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1

Vulvar edema.  

PubMed

Vulvar edema is associated with a variety of conditions. The edema can result from inflammatory conditions, infections, infestations, trauma, pregnancy, tumors and iatrogenic causes. At times, it is difficult to determine the cause of the vulvar edema. Treatment consists of determining the origin of the edema and giving the appropriate therapy for that diagnosis as well as the use of compression and, at times, lymphatic massage. PMID:20883919

Amankwah, Yaa; Haefner, Hope

2010-10-01

2

Edema  

MedlinePLUS

... edema of the legs, especially in hot weather. Eating food with too much salt can make the problem worse. Edema can also be a side effect of taking certain medicines. Some health problems, such as congestive heart failure, liver disease and kidney disease, can cause edema. You cannot ...

3

Vulvar Cancer  

Microsoft Academic Search

Vulvar cancer was reported in 3,200 women in 1998, resulting in 800 deaths. Recent evi- dence suggests that vulvar cancer comprises two separate diseases. The first type may develop from vulvar intraepithelial neoplasia caused by human papillomavirus infection and is increasing in prevalence among young women. The second type, which more often afflicts older women, may develop from vulvar non-neoplastic

TIMOTHY P. CANAVAN; DONNA COHEN

4

Melanoma vulvar  

Microsoft Academic Search

Vulvar cancer accounts for 5% of all female genital cancers and 1% of all malignancies in women. The most common histological type affecting the vulva is squamous cell carcinoma, accounting for approximately 90%-95% of these lesions. Malignant melanoma is the second most common cancer occurring in the vulva, accounting for about 8%-10% of lesions. This uncommon tumor shows a certain

V. Benito; B. Vega; A. Lubrano; J. A. García-Hernández; O. Falcón

2005-01-01

5

Treatment of Vulvar Adenocarcinoma  

MedlinePLUS

... of a Bartholin gland or of vulvar skin sweat glands is present, a partial radical vulvectomy is ... Abuse More ACS Sites Bookstore ACS CAN Gift Shop Global Health More Birthdays Mobile Site Help Site ...

6

What Is Vulvar Cancer?  

MedlinePLUS

... What is vulvar cancer? The vulva is the outer part of the female genitals. The vulva includes ... vagina (sometimes called the vestibule ), the labia majora (outer lips), the labia minora (inner lips), and the ...

7

Vaginal and Vulvar Cancers  

MedlinePLUS

... Doing Related Links Inside Knowledge Campaign Survivor Stories Television Public Service Announcements Radio Public Service Announcements Print ... and vulvar cancers are very rare. While all women are at risk for these cancers, very few ...

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

[Vulvar intraepithelial neoplasia].  

PubMed

HPV infections of the lower genital tract are associated with the increasing incidence of vulvar intraepithelial neoplasia. The new classification divides vulvar intraepithelial neoplasia according to its incidence into two groups: usual and differentiated type. The usual type occurs mainly in young women and is associated with HPV infection, the differentiated type is HPV-negative and occurs in older women. The diagnosis is based on biopsy from a suspicious lesion. The standard treatment involves surgical excision. Topical treatment is now being preferred in young women in order to preserve appearance of the genitalia and sexual function. The high risk of recurrence is the reason for strict monitoring of patients after treatment completion. PMID:21542276

Miklos, P; Babala, P; Klacko, M; Masák, L; Ondrus, D

2011-01-01

10

Vulvar congenital dysplastic angiopathy.  

PubMed

Congenital dysplastic angiopathy is a syndrome consisting of vascular angiomata, congenital varicosities, and trophic changes of the soft tissue and the skeleton. Frequently referred to as Klippel-Trenaunay or Klippel-Trenaunay-Weber syndrome, it rarely affects the female genitalia. An 18-year-old woman underwent evaluation and treatment for Klippel-Trenaunay syndrome with vulvar involvement. Preoperative evaluation included consultation with pediatric surgeons, gynecologic surgeons, and an interventional radiologist as well as individual and family psychological counseling. Attention to intraoperative detail resulted in minimal operative blood loss and preservation of normal anatomy. A postoperative hematoma was treated aggressively with surgical evacuation and drainage. Six-month follow-up revealed functionally and cosmetically normal vulvar anatomy. PMID:2154731

Tjaden, B L; Buscema, J; Haller, J A; Rock, J A

1990-03-01

11

[Review of precancerous vulvar lesions].  

PubMed

Classification of squamous vulvar precancerous lesions is based on the concept of vulvar intraepithelial neoplasia (VIN) and incorporates a three grade evaluation of the intensity of dysplastic changes (VIN I, II and III). On the basis of histological features, VIN has been subdivided into the usual VIN (u-VIN) and differentiated VIN (d-VIN), which represent the two basic pathways of the pathogenesis of vulvar squamous cell carcinoma. Although u-VIN is etiologically associated with the human papillomavirus (HPV) infection and histologically corresponds to cervical intraepithelial neoplasia, d-VIN represents the HPV-negative sequence of vulvar carcinogenesis, which is linked to lichen sclerosus (LS) and lichen simplex chronicus (LSC). u-VIN preferentially occurs in relatively young women with a history of cervical, vaginal or vulvar premalignant lesions. On the other hand, d-VIN usually affects postmenopausal women without anamnestic data of other dysplastic lesions of the lower female genital tract. d-VIN is characterized by a higher tendency of stromal invasion than u-VIN and its malignant potential is analogous to carcinoma in situ (VIN III). The histological appearance of d-VIN is subtle with basal atypia and a well-preserved differentiation of the superficial parts of the squamous epithelium, therefore it is frequently misdiagnosed for u-VIN I, LS or LSC in vulvar biopsies. Primarily because of the low diagnostic reproducibility of the u-VIN I category and the doubts about its precancerous potential as well as due to the questionable differentiation between u-VIN II and III, a revised VIN classification was proposed in 2004. The grading of vulvar precancerous lesions was abandoned, the u-VIN I category was discontinued and u-VIN II and III were merged. In the revised terminology, the term u-VIN represents HPV-associated high grade precancerous vulvar lesions (formerly u-VIN II and III) and d-VIN encompasses HPV-negative high grade dysplasias. PMID:22716003

Skapa, P; Robová, H; Rob, L; Záme?ník, J

2012-01-01

12

Estrogen receptor expression in vulvar vestibulitis syndrome  

Microsoft Academic Search

OBJECTIVE: A pilot study was performed to investigate the relationship between vulvar vestibulitis syndrome and estrogen receptor expression.STUDY DESIGN: Women with a diagnosis of vulvar vestibulitis syndrome had tissue samples taken for vulvar estrogen receptor-? expression and this was compared with a control group.RESULTS: The study group showed a significant decrease in estrogen receptor expression, and 50% of the samples

Lois J Eva; Allan B MacLean; Wendy M. N Reid; Kerstin J Rolfe; Christopher W Perrett

2003-01-01

13

Idiopathic edema  

Microsoft Academic Search

Idiopathic edema is a syndrome of real or perceived excessive weight gain. This article reviews what is known about the possible causes, evaluation, and treatment. Although the cause is unknown but often thought to be due to secondary hyperaldosteronism, primary abnormalities of the hypothalamus, thyroid, dopaminergic release or renal dopaminergic metabolism, vascular basement membrane, or capillary sphincter control could perhaps

Alex Kay; Connie L. Davis

1999-01-01

14

Vulvar Malignancy in Neurofibromatosis Syndrome  

PubMed Central

Type 1 neurofibromatosis (NF1) is a dominantly inherited neurologic disorder that affects primarily the skin, bones, and peripheral nervous system. It may be associated with a variety of clinical manifestations including cafe-au-lait spots, skinfold freckling, Lisch nodules, and visceral neurofibromas. Individuals affected by NF1 harbor an increased risk for both benign and malignant tumors. Malignant transformation is usually observed in the form of neurosarcoma. Rarely, NF1 affects the genital tract, and isolated vulvar localization is extremely rare. Here is reported a rare case of a solitary neurosarcoma of the vulva in a 43-year-old woman affected by NF1 syndrome treated with surgical excision. The purpose of this case is to underline the possibility of association between NF1 and genital tract sarcoma and to suggest an accurate evaluation of rapid growth vulvar mass in this setting.

Musella, Angela; Palaia, Innocenza; Domenici, Lavinia; Casorelli, Assunta; Martoccia, Angela; Benedetti Panici, Pierluigi

2013-01-01

15

Psychosexual Adjustment After Vulvar Surgery  

PubMed Central

Fifteen patients treated surgically for vulvar cancer from two institutions participated in semistructured interviews and objective assessment to examine postoperative psychologic, social, marital, and sexual adjustment. Descriptive statistics indicate that after vulvar surgery patients report mild distress, but they report reasonable levels of and satisfaction with their free-time and social activities. Mild levels of marital distress may exist. Sexual functioning and body image appear to undergo major disruption despite the fact that intercourse remains possible. Women reported levels of sexual arousal at the eighth percentile and body image at the fourth percentile. Although replication of these findings is clearly necessary, this investigation provides the first substantive look at the posttreatment life circumstances for these patients and offers a data base for future investigation.

Andersen, Barbara L.; Hacker, Neville F.

2009-01-01

16

Human papillomavirus distribution in vulvar intraepithelial neoplasia.  

PubMed

This pilot study investigated the prevalence and distribution of human papillomavirus (HPV) type in vulvar lesions in women with a history of vulvar intraepithelial neoplasia. Fifty-two specimens were collected. Uncommon HPV subtypes were found among the specimens, which may have implications for HPV vaccination coverage. PMID:22300742

Likes, Wendy; Bloom, Leonard

2012-02-01

17

Vulvar Paget's disease--a case report.  

PubMed

Vulvar Morbus Paget (MP) represents a rare intraepithelial adenocarcinoma. It accounts for less than 1% of all vulvar neoplasia and usually appears in postmenopausal women. Histologically it is analogous to Paget's disease of the breast. The most common clinical symptom is pruritus. The lesion appears as an erythematous or as an eczematous lesion with islands of hyperkeratosis. Occasionally, single anaplastic Paget's cells can be found on the vulvar smears which make cytological diagnosis of the disease possible. However, the disease can be diagnosed only by biopsy. We present a case of 49-year old woman with vulvar symptoms of pruritus, who had liver and kidney transplantation two years ago. During the standard gynecological examination the vulvar smear was taken for cytological evaluation. The smear was scanty, with inflammatory background, overloaded with squamae. There were two types of cells: dysplastic squamous cells from lower layer of the epithelium and the single, anaplastic cells with a high nuclear:cytoplasmic ratio who possessed eccentric, large nucleus. Nucleoli were rare. Cytoplasm varied from pale and delicate to densely basophilic. Accordingly, cytological diagnosis vulvar intraepithelial neoplasia (VIN III) with differential diagnosis of vulvar Paget's disease was made. The pathological verification supported the diagnosis of MP and an immunohistochemistry panel confirmed type III of Paget's disease and an evaluation of bladder was suggested. PMID:20698146

Simon, Suzana Kataleni?; Bolanca, Ines Krivak; Sentija, Karmela; Kukura, Vlastimir; Valeti?, Josip; Skrti?, Anita

2010-06-01

18

Symptoms of Vaginal and Vulvar Cancers  

MedlinePLUS

... Doing Related Links Inside Knowledge Campaign Survivor Stories Television Public Service Announcements Radio Public Service Announcements Print ... when you pass urine or have sex. Many women who have vulvar cancer have signs and symptoms. ...

19

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

20

Vulvar puritus for one year.  

PubMed

A 60-year-old menopausal female presented with vulvar itching for one year. She had noticed a whitish lesion on the vulva that slowly increased in size over the year. She had been unsuccessfully treated with oral fluconazole and topical clotrimazole-mometasone combinations and the plaque had gradually spread to involve the clitoris and peri-urethral area. She was neither diabetic nor hypertensive and had no other systemic complaints. Examination revealed a well-defined non-tender whitish plaque situated on her left labia minora and clitoris (Figure 1). A swab from the plaque did not grow any organism. Routine blood chemistry including a VDRL and HIV ELIZA were within normal limits. A punch biopsy from the lesion was taken and histopathology findings were as seen in (Figures 2 and 3). PMID:21062604

Madnani, Nina A; Bhalerao-Gandhi, Ashwini; Khan, Kaleem J

2010-10-15

21

Prognostic Significance of Epithelial Disorders Adjacent to Invasive Vulvar Carcinomas  

Microsoft Academic Search

Objective. Epithelial disorders are found adjacent to vulvar carcinoma in 70–80% of patients. Epithelial disorder may be human papillomavirus related [undifferentiated high-grade vulvar intraepithelial neoplasia (VIN III)] or not [vulvar lichen sclerosus and squamous cell hyperplasia with or without atypia (differentiated VIN III)]. The aim of this study was to evaluate the impact of associated epithelial disorders on the outcome

Roman Rouzier; Philippe Morice; Christine Haie-Meder; Catherine Lhomme; Marie-Françoise Avril; Pierre Duvillard; Damienne Castaigne

2001-01-01

22

Management options for vulvar carcinoma in a low resource setting  

Microsoft Academic Search

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

Ahizechukwu C Eke; Lilian I Alabi-Isama; Josephat C Akabuike

2010-01-01

23

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

24

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

PubMed

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 resolved. We analyzed 11 differentiated vulvar intraepithelial neoplasms and 6 associated vulvar squamous cell carcinomas. Sections were stained for p53 and p63 and DNA from multiple epithelial sites, representing normal control tissues (n=10), differentiated vulvar intraepithelial neoplasias (n=18), and vulvar squamous cell carcinomas (n=6), were obtained by laser capture microdissection, and sequenced for exons 2-11 of Tp53. Six of 10 cases contained at least one Tp53 mutation-positive differentiated vulvar intraepithelial neoplasia focus; 4 strongly p53 immuno-positive and 2 negative. Staining for p53 and p63 co-localized, targeting the immature epithelium, but surface epithelium was Tp53 mutation-positive. Four of five vulvar squamous cell carcinomas were Tp53 mutation-positive; two shared identical Tp53 mutation with adjacent differentiated vulvar intraepithelial neoplasia. Disparate foci of differentiated vulvar intraepithelial neoplasia often showed different mutations consistent with multiple neoplastic clones. Differentiated vulvar intraepithelial neoplasia is, with few exceptions, associated with Tp53 mutations and will be p53 immunopositive when missense mutations (versus some nonsense and all deletion mutations) are present. Multiple Tp53 mutations in different sites supports the presence of multiple independent genetic events, but shared Tp53 mutations in both differentiated vulvar intraepithelial neoplasia and vulvar squamous cell carcinoma support a genetic relationship between the two. The confinement of p53 staining to immature cell nuclei is consistent with maturation-dependent degradation of mutant p53 protein. PMID:20062014

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

2010-01-08

25

papillomavirus DNA in invasive vulvar carcinoma  

Microsoft Academic Search

Received 15 July 2003 Abstract Objective. The present study investigates the influence of lymph node pathological features and HPV DNA status on the prognosis of vulvar invasive tumors. Methods. This study includes 184 consecutive cases of primary invasive squamous cell carcinoma of the vulva treated by radical surgery from 1975 to 1992, in Sao Paulo, Brazil. Clinical follow-up data was

Alvaro P. Pinto; Nicolas F. Schlecht; Javier Pintos; Jane Kaiano; Eduardo L. Franco; Christopher P. Crum; Luisa L. Villa

26

Surgery and radiotherapy in vulvar cancer  

Microsoft Academic Search

The majority of patients with vulvar cancer have squamous cell carcinomas (SCC). The cornerstone of the treatment is surgery. Radical vulvectomy with “en bloc” inguinofemoral lymphadenectomy has led to a favorable prognosis but with impressive morbidity. Nowadays, treatment is more individualized with wide local excision with uni- or bilateral inguinofemoral lymphadenectomy via separate incisions as the standard treatment for early

J. A. de Hullu

2006-01-01

27

STUDIES ON PULMONARY EDEMA  

PubMed Central

1. Guinea pigs die shortly after bilateral cervical vagotomy, even when continuous artificial respiration effected through a tracheal cannula is carried out. Death is caused by severe pulmonary edema and congestion. 2. Direct observation of the lungs after bilateral vagotomy demonstrates that pulmonary edema develops gradually and increases slowly in amount and severity. Congestion precedes and accompanies the development of the edema. 3. Neuropathic pulmonary edema in the guinea pig is caused by disturbance to or abolition of the pulmonary vasomotor nerves. 4. The evidence obtained by experiments on animals suggests that neuropathic pulmonary edema in man is caused by disturbances, either central or peripheral, to the vasomotor control of the pulmonary vessels.

Farber, Sidney

1937-01-01

28

Premalignant epithelial disorders of the vulva: squamous vulvar intraepithelial neoplasia, vulvar Paget's disease and melanoma in situ.  

PubMed

No standard screening programs exist to detect vulvar carcinoma or its precursor lesions, and therefore gynecologists, dermatologists and other healthcare providers in this field should be aware of the clinical features, behavior and management of the different existing premalignant vulvar lesions, squamous vulvar intraepithelial neoplasia (VIN), vulvar Paget's disease and melanoma in situ. In 2004, a new classification for squamous VIN was introduced by the International Society for the Study of Vulvar Disease, subdividing squamous VIN into the HPV-related usual type, and into differentiated type, which is associated with lichen sclerosus. This review describes the relevant aspects of squamous VIN, vulvar Paget's disease and melanoma in situ, its epidemiological characteristics, diagnosis, management and malignant potential. PMID:20504079

Terlou, Annelinde; Blok, Leen J; Helmerhorst, Theo J M; van Beurden, Marc

2010-06-01

29

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.

Ibiloglu, Ibrahim; Durmazlar, Nezih

2013-01-01

30

Vulvar nonclear cell syringoma associated with pruritus and diabetes mellitus.  

PubMed

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

Akoglu, Gulsen; Ibiloglu, Ibrahim; Durmazlar, Nezih

2013-08-28

31

Vulvar Merkel Carcinoma: A Case Report  

PubMed Central

This is a new case of Merkel cell carcinoma of the vulva. It is a rare neuroendocrine carcinoma with an aggressive behavior. Because of its rarity in this location, it is not clear whether it behaves differently from the usual neuroendocrine carcinomas of the skin. A case of a 63-year-old patient with vulvar Merkel carcinoma is presented. The clinical presentation, microscopic and immunohistochemical features, and treatment are discussed.

Iavazzo, C.; Terzi, M.; Arapantoni-Dadioti, P.; Dertimas, V.; Vorgias, G.

2011-01-01

32

Macular edema: miscellaneous.  

PubMed

This article provides the reader with practical information to be applied to the various remaining causes of macular edema. Some macular edemas linked to ocular diseases like radiotherapy after ocular melanomas remained of poor functional prognosis due to the primary disease. On the contrary, macular edemas occurring after retinal detachment or after some systemic or local treatment use are often temporary. Macular edema associated with epiretinal membranes or vitreomacular traction is the main cause of poor functional recovery. However, the delay to observe a significant improvement of vision after surgery should be long, as usually observed in tractional myopic vitreoschisis. Finally, some circumstances of macular edemas such as hemangiomas or macroaneurysms should be treated, if symptomatic, with the treatments currently used in diabetic macular edema or exudative macular degeneration. PMID:23264332

Creuzot-Garcher, Catherine; Jonas, Jost; Wolf, Sebastian

2011-01-01

33

[Drug-induced edema].  

PubMed

It is well known that there are many drugs which induce edema. Drug-induced edema can be divided into three types by the mechanism as follows, 1) sodium overload, 2) renal dysfunction and 3) hyperpermeability of blood vessel. In the category of sodium overload, edema is induced by much fluid replacement and antibiotics which contain large amount of sodium and sodium bicarbonate. As the category of renal dysfunction, NSAIDs, antihypertensive drugs, anticancer drugs and so on induce edema in patients with renal dysfunction. In the category of hyperpermeability of blood vessel, edema is induced by calcium antagonist, insuline and so on. In order to diagnose drug-induced edema early, it is important that we interrupt or reduce the quantity of suspicious drug. PMID:15675326

Kaizu, Kazo; Abe, Masanori

2005-01-01

34

Potential Applications of Intraoperative Lymphatic Mapping in Vulvar Cancer  

Microsoft Academic Search

Objective: We describe early results of and potentially important anatomic findings with intraoperative lymphatic mapping in patients with vulvar cancer. Methods: Isosulfan blue was injected into the dermis at the leading edge of the vulvar lesion in 21 patients. One to five minutes later a standard groin incision was made and carried to the superficial fascia. After gentle dissection, the

CHARLES LEVENBACK; THOMAS W. BURKE; MITCHELL MORRIS; ANAIS MALPICA; KRISTIN R. LUCAS; DAVID M. GERSHENSON

1995-01-01

35

Pathophysiology of Macular Edema  

Microsoft Academic Search

Macular edema is defined as an accumulation of fluid in the outer plexiform layer and the inner nuclear layer as well as a swelling of Müller cells of the retina. It consists of a localized expansion of the retinal extracellular space (sometimes associated with the intracellular space) in the macular area. Macular edema is a common cause of a sudden

Stefan Scholl; Janna Kirchhof; Albert J. Augustin

2010-01-01

36

Vulvar cancer and the need for awareness of precursor lesions.  

PubMed

Vulvar cancer continues to rise in incidence. In the absence of screening, attempts to reduce this cancer must focus on recognizing precursor lesions, namely, lichen sclerosus and vulvar intraepithelial neoplasia (VIN). The steep rise in human papillomavirus-repeated VIN will fall after the introduction of vaccination against human papillomavirus; in the meantime, those patients with VIN must be treated and then reviewed carefully and frequently. Lichen sclerosus has a 3% to 5% risk of progressing to vulvar cancer. Recommendations about which patients require referral to and follow-up by specialists/specialist clinics are given. PMID:19387133

Maclean, Allan B; Jones, Ronald W; Scurry, James; Neill, Sallie

2009-04-01

37

Edema: diagnosis and management.  

PubMed

Edema is an accumulation of fluid in the interstitial space that occurs as the capillary filtration exceeds the limits of lymphatic drainage, producing noticeable clinical signs and symptoms. The rapid development of generalized pitting edema associated with systemic disease requires timely diagnosis and management. The chronic accumulation of edema in one or both lower extremities often indicates venous insufficiency, especially in the presence of dependent edema and hemosiderin deposition. Skin care is crucial in preventing skin breakdown and venous ulcers. Eczematous (stasis) dermatitis can be managed with emollients and topical steroid creams. Patients who have had deep venous thrombosis should wear compression stockings to prevent postthrombotic syndrome. If clinical suspicion for deep venous thrombosis remains high after negative results are noted on duplex ultrasonography, further investigation may include magnetic resonance venography to rule out pelvic or thigh proximal venous thrombosis or compression. Obstructive sleep apnea may cause bilateral leg edema even in the absence of pulmonary hypertension. Brawny, nonpitting skin with edema characterizes lymphedema, which can present in one or both lower extremities. Possible secondary causes of lymphedema include tumor, trauma, previous pelvic surgery, inguinal lymphadenectomy, and previous radiation therapy. Use of pneumatic compression devices or compression stockings may be helpful in these cases. PMID:23939641

Trayes, Kathryn P; Studdiford, James S; Pickle, Sarah; Tully, Amber S

2013-07-15

38

Vulvar squamous cell carcinoma and lichen sclerosus.  

PubMed

There are two clinicopathological types of vulvar squamous cell carcinoma, human papillomavirus (HPV)-positive and HPV-negative, which can be distinguished to some degree on routine histology. Human papillomavirus-positive carcinomas account for one-quarter to one-third of cases, occur in women on average 20 years younger than in HPV-negative, and are associated with multiple lower genital tract neoplasia. Human papillomavirus negative carcinoma is linked to lichen sclerosus. Of all carcinomas, 7-96% show lichen sclerosus in skin adjacent to the carcinoma, the majority being the first presentation of lichen sclerosus, and up to 5% of patients with lichen sclerosus develop carcinoma after long-term follow up. Where lichen sclerosus is associated with malignancy, it is often hyperplastic, may show a subtle form of intraepithelial neoplasia termed 'differentiated vulvar intraepithelial neoplasia', and may lose its pathognomonic oedematous-hyaline layer. The local additional factors causing lichen sclerosus to develop malignancy on the vulva are not known. PMID:10994466

Scurry, J P; Vanin, K

1997-06-01

39

[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

40

Medical and surgical approaches to vulvar intraepithelial neoplasia.  

PubMed

Vulvar intraepithelial neoplasia (VIN) is a precursor to invasive vulvar carcinoma. The two major types of VIN, usual and differentiated, differ in epidemiology, pathogenesis, clinical manifestations, pathology, and malignant potential. Usual VIN commonly occurs in younger women. It is associated with human papillomavirus and tends to have multifocal and multicentric involvement. Differentiated VIN is frequently associated with benign vulvar dermatoses such as lichen sclerosus and lichen simplex chronicus. It occurs in older women and typically is unifocal and unicentric. Clinicians must have a high suspicion for VIN, which is diagnosed by biopsy. Surgical excision has been the standard treatment in order to prevent progression to invasive disease. The objectives of treatment have expanded to include preservation of normal vulvar function and anatomy. Therefore, management options are being investigated, including topical therapy, laser excision and vaporization, and photodynamic therapy. All can be effective in both eliminating disease and maintaining relatively normal-appearing and functioning anatomy. PMID:20868402

Lai, Kimberly W; Mercurio, Mary Gail

41

Vulvar intraepithelial neoplasia and microinvasive carcinoma of the vulva.  

PubMed Central

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 concluded that no satisfactory definition of this entity has been achieved. Images

Buckley, C H; Butler, E B; Fox, H

1984-01-01

42

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.

Rotsos, Tryfon G; Moschos, Marilita M

2008-01-01

43

Vulvar pruritus and burning sensation in women with psoriasis.  

PubMed

Approximately 80% of psoriatic individuals experience pruritus, of varying intensity. This study evaluated the frequency of vulvar itching and burning and its influence on well-being in women with psoriasis. A total of 93 women were included in the study. Psoriasis severity was assessed according to the Psoriasis Area and Severity Index, the intensity of vulvar discomfort by visual analogue scale and depressive symptoms by Beck's Depression Inventory. On admission 41 (44.1%) women experienced vulvar discomfort, 18 (19.4%) itching, 10 (10.8%) burning and 13 (14.0%) both itching and burning sensations. Psoriatic lesions on the vulva were found in 22 (23.7%) women. No significant correlation was found between burning or itching intensity and global psoriasis severity (r = 0.19, p = 0.26). Patients with vulvar discomfort had psoriatic lesions on the vulva more often than women without discomfort (43.6% vs. 8.2%, p < 0.001). In addition, patients with vulvar discomfort more frequently demonstrated depressive symptoms (p < 0.05). We conclude that vulvar discomfort is an important clinical problem in women with psoriasis and should be taken into consideration during treatment. PMID:18311439

Zamirska, Aleksandra; Reich, Adam; Berny-Moreno, Joanna; Salomon, Joanna; Szepietowski, Jacek C

2008-01-01

44

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

45

Characterization of vulvar skin of healthy Thai women: influence of sites, age and menopause.  

PubMed

Although the physiological characteristics of vulvar skin have been characterized in Caucasians, little is known about the vulvar skin of Asian women. This study assessed the moisture content, transepidermal water loss (TEWL) and pH of vulvar skin of 99 healthy Asian women residing in Bangkok, aged 20-69 years, during their non-menstrual period, including 39 post-menopausal women. Skin pH was acidic at all sites, and the pH of the vulvar areas was significantly higher than the control sites (inner thigh, inner forearm). Skin moisture was slightly, but significantly, lower around the vulvar area and the thigh than around the forearm. TEWL was significantly higher in vulvar areas than control sites. Ageing and menopause did not cause notable alterations in most properties of vulvar skin. In conclusion, the vulvar skin of Asian women has similar properties to that of Caucasians. PMID:23435846

Fujimura, Tsutomu; Sato, Noriko; Ophaswongse, Suwirakorn; Takagi, Yutaka; Hotta, Mitsuyuki; Kitahara, Takashi; Takema, Yoshinori; Palungwachira, Piti

2013-03-27

46

[Toxic, allergic, and inflamatory edema].  

PubMed

Edema is defined as the condition in which intraluminal lymph fluid components leak into the tissues and the interstitium fluid is abnormally increased. At the site of edema, toxication, allergy or inflammation occasionally occurs. This paper will focus on local skin and mucosal edema. Toxic edema is locally caused by intake of industrial goods or medical products (pharmaceuticals). Like urticaria, allergic edema is attributed to the increased vascular permeability caused by a chemical mediator. Inflammatory edema is the state in which increased inflammatory reaction in local skin causes increases in osmotic pressure of the tissues and metabolism and then inflammatory effusion accumulate there. It includes burn and cellulites. PMID:15675328

Takada, Yuko; Yoshida, Shunji

2005-01-01

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

Transient Idiopathic Primary Penoscrotal Edema  

PubMed Central

We present the case of a male born prematurely at 32 weeks gestation by cesarean section following overt symptoms of maternal preeclampsia. He developed severe penoscrotal edema anew one month from birth. No remarkable exposure or trauma was identified. This unexplained swelling remained uniform till 4 months of age, while the penile edema resolved spontaneously. A small benign hydrocele remained unchanged, since onset of the edema and continued after the edema subsided. This is the first report of persistent, but transient penoscrotal edema resolving in a 3 months course, without any apparent explanation, a possible pathogenetic mechanism was suggested.

Namir, Sody A; Trattner, Akiva

2013-01-01

49

ACOG Committee Opinion No. 509: Management of vulvar intraepithelial neoplasia.  

PubMed

Vulvar intraepithelial neoplasia (VIN) is an increasingly common problem, particularly among women in their 40s. The term VIN is used to denote high-grade squamous lesions and is subdivided into usual-type VIN (including warty, basaloid, and mixed VIN) and differentiated VIN. Usual-type VIN is commonly associated with carcinogenic genotypes of human papillomavirus (HPV) and other HPV persistence risk factors, such as cigarette smoking and immunocompromised status, whereas differentiated VIN usually is not associated with HPV and is more often associated with vulvar dermatologic conditions, such as lichen sclerosus. Biopsy is indicated for any pigmented vulvar lesion. Treatment is indicated for all cases of VIN. When occult invasion is not a concern, VIN can be treated with surgical therapy, laser ablation, or medical therapy. After resolution, women should be monitored at 6 and 12 months and annually thereafter. PMID:22015906

2011-11-01

50

Conservative surgical treatment for early-stage vulvar malignant melanoma  

Microsoft Academic Search

Purpose  To investigate the efficacy of wide local excision as a surgical treatment for early-stage vulvar melanomas.\\u000a \\u000a \\u000a \\u000a Methods  Wide local excision with or without lymph node dissection was performed in three patients with stage I vulvar melanoma (American\\u000a Joint Committee on Cancer classification, 1992).\\u000a \\u000a \\u000a \\u000a Results  All three patients were successfully treated by wide local excision. There was no evidence of recurrence at long-term

Kaei Nasu; Yoshitaka Kai; Masaki Ohishi; Aiko Kato; Haruaki Sato; Sakuhei Fujiwara; Noriyuki Takai; Hisashi Narahara

2010-01-01

51

Vulvar intraepithelial neoplasia: historical aspects and current status.  

PubMed

Vulvar intraepithelial neoplasia (VIN) is the currently accepted generic designation for the spectrum of vulvar lesions with the histologic features of squamous dysplasia and squamous cell carcinoma in situ. Although several classifications of VIN have been espoused in the past 20 years, VIN can be readily classified into two principal clinicopathologic types: classic (bowenoid) VIN and simplex (differentiated) VIN. This manuscript summarizes the historical development and current status of our knowledge about VIN. Information on the clinical and pathologic aspects are detailed and illustrated, as are considerations of differential diagnosis. PMID:11192069

Hart, W R

2001-01-01

52

Tecniche chirurgiche aTTuali nel carcinoma vulvare  

Microsoft Academic Search

The aim of this review is to give an overview of the surgical management of Squamous Cell Carcinoma (SCC) of the vulva. Today the majority of patients with vulvar SCC can be safely treated by radical wide local excision or partial vulvectomy and bilateral inguinofemoral lymphadenec - tomy with triple incision technique avoiding the more aggressive classic radical vulvectomy with

Leonardo Micheletti; Federica Barberis

53

Prediction of lymph node metastases in vulvar cancer: a review  

Microsoft Academic Search

The aim of this study was to review the literature on currently available non- and minimally-invasive diagnostic methods and analysis of primary tumor characteristics for prediction of inguinofemoral lymph node metastases in patients with primary squamous cell carcinoma of the vulva. We used the English language literature in PubMed and reference lists from selected articles. Search terms included vulvar carcinoma,

M. H. M. OONK; H. Hollema; J. A. de Hullu

2006-01-01

54

Vulvar cancer patients' quality of life: a qualitative assessment.  

PubMed

To develop a vulvar cancer-specific quality of life (QOL) subscale to accompany the Functional Assessment of Cancer-General (FACT-G) questionnaire, semistructured interviews were performed with 15 patients treated for vulvar cancer (FIGO stage 0-3). All but one patient, who received chemoradiotherapy, were treated by radical vulvectomy and six patients received a groin lymph node dissection. Patients experienced reductions in several aspects of QOL including emotional functioning, physical functioning, social functioning, sexuality, and body image. Six patients suffered from lymphedema of the legs with a mean severity of 3.5 on a 10-point scale. Four patients reported pruritus (severity rating 8.5). Seven patients expressed a need for more information about the illness and treatment. Only four patients returned to employment after treatment, and all of these patients reported work-related problems. Reductions in sexual functioning were a major concern for five patients, all younger than 65 years. Other topics were groin discomfort after removal of the lymph nodes and disturbance by odor from the vulva. Results of this study revealed vulvar cancer-specific reductions in QOL for inclusion in the newly developed vulvar cancer-specific subscale. PMID:15361198

Janda, M; Obermair, A; Cella, D; Crandon, A J; Trimmel, M

55

Vulvar Discomfort in Hospitalized Dermatological Patients – Preliminary Results  

Microsoft Academic Search

Summary Background: The frequency and importance of pruritus vulvae and vulvodynia are frequently underestimated. We conducted a survey to examine the prevalence and characteristics of these complaints. Methods: Using a questionnaire which we developed, patients hospitalized at the University Dermatology Clinic Halle were questioned about any vulvar complaints and their characteristics. Results: 108 questionnaires were evaluated. Of the respondents, 27

M. Fischer; B. Kreft; S. Born; K.-M. Taube

2001-01-01

56

Genetic aberrations detected by comparative genomic hybridisation in vulvar cancers.  

PubMed

Squamous cell carcinoma of the vulva is a disease of significant clinical importance, which arises in the presence or absence of human papillomavirus. We used comparative genomic hybridisation to document non-random chromosomal gains and losses within human papillomavirus positive and negative vulvar cancers. Gain of 3q was significantly more common in human papillomavirus-positive cancers compared to human papillomavirus-negative cancers. The smallest area of gain was 3q22-25, a chromosome region which is frequently gained in other human papillomavirus-related cancers. Chromosome 8q was more commonly gained in human papillomavirus-negative compared to human papillomavirus-positive cancers. 8q21 was the smallest region of gain, which has been identified in other, non-human papillomavirus-related cancers. Chromosome arms 3p and 11q were lost in both categories of vulvar cancer. This study has demonstrated chromosome locations important in the development of vulvar squamous cell carcinoma. Additionally, taken together with previous studies of human papillomavirus-positive cancers of other anogenital sites, the data indicate that one or more oncogenes important in the development and progression of human papillomavirus-induced carcinomas are located on 3q. The different genetic changes seen in human papillomavirus-positive and negative vulvar squamous cell carcinomas support the clinicopathological data indicating that these are different cancer types. PMID:11953825

Allen, D G; Hutchins, A-M; Hammet, F; White, D J; Scurry, J P; Tabrizi, S N; Garland, S M; Armes, J E

2002-03-18

57

Vulvar Merkel Cell Tumor with Glandular and Squamous Differentiation  

Microsoft Academic Search

A case of a Merkel cell tumor of the vulva is presented. In addition to the typical microscopic, immunohistochemical, and ultrastructural features of Merkel cell tumor, there were areas of squamous and glandular differentiation. This is the ninth reported case of a vulvar Merkel cell tumor, and the first where squamous and glandular differentiation were seen. The findings support an

James Scurry; Alison Brand; Robert Planner; John Dowling; Jurgen Rode

1996-01-01

58

Genetic aberrations detected by comparative genomic hybridisation in vulvar cancers  

PubMed Central

Squamous cell carcinoma of the vulva is a disease of significant clinical importance, which arises in the presence or absence of human papillomavirus. We used comparative genomic hybridisation to document non-random chromosomal gains and losses within human papillomavirus positive and negative vulvar cancers. Gain of 3q was significantly more common in human papillomavirus-positive cancers compared to human papillomavirus-negative cancers. The smallest area of gain was 3q22–25, a chromosome region which is frequently gained in other human papillomavirus-related cancers. Chromosome 8q was more commonly gained in human papillomavirus-negative compared to human papillomavirus-positive cancers. 8q21 was the smallest region of gain, which has been identified in other, non-human papillomavirus-related cancers. Chromosome arms 3p and 11q were lost in both categories of vulvar cancer. This study has demonstrated chromosome locations important in the development of vulvar squamous cell carcinoma. Additionally, taken together with previous studies of human papillomavirus-positive cancers of other anogenital sites, the data indicate that one or more oncogenes important in the development and progression of human papillomavirus-induced carcinomas are located on 3q. The different genetic changes seen in human papillomavirus-positive and negative vulvar squamous cell carcinomas support the clinicopathological data indicating that these are different cancer types. British Journal of Cancer (2002) 86, 924–928. DOI: 10.1038/sj/bjc/6600112 www.bjcancer.com © 2002 Cancer Research UK

Allen, D G; Hutchins, A-M; Hammet, F; White, D J; Scurry, J P; Tabrizi, S N; Garland, S M; Armes, J E

2002-01-01

59

Large Vulvar Lipoma in an Adolescent: A Case Report  

PubMed Central

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.

Chung, Seung Moon

2008-01-01

60

Other Gynecologic Cancers: endometrial, ovarian, vulvar and vaginal cancers  

Microsoft Academic Search

HEALTH ISSUE: In Canada, cancers of the endometrium, ovaries, vulva, vagina, placenta and adnexa account for 11% of all malignant neoplasms in women and 81% of all genital cancers. Although the incidence and mortality from vulvar and vaginal cancers are very low, endometrium and ovarian cancer are important public health problems. KEY FINDINGS: In Canada, there has been no appreciable

Eliane Duarte-Franco; Eduardo L Franco

2004-01-01

61

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

62

Topical calcineurin inhibitors for the treatment of vulvar dermatoses.  

PubMed

Repeated courses of potent topical corticosteroids and maintenance therapy with moderately potent topical corticosteroids are frequently needed to treat various forms of vulvar dermatoses, which are often characterized by an abnormal proliferation or activation of T lymphocytes. Because such therapeutic regimen is associated with an increased risk of potential side effects, particularly skin atrophy, an anti-inflammatory alternative to topical corticosteroids is desirable. The two non-steroid topical calcineurin inhibitors pimecrolimus and tacrolimus are immunomodulators that block the release of inflammatory cytokines from T lymphocytes in the skin while promoting cutaneous innate host defences. They are currently approved in Europe and in the United States of America as second-line anti-inflammatory agents for the treatment of atopic dermatitis. We provide a comprehensive summary of existing case reports, series of cases, and open-label prospective studies concerning the use of topical pimecrolimus and tacrolimus for the treatment of anogenital lichen sclerosus, genital lichen planus, vulvar lichen simplex chronicus and related pruritic vulvar dermatoses (chronic vulvar pruritus and allergic contact dermatitis of the vulva). The available data suggest that both topical calcineurin inhibitors may be effective and well tolerated in these vulvar dermatoses, although topical pimecrolimus may exhibit a better long-term tolerability profile. Being devoid of steroid-related side effects, they may represent a useful second-line therapeutic option for patients who are intolerant of, or resistant to topical corticosteroids. Controlled clinical trials and comparative studies are warranted to substantiate the promising findings summarized in this review. PMID:19631446

Goldstein, Andrew T; Thaçi, Diamant; Luger, Thomas

2009-07-23

63

Interstitial Cystitis Coexisting with Vulvar Vestibulitis in a 4-year-old Girl  

Microsoft Academic Search

:   Interstitial cystitis (IC) is a disorder that is difficult to diagnose and is thought to be uncommon in children. We report\\u000a the first case of IC coexisting with vulvar vestibulitis in a 4-year-old girl. She presented with urinary symptoms and pelvic\\u000a and vulvar pain. Cystoscopic and histological investigation confirmed interstitial cystitis and vulvar vestibulitis. Gynecologists\\u000a are often called upon

D. O. Selo-Ojeme; S. Paranjothy; J. L. Onwude

2002-01-01

64

Guidelines for the follow-up of women with vulvar lichen sclerosus in specialist clinics.  

PubMed

It is recommended that women with vulvar lichen sclerosus be followed in specialist clinics where difficulty exists with symptom control or where there is clinical evidence of localized skin thickening. Follow-up is also recommended for women who have previously been treated for squamous cell carcinoma of the vulva (arising in lichen sclerosus or vulvar intraepithelial neoplasia) or where the pathologist expresses concern and is unable to make a definitive diagnosis of differentiated vulvar intraepithelial neoplasia. PMID:17905173

Jones, Ronald W; Scurry, James; Neill, Sallie; MacLean, Allan B

2007-10-01

65

Drug-induced macular edema.  

PubMed

Macular edema constitutes a serious pathologic entity of ophthalmology resulting in vision loss with a remarkable impact on the quality of life of patients. It is the final common pathway of various systemic diseases and underlying intraocular conditions, with diabetes mellitus being the most frequent cause. Other causes include venous occlusive disease, intraocular surgery, and inflammatory conditions of the posterior segment of the eye. Macular edema is a recognized side effect of various systemic and local medications and requires special consideration among ophthalmologists and other clinicians. Recently, antidiabetic thiazolidinediones have been implicated in the development of macular edema, and a review of the English literature revealed that other systemically administered drugs like fingolimod, recently approved for relapsing forms of multiple sclerosis, the anticancer agents tamoxifen and the taxanes, as well as niacin and interferons have been reported to cause macular edema. Ophthalmologic pharmaceutical agents, like prostaglandin analogs, epinephrine, timolol, and ophthalmic preparation preservatives have also been reported to cause macular edema as an adverse event. The purpose of this article is to provide a short, balanced overview of the available evidence in this regard. The available data and the possible pathophysiologic mechanisms leading to the development of macular edema are discussed. Possible therapeutic strategies for drug-induced macular edema are also proposed. PMID:23640687

Makri, Olga E; Georgalas, Ilias; Georgakopoulos, Constantine D

2013-06-01

66

Acute hemorrhagic edema of infancy.  

PubMed

Acute hemorrhagic edema of infancy is a distinctive, cutaneous small vessel leukocytoclastic vasculitis of young children with dramatic characteristic skin findings. It is characterized by low- grade fever, erythematous edema, and purpuric lesions mainly on the face and extremities. Visceral involvement is uncommon, and spontaneous recovery usually occurs within one to three weeks without sequelae. The main differential diagnosis is Henoch-Schönlein purpura. We report this case to highlight the condition and emphasize its benign nature. We describe a classic case of acute hemorrhagic edema of infancy, and comment on the clinical features, pathology, treatment, and prognosis. The disease has spontaneous recovery without sequelae. PMID:18154430

Javidi, Zari; Maleki, Masoud; Mashayekhi, Vahid; Tayebi-Maybodi, Naser; Nahidi, Yalda

2008-01-01

67

Overexpression of wild-type p53 in lichen sclerosus adjacent to human papillomavirus-negative vulvar cancer.  

PubMed

Human papillomavirus is a risk factor for vulvar cancer, whereas human papillomavirus-negative late onset vulvar carcinoma is associated with the dermatologic condition, lichen sclerosus. Human papillomavirus E6 protein targets TP53 for degradation and by inference it has been assumed that human papillomavirus-negative vulvar cancer is dependent upon the acquisition of p53 somatic mutations and subsequent allelic loss. To investigate this, TP53 expression, loss of heterozygosity, and p53 genomic sequence were examined in 29 cases of human papillomavirus-negative vulvar carcinoma with adjacent lichen sclerosus. We examined 37 cases of lichen sclerosus without vulvar carcinoma, 10 cases of nongenital lichen sclerosus, and 12 cases of normal vulvar epithelium served as controls. TP53 was evident in 72% of vulvar carcinoma, 48% in epithelium adjacent to vulvar carcinoma, but was minimal in normal samples. When lichen sclerosus cases were selected to exclude samples with absolutely no TP53 expression through probable failed antigen retrieval or homozygous p53 loss the number of epithelial cells expressing TP53 increased progressively from nongenital lichen sclerosus to lichen sclerosus without vulvar carcinoma, then to lichen sclerosus with vulvar carcinoma (p<0.0001). These data suggest elevated TP53 is a feature of vulvar lichen sclerosus. Seventy-four percent of vulvar carcinoma had chromosome 17p-linked loss of heterozygosity, whereas 47% of adjacent lichen sclerosus featured loss of heterozygosity, but only 31% of vulvar carcinoma had p53 mutations, a frequency less than reported previously. Seven percent of adjacent lichen sclerosus had mutations, showing for the first time the presence of an identical mutation to the matched vulvar carcinoma. These data, however, implicate p53 mutations as a later event in vulvar carcinoma and in marked contrast to the original expectation, our loss of heterozygosity data are consistent with loss of another locus (not p53) on 17p operating as a tumor suppressor in lichen sclerosus destined to develop vulvar carcinoma. PMID:12445188

Vanin, Katrina; Scurry, James; Thorne, Heather; Yuen, Kally; Ramsay, Robert G

2002-11-01

68

Squamous vulvar intraepithelial neoplasia: 2004 modified terminology, ISSVD Vulvar Oncology Subcommittee.  

PubMed

In the current classification, squamous vulvar intraepithelial neoplasia (VIN) is categorized as VIN 1, 2 and 3 according to the degree of abnormality. There is neither evidence that the VIN 1-3 morphologic spectrum reflects a biologic continuum nor that VIN 1 is a cancer precursor. The VIN 2 and 3 category includes 2 types of lesion, which differ in morphology, biology and clinical features. VIN, usual type (warty, basaloid and mixed), is HPV related in most cases. Invasive squamous carcinomas of warty or basaloid type is associated with VIN, usual type. VIN, differentiated type, is seen particularly in older women with lichen sclerosus and/or squamous cell hyperplasia in some cases. Neither VIN, differentiated type, nor associated keratinizing squamous cell carcinoma is HPV related. The term VIN should apply only to histologically high grade squamous lesions (former terms, VIN 2 and VIN 3 and differentiated VIN 3). The term VIN 1 will no longer be used. Two categories should describe squamous VIN: VIN, usual type (encompassing former VIN 2 and 3 of warty, basaloid and mixed types) and VIN, differentiated type (VIN 3, differentiated type). PMID:16419625

Sideri, Mario; Jones, Ronald W; Wilkinson, Edward J; Preti, Mario; Heller, Debra S; Scurry, James; Haefner, Hope; Neill, Sallie

2005-11-01

69

Human Papillomavirus-Specific Serologic Response in Vulvar Neoplasia  

Microsoft Academic Search

Epidemiological and virological evidence suggests that invasive squamous cell carcinoma (SCC) of the vulva is etiologically heterogeneous and that basaloid or warty SCC (BWSCC) and vulvar intraepithelial neoplasia (VIN) are linked to human papillomavirus (HPV) infections while keratinizing SCC (KSCC) is a non-HPV-associated malignancy. In the present study, HPV-specific antibodies in sera of patients with BWSCC, VIN, and KSCC and

Yeping Sun; Allan Hildesheim; Louise A. Brinton; Philip C. Nasca; Cornelia L. Trimble; Robert J. Kurman; Raphael P. Viscidi; Keerti V. Shah

1996-01-01

70

Genetic aberrations detected by comparative genomic hybridisation in vulvar cancers  

Microsoft Academic Search

Squamous cell carcinoma of the vulva is a disease of significant clinical importance, which arises in the presence or absence of human papillomavirus. We used comparative genomic hybridisation to document non-random chromosomal gains and losses within human papillomavirus positive and negative vulvar cancers. Gain of 3q was significantly more common in human papillomavirus-positive cancers compared to human papillomavirus-negative cancers. The

D G Allen; A-M Hutchins; F Hammet; D J White; J P Scurry; S N Tabrizi; S M Garland; J E Armes

2002-01-01

71

Clobetasol propionate in the treatment of premenarchal vulvar lichen sclerosus  

Microsoft Academic Search

OBJECTIVE:To assess the effectiveness of treating premenarchal vulvar lichen sclerosus with clobetasol propionate.METHODS:A retrospective chart review was performed of girls presenting to the University of Michigan Pediatric and Adolescent Gynecology Clinic from January, 1995, to July, 2000, with premenarchal lichen sclerosus. Subjects in the study were treated with topical clobetasol propionate ointment 0.05% for 2–4 weeks, and then tapered to

Yolanda R Smith; Elisabeth H Quint

2001-01-01

72

Human papillomavirus in vulvar and vaginal carcinoma cell lines.  

PubMed Central

A number of reports associate human papillomavirus (HPV) with cervical cancer and cancer cell lines derived from this tumour type. Considerably fewer reports have focused on the role of HPV in carcinomas from other sites of female anogenital squamous epithelia. In this study we have tested for the presence of HPV in eight low-passage vulvar carcinoma cell lines and one extensively passaged cell line, A431. One cell line from a primary vaginal carcinoma was included. The presence of the HPV was evaluated by the polymerase chain reaction (PCR), by Southern blot analysis and by two-dimensional gel electrophoresis. General primer-mediated PCR was applied by using primers from the L1 region, E1 region and HPV 16 E7 region. Southern blot hybridisation was performed under low-stringency conditions (Tm = -35 degrees C) using a whole genomic HPV 6/16/18 probe mixture and under high stringency conditions (Tm = -18 degrees C) with the whole genomic probes of HPV 16 and 33. HPV 16 E6-E7 mRNA was assessed by ribonuclease protection assay (RPA). HPV was found in only one vulvar carcinoma cell line, UM-SCV-6. The identified type, HPV 16, was integrated in the cell genome and could be amplified with all primers used. Also E6-E7 transcripts were found in these cells. Five original tumour biopsies were available from the HPV-negative cell lines for in situ hybridisation. All these were HPV negative with both the HPV 6/16/18 screening probe mixture under low stringency and the HPV 16 probe under high stringency. The results indicate that vulvar carcinoma cell lines contain HPV less frequently than cervical carcinoma cell lines and suggest that a significant proportion of vulvar carcinomas may evolve by an HPV-independent mechanism. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6

Hietanen, S.; Grenman, S.; Syrjanen, K.; Lappalainen, K.; Kauppinen, J.; Carey, T.; Syrjanen, S.

1995-01-01

73

Amelanotic vulvar melanoma: case report and review of the literature.  

PubMed

A rare case of amelanotic vulvar melanoma is presented. The patient was a 71-year-old woman complaining of vulvar itching and yellowish vaginal discharge who underwent a complete gynecological evaluation during which a suspicious grey-whitish mass on her vulva was observed. The tumor presented superficial ulceration and was located in the upper half of the labia minora and clitoris. Initially it was suspected to be a vulvar carcinoma. A biopsy was taken and a histopathological suspicion of amelanotic melanoma was rendered. The mass was radically excised and the diagnosis was confirmed using HMB-45, Melan-A and anti-S-100 protein antibodies. Malignant melanoma is readily diagnosed by the presence of melanin granules. Although amelanotic melanoma contains a few melanin granules, it is often difficult to differentiate it from other non-epithelial malignant tumors. This report describes a case of amelanotic melanoma of the vulva, which was correctly diagnosed by immunohistochemical staining with the HMB-45, Melan-A antibody and for the S-100 protein. PMID:18516330

Baderca, Flavia; Cojocaru, Silvia; Laz?r, Elena; L?zureanu, Codru?a; Lighezan, Rodica; Alexa, Aurora; Raica, M; Nicola, T

2008-01-01

74

Pharmacologic management of brain edema  

Microsoft Academic Search

Opinion statement  Cerebral edema is an intrinsic response to a variety of structural and metabolic insults. It is a major contributing factor\\u000a in the development of intracranial hypertension and brain herniation, underscoring the need for early identification through\\u000a an integration of clinical and neuroimaging findings, followed by timely institution of measures to reduce brain edema and\\u000a intracranial hypertension. The management of

Alexander Papangelou; John J. Lewin III; Marek A. Mirski; Robert D. Stevens

2009-01-01

75

The gluteal fold fascio-cutaneous flap for reconstruction after radical excision of primary vulvar cancers  

Microsoft Academic Search

ObjectivesReconstructive surgery plays an important role in cosmetic and functional results of major excisional surgery performed as a treatment for invasive vulvar cancer. Traditional techniques – gracilis myocutaneous o rectus abdominis flaps – have several limits. We describe here a different surgical approach that we have used since 1998 in an effort to obtain better results in vulvar reconstruction.

S. Franchelli; M. S. Leone; M. Bruzzone; M. Muggianu; A. Puppo; C. Gustavino; E. Di Capua; M. G. Centurioni

2009-01-01

76

Vulvar Vestibulitis: Evidence of Depression and State Anxiety in Patients and Partners  

Microsoft Academic Search

Vulvar vestibulitis is believed to be the most frequent cause of dyspareunia in premenopausal women, with the symptoms affecting the patient's life in several ways. We therefore assessed the level of depression and state anxiety in women with vulvar vestibulitis and their partners, and the association of depression and state anxiety with genital symptoms. In this prospective study, 30 women

Elisabet Nylanderlundqvist; Jan Bergdahl

2003-01-01

77

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

78

Dosimetric Predictors of Laryngeal Edema  

SciTech Connect

Purpose: To investigate dosimetric predictors of laryngeal edema after radiotherapy (RT). Methods and Materials: A total of 66 patients were selected who had squamous cell carcinoma of the head and neck with grossly uninvolved larynx at the time of RT, no prior major surgical operation except for neck dissection and tonsillectomy, treatment planning data available for analysis, and at least one fiberoptic examination of the larynx within 2 years from RT performed by a single observer. Both the biologically equivalent mean dose at 2 Gy per fraction and the cumulative biologic dose-volume histogram of the larynx were extracted for each patient. Laryngeal edema was prospectively scored after treatment. Time to endpoint, moderate or worse laryngeal edema (Radiation Therapy Oncology Group Grade 2+), was calculated with log rank test from the date of treatment end. Results: At a median follow-up of 17.1 months (range, 0.4- 50.0 months), the risk of Grade 2+ edema was 58.9% {+-} 7%. Mean dose to the larynx, V30, V40, V50, V60, and V70 were significantly correlated with Grade 2+ edema at univariate analysis. At multivariate analysis, mean laryngeal dose (continuum, hazard ratio, 1.11; 95% confidence interval, 1.06-1.15; p < 0.001), and positive neck stage at RT (N0-x vs. N +, hazard ratio, 3.66; 95% confidence interval, 1.40-9.58; p = 0.008) were the only independent predictors. Further stratification showed that, to minimize the risk of Grade 2+ edema, the mean dose to the larynx has to be kept {<=}43.5 Gy at 2 Gy per fraction. Conclusion: Laryngeal edema is strictly correlated with various dosimetric parameters; mean dose to the larynx should be kept {<=}43.5 Gy.

Sanguineti, Giuseppe [Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX (United States)]. E-mail: gisangui@utmb.edu; Adapala, Prashanth [Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX (United States); Endres, Eugene J. C [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States); Brack, Collin [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States); Fiorino, Claudio [Department of Physics, Ospedale San Raffaele, Milan (Italy); Sormani, Maria Pia [Biostatistics Unit, University of Genoa, Genoa (Italy); Parker, Brent [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States)

2007-07-01

79

Pediatric mumps with laryngeal edema.  

PubMed

Mumps virus infection primarily affects the salivary glands and may incur various complications. Laryngeal edema is such a rare complication that few adult cases have been reported. We report the first known pediatric patient with mumps with laryngeal edema. An 8-year-old boy developed dyspnea after a rapidly progressive swelling of his face and neck. Laryngoscopy revealed edematous changes in the supraglottic and subglottic regions, and computed tomography confirmed significant laryngeal edema in addition to swelling of the cervical soft tissue and the salivary glands. Laboratory findings revealed a high serum amylase level and confirmed the diagnosis of mumps. Intravenous steroid administration alleviated the dyspnea, although the patient required temporary tracheal intubation to maintain airway patency. He did not need tracheotomy and did not experience any other complications. Laryngeal edema must be regarded as a rare, potentially life-threatening complication of mumps. When mumps is diagnosed with significant swelling of the neck, an emergency airway should be established to prevent airway obstruction. PMID:24084609

Hattori, Yujiro; Oi, Yasufumi; Matsuoka, Ryo; Daimon, Yumi; Ito, Asami; Kubota, Wataru; Konishi, Kyoko; Onguchi, Toshimi; Sato, Akihiro; Yamashita, Yukio; Ishihara, Jun

2013-10-01

80

Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site  

PubMed Central

Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma.

Dhaoui, Amen; Nfoussi, Haifa; Kchir, Nidhameddine; Haouet, Slim

2012-01-01

81

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

PubMed Central

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.

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

2013-01-01

82

Diabetic Macular Edema: Pathogenesis and Treatment  

Microsoft Academic Search

Diabetic macular edema is a major cause of visual impairment. The pathogenesis of macular edema appears to be multifactorial. Laser photocoagulation is the standard of care for macular edema. However, there are cases that are not responsive to laser therapy. Several therapeutic options have been proposed for the treatment of this condition. In this review we discuss several factors and

Neelakshi Bhagat; Ruben A. Grigorian; Arthur Tutela; Marco A. Zarbin

2009-01-01

83

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.

84

Late recurrence of sigmoid carcinoma mimicking primary vulvar cancer: case report and review of the literature  

PubMed Central

Objective To demonstrate a unique case report about late and isolated vulvar metastasis of sigmoid adeno-carcinoma with review of the literature. Material-method 57 year old postmenopausal patient with prior sigmoid colon cancer history was admitted with isolated vulvar mass. Immunohistochemistry (IHC) and KRAS gen mutation analysis following surgery were performed to discriminate the metastasis from a vulvar primary malignancy. Further imaging techniques were also performed to exclude additional tumours. Results Immunohistochemistry (IHC) and KRAS gene mutation analysis revealed isolated metastasis of the colonic adeno-carcinoma in the vulva. Conclusion Isolated and late occurring vulvar metastasis of colonic origin is very unusual. Careful evaluation and IHC is useful for such cases.

Pabuccu, Emre; Tolunay, Harun Egemen; Kocbulut, Evren; Task?n, Salih; Ortac, F?rat; Sertcelik, Ayse; Sasmaz, Aysegul; Savas, Berna

2012-01-01

85

2006 ISSVD classification of vulvar dermatoses: pathologic subsets and their clinical correlates.  

PubMed

The International Society for the Study of Vulvovaginal Disease (ISSVD) has, as one of its major societal goals, the development and promulgation of nomenclature and classification of vulvar disease. A committee of the ISSVD has developed new nomenclature and classification for the specific area of vulvar dermatoses. This classification was approved by the ISSVD members at the most recent international congress, held in New Zealand in February 2006. PMID:17286059

Lynch, Peter J; Moyal-Barracco, Micheline; Moyal-Barrocco, Micheline; Bogliatto, Fabrizio; Micheletti, Leonardo; Scurry, James

2007-01-01

86

Multiple primary tumours in women with vulvar neoplasms: a case-control study  

Microsoft Academic Search

We sought to determine whether women with in situ or invasive squamous cell vulvar cancer were more likely than other women to have had a previous or concurrent tumour at other anogenital sites. One hundred and fifty-eight women with vulvar cancer were identified who were first diagnosed during 1980-1985, were ages 18-79 years at that time, and were residents of

KJ Sherman; JR Daling; J Chu; B McKnight; NS Weiss

1988-01-01

87

Diabetic macular edema: pathogenesis and treatment.  

PubMed

Diabetic macular edema is a major cause of visual impairment. The pathogenesis of macular edema appears to be multifactorial. Laser photocoagulation is the standard of care for macular edema. However, there are cases that are not responsive to laser therapy. Several therapeutic options have been proposed for the treatment of this condition. In this review we discuss several factors and mechanisms implicated in the etiology of macular edema (vasoactive factors, biochemical pathways, anatomical abnormalities). It seems that combined pharmacologic and surgical therapy may be the best approach for the management of macular edema in diabetic patients. PMID:19171208

Bhagat, Neelakshi; Grigorian, Ruben A; Tutela, Arthur; Zarbin, Marco A

88

Overexpression of Wild-type p53 in Lichen Sclerosus adjacent to Human Papillomavirus-negative Vulvar Cancer  

Microsoft Academic Search

Human papillomavirus is a risk factor for vulvar cancer, whereas human papillomavirus-negative late onset vulvar carcinoma is associated with the dermatologic condition, lichen sclerosus. Human papillomavirus E6 protein targets TP53 for degradation and by inference it has been assumed that human papillomavirus-negative vulvar cancer is dependent upon the acquisition of p53 somatic mutations and subsequent allelic loss. To investigate this,

Katrina Vanin; James Scurry; Heather Thorne; Kally Yuen; Robert G. Ramsay

2002-01-01

89

Spindle cell morphology is related to poor prognosis in vulvar squamous cell carcinoma  

PubMed Central

Background: Vulvar cancer is the fourth most common gynaecological malignancy, with an annual incidence of 2 out of 100?000 women. Although most cases of early stage vulvar cancer have a good prognosis, recurrence and rapid tumour progression can occur. We investigated the prevalence of spindle cell morphology in vulvar cancer and its association with survival. Methods: This retrospective cohort study included 108 patients with primary vulvar squamous cell carcinoma who were treated at the Leiden University Medical Center during 2000–2009. Paraffin-embedded tissue was examined for the presence of spindle cell morphology. Survival and histology data were compared between cases with spindle and without spindle cell morphology. Results: Twenty-two (20%) tumours showed spindle cells infiltrating the stromal tissue. All spindle cell tumours were human papillomavirus (HPV) negative. Spindle cell morphology was strongly associated with poor prognosis and with a high risk of lymph node involvement at the time of diagnosis (relative risk 2.26 (95% CI 1.47–3.47)). Five-year disease-specific survival was lower in patients with vs without spindle cell morphology (45.2% vs 79.7%, respectively; P=0.00057). Conclusion: Vulvar spindle cell morphology occurs frequently and seems to develop through the non-HPV pathway. It is associated with a worse prognosis than conventional vulvar squamous cell carcinoma.

Trietsch, M D; Peters, A A W; Gaarenstroom, K N; van Koningsbrugge, S H L; ter Haar, N T; Osse, E M; Halbesma, N; Fleuren, G J

2013-01-01

90

Spindle cell morphology is related to poor prognosis in vulvar squamous cell carcinoma.  

PubMed

Background:Vulvar cancer is the fourth most common gynaecological malignancy, with an annual incidence of 2 out of 100?000 women. Although most cases of early stage vulvar cancer have a good prognosis, recurrence and rapid tumour progression can occur. We investigated the prevalence of spindle cell morphology in vulvar cancer and its association with survival.Methods:This retrospective cohort study included 108 patients with primary vulvar squamous cell carcinoma who were treated at the Leiden University Medical Center during 2000-2009. Paraffin-embedded tissue was examined for the presence of spindle cell morphology. Survival and histology data were compared between cases with spindle and without spindle cell morphology.Results:Twenty-two (20%) tumours showed spindle cells infiltrating the stromal tissue. All spindle cell tumours were human papillomavirus (HPV) negative. Spindle cell morphology was strongly associated with poor prognosis and with a high risk of lymph node involvement at the time of diagnosis (relative risk 2.26 (95% CI 1.47-3.47)). Five-year disease-specific survival was lower in patients with vs without spindle cell morphology (45.2% vs 79.7%, respectively; P=0.00057).Conclusion:Vulvar spindle cell morphology occurs frequently and seems to develop through the non-HPV pathway. It is associated with a worse prognosis than conventional vulvar squamous cell carcinoma. PMID:24064972

Trietsch, M D; Peters, A A W; Gaarenstroom, K N; van Koningsbrugge, S H L; Ter Haar, N T; Osse, E M; Halbesma, N; Fleuren, G J

2013-09-24

91

Diagnosis of vulvar lesions by non-invasive optical analysis: a pilot study.  

PubMed

A procedure that could allow an early in vivo and non-invasive detection of vulvar lesions would be extremely useful. We tested an innovative optical method (Optiprobe), which uses a harmless, visible light source for the in vivo, on-line detection of minimal alterations in the structure of vulvar epithelium. A group of 3 female volunteers without gynecological symptoms were first screened to evaluate optical properties of normal vulvar tissue. Next, a group of 16 patients undergoing gynecological examination for vulvar lesions was evaluated by the Optiprobe at suspected sites before these sites were biopsied for histological analysis. Adjacent, non-involved sites were also measured to provide internal controls. Histological analysis of the biopsies identified one case that did not show obvious alterations, 4 cases of high-grade vulvar intraepithelial neoplasia (VIN), 5 cases of vulvitis, and 6 cases of lichen sclerosis (LS).The optical properties of the VIN cases were significantly different from those of controls, due to a decrease in the absorption spectra and an increase in the scattering spectra. In contrast, a significant increase in the absorption spectra and a decrease in the scattering spectra were observed in the cases of vulvitis. In the LS cases, the absorption spectra were as in controls, whereas the scattering spectra were significantly decreased. We conclude that the Optiprobe provides a useful tool for a rapid and non-invasive detection of vulvar alterations. The method should contribute to reduce the number of biopsies and to facilitate the long-term follow-up of vulvar lesions. PMID:21139902

Vlastos, Anne-Therese; Charvet, Igor; Dellacasa, Ilaria; Capanna, Federica; Pelte, Marie-Françoise; Thueler, Philippe; Saint-Ghislain, Michel; Depeursinge, Christian; Meda, Paolo

2009-07-22

92

Late onset tongue edema after palatoplasty  

Microsoft Academic Search

Cleft lip palate is a congenital anomaly that requires surgical reconstruction, and patients rarely develop tongue edema after palatoplasty. We describe a 1-year-and-8-month-old boy who underwent palatoplasty for left-sided cleft lip palate accompanied by exudative otitis media. Although previous reports have described that tongue edema usually sets in early after surgery, the symptoms of edema persisted more than 4 hours postoperatively

Mai Mukozawa; Takashi Kono; Shigeki Fujiwara; Ko Takakura

2011-01-01

93

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.

Wenick, Adam S.; Bressler, Neil M.

2012-01-01

94

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

PubMed

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 of this study was to test the hypothesis that of all lesions that have been diagnosed as lichen sclerosus in the past, a part might currently be diagnosed as differentiated VIN, and to identify histopathological differences between lichen sclerosus lesions with and without progression to vulvar squamous cell carcinoma. All lichen sclerosus slides were revised by two expert gynecopathologists and histopathological characteristics were documented. After revision of lichen sclerosus biopsies without progression (n = 61), 58 were reclassified as lichen sclerosus. Revision of lichen sclerosus biopsies with progression yielded concordant diagnoses in 18 of 60 cases (30%). Of 60 lesions, 25 (42%) were reclassified as differentiated VIN. The median time from differentiated VIN to vulvar squamous cell carcinoma was shorter (28 months) than that from lichen sclerosus to vulvar squamous cell carcinoma (84 months) (P < 0.001). Lichen sclerosus that progressed to squamous cell carcinoma, but did not meet the criteria for differentiated VIN, more often showed parakeratosis (P = 0.004), dyskeratosis (P < 0.001), hyperplasia (P = 0.048) and basal cellular atypia (P = 0.009) compared with lichen sclerosus without progression. In conclusion, differentiated VIN diagnosis has been frequently missed and is associated with rapid progression to squamous cell carcinoma. Patients with lichen sclerosus with dyskeratosis and parakeratosis, hyperplasia and/or basal cellular atypia should be kept under close surveillance as these lesions also tend to progress to squamous cell carcinoma. PMID:21057461

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

2010-11-05

95

[Bone marrow edema syndrome (BMES)].  

PubMed

Bone marrow edema (BME) syndrome represents a pathologic accumulation of interstitial fluid in bone - with a traumatic BME being differentiated from a non-traumatic, often ischemic, and a reactive as well as a mechanical BME. Atraumatic/ischemic BME is inconsistently described as a separate entity or as a reversible preliminary stage of osteonecrosis (ON). However, there is always the risk of transformation of BME into ON and subsequent joint destruction. The most common sites of BME are the hip, knee, and ankle. Magnetic resonance imaging is the diagnostic gold standard. Differential diagnoses of the transient BME as osteonecrosis, osteochondrosis dissecans, and a reflex dystrophy should be considered. Conservative or surgical treatment is considered, depending on the etiology of BME. BME syndrome is generally treated conservatively. Infusion of prostacycline or bisphosphonates is a promising option. Ischemic BME and early stages of ON can be successfully treated by core decompression. A combination of both treatment options may also offer advantages. PMID:23460121

Craiovan, B S; Baier, C; Grifka, J; Götz, J; Schaumburger, J; Beckmann, J

2013-03-01

96

Cytotoxic edema: mechanisms of pathological cell swelling  

PubMed Central

Cerebral edema is caused by a variety of pathological conditions that affect the brain. It is associated with two separate pathophysiological processes with distinct molecular and physiological antecedents: those related to cytotoxic (cellular) edema of neurons and astrocytes, and those related to transcapillary flux of Na+ and other ions, water, and serum macromolecules. In this review, the authors focus exclusively on the first of these two processes. Cytotoxic edema results from unchecked or uncompensated influx of cations, mainly Na+, through cation channels. The authors review the different cation channels that have been implicated in the formation of cytotoxic edema of astrocytes and neurons in different pathological states. A better understanding of these molecular mechanisms holds the promise of improved treatments of cerebral edema and of the secondary injury produced by this pathological process.

Liang, Danny; Bhatta, Sergei; Gerzanich, Volodymyr; Simard, J. Marc

2009-01-01

97

Vulvar squamous cell carcinoma associated with Fanconi's anemia.  

PubMed

Fanconi's anemia is a rare autosomal recessive disorder which is rarely associated with squamous cell carcinoma (SCC) of the vulva. We report a 23-year-old virgin female with Fanconi's anemia and diabetes mellitus who presented with a history of 6-month ulcerative lesions of the vulva. Gynecologic examination disclosed a 1 x 2 cm ulcerated tumor lesion at the right labia minor near to the urethra. The biopsy showed a high-grade vulvar intraepithelial neoplasia (VIN III). She underwent wide local excision for this lesion. Pathologic examination of the surgically removed specimen revealed SCC of the vulva. Therefore, radical vulvectomy and bilateral inguino-femoral lymphadenectomy were performed. Due to the involvement of right inguinal lymph node, radiotherapy with a total dose of 45 Gy was delivered to mid-pelvis through antero-posterior/postero-anterior fields with 18 mV photon energies. Until her last follow-up about 1 year after the treatment, the patient was free of disease or any recurrence at the site of operation. Patients with Fanconi's anemia have the risk of developing SCC of the genital tract. Radical vulvectomy and lymphadenectomy along with radiotherapy were associated with a satisfactory outcome in 1-year follow-up period in the presented patient. PMID:20217286

Mousavi, Azamsadat; Abbasi, Fatemeh; Abadi, Akram Ghahghai Nezam; Hashemi, Farnaz Amouzegar

2010-03-10

98

Vulvar Dermatitis From Allergy to Moist Flushable Wipes.  

PubMed

Methylchloroisothiazolinone/methylisothiazolinone is a preservative found in cosmetic and industrial products, and is a common ingredient in moist toilet paper. It is a well-known allergen and is capable of causing allergic contact dermatitis.We present the case of a 58-year-old white woman with a cutaneous vulvar eruption with associated discomfort and pruritus of 6 months in duration. She had been treated with antibiotic and antifungal agents without improvement of symptoms. Careful history taking revealed that the patient was using moist toilet paper. Patch testing confirmed an allergy to methylchloroisothiazolinone, a preservative in the moist toilet paper. After discontinuation of the product and treatment with potent topical steroids, the eruption completely cleared.With the growing use of moist toilet paper among adults, the risk of exposure and potential sensitization is increasing. Health care providers should be aware of the risks of moist toilet paper containing potential allergens because perianal and perineal dermatitis caused by these products may be unrecognized or misdiagnosed. After proper treatment, patients must be educated about alternatives and the importance of label reading. PMID:23760148

Foote, Caitlyn A; Brady, Sean P; Brady, Kimberly L; Clark, Nancy S; Mercurio, Mary Gail

2013-06-11

99

Mitochondrial genotype in vulvar carcinoma - cuckoo in the nest.  

PubMed

Vulvar squamous cell carcinoma (VSCC) is a rare female genital neoplasm. Although numerous molecular changes have been reported in VSCC, biomarkers of clinical relevance are still lacking. On the other hand, there is emerging evidence on the use of mtDNA as a diagnostic tool in oncology. In order to investigate mtDNA status in VSCC patients, haplogroup distribution analysis and D-loop sequencing were performed. The results were compared with available data for the general Polish population, cancer free-centenarians as well as patients with endometrial and head and neck cancer. The obtained data were also compared with the current status of mitochondrial databases. Significant differences in haplogroup distribution between VSCC cohort, general Polish population and cancer-free centenarians cohort were found. Moreover, a correlation between the VSCC patients haplogroup and HPV status was observed. Finally, a specific pattern of mtDNA polymorphisms was found in VSCC. Our results suggest that the mitochondrial genetic background may influence the risk of VSCC occurrence as well as susceptibility to HPV infection. PMID:20825678

Klemba, Aleksandra; Kowalewska, Magdalena; Kukwa, Wojciech; Tonska, Katarzyna; Szybinska, Aleksandra; Mossakowska, Malgorzata; Scinska, Anna; Golik, Pawe?; Koper, Kamil; Radziszewski, Jakub; Kukwa, Andrzej; Czarnecka, Anna M; Bartnik, Ewa

2010-09-08

100

Ploidy in human papillomavirus positive and negative vulvar squamous cell carcinomas and adjacent skin lesions.  

PubMed

To better characterize the two clinicopathologic types of squamous cell carcinoma, human papillomavirus (HPV) positive and negative, and their adjacent skin changes, we performed cytomorphometric analysis on 12 HPV-positive squamous cell carcinomas and adjacent vulvar intraepithelial neoplasia and 22 HPV-negative squamous cell carcinomas and adjacent squamous cell hyperplasia and lichen sclerosis. Our results were that 83% (10 of 12) HPV-positive carcinomas and 78% (7 of 9) adjacent vulvar intraepithelial neoplasia were aneuploid, compared with 59% (13 of 22) HPV-negative carcinomas, 6% (1 of 16) squamous cell hyperplasias and 0% (0 of 20) lichen scleroses. Seventy-five percent (9 of 12) HPV carcinomas and 78% (7 of 9) vulvar intraepithelial neoplasias showed two aneuploid peaks, but no HPV-negative carcinoma or non-neoplastic epithelial lesion showed multiple aneuploid peaks. Fifty percent of squamous cell hyperplasias (8 of 16) and lichen scleroses (10 of 20) adjacent to HPV-negative carcinomas were hypodiploid. The mean DNA indices were: 1.70 for the dominant tumor cell population of HPV-positive carcinoma, 1.64 for the dominant population of vulvar intraepithelial intraepithelial neoplasia, 1.41 for HPV-negative carcinoma, 0.85 for squamous cell hyperplasia and 0.83 for lichen sclerosis. In conclusion, the higher rate of aneuploidy, higher mean DNA index, and presence of multiploid peaks in HPV-positive carcinomas and adjacent vulvar intraepithelial neoplasias compared with the lower rate of aneuploidy, lower mean DNA index, absence of multiploid peaks of HPV-negative carcinomas and tendency to hypodiploidy in squamous cell hyperplasia and lichen sclerosis support the hypothesis that there are two clinicopathologic types of vulvar carcinoma, with different pathogenetic mechanisms. The similarities in ploidy findings between vulvar HPV-positive carcinomas and vulvar intraepithelial neoplasia and those previously published for cervical carcinoma and cervical intraepithelial neoplasia support the view that these two cancers are analogous and have similar pathogenetic mechanisms. The frequent finding of hypodiploidy in squamous cell hyperplasia and lichen sclerosis next to HPV-negative carcinomas requires further investigation of the molecular pathogenesis of this cancer type. PMID:11240765

Scurry, J.; Hung, J.; Flowers, L.; Kneafsay, P.; Gazdar, A.

1999-05-01

101

Approach to leg edema of unclear etiology.  

PubMed

A common challenge for primary care physicians is to determine the cause and find an effective treatment for leg edema of unclear etiology. We were unable to find existing practice guidelines that address this problem in a comprehensive manner. This article provides clinically oriented recommendations for the management of leg edema in adults. We searched on-line resources, textbooks, and MEDLINE (using the MeSH term, "edema") to find clinically relevant articles on leg edema. We then expanded the search by reviewing articles cited in the initial sources. Our goal was to write a brief, focused review that would answer questions about the management of leg edema. We organized the information to make it rapidly accessible to busy clinicians. The most common cause of leg edema in older adults is venous insufficiency. The most common cause in women between menarche and menopause is idiopathic edema, formerly known as "cyclic" edema. A common but under-recognized cause of edema is pulmonary hypertension, which is often associated with sleep apnea. Venous insufficiency is treated with leg elevation, compressive stockings, and sometimes diuretics. The initial treatment of idiopathic edema is spironolactone. Patients who have findings consistent with sleep apnea, such as daytime somnolence, loud [corrected] snoring, or neck circumference >17 inches, should be evaluated for pulmonary hypertension with an echocardiogram. If time is limited, the physician must decide whether the evaluation can be delayed until a later appointment (eg, an asymptomatic patient with chronic bilateral edema) or must be completed at the current visit (eg, a patient with dyspnea or a patient with acute edema [<72 hours]). If the evaluation should be conducted at the current visit, the algorithm shown in Figure 1 could be used as a guide. If the full evaluation could wait for a subsequent visit, the patient should be examined briefly to rule out an obvious systemic cause and basic laboratory tests should be ordered for later review (complete blood count, urinalysis, electrolytes, creatinine, blood sugar, thyroid stimulating hormone, and albumin). PMID:16513903

Ely, John W; Osheroff, Jerome A; Chambliss, M Lee; Ebell, Mark H

102

Vulvar Squamous Cell Carcinoma in Young Women: A Clinicopathologic Study of 21 Cases  

Microsoft Academic Search

Objectives. Invasive squamous cell carcinoma (ISCC) of the vulva occurs most often in older women and the clinical, pathological, and immunohistochemical features of vulvar ISCC in young women are poorly characterized. The aim of this study was to examine clinical and pathological features of ISCC presenting in women younger than 40 years of age.Methods. Patients younger than 40 years of

A. Al-Ghamdi; D. Freedman; D. Miller; C. Poh; M. Rosin; L. Zhang; C. B. Gilks

2002-01-01

103

Subpubic cartilaginous cystic lesion presenting as a vulvar mass: a case report  

PubMed Central

Introduction A subpubic cartilaginous cyst is a rare and innocent defect originating from the symphysis pubis and may present as a vulvar mass and/or chronic abdominal pain. The symphysis pubis is a non-synovial amphiarthrodial joint that forms a fibrocartilaginous union between the two pubic bones and in general lies without mainstream interest, despite its clinical relevance. This case report focuses attention on this joint. Case presentation A 55-year-old Caucasian woman presented with a painful and rapidly increasing vulvar mass. Imaging techniques revealed a cyst-like structure originating from a degenerated symphysis pubis. The cyst was excised, however, recovery was complicated by a symphysiolysis. Conclusion A subpubic cartilaginous cyst is a rare cystic lesion originating from the symphysis of the pubic bone which presents as a vulvar mass which might be complicated by symphysiolysis. Several diseases affect the symphysis pubis and result in significant discomfort and disability in patients. The symphysis pubis is therefore clinically important and should not be omitted in the differential diagnosis of a vulvar mass and/or chronic abdominal pain.

2009-01-01

104

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

105

Extensive pigmented vulvar basal-cell carcinoma presenting as pruritus in an elderly woman.  

PubMed

Basal cell carcinoma (BCC), the most common human cancer, is seldom seen in the genital area. We present a case of an extensive pigmented BCC that developed on the mucosal surface of the vulva of an elderly woman and briefly review the relevant literature on vulvar BCC. PMID:21272499

Kanitakis, Jean; Arbona-Vidal, Elise; Faure, Michel

2011-01-15

106

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.

Halpern, Meredith

1995-01-01

107

Case-control study of vulvar vestibulitis risk associated with genital infections.  

PubMed Central

OBJECTIVE: To evaluate the risk of vulvar vestibulitis syndrome (VVS) associated with genital infections in a case-control study. METHODS: Diagnosed cases with VVS (n = 69) and age-frequency-matched healthy controls (n = 65) were enrolled from gynecology clinics in a university medical hospital during 1999. They were compared for potential risk factors and symptoms of disease. RESULTS: VVS cases had a significantly higher risk of physician-reported bacterial vaginosis (BV) (odds ratio, OR = 9.4), Candida albicans (OR = 5.7), pelvic inflammatory disease (PID) (OR = 11.2), trichomoniasis (OR = 20.6), and vulvar dysplasia (OR = l5.7) but no risk associated with human papillomavirus (HPV), ASCUS, cervical dysplasia, genital warts, chlamydia, genital herpes or gonorrhea. Genital symptoms reported significantly more often with VVS included vulvar burning (91 vs. 12%), dyspareunia (81 vs. 15%), vulvar itching (68 vs. 23%) and dysuria (54 vs. 19%) (p < 0.0001). CONCLUSION: A history of genital infections is associated with an increased risk of VVS. Long-term follow-up case-control studies are needed to elucidate etiologic mechanisms, methods for prevention and effective treatment.

Smith, Elaine M; Ritchie, Justine M; Galask, Rudolph; Pugh, Erica E; Jia, Jian; Ricks-McGillan, Joan

2002-01-01

108

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

109

Is Elective Vulvar Plastic Surgery Ever Warranted, and What Screening Should Be Conducted Preoperatively?  

Microsoft Academic Search

A B S T R A C T Introduction. Elective vulvar plastic surgery was the topic of a heated discussion on the list-serve of the International Society for the Study of Women's Sexual Medicine. At the suggestion of a board member, it was determined that this discussion might of interest to journal readers in the form of a published controversy.

Michael P. Goodman; Gloria Bachmann; Crista Johnson; Jean L. Fourcroy; Andrew Goldstein; Gail Goldstein; Susan Sklar

2007-01-01

110

Vulvar epithelial inclusion cyst as a late complication of childhood female traditional genital surgery  

Microsoft Academic Search

Epithelial inclusion cysts may be a late complication of traditional female genital surgery. We present the case of a 19-year-old Eritrean woman who had been circumcised at birth and sought treatment for an enlarging vulvar mass that arose after the onset of puberty. Symptoms included pain, pruritus, and interference with walking. (Am J Obstet Gynecol 2000;183:509-10.)

Gigi L. Kroll; Leslie Miller

2000-01-01

111

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

112

Angioneurotic edema from an oral contraceptive.  

PubMed

To the editor:--A 29-year-old white woman was seen April 17, 1967, with a severe angioneurotic edema of the face which had developed suddenly. She had taken aspirin for the two previous days and ethynodiol diacetate with mestranol (Ovulen) for 15 days. Treatment with epinephrine and dexamethasone administered parenterally and diphenhydramine orally did not benefit. Oral contraceptive thereapy was discontinued, and the edema subsided five days later. On April 25, she was asymptomatic. Aspirin had produced no ill effect, and oral contraceptive therapy was started again. After four days edema of the uvula and soft palate appeared, and again medication did not give relief. The edema subsided after a few days during which the patient abstained from cosmetics, tooth pastes, and all allergenic dietary items. Later she resumed all foods and contactants, but has taken no oral contraceptives, and has remained asymptomatic. PMID:12254853

Wolf, R L

1967-09-18

113

HEPES prevents edema in rat brain slices  

Microsoft Academic Search

Brain slices gain water when maintained in bicarbonate-buffered artificial cerebro-spinal fluid (ACSF) at 35°C. We previously showed that this edema is linked to glutamate receptor activation and oxidative stress. An additional factor that may contribute to swelling is acidosis, which arises from high CO2 tension in brain slices. To examine the role of acidosis in slice edema, we added N-2-hydroxyethylpiperazine-N?-2-ethanesulfonic

Duncan G. MacGregor; Mitchell Chesler; Margaret E. Rice

2001-01-01

114

Brain edema in diseases of different etiology.  

PubMed

Cerebral edema is a potentially life-threatening complication shared by diseases of different etiology, such as diabetic ketoacidosis, acute liver failure, high altitude exposure, dialysis disequilibrium syndrome, and salicylate intoxication. Pulmonary edema is also habitually present in these disorders, indicating that the microcirculatory disturbance causing edema is not confined to the brain. Both cerebral and pulmonary subclinical edema may be detected before it becomes clinically evident. Available evidence suggests that tissue hypoxia or intracellular acidosis is a commonality occurring in all of these disorders. Tissue ischemia induces physiological compensatory mechanisms to ensure cell oxygenation and carbon dioxide removal from tissues, including hyperventilation, elevation of red blood cell 2,3-bisphosphoglycerate content, and capillary vasodilatation. Clinical, laboratory, and necropsy findings in these diseases confirm the occurrence of low plasma carbon dioxide partial pressure, increased erythrocyte 2,3-bisphosphoglycerate concentration, and capillary vasodilatation with increased vascular permeability in all of them. Baseline tissue hypoxia or intracellular acidosis induced by the disease may further deteriorate when tissue oxygen requirement is no longer matched to oxygen delivery resulting in massive capillary vasodilatation with increased vascular permeability and plasma fluid leakage into the interstitial compartment leading to edema affecting the brain, lung, and other organs. Causative factors involved in the progression from physiological adaptation to devastating clinical edema are not well known and may include uncontrolled disease, malfunctioning adaptive responses, or unknown factors. The role of carbon monoxide and local nitric oxide production influencing tissue oxygenation is unclear. PMID:22579570

Adeva, María M; Souto, Gema; Donapetry, Cristóbal; Portals, Manuel; Rodriguez, Alberto; Lamas, David

2012-05-09

115

Rates of Self-Reported Urinary, Gastrointestinal and Pain Comorbidities in Women with Vulvar Lichen Sclerosus  

PubMed Central

Objective To determine the prevalences of comorbid disorders in women with vulvar lichen sclerosus. Materials and Methods A retrospective review of self-administered questionnaires regarding the health history of 308 women with lichen sclerosus seen at a vulvar clinic between 2006–2011 was performed. Responses to questions about urinary [overactive bladder (OAB), urinary incontinence (UI), stress urinary incontinence (SUI)], gastrointestinal [inflammatory bowel diseases (IBD), constipation, irritable bowel syndrome (IBS)], thyroid dysfunction, and pain [interstitial cystitis (IC), fibromyalgia, temporomandibular joint disorder (TMJ) and vulvar pain] disorders were collected. The percentage of subjects self-reporting each comorbidity was compared to the published prevalence in the general population using a single-value binomial test. Results Subject demographics [data presented as median (minimum, maximum) or percentage]: Age 56.4 years (20.0, 92.5), BMI 27.5 kg/m2 (17.4, 53.1), Parity 2 (0, 10), Caucasian 92.9%, Biopsy proven 65.6%. Prevalences of self-reported comorbidities in our subjects are: OAB 15.3%, UI 38.6%, SUI 27.9%, IBD 1.9%, Constipation 32.5%, IBS 19.5%, Thyroid dysfunction 33.1%, IC 2.6%, Fibromyalgia 9.1%, TMJ 13.0%, Vulvar pain 83.1%. The prevalence of each disorder is significantly different than that in the general population, with all p values ? 0.02. Conclusions Vulvar lichen sclerosus is associated with numerous bladder, bowel, and pain comorbidities. The prevalences of all of these disorders are higher in our subjects than the general population except OAB, which we find at approximately 1/3 that of the general population. Patients with lichen sclerosus should be screened for comorbidities that may affect their health and/or quality of life.

Berger, Mitchell B.; Damico, Nicholas J.; Menees, Stacy B.; Fenner, Dee E.; Haefner, Hope K.

2012-01-01

116

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

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

2001-01-01

117

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

118

Single Large Inguinal Lymph Node Metastasis in Human Papillomavirus-Induced Early Invasive Vulvar Cancer of the Anterior Fourchette in Two Young Women  

Microsoft Academic Search

The incidence of human papillomavirus (HPV)-induced vulvar cancer in young women is increasing and often presents as microinvasive or early invasive tumors in a grade 3 vulvar intraepithelial neoplasia. So far, the risk of lymph node metastases in early invasive vulvar carcinoma (depth of invasion 1.1–2.0 mm) is reported to be less than 8%. We present 2 cases of young

Monika Hampl; Volkmar Kueppers; Hans Georg Bender

2009-01-01

119

International brain edema symposia 1967-2011.  

PubMed

This is a brief review of previous international brain edema symposia. The symposia that took place from 1965 to 1999 were summarized by Igor Klatzo and A. Marmarou in the proceedings Brain Edema XI [1]. In this article the author summarized the symposia, including latest five. Images from previous symposia such as the cover pages of the proceedings and snapshots of organizers were included. The outline and key words of the symposia were summarized in tables. The name of the prize winner and the title of the memorial lectures in recent symposia were also summarized in a table. PMID:23564096

Kuroiwa, Toshihiko

2013-01-01

120

Primary treatment of diabetic macular edema  

PubMed Central

Diabetic macular edema (DME) is a leading cause of vision loss in older Americans. Thermal laser treatment remains the mainstay of treatment for DME. Recently, alternative primary treatments for DME have been evaluated. These treatments include intravitreal injections of steroids as well as pharmaceuticals containing antibodies against vascular endothelial growth factor (VEGF). Surgical treatment has been shown to be appropriate in selected cases. We review the evidence and scientific rationale for various primary treatment options in patients with DME. Regular and timely ophthalmologic evaluation remains crucial to recognition and treatment of macular edema in diabetic patients.

Ranchod, Tushar M; Fine, Stuart L

2009-01-01

121

Differentiated (simplex) vulvar intraepithelial neoplasia: a case report and review of the literature.  

PubMed

Differentiated (simplex) vulvar intraepithelial neoplasia (VIN) is an uncommon variant of VIN characterized by highly differentiated morphology, making it a potential diagnostic pitfall. It may arise in the background of lichen sclerosus, and unlike most VIN, is not causally associated with human papilloma virus infection. It occurs in an older demographic and is thought to be the precursor of aggressive, invasive vulvar squamous cell carcinoma. For this reason, the timely and accurate diagnosis of this unusual lesion is crucial. The clinical and histologic features of a case of a 70-year-old woman with newly diagnosed differentiated (simplex) VIN arising in a background of long-standing lichen sclerosus is reported, and the historic aspects, current terminology, and diagnostic criteria of differentiated (simplex) VIN are reviewed. PMID:21522046

Taube, Janis M; Badger, Joanna; Kong, Christina S; Dadras, Soheil S

2011-05-01

122

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.

Ozmen, Evrim; Guney, Guven; Algin, Oktay

2013-01-01

123

Prognostic significance of lymph node variables and human papillomavirus DNA in invasive vulvar carcinoma  

Microsoft Academic Search

Objective. The present study investigates the influence of lymph node pathological features and HPV DNA status on the prognosis of vulvar invasive tumors.Methods. This study includes 184 consecutive cases of primary invasive squamous cell carcinoma of the vulva treated by radical surgery from 1975 to 1992, in São Paulo, Brazil. Clinical follow-up data was collected from patient files and hematoxilin–eosin

Álvaro P Pinto; Nicolas F. Schlecht; Javier Pintos; Jane Kaiano; Eduardo L. Franco; Christopher P. Crum; Luisa L. Villac

2004-01-01

124

Preoperative chemoradiation for advanced vulvar cancer: a phase II study of the Gynecologic Oncology Group  

Microsoft Academic Search

Purpose: To determine the feasibility of using preoperative chemoradiotherapy to avert the need for more radical surgery for patients with T3 primary tumors, or the need for pelvic exenteration for patients with T4 primary tumors, not amenable to resection by standard radical vulvectomy.Methods and Materials: Seventy-three evaluable patients with clinical Stage III–IV squamous cell vulvar carcinoma were enrolled in this

David H Moore; Gillian M Thomas; Gustavo S Montana; Angelika Saxer; Donald G Gallup; George Olt

1998-01-01

125

Clobetasol dipropionate 0.05% versus testosterone propionate 2% topical application for severe vulvar lichen sclerosus  

Microsoft Academic Search

OBJECTIVE: Our goal was to evaluate short-term (3 months) and long-term (1 year) treatment of vulvar lichen sclerosus, by comparing topical application of testosterone propionate 2% in petrolatum with the corticosteroid clobetasol dipropionate 0.05%. STUDY DESIGN: There were 20 women in each treatment group. The patients' symptoms and the gynecologist's examination findings were recorded before treatment, at 3 months, and

Jacob Bornstein; Sigal Heifetz; Yehudith Kellner; Zmira Stolar; Haim Abramovici

1998-01-01

126

Vaginal microbiological flora, and behavioural and clinical findings in women with vulvar pain  

Microsoft Academic Search

Objective To study genital symptoms and signs in women with vulvar pain, and the association with potential risk factors such as microbiological agents, sexual behaviour and genital hygiene.Design Prospective cohort study of apparently healthy women attending for contraceptive advice.Setting Two family planning clinics and one youth clinic in Sweden.Population Out of 996 women recruited, 79 women (7.9%) had, on request,

Krasimira Tchoudomirova; Per-Anders Mårdh; Dan Hellberg

2001-01-01

127

Patterns of allelic loss (LOH) in vulvar squamous carcinomas and adjacent noninvasive epithelia.  

PubMed Central

The pathogenesis of carcinoma of the vulva is diverse and includes both human papilloma virus (HPV)-positive and HPV-negative pathways. The objective of this study was to correlate the morphology with patterns of loss of heterozygosity (LOH) within four vulvar carcinomas and in adjacent vulvar epithelia. Tumors were categorized as HPV positive or negative by polymerase chain reaction (PCR) analysis. Forty-one different sites of normal squamous mucosa, hyperplasia, vulvar intraepithelial neoplasia (VIN), and carcinoma were microdissected in duplicate, and each extracted DNA was analyzed in duplicate for LOH at 10 chromosomal loci by PCR and polyacrylamide gel electrophoresis. Patterns of LOH were compared within different sites of tumors and between the tumor and the noninvasive epithelia. Of three tumors with multiple invasive foci analyzed, divergent patterns of LOH were identified in two, correlating in one with differences in tumor grade. In one HPV-16-positive case, multiple sites of VIN displayed heterogeneity for LOH consistent with divergent clonal or subclonal populations, some of which were not shared by the tumor. In one HPV-negative case, LOH was found in foci of hyperplasia and differentiated VIN (atypical hyperplasia), the latter sharing LOH with the invasive carcinoma at some but not all chromosomal loci. This study suggests that a genetic relationship exists between VIN and carcinoma, irrespective of HPV involvement. It also suggests that in HPV-negative tumors, allelic loss may predate the onset of invasive carcinoma and, in some cases, cellular atypia (VIN). However, the divergent patterns of LOH observed imply that many genetic alterations in the adjacent vulvar epithelium are not directly related to the invasive carcinoma. Images Figure 1 Figure 2 Figure 3 Figure 4

Lin, M. C.; Mutter, G. L.; Trivijisilp, P.; Boynton, K. A.; Sun, D.; Crum, C. P.

1998-01-01

128

Comportamiento del cáncer de vulva durante 16 años en el Instituto Nacional de Cancerología (Colombia) Behavior of Vulvar Cancer over a 16-year Period at the National Cancer Institute (Colombia)  

Microsoft Academic Search

Objective: To describe patient mortality among patients with vulvar cancer at the National Cancer Institute of Colombia (INC). Materials and Methods: Retrospective cohort study among vulvar cancer patients at the INC from 1990-2006. Survival estimated by Kaplan-Meyer; comparison with logarithmic trial rankings. Results: 303 patients were diagnosed with vulvar cancer, including. One hundred and ninety cases fulfilled inclusion criteria. Average

Mónica Medina; Ricardo Sánchez; Natascha Ortíz; Alexánder Rodríguez; Simón Oróstegui

129

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.

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

2013-01-01

130

Relationship between gonadal steroid hormones and vulvar bleeding in southern tamandua, Tamandua tetradactyla.  

PubMed

This study aimed at demonstrating the profiles of circulating gonadal steroid hormones during the estrous cycle and pregnancy in a southern tamandua (Tamandua tetradactyla). Additionally, this study clarified the relationship between vulvar bleeding and hormonal changes. The concentrations of serum progesterone (P(4)) and estradiol-17? (E(2)) were determined by enzyme immunoassays. Serum P(4) and E(2) concentrations changed cyclically and the estrous cycle length (± SD) based on the E(2) cycles was 44.3 ± 4.5 days. Vulvar bleeding started to be seen at the decreasing of P(4). The cycle length for vulvar bleeding was 43.3 ± 4.2 days. Interval from the first day of bleeding to the peak of E(2) concentration was 23.1 ± 3.1 days. Serum P(4) during pregnancy remained high and E(2) increased 8 weeks after conception and remained high until parturition. The female delivered normally after a 165 day-pregnancy period and reared the offspring well. Approximately 3 weeks after parturition, serum E(2) and P(4) cycles resumed. Visual bleeding may be useful as a real-time indicator for understanding the ovarian cycle of southern tamanduas, and estrus could be expected approximately 3 weeks after the first bleeding. PMID:21462248

Kusuda, Satoshi; Endoh, Tomoko; Tanaka, Hiroyuki; Adachi, Itsuki; Doi, Osamu; Kimura, Junpei

131

[Vulvar lichen sclerosus. The importance of early clinical and histological diagnosis].  

PubMed

Vulvar lichen sclerosus (LS) is a chronic progressive skin disease of unclear etiology. It is often overlooked in early stages, but progresses to destructive atrophy and is associated with an increased risk of vulvar squamous cell carcinoma. The classical symptoms are pruritus and pain, but they are often not distinctive, so that unclear vulvar problems often lead to a biopsy. The histological picture of early LS is quite different from that of late LS with an atrophic epidermis, markedly sclerotic dermis and stiff dilated vessels. The epidermis in early LS is usually normal with only minor irregularities in the rete pattern. The basement membrane is normal or focally widened, while the edematous dermis has only scattered ectatic vessels. The often dense lichenoid and intraepidermal infiltrate explains the spongiosis and vacuolization of the basal layer keratinocytes. Very early cases may only have a sparse lymphocytic infiltrate and hyper-/parakeratosis of the follicular ostia. Early topical therapy can dampen the progression to atrophic, irreversible LS. PMID:14968326

Regauer, S; Liegl, B; Reich, O; Pickel, H; Beham-Schmid, C

2004-02-01

132

Implication of human papillomavirus-66 in vulvar carcinoma: a case report  

PubMed Central

Introduction Vulvar cancer in older women is seldom associated with human papillomavirus infection. Case presentation We present the case of an 80-year-old Greek Caucasian woman with an undetermined obstetric and gynecologic history. The patient underwent radical vulvectomy and bilateral inguinal lymphadenectomy for a vulvar carcinoma. A human papillomavirus infection was suggested on the basis of histological and cytological examinations followed by human papillomavirus DNA typing, which revealed the presence of human papillomavirus-66. Conclusion Even though human papillomavirus-16 and human papillomavirus-18 are most frequently implicated in the pathogenesis of vulvar carcinoma, human papillomavirus-66 can also be regarded as a causative factor. Suspicious lesions should be biopsied, and in the presence of carcinoma, vulvectomy with bilateral lymphadenectomy, if necessary, must be performed. Furthermore, polymerase chain reaction assay analysis with clinical arrays in cytological samples is an accurate test for the detection of a wide range of human papillomavirus genotypes and can be used to verify the infection and specify the human papillomavirus type implicated.

2011-01-01

133

Pidotimod in the management of vulvar papillomatosis: double-blind clinical trial versus placebo.  

PubMed

To investigate whether the immune system improvement induced by pidotimod increases the rate of spontaneous disappearance of vulvar papillomatous lesions, a multicenter, double-blind, placebo-controlled, randomized clinical trial was performed. Forty-nine patients (23 in the pidotimod group and 26 in the placebo group) with first diagnosis of vulvar papillomatosis as shown by clinical and histological findings underwent 90-day treatment with oral 800-mg pidotimod once a day or identical placebo. The main outcome measure was the difference between vulvar papillomatous infected area before and after treatment judged by the following: complete regression (complete disappearance of all papillomatous lesions); partial regression (a decrease of at least 75% of the infected area); no response (a decrease of less than 75% of the infected area or new viral lesions not present at baseline). Forty patients completed the trial according to the study protocol and were entered in the "per protocol" analysis of efficacy. Complete regression was observed in 12 of 18 patients (66.7%) receiving pidotimod compared with 7 of 22 patients (31.8%) receiving placebo. The total infected surface area at the end of treatment was 10.1 +/- 18.5 mm2 (mean +/- SD) in the pidotimod arm and 198.3 +/- 399.2 mm2 in the placebo arm (p < 0.05 between treatment). Notwithstanding the fact that better results were obtained in the pidotimod group, more data are needed to confirm our encouraging results. PMID:10099052

Guerra, B; Perino, A; Polatti, F; Scala, M

1998-05-01

134

Influence of treatments on prognosis for vulvar lichen sclerosus: Facts and controversies.  

PubMed

Lichen sclerosus (LS) is an inflammatory dermatosis with a predilection for the anogential skin. Vulvar LS can be a debilitating disease, causing pruritus and pain, and it carries the potential for atrophy, scarring, and significant functional impairment. Recently, many advances have been made regarding the etiology and natural history of the disease process; however, much debate still exists regarding the most advantageous medical and surgical management of this disorder. In an effort to provide a comprehensive review on current vulvar LS literature, the following three controversies will be discussed: (1) optimal disease treatment, (2) theories behind LS's oncogenicity and treatments for minimizing malignancy, and (3) the value of surgical treatment for LS. Ultra-potent topical corticosteroids (TCSs) are the first-line treatment for vulvar LS, while topical calcineurin inhibitors (TCIs) remain second-line agents for patients for whom TCS treatment resulted in incomplete resolution of symptoms or adverse events. Due to the relapsing nature of the disease, long-term maintenance therapy is often required. In addition, recent advances have contributed to the understanding of the association between LS and squamous cell carcinoma (SCC). While the exact mechanism responsible for LS-associated SCC is not known, immune dysregulation and inflammation may play an important role; therefore, successful treatment of LS should be directed towards alleviation of symptoms and reversal of the underlying histopathologic changes. Patients with LS-associated malignancy, as well as patients who need correction of functionally restrictive, scarring processes, can successfully undergo surgical intervention with tissue conservation. PMID:24160287

Brodrick, Brooks; Belkin, Zoe R; Goldstein, Andrew T

135

Steroids and the Management of Macular Edema  

Microsoft Academic Search

Macular edema (ME) is a condition which is usually secondary to an underlying disease process. It is most commonly seen following venous occlusive disease, diabetic retinopathy and posterior segment inflammatory disease. The treatment of ME varies, depending upon the underlying etiology, and has led to varying degrees of success. Traditionally, the main treatment options have included topical and systemic steroids,

Shani Golan; Anat Loewenstein

2010-01-01

136

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.

Romero-Aroca, Pedro

2013-01-01

137

Intraoperative solumedrol helps prevent postpneumonectomy pulmonary edema  

Microsoft Academic Search

BackgroundPostpneumonectomy pulmonary edema and pneumonia are life threatening and seemingly unavoidable complications after pneumonectomy. We theorized that an intraoperative dose of intravenous steroids (as a prophylactic measure to reduce pulmonary injury to the remaining lung) just before pulmonary artery ligation might decrease this problem.

Robert J Cerfolio; Ayesha S Bryant; John S Thurber; Cynthia Sales Bass; William A Lell; Alfred A Bartolucci

2003-01-01

138

Clinical management of hydrogel-induced edema.  

PubMed

Clinical techniques and guidelines are discussed to manage manifestations of edema induced by hydrogels. Emphasis is on the pathogenesis of folds in Descemet's membrane (striate keratopathy) accompanying vertical striae that have been found to occur horizontally as well as vertically. PMID:984176

Kame, R T

1976-09-01

139

Interobserver Agreement for Assessing Invasion in Stage 1A Vulvar Squamous Cell Carcinoma.  

PubMed

Invasive squamous cell carcinoma of the vulva with ?1 mm stromal invasion is classified as stage 1A. Cancer staging systems state that the depth of invasion should be measured from the epithelial-stromal junction of the adjacent most superficial dermal papilla to the deepest point of the invasive tumor. Measurement of the depth of invasion guides patient management. Even though this measurement is critical, no studies have reported the reliability among pathologists for determining the cutoff point of ?1 mm stromal invasion in vulvar cancer. We assessed agreement among pathologists for determining whether a vulvar tumor is invasive, for the depth of invasion, and for tumor thickness. Forty-five cases of vulvar squamous cell carcinoma with a depth of invasion of ?5 mm were chosen. Eleven gynecologic pathologists independently reviewed the slides and, for a subset of cases, pictorially recorded measurements on photographs. The number of cases that were reported as invasive by the 11 pathologists ranged from 21 to 44. The number of cases that were reported as showing a depth of invasion of ?1 mm ranged from 7 to 27. Eight pathologists provided measurements for all lesions reported as invasive, the remaining 3 pathologists stated that they were unable to measure 2, 7, and 16 lesions, respectively. Mean ? for diagnosing vulvar carcinoma as invasive was 0.24 and for measuring the depth of invasion and thickness was 0.51 and 0.49, respectively. There was only fair agreement in determining whether the lesion was invasive. In cases in which pathologists agreed upon the diagnosis of invasion, agreement on depth was moderate. When using the recommended cancer staging method, interpretation of the location of the most superficial dermal papilla varied among pathologists. Measuring thickness did not improve agreement. This is the first study that has assessed the reliability of the diagnosis of invasion in vulvar cancer among gynecologic pathologists, the interobserver agreement for reporting the critical 1 mm threshold of depth of stromal invasion, and the way in which the International Federation of Gynecology and Obstetrics method is used by pathologists. PMID:24076774

Abdel-Mesih, Amal; Daya, Dean; Onuma, Kazu; Sur, Monalisa; Tang, Shangguo; Akhtar-Danesh, Noori; Boutross-Tadross, Odette; Ceballos, Kathy M; Chapman, William; Colgan, Terence; Deb, Pratima; Nucci, Marisa R; Oliva, Esther; Lytwyn, Alice

2013-09-01

140

Periorbital edema as initial manifestation of chronic cutaneous lupus erythematosus  

PubMed Central

Periorbital edema occurs frequently in dermatomyositis, but it has rarely been noted in systemic systemic lupus erythematosus. We describe a patient who developed bilateral periorbital edema and erythema as the sole manifestation of systemic lupus erythematosus.

Erras, Samar; Benjilali, Laila; Essaadouni, Lamiaa

2012-01-01

141

Intravitreal Cortisone Injection for Refractory Diffuse Diabetic Macular Edema  

Microsoft Academic Search

Purpose: The purpose of this study was to evaluate the safety and efficacy of intravitreal triamcinolone acetonide injection in patients with diffuse diabetic macular edema. We also compared the effect of intravitreal triamcinolone with macular grid laser photocoagulation in macular edema. Patients and Methods: Thirty patients with diabetic diffuse macular edema unresponsive to grid laser photocoagulation for at least 4

Hamdi Er

2005-01-01

142

Localization of dermal edema in lipodermatosclerosis, lymphedema, and cardiac insufficiency  

Microsoft Academic Search

Background: Chronic edema in venous insufficiency is associated with leg ulceration, whereas in lymphedema skin ulceration is less frequent and edema from cardiac failure does not cause major skin changes. The reason for these differences is unclear.Objective: Our purpose was to investigate, by means of ultrasound, the distribution of intradermal fluid in patients with edema associated with lipodermatosclerosis, lymphedema, or

Monika Gniadecka

1996-01-01

143

Optical Coherence Tomographic Findings in Berlin's Edema  

PubMed Central

Purpose To describe optical coherence tomography (OCT) findings in a patient with Berlin’s edema following blunt ocular trauma. Case Report A 26-year-old man presented with acute loss of vision in his left eye following blunt trauma. He underwent a complete ophthalmologic examination and OCT. Fundus examination revealed abnormal yellow discoloration in the macula. OCT disclosed thickening of outer retinal structures and increased reflectivity in the area of photoreceptor outer segments with preservation of inner retinal architecture. Re-examination was conducted one month later at the time which OCT changes resolved leading to a surprisingly normal appearance. Conclusion OCT can be a useful tool in the diagnosis and follow-up of eyes with Berlin’s edema and may reveal ultrastructural macular changes.

El Matri, Leila; Chebil, Ahmed; Kort, Fedra; Bouraoui, Rym; Largueche, Leila; Mghaieth, Fatma

2010-01-01

144

Osmotherapy in brain edema: a questionable therapy.  

PubMed

Despite the fact that it has been used since the 1960s in diseases associated with brain edema and has been investigated in >150 publications on head injury, very little has been published on the outcome of osmotherapy. We can only speculate whether osmotherapy improves outcome, has no effect on outcome, or leads to worse outcome. Here we describe the action and potentially beneficial and adverse effects of the 2 most commonly used osmotic solutions, mannitol and hypertonic saline, and present some critical aspects of their use. There is a well-documented transient intracranial pressure (ICP)-reducing effect of osmotherapy, but an adverse rebound increase in ICP after its withdrawal has been discussed extensively in the literature and is an expected pathophysiological phenomenon. From side effects related to renal and pulmonary failure, electrolyte disturbances, and a rebound increase in ICP, osmotherapy can be negative for outcome, which may explain why we lack scientific support for its use. These drawbacks, and the fact that the most recent Cochrane meta-analyses of osmotherapy in brain edema and stroke could not find any beneficial effects on outcome, make routine use of osmotherapy in brain edema doubtful. Nevertheless, the use of osmotherapy as a temporary measure may be justified to acutely prevent brain stem compression until other measures, such as evacuation of space-occupying lesions or decompressive craniotomy, can be performed. This article is the Con part in a Pro-Con debate in the present journal on the general routine use of osmotherapy in brain edema. PMID:22955195

Grände, Per-Olof; Romner, Bertil

2012-10-01

145

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

146

Itch and burning pain in women with partial vaginismus with or without vulvar vestibulitis.  

PubMed

Fifty-three women with partial vaginismus with or without vulvar vestibulitis and 27 asymptomatic women estimated sensations of burning pain and itch at 20 standardized moments during a standardized penetration situation, including vaginal muscle contractions. Forty-three women with partial vaginismus (81.1%) reported burning pain, 23 (43.4%) itch, and 22 (41.5%) both complaints, compared to 0% of the asymptomatic women. In 17 of 22 cases, burning pain preceded the appearance of itch and in four cases the two complaints coincided. The median time from the moment when burning pain started until itch appeared was 150 seconds. PMID:17365516

Engman, Maria; Wijma, Klaas; Wijma, Barbro

147

Case report: vulvar lichen sclerosus in a premenarchal girl with a complicated biopsy.  

PubMed

Lichen sclerosus is a T-lymphocyte mediated chronic cutaneous disorder with predilection for the vulva. In prepubertal girls, lichen sclerosus presents as vulvar discomfort, pruritus, bruising/bleeding, discharge, dysuria, or painful defecation. Diagnosis and treatment of lichen sclerosus is of utmost importance in the prevention of complications such as scarring, adhesions, atrophy, or long-term sexual dysfunction. We discuss a case of a 4-year-old female with an atypical presentation of genital lichen sclerosus and a complicated biopsy. PMID:19706110

Yousefi, Morvarid; Pride, Howard; Elston, Dirk

148

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

149

Vulvodynia in Arkansas: a survey of Arkansas gynecologists' practice experience and management of vulvar pain.  

PubMed

The objective of this survey was to determine the level of experience OB/GYN (Obstetrics & Gynecology) physicians in the state of Arkansas have in seeing and managing patients with vulvar pain, commonly known as vulvodynia. The 8 question, anonymous survey was mailed to Arkansas OB/GYN physicians. The survey assessed the experience of the providers, the age range of their patients, and whether or not they treat and/or refer. Thirty of 182 surveys were returned for a rate of 16.4%. The survey revealed that physicians are moderately comfortable treating vulvodynia within their practice and refer mostly for treatment failure. PMID:23540096

Phillips, Amy M; Large, Erin; Bird, T Mac; Hitt, W C; Eastham, Donna G; Pulley, Leavonne; Hutchins, David A

2013-03-01

150

Advanced vulvar apocrine carcinoma expressing estrogen receptors that responds to tamoxifen therapy.  

PubMed

Primary vulvar carcinoma is rare and thought to arise from either anogenital mammary-like glands or native apocrine sweat glands. The diagnosis is predominantly based on tumor morphology with supportive evidence from immunohistochemical staining and exclusion of a primary breast carcinoma. The primary modality of treatment is surgery, while optimal managment of advanced disease is unclear. We present the case of a lady who had metastatic recurrent apocrine carcinoma expressing estrogen receptors, who had a complete response assessed by PET-CT scanning after 7 months of tamoxifen therapy. The report includes a discussion of the histological diagnosis and assessment of response to treatment by PET-CT scanning. PMID:23030494

Goldstein, Robert; Stefanato, Catherine M; Warbey, Victoria; Harries, Mark

2012-09-01

151

Proton nuclear magnetic resonance studies on brain edema.  

PubMed

The water in normal and edematous brain tissues of rats was studied by the pulse nuclear magnetic resonance (NMR) technique, measuring the longitudinal relaxation time (T1) and the transverse relaxation time (T2). In the normal brain, T1 and T2 were single components, both shorter than in pure water. Prolongation and separation of T2 into two components, one fast and one slow, were the characteristic findings in brain edema induced by both cold injury and triethyl tin (TET), although some differences between the two types of edema existed in the content of the lesion and in the degree of changes in T1 and T2 values. Quantitative analysis of T1 and T2 values in their time course relating to water content demonstrated that prolongation of T1 referred to the volume of increased water in tissues examined, and that two phases of T2 reflected the distribution and the content of the edema fluid. From the analysis of the slow component of T2 versus water content during edema formation, it was demonstrated that the increase in edema fluid was steady, and its content was constant during formation of TET-induced edema. On the contrary, during the formation of cold-injury edema, water-rich edema fluid increased during the initial few hours, and protein-rich edema fluid increased thereafter. It was concluded that proton NMR relaxation time measurements may provide new understanding in the field of brain edema research. PMID:6281400

Naruse, S; Horikawa, Y; Tanaka, C; Hirakawa, K; Nishikawa, H; Yoshizaki, K

1982-06-01

152

Lymphoscintigraphy in the evaluation of limb edema.  

PubMed

Lymphedema is a chronic condition caused by ineffective lymphatic transport that results in edema and skin damage. Distinguishing lymphedema from other causes can be difficult. Lymphoscintigraphy is a simple and noninvasive functional test for the evaluation of the lymphatic system. Technetium-labeled sulfur colloid is injected intradermally at the interdigital web spaces of the upper/lower limbs. Once injected, the radiolabeled colloid particles travel through the superficial lymphatic channels. Thus, their lymphatic transport is monitored with dual-head gamma camera. The typical patterns of upper and lower limb lymphedema on lymphoscintigraphy are summarized in this section. PMID:24089069

Sundaram, P Shanmuga; Subramanyam, Padma

2013-11-01

153

Pure vulvar Langerhans cell histiocytosis: a case report and literature review.  

PubMed

Langerhans cell histiocytosis (LCH) of the female genital tract is a very rare disease. Only 16 cases of primary vulvar LCH without subsequent systemic spread of disease have previously been published in the literature. We describe an additional case of LCH in which the lesion was confined to the vulva. A 52-year-old Caucasian woman presented for further investigation with a 6-month history of vulvar pruritus. Physical examination revealed multiple fine red papules on both labia minor. A metastatic workup did not reveal any evidence of disease beyond the vulva. The lesion was biopsied, and histological findings were characteristic of LCH. The patient was treated by local extirpation of both labia minor. Ten months after surgery, the patient has no signs of local recurrence or systemic spread. It is necessary to perform a biopsy of the lesions when a woman presents atypical chronic lesions on the vulva. Although different treatment has been proposed, complete surgical excision is fundamental in "pure" genital Langerhans cell histiocytosis as initial therapy. PMID:20099508

Triantafyllidou, O; Giannakopoulos, K; Pergialiotis, V; Simou, M; Lagkadas, A; Alexandrou, P

2009-01-01

154

Multiple primary tumours in women with vulvar neoplasms: a case-control study.  

PubMed

We sought to determine whether women with in situ or invasive squamous cell vulvar cancer were more likely than other women to have had a previous or concurrent tumour at other anogenital sites. One hundred and fifty-eight women with vulvar cancer were identified who were first diagnosed during 1980-1985, were ages 18-79 years at that time, and were residents of one of three counties in western Washington. Two control groups were selected: (1) from records of hospital pathology departments, a sample of 113 women with certain benign conditions of the vulva; (2) through random digit dialing, a sample of 212 women from the general population of these counties. Information on a history of other cancers, and on sexual, reproductive, medical, and demographic characteristics was collected from cases and controls in at-home interviews. Cases were more likely to report a history of other anogenital cancers than were controls, with relative risks of 3.5-29.8, depending on the type of case group and type of control. These associations were not explained by case-control differences in demographic characteristics or frequency of cervical screening. On the other hand, prior or concurrent non-anogenital cancers were equally common in cases and controls. These results support the hypothesis that the different anogenital cancers have at least one aetiology in common. PMID:3390379

Sherman, K J; Daling, J R; Chu, J; McKnight, B; Weiss, N S

1988-04-01

155

Study of the vulvar skin in healthy Japanese women: components of the stratum corneum and microbes.  

PubMed

Background? Although the physiological conditions of vulvar skin in Caucasian populations have been characterized, little is known about these conditions in Japanese women. Methods? Skin of the labia, groin, mons pubis, and inner thigh was examined in 40 healthy Japanese women outwith their menstrual period. Skin moisture, skin pH, ceramide content and inflammatory cytokine proteins of the stratum corneum, and bacterial flora were assessed. Results  Skin moisture was found to be significantly lower in the labia than at the other three sites examined. No differences were found in skin pH. A significant difference in ceramide content was observed between the groin and inner thigh. The ratio of interleukin-1? (IL-1?) and interleukin-1? receptor antagonist (IL-1Ra) was significantly higher in the labia than in the other sites. Numbers of total bacteria, Staphylococcus epidermis, and Lactobacillus spp. were greater in the labia and mons pubis sites compared with the inner thigh. Prevotella spp. were found only in the labia. Conclusions? In Japanese women, the skin at the labia is drier and more inflammatory than the skin at the groin, mons pubis, and inner thigh; this cannot be explained by the ceramide content and/or pH of the stratum corneum. Prevotella spp. may perform a key role in the vulvar skin of Japanese women. PMID:23228142

Miyamoto, Toshinobu; Akiba, Syunichi; Sato, Noriko; Fujimura, Tsutomu; Takagi, Yutaka; Kitahara, Takashi; Takema, Yoshinori; Iizuka, Hajime; Sengoku, Kazuo

2012-12-11

156

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

157

Cerebral edema associated with Gliadel wafers: Two case studies  

PubMed Central

While the introduction of carmustine wafers (Gliadel wafers) into the tumor resection cavity has been shown to be a beneficial therapy for malignant glioma, it is recognized that clinically significant cerebral edema is a potential adverse effect. Following are two clinical case reports demonstrating profound cerebral edema associated with implantation of Gliadel wafers. As a result, one of these individuals had premature death. A brief literature review is provided to assist in explaining the mechanisms by which clinically significant cerebral edema may develop.

Weber, Emil L.; Goebel, Eric A.

2005-01-01

158

Genetic variation in CD83 and risks of cervical and vulvar cancers: A population-based case-control study  

PubMed Central

Objectives The CD83 glycoprotein is a marker of dendritic cell maturation that may contribute to the T cell response to oncogenic human papillomavirus (HPV) infection. Whether single nucleotide polymorphisms (SNPs) in CD83 influence the risk of HPV-related genital cancers has not been adequately studied. We investigated whether the common genetic variation of the CD83 region was associated with the risks of cervical and vulvar cancers in a population-based case–control study conducted in the Seattle-Puget Sound Region. Methods A total of 17 tagSNPs were genotyped in the CD83 region of 886 cervical cases, 517 vulvar cases and 1100 controls. Odds ratio (OR) and 95% confidence intervals (CI) were computed to assess the risk of cervical and vulvar cancers. The interaction between the tagSNPs and cigarette smoking was also explored. Results TagSNPs in the CD83 chromosomal region were not associated with risk of either cervical or vulvar cancer. TagSNP rs853360 was associated with a decreased risk of cervical squamous cell carcinoma (SCC) (OR = 0.80; 95% CI: 0.66–0.98). Conclusions Our results do not suggest that the common genetic variation of CD83 is related to cervical or vulvar cancers. The association between tagSNP rs853360 and risk of cervical SCC is likely to be due to chance. If larger or pooled studies confirm our results, CD83 has little or no influence in the risk of HPV-related cancers.

Bodelon, Clara; Madeleine, Margaret M.; Johnson, Lisa G.; Du, Qin; Malkki, Mari; Petersdorf, Effie W.; Schwartz, Stephen M.

2013-01-01

159

Effects of vasodilators on fibrin-induced pulmonary edema, so-called neurogenic pulmonary edema, in the rat  

Microsoft Academic Search

The present study was undertaken to evaluate the effects of vasodilators on the development of neurogenic pulmonary edema.\\u000a Pulmonary edema was induced by injecting fibrinogen and thrombin into the cisterna magna of vagotomized rats (fibrin-induced\\u000a pulmonary edema). Before the intrathecal injections, rats were pretreated with intravenous injection of one of the following\\u000a vasodilators: phentolamine, isoproterenol, nifedipine, diltiazem, isosorbide dinitrate, or

Kimitoshi Nishiwaki; Akiko Hirabayashi; Yasuhiro Shimada; Naohisa Ishikawa

1994-01-01

160

Overexpression of carbonic anhydrase IX (CAIX) in vulvar cancer is associated with tumor progression and development of locoregional lymph node metastases  

Microsoft Academic Search

Carbonic anhydrase IX (CAIX) is a strictly membranous expressed metalloenzyme involved in cell adhesion, pH homeostasis, and\\u000a cancer progression. The protein is specifically overexpressed in a wide variety of malignant tumors. This study was designed\\u000a to assess the role of CAIX in primary vulvar cancer. One hundred forty-two well-characterized primary vulvar carcinomas were\\u000a analyzed on a tissue microarray (TMA). Three

Matthias Choschzick; Linn Woelber; Stephan Hess; Christine zu Eulenburg; Jörg Schwarz; Ronald Simon; Sven Mahner; Fritz Jaenicke; Volkmar Müller

2010-01-01

161

Smoke aldehyde component influences pulmonary edema  

SciTech Connect

The pulmonary edema of smoke inhalation is caused by the toxins of smoke and not the heat. We investigated the potential of smoke consisting of carbon in combination with either acrolein or formaldehyde (both common components of smoke) to cause pulmonary edema in anesthetized sheep. Seven animals received acrolein smoke, seven animals received a low-dose formaldehyde smoke, and five animals received a high-dose formaldehyde smoke. Pulmonary arterial pressure, pulmonary capillary wedge pressure, and cardiac output were not affected by smoke in any group. Peak airway pressure increased after acrolein (14 +/- 1 to 21 +/- 2 mmHg; P less than 0.05) and after low- and high-dose formaldehyde (14 +/- 1 to 21 +/- 1 and 20 +/- 1 mmHg, respectively; both P less than 0.05). The partial pressure of O2 in arterial blood fell sharply after acrolein (219 +/- 29 to 86 +/- 9 (SE) Torr; P less than 0.05) but not after formaldehyde. Only acrolein resulted in a rise in lung lymph flow (6.5 +/- 2.2 to 17.9 +/- 2.6 ml/h; P less than 0.05). Lung lymph-to-plasma protein ratio was unchanged for all three groups, but clearance of lymph protein was increased after acrolein. After acrolein, the blood-free extravascular lung water-to-lung dry weight ratio was elevated (P less than 0.05) compared with both low- and high-dose formaldehyde groups (4.8 +/- 0.4 to 3.3 +/- 0.2 and 3.6 +/- 0.2, respectively). Lymph clearance (ng/h) of thromboxane B2, leukotriene B4, and the sulfidopeptide leukotrienes was elevated after acrolein but not formaldehyde.(ABSTRACT TRUNCATED AT 250 WORDS)

Hales, C.A.; Musto, S.W.; Janssens, S.; Jung, W.; Quinn, D.A.; Witten, M. (Department of Medicine (Pulmonary/Critical Care Unit), Massachusetts General Hospital, Boston (United States))

1992-02-01

162

Oxygen-deficient metabolism and corneal edema.  

PubMed

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 of glucose, as well as acidosis and pH buffering, are incorporated in a seven-layer corneal model (anterior chamber, endothelium, stroma, epithelium, postlens tear film, contact lens, and prelens tear film). Corneal swelling is predicted from coupled transport of water, dissolved salts, and especially metabolites, along with membrane-transport resistances at the endothelium and epithelium. At the endothelium, the Na+/K+ - ATPase electrogenic channel actively transports bicarbonate ion from the stroma into the anterior chamber. As captured by the Kedem-Katchalsky membrane-transport formalism, the active bicarbonate-ion flux provides the driving force for corneal fluid pump-out needed to match the leak-in tendency of the stroma. Increased lactate-ion production during hypoxia osmotically lowers the pump-out rate requiring the stroma to swell to higher water content. Concentration profiles are predicted for glucose, water, oxygen, carbon dioxide, and hydronium, lactate, bicarbonate, sodium, and chloride ions, along with electrostatic potential and pressure profiles. Although the active bicarbonate-ion pump at the endothelium drives bicarbonate into the aqueous humor, we find a net flux of bicarbonate ion into the cornea that safeguards against acidosis. For the first time, we predict corneal swelling upon soft-contact-lens wear from fundamental biophysico-chemical principles. We also successfully predict that hypertonic tear alleviates contact-lens-induced edema. PMID:21820076

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

2011-07-26

163

Anthrax Edema Toxin Impairs Clearance in Mice  

PubMed Central

The anthrax edema toxin (ET) of Bacillus anthracis is composed of the receptor-binding component protective antigen (PA) and of the adenylyl cyclase catalytic moiety, edema factor (EF). Uptake of ET into cells raises intracellular concentrations of the secondary messenger cyclic AMP, thereby impairing or activating host cell functions. We report here on a new consequence of ET action in vivo. We show that in mouse models of toxemia and infection, serum PA concentrations were significantly higher in the presence of enzymatically active EF. These higher concentrations were not caused by ET-induced inhibition of PA endocytosis; on the contrary, ET induced increased PA binding and uptake of the PA oligomer in vitro and in vivo through upregulation of the PA receptors TEM8 and CMG2 in both myeloid and nonmyeloid cells. ET effects on protein clearance from circulation appeared to be global and were not limited to PA. ET also impaired the clearance of ovalbumin, green fluorescent protein, and EF itself, as well as the small molecule biotin when these molecules were coinjected with the toxin. Effects on injected protein levels were not a result of general increase in protein concentrations due to fluid loss. Functional markers for liver and kidney were altered in response to ET. Concomitantly, ET caused phosphorylation and activation of the aquaporin-2 water channel present in the principal cells of the collecting ducts of the kidneys that are responsible for fluid homeostasis. Our data suggest that in vivo, ET alters circulatory protein and small molecule pharmacokinetics by an as-yet-undefined mechanism, thereby potentially allowing a prolonged circulation of anthrax virulence factors such as EF during infection.

Sastalla, Inka; Tang, Shixing; Crown, Devorah; Liu, Shihui; Eckhaus, Michael A.; Hewlett, Indira K.; Leppla, Stephen H.

2012-01-01

164

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.

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

2013-01-01

165

Fumonisin-induced pulmonary edema and hydrothorax in swine  

Microsoft Academic Search

Pulmonary edema and hydrothorax were observed in mature swine that died approximately 5 days after consuming corn screenings. These postmortem observations were reproduced in younger pigs that died within 1 week when fed the corn screenings under experimental conditions. Additionally, pulmonary edema and hydrothorax were induced in a pig that died after receiving 4 daily intravenous injections of fumonisin B1,

Bill M. Colvin; Lenn R. Harrison

1992-01-01

166

Mechanisms of perianeurysmal edema following endovascular embolization of aneurysms.  

PubMed

Summary: After coil embolization for an aneurysm, edema surrounding the aneurysm revealed by magnetic resonance imaging (MRI) is rarely seen and is usually associated with neurological symptoms. Perianeurysmal edema was found by postoperative MRI in three out of 182 patients with cerebral aneurysm, which was treated with Guglielmi Detachable Coil (GDC), and neurological symptoms developed simultaneously. In cases where neurological symptoms improved with conservative medical treatment, a temporary increase in the volume of an aneurysm, due to coil and thrombus formation, may result in edema. In cases where symptoms were not alleviated with conservative medical treatment, persistent water-hammer effect against the residual lumen of the aneurysm as well as an increase in the volume of aneurysm by hemorrhage in the aneurysmal wall may contribute to the development of perianeurysmal edema. Consideration of the mechanism of edema development by neurological symptoms, MRI findings, and angiographic findings is needed in order to select appropriate treatment. PMID:20566093

Tomokiyo, M; Kazekawa, K; Onizuka, M; Aikawa, H; Tsutsumi, M; Ikoh, M; Kodama, T; Nii, K; Matsubara, S; Tanaka, A

2007-06-27

167

Mechanisms of Perianeurysmal Edema Following Endovascular Embolization of Aneurysms  

PubMed Central

Summary After coil embolization for an aneurysm, edema surrounding the aneurysm revealed by magnetic resonance imaging (MRI) is rarely seen and is usually associated with neurological symptoms. Perianeurysmal edema was found by postoperative MRI in three out of 182 patients with cerebral aneurysm, which was treated with Guglielmi Detachable Coil (GDC), and neurological symptoms developed simultaneously. In cases where neurological symptoms improved with conservative medical treatment, a temporary increase in the volume of an aneurysm, due to coil and thrombus formation, may result in edema. In cases where symptoms were not alleviated with conservative medical treatment, persistent water-hammer effect against the residual lumen of the aneurysm as well as an increase in the volume of aneurysm by hemorrhage in the aneurysmal wall may contribute to the development of perianeurysmal edema. Consideration of the mechanism of edema development by neurological symptoms, MRI findings, and angiographic findings is needed in order to select appropriate treatment.

Tomokiyo, M.; K., Kazekawa; Onizuka, M.; Aikawa, H.; Tsutsumi, M.; Ikoh, M.; Kodama, T.; Nii, K.; Matsubara, S.; Tanaka, A.

2007-01-01

168

Investigating a cluster of vulvar cancer in young women: a cross-sectional study of genital human papillomavirus prevalence  

PubMed Central

Background Vulvar cancer is a relatively rare malignancy, which occurs most often in postmenopausal women. We have previously identified a geographic cluster of vulvar cancer in young Indigenous women living in remote communities in the Arnhem Land region of Australia. In this population, we investigated the prevalence of oncogenic human papillomavirus (HPV) infection in anogenital samples (vulvar/vaginal/perianal area and cervix) and compared the overall, type-specific and multiple infection prevalence between sites. Methods A cross-sectional survey of 551 Indigenous women aged 18–60 years was undertaken in 9 Arnhem Land communities. Women were consented for HPV detection and genotyping collected by a combined vulvar/vaginal/perianal (VVP) sweep swab and a separate PreservCyt endocervical sample collected during Pap cytology screening. HPV DNA testing was undertaken using PCR with broad spectrum L1 consensus PGMY09/11 primers with genotyping of positive samples by Roche Linear Array. The primary outcomes were the prevalence of cervical and VVP high-risk (HR) HPV. Results The prevalence of VVP HR-HPV was 39%, which was significantly higher than the cervical HR-HPV prevalence (26%, p<0.0001). HPV-16 was the most common genotype detected in both sites (VVP 11%, cervical 6%). HPV-16 infection peaked in women aged <20 years; however, there was a marked decline in cervical HPV-16 prevalence with age (p=0.007), whereas following an initial decline, the prevalence of VVP HPV-16 remained constant in subsequent age-groups (p=0.835). Conclusions In this population experiencing a cluster of vulvar cancer, the prevalence of cervical oncogenic HPV infection was similar to that reported by studies of other Australian women; however there was a significantly higher prevalence of vulvar/vaginal/perianal infection to cervical. The large discrepancy in HPV prevalence between anogenital sites in this population may represent more persistent infection at the vulva. This needs further investigation, including the presence of possible environmental and/or genetic factors that may impair host immunity.

2012-01-01

169

Photodynamic therapy of vulvar lichen sclerosus et atrophicus in a woman with hypothyreosis--case report.  

PubMed

Lichen sclerosus et atrophicus (LSA) is disease of skin and mucosa, its pathogenesis remains unknown. Itching, pain and burning sensations and atrophy of vulva impair quality of life. Treatment is symptomatic. We report case of 30-year old woman with lesions in vulva in which series of topical PDT were carried out. We applied Levulan®Kerastick® for 4h and after that lesions were illuminated with red light. Along with above treatment patient started receiving Euthyrox®, because of recently diagnosed hypothyreosis. Significant relief from subjective symptoms was achieved and lesions in vulvar region disappeared. Combination of topical PDT with hormonal therapy allowed controlling course of disease and minimizing symptoms, and thus improved quality of life. PMID:22594990

Osiecka, B J; Nockowski, P; Jurczyszyn, K; Ziólkowski, P

2012-03-27

170

Vulvar "proximal-type" epithelioid sarcoma: report of a case and review of the literature  

PubMed Central

Background The “proximal-type” epithelioid sarcoma is a very rare kind of mesenchimal tumor characterized by the difficulty in histological diagnosis and the very aggressive biological behavior. Case We report of a case of a 63 years old woman with a vulvar “proximal-type” epithelioid sarcoma that underwent a radical surgical staging followed by an adjuvant radiotherapy. She is on follow-up care for 14 months and there is no clinical evidence of disease. Conclusion Even if quite rare the proximal type epithelioid sarcoma should be regarded as a separate entity of particularly aggressive biologic behaviour. Its diagnosis attracts controversies and criticism related to the surgical approach and the choice of an adjuvant therapy. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1508554852942125

2013-01-01

171

Sexual Functioning After Treatment of In Situ Vulvar Cancer: Preliminary Report  

PubMed Central

Forty-two patients treated for in situ vulvar cancer at two institutions participated in structured assessment interviews and completed questionnaires to examine postoperative sexual, marital, and psychological adjustment. Patient responses were compared with a matched sample of gynecologically healthy women. The results indicated a specific pattern of sexual disruption for the women treated for preinvasive disease. Sexual behavior patterns appeared to be maintained, as was the desire phase of the sexual response cycle. However, there was specific disruption of the phases of excitement and resolution and, to a lesser extent, orgasm. In addition to a two- to threefold increase in the frequency of sexual dysfunction, 30% of the sample was sexually inactive at follow-up. Although replication of these findings is necessary, this investigation suggests that sexual functioning correlates with the magnitude of treatment.

Andersen, Barbara L.; Turnquist, Dawn; LaPolla, James; Turner, Deborah

2010-01-01

172

Clinical effects of selective estrogen receptor modulators on vulvar and vaginal atrophy.  

PubMed

OBJECTIVE: Vaginal estrogen therapy at the lowest effective dose is generally recommended for the treatment of vulvar and vaginal atrophy (VVA), but not all women are candidates. Selective estrogen receptor modulators (SERMs) aim to elicit specific positive effects on targeted tissues with neutral or minimal negative effects on other tissues. This review compares the vaginal effects of currently available and investigational SERMs. METHODS: Relevant English-language articles published between 1980 and 2012 were identified through the PubMed database (search string "[Selective Estrogen Receptor Modulator OR SERM] AND [Vulvar OR Vaginal] AND Atrophy"), article reference lists, and EMBASE searches for individual SERMs. Both authors reviewed all articles, which formed the basis of this narrative literature review. RESULTS: Activity profiles of SERMs in various tissues are distinct. Tamoxifen and arzoxifene have no specific positive vaginal effects but have reported variable or adverse gynecologic effects. Raloxifene does not improve VVA but can be used safely in combination with vaginal estrogen. Bazedoxifene has no demonstrated efficacy for VVA but, in combination with oral conjugated equine estrogens, improves the signs and symptoms of VVA. SERMs with positive vaginal effects (such as improvement in the vaginal maturation index, reduced vaginal pH, and improvement in the signs and symptoms of VVA) on postmenopausal symptomatic women include lasofoxifene (clinical development on hold) and ospemifene, which was recently approved for the treatment of VVA-related dyspareunia, with a class effect warning of potential venous thrombosis risk. CONCLUSIONS: SERMs that specifically target the pathophysiology underlying VVA may provide an alternative to vaginal or systemic estrogen therapy. PMID:23777900

Pinkerton, Joann V; Stanczyk, Frank Z

2013-06-18

173

Economic Considerations of Macular Edema Therapies  

PubMed Central

Purpose To relate costs and treatment benefits for macular edema due to diabetes (DME) and branch and central retinal vein occlusion (BRVO, CRVO). Design A model of resource utilization, outcomes, and cost effectiveness and utility. Participants none Methods Results from published clinical trials (index studies) of laser, intravitreal corticosteroids, intravitreal anti-vascular endothelial growth factor (VEGF) agents, and vitrectomy trials were used to ascertain visual benefit and clinical protocols. Calculations followed from the costs of one year of treatment for each treatment modality and the visual benefits as ascertained. Main Outcome measures Visual acuity (VA) saved, cost of therapy, cost per line saved, cost per line-year saved, and costs per quality adjusted life years (QALYs). Results The lines saved for DME (0.26 to 2.02), BRVO (0.74 to 4.92), and CRVO (1.2 to 3.75) yielded calculations of costs/line of saved VA for DME ($1329 to 11609), BRVO ($494 to 13039), and CRVO ($704 to 7611), costs/line-year for DME ($60 to 561), BRVO ($25 to 754), and CRVO ($45 to 473), and costs/QALY of $824 to $25566. Conclusion Relative costs and benefits should be considered in perspective when applying and developing treatment strategies.

Smiddy, William E.

2012-01-01

174

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.

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

2008-01-01

175

The clinicopathological and prognostic impact of 14-3-3 sigma expression on vulvar squamous cell carcinomas  

PubMed Central

Background 14-3-3 sigma (?) promotes G2/M cell cycle arrest by sequestering cyclin B1-CDC2 complex in cytoplasm. Down-regulation of 14-3-3?, which has been demonstrated in various carcinomas, may contribute to malignant transformation. However, the exact role of 14-3-3? in the pathogenesis of vulvar carcinoma is not fully characterized, and the prognostic impact of 14-3-3? protein expression is still unknown. Methods We investigated the 14-3-3? expression in a series of 302 vulvar squamous cell carcinomas using immunohistochemistry and its associations with clinicopathological factors and clinical outcome. Results In cytoplasm, nucleus and cytoplasm/nucleus of vulvar carcinomas high 14-3-3? protein expression was found in 72%, 59% and 75% of the carcinomas, respectively, and low levels in 28%, 41% and 25% of the cases, respectively. High level of 14-3-3? in cytoplasm, nucleus and cytoplasm/nucleus was significantly correlated to large tumor diameter (p = 0.001, p = 0.002 and p = 0.001, respectively) and deep invasion (p = 0.01, p = 0.001 and p = 0.007, respectively). Variations of 14-3-3? protein expression were not associated to disease-specific survival. Conclusion Our results indicate that 14-3-3? may be involved in the development of a subset of vulvar squamous cell carcinomas by down-regulation of 14-3-3? protein. Neither cytoplasmic nor nuclear level of 14-3-3? expression was associated with prognosis.

Wang, Zhihui; Trope, Claes G; Suo, Zhenhe; Tr?en, Gunhild; Yang, Guanrui; Nesland, Jahn M; Holm, Ruth

2008-01-01

176

The clinicopathological and prognostic impact of 14-3-3 sigma expression on vulvar squamous cell carcinomas  

Microsoft Academic Search

BACKGROUND: 14-3-3 sigma (?) promotes G2\\/M cell cycle arrest by sequestering cyclin B1-CDC2 complex in cytoplasm. Down-regulation of 14-3-3?, which has been demonstrated in various carcinomas, may contribute to malignant transformation. However, the exact role of 14-3-3? in the pathogenesis of vulvar carcinoma is not fully characterized, and the prognostic impact of 14-3-3? protein expression is still unknown. METHODS: We

Zhihui Wang; Claes G Tropè; Zhenhe Suo; Gunhild Trøen; Guanrui Yang; Jahn M Nesland; Ruth Holm

2008-01-01

177

Aquaporin 4: a player in cerebral edema and neuroinflammation  

PubMed Central

Neuroinflammation is a common pathological event observed in many different brain diseases, frequently associated with blood brain barrier (BBB) dysfunction and followed by cerebral edema. Neuroinflammation is characterized with microglia activation and astrogliosis, which is a hypertrophy of the astrocytes. Astrocytes express aquaporin 4, the water channel protein, involved in water homeostasis and edema formation. Aside from its function in water homeostasis, recent studies started to show possible interrelations between aquaporin 4 and neuroinflammation. In this review the roles of aquaporin 4 in neuroinflammation associated with BBB disruption and cerebral edema will be discussed with recent studies in the field.

2012-01-01

178

Amiloride-Sensitive Sodium Channels and Pulmonary Edema  

PubMed Central

The development of pulmonary edema can be considered as a combination of alveolar flooding via increased fluid filtration, impaired alveolar-capillary barrier integrity, and disturbed resolution due to decreased alveolar fluid clearance. An important mechanism regulating alveolar fluid clearance is sodium transport across the alveolar epithelium. Transepithelial sodium transport is largely dependent on the activity of sodium channels in alveolar epithelial cells. This paper describes how sodium channels contribute to alveolar fluid clearance under physiological conditions and how deregulation of sodium channel activity might contribute to the pathogenesis of lung diseases associated with pulmonary edema. Furthermore, sodium channels as putative molecular targets for the treatment of pulmonary edema are discussed.

Althaus, Mike; Clauss, Wolfgang G.; Fronius, Martin

2011-01-01

179

Intensity-modulated radiotherapy for the treatment of vulvar carcinoma: A comparative dosimetric study with early clinical outcome  

SciTech Connect

Objectives: To assess early clinical outcome of intensity-modulated radiation therapy (IMRT) in the treatment of vulvar cancer and compare dosimetric parameters with 3D conformal radiotherapy (3D CRT). Methods: Fifteen patients with vulvar cancer were treated with IMRT. Seven patients were treated with preoperative chemoradiation, and 8 patients were treated with adjuvant postoperative radiation therapy. Median dose was 46 Gy in the preoperative and 50.4 Gy in the postoperative group. Results: The mean volume of small bowel, rectum, and bladder that received doses in excess of 30 Gy with IMRT was reduced when compared with 3D CRT. Treatment was well tolerated, and only 1 patient had acute Grade 3 small-bowel toxicity. Median follow-up was 12 months. In the preoperative group, 5 patients (71%) had clinical complete response and 3 patients (42.8%) had pathologic complete response. In the adjuvant group, 2 patients had recurrences in the treatment field. No patients had late Grade 3 toxicity. The 2-year actuarial disease-specific survival was 100%. Conclusions: Intensity-modulated RT appears to offer advantages over 3D CRT treatment of vulvar cancer by elimination of dose modulation across overlapping regions and reduction of unnecessary dose to the bladder, rectum, and small bowel. Early results with a small number of patients show promising results, with a low incidence of severe toxicity.

Beriwal, Sushil [University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)]. E-mail: beriwals@upmc.edu; Heron, Dwight E. [University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Kim, Hayeon [University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); King, Gwendolyn [University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Shogan, Jeffrey [University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Bahri, Sanjeev [University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Gerszten, Kristina [University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Lee, Joe [D3 Advanced Radiation Planning, Pittsburgh, PA (United States); Kelley, Joseph [University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Edwards, Robert P. [University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)

2006-04-01

180

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

PubMed Central

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.

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

2013-01-01

181

Hemoglobin level predicts outcome for vulvar cancer patients independent of GLUT-1 and CA-IX expression in tumor tissue  

PubMed Central

Intratumoral hypoxia has been associated with poor prognosis in several solid tumors. The aim of this study was to determine whether the hypoxia-associated markers glucose transporter (GLUT)-1 and carbonic anhydrase (CA)-IX expression and preoperative hemoglobin (Hb) levels correlate with presence of inguinofemoral or distant metastases, and disease-free survival (DSS) in vulvar squamous cell carcinoma (SCC) patients. Vulvar SCC (n?=?103) were reviewed for histopathological characteristics by an expert gynecopathologist and stained for GLUT-1 and CA-IX. Clinical data and preoperative Hb levels were obtained from medical records. No significant correlations were observed between GLUT-1 or CA-IX expression patterns and preoperative Hb levels, presence of inguinofemoral or distant metastases and DSS. However, anemic patients (Hb?vulvar SCC patients, whereas tumor hypoxia reflected by GLUT-1 and CA-IX expression does not have a predictive value. Because preoperative Hb levels inversely correlated with the number of comorbidic conditions and not with GLUT-1 or CA-IX expression, it is most likely that preoperative Hb levels represent overall physical condition.

de Hullu, Joanne A.; Kaanders, Johannes H. A. M.; Bulten, Johan; Massuger, Leon F. A. G.; van Kempen, Leon C. L. T.

2010-01-01

182

Vulvar Cancer  

MedlinePLUS

... the type of tissue where the cancer started. Squamous cell carcinoma. Squamous cell carcinoma is a type of skin cancer that accounts ... and verrucous carcinoma, a slow-growing subtype of squamous cell carcinoma that looks like a wart. Find out more ...

183

High altitude pulmonary edema among "Amarnath Yatris"  

PubMed Central

Background: Annual pilgrimage (Yatra) to the cave shrine of Shri Amarnath Ji’ is a holy ritual among the Hindu devotees of Lord Shiva. Located in the Himalayan Mountain Range (altitude 13,000 ft) in south Kashmir, the shrine is visited by thousands of devotees and altitude sickness is reportedly common. Materials and Methods: More than 600,000 pilgrims visited the cave shrine in 2011 and 2012 with 239 recorded deaths. Thirty one patients with suspected altitude sickness were referred from medical centers en-route the cave to Sher-i-Kashmir Institute of Medical Sciences, a tertiary-care center in capital Srinagar (5,000 ft). The clinical features and the response to treatment were recorded. Results: Thirty-one patients (all lowlanders, 19 male; age 18-60 years, median 41) had presented with acute onset breathlessness of 1-4 days (median 1.9 d) starting within 12-24 h of a rapid ascent; accompanied by cough (68%), headache (8%), dizziness and nausea (65%). Sixteen patients had associated encephalopathy. Clinical features on admission included tachypnea (n = 31), tachycardia (n = 23), bilateral chest rales (n = 29), cyanosis (n = 22) and grade 2-4 encephalopathy. Hypoxemia was demonstrable in 24 cases and bilateral infiltrates on radiologic imaging in 29. Ten patients had evidence of high-altitude cerebral edema. All patients were managed with oxygen, steroids, nifedipine, sildenafil and other supportive measures including invasive ventilation (n = 3). Three patients died due to multiorgan dysfunction. Conclusions: Altitude sickness is common among Amaranath Yatris from the plains and appropriate educational strategies should be invoked for prevention and prompt treatment.

Koul, Parvaiz A.; Khan, Umar Hafiz; Hussain, Tajamul; Koul, Ajaz Nabi; Malik, Sajjad; Shah, Sanaullah; Bazaz, Sajjad Rajab; Rashid, Wasim; Jan, Rafi Ahmad

2013-01-01

184

Inhibitors of Bacillus anthracis edema factor.  

PubMed

Edema factor (EF) is a calmodulin (CaM)-activated adenylyl cyclase (AC) toxin from Bacillus anthracis that contributes to anthrax pathogenesis. Anthrax is an important medical problem, but treatment of B. anthracis infections is still unsatisfying. Thus, selective EF inhibitors could be valuable drugs in the treatment of anthrax infection, most importantly shock. The catalytic site of EF, the EF/CaM interaction site and allosteric sites constitute potential drug targets. To this end, most efforts have been directed towards targeting the catalytic site. A major challenge in the field is to obtain compounds with high selectivity for AC toxins relative to mammalian membranous ACs (mACs). 3'-(N-methyl)anthraniloyl-2'-deoxyadenosine-5'-triphosphate is the most potent EF inhibitor known so far (Ki, 10nM), but selectivity relative to mACs needs to be improved (currently ~5-50-fold, depending on the specific mAC isoform considered). AC toxin inhibitors can be identified in virtual screening studies based on available EF crystal structures and examined in cellular test systems or at the level of purified toxin using classic radioisotopic or non-radioactive fluorescence assays. Binding of certain MANT-nucleotides to AC toxins elicits large direct fluorescence- or fluorescence resonance energy transfer signals upon interaction with CaM, and these signals can be used to identify toxin inhibitors in competition binding studies. Collectively, potent EF inhibitors are available, but before they can be used clinically, selectivity against mACs must be improved. However, several methodological approaches, complementing each other, are now available to direct the development of potent, selective, orally applicable and clinically useful EF inhibitors. PMID:23850654

Seifert, Roland; Dove, Stefan

2013-07-09

185

Scalp edema: don't forget sunburn in children.  

PubMed

Scalp edema is an uncommon and striking finding in children that may alarm both parents and physicians. The objectives of this case report were to raise awareness among pediatric emergency physicians of the unusual presentation of sunburn as scalp edema. We present the case of an eight-year-old boy with sunburn of the head, presenting with scalp and face edema. Pitting edema and erythema were dominant on the forehead. Shaving of the boy's head the day before the symptoms was the most striking issue, and the sunburn healed gradually without any complications. Healthcare professionals should be aware of this condition, and the diagnosis of sunburn must be kept in mind in otherwise healthy-looking patients with a unique history. PMID:23427522

Shah, Binod; Yavuz, Süleyman Tolga; Tek?am, Ozlem

186

Pathogenesis of Pulmonary Edema Following Head Trauma: An Experimental Study.  

National Technical Information Service (NTIS)

The hemodynamic response of seven chimpanzees to varying degrees of increased intracranial pressure was determined in order to delineate the sequence of events which precedes the development of pulmonary edema in patients with intracranial disease. At mod...

R. L. Simmons T. B. Ducker R. W. Anderson

1968-01-01

187

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

188

Hypertrophic Cardiomyopathy Complicated by Pulmonary Edema in the Postpartum Period  

PubMed Central

We report the case of a 42-year-old patient with hypertrophic cardiomyopathy (HCM) who presented to the emergency department with severe shortness of breath one week following uneventful cesarean delivery. Thoracic CT ruled out pulmonary embolus and confirmed pulmonary edema. Asymmetric interventricular septal thickening was clearly identified, demonstrating that the heart may be evaluated even on a non-ECG gated study. Acute pulmonary edema in the postpartum period is an unusual clinical presentation of HCM.

Nguyen, Elsie T.; Crean, Andrew M.

2013-01-01

189

Acute idiopathic scrotal edema: ultrasonographic findings at an emergency unit  

Microsoft Academic Search

We evaluated the US findings in acute idiopathic scrotal edema (AISE) in order to identify diagnostic features that may help\\u000a to avoid unnecessary surgical intervention. We investigated 12 boys with AISE diagnosed according to the clinical course and\\u000a US findings. We assessed the thickness, compressibility, and vascularity of the scrotal wall, the extent of edema, and enlargement\\u000a of inguinal lymph

Aleum Lee; Seong Jin Park; Hae Kyung Lee; Hyun Sook Hong; Boem Ha Lee; Dae Ho Kim

2009-01-01

190

Diagnosis, Prevention and Management of Postoperative Pulmonary Edema  

PubMed Central

Postoperative pulmonary edema is a well-known postoperative complication caused as a result of numerous etiological factors which can be easily detected by a careful surveillance during postoperative period. However, there are no preoperative and intraoperative criteria which can successfully establish the possibilities for development of postoperative pulmonary edema. The aims were to review the possible etiologic and diagnostic challenges in timely detection of postoperative pulmonary edema and to discuss the various management strategies for prevention of this postoperative complication so as to decrease morbidity and mortality. The various search engines for preparation of this manuscript were used which included Entrez (including Pubmed and Pubmed Central), NIH.gov, Medknow.com, Medscape.com, WebMD.com, Scopus, Science Direct, MedHelp.org, yahoo.com and google.com. Manual search was carried out and various text books and journals of anesthesia and critical care medicine were also searched. From the information gathered, it was observed that postoperative cardiogenic pulmonary edema in patients with serious cardiovascular diseases is most common followed by noncardiogenic pulmonary edema which can be due to fluid overload in the postoperative period or it can be negative pressure pulmonary edema (NPPE). NPPE is an important clinical entity in immediate post-extubation period and occurs due to acute upper airway obstruction and creation of acute negative intrathoracic pressure. NPPE carries a good prognosis if promptly diagnosed and appropriately treated with or without mechanical ventilation.

Bajwa, SJ Singh; Kulshrestha, A

2012-01-01

191

Evaluation of brain edema using magnetic resonance proton relaxation times  

SciTech Connect

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.

Fu, Y.; Tanaka, K.; Nishimura, S. (Baba Memorial Hospital, Osaka (Japan))

1990-01-01

192

Vulvar Intraepithelial Neoplasia (VIN2/3): comparing clinical outcomes and evaluating risk factors for recurrence  

PubMed Central

Objective To determine risk factors for the development of vulvar intraepithelial neoplasia (VIN 2/3), and factors associated with recurrence. Methods A retrospective chart review of 303 patients with VIN 2/3 evaluated at a single institution between 1993 and 2011 was performed. Medical records were reviewed for demographic information, risk factors, treatment type, pathologic diagnosis, and recurrence/outcome information. Recurrent disease was defined as a diagnosis of VIN 2/3 and/or invasive vulvar cancer after initial treatment of VIN 2/3. Patients with VIN 1 and patients with invasive disease, including microinvasion, were excluded. Results The median age at diagnosis was 47 years (range 14–87). 33% of patients were symptomatic, with pruritus being the most common presenting symptom. Smoking history was available for 299 patients, with 40% reporting current tobacco use and 26% reporting previous use. Primary treatment included excision (n=176, 59%), laser ablation (n=40, 13%), imiquimod (n=22, 7.4%), excision with laser (n=24, 8.1%), or excision with imiquimod (n=10, 3.4%). Margin status was available for 147 patients. 92 patients (62.6%) were noted to have positive margins, which were associated with larger tumor size (p=0.004). 87 patients (28.7%) developed recurrent disease and it was associated with smoking (p<0.001), larger lesion size (p=0.016), and positive margins (p=0.005). Furthermore, higher rates of recurrence were associated with laser (41.9%) compared with excision (26.4%) or imiquimod (13.6%) (p=0.003). 7 patients (2.3%) recurred with invasive disease a median of 109 months (range 12–327) from initial VIN 2/3 diagnosis. Conclusions This large cohort of women with VIN2/3 further delineates the demographic and clinical factors associated with VIN2/3. High rates of recurrence were noted and found to be associated with smoking, large lesion size, positive margins, and treatment with laser ablation.

Wallbillich, J.J.; Rhodes, H.E.; Milbourne, A.M.; Munsell, M.F.; Frumovitz, M.; Brown, J.; Trimble, C.L.; Schmeler, K.M.

2013-01-01

193

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.

Jorge, Juaquito M.

2013-01-01

194

Resolution of macular edema after systemic treatment with furosemide.  

PubMed

We report two cases of macular edema treated with the oral administration of furosemide. The first case presented here was a 78-year-old male patient with visual disturbance of the left eye. He had been taking an oral agent for diabetes and had chronic renal failure for 7 years. From 10 days prior to the visit, he had visual disturbance of the left eye accompanied by systemic edema. There were no specific findings in the anterior segment, but sub-retinal fluid was observed in the left fundus. Macular edema was observed on fluorescein angiography and optical coherence tomography; therefore, the oral administration of furosemide was initiated. After seven days, the sub-retinal fluid disappeared. The second case was a 43-year-old female patient with visual disturbance of the left eye who had been taking hypoglycemic agents for diabetes for 13 years. There were no specific findings in the anterior segment, but flame-shaped retinal hemorrhages were scattered over both posterior poles, neovascularization was observed in the left eye, and, of particular note, sub-retinal fluid was detected in the macula of the left eye. Macular edema was also observed on fluorescein angiography and optical coherence tomography, and oral administration of furosemide was initiated. After 3 weeks, the macular edema had significantly decreased. PMID:22870034

Koo, Nam Kyun; Kim, Yu Cheol

2012-07-24

195

Adenoid cystic carcinoma of the Bartholin’s gland: a rare tumor unmarked by persistent vulvar pain in a postmenopausal women  

Microsoft Academic Search

Introduction  Adenoid cystic carcinoma (ACC) of the Bartholin’s gland is a rare malignancy characterized by slow growth, local invasion\\u000a and perineural infiltration.\\u000a \\u000a \\u000a \\u000a Case  A 64-year-old postmenopausal woman presented with persistent vulvar pain. Local examination revealed a 2 × 2 cm painful vulvar\\u000a nodule. Nodule was excised and ACC originating in the Bartholin’s gland with positive resection margin was determined in pathological\\u000a examination. We performed hemivulvectomy

Özgür ?ahincio?lu; Bülent Berker; Mete Güngör; Duygu Kankaya; Ay?e Sertçelik

2008-01-01

196

Resolution of macular edema in Coats' disease with intravitreal bevacizumab  

PubMed Central

A 13-year-old boy was referred because of visual deterioration in his right eye. The visual acuity was two meters of counting fingers. Indirect ophthalmoscopy and biomicroscopy revealed exudative macular edema as well as tumor-like telangiectatic vessels and exudation in temporal periphery. With diagnosis of Coats' disease (stage II) confirmed by fluorescein angiography, three intravitreal injections of bevacizumab were performed at 6-week intervals. One year after the last injection, there was a significant resolution of macular edema as well as visual acuity improvement to 20/20. This is the first case report in which a distinct improvement in macular edema was observed with intravitreal bevacizumab in Coats' disease.

Entezari, Morteza; Ramezani, Alireza; Safavizadeh, Ladan; Bassirnia, Nader

2010-01-01

197

Resolution of macular edema in Coats' disease with intravitreal bevacizumab.  

PubMed

A 13-year-old boy was referred because of visual deterioration in his right eye. The visual acuity was two meters of counting fingers. Indirect ophthalmoscopy and biomicroscopy revealed exudative macular edema as well as tumor-like telangiectatic vessels and exudation in temporal periphery. With diagnosis of Coats' disease (stage II) confirmed by fluorescein angiography, three intravitreal injections of bevacizumab were performed at 6-week intervals. One year after the last injection, there was a significant resolution of macular edema as well as visual acuity improvement to 20/20. This is the first case report in which a distinct improvement in macular edema was observed with intravitreal bevacizumab in Coats' disease. PMID:20029156

Entezari, Morteza; Ramezani, Alireza; Safavizadeh, Ladan; Bassirnia, Nader

198

Yellow nail syndrome as a cause of unexplained edema.  

PubMed

Yellow nail syndrome is a rare cause of edema due to a disordered lymphatic drainage. We recently observed two cases of long-standing, chronic edema, whose nature could not be understood despite innumerable diagnostic procedures. The diagnosis was suspected based on an attentive clinical exam and confirmed by radionuclide lymph scan. Yellow nail syndrome has to be considered in the differential diagnosis in cases of systemic edema, as well as long standing pleural effusions, particularly in patients with bronchiectasis or sinusitis. Clues to diagnosis are the presence of dystrophic, yellowish nails, peripheral lymphedema and relapsing pleural effusions and/or ascites. Long-term control of symptoms is difficult to achieve and may benefit from the judicious use of diuretics and intravenous albumin and by topical alpha-tocopherol. Pleurodesis may be needed. Other pathologic conditions are often associated to yellow nail syndrome and should be ruled out. PMID:20440922

Cimini, C; Giunta, R; Utili, R; Durante-Mangoni, E

2009-12-01

199

Neurogenic pulmonary edema associated with pediatric status epilepticus.  

PubMed

Neurogenic pulmonary edema (NPE) can result from various central nervous system disorders such as brain malignancies, traumatic brain injuries, infections, and seizures. Although the pathogenesis is not completely understood, NPE creates an increase in pulmonary interstitial and alveolar fluid. In adults, it has been reported with prolonged seizure activity. In pediatric patients, pulmonary edema has rarely been reported after status epilepticus, and respiratory compromise is most often due to anticonvulsant-related respiratory depression. Treatment for NPE is largely supportive. If unrecognized, it can lead to hypoxia and respiratory arrest. We report a case of status epilepticus-related pulmonary edema in a female toddler, the youngest patient to be reported in the literature. PMID:21975498

Reuter-Rice, Karin; Duthie, Susan; Hamrick, Justin

2011-10-01

200

Itraconazole associated quadriparesis and edema: a case report  

PubMed Central

Introduction Itraconazole is an anti-fungal agent widely used to treat various forms of mycosis. It is particularly useful in allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization. Side effects are uncommon and usually mild. Mild neuropathy is noted to occur very rarely. We present an unusual and, to the best of our knowledge, as yet unreported case of severe neuropathy and peripheral edema due to itraconazole in the absence of a concomitant risk factor. Case presentation A 72-year-old Caucasian man was started on itraconazole following diagnosis of severe asthma with fungal sensitization. One month later he presented with severe bilateral ankle edema with an elevated serum itraconazole level. The itraconazole dose was reduced but his ankle edema persisted and he developed weakness of all four limbs. Itraconazole was completely stopped leading to improvement in his leg edema but he became bed bound due to weakness. He gradually improved with supportive care and neurorehabilitation. On review at six months, our patient was able to mobilize with the aid of two elbow crutches and power had returned to 5/5 in distal extremities and 4+/5 in proximal extremities. The diagnosis was established based on the classical presentation of drug-induced neuropathy and negative investigatory findings for any alternative diagnoses. Conclusion We report the case of a patient presenting with an unusual complication of severe neuropathy and peripheral edema due to itraconazole. Clinicians should be alert to this association when encountered with neuropathy and/or edema in an itraconazole therapy recipient.

2011-01-01

201

The Co-Existence of Vulvar Lichen Sclerosus, Ulcerated Calcinosis Cutis, and Dermatomyositis: Coincidence or Immunological Mechanism?  

PubMed Central

Calcinosis cutis is a condition characterized by the deposition of calcium salts in the skin and subcutaneous tissues, and patients suffering from it encounter various connective tissue disorders, such as dermatomyositis (DM), scleroderma, and systemic lupus erythematosus. Although calcinosis cutis is frequently accompanied by juvenile dermatomyositis, rare cases have been reported in adult patients with DM. On the other hand, lichen sclerosus (LS) is a chronic inflammatory disease of the skin and mucosal surfaces. In the present report, we present a rare case of a 71-year-old patient with DM accompanied by ulcerated calcinosis cutis and vulvar LS.

Celik, Ebru; Sar?kaya, Gokhan; Yenin, Julide Zehra; Atik, Esin

2011-01-01

202

The co-existence of vulvar lichen sclerosus, ulcerated calcinosis cutis, and dermatomyositis: coincidence or immunological mechanism?  

PubMed

Calcinosis cutis is a condition characterized by the deposition of calcium salts in the skin and subcutaneous tissues, and patients suffering from it encounter various connective tissue disorders, such as dermatomyositis (DM), scleroderma, and systemic lupus erythematosus. Although calcinosis cutis is frequently accompanied by juvenile dermatomyositis, rare cases have been reported in adult patients with DM. On the other hand, lichen sclerosus (LS) is a chronic inflammatory disease of the skin and mucosal surfaces. In the present report, we present a rare case of a 71-year-old patient with DM accompanied by ulcerated calcinosis cutis and vulvar LS. PMID:22346282

Balc?, Didem Didar; Celik, Ebru; Sar?kaya, Gökhan; Yenin, Jülide Zehra; Atik, Esin

2011-12-27

203

Coagulation abnormalities in osteonecrosis and bone marrow edema syndrome.  

PubMed

The aim of this review was to provide information about the variety of thrombophilic and hypofibrinolytic markers that are possible risk factors for the development of osteonecrosis and bone marrow edema syndrome. A total of 48 parameters were identified in 45 studies that included 2163 patients. The most frequently reported laboratory findings included altered serum concentrations of lipoproteins, decreased concentration and function of fibrinolytic agents, increased levels of thrombophilic markers, and several single nucleotide polymorphisms. Despite inhomogeneities in reported parameters, results, patients' collectives, and treatment strategies, these data suggest that coagulation abnormalities may play an important role in the emergence of osteonecrosis and bone marrow edema syndrome. PMID:23590772

Orth, Patrick; Anagnostakos, Konstantinos

2013-04-01

204

Hemodynamic response to intravitreal triamcinolone in eyes with macular edema  

Microsoft Academic Search

Purpose  To assess ocular hemodynamic response to intravitreal triamcinolone in patients with macular edema due to diabetes or retinal\\u000a vein occlusion.\\u000a \\u000a \\u000a \\u000a Methods  Forty-three patients that were injected by intravitreal triamcinolone acetonide (0.1 cc 4 mg) for unilateral macular edema\\u000a due to diabetes mellitus (n = 17) and occlusion of retinal vein (n = 26) underwent ocular hemodynamic evaluation by color Doppler imaging (CDI) before and one, two and

Osman Çekiç; Yavuz Bardak; ?ahin U. T??; Aykut Demirkol; Mustafa M. Ekim; Önem Alt?nta?; Ahmet Ye?ilda?; Orhan Oyar

2007-01-01

205

A Case of Cystoid Macular Edema Associated with Paclitaxel Chemotherapy  

PubMed Central

We encountered a patient with cystoid macular edema (CME) secondary to paclitaxel use. A 57-year-old man presented with gradual decreased bilateral vision. His chemotherapeutic regimen consisted of bevacizumab, paclitaxel (175 mg/m2 for 5 months), and carboplatin. Optical coherence tomography imaging revealed bilateral CME greater than 500 µm. However, one year later, visual acuity was improved, best-corrected Snellen visual acuity was 40 / 80 in each eye, and CME was spontaneously improved. Our study confirmed that macular edema associated with paclitaxel use shows spontaneous resolution and improvement of visual acuity after a change of chemotherapeutic regimen.

Ham, Dong Sik; Lee, Joo Eun; Yun, Il Han

2012-01-01

206

Bilateral Reversible Corneal Edema Associated With Amantadine Use  

PubMed Central

Purpose: In this article, we report a case of bilateral severe reversible corneal edema caused by amantadine therapy. Case: A 39-year-old women was referred to us for evaluation of bilateral corneal edema. Her past medical history was significant for multiple sclerosis, anorexia, and seizures. She developed painless progressive bilateral loss of vision for the past 6 months. She was evaluated by several ophthalmologists elsewhere who felt that the patient’s visual loss was secondary to a nutritional deficiency as opposed to related to multiple sclerosis. She was started on vitamin B-12 medication without improvement in her symptoms. She was then evaluated by neuro-ophthalmology. The examination revealed severe bilateral corneal edema and was referred to our corneal service for further evaluation of her corneal condition. Our examination revealed best corrected visual acuity of 20/400 bilaterally. Corneal thickness was 940 µm in the right eye and 802 µm in the left. Color vision was intact. Conjunctivas were white bilaterally. Cornea evaluation revealed diffuse stromal edema and Descemet’s folds and microcystic subepithelial edema with to guttae noted. Anterior chambers were deep and quiet. A specular microscopy revealed significant pleomorphism and polymegathism with an endothelial cell count of 1,504 cells in the right eye and 1,596 in the left eye. Results: Review of the patient’s medical information revealed therapy with amantadine 2 months prior to the appearance of the patient’s symptoms as a means to control the patient’s tremors. The patient experienced rapid resolution of the corneal edema within the next 2 months after discontinuation of the agent with recovery of best corrected visual acuity of 20/40 in the right eye and 20/30 in the left. Conclusions: In cases of unexplained corneal edema and in the absence of any identifiable ocular cause, a review of toxic effects of systemic medications should be performed. Early diagnosis may prevent irreversible endothelial damage. Amantadine can cause endothelial failure and needs to be considered as part of the differential diagnosis of corneal edema.

Esquenazi, Salomon

2009-01-01

207

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

208

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

2012-04-12

209

Epidemiology of vulvar vestibulitis syndrome: an exploratory case-control study  

PubMed Central

BACKGROUND: Vulvar vestibulitis syndrome (VVS) is a chronic, persistent syndrome characterised by vestibular pain, tenderness, and erythema. The aetiology of VVS is unknown and few of the hypothesised risk factors have been tested in controlled studies. METHODS: Using a matched case-control study design, medical, sexual, health behaviour, and diet history of 28 women with VVS were compared with 50 friend controls without VVS to identify possible causal factors. RESULTS: Cases were more likely than controls to report every vaginal and urinary symptom at the time of interview measured, particularly vaginal soreness or pain (60.7%) and pain during intercourse (64.3%). There were no significant differences between cases and controls with respect to sexual behaviour. Cases were more likely than controls to report self reported history of physician diagnosed bacterial vaginosis (OR = 22.2, 95% CI = 2.8, 177.2, p value = 0.0001), vaginal yeast infections (OR = 4.9, 95% CI = 1.4, 18.0, p value = 0.01), and human papillomavirus (OR = 7.1, 95% CI = 0.6, 81.2, p value = 0.08). There were no differences between cases and controls with respect to dietary intake of oxalate. Cases were more likely than controls to report poor health status (OR = 5.7, 95% CI = 1.1, 28.7, p value = 0.02) and history of depression for 2 weeks or more during the past year (OR = 4.4, 95% CI = 1.6, 12.3, p value = 0.002). CONCLUSION: Self reported history of bacterial vaginosis, yeast infections, and human papillomavirus were strongly associated with VVS. An infectious origin for VVS should be pursued in larger controlled studies, using questionnaire and laboratory measures. ???

Sarma, A. V.; Foxman, B.; Bayirli, B.; Haefner, H.; Sobel, J. D.

1999-01-01

210

Negative-pressure pulmonary edema in the otolaryngology patient  

Microsoft Academic Search

It is estimated that 11% of all patients requiring active intervention for acute upper airway obstruction develop negative-pressure pulmonary edema. This pathologic process typically has a benign and rapidly resolving clinical course with the prompt use of mechanical ventilation and positive and expiratory pressure. A review of the literature, however, has revealed a morbidity and mortality rate of 11% to

JOHN D. GOLDENBERG; LOUIS G. PORTUGAL; BARRY L. WENIG; RANDALL T. WEINGARTEN

1997-01-01

211

Alcohol Abuse Enhances Pulmonary Edema in Acute Respiratory Distress Syndrome  

Microsoft Academic Search

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 hypothe- sized that a history of chronic alcohol abuse in ARDS patients is associated with greater quanti- ties and

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

2009-01-01

212

[Bromocriptine in patients with idiopathic edema (author's transl)].  

PubMed

The diuretic therapy of patients with idiopathic edema is known to induce a secondary aldosteronism, which perpetuates edema formation and exacerbates the clinical symptoms. The observation of a decreased excretion of dopamine in these patients suggests that a treatment with the orally active dopamine agonist bromocriptine might be beneficial. Nine patients with typical symptoms of idiopathic edema, which had been present for several years, were treated with bromocriptine (Pravidel) 2 X 2.5 mg/die. The response to therapy was assessed clinically by the normalization of diurnal weight gain and general well-being. Seven patients showed a good response to bromocriptine, in one patient the response was only modest, and in one patient the medication had to be stopped because of nausea. Bromocriptine normalized diurnal weight gain without inducing weight loss. Both without therapy and during bromocriptine treatment electrolytes in serum, blood pressure, plasma renin activity and aldosterone are within the normal range. From the present pilot study it can be concluded that bromocriptine is an effective alternative to the traditional diuretic therapy in some patients with idiopathic edema. It remains unclear, whether the beneficial effect of bromocriptine reveals a dopamine deficiency, or whether bromocriptine is only a symptomatic treatment. PMID:7321484

Jungmann, E; Althoff, P H; Schwedes, U; Walther, F; Schöffling, K

1981-12-15

213

Nifedipine for Treatment of High Altitude Pulmonary Edema.  

National Technical Information Service (NTIS)

In 12 subjects with high altitude pulmonary edema, we studied the effects of 10mg nifedipine on pulmonary and systemic hemodynamics and arterial oxygen saturation. In five of these, repeated dosing was done over 3 hours and spirometry and clinical HAPE sc...

P. H. Hackett R. C. Roach E. R. Greene B. Levine

1992-01-01

214

Hemoptysis and pulmonary edema in a scuba diver using diclofenac.  

PubMed

Hemoptysis and pulmonary edema associated with nonsteroidal anti-inflammatory drug use is a known condition, but is probably underreported. The mechanisms of induction of pulmonary toxicity are still not well understood. We describe a case of hemoptysis and dyspnea in a scuba diver who was taking diclofenac. PMID:22354373

Van Renterghem, Dirk; Depuydt, Charlotte

2012-02-21

215

The Evolving Treatment Options for Diabetic Macular Edema  

PubMed Central

Diabetic retinopathy (DR) is the leading cause of vision loss in working-age adults, and diabetic macular edema (DME) is the most common cause of visual impairment in individuals with DR. This review focuses on the pathophysiology, previous treatment paradigms, and emerging treatment options in the management of DME.

Jain, Atul; Varshney, Neeta; Smith, Colin

2013-01-01

216

Immunohistochemical patterns of ProEx C in vulvar squamous lesions: detection of overexpression of MCM2 and TOP2A.  

PubMed

Two major subtypes of vulvar squamous cell carcinomas (SCC) have been described. Basaloid and warty SCC are human papillomavirus-related and associated with classic vulvar intraepithelial neoplasia (VIN). Keratinizing SCC is associated with lichen sclerosus and differentiated VIN, but not with human papillomavirus. This study was undertaken to examine the expression patterns of ProEx C in vulvar SCC and its precursors. We analyzed 22 cases with normal vulvar epidermis, 13 cases of lichen sclerosus, 14 cases of condylomas, 23 cases of high-grade classic VIN, 6 cases of differentiated VIN, 3 cases of verrucous carcinomas, 10 cases of keratinizing SCC, and 8 cases of basaloid and warty SCC. ProEx C targets minichromosome maintenance protein and topoisomerase II alpha protein which are overexpressed in the cell nucleus during aberrant S-phase induction. Marked confluent ProEx C expression is present in high-grade classic VIN with nuclear staining extending into the middle and upper layers of the epidermis. Condylomas show parabasal nuclear immunoreactivity associated with scattered ProEx C-positive nuclei in the more differentiated suprabasilar layers. Invasive SCC shows variable staining patterns. In contrast, ProEx C staining is essentially limited to the basal and parabasal layers in normal epidermis, lichen sclerosus, differentiated VIN, and verrucous carcinoma. Overall, ProEx C is a useful proliferation marker for high-grade VIN analogous to the staining patterns reported in high-grade cervical intraepithelial neoplasia. PMID:20697251

Chen, Hui; Gonzalez, Jorge L; Brennick, Jeoffry B; Liu, Miaoliang; Yan, Shaofeng

2010-09-01

217

Intraoperative intravitreal triamcinolone decreases macular edema after vitrectomy with phacoemulsification  

PubMed Central

Background The purpose of this study was to evaluate the incidence and amount of macular edema by optical coherence tomography (OCT) after combined small gauge sutureless vitrectomy with phacoemulsification and intravitreal triamcinolone. Methods This retrospective case series included 194 consecutive eyes undergoing nonemergent vitrectomy with phacoemulsification and intravitreal triamcinolone. Ninety-one eyes had preoperative and postoperative OCT available and were included in the analysis. The eyes were evaluated for retinal thickness with preoperative and postoperative OCT, and for preoperative and postoperative best-corrected visual acuity. The main outcome measures were retinal thickness, OCT appearance, and best-corrected visual acuity. Results The incidence of macular edema in all eyes preoperatively was 64.8% and postoperatively was 50.5%. Mean central subfield and center point thickness in eyes with macular edema preoperatively were 361 ?m and 349 ?m, respectively, and postoperatively were 315 ?m and 304 ?m, respectively. In eyes without preoperative macular edema, mean preoperative central subfield and center point thickness were, respectively, 210 ?m and 181 ?m versus 220 ?m and 192 ?m postoperatively. Best corrected visual acuity improved from 20/190 preoperatively to 20/150 at postoperative month 1 and 20/110 at month 6. Postoperative intraocular pressure ? 25 mmHg was observed in 7.7% of eyes, none of which required surgical intervention for steroid-induced glaucoma. Conclusion Use of intravitreal triamcinolone with combined vitrectomy and phacoemulsification may play an important role in modulating postoperative macular edema. Adverse pressure rise is infrequent and usually limited.

Parke, D Wilkin; Sisk, Robert A; Murray, Timothy G

2012-01-01

218

Post-anesthetic pulmonary edema in two horses.  

PubMed

CASE 1: A two-year old, 462 kg Standard bred horse was anesthetized for arthroscopy and castration. During anesthesia, hyperemia of the mucosal membranes and urticaria were noticed. During 5 hours of anesthesia subcutaneous edema of the eyelids and neck region developed. In the recovery box, the orotracheal (OT) tube was left in situ and secured in place with tape. Following initial attempts to stand, the horse became highly agitated and signs consistent with pulmonary edema developed subsequently. Arterial hypoxemia (PaO(2): 3.7 kPa [28 mmHg]) and hypocapnia (PaCO(2): 3.1 kPa [23 mmHg]) were confirmed. Oxygen and furosemide were administered. The horse was assisted to standing with a sling. Therapy continued with bilateral intra-nasal oxygen insufflation. Ancillary medical therapy included flunixin meglumine, penicillin, gentamycin and dimethylsulfoxide. Following 7 hours of treatment the arterial oxygen tensions began to increase towards normal values. CASE 2: An 11-year old, 528 kg Paint horse was anesthetized for surgery of a submandibular mass. The 4-hour anesthetic period was unremarkable. The OT tube was left in situ for the recovery. During recovery, the horse was slightly agitated and stood after three attempts. Clinical signs consistent with pulmonary edema and arterial hypoxemia (PaO(2): 5 kPa [37.5 mmHg]) subsequently developed following extubation. Respiratory signs resolved with medical therapy, including unilateral nasal oxygen insufflation, furosemide, flunixin meglumine and dimethylsulfoxide. The diagnosis of pulmonary edema in these horses was made by clinical signs and arterial blood-gas analysis. While pulmonary radiographs were not taken to confirm the diagnosis, the clinical signs following anesthesia support the diagnosis in both cases. The etiology of pulmonary edema was most likely multifactorial. PMID:20230564

Kaartinen, M Johanna; Pang, Daniel S J; Cuvelliez, Sophie G

2010-03-01

219

Edema, Oncotic Pressure, and Free Entropy: Novel Considerations for the Treatment of Edema through Attention to Thermodynamics  

Microsoft Academic Search

Over 170 years after Richard Bright and a century after Ernest H. Starling, the development, location, and severity of edema in patients with renal impairment continue to baffle the predictions of most nephrologists. While much of the phenomenon can be explained by levels of serum proteins, or hydrostatic pressures, there are stunning exceptions well known to any practicing nephrologist. Some

Charles J. Diskin; Ram B. Gupta; William Ravis; Thomas J. Stokes; Linda M. Dansby; Thomas B. Carter; Selby G. Thomas

1998-01-01

220

A Systematic Review of the Prevalence and Attribution of Human Papillomavirus Types Among Cervical, Vaginal and Vulvar Pre-cancers and Cancers in the United States  

PubMed Central

Objectives To describe (1) prevalence and (2) estimated attribution of human papillomavirus (HPV) types in U.S. cervical, vaginal and vulvar precancers and cancers. Methods U.S. studies reporting HPV typing for cervical (CIN), vulvar (VIN) and vaginal (VaIN) intraepithelial neoplasias and/or invasive cancers of those sites were gathered from the PubMed database (http://www.ncbi.nlm.nih.gov/sites/entrez/). Selected studies had polymerase chain reaction testing data for ?10 cases for a disease endpoint. Analytic methods augmented prior reviews of cervical disease with an updated and expanded analysis (including vulvar and vaginal disease), new selection criteria for specimens, and adjustment for histologic type, where possible, among pooled cancer cases. In addition, for analyses of estimated attribution of HPV types, we incorporated accounting methods for lesions infected with multiple HPV types. Results Data from 22 U.S. studies meeting review eligibility criteria were tabulated. Following adjustment for the presence of multiple HPV types in a single specimen, the top two HPV types contributing to disease were: CIN 1 (HPV 16/66) [15.3%], CIN 2/3 (16/31) [61.9%], cervical cancer (16/18) [79.2%], VIN 1 (6/11) [41.7%], VIN 3 (16/18) [84.0%], vulvar cancer (16/33) [55.5%], VaIN 3 (16/18) [65.1%], vaginal cancer (16/18) [72.7%]. Conclusions The HPV type distribution and proportion of cases testing positive for any HPV type were observed to vary among U.S. cervical, vulvar and vaginal neoplasias and by grade of disease. Adjustment for the presence of multi-type HPV infections can have an important impact on the estimated attribution of HPV types to disease, particularly for types other than HPV 16.

Insinga, Ralph P.; Liaw, Kai-Li; Johnson, Lisa G.; Madeleine, Margaret M.

2008-01-01

221

Intravitreal Steroids for Macular Edema: The Past, the Present, and the Future  

Microsoft Academic Search

Macular edema, a condition usually associated with an underlying disease process, is a common cause of severe visual loss. There have been a variety of approaches to the treatment of macular edema; within the past few years, however, intravitreal corticosteroid treatments have emerged as an increasingly used treatment option for patients with macular edema. Intravitreal delivery allows the steroid to

Matthew A. Cunningham; Jeffrey L. Edelman; Shalesh Kaushal

2008-01-01

222

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

223

The cuff leak test to predict failure of tracheal extubation for laryngeal edema  

Microsoft Academic Search

Objective. Laryngeal edema secondary to endotracheal intubation may require early re-intubation. Prior to extubation the absence of leak around an endotracheal tube may predict laryngeal edema after extubation. We evaluated the usefulness of a quantitative assessment of such a leak to identify the patients who will require early re-intubation for laryngeal edema. Methods. This prospective study included 76 patients with

Yann De Bast; Daniel De Backer; Jean-Jacques Moraine; Muriel Lemaire; Cécile Vandenborght; Jean-Louis Vincent

2002-01-01

224

Quick detection of brain tumors and edemas: A bounding box method using symmetry  

Microsoft Academic Search

A significant medical informatics task is indexing patient databases according to size, location, and other characteristics of brain tumors and edemas, possibly based on magnetic resonance (MR) imagery. This requires segmenting tumors and edemas within images from different MR modalities. To date, automated brain tumor or edema segmentation from MR modalities remains a challenging, computationally intensive task. In this paper,

Baidya Nath Saha; Nilanjan Ray; Russell Greiner; Albert Murtha; Hong Zhang

225

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

226

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

227

b Adrenergic Stimulation Restores Rat Lung Ability to Clear Edema in Ventilator-associated Lung Injury  

Microsoft Academic Search

Mechanical ventilation with high tidal volume (HVT) causes lung injury and decreases the lung's ability to clear edema in rats. b -adrenergic agonists increase active Na 1 transport and lung edema clearance in normal rat lungs by stimulating apical Na 1 channels and basolateral Na,K-ATPase in alveolar epithelial cells. We studied whether b -adrenergic agonists could restore lung edema clearance

F. J. SALDÍAS; E. LECUONA; A. P. COMELLAS; K. M. RIDGE; D. H. RUTSCHMAN; J. I. SZNAJDER

228

Corneal edema in divers wearing hard contact lenses.  

PubMed

Polymethylmethacrylate (hard) contact lens-wearing Navy divers involved in hyperbaric research complained of ocular discomfort, halos, specular highlights, and decreased visual acuity during and immediately after the decompression phase of dry chamber dives. These symptoms were related to bubbles in the tear film between the cornea and hard contact lens. The bubbles developed during the decompression phase of the dive and represented the trapping (by the hard contact lens) of nitrogen outgassing from the cornea and precorneal tear film. The bubbles effected nummular patches of corneal epithelial edema persisting up to two hours after diving. Gas trapping and corneal edema were not observed in uncovered corneas or corneas covered with membrane lenses. PMID:655226

Simon, D R; Bradley, M E

1978-04-01

229

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

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

2013-01-01

230

Significance of bone marrow edema in pathogenesis of rheumatoid arthritis.  

PubMed

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

Sudo?-Szopi?ska, Iwona; Kontny, Ewa; Ma?li?ski, W?odzimierz; Prochorec-Sobieszek, Monika; Warczy?ska, Agnieszka; Kwiatkowska, Brygida

2013-01-01

231

Intravitreal Ranibizumab for Macular Edema Secondary to Retinal Vein Occlusion  

Microsoft Academic Search

Background\\/Aims: To investigate the effects of intravitreal ranibizumab treatment for macular edema (ME) secondary to retinal vein occlusion (RVO) and the relationship between spectral-domain optical coherence tomography (SD-OCT) findings and visual outcome after successful resolution of ME. Methods: Forty consecutive eyes with ME secondary to branch RVO (BRVO; 29 eyes of 29 patients) or central RVO (CRVO; 11 eyes of

Moosang Kim; Seung-Young Yu; Eung-Suk Kim; So Hyun Bae; Jung Hyun Park; Hyeong Gon Yu; Hyung-Woo Kwak

2012-01-01

232

Inhibition of mouse ear edema by steroidal and triterpenoid saponins  

Microsoft Academic Search

Certain steroids and triterpenoids isolated from diverse plant families were known to possess anti-inflammatory activity.\\u000a In the course of finding new anti-inflammatory natural products, some steroidal and triterpenoid saponins were isolated and\\u000a evaluated for their anti-inflammatory activity usingin vivo mouse ear edema test. At the oral dose of 100 mg\\/kg, several steroidal saponins and triterpenoid saponins such as hederagenin\\u000a glycosides

Sung Yong Kim; Kun Ho Son; Hyeun Wook Chang; Sam Sik Kang; Hyun Pyo Kim

1999-01-01

233

Acute pulmonary edema following pericardiocentesis for cardiac tamponade  

PubMed Central

Pericardiocentesis for therapeutic drainage of pericardial fluid may be associated with a variety of complications, including laceration of the right ventricle or coronary artery, arrhythmias, viscus perforation, hypotension, pneumothorax, adult respiratory distress syndrome and death. Hemodynamic derangements such as acute left ventricular failure, pulmonary edema and cardiogenic shock are infrequent and, hence, less well recognized. The present report describes a patient with pericardial effusion and tamponade who developed cardiogenic shock requiring inotropic support shortly following uncomplicated ultrasound-guided pericardial drainage.

Bernal, Juan M; Pradhan, Jyotiranjan; Li, Tao; Tchokonte, Ronny; Afonso, Luis

2007-01-01

234

Macroglossia and generalized edema not due to hypothyroidism.  

PubMed

We present a 69-year-old male patient with the macroglossia, dysphagia and generalized edema. He was seen previously by other physicians and diagnosed as hypothyroidism. With thyroid stimulating hormone in normal range, tongue biopsy revealed primary systemic amyloidosis. Amyloidosis is the most common cause of macroglossia. Primary systemic amyloidosis should be suspected when laboratory does not support hypothyroidism especially if the enlarged tongue is firm and additional findings are present. PMID:22052249

Alimoglu, Yalcin; Sacli, Fadime Sevgi; Erdamar, Sibel

2011-11-04

235

Ethchlorvynol-induced pulmonary edema in rats. An ultrastructural study.  

PubMed Central

Studies of ethchlorvynol (ECV)-induced pulmonary edema were undertaken for determination of the structural basis of increased microvascular permeability. Rats were administered an intravenous bolus dose of 15 mg/kg ECV and killed at time intervals between 5 minutes and 72 hours. Oyster glycogen and ferritin were used as permeability probes for identification of the sites of altered microvascular permeability. Edema fluid containing ferritin begins to accumulate in the alveolar interstitium 10 minutes after EVC . Thirty minutes after ECV, marked intersitial edema fluid is present containing both permeability probes. The absence of any appreciable transendothelial movement of either probe via vesicles and the presence of open endothelial junctions led the authors to propose the latter as the principal determinant of the increase in permeability. In addition to open endothelial junctions, prominent subendothelial blebs occur. These blebs develop in an otherwise intact endothelium and increase in frequency and size with time following their appearance at 10 minutes. Ferritin and glycogen progressively accumulate within the blebs. At 15 minutes the concentration of ferritin in blebs appears to equal that in plasma, whereas glycogen is absent or sparsely present in a few blebs. At 60 minutes both permeability probes have become concentrated in the blebs. The mechanism of formation of the blebs and concentration in them of the permeability probes cannot yet be specified. The lesion caused by ECV is completely reversible, so that by 72 hours after ECV there is complete resolution of interstitial edema, disappearance of the subendothelial blebs, and closure of endothelial junctions. A small amount of exudate remaining in the alveoli is cleared by 72 hours. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11

Wysolmerski, R.; Lagunoff, D.; Dahms, T.

1984-01-01

236

Edema Toxin Impairs Anthracidal Phospholipase A2 Expression by Alveolar  

Microsoft Academic Search

Bacillus anthracis, the etiological agent of anthrax, is a spore-forming Gram-positive bacterium. Infection with this pathogen results in multisystem dysfunction and death. The pathogenicity of B. anthracis is due to the production of virulence factors, including edema toxin (ET). Recently, we established the protective role of type-IIA secreted phospholipase A2 (sPLA2-IIA) against B. anthracis. A component of innate immunity produced

Macrophages Benoit Raymond; Dominique Leduc; Lucas Ravaux; Ronan Le Goffic; Thomas Candela; Michel Raymondjean; Pierre Louis Goossens; Lhousseine Touqui

237

Cystoid macular edema induced by nab-paclitaxel.  

PubMed

Cystoid macular edema (CME) is a rare complication of taxane-based chemotherapy. We encountered a patient who developed CME during treatment with nab-paclitaxel for metastatic breast cancer. Early detection of this disease enables continuation of appropriate treatment without reducing the quality of life for patients with end-stage disease. Physicians should be aware of this potential adverse effect, and should make changes to the treatment of patients as soon as possible. PMID:22592399

Tanaka, Yuko; Bando, Hiroko; Hara, Hisato; Ito, Yasuaki; Okamoto, Yoshifumi

2012-05-17

238

T2 quantification for improved detection of myocardial edema  

Microsoft Academic Search

BACKGROUND: T2-Weighted (T2W) magnetic resonance imaging (MRI) pulse sequences have been used to detect edema in patients with acute myocardial infarction and differentiate acute from chronic infarction. T2W sequences have suffered from several problems including (i) signal intensity variability caused by phased array coils, (ii) high signal from slow moving ventricular chamber blood that can mimic and mask elevated T2

Shivraman Giri; Yiu-Cho Chung; Ali Merchant; Georgeta Mihai; Sanjay Rajagopalan; Subha V Raman; Orlando P Simonetti

2009-01-01

239

Pulmonary edema after competitive breath-hold diving  

Microsoft Academic Search

ABSTRACT During an international breath-hold diving competition, 19 of the participating divers volunteered for the present study, aimed at elucidating possible symptoms and signs of pulmonary edema after deep dives. Measurements,included dynamic spirometry and pulse oximetry, and chest auscultation was performed on those with the most severe symptoms. After deep dives (25-75 meters), 12 of the divers had signs of

M. H. Liner; Johan P. A. Andersson

2008-01-01

240

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

2013-03-27

241

A dosimetric evaluation of dose escalation for the radical treatment of locally advanced vulvar cancer by intensity-modulated radiation therapy  

SciTech Connect

The purpose of this planning study was to determine whether intensity-modulated radiation therapy (IMRT) reduces the radiation dose to organs at risk (OAR) when compared with 3D conventional radiation therapy (3D-CRT) in patients with vulvar cancer treated by irradiation. This study also investigated the use of sequential IMRT boost (seq-IMRT) and simultaneous integrated boost (SIB-IMRT) for dose escalation in the treatment of locally advanced vulvar cancer. Five vulvar cancer patients treated in the postoperative setting and 5 patients treated with definitive intent (def-group) were evaluated. For the postoperative group, 3D-CRT and IMRT plans to a total dose (TD) of 45 Gy were generated. For the def-group, 4 plans were generated: a 3D-CRT and an IMRT plan to a TD of 56.4 Gy, a SIB-IMRT plan to a TD of 56 Gy, and a SIB-IMRT with dose escalation (SIB-IMRT-esc): TD of 67.2 Gy. Mean dose and dose-volume histograms were compared using Student's t-test. IMRT significantly (all p < 0.05) reduced the D{sub mean}, V30, and V40 for all OAR in the adjuvant setting. The V45 was also significantly reduced for all OAR except the bladder. For patients treated in the def-group, all IMRT techniques significantly reduced the D{sub mean}, V40, and V45 for all OAR. The mean femur doses with SIB-IMRT and SIB-IMRT-esc were 47% and 49% lower compared with 3D-CRT. SIB-IMRT-esc reduced the doses to the OAR compared with seq-3D-CRT but increased the D{sub max.} for the small bowel, rectum, and bladder. IMRT reduces the dose to the OAR compared with 3D-CRT in patients with vulvar cancer receiving irradiation to a volume covering the vulvar region and nodal areas without compromising the dosimetric coverage of the target volume. IMRT for vulvar cancer is feasible and an attractive option for dose escalation studies.

Bloemers, Monique C.W.M., E-mail: c.bloemers@nki.nl [Department of Radiotherapy, the Netherlands Cancer Institute, Amsterdam (Netherlands); Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Portelance, Lorraine [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Ruo, Russell; Parker, William [Department of Medical Physics, McGill University Health Centre, Montreal, Quebec (Canada); Souhami, Luis [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada)

2012-10-01

242

Is there an increased risk for tumor dissemination using ultrasonic surgical aspiration in patients with vulvar carcinoma?  

PubMed

The ultrasonic surgical aspirator (USA) is a new surgical instrument that allows precise and selective tissue dissection. Ultrasonic cell destruction is combined with continuous irrigation causing a cloud of fine droplets, which sometimes contains viable tumor cells, hanging above the operative field. We present a patient who developed massive recurrent vulvar carcinoma in the subcutaneous tissue in the proximity of the incisions of the vulva and both groins 3.5 months after a USA-assisted radical vulvectomy and inguinal lymphadenectomy. The atypical pattern of recurrence in the entire operative field suggests that tumor cells might have been spread by the irrigation fluid of the USA. Further investigation is needed to assess the risk of tumor dissemination with USA before the instrument can be used safely in patients with early cancer. PMID:7958153

van Dam, P A; Coppens, M; van Oosterom, A T; Van Marck, E; Buytaert, P

1994-06-15

243

Comparison of incident cervical and vulvar/vaginal human papillomavirus infections in newly sexually active young women.  

PubMed

Vulvar/vaginal human papillomavirus (HPV) infections may precede cervical infections, and certain low-risk types may display vaginal tropism. We evaluated whether incident infections in young women display site-specific preferences by HPV risk group or phylogenetic species. Although incident infections were more likely to be detected in the vulva/vagina than in the cervix (odds ratio, 4.38 [95% confidence interval, 2.51-7.63]), the majority were first detected at both sites. Low- or undetermined-risk types were more likely than high-risk types to be first detected in the vulva/vagina (P = .03). Site-by-species differences were not statistically significant. Our results suggest that low- or undetermined-risk HPV types preferentially infect vaginal epithelium. PMID:19434913

Winer, Rachel L; Hughes, James P; Feng, Qinghua; O'Reilly, Sandra; Kiviat, Nancy B; Koutsky, Laura A

2009-03-15

244

A surgical approach to giant condyloma (Buschke-L?wenstein tumour) with underlying superficial vulvar carcinoma: A case report  

PubMed Central

Anogenital warts (condyloma acuminatum or venereal warts) are a common sexually transmitted disease in males and females. Common clinical treatment of anogenital warts is conservative, however, in extreme cases conservative therapy is insufficient and surgical excision is required. Giant condyloma acuminata (Buschke-Löwenstein tumour) is an extremely rare clinical type of genital wart, characterised by aggressive down growth into underlying dermal structures. A 55-year-old female presented with cauliflower-like growth over the anogenital and sacral region, earlier diagnosed as condyloma acuminatum which was resistant to conservative therapy. During the period between 2005 and 2008 the patient underwent five surgical procedures. Due to the size and location of the tumour, gynaecological and plastic surgeons were involved in the procedures. In addition, definitive histology examination identified a superficial vulvar carcinoma.

ZEKAN, JOSKO; PETROVIC, DAVOR; EL-SAFADI, SAMER; BANOVIC, MAJA; HULINA, DAVOR; HRGOVIC, ZLATKO

2013-01-01

245

Imiquimod-induced clearance of HPV is associated with normalization of immune cell counts in usual type vulvar intraepithelial neoplasia.  

PubMed

Recently, we reported on the efficacy of imiquimod for treatment of usual type vulvar intraepithelial neoplasia (uVIN). A histologic regression of uVIN to normal tissue was observed in 58% of patients. As success of treatment is related to clearance of high-risk human papilloma virus (HPV), the aim of our study was to assess differences in immune cell counts and in the expression of p16(INK4a) in VIN tissue before and after imiquimod treatment, in relation to HPV clearance and clinical response. Vulvar tissue samples taken prior to imiquimod treatment and 4 weeks after treatment were tested for the presence of HPV. Previously determined immune cell counts (CD1a, CD207, CD208, CD123/CD11c, CD94, CD4, CD8 and CD25/HLA-DR) in epidermis and dermis of 25 VIN patients and 19 healthy controls were completed with the counts for CD14 and CD68. The expression of p16(INK4a) was investigated by immunohistochemistry in 15 patients. Before imiquimod treatment, both HPV cleared and HPV noncleared patients showed mainly in the dermis significantly upregulated immune cell counts compared to healthy controls. However, in patients that cleared HPV and showed histologic regression already 4 weeks after imiquimod treatment, immune cell counts and p16(INK4a) expression were normalized. In conclusion, our data indicate that imiquimod-induced clearance of HPV results in normalization of counts for certain immune cells and is strongly correlated with histologic regression of the disease. PMID:21351262

Terlou, Annelinde; van Seters, Manon; Kleinjan, Alex; Heijmans-Antonissen, Claudia; Santegoets, Lindy A M; Beckmann, Ilse; van Beurden, Marc; Helmerhorst, Theo J M; Blok, Leen J

2010-12-15

246

Genital Warts and Vulvar Intraepithelial Neoplasia: Natural History and Effects of Treatment and Human Immunodeficiency Virus Infection  

PubMed Central

Objective To describe the natural history of genital warts and vulvar intraepithelial neoplasia (VIN) in women with human immunodeficiency virus (HIV). Methods A cohort of 2,791 HIV infected and 953 uninfected women followed for up to 13 years had genital examinations at 6-month intervals, with biopsy for lesions suspicious for VIN. Results The prevalence of warts was 4.4% (5.3% for HIV seropositive women and 1.9% for seronegative women, P < 0.0001). The cumulative incidence of warts was 33% (95% C.I. 30, 36%) in HIV seropositive and 9% (95% C.I. 6, 12%) in seronegative women (P < 0.0001). In multivariable analysis, lower CD4 lymphocyte count, younger age, and current smoking were strongly associated with risk for incident warts. Among 501 HIV seropositive and 43 seronegative women, warts regressed in 410 (82%) seropositive and 41 (95%) seronegative women (P = 0.02), most in the first year after diagnosis. In multivariable analysis, regression was negatively associated with HIV status and lower CD4 count as well as older age. Incident VIN of any grade occurred more frequently among HIV seropositive than seronegative women: 0.42 (0.33 – 0.53) vs 0.07 (0.02 – 0.18)/100 person-years (P < 0.0001). VIN2+ was found in 58 women (55 with and 3 without HIV, P < 0.001). Two women with HIV developed stage IB squamous cell vulvar cancers. Conclusion While genital warts and VIN are more common among HIV seropositive than seronegative women, wart regression is common even in women with HIV, and cancers are infrequent.

Massad, L. Stewart; Xie, Xianhong; Darragh, Teresa; Minkoff, Howard; Levine, Alexandra M.; Watts, D. Heather; Wright, Rodney L.; D'Souza, Gypsyamber; Colie, Christine; Strickler, Howard D.

2011-01-01

247

Detection of Lymphovascular Invasion in Vulvar Cancer by D2-40 (Podoplanin) as a Predictor for Inguinal Lymph Node Metastases  

Microsoft Academic Search

SummaryBackground: Lymphatic vessel invasion (LVI) plays a major role in the spread of vulvar cancer and predicts regional lymph node metastasis. D2-40, a monoclonal immunohistochemical marker might be able to increase the detection rate of LVI compared to conventional hematoxylin-eosin (HE) staining. The aim of the study was to evaluate the suitability of D2-40 for the prediction of regional lymph

Michael Braun; Eva Wardelmann; Manuel Debald; Gisela Walgenbach-Bruenagel; Tobias Höller; Matthias Wolfgarten; Axel Sauerwald; Christian Rudlowski; Reinhard Büttner; Walther Kuhn; Martin Pölcher

2009-01-01

248

Glutathlone S-Transferase M1 Genotypes and the Risk of Vulvar Cancer: A Population-based Case-Control Study  

Microsoft Academic Search

Glutathione S-transferases (GSTs) facilitate the excretion of a variety of potential carcinogens. Some 50-60% of Caucasians are homozygous for the null allele of GSTM1, a gene responsible for the presence of one of these enzymes. The authors examined whether women with the GSTM1 null genotype are at altered risk of vulvar cancer. They obtained peripheral blood specimens from 18- to

Chu Chen; Margaret M. Madeleine; Noel S. Weiss; Janet R. Daling

249

A randomized comparison of group cognitive–behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis  

Microsoft Academic Search

This study compared group cognitive–behavioral therapy (12-week trial), surface electromyographic biofeedback (12-week trial), and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Subjects were 78 women randomly assigned to one of three treatment conditions and assessed at pretreatment, posttreatment and 6-month follow-up via gynecological examinations, structured interviews and standard questionnaires pertaining to pain (Pain Rating Index and Sensory

Sophie Bergeron; Yitzchak M. Binik; Samir Khalifé; Kelly Pagidas; Howard I. Glazer; Marta Meana; Rhonda Amsel

2001-01-01

250

The Prognostic Value of 14-3-3 Isoforms in Vulvar Squamous Cell Carcinoma Cases: 14-3-3? and ? Are Independent Prognostic Factors for These Tumors  

PubMed Central

Background The 14-3-3 family is comprised of highly conserved proteins that are functionally important in the maintenance of homeostasis. Their involvement with the cell cycle, their association with proto-oncogenes and oncogenes, and their abnormal expression in various tumors has linked this family of proteins to the etiology of human cancer. Mounting evidence now indicates that 14-3-3? is a cancer suppressor gene but the roles of the other 14-3-3 isoforms and their interactions in tumorigenesis have not yet been elucidated. In our current study, we examined the expression of 14-3-3?, ?, ?, ?, ? and ? in a large series of vulvar squamous cell carcinomas to evaluate any clinical significance. Methods Tumor biopsies from 298 vulvar carcinomas were examined by immunohistochemistry for the expression of 14-3-3?, ?, ?, ?, ? and ?. Statistical analyses were employed to validate any associations between the expression of any 14-3-3 isoform and clinicopathologic variables for this disease. Results High cytoplasmic levels of 14-3-3?, ?, ?, ? and ? were observed in 79%, 58%, 50%, 86% and 54% of the vulvar carcinomas analyzed, respectively, whereas a low nuclear expression of 14-3-3? was present in 80% of these cases. The elevated cytoplasmic expression of 14-3-3?, ?, ?, ? and ? was further found to be associated with advanced disease and aggressive features of these cancers. The overexpression of cytoplasmic 14-3-3? and ? significantly correlated with a poor disease-specific survival by univariate analysis (P?=?0.007 and P?=?0.04, respectively). The independent prognostic significance of these factors was confirmed by multivariate analysis (P?=?0.007 and P?=?0.009, respectively). Conclusions We reveal for the first time that the 14-3-3?, ?, ?, ?, ? and ? isoforms may be involved in the progression of vulvar carcinomas. Furthermore, our analyses show that high cytoplasmic levels of 14-3-3? and ? independently correlate with poor disease-specific survival.

Wang, Zhihui; Nesland, Jahn M.; Suo, Zhenhe; Trope, Claes G.; Holm, Ruth

2011-01-01

251

Tissue hyperosmolality and brain edema in cerebral contusion.  

PubMed

Severe cerebral contusion is often associated with nonhemorrhagic mass effect that progresses rapidly within 12 to 48 hours posttrauma. The mechanisms underlying such a rapid progression of mass effect cannot be fully explained by classic concepts of vasogenic and cytotoxic brain edema. Data from previous clinical trials, including diffusion-weighted magnetic resonance imaging studies, have indicated that cells in the central (core) area of the contusion undergo shrinkage, disintegration, and homogenization, whereas cellular swelling is located predominately in the peripheral (rim) area during this period. The authors hypothesized that high osmolality within the contused brain tissue generates an osmotic potential across the central and peripheral areas or causes blood to accumulate a large amount of water. To elucidate the role of tissue osmolality in contusion edema, they investigated changes in tissue osmolality, specific gravity, and ion concentration in contused brain in both experimental and clinical settings. Their results demonstrated that cerebral contusion induced a rapid increase in tissue osmolality from a baseline level of 311.4 +/- 11.3 to 402.8 +/- 15.1 mOsm at 12 hours posttrauma (p < 0.0001). Specific gravity in tissue significantly decreased from 1.0425 +/- 0.0026 to 1.0308 +/- 0.0028 (p < 0.01), reflecting water accumulation in contused tissue. The total ionic concentration [Na+] + [K+] + [Cl-] did not change significantly at any time point. Inorganic ions do not primarily contribute to this elevation in osmolality, suggesting that the increase in colloid osmotic pressure through the metabolic production of osmoles or the release of idiogenic osmoles can be a main cause of contusion edema. PMID:17613236

Kawamata, Tatsuro; Mori, Tatsuro; Sato, Shoshi; Katayama, Yoichi

2007-05-15

252

Subconjunctival sirolimus in the treatment of diabetic macular edema  

PubMed Central

Background Diabetic macular edema (DME) is a leading cause of blindness in the developed world. Sirolimus has been shown to inhibit the production, signaling, and activity of many growth factors relevant to the development of diabetic retinopathy. This phase I/II study assesses the safety of multiple subconjunctival sirolimus injections for the treatment of DME, with some limited efficacy data. Methods In this phase I/II prospective, open-label pilot study, five adult participants with diabetic macular edema involving the center of the fovea and best-corrected ETDRS visual acuity score of ?74 letters (20/32 or worse) received 20 ?l (440 ?g) of subconjunctival sirolimus at baseline, month 2 and every 2 months thereafter, unless there was resolution of either retinal thickening on OCT or leakage on fluorescein angiography. Main outcome measures included best-corrected visual acuity and central retinal thickness on OCT at 6 months and 1 year, as well as safety outcomes. Results Repeated subconjunctival sirolimus injections were well-tolerated, with no significant drug-related adverse events. There was no consistent treatment effect related to sirolimus; one participant experienced a 2-line improvement in visual acuity and 2 log unit decrease in retinal thickness at 6 months and 1 year, two remained essentially stable, one had stable visual acuity but improvement of central retinal thickness of 1 and 3 log units at 6 months and 1 year respectively, and one had a 2-line worsening of visual acuity and a 1 log unit increase in retinal thickness at 6 months and 1 year. Results in the fellow eyes with diabetic macular edema, not treated with sirolimus, were similar. Conclusions Subconjunctival sirolimus appears safe to use in patients with DME. Assessment of possible treatment benefit will require a randomized trial.

Krishnadev, Nupura; Forooghian, Farzin; Cukras, Catherine; Wong, Wai; Saligan, Leorey; Chew, Emily Y.; Nussenblatt, Robert; Ferris, Frederick

2011-01-01

253

A case report of acute idiopathic scrotal edema.  

PubMed

Acute Idiopathic Scrotal Edema (AISE) is an uncommon cause of bilateral scrotal swelling encountered in primary care. AISE is usually seen in children; however, several case reports have shown that AISE can occur in adult males. We present an active duty adult male who presented with AISE while deployed in Afghanistan. The clinical course of AISE is usually benign with labs and ultrasound being unremarkable. Besides swelling, the most common symptom tends to be intense scrotal puritis. Treatment for AISE is watchful waiting and conservative therapy. Full symptom resolution usually occurs within 24 hours. PMID:23820373

Braun, Michael M; Cronin, Aaron J; Bell, David G

2013-07-01

254

[Acute recurring Quincke edema in allergy to malt extract].  

PubMed

The case is reported of a 19-year-old patient with recurrent Quincke edema with systemic symptoms. Based on observations of the course, diary entries and specific skin tests (scratch), sensitization to malt extract from germinated barley was diagnosed. The allergic reactions usually occurred after consumption of malt-containing chocolate drinks and malt-containing snack products. In cooperation with Prof. S. G. O. JOHANSSON, Stockholm, we have for the first time identified specific serum IgE antibodies against malt extract. PMID:6710112

Wüthrich, B

1984-02-25

255

Acute pulmonary edema caused by a giant atrial myxoma.  

PubMed

Atrial myxoma is the most common primary cardiac tumor. Its clinical presentation spreads from asymptomatic incidental mass to serious life-threatening cardiovascular complications. We report the case of a 44-year-old man with evening fever and worsening dyspnea in the last weeks, admitted to our hospital for acute pulmonary edema. The cardiac auscultation was very suspicious for mitral valve stenosis, but the echocardiography revealed a huge atrial mass with a diastolic prolapse into mitral valve orifice causing an extremely high transmitral gradient pressure. Awareness of this uncommon acute presentation of atrial myxoma is necessary for timely diagnosis and prompt surgical intervention. PMID:23762077

Fisicaro, Andrea; Slavich, Massimo; Agricola, Eustachio; Marini, Claudia; Margonato, Alberto

2013-05-16

256

Routine Diagnostic Venous Ultrasound and LAS for Leg Edema of Unknown Cause  

PubMed Central

Objective: To verify the diagnostic efficiency of venous duplex ultrasound and lymphangioscintigraphy (LAS) in establishing the cause of leg edema and to clarify the pathology of these leg edemas. Materials and Methods: Between April 2009, and March 2010, 62 patients with leg edema of unknown origin were referred to the Edema Clinic of the Yamaguchi University Graduate School of Medicine. All patients underwent a venous duplex ultrasound scan and LAS. Results: Of 62 patients, lymphatic insufficiency, venous insufficiency or both was diagnosed in 42 (68%), and lymphedema, in 29 (47%). Venous duplex ultrasound detected obvious venous disorders in only 13 (21%), and for 20 patients, the ultrasound and LAS did not reveal any abnormalities; however, for 15 of the 20 (24% of all patients), venous edema was attributed to functional causes. Conclusion: Venous duplex ultrasound and LAS assisted in the diagnosis of leg edema of unknown origin and also proved useful in establishing treatment strategies.

2010-01-01

257

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.

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

2013-01-01

258

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

259

Postobstructive pulmonary edema following accidental near-hanging  

PubMed Central

Patient: Female, 14 Final Diagnosis: Postobstructive pulmonary edenma Symptoms: Chest indrawing • bilateral pulmonary crepitations • tachypnea Medication: — Clinical Procedure: Controlled ventilatory support • positive end expiratory pressure Specialty: Intensive care Objective: Unusual clinical course Background: Postobstructive pulmonary edema (POPE) is a life-threatening complication that occurs after the relief of an upper airway obstruction. POPE occurs rarely in children, primarily after non-lethal hanging. Case Report: We report the case of a 14-year-old girl who developed POPE after accidental near hanging. She had chest in-drawing, the SpO2 was 81% on room air, and pulmonary auscultation revealed bilateral crepitations. The chest x-ray showed bilateral diffuse infiltrates consistent with pulmonary edema. The intensive care management consisted of controlled ventilatory support with high-level positive end expiratory pressure. On the third day of hospitalization, the patient was weaned from the ventilator and extubated with a full recovery. Conclusions: This case confirms the importance of early recognition of POPE and the value of adapted treatment, which can lead to a favorable outcome and full recovery in cases of near hanging.

Berdai, Adnane Mohamed; Labib, Smael; Harandou, Mustapha

2013-01-01

260

Transient increase in macular edema following vitrectomy for retinal branch vein occlusion  

Microsoft Academic Search

Purpose We confirmed a transient increase in macular edema in some patients after simple vitrectomy for macular edema associated\\u000a with branch retinal vein occlusion (BRVO). Methods We studied 54 consecutive patients (54 eyes) with macular edema secondary to BRVO and preoperative visual acuity of 0.5 or\\u000a below, who underwent vitrectomy and were followed for at least 1 year. Visual acuity and

Hiroyuki Shimada; Hiroyuki Nakashizuka; Takayuki Hattori; Ryusaburo Mori; Yoshihiro Mizutani

2009-01-01

261

Increased cerebrospinal fluid glutamate and taurine concentrations are associated with traumatic brain edema formation in rats  

Microsoft Academic Search

Glutamate-mediated excitotoxicity results in cell swelling and contributes to brain edema formation. Since increased extracellular taurine reflects glutamate-induced cell swelling in vitro, elevated CSF taurine could therefore unmask glutamate-mediated cytotoxic edema formation under in vivo conditions. For this, the temporal profile of brain edema and changes in cisternal CSF glutamate and taurine levels were determined in 28 rats following focal

John F. Stover; Andreas W. Unterberg

2000-01-01

262

Cerebral edema during treatment of diabetic ketoacidosis in an adult with new onset diabetes  

Microsoft Academic Search

Introduction: Diabetic ketoacidosis (DKA) continues to be a medical emergency, in part because of a rare and devastating complication associated\\u000a with its treatment, cerebral edema. In children, cerebral edema is the principal cause of mortality, but clinically significant\\u000a cerebral edema in adults is rare.\\u000a \\u000a \\u000a Methods and Results: We report the case of a 27-year-old male (not previously known to be

Patrick J. Troy; Roger P. Clark; Sri G. Kakarala; Jocelyn Burns; Isaac E. Silverman; Eric Shore

2005-01-01

263

Intravitreal pegaptanib for refractory macular edema secondary to retinal vein occlusion  

PubMed Central

Purpose To assess the efficacy of intravitreal Pegaptanib sodium (Macugen®) injection in the management of refractory macular edema secondary to branch retinal vein occlusion. Methods This is a prospective, nonrandomized, interventional case series. Five eyes of five patients with macular edema refractory to either bevacizumab or triamcinolone were treated with intravitreal injection of Pegaptanib sodium. Results After three months follow-up, both visual acuity and macular edema, measured by optical coherence tomography and fluorescence angiography, dramatically improved. Conclusion Pegaptanib sodium is a safe and efficacy treatment for macular edema secondary to branch retinal vein occlusion.

Udaondo, Patricia; Garcia-Delpech, Salvador; Salom, David; Garcia-Pous, Maria; Diaz-Llopis, Manuel

2011-01-01

264

Deep vein thrombosis (DVT) in advanced cancer patients with lower extremity edema referred for assessment.  

PubMed

Lower extremity edema is a common complication in advanced cancer patients, and deep vein thrombosis (DVT) is one among many causes. Clinical signs and symptoms are known to be unreliable, and radiographic investigations are often required in diagnosing DVT. A retrospective chart review was conducted on 46 advanced cancer patients with lower extremity edema. Researchers analyzed 52 venous duplex scans to determine the radiographic incidence of DVT the reliability of other clinical signs and symptoms in diagnosing DVT, apart from leg edema, and to assess other potential causes of lower extremity edema and their correlation to DVT. Twenty-three (44 percent) of 52 scans were positive for DVT. The most common presentation of edema in the patients with positive scans was bilateral asymmetric edema (11/23, 48 percent). There was limited documentation of other clinical signs and symptoms suggesting DVT. Other variables such as serum albumin (p = 0.46) and creatinine (p = 0.11) were not statistically different in patients who had positive and negative scans. Of other potential causes of lower extremity edema, such as previous surgery, radiotherapy, tumor, or lymph node compression, a number of patients had a coexisting DVT with bilateral asymmetric edema as the most common presentation. The results of this study suggest that advanced cancer patients with bilateral asymmetric lower extremity edema of potentially multifactorial origin have a high incidence of DVT. PMID:15853094

Kirkova, Jordanka; Oneschuk, Doreen; Hanson, John

265

Pharmaco-modulations of induced edema and vascular permeability changes by Vipera lebetina venom: inflammatory mechanisms.  

PubMed

The inflammatory response induced by Vipera lebetina venom (VLV) in the mice hind paw was evaluated by paw edema value and vascular permeability changes. The edema was produced in a dose- and time-dependent manner. This response was maximal within 2 h and disappeared after 24 h The minimum edema-forming dose was estimated at 0.8 ?g/20 g body weight. Microscopic examination confirmed that VLV also induces skin structure alterations with collagen fiber dissociation and polynuclear infiltration, which is characteristic of edema formation. The induced edema with VLV (1 ?g/paw) could be due to the release of pharmacological active substances at the site of injection. Histamine, serotonine, and arachidonate metabolites may play important roles in the vasoactive and edematic effect of VLV since pretreatment of mice with cromoglycate, cyproheptadine, ibuprofen, loratidine, and indomethacin significantly reduced the edema formation (77, 63, 57, 45, and 43 %, respectively). The obtained results demonstrate that the induced edema and vasodilatation by this venom may be triggered and maintained by different pharmacological mechanisms, since cromoglycate and cyproheptadine were the most active inhibitors of the edema. The relationships between histamine and serotonin release from mast cells and arachidonate metabolites activation could be the main step in edema-forming and the induced vasodilatation by the venom. PMID:23108954

Sebia-Amrane, Fatima; Laraba-Djebari, Fatima

2013-04-01

266

In vivo photoacoustic tomography of mouse cerebral edema induced by cold injury  

PubMed Central

For the first time, we have implemented photoacoustic tomography (PAT) to image the water content of an edema in vivo. We produced and imaged a cold-induced cerebral edema transcranially, then obtained blood vessel and water accumulation images at 610 and 975 nm, respectively. We tracked the changes at 12, 24, and 36 h after the cold injury. The blood volume decreased after the cold injury, and the maximum area of edema was observed 24 h after the cold injury. We validated PAT of the water content of the edema through magnetic Resonance Imaging and the water spectrum from the spectrophotometric measurement.

Xu, Zhun; Zhu, Quing; Wang, Lihong V.

2011-01-01

267

In vivo photoacoustic tomography of mouse cerebral edema induced by cold injury  

NASA Astrophysics Data System (ADS)

For the first time, we have implemented photoacoustic tomography (PAT) to image the water content of an edema in vivo. We produced and imaged a cold-induced cerebral edema transcranially, then obtained blood vessel and water accumulation images at 610 and 975 nm, respectively. We tracked the changes at 12, 24, and 36 h after the cold injury. The blood volume decreased after the cold injury, and the maximum area of edema was observed 24 h after the cold injury. We validated PAT of the water content of the edema through magnetic Resonance Imaging and the water spectrum from the spectrophotometric measurement.

Xu, Zhun; Zhu, Quing; Wang, Lihong V.

2011-06-01

268

Dynorphin A(6-12) analogs suppress thermal edema.  

PubMed

Dynorphin A (Dyn A) is a 17-residue opioid peptide derived from prodynorphin precursors found in mammalian tissues. Removal of Tyr1 from Dyn A produces a peptide that is more potent than Dyn A in attenuating the acute phase of the inflammatory response, as measured by inhibition of heat-induced edema in the anesthetized rat's paw (exposure to 58 degrees C water for 1 min). Dyn A(2-17), however, no longer interacts with opioid receptors. It was postulated that the non-opioid anti-inflammatory actions of Dyn A(2-17) may reside in Dyn A(6-12); that is, Arg-Arg-Ile-Arg-Pro-Lys-Leu. here we report on the activities of Dyn A(6-12) analogs modified by substitutions on the N terminus, by single N-methyl substitution and by single replacement of residues by alanine. The results indicated that the minimal sequence required for an anti-edema ED50 of <1.0 micromol/kg i.v. was anisoyl-Arg6-Arg7-Xaa8-Arg9-Pro10)-Xaa11-+ ++Xaa12-NH2. A prototype, p-anisoyl-[D-Leu12] Dyn A(6-12)-NH2, with an ED50 of 0.20 micromol/kg i.v. compared to an ED50 of 0.08 micromol/kg i.v. for Dyn A(2-17), was selected for further tests of biological activity. This analog, like Dyn A(2-17), lowered blood pressure in anesthetized rats. In a model of neurogenic inflammation, produced by antidromic stimulation of the vagus in the anesthetized rat, p-anisoyl-[D-Leu12] Dyn A(6-12)-NH2, 0.23 micromol/kg i.v., attenuated the negativity of tracheal tissue interstitial pressure (Pif), which normally develops after nerve stimulation. Modulation of interstitial pressure may be the mechanistic basis for the anti-edema properties of these Dyn A(6-12) analogs. PMID:9622034

Wei, E T; Thomas, H A; Gjerde, E A; Reed, R K; Burov, S V; Korolkov, V I; Glynskaya, O V; Dorosh, M Y; Vlasov, G P

1998-01-01

269

Evaluation of fatty acid amides in the carrageenan-induced paw edema model  

PubMed Central

While it has long been recognized that ?9-tetrahydrocannabinol (THC), the primary psychoactive constituent of cannabis, and other cannabinoid receptor agonists possess anti-inflammatory properties, their well known CNS effects have dampened enthusiasm for therapeutic development. On the other hand, genetic deletion of fatty acid amide hydrolase (FAAH), the enzyme responsible for degradation of fatty acid amides, including endogenous cannabinoid N-arachidonoyl ethanolamine (anandamide; AEA), N-palmitoyl ethanolamine (PEA), N-oleoyl ethanolamine (OEA), and oleamide, also elicits anti-edema, but does not produce any apparent cannabinoid effects. The purpose of the present study was to investigate whether exogenous administration of FAAs would augment the anti-inflammatory phenotype of FAAH (-/-) mice in the carrageenan model. Thus, we evaluated the effects of the FAAs AEA, PEA, OEA, and oleamide in wild-type and FAAH (-/-) mice. For comparison, we evaluated the anti-edema effects of THC, dexamethasone (DEX), a synthetic glucocorticoid, diclofenac (DIC), a nonselective cyclooxygenase (COX) inhibitor, in both genotypes. A final study determined if tolerance to the anti-edema effects of PEA occurs after repeated dosing. PEA, THC, DEX, DIC elicited significant decreases in carrageenan-induced paw edema in wild type mice. In contrast OEA produced a less reliable anti-edema effect than these other drugs, and AEA and oleamide failed to produce any significant decreases in paw edema. Moreover, none of the agents evaluated augmented the anti-edema phenotype of FAAH (-/-) mice, suggesting that maximal anti-edema effects had already been established. PEA was the most effective FAA in preventing paw edema and its effects did not undergo tolerance. While the present findings do not support a role for AEA in preventing carrageenan-induced edema, PEA administration and FAAH blockade elicited anti-edema effects of an equivalent magnitude as produced by THC, DEX, and DIC in this assay.

Wise, Laura E.; Cannavacciulo, Roberta; Cravatt, Benjamin F.; Martin, Billy F.; Lichtman, Aron H.

2008-01-01

270

Evaluation of fatty acid amides in the carrageenan-induced paw edema model.  

PubMed

While it has long been recognized that Delta(9)-tetrahydrocannabinol (THC), the primary psychoactive constituent of cannabis, and other cannabinoid receptor agonists possess anti-inflammatory properties, their well known CNS effects have dampened enthusiasm for therapeutic development. On the other hand, genetic deletion of fatty acid amide hydrolase (FAAH), the enzyme responsible for degradation of fatty acid amides, including endogenous cannabinoid N-arachidonoyl ethanolamine (anandamide; AEA), N-palmitoyl ethanolamine (PEA), N-oleoyl ethanolamine (OEA), and oleamide, also elicits anti-edema, but does not produce any apparent cannabinoid effects. The purpose of the present study was to investigate whether exogenous administration of FAAs would augment the anti-inflammatory phenotype of FAAH (-/-) mice in the carrageenan model. Thus, we evaluated the effects of the FAAs AEA, PEA, OEA, and oleamide in wild-type and FAAH (-/-) mice. For comparison, we evaluated the anti-edema effects of THC, dexamethasone (DEX), a synthetic glucocorticoid, diclofenac (DIC), a nonselective cyclooxygenase (COX) inhibitor, in both genotypes. A final study determined if tolerance to the anti-edema effects of PEA occurs after repeated dosing. PEA, THC, DEX, DIC elicited significant decreases in carrageenan-induced paw edema in wild-type mice. In contrast OEA produced a less reliable anti-edema effect than these other drugs, and AEA and oleamide failed to produce any significant decreases in paw edema. Moreover, none of the agents evaluated augmented the anti-edema phenotype of FAAH (-/-) mice, suggesting that maximal anti-edema effects had already been established. PEA was the most effective FAA in preventing paw edema and its effects did not undergo tolerance. While the present findings do not support a role for AEA in preventing carrageenan-induced edema, PEA administration and FAAH blockade elicited anti-edema effects of an equivalent magnitude as produced by THC, DEX, and DIC in this assay. PMID:17675189

Wise, Laura E; Cannavacciulo, Roberta; Cravatt, Benjamin F; Martin, Billy F; Lichtman, Aron H

2007-06-22

271

Peripheral Edema Occurring during Treatment with Risperidone Combined with Citalopram  

PubMed Central

An 80-year-old female presented with symptoms of depression, worthlessness, hopelessness, loss of energy, insomnia, impatience, and forgetfulness associated with persecutory delusion that had begun about one year before her visit. She was diagnosed with major depression with psychotic signs and began treatment with risperidone (2?mg/night) and citalopram (20?mg/day). After 20 days, she returned and reported partial improvement in her symptoms, although she had developed severe swelling of the hands and feet. The results of liver and renal function tests and rheumatologic tests were found to be within normal limits. Risperidone was discontinued for a week, and the swelling resolved completely. Risperidone was then administered again, and the swelling returned so that the patient had to discontinue taking the drug. The reappearance of edema on rechallenge is strong evidence implicating risperidone as the cause of the swelling.

Hosseini, Seyed Hamzeh; Ahmadi, Amirhossein

2012-01-01

272

Hemorrhagic stroke associated with pulmonary edema and catastrophic cardiac failure.  

PubMed

Cerebral arteriovenous fistula (AVF) is a vascular malformation that is rare in the pediatric population. Older children with cerebral AVF tend to present with neurologic problems related to intracranial venous hypertension or intracranial hemorrhage. Cardiac and pulmonary complications following acute neurologic injury such as subarachnoid hemorrhage are common in adults, but are rarely reported in children. However, complications have been reported in cases of enterovirus 71 rhombencephalitis in infants and children and can cause high morbidity and mortality. Here, we report a 14-year-old boy who presented with cardiac failure associated with pulmonary edema following cerebral hemorrhagic stroke due to AVF. After aggressive investigation and management, we intervened before significant hypoxia and hypotension developed, potentially reducing the risk of long-term adverse neurologic consequences in this patient. PMID:18947007

Lee, Jiun-Chang; Lin, Jainn-Jim; Lin, Kuang-Lin; Hsia, Shao-Hsuan; Wu, Chang-Teng; Wong, Alex Mun-Ching

2008-06-01

273

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.

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

2011-01-01

274

Treatment of macular edema due to retinal vein occlusions.  

PubMed

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

2011-05-24

275

Negative Pressure Pulmonary Edema after Laparoscopic Donor Nephrectomy  

PubMed Central

Introduction: Laparoscopic donor nephrectomy is associated with a 10% chance of morbidity and a 0.03% mortality rate. We present a case of negative pressure pulmonary edema (NPPE) in a healthy subject immediately following a laparoscopic donor nephrectomy. In this report, we will use the case to review the complications of NPPE and to illustrate its management. Case Description: A healthy 19-y-old male presented at our institution as a living-related donor for left laparoscopic donor nephrectomy. Following the surgery, the patient was reintubated and kept in the intensive care unit secondary to NPPE. The patient experienced an uneventful postoperative course and was subsequently discharged. Discussion: Although a self-limiting phenomenon, mainstay NPPE therapy requires immediate re-establishment of the airway, adequate oxygenation, and application of positive airway pressure.

Gupta, Mohit; Akhavan, Ardavan; Hall, Matthew

2012-01-01

276

Localized bi-nasal macular edema in optic chiasmal syndrome  

PubMed Central

A 28-year-old healthy male complaining of vision loss in his right eye was discovered to have localized bi-nasal macular edema in the presence of a pituitary adenoma. The presence of a junctional scotoma composed by a central scotoma in the right eye associated with superior temporal quadrantanopia in the fellow eye was seen. The pattern detected in the visual field suggested the presence of an expansive mass at the level of the optic chiasm. Optical coherence tomography findings also revealed subtle macular thickness beyond normal in the superior and nasal quadrants of both maculae. This report illustrates the importance of suspecting a pituitary adenoma in the light of uncharacteristic retinal alterations.

Lavaque, Alejandro J; Yilmaz, Taygan; Cordero-Coma, Miguel

2013-01-01

277

Proton-nuclear magnetic resonance relaxation times in brain edema  

SciTech Connect

Proton relaxation times of protein solutions, bovine brain, and edematous feline brain tissue were studied as a function of water concentration, protein concentration, and temperature. In accordance with the fast proton exchange model for relaxation, a linear relation could be established between R1 and the inverse of the weight fraction of tissue water. This relation also applied to R2 of gray matter and of protein solutions. No straightforward relation with water content was found for R2 of white matter. Temperature-dependent studies indicated that in this case, the slow exchange model for relaxation had to be applied. The effect of macromolecules in physiological relevant concentrations on the total relaxation behavior of edematous tissue was weak. Total water content changes predominantly affected the relaxation rates. The linear relation may have high clinical potential for assessment of the status of cerebral edema on the basis of T1 and T2 readings from MR images.

Kamman, R.L.; Go, K.G.; Berendsen, H.J. (Univ. of Groningen (Netherland))

1990-01-01

278

Cardiac resynchronization therapy in acute pulmonary edema: A case report  

PubMed Central

We are reporting a case of 71-year old lady with a dual chamber demand pacemaker, who developed acute pulmonary edema due to an acute left ventricular (LV) dysfunction and worsening in mitral valve regurgitation after atrioventricular nodal ablation for uncontrolled atrial fibrillation. This was attributed to right ventricular apical pacing leading to LV dyssynchronization. Patient dramatically improved within 12-24 h after upgrading her single chamber pacemaker to biventricular pacing. Our case demonstrates that biventricular pacing can be an effective modality of treatment of acute congestive heart failure. In particular, it can be used when it is secondary to LV dysfunction and severe mitral regurgitation attributed to significant dyssynchrony created by right ventricular pacing in patients with atrioventricular nodal ablation for chronic atrial fibrillation.

Barsoum, Emad A; Bhat, Tariq; Asti, Deepak; Kowalski, Marcin; Vazzana, Thomas

2013-01-01

279

Cardiac resynchronization therapy in acute pulmonary edema: A case report.  

PubMed

We are reporting a case of 71-year old lady with a dual chamber demand pacemaker, who developed acute pulmonary edema due to an acute left ventricular (LV) dysfunction and worsening in mitral valve regurgitation after atrioventricular nodal ablation for uncontrolled atrial fibrillation. This was attributed to right ventricular apical pacing leading to LV dyssynchronization. Patient dramatically improved within 12-24 h after upgrading her single chamber pacemaker to biventricular pacing. Our case demonstrates that biventricular pacing can be an effective modality of treatment of acute congestive heart failure. In particular, it can be used when it is secondary to LV dysfunction and severe mitral regurgitation attributed to significant dyssynchrony created by right ventricular pacing in patients with atrioventricular nodal ablation for chronic atrial fibrillation. PMID:24109499

Barsoum, Emad A; Bhat, Tariq; Asti, Deepak; Kowalski, Marcin; Vazzana, Thomas

2013-09-26

280

Primary vulvar Ewing sarcoma/primitive neuroectodermal tumor: a report of 2 cases and review of the literature.  

PubMed

Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) family of tumor is a very aggressive malignant round cell tumor characterized by translocations involving EWS-FLI1 genes. They are increasingly recognized in extraosseous sites as a result of improvements in diagnostic tools. In this paper, we report 2 additional cases arising in vulva of young adults who have been treated aggressively and have survived fore more than 7 and 4 years successively. Histologic examination showed small round (blue) cell morphology in both cases. The tumor cells contained glycogen and were positive for CD99 and vimentin and negative for keratins, lymphoid markers, S-100, synaptophysin, chromogranin, and desmin. Reverse transcriptase polymerase chain reaction analysis from paraffin-embedded tissue revealed EWS-FLI1 fusion product in 1 case. Collectively, 13 cases of vulvar ES/PNET have been reported in the literature. Only 8 cases have detailed follow-up information with an average follow-up data of 28 months. Ewing sarcoma/PNET should be considered in the differential diagnosis of any undifferentiated tumors involving the lower gynecologic tract and all axillary tests including molecular tests should be performed for correct diagnosis because prolonged survival is possible for this dreadful disease after complete surgical resection, followed by adjuvant therapy. PMID:19820381

Cetiner, Handan; Kir, Gözde; Gelmann, Edward P; Ozdemirli, Metin

2009-08-01

281

Intravitreal vs. subtenon triamcinolone acetonide for the treatment of diabetic cystoid macular edema  

Microsoft Academic Search

BACKGROUND: To assess the efficacy of the intravitreal (IVT) injection of Triamcinolone Acetonide (TA) as compared to posterior subtenon (SBT) capsule injection for the treatment of cystoid diabetic macular edema. METHODS: Fourteen patients with type II diabetes mellitus and on insulin treatment, presenting diffuse cystoid macular edema were recruited. Before TA injection all focal lakes were treated by laser photocoagulation.

Mauro Cellini; Alberto Pazzaglia; Eugenio Zamparini; Pietro Leonetti; Emilio C Campos

2008-01-01

282

The role of myocardial edema in the left ventricular diastolic stiffness.  

PubMed

It has been shown that simultaneous administration of norepinephrine (10mug/kg/min) and drotaverine (200 mug/kg/min) does induce interstitial myocardial edema which tends to increase left ventricular diastolic stiffness. These results suggest that in myocardial ischaemia temporary increase of left ventricular diastolic stiffness may be caused by interstitial edema. PMID:938438

Pogátsa, G; Dubecz, E; Gábor, G y

283

Treatment of Branch Retinal Vein Occlusion induced Macular Edema with Bevacizumab  

Microsoft Academic Search

BACKGROUND: Branch retinal vein occlusion is a frequent cause of visual loss with currently insufficient treatment options. We evaluate the effect of Bevacizumab (Avastin®) treatment in patients with macular edema induced by branch retinal vein occlusion. METHODS: Retrospective analysis of 32 eyes in 32 patients with fluorescein angiography proven branch retinal vein occlusion, macular edema and Bevacizumab treatment. Outcome measures

Mathias Abegg; Christoph Tappeiner; Ute Wolf-Schnurrbusch; Daniel Barthelmes; Sebastian Wolf; Johannes Fleischhauer

2008-01-01

284

Multiple Laser Treatments for Macular Edema Attributable to Branch Retinal Vein Occlusion  

Microsoft Academic Search

? PURPOSE: To report the visual outcome of multiple laser treatments for macular edema attributable to branch retinal vein occlusions (BRVO) and to determine if any prognostic factors exist for improvement. ? DESIGN: Retrospective chart review. ? METHODS: A private practice with four vitreoretinal surgeons performed laser treatments on 88 eyes of 88 patients with macular edema secondary to BRVO

ERICA ESRICK; MANJU L. SUBRAMANIAN; JEFFREY S. HEIER; ANAND K. DEVAIAH; TREXLER M. TOPPING; ALBERT R. FREDERICK; MICHAEL G. MORLEY

285

Increased pulmonary vascular permeability as a cause of re-expansion edema in rabbits  

SciTech Connect

In order to study the mechanism(s) underlying re-expansion edema, we measured the concentration of labeled albumin (RISA) in the extravascular, extracellular water (EVECW) of the lung as a measure of pulmonary vascular permeability. Re-expansion edema was first induced by rapid re-expansion of rabbit lungs that had been collapsed for 1 wk by pneumothorax. The RISA in EVECW was expressed as a fraction of its plasma concentration: (RISA)L/(RISA)PL. The volume of EVECW (ml/gm dry lung) was measured using a /sup 24/Na indicator. Results in re-expansion edema were compared with normal control lungs and with oleic acid edema as a model of permeability edema. In re-expanded lungs, EVECW (3.41 +/- SD 1.24 ml/g) and (RISA)L/(RISA)PL 0.84 +/- SD 0.15) were significantly increased when compared with normal control lungs (2.25 +/- 0.41 ml/g and 0.51 +/- 0.20, respectively). Results in oleic acid edema (5.66 +/- 2.23 ml/g and 0.84 +/- 0.23) were similar to re-expansion edema. This suggested that re-expansion edema is due to increased pulmonary vascular permeability caused by mechanical stresses applied to the lung during re-expansion.

Pavlin, D.J.; Nessly, M.L.; Cheney, F.W.

1981-01-01

286

Bone marrow edema syndrome of the foot: one year follow-up with MR imaging  

Microsoft Academic Search

Objective. To describe the MR findings of bone marrow edema syndrome (BMES) of the foot and its evolution at 1 year follow-up. Design and patients. Twenty-five of 32 patients with disabling foot and ankle pain unrelated to trauma diagnosed as BMES when MR imaging demonstrated a bone marrow edema pattern in one or more bones without any radiological or underlying

Guillermo Fernandez-Canton; Oscar Casado; Ana Capelastegui; Elena Astigarraga; Jose Alejandro Larena; Amaya Merino

2003-01-01

287

Monensin and the Prevention of Tryptophan-Induced Acute Bovine Pulmonary Edema and Emphysema  

Microsoft Academic Search

3-Methylindole, a ruminal fermentation product of tryptophan, induces acute pulmonary edema and emphysema in cattle, and 3-methylindole is present in the ruminal fluid and blood of cows with a natually occurring form of this disease. Monensin, a polyether antibiotic and widely used feed additive for beef cattle, prevented tryptophan-induced acute bovine pulmonary edema and emphysema. Monensin acted by reducing the

A. C. Hammond; J. R. Carlson; R. G. Breeze

1978-01-01

288

GENETIC RELATEDNESS OF ESCHERICHIA COLI O147 STRAINS CAUSING EDEMA DISEASE  

Technology Transfer Automated Retrieval System (TEKTRAN)

Edema disease is a systemic disease of weaned pigs caused by host adapted strains of E. coli that encode virulence genes for F18 fimbriae, shiga toxin 2e and heat stable entertoxin(s). Outbreaks of edema disease are most often caused by E. coli belonging to serogroups O138, O139 or O141. Conversel...

289

Removal of dermal edema with class I and II compression stockings in patients with lipodermatosclerosis  

Microsoft Academic Search

Background: Lipodermatosclerosis is a sequela of deep venous insufficiency and a risk factor for the occurrence of venous leg ulceration. Medical compression stockings facilitate leg ulcer healing and prevent occurrence of ulcers resulting from removal of edema. Although the exact level of compression necessary for removal of dermal edema in patients with deep venous insufficiency has not been established, garments

Monika Gniadecka; Tonny Karlsmark; Annegrete Bertram

1998-01-01

290

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

291

Deep vein thrombosis (DVT) in advanced cancer patients with lower extremity edema referred for assessment  

Microsoft Academic Search

Lower extremity edema is a common complication in advanced cancer patients, and deep vein thrombosis (DVT) is one among many causes. Clinical signs and symptoms are known to be unreliable, and radiographic investigations are often required in diagnosing DVT. A retrospective chart review was conducted on 46 advanced cancer patients with lower extremity edema. Researchers analyzed 52 venous duplex scans

Jordanka Kirkova; Doreen Oneschuk; John Hanson

2005-01-01

292

Edema and uremia from 1827 to 1905: The first faltering steps of renal pathophysiology  

Microsoft Academic Search

Edema and uremia from 1827 to 1905: The first faltering steps of renal pathophysiology. After Richard Bright's studies, both edema and uremia were thought to be due to a renal retention of urinary substances; but if so why were they so rarely associated with each other? To solve this dilemma, a few clinicians turned to physics and chemistry. In 1897,

Gabriel Richet

1993-01-01

293

Vitrectomy for diabetic macular edema: the role of posterior vitreous detachment and epimacular membrane  

Microsoft Academic Search

PURPOSE: To evaluate the surgical efficacy of pars plana vitrectomy on eyes with diabetic macular edema in the presence or absence of a complete posterior vitreous detachment and with or without an epimacular membrane.METHODS: Pars plana vitrectomy was performed on 30 eyes of 29 cases with diabetic macular edema. Visual acuity was measured, and retinal thickness was determined by optical

Teiko Yamamoto; Naoko Akabane; Shinobu Takeuchi

2001-01-01

294

One day wonder: Fast resolution of macular edema following intravitreal ranibizumab in retinal venous occlusions.  

PubMed

Macular edema is a significant cause of vision loss in patients with central retinal vein occlusions and branch retinal vein occlusions. Vascular endothelial growth factor (VEGF) appears to be a key factor in the pathogenesis of this disease. Anti-VEGF therapy, such as intravitreal ranibizumab provides an effective treatment against vision-threatening macular edema. We report three patients of retinal vein occlusion with macular edema who demonstrated overnight resolution of macular edema following treatment with intravitreal ranibizumab (0.5 mg). 3D optical coherence tomography (Optovue) was used as a tool for comparison of the macular thickness before and after treatment. The significant reductions in the central foveal thickness demonstrated in these patients one night after intravitreal injections could have significant influence on modifying current treatment protocols. Early treatment of macular edema related to retinal venous occlusive disease with anti-VEGF injections could result in faster visual rehabilitation in these patients. PMID:24104718

Verma, Lalit; Chakravarti, Arindam; Gupta, Avnindra; Prakash, Smriti

2013-09-01

295

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.

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

2012-01-01

296

Neurogenic pulmonary edema and acute respiratory distress syndrome in a healthy child with febrile status epilepticus.  

PubMed

Neurogenic pulmonary edema is a clinical syndrome that manifests as an acute onset of pulmonary edema in the setting of a central nervous system injury, without cardiac dysfunction. Neurogenic pulmonary edema is rare in children, and the mechanism is still not completely understood.  The clinical pathology overlaps with acute lung injury and acute respiratory distress syndrome. The authors report a case of a 14-month-old previously healthy child who presented with febrile status epilepticus, fulminant neurogenic pulmonary edema, and acute respiratory distress syndrome.  Neurogenic pulmonary edema should be considered in the differential diagnosis for the rapid progression of respiratory failure following an acute neurological injury such as status epilepticus in a child. Prompt respiratory support and treatment of the acute neurological insult can prevent further cerebral hypoxemic injury. PMID:22899797

Nguyen, Thanh T; Hussain, Elora; Grimason, Michele; Goldstein, Joshua; Wainwright, Mark S

2012-08-16

297

PET Reveals Inflammation around Calcified Taenia solium Granulomas with Perilesional Edema  

PubMed Central

Objective Neurocysticercosis, an infection with the larval form of the tapeworm, Taeniasolium, is the cause of 29% of epilepsy in endemic regions. Epilepsy in this population is mostly associated with calcified granulomas; at the time of seizure recurrence 50% of those with calcifications demonstrate transient surrounding perilesional edema. Whether edema is consequence of the seizure, or a result of host inflammation directed against parasite antigens or other processes is unknown. To investigate whether perilesional edema is due to inflammation, we imaged a marker of neuroinflammation, translocater protein (TSPO), using positron emission tomography (PET) and the selective ligand 11C-PBR28. Methods In nine patients with perilesional edema, degenerating cyst or both, PET findings were compared to the corresponding magnetic resonance images. Degenerating cysts were also studied because unlike perilesional edema, degenerating cysts are known to have inflammation. In three of the nine patients, changes in 11C-PBR28 binding were also studied over time. 11C-PBR28 binding was compared to the contralateral un-affected region. Results 11C-PBR28 binding increased by a mean of 13% in perilesional edema or degenerating cysts (P = 0·0005, n = 13 in nine patients). Among these 13 lesions, perilesional edema (n=10) showed a slightly smaller increase of 10% compared to the contralateral side (P = 0·005) than the three degenerating cysts. In five lesions with perilesional edema in which repeated measurements of 11C-PBR28 binding were done, increased binding lasted for 2-9 months. Conclusions Increased TSPO in perilesional edema indicates an inflammatory etiology. The long duration of increased TSPO binding after resolution of the original perilesional edema and the pattern of periodic episodes is consistent with intermittent exacerbation from a continued baseline presence of low level inflammation. Novel anti-inflammatory measures may be useful in the prevention or treatment of seizures in this population.

Fujita, Masahiro; Mahanty, Siddhartha; Zoghbi, Sami S.; Ferraris Araneta, Maria Desiree; Hong, Jinsoo; Pike, Victor W.; Innis, Robert B.; Nash, Theodore E.

2013-01-01

298

Frequency of edema in patients with pulmonary arterial hypertension receiving ambrisentan.  

PubMed

Edema is a common side effect of endothelin receptor antagonists. Ambrisentan is an endothelin type A-selective endothelin receptor antagonist approved for the treatment of pulmonary arterial hypertension. We examined the clinical outcomes of patients who developed edema with and without ambrisentan treatment in 2 phase III, randomized placebo-controlled trials, ambrisentan for the treatment of pulmonary arterial hypertension: results of the ambrisentan in pulmonary arterial hypertension, randomized, double-blind, placebo-controlled, multicenter, efficacy (ARIES) study 1 and 2 (ARIES-1 and ARIES-2) (n = 393). Edema-related adverse events were extracted using broad adverse event search terms. The present post hoc analysis included 132 placebo patients and 261 ambrisentan patients. Of these patients, 14% of the placebo patients and 23% of the ambrisentan patients experienced edema-related adverse events. Overall, the patients who experienced edema tended to have a worse baseline World Health Organization (WHO) functional class (edema 76%, WHO functional class III-IV; no edema 56%, WHO functional class III-IV). In the ambrisentan patients, those with edema were older (mean age 58 ± 13 years) and heavier (mean weight 75 ± 19 kg) than those without edema (mean age 49 ± 15 years; mean weight 70 ± 17 kg). At week 12 of treatment, the ambrisentan patients had significantly increased their 6-minute walk distance (6MWD) by 34.4 m compared to the placebo patients in whom the 6MWD had deteriorated by -9.0 m (p <0.001). Among the ambrisentan patients, those without edema had a 6MWD increase of 38.9 m and those with edema had a 6MWD increase of 19.4 m. Ambrisentan significantly improved the brain natriuretic peptide levels by -34% compared to the brain natriuretic peptide levels in the placebo group that had worsened by +11% (p <0.001). Ambrisentan reduced the brain natriuretic peptide concentrations similarly in patients with and without edema. In conclusion, the present subanalysis of patients with pulmonary arterial hypertension has revealed that ambrisentan therapy provides clinical benefit compared to placebo, even in the presence of edema. PMID:22858181

Shapiro, Shelley; Pollock, David M; Gillies, Hunter; Henig, Noreen; Allard, Martine; Blair, Christiana; Anglen, Crystal; Kohan, Donald E

2012-08-02

299

Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial  

PubMed Central

Objectives To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata). Design Data from two international, double blind, placebo controlled, randomised efficacy trials of quadrivalent HPV vaccine (protocol 013 (FUTURE I) and protocol 015 (FUTURE II)). The trials were to be 4 years in length, and the results reported are from final study data of 42 months’ follow-up. Setting Primary care centres and university or hospital associated health centres in 24 countries and territories around the world. Participants 17?622 women aged 16-26 years enrolled between December 2001 and May 2003. Major exclusion criteria were lifetime number of sexual partners (>4), history of abnormal cervical smear test results, and pregnancy. Intervention Three doses of quadrivalent HPV vaccine (for serotypes 6, 11, 16, and 18) or placebo at day 1, month 2, and month 6. Main outcome measures Vaccine efficacy against cervical, vulvar, and vaginal intraepithelial neoplasia grade I and condyloma in a per protocol susceptible population that included subjects who received all three vaccine doses, tested negative for the relevant vaccine HPV types at day 1 and remained negative through month 7, and had no major protocol violations. Intention to treat, generally HPV naive, and unrestricted susceptible populations were also studied. Results In the per protocol susceptible population, vaccine efficacy against lesions related to the HPV types in the vaccine was 96% for cervical intraepithelial neoplasia grade I (95% confidence interval 91% to 98%), 100% for both vulvar and vaginal intraepithelial neoplasia grade I (95% CIs 74% to 100%, 64% to 100% respectively), and 99% for condyloma (96% to 100%). Vaccine efficacy against any lesion (regardless of HPV type) in the generally naive population was 30% (17% to 41%), 75% (22% to 94%), and 48% (10% to 71%) for cervical, vulvar, and vaginal intraepithelial neoplasia grade I, respectively, and 83% (74% to 89%) for condyloma. Conclusions Quadrivalent HPV vaccine provided sustained protection against low grade lesions attributable to vaccine HPV types (6, 11, 16, and 18) and a substantial reduction in the burden of these diseases through 42 months of follow-up. Trial registrations NCT00092521 and NCT00092534.

2010-01-01

300

T2 quantification for improved detection of myocardial edema  

PubMed Central

Background T2-Weighted (T2W) magnetic resonance imaging (MRI) pulse sequences have been used to detect edema in patients with acute myocardial infarction and differentiate acute from chronic infarction. T2W sequences have suffered from several problems including (i) signal intensity variability caused by phased array coils, (ii) high signal from slow moving ventricular chamber blood that can mimic and mask elevated T2 in sub-endocardial myocardium, (iii) motion artifacts, and (iv) the subjective nature of T2W image interpretation. In this work we demonstrate the advantages of a quantitative T2 mapping technique to accurately and reliably detect regions of edematous myocardial tissue without the limitations of qualitative T2W imaging. Methods Methods of T2 mapping were evaluated on phantoms; the best of these protocols was then optimized for in vivo imaging. The optimized protocol was used to study the spatial, view-dependent, and inter-subject variability and motion sensitivity in healthy subjects. Using the insights gained from this, the utility of T2 mapping was demonstrated in a porcine model of acute myocardial infarction (AMI) and in three patients with AMI. Results T2-prepared SSFP demonstrated greater accuracy in estimating the T2 of phantoms than multi-echo turbo spin echo. The T2 of human myocardium was found to be 52.18 ± 3.4 ms (range: 48.96 ms to 55.67 ms), with variability between subjects unrelated to heart rate. Unlike T2W images, T2 maps did not show any signal variation due to the variable sensitivity of phased array coils and were insensitive to cardiac motion. In the three pigs and three patients with AMI, the T2 of the infarcted region was significantly higher than that of remote myocardium. Conclusion Quantitative T2 mapping addresses the well-known problems associated with T2W imaging of the heart and offers the potential for increased accuracy in the detection of myocardial edema.

2009-01-01

301

Effect of ifenprodil, a polyamine site NMDA receptor antagonist, on brain edema formation following asphyxial cardiac arrest in rats  

Microsoft Academic Search

Objective: Brain edema occurs in experimental and clinical cardiac arrest (CA) and is predictive of a poor neurological outcome. N-Methyl-d-aspartate (NMDA) receptors contribute to brain edema elicited by focal cerebral ischemia\\/reperfusion (I\\/R). Ifenprodil, a NMDA receptor antagonist, attenuates brain edema and injury size in rats after focal cerebral I\\/R. We assessed the hypothesis that ifenprodil reduces CA-elicited brain edema. Methods:

Feng Xiao; Sibile Pardue; Thomas Arnold; Donna Carden; J. Steven Alexander; Jared Monroe; Christopher D Sharp; Richard Turnage; Steven Conrad

2004-01-01

302

Is intra-articular pathology associated with MCL edema on MR imaging of the non-traumatic knee?  

Microsoft Academic Search

Objective: Edema sur- rounding the medial collateral liga- ment (MCL) is seen on MR imaging in patients with MCL injuries and in patients with radiographic osteoar- thritis in the non-traumatic knee. Because we noted MCL edema in patients without prior trauma or os- teoarthritis, we studied the associa- tion between intra-articular pathology and MCL edema in patients without knee trauma.

Donna G. Blankenbaker; Arthur A. De Smet; Jason P. Fine

2005-01-01

303

Efficacy of Vitrectomy and Internal Limiting Membrane Removal for Macular Edema Associated with Branch Retinal Vein Occlusion  

Microsoft Academic Search

Aim: To compare the results of vitrectomy with internal limiting membrane (ILM) peeling to that without ILM peeling for macular edema associated with branch retinal vein occlusion (BRVO). Methods: The medical records of 47 eyes of 47 patients with BRVO-associated macular edema were examined. To treat the macular edema, a posterior vitreous detachment (PVD) was created, and the ILM was

Miyuki Arai; Shuichi Yamamoto; Yoshinori Mitamura; Eiju Sato; Takeshi Sugawara; Satoshi Mizunoya

2009-01-01

304

Expression of aquaporin-4 augments cytotoxic brain edema after traumatic brain injury during acute ethanol exposure.  

PubMed

We previously reported that ethanol consumption affects morbidity and mortality after traumatic brain injury (TBI) by accelerating brain edema via oxidative stress after TBI. Aquaporin-4 (AQP4), a water channel, is involved in brain edema formation. In this study, we found that acute ethanol administration increased AQP4 expression after TBI, leading to severe brain edema in rats. Rats were pretreated with ethanol (3 g/kg) or dl-buthionine-(S,R)-sulfoximine (BSO; 100 mg/kg), an oxidative stressor, before TBI. Acetazolamide, an AQP4 inhibitor, was administered to ethanol-pretreated rats 3 or 12 hours after TBI. Brain edema was increased 24 hours after TBI in both the ethanol- and BSO-pretreated groups. Ethanol pretreatment induced lipid peroxidation 24 hours after TBI. Transcription factors, NF-?B and hypoxia-inducible factor-1?, were activated 3 and 24 hours after TBI in the BSO- and ethanol-pretreated groups, respectively. In the ethanol-pretreated group, AQP4 was accumulated, particularly in astrocyte end feet, 24 hours after TBI. Acetazolamide treatment improved the survival rate to 100% and decreased brain edema and AQP4 in ethanol-pretreated rats. These findings suggest that ethanol induces up-regulation of AQP4, leading to brain edema. The accumulation of AQP4 may play an important role in the augmentation of brain edema after TBI under ethanol consumption. PMID:22051773

Katada, Ryuichi; Nishitani, Yoko; Honmou, Osamu; Mizuo, Keisuke; Okazaki, Shunichiro; Tateda, Kenji; Watanabe, Satoshi; Matsumoto, Hiroshi

2011-11-01

305

Aqueous soluble vascular endothelial growth factor receptor-2 in macular edema with branch retinal vein occlusion.  

PubMed

Abstract Purpose/Aim: The aqueous humor level of soluble vascular endothelial growth factor receptor (sVEGFR)-2 may influence macular edema in patients with branch retinal vein occlusion (BRVO). The association of sVEGFR-2 with macular edema was investigated in this study. Materials and methods: A retrospective case-controlled study was performed in 22 patients with BRVO and macular edema, as well as 5 patients with non-ischemic ocular diseases as the control group. The severity of macular edema was examined by optical coherence tomography. Aqueous humor samples were obtained during intravitreous injection of anti-VEGF agents, triamcinolone acetonide, or combined vitrectomy and cataract surgery. sVEGFR-2 levels in aqueous humor were determined by enzyme-linked immunosorbent assay. Results: The aqueous humor level of sVEGFR-2 (median: 124.5?ng/ml) was significantly elevated in BRVO patients compared with the control group (78.1?pg/ml) (p?=?0.010). In addition, the sVEGFR-2 level was correlated with the severity of macular edema (p?=?0.033). Conclusions: sVEGFR-2 may be involved in the pathogenesis of macular edema associated with BRVO. Measurement of aqueous humor sVEGFR-2 levels may be helpful for understanding the disease status in BRVO patients with macular edema. PMID:23972086

Noma, Hidetaka; Mimura, Tatsuya

2013-08-23

306

Impact of edema and seed movement on the dosimetry of prostate seed implants  

PubMed Central

This article summarizes current knowledge concerning the characterization of prostatic edema and intra-prostatic seed movement as these relate to dosimetry of permanent prostate implants, and reports the initial application to clinical data of a new edema model used in calculating pre- and post-implant dose distributions. Published edema magnitude and half-life parameters span a broad range depending on implant technique and measurement uncertainty, hence clinically applicable values should be determined locally. Observed intra-prostatic seed movements appear to be associated with particular aspects of implant technique and could be minimized by technique modification. Using an extended AAPM TG-43 formalism incorporating the new edema model, relative dose error RE associated with neglecting edema was calculated for three I-125 seed implants (18.9 cc, 37.6 cc, 60.2 cc) performed at our center. Pre- and post-plan RE average values and ranges in a 50 × 50 × 50 mm3 calculation volume were similar at ~2% and ~0–3.5%, respectively, for all three implants; however, the spatial distribution of RE varied for different seed configurations. Post-plan values of D90 and V100 for prostate were reduced by ~2% and ~1%, respectively. In cases where RE is not clinically negligible as a consequence of large edema magnitude and / or use of Pd-103 seeds, the dose calculation method demonstrated here can be applied to account for edema explicitly and there by improve the accuracy of clinical dose estimates.

Sloboda, Ron S.; Usmani, N.; Monajemi, T. T.; Liu, D. M-C

2012-01-01

307

Superolateral Hoffa's Fat Pad Edema: Association With Patellofemoral Maltracking and Impingement  

PubMed Central

OBJECTIVE Nonelderly patients presenting with knee pain often have patellofemoral maltracking or impingement abnormalities. There is a relative paucity of literature on the incidence and significance of impingement-related edema of the superolateral aspect of Hoffa’s (infrapatellar) fat pad in these cases. Our study was designed to systematically evaluate the correlation of superolateral Hoffa’s fat pad edema with various anatomic parameters of trochlear morphology and patellar alignment. MATERIALS AND METHODS We evaluated 50 knee MRI examinations in 47 patients for the presence of edema in superolateral Hoffa’s fat pad and associated anatomic abnormalities of the patellofemoral joint. RESULTS Of the 50 examinations, 25 (50%) showed superolateral Hoffa’s fat pad edema, and statistically significant differences were seen between those with and without edema with respect to sex (6/22 men vs 19/28 women) and patellar tendon patellar–length ratio (1.3 ± 0.16 and 1.1 ± 0.12 for those with and without edema, respectively). CONCLUSION The findings in our study suggest that edema in superolateral Hoffa’s fat pad may be an important indicator of underlying patellofemoral maltracking or impingement in younger, symptomatic patients.

Subhawong, Ty K.; Eng, John; Carrino, John A.; Chhabra, Avneesh

2011-01-01

308

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.

Yoshimura, Nagahisa

2013-01-01

309

Urticaria and angioneurotic edema due to the temporary henna tattoo.  

PubMed

Temporary henna tattoo, which has become popular among young people, is obtained from the mixture of the plants Lawsonia alba or Lawsonia inermis and paraphenylenediamine (PPD). In forming reactions frequent development of anti-PPD substance is noticed. A 13-year old boy who started itching, erythema, enduration on the application area, increasingly urticarial rash, conjunctivitis and swelling of the lips 48 h after being applied the temporary henna tattoo was hospitalized. He had a local reaction to henna tattoo when he was 5-year old. He was treated with parenteral corticosteroids and oral antihistaminic drugs. Skin reactions persisted for 18 days. The patient showed no early reaction to henna 10% and PPD 1% concentration in saline solution but did late reaction (after 48 h) to PPD in diameter of 12x13 mm in prick test in 3 weeks after the reaction. A case who developed angioneurotic edema and urticaria to temporary henna tattoo noticed that the henna tattoo is not an innocent application and young people need to be informed on this subject. PMID:17093382

Gulen, F; Zeyrek, D; Altinoz, S; Peker, E; Demir, E; Tanac, R

2006-12-01

310

Intravitreal Diclofenac for Refractory Uveitic Cystoid Macular Edema  

PubMed Central

Purpose To evaluate the effect of a single dose of intravitreal diclofenac on best- corrected visual acuity (BCVA) and central macular thickness (CMT) in patients with refractory uveitic cystoid macular edema (CME). Methods In this prospective non-comparative case series, 8 eyes of 8 patients with refractory CME secondary to chronic intermediate uveitis received a single intravitreal injection of diclofenac (500 µg/0.1ml) in addition to other systemic (oral prednisolone and methotraxate) and topical (betamethasone) remission maintaining drugs. Outcome measures were changes in BCVA and CMT after treatment. Results Mean BCVA remained relatively unchanged at 12, 24 and 36 weeks (0.69, 0.70 and 0.64 LogMAR, respectively) as compared to baseline (0.71 LogMAR). Mean CMT, however, decreased from 488 µm at baseline to 416 and 456 µm at 24 and 36 weeks, respectively. None of the changes were statistically significant. Conclusion In eyes with refractory uveitic CME, intravitreal injection of diclofenac insignificantly reduced CMT but this was not associated with visual improvement.

Ramezani, Alireza; Fard Esmaeilpour, Nassim; Eskandari, Armen; Rabbanikhah, Zahra; Soheilian, Roham; Soheilian, Masoud

2013-01-01

311

Specific antagonist of platelet-activating factor suppresses edema formation in an Arthus reaction but not edema induced by leukocyte chemoattractants in rabbit skin  

SciTech Connect

The properties of a novel platelet-activating factor (PAF) antagonist, L-652731, on edema responses in rabbit skin induced by exogenous inflammatory mediators and by mediators generated endogenously in a reversed passive Arthus reaction have been investigated. Edema responses in the skin were measured by using the local accumulation of i.v. injected /sup 125/I-albumin. The antagonist, mixed with mediators before intradermal injection, caused a dose-dependent suppression of edema responses to PAF. In contrast, responses induced by other directly acting mediators (bradykinin and histamine) and responses induced by PMN leukocyte-dependent mediators (C5a des Arg, N-formyl-methionyl-leucyl-phenylalanine, and keukotriene B/sub 4/) were not suppressed. Thus, a secondary release of PAF does not appear to be involved in mediating the actions of these agents. In a reversed passive Arthus reaction, intradermal injection of L-652731 together with antibody resulted in a significant inhibition of the edema formation measured for 2 hr after i.v. antigen challenge. In contrast, edema responses induced by intradermal injection of performed immune complexes were not affected by the antagonist. These results suggest that the endogenous production of PAF, in close proximity to microvascular endothelial cells, appears to be an important step in the development of an Arthus reaction. The cellular source of PAF is unknown, but one possibility is the PMN leukocyte, which releases PAF during phagocytosis of immune complexes.

Hellewell, P.G.; Williams, T.J.

1986-07-15

312

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

313

Prostatic edema in {sup 125}I permanent prostate implants: Dynamical dosimetry taking volume changes into account  

SciTech Connect

The purpose of this study is to determine the impact of edema on the dose delivered to the target volume. An evaluation of the edema characteristics was first made, and then a dynamical dosimetry algorithm was developed and used to compare its results to a standard clinical (static) dosimetry. Source positions and prostate contours extracted from 66 clinical cases on images taken at different points in time (planning, implant day, post-implant evaluation) were used, via the mean interseed distance, to characterize edema [initial increase ({delta}r{sub 0}), half-life ({tau})]. An algorithm was developed to take into account the edema by summing a time series of dose-volume histograms (DVHs) with a weight based on the fraction of the dose delivered during the time interval considered. The algorithm was then used to evaluate the impact of edema on the dosimetry of permanent implants by comparing its results to those of a standard clinical dosimetry. The volumetric study yielded results as follows: the initial prostate volume increase was found to be 1.58 (ranging from 1.15 to 2.48) and the edema half-life, approximately 30 days (range: 3 to 170 days). The dosimetric differences in D{sub 90} observed between the dynamic dosimetry and the clinical one for a single case were up to 15 Gy and depended on the edema half-life and the initial volume increase. The average edema half-life, 30 days, is about 3 times longer than the previously reported 9 days. Dosimetric differences up to 10% of the prescription dose are observed, which can lead to differences in the quality assertion of an implant. The study of individual patient edema resorption with time might be necessary to extract meaningful clinical correlation or biological parameters in permanent implants.

Leclerc, Ghyslain; Lavallee, Marie-Claude; Roy, Rene; Vigneault, Eric; Beaulieu, Luc [Departement de Physique, de Genie Physique et d'Optique, Universite Laval, Quebec, G1K 7P4 (Canada) and Centre de Recherche en Cancerologie, CHUQ-Hotel-Dieu de Quebec, Quebec, G1R 2J6 (Canada); Department de Physique, de Genie Physique et d'Optique, Universite Laval, Quebec, G1K 7P4 (Canada); Centre de Recherche en Cancerologie, CHUQ-Hotel-Dieu de Quebec, Quebec, G1R 2J6, (Canada); Department de Physique, de Genie Physique et d'Optique, Universite Laval, Quebec, G1K 7P4, Canada, and Centre de Recherche en Cancerologie, CHUQ - Hotel-Dieu de Quebec, Quebec, G1R 2J6 (Canada)

2006-03-15

314

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

315

Nonsteroidal anti-inflammatory drugs do not interfere with imiquimod treatment for usual type vulvar intraepithelial neoplasia.  

PubMed

Imiquimod has been shown to be an effective treatment for usual type vulvar intraepithelial neoplasia (uVIN). Since local inflammation and burning are common side effects, patients often use nonsteroidal anti-inflammatory drugs (NSAIDs). Our study investigated whether NSAID-use, which has been documented to inhibit the cell-mediated immune response, interferes with the outcome of imiquimod treatment. Monocyte-derived dendritic cells (moDCs) and Langerhans cells (moLCs) were cultured in the presence of NSAIDs. The expression of relevant surface markers (CD80, CD86, CD40, HLA-DR, CCR6 and CCR7), stimulatory function, and cytokine production were evaluated. Furthermore, we analyzed in uVIN patients whether frequent NSAID-use had an effect on the clinical response and on immunocompetent cell counts before and after imiquimod treatment. Although an effect was observed on the expression of moDC and moLC maturation markers, NSAIDs did not affect the ability of moDCs and moLCs to stimulate allogeneic T-cell proliferation, or the production of cytokines in an allogeneic T-cell stimulation assay. In agreement with this, in uVIN patients treated with imiquimod, no interference of frequent NSAID-use with clinical outcome was observed. However, we did notice that high CD1a(+) and CD207(+) cell counts in frequent NSAID-users before treatment seemed to predict a favourable response to imiquimod treatment. Our data indicate that NSAID-use does not seem to interfere with moDC and moLC function and does not interfere with immunomodulatory properties of imiquimod in uVIN patients. Therefore, NSAIDs can safely be used to reduce imiquimod side effects in uVIN patients during treatment. PMID:20658529

Terlou, Annelinde; Kleinjan, Alex; Beckmann, Ilse; Heijmans-Antonissen, Claudia; van Seters, Manon; Santegoets, Lindy A M; van Beurden, Marc; Helmerhorst, Theo J M; Blok, Leen J

2011-05-15

316

Sentinel lymph node biopsy in vulvar cancer: a health technology assessment for the canadian health care context.  

PubMed

Objectives: Inguinofemoral lymphadenectomy for vulvar cancer is associated with a high incidence of groin wound complications and lymphedema. Sentinel lymph node biopsy (SLNB) is a morbidity-reducing alternative to lymphadenectomy. The objective of this health technology assessment was to determine the clinical effectiveness, cost-effectiveness, and organizational feasibility of SLNB in the Canadian health care system. Methods: A review of the English-language literature published from January 1992 to October 2011 was performed across five databases and six grey-literature sources. Predetermined eligibility criteria were used to select studies, and results in the clinical, economic, and organizational domains were summarized. Included studies were evaluated for methodologic quality using the Newcastle-Ottawa Scale. Results: Of 825 reports identified, 88 observational studies met the eligibility criteria. Overall study quality was poor, with a median Newcastle-Ottawa Scale score of 2 out of 9 stars. Across all studies, the detection rate of the sentinel lymph node was 82.2% per groin and the false-negative rate was 6.3%. The groin recurrence rate after negative SLNB was 3.6% compared with 4.3% after negative lymphadenectomy, and complications were reduced after SLNB. No economic evaluations were identified comparing SLNB to lymphadenectomy. Safe implementation of SLNB requires appropriate patient selection, detection technique, and attention to the learning curve. Conclusions: Although study quality is poor, the available data suggest implementation of SLNB may be safe and feasible in Canadian centres with adequate procedural volumes, assuming that implementation includes careful patient selection, careful technique, and ongoing quality assessment. Cost-effectiveness has yet to be determined. PMID:23231843

Reade, Clare J; Jimenez, Waldo; O'Reilly, Daria; Covens, Al

2012-11-01

317

[Changes in content of glycolipids, sphingosine and cytokines in the rat brain with experimental edema].  

PubMed

The study of the content of cerebrosides, gangliosides and their hydrolytic degradation product--sphingosine in the rat brain with experimental edema was carried out. In parallel, the cytokine profile of pro- and anti-inflammatory cytokines in the blood of rats with experimental cerebral edema was studied. The experiments indicated that a decrease of the total fraction of glycolipids and an increase of sphingosine content in the brain of rats with brain swelling were observed. The development of brain edema was accompanied by the increase in proinflammatory and decrease in anti-inflammatory cytokine content. PMID:22946303

Zakharian, G V

318

Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer-Gynaecological Cancer Group)  

Microsoft Academic Search

Patients and methods: In this phase II study, patients with advanced vulvar cancer received paclitaxel (Taxol) every 3 weeks for up to 10 cycles. Primary objective was response rate. Secondary objectives were response duration and toxicity. Response evaluation was assessed by World Health Organisation criteria, toxicity according to Common Toxicity Criteria. Results: Thirty-one women from 10 institutions were included, with

P. O. Witteveen; J. van der Velden; I. Vergote; C. Guerra; C. Scarabeli; C. Coens; G. Demonty; N. Reed

2009-01-01

319

Does lichen sclerosus play a central role in the pathogenesis of human papillomavirus negative vulvar squamous cell carcinoma? The itch-scratch-lichen sclerosus hypothesis.  

PubMed

In the past decade, two types of vulvar squamous cell carcinoma (SCC) have been delineated, Human papillomavirus (HPV) positive and negative. Clinicopathologic, virologic, cytomorphometric, and genetic differences support the view that these two types of carcinoma are fundamentally different and that HPV-negative carcinoma is not simply carcinoma where viral DNA has not been able to be identified. The traditional view of HPV-negative carcinoma is that it is caused by chronic tissue damage from itching and scratching. However, itching and scratching alone do not explain the close association of carcinoma with lichen sclerosus, nor the absence of such an association with other itchy conditions such as eczema or psoriasis. These observations point to a role for lichen sclerosus in the pathogenesis of vulvar carcinoma. Most observations about the etiology of lichen sclerosus can be grouped into its immunogenetic or genital predisposition, or the Köbner phenomenon. In the itch-scratch-lichen sclerosus hypothesis, lichen sclerosus is postulated to occur as a Köbner phenomenon in women with the susceptible immunophenotype who scratch because of genital irritants such as urine, vaginal secretions and smegma, and psychological factors. Lichen sclerosus, itself a very itchy condition, contributes to a vicious cycle of itching and scratching which leads to superimposed lichen simplex chronicus, squamous cell hyperplasia, and ultimately carcinoma. The itch-scratch-lichen sclerosus hypothesis reconciles the traditional itch-scratch hypothesis with the strong clinicopathologic association of lichen sclerosus with carcinoma. PMID:11240748

Scurry, J.

1999-03-01

320

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

321

Nonlinear lymphangion pressure-volume relationship minimizes edema  

PubMed Central

Lymphangions, the segments of lymphatic vessel between two valves, contract cyclically and actively pump, analogous to cardiac ventricles. Besides having a discernable systole and diastole, lymphangions have a relatively linear end-systolic pressure-volume relationship (with slope Emax) and a nonlinear end-diastolic pressure-volume relationship (with slope Emin). To counter increased microvascular filtration (causing increased lymphatic inlet pressure), lymphangions must respond to modest increases in transmural pressure by increasing pumping. To counter venous hypertension (causing increased lymphatic inlet and outlet pressures), lymphangions must respond to potentially large increases in transmural pressure by maintaining lymph flow. We therefore hypothesized that the nonlinear lymphangion pressure-volume relationship allows transition from a transmural pressure-dependent stroke volume to a transmural pressure-independent stroke volume as transmural pressure increases. To test this hypothesis, we applied a mathematical model based on the time-varying elastance concept typically applied to ventricles (the ratio of pressure to volume cycles periodically from a minimum, Emin, to a maximum, Emax). This model predicted that lymphangions increase stroke volume and stroke work with transmural pressure if Emin < Emax at low transmural pressures, but maintain stroke volume and stroke work if Emin= Emax at higher transmural pressures. Furthermore, at higher transmural pressures, stroke work is evenly distributed among a chain of lymphangions. Model predictions were tested by comparison to previously reported data. Model predictions were consistent with reported lymphangion properties and pressure-flow relationships of entire lymphatic systems. The nonlinear lymphangion pressure-volume relationship therefore minimizes edema resulting from both increased microvascular filtration and venous hypertension.

Venugopal, Arun M.; Stewart, Randolph H.; Laine, Glen A.

2010-01-01

322

Status Epilepticus Induces Vasogenic Edema via Tumor Necrosis Factor-?/ Endothelin-1-Mediated Two Different Pathways.  

PubMed

Status epilepticus (SE) induces vasogenic edema in the piriform cortex with disruptions of the blood-brain barrier (BBB). However, the mechanisms of vasogenic edema formation following SE are still unknown. Here we investigated the endothelin B (ETB) receptor-mediated pathway of SE-induced vasogenic edema. Following SE, the release of tumor necrosis factor-? (TNF-?) stimulated endothelin-1 (ET-1) release and expression in neurons and endothelial cells. In addition, TNF-?-induced ET-1 increased BBB permeability via ETB receptor-mediated endothelial nitric oxide synthase (eNOS) activation in endothelial cells. ETB receptor activation also increased intracellular reactive oxygen species by NADPH oxidase production in astrocytes. These findings suggest that SE results in BBB dysfunctions via endothelial-astroglial interactions through the TNF-?-ET-1-eNOS/NADPH oxidase pathway, and that these ETB receptor-mediated interactions may be an effective therapeutic strategy for vasogenic edema in various neurological diseases. PMID:24040253

Kim, Ji-Eun; Ryu, Hea Jin; Kang, Tae-Cheon

2013-09-05

323

Effects of Albumin and Urea on Hydrostatic Edema in the Perfused Lung.  

National Technical Information Service (NTIS)

Hydrostatic interstitial pulmonary edema was induced in isolated perfused canine lungs to evaluate the effects of treatment with osmotic agents. In 14 preparations after induced venous hypertension adding fluid weights of 20 gms, 30 gms, 40 gms, or 60 gms...

P. P. Brown J. R. McCurdy R. C. Elkins L. J. Greenfield

1973-01-01

324

Fluid Distribution in Progressive Pulmonary Edema: A Low-Temperature Scanning-Electron-Microscopy Study.  

National Technical Information Service (NTIS)

High pressure pulmonary edema is a common medical disorder caused by venous hypertension following left ventricular heart failure. Abnormal fluid accumulation in the alveolar air spaces results in a life-threatening loss of respiratory function. The prima...

G. R. Hook

1981-01-01

325

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...

326

Status Epilepticus Induces Vasogenic Edema via Tumor Necrosis Factor-?/ Endothelin-1-Mediated Two Different Pathways  

PubMed Central

Status epilepticus (SE) induces vasogenic edema in the piriform cortex with disruptions of the blood-brain barrier (BBB). However, the mechanisms of vasogenic edema formation following SE are still unknown. Here we investigated the endothelin B (ETB) receptor-mediated pathway of SE-induced vasogenic edema. Following SE, the release of tumor necrosis factor-? (TNF-?) stimulated endothelin-1 (ET-1) release and expression in neurons and endothelial cells. In addition, TNF-?-induced ET-1 increased BBB permeability via ETB receptor-mediated endothelial nitric oxide synthase (eNOS) activation in endothelial cells. ETB receptor activation also increased intracellular reactive oxygen species by NADPH oxidase production in astrocytes. These findings suggest that SE results in BBB dysfunctions via endothelial-astroglial interactions through the TNF-?-ET-1-eNOS/NADPH oxidase pathway, and that these ETB receptor-mediated interactions may be an effective therapeutic strategy for vasogenic edema in various neurological diseases.

Kim, Ji-Eun; Ryu, Hea Jin; Kang, Tae-Cheon

2013-01-01

327

Ethnicity, race, and clinically significant macular edema in the Veterans Affairs Diabetes Trial (VADT)  

Microsoft Academic Search

ObjectiveTo determine risk factors in clinically significant macular edema (CSME) and if increased CSME in minorities is due to ethnicity or other factors in the Veterans Affairs Diabetes Trial (VADT).

Nicholas Emanuele; Thomas Moritz; Ronald Klein; Matthew D. Davis; Kathleen Glander; Anuradha Khanna; Lizy Thottapurathu; Gideon Bahn; William Duckworth; Carlos Abraira

2009-01-01

328

Bacillus anthracis Edema Toxin Inhibits Staphylococcus aureus Enterotoxin B Effects in Vitro: A Potential Protein Therapeutic.  

National Technical Information Service (NTIS)

Various in vitro effects of staphylococcal enterotoxin B (SEB) on human peripheral blood mononuclear cells were mitigated by Bacillus anthracis edema toxin. In particular, levels of some SEB-induced cytokines (tumor necrosis factor alpha, gamma interferon...

T. Krakauer S. F. Little B. G. Stiles

2005-01-01

329

Vasogenic edema and VEGF expression in a rat two-vein occlusion model.  

PubMed

Vasogenic edema plays an important etiologic role in the pathogenesis of cerebral venous circulation disturbances (CVCDs). Since vascular endothelial growth factor (VEGF) is a major mediator in angiogenesis and vascular permeability, including induction of vasogenic edema, the present study was undertaken to investigate whether it has any relevance to CVCDs. Male Wistar rats (n = 15) were used. Two adjacent cortical veins were occluded photochemically using rose bengal dye and fiberoptic illumination, with evaluation 24 hours thereafter by magnetic resonance imaging (MRI). Each brain was removed from the skull immediately after MRI and processed for hematoxylin-eosin staining (H&E staining) of sections for histopathology and comparison with MRI data. VEGF expression as demonstrated immunohistochemically appeared to coincide with vasogenic edema, diagnosed as high intensity areas on apparent diffusion coefficient of water (ADCw) maps. On the basis of these data, we conclude that VEGF is related to formation of vasogenic edema in the acute stage of CVCD. PMID:14753438

Kimura, R; Nakase, H; Sakaki, T; Taoka, T; Tsuji, T

2003-01-01

330

Activity of some Mexican medicinal plant extracts on carrageenan-induced rat paw edema.  

PubMed

The extracts obtained from 14 plants of the Mexican medicinal flora were assessed for anti-inflammatory activity by carrageenan-induced rat paw edema model. The i.p. administration of the extracts at a dose of 400 mg/kg produced a high reduction of edema with 70% of the plant extracts. Oenothera rosea methanol extract, Sphaeralcea angustifolia chloroform extract, Acaciafarnesiana, Larrea tridentata and Rubus coriifolius methanol extracts as well as the aqueous extract of Chamaedora tepejilote were demonstrated to be particularly active against the induced hind-paw edema. Moderate inhibition of edema formation was also demonstrated with the methanol extracts of Astianthus viminalis, Brickellia paniculata, C. tepejilote and Justicia spicigera. PMID:15330501

Meckes, M; David-Rivera, A D; Nava-Aguilar, V; Jimenez, A

2004-07-01

331

CD14 and NFAT mediate lipopolysaccharide-induced skin edema formation in mice  

PubMed Central

Inflammation is a multistep process triggered when innate immune cells — for example, DCs — sense a pathogen or injured cell or tissue. Edema formation is one of the first steps in the inflammatory response; it is fundamental for the local accumulation of inflammatory mediators. Injection of LPS into the skin provides a model for studying the mechanisms of inflammation and edema formation. While it is known that innate immune recognition of LPS leads to activation of numerous transcriptional activators, including nuclear factor of activated T cells (NFAT) isoforms, the molecular pathways that lead to edema formation have not been determined. As PGE2 regulates many proinflammatory processes, including swelling and pain, and it is induced by LPS, we hypothesized that PGE2 mediates the local generation of edema following LPS exposure. Here, we show that tissue-resident DCs are the main source of PGE2 and the main controllers of tissue edema formation in a mouse model of LPS-induced inflammation. LPS exposure induced expression of microsomal PGE synthase-1 (mPGES-1), a key enzyme in PGE2 biosynthesis. mPGES-1 activation, PGE2 production, and edema formation required CD14 (a component of the LPS receptor) and NFAT. Therefore, tissue edema formation induced by LPS is DC and CD14/NFAT dependent. Moreover, DCs can regulate free antigen arrival at the draining lymph nodes by controlling edema formation and interstitial fluid pressure in the presence of LPS. We therefore suggest that the CD14/NFAT/mPGES-1 pathway represents a possible target for antiinflammatory therapies.

Zanoni, Ivan; Ostuni, Renato; Barresi, Simona; Gioia, Marco Di; Broggi, Achille; Costa, Barbara; Marzi, Roberta; Granucci, Francesca

2012-01-01

332

Effects of photobiostimulation on edema and hemorrhage induced by Bothrops moojeni venom  

Microsoft Academic Search

Antivenom (AV) treatment has been ineffective in neutralizing the severe local fast-developing tissue damage following snake-bite\\u000a envenoming. We studied the effectiveness of low-level laser (LLL) and light-emitting diode (LED) irradiation alone or in combination\\u000a with AV in reducing local edema formation and hemorrhage induced by Bothrops moojeni venom (BmV) in mice. Edema formation was induced by injection of 1 ?g per

Nikele Nadur-Andrade; Ana Maria Barbosa; Fernando Pereira Carlos; Carlos José Lima; José Carlos Cogo; Stella Regina Zamuner

333

Acute hemorrhagic edema of infancy: a worrisome presentation, but benign course.  

PubMed

Acute hemorrhagic edema of infancy (AHEI) is a benign type of leukocytoclastic vasculitis. It is a benign phenomenon although it manifests with fever, large palpable purpuric skin lesions, and edema. The presentation of AHEI can often resemble that of Henoch-Schönlein purpura. Since AHEI is a self-limited disease, conservative management is the most commonly followed approach. Our patient had complete resolution of AHIE without medical treatment. PMID:24043950

Alhammadi, Ahmed H; Adel, Ashraf; Hendaus, Mohamed A

2013-09-05

334

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome: A case report  

Microsoft Academic Search

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare form of paraneoplastic tenosynovitis, which is more prone to occur in elderly males. A 78-year-old male had a past history of gastric cancer 23 years ago and underwent subtotal gastrectomy then. He led a fair life after the surgery. However, fever, edema in four extremities, gait disturbance, and liver

Yi-Ming Chen; Liang-Kung Chen; Shinn-Jang Hwang; Der-Yuan Chen; Hidenori Arai

2011-01-01

335

Noninvasive pressure support ventilation vs. continuous positive airway pressure in acute hypercapnic pulmonary edema  

Microsoft Academic Search

Objective  This study compared noninvasive pressure support ventilation (NIPSV) and continuous positive airway pressure (CPAP) in patients with acute hypercapnic pulmonary edema with regard to resolution time.Design and setting  Randomized prospective study in an emergency department.Patients and participants  We randomly assigned 36 patients with respiratory failure due to acute pulmonary edema and arterial hypercapnia (PaCO2 >45 mmHg) to NIPSV (n=18) or CPAP through a

Andrea Bellone; Marco Vettorello; Alessandra Monari; Francesca Cortellaro; Daniele Coen

2005-01-01

336

Tachyphylaxis in 12-0-Tetradecanoylphorbol Acetate and Arachidonic Acid-Induced Ear Edema  

Microsoft Academic Search

12-0-Tetradecanoylphorbol acetate (TPA) applied to mouse ears rapidly induces an edema which is maximal by 6 hr but has substantially waned by 24 hr. (This is in contrast to many inflammatory agents that cause a prolonged edema lasting many days.) Reapplication of TPA at 16-24 hr will not provoke a second edematous response although increased erythema is evident. Arachidonic acid

John M. Young; Bonnie M. Wagner; Doreen A. Spires

1983-01-01

337

A randomized, placebo-controlled clinical trial of intravitreal triamcinolone for refractory diabetic macular edema  

Microsoft Academic Search

Purpose To evaluate the effect of intravitreal triamcinolone acetonide (IVT) on refractory diabetic macular edema (DME). Methods In a prospective, placebo-controlled, randomized clinical trial, 88 eyes of 61 patients with clinically significant macular\\u000a edema that would have responded unfavourably to laser photocoagulation were randomly assigned to two groups. The treatment\\u000a group (45 eyes) received 4 mg IVT and the control group

Mohammad H. Dehghan; Hamid Ahmadieh; Alireza Ramezani; Morteza Entezari; Arash Anisian

2008-01-01

338

An improved right sided electrical impedance method to monitor pulmonary edema  

Microsoft Academic Search

\\u000a Currently commercial devices exist that monitor pulmonary edema by measuring the electrical impedance between a lead in the\\u000a right ventricle (RV) and the device can. Studies have shown up to a 40% false alarm rate with these devices. We have published,\\u000a using a computer model, about a three fold improvement in lung sensitivity to edema by measuring the impedance between

R. P. Patterson; F. Yang; A. Belalcazar

339

Hydrostatic intestinal edema induced signaling pathways: potential role of mechanical forces  

PubMed Central

Background Hydrostatic intestinal edema initiates a signal transduction cascade that results in smooth muscle contractile dysfunction. Given the rapid and concurrent alterations in the mechanical properties of edematous intestine observed with the development of edema, we hypothesize that mechanical forces may serves as a stimulus for activation of certain signaling cascades. We sought to examine if isolated similar magnitude mechanical forces induced the same signal transduction cascades associated with edema. Methods The distal intestine from adult male Sprague Dawley rats was longitudinally stretched for two hours to 122.5% its original length, correlating with the interstitial stress seen with edema. Wet to dry ratios, myeloperoxidase activity, nuclear STAT-3 and NF-kappa B DNA binding, STAT-3 phosphorylation, myosin light chain phosphorylation, baseline and maximally stimulated intestinal contractile strength, and iNOS and sodium hydrogen exchanger 1–3 mRNA in stretched and adjacent control segments of intestine were compared. Results Mechanical stretch did not induce intestinal edema or an increase in myeloperoxidase activity. Nuclear STAT-3 DNA binding, STAT-3 phosphorylation and nuclear NF-kappa B DNA binding were significantly increased in stretched seromuscular samples. There was increased expression of sodium hydrogen exchanger 1 but no increase in iNOS expression. Myosin light chain phosphorylation was significantly decreased in stretched intestine as was baseline and maximally stimulated intestinal contractile strength. Conclusions Intestinal stretch, in the absence of edema/inflammatory/ischemic changes, leads to activation of signaling pathways known to be altered in intestinal edema. Edema may initiate a mechanotransductive cascade that is responsible for subsequent activation of various signaling cascades known to induce subsequent contractile dysfunction.

Shah, Shinil K.; Fogle, Lindsey N.; Aroom, Kevin R.; Gill, Brijesh S.; Moore-Olufemi, Stacey D.; Jimenez, Fernando; Uray, Karen S.; Walker, Peter A.; Stewart, Randolph H.; Laine, Glen A.; Cox, Charles S.

2009-01-01

340

Noncardiogenic pulmonary edema induced by a molecular adsorbent recirculating system: case report  

Microsoft Academic Search

Noncardiogenic pulmonary edema is a well-recognized manifestation of acute lung injury which has been related, among others, to blood or blood-product transfusion, intravenous contrast injection, air embolism, and drug ingestion. We describe two cases of noncardiogenic pulmonary edema after use of a molecular adsorbent recirculating system, a cell-free dialysis technique. Patients in this series presented at our institution to be

Cataldo Doria; Lucio MandalÀ; Victor L. Scott; Ignazio R. Marino; Salvatore Gruttadauria; Roberto Miraglia; Claudio H. Vitale; Jan Smith

2003-01-01

341

An orally active TRPV4 channel blocker prevents and resolves pulmonary edema induced by heart failure.  

PubMed

Pulmonary edema resulting from high pulmonary venous pressure (PVP) is a major cause of morbidity and mortality in heart failure (HF) patients, but current treatment options demonstrate substantial limitations. Recent evidence from rodent lungs suggests that PVP-induced edema is driven by activation of pulmonary capillary endothelial transient receptor potential vanilloid 4 (TRPV4) channels. To examine the therapeutic potential of this mechanism, we evaluated TRPV4 expression in human congestive HF lungs and developed small-molecule TRPV4 channel blockers for testing in animal models of HF. TRPV4 immunolabeling of human lung sections demonstrated expression of TRPV4 in the pulmonary vasculature that was enhanced in sections from HF patients compared to controls. GSK2193874 was identified as a selective, orally active TRPV4 blocker that inhibits Ca(2+) influx through recombinant TRPV4 channels and native endothelial TRPV4 currents. In isolated rodent and canine lungs, TRPV4 blockade prevented the increased vascular permeability and resultant pulmonary edema associated with elevated PVP. Furthermore, in both acute and chronic HF models, GSK2193874 pretreatment inhibited the formation of pulmonary edema and enhanced arterial oxygenation. Finally, GSK2193874 treatment resolved pulmonary edema already established by myocardial infarction in mice. These findings identify a crucial role for TRPV4 in the formation of HF-induced pulmonary edema and suggest that TRPV4 blockade is a potential therapeutic strategy for HF patients. PMID:23136043

Thorneloe, Kevin S; Cheung, Mui; Bao, Weike; Alsaid, Hasan; Lenhard, Stephen; Jian, Ming-Yuan; Costell, Melissa; Maniscalco-Hauk, Kristeen; Krawiec, John A; Olzinski, Alan; Gordon, Earl; Lozinskaya, Irina; Elefante, Lou; Qin, Pu; Matasic, Daniel S; James, Chris; Tunstead, James; Donovan, Brian; Kallal, Lorena; Waszkiewicz, Anna; Vaidya, Kalindi; Davenport, Elizabeth A; Larkin, Jonathan; Burgert, Mark; Casillas, Linda N; Marquis, Robert W; Ye, Guosen; Eidam, Hilary S; Goodman, Krista B; Toomey, John R; Roethke, Theresa J; Jucker, Beat M; Schnackenberg, Christine G; Townsley, Mary I; Lepore, John J; Willette, Robert N

2012-11-01

342

Management of macular edema secondary to central retinal vein occlusion: an evidence-based.  

PubMed

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity. Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. Decreased vision in patients afflicted with CRVO may result from retinal ischemia and/or the accumulation of fluid within the center of the retina (macular edema). The Central Vein Occlusion Study (CVOS) Group demonstrated that grid laser photocoagulation is not an effective treatment for decreased vision due to CRVO-related macular edema. Since publication of that report, the standard of care for patients with decreased vision due to CRVO-associated macular edema was observation. However, in the past 5 years, several major randomized controlled clinical trials have investigated new therapeutic modalities for the treatment of macular edema secondary to CRVO. This article aims to provide insight into current evidence-based approaches to the management of macular edema secondary to CRVO. A companion article reviews approaches for the management of macular edema secondary to BRVO. PMID:21153510

Aref, Ahmad A; Scott, Ingrid U

2010-12-09

343

Management of macular edema secondary to branch retinal vein occlusion: an evidence-based update.  

PubMed

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity. Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. The most common cause of decreased vision in patients afflicted with BRVO is the accumulation of fluid within the macula (macular edema). The Branch Vein Occlusion Study (BVOS) demonstrated the efficacy of grid laser photocoagulation in the treatment of BRVO-related macular edema. After publication of that report, grid laser became the standard of care for decreased vision due to BRVO-associated macular edema in patients similar to those enrolled in the BVOS. However, several recent major randomized, controlled clinical trials have investigated new therapeutic modalities for the treatment of decreased vision due to macular edema secondary to BRVO. This article aims to provide insight into current evidence-based approaches to management of macular edema secondary to BRVO. A companion article reviews approaches for management of macular edema secondary to CRVO. PMID:21153509

Aref, Ahmad A; Scott, Ingrid U

2010-12-09

344

Autofluorescence Imaging for Diagnosis and Follow-up of Cystoid Macular Edema  

PubMed Central

Lipofuscin results from digestion of photoreceptor outer segments by the retinal pigment epithelium (RPE) and is the principal compound that causes RPE fluorescence during autofluorescence imaging. Absorption of the 488-nanometer blue light by macular pigments, especially by the carotenoids lutein and zeaxanthin, causes normal macular hypo-autofluorescence. Fundus autofluorescence imaging is being increasingly employed in ophthalmic practice to diagnose and monitor patients with a variety of retinal disorders. In macular edema for example, areas of hyper-autofluorescence are usually present which are postulated to be due to dispersion of macular pigments by pockets of intraretinal fluid. For this reason, the masking effect of macular pigments is reduced and the natural autofluorescence of lipofuscin can be observed without interference. In cystic types of macular edema, e.g. cystoid macular edema due to retinal vein occlusion, diabetic macular edema and post cataract surgery, hyper-autofluorescent regions corresponding to cystic spaces of fluid accumulation can be identified. In addition, the amount of hyper-autofluorescence seems to correspond to the severity of edema. Hence, autofluorescence imaging, as a noninvasive technique, can provide valuable information on cystoid macular edema in terms of diagnosis, follow-up and efficacy of treatment.

Ebrahimiadib, Nazanin; Riazi-Esfahani, Mohammad

2012-01-01

345

The importance of volumetry, lymphscintigraphy and computer tomography in the diagnosis of brachial edema after mastectomy.  

PubMed

Arm volumes of 360 patients with breast cancer were determined by a new optoelectronic technique. About 42% developed swelling of the arm after modified radical mastectomy which varied from mild (edema-volume 150-400 ml), moderate (400-800 ml), to severe (more than 800 ml) lymphatic edema. Lymphscintigraphy and computer tomography of the arms was also studied in different grades of lymphatic edema. Two years after operation and telecobalt-irradiation, one half of the patients without arm edema showed marked signs of a decreased capacity of lymphatic transport. In patients with severe lymphatic edema, the dynamic as well as the static evaluation of the lymphscintigrams revealed delayed transport, lack of radioisotope accumulation in the axillary region and notable congestion in the upper arm and forearm. Computerized tomography displayed a shift of fluid volume in the epifascial and subfascial tissue compartments and detected progressive structural changes in the soft tissue. Moderate edema not only increased the epifascial but also the subfascial compartments. In severe postmastectomy arm lymphedema, however, expansion of the epifascial space was paradoxically sometimes associated with a decrease in the subfascial compartment. PMID:3199873

Göltner, E; Gass, P; Haas, J P; Schneider, P

1988-09-01

346

Molecular Mechanisms of Ischemic Cerebral Edema: Role of Electroneutral Ion Transport  

NSDL National Science Digital Library

The brain achieves homeostasis of its intracellular and extracellular fluids by precisely regulating the transport of solute and water across its major cellular barriers: endothelia of the blood-brain barrier (BBB), choroid plexus epithelia, and neuroglial cell membranes. Cerebral edema, the pathological accumulation of fluid in the brainÃÂs intracellular and extracellular spaces, is a major cause of morbidity and mortality following stroke and other forms of ischemic brain injury. Until recently, mechanisms of cerebral edema formation have been obscure; consequently, its treatment has been empiric and suboptimal. Here, we provide a paradigm for understanding ischemic cerebral edema, showing that its molecular pathogenesis is a complex yet step-wise process that results largely from impaired astrocytic cell volume regulation and permeability alterations in the cerebral microvasculature, both of which arise from pathological changes in the activities of specific ion channels and transporters. Recent data has implicated the bumetanide-sensitive NKCC1, an electroneutral cotransporter expressed in astrocytes and the BBB, in cerebral edema formation in several different rodent models of stroke. Pharmacological inhibition or genetic deficiency of NKCC1 decreases ischemia-induced cell swelling, BBB breakdown, cerebral edema, and neurotoxicity. Combination pharmacological strategies that include NKCC1 as a target might thus prove beneficial for the treatment of ischemic, and potentially other types of, cerebral edema.

Kristopher Kahle (Massachusetts General Hospital and Harvard Medical School Neurosurgery)

2009-08-01

347

Clinical correlates of the spectrum of lung microvascular injury in human noncardiac edema  

SciTech Connect

Researchers measured the clearance from blood to pulmonary edema fluid of a small molecular researchersight hydrophilic radiotracer, Indium-111-DTPA (In-DTPA) and a larger molecular researchrsight radiotracer, Iodine-125-HSA (I-HSA), in patients with pulmonary edema on either a cardiac or noncardiac (permeability) basis. In previous investigations, researchers had noted an apparent relationship between the magnitude of clearance of I-HSA across the alveolocapillary membrane and the severity of noncardiac pulmonary edema. In this study, researchers were able to distinguish at least 2 distinct groups of patients with noncardiac pulmonary edema. Patients with the greatest damage to the alveolo-capillary exchanging membrane, defined by the flux of I-HSA from blood to edema fluid, were significantly differentiated from those with a lesser microvascular injury on the basis of higher mean heart rate (HR), temperature, cardiac index (CI), pulmonary artery pressures, right ventricular stroke work index (RVSWI), and a lower mean total white blood cell count (WBC), among others. Therefore, noncardiac pulmonary edema is characterized by a spectrum of permeability injury to the pulmonary microvasculature which seems to parallel other measurable indices of the severity of the systemic response to the illness.

Sibbald, W.J.; Driedger, A.A.; Wells, G.A.; Koval, J.J.

1983-02-01

348

Sodium hydrogen exchanger as a mediator of hydrostatic edema induced intestinal contractile dysfunction  

PubMed Central

Background Resuscitation-induced intestinal edema is associated with early and profound mechanical changes in intestinal tissue. We hypothesize that the sodium hydrogen exchanger (NHE), a mechano-responsive ion channel, is a mediator of edema-induced intestinal contractile dysfunction. Methods An animal model of hydrostatic intestinal edema was utilized for all experiments. NHE isoforms 1-3 mRNA and protein were evaluated. Subsequently, the effects of NHE inhibition (with 5-(N-ethyl-N-isopropyl) amiloride (EIPA)) on wet to dry ratios, signal transduction and activator of transcription (STAT)-3, intestinal smooth muscle myosin light chain (MLC) phosphorylation, intestinal contractile activity, and intestinal transit were measured. Results NHE1-3 mRNA and protein levels were significantly increased in the small intestinal mucosa with the induction of intestinal edema. Administration of EIPA, an NHE inhibitor, attenuated validated markers of intestinal contractile dysfunction induced by edema as measured by decreased STAT-3 activation, increased MLC phosphorylation, improved intestinal contractile activity, and enhanced intestinal transit. Conclusion The mechano-responsive ion channel NHE may mediate edema-induced intestinal contractile dysfunction, possibly via a STAT-3 related mechanism.

Uray, Karen S.; Shah, Shinil K.; Radhakrishnan, Ravi S.; Jimenez, Fernando; Walker, Peter A.; Stewart, Randolph H.; Laine, Glen A.; Cox, Charles S.

2010-01-01

349

The LONFLIT4-VENORUTON study: a randomized trial prophylaxis of flight-edema in normal subjects.  

PubMed

This study evaluated the protective effects of Venoruton on the development of flight edema in normal subjects travelling in economy in long-haul flights (8-9 hours). Edema is a relevant aspect of long-haul flights affecting both venous patients and normal subjects. Edema and flight microangiopathy were studied in a group of 164 subjects randomized (after informed consent) into two groups to evaluate prophylaxis in 8- to 9-hour flights. The treatment group received Venoruton (hydroxyethyl rutosides) 1 g twice daily for 3 days (2 days before the flight and the day of the flight). The control group received comparable placebo. Edema was evaluated with a composite edema score based on the edema tester, on the measurements of ankle circumference, volume measurements, subjective swelling, and on a discomfort score. Items 1, 4, and 5 are based on an analogue scale line (1 to 10) directly defined by the subjects before and after the flights. Of the included subjects, 151 completed the study. Dropouts were due to poor compliance, travelling, or connection problems. Age and gender distribution were comparable in the two groups as were risk factor distributions. The level of edema at inclusion was comparable in the two groups of subjects. After the flight there was an average score of 6.7 (SD 1.7) in the control group, while in the Venoruton group the score was on average 3 (SD 1.1) (p < 0.05). In the control group 77% of the subjects had an evident increase in ankle circumference and volume, which was clearly visible at inspection and associated with discomfort. In the Venoruton group, edema was clearly present only in 8% of subjects (associated with discomfort rated between 3 and 6 on the analogue scale line) and it was mild, not associated with symptoms. Therefore the control of flight edema with Venoruton was clear both considering parametric data (circumference and volume) and non-parametric (analogue scale lines) measurements. The combined evaluation of the edema score is significantly favorable for subjects under prophylaxis with Venoruton. PMID:12643319

Belcaro, Gianni; Cesarone, Maria Rosaria; Nicolaides, Andrew N; Geroulakos, George; Acerbi, Giovanni; Candiani, Carlo; Griffin, Maura; Bavera, Peter; Dugall, Mark; Brandolini, Rossella; Di Renzo, Andrea; Ricci, Andrea; Ippolito, Edmondo; Winford, Michelle; Golden, Gerard

2003-01-01

350

Effect of the human papillomavirus (HPV) quadrivalent vaccine in a subgroup of women with cervical and vulvar disease: retrospective pooled analysis of trial data  

PubMed Central

Objectives To determine the effect of human papillomavirus (HPV) quadrivalent vaccine on the risk of developing subsequent disease after an excisional procedure for cervical intraepithelial neoplasia or diagnosis of genital warts, vulvar intraepithelial neoplasia, or vaginal intraepithelial neoplasia. Design Retrospective analysis of data from two international, double blind, placebo controlled, randomised efficacy trials of quadrivalent HPV vaccine (protocol 013 (FUTURE I) and protocol 015 (FUTURE II)). Setting Primary care centres and university or hospital associated health centres in 24 countries and territories around the world. Participants Among 17?622 women aged 15–26 years who underwent 1:1 randomisation to vaccine or placebo, 2054 received cervical surgery or were diagnosed with genital warts, vulvar intraepithelial neoplasia, or vaginal intraepithelial neoplasia. Intervention Three doses of quadrivalent HPV vaccine or placebo at day 1, month 2, and month 6. Main outcome measures Incidence of HPV related disease from 60 days after treatment or diagnosis, expressed as the number of women with an end point per 100 person years at risk. Results A total of 587 vaccine and 763 placebo recipients underwent cervical surgery. The incidence of any subsequent HPV related disease was 6.6 and 12.2 in vaccine and placebo recipients respectively (46.2% reduction (95% confidence interval 22.5% to 63.2%) with vaccination). Vaccination was associated with a significant reduction in risk of any subsequent high grade disease of the cervix by 64.9% (20.1% to 86.3%). A total of 229 vaccine recipients and 475 placebo recipients were diagnosed with genital warts, vulvar intraepithelial neoplasia, or vaginal intraepithelial neoplasia, and the incidence of any subsequent HPV related disease was 20.1 and 31.0 in vaccine and placebo recipients respectively (35.2% reduction (13.8% to 51.8%)). Conclusions Previous vaccination with quadrivalent HPV vaccine among women who had surgical treatment for HPV related disease significantly reduced the incidence of subsequent HPV related disease, including high grade disease. Trial registrations NCT00092521 and NCT00092534

2012-01-01

351

TCDD Induced Pericardial Edema and Relative COX-2 Expression in Medaka (Oryzias Latipes) Embryos  

PubMed Central

Exposure to dioxin and other aryl hydrocarbon receptor (AhR) ligands results in multiple, specific developmental cardiovascular phenotypes including pericardial edema and circulatory failure in small aquarium fish models. Although phenotypes are well described, mechanistic underpinnings for such toxicities remain elusive. Here we suggest that AhR activation results in stimulation of inflammation and “eicosanoid” pathways, which contribute to the observed developmental, cardiovascular phenotypes. We demonstrate that medaka embryos exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (0.05–1 ppb) during early development result in a dose-related increase in the prevalence of pericardial edema and that this phenotype correlates with an increase in cyclooxygenase-2 (COX-2) gene expression. Those individuals exhibiting the edema phenotype had significantly greater COX-2 mRNA than their nonedematous cohort. Selective pharmacological inhibition of COX-2, with NS-398, and genetic knock down of COX-2 with a translation initiation morpholino significantly attenuated prevalence and severity of edema phenotype. Subsequently, exposures of medaka embryos to arachidonic acid (AA) resulted in recapitulation of the pericardial edema phenotype and significantly increased COX-2 expression only in those individuals exhibiting the edema phenotype compared with their nonedematous cohort. AA exposure does not result in significant induction of cytochrome P450 1A expression, suggesting that pericardial edema can be induced independent of AhR/aryl hydrocarbon receptor nuclear translocator/dioxin response element interactions. Results from this study demonstrate that developmental exposure to TCDD results in an induction of inflammatory mediators including COX-2, which contribute to the onset, and progression of heart dysmorphogenesis in the medaka model.

Dong, Wu; Matsumura, Fumio; Kullman, Seth W.

2010-01-01

352

Overexpression of CDC25B, CDC25C and phospho-CDC25C (Ser216) in vulvar squamous cell carcinomas are associated with malignant features and aggressive cancer phenotypes  

PubMed Central

Background CDC25 phosphatases are important regulators of the cell cycle. Their abnormal expression detected in a number of tumors implies that their dysregulation is involved in malignant transformation. However, the role of CDC25s in vulvar cancer is still unknown. To shed light on their roles in the pathogenesis and to clarify their prognostic values, expression of CDC25A, CDC25B and CDC25C in a large series of vulvar squamous cell carcinomas were examined. Methods Expression of CDC25A, CDC25B, CDC25C and phosphorylated (phospho)-CDC25C (Ser216) were examined in 300 vulvar carcinomas using immunohistochemistry. Western blot analysis was utilized to demonstrate CDC25s expression in vulvar cancer cell lines. Kinase and phosphatase assays were performed to exclude cross reactivity among CDC25s isoform antibodies. Results High nuclear CDC25A and CDC25B expression were observed in 51% and 16% of the vulvar carcinomas, respectively, whereas high cytoplasmic CDC25C expression was seen in 63% of the cases. In cytoplasm, nucleus and cytoplasm/nucleus high phospho-CDC25C (Ser216) expression was identified in 50%, 70% and 77% of the carcinomas, respectively. High expression of CDC25s correlated significantly with malignant features, including poor differentiation and infiltration of vessel for CDC25B, high FIGO stage, presence of lymph node metastases, large tumor diameter, poor differentiation for CDC25C and high FIGO stage, large tumor diameter, deep invasion and poor differentiation for phospho-CDC25C (Ser216). In univariate analysis, high expression of phospho-CDC25C (Ser216) was correlated with poor disease-specific survival (p = 0.04). However, such an association was annulled in multivariate analysis. Conclusions Our results suggest that CDC25C and phospho-CDC25C (Ser216) play a crucial role and CDC25B a minor role in the pathogenesis and/or progression of vulvar carcinomas. CDC25B, CDC25C and phospho-CDC25C (Ser216) were associated with malignant features and aggressive cancer phenotypes. However, the CDC25s isoforms were not independently correlated to prognosis.

2010-01-01

353

The permissive nature of blood brain barrier (BBB) opening in edema formation following traumatic brain injury.  

PubMed

The contribution of blood brain barrier opening to traumatic brain edema is not known. This study compares the course of traumatic BBB disruption and edema formation, with the hypothesis that they are not obligately related. Sprague-Dawley rats were divided into three groups: Group A (n = 47)--Impact Acceleration (IAM); Group B (n = 104)--lateral cortical impact (CCI); Group C (n = 26)--IAM + hypoxia & hypotension (THH). BBB integrity was assessed using i.v. markers (Evan's Blue, or gadolinium-DTPA). Edema formation was evaluated with gravimetry, and T1-weighted MRI. In IAM, BBB opened immediately but closed rapidly, and remained closed for at least the next 36 hours whilst 24-hour hemispheric water content (HWC) rose by 0.9% (p < 0.01). In CCI, BBB opened in both hemispheres for up to 4 hours; four hour HWC in the uninjured hemisphere was indistinguishable from Sham, where HWC in the injured hemisphere rose by approximately 1.5% (p < 0.005). We distinguished two THH animals based on Apparent Diffusion Coefficient (ADC) recovery: in ADC-recovery animals 4 hour cortical water content (CWC) was 80.4 +/- 0.6%, cf 81.4 +/- 1.3% in ADC-non-recovery (p < 0.05). In all animals the BBB was open, however two populations of permeability were seen which likely related to flow-limited extravasation of gadolinium. In IAM edema forms despite only brief BBB opening. Although there is diffuse BBB opening with lateral contusion, edema only forms in the injured hemisphere. In THH, edema formation in the face of a widely permeable barrier is driven by ADC changes or cell swelling. Edema formation clearly does not correspond with BBB opening and an open BBB is clearly not required for edema formation. However we hypothesize that a permeable BBB permissively worsens the process, by acting as a low resistance pathway for ion and water movement. These findings are consistent with our general hypothesis that edema formation after TBI is mainly cytotoxic. PMID:11449990

Beaumont, A; Marmarou, A; Hayasaki, K; Barzo, P; Fatouros, P; Corwin, F; Marmarou, C; Dunbar, J

2000-01-01

354

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.

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

2012-01-01

355

Correlations between edema and the immediate and prolonged painful consequences of inflammation: therapeutic implications?  

SciTech Connect

The precise relationship between the degree of pan and the degree of inflammation in the individual remains debated. A quantitative analysis simultaneously applied to the immediate and prolonged painful consequences of inflammation has not yet been done. Thus, the correlations between edema, nociception and hypersensitivity following an inflammatory insult were assessed in rodents. To better understand the therapeutic value of modifying specific aspects of inflammation, the effects of anti-inflammatory drug were compared to the results. Inbred strains of mice and outbred rats received an intraplantar injection of honeybee venom and the between group and within-group correlations were calculated for spontaneous nociceptive measures, thermal and mechanical hypersensitivity, and edema and temperature. The effect of indomethacin on the pain and the inflammation measures was examined. Edema correlated with spontaneous flinching, licking and lifting of the inject paw, and not with thermal or mechanical hypersensitivity. Indomethacin affected edema and spontaneous nociception dose-dependently, and affected hypersensitivity only at the highest dose test (P <0.005). These results suggest that edema may contribute only to immediate spontaneous nociceptive responses to an inflammatory insult, and not to the more clinically relevant prolonged hypersensitivity. This analysis represents a method for determine which inflammatory processes are the most promising therapeutic targets against the multiple painful consequences of inflammation.

Chesler, Elissa J [ORNL; Lariviere, William R [University of Pittsburgh; Zhen, Li [Institute for Biomedical Sciences of Pain, Beijing, China; Shang, G [Institute for Biomedical Sciences of Pain, Beijing, China; Chen, Ya [Institute for Biomedical Sciences of Pain, Beijing, China; Yu, Yao [Institute for Biomedical Sciences of Pain, Beijing, China; Lu, Zhuo [Institute for Biomedical Sciences of Pain, Beijing, China; Chang, Ying [Institute for Biomedical Sciences of Pain, Beijing, China; Luo, Ceng [Institute for Biomedical Sciences of Pain, Beijing, China; Li, KaiCheng [Institute for Biomedical Sciences of Pain, Beijing, China; Chen, Jun [Institute for Biomedical Sciences of Pain, Beijing, China

2005-06-01

356

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.

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

2012-01-01

357

Cystoid Macular Edema Associated with Oral Antineoplastic Agent S-1 in a Patient with Diabetic Retinopathy  

PubMed Central

A 60-year-old man with neovascular glaucoma due to diabetic retinopathy received an intravitreal injection of 1.25 mg bevacizumab (IVB) followed by extensive panretinal photocoagulation in the right eye. The anterior segment neovascularization regressed within 10 days after IVB. One and a half months later, the patient underwent gastrectomy for stage IIIb gastric cancer. Two months later, he was started on S-1 orally (100 mg/day for 48, 26, and 32 consecutive days in the first, second, and third treatment cycle, respectively). The interval between the first and second treatment cycle was 20 days and between the second and third cycle it was 24 days. The patient developed anemia and diarrhea. At the end of the second S-1 cycle, cystoid macular edema developed in the right eye, although diabetic retinopathy and neovascular glaucoma were stable. Macular edema persisted for 5 months despite another IVB, and disappeared 3 months after termination of S-1 therapy. The time course of the magnitude of macular edema correlated well with the severity of anemia. The macular edema was possibly associated with anemia, which is a major side effect of S-1. Further studies are warranted to investigate the relationship between anemia and macular edema in patients with diabetic retinopathy.

Higashide, Tomomi; Murotani, Eiji; Sugiyama, Kazuhisa

2012-01-01

358

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

2013-07-31

359

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

360

Edema and Tetraparesis in a Miniature Pig after Allogeneic Hematopoietic Cell Transplantation  

PubMed Central

A 3-mo-old, 12-kg, intact, miniature pig presented with severe neurologic signs on day 8 after hematopoietic cell transplantation. This pig had received an immunosuppressive regimen before transplantation that included an antiCD3 immunotoxin for T-cell depletion, 100 cGy of total-body irradiation, and cyclosporine for 45 d. The pig began exhibiting erythematous lesions on posttransplantation day 7. He also demonstrated increased conscious proprioceptive deficits and recumbency but normal mentation. Neurologic signs worsened over several days; the pig became lethargic but remained afebrile. Conjunctival swelling developed on posttransplantation day 9, which subsequently spread to the animal's head, ears and hocks by day 10. Analgesics were given for pain, and cyclosporine levels were decreased. Despite the measures taken, neurologic signs progressed. Given the worsening subcutaneous edema and neurologic status, Escherichia coli infection was suspected, and treatment with a third-generation cephalosporin was instituted. The clinical signs resolved within 12 h after the start of antibiotics. ‘Shiga-like’ toxin from E. coli can cause peracute toxemia and induce ataxia, paralysis, and recumbency. Other common and pathognomonic findings include periocular edema and variable edema in other subcutaneous regions. A fecal sample demonstrated an overgrowth of gram-negative, lactose-fermenting colonies. On the basis of the clinical presentation, exclusion of other potential conditions compatible with edema and neurologic diseases, physical exam findings, microbiology and the resolution of signs after therapy, the pig was diagnosed with edema disease.

Crepeau, Rebecca; Matar, Abraham; Spitzer, Thomas R; Robson, Simon; Pathiraja, Vimukthi; Sachs, David H; Huang, Christene A; Duran-Struuck, Raimon

2012-01-01

361

Propofol Administration Modulates AQP-4 Expression and Brain Edema After Traumatic Brain Injury.  

PubMed

The increased intracranial pressure caused by brain edema following traumatic brain injury (TBI) always leads to poor patient prognosis. Aquaporin-4 (AQP-4) plays an important role in edema formation and resolution, which may provide a novel therapeutic target for edema treatment. In this present study, we found that propofol treatment, within a short time, after TBI significantly reduced brain edema in a controlled cortical injury rat model and suppressed in vivo expression of AQP-4. The ameliorating effect of propofol was associated with attenuated expression of interleukin-1? (IL-1?) and tumor necrosis factor-? (TNF-?). In addition, the regulatory effect of propofol on AQP-4 expression was investigated in cultured astrocytes. Results showed that propofol could block the stimulatory effect of IL-1? and TNF-? on AQP-4 expression in cultured astrocytes. We also found that both NF?B and p38/MAPK pathways were involved in IL-1? and TNF-?-induced AQP-4 expression and that propofol functions as a dual inhibitor of NF?B and p38/MAPK pathways. In conclusion, treatment with propofol, within a short time, after TBI attenuates cerebral edema and reduces the expression of AQP-4. Propofol modulates acute AQP-4 expression by attenuating IL-1? and TNF-? expression and inhibiting IL-1? and TNF-? induced AQP-4 expression. PMID:23494261

Ding, Zhongyang; Zhang, Jiaming; Xu, Jinyu; Sheng, Guangjie; Huang, Guorong

2013-11-01

362

Xanthine oxidase-derived hydrogen peroxide contributes to ischemia reperfusion-induced edema in gerbil brains.  

PubMed Central

The contribution of toxic O2 metabolites to cerebral ischemia reperfusion injury has not been determined. We found that gerbils subjected to temporary unilateral carotid artery occlusion (ischemia) consistently developed neurologic deficits during ischemia with severities that correlated with increasing degrees of brain edema and brain H2O2 levels after reperfusion. In contrast, gerbils treated just before reperfusion (after ischemia) with dimethylthiourea (DMTU), but not urea, had decreased brain edema and brain H2O2 levels. In addition, gerbils fed a tungsten-rich diet for 4, 5, or 6 wk developed progressive decreases in brain xanthine oxidase (XO) and brain XO + xanthine dehydrogenase (XD) activities, brain edema, and brain H2O2 levels after temporary unilateral carotid artery occlusion and reperfusion. In contrast to tungsten-treated gerbils, allopurinol-treated gerbils did not have statistically significant decreases in brain XO or XO + XD levels, and reduced brain edema and brain H2O2 levels occurred only in gerbils developing mild but not severe neurologic deficits during ischemia. Finally, gerbils treated with DMTU or tungsten all survived, while greater than 60% of gerbils treated with urea, allopurinol, or saline died by 48 h after temporary unilateral carotid artery occlusion and reperfusion. Our findings indicate that H2O2 from XO contributes to reperfusion-induced edema in brains subjected to temporary ischemia. Images

Patt, A; Harken, A H; Burton, L K; Rodell, T C; Piermattei, D; Schorr, W J; Parker, N B; Berger, E M; Horesh, I R; Terada, L S

1988-01-01

363

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

2012-05-21

364

Changes in foveal thickness after vitrectomy for macular edema with branch retinal vein occlusion and intravitreal vascular endothelial growth factor  

Microsoft Academic Search

Purpose To examine the outcome of vitrectomy for macular edema associated with branch retinal vein occlusion (BRVO) and determine\\u000a the relationship between the severity of macular edema and the concentration of vascular endothelial growth factor (VEGF)\\u000a and interleukin-6 (IL-6) in the vitreous fluid. Design Prospective observational case series. Patients and Methods Thirty-four consecutive patients (34 eyes) with macular edema associated

Makiko Yamasaki; Hidetaka Noma; Hideharu Funatsu; Atsushi Minamoto; Tatsuya Mimura; Katsunori Shimada; Hidetoshi Yamashita; Yoshiaki Kiuchi

2009-01-01

365

Manual lymphatic drainage in management of edema in a case with CRPS: why the(y) wait?  

Microsoft Academic Search

Complex regional pain syndrome (CRPS) is a disorder characterized by pain, edema, skin color changes and autonomic abnormalities.\\u000a Its treatment is quite difficult and in most of the patients effective results cannot be reached. Manual lymphatic drainage\\u000a is a very rare method for managing limb edema in CRPS. In this case report, the dramatic response of an excessive edema to

?smail Safaz; Fatih Tok; Mehmet Ali Ta?kaynatan; Ahmet Ozgul

2011-01-01

366

Manual lymphatic drainage in management of edema in a case with CRPS: why the(y) wait?  

PubMed

Complex regional pain syndrome (CRPS) is a disorder characterized by pain, edema, skin color changes and autonomic abnormalities. Its treatment is quite difficult and in most of the patients effective results cannot be reached. Manual lymphatic drainage is a very rare method for managing limb edema in CRPS. In this case report, the dramatic response of an excessive edema to lymphatic drainage was discussed in a CRPS patient. PMID:19823831

Safaz, Ismail; Tok, Fatih; Ta?kaynatan, Mehmet Ali; Ozgul, Ahmet

2009-10-13

367

Estimation of groin recurrence risk in patients with squamous cell vulvar carcinoma by the assessment of marker gene expression in the lymph nodes  

PubMed Central

Background Regional lymph node (LN) status is a well-known prognostic factor for vulvar carcinoma (VC) patients. Although the reliable LN assessment in VC is crucial, it presents significant diagnostic problems. We aimed to identify specific mRNA markers of VC dissemination in the LN and to address the feasibility of predicting the risk of nodal recurrence by the patterns of gene expression. Methods Sentinel and inguinal LN samples from 20 patients who had undergone surgery for stage T1-3, N0-2, M0 primary vulvar squamous cell carcinoma were analyzed. Gene expression profiles were assessed in four metastatic [LN(+)] and four histologically negative [LN(?)] lymph node samples obtained from four VC patients, by the Affymetrix U133 Plus 2.0 gene expression microarrays. Of the set of genes of the highest expression in the metastatic LNs compared to LN(?), seven candidate marker genes were selected: PERP, S100A8, FABP5, SFN, CA12, JUP and CSTA, and the expression levels of these genes were further analyzed by the real-time reverse transcription polymerase chain reaction (qRT-PCR) in 71 LN samples. Results All of the seven genes in question were significantly increased in LN(+) compared to LN(?) samples. In the initial validation of the seven putative markers of metastatic LN, the Cox proportional hazard model pointed to SFN, CA12 and JUP expression to significantly relate to the time to groin recurrence in VC patients. Conclusions Our findings first provided evidence that SFN, CA12 and JUP have a potential of marker genes for the prediction of the groin recurrence LN in VC patients.

2012-01-01

368

In the absence of (early) invasive carcinoma, vulvar intraepithelial neoplasia associated with lichen sclerosus is mainly of undifferentiated type: new insights in histology and aetiology  

PubMed Central

Background Differentiated vulvar intraepithelial neoplasia (VIN) is presumed to be the precursor of invasive squamous cell carcinoma (SCC) of the vulva. It is commonly assumed that differentiated VIN is related to lichen sclerosus (LS). However, evidence for this is limited to a small number of studies describing epithelial alterations adjacent to vulvar SCC. Aim To study the histology and human papillomavirus (HPV) status in patients with a history of both LS and VIN without coexistent SCC. Methods Original biopsy specimens and surgical specimens of patients retrieved from the pathology files were revised for the presence of LS, VIN and (early) invasive SCC, specifically focused on the two different types of VIN: differentiated and undifferentiated. Thereafter, VIN lesions were tested for the presence of HPV DNA. Results Twenty?seven patients fulfilled the criteria for LS and VIN without SCC. In all 27 patients, LS was found to be related to undifferentiated VIN. Grading yielded the following results: VIN 1 (n?=?10), VIN 2 (n?=?11) and VIN 3 (n?=?6). Additionally, VIN lesions from 26 patients could be tested for the presence of HPV DNA. HPV DNA, predominantly type 16, was present in 8 (31%) of them. Seven of these eight patients had VIN 2 or 3. During follow?up, three patients progressed to (early) invasive carcinoma. In two of these patients, differentiated VIN was observed overlying early invasive SCC. Conclusions VIN related to LS without coexisting SCC is likely to be undifferentiated, in contrast to what was previously thought. HPV DNA was demonstrated in 31% of the lesions, and was strongly related to high?grade VIN.

van Seters, M; Kate, F J W ten; van Beurden, M; Verheijen, R H M; Meijer, C J L M; Burger, M P M; Helmerhorst, T J M

2007-01-01

369

Inductive phase shift spectroscopy for volumetric brain edema detection: an experimental simulation.  

PubMed

This study evaluates experimentally an induction based non-invasive technique for detection of changes of fluid volume through phase shift measurements as a possible method for volumetric brain edema monitoring. An induction coil - spherical head model was build and tested. The model involves two different diameter coils coaxially centered on a two-compartment glass sphere head model centrally placed with respect to the coils. Three different fluid volumes of physiological saline in 20 ml increments were used to simulate different edema levels. Phase shift of the impedance coils as a function of relative fluid volume was measured at five frequencies (40, 50, 100, 200 and 300 MHz) by a commercial vector network analyzer. The results show significant phase shift increase as a function of frequency and fluid volume. The experiments with the coil-spherical head system suggest that the tested technique has the potential to become a practical configuration for non-invasive volumetric brain edema monitoring. PMID:18002463

González, César A; Rojas, Rafael; Villanueva, Cleva; Rubinsky, Boris

2007-01-01

370

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

371

Clinical applications of the sustained-release dexamethasone implant for treatment of macular edema  

PubMed Central

Macular edema is one of the leading causes of vision loss among patients with retinal vein occlusion, diabetic retinopathy, and posterior chamber inflammatory disease. However, the treatment of macular edema is considerably limited by the difficulty in delivering effective doses of therapeutic agents into the vitreous cavity. In recent years, the development of a sustained-release dexamethasone intravitreal implant (Ozurdex®) has enabled more controlled drug release at a stable rate over a long period of time, with a potentially lower rate of adverse events. Clinical studies indicate that this dexamethasone implant is a promising new treatment option for patients with persistent macular edema resulting from retinal vein occlusion, diabetic retinopathy, and uveitis or Irvine-Gass syndrome.

Herrero-Vanrell, Rocio; Cardillo, Jose Augusto; Kuppermann, Baruch D

2011-01-01

372

Ethanol-induced hyponatremia augments brain edema after traumatic brain injury.  

PubMed

Alcohol consumption augments brain edema by expression of brain aquaporin-4 after traumatic brain injury. However, how ethanol induces brain aquaporin-4 expression remains unclear. Aquaporin-4 can operate with some of ion channels and transporters. Therefore, we hypothesized that ethanol may affect electrolytes through regulating ion channels, leading to express aquaporin-4. To clarify the hypothesis, we examined role of AQP4 expression in ethanol-induced brain edema and changes of electrolyte levels after traumatic brain injury in the rat. In the rat traumatic brain injury model, ethanol administration reduced sodium ion concentration in blood significantly 24 hr after injury. An aquaporin-4 inhibitor recovered sodium ion concentration in blood to normal. We observed low sodium ion concentration in blood and the increase of brain aquaporin-4 in cadaver with traumatic brain injury. Therefore, ethanol increases brain edema by the increase of aquaporin-4 expression with hyponatremia after traumatic brain injury. PMID:22746038

Katada, Ryuichi; Watanabe, Satoshi; Ishizaka, Atsushi; Mizuo, Keisuke; Okazaki, Shunichiro; Matsumoto, Hiroshi

2012-04-01

373

Bilateral reexpansion pulmonary edema associated with pleural empyema: a case report.  

PubMed

Reexpansion pulmonary edema is an uncommon complication following rapid reexpansion of the lungs. The risk increases with a prolonged duration of pulmonary collapse, the amount of drained liquid or air, and with decreased time of draining. Treatment is supportive. In general, the prognosis is favorable. A nine-year-old boy was presented with fever, cough, and respiratory distress. Pneumonia and left-sided pleural empyema were determined and a chest tube was emplaced. Clinical deterioration occurred in just a few minutes following chest tube insertion. His chest radiography revealed a pulmonary edema in the left lung. Despite mechanical ventilation, antibiotics, and diuretic treatment, no significant improvement occurred. Acute respiratory distress syndrome and multiple organ dysfunctions developed in the follow-up. The patient died on day 5 of hospitalization. In this report, a complicated reexpansion pulmonary edema with a lathal outcome in a 9-year-old child is presented. PMID:21394503

Paksu, Muhammet Sukru; Paksu, Sule; Akgün, Muhammet; Kalayc?, Ayhan Gazi; Baysal, Kemal

2011-03-11

374

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

375

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.

Takeyama, Masayuki; Iwaki, Masayoshi; Zako, Masahiro

2012-01-01

376

Laser Photocoagulation Combined with Intravitreal Triamcinolone Acetonide Injection in Proliferative Diabetic Retinopathy with Macular Edema  

PubMed Central

Purpose To evaluate therapeutic effects and usefulness of a combination treatment of intravitreal injection of triamcinolone acetonide (IVTA) and panretinal photocoagulation (PRP) in patients with clinically significant macular edema secondary to proliferative diabetic retinopathy (PDR). Methods Visual acuity test, fundoscopy, fluorescein angiography, and optical coherence tomography (OCT) were taken in 20 patients (20 eyes) of macular edema and PDR. A combination of intravitreal injection of triamcinolone acetonide and PRP was performed in 10 patients (10 eyes) and a combination of focal or grid laser photocoaqulation and PRP in the remaining 10 eyes. The postoperative outcomes were compared between the two combination treatments by best corrected visual acuity (BCVA), tonometry, fluorescein angiography, and OCT at 2 weeks, 1, 2, and 3 months. Results Average BCVA (log MAR) significantly improved from preoperative 0.56±0.20 to 0.43±0.08 at 1 month (P=0.042) and it was maintained until 3 months after a combination of IVTA and PRP in 10 eyes (P=0.007). The thickness of fovea decreased from average 433.3±114.9 µm to average 279.5±34.1 µm at 2 weeks after combined treatment of IVTA and PRP (P=0.005), which was significantly maintained until 3 months, but there was a transient visual disturbance and no significant difference in thickness of the fovea before and after treatment in the groups with PRP and focal or grid laser photocoagulation. Conclusions A combination of IVTA and PRP might be an effective treatment modality in the treatment of macular edema and PDR and prevent the subsequent PRP-induced macular edema result in visual dysfunction. In combination with PRP, IVTA might be more effective than focal or grid laser photocoagulation and PRP for reducing diabetic macular edema and preventing aggravation of macular edema without transient visual disturbance in patients requiring immediate PRP.

Chung, JK; Lim, Sang Hyun

2007-01-01

377

Evidence for Diffuse Central Retinal Edema In Vivo in Diabetic Male Sprague Dawley Rats  

PubMed Central

Background Investigations into the mechanism of diffuse retinal edema in diabetic subjects have been limited by a lack of animal models and techniques that co-localized retinal thickness and hydration in vivo. In this study we test the hypothesis that a previously reported supernormal central retinal thickness on MRI measured in experimental diabetic retinopathy in vivo represents a persistent and diffuse edema. Methodology/Principal Findings In diabetic and age-matched control rats, and in rats experiencing dilutional hyponatremia (as a positive edema control), whole central retinal thickness, intraretinal water content and apparent diffusion coefficients (ADC, ‘water mobility’) were measured in vivo using quantitative MRI methods. Glycated hemoglobin and retinal thickness ex vivo (histology) were also measured in control and diabetic groups. In the dilutional hyponatremia model, central retinal thickness and water content were supernormal by quantitative MRI, and intraretinal water mobility profiles changed in a manner consistent with intracellular edema. Groups of diabetic (2, 3, 4, 6, and 9 mo of diabetes), and age-matched controls were then investigated with MRI and all diabetic rats showed supernormal whole central retinal thickness. In a separate study in 4 mo diabetic rats (and controls), MRI retinal thickness and water content metrics were significantly greater than normal, and ADC was subnormal in the outer retina; the increase in retinal thickness was not detected histologically on sections of fixed and dehydrated retinas from these rats. Conclusions/Significance Diabetic male Sprague Dawley rats demonstrate a persistent and diffuse retinal edema in vivo, providing, for the first time, an important model for investigating its pathogenesis and treatment. These studies also validate MRI as a powerful approach for investigating mechanisms of diabetic retinal edema in future experimental and clinical investigations.

Berkowitz, Bruce A.; Bissig, David; Ye, Yongquan; Valsadia, Puja; Kern, Timothy S.; Roberts, Robin

2012-01-01

378

Effect of Edema on Postimplant Dosimetry in Prostate Brachytherapy Using CT/MRI Fusion  

SciTech Connect

Purpose: To investigate the time course of prostatic edema and the effect on the dose-volume histograms of the prostate for patients treated with brachytherapy. Methods and Materials: A total of 74 patients with prostate cancer were enrolled in this prospective study. A transrectal ultrasound-based preplan was performed 4 weeks before implantation and computed tomography/magnetic resonance imaging fusion-based postimplant dosimetry was performed on the day after implantation (Day 1) and 30 days after implantation (Day 30). The prostate volume, prostate volume covered by 100% of the prescription dose (V{sub 100}), and dose covering 90% of the prostate (D{sub 90}) were evaluated with prostatic edema over time. Results: Prostatic edema was greatest on Day 1, with the mean prostate volume 36% greater than the preplan transrectal ultrasound-based volume; it thereafter decreased over time. It was 9% greater than preplan volume on Day 30. The V{sub 100} increased 5.7% from Day 1 to Day 30, and the D{sub 90} increased 13.1% from Day 1 to Day 30. The edema ratio (postplan/preplan) on Day 1 of low-quality implants with a V{sub 100} of <80% was significantly greater than that of intermediate- to high-quality implants (>80% V{sub 100}; p = 0.0272). The lower V{sub 100} on Day 1 showed a greater increase from Day 1 to Day 30. A V{sub 100} on Day 1 of >92% is unlikely to increase >0% during the interval studied. Conclusion: Low-quality implants on Day 1 were highly associated with edema; however, such a low-quality implant on Day 1, with significant edema, tended to improve by Day 30. If a high-quality implant (V100 >92%) can be obtained on Day 1, a re-examination is no longer necessary.

Tanaka, Osamu [Department of Radiology, Gifu University School of Medicine, Gifu (Japan); Division of Radiation Oncology, Gifu University Hospital, Gifu City (Japan)], E-mail: osa-mu@umin.ac.jp; Hayashi, Shinya; Matsuo, Masayuki [Department of Radiology, Gifu University School of Medicine, Gifu (Japan); Division of Radiation Oncology, Gifu University Hospital, Gifu City (Japan); Nakano, Masahiro; Uno, Hiromi [Department of Urology, Gifu University School of Medicine, Gifu (Japan); Ohtakara, Kazuhiro [Department of Radiology, Gifu University School of Medicine, Gifu (Japan); Division of Radiation Oncology, Gifu University Hospital, Gifu City (Japan); Miyoshi, Toshiharu [Division of Radiation Oncology, Gifu University Hospital, Gifu City (Japan); Deguchi, Takashi [Department of Urology, Gifu University School of Medicine, Gifu (Japan); Hoshi, Hiroaki [Department of Radiology, Gifu University School of Medicine, Gifu (Japan)

2007-10-01

379

Proteomic analysis of aqueous humor from patients with branch retinal vein occlusion-induced macular edema.  

PubMed

The mechanisms responsible for macular edema with branch retinal vein occlusion (BRVO) remain to be elucidated. It is known that the expression profile of certain proteins in the aqueous humor (AH) changes in some diseases. Accordingly, determining the expression of these AH proteins may aid in the understanding of their potential role in this pathogenesis. The aim of this study was to identify the possible mechanisms involved in the development of BRVO-induced macular edema. A proteomic analysis of the AH composition in the eyes of patients with BRVO was performed and compared with that in the eyes of patients with cataract (non-BRVO; controls). AH from 6 patients with macular edema due to BRVO and 6 patients with cataract (non-BRVO) was collected. A proteomic approach which included 2?dimensional electrophoresis (2?DE) coupled with mass spectrometry (MS) and bioinformatics analysis were used to identify AH proteins with altered expression in patients with macular edema due to BRVO compared with the controls. An enzyme?linked immunosorbent assay was used to validate the proteomic results. The total protein concentration in the AH of patients with BRVO-induced macular edema was significantly greater than that of the controls. In the patients with BRVO, a total of 56 protein spots were significantly altered on the 2D gels. A total of 49 protein spots were identified by MS; many of these proteins have been implicated in angiogenesis, oxidative stress and collagen synthesis. In conclusion, the protein composition in AH differed significantly between the patients with BRVO and the controls. The identified proteins may be potential biomarkers for the development of macular edema due to BRVO and may play a role in the mechanisms responsible for it. PMID:24068204

Yao, Jiaqi; Chen, Zhijun; Yang, Qin; Liu, Xiaoyi; Chen, Xi; Zhuang, Min; Liu, Qinghuai

2013-09-25

380

MRI Reveals Edema in Larynx (But Not in Brain) During Anaphylactic Hypotension in Anesthetized Rats  

PubMed Central

Purpose Anaphylactic shock is sometimes accompanied by local interstitial edema due to increased vascular permeability. We performed magnetic resonance imaging (MRI) to compare edema in the larynx and brain of anesthetized rats during anaphylactic hypotension versus vasodilator-induced hypotension. Methods Male Sprague Dawley rats were subjected to hypotension induced by the ovalbumin antigen (n=7) or a vasodilator sodium nitroprusside (SNP; n=7). Apparent diffusion coefficient (ADC) and T2-relaxation time (T2RT) were quantified on MRI performed repeatedly for up to 68 min after the injection of either agent. The presence of laryngeal edema was also examined by histological examination. Separately, the occurrence of brain edema was assessed by measuring brain water content using the wet/dry method in rats with anaphylaxis (n=5) or SNP (n=5) and the non-hypotensive control rats (n=5). Mast cells in hypothalamus were morphologically examined. Results Mean arterial blood pressure similarly decreased to 35 mmHg after an injection of the antigen or SNP. Hyperintensity on T2-weighted images (as reflected by elevated T2RT) was found in the larynx as early as 13 min after an injection of the antigen, but not SNP. A postmortem histological examination revealed epiglottic edema in the rats with anaphylaxis, but not SNP. In contrast, no significant changes in T2RT or ADC were detectable in the brains of any rats studied. In separate experiments, the quantified brain water content did not increase in either anaphylaxis or SNP rats, as compared with the non-hypotensive control rats. The numbers of mast cells with metachromatic granules in the hypothalamus were not different between rats with anaphylaxis and SNP, suggesting the absence of anaphylactic reaction in hypothalamus. Conclusion Edema was detected using the MRI technique in the larynx during rat anaphylaxis, but not in the brain.

Toyota, Ichiro; Tanida, Mamoru; Wang, Mofei; Kurata, Yasutaka; Tonami, Hisao

2013-01-01

381

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.

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

2013-01-01

382

Macular microcirculation before and after vitrectomy for macular edema with branch retinal vein occlusion  

Microsoft Academic Search

Background  The changes of perifoveal capillary blood flow velocity (BFV), visual acuity, and retinal thickness after pars plana vitrectomy\\u000a (PPV) have been unclear in patients with branch retinal vein occlusion (BRVO) and macular edema.\\u000a \\u000a \\u000a \\u000a Methods  In a prospective study, PPV was performed on six eyes of six consecutive BRVO patients with macular edema (two women and four\\u000a men; mean age: 66.3?±?5.0 years). Patients

Hidetaka Noma; Hideharu Funatsu; Kumi Sakata; Tatsuya Mimura; Sadao Hori

2010-01-01

383

Safety and Efficacy of Ranibizumab in Macular Edema following Retinal Vein Occlusion  

PubMed Central

Macular edema is the leading cause of visual impairment in patients with retinal vein occlusion. Limited improvements may be obtained with laser photocoagulation or intravitreal triamcinolone. However, according to the data provided by randomized clinical trials, intravitreal injections of ranibizumab (Lucentis; Genentech, South San Francisco, CA) constitute a new effective and safe option for the management of these vision-threatening diseases. The aim of the present review is to summarize the clinical evidence of ranibizumab for macular edema due to retinal vein occlusions.

Gallego-Pinazo, Roberto; Dolz-Marco, Rosa; Marin-Lambies, Cristina; Diaz-Llopis, Manuel

2012-01-01

384

Intravitreal triamcinolone acetonide versus bevacizumab therapy for macular edema associated with branch retinal vein occlusion  

Microsoft Academic Search

Purpose  To compare visual outcomes after intravitreal triamcinolone acetonide (IVTA) injection and intravitreal bevacizumab (IVB)\\u000a administration for treatment of macular edema associated with branch retinal vein occlusion (BRVO).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective comparative case series of 134 consecutive patients that were treated with either IVTA or IVB for macular\\u000a edema caused by BRVO. Visual acuity at baseline and 1, 3, 6, 9, and

Yeo Jue Byun; Mi In Roh; Sung Chul Lee; Hyoung Jun Koh

2010-01-01

385

An unusual cause of post-operative orbital edema in a child after general anesthesia.  

PubMed

We present an unusual ocular complication during the perioperative period, bilateral orbital edema in an otherwise healthy child after an outpatient surgical procedure. Ocular complications under general anesthesia remain a rare event. When periorbital edema is present, the appropriate work-up includes ruling out the potential for an allergic event by reviewing the medications administered and serum tryptase testing. Ophthalmology consultation should be considered to exclude pathology native to the eye itself. An allergist may assist in confirming a diagnosis and for allergic testing, if indicated. In our patient, the eventual diagnosis of exclusion was that of a localized reaction to the cellophane-based eye tape. PMID:21655032

Tobias, Joseph D; Jagannathan, Narasimhan; Sawardekar, Amod; Bhalla, Tarun

2011-01-01

386

[Hyponatremic encephalopathy with non-cardiogenic pulmonary edema. Development following marathon run].  

PubMed

This article presents the case of a 52-year-old woman who developed exercise-associated hyponatremia (EAH) complicated by non-cardiogenic pulmonary edema after a marathon run. The condition of EAH is a potentially life-threatening complication of endurance exercise. The main cause seems to be inadequate intake of free water during or following exercise with enduring antidiuresis due to nonosmotic stimulation of ADH secretion. Known risk factors are female gender, slow running pace and lack of weight loss. Emergency therapy is fluid restriction and bolus infusion of 3% NaCl solution to rapidly reduce brain edema. PMID:23381723

Wellershoff, G

2012-12-21

387

Life-threatening cerebral edema caused by acute occlusion of a superior vena cava stent.  

PubMed

A71-year-old man with advanced lung cancer developed a life-threatening cerebral edema caused by the acute occlusion of a superior vena cava (SVC) stent and was successfully treated by an additional stent placement. Although stent occlusion is a common early complication, no life-threatening situations have been reported until now. Our experience highlights the fact that acute stent occlusion can potentially lead to the complete venous shutdown of the SVC, resulting in life-threatening cerebral edema, after SVC stent placement. Immediate diagnosis and countermeasures are required. PMID:22588276

Sofue, Keitaro; Takeuchi, Yoshito; Arai, Yasuaki; Sugimura, Kazuro

2012-05-17

388

Perinatal and neonatal significance of bacteria-related placental villous edema.  

PubMed

In a study of 82 cases of clinical chorioamnionitis in which no antibiotics were administered antenatally, significant villous edema was observed in 51 placentas (62%). Polymorphonuclear leukocyte invasion of the placental plate was found in 53 placentas (65%). The presence of SVE was significantly associated with placental bacterial recovery, occurrence of prolonged rupture of membranes, lower one minute Apgar score, the need for resuscitation and significant neonatal respiratory problems. Findings suggest that bacteria-related placental villous edema can lead to significant perinatal and neonatal morbidities. PMID:2244458

Ilagan, N B; Elias, E G; Liang, K C; Kazzi, G; Piligian, J; Khatib, G

1990-01-01

389

Aphakic cystoid macular edema and the operating microscope: is there a connection?  

PubMed Central

The literature documenting the phototoxic effect of relatively low intensity light on the retina and the suggestions by several authors that this might influence the development of cystoid macular edema in the aphakic and pseudophakic patient is reviewed. In particular, the possibility that the operating microscope may be a factor has been emphasized. A study is presented, designed to investigate the possibility that the operating microscope is a factor important in the development of cystoid macular edema. No correlation was found. The need for further investigation into other phototoxic effects from the light of the operating microscope is stressed.

Iliff, W J

1985-01-01

390

The impact of prostate edema on cell survival and tumor control after permanent interstitial brachytherapy for early stage prostate cancers  

NASA Astrophysics Data System (ADS)

Previous studies have shown that procedure-induced prostate edema during permanent interstitial brachytherapy (PIB) can cause significant variations in the dose delivered to the prostate gland. Because the clinical impact of edema-induced dose variations strongly depends on the magnitude of the edema, the temporal pattern of its resolution and its interplay with the decay of radioactivity and the underlying biological processes of tumor cells (such as tumor potential doubling time), we investigated the impact of edema-induced dose variations on the tumor cell survival and tumor control probability after PIB with the 131Cs, 125I and 103Pd sources used in current clinical practice. The exponential edema resolution model reported by Waterman et al (1998 Int. J. Radiat. Oncol. Biol. Phys. 41 1069-77) was used to characterize the edema evolutions previously observed during clinical PIB for prostate cancer. The concept of biologically effective dose, taking into account tumor cell proliferation and sublethal damage repair during dose delivery, was used to characterize the effects of prostate edema on cell survival and tumor control probability. Our calculation indicated that prostate edema, if not appropriately taken into account, can increase the cell survival and decrease the probability of local control of PIB. The magnitude of an edema-induced increase in cell survival increased with increasing edema severity, decreasing half-life of radioactive decay and decreasing photon energy emitted by the source. At the doses currently prescribed for PIB and for prostate cancer cells characterized by nominal radiobiology parameters recommended by AAPM TG-137, PIB using 125I sources was less affected by edema than PIB using 131Cs or 103Pd sources due to the long radioactive decay half-life of 125I. The effect of edema on PIB using 131Cs or 103Pd was similar. The effect of edema on 103Pd PIB was slightly greater, even though the decay half-life of 103Pd (17 days) is longer than that of 131Cs (9.7 days), because the advantage of the longer 103Pd decay half-life was negated by the lower effective energy of the photons it emits (~21 keV compared to ~30.4 keV for 131Cs). In addition, the impact of edema could be reduced or enhanced by differences in the tumor characteristics (e.g. potential tumor doubling time or the ?/? ratio), and the effect of these factors varied for the different radioactive sources. There is a clear need to consider the effects of prostate edema during the planning and evaluation of permanent interstitial brachytherapy treatments for prostate cancer.

(Jay Chen, Zhe; Roberts, Kenneth; Decker, Roy; Pathare, Pradip; Rockwell, Sara; Nath, Ravinder

2011-08-01

391

Pediatric Vulvar Lichen Sclerosus  

MedlinePLUS

... removed and sent to the laboratory for examination. Cultures for bacterial, fungal, and viral infections are sometimes ... is not occurring along with the lichen sclerosus. Cultures are done by gently touching the area with ...

392

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

393

Posterior Subtenon Triamcinolone, Intravitreal Triamcinolone and Grid Laser Photocoagulation for the Treatment of Macular Edema in Branch Retinal Vein Occlusion  

Microsoft Academic Search

Purpose: To evaluate the efficacy of posterior subtenon triamcinolone (PSTT), intravitreal triamcinolone (IVT) injections and grid laser photocoagulation (GLP) in eyes with macular edema secondary to branch retinal vein occlusion (BRVO). Material and Methods: Patients with macular edema due to BRVO treated with PSTT, IVT injections or GLP were evaluated retrospectively. Complete ophthalmic examination with fluorescein angiography and optic coherence

Sengul Ozdek; Yudum Tiftikcioglu Deren; Gokhan Gurelik; Berati Hasanreisoglu

2008-01-01

394

Visual acuity and foveal thickness after vitrectomy for macular edema associated with branch retinal vein occlusion: a case series  

Microsoft Academic Search

BACKGROUND: The mechanism by which vitrectomy improves macular edema in patients with branch retinal vein occlusion remains unclear, although intraocular levels of vascular endothelial growth factor have been suggested to influence the visual prognosis and macular edema. METHODS: A series of 54 consecutive patients (54 eyes) with branch retinal vein occlusion was studied prospectively. All patients underwent pars plana vitrectomy

Hidetaka Noma; Hideharu Funatsu; Tatsuya Mimura; Shuichiro Eguchi; Katsunori Shimada

2010-01-01

395

Effects of the L\\/N-type calcium channel antagonist cilnidipine on morning blood pressure control and peripheral edema formation  

Microsoft Academic Search

The L\\/N-type calcium channel blocker cilnidipine has unique effects including sympathetic nerve suppression and the balanced vasodilatation of arteries and veins that may alleviate morning hypertension (MHT) or peripheral edema caused by calcium channel antagonists. We used ambulatory blood pressure monitoring (ABPM) and a unique peripheral edema measurement to evaluate the effect of morning and bedtime cilnidipine in patients with

Sumito Narita; Yasuko Yoshioka; Atsumi Ide; Toshiaki Kadokami; Hidetoshi Momii; Masayoshi Yoshida; Shin-ichi Ando

2011-01-01

396

Edema induced by Bothrops asper (Squamata: Viperidae) snake venom and its inhibition by Costa Rican plant extracts  

Microsoft Academic Search

W e tested the capacity of leaf (Urera baccifera, Loasa speciosa, Urtica leptuphylla, Chaptalia nutans, and Satureja viminea) and root (Uncaria tomentosa) extracts to inhibit edema induced by Bothrops asper snake venom. Edema-forming activity was studied plethysmographically in the rat hind paw model. Groups of rats were injected intraperitoneally with various doses of each extract and, one hour later, venom

Beatriz Badilla; Fernando Chaves; Gerardo Mora; Luis J. Poveda

2006-01-01

397

Severe Macular Edema in Patients with Juvenile Idiopathic Arthritis-Related Uveitis  

PubMed Central

Purpose. To report the onset of severe macular edema in adolescent female patients affected by juvenile idiopathic arthritis (JIA). Methods. Four female patients affected by JIA-related chronic anterior uveitis (CAU), complicated by severe macular edema, were retrospectively analyzed. Macular area was evaluated by fluorescein angiography and optical coherence tomography (OCT). Results. CAU was bilateral in three patients. Mean age of uveitis and arthritis onset was, respectively, 4.5 ± 1.7 years and 6.0 ± 3.9 years. All patients underwent cataract extraction surgery. Despite ocular inflammation being controlled by topical/systemic therapy, during adolescence (mean age of appearance/diagnosis: 12.7 ± 3.9 years) patients developed severe unilateral macular edema. OCT revealed massive macular thickening (range from 550??m to 1214??m). Conclusions. Macular edema appeared in female adolescent patients in eyes with long-dating CAU submitted to cataract surgery. In such patients, in presence of age-related microvascular changes due to the enhancer effect of sex hormones, cataract extraction should be a factor triggering the retinal complication.

Paroli, Maria Pia; Fabiani, Claudia; Spinucci, Giovanni; Sapia, Alfredo; Spadea, Leopoldo

2013-01-01

398

The use of non-invasive ventilation in the treatment of acute cardiogenic pulmonary edema  

Microsoft Academic Search

The patient with acute heart failure may present with acute cardiogenic pul- monary edema (ACPE), a condition accompa- nied by severe respiratory distress, with crack- les over the lung and orthopnea, and an O2 sat- uration usually < 90% on room air, prior to treatment. Non-invasive ventilation is the delivery of assisted ventilation without the need for endo- tracheal intubation

S. URSELLA; M. MAZZONE; G. PORTALE; G. CONTI; M. ANTONELLI; N. GENTILONI SILVERI

2007-01-01

399

Role of a Hydrostatic Pressure Gradient in the Formation of Early Ischemic Brain Edema  

Microsoft Academic Search

Summary: We studied whether a hydrostatic pressure gradient between arterial blood and brain tissue plays a role in the formation of early ischemic cerebral edema after middle cerebral artery (MCA) occlusion in cats. Tissue pressure, regional CBF, and water content were measured from the cortex in the core and the peripheral zone of brain normally perfused by the MCA. Intraluminal

Shizuo Hatashita; Julian T. Hoff

1986-01-01

400

Case Report of Optic Atrophy in Pansynostosis: An Unusual Presentation of Scalp Edema from Hair Braiding  

Microsoft Academic Search

Pansynostosis (fusion of all cranial sutures) and optic atrophy were found as incidental CT scan and ophthalmological findings in an 8-year-old who presented to the emergency room with scalp edema from tight ‘cornrow’ hair braiding. Cranial vault expansion was successfully performed. Ophthalmological problems have stabilized but have not reversed. Late presentation of craniosynostosis and the pathophysiology of secondary optic atrophy

Catherine M. O’Hara; Keyoumars Izadi; Leland Albright; James P. Bradley

2006-01-01

401

Pulmonary Edema in 6 Children With Down Syndrome During Travel to Moderate Altitudes  

Microsoft Academic Search

Objective. Children with Down syn- drome (DS) are living longer and are increasingly partic- ipating in recreational activities. When a child with DS was diagnosed with high-altitude pulmonary edema (HAPE), this study was undertaken to determine whether and under what circumstances children with DS develop HAPE. Design. A retrospective review of the medical records of Children's Hospital, Denver, Colorado was

Anthony G. Durmowicz

402

Acute pulmonary edema after low-level air embolism during craniotomy. Case report.  

PubMed

Acute pulmonary edema after a large air embolus occurring during neurosurgery is a recognized phenomenon. The authors describe the course of a 76-year-old man who presented with noncardiogenic pulmonary edema shortly after undergoing resection of a high convexity meningioma. Transthoracic Doppler sonography, however, showed no evidence of a large intraoperative emboli; the evidence for ongoing but low-magnitude air embolus included visualization of bone aspiration of irrigant before bone-edge waxing, transient intraoperative declines in end-tidal CO2 tension, and an increase of the fraction of inspired oxygen to maintain adequate saturation after removal of the craniotomy flap. There was no hemodynamic instability noted. The airspace disease was self-limited and resolved on supportive treatment after approximately 1 week, as would be expected for pulmonary edema caused by a single large intravenous air embolus. The authors present this case as the first report of pulmonary edema resulting from low-level air embolus occurring during craniotomy. This situation may go unrecognized intraoperatively but can cause the same significant postoperative morbidity as larger, more easily identified air emboli. PMID:8893735

Frim, D M; Wollman, L; Evans, A B; Ojemann, R G

1996-11-01

403

Modulation of mouse ear edema by cyclooxygenase and lipoxygenase inhibitors and other pharmacologic agents  

Microsoft Academic Search

Inhibitors of arachidonic acid (AA) metabolism and other pharmacologic agents were evaluated against ear edema produced in mice by tetradecanoylphorbol acetate (TPA) or AA. Drugs were administered orally and topically either 30 min prior to AA or 30 min after TPA, except for steroids which were administered 2.5–3 hr prior to AA. Several cyclooxygenase (CO) inhibitors including indomethacin, aspirin, piroxicam

Richard P. Carlson; O'Neill-Davis Lynn; Joseph Chang; Alan J. Lewis

1985-01-01

404

Pars-plana vitrectomy in cystoid macular edema associated with intermediate uveitis  

Microsoft Academic Search

Background: Cystoid macular edema (CME) is a common complication in the course of intermediate uveitis. In spite of systemic therapy with steroids or carbonic anhydrase inhibitors, persistence of CME is observed. Pars plana vitrectomy (PPV) is known to influence the course of intermediate uveitis positively. The present study was performed to investigate the role of PPV in the therapy of

Burkhard Wiechens; Bernhard Nölle; Jan A. Reichelt

2001-01-01

405

Intravitreal versus Sub-Tenon Posterior Triamcinolone Injection in Bilateral Diffuse Diabetic Macular Edema  

Microsoft Academic Search

Purpose: To compare the efficacy of intravitreal and sub-Tenon (ST) posterior triamcinolone injection in the treatment of bilateral diabetic diffuse macular edema (DDME). Methods: 28 eyes of 14 diabetic patients with bilateral DDME were included in this prospective randomized study. One eye of each individual received a sub-Tenon (ST) posterior triamcinolone injection (ST group), whereas the fellow eye received an

Ozgur Yalcinbayir; Oner Gelisken; Berkant Kaderli; Remzi Avci

2011-01-01

406

Correlations between edema and the immediate and prolonged painful consequences of inflammation: therapeutic implications?  

Microsoft Academic Search

The precise relationship between the degree of pain and the degree of inflammation in the individual remains debated. A quantitative analysis simultaneously applied to the immediate and prolonged painful consequences of inflammation has not yet been done. Thus, the correlations between edema, nociception and hypersensitivity following an inflammatory insult were assessed in rodents. To better understand the therapeutic value of

W R Lariviere; E J Chesler; Li Zhen; G W Shang; Y N Chen; Yao Yu; Zhuo Lu; Ying Chang; Ceng Luo; KaiCheng Li; Jun Chen

2005-01-01

407

Volume recruitment and oxygenation in pulmonary edema: A comparison between HFOV and CMV  

Microsoft Academic Search

Purpose: In acute lung injury, edema floods alveoli decreasing mean lung volume (MLV) and increasing pulmonary venous admixture (Qva\\/Qt). We reasoned that a ventilatory strategy that uses large tidal volumes (Vt) might recruit volume differently than a strategy that uses very small Vt (high-frequency oscillatory ventilation, HFOV) which may require an inflation maneuver to total lung capacity (TLC) for full

Jacob Iasha Sznajder; Avi Nahum; David E. Hansen; G. Richard Long; Lawrence D. H. Wood

1998-01-01

408

Urticaria and periorbital edema as prodromal presenting signs of acute hepatitis B infection.  

PubMed

A 34-year-old patient presented with giant, transient urticarial skin lesions and periorbital edema after a 3-month stay in DR Congo. Retrospective analysis of stored samples revealed that these signs were prodromal manifestations of acute hepatitis B infection. The hepatitis B infection was spontaneously cleared; the skin lesion did not recur. PMID:21539670

van Aalsburg, Rob; de Pagter, Anne P J; van Genderen, Perry J

2011-04-11

409

Grid photocoagulation combined with intravitreal bevacizumab for recurrent macular edema associated with retinal vein occlusion  

PubMed Central

Purpose: To report the efficacy of grid photocoagulation combined with intravitreal bevacizumab (IVB) for macular edema recurring after previous IVBs associated with retinal vein occlusion (RVO). Methods: This retrospective study consisted of 19 eyes with branch retinal vein occlusion (BRVO) and nine eyes with central retinal vein occlusion (CRVO), which were treated with grid photocoagulation combined with IVB for recurrent macular edema after previous IVBs. The mean duration of total follow-up was 29.3 ± 5.8 months. Results: After this combination therapy, foveal thickness was reduced, significant with slight improvement in visual acuity (VA). At 1 month after treatment, although 25 of the 28 eyes showed complete resolution of the cystoid space, the macular edema recurred to some extent in 19 eyes. Compared with initial values, final foveal thickness was reduced significantly in both BRVO and CRVO groups (P < 0.001), but improvement in VA was significant only for eyes with BRVO (P = 0.012). The total number of IVB was 2.8 ± 0.7 for eyes with either BRVO or CRVO. Conclusion: Grid photocoagulation combined with IVB has a substantial effect on reducing recurrent macular edema associated with RVO, but the effect on visual acuity is limited.

Ogino, Ken; Tsujikawa, Akitaka; Murakami, Tomoaki; Muraoka, Yuki; Kurashige, Yumiko; Yoshimura, Nagahisa

2011-01-01

410

Pars plana vitrectomy and internal limiting membrane peeling for macular edema secondary to retinal vein occlusion  

PubMed Central

Purpose: To evaluate the effects of vitrectomy and internal limiting membrane peeling for treatment of macular edema secondary to retinal vein occlusion (RVO). Methods: Nine cases of visual loss due to macular edema caused by central retinal vein occlusion or branch retinal vein occlusion underwent pars plana vitrectomy with removal of the preretinal hyaloid, peeling of the internal limiting membrane stained with indocyanine green dye, air–fluid exchange, and postoperative prone positioning. Best-corrected visual acuity (BCVA) and central foveal thickness by optical coherence tomography were measured pre- and postoperatively then compared to assess the outcome of surgery. Results: In all cases intraretinal blood and retinal thickening diminished within 2 months of surgery. Visual acuity improved in all of the central retinal vein occlusion cases and 3/6 branch retinal vein occlusion cases. The decrease in macular thickness was statistically significant (mean postoperative macular thickness 361 ± 61.1 versus mean preoperative macular thickness 563.9 ± 90.0, P = 0.001, t-test). The improvement in BCVA was not statistically significant (mean preoperative BCVA in LogMAR 1.23 ± 0.29 versus mean postoperative BCVA in LogMAR 1.06 ± 0.49, P = 0.09, t-test). Conclusion: In eyes with macular edema secondary to RVO, pars plana vitrectomy with internal limiting membrane peeling can resolve macular edema, but the improvement in BCVA was not statistically significant in this study.

Baharivand, Nader; Hariri, Amirhossein; Javadzadeh, Alireza; Heidari, Ebadollah; Sadegi, Karim

2011-01-01

411

Fast Resolution of Recurrent Pronounced Macular Edema following Intravitreal Injection of Dexamethasone 0.7 mg  

PubMed Central

Purpose To report the fast resolution of recurrent pronounced macular edema due to central retinal vein occlusion (CRVO) within 72 h following intravitreal injection of dexamethasone 0.7 mg (Ozurdex®). Methods An interventional case report with optical coherence tomography scans and fluorescein angiographic pictures. Results A 69-year-old Caucasian man underwent intravitreal injection of dexamethasone 0.7 mg due to incomplete CRVO. He had previously undergone 6 intravitreal injections of bevacizumab 1.25 mg (Avastin®) and a C-grid laser photocoagulation over an interval of 16 months. After repeated recurrences of macular edema, the injection of dexamethasone reduced the macular edema from 570 ?m preoperatively to 246 ?m postoperatively within 72 h following the injection. Best-corrected visual acuity improved from 0.1 to 0.6 within the same interval. Conclusion Dexamethasone can lead to a very fast reduction of macular edema in patients with vision loss due to CRVO and may facilitate an immediate visual rehabilitation. Retinal anatomy and visual acuity may be restored even in long-standing, recurrent cases.

Meyer, Linda M.; Schonfeld, Carl-Ludwig

2011-01-01

412

NTCP Modeling of Subacute\\/Late Laryngeal Edema Scored by Fiberoptic Examination  

Microsoft Academic Search

Purpose: Finding best-fit parameters of normal tissue complication probability (NTCP) models for laryngeal edema after radiotherapy for head and neck cancer. Methods and Materials: Forty-eight patients were considered for this study who met the following criteria: (1) grossly uninvolved larynx, (2) no prior major surgery except for neck dissection and tonsillectomy, (3) at least one fiberoptic examination of the larynx

Tiziana Rancati; Claudio Fiorino; Giuseppe Sanguineti

2009-01-01

413

Attenuation of Ischemic Brain Edema and Cerebrovascular Injury After Ischemic Preconditioning in the Rat  

Microsoft Academic Search

Ischemic preconditioning (IPC) induces neuroprotection to subsequent severe ischemia, but its effect on the cerebrovasculature has not been studied extensively. This study evaluated the effects of IPC on brain edema formation and endothelial cell damage that follows subsequent permanent focal cerebral ischemia in the rat. Transient (15 minute) middle cerebral artery occlusion (MCAO) was used for IPC. Three days after

Tetsuya Masada; Ya Hua; Guohua Xi; Steven R Ennis; Richard F Keep

2001-01-01

414

An improved Percoll density gradient for measurements of experimental brain edema  

Microsoft Academic Search

Microgravimetric methods are very useful for quantitative studies on brain edema. One of the techniques available is based on a gradient made up by NaCl and polyvinyl pyrrolidone-coated silica particles (Percoll). The present study was performed to find a way of minimizing fluid shifts between the gradient and the samples. For this purpose, five Percoll density gradients containing various concentrations

C. Tengvar; D. Hultström; Y. Olsson

1983-01-01

415

Decreased Visual Acuity Associated With Cystoid Macular Edema in Neovascular Age-related Macular Degeneration  

Microsoft Academic Search

Objective: To determine the prevalence and visual sig- nificance of cystoid macular edema (CME) in eyes with subfoveal neovascular age-related macular degenera- tion using optical coherence tomography (OCT). Materials and Methods: The medical records of 61 consecutive patients initially seen with nondisciform sub- foveal neovascular age-related macular degeneration were retrospectively reviewed. All patients underwent fluo- rescein angiography and OCT imaging.

T. Daniel Ting; Mila Oh; Terry A. Cox; Carsten H. Meyer; Cynthia A. Toth

416

Pulmonary Edema after Catastrophic Carbon Dioxide Embolism during Laparoscopic Ovarian Cystectomy  

PubMed Central

Laparoscopy is a surgical procedure used both for diagnosis and for various treatments. A rare but sometimes fatal complication of laparoscopy is pulmonary embolism with CO2 resulting in pulmonary edema. During laparoscopic gynecological surgery in a 29-year-old woman who had previously undergone lower abdominal surgery, the end-tidal CO2 suddenly increased from 40 mmHg to 85 mmHg and then decreased to 13 mmHg with hemodynamic deterioration. These events are characteristic of a CO2 embolism. When this occurred, CO2 insufflation was immediately stopped and the patient was resuscitated. The patient's condition gradually improved with aggressive treatment, but the clinical course was complicated by bilateral pulmonary edema. This case of pulmonary edema was soon resolved with supportive management. The formation of a CO2 embolism during laparoscopy must be suspected whenever there is a sudden change in the end-tidal CO2. In addition, the possibility of pulmonary edema should be considered when a CO2 embolism occurs.

Lee, Yoonki; Kim, Eun Sung

2008-01-01

417

Reexpansion pulmonary edema after treatment of simultaneous bilateral spontaneous tension pneumothorax.  

PubMed

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

Kwon, Jong Bum; Choi, Si Young; Kim, Chi Kyung; Park, Chan Beom

2013-04-04

418

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.

2013-01-01

419

Taut Internal Limiting Membrane Causing Diffuse Diabetic Macular Edema after Vitrectomy: Clinicopathological Correlation  

Microsoft Academic Search

Aims: To describe 2 cases of diffuse diabetic macular edema (DME) after diabetic vitrectomy caused by a taut internal limiting membrane (ILM), with clinicopathological correlation. Methods: Interventional case series with immunohistochemical analysis. Results: Two patients were referred for unresponsive diffuse DME after pars plana vitrectomy with removal of the posterior hyaloid. Clinically, a taut ILM was noted over the fovea,

Ronald C. Gentile; Tatyana Milman; Dean Eliott; Juan M. Romero; Steven A. McCormick

2011-01-01

420

Effectiveness of morphine in non-cardiogenic pulmonary edema due to chlorine gas inhalation.  

PubMed

We report the case of an 11-yr-old boy who developed a non-cardiogenic pulmonary edema following inhalation of chlorine gas at a swimming pool. Rapid clinical improvement was noted after i.v. administration of morphine. PMID:8434449

Pino, F; Puerta, H; D'Apollo, R; Ferrer, M; Arias, I; Irastorza, I M; Ramirez, M S

1993-02-01

421

Vagal and sympathetic denervation in the development of oleic acid-induced pulmonary edema  

Microsoft Academic Search

This study investigates the effects of autonomic denervation on extravascular lung water, pulmonary hemodynamics, the filtration coefficient of pulmonary vasculature and oxygenation in the development of pulmonary edema. Thirty seven dogs were divided into seven groups. No experimental treatment was conducted in group Nc (n=4, sham operation) or group Nv (n=6, bilateral vagotomy) during a 3 h observation period. In

Hong-Lin Du; Yoshitsugu Yamada; Ryo Orii; Kunio Suwa; Kazuo Hanaoka

1997-01-01

422

Treatment for painful bone marrow edema by open wedge tibial osteotomy.  

PubMed

We evaluated the results of patients who had undergone medial open wedge proximal tibial osteotomy, with painful bone marrow edema in the medial tibial plateau. The study included 21 patients who had presented with knee pain and whose MRIs showed bone marrow edema in medial plateau. The degree of osteoarthritis was evaluated radiologically according to the Kellgren-Lawrence criteria; 6 cases were Grade 1, 11 cases were Grade 2, and 3 cases were Grade 3. Preoperative varus angle was a mean of 2.19° (0-4). The bone marrow edema was classified according to the width of the lesions extending into the joint surface subchondral area on MRI T2 sequences. Open wedge osteotomy was performed in all patients. The postoperative results were evaluated by X-ray, MRI, and WOMAC (Western Ontario and McMaster Universities) knee scores. The preoperative 2.19° varus angle was evaluated postoperatively as valgus 6.57° (4-8°) (p < 0.05). The postoperative WOMAC knee scores revealed a significant decrease in pain (p < 0.05). In conclusion, we are of the opinion that medial open wedge proximal tibial osteotomy is an effective treatment in patients who have painful bone marrow edema in medial tibia plateau. PMID:23412209

Kesemenl?, Cumhur Cevdet; Mem?soglu, Kaya; Muezz?noglu, Um?t Sefa; Akansel, Gur

2012-09-12

423

Bacillus anthracis Edema Toxin Inhibits Staphylococcus aureus Enterotoxin B Effects In Vitro: a Potential Protein Therapeutic?  

Microsoft Academic Search

Various in vitro effects of staphylococcal enterotoxin B (SEB) on human peripheral blood mononuclear cells were mitigated by Bacillus anthracis edema toxin. In particular, levels of some SEB-induced cytokines (tumor necrosis factor alpha, gamma interferon) and chemokines (monocyte chemoattractant protein 1, macrophage inflammatory protein 1 alpha (MIP-1), MIP-1) were significantly diminished or even nonexistent, depend- ing upon the timing of

Teresa Krakauer; Stephen F. Little; Bradley G. Stiles

2005-01-01

424

Traumatic brain edema induced by ventricular puncture. A study by magnetic resonance imaging  

Microsoft Academic Search

Magnetic resonance imaging demonstrates after ventricular catheterization a focal brain hypersignal corresponding to a parenchymal edema along the drain track. In the course of our daily clinical activity, this hypersignal extention seemed more pronounced when catheterizing the frontal area than the junctional parieto-tempro-occipital parenchyma (or trigonal area). In order to confirm this impression, we prospectively studied ten consecutive patients with

Christian Raftopoulos; Daniel Balériaux; Cristo Chaskis; Florence Delecluse; Jacques Brotchi

1992-01-01

425

Flash pulmonary edema in a post arterial switch operation - High flow oxygen as a treatment modality.  

PubMed

We report a case of a 3-year-old boy who underwent an arterial switch operation with relief of left ventricular outflow tract obstruction and later presented with recurrent episodes of flash pulmonary edema. High-flow humidified oxygen with positive pressure support (Vapotherm) was used as a treatment modality, thereby avoiding intubation and mechanical ventilation. PMID:20808637

Kumar, Jamuna; Hegde, Rajesh; Maheshwari, Sunita; Rao, Shekar

2009-07-01

426

Effect of VEGF Receptor Antagonist (VGA1155) on Brain Edema in the Rat Cold Injury Model  

Microsoft Academic Search

Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and a strong vascular permeability factor. Blockade of VEGF may have a potential to treat brain edema after brain injury. In the rat cold injury model, the VEGF receptor antagonist VGA1155 significantly reduced the brain water content and the maximum effect was obtained when given at 30 minutes after

JUNJI KOYAMA; SHIGERU MIYAKE; TAKASHI SASAYAMA; TAKESHI KONDOH; EIJI KOHMURA

2007-01-01

427

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

428

[The effects of a benzopyrone derivative in experimental brain edema due to cold in the rabbit].  

PubMed

On this study, parenchymal changes during a cerebral edema caused by thermic injury (cool) on the rabbit, are analyzed. The work was based on the ultrastructural findings obtained by transmission electronic microscopy and on the effects produced by a benzopironic derived (F-117 Hydrosmina). The injury was produced with solid CO2, previous a craniectomy, on the dura mater of the left hemisphere. Forty rabbits were included into the study, the animals were distributed into five groups (n = 8): a control group and 4 treatment groups. One of the groups received treatment without previous cerebral injury. The group of rabbits with doses of 50 mg/Kg of weight showed focal and diffuse areas of edema alternating with less damaged areas, the edema was evident on the white substance. This group also showed a dissociation of the myelinic fibers and an intracytoplasmatic tumefaction into the glial cells. These findings contrast with the histopathological findings obtained from the rabbits (V), the extracellular edema was poor, the myelinic fiber disorganization was minimal with no vacuolar degeneration and no structural mitochondrial changes had been showed. The discontinuance of the hematoencephalic barrier caused by the cool could be a possible mechanism that causes the opening of the endothelial unions from the capillary vessels, changing their membranes and resulting in a free penetration of the molecule into the cerebral parenchyma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8338248

Góngora Castillo, C; Gómez de Segura, I A; López Bravo, A; de Miguel del Campo, E

429

Relationship between isotope half-life and prostatic edema for optimal prostate dose coverage in permanent seed implants  

SciTech Connect

The robustness of treatment planning to prostatic edema for three different isotopes ({sup 125}I, {sup 103}Pd, and {sup 131}Cs) is explored using dynamical dose calculations on 25 different clinical prostate cases. The treatment plans were made using the inverse planning by simulated annealing (IPSA) algorithm. The prescription was 144, 127, and 125 Gy for {sup 125}I, {sup 131}Cs, and {sup 103}Pd, respectively. For each isotope, three dose distribution schemes were used to impose different protection levels to the urethra: V{sub 120}=0%, V{sub 150}=0%, and V{sub 150}=30%. Eleven initial edema values were considered ranging from 1.0 (no edema) to 2.0 (100%). The edema was assumed to resolve exponentially with time. The prostate volume, seed positions, and seed activity were dynamically tracked to produce the final dose distribution. Edema decay half-lives of 10, 30, and 50 days were used. A total of 675 dynamical calculations were performed for each initial edema value. For the {sup 125}I isotope, limiting the urethra V{sub 120} to 0% leads to a prostate D{sub 90} under 140 Gy for initial edema values above 1.5. Planning with urethra V{sub 150} at 0% provides a good response to the edema; the prostate D{sub 90} remains higher than 140 Gy for edema values up to 1.8 and a half-life of 30 days or less. For {sup 103}Pd, the prostate D{sub 90} is under 97% of the prescription dose for approximately 66%, 40%, and 30% of edema values for urethra V{sub 120}=0%, V{sub 150}=0%, and V{sub 150}=30%, respectively. Similar behavior is seen for {sup 131}Cs and the center of the prostate becomes 'cold' for almost all edema scenarios. The magnitude of the edema following prostate brachytherapy, as well as the half-life of the isotope used and that of the edema resorption, all have important impacts on the dose distribution. The {sup 125}I isotope with its longer half-life is more robust to prostatic edema. Setting up good planning objectives can provide an adequate compromise between organ doses and robustness. This is even more important since seed misplacements will contribute to further degrade dose coverage.

Villeneuve, Maxime; Leclerc, Ghyslain; Lessard, Etienne; Pouliot, Jean; Beaulieu, Luc [Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, Hotel-dieu de Quebec, CHUQ, 11 Cote du Palais, Quebec, Quebec G1R 2J6 (Canada) and Departement de physique, de genie physique et d'optique, Universite Laval, Quebec, Quebec G1K 7P4 (Canada); Departement de Radio-Oncologie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec J1H 5N4 (Canada); Department of Radiation Oncology, University of California-California, San Francisco, San Francisco, California 94713-1708 (United States); Departement de Radio-Oncologie et Centre de Recherche en Cancerologie, Hotel-dieu de Quebec, CHUQ, 11 Cote du Palais, Quebec, Quebec G1R 2J6 (Canada) and Departement de physique, de genie physique et d'optique, Universite Laval, Quebec, Quebec G1K 7P4 (Canada)

2008-05-15