Case report 583: Elastofibroma dorsi.
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Elastin↗
Biomedical subjects
F O Tio
Publications and source records attributed to F O Tio.
Evaluation of polymer-coated balloon-expandable stents in bile ducts.
The long-term patency of and biologic response to the presence of polymer-coated balloon-expandable intraluminal stents in the bile ducts was studied in 18 dogs. Metallic stents coated with two different polymers (silicone rubber and segmented polyether-polyurethane) were placed in 12 dogs and uncoated stents in six, and animals were killed after 4, 12, and 24 weeks of observation. Cholangiograms were obtained at 1, 4, 6, 12, and 24 weeks, depending on length of follow-up. All bile duct segments containing stents remained patent throughout the follow-up periods. Characteristic luminal narrowings due to hyperplastic papillary mucosa occurred with all three stent types. although no difference could be found in the degree of narrowing of the most restrictive segment among the three stent types, mucosal proliferation was most extensive with the uncoated stent. Lack of concretion buildup and benign tissue response encourage the development of a clinically useful expandable biliary endoprosthesis.
Animals↗
Experimental murine chromomycosis mimicking chronic progressive human disease.
Congenitally athymic (nu/nu) mice, mice defective in NK cell and macrophage function (bg/bg), and normal BALB/c mice were inoculated sc with 10 conidia of Fonsecaea pedrosoi (FP). In immunologically intact and immunodeficient mice, a local infection developed approximately 2 weeks post-inoculation and enlarged over 1-2 weeks. In bg/bg and normal nu/+ mice, lesions resolved within 5-6 weeks. However, nu/nu mice continued to have enlarging sc lesions during greater than 4-6 months of observation. These eventually metastasized. Lesions contained few hyphal elements and massive numbers of sclerotic bodies. Five weeks after inoculation, 10 conidia forming units/gm of tissue were recovered from lesions. Delayed type hypersensitivity and serum antibody to FP antigens were demonstrated. Adoptive transfer of lymphocytes from nu/+ mice was followed in 2 months by the resolution of the lesions.
Animals↗
Primary lymphocutaneous Nocardia brasiliensis infection: three case reports and a review of the literature.
The occurrence of human nocardiosis is increasing in both immunocompetent as well as immunosuppressed patients. We report three rare cases of primary lymphocutaneous Nocardia brasiliensis infection. The mode of inoculation in each case was that of a puncture wound that occurred 1-3 wk prior to the development of the clinically apparent infections. The original clinical diagnosis was erroneous in each case. A review of 16 previously reported cases is presented as well as a discussion of appropriate medical therapy.
Adult↗
Intraperitoneal nucleopore chambers: a murine model for allograft rejection.
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Adenosine Deaminase↗
Osteogenesis in replamineform hydroxylapatite porous (RHAP) ceramic implants used for human mandibular ridge augmentation: report of two cases.
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Alveolar Ridge Augmentation↗
Nocardial osteomyelitis: a case report and review of the literature.
The occurrence of human nocardiosis is increasing in both immunocompetent as well as immunosuppressed patients. A 63-yr-old male construction worker presented with complaints of left hip pain and rapidly enlarging masses on his left neck and chest. He had been treated for a pneumonia of unknown etiology 3 mo prior to admission. A debridement of the left femur was performed and the curetted material was positive for Nocardia asteroides. Osteomyelitis due to the hematogenous spread of Nocardia asteroides is rare, but will undoubtedly be seen with increasing frequency. The literature, as well as 11 reported cases of the hematogenous spread of this organism, are reviewed.
Abscess↗
Normal and stenotic renal arteries: experimental balloon-expandable intraluminal stenting.
Elastic recoil of the vessel wall is a common cause of failure of percutaneous transluminal angioplasty in renal arteries. To oppose such recoil, balloon-expandable metal stents were implanted in artificially stenotic renal arteries in pigs and normal renal arteries in dogs and pigs. The stents were then examined angiographically and histologically at regular intervals. All stents were completely covered with endothelialized neointima in 3 weeks. There was no difference in intimal thickness between the stenotic and nonstenotic renal arteries. A large stent diameter and a large open or nonmetal surface may cause less intimal hyperplasia, but nonturbulent, fast arterial flow is probably the most important factor in ensuring long-term patency of the vessel.
Angioplasty, Balloon↗
Balloon-expandable intracoronary stents in the adult dog.
We studied the acute and chronic biological reaction to balloon-expandable intracoronary stents in the adult dog. Twenty stainless steel stents were placed, by standard angioplasty techniques, into the left anterior descending, left main, or circumflex coronary arteries of 20 dogs. Angiography was performed at 1, 3, 6, and 12 months and animals were killed in groups of three at 1, 3, 8, and 32 weeks, for gross, light, and electronmicroscopic analysis. All dogs survived, all stents were patent, and there was no evidence of myocardial infarction, spasm, rupture, or aneurysm formation during follow-up (longest 18 months; average, 12 months). The stent was initially covered by a thin layer of thrombus that was replaced later by neointimal muscular proliferation that reached its maximal thickness by 8 weeks (p less than .01). This neointima gradually thinned as it became more sclerotic and less cellular. The stents were covered completely by immature endothelium by 1 week without loss of side branches. We conclude that balloon-expandable intraluminal stents can be safely placed percutaneously into normal canine coronary arteries. Because of rapid endothelialization high patency rates can be expected, thus offering promise for clinical applications in man.
Angioplasty, Balloon↗
Black thyroid syndrome: exaggeration of a normal process?
Coal-black thyroid discoloration usually is identified in patients receiving chronic minocycline therapy. This report concerns the use of light microscopic, electron microscopic, and energy dispersion spectroscopy of thyroid pigments in three separate situations: minocycline-associated black thyroid; idiopathic black thyroid; and normally pigmented thyroid glands. One of the pigments, which is found in each situation, is best described as neuromelanin. This melanin pigment, like lipofuscin, appears to accumulate with advancing age. Pigment accumulation, therefore, is a normal process in the thyroid gland. Accelerated pigment accumulation occurs with minocycline therapy but can uncommonly be seen without associated minocycline treatment. Possible mechanisms for the development of these pigments in normal and black thyroid glands are discussed. Minocycline-associated pigment is also described in substantia nigra and atherosclerotic plaques.
Adult↗
Atherosclerotic rabbit aortas: expandable intraluminal grafting.
Balloon-expandable intraluminal grafts that ranged in diameter from 2 to 4 mm were placed in the atherosclerotic abdominal aortas of 24 rabbits. The animals were killed 1, 3, 8, or 24 weeks after placement of the graft. All grafts retained patency without altering the luminal diameter. The small degree of neointimal thickening covering the graft's inner surface was not detectable on conventional in vivo arteriograms. Aortic atherosclerotic plaque external to the graft was markedly compressed 1 week after graft placement. The plaque regained full thickness 24 weeks after grafting when the plaque expanded outside the graft as a result of relaxation or atrophy of the surrounding arterial media.
Angioplasty, Balloon↗
Filamentous Histoplasma capsulatum involving a ventriculoatrial shunt.
We describe the first case, to our knowledge, of filamentous Histoplasma capsulatum infection in a ventriculoatrial shunt. A review of the literature on the incidence, etiologies, and symptomatology of shunt-related infections is presented. The pathogenesis and treatment of the fungus-infected shunts are also discussed.
Cerebrospinal Fluid Shunts↗
Expandable intrahepatic portacaval shunt stents in dogs with chronic portal hypertension.
A canine experimental model was used to investigate the feasibility of using balloon-expandable portacaval shunts in humans with chronic portal hypertension. Intrahepatic portacaval shunts were created in nine dogs with stable portal hypertension previously induced by intraportal injections of polyvinyl alcohol (Ivalon). Embolic material was injected periodically through a subcutaneous port that allowed repeated access to the portal system. Shunts were placed 14 weeks after the last embolization. A shunt patency rate of 100% was observed up to 48 weeks. Low portacaval pressure gradient and high shunt flow accounted for the good results.
Animals↗
Expandable intraluminal vascular graft: a feasibility study.
An expandable intraluminal graft mounted coaxially over an angioplasty balloon catheter was used in dog arteries. The graft, a wire mesh tube that has the ability to retain its expanded shape, opposes elastic recoil of the arterial wall after maximum balloon inflation. Eighteen grafts were placed in the abdominal aorta and iliac femoral, renal, superior mesenteric, and carotid arteries of eight dogs through femoral or carotid arteriotomies. Two grafts were placed in areas of artificially induced stenosis, completely restoring the lumen. Overall patency rate at 35 weeks was 77%. Histopathologic examination of patent grafts showed complete endothelialization at 3 weeks. The smaller caliber grafts and those that had outflow obstruction showed significant degrees of intimal hyperplasia.
Angiography↗
Expandable intraluminal graft: a preliminary study. Work in progress.
To overcome the problem of recurrence of stenosis after vascular balloon dilatations, we developed an expandable, intraluminal graft that allows dilatation of the lesion and simultaneous placement of a supportive endoprosthesis to prevent recoil of the arterial wall. The graft is made of continuous, woven, stainless steel wire. The resulting tubular mesh has a wall thickness of 200-450 micron and 80% open surface. The grafts, mounted on angioplasty catheters, are introduced through 8-12-F Teflon sheaths. Eleven grafts of 6, 8, and 10 mm in diameter by 20 mm long were placed in the aorta, common carotid, superior mesenteric, iliac, and renal arteries of dogs. Six grafts showed no stenosis in follow-up studies of up to 8 weeks. Two grafts had moderate stenosis as a result of neointimal hyperplasia. Two partial and one complete graft thrombosis occurred in nonheparinized animals in which the graft outflow was restricted. Anticoagulant was not used on a long-term basis. Light and electron microscopy studies showed complete covering of the graft's inner surface by endothelium at 3 weeks.
Angioplasty, Balloon↗
The normal mucosal surface pattern of the duodenal bulb: radiologic-histologic correlation.
Similar to the stomach and colon, the duodenum also demonstrates a fine mucosal relief pattern on double-contrast radiographic examination. Two patterns may be identified--fine reticular and "small dot." In order to investigate the origin of these patterns, duodenal bulb specimens were obtained at autopsy, and macroscopic and microscopic features were correlated with radiographic patterns. Findings indicate that the surface patterns identified radiographically on cadaveric specimens and in live patient subjects are due to villi and the collections of barium within the intervening sulci. Knowledge of this normal pattern will prevent misdiagnoses, especially when inflammatory disease of the duodenum is being considered.
Duodenum↗
Expandable intrahepatic portacaval shunt stents: early experience in the dog.
Intrahepatic portacaval shunts were established in dogs by the transjugular approach. The shunts extended from the anterior aspect of the inferior vena cava to the portal bifurcation through interposed liver parenchyma. The tissue track was created by a long transjugular needle and enlarged by balloon angioplasty catheter dilatation. The opening was then stented with a specially made, expandable, tubular, woven mesh of stainless steel wire. The stent was introduced mounted in a collapsed fashion around a folded angioplasty balloon. Inflation of the balloon expanded the stent and the tissue track simultaneously, leaving a large side-to-side portacaval shunt. Nine out of 12 animals survived the procedure and eight of them had functioning shunts as long as 9 months after placement. Pathologic examination showed complete endothelialization of the inner surface of the stents.
Animals↗
Massive metastatic pulmonary calcification in an infant with aleukemic monocytic leukemia.
An 18-month-old infant with aleukemic monocytic leukemia and osteoclastic bone resorption demonstrated in the pelvis, vertebral bodies, and ribs developed severe refractory hypercalcemia. Bilateral interstitial pulmonary radiopacities developed rapidly, accompanied by hypoxemia and hypercapnea. Von Kossa staining of an open lung biopsy revealed extensive, finely granular metastatic septal calcifications not apparent on H&E-stained sections. Autopsy revealed the massive nature of the pulmonary calcinosis and the presence of additional calcifications in the atrial subendocardium, liver, kidneys, vessels, and skin. Metastatic pulmonary calcification has been infrequently described in infants, and premortem detection of such deposits has been rarely reported. The Von Kossa stain is useful in detecting minute pulmonary calcifications which may radiographically simulate infiltrates of infectious origin.
Biopsy↗