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PubMedDate not supplied

[Atrial septal aneurysm. Report of two clinical cases and review of the literature].

We report two cases of atrial septal aneurysm, one associated with paroxysmal supraventricular tachycardia, the second with atrial septal defect. In both cases there were verified some transitory ischemic attacks. Carotid ultrasonography excluded atherosclerosis lesions. Two-dimensional transthoracic echocardiography showed an atrial septal aneurysm which, in the second case, was associated with atrial septal defect as demonstrated by color Doppler. The therapy is discussed in the case of septal atrial aneurysm associated with transitory ischemic attack, anticoagulant therapy is indicated; in the other, surgical correction of the defect is necessary.

Adult↗
PubMed2002

Acute scleral thinning after pterygium excision with intraoperative mitomycin C: a case report of scleral dellen after bare sclera technique and review of the literature.

PURPOSE: To describe a patient with scleral dellen after pterygium excision with intraoperative mitomycin C. METHODS: Case report and MEDLINE review of the medical literature on scleral dellen after bare sclera technique. RESULTS: A 48-year-old man had a left nasal pterygium excised by the bare sclera technique with intraoperative mitomycin C. Eight days after surgery, the patient noticed a small black spot in the bare sclera area with mild irritation. Slit-lamp examination revealed a focal area of extreme thinning, centered on the nonepithelialized bare sclera, surrounded by edematous conjunctiva. The ciliary body was visible through the thin and dry scleral lesion. After topical lubricant therapy, the scleral lesion appeared normal thickness and white in color 3 days later. Therapy was continued until the sclera epithelialized. CONCLUSIONS: Scleral dellen is an early postoperative complication of bare sclera technique owing to delayed conjunctival wound closure. Hydration of the thinned sclera will rapidly thicken it. However, medical therapy should be continued until the surrounding conjunctiva has flattened and the sclera has epithelialized. Surgical wound closure is an alternative management and may be the way to prevent scleral dellen formation after bare sclera technique. All patients after bare sclera surgery should be followed up until the conjunctival wound has healed. If delayed healing is found, frequent artificial tears, patching, or surgical intervention is necessary.

Acute Disease↗
PubMed2000

Stereotactically guided laser therapy of occult breast tumors: work-in-progress report.

HYPOTHESIS: Mammographically detected breast tumors can be completely ablated with laser energy. DESIGN: Nonrandomized control trial. SETTING: A university hospital ambulatory care center. PATIENTS: Thirty-six patients with mammographically detected well-defined breast tumors were selected. INTERVENTIONS: The diagnosis of malignant neoplasms and determination of prognostic factors were established by image-guided needle-core biopsy. Patients were treated on a stereotactic table, using a 16- to 18-gauge laser probe, with an optic fiber transmitting a predetermined amount of laser energy. A multisensor thermal probe was inserted into the breast adjacent to the laser probe to monitor treatment. In the last 10 patients, the tumor blood flow was evaluated before and after laser therapy with contrast-enhanced color Doppler ultrasound. One to 8 weeks after laser therapy, the tumors were surgically removed and serially sectioned. MAIN OUTCOME MEASURE: Complete necrosis in 66% of tumors. RESULTS: Total tumor ablation with negative margins was observed whenever 2500 J/mL of tumor was given or the thermal sensors recorded 60 degrees C. Microscopic examination at 1 week showed disintegration of malignant cells, with peripheral acute inflammatory response and at 4 to 8 weeks extensive fibrosis. Contrast-enhanced color Doppler ultrasound revealed loss of tumor circulation after therapy, and positron emission tomography scan correlated well with histologic findings. There were no systemic adverse effects. Two patients sustained 3 x 4-mm skin burns around the laser needle. CONCLUSION: A stereotactically guided minimally invasive technique may be effective for the treatment of mammographically detected breast cancer.

Breast Neoplasms↗
PubMed2000

Color flow signal in the left atrium as a mirror image artifact suggesting one leaflet constriction of the St. Jude Medical valve: a case report.

Color Doppler echocardiography detected an abnormal color flow signal originating from the prosthetic mitral valve and extending to the left atrium during diastole in an 84-year-old woman with St. Jude Medical valve replacement. The flow was away from the transducer and almost identical to the left ventricular inflow signal except for the direction. Cinefluoroscopy showed one of the leaflets fixed at systole whereas the other leaflet was mobile. After reinforcement of anticoagulant therapy, this abnormal color flow signal disappeared and motion of both leaflets normalized. This color flow signal, presumably a mirror image artifact of the left ventricular inflow caused by the immobilized leaflet, could be a sign of one leaflet constriction in patients with St. Jude Medical valve replacement.

Aged↗
PubMed1989

[Usefulness of the Doppler color technic in the diagnosis of thrombosis in a mitral valve mechanical prosthesis and in the monitoring of the results of thrombolytic therapy].

We report the usefulness of Doppler color echocardiography in diagnosis and follow-up in a case of thrombosis of a prosthetic mitral valve. The patient received thrombolytic therapy for this disorder and a favorable clinical outcome was observed. Integrated echocardiographic techniques (M-Mode, cross-sectional, continuous-wave, pulsed-Doppler and color Doppler) could increase the amount of diagnostic information in these situations.

Aged↗
PubMed2005

Optimum prednisolone usage in patients with biliary atresia postportoenterostomy.

PURPOSE: Prednisolone is used routinely after portoenterostomy (PE) in patients with biliary atresia (BA). The authors reviewed their patients with BA post-PE to assess prednisolone protocols. METHOD: Severity of fibrosis at PE (moderate or severe), age at PE (30-70 days), size of bile ductules in the fibrotic biliary remnant at the porta hepatis (>100 microm), and type of BA (uncorrectable type) were used as criteria for selecting 63 subjects from our patients with BA post-PE. Subjects were divided into 5 groups according to prednisolone dosage: group 1, no prednisolone; groups 2 to 4, single courses of intravenous prednisolone commencing on day 7 post-PE administered in decreasing dose for 3 days each as follows: group 2, 6, 4, and 2 mg; group 3, 10, 5, and 2.5 mg; group 4, 20, 15, 10, 5, and 2.5 mg; group 5, same as group 4, but stool color was used to monitor bile excretion and a course was restarted from 20 mg whenever stools began to turn pale. If necessary, single courses were repeated until serum total bilirubin was less than 2.0 mg/dL. Protocol efficacy was assessed by comparing the number of patients who became jaundice free, the period taken to become jaundice free, and the incidence of side effects related to prednisolone. RESULTS: The number of patients who became jaundice free in the no prednisolone group (group 1, 7/12 or 58.3%) was not significantly different from the number in the single-course groups (group 2, 8/12 or 66.6%; group 3, 10/13 or 76.9%; and group 4, 11/15 or 73.3%). The number in the stool-monitored group (group 5, 10/11 or 90.9%) was significantly greater (P < .05). The mean period taken to become jaundice free in group 1 (82.6 +/- 29.1 days) was not significantly different from the single-course groups (group 2, 74.5 +/- 29.3 days; group 3, 49.6 +/- 19.8 days; and group 4, 48.3 +/- 26.0 days). The mean period taken in the stool-monitored group (group 5, 33.3 +/- 6.4 days) was significantly shorter (P < .05). The number of subjects who developed cholangitis after becoming jaundice free was not significantly different (group 1, 2/7; group 2, 2/8; group 3, 2/10; group 4, 2/11; group 5, 2/10). There were no prednisolone-related complications identified in any subject. CONCLUSIONS: These results provide strong evidence that large-dose prednisolone therapy with stool color monitoring of bile flow has a positive impact on the time taken for patients with BA post-PE to become jaundice free and the number of patients who remain jaundice free.

Anti-Inflammatory Agents↗
PubMedDate not supplied

Melanocyte destruction and repigmentation in vitiligo: a model for nerve cell damage and regrowth.

Melanocytes (MCs) are melanin-producing cells of the skin that are derived from neural crest cells. Vitiligo vulgaris is a common depigmentation disorder resulting from the destruction of functional MCs in the affected skin. The three prevailing pathomechanisms of vitiligo are the immune hypothesis, the neural hypothesis and the autocytotoxic hypothesis. None of these mechanisms has been conclusively proven. Melanoblasts (MBs) in the outer root sheath of the hair follicles are the reservoir cells for repigmentation. Recovery from vitiligo is initiated by activation and proliferation of these MBs, followed by upward migration to the nearby epidermis that forms perifollicular pigmentation islands. Migration, proliferation and differentiation of MCs and MBs are regulated by keratinocyte-derived factors and some coat color genes. Any therapy for vitiligo must explain not only the repopulation of MCs but also their functional development. In patients with vitiligo, MCs are destroyed in the skin, the eyes, and possibly the ears. However, the concept of vitiligo as a systemic disease will be clearly established only when the mechanisms involved in vitiligo are identified. Recent advances in the fields of neural crest cell culture and molecular genetics have opened new perspectives in the understanding of vitiligo. Not only will this result in better treatments for vitiligo patients, but possibly will also provide a key to triggering nerve cell regrowth in other nervous diseases.

Animals↗
PubMed1985

Retinal toxicity after high-dose cisplatin therapy.

Because of increasing complaints of visual dysfunction, 13 patients with refractory or recently diagnosed ovarian carcinoma were evaluated for possible cisplatin-induced ophthalmologic toxicity. All patients had received high-dose cisplatin (200 mg/m2 in five divided daily doses) over two to four cycles. Eight patients (62%) developed symptoms of blurred vision and three (23%) also developed altered color perception. Retinal toxicity in the form of cone dysfunction was documented by electroretinography and color vision testing in 11 patients. Three patients were studied prospectively. Two patients who developed cone dysfunction had normal ophthalmologic exams before the initiation of chemotherapy or after one cycle of cisplatin, suggesting a causal relationship between cisplatin therapy and subsequent retinal abnormalities. Though visual acuity improved off therapy, color vision abnormalities persisted as long as 16 months beyond therapy.

Adult↗
PubMed2002

Transforming an MFT program: a model for enhancing diversity.

Marriage and family therapy programs need to go beyond the typical practices of recruiting and retaining students of color. Marriage and family therapy educators must assume positions of leadership by transforming graduate programs to reflect a deep, active, systemic commitment to both diversity and social justice. In this article, we argue that it is through this type of transformation that programs become truly ready to support students of color and to prepare all therapists to advocate for equity in a diverse, often unfair society. This article offers a model that addresses readiness, recruitment, retention, assessment, and professional development from this perspective.

Cultural Diversity↗
PubMed1991

Valvular emergencies.

Valvular emergencies result from a wide variety of causes, including infectious, inflammatory, ischemic, traumatic, degenerative, and recently iatrogenic processes. In addition, prosthetic valves have brought new valvular emergencies that present unique challenges in diagnosis and therapy. The advent of color Doppler and TEE have provided significant enhancements to our diagnostic armamentarium. Similarly, thrombolytic therapy has also found a place in the treatment of a common prosthetic valve emergency--thrombosed mechanical valves. Because of the likelihood of serious consequences, rapid diagnosis and aggressive management of valvular emergencies are needed, but the results can be very gratifying and lead to excellent short- and long-term outcomes.

Aortic Dissection↗
PubMed1982

[Similarities and differences in the color choice of patients under life-prolonging therapy and of healthy subjects].

The hypothesis of probable differences between subjects under life-extending treatment and healthy people was tested by applying the Lüscher Colour test to 2 groups of patients, one under dialysis, the other cardiopathic pacemaker wearers, and comparing them with a control group of healthy subjects. The results partly confirm the hypothesis and also show a further differentiation between the dialysis and pace-maker groups. A support programme using relaxation techniques (autogenous training and/or hypnosis) to balance and reduce problems revealed is therefore proposed.

Aged↗
PubMed2007

Color and duplex Doppler sonography to detect sacroiliitis and spinal inflammation in ankylosing spondylitis. Can this method reveal response to anti-tumor necrosis factor therapy?

OBJECTIVE: To investigate the role of color and duplex Doppler ultrasound (CDDUS) in the detection of sacroiliac (SI) and spinal inflammation, as well as response to anti-tumor necrosis factor (TNF) therapy in patients with ankylosing spondylitis (AS). METHODS: We included 39 consecutive patients with AS followed at our center and 14 healthy controls. In the AS and control groups, blood vessels in SI joints and lumbar vertebral (LV) and thoracal vertebral (TV) paraspinal areas were investigated by CDDUS. When the artery was found, the resistive index (RI) was measured by CDDUS. Disease activity characteristics (ESR, CRP, BASDAI, and BASMI) were evaluated in patients with AS. In 11 patients for whom anti-TNF therapy was indicated, CDDUS measurements were performed before and on Week 12 of therapy. RESULTS: In patients with AS, RI values of SI joints and of LV and TV areas were lower than in controls (all p < or = 0.01). In AS patients with active disease according to BASDAI, RI values of TV (p = 0.0013) and LV (p = 0.027) were significantly lower than in the inactive group. In the group with active AS, SI RI was nonsignificantly lower (p = 0.16). After anti-TNF therapy, there were significant increases in mean SI RI (p = 0.028) and LV RI (p = 0.039), and a nonsignificant increase in TV RI (p > 0.05). CONCLUSION: CDDUS may be an alternative, less expensive, and easier method for detecting inflammation secondary to increased SI and spinal vascularization and in evaluating response to anti-TNF therapy in AS.

Adult↗
PubMed2001

[Influence of reflex zone therapy of the feet on intestinal blood flow measured by color Doppler sonography].

OBJECTIVE: An influence on organ-associated blood flow is considered as a possible mechanism of action of reflex zone massage of the feet (FRZM) therapy. In the present study we investigated whether changes in intestinal blood flow can be achieved by FRZM. MATERIAL AND METHODS: 32 healthy adults (19 women and 13 men) were randomly assigned to the treatment or the placebo group. Subjects of the treatment group received foot massage on the zones assigned to the intestines and those of the placebo group received massage on zones unrelated to the intestines. Before, during and after FRZM, the blood flow velocity, the peak systolic and the end diastolic velocities in the superior mesenteric artery as well as the resistive index as a parameter of vascular resistance were calculated. RESULTS: During FRZM, in the subjects of the treatment group there was a significant reduction in the resistive index (p = 0.021), suggesting an increase in the blood flow in the superior mesenteric artery and the subordinate vascular system. In contrast, there were no significant changes in the resistive index in the subjects of the placebo group. CONCLUSION: The reduction in the resistive index observed in the treatment group supports the assumption that FRZM improves blood flow in the organs considered to be associated with the specific foot zones, at least during the therapy process.

Adult↗
PubMed2006

[Laser therapy for tattoos].

Tattoos are produced by bringing colorants of various compositions into the skin. The ingredients of these colorants are not declared and are not subjected to pharmacological and toxicological tests. Ultrashort and high intensity laser pulses are used to remove tattoos. The laser beam breaks up the pigments embedded in the skin so that they can be transported away from the site. Clinically, the pigment becomes less intense or completely disappears. The success of the laser treatment essentially depends on the pigments used in the tattoo and on how deeply the pigments are embedded in the skin. The laser treatment is slightly painful and has a low rate of permanent side effects.

Coloring Agents↗
PubMed2006

Contrast-enhanced color duplex sonography (CDS): an alternative for the evaluation of therapy-relevant tumor oxygenation?

PURPOSE: To evaluate the predictive value of radiotherapeutically relevant tumor hypoxia by contrast-enhanced color duplex sonography (CDS). The objectification was based on pO(2) histography. MATERIAL AND METHODS: 25 patients with metastatic neck lymph node from a primary squamous carcinoma of the head and neck were examined. To visualize as many vessels as possible, a contrast enhancer (Levovist), Schering Corp., Germany) was administered. Horizontal and longitudinal sonographic scans with a thickness of 5 mm were performed on the metastatic neck lymph node. Color pixel density (CPD) was defined as the ratio of colored to gray pixels in a region of interest. It represents the extent of vascularization in the investigated slice. To assess the biological and clinical relevance of oxygenation measurement, the relative frequency of pO(2) readings < or = 2.5, 5.0, and 10.0 mmHg, as well as mean and median pO(2), were documented. RESULTS: In order to investigate the degree of linear association, the Pearson correlation coefficient was calculated. Moderate (/r/ > 0.5) to high (/r/ > 0.7) correlation was found between the CPD and the parameters of hypoxic fraction (pO(2) readings with values < or = 5.0 and 10.0 mmHg, as well as mean and median). There was only a slight correlation between CPD and the fraction of pO(2) values < or = 2.5 mmHg (r = -0.479). CONCLUSION: CPD represents the mean degree of vascularization. As a noninvasive measurement, this method seems feasible for evaluating the state of global oxygenation in superficial tumors. Nevertheless, this method is limited through its deficiency in describing the vascular heterogeneity of tumors.

Adult↗
PubMedDate not supplied

Takayasu's arteritis: anatomic change before and after steroid therapy evaluated by angiography and echo-Doppler color-flow.

A 36-year-old Italian woman with active Takayasu's disease presented a bilateral occlusions of subclavian artery and stenosis of bilateral common carotid arteries: the maximal diameter stenosis, measured with echo-Doppler color-flow (EDCF) in the longitudinal section was of 43.5 +/- 2.4% on the right and 61 +/- 1.4% on the left. Prednisolone was administered for 30 months at doses from 25 to 6 mg daily (12.5 mg every two days). During steroid therapy we could monitor by EDCF the anatomic change of the involved vessel and a final decrease in carotid wall thickening of 19.8% on the left and 14.0% on the right side. This work demonstrates for the first time that duplex sonography may be an useful tool to asses possible anatomic changes in the carotid lesions of Takayasu's arteritis in response to steroid therapy.

Adult↗