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At least 541 records · Page 30Linked to original sources
PubMed2003

Perinatal outcome after prenatal diagnosis of placental chorioangioma.

OBJECTIVE: To review the prenatal complications, management, and perinatal outcome in pregnancies complicated by placental chorioangioma. METHODS: Cases of placental chorioangioma diagnosed prenatally as part of a prospective, multicentric program for fetal diagnosis and therapy were identified. All cases were evaluated with color flow imaging. In the latter part of the study, three-dimensional power Doppler angiography was also used to study the vascular pattern of the tumor. Information on maternal demographics, prenatal sonographic findings, pregnancy complications, antenatal intervention, and perinatal outcome was obtained by reviewing the medical records or contacting the referring obstetricians. RESULTS: In the 5-year period from January 1997 to December 2001, 11 cases of placental chorioangioma were diagnosed prenatally. Nine cases were diagnosed in singleton and two in twin pregnancies. Among the nine cases occurring in singletons, five (56%) were associated with pregnancy complications, including polyhydramnios (n = 3), oligohydramnios (n = 2), fetal growth restriction (n = 2), and nonimmune hydrops (n = 1). Amniodrainage was required in one of these cases, allowing prolongation of pregnancy until term. Four (44%) singletons delivered before 35 weeks. Overall, two fetuses died, including one twin due to complications of twin-twin transfusion syndrome and another with hydrops after alcohol injection into the chorioangioma. In four pregnancies, no prenatal complications were detected in spite of continuous growth and vascularity of the placental mass in three of them. CONCLUSION: Placental chorioangioma is associated with an increased risk of pregnancy complications, the most common being polyhydramnios and preterm delivery. In selected cases, amniodrainage allows continuation of the pregnancy with improving perinatal outcome. Fetuses who develop hydrops are at the highest risk for perinatal death, with limited therapeutic options being available. Close follow-up is advised, even in those cases with no associated findings at the time of the diagnosis.

Adult↗
PubMed1988

Histopathology of the effects of tuneable dye laser on monkey retina.

The tuneable dye laser was used to simulate treatment of choroidal neovascularization and panretinal photocoagulation (PRP) in monkey retina. The histopathologic effects of wavelengths from 560 to 630 nm in juxtafoveal, papillomacular bundle, and nonfoveal areas were investigated. An unexpected observation using high-intensity burns in juxtafoveal and, to a lesser extent, in papillomacular bundle areas was inner retinal damage with 600-nm light. At moderate energy levels, the effect of 600 nm were more comparable with those with other wavelengths and included much less damage to the inner retinal layers. At mild energy levels, the effects were comparable with other wavelengths. During and after the application of the burns, the energy levels and ophthalmoscopic appearances were comparable for each wavelength for the high-, moderate-, and mild-intensity burns. The histopathologic effects of 630-nm light (tuneable dye red) were comparable with those of the standard krypton red (647 nm) laser. Nonmacular and PRP effects were similar with all wavelengths. These results indicate that power levels may need to be reduced when placing 600-nm (orange) laser burns in the macula.

Animals↗
PubMed1996

Small cell carcinoma of the cervix.

Small cell carcinoma of the cervix represents an uncommon variant of cervical cancer with a particularly poor prognosis. Traditionally, the diagnosis was established from routine histopathological sections, but there has been a trend to refer to this tumour as neuroendocrine carcinoma, with a requirement to demonstrate cytoplasmic granules. Five patients are described, who share the clinical features of young age of onset, early metastasis in the presence of apparently low stage disease, early failure of appropriate local treatment, and extreme chemosensitivity (features that are quite distinct from those seen in squamous cell cancer of the cervix). Light microscopy suggested a diagnosis of small cell cancer in all five tumours, but not all showed evidence of neuroendocrine differentiation. It is proposed that the present criteria for the diagnosis of cervical small cell carcinoma are too strict. The diagnosis should rely on the light microscopy of haemotoxylin and eosin sections and the distinctive clinical behaviour. The absence of neuroendocrine differentiation should not exclude the diagnosis, it does not appear to influence the clinical behaviour. The appropriate management of small cell carcinoma of the cervix is systemic, with chemotherapy as the first line of treatment. Surgery and radiotherapy may improve control of local disease but are unlikely significantly to influence the overall prognosis.

Adult↗
PubMed2001

Tricuspid regurgitation secondary to mitral valve disease: tricuspid annulus function as guide to tricuspid valve repair.

METHODS: A prospective analysis was performed on 50 patients (pts) with rheumatic mitral disease and associate secondary tricuspid insufficiency who underwent mitral valve replacement from January 1995 to December 1998. Surgical indication to tricuspid annuloplasty was considered in patients with echocardiographic tricuspid annulus diameter > 21 mm/m2, regardless semiquantitative evaluation of tricuspid insufficiency. De Vega annuloplasty was performed in 33 out of 50 patients. RESULTS: Hospital mortality was 2.0% (CL 0.3-3.6). The follow up of the discharged patients ranged from 3 to 48 months (mean 25 +/- 15.9). Three late deaths occurred (6.1% CL 2.8-9.2). Forty-two patients out of the 46 followed up (91.3% CL 84.9-93.8) were in I or II NYHA class. In eight patients (16.3% of discharged patients) the obtained result has been considered as 'negative late results': persisting moderate (three cases) or moderate-severe (five cases) TrI, together with congestive heart failure requiring a furosemide intake of > 25 mg/day. No patients had severe TrI at follow up. The statistics analysis demonstrated the 'preoperative fraction shortening of the tricuspid annulus' (P = 0.038) as factor predictive of late negative result. The incidence of late negative result was 57.1% among patients with fractional shortening lower than 25% and 0% among those patients with fractional shortening greater than 25% (P = 0.0001). CONCLUSIONS: The choice to treat the tricuspid insufficiency according to indexed tricuspid annulus dimension (> 21 mm/m2) has been effective in terms of clinical efficacy and of late functional result. Fractional shortening of the tricuspid annulus, expression of right ventricular cardiomyopathy in patients with poorest prognosis, affects the postoperative evolution of tricuspid insufficiency.

Adult↗
PubMed1998

Artificial vision.

Outer retinal degenerations such as retinitis pigmentosa (RP) and age-related macular degeneration (AMD) lead to blindness because of photoreceptor degeneration. To test whether controlled electrical stimulation of the remaining retinal neurons could provide form vision, we electrically stimulated the inner retinal surface with micro-electrodes inserted through the sclera/eye wall of 14 of these patients (12 RP and 2 AMD). This procedure was performed in the operating room under local anaesthesia and all responses were recorded via a video camera mounted on the surgical microscope. Electrical stimulation of the inner retinal surface elicited visual perception of a spot of light (phosphene) in all subjects. This perception was retinotopically correct in 13 of 14 patients. In a resolution test in a subject with no light perception, the patient could resolve phosphenes at 1.75 degrees centre-to-centre distance (i.e. visual acuity compatible with mobility; Snellen visual acuity of 4/200).

Blindness↗
PubMed2003

Indocyanine green-mediated photothrombosis combined with intravitreal triamcinolone for the treatment of choroidal neovascularization in serpiginous choroiditis.

PURPOSE: To report a case of peripapillary choroidal neovascularization (CNV) complicating serpiginous choroiditis that was treated by a single indocyanine green (ICG)-mediated photothrombosis session combined to intravitreous triamcinolone acetonide (TA) injection. METHODS: Interventional case report. A 48-year-old patient with peripapillary CNV was submitted to a laser-dye-mediated technique that uses ICG and low-intensity 810-nm light for continuous laser application; TA was then injected into the vitreous cavity 1 hour later, and prospective evaluation with fluorescein and ICG angiography as well as optical coherence tomography (OCT) was performed. RESULTS: At 2 weeks after treatment, best-corrected visual acuity improved from 20/200 to 20/50, with further improvement to 20/20-1 in the subsequent 10 weeks. Absence of fluorescein leakage from the CNV and OCT evidence of resolved retinal oedema was observed at that time. Clinical stabilization was maintained up to 1 year of follow-up. There was no significant complication related to the procedure. CONCLUSION: Combined ICG-mediated photothrombosis and intravitreous TA induced rapid and significant visual acuity recovery in this particular case of peripapillary CNV complicating serpiginous choroiditis. Accordingly, angiographic and OCT findings demonstrated neovascular lesion regression and restoration of the macular architecture.

Anti-Inflammatory Agents↗
PubMed2006

Complete correction of hyperphenylalaninemia following liver-directed, recombinant AAV2/8 vector-mediated gene therapy in murine phenylketonuria.

Novel recombinant adeno-associated virus vectors pseudotyped with serotype 8 capsid (rAAV2/8) have recently shown exciting promise as effective liver-directed gene transfer reagents. We have produced a novel liver-specific rAAV2/8 vector expressing the mouse phenylalanine hydroxylase (Pah) cDNA and have administered this vector to hyperphenylalaninemic PAH-deficient Pah(enu2) mice, a model of human phenylketonuria (PKU). Our hypothesis was that this vector would produce sufficient hepatocyte transduction frequency and PAH activity to correct blood phenylalanine levels in murine PKU. Portal vein injection of recombinant AAV2/8 vector into five adult Pah(enu2) mice yielded complete and stable (up to 17 weeks) correction of serum phenylalanine levels. Liver PAH activity was corrected to 11.5+/-2.4% of wild type liver activity and was associated with a significant increase in phenylalanine clearance following parenteral phenylalanine challenge. Although questions of long-term safety and stability of expression remain, recombinant AAV2/8-mediated, liver-directed gene therapy is a promising novel treatment approach for PKU and allied inborn errors of metabolism.

Animals↗
PubMed2006

Administration-route and gender-independent long-term therapeutic correction of phenylketonuria (PKU) in a mouse model by recombinant adeno-associated virus 8 pseudotyped vector-mediated gene transfer.

Phenylketonuria (PKU) is an inborn error of metabolism caused by deficiency of the hepatic enzyme phenylalanine hydroxylase (PAH) which leads to high blood phenylalanine (Phe) levels and consequent damage of the developing brain with severe mental retardation if left untreated in early infancy. The current dietary Phe restriction treatment has certain clinical limitations. To explore a long-term nondietary restriction treatment, a somatic gene transfer approach in a PKU mouse model (C57Bl/6-Pahenu2) was employed to examine its preclinical feasibility. A recombinant adeno-associated virus (rAAV) vector containing the murine Pah-cDNA was generated, pseudotyped with capsids from AAV serotype 8, and delivered into the liver of PKU mice via single intraportal or tail vein injections. The blood Phe concentrations decreased to normal levels (< or =100 microM or 1.7 mg/dl) 2 weeks after vector application, independent of the sex of the PKU animals and the route of application. In particular, the therapeutic long-term correction in females was also dramatic, which had previously been shown to be difficult to achieve. Therapeutic ranges of Phe were accompanied by the phenotypic reversion from brown to black hair. In treated mice, PAH enzyme activity in whole liver extracts reversed to normal and neither hepatic toxicity nor immunogenicity was observed. In contrast, a lentiviral vector expressing the murine Pah-cDNA, delivered via intraportal vein injection into PKU mice, did not result in therapeutic levels of blood Phe. This study demonstrates the complete correction of hyperphenylalaninemia in both males and females with a rAAV serotype 8 vector. More importantly, the feasibility of a single intravenous injection may pave the way to develop a clinical gene therapy procedure for PKU patients.

Animals↗
PubMed2003

Growth modification of the rabbit mandible using therapeutic ultrasound: is it possible to enhance functional appliance results?

Previous studies have shown that functional appliances can enhance mandibular growth when applied during the active growth period. However, besides patient compliance problems with bulky appliances and prolonged treatment demands, there is contradictory evidence that functional appliances have a significant long-term effect. Is there a method to enhance the growth response and improve the long-term success of functional appliances? Previous studies have also found that therapeutic ultrasound (US) can stimulate cartilage and bone growth. The objective of this study was to evaluate the effect of therapeutic US on condylar and mandibular growth in the rabbit model. Eight growing New Zealand male rabbits were chosen for this study. They received therapeutic US on one side of the mandible for 20 minutes/day for four weeks. Anthropometrical and histological evaluations revealed that US enhances mandibular growth by condylar endochondreal bone growth and consequently mandibular ramus growth. The significant results of this study support conducting a long-term study to evaluate the ultimate stability of the results obtained. Also, they suggest an extended research with a larger sample size and investigating the molecular basis of this stimulatory effect, together with forward posturing splints for optimal macroscopic and microscopic responses.

Animals↗
PubMed1988

[The effect of combined iodine treatment in Bad Hall on the color perception of patients].

After taking a cure with iodine treatments in Bad Hall (Upper Austria), patients with eye diseases repeatedly report improvements in their color vision. They state that colors are once again "more saturated, richer, and more distinct." These statements were checked using the Farnsworth Panel D-15 dicotomous test and the Lanthony desaturated 15 Hue test. The analysis of the results showed that there is indeed a statistically significant improvement in color vision after the cure. The spontaneous observations of the patients were therefore confirmed by the study.

Adult↗
PubMed1996

Methylene blue sensitizes E. coli cells to X-rays.

Methylene blue (MB) is shown to sensitize E. coli cells to the effects of X-rays. This sensitization is dependent on factors such as dye concentration, incubation temperature, membrane permeability, and repair capacities, suggesting that the binding and/or penetration of the dye into the cells determines the potentiation of the lethal effects of X-rays by MB. It is also demonstrated that the presence of the polymerase 1 enzyme is essential for this sensitization to take place. Since MB is known to penetrate, accumulate, and be retained preferentially in some malignant tissues, the possibility of using this dye as a specific sensitizer to X-rays in the radiotherapy of some cancers is discussed.

Coloring Agents↗
PubMed2003

Transpupillary thermotherapy threshold parameters: effect of indocyanine green pretreatment.

PURPOSE: To evaluate the effect of combined treatment with systemic indocyanine green (ICG) on threshold fluence levels of transpupillary thermotherapy (TTT) in rabbits. METHODS: Four pigmented rabbits and 13 nonpigmented rabbits were studied. TTT was performed on normal rabbit choriocapillaris using an 810-nm diode laser via slit-lamp biomicroscope delivery through a Goldmann macular lens. Laser spot size, power, and duration of laser exposure were varied to achieve a range of TTT fluences for threshold testing in both albino and pigmented rabbit fundi. Intravenous ICG pretreatment at doses of 0.41 to 10 mg/kg was initiated at varying times before TTT treatment. After the experiment, the eyes were enucleated under deep anesthesia, the animals were killed, and the eyes were prepared for light microscopy. RESULTS: When intravenous ICG pretreatment was employed, there was a dose-dependent decrease in the TTT fluence threshold as compared with known threshold values. At threshold fluences, histopathologic sections revealed damage to all layers of the retina in addition to choriocapillaris damage. CONCLUSION: Intravenous ICG pretreatment can be used to lower the TTT threshold fluence and irradiance required to create angiographically visible lesions in the normal rabbit choriocapillaris. Damage was seen in all layers of the retina and choriocapillaris at threshold levels when TTT was used alone or in combination with ICG pretreatment.

Animals↗