1/88. Free vascularized appendix transfer for reconstruction of penile urethras with severe fibrosis.Despite the development of newer techniques with a free radial forearm tube flaps for phallus reconstruction, severe urethral strictures are still seen in such cases after irradiation or repeated infection because of the paucity of healthy, well-vascularized tissue. For urethral reconstruction in cases with poorly vascularized tissue as well as for total penile creation, a new technique involving a free vascularized appendix transfer combined with a radial forearm osteocutaneous flap was successfully used in two cases. The appendix provides a normal tube structure composed of a muscular tubular layer lined with mucosal epithelium. It has no hair and has rich vascularization. This results in little stricture at the junction with the original urethra, no occurrence of urethral stones, and possible postoperative enlargement of the diameter with changes in catheters. This method will allow a patient with severe fibrosis around the urethra to undergo one-stage phallus reconstruction with minimal complications.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
2/88. Complete occlusion of the anterior capsular opening after intact capsulorhexis: clinicopathologic correlation.PURPOSE: To report histopathologic findings of capsule contraction syndrome with complete occlusion of the capsulorhexis opening. methods: Case report. In an 81-year-old woman, a complete occlusion of the anterior capsulorhexis opening developed 2 months after phacoemulsification and intraocular lens implantation. We surgically removed the contracted anterior capsule and analyzed the membrane by standard light microscopy and actin immunohistology. RESULTS: light microscopic analysis of the membrane showed fibrous tissue subcapsularly with metaplastic lens epithelial cells. The contracted capsulorhexis opening was filled completely with proliferated actin-positive lens epithelial cells. CONCLUSIONS: Complete occlusion of the capsulorhexis opening can be attributed to excessive shrinkage of the capsule, probably caused by actin filaments found in the residual lens epithelial cells together with weak zonular support, and to the occlusion of the remaining central defect by massive proliferation of metaplastic lens epithelial cells.- - - - - - - - - - ranking = 7.362087614927keywords = membrane (Clic here for more details about this article) |
3/88. cystic fibrosis with fibrosing colonopathy in the absence of pancreatic enzymes.Fibrosing colonopathy, characterized by dense submucosal fibrosis in the large bowel, is a disorder associated with bowel dysfunction in patients with cystic fibrosis who receive pancreatic enzyme supplementation. Most commonly, patients present with a distended abdomen and abdominal pain. Radiographs frequently demonstrate colonic wall thickening and luminal narrowing. Here I describe a neonate with cystic fibrosis who presented with both clinical and histological features of fibrosing colonopathy who had not received pancreatic enzymes. This report expands our understanding of the pathogenesis of fibrosing colonopathy.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
4/88. Dysphagia in oesophageal intramural pseudo-diverticulosis: fibrosis, dysmotility or web?We describe two cases of oesophageal intramural pseudo-diverticulosis associated with a cervical oesophageal web presenting as intermittent dysphagia. In both cases, disruption of the web endoscopically resulted in lasting relief from symptoms. This observation, together with a review of the literature written during the past 39 years, suggests that oesophageal web formation may be under-reported in this condition and may be more important than either dysmotility or submucosal fibrosis and stricturing in the aetiology of the dysphagia seen in these patients. All patients with a radiological diagnosis of oesophageal intramural pseudo-diverticulosis should have an endoscopic examination which may be both diagnostic and potentially therapeutic.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
5/88. Incising the thick retrolental fibrovascular tissue with a hooked sclerotome in persistent hyperplastic primary vitreous.A technique for incising thick retrolental fibrovascular tissue and extensive cyclitic membrane is reported in a case of anterior persistent hyperplastic primary vitreous. A membranectomy was performed in a 1-month-old post-lensectomy baby via a limbal approach. A sclerotome tip was hooked to cut through an extremely thick fibrovascular tissue by rotating the sclerotome by its grip. Sutherland microscissors (Grieshaber, switzerland) and a vitrectomy cutter were used for further membranectomy. The baby was followed-up until age 18 months. A total of 3 membranectomy sessions were required because of rapid cyclitic membrane formation, severe centripetal retraction of the membrane on the ciliary processes, and posterior synechia. Thorough membranectomy and cutting the iris edge maintained a clear pupillary area during the 13-month postoperative period. Extremely thick retrolental fibrovascular tissue is a challenging condition that can be dealt with by delicate instrumentation.- - - - - - - - - - ranking = 25.767306652244keywords = membrane (Clic here for more details about this article) |
6/88. endomyocardial fibrosis (Davies disease) coincidental with systemic lupus erythematosus.This is the case of a 27 years-old woman with signs and symptoms of severe untreatable congestive heart failure, anemia, gingival mucosa ulcers, photosensitivity and alopecia. The electrocardiographic, echocardiographic, angiographic and hemodynamic data oriented the diagnosis of restrictive cardiomyopathy, mitral insufficiency secondary to mitral prolapse and bi-atrial dilation. The histologic study of the endomyocardial biopsy, performed during catheterization, showed signs of endomyocardial fibrosis, and immunological analysis was compatible with systemic lupus erythematosus. As far as we know, this is the first case of endomyocardial fibrosis (Davies disease) associated with systemic lupus erythematosus published in the medical literature. The etiology of Davies disease remains unrevealed and its association with systemic lupus erythematosus suggest a probable autoimmune origin.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
7/88. choroideremia associated with subretinal neovascular membrane.PURPOSE: To report two Japanese patients with choroideremia, one male and one heterozygous female, who developed subretinal neovascular membrane and/or subretinal fibrosis in the intermediate stage of the disease, and, in addition, to describe marked clinical manifestation in a heterozygous carrier female. METHOD: Two patients were examined by slip-lamp biomicroscopy, ophthalmoscopy and other ophthalmoloscopic examinations. RESULTS: Two cases showed moderately advanced ophthalmoscopic and functional abnormalitities compatible with choroideremia, and in addition, subretinal lesion in the fovea and/or midperiphery. CONCLUSION: The intermediate stage of choroideremia may occasionally be complicated with choroidal neovascular membrane in the fovea, the midperiphery, or both, which resolves spontaneously and results in subretinal fibrous scarring. The occurrence of this complication in the fovea leads to episodic central visual loss, while midperipheral lesion may remain unrecognized.- - - - - - - - - - ranking = 22.086262844781keywords = membrane (Clic here for more details about this article) |
8/88. Eosinophilic angiocentric fibrosis.Eosinophilic angiocentric fibrosis (EAF) is a rare inflammatory fibrosing condition of unknown aetiology that involves the nose or larynx producing mucosal thickening and severe obstructive symptoms. We report the first case affecting a male. He presented with nasal obstruction requiring septoplasty. The clinical and histopathological features of the condition are discussed and a comparison is made with the seven previous reported cases.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
9/88. Can migraine damage the inner ear?BACKGROUND: Auditory and vestibular symptoms and signs are common in patients with migraine, yet little is known about the pathogenesis of these symptoms and signs. OBJECTIVE: To perform clinicopathological correlation in a patient with migraine, sudden deafness, and delayed endolymphatic hydrops. methods: A patient with long-standing migraine with aura developed sudden hearing loss in the left ear at the age of 50 years and meniere disease on the right side at age 73. At age 76, he had a flurry of sudden drop attacks typical of otolithic crisis. He died of unrelated causes at age 81. The brain and temporal bones were removed approximately 24 hours after death. The cochlea and vestibular end organs were dissected after the surrounding bone was carefully removed. RESULTS: The brain and cerebrovasculature were normal. The left cochlea showed prominent fibrosis consistent with an old infarction. The right inner ear showed hydrops, with relatively good preservation of the hair cells in the cochlea, saccular macule, and cristae of the semicircular canals. However, the utricular macule was denuded of hair cells. CONCLUSIONS: The sudden left-sided deafness likely resulted from ischemia, possibly due to migraine-associated vasospasm. Presumably, the right ear suffered only minimal damage when the patient was 50 years old, but this damage later led to the development of delayed endolymphatic hydrops on the right. Otolithic crises are thought to result from pressure changes across the utricular macule. We speculate that loss of hair cells in the utricular macule resulted from a collapse of the utricular membrane onto the macule.- - - - - - - - - - ranking = 3.6810438074635keywords = membrane (Clic here for more details about this article) |
10/88. Polypoidal choroidal vasculopathy pattern in age-related macular degeneration: a clinicopathologic correlation.PURPOSE: To report the histopathologic features of surgically removed submacular tissue from an elderly patient with a pattern of polypoidal choroidal vasculopathy on indocyanine green angiography. methods: Clinical examination including fluorescein and indocyanine green angiography and light microscopy of surgical specimen. RESULTS: A thick yellow proteinaceous subretinal fluid was seen in the right macula of an 81-year-old white man. fluorescein angiography indicated progressive leakage from undetermined source apart from a few focal hyperfluorescent points. indocyanine green angiography showed several polyps as well as dilated choroidal vessels in the macula and along the superior temporal arcade. A large plaque was visualized in the late phase. Microscopically, the specimen consisted of a thick fibrovascular membrane located on the choroidal side of the retinal pigment epithelium (RPE). The RPE layer was discontinuous whereas on its choroidal side an almost intact layer of diffuse drusen was observed. A group of dilated thin-walled vessels were found that appeared to be saccular on serial sections. Some of these were located almost immediately under the diffuse drusen. CONCLUSION: Histologic examination of submacular tissue removed from an eye with polypoidal choroidal vasculopathy showed several aneurysmal dilatations located directly under diffuse drusen within a sub-RPE, intra-Bruch's fibrovascular membrane.- - - - - - - - - - ranking = 7.362087614927keywords = membrane (Clic here for more details about this article) |
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