Large Lesions (large + lesion)

Distribution by Scientific Domains


Selected Abstracts


An epidemiological study of renal pathology in tuberous sclerosis complex

BJU INTERNATIONAL, Issue 6 2004
Finbar J. O'Callaghan
OBJECTIVES To report the frequency of renal symptoms and complications of patients with tuberous sclerosis complex (TSC), to describe the ultrasonographic appearance of the kidneys in a population-based sample, and to investigate the relationship between a history of renal haemorrhage and renal lesions identified by ultrasonography. PATIENTS AND METHODS As part of an epidemiological study, 179 patients with TSC were identified as living in the Wessex Region in the South of England. Patients were interviewed and examined in their homes, to elicit the presence of renal symptoms or a history of renal complications. Renal ultrasonography was used in consenting patients in their homes. RESULTS There was a history of renal complications in 16 (9%) patients; 149 consented to interview and examination, and 19 gave a history of renal symptoms in the previous year; 124 had renal ultrasonography; 86 (69%) had renal angiomyolipomas and 37 (30%) had renal cysts. Large lesions (>3 cm in diameter) were strongly associated with a history of symptomatic bleeding, although significant haemorrhage occurred in a 6-year-old child with small angiomyolipomas. CONCLUSIONS The formation of angiomyolipoma in TSC is common. Polycystic kidney disease, renal carcinoma and renal failure, although rare, occur in TSC. Most patients with angiomyolipomas have neither complications nor symptoms. There was no appreciable difference between the sexes in the risk of developing these lesions. Although less commonly seen in the very young, there is no identifiable relationship after adolescence between age and the risk of having a renal angiomyolipoma. Bleeding tends to occur from large lesions (>3 cm) but most such patients have remained asymptomatic to date. [source]


Angiokeratoma Circumscriptum Naeviforme: Successful Treatment with Carbon-Dioxide Laser Vaporization

DERMATOLOGIC SURGERY, Issue 2 2005
Jesús del Pozo MD
Background Angiokeratoma circumscriptum naeviforme (ACN) is an unusual type of localized angiokeratoma that occurs more frequently in females and is usually located on the buttocks or thighs, showing a unilateral distribution. ACN usually causes large lesions, which may require laser ablation because they often are too extensive to perform surgical excision. Carbon-dioxide laser is a known alternative for treating angiokeratomas. Objective Report of two cases of ACN treated with carbon-dioxide laser vaporization. Patients and methods A 28-year-old woman with a hyperkeratotic, violaceus plaque on her left buttock and a 24-year-old woman with a similar lesion on her right buttock were treated with a carbon-dioxide laser. Two laser passes were performed on each lesion within a single session. Results A successful cosmetic aspect of treated areas was obtained, with minimal pigmentary or textural changes. After a 2-year follow-up in the first patient and a 6-month follow-up in the second patient, no recurrence of the lesions was observed. Conclusions Our results, obtaining relevant cosmetic improvement after a few sessions of treatment, with low morbidity and minimal secondary effects, suggest that continuous-wave carbon-dioxide laser vaporization is a safe and effective treatment for ACN. JESÚS DEL POZO, MD, AND EDUARDO FONSECA, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source]


ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY GASTRIC CANCER: TECHNICAL FEASIBILITY, OPERATION TIME AND COMPLICATIONS FROM A LARGE CONSECUTIVE SERIES

DIGESTIVE ENDOSCOPY, Issue 1 2005
Ichiro Oda
Background:, Endoscopic mucosal resection (EMR) is a recognized treatment for early gastric cancer (EGC). One-piece resection is considered to be a gold standard of EMR, as it provides accurate histological assessment and reduces the risk of local recurrence. Endoscopic submucosal dissection (ESD) is a new technique developed to obtain one-piece resection even for large and ulcerative lesions. The present study aims to identify the technical feasibility, operation time and complications from a large consecutive series. Methods:, We reviewed all patients with EGC who underwent ESD using the IT knife at National Cancer Center Hospital in the period between January 2000 and December 2003. Results:, During the study period of 4 years we identified a total of 1033 EGC lesions in 945 consecutive patients who underwent ESD using the IT knife. We found a one-piece resection rate (OPRR) of 98% (1008/1033). Our OPRR with tumor-free margins was 93% (957/1033). On subgroup analysis it was found to be 86% (271/314) among large lesions (, 21 mm) and 89% (216/243) among ulcerative lesions. The overall non-evaluable resection rate was 1.8% (19/1033). The median operation time was 60 min (range; 10,540 min). Evidence of immediate bleeding was found in 7%. Delayed bleeding after ESD was seen in 6% and perforation in 4% of the cases. All cases with complications except one were successfully treated by endoscopic treatment. Conclusion:, The present study shows the technical feasibility of ESD, which provides one-piece resections even in large and ulcerative EGC. [source]


Preoperative staging of gastric cancer by endoscopic ultrasonography and multidetector-row computed tomography

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2010
Sung Wook Hwang
Abstract Background and Aim:, The aim of this study was to determine the accuracy of endoscopic ultrasonography (EUS) and multidetector-row computed tomography (MDCT) for the locoregional staging of gastric cancer. EUS and computed tomography (CT) are valuable tools for the preoperative evaluation of gastric cancer. With the introduction of new therapeutic options and the recent improvements in CT technology, further evaluation of the diagnostic accuracy of EUS and MDCT is needed. Methods:, In total, 277 patients who underwent EUS and MDCT, followed by gastrectomy or endoscopic resection at Bundang Hospital, Seoul National University, from July 2006 to April 2008, were analyzed. The results from the preoperative EUS and MDCT were compared to the postoperative pathological findings. Results:, Among the 277 patients, the overall accuracy of EUS and MDCT for T staging was 74.7% and 76.9%, respectively. Among the 141 patients with visualized primary lesions on MDCT, the overall accuracy of EUS and MDCT for T staging was 61.7% and 63.8%, respectively. The overall accuracy for N staging was 66% and 62.8%, respectively. The performance of EUS and MDCT for large lesions and lesions at the cardia and angle had significantly lower accuracy than that of other groups. For EUS, the early gastric cancer lesions with ulcerative changes had significantly lower accuracy than those without ulcerative changes. Conclusions:, For the preoperative assessment of individual T and N staging in patients with gastric cancer, the accuracy of MDCT was close to that of EUS. Both EUS and MDCT are useful complementary modalities for the locoregional staging of gastric cancer. [source]


Ex vivo and in vivo evaluation of laser-induced thermotherapy for nodular thyroid disease

LASERS IN SURGERY AND MEDICINE, Issue 7 2009
Jörg-P.
Abstract Background and Objective The prevalence of thyroid nodules ranges between 2% and 60% depending on the population studied. However, minimally invasive procedures like laser-induced thermotherapy (LITT) are increasingly used to treat tumors of parenchymatous organs and seem to be suitable for singular thyroid nodules as well. Their successful clinical application depends on the induction of sufficiently large lesions and a knowledge of the energy parameters required for complete thermal ablation. The aim of this study was to establish a dose,response relationship for LITT of thyroid nodules. Materials and Methods Thermal lesions were induced in healthy porcine thyroid glands ex vivo (n,=,110) and in vivo (n,=,10) using an Nd:YAG laser (1,064,nm). Laser energy was applied for 300,seconds in a power range of 10,20,W. During the ablation, continuous temperature measurement at a distance of 5 and 10,mm from the applicator was performed. The lesions were longitudinally and transversally measured, and the volume was calculated. Furthermore, enzyme histochemical analysis of the thyroid tissue was performed. Results The maximum inducible lesion volumes were between 0.74,±,0.18,cm3 at a laser power of 10,W and 3.80,±,0.41,cm3 at 20,W. The maximum temperatures after ablation were between 72.9,±,2.9°C (10,W) and 112.9,±,9.2°C (20,W) at a distance of 5,mm and between 49.5,±,2.2°C (10,W) and 73.2,±,6.7°C (20,W) at a distance of 10,mm from the applicator. The histochemical analysis demonstrates a complete loss of NADPH dehydrogenase activity in thermal lesions as a sign of irreversible cell damage. Conclusions This study is the first to demonstrate a dose,response relationship for LITT of thyroid tissue. LITT is suitable for singular thyroid nodules and induces reproducible clinically relevant lesions with irreversible cell damage in an appropriate application time. Lasers Surg. Med. 41:479,486, 2009. © 2009 Wiley-Liss, Inc. [source]


Diffusion-weighted MRI measurements on stroke patients reveal water-exchange mechanisms in sub-acute ischaemic lesions

NMR IN BIOMEDICINE, Issue 6 2009
J. Lätt
Abstract The aim of this study was to investigate the diffusion time dependence of signal- versus - b curves obtained from diffusion-weighted magnetic resonance imaging (DW-MRI) of sub-acute ischaemic lesions in stroke patients. In this case series study, 16 patients with sub-acute ischaemic stroke were examined with DW-MRI using two different diffusion times (60 and 260,ms). Nine of these patients showed sufficiently large lesions without artefacts to merit further analysis. The signal- versus - b curves from the lesions were plotted and analysed using a two-compartment model including compartmental exchange. To validate the model and to aid the interpretation of the estimated model parameters, Monte Carlo simulations were performed. In eight cases, the plotted signal- versus - b curves, obtained from the lesions, showed a signal,curve split-up when data for the two diffusion times were compared, revealing effects of compartmental water exchange. For one of the patients, parametric maps were generated based on the extracted model parameters. These novel observations suggest that water exchange between different water pools is measurable and thus potentially useful for clinical assessment. The information can improve the understanding of the relationship between the DW-MRI signal intensity and the microstructural properties of the lesions. Copyright © 2009 John Wiley & Sons, Ltd. [source]


Relationship Between Growth, Secondary Metabolism, and Resistance of Apple

PLANT BIOLOGY, Issue 2 2002
S. Rühmann
Abstract: The paper shows that N-induced vigorous shoot growth increases susceptibility of apple trees to Venturia inaequalis. This is due to a weakened defence in infected leaves of the high N cultures showing large lesions with excessive sporulation, whereas infected leaves from the low N cultures exhibited successful defence with only small chlorotic lesions and no sporulation. This might be explained by biosynthesis of phenylpropanoids in the young leaves of the resistant trees. A negative correlation between shoot growth of apple trees and the concentration of phenolic compounds in young leaves was found. Studies on in vitro shoot cultures revealed that the availability of sugars for the phenylpropanoid pathway is a strong regulatory factor. The ratio of sucrose and nitrogen in the medium influenced the total level of secondary products in the in vitro grown plantlets. Moreover, the relative deficiency of sugars was responsible for a metabolic block mainly at the level of glucosyl transferase and concomitant aglycone accumulation. [source]


An epidemiological study of renal pathology in tuberous sclerosis complex

BJU INTERNATIONAL, Issue 6 2004
Finbar J. O'Callaghan
OBJECTIVES To report the frequency of renal symptoms and complications of patients with tuberous sclerosis complex (TSC), to describe the ultrasonographic appearance of the kidneys in a population-based sample, and to investigate the relationship between a history of renal haemorrhage and renal lesions identified by ultrasonography. PATIENTS AND METHODS As part of an epidemiological study, 179 patients with TSC were identified as living in the Wessex Region in the South of England. Patients were interviewed and examined in their homes, to elicit the presence of renal symptoms or a history of renal complications. Renal ultrasonography was used in consenting patients in their homes. RESULTS There was a history of renal complications in 16 (9%) patients; 149 consented to interview and examination, and 19 gave a history of renal symptoms in the previous year; 124 had renal ultrasonography; 86 (69%) had renal angiomyolipomas and 37 (30%) had renal cysts. Large lesions (>3 cm in diameter) were strongly associated with a history of symptomatic bleeding, although significant haemorrhage occurred in a 6-year-old child with small angiomyolipomas. CONCLUSIONS The formation of angiomyolipoma in TSC is common. Polycystic kidney disease, renal carcinoma and renal failure, although rare, occur in TSC. Most patients with angiomyolipomas have neither complications nor symptoms. There was no appreciable difference between the sexes in the risk of developing these lesions. Although less commonly seen in the very young, there is no identifiable relationship after adolescence between age and the risk of having a renal angiomyolipoma. Bleeding tends to occur from large lesions (>3 cm) but most such patients have remained asymptomatic to date. [source]


Survey of U.K. current practice in the treatment of lentigo maligna

BRITISH JOURNAL OF DERMATOLOGY, Issue 1 2001
R. Mahendran
Background ,Lentigo maligna (LM) is the in situ phase of LM melanoma (LMM). There is a paucity of data on the natural history of LM, the risk factors for progression to LMM and on treatment outcomes of the various modalities used. Objectives ,To investigate our impression that this, combined with the difficulties of treatment for large lesions particularly in the elderly and infirm, has led to considerable variation between dermatologists in the management of LM within the U.K. Methods ,A postal questionnaire survey was performed to establish current practice. Results ,One hundred and seventy clinicians representing one-third of U.K. consultant dermatologists responded. Fifty-seven per cent of the dermatologists reported treating only one to four LMs per year, 30% treated five to 10 LMs per year and only 13% treated more than 10 LMs per year. Ninety-four per cent of the respondents routinely took an initial biopsy to confirm the diagnosis and plan treatment. The preferred treatment option was dependent on the age of the patient. Dermatologists were far more likely to use surgery for patients under the age of 60 years and more likely to use cryotherapy/radiotherapy or merely to observe with increasing age. Where surgery was used, the excision margins chosen ranged from 0 to 10 mm. Conclusions ,This survey highlights that a significant proportion of U.K. dermatologists is managing small numbers of LMs each year. On the basis of this current practice and the data in the literature on the recurrence rates for the different modalities, we propose an algorithm for treatment options. The survey, however, showed no consensus between dermatologists regarding surgical margins for excision, which is reflected in the literature; further studies to establish this are required. [source]


Ocular manifestations of molluscum contagiosum

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 6 2006
Muriel M Schornack OD FAAO
Purpose:, Two cases of molluscum contagiosum (MC) are presented to illustrate the range of potential anterior segment complications of this condition. Methods:, Clinical records for two patients diagnosed with MC are retrospectively reviewed. Diagnosis and management of both cases are presented. Results:, The first patient demonstrates a classic presentation of ocular MC. The patient was young and had several dermal lid lesions at the time of presentation. The second case represents a less common presentation. The patient was an adult and had a single lid lesion that was not apparent at the initial examination. Both patients had follicular conjunctivitis that resolved with excision of the concomitant eyelid lesions. Conclusion:, MC is a treatable cause of chronic conjunctivitis or keratoconjunctivitis. Eye-care providers should be mindful that MC could present as a follicular keratoconjunctivitis with or without obvious dermal lid lesions. The possibility of immuno-compromise must be considered in patients with multiple large lesions, cutaneous lesions that do not respond to standard therapy, or recurrent lesions. [source]