Scar Disease Research Articles

Conservative management of large uterine arteriovenous malformation: case report

Uterine arteriovenous malformation is a rare condition that may be associated with uterine bleeding. Eventually morphologic aspects of the lesions induce unnecessary aggressive surgery; we report here a case of successful expectant management.

Catheter Ablation for Ventricular Tachycardia

Sustained ventricular tachycardia (VT) is an important cause of morbidity and sudden death in patients with heart disease.1 Implantable cardioverter-defibrillators (ICDs) terminate VT episodes, reducing the risk of sudden death. Recurrent VT develops in 40% to 60% of patients who receive an ICD after an episode of spontaneous sustained VT. A first episode of VT occurs in ≈20% of patients within 3 to 5 years after ICD implantation for primary prevention of sudden death in high-risk groups.2–4 ICD shocks reduce quality of life and are associated with an increased risk of death.2–4 Antiarrhythmic drug therapy with amiodarone or sotalol reduces VT episodes but with disappointing incidence of side effects and efficacy.2 Catheter ablation is useful for reducing VT episodes and can be life-saving when VT is incessant.1,5,6 Idiopathic VTs occur in patients without structural heart disease and rarely cause sudden death. Electrophysiological study with catheter ablation is often warranted to confirm the diagnosis, to provide further evidence for the absence of ventricular scar or other disease, and often to cure the arrhythmia. Ablation is also an option for symptomatic nonsustained VT and frequent ventricular ectopy in these patients.1 The appearance of the VT on ECG often suggests its likely cause and associated heart disease (Figure 1). Monomorphic VT has the same QRS complex from beat to beat, indicating repetitive ventricular activation from a structural substrate or focus that can be targeted for ablation. Most are due to reentry through regions of ventricular scar.7 Figure 1. ECG types of VT and most common causes are shown with characteristic ECG features of selected VTs. LBBB indicates left bundle-branch block; LVOT, LV outflow tract; RBBB, right bundle-branch block; L, left; and R, right. Polymorphic VTs have a changing ventricular activation sequence that can be due to …

La tomographie par émission de positons au 18FDG dans la caractérisation des masses résiduelles en fin de traitement dans les lymphomes : étude quantitative rétrospective

While the limits of Computed Tomography (CT) in the assessment of post-therapeutic residual masses has been studied extensively, few works have evaluated the interest of the combined use of metabolic and morphological criteria in the management of patients with lymphoma. The purpose of this study is to find out optimal morphological and functional threshold values that are likely to characterize residual masses after the treatment of lymphoma. Nineteen patients referred to the hematological department of a university hospital for the initial treatment of a malignant lymphoma were retrospectively included in the study. Inclusion criteria included the finding of one or more residual masses after the completion of the treatment. At the end of the treatment, all patients underwent a 18-Fluoro-deoxy-glucose Positron Emission Tomography (PET) together with a CT. For each residual mass, the small and large axial diameters and the Standardized Uptake Values of the FDG (SUV max, avg and min) were quantified after the completion of the treatment. All patients underwent clinical examination together with biological and imaging tests five months later to decide the nature of the residual masses (scar or residual disease). Only the SUVmax, the SUVavg and the diameter were useful to predict the follow-up. A SUVmax greater than 4 is in favour of a residual disease with a specificity of 90–100%. A small axial diameter of 11.5 mm has a specificity of 92%. After ROC (Receiver operating characteristic) curves analysis, the combination “SUV– small axial diameter” is more efficient to detect a residual disease than the SUV or the small axial diameter alone, however the difference is not significant. As a consequence, further studies involving a larger population are necessary to confirm the usefulness of the combination of SUV and small axial diameter in the assessment of malignant lymphoma at the end of the treatment.

Interdependence of radial scar and proliferative disease with respect to invasive breast carcinoma risk in patients with benign breast biopsies

Radial scars (RS) are benign breast lesions that have been implicated as independent risk factors for invasive breast carcinoma (IBC). A retrospective cohort study of 9556 women who underwent biopsy between 1950-1986 and enrolled in the Nashville Breast Cohort was performed to investigate the association between RS in a benign breast biopsy and the risk of IBC. The risk associated with RS and coexistent proliferative disease (PD) was assessed adjusting for age at biopsy using a Cox hazards regression analysis with time-dependent covariates. RS were identified in 880 women (9.2%). The average follow-up time was 20.4 years. Sixty-two women (7.0%) with RS developed IBC compared with 5.5% of controls. The relative risk of IBC associated with RS was 1.82 (95% confidence interval [95% CI], 1.2-2.7) at 10 years. Restricting the analysis to women age > 49 years increased the risk to 2.14 (95% CI, 0.6-2.8). These risks decreased with increasing years of follow-up. Approximately 92% of women with RS also had PD, but RS were present in only 1.3% of biopsies without PD. Analyses stratifying relative risk with regard to PD found RS to minimally elevate the relative risk of subsequent IBC. RS in the absence of PD is uncommon. Although the presence of RS in a benign breast biopsy mildly elevates the risk of IBC risk, the current analysis indicated that this risk can be largely attributed to the category of coexistent PD. In women with both RS and atypical hyperplasia, recommendations for interventions beyond biopsy should be based on the extent of atypical hyperplasia.

Detection and Distribution of Apple scar skin viroid-Korean Strain (ASSVd-K) from Apples Cultivated in Korea

Apple scar skin viroid (ASSVd) has been one of the most destructive diseases in Korean apple orchards. Symptoms of the scar skin viroid disease were detected in various apple cultivars, namely, Sansa, Fuji, Chukwang, Miki-Life, Hongro, and Songbongeum cultivated in the southern part of Korea. The RNA molecules were extracted from the apples bearing dapple apple symptoms with the application of CF-11 RNA extraction method. The purified RNAs were used for the synthesis of cDNA with RT-PCR. The PCR products were cloned and sequenced. The viroid RNA molecules from the six different cultivars bearing the dapple symptos showed the same nucleotide sequences as that of the Korean strain of ASSVd（ASSVd-K). ASSVd-K was detected from apple orchards in Kunwi, Sangju, Uiseong, Yeong-yang, Andong, and Youngduk in Gyeongbuk Province in 2001, and in Muju in Jeonbuk Province in 2002. As the viroid disease could be propagated vegetatively, it can be widely transmitted gradually in Korea.

Scar sarcoidosis in a patient with Crohn's disease.

A patient with scar sarcoidosis and Crohn's disease is described. The possibility of patients with Crohn's disease being more prone to develop sarcoidosis is discussed.

Low-dose flying spot digital radiography of the chest: sensitivity studies.

Standard film examinations of the chest were compared with low-dose flying spot digital radiographic examinations obtained with a prototype unit in 174 patients. Analysis of pooled data from a double-blind study of 120 patients showed that film was more sensitive than digital images in the detection of pulmonary parenchymal abnormalities, that is, abnormal opacities, atelectasis, scar, and interstitial lung disease (P less than .05). Analysis of pooled data from a side-by-side study of 54 patients showed that the digital images were more sensitive than film in the detection of normal mediastinal and pleural soft-tissue contours, including the azygoesophageal recess, paraspinal line, and vertebral disk spaces (P less than .05). However, film was more sensitive than digital images in the detection of abnormalities of the lung, including scar, interstitial lung disease, septal lines, and the presence of vascular catheters (P less than .05). These findings suggest that low-dose flying spot digital radiography of the chest, as performed with this specific prototype unit, is not adequate to replace film in the detection of abnormalities of the lung parenchyma.

Transmission to apple seedlings of a low molecular weight RNA extracted from apple scar skin diseased trees.

Two species of low molecular weight RNA have been associated with apple scar skin disease. One of the RNAs, ASSARNA 1 was detected in the bark tissue as well as in the fruit tissue of diseased apple trees. Inoculation of young seedlings with extracted RNA was performed by rubbing with carborundum or by slashing with a razor. Nucleic acid was extracted from the bark of inoculated seedlings and analysed by two cycles of polyacrylamide gel electrophoresis. ASSARNA 1 was detected in one of 13 seedlings after 28 months following inoculation by the rubbing method with phenol-extracted nucleic acid and in 8 of 14 seedlings after 13 months following inoculation by the razor-slash method with purified ASSARNA 1. The results indicate that ASSARNA 1 was transmitted to apple seedlings and multiplied in them. These facts provided additional evidence for the viroid etiology of the causal agent of apple scar skin disease. However, the pathogenecity of ASSARNA 1 and the role of another disease-associated RNA, ASSARNA 2, are still unknown.