THREE TYPES OF INTRAHEPATIC SHUNTS PRESENTING IN A SINGLE PATIENT WITH HEREDITARY HEMORRHAGIC TELANGIECTASIA

2018 ◽  
Vol 71 (11) ◽  
pp. A2393 ◽  
Author(s):  
Eric Brandt ◽  
Leila Haghighat ◽  
Guadalupe Garcia-Tsao ◽  
Katharine Henderson ◽  
Jeffrey Pollak ◽  
...  
2018 ◽  
Vol 169 (7) ◽  
pp. 508 ◽  
Author(s):  
Leila Haghighat ◽  
Eric J. Brandt ◽  
Deborah D. Proctor ◽  
Guadalupe Garcia-Tsao ◽  
Jeffrey Pollak ◽  
...  

2007 ◽  
Vol 106 (3) ◽  
pp. 470-477 ◽  
Author(s):  
Rose Du ◽  
Tomoki Hashimoto ◽  
Tarik Tihan ◽  
William L. Young ◽  
Victor Perry ◽  
...  

✓ Data on the growth, regression, and de novo formation of arteriovenous malformations (AVMs) suggest that some of these lesions are not formed and developed only during embryogenesis. Patients with hereditary hemorrhagic telangiectasia (HHT) have a genetic propensity to form AVMs. The authors report on the growth and regression of AVMs in a single patient with HHT. This 26-day-old boy with a family history of HHT1 and a mutation in ENG on chromosome 9 presented with a generalized seizure. Results of computed tomography revealed a left frontoparietal intra-parenchymal hemorrhage. Cerebral angiography revealed multiple AVMs. Follow-up angiograms obtained 5 months later showed both growth and regression of the AVMs. A craniotomy was performed for complete resection of the left parietal AVM. Histopathological features of the surgical specimen were examined. Active angiogenesis, as indicated by increased endothelial proliferation, might be a part of the underlying pathophysiology of the growth and regression of AVMs.


2001 ◽  
Vol 125 (9) ◽  
pp. 1219-1223
Author(s):  
Motoji Sawabe ◽  
Tomio Arai ◽  
Yukiyoshi Esaki ◽  
Masanobu Tsuru ◽  
Toshio Fukazawa ◽  
...  

Abstract Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant systemic fibrovascular dysplasia. Although hepatic vascular shunts are often observed in HHT, the responsible pathological mechanism is unknown. This issue was addressed by performing a 3-dimensional reconstruction study of the hepatic microvasculature of an HHT-involved liver in a 79-year-old woman. Clinical observation revealed high-output congestive heart failure and hepatic encephalopathy due to arteriovenous and portovenous shunts, respectively. Angiography revealed tortuous dilation of hepatic arterial branches and intrahepatic arteriovenous shunts. The 3-dimensional analysis of the autopsy liver revealed focal sinusoidal ectasia, arteriovenous shunts through abnormal direct communications between arterioles and ectatic sinusoids, and portovenous shunts due to frequent and large communications between portal veins and ectatic sinusoids. Type 1 HHT was suggested by the lack of endoglin immunoreactivity in the liver. The 3-dimensional reconstruction study of hepatic microvasculature was successful in identifying the pathological changes responsible for the intrahepatic shunts in HHT.


1967 ◽  
Vol 10 (2) ◽  
pp. 367-372 ◽  
Author(s):  
James D. Miller ◽  
Arthur F. Niemoeller

Results of intelligibility tests on a single patient with a severe discrimination loss for speech are reported. The patient was tested with four different hearing aids and with no aid, and the effects of opportunity for lipreading, background noise, and reverberation were evaluated. The tests appear to allow an accurate estimate of the amount of help to be expected in various situations and show that an aid with good fidelity is clearly superior to the others tested. The destructive effects of background noise and reverberation are demonstrated separately and in combination.


1963 ◽  
Vol 44 (1) ◽  
pp. 1-6 ◽  
Author(s):  
C. Russell Smith ◽  
Lloyd G. Bartholomew ◽  
James C. Cain

2005 ◽  
Vol 38 (15) ◽  
pp. 81
Author(s):  
DEBORAH LEVENSON
Keyword(s):  

1997 ◽  
Vol 77 (02) ◽  
pp. 243-247 ◽  
Author(s):  
Hiroshi Yamaguchi ◽  
Hiroyuki Azuma ◽  
Toshio Shigekiyo ◽  
Hideo Inoue ◽  
Shiro Saito

SummaryHereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by multisystem vascular dysplasia and recurrent hemorrhage. Recent investigation has mapped one of the responsible genes for HHT to chromosome 9q33-q34; subsequently, nine different mutations have been identified in the endoglin gene, which encodes a transforming growth factor β(TGF-β) binding protein, in nine unrelated families with HHT. We examined the endoglin gene in a Japanese patient with HHT and her family members. Using PCR-SSCP. analysis followed by sequencing, we identified a C to A missense mutation in exon 4 which changed an Ala160 codon(GCT) to an Asp160 codon (GAT). Since this mutation destroys one of three Fnu4H I sites in exon 4, the Fnu4H I digestion patterns of the PCR-amplified exon 4 fragments from each family member were analyzed. In affected members, the restriction patterns were all consistent with a phenotype of HHT. PCR-amplified exon 4 fragments from 150 normal individuals were also analyzed by allele-specific oligonucleotide hybridization analysis. As a result, the mutation was not found in any of them. We conclude that the C to A mutation in exon 4 of the endoglin gene in this proband is responsible for the occurrence of HHT in this family.


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