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1

Quantificação morfométrica de Chlamydia pneumoniae e Mycoplasma pneumoniae em aneurismas de aorta abdominal humana Morphometrical quantification of Chlamydia pneumoniae and Mycoplasma pneumoniae in human atherosclerotic abdominal aortic aneurysms  

Microsoft Academic Search

Objective: Atherosclerotic inflammation with a possible role of infectious agents can contribute to the pathogenesis of abdominal aortic aneurysms (AAA). The finding of Chlamydia pneumoniae (CP) in these lesions in previous non-quantifying studies ranged from 0-100%. The objective is to quantify the presence of CP and Mycoplasma pneumoniae (MP) in AAA. Methods: The thickness, and the number of cells positive

Lucas José; Tachotti PIRES; Paulo Sampaio GUTIERREZ

2007-01-01

2

A Fibromatosis Case Mimicking Abdominal Aorta Aneurysm  

PubMed Central

Retroperitoneal fibrosis is a rare fibrosing reactive process that may be confused with mesenteric fibromatosis. Abdominal aorta aneurysm is rare too and mostly develops secondary to Behcet's disease, trauma, and infection or connective tissue diseases. Incidence of aneurysms occurring as a result of atherosclerotic changes increases in postmenopausal period. Diagnosis can be established with arteriography, tomography, or magnetic resonance imaging associated with clinical findings. Tumors and cysts should be considered in differential diagnosis. Abdominal ultrasound and contrast-enhanced computerized tomography revealed an infrarenal abdominal aorta aneurysm in a 41-year-old woman, but, on surgery, retroperitoneal fibrosis surrounding the aorta was detected. We present this interesting case because retroperitoneal fibrosis encircling the abdominal aorta can mimic abdominal aorta aneurysm radiologically.

Tasdemir, Arzu; Kahraman, Cemal; Tasdemir, Kutay; Mavili, Ertugrul

2013-01-01

3

Pathology of the ThoracoAbdominal Aorta  

Microsoft Academic Search

\\u000a The aorta is the great systemic artery of the human body. It is composed of three layers or tunicae — the intima, media, and\\u000a adventitia. The strength of the aorta lies in the tunica media, with the so-called lamellar units that represent the basic\\u000a structural and functional components in the aortic wall. The pathology of the thoraco-abdominal aorta is traditionally

Cristina Basso; Stefania Rizzo; Gaetano Thiene

4

Spontaneous isolated dissection of the abdominal aorta.  

PubMed

Isolated spontaneous dissection of the abdominal aorta is such a rare entity and there are only a few cases reported in literature up to date. A 42-year old male was admitted to the hospital with mild pain in the lower abdomen and back that had began seven days prior to admission together with the sudden onset of the ischemic symptoms of the left leg (ischemic ulcers of the calf gangrenous toe and pallor foot). Patient denied any trauma, hypertension history was negative, while he was active cigarette smoker. MSCT and digital subtracted angiography have shown a dissection of the abdominal aorta approximately two centimeters below the origin of the inferior mesenteric artery extending in the left common iliac artery, with no sign of the aneurysmatic dilatation of the abdominal aorta. Emergent surgery was performed with aorto-biiliacal bypass graft interposition, amputation of the left toe and necrectomy of the left calf Postoperative follow up and local vascular condition were satisfied. Even though is rare entity, isolated abdominal aorta dissection accounts for approximately 2-4% of all aortic dissection. Nowadays therapeutic regimen includes endovascular, open surgery or conservative treatment. PMID:24611358

Ivkosi?, Ante; Budincevi?, Hrvoje; Krstonijevi?, Zoran; Bari?, Marko; Lojo, Nermin; Trajbar, Dubravka; Gorski, Dinko; Suknai?, Slaven; Suci?, Tena

2013-12-01

5

Infrarenal abdominal aorta approach through median minilaparotomy.  

PubMed

Classically, infrarenal aortic exposure is achieved by xyphopubic or xypho-infraumbilical laparotomy, in transperitoneal approach, or through a left abdominal incision, in retroperitoneal approach. The transperitoneal approach is associated with longer intestinal activity resumption time and incisional hernias on long term, due to intestinal extracavitary mobilization and long incision. These disadvantages disappear in laparoscopic approach, but this method is extremely laborious, requires an extended period for dissection, and elicits increased difficulty in performing the anastomosis on the aorta. The purpose of the study is to evaluate the infrarenal abdominal aorta approach through median minilaparotomy, a method that combines the excellent exposure of xypho-pubic incision with the low morbidity of laparoscopic approach. Between 07.01.2010 - 07.01.2011, we performed 37 revascularization surgeries in 36 patients with aorto-iliac occlusive disease (one patient required reintervention due to graft thrombosis), approaching the infrarenal aorta through median minilaparotomy. The sex distribution was 35 men and one woman. The average age was 61.1 years. There have been 25 aorto-bifemoral bypasses, 11 aorto-unifemoral bypasses, and one aorto-biiliac bypass. The mean aorta clamping time was 15 minutes. Average operating time was 150 minutes. We used 26 bifurcated Dacron prostheses and 11 linear ePTFEprostheses. The average intestinal activity resumption time was 32 hours. All patients included in the study were mobilized 24 hours after surgery. The average length of hospitalization was 7.7 days. 5 patients experienced complications during hospitalization and 3 patients suffered long term complications. Infrarenal abdominal aorta approach through median minilaparotomy is a viable alternative to conventional surgical techniques used in aortoiliac occlusive disease. PMID:23294956

P?tru?, G V; Jiga, L P; T?ranu, G P; Rata, A; Neamtu, C; Ionac, M

2012-01-01

6

Quantitative anatomy of the growing abdominal aorta in human fetuses: An anatomical, digital and statistical study  

PubMed Central

Summary Background Advances in perinatal medicine have required an extensive knowledge of fetal aorto-iliac measurements. The present study was performed to compile reference data for dimensions of the abdominal aorta at varying gestational ages. Material/Methods Using the methods of anatomical dissection, digital-image analysis (Leica QWin Pro 16 system), and statistical analysis (Student’s t-test, one-way ANOVA, post-hoc RIR Tukey test, regression analysis, and Wilcoxon signed-rank test), the growth of length (mm), proximal and distal external diameters (mm), and volume (mm3) of the abdominal aorta in 124 (60 male, 64 female) spontaneously aborted human fetuses aged 15–34 weeks was examined. Results No significant male-female differences were found. The length ranged from 9.35±1.24 to 36.29±4.98 mm, according to the linear function y=?14.596+1.519 × Age ±2.639 (R2=0.92; p<0.0001). The proximal external diameter varied from 1.18±0.25 to 5.19±0.49 mm, according to the linear pattern y=?2.065+0.212 × Age ±0.348 (R2=0.92; p<0.0001). The distal external diameter increased from 1.03±0.23 to 4.92±0.46 mm, in accordance with the linear model y=?2.097+0.203 × Age ±0.351 (R2=0.92; p<0.0001). Both length and proximal external diameter of the abdominal aorta indicated a proportionate evolution, because the length-to-proximal external diameter ratio was stable, following the linear function y=7.724–0.017 × Age ±0.925. The abdominal aorta volume ranged from 9.6±4.5 to 740.5±201.8 mm3, given by the quadratic function y=911–101 × Age +2.838 × Age2 ±78 (R2=0.89; p<0.0001). Conclusions There are no significant differences between males and females for morphometric parameters of the abdominal aorta. The abdominal aorta grows linearly in both length and diameters, and parabolically in volume. These detailed morphometric data of the abdominal aorta provide a database for intra-uterine echographic examinations in the early diagnosis, monitoring and management of aorto-iliac malformations.

Szpinda, Michal; Szpinda, Anna; WoYniak, Alina; Mila-Kierzenkowska, Celestyna; Kosinski, Adam; Grzybiak, Marek

2012-01-01

7

Paratesticular rhabdomyosarcoma with metastatic encasement of the abdominal aorta.  

PubMed

Paratesticular rhabdomyosarcoma is a rare but aggressive malignancy in children and adolescents. Prognosis is related to initial tumor resectability as well as staging of the disease based on tumor invasiveness, tumor bulk, nodal disease and metastases. We report the unusual presentation of paratesticular rhabdomyosarcoma with metastatic extension through the inguinal canal and encasement of the abdominal aorta. These features portend a poor prognosis given their association with a greater stage of disease and unresectable nature at presentation. Delayed surgical resection follows a regimen of chemotherapy and radiation therapy in such cases of extensive disease. Encasement of the abdominal aorta has been shown to increase presurgical risk for intraoperative vascular injury when related to other malignancies, but its role in relation to metastatic paratesticular rhabdomyosarcoma has not been investigated. Also, rhabdomyosarcoma should be considered in the differential diagnoses of tumors that demonstrate encasement of the abdominal aorta. PMID:21258928

Aquino, Michael R; Gibson, Donald P; Bloom, David A

2011-08-01

8

An unusual presentation of ruptured abdominal aorta aneurysm  

PubMed Central

Patient: Female, 65 Final Diagnosis: Ruptured abdominal aorta aneursym Symptoms: — Medication: — Clinical Procedure: After surgery the patient was discharged without sequelae Specialty: Surgery Objective: Unusual clinical course Background: Rupture of an abdominal aortic aneurysm is the most frightening and potentially life threatening complication of an abdominal aorta aneurysm (AAA). Patients present with atypical symptoms such as abdominal or flank pain, gastrointestinal hemorrhage, or shock. Case Report: A 65-year-old woman presented to our emergency department with gradually increasing left flank pain for 4–5 days. Her laboratory, radiologic, and physical examination revealed no significant pathology, so she was discharged, but 3 days later she was readmitted because her symptoms returned. Further research revealed a ruptured AAA and the patient was hospitalized for surgical intervention. Conclusions: Emergency physicians should keep in mind that AAA and its rupture can present with a wide range of symptoms that appear to be simple.

Durdu, Tamer; Yilmaz, Fevzi; Sonmez, Bedriye Muge; Ulgen, Sultan; Demir, Ali; Y?lmaz, Muhittin Serkan; Arslan, Engin Deniz; Hakbilir, Oktay

2013-01-01

9

Mechanics, Mechanobiology, and Modeling of Human Abdominal Aorta and Aneurysms  

PubMed Central

Biomechanical factors play fundamental roles in the natural history of abdominal aortic aneurysms (AAAs) and their responses to treatment. Advances during the past two decades have increased our understanding of the mechanics and biology of the human abdominal aorta and AAAs, yet there remains a pressing need for considerable new data and resulting patient-specific computational models that can better describe the current status of a lesion and better predict the evolution of lesion geometry, composition, and material properties and thereby improve interventional planning. In this paper, we briefly review data on the structure and function of the human abdominal aorta and aneurysmal wall, past models of the mechanics, and recent growth and remodeling models. We conclude by identifying open problems that we hope will motivate studies to improve our computational modeling and thus general understanding of AAAs.

Humphrey, J.D.; Holzapfel, G.A.

2011-01-01

10

Paratesticular rhabdomyosarcoma with metastatic encasement of the abdominal aorta  

Microsoft Academic Search

Paratesticular rhabdomyosarcoma is a rare but aggressive malignancy in children and adolescents. Prognosis is related to initial\\u000a tumor resectability as well as staging of the disease based on tumor invasiveness, tumor bulk, nodal disease and metastases.\\u000a We report the unusual presentation of paratesticular rhabdomyosarcoma with metastatic extension through the inguinal canal\\u000a and encasement of the abdominal aorta. These features portend

Michael R. Aquino; Donald P. Gibson; David A. Bloom

11

Axial prestretch and circumferential distensibility in biomechanics of abdominal aorta.  

PubMed

Elastic arteries are significantly prestretched in an axial direction. This property minimises axial deformations during pressure cycle. Ageing-induced changes in arterial biomechanics, among others, are manifested via a marked decrease in the prestretch. Although this fact is well known, little attention has been paid to the effect of decreased prestretch on mechanical response. Our study presents the results of an analytical simulation of the inflation-extension behaviour of the human abdominal aorta treated as nonlinear, anisotropic, prestrained thin-walled as well as thick-walled tube with closed ends. The constitutive parameters and geometries for 17 aortas adopted from the literature were supplemented with initial axial prestretches obtained from the statistics of 365 autopsy measurements. For each aorta, the inflation-extension response was calculated three times, with the expected value of the initial prestretch and with the upper and lower confidence limit of the initial prestretch derived from the statistics. This approach enabled age-related trends to be evaluated bearing in mind the uncertainty in the prestretch. Despite significantly decreased longitudinal prestretch with age, the biomechanical response of human abdominal aorta changes substantially depending on the initial axial stretch was used. In particular, substituting the upper limit of initial prestretch gave mechanical responses which can be characterised by (1) low variation in axial stretch and (2) high circumferential distensibility during pressurisation, in contrast to the responses obtained for their weakly prestretched counterparts. The simulation also suggested the significant effect of the axial prestretch on the variation of axial stress in the pressure cycle. Finally, the obtained results are in accordance with the hypothesis that circumferential-to-axial stiffness ratio is the quantity relatively constant within this cycle. PMID:24136338

Horný, Lukáš; Netušil, Marek; Vo?avková, Tereza

2014-08-01

12

Acute thrombosis of the non-aneurysmal abdominal aorta.  

PubMed

Fourteen patients admitted over a 9 year period with acute thrombotic occlusion of the non-aneurysmal abdominal aorta have been reviewed. Twelve patients underwent aortic bifurcation graft reconstruction, one thromboendarterectomy alone, and one a re-entry operation for dissection. Two patients (14%) died in the perioperative period. The mean postoperative survival of the remaining patients is to date 55 (range 4-93) months with a mean follow-up period of 69 (range 18-100) months. The results indicate these patients should be treated aggressively by early reconstructive surgery in the expectation that the majority will survive their operation and gain a useful extension to their lives. PMID:8513913

Bradbury, A W; Stonebridge, P A; John, T G; Ruckley, C V; Jenkins, A M; Murie, J A

1993-05-01

13

A Case of Double Inflammatory Aneurysms in the Thoracic and Abdominal Aorta Repaired Simultaneously  

PubMed Central

A 54-year-old male who had been experiencing a high fever for a month was admitted to a local hospital for examination. Computed tomography revealed saccular aneurysms in the descending thoracic aorta and infrarenal abdominal aorta. The walls of the aneurysms were thickened and enhanced by intravenous contrast which suggested the inflammatory change. He was transferred to this hospital and underwent graft replacement of both the descending thoracic aorta and the abdominal aorta simultaneously. Simultaneous surgery should be considered in patients presenting with multiple inflammatory aneurysms, since inflammatory aneurysms have a risk of demonstrating rapid enlargement.

2010-01-01

14

Aneurysm of the abdominal aorta in an eighteen-month-old child  

Microsoft Academic Search

We report the case of an infected aneurysm of the abdominal aorta in a 18 month-old child, discovered by routine palpation\\u000a of the abdomen during hospitalization for pneumonia. Ultrasonography and arteriography showed a 6 cm aneurysm of the abdominal\\u000a aorta beginning distal to the renal arteries which occluded the right common Iliac artery. The aneurysm was treated by interposing\\u000a a

Jean Olivier Defraigne; Jean Pierre Paquot; Etienne Creemers

1988-01-01

15

Acute Abdominal Aorta Embolism Caused by Rupture of a Cardiac Hydatid Cyst  

Microsoft Academic Search

We report a case of an abdominal aortic embolism due to rupture of a cardiac hydatid cyst. This report emphasizes the diagnostic, preventative, and treatment options for hydatid cyst embolism of abdominal aorta. Echocardiography should be routinely performed in all patients with hydatid disease for possible involvement of the heart. This enables early diagnosis and treatment of cardiac echinococcus before

Vedat Nisanoglu; Nevzat Erdil; Burak Isik; Bektas Battaloglu; ?lker Alat

2004-01-01

16

Classic pneumatosis intestinalis and hepatic portal venous gas in setting of severe abdominal aorta atherosclerosis  

PubMed Central

An 86-year-old man with extensive past medical history was referred to Emergency Department for evaluation of dehydration, hyperkalemia and worsening of mental status. In physical examination, abdomen was distended and tender with no bowel sounds. Abdominal computed tomographic imaging revealed pneumatosis intestinalis (PI) and hepatic portal venous gas (HPVG) in presence of severe atherosclerotic calcification of abdominal aorta.

Khosraviani, Khashayar; Guelfguat, Mark

2013-01-01

17

Morphometric analysis of hypertension-induced hypertrophy of rat thoracic aorta.  

PubMed Central

The response of the intima-media of the thoracic aorta to 1 to 4 weeks of two-kidney renal hypertension in the rat has been analyzed by morphometric techniques at light and electron microscopic levels. The increased thickness of the aorta that ensues is the result of an increase in the size but not the number of smooth muscle cell layers. The volume fractions of intima occupied by endothelium (26%), internal elastic lamina (37%), and subendothelial space (37%) in normotensive animals are not significantly altered by the hypertension. The percent increases in muscle cross-sectional area is greatest (58 to 60%) in the two innermost layers (M1 and M2). M1 is composed of nearly equal compartments of smooth muscle cells and interstitial space that expand 69% and 50%, respectively, with hypertension. Analysis of the subcellular constituents of the M1 smooth muscle cells indicates that significant changes in absolute volume include increases of caveolae (45%), myofibrils (59%), mitochondria (81%), glycogen (163%), and rough endoplasmic reticulum (221%). Factors contributing to these alterations are discussed. Images Figure 1 Figure 2

Wiener, J.; Loud, A. V.; Giacomelli, F.; Anversa, P.

1977-01-01

18

Pulse-wave Doppler interrogation of the abdominal aorta: a window to the left heart and vasculature.  

PubMed

Systematic imaging of the abdominal aorta during transthoracic echocardiography is advocated as a useful screening tool for aortic aneurysms. The addition of pulse Doppler interrogation to the two-dimensional imaging can be highly valuable and provides incremental hemodynamic information regarding a wide spectrum of diseases that involve the left heart, aorta, and vasculature. In this manuscript, we review the usefulness of pulse Doppler recording of the abdominal aorta and provide case examples of its value in various disease states. PMID:24702564

Fadel, Bahaa M; Bakarman, Hatem; Al-Admawi, Mohamad; Bech-Hanssen, Odd; Di Salvo, Giovanni

2014-04-01

19

[False hydatic aneurysm of the thoraco-abdominal aorta].  

PubMed

Arterial complications of hydatic disease are rarely encountered. We report a false hydatic aneurysm of the thoracoabdominal aorta revealed by ischemic embolism of the lower limbs. Surgical treatment included aorto-aortic prosthesis and albendazol for 6 months. Results at 18 months are excellent with negative hydatic serology. In endemic areas, hydatic disease is a possible cause of false aneurysms. Long-term surveillance is required after curative surgery and medical treatment. PMID:8999043

El Mesnaoui, A; Bensaïd, Y; Ammar, A; El Yagoubi, M; Benabderrazik, T; Benjelloun, A; Benyahia, B

1996-07-01

20

Effect of danshen on the zero-stress state of rat's abdominal aorta.  

PubMed

The objective of our study was to study the effect of danshen, a Chinese herbal medicine known to prevent hypertension, on the zero-stress state of rat's abdominal aorta. The zero-stress state of a blood vessel represents the release of residual stress on the vessel wall, and is the basic configuration of blood vessel affected solely by intrinsic parameters. At the in vivo state, the rat's abdominal aorta was subjected to blood pressure and flow and longitudinal stress. After dissecting from the abdominal aorta, the aortic specimens were cut into small rings at no-load state, in which the internal pressure, external pressure, and longitudinal stress in a short ring-shaped segment were all zero; by cutting radially to release the residual stress in the wall, the vessel ring opened up into a sector quickly, and the sector's configuration would not change at 20 min after cutting and was defined as the zero-stress state of a blood vessel, which was characterized by its residual strain and opening angle. Then aqueous extract of danshen prepared with methanol was added in the Krebs solution, and the changes of the aorta's zero-stress state were monitored by taking photos routinely for analysis to determine the opening angle and residual strain. Additionally, other sets of samples were tested in a Norepinephrine-Krebs solution as positive control or a Krebs solution as negative control, respectively. It was demonstrated that the zero-stress state of rat's abdominal aorta was affected by danshen extract and norepinephrine in two different patterns, while the Krebs solution did not have similar effects. The present work provides a new approach to study the anti-hypertension effect and mechanism of danshen. PMID:23724433

Han, Hui; Lam, David C C; Huang, Wei

2012-12-01

21

Successful hybrid operation of an acute mobile thrombus in the abdominal aorta induced by chemotherapy  

PubMed Central

Acute mobile thrombus of the abdominal aorta after chemotherapy is a very unusual finding, which can be a potential source of arterial embolism. We report here on a case of an acute mobile aortic thrombus with renal infarction. We successfully treated the patient with hybrid operation-open surgical and endovascular approach. Our case shows that hybrid treatment using wire-directed balloon catheter thrombectomy is a feasible, minimally-invasive treatment for a mobile aortic thrombus.

Kim, Woo Chul; Hong, Kee Chun; Kim, Jang Yong; Cho, Soon Gu

2011-01-01

22

Reference Diameters of the Abdominal Aorta and Iliac Arteries in the Korean Population  

PubMed Central

Purpose It is important to know the normal diameter of artery throughout the body so that clinicians are able to determine when an artery becomes aneurysmal. However, there are no previous studies on the normal diameter of arteries in the general Korean population. The purpose of this article is to determine the normal reference diameters of the abdominal aorta and iliac arteries in the Korean population. Materials and Methods We recruited the study population from three cities in Korea for the abdominal aortic aneurysm (AAA) screening. We measured the diameter of the aorta and iliac arteries. We analyzed the reference diameter of the population without AAA. The results were analyzed by Student's t-test and ANOVA on SPSS version 19. A p value <0.05 was considered to be statistically significant. Results One thousand two hundred and twenty-nine people were enrolled. 478 men and 751 women, with a mean age of 63.9±10.1 years (range 50 to 91) were examined. Eleven out of 1229 (0.89%) were diagnosed with AAA. In the population of 1218 people without AAA, the mean diameters (cm) of male/female were 2.20/2.11 (p<0.001) at suprarenal, 2.04/1.90 (p<0.001) at renal, 1.90/1.79 (p<0.001) at infrarenal, 1.22/1.17 (p<0.001) at right iliac and 1.47/1.15 (p=0.097) at the left iliac, respectively. There was a significantly larger diameter in the male population. The diameter of each level increased with age. Conclusion The normal reference diameter of the infrarenal abdominal aorta in the Korean population is 1.9 cm in males and 1.79 cm in females. The diameter of the abdominal aorta increases with age.

Ahn, Hyung-Joon; Park, Ho-Chul

2013-01-01

23

The effect of adrenergic ?2 receptor agonist on paraplegia following clamping of abdominal aorta  

PubMed Central

Introduction Surgical repair of an aortic aneurysm might be complicated by spinal cord injury and paraplegia. Since ?-adrenoreceptor agonists showed neuroprotective effects, the study was designed to investigate the effect of clenbuterol on post-aortic clamping paraplegia and to identify if there is hyperemia associated with paraplegia. Material and methods Material and methods: Thirty rabbits were divided into two groups: 15 control and 15 experimental (given clenbuterol 9 mg in drinking water 24 h prior to surgery). All the animals were subjected to laparotomy whereas the abdominal aorta was identified. Using a vascular clamp, the abdominal aorta was clamped just distal to the renal arteries. Abdominal aortic blood flow was recorded with a transonic flow meter. The neurological assessment was made according to Tarlov’s Neurological Scale upon recovering from anesthesia. Anal sphincter tonus and bladder sphincter function were also checked. Results Four rabbits (2 control and 2 experimental) developed complete paraplegia within 30 min of cross-clamping of the aorta. Of the 13 controls, 77% developed paraplegia, and of the 13 experimental rabbits administered clenbuterol 24 h prior to surgery with 22 min of aortic cross-clamping, 38% developed paraplegia The rabbits which did not develop paraplegia had a minimal increase in aortic blood flow, whereas the rabbits which developed paraplegia had a significant increase in aortic blood flow measurements after aortic decamping. Conclusions Post-aortic clamping paraplegia is associated with hyperemia and clenbuterol has a significant neuroprotective effect, obviously by preventing an increase in aortic blood flow following unclamping.

Lee, Bok Y.; Al-Waili, Noori; Butler, Glenn

2011-01-01

24

Adipose-derived stem cells stimulate reendothelialization in stented rat abdominal aorta.  

PubMed

Background:?Although drug-eluting stents (DES) have been widely used for the treatment of coronary artery disease, they potentially increase the risk of late thrombosis. It is, therefore, desirable to establish a strategy to stimulate reendothelialization. Endothelial injury models have been widely used to analyze the mechanisms of coronary restenosis. However, animal models deployed with coronary stents in the blood vessels are necessary to accurately analyze the mechanisms of coronary restenosis and late thrombosis because persistent inflammation occurs around the coronary stents. Methods and Results:?Coronary stents were implanted into rat abdominal aorta and adipose tissue-derived stem cells (ASC) were administered from the adventitial side. Reendothelialization was then visualized by Evans blue staining, and neointimal formation was analyzed histologically. ASC significantly stimulated reendothelialization and inhibited neointimal formation in bare metal stents (BMS)-implanted aorta. In addition, ASC promoted reendothelialization in DES-implanted aorta; however, the effects were weaker than in BMS-implanted aorta. Among the cytokines that ASC produce, adrenomedullin (AM) significantly stimulated reendothelialization and inhibited neointimal formation in BMS-implanted aorta, when an adenovirus expressing AM was administered from the adventitial side. Conclusions:?These results suggest that ASC produce several cytokines that stimulate reendothelialization and inhibit neointimal formation in stent-deployed vessels, and that AM could mediate these effects.??(Circ J?2014; 78: 1762-1769). PMID:24758766

Sato, Tomohiko; Takahashi, Masao; Fujita, Daishi; Oba, Shigeyoshi; Nishimatsu, Hiroaki; Nagano, Tetsuo; Suzuki, Etsu

2014-06-25

25

Infrarenal abdominal aorta aneurysm: a rare cause of anterior nutcracker syndrome with associated pelvic congestion.  

PubMed

We present a rare case of anterior nutcracker syndrome caused by an abdominal aorta aneurysm (AAA). A 61-year-old woman was admitted to our institution for computed tomography angiography. It revealed an AAA 51 mm in diameter that was lifting off of the left renal vein toward the superior mesenteric artery, causing anterior nutcracker syndrome with consequent left renal vein compression and left ovarian vein congestion. Aneurysm resection was performed, followed by left ovarian vein ligation and left adnexectomy to prevent vein conglomerate rupture. This is the first case that describes anterior nutcracker syndrome caused by AAA, which was successfully treated by aneurysm resection. PMID:24200129

Lozuk, Branko; Tanaskovic, Slobodan; Radak, Djordje; Babic, Srdjan; Kovacevic, Vladimir; Matic, Predrag

2014-01-01

26

The effect of age on the distensibility of the abdominal aorta of man.  

PubMed

The variation with age in distensibility and the dimensions of the abdominal aorta at the bifurcation have been measured in 43 fresh human cadavers. The age range was from birth to 69 years, both sexes being represented. Patients with vascular disease were excluded. Barium sulfate infused into the aorta through an iliac artery enabled the change in diameter to be measured from a roentgenogram with change in pressure. Incremental strain value could thus be calculated. Strain value increased from 0.02 at birth to a maximum at the end of the first decade of life and then decreased to less than 0.01 by the age of 70 years. Aortas in the age group of four to 11 years showed less stiffness with increasing pressure than at other ages. Variations of strain with age correlate with alterations in the ratio of aortic wall collagen to elastin in the young. An increase in the thickness of the wall and an atheroma, in response to prolonged hemodynamic stress, account for increased stiffness in the older age groups. Other age and disease factors may play a part, but further work is required in man to examine the role of relative wall thickness, elastic modulus and alteration in wall structure in determining the variation of aortic distensibility with age reported herein. PMID:684572

Newman, D L; Lallemand, R C

1978-08-01

27

Primary Self-Expandable Nitinol Stent Placement in Focal Lesions of Infrarenal Abdominal Aorta: Long Term Results  

SciTech Connect

Purpose. To evaluate the technical and clinical success, safety and long term results of percutaneous transluminal angioplasty/self-expandable nitinol stent placement of infrarenal abdominal aorta focal lesions. Materials and Methods. Eighteen patients underwent PTA of focal atherosclerotic occlusive disease of distal abdominal aorta. Two symptomatic occlusions and 16 stenoses in 10 male and 8 female patients (mean age 68.2 years) were treated with primary self-expandable nitinol stent placement. Results. Primary self-expandable nitinol stent placement was technically successful in all 18 procedures; clinical success was achieved in 100% of patients. No complications associated with the procedure occurred. During the 49.4 months of mean follow up (range 3-96, 4 months) all treated aortic segments remained patent. Conclusions. Endovascular treatment (primary self-expandable nitinol stent placement) of focal atherosclerotic lesions of distal abdominal aorta is a safe method with excellent primary technical and clinical success rates and favourable Long term results.

Lastovickova, Jarmila, E-mail: jala@medicon.cz; Peregrin, Jan H. [Institute for Clinical and Experimental Medicine, Department of Diagnostic and Interventional Radiology (Czech Republic)

2008-01-15

28

Abdominal aorta anastomosis in rats and stable gastric pentadecapeptide BPC 157, prophylaxis and therapy.  

PubMed

We focused on abdominal aorta, clamped and transected bellow renal arteries, and aortic termino-terminal anastomosis created in Albino male rats. We suggested stomach cytoprotection theory holding endothelium protection and peptidergic anti-ulcer cytoprotection therapy to improve management of abdominal aorta anastomosis and thrombus formation. The stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419) is a small anti-ulcer peptide efficient in inflammatory bowel disease trials (PL 14736) and various wound treatment, no toxicity reported. After 24 h following aortic termino-terminal anastomosis, we shown that BPC 157 (10 microg/kg) may also decrease formation of cloth after aortic termino-terminal anastomosis and preserved walking ability and muscle strength when given as a bath immediately after aortic anastomosis creation. This may be important since aortic termino-terminal anastomosis is normally presenting in rats with a formed cloth obstructing more than third of aortic lumen, severely impaired walking ability, painful screaming and weak muscle strength. Thereby, the effect of BPC 157 (10 microg/kg) was additionally studied at 24 h following aortic termino-terminal anastomosis. Given at the that point, intraperitoneally, within 3 minutes post-application interval the pentadecapeptide BPC 157 rapidly recovered the function of lower limbs and muscle strength while no cloth could be seen in those rats at the anastomosis site. PMID:20388960

Hrelec, M; Klicek, R; Brcic, L; Brcic, I; Cvjetko, I; Seiwerth, S; Sikiric, P

2009-12-01

29

Effects of hindlimb unweighting on the mechanical and structure properties of the rat abdominal aorta  

NASA Technical Reports Server (NTRS)

Previous studies have shown that hindlimb unweighting of rats, a model of microgravity, reduces evoked contractile tension of peripheral conduit arteries. It has been hypothesized that this diminished contractile tension is the result of alterations in the mechanical properties of these arteries (e.g., active and passive mechanics). Therefore, the purpose of this study was to determine whether the reduced contractile force of the abdominal aorta from 2-wk hindlimb-unweighted (HU) rats results from a mechanical function deficit resulting from structural vascular alterations or material property changes. Aortas were isolated from control (C) and HU rats, and vasoconstrictor responses to norepinephrine (10(-9)-10(-4) M) and AVP (10(-9)-10(-5) M) were tested in vitro. In a second series of tests, the active and passive Cauchy stress-stretch relations were determined by incrementally increasing the uniaxial displacement of the aortic rings. Maximal Cauchy stress in response to norepinephrine and AVP were less in aortic rings from HU rats. The active Cauchy stress-stretch response indicated that, although maximum stress was lower in aortas from HU rats (C, 8.1 +/- 0.2 kPa; HU, 7.0 +/- 0.4 kPa), it was achieved at a similar hoop stretch. There were also no differences in the passive Cauchy stress-stretch response or the gross vascular morphology (e.g., medial cross-sectional area: C, 0.30 +/- 0.02 mm(2); HU, 0.32 +/- 0.01 mm(2)) between groups and no differences in resting or basal vascular tone at the displacement that elicits peak developed tension between groups (resting tension: C, 1.71 +/- 0.06 g; HU, 1.78 +/- 0.14 g). These results indicate that HU does not alter the functional mechanical properties of conduit arteries. However, the significantly lower active Cauchy stress of aortas from HU rats demonstrates a true contractile deficit in these arteries.

Papadopoulos, Anthony; Delp, Michael D.

2003-01-01

30

Platelet Adhesion in the Rabbit Abdominal Aorta Following the Removal of the Endothelium: A Scanning and Transmission Electron Microscopical Study  

Microsoft Academic Search

The initial reactions of the blood components and the intima of the rabbit abdominal aorta have been observed following mechanical trauma. The endothelium was removed by the insertion of a roughened metal probe into the lumen of the vessel, thus exposing the subendothelial fibres and the internal elastic lamina. On restoration of the blood flow, platelets and later leucocytes adhered

B. L. Sheppard; J. E. French

1971-01-01

31

Real-Time Intravascular Shear Stress in the Rabbit Abdominal Aorta  

PubMed Central

Fluid shear stress is intimately linked with the biological activities of vascular cells. A flexible microelectromechanical system (MEMS) sensor was developed to assess spatial- and temporal-varying components of intravascular shear stress (ISS) in the abdominal aorta of adult New Zealand white (NZW) rabbits. Real-time ISS (ISSreal-time) was analyzed in comparison with computational fluid dynamics (CFD) simulations for wall shear stress (WSS). Three-dimensional abdominal arterial geometry and mesh were created using the GAMBIT software. Simulation of arterial flow profiles was established by FLUENT. The Navier–Stokes equations were solved for non-Newtonian blood flow. The coaxial-wire-based MEMS sensor was deployed into the abdominal arteries of rabbits via a femoral artery cutdown. Based on the CFD analysis, the entrance length of the sensor on the coaxial wire (0.4 mm in diameter) was less than 10 mm. Three-dimensional fluoroscope and contrast dye allowed for visualization of the positions of the sensor and ratios of vessel to coaxial wire diameters. Doppler ultrasound provided the velocity profiles for the CFD boundary conditions. If the coaxial wire were positioned at the center of vessel, the CFD analysis revealed a mean ISS value of 31.1 with a systolic peak at 102.8 dyn · cm?2. The mean WSS was computed to be 10.1 dyn · cm?2 with a systolic peak at 33.2 dyn · cm?2, and the introduction of coaxial wire increased the mean WSS by 5.4 dyn · cm?2 and systolic peak by 18.0 dyn · cm?2. Experimentally, the mean ISS was 11.9 dyn · cm?2 with a systolic peak at 47.0 dyn · cm?2. The waveform of experimental ISS was similar to that of CFD solution with a 30.2% difference in mean and 8.9% in peak systolic shear stress. Despite the difference between CD and experimental results, the flexible coaxial-wire-based MEMS sensors provided a possibility to assess real-time ISS in the abdominal aorta of NZW rabbits.

Ai, Lisong; Yu, Hongyu; Dai, Wangde; Hale, Sharon L.; Kloner, Robert A.

2012-01-01

32

[The nearest and remote results in treatment aneurysms of the abdominal aorta and the main arteries].  

PubMed

In the modern literature are taken widely up questions of medical tactics at an aneurysm of abdominal aorta (AA) depending on its sizes, presence of signs and presence of risk factors. The purpose of work was studying current aneurysm illnesses in various arterial parts, developments of optimum tactics of conducting patients and its influence on the remote results of operative treatment. Into research have entered 51 patient, suffering aneurism of an aorta, it branches and other main arteries. The nearest and remote results of dynamic supervision and operative treatment have been studied. The age of patients was within the limits of from 50 till 88 years, and has on the average made 71,8 ± 6,16. A parity men and women 8:1. Diameter AA changed from 3 up to 12 sm. Aneurysms combination met in an ascending part of an aorta, subclavian arteries, brachiochephalic trunk, carotid, iliofemoral, popliteal and limb arteries. All patients had accompanying cardial pathology. Patients have been divided into 2 groups. The first was made by 34 patients by whom resection AA has been made. Patients of the second group (17 patients) has been executed by dynamic supervision. The remote results are studied at 32 (62,7%) persons. Term of supervision has made from 6 till 168 months on the average. Postoperative lethal cases at scheduled operations were 4,7%, the general postoperative lethal cases were about - 11,7%. At the analysis of the remote results it is established, that the survival rate in a year has made 100 %, 5 years - 83,3% of patients. Average life expectancy in the given group of patients has made 76,4 ± 4 years, that there corresponds to data the WOHC for a healthy population. Dynamic supervision in both groups has shown progressing current of aneurysms combination in all arterial parts. Our data show perspectivity of surgical treatment aneurysms of an aorta and the main arteries except for patients with multistorey aneurysmosis arteries of legs in a combination to the continued thrombosis, in which treatment we adhere conservative tactics. PMID:21983459

Cherviakov, Iu V; Staroverov, I N; Smurov, S Iu; Lavlinski?, S N; Lonchakova, O M

2011-01-01

33

Extra-anatomic Bypass of the Abdominal Aorta: Management of Postoperative Thrombosis  

PubMed Central

Extra-anatomic bypass of the abdominal aorta was performed in 25 patients too ill to undergo abdominal operation (Group I) and in 22 patients with graft sepsis or hemorrhage (Group II). The graft patency rate determined by life table analysis in Group I patients was 83.5% at one year and 60% at two years. The graft patency rate for Group II patients of 47% at one year was significantly lower than the patency rate for Group I patients (p <.01). Thrombectomy was attempted in 11 of the 18 grafts that occluded postoperatively. Patency was re-established by this method in nine grafts (82%), failures resulted in amputation. Recurrent occlusion of three thrombectomized grafts was treated by multiple thrombectomies with cumulative patencies up to 44.5 months. Thrombectomy was not attempted in seven occluded grafts. Two graft occlusions resulted in amputation of extremities. Contralateral axillofemoral grafts were performed in three of the patients, ipsilateral axillofemoral graft in one patient, and aortobifemoral graft in one patient. Thrombectomy is the treatment of choice for occluded extra-anatomic bypass grafts. It can be performed easily under local anesthesia. If unsuccessful, contralateral axillofemoral or femoro-femoral grafts are indicated to re-establish blood flow.

Oblath, Robert W.; Green, Richard M./; DeWeese, James A.; Rob, Charles G.

1978-01-01

34

Extra-anatomic bypass of the abdominal aorta: management of postoperative thrombosis.  

PubMed

Extra-anatomic bypass of the abdominal aorta was performed in 25 patients too ill to undergo abdominal operation (Group I) and in 22 patients with graft sepsis or hemorrhage (Group II). The graft patency rate determined by life table analysis in Group I patients was 83.5% at one year and 60% at two years. The graft patency rate for Group II patients of 47% at one year was significantly lower than the patency rate for Group I patients (p <.01). Thrombectomy was attempted in 11 of the 18 grafts that occluded postoperatively. Patency was re-established by this method in nine grafts (82%), failures resulted in amputation. Recurrent occlusion of three thrombectomized grafts was treated by multiple thrombectomies with cumulative patencies up to 44.5 months. Thrombectomy was not attempted in seven occluded grafts. Two graft occlusions resulted in amputation of extremities. Contralateral axillofemoral grafts were performed in three of the patients, ipsilateral axillofemoral graft in one patient, and aortobifemoral graft in one patient. Thrombectomy is the treatment of choice for occluded extra-anatomic bypass grafts. It can be performed easily under local anesthesia. If unsuccessful, contralateral axillofemoral or femoro-femoral grafts are indicated to re-establish blood flow. PMID:646505

Oblath, R W; Green, R M; DeWeese, J A; Rob, C G

1978-06-01

35

Novel aspects of the pathogenesis of aneurysms of the abdominal aorta in humans  

PubMed Central

Aneurysm of the abdominal aorta (AAA) is a particular, specifically localized form of atherothrombosis, providing a unique human model of this disease. The pathogenesis of AAA is characterized by a breakdown of the extracellular matrix due to an excessive proteolytic activity, leading to potential arterial wall rupture. The roles of matrix metalloproteinases and plasmin generation in progression of AAA have been demonstrated both in animal models and in clinical studies. In the present review, we highlight recent studies addressing the role of the haemoglobin-rich, intraluminal thrombus and the adventitial response in the development of human AAA. The intraluminal thrombus exerts its pathogenic effect through platelet activation, fibrin formation, binding of plasminogen and its activators, and trapping of erythrocytes and neutrophils, leading to oxidative and proteolytic injury of the arterial wall. These events occur mainly at the intraluminal thrombus–circulating blood interface, and pathological mediators are conveyed outwards, where they promote matrix degradation of the arterial wall. In response, neo-angiogenesis, phagocytosis by mononuclear cells, and a shift from innate to adaptive immunity in the adventitia are observed. Abdominal aortic aneurysm thus represents an accessible spatiotemporal model of human atherothrombotic progression towards clinical events, the study of which should allow further understanding of its pathogenesis and the translation of pathogenic biological activities into diagnostic and therapeutic applications.

Michel, Jean-Baptiste; Martin-Ventura, Jose-Luis; Egido, Jesus; Sakalihasan, Natzi; Treska, Vladislav; Lindholt, Jes; Allaire, Eric; Thorsteinsdottir, Unnur; Cockerill, Gillian; Swedenborg, Jesper

2011-01-01

36

Endovascular Repair of an Actively Hemorrhaging Stab Wound Injury to the Abdominal Aorta  

SciTech Connect

Traumatic injury of the abdominal aorta is rare and potentially lethal (Yeh et al., J Vasc Surg 42(5):1007-1009, 2005; Chicos et al., Chirurgia (Bucur) 102(2):237-240, 2007) as it can result in major retroperitoneal hemorrhage, requiring an urgent open surgery. In case of concomitant bowel injury or other conditions of hostile abdomen, endovascular repair can be an alternative treatment. This case report deals with a 50-year-old man presenting at the emergency ward with three stab wounds: two in the abdomen and one in the chest. During explorative laparotomy, liver laceration and bowel perforation were repaired. One day later, abdominal CT-scan revealed an additional retroperitoneal hematoma associated with an aortic pseudoaneurysm, located anteriorly 3 cm above the aortic bifurcation. Because of the risk of graft infection, an endovascular repair of the aortic injury using a Gore excluder stent-graft was performed. Radiological and clinical follow-up revealed a gradual shrinkage of the pseudo-aneurysm and no sign of graft infection at two years' follow-up.

Hussain, Qasim; Maleux, Geert, E-mail: geert.maleux@uz.kuleuven.ac.be; Heye, Sam [University Hospitals Leuven, Department of Radiology (Belgium); Fourneau, Inge [University Hospitals Leuven, Department of Vascular Surgery (Belgium)

2008-09-15

37

[Diameter decrement of abdominal aorta and redistribution of systemic blood flow in non-ambulant Duchenne muscular dystrophy patients].  

PubMed

Cardiomyopathy is a major life-threatening complication in Duchenne muscular dystrophy (DMD). Cardiac output is always low in advanced stage patients. Impaired muscles presumably require extremely low circulation, while blood flow to brain and internal organs is probably maintained. Therefore, the redistribution of systemic circulation must be another important factor which determines whether or not the cardiomyopathy results in fatal heart failure. Although great efforts have been focused on the cardiac function, this problem has seldom attracted attentions. Assuming that diameter of blood vessels reflects blood flow, we measured the diameter of abdominal aorta on CT at four levels: 1) beginning of the abdominal aorta, 2) before and 3) after the branching of renal arteries, 4) before bifurcation of the common iliac arteries. Six bed-ridden DMD patients were compared with 10 ambulant patients suffering from other neurological and non-neurological diseases. We obtained following results. First, the diameter of abdominal aorta is significantly smaller in DMD patients. Second, the decrement is most prominent between before and after the branching of the renal arteries. These results clearly showed predilection of renointestinal circulation at the sacrifice of lower extremities. This narrowing of distal aorta was also observed in Kugelberg-Welander disease and understood as a sequelae of longstanding abolition of lower extremity functions. PMID:8997143

Shinoe, T; Kawai, M

1996-10-01

38

[Recurrence of vascular prosthesis infection: treatment by bypass of the lower part of the thoracic aorta using abdominal approach].  

PubMed

Two years before admission a 72-year-old woman received an aortobifemoral bypass graft. When the graft became infected it was replaced by an axillofemoral bypass graft. This also became infected. In another attempt at revascularization, a bypass was installed between the lower part of the thoracic aorta and the two distal parts of the superficial femoral arteries, passing through the obturator foramen. Access to the lower part of the thoracic aorta was made through an abdominal incision, lowering the risk factors associated with such an intervention. At 18-month follow-up, the results were satisfactory; the graft was patent and not infected. PMID:3756666

Formichi, M; Girard, J F; Rouleau, C A

1986-09-01

39

Adalimumab ameliorates abdominal aorta cross clamping which induced liver injury in rats.  

PubMed

The aim of this study was to investigate the possible protective effects of adalimumab (ADA) on cell damage in rat liver tissue during ischemia/reperfusion (I/R) injury of infrarenal abdominal aorta. Thirty male Wistar-albino rats were divided into three groups: control, I/R, and I/R+ADA, each group containing 10 animals. Laparotomy without I/R injury was performed in the control group animals. Laparotomy in the I/R group was followed by two hours of infrarenal abdominal aortic cross ligation and then two hours of reperfusion. ADA (50 mg/kg) was administered intraperitoneally as a single dose, to the I/R+ADA group, five days before I/R. The tumor necrosis factor-alpha (TNF-?) (pg/mg protein) and nitric oxide (NO) (µmol/g protein) levels in the I/R group (430.8 ± 70.1, 8.0 ± 1.1, resp.) were significantly higher than those in the I/R+ADA group (338.0 ± 71.6, P = 0.006; 6.3 ± 1.2, P = 0.008) and the control group (345.5 ± 53.3, P = 0.008; 6.5 ± 1.5, P = 0.010, resp.). I/R causes severe histopathological injury to the liver tissue, but ADA leads to much less histopathological changes. ADA treatment significantly decreased the severity of liver I/R injury. ADA pretreatment may have protective effects on experimental liver injury. PMID:24551855

Cure, Erkan; Cumhur Cure, Medine; Tumkaya, Levent; Kalkan, Yildiray; Aydin, Ibrahim; Kirbas, Aynur; Yilmaz, Arif; Yuce, Suleyman; Yücel, Ahmet Fikret

2014-01-01

40

One-molar gadolinium chelate (gadobutrol) as a contrast agent for CT angiography of the thoracic and abdominal aorta.  

PubMed

The aim of our study was to evaluate the use of a 1-molar gadolinium chelate (gadobutrol) as an alternative contrast medium for computed tomography angiography (CTA) exams of the aorta. CTA exams of the thoracic and/or abdominal aorta were performed on 15 patients with contraindications for the use of iodine who were not suitable for magnetic resonance examinations. The exams were performed with a 16-detector row scanner, injecting a mean dose of 0.37 mmol Gd/kg of body weight at a flow rate of 4 ml/s. Creatinine levels were obtained prior to the exam in patients with impaired renal function, and 24 and 48 h afterwards. The mean attenuation values obtained in the middle ascending and middle descending thoracic aorta were 202.3 and 216.8, respectively. The mean HU values of the abdominal aorta were 210.4 at the level of the renal arteries and 186.8 in the aortic bifurcation. All the exams were considered diagnostically adequate. No significant increase in serum creatinine was observed 24 and 48 h after the exam. We believe that gadobutrol could be an alternative contrast medium for CTA exams with 16-detector row scanners in patients with contraindications for iodinated contrast medium. PMID:17285280

Esteban, José M; Alonso, Antonio; Cervera, Vicente; Martínez, Vicente

2007-09-01

41

A Laparoscopic Approach to the Abdominal Aorta for Thoracic Stent-Graft Deployment: Evaluation in a Porcine Model  

Microsoft Academic Search

l l Purpose: To develop laparoscopic techniques for aortic stent-graft placement as an alter- native to the femoral approach. Methods: Endovascular stent-grafts were placed in 8 pigs via a totally laparoscopic ret- roperitoneal approach. After needle puncture, a guidewire was inserted into the abdominal aorta, followed by an 18-F sheath through which a Talent stent-graft was deployed in the descending

Maxime Formichi; Jean-François Renier

2002-01-01

42

Determination of the layer-specific distributed collagen fibre orientations in human thoracic and abdominal aortas and common iliac arteries  

PubMed Central

The established method of polarized microscopy in combination with a universal stage is used to determine the layer-specific distributed collagen fibre orientations in 11 human non-atherosclerotic thoracic and abdominal aortas and common iliac arteries (63 ± 15.3 years, mean ± s.d.). A dispersion model is used to quantify over 37 000 recorded fibre angles from tissue samples. The study resulted in distinct fibre families, fibre directions, dispersion and thickness data for each layer and all vessels investigated. Two fibre families were present for the intima, media and adventitia in the aortas, with often a third and sometimes a fourth family in the intima in the respective axial and circumferential directions. In all aortas, the two families were almost symmetrically arranged with respect to the cylinder axis, closer to the axial direction in the adventitia, closer to the circumferential direction in the media and in between in the intima. The same trend was found for the intima and adventitia of the common iliac arteries; however, there was only one preferred fibre alignment present in the media. In all locations and layers, the observed fibre orientations were always in the tangential plane of the walls, with no radial components and very small dispersion through the wall thickness. A wider range of in-plane fibre orientations was present in the intima than in the media and adventitia. The mean total wall thickness for the aortas and the common iliac artery was 1.39 and 1.05 mm, respectively. For the aortas, a slight thickening of the intima and a thinning of the media in increasingly distal regions were observed. A clear intimal thickening was present distal to the branching of the celiac arteries. All data, except for the media of the common iliac arteries, showed two prominent collagen fibre families for all layers so that two-fibre family models seem most appropriate.

Schriefl, Andreas J.; Zeindlinger, Georg; Pierce, David M.; Regitnig, Peter; Holzapfel, Gerhard A.

2012-01-01

43

Penetrating Atherosclerotic Ulcer of the Abdominal Aorta Involving the Celiac Trunk Origin and Superior Mesenteric Artery Occlusion: Endovascular Treatment  

SciTech Connect

We describe a case of endovascular treatment in a 64-year-old woman affected by a penetrating atherosclerotic ulcer (PAU) of the abdominal aorta with a 26-mm pseudoaneurysm involving the celiac trunk (CT) origin and with superior mesenteric artery (SMA) occlusion in the first 30 mm. The patient underwent stenting to treat the SMA occlusion and subsequent deployment of a custom-designed fenestrated endovascular stent-graft to treat the PAU involving the CT origin. Follow-up at 6 months after device placement demonstrated no complications, and there was complete thrombosis of the PAU and patency of the two branch vessels.

Ferro, Carlo; Rossi, Umberto G., E-mail: urossi76@hotmail.com; Petrocelli, Francesco; Seitun, Sara [San Martino University Hospital, Department of Diagnostic and Interventional Radiology (Italy); Robaldo, Alessandro; Mazzei, Raffaele [San Martino University Hospital, Department of Vascular Surgery (Italy)

2011-02-15

44

Abdominal aorta: characterisation of blood flow and measurement of its regional distribution by cine magnetic resonance phase-shift velocity mapping  

Microsoft Academic Search

Magnetic resonance phase-shift-induced velocity mapping is a powerful technique for measuring in vivo blood velocity and flow non-invasively. Using this method we examined dimensions, distensibility, blood flow and its regional distribution in the abdominal aorta in 10 normal volunteers. Data were acquired at three levels of the descending aorta. Thirty percent reduction in diastolic cross sectional area was observed in

M. Amanuma; R. H. Mohiaddin; M. Hasegawa; A. Heshiki; D. B. Longmore

1992-01-01

45

Palliative surgery for primary sarcoma in the abdominal aorta: A case report and review of the literature  

PubMed Central

Primary sarcoma of the aorta is extremely rare and accounts for <1% of all sarcomas. The present study describes the case of a 45-year-old male who presented with lower limb and abdominal pain. Abdominal computed tomography (CT) and magnetic resonance (MR) arteriography revealed a tumor that extended from the infrarenal aorta to the aortic bifurcation. The external and internal iliac arteries were occluded by the tumor incursion. Palliative surgery was performed for the sarcoma since the patient refused a radical resection. To improve the blood supply to the lower limbs, an axillary bifemoral bypass was established. Following the surgery, the pain was significantly reduced. However, the patient succumbed due to extensive metastasis 6 months after this surgery. Aortic sarcoma is an extremely rare disease with a poor prognosis. A diagnosis at a relatively early stage is necessary for a longer survival time. Radical surgery is the most significant treatment. Patients at advanced stages should consider palliative surgery in order to improve their quality of life.

ZHANG, JU-LIANG; YANG, SU-MIN; YAO, QING; CHEN, JIANG-HAO; WANG, TING; WANG, HUI; FAN, JING; LING, RUI; YI, JUN; YUAN, SHI-FANG; WANG, LING

2013-01-01

46

Gradient Echo MRI Characterization of Development of Atherosclerosis in the Abdominal Aorta in Watanabe Heritable Hyperlipidemic Rabbits  

SciTech Connect

Purpose. The Watanabe Heritable Hyperlipidemic (WHHL) rabbit provides an important model of spontaneous atherosclerosis. With a strain of WHHL rabbits which do not develop abdominal aorta lumen stenosis even with advanced atherosclerosis, we studied the MRI-histology correlation, and the natural progression of atherosclerosis in the abdominal aorta. In addition, intra-reader segmentation repeatability and scan-rescan reproducibility were assessed. Methods. Two batches of female WHHL rabbits were used. The first batch of 6 rabbits was scanned at 20 weeks old. A second batch of 17 rabbits was scanned at 50 weeks old and then randomly divided into two subgroups: 8 were killed for histologic investigation; 9 were kept alive for follow-up, with repeat scanning a week later to assess scan-rescan reproducibility, and again at 73 weeks old to assess disease progression. MR images were acquired at 4.7 T using a chemical shift selective fat suppression gradient echo with a saturation band suppressing blood signal within the aortic lumen. Five slices per animal were acquired, centered around the renal artery region of the abdominal aorta, with in-plane resolution of 0.195 mm and slice thickness of 3 mm. Results. The coefficient of variation for intra-reader reproducibility for aortic wall thickness measurements was 2.5% for repeat segmentations of the same scans on the same day, but segmentations of these same scans made 8 months later showed a systematic change, suggesting that intra-reader bias as well as increased variability could compromise assessments made over time. Comparative analyses were therefore performed in one postprocessing session. The coefficient of variation for scan-rescan reproducibility for aortic wall thickness was 5.5% for nine pairs of scans acquired a week apart and segmented on the same day. Good MRI-histology correlation was obtained. The MRI-measured mean aortic wall thickness of animals at 20 weeks of age was 76% that of animals at 50 weeks of age (p < 0.001). There was a small increase in aortic wall thickness between 50 and 73 weeks of age, but this was not significant (p > 0.05). The corresponding differences in lumen cross-sectional areas at 20, 50, and 73 weeks of age were not significant. These results were consistent with in-house historical histology data on this strain of rabbits. Conclusions. High-resolution gradient echo MRI can follow disease progression in the WHHL rabbit spontaneous atherosclerosis disease model.

Wang, Yi-Xiang J., E-mail: yi-xiang.wang@astrazeneca.com; Kuribayashi, Hideto [AstraZeneca (United Kingdom); Wagberg, Maria [AstraZeneca (Sweden); Holmes, Andrew P.; Tessier, Jean J.; Waterton, John C. [AstraZeneca (United Kingdom)

2006-08-15

47

In vitro contractility of normal and aneurysmal abdominal aorta muscle coat sections in human and animal material.  

PubMed

The objective of the study was to demonstrate spontaneous contractile activity of the smooth muscle coat of the aorta in human and animal material. Spontaneous contractility of smooth muscle tissue, or tonus, is essential for the proper function of many internal organs as observed in the many types of muscle cells which make up the internal structures. The spontaneous contractile activity of the muscle tissue in blood vessels is particularly marked in resistance vessels, regulating circulation within organs or tissues. It can also be observed in large blood vessels such as arteries and veins. The contractile activity of muscular tissue isolated from arteries is the result of a number of factors, including endogenous paracrine substances, neurotransmitters released at postganglionic endings (mostly within the sympathetic system), cells capable of spontaneously generation of functional potentials (pacemaking cells) and the vascular endothelium. Pacemaking cells present in the aortic wall are an important factor in the development of the spontaneous contractility of the muscular coat of the aorta. They are capable of generating functional potentials, resulting in the constant tonus of the smooth muscular coat (comprising the aortic wall) due to tonic contraction. In vitro studies were carried out on abdominal aortic sections collected from 30 New Zealand rabbits with a body mass of 3-4 kilograms each and also on aneurysmal abdominal aortic sections collected during elective aneurysm repair procedures in humans (10 abdominal aortic sections). The 1.5 cm-long sections were mounted in chambers of an automated water bath. The sections were oriented in a transverse and longitudal fashion in order to compare contractility. The incubation medium consisted of Krebs-Henseleit buffer. Spontaneous contractile activity was observed during the study, characterized by rhythmic contractions of the muscular layer of the aorta. The contractile tension within the sections was 0.15 mN in the case of rabbit sections and 0.8 mN in the case of human sections. The average duration of a single contraction was 38.3 +/- 15.05 seconds. The average contraction frequency, i.e. the average number of contractions per minute, was 1.61 +/- 0.54 contractions per minute. The spontaneous contraction is modulated by many factors like endogenous paracrine substances, neurotransmitters or vascular endothelium. PMID:22428311

Gnus, Jan; Czerski, Albert; Zawadzki, Wojciech; Witkiewicz, Wojciech; Hauzer, Willy; Rusiecka, Agnieszka; Ferenc, Stanis?aw

2012-01-01

48

[Sonographic observation of the course of aneurysms of the abdominal aorta].  

PubMed

Forty-two patients with an abdominal aortic aneurysm that had not been treated surgically were repeatedly examined by ultrasonography. The average observation time of all patients was 3.1 years. The total observation period including follow-up times of all patients adds up to 129 "patient years". Within this time none of the 35 asymptomatic abdominal aneurysms with transversal diameters of maximally 5 cm ruptured. Three patients of seven with larger and symptomatic aneurysms died in consequence of a rupture. Small asymptomatic abdominal aortic aneurysms seem to have a better prognosis than previously supposed. The question whether all abdominal aneurysms should be operated on needs reconsideration, especially in the elderly. PMID:6394891

Kremer, H; Weigold, B; Dobrinski, W; Schreiber, M A; Zöllner, N

1984-12-01

49

A comparison of the effect of bleeding site on haematological and plasma chemistry values of F344 rats: The inferior vena cava, abdominal aorta and orbital venous plexus  

Microsoft Academic Search

Of paramount importance to most toxicity studies in rats is the evaluation of haematological, coagulation and clinical chemistry parameters. In European and North American countries, the orbital venous plexus (OVP) is currently the most common route for obtaining blood, whereas in Japan the inferior vena cava (IVC) and abdominal aorta (AA) are the preferred routes. In order to compare clinical

T. Matsuzawa; H. Tabata; M. Sakazume; S. Yoshida; S. Nakamura

1994-01-01

50

Antioxidant Effect of Captopril and Enalapril on Reactive Oxygen Species-Induced Endothelial Dysfunction in the Rabbit Abdominal Aorta  

PubMed Central

Background Reactive oxygen species (ROS) are known to be related to cardiovascular diseases. Many studies have demonstrated that angiotensin-converting enzyme inhibitors have beneficial effects against ROS. We investigated the antioxidant effect of captopril and enalapril in nitric oxide mediated vascular endothelium-dependent relaxations. Materials and Methods Isolated rabbit abdominal aorta ring segments were exposed to ROS by electrolysis of the organ bath medium (Krebs-Henseleit solution) after pretreatment with various concentrations (range, 10-5 to 3×10-4 M) of captopril and enalapril. Before and after electrolysis, the endothelial function was measured by preconstricting the vessels with norepinephrine (10-6 M) followed by the cumulative addition of acetylcholine (range, 3×10-8 to 10-6 M). The relevance of the superoxide anion and hydrogen peroxide scavenging effect of captopril and enalapril was investigated using additional pretreatments of diethyldithiocarbamate (DETCA, 0.5 mM), an inhibitor of Cu/Zn superoxide dismutase, and 3-amino-1,2,4-triazole (3AT, 50 mM), an inhibitor of catalase. Results Both captopril and enalapril preserved vascular endothelium-dependent relaxation after exposure to ROS in a dose-dependent manner (p<0.0001). Pretreatment with DETCA attenuated the antioxidant effect of captopril and enalapril (p<0.0001), but pretreatment with 3AT did not have an effect. Conclusion Both captopril and enalapril protect endothelium against ROS in a dose-dependent fashion in isolated rabbit abdominal aortas. This protective effect is related to superoxide anion scavenging.

Kim, Ji Hoon; Kim, Young Hak; Chung, Won-Sang; Suh, Jung Kook; Kim, Sung Jin

2013-01-01

51

The diabetes-induced functional and distributional changes of the alpha 1-adrenoceptor of the abdominal aorta and distal mesenteric artery from streptozotocin-induced diabetic rats  

PubMed Central

Background The aim of this study was to evaluate the effect of diabetes on the function and distribution of vascular ?1-adrenoceptors in the abdominal aorta and distal mesenteric artery from streptozotocin (STZ)-induced diabetic rats at the level of the ?1-adrenoceptor subtypes. Methods Diabetes was induced by a single intravenous injection of STZ (60 mg/kg) in 8 week-old male Sprague-Dawley rats (n = 11). Age-matched normal rats (n = 14) were used as a control group. Four weeks after STZ injection, the tilting-induced change of the mean arterial pressure was recorded. The ?1-adrenoceptor subtypes mediating the contractions of the distal mesenteric artery and abdominal aorta were investigated using the agonist phenylephrine and subtype-selective antagonists that included prazocin, 5-methylurapidil and BMY 7378. The expressions of the ?1-adrenoceptor subtypes of each artery were examined by immunofluorescence staining using the subtype selective antibodies. Results The recovery of the mean arterial pressure was delayed after positional change in the diabetic rats. Compared with that of the normal rats, the contractile response to phenylephrine was increased in the abdominal aortas and it was decreased in the distal mesenteric arteries in the diabetic rats. In addition, compared with the normal rats, the fluorescent intensity of all the ?1-adrenoceptor subtypes was increased in the abdominal aortas and it was decreased in the mesenteric arteries of the diabetic rats. Conclusions Diabetes increased the contractility of the abdominal aorta in response to phenylephrine, yet diabetes decreased that of the mesenteric arteries in the STZ-induced diabetic rats. Those results are mainly based on the overall change of the ?1-adrenoceptor, and not on the change of the specific ?1-adrenoceptor subtypes.

Lee, Jong-Hwan; Park, Sang-Hyun; Huh, Jin

2011-01-01

52

Bullet embolization to the external iliac artery after gunshot injury to the abdominal aorta: a case report  

PubMed Central

Introduction Abdominal vascular trauma is fairly common in modern civilian life and is a highly lethal injury. However, if the projectile is small enough, if its energy is diminished when passing through the tissue and if the arterial system is elastic enough, the entry wound into the artery may close without exsanguination and therefore may not be fatal. A projectile captured may even travel downstream until it is arrested by the smaller distal vasculature. The occurrence of this phenomenon is rare and was first described by Trimble in 1968. Case presentation Here we present a case of a 29-year-old Albanian man who, due to a gunshot injury to the back, suffered fracture of his twelfth thoracic and first lumbar vertebra, injury to the posterior wall of his abdominal aorta and then bullet embolism to his left external iliac artery. It is interesting that the signs of distal ischemia developed several hours after the exploratory surgery, raising the possibility that the bullet migrated in the interim or that there was a failure to recognize it during the exploratory surgery. Conclusion In all cases where there is a gunshot injury to the abdomen or chest without an exit wound and with no projectile in the area, there should be a high index of suspicion for possible bullet embolism, particularly in the presence of the distal ischemia.

2011-01-01

53

[Effect of preoperative factors on survival in patients with ruptured aneurysms of the abdominal aorta].  

PubMed

Between 1991-2001 total number of 1058 patients was operated at the Institute of Cardiovascular Diseases of Serbian Clinical Centre due to abdominal aortic aneurysm. Of this number, 288 patients underwent urgent surgical treatment because of ruptured abdominal aortic aneurysm. The aim of this retrospective study was to show results of the early outcome of the surgical treatment of patients with ruptured abdominal aortic aneurysm, and to define relevant preoperative factors that influenced their survival. There were 83% male and 17% female patients in the study, mean aged 67 years. Intrahospital mortality that included intraoperative and postoperative deaths was 53.7%. Therefore, 46.3% patients survived surgical treatment and were released from hospital. Intraoperative mortality was 13.5%. Statistics showed that the gender and the age did not have any influence on mortality of our patients, as well as their co morbid conditions (p > 0.05). Clinical parameters at admission in hospital such as state of consciousness, systolic blood pressure, cardiac arrest and diuresis significantly influenced the outcome of treatment, as well as laboratory findings such as levels of hematocrit, hemoglobin, white blood cells, urea and creatinin (p < 0.05; p < 0.01). Ruptured abdominal aortic aneurysm still remains one of the most dramatic surgical states with very high mortality reported. We assume that important preoperative factors that influence the outcome of surgical treatment can be defined, but there is no single parameter which can certainly predict the lethal outcome after surgery. Also, the presence of co morbid conditions does not significantly influence the outcome of treatment in these patients. Therefore, urgent operation should not be withheld in most of the patients with ruptured abdominal aortic aneurysm. PMID:15114783

Markovi?, Miroslav; Davidovi?, Lazar; Maksimovi?, Zivan; Kosti?, Dusan; Cinara, Ilijas; Cvetkovi?, Slobodan; Sindjeli?, Radomir; Vasi?, Dragan; Lotina, Slobodan

2003-01-01

54

Angiotensin II Increases Urokinase-Type Plasminogen Activator Expression and Induces Aneurysm in the Abdominal Aorta of Apolipoprotein E-Deficient Mice  

PubMed Central

Urokinase-type plasminogen activator (uPA) is increased in human abdominal aortic aneurysm (AAA). Chronic infusion of angiotensin II (Ang II) results in AAA in apolipoprotein E-deficient mice. We tested the hypothesis that Ang II infusion results in an elevation of uPA expression contributing to aneurysm formation. Ang II or vehicle was infused by osmotic pumps into apoE-KO mice. All mice treated with Ang II developed a localized expansion of the suprarenal aorta (75% increase in outer diameter), accompanied by an elevation of blood pressure (22 mmHg), compared to the vehicle-treated group. Histological examination of the dilated aortic segment revealed similarities to human AAA including focal elastin fragmentation, macrophage infiltration, and intravascular hemorrhage. Ang II treatment resulted in a 13-fold increase in the expression of uPA mRNA in the AAA segment in contrast to a twofold increase in the atherosclerotic aortic arch. Increased uPA protein was detected in the abdominal aorta as early as 10 days after Ang II infusion before significant aorta expansion. Thus, Ang II infusion results in macrophage infiltration, increased uPA activity, and aneurysm formation in the abdominal aorta of apoE-KO mice. These data are consistent with a causal role for uPA in the pathogenesis of AAA.

Wang, Yi-Xin; Martin-McNulty, Baby; Freay, Ana D.; Sukovich, Drew A.; Halks-Miller, Meredith; Li, Wei-Wei; Vergona, Ronald; Sullivan, Mark E.; Morser, John; Dole, William P.; Deng, Gary G.

2001-01-01

55

Can the infusion of elastase in the abdominal aorta of the Yucatán miniature swine consistently produce experimental aneurysms?  

PubMed

The intraluminal elastase perfusion model has been proved to be potentially effective in producing abdominal aortic aneurysm in rodents, but it produced unpredictable results in larger animals. The purpose of this study was to explore the potential ability of such a model to produce experimental aneurysm consistently in the Yucatán miniature swine. Six Yucatán miniature swine received infusion with porcine elastase into an isolated segment of the infrarenal aorta. The excised arterial segments were examined macroscopically to assess the luminal surface characteristics and histologically to describe the different pathologic injuries induced by the elastase treatment on the intima, media, and adventitia of the arterial wall. Histologic examination revealed that the elastic network of the media was destroyed. In the first week after perfusion, altered smooth muscle cells were located in the intima and innermost layer of the media in juxtaposition with the occlusive thrombus. Infiltration of inflammatory cells was observed in these regions of elastic network and smooth muscle cell alterations. In the arterial segments of swine sustained for 3 weeks, a reduction of smooth muscle cells was noted in some areas. An important number of necrotic lesions was observed, and they were associated with the development of calcium deposits. Significant intimal hyperplasic reaction was identified at day 19 and again at day 21. However, no aneurysmal development was observed. This study constituted the first experiment with infusion of porcine elastase in the Yucatán miniature swine infrarenal aorta. The present experimental protocol induced important elastic network and smooth muscle cell alterations leading to severe necrotic lesions associated with calcium deposition, but it produced no aneurysmal dilatation. This model requires further testing to obtain a more complete degradation of the elastic network in both the media and adventitia and more significant collagenolysis without early thrombotic events. PMID:9219089

Marinov, G R; Marois, Y; Pâris, E; Roby, P; Formichi, M; Douville, Y; Guidoin, R

1997-01-01

56

Interaction between widening of diameter of abdominal aorta and cardiovascular risk factors and atherosclerosis burden.  

PubMed

The aim of this study was to investigate influence of traditional cardiovascular risk factors (CVRF) and subclinical atherosclerosis (ATS) burden on early stages of abdominal aortic diameter (AAD) widening among adults. 2,052 consecutive patients (P) (39 % women), mean age 52 ± 13 years, were prospectively screened for CVRF, ATS, and AAD. B-mode ultrasound was used to evaluate the largest AAD and to detect carotid and femoral atherosclerotic plaques. Mean AAD was 15.2 ± 2.8 mm. Atherosclerotic plaques were detected in 71 % of patients. Significant univariate correlation between AAD, traditional CVRF, and ABS was found. However, multiple regression analysis showed that only seven of them were significantly and weakly correlated with AAD (R² = 0.27, p < 0.001). On the other hand, a multivariate logistic analysis was used to evaluate CVRF impact on enlarged AAD ?25 mm (EAAD) as compared to those with AAD <25 mm. These factors did not account for more than 30 % of interaction (R² = 0.30, p = 0.001). Furthermore, despite a large proportion of patients with high number of CVRF, and subclinical ATS, rate of patients with AAD ?25 mm was low (1 %) and scattered regardless their CHD risk score or ATS burden. In conclusion, these results suggest that although some traditional CVRF and presence of ATS are associated with early stages of EAAD, other determinants still need to be identified for a better understanding of abdominal aortic aneurysm pathogenesis. PMID:23568317

Glauser, Frédéric; Mazzolai, Lucia; Darioli, Roger; Depairon, Michèle

2014-06-01

57

Layer-specific damage experiments and modeling of human thoracic and abdominal aortas with non-atherosclerotic intimal thickening.  

PubMed

Many treatments for cardiovascular diseases include an endovascular insertion of stents or stent grafts into arteries, a procedure which may cause high tissue stresses and even damage in the arterial wall. In order to study such problems by using finite element methods, both appropriate constitutive models and experimental data on human tissue samples are required. Layer-specific experimental data for human tissue tested up to the supra-physiological loading range are rare in the literature. In this study, intact and layer-separated experimental data from uniaxial extension tests are presented for human thoracic and abdominal aortas with non-atherosclerotic intimal thickening undergoing supra-physiological loading. A novel pseudo-elastic damage model, proposed to describe discontinuous softening in aortic arterial tissues, is fit to the obtained experimental data. Fitting of the model with and without consideration of damage accumulation in the non-collagenous matrix material reveals that tissue damage is primarily related to the collagen fiber fabric. By employing the fit model, the effect of aortic tissue pre-conditioning on the material parameters from the resulting data fits is evaluated. Histological examination of the collagen fibers under different applied stretches is used to gain more insights into the structural changes of the tissue under supra-physiological loading. PMID:22659370

Weisbecker, Hannah; Pierce, David M; Regitnig, Peter; Holzapfel, Gerhard A

2012-08-01

58

Automatic identification and validation of planar collagen organization in the aorta wall with application to abdominal aortic aneurysm.  

PubMed

Arterial physiology relies on a delicate three-dimensional (3D) organization of cells and extracellular matrix, which is remarkably altered by vascular diseases like abdominal aortic aneurysms (AAA). The ability to explore the micro-histology of the aorta wall is important in the study of vascular pathologies and in the development of vascular constitutive models, i.e., mathematical descriptions of biomechanical properties of the wall. The present study reports and validates a fast image processing sequence capable of quantifying collagen fiber organization from histological stains. Powering and re-normalizing the histogram of the classical fast Fourier transformation (FFT) is a key step in the proposed analysis sequence. This modification introduces a powering parameter w, which was calibrated to best fit the reference data obtained using classical FFT and polarized light microscopy (PLM) of stained histological slices of AAA wall samples. The values of w = 3 and 7 give the best correlation (Pearson's correlation coefficient larger than 0.7, R 2 about 0.7) with the classical FFT approach and PLM measurements. A fast and operator independent method to identify collagen organization in the arterial wall was developed and validated. This overcomes severe limitations of currently applied methods like PLM to identify collagen organization in the arterial wall. PMID:24016340

Polzer, Stanislav; Gasser, T Christian; Forsell, Caroline; Druckmüllerova, Hana; Tichy, Michal; Staffa, Robert; Vlachovsky, Robert; Bursa, Jiri

2013-12-01

59

Abdominal Aortic Intimal Flap Motion Characterization in Acute Aortic Dissection: Assessed with Retrospective ECG-Gated Thoracoabdominal Aorta Dual-Source CT Angiography  

PubMed Central

Objectives To evaluate the feasibility of dose-modulated retrospective ECG-gated thoracoabdominal aorta CT angiography (CTA) assessing abdominal aortic intimal flap motion and investigate the motion characteristics of intimal flap in acute aortic dissection (AAD). Materials and Methods 49 patients who had thoracoabdominal aorta retrospective ECG-gated CTA scan were enrolled. 20 datasets were reconstructed in 5% steps between 0 and 95% of the R-R interval in each case. The aortic intimal flap motion was assessed by measuring the short axis diameters of the true lumen and false lumen 2 cm above of celiac trunk ostium in different R-R intervals. Intimal flap motion and configuration was assessed by two independent observers. Results In these 49 patients, 37 had AAD, 7 had intramural hematoma, and 5 had negative result for acute aortic disorder. 620 datasets of 31 patients who showed double lumens in abdominal aorta were enrolled in evaluating intimal flap motion. The maximum and minimum true lumen diameter were 12.2±4.1 mm (range 2.6?17.4) and 6.7±4.1 mm (range 0?15.3) respectively. The range of intimal flap motion in all patients was 5.5±2.6 mm (range 1.8?10.2). The extent of maximum true lumen diameter decreased during a cardiac cycle was 49.5%±23.5% (range 12%?100%). The maximum motion phase of true lumen diameter was in systolic phase (5%?40% of R-R interval). Maximum and minimum intimal flap motion was at 15% and 75% of the R-R interval respectively. Intimal flap configuration had correlation with the phase of cardiac cycle. Conclusions Abdominal intimal flap position and configuration varied greatly during a cardiac cycle. Retrospective ECG-gated thoracoabdominal aorta CTA can reflect the actual status of the true lumen and provide more information about true lumen collapse. This information may be helpful to diagnosis and differential diagnosis of dynamic abstraction.

Yang, Shifeng; Li, Xia; Chao, Baoting; Wu, Lebin; Cheng, Zhaoping; Duan, Yanhua; Wu, Dawei; Zhan, Yiqiang; Chen, Jiuhong; Liu, Bo; Ji, Xiaopeng; Nie, Pei; Wang, Ximing

2014-01-01

60

In Vivo Deformation of the Human Abdominal Aorta and Common Iliac Arteries With Hip and Knee Flexion: Implications for the Design of Stent-Grafts  

PubMed Central

Purpose: To quantify in vivo deformations of the abdominal aorta and common iliac arteries (CIAs) caused by musculoskeletal motion. Methods: Seven healthy subjects (age 34±11 years, range 24–50) were imaged in the supine and fetal positions (hip flexion angle 134.0°±9.7°) using contrast-enhanced magnetic resonance angiography. Longitudinal strain, twisting, and curvature change of the infrarenal aorta and CIAs were computed. The angle between the left and right CIAs and translation of the arteries were also computed. Results: Maximal hip flexion induced shortening (5.2%±4.6%), twisting (0.45±0.27 °/mm), and curvature changes (0.015±0.007 mm?1) of the CIAs. The angle between the CIAs increased by 17.6°±8.6°. The iliac arteries moved predominantly in the superior direction relative to the aortic bifurcation, which would induce compression and bending, thus increasing curvature and angle between the CIAs. The abdominal aorta also exhibited shortening (2.9%±2.1%) and twisting (0.07±0.05 °/mm) deformation associated with the hip flexion. Conclusion: Although this study was limited to a few healthy young adults, musculoskeletal motion, specifically hip flexion, caused significant in vivo morphological changes (shortening, twisting, and bending) of the arteries. Predominant superior translation of the CIAs was observed, which suggests that preclinical testing of cyclic superior-inferior translational motion may aid in predicting stent-graft fractures. In turn, stent-graft design could be improved, decreasing overall stent-graft–related complications.

Choi, Gilwoo; Shin, Lewis K.; Taylor, Charles A.; Cheng, Christopher P.

2009-01-01

61

The value of true-FISP sequence added to conventional gadolinium-enhanced MRA of abdominal aorta and its major branches.  

PubMed

To test true-fast imaging with steady-state precession (true-FISP) added to gadolinium-based MR angiography (Gd-MRA) for imaging abdominal aorta and major abdominal vessels, 35 consecutive patients (age 67+/-11 years) with known or suspected abdominal and/or peripheral vascular disease were studied with sagittal and axial 2D true-FISP during free breathing and coronal 3D fast low-angle shot (FLASH) Gd-MRA (breath-holding, 0.2 mmol/kg of Gd-DOTA at 2 ml/s). We evaluated: suprarenal aorta, celiac trunk, superior mesenteric artery, right renal artery, left renal artery, infrarenal aorta, inferior mesenteric artery, aortic bifurcation/common iliac arteries, lumbar arteries and aortic atheromasia. The possible presence of accessory renal arteries, collateral vasculature and vascular prosthesis/stent was evaluated. A quality four-point score was assigned to each item on both sequences, from 0 (not visible) to 3 (good-to-excellent image quality) and Wilcoxon test was used. Main diagnoses resulted: normal or atheromasic aorta (n=25); aortic aneurysm (n=2); patent aorto-iliac surgical prosthesis (n=2); patent vascular iliac stent (n=2); aneurysm of iliac artery (n=1); patent aortic endovascular prosthesis (n=1); patent aorto-femural bypass (n=1) and aorto-iliac surgical prosthesis endoleak (n=1). We also found three patients with accessory renal arteries, two with collateral circulation, and three with surgical aorto-iliac prosthesis. The score of true-FISP (25.9+/-4.1, median 27) was significantly higher (p=0.003) than that of Gd-MRA (23.9+/-3.6, median 24). True-FISP was superior for visualizing inferior mesenteric artery (score 2.5+/-1.1 vs. 1.0+/-1.4; p<0.001) and atheromasic plaques (2.5+/-1.1 vs. 1.2+/-1.1; p<0.001). One collateral vasculature was demonstrated only with Gd-MRA. Summarizing, true-FISP is a power and fast non-breath-hold sequence to be added to Gd-MRA, obtaining an information increase. PMID:18926654

Iozzelli, Andrea; D'Orta, Giovanni; Aliprandi, Alberto; Secchi, Francesco; Di Leo, Giovanni; Sardanelli, Francesco

2009-12-01

62

Minimally-invasive catheterization of the portal, hepatic and cranial mesenteric veins and the abdominal aorta for quantitative determination of hepatic metabolism in dairy cows.  

PubMed

The objective of this study was to establish a minimally-invasive, ultrasound (US)-guided technique for the placement of indwelling catheters into the portal, hepatic, and cranial mesenteric veins as well as the abdominal aorta. Catheters were placed in eight healthy dairy cows on day 1. The patency of catheters was tested daily until day 14 when a necropsy was carried out. On day 6, energy intake and hepatic net output of glucose, removal of lactate, and oxygen were determined in seven cows. Post mortem examination revealed that all implanted catheters were in the intended locations. Loss of patency in one portal vein catheter on day 9 was attributable to a fibrin clot. Significant correlations were found between mean energy intake and mean hepatic plasma flow (r=0.91; P=0.004), hepatic glucose output (r=0.81; P=0.027) and hepatic removal of lactate (r=-0.70; P=0.08) and oxygen (r=-0.77; P=0.039), as well as between hepatic glucose net output and removal of lactate (r=-0.92; P=0.004). Minimally-invasive, US-guided transcutaneous catheter placement into the cranial mesenteric, portal and hepatic veins as well as the technique for catheterization of the abdominal aorta appear to be safe, and suitable for studies of quantitative hepatic metabolism in cattle. PMID:21924930

Starke, A; Wussow, K; Matthies, L; Kusenda, M; Busche, R; Haudum, A; Beineke, A; Pfarrer, C; Rehage, J

2012-06-01

63

New approach of assessing hypovolemic shock class 1 during acute emergencies: Ultrasonographic inferior vena cava and abdominal aorta diameter ratio  

NASA Astrophysics Data System (ADS)

In a patient with hypovolemic shock class 1, the vital signs and biochemical properties are almost normal. The alteration of hemodynamic parameters and biochemical values occurs mainly in advanced hypovolemia state (neuroendocrine response). The availability of ultrasound machine at healthcare centers makes the measurement of vascular calibre feasible and possible. Inspiration and expiration inferior vena cava diameter changes predict hypovolemic shock class 1 but in acute emergencies this method is impractical. The purpose of this study is to develop a new approach in identifying hypovolemic shock at early phase by measuring the inferior vena cava and aorta diameter ratio using bedside ultrasound machine.

Ahmad, Rashidi; Kunji, Mohamad Iqhbal; Hj Abd Kareem, Meera Mohaideen; Halim, Shamimi A.

2013-09-01

64

Abdominal aortic aneurysm  

MedlinePLUS

... to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ... blood pressure Male gender Genetic factors An abdominal aortic aneurysm is most often seen in males over age ...

65

Morphometric analysis of anatomic variables affecting endovascular stent design in patients undergoing elective and emergency repair of endovascular abdominal aortic aneurysm  

PubMed Central

Background Our objective was to identify morphologic trends in elective and emergency endovascular aneurysm repair (EVAR). This work will inform hospitals with endovascular programs about the diameters and lengths of endostents that should be available to efficiently care for patients with these conditions. Methods We performed a retrospective review of patients undergoing elective (n = 127) and emergency (n = 17) EVAR. Using computed tomography and 3-dimensional reconstructions, we evaluated the following: diameters of the aneurysm (D3), the aorta at the superior mesenteric (D1) and renal (D2a,b,c; 3 levels) levels, the iliac arteries (D5a,b; right and left) and the aortic bifurcation (D4); lengths from the lowest renal artery to the distal aspect of the aortic neck (H1), to the aortic bifurcation (H3), to the right and left iliac bifurcations (H4a,b); and angles of the origin of the common iliac arteries on the transverse plane (A1). We used descriptive statistics of trends within groups and independent sample t tests. Results In elective and emergency aneurysm repair, D2max (26, standard deviation [SD] 3, mm v. 30.7 [SD 3] mm), D5a (16 [SD 4.7] mm v. 19.3 [SD 5] mm), D5b (15.3 [SD 4] mm v. 18.1 [SD 3.6] mm), H1 (25.6 [SD 8.6] mm v. 18 [SD 2] mm), H4a (173 [SD 22] mm v. 189.5 [SD 22] mm) and H4b (174 [SD 25] mm v. 190 [SD 14] mm) were significantly different between the 2 groups (p = 0.001, p = 0.006, p = 0.007, p < 0.001, p = 0.05 and p = 0.01, respectively). H3 (118 [SD 17] mm v. 121.5 [SD 13.5] mm) was not significantly different (p = 0.40). In elective patients, A1 identified the right common iliac more frequently anterior relative to the left common iliac (mean 23°, SD 16°). Conclusion Significant anatomic differences between elective and emergency patients will require hospitals to stock separate endovascular devices to treat abdominal aortic aneurysms in both groups.

Kilian, Michael; Dang, Wilfred; Cina, Claudio S.

2010-01-01

66

Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: Experience with anatomic and extra-anatomic repair in 33 cases  

Microsoft Academic Search

Objective: A mycotic aneurysm of the aorta and adjacent arteries is a dreadful condition, threatening life, organs, and limbs. With regard to the aortic segment involved, repair by either in situ replacement or extra-anatomic reconstruction can be quite challenging. Even when surgery has been successful, the prognosis is described as very poor because of the weakened health status of the

Barbara Theresia Müller; Otto Ruano Wegener; Klaus Grabitz; Michael Pillny; Lutz Thomas; Wilhelm Sandmann

2001-01-01

67

Bad aorta.  

PubMed

As its outcomes improve, cardiac surgery has been performed on more and more cases which were previously considered to be difficult to deal with. However, there are still a number of problems to be solved regarding surgery on patients with severe sclerotic lesions in the ascending aorta, which we collectively call "bad aorta". Concerning a preoperative assessment of the ascending aorta, our report revealed no relationship between the severity of calcification detected with a preoperative non-enhanced CT and the aortic lesion found during the surgery. Meanwhile, an intraoperative epiaortic ultrasound enables us to make high-quality evaluations of the aorta without imposing much burden on the patient. This modality may be essential for cardiac surgery. As for surgical management for bad aorta, quite a few methods have been reported to this point, but the overall operative mortality rate and cerebrovascular accident rate are relatively high, at a little <10 %, respectively. With the recent cross-clamping method under short-term total circulatory arrest (TCA), however, the results are much better; these rates total around 5 %. Further improvement is expected in the outcome of cardiac surgery on bad aorta cases by establishing a modality to evaluate sclerotic lesions in the ascending aorta with epiaortic ultrasound and by selecting a proper procedure for each case. PMID:24634147

Tajima, Kazuyoshi

2014-05-01

68

Imaging of gastrointestinal and abdominal tuberculosis  

Microsoft Academic Search

This article discusses the range of manifestations of tuberculosis (TB) of the abdomen, including involvement of the gastrointestinal tract, the peritoneum, mesentery, omentum, abdominal lymph nodes, solid abdominal organs, the genital system and the abdominal aorta. Abdominal TB is a diagnostic challenge, particularly when pulmonary TB is absent. It may mimic many other abdominal diseases, both clinically and radiologically. An

F. M. Vanhoenacker; A. I. De Backer; B. Op de Beeck; M. Maes; R. Van Altena; D. Van Beckevoort; P. Kersemans; A. M. De Schepper

2004-01-01

69

Aortic arch/elephant trunk procedure with SiennaTM graft and endovascular stenting of thoraco-abdominal aorta for treatment of complex chronic dissection  

PubMed Central

Aneurismal dilatation of the remaining thoracic aorta after ascending aortic interposition grafting for type ‘A’ aortic dissection is not uncommon. For such complex cases, one treatment option is total arch replacement and elephant trunk procedure with the SiennaTM collared graft (Vascutek, Inchinnan, UK) technique followed by a staged thoracic endovascular aortic repair (TEVAR). The video illustrates our technique in a 56-year-old man with an extensive aortic arch and descending thoracic aortic dissecting aneurysm. For the ‘open’ procedure femoral arterial and venous cannulation was used along with systemic cooling and circulatory arrest at 22 °C. Upon circulatory arrest, the aortic arch was incised and antegrade cerebral perfusion achieved via selective cannulation to the right brachiocephalic and left common carotid artery, keeping flow rates at 10-15 mL/kg/min and perfusion pressure at 50-60 mmHg. Arch replacement with an elephant trunk component was then performed and after completion of the distal aortic anastomosis antegrade perfusion via a side-arm in the graft was started and the operation completed using a variation of the ‘sequential’ clamping technique to maximize cerebral perfusion. The second endovascular stage was performed two weeks after discharge. Two covered stents were landing from the elephant trunk to the distal descending thoracic aorta, to secure the distal landing a bare stent of was placed to cover the aorta just distal to the origin of the celiac axis. The left subclavian artery was embolised with fibre coils. Post TEVAR angiogram showed no endoleak Although re-operative total arch replacement and elephant trunk procedure and subsequent TEVAR remained a challenging procedure, we believe excellent surgical outcome can be achieved with carefully planned operative strategy.

Wong, Randolph H.L.; Baghai, Max; Yu, Simon C.H.

2013-01-01

70

New indices to classify location, severity and progression of calcific lesions in the abdominal aorta: a 25-year follow-up study  

Microsoft Academic Search

The purpose of the present study was to assess the location, severity and progression of radiopaque lumbar aortic calcifications and to evaluate the utility of summary scores of lumbar calcification in a population-based cohort. Lateral lumbar films, obtained in 617 Framingham heart study participants, were analysed for the presence of abdominal aortic wall calcification in the region corresponding to the

Leena I Kauppila; Joseph F Polak; L. Adrienne Cupples; Marian T Hannan; Douglas P Kiel; Peter W. F Wilson

1997-01-01

71

Self-Expandable Nitinol Stent Placement in Homocysteinemic Porcine Aorta  

PubMed Central

PURPOSE To compare aortic intimal thickening of normal and hyperhomocysteinemic pigs (induced with a methionine-rich diet) following placement of a self-expanding nitinol stent. METHODS Eighteen Macau pigs were used. They were older than eight weeks in age and had an average weight of 30 kg. Pigs were randomly divided into two groups. The first, Group C (control), was fed a regular diet, and the second group, Group M, was fed a methionine-rich diet for 30 days to induce hyperhomocysteinemia. The self-expandable nitinol stents were 25mm in length and 8 mm in diameter after expansion. Blood samples were collected to measure total cholesterol, triglycerides, HDL and homocysteine concentrations. All animals were subjected to angiography. Thirty days after the procedure, the animals were sacrificed, and the abdominal aorta was removed for histological and digital morphometry analysis. RESULTS Under microscopic evaluation, the intima was significantly thicker in Group C than in Group M. When groups were compared by digital morphometric analysis, intimal thickening of the vessel wall was higher in Group C than in Group M. There was no significant change in total cholesterol, triglycerides or HDL concentrations in either group. In group C the levels of plasma homocysteine ranged from 14,40 to 16,73?mol/l; in Group M, plasma homocysteine levels ranged from 17.47 to 59.80 ?mol/l after 30 days of a methionine-rich diet. CONCLUSION Compared to normal pigs, less intimal hyperplasia was observed in the abdominal aortas of hyperhomocysteinemic pigs thirty days after the insertion of a self-expandable nitinol stent.

Franca, Luis Henrique Gil; Pereira, Adamastor Humberto; Perini, Silvio Cesar

2008-01-01

72

Morphologic and morphometric evaluation of experimental acute crush injuries of the sciatic nerve of rats.  

PubMed

In order to qualify and quantify nerve fiber lesion following an acute crush injury, a morphologic and morphometric study was carried out in 25 Wistar rats divided into five groups of five animals each according to the crushing load applied, i.e., 500, 1,000, 5,000, 10,000, and 15,000 g. The injury was produced under general anesthesia on a 5mm-long intermediate segment of the right sciatic nerve for 10 min using a dead-weight machine. The animals were killed with an excessive dose of anesthetics 72 h later and submitted to perfusion with a fixing solution through the abdominal aorta immediately after death. Both the right and left sciatic nerves were removed and prepared for histologic and morphometric examinations; 5 microm-thick sections stained with 1% Toluidine blue were examined under a light microscope equipped with a video camera linked to a computer loaded with a graphic program (KS 400). The morphometric studies included measuring total number of fibers, fiber density, fiber diameter, myelin fiber area, axon diameter, axon area and G ratio. The results showed that damage to the nerve fibers began to appear as early as with the 500 g load and was similar in all groups despite the load applied, increasing with the 10,000 and 15,000 g loads, although the external supporting tissues and small diameter fibers were preserved. The predominant type of lesion produced was axonotmesis. PMID:18644327

Mazzer, Patrícia Yume Cantalejo Nagima; Barbieri, Cláudio Henrique; Mazzer, Nilton; Fazan, Valéria Paula Sassoli

2008-08-30

73

[Aneurysm of the abdominal aorta and stenosis caused by compression of the celiac tripod in a young woman with tuberous sclerosis and previous mesoblastic nephroma].  

PubMed

Tuberous sclerosis, first described by Bourneville in 1880, is a syndrome characterized essentially by mental deterioration, seizures and cutaneous sebaceous adenoma; an association with malformative lesions of the kidney and cardiovascular apparatus has been documented. Recently a case of a young woman with tuberous sclerosis has come to our observation; she was also affected by abdominal aortal aneurysm and stenosis due to compression of the truncus coeliacus; previously she operative elsewhere for right nephrectomy for breakage of nephric right arterial aneurysm: the histological examination of the removed kidney manifested the presence of a mesoblastic nephroma and afterward tuberous sclerosis was diagnosed. The angiomyolipomatosis evidence confirmed the suspicion of a notable inclination to polydistrict malformations in tuberous sclerosis. PMID:1666427

Occhionorelli, S; Mascoli, F; Romano, D; Taddia, M C; Donini, A; Vasquez, G; Santini, M; Galeotti, R; Cavagna, E

1991-12-01

74

Characterization of the time course of the superior mesenteric, abdominal aorta, internal carotid and vertebral arteries blood flow response to the oral glucose challenge test using magnetic resonance imaging.  

PubMed

Blood flow to the splanchnic circulation increases postprandially which may cause a reduction in systemic and cerebral perfusion leading to postprandial syncope in the elderly who lack adequate cardiovascular reserve. We used multi-station 2D phase contrast cine magnetic resonance imaging (PC-MRI) with the aim of characterizing the time course of the haemodynamic response to an oral glucose challenge test (OGCT) in the large arteries perfusing the splanchnic, systemic and cerebral circulations (superior mesenteric artery SMA, abdominal aorta AA, internal carotid arteries, ICA and vertebral arteries VA). In this study nine fasted healthy volunteers were studied. Separate cine PC-MRI scans were acquired in the neck and in the abdomen every 88 s, these two measurements being interleaved for ten baseline scans at each station with the scanner automatically moving the subject between the two stations. After ingestion of the OGCT, a further 30 cine PC-MRI scans were acquired at each station. Using this technique we were able to characterize with frequent sampling of volumetric blood flow the time course of blood flow response to the OGCT of the SMA, AA and both VA and ICA. We found a substantial variation between individuals in the amplitude and the time to the peak of the SMA blood flow response to the OGCT which correlated positively with body mass index. MRI provides a robust, non-invasive method of studying normal physiology that could be valuable in studies of diseases such as postprandial hypotension. PMID:19759401

Totman, J J; Marciani, L; Foley, S; Campbell, E; Hoad, C L; Macdonald, I A; Spiller, R C; Gowland, P A

2009-10-01

75

Transabdominal access to the thoracic aorta for aortofemoral bypass grafting.  

PubMed Central

When acute thrombosis of the abdominal aorta occurs in a comatose patient, direct examination of the intraabdominal organs becomes mandatory. Once a laparotomy has been performed, media calcinosis of the infrarenal aorta is a contraindication to its use as an inflow source. We describe a technique for exposing the thoracic aorta through the abdomen, which obviates the need for a thoracoabdominal incision in such critically ill patients. Images

Tovar, E A; Del Campo, C; McCoy, R E; Ness, R L

1995-01-01

76

[Subrenal coarctation of the aorta. Presentation of a clinical case].  

PubMed

Coarctation of abdominal aorta constitutes a rare group of vascular abnormalities, including segmental stenoses and extended hypoplasia below the restriction. Usually hypertension is the only clinical evidence. The natural history of the surgically untreated disease foresees a decline of life expectancy; while surgical operation permit an almost complete "restitutio ad integrum". The Authors report a case of coarctation of the abdominal aorta come to their observation whose particularly was determined by the absence of high blood pressure, the aortic stenoses being located under the renal arteries. PMID:1780082

Occhionorelli, S; Taddia, M C; Romano, D; Vasquez, G; Mari, F; Pollinzi, V; Cavagna, E; Saletti, A; Mascoli, F

1991-01-01

77

A study of atherosclerosis regression in Macaca mulatta. V. Changes in abdominal aorta and carotid and coronary arteries from animals with atherosclerosis induced for 38 months and then regressed for 24 or 48 months at plasma cholesterol concentrations of 300 or 200 mg/dl.  

PubMed

Young adult male rhesus monkeys (Macaca mulatta) were fed an atherogenic diet for 38 months. After 38 months of atherosclerosis induction, a baseline group was selected and necropsied to determine the extent and severity of atherosclerosis before regression regimens were begun. The remaining animals were fed diets that varied in cholesterol concentration in order to maintain plasma cholesterol concentrations of approximately 200 or 300 mg/dl for either 24 or 48 months. The progression or regression of atherosclerosis in coronary arteries, abdominal aorta, and carotid arteries was determined by comparing them to the baseline group. Coronary artery atherosclerosis regressed in the majority of animals after 4 years but not after 2 years when plasma cholesterol concentrations were about 200 mg/dl. Among the animals maintained at plasma cholesterol concentrations of about 300 mg/dl, about half the animals progressed in the extent of coronary artery atherosclerosis while about half regressed. The majority of the animals that progressed in lesion extent were genetic hyperresponders to dietary cholesterol whereas those that regressed were predominantly hyporesponders, even though their plasma lipid concentrations were equivalent during the regression phase. The changes seen in atherosclerosis extent in the abdominal aorta were quite similar to the changes seen in coronary arteries. Changes at this site were not pronounced after 2 years, but after 4 years animals with plasma cholesterol concentrations of about 300 mg/dl progressed while the animals at 200 mg/dl were mostly unchanged. No evidence for atherosclerosis regression was found in the common carotid arteries or in the carotid bifurcations. PMID:6468638

Clarkson, T B; Bond, M G; Bullock, B C; McLaughlin, K J; Sawyer, J K

1984-08-01

78

Abdominal Adhesions  

MedlinePLUS

... cavity to stick together. What is the abdominal cavity? The abdominal cavity is the internal area of the body between ... adhesions cause tissues and organs in the abdominal cavity to stick together. • Abdominal surgery is the most ...

79

Abdominal Adhesions  

MedlinePLUS

... tissues and organs. [ Top ] What is the abdominal cavity? The abdominal cavity is the internal area of the body between ... adhesions cause tissues and organs in the abdominal cavity to stick together. Abdominal surgery is the most ...

80

Delayed rupture of abdominal aortic false aneurysm following blunt trauma  

Microsoft Academic Search

  \\u000a Blunt injury of the abdominal aorta resulting in pseudoaneurysm formation is very rare. Such a pseudoaneurysm may rupture\\u000a at any time, usually with fatal outcome. We report the case of a 32-year-old man with a clinically unsuspected ruptured abdominal\\u000a aorta pseudoaneurysm, which had probably formed 3 years earlier, and emphasize the CT features.

G. Gayer; A. Bass

2003-01-01

81

Aorta pathology and pregnancy.  

PubMed

In addition to the haemodynamic changes in pregnancy, hormones also induce changes in the aortic wall. Women with diseases like Marfan syndrome, Ehlers-Danlo syndrome, or other aortic abnormalities, have an increased risk of complications during pregnancy. Counselling and risk assessment before pregnancy is mandatory for all women with known aortic disease. Proper information should be provided about the risks of morbidity and mortality during pregnancy and information on the risks for the fetus, including the potential recurrence of disease in the offspring. Evaluation of past medical and family history, the aortic size before conception, and any increase in size before and during pregnancy, is essential to try and estimate the risk of aortic dissection. If the aorta is dilated, prophylactic repair before pregnancy may be indicated. In some cases, elective surgery during pregnancy may be warranted. In women with a severely dilated ascending aorta, caesarean section is, at present, the advised mode of delivery. PMID:24726851

van Hagen, Iris M; Roos-Hesselink, Jolien W

2014-05-01

82

Tenascin C protects aorta from acute dissection in mice  

NASA Astrophysics Data System (ADS)

Acute aortic dissection (AAD) is caused by the disruption of intimomedial layer of the aortic walls, which is immediately life-threatening. Although recent studies indicate the importance of proinflammatory response in pathogenesis of AAD, the mechanism to keep the destructive inflammatory response in check is unknown. Here, we report that induction of tenascin-C (TNC) is a stress-evoked protective mechanism against the acute hemodynamic and humoral stress in aorta. Periaortic application of CaCl2 caused stiffening of abdominal aorta, which augmented the hemodynamic stress and TNC induction in suprarenal aorta by angiotensin II infusion. Deletion of Tnc gene rendered mice susceptible to AAD development upon the aortic stress, which was accompanied by impaired TGF? signaling, insufficient induction of extracellular matrix proteins and exaggerated proinflammatory response. Thus, TNC works as a stress-evoked molecular damper to maintain the aortic integrity under the acute stress.

Kimura, Taizo; Shiraishi, Kozoh; Furusho, Aya; Ito, Sohei; Hirakata, Saki; Nishida, Norifumi; Yoshimura, Koichi; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Ikeda, Yasuhiro; Miyamoto, Takanobu; Ueno, Takafumi; Hamano, Kimikazu; Hiroe, Michiaki; Aonuma, Kazutaka; Matsuzaki, Masunori; Imaizumi, Tsutomu; Aoki, Hiroki

2014-02-01

83

Fetal aorta wall inflammation in ultrasound-detected aortic intima/media thickness and growth retardation.  

PubMed

Several studies have reported that fetuses with intrauterine growth restriction (IUGR) and infants with low birth weight present increased intima/media thickness (aIMT) of the abdominal aorta wall compared with fetuses and infants appropriate for gestational age (AGA). Evidence suggested that aIMT might be related to inflammation, probably indicating a very early stage of future adulthood disease, such as atherosclerosis. We aimed to investigate histological findings in the abdominal aorta wall of one IUGR stillbirth in which ultrasound had detected aIMT. Microscopy observations of the abdominal aorta wall confirmed the intima thickening and detected condensation of the elastic fibers forming an evident internal elastic membrane and presence of inflammatory elements, such as macrophages, activated endothelial cells, and fibroblastoid cells. The present study highlights that IUGR associated with aIMT is related to inflammation, which might represent a very early sign of future adult lesions. PMID:21742382

Lo Vasco, Vincenza Rita; Salmaso, Roberto; Zanardo, Vincenzo; Businaro, Rita; Visentin, Silvia; Trevisanuto, Daniele; Cosmi, Erich

2011-09-01

84

Cannulation in the Diseased Aorta  

PubMed Central

The Seldinger technique is a method of femoral cannulation that has been used to establish cardiopulmonary bypass. Reports of cannulation of the ascending aorta for antegrade perfusion using the Seldinger method are anecdotal. To the best of our knowledge, the approach described herein for direct cannulation of the ascending aorta with use of the Seldinger technique for antegrade perfusion has not been previously described in the English-language medical literature. This method is helpful when the surgeon is treating a patient who has a calcified ascending aorta, complicated aortic dissection, calcified femoral vessels, or a diseased thoracoabdominal aorta. In such cases, retrograde perfusion has been associated with severe complications as a result of atheromatous embolization from the descending thoracic aorta. Herein, we describe our approach to cannulation for cardiopulmonary bypass, which entails insertion of an aortic cannula into the ascending aorta by means of the Seldinger technique. A soft-tip guidewire is inserted through an arterial entry catheter that has been used to puncture a hole in the wall of the vessel. Then the aortic cannula is introduced into the vessel, sliding along the guidewire. Guided by transesophageal echocardiography, the tip of the cannula is positioned carefully and is then advanced into the descending aorta. This positioning of the cannula decreases the chance of arterial embolization, thereby improving cerebral protection. If cannulation of the ascending aorta is not feasible, the transverse aortic arch or proximal descending aorta can be used.

Khoynezhad, Ali; Plestis, Konstadinos A.

2006-01-01

85

Flow Patterns in the Dog Descending Aorta under a Steady Flow Condition Simulating Mid-Systole  

NASA Astrophysics Data System (ADS)

Hemodynamic factors are suspected to be involved in the localized pathogenesis and development of atherosclerotic lesions in the human thoracico-abdominal aorta. Hence, we studied the detailed flow patterns and the distributions of fluid velocity and wall shear stress there under the condition of a steady flow using five transparent aortic trees prepared from dogs as models of the human descending aorta and by means of flow visualization and high-speed cinemicrographic techniques. It was found that in all the cases the flow in the descending aorta was not fully developed to the extent to provide a parabolic velocity profile. Flow was disturbed at each junction, and most complex secondary and adverse flows formed at the branching site of the left renal artery adjacent to the lateral and posterior walls of the descending aorta. Furthermore, there was considerable interaction between the secondary and adverse flows formed at the branching sites of the four major arteries that stemmed off the descending aorta.

Endo, Shunsuke; Goldsmith, Harry Leonardo; Karino, Takeshi

86

Immunohistochemical localization of apoprotein B in aortas from hyperlipemic swine. Preferential accumulation in lesion-prone areas.  

PubMed

In hyperlipemic swine, areas of the aortic arch that accumulate intravenously injected Evans blue dye (blue areas) appear to be more susceptible to early atherogenesis than adjacent areas that are devoid of dye uptake (white areas). We used immunofluorescence microscopy to determine the localization of apoprotein-B (apoB) in these blue and white areas, and in intimal cell masses (ICMs) of the abdominal aortas obtained from hyperlipemic and normolipemic swine. The results showed that before aortic lesions were visible grossly or microscopically, extracellular accumulations of apoB occurred preferentially in the thickened intima of blue areas and in ICMs of the abdominal aorta. Normal white areas in the aortic arch and abdominal aortas, and in the aortas obtained from control swine showed negligible immunoreactivity. Thus, the accumulation of apoB at anatomic sites predilected to early atherogenesis lends further evidence linking these lipoproteins with atherogenesis. PMID:6383260

Feldman, D L; Hoff, H F; Gerrity, R G

1984-10-01

87

Distribution, Size, and Shape of Abdominal Aortic Calcified Deposits and Their Relationship to Mortality in Postmenopausal Women  

PubMed Central

Abdominal aortic calcifications (AACs) correlate strongly with coronary artery calcifications and can be predictors of cardiovascular mortality. We investigated whether size, shape, and distribution of AACs are related to mortality and how such prognostic markers perform compared to the state-of-the-art AC24 marker introduced by Kauppila. Methods. For 308 postmenopausal women, we quantified the number of AAC and the percentage of the abdominal aorta that the lesions occupied in terms of their area, simulated plaque area, thickness, wall coverage, and length. We analysed inter-/intraobserver reproducibility and predictive ability of mortality after 8-9 years via Cox regression leading to hazard ratios (HRs). Results. The coefficient of variation was below 25% for all markers. The strongest individual predictors were the number of calcifications (HR = 2.4) and the simulated area percentage (HR = 2.96) of a calcified plaque, and, unlike AC24 (HR = 1.66), they allowed mortality prediction also after adjusting for traditional risk factors. In a combined Cox regression model, the strongest complementary predictors were the number of calcifications (HR = 2.76) and the area percentage (HR = ?3.84). Conclusion. Morphometric markers of AAC quantified from radiographs may be a useful tool for screening and monitoring risk of CVD mortality.

Ganz, Melanie; de Bruijne, Marleen; Dam, Erik B.; Pettersen, Paola; Karsdal, Morten A.; Christiansen, Claus; Nielsen, Mads

2012-01-01

88

Divergent phenotype of rat thoracic and abdominal perivascular adipose tissues  

PubMed Central

Perivascular adipose tissue (PVAT) is implicated as a source of proatherogenic cytokines. Phenotypic differences in local PVAT depots may contribute to differences in disease susceptibility among arteries and even regions within an artery. It has been proposed that PVAT around the abdominal and thoracic aorta shares characteristics of white and brown adipose tissue (BAT), respectively; however, a detailed comparison of the phenotype of these PVAT depots has not been performed. Using young and older adult rats, we compared the phenotype of PVATs surrounding the abdominal and thoracic aorta to each other and also to epididymal white and subscapular BAT. Compared with young rats, older rats exhibited greater percent body fat (34.5 ± 3.1 vs. 10.4 ± 0.9%), total cholesterol (112.2 ± 7.5 vs. 58.7 ± 6.3 mg/dl), HOMA-insulin resistance (1.7 ± 0.1 vs. 0.9 ± 0.1 a.u.), as well as reduced ACh-induced relaxation of the aorta (maximal relaxation: 54 ± 10 vs. 77 ± 6%) (all P < 0.05). Expression of inflammatory genes and markers of immune cell infiltration were greater in abdominal PVAT than in thoracic PVAT, and overall, abdominal and thoracic PVATs resembled the phenotype of white adipose tissue (WAT) and BAT, respectively. Histology and electron microscopy indicated structural similarity between visceral WAT and abdominal PVAT and between BAT and thoracic PVAT. Our data provide evidence that abdominal PVAT is more inflamed than thoracic PVAT, a difference that was by and large independent of sedentary aging. Phenotypic differences in PVAT between regions of the aorta may be relevant in light of the evidence in large animals and humans that the abdominal aorta is more vulnerable to atherosclerosis than the thoracic aorta.

Jenkins, Nathan T.; Vieira-Potter, Victoria J.; Laughlin, M. Harold

2013-01-01

89

Intraluminal ascending aorta fibroma.  

PubMed

Primary cardiac tumors are quite rare, especially in the pediatric age group, and their atypical presentations often prevent a timely diagnosis. Most primary cardiac tumors in the pediatric age group are benign. Fibromas are generally reported as the second most common primary cardiac tumors in the pediatric age group. These neoplasms are often intramural and involve the left ventricular free wall or the interventricular septum. Although benign, fibromas may become life-threatening by causing arrhythmias or obstruction to the blood flow. A case of supravalvular intraluminal ascending aorta fibroma in a 23-month-old girl, presenting with syncope, is described here; the location is rare and the presentation atypical for this type of tumor. Transesophageal echocardiography helped us to evaluate the anatomic details of the tumor and plan surgery. PMID:23074605

Moghadam, Mohammad Yusef Aarabi; Moradian, Maryam; Givtaj, Nader; Mozaffari, Kambiz

2011-01-01

90

Intraluminal Ascending Aorta Fibroma  

PubMed Central

Primary cardiac tumors are quite rare, especially in the pediatric age group, and their atypical presentations often prevent a timely diagnosis. Most primary cardiac tumors in the pediatric age group are benign. Fibromas are generally reported as the second most common primary cardiac tumors in the pediatric age group. These neoplasms are often intramural and involve the left ventricular free wall or the interventricular septum. Although benign, fibromas may become life-threatening by causing arrhythmias or obstruction to the blood flow. A case of supravalvular intraluminal ascending aorta fibroma in a 23-month-old girl, presenting with syncope, is described here; the location is rare and the presentation atypical for this type of tumor. Transesophageal echocardiography helped us to evaluate the anatomic details of the tumor and plan surgery.

Moghadam, Mohammad Yusef Aarabi; Moradian, Maryam; Givtaj, Nader; Mozaffari, Kambiz

2011-01-01

91

BIOMECHANICS OF ABDOMINAL AORTIC ANEURYSM  

PubMed Central

Abdominal aortic aneurysm (AAA) is a condition whereby the terminal aorta permanently dilates to dangerous proportions, risking rupture. The biomechanics of AAA has been studied with great interest since aneurysm rupture is a mechanical failure of the degenerated aortic wall and is a significant cause of death in developed countries. In this review article, the importance of considering the biomechanics of AAA is discussed, and then the history and the state-of-the-art of this field is reviewed - including investigations into the biomechanical behavior of AAA tissues, modeling AAA wall stress and factors which influence it, and the potential clinical utility of these estimates in predicting AAA rupture.

Vorp, David A.

2009-01-01

92

Abdominal aortic rupture from an impaling osteophyte following blunt trauma.  

PubMed

Blunt injury of the abdominal aorta is highly fatal. We present an unusual case of an osteophyte impaling the abdominal aorta treated by endovascular repair. A 77-year-old man sustained a thoracolumbar fracture-dislocation with posterior aortic rupture between his celiac and superior mesenteric artery origins. His aortic injury was treated with a stent graft, excluding the celiac origin. He was dismissed on postoperative day 6. At 6 months, he had returned to most preinjury activities, and at 2-year follow-up, he continues to have good functional outcome. Endovascular repair may be successfully employed in select aortic injuries in hemodynamically stable patients. PMID:23810261

Vernon, Seth A; Murphy, William R C; Murphy, Todd W; Haan, James M

2014-04-01

93

A patient with fever and an abdominal aortic aneurysm  

PubMed Central

A 55-year-old man with an abdominal aortic aneurysm presented with fever and abdominal pain 3 weeks after an episode of Salmonella gastroenteritis. His symptoms persisted despite antimicrobial therapy. Two abdominal computed tomography (CT) scans showed no evidence of aortitis. His abdominal pain worsened and further investigation including a third CT scan demonstrated a leaking aortic aneurysm. The wall of the aorta was shown to contain Gram-negative bacilli. This case illustrates the difficulty in diagnosing bacterial aortitis.???Keywords: Salmonella; aortitis

Barlow, G.; Green, S.

1999-01-01

94

Morphometrics for cephalometric diagnosis.  

PubMed

This article demonstrates morphometric methods by applying them to an orthodontic sample. A total of 150 pretreatment cephalograms of consecutive patients (84 female, 66 male) were traced and digitized. Fifteen points were used for the analysis. The tracings were superimposed by the Procrustes method, and shape variability was assessed by principal component analysis. Approximately 70% of the total sample variability was incorporated in the first 5 principal components. The most significant principal component, accounting for 29% of shape variability, was the divergence of skeletal pattern; the second principal component, accounting for 20% of shape variability, was the anteroposterior maxillary relationship. It is recommended that Procrustes superimposition and principal component analysis be incorporated into routine cephalometric analysis for more valid and comprehensive shape assessment. PMID:15127026

Halazonetis, Demetrios J

2004-05-01

95

Abdominal actinomycosis.  

PubMed

Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases. PMID:14616714

Wagenlehner, F M E; Mohren, B; Naber, K G; Männl, H F K

2003-08-01

96

Coronary artery aneurysm associated with aneurysm of descending thoracic aorta: Case report  

Microsoft Academic Search

Coronary artery aneurysm is one of the rare abnormalities of cardiovascular system. Coronary artery aneurysm concomitant with abdominal, and ascending thoracic aortic aneurysm has been reported, but with descending thoracic aneurysm has not been reported. We are presenting a case of atherosclerotic left circumflex coronary artery aneurysm associated with aneurysm of descending thoracic aorta.

Ertan Okmen; Nese Cam; Izzet Erdinler; Seden Celik; Arda Sanli; Recep Ozturk

2002-01-01

97

Fluid-structure interaction in abdominal aortic aneurysms: effects of asymmetry and wall thickness  

Microsoft Academic Search

BACKGROUND: Abdominal aortic aneurysm (AAA) is a prevalent disease which is of significant concern because of the morbidity associated with the continuing expansion of the abdominal aorta and its ultimate rupture. The transient interaction between blood flow and the wall contributes to wall stress which, if it exceeds the failure strength of the dilated arterial wall, will lead to aneurysm

Christine M Scotti; Alexander D Shkolnik; Satish C Muluk; Ender A Finol

2005-01-01

98

Clear Depiction of Inflammatory Abdominal Aortic Aneurysm with Diffusion-Weighted Magnetic Resonance Imaging  

SciTech Connect

We report the case of an inflammatory abdominal aortic aneurysm incidentally detected clearly with diffusion-weighted magnetic resonance imaging (DW-MRI) during the examination of a patient with myelofibrosis with myeloid metaplasia that later converted to acute myeloid leukemia. DW-MRI revealed a hyperintense halo surrounding the abdominal aorta with aneurysmatic dilatation, establishing the diagnosis.

Orta Kilickesmez, Kadriye, E-mail: kadriye11@yahoo.co [Istanbul University Institute of Cardiology, Department of Cardiology (Turkey); Kilickesmez, Ozgur [Yeditepe University, Department of Radiology, School of Medicine (Turkey)

2010-04-15

99

Fatal hemopericardium caused by retrograde acute abdominal aortic dissection: An autopsy report and morphological consideration  

Microsoft Academic Search

A case of acute aortic dissection in which entry is formed at the abdominal aorta is unusual. In addition, an autopsy case of cardiac tamponade caused by spontaneous acute retrograde abdominal aortic dissection is extremely rare and such a report has never previously been published to our knowledge. We herein present an autopsy case of sudden unexpected death due to

Takashi Chiba; Naoki Nishida; Maki Ohtani; Ichiro Suzuki; Naofumi Yoshioka

2006-01-01

100

Abdominal Aortic Aneurysms: Treatments  

MedlinePLUS

... Minimally Invasive Treatments Snapshots Multimedia Multimedia Archive Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

101

Micromanaging abdominal aortic aneurysms.  

PubMed

The contribution of abdominal aortic aneurysm (AAA) disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to "fine tune" the translational output of their target messenger RNAs (mRNAs) by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility. PMID:23852016

Maegdefessel, Lars; Spin, Joshua M; Adam, Matti; Raaz, Uwe; Toh, Ryuji; Nakagami, Futoshi; Tsao, Philip S

2013-01-01

102

Nondilated abdominal aortic rupture caused by acute type B aortic dissection.  

PubMed

A 31-year-old man presented with sudden abdominal pain. Computed tomography showed type B aortic dissection and a huge retroperitoneal hematoma. Accordingly, we diagnosed rupture of the abdominal aorta which was of almost normal caliber. Emergency open abdominal aortic repair was performed successfully. Pathology of the aortic wall revealed diffuse medial degeneration with severe elastin fragmentation, but gene analysis found no gene mutation that could lead to a connective tissue disorder. PMID:24771739

Iba, Yutaka; Fukazawa, Kazutoshi; Minatoya, Kenji; Matsuda, Hitoshi; Sasaki, Hiroaki; Tanaka, Hiroshi

2014-05-01

103

Fatal thromboembolic complications following assault in a subject with an abdominal aortic aneurysm  

Microsoft Academic Search

A 62-year-old male with no significant medical history developed thromboembolic complications in the lower limbs shortly after\\u000a an assault which involved punching and kicking to the trunk. Laparotomy revealed intra-abdominal injuries and an abdominal\\u000a aortic aneurysm. Death from multi-organ failure and sepsis occurred 9 days post-injury. The discussion concentrates on blunt\\u000a force trauma to the abdominal aorta, specifically on causation, mechanisms

Andrew Meikle Davison

2009-01-01

104

Elastin and collagen fibre microstructure of the human aorta in ageing and disease: a review  

PubMed Central

Aortic disease is a significant cause of death in developed countries. The most common forms of aortic disease are aneurysm, dissection, atherosclerotic occlusion and ageing-induced stiffening. The microstructure of the aortic tissue has been studied with great interest, because alteration of the quantity and/or architecture of the connective fibres (elastin and collagen) within the aortic wall, which directly imparts elasticity and strength, can lead to the mechanical and functional changes associated with these conditions. This review article summarizes the state of the art with respect to characterization of connective fibre microstructure in the wall of the human aorta in ageing and disease, with emphasis on the ascending thoracic aorta and abdominal aorta where the most common forms of aortic disease tend to occur.

Tsamis, Alkiviadis; Krawiec, Jeffrey T.; Vorp, David A.

2013-01-01

105

Abdominal Compartment Syndrome, Abdominal Decompression, and Temporary Abdominal Closure  

Microsoft Academic Search

\\u000a Intra-abdominal hypertension (IAH) and the abdominal compartment syndrome are life-threatening complications in severely injured\\u000a patients. They may trigger a multiple organ dysfunction syndrome with subsequent fatal outcome. Early identification of high-risk\\u000a patients, close monitoring including repeated measuring of intra-abdominal pressure (IAP), and early or even prophylactic\\u000a surgical decompression of the abdomen may effectively lower morbidity and mortality. Following abdominal decompression,

Christoph Meier

106

Abdominal aortic surgery and horseshoe kidney.  

PubMed

Horseshoe kidney presents a special challenge during surgery of the abdominal aorta. The aim of this study was to evaluate the morbidity and define optimal management based on clinical histories of 15 patients with horseshoe kidney who underwent surgical procedures on the abdominal aorta over a 20-year period. There were 2 female and 13 male patients with an average age of 62.66 (50-75) years. The indications for surgery included aortic aneurysms in 10 patients and aortoiliac occlusive disease in 5. The horseshoe kidney was detected before surgery in 12 patients (80%) by ultrasonography, angiography, computed tomography (CT) or excretory urography. Angiography revealed multiple or anomalous renal arteries in 8 of 12 patients studied preoperatively. At surgery, 10 patients (66.6%) were found to have multiple or anomalous renal arteries. Five patients (33.41%) were without multiple or anomalous renal arteries. Ten required renal revascularization (reimplantation with a Carrel patch in 7 patients and aortorenal bypass in 3). Two patients, both with ruptured abdominal aortic aneurysms, died postoperatively. In the other 10 cases the average follow-up period was 5.3 years (6 months to 17 years). During this period there were no signs of graft occlusion, renovascular hypertension, or renal failure. From these results we conclude that aortic surgery can be performed safely in patients with horseshoe kidney without increased mortality. These patients require exact preoperative diagnosis (ultrasonography, CT scan, angiography), reimplantation of anomalous renal arteries, and preservation of the renal isthmus. PMID:15599631

Davidovi?, Lazar B; Kosti?, Dusan M; Jakovljevi?, Nenad S; Perisi?, Mirjana; Cinara, Ilijas S; Cvetkovi?, Slobodan D; Sindeli?, Radomir B; Kacar, Sasa

2004-11-01

107

Abdominal tuberculosis.  

PubMed Central

Tuberculosis has staged a global comeback and forms a dangerous combination with AIDS. The abdomen is one of the common sites of extrapulmonary involvement. Patients with abdominal tuberculosis have a wide range and spectrum of symptoms and signs; the disease is therefore a great mimic. Diagnosis, mainly radiological and supported by endoscopy, is difficult to make and laparotomy is required in a large number of patient. Management involves judicious combination of antitubercular therapy and surgery which may be required to treat complications such as intestinal obstruction and perforation. The disease, though potentially curable, carries a significant morbidity and mortality. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13

Kapoor, V. K.

1998-01-01

108

Abdominal wall surgery  

MedlinePLUS

Abdominal wall surgery is surgery that improves the appearance of flabby, stretched-out abdominal (belly) muscles and skin. ... mini-tummy tuck" to more complicated, extensive surgery. Abdominal wall surgery is not the same as liposuction, which ...

109

Inositol uptake in rat aorta  

SciTech Connect

{sup 3}H-inositol uptake into deendothelialized aorta was linear for at least 2 h and was composed of both a saturable, Na{sup +}-dependent, and a nonsaturable, Na{sup +}-independent component. The Na{sup +}-dependent component of inositol uptake had a K{sub m} of 50 {mu}M and a V{sub max} of 289 pmol/mg prot/h. Exposure to LiCl, ouabain, or Ca{sup 2+} - free Krebs-Ringer bicarbonate solution inhibited uptake. Metabolic poisoning with dinitrophenol, as well as incubation with phloretin, an inhibitor of carrier-mediated hexose transport, also inhibited uptake. Exposure to norepinephrine decreased inositol uptake, while phorbol myristate acetate was without effect. Isobutylmethylxanthine significantly increased inositol uptake, while the increased uptake due to dibutyryl cyclic AMP and forskolin were not statistically significant. Sodium nitroprusside, and activator of guanylate cyclase, and 8-bromo cyclic GMP, were without effect on uptake, as was methylene blue, an inhibitor of guanylate cyclase. Inositol uptake into the aorta was increased when the endothelium was allowed to remain intact, although this effect was likely due to uptake in both the endothelial and smooth muscle cells.

Rapoport, R.M.; Van Gorp, C.; Chang, Ki-Churl (Univ. of Cincinnati College of Medicine, OH (USA))

1990-01-01

110

MORPHOMETRICS OF HARD STRUCTURES IN CUTTLEFISH  

Microsoft Academic Search

Cuttlefishes exhibit several hard structures that have been charac- terised using morphometric analysis. Most of these data come from cuttlebones, al- though statoliths and beaks are also used. It appears that morphometric techniques are mainly used for taxonomic purposes. However, some analyses have emphasised functional morphology and macroevolution. Morphological features (including the inner shell) of cuttlefishes and their availability for

P. NEIGE

2006-01-01

111

Circumaortic Left Renal Vein Associated with Juxtarenal Abdominal Aortic Aneurysm  

PubMed Central

The patient was an 82-year-old man who was found to have a juxtarenal abdominal aortic aneurysm accompanied by a circumaortic left renal vein (CLRV). During dissection of the proximal anastomosis site the CLRV was injured, but was successfully repaired. A graft implantation was performed below the renal arteries. The incidence of CLRV is thought to be rare, however it is found in 7% of cadavers donated for anatomy. CLRV may cause unexpected bleeding by inadvertent dissection of the abdominal aorta. To prevent unexpected bleeding, surgeons should always keep in mind this potential risk when performing surgery.

2013-01-01

112

Abdominal aortic dilatation in patients operated on for carotid artery stenosis.  

PubMed

The prevalence of abdominal aortic dilatation among 201 men and 86 women who underwent carotid endarterectomy in 1971-1982 was studied from the date of operation to the end of 1984. Of the 109 patients who died during this time, 96 were autopsied, and 13 (13.5%) of them had aneurysm of the abdominal aorta. Ultrasonographic screening of the abdominal aorta was performed on 154 survivors, and showed dilatation in 17 (11%), 12/100 men and 5/54 women. The prevalence of hypertension, intermittent claudication, diabetes mellitus and coronary insufficiency at the time of endarterectomy did not differ between the patients with or without aortic aneurysm or dilatation. Patients who have undergone endarterectomy of the internal carotid artery constitute a group with high prevalence of abdominal aortic dilatation. PMID:3188791

Bengtsson, H; Ekberg, O; Aspelin, P; Takolander, R; Bergqvist, D

1988-01-01

113

Mechanical characterization of human aortas from pressurization testing and a paradigm shift for circumferential residual stress.  

PubMed

Material properties needed for accurate stress analysis of the human aorta are still incompletely known, especially as many reports have ignored the presence of residual stresses in the aortic wall. To contribute new material regarding these issues, we carried out measurements and pressurization testing on ascending, thoracic and abdominal aortic samples from 24 human subjects aged 38-77 years, and evaluated the opening angle describing the circumferential residual stress level present in the aorta. We determined material constants for the aorta by gender, anatomic location and age group, according to a simple phenomenological constitutive model. The unpressurized aortic radius positively correlated with age, and the circumferential and longitudinal stretch ratios under systemic pressure negatively correlated with age, confirming the known enlargement and stiffening of the aorta with aging. The opening angle was measured to range from a minimum of 89° to above 360° for extreme cases. For given aortic dimensions and material properties, analysis of the in vivo circumferential and longitudinal mural stress distributions indicated a profound influence of the opening angle. For instance, in the thoracic aorta of males aged 38-66, opening angles in the range of 0° to 80° (resp. 60°) may equalize the gradient of in vivo circumferential (resp. longitudinal) stress between the inner and outer layers of the aorta, as commonly expected; however, opening angles above 160° (resp. 120°) may cause the gradient of circumferential (resp. longitudinal) stress to reverse and increase compared to the case without residual stress, putting the maximum stresses toward the adventitia instead of the intima. Even though the analysis of the aortic wall excluded possible longitudinal residual stresses as well as material inhomogeneities, such as constitutive differences between the intimal, medial and adventitial layers, the experimental data reported herein are important to aortic modeling at large and the better understanding of aortic pathophysiology in particular. PMID:23127625

Labrosse, Michel R; Gerson, Eleanor R; Veinot, John P; Beller, Carsten J

2013-01-01

114

Fatal abdominal aortic compression associated with thoracic vertebral fracture-dislocation after a short fall  

Microsoft Academic Search

Abdominal aortic injury after blunt trauma is a rare event, as these injuries occur much less frequently than do those of\\u000a the thoracic aorta. We present an unusual case of fatal abdominal aortic compression with presumed compression associated\\u000a with a fracture-dislocation of the T11 vertebral body after a short fall, which to our knowledge is the first reported case\\u000a of

Michael M. Herskowitz; Wen Wang; George Agriantonis

2003-01-01

115

Thoraco-abdominal aortic aneurysm branched repair.  

PubMed

Open thoraco-abdominal aortic aneurysm repair is a demanding procedure with high impact on the patient and the operating team. Results from expert centres show mortality rates between 3-21%, with extensive morbidity including renal failure and paraplegia. Endovascular repair of abdominal aortic aneurysms initially required an undilated portion of the aorta below the renal arteries to safely fixate the stent-graft. More complex abdominal artic aneurysms (i.e., short-necked, juxta- and suprarenal aneurysms) were later successfully treated with fenestrated grafts. The development of branched grafts opened the way to treat thoraco-abdominal aneurysms endovascularly. In this review, a comprehensive overview of technical aspects and results of the available literature is given. Mortality rates are below 10%, with spinal cord ischemia reported between 2.7% and 20%. Target vessel branch patency invariably has been reported between 95% and 100%, with first mid-term results demonstrating evidence for durability. Most series included high-risk patients, who were denied open repair. Nevertheless, risks associated with endovascular repair of thoraco-abdominal aneurysm should be acknowledged. Technique-specific complications including perforation of small vessels due to multiple catheterization resulting in retroperitoneal hematoma, and compartment syndrome of the lower limbs should be mentioned. Technical evolution of branched grafts is ongoing. Tapering down the main graft to allow for room for the branches has resulted in easier catheterization of target vessels and insertion of bridging stent-grafts. For the same reason, the branches for celiac artery and superior mesenteric artery are deliberately off-set in position. To stabilise the usually long devices, additional spiral wires have been added, to facilitate deployment in the correct orientation. Endovascular repair of thoraco-abdominal aneurysms will continue to evolve and gradually take over from open repair, in view of the much lower physical impact on the patient. PMID:20354484

Verhoeven, E L G; Tielliu, I F J; Ferreira, M; Zipfel, B; Adam, D J

2010-04-01

116

In vivo determination of elastic properties of the human aorta based on 4D ultrasound data.  

PubMed

Computational analysis of the biomechanics of the vascular system aims at a better understanding of its physiology and pathophysiology. To be of clinical use, however, these models and thus their predictions, have to be patient specific regarding geometry, boundary conditions and material. In this paper we present an approach to determine individual material properties of human aortae based on a new type of in vivo full field displacement data acquired by dimensional time resolved three dimensional ultrasound (4D-US) imaging. We developed a nested iterative Finite Element Updating method to solve two coupled inverse problems: The prestrains that are present in the imaged diastolic configuration of the aortic wall are determined. The solution of this problem is integrated in an iterative method to identify the nonlinear hyperelastic anisotropic material response of the aorta to physiologic deformation states. The method was applied to 4D-US data sets of the abdominal aorta of five healthy volunteers and verified by a numerical experiment. This non-invasive in vivo technique can be regarded as a first step to determine patient individual material properties of the human aorta. PMID:23668998

Wittek, Andreas; Karatolios, Konstantinos; Bihari, Peter; Schmitz-Rixen, Thomas; Moosdorf, Rainer; Vogt, Sebastian; Blase, Christopher

2013-11-01

117

Morphometrical analysis of transbronchial cryobiopsies  

PubMed Central

The recent introduction of bronchoscopically recovered cryobiopsy of lung tissue has opened up new possibilities in the diagnosis of neoplastic and non-neoplastic lung diseases in various aspects. Most notably the morphological diagnosis of peripheral lung biopsies promises to achieve a better yield with a high quality of specimens. To better understand this phenomenon, its diagnostic options and perspectives, this study morphometrically compares 15 cryobiopsies and 18 transbronchial forceps biopsies of peripheral lung tissue a priori without considering clinical hit ratio or integration of results in the clinical diagnostic processing. Cryotechnically harvested specimens were significantly larger (mean: 17.1 ± 10.7 mm2 versus 3.8 ± 4.0 mm2) and contained alveolar tissue more often. If present, the alveolar part in cryobiopsies exceeded the one of forceps biopsies. The alveolar tissue of crybiopsy specimens did not show any artefacts. Based on these results cryotechnique seems to open up new perspectives in bronchoscopic diagnosis of lung disease.

2011-01-01

118

Shaggy and calcified aorta: surgical implications.  

PubMed

Atheroembolism is an emerging problem in cardiovascular surgery, especially in elderly patients. Severe atherosclerosis of the thoracic aorta usually reflects systemic atherosclerosis. Aggressive preoperative and intraoperative evaluation of the aorta using enhanced CT, transesophageal echocardiography and epiaortic ultrasound is important in elderly patients as well as those with systemic atherosclerosis. To prevent atheroembolism, it is important to select an adequate arterial perfusion site and to avoid touching the diseased aorta until circulatory arrest. In atherosclerotic aortic arch aneurysm, central cannulation under ultrasound guidance and directing the dispersive cannula toward the aortic root is a simple and effective perfusion strategy. Axillary perfusion is useful as an alternative to central cannulation in atherosclerotic aortic disease, but special care is necessary to avoid complications when the patient has a small axillary artery or flail atheroma around the arch vessels. In femoral artery perfusion, retrograde perfusion may induce paradoxical cerebral embolism, but the incidence of stroke is comparable with axillary perfusion when there is adequate preoperative screening using transesophageal echography. Circulatory arrest with/without cerebral perfusion is another important strategy when the aorta has severe atherosclerosis. Recent literature has shown that mild hypothermia may be safe for anterior cerebral perfusion during circulatory arrest, but optimal flow rates and time limitations are unknown. A simple calcified aorta called "porcelain aorta" may be managed by circulatory arrest, local debridement and the clamp method. Several surgical options are proposed for this clinical entity but their use will diminish in the future because of transcatheter valve replacement. PMID:23404308

Fukuda, Ikuo; Daitoku, Kazuyuki; Minakawa, Masahito; Fukuda, Wakako

2013-06-01

119

Impact Tolerance - Abdominal Injury.  

National Technical Information Service (NTIS)

In order to provide data on human tolerance to blunt abdominal impact a literature study and laboratory tests were carried out to determine the major causes of abdominal injury, injury mechanisms, a quantitative relationship between input and occurrence o...

D. L. Beckman J. H. McElhaney R. L. Stalnaker V. L. Roberts

1971-01-01

120

Abdominal Pain Syndrome  

MedlinePLUS

... of the structures within the abdomen or the abdominal wall. In addition, pain messages originating in the chest, ... lungs) Pulmonary embolism (blood clots to the lungs) Abdominal or chest wall pain: Shingles (herpes zoster infection) Costochondritis (inflammation of ...

121

Acute Limb Ischemia from Sudden Thrombosis of an Abdominal Aortic Aneurysm  

PubMed Central

Thrombosis of a previously undiagnosed aneurysm of the abdominal aorta in a 64-year-old woman resulted in acute and severe ischemia in both legs. Prompt surgical resection of the aneurysm and restoration of aortic continuity with a fabric graft brought about complete resolution of her symptoms, with excellent functional results one year after the operation. Images

Subram, Aswath N.; Duncan, J. Michael

1982-01-01

122

Pediatric blunt abdominal aortic injury and the use of intra-operative aortic ultrasound for surgical decision making.  

PubMed

Traumatic injury has been the most common cause of morbidity and mortality in the pediatric population, but injuries to the abdominal aorta are rare. We reviewed 2 children who underwent exploratory laparotomy for blunt aortic injury in which intra-operative ultrasound guided the surgical approach. Intra-operative ultrasound allowed us to minimize resection of normal aorta and achieve primary repair. In the pediatric population, achieving primary repair is ideal, as synthetic grafts will likely need future revisions as children grow. Here we present the use of intra-operative ultrasound in maximizing the chance at primary repair of the aorta following blunt injury. PMID:23895976

Bairdain, Sigrid; Modi, Biren P; Kim, Heung B; Mooney, David P; Durkin, Emily; Vakili, Khashayar

2013-07-01

123

Fast track occlusion of aorta with atrial septal defect sizing balloon.  

PubMed

We describe the case of a 57-year-old woman referred to our emergency service with ruptured abdominal aneurysm. We placed a 34-mm Amplatzer sizing balloon II into the suprarenal level of aorta to immediately control the active massive bleeding and to get the patient out of hemorrhage shock into the stable condition. After the bleeding control, endovascular repair was successfully performed. This is the first case report, to our knowledge, of atrial septal defect (ASD) sizing balloon use for blocking the blood flow through aorta to control the bleeding. ASD sizing balloon has some different properties compared to aortic occlusion balloon catheter (AOBC). Due to availability of sheathless usage, ASD sizing balloon may be preferred over AOBC for some of patient groups with peripheral artery diseases and small femoral artery diameters. PMID:24403245

Cak?r, Hakan; Acar, Göksel; Pala, Selçuk

2014-06-01

124

Opposing changes in thoracic and abdominal aortic biomechanical properties in rodent models of vascular calcification and hypertension.  

PubMed

This study investigated the effects of hypertension on regional aortic biomechanical and structural properties in three rat models of vascular calcification: the hypertensive Lewis polycystic kidney (LPK; n = 13) model of chronic kidney disease, spontaneously hypertensive rats (SHRs; n = 12), and calcification in normotensive Lewis rats induced by vitamin D3 and nicotine (VDN; n = 8). Lewis and Wistar-Kyoto rats were controls. Thoracic and abdominal aortic stiffness parameters were assessed by tensile testing. In models where aortic stiffness differences compared with controls existed in both thoracic and abdominal segments, an additional cohort was quantified by histology for thoracic and abdominal aortic elastin, collagen, and calcification. LPK and VDN animals had higher thoracic breaking strain than control animals (P < 0.01 and P < 0.05, respectively) and lower energy absorption within the tensile curve of the abdominal aorta (P < 0.05). SHRs had a lower abdominal breaking stress than Wistar-Kyoto rats. LPK and VDN rats had more elastic lamellae fractures than control rats (P < 0.001), which were associated with calcium deposition (thoracic R = 0.37, P = 0.048; abdominal: R = 0.40, P = 0.046). LPK rats had higher nuclear density than control rats (P < 0.01), which was also evident in the thoracic but not abdominal aorta of VDN rats (P < 0.01). In LPK and VDN rats, but not in control rats, media thickness and cross-sectional area were at least 1.5-fold greater in thoracic than abdominal regions. The calcification models chronic kidney disease and induced calcification in normotension caused differences in regional aortic stiffness not seen in a genetic form of hypertension. Detrimental abdominal aortic remodeling but lower stiffness in the thoracic aorta with disease indicates possible compensatory mechanisms in the proximal aorta. PMID:24838503

Ameer, Omar Z; Salman, Ibrahim M; Avolio, Alberto P; Phillips, Jacqueline K; Butlin, Mark

2014-07-15

125

Estimation of prenatal aorta intima-media thickness in ultrasound examination  

NASA Astrophysics Data System (ADS)

Prenatal events such as intrauterine growth restriction have been shown to be associated with an increased thickness of abdominal aorta in the fetus. Therefore the measurement of abdominal aortic intima-media thickness (aIMT) has been recently considered a sensitive marker of artherosclerosis risk. To date measure of aortic diameter and of aIMT has been performed manually on US fetal images, thus being susceptible to intra- and inter- operator variability. This work introduces an automatic algorithm that identifies abdominal aorta and estimates its diameter and aIMT from videos recorded during routine third trimester ultrasonographic fetal biometry. Firstly, in each frame, the algorithm locates and segments the region corresponding to aorta by means of an active contour driven by two different external forces: a static vector field convolution force and a dynamic pressure force. Then, in each frame, the mean diameter of the vessel is computed, to reconstruct the cardiac cycle: in fact, we expect the diameter to have a sinusoidal trend, according to the heart rate. From the obtained sinusoid, we identify the frames corresponding to the end diastole and to the end systole. Finally, in these frames we assess the aIMT. According to its definition, we consider as aIMT the distance between the leading edge of the blood-intima interface, and the leading edge of the media-adventitia interface on the far wall of the vessel. The correlation between end-diastole and end-systole aIMT automatic and manual measures is 0.90 and 0.84 respectively.

Veronese, Elisa; Poletti, Enea; Cosmi, Erich; Grisan, Enrico

2012-02-01

126

Abdominal epilepsy in chronic recurrent abdominal pain  

PubMed Central

Background: Abdominal epilepsy (AE) is an uncommon cause for chronic recurrent abdominal pain in children and adults. It is characterized by paroxysmal episode of abdominal pain, diverse abdominal complaints, definite electroencephalogram (EEG) abnormalities and favorable response to the introduction of anti-epileptic drugs (AED). We studied 150 children with chronic recurrent abdominal pain and after exclusion of more common etiologies for the presenting complaints; workup proceeded with an EEG. We found 111 (74%) children with an abnormal EEG and 39 (26%) children with normal EEG. All children were subjected to AED (Oxcarbazepine) and 139 (92%) children responded to AED out of which 111 (74%) children had an abnormal EEG and 27 (18%) had a normal EEG. On further follow-up the patients were symptom free, which helped us to confirm the clinical diagnosis. Context: Recurrent chronic abdominal pain is a common problem encountered by pediatricians. Variety of investigations are done to come to a diagnosis but a cause is rarely found. In such children diagnosis of AE should be considered and an EEG will confirm the diagnosis and treated with AED. Aims: To find the incidence of AE in children presenting with chronic recurrent abdominal pain and to correlate EEG findings and their clinical response to empirical AEDs in both cases and control. Settings and Design: Krishna Institute of Medical Sciences University, Karad, Maharashtra, India. Prospective analytical study. Materials and Methods: A total of 150 children with chronic recurrent abdominal pain were studied by investigations to rule out common causes of abdominal pain and an EEG. All children were then started with AED oxycarbamezepine and their response to the treatment was noted. Results: 111 (74%) of the total 150 children showed a positive EEG change suggestive of epileptogenic activity and of which 75 (67.56%) were females and 36 (32.43%) were male, majority of children were in the age of group of 9-12 years. Temporal wave discharges were 39 (35.13%) of the total abnormal EEG's. All the children were started on AEDs and those with abnormal EEG showed 100% response to treatment while 27 (18%) children with normal EEG also responded to treatment. Twelve (8%) children did not have any improvement in symptoms. Conclusions: A diagnosis of AE must be considered in children with chronic recurrent abdominal pain, especially in those with suggestive history, and an EEG can save a child from lot of unnecessary investigations and suffering.

Kshirsagar, V. Y.; Nagarsenkar, Suhel; Ahmed, Minhajuddin; Colaco, Sylvia; Wingkar, K. C.

2012-01-01

127

A basic trilobite morphometric exercise  

NSDL National Science Digital Library

This activity entails a basic morphometrics lab, followed up by an in-class exercise to reinforce some of the same key concepts. The lab exercise familiarizes the student with basic methods of quantitative characterization and statistical comparison through measurement of pygidia (tails) of two species of the Ordovician trilobite Bellefontia â one from New York and one from Pennsylvania. Actual specimens, while nice, are not required; data acquired by measurement from photo collages will suffice. The exercise culminates in a statistical test of significance (using the Z-statistic) of the difference in slopes of the lines acquired for data from the two species. The data also serve to pose questions and prompt consideration of growth trajectories and discrimination of isometric from anisometric growth. The in-class activity builds on the knowledge base built in the lab but applies it to species discrimination based on the cranidia (central part of the head) of three species of the Upper Cambrian genus Bartonaspis, known to be of identical age from their occurrences within the very thin (everywhere 2m or less) Irvingella major Zone of the Elvinia trilobite Zone. The importance of that subzone, which is the "critical interval" at the top of the Pterocephaliid Biomere the basal unit of the Sunwaptan Stage traceable throughout Laurentian North America, also contributes to the significance of the exercise. With the insight developed from the lab, students are able to confidently distinguish the three species of Bartonaspis (from three photo collages), but must thoughtfully evaluate the data presented in bivariate plots of cranidial morphologic data to do so. The exercise gives the students a good sense of the level of familiarity and morphologic characterization necessary to do species-level identification, and also some worthwhile practice in basic quantitative methods.

Taylor, John

128

Hybrid procedure in a patient with symptomatic thoraco-abdominal aneurysm and prior abdominal aortic reconstruction - case report  

PubMed Central

Open repair of thoracoabdominal aortic aneurysm is connected with high mortality and morbidity. On the other hand, endovascular treatment of thoraco-abdominal aneurysms, which started 10 years ago, reduced perioperative mortality and morbidity. However, it results in a high level of late complications. It seems that an interesting solution to the problem is a hybrid procedure, which allows late complications to be reduced with acceptable levels of operative mortality and morbidity. This case report presents the use of a hybrid procedure in treatment of symptomatic thoraco-abdominal aneurysm in a patient with prior abdominal aortic reconstruction. In the first stage the patient underwent open revascularization of visceral vessels of the aorta. One week later a thoraco-abdominal stent-graft was implanted. The perioperative and postoperative period was uncomplicated. Two months after the second intervention the patient returned to work. Control imaging conducted 30 and 90 days after the procedure confirmed patency of all revascularized vessels and did not reveal any graft-related complications. The hybrid procedure seems to be an interesting alternative for open and endovascular repair of thoraco-abdominal aneurysms because it combines the advantages of open and endovascular repair. It also gives an opportunity to perform the procedure within a reasonable period of time from diagnosis of symptomatic thoraco-abdominal aneurysm.

Checinski, Pawel; Samolewski, Przemyslaw; Zielinski, Wojciech; Konik-Pinski, Daniel; Kuczmarska, Angelika

2012-01-01

129

Ultrasonography Performed by Primary Care Residents for Abdominal Aortic Aneurysm Screening  

PubMed Central

A prospective pilot study was undertaken to assess a protocol to educate primary care residents in how to personally perform ultrasonography for abdominal aortic aneurysm screening. Resident exams were proctored by a primary care physician trained in ultrasonography and were scored on the level of competence in doing the examination. Patients had ultrasound performed by a resident, followed by repeat examination by the vascular lab. Primary care resident abdominal aortic imaging was achieved in 79 of 80 attempts. Four abdominal aortic aneurysms were identified. There were 75 normal examinations; resident ultrasonography results were consistent with the results of the vascular lab. Ten residents achieved an abdominal aortic ultrasound-independent competence level after an average of 3.4 proctored exams. The main outcome of this study is that a primary care resident, with minimal training in ultrasonography imaging, is able to rapidly learn the technique of ultrasonography imaging of the abdominal aorta.

Bailey, Raymond P; Ault, Mark; Greengold, Nancy L; Rosendahl, Thomas; Cossman, David

2001-01-01

130

Functional chiral asymmetry in descending thoracic aorta.  

PubMed

To determine whether rotational blood flow or chiral asymmetry exists in the human descending thoracic aorta, we established the ability of color Doppler ultrasound to detect rotational flow in a tornado tube model of a vortex descending fluid column. In a model of the human aortic arch with a pulse duplicator, color Doppler was then used to demonstrate that rotational flow occurs first in the transverse arch and then in the proximal descending thoracic aorta. With the use of color Doppler esophageal echocardiography, 53 patients (age range, 25-78 years; mean age, 56.4 years) were prospectively examined for rotational flow in the descending thoracic aorta. At 10 cm superior to retro-left ventricular position, 22 of 38 patients (58%) revealed rotational flow with obvious diastolic counterclockwise rotation but less obvious systolic clockwise rotation. At 5 cm superior to retro-left ventricular position, 29 of 46 patients (63%) revealed rotational flow with a tendency toward systolic clockwise and diastolic counterclockwise rotation. At the retro-left ventricular position, 47 of 53 patients (89%) revealed rotational flow, usually of a clockwise direction, occurring in systole. Our data suggest that aortic flow is not purely pulsatile and axial but has a rotational component. Rotational flow begins in the aortic arch and is carried through to the descending thoracic aorta, where flow is chirally asymmetric with systolic clockwise and diastolic counterclockwise components. These data demonstrate an aortic rotational flow component that may have physiological implications for organ perfusion. PMID:2242523

Frazin, L J; Lanza, G; Vonesh, M; Khasho, F; Spitzzeri, C; McGee, S; Mehlman, D; Chandran, K B; Talano, J; McPherson, D

1990-12-01

131

Modeling Blood Flow in the Aorta.  

ERIC Educational Resources Information Center

Presents an exercise to demonstrate two fundamental concepts of fluid mechanics: the Reynolds number and the Principle of Continuity. The exercise demonstrates flow in a major blood vessel, such as the aorta, with and without a stenosis. Students observe the transition from laminar to turbulent flow as well as downstream persistence of turbulence.…

McConnell, Colin J.; Carmichael, Jonathan B.; DeMont, M. Edwin

1997-01-01

132

Type B aortic dissection after standard endovascular repair of abdominal aortic aneurysm.  

PubMed

Dissection of the aorta is a rare yet potentially serious complication following endovascular abdominal aortic aneurysm (EVAR). These can lead to visceral branch hypoperfusion, compromise of aneurysm exclusion, arterial dilation or rupture. Intimal injury and dissection in the context of EVAR may be associated with a number of risk factors that include adverse infrarenal neck morphology, device oversizing, barbed fixation and wire manipulation in the proximal aorta. Herein, we describe three cases of type B aortic dissection following EVAR and discuss possible causes. As the applicability of endovascular technology widens, clinicians are reminded of the importance of early recognition and detection of unusual sequelae following EVAR. PMID:23667216

Khanbhai, Mustafa; Ghosh, Jonathan; Ashleigh, Raymond; Baguneid, Mohammed

2013-01-01

133

Eicosanoid-dependent and endothelium-independent oscillations of rat aorta.  

PubMed

We studied the role of endothelium and eicosanoids in rhythmic contractions of rat thoracic aorta. Spontaneous oscillations were observed in 35% of 385 endothelium-intact and in 46% of 22 endothelium-denuded aortic strips from normotensive Sprague-Dawley male rats. Vasoactive agents (norepinephrine, epinephrine, phenylephrine, isoproterenol, arachidonic acid, PGF2 alpha, serotonin, potassium, endothelin, atrial natriuretic factor and angiotensin II) induced rhythmic contractions in the majority of tissues. Rhythmic activity was also observed in aortic strips from adult female, pregnant and old male rats. Aortic oscillations were partially inhibited by indomethacin, ibuprofen and nordihydroguaiaretic acid (NDGA), and completely inhibited by indomethacin plus NDGA, nifedipine, low external calcium (less than 1 mM) and pretreatment with dexamethasone. Indomethacin, NDGA and arachidonic acid did not affect oscillations of the portal vein. Rhythmic contractions were observed in thoracic aortic strips from neonatal but not from adult rabbits. However, oscillations could be induced in strips of the mesenteric artery and terminal abdominal aorta of adult rabbits. Also, adult rabbit thoracic aortic strips exhibited oscillations when set up in close proximity of rat aorta. It is suggested that rhythmic contractions are physiological characteristics of many and perhaps all blood vessels and may play a role in blood flow and turbulence; the likely cause of these oscillations is the cyclic release of one or more eicosanoids. PMID:1387009

Chemtob, S; Inayatulla, A; Varma, D R

1992-01-01

134

Abdominal injuries and sport  

PubMed Central

Serious abdominal injuries resulting from sport are rare. The potential for misdiagnosis is significant and the consequences may be serious. Patients with abdominal pain should be taken very seriously and investigated with appropriate diagnostic equipment. Sporting bodies have a responsibility to address safety within a particular sport and to change the rules where necessary as injury patterns are identified. ?????

Ryan, J. M.

1999-01-01

135

Recurrent Abdominal Pain  

ERIC Educational Resources Information Center

The purpose of this article is to provide an empirically informed but clinically oriented overview of behavioral treatment of recurrent abdominal pain. The epidemiology and scope of recurrent abdominal pain are presented. Referral process and procedures are discussed, and standardized approaches to assessment are summarized. Treatment protocols…

Banez, Gerard A.; Gallagher, Heather M.

2006-01-01

136

Abdominal hernias: Radiological features  

PubMed Central

Abdominal wall hernias are common diseases of the abdomen with a global incidence approximately 4%-5%. They are distinguished in external, diaphragmatic and internal hernias on the basis of their localisation. Groin hernias are the most common with a prevalence of 75%, followed by femoral (15%) and umbilical (8%). There is a higher prevalence in males (M:F, 8:1). Diagnosis is usually made on physical examination. However, clinical diagnosis may be difficult, especially in patients with obesity, pain or abdominal wall scarring. In these cases, abdominal imaging may be the first clue to the correct diagnosis and to confirm suspected complications. Different imaging modalities are used: conventional radiographs or barium studies, ultrasonography and Computed Tomography. Imaging modalities can aid in the differential diagnosis of palpable abdominal wall masses and can help to define hernial contents such as fatty tissue, bowel, other organs or fluid. This work focuses on the main radiological findings of abdominal herniations.

Lassandro, Francesco; Iasiello, Francesca; Pizza, Nunzia Luisa; Valente, Tullio; Stefano, Maria Luisa Mangoni di Santo; Grassi, Roberto; Muto, Roberto

2011-01-01

137

Abdominal compartment syndrome  

PubMed Central

The abdominal compartment syndrome (ACS) was first described in surgical patients with abdominal aortic aneurysm repair, trauma, bleeding, or infection, but in recent years it has also been described in patients with other pathologies such as burn injury and sepsis and in medical patients. This F1000 Medicine Report is intended to provide critical care physicians a clear insight into the current state of knowledge regarding intra-abdominal hypertension (IAH) and ACS, and will focus primarily on the recent literature as well as on the definitions and recommendations published by the World Society of the Abdominal Compartment Syndrome. The definitions regarding increased intra-abdominal pressure (IAP) will be listed, followed by a brief but comprehensive overview of the different mechanisms of organ dysfunction associated with IAH. The gold standard measurement technique for IAP as well as recommendations for organ function support in patients with IAH and options for medical and surgical treatment of IAH and ACS will be discussed.

2009-01-01

138

Multilevel somatosensory evoked potentials (SEPs) for spinal cord monitoring in descending thoracic and thoraco-abdominal aortic surgery  

Microsoft Academic Search

The usefulness of somatosensory evoked potential (SEP) monitoring as a means of preventing paraplegia in descending aorta surgery was evaluated in 47 consecutive cases operated on for isthmic (14 cases), thoracic (22 cases), or thoraco-abdominal (11 cases) repair. An aortic dissection was found in 11 cases (acute in 6). Somatosensory evoked potentials were obtained by unilateral left and right posterior

A. Matta; R VERHELST; J RUBAY; G KHOURY; R DION

1996-01-01

139

Morphometric analysis of face in dysmorphology  

Microsoft Academic Search

Dysmorphology refers to study of human congenital malformations (birth defects). Most of the case reporting in dysmorphology is subjective and is based on experience of the reporting clinician. We have used the methods of geometric morphometrics to analyze the variation in faces of normal individuals and those with dysmorphic syndrome.We obtained photographs of 20 individuals with Rubinstein Taybi syndrome and

Ashwin B. Dalal; Shubha R. Phadke

2007-01-01

140

Biometrics, biomathematics and the morphometric synthesis  

Microsoft Academic Search

At the core of contemporary morphometrics—the quantitative study of biological shape variation—is a synthesis of two originally divergent methodological styles. One contributory tradition is the multivariate analysis of covariance matrices originally developed as biometrics and now dominant across a broad expanse of applied statistics. This approach, couched solely in the linear geometry of covariance structures, ignores biomathematical aspects of the

Fred L. Bookstein

1996-01-01

141

Morphometric studies in Datura metel linn  

Microsoft Academic Search

The various forms\\/varieties ofDatura metel have so far been distinguished mainly on their morphological charactersviz flower colour and number of corolla tubes. This paper deals with morphometric analysis of four forms ofD. metel considering all sorts of possible morphological characters. The results clearly indicate large variations among the four\\u000a forms deserving individual taxonomic identity.

A B Bhatt; G V Saratbabu; S C Pandeya

1984-01-01

142

Diagnosing Aorta Stiffness by Temporal Analysis of Echocardiographic Images  

NASA Astrophysics Data System (ADS)

In the diagnosis of cardiovascular diseases, information about the intracardiac system function and blood flow can be obtained by echocardiography due to its high spatial resolution capability. However, seldom message is known about the aorta stiffness. This work investigated a method to quantitatively analyze the aorta stiffness. The aorta was modeled as a periodic-force-driven damping oscillator, in which the aorta stiffness was the damping factor. From the analysis of echocardiographic images, the delay time of the maximal aorta distention relative to the R-peak of the electrocardiographic trace was measured to reveal the aorta stiffness. A study based on 10 samples suggested that a delay time greater than 0.17 sec could be a criterion to diagnose that the aorta is quite stiff. This method could also clearly discern some abnormal cardiac performance. A large-scale study with this method should be conducted in the future.

Cheng, Yu-Hsi; Yen, Tsu-Chiang; Lee, Doyal

2005-03-01

143

Flattening the abdominal aortic tree for effective visualization.  

PubMed

We developed a novel visualization method for providing an uncluttered view of the abdominal aorta and its branches. The method abstracts the complex geometry of vessels using a convex primitive, and uses a sweep line algorithm to find a suboptimal placement of the primitive. The method was evaluated using 10 CT angiography datasets and resulted in a clear visualization with all cluttering intersections removed. The method can be used to convey clinical findings, including lumen patency and lesion locations, in a single two-dimensional image. PMID:17946176

Won, Joong Ho; Rubin, Geoffrey D; Napel, Sandy

2006-01-01

144

Involvement of the aorta in brucellosis: the forgotten, life-threatening complication. A systematic review.  

PubMed

Human brucellosis is a disease of protean manifestations, and has been implicated in complications and focal disease in many human organ systems. However, little is collectively known about the background, the course, the clinical characteristics, the diagnostic issues raised, and the short- and long-term therapeutic approaches in patients with aortic involvement as a complication of brucellosis. With the aim to glean from the literature useful information to better understand and manage this complication, a computerized search without language restriction was conducted using PubMed and SCOPUS. An article was considered eligible for inclusion in the systematic review if it reported data on patients with involvement of the aorta due to a Brucella infection. The epidemiologic and clinical characteristics of 44 cases of brucellar aortic involvement found through the systematic review of the literature were analyzed together with those of two new cases that we treated in the recent past. This complication involved the ascending thoracic aorta in 18 cases (in 16 of them as a consequence of brucellar endocarditis), and the descending thoracic aorta or the abdominal aorta in the remaining 30 cases. In the latter it was associated with spondylodiscitis of the lumbar spine in 13 cases. History of or symptoms indicative of brucellosis were not universally present. Brucellar aortic involvement represents a possibly underdiagnosed and underreported complication with major morbidity and mortality potential. Experience with novel invasive therapeutic approaches remains limited. Early suspicion through detailed history and diagnosis, aided by advances in aortic imaging, would allow for better planning of therapeutic interventions. PMID:22994597

Cascio, Antonio; De Caridi, Giovanni; Lentini, Salvatore; Benedetto, Filippo; Stilo, Francesco; Passari, Gabriele; Iaria, Chiara; Spinelli, Francesco; Pappas, Georgios

2012-10-01

145

[Ruptured abdominal aortic aneurysm].  

PubMed

Rupture of the abdominal aortic aneurysm is a high lethal risk pathology, which requires precise diagnosis and urgent and efficient surgical treatment. Despite improved diagnostic capabilities (echoscopy, in specialized departments--angiography, computed tomography, magnetic nucleus resonance), mortality related to this pathology remains high in intensive care units. In the present article data concerning prevalence and clinical outcomes of the rupture of the abdominal aortic aneurysm for 1999-2001 is presented in detail. During this period 22 patients have undergone surgery due to abdominal aortic aneurysm rupture. Described are most prevalent complications, mortality rates and causes, analyzed are treatment strategy and tactics. PMID:12474751

Urbonavicius, Sigitas; Antusevas, Aleksandras

2002-01-01

146

Abdominal compartment syndrome  

Microsoft Academic Search

Intra-abdominal hypertension (IAH) associated with organ dysfunction\\u0009\\u0009\\u0009 defines the abdominal compartment syndrome (ACS). Elevated intra-abdominal\\u0009\\u0009\\u0009 pressure (IAP) adversely impacts pulmonary, cardiovascular, renal, splanchnic,\\u0009\\u0009\\u0009 musculoskeletal\\/integumentary, and central nervous system physiology. The\\u0009\\u0009\\u0009 combination of IAH and disordered physiology results in a clinical syndrome\\u0009\\u0009\\u0009 with significant morbidity and mortality. The onset of the ACS requires prompt\\u0009\\u0009\\u0009 recognition and appropriately timed and staged intervention

Jeffrey Bailey; Marc J Shapiro

2000-01-01

147

[Ultrasound for abdominal lymphadenopathy].  

PubMed

This CME-review is about the clinical importance of the abdominal lymph node diagnostic with special attention to various ultrasound techniques. This includes innovative techniques like contrast enhanced ultrasound and elastography. The clinical importance of ultrasound in relation to cross sectional imaging will be the target of the article as well as anatomic- topographic aspects. The article deals as well with endosonographic techniques because of the upmost importance of the technique for diagnosing mediastinal and abdominal lymphnode swellings. In conclusion of the article different clinical scenarios and clinical algorithms are presented to help the reader to diagnose abdominal lymphadenopathy correctly in an efficient way. PMID:23633280

Dietrich, C F; Hocke, M; Jenssen, C

2013-05-01

148

MicroRNAs in Abdominal Aortic Aneurysm.  

PubMed

Abdominal aortic aneurysms (AAA) are an important source of morbidity and mortality in the U.S. and worldwide. Treatment options are limited, with open surgery or endovascular repair remaining the only curative treatments. Classical cardiovascular medications have generally failed to prevent or significantly alter AAA formation or progression. Therefore, there is a tremendous need for better therapeutic approaches. With increasing knowledge of microRNA (miR) regulation in the context of cardiovascular disease, and with improving technical options permitting alteration of miR-expression levels in vitro and in vivo, we are offered a glimpse into the diagnostic and therapeutic possibilities of using miRs to treat vascular pathobiology. This review focuses on the role of miRs in aneurysmal disease of the abdominal aorta, summarizing recent publications regarding this topic, and outlining known effects of relevant miRs in AAA formation, including miR-21 and miR-29b. Despite there being only limited studies available, several other miRs also display clear potential for alteration of the disease process including miR-26a, the miR-17-92-cluster, miRs-221/222, miR-133 and miR-146a. While studies have shown that miRs can regulate the activity and interplay of vascular inflammatory cells, endothelial cells, smooth muscle cells and fibroblasts, all key elements leading to AAA formation, much work remains to be done. PMID:23713862

Adam, Matti; Raaz, Uwe; Spin, Joshua M; Tsao, Philip S

2013-05-13

149

Fourier transform infrared spectroscopy to quantify collagen and elastin in an in vitro model of extracellular matrix degradation in aorta.  

PubMed

Extracellular matrix (ECM) is a key component and regulator of many biological tissues including aorta. Several aortic pathologies are associated with significant changes in the composition of the matrix, especially in the content, quality and type of aortic structural proteins, collagen and elastin. The purpose of this study was to develop an infrared spectroscopic methodology that is comparable to biochemical assays to quantify collagen and elastin in aorta. Enzymatically degraded porcine aorta samples were used as a model of ECM degradation in abdominal aortic aneurysm (AAA). After enzymatic treatment, Fourier transform infrared (FTIR) spectra of the aortic tissue were acquired by an infrared fiber optic probe (IFOP) and FTIR imaging spectroscopy (FT-IRIS). Collagen and elastin content were quantified biochemically and partial least squares (PLS) models were developed to predict collagen and elastin content in aorta based on FTIR spectra. PLS models developed from FT-IRIS spectra were able to predict elastin and collagen content of the samples with strong correlations (RMSE of validation = 8.4% and 11.1% of the range respectively), and IFOP spectra were successfully used to predict elastin content (RMSE = 11.3% of the range). The PLS regression coefficients from the FT-IRIS models were used to map collagen and elastin in tissue sections of degraded porcine aortic tissue as well as a human AAA biopsy tissue, creating a similar map of each component compared to histology. These results support further application of FTIR spectroscopic techniques for evaluation of AAA tissues. PMID:24761431

Cheheltani, Rabee; McGoverin, Cushla M; Rao, Jayashree; Vorp, David A; Kiani, Mohammad F; Pleshko, Nancy

2014-06-21

150

Abdominal etching: Differential liposuction to detail abdominal musculature  

Microsoft Academic Search

Male athletes seeking improvement in the detail of their abdominal musculature have traditionally utilized vigorous exercise and a tightly controlled diet. Abdominal etching is a technique devised to enhance the appearance of the abdominal musculature by removing fat with liposuction at variable levels. The abdominal musculature is topographically visualized as the linea alba, linea semilunaris, and the transverse tendinous intersections

Henry A. Mentz; Mark D. Gilliland; Christopher K. Patronella

1993-01-01

151

Intra-abdominal hypertension and abdominal compartment syndrome  

Microsoft Academic Search

Background: The effects of increased intra-abdominal pressure in various organ systems have been noted over the past century. The concept of abdominal compartment syndrome has gained more attention in both trauma and general surgery in the last decade. This article reviews the current understanding and management of intra-abdominal hypertension and abdominal compartment syndrome. Methods: Relevant information was gathered from a

K.-M. Sieh; Kent-Man Chu; John Wong

2001-01-01

152

Abdominal exploration - series (image)  

MedlinePLUS

... exploration of the abdomen, also called an exploratory laparotomy, may be recommended when there is abdominal disease ... trauma"). Diseases that may be discovered by exploratory laparotomy include: inflammation of the appendix (acute appendicitis) inflammation ...

153

Normal Abdominal CT  

NSDL National Science Digital Library

Set of normal abdominal CT images with various important anatomic structures outlined, for cine viewing to gain a 3D view of the structure and its relationship to adjacent organs.Annotated: trueDisease diagnosis: Normal

Shaffer, Kitt

2007-06-05

154

Fatal abdominal thorotrast granuloma.  

PubMed

We report a case of fatal abdominal thorotrast granuloma seen in a 65-year-old man who had undergone a femoral angiography of thorotrast with some accidental extravasation 49 years previously. As the thorotrast granuloma gradually increased in size, it caused ureteral obstruction, venous thrombosis, and perforation of the urinary bladder and rectum. Symptomatic abdominal thorotrast granuloma is quite rare and this is the first reported case of the granuloma associated with perforation through the urinary bladder and rectum. PMID:1286232

Ishii, H; Tanaka, A; Nakayama, Y; Kuroda, Y; Kuramoto, H; Ibayashi, H

1992-10-01

155

Linear abdominal trauma.  

PubMed

Three cases of blunt abdominal trauma are presented to exemplify the mechanism of trauma and the problems of diagnosis associated with any linear blow to the abdomen. The mechanisms of visceral injury are reviewed, and special attention is directed to the abdominal wall injury that can be present in these patients. This injury has special implications in directing the operative approach and repair. An unusual aortic occlusion is described which is peculiar to this type of injury. PMID:130499

Danto, L A; Wolfman, E F

1976-03-01

156

3D image analysis of abdominal aortic aneurysm  

NASA Astrophysics Data System (ADS)

This paper presents a method for 3-D segmentation of abdominal aortic aneurysm from computed tomography angiography images. The proposed method is automatic and requires minimal user assistance. Segmentation is performed in two steps. First inner and then outer aortic border is segmented. Those two steps are different due to different image conditions on two aortic borders. Outputs of these two segmentations give a complete 3-D model of abdominal aorta. Such a 3-D model is used in measurements of aneurysm area. The deformable model is implemented using the level-set algorithm due to its ability to describe complex shapes in natural manner which frequently occur in pathology. In segmentation of outer aortic boundary we introduced some knowledge based preprocessing to enhance and reconstruct low contrast aortic boundary. The method has been implemented in IDL and C languages. Experiments have been performed using real patient CTA images and have shown good results.

Subasic, Marko; Loncaric, Sven; Sorantin, Erich

2002-05-01

157

Abdominal compartment syndrome in children.  

PubMed

Abdominal compartment syndrome is defined as sustained intra-abdominal pressure greater than 20 mm Hg (with or without abdominal perfusion pressure <60 mm Hg) associated with new organ failure or dysfunction. The syndrome is associated with 90% to 100% mortality if not recognized and treated in a timely manner. Nurses are responsible for accurately measuring intra-abdominal pressure in children with abdominal compartment syndrome and for alerting physicians about important changes. This article provides relevant definitions, outlines risk factors for abdominal compartment syndrome developing in children, and discusses an instructive case involving an adolescent with abdominal compartment syndrome. Techniques for measuring intra-abdominal pressure, normal ranges, and the importance of monitoring in the critical care setting for timely identification of intra-abdominal hypertension and abdominal compartment syndrome also are discussed. PMID:23203955

Newcombe, Jennifer; Mathur, Mudit; Ejike, J Chiaka

2012-12-01

158

Quantitative abdominal aortic flow measurements at controlled levels of ergometer exercise  

Microsoft Academic Search

Measuring the exercise-induced flow changes in the arteries of the body is a major challenge. The use of quantitative MR flow measurements for this purpose is hampered by movement artifacts and ECG triggering problems. To quantify exercise-induced flow changes in the abdominal aorta, we applied a fast hybrid phase contrast sequence with K-space segmentation and echo planar imaging readouts during

E. M Pedersen; S Kozerke; S Ringgaard; M. B Scheidegger; P Boesiger

1999-01-01

159

Results of 256 consecutive abdominal aortic aneurysm repairs using extraperitoneal approach  

Microsoft Academic Search

Two hundred and fifty-six consecutive abdominal aortic aneurysms were repaired using three approaches for extraperitoneal exposure of the aorta and iliac vessels from February 1990 through September 1998. The perioperative mortality rate was 3.1% in 228 elective repairs and 14.3% in 28 ruptured cases. The initial 23 cases were repaired using Sicard's method. The duration of endotracheal intubation was 1.0±2.8

T. Igari; S. Hoshino; F. Iwaya; H. Satokawa; H. Midorikawa; S. Takase; Y. Hoshino

2001-01-01

160

Traumatic abdominal wall hernia  

PubMed Central

INTRODUCTION Traumatic abdominal wall hernia (TAWH) is a rare entity. Most cases occur in children, following an injury from the bicycle handle bar. In adults, it usually results from road traffic accidents (RTA). We present one of the largest reported cases of TAWH following RTA managed by delayed mesh repair. PRESENTATION OF CASE A 35 yr old obese male with RTA was diagnosed with TAWH with 19 cm × 15 cm defect in left flank. As there were no intra abdominal injuries and overlying skin was abraded, he was planned for elective repair after 6 months. On exploration a defect of 30 cm × 45 cm was found extending from midline anteriorly to 8 cm short of midline posteriorly in transverse axis and costal margin to iliac crest in craniocaudal axis. After restoration of bowel into abdominal cavity, primary closure or even approximation of muscular defect was not possible thus a mesh closure using 60 cm × 60 cm prolene mesh in subcutaneous plane was done. After 4 months follow up, patient is healthy and has no recurrence. DISCUSSION Emergent surgical management of TAWH is usually favoured due to high incidence of associated intra abdominal injuries. Delayed repair may be undertaken in selected cases. CONCLUSION TAWH, although rare, should be suspected in cases of RTA with abdominal wall swellings. With time, the hernia defect may enlarge and muscles may undergo atrophy making delayed repair difficult.

Yadav, Siddharth; Jain, Sunil K.; Arora, Jainendra K.; Sharma, Piyush; Sharma, Abhinav; Bhagwan, Jai; Goyal, Kaushal; Sahoo, Bhabani S.

2012-01-01

161

Endovascular Repair of Abdominal Aortic Aneurysm  

PubMed Central

EXECUTIVE SUMMARY The Medical Advisory Secretariat conducted a systematic review of the evidence on the effectiveness and cost-effectiveness of endovascular repair of abdominal aortic aneurysm in comparison to open surgical repair. An abdominal aortic aneurysm [AAA] is the enlargement and weakening of the aorta (major blood artery) that may rupture and result in stroke and death. Endovascular abdominal aortic aneurysm repair [EVAR] is a procedure for repairing abdominal aortic aneurysms from within the blood vessel without open surgery. In this procedure, an aneurysm is excluded from blood circulation by an endograft (a device) delivered to the site of the aneurysm via a catheter inserted into an artery in the groin. The Medical Advisory Secretariat conducted a review of the evidence on the effectiveness and cost-effectiveness of this technology. The review included 44 eligible articles out of 489 citations identified through a systematic literature search. Most of the research evidence is based on non-randomized comparative studies and case series. In the short-term, EVAR appears to be safe and comparable to open surgical repair in terms of survival. It is associated with less severe hemodynamic changes, less blood transfusion and shorter stay in the intensive care and hospital. However, there is concern about a high incidence of endoleak, requiring secondary interventions, and in some cases, conversion to open surgical repair. Current evidence does not support the use of EVAR in all patients. EVAR might benefit individuals who are not fit for surgical repair of abdominal aortic aneurysm and whose risk of rupture of the aneurysm outweighs the risk of death from EVAR. The long-term effectiveness and cost-effectiveness of EVAR cannot be determined at this time. Further evaluation of this technology is required. OBJECTIVE The objective of this health technology policy assessment was to determine the effectiveness and cost-effectiveness of endovascular repair of abdominal aortic aneurysms (EVAR) in comparison to open surgical repair (OSR). BACKGROUND Clinical Need An abdominal aortic aneurysm (AAA) is a localized, abnormal dilatation of the aorta greater than 3 cm or 50% of the aortic diameter at the diaphragm. (1) A true AAA involves all 3 layers of the vessel wall. If left untreated, the continuing extension and thinning of the vessel wall may eventually result in rupture of the AAA. The risk of death from ruptured AAA is 80% to 90%. (61) Heller et al. (44) analyzed information from a national hospital database in the United States. They found no significant change in the incidence rate of elective AAA repair or ruptured AAA presented to the nation’s hospitals. The investigators concluded that technologic and treatment advances over the past 19 years have not affected the outcomes of patients with AAAs, and the ability to identify and to treat patients with AAAs has not improved. Classification of Abdominal Aortic Aneurysms At least 90% of the AAAs are affected by atherosclerosis, and most of these aneurysms are below the level of the renal arteries.(1) An abdominal aortic aneurysm may be symptomatic or asymptomatic. An AAA may be classified according to their sizes:(7) Small aneurysms: less than 5 cm in diameter. Medium aneurysms: 5-7cm. Large aneurysms: more than 7 cm in diameter. Small aneurysms account for approximately 50% of all clinically recognized aneurysms.(7) Aortic aneurysms may be classified according to their gross appearance as follows (1): Fusiform aneurysms affect the entire circumference of a vessel, resulting in a diffusely dilated lesion Saccular aneurysms involve only a portion of the circumference, resulting in an outpouching (protrusion) in the vessel wall. Prevalence of Abdominal Aortic Aneurysms In community surveys, the prevalence of AAA is reported to be between 1% and 5.4%. (61) The prevalence is related to age and vascular risk factors. It is more common in men and in those with a positive family history. In Canada, Abdominal aortic aneurysms are the 10th leading cause of death in men 6

2002-01-01

162

Morphometric study of aortic wall parameters evolution in newborn and child.  

PubMed

The largest artery in the human body, intimately connected to the heart, aorta is usually regarded as the major source of oxygenated blood for the circulatory system. The three concentric layers, which surround the aortic lumen-the tunics intima, media and adventitia, transform the aorta in a large elastic duct, which is irregular calibrated according to its segments. The special aortic distensibility is facilitated by its elastic circumferential lamellar complex. Any disturbance of its structural components is able to interfere with its normal and vital activity. Our study intends to reveal that the development of elastic lamellae should be regarded not only as an indispensable step for the aortic wall configuration, but also like a process in a firm connection with the rest of aortic wall components. The transition from intrauterine life to a new stage of life, childhood, has to determine an adequate adaptation of almost all the components of aortic wall, in order to sustain a consistent pulsatile blood flow. Stereological quantitative analysis of thoracic aortic fragments prelevated from newborns and children was performed in order to estimate the dynamic of vascular wall increase. We first estimated the general configuration of the thoracic aortic wall, quantifying the principal constituents; the connective tissue profile, investigated through its main elements, collagen and elastic fibers, supports the idea that each type of fiber has a distinct evolution in different groups of ages and has to be correlated with their involvement in maintaining of the aortic wall mechanical properties. Elastic fibers percentage volume was increased in both examined groups, with a small difference reported in children aorta, while collagen fibers exhibit a slow increase in children aorta. Our morphometric quantitative assessment suggests that further studies have to draw of in a precisely manner the outline of the secretory well defined function of vascular smooth muscle cells; the elucidation of the manner in which the secretory pathway for each type of fiber becomes fully adapted to every stage of aortic development will allow a new perspective in aortic pathology. PMID:23771088

Popescu, Mihaela Roxana; Zugun, F E; Cojocaru, Elena; Tocan, Lelioara; Folescu, Roxana; Zamfir, Carmen L?cr?mioara

2013-01-01

163

Computer-assisted diagnosis in CT angiography of abdominal aortic aneurysms  

NASA Astrophysics Data System (ADS)

The purpose of this study was to develop methods for automatic 3D-segmentation and automatic quantification of vascular structures in CT angiographic studies, e.g., abdominal aortic aneurysms. Methods for segmentation were developed based on thresholding, maximum gradient, and second derivative techniques. All parameters for the segmentation are generated automatically, i.e. no user interaction is necessary for this process. Median filtering of all images is initially performed to reduce the image noise. The algorithm then automatically identifies the starting point inside the aorta for the volume growing. The segmentation of the vascular tree is achieved in two steps. First, only the aorta and small parts of branch vessels are segmented by using strong restrictions in the parameters for threshold and gradient. A description of the aorta is generated by fitting the detected outer border of the aorta with an ellipse. This description includes centerline, direction, contour, eccentricity, and area. In the second step, segmentation parameters are changed automatically for segmentation of branch vessels. A shaded surface display of the segmented structures is then generated. The segmentation of the aorta appears accurate, is fast, and the 3D display can be manipulated in real time. The quantitative description of the aorta is reliable giving reproducible information. Total CPU time for the segmentation and description is less than five minutes on a standard workstation. Time-consuming manual segmentation and parameterization of vascular structures are obviated, with 3D visualization and quantitative results available in minutes instead of hours. This technique for segmentation and description of the aorta and renal arteries shows the feasibility of computer assisted diagnosis in CT angiographic studies without user interaction. Besides the description, a rapid 3D view of the vessels is generated, often needed by the physician and normally only achievable by time consuming manual segmentation.

Fiebich, Martin; Tomiak, Myrosia M.; Engelmann, Roger M.; McGill, James; Hoffmann, Kenneth R.

1997-04-01

164

Fetal abdominal wall defects.  

PubMed

The most common fetal abdominal wall defects are gastroschisis and omphalocele, both with a prevalence of about three in 10,000 births. Prenatal ultrasound has a high sensitivity for these abnormalities already at the time of the first-trimester nuchal scan. Major unrelated defects are associated with gastroschisis in about 10% of cases, whereas omphalocele is associated with chromosomal or genetic abnormalities in a much higher proportion of cases. Challenges in management of gastroschisis are related to the prevention of late intrauterine death, and the prediction and treatment of complex forms. With omphalocele, the main difficulty is the exclusion of associated conditions, not all diagnosed prenatally. An outline of the postnatal treatment of abdominal wall defects is given. Other rarer forms of abdominal wall defects are pentalogy of Cantrell, omphalocele, bladder exstrophy, imperforate anus, spina bifida complex, prune-belly syndrome, body stalk anomaly, and bladder and cloacal exstrophy; they deserve multidisciplinary counselling and management. PMID:24342556

Prefumo, Federico; Izzi, Claudia

2014-04-01

165

Abdominal Inflammatory Myofibroblastic Tumor  

PubMed Central

A 28-year-old woman was referred to our hospital because of abdominal pain, weight loss and a palpable intra-abdominal mass. A CT scan revealed a tumor with a diameter of 7 cm with sharp margins, intra-tumoral fatty components and enhancing soft tissue. After initial workup, which suggested an inflammatory myofibroblastic tumor (IMT), she underwent laparotomy with complete resection. Pathological examination indeed revealed IMT. IMT is a rare benign neoplasm and has been described in nearly the entire body. It presents with nonspecific symptoms. The therapy of abdominal IMT consists of radical surgery because of high local recurrence rates. In this case report clinical, surgical, radiological and histological features with a review of the relevant literature are described.

Groenveld, Roosmarijn L.; Raber, Menno H.; Oosterhof-Berktas, Richard; Eijken, Erik; Klaase, Joost M.

2014-01-01

166

Intra-abdominal Infections  

Microsoft Academic Search

Intra-abdominal infections are more common in the elderly and carry greater associated morbidity and mortality.\\u000a \\u000a Intra-abdominal infections in the elderly have atypical presentations, frequently resulting in delayed diagnosis. The absence\\u000a of any one symptom or sign rarely excludes a diagnosis.\\u000a \\u000a \\u000a \\u000a Obstruction of a hollow viscus, followed by distension, ischemia, and bacterial proliferation is a common pathophysiologic\\u000a evolution in the infections

Meghann L. Kaiser; Samuel Eric Wilson

167

Abdominal Aortic Aneurysms  

PubMed Central

Aneurysms are common in our increasingly elderly population, and are a major threat to life and limb. Until the advent of vascular reconstructive techniques, aneurysm patients were subject to an overwhelming risk of death from exsanguination. The first successful repair of an abdominal aortic aneurysm using an interposed arterial homograft was reported by Dubost in 1952. A milestone in the evolution of vascular surgery, this event and subsequent diagnostic, operative and prosthetic graft refinements have permitted patients with an unruptured abdominal aortic aneurysm to enjoy a better prognosis than patients with almost any other form of major systemic illness. Images

Fortner, George; Johansen, Kaj

1984-01-01

168

Laparoscopy for abdominal emergencies  

Microsoft Academic Search

Background  Emergency laparoscopic exploration can be used to identify the causative pathology of acute abdominal pain. Laparoscopic surgery\\u000a also allows treatment of many intraabdominal disorders. This report was prepared to describe the effectiveness of laparoscopic\\u000a surgery compared to laparotomy or nonoperative treatment.\\u000a \\u000a \\u000a \\u000a Methods  A panel of European experts in abdominal and gynecological surgery was assembled and participated in a consensus conference\\u000a using

S. Sauerland; F. Agresta; R. Bergamaschi; G. Borzellino; A. Budzynski; G. Champault; A. Fingerhut; A. Isla; M. Johansson; P. Lundorff; B. Navez; S. Saad; E. A. M. Neugebauer

2006-01-01

169

Endovascular Treatment of a Ruptured Para-Anastomotic Aneurysm of the Abdominal Aorta  

SciTech Connect

We report a case of a ruptured para-anastomotic aortic aneurysm treated with implantation of a bifurcated stent-graft. A 72-year-old patient, who had undergone aortobifemoral bypass for aortoiliac occlusive disease 16 years ago, presented with a ruptured para-anastomotic aortic aneurysm. A bifurcated stent-graft was successfully deployed into the old bifurcated graft. This is the first report of a bifurcated stent-graft being placed through an 'end-to-side' anastomosed old aortobifemoral graft. Endovascular treatment of ruptured para-anastomotic aortic aneurysms can be accomplished successfully, avoiding open surgery which is associated with increased mortality and morbidity.

Sfyroeras, Giorgos S.; Lioupis, Christos, E-mail: lioupisC@vodafone.net.gr; Bessias, Nikolaos; Maras, Dimitris [Red Cross Hospital of Athens, Department of Vascular Surgery (Greece); Pomoni, Maria [Red Cross Hospital of Athens, Department of Radiology (Greece); Andrikopoulos, Vassilios [Red Cross Hospital of Athens, Department of Vascular Surgery (Greece)

2008-07-15

170

P188Lipopolysaccharide- and omega-3 fatty acids-induced changes in connexin40 expression in endothelium of normotensive rat aorta.  

PubMed

The aim of our study was to investigate the effect of omega-3 fatty acids (FA) on expression of connexin40 (Cx40) in rat aorta during inflammation. Cxs are proteins of gap junction channels which regulate homeostasis and vasomotion through direct intercellular communication. FA are known for their anti-inflammatory and beneficial effects on the cardiovascular system. In 10-day-lasting experiment, we used adult Wistar rats divided into four groups: W(C) - controls, W(FA) - FA in dose 30mg/kg/day, W(L) - application of a single dose of lipopolysaccharide (LPS, 1 mg/kg, i.p), W(L+FA). Cx40 expression was analyzed in aortic tissue using Western blot, its distribution by immunofluorescence and morphometric image analysis. We studied NO dependent relaxation of aorta and NOS activity, together with biomarkers CRP, MDA, NAGA in plasma and CD68 in aorta. Immunofluorescence revealed changes only in endothelial Cx40 spatial expression. In W(L+FA) density of Cx40 spots was decreased when compared to W(L) which increased Cx40 density in comparision to W(C). Total Cx40 expression in aorta of W(L) was significantly higher than in W(C). In W(L+FA), Cx40 expression was lower than in W(L). LPS increased expression of CD68, while its expression was reduced in W(L+FA) group compared to W(L). FA did not affect LPS-induced impairment of NO-dependent relaxation of aorta, and they had no protective effect on NOS activity. FA diet reduced also LPS-induced increase in levels of biomarkers. Our results suggest that endothelial Cx40-gap junctions might represent one of potential targets of the anti-inflammatory effects of FA diet. PMID:25020606

Frimmel, K; Bernatova, I; Sotnikova, R; Navarova, J; Okruhlicova, L

2014-07-15

171

Surgical Site Infection and Analytic Morphometric Assessment of Body Composition in Patients Undergoing Midline Laparotomy  

PubMed Central

Background Obesity is a known risk factor for surgical site infection (SSI). Our hypothesis is that morphometric measures of midline subcutaneous fat will be associated with increased risk of SSI, and will predict SSI better than conventional measures of obesity. Study Design We identified 655 patients who underwent midline laparotomy (2006 - 2009) using the Michigan Surgical Quality Collaborative database. Using novel, semi-automated analytic morphometric techniques, the thickness of subcutaneous fat along the linea alba was measured between T12 and L4. To adjust for variations in patient size, subcutaneous fat was normalized to the distance between the vertebrae and anterior skin. Logistic regression analyses were used to identify factors independently associated with the incidence of SSI. Results Overall, SSIs were observed in 12.5% (n = 82) of the population. Logistic regression revealed that patients with increased subcutaneous fat had significantly greater odds of developing a superficial incisional SSI (OR = 1.76 per 10% increase, 95% CI: 1.10 – 2.83, p = 0.019). Smoking, steroid use, ASA classification, and incision-to-close operative time were also significant independent risk factors for superficial incisional SSI. When comparing subcutaneous fat and body mass index (BMI) as the only model variables, subcutaneous fat significantly improved model predictions of superficial incisional SSI (AUC: 0.60, p = 0.023) while BMI did not (AUC = 0.52, p = 0.73). Conclusions Abdominal subcutaneous fat is an independent predictor of superficial incisional SSI following midline laparotomy. Novel morphometric measures may improve risk stratification and help elucidate the pathophysiology of surgical complications.

Lee, Jay S; Terjimanian, Michael N; Tishberg, Lindsay M; Alawieh, Abbas Z; Harbaugh, Calista M; Sheetz, Kyle H; Holcombe, Sven A; Wang, Stewart C; Sonnenday, Christopher J; Englesbe, Michael J

2011-01-01

172

PIV and MRV Measurements in Human Thoracic Aorta Phantoms  

Microsoft Academic Search

Aortic dissection is a non-traumatic injury to the aorta in which a flap is created inside the aorta by the separation of the inner lining of the vessel wall from its outer layers. It is hypothesized that dissections start as tears in vessels' inner lining and propagate as blood impinges through the tear into the separated part of the vessel

Ananth Iyengar; Christopher Elkins; Mary Draney; Francisco Medina; Ryan Wicker

2004-01-01

173

Huge ascending aorta and aortic arch aneurysm in ultra octogenarian.  

PubMed

Giant ascending aorta aneurysms (AAA), which are larger than 10 cm, are rarely been reported (1-7). We hereby present the case of a giant AAA of about 11 cm in a very old women who was successfully operated on for ascending aorta and aortic arch replacement under deep hypothermic circulatory arrest. PMID:24841684

Ceresa, F; Sansone, F; Zagarella, G; Patanè, F

2014-01-01

174

Abdominal segment reduction  

PubMed Central

When a new student first begins to push flies, an immediate skill that must be learned is sorting the sexes. In Drosophila melanogaster several sexually dimorphic characters can be used to readily distinguish males from females including abdominal pigmentation, male sex combs and genital morphology. Another, often-overlooked, sexual dimorphism is adult abdominal segment number. Externally, adult Drosophila males possess one fewer abdominal segment than females; the terminal pre-genital segment apparently either absent or fused with the next-most anterior segment. Beyond known roles for the homeotic protein Abdominal-B (Abd-B) and the sex-determining transcription factor Doublesex (Dsx) as key regulators of this trait, surprisingly little is known about either the morphogenetic processes or the downstream genetics responsible for patterning these events. We have explored both and found that rapid epithelial reorganization during pupation eliminates a nascent terminal male segment. We found this Abd-B-dependent process results from sex- and segment-specific regulation of diverse developmental targets including the wingless gene and surprisingly, dsx itself.1,2 Here, I review our observations and discuss this trait as a model to explore both dynamics of epithelial morphogenesis as well as the evolution of developmental mechanisms.

Yoder, John H.

2012-01-01

175

Functional Abdominal Pain Syndrome  

Microsoft Academic Search

Functional abdominal pain syndrome (FAPS) differs from the other functional bowel disorders; it is less common, symptoms largely are unrelated to food intake and defecation, and it has higher comorbidity with psy- chiatric disorders. The etiology and pathophysiology are incompletely understood. Because FAPS likely repre- sents a heterogenous group of disorders, peripheral neu- ropathic pain mechanisms, alterations in endogenous pain

DOUGLAS A. DROSSMAN; EMERAN A. MAYER; QASIM AZIZ; DAN L. DUMITRASCU; HUBERT MÖNNIKES; BRUCE D. NALIBOFF

2004-01-01

176

The Abdominal Circulatory Pump  

Microsoft Academic Search

Blood in the splanchnic vasculature can be transferred to the extremities. We quantified such blood shifts in normal subjects by measuring trunk volume by optoelectronic plethysmography, simultaneously with changes in body volume by whole body plethysmography during contractions of the diaphragm and abdominal muscles. Trunk volume changes with blood shifts, but body volume does not so that the blood volume

Andrea Aliverti; Dario Bovio; Irene Fullin; Raffaele L. Dellacà; Antonella Lo Mauro; Antonio Pedotti; Peter T. Macklem; Fabien Tell

2009-01-01

177

Abdominal Aortic Aneurysm (AAA) Screening  

MedlinePLUS

... covered? Search Medicare.gov for covered items Abdominal aortic aneurysm screening How often is it covered? Medicare Part B (Medical Insurance) covers a one-time abdominal aortic aneurysm ultrasound. You must get a referral for it ...

178

Aorta-Left Renal Vein Fistula Complicating an Aortic Aneurysm: Preoperative and Postoperative Multislice CT Findings  

SciTech Connect

Fistulas complicating an abdominal aortic aneurysm (AAA) are rare, and fistulas involving the left renal vein are particularly uncommon. We highlight here a fistula between an infrarenal aortic aneurysm and a retroaortic left renal vein, revealed by left flank pain associated with hematuria and acute renal failure. The multislice CT angiography performed in this 68-year-old patient revealed communication and equal enhancement between the aorta and the left gonadic vein, suggesting the presence of a fistula. The three-dimensional VRT reconstructions presented in this case were of great value in the preoperative planning, enabling immediate visualization of this unusual feature. Alternative diagnoses to consider when encountering this clinical presentation are reviewed.

Barrier, Pierre, E-mail: p.barrier@gmail.com; Otal, Philippe [Hopital de Rangueil CHU de Toulouse, Department of Radiology (France); Garcia, Olivier; Vahdat, Olivier; Domenech, Brice [Clinique Pasteur, Department of Radiology (France); Lannareix, Valerie; Joffre, Francis; Rousseau, Herve [Hopital de Rangueil CHU de Toulouse, Department of Radiology (France)

2007-06-15

179

Abdominal obesity is associated with heart disease in dogs  

PubMed Central

Background The relationship between overall obesity and fat distribution in dogs and the development of heart disease is unclear. In the present study we evaluated the association between overall obesity and fat distribution and clinical heart disease by morphometric and computed tomography (CT)-based measurements. Body condition score (BCS), modified body mass index (MBMI, kg/m2), waist-to-hock-to-stifle distance ratio (WHSDR), waist-to-ilium wing distance ratio (WIWDR), and waist-to-truncal length ratio (WTLR) were compared between dogs with (n?=?44) and without (n?=?43) heart disease using receiver operating characteristic (ROC) analysis. Intra-abdominal fat (IAF) and subcutaneous fat (SQF) were measured in dogs with (n?=?8) and without (n?=?9) heart disease at the center of the fourth and fifth lumbar vertebrae by CT. Results BCS was similar between heart disease and healthy groups (3.6?±?0.2 vs. 3.3?±?0.1, P?=?0.126). The following morphometric measurements were greater in the heart disease group compared with healthy canines: MBMI (65.0?±?4.5 vs. 52.5?±?3.7 kg/m2, respectively, P?=?0.035); WIWDR (4.1?±?0.1 vs. 3.1?±?0.1, P?morphometric indices studied, WIWDR and WTLR provided acceptable discrimination for diagnosing heart disease in dogs, with areas under the ROC curve of 0.778 (95% confidence interval [CI]:0.683-0.874) and 0.727 (95% CI:0.619-0.835), respectively. Conclusions Our data indicate that abdominal obesity, rather than overall obesity, is associated with heart disease in dogs. Measurements of both WIWDR and WTLR are particular useful for detection of an abdominal obesity in dogs.

2014-01-01

180

Robotic abdominal surgery  

Microsoft Academic Search

As a whole, abdominal surgeons possess excellent videoendoscopic surgical skills. However, the limitations of laparoscopy—such as reduced range of motion and instrument dexterity and 2-dimensional view of the operative field—have inspired even the most accomplished laparoscopists to investigate the potential of surgical robotics to broaden their application of the minimally invasive surgery paradigm. This review discusses data obtained from articles

Eric J. Hanly; Mark A. Talamini

2004-01-01

181

Atherosclerosis and aging. A morphometric study on arterial lesions of elderly and very elderly necropsy subjects.  

PubMed

A histomorphometric study was performed on arterial wall lesions of different arterial regions (arch, thoracic, abdominal parts of the aorta; right and left common and internal carotid arteries; coronary arteries; and basilar and middle cerebral arteries), collected from 108 elderly and very elderly (greater than 90 years of age) subjects who underwent necropsy. Lumen stenosis percentage, mean intimal thickening, and mean thickness of the media were measured by means of a computerized system using a manual input and graphic printout; statistical tests were performed using variance and regression analysis. Results showed that the arterial wall lesions in patients over 60 years of age tend to be stabilized in all regions studied except for the cerebral region, where the lesions tend to have a continuous progression related to age, even in a group of subjects over 90 years of age. PMID:3178417

Weber, G; Bianciardi, G; Bussani, R; Gentilini, R; Giarelli, L; Novelli, M T; Resi, L; Salvi, M; Silvestri, F; Tanganelli, P

1988-10-01

182

Aorto-Left Renal Vein Fistula Caused by a Ruptured Abdominal Aortic Aneurysm  

PubMed Central

Retroaortic left renal vein is a malformation in which the left renal vein courses dorsal to the abdominal aorta. In patients with abdominal aortic aneurysm, an aorto-left renal vein fistula can form if the left renal vein is sandwiched between the aneurysm wall and lumbar vertebrae. The patient was an 84-year-old man with lower back pain. We performed a contrast-enhanced computed tomography (CT), although renal dysfunction was noted. The CT showed a ruptured juxta-renal abdominal aortic with aorto-left renal vein fistula. This clinical condition can cause severe renal dysfunction, in spite of which an enhanced contrasted CT scan would be extremely informative preoperatively.

2013-01-01

183

[Long-term evolution of a thoraco-abdominal cryopreserved arterial allograft].  

PubMed

We report a case of thoraco-abdominal pseudo-coarctation which developed late after implantation of a cryopreserved arterial allograft. The allograft was placed in a thoraco-abdominal position to treat an aorto-esophageal fistula after colonic esophagoplasty. Follow-up was free of complications for eight Years. The pseudo-coarctation was discovered during the evaluation of hypertension. Surgical treatment involved transdiaphragmatic bypass between the thoracic and infra-renal abdominal aorta. Arterial pressure immediately returned to normal. Twelve Months later, the patient is alive and well with normal blood pressure. A review of the literature revealed rare cases of arterial allograft with a description of the long-term outcome. PMID:15094667

Blin, V; Picquet, J; Jousset, Y; Papon, X; Enon, B

2004-02-01

184

Fault-bounded mountains and morphometric properties  

NSDL National Science Digital Library

This exercise is based on the information presented in following article: Bull, W.B., 1984, Tectonic Geomorphology: Journal of Geological Education 32, pp.310-324. To prepare for the classroom exercise, the instructor briefly presents the concept that measurable landform properties can reflect the intensity of tectonic activity. We discuss that certain landforms and settings are particularly useful in these types of analyses, for example, fault-bounded mountains and piedmonts. The class goes through a quick review of dip-slip faults, fault scarps, and triangular facets, and the Tobin Range is introduced as a typical example of a fault-bounded mountain range. We then ask the question, what are the useful characteristics of these settings in terms of inferring tectonic activity? To address the question, students work in groups of 2 or 3. Each group is given a set of topographic maps chosen from the following (the region can also be printed from CDs of digital, seamless topo.s, but the quad. names are provided for reference): 7.5 minute quad.s: Home Station Ranch , Jersey Summit , Kennedy Canyon, Mount Tobin , Needle Peak 15-minute quad.s: Mt. Tobin, Buffalo Springs, Cain Mountain On each map set, two lengths along the fault scarps are marked. One is marked in red and one in purple. Each student group has a map set of a slightly different region, but all map sets have a red fault scarp and a purple fault scarp marked. The red fault scarps in all of the sets are those that have experienced more recent displacement. Each group is asked to do the following: 1. List physical characteristics of each of the two fault-bounded mountains/piedmonts that are marked on your quad.s with different colors. 2. Decide among yourselves which fault-bounded mountains/piedmont has experienced more recent displacement. 3. Suggest morphometric properties that could be used to differentiate between the more recent and less recent displacement, and explain why each of your properties makes sense. Morphometric properties must be measurable from the topographic maps. After about 10 minutes, the class reconvenes and we go through the first two questions as a class. Then, each group presents at least one morphometric property and explains their reasoning. Once we have a list of properties that the class agrees on, the instructor presents and the class discusses the properties that Bull (1984) used in his research of the Tobin Range region, such as sinuosity, the ratio between the valley floor width and the total valley height, the development of triangular facets. Designed for a geomorphology course Addresses student fear of quantitative aspect and/or inadequate quantitative skills

Swanson, Sue

185

Morphometric studies on rat seminiferous tubules.  

PubMed

The goal of this morphometric study was to obtain quantitative information on the seminiferous tubules of Sprague-Dawley rats, including changes seen at various stages of the cycle of the seminiferous epithelium. Tissue from perfusion-fixed testes was embedded in Epon-Araldite; and sections were subjected to morphometric measurements at the light microscopic level, using point counting for volume densities and the Floderus equation for numerical densities. Changes occur in the diameter of the seminiferous tubule, as well as in the volume of the seminiferous epithelium and tubule lumen, from stage to stage during the cycle. A significant constriction of the seminiferous tubule accompanies spermiation. The volume of the seminiferous epithelium per unit length of the tubule begins to increase after stage XIV, and peaks at stage V of the next cycle. The tubule lumen increases dramatically from stages V to VII, at the expense of the epithelium. The number of Sertoli cells is constant per unit length of the seminiferous tubule at all stages of the cycle. This is also true for primary spermatocytes of various developmental phases and for round spermatids from step 1 through step 10 of spermiogenesis. The average number of younger (preleptotene, leptotene, zytgotene) primary spermatocytes per Sertoli cell is 2.34 +/- 0.082 (SEM), the number of older (pachytene, diplotene) primary spermatocytes per Sertoli cell is 2.37 +/- 0.064, and the ratio of step 1-10 spermatids to Sertoli cells is 7.89 +/- 0.27. By studying tangential views of serially sectioned seminiferous tubules at stage V, it is shown that the number of step-17 spermatids associated with each Sertoli cell averages 8.35 +/- 0.128, although the counts ranged from 6 to 11. The only appreciable occurrence of cell death after the last spermatogonial mitosis appears to be a 15% loss during the first meiotic division. From our morphometric results, corrected for volume changes during preparation for microscopy, there are 15.7 million (+/- 0.99 million) Sertoli cells per gram of fresh rat testis. The length of seminiferous tubule per gram of testis is estimated to be 12.4 +/- 0.56 meters, and the tubule surface area per gram testis is 119.7 +/- 2.57 cm2. The daily production of mature spermatids is 9.61 million (+/- 0.615 million) per gram of testis. PMID:7137056

Wing, T Y; Christensen, A K

1982-09-01

186

Morphometric magnetic resonance imaging in psychiatry.  

PubMed

Although advances in the clinical criteria of various axis I psychiatric disorders are continually being made, there is still considerable overlap in the clinical features, and diagnosis is often challenging. As a result, there has been substantial interest in using morphometric magnetic resonance imaging to better characterize these diseases and inform diagnosis. Region of interest and voxel-based morphometry studies are reviewed herein to examine the extent to which these goals are being met across various psychiatric disorders. It is concluded based on the studies reviewed that specific patterns of regional loss, although present in certain axis I disorders, are not, as yet, diagnostically useful. However, advances in outcome and treatment monitoring show considerably more promise for rapid application in psychiatry. PMID:19363434

Fleck, David E; Nandagopal, Jayasree; Cerullo, Michael A; Eliassen, James C; DelBello, Melissa P; Adler, Caleb M; Strakowski, Stephen M

2008-04-01

187

Geometric morphometric footprint analysis of young women  

PubMed Central

Background Most published attempts to quantify footprint shape are based on a small number of measurements. We applied geometric morphometric methods to study shape variation of the complete footprint outline in a sample of 83 adult women. Methods The outline of the footprint, including the toes, was represented by a comprehensive set of 85 landmarks and semilandmarks. Shape coordinates were computed by Generalized Procrustes Analysis. Results The first four principal components represented the major axes of variation in foot morphology: low-arched versus high-arched feet, long and narrow versus short and wide feet, the relative length of the hallux, and the relative length of the forefoot. These shape features varied across the measured individuals without any distinct clusters or discrete types of footprint shape. A high body mass index (BMI) was associated with wide and flat feet, and a high frequency of wearing high-heeled shoes was associated with a larger forefoot area of the footprint and a relatively long hallux. Larger feet had an increased length-to-width ratio of the footprint, a lower-arched foot, and longer toes relative to the remaining foot. Footprint shape differed on average between left and right feet, and the variability of footprint asymmetry increased with BMI. Conclusions Foot shape is affected by lifestyle factors even in a sample of young women (median age 23 years). Geometric morphometrics proved to be a powerful tool for the detailed analysis of footprint shape that is applicable in various scientific disciplines, including forensics, orthopedics, and footwear design.

2013-01-01

188

Morphometric analysis of face in dysmorphology.  

PubMed

Dysmorphology refers to study of human congenital malformations (birth defects). Most of the case reporting in dysmorphology is subjective and is based on experience of the reporting clinician. We have used the methods of geometric morphometrics to analyze the variation in faces of normal individuals and those with dysmorphic syndrome. We obtained photographs of 20 individuals with Rubinstein Taybi syndrome and 30 normal, age and sex matched individuals. The photographs were digitized with 16 landmarks on the face to obtain 32 "x" and "y" co-ordinates. These co-ordinates were then subjected to generalized procrustes superimposition in order to normalize for effects of size, rotation and position of image. The procrustes residuals thus obtained were then subjected to principal component analysis. The principal component analysis resulted in extraction of three important principal components explaining 41%, 17% and 14% of variance, respectively. Discriminant analysis could differentiate the two groups using first two principal component scores for each individual, with a predictive accuracy of 76% (Wilks lambda=0.725, chi2=15.09, d.f.=2, p=0.001). Binary logistic regression analysis showed predictive accuracy of 78% based on this model. The utility of the subjective evaluation of facial characteristics is multifold. The results of the analysis can be used as representatives of the facial dysmorphism for any genotype-phenotype association study. We conclude that application of the principles of geometric morphometrics to study of shape variation in facies of patients with dysmorphic syndromes appears to be a promising new area of research. PMID:17118483

Dalal, Ashwin B; Phadke, Shubha R

2007-02-01

189

Invariant morphometric properties of headwater subcatchments  

NASA Astrophysics Data System (ADS)

The distinction between the channel network, the headwater subcatchments, and the lateral subcatchments plays an important role in distributed hydrological and ecohydrological applications. This paper presents some newly found invariance properties of headwater and upstream subcatchments and shows that the invariant morphometric properties characterize only natural networks and virtual networks verifying optimal channel networks (OCN) properties but are not verified for virtual non-OCNs. A model based on self-affine properties was developed in order to calculate the number of headwater catchments N and the total upstream area of headwater catchments U as a function of the cutoff area A used to delineate streams. For 18 French catchments between 43 and 116,450 km2 and for 4 virtual OCNs, results show that U(A)/A0 (with A0 being the catchment area) is independent of A for 0.5 < A < 5 km2 and seems to be constant (0.29 ± 0.03) for various shapes and sizes of channel networks and, consequently, can be considered as an invariant general descriptor of natural channel and virtual OCN networks. On the contrary, this is not the case when the approach is applied on six virtual non-OCNs. Moreover, results show that the knowledge of six morphometric indices enable us to calculate both functions N(A) and U(A) for all values of A < A0. These indices can be considered as geometric and topological properties of headwater and upstream subcatchments and are useful for studying the effects of cutoffs on self-affine river networks or as similarity indices for channel network comparison.

Moussa, Roger; Colin, FrançOis; Rabotin, MichaëL.

2011-08-01

190

Successful Endovascular Management of Intraoperative Graft Limb Occlusion and Iliac Artery Rupture Occurred during Endovascular Abdominal Aortic Aneurysm Repair  

PubMed Central

For high-risk patients, endovascular aortic aneurysm repair (EVAR) is a good option but may lead to serious complications, which should be addressed immediately. A 75-year-old man with a history of abdominal surgery underwent EVAR for an aneurysm of the abdominal aorta and iliac arteries. During EVAR, iliac artery rupture and graft limb occlusion occurred, and they were successfully managed by the additional deployment of an iliac stent graft and balloon thrombectomy, respectively. We, herein, report a rare case of the simultaneous development of the two fatal complications treated by the endovascular technique.

Lim, Jae Hong; Sung, Yong Won; Oh, Se Jin; Moon, Hyeon Jong; Lee, Jeong Sang

2014-01-01

191

Coral reef aorta, emergency surgical: case report and literature review.  

PubMed

Coral reef aorta is described as an uncommon entity characterized by the presence of coarse calcifications, which are developed in the visceral aorta. These calcifications grow toward the lumen of the artery and can result in significant stenosis, so that causing malperfusion of the lower limbs, visceral ischemia or hypertension secondary to renal involvement. We report here a case of a 54-year-old patient with coral reef aorta and symptomatic. The clinical presentation of the patient required the surgical approach. A review of literature in major databases was conducted to compare health-related aspects of the disease presentation and management. Coral reef aorta should be considered as the diagnosis for patients with visceral and limbs ischemia. The approach in our case was consistent with other studies previously published in the literature. PMID:25003933

Belczak, Sergio Quilici; Sincos, Igor Rafael; Aun, Ricardo; Costa, Kaline Viana; Araujo, Etianne Andrade

2014-04-01

192

Successful treatment of an abdominal aortic aneurysm with a severely angulated and large aortic neck using a modified Zenith.  

PubMed

This report presents the case of an abdominal aortic aneurysm (AAA), in which the aortic neck was severely angulated. Furthermore, there was moderate stenosis and a severe angle with calcification of the suprarenal aorta. EVAR was performed with a commercial Zenith stent-graft, with a slight modification, because an open aneurysm repair was risky in general condition. No complications occurred during the follow-up period. PMID:24800529

Guntani, Atsushi; Fukunaga, Ryota; Kuma, Sosei; Okazaki, Jin; Nishihara, Yunosuke; Aibe, Hitoshi; Okadome, Jun; Morisaki, Koichi; Matsumoto, Takuya; Maehara, Yoshihiko

2014-01-01

193

Surgical management of abdominal tuberculosis  

Microsoft Academic Search

Recent reports suggest an increased incidence of abdominal tuberculosis in the United States, particularly in high-risk groups.\\u000a The aim of this study was to review the spectrum of abdominal tuberculosis and its surgical management at a tertiary referral\\u000a center in the United States. The medical records of patients treated for abdominal tuberculosis at our institution between\\u000a January 1992 and June

Imran Hassan; Emmanouil S. Brilakis; Rodney L. Thompson; Florencia G. Que

2002-01-01

194

PIV and MRV Measurements in Human Thoracic Aorta Phantoms  

NASA Astrophysics Data System (ADS)

Aortic dissection is a non-traumatic injury to the aorta in which a flap is created inside the aorta by the separation of the inner lining of the vessel wall from its outer layers. It is hypothesized that dissections start as tears in vessels' inner lining and propagate as blood impinges through the tear into the separated part of the vessel wall. No two dissections are alike, but many share common characteristics, one of which is that tear sites occur in similar places in the aorta. In an effort to understand the origins of these tear sites and the propagation of dissections, we are studying blood flow in human aortas. To begin, we are using rigid aorta phantoms based on anatomies of healthy adults extracted from computed tomography (CT) and magnetic resonance imaging (MRI) medical scans. Clear polyurethane phantoms are created by casting around water-soluble positive molds manufactured using rapid prototyping. We study steady flows with Reynolds numbers comparable to those present in the aorta during the systolic pulse and physiologically pulsatile flows. The entire three-dimensional flow is measured using magnetic resonance velocimetry (MRV), a technique based on MRI principles capable of measuring three-component mean velocities. MRV results are compared to the instantaneous and average two-component velocity fields measured in a few 2D planes with particle image velocimetry (PIV). The PIV results provide validation for the MRV and insight into the instantaneous flow structures that may possibly lead to aortic dissection through fluid structure wall interaction.

Iyengar, Ananth; Elkins, Christopher; Draney, Mary; Medina, Francisco; Wicker, Ryan

2004-11-01

195

Active axial stress in mouse aorta.  

PubMed

The study verifies the development of active axial stress in the wall of mouse aorta over a range of physiological loads when the smooth muscle cells are stimulated to contract. The results obtained show that the active axial stress is virtually independent of the magnitude of pressure, but depends predominately on the longitudinal stretch ratio. The dependence is non-monotonic and is similar to the active stress-stretch dependence in the circumferential direction reported in the literature. The expression for the active axial stress fitted to the experimental data shows that the maximum active stress is developed at longitudinal stretch ratio 1.81, and 1.56 is the longitudinal stretch ratio below which the stimulation does not generate active stress. The study shows that the magnitude of active axial stress is smaller than the active circumferential stress. There is need for more experimental investigations on the active response of different types of arteries from different species and pathological conditions. The results of these studies can promote building of refined constrictive models in vascular rheology. PMID:22698830

Agianniotis, A; Rachev, A; Stergiopulos, N

2012-07-26

196

Abdominal magnetic resonance elastography.  

PubMed

Magnetic resonance elastography (MRE) is a magnetic resonance imaging-based technique for quantitatively assessing the mechanical properties of tissues based on the propagation of shear waves. Multiple studies have described many potential applications of MRE, from characterizing tumors to detecting diffuse disease processes. Studies have shown that MRE can be successfully implemented to assess abdominal organs. The first clinical application of MRE to be well documented is the detection and characterization of hepatic fibrosis, which systematically increases the stiffness of liver tissue. In this diagnostic role, it offers a safer, less expensive, and potentially more accurate alternative to invasive liver biopsy. Emerging results suggest that measurements of liver and spleen stiffness may provide an indirect way to assess portal hypertension. Preliminary studies have demonstrated that it is possible to use MRE to evaluate the mechanical properties of other abdominal structures, such as the pancreas and kidneys. Steady technical progress in developing practical protocols for applying MRE in the abdomen and the pelvis provides opportunities to explore many other potential applications of this emerging technology. PMID:20010062

Yin, Meng; Chen, Jun; Glaser, Kevin J; Talwalkar, Jayant A; Ehman, Richard L

2009-04-01

197

[Ruptured abdominal aortic aneurysms].  

PubMed

Eighty two aortic replacements of ruptured abdominal aortic aneurysms have been performed during the last 6 years. There were 72 male and 10 female patients, and the average age was 71.33 years. Hemorrhagic shock on the admission was observed in 45 patients, and 13 have been operated urgently without any diagnostic procedures. The transperitoneal approach have been used for the operation. Two aorto duodenal and one aorto caval fistulas, have been found. Only exploration (three patients died immediately after laparotomy and 6 after cross clamping) has been done in 9 cases, and the aortic replacement in 70 cases (27 with tubular, and 43 with bifurcated graft). In 3 cases and axillobifemoral bypass had to be done. During the operation eleven patients died, and 30 in postoperative period, during the period between one and 40 days. Total intrahospital mortality rate was 50%, compared with 3.5% for 250 electively operated patients with abdominal aortic aneurysms in same period. In postoperative period the most important cause of death was multiple organs failures. Statistically significant greater mortality rate (p > 0.01%) was found in cases of late operative treatment, hemorrhagic shock, intra-operational bleeding, ruptured front wall, suprarenal cross clamping and in patients older than 75 year. In complicated cases such as juxtarenal aneurysm, 3 sutures parachute technique for proximal anastomosis, a temporary transection of the left renal vein, and intraaortal balloon occlusive catheter for proximal bleeding control are recommended. PMID:10951761

Lotina, S I; Davidovi?, L B; Kosti?, D M; Stojanov, P L; Velimirovi?, D B; Djuki?, P L; Cinara, I S; Vojnovi?, B M; Savi?, D V

198

Improving the Efficiency of Abdominal Aortic Aneurysm Wall Stress Computations  

PubMed Central

An abdominal aortic aneurysm is a pathological dilation of the abdominal aorta, which carries a high mortality rate if ruptured. The most commonly used surrogate marker of rupture risk is the maximal transverse diameter of the aneurysm. More recent studies suggest that wall stress from models of patient-specific aneurysm geometries extracted, for instance, from computed tomography images may be a more accurate predictor of rupture risk and an important factor in AAA size progression. However, quantification of wall stress is typically computationally intensive and time-consuming, mainly due to the nonlinear mechanical behavior of the abdominal aortic aneurysm walls. These difficulties have limited the potential of computational models in clinical practice. To facilitate computation of wall stresses, we propose to use a linear approach that ensures equilibrium of wall stresses in the aneurysms. This proposed linear model approach is easy to implement and eliminates the burden of nonlinear computations. To assess the accuracy of our proposed approach to compute wall stresses, results from idealized and patient-specific model simulations were compared to those obtained using conventional approaches and to those of a hypothetical, reference abdominal aortic aneurysm model. For the reference model, wall mechanical properties and the initial unloaded and unstressed configuration were assumed to be known, and the resulting wall stresses were used as reference for comparison. Our proposed linear approach accurately approximates wall stresses for varying model geometries and wall material properties. Our findings suggest that the proposed linear approach could be used as an effective, efficient, easy-to-use clinical tool to estimate patient-specific wall stresses.

Zelaya, Jaime E.; Goenezen, Sevan; Dargon, Phong T.; Azarbal, Amir-Farzin; Rugonyi, Sandra

2014-01-01

199

Improving the efficiency of abdominal aortic aneurysm wall stress computations.  

PubMed

An abdominal aortic aneurysm is a pathological dilation of the abdominal aorta, which carries a high mortality rate if ruptured. The most commonly used surrogate marker of rupture risk is the maximal transverse diameter of the aneurysm. More recent studies suggest that wall stress from models of patient-specific aneurysm geometries extracted, for instance, from computed tomography images may be a more accurate predictor of rupture risk and an important factor in AAA size progression. However, quantification of wall stress is typically computationally intensive and time-consuming, mainly due to the nonlinear mechanical behavior of the abdominal aortic aneurysm walls. These difficulties have limited the potential of computational models in clinical practice. To facilitate computation of wall stresses, we propose to use a linear approach that ensures equilibrium of wall stresses in the aneurysms. This proposed linear model approach is easy to implement and eliminates the burden of nonlinear computations. To assess the accuracy of our proposed approach to compute wall stresses, results from idealized and patient-specific model simulations were compared to those obtained using conventional approaches and to those of a hypothetical, reference abdominal aortic aneurysm model. For the reference model, wall mechanical properties and the initial unloaded and unstressed configuration were assumed to be known, and the resulting wall stresses were used as reference for comparison. Our proposed linear approach accurately approximates wall stresses for varying model geometries and wall material properties. Our findings suggest that the proposed linear approach could be used as an effective, efficient, easy-to-use clinical tool to estimate patient-specific wall stresses. PMID:25007052

Zelaya, Jaime E; Goenezen, Sevan; Dargon, Phong T; Azarbal, Amir-Farzin; Rugonyi, Sandra

2014-01-01

200

Enlargement of the aorta: An occupational disease?  

PubMed Central

BACKGROUND: Aortic dilation may critically precede progression to thoracic aortic aneurysm (TAA). Prolonged or repetitive isometric-type heavier strenuous activities resulting from the nature of some professions may be an important causative factor for TAA. METHOD: The echocardiographic measurement data of middle-age subjects who were isometric-type daily strenuous activity trainers or ordinary activity trainers were retrospectively analyzed. Clinical features and echocardiographic parameters of the left ventricle and left atrium (LA), aortic root (AR) and ascending aorta (AA) were compared between the groups. RESULTS: AR (35.6±3.0 mm versus 33.5±1.9 mm), AA (36.8±3.0 mm versus 34.4±1.9 mm) and LA (37.4±2.2 mm versus 36.2±2.2 mm) diameters were significantly enlarged in the strenuous activity trainer group versus the ordinary activity group. Diastolic blood pressure was significantly lower (73.8±5.9 mmHg versus 78.3±6.0 mmHg) in this group. AR diameter was correlated with height (?=0.460; P=0.004) and LA diameter (?=0.280; P=0.008) while AA diameter was correlated with type of profession (?=0.309; P=0.003), left ventricular systolic diameter (?=0.500; P=0.001) and LA diameter (?=0.272; P=0.005) in regression analysis. CONCLUSION: Aortic dilation and, subsequently, TAA may be an occupational disease due to nature of some professions (eg, the military, security, weight lifters, athletes, heavy workers, etc). Echocardiography is a convenient method of imaging that could be easily applied either during preparticipation screening or during periodical examination of these subjects. Earlier detection of TAA and limitation of such strenuous activities in these individuals may be initial lifesaving measures for the prevention of future cases of aortic aneurysm and dissection.

Aparci, Mustafa; Erdal, Muhammed; Isilak, Zafer; Yalcin, Murat; Uz, Omer; Arslan, Zekeriya; Kardesoglu, Ejder

2013-01-01

201

Management of Severe Abdominal Infections  

Microsoft Academic Search

Abdominal infections are associated with significant morbidity and mortality. Nearly all bacteria causing abdominal infections are derived from the endogenous flora of the alimentary tract. The resulting infection is typically polymicrobial and comprised of both aerobic and anaerobic microbes. They can be classified by their severity as uncomplicated and complicated or by their origin as community or hospital acquired. Escherichia

Dietrich Hasper; Joerg C. Schefold; Daniel C. Baumgart

2009-01-01

202

Ruptured Abdominal AorticAneurysm  

Microsoft Academic Search

Background and Purpose: A ruptured abdominal aortic aneurysm is one of the most urgent surgical conditions with high mortality. The aim of the present study was to define relevant prognostic predictors for the outcome of surgical treatment. Patients and Methods: This study included 229 subsequent patients (83% males, 17% females, age 67.0 ± 7.5 years) with a ruptured abdominal aortic

Miroslav Markovi?; Lazar Davidovi?; Živan Maksimovi?; Dušan Kosti?; Ilijas ?inara; Slobodan Cvetkovi?; Radomir Sindjelic; Petar M. Seferovi?; Arsen D. Risti?

2004-01-01

203

Functional Abdominal Pain in Children  

MedlinePLUS

... causes that should be considered when evaluating a child with chronic abdominal pain. Some of those causes are not very serious ... none of these more severe problems cause abdominal pain in most children with chronic or recurrent bellyaches. Instead, the pain is usually “ ...

204

How I Manage Abdominal Injuries.  

ERIC Educational Resources Information Center

In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

Haycock, Christine E.

1986-01-01

205

ABDOMINAL COMPARTMENT SYNDROME IN POLYTRAUMA  

Microsoft Academic Search

Authors inform about the group of 8 patients with abdominal compartment syndrome (ACS) occurred as a compli- cation in large blunt injury of abdominal cavity. To the ACS diagnose, the measurement of intracystic pressure is used routinely, whose values correlate fully with values of intraabdominal pressure (IAP). In case of increasing values of IAP over 25 mm Hg with positive

Leopold Pleva; Jaroslav Mayzlíkb

206

Method for extracting the aorta from 3D CT images  

NASA Astrophysics Data System (ADS)

Bronchoscopic biopsy of the central-chest lymph nodes is vital in the staging of lung cancer. Three-dimensional multi-detector CT (MDCT) images provide vivid anatomical detail for planning bronchoscopy. Unfortunately, many lymph nodes are situated close to the aorta, and an inadvertent needle biopsy could puncture the aorta, causing serious harm. As an eventual aid for more complete planning of lymph-node biopsy, it is important to define the aorta. This paper proposes a method for extracting the aorta from a 3D MDCT chest image. The method has two main phases: (1) Off-line Model Construction, which provides a set of training cases for fitting new images, and (2) On-Line Aorta Construction, which is used for new incoming 3D MDCT images. Off-Line Model Construction is done once using several representative human MDCT images and consists of the following steps: construct a likelihood image, select control points of the medial axis of the aortic arch, and recompute the control points to obtain a constant-interval medial-axis model. On-Line Aorta Construction consists of the following operations: construct a likelihood image, perform global fitting of the precomputed models to the current case's likelihood image to find the best fitting model, perform local fitting to adjust the medial axis to local data variations, and employ a region recovery method to arrive at the complete constructed 3D aorta. The region recovery method consists of two steps: model-based and region-growing steps. This region growing method can recover regions outside the model coverage and non-circular tube structures. In our experiments, we used three models and achieved satisfactory results on twelve of thirteen test cases.

Taeprasartsit, Pinyo; Higgins, William E.

2007-03-01

207

Hemodynamic variations due to spiral blood flow through four patient-specific bifurcated stent graft configurations for the treatment of abdominal aortic aneurysms.  

PubMed

Endovascular repair is now a recognised procedure for treating abdominal aortic aneurysms. However, post-operative complications such as stent graft migration and thrombus may still occur. To assess these complications numerically, the correct input boundary conditions, which include the full human aorta with associated branching, should be included. Four patient-specific computed tomography scanned bifurcated stent grafts (SGs) were modelled and attached onto a full human aorta, which included the ascending, aortic arch and descending aortas. Two of the SG geometries had a twisted leg configuration, while the other two had conventional nontwisted leg configurations. Computational fluid dynamics was completed for both geometries and the hemodynamics assessed. The complexity of the flow patterns and secondary flows were influenced by the inclusion of the full human aorta at the SG proximal section. During the decelerating phase significant recirculations occurred along the main body of all SG configurations. The inclusion of the full human aorta did not impact the velocity contours within the distal legs and there was no difference in drag forces with the SG containing the full human aorta and those without. A twisted leg configuration further promoted a spiral flow formation along its distal legs. PMID:23255342

Stefanov, Florian; McGloughlin, Tim; Delassus, Patrick; Morris, Liam

2013-02-01

208

17beta-estradiol, gender independently, reduces atheroma development but not neointimal proliferation after balloon injury in the rabbit aorta.  

PubMed

The aim of the present study was to investigate anti-proliferative and anti-atherogenic properties of 17beta-estradiol in balloon injured female and male rabbit aortae. Thirty-two female and 32 male New Zealand White rabbits where gonadectomised. Vascular injury was performed with a balloon catheter in the lower abdominal aorta. Male and female rabbits were randomised into four groups of eight animals each. Only two of four groups received a 0.5% cholesterol-enriched diet. One cholesterol-diet group and one normal-diet group received intramuscular injections of estradiol valerate (1 mg/kg body weight/week). After 28 days, the denuded part of the abdominal aorta was excised and analysed by morphometry and immunohistochemistry. Estrogen treatment did not show an inhibitory effect on neointimal proliferation in normo-cholesterolemic male or female rabbits. A gender independent inhibitory effect of 17beta-estradiol was seen on atheroma development in cholesterol-fed female and male rabbits, while plasma total cholesterol levels were significantly reduced in male rabbits only. The 17beta-estradiol treatment was associated with a significantly decreased number of luminal endothelial cells in normo and hyper-cholesterolemic female rabbits, as evaluated by immunohistochemical staining for 'von Willebrand factor'. Staining for Ki-67-positive proliferating cells after 28 days showed a statistically significant increased proliferative activity in the neointima of hyper-cholesterolemic female rabbits. The neointimal content of macrophages increased significantly in all hyper-cholesterolemic rabbits. Under 17beta-estradiol treatment, the number of macrophages was increased in female and decreased in male rabbits by tendency. Additionally, the 'classical' vascular estrogen receptor was present in both female and male rabbit aortae without statistically significant differences. In conclusion, 17beta-estradiol did not reduce post-injury neointima formation in normo-cholesterolemic rabbits. However, in hyper-cholesterolemic rabbits, 17beta-estradiol reduced atheroma development gender independently. This effect cannot be explained by lowering of plasma cholesterol levels or endothelium-mediated pathways, and requires further investigation on, for example, antioxidative, antiproliferative or estrogen receptor mediated effects. PMID:11137081

Finking, G; Krauss, N; Römer, S; Eckert, S; Lenz, C; Kamenz, J; Menke, A; Brehme, U; Hombach, V; Hanke, H

2001-01-01

209

Total and subtotal abdominal hysterectomy.  

PubMed

Hysterectomy is one of the most frequently performed operations in the world, accounting for 500,000-600,000 procedures annually in the USA; the abdominal route for hysterectomy is the preferred route in 60-80% of these operations. Although the number of total abdominal hysterectomies performed annually has decreased, the number of subtotal abdominal hysterectomies increased by >400%. The major indications for abdominal hysterectomy include abnormal uterine bleeding, myomata uteri, adenomyosis, endometriosis, neoplasia, and chronic salpingitis. The basis for selection for subtotal versus total hysterectomy has little in the way of factual data to support it and may actually present some significant disadvantages, such as continued menstruation and cervical prolapse. The detailed technique for performing intrafascial abdominal hysterectomy relies heavily on precise knowledge of pelvic anatomy and compulsive detail to tissue handling. The consistent and correct usage of prophylactic antimicrobials, measures to prevent thromboemboli, and procedures to avoid urinary retention are key to the overall success of the surgery. PMID:15985251

Baggish, Michael S

2005-06-01

210

New morphometric data for fresh lunar craters  

NASA Technical Reports Server (NTRS)

Morphometric relations have been determined for 2598 fresh craters on the lunar nearside using data given in the catalog of Wood and Andersson (1978). For each of five principal morphological types, typified by Albategnius C, Biot, Sosigenes, Triesnecker, and Tycho, statistical relations are documented for the following: crater diameter and depth; floor diameter and crater diameter; central peak height and crater diameter; average wall slope and crater depth; central peak occurrence and crater diameter; occurrence of scallops or terraces and crater diameter. The first four relations generally confirm the conclusions of Pike (1977), but the last two differ from results reported by Smith and Sanchez (1973). Small (diameter less than 20 km) flat-floored craters formed in mare terrains are as much as 10% deeper than those formed in the highlands, and the depths of small bowl-shaped craters reflect even greater dependence on terrain. Larger, scalloped-walled craters are deeper in highland terrain than on the maria. Although wall failure does not occur until the crater diameter reaches 13 km, central peaks are found in flat floor craters as small as 2 km.

Wood, C. A.; Anderson, L.

1978-01-01

211

How morphometric characteristics affect flow accumulation values  

NASA Astrophysics Data System (ADS)

Remote sensing methods (like aerial based LIDAR recording, land-use recording etc.) become continually more available and accurate. On the other hand in-situ surveying is still expensive. Above all in small, anthropogenically uninfluenced catchments, with poor, or non-existing surveying network could be remote sensing methods extremely useful. Overland flow accumulation (FA) values belong to important indicators of higher flash floods or soil erosion exposure. This value gives the number of cells of the Digital Elevation Model (DEM) grid, which are drained to each point of the catchment. This contribution deals with relations between basic geomorphological and morphometric characteristics (like hypsometric integral, Melton index of subcatchment etc.) and FA values. These relations are studied in the rocky sandstone landscapes of National park Ceské Svycarsko with the particular occurrence of broken relief. All calculations are based on high-resolution LIDAR DEM named Genesis created by TU Dresden. The main computational platform is GIS GRASS . The goal of the conference paper is to submit a quick method or indicators to estimate small particular subcatchments threatened by higher flash floods or soil erosion risks, without the necessity of using sophisticated rainfall-runoff models. There is a possibility to split catchments easily to small subcatchments (or use existing disjunction), compute basic characteristics and (with knowledge of links between this characteristics and FA values) identify, which particular subcatchment is potentially threatened by flash floods or soil erosion.

Farek, Vladimir

2014-05-01

212

Fused traditional and geometric morphometrics demonstrate pinniped whisker diversity.  

PubMed

Vibrissae (whiskers) are important components of the mammalian tactile sensory system, and primarily function as detectors of vibrotactile information from the environment. Pinnipeds possess the largest vibrissae among mammals and their vibrissal hair shafts demonstrate a diversity of shapes. The vibrissae of most phocid seals exhibit a beaded morphology with repeating sequences of crests and troughs along their length. However, there are few detailed analyses of pinniped vibrissal morphology, and these are limited to a few species. Therefore, we comparatively characterized differences in vibrissal hair shaft morphologies among phocid species with a beaded profile, phocid species with a smooth profile, and otariids with a smooth profile using traditional and geometric morphometric methods. Traditional morphometric measurements (peak-to-peak distance, crest width, trough width and total length) were collected using digital photographs. Elliptic Fourier analysis (geometric morphometrics) was used to quantify the outlines of whole vibrissae. The traditional and geometric morphometric datasets were subsequently combined by mathematically scaling each to true rank, followed by a single eigendecomposition. Quadratic discriminant function analysis demonstrated that 79.3, 97.8 and 100% of individuals could be correctly classified to their species based on vibrissal shape variables in the traditional, geometric and combined morphometric analyses, respectively. Phocids with beaded vibrissae, phocids with smooth vibrissae, and otariids each occupied distinct morphospace in the geometric morphometric and combined data analyses. Otariids split into two groups in the geometric morphometric analysis and gray seals appeared intermediate between beaded- and smooth-whiskered species in the traditional and combined analyses. Vibrissal hair shafts modulate the transduction of environmental stimuli to the mechanoreceptors in the follicle-sinus complex (F-SC), which results in vibrotactile reception, but it is currently unclear how the diversity of shapes affects environmental signal modulation. PMID:22509310

Ginter, Carly C; DeWitt, Thomas J; Fish, Frank E; Marshall, Christopher D

2012-01-01

213

Fused Traditional and Geometric Morphometrics Demonstrate Pinniped Whisker Diversity  

PubMed Central

Vibrissae (whiskers) are important components of the mammalian tactile sensory system, and primarily function as detectors of vibrotactile information from the environment. Pinnipeds possess the largest vibrissae among mammals and their vibrissal hair shafts demonstrate a diversity of shapes. The vibrissae of most phocid seals exhibit a beaded morphology with repeating sequences of crests and troughs along their length. However, there are few detailed analyses of pinniped vibrissal morphology, and these are limited to a few species. Therefore, we comparatively characterized differences in vibrissal hair shaft morphologies among phocid species with a beaded profile, phocid species with a smooth profile, and otariids with a smooth profile using traditional and geometric morphometric methods. Traditional morphometric measurements (peak-to-peak distance, crest width, trough width and total length) were collected using digital photographs. Elliptic Fourier analysis (geometric morphometrics) was used to quantify the outlines of whole vibrissae. The traditional and geometric morphometric datasets were subsequently combined by mathematically scaling each to true rank, followed by a single eigendecomposition. Quadratic discriminant function analysis demonstrated that 79.3, 97.8 and 100% of individuals could be correctly classified to their species based on vibrissal shape variables in the traditional, geometric and combined morphometric analyses, respectively. Phocids with beaded vibrissae, phocids with smooth vibrissae, and otariids each occupied distinct morphospace in the geometric morphometric and combined data analyses. Otariids split into two groups in the geometric morphometric analysis and gray seals appeared intermediate between beaded- and smooth-whiskered species in the traditional and combined analyses. Vibrissal hair shafts modulate the transduction of environmental stimuli to the mechanoreceptors in the follicle-sinus complex (F-SC), which results in vibrotactile reception, but it is currently unclear how the diversity of shapes affects environmental signal modulation.

Ginter, Carly C.; DeWitt, Thomas J.; Fish, Frank E.; Marshall, Christopher D.

2012-01-01

214

Elastic fibers and collagen distribution in human aorta  

NASA Astrophysics Data System (ADS)

Elastic and collagen fibers are essential components of the aorta, the remodeling of these structures is accompanied with aging in various diseases and life-threatening events. While the elastic fibers confer resilience to major blood vessels collagen confers resistance to the same. Elastic fibers are easily visualized in the fluorescent light when stained with hematoxylin eosin. Second Harmonic Generation (SHG) is a non linear signal that occurs only in molecules without inversion symmetry and is particularly strong in the collagen fibers arranged in triple helices. The aim of this paper is to describe the distribution of collagen in the thickness of the thoracic aorta, and to demonstrate the distribution of between elastic fibers. The images were acquired in a multifoton microscopy and both signals, Two-phtoton excitaded fluorescence (TPEF) and SHG, were excited by a Ti:Sapphire laser. We used a band pass filter to filter the SHG signal from the TPEF signal. The thickness of the aorta varies 2-3 mm, and the image was composed of the juxtaposition of images of 220 x 220 microns. We acquired images of a histological slide of the thoracic aorta stained with picrosirius red (specific for collagen) at a wavelength of 670nm SHG subsequently acquired images with the same region and observed that the images are overlapping. Therefore, the following images were acquired by confocal microscopy (fluorescence of eosin for visualization of elastic fibers) and for collagen SHG. After reconstruction of the images, we observed the distribution of collagen along the aorta.

Vieira-Damiani, G.; Ferro, D. P.; Adam, R. L.; de Thomaz, A. A.; Pelegati, V.; Cesar, C. L.; Metze, K.

2011-02-01

215

[Abdominal intercostal neuralgia: a forgotten cause of abdominal pain].  

PubMed

Four patients, 3 women aged 39, 36 and 58 and a man aged 51, had been experiencing recurring bouts of abdominal pain for periods varying from a few months to years. The pain could be provoked by palpation of a small circumscript area in the lower abdomen. A positive Carnett's sign (pain intensification during palpation while contracting the abdominal muscles by raising the head, whilst lying flat) may aid the diagnosis. An injection ofa local anaesthetic agent confirmed the diagnosis of nerve entrapment and appeared therapeutic in one patient. The other three patients experienced long-term relief following surgical nerve excision. Establishing a diagnosis in patients with abdominal cutaneous nerve entrapment syndrome is often delayed due to physicians being unaware of this condition. Most patients have to undergo numerous investigations including laparoscopies and explorative laparotomies, often to no avail. This syndrome should be considered in patients with chronic abdominal pain syndromes. PMID:16999272

Roumen, R M H; Scheltinga, M R M

2006-09-01

216

Congestive heart failure due to coral reef thoracoabdominal aorta.  

PubMed

Acquired coarctation due to coral reefs is a rare and unique entity characterized by extensively calcified thrombus of the entire aorta. There are few reports of coral reef aorta resulting in severely congestive heart failure in the literature. We describe a 60-year-old female with acute heart failure. Computed tomography (CT)-scan and magnetic resonance imaging (MRI) revealed that the cause of the heart failure was cardiac after-load mismatch due to serious stenosis of the aorta. In order to prevent cardio-respiratory failure, an axillofemoral bypass was performed to release the cardiac after-load mismatch. This diminished the pressure gradient between upper and lower blood pressure that caused cardiac dysfunction. PMID:21908885

Satsu, Takuma; Saga, Toshihiko; Kaneda, Toshio; Imura, Masato

2011-12-01

217

Extrinsic erosion of the descending aorta by a vertebral fixator.  

PubMed

We report a rare case in which mechanical extrinsic erosion of the descending thoracic aorta resulted in perforation and periaortic hematoma formation in a 16-year-old girl. Five months before admission to our clinic, the patient had undergone surgical spondylosyndesis with inner vertebral fixation, for the correction of scoliosis. Subsequently, a screw on the fixator became loose, eroding and eventually perforating the wall of the descending aorta. The resultant lesion was at first misdiagnosed as a paravertebral abscess; extrinsic perforation of the descending aorta was suspected prior to operation, but was confirmed only upon surgical exploration. After evacuation of the hematoma, the 1.5-cm aortic perforation was closed directly with continuous sutures. Seven months later, the patient continues to do well. PMID:15227498

Sokoli?, J; Sosa, T; Ugljen, R; Biocina, B; Simuni?, S; Slobodnjak, Z

1991-01-01

218

[Surgery of the ascending aorta and aortic arch].  

PubMed

The surgical therapy of the ascending aorta and the aortic arch with its supraarotic branches has been, and still is, one of the major challenges in the therapy of the aorta. There have been major developments in the endovascular therapy field, which can be used as a complementary or even sometimes as an alternative to the standard surgery. Therefore, an interdisciplinary approach is a prerequisite for optimal therapy planning for such patients. The risk of operating under circulatory arrest has been markedly reduced due to the continued development of cardiosurgical techniques, especially selective cerebral perfusion and mild hypothermia. Further developments of the therapy of aortic diseases via alternative approaches are expected in the near future. However, the conventional surgical therapy for pathologies in the ascending aorta (with/out the aortic valve) and the aortic arch is still the gold standard. PMID:23568059

Kappert, U; Ghazy, T; Matschke, K

2013-05-01

219

Extrinsic Erosion of the Descending Aorta by a Vertebral Fixator  

PubMed Central

We report a rare case in which mechanical extrinsic erosion of the descending thoracic aorta resulted in perforation and periaortic hematoma formation in a 16-year-old girl. Five months before admission to our clinic, the patient had undergone surgical spondylosyndesis with inner vertebral fixation, for the correction of scoliosis. Subsequently, a screw on the fixator became loose, eroding and eventually perforating the wall of the descending aorta. The resultant lesion was at first misdiagnosed as a paravertebral abscess; extrinsic perforation of the descending aorta was suspected prior to operation, but was confirmed only upon surgical exploration. After evacuation of the hematoma, the 1.5-cm aortic perforation was closed directly with continuous sutures. Seven months later, the patient continues to do well. (Texas Heart Institute Journal 1991;18:136-9) Images

Sokolic, Josip; Sosa, Tomislav; Ugljen, Ranko; Biocina, Bojan; Simunic, Slavko; Slobodnjak, Zoran

1991-01-01

220

Serial postmortem abdominal radiographic findings in canine cadavers.  

PubMed

Postmortem radiographic examinations of animals are often performed in judicial investigation to rule out gunshot and fractures due to cruelty or illegal hunting or poaching activities. Literature describing postmortem changes seen on radiographs of animals is rarely available. Serial abdominal radiography of 6 recently euthanized dogs were performed in an interval of 8h at a tropical ambient temperature of 22-33 degrees C. Severe decomposition of the cadavers prevented the study to be performed beyond 24h. Gradual increment of gas accumulation in the gastrointestinal tract, liver, spleen, kidney and blood vessels were observed. Increased amount of gas in the gastrointestinal tract was detected as early as 8h post-euthanasia and continuously increased throughout the study. Gas was seen in the portal vein and caudal vena cava of all cadavers at 16h post-euthanasia. The presence of gas in the aorta occurred at a later stage. Tubular branching gas pattern in the liver and spleen was first observed and progressed to vesicular gas pattern due to tissue decomposition. This study showed that abdominal radiographic postmortem changes occurred most rapidly between 8 and 16h post-euthanasia at the ambient temperature of 22-33 degrees C. PMID:19716666

Heng, Hock Gan; Selvarajah, Gayathri Thevi; Lim, Hiang Tee; Ong, Jin Seng; Lim, Jiehan; Ooi, Jin Tatt

2009-11-20

221

Transapical endovascular stenting of penetrating atherosclerotic ulcer of ascending aorta.  

PubMed

A 71-year-old woman presented with acute chest pain and was admitted at our institution. Computed tomography revealed a penetrating atherosclerotic ulcer in the ascending aorta with extensive intramural hematoma. A transapical endovascular stenting was successfully performed. Computed tomography at a 6-month follow-up visit revealed a type I endoleak, which was restented through the same approach. Despite initial satisfactory results, follow-up revealed a persistent endoleak, so that a high-risk open surgical repair was required. Surgical replacement of the ascending aorta was successfully performed without postoperative neurologic deficit. PMID:24088494

Kappert, Utz; Ghazy, Tamer; Ouda, Ahmed; Hoffmann, Ralf-Thorsten; Simonis, Gregor; Matschke, Klaus

2013-10-01

222

Intrapericardial bronchogenic cyst adherent to the ascending aorta.  

PubMed

Bronchogenic cysts arise from an abnormal budding of the ventral diverticulum of the foregut or the tracheobronchial tree during embryogenesis. Pericardial location of these cysts is very rare. We describe a case of a young asymptomatic woman with an intrapericardial cystic mass compressing the right heart. Because of severe adhesions of the mass to the ascending aorta and to the right coronary artery, these structures were injured during surgical resection requiring the replacement of the ascending aorta and a coronary artery by-pass graft. Only the histopathologic findings provided the final diagnosis. PMID:22252329

Durieux, Rodolphe; Lavigne, Jean-Paul; Scagnol, Irène; Defraigne, Jean-Olivier

2014-03-01

223

Dietary Ecology of Murinae (Muridae, Rodentia): A Geometric Morphometric Approach  

PubMed Central

Murine rodents represent a highly diverse group, which displays great ecological versatility. In the present paper we analyse the relationship between dental morphology, on one hand, using geometric morphometrics based upon the outline of first upper molar and the dietary preference of extant murine genera, on the other. This ecomorphological study of extant murine rodents demonstrates that dietary groups can be distinguished with the use of a quantitative geometric morphometric approach based on first upper molar outline. A discriminant analysis of the geometric morphometric variables of the first upper molars enables us to infer the dietary preferences of extinct murine genera from the Iberian Peninsula. Most of the extinct genera were omnivore; only Stephanomys showed a pattern of dental morphology alike that of the herbivore genera.

Gomez Cano, Ana Rosa; Hernandez Fernandez, Manuel; Alvarez-Sierra, M. Angeles

2013-01-01

224

JAMA Patient Page: Abdominal Paracentesis  

MedlinePLUS

... blood pressure • Localized infection at the puncture site • Abdominal wall blood clots or bruises • Bleeding • Injury to organs in the abdomen Downloaded From: http://jama.jamanetwork.com/ by a ...

225

Management of functional abdominal pain  

Microsoft Academic Search

Opinion statement  The diagnosis of functional abdominal pain should be made based on the Rome II symptom criteria with only limited testing\\u000a to exclude other disease. During physical examination the clinician may look for evidence of pain behavior which would be\\u000a supportive of the diagnosis. Reassurance and proper education regarding the clinical entity of functional abdominal pain is\\u000a critical for successful

Yuri A. Saito; Jean C. Fox

2004-01-01

226

Low prevalence of abdominal aortic aneurysm in the Seychelles population aged 50 to 65 years.  

PubMed

The prevalence of abdominal aortic aneurysm (AAA) and its risk factors are well known in Western countries but few data are available from low- and middle- income countries. We are not aware of systematically collected population- based data on AAA in the African region. We evaluated the prevalence of AAA in a population- based cardiovascular survey conducted in the Republic of Seychelles in 2004 (Indian Ocean, African region). Among the 353 participants aged 50 to 64 years and screened with ultrasound, the prevalence of AAA was 0.3% (95% CI: 0- 0.9) and the prevalence of ectatic dilatations of the abdominal aorta was 1.5% (95% CI: 0.2- 2.8). The prevalence of AAA in the general population seemed lower in Seychelles than in Western countries, despite a high prevalence in Seychelles of risk factors of AAA, such as smoking (in men), high blood pressure and hypercholesterolaemia. PMID:23612948

Yerly, Patrick; Madeleine, George; Riesen, Walter; Bovet, Pascal

2013-03-01

227

Treatment of suprarenal abdominal aortic stump rupture using a modified stent graft.  

PubMed

Suprarenal abdominal aortic rupture cannot be repaired using a conventional covered stent without branches because it is necessary to reconstruct the visceral arteries. Traditional open aortic repair is associated with relatively high perioperative mortality and morbidity rates. We present a patient with a history of thoracoabdominal aortic pseudoaneurysm that had been treated with bypass grafting from the thoracic aorta to the left common iliac artery 5 months earlier. The patient presented with rupture of the suprarenal abdominal aortic stump. He was successfully treated by placement of a modified stent graft using a hybrid technique, which decreased the difficulty of operation and avoided serious postoperative complications. This hybrid method, which has not previously been reported, highlights the usefulness of vascular surgeons having experience in both open and endovascular techniques. PMID:24365077

Hai, Feng; Xueming, Chen; Zhe, Zhang; Chenyu, Li; Bin, Liu; Zhiwen, Zhang

2014-07-01

228

[Crisis management in abdominal surgery].  

PubMed

During an abdominal surgery, life-threatening events such as severe bradycardia and massive hemorrhage may occur. Reflex bradycardia may arise with surgical manipulation of abdominal contents. Anesthetic agents such as propofol or remifentanil increase the risk of bradycardia. Epidural analgesia using local anesthetics during an abdominal surgery also increases the occurrence of bradycardia and hypotension. Combination of these three factors causes severe bradycardia during the abdominal surgery. Anesthesiologist has to pay close attention to heart rate during the abdominal surgery. The surveillance of Anesthesia-Related Critical Incidents in Japan conducted by Japan Society of Anesthesiologist (JSA) shows that life-threatening events due to hemorrhage during abdominal surgery accounted for 43.9% of all perioperative life-threatening events due to hemorrhage. When we find critical hemorrhage, we have to manage the condition in accordance with "The guideline for critical intraoperative hemorrhage" published by JSA and the Japan Society of Transfusion Medicine and Cell Therapy. The pneumoperitoneum required for laparoscopy induces physiologic changes that complicate anesthetic management and could cause CO2-subcutaneous emphysema, pneumothorax, endobronchial intubation, and gas embolism. During laparoscopy, blood pressure, heart rate, electrocardiogram, end-tidal CO2, and oxygen saturation by pulse oximetry must be continuously monitored. PMID:19462794

Suzuki, Akira; Sato, Shigehito

2009-05-01

229

Abdominal Radical Trachelectomy  

PubMed Central

Objective Abdominal radical trachelectomy (ART) is one of the fertility-sparing procedures in women with early-stage cervical cancer. The published results of ART, in comparison with vaginal radical trachelectomy, so far are limited. Materials and Methods This retrospective study comprises all cases of female patients referred to ART with early-stage cervical cancer from 2 gynecologic oncology centers in Romania. Results A total of 29 women were referred for ART, but subsequently, fertility could not be preserved in 3 of them. Eleven women had stage IA2 disease (42.3%), 14 (53.8%) women had stage IB1 disease, and 1 (3.8%) woman had stage IB2 disease. Histologic subtypes were 15 (57.6%) squamous, 8 (30.7%) adenocarcinoma, and 3 (11.5%) adenosquamous. There were no major intraoperative complications in both hospitals. Early postoperative complications were mainly related to the type C parametrectomy—bladder dysfunction for more than 7 days (8 [30.7%] women) and prolonged constipation (6 [23.0%] women). Other complications consisted in symptomatic lymphocele in 2 (7.6%) patients, which were drained. Median follow-up time was 20 months (range, 4–43 months). Up to the present time, there has been 1 (3.8%) recurrence in our series. Most patients did not experience late postoperative complications. Three (11.5%) women are amenorrheic, and 1 (3.8%) woman developed a cervical stenosis. Of the 23 women who have normal menstruation and maintained their fertility, a total of 7 (30.4%) women have attempted pregnancy, and 3 (42.8%) of them achieved pregnancy spontaneously. These pregnancies ended in 2 first trimester miscarriages and 1 live birth at term by cesarean delivery. Conclusions Our results demonstrate that ART preserves fertility and maintains excellent oncological outcomes with low complication rates.

Capilna, Mihai Emil; Ioanid, Nicolae; Scripcariu, Viorel; Gavrilescu, Madalina Mihaela; Szabo, Bela

2014-01-01

230

Direct pharmacological comparison of the muscarinic receptors mediating relaxation and contraction in the rabbit thoracic aorta  

Microsoft Academic Search

The purpose of the present studies was to directly compare the pharmacology of the muscarinic cholinergic receptors coupled to carbachol-induced relaxation and contraction of the intact and the endothelium-denuded rabbit thoracic aorta, respectively. The order of potencies of agonists for producing relaxation in the intact aorta was similar to that for producing contraction in the denuded aorta. In both preparations,

Barry D. Sawyer; Frank P. Bymaster; David O. Calligaro; Julie Falcone; Charles H. Mitch; John S. Ward; Celia Whitesitt; Harlan E. Shannon

1999-01-01

231

Elastic properties and Windkessel function of the human aorta  

Microsoft Academic Search

An understanding of the role of the aortic elastic properties indicates their relevance at several sites of cardiovascular function. Acting as an elastic buffering chamber behind the heart (the Windkessel function), the aorta and some of the proximal large vessels store about 50% of the left ventricular stroke volume during systole. In diastole, the elastic forces of the aortic wall

Gustav G. Belz

1995-01-01

232

Surgical exclusion of postsurgical pseudoaneurysm of the ascending aorta  

PubMed Central

Pseudoaneurysm of ascending aorta after cardiac surgery is rare in children. We report a case of successful surgical exclusion of ascending aortic pseudoaneurysm in a 15-year-old boy. The neck of the aneurysm was in close proximity to the right coronary artery (RCA).

Barik, Ramachandra; Patnaik, Amar Narayana; Kumar, Ravintula Venkata; Mohapatra, Rudra Prasad; Medep, Vikas; Nemani, Lalita

2014-01-01

233

Development of a Left Ventricle-To-Aorta Assist Device.  

National Technical Information Service (NTIS)

A left ventricular assist device (LVAD) has been developed and evaluation has been made of the short-and long-term physiological effects of the device. The LVAD is a double-valve pump interposed between the left ventricular apex and the descending aorta. ...

W. F. Bernard C. G. LaFarge W. J. Bornhorst

1971-01-01

234

ACR Appropriateness Criteria® pulsatile abdominal mass, suspected abdominal aortic aneurysm.  

PubMed

Clinical palpation of a pulsating abdominal mass alerts the clinician to the presence of a possible abdominal aortic aneurysm (AAA). Generally an arterial aneurysm is defined as a localized arterial dilatation ?50% greater than the normal diameter. Imaging studies are important in diagnosing the cause of a pulsatile abdominal mass and, if an AAA is found, in determining its size and involvement of abdominal branches. Ultrasound (US) is the initial imaging modality of choice when a pulsatile abdominal mass is present. Noncontrast computed tomography (CT) may be substituted in patients for whom US is not suitable. When aneurysms have reached the size threshold for intervention or are clinically symptomatic, contrast-enhanced multidetector CT angiography (CTA) is the best diagnostic and preintervention planning study, accurately delineating the location, size, and extent of aneurysm and the involvement of branch vessels. Magnetic resonance angiography (MRA) may be substituted if CT cannot be performed. Catheter arteriography has some utility in patients with significant contraindications to both CTA and MRA. The American College of Radiology Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:22644671

Desjardins, Benoit; Dill, Karin E; Flamm, Scott D; Francois, Christopher J; Gerhard-Herman, Marie D; Kalva, Sanjeeva P; Mansour, M Ashraf; Mohler, Emile R; Oliva, Isabel B; Schenker, Matthew P; Weiss, Clifford; Rybicki, Frank J

2013-01-01

235

Dimensions of the ascending aorta in conotruncal heart defects.  

PubMed

Dilatation of the ascending aorta is an important sequel in conotruncal anomalies, such as tetralogy of Fallot (TOF) or d-transposition of the great arteries (TGA). We measured dimensions and their progression at different levels of the ascending aorta in 80 patients. In TOF patients, mean z-score for aortic annulus was 1.65 (range -3.16-6.47), for sinus 1.93 (range -2.28-5.39), for st-junction 4.15 (range 0.0-8.18), and for ascending aorta 3.51 (range -1.23-6.36). Over time, annulus z-scores increased in the univariate analysis [0.07/year, 95 % confidence interval (CI) 0.01-0.14; p = 0.02], and this was unique to male patients (0.08/year, 95 % CI 0.00-0.15; p = 0.05). z-scores of the ascending aorta decreased (-0.1/year, 95 % CI -0.18 to -0.02; p = 0.02), and this was confined to patients without aortic regurgitation (AR; -0.09/year, 95 % CI -0.18 to -0.01; p = 0.04). In TGA, mean z-score for the aortic annulus was 2.13 (range -3.71-8.39), for sinus 1.77 (range -3.04-6.69), for st-junction 1.01 (range -5.44-6.71), and for ascending aorta 0.82 (range -4.91-6.46). In bivariate analysis, annulus z-scores decreased in females (-0.14/year, 95 % CI -0.25 to -0.03; p = 0.01) and in patients without AR (-0.07/year, 95 % CI -0.14-0.0; p = 0.03). z-scores of the ascending aorta increased significantly in males (0.08/year, 95 % CI 0.0 to 0.16; p = 0.05) and in patients with AR (0.12/year, 95 % CI 0.03-0.21; p = 0.01). In conclusion, TOF and TGA z-scores of the ascending aorta differ significantly from those of the normal population. Progression of z-scores over time is influenced by diagnosis, sex, and presence of AR. PMID:24469005

Trippel, Amedeo; Pallivathukal, Sabine; Pfammatter, Jean-Pierre; Hutter, Damian; Kadner, Alexander; Pavlovic, Mladen

2014-06-01

236

The novel phenylpropiophenone derivates induced relaxation of isolated rat aorta.  

PubMed

Our aim was to define how different chemical properties of newly developed phenylpropiophenone derivates (PhPds) influenced their potency and efficacy to relax rat aorta. A contribution of ion channels in the PhPds and propafenone mechanism of vasodilatation was tested. PhPds were syntethysed by substitution in the benzyl moiety with -F, -CH3 or -CF3 groups on the ortho or para position. The vasodilatation by PhPds was examined on the rings of rat aorta precontracted with phenylephrine. In order to test involvement of voltage-gated Na+ and K+ channels and L-type Ca2+ channels in a mechanism of action of PhPds, we used their blockers: lidocaine, nifedipine and 4-aminopiridine, respectively. Aorta was more sensitive to 5-ortho-trifluoromethyl derivate than to propafenone and other PhPds. The 5-para-methyl derivate had lower potency and efficacy than propafenone and other PhPds. Lidocaine did not influenced relaxation induced by PhPds, but slightly inhibited the effect of propafenone. The 4-aminopiridine only inhibited relaxation induced by 5-para-methyl derivate. Nifedipine inhibited relaxation of the rat aorta induced by 5-ortho-trifluoromethyl derivate and by propafenone. Introduction of 5-ortho-trifluoromethyl and 5-para-methyl group in the benzyl moiety of propafenone molecule changed its potency, efficacy and mechanism of action in the rat aorta. The 4-aminopiridine- and nifedipine sensitive ion channels are involved in mechanism of action of 5-para-methyl and 5-ortho-trifluoromethyl derivate. The introduction of other tested groups in the benzyl moiety does not affect pharmacological properties of the PhPds in relation to propafenone. PMID:22628063

Ivkovi?, B; Vladimirov, S; Novakovi?, R; Cupi?, V; Heinle, H; Gojkovi?-Bukarica, L

2012-07-01

237

Methodologic aspects of acetylcholine-evoked relaxation of rabbit aorta.  

PubMed

The acetylcholine-evoked relaxation of rabbit isolated thoracic aorta precontracted by phenylephrine was studied. Phenylephrine caused a steady contraction that was maintained for 6 h. In the presence of calcium disodium ethylenediaminetetraacetate (EDTA) and ascorbic acid the contraction decreased with time. N(G)-Nitro-L-arginine abolished the inhibitory effect of EDTA and ascorbic acid. Acetylcholine evoked a rapid concentration-dependent relaxation that recovered spontaneously and slowly, but fully, with time. Relaxation evoked by equieffective concentrations of carbachol and acetylcholine had the same time course. Cumulative addition of acetylcholine (10(-7)-3 x 10(-5) M) caused a marked relaxation that was reverted slightly at high concentrations. The relaxation was the same with rings derived from the upper, middle, and lower part of the thoracic aorta. Two consecutive concentration-response curves for acetylcholine obtained at a 2-h interval demonstrated a slight development of tachyphylaxis. The relaxation was inversely related to precontractile tension evoked by phenylephrine when expressed as a percentage, but independent when expressed as g tension. Storage of aorta in cold salt solution for 24 h did not alter the relaxation. EDTA and ascorbic acid did not alter the relaxation. It is concluded that (1) EDTA and ascorbic acid can not be used with impunity to stabilize catecholamines used as preconstriction agents; (2) the reversal of the acetylcholine-evoked relaxation is not due to hydrolysis of acetylcholine; (3) the relaxation is uniform in all segments of thoracic aorta; (4) cold storage of aorta does not alter the relaxation; and (5) acetylcholine releases the same amount of relaxing factor, irrespective of the precontractile tension. PMID:10691020

Hansen, K; Nedergaard, O A

1999-08-01

238

Marfan syndrome. Demonstration of abnormal elastin in aorta.  

PubMed Central

Aortae from three patients with classic presentation of Marfan syndrome, who died of vascular complications, were subjected to biochemical analyses of the connective tissue; for comparison, aortae from eight age-matched controls, without evidence of connective tissue abnormalities, were examined. Elastin was prepared from the aortae by two techniques. First, the tissues were extracted with 5 M guanidine-HCl, bacterial collagenase digestion and reduction with dithiothreitol (elastin I preparation). Secondly, this material was further purified by extraction with 0.1 M NaOH at 99 degrees C (elastin II preparation). Amino acid analyses of both elastin preparations indicated that the values for desmosine and isodesmosine were reduced in Marfan cases to approximately one-half of the control values. A corresponding increase in lysyl residues was noted in elastin II preparations. Also, the concentration of elastin per milligram dry weight of tissue was reduced in Marfan cases. The hydroxyproline content of elastin was increased in two cases with the Marfan syndrome. Recoveries indicated that the alkali treatment solubilized 46.2% of the elastin I preparations in Marfan aortae compared with 23.7% in controls. In contrast to elastin, the concentration and solubility of collagen were unchanged; the amino acid composition and the genetic types of insoluble collagen isolated by limited pepsin proteolysis were the same in both Marfan and control aortae. The results of our study demonstrate that the cross-linking of aortic elastin is reduced in the three patients with Marfan syndrome. Thus, a defect in elastin could explain the vascular fragility observed clinically in these patients. Images

Abraham, P A; Perejda, A J; Carnes, W H; Uitto, J

1982-01-01

239

Statins Reduce Extensive Aortic Atheromas in Patients with Abdominal Aortic Aneurysms  

PubMed Central

Objective: Statins have been used widely to reduce dyslipidemia and recently have been reported to have pleiotropic effects such as plaque reduction and stabilization. This study retrospectively evaluated the regression of extensive thoracic atheromas (“shaggy aorta”) in abdominal aortic aneurysm (AAA) patients who underwent contrast-enhanced computed tomography (CECT) before and after statin administration. Materials and Methods: CECT was used to examine thoracic aortas of 29 patients (statin group; n = 22, non-statin group; n = 7) with extensive atheromas from the ostium of the left subclavian artery to that of the more proximal renal artery. Extensive thoracic atheroma was defined by: (1) thickness >5 mm, (2) involved circumference of thoracic aorta >50%, and (3) length >30 mm. The areas of atheroma (cm2) were measured before and after administration of statins, and the atheroma reduction ratio (ARR) was evaluated. Results: The area of atheroma decreased after administration of statins, and the ARR was significant (P <0.01). The ARR increased with all cases in non-statin group. No complications associated with extensive atheroma were observed during the follow-up period. Conclusion: This pilot study indicates statins can reduce extensive thoracic atheromas and lower lipid concentrations.

2013-01-01

240

Experimental unsteady flow study in a patient-specific abdominal aortic aneurysm model  

NASA Astrophysics Data System (ADS)

The velocity field in a patient-specific abdominal aneurysm model including the aorto-iliac bifurcation was measured by 2D PIV. Phase-averaged velocities obtained in 14 planes reveal details of the flow evolution during a cycle. The aneurysm expanding asymmetrically toward the anterior side of the aorta causes the generation of a vortex at its entrance, covering the entire aneurysm bulge progressively before flow peak. The fluid entering the aneurysm impinges on the left side of its distal end, following the axis of the upstream aorta segment, causing an increased flow rate in the left (compared to the right) common iliac artery. High shear stresses appear at the aneurysm inlet and outlet as well as along the posterior wall, varying proportionally to the flow rate. At the same regions, elevated flow disturbances are observed, being intensified at flow peak and during the deceleration phase. Low shear stresses are present in the recirculation region, being two orders of magnitude smaller than the previous ones. At flow peak and during the deceleration phase, a clockwise swirling motion (viewed from the inlet) is present in the aneurysm due to the out of plane curvature of the aorta.

Stamatopoulos, Ch.; Mathioulakis, D. S.; Papaharilaou, Y.; Katsamouris, A.

2011-06-01

241

Topographical and ultrastructural alterations of smooth muscle cells lining damaged rabbit aorta.  

PubMed Central

The notion that medial smooth muscle cells can be a source of neointima has been a subject of several recent publications. However, the morphological and topographical changes and the degree of thrombogenicity of these cells once they are lining the vessel wall have not been investigated. We were able to inflict a lesion on the rabbit abdominal aorta which resulted in the sloughing of the intima and several layers of the media. As a result, a layer of medial smooth muscle cells was exposed to the circulating blood. Each of these cells retained its characteristic myofilaments but underwent structural as well as topographical changes. The ribosomal elements were greatly increased and mitochondrial cristea obliterated. The cells were closely approximated, leaving no large gaps to permit escape of blood cells. The subjacent region of the lining cells was somewhat oedematous and the internal elastic lamina was absent. On the luminal surface of the lining cells, remnants of connective tissue fibres were not detected and the cell surface was free of platelets, fibrin strands or other formed elements of the blood. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6

Ts'ao, C. H.

1975-01-01

242

Morphometric analysis of Leydig cells in the normal rat testis  

Microsoft Academic Search

Leydig cells are thought to be the source of most, if not all, the testosterone produced by the testis . The goal of this study was to obtain quantitative infor- mation about rat Leydig cells and their organelles that might be correlated with pertinent physiological and biochemicaldata available either now or in the future . Morphometric analysis of Leydig cells

HIROSHI MORI; A. KENT CHRISTENSEN

1980-01-01

243

Morphometrical analysis of retinal hemorrhages in the shaken baby syndrome  

Microsoft Academic Search

A morphometrical analysis of retinal hemorrhages was performed in cases of physical child abuse including the shaken baby syndrome and in controls (severe head injury, intravital brain death, non-traumatic intracranial hemorrhage, SIDS including cardiopulmonary resuscitation). The extent of the retinal hemorrhages was significantly different between both groups. In all cases of physical child abuse, massive retinal hemorrhages in at least

P. Betz; K. Püschel; E. Miltner; E. Lignitz; W. Eisenmenger

1996-01-01

244

The mammalian renal pelvis: Physiological implications from morphometric analyses  

Microsoft Academic Search

Morphometric analyses have been used to study the renal pelvises of four common rodents: laboratory rat (R), hamster (H), gerbil (M), sand rat (P). Measurements on photographs of serial sections were used to determine the 1) area of the outer kidney surface, 2) surface area of each kidney zone and hilum facing the pelvic space, 3) volume of the pelvic

Eric R. Lacy

1980-01-01

245

Potential of P40 plastination for morphometric hip measurements  

Microsoft Academic Search

Total hip replacement has become one of the most successful surgical operations over the past 25 years. The duration of a total hip prosthesis depends on primary stability, and many studies have tried precisely to evaluate hip joint morphology to obtain excellent contact between bone and prosthetic component. This study performed a morphometric analysis of the human hip joint using, for

B. Genser-Strobl; M. C. Sora

2005-01-01

246

A geometric morphometric analysis of hominin upper first molar shape  

Microsoft Academic Search

Recent studies have revealed interesting differences in upper first molar morphology across the hominin fossil record, particularly significant between H. sapiens and H. neanderthalensis. Usually these analyses have been performed by means of classic morphometric methods, including the measurement of relative cusp areas or the angles defined between cusps. Although these studies have provided valuable information for the morphological characterization

A. Gómez-Robles; M. Martinón-Torres; J. M. Bermúdez de Castro; A. Margvelashvili; M. Bastir; J. L. Arsuaga; A. Pérez-Pérez; F. Estebaranz; L. M. Martínez

2007-01-01

247

Morphometric Evaluation of Preeclamptic Placenta Using Light Microscopic Images  

PubMed Central

Deficient trophoblast invasion and anomalies in placental development generally lead to preeclampsia (PE) but the inter-relationship between placental function and morphology in PE still remains unknown. The aim of this study was to evaluate the morphometric features of placental villi and capillaries in preeclamptic and normal placentae. The study included light microscopic images of placental tissue sections of 40 preeclamptic and 35 normotensive pregnant women. Preprocessing and segmentation of these images were performed to characterize the villi and capillaries. Fisher's linear discriminant analysis (FLDA), hierarchical cluster analysis (HCA), and principal component analysis (PCA) were applied to identify the most significant placental (morphometric) features from microscopic images. A total of 10 morphometric features were extracted, of which the villous parameters were significantly altered in PE. FLDA identified 5 highly significant morphometric features (>90% overall discrimination accuracy). Two large subclusters were clearly visible in HCA based dendrogram. PCA returned three most significant principal components cumulatively explaining 98.4% of the total variance based on these 5 significant features. Hence, quantitative microscopic evaluation revealed that placental morphometry plays an important role in characterizing PE, where the villous is the major component that is affected.

Mukherjee, Rashmi

2014-01-01

248

Abdominal muscle training in sport.  

PubMed Central

This paper evaluates several abdominal exercises, and highlights factors which are important for their safe prescription and effective use. The function of the abdominal muscles and hip flexors is considered, and the importance of the infra-umbilical portion of the rectus abdominis is emphasized. The effects of flexion on the lumbar spine are outlined. The trunk curl, sit-up, and straight leg raise are analysed, together with modifications of these exercises. The effect of foot fixation and hip flexion during the performance of the sit-up is discussed. The sit-up performed with foot fixation, and the bilateral straight leg raise can compound hip muscle imbalance, and both hyperextend and hyperflex the lumbar spine and are therefore not recommended. The importance of muscular control of pelvic tilt is considered with reference to muscle imbalance around the pelvis. It is recommended that a musculoskeletal assessment should be performed before prescribing abdominal exercises. Exercise therapy to re-educate control of pelvic tilt is described. Intra-abdominal pressure, and the effects of abdominal exercise on this mechanism, and lumbar stabilization are examined. The importance of training specificity is stressed.

Norris, C M

1993-01-01

249

Bridging circuit for the resection of retroperitoneal sarcoma involving the aorta and the IVC- veno-venous to veno-arterial perfusion.  

PubMed

A 50-year-old female underwent surgery for removal of a massive retroperitoneal sarcoma (RPS) involving the right hepatic lobe and the inferior vena cava (IVC), abdominal aorta, right lung, right hemi-diaphragm and pericardium. Resection of the RPS necessitated cross-clamping of the abdominal aorta, IVC and the hepatic artery. Cross-clamp time cannot be predicted prior to tumour resection and vascular re-construction. To prevent complications of prolonged cross-clamp time and distal hypo-perfusion, circulatory support was sought to facilitate the procedure. A perfusion circuit was designed to accommodate an easy and immediate redirection of blood flow from venovenous bypass (VVB) to veno-arterial bypass (VAB) without requiring a change of circuit and with minimum heparin administration. Furthermore, this circuit provides the added safety of an oxygenator and a heat-exchanger. Utilising the circuit enabled successful resection of the RPS. The patient was discharged from the intensive care unit (ICU) seven days later without any post-operative complications. This case report of a design of a perfusion circuit for the resection of RPS made use of a perfusion approach that had not previously been described and allowed for a reduction in the duration of ischaemic time and retroperitoneal bleeding. PMID:18788220

Miraziz, R; Hines, L; Brouwer, M; Steel, R; Klineberg, P

2008-01-01

250

Influence of Tribulus terrestris extract on lipid profile and endothelial structure in developing atherosclerotic lesions in the aorta of rabbits on a high-cholesterol diet.  

PubMed

The aim of this study was to investigate the pleotropic effects of an extract of a traditional herb, Tribulus terrestris (TT), on the lipid profile and vascular endothelium of the abdominal aorta in New Zealand rabbits fed a cholesterol-rich diet. Eighteen rabbits were randomly divided into three groups (n=6 for each). One experimental group (EG-I) was given a cholesterol-rich diet, a second experimental group (EG-II) was treated with TT following a cholesterol-rich diet, and a control group (CG) was fed a standard diet. Blood samples were collected on day 0 and then at weeks 4 and 12 to determine total serum cholesterol (TC), high density lipid-cholesterol (HDL-C), low density lipid-cholesterol (LDL-C) and triglyceride (TG) levels. Tissues were collected from the abdominal aorta for immunohistochemistry and transmission and scanning electron microscopy. In EG-II, the serum lipid profile was significantly lower than that of EG-I at week 12 with a reduction of TC: 65%; LDL-C: 66%; HDL-C: 64%; TG: 55%. Ultrastructural analysis revealed that endothelial damage was more prominent in EG-I compared to EG-II. The ruptured endothelial linings and damaged cellular surfaces increased in EG-I compared to EG-II. Our data indicate that dietary intake of TT can significantly lower serum lipid profiles, decrease endothelial cellular surface damage and rupture and may partially repair the endothelial dysfunction resulting from hyperlipidemia. PMID:19269683

Tuncer, M Altug; Yaymaci, Bengi; Sati, Leyla; Cayli, Sevil; Acar, Goksemin; Altug, Tuncay; Demir, Ramazan

2009-01-01

251

Results of 256 consecutive abdominal aortic aneurysm repairs using extraperitoneal approach.  

PubMed

Two hundred and fifty-six consecutive abdominal aortic aneurysms were repaired using three approaches for extraperitoneal exposure of the aorta and iliac vessels from February 1990 through September 1998. The perioperative mortality rate was 3.1% in 228 elective repairs and 14.3% in 28 ruptured cases. The initial 23 cases were repaired using Sicard's method. The duration of endotracheal intubation was 1.0+/-2.8 h, alimentation initiation was 2.7+/-1.6 days, and narcotic requirements were 1.2+/-1.1 times. Following these initial cases, we employed Williams' method for 192 abdominal aneurysms, however; repeated incisional pain and three cases of deforming bulge led us to avoid dividing muscles. In the last 13 cases, our approach was performed without muscle dividing. The narcotic requirements decreased to 0.3+/-0.7 times. As for postoperative complications, the larger skin incision approach had no shower embolism. However, the shorter skin incision had four cases of shower embolisms, one lymphorrhea and one vascular trauma by the aortic clamp. The extraperitoneal approach offers certain physiologic advantages with minimal disturbance of gastrointestinal and respiratory function. We believe that this method is useful for rapid approach to the proximal aorta in case of emergency. Postoperative wound complications could be prevented via an oblique incision without muscle dividing. PMID:11336848

Igari, T; Hoshino, S; Iwaya, F; Satokawa, H; Midorikawa, H; Takase, S; Hoshino, Y

2001-06-01

252

The spontaneous course of small abdominal aortic aneurysms. Aneurysmal growth rates and life expectancy.  

PubMed

Since abdominal ultrasonography has become a routine diagnostic procedure, increasing numbers of small asymptomatic abdominal aortic aneurysms are detected incidentally. Of 128 patients (108 male, 20 female) with abdominal aortic aneurysms, 96 patients were observed clinically and by repeated ultrasound studies for an average of 3.47 years, adding up to a total observation period of 333 patient-years. Among these 96 patients, 72 had small aneurysms (averaged diameters less than 5 cm). Three of them were lost to follow up. None of the remaining 69 patients died from rupture, 20 died from other causes and 8 patients were successfully operated. Of the patients with a large aneurysm one was lost to follow up. Five patients of the remaining 23 died as a result of rupture, 7 were successfully operated. The average growth rate of small aneurysms was 0.18 cm/year, whereas the larger aneurysms showed a growth rate of 0.28 cm/year (diameter). The survival rate of patients with small aneurysms was 94% after one year, 80% after 3 years, and 73% after 5 years, indicating that life expectancy is reduced in patients with an aneurysm of the abdominal aorta, but not because of complications of the aneurysm. PMID:1749201

Zöllner, N; Zoller, W G; Spengel, F; Weigold, B; Schewe, C K

1991-09-16

253

MicroRNA expression signature in human abdominal aortic aneurysms  

PubMed Central

Background Abdominal aortic aneurysm (AAA) is a dilatation of the aorta affecting most frequently elderly men. Histologically AAAs are characterized by inflammation, vascular smooth muscle cell apoptosis, and extracellular matrix degradation. The mechanisms of AAA formation, progression, and rupture are currently poorly understood. A previous mRNA expression study revealed a large number of differentially expressed genes between AAA and non-aneurysmal control aortas. MicroRNAs (miRNAs), small non-coding RNAs that are post-transcriptional regulators of gene expression, could provide a mechanism for the differential expression of genes in AAA. Methods To determine differences in miRNA levels between AAA (n?=?5) and control (n?=?5) infrarenal aortic tissues, a microarray study was carried out. Results were adjusted using Benjamini-Hochberg correction (adjusted p?

2012-01-01

254

Phosphorylation of AKT and abdominal aortic aneurysm formation.  

PubMed

It is hypothesized that differential AKT phosphorylation between sexes is important in abdominal aortic aneurysm (AAA) formation. Male C57BL/6 mice undergoing elastase treatment showed a typical AAA phenotype (80% over baseline, P < 0.001) and significantly increased phosphorylated AKT-308 (p308) and total-AKT (T-AKT) at day 14 compared with female mice. Elastase-treated Raw cells produced increased p308 and significant amounts of matrix metalloproteinase 9 (MMP-9), and these effects were suppressed by LY294002 treatment, a known AKT inhibitor. Male and female rat aortic smooth muscle cells treated with elastase for 1, 6, or 24 hours demonstrated that the p308/T-AKT and AKT-Ser-473/T-AKT ratios peaked at 6 hours and were significantly higher in the elastase-treated cells compared with controls. Similarly, male cells had higher phosphorylated AKT/T-AKT levels than female cells. LY294002 also inhibited elastase-induced p308 formation more in female smooth muscle cells than in males, and the corresponding cell media had less pro-MMP-9. AKT siRNA significantly decreased secretion of pro-MMP-9, as well as pro-MMP-2 and active MMP-2 from elastase-treated male rat aortic smooth muscle cells. IHC of male mice AAA aortas showed increased p308, AKT-Ser-473, and T-AKT compared with female mice. Aortas from male AAA patients had a significantly higher p308/T-AKT ratio than female AAA tissues. These data suggest that AKT phosphorylation is important in the upstream regulation of MMP activity, and that differential phosphorylation may be important in sex differences in AAA. PMID:24332015

Ghosh, Abhijit; Lu, Guanyi; Su, Gang; McEvoy, Brendan; Sadiq, Omar; DiMusto, Paul D; Laser, Adriana; Futchko, John S; Henke, Peter K; Eliason, Jonathan L; Upchurch, Gilbert R

2014-01-01

255

Considerations in Abdominal Wall Reconstruction  

PubMed Central

Reconstruction of complex defects of the central abdomen is both challenging and technically demanding for plastic surgeons. Advancements in the use of pedicle and free tissue transfer along with the use of bioprosthetic and synthetic meshes have provided for novel approaches to these complex defects. Accordingly, detailed knowledge of abdominal wall and lower extremity anatomy in combination with insight into the design, implementation, and limitations of various flaps is essential to solve these complex clinical problems. Although these defects can be attributed to a myriad of etiologic factors, the objectives in abdominal wall reconstruction are consistent and include the restoration of abdominal wall integrity, protection of intraabdominal viscera, and the prevention of herniation. In this article, it is our goal to review pertinent anatomy, pre- and postoperative care regimens, and the various local, regional, and distant flaps that can be utilized in the reconstruction of these complex clinical cases of the central abdomen.

Sacks, Justin M.; Broyles, Justin M.; Baumann, Donald P.

2012-01-01

256

Abdominal radiation causes bacterial translocation  

SciTech Connect

The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

1989-02-01

257

Lap Pak for Abdominal Retraction  

PubMed Central

Retraction of the bowels during abdominal surgery is generally facilitated by the use of a combination of various retractors along with surgical towels or sponges. The use of surgical towels and sponges may lead to retained foreign bodies or adhesions. In addition, these towels and sponges often require manipulation during long surgical procedures. The ideal way to avoid these problems in abdominal surgery is to develop a technique for retraction of the abdominal contents that eliminates the requirement for these foreign bodies. This article presents the results of a small trial for Lap Pak (Seguro Surgical, Columbia, MD), a disposable radio-opaque device that is made of silicone and retracts the bowels in a cephalad orientation without the need for towels or sponges.

Sivarajan, Ganesh; Chang, Sam S; Fergany, Amr; Malkowicz, S. Bruce; Steinberg, Gary D; Lepor, Herbert

2012-01-01

258

Fibrolipomas masquerading as abdominal hernias.  

PubMed

A 15-year-old Caucasian girl presented to her general practitioner with a tender, irreducible mass in the paraumbilical region. On examination, two small masses could be felt. She was referred to general surgery. Ultrasound imaging and MRI were unremarkable. However, clinical suspicion suggested multiple areas of abdominal wall herniation. The patient was admitted for elective surgery to exclude herniation. At operation, three subcutaneous masses were found but with no evidence of abdominal wall herniation. Histopathology results from the specimens showed mature adipose tissue mixed with fibrous deposits. There was no evidence of malignancy. A diagnosis of fibrolipoma was given. PMID:24343803

Watson, Hannah Isabella; Saunders, Andrew John

2013-01-01

259

Abdominal bloating: pathophysiology and treatment.  

PubMed

Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

Seo, A Young; Kim, Nayoung; Oh, Dong Hyun

2013-10-01

260

Functional abdominal bloating with distention.  

PubMed

Ten to 25% of healthy persons experience bloating. It is particularly common in persons with the irritable bowel syndrome and constipation. While the cause of bloating remains unknown old explanations such as a excessive intestinal gas, exaggerated lumbar lordosis and psychiatric problems have been disproved. New suggestions include recent weight gain, weak or inappropriately relaxed abdominal muscles, an inappropriately contracted diaphragm and retained fluid in loops of distal small bowel. No treatment is of unequivocal benefit but a low FODMAPs diet, probiotics and the non-absorbable antibiotic rifaximin offer some hope. Treatment by weight loss, abdominal exercise, prokinetics and girdles need more study. PMID:22778978

Sullivan, Stephen Norman

2012-01-01

261

Penetrating abdominal injuries: management controversies  

PubMed Central

Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries.

Butt, Muhammad U; Zacharias, Nikolaos; Velmahos, George C

2009-01-01

262

Recurrent abdominal pain in children.  

PubMed

Eighty five children with recurrent abdominal pain(RAP) were studied. Organic cause was noticed in 70 cases and non-organic in 15 cases. Giardiasis was the commonest organic cause in 57 (67.0 percent), either alone or with other parasitic infestations. Other organic causes include gallstones (4.7 percent), urinary infections (4.7 percent), esophagitis/gastritis (3.5 percent) and abdominal tuberculosis (2.3 percent). Single parent, school phobia, sibling rivalry, RAP in other family members and nocturnal enuresis are significant factors associated with nonorganic causes PMID:12368527

Buch, Niyaz A; Ahmad, Sheikh Mushtaq; Ahmed, S Zubair; Ali, Syed Wazid; Charoo, B A; Hassan, Masood Ul

2002-09-01

263

Characterization of human aortic elastase found in patients with abdominal aortic aneurysms.  

PubMed

Recent evidence indicates that the homeostatic balance between elastase and antiprotease activity is altered in the infrarenal aorta of those patients with different types of aortic pathologic findings. The specific properties of elastase found in the aorta of patients with abdominal aortic aneurysms (AAA) are discussed herein. Activity of elastase extracted from ten pooled AAA specimens was observed when incubated with several inhibitors: 13.2 per cent for phenyl-suphonyl flouride (PSF); 43.3 per cent for ethylenediaminetetraacetic acid (EDTA); 77.7 per cent for pepstatin; 137.0 per cent for leupeptin, and 24.0 per cent for alpha-1-antitrypsin. Irreversible inhibition by PSF indicates that the elastase is a serine protease. The elastase is most likely not a metallo enzyme, since it had no absolute requirement for divalent cations as indicated by only partial inhibition by EDTA. Elastase activity is most likely not due to cathepsins B or D, since cathepsins are active in an acid pH and selectively inhibited by leupeptin and pepstatin. The pH curve revealed a maximum activity at pH 8.2 and elastase activity was significantly inhibited by alpha-1-antitrypsin in a dose response manner determining functional elastase activity. These data indicate that the elastase in the aorta of patients with an AAA has the exact properties of the serine elastase found in the smooth muscle cells of the aorta in rats. These results also confirm the critical role of alpha-1-antitrypsin in determining functional elastase activity. Smooth muscle cell regulation of elastin metabolism may be important in determining why some patients have AAA and others have occlusive aortic disease develop. PMID:3477880

Cohen, J R; Mandell, C; Wise, L

1987-10-01

264

[Atypical coarctation of the thoracic aorta caused by fibromuscular dysplasia].  

PubMed

Fibromuscular dysplasia is a non-inflammatory disease unrelated to atherosclerosis of the small and medium sized arterial walls, which often affects the renal and carotid arteries and occurs mainly in women. The authors report a case of atypical coarctation of the thoracic aorta due to fibromuscular dysplasia confirmed histologically in a 27 year old man. Arteriography was performed because of hypertension and asymmetry of blood pressure measurements and showed irregular stenosis of the aortic isthmus and of the origin of the left subclavian artery. Surgery comprised resection of the pathological segment of the aorta which was replaced by a prosthetic tube with reimplantation of the left subclavian artery. Histological examination showed fibromuscular dysplasia in perimedial areas and diffusely throughout the media. To the author's knowledge this is the first case to be reported in the medical literature. PMID:7646238

Sousa Uva, M; Bical, O; Voung, P N; Gigou, F; Foiret, J C; Braunberger, E; Vanetti, A

1994-09-01

265

MagnetoHemoDynamics in the aorta and electrocardiograms  

NASA Astrophysics Data System (ADS)

This paper addresses a complex multi-physical phenomenon involving cardiac electrophysiology and hemodynamics. The purpose is to model and simulate a phenomenon that has been observed in magnetic resonance imaging machines: in the presence of a strong magnetic field, the T-wave of the electrocardiogram (ECG) gets bigger, which may perturb ECG-gated imaging. This is due to a magnetohydrodynamic (MHD) effect occurring in the aorta. We reproduce this experimental observation through computer simulations on a realistic anatomy, and with a three-compartment model: inductionless MHD equations in the aorta, bi-domain equations in the heart and electrical diffusion in the rest of the body. These compartments are strongly coupled and solved using finite elements. Several benchmark tests are proposed to assess the numerical solutions and the validity of some modeling assumptions. Then, ECGs are simulated for a wide range of magnetic field intensities (from 0 to 20 T).

Martin, Vincent; Drochon, Agnès; Fokapu, Odette; Gerbeau, Jean-Frédéric

2012-05-01

266

Dual-Balloon Angioplasty of Recoarctation of the Aorta  

PubMed Central

Percutaneous balloon angioplasty is a successful method for treating recoarctation of the aorta after surgical repair. The procedure is usually performed with small balloons on 4 or 5 French (Fr) shafts (Gruentzig or Cook) in infants or large balloons on 8 or 9 Fr shafts (Meditech or Mansfield) in older children. In certain children, however, the 8 or 9 Fr shafts may be too large for insertion in the femoral artery, and the 4 or 5 Fr shafts may not carry a balloon large enough to effectively dilate the area of restenosis. We describe a case involving a 9-kg infant in whom recoarctation of the aorta was successfully treated with two small side-by-side balloon angioplasty systems. (Texas Heart Institute Journal 1987; 14:102-105) Images

Moore, John W.; Pearson, Clarence E.; Lee, Da Hae; Raybuck, Bryan

1987-01-01

267

Abdominal aortic aneurysm repair - open - discharge  

MedlinePLUS

AAA - open - discharge; Repair - aortic aneurysm - open - discharge ... You had open aortic aneurysm surgery to repair an aneurysm (a widened part) in your aorta, the large artery that carries blood to your ...

268

Vasorelaxing activity of resveratrol and quercetin in isolated rat aorta  

Microsoft Academic Search

1.1. Both resveratrol and quercetin dose-dependently inhibited the contractile response to noradrenaline (NA) in isolated endothelium-intact rat aorta. This inhibitory effect on vascular contraction was blocked by pretreatment of the blood vessel with the nitric oxide (NO) synthase inhibitor, L-NNA (1 ?M).2.2. Quereetin at a concentration >1 × 10?5M, and resveratrol at >3 × 10?5M, caused relaxation of the phenylephrine

Cora Ke Chen; Cecil R. Pace-Asciak

1996-01-01

269

Congenital Stridor: Unusual Manifestation of Coarctation of the Aorta  

Microsoft Academic Search

Coarctation of the aorta is a relatively common congenital condition. Most infantile presentations of aortic coarctation are\\u000a related to the associated congenital cardiac abnormalities leading to congestive heart failure or systemic hypoperfusion.\\u000a We describe a 4-month-old infant who presented with stridor as the sole manifestation of coarctation. Radiologic studies revealed\\u000a enlarged innominate artery due to the aortic coarctation that resulted

J. G. Park; M. E. Wylam

2006-01-01

270

Mesh erosion after abdominal sacrocolpopexy  

Microsoft Academic Search

Objective: To report our experience with erosion of permanent suture or mesh material after abdominal sacrocolpopexy.Methods: A retrospective chart review was performed to identify patients who underwent sacrocolpopexy by the same surgeon over 8 years. Demographic data, operative notes, hospital records, and office charts were reviewed after sacrocolpopexy. Patients with erosion of either suture or mesh were treated initially with

Neeraj Kohli; Peggy M Walsh; Todd W Roat; Mickey M Karram

1998-01-01

271

Abdominal manifestations of neurologic disorders.  

PubMed

A variety of disorders-including infectious, inflammatory, hereditary, and metabolic diseases-may affect both the brain and abdominal cavity, and the findings in one region may help establish the diagnosis or limit the differential diagnosis. Establishing an accurate early diagnosis enables clinicians to adequately manage these unusual diseases and potentially avert life-threatening complications. For example, an early diagnosis of Gardner syndrome enables annual sigmoid- or colonoscopy and ultrasonography. In many conditions, abdominal manifestations precede neurologic manifestations and may have prognostic significance. Patients with celiac disease more often present with abdominal manifestations such as duodenitis, slow transit time, reversal of the jejunal-ileal fold pattern, and transient small bowel intussusception than with intracranial manifestations. In other conditions, the neurologic manifestations may be the same as the presenting symptoms. For example, patients with Gardner syndrome may initially present with multiple mandibular or sinonasal osteomas. In addition, sarcoidosis may manifest with multifocal enhancing dural masses. Abdominal and neurologic manifestations may even occur simultaneously, as in several of the phakomatoses such as neurofibromatosis type 1, tuberous sclerosis complex, and von Hippel-Lindau syndrome. Ultimately, familiarity with the appearances of these conditions allows radiologists to pinpoint a diagnosis, even when imaging findings in either location are nonspecific. PMID:23322834

Bhavsar, Anil S; Verma, Sadhna; Lamba, Ramit; Lall, Chandana G; Koenigsknecht, Vincent; Rajesh, Arumugam

2013-01-01

272

Abdominal obesity and metabolic syndrome  

Microsoft Academic Search

Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease

Jean-Pierre Després; Isabelle Lemieux

2006-01-01

273

Aorta-Left Renal Vein Fistula in a Woman  

PubMed Central

Spontaneous rupture of an abdominal aortic aneurysm into a retroaortic left renal vein is an uncommon occurrence. A 55-year-old woman presented with shortness of breath, vomiting, and diffuse abdominal pain that had radiated to her back and legs for the preceding 10 days. A pulsatile abdominal mass, hematuria, renal insufficiency, and heart failure were present at the initial evaluation. Computed tomography showed an infrarenal abdominal aortic aneurysm that communicated with a retroaortic left renal vein. After urgent surgical repair, cardiac and renal function were dramatically improved. To the best of our knowledge, this is the 1st reported case of a woman with such a fistula. We review treatments reported in the literature.

Yagdi, Tahir; Atay, Yuksel; Engin, Cagatay; Ozbek, S. Sureyya; Buket, Suat

2004-01-01

274

Analysis of human aorta using fluorescence lifetime imaging microscopy (FLIM)  

NASA Astrophysics Data System (ADS)

The use of photonics has improved our understanding of biologic phenomena. For the study of the normal and pathologic architecture of the aorta the use of Two-Photon Excited Fluorescence (TPEF) and Second Harmonic Generation showed interesting details of morphologic changes of the elastin-collagen architecture during aging or development of hypertension in previous studies. In this investigation we tried to apply fluorescence lifetime imaging (FLIM) for the morphologic analysis of human aortas. The aim of our study was to use FLIM in non-stained formalin-fixed and paraffin-embedded samples of the aorta ascendants in hypertensive and normotensive patients of various ages, examining two different topographical regions. The FLIM-spectra of collagen and elastic fibers were clearly distinguishable, thus permitting an exact analysis of unstained material on the microscopic level. Moreover the FLIM spectrum of elastic fibers revealed variations between individual cases, which indicate modifications on a molecular level and might be related to FLIM age or diseases states and reflect modifications on a molecular level.

Vieira-Damiani, Gislaine; Adur, J.; Ferro, D. P.; Adam, R. L.; Pelegati, V.; Thomáz, A.; Cesar, C. L.; Metze, K.

2012-02-01

275

Endovascular Repair of Contained Rupture of the Thoracic Aorta  

SciTech Connect

Purpose: To assess the efficacy of stent-grafts for the treatment of acute rupture of the thoracic aorta. Methods: Four patients with acute contained ruptures of the thoracic aorta were treated by insertion of stent-grafts. The underlying aortic lesions were aneurysm, acute aortic ulcer, acute type B dissection and giant cell aortitis. The procedures were performed under general anesthesia in three patients and local anesthesia in one patient. Results: All stent-grafts were successfully deployed. All patients survived the procedure and are now alive and well at follow-up (mean 6.3 months, range 44 days-16 months). One patient underwent a second stent procedure 10 days after the first procedure because of a proximal endoleak. All hemothoraces have resolved. There were no complications. Conclusion:Treatment of acute contained ruptures of the thoracic aorta by the insertion of stent-grafts is feasible. The technical success rates,complication rates and patient survival compare favorably with emergency surgery.

Morgan, Robert [Department of Radiology, St. George's Hospital, Blackshaw Road, London SW17 0QT (United Kingdom); Loosemore, Tom [Department of Vascular Surgery, St. George's Hospital, Blackshaw Road, London SW17 0QT (United Kingdom); Belli, Anna-Maria [Department of Radiology, St. George's Hospital, Blackshaw Road, London SW17 0QT (United Kingdom)

2002-08-15

276

Multilayer material properties of aorta determined from nanoindentation tests  

PubMed Central

In a wide range of biomechanical modeling of aorta from traumatic injury to stent grafts, the arterial wall has been considered as a single homogeneous layer vessel, ignoring the fact that arteries are composed of distinct anatomical layers with different mechanical characteristics. In this study, using a custom-made nanoindentation technique, changes in the mechanical properties of porcine thoracic aorta wall in the radial direction were characterized using a quasi-linear viscoelastic model. Two layers of equal thickness were mechanically distinguishable in descending aorta based on the radial variations in the instantaneous Young's modulus E and reduced relaxation function G(t). Overall, comparison of E and G? of the outer half (70.27 ± 2.47 kPa and 0.35 ± 0.01) versus the inner half (60.32 ± 1.65 kPa and 0.33 ± 0.01) revealed that the outer half was stiffer and showed less relaxation. The results were used to explain local mechanisms of deformation, force transmission, tear propagation and failure in arteries.

Hemmasizadeh, Ali; Autieri, Michael; Darvish, Kurosh

2013-01-01

277

Hemodynamic Modeling of Surgically Repaired Coarctation of the Aorta  

PubMed Central

PURPOSE Late morbidity of surgically repaired coarctation of the aorta includes early cardiovascular and cerebrovascular disease, shortened life expectancy, abnormal vasomodulator response, hypertension and exercise-induced hypertension in the absence of recurrent coarctation. Observational studies have linked patterns of arch remodeling (Gothic, Crenel, and Romanesque) to late morbidity, with Gothic arches having the highest incidence. We evaluated flow in native and surgically repaired aortic arches to correlate respective hemodynamic indices with incidence of late morbidity. METHODS Three dimensional reconstructions of each remodeled arch were created from an anatomic stack of magnetic resonance (MR) images. A structured mesh core with a boundary layer was generated. Computational fluid dynamic (CFD) analysis was performed assuming peak flow conditions with a uniform velocity profile and unsteady turbulent flow. Wall shear stress (WSS), pressure and velocity data were extracted. RESULTS The region of maximum WSS was located in the mid-transverse arch for the Crenel, Romanesque and Native arches. Peak WSS was located in the isthmus of the Gothic model. Variations in descending aorta flow patterns were also observed among the models. CONCLUSION The location of peak WSS is a primary difference among the models tested, and may have clinical relevance. Specifically, the Gothic arch had a unique location of peak WSS with flow disorganization in the descending aorta. Our results suggest that varied patterns and locations of WSS resulting from abnormal arch remodeling may exhibit a primary effect on clinical vascular dysfunction.

Olivieri, Laura J; de Zelicourt, Diane A.; Haggerty, Christopher M.; Ratnayaka, Kanishka; Cross, Russell R; Yoganathan, Ajit P.

2011-01-01

278

Renal autotransplant for subsequent endovascular exclusion of the thoracoabdominal aorta.  

PubMed

In the last 20 years, endovascular procedures have radically altered the treatment of diseases of the aorta. The objective of endovascular treatment of dissections is to close the entry point to redirect blood flow toward the true lumen, thereby achieving thrombosis of the false lumen. In extensive chronic dissections that have evolved with the formation of a large aneurysm, the dissection is maintained from the end of the endoprosthesis due to multiple orifices, or reentries, that communicate with the lumens. In addition, one of the primary limitations of this technique is when the visceral arteries have disease involvement. In this report we present a case where, despite having treated the entire length of the descending thoracic aorta, the dissection was maintained distally, leading to progression of the diameter of the aneurysm. After reviewing the literature, and to the best of our knowledge, we describe the first case in which renal autotransplant was performed to allow for subsequent exclusion of the aorta at the thoracoabdominal level using a fenestrated endoprosthesis for the celiac trunk and the superior mesenteric artery. PMID:23993115

Espinosa, Gaudencio; Grochowicz, Lukasz; Pascual, Ignacio; Lavilla, Javier; Olavide, Isidro; Hernández, Miguel David; Landecho, Manuel Fortún; Lucena, Juan Felipe; Bastarrika, Gorka; Del Pozo, José Luis; Gavira, Juan José; Alegre, Félix

2013-10-01

279

Primary balloon dilatation of coarctation of the aorta in neonates.  

PubMed Central

Primary balloon dilatation of coarctation of the aorta was attempted in 10 consecutive neonates (age range 2-23 days). The coarctation site was crossed and the balloon inflated in all but one patient. In two patients with associated severe isthmal hypoplasia there was no change in the gradient after dilatation. In the remainder, the residual gradients were trivial and angiography showed complete relief of coarctation. Severe recoarctation developed 5-12 weeks after dilatation in five patients, each considered to have had an excellent initial result. The coarctation was rapidly progressive in three patients in whom Doppler studies within two weeks of the development of recoarctation had shown no significant gradient. In the other two patients progressive restenosis was charted by Doppler examinations over the course of 6-8 weeks. Three patients had a second, initially successful, dilatation procedure. One patient remained well with no residual gradient 18 weeks later. Stenosis recurred within eight weeks in the other two, and both have undergone successful surgical repair. Balloon dilatation of a native coarctation of the aorta gave excellent immediate results in most neonates. Severe isthmal hypoplasia is, however, a contraindication to balloon dilatation and early restenosis is an important problem. These results do not support the continued use of primary balloon dilatation of coarctation of the aorta in neonates. Images

Redington, A N; Booth, P; Shore, D F; Rigby, M L

1990-01-01

280

Abdominal pain - children under age 12  

MedlinePLUS

Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if s/he can describe it to you. Here are different kinds of pain: ...

281

Abdominal Wall Tumors and Their Reconstruction  

Microsoft Academic Search

\\u000a The abdominal wall protects and contains the abdominal viscera, and serves to position and stabilize the thorax and upper\\u000a body in space during movement. Components of the abdominal wall may be completely replaced if needed. The internal protective\\u000a function of the abdominal wall can be replaced with synthetic meshes, fascial flaps, or grafts. External skin can usually\\u000a be replaced with

Gregory A. Dumanian

282

Production and localization of 92-kilodalton gelatinase in abdominal aortic aneurysms. An elastolytic metalloproteinase expressed by aneurysm-infiltrating macrophages.  

PubMed Central

Abdominal aortic aneurysms (AAA) are characterized by disruption and degradation of the elastic media, yet the elastolytic proteinases involved and their cellular sources are undefined. We examined if 92-kD gelatinase, an elastolytic matrix metalloproteinase, participates in the pathobiology of AAA. Gelatin zymography of conditioned medium from normal, atheroocclusive disease (AOD), or AAA tissues in organ culture showed that all tissues produced 72-kD gelatinase. AOD and AAA cultures also secreted 92-kD gelatinase, but significantly more enzyme was released from AAA tissues. ELISA confirmed that AAA tissues released approximately 2-fold more 92-kD gelatinase than AOD tissue and approximately 10-fold more than normal aorta. Phorbol ester induced a 5.3-fold increase in 92-kD gelatinase secretion by normal aorta and AOD and an 11.5-fold increase by AAA. By immunohistochemistry, 92-kD gelatinase was not detected in normal aorta and was only occasionally seen within the neointimal lesions of AOD tissue. In all AAA specimens, however, 92-kD gelatinase was readily localized to numerous macrophages in the media and at the adventitial-medial junction. The expression of 92-kD gelatinase mRNA by aneurysm-infiltrating macrophages was confirmed by in situ hybridization. These results demonstrate that diseased aortic tissues secrete greater amounts of gelatinolytic activity than normal aorta primarily due to increased production of 92-kD gelatinase. In addition, the localization of 92-kD gelatinase to macrophages in the damaged wall of aneurysmal aortas suggests that chronic release of this elastolytic metalloproteinase contributes to extracellular matrix degradation in AAA. Images

Thompson, R W; Holmes, D R; Mertens, R A; Liao, S; Botney, M D; Mecham, R P; Welgus, H G; Parks, W C

1995-01-01

283

Production and localization of 92-kilodalton gelatinase in abdominal aortic aneurysms. An elastolytic metalloproteinase expressed by aneurysm-infiltrating macrophages.  

PubMed

Abdominal aortic aneurysms (AAA) are characterized by disruption and degradation of the elastic media, yet the elastolytic proteinases involved and their cellular sources are undefined. We examined if 92-kD gelatinase, an elastolytic matrix metalloproteinase, participates in the pathobiology of AAA. Gelatin zymography of conditioned medium from normal, atheroocclusive disease (AOD), or AAA tissues in organ culture showed that all tissues produced 72-kD gelatinase. AOD and AAA cultures also secreted 92-kD gelatinase, but significantly more enzyme was released from AAA tissues. ELISA confirmed that AAA tissues released approximately 2-fold more 92-kD gelatinase than AOD tissue and approximately 10-fold more than normal aorta. Phorbol ester induced a 5.3-fold increase in 92-kD gelatinase secretion by normal aorta and AOD and an 11.5-fold increase by AAA. By immunohistochemistry, 92-kD gelatinase was not detected in normal aorta and was only occasionally seen within the neointimal lesions of AOD tissue. In all AAA specimens, however, 92-kD gelatinase was readily localized to numerous macrophages in the media and at the adventitial-medial junction. The expression of 92-kD gelatinase mRNA by aneurysm-infiltrating macrophages was confirmed by in situ hybridization. These results demonstrate that diseased aortic tissues secrete greater amounts of gelatinolytic activity than normal aorta primarily due to increased production of 92-kD gelatinase. In addition, the localization of 92-kD gelatinase to macrophages in the damaged wall of aneurysmal aortas suggests that chronic release of this elastolytic metalloproteinase contributes to extracellular matrix degradation in AAA. PMID:7615801

Thompson, R W; Holmes, D R; Mertens, R A; Liao, S; Botney, M D; Mecham, R P; Welgus, H G; Parks, W C

1995-07-01

284

Automatic segmentation and co-registration of gated CT angiography datasets: measuring abdominal aortic pulsatility  

NASA Astrophysics Data System (ADS)

Purpose: To develop robust, novel segmentation and co-registration software to analyze temporally overlapping CT angiography datasets, with an aim to permit automated measurement of regional aortic pulsatility in patients with abdominal aortic aneurysms. Methods: We perform retrospective gated CT angiography in patients with abdominal aortic aneurysms. Multiple, temporally overlapping, time-resolved CT angiography datasets are reconstructed over the cardiac cycle, with aortic segmentation performed using a priori anatomic assumptions for the aorta and heart. Visual quality assessment is performed following automatic segmentation with manual editing. Following subsequent centerline generation, centerlines are cross-registered across phases, with internal validation of co-registration performed by examining registration at the regions of greatest diameter change (i.e. when the second derivative is maximal). Results: We have performed gated CT angiography in 60 patients. Automatic seed placement is successful in 79% of datasets, requiring either no editing (70%) or minimal editing (less than 1 minute; 12%). Causes of error include segmentation into adjacent, high-attenuating, nonvascular tissues; small segmentation errors associated with calcified plaque; and segmentation of non-renal, small paralumbar arteries. Internal validation of cross-registration demonstrates appropriate registration in our patient population. In general, we observed that aortic pulsatility can vary along the course of the abdominal aorta. Pulsation can also vary within an aneurysm as well as between aneurysms, but the clinical significance of these findings remain unknown. Conclusions: Visualization of large vessel pulsatility is possible using ECG-gated CT angiography, partial scan reconstruction, automatic segmentation, centerline generation, and coregistration of temporally resolved datasets.

Wentz, Robert; Manduca, Armando; Fletcher, J. G.; Siddiki, Hassan; Shields, Raymond C.; Vrtiska, Terri; Spencer, Garrett; Primak, Andrew N.; Zhang, Jie; Nielson, Theresa; McCollough, Cynthia; Yu, Lifeng

2007-03-01

285

Three-year-old female with abdominal distention: Overview of a rare abdominal tumor in childhood  

Microsoft Academic Search

Lipoblastoma is a rare benign neoplasm of fetal- embryonal fat tissue. Asymptomatic abdominal mass, progressive abdominal distension, and radiolucent fat density mass on computed tomography are the main diagnostic criteria. Our patient was a 3-year old female who had been noted by mom to have abdominal distention almost since birth. The patient seemed to be having progressive abdominal distention, but

Jill Flippin; John Pohl; David Easley; Donald Cooney; Jose Santiago; Ludvik Donner

286

Abdominal Compartment Syndrome in the Open Abdomen  

Microsoft Academic Search

Background: Multiple methods exist to manage in the intensive care unit the patient with an open abdomen. An increasingly common method is the vacuum packed technique. This method accommodates considerable ex- pansion of intra-abdominal contents and should obvi- ate the potential development of the abdominal com- partment syndrome (ACS). Despite this, some patients with these temporary abdominal dressings will go

Vicente H. Gracias; Benjamin Braslow; Jon Johnson; John Pryor; Rajan Gupta; Patrick Reilly; C. William Schwab

2002-01-01

287

Morphometric Characterization and Reconstruction Effect Among Lunar Impact Craters  

NASA Astrophysics Data System (ADS)

Impact craters on the lunar surface have a variety of morphometric characteristics that are very useful in understanding the evolutionary history of lunar landscape morphologies. Based on digital elevation model data and photographs from China's Chang'E-1 lunar orbiter, we develop morphologic parameters and quantitative methods for presenting the morphometric characteristics of impact craters, analyzing their relational distribution, and estimating the relative order of their formation. We also analyze features in profile where craters show signs of having formed on the edge of previously existing craters to show that superimposed impacts affect morphologic reconstructions. As a result, impact craters have significant effects on the reconstruction of ancient topography and the estimation of relative formation ages.

Cheng, Weiming; Wang, Jiao; Wan, Cong

2014-03-01

288

Morphometric Characterization and Reconstruction Effect Among Lunar Impact Craters  

NASA Astrophysics Data System (ADS)

Impact craters on the lunar surface have a variety of morphometric characteristics that are very useful in understanding the evolutionary history of lunar landscape morphologies. Based on digital elevation model data and photographs from China's Chang'E-1 lunar orbiter, we develop morphologic parameters and quantitative methods for presenting the morphometric characteristics of impact craters, analyzing their relational distribution, and estimating the relative order of their formation. We also analyze features in profile where craters show signs of having formed on the edge of previously existing craters to show that superimposed impacts affect morphologic reconstructions. As a result, impact craters have significant effects on the reconstruction of ancient topography and the estimation of relative formation ages.

Cheng, Weiming; Wang, Jiao; Wan, Cong

2014-05-01

289

Morphometric, geographic, and territorial characterization of brain arterial trees.  

PubMed

Morphometric information of the brain vascularization is valuable for a variety of clinical and scientific applications. In particular, this information is important when creating arterial tree models for imposing boundary conditions in numerical simulations of the brain hemodynamics. The purpose of this work is to provide quantitative descriptions of arterial branches, bifurcation patterns, shape, and geographical distribution of the arborization of the main cerebral arteries as well as estimations of the corresponding vascular territories. For this purpose, subject-specific digital reconstructions of the brain vascular network created from 3T magnetic resonance angiography images of healthy volunteers are used to derive population-averaged morphometric characteristics of the cerebral arterial trees. Copyright © 2014 John Wiley & Sons, Ltd. PMID:24470176

Mut, Fernando; Wright, Susan; Ascoli, Giorgio A; Cebral, Juan R

2014-07-01

290

Morphometric analysis of a subtropical Andean basin (Tucumán, Argentina)  

Microsoft Academic Search

A morphometric analysis was done to determine the drainage characteristics of Lules River basin using land-sat imageries and topographical maps. This catchment was divided into seven sub-basins for the analysis: Liquimayo, Hoyada, Ciénaga, De Las Tablas, Siambón, Potrerillo and San Javier. Yungas ecoregion covers almost all the watershed. The drainage patterns of the sub-basins are dendritic and parallel. The basin

L. M. Mesa

2006-01-01

291

Maternal cocaine abuse and fetal renal arteries: a morphometric study  

Microsoft Academic Search

The purpose of the present study was to evaluate the pathological findings and perform morphometric analysis of the renal\\u000a arteries of fetuses exposed to cocaine in utero. The control group consisted of 22 stillborn fetuses of unknown etiology whose\\u000a mothers’ urine was negative for cocaine or any other vasoactive substances. The study group comprised 29 stillborn fetuses\\u000a whose mothers’ urine

Subhash C. Mitra; Surya V. Seshan; Jose R. Salcedo; Joan Gil

2000-01-01

292

Morphometrics in the Study of Ediacaran Fossil Forms  

Microsoft Academic Search

\\u000a The evaluation of fossil shapes is the primary goal in the study of paleontology. Unlike biologists who are able to utilize\\u000a an animal’s behavior, soft tissue anatomy, and molecular make-up to study species, paleontologists must concentrate on phenotypical\\u000a approaches that rely on morphological differences between fossil populations. Morphometric methods which quantify form and\\u000a shape are extremely powerful tools for assessing

Marc Laflamme; Michelle M. Casey

293

Ruptured abdominal aortic aneurysm in a 24-year-old African woman. Unusual presentation--unknown aetiology.  

PubMed

Case report: 24-year-old black female presenting with progressive paralysis of the left lower limb. The clinical examination and investigations describe an extensive retroperitoneal mass. An exploratory laparotomy reveals a ruptured saccular infrarenal aortic aneurysm, a narrowing of the distal aorta and a complete obstruction of the left common iliac artery. The aneurysm was resected, an aortoiliac bypass and femorofemoral crossover bypass were performed, with success. The clinical presentation of this ruptured abdominal aneurysm is unusual. Its etiology is discussed: the findings are suggestive of Takayasu's disease. PMID:3766024

Sinzobahamvya, N; Afriyie, K; Shah, S; Emsens, L; Rankin, K C; Mbawa, N C

1986-01-01

294

Identification of Erosion Prone Areas by Morphometric Analysis Using GIS  

NASA Astrophysics Data System (ADS)

This study was undertaken to determine the priority watersheds for conservation of natural resources of the Haharo sub catchment in the Damodar catchment of upper Damodar valley area having an area of 565 km2 involving four watersheds in Jharkhand State in eastern India by morphometric analysis using topographical maps on a scale of 1:50,000. To define the morphometric features of the watershed, the topographic information of the study area at 1:50,000 scaled are taken for analysis with the help of GIS tools. The topographical information derived from this map is utilized for calculating parameters and fixing of priority of watershed for suggesting conservation measures. The parameters computed include the morphometric parameters like bifurcation ratio, drainage density, stream frequency, texture ratio, and three basin shape parameters i.e., form factor, circularity ratio, and elongation ratio. A rating was done for each of these parameters according to their value. Average of all these parameter for each watershed is calculated to determine the priority. Among the four watersheds 4/4 was the highest priority area where conservation measure has to be taken first then watershed 4/3. Watershed 4/1 was the medium priority area and watershed 4/2 was the low priority area.

Das, D.

2014-05-01

295

Regional morphometric and geomorphologic mapping of Martian landforms  

NASA Astrophysics Data System (ADS)

Initial mapping of the Martian surface, based on stratigraphic markers identified from Viking imagery, resulted in the demarcation of broad planetary scale geological zones. Recent advances in image resolution have established the presence of many smaller surface elements superposed on the older geological zones, thereby indicating younger surface morphologies that are in contradiction with the older mapping. Moreover, the stratigraphic mapping technique is subjective and relatively cumbersome because of its reliance on visual interpretation of images. In this paper a new analytical technique is developed which uses morphometric analysis of the Martian elevation map (MOLA data) to automate delineation and mapping of landforms at the regional scale. The analysis relies on altitude, local relief and local watershed clustering to delineate the landforms, and applies statistical clustering to identify structures with similar properties. As a case study, the technique is applied to Atlantis and Gorgonum basins. Comparison of the delineated features with landforms visible on high-resolution THEMIS images illustrates the accuracy of the morphometric technique in delineating and classifying surface structures, and also permits interpretation of the origin and evolution of the landforms. Our results also show that morphometric data and morphologic evaluation can be combined into a single interpretation of the distribution of surface patterns. A new geomorphological map of the study area is produced and contrasted with the existing stratigraphic map.

Dan Capitan, Radu; Van De Wiel, Marco J.

2012-08-01

296

Morphometric growth relationships of the immature human mandible and tongue.  

PubMed

The masticatory apparatus is a highly adaptive musculoskeletal complex comprising several relatively independent structural components, which assist in functions including feeding and breathing. We hypothesized that the tongue is elemental in the maintenance of normal ontogeny of the mandible and in its post-natal growth and development, and tested this using a morphometric approach. We assessed tongue and mandibular measurements in 174 (97 male) human cadavers. Landmark lingual and mandibular data were gathered individuals aged between 20 gestational weeks and 3 yr postnatal. In this analysis, geometric morphometrics assisted in visualizing the morphometrical growth changes in the mandible and tongue. A linear correlation in conjunction with principal component analysis further visualized the growth relationship between these structures. We found that the growth of the tongue and mandible were intrinsically linked in size and shape between 20 gestational weeks and 24 months postnatal. However, the mandible continued to change in shape and size into the 3rd yr of life, whereas the tongue only increased in size over this same period of time. These findings provide valuable insights into the allometric growth relationship between these structures, potentially assisting the clinician in predicting the behaviour of these structures in the assessment of malocclusions. PMID:24712417

Hutchinson, Erin F; Kieser, Jules A; Kramer, Beverley

2014-06-01

297

Evolution of Hominid Femur and Tibia: A morphometric approach to the evolutionary research in anthropology  

Microsoft Academic Search

Some theoretical and methodological morphometrical approaches in evolutionary anthropology and paleoanthropology are reviewed\\u000a in this study. It is shown which are the contemporary possibilities of sophisticated biometrical and biostatistical methods\\u000a and the role of the morphometrical approach. A new approach, experimental morphometrics, is presented, reflecting recent trends\\u000a in evolutionary morphology as well as sophisticated biostatistical methods. The approach emphasizes the

V. Van?ata

1993-01-01

298

Percutaneous closure of complex paravalvular aortic root pseudoaneurysm and aorta-cavitary fistulas.  

PubMed

Native aortic valve or its prosthetic valve endocarditis can extend to the adjacent periannular areas and erode into nearby cardiac chambers, leading to pseudoaneurysm and aorta-cavitary fistulas respectively. The later usually leads to acute cardiac failure and hemodynamic instability requiring an urgent surgical intervention. However rarely this might pass unnoticed and the patient might present later with cardiac murmur. Percutaneous device closure of aortic pseudoaneurysm, ruptured sinus of Valsalva aneurysm, aorta-pulmonary window, paravalvular leaks, and aorta-cavitary fistula have been reported. We present a 59-year-old female who developed a large aortic root pseudoaneurysm with biventricular communication aorta-cavitary fistulas presenting late following aortic prosthetic valve endocarditis. She underwent successful percutaneous device closure of her pseudoaneurysm and aorta-cavitary fistulas using two Amplatzer Duct Occluders. This case illustrates a challenging combination of aortic root pseudoaneurysm and biventricular aorta-cavitary fistulas that was successfully treated with percutaneous procedure. PMID:24973845

Al-Maskari, Salim; Panduranga, Prashanth; Al-Farqani, Abdullah; Thomas, Eapen; Velliath, John

2014-01-01

299

Endothelium-dependent relaxation by cilostazol, a phosphodiesteras III inhibitor, on rat thoracic aorta  

Microsoft Academic Search

The relaxation effect of cilostazol, a phosphodiesterase III inhibitor, on the thoracic aorta was investigated. Cilostazol induced the relaxation of the thoracic aorta precontracted by phenylephrine in a concentration-dependent manner. The concentration-dependent relaxation was shifted to the right in the endothelium denuded aorta compared with that of intact endothelium, suggesting that this relaxation was partly dependent on endothelium. Cilostazol-induced relaxation

Toshimi Nakamura; Hitoshi Houchi; Asako Minami; Sadaichi Sakamoto; Koichiro Tsuchiya; Yasuharu Niwa; Kazuo Minakuchi; Yutaka Nakaya

2001-01-01

300

[Dissection of the ascending aorta in pregnancy. Apropos of a case and review of the literature].  

PubMed

Dissection of ascendant aorta is infrequent during pregnancy. Given this low prevalence, diagnosis is often delayed or even unrecognized. This delay in diagnosis can have a highly jeopardizing effect on vital maternal prognosis. In this study, we report a case of ascendant aorta dissection in the 3rd trimester of pregnancy with maternal and fetal survival through combined surgery of a cesarean section and replacement of the ascendant aorta. PMID:9417470

Bercau, G; Castaigne, V; Mihaileanu, S; Couetil, J P; Freund, M; Sauvanet, E

1997-01-01

301

[Plastic widening of the aorta associated with implantation of valvular prosthesis].  

PubMed

Widening of the supravalvular aorta by means of a lozenge-shaped dacron patch was performed in 9 cases of stenosis and/or aorta insufficiency. Marked improvement was noted in the 8 patients followed up: the transvalvular gradient was not significant and neither haemolytic anaemia nor hyperhaemolysis were present. This expedient is both useful and indicated in cases where the calibre of the descending aorta is small. PMID:1134664

Actis Dato, A; Borio, L; Panero, G B; De Michelis, M

1975-04-01

302

Abdominal Compartment Syndrome: pathophysiology and definitions  

PubMed Central

"Intra-abdominal hypertension", the presence of elevated intra-abdominal pressure, and "abdominal compartment syndrome", the development of pressure-induced organ-dysfunction and failure, have been increasingly recognized over the past decade as causes of significant morbidity and mortality among critically ill surgical and medical patients. Elevated intra-abdominal pressure can cause significant impairment of cardiac, pulmonary, renal, gastrointestinal, hepatic, and central nervous system function. The significant prognostic value of elevated intra-abdominal pressure has prompted many intensive care units to adopt measurement of this physiologic parameter as a routine vital sign in patients at risk. A thorough understanding of the pathophysiologic implications of elevated intra-abdominal pressure is fundamental to 1) recognizing the presence of intra-abdominal hypertension and abdominal compartment syndrome, 2) effectively resuscitating patients afflicted by these potentially life-threatening diseases, and 3) preventing the development of intra-abdominal pressure-induced end-organ dysfunction and failure. The currently accepted consensus definitions surrounding the diagnosis and treatment of intra-abdominal hypertension and abdominal compartment syndrome are presented.

Cheatham, Michael L

2009-01-01

303

Distribution of Wall Stress in Abdominal Aortic Aneurysm (AAA)  

NASA Astrophysics Data System (ADS)

Abdominal aortic aneurysm (AAA) rupture is believed to occur when the mechanical stress acting on the wall exceeds the strength of the wall tissue. Therefore, knowledge of the AAA wall stress distribution could be useful in assessing its risk of rupture. In our research, a finite element analysis was used to determine the wall stresses both in idealized models and in a real clinical model in which the aorta was considered isotropic with nonlinear material properties and was loaded with a given pressure. In the idealized models, both maximum diameter and asymmetry were found to have substantial influence on the distribution of the wall stress. The thrombus inside the AAA was also found to help protecting the walls from high stresses. Using CT scans of the AAA, the actual geometry of the aneurysm was reconstructed and we found that wall tension increases on the flatter surface (typically corresponds to the posterior surface) and at the inflection points of the bulge. In addition to the static analysis, we also performed simulations of the effect of unsteady pressure wave propagation inside the aneurysm.

Lasheras, Juan

2005-11-01

304

3D image analysis of abdominal aortic aneurysm  

NASA Astrophysics Data System (ADS)

In this paper we propose a technique for 3-D segmentation of abdominal aortic aneurysm (AAA) from computed tomography angiography (CTA) images. Output data (3-D model) form the proposed method can be used for measurement of aortic shape and dimensions. Knowledge of aortic shape and size is very important in planning of minimally invasive procedure that is for selection of appropriate stent graft device for treatment of AAA. The technique is based on a 3-D deformable model and utilizes the level-set algorithm for implementation of the method. The method performs 3-D segmentation of CTA images and extracts a 3-D model of aortic wall. Once the 3-D model of aortic wall is available it is easy to perform all required measurements for appropriate stent graft selection. The method proposed in this paper uses the level-set algorithm for deformable models, instead of the classical snake algorithm. The main advantage of the level set algorithm is that it enables easy segmentation of complex structures, surpassing most of the drawbacks of the classical approach. We have extended the deformable model to incorporate the a priori knowledge about the shape of the AAA. This helps direct the evolution of the deformable model to correctly segment the aorta. The algorithm has been implemented in IDL and C languages. Experiments have been performed using real patient CTA images and have shown good results.

Subasic, Marko; Loncaric, Sven; Sorantin, Erich

2001-07-01

305

Chronic hematuria and abdominal pain.  

PubMed

An 18-year-old Asian woman with a history of substance abuse presented to the Emergency Department with right-sided abdominal pain and hematuria of several months duration. Physical examination revealed right upper quadrant and suprapubic tenderness. Liver function tests were normal. Urinalysis showed: large blood, 30-50 red blood cells/high-powered field, and no bacteria. She underwent a CT of the abdomen and pelvis following oral and intravenous contrast. PMID:24580064

Connors, N J; Grino, A; Tunik, M G; Hoffman, R S

2014-03-01

306

Single Therapeutic Catheterization for Treatment of Late Diagnosed Native Coarctation of Aorta Using A Covered Stent  

PubMed Central

Here in we are reporting a 35-year-old pregnant, hypertensive woman with a strict descending aorta coarctation. She had two missing pregnancies which were complicated with hypertension, but which were not diagnosed for any pathologies before. We diagnosed coarctation of aorta, but however postponed her treatment after delivery of baby, because hypertension was under control with medical treatment and she had no complication. She had an uneventful delivery. MRI angiography revealed coarctation of aorta and it was successfully treated by using an endovascular covered stent during a single cardiac catheterization. Endovascular covered stent implantation is an easy, safe and effective method for treating coarctation of aorta in adults.

Ural, Alper V; Caglar, Ilker Murat; Caglar, Fatma Nihan Turhan; Ciftci, Serkan; Karakaya, Osman

2014-01-01

307

Pulse Wave Imaging (PWI) in Normal, Hypertensive and Aneurysmal Human Aortas In Vivo: A Feasibility Study  

PubMed Central

Arterial stiffness is a well-established biomarker for cardiovascular risk, especially in the case of hypertension. The progressive stages of an abdominal aortic aneurysm (AAA) have also been associated with varying arterial stiffness. Pulse Wave Imaging (PWI) is a noninvasive, ultrasound imaging-based technique that uses the pulse wave-induced arterial wall motion to map the propagation of the pulse wave and measure the regional pulse wave velocity (PWV) as an index of arterial stiffness. In this study, the clinical feasibility of PWI was evaluated in normal, hypertensive, and aneurysmal human aortas. Radiofrequency-based speckle tracking was used to estimate the pulse wave-induced displacements in the abdominal aortic walls of normal (N = 15, mean age 32.5 years ± 10.2), hypertensive (N = 13, mean age 60.8 years ± 15.8), and aneurysmal (N = 5, mean age 71.6 years ± 11.8) human subjects. Linear regression of the spatio-temporal variation of the displacement waveform in the anterior aortic wall over a single cardiac cycle yielded the slope as the PWV and the coefficient of determination r2 as an approximate measure of the pulse wave propagation uniformity. The aortic PWV measurements in all normal, hypertensive, and AAA subjects were 6.03 ± 1.68, 6.69 ± 2.80, and 10.54 ± 6.52 m/s, respectively. There was no significant difference (p = 0.15) between the PWVs of the normal and hypertensive subjects while the PWVs of the AAA subjects were significantly higher (p < 0.001) compared to those of the other two groups. Also, the average r2 in the AAA subjects was significantly lower (p < 0.001) than that in the normal and hypertensive subjects. These preliminary results suggest that the regional PWV and the pulse wave propagation uniformity (r2) obtained using PWI, in addition to the PWI images and spatio-temporal maps that provide qualitative visualization of the pulse wave, may potentially provide valuable information for the clinical characterization of aneurysms and other vascular pathologies that regionally alter the arterial wall mechanics.

Li, Ronny X.; Luo, Jianwen; Balaram, Sandhya K.; Chaudhry, Farooq A.; Shahmirzadi, Danial; Konofagou, Elisa. E.

2014-01-01

308

Pulse wave imaging in normal, hypertensive and aneurysmal human aortas in vivo: a feasibility study.  

PubMed

Arterial stiffness is a well-established biomarker for cardiovascular risk, especially in the case of hypertension. The progressive stages of an abdominal aortic aneurysm (AAA) have also been associated with varying arterial stiffness. Pulse wave imaging (PWI) is a noninvasive, ultrasound imaging-based technique that uses the pulse wave-induced arterial wall motion to map the propagation of the pulse wave and measure the regional pulse wave velocity (PWV) as an index of arterial stiffness. In this study, the clinical feasibility of PWI was evaluated in normal, hypertensive, and aneurysmal human aortas. Radiofrequency-based speckle tracking was used to estimate the pulse wave-induced displacements in the abdominal aortic walls of normal (N = 15, mean age 32.5 ± 10.2 years), hypertensive (N = 13, mean age 60.8 ± 15.8 years), and aneurysmal (N = 5, mean age 71.6 ± 11.8 years) human subjects. Linear regression of the spatio-temporal variation of the displacement waveform in the anterior aortic wall over a single cardiac cycle yielded the slope as the PWV and the coefficient of determination r(2) as an approximate measure of the pulse wave propagation uniformity. The aortic PWV measurements in all normal, hypertensive, and AAA subjects were 6.03 ± 1.68, 6.69 ± 2.80, and 10.54 ± 6.52 m s(-1), respectively. There was no significant difference (p = 0.15) between the PWVs of the normal and hypertensive subjects while the PWVs of the AAA subjects were significantly higher (p < 0.001) compared to those of the other two groups. Also, the average r(2) in the AAA subjects was significantly lower (p < 0.001) than that in the normal and hypertensive subjects. These preliminary results suggest that the regional PWV and the pulse wave propagation uniformity (r(2)) obtained using PWI, in addition to the PWI images and spatio-temporal maps that provide qualitative visualization of the pulse wave, may potentially provide valuable information for the clinical characterization of aneurysms and other vascular pathologies that regionally alter the arterial wall mechanics. PMID:23770991

Li, Ronny X; Luo, Jianwen; Balaram, Sandhya K; Chaudhry, Farooq A; Shahmirzadi, Danial; Konofagou, Elisa E

2013-07-01

309

Endovascular Repair of Traumatic Rupture of the Thoracic Aorta: Single-Center Experience  

SciTech Connect

Purpose. Traumatic rupture of the thoracic aorta secondary to blunt chest trauma is a life-threatening emergency and a common cause of death, usually following violent collisions. The objective of this retrospective report was to evaluate the efficacy of endovascular treatment of thoracic aortic disruptions with a single commercially available stent-graft. Methods. Nine men (mean age 29.5 years) were admitted to our institution between January 2003 and January 2006 due to blunt aortic trauma following violent motor vehicle collisions. Plain chest radiography, spiral computed tomography, aortography, and transesophageal echocardiography were used for diagnostic purposes in all cases. All patients were diagnosed with contained extramural thoracic aortic hematomas, secondary to aortic disruption. One patient was also diagnosed with a traumatic thoracic aortic dissection, secondary to blunt trauma. All subjects were poor surgical candidates, due to major injuries such as multiple bone fractures, abdominal hematomas, and pulmonary contusions. All repairs were performed using the EndoFit (LeMaitre Vascular) stent-graft. Results. Complete exclusion of the traumatic aortic disruption and pseudoaneurysm was achieved and verified at intraoperative arteriography and on CT scans, within 10 days of the repair in all patients. In 1 case the deployment of a second cuff was necessary due to a secondary endoleak. In 2 cases the left subclavian artery was occluded to achieve adequate graft fixation. No procedure-related deaths have occurred and no cardiac or peripheral vascular complications were observed within the 12 months (range 8-16 months) follow-up. Conclusions. This is the first time the EndoFit graft has been utilized in the treatment of thoracic aortic disruptions secondary to chest trauma. The repair of such pathologies is technically feasible and early follow-up results are promising.

Saratzis, Nikolaos A., E-mail: saratzis@germanosnet.gr; Saratzis, Athanasios N.; Melas, Nikolaos; Ginis, Georgios; Lioupis, Athanasios; Lykopoulos, Dimitrios; Lazaridis, John; Dimitrios, Kiskinis [Aristotle University, Papageorgiou General Hospital, 1st Department of Surgery (Greece)

2007-06-15

310

[Coronary bypass surgery on the beating heart and surgery of an abdominal aortic aneurysm. Immediately sequential surgical treatments].  

PubMed

The authors report sequential association during the same general anaesthetic of coronary bypass surgery on the beating heart and surgery of an abdominal aortic aneurysm. Two aorto-coronary bypass grafts were carried out without cardiopulmonary bypass using the two pediculated internal mammary arteries (without manipulation of the ascending aorta), followed, after closure of the chest and monitoring in the operating theatre for one hour, by reinstallation of the patient for treatment of an infra-renal abdominal aortic aneurysm by classical prosthetic implantation. The postoperative course was uncomplicated. Sequential management of coronary revascularisation without cardiopulmonary bypass and aortic aneurysmal lesions during the same anaesthetic provides an alternative to classical two-stage surgery in selected patients. PMID:11387936

Braunberger, E; Combes, M A; Meimoun, P; Loeb, T; Julia, P; Thebault, B; Bellorini, M; Cheysson, E; Funck, F; Deloche, A

2001-04-01

311

Renal and abdominal visceral complications after open aortic surgery requiring supra-renal aortic cross clamping  

PubMed Central

Purpose The aim of this study was to assess renal or abdominal visceral complications after open aortic surgery (OAS) requiring supra-renal aortic cross clamping (SRACC). Methods We retrospectively reviewed the medical records of 66 patients who underwent SRACC. Among them, 17 followed supra-celiac aortic cross clamping (SCACC) procedure, 42 supra-renal, and 7 inter-renal aorta. Postoperative renal, hepatic or pancreatic complications were investigated by reviewing levels of serum creatinine and hepatic and pancreatic enzymes. Preoperative clinical and operative variables were analyzed to determine risk factors for postoperative renal insufficiency (PORI). Results Indications for SRACC were 25 juxta-renal aortic occlusion and 41 aortic aneurysms (24 juxta-renal, 12 supra-renal and 5 type IV thoraco-abdominal). The mean duration of renal ischemic time (RIT) was 30.1 ± 22.2 minutes (range, 3 to 120 minutes). PORI developed in 21% of patients, including four patients requiring hemodialysis (HD). However, chronic HD was required for only one patient (1.5%) who had preoperative renal insufficiency. RIT ? 25 minutes and SCACC were significant risk factors for PORI development by univariate analysis, but not by multivariate analysis. Serum pancreatic and hepatic enzyme was elevated in 41% and 53% of the 17 patients who underwent SCACC, respectively. Conclusion Though postoperative renal or abdominal visceral complications developed often after SRACC, we found that most of those complications resolved spontaneously unless there was preexisting renal disease or the aortic clamping time was exceptionally long.

Yang, Shin-Seok; Park, Keun-Myoung; Roh, Young-Nam; Park, Yang Jin; Kim, Dong-Ik

2012-01-01

312

Abdominal aortic aneurysm: Treatment options, image visualizations and follow-up procedures  

PubMed Central

Abdominal aortic aneurysm is a common vascular disease that affects elderly population. Open surgical repair is regarded as the gold standard technique for treatment of abdominal aortic aneurysm, however, endovascular aneurysm repair has rapidly expanded since its first introduction in 1990s. As a less invasive technique, endovascular aneurysm repair has been confirmed to be an effective alternative to open surgical repair, especially in patients with co-morbid conditions. Computed tomography (CT) angiography is currently the preferred imaging modality for both preoperative planning and post-operative follow-up. 2D CT images are complemented by a number of 3D reconstructions which enhance the diagnostic applications of CT angiography in both planning and follow-up of endovascular repair. CT has the disadvantage of high cummulative radiation dose, of particular concern in younger patients, since patients require regular imaging follow-ups after endovascular repair, thus, exposing patients to repeated radiation exposure for life. There is a trend to change from CT to ultrasound surveillance of endovascular aneurysm repair. Medical image visualizations demonstrate excellent morphological assessment of aneurysm and stent-grafts, but fail to provide hemodynamic changes caused by the complex stent-graft device that is implanted into the aorta. This article reviews the treatment options of abdominal aortic aneurysm, various image visualization tools, and follow-up procedures with use of different modalities including both imaging and computational fluid dynamics methods. Future directions to improve treatment outcomes in the follow-up of endovascular aneurysm repair are outlined.

Sun, Zhong-Hua

2012-01-01

313

On the prediction of monocyte deposition in abdominal aortic aneurysms using computational fluid dynamics.  

PubMed

In abdominal aortic aneurysm disease, the aortic wall is exposed to intense biological activity involving inflammation and matrix metalloproteinase-mediated degradation of the extracellular matrix. These processes are orchestrated by monocytes and rather than affecting the aorta uniformly, damage and weaken focal areas of the wall leaving it vulnerable to rupture. This study attempts to model numerically the deposition of monocytes using large eddy simulation, discrete phase modelling and near-wall particle residence time. The model was first applied to idealised aneurysms and then to three patient-specific lumen geometries using three-component inlet velocities derived from phase-contrast magnetic resonance imaging. The use of a novel, variable wall shear stress-limiter based on previous experimental data significantly improved the results. Simulations identified a critical diameter (1.8 times the inlet diameter) beyond which significant monocyte deposition is expected to occur. Monocyte adhesion occurred proximally in smaller abdominal aortic aneurysms and distally as the sac expands. The near-wall particle residence time observed in each of the patient-specific models was markedly different. Discrete hotspots of monocyte residence time were detected, suggesting that the monocyte infiltration responsible for the breakdown of the abdominal aortic aneurysm wall occurs heterogeneously. Peak monocyte residence time was found to increase with aneurysm sac size. Further work addressing certain limitations is needed in a larger cohort to determine clinical significance. PMID:23886969

Hardman, David; Doyle, Barry J; Semple, Scott I K; Richards, Jennifer M J; Newby, David E; Easson, William J; Hoskins, Peter R

2013-10-01

314

Mycotic Abdominal Aneurysm Caused by Campylobacter Fetus: A Case Report for Surgical Management  

PubMed Central

We report a rare case of mycotic abdominal aortic aneurysm associated with Campylobacter fetus. A 72-year-old male admitted to the hospital because of pain in the right lower quadrant with pyrexia. The enhanced abdominal computed tomography (CT) examination showed abdominal aortic aneurysm (AAA) measuring 50 mm in maximum diameter and a high-density area of soft tissue density from the right lateral wall to the anterior wall of the aorta. However, since the patient showed no significant signs of defervescence after antibiotics administration, so we performed emergency surgery on the patient based on the diagnosis of impending rupture of mycotic AAA. The aneurysm was resected in situ reconstruction using a bifurcated albumin-coated knitted Dacron graft was performed. The cultures of blood and aneurysmal wall grew Campylobacter fetus, allowing early diagnosis and appropriate surgical management in this case, and the patient is making satisfactory progress. This is the fifth report of mycotic AAA characterizing culture positive for Campylobacter fetus in blood and tissue culture of the aortic aneurysm wall.

Noda, Yukihiro; Sawada, Ko-ichiro; Yoshida, Syu-hei; Nishida, Satoru; Yamamoto, Shinichiro; Otake, Yuji; Watanabe, Go

2011-01-01

315

Rarefaction of the aorta under Dacron wrap: a rare complication.  

PubMed

Treatment for ascending aortic dilatation varies from a wait-and-watch approach to aortic replacement. The use of an external prosthesis to gird and support the proximal aorta is safe and durable for selected aortic aneurysms. We report a rare complication in a 62-year-old man with bicuspid aortic valve and coronary artery disease who had undergone coronary artery bypass surgery and ascending aortic wrapping 10 years previously. During subsequent aortic valve surgery, he was incidentally found to have erosion of Dacron wrap through the aortic wall. PMID:24778144

Doyle, Mathew; Peeceeyan, Sheen; Bonar, Fiona; Horton, Matthew

2014-08-01

316

Pseudo-dissection of ascending aorta in inferior myocardial infarction  

PubMed Central

Acute aortic dissection is a cardiac emergency which can present as inferior myocardial infarction. It has high morbidity and mortality requiring prompt diagnosis and treatment. Rapid advances in non-invasive imaging have facilitated the early diagnosis of this condition and in ruling out this potentially catastrophic illness. We report an interesting case of a 57-year old man who presented with inferior myocardial infarction requiring thrombolysis and temporary pacing wire for complete heart block. An echocardiogram was highly suspicious of aortic dissection. CT scan confirmed that the malposition of the temporary pacing wire through the aorta mimicked aortic dissection.

Attar, Muhammad Nadeem; Elmahy, Hossam; Goode, Grahame K.

2011-01-01

317

Interruption of the ascending aorta: a hitherto undescribed lesion.  

PubMed

We are describing a most unusual variant of aortic arch interruption. The ascending aorta was atretic above the sinutubular junction forming a blind-ending pouch. The coronary arteries were the only vessels arising from the aortic trunk. All the brachiocephalic vessels were perfused in retrograde fashion through the arterial duct. The aortic valve itself was dysplastic, stenotic, and permitted severe regurgitation. There was no subaortic obstruction. A modified first stage Norwood palliation was performed. Due to myocardial insufficiency transthoracic extracorporeal membrane oxygenation had to be commenced at the end of surgery. Unfortunately the child died due to severe intracranial hemorrhage. PMID:18355555

Weidenbach, Michael; Daehnert, Ingo; Razek, Vit; Beller, Alexandra; Janousek, Jan; Kostelka, Martin; Anderson, Robert H

2008-04-01

318

Current Management of Traumatic Rupture of the Descending Thoracic Aorta  

PubMed Central

Traumatic rupture of the descending thoracic aorta remains a leading cause of death following major blunt trauma. Management has evolved from uniformly performing emergent open repair with clamp and sew technique to include open repair with mechanical circulatory support, medical management and most recently, endovascular repair. This latter approach appears, in the short term, to be associated with perhaps better outcome, but long term data is still accruing. While an attractive option, there are specific anatomic and physiologic factors to be considered in each individual case.

Karmy-Jones, Riyad; Jackson, Nichole; Long, William; Simeone, Alan

2009-01-01

319

Morphometric analysis of the Marmara Sea river basins, Turkey  

NASA Astrophysics Data System (ADS)

The drainage basin, the fundamental unit of the fluvial landscape, has been focus of research aimed at understanding the geometric characteristics of the master channel and its tributary network. This geometry is referred to as the basin morphometry and is nicely reviewed by Abrahams (1984). A great amount of research has focused on geometric characteristic of drainage basins, including the topology of the stream networks, and quantitative description of drainage texture, pattern, shape, and relief characteristics. Evaluation of morphometric parameters necessitates the analysis of various drainage parameters such as ordering of the various streams, measurement of basin area and perimeter, length of drainage channels, drainage density (Dd), stream frequency (Fs), bifurcation ratio (Rb), texture ratio (T), basin relief (Bh), Ruggedness number (Rn), time of concentration (Tc), hypsometric curve and integral (Hc and Hi) (Horton, 1932, Schumn, 1956, Strahler, 1957; Verstappen 1983; Keller and Pinter, 2002; Ozdemir and Bird, 2009). These morphometric parameters have generally been used to predict flood peaks, to assess sediment yield, and to estimate erosion rates in the basins. River basins of the Marmara Sea, has an area of approximately 40,000 sqkm, are the most important basins in Turkey based on their dense populations, industry and transportation systems. The primary aim of this study is to determine and analyse of morphometric characteristics of the Marmara Sea river basins using 10 m resolution Digital Elevation Model (DEM) and to evaluate of the results. For these purposes, digital 10 m contour maps scaled 1:25000 and geological maps scaled 1:100000 were used as the main data sources in the study. 10 m resolution DEM data were created using the contour maps and then drainage networks and their watersheds were extracted using D8 pour point model. Finally, linear, areal and relief morphometries were applied to the river basins using Geographic Information Systems (GIS). This study shows that morphometric analysis of the basins in regional level are very important to understand general morphological characteristics of the basins. In this case, tectonic and lithological conditions of the basins have greatly affected the morphometric characteristics of the north and south basins of the Marmara Sea. References Abrahams, AD. 1984. Channel Networks: A Geomorphological Perspective. Water Resources Research, Volume 20, Issue 2, pages 161-188. Horton, R.E. 1932. Drainage basin characteristics. Trans Am Geophys Union 13:350-361. Keller, E.A., Pinter, N. 2002. Active Tectonics Earthquakes, Uplift, and Landscape, Second Edition, Prentice Hall, New Jersey. Ozdemir H., Bird D. 2009. Evaluation of morphometric parameters of drainage networks derived from topographic maps and DEM in point of floods, Environmental Geology, vol.56, pp.1405-1415. Schumm, S.A. 1956. Evolution of drainage systems and slopes in badlands at Perth Amboy, New Jersey. Geol Soc Am Bull 67:597-646. Strahler, A.N. 1957. Quantitative geomorphology of drainage and channel networks. In: Chow YT (ed) Handbook of appliecl hydrology. Me Graw Hill Book Company, New York. Verstappen, H.Th. 1983. Applied geomorphology. ITC, Enschede.

Elba??, Emre; Ozdemir, Hasan

2014-05-01

320

Automatic segmentation of the aorta and the adjoining vessels  

NASA Astrophysics Data System (ADS)

Diseases of the cardiovascular system are one of the main causes of death in the Western world. Especially the aorta and its main descending vessels are of high importance for diagnosis and treatment. Today, minimally invasive interventions are becoming increasingly popular due to their advantages like cost effectiveness and minimized risk for the patient. The training of such interventions, which require much of coordination skills, can be trained by task training systems, which are operation simualtion units. These systems require a data model that can be reconstructed from given patient data sets. In this paper, we present a method that allows to segment and classify aorta, carotides, and ostium (including coronary arteries) in one run, fully automatic and highly robust. The system tolerates changes in topology, streak artifacts in CT caused by calcification and inhomogeneous distribution of contrast agent. Both CT and MRI-Images can be processed. The underlying algorithm is based on a combination of Vesselness Enhancement Diffusion, Region Growing, and the Level Set Method. The system showed good results on all 15 real patient data sets whereby the deviation was smaller than two voxels.

Stutzmann, Tobias; Hesser, Jürgen; Völker, Wolfram; Dobhan, Matthias

2010-03-01

321

The ?-3 Polyunsaturated Fatty Acid, Eicosapentaenoic Acid, Attenuates Abdominal Aortic Aneurysm Development via Suppression of Tissue Remodeling.  

PubMed

Abdominal aortic aneurysm (AAA) is a prevalent vascular disease that can progressively enlarge and rupture with a high rate of mortality. Inflammation and active remodeling of the aortic wall have been suggested to be critical in its pathogenesis. Meanwhile, ?-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) are known to reduce cardiovascular events, but its role in AAA management remains unclear. Here, we show that EPA can attenuate murine CaCl2-induced AAA formation. Aortas from BALB/c mice fed an EPA-diet appeared less inflamed, were significantly smaller in diameter compared to those from control-diet-fed mice, and had relative preservation of aortic elastic lamina. Interestingly, CT imaging also revealed markedly reduced calcification of the aortas after EPA treatment. Mechanistically, MMP2, MMP9, and TNFSF11 levels in the aortas were reduced after EPA treatment. Consistent with this finding, RAW264.7 macrophages treated with EPA showed attenuated Mmp9 levels after TNF-? simulation. These results demonstrate a novel role of EPA in attenuating AAA formation via the suppression of critical remodeling pathways in the pathogenesis of AAAs, and raise the possibility of using EPA for AAA prevention in the clinical setting. PMID:24798452

Wang, Jack H; Eguchi, Kosei; Matsumoto, Sahohime; Fujiu, Katsuhito; Komuro, Issei; Nagai, Ryozo; Manabe, Ichiro

2014-01-01

322

The ?-3 Polyunsaturated Fatty Acid, Eicosapentaenoic Acid, Attenuates Abdominal Aortic Aneurysm Development via Suppression of Tissue Remodeling  

PubMed Central

Abdominal aortic aneurysm (AAA) is a prevalent vascular disease that can progressively enlarge and rupture with a high rate of mortality. Inflammation and active remodeling of the aortic wall have been suggested to be critical in its pathogenesis. Meanwhile, ?-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) are known to reduce cardiovascular events, but its role in AAA management remains unclear. Here, we show that EPA can attenuate murine CaCl2-induced AAA formation. Aortas from BALB/c mice fed an EPA-diet appeared less inflamed, were significantly smaller in diameter compared to those from control-diet-fed mice, and had relative preservation of aortic elastic lamina. Interestingly, CT imaging also revealed markedly reduced calcification of the aortas after EPA treatment. Mechanistically, MMP2, MMP9, and TNFSF11 levels in the aortas were reduced after EPA treatment. Consistent with this finding, RAW264.7 macrophages treated with EPA showed attenuated Mmp9 levels after TNF-? simulation. These results demonstrate a novel role of EPA in attenuating AAA formation via the suppression of critical remodeling pathways in the pathogenesis of AAAs, and raise the possibility of using EPA for AAA prevention in the clinical setting.

Wang, Jack H.; Eguchi, Kosei; Matsumoto, Sahohime; Fujiu, Katsuhito; Komuro, Issei; Nagai, Ryozo; Manabe, Ichiro

2014-01-01

323

Morphometrics and the role of the phenotype in studies of the evolution of developmental mechanisms  

Microsoft Academic Search

Developmental mechanisms are usually assumed to evolve by natural selection of the morphological traits they produce. Therefore, information on phenotypic traits is an important component of comparative studies of development. Morphometrics permits the rigorous quantitative analysis of variation in organismal size and shape, and is increasingly being used in developmental contexts. The new methods of morphometrics combine a geometric concept

Christian Peter Klingenberg

2002-01-01

324

Abdominal adhesions: current and novel therapies.  

PubMed

An adhesion occurs when two tissues that normally freely move past each other attach via a fibrous bridge. Abdominal adhesions place a tremendous clinical and financial burden on public health. Adhesions develop after nearly every abdominal surgery, commonly causing female infertility, chronic pelvic pain, and, most frequently, small bowel obstruction. A National Hospital Discharge Survey of hospitalizations between 1998 and 2002 reported that 18.1% of hospitalizations were related to abdominal adhesions annually accounting for 948,000 days of inpatient care at an estimated cost of $1.18 billion. This review discusses the current or proposed therapies for abdominal adhesions. While many therapies for abdominal adhesions have been attempted, the need for a definitive therapy to prevent or even reduce abdominal adhesions still exists. PMID:20036389

Ward, Brian C; Panitch, Alyssa

2011-01-01

325

Endovascular abdominal aortic aneurysm repair  

PubMed Central

The operative mortality following conventional abdominal aortic aneurysm (AAA) repair has not fallen significantly over the past two decades. Since its inception in 1991, endovascular aneurysm repair (EVAR) has provided an alternative to open AAA repair and perhaps an opportunity to improve operative mortality. Two recent large randomised trials have demonstrated the short and medium term benefit of EVAR over open AAA repair, although data on the long term efficacy of the technique are still lacking. This review aimed at providing an overview of EVAR and a discussion of the potential benefits and current limitations of the technique.

Norwood, M G A; Lloyd, G M; Bown, M J; Fishwick, G; London, N J; Sayers, R D

2007-01-01

326

Pathology Case Study: Abdominal Pain  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 65-year-old man is complaining of abdominal pain. Visitors are given the radiology, gross and microscopic descriptions, flow cytometry, and molecular diagnostics, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology.

Latulippe, Steven; Ohori, N. P.

2007-12-05

327

A multivariate analysis of morphometric characters of Heterorhabditis species (Nemata: Heterorhabditidae) and the role of morphometrics in the taxonomy of species of the genus.  

PubMed

A multivariate analysis on the morphometrics of 7 Heterorhabditis species was conducted to review the status of the traditional morphometric characterization methods for differentiating species of these nematodes. Results from this study showed consistency in the selection of morphometric characters for discriminating among males and infective juveniles of Heterorhabditis species. For the males, testis reflexion (TREF) and total length (LENGTH) were the variables that contributed most in the discrimination among the different species, and for the infective juveniles, tail length (TAILL) and total length (LENGTH) were the variables that contributed most. Therefore, we consider that these morphometric characters are useful and reliable, and that they should be used for the identification of Heterorhabditis species/isolates. PMID:8885892

Stock, S P; Kaya, H K

1996-10-01

328

Elastic Properties of the Reconstructed Aorta in Hypoplastic Left Heart Syndrome  

Microsoft Academic Search

Background. Patients with repaired coarctation of the aorta retain abnormal elastic properties of the aorta. It is not known whether patients with hypoplastic left heart syndrome also manifest abnormal elastic properties after palliative surgery. The presence of such abnormalities may have important clinical implications as reduced aortic compliance might adversely impact single right ventricular function. Methods. We prospectively evaluated the

Brian M. Cardis; Derek A. Fyfe; William T. Mahle

2006-01-01

329

Effects on rat uterine and aorta strip smooth muscle of Thymus leptophyllus extract  

Microsoft Academic Search

The diethylether extract from Thymus leptophyllus was found to be more active on uterine smooth muscle than on aorta strips. Rat uterus experiments with and without extracellular calcium, yielded similar IC50 values. A non-specific mechanism for the relaxant activity can therefore be postulated. In rat aorta and in the presence of extracellular calcium the extract inhibited the contractile response induced

María Amparo Blázquez; María Catret; María Carmen Zafra-Polo

1995-01-01

330

Obstruction of the Aorta and Left Pulmonary Artery After Gianturco Coil Occlusion of Patent Ductus Arteriosus  

SciTech Connect

We report an unusual case of simultaneous obstruction of the left pulmonary artery and descending thoracic aorta after Gianturco coil occlusion in a 15-month-old boy. The diagnosis was made by echocardiography and cardiac angiography. At surgery, thrombi coating on the protruded parts of the Gianturco coil in the pulmonary artery and aorta were found.

Kuo, H.-Cg [Chang Gung Children's Hospital, Department of Pediatrics (China); Ko, Sheung-Fat [Chang Gung Children's Hospital, Department of Radiology (China); Wu, Yu-Tsun; Huang, Chien-Fu; Chien, Shao-Ju; Tiao, Mao-Meng; Liang, Chi-Di [Chang Gung Children's Hospital, Department of Pediatrics (China)], E-mail: cdliang@adm.cgmh.org.tw

2005-01-15

331

Endovascular stent graft repair for aneurysms on the descending thoracic aorta  

Microsoft Academic Search

Background. The traditional treatment of aneurysms of the descending thoracic aorta includes posterolateral thoracotomy and aortic replacement with a prosthetic graft. In this study, we report our experiences and results in endovascular stent graft placement as an alternative to surgical repair.Methods. Between January 1989 and July 1997, a total of 68 patients (24 women) underwent replacement of the thoracic aorta.

Marek Ehrlich; Martin Grabenwoeger; Fabiola Cartes-Zumelzu; Michael Grimm; Dietmar Petzl; Johannes Lammer; Siegfried Thurnher; Ernst Wolner; Michael Havel

1998-01-01

332

Methods of Patient Warming during Abdominal Surgery  

Microsoft Academic Search

BackgroundKeeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients.MethodsPatients (n = 160) scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion\\/fluid infusion

Li Shao; Hong Zheng; Feng-Ju Jia; Hui-Qin Wang; Li Liu; Qi Sun; Meng-Ying An; Xiu-Hua Zhang; Hao Wen

2012-01-01

333

The Abdominal Compartment Syndrome Following Aortic Surgery  

Microsoft Academic Search

Background: multi-organ failure is a leading cause of death following aneurysm surgery, especially in the emergency setting. Intra-abdominal hypertension is an important factor in the development of multi-organ failure. Prevention, early recognition and prompt treatment of abdominal hypertension and the abdominal compartment syndrome may reduce mortality following aneurysm surgery.Methods: a descriptive review of the literature from a Medline search.Results and

I. M Loftus; M. M Thompson

2003-01-01

334

[Abdominal tuberculous lymphadenitis simulating pancreatis cancer].  

PubMed

The Authors report the case of a patient symptomatic for fever, weight loss and abdominal pain submitted to abdominal sonography and CT which identified a mass of the pancreatic head. The patient underwent laparotomy plus biopsy; the istologic and bacteriological diagnosis demonstrated a tuberculous lymphoadenitis in spite of a normal cutaneous tuberculin test. Abdominal localization of TBC infection therefore is increasing in epidemiological studies, and thus it must be included in the differential diagnosis of subdiaphragmatic disease. PMID:9296597

Casolino, V; Arcuri, V; Fontana, I; Tommasi, G V; Manolitsi, O; Valente, R; Valente, U

1997-01-01

335

Abdominal apoplexy: two unusual cases of hemoperitoneum  

PubMed Central

Abdominal apoplexy, or idiopathic spontaneous intraperitoneal hemorrhage, is a rare and often fatal condition resulting from a variety of disease processes affecting the arterial and venous abdominal vasculature. Preoperative and intraoperative diagnosis and treatment of abdominal apoplexy are challenging. The source of bleeding may remain elusive even after careful autopsy dissection given the absence of intravascular pressure. Despite these challenges, early diagnosis and rapid treatment remain central to a successful outcome, as nonsurgical mortality has approached 100%. Presented here are two fatal cases of abdominal apoplexy, one involving a patient with arterial dissection of the gastroduodenal artery and one involving rupture of the superior mesenteric-portal venous system with perivascular pseudoaneurysm formation.

Harbour, Lori N.; Koch, Meghan S.; Louis, Thomas H.; Fulmer, James M.

2012-01-01

336

Blood flow and coherent vortices in the normal and aneurysmatic aortas: a fluid dynamical approach to intra-luminal thrombus formation.  

PubMed

Abdominal aortic aneurysms (AAAs) are frequently characterized by the development of an intra-luminal thrombus (ILT), which is known to have multiple biochemical and biomechanical implications. Development of the ILT is not well understood, and shear-stress-triggered activation of platelets could be the first step in its evolution. Vortical structures (VSs) in the flow affect platelet dynamics, which motivated the present study of a possible correlation between VS and ILT formation in AAAs. VSs educed by the ?(2)-method using computational fluid dynamics simulations of the backward-facing step problem, normal aorta, fusiform AAA and saccular AAA were investigated. Patient-specific luminal geometries were reconstructed from computed tomography scans, and Newtonian and Carreau-Yasuda models were used to capture salient rheological features of blood flow. Particularly in complex flow domains, results depended on the constitutive model. VSs developed all along the normal aorta, showing that a clear correlation between VSs and high wall shear stress (WSS) existed, and that VSs started to break up during late systole. In contrast, in the fusiform AAA, large VSs developed at sites of tortuous geometry and high WSS, occupying the entire lumen, and lasting over the entire cardiac cycle. Downward motion of VSs in the AAA was in the range of a few centimetres per cardiac cycle, and with a VS burst at that location, the release (from VSs) of shear-stress-activated platelets and their deposition to the wall was within the lower part of the diseased artery, i.e. where the thickest ILT layer is typically observed. In the saccular AAA, only one VS was found near the healthy portion of the aorta, while in the aneurysmatic bulge, no VSs occurred. We present a fluid-dynamics-motivated mechanism for platelet activation, convection and deposition in AAAs that has the potential of improving our current understanding of the pathophysiology of fluid-driven ILT growth. PMID:21471188

Biasetti, Jacopo; Hussain, Fazle; Gasser, T Christian

2011-10-01

337

The Role of Extracellular Signal-Related Kinase During Abdominal Aortic Aneurysm Formation  

PubMed Central

BACKGROUND It is hypothesized that activation of extracellular signal-related kinase (ERK) is critical in activating matrix metalloproteinases (MMPs) during abdominal aortic aneurysm (AAA) formation. STUDY DESIGN C57BL/6 male mice underwent either elastase or heat-inactivated elastase aortic perfusion (n = 9 per group). Mouse aortic smooth muscle cells were transfected with ERK-1 and 2 siRNA along with or without elastase treatment. Mouse and human aortic tissue were analyzed by Western blots, zymograms, and immunohistochemistry, and statistical analysis was done using Graphpad and Image J softwares. RESULTS Western blot and immunohistochemistry documented increased phospho-mitogen-activated protein kinase kinase-1/2 (pMEK-1/2; 153%, p = 0.270 by Western) and pERK (171%, p = 0.004 by Western blot) in the elastase perfused aortas. Male ERK-1?/? mice underwent elastase perfusion, and aortic diameter was determined at day 14. ERK-1?/? mice failed to develop AAA, and histologic analysis depicted intact collagen and elastin fibers in the aortas. Zymography of aortas of elastase-treated ERK-1?/? mice showed lower levels of proMMP2 (p < 0.005) and active MMP2 (p < 0.0001), as well as proMMP9 (p = 0.037) compared with C57BL/6 mice. siRNA transfection of ERK-1 and -2 significantly reduced formation of pro- and active MMP2 (p < 0.01 for both isoforms) in aortic smooth muscle cells treated with elastase in vitro. Human AAA tissue had significantly elevated levels of pMEK-1/2 (150%, p = 0.014) and pERK (159%, p = 0.013) compared with control tissues. CONCLUSIONS The MAPK (mitogen-activated protein kinase)/ERK pathway is an important modulator of MMPs during AAA formation. Targeting the ERK pathway by reagents that inhibit either the expression or phosphorylation of ERK isoforms could be a potential therapy to prevent AAA formation.

Ghosh, Abhijit; DiMusto, Paul D; Ehrlichman, Lauren K; Sadiq, Omar; McEvoy, Brendan; Futchko, John S; Henke, Peter K; Eliason, Jonathan L; Upchurch, Gilbert R

2013-01-01

338

Expression and localization of macrophage elastase (matrix metalloproteinase-12) in abdominal aortic aneurysms.  

PubMed Central

Elastolytic matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of abdominal aortic aneurysms (AAA), a disorder characterized by chronic aortic wall inflammation and destruction of medial elastin. The purpose of this study was to determine if human macrophage elastase (HME; MMP-12) might participate in this disease. By reverse transcription-polymerase chain reaction, HME mRNA was consistently demonstrated in AAA and atherosclerotic occlusive disease (AOD) tissues (six of six), but in only one of six normal aortas. Immunoreactive proteins corresponding to proHME and two products of extracellular processing were present in seven of seven AAA tissue extracts. Total HME recovered from AAA tissue was sevenfold greater than normal aorta (P < 0.001), and the extracted enzyme exhibited activity in vitro. Production of HME was demonstrated in the media of AAA tissues by in situ hybridization and immunohistochemistry, but HME was not detected within the media of normal or AOD specimens. Importantly, immunoreactive HME was specifically localized to residual elastin fragments within the media of AAA tissue, particularly areas adjacent to nondilated normal aorta. In vitro, the fraction of MMP-12 sequestered by insoluble elastin was two- to fivefold greater than other elastases found in AAA tissue. Therefore, HME is prominently expressed by aneurysm-infiltrating macrophages within the degenerating aortic media of AAA, where it is also bound to residual elastic fiber fragments. Because elastin represents a critical component of aortic wall structure and a matrix substrate for metalloelastases, HME may have a direct and singular role in the pathogenesis of aortic aneurysms.

Curci, J A; Liao, S; Huffman, M D; Shapiro, S D; Thompson, R W

1998-01-01

339

The effects of hypothyroidism on the mechanical properties and histomorphological structure of the thoracic aorta.  

PubMed

This experimental study investigates the effects of hypothyroidism on the descending thoracic aorta. Hypothyroidism was induced in 20 male Wistar rats by administering 0.05% of 6-n propyl 2-thiouracil (PTU) in their drinking water for 8 weeks. Euthyroid rats were used as controls. Animals were sacrificed and longitudinal strips of the descending aorta were subjected to various preselected levels of stress in a uniaxial tensile-testing device. Analysis of stress-strain, elastic modulus-strain curves disclosed significant differences between groups, indicative of stiffer aortas in hypothyroid animals at the upper physiologic and higher levels of pressure. Remodeling of the aortic wall of hypothyroid animals revealed significant histological changes. The thoracic aorta of hypothyroid rats compared with that of euthyroid ones became stiffer at high strains, including the upper physiologic range, loosing part of its distensibility. Hypothyroidism was also associated with diameter enlargement and substantial lengthening of the aorta. PMID:19679591

Moulakakis, Konstantinos G; Sokolis, Dimitrios P; Perrea, Despina N; Dontas, Ismene; Dosios, Theodosios; Poulakou, Maria V; Mylonas, Spyridon N; Dimitriou, Constantinos A; Karayannacos, Panayotis E

2010-04-01

340

Steady flow development past valve prostheses in a model human aorta. I. Centrally occluding valves.  

PubMed

In this paper, laser-Doppler anemometry measurement of steady flow development in a model human aorta has been reported. Studies were made with uniform entry flow at the root of the aorta and our measurements showed the establishment of a pair of Dean vortices in the mid-arch region. Subsequently, the nature of flow development past centrally occluding caged ball valves in the model aorta was investigated. Our studies showed that in the ascending aorta, an asymmetric velocity profile is obtained with larger velocity gradients towards the inner wall of tertiary curvature (anatomically the left lateral wall) with centrally occluding valves. The peripheral flow past these valves prevented the development of Dean vortices in the mid-arch region. The caged ball valves at the root of the aorta had no discernible effect on the velocity profiles in the brachio-cephalic artery. PMID:6671983

Khalighi, B; Chandran, K B; Chen, C J

1983-01-01

341

Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report  

PubMed Central

Introduction Coxiella burnetii, the causative agent of Q fever, may cause endocarditis and vascular infections that result in severe morbidity and mortality. We report a case of a C. burnetii-infected abdominal aorta and its management in a patient with a previous endovascular aortic aneurysm repair. Case presentation A 62-year-old Caucasian man was admitted to our hospital three months after endovascular aortic aneurysm repair with a bifurcated stent graft. He had increasing abdominal complaints and general malaise. A computed tomography scan of his abdomen revealed several para-aneurysmal abscesses. Surgery was performed via midline laparotomy. The entire abdominal wall of his aneurysmal sac, including the abscesses, was removed. The vascular endoprosthesis showed no macroscopic signs of infection. The decision was made to leave the endograft in place because of the severe cardiopulmonary comorbidities, thereby avoiding suprarenal clamping and explantation of this device with venous reconstruction. The proximal and distal parts of the endograft were secured to the aortic wall and common iliac artery walls, respectively, to avoid future migration. Polymerase chain reaction for C. burnetii was positive in all specimens of aortic tissue. Specific antibiotic therapy was initiated. Our patient was discharged in good clinical condition after six days. Conclusions In our patient, the infection was limited to the abdominal aneurysm wall, which was removed, leaving the endograft in place. Vascular surgeons should be familiar with this bailout procedure in high-risk patients.

2011-01-01

342

Disparate Changes in the Mechanical Properties of Murine Carotid Arteries and Aorta in Response to Chronic Infusion of Angiotensin-II  

PubMed Central

Chronic infusion of angiotensin-II has proved useful for generating dissecting aortic aneurysms in atheroprone mice. These lesions preferentially form in the suprarenal abdominal aorta and sometimes in the ascending aorta, but reasons for such localization remain unknown. This study focused on why these lesions do not form in other large (central) arteries. Toward this end, we quantified and compared the geometry, composition, and biaxial material behavior (using a nonlinear constitutive relation) of common carotid arteries from three groups of mice: non-treated controls as well as mice receiving a subcutaneous infusion of angiotensin-II for 28 days that either did or did not lead to the development of a dissecting aortic aneurysm. Consistent with the mild hypertension induced by the angiotensin-II, the carotid wall thickened as expected and remodeled modestly. There was no evidence, however, of a marked loss of elastic fibers or smooth muscle cells, each of which appear to be initiating events for the development of aneurysms, and there was no evidence of intramural discontinuities that might give rise to dissections.

Bersi, M.R.; Collins, M.J.; Wilson, E.; Humphrey, J.D.

2014-01-01

343

Tissue Responses to Endovascular Stent Grafts for Saccular Abdominal Aortic Aneurysms in a Canine Model  

PubMed Central

We investigated tissue responses to endoskeleton stent grafts for saccular abdominal aortic aneurysms (AAAs) in canines. Saccular AAAs were made with Dacron patch in 8 dogs, and were excluded by endoskeleton stent grafts composed of nitinol stent and expanded polytetrafluoroethylene graft. Animals were sacrificed at 2 months (Group 1; n = 3) or 6 months (Group 2; n = 5) after the placement, respectively. The aortas embedding stent grafts were excised en bloc for gross inspection and sliced at 5 to 8 mm intervals for histopathologic evaluation. Stent grafts were patent in all except a dog showing a thrombotic occlusion in Group 2. In the 7 dogs with patent lumen, the graft overhanging the saccular aneurysm was covered by thick or thin thrombi with no endothelial layer, and the graft over the aortic wall was completely covered by neointima with an endothelial layer. Transgraft cell migration was less active at an aneurysm than at adjacent normal aorta. In conclusion, endoskeleton stent grafts over saccular aneurysms show no endothelial coverage and poor transgraft cell migration in a canine model.

Kim, Hyun Beom; Choi, Young Ho; So, Young Ho; Min, Seung-Kee; Kim, Hyo-Cheol; Kim, Young Il; Park, Jae Hyung

2012-01-01

344

Induction of Timp1 in smooth muscle cells during development of abdominal aortic aneurysms.  

PubMed

Abdominal aortic aneurysm (AAA) is known to develop mainly by the increased diameter of aorta through metalloproteinases (MMPs). Although activities of MMPs are tightly regulated by the presence of tissue inhibitor of MMPs (TIMPs) and imbalances between MMPs and TIMPs may serve to fragility of arterial wall, little is known about TIMPs behavior in aneurysmal formation. Here, we utilized a murine experimental AAA model, and found that by immunohistochemical analysis, Timp1 as and Timp1 mRNA levels was also revealed in aortic tissue in AAA by RT-PCR. In cultured vascular smooth muscle cells (SMCs), Tumor Necrosis Factor (TNF)-alpha significantly activated both Mmp9 and Timp1 expression, and they were blocked by Jun kinase inhibitor (SP600125) in a dose-dependent manner. Interestingly, a proteasome inhibitor (MG132), which is known as an agent for inhibition of the nuclear factor-kappa B (NF-kappaB), significantly inhibited the TNF-alpha-induced expression of Timp1, whereas MG132, which also works as an activator of c-Jun/AP-1 pathway, strongly increased Mmp9. Taken together, inflammatory cytokines, including TNF-alpha, may simultaneously induce MMPs and TIMPs for the remodeling of the medial layer, leading to the increased diameter of the aorta, the aneurysm. PMID:24279124

Bumdelger, Batmunkh; Kokubo, Hiroki; Kamata, Ryo; Fujii, Masayuki; Ishida, Mari; Ishida, Takafumi; Yoshizumi, Masao

2013-09-01

345

Genetically engineered collagenase resistance promotes abdominal aortic aneurysm formation in mice infused with angiotensin II  

PubMed Central

Clinical evidence links increased aortic collagen content and stiffness to abdominal aortic aneurysm (AAA) formation. However, the possibility that excess collagen contributes to AAA formation remains untested. We investigated the hypothesis that augmentd collagen promotes AAA formation, and employed apoE-null mice expressing collagenase-resistant mutant collagen (ColR/R/apoE?/?), heterozygote (ColR/+/apoE?/?), or wild-type collagen (Col+/+/apoE?/?) infused with angiotensin II to induce AAA. As expected, the aortas of ColR/R/apoE?/? mice contained more interstitial collagen than those from the other groups. Angiotensin II treatment elicited more AAA formation in ColR/R/apoE?/? mice than ColR/+/apoE?/? or Col+/+/apoE?/? mice. Aortic circumferences correlated positively with collagen content, determined by picrosirius red and Masson trichrome staining. Mechanical testing of aortas of ColR/R/apoE?/? mice showed increased stiffness and susceptibility to mechanical failure compared to those of Col+/+/apoE?/? mice. Optical analysis further indicated altered collagen fiber orientation in the adventitia of ColR/R/apoE?/? mice. These results demonstrate that collagen content regulates aortic biomechanical properties and influences AAA formation.

Deguchi, Jun-o; Huang, Hayden; Libby, Peter; Aikawa, Elena; Whittaker, Peter; Sylvan, Jeremy; Lee, Richard T.; Aikawa, Masanori

2010-01-01

346

Morphometric study of Rynchotus rufescens testis throughout the year.  

PubMed

The research aimed to study the morphologic variation of the testis, seeking to promote the selection and genetic control of those that present appreciable spermatic production throughout the year. Testis morphology of the Rynchotus rufescens partridge was investigated, analyzing the testis weight, the seminiferous tubules diameter, the thickness of the seminiferous epithelium, the amount of meiotic figures and the thickness of the tunica albuginea. Sixty male partridges were used, divided in 12 groups, and one group per month had the testis collected for the histological routine and the sections were stained using the Hematoxilin-Eosin technique. For the histological sections analysis, morphometric measures were taken, with the aid of an Image Analyzer and the resulting data were submitted to analysis of variance and to Tukey's test. Based on the histological modifications of the seminiferous epithelium and the morphometric analysis, the partridge testis morphology could be divided in four successive phases throughout the year. The reproductive phase occurred in the spring, characterized by the complete spermatogenesis process. The regression phase occurred in the summer, with the involution of the seminiferous epithelium. The rest phase took place in the fall, with spermatogonias presence and some spermatocytes beginning the meiosis. The phase of recrudescence occurred in the winter, with the recovery of the seminiferous epithelium and absence of spermatozoa. In conclusion, the characteristics analyzed revealed a variation over the year, with greater production of spermatozoa in the spring and less in the winter. PMID:17876449

Baraldi-Artoni, S M; Bottino, F; Oliveira, D; Sobue Franzo, V; Amoroso, L; Orsi, A M; Cruz, C

2007-05-01

347

Morphometric analysis of caudate veins for advanced liver surgery  

PubMed Central

Background Accurate knowledge of the surgical anatomy of the caudate lobe is indispensable in the performance of liver surgery. Although previous cast studies have provided much useful overall information about the locations of the caudate veins, little is known about how to establish the exact locations of the caudate and short hepatic veins prior to surgery. Objectives This study was conducted as a practical morphometric analysis of the caudate veins using preoperative enhanced computed tomography (CT) and intraoperative ultrasound (IOUS). Methods From July 2003 to October 2005, 116 donor hepatectomies were performed for adult living donor liver transplantation. The numbers and locations of visible caudate veins were examined pre- and intraoperatively using CT and IOUS. Results In the 116 patients, a total of 152 caudate veins were detected, which were classified as being of either typical (n = 135) or non-typical (n = 17) type. One caudate vein was detectable in 83 patients (72%), two in 30 patients (26%) and three in three patients (3%). A total of 67% of caudate veins detected by IOUS and 70% detected by CT were located on the ventral 60 ° of the inferior vena cava (IVC). The remaining veins were scattered on both lateral sides. Conclusions Preoperative CT and IOUS were useful in providing morphometric information of sizable caudate veins. Precise information on these veins is essential for the safe dissection of the caudate lobe from the IVC in advanced liver surgery.

Takemura, Nobuyuki; Hasegawa, Kiyoshi; Sugawara, Yasuhiko; Zhang, Keming; Aoki, Taku; Beck, Yoshifumi; Makuuchi, Masatoshi; Kokudo, Norihiro

2010-01-01

348

Morphometric Approach to Pulp Fibroblast Development in Tooth Germ  

PubMed Central

This paper builds a morphometric framework for the analysis of dental pulp fibroblast evolution during tooth development. We investigated 15 tooth germs (cases) organized, by histological criteria, in three groups corresponding to cap, early bell, and late bell stages, respectively. Each group comprised five cases. The morphometric description used the following parameters: area (A), perimeter (P)—automatically extracted by a color segmentation technique, and form factor (FF)—calculated as 4?A/P2. The designed framework operated at inter- and intragroup levels. The intergroup analysis quantified the differences between groups, in the sense of a relative distance (RD) adequately defined by mean-value scaling. We showed that the stage of early bell is approximately 5 times closer to late bell than to cap. The quantification procedure required concomitant information about A, P parameters (as P versus A dependences, or FF values), whereas the procedure failed for A or P separately used. The intragroup analysis quantified the similarity of the cases belonging to the same stage. We proved that, unlike the intergroup tests, the individual exploitation of all three descriptors A, P, and FF is effective, yielding highly compatible results. Within any group, most cases presented RDs less than 10% from the group mean value, regardless of the descriptor type.

Caruntu, Irina-Draga; Savinescu, Sergiu Daniel; Amalinei, Cornelia

2014-01-01

349

Abdominal Aortic Aneurysms Targeted by Functionalized Polysaccharide Microparticles: a new Tool for SPECT Imaging.  

PubMed

Aneurysm diagnostic is nowadays limited by the lack of technology that enables early detection and rupture risk prediction. New non invasive tools for molecular imaging are still required. In the present study, we present an innovative SPECT diagnostic tool for abdominal aortic aneurysm (AAA) produced from injectable polysaccharide microparticles radiolabeled with technetium 99m ((99m)Tc) and functionalized with fucoidan, a sulfated polysaccharide with the ability to target P-Selectin. P-Selectin is a cell adhesion molecule expressed on activated endothelial cells and platelets which can be found in the thrombus of aneurysms, as well as in other vascular pathologies. Microparticles with a maximum hydrodynamic diameter of 4 µm were obtained by crosslinking the polysaccharides dextran and pullulan. They were functionalized with fucoidan. In vitro interactions with human activated platelets were assessed by flow cytometry that demonstrated a specific affinity of fucoidan functionalized microparticles for P-Selectin expressed by activated platelets. For in vivo AAA imaging, microparticles were radiolabeled with (99m)Tc and intravenously injected into healthy and AAA rats obtained by elastase perfusion through the aorta wall. Animals were scanned by SPECT imaging. A strong contrast enhancement located in the abdominal aorta of AAA rats was obtained, while no signal was obtained in healthy rats or in AAA rats after injection of non-functionalized control microparticles. Histological studies revealed that functionalized radiolabeled polysaccharide microparticles were localized in the AAA wall, in the same location where P-Selectin was expressed. These microparticles therefore constitute a promising SPECT imaging tool for AAA and potentially for other vascular diseases characterized by P-Selectin expression. Future work will focus on validating the efficiency of the microparticles to diagnose these other pathologies and the different stages of AAA. Incorporation of a therapeutic molecule is also considered. PMID:24723981

Bonnard, Thomas; Yang, Gonord; Petiet, Anne; Ollivier, Véronique; Haddad, Oualid; Arnaud, Denis; Louedec, Liliane; Bachelet-Violette, Laure; Derkaoui, Sidi Mohammed; Letourneur, Didier; Chauvierre, Cedric; Le Visage, Catherine

2014-01-01

350

Abdominal Aortic Aneurysms Targeted by Functionalized Polysaccharide Microparticles: a new Tool for SPECT Imaging  

PubMed Central

Aneurysm diagnostic is nowadays limited by the lack of technology that enables early detection and rupture risk prediction. New non invasive tools for molecular imaging are still required. In the present study, we present an innovative SPECT diagnostic tool for abdominal aortic aneurysm (AAA) produced from injectable polysaccharide microparticles radiolabeled with technetium 99m (99mTc) and functionalized with fucoidan, a sulfated polysaccharide with the ability to target P-Selectin. P-Selectin is a cell adhesion molecule expressed on activated endothelial cells and platelets which can be found in the thrombus of aneurysms, as well as in other vascular pathologies. Microparticles with a maximum hydrodynamic diameter of 4 µm were obtained by crosslinking the polysaccharides dextran and pullulan. They were functionalized with fucoidan. In vitro interactions with human activated platelets were assessed by flow cytometry that demonstrated a specific affinity of fucoidan functionalized microparticles for P-Selectin expressed by activated platelets. For in vivo AAA imaging, microparticles were radiolabeled with 99mTc and intravenously injected into healthy and AAA rats obtained by elastase perfusion through the aorta wall. Animals were scanned by SPECT imaging. A strong contrast enhancement located in the abdominal aorta of AAA rats was obtained, while no signal was obtained in healthy rats or in AAA rats after injection of non-functionalized control microparticles. Histological studies revealed that functionalized radiolabeled polysaccharide microparticles were localized in the AAA wall, in the same location where P-Selectin was expressed. These microparticles therefore constitute a promising SPECT imaging tool for AAA and potentially for other vascular diseases characterized by P-Selectin expression. Future work will focus on validating the efficiency of the microparticles to diagnose these other pathologies and the different stages of AAA. Incorporation of a therapeutic molecule is also considered.

Bonnard, Thomas; Yang, Gonord; Petiet, Anne; Ollivier, Veronique; Haddad, Oualid; Arnaud, Denis; Louedec, Liliane; Bachelet-Violette, Laure; Derkaoui, Sidi Mohammed; Letourneur, Didier; Chauvierre, Cedric; Le Visage, Catherine

2014-01-01

351

Feasibility of Angioplasty and Stenting for Abdominal Aortic Lesions Adjacent to Previously Stented Visceral Artery Lesions in Patients with Takayasu Arteritis  

SciTech Connect

Two young female patients with Takayasu arteritis presented with symptomatic long-segment abdominal aortic stenosis in the vicinity of previously deployed celiac and renal artery stents that projected markedly into the narrowed aortic lumen. Crushing or distortion of the visceral artery stents during aortic angioplasty was avoided by performing simultaneous or alternating balloon dilatations in the aorta and in the visceral artery stents. Consequently, the visceral artery stents remained patent and shortened longitudinally, allowing unhindered deployment of Wallstents in the adjacent aorta and abolition of a pressure gradient across the aortic lesions. Access to side branches covered by the Wallstent was obtained without difficulty, enabling the performance of balloon dilatation in multiple side branches and ostial stent deployment in a renal artery. These techniques could increase the scope of endovascular therapy in the treatment of patients with Takayasu arteritis.

Joseph, George, E-mail: joseph59@gmail.com; George, Paul V.; Pati, Purendra Kumar; Chandy, Sunil Thomas [Christian Medical College, Department of Cardiology (India)

2007-04-15

352

Abdominal pain in an adult with Type 2 diabetes: A case report  

PubMed Central

Introduction Chronic abdominal pain (CAP) may be a manifestation of diseases involving many intra-abdominal organs. Beside diseases affecting subjects without diabetes mellitus, diabetic patients may have CAP due to diabetes-related complications like neuritis, motor diseases of the gastrointestinal tract and autonomic dysfunction. Atherosclerosis is 2–4 times more common in patients with diabetes and affects mainly carotid, coronary, iliac and lower limb arteries as well as aorta. Another less common complication is chronic mesenteric ischemia (CMI, intestinal angina), caused by atherosclerotic obstruction of the celiac artery and its branches and results in episodic or constant intestinal hypoperfusion. Case presentation We present a case of a diabetic patient with CMI in whom the diagnosis was delayed by almost 5 years. The dominant symptoms were crampy abdominal postprandial pain, anorexia, changes in bowel habits and cachexia. Conventional angiography revealed significant stenosis of the celiac artery and complete obstruction of the inferior mesenteric artery. Noteworthy, no significant stenoses in carotids or limbs' arteries were found. Revascularization resulted in clinical improvement 1 week post-intervention. Conclusion CAP in patients with diabetes may be due to CMI. The typical presentation is crampy postprandial abdominal pain in a heavy smoker male patient with long-standing diabetes, accompanied by anorexia, changes in bowel habits and mild to moderate weight loss. At least two of the three main splanchnic arteries must be significantly occluded in order CMI to be symptomatic. The diagnostic procedure of choice is conventional angiography and revascularization of the occluded arteries is the radical treatment.

Panagoulias, George; Tentolouris, Nicholas; Ladas, Spiros S

2008-01-01

353

Predictive models of insulin resistance derived from simple morphometric and biochemical indices related to obesity and the metabolic syndrome in baboons  

PubMed Central

Background Non-human primates are valuable models for the study of insulin resistance and human obesity. In baboons, insulin sensitivity levels can be evaluated directly with the euglycemic clamp and is highly predicted by adiposity, metabolic markers of obesity and impaired glucose metabolism (i.e. percent body fat by DXA and HbA1c). However, a simple method to screen and identify obese insulin resistant baboons for inclusion in interventional studies is not available. Methods We studied a population of twenty baboons with the euglycemic clamp technique to characterize a population of obese nondiabetic, insulin resistant baboons, and used a multivariate linear regression analysis (adjusted for gender) to test different predictive models of insulin sensitivity (insulin-stimulated glucose uptake = Rd) using abdominal circumference and fasting plasma insulin. Alternatively, we tested in a separate baboon population (n = 159), a simpler model based on body weight and fasting plasma glucose to predict the whole-body insulin sensitivity (Rd/SSPI) derived from the clamp. Results In the first model, abdominal circumference explained 59% of total insulin mediated glucose uptake (Rd). A second model, which included fasting plasma insulin (log transformed) and abdominal circumference, explained 64% of Rd. Finally, the model using body weight and fasting plasma glucose explained 51% of Rd/SSPI. Interestingly, we found that percent body fat was directly correlated with the adipocyte insulin resistance index (r = 0.755, p < 0.0001). Conclusion In baboons, simple morphometric measurements of adiposity/obesity, (i.e. abdominal circumference), plus baseline markers of glucose/lipid metabolism, (i.e. fasting plasma glucose and insulin) provide a feasible method to screen and identify overweight/obese insulin resistant baboons for inclusion in interventional studies aimed to study human obesity, insulin resistance and type 2 diabetes mellitus.

Chavez, Alberto O; Gastaldelli, Amalia; Guardado-Mendoza, Rodolfo; Lopez-Alvarenga, Juan C; Leland, M Michelle; Tejero, M Elizabeth; Sorice, GianPio; Casiraghi, Francesca; Davalli, Alberto; Bastarrachea, Raul A; Comuzzie, Anthony G; DeFronzo, Ralph A; Folli, Franco

2009-01-01

354

Whole genome expression analysis within the angiotensin II-apolipoprotein E deficient mouse model of abdominal aortic aneurysm  

PubMed Central

Background An animal model commonly used to investigate pathways and potential therapeutic interventions relevant to abdominal aortic aneurysm (AAA) involves subcutaneous infusion of angiotensin II within the apolipoprotein E deficient mouse. The aim of this study was to investigate genes differentially expressed in aneurysms forming within this mouse model in order to assess the relevance of this model to human AAA. Results Using microarrays we identified genes relevant to aneurysm formation within apolipoprotein E deficient mice. Firstly we investigated genes differentially expressed in the aneurysm prone segment of the suprarenal aorta in these mice. Secondly we investigated genes that were differentially expressed in the aortas of mice developing aneurysms relative to those that did not develop aneurysms in response to angiotensin II infusion. Our findings suggest that a host of inflammation and extracellular matrix remodelling pathways are upregulated within the aorta in mice developing aneurysms. Kyoto Encyclopedia of Genes and Genome categories enriched in the aortas of mice with aneurysms included cytokine-cytokine receptor interaction, leukocyte transendothelial migration, natural killer cell mediated cytotoxicity and hematopoietic cell lineage. Genes associated with extracellular matrix remodelling, such as a range of matrix metalloproteinases were also differentially expressed in relation to aneurysm formation. Conclusion This study is the first report describing whole genome expression arrays in the apolipoprotein E deficient mice in relation to aneurysm formation. The findings suggest that the pathways believed to be critical in human AAA are also relevant to aneurysm formation in this mouse model. The findings therefore support the value of this model to investigate interventions and mechanisms of human AAA.

Rush, Catherine; Nyara, Moses; Moxon, Joseph V; Trollope, Alexandra; Cullen, Bradford; Golledge, Jonathan

2009-01-01

355

Studies of plasma renin activity in coarctation of the aorta.  

PubMed Central

Experimental and clinical studies were performed to assess the role of the renin-angiotensin system in producing hypertension in coarctation of the aorta. Basal and stimulated peripheral plasma renin activity were determined in the canine model and in four patients with coarctation. The animal studies showed no significant elevation of peripheral plasma renin activity (PPRA), and no increase in the response of PPRA to stimuli. The human studies showed a significant elevation in the response to PPRA to postural change and to exercise in three of four patients with coarctation, as compared to the same patients after correction of the coarctation. It is concluded that hyperactivity of the renin-angiotensin system is not the primary cause in coarctation hypertension in dog or man. It is nonetheless probable that the renin-angiotensin system has a role in coarctation hypertension, and further studies will be necessary to determine its place.

Van Way, C W; Michelakis, A M; Anderson, W J; Manlove, A; Oates, J A

1976-01-01

356

Proteomics Characterization of Extracellular Space Components in the Human Aorta*  

PubMed Central

The vascular extracellular matrix (ECM) is essential for the structural integrity of the vessel wall and also serves as a substrate for the binding and retention of secreted products of vascular cells as well as molecules coming from the circulation. Although proteomics has been previously applied to vascular tissues, few studies have specifically targeted the vascular ECM and its associated proteins. Thus, its detailed composition remains to be characterized. In this study, we describe a methodology for the extraction of extracellular proteins from human aortas and their identification by proteomics. The approach is based on (a) effective decellularization to enrich for scarce extracellular proteins, (b) successful solubilization and deglycosylation of ECM proteins, and (c) relative estimation of protein abundance using spectral counting. Our three-step extraction approach resulted in the identification of 103 extracellular proteins of which one-third have never been reported in the proteomics literature of vascular tissues. In particular, three glycoproteins (podocan, sclerostin, and agrin) were identified for the first time in human aortas at the protein level. We also identified extracellular adipocyte enhancer-binding protein 1, the cartilage glycoprotein asporin, and a previously hypothetical protein, retinal pigment epithelium (RPE) spondin. Moreover, our methodology allowed us to screen for proteolysis in the aortic samples based on the identification of proteolytic enzymes and their corresponding degradation products. For instance, we were able to detect matrix metalloproteinase-9 by mass spectrometry and relate its presence to degradation of fibronectin in a clinical specimen. We expect this proteomics methodology to further our understanding of the composition of the vascular extracellular environment, shed light on ECM remodeling and degradation, and provide insights into important pathological processes, such as plaque rupture, aneurysm formation, and restenosis.

Didangelos, Athanasios; Yin, Xiaoke; Mandal, Kaushik; Baumert, Mark; Jahangiri, Marjan; Mayr, Manuel

2010-01-01

357

Basal lamina structural alterations in human asymmetric aneurismatic aorta.  

PubMed

Basal lamina (BL) is a crucial mechanical and functional component of blood vessels, constituting a sensor of extracellular microenvironment for endothelial cells and pericytes. Recently, an abnormality in the process of matrix microfibrillar component remodeling has been advocated as a mechanism involved in the development of aortic dilation. We focused our attention on BL composition and organization and studied some of the main components of the Extracellular Matrix such as Tenascin, Laminins, Fibronectin, type I, III and IV Collagens. We used surgical fragments from 27 patients, submitted to operation because of aortic root aneurysm and 5 normal aortic wall specimens from heart donors without any evidence for aneurysmal or atherosclerotic diseases of the aorta. Two samples of aortic wall were harvested from each patient, proximal to the sinotubular junction at the aortic convexity and concavity. Each specimen was processed both for immunohistochemical examination and molecular biology study. We compared the convexity of each aortic sample with the concavity of the same vessel, and both of them with the control samples. The synthesis of mRNA and the levels of each protein were assessed, respectively, by RT-PCR and Western Blot analysis. Immunohistochemistry elucidated the organization of BL, whose composition was revealed by molecular biology. All pathological samples showed a wall thinner than normal ones. Basal lamina of the aortic wall evidentiated important changes in the tridimensional arrangement of its major components which lost their regular arrangement in pathological specimens. Collagen I, Laminin alpha2 chain and Fibronectin amounts decreased in pathological samples, while type IV Collagen and Tenascin synthesis increased. Consistently with the common macroscopic observation that ascending aorta dilations tend to expand asymmetrically, with prevalent involvement of the vessel convexity and relative sparing of the concavity, Collagen type IV is more evident in the concavity and Tenascin in the convexity. PMID:16377578

Cotrufo, M; De Santo, L; Della Corte, A; Di Meglio, F; Guerra, G; Quarto, C; Vitale, S; Castaldo, C; Montagnani, S

2005-01-01

358

Electrical stimulation of human abdominal muscles  

Microsoft Academic Search

Abdominal muscles are the most important expiratory muscles in active expiration, such as during coughing. Spinal cord injured patients may suffer respiratory complications because of abdominal muscle paralysis and subsequent reduced ability to cough. In 6 able- bodied subjects, we compared twitch pressures from a single electrical pulse through surface electrodes, postero-laterally and anteriorly on the torso to twitches from

Lim J; Gorman RB; Gandevia SC; Butler JE

359

Spontaneous Endometriosis of the Abdominal Wall  

Microsoft Academic Search

Background: The abdominal wall is the commonest site of extrapelvic endometriosis, which usually develops in association with a prior surgical scar. Case: A 28-year-old woman with two endometriomas in the recti abdominis, which developed in a scarless abdomen. Conclusions: Abdominal wall endometrioma can develop spontaneously in the absence of prior surgical scar and should be considered in the differential diagnosis

Steve C. Ideyi; Moshe Schein; Massoma Niazi; Paul H. Gerst

2003-01-01

360

Suprapubic paramedian laparotomy for equine abdominal cryptorchidism  

Microsoft Academic Search

The history of techniques for abdominal equine cryptorchidectomy is briefly reviewed. The technique of suprapubic paramedian laparotomy as used since 1955 at the University of Liverpool veterinary field station is described in detail and an account given of the authors' experience with the technique in nearly 200 cases. It is concluded that the approach to the abdominal cavity is easy,

JE Cox; GB Edwards; PA Neal

1975-01-01

361

Abdominal aortic pseudoaneurysm secondary to melioidosis.  

PubMed

Melioidosis is an infective condition which is common in South East Asia. It can present in various forms like cutaneous abscess, pneumonia and severe septicaemia. However, melioidosis causing abdominal aortic pseudoaneurysms is extremely rare and a difficult condition to diagnose and treat. We present our management of two cases of abdominal aortic pseudoaneurysms secondary to melioidosis and their subsequent outcomes. PMID:19321406

Rao, Jaideepraj; Kaushal, A S; Hoong, Chia Kok

2009-01-01

362

Recurrent abdominal pain: a psychogenic disorder?  

Microsoft Academic Search

A controlled study of 30 children with recurrent abdominal pain and 30 pain free children failed to show any statistically significant differences between the groups on a variety of psychological variables thought to be associated with psychogenicity. A psychogenic basis has often been assumed as the cause in diagnosis of recurrent abdominal pain when clinical examination and laboratory tests show

P J McGrath; J T Goodman; P Firestone; R Shipman; S Peters

1983-01-01

363

Pathology Case Study: Abdominal Distention  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 60-year-old woman who presented with a history of marked abdominal distention lasted for several months with associated progressive fatigue, progressive weight loss and fever. Visitors are given patient history along with gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in soft tissue pathology.

Rao, Uma N.; Sepulveda, Antonia; Yu, Hongbo

2009-03-18

364

Mapping the Longitudinal Wall Stiffness Heterogeneities within Intact Canine Aortas using Pulse Wave Imaging (PWI) Ex Vivo  

PubMed Central

The aortic stiffness has been found to be a useful independent indicator of several cardiovascular diseases such as hypertension and aneurysms. Existing methods to estimate the aortic stiffness are either invasive, e.g. catheterization, or yield average global measurements which could be inaccurate, e.g., tonometry. Alternatively, the aortic pulse wave velocity (PWV) has been shown to be a reliable marker for estimating the wall stiffness based on the Moens–Korteweg (M–K) formulation. Pulse Wave Imaging (PWI) is a relatively new, ultrasound-based imaging method for noninvasive and regional estimation of PWV. The present study aims at showing the application of PWI in obtaining localized wall mechanical properties by making PWV measurements on several adjacent locations along the ascending thoracic to the suprarenal abdominal aortic trunk in its intact vessel form. The PWV estimates were used to calculate the regional wall modulus based on the M-K relationship and were compared against conventional mechanical testing. The findings indicated that for the anisotropic aortic wall, the PWI estimates of the modulus are smaller than the circumferential modulus by an average of ?32.22% and larger than the longitudinal modulus by an average of 25.83%. Ongoing work is focused on the in vivo applications of PWI in normal and pathological aortas with future implications in the clinical applications of the technique.

Shahmirzadi, Danial; Narayanan, Prathyush; Li, Ronny X.; Qaqish, William W.; Konofagou, Elisa E.

2014-01-01

365

Arterial wall metabolism in experimental hypertension of coarctation of the aorta of short duration  

PubMed Central

Coarctation of the mid-thoracic aorata was surgically produced in mongrel dogs which were sacrificed from 4-12 wk after the operation. As compared to the findings in control animals, the sodium, chloride, and water content of the hypetensive portion of the coarcted thoracic aorta was significantly elevated, whereas the electrolyte and water content of the relatively normotensive portion of the coarcted aorta was normal. The sodium, potassium, and water content of the pulmonary artery, skeletal muscle, and cardiac muscle of the coarcted dog was not altered. These observations suggest that an elevated arterial pressure may influence the electrolyte and water composition of the arteries. The arterial pressure also may influence the content and synthesis of acid mucopolysaccharides (MPS) in the arteries since the content of sulfated MPS and the incorporation of injected radiosulfate into sulfated MPS were significantly increased in the hypertensive portion of the coarcted thoracic aorta but were significantly reduced in the relatively normotensive (“hypotensive”) portion of the coarcted aorta. The observed increase in MPS may have been a factor directly responsible for the increase in the sodium content of the hypertensive aorta since MPS can act as polyelectrolytes and bind cations. Although the arterial pressure may influence certain metabolic functions in the arteries, it did not appear to have a direct effect on the arterial lipids since the lipid content of the hypertensive and of the relatively normotensive portions of the coarcted aorta were comparable to the values found in the normal aorta. Images

Hollander, William; Kramsch, Dieter M.; Farmelant, Melvin; Madoff, Irving M.

1968-01-01

366

A Hemodynamic Predict of an Intra-Aorta Pump Application in Vitro Using Numerical Analysis  

NASA Astrophysics Data System (ADS)

The Intra-Aorta Pump is a novel LVAD assisting the native heart without percutaneous drive-lines. The Intra-Aorta Pump is emplaced between the radix aortae and the aortic arch to draw-off the blood from the left ventricle to the aorta. To predict the change of pressure drop and blood flow along with the change of pump speed, a nonlinear model has been made based on the structure and speed of the Intra-Aorta Pump. To do this, a nonlinear electric circuit for the Intra-Aorta Pump has been developed. The model includes two speed dependent current sources and flow dependent resistant to simulate the relationship between the pressure drop of the Intra-Aorta Pump and the flow through the pump along with the change of pump speed. The pressure drop and blood flow is derived by solving differential equations with variable coefficients. The parameters of the model are determined by experiment, and the results of the experiment show that these parameters change along with the change of the pump speed distinctness. The accuracy of the model is tested experimentally on a test loop. The comparison of the prediction data derived from the model with the experimental data shows that the error is lest than 15%. The experimental results showed that the model can predict the change of pressure drop and blood flow accurately.

Gao, Bin; Chen, Ningning; Chang, Yu

367

21 CFR 884.5225 - Abdominal decompression chamber.  

Code of Federal Regulations, 2010 CFR

...Therapeutic Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike...patient's abdomen for the relief of abdominal pain during pregnancy or labor....

2009-04-01

368

21 CFR 884.5225 - Abdominal decompression chamber.  

Code of Federal Regulations, 2010 CFR

...Therapeutic Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike...patient's abdomen for the relief of abdominal pain during pregnancy or labor....

2010-04-01

369

Hydrogen peroxide modulates phenylephrine-induced contractile response in renal hypertensive rat aorta.  

PubMed

Endothelium-derived factors play an important role in vascular tone control. This study aimed to evaluate how endothelium and reactive oxygen species (ROS) contribute to phenylephrine (PE)-induced contraction in renovascular hypertensive (2K-1C) and normotensive (2K) rats aortas. The effects of the superoxide scavenger Tiron (0.1mM and 1mM) or catalase (30 U/ml, 90 U/ml, 150 U/ml and 300 U/ml) on the PE-induced contraction were evaluated in both intact endothelium (E+) and denuded (E-) aortas. Endothelium removal increased the PE-induced contractions. The maximum contractile response decreased only in 2K-1C rat E+ aorta, and catalase (30 U/ml, 90 U/ml, 150 U/ml) partially reversed this effect. Endothelium increased the basal hydrogen peroxide (H2O2) production in 2K and 2K-1C rats aortas. PE-stimulated H2O2 production was higher in 2K-1C (E+/E-) than in 2K (E+/E-). Inhibition of the enzymes cyclooxygenase, NADPH-oxidase, xanthine-oxidase, and superoxide dismutase reduced the PE-stimulated H2O2 production in 2K-1C rat aorta. The decreased contraction to PE in 2K-1C rat aorta is partially due to endothelial H2O2 production; however, in denuded aorta, it contributes to maintaining the contractile response. Superoxide plays an important role on the PE-induced contraction in 2K rat denuded aorta, whereas in 2K-1C rat aorta, it is H2O2 that plays an important role in this effect. PMID:24091168

Silva, Bruno R; Pernomian, Laena; Grando, Marcella D; Amaral, Jefferson H; Tanus-Santos, José E; Bendhack, Lusiane M

2013-12-01

370

[Remote results of open interventions in treatment of abdominal aortic aneurysms].  

PubMed

Analysed herein are the results of treating a total of 471 patients operated on at the Department of Surgical Treatment for Arterial Pathology of the Research Centre of Cardiovascular Surgery named after A. N. Bakulev under the Russian Academy of Medical Sciences for an aneurysm of the infrarenal portion of the abdominal aorta. Complicated forms of AAA were observed in 71 (15.1%) patients. Of these, 13 patients were admitted presenting with a clinical picture of aortic rupture, 56 patients with aortic wall tear (according to ultrasound and/or MSCH findings), and two patients had break of the inferior vena cava. The most frequently encountered accompanying diseases were as follows: CAD noted in 367 (78.2%) patients. Valvular heart defects were revealed in 68 (14.4%) patients. Atherosclerotic alterations of the ascending aorta were diagnosed in 97 (20.6%) patients, and an ascending aortic aneurysm in 14 (2.8%) patients. Operations on the heart were performed in 45 (19.1%) patients. Mitral valve plasty was carried out in 7 patients, and 11 patients had a history of prior interventions on the aortic root and ascending aorta (Bentall-De Bono operation in 3 patients, Carbol operation in 3 patients). 32 patients underwent reconstructive operations on coronary arteries. Transmyocardial laser revascularization of the myocardium was carried out in 4 patients. Endovascular interventions were performed in 32 (6.8%) patients (stenting or transluminal balloon angioplasty of coronary arteries). All patients underwent AAA resection with prosthetic repair. The mentioned operations were combined with the following simultaneous interventions: aortocoronary bypass grafting performed in 31 cases, carotid endarterectomy in 27 cases, and plasty of renal arteries was carried out in 48 patients. Complications in the immediate postoperative period were observed in 79 (16.8%) patients. Hospital mortality amounted to 11 (2.3%) patients. The cumulative survival rate after 1, 5 and 10 years after surgery amounted to 93%, 81% and 44%, respectively, in a complicated course amounting to 91%, 79% and 16%, respectively. The obtained findings of the study demonstrated that the results of the AAA resection should be regarded as fairly good. The main factors influencing the quality of life and surgical outcomes in abdominal aortic aneurysms are as follows: CAD, arterial hypertension, and chronic cerebrovascular diseases. In patients without accompanying diseases, the criteria of quality of life after surgery approximate to those in a healthy population. PMID:22929680

Bokeriia, L A; Arakelian, V S; Zhane, A K; Papitashvili, V G; Siradze, I V

2012-01-01

371

Decreased vascular smooth muscle cell density in medial degeneration of human abdominal aortic aneurysms.  

PubMed Central

Abdominal aortic aneurysms (AAAs) are characterized by structural deterioration of the aortic wall leading to progressive aortic dilatation and eventual rupture. The histopathological changes in AAAs are particularly evident within the elastic media, which is normally dominated by vascular smooth muscle cells (SMCs). To determine whether a decrease in vascular SMCs contributes to medial degeneration, we measured SMC density in 21 normal and pathological human abdominal aortic tissue specimens using immunohistochemistry for alpha-SMC actin and direct cell counts (medial SMCs per high-power field (HPF)). Medial SMC density was not significantly different between normal aorta (n = 5; 199.5 +/- 14.9 SMCs/HPF) and atherosclerotic occlusive disease (n = 6; 176.4 +/- 13.9 SMCs/HPF), but it was reduced by 74% in AAA (n = 10; 50.9 +/- 6.1 SMCs/HPF; P < 0.01 versus normal aorta). Light and electron microscopy revealed no evidence of overt cellular necrosis, but SMCs in AAAs exhibited ultrastructural changes consistent with apoptosis. Using in situ end-labeling (ISEL) of fragmented DNA to detect apoptotic cells, up to 30% of aortic wall cells were ISEL positive in AAAs. By double-labeling techniques, many of these cells were alpha-actin-positive SMCs distributed throughout the degenerative media. In contrast, ISEL-positive cells were observed only within the intimal plaque in atherosclerotic occlusive disease. The amount of p53 protein detected by immunoblotting was increased nearly fourfold in AAA compared with normal aorta and atherosclerotic occlusive disease (P < 0.01), and immunoreactive p53 was localized to lymphocytes and residual SMCs in the aneurysm wall. Using reverse transcription polymerase chain reaction assays a substantial amount of p53 mRNA expression was observed in AAAs. These results demonstrate that medial SMC density is significantly decreased in human AAA tissues associated with evidence of SMC apoptosis and increased production of p53, a potential mediator of cell cycle arrest and programmed cell death. Given the role that SMCs normally play in maintaining medial architecture and in arterial wall matrix remodeling, the induction of SMC apoptosis likely makes an important contribution to the evolution of aneurysm degeneration. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6

Lopez-Candales, A.; Holmes, D. R.; Liao, S.; Scott, M. J.; Wickline, S. A.; Thompson, R. W.

1997-01-01

372

Morphometric evaluation of keratocystic odontogenic tumor before and after marsupialization.  

PubMed

The aim of the present study was the morphometric evaluation of the epithelial lining and fibrous capsule in histological specimens of keratocystic odontogenic tumors (KOTs) before and after marsupialization. Histological sections from six KOTs that had undergone marsupialization followed by enucleation were photographed. The thickness and features of the capsule and of the epithelial lining of the tumor were evaluated upon marsupialization and upon subsequent enucleation using Axion Vision software. The histological specimens taken upon marsupialization presented an epithelial lining that is typical of KOTs. After marsupialization, the enucleated specimens had a modified epithelial lining and a fibrous capsule that both presented a greater median thickness (p = 0.0277 and p = 0.0212, respectively), morphological changes, and significant enlargement. These modifications can facilitate full surgical treatment and may well be related to a low KOT recurrence rate. PMID:24346047

Telles, Déborah Campos; Castro, Wagner Henriques; Gomez, Ricardo Santiago; Souto, Giovanna Ribeiro; Mesquita, Ricardo Alves

2013-01-01

373

Lunar intrusive domes: Morphometric analysis and laccolith modelling  

NASA Astrophysics Data System (ADS)

This study examines a set of lunar domes with very low flank slopes which differ in several respects from the frequently occurring lunar effusive domes. Some of these domes are exceptionally large, and most of them are associated with faults or linear rilles of presumably tensional origin. Accordingly, they might be interpreted as surface manifestations of laccolithic intrusions formed by flexure-induced vertical uplift of the lunar crust (or, alternatively, as low effusive edifices due to lava mantling of highland terrain, or kipukas, or structural features). All of them are situated near the borders of mare regions or in regions characterised by extensive effusive volcanic activity. Clementine multispectral UVVIS imagery indicates that they do not preferentially occur in specific types of mare basalt. Our determination of their morphometric properties, involving a combined photoclinometry and shape from shading technique applied to telescopic CCD images acquired at oblique illumination, reveals large dome diameters between 10 and more than 30 km, flank slopes below 0.9°, and volumes ranging from 0.5 to 50 km 3. We establish three morphometric classes. The first class, In1, comprises large domes with diameters above 25 km and flank slopes of 0.2°-0.6°, class In2 is made up by smaller and slightly steeper domes with diameters of 10-15 km and flank slopes between 0.4° and 0.9°, and domes of class In3 have diameters of 13-20 km and flank slopes below 0.3°. While the morphometric properties of several candidate intrusive domes overlap with those of some classes of effusive domes, we show that a possible distinction criterion are the characteristic elongated outlines of the candidate intrusive domes. We examine how they differ from typical effusive domes of classes 5 and 6 defined by Head and Gifford [Head, J.W., Gifford, A., 1980. Lunar mare domes: classification and modes of origin. Moon Planets 22, 235-257], and show that they are likely no highland kipukas due to the absence of spectral contrast to their surrounding. These considerations serve as a motivation for an analysis of the candidate intrusive domes in terms of the laccolith model by Kerr and Pollard [Kerr, A.D., Pollard, D.D., 1998. Toward more realistic formulations for the analysis of laccoliths. J. Struct. Geol. 20(12), 1783-1793], to estimate the geophysical parameters, especially the intrusion depth and the magma pressure, which would result from the observed morphometric properties. Accordingly, domes of class In1 are characterised by intrusion depths of 2.3-3.5 km and magma pressures between 18 and 29 MPa. For the smaller and steeper domes of class In2 the magma intruded to shallow depths between 0.4 and 1.0 km while the inferred magma pressures range from 3 to 8 MPa. Class In3 domes are similar to those of class In1 with intrusion depths of 1.8-2.7 km and magma pressures of 15-23 MPa. As an extraordinary feature, we describe in some detail the concentric crater Archytas G associated with the intrusive dome Ar1 and discuss possible modes of origin. In comparison to the candidate intrusive domes, terrestrial laccoliths tend to be smaller, but it remains unclear if this observation is merely a selection effect due to the limited resolution of our telescopic CCD images. An elongated outline is common to many terrestrial laccoliths and the putative lunar laccoliths, while the thickness values measured for terrestrial laccoliths are typically higher than those inferred for lunar laccoliths, but the typical intrusion depths are comparable.

Wöhler, Christian; Lena, Raffaello; Geologic Lunar Research (GLR) Group

2009-12-01

374

Systematic morphometric characterization of volcanic edifices using digital elevation models  

NASA Astrophysics Data System (ADS)

Quantitative characterization of the size and shape of volcanic edifices is an essential step towards the understanding of factors controlling volcano growth and morphology. The recent advent of digital elevation models (DEMs) with worldwide coverage offers the opportunity to systematically document the morphometry of all types of volcanoes using quantitative well-formalized methodologies. We present a methodology for the morphometric characterization of volcanic edifices. After reviewing previous studies on volcano morphometry and the various existing DEM sources, we describe an integrated procedure that uses a DEM and its derived products (slope, curvature) to extract a coherent set of morphometric parameters for a given volcanic edifice. Edifice boundaries are manually defined by searching for breaks in slope around the base. The parameters describe the overall size (basal and summit region area and widths, height, volume), planar shape (ellipticity and irregularity index of elevation contours), profile shape (height-width ratios) and slope of the edifice. Similar parameters for relatively large (depending on DEM spatial resolution) summit craters/calderas are also computed. Slope values and ellipticity and irregularity indexes are extracted for successive height intervals providing detailed information of volcano shape as a function of height. The number of secondary peaks is also estimated. The method is tested on thirteen composite volcanoes in Nicaragua using three DEM datasets (90 m SRTM, 30 m ASTER G-DEM and an 80 m topographic map-derived DEM) and the resulting parameters are evaluated in terms of boundary delineation and DEM source. Finally, the parameters obtained for the Nicaraguan volcanoes are discussed as an illustrative example of the type of data and information that can be extracted systematically for volcanoes worldwide.

Grosse, Pablo; van Wyk de Vries, Benjamin; Euillades, Pablo A.; Kervyn, Matthieu; Petrinovic, Iván A.

2012-01-01

375

Intestinal injury mechanisms after blunt abdominal impact.  

PubMed Central

Intestinal injury is frequent after non-penetrating abdominal trauma, particularly after modern, high-energy transfer impacts. Under these circumstances, delay in the diagnosis of perforation is a major contributor to morbidity and mortality. This study establishes patterns of intestinal injury after blunt trauma by non-penetrating projectiles and examines relationships between injury distribution and abdominal wall motion. Projectile impacts of variable momentum were produced in 31 anaesthetised pigs to cause abdominal wall motion of varying magnitude and velocity. No small bowel injury was observed at initial impact velocity of less than 40 m/s despite gross abdominal compression. At higher velocity, injury to the small bowel was frequent, irrespective of the degree of abdominal compression (P = 0.00044). Large bowel injury was observed at all impact velocities and at all degrees of abdominal compression. This study confirms the potential for intestinal injury in high velocity, low momentum impacts which do not greatly compress the abdominal cavity and demonstrates apparent differences in injury mechanisms for the small bowel and colon. Familiarity with injury mechanisms may reduce delays in the diagnosis of intestinal perforation in both military and civilian situations.

Cripps, N. P.; Cooper, G. J.

1997-01-01

376

Intestinal injury mechanisms after blunt abdominal impact.  

PubMed

Intestinal injury is frequent after non-penetrating abdominal trauma, particularly after modern, high-energy transfer impacts. Under these circumstances, delay in the diagnosis of perforation is a major contributor to morbidity and mortality. This study establishes patterns of intestinal injury after blunt trauma by non-penetrating projectiles and examines relationships between injury distribution and abdominal wall motion. Projectile impacts of variable momentum were produced in 31 anaesthetised pigs to cause abdominal wall motion of varying magnitude and velocity. No small bowel injury was observed at initial impact velocity of less than 40 m/s despite gross abdominal compression. At higher velocity, injury to the small bowel was frequent, irrespective of the degree of abdominal compression (P = 0.00044). Large bowel injury was observed at all impact velocities and at all degrees of abdominal compression. This study confirms the potential for intestinal injury in high velocity, low momentum impacts which do not greatly compress the abdominal cavity and demonstrates apparent differences in injury mechanisms for the small bowel and colon. Familiarity with injury mechanisms may reduce delays in the diagnosis of intestinal perforation in both military and civilian situations. PMID:9135238

Cripps, N P; Cooper, G J

1997-03-01

377

Management of intra-abdominal hypertension and abdominal compartment syndrome: a review.  

PubMed

Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS).Aim: This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function. PMID:24499574

Hunt, Leanne; Frost, Steve A; Hillman, Ken; Newton, Phillip J; Davidson, Patricia M

2014-01-01

378

Traumatic mesenteric cyst after blunt abdominal trauma.  

PubMed

Mesenteric cysts are rare abdominal tumors of unclear histologic origin, usually asymptomatic. Post-traumatic mesenteric cyst usually results as a consequence of a mesenteric lymphangitic rupture or a hematoma followed by absorption and cystic degeneration. The preoperative histological and radiological diagnosis is difficult. We present the case of a 45-year-old male patient with sizable, palpable abdominal tumor, the gradual swelling of which the patient himself combined with the blunt abdominal trauma he acquired from an opponent's knee in a football game 5 months ago. PMID:22096714

Falidas, Evangelos; Mathioulakis, Stavros; Vlachos, Konstantinos; Pavlakis, Emmanouil; Anyfantakis, Georgios; Villias, Constantinos

2011-01-01

379

[Growth curves of abdominal aortic aneurysms].  

PubMed

79 patients with abdominal aortic aneurysms were repeatedly examined by ultrasound to gain information about growth rate and prognosis. 67 small asymptomatic abdominal aortic aneurysms showed an average growth rate of 0.22 cm per year. 12 big aneurysms had a growth rate of 0.59 cm per year. The individual plots were highly variable. Only 5% of the patients died of rupture of the aneurysms, while 15% died of heart failure, myocardial infarction or cerebrovascular accident. Thus, the prognosis of small asymptomatic abdominal aortic aneurysms is better than in the medical literature of older date. PMID:3334331

Kremer, H; Haschka, C; Weigold, B; Zoller, W; Spengel, F; Zöllner, N

380

Traumatic mesenteric cyst after blunt abdominal trauma  

PubMed Central

Mesenteric cysts are rare abdominal tumors of unclear histologic origin, usually asymptomatic. Post-traumatic mesenteric cyst usually results as a consequence of a mesenteric lymphangitic rupture or a hematoma followed by absorption and cystic degeneration. The preoperative histological and radiological diagnosis is difficult. We present the case of a 45-year-old male patient with sizable, palpable abdominal tumor, the gradual swelling of which the patient himself combined with the blunt abdominal trauma he acquired from an opponent's knee in a football game 5 months ago.

Falidas, Evangelos; Mathioulakis, Stavros; Vlachos, Konstantinos; Pavlakis, Emmanouil; Anyfantakis, Georgios; Villias, Constantinos

2011-01-01

381

Cyclooxygenase-2 Inhibition Attenuates Abdominal Aortic Aneurysm Progression in Hyperlipidemic Mice  

PubMed Central

Abdominal aortic aneurysms (AAAs) are a chronic inflammatory disease that increase the risk of life-threatening aortic rupture. In humans, AAAs have been characterized by increased expression of cyclooxygenase-2 and the inactivation of COX-2 prior to disease initiation reduces AAA incidence in a mouse model of the disease. The current study examined the effectiveness of selective cyclooxygenase-2 (COX-2) inhibition on reducing AAA progression when administered after the initiation of AAA formation. AAAs were induced in hyperlipidemic apolipoprotein E-deficient mice by chronic angiotensin II (AngII) infusion and the effect of treatment with the COX-2 inhibitor celecoxib was examined when initiated at different stages of the disease. Celecoxib treatment that was started 1 week after initiating AngII infusion reduced AAA incidence by 61% and significantly decreased AAA severity. Mice treated with celecoxib also showed significantly reduced aortic rupture and mortality. Treatment with celecoxib that was started at a late stage of AAA development also significantly reduced AAA incidence and severity. Celecoxib treatment significantly increased smooth muscle alpha-actin expression in the abdominal aorta and did not reduce expression of markers of macrophage-dependent inflammation. These findings indicate that COX-2 inhibitor treatment initiated after formation of AngII-induced AAAs effectively reduces progression of the disease in hyperlipidemic mice.

Ghoshal, Sarbani; Loftin, Charles D.

2012-01-01

382

The Benefits of Internal Thoracic Artery Catheterization in Patients With Chronic Abdominal Aortic Occlusion  

SciTech Connect

Occlusion of the abdominal aorta may be caused by an embolic lesion, but more commonly by thrombotic disease at the aortoiliac area, progressing retrograde. However, the visualization of the distal run-off via internal thoracic-epigastric inferior artery collateral channel may be a very important diagnostic tool, especially in countries with poor technical equipment. This study was designed to show the benefit of the selective internal thoracic angiography in cases with complete aortic occlusion. We present 30 patients with chronic aortic abdominal occlusion who were submitted to the transaxillary aortography and selective ITA angiography with purpose of distal run off evaluation. Angiographic evaluation was performed by two independent radiologists according to previously defined classification. Good angiographic score via internal thoracic angiography by first observer was achieved in 19 (63.3%) patients and in 18 (60%) by a second observer. Transaxillary aortography showed inferior results: good angiographic score by the first observer in six (20%) patients and by the second observer in three (3%) patients. Low extremity run-off is better visualized during internal thoracic angiography than during transaxillary aortography.

Ilic, Nikola, E-mail: fosafosa75@yahoo.com; Davidovic, Lazar; Koncar, Igor; Dragas, Marko; Markovic, Miroslav; Colic, Momcilo; Cinara, Ilijas [Clinical Center Serbia, Clinic of Vascular and Endovascular Surgery (Serbia)

2011-04-15

383

The Effects of Anisotropy on the Stress Analyses of Patient-Specific Abdominal Aortic Aneurysms  

PubMed Central

The local dilation of the infrarenal abdominal aorta, termed an abdominal aortic aneurysm (AAA), is often times asymptomatic and may eventually result in rupture —an event associated with a significant mortality rate. The estimation of in-vivo stresses within AAAs has been proposed as a useful tool to predict the likelihood of rupture. For the current work, a previously-derived anisotropic relation for the AAA wall was implemented into patient-specific finite element simulations of AAA. There were 35 AAAs simulated in the current work which were broken up into three groups: elective repairs (n = 21), non-ruptured repairs (n = 5), and ruptured repairs (n = 9). Peak stresses and strains were compared using the anisotropic and isotropic constitutive relations. There were significant increases in peak stress when using the anisotropic relationship (p<0.001), even in the absence of the ILT (p = 0.014). Rutpured AAAs resulted in elevated peak stresses as compared to non-ruptured AAAs when using both the isotropic and anisotropic simulations, however these comparisons did not reach significance (pani = 0.55, piso = 0.73). While neither the isotropic or anisotropic simulations were able to significantly discriminate ruptured vs. non-ruptured AAAs, the lower p-value when using the anisotropic model suggests including it into patient-specific AAAs may help better identify AAAs at high risk.

Vande Geest, Jonathan P.; Schmidt, David E.; Sacks, Michael S.; Vorp, David A.

2009-01-01

384

Evolution of the wall shear stresses during the progressive enlargement of symmetric abdominal aortic aneurysms  

NASA Astrophysics Data System (ADS)

The changes in the evolution of the spatial and temporal distribution of the wall shear stresses (WSS) and gradients of wall shear stresses (GWSS) at different stages of the enlargement of an abdominal aortic aneurysm (AAA) are important in understanding the aetiology and progression of this vascular disease since they affect the wall structural integrity, primarily via the changes induced on the shape, functions and metabolism of the endothelial cells. Particle image velocimetry (PIV) measurements were performed in in vitro aneurysm models, while changing their geometric parameters systematically. It has been shown that, even at the very early stages of the disease, i.e. increase in the diameter ? 50%, the flow separates from the wall and a large vortex ring, usually followed by internal shear layers, is created. These lead to the generation of WSS that drastically differ in mean and fluctuating components from the healthy vessel. Inside the AAA, the mean WSS becomes negative along most of the aneurysmal wall and the magnitude of the WSS can be as low as 26% of the value in a healthy abdominal aorta.

Salsac, A.-V.; Sparks, S. R.; Chomaz, J.-M.; Lasheras, J. C.

2006-08-01

385

The benefits of internal thoracic artery catheterization in patients with chronic abdominal aortic occlusion.  

PubMed

Occlusion of the abdominal aorta may be caused by an embolic lesion, but more commonly by thrombotic disease at the aortoiliac area, progressing retrograde. However, the visualization of the distal run-off via internal thoracic-epigastric inferior artery collateral channel may be a very important diagnostic tool, especially in countries with poor technical equipment. This study was designed to show the benefit of the selective internal thoracic angiography in cases with complete aortic occlusion. We present 30 patients with chronic aortic abdominal occlusion who were submitted to the transaxillary aortography and selective ITA angiography with purpose of distal run off evaluation. Angiographic evaluation was performed by two independent radiologists according to previously defined classification. Good angiographic score via internal thoracic angiography by first observer was achieved in 19 (63.3%) patients and in 18 (60%) by a second observer. Transaxillary aortography showed inferior results: good angiographic score by the first observer in six (20%) patients and by the second observer in three (3%) patients. Low extremity run-off is better visualized during internal thoracic angiography than during transaxillary aortography. PMID:20532775

Ilic, Nikola; Davidovic, Lazar; Koncar, Igor; Dragas, Marko; Markovic, Miroslav; Colic, Momcilo; Cinara, Ilijas

2011-04-01

386

Update on Abdominal Aortic Aneurysm Research: From Clinical to Genetic Studies  

PubMed Central

An abdominal aortic aneurysm (AAA) is a dilatation of the abdominal aorta with a diameter of at least 3.0?cm. AAAs are often asymptomatic and are discovered as incidental findings in imaging studies or when the AAA ruptures leading to a medical emergency. AAAs are more common in males than females, in individuals of European ancestry, and in those over 65 years of age. Smoking is the most important environmental risk factor. In addition, a positive family history of AAA increases the person's risk for AAA. Interestingly, diabetes has been shown to be a protective factor for AAA in many large studies. Hallmarks of AAA pathogenesis include inflammation, vascular smooth muscle cell apoptosis, extracellular matrix degradation, and oxidative stress. Autoimmunity may also play a role in AAA development and progression. In this Outlook paper, we summarize our recent studies on AAA including clinical studies related to surgical repair of AAA and genetic risk factor and large-scale gene expression studies. We conclude with a discussion on our research projects using large data sets available through electronic medical records and biobanks.

Kuivaniemi, Helena; Ryer, Evan J.; Elmore, James R.; Hinterseher, Irene; Smelser, Diane T.; Tromp, Gerard

2014-01-01

387

Sutureless technique to support anastomosis during thoracic aorta replacement  

PubMed Central

Background In aortic replacement procedures the aortic wall and Teflon strips form a double layer, with the use of continuous sutures. Surgical glues may or may not be used to enhance the durability of the anastomoses. In this technical report a modification of the aortic stumps preparation is devised. The technique reduces substantially the preparation time of the aortic stumps by the use of ligation clips and a surgical sealant. Technique Suturing is the standard method for the aortic-teflon double-layer formation prior to Dacron anastomosis. In this study, instead of suturing, 5-6 ligation clips are primarily applied on the exterior of the double layer to facilitate proper cooptation. Secondarily, in order to fuse the two layers together, a sealant is injected in between the Teflon and aortic wall. Thus each stump is delivered quickly sutureless for the Dacron anastomosis. Between January 2003 and March 2009 this modified operative technique was performed in 14 cases (group A) with a mean age of 50 ± 16 years. This was contrasted against 24 controls (group B), with a mean age of 40 ± 28 years, treated with the conventional method, where only continuous sutures were used during the anastomosis. All patients were cases of ascending aorta replacement and/or aortic hemi-arch replacement, for acute aortic dissection or aortic dilatation. Results The pure anastomosis time (stump preparation and Dacron connection) was shortened by approximately 25 minutes depending on surgeon's experience. The anastomosis blood-loss was also significantly reduced in the sutureless group A, as evident by the dry operative field and the limited use of blood products, post-prosthetic graft anastomosis. This reflected to a faster post-operative recovery, faster extubation and fewer complications. At a mean follow-up of 21 ± 7 days, there were no post-operative deaths being related to acute aortic dissection or rupture of the anastomotic site. Conclusion Aortic replacement with the combination of ligation clips and a surgical sealant vs. sutures alone allows easy manipulations of the aorta and adaptation of the diameters, thus optimizing aortic operational timings and hemostasis. Moreover, it prevents blood loss and aortic wall trauma from multiple sutures.

2009-01-01

388

Management of bicuspid aortic valve with or without involvement of ascending aorta and aortic root.  

PubMed

Patients with a bicuspid aortic valve (BAV) constitute a heterogeneous population with variable clinical presentation and complications. More than 50% of the patients who require aortic valve replacement have a BAV, a condition that may be associated with dilation of ascending aorta and aortic insufficiency caused by cusp disease or aortic root pathology. Of the potential BAV-related complications, dilation of the aortic root and ascending aorta are among the most serious. The dilation of ascending aorta and aortic root have been the subject of controversy. Whereas some surgeons believe that the dilation of the aorta is caused by the hemodynamic properties of the BAV, others believe that the dilation of the aortic root is secondary to genetic defects associated with the BAV. Management of a BAV should be tailored to each patient's clinical condition. The surgical approach varies from aortic valve replacement to combined aortic valve and root replacement to aortic-valve-sparing root replacement. PMID:23138607

Neragi-Miandoab, S

2014-06-01

389

Relapsing polychondritis: bone marrow and circular fibrous nodules in the aorta.  

PubMed Central

A case is reported of extensive aortic calcification, bone formation, and haemopoietic tissue in a woman with relapsing polychondritis. An additional feature was 'clock face' nodules of collagen in the aorta. Images

Wilson, G E; Hasleton, P S; Manns, J J; Marks, J S

1990-01-01

390

THE INFLUENCE OF FRESHWATER RUNOFF ON BIOMASS, MORPHOMETRICS, AND PRODUCTION OF THALASSIA TESTUDINUM. (R827453)  

EPA Science Inventory

Efforts to restore more natural freshwater flows in South Florida will impact Biscayne Bay. In order to evaluate possible effects of decreased freshwater discharge on the seagrass Thalassia testudinum , we determined the biomass, density, morphometrics (width, length, nu...

391

Abdominal surgery. [Radiology, screening techniques  

SciTech Connect

A new art of ''interventional radiology'' has been developed in the past few years. Major applications include postoperative instrumentation of the biliary tract, percutaneous biliary drainage, tumor biopsy, abscess drainage, and intestinal-intubation procedures. Intervention by angiography encompasses injection of such substances as Pitressin (vasopressin), and embolization. These procedures have been of immense value. Fortunately, complications, such as sepsis and bleeding, have been infrequent. Computerized body tomography has also proved extremely important, particularly in the diagnosis of subphrenic abscess and pancreatic and pelvic pathology. /sup 99m/Tc-labeled-erythrocyte scans can be used to detect gastrointestinal bleeding sites. Scans can also identify hepatobiliary disease and splenic injury or differentiate the cause of jaundice. /sup 111/Indium-labeled autologous leukocytes may be useful in differentiating a pancreatic abscess from a pseudocyst. The advantage of indium scans over /sup 67/Ga scans is that a shorter time is required for maximum resolution: gallium requires 48 hours, indium 4. Another advantage is that indium is cleared through the liver and spleen and is not secreted into the bowel. /sup 67/Ga is absorbed by lymphomas and hepatocarcinomas. Nuclear magnetic resonance has many possible uses in abdominal surgery, but so far little information is available. This technique has been used to detect an empyema of the gallbladder that was not diagnosed by ultrasound. Among hepatic lesions, it can easily differentiate tumors from cysts and in that regard is superior to both ultrasound and scan. (JMT)

Welch, C.E.; Malt, R.A.

1983-03-31

392

Motorcycle Exhaust Particulates Enhance Vasoconstriction in Organ Culture of Rat Aortas and Involve Reactive Oxygen Species  

Microsoft Academic Search

The effects of motorcycle exhaust particulate on vasoconstric- tion were determined using rat thoracic aortas under organ culture conditions treated with organic extracts of motorcycle exhaust particulate from a two-stroke engine. The motorcycle exhaust particulate extract (MEPE) induced a concentration-dependent enhancement of vasoconstriction elicited by phenylephrine in the organ cultures of both intact and endothelium-denuded aortas for 18 h. Nifedipine

Hui-Ping Tzeng; Rong-Sen Yang; Tzuu-Huei Ueng; Shoei-Yn Lin-Shiau; Shing-Hwa Liu

2003-01-01

393

Effect of taurine deficiency on adenosine receptor-mediated relaxation of the rat aorta  

Microsoft Academic Search

We recently demonstrated that chronic taurine supplementation or deficiency causes alterations in reactivity of the rat aorta to several vasoactive agents. In the present investigation, we examined the effects ?-alanine-induced endogenous taurine deficiency on the mechanical responsiveness of the isolated rat aorta to adenosine receptor stimulation with 2-chloroadenosine (CAD), 5?-N-ethylcarboxyamidoadenosine (NECA), and N6-cyclopentyladenosine (CPA). The adenosine analogs produced concentration-dependent (1×10?9?3×10?3

Worku Abebe; Mahmood S. Mozaffari

2003-01-01

394

Medial degeneration does not involve uniformly the whole ascending aorta: morphological, biochemical and clinical correlations  

Microsoft Academic Search

Objective: To investigate whether and how the severity of medial degeneration (MD) lesions varies along the circumference of the dilated intrapericardial aorta. Methods: Two groups of aortic wall specimens, respectively harvested 1cm distal to the non-coronary (NC) sinus (right postero-lateral wall) and to the right coronary sinus (anterior wall) in 22 patients undergoing surgery for dilatation of the intrapericardial aorta

L. Agozzino; F. Ferraraccio; S. Esposito; A. Trocciola; A. Parente; A. Della Corte; M. De Feo; M. Cotrufo

2002-01-01

395

Mycotic aneurysm of the descending thoracic aorta: the role of transesophageal echocardiography.  

PubMed

Mycotic aneurysms of the aorta are prone to rupture. Thus rapid and accurate diagnosis is essential so that surgical repair can be undertaken. We report a case of mycotic aortic aneurysm caused by mitral valve endocarditis. The aneurysm situated at the junction of the thoracoabdominal aorta was readily detected by transesophageal echocardiography. Computed tomography and aortography were complementary to transesophageal echocardiography in establishing the diagnosis. The patient underwent successful repair and acute inflammation of the aneurysm was present at histologic examination. PMID:8887869

Joffe, I I; Emmi, R P; Oline, J; Jacobs, L E; Owen, A N; Ioli, A; Najjar, D; Kotler, M N

1996-01-01

396

Alterations in the Lipid Metabolism of Rat Aorta: Effects of Vitamin A Deficiency  

Microsoft Academic Search

Antioxidants are known to reduce cardiovascular disease by reducing the concentration of free radicals in the vessel wall and by preventing the oxidative modification of low-density lipoproteins. The prooxidative effect of a vitamin-A-deficient diet on the aorta has previously been demonstrated by us. In this study, the lipid metabolism in the aorta of rats fed on a vitamin-A-deficient diet was

Laura V. Gatica; Verónica A. Vega; Fanny Zirulnik; Liliana B. Oliveros; María S. Gimenez

2006-01-01

397

Ruptured Sinus of Valsalva Aneurysm and Coarctation of Aorta in a Woman at Early Postpartum Period  

PubMed Central

Coarctation of aorta and sinus of Valsalva aneurysm are frequently missed congenital cardiac defects that their diagnosis might be delayed. To our knowledge, coincidence of these cardiac defects is unusual and has not been reported in the literature before. Here, we present a patient with coarctation of aorta and ruptured noncoronary sinus of Valsalva aneurysm leading to aorto-right atrial fistula in the early postpartum period and our management of this unusual case.

Sener, Erol; Kucuker, Aslihan; Kurt, Kadir; Uguz, Emrah; Saglam, Muhammed Fethi

2014-01-01

398

Increased Chymase-Dependent Angiotensin II Formation in Human Atherosclerotic Aorta  

Microsoft Academic Search

Abstract—Locally formed,angiotensin II (Ang II) and mast cells may,participate in the development,of atherosclerosis. Chymase, which originates from mast cells, is the major Ang II?forming enzyme in the human heart and aorta in vitro. The aim of the present study was,to investigate aortic Ang II?forming activity (AIIFA) and the histochemical localization of each Ang II?forming enzyme in the atheromatous human aorta.

Makoto Ihara; Hidenori Urata; Akio Kinoshita; Junji Suzumiya; Manabu Sasaguri; Masahiro Kikuchi; Munehito Ideishi; Kikuo Arakawa

2010-01-01

399

The Tribolium homeotic gene Abdominal is homologous to abdominal-A of the Drosophila bithorax complex  

NASA Technical Reports Server (NTRS)

The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.

Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)

1993-01-01

400

Cranial morphometric and fine scale genetic variability of two adjacent Mastomys natalensis (Rodentia: Muridae) populations  

Microsoft Academic Search

The objective of this multidisciplinary project was to study the intra-specific morphometric and genetic variability between\\u000a two adjacent populations ofMastomys natalensis Smith, 1834 living in different environments. The study of micro-evolutionary processes at work by using geometrical morphometrics\\u000a allowed us to define two groups, characterized by different features of the skull shape. Using molecular microsatellites analysis,\\u000a we showed that the

Aude Lalis; Michel Baylac; Jean François Cosson; Rhodes H. Makundi; Robert S. Machang’u; Christiane Denys

2009-01-01

401

A three-dimensional comparison of a morphometric and conventional cephalometric midsagittal planes for craniofacial asymmetry  

Microsoft Academic Search

Morphometric methods are used in biology to study object symmetry in living organisms and to determine the true plane of symmetry.\\u000a The aim of this study was to determine if there are clinical differences between three-dimensional (3D) cephalometric midsagittal\\u000a planes used to describe craniofacial asymmetry and a true symmetry plane derived from a morphometric method based on visible\\u000a facial features.

Janalt Damstra; Zacharias Fourie; Marnix De Wit; Yijin Ren

402

Cervical pedicle screw placement: feasibility and accuracy of two new insertion techniques based on morphometric data  

Microsoft Academic Search

This morphometric and experimental study was designed to assess the dimensions and axes of the subaxial cervical pedicles\\u000a and to compare the accuracy of two different techniques for subaxial cervical pedicle screw (CPS) placement using newly designed\\u000a aiming devices. Transpedicular fixation is increasingly used for stabilizing the subaxial cervical spine. Development of the\\u000a demanding technique is based on morphometric studies

M. Reinhold; F. Magerl; M. Rieger; M. Blauth

2007-01-01

403

Morphometric sex determination of young Ospreys Pandion haliaetus using discriminant analysis  

Microsoft Academic Search

Capsule Discriminant functions based on morphometric variables provide a reliable method for sex identification of free?living and hacked young Ospreys.Aims To describe an easy, accurate and low?cost method for sex determination of fully grown nestling and fledgling Ospreys Pandion haliaetus based on morphometric measurements.Methods Four different measurements were taken in 114 birds (40–73 days old) and a DNA analysis, using

Roberto Muriel; Eva Casado; Daniel Schmidt; Cecilia P. Calabuig; Miguel Ferrer

2010-01-01

404

Genetics Home Reference: Abdominal wall defect  

MedlinePLUS

... is inherited in the pattern of that condition. Where can I find information about diagnosis or management ... genetics professional in my area? in the Handbook. Where can I find additional information about abdominal wall ...

405

Evaluating Abdominal Injury in Workstation Table Impacts.  

National Technical Information Service (NTIS)

In rail passenger seating arrangements with workstation tables, there is a risk of serious thoracic and abdominal injury. Strategies to mitigate this injury risk are being developed through a cooperative agreement between the Federal Railroad Administrati...

B. Perlman D. Parent D. Tyrell P. Matthews

2004-01-01

406

Abdominal imaging in zinc phosphide poisoning.  

PubMed

Radiography has been proved to be a good diagnostic tool in visualization of many radiopaque xenobiotics in clinical toxicology. Zinc is a potentially radiopaque material which is a constituent of the zinc phosphide (ZN2P3) rodenticide. We report two cases of zinc phosphide poisoning with positive abdominal X-rays in whom the diagnosis was confirmed by abdominal imaging. Positive abdominal imaging was an indication for aggressive management; however, aggressive treatment was not lifesaving in one of them. We aim to emphasize the diagnostic value of abdominal X-rays in zinc phosphide-poisoned patients. We also would like to suggest that zinc phosphide (ZP)-poisoned patients with positive X-rays have more chance to become unstable even if they are symptom free on presentation and should be more aggressively managed. PMID:24477450

Hassanian-Moghaddam, Hossein; Shahnazi, Makhtoom; Zamani, Nasim; Bahrami-Motlagh, Hooman

2014-06-01

407

Abdominal Compartment Syndrome After Hip Arthroscopy.  

National Technical Information Service (NTIS)

As hip arthroscopy becomes a more common procedure, more complications may occur. We present a case of abdominal compartment syndrome resulting from fluid extravasation in a 42-year-old man who underwent routine hip arthroscopy for femoral acetabular impi...

B. D. Owens J. Fowler

2010-01-01

408

Abdominal apoplexy: two unusual cases of hemoperitoneum.  

PubMed

Abdominal apoplexy, or idiopathic spontaneous intraperitoneal hemorrhage, is a rare and often fatal condition resulting from a variety of disease processes affecting the arterial and venous abdominal vasculature. Preoperative and intraoperative diagnosis and treatment of abdominal apoplexy are challenging. The source of bleeding may remain elusive even after careful autopsy dissection given the absence of intravascular pressure. Despite these challenges, early diagnosis and rapid treatment remain central to a successful outcome, as nonsurgical mortality has approached 100%. Presented here are two fatal cases of abdominal apoplexy, one involving a patient with arterial dissection of the gastroduodenal artery and one involving rupture of the superior mesenteric-portal venous system with perivascular pseudoaneurysm formation. PMID:22275776

Harbour, Lori N; Koch, Meghan S; Louis, Thomas H; Fulmer, James M; Guileyardo, Joseph M

2012-01-01

409

Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery  

PubMed Central

OBJECTIVE: Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC) to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior). METHODS: We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique. RESULTS: The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3%) had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior). The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L) and FVC (2.0±0.7 L) with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p?=?0.59) for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed. CONCLUSIONS: Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery.

de Cleva, Roberto; de Assumpcao, Marianna Siqueira; Sasaya, Flavia; Chaves, Natalia Zuniaga; Santo, Marco Aurelio; Flo, Claudia; Lunardi, Adriana C.; Filho, Wilson Jacob

2014-01-01

410

Mechanisms of traumatic rupture of the aorta and associated peri-isthmic motion and deformation.  

PubMed

This study investigated the mechanisms of traumatic rupture of the aorta (TRA). Eight unembalmed human cadavers were tested using various dynamic blunt loading modes. Impacts were conducted using a 32-kg impactor with a 152-mm face, and high-speed seatbelt pretensioners. High-speed biplane x-ray was used to visualize aortic motion within the mediastinum, and to measure deformation of the aorta. An axillary thoracotomy approach was used to access the peri-isthmic region to place radiopaque markers on the aorta. The cadavers were inverted for testing. Clinically relevant TRA was observed in seven of the tests. Peak average longitudinal Lagrange strain was 0.644, with the average peak for all tests being 0.208 +/- 0.216. Peak intraluminal pressure of 165 kPa was recorded. Longitudinal stretch of the aorta was found to be a principal component of injury causation. Stretch of the aorta was generated by thoracic deformation, which is required for injury to occur. The presence of atherosclerosis was demonstrated to promote injury. The isthmus of the aorta moved dorsocranially during frontal impact and submarining loading modes. The aortic isthmus moved medially and anteriorly during impact to the left side. The results of this study provide a better understanding of the mechanisms associated with TRA, and can be used for the validation of finite element models developed for the examination and prediction of TRA. PMID:19085165

Hardy, Warren N; Shah, Chirag S; Mason, Matthew J; Kopacz, James M; Yang, King H; King, Albert I; Van Ee, Chris A; Bishop, Jennifer L; Banglmaier, Richard F; Bey, Michael J; Morgan, Richard M; Digges, Kennerly H

2008-11-01

411

Fluid Dynamics of Coarctation of the Aorta and Effect of Bicuspid Aortic Valve  

PubMed Central

Up to 80% of patients with coarctation of the aorta (COA) have a bicuspid aortic valve (BAV). Patients with COA and BAV have elevated risks of aortic complications despite successful surgical repair. The development of such complications involves the interplay between the mechanical forces applied on the artery and the biological processes occurring at the cellular level. The focus of this study is on hemodynamic modifications induced in the aorta in the presence of a COA and a BAV. For this purpose, numerical investigations and magnetic resonance imaging measurements were conducted with different configurations: (1) normal: normal aorta and normal aortic valve; (2) isolated COA: aorta with COA (75% reduction by area) and normal aortic valve; (3) complex COA: aorta with the same severity of COA (75% reduction by area) and BAV. The results show that the coexistence of COA and BAV significantly alters blood flow in the aorta with a significant increase in the maximal velocity, secondary flow, pressure loss, time-averaged wall shear stress and oscillatory shear index downstream of the COA. These findings can contribute to a better understanding of why patients with complex COA have adverse outcome even following a successful surgery.

Keshavarz-Motamed, Zahra; Garcia, Julio; Kadem, Lyes

2013-01-01

412

Dual-energy computed tomography imaging of the aorta.  

PubMed

There are 2 inseparable and complimentary technical advantages of dual-energy computed tomography (CT) imaging of the thoracic aorta. One advantage stems from the simultaneous availability of low and high peak kilovoltage (kVp) spectra data and, in particular, the benefits conferred by the improved conspicuity of iodinated contrast media at lower kVp CT imaging. This, in turn, permits improved aortic visualization or, alternatively, reduction in the volume or rate of contrast administration. Image noise at low kilovoltage does not appear to be a significant issue, with the backup availability of simultaneously acquired high kVp images a distinct advantage over single, low kVp imaging techniques. The second advantage of dual-energy CT imaging stems from the potential to calculate material-specific images derived mathematically from the simultaneous availability of attenuation measurements at 2 distinct energies. These material-specific data sets include virtual noncontrast images, virtual contrast, or "bone-subtracted" angiographic-like images. These techniques may confer significant advantages in the evaluation of patients with aortic disease, improving interpretation and reducing reconstruction time, while potentially reducing the need for, and associated radiation burden of, precontrast or postcontrast multiphasic imaging. PMID:21042067

Vlahos, Ioannis; Godoy, Myrna C B; Naidich, David P