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At least 613 records · Page 34Linked to original sources
PubMed2002

Use of eye movement desensitization and reprocessing (EMDR) in the treatment of dermatologic disorders.

BACKGROUND: The use of psychological therapies in dermatology is being increasingly recognized because stress and negative emotions are major factors in a wide range of dermatologic disorders. Eye movement desensitization and reprocessing (EMDR) is a relatively new psychological intervention which was first described to be effective in post-traumatic stress disorder, a condition associated with extremely stressful life situations. OBJECTIVE: We evaluated the efficacy of EMDR in primary dermatologic disorders where psychological stress plays an important part in the pathogenesis of the disorder, and in clinical situations where the dermatologic symptom is the feature of a stress-related psychiatric disorder. METHODS: Four patients (two patients with atopic dermatitis and psoriasis, respectively, whose symptoms were exacerbated by stress, one patient with acne excoríee associated with body image pathology as a result of childhood emotional abuse, and one patient with generalized urticaria associated with post-traumatic stress disorder) were treated using the standard EMDR protocol with 3-6 sessions for a period ranging from 4 to 12 weeks, and followed up for 6-12 months after the end of EMDR therapy. RESULTS: All 4 patients experienced a marked improvement in their symptoms after 3-6 sessions of EMDR, within a period of </= 3 months, and maintained improvement during followup periods of 6-12 months. CONCLUSION: Our preliminary findings suggest that EMDR may be beneficial in the treatment of a wide range of stress-mediated dermatologic symptoms.

Adult↗
PubMed1992

Visualization of myocardial cellular architecture using acoustic microscopy.

The resolution of an ultrasound transducer depends on its frequency. The resolution improves when higher frequency transducers are used. A 1000 MHz transducer has a resolution of approximately 1 micron. Acoustic microscopy utilizes very high-frequency ultrasound (600 to 1000 MHz) to visualize structures on a microscopic level. Unstained, deparaffinized, 5 microns sections of myocardial biopsy specimens from 10 patients were placed on a slide and imaged using an Olympus UH3 scanning acoustic microscope. To compare with light microscopy, the section used for acoustic microscopy was subsequently stained with hematoxylin and eosin and a serial section from the paraffin block was stained with PTAH stain. Myocytes, myofibrils, and interstitial tissue were accurately imaged. Pathologic phenomena such as cell fallout, interstitial fibrosis, and lymphocytic infiltration were identified by acoustic microscopy. Intramural vessels, nuclei of endothelial cells, and the media were clearly identified by this technique. There was close correlation between findings by acoustic microscopy and light microscopy. Acoustic microscopy permitted the visualization of cardiac cellular detail with a resolution similar to that of light microscopy. Unlike light microscopy, acoustic microscopy requires no staining of the specimen.

Biopsy↗
PubMed1989

Malignant mesothelioma of tunica vaginalis testis.

Malignant mesothelioma of the tunica vaginalis is rare, but sometimes curable. It is similar to malignant mesothelioma of the peritoneum and of the pleura, and is likewise associated with asbestos exposure. We report a case, with correlative computed tomography, ultrasound, and gross pathology images that demonstrate tiny tumor implants studding the vaginalis testis. The literature is reviewed.

Aged↗
PubMed2006

Identifying patients at risk of compromised margins following breast conservation for lobular carcinoma.

BACKGROUND: The association of invasive lobular carcinoma with high rates of compromised margins in breast conservation makes choice of operation for these patients difficult. We sought to identify patients at risk of compromised margins following breast conservation surgery. METHODS: We reviewed all patients with invasive lobular and invasive ductal carcinoma over a 5-year period (1999-2004). The imaging, pathology and surgical details of patients with invasive lobular carcinoma undergoing breast conservation were analyzed. RESULTS: A total of 991 patients with invasive ductal carcinoma and 150 patients with invasive lobular carcinoma were identified. Lobular carcinomas had a compromised margin rate of 49% (n = 38/77) in breast conservation compared to 24% (n = 143/588) of ductal carcinomas (P < .0001). Mammographic size (P = .017), pathological size (P = .01), age (P = .03), multifocality (P < .0001), and lymphovascular invasion (P = .015) were significantly associated with compromised margins. CONCLUSION: Invasive lobular carcinoma has a 49% rate of compromised margins following breast conservation. Mammographic size greater than 1.5 cm and young age were preoperative factors predictive of compromised margins.

Breast Neoplasms↗
PubMed2006

Evaluating learning and knowledge retention after a continuing medical education course on total mesorectal excision for surgeons.

The purpose of this study was to determine whether knowledge gained (as determined by a formal course test) by surgeons in a continuing education course on total mesorectal excision and rectal cancer management is retained 1 year later. A formal course test had been previously developed and validated. The test evaluated course content including pelvic anatomy, surgical techniques, imaging, pathology, adjuvant therapies, and cancer and functional outcomes. Validation was determined by the absence of change in pre- and posttest scores of the "expert" course instructors (n = 8, P = .6) and by a linear correlation in test scores with increasing level of general-surgery resident training (n = 16, P = .001). Significant learning by the 58 surgeons taking the course had been shown by improvement in test scores from before the course (mean score 19) to after the course (mean score 25.3, P = .001, out of a possible 33 total mark). At 1 year after the course, those course participants (n = 44, 76%) who had provided postcourse contact information were asked to complete the course test again. Responses were received from 18 surgeons (41% of those surveyed, 31% of the original course participants). The mean score on the test after 1 year was 23.8. Compared with the immediate posttest scores, there was no significant knowledge loss over the year (P = .09). We conclude that knowledge acquired during a continuing education course for surgeons on total mesorectal excision and rectal-cancer management is retained 1 year later.

Clinical Competence↗
PubMed2005

Evaluating cognitive functions with visual and auditory number assays and P300 in children with epilepsy.

This study was planned to evaluate cognitive functions, especially attention and immediate recall, in children with epilepsy by using P300 and neuropsychological tests, which included visual and auditory number assays. Fifty five patients with partial seizures, 45 patients with generalized seizures and 20 patients with intractable seizures were enrolled in the study. Twenty five healthy children were taken as the control group. The results were as follows: 1. P300 latencies were significantly longer in the intractable and partial groups when compared with the control subjects. 2. The duration of epilepsy, seizure frequency, cerebral imaging pathologies were not significantly correlated with delayed P300 latencies. 3. The results of the visual and auditory number assays test showed significant abnormalities when each of the three groups were compared with the normal controls. 4. Though some subgroups of the neuropsychological tests were correlated with the P300 latencies, an overall significant correlation was not present between them. So, we suggest that neuropsychological tests are more convenient for the assessment of cognitive functions in children with epilepsy than the P300 recordings.

Acoustic Stimulation↗
PubMed2005

Psychiatric evaluation of the dermatology patient.

Over one third of dermatologic disorders have significant psychiatric comorbidity. The impact of the skin disorder on quality of life, the role of psychosocial stressors, and use of substances should be assessed. Major depressive disorder is the most frequently encountered psychiatric disorder in dermatology and is often associated with suicide risk. Other psychiatric syndromes comorbid with dermatologic disorders include obsessive-compulsive disorder, social phobia, posttraumatic stress disorder associated with dissociation and conversion symptoms, body image pathologies, delusional disorder, and a wide range of personality disorders. This article reviews psychiatric guidelines that may be used to assess psychopathology in the dermatology patient.

Humans↗
PubMed2004

Ethnic differences in preferences for female weight and waist-to-hip ratio: a comparison of African-American and White American college and community samples.

This study examined both ethnic differences and differences between college and community samples in male preferences for ideal body size and shape in women. As expected, it was found that African-American men were more likely to choose heavier figures as ideal than White American men did. Contrary to expectations, there were no differences in chosen ideal weight between college and community subsamples. As expected, both ethnic groups chose figures with a low waist-to-hip ratio (WHR), but African-American men were more likely to choose a very low WHR as ideal. The findings replicate and extend research showing weight to be a more important cue than WHR in the mate-selection process and support the theory that African-American men's preferences may serve as a protective factor against eating and body image pathology in African-American women.

Adult↗
PubMed2004

Study on the expression of angiotensin II (ANG II) receptor subtype 1 (AT1R) in the placenta of pregnancy-induced hypertension.

OBJECTIVE: To study the expression of angiotensin II (ANG II) receptor subtype 1 (AT(1)R) in the human placenta with pregnancy-induced hypertension (PIH). METHODS: Immunohistochemistry was used to detect the expression of AT(1)R in placental tissues of 30 patients with PIH and 10 patients with normal pregnancies (control group). The PIH tissues were further divided into 3 groups: mild PIH group, moderate PIH group and severe PIH group. Each group consisted of 10 patients. A high-resolution pathological image analysis system (HPIAS-1000) was used to determine the quantity of AT(1)R expression. RESULTS: The integral optical density and area of staining in the syncytiotrophoblast (STB) layer and villous endothelium of the placenta were significantly increased in PIH patients, in the moderate and severe PIH groups, as compared with the control group (P < 0.05), indicating that the expression of AT(1)R was highly increased in PIH. However, there was no significant difference between normal pregnancy and the mild PIH group (P > 0.05). Furthermore, statistically significant differences in AT(1)R expression were observed between mild, moderate and severe PIH groups (P < 0.05). CONCLUSION: The expression of AT(1)R is statistically significantly increased in the STB layer and villous endothelium of human placenta with PIH. Expression increases with the severity of the disease. Increased expression may be involved in the pathogenesis of PIH.

Adult↗
PubMed1999

Axonal cytoskeleton changes in experimental optic neuritis.

Axonal loss and degeneration in multiple sclerosis (MS) and experimental allergic encephalomyelitis (EAE) have been suggested by brain imaging, pathological and axonal transport studies. Further elucidation of the processes and mechanisms of axonal degeneration in demyelinating diseases is therefore of potential importance in order to alleviate the permanent disabilities of MS patients. However, detailed studies in this area are impeded by the small number of reliable models in which the onset and location of demyelination can be well-controlled. In this study, microinjection of polyclonal rabbit anti-galactocerebroside (anti-Gal C) antibody and guinea pig complement was used to induce local demyelination in the rat optic nerve. We found that treatment with appropriate volumes of the antibody and complement could induce local demyelination with minimal pressure- or trauma-induced damage. Local changes in neurofilaments (NFs) and microtubules (MTs) were examined with both immunohistochemistry (IHC) and electron microscopy (EM). On day 1 after microinjection, we observed moderate NF and MT disassembly in the local demyelinated area, although in most cases, no apparent inflammatory cell infiltration was seen. The NF and MT changes became more apparent on days 3, 5, 7 after microinjection, along with gradually increased inflammatory cell infiltration. These results suggested that acute demyelination itself may induce local cytoskeleton changes in the demyelinated axons, and that the ensuing local inflammation may further enhance the axonal damage. When the lesions were stained with specific antibodies for T lymphocytes, macrophages, and astrocytes, we found that most of the cells were macrophages, suggesting that macrophages may play a greater role in inflammation-related axonal degeneration and axonal loss. These results were confirmed and further characterized on the ultrastructural level.

Animals↗
PubMed2003

A conceptual model integrating spatial information to assess target volume coverage for IMRT treatment planning.

PURPOSE: We propose a model that integrates the spatial location of each voxel within a clinical target volume (CTV) to differentiate the merit of intensity-modulated radiation therapy (IMRT) plans with similar dose-volume histogram (DVH). This conceptual model is based on the hypothesis that various subregions within a given CTV that may carry different degree of risk in containing microscopic disease. METHODS AND MATERIALS: We hypothesize that a correlation between the probability of microscopic tumor extension and the risk of lymph node metastasis of a particular voxel point within CTV can be inferred based on its distance from the surface of radiographically evident gross disease. A preliminary observation was gathered from existing clinicopathologic data, and, based on these observations, a conceptual model for exponential-decay microscopic-extension probability function around primary tumor and linear function parameters relating the likelihood of lymph node metastasis to the distance from primary tumor was proposed. This model was generated to provide scoring functions to examine the merit of IMRT plans. To test the feasibility of this model, we generated two IMRT plans with similar and clinically acceptable DVH-based CTV coverage. Planning data were transferred to a data analysis software package (Matlab, The Mathworks Inc.). A 3D scoring function was calculated for each voxel inside the CTV. The adequacy of target coverage was evaluated by several novel approaches: 2D dose-volume scoring-function histograms (DVSH), the integral probability of relative residual tumor burden (RRTB), and tumor control probabilities (TCP) employing the scoring function as a pseudo-clonogen density distribution. RESULTS: Incorporating parameters for the risk of containing microscopic disease in each voxel into the scoring function algorithm, 2D DVSHs, RRTBs, integral RRTBs, and TCPs were computed. On each axial image, an RRTB map could locate the regions at greatest risk. These scoring functions were able to differentiate the merit of CTV coverage of clinically different IMRT plans but having very similar DVHs; one with cold spots centrally located over the gross tumor, and the other with more acceptable cold spots on the periphery of the CTV further away from the gross tumor volume. CONCLUSIONS: We demonstrated the feasibility and potential utility of an IMRT scoring method derived from this conceptual modeling approach. These methods are capable of ranking treatment plans with similar DVH profiles but different underdosed regions within the target. We will examine the accuracy of model parameters by performing tumor-specific image-pathologic correlation studies. Upon validation of these parameters, incorporating this scoring function model into plan optimization may have the potential to avoid underdosing subvolumes within CTV that harbor a higher likelihood of microscopic disease.

Humans↗
PubMed1996

Validation of a test of competence in transesophageal echocardiography.

OBJECTIVE: A test was developed that is based on intraoperative findings to evaluate knowledge of intraoperative echocardiography. This study examines the performance of attending anesthesiologists and residents at various levels of training in order to validate the test's ability to measure physician competence in intraoperative echocardiographic diagnosis. DESIGN: This study was a prospective evaluation of a test of competence in transesophageal echocardiography. SETTING: Two university medical centers. PARTICIPANTS: Volunteer anesthesia faculty and residents. INTERVENTIONS: The participants took an echocardiographic examination that consisted of 34 "K"-type multiple-choice questions and a 45-second video-loop sequence for each question. The video sequences were chosen for their high quality and unambiguous representation of both normal and pathologic images obtained by transverse transesophageal echocardiographic imaging. The questions were written by experienced echocardiographers. The test was administered to 25 individuals at two academic institutions: 11 residents with minimal transesophageal echocardiography exposure and 14 faculty who were relatively experienced with transesophageal echocardiography. All of the residents repeated the examination at the end of their third clinical anesthesia year, which included transesophageal echocardiography training. The differences between the groups' scores were analyzed using the Kruskal-Wallis test and Wilcoxon's rank-sum test. To correct for the multiple comparisons, p < 0.025 was deemed significant. MEASUREMENTS AND MAIN RESULTS. Before their transesophageal echocardiography training, the residents scored significantly lower than the faculty (p < 0.002). After 1 year of training, their scores significantly increased (p = 0.021), and their scores were not significantly different from the faculty level (p = 0.052). CONCLUSIONS: Test performance differed according to level of experience. This suggests that the test is a valid measure of intraoperative transesophageal echocardiography competence.

Anesthesiology↗
PubMed2005

Multifocal motor neuropathy.

Multifocal motor neuropathy (MMN) is an immune-mediated disorder characterised by slowly progressive, asymmetrical weakness of limbs without sensory loss. The clinical presentation of MMN mimics that of lower-motor-neuron disease, but in nerve-conduction studies of patients with MMN motor-conduction block has been found. By contrast with chronic inflammatory demyelinating polyneuropathy, treatment with prednisolone and plasma exchange is generally ineffective in MMN and even associated with clinical worsening in some patients. Of the immunosuppressants, cyclophosphamide has been reported as effective but only anecdotally. Various open trials and four placebo-controlled trials have shown that treatment with high-dose intravenous immunoglobulin leads to improvement of muscle strength in patients with MMN. Although clinical, pathological, imaging, immunological, and electrophysiological studies have improved our understanding of MMN over the past 15 years, further research is needed to elucidate pathogenetic disease mechanisms in the disorder.

Clinical Trials as Topic↗
PubMed1992

Fistulae in the inner canthus associated with ethmoiditis.

A case of fistulae in the inner canthus arising from the ethmoidal air cell sinuses is presented. This type of complication is very rare, and to the best of our knowledge no similar case has been reported in the literature. Clinical findings, imaging, pathology and treatment are presented and discussed.

Adult↗
PubMed2001

Detection of lymph node metastases in colorectal carcinoma.

The detection of lymph node metastases is the single most important prognostic factor for patients with colorectal cancer. This review outlines the difficulties and methods of detecting positive lymph node metastases in this disease. An outline of traditional diagnostic methods including preoperative ultrasound and cross sectional imaging techniques are evaluated alongside newer modalities including immunoscintography and PET scanning and intraoperative radioguided imaging. Pathological methods of detecting positive nodal disease using standard histopathological staging, enhanced lymph node harvesting and determination of micrometastases are also discussed.

Journal Article↗
PubMed1992

[MR angiography of occlusive changes in the superior thoracic inlet veins].

We used MR angiography to assess the thoracic inlet veins in 5 normal volunteers and 14 patients with thrombosis of these veins. The results were compared with conventional venography and contrast-enhanced computed tomography (CT). The normal anatomy was readily depicted by MR angiography in all normal volunteers. Pathology was assessed correctly by MR angiography in all patients. Thrombosis of the internal jugular vein was seen on MR angiography in all cases whereas conventional venography failed to demonstrate this region adequately in 3 cases. The best overview of the thoracic inlet veins was achieved in the coronal plane; however, for detailed demonstration of pathology, imaging in additional planes was necessary. We conclude that MR angiography is a promising method for non-invasive assessment of thoracic veins.

Evaluation Studies as Topic↗
PubMedDate not supplied

Infrared microspectroscopic detection of epithelial and stromal growth in the human benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) is one of the most common diseases in elderly men. It describes an overgrowth of the epithelial and fibromuscular tissues in the human prostate, in which both epithelium and stroma continue to proliferate at different rates. There is lack of suitable techniques for direct evaluation of the biophysical structure of molecular constituents and the proliferative changes in the structure of both compartments at the microscopic level. Reflectance Fourier transform infrared (FT-IR) microspectroscopy was used to pathologically image and examine the structural changes in the proliferation of epithelial and stromal tissues of human BPH. Two successive thin tissue slices were obtained by cutting the tissue with a microtome: one unstained slice was used for FT-IR spectroscopic analysis and the other stained slice was used for position referencing. The result indicates that the amide I maximum for BPH epithelial tissue was near 1,638 cm(-1) and showed its protein secondary structure by a combination of unordered and beta-sheet structures. However, an intense absorption band of amide I was at 1,630 cm(-1) for stromal BPH tissue due to the predominant beta-sheet structure. The higher peak intensity of several IR bands at 1,337, 1,281, 1,238, 1,206, 1,055, and 1,034 cm(-1), assigned to the C-O stretching mode of collagen, was observed in BPH stromal tissue. This suggests that the obvious collagen will be more enriched in the stroma of BPH tissue.

Aged↗
PubMedDate not supplied

Effect of oral metrizamide on hematocrit and serum osmolality in the neonate.

Sixteen newborns and young infants, weighing between 800 and 5200 grams, received orally administered metrizamide for evaluation of suspected gastrointestinal pathology. Images were judged good to excellent in 14 cases. No effect of metrizamide on hematocrit and serum osmolality was noted. Metrizamide appears to be a relatively safe and effective agent for examination of the neonatal gastrointestinal tract.

Administration, Oral↗