The Experts below are selected from a list of 423 Experts worldwide ranked by ideXlab platform
Munaza Akunjee - One of the best experts on this subject based on the ideXlab platform.
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Superior Vena Cava Thrombosis Due to a Temporary Hemodialysis Catheter Presenting After 5 Years With Hematemesis, Hemoptysis and Pleural Effusion
Journal of Medical Cases, 2014Co-Authors: Nidal Arnous, Munaza AkunjeeAbstract:Superior vena cava (SVC) thrombosis is increasingly seen now due to the liberal use of intravascular catheters. Most of these cases present with symptoms acutely, like any case of deep vein thrombosis, usually with ipsilateral arm and face swelling. Our patient presented after 5 years with unusual symptoms that are unrelated to the thrombosis itself, but due to the collateral circulation. He was a 38-year-old male patient with end-stage renal disease on hemodialysis (HD) for 9 years, initially via a left arm arteriovenous (AV) fistula, then via a temporary right subclavian dialysis catheter for a period of 5 months before being maintained on his current AV fistula in the right arm for the last 5 years. He presented with intermittent episodes of hematemesis and hemoptysis, and was also found to have pleural effusion. He was found to have chronic thrombosis in the SVC. Chronic SVC obstruction causes formation and increase in the flow in the collateral circulation in the Esophageal Plexus causing varices, in the intercostals veins causing pleural fluid formation, and in the bronchial veins leading to hemoptysis. The AV fistula aggravated these findings by further increasing the flow and the pressure in the collateral circulation. In conclusion, chronic SVC thrombosis can occur as a consequence of HD catheters, and may present with symptoms related to the collateral circulation. J Med Cases. 2014;5(10):515-518 doi: http://dx.doi.org/10.14740/jmc1925w
Wei Zhao - One of the best experts on this subject based on the ideXlab platform.
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activated eosinophils are present in Esophageal muscle in patients with achalasia of the esophagus
Medical Science Monitor, 2018Co-Authors: Bin Wang, Lili Zhang, Wei ZhaoAbstract:: BACKGROUND The aim of this study was to undertake a histological evaluation of the presence of eosinophils in Esophageal muscle in patients with achalasia before treatment with peroral endoscopic myotomy (POEM), with clinical follow-up at one year. MATERIAL AND METHODS Before treatment, Esophageal biopsies including mucosa and Esophageal muscle were obtained from 28 patients with achalasia. Nine patients who had undergone esophagectomy for Esophageal carcinoma were included in the control group. The Eckardt Score was used to evaluate the clinical symptoms of achalasia. Histology of routinely processed tissue sections was used to perform eosinophil cell counts (0 to +++), and immunohistochemistry was used to detect expression of eosinophil major basic protein (MBP), eosinophil-derived neurotoxin (EDN), and S100 protein in cases of achalasia (n=28) and controls (n=9). The findings in patients with achalasia were compared before and one year following POEM. RESULTS Esophageal tissue from patients with achalasia showed eosinophils infiltrating into the muscularis externa in 85.7% (24/28), into the muscularis propria in 28.6% (8/28), and in 89% (25/28) there were few remaining myenteric ganglion cells, before POEM. The extent of inflammation was similar in all regions of the esophagus and between subtypes of achalasia. At one year following POEM, the Eckardt Scores between the former eosinophil (0) group and the eosinophil (+++) group were significantly different (Z=3.50, P=0.030). CONCLUSIONS Achalasia of the esophagus was associated with infiltration of the Esophageal muscle by activated eosinophils and a decrease in the density of ganglion cells in the myenteric Esophageal Plexus.
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Activated Eosinophils are Present in Esophageal Muscle in Patients with Achalasia of the Esophagus
Medical Science Monitor, 2018Co-Authors: Hong Jin, Bin Wang, Lili Zhang, Wei ZhaoAbstract:BACKGROUND The aim of this study was to undertake a histological evaluation of the presence of eosinophils in Esophageal muscle in patients with achalasia before treatment with peroral endoscopic myotomy (POEM), with clinical follow-up at one year. MATERIAL AND METHODS Before treatment, Esophageal biopsies including mucosa and Esophageal muscle were obtained from 28 patients with achalasia. Nine patients who had undergone esophagectomy for Esophageal carcinoma were included in the control group. The Eckardt Score was used to evaluate the clinical symptoms of achalasia. Histology of routinely processed tissue sections was used to perform eosinophil cell counts (0 to +++), and immunohistochemistry was used to detect expression of eosinophil major basic protein (MBP), eosinophil-derived neurotoxin (EDN), and S100 protein in cases of achalasia (n=28) and controls (n=9). The findings in patients with achalasia were compared before and one year following POEM. RESULTS Esophageal tissue from patients with achalasia showed eosinophils infiltrating into the muscularis externa in 85.7% (24/28), into the muscularis propria in 28.6% (8/28), and in 89% (25/28) there were few remaining myenteric ganglion cells, before POEM. The extent of inflammation was similar in all regions of the esophagus and between subtypes of achalasia. At one year following POEM, the Eckardt Scores between the former eosinophil (0) group and the eosinophil (+++) group were significantly different (Z=3.50, P=0.030). CONCLUSIONS Achalasia of the esophagus was associated with infiltration of the Esophageal muscle by activated eosinophils and a decrease in the density of ganglion cells in the myenteric Esophageal Plexus.
Munaza Akunjeeb - One of the best experts on this subject based on the ideXlab platform.
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Case Report J Med Cases. 2014;5(10):515-518ressElmer Superior Vena Cava Thrombosis Due to a Temporary Hemodialysis Catheter Presenting After 5 Years With
2014Co-Authors: Pleural Effusion, Nidal Arnousa, Munaza AkunjeebAbstract:Superior vena cava (SVC) thrombosis is increasingly seen now due to the liberal use of intravascular catheters. Most of these cases pre-sent with symptoms acutely, like any case of deep vein thrombosis, usually with ipsilateral arm and face swelling. Our patient presented after 5 years with unusual symptoms that are unrelated to the throm-bosis itself, but due to the collateral circulation. He was a 38-year-old male patient with end-stage renal disease on hemodialysis (HD) for 9 years, initially via a left arm arteriovenous (AV) fistula, then via a temporary right subclavian dialysis catheter for a period of 5 months before being maintained on his current AV fistula in the right arm for the last 5 years. He presented with intermittent episodes of hemate-mesis and hemoptysis, and was also found to have pleural effusion. He was found to have chronic thrombosis in the SVC. Chronic SVC obstruction causes formation and increase in the flow in the collateral circulation in the Esophageal Plexus causing varices, in the intercos-tals veins causing pleural fluid formation, and in the bronchial veins leading to hemoptysis. The AV fistula aggravated these findings by further increasing the flow and the pressure in the collateral circula-tion. In conclusion, chronic SVC thrombosis can occur as a conse-quence of HD catheters, and may present with symptoms related to the collateral circulation
Nidal Arnous - One of the best experts on this subject based on the ideXlab platform.
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Superior Vena Cava Thrombosis Due to a Temporary Hemodialysis Catheter Presenting After 5 Years With Hematemesis, Hemoptysis and Pleural Effusion
Journal of Medical Cases, 2014Co-Authors: Nidal Arnous, Munaza AkunjeeAbstract:Superior vena cava (SVC) thrombosis is increasingly seen now due to the liberal use of intravascular catheters. Most of these cases present with symptoms acutely, like any case of deep vein thrombosis, usually with ipsilateral arm and face swelling. Our patient presented after 5 years with unusual symptoms that are unrelated to the thrombosis itself, but due to the collateral circulation. He was a 38-year-old male patient with end-stage renal disease on hemodialysis (HD) for 9 years, initially via a left arm arteriovenous (AV) fistula, then via a temporary right subclavian dialysis catheter for a period of 5 months before being maintained on his current AV fistula in the right arm for the last 5 years. He presented with intermittent episodes of hematemesis and hemoptysis, and was also found to have pleural effusion. He was found to have chronic thrombosis in the SVC. Chronic SVC obstruction causes formation and increase in the flow in the collateral circulation in the Esophageal Plexus causing varices, in the intercostals veins causing pleural fluid formation, and in the bronchial veins leading to hemoptysis. The AV fistula aggravated these findings by further increasing the flow and the pressure in the collateral circulation. In conclusion, chronic SVC thrombosis can occur as a consequence of HD catheters, and may present with symptoms related to the collateral circulation. J Med Cases. 2014;5(10):515-518 doi: http://dx.doi.org/10.14740/jmc1925w
Benjamin H. Landing - One of the best experts on this subject based on the ideXlab platform.
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Reduced Number of Neurons in Esophageal Plexus Ganglia in Down Syndrome: Additional Evidence for Reduced Cell Number as a Basic Feature of the Disorder
Pediatric pathology, 2009Co-Authors: Yutaka Nakazato, Benjamin H. LandingAbstract:Four patients with Down syndrome and 3 age-matched control patients were studied by a microdissection technique to investigate the number of neurons in the ganglia of the deep submucous and Auerbach Plexuses of the esophagus. The mean number of neurons per ganglion of the deep submucous Plexus in Down patients was 69% of the control value, and the value for the Auerbach Plexus was 75% of control number. These findings may explain Esophageal dysfunction, common in Down syndrome, and support a proposal that a biochemical “signal” relating to chromosome 21 determines the number and sizes of certain cell types.