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PubMed2006

Ectopic bone induction by equine bone protein extract.

Demineralized bone matrix from horse has been reported to be osteoinductive. However, its performance was inferior to autogenous bone graft in terms of new bone formation. In the present experiment, an equine bone protein extract-COLLOSS E was investigated for its osteoinductivity in a rat model. At the mean time, carboxymethyl-cellulose (CMC) was tested as a potential carrier for the protein extract. 18 male Wistar rats (8 weeks) were employed in the experiment. Each rat was implanted randomly with the 2 of the following implants, one on each side of the abdominal muscle. 1) COLLOSS E lyophilisate. 2) PEEK ring holder. 3) 3% or 10% CMC .in gel or lyophilized form 4) COLLOSS E lyophilisate with 3% CMC, implanted as gel or in lyophilized form. 5) COLLOSS E suspension with 10% CMC, implanted as gel or in lyophilized form. The rats were followed up for 21 days. After termination, samples were subjected to macroscopic examination, plain radiograph, micro-CT and histological evaluations. The results showed that PEEK ring or CMC alone could not induce ectopic bone formation. COLLOSS E lyophilisate has a slightly higher (6 out of 7) positive bone formation rate over COLLOSS E/3% CMC (3 out of 5, both gel and lyophilized form), however, the difference is non-significant (p=0.36, Fisher's exact test). 10% CMC with COLLOSS E did not show ectopic bone formation when implanted as gel form (0/8), while 1 positive bone formation was found when implanted as the lyophilized form (1/4). Bone tissue volume ranged from 0 mm(3) to 23.1mm(3) for COLLOSS-E lyophilisate alone and 0 to 29.7mm(3) for COLLOSS E/3%CMC (gel or lyophilized form). We concluded that equine bone protein extract has the ability to induce ectopic bone formation in the rat model. CMC could be a potential carrier, however, further studies are needed to verify the proportion and efficacy.

Animals↗

PubMed1989

Ectopic Purkinje-like cells are GABAergic: immunohistochemistry with an immune serum against glutamic acid decarboxylase.

Intensely stained cells are found in the cerebellar white matter of the vermis and paravermis in adult rats after immunoreaction with an immune serum raised against glutamic acid decarboxylase (GAD). The cells are similar in size to cortical Purkinje cells and three times the size of Golgi cells of the internal granule layer, and have a thick immunopositive cell process emerging from a well-defined cytoplasmic cone. In the cytoplasm, immunoprecipitates are more dense around the nucleus as in normally located Purkinje cells. The morphological appearance of the immunopositive cells suggests that they may be ectopically located Purkinje cells. The soma of the ectopic Purkinje cells is contacted by a few darkly stained terminal boutons. Data indicate that, in spite of the different cellular environment, ectopic Purkinje cells can develop not only the typical morphological pattern already described but also other intrinsic features, such as their typical inhibitory neurotransmitter.

Animals↗

PubMed1995

Ectopic expression of beta-lactoglobulin transgenes.

Genomic constructs comprising the ovine beta-lactoglobulin gene are expressed in a position-independent manner in the mammary gland of transgenic mice. In some lines however, constitutive low-level transgene expression was detected in all other tissues. This ectopic expression presumably represents a position-dependent phenomenon since it was observed in only a proportion (40%) of the lines generated. Different lines of BLG transgenic mice displayed similar temporal patterns of ectopic expression. This pattern differed from that of BLG in the mammary gland. These data imply that the DNA elements that direct position-independent expression of beta-lactoglobulin transgenes in the mammary gland do not have the ability to insulate them from position effects in other tissues. Furthermore, the relatively high frequency and constitutive nature of ectopic expression suggests that transgene integration may not be totally random.

Animals↗

PubMed1980

Deformed dendrites and reduced spine numbers on ectopic neurones in the hippocampus of rats exposed to methylazoxymethanol-acetate. A Golgi-Cox study.

Clusters of ectopic neurones appeared in the hippocampus of rat offspring which were exposed to the alkylating neurotoxin methylazoxymethanol-acetate (MAMac) during foetal development. The offspring were 30 and 60 days old when their brains were removed and prepared by the Golgi-Cox procedure outlined by Sholl (1953). Reductions in the number of dendritic branches, changes in apical dendritic lengths, abnormalities in the shapes of the dendritic shafts, and significant diminution in spine numbers were observed in ectopic neurones. The significance of these pathological alterations in dendritic morphology is discussed with special reference to the findings of an earlier study which revealed that afferent axons terminate upon ectopic neurones in an abnormal way.

Animals↗

PubMed1978

Efficacy of oral mexiletine in the prevention of exercise-induced ventricular ectopic activity.

The anti-arrhythmic effect of oral mexiletine on exercise-induced ventricular arrhythmia was studied in a double blind trial of 10 patients suffering from ventricular ectopic beats of different origins. There was a good reproducibility of the amount of ectopic ventricular activity between consecutive exercise tests when no active drug was given. Treatment for 1 week with mexiletine 600 mg daily resulted in a statistically significant reduction in ventricular ectopic beats, particularly during and after exercise; there were virtually no side-effects. The results suggest that mexiletine has considerable potential in the treatment of ventricular arrhythmias.

Adult↗

PubMed1998

Ectopic dural osteolytic meningiomas.

Intracranial meningiomas usually originate from the arachnoidal cells of the internal dural layer: meningiomas that originate from different sites are ectopic. The authors describe the case of a small meningioma adhering to the external dural layer without involvement of the internal layer, accompanied by osteolysis of the internal surface of the skull. A review of the literature on cranial ectopic meningiomas yielded only four cases described as originating from the external dural layer. Osteolysis of the skull was always present and was not found to have prognostic significance. The authors suggest that these four primary ectopic meningiomas originating from the external dural layer should be differentiated from intraosseous meningiomas of the skull.

Dura Mater↗

PubMed1994

Expectant management of suspected ectopic pregnancies even with rising beta-subunit human chorionic gonadotropin levels. A clinical prospective study.

A prospective study was undertaken to evaluate possibility of expectant management of ectopic pregnancy in a selected group of patients with few symptoms, no gestational sac on sonography, and rising but low beta hCG levels. Using the above mentioned criteria, 26 patients were enrolled during prospective study period of 24 month. Five patients (19.2%) had a ruptured tubal pregnancy during the period of observation. Ten patients (38.5%) underwent laparoscopy with subsequent surgery for tubal pregnancy. The indication for laparoscopy in all 10 cases was abdominal pain. In all these 10 patients the pregnancy was unruptured. The remaining 11 patients (42.3%) escaped surgical intervention. Three had intrauterine pregnancies. In the remaining 8 patients the diagnosis remained presumed ectopic. The mean interval from admission of beta hCG level of < 5 mIU/ml in these 8 patients was 19.2 +/- 8.4 days. They were inpatients until the beta hCG level begun to decline. Thereafter, the patients were observed as outpatients. We conclude that in carefully selected cases of suspected ectopic pregnancies with rising but low beta hCG levels, expectant management is appropriate as long as the patient remains relatively asymptomatic.

Adult↗

PubMed1983

Massive ectopic calcification of the leg following nerve injury.

Four cases showing massive ectopic calcifications in muscles of the lower leg combined with nerve paralysis following war injuries or traffic accident are reported. The development and increase of localized soft tissue calcifications were observed for several years. One case was treated by extirpating the ectopic calcified mass. Several operations were performed because of abnormalities in the feet as a sequel of nerve injury. No clear connection was observed between primary infection or reduced blood supply and development of calcification, although microtrauma of paretic muscle fibers is believed to cause partially induction of massive ectopic calcifications in the cases described.

Adult↗

PubMed1994

Electrocardiographic inverse solution for ectopic origin of excitation in two-dimensional propagation model.

Inverse calculations were examined that sought the origin of a cardiac ectopic excitation sequence. Cardiac anatomy and its geometric relationships to sites on the body surface were adapted from human cross-sectional images to form a two-dimensional model, which included ventricular muscle and a primitive conduction system. The surrounding volume conductor was modelled in a simplified way as unbounded, homogeneous and isotropic. In a series of tests, one ectopic origin was designated the 'true' origin. The ECG for this true origin was compared to ECGs for 197 ectopic 'trial' origins, and differences between the wave forms for true versus trial origins were determined. Core issues were the magnitudes of changes in ECG wave forms as a function of the site of origin, whether these changes were sufficient to imply uniqueness, and what spatial resolution might be expected, in the presence of realistic noise levels. For a noise level of 10 microV RMS, the origin of excitation was localised to a single region of the muscle using one wave form from the body surface, with a resolution of 10 mm. The resolution was not improved significantly with a second electrode on the body surface, but was substantially improved with an endocardial electrode.

Algorithms↗

PubMed1996

Congenital ectopic vas deferens inserting into the bladder with ipsilateral renal agenesis.

Vas deferens ectopia is a rare congenital anomaly which is frequently associated with anorectal abnormalities. There have been 20 cases up to date with an ectopic vas deferens inserting into the ureter. Out of these 6 had a bilateral insertion and another 4 cases with an ectopic vas deferens inserting directly into the bladder, out of which 1 had a bilateral insertion. There is an embryological hypothesis which may explain this rare condition that may result from a possible underlying defect of the proximal vas precursor segment of the Wolffian duct. Herein, we present a case of an ectopic vas deferens terminating in the urinary bladder and accompanied by ipsilateral renal agenesis. This is the second case report in the world literature.

Abnormalities, Multiple↗

PubMed1999

Plurihormonal Bronchial Carcinoid Associated with Ectopic Cushing's Syndrome.

A 31-year-old woman presented with progressive weight gain, facial acne, round facies, hirsutism, and secondary amenorrhea. Her plasma cortisol, urinary free cortisol, and plasma ACTH were elevated. CT scan of abdomen revealed bilateral diffuse adrenal enlargement. MRI of pituitary failed to identify a lesion. CT scan of chest revealed an 8 mm nodule in the lower lobe of the left lung. The diagnosis of ectopic Cushing's syndrome was made. The lung tumor was surgically removed. The tumor measured up to 1.5 cm in diameter. By light microscopy, a tumor with characteristic features of bronchial carcinoid was noted. Immunostains were positive for neuron-specific enolase, synaptophysin, chromogranin, low-molecular-weight keratin, ACTH, beta endorphin, corticotropin-releasing hormone, bombesin, alpha subunit, and somatostatin. Electron microscopy revealed an endocrine neoplasm. The secretory granules displayed great variation subdividing the endocrine neoplasm. The secretory granules displayed great variation subdividing the cell population into an undetermined number of phenotypes. In situ hybridization demonstrated positivity for pro-opiomelanocortin mRNA in the tumor cells. Postoperatively, plasma cortisol had fallen. The patient remained symptom-free one year later. The case presented here was regarded as a plurihormonal bronchial carcinoid associated with ectopic Cushing's syndrome. This unique plurihormonal bronchial carcinoid tumor produced three hormones, ACTH, CRH, and bombesin, that may have contributed to the patient's ectopic Cushing's syndrome.

Journal Article↗

PubMed2006

Ectopic cervico-mediastinal thymoma confirmed by flow cytometric analysis of tumor-derived lymphocytes.

Ectopic cervical or cervico-mediastinal thymomas are very rare and most of them are asymptomatic, except for the presence of a cervical mass. We present the case of a 71-year-old man with an ectopic cervico-mediastinal thymoma threatening superior vena cava syndrome. He had a slight headache and presented with venous dilatation on the chest wall. A computed tomographic scan and magnetic resonance imaging of the chest demonstrated a mass extending from the right neck to the hilum, that indented the trachea and compressed and displaced the brachiocephalic veins anteriorly. Under a right hemicollar incision and median sternotomy, the mass was resected en bloc together with the thymus. The resected specimen was an encapsulated mass measuring 11x7x4 cm. The pathological diagnosis was type AB, non-invasive thymoma, confirmed by 3-color flow cytometry of tumor-derived lymphocytes. Flow cytometry using biopsy material may contribute to the preoperative diagnosis of ectopic thymoma.

Aged↗

PubMed1992

Ectopic ureterocele in adults with a comparison of the anomaly in children.

Ectopic ureteroceles, while not uncommon in children, have been reported only rarely in adults. We present five adults with ectopic ureteroceles with emphasis on the varied clinical and radiographic manifestations. These findings were compared with those in 32 children with ectopic ureterocele. It was found that the clinical presentation differed in adults and children, but the radiological findings were similar. The diagnosis was in some cases delayed for many years. The anomaly could not be detected by imaging means in two of five adults and eight of 32 children, and was found only at surgery.

Adult↗

PubMed2004

Dual ectopic thyroid gland with Graves' disease and unilateral ophthalmopathy: a case report and review of the literature.

Ectopic thyroid gland (ETG) is a rare entity and can be seen anywhere in the route of descending gland. It is much rarer when encountered away from the midline. Dual ETG is such a rare entity that only a few have been reported in the literature. ETGs not only cause thyroid dysfunction, most commonly hypothyroidism and rarely hyperthyroidism, but also frequent local symptoms. Therapeutic options change according to patients' co-morbid diseases, age, size of goiter and presence of local symptoms. Graves' disease is very rarely detected in a patient with ectopic thyroid. There is no report in literature concerning ectopic thyroid presenting with Graves' disease and unilateral ophthalmopathy. We describe a case with dual ETG and Graves' disease and unilateral ophthalmopathy: it is the first reported in literature.

Choristoma↗

PubMed2003

Is there a therapeutic role for octreotide in patients with ectopic Cushing's syndrome?

Cushing's syndrome (CS) due to ectopic ACTH secretion (EAS) has a high morbidity and mortality, because of the underlying tumor and the sequelae of severe hypercortisolemia. Therefore, rapid treatment of ectopic CS is mandatory. Scintigraphy shows that up to 80% of ectopic ACTH-producing tumors have somatostatin receptors. While this suggests that somatostatin analogs may reduce ACTH production and treat patients with EAS, the therapeutic role of these agents is still evolving. Here we demonstrate the spectrum of responses to octreotide therapy in 3 patients with EAS. Diagnostic imaging with the 111In-pentetreotide scan did not predict the therapeutic response to octreotide. Two patients with positive somatostatin receptor scintigraphy failed to respond to octreotide, while one with a negative scan reached eucortisolemia on a maintenance dose of 75 microg octreotide twice daily or octreotide LAR 30 mg per month. We conclude that octreotide is not a first line agent to control hypercortisolemia but may be a useful agent when other inhibitors of steroidogenesis fail or parenteral administration is required. Before therapy an octreotide challenge test may predict therapeutic response. Cortisol levels should be monitored regularly on somatostatin analog therapy, because of its unpredictable long-term pharmacodynamic profile.

Adrenocorticotropic Hormone↗

PubMedDate not supplied

Occult bilateral ectopic vaginal ureters causing urinary incontinence: diagnosis by computed tomography.

Diagnosis of an ectopic, infrasphincteric ureter can be difficult because the renal moiety drained by the ectopic ureter is often small and functions poorly. We present a 6-year-old girl with urinary incontinence caused by bilateral vaginal ectopic ureters that were not seen on excretory urography or renal sonography and were diagnosed only by contrast-enhanced computerized tomography.

Child↗

PubMedDate not supplied

Usefulness of transjugular intrahepatic portosystemic shunt in the management of bleeding ectopic varices in cirrhotic patients.

PURPOSE: To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the control of bleeding from ectopic varices. METHODS: From 1995 to 2004, 24 cirrhotic patients, bleeding from ectopic varices, mean age 54.5 years (range 15-76 years), were treated by TIPS. The etiology of cirrhosis was alcoholic in 13 patients and nonalcoholic in 11 patients. The location of the varices was duodenal (n = 5), stomal (n = 8), ileocolic (n = 6), anorectal (n = 3), umbilical (n = 1), and peritoneal (n = 1). RESULTS: TIPS controlled the bleeding in all patients and induced a decrease in the portacaval gradient from 19.7 +/- 5.4 to 6.4 +/- 3.1 mmHg. Postoperative complications included self-limited intra-abdominal bleeding (n = 2), self-limited hemobilia (n = 1), acute thrombosis of the shunt (n = 1), and bile leak treated by a covered stent (n = 1). Median follow-up was 592 days (range 28-2482 days). Rebleeding occurred in 6 patients. In 2 cases rebleeding was observed despite a post-TIPS portacaval gradient lower than 12 mmHg and was controlled by variceal embolization; 1 patient underwent surgical portacaval shunt and never rebled; in 3 patients rebleeding was related to TIPS stenosis and treated with shunt dilatation with addition of a new stent. The cumulative rate of rebleeding was 23% and 31% at 1 and 2 years, respectively. One- and 2-year survival rates were 80% and 76%, respectively. CONCLUSION: The present series demonstrates that bleeding from ectopic varices, a challenging clinical problem, can be managed safely by TIPS placement with low rebleeding and good survival rates.

Adolescent↗

PubMed2001

Double common bile duct with ectopic drainage into the stomach. Case report and review of the literature.

A rare abnormal biliary tract consisting in a double common bile duct with an ectopic biliary tree draining into the stomach is described. This congenital anomaly, associated with lithiasis in the ectopic duct, was detected for the first time on MR-cholangiopancreatography. Only 23 cases of abnormal biliary drainage into the stomach have been reported in the literature. Embryogenesis and potential risks, such as lithiasis in the ectopic duct and the development of gastric carcinoma, are discussed.

Aged↗