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Biomedical subjects

E Verbeken

Publications and source records attributed to E Verbeken.

86 records · Page 5Linked to original sources

"Skip areas" in hepatic steatosis: a sonographic-angiographic study.

"Skip areas" in focal steatosis describes a newly proposed "subsegmental type" of focal steatosis, which differs in both extent and topography from the more classic "lobar or segmental type" of focal steatosis. In the subsegmental type of steatosis, fatty infiltration can be considered homogeneous throughout the liver, with the exception of small flattened portions of less affected parenchyma, called "skip areas." These regions are mainly located in the subcapsular areas or along the interlobar fissures or the gallbladder bed. Observations using ultrasound in vivo, as well as on postmortem in vitro angiograms, suggest that both the extent and topography of these skip areas can be explained by local differences in vascular anatomy.

Adult↗

Ultrasound of the normal kidney: a sonographic, anatomic and histologic correlation.

Technical progress in sonographic equipment providing routinely high resolution images makes it appropriate that some criteria of normality have to be reviewed. In this paper normal sonographic images of the kidney are correlated with anatomy and histology. The effect of aging upon normal anatomical relations and histologic findings is analysed. Special attention is focussed on particular anatomical details as far as they can explain the particular topography or sonographic appearance of some pathologies.

Adult↗

High-resolution real-time sonography of the adrenal glands: a routine examination?

The feasibility of imaging the adrenal glands during routine upper abdominal examinations was studied for 100 consecutive patients, 47 males and 53 females. The mean patient age was 46 years and the mean weight 63 kg. The suprarenal areas were scanned in a slightly oblique frontal plane through the intercostal spaces with the patient recumbent. The right adrenal gland was detected in 92 per cent of the patients, with a mean examination time of less than one minute. Visualization of the left adrenal gland was more difficult and was successful in only 71 per cent, even where additional views in the right lateral decubitus or erect position were added. The mean examination time on the left was 2 1/2 minutes. Complete visualization of the adrenal gland is impossible in one single plane because of the complex shape of the organ, which necessitates multiple contiguous scan planes. In 13 per cent of the visualized adrenals, cortex and medulla could be differentiated.

Adolescent↗

Lung metastasis of malignant epithelioid hemangioendothelioma mimicking a primary intravascular bronchioalveolar tumor. A histologic, ultrastructural, and immunohistochemical study.

A 40-year-old woman presented with multiple nodules in both lungs and a small tumoral mass at the level of the left brachial artery. A pathologic diagnosis of pulmonary intravascular bronchioloalveolar tumor (IVBAT) and epithelioid hemangioendothelioma of the limb was established. Morphologic and immunohistochemical studies highly suggest that both tumors are manifestations of the same neoplastic process. In this case a metastatic nature of the IVBAT is suggested. The diagnosis of pulmonary IVBAT should be followed by a search for sclerosing vascular tumors elsewhere. Finally, the results substantiate the vascular origin of the IVBAT.

Adenocarcinoma, Bronchiolo-Alveolar↗

Cobalt lung in diamond polishers.

Five diamond polishers with interstitial lung disease attributed to cobalt not alloyed to carbides of hard metals are described. The exposure originated from high-speed grinding tools with a polishing surface of microdiamonds cemented in very fine cobalt. Mineralogic analysis of lung tissue, lavage fluid, filtered air, and exhaust dust in the work environment revealed cobalt as the only toxic agent. Complaints consisted of work-related rhinitis, cough, chest tightness, dyspnea, anorexia, and weight loss, and were intensified in the absence of an adequate exhaust ventilation. Three subjects were in a rather subacute stage, as documented by open lung biopsy in 2 of them, and had a severe restrictive defect and markedly decreased diffusing capacity. Two patients presented a more chronic histologic pattern and had a less decreased diffusing capacity. Open lung biopsies showed in these 4 a fibrosing alveolitis, mainly of the centrilobular zones. In the former 2 patients, subacute lesions consisting of a mural mononuclear cell infiltrate, marked intra-alveolar desquamation, and multinucleated giant cells were found, whereas in the latter 2, centrilobular fibrosis with some microcyst formation was also already seen. Multiple multinucleated giant cells were present in the bronchoalveolar lavage fluid. Interruption of the exposure, with or without corticotherapy, caused a rapid regression of the complaints and a partial improvement of lung function.

Adolescent↗

[Comparative microangiographic and histological study of hepatic metastases. Possible implications in the phenomena of contrast medium uptake in x-ray computed tomography of the neoplastic liver].

A comparative study using microangiographic and histologic techniques was realized in 43 metastatic livers, totaling 109 lesions. Three different types of tumor vascularization could be recognized. In 30 lesions, residual vessels could be identified. They constitute the only vascular elements in most of the hypervascular lesions studied. On histology, these vessels corresponded to preserved hepatic arterial branches and portal radicles. 79 lesions appeared hypervascular. In 51 lesions, hypervascularity was due to tortuous irregular vessels, corresponding at microscopy to dysplastic capillaries clearly lined with endothelial cells. On the contrary, in 28 metastases, microangiographies showed amorphous contrast uptake. In these cases the contrast was found in large intercellular spaces without endothelial lining, suggesting free interstitial circulation. These observations suggest that the morphology and the dynamic of CT in liver metastases must be influenced by the arterial or portal venous nature of the different vessels. Furthermore, the extravascular diffusion should be function of the type of tumor circulation. If this circulation is confined to real vessels, diffusion will be function of the structure of the walls of these vessels. On the contrary, if the intratumoral circulation is of the free interstitial type, diffusion will be absent and mixing will occur because of the continuity of vascular and interstitial spaces.

Angiography↗

Partitioning of pulmonary impedance in excised human and canine lungs.

Partitioning of pulmonary resistance of 15 excised human and 5 canine lungs by means of a retrograde catheter demonstrated that the share of peripheral airways (with an ID of 2.4 mm or less) and of lung tissue in pulmonary resistance was markedly larger (44-96%) in humans than in dogs (41-59%). Similar percentages were found in patients with chronic obstructive pulmonary disease (COPD). The variations of resistance with volume during deflation and inflation of the lungs were due primarily to variations of peripheral resistance (Rp). The latter systematically increased at high and low lung volumes. Higher Rp values, with a more pronounced frequency dependence, were met in patients with COPD. A morphometrical study showed an inverse relationship between the value of Rp and the mean diameter of the terminal bronchioles, provided the airways density was taken into account.

Adult↗

The Meckel Syndrome. Pathological and cytogenetic observations in eight cases.

Eight new cases of Meckel syndrome, two of them occurring in the same family, are presented. Occipital encephalocele of varying extent, multicystic renal dysplasia not associated with urinary tract obstruction, and postaxial hexadactyly comprise the three basic features of this lethal syndrome with autosomal recessive inheritance. From our observations it appears that congenital hepatic fibrosis, abnormal external genitalia in male infants and a malformed tongue with lipomatous excrescences are also frequently occurring anomalies with important diagnostic value. The statement that the majority of cases of Meckel syndrome can be detected prenatally is further supported by two cases in the present series. The incidence of this syndrome may be much higher than previously thought.

Abnormalities, Multiple↗

Comparison of self-expanding polyethylene terephthalate and metallic stents implanted in porcine iliac arteries.

PURPOSE: Comparison of the biocompatibility of self-expanding polyethylene terephthalate (PET) stents with self-expanding metallic stents (Wallstents). METHODS: Diameter- and length-matched PET stents and Wallstents were symmetrically implanted in the paired iliac arteries of 13 crossbred domestic swine. Stent deployment was studied angiographically and with intravascular ultrasound immediately after stent implantation. The angiographic stented lumen diameter was measured using quantitative vessel analysis before, immediately after stenting, and at 6-week follow-up. Cross-section histopathology and area morphometry were performed. RESULTS: Immediately poststenting, intravascular ultrasound revealed proximal dislocation of 5 of the 13 PET stents, whereas all metal stents were firmly embedded at the implantation site. At 6-week follow-up, three of the remaining PET stents were totally or subtotally occluded by organized thrombus, whereas all metal stents were patent. Compared with immediately poststenting, the angiographic lumen diameter within the five remaining PET stents was reduced by 30%, and that of the metallic stents was virtually unaltered (p < 0.02). This observation was confirmed by postmortem morphometry, wherein the PET-stented vessel segments a diameter stenosis of 40% was measured vs only 9% in the metallic stents (p < 0.0001). CONCLUSION: PET-stent deployment is difficult to control due to the lack of radiopacity of this stent. PET stents seem to be more thrombogenic and lead to significantly more neointimal proliferation than metallic stents.

Animals↗

Cancer presenting as fatal pulmonary tumour embolism.

Rapidly fatal pulmonary tumour embolism is a rare complication of malignancy, and often presents as progressive dyspnea without obvious cause. We describe two cases presenting with a dramatic clinical picture of lactic acidosis and cardiopulmonary arrest soon after admission on ICU. The first patient was a 29-year old woman with a breast cancer seeming in remission who was admitted with rapidly increasing dyspnea since two weeks. The second patient was a 46-year old woman with HIV and no history of malignancy, who developed dyspnea and lactic acidosis over the course of a few days while she was investigated for an occipital brain lesion. Both patients died soon after admission and massive tumour emboli were found on autopsy. Breast cancer was the origin of the emboli in both cases. Symptoms were out of proportion to the initial physical cardiopulmonary findings and radiographic features. Clinical signs of pulmonary tumour embolism are non-specific and subacute. Prognosis is poor and definite diagnosis is usually made post-mortem. Solid malignancies such as breast cancer account for most of the cases. Pulmonary tumour embolism should be considered in critically ill patients with unexplained hypoxemia and lactic acidosis, mild or no radiological abnormalities and fast clinical deterioration. It may occur in young patients and in patients without history of malignancy.

Adult↗

Metallic surface modification.

The potential beneficial effect of metal surface treatment using electrochemical polishing on stent thrombogenicity and neointimal hyperplasia was evaluated in a rat A-V model and a porcine coronary model. Thrombogenicity of polished stents (n=6) was compared to non-polished stents (n=5) in a rat A-V shunt model using 125I-fibrinogen and 51Cr-labelled platelets. Total clot weight after 30 min was significantly lower in the polished stents (32.1+/-2.8 vs 18.1+/-4.4: p<0.001). Also, 125I-fibrinogen deposition was significantly lower in the polished stents (1.30+/-0.07 vs 0.66+/-0.04: p<0.001). Platelet deposition was, however, not significantly reduced (12.7+/-3.4 vs 9.87+/-1.9, NS). Subsequently, the effect of electrochemical polishing on neointimal hyperplasia was evaluated in a porcine coronary model. Polished (n=10) and non-polished stents (n=10) were randomly implanted in the right coronary artery of healthy pigs. Neointimal hyperplasia was significantly decreased in the polished stents (0.56+/-0.28 vs 0.94+/-0.34 mm2: p<0.01).

Animals↗