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Salahshour F, Tefagh G, Safaei M, Azmoudeh ardalan F, Ayoobi yazdi N, Sedighi N. Extramedullary hematopoiesis (EMH) in the liver allograft presenting with a mass-like lesion. Radiol Case Rep 2023; 18:2325-2328. [PMID: 37179804 PMCID: PMC10173390 DOI: 10.1016/j.radcr.2023.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 05/15/2023] Open
Abstract
This is a rare case of extramedullary hematopoiesis (EMH) presenting as a mass-like lesion in liver allograft. Our patient was a 57-year-old woman who had undergone liver transplantation due to hepatic epithelioid hemangioendothelioma. She presented with an ill-defined hypoechoic lesion on ultrasound which showed features of focal EMH on pathologic examinations. While transient intrahepatic hematopoiesis has been reported in liver transplant patients, focal EMH mass lesion is a rarely encountered phenomenon. Therefore, focal EMH may need to be considered as a differential diagnosis when encountering a mass in post liver transplant patients.
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Affiliation(s)
- Faeze Salahshour
- Department of Radiology, Advanced Diagnostic and Interventional Radiology, Research Center, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazale Tefagh
- Department of Radiology, Advanced Diagnostic and Interventional Radiology, Research Center, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoume Safaei
- Cancer Institute, Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Gharib Street, Tehran, Iran
- Corresponding author.
| | - Farid Azmoudeh ardalan
- Cancer Institute, Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Gharib Street, Tehran, Iran
| | - Niloofar Ayoobi yazdi
- Department of Radiology, Advanced Diagnostic and Interventional Radiology, Research Center, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Sedighi
- Department of Radiology, Advanced Diagnostic and Interventional Radiology, Research Center, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Motevalli M, Allameh A, Tefagh G, Pouraliakbar H, Rabiei P, Asadian S, Kiani Amin K, Houshmand G, Mohammadi-Vajari MA. The Use of Feature Tracking Technique for the Quantification of Ventricular Strain Pattern in Patients with Ebstein's Anomaly: A Case-Control Study. Iran J Med Sci 2022; 47:314-319. [PMID: 35919073 PMCID: PMC9339115 DOI: 10.30476/ijms.2021.90064.2088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/17/2021] [Accepted: 07/08/2021] [Indexed: 11/19/2022]
Abstract
Background Ebstein's anomaly (EA) is a congenital heart disorder characterized by abnormal function of the tricuspid valve. There are several ways to study tissue composition using magnetic resonance imaging (MRI). One of the most accurate methods is strain calculation using the feature tracking (FT) technique. Due to the novelty of the FT technique in cardiac magnetic resonance (CMR) imaging, there is a lack of comprehensive guidelines to conduct FT-MRI and to present a quantitative report. The current study is aimed to evaluate the FT technique in EA patients and to compare the obtained numerical values with those of healthy individuals. Methods A total of 33 individuals were enrolled in a study conducted in 2018-2019 at Shahid Rajaei Hospital, Tehran, Iran. Radial, longitudinal, and circumferential strain patterns of the left and right ventricles were determined in both the patients and the controls using the FT technique. Data were analyzed using SPSS software, version 22.0. Results The results showed a significantly lower left ventricular (LV) radial strain in EA patients compared to the control group (P=0.002). In addition, the right ventricular (RV) global longitudinal strain (GLS) in EA patients was significantly lower than in the controls (P=0.001). Other parameters (LV global longitudinal strain, RV radial strain, LV circumferential strain, and RV circumferential strain) did not differ significantly between the two groups. Conclusion Determination of strain patterns using cardiac MRI is a promising method for the diagnosis of EA. Markers such as LV longitudinal strain and RV-GLS are the most suitable parameters for the early diagnosis of heart dysfunction.
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Affiliation(s)
- Marzieh Motevalli
- Rajaie Cardiovascular, Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Allameh
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ghazale Tefagh
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular, Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Rabiei
- Rajaie Cardiovascular, Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sanaz Asadian
- Rajaie Cardiovascular, Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Kasra Kiani Amin
- Rajaie Cardiovascular, Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Golnaz Houshmand
- Rajaie Cardiovascular, Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Ali Mohammadi-Vajari
- Department of Radiology, Hazrat Rasoul Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Jamali A, Karbalai S, Tefagh G, Jamali R, Ahmadi A. The Effects of Helicobacter Pylori Eradication on Liver Function and Metabolic Profile in Non-diabetic Non-alcoholic Steatohepatitis: A 5-year Randomized Clinical Trial. Middle East J Dig Dis 2022; 14:85-95. [PMID: 36619724 PMCID: PMC9489323 DOI: 10.34172/mejdd.2022.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 08/07/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND: To evaluate the effects of Helicobacter pylori (HP) eradication on liver function tests (LFT) and fat content (LFC) in non-diabetic non-alcoholic steatohepatitis (NASH). METHODS: This randomized clinical trial included dyspeptic HP infected non-diabetic NASH participants. The intervention arm received HP eradication treatment, while the control arm did not get any HP treatment. In the meantime, the standard management of NASH was performed in both trial arms. Mean alterations in LFT were the primary outcome and the secondary outcomes included the mean changes in LFC and serum metabolic profile. The trial follow-up period was 5 years. RESULTS: 40 participants (female: 20), with a mean age of 41.58 (±12.31) years, were enrolled in the study. The HP eradication arm included 20 participants (female: 11) with a mean age of 40.25 (±10.59) years, and the control arm consisted of 20 individuals (female: 9) with a mean age of 42.90 (±13.97) years. The tests of within-subjects effects showed a significant decrease in mean serum alanine aminotransferase (ALT; P=0.007), triglyceride (TG; P=0.04), cholesterol (P=0.004), and fasting blood sugar (FBS; P<0.001), and an increase in high-density lipoprotein (HDL; P=0.04) in both research groups during the study period. The tests of between-subjects effects demonstrated a more significant decrement of FBS in HP eradicated patients than the controls (P=0.02). The reduction in waist circumference, aspartate aminotransferase (AST), ALT, alkaline phosphatase, triglyceride, cholesterol, low-density lipoprotein, insulin, and LFC were more prominent in the intervention group than the controls; however, these differences were not statistically significant. CONCLUSION: Adding HP eradication treatment to standard NASH treatment showed more therapeutic effect thanthe standard NASH treatment protocol alone regarding the decrement of FBS in participants with dyspeptic non-diabetic NASH. Considering the non-statistically significant improvement in other metabolic indices and LFT in this trial, further studies are recommended.
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Affiliation(s)
- Arsia Jamali
- Department of Internal Medicine, Eisenhower Medical Center, California, USA
| | - Shahrokh Karbalai
- Research Development Center, Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazale Tefagh
- Department of Internal Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Raika Jamali
- Research Development Center, Sina Hospital; Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author: Raika Jamali, MD Research Development Center, Sina Hospital; Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran Tel:+98 21 63120000 Fax:+98 21 63124455
| | - Ayat Ahmadi
- Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Adib-Moghaddam S, Haydar AA, Razi-Khosroshahi M, Soleyman-Jahi S, Tefagh G, Grentzelos MA, Arba-Mosquera S, Kymionis GD. Predictors of Visual Acuity Improvement and Supernormal Vision After Refined Single-Step Transepithelial Photorefractive Keratectomy. J Refract Surg 2019; 35:771-780. [PMID: 31830293 DOI: 10.3928/1081597x-20191025-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/25/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate predicting factors of visual acuity improvement and achieving uncorrected (UDVA) or corrected (CDVA) distance visual acuity supernormal vision (⩾ 15/10; Snellen 20/13) 1 year after refined transepithelial photorefractive keratectomy (TransPRK). METHODS In this retrospective case series, a total of 155 eyes with myopia (mean ± standard deviation = -3.53 ± 1.81 diopters) with and without astigmatism (range = 0.25 to 4.50 diopters) were recruited and observed for 1 year. Patients underwent refined single-step TransPRK using the SCHWIND AMARIS 500 laser (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). The main predicting factors of postoperative supernormal vision and visual acuity improvements were sought by statistical modeling. RESULTS Logistic models showed mesopic contrast sensitivity, high laser fluence, and coma higher-order aberration (HOA) as predicting factors for both UDVA and CDVA super-normal vision. Myopia, astigmatism, dynamic cyclotorsion correction, optical zone, and transitional zone showed associations only in simple models and were not retained in multivariable models. According to the linear regression models, CDVA, mesopic contrast sensitivity, coma HOA, and keratometry were common predictors of both postoperative UDVA and CDVA improvement compared to preoperative UDVA. Astigmatism, optical and transitional zones, and high laser fluence were common predictors only in simple regression models. CONCLUSIONS Through statistical modeling, preoperative CDVA, mesopic contrast sensitivity, coma HOA, and simulated keratometry were found to be the main factors that predicted improvement of both postoperative CDVA and UDVA compared to preoperative CDVA. Furthermore, mesopic contrast sensitivity, coma HOA, and high laser fluence were the common predictors of achieving both CDVA and UDVA supernormal vision 1 year after refined single-step TransPRK. [J Refract Surg. 2019;35(12):771-780.].
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Adib-Moghaddam S, Soleyman-Jahi S, Tofighi S, Tefagh G, Arba-Mosquera S, Kontadakis G, Kymionis GD. Factors Associated With Ocular Cyclotorsion Detected by High-Speed Dual-Detection Eye Tracker During Single-Step Transepithelial Photorefractive Keratectomy. J Refract Surg 2018; 34:736-744. [PMID: 30428093 DOI: 10.3928/1081597x-20181001-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/24/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine demographic, surgical, and preoperative visual factors affecting the level of static and dynamic cyclotorsion (SC and DC) in eyes undergoing single-step transepithelial photorefractive keratectomy (TransPRK). METHODS In this cross-sectional study, 386 patients with different types of refractive errors scheduled for single-step TransPRK were enrolled. A comprehensive profile of personal, optic, and visual characteristics of patients as surgical parameters were collected. Statistical modeling was used to explore correlates of SC and DC before and during the refractive procedure, respectively. RESULTS There was no difference in various indices of SC and DC between right and left eyes. Lower age (beta = -0.20), uncorrected (beta = -0.99) and corrected (beta = -0.72) visual acuities, and keratometry (beta = -0.09) were significantly associated with higher ranges of DC during the laser ablation procedure. Worse mesopic contrast sensitivity (beta = 0.24) and higher (beta = 0.002, left eyes) or lower (beta = -0.002, right eyes) kappa locus also showed significant associations with a higher range of DC. In cases of SC before the procedure, amount (beta = 0.46) and axis (beta = -0.003) of the astigmatism demonstrated notable associations. CONCLUSIONS Through comprehensive modeling, age, visual axis indices, visual acuity, and contrast sensitivity were found to be the main factors significantly associated with dynamic ocular globe cyclotorsions during single-step TransPRK. This could help identify eyes at higher risk of cyclotorsion and its potential complications in refractive surgery. [J Refract Surg. 2018;34(11):736-744.].
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Adib-Moghaddam S, Soleyman-Jahi S, Tefagh G, Tofighi S, Grentzelos MA, Kymionis GD. Comparison of Single-Step Transepithelial Photorefractive Keratectomy With or Without Mitomycin C in Mild to Moderate Myopia. J Refract Surg 2018; 34:400-407. [PMID: 29889293 DOI: 10.3928/1081597x-20180402-02] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 04/02/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare efficacy and safety of single-step transepithelial photorefractive keratectomy (PRK) with or without mitomycin C (MMC) in patients with mild to moderate myopia. METHODS Patients with mild to moderate myopia (≤ -5.50 diopters [D]) underwent single-step transepithelial PRK using the Amaris laser (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). Total ablation depth (epithelium and stroma) was 160 μm or less. The right eye of each patient was treated with 0.02% MMC for 10 seconds, whereas the left eye did not receive any MMC. Corneal haze, endothelial cell indices, refraction, visual acuity, contrast sensitivity, and higher order aberrations were assessed preoperatively and postoperatively. RESULTS In this comparative case series, 71 patients (16 men and 55 women; 142 eyes) were enrolled. Mean patient age was 27.97 ± 5.74 years. Mean preoperative spherical equivalent of patients' right and left eyes were -3.20 ± 1.20 and -3.30 ± 1.20 diopters, respectively (P = .70); other preoperative visual parameters were also comparable. Incidence of 2+ grade of haze was detected in 1 (2.5%) right and 2 (5.0%) left eyes (P > .99) 3 to 6 months postoperatively. Incidence of 1+ degree of haze was also comparable. No eye developed 3+ degrees or more of haze. One year postoperatively, both eyes achieved comparable refraction, visual acuity, contrast sensitivity, and higher order aberrations, and no greater than trace haze was detected. MMC-treated eyes suffered a greater loss of endothelial cell density (P < .001) and showed higher variance in cell size (P = .001). CONCLUSIONS Single-step transepithelial PRK with or without MMC showed similar efficacy and incidence of haze in eyes with mild to moderate myopia with total ablation depths of 160 μm or less. However, MMC-treated eyes showed a worse profile of endothelial cell indices. Applications of MMC in this subgroup of patients may be reconsidered. [J Refract Surg. 2018;34(6):400-407.].
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