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Lesion Size (lesion + size)

Distribution by Scientific Domains

Medical Sciences	69%
Life Sciences	30%

Distribution within Medical Sciences

Dermatology	10%
Radiology & Imaging	7%
16 Other Subdomains	73%

Selected Abstracts

The Effect of Ablation Electrode Length and Catheter Tip to Endocardial Orientation on Radiofrequency Lesion Size in the Canine Right Atrium

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1 2002
RODRIGO C. CHAN
CHAN, R.C., et al.: The Effect of Ablation Electrode Length and Catheter Tip to Endocardial Orientation on Radiofrequency Lesion Size in the Canine Right Atrium. Although the determinants of radiofrequency lesion size have been characterized in vitro and in ventricular tissue in situ, the effects of catheter tip length and endocardial surface orientation on lesion generation in atrial tissue have not been studied. Therefore, the dimensions of radiofrequency lesions produced with 4-, 6-, 8-, 10-, and 12-mm distal electrode lengths were characterized in 26 closed-chested dogs. The impact of parallel versus perpendicular catheter tip/endocardial surface orientation, established by biplane fluoroscopy and/or intracardiac echocardiography, on lesion dimensions was also assessed. Radiofrequency voltage was titrated to maintain a steady catheter tip temperature of 75°C for 60 seconds. With a perpendicular catheter tip/tissue orientation, the lesion area increased from 29 ± 7 mm2 with a 4-mm tip to 42 ± 12 mm2 with the 10-mm tip, but decreased to 29 ± 8 mm2 with ablation via a 12-mm tip. With a parallel distal tip/endocardial surface orientation, lesion areas were significantly greater: 54 ± 22 mm2 with a 4-mm tip, 96 ± 28 mm2 with a 10- mm tip and 68 ± 24 mm2 with a 12-mm tip (all P < 0.001 vs perpendicular orientation). Lesion lengths and apparent volumes were larger with parallel, compared to perpendicular tip/tissue orientations, although lesion depth was independent of catheter tip length with both catheter tip/tissue orientations. Electrode edge effects were not observed with any tip length. Direct visualization using intracardiac ultrasound guidance was subjectively helpful in insuring an appropriate catheter tip/tissue interface needed to maximize lesion size. Although atrial lesion size is critically dependent on catheter tip length, it is more influenced by the catheter orientation to the endocardial surface. This information may also be helpful in designing electrode arrays for the creation of continuous linear lesions for the elimination of complex atrial tachyarrhythmias. [source]

Determinants of Lesion Sizes and Tissue Temperatures During Catheter Cryoablation

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2007
MARK A. WOOD M.D.
Background:Factors which influence lesion size from catheter-based cryoablation have not been well described. This study describes factors which influence lesion size during catheter cryoablation. Methods and Results:Cryoablation was delivered to porcine left ventricular myocardium in a saline bath using 4- or 8-mm electrode catheters. Ablation was delivered with the electrodes either vertical or horizontal to the tissue and both with and without superfusate flow over the electrode. The effect of electrode contact pressure was tested. Lesion dimensions were measured. All experiments were duplicated to measure tissue temperatures at 1-, 2-, 3-, and 5-mm deep to the ablation electrode. The 8-mm electrode produced lower tissue temperatures and larger lesion volumes when compared with the 4-mm electrode (all P < 0.05). Superfusate flow slowed the rate of tissue cooling, markedly warmed tissue temperatures, and reduced lesion volume when compared with no flow conditions. By linear regression modeling, lesion sizes and tissue temperatures were related to the presence of superfusate flow, electrode orientation, contact pressure and electrode size, or catheter refrigerant flow rate (r2 for models = 0.90,0.96, all P < 0.001). Electrode temperature predicted lesion size or tissue temperatures only when analyzed independent of electrode size or refrigerant flow rate. Conclusions:Lesion sizes and tissue temperatures during catheter cryoablation are related to convective warming, electrode orientation, electrode contact pressure, and any of the following: electrode size, catheter refrigerant flow rate or electrode temperature. However, electrode temperature may be a poor predictor of lesion size and tissue temperature for a given catheter size. [source]

Poor correlation between clinical impression, the small colonic polyp and their neoplastic risk

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2006
Ian Craig Lawrance
Abstract Background and Objectives:, ,Significance of the small colonic polyp is unclear and its removal is frequently determined by the proceduralist's clinical impression. Our aims were to determine if clinical discernment is accurate, and the likelihood that lesions <,10 mm are histologically advanced. Method:, ,We prospectively collected 1988 lesions from 854 subjects (2215 consecutive colonoscopies). Lesion size, location, patient age, sex and the colonoscopist's clinical impression was recorded. Results:, Clinical assessment for neoplasia had a sensitivity of 87.4%, specificity of 65.0%, positive predictive value of 76.0% and negative predictive value of 80.2%, resulting in an accuracy of 73.4%. Factors predictive of correct clinical impression were polyp size, location in the rectum and being pedunculated, but not the patient's age, sex or the endoscopist's experience. Of the 1434 lesions ,,5 mm in size, 44.5% were neoplastic and 3.5% were histologically advanced. Of the 266 lesions 6,9 mm, 79.3% were neoplastic, 19.9% were histologically advanced, five demonstrated high-grade dysplasia and three were malignant. Only two patients with an adenocarcinoma or high-grade dysplasia in a polyp <10 mm had a lesion ,10 mm elsewhere in the colon. Of the 288 lesions ,10 mm in size, 92.7% were neoplastic, 29.5% had a villous component, 6.9% demonstrated high-grade dysplasia and 29.2% were malignant. Factors predictive of neoplasia were patient age, polyp size and sessile nature of the lesion. Conclusion:, Polyps <,10 mm had a significant risk of neoplasia and advanced histology and, in general, clinical impression correlated poorly with neoplasia. Removal of all lesions proximal to the rectum, regardless of size, should therefore be considered. [source]

MRI of atherosclerosis in clinical trials

NMR IN BIOMEDICINE, Issue 6 2006
Chun Yuan
Abstract Magnetic resonance imaging (MRI) of the arterial wall has emerged as a viable technology for characterizing atherosclerotic lesions in vivo, especially within carotid arteries and other large vessels. This capability has facilitated the use of carotid MRI in clinical trials to evaluate therapeutic effects on atherosclerotic lesions themselves. MRI is specifically able to characterize three important aspects of the lesion: size, composition and biological activity. Lesion size, expressed as a total wall volume, may be more sensitive than maximal vessel narrowing (stenosis) as a measure of therapeutic effects, as it reflects changes along the entire length of the lesion and accounts for vessel remodeling. Lesion composition (e.g. lipid, fibrous and calcified content) may reflect therapeutic effects that do not alter lesion size or stenosis, but cause a transition from a vulnerable plaque composition to a more stable one. Biological activity, most notably inflammation, is an emerging target for imaging that is thought to destabilize plaque and which may be a systemic marker of vulnerability. The ability of MRI to characterize each of these features in carotid atherosclerotic lesions gives it the potential, under certain circumstances, to replace traditional trials involving large numbers of subjects and hard end-points , heart attacks and strokes , with smaller, shorter trials involving imaging end-points. In this review, the state of the art in MRI of atherosclerosis is presented in terms of hardware, image acquisition protocols and post-processing. Also, the results of validation studies for measuring lesion size, composition and inflammation will be summarized. Finally, the status of several clinical trials involving MRI of atherosclerosis will be reviewed. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Relative susceptibility of oaks to seven species of Phytophthora isolated from oak forest soils

FOREST PATHOLOGY, Issue 6 2008
Y. Balci
Summary Isolates of Phytophthora cambivora, P. cinnamomi, P. citricola, P. europaea, P. quercetorum and two unidentified species were tested for their pathogenicity to eastern US oak species by root and stem inoculations. Experiments were conducted during two different periods and included 1-, 2- and 20-year-old oaks grown under greenhouse and field conditions. Species of Phytophthora were pathogenic in varying degrees to the oak species tested. All species were pathogenic to fine and taproots of at least one oak species. The fine root damage caused by the species of Phytophthora ranged from 9 to 55% when compared to the controls. Roots were more susceptible during the fall inoculation period than the summer. With exception of Phytophthora sp1 and P. quercina -like, all species of Phytophthora were pathogenic to oak stems with P. cinnamomi and P. citricola being the most aggressive. Quercus montana and Q. rubra were the most susceptible oak species to stem inoculation. Lesion sizes were considerably larger when 20-year-old trees were inoculated. Generally, no significant differences in lesion sizes were detected in greenhouse tests when the summer and fall inoculation periods were compared. However, on 2-year-old field-grown seedlings, lesion sizes were considerably smaller or not significantly different from controls during the fall inoculation period, suggesting lower, late season temperatures may restrict lesion development. [source]

Determinants of Lesion Sizes and Tissue Temperatures During Catheter Cryoablation

Mohs Micrographic Surgery: How ACMS Fellowship Directors Practice

DERMATOLOGIC SURGERY, Issue 5 2009
ANGELA S. CASEY MD
BACKGROUND Mohs micrographic surgery (MMS) is widely employed in the removal of skin cancer. As this technique becomes more widely employed, it is useful to establish the patterns of care provided by American College of Mohs Surgery (ACMS),approved fellowship directors. OBJECTIVE To compile and analyze data collected annually by the ACMS to determine practice patterns and trends in MMS as performed by ACMS-approved fellowship directors. MATERIALS AND METHODS A retrospective study of case logs from 50 fellowship directors obtained from the ACMS detailing case volume, type of cancer treated, location, lesion size, wound size, number of stages, referral percentage, and type of repairs performed. RESULTS Annual case volume per surgeon has increased linearly. The incidence of squamous cell carcinoma treated using MMS is rising steadily. The size of lesions treated using MMS has decreased slightly over several decades, as has the number of stages of MMS taken per lesion. The majority of MMS performed by fellowship directors is for skin cancer on the face. Dermatologic surgeons perform most of their own reconstructions. Academic and private fellowship practice patterns are nearly identical. CONCLUSIONS ACMS-approved fellowship directors use MMS mainly for facial skin cancers, and they perform most of their own reconstructions. Practice patterns for most fellowship directors are similar. Private fellowships and academic fellowships are similar in scope and practice. [source]

The Results of Questionnaire about Endoscopic Mucosal Resection in the Stomach

DIGESTIVE ENDOSCOPY, Issue 2003
MOTOTSUGU KATO
Isolated exfoliation method of gastric endoscopic mucosal resection (EMR) as a new technique has not yet reached the popularity of the conventional EMR techniques. From the results of a questionnaire about EMR in the stomach, the isolated exfoliation method has the advantage of permitting en bloc and histologically complete resection regardless of lesion size. However, this method has the disadvantage of long performance time and high frequency of complication as well as the need for a high level of technical skill. New devices and ideas are needed for the development of the isolated exfoliation method. [source]

Critical appraisal of the mouse model of myocardial infarction

EXPERIMENTAL PHYSIOLOGY, Issue 4 2004
Naomi M. Degabriele
In order to critically evaluate the utility of a mouse model of myocardial infarction (MI) for therapeutic studies, we investigated survival, haemodynamic measurements and histopathology in mice with an occluding suture placed at one of three distinct sites along the left anterior descending coronary artery. The suture was placed at the atrioventricular juncture (High), or at two sites more distally towards the base (Middle and Low). In the High group, only 33% of animals survived 7 days after MI (P < 0.05 compared to all other groups). Only the Middle group had significantly reduced haemodynamics compared to sham-operated animals (maximum left ventricular pressure: 55.9 ± 3.5 versus 80.8 ± 5.1 mmHg, maximum change in pressure over time : 2003 ± 172 versus 4402 ± 491, P < 0.01). Histological examination showed morphological changes in all MI groups. The Middle group had larger lesions than the Low group (P < 0.05). Lesions in the anterior and lateral walls correlated, albeit weakly, with cardiac function. Power calculations indicated that, despite a certain amount of intragroup variation, the Middle Suture model may be useful for therapeutic studies to assess the effects of treatment on cardiac function and overall lesion size. [source]

Systemic induced resistance in Monterey pine

FOREST PATHOLOGY, Issue 2 2001
Bonello
The pathogenic fungus Fusarium circinatum causes pitch canker of pines. This study shows that Monterey pine (Pinus radiata), one of the most economically important pine species in the world and the main host in California, responds to infection by Fusarium circinatum in a manner consistent with systemic induced resistance. Repeated mechanical inoculations of the same trees in the field produced progressively smaller lesions over a period of 2 years, with mean lesion length decreasing significantly from 2.89 ± 0.42 cm to 1.04 ± 0.17 cm. In the greenhouse, predisposing inoculations with the pathogen induced a significant lesion length reduction, from 5.5 ± 0.21 cm in control trees to 4.46 ± 0.36 cm in predisposed trees over a period of 6 weeks. Under constant environmental conditions in a growth chamber, predisposing inoculations also induced a significant reduction in lesion size, from 3.01 ± 0.15 cm to 2.55 ± 0.18 cm over a period of 4 weeks. This is the first unequivocal report of systemic induced resistance in a conifer. Résistance systémique induite chez le Pinus radiata Fusarium circinatum est l'agent causal du ,pitch canker' des pins. Le Pinus radiata est l'un des pins les plus importants économiquement dans le monde, et le principal hôte de la maladie en Californie. Cette étude montre que P. radiata réagit régulièrement à l'infection de Fusarium circinatum d'une façon qui peut être de la résistance systémique induite. Des inoculations mécaniques répétées sur de mêmes arbres en nature ont produit progressivement des lésions dont la taille diminuait au cours d'une période de deux ans; la longueur des lésions diminuait significativement de 2.89 ± 0.42 cm à 1.04 ± 0.17 cm. En serre, des inoculations de pré-conditionnement avec le parasite ont entraîné une réduction significative de la longueur des lésions, de 5.5 ± 0.21 cm chez les témoins à 4.46 ± 0.36 cm chez les arbres pré-conditionnés, au cours d'une période de six semaines. En conditions environnementales constantes en chambre climatique, les inoculations de pré-conditionnement ont aussi induit une réduction significative de la taille des lésions, de 3.01 ± 0.15 cm à 2.55 ± 0.18 cm, en une période de 4 semaines. Ceci est la première mention non équivoque d'une résistance systémique induite chez un conifère. Induzierte systemische Resistenz in Monterey-Kiefer Der pathogene Pilz Fusarium circinatum verursacht einen Krebs an Kiefern (pitch canker). Die vorliegende Untersuchung zeigt, dass die Monterey-Kiefer (Pinus radiata), eine der ökonomisch wichtigsten Kiefernarten der Welt und Hauptwirt in Kalifornien, auf Infektionen durch Fusarium circinatum mit induzierter systemischer Resistenz reagiert. Wiederholte mechanische Inokulationen der gleichen Bäume im Feld führten zu zunehmend kleineren Läsionen über einen Beobachtungszeitraum von zwei Jahren. Die Länge der Läsionen nahm von 2.89 ± 0.42 cm auf 1.04 ± 0.17 cm signifikant ab. Im Gewächshaus bewirkten prädisponierende Inokulationen mit dem Pathogen eine signifikante Reduktion der Läsionslänge von 5.5 ± 0.21 cm in den Kontrollen auf 4.46 ± 0.36 cm in den prädisponierten Pflanzen über einen Beobachtungszeitraum von sechs Wochen. Prädisponierende Inokulationen bewirkten auch unter konstanten Umweltbedingungen in einer Klimakammer eine signifikante Abnahme der Läsionsgrösse von 3.01 ± 0.15 cm auf 2.55 ± 0.18 über eine Periode von vier Wochen. Es handelt sich hier um den ersten eindeutigen Nachweis von induzierter systemischer Resistenz bei einer Konifere. [source]

Abstract no.: 6 Endothelium-dependent relaxation by purinergic receptors in the aorta of apolipoprotein E-deficient mice

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 3 2005
A. Korda
Previously we reported that the acetylcholine-induced relaxation in the isolated aorta of apolipoprotein E-deficient (apoE -/- ) mice deteriorates after the development of atherosclerotic plaques, but remains normal in adjacent, plaque-free segments. The present study investigated the presence of functional purinergic receptors in the murine aorta, and whether their function changes before or after the development of atherosclerosis. Endothelium-dependent relaxation was measured in aorta segments of apoE -/- , C57BL6 (WT) and human apoAI-overexpressing apoE -/- mice (apoAI/apoE -/- ) on regular chow. Rings were isometrically contracted with phenylephrine to 50% of their maximum force before performing cumulative concentration-response curves to different nucleotides or their stable analogues. After the functional study, the cross-sectional area of the plaque was determined in every segment. The nucleotides induced complete (UTP, UDP, ATP) or partial (ADP) relaxation that was abolished by endothelial cell removal or nitric oxide (NO) synthase inhibition. The responses pointed to the presence of functional P2y1, P2y2 or P2y4 receptors on endothelial cells. RT-PCR confirmed the presence of P2y1 and P2y4 mRNA in the aorta of WT mice. Nucleotide responses were unaltered in lesion-free apoE -/- mice (5 months). However, in atherosclerotic segments of apoE -/- mice (18 months), the relaxation to ATP was impaired compared to age-matched WT controls (maximum amplitude (Emax) 25 ± 14%, n = 6 vs. 90 ± 3%, n = 5, P < 0.01). A similar defect was seen for the stable analogue ATP-gamma-S (Emax 36 ± 12% vs. 86 ± 3%, P < 0.01). Atherosclerotic apoE -/- segments were less sensitive to the NO donor spermineNONOate (pD2 6.74 ± 0.18) than WT segments (7.25 ± 0.20), but maximum relaxation was unaltered. In non-atherosclerotic aorta segments of the same apoE -/- mice all relaxation responses remained normal and were not different from WT. Strong negative correlations (P < 0.001) existed between lesion size and the Emax for ATP (rs = ,0.82) and ATP-gamma-S (rs = ,0.73) in apoE -/- mice. ApoAI overexpression improved the purinergic responses (Emax ATP 64 ± 9%, ATP-gamma-S 64 ± 10%, n = 5) and these were not different from WT (P > 0.05). An analysis of covariance with plaque size as covariate suggested that this benefit was secondary to the strongly reduced plaque formation in apoAI/apoE -/- mice. It is concluded that functional P2 y receptors are present on murine aortic endothelium. Furthermore, endothelium-dependent purinergic relaxation declines after plaque development. This deterioration involves decreased bioavailability of NO rather than enhanced ATP degradation. The defect is, however, not systemic since the responses remain unaltered in plaque-free segments of atherosclerosis-prone apoE -/- mice. [source]

Structured treatment interruption in patients with alveolar echinococcosis

HEPATOLOGY, Issue 2 2004
Stefan Reuter
In human alveolar echinococcosis (AE), benzimidazoles are given throughout life because they are only parasitostatic. It has been a longstanding goal to limit treatment, and recent reports suggest that, in selected cases, benzimidazoles may be parasitocidal. Previously, we showed that positron ,emission tomography (PET) using [18F]fluoro-deoxyglucose discriminates active from inactive lesions in AE. We have now performed a 3-year prospective study in 23 patients and conducted a structured treatment interruption in those without signs of PET activity. Disease progression was further assessed by ultrasound, computerized tomography, laboratory parameters, and clinical examination. We found PET-negative lesions in 15 of 23 patients and benzimidazoles were discontinued in these patients. After 18 months, patients were reevaluated, and, of the 15 initially PET-negative patients, 8 showed either new activity on PET (n = 6) or signs of clinical progression (n = 2). Reinitiation of benzimidazoles halted parasite growth again. No further progression was detected after 36 months. PET had a sensitivity of 91% for the detection of active lesions. In conclusion, despite successful suppression of metabolic activity, in most cases benzimidazoles do not kill the parasite. PET is a reliable tool for assessing metabolic activity and for timely detection of relapses. Neither duration of treatment, kind of treatment, lesion size, calcifications, or regressive changes reliably indicate parasite death. We discourage the discontinuation of benzimidazoles in inoperable AE even after many years of treatment. However, patients with a poor compliance of benzimidazole intake or patients suffering from side effects to benzimidazoles might be assessed for PET negativity. If permanent discontinuation of benzimidazoles is attempted, the course of disease should be followed by PET. (HEPATOLOGY 2004;39:509,517.) [source]

Treatment response to transcatheter arterial embolization and chemoembolization in primary and metastatic tumors of the liver

HPB, Issue 6 2008
Avo Artinyan
Abstract Introduction. Transcatheter arterial embolization (TAE) and chemoembolization (TACE) are increasingly used to treat unresectable primary and metastatic liver tumors. The purpose of this study was to determine the objective response to TAE and TACE in unresectable hepatic malignancies and to identify clinicopathologic predictors of response. Materials and methods. Seventy-nine consecutive patients who underwent 119 TAE/TACE procedures between 1998 and 2006 were reviewed. The change in maximal diameter of 121 evaluable lesions in 56 patients was calculated from pre and post-procedure imaging. Response rates were determined using Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. The Kaplan-Meier method was used to compare survival in responders vs. non-responders and in primary vs. metastatic histologies. Results. TAE and TACE resulted in a mean decrease in lesion size of 10.3%±1.9% (p<0.001). TACE (vs. TAE) and carcinoid tumors were associated with a greater response (p<0.05). Lesion response was not predicted by pre-treatment size, vascularity, or histology. The RECIST partial response (PR) rate was 12.3% and all partial responders were in the TACE group. Neuroendocrine tumors, and specifically carcinoid lesions, had a significantly greater PR rate (p<0.05). Overall survival, however, was not associated with histology or radiologic response. Discussion. TAE and TACE produce a significant objective treatment response by RECIST criteria. Response is greatest in neuroendocrine tumors and is independent of vascularity and lesion size. TACE appears to be superior to TAE. Although an association of response with improved survival was not demonstrated, large cohort studies are necessary to further define this relationship. [source]

Biopsy site selection for endobronchial ultrasound guide-sheath transbronchial biopsy of peripheral lung lesions

INTERNAL MEDICINE JOURNAL, Issue 2 2008
D. I. K. Fielding
Abstract Background: Choice of biopsy method for peripheral lung lesions is usually between CT-guided fine-needle aspiration biopsy (CT FNA) and bronchoscopy. Endobronchial ultrasound guide-sheath biopsy (EBUS GS) is a new method to improve the yield of bronchoscopy. Guidance on which lesions would be appropriate for either method is needed. The aim of the study was to compare the diagnostic yields and pneumothorax rate of EBUS GS and CT FNA in terms of the location of the lesion needing biopsy, in particular, whether the lesion is touching the pleura. Methods: Prospective series of EBUS GS were compared to retrospective review of CT FNA carried out simultaneously in a large teaching hospital. Results: For EBUS GS 140 cases were carried out with mean lesion size 29 mm. Overall diagnostic sensitivity was 66%. For lesions not touching visceral pleura it was 74% compared with 35% where it was on the pleura (P < 0.01). For CT FNA 121 cases were carried out with mean lesion size 37 mm. The overall diagnostic sensitivity was 64%. Rate of pneumothorax and ICC placement in EBUS GS was 1 and 0% and in CTFNA was 28 and 6%, with P < 0.001 for both. Conclusion: Lesion location, in particular, connection to the visceral pleura, can improve decision-making in referral for either CT FNA or EBUS GS to maximize diagnostic yield and minimize pneumothorax rate. [source]

Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis

INTERNATIONAL ENDODONTIC JOURNAL, Issue 6 2001
V. Peciuliene
Abstract Aims The aim of this study was to determine the occurrence and role of yeasts, enteric gram-negative rods and Enterococcus species in root-filled teeth with chronic apical periodontitis, and the antimicrobial effect of iodine potassium iodide (IKI) irrigation. Methodology Forty symptom-free root-filled teeth with chronic apical periodontitis were included in the study. The patients were divided into two groups. In group A the canals were filled with calcium hydroxide for 10,14 days after cleaning and shaping; in group B the canals were irrigated with IKI for 5 min after cleaning and shaping followed by a permanent root filling. Microbiological samples were taken from the canals before and after the chemomechanical preparation and after iodine irrigation (group B). Results Microbes were isolated from 33 of 40 teeth in the initial sampling. Yeasts were isolated from six teeth, three of them together with E. faecalis. Enteric rods (Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis) were present in three teeth and E. faecalis was isolated from 21 of the 33 culture positive teeth, 11 in pure culture. Growth was detected in 10 teeth of the second samples. Six of the 10 cases were E. faecalis, with five being a pure culture. All third samples (after IKI) except one were negative. The number of microbial cells per sample did not correlate with lesion size. Two flare-ups were recorded, both in teeth with a mixed infection. Conclusion The high prevalence of enteric bacteria and yeasts in root-filled teeth with chronic apical periodontitis was established. IKI improved the antimicrobial effect of the treatment. [source]

Efficacy and safety of pimecrolimus cream 1% in adult patients with vitiligo: Results of a randomized, double-blind, vehicle-controlled study

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 11 2006
Markus Dawid
Pimecrolimus; Elidel®; Vitiligo Summary Background: Vitiligo is an acquired, pigmentary skin disorder which is disfiguring and difficult to treat. In an earlier open label study in adult patients with vitiligo, pimecrolimus cream 1% was reported to have similar efficacy as clobetasol propionate 0.05%. We performed a double-blind, intrapatient comparison of pimecrolimus cream 1% with placebo cream. Patients and methods: Twenty adult Caucasians with symmetrical vitiligo (predominantly on extremities, none in the face) were treated b.i.d. for 6 months left/right with pimecrolimus/vehicle (N = 10) or vehicle/pimecrolimus (N = 10), respectively. Primary efficacy endpoint was the size of the target lesion at month 6 and secondary efficacy endpoint was re-pigmentation. Results: Treatment with pimecrolimus cream 1% or vehicle resulted in no significant change in mean target lesion size. Modest repigmentation (1,25%) was noted with pimecrolimus at month 2 in 12 of 17 patients (vehicle: 9 of 17 patients). Afterwards, the number of patients who experienced an improvement of pigmentation steadily decreased (3 of 14 patients with pimecrolimus and 2 of 14 with placebo at month 6).Treatment was well tolerated. There were no treatment-related adverse events, no induction of skin atrophy nor any other application site side effects. Conclusion: In this group of adult patients with symmetrical vitiligo, treatment of body lesions (except face) with pimecrolimus cream 1% could not be shown to be effective. Zusammenfassung Hintergrund: Vitiligo ist eine erworbene Pigmentstörung der Haut, die entstellend und schwer zu behandeln ist. In einer früheren offenen Studie an erwachsenen Patienten mit Vitiligo wurde mit Pimecrolimus-Creme 1% eine ähnliche Wirksamkeit beobachtet wie mit Clobetasol propionat 0.05%. Bei der vorliegenden Studie handelte es sich um einen doppelblinden, intraindividuellen Vergleich von Pimecrolimus-Creme 1% und Plazebo-Creme. Patienten und Methodik: Zwanzig erwachsene Patienten weißer Hautfarbe mit symmetrischer Vitiligo (vorwiegend an den Extremitäten) wurden zweimal täglich über 6 Monate im Halbseitenvergleich mit Pimecrolimus/Cremegrundlage (N = 10) oder Cremegrundlage/Pimecrolimus (N = 10) behandelt. Primärer Endpunkt war die Größe der behandelten Läsion, sekundärer Endpunkt der Prozentsatz an Repigmentierung. Ergebnisse: Die Behandlung mit Pimecrolimus-Creme 1% oder Vehikel ergab keine signifikante ,nderung der durchschnittlichen Größe der Läsion. Eine mäßige (1,25%) Repigmentierung wurde mit Pimecrolimus bei 12 von 17 (Grundlage:9 von 17) Patienten in Monat 2 beobachtet. Anschließend nahm die Anzahl der Patienten, die eine Repigmentierung aufwiesen, kontinuierlich ab (3 von 14 unter Pimecrolimus, 2 von 14 unter Grundlage im Monat 6). Die Behand-lung wurde gut vertragen. Es gab keine behandlungsbedingten Zwischenfälle und keine Induktion von Hautatrophie oder irgendwelche anderen Nebenwirkungen an der Applikationsstelle. Schlussfolgerung: In dieser Gruppe erwachsener Patienten mit symmetrischer Vitiligo konnte eine Wirksamkeit der Behandlung von Läsionen am Körper (nicht Gesicht) mit Pimecrolimus-Creme nicht gezeigt werden. [source]

Endoscopic ultrasound guided fine needle aspiration of solid pancreatic lesions: Performance and outcomes

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2009
Leon Fisher
Abstract Background and Aim:, We report our single-centre experience with endoscopic ultrasound guided fine needle aspiration (EUS-FNA) of solid pancreatic lesions with regard to clinical utility, diagnostic accuracy and safety. Methods:, We prospectively reviewed data on 100 consecutive EUS-FNA procedures performed in 93 patients (54 men, mean age 60.6 ± 12.9 years) for evaluation of solid pancreatic lesions. Final diagnosis was based on a composite standard: histologic evidence at surgery, or non-equivocal malignant cytology on FNA and follow-up. The operating characteristics of EUS-FNA were determined. Results:, The location of the lesions was pancreatic head in 73% of cases, the body in 20% and the tail in 7%. Mean lesion size was 35.1 ± 12.9 mm. The final diagnosis revealed malignancy in 87 cases, including adenocarcinomas (80.5%), neuroendocrine tumours (11.5%), lymphomas (3.4%) and other types (4.6%). The FNA findings were: 82% interpreted as malignant cytology, 1% as suspicious for neoplasia, 1% as atypical, 7% as benign process and 9% as non-diagnostic. No false-positive results were observed. There was a false-negative rate of 5%. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 94.3%, 100%, 100%, 72.2% and 95%, respectively. In 23 (88.5%) of 26 aspirated lymph nodes malignancy was found. Minor complications occurred in two patients. Conclusions:, Our experience confirms that EUS-FNA in patients with suspected solid pancreatic lesions is safe and has a high diagnostic accuracy. This technique should be considered the preferred test when a cytological diagnosis of a pancreatic mass lesion is required. [source]

Subcortical lesions after transient thread occlusion in the rat: T2 -weighted magnetic resonance imaging findings without corresponding sensorimotor deficits

JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2005
Susanne Wegener MD
Abstract Purpose To investigate infarct evolution and functional consequences of exclusive subcortical or cortico-subcortical strokes, transient middle cerebral artery occlusion (MCAO) was conducted in Wistar rats. Materials and Methods MCAO was induced in male Wistar rats (260,300 g) for 60 minutes. Lesion volumes and absolute T2 times on magnetic resonance imaging (MRI) were assessed 1 and 14 days after MCAO using a 4.7-T MRI animal scanner in conjunction with functional testing (adhesive tape removal, cylinder test, and ledged beam walking). Results Functional test scores were not distinguishable between sham-operated animals (N = 5) and those with exclusive caudoputaminal infarct (N = 8; group cp), but showed significant deficits in animals with cortico-subcortical infarction (N = 10; group cp+). The cp group had lower absolute T2 times and a more pronounced reduction in T2 lesion volume over time than the subcortical component in the cp+ group. There was no correlation of T2 lesion size or absolute T2 times and functional impairment in either group. Conclusion When judged from functional tests alone, subcortical ischemic lesions may not be diagnosed reliably. Furthermore, T2 -weighted (T2 -w) MRI does not well anticipate functional deficits in primarily striatal lesions. J. Magn. Reson. Imaging 2005;21:340,346. © 2005 Wiley-Liss, Inc. [source]

Use of volumetric computerized tomography as a primary outcome measure to evaluate drug efficacy in the prevention of peri-prosthetic osteolysis: A 1-year clinical pilot of etanercept vs. placebo

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 6 2003
Edward M. Schwarz
Although total hip replacement (THR) is amongst the most successful and beneficial medical procedures to date, long-term outcomes continue to suffer from aseptic loosening secondary to peri-prosthetic osteolysis. Extensive research over the last two decades has elucidated a central mechanism for osteolysis in which wear debris generated from the implant stimulates inflammatory cells to promote osteoclastogenesis and bone resorption. The cytokine tumor necrosis factor alpha (TNF,) has been demonstrated to be central to this process and is considered to be a leading target for intervention. Unfortunately, even though FDA approved TNF antagonists are available (etanercept), currently there are no reliable outcome measures that can be used to evaluate the efficacy of a drug to prevent peri-prosthetic osteolysis. To the end of developing an effective outcome measure, we evaluated the progression of lesion size in 20 patients with established peri-acetabular osteolysis (mean = 29.99 cm3, range = 2.9,92.7 cm3) of an uncemented primary THR over 1-year, using a novel volumetric computer tomography (3D-CT) technique. We also evaluated polyethylene wear, urine N-telopeptides and functional assessments (WOMAC, SF-36 and Harris Hip Score) for comparison. At the time of entry into the study baseline CT scans were obtained and the patients were randomized to etanercept (25 mg s.q., twice/week) and placebo in a double-blinded fashion. CT scans, urine and functional assessments were also obtained at 6 and 12 months. No serious adverse drug related events were reported, but one patient had to have revision surgery before completion of the study due to aseptic loosening. No remarkable differences between the groups were observed. However, the study was not powered to see significant drug effects. 3D-CT data from the 19 patients was used to determine the mean increase in lesion size over 48 weeks, which was 3.19 cm3 (p < 0.0013). Analysis of the urine N-telopeptides and functional assessment data failed to identify a significant correlation with wear or osteolysis. In conclusion, volumetric CT was able to measure progression of osteolysis over the course of a year, thus providing a technology that could be used in therapeutic trials. Using the data from this pilot we provide a model power calculation for such a trial. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]

Wheat Resistance to Spot Blotch Potentiated by Silicon

JOURNAL OF PHYTOPATHOLOGY, Issue 5 2010
Gisele Pereira Domiciano
Abstract Spot blotch, caused by the fungus Bipolaris sorokiniana, is one of the most important diseases on wheat. The effects of silicon (Si) on this wheat disease were studied. Plants of wheat cultivars BR-18 and BRS-208 were grown in plastic pots containing Si-deficient soil amended with either calcium silicate (+Si) or calcium carbonate (,Si). The content of Si in leaf tissue was significantly increased by 90.5% for the +Si treatment. There was no significant difference between Si treatments for calcium content, so variations in Si accounted for differences in the level of resistance to spot blotch. The incubation period was significantly increased by 40% for the +Si treatment. The area under spot blotch progress curve, number of lesions per cm2 of leaf area, and real disease severity significantly decreased by 62, 36 and 43.5% in +Si treatment. There was no significant effect of Si on lesion size. The role played by total soluble phenolics in the increased resistance to spot blotch of plants from both cultivars supplied with Si was not clear. Plants from cultivar BR-18 supplied with Si showed the highest values for concentration of lignin-thioglycolic acid derivatives during the most advanced stages of fungus infection. Chitinase activity was high at the most advanced stages of fungus infection on leaves from both cultivars supplied with Si and may have had an effect on fungus growth based on the reduction of the components of resistance evaluated. Peroxidase activity was found to be high only at 96 h after inoculation of both cultivars supplied with Si. Polyphenoloxidase activity had no apparent effect on resistance regardless of Si treatments. Results revealed that supplying Si to wheat plants can increase resistance against spot blotch. [source]

Heritability of Phenols in the Resistance of Theobroma cacao against Phytophthora megakarya, the Causal Agent of Black Pod Disease

JOURNAL OF PHYTOPATHOLOGY, Issue 9 2007
P. F. Djocgoue
Abstract The black pod disease caused by Phytophthora megakarya is responsible for 80% of the cocoa production loss in Cameroon. To assess the resistance of cocoa plants against this pathogen, necrotic lesions, phenolic content and qualitative alteration of phenolics were conducted in ICS84 and ICS95 clones (two Trinitario introduced from Trinidad) and their hybrids (families F30 and F25) derived from reciprocal cross breeding between these two parental clones after inoculation. The existence of strong hybrid vigour has been shown. Ninety percentage of the hybrid's genotypes manifested a positive heterosis effect for the development of lesion size. This suggests the existence of hybrid vigour with a genetic additive effect. F3086, F2509, F2552 and F2586 hybrids were characterized by localized lesions. Those hybrids genotypes can be considered as elite clones. In relation to analysis of total phenolics and lesion size, no maternal effect was detected in the transmission of these characters. A significant and negative correlation (r = ,0.683) (P < 0.01) has been observed between necrosis evolution and phenolics accumulation. The values of the heritability of lesion size and the total phenolic content in offsprings did not permit to show the maternal effect. Qualitative analyses of phenolics showed high flavonones content in cocoa leaves. Qualitative analyses of phenolics in ICS84, ICS95 clones and their hybrids showed a modification of the phenolics profiles, notably concerning apigenin and luteolin derivatives due to the inoculation. These compounds, along with others that were not identified, could have a role in the reaction and mechanism of defence of cocoa against P. megakarya. [source]

Incidence, Aggressiveness and In Planta Interactions of Botrytis cinerea and other Filamentous Fungi Quiescent in Grape Berries and Dormant Buds in Central Washington State

JOURNAL OF PHYTOPATHOLOGY, Issue 7 2002
F. M. Dugan
Abstract Recovery of quiescent filamentous fungi from non-symptomatic grape berries and dormant buds demonstrated dominance of Alternaria, Aureobasidium, Cladosporium, Ulocladium and other dematiaceous hyphomycetes. Up to 78% of berries contained fungi prior to harvest. Botrytis cinerea was recovered from 0.2 to 0.5% of surface-disinfested berries just subsequent to fruit set, and 1.6,4.8% of surface-disinfested, over-wintered dormant buds. In laboratory inoculations of mature grape berries with strains of Alternaria, Aureobasidium, Cladosporium, Ulocladium and Botrytis, only the latter was aggressive in rotting berry fruits. Inoculations with B. cinerea alone and in combination with strains of Alternaria, Aureobasidium, Cladosporium and Ulocladium recovered from grape demonstrated that prior occupation of wound sites by the latter fungi resulted in reduced lesion size compared to inoculation with B. cinerea alone. [source]

Dietary Cholate Is Required for Antiatherogenic Effects of Ethanol in Mouse Models

ALCOHOLISM, Issue 9 2003
Mark A. Deeg
Background: Human consumption of moderate amounts of ethanol is associated with reduced cardiovascular events. Studies examining the effect of ethanol on atherosclerosis in mouse models have yielded conflicting results that may be due to differences in dietary fat and cholate content. To determine if dietary cholate influences ethanol's effect on atherosclerosis, we fed apolipoprotein E,/, and low-density lipoprotein receptor (LDLR),/, mice different liquid diets with or without ethanol. Methods: Apolipoprotein E,/, mice were fed a low-fat or high saturated fat, cholate-containing diet with or without ethanol for 3 to 10 weeks, and LDLR,/, mice were fed a low-fat, high saturated fat, or high saturated fat diet with cholate with or without ethanol for 7 weeks. At the end of the feeding study, aortic root lesion size was determined and compared with serum cholesterol, triglycerides, and high-density lipoprotein cholesterol. Because dietary cholate increases hepatic nuclear factor (NF)-,B and ethanol inhibits NF-,B, we also examined the effect of ethanol on aortic NF-,B binding activity. Results: Adding ethanol to a low-fat diet had no effect on lesion size. Similarly, ethanol had no effect on lesion size in LDLR,/, mice consuming a high saturated fat diet. Adding ethanol to a high-fat, cholate-containing diet for either strain resulted in a 25% to 50% reduction in lesion size. Dietary cholate increased and ethanol reduced NF-,B binding activity in the aorta. Conclusions: These results suggest that ethanol inhibits atherosclerosis in the presence of dietary cholate, which may occur via an anti-inflammatory mechanism. [source]

The effects of multiple passes on the epidermal thermal damage pattern in nonablative fractional resurfacing,

LASERS IN SURGERY AND MEDICINE, Issue 2 2009
Dieter Manstein MD
Background and Objective Nonablative fractional resurfacing is a concept of cutaneous re-modeling whereby laser-induced microscopic treatment zones (MTZs) are surrounded by normal viable tissue. Such thermal damage pattern with a small diameter of individual lesions allows fast re-epithelialization with minimal side effects. The purpose of this in vitro study was to determine the fraction of thermal injury per unit surface area (fill factor) and lesion size in relation to pulse energy and number of passes. Methods Full thickness abdominal skin samples were exposed ex vivo to the Fraxel SR 750 laser (Reliant Technologies, Mountain View, CA). One set of exposures was performed for pulse energies in the range of 8 to 40 mJ for a single pass at 250 MTZ/cm2. A second set of exposures was performed at 10 mJ with number of passes from 1 to 30. The thermal damage pattern was assessed by incubation of epidermal sheets with NitroBlueTetrazoliumChloride (NBTC) stain. Size of individual MTZ and fill factor were determined by image analysis (ImageJ, NIH, Bethesda, MD) of digital micrographs. Results Width of the thermal injury zone was directly related to the pulse energy used. The fill factor did not have a uniform relationship with the number of passes. Due to the stochastic placement of individual MTZs, even for greater number of passes, some residual undamaged tissue was found. Due to formation of thermal damage clusters, defined as overlapping individual MTZs, the size of the resulting clustering lesions which we defined as microscopic treatment cluster (MTC) increased linearly as a function of the number of passes. Conclusion We have described the fill factor as it relates to the number of passes and have demonstrated that the average size of individual lesions depends on the number of passes. Clustering of MTZs lead to the development of MTC, the average size of which increased with the number of passes. The clinical implications of these findings are contingent on further studies. Lasers Surg. Med. 41:149,153, 2009. © 2009 Wiley-Liss, Inc. [source]

Real-time MR temperature mapping of rabbit liver in vivo during thermal ablation

MAGNETIC RESONANCE IN MEDICINE, Issue 2 2003
Claudia Weidensteiner
Abstract It has been shown that quantitative MRI thermometry using the proton resonance frequency (PRF) method can be used to noninvasively monitor the evolution of tissue temperature, and to guide minimally-invasive tumor ablation based on local hyperthermia. Although hepatic tumors are among the main targets for thermal ablation, PRF-based temperature MRI of the liver is difficult to perform because of motion artifacts, fat content, and low T. In this study the stability of real-time thermometry was tested on a clinical 1.5 T scanner for rabbit liver in vivo. The fast segmented EPI principle was used together with respiratory gating to limit respiratory motion artifacts. Lipid signal suppression was achieved with a binomial excitation pulse. Saturation slabs were applied to suppress artifacts due to flowing blood. The respiratory-gated MR thermometry in the rabbit liver in vivo showed a standard deviation (SD) of 1,3°C with a temporal resolution of 3 s per slice and 1.4 mm × 1.9 mm spatial resolution in plane (slice thickness = 5 mm). The method was used to guide thermal ablation experiments with a clinical infrared laser. The estimated size of the necrotic area, based on the thermal dose calculated from MR temperature maps, corresponded well with the actual lesion size determined by histology and conventional MR images obtained 5 days posttreatment. These results show that quantitative MR temperature mapping can be obtained in the liver in vivo, and can be used for real-time control of thermal ablation and for lesion size prediction. Magn Reson Med 50:322,330, 2003. © 2003 Wiley-Liss, Inc. [source]

Textural analysis of contrast-enhanced MR images of the breast

MAGNETIC RESONANCE IN MEDICINE, Issue 1 2003
Peter Gibbs
Abstract Texture analysis was applied to high-resolution, contrast-enhanced (CE) images of the breast to provide a method of lesion discrimination. Significant differences were seen between benign and malignant lesions for a number of textural features, including entropy and sum entropy. Using logistic regression analysis (LRA), a diagnostic accuracy of Az = 0.80 ± 0.07 was obtained with a model requiring only three parameters. By initially dividing the patient data into training and test datasets, reasonable model robustness was also established. On combining features obtained using textural analysis with lesion size, time to maximum enhancement, and patient age, a diagnostic accuracy of Az = 0.92 ± 0.05 was demonstrated. Magn Reson Med 50:92,98, 2003. © 2003 Wiley-Liss, Inc. [source]

Functional analysis of the Alternaria brassicicola non-ribosomal peptide synthetase gene AbNPS2 reveals a role in conidial cell wall construction

MOLECULAR PLANT PATHOLOGY, Issue 1 2007
KWANG-HYUNG KIM
SUMMARY Alternaria brassicicola is a necrotrophic pathogen causing black spot disease on virtually all cultivated Brassica crops worldwide. In many plant pathosystems fungal secondary metabolites derived from non-ribosomal peptide synthetases (NPSs) are phytotoxic virulence factors or are antibiotics thought to be important for niche competition with other micro-organisms. However, many of the functions of NPS genes and their products are largely unknown. In this study, we investigated the function of one of the A. brassicicola NPS genes, AbNPS2. The predicted amino acid sequence of AbNPS2 showed high sequence similarity with A. brassicae, AbrePsy1, Cochliobolus heterostrophus, NPS4 and a Stagonospora nodorum NPS. The AbNPS2 open reading frame was predicted to be 22 kb in length and encodes a large protein (7195 amino acids) showing typical NPS modular organization. Gene expression analysis of AbNPS2 in wild-type fungus indicated that it is expressed almost exclusively in conidia and conidiophores, broadly in the reproductive developmental phase. AbNPS2 gene disruption mutants showed abnormal spore cell wall morphology and a decreased hydrophobicity phenotype. Conidia of abnps2 mutants displayed an aberrantly inflated cell wall and an increase in lipid bodies compared with wild-type. Further phenotypic analyses of abnps2 mutants showed decreased spore germination rates both in vitro and in vivo, and a marked reduction in sporulation in vivo compared with wild-type fungus. Moreover, virulence tests on Brassicas with abnps2 mutants revealed a significant reduction in lesion size compared with wild-type but only when aged spores were used in experiments. Collectively, these results indicate that AbNPS2 plays an important role in development and virulence. [source]

High dose levodopa therapy is not toxic in multiple system atrophy: Experimental evidence

MOVEMENT DISORDERS, Issue 7 2007
Nadia Stefanova MD
Abstract Levodopa is generally regarded the first choice therapy for parkinsonism associated with multiple system atrophy (MSA-P). However, MSA-P patients often show a poor or unsustained levodopa response which inflicts high dose therapy. This is generally attributed to progressive striatal degeneration with loss of dopamine receptors. Experimental evidence suggests that dopaminergic stimulation may accelerate the striatal disease process in MSA, possibly by pro-oxidative mechanisms. Intact nigrostriatal dopamine release augments striatal lesion size in the unilateral nigral and striatal double lesion rat model of MSA-P. Further, neuronal vulnerability to exogenous oxidative stress is increased in a transgenic MSA mouse model with oligodendroglial ,-synuclein inclusions. The aim of the present study was to analyze whether high dose levodopa delivery in the transgenic MSA model is associated with neurotoxicity exacerbated by the presence of oligodendroglial ,-synuclein inclusion pathology. Control and transgenic MSA mice underwent pulsatile treatment with either vehicle, low or high dose levodopa for a period of 1 month. Behavioral and neuropathological indices failed to show evidence for neurotoxic effects of high-dose levodopa in this ,-synuclein transgenic MSA model. These findings support the idea that high dose levodopa therapy in MSA is not detrimental to the underlying neuropathological process. © 2007 Movement Disorder Society [source]