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At least 19 recordsLinked to original sources
PubMed1990

Acquired perforating dermatosis: comparison of an acquired perforating dermatosis and perforation as an incidental histologic finding.

A 66-year-old Japanese woman with a rare acquired perforating disorder, usually called adult-type reactive perforating collagenosis, is reported. The patient had poorly controlled diabetes mellitus with retinopathy under oral diabetic medication. She was found to have multiple papules and umbilicated nodules on the trunk and four extremities when she was admitted and examined for the origin of jaundice and severe pruritus of sudden onset. In the biopsy specimen, collagen fibers were observed to be eliminated from the dermis through epidermal tunnel-like perforations. No elastic fibers were eliminated, and serial sectioning of the specimen could not prove follicular perforation. Adenocarcinoma of the biliary duct was found to be the cause of the jaundice with pruritus. Although such cases are usually classified as acquired reactive perforating collagenosis of adult onset, proposed reclassification for acquired perforating disorders is discussed. Another case which also showed perforation and transepithelial elimination of both collagen and elastic fibers as an incidental histologic finding is described. Such elimination seems to be a not uncommon step in the formation of pruriginous eruptions. Therefore, these cases should be differentiated from acquired-type characteristic perforating disorders.

Aged↗
PubMed1991

[Retinal detachment after perforating eye injuries. III. Analysis of retinal detachment after perforating eye injuries and determination of the characteristics of the retinal detachment after perforating eye injuries].

In 1977-1987 the authors operated, using the cryosurgical method post-traumatic retinal detachment in 69 patients. Retinal detachment developed in 37 patients after simple perforation of the eye by a foreign intraocular body. In all patients the perforation penetrated as far as the vitreous space. In patients with retinal detachment the authors investigated the following: the patient's age, refraction, period of retinal detachment, extent of retinal detachment, the state of the macula, the characteristics of the retinal defect (site, size and number), type of retinal detachment and associated adverse factors. In the characteristics of retinal detachment after perforating eye injuries the first place was held by prognostically adverse vitreous traction in 73.9%.

Adolescent↗
PubMed1991

Perforated and non-perforated synapses in rat neocortex: three-dimensional reconstructions.

Perforated and non-perforated synapses in the molecular layer of rat parietal cortex have been assessed morphologically and quantitatively using three-dimensional reconstructions of the postsynaptic terminal. Perforated synapses were analyzed at nine ages, ranging from 0.5 to 22 months of age, and non-perforated synapses at three ages--0.5, 12, and 22 months. Examination of the reconstructions shows that perforated synapses increase in size and complexity with increasing age. This increasing complexity is reflected in a break-up of the postsynaptic density, which is punctuated by larger, branched perforations. In the most extreme cases the result is the appearance of isolated islands of postsynaptic density separated by, and also surrounded by, a synaptic contact zone. Spinules are especially prominent at around 12 months of age in perforated synapses, and the overall negative curvature of the young junctions is replaced by positively curved junctions from 4 months onwards. The non-perforated synapses are relatively small and show few changes with increasing age. Using the measurement option in the reconstruction program, the following trends emerged. All parameters of perforated synapses increased in size with increasing age, whereas the corresponding parameters of non-perforated synapses remained relatively unchanged over this age range. In addition, the percentage of the synaptic contact zone surface area occupied by the postsynaptic density decreased with increasing age in perforated synapses, but increased in non-perforated synapses. The total postsynaptic density surface area of non-perforated synapses per unit volume of molecular layer was double that of perforated synapses at 0.5 months, but the situation was reversed at 12 months. This parameter was similar in the 2 populations at 22 months. This suggests that perforated synapses contribute more to the total surface area of the postsynaptic density in mid- to late-adulthood than do non-perforated synapses, despite non-perforated synapses outnumbering perforated by 2-3:1 at these ages. These data provide more specific evidence that perforated and non-perforated synapses constitute separate synaptic populations from early in development, and that perforated synapses are responsible for the maintenance of neuronal postsynaptic density surface area from mid-adulthood onwards.

Animals↗
PubMed1991

"Mini-perforation" of the colon--not all postpolypectomy perforations require laparotomy.

In a 10-year experience with 4,784 consecutive colonoscopic polypectomies, the need for operative intervention in just two of seven perforations indicates that patients with specially defined, limited perforations can usually be treated nonoperatively. This specific complication, which has been termed "mini-perforation," is generally detected within 6-24 hours of polypectomy, and is characterized by local pain and tenderness, without signs of diffuse or spreading peritoneal irritation. Free intra-abdominal or retroperitoneal air on x-ray documents the actual perforation. Complete resolution of symptoms within 24-48 hours confirms the diagnosis of "mini-perforation." Success depends on good bowel preparation for colonoscopy, and early recognition of perforation, with institution of bowel rest and intravenous antibiotics. The "mini-perforation" spontaneously closes, probably by omental adherence. Frequent serial clinical examinations are mandatory so that frank perforation with advancing peritonitis will be promptly recognized and treated surgically. An understanding of the three levels of cautery injury to the colon wall--"serosal burn," "mini-perforation," and "frank perforation" are essential in managing the complications of colonoscopic polypectomy.

Anti-Bacterial Agents↗
PubMed1977

Resection of the perforated segment. A significant advance in treatment of diverticulitis with free perforation or abscess.

As a result of improved medical management of chronic diverticular disease, perforation has become the most common indication for surgical intervention. During the past five years sixty-three patients underwent operation for colonic diverticular disease, of which forty-six were for perforation (generalized peritonitis in 8, abscess in 30, and fistula in 8). The eight patients with generalized peritonitis underwent emergency exploration for spreading peritoneal signs and were managed by resection of the perforated segment, end colostomy, and mucous fistula or Hartmann's pouch. Treatment of thirty-eight patients with abscess or fistula has also stressed primary resection of the perforated segment of colon. Resection and end colostomy without anastomosis was performed in three. Primary anastomosis with proximal diverting colostomy was performed in four. Primary anastomosis alone was done in thirty-one patients. There were no deaths. These results support primary resection of the involved colon with immediate or delayed anastomosis in the operative management of perforated diverticular disease.

Abscess↗
PubMedDate not supplied

Endothelial reaction to perforating and non-perforating excimer laser excisions in rabbits.

With an ArF excimer laser (193 nm, 750 mJ/cm2, 20 Hz) and a special slit-mask system, perforating and non-perforating linear keratectomies were performed in 55 rabbit corneas with a follow-up from 1 hour to 6 months. Varying the pulse number according to ablation rate (0.8 micron/pulse) and corneal thickness, four linear radial excisions (3 mm length, 70 microns width) of increasing depth (70%, 80%, 90%, 100% perforation) were produced. The corneas were processed for light microscopy, scanning and transmission electron microscopy, and vital staining of the endothelium. Except for mild cell contact alterations and discrete single cell damage in the 90% deep excisions, no endothelial damage could be detected after non-perforating keratectomies. Minute (less than 20 microns) and small (20 to 100 microns maximal diameter) perforations induced cell enlargement, formation of pseudopodia, rosette-like figures, multi-nucleated giant cells, and ultimately uniform reformation of the cell pattern (1 hour to 7 days postoperatively). Larger excimer laser defects of Descemet's membrane (greater than 100 microns) were overgrown by dedifferentiated endothelial cells producing a new PAS-positive basement membrane. Vital staining revealed the complete and stable reorganization of the endothelium over these lesions within 6 months. Our observations are similar to those reported on the endothelial repair process following other surgical manipulations (knife incisions, direct Nd:YAG-laser trauma) and support the applicability of excimer lasers for corneal trephination in patients.

Animals↗
PubMed1989

[Use of a fibrin glue (Tissucol) for treating perforated or pre-perforated corneal ulcer].

Treatment of perforated and preperforated corneal ulcers is a difficult task. As emergency penetrating keratoplasty results in poor visual outcome, surgical glue has been suggested as an alternative solution, but poor corneal tolerance for cyanoacrylate made this treatment non satisfactory. We treated 15 corneal ulcers (11 perforations, 2 descemetoceles and 2 deep ulcers) with a fibrin glue. Cicatrisation was obtained in 14 cases by this technic. In one case, cicatrisation was not satisfactory and penetrating keratoplasty was performed 3 days later. This method permits healing of the corneal perforation without the necessity of performing penetrating keratoplasty either if the perforation is distant from the visual axis or if penetrating keratoplasty is contraindicated. In other cases it permits a later penetrating keratoplasty to be performed an a quiet eye. We think this technic can be useful in corneal perforations less than 2 mm in diameter and in chronic deep ulcers difficult to heal.

Corneal Ulcer↗
PubMed1989

Ehlers-Danlos syndrome complicated by eventration of the diaphragm, colonic perforation and jejunal perforation--a case report.

A case of a 61 year old woman with Ehlers-Danlos syndrome who developed recurrent gastrointestinal complications is reported herein. She has been followed by Kyoundo Hospital since 1965, when she originally underwent treatment for eventration of the diaphragm and a volvulus of the stomach at the age of 41. During the past 22 years she has experienced perforation of the colon three times and jejunal perforation once. This case was considered to be type II Ehlers-Danlos syndrome. We have found 12 other cases of Ehlers-Danlos syndrome with gastrointestinal complications in the Japanese literature. More thorough examination of Ehlers-Danlos syndrome cases may reveal more subclinical gastrointestinal abnormalities. We concluded from our experience and from the literature that when colonic perforation occurs in this syndrome, total colectomy and ileo-rectal anastomosis is reasonably indicated.

Adult↗
PubMed1992

Small bowel perforation associated with intraperitoneal and extraperitoneal bladder perforation caused by stab wound to the penis.

We report an unusual case of small bowel and bladder perforation caused by a stab wound to the penis with preservation of intact corporeal penile bodies and urethra. Diagnosis of bladder perforation was made by the urethrogram and diagnosis of small bowel perforation was made by clinical signs even though the initial physical examination suggested neither of these conditions.

Adult↗
PubMed1979

[Colonic perforation with special reference to spontaneous ileo-colic perforation].

Aetiology of colonic perforation is reviewed and discussed. 8 cases of "spontaneous" ileo-colic perforations observed between 1975 and 1977 are presented. Two of these patients had recently undergone appendectomy, and 4 others showed a simultaneous distal carcinoma of the large bowel. Histo-pathological evaluation did not reveal the cause of intestinal perforation. Operative treatment and results are given.

Adolescent↗
PubMed1990

[Corneal wound healing after perforating and non-perforating excimer laser keratectomy. An experimental study].

For clinical use of the excimer laser more detailed knowledge of corneal wound healing is necessary. With an ArF excimer laser (193 nm, 750 mJ/cm2, 20 Hz) and a special slit mask system perforating and non-perforating keratectomies were performed in a series of 55 rabbits with a follow-up from one hour to six months post-op. After enucleation the corneas were immediately processed for light microscopy, scanning and transmission electron microscopy and vital staining of the endothelium (trypan blue/alizarin red S). In perforating cuts the endothelial reaction consists of polymegathism, migration, formation of multi-nucleated giant cells, metaplasia-like proliferation and ultimately stable reformation of the cell pattern (1h to 42d). Epithelium fills the anterior wound gap within three days with subsequent regression of the plug. Fibroblastic activity in the adjacent stroma leads to cellular immigration, production of new collageneous lamellae and complete reorganization of the wound cleft (1d to 6m). Nonperforating excisions showed similar healing tendency of stroma and epithelium, but no severe endothelial damage could be detected. Compared with former studies using knife incisions our results do not reveal significant difference regarding epithelial and stromal wound healing events. The encouraging healing tendency of the endothelium--similar to regeneration after ultrasound and Nd:YAG-laser damage--also confirms the applicability of excimer lasers in corneal surgery.

Animals↗
PubMed1989

[Incidence of recurrence following surgery of perforating and non-perforating complications in Crohn disease].

From 1980-1987 131 patients were operated for Crohn's disease. Among these 73 patients had perforated (PC) free perforation, abscess, fistula, and 47 had nonperforating complications (NC). Ileums, bleeding, stenosis reoperations (58 pts, 44%) were seen more often in the PC-group (57%) compared to 31% in the NC-group. Furthermore there was a high concordance in the indication for the initial and subsequent operations.

Adult↗
PubMed1976

Transepidermal elimination of traumatically altered collagen. Report of three cases and considerations on the relationship between 'collagénome perforant verruciforme' and reactive perforating collagenosis.

Three cases of transepidermal elimination of traumatically altered collagen, including a case of 'collagénome perforant verruciforme' (CPV), are reported. On the basis of our own observations and on the data of the literature, CPV and reactive perforating collagenosis are considered as related, but different entities.

Adult↗