Fibrotic Membrane Research Articles

Morphology and dynamic change of discrete subaortic stenosis can be imaged and quantified with three-dimensional transesophageal echocardiography

This report describes three-dimensional transesophageal echocardiographic findings in three consecutive patients with discrete subaortic stenosis. The discrete subaortic stenosis lesions included a circumferential, a remnant crescent, and a broken fibrotic subaortic membrane. The lesions were best imaged by using a three-dimensional transesophageal echocardiography–generated “aortotomy view” of the left ventricular outflow tract immediately below the plane of the aortic valve. The three-dimensional images correlated well with surgical and pathologic findings. The three-dimensional surface areas of the left ventricular outflow tract at the level of discrete subaortic stenosis during systole (0.8 ± 0.5 cm 2) and diastole (1.7 ± 0.7 cm 2) were measured by planimetry of the three-dimensional transesophageal echocardiographic images. The novel “aortotomy view” offered by three-dimensional transesophageal echocardiography provided direct visualization and quantification of discrete subaortic stenosis in a dynamic fashion. In summary, three-dimensional transesophageal echocardiography can accurately display and quantify discrete subaortic stenosis and could be a new clinically useful tool for assessing discrete subaortic stenosis and guiding surgical and transcatheter interventions. (J Am Soc Echocardiogr 1997;10;713–6.)

Gonioscopic Evaluation of Haptic Position in Transsclerally Sutured Posterior Chamber Lenses

To determine the haptic position in transsclerally sutured posterior chamber lenses. Fifty eyes with transsclerally sutured posterior chamber lenses were evaluated gonioscopically to determine the superior haptic position using previous peripheral iridectomies. The superior haptic of the transsclerally sutured posterior chamber lens was visualized in 31 (62%) of the eyes. In 24 (77%) of the 31 eyes, the haptic was within the ciliary sulcus, and in seven (23%), it was located posterior to the sulcus. A fibrotic membrane was detected around the sutured haptic in 20 (83%) of the 24 lenses located within the sulcus, whereas no fibrosis was seen surrounding the seven haptics outside the sulcus (P < .0001). Proper positioning of the haptics may be correlated with the development of fibrosis surrounding the haptic and therefore may be an important factor in the long-term stability of transsclerally sutured posterior chamber lenses.

Neodymium:YAG Laser Treatment for Hemorrhages under the Internal Limiting Membrane and Posterior Hyaloid Face in the Macula

A dense premacular hemorrhage may occur from proliferative diabetic retinopathy, a ruptured retinal artery macroaneurysm, or Valsalva retinopathy. Spontaneous clearing of the hemorrhage in Valsalva retinopathy usually occurs, taking several months. In diabetic retinopathy, a traction macular detachment may result as early as 5 weeks after the hemorrhage. In diabetic retinopathy or a macroaneurysm, only a fibrotic epiretinal membrane overlying the macula may develop. Observation or vitrectomy is the current way of managing a dense premacular hemorrhage. This study was undertaken to investigate an alternative, neodymium:YAG (Nd:YAG) laser membranotomy, in treating this type of hemorrhage. Six eyes in six patients had Q-switched Nd:YAG laser treatment to open trapped hemorrhage overlying the macula. One to three laser membranotomies were performed. Colored fundus photographs were obtained before and after the hemorrhage was treated. In some cases, fluorescein angiography was done before the hemorrhage was treated. The size of the pretreated hemorrhage was estimated from the photographs and expressed in disc diameters. Patients with diabetes had panretinal laser before Nd:YAG laser membranotomy. The premacular bleeding originated from proliferative diabetic retinopathy in four eyes and from a retinal artery macroaneurysm in two. Average estimated area of the pretreated hemorrhage was 14 disc diameters. Five eyes had marked clearing of hemorrhage and rapid improvement of vision after Nd:YAG laser membranotomy. Average follow-up after laser treatment was 20 months. One diabetic eye required vitrectomy for rebleeding. One eye had little visual improvement due to pre-existing subretinal bleeding. Neodymium:YAG laser membranotomy seems helpful in rapid clearing of premacular hemorrhage in certain eyes. A randomized prospective study is needed to evaluate observation, vitrectomy, and Nd:YAG laser treatment of dense premacular hemorrhage.

Distribution of Collagen Type I and Type III and of two Collagenous Components of Basement Membranes in the Human Liver

The distribution of collagen type I and III and of the basement membrane collagens type IV and alphaA (alphaB)2 in normal and fibrotic human livers has been studied by indirect immunofluorescence using type specific antibodies. Collagens type I as well as type III are present in normal livers in the blood vessel walls and the wall of biliary ducts of the portal tracts. In the parenchyma both types are visible along the sinusoids. Basement membrane collagens are only present in the connective tissue of portal canals and of central veins whereas in the parenchyma both type IV and alphaA (alphaB)2-collagen are nearly absent. In the tissue of fibrotic livers basement membrane collagens are also found in the parenchyma in similar distribution as type I and III.

Congenital Preretinal Macular Fibrosis

A 35-year-old woman and a 36-year-old man had asymptomatic, preretinal macular fibrosis involving their left eyes. Both patients were asymptomatic and the lesions were found on routine ocular examination. An opaque gray fibrotic membrane extended toward a lamellar hole in the macular region. Vision, fluorescein angiograms, and Amsler grid testing were normal in both cases. The defect in these two cases possibly arose during early embryonic development and might have been due to a defect produced by adherence of the primary vitreous body to the retina, thus differentiating them from idiopathic preretinal fibrosis,

Experimental and clinical aspects of transplantation of entire hyaline cartilage surfaces.

ABSTRACT: Experiments were conducted on the storage of hyaline cartilage, and on the results of cartilage allografts implanted in dogs over a two‐year period. Rejection phenomena were minimal as long as joint function was resumed early and adverse mechanical factors were controlled. Parallel experiments on dogs confirmed the potential of hyaline cartilage for repair with a smooth fibrotic membrane. It proved impossible to preserve viable hyaline cartilage grafts for longer than a week. Articular surface transplantation was performed in a small group of patients. Results have been sufficiently encouraging to conclude that human articular surface allografts may still have a place in the management of certain disorders in which artificial joint replacement may not be feasible.

Pathologic and Some Diagnostic Features of Histoplasmosis in Patients Entering a Missouri Hospital Final Report

Pathologic and Some Diagnostic Features of Histoplasmosis in Patients Entering a Missouri Hospital Final Report