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Lai J, Garvey KY, Li P, Azevedo RA. Primary Ovarian Melanoma Arising From a Mature Teratoma With Melanoma In Situ Present in the Ciliated Columnar and Squamous Epithelium in a Patient With Synchronous Skin Basal Cell Carcinoma. Int J Gynecol Pathol 2021; 40:383-390. [PMID: 33560745 DOI: 10.1097/pgp.0000000000000727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Primary ovarian melanoma arising from ovarian teratomas are rarely reported and difficult to accurately diagnose. Cases in the literature rely on a diagnosis of exclusion, and cases of primary ovarian melanoma with pathologic evidence of melanoma in situ are exceedingly rare. We report a case of a 66-yr-old female who presented to emergency department with abdominal pain and bloating. Computed tomography scan showed a 21 cm complex pelvic mass. An urgent laparoscopic bilateral salpingo-oophorectomy was performed. Pathologically the mass was identified as a mature teratoma. Within the cystic teratoma, there was an area showing a sheet arrangement of atypical cells. Those atypical cells were positive for Melan A, Sox10, HMB45, and c-KIT, and negative for PD-L1. Melanoma in situ was present in both the squamous and ciliated columnar epithelium. The melanoma was negative for PD-L1, and no BRAF (codon 600, exons 11, 14, and 15) or c-KIT (exons 2, 9, 10, 11, 13, 14, 15, 17, 18) mutations were identified, thus supporting the so-called triple negative malignant melanoma. A thorough dermatologic exam was conducted and only a 3 mm skin basal cell carcinoma was confirmed on biopsy. At 11 mo of follow-up, the patient is disease free and doing well and no metastatic melanoma has been identified. To the best of our knowledge, this is the first documented case of a primary ovarian melanoma arising in a mature teratoma with evidence of melanoma in situ present in both ciliated columnar and squamous epithelium in a patient with synchronous skin basal cell carcinoma. Our case is positive for c-KIT protein (CD117) by immunohistochemistry, but negative for KIT mutation. More case reports are needed to further characterize the disease.
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Amer HZM, Ren R, Shen R. Biphasic chest wall synovial sarcoma with epithelial pleural effusion: a diagnostic challenge. J Am Soc Cytopathol 2019; 8:293-298. [PMID: 31078450 DOI: 10.1016/j.jasc.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 06/09/2023]
Abstract
Synovial sarcoma (SS) is a rare malignancy that most commonly involves the extremities and large joints. We describe a 67-year-old woman who presented with shortness of breath and flu-like symptoms, and a chest wall mass. On resection of the mass biphasic morphology of SS was noted, as well as confirmatory immunostains including TLE1 and bcl2. An SS18/SSX2 fusion transcript was detected by reverse transcriptase-DNA amplification. A year later, following chemotherapy, the patient developed a right-sided pleural effusion. Cytological examination of the fluid showed an epithelial population forming clusters and groups. TLE1 was positive, as well as fluorescent in situ hybridization analysis for the SS18/SSX2 fusion transcript. SS can be a challenging diagnosis in fluid-filled cavities, when the epithelial component predominates and its original biphasic quality is not seen. We discuss the diagnostic challenges of monophasic and biphasic SS, and updates to ancillary testing.
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Affiliation(s)
- Hoda Zeinab M Amer
- Cytopathology Department, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Rongqin Ren
- Cytopathology Department, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Rulong Shen
- Cytopathology Department, The Ohio State University Wexner Medical Center, Columbus, Ohio.
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Bucaria V, Elia R, Maruccia M, Vestita M, Boccuzzi A, Giudice G. Methylene Blue: A Color Test for a Quality De-epithelialization. Aesthetic Plast Surg 2018; 42:1434-1435. [PMID: 29654345 DOI: 10.1007/s00266-018-1126-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/25/2018] [Indexed: 11/28/2022]
Affiliation(s)
- V Bucaria
- Division of Plastic and Reconstructive Surgery, Mater Dei Hospital, 10 v. Samuel F Hahnemann, 70125, Bari, Italy
| | - R Elia
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11, Piazza Giulio Cesare, 70124, Bari, Italy.
| | - M Maruccia
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11, Piazza Giulio Cesare, 70124, Bari, Italy
| | - M Vestita
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11, Piazza Giulio Cesare, 70124, Bari, Italy
| | - A Boccuzzi
- Division of Plastic and Reconstructive Surgery, Mater Dei Hospital, 10 v. Samuel F Hahnemann, 70125, Bari, Italy
| | - G Giudice
- Division of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, 11, Piazza Giulio Cesare, 70124, Bari, Italy
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Servais AB, Valenzuela CD, Kienzle A, Ysasi AB, Wagner WL, Tsuda A, Ackermann M, Mentzer SJ. Functional Mechanics of a Pectin-Based Pleural Sealant after Lung Injury. Tissue Eng Part A 2018; 24:695-702. [PMID: 28920559 PMCID: PMC5963544 DOI: 10.1089/ten.tea.2017.0299] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/23/2017] [Indexed: 01/08/2023] Open
Abstract
Pleural injury and associated air leaks are a major influence on patient morbidity and healthcare costs after lung surgery. Pectin, a plant-derived heteropolysaccharide, has recently demonstrated potential as an adhesive binding to the glycocalyx of visceral mesothelium. Since bioadhesion is a process likely involving the interpenetration of the pectin-based polymer with the glycocalyx, we predicted that the pectin-based polymer may also be an effective sealant for pleural injury. To explore the potential role of an equal (weight%) mixture of high-methoxyl pectin and carboxymethylcellulose as a pleural sealant, we compared the yield strength of the pectin-based polymer to commonly available surgical products. The pectin-based polymer demonstrated significantly greater adhesion to the lung pleura than the comparison products (p < 0.001). In a 25 g needle-induced lung injury model, pleural injury resulted in an air leak and a loss of airway pressures. After application of the pectin-based polymer, there was a restoration of airway pressure and no measurable air leak. Despite the application of large sheets (50 mm2) of the pectin-based polymer, multifrequency lung impedance studies demonstrated no significant increase in tissue damping (G) or hysteresivity (η)(p > 0.05). In 7-day survival experiments, the application of the pectin-based polymer after pleural injury was associated with no observable toxicity, 100% survival (N = 5), and restored lung function. We conclude that this pectin-based polymer is a strong and nontoxic bioadhesive with the potential for clinical application in the treatment of pleural injuries.
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Affiliation(s)
- Andrew B. Servais
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cristian D. Valenzuela
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Arne Kienzle
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexandra B. Ysasi
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Willi L. Wagner
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Akira Tsuda
- Molecular and Integrative Physiological Sciences, Harvard School of Public Health, Boston, Massachusetts
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Steven J. Mentzer
- Laboratory of Adaptive and Regenerative Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Croley JA, Malone CH, Wagner RF. Deepithelialized flaps and grafts: applications in dermatologic surgery. Cutis 2018; 101:213-216. [PMID: 29718019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Deepithelialized flaps and grafts have been widely used by reconstructive surgeons in a diverse array of surgical specialties and have more recently made an appearance in dermatologic surgery. These techniques may be advantageous in their enabling of contour preservation of deep defects, reconstructions in areas of high mechanical tension, single-stage repairs, auricle reconstruction requiring tissue transfer, and reconstruction requiring free margins in areas with a paucity of local soft tissue. This article provides a review of the literature on deepithelialized flaps and grafts. We also highlight the use of these techniques in the field of dermatology and encourage appropriate application of deepithelialized flaps and grafts in dermatologic surgery.
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Affiliation(s)
- Julie A Croley
- Department of Dermatology, University of Texas Medical Branch, Galveston, USA
| | - C Helen Malone
- Department of Dermatology, University of Texas Medical Branch, Galveston, USA
| | - Richard F Wagner
- Department of Dermatology, University of Texas Medical Branch, Galveston, USA
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Abstract
In 12 consecutive cases of epithelial ingrowth operated on during the past 50 months, therapy included photocoagulation on the iris followed by excision of involved iris tissue and vitreous gel by means of instruments designed for vitreous surgery. Epithelium remaining on the posterior surface of the cornea, the ciliary body, and in the anterior chamber was destroyed by controlled transcorneal and transscleral cryotherapy. An intraocular air bubble was used to provide an insulating effect and a more effective, controllable freeze. All patients except two had improved vision postoperatively, and 3 of the 12 patients has postoperative visual acuity of 6/12 (20/40) or better. Similar closed-eye cryodestructive techniques have been used for treatment of enlarging epithelial cysts.
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Chun SY, Kim BS, Kwon SY, Park SI, Song PH, Yoo ES, Kim BW, Kwon TG, Kim HT. Urethroplasty using autologous urethral tissue-embedded acellular porcine bladder submucosa matrix grafts for the management of long-segment urethral stricture in a rabbit model. J Korean Med Sci 2015; 30:301-7. [PMID: 25729254 PMCID: PMC4330486 DOI: 10.3346/jkms.2015.30.3.301] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 10/30/2014] [Indexed: 11/20/2022] Open
Abstract
We conducted this study to evaluate the combined effect of acellular bladder submucosa matrix (BSM) and autologous urethral tissue for the treatment of long segment urethral stricture in a rabbit model. To prepare the BSM, porcine bladder submucosa was processed, decellularized, configured into a sheet-like shape, and sterilized. Twenty rabbits were randomized to normal control, urethral stricture, urethroplasty using BSM only or BSM/autologous urethral tissue (n=5 per group). Retrograde urethrography was performed at 4, 8, and 12 weeks postoperatively, and the grafted specimens were harvested at week 12 to evaluate urethral reconstruction through histopathologic and immunohistochemical analysis. The mean urethral width of the control, stricture, BSM, and BSM/autologous urethral tissue groups at week 12 was 10.3±0.80, 3.8±1.35, 8.8±0.84, and 9.1±1.14 mm, respectively. The histopathologic study revealed that the BSM/autologous urethral tissue graft had a normal area of urethral lumen, compact muscular layers, complete epithelialization, and progressive infiltration by vessels in the regenerated urethra. In contrast, the BSM grafts revealed keratinized epithelium, abundant collagenized fibrous connective tissue, and were devoid of bundles of circular smooth muscle. Nontransected ventral onlay-augmented urethroplasty using an acellular BSM scaffold combined with an autologous urethral tissue graft represents a feasible procedure for urethral reconstruction.
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Affiliation(s)
- So Young Chun
- Joint Institute for Regenerative Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Bum Soo Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Se Yun Kwon
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung Il Park
- Laboratory Animal Center, Yeungnam University, Daegu, Korea
| | - Phil Hyun Song
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Eun Sang Yoo
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Bup Wan Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Tae Gyun Kwon
- Joint Institute for Regenerative Medicine, Kyungpook National University Hospital, Daegu, Korea
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun Tae Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
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Cai Z, Xie Q, Wang X, Guo B, Wang X, Wang K. [Nodular histiocytic/mesothelial hyperplasia: a clinicopathologic analysis of 7 cases]. Zhonghua Bing Li Xue Za Zhi 2014; 43:256-259. [PMID: 24915817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To analyze the clinicopathologic and immunohistochemical features of nodular histiocytic/mesothelial hyperplasia (NHMH) and to improve the knowledge of this disease. METHODS Seven cases of NHMH were collected and the clinicopathologic and immunohistochemical data were analyzed with review of the literature. RESULTS Seven male patients aged from 1.5 to 5.0 years (mean 2.8). The main clinical symptom was an inguinal mass.Grossly, main pathological changes were the mural nodule or free nodule in lumen, with diameter of 0.1-0.5 cm.Histologically, the tumor cell morphology was relatively single, cohesive polygonal or oval cells which were arranged in solid sheets or nests, usually with ovoid or deeply grooved nuclei and a moderate amount of pale pink cytoplasm in the nodular collection area. The nuclei had delicate chromatin and no obvious atypia, and mitosis was incidentally found. A few scattered lymphocytes were found in the stroma. The cyst wall was lined by a single layer of mesothelial cells.Immunohistochemically, the most cells in nodular lesion were strongly positive for the histiocytic marker CD68, vimentin and α1-antichymotrypsin, while lining mesothelial cells on the wall were positive for calretinin, MC, WT1, CK5/6, CKpan and EMA. CONCLUSIONS NHMH is a rare and benign tumor-like lesion, and easy to be misdiagnozed, which should be distinguished from neuroendocrine tumors, Langerhans cell histiocytosis, seminoma, mesothelioma and so on. The correct diagnosis of this lesion depends on the clinical characteristics, morphology and immunohistochemistry.
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Affiliation(s)
- Zhaogen Cai
- Department of Pathology, First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233003, China. E-mail:
| | - Qun Xie
- Department of Pathology, First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233003, China
| | - Xiaoming Wang
- Department of Pathology, First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233003, China
| | - Bingqin Guo
- Department of Pathology, First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233003, China
| | - Xin Wang
- Department of Pathology, First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233003, China
| | - Kun Wang
- Department of Pathology, First Affiliated Hospital of Bengbu Medical College, Bengbu Medical College, Bengbu 233003, China
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Hutchens TC, Darafsheh A, Fardad A, Antoszyk AN, Ying HS, Astratov VN, Fried NM. Detachable microsphere scalpel tips for potential use in ophthalmic surgery with the erbium:YAG laser. J Biomed Opt 2014; 19:18003. [PMID: 24441945 DOI: 10.1117/1.jbo.19.1.018003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 12/18/2013] [Indexed: 05/03/2023]
Abstract
Vitreoretinal surgery is performed using mechanical dissection that sometimes results in iatrogenic complications, including vitreous hemorrhage, retinal breaks, incomplete membrane delamination, retinal distortion, microscopic damage, etc. An ultraprecise laser probe would be an ideal tool for cutting away pathologic membranes; however, the depth of surgery should be precisely controlled to protect the sensitive underlying retina. The ultraprecise surgical microprobe formed by chains of dielectric spheres for use with the erbium:YAG laser source (λ=2940 nm), with extremely short optical penetration depth in tissue, was optimized. Numerical modeling demonstrated a potential advantage of five-sphere focusing chains of sapphire spheres with index n=1.71 for ablating the tissue with self-limited depth around 10 to 20 μm. Novel detachable microsphere scalpel tips formed by chains of 300 μm sapphire (or ruby) spheres were tested on ophthalmic tissues, ex vivo. Detachable scalpel tips could allow for reusability of expensive mid-infrared trunk fibers between procedures, and offer more surgical customization by interchanging various scalpel tip configurations. An innovative method for aiming beam integration into the microsphere scalpel to improve the illumination of the surgical site was also shown. Single Er:YAG pulses of 0.2 mJ and 75-μs duration produced ablation craters in cornea epithelium for one, three, and five sphere structures with the latter generating the smallest crater depth (10 μm) with the least amount of thermal damage depth (30 μm). Detachable microsphere laser scalpel tips may allow surgeons better precision and safety compared to mechanical scalpels when operating on delicate or sensitive areas like the retina.
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Affiliation(s)
- Thomas C Hutchens
- University of North Carolina at Charlotte, Department of Physics and Optical Science, Charlotte, North Carolina
| | - Arash Darafsheh
- University of North Carolina at Charlotte, Department of Physics and Optical Science, Charlotte, North Carolina
| | | | - Andrew N Antoszyk
- Retina Service, Charlotte Eye Ear Nose and Throat Associates, Charlotte, North Carolina
| | - Howard S Ying
- Johns Hopkins University, Wilmer Eye Institute, Baltimore, Maryland
| | - Vasily N Astratov
- University of North Carolina at Charlotte, Department of Physics and Optical Science, Charlotte, North Carolina
| | - Nathaniel M Fried
- University of North Carolina at Charlotte, Department of Physics and Optical Science, Charlotte, North Carolina
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Chao AH, Gangopadhyay N, Tenenbaum MJ, Myckatyn TM. Ultrapulse carbon dioxide laser versus traditional deepithelialization in reduction mammoplasty and mastopexy: clinical outcomes and cost analysis. J Plast Reconstr Aesthet Surg 2013; 66:e387-9. [PMID: 23953674 DOI: 10.1016/j.bjps.2013.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 06/07/2013] [Accepted: 07/09/2013] [Indexed: 11/18/2022]
Affiliation(s)
- Albert H Chao
- Department of Plastic Surgery, The Ohio State University, 915 Olentangy River Road, Suite 2100, Columbus, OH 43212, USA
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Dua KS, Merrill J, Komorowski R. Neosquamous epithelium after ablation of Barrett's epithelium: cause for concern? Gastrointest Endosc 2012; 76:1082-3. [PMID: 23078943 DOI: 10.1016/j.gie.2012.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 07/05/2012] [Indexed: 12/11/2022]
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Thompson LDR. Paranasal sinus mucocele. Ear Nose Throat J 2012; 91:276-278. [PMID: 22829031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- Lester D R Thompson
- Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills, CA, USA
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Tinti C, Parma-Benfenati S. Minimally invasive technique for gingival augmentation around dental implants. INT J PERIODONT REST 2012; 32:187-193. [PMID: 22292148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This article describes a soft tissue surgical modification--the trap door technique--used to enhance contemporary patient esthetic expectations and preserve periodontal health longitudinally. This surgical modification is greatly indicated for single-stage single and multiple implant surgery to preserve the integrity of the papillae and eliminate buccal soft tissue concavity. This procedure also addresses the issue of interproximal papillary development to obviate the presence of a black triangle. The technique is very effective in cases of minimal interproximal bone loss, it does not require autogenous bone harvesting, and is therefore less invasive and well accepted by the patient.
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Fu LF, Zhang DM, Xu AE. De-epithelialization of vitiliginous area for transplantation of cultured autologous melanocyte: a case report of two patients with different methods. Int J Dermatol 2012; 51:747-9. [PMID: 22233097 DOI: 10.1111/j.1365-4632.2010.04611.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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González-Mosquera A, Seoane J, García-Caballero L, López-Jornet P, García-Caballero T, Varela-Centelles P. Er,CR:YSGG lasers induce fewer dysplastic-like epithelial artefacts than CO2 lasers: an in vivo experimental study on oral mucosa. Br J Oral Maxillofac Surg 2011; 50:508-12. [PMID: 21974898 DOI: 10.1016/j.bjoms.2011.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 09/13/2011] [Indexed: 11/18/2022]
Abstract
Our aim was to assess wounds made by lasers (CO(2) and Er,Cr:YSGG) for their epithelial architectural changes and width of damage. We allocated 60 Sprague-Dawley(®) rats into groups: glossectomy by CO(2) laser at 3 different wattages (n=10 in each); glossectomy by Er,Cr:YSGG laser at two different emissions (n=10 in each), and a control group (n=10). Histological examination assessed both prevalence and site of thermal artefacts for each group. Both lasers (CO(2) and Er,Cr:YSGG) caused the same type of cytological artefacts. The 3W Er,Cr:YSGG laser produced the fewest cytological artefacts/specimen, and was significantly different from the other experimental groups: 3W CO(2) laser (95% CI=0.8 to 1.0); the 6W CO(2) laser (95% CI=0.1 to 2.0) and the 10W CO(2) laser (95% CI=1.1 to 3.0). CO(2) lasers (3-10W) generate epithelial damage that can simulate dysplastic changes with cytological atypia that affects mainly the basal and suprabasal layers. Irradiation with Er,CR:YSGG laser (2-4W) produces significantly fewer cellular artefacts and less epithelial damage, which may be potentially useful for biopsy of oral mucosa.
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Affiliation(s)
- A González-Mosquera
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, 15782 Santiago de Compostela, Spain.
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Carranza N, Zogbi C. Reconstruction of the interdental papilla with an underlying subepithelial connective tissue graft: technical considerations and case reports. INT J PERIODONT REST 2011; 31:e45-e50. [PMID: 21845236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This article introduces a surgical technique developed to achieve soft tissue augmentation of the interproximal space. The technique was designed to minimize surgical trauma and blockage of blood supply to the existing papilla by accessing the papillary area through vertical incisions and by elevating a single full-thickness flap without disrupting the papillary bridge. A free connective tissue graft was placed beneath the undermined papilla and secured with sutures. Advantages and variations of the technique are discussed.
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Affiliation(s)
- Nelson Carranza
- Department of Periodontology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina.
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Swamy GG, Satyanarayana N. Clinicopathological analysis of ovarian tumors--a study on five years samples. Nepal Med Coll J 2010; 12:221-223. [PMID: 21744762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Ovarian neoplasms have become increasingly important not only because of the large variety of neoplastic entities but more because they have gradually increased the mortality rate due to female genital cancers. A total of 120 cases of ovarian tumors were studied at the Department of Pathology, Konaseema Institute of Medical Sciences, Amalapuram, India, during the period of March 2005 to March 2010, to find out frequency of different histological patterns of ovarian tumors at Konaseema Region. Among 120 cases, majority 86 (71.6%) were benign, but alarming number 30 (25.0%) were malignant, remaining 4 cases were borderline. The commonest histological pattern observed in the study was epithelial tumors (61.6%). The commonest benign tumor was serous cyst adenoma, while; the commonest malignant tumors were granulosa cell tumor and endometrial carcinoma. Epithelial tumors were commonest variety of ovarian tumors followed by germ cell tumors. A relatively high number of malignancies were observed in this study.
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Affiliation(s)
- G G Swamy
- Department of Pathology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India.
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Li P, Cai M, Li Z, Zhan S, Jin H, Wang S, Wang Q, Xu L, Shi B. [Long-term observation of prefabricated urethra with buccal mucosa in expanded capsule]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2009; 23:1487-1490. [PMID: 20073316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To investigate the histological and keratinous variation of prefabricated urethra in the capsule with micro-mucosa and gelatin sponge compound graft. METHODS Five 8-week-old Guizhou miniature pigs (2 females and 3 males) weighing 20-25 kg were used. Eight tissue expanders were bilaterally inserted into subcutaneous position on the dorsal thorax of each pig. Forty inserted expanders were randomized into two groups (n=20 per group). For the experimental group, the free buccal mucosa was cut into particles less than 1 mm in diameter, spread onto the gelatin sponge (3 cm x 2 cm) and then transplanted to the capsule; the area expansion ratio of autogenous micro-mucosa was 8 : 1. For the control group, soft tissue expander without mucosa graft was implanted. The pressure in inserted expander was about 40 mm Hg (1 mm Hg=0.133 kPa). Inflation should be stopped when the injected saline volume reached 15 mL. The animals were killed 1 and 2 weeks and 1, 2, and 4 months after the implant to receive examination. Microscope, histology, and immunohistochemistry changes were observed. RESULTS All the animals survived to the end of the experiment and the wounds healed by first intention. There was no obvious degeneration of gelatin sponge, and some of the mucosa survived 1 week after implant. The gelatin sponge was partly absorbed, most of the mucosa survived 2 weeks after implant. Visual examination showed complete epithelialization of the entire cavity 1 month after implant. The experimental group at 2 and 4 months were similar to that of at 1 month in gross observations. The neo-mucosa was not found in the control group at different time points after implant. Histology examination revealed that compound implant was mainly infiltrated by inflammatory cells and the micro-mucosa survived well 1 week after implant in the experimental group. The stratified squamous epithelium presented obvious polarity and the submucous neovascularization was abundant 2 weeks after implant. The compound implant achieved complete epithelialization 1 month after implant. The epithelium degeneration occurred 2 months after implant. The stratified squamous epithelium presented no abovious polarity 4 months after implant. No neo-mucosa was evident in control group at different time points. The experimental group was positive for the pan-cytokeratin staining at 1, 2 weeks, and 1, 2 months after implant, but negative at 4 months after implant. The pan-cytokeratin staining was negative in the control group at different time points. CONCLUSION The buccal micromucosa and gelatin sponge compound graft can grow well on the expanded capsule 1 month after implant and the epithelium degeneration is evident 2 months after implant. Environment of implanted mucosa has great influence on epithelium mucosa.
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Affiliation(s)
- Pengcheng Li
- Department of Urology, the 309th Hospital of Chinese PLA, Beijing, 100091, P.R. China
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Shields JA, Shields CL, Eagle RC, Friedman ES, Wheatley HM. Age-related hyperplasia of the nonpigmented ciliary body epithelium (Fuchs adenoma) simulating a ciliary body malignant neoplasm. ACTA ACUST UNITED AC 2009; 127:1224-5. [PMID: 19752438 DOI: 10.1001/archophthalmol.2009.217] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abstract
New approaches to improving corneal epithelial wound healing include stromal puncture and removal of abnormal basement membrane material by excimer laser ablation (phototherapeutic keratectomy). Non-healing corneal erosions and chemical burns may also benefit from laser excision of the damaged surface to permit more normal epithelial attachments. Reduction of postsurgical astigmatism may be facilitated by adjustable sutures after penetrating keratoplasty or by molding the cornea with the use of a rigid contact lens in the immediate postoperative period.
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Affiliation(s)
- H E Kaufman
- LSU Eye Center, Louisiana State University Medical Center, School of Medicine, New Orleans
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Lonergan I, Moquin K. Use of the VersaJet for pedicle deepithelialization during breast reduction surgery. Aesthetic Plast Surg 2009; 33:250-3. [PMID: 18752023 DOI: 10.1007/s00266-008-9217-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Accepted: 07/01/2008] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many modern techniques of breast reduction require that a pedicle of breast tissue be deepithelialized. The process of deepithelialization is both tedious and time consuming. Many techniques have been described to facilitate the process of deepithelialization in breast reduction, but none have replaced the gold standard of using the scalpel. This series details the authors' results using the VersaJet Hydrosurgery System for pedicle deepithelialization in breast reduction surgery. METHODS In this study, 20 patients underwent inferior pedicle breast reduction using the VersaJet for pedicle deepithelialization between September 2006 and June 2007. The overall time required for pedicle deepithelialization using the VersaJet was compared with the average overall time required for deepithelialization using the scalpel. Intraoperative and postoperative complications were recorded. RESULTS An overall time-savings of 10 to 25 min per case was noted using the VersaJet for pedicle deepithelialization rather than the scalpel. No intraoperative or postoperative complications were encountered due to use of the VersaJet for pedicle deepithelialization. CONCLUSIONS The VersaJet is a safe and effective tool for pedicle deepithelialization in breast reduction surgery. The VersaJet significantly facilitates the process of pedicle deepithelialization and requires less time than use of the scalpel for the procedure.
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Affiliation(s)
- Ian Lonergan
- Department of Plastic and Reconstructive Surgery, K-16, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
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Abstract
Intraspinal bronchogenic cysts are rare congenital cystic lesions. In all the reported cases, the cysts have been located in the cervical, upper thoracic or thoracolumbar segments. We report the case of an intraspinal bronchogenic cyst in the sacral location. We present the case of a 5-month-old female with a skin dimple in the midline over the sacral vertebra. Magnetic resonance image of the lumbar and sacral vertebra revealed a dermal sinus tract and an epidural cystic mass at the S2 level. The patient underwent the removal of the dermal sinus tract and the cyst. The cystic mass was shown to be connected to the subarachnoid space through a slender pedicle from the dura. The cyst was diagnosed to be a bronchogenic cyst based on the results of the histopathological examination. We conclude that intraspinal bronchogenic cysts may appear in the sacral location.
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Affiliation(s)
- Kwang-Seok Ko
- Department of Neurosurgery, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Sin-Soo Jeun
- Department of Neurosurgery, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Youn-Soo Lee
- Department of Neurosurgery, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Chun-Kun Park
- Department of Neurosurgery, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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Ungari C, Paparo F, Colangeli W, Iannetti G. Parotid glands tumours: overview of a 10-year experience with 282 patients, focusing on 231 benign epithelial neoplasms. Eur Rev Med Pharmacol Sci 2008; 12:321-325. [PMID: 19024217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Salivary gland tumours are uncommon, representing less than 6% of head and neck neoplasm. Pleomorphic adenoma is the most common benign epithelial salivary gland neoplasm, comprising 50%-74% of all parotid tumours. It is followed by Warthin's tumour (4-14%). The authors retrospectively reviewed 282 eligible patients surgically treated for parotid gland tumours in the last 10 years, focusing on 231 benign epithelial neoplasms. Clinical and diagnostic findings, surgical treatment and surgical outcome were discussed. The diagnosis of a parotid gland neoplasm must be considered in any patient presenting with a lump near the mandible. Smoking habit is important in Warthin's tumour pathogenesis. Fine needle aspiration citology (FNAC) can't lead alone to histological diagnosis. Only surgery can give histological certainty of benignity, thus preventing malignant degeneration, lump infection or risk of size-dependent surgical complications. Conservative formal parotidectomy appears to be the treatment of choice. Tumour pseudopodia and capsule ruptures are recognised factors involved in pleomorphic adenoma recurrences but also tumour multicentricity might play an important role.
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Affiliation(s)
- C Ungari
- Cattedra di Chirurgia Maxillo-Facciale, La Sapienza University, Rome, Italy
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Lee DY, Lee KJ, Kim WS, Yang JM. Presence of specialized mesenchymal cells (onychofibroblasts) in the nail unit: implications for ingrown nail surgery. J Eur Acad Dermatol Venereol 2007; 21:575-6. [PMID: 17374015 DOI: 10.1111/j.1468-3083.2006.01975.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lopes CV, Hela M, Pesenti C, Bories E, Caillol F, Monges G, Giovannini M. Circumferential endoscopic resection of Barrett's esophagus with high-grade dysplasia or early adenocarcinoma. Surg Endosc 2007; 21:820-4. [PMID: 17294308 DOI: 10.1007/s00464-006-9187-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2006] [Accepted: 11/24/2006] [Indexed: 12/28/2022]
Abstract
BACKGROUND Barrett's esophagus-related high-grade dysplasia or mucosal cancer can be treated by endoscopic mucosal resection (EMR), but the adjacent metaplastic epithelium remains at risk for developing further lesions. Our objective was to evaluate the results of the circumferential EMR in removing not only the neoplastic lesion but also the remaining Barrett's epithelium. METHODS Forty-one consecutive patients (mean age: 66 years) with Barrett's esophagus were submitted to 63 EMR sessions in one single-referral endoscopic unit. All patients had high-grade dysplasia, and cancer was detected in 23 of these cases, most of them classified as T1N0 (20 patients) by endosonography. Mucosectomy after saline submucosal injection was performed for the neoplastic lesions and, if necessary, the residual Barrett's epithelium was removed by the same technique one month later. RESULTS A retrospective evaluation showed that, during a mean follow-up of 31.6 months, Barrett's epithelium was completely replaced by squamous epithelium in 31 (75.6%) cases. There were 10 complications, all of which were managed endoscopically: 8 cases of bleeding and two perforations occurred in 9 (14.3%) patients. One patient developed an esophageal stricture. Barrett's epithelium recurred in 10 (24.4%) patients and recurrent or metachronous early cancer was detected in 5 (12.2%), all but one of which were treated again by EMR; the fifth patient was referred to surgery. Argon plasma coagulation was used in 6 cases to treat Barrett's epithelium, and two patients received concomitant chemoradiotherapy as adjuvant therapy. CONCLUSIONS Circumferential EMR provides an effective endoscopic approach to the management of Barrett's esophagus-related high-grade dysplasia and mucosal cancer. Additional studies are necessary to evaluate the long-term results.
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Affiliation(s)
- C V Lopes
- Endoscopy Unit, Paoli-Calmettes Institute, 232 Bd St-Marguerite, 13273, Marseille, Cedex 9, France
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Abstract
We report a case of parameatal urethral cyst in a 15-year-old boy which is a very rare congenital anomaly. The cyst recognized at infancy but the boy presented to our clinic at the age of 15 when the mass was grown enough to cause spraying of urine and poor cosmesis. Complete excision of the cyst with total removal of the epithelium is the required for treatment and prevention of recurrence.
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Affiliation(s)
- Metin Onaran
- School of Medicine, Urology Department, Gazi University, 12. kat, 06510, Besevler, Ankara, Turkey.
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Lee KW, Kuo WR, Ho KY, Chiang FY. Microsurgical pressing excision technique for vocal nodules and simple epithelial hyperplasia of the vocal fold. J Laryngol Otol 2006; 118:223-7. [PMID: 15068522 DOI: 10.1258/002221504322928026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Precise bimanual microsurgical excision of sessile, thin benign epithelial lesions of the vocal folds can be difficult. During microlaryngeal surgery, the potential risks of over-excision and under-excision are of major concern. We introduce a microsurgical technique using horizontally-opening curved microforceps and microscissors, instead of the conventional vertically-opening microinstruments, to remove vocal nodules and simple epithelial hyperplasia. The treatment results were satisfactory, with 208 (90.8 per cent) of patients retaining a satisfactory/normal (G0) voice. No patient had a worsened voice after the procedure. This microsurgical pressing excision technique is an alternative precise method for microlaryngosurgery.
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Affiliation(s)
- Ka-Wo Lee
- Department of Otolaryngology, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Wachtel H, Fickl S, Zuhr O, Hürzeler MB. The double-sling suture: a modified technique for primary wound closure. Eur J Esthet Dent 2006; 1:314-324. [PMID: 19655501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The attainment of primary wound closure is one of the major determining factors of success in oral surgery. Especially when dealing with regenerative or augmentative procedures, healing in a submerged environment is crucial to achieving the desired treatment result. In this context, the use of a microsurgical approach and layered suturing techniques is of utmost importance for precise and meticulous wound closure. However, microsurgical wound closure using both mattress sutures and interrupted sutures is very time consuming and may be detrimental to wound healing because of trauma and extended surgical time. The double-sling suture, a modified suture technique that combines two interrupted sutures that have different bite sizes and engage different tissue layers, is able to predictably and efficiently close the surgical site for improved wound healing. This article describes this new technique and presents two case examples.
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Affiliation(s)
- Hannes Wachtel
- Department of Restorative Dentistry University School of Dental Medicine, Benjamin Franklin Campus Charité-University Medicine, Berlin, Germany.
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Dunkin BJ, Martinez J, Bejarano PA, Smith CD, Chang K, Livingstone AS, Melvin WS. Thin-layer ablation of human esophageal epithelium using a bipolar radiofrequency balloon device. Surg Endosc 2005; 20:125-30. [PMID: 16333533 DOI: 10.1007/s00464-005-8279-9] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2004] [Accepted: 05/02/2005] [Indexed: 12/15/2022]
Abstract
BACKGROUND The goal of this study was to determine the optimal treatment parameters for the ablation of human esophageal epithelium using a balloon-based bipolar radiofrequency (RF) energy electrode. METHODS Immediately prior to esophagectomy, subjects underwent esophagoscopy and ablation of two separate, 3-cm long, circumferential segments of non-tumor-bearing esophageal epithelium using a balloon-based bipolar RF energy electrode (BARRX Medical, Inc., Sunnyvale, CA, USA). Subjects were randomized to one of three energy density groups: 8, 10, or 12 J/cm2. RF energy was applied one time (1x) proximally and two times (2x) distally. Following resection, sections from each ablation zone were evaluated using H&E and diaphorase. Histological endpoints were complete epithelial ablation (yes/no), maximum ablation depth, and residual ablation thickness after tissue slough. Outcomes were compared according to energy density group and 1x vs 2x treatment. RESULTS Thirteen male subjects (age, 49-85 years) with esophageal adenocarcinoma underwent the ablation procedure followed by total esophagectomy. Complete epithelial removal occurred in the following zones: 10 J/cm2 (2x) and 12 J/cm2 (1x and 2x). The maximum depth of injury was the muscularis mucosae: 10 and 12 J/cm2 (both 2x). A second treatment (2x) did not significantly increase the depth of injury. Maximum thickness of residual ablation after tissue slough was only 35 microm. CONCLUSIONS Complete removal of the esophageal epithelium without injury to the submucosa or muscularis propria is possible using this balloon-based RF electrode at 10 J/cm2 (2x) or 12 J/cm2 (1x or 2x). A second application (2x) does not significantly increase ablation depth. These data have been used to select the appropriate settings for treating intestinal metaplasia in trials currently under way.
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Affiliation(s)
- B J Dunkin
- University of Miami School of Medicine, Miami, FL 33136, USA.
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Larson PS, Schlechter BL, de las Morenas A, Garber JE, Cupples LA, Rosenberg CL. Allele Imbalance, or Loss of Heterozygosity, in Normal Breast Epithelium of Sporadic Breast Cancer Cases and BRCA1 Gene Mutation Carriers Is Increased Compared With Reduction Mammoplasty Tissues. J Clin Oncol 2005; 23:8613-9. [PMID: 16314623 DOI: 10.1200/jco.2005.02.1451] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Normal-appearing breast epithelium can contain genetic abnormalities, including allele imbalance (AI), also referred to as loss of heterozygosity. Whether abnormalities are associated with cancer or cancer risk is unknown. Patients and Methods We performed a miniallelotype, using 20 microsatellites, on each of 460 histologically normal, microdissected breast terminal ducto-lobular units (TDLUs) from three groups of women: sporadic breast cancer patients (SP; n = 18), BRCA1 gene mutation carriers (BRCA1; n = 16), and controls undergoing reduction mammoplasty (RM; n = 18). We analyzed the results using Fisher's exact tests, logistic regression, and generalized estimating equations. Results AI was increased three-fold in SP and BRCA1 groups compared with RM. Both the number of TDLUs with AI increased (eight [5%] of 162 in the RM group compared with 24 [15%] of 162 in the SP and 22 [16%] of 136 in the BRCA1 groups; P = .0150), and the proportion of patients with AI increased (five [28%] of 18 in the RM group compared with 15 [83%] of 18 in the SP and 13 [81%] of 16 in the BRCA1 groups; P = .0007). The adjusted odds ratios (OR) for AI in TDLU increased in SP (OR = 15.5) and BRCA1 (OR = 13.7) patients compared with RM (P = .0025). This result was particularly evident on chromosome 17q (P = .0393), where more AI was seen in BRCA1 (OR = 12.4) than in SP (OR = 4.9) patients or RM controls. Conclusion Increased prevalence of AI in normal-appearing epithelium is associated with breast cancer and increased breast cancer risk. The increased prevalence may reflect dysregulation, even in normal-appearing epithelium, of genomic processes contributing to cancer development. The clinical significance of genetic alterations in the subset of controls remains to be determined.
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Affiliation(s)
- Pamela S Larson
- Department of Pathology and Laboratory Medicine and Medicine, Boston University School of Medicine, Boston, MA 02118, USA
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Trelles MA, Pardo L, Chamorro JJ, Bonanad E, Allones I, Buil C, Luna R. Erbium:YAG Laser as a Method of Deepithelization in Corrective and Reductive Breast Surgery. Ann Plast Surg 2005; 55:122-6. [PMID: 16034238 DOI: 10.1097/01.sap.0000168885.73496.c0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Deepithelization of the breast in breast ptosis surgery is important, being associated with risks which could affect the clinical outcome. The role of Er:YAG laser deepithelization was investigated. A total of 12 bilateral mammoplasties were performed, randomly assigned to 2 groups, one of experienced and one of less-experienced surgeons. Results were compared between the 2 groups of surgeons for scalpel deepithelization on one breast and the Er:YAG laser on the contralateral breast. No complications; less edema, pain, and erythema; and quicker wound healing were observed in the laser-deepithelized breasts, with a shorter operation time even for the less-experienced surgeons. The authors do not suggest that the Er:YAG laser should replace the scalpel in the hands of the expert surgeon for breast deepithelization in breast ptosis surgery, but the results of the study suggest that Er:YAG laser ablation is a safe, precise, effective and complication-free method.
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Affiliation(s)
- Mario A Trelles
- Instituto Médico Vilafortuny, Antoni De Gimbernat Foundation, Tarragona, Spain.
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Al-Qattan MM. De-epithelialized cross-finger flaps versus adipofascial turnover flaps for the reconstruction of small complex dorsal digital defects: a comparative analysis. J Hand Surg Am 2005; 30:549-57. [PMID: 15925166 DOI: 10.1016/j.jhsa.2005.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2004] [Revised: 01/31/2005] [Accepted: 02/03/2005] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the results of 2 reconstructive options (the de-epithelialized cross-finger flap vs the adipofascial turnover flap) for coverage of small complex dorsal digital defects. METHODS A total of 73 patients with small complex dorsal digital defects were included in the study and were classified into 2 groups: group 1 (n = 31) had reconstruction using the de-epithelialized cross-finger flap and group 2 (n = 42) had reconstruction using the adipofascial turnover flap. The type of complication and patient dissatisfaction with the appearance of the donor site were documented in each study group. RESULTS All flaps in both groups survived with no infection or hematoma. Specific complications were found in group 1 patients and included flap dehiscence (1 patient), considerable skin graft loss (2 patients), stiffness of the donor finger (5 patients), and inclusion cyst (1 patient). The only specific complication for group 2 patients was the occasional epidermolysis of the skin of the donor site, which was observed in 6 patients. Patient dissatisfaction with the appearance of the donor site was documented in 10 patients in group 1 and none in group 2. The elective flap division in the cross-finger-flap group was considered a disadvantage in children because it required general anesthesia. CONCLUSIONS The versatility of both flap techniques in digital reconstruction is confirmed; however, considering the type of complication and the need for general anesthesia in children for cross-finger-flap division, the adipofascial flap was determined to be superior in the following specific groups: children, older patients, and patients with osteoarthritis and multiple defects of adjacent border digits.
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Guo J, Colgan TJ, DeSouza LV, Rodrigues MJ, Romaschin AD, Siu KWM. Direct analysis of laser capture microdissected endometrial carcinoma and epithelium by matrix-assisted laser desorption/ionization mass spectrometry. Rapid Commun Mass Spectrom 2005; 19:2762-6. [PMID: 16134212 DOI: 10.1002/rcm.2119] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Direct analysis of laser capture microdissected malignant and normal endometrial epithelium using matrix-assisted laser desorption/ionization (MALDI) time-of-flight mass spectrometry (MS) was able to detect a number of proteins that are overexpressed in malignant epithelial cells. A total of 16 physiologic and malignant endometrial samples were laser capture microdissected, including four proliferative and four secretory endometria, and eight endometrioid adenocarcinomas. Two of these proteins, at 10,834 and 10,843 Da, likely correspond to calgranulin A and chaperonin 10, two proteins that had previously been identified in endometrioid adenocarcinoma in whole tissue homogenate by MS analysis. Direct analysis by MALDI-MS not only confirms that these proteins are overexpressed in endometrial carcinoma, but also localizes them to the epithelial cells, the expected cancer site.
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Affiliation(s)
- Jingzhong Guo
- Department of Chemistry and Centre for Research in Mass Spectrometry, York University, 4700 Keele Street, Toronto, Ontario, Canada M3J 1P3
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Greenwell H, Vance G, Munninger B, Johnston H. Superficial-layer split-thickness flap for maximal flap release and coronal positioning: a surgical technique. INT J PERIODONT REST 2004; 24:521-7. [PMID: 15626315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The aim of this report is to describe the superficial-layer split-thickness flap, which provides maximal flap release and mobilization for coronal positioning. The traditional split-thickness flap technique dissects following the contour of the buccal alveolar plate, leaving a periosteal layer on the osseous surface, while the muscular layer remains with the flap. This limits flap mobilization and can lead to flap retraction during healing because of muscle pull from lip and cheek movement. The superficial-layer split-thickness flap technique dissects following the contour of the external surface of the flap, toward the lip or cheek, and separates the epithelium and connective tissue from the underlying muscular and periosteal layers, which remain attached to bone. The advantages of this technique are: (1) the extreme flap release that allows complete, passive flap coverage for virtually all root coverage, ridge preservation, and ridge augmentation procedures; and (2) the absence of muscle pull during healing, which prevents flap retraction and promotes more rapid union of flap margins. Four cases are presented to demonstrate the flap technique and healing advantages.
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Affiliation(s)
- Henry Greenwell
- Department of Periodontics, Endodontics, and Dental Hygiene, School of Dentistry, University of Louisville, Kentucky 40292, USA
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Romanos GE, Henze M, Banihashemi S, Parsanejad HR, Winckler J, Nentwig GH. Removal of Epithelium in Periodontal Pockets following Diode (980 nm) Laser Application in the Animal Model: Anin VitroStudy. Photomed Laser Surg 2004; 22:177-83. [PMID: 15315723 DOI: 10.1089/1549541041438597] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the removal of the epithelium in the periodontal pocket using a diode (980 nm) laser in comparison with the conventional techniques in an animal experimental model. BACKGROUND DATA The goal of periodontal therapy is to reduce the bacterial deposits in the pockets and to enhance the clinical attachment. Different surgical techniques have been used in the past, which control the epithelial migration and promote the connective tissue formation. MATERIALS AND METHODS The buccal pockets of the posterior teeth in 10 freshly sacrificed adult pigs were scaled by three different examiners (with different levels of experience in periodontal surgery) using conventional curettes. The lingual pockets were treated using a diode (980 nm) laser. The laser was used in a continuous wave (c. w.) mode with two different power settings (2 and 4 Watts) with a 300-microm-thick glass fiber. The instrumentation period revealed 15 sec in all of the sites. Soft tissue biopsies of the instrumented sites were removed and examined histologically. RESULTS In all of the lased sections, no epithelial remnants were found. The laser with a low power was able to remove the thin pocket epithelium in the same way regardless of the level of surgical experience of the examiner. A high-power setting presented significant damage to the underlying connective tissues. The sites, which were instrumented with the conventional curettes, demonstrated significant epithelial remnants in all of the tissues regardless of the level of periodontal surgical experience. CONCLUSION The histological findings presented in this study showed that instrumentation of the soft periodontal tissues with a diode laser (980 nm) leads to a complete epithelial removal in comparison to conventional treatment methods with hand instruments (independent of the clinician's experience).
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Affiliation(s)
- George E Romanos
- Department of Oral Surgery and Implantology, Dental School (Carolinum), Frankfurt, Germany.
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Gasparini DO. Double-fold connective tissue pedicle graft: a novel approach for ridge augmentation. INT J PERIODONT REST 2004; 24:280-7. [PMID: 15227776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Localized defects of the alveolar crest are deformities that impair prosthetic restoration of the damaged ridge area, causing esthetic, phonetic, and oral hygiene complications. Among the alternatives that have been proposed to restore the damaged ridge area and dentition to normal form, function, and esthetics, the procedures that involve ridge augmentation with soft tissues have been widely accepted. The present clinical report describes a novel surgical procedure to treat these deformities.
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Affiliation(s)
- Diego Orlando Gasparini
- Department of Periodontics, Faculty of Dentistry, National University of the North-East, Corrientes, Argentina.
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Abstract
Small-bowel biopsies are routinely obtained from adult patients as a screening tool to evaluate the possibility of gluten sensitivity (GS). Previous morphological criteria of GS including completely flattened villi are usually absent. In the context of screening for GS, an altered distribution density pattern of villous intraepithelial lymphocytes (IELs) is probably the most sensitive morphological feature to suggest the possibility of GS and prompt the initiation of further medical evaluation. Altered villous IEL density distribution is a more sensitive screening feature than villous IEL counts. With increased small-bowel GS screening biopsies, occasional adults without GS with complete villous flattening and numerous villous IELs are encountered. These patients are usually incorrectly diagnosed with GS. However, they do not respond to a gluten-free diet and slowly improve over months.
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Affiliation(s)
- N S Goldstein
- Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, MI 48073, USA.
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42
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Abstract
We herein describe an atypical presentation of a migrating coelomic cyst attached to a pedicle of pericardial fat pad in an asymptomatic 45-year-old woman. A review of the English-language literature revealed only one such case report.
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Affiliation(s)
- Michael J Walker
- Department of Thoracic Surgery, Danbury Hospital, Danbury, Connecticut, USA.
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Cheremisina OV, Pankova OV. [Intravenous blood laser irradiation in patients with chronic nonspecific lung diseases and bronchial epithelial dysplasia]. Klin Med (Mosk) 2004; 82:39-41. [PMID: 15230040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
The study included patients with chronic nonspecific lung diseases (CNLD) and a morphologically verified diagnosis of first-second degree bronchial epithelial dysplasia (BED). Forty-six patients underwent intravenous blood laser irradiation (IBLI) (a study group); 45 patients received routine anti-inflammatory therapy (a control group). After therapy in the study group, the clinical and endoscopic signs of an inflammatory process were eliminated in 80.4 and 78.2% of cases, respectively. With morphological monitoring, a full and partial regression of BED occurred in 63.1 and 17.4%, respectively. In the control group, clinical and endoscopic improvements were achieved in 53.3 and 52.0% of cases. Dysplastic changes could be arrested only in 8.9% of cases. The differences were statistically significant (p < 0.05). Thus, IBLI is a highly effective treatment of dysplastic bronchial epithelial changes in patients with CNLD as compared with the controls.
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von Pechmann WS, Mutone M, Fyffe J, Hale DS. Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol 2003; 189:121-6. [PMID: 12861149 DOI: 10.1067/mob.2003.546] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Our purpose was (1). to report long-term objective and subjective outcome data after total colpocleisis with high levator plication and (2). to compare operative morbidity of total colpocleisis in patients with prior versus concurrent hysterectomy. STUDY DESIGN The medical records of patients who underwent total colpocleisis with high levator plication between August 1, 1988, and December 31, 2000, were retrospectively reviewed. Patient characteristics, operative data, and objective outcome measures including pelvic organ prolapse staging measurements were obtained from subject records. Subjective outcome measures were obtained by a standardized telephone survey. A t test was used to compare continuous variables between patients who underwent prior versus concurrent hysterectomy. The Fisher exact test was used to test for association between patient group and each categorical variable. RESULTS During the 12-year study period, 92 subjects underwent total colpocleisis with high levator plication. Of the 92 subjects, 90 (97.8%) underwent concurrent operations and 37 (40.2%) underwent simultaneous hysterectomy. With objective cure defined as absence of prolapse to the hymen, 90 subjects (97.8%) were objectively cured after a median follow-up of 12 months (range, 0-64 months). Of 62 subjects available for telephone follow-up, 56 (90.3%) reported being satisfied or very satisfied with how the surgery cured their prolapse after a median follow-up of 24 months (range, 13-161 months). Concurrent hysterectomy was associated with statistically significant increases in absolute change in hematocrit (9.5% without vs 11.9% with hysterectomy) and transfusion requirement (12.7% without vs 35.1% with hysterectomy). There was no significant difference in surgical complications between groups. CONCLUSION Total colpocleisis is an effective operation for the treatment of advanced pelvic organ prolapse. Concurrent hysterectomy is associated with higher blood loss and transfusion requirements.
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Affiliation(s)
- Walter S von Pechmann
- Department of Obstetrics and Gynecology, Methodist Hospital of Indianapolis/Indiana University, Indianapolis, Indiana, USA
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45
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Abstract
Neuroepithelial cysts are lesions of the central nervous system that have previously been reported in cerebral parenchyma, in the spinal cord, and within the ventricles in association with the choroid plexus. We describe 2 cases of neuroepithelial cysts of the middle ear. One was diagnosed after surgery for a retraction pocket and chronic otitis media complicated by an intraoperative cerebrospinal fluid (CSF) leak. The other produced bilateral spontaneous CSF otorrhea and mimicked the presentation of arachnoid granulations. Both cases were verified with immunohistochemical stains. Neuroepithelial cysts, although rare, should be considered in the differential diagnosis of spontaneous CSF otorrhea or an epitympanic mass.
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Affiliation(s)
- Arthur F Chen
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa 52242, USA
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Affiliation(s)
- David S Cassarino
- National Institutes of Health, National Cancer Institute, Laboratory of Pathology, Bethesda, Md., USA
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47
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Abstract
A new application of a well-known technique; lateral wall sinus approach, to remove a root fragment from the maxillary sinus with minimal damage to the epithelial lining and anterior face of maxilla is described. The technique presented in this article helps eliminate some of the complications associated with Caldwell Luc procedure while preserving the epithelial lining of the maxillary sinus and bony face of maxilla.
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Affiliation(s)
- S Uckan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey.
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48
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Affiliation(s)
- M Stolte
- Institut für Pathologie, Klinikum Bayreuth
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Spicuzza L, Basile L, Belvisi MG, Bellofiore S, Matera MG, Cazzola M, Di Maria GU. The protective role of epithelium-derived nitric oxide in isolated bovine trachea. Pulm Pharmacol Ther 2002; 15:357-62. [PMID: 12220940 DOI: 10.1006/pupt.2002.0377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Airway epithelial cells from bovine airways can release relaxant factors such as nitric oxide (NO) and prostaglandin E(2) and the removal of airway epithelium results in an increased responsiveness of smooth muscle to spasmogen stimuli. In this study, we assessed whether or not epithelial NO modulates the contractile response of bovine trachea in vitro.Cumulative concentration-response curves to acetylcholine (ACh), histamine (Hist) and 5-hydroxytryptamine (5-HT) were obtained in both intact and epithelium denuded tracheal strips in the presence of indomethacin (10 microM).In intact, but not in epithelium denuded strips, preincubation with the NO synthase inhibitor L-N((G))-Nitro-arginine methyl ester (L-NAME), but not with D-NAME, shifted to the left the concentration-response curve to ACh (pD(2) values in the absence and in the presence of L-NAME were 3.47+/-0.1 and 4.60+/-0.1, respectively; P<0.05) and to Hist (pD(2) in the absence and in the presence of L-NAME: 3.89+/-0.1 and 4.54+/-0.1, respectively; P<0.05). This effect was reversed by L-arginine (1mM), but not by D-arginine. The contractile response to 5-HT was not affected by L-NAME in either intact or epithelium denuded strips. These data suggest that NO is an epithelial relaxant factor modulating airway cholinergic and histaminergic contraction of bovine trachea and that the activation of the epithelial NO synthase is a mediator-specific process.
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Affiliation(s)
- L Spicuzza
- Dipartimento di Medicina Interna e Medicina Specialistica, Università di Catania, Italy
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50
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Abstract
We investigated the effect of exogenously generated superoxide anions (O(2)(-)), hydrogen peroxide (H(2)O(2)) and hydroxyl radicals (.OH) on isolated rabbit tracheal smooth muscle suspended in Krebs-Ringer solution. The ability of oxygen free radicals (OFRs) to affect acetyicholine (Ach)-induced contraction in these muscles was also investigated. OFRs, in general, produced a concentration-dependent relaxation of the tracheal smooth muscle in the doses used. However, in large concentrations, O(2)(-) and H(2)O(2) produced effects which were smaller than those obtained with lower concentrations. The relaxant effects of these oxyradicals were progressive and lasted throughout the 20min observation period. At all concentrations used, the OFRs tended to abolish or reduce Ach-induced contraction in a concentration-dependent manner. O(2)(-) was more potent than H(2)O(2) or DHF in relaxing the Ach-precontracted muscle and in inhibiting the response of the muscle to Ach. OFR-induced relaxation of the Ach-contracted muscle was not due to inactivation of the Ach by OFRs. Relaxation produced by OFRs was greater in preparations with intact epithelium than in those denuded of epithelium. The relaxant effects were blocked by indomethacin, a cyclooxygenase inhibitor. OFRs in the presence of indomethacin produced contraction only in the preparations with intact epithelium, suggesting a release of contractile factor(s) from epithelium. These results suggest that OFRs relax rabbit tracheal smooth muscle. The relaxation appears to be mediated through the synthesis and release of prostaglandins from the epithelium and smooth muscles.
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Affiliation(s)
- Kailash Prasad
- Department of Physiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, Saskatchewan S7N 5E5, USA.
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