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Andrew Soo Hoo, Liam Ryan, Richard Neville, Dipankar Mukherjee
Open technique for elective repair of iliac artery aneurysms can be safely performed with good outcomes but not inconsequential morbidity. An endovascular approach has been shown to have both periprocedural and postoperative advantages with equivalent outcomes. Endovascular repair of common iliac arteries (CIAs) without sacrificing the hypogastric artery using an iliac branch device is a complex endovascular technique requiring a proximal seal zone that may be absent in larger CIA aneurysms. We present two cases in which CIA aneurysms were repaired with a customized endovascular technique using the benefit of the aortic bifurcation for stability in addition to providing a long proximal seal zone with the AFX device (Endologix, Irvine, Calif) paired with the iliac branch device (W...
December 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Katharina Welsch, Helmut Breuninger, Gisela Metzler, Franziska Sickinger, Franziska Carola Eberle, Hans-Martin Häfner, Saskia Maria Schnabl
BACKGROUND: Cutaneous sarcomas are rare and characterized by pathogenetic heterogeneity. Knowledge about local infiltration patterns and recurrence rates may be useful in improving patient care and outcomes. The objective of the present study was to compare these two characteristics in sarcomas that had been treated using the identical surgical procedure. PATIENTS AND METHODS: Between 2006-2010, 84 patients with various types of sarcoma underwent surgery followed by three-dimensional histology...
December 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Anaïs Nassios, Susanne Wallner, Sebastian Haferkamp, Christoph Klingelhöffer, Christoph Brochhausen, Stephan Schreml
BACKGROUND: In humans, there are four known proton-sensing G-Protein-coupled receptors (pH-GPCRs): GPR4 (GPR19), TDAG8 (GPR65, T-cell death-associated gene 8), OGR1 (GPR68, ovarian cancer GPCR1), and G2A (GPR132, G2 accumulation protein). They are known to be involved in sensing changes of extracellular proton-concentrations in the acidic microenvironment of tumors, which leads to altered cell proliferation, migration, metastasis, immune cell function and inflammation. However, little is known about the expression of pH-GPCRs in the skin and especially skin cancers...
October 19, 2018: Experimental Dermatology
Wassim Shatila, Zvonimir Krajcer
Aortocaval fistula (ACF) is rare and lethal and can be either primary (due to an enlarged abdominal aortic aneurysm) or secondary (iatrogenic or secondary to abdominal surgery) in origin. We describe a case of an ACF secondary to a ruptured abdominal aortic pseudoaneurysm that we successfully treated with a planned endovascular approach using an AFX aortic cuff on both the arterial and venous sides.
September 27, 2018: Catheterization and Cardiovascular Interventions
Nikolai Klebanov, Mai P Hoang, Bobby Y Reddy
Pleomorphic dermal sarcoma (PDS) is a rare mesenchymal tissue tumor. Distinguishing PDS from similar conditions, such as atypical fibroxanthoma (AFX), its less aggressive tumor counterpart, is difficult, as they are clinically and histologically similar. We present a case of a 77-year-old man presenting with a large nodular scalp lesion of three weeks duration. Pathology revealed a 3.3 cm invasive pleomorphic dermal sarcoma. Surgical excision with 2 cm margins was performed with successful healing of the graft...
July 13, 2018: Curēus
Kim van Noort, Suzanne Holewijn, Richte C L Schuurmann, Johannes T Boersen, Simon P Overeem, Erik Groot Jebbink, Jenske J M Vermeulen, Michel M P J Reijnen, Cornelis H Slump, Jean-Paul P M de Vries
OBJECTIVE: Aortic pulse-wave-velocity (aPWV) is a measure for arterial stiffness, which is associated with increased cardiovascular risk. Recent evidence suggests aPWV increases after endograft-placement for aortic aneurysms. The aim of this study was to investigate the influence of different aortic endoprostheses on aPWV and structural stiffness in vitro. APPROACH: Three different abdominal aortic endoprostheses (AFX, Endurant II, and Nellix) were implanted in identical silicone aneurysm models...
October 11, 2018: Physiological Measurement
Yuri Murakami, Naoki Toya, Soichiro Fukushima, Eisaku Ito, Tadashi Akiba, Takao Ohki
INTRODUCTION: We report a case with delayed aneurysm sac enlargement 16 years after EVAR due to late type IIIb endoleak. PRESENTATION OF CASE: An 84-year-old man was referred to our hospital with an aneurysm sac enlargement after endovascular aortic aneurysm repair (EVAR), which had been performed at another hospital 18 years earlier using the Zenith endograft. Computed tomography (CT), after EVAR had shown significant sac shrinkage. However, the patient presented with delayed aortic aneurysm enlargement due to an assumed endoleak...
2018: International Journal of Surgery Case Reports
Stanislav N Tolkachjov, Benjamin F Kelley, Fares Alahdab, Patricia J Erwin, Jerry D Brewer
BACKGROUND: Atypical fibroxanthoma (AFX) is a fibrohistiocytic tumor with relatively high local recurrence rates but low metastatic potential. Wide local excision (WLE) and Mohs micrographic surgery (MMS) are common treatments, although no consensus exists regarding optimal therapy. OBJECTIVE: To systematically review evidence of AFX recurrence and metastatic rates after different surgical modalities. METHODS: A comprehensive search was performed for articles published from 1946 or database inception to March 20, 2017...
July 5, 2018: Journal of the American Academy of Dermatology
Charlotte Bernigaud, Fang Fang, Katja Fischer, Anne Lespine, Ludwig S Aho, Amanda J Mullins, Berhane Tecle, Andrew Kelly, Jean-François Sutra, Francis Moreau, Thomas Lilin, Frédéric Beugnet, Françoise Botterel, Olivier Chosidow, Jacques Guillot
Scabies is a major and potentially growing public health problem worldwide with an unmet need for acaricidal agents with greater efficacy and improved pharmacological properties for its treatment. The objective of the present study was to assess the efficacy and describe the pharmacokinetics profile of a novel acaricide, afoxolaner (AFX), in a relevant experimental porcine model. Twelve pigs were experimentally infested and either treated with 2.5 mg/kg single dose oral AFX ( n = 4) or 0.2 mg/kg, two doses 8 days apart, oral ivermectin ([IVM] n = 4) or not treated for scabies ( n = 4)...
September 2018: Antimicrobial Agents and Chemotherapy
Dean J Arnaoutakis, Gaurav Sharma, Stuart Blackwood, Samir K Shah, Matthew Menard, C Keith Ozaki, Michael Belkin
BACKGROUND: Failure of endovascular aneurysm repairs (EVARs) requiring open conversion remains a major challenge. We analyzed indications for repair, operative strategies, and outcomes with a focus on iliac artery degeneration after endograft removal. METHODS: A prospective, institutional database was reviewed to identify patients who underwent explantation of a failed EVAR device. Demographics, reason for failure, operative details including extent of endograft removal, and complications/survival were examined...
June 15, 2018: Journal of Vascular Surgery
Brandon Worley, Andrew J Nemechek, Samantha Stoler, Joel L Cohen
BACKGROUND: Alternative therapies are favored by some patients. In skin cancer, this may be to try to avoid surgery out of fear for the procedure and its functional or cosmetic consequences. Frequently, use of these therapies is not curative and can cause harm. Our objective is to detail a case where black salve was used as a natural remedy for an atypical fibroxanthoma and resulted in a severe burn. We highlight the challenges of communicating effective treatment options for those who have strong beliefs concerning natural remedies after a cancer diagnosis...
June 1, 2018: Journal of Drugs in Dermatology: JDD
Sambit K Mohanty, Shivani Sharma, Dinesh Pradhan, Shivani R Kandukuri, Navid Farahani, Catherine Barry, Julie M Wu, David Frishberg, Bonnie Balzer
Microphthalmia-associated transcription factor (MiTF) is used as a marker of melanocytic differentiation. However, MiTF immunoexpression has also been observed in histiocytes, macrophages, smooth muscle cells and fibroblasts, which raise the concern of fibrohistiocytic (FH) lesions being misdiagnosed as melanoma based on MiTF immunoreactivity. MiTF has been known to be positive in FH tumors, but this is the first study evaluating ninety-three fibrohistiocytic neoplasms to understand and delineate the staining pattern of MiTF in these tumors...
June 2018: Pathology, Research and Practice
Timo Gaiser, Daniela Hirsch, Azadeh Orouji, Marisa Bach, Peter Kind, Doris Helbig, Alexander Quaas, Jochen Utikal, Alexander Marx, Maria Rita Gaiser
Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are rare malignancies typically occurring in elderly patients and predominantly located in skin regions exposed to UV-light. Thus, a role of UV-radiation-induced damage for AFX and PDS tumorigenesis has been postulated. MYC gene amplification has been demonstrated as a distinctive feature of radiation-induced angiosarcoma. In order to investigate whether chronic exposure to UV-light might also lead to MYC copy number changes, 51 AFX and 24 PDS samples were retrospectively analyzed for MYC amplification by fluorescence in situ hybridization using a MYC and a CEP8 gene probe...
April 20, 2018: Oncotarget
Shakuntala H Mauzo, Denái R Milton, Victor G Prieto, Carlos A Torres-Cabala, Wei-Lien Wang, Nitin Chakravarti, Priyadharsini Nagarajan, Michael T Tetzlaff, Jonathan L Curry, Doina Ivan, Robert E Brown, Phyu P Aung
BACKGROUND: Serum protein acidic and rich in cysteine (SPARC) is a matricellular glycoprotein, which regulates cell proliferation and facilitates intracellular transport of albumin bound particles including chemotherapeutic agents such as Nab-paclitaxel/ABI-007. Therefore the presence of SPARC may achieve higher intra-tumoral drug concentration with lower dosage and thus reduce systemic side-effects. Several trials of ABI-007, in melanoma, show promising clinical activity. DESIGN: Fifty-four cases of dermal based neoplasms were retrieved including 24 angiosarcomas (AS), 10 hemangiomas, 9 nodular melanomas, 4 Kaposi sarcomas (KS), 3 leiomyosarcomas (LMS), 3 atypical fibroxanthomas (AFX) and 1 spindle cell squamous cell carcinoma (SSCC)...
June 2018: Annals of Diagnostic Pathology
Eugene Omakobia, Ahmad Orabi, Richard Knights
Objective: To report a unique case of pinna squamous cell carcinoma (SCC) arising shortly after resection of atypical fibroxanthoma (AFX) at the same site. Case report: An 81-year-old gentleman presented with a nodular right pinna lesion. This was excised, and histology confirmed AFX. Ten weeks later, an ulcerative lesion appeared at the resection site. This was confirmed to be SCC. Comparative analysis revealed no morphological resemblance between the initial AFX and new SCC lesion, and there was no evidence of initial misdiagnosis...
2018: Case Reports in Otolaryngology
Anastasios Raptis, Michalis Xenos, George Kouvelos, Athanasios Giannoukas, Miltiadis Matsagkas
OBJECTIVES: The objective of this study is to analyse the flow conditions in the AFX and Nellix endografts (EGs) accounting for their postimplantation configuration in patients with an endovascular aneurysm repair-treated abdominal aortic aneurysm. METHODS: We reconstructed post-endovascular aneurysm repair computed tomography scans of patients treated with an AFX or Nellix EG creating post-implantation EG models. We examined 16 patients, 8 in each group. The blood flow properties were obtained by computational fluid dynamics simulations and were subsequently compared with physiological infrarenal blood flow properties measured in 5 healthy subjects...
May 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Doris Helbig, Alexander Quaas, Cornelia Mauch, Sabine Merkelbach-Bruse, Reinhard Büttner, Michael Emberger, Marion Wobser, Vanessa Rüsseler, Katharina Pütz, Elke Binot, Jan Rehker, Jan Budczies, Michaela Angelika Ihle
Atypical fibroxanthomas (AFX) and pleomorphic dermal sarcomas (PDS) are frequent cutaneous sarcomas typically arising on sun-exposed skin in elderly patients. In contrast to AFX, which generally do not recur after complete excision, PDS locally recur in up to 50% and metastasize in up to 20%. We recently detected characteristic UV-induced TP53 mutations as potential driver mutation in almost all PDS investigated as well as activating PIK3CA and RAS gene mutations in around one third of our tumors representing targets for personalized treatments in patients with unresectable or metastasized PDS...
December 12, 2017: Oncotarget
Giulia Magi Meconi, Nicholas Ballard, José M Asua, Ronen Zangi
Although surfactants are known to play a vital role in polymerization reactions carried out in dispersed media, many aspects of their use are poorly understood, perhaps none more so than the vastly different action of ionic and nonionic surfactants in emulsion polymerization. In this work, we combine experimental measurements of emulsion polymerization of styrene with atomistic molecular dynamics simulations to better understand the behavior of surfactants at monomer/polymer-water interfaces. In a batch emulsion polymerization of styrene, the nonionic surfactant Disponil AFX 1080 leads to two nucleation periods, in contrast to the behavior observed for the ionic surfactant SDS...
December 6, 2017: Physical Chemistry Chemical Physics: PCCP
Kevin Lai, Catherine A Harwood, Karin J Purdie, Charlotte M Proby, Irene M Leigh, Namita Ravi, Thaddeus W Mully, Lionel Brooks, Priscilla M Sandoval, Michael D Rosenblum, Sarah T Arron
Atypical fibroxanthoma (AFX), is a rare type of skin cancer affecting older individuals with sun damaged skin. Since there is limited genomic information about AFX, our study seeks to improve the understanding of AFX through whole-exome and RNA sequencing of 8 matched tumor-normal samples. AFX is a highly mutated malignancy with recurrent mutations in a number of genes, including COL11A1, ERBB4, CSMD3, and FAT1. The majority of mutations identified were UV signature (C>T in dipyrimidines). We observed deletion of chromosomal segments on chr9p and chr13q, including tumor suppressor genes such as KANK1 and CDKN2A, but no gene fusions were found...
2017: PloS One
Jeffrey D Cizenski, Ramsay S Farah
We describe a painful atypical fibroxanthoma (AFX) arising in a setting of erosive pustular dermatosis of the scalp. Complete excision was curative and also was associated with resolution of pain and clearance of the erosive pustular dermatosis of the scalp. We review the diagnosis and management of AFX and discuss the role of actinic damage in this process.
September 2017: Cutis; Cutaneous Medicine for the Practitioner
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