially in case of multiple pregnancy, the use of beta 2-adrenergic agonists in concentrated solution in order to reduce the amounts of fluids given intravenously, and the association with progesterone therapy which can reduce the infusion rate and the duration of tocolytic therapy. PMID:8926357

Hourdequin, P; Bednarczyk, L; Gabriel, R; Harika, G; Quereux, C; Wahl, P

1996-01-01

419

Association of electroretinogram and morphological findings in central retinal vein occlusion with macular edema  

PubMed Central

The objective of this study was to evaluate the relations among electroretinogram (ERG) parameters (cone a-wave, cone b-wave, and 30 Hz flicker), retinal thickness, and retinal volume in 16 patients with central retinal vein occlusion and macular edema. The amplitude and implicit time of the ERG parameters were extracted from the ERG traces. Retinal thickness and volume were measured by optical coherence tomography in nine macular subfields. Then the correlations among ERG parameters and morphological parameters were analyzed. The cone b-wave and 30 Hz flicker implicit time were correlated with retinal thickness and volume in seven out of nine subfields, excluding the temporal subfields. In addition, the amplitude of the cone b-wave was correlated with retinal thickness and volume in the nasal inner and nasal outer subfields. These findings suggest that retinal thickness and volume may be associated with outer and inner retinal function in central retinal vein occlusion patients. PMID:24531560

Noma, Hidetaka; Mimura, Tatsuya; Kuse, Manami; Shimada, Katsunori

2014-01-01

420

Neurogenic pulmonary edema caused by spontaneous cerebellar hemorrhage: A fatal case report  

PubMed Central

Background: Neurogenic pulmonary edema (NPE) is a clinical syndrome characterized by an acute increase of pulmonary interstitial and alveolar fluid. It could result from a significant central nervous system (CNS) insult such as intracranial hemorrhage. However, NPE as a major presenting manifestation of cerebellar hemorrhage was seldom reported. Case Description: We introduce a rare case of a 34-year-old woman suffering from a fulminant NPE in parallel with a spontaneous cerebellar hemorrhage. Although appropriate supportive measures were taken in the neuroscience care unit, the patient failed to survive hypoxemia within 28 h after hospital admission. Conclusion: Pathological lesions of the cerebellum may initiate a cascade of reactions including massive sympathetic discharge and catecholamine storm, leading to a dysfunction of both cardiovascular and respiratory systems. By far, no effective therapeutic strategies have been utilized to treat such a situation. Our present report would shed light on the underlying mechanism of NPE. PMID:25101198

Dai, Qiaoding; Su, Lida

2014-01-01

421

Lymphangiopathy in neurofibromatosis 1 manifesting with chylothorax, pericardial effusion, and leg edema  

PubMed Central

Background This case report documents the affliction of the lymph vessels as a phenotypic feature of neurofibromatosis-1 (NF-1). Methodology Routine transthoracic echocardiography, computed tomography scan of the thorax, magnetic resonance angiography of the renal arteries, and conventional digital subtraction angiography were applied. Comprehensive NF-1 mutation analysis was carried out by fluorescence in situ hybridization analysis, long-range reverse transcriptase polymerase chain reaction, and multiple-ligation probe assay. All other investigations were performed using routine, well-established techniques. Results The subject is a 34-year-old, half-Chinese male; NF-1 was suspected at age 15 years for the first time. His medical history included preterm birth, mild facial dysmorphism, “café au lait” spots, subcutaneous and paravertebral fibromas, multifocal tachycardia, atrial fibrillation, and heart failure in early infancy. Noncalcified bone fibromas in the femur and tibia were detected at age 8 years. Surgical right leg lengthening was carried out at age 11 years. Bilateral renal artery stenosis, stenosis and aneurysm of the superior mesenteric artery, and an infrarenal aortic stenosis were detected at age 15 years. Leg edema and ectasia of the basilar artery were diagnosed at age 18 years. After an episode with an erysipela at age 34 years, he developed pericardial and pleural effusion during a 4-month period. Stenosis of the left subclavian vein at the level of thoracic duct insertion was detected. After repeated pleural punctures, pleural effusion was interpreted as chylothorax. Reduction of lymph fluid production by diet and injection of talcum into the pleural cavity had a long-term beneficial effect on the chylothorax. Leg edema and chylothorax were attributed to affliction of the lymph vessels by the NF-1. Discussion Lymphangiopathy resulting in impaired lymph fluid flow and sequestration of lymph fluid into the pleural sinus and the legs may be a rare phenotypic feature of NF-1. PMID:24043952

Finsterer, Josef; Stollberger, Claudia; Stubenberger, Elisabeth; Tschakoschian, Sasan

2013-01-01

422

[Successful perioperative use of noninvasive positive pressure ventilation in a pregnant woman with acute pulmonary edema].  

PubMed

A 32-year-old woman (148 cm, 59 kg, gravida 2, para 2) with quadruplet pregnancy was admitted to our hospital for the threatened preterm labor at 23 weeks and 2 days of gestation. She was treated with ritodrine, magnesium sulfate and nifedipine to maintain tocolysis. Betamethasone was administered to accelerate fetal lung maturity. After ritodrine dose was increased at 23 weeks and 5 days of gestation, she developed dyspnea with desaturation. Acute pulmonary edema was revealed on chest X-ray. The decision was made to proceed with emergency cesarean delivery. On arrival at the operating room, the blood pressure was 123/53 mmHg, heart rate 111 beats x min(-1), and oxygen saturation (SpO2) 84% with supplemental oxygen 15 l x min(-1) via a reserved face mask. Noninvasive positive pressure ventilation (NPPV) was initiated with S/T mode (FIO2 1.0, inspiratory positive airway pressure 10 cmH2O, expiratory positive airway pressure 6 cmH2O). The dyspnea was improved with her SpO2 100%. Spinal anesthesia was performed at L 34 using 2.5 ml of 0.5% bupivacaine and 100 microg morphine. Throughout the operation (operation time 44 minutes), she did not develop dyspnea under NPPV. NPPV was discontinued after the operation. Her SpO2 declined, and pulmonary edema on chest X-ray was exacerbated. She was transferred to the intensive care unit and NPPV was continued for 22 hours after the operation. She was discharged from the intensive care unit on the next day and was discharged from the hospital on the 6th postoperative day. PMID:24864580

Fujita, Naoko; Tachibana, Kazuya; Takeuchi, Muneyuki; Kinouchi, Keiko

2014-05-01

423

Volumetric Electromagnetic Phase-Shift Spectroscopy of Brain Edema and Hematoma  

PubMed Central

Motivated by the need of poor and rural Mexico, where the population has limited access to advanced medical technology and services, we have developed a new paradigm for medical diagnostic based on the technology of “Volumetric Electromagnetic Phase Shift Spectroscopy” (VEPS), as an inexpensive partial substitute to medical imaging. VEPS, can detect changes in tissue properties inside the body through non-contact, multi-frequency electromagnetic measurements from the exterior of the body, and thereby provide rapid and inexpensive diagnostics in a way that is amenable for use in economically disadvantaged parts of the world. We describe the technology and report results from a limited pilot study with 46 healthy volunteers and eight patients with CT radiology confirmed brain edema and brain hematoma. Data analysis with a non-parametric statistical Mann-Whitney U test, shows that in the frequency range of from 26 MHz to 39 MHz, VEPS can distinguish non-invasively and without contact, with a statistical significance of p<0.05, between healthy subjects and those with a medical conditions in the brain. In the frequency range of between 153 MHz to 166 MHz it can distinguish with a statistical significance of p<0.05 between subjects with brain edema and those with a hematoma in the brain. A classifier build from measurements in these two frequency ranges can provide instantaneous diagnostic of the medical condition of the brain of a patient, from a single set of measurements. While this is a small-scale pilot study, it illustrates the potential of VEPS to change the paradigm of medical diagnostic of brain injury through a VEPS classifier-based technology. Obviously substantially larger-scale studies are needed to verify and expand on the findings in this small pilot study. PMID:23691001

Gonzalez, Cesar A.; Valencia, Jose A.; Mora, Alfredo; Gonzalez, Fernando; Velasco, Beatriz; Porras, Martin A.; Salgado, Javier; Polo, Salvador M.; Hevia-Montiel, Nidiyare; Cordero, Sergio; Rubinsky, Boris

2013-01-01

424

Cerebral Blood Flow and Cerebral Edema in Rats With Diabetic Ketoacidosis  

PubMed Central

OBJECTIVE— Cerebral edema (CE) is a potentially life-threatening complication of diabetic ketoacidosis (DKA) in children. Osmotic fluctuations during DKA treatment have been considered responsible, but recent data instead suggest that cerebral hypoperfusion may be involved and that activation of cerebral ion transporters may occur. Diminished cerebral blood flow (CBF) during DKA, however, has not been previously demonstrated. We investigated CBF and edema formation in a rat model of DKA and determined the effects of bumetanide, an inhibitor of Na-K-Cl cotransport. RESEARCH DESIGN AND METHODS— Juvenile rats with streptozotocin-induced DKA were treated with intravenous saline and insulin, similar to human treatment protocols. CBF was determined by magnetic resonance (MR) perfusion–weighted imaging before and during treatment, and CE was assessed by determining apparent diffusion coefficients (ADCs) using MR diffusion–weighted imaging. RESULTS— CBF was significantly reduced in DKA and was responsive to alterations in pCO2. ADC values were reduced, consistent with cell swelling. The reduction in ADCs correlated with dehydration, as reflected in blood urea nitrogen concentrations. Bumetanide caused a rapid rise in ADCs of DKA rats without significantly changing CBF, while saline/insulin caused a rapid rise in CBF and a gradual rise in ADCs. DKA rats treated with bumetanide plus saline/insulin showed a trend toward more rapid rise in cortical ADCs and a larger rise in striatal CBF than those observed with saline/insulin alone. CONCLUSIONS— These data demonstrate that CE in DKA is accompanied by cerebral hypoperfusion before treatment and suggest that blocking Na-K-Cl cotransport may reduce cerebral cell swelling. PMID:18633109

Yuen, Natalie; Anderson, Steven E.; Glaser, Nicole; Tancredi, Daniel J.; O'Donnell, Martha E.

2008-01-01

425

Relative odds of temporomandibular joint pain as a function of magnetic resonance imaging findings of internal derangement, osteoarthrosis, effusion, and bone marrow edema  

Microsoft Academic Search

Objective. The purpose of this study was to evaluate whether common magnetic resonance (MR) imaging variables such as temporomandibular joint (TMJ) internal derangement, osteoarthrosis, effusion, and bone marrow edema are predictive of the presence of TMJ pain. Study Design. The relationship between TMJ pain and TMJ internal derangement, osteoarthrosis, effusion, and bone marrow edema was analyzed in MR images of

Rüdiger Emshoff; Iris Brandlmaier; Stefan Bertram; Ansgar Rudisch

2003-01-01

426

Tomographic findings of foveal hard exudates in diabetic macular edema 1 1 The authors have no proprietary interest in any aspect of this study  

Microsoft Academic Search

PURPOSE: To report the intraretinal location of foveal hard exudates after vitrectomy to treat diabetic macular edema and to evaluate the visual outcome.METHODS: In a prospective study, the tomographic features of 11 eyes (8 patients) with diabetic macular edema were evaluated with optical coherence tomography after vitrectomy. The intraretinal location of hard exudates at the fovea (anatomic foveola) and the

Tomohiro Otani; Shoji Kishi

2001-01-01

427

In-vivo multi-exponential T2, magnetization transfer and quantitative histology in a rat model of intramyelinic edema???  

PubMed Central

Two MRI methods, multi-exponential analysis of transverse relaxation (MET2) and quantitative magnetization transfer (qMT), were used along with quantitative evaluation of histology in a study of intra-myelinic edema in rat spinal white matter. The results showed a strong linear correlation between a distinct long-T2 signal from MET2 analysis and the edema water volume fraction as measured by histology, although this analysis overestimated the edema water content by ? 100% relative to quantitative histological measurements. This overestimation was reasoned to result from the effects of inter-compartmental water exchange on observed transverse relaxation. Commonly studied MRI markers for myelin, the myelin water fraction (from MET2 analysis) and the macromolecular pool size ratio (from qMT analysis) produced results that could not be explained purely by changes in myelin content. The results demonstrate the potential for MET2 analysis as well as the limits of putative myelin markers for characterizing white matter abnormalities involving intra-myelinic edema. PMID:24179832

Harkins, Kevin D.; Valentine, William M.; Gochberg, Daniel F.; Does, Mark D.

2013-01-01