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At least 325 records · Page 18Linked to original sources
PubMed2007

Dual ectopic thyroid: case series and review of the literature.

Ectopic thyroid tissue is an uncommon congenital aberration. It is further unusual for ectopic thyroid to be present at 2 different sites simultaneously. Only 19 cases of dual ectopic thyroid have been reported in the English literature. Most of the patients were adolescents and presented with anterior neck swelling with or without altered metabolic status. Lingual/sublingual thyroid was the most common ectopic location. Subhyoid was the most common site of a second ectopic thyroid in these patients. The thyroid scan has been used successfully to diagnose ectopic thyroid tissue. We report 4 such cases in which ectopic thyroid tissue was simultaneously present at 2 different locations using thyroid scanning. The literature of already reported cases is reviewed in detail.

Adolescent↗
PubMed2006

Stereological methods reveal the robust size and stability of ectopic hilar granule cells after pilocarpine-induced status epilepticus in the adult rat.

Following status epilepticus in the rat, dentate granule cell neurogenesis increases greatly, and many of the new neurons appear to develop ectopically, in the hilar region of the hippocampal formation. It has been suggested that the ectopic hilar granule cells could contribute to the spontaneous seizures that ultimately develop after status epilepticus. However, the population has never been quantified, so it is unclear whether it is substantial enough to have a strong influence on epileptogenesis. To quantify this population, the total number of ectopic hilar granule cells was estimated using unbiased stereology at different times after pilocarpine-induced status epilepticus. The number of hilar neurons immunoreactive for Prox-1, a granule-cell-specific marker, was estimated using the optical fractionator method. The results indicate that the size of the hilar ectopic granule cell population after status epilepticus is substantial, and stable over time. Interestingly, the size of the population appears to be correlated with the frequency of behavioral seizures, because animals with more ectopic granule cells in the hilus have more frequent behavioral seizures. The hilar ectopic granule cell population does not appear to vary systematically across the septotemporal axis, although it is associated with an increase in volume of the hilus. The results provide new insight into the potential role of ectopic hilar granule cells in the pilocarpine model of temporal lobe epilepsy.

Algorithms↗
PubMed2006

Primary carcinoma of ectopic axillary breast tissue.

The presence of ectopic breast tissue is reported in 2-6% of the general population with most cases being located in the axillary region. Although the same pathology occurs in both eutopic and ectopic breast tissue, primary carcinoma of ectopic breast tissue has been reported only in a small number of cases. Because an overlying accessory areola or nipple is often missing and because of a general lack of awareness among physicians and patients concerning these unsuspicious nodules, clinical diagnosis is frequently delayed. Histological diagnosis can also be delayed if ectopic breast tissue is not present or screened for in the biopsy specimens as apocrine glands of the breast and skin, respectively, exhibit striking similarities and immunohistochemistry is of limited help. Diagnostic delay is demonstrated by the case of a 56-year-old patient who underwent a series of four surgical excisions of a primary ectopic breast carcinoma and developed local lymph node metastasis until treatment with tamoxifen was started. As two-thirds of reported cases of primary ectopic breast carcinoma arose within the axillae, this case underlines the importance of a search for ectopic breast tissue in the context of axillary ductal carcinoma.

Axilla↗
PubMed2005

Pigmented axillary nodule: carcinoma of an ectopic axillary breast.

BACKGROUND: Ectopic mammary tissue appears in humans owing to an incomplete embryologic regression of the mammary ridges. The same pathology that affects normally positioned breasts, including carcinoma, can occur in ectopic mammary tissue. OBJECTIVE: The objective was to present the case of a 43-year-old woman who developed a ductal mammary carcinoma of ectopic breast tissue. METHODS: We describe the patient's history, the histologic diagnosis, and the therapy carried out. We also discuss the clinical differential diagnosis and current management options. RESULTS: The patient developed a ductal mammary carcinoma in the axilla, which is the most common site for the occurrence of carcinoma of ectopic breast tissue. She has been sucessfully treated with surgery, lymphadenectomy, radiotherapy, and chemotherapy. Accessory mammary tissue is a relatively frequent incidental finding, whereas carcinoma of ectopic tissue is very rare. CONCLUSIONS: Carcinoma occurring in ectopic breast tissue remains rare, but this diagnosis must be suspected when confronted with any axillary nodule. The prognosis is similar to carcinoma of normal breast in the same tumor, node, metastasis stage, although it has a higher rate of lymph node involvement. There is no consensus on the advisability of excising ectopic mammary tissue.

Adult↗
PubMed1994

Release and synthesis of acetylcholine at ectopic neuromuscular junctions in the rat.

1. The ability of axons in the superficial fibular nerve to synthesize and release acetylcholine (ACh) has been studied before and after the formation of ectopic neuromuscular junctions (NMJs) with denervated soleus muscles of adult rats. 2. The central end of the severed fibular nerve was transplanted to the surface of the soleus muscle. After 3.5-5 weeks the soleus muscle was denervated in one group of rats by cutting the tibial nerve, allowing the formation of functional ectopic NMJs within a few days. In other rats the tibial nerve remained intact, preventing the formation of functional ectopic NMJs. 3. A month later the content of ACh, the levels of activity of choline acetyltransferase (ChAT) and acetylcholinesterase (AChE), and the amount of ACh released by depolarization by exposure to 50 mM KCl were measured in segments of isolated muscles that (i) contained normal or ectopic NMJs, (ii) were free of nerve or (iii) contained nerve that had not made NMJs. 4. Regions of muscles with ectopic nerve growth in which new NMJs had not formed contained substantial amounts of ACh and ChAT but no AChE. No detectable release of ACh could be evoked from these regions. 5. In muscles in which ectopic NMJs had formed after cutting the tibial nerve, the amounts of ACh and ChAT were about one-fifth of those in the regions of innervation of control muscles. ACh release could be evoked from the region of ectopic nerve growth in amounts nearly as great as those released from NMJs in normal and contralateral control muscles. 6. We conclude that the ability of the terminal parts of mature motor axons to synthesize and store ACh is largely independent of functional contact with muscle fibres. By contrast, the ability to release ACh in substantial amounts only develops when NMJs are formed. The possible significance of this situation for the development of synapses is discussed.

Acetylcholine↗
PubMed2002

Effect of 2-(phosphono-methyl)-pentanedioic acid on allodynia and afferent ectopic discharges in a rat model of neuropathic pain.

Increased glutamate availability in the spinal cord and primary afferent nerves plays an important role in acute and chronic pain. Afferent ectopic discharges from the site of nerve injury constitute a source of abnormal sensory input to the spinal dorsal horn. The ectopic afferent activity is largely responsible for the development of hypersensitivity of dorsal horn neurons and neuropathic pain. Inhibition of glutamate carboxypeptidase II (GCP II) reduces glutamate release generated from N-acetyl-aspartyl-glutamate in nerve tissues and may have an analgesic effect on neuropathic pain. In the present study, we determined the effect of a GCP II inhibitor, 2-(phosphono-methyl)-pentanedioic acid (2-PMPA), on allodynia and ectopic afferent discharges in an animal model of neuropathic pain. Neuropathic pain was induced by partial ligation of the left sciatic nerve in rats. Tactile allodynia was assessed using von Frey filaments applied to the plantar surface of the injured hindpaw. Single-unit activity of ectopic discharges was recorded from the sciatic nerve proximal to the site of ligation. Intravenous injection of 50 to 100 mg/kg 2-PMPA significantly reduced allodynia in a dose-dependent manner. Furthermore, 2-PMPA dose-dependently attenuated the ectopic discharge activity of injured sciatic afferent nerves. At a dose of 100 mg/kg, 2-PMPA significantly inhibited the ectopic activity from 14.7 +/- 2.1 to 4.4 +/- 0.5 impulses/s without altering the conduction velocity of afferent nerves. Therefore, these data suggest that the antiallodynic effect of 2-PMPA may be mediated, at least in part, by inhibition of ectopic afferent discharges at the site of nerve injury.

Animals↗
PubMed1971

Lignocaine therapy for ventricular ectopic activity after acute myocardial infarction: a double-blind trial.

The effectiveness of intravenous lignocaine in suppressing ventricular ectopic activity after acute myocardial infarction was examined in a double-blind trial in 82 patients. Whereas suppression of unifocal ventricular ectopics was achieved by lignocaine in 90% of patients, other forms of potentially more dangerous ectopic activity (multifocal or R-on-T ectopics) seemed more resistant to therapy. Cessation of ectopic activity was also observed in about one-third of the patients in the control group. The incidence of ventricular tachycardia and fibrillation and the mortality during and after the trial period were similar in the lignocaine-treated and control groups, whether or not the initial ventricular ectopics had been suppressed.This study provides no evidence to support the routine use of intravenous lignocaine in the management of ventricular ectopic activity after acute myocardial infarction.

Acute Disease↗
PubMed1986

Ectopic ureter and ureterocele: their varied sonographic manifestations.

The sonographic examinations of four patients with simple ectopic ureters and 11 with ectopic ureteroceles were reviewed to determine distinguishing characteristics. Ectopic ureters, in cases of extreme dilatation and tortuosity, sometimes mimic multiseptated, cystic abdominal masses. However, the proximal portions of some severely dilated ureters are surprisingly small. Ectopic ureters sometimes indent the lower vesical wall, simulating a ureterocele. Ectopic ureteroceles are dynamic structures, changing in shape and size according to intravesical pressure. The lower pole of a duplex kidney may be difficult to detect because of displacement by the dilated upper renal pelvis and ureter. The renal parenchyma associated with an ectopic ureter may be equally difficult or impossible to find because of diminutive dysplasia or, less commonly, acquired atrophy. Dysplasia is characterized sonographically by highly echogenic parenchyma, lack of corticomedullary differentiation, and occasionally massive enlargement by cysts. Ectopic ureters and ureteroceles can be identified by fetal sonography.

Adolescent↗
PubMed2002

Initiation and propagation of ectopic waves: insights from an in vitro model of ischemia-reperfusion injury.

The objective of the present study was to directly visualize ectopic activity associated with ischemia-reperfusion and its progression to arrhythmia. To accomplish this goal, we employed a two-dimensional network of neonatal rat cardiomyocytes and a recently developed model of localized ischemia-reperfusion. Washout of the ischemia-like solution resulted in tachyarrhythmic episodes lasting 15-200 s. These episodes were preceded by the appearance of multiple ectopic sources and propagation of ectopic activity along the border of the former ischemic zone. The ectopic sources exhibited a slow rise in diastolic calcium, which disappeared upon return to the original pacing pattern. Border zone propagation of ectopic activity was followed by its escape into the surrounding control network, generating arrhythmias. Together, these observations suggest that upon reperfusion, a distinct layer, which consists of ectopically active, poorly coupled cells, is formed transiently over an injured area. Despite being neighbored by a conductive and excitable tissue, this transient functional layer is capable of sustaining autonomous waves and serving as a special conductive medium through which ectopic activity can propagate before spreading into the surrounding healthy tissue.

Animals↗
PubMed2005

Risk factors associated with the rupture of tubal ectopic pregnancy.

OBJECTIVE: To identify risk factors that may lead to the rupture of ectopic pregnancies. STUDY DESIGN: A retrospective chart review was performed on patients with ectopic pregnancies at the University of Miami/Jackson Memorial Hospital between 1/1/1995 and 3/1/2002. 738 patients were identified with ectopic pregnancies. Women with tubal rupture were compared to those without rupture. Variables analyzed were demographic data, patient-related risk factors (history of pelvic surgery, bilateral tubal ligation, history of pelvic inflammatory disease, previous ectopic pregnancy, intrauterine device use) and beta-human chorionic gonadotropin (betahCG) measurement. RESULTS: There were 439 (59%) cases with a ruptured and 299 (41%) cases with an unruptured ectopic pregnancy. Multivariate logistic regression analysis revealed that previous ectopic pregnancy (OR 2.88; 95% CI 1.92, 4.33) and betahCG level >or=5,000 mIU/ml (OR 1.85; 95% CI 1.12, 3.06) were the only significant risk factors for tubal rupture. CONCLUSION: Patients with betahCG levels >or=5,000 mIU/ml and patients with a history of a previous ectopic pregnancy are significantly more likely to experience a tubal rupture.

Adult↗
PubMed2006

Genomic alterations in ectopic and eutopic endometria of women with endometriosis.

BACKGROUND/AIMS: Ectopic and eutopic endometria of women with endometriosis have been shown to contain genomic alterations. In this study, we sought to identify genomic alterations in both ectopic and eutopic endometria of 5 women with endometriosis and to examine whether the two tissues share any genomic alterations. We also attempted to classify tissue samples based on the alteration profiles. METHODS: Laser capture microdissection was used to harvest epithelial cells. High-resolution comparative genomic hybridization microarrays were used to identify genomic alterations in eutopic and ectopic endometria from 5 women with endometriosis. The results were validated by real-time RT-PCR and loss of heterozygosity analysis. RESULTS: All 5 patients had genomic alterations in their eutopic and ectopic endometria. The ectopic and eutopic endometria shared a sizable portion of genomic alterations. Cluster analysis of the genomic alteration profile correctly and consistently classified tissue samples from the 5 patients into two groups: peritoneal implants and ovarian cysts. CONCLUSIONS: The correct classification of tissue samples into two groups suggests that these two subtypes of endometriosis may have distinct genomic alteration profiles and are thus distinct entities, as previously proposed. The shared alterations are likely the ones that harbor genes responsible for an increased propensity of endometrial debris to implant to the ectopic sites and for early events that lead to the establishment of lesions. Alternatively, these shared alterations may harbor genes that are dysregulated in both eutopic and ectopic endometria. The identified genomic alterations should help to zero in genes involved in the pathogenesis of endometriosis in future studies.

Adult↗
PubMed2007

Ectopic granule cells of the rat dentate gyrus.

Granule cells of the mammalian dentate gyrus normally form a discrete layer, and virtually all granule cells migrate to this location. Exceptional granule cells that are positioned incorrectly, in 'ectopic' locations, are rare. Although the characteristics of such ectopic granule cells appear similar in many respects to granule cells located in the granule cell layer, their rare occurrence has limited a full evaluation of their structure and function. More information about ectopic granule cells has been obtained by studying those that develop after experimental manipulations that increase their number. For example, after severe seizures, the number of ectopic granule cells located in the hilus increases dramatically. These experimentally-induced ectopic granule cells may not be equivalent to normal ectopic granule cells necessarily, but the vastly increased numbers have allowed much more information to be obtained. Remarkably, the granule cells that are positioned ectopically develop intrinsic properties and an axonal projection that are similar to granule cells that are located normally, i.e., in the granule cell layer. However, dendritic structure and synaptic structure/function appear to differ. These studies have provided new insight into a rare type of granule cell in the dentate gyrus, and the plastic characteristics of dentate granule cells that appear to depend on the location of the cell body.

Animals↗
PubMed2003

Color Doppler ultrasonography: diagnosis of ectopic thyroid gland in patients with congenital hypothyroidism caused by thyroid dysgenesis.

The etiology of congenital hypothyroidism (CH) may play an important role in determining disease severity, outcome, and, therefore, its treatment schedule. Radionuclide imaging (RI) is currently the most precise diagnostic technique to establish the etiology of CH. Conventional ultrasound can identify an athyrotic condition at the normal neck position and has gained acceptance for the initial evaluation of CH; however, its ability in delineating ectopic thyroid is limited. We used color Doppler ultrasonography (CDU) to assess blood flow and morphology in the detection of ectopic thyroid in 11 CH patients disclosed by neonatal screening; thyroid glands were undetectable at the normal location by gray-scale ultrasonography (GSU). The patients studied consisted of two infants for initial investigation and nine children for reevaluating the cause of CH. All of the patients underwent GSU, CDU, RI, and magnetic resonance imaging (MRI) investigation. We set RI as the defining diagnostic test for detecting ectopic thyroid and compared the imaging of CDU with those of GSU and MRI. The results of RI showed 10 ectopic thyroids and one athyreosis. In the patients with ectopic thyroid, the sensitivity of CDU, GSU, and MRI for detecting ectopic thyroid was 90, 70, and 70%, respectively. We conclude that CDU is superior to GSU and MRI for detecting ectopic thyroid and that CDU may be adopted as the diagnostic tool for the initial investigation of suspected CH.

Adolescent↗
PubMed1987

Ectopic gastric mucosa in the cervical esophagus.

Ectopic gastric mucosa is a known entity of the mid and lower esophagus which was initially described by Schmidt in 1805. The presence of ectopic gastric mucosa in the cervical esophagus, however, was not described. A review of the literature reveals that ectopic gastric mucosa of the cervical esophagus is not uncommon, but symptoms rarely have been attributed to its presence. This paper reports five patients with isolated inflamed ectopic gastric mucosa in the cervical esophagus who presented with odynophagia and/or dysphagia. Physical examination was unremarkable in each case, and an acid barium esophagram was negative in four of five patients. Factors that distinguish these patients from other cases of odynophagia and dysphagia, as well as detailed clinical findings and treatment, are described. Debate exists as to whether the origin of ectopic gastric mucosa is congenital or acquired. The embryology, gross and microscopic anatomy, and pathologic features are outlined. Patients with persistent dysphagia should have flexible fiberoptic esophagoscopy with an index of suspicion to the existence of ectopic gastric mucosa. Inflamed or ulcerated ectopic gastric mucosa in the cervical esophagus should be treated to relieve symptoms and because of the potential for complications.

Adult↗
PubMed2004

Differential control of synaptic and ectopic vesicular release of glutamate.

Exocytosis of synaptic vesicles occurs not only at synaptic active zones but also at ectopic sites. Ectopic exocytosis provides a direct and rapid mechanism for neurons to communicate with glia that does not rely on transmitter spillover from the synaptic cleft. In the cerebellar cortex the processes of Bergmann glia cells encase synapses between presynaptic climbing fiber varicosities and postsynaptic Purkinje cell spines and express both AMPA receptors and electrogenic glutamate transporters. AMPA receptors expressed by Purkinje cells and Bergmann glia cells are activated predominantly by synaptic and ectopic release, respectively, and therefore can be used to compare the properties of the two release mechanisms. We report that vesicular release differs at synaptic and ectopic sites in the magnitude of short-term plasticity and the proportions of Ca2+ channel subtypes that trigger glutamate release. High-affinity glutamate transporter-mediated currents in Bergmann glia cells follow the rules of synaptic release more closely than the rules of ectopic release, indicating that the majority of glutamate is released from conventional synapses. On the other hand, ectopic release produces high-concentration glutamate transients at Bergmann glia cell membranes that are necessary to activate low-affinity AMPA receptors rapidly. Ectopic release may provide a geographical cue to guide Bergmann glia cell membranes to surround active synapses and ensure efficient uptake of glutamate that diffuses out of the synaptic cleft.

Amino Acid Transport System X-AG↗
PubMed1980

Ectopic bone formation following Charnley hip arthroplasty.

In a consecutive series of 309 patients the degree of ectopic bone formation was assessed 3 months, 2 years, and 5 years after total hip arthroplasty. At the three follow-up examinations ectopic bone formation was found in 49 per cent, 61 per cent, and 71 per cent. In men ectopic bone formation was more common and more pronounced than in women. It was demonstrated that walking ability and range of hip movement may be reduced in the presence of ectopic bone formation. A past history of hip surgery, preoperative exostoses, and postoperative elevation of the erythrocyte sedimentation rate did not appear to influence the formation of ectopic bone. There was no correlation between the degree of ectopic bone formation in the two hips of patients who had undergone bilateral operation. In the present study it was not possible to demonstrate preoperatively which groups of patients are most liable to develop ectopic bone postoperatively.

Adult↗
PubMed1999

[Single-system ectopic ureters. A review of 19 cases].

Single system ectopic ureters are usually associated with multiple congenital abnormalities and the corresponding renal units is frequently abnormal. 19 cases of single system ectopic ureters were diagnosed and treated in our hospital during the last 20 years. The patients were less than 11 years old. The abnormality was bilateral in two cases and the 63% of all had associated malformations, being the anorectal abnormalities the most frequent. The incidence of reflux into the ectopic ureter was 57%, and the association to unilateral or contralateral renal agenesis, 26.3%. Thirteen ectopic ureters were reimplanted successfully into the bladder, and the cases of nonfunctioning kidneys were removed (nephroureterectomy). The follow-up period was 10 months to 14 years, developing the 68% of the cases without any complication and a good renal function. Two patients were transplanted due to a kidney failure. Diagnosis is often extremely difficult and requires a high degree of suspicion. This diagnosis may be incidental, and it may be made during investigation of patients with other malformations. An early diagnosis and treatment must be made in order to avoid a disturbance of renal function. We wish to point up the high incidence of reflux into the ectopic ureter and the high association to renal agenesis in the single system ectopic ureters in comparison with ectopic ureter of duplex system.

Abnormalities, Multiple↗
PubMed2000

Immunohistochemical expression of matrix metalloproteinases 1 and 2 (MMP-1 and MMP-2) and tissue inhibitor of metalloproteinase 2 (TIMP-2) in ruptured and non-ruptured tubal ectopic pregnancies.

OBJECTIVE: Recent evidence suggests that matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) are crucial for trophoblast implantation in normal pregnancy. To evaluate the expression of MMP-1, MMP2, and the tissue inhibitor of MMP-2 (TIMP-2) along the invasive pathway of trophoblast in ruptured and non-ruptured tubal ectopic pregnancies, we performed a retrospective immunohistochemical study. METHODS: In 15 tissue specimens of patients with ruptured (N = 7) and non-ruptured (N = 8) first trimester tubal ectopic pregnancies who underwent laparoscopic salpingectomy, immunohistochemical staining against MMP-1, MMP-2, and TIMP-2 was performed. Serial paraffin sections were photographed and digitized for a computerized quantitative image analysis. Mean percentages of positive stained areas by MMP-1, MMP-2, and TIMP-2 antibodies in the extravillous trophoblast were determined for ruptured and non-ruptured tubal ectopic pregnancies and compared. RESULTS: In our 15 tissue specimens of ectopic pregnancies MMP-1 and TIMP-2 were found to be more prominent in the immunohistochemical distribution pattern than MMP-2. However, no statistically significant difference could be detected between the mean percentages of positive stained area by MMP-1, MMP-2, and TIMP-2 antibodies in ruptured and non-ruptured tubal pregnancies. DISCUSSION: For the first time, we measured the comparative immunohistochemical expression of MMP-1, MMP-2, and TIMP-2 in ruptured and non-ruptured tubal ectopic pregnancies. Although our results did not show any statistically significant difference between ruptured and non-ruptured tubal ectopic pregnancies, we conclude that MMP-1, MMP-2, and TIMP-2 are functionally involved in the highly proliferative early first part of ectopic implantation.

Adult↗